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CROIX COUNTY ZONING DEPARTMEN AS BUILT SANITARY REPORT Owner TA hn t S �'a c v r� Property Address 3r —Xly i i ,� c �,olx City /State N s oa Gt1 \ . - -, OT cP D Legal Description: ; Lot /0 Block Subdivision/CSM # S Q I! — t /4 — t /4, Sec. ,_, TAN -R W, Town of Ito [, PIN # Y - M ' -60 -ya SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer Wt°lS -p r Size ST1PC 1- r•r 1/6& Setback from: House — Well PAL /40 Pump manufacturer & vrvs Model /A F Y0 Alarm location 0.4 ra ,e (H G TANKS ONLY) Setbacks: ice road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM: S�e w�hdar n�'f(�+t or Type of system: '` Width ,3 Length 7, Number of Trenches 3 Setback from: House y0 Well PAL l /,z a Vent to fresh air intake ELEVATIONS Description of benchmark r A,, r .got C Elevation ,� G Description of alternate benchmark Al " kJe o e Elevation 8 /, 7 Building Sewer ST/HT Inlet 9 3 S, 7 ST Outlet S ' PC Inlet Z 3 PC Bottom 8. Z �� _ Header/Manifold 8 3`l• oy Top of ST/PC Manhole Cover Distribution Lines () 8 0. 7 4 () ( ) Bottom of System () 9,37. Final Grade ( ) () ( ) Date of installation 01 / Permit number State plan number / 4 16 , P 6 Plumber's signature QcrX� 1 License number c)aS f n Date ) 1 / 3/9 Inspector Complete plot plan + 4,,... 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. ca o,0 / —0 PLAN VIEW '/2 In 6,lfra/oc< \‘'\ \S icf r cu,t.:OJc Go ral l a,o ‘I\.. . 1.< 1?..„40,.., • N. ' '''4-- , \\\ INDICATE NORTH ARROW Wisconsin Department Commerce PRIVATE SEWAGE SYSTEM Coun ` 'Safety and Buildings Division ST . CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitar y320280: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: ❑ Cit ❑ Village Town of: State Plan ID No.: SPRINGER, THOMAS TRY CST BM Elev.; � Insp.� M Ele�_ � BM Descri ti � Parcel T � P I 4 � & � � I� x No.: l L d40- 1228 -00 -000 TANK INFORMATION V ELEVATION DATA A9800467 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. S p Ic W ( Benc 3.3C� Dosin 6 �� qS S" Aeration Aeration Bldg. Sewer g�{¢.SI v.3z 3G -1 Holding OS/ I* Inlet I �•7a ii5 y.�7 TANK SETBACK INFORMATION Ot W Outlet. 61 � TANK TO P/ L WELL BLDG. Air l to ntake ROAD Dt Inlet q.2pj Air I , � ( 3 S , �3 Septi �' NA Dt Bottom }a '532 ) S D osing/ v NA Header / Man. 3 Z d lv 3°I Aera ' Dist. Pipe ��5 g•� �5� -7 $� Holding -- Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer lV Demand ��� �f3`�,cI Model Number ��p �� GPM TDH Lift Loss 2_ System TDHfa,a-fl Forcemain Length as Dia.a" Dist. To Well SOIL ABS SYSTEM BED / RENC w idth r Length 1 _ / No. Of enches PIT No. Of Pits Inside Dia. Liquid Depth DIM EN N 1/ S DIMENSION L BLDG WELL LAKE /STREAM STREAM LEAC nu acturer: SETBACK SYSTEM TO P / INFORMATION Type 7 CHA ER Model Numb syst t -- OR UNIT DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) r x Hole Size x Hole Spacing Vent To Air Intake r Length _22 Dia- Length n� I Dia. � Spacing 6" 7 / � SOIL COVER 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 E] No