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HomeMy WebLinkAbout038-1113-70-020 - 0 C) > CD ts 0 ts 0 z (D 0 z 0 LL 0 c Lu co cr Z IL co C-4 0 0 z :!t c \ § 7 / / / 0 z '2 Cl) CD . N C; 43 U) c (�D 0 (D .0 IL 0 z z 0 z Cj 'a 0) c I Lo CN 0) CLAL //\ U) CD (D E E Q C4 D C, z Cl) 0 04 co C) 0 o o 0 z 0 0 Pftb E IL CL CL ;j 0 U) co C) 0) a) 0) CY) U) -j a) z C-4 / \ 0 C,4 E CD % :3 C\j a) < >- iT) C) 0 U) C 0 E C4 LO 9 1 6 CD C) co CD a C) a- a N N 2 C a. 1 ! 04 0 M M E2 r- C CD * cb cl -6 = � c') 0 0 0 U a CV U) Cl) 0 z co Cd Z.; E E at IL L: IL E 0 0 IL 2 0 k ) L.H 111-q YO -142 9 A V�' l/ �Y 1 4 51V FILED q FEB 10 19 JAMCS Registe• of o kodS St Crft S 4" q CO., M ',0 K % / � - Ile CERTIFIED SURVEY MAP Located in part of the SW of the SE4 and in part of the SEk of the SE;, all in Section 28, T3114, R18W, Town of Star Prairie, St. Croix County, Wisconsin. — UNEILATIED LANDS LOT LOT2 LOT3 LOT OUT I ACRES INC R1W 2.00 10.69 - 2.00 SO: FT MQ R/W 87,120 465,696 - 86,%2, Z ALL ACRES EXC, RIW 1.80 10,36 2.19 ' 1192 SO, FT. EXC, R/W. IE39(:i M 78,290 451,350 95,390 83,757 192UP AVE. 4 NORTH LINE OF THE SW/4 OF THE SE/4 - "IT —7 48 41' C N89 5 4 5 .-0-6 1 N69 *5.000' K) N 296.45"1 6 'O 0 0 SHED WELL OUSE BARN 7�0 0 WELL SE 'TIC m S E ❑ .M V) 0 C) 0 < 2. 0 0 (D 0 M . -M CAL w F M Cr :r m CD CD CORN -4 C/7 M CRIB 00 0 1c: 4 I-r z IQ rn 182.55 0 0 1> rn 0 H (Z H IM 3 a 0 APPROVED f 95 Note: •X! 1> Lot 2 cannot be subdivide CO 0 until remaining land Is 1> N 1'z �o developed to south or a 0 0 1z 4 c ul -de -sac Is In place. '.0 0 c 1 CROiX COUNTY J 0 . Planning 0 Zoning and ')/1) tp 9) 10. Li IEfk Cornn-ittee �� /�� OWNER �' -0. Ln Scott Cou nter nter MkIt'r0corded 1911 Riverview Lane V-W&'.30 days of Somerset, Wi. 54025 awoval date N88 'E 523.08' CA O' (Mo ' be ntv"S void $00 IRON PIPE FOUND / 12%� W - E 7 x 6' i:� I q 6 "� Un Wysconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page of 3 Labor and Human Relations g — Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY -sT• Cl'W i Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION 1"1 t`LR4 `f 6e S SC&T CZUn)T1E'R GOVT. LOT Sk1 1/4 St 1/4,S zb T 31 ,N,R ib E (or G� PROPERTY OWNER':S MAILING ADDRESS BLOCK # SUBD. NAME OR CSM # L 1 4S?- t. S V ST'. 1 - C ►"1 CITY, STATE ZIP CODE PHONE NUMBER QCITY ❑VILLAGE [@TOWN NEAREST ROAD WI t�H.v R 1Ct.1 Y1 W I S'/ o t 7 ( 5) - 2 V6, _ s b y b S'CP�Z lam - R I'1 1 \21 1 °t Z YA Aw. [� New Construction Use [4 Residential / Number of bedrooms 6 [ ) Additkn to existing building j ] Replacement [ ) Public or commercial describe Code derived daily flow 0 1 b0 gpd Recommended design loading rate 0.3 S bed, gpd$ — trench, gpdtft Absorption area required - 7 S O bed, ft 7 5 0 trench, ft Maximum design loading rate o . S bed, gpd/11 0.16 trench, gpd/ft Recommended infiltration surface elevation(s) q8.5 ' It (as referred to site plan benchmark) Additional