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Home My WebLink About040-1100-30-000 (2)St. Croix County Planning and Zoning Tiiestlt�j�, Ane 01, 2010 tit 4:.#'1:24 PAI Detail Sanitary Information pa�-'-e I of I Computer 040-1100-30-000 Sub/Plat: NA Section: 25 Parcel #: 25-28.19.396E Lot: 1 TN/RNG: T28N R 1 9W Municipality: Troy, Town of CSM: Vol. 01 Pg. 81 1/4 114: E 1/2 SE 1/4 Owner: Sumner, Kenneth 883 Hwy 65 Hudson, W1 54016 State Permit: 12390 Issued: 03/06/1975 POWTS Dispersal: Non -Pressurized In -ground Permit: New County Permit: 13 Installed: 05/09/1975 POWTS Detail: Bed- Seepage Bedrooms: 0 WI Fund: POWTS Pretreatment: NA Notes Issuer/l_nspector As Built Plumber Other Requirements Additional Notes Money Owed Harold Barber No Grove, E.F. former Land O'Lakes feed store until sole in $0.00 Harold Barber Signed Off- No 2001. file with more recent replacement permit Owner: Nelson, Scott J. & Erica 883 Hwy 65 Hudson, WI 54016 State Permit: 193404 Issued: 05/04/1993 POWTS Dispersal: Mound Permit: Replacement County Permit: 0 Installed: 05/06/1993 POWTS Detail: NA Bedrooms: 3 WI Fund: POWTS Pretreatment: NA Notes Issuer/inspector As Built Plumber Other Requirements Additional Notes Money Owed Jim Thompson Yes Wang, Tom no BOA file found for commercial use, not $0.00 Mary Jenkins Signed Off: Yes annexed to city Maintenance Notification Scheduled Pum Date Pumped Notification 5/6/1996 11/8/2005 04/20/2006 11/8/2008 11/20/2009 11/20/2012 STC 104 AS BUILT SANITARY SYSTEM REPORT OWNER'SCO P414 FreJerj�k ADDRESS - SUBDIVISION CSM# LOT SECTION. T, ZZ N-R W, Town of ST, CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 1100 Qu <P �e - INDICATE NORTH ARROW Provide setback and elevation information on reverse of this -form. Provide 2 dimensions to center of septic tank manhole covero 0 ALTERNATE BM* SEPTIC TANK / PUMP CHAMBER HOLDING TANK INFORMATION . we tfhkori - I" _+ Manuf acturer:&Luec? Liquid Capacity Setback from: Well House 51-19 Other Pump: Manufacturer C-�o M_L0�'�A Model#&)J6311). Size 3 46 Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: Length Z/ Number of trenches __LcA Distance & Direction to nearest Laropqv line: Setback from: well: House Other Building Sewer PC inlet Header/Manifold Exist ing Grade tLEVATIONS ST Inlet; ST outlet PC bottom Pump Off Bottom of system DATE OF INSTALLATIO_N: PLUMBER ON JOB: LICENSE NUMBER: 10 INSPECTOR. 3/93:3t Final grade p 19 9 �RNA" JESWA61?SYSTEM Labor and'H uman Relations INSPECTION REPORT Sbfety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) PerrY)it Holder's Name: City 0 Village Town of nn r,,,l T "FI-SON ' A & P F ME. R I C TROY CST BM Ele�.: Insp.'BM Elev,: BM Description'. co TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic e& 1 6 Dosi ng iucl �i"e,5 Aeration Holding TANK SETBACK INFORMATION TANKTO P L WELL BLDG. ventto Air Intake ROAD Septic 7 7,5 J./o NA Dosing r NA Aeration NA Holding PUMP/ SIPHON INFORMATION Manufacturer GOAJ� Demand ji Model Number . ....... GPM F I L-1— TDH Lift riction �ystem TDH Ft Head Forcernain Length _,pt Dia. Dist-ToWell County� S T C Sanitary'Pj`rr�lt �T(3,` '11 q 3 a Ig 11 State Plan D No-* Parcel Tax No., AWNnnnAq or ItUVA I 1UN UA 4- .1A STATION BS HI FS ELEV. Benchmark -91 Bldg. Sewer St/ Ht Inlet 9 7- St / Ht Outlet Dt Inlet Dt Bottom Header / Man. voi Dist- Pipe /0 Bot. System Final Grade 5 SOIL ABSORPTION SYSTEM I I _d BED/TRENCH Width Length, N frenches PIT No- Of Pits inside Dia. L qui Depth DIMENSIONS DIMENSIONS LEACHING Manufacturer: SYSTEM TO P L BLDG WELL LAKE STREAM', SETBACK CHAMBER Model Number: INFORMATION T y p e 0 f/,/3- OR UNIT System lld5j'l /7'0 DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing vent To Air Intake Length D D a. Spacing 11C4 la Length SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only xx Seeded x hed Depth Over Depth Over Xx Depth Of X IC Bed /Trench Center Bed / Trench Edges Topsoil 0/yes D No y e s E] No COMMENTS: (Include code discrepancies, persons present, etc.) LO%"-'ATION*e TROY 25028 _19.396E,NE,Z'3E,HWY 65 L_57- 11-D �;3 q4, W-t� 4,j�,/ C-4 0 'Ut, � e Z/ - (3 - (,4 1k) 2 *-9 Plan revision required. 