Loading...
HomeMy WebLinkAbout040-1245-70-000 C aa> kl� ^ O V M � I I I � I O co C O N N O @ H C � N cu N C @ [y N U � N = ' w Z N N O C O O 0 N a C Z N 0 E 7 (CS @ O Q LL C U 7 N O m � 3 �c r Q S O (D z E rn Z = c rn C14 a m 0 c C7 0 z d' 'O U tl Z `O N m c Z C 'a N m @ U N N ►Nrl d () .c _O ► � O @ © O N Q Z 0o Z N Z � E C N N @ @ 0. .. U O 3 3 3 °- °- z o l o a m m ►� @ 3 a � 7 O N r W O ��yy Vl J V 0 Z �i U C N U ~ O O E E m a N N Q } i:{} cu N d i �+" N u) N @ Iq C O O _ � O 'O c � O M i © o 04 ° a�i v a o C N W ~ N M — O L r-- r ] N p 'UI �V r ' m O 'L Z5 n (nI o L - tCt r 6 a a 0 a 'u y °� c A U d O (A V ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner 1 1 o Address O� City /State LA S Legal Description: Lot - /2 _ Block — Subdivision/CSM # /t-O J l Ct _ .0— Y4 VW V �, Sec, T o?$ N -R, f " Town of o PIN # 7Cj SEPTIC TANK ­120 E CHAMBER HOLDING TANK INFORMATION I � 5 Tank manufacturer (-j t a,,' Size ST/PC /'SQ Setback from: House Q,9 Well P/Ls 60 Pump manufacturer — Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM: Type of system: Width ! a Len 7 a Number of Trenches Setback from: House c?:2_ Well p/L �a � - yeat to fresh air intake /cU ELEVATIONS: Description of benchmark S .� Elevation -,61 /�Z Description of alternate benchmark Elevation Building Sewer ST/H Inlet ST Outlet / d a, 9 5 PC Inlet 2S PC Bottom Header/Manifold _Top of STIPC Manhole Cover Distribution Lines O 3� O 9 2� ( ) Bottom of System( () �j, ( ) Final Grade Date of installation d- / Per number 6) ZState plan number Plumber's signature License number _a a O S 3 7 Date Inspector Complcte plot plan 0r Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count Safety and Buildings Division y ST . CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanita1jit1.: Personal information you provice may be used for secondary purposes [Privacy L , s.15.04 (1)(m)]. Permit Holder's Name: Village Town of: State Plan ID No.: TROY DEVELOPMENT CORP ifi8) CST BM Elev.: Insp. BM Elev.: BM Description: Parcel bI'4�:1245- 70-000 TANK INFORMATION ELEVATION DATA A980o123 a� TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 7, 3 S! Dos' 6, ) /i L 93 Aeration Bldg. Sewer H Ing St /�K Inlet / TANK SETBACK INFORMATION St /W Outlet' TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic aL �� NA Dt Bottom Dosing NA Header-fl=:I. 2Z Aeration ,Z2� Aeration NA Dist. Pipe /3.2 Holclk6 Bot. System -� PUMP/ SIPHON INFORMATION Final Grade Man turer Demand Model Number GPM TDH I Lift Fri ' n stem TDH Ft Forcemain ngth Dia. Dist. To well SOIL ABSORPTION SYSTEM BED/TRENCH Widt / Length i No. Of Trenches T No. Of Pits Inside Dia. Liquid Depth D IM EN 1 N DIMEN I N SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEPrA 'M anufacturer: INFORMATION Type o n p,�cr ® M BER Mo el Number: System: v OR UNIT DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. —50� Spacing , SOIL COVER x Pressure Systems Only xx Mound Or At -Gra ystems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed / Trench Edges Topsoil El E] No E] Yes E] No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: TROY 19.28.19,SW,NW 260 TROON COURT — TROY VILLAGE LOT 17 c t pri Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert No. * sconsin SANITARY PERMIT APPLICATION 201 shn sion In accord with ILHR 83.05, Wis. Adm. P.O. Box 7969 Code Department of Commerce Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8112 x 11 inches in size. ,& ` • See reverse side for instructions for completing this application State sanitary Permit - N The information you provide may be used by other government agency programs [I Check it revision topr vious application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION Pr erty Owner Name Property Location w 1 / 4 W 1/4, S T , N, R C*r) W Prope y Owner's Mailing Address Lot Number Block u ber z e a !V/ A- C'ty, State Zi Code Phone Number Subdiv' ion Name or CS umber a II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ it � Nearest Road Public W 1 or 2 Family Dwelling - No. of bedrooms Town OF Ill. BUILDING SE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo D R S 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. M New 2 ❑ Replacement 3_ ❑ Replacement of 4 ❑ Reconnection of 5. ❑ Repair of an System -------- System ------------- Tank Only Existing System Existing System 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 11P!rSeepage Bed 21 E] Mound 30 C] Specify Type 41 E] Holding Tank 12 171 Seepage Trench 22 ❑ In- Ground Pressure 1z t X , 42 E] Pit Privy 13 E] Seepage Pit Z 43 ❑ Vault Privy 14 ❑ System -In -Fill 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 / 11 red (s q. ft.) Proposed (sq. ft.) (Gals/da /sq. ft.) (Min. /inch) q a- Elevation r /S/ Feet Feet Capacity VII. TANK in Ca gallo s Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel lass Plastic App New Existing strutted 9 Tanks Tanks e tic Tank ,, Q r ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ I ❑ ❑ 1 ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. PI mber's Name: (Pr Plu Signat re: o Stamps) �.No.: Business Phone Number: MZ 22 Qa Plurp q r 's Address (Str et City, St Zip Code): IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate Issued Issuing gent Signature (No Stamps) ,Approved ❑ Owner Given Initial Surcharge Fee) Adverse Determination ` $� l IV «' X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD.6398 (R. 11/96) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber • .. - -tea F ro _ d ID r&oo CroSS S A Zt S, 1 � �e �4 /Hen a � 1 (1,,; ol r � - 14,.e V Aa C Fra►A Alt IAIGI► And Obtervollon Plpa aV,kr.. i m N —1s"s 30y S V I r agiv ,� ► �Lu ^— r - -- ApproriC V.nl Cop y • ' 4l1n1mum 12 Above {., 1 7 Flnol Grad. rrol / - 20• 42' Above Plpp 4* Cast Iron To Final Greed Venl Pipe wren Not Or S,nln.tk Co.ulny 'urn 2' Ayyreyole Oral Ptpa Dielrlbvllon Vipa 0 0 0 -- Tee - 6� Ayyreyole Beneath Pipe ° Perforated Pipe Is o �Cayitny T.rminaltny Al BOIIOdI Of $tll►nl SOIL FILL DISTRI PIPE ` i APPROVED aS4ltIpETIC COVC0. 