design /site considerations Wl ouvvo w/ $ 'K 9 y ' B WE`, M i N , I o F S )4 W p F/ u_ Parent material O u Tw h 40% Flood plain elevation, If applicable N- A . It S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ❑ S ® U 25 S ❑ U ❑ S ®U ❑ S ®U ❑ S 94U ❑ S O il SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu, Sz, Cont Color Gr. Sz. Sh. Bed Trench 1 0 _ 9 1b�iR 3l3 Si l Z mS wi �ti c-S o,S o•b Z 0 /- 30 )0 `1fz 3/(, Ground S L / (? 3! y _ s 1 1 'FS b>z r� �' c S n `l 0.5 elev. c Z 7.S Ye51R q6•C� ft. y 14 -so `�•S`f2 3! It to Ilk LIZ s� 1 ��bk >n'�� e S Depth to 5 So- 63 S limiting 3 fac _`� Remarks: Boring # E41, � o - �Z l0`�2 o•b Ground 3 28-4 S y t n. S elev. y7 -loo 1p `1 Q C) t) ft. Depth to limitin factor y -r Remarks: CS T Name: BeasePrint Arthur L. We erer Phone. 715 425 - 0165 Ad dress: Soil Testing & Design Service - P.O. Box 74 River Falls,WI 54022 Signature= \ Date: CST Number: C'niz - V) 3 z�!'tic- ty, tRaz_ M00576 PLOT PLAN Page 3 of 3 I CALE 1 \— L k13r�1G 1puSN o Le C" rJ S L� 1� k - — 3eo�� --a s� aotu►e� c,F VI Slu /iV_SE /iY P stz a` m O I 1 J0 ►vOT CW^1PftCT 3i O R l s lvxr i o - / wSLL > so' t-msT wF r o f= 5' Flom ST ,/ Sl LoT U or - PR - g t's'ED ► � . ED- a6° r � r B.3 9C) PE'Yu C.E - k.> OT L! RJ E w /Lcf7r! r= C) 1Z -1y- 9 2 ( 715 ) 425 -0169 M 00576 y CST Signature Date Signed Telephone No. CST # Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page of 3 Labor and Human Relations • Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY -sT• CCWl� Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION f"1�`LRa`I 6t S 5 O- 6 �1 - r C1:1 GOVT. LOT Sw 1/4 1/4,S T 31 ,N,R Ig E(or & PROPERTY OWNERS MAILING ADDRESS LOT # B SUBD. NAME OR CSM # 145 e S'CL ST, - eblposin CS►" 1 CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE (MOWN NEAREST ROAD i\ RjQj IyU wl Syol7 ( Soyb S - ' N m Notzyrk. Ave. (0� New Construction Use [,1C] Residential / Number of bedrooms 6 (] Add'kn to existing building [ ] Replacement [ ] Public or commercial describe Code derived daily flow 9 DO gpd Recommended design loading rate o.3 S bed, gpd/ft - trench, gpd/ft Absorption area required - 7S'3 bed, ft - 750 trench, ft Maximum design loading rate o - S bed, gpd$ 0 . fo trench, gpd/ft Recommended Infiltration surface elevation(s) q5'• 5 ' ft (as referred to site plan benchmark) Additional design /site considerations tr-twwvo / 8'K 9 y r & ft M IAJ - 1 ' o F S RAvb F1 L'L Parent material o v 1" w k SY1 Flood plain elevation, if applicable ft. S = Sui1,able for system cOWWnONAL MOUND W -GROMD PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for stem ❑ S ® U L9 S❑ u ❑ S ®U ❑ S ®U ❑ S K u [Is O U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistenoe Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tmnch 0 -9 lb`1R 3!3 Si Z �nSbK wi L S o S o 6 r m!w - Z 9 30 lb 3/ S Z Stir M b c S Ground 3 30 -3 7. S `/ 3! y S 1 FS bh 'F c S n . Ll o. 5 elev. q6•o ft. t / 34 -S' 7 S`/2 3/ it to 1 (-/Z .3� Yrt - i Depth t o S 30 -83 - ).S '-12 3!y -- 5 o S 9 limiting factor � 3 Remarks: Boring # ; lZ 313 s t 1 Z' bk m i� cS o•S o b E l Z 12 -Z $ l o `12 3) -' S 1 I Z '� s b k in ' l 'S a S 0.6 3 _47 S L ) 1Z 3)y o. S Ground g el ft y7 -6o �o `T e WV 0 s ", 2 Depth to limiting bw y .