0 Yes EJ N o ion - Use other side for additional informat' p SBD-671 0 (R 05/91) Date Inspettor's Signature Cert. No- .A 0-- C/o y ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ow. 0 STC - jo4 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS— 0 d 531 SUBDIVISION CSMg SECTION__Q? T X-R Town o f ST. CROIX COUNTYf Wincoll-S-BP Provide setback- and elevation I '11for-mation on reverse of this foil-M. 11rovIde 2 di-meris- 101's t:O center of septic t--ank m�mhale covei.-- 41 B ENCHMARK: Z06�O ALTERNATE BM: SEPTIC TANK PUMP CHAMBER HOLDING TANK INFORMATION A 4Z, Manufacturer: Liquid Capacity* Setback from: Well 30 1 House 34� Other Pump: Manuf acturer Model# Size Float seperation Gallons/cycle: Alarm Location _j t, Xbove olf- Width . : SOIL ABSORPTION SYSTEM . ged be Length C Number oftrenches *� 0 'f Distance & Direction to nearest prop. line: — /1:5 14E Setback from: well: 501 House /</O I Other ELEVATIONS Building Sewer ST Inlet.. ST outlet PC inlet PC bottom Pump Off Header/Manifold Bottom of system Existing Grade Final grade DATE OF INSTALLATI N: JN** PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: 3/9 3: it 0 F; t ;Z7 ML �M_ SANITARY PFRL41T APPI.Ir.ATInN � Li J U=14H In accord with ILHR 83.05, Wis. Adm. Code COUNTY 'r," STATE SANITARY PEfIM I IT ff/ —Attach complete plans (to the county copy only) for the system, on paper not less than V6 8% X'l 1 inches in size. j-4. Ch eick i revision to pr ious application yc —See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION — PLEASE PRINT ALL INFORMATION. PROPERTY OWNOM PROPER LOCATION TF4 CW) /4 S T N (or PROPERTY OWNER'S MPA LING ADr'0E'Q'Q LOT # BLOCK# I ------- C TY, STATE I I F, / /_3 Lu,` ZIP CODE PHONE NUMBER SUBDIVISION NAMP/09Z9`M_ 'NUMBI�V_ 0-3 e I - 2 �� Li CITY NEAREST III. TYPE OF BUILDING: (Check one) A OROAD State Owned 0 VILLAGE TOWN OF:' LjPublic 1 or 2 Fam. Dwelling—# of bedrooms PARCEL TAX NUMBER(S)" 111111. BUILDING USE: (if building type is public, check all that apply) 1 El Apt/Condo 2 DAssembly Hall 6 0 Medical Facility/Nursing Home 10 El'Outdoor Recreational Facility 3 El Campground 7 El Merchandise: Sales/Repairs 11 . El Restaurant/Bar/Dining 40 Church/School 80 Mobile Home Park 12 0 Service Station/Car Wash 5 El Hotel/Motel 9 El Off ice/Factory 13 1:1 Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1.0 New 2. M Replacement 3. El Replacement of 4. El Reconnection of 5.0 Repair of an System System Tank Only Existing System Existing System 13) A Sanitary Permit was previously issued. Permit # Date Issued V. TYPE OF SYSTEM: (Check only one) Non -Pressurized Distribution Pressurized Distribution Experimental Other 11 Seepage Bed 21 M Mound 300 Specify Type 41 El Holding Tank 12 SeepageTrench 22 In -Ground 42 0 Pit Privy 13 El Seepage Pit Pressure 430 Vault Privy 14 0 System -In -Fill V1. 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 (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION </ 'D L,*Al) n", - el F je /C. I i � 2z-) ZN6 Feet Feet Vill. TANK CAPACITY Site INFORMATION in gallons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. New xisting Gallons Tanks Concrete glass App. Tanks Tanks structed Septic Tank or Holding Tank t rrLro(w S-T F] F f L2 Lift PumeTank/Siphon Chamber, 0 0 Vill. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumher's, Name (Print): Plumbar' Signature: (No Sta ps) S, M ft��W Business Phone Number: 7 I Ir-) I.