2 "oF GG AGATE ' OR 9" OF STRAW A R OR MARSW NA-j fo O F JZ - 2 / A G G R E C. AT E ELEV. of FEET —_._ � DISTRIBIJTIOIJ PIPE TU BE AT LEAST WCHES BELOW ORIGIIJAL GRADE AQU AT LEAST t0 INCHES BUT I.10 MORC � 42 IMCIIES BELOW FINAL GRADE MAXIMUM DaPrH of EXCAVATIOP FK o m OR16 6RAVF- W►LL BE _. IIJCHES 111KIMUM OEFni OF EACAVATImN r'PjOIA O� IC,IMAE (3RAD WILL BE INCHES SIGIJEO: LICEUSE I.IUMBER: DATE. Wiscoftin Department of Commence SOIL AND SITE EVALUATION Page 1 of 4 Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code Environmental By Design Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and $t. Croix percent slope, scale or dimensions, north arrow, and location and distance to nearest road. l D # -- c. APPLICANT INFORMATION - Please print all information. 1 7Ree� , P ersonal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). A., Y- Date Property Owner Property Lc tiokl r� Derrick Construction Co. Inc. Govt. Lot ' SW` IA /4 ;NVP 1/4 S 19 , T 28 N,R 19 W Property Owner's Mailing Address Lot # 'Brick # r Subd. Name or CSM# 1505 Hwy 65 17 Tr age City State Zip Code PhoneNumber ❑ City Village Nearest. Road New Richmond W1 246 -2320 Troy Troon Court ❑ New Construction Use: ❑ Residential / Number of bedrooms 4 [❑Addition to existing *ding F Replacement ❑ Public or commercial describe Code Derived daily flow 600 gpd Recommended design loading rate .7 bed, gpd/ft __.8 trench, gpd/ft Absorption area required 857 bed, ft? 750 trench, f 2 Maximum design loading rate .7 bed, gpd/ft2 .8 tr ench, gpd/ft Recommended infiltration surface elevation(s) 95.00' It (as referred to site plan benchmar Additional design / site consideration Site to be graded to meet 42 maximum over distribution pipe Parent material Loess over glacial outwash Flood plain elevation, if applicable ft S= Suitable for system Conventional Mound In - Ground Pressure AT - Grade System in Fill Holding Tank U= Unsuitable for system ® S❑ U M S❑ U ® S❑ U ❑ S ®U ❑ S ®U ❑ S® U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft Boring# Horizon in. Munsell Qu. Sz. Cont Color Texture Gr. Sz. Sh. Consistence Rood Bed ! Trench 1 1 0 -23 10yr3 /1 - sil 2mabk mfr cs 2f .5 .6 2 23 -55 10yr4 /4 - sil 2mabk mfr cs 2f .5 .6 Ground 3 55 -65 7.5yr4/6 - s osg ml cs - 7 8 elev 99.64 ft 4 65 -115 7.5yr5/6 - s osg ml 8 Depth to limiting factor >115" Remarks: Z 1 0 -10 10yr3/2 - sil 2mabk mfr cs 2f .5 .6 2 10 -32 10yr4 /4 - sil lmabk mfr cs if .5 .6 Ground 3 32 -39 7.5yr4/6 - s Osg ml cs - 7 8 elev 102.3 ft 4 39 -56 7.5yr3/2 - s Osg ml cs - 7 8 Depth to 5 56 -125 7.5yr6/4 - s Osg ml - - 7 i 8 limiting factor >125" Remarks: CST Name (Please Print) Signature: Telephone No, Thomas C. Nelson �'� 715- 246 -2454 Address Environmental By Design Date CST Number Ref# 1432 120th Street, New Richmond, W1 54017 4/14/98 MO2605 77 PROPERTY OWNER: Derrick Construction Co. Inc. SOIL DESCRIPTION REPORT 0 Page 2 of 4 PARCEL I.D.