� rr Remarks: TName:- Please Print Arthur L. We erer Phone. 715- 425 -0165 egerer Soil Testing & Design Service -P.O. Box 74 River Fa11s,WI 54022 Signature: Date: CST Number: 11(, 19 97. M00576 PLOT PLAN Page 3 of 3 I CALF 1 "= 30 ' 0 i°lZ y,g Pn� l l o Le c"u S1 z.mv o a p�tv H l >c — 3eo Se J0%mL of CO set _.z$ m wo 0OLm 4 O 1O air O fi T�} is ML�q L- qa - / r ?- IIK11klum OF S' 1�w') �F'lbwvu 1'O N�CR��7' S LoT U k) r g.i ti r � ` / r .err t:rL _ tL, loo.O oN avy"PUC y �Z ty ( 715 ) 425 -0165 M 00576 CST Signature Date Signed Telephone No. CST # r M w WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE - 911 FOURTH STREET • HUDSON, WI 54016 � = (715) 386 -4680 December 22, 1992 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: Four onsite soil investigations of the Melroy Geis / Scott Counter property, located in the SW1 /4 of the SE1 /4, Sec. 28, & NE1 /4 NE1 /4, Sec 33, T31N, R18W, Town of Star Prarie, St. Croix County, WI., have been conducted with the assistance of Art Wegerer, CST# 576. These onsites revealed suitable soil for onsite sewage disposal to a minimum depth of 28" at each of the four locations while meeting the requirements of the A + 4" rule. This site should be suitable for new construction utilizing a mound septic system having 12" of sand fill. Should you have any questions, please feel free to contact me at this office. S ce ely, es K, Thompson Assistant Zoning Administrator cc: file `Wisconsi6 Department of Commerce Count ST PRIVATE SEWAGE SYSTEM Y' Safety and Buildings Division . CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitn"TY.: Personal information you provice may be used for secondary purposes [Privacy L r, s.15.04 (1)(m)). Permit MORALES , N R?JL >� g T vv of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description: Parcel 13'��0 TANK INFORMATION ELEVATION DATA A9800117 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic (Zv0 Bench Dosing d Y60 41 0 Ae Ion Bldg. Sewer Holding St /1* Inlet 13, /o TANK SETBACK INFORMATION St #t Outlet �� %C g�,-2 TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake � 3. Septic l�� 1��� JJ� NA Dt Bottom Dosing �O' , /pr ' " NA Header/ Man. 10.70 �°J• Ae A Dist. Pipe .8' 29 3 Holding Bot. System Pir 7 PUMP/ SIPHON INFORMATION wxt '< Final Grade Manufacturer U11 Demand p Z✓ �o�l ��_ Model Number O` PM TDH Lift (D,c Lri Systemf TDH� ction a Ft Forcemain Length V Dia. Z,' 1 Dist. To Well SOIL ABSORPTION SYSTEM BED / RE Width Length J No. Of renches PIT N0.Of Pits Inside Dia.