- Plumber's Address (Street, City, St#je Zip C:?): IX. CQUNTY/DEPARTMENT USE ONLY O'er F_� Disapproved &�V' ary Permit Fee (Inciudes Groundwater Surcharge Fee) Issued Issuing Agfent Signatu tamps AApproved E] Owner Given Initial ;ell 0 Fir Adverse Determination =4 mmwaw�l X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A san irtary Perm it is val id for two (2) years 2. y6u'r sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority, 4. Changes in ownership or plumber. requires a Sanitary. Permit Transfer/Renewal Form (SBD 6399) to be siubmifted%to the county priorlo installati V 5. Onsite sewage systems must be properly mainlained. The septic tank(s) must be pumped by a licensed. pumper whenever necessary, usually every 2 to 3 years. k 6. If you have questions concerning youronsite sewage system, contact your local code administrator or the State of Wisconsin,. Safety,,& Buildings Division, 60&26&3815. To be complete and -accurate-,thi% it application must include: 1. Property owner's name And mailing address. Provide the legal description and -parcel tax number(s)%,of where the system is to be Installetr-'T 1� ZAL 11. Type of building being served. Ch6ck only one and complete # of bedrooms if 1 or 2 Family Dwelling. Ill. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in #1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gall k ons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if -tanks received experimental product approval from DILHR. 2 VIII. Responsibility statement. Installing plumber-1s to fill in name, license number with appropriate prefix (e.g. MIR, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or. other treatment tanks.; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soilabsorption system if required by the"county; E) soil test data on a 115 form; -and F) all -sizing information. GROUNDWATER- SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect gro.undwater. The monies collected through thesesUrcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards'. SBD-6398 (R-11/88) SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations PRIVATE SEWAGE PLAN APPROVAL WANG EXCAVATING W9672 770TH AVE RIVER FALLS WI 54022 Western Regional Office 2226 Rose Street LaCrosse, Wisconsin 54603 Owner: SCOTT NELSON & PHYLLIS FREDERICK 883 HWY 65 RIVER FALLS WI 54022 RE: Plan Number: S92-40845 Date Approved: September 18, 1992 Gallons Per Day: 318 Date Received: September 18, 1992 Project Name: NELSON & FREDERICK-SCOTT & PHYLLIS Location: NE,SE,35,28,19W Town of TROY County: ST CROIX The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped 'conditionally approved'. This approval is contingent u0on compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. This approval will expire two years from the date approved or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. The Section of Private Sewage has reviewed these plans for private sewage system code requirements only. These plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the Wisconsin Administrative code. This approval is for the following components only: - REPLACEMENT MOUND Inquiries concerning this approval may be made by calling (608) 785-9348. Sincerely, GERARD M. SWIML-, Section of Private Sewage Division of Safety and Buildings PPP039/0009n/27 cc: SCOTT NELSON & PHYLLIS FREDERICK X Private Sewage Consultant S B D .6423 (R. 0 1 /9 1) �',ne L1 T ,,Xb4ibom 'MC v y y fal4k lw%A.M�%f flub SO& was r e. e Ive13 f,r) ills trede-l"'It ./vF Y Ste. PRIVATE SEWAGE A) )IS 'ConaldonW AR IJPR 0 VED My- OF WoUM,19 LUOs Ilu him OF SAFOY sun* SEE CO ENC . E 393 1 PRW,,ATF. StWAbE A*WEM Conditi,onW Page 0 f Straw, Marsh Hay, Or 0 I APPKL VEY Synthetic' C'Overing�� DEPre OF WOUSTRY, LABOR & HUMAN REUTIONS DMION OF SAFETY AND BUI d OOOJ SEE CORRE "D'ON C E Dist ribut ion Pipe F D % slope Force Main Bed Of ;i-21-2 Aggregate (611 13elow P*Ipe) Cross Section Of A Mound System Using A Bed For The Absorption Area Signed: �,A e? License Number: 7 Date: Alternate Position of Force Main L A Ft, B q5 Ft. K I.Q Ft. L Ft. j Ft. i lo Fto W '-Z 5 -'F t G Plowed Loyer D F t 0 E Ft. F 15 Ft, G I Ft, H Is5 Ft. Observation Pipe--,� IK— A Force Main `7 W 0 Distribution Bed Of -'*2*"— 2 '0'2" Pipe Aggregate 7:E Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area WIN rd -�L e-,, man tCold. go ld N LO&Awk. — --- 9 v . %F . 