# Environmental By Desi Horizon Depth Dominant Color Mottles Texture Structure nsistence Boundary Roots GPD1Y in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed ! Trench 3 1 0 -12 10yr3 /1 - sil 2mabk mfr cs 2f .5 .6 2 12 -24 10yr4/4 - A 2mabk mfr cs 2f .5 .6 Ground elev 3 24 -36 7.5yr4/6 - s Osg ml cs - .7 .8 99.44 ft 4 36 -100 7.5yr6/4 - s Osg ml - - 7 ? 8 Depth to limiting factor >�1 .4_ Remarks: 4 1 0 -32 10yr3/1 - sil 2mabk mfr cs 2f .5 .6 2 3242 7.5yr4/6 - sil 2mabk mfr cs if .5 i .6 Ground elev 3 42 -57 1Oyr5 /6 - sil 2mabk mfr cs if .5 .6 102.94 ft 4 57 -69 10yr5 /6 - is lfgr ml cs - 5 6 Depth to 5 69 -135 7.5yr5/4 - s Osg ml - - 7 i 8 limiting factor >135° Remarks: 5 1 0 -39 10yr2 /1 - sil 2mabk mfr Cs 2f .5 .6 2 39 -79 1Oyr4/4 - A 2mabk mfr cs if .5 i .6 Ground elev 3 79 -89 7.5yr4/4 - A 2mabk mfr cs if 5 6 98.56 ft 4 89 -120 7.5yr5/4 - s Osg ml - - 7 8 Depth to limiting factor >120 Remarks: Ground elev Depth to limiting factor Remarks: t�a 3 OF '9 B D � SIGN 1432 120"' STREET, NEW RICHMOND, WISCONSIN 715 - 246 -2454 PROJECT NAME: 7 TOp Village DESCRIPTION: SW%, Nwl /, SECTION 19 „T 28N, R19W TOWNSHIP: TROY COUNTY: ST.CROIX LOT: °17 SUBDIVISION: TROY VILLAGE L ot Lot � a 0 L.of 2 0 0- c. L o 1 7 .� � 167. J7 Lat icy SCALE - 1' G _° JC, J e Tom Nelson BM i NE LOT CORNER STAKE ...Elevation 100' cstm o2605 BM 2 vent pipe lot 20-Elevation 98.86 l�...c. 0 B D 1�T'VI NIVI �JrT L SIGN 1432 120"` STREET, NEW RICHMOND, WISCONSIN 715 246 - 2454 PROJECT NAME: Troy Village DESCRIPTION: SW%, Nwl /, SECTION 19 „T 28N, R19W TOWNSHIP: TROY COUNTY: ST.CROIX LOT: 17 SUBDIVISION: TROY VILLAGE g �oQ Wjo 65 �3 Qm � sc I Tom Nelson BM 1 NE LOT CORNER STAKE ...Elevation 100' cstmo2605 BM 2 vent pipe lot 20- Flevation 98.86 -; Wisconsin Osparinvint of Industry. SOIL AND SITE EVALUATION REPORT Page I of __I_ Labor and Human Roiaucns giwston of Safety s Bwfdings in accord with ILHR 83.05. Wis. Adm. Code COUNT Attach complete site plan on paper not less than 8 1 / ST. CROIX ` e ize. Plan must include, but PARCEL I.O. x not limited to vertical and horizontal reference IJ r>` rd of slope, scale or dimensioned, north arrow, and location and di nears& road: APPLICANT INFORMATION- PLEASE T ALR TI REVIEWED BY OATS PROPERTY OWNER: APt ERTY LOCATION E 1/2S 24T 28 NR 20 W TOM RUEMMELE &JOHN AND B RUE 3 f 997 G LOT 114W 1 /2S 19T 29 NR 19 �1 W PROPERTY OWNER':S MAILING ADDRESS COUNTY x at6 it I SUBO. NAME OR GSM ft 260 COUNTY ROAD F 17 TROY VILLAGE CITY, STATE ZIP CODE tP NE NUMB CITY ILLAGE WOWN NEAREST ROAD HUDSON WISCONSIN 54016 '��6 TROY T rJ CaUzlr BQ New Cans=6011 Use (X ( Residential I Number of 4 ( Addition to existing building L I Replacement ( Public or commercial describe Code derived daiiy flow 600 gpd Recommended design loading rate �bed. gpolft � trench, gpolft Absorption area required 40 bed. ft -' trench, ft Maximum design loading rate bed. gpd/ft DE 6 trends, gpdM Recommended infiltration surface elevations) BY DESIGNER it (as referred to site plan benchmark) Additional design / site considerati /n/OT oil/ �� E 3 Parent material e l /GL QV1�U�95f: Rood plain elevation, if applicable N/A it S s Suitable for system CONVENTIONAL r� NO IN- GROUND PRESSURE AT-GRAOE SYSTEM IN FILL HOLDING TANK U- Unsuitable for system I Q S ZU I ® S ❑ U ❑ S cffU Q S ❑ S KU SOIL DESCRIPTION REPORT Horizon Depth Dominant Color Mottles Structure GPD /ft in. Munsell p . S Corot Cow Texture Gr. S . Sh. � Boring # A 0 -21 IOYR 3/2 - -- sil 2msbk mfr cw 2vf- 0.5 0.6 IN434 1 B1 21 -37 10YR 4/4 - -- sicl 2m -csbk mfi cs 2vf- 0.4 0.5 oSfeti;YEnC?a:: B2 37 -44 IOYR 4/4 - -- gsl lcsbk mvfr cs 2vf- 0.4 0.5 Ground clew• C 44 -72 IOYR 5/6 - -- s Os 8 80. 1 ft. Depth to limiting factor 72" Remarks: Boring # I 1 Al 0 -19 10YR 4/2 1 2msbk mfr cw 1 2vf- � 0.5 - -- <<433 > A2 14 -31 10YR 3/1 - -- sil 2msbk mfr I gW 2vf- 0.5 0.6 A3 31 -49 10YR 3/2 - -- sil 1 3f-msbk mfi ` w 2vf- 0.5 0.6 Ground elev. B 9 -72 OYR 4/6 - -- sil 1 3f-mabk mfi - -- lvf 1 0. -5 0. 88 ft. Depth to limiting i i factor > 72 Horizon A has seams of 7.5YR 416 lfs- lmsbk. mvfr Names -prase Print ,DAMES • D. FILKWS Phwr (715) 425 -7831 Addr OGDEN ENGINEERING CO., 113 WEST WALNUT ST., RIVER FALLS, WI 54022 Signature - Dares l° �7 SST Nm bw. CSTM03988 PRCPEMOWNER SOIL OESCRIPTION REPORT Page 2 at 2 PARCM 1.0. a Oepth (Dominant Color ( Mottles Texture I Structure IConsisteince Bouncy Roots GPO /tt� Boring # Horizon in Munsell Qu. Sz. Cont Color Texture Sz. Sh. Bed ITMrK:h �` A 0 - 24 10YR 3 1 - -- mfr gw 2vf 0.51 0.6 43L B 24 -49 10YR 4/6 - -- sil 2msbk mfr cs 2vf 0.51 0.6 Ground C 49 - 72 10YR 5/6 - -- s OS9 ml - -- lvf 0.71 0.8 etev. t Depth to limifing tatdor >72" Boring # Remarks: 567< A 0 -20 10YR 2/1 - -- sil 2csbk mfr cs 2vf 10.5 10.6 B1 20 -27 10YR 3/2 - -- sicl 2msbk mfr gw 2vf 0.4 10.5 Ground B2 27 -53 10YR 4/3 - -- sil 2mabk mfr as 2vf 0.5 10.6 ele - -- - -- t - -- 8 C 53 - 10YR 4/6 c2d 10YR 3/4 s Osg ml lvf Depth to limiting factor 53" Remarks: Boring ;t 1 Ground 1 1 1 1 elev. ft. i Depth to lirmting 1 [actor 1 1 1 Remarks: Boring # I Ground elev. ft 000 to limrotx� fa= 1 1 Remarks: - 380.8'LZO(F1.OtsIDZt PAGE 3OF3 SITE PLAN G o T /9 SCALE: 1 " = 40' GAT 0 DoT / C} J� C° \ G© T /6 NOTES: PROVIDE MINIMUM OF 1' SAND BETWEEN BOTTOM OF BED AND EXISTING GROUND. MOUND TO BE A MINIMUM OF: 25' FROM DWELLING; 50' FROM WELL; 5' FROM LOT LINE. - OGDEN ENGINEERING CO. JAMES . FILKINS, CSTM03-988 Civil Engineers & Land Surveyors / 113 W. Walnut St. River falls. WI 54022 DATE: �! la /y7 (715) 425 -7631 wsconiin oepamTMnr of Inousixy• SOIL 'AND SITE EVALUATION REPORT Page 1 of 3_ L and Human RaiaUOM oivisan or Satery s 8udd1ngs in accord with ILHR 83.05. Wis. Adm. Cade COON iY ST. CROIX Attach complete site plan on paper not less than 8 1/2 x 11 ' s in s� an must include, but PARCEL I.D. e not limited to vertical and horizontal reference point (8 �, rand �/obf slgee, scale or dimensioned, north arrow, and location and distanc at road APPLICANT INFaRMAT10N- PLEASE PRI �ry /,jt INF �t;.; REVIEWED 