E] Yes E] No COMMENTS: (Include code discrepancies, persons present, etc.) 14J8" LOCATION: TROY 13.28.20 298 SALISHAN DR — SALISHAN LOT 10 D 3U f 411SV l�pe �r�h R S� (44e Gu �r✓rrs {yr� ��' ✓!of �LCn- ei T � Y'` (UCH -4 - Pla Fr (Sion reg red? ❑ Yes ET Use other side for additional information. k SBD -6710 (R.3/97) Date Inspector's Si ature Cert. No. V SANITARY PERMIT APPLICATION 2 01 E. W shngtonnA 8 " °n sconsin Code I n accord with ILHR 83.05, Wis. Adm. P.O. Box Wl 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. , (, Yb • See reverse side for instructions for completing this application State Sanitar �erJ Perm N umber The'information you provide may be used by other government agency programs E] Check it revision to previous �lication [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION 1 Propert Owner Name Property Location S S if` n r t o *ton of is 1/4 1/4, 13 Tag , N, Rao E (or W Property Owner's Mailing Address I Lot Number 4 . t � Block Number qo 6k t n 'zyt 01 98 Z(x1 i *kar 0v CItVA St at Zip Code Phone Number Subdivision Name or CSM Number mn II. TYPE OF BUILDING: (check one) ❑ State Owned Nearest Road pA Public 19 1 or 2 Family Dwelling - No. of bedrooms Town OF T ro h z �cC III BUILDIN USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 1­1 Apartment/ Condo J o r — I 2 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. PSG New 2 ❑ Replacement 3 ❑ Replacement of 4 ❑ Reconnection of 5_ ❑ Repair of an __ystem ________ 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 11 ❑ Seepage Bed 30 ❑ Specify Type 41 ❑ Holding Tank 12 Trench 22 ❑ In Ground Pressure f 42 ❑ Pit Privy 13 E] t Seepage Pit $tats W wty IV �') t'"` or 43 ❑ Vault Privy .14 ❑ System -In -Fill 3- r X 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.) Proposed (s q. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation 00 ,1 13 00 3 06 Rol 10 Feet $40. Feet VII. TANK Capacity in gallons Total # Of Prefab. Site Fiber Plastic Exper. INFORMATION New Existin Gallons Tanks Manufacturers Name Concrete Con- Steel glass App" structed T s Tanks Septic Tank or+lofdt g-Twrk 141605 ^ W iese r Commit ❑ ❑ ❑ ❑ ❑ Lift Pump Tank �n������� K "` ❑ ❑ ❑ ❑ I ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) P is igna ure (No Stamps) MPEAAR�R$MPNo.: Business Phone Number: e. ��_ e,�r - ��r C a a5�5 '115- 55yq Plumber's Address (Street, City State, Zip Code): %'WbO 9H. �{. - TRvver IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved S itary Permit Fee (includes Groundwater ate I ssued Issuin gent Signature (No Stamps) �� Approved ❑O Surcharge Fee) wner Given Initial /Q' �/ / ' Adverse Determination G ' / /4C� X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: J� pvro,%y1t AejA 1e7 07; y-d -47'v'- 'A 5 W(?IU SBD -6399 (R.11l96) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber PLOT PLAN Page of Scale 1"= �o ' � .• ,j�.. "� mot ��I lRO►.1 �LPH �La4l ? DoT- coR4.