'q- &a 11 9 w w IF %NWW w %W I A rw A I I v Cr\ OL CA p PRW.,,A, be A+Wm :TE SNIA Conditi,onW APPROVM,-, Kff,o OF NOUSTRY, LABOR & HUMAN RELATIONS DWISION OF SAFETY AND BUI "u, SEE CORRE?rD CE --F n A e-k es IN I r-1 c I I c,% - VI c k (e- 5) 1 rrlo,r.t roick af Po rc c- Ina 11 n I r\ ck e's 0 liolt per pipe I r) u P. rq -'e. It. 1 010 101 !F4- 0 PA (v V G F PUMP CHAMBER CROcS SCIC-4-10IJ AIQ0 SPECIFICA-riokjS VE WT CAP 4 1. EMT PIPE WEATHEKPKOOF 5 ROM DOOR, JULICTIOW BOX w I U-1 OR FRESH tom I U. AIR IMTAKE vl" Cr!kA DE P"TEstw'oe Rkwm 000 Con ditiofiW APPROVBI KI L E T WTs OF MUSTRY', LABOR & HUMAN RELATIONS PROVIDE I OM ION OF SAFETY AND BUI AlItTICPHT SEAL SEE CORR CE lioi r% *APPROVED c JOINTS WITH ELEV. F T. APPROVED PIPE 11 3' ONTO 0 SOLID SOIL F U tA p I COMCKETIE BLOCK APFROVED LOCKINIG MAMHOLE COVER 4" MiW. Li 7T ALARM om OFF * KISEK EXT PEKMIITED OQL�J IF TAWK MAMUFACTURLIt HAS SUCH APPROVAL SEPTIC 5 PE Co I F I'CATI Oki DOSE TAWKS MAkJUFACTUFLr6K:-MjT6>L 15T2ccair QUMbER OF DOSES: -.�PEK DA.4 TAWK SIZE: 'pi 0 GALLOMS oosc VOLUME ALARM MAMUFACTUILER: -o-�� INCLUDIMG 6ACKFLOW: 540 GALL AODEL KIUM15EK: CA-PACITIES: A = IMCRES Op, GALL( SWITCH TSPE: B = INCHES OR 3 15 CpALL( PUMP MAWLI FACTURE it's. jQ w WE HES OR GALL( MODEL UUMBEK". -WF,92 1- /o Dw INCHES OR .1 GALL 3WITCH TtiPE. MOTE: PUMP AMD ALAKM ARE TO BL MIMIMUM DISCHAFtGE RATE.. 7?) (p r. P Ak INSTALLED OlkJ 5EPXRATE CIRCUITS VE.KrICAL DIFFEKENCE BETWEEL) PUMP OFF AWD 013TRIBUTIOM PIPE.. ZQ FEET + MI&JIMUM METWORK SUPPL�l PKESSUKE FLET 1-7,4q/7-N 'Zv Fy + FEET OF FORCE MAIM goo IrTIFRICTIOU FACTOR. aV FEET TOTAL DtWAMIL HEAD FEET LITEKILIAL. DI.m-tW6joWfs OF TAWK: LF-W&TH --;Wl DT H L I Q U 10 D E: P T H IGUED: LICEMSE 3 MUMBER'. DATE:OW/� 1V For Homes Farms 10 Trailer' courts 10 Motels ,0 Schools • Hospitals • I ndustry 11 Effluent Systems anywhere effluent or drainage must be disposed of quickly, quietly and efficiently. Heavy -Duty Sol ids Handling Dependable Capability to3/4 L1 1/3, 1h H.P. 60 Hz Single Phase 115, 230 Volt. 1h, 3/4, 1 9 1 1h H. R'60 Hz Single Phase 230 Volt. Three Phase 208-230, 460 Volt. VU 80 70 W W 4 6o Uj 50 40 30 20 10 0 r 10 �4 Bulletin CLZ1A July 8, 1983 GOULDS Model 3885 (Supersedes Model 3870) Submersible _ff luent Pumps Pump Specifications Solids Handling Capability to Vs", Discharge Size 2" NPT. Semi -Open Impeller 3 vane design. threaded on shaft Three phase Units use impeller locknLA to prevent accidental back -off. Pump out vanes on backs I cle of impeller for protection of mechanical seal. Casing Volute type for maxirnUm efficiency. Stainless Steel Fasteners Series 300 stainless steel for corrosion reSistance. Mechanical Seal Ceramic vs Cdrbon sealing f,ices. stainless steel spring and Buna N elastomers Maximum Temperature 160'3 F. Capable of Running Dry without damage to components. Motor Specifications Motor Fully Submerged in high grade ll,irbine oil for permanent lLibrica- tion of bearings and mechanical seal and efficient heat dissipation Motor sealed from environment by rugged cast iron enclosure. Bearings Heavy-duty all ball bearing constrUCtion, Stainless Steel Shaft Series 300 stainless steel for corrosion resistance, Threaded shaft. Single Phase Units All single phasp units have built-in thermal overload protection with 'ititomatic fv-,�ej. Three Phase Units Overload protoction in starlt.J Unit C'08-.,?,30 or 460 volts. Threzid(,d shaft 60 Hz operation. Power Cord Water and uil resistdrit Epoxy seal on motor end -is aCIS a secon Jary 1110IStUre barrier in cas e of da m ige to otiler Ilicketing Corrosion resi'3 t.