__ Liquid Depth DIMENSIONS 3 ol. LS DIMENSION SETBACK CHA ER SYSTEM TO P/L BLDG WELL LAKE /STREAM LEA ING Manufacturer: -- INFORMATION Type Mo a Num er: Syst OR UNIT DISTRIBUTION SYSTEM Header/Manifold t/ Distribution Pipe(s) / x Hole Size x Hole Spacing Vent To Air Intake Length ZO Dia. T Length 31•Z S ' Dia. .77 Spacing l SOIL COVER z x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No 1 COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: STAR PRAIRIE 28.31.18,SW,SE 1904 107TH STREET G. (� I �d Plan revision required? �� Yes ❑ No Use other side for additional information. 3 7 1 a� SBD -6710 (R.3/97) Date Inspectors Signature ert. No. NOTICE Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW O Jr ova- INDICATE 44ORTH ARROW, '� SANITARY PERMIT APPLICATION Safet �Bng Division Vi sconsin P.O. I accord with ILHR 83.05, Wis. Adm. Code Box 7969 Department of Commerce Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. do ' • See reverse side for instructions for completing this application State Sanitary Permit Number .7 The information you provide may be used by other government agency programs p Check 3 0 77 it revision to prevto s application (Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATI N Proffer y Owner Name Property Location .5U) 1 / 4 e 1/4, S d&9 T ,3/ , N, R / E (or) W Proper Cit Stat O ner's Mailing Addresk Lot Number Block Number tV ,S Zip Code Phone Number Subdivision Name or CS Number . TYPE BUILDING: (check one) E] State Owned [] i Neares Road , _ Public 1 or 2 Family Dwelling - No. of bedrooms ° Town of r�/''E I - III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 0339- 1// 3-70 -0 ,9 O 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel / Motel 9 ❑ Office / Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. New 2 ❑ Replacement 3. F] Replacementof 4 ❑ Reconnection of S E] Repair of an - - ___ System ________ System _____ _____ _ __ Tank Only___ _ _______ Existing System _- ______ Existin -S -stem B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 D(Seepage Trench - 451 o5 - Eu Tjf''� , ? ❑ In Ground Pressure �� ` rX S ! Z �i 42 ❑ Pit Privy E] 13 Seepage Pit s5d-eri J 43 ❑ Vault Privy 14 ❑ System-In-Fi I I VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade (_ ��\\ Required (sq. ft.) Pro osed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) 4 Elevation W ®V lia laY6 • S g&W Feet (Oa Feet VII. TANK Capacity in gallons Total # of Prefab. Site Fiber- Ex er. INFORMATION Gallons Tanks Manufacturers Name Concrete Con steel Plastic p New Existin strutted glass App. Tanks Tanks k I JUO G ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: Print) Plumber's Signature: (No Stam s) TMPMPRSW No.: Business Phone Number: Plumber's Addres&Str et , City, State, Zip Code): IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater ate I ssued Issui Ayent Signature (No Stamps) pp ❑ Owner Given Initial . 