� s.g L LA V 67 P „ a rr•Y'� 9( of N \ ` ti\ �Si ts �7t 1 t�� \ \•� 3 WL 3 c4v e �►JS�`P(LJI, C,I.RS e1. e� 4 LO CgY1.O N L �► s'1'Pc� 3 1't�ac�-�s, evie�t 3 ' x �S ` Lou6 w�� � 4 Vti � o� ® O � Tt1� 1�GN CA�PPsC"TY -, >tberkjwb(2 L-ImtJ4 _ Qftmaelts. �N �'rlL l'2�1C1� �n Z)"UWS lU i3e ft 4 V NGS SYSTEM O G) d NI • rially Cori R � 6 �1ro�NC�► s v .. Np 8 RR �S PO NDD� 5�E C PkGL- 4 or-- 6 -- -_ �---� CY) O cn - �---il �a T _ 4�j r T 9 N �r a a Sv v C7 cr p m ' C m _O C �5 0. I . �m m M ("1 Q � s CP a A + m� 3 C p• 0 m a� p 2 : v N Cl 1� S 4Lh p r (n p ti y N jr -_ - I �a I 3 X • • • • � i I I I �- U) (A a _ FD IW F N (D = Q n I !iI iii LD O `- 11 I'i i x J Q 5D p3 a' cn � cD � �;, � � I , CD x "a a 2 �� Q�� a� (D c o cn �[1 —di I;l 0CD K3 -� m o -0 M ,{oo cn W -% J w (D cn � Q N CD (D rWV� x Z 5 I - w rn C I I , B C o i C W i w m 0 _ Invert 11' w CD C%? co C Y c w' Safety and Buildings 2226 ROSE ST LACROSSE WI 54603 -1905 Nvisconsin Tommy G. Thompson, Governor Department of Co William J.Mccoshen,Secretary 'l September 16, 1998 ?IN :& CUST ID No.267341 ATTN.• Rod Eslinger WEGERER SOIL TESTING & DESIGN 421 N MAIN ST PO BOX 74 RIVER FALLS WI 54022 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 09/16/2000 Identification Numbers .. Transaction ID No. 146814 Site ID No. 15692 SITE. Please refer fo both tieittificutiort numbers:' Site ID: 15692 above, iii all correspondence with the St Croix County, Town of Troy a en Gov't Lot 1, S13, T28N, R20W Lot: 10, Subdivision: Salishan Facility: Tom Springer FOR: Description: Revised Non - Pressurized In- Ground Object Type: POWT System Regulated Object ID No.: 34520 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Adm. Code. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(d), Wis. Stats. • The gravelless system components must be installed in accordance with the manufacturer's printed instructions, the plan approval, and ch. Comm 83 system sizing criteria. If there is a conflict between the manufacturer's instructions and the plan approval, the plan approval and code requirements will take precedence. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /instal lation/operation. Inquiries concerning this correspondence may be' made to me at the telephone number listed below, or at the address on this letterhead. Za QA DATE RECEIVED 09/10/1998 DENNIS R SORENSON , WASTEWATER SPECIALIST FEE REQUIRED $ 60.00 Field Operations FEE RECEIVED $ 60.00 (608)785-9336, MONDAYS 7 :OOAM- 3:45PM BALANCE DUE $ 0.00 DSORENSON @COMMERCE. STATE. WI.US DOSED CONVENTIONAL SOIL ABSORPTION SYSTEM Page 1 of b ° FOR Gou. DoT ` LOCATED IN THE — 1/4 OF THE - 1/4 OF SECTION 13 , T _ZZ N, R Z- 10 W, TOWN OF ���-, C,�� COUNTY, WISCONSIN (`,oT \O or- ITM 1'LAT OF SKt �s�tfstJ> ' INDEX PAGE 1 OF 6 TITLE SHEET SFp, ��L�•O a PAGE 2 OF 6 PROJECT DATA B�O 1998 PAGE 3 OF 6 PLOT PLAN PAGE 4 OF 6 PLAN VIEW -CROSS SECTION (\, C�1Ps�►e�tt PAGE 5 OF 6 PUMP CHAMBER PAGE 6 OF 6 PUMP PERFORMANCE CURVE l PREPARED FOR ' T i \ Rk>b zmcl_4 S�21K1 - 107. w LS c_0" S) Q S7TLEZrt` V _Nlb sGxj , wl sv o1b it 0 c 0 Ns PREPARED BY j '� j AgTHUP L S' WEGEHER aa,s v EL.LSWORTH. L W WEGEE:RER E3 C3 I L TEST I t (B AND ••.......