-I ri t gland nut Single Phase Units H F) models equipped with 1,1,)' of K) .3 SJ10 with 3-prono (jf0Ljndinq pluci 1, 1 . H P mc)(10-s eqwppod with 15' of 14 -1 STO power cold SPECIFICATIONS ARC SUBJECT TO CHANGE WITHOUT NOTICE 20 .30 40 so 60 70 80 90 100 110 120 GOULDS PUMPS. INC. GALLONS PER MINUTE SENECA FALLS NEW YOPK 13148 DEPART�4ENT OF INQ,oZJS_FRY, LABOR AND HUMAN RELATIONS REPORT ON SOIL BORINGS AND SAF ETY & BU I LD I NGS DIVISION PERCOLATION TESTS (115) P.O. BOX 7969 MADISON, WI 53707 __"S!J'1�113.09(11) & Chapter 145) LOCATION: ,-I / IV% (3,E;(4 SECTION: �)s�/TWN/R OWNSH I U -ffbiVISION NAME: 0' NICIPALITY: LOT NO.: BLK. NO, SU E (o r__ 7� 41 lid (o ' I COUNTY- �JE 5WNER'S/BUY�R'S NAME: I-MAILIOG ADDRESS: USE E]ResiAVAIN NO. BEDRJMS.: A 4" DATES OBSERVATIONS MADE COMMERCIJL DESCRIPTI N: PROFILE D CR IONS-: PERCOLATION TESTS E New R�Replace �. is 17 T ke �0 it S C� Eoirle- ets I f'ke ;- 0 x le RATING: S= Site suitable for system CONVENTIONAL: MOUND: 70 !S� MWVIUC, M S F I U LI—Xte unsuitable for system" &G—ROUND-PRESSURE: SYSTEM-IN-Fl LIHOLDING T RECOMMEND YSTEM: (optional) E] S [� [:]S U 0 ANKI U YU S Eu ,',DL If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area Is in the under s. I LHR 83.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER -INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST — TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B_ 3 AIN --/too t L51 B- �' 0- )"� B --27") o r -1 "e4 00 1 1 o'ls F; E�Q C t I B- 3'oo 6 A 51 6.66 f , r, B_ 312 '0 'SD h PERCOLATION TESTS I I to I NUMBER ULF I H INCHES W TER IN HOLE AFTERSWELLING TEST TIME INTERVAL -MIN. DROP IN WATER LEVEL -INCHES RATE MINUTES PER INCH PERIOD 1 PERIOD 2 PERIOD 3 - P_ 170 CA I yf� P_ 3/v P_ 0— P_ P__ P_ PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION ;A 6.2 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord vv I th the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (prinfl: ITESTS WERE COMPLETED ON: k)4;1 AD R I CERTIFICATION NUMBIfR -n 0 er L () - A 05 /L to CST S I G KAWLJ R E: 101? ONE NUMBER (o n tional) V DISTRIBUTION- Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) — OVER — . b D ' E-PARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, - DIVISION LABOR AND PERCOLATION TEST9 (115) P.O. BOX 7969 HUMAN RELATIONS MADISON, WI 53707 1 (1) & Chapter 145) _'L!Lk1B 83.09 �ECTION: LOCATION: WL7'1E3jHj?AAU ICIPALITY: LOT NO.: BLK. NO. IVISION NAME: top. /T Fft.— '/4 )YNIR /9 E (o COLIN Y- OWNER'S/13 u Y4R's NAME: AILIOG ADDRESS: Ire i V 1 5 e-o-H Ne iseh 4- A� /I'- r USE DATES OBSERVATIONS MADE 0. BEDr.: ICOMMERCIIL DESCRIPTION: PROFILE DFSCRI ONS: COEATION TESTS. PTI EIResidgeAlt ONew RS�Replace c� E7,ork- eirs Irke - 0 ri'vj RATING: S= Site suitable for system UNite unsuitable fo: systerno 11x IOUND: 1�4-_GROUND-PRESSURE: SYSTE CONVENT M-IN-FILL HOLDING TANK:IRECOMMENDED YSTEM: (optional) i:is YuTys Ei T [IS [4 EIS YU I EIS SU I MPIA4,& If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s. I LH R 83.09(5) (b), indicate: Floodplain, indicate Floodplain elevation; PROFILE DESCRIPTIONS TEST DEPTH WATER IN HOLE TEST TIME NUN18ER INCHES AFTERSWELLING INTEHVAL-MIN. P_ - r- si 0' P_ Z�--Oc/ a P_ P_ P_ PERCOLATION TESTS DROP IN WATER LEVEL -INCHES PERIOD 1 PERIOD 2 PERIOD 3 44V RATE MINUI PER INCH �/40 PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION m 6a C� N 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) OVER — SOIL DESCRIPTION REPORT Bor�%, # Depth Horizzon in. Dominant Color Munsell MoWes Texture Structure Consistence Bourday Roots GPD/Q2 Qu. Sz. Cont- Color Gr. Sz. Sh. Bed :Tod C000 Ground lot elev. Depth to firniting O�. ur�--'/ factor v V Rernark�: Boring # Mn 1 ............ U-12 Ground elev. ft. Depth to 4�__j air— C', limiting factor T Rernark"S: Boring # -19 Iq - 4/ 2 Of Ground elev. ? Depth to fimiting factor Remark�;4. Boring # ......... . :.:- 2-) �,/q Ground elev. LZ/ Depth to limi6ng 0 4 factor Remarks: ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET 0 HUDSON, WI 54016 (715) 386-4680 Aug. 24, 1992 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An onsi te soil investigation of the Frederick property, Scott Nelson Phyllis located in the NE1/4 of the SE1/4,, Sec.35, T28N, R19W, Town of Troy, sto Croix County, WI, with the assistance of Tom Wang, CST# 2860. , has been conducted This onsite revealed Suitable soil for onsite sewage diSposal 0 depth of 3611 while meeting the requirements of the A +& 411 rule. This " site'should be suitable for a replacement septic system serving a commercial business using either an At -Grade or a mound system having 1211 Of sand fill. Should you have any questionst please feel free to contact this office, I nc el nc ely, m m es K Thompson Assistant Zoning Administrator cc f ile CERTIFIED SURVEY MAP Part of the E 1/2 of the SE 1/4 of Section 25 Township 28 North, Range 19 West, Town of Troy, St. Croix County, Wisconsin Scale; 1" 200' XV A� 14r� bo 0 1P 910 -ai� 13 4e jE �14 j05 r2SA'jo 1?19W J-4 ,eO,W. 5.7'YV 66 ;K All D F I L E FEB 25 1975 JAMLS 0,1-4 N E L L istsr ei Died& CrojA Cotinty, W jif:Qnsin Indicates 30" iron pipe stake weighing 10'13 #/fto Descript ion *7 That certain parcel of land or tract of real estate located in the E 1/2 of the SE 1/4 of Section 25, T 28 N, R 19 W, Town of Troy, St. Croix County, Wisconsin, more fully described as follows-, Beginning at a point on the southerly right-of-way line of S.T,H, 65 S 340 451 30" W and 927*36 feet distance from the East quarter corner of said Section 25; thence continue along 4 said southerly ri 1-t-of-way line S 420 33' 00" W a distance of 50,00 feet; thence S, fri 70 271 0011 E a distance of 400.00 feet, thence N 420 331 00" E P a distance of 450.00 feet; thence N 470 271 0011 W a distance of 400.00 feet to the Point -of -Beginning. Cerf If Icati on: I, James L. Murphy, Registered Land Surveyor, hereby certify that by direction of the Owner, Kenneth Sumner, I have surveyed and divided the lands shown hereon and that the map and description hereon are a true and correct representation of and description for the lands as divided; and that I have complied with all the provisions of Chapter 236-34 of Wisconsin Statutes In surveying dividing, mapping and describing said lands* "I'll III I I (1 '1111/10 / C'0 Aj Dated: 25 February 1975 �aam6s L -`�Mur Phf Re -1,s-t-erecl I;btnd ..,$I��,Veyor 9 4CIU Vol . 1 page 81 Certified Survey Maps, St. Croix County, Wise ..e I APPLICATION FOR SANITARY PERMIT STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER Z L ROUTE/BOX NUMBER FIRE NO. ZIP 5 CITY/STATE PROPERTY LOCATION: 1/4 -1/4, Section T c7 9 Nr R W St. Croix County, Town of 101, subdivision Lot No. __ -N- _. 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 SEPTIC TANK PUMPRR. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County Residents MAY be eligible to receive a grant for a MAXIMUM of $3000 of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of ALL NEW SYSTEMS agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is In proper operating condition and (2) after Inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Department of Natural Resources. Certification form must be completed and returned to the St.Croix County Zoning Office within 30 days of the three year expiration date. SIGNED DATE. St. Croix County Zoning Office St. Croix County Courthouse 911 4th Street Hudson, WI 54016 (715) 386-4680 Sign, Date, and Return to above address % Xr 8t3 ? 0 S SPA�_E RE�ILRVED FOR RECORDING DATA DOCUmEt-ji" NO. WARRANTY DEED 982 STATE BAR OF WISCONSIN FORM 2-1 43-81,19G REGISTER"S 0"or '.3 ST. CROIX CO., W1 Paraclise pools,, Jrc.,p a WiscOnsin Corwration . .. ....... .... ....... .. ...... . ......... ... . .......... ...... Re<:"d for Recnrd ....... ...... ......... .......... ...... .......... ........... .... ..... I ....... ........... . ........... . ... .... ........ . .... ............... JUN .......... ....... .. ........ ... ............. conveys and warrants to pj�yll.i_s. 0.. Frederi.ck..and-.Sc0tt..L... at 11-30 A M Ne_1sQny.. as.. join+.-.. tenants .......... ..... ......................... ........... .... ....... ... .......... ............. ........... ................... ftq1stw of Do" - --------- ........ .. ...... .............. .. ...... ................. --- --------- rP C T U 0 S ................ ... To ............. .. .. .... ............................... ........ .. .... . ........................ .. .... ------ ------------- ------------------- ... ... .... ..... .... ....... the following described real estate in St:-. croix -------_------------ Count), State of Wisconsin: Tax Parcel No: -----_---------------------- CerUfied Survey Map filed February 251 1975 in Volume 1 Of Cextified Survey MaPs.- page 81, as D=xment nzrber 325802, being a part of the East lialf of Southeast Quarter (E�j of- SEh) of Section Twenty Five (25) . TtmnshiP Twenty Fight (28) North,, 'onsin. Pznge Nineteen (19) Westp TOwn Of TrOYt St- CrOix COLMty" Wsc 7.4 This . ------- homestead property. 1CbgX (is not) ExceptiDn to warrantie5: Subject tr ts, restrictions and rights of way Of record, if any. .) easanmt -T Dated tHs ..... . 7th-. -- --- --- ----- _. day of . . . ... -- - 0 19-88 PAPADISE POOLS.- IW- . ..... . ..(SEAL) --------------------- I— ........ .. ...... ..(SEAL) AUTHENTICATION Signature(s) ----_----------- ----------------------------------------- -------------------------------------------------------------------------------- authenticated this -------- day of -------- __ --------------- 19 ------ ------------------------------------- ------------------------------------------ 0 - ------------------------------------------- ----------------------------------- TITLE: MEMBER STATE BAR OF WISCONSIN (If not - -------------------------- --------------------------------- authorized by 5 706.06, Wis. Stats.) TH!S INSTRUMENr WAS DRAFTED BY Keith Rodli, Attorney At Isaw -r6tL!'F- - -B'ESKAR" BOLES-1 co ------------------------- 219--N.- Main- - Stxeet--,- River-, Falls.o - - WT -.5-4.Q22 (Signatures may be authenticated or acknewled,-ed. Both el are not necessary.) *Names of per5ons .qi%rning in any capacity should be type,l or printed hole�w thuir �tignnt'.rvs WARRANTY DEED STATF BAR OF FORM No� BY: (SEAL) dem Attest: 7- (SEAL) ACKNOWLEDGMENT STATE OF WISCONSIN -------- 2. Ze t � . �. ---------- county. Personally came before me this .... 9-NA ... day of the above named .......... -------------------------------------- -------------------- ------ ----------------- I -------------- ---- I ------- ....... to me known to be the person 5 .... ... _ who executed the fore,goin�� instrument and acki,owledge the same. -------- ------- Public County, Wis. Mv Commizzion is pernianent.(If riot, state CXP�ratiori da te: .3 c :�'C_ L W 1 7� C 0 Z!N f.- irw AM a 1 2 �v �4 � 1� y f CERTIFIED SURVEY MAP Pa rt of the E 1/2 of the SE 1/4 of Section 25, Township 28 North, Range 19 West, Town of Troy, St. Croix County, Wisconsin Scale; 111 2001 Iro - sz� �7 q0 14 X 4 0 0 CP t to , Z5 r281V 7 1?1!9W Indicates 30" iron pipe stake weighing 1,13 #/ft. Descript ion -- Thp,t certain percel of land or trarct of real estate located in the F 1/2 of the SE 1/4 of Section 25, T 28 N, H 19 W, Town of Troy, St. Croix County, Wisconsin, more fully described as follows; Beginning at a point on the southerly right-of-way line of S.T.H. 65 S 340 45 f 3011 W arid 927,36 feet distance from the East quarter corner of said Section 2�; thence continue along said southerly S- 0 ri rit-of-way line S 42 33' 00" W a distance of 450,00 f eet; thence S , 970 27' 0011 E a distance