1 Ap proved urcharg¢ Fee) q� 49 � �Z�l Adverse Determination l X. CONDITIONS OF APPROVAL / REASONS FOR ( ISAPPROVAL: f f f I C4 loj' lt& is A. - soy 1-f f s��k;ff �� ��f W nn 1�c�- l�� 1 . sm-MM M.t 1MM DISTMOT": orb to county. Om 00" To: safety a su"rmp a wslon, owner, Plumber NA E VO _ �'. L A I 0 ._� L I C .E N S _ • �ok. �A fi This b�� • 1 �r"a�'Q �Mouuy� • / N °fie � d�r�cp N� IU Joe 4 &pKO " NU ►`t U A C. U Is. Foxf 0` St Ch, 7G , G is i S6 , 8 0 • � uS�AJ4 Tu� s�f7��. ' G 66 FRES11 Arl'. IN LETS �AND OBSERVAPION PI.BB .... S1 . 10"S . SE CTION Approved Vent Cap Minimum 12" Above . ' nal _._ s • A Cast Iron . Above Pipe � Vent To Final Grad • . Pipe • • PRIVATE SEWAGE SYSTEMS - II PAGE OF PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS ' VENT CAP H "C.I. VENT PIPE APPROVED LOCKING WEATHER PROOF JUNCTION BOX MAIJHOLE COVER � 25' FROM DOOR, I2 "MIU. WINDOW OR FRESH AIR INTAKE GRADE I IB' MIIJ. COIJDUIT -- ---- - - - - -- I8 "MIN. ---- - - - - -- 11� INLET PROVIDE I -- - -- AIRTIGHT SEAL I III V I I APPROVED �01NTS APPROVED JOINT A I II W /C.I. PIPE W/C.I. PIPE I I EXTENDING 3' EXTENDING 3' I ALARM ONTO SOLID SOIL OIJTO SOLID SOIL B I II I I I I ON C I I OFF I ELEV. FT. PUMP -� - -j r D CONCRETE BLOCK RISER EXIT PERM17rED GNL`J IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E i , L SPEC,IFICATIOUS DOSE ln' 1 5 �- NUMBER OF DOSES: PER DAy TANKS MANUFACTUP r o c - All TANK SIZE:_ �•- : ,� ZGfi` GALLONS DOSE VOLUME ALARM MANUFACTURER: 1J I'. A.L'to INCLUDING BACKFLOW: GALLONS . _ J .� MODEL NUMBER: 101 )A k,3 CAPACITIES: A = INCHES OR 40 S GALLONS SWITCH TYPE: mtn R.s B= INCHES OR GALLONS PUMP MANUFACTURER: o - f 11 r C = INCHES OR GALLONS MODEL NUMBER: r k D= + INCHES OR r GALLONS SWITCH TYPE: YtC NOTE: PUMP AND ALARM ARE TO BE IKISTALLED ON SEPARATE CIRCUITS MINIMUM DISCHARGE RATE GPM VERTICAL DIFFFFENCE BETWEEN PUMP OFF AND D15TRIBUTIOU PIP lJ�,`� -E +ET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . ���!%VE.ET + I u FEET OF FORCE MAIN F Yo FT.FRICTION FACTOR.. FEET FEET TOTAL DYNAMIC HLAD = 0 FEET I ) INTERNAL DIMENSIONS OF TANK: LENGTH ;WIDTH 1 ;LIQUID DEPTH J� SIGNED: -- Ta l l NUMBER: ��'� V PATE: HEAD CAPACITY CURVE EFFLUENT M ■■■■■■■■■■■■■■■■■ ■■11\ 0000■■■■■■■ \�\ ■111 ■ \ ■ ■ ■ ■ ■ ■ ■ ■■ \� ■ \`M111\ ■■\\\■■■■■■ M EN \■ 0000■■ ■ ■11►� I\ ■� ■\ 0000■ \�Q§;'b".. :\ \\0000;\■■■ EEC - � ,, i 11 i ' - W\\RI■■■\■■■ ■ ■ ■�11M ■�■ ■ ■ ■� ■■ ®gym ®m ®m ®m ®m ®m ®m ®m ®m ®m ®m ®m® o ®mmm ®m ®mm mm ®m ®mmmm ®m ®mmm m ® ®mm ®mmmmm ®m ®m ®mmmmmmmmmm ®mmm ®mmmmmm ®m ®m ®mmommm ® ®mm mmmm ®mmmo ®mmm ®o ®mmommm ®mmm ®mmmmmoom ®mm ®mm ®mmom ®m ® ® ®m ommmmmmmmmm ® ®momm ®ommmm ®mm m ®mmmmma ®m ®mm ® ®mmmommmm ®mm o ®mmmmmmmmmm ® ®om ®momm ®mmmm mmmmmmmmmmmm ® ®mm ® ®ommmo ®mm m ®mmmmmmmmmmmm ®mom ®m ®mmmmm m ®mmmmmmmmmmmmmommmmmm ®mmm mmmmmmmmmmmmmmmmmm ® ® ©ommmm