6Y DATE Y PROPERTY OWNER: PRO LOCATION E 1 / 2S 24T 28 NR 20 W TOM RUEMMELE &JOHN AND BARB "LE 114W 1/ 19T 29 NR 19 - 600 W + w13' PROPERTY OWNER':S MAILING ADDRESS l "9I:9Cltit SUf30. NAME OR CSM e r ' 260 COUNTY ROAD F Zrj TROY VILLAGE CITY, STATE ZIP CODE P N ER ILLAGE MrOWN I NEAREST ROAD HUDSON WISCONSIN 54016 (71 T Y T rJ CoU� 8Q New Cortstrtx tkM Use [K Residential / Number of bed ooms 4 ( ( Addition to existing building L 1 Replacement (j Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate A 4' bed. gpdrft — trend[, gpdM Absorption area required Dd bed. ft _ 452 trench, ft Maximum design boding rate D.5 bed. 91XIM D. _ 4 ft", gpdM Recommended inflitmoon surface elevations) BY DESIGNER it (as referred to site plan benchmark) Additional design / site considerati G ND Oil/ eC 3 Parent material /�1r�5S Y QV >,tl�A95f/ Rood plain elevation, it applicable N/A it S a Suitable for System CONVENTIONAL MOUND IN-GROUNO PRESSURE AT GRADE SYSTEM IN FILL NK HOLDING TA U - Unsuitable for system I ❑ S ZU I t9S ❑ U ❑ S �(U Q S 9U I ❑ S (ErU 1 ❑ S IffU SOIL DESCRIPTION REPORT Horizon Depth Dominant Color Mottles Texture Structure C GPO /ft in. I Munsell Q U. SL Cons Gr. Sz. Sh. Boring # A 0 -21 lOYR 3/2 - -- sil 2msbk mfr cw 2vf- 0.5' 0.6 v 434 , B1 21 -37 10YR 4/4 - -- sicl 2m -csbk mfi cs 2vf- 0.4 0.5 }� B2 37 -44 10YR 4/4 - -- gsl lcsbk mvfr cs 2vf-f 0.4 0.5 Ground elev. C 44 -72 10YR 5/6 I S Qs 8 80. 1 It. Depth to limiting facto r Remarks: Boring # I 1 Al 0 -19 10YR 4/2 1 2msbk mfr cw Zvf- 0.5 0 - -- 33 A2 14 -31 10YR 3/1 - -- sil 2msbk mfr w 2vf-t 0.5 0.6 A3 31 -49 10YR 3/2 - -- sil 3f -msbk mfi L w 2 vf-ii l 0.5 0.6 Ground elev. B 9 -72 OYR 4/6 - -- sil 3f -mabk mfi - -- lvf 0. -5 0. 88 ft. Depth to limiting factor > 72" aft: _ Horizon A has seams of 7 5YR 4/6 1fc, lmsbk. mvfr Nemr.— Plee>te Prim � S D. FLKINS P1 =r (715) 425 -7631 OGDEN E7NGiNEEAI14G CO., 113 WEST WALNUT ST., RIVER FALLS, WI 54022 Sgnaar. Oanc / 1 CSTM03988 PRoPERYOWNER SOIL_ DESCRIPTION REPORT Page 2 ofd_ PARCEL 1.0. s Depth Dominant Color Mottles Texture Structure Consstenoe R oots GPOity� Boring # Horizon in Munsell Qu. Sz. corn. Color I Gr. Sz. Sh. I Bed ITwich 431k: A 0 -24 10YR 3/1 - -- mfr gw 2vf -t 0.51 0.6 B 24 -49 10YR 4/6 - -- sil 2msbk mfr cs 2vf4 0.51 0.6 Ground C 49 -72 10YR 5/6 - -- s 0SR ml - -- lvf 0.71 0.8 t elew. g $Il,.,S ft. Depth to tadtx >72" Boring # Remarks: A 0 -20 10YR 2/1 - -- sil 2csbk mfr cs 2v 10.6 B1 20 -2 7 10YR 3/2 - -- sicl 2msbk mfr r gw 2vf 0.4 10.5 B2 27 -53 10YR 4/3 - -- sil 2mabk mfr as 2vf 0.5 10.6 Ground I C 53 -84 10 YR 3/4 s Osg 8 8.3 ft. lOYR 4/6 c2d lO Ml -- lvf - -- : - -- Depth to Grradng . factor 53" Remarks: Boring 1 Ground 1 1 1 elew. It. 1 1 Depth to 1 limiting I j factor 1 1 1 Remarks: Boring # 1 wa Ground efev. fL Depth to Ii rrnOng factor I Remarks: S6t3.es:totR.Oaiaaf PAGE 3 OF 3 SITE PLAN DoT /9 SCALE: 1 " = 40' z 2a \ N�ii� iv BoX � Lo�,�, ELE = 583.7G J� C h /p ' p/ /OE p/2A /NNE �/`IS�ItIEN;r \ \ Go T /6 NOTES: PROVIDE MINIMU HINIMUM SAND B ET W EEN FROM DWELLING; 50' FROM E XISTING WELL; 5'G N D . FROMLOT LINE. MOUND TO OGDEN ENGINEERING CO. JAM D. FILKINS, CSTM03988 Civil Engineers & Land Surveyors / /6 /g 7 113 Y� . Walnut 425 -7631 S. WI 54022 DATE: 'f! ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Derv►E►.tT h t�Ttc� /�.t� -n n-� 5, Cooir- , Mailing Address �� 30 l C ��Trw� �.� #�� I�j�,�� �- IXA w SS 3 0 ¢ Property Address a Y x� Igo c t (Verification required from Planning Department for new construction) City /State RU A SAN f V.l Parcel Identification Number O qC -- 1 LEGAL DESCRIPTION Property Location e '/4, %,, Sec. _ IA - , T ti` N -R W W, Town of _ I t� V _ . Subdivision Lot # L Certified Survey Map # , Volume , Page # _ Warranty Deed # �S9 ( ;l 40 , Volume Z41 . Page # 2 ci 4' Spec house K yes ❑ no Lot lines identifiableX4es ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman pl*ber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days f the three year expiration date. a-� -5 &a �( / / 7 / 9 z - SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the p perry described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in 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 • 16 21 1.62 Z ` .E 3 „ o ;, p o , p V n ,,/ o r ASSUMED BEARINGS REFERENCED TO THE 20 1 % ��, O m NORTH -SOUTH 1/4 SECTION LINE OF SECTION 19, C I 1 T28N, R 19W, WHICH BEARS N 00 E. r 0 / I o II N I 0 I -� i OD 1 00 ,OOe9 N M I I I , :O SL R ....... , o g Ch 19Q ° � Z N �gZ \ J' I N o Z 46 I` v► \� cp rl y 6000, 00,, o_ p 8 9 Z b LM' \ \ tZ \ 00 cv_ ; O� OF ? ,Z+ IZ '� d,� ao p O t? cr�' 0 tT ,zg'S6Z e r 'O 'V 18 8 �Q6 5ZZ ODO iO V - W pw pco C ( D _a CT Z �N :O A � t 1 1 a \ n'1 ' 1 � n D N V1`�' N V1VT , 0 O tD � _ �m0��f O � N �s I � I rr Nut ?1 O � � .: y 0 �/ O Ln I CA 00 \ o o m a �� a N CD , Q8 �, i s� v :'�;p rnn , cb � 1 I 1 1 I 3 „00 ,00e90 S N �; ;O N N ' 1 , c n o � v p °�s, l ey 0 i O I , v / OD c ° _L A3,, ti' s OHO C 1 p� 2 e2. 63. ,, 6 ) 1 D O N 14 N 0 � 110, n cS � � cn o / � _n c ss, iz 1 0 cn _\� S 24 0 _$ -�' v o o 278 63 �" e c 00 ' e 3 ,CO ,91►050 S 448300,, w m �� c°n r . �Q�/1/ ' u' I con � C J1 2 0 '�' ��S c , N o wcO C4j J N _6'8� , I o� D °' 0 0 O 0 � c� J w �- 00 V 8,\ � °0 = 0 J �189`m S� uh °• m m ' Icv �, b a� .r-� C4 1 j ° 00 , 00" �� ► S 110 C 22° O_N cn O O _ _ s tn 2 �` -�_ �? , ° e m 4 6.8 N 1 1 00 0, 0 0 " \ ,� �' 4 8 C93 cr �O CA H 18 'l, ~ � , , oN ° ' 0 97 % • �_R 00 a)4" a 0 18 9 og 0 �� F '� o ! o ° u o CA C 01 g H 2 N' n cn N � ° cn ' t = C 104 m'i 0 rn yN Q/ �' n cn I � o 0 O ,ccoo N 1Qo � , A . I o � 03 °00 00" � o c .400 - r' E o _ g �+-° 248 85 0' E I °' 0 1 27378' o o_ O (0 00 p �w CY X 1/ P 1 cn m D cn Ul _� QQ ,QQe� J D (� I �I I —� V p w V) bo e M En ':,'E 71 i N �D 1 03°8'0 00 0 I co � I v �Z Z 275.00' E 159. S N 03 °00' 0 " E ° IITI OD 16 °126, c, o cc : w LA p' Ln w c 218.82, g , N p o I o ° o a) N 06 t1: �1 1 O O Cn acD��:. 1 $ ID D !0 pp N �` �Oo_ nN � Q i m IT _O I �.TI o li