••'" I3ES = G4V SER V = CE 00 *. Z G10' P.R. BRX 74 421 K. MIK ST. RIM FALLS. WI 54022 715- 425AlbS lS R v_(FU1310►j of �Lh # 1\ q 16s — PrPPrwuUTp �U�-`( ZZ 1898, JOB NO. 7vm ML u W u L`( l lu `T" amwGL 1 S �l.l►"'Il u �l�n , (� ZAJ ' 01 1 W1 l 8F� tiYV S'TM f�sp �0`(L ~ll 3wNL U SlEi . f-30 C tt r G [sS WO Tl-tl-- S'4_� Coll 01`1 Eli S l {�A - F'►'R'D� - PROJECT DATA Page Z of This dosed Conventional system will serve a 4 bedroom home and a bathroom in a detached garage for the owner's use only.. A Wieser Concrete Products 1465/1000 gallon combination tank will be installed to dose the system which is comprised,of 3 trenches with High Capacity Sidewinder leach chambers :Nj Infiltrator Systems, Inc. Combination Sept, c; Tank and PUMP CHAMBER CROSS SECTION; ARID SPECIFICATIOUS ' PAGE S .OF b VENT CAP WEATHER PROOF JuIJCTION BOX 4' VENT PIPE APPROVED LOCKIPJG �:. 10' FROM OOOR.. MAWHOLE COVER mily - .hmDOW OR FRESH wARr.1 WG LI SEL.. ALP, cowpu�r s >`1 O S 3 16 "M+��. IGRA I Y" MIIJ. PPt I PROVIDE I MILE T AIRTIGHT SEAL I v APPROVED JOIW PPROYED JOINT S 3gFF��S A I III A vP G onstruction I III `'� /c.=. PIPE,x�c pK� • imi p ly with I II ALARM Oft I H and 33.20 a I I I I OIJ a gV�1�NG4 o C j I ^' f AF L FT __ J `. N (�F PUMP � OFF �- ` D COUCRETE SEE � �T -�v • �2.s. �h � BLOCK 3" APPRove'" RISER EXIT PERMITTED OIJL'J IF TAIJK MAIJUFACTUR{`R HAS SUCH APPROVAL gEDOINQ SEPTIC f SPECIFICATIOUS OOSE W `R EV CQ" c, Z pl� IJUMbER OF .DOSES: 3 • PER D" TA,WKJ MANUFACTURER. TAWK :,IZC: 1��5 / Iuyb &ALLOWS DOSE VOLUME r ALARM MA►JUFACTUR{`R: S�$• S ` ' %Ytyt S IM CL UDIIJG OACKFLOW: Z' � Q 1 GALLONS -y MODEL QLIMBER. �l HW CAPACITIES: A = =_ ( - wCHES OR QQ 9 GALLOAIS Z I ' 3 GrLLOIJ5 SWITCH TAPE: B = PUMP !'IAWUFACTURCK: `� INCHES OR Z VQ' 1 CALLOUS MODEL UUMBER: �� �� D= WCHESOR 7-3S GALLOIJS SWITCH TYPE: �2GU�Z'Y MOTE: PUMP AUD ALARM ARE Z.` MINIMUM DISCKARGE RATE - GPM INSTALLED ON 5EPARATE CIRCUITS VFKTICAL DIFFERENCE 15ETWLEIJ PUMP OFF AU0_0I5TRIBUTIOM PIPE.. FEET t mimIMUM IJ ETWORK SUPPLY PRESSURE .. . . — FEET { F OF FORCE MAIN X u 3Y F YoFr . FKICTI0W FAC7 -. b Zq FEET ._ TOTAL D9WAMIC HERO FEET Pump chamber DIAMETER IIJTERNAL DIMLWSIOMJ OF TANK: LEAJGTH ;WIDTH ;LIQUID DEPTH BOTTOM AREA 231= GAL /INCH AS PER MANUFACTURER = 19.6 GAL /INCH M E40 Series MyNt 4/10 HP Effluent and Drain Water Pumps. Performance Curve MODEL ME40 EFFLUENT PUMP CAPACITY LITERS PER MINUTE 0 50 100 150 200 250 300 350 40 12 35 10 to W 30 t H 25 8 Z 20 6 J H 15 Q 0 4 �- 10 4 ~ 2 5 0 0 0 10 20 30 40 50 60 70 80 90 100 CAPACITY GALLONS PER MINUTE 4 �Y 1101 Myers Parkway, Ashland, Ohio 44805 -1923 419/289 -1144 FAX 419/289 -6658 Telex 98 -7443 K3326 7/91 Printed in U.S.A. Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page of 3 LatiZ# and Human Relations iNvisidn of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but S r G tX 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. �u APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: �Ct�ttZ.Q 1SOtiJ I GuDp 8 �,p� PROPERTY LOCATION C S'C� — U E1'3 CU'b t� GOVT. LOT [ 1/4 1/4,S 13 T 2'13 .,N,R ZD E (0 PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # \ \ZO 7Z)Vwe iR tr3GG7 \jQbue [Q FIZ6 ep P".h or- !3KIS)ipkw CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE ®TOWN NEAREST ROAD ��Ut�12 7---oTLL w I SSIt�ZZnis) qZ - Z'1S7 TZ,ol -( leocr COUE RARt' New Construction Use [)(j Residential / Number of bedrooms L/ [ ] Additin to existing building Replacement [ ] Public or commercial describe Code derived daily flow 6 o O gpd Recommended design loading rate e• S bed, glxW 0 - 6 trench, gpd1 t Absorption area required 1 Zo O bed, ft ) oa 0 trench, ft Maximum design loading rate o - 5 bed, gpd$ 0- b trench, gpd1ft Recommended infiltration surface elevation(s) S aL-P PA6E 3 of 3 ft (as referred to site plan benchmark) Additional design/ site considerations ANRJ� l�C COwfw1EluU� - D . Parent material s � k-Yj SftAv4 RAT o u e=R s NM't> 4 Gti'-f fug Flood plain elevation, if applicable N - A . It S = Suitable for system CONVENTIONAL I MOUND IN- GROUND PRESSURE I AT GRADE SYSTEM IN FlLL I HOLDING TANK U= Unsuitable for system I IDS ❑ U NI S ❑ U [as El U C? S ❑ U RI S ❑ U [Is IO U 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 l0 `'t% 7 - 1 - L L �F S d1^t; t. '�H a, S 0.5 ZS .•` Z 8 -lb )OyR j/ - L Z Sb ►n'Ft- ew o •S 0A. Ground Vo 4 Q '51L C. S b1rt YA v .'! O's elev. 8cl l- 3 ft. y ZS -�l0 L o `t R �l b s l S b k lvt FI - c S o Z o. 3 Depth to S Y0 - to 4 L Yly S e `Fs O St9 >.,\ S '3• t limiting f actor 6 6z_9y \cj't �!!y _ s 0 s� I �.7 0 Remarks: Boring # ; Y I o -tI b'r" ti►'+`F>^ as 0. igi o - Z Z 11 -z� ZoKrc Sly -- 1L Z F SbN rn'F> CS o•S 0.6 3 U -SS 1o't1Z y/y — S S o- S Ground elev. y SS - 6 10 i tz y! 8 S v s9 M o. - 7 0• S �� -3 ft Depth to limiting factDr Remarks: v TName:- Please Print Arthur L. We ti� Phone' 715-425-0165 egerer Soil Testing & Design -P.O. Box 74 River Falls,WI 54022 Signature: n Date: CST Number: 93 -03 -10 t -t3 -93 M00576 PROPERTY OWNER NR2cZISO►-,G43OD it CA-IDI SOIL DESCRIPTION REPORT Page -of' 3 -. PARCEL I.D.# Depth Dominant Color Mottles Structure GPD/ft2 Boring# Horizon Texture Consistence Boundary Roots in. Munsell Qu.Sz.Cont.Color Gr. Sz. Sh. Bed Trench ili <:> \ o-1 \o‘-t.„ z)z — L z ''-s b t- a.5 Co 3 ; 1L m oS o Z. -1-Z2, 1OM.Q 341 sI \c. Sblrc ) L)4 c. o,LL o.s Ground 3 2Z-30 1O`-tQ 31(0 — i51 1c-5bk Ynv`F1r C-S o-14 o-S elev. 8`t 1.5 ft. y 36-q Z 1 O-4 lZ 3)6 "" S 1` \j 5\)1T Yr1 - C S Q• 1.- o.3 Depth to S yz-63 vo`1czV/y Svcs O sg lrv, \ cw o. s b-L limiting factor�., b 63-s.q t\ '1 coyS 0 S5 i I o.-) o•'a Remarks: Boring# . 1 0-10 Doti .. 2.-11 — L Z i s bk mil. c,k-s o.s 036 4. €<€< Z )b-`LZ \o L'I2 3)y L Z`F s l�k w 4h e.� o- S o.L . <:<:: . 3 2Z 36 )O`1.1z 3)6 — 1``-t-��5 \ c sVic. yr)0*fi- C-s o,y o.S Ground elev. LI 36-SO 10412 3)6 — 51\ \ 4Sb\2 'Pr,`-4. cS b. Z 0.3 $42.. Z. ft. Depth to S 5r-q4/ 1OKQ- U/y — S p Sg i► 1 a•-7 o.g limiting factor 7c14" Remarks: Boring# a-I b \o•it. . 