mmmmmmmmmmmmmmmmmmmmmmmmm® mmmmmmmmmmmmmmmmmmo ®mmmmo® mmmmmmmmmmmmmmmmmmmmmmmmmm mmmmmmmmmmmmmmmmmmmmmmmmmo Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code _ Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must Environmental By Design C :11.. include, but not limited to: vertical and horizontal reference point (QM), direction and $t. C ro 1X percent slope, scale or dimensions, north arrow, and location and distance to nearest road. P APPLICANT INFORMATION - P /ease print all information. Personal information you provide may be used for secgndary purposes (privacy Law, s. 15.04 (1) (m)). R Y Dat YA Property Owner Property Location Moralis, Paul Govt. Lot SW 1/4 SE 1/4 S 28 T 31 N,R 18 W __ Property Owner's Mailing Address Lot # Block # Tubd. Name or CSM# 364 W 9th - Scott Counter City State Zip Code PhoneNumber E] City L) Village ®Town Nearest Road New Richmond W1 246 -7316 tar Prairie 192Nd Ave Z New Construction Use: Z Residential / Number of bedrooms ❑Addition to existing building ❑ Replacement Public or colrcial describe Code Derived daily flow gpd 1 ��, Recommended design loading rate .4 bed, gpd/fF 5 trench, gpd/ftz Abs orption area require * bed, ff .g66r trench, ftz Maximum design loading rate 4 bed, gpd/fF 5 tr ench, gpolft Recommended infiltration surface elevation(s) 98.00 ft (as referred to site plan benchmar Additional design / tie consideration Parent materia ial till Flood plain elevation, ff applicable ft S= Suitable for system Conventional M7SE] In -Ground Pressure AT -Grade System in Fill Holding Tank U= Unsuitable for spm NS ❑ U ® U ®S ❑ U E] S ®U EIS M U ❑ S® u SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/Its Borings IlKorizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench 1 1 0 -8 10yr4/4 - sil 2fsbk mfr cs 2f .5 .6 2 8 -53 7.5yr4/4 - A 2msbk mfr cs if .5 .6 Ground 3 53 -100 7.5yr4/4 - si 2msbk mfr - - 5 6 elev 101.07 ft Depth to limiting factor >100" L 10-4 . ..... Remarks: 2 1 0 -17 1 Oyr4 /4 sil 2fsbk mfr cs 2f 5 6 2 17 -62 7.5yr4/4 - s Osg ml cs - .7 .8 Ground 3 62 -100 7.5yr6/4 - s Osg ml - - 7 8 elev 101.98 ft Depth to limiting factor r, >100" l e 7\ � 17 - � R®Wk CST Name (Please Print) Signature: v o Thomas C. Nelson 5- 246-244,. Address Environmental By Design Date T N` - nFM - r ' Ref # 1432 120th Street, New Richmond, WI 54017 4/14/98 2 PROBERTY OWNER: Moralis, Paul SOIL DESCRIPTION REPORT s2 Page 2 of 3 PARCEL I.D.# Environmental Bv Dmi Horizon Depth Dominant Color Mottles Texture Structure � onsistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3 1 0 - 16 1Oyr4/4 - sil 2msbk mfr cs 2f .5 .6 2 16 -72 7.5yr4/4 - s Osg ml cs - 7 8 Ground elev 3 72 -100 7.5yr5/4 - fs Om mfl - - 4 5 103.17 ft Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: 3 -F3 ENY19ONMENTRL BY DE51GN 1432 120 STREET, NEW RICHMOND, WISCONSIN 715 -246 -2454 PROJECT NAME: Paul MorahZ DESCRIPTION: SWY4, se %, SECTION 