of 400.00 feet; thence N 420 33' 00" E a distance of 450-00 feet; thence N 470 271 00" W a distance of 400.00 feet to the Point -of -Beginning. Cerflfication: 1, James L. Murphy, Registered Land Surveyor, hereby certify that by direction of the Owner, Kenneth Sumner, I have surveyed and divided the lands shown hereon and that the map and description hereon are a true and correct representation of and description for the lands as divided; and that I have complied with all the provisions of Chapter 236.34 of Wisconsin Statutes In surveying, dividing, mapping and describing said lands, C 0 A/ Dated: 25 February 19?5 �0�dm6s, L.1- -"Marph ,F ey, o r R e 9A s t4r e cf,"Da n d. 1 to I Vol . 1 — Page 81 Certified Survey Maps, St. Croix County, Wis. N CFI�TIFIE'D SURVEY MAP KTaO�TETH SUMNER FILED N: *94 19 OV N 17 98! OV 171982 0 wwn JAAU V OOMMU at sawk &* ft=W Part of the West 112 of -the Southeast 1/4 of Section 25, Township 28 North, Range 19 West, Town of Troy, St. Croix County, Wisconsin, Indicates 111 2-ron pipe found o Indicates 1" x 241, iron pipe weighing 1.13 lbs./lin. ft. set N 146 40'51" W 66.22 t rn ALL BEARINGS REF.TOTHE N,)S 1/4 LINE OF .0. SEC-25,T28N, R19W, ASSUM-ED SOO"00'00"E 01 0 00 0, z 3� 0 00 _j 0 W 0 0 . I to C4 0 0 w X t- o U') 0 0 t- a. 0 10 0 4j) 0 (7) . % z to 0 0 06, 0 CY) 0 N 0 0 rn 0 JAMES L. 0 w w U Z-_ j MURPHY J tA 41 0"& U. 0 S - 1 0 4 2- 0) C; RIVM FALLS, W,sc* 0 0 0 0 vw\ ' t ' '% \ / ' " " - 0� N 0 0 0. LA14b 0 0 0%0 0 rn 0 0 J 7:7 0.1 --- 0 t- W o U) 6 (P\ < P 0 P C" r-N .0 0. z Uj 0 0 w 0 0 0 4 w to 1-1 7- 00: OD �: �3 0 z 0 w (3210.24') 0 0 w CD z 0 0 to to 0 0 w _j a. W 0 Z 0 0\ \0 0 C4 C4 43. 0 At r0ro. 0 % S 000 00'00" E 0 \0 S1 ().00 Ix NA- 1/4 L IN E OD S 10 ........ ...... 2F -'� �: . 0 M Z OD Q to N 0 —0 V) AC a loft �bl �- 1 100 N a: 60 Uj LU D z 0 L) z 4tj' :3 X Ir 41( �' 0 . (�4 4 osi& w z )0 CX) �p Ot. w U 4 0 0 �0 dO P.- w > % 0 a) Ci 0 IX (b* 0 w W Ix k(I 0 z M 7- OD 0 0 U Z n 0 0 U 0 0 _j (D 0 :3 0c) U 0 W 411 �v Z� L) LL 0, z 0 Zi J James L. Murphy co 131 to Registered Land Surveyor Vol. Page 1222 _j a. Certified Survey Maps ZI St. Croix CoLmty, Wisconsin DESCRIPTION ON RE -VERSE n 0 C 0 Ln ROVED 0 1982 cc�u�iiTv -r -) RE, PORT OF J -A. "IS PE C T !ON. - JNDrP, D T T L S-F. -7, G7 Zz -P jW z )SA 1, SYSTE PA P I - It * - -4 R`rM_:6RY TREPTMENT consists of E)eptic Tan.K. Uffier (Describe) WAM SEPTIC TA NK: Distance frorn: Well Lot Line 4 ft,* Esuiliding Eigh,w-vater Mark ft* 12% or reater slope Cistern 4 fr-T 'IV etland No. cornpartments Liquid capacRy/,,,-! Ogal, C, EFFLUENT DISPOSAL cvSTEMi consists of k-� __ Tile field Seepage Pit Seepage i it or Tile T-4 i—eld: 17.)istance from: ve ej I ft, Building Lot Line ft. Ci stern ft. highwater Mark,�,.of water course ft 13 enb 42% or g r e a t e r etl and ft Tclk,al ngth of tile lines C, ft. Numb er of 1 in e s Lerg+h cf each ft. Distance b ween lines ft. v idth of t rench Too, e i ach E`ottom c"I ffective absorption area of trei A e e L., L �Pp e material. over Dep-'-h of filter material below tile, of f tile�Z, in. Cover over filter materi, 01 Depth f tile below finished grade in. S-,1ope_( bl, - 2 P t r e- n c,:# b ot t om '!P�n. per 100 ft. Depth of bedrock Depth to ground water ft Is Nunriber of Pits S I 1 d"W %liameter ft. Depth below inlet fig Lining material Gravel around pit: ve s No. Total absor t ivK a, T a sq. feet. Square feet of seepage trench bottom area required Squa.Ve feet of seepa pit area required ee Inspected by: 10 ILI Title: Ipproved C /) - Date 19 7<6* IR e I jected Date_ 197 County., Town of" Owi-er I ------------------- 6' -�anitary Permit No. P roperty Iddress 2,, ,jep-o'--ic Tank -Permit No,.L_2 i, ion Subdiv*s* �U tv egv, ILr ?I. Ii:�, --,f! 7 4,7 Ik cl Lf I. 4v ay. 14, .71 IIt, I41 OL 3ir Ibr V1. po W 49, 40� I .. ......... ;74 4V�4 -4 II iqr, I, 4�.Ir ,015 IIiIIJ',Z. IIrIIIIiI*j 4,