7-1.1. — L 2.`c sbk 1n`Fy c- a.S o, L S11 Z )b-2y Ii04nR, 3)yr L Z'Fs bvc rn'Ft- c-w o.s 0.Co Ground 3 zy-3y \o�c? 316 — 1` S 1 csbie vhu �N CS o-'./ o-s elev. t) 3q-VZ )b`72 3IL St ) l'c sbiT r-'rt- S O• 2- 0,.3 8'41•Z ft. Depth to S q2.61 \04 v._ v/ — S $ Cs o s.5 Y,, ) c,(, o•S o.6 limiting 6 6)-orz. y o yR u/y — ,S O s q rye ` o.' u. factor 7 al Z'' Remarks: Boring# ¶`lam= Ilk°E". PrB m.) 1 13 N- i zooki 5 ��S c2 .1 13 ED A S S t`F S \ TA -. R1),-1 CL 1 L.'f Yam► 1 v)vl s lo'u'p w L`ril Pr- F-(.1i. ' Ground b1 S Ct P-i ') .,)U OCJ S InLS' 1�wt=• Shlti tj 13 .b 5 . elev. LOP ))v G h ..-s Z_ `T}t'1 S 1 f__t-zANQ ►-isz-L A S eiR". ft. Depth to �`' cS RATE ' - limiting factor Remarks: SBD-8330(R.05/92) PLOT PLAN Page 3 of a RCN Io SCALE 1 "= So ' c X S ETcK RL1 Vpj TE of ® O �t 8y l ass • �.=. O Bs — —� E. e Z.ob� O B•Z Sly" � 4�'►eR 6 w / l.Fl T'rk O ai ° 0 I H. 3 O i L� %il l 5 7 i jo/ 0 a � o - -- A`1RJC'1.1S ita, 43S' ra • e� m F3 4?- , !L 6L. 842-99' ON 4 u ' ! vs� Zo ae n-r L keftsr Z s" Fito)i DRttWFDILY0. w / n 1T�1 ►jo'i'e 'N lt.►SLLL2: %%T' K OF s4 STLTrj To t t'` 'hT trteU. 88 ? Ce WL`nt. 7A tZ Su tj fv -t3 t. li ) �L p `� 1`C ►-� hxthut�t ®f= Ll L O�- eau L�12 ou T'1� ti O Slyz Itsu`nua.► tz NN 0 3 J M �o a 3 -03 -10 715 4 M00576 CST Signature Date Signed Telephone No. CST # Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page -of 3 La 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 8 1/2 x 11 inches in size. Plan must include, but 5 T• GR� tx 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: gyp. 0),a I CGuDD g (�,op PROPERTY LOCATION C �o ST� I=TJ C.UQ(> GOVT. LOT ( 1/4 1/4,S )3 T 210 .,N,R - 4Z E (o, W PROPERTY OWNER' :S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # \ \ZO Ptit 1Z�pGl A2l�C" IO — �P05e4 Vl%-NT OF Sf1US1'IP�N CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE ®TOWN NEAREST ROAD pQ New Construction Use [kJ Residential / Number of bedrooms y ( ] Addition to existing building Replacement (] Public or commercial describe Code derived daily flow 6 o O gpd Recommended design loading rate b• S bed, gpd/ft 0- 6 trench, gVW Absorption area required N W-,0 bed, 11 ) o trench, ft Maximum design loafing rate 0 - S bed, gpd/ft 0• b trench, gpd1ft Recommended infiltration surface elevation(s) 5 ffe t#RGE 3 of 3 It (as referred to site plan benchmark) Additional design / site considerations 'b(3 SAD 'TrR�►.)C -11 `L� $ ��O' f�"�D�"b . Parent material s t �-Yj Sqp t col *A)T o u (M s hKVt> 4( c&ri Aug- Rood plain elevation, d applicable N.N. ft S = Sltitable for system CONVENTIONAL MOUND IN�C O D PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U =tlnsrAtable for Stem ®S ❑ u ®S ❑ u 19S ❑ u IQ' ❑ u ®s [] u I ❑'s IOU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color MoUles Texture Structure Consistence Botr>Itry Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tud 1 o -S 1oKQ zlz L L`Fsd1 > a.S ©.5 a:b Z g -!b )OyR 3)y L z sbk fn 'FN cw o -S 0.6 Ground 3 16 -Z$ VO `t V_ 3/ t. yn v c.s r,. s elev. g4 ft. y Z8 -V0 L O `12 al b s i S b k Yr1 FM c S o• Z o- 3 Depth to S YO - 6Z 1 0 `1 \1 y w os o.S o•6 limiting a . o , ' fac to, 6 6Z -gy t o , t.kx y /y - s a s� ,� I Remarks: Boring # 1 0 -�1 to�t2 Z/ Z L Z`F sb �� as o• S o.6 1 Z Z Z�SdN Vn'F1- CS o S o,6 3 U - fz y/y S 0' s u S9 m c S o• S ,M- I. Ground elev. g oo_ -a ft y SS-R t o 4 (z y!y 7 8 S v s9 h1 o.'t 0.8 Depth to limiting en factar � 86 " Remarks: ro v TNarne:— Please Print Arthur L. We 'l Phone. 