28 „T 31N, R18W TOWNSHIP: Star Prairie COUNTY: ST.CROIX LOT , .'' ' SUBDIVISION: Scott Counter A 2 ,1 v 0.cres 5 / S Co p& 17 & 2 4 -. SCALE 1"=40' Tom Nelson BM 1 NE LOT CORNER STAKE Elev 100 cstmo2605 BM 2 TELEPHONE PEDISTAL ..... Elev 106.60 w$consin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Later and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of sbpe, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION — PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION "ELY-w GAS' SC61 C4UKJTEm GOVT. LOT St 3 1/4 SST 1 /4,S -`a T 31 ,N,R 1% E(or V� PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # y Sz E . sv ST, - - �2o�os�p C-S CITY, STATE ZIP CODE PHONE NUMBER OCITY []VILLAGE [MOWN NEAREST ROAD K ?-ICH" M4 WI Syo17 06) ZV6_ Soy.(, \1 �o%Z*t flwt [4 New Construction Use [,K] Residential / Number of bedrooms 6 [ ] Additif�n to existing building I ]Replacement [ ] Public or commercial describe Code derived daily flow . 0 1 DO gpd Recommended design loading rate o.3 S bed, gpd/ft - trench, gpolfl Absorption area required -7 S O tom, ft 7 S O trench, ft KVimum design loading rate o . S bed, gpd/ft2 o . 6 trench, gpdjtt2 Recommended infiltration surface elevation(s) CM-S ' ft (as referred to site plan benchmark) Additional design / site considerations TINE M m eve lr-r eurvta L• / g ')L 9 ey ` B to M f N S HAvp Ft t~L Parent material Flood plain elevation, d apple S = Suitable for System coNVENTIoNAL MOUND W4110AID PRESSURE AT -GRADE SYSTEM IN FILL HOLDIN TANK U= tJnsuitable for stem CIS ®U 0 S ❑ U [IS ®U ❑ S ®U ❑ S U CIS M U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color momw Texture Structure Consistence BDurd3y Roots GPD /ft in. Munsell Qu. Sz. Cant Color Gr. Sz. Sh. Bed Tiench 1 o - 1byQ 3l3 Si Z msbvc wt S o•b Z 0 1- 30 10`i2 3 _ S I Z 'CSbk Mfl' �S o.S o•b Ground 3 30 -3'4 - ) .s Y e 3/ — S 1 1 J5 bk m Ll a. s elev. C Z 1.S'iQ 519 06.0 ft. y 34 - Sb - )•Sye 3/y r to -itZ 6/z Depth to S Sb - 7_ S `!2 3/Y — S o s 9 limiting factor 3� Remarks: Boring # O -YZ LOCI t2 31 3 � S � 1 Z�S bk w1'�6. GS o,S � 0• E Z lZ_Z$ l O y 2 316 S t Z '� 3 b k ►n `FL. cs a S 10-L Ground 3 -47 - LJ R, 3J - s csbk `�"�� c s o•Y 'o. $ elev. y7 -bo tp `1 Q Y/ Z 9 b ft Y S y It V/G s 1 0� f�• Depth to limitin factor Remarks: TName:- Please Print one: Ph Arthur L. We erer 715 425 - 0165 egerer S , oi Q l _ Testing & Design Service -P.O. Box 74 River Fa11s,WI 54022 Signature: C/ N21t Date: CST Number: om—v) Utz._ 04,Ig9 Z M00576 ' PLOT PLAN Page 3 of 3 I CALE 1 o�� �— L ktS1�K►G t��S@ LO Ci'ovvn S)t-m �n y sm 5E aoUAPM of Ul s w /iV- SE /i�r � Sez .Zg Q7 woWb �i 4 ¢t O J .t ef S YU\ La i TZ} �g ►Mt- -� LPL 96 r / � T )k.1th WLzLL Qt > SO 0-�Sr 01= M0O►W 311 . ! �Rln1` - 1N r�1t�1lM�UU -1 o F S '� w'1 lhbwuu 1 ��ST' U wL o F P12 p 1�os�D 1 °PL . t2L a6' / 41 ba- ` B•3 '0'C -r _ OT P 2 vQ'VRT'f L!dlE tTt, IoC.D oN 3ly'�PUC y 9 z ( 715 ) 425 -oi 65 M00576 CST Signature Date Signed Telephone No. CST # ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND �-� OWNERSHIP CERTIFICATION FORM Owner/Buyer � f . Mailing Address Ale- U ' A i i� M A d ) Property Address (Verification required from Planting Department for new construction ) City/State ��1Moar� ( Parcel Identification Number 039 1113 - �© - vao LEGAL DESCRIPTION Property Location Su j /s, Sec. T —aLN R, - Zf W, Town of Subdivision Lot # Certified Survey Map # 9 W/ 3 / Volume Page # 9a Warranty Deed # 5 7' h Volume _� // 7 . Page # o? 7 Spec house 0 yes P no Lot lines identifiable - yes ❑. no Sys rl? I.i NANCE consists c use sad mainzenanceof yourseptic syrtem could tesolt m its pcemamre ire to handle wastes. can fim oa oof the septi tank curry three yew ifneeded a licensed you put into septic tank as. a treatment by pumper: What waste disposal- . n>aster The property owner agrees to submit to St Croix Zoning Dew ratification foam, P iomneymanpl restricted signed by the dispos s �y a s �� phmrber or a licensedpu�mpervaifyiag $iat ( the on-site wastewaterdisP°sal system is i Proper operating condition and/or (2) after inspection and g (f ly). the septic -tank is less than 1/3 full of sludge. set e the wed have read the above requires and agree to maintain the private sewage disposal system with the standards f ork &min.'as set by the Department of Commerce and the Department of Natural Reso stating that Your septic system has been State of Wisconsin.. Certifcation days ° year expiration date. � maintained must be co leted and returned to the St. Croix.County Zoning Office within 30 SIGNATURE OF APPLICANT DATE .OWNER CERTIFICATION I we) certify that all statements on this form are tau to the best of my (our) knowledge. I (we) am (are) the owners) of described above hv virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT DATE « « « « «« Any information that is mis- represented may result is the sanitary permit being revoked by the Zoning Department. «« Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed !! PLED 0 B JAM 101993• 4 E8 Or INNFLL � 993 , CERTIFIED SURVEY MAP Located in part of the SW4 of the SE4 and in part of the SEk of the SEh, all in Section 28, T31N, R18W, Town of Star Prairie, St. Croix County, Wi:•sconsin. UNPLATTED LANDS LOT I LOT2 LOT `3 LOT t ACRES ING R/W 2.00 10.88 2.'0o SQ:;FT,'MQ R/W 87,120 465,686 - 66,952. ACRES EXC, R"M 1.80 10.36 2.18 '1.92 " SQ.FT. EXC, R/W 78,280 451,350 95,590 83,757 NORTH L EOFTHE SWV*OF�THE SE N89 "E ��d'5 10 162.5T5\ 9 E 54 5.00' N 18 .52 O 48.38' 286.45 6, � �'•{ n3 cn ao O HOUSE ' `1 ao o m Z a" WELL I n S O SHED tEPTIC $ O •~ n A d O < O o 0 C O N ,p �J m �P Q ,.,• o �' � '• � �. W i a rt N N N • y ' Ph r+' m 7 y C°�N Ao W a0, IC El w IC O 1 z ' u q 0 J l+ Iz cn el T I� p ", S89'�3'30 W '� N 9 It A _ w. � — ,•-, ,ems �.. a, ._ ._ a