715 - 425 -0165 AddwA egerer Soil Testing & Design -P.O. Box 74 River Falls,WI 54022 Signature: Date: CST Number: 10 I -t3 -9 3 M00576 PLOT P LAN Page 3 of 3_ Lo T 10 SCALE 1 "= Scy ' � .8 �o tJ _ - Mt- "RILtTST LU�IcTS -- - -- - / o f TE If sLA S reHS, T-A ,Z C EL. ® O Lit aq l � 8.5 • `3=1 $S f j� eq? o 6' o'v O O g•Z G �+/ I.PiTi1 O 4 O O °+ ° 0 D. 3 a I o a•4 • eh IHL' 4L z LYL. 8yZ - 99' ON I lacuu S� 1'0 �3� 11rT LL+R - ST 2 S ` F�uwt D Rl�t t ►.� Rt3.Ia , k, Y l R i �� � w qt- L -t 4 e, 6 S �' �t v , 1v o Tp 1 Q SIft t.l. Zk ; 8 °Z'Yo r-t of SH S TIFA"I To )� 'hT L�t'U, 83-j '7 t 'fM L L t} S "W kJ OF cl L" or CpULa12 ou r _ 3 j M �o Q 3 -03 — 10 ( 715 ) 425 -C1 6S _ M00576 CST Signature Date Signed Telephone No. . CS'r # T ( 105 SF1' I It "DANK MAIN"TBNANCI: AGIEl Ih.N "t SC Croix County t )WNF1Z /It IN I?R I ho Yv\c f t ,ti MAILING AUUR1 ?SS � O2_ _ hl � sc t w S i- PROP ,R"I Y ADDRESS t V v � S �`�r'`I Or . 1 (lor"Ition of septic system) Please obtain from the Planning; Dept. CITY /S'T'A'I'D h S 0_�j �Aj PROPPAZ IN LOCATION 114, - 114, Section I T N It Z� %V TOWN OF �Yoy - -- - -- ---- - - - - -- ST. URO[X COUN'T'Y, \ V'I fi1 fill) IVISION alb S�C IJ) F NUMBER `l.l t ER'I iFll•:I)S11JRVI• :Y MAT' VOLUME fL, PAGE l'o r Nl1Ml31:lt 10 _ ln,plopet use and maintenance of your septic system could result in its premature failure to handle wa Proper maintenance con-fists of pumping out the septic tank every three years or sooner, 11' needed by Item ;eel septic tank pumpe What you put into the system can afTect the function of the septic tank as a treatment stage in the waste disposal system. SI Croix County tesidents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July I, I978. St. Croix County acceptcd this program in August of' 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner af"wes to submit to St. Croix Zoning a cetiilication lurnt, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the, on site wastewater dispw;al system is in proper operating condition and ( ?) alter inspection and 1,umping Of necessary), the septic tank is less than 1/3 full of sludge and scum I /We, the undersigned have read the above requirements and agree to nruntain the private Sewage disposal System in accordance with the standards set forth, herein, as sct by the Wisconsin Dldit Certific:at,cm stating that you, septic: has been maintained must be completed and returned to the St Croix County /,miing Officer \vilhin 30 days of tile three year expiration date SI(.iNLD. I )A IT to 2 �S `;t Crnrx ('aunty Zoning' (IIIli(Ac (;c,�rrnn„•nl (c•nlcr 1101 t Road I lud :ran, V,1 ') ir S T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner /contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. ------------------------------------------------------------------- owner of property p e Location of property 1/4 1 /4, section _,TN -R Township Mailing address a2 (AJ c S Co w 5 ( w S - F Address of site Subdivision name s V v.l Lot no. (� other homes on property? _ Yes No Previous owner of property f rSpN Q cu Total size of property Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)? Yes No Volume and Page Number 292— recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No. 5S3 70& , and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for they construction of said system, and the same has been duly recorded in the office of the County Register of Deeds as Document No. j o Signature of A p.l_i t Co - App icant Date of Signature Date of Si na ure .r. i' DOC - jMMrr NO. WARRAlT T ORM 553'7GG w Steven 0. Cud, and Jeffrey P. Cudd, conveys Edward J. Harrison III, , b,11 and warrants to Thomas R. Springer and Stacy J. Springer, husband and ,T Mix „ wife as survivQ,�ship marital property, the following described real estate in St. Croix County, 'State of Wisconsin: D EG 2 7 1996 Lot 10, Plat of Saiishan in the Town of Troy, St. Croix county, R'_ ��� 15 A M •`^ Wisconsin yA"'."'R Idw, � ragi of Jiwu J J JF NAME AND RGT[JTiH D c g $ o §F -R 0- 22 -00 Parcel Identification Nwnber (PIN) This is not homestead property, Exception to warranties: a cements, restrictions and rights of way of record, if any. Dated this A day of November, 1996. fd/'1� II (SEAL) (SEAL) S war J. Her on III teven d. Cu BAL) (SEAT.) Jef ey a.BDGKZ1iT AUTEXXTICATION Signature(s) STATE OFIIIIIIOIs ) as. COOK COL"M ) authenticated this day of _ 19_ eraor. lly came before me 19iy ��_ { �' Q of E war err son. 7 to me known to be the person(s) w o executed the foregoing instrume d ackno�l the same. TITLE: MEMBER STATE BAR OF WISCONSIN (If not authorize 3706.06, W s. State - Notar ublic County I11. THIS INSTRMMUT WAS DRAFTED By' pl commission Ir – permanent. l nut, exp ration date: Joseph D. Soles P �+ �T oa ` 1 Rodli, Beaker. Boles L Krueger, S.C. — Y.O. box 138 'OFFICIAL SEAL' River Falls, WI 5.1022 MERLEOES CAVILA NWARY PIJUC, STATE OF ILLIKITS MY Cp.*',SSi 1 N Ex9!RES 18 /09/00 12iracE273 acsoQMXWT STATE OF WISCONSIN ) ) ss. St. Croix cooNTY ) Personally came before me this Lath day of December , 19 the above named Steven 0. Cu an Je rey P. Cu to me known to be the person(s) who executed the foregoing instrument and acknowledge the same. NOTARY PUBLIC L S ._ Linda Singel State of Wi8C0081R Notary Public St. Croix county, via. My commission is permanent. (If not, exp ration date: November 2 19 96 _ ? a f y f uw 704.6x' 00 OWNED BY WMRS i � S88 ° 04'17 "` q 133.37 d r W N C 1111 '00 "E • Va- 1 / Q 2 L u F F VO I f 2 ' 1 1 3.83 ACRES I \ ( 167, 8 40 SO.FT.) I 3.22 AC. EXC. EASEMENT I ( 140,4 48 SO. FT.) \ =W 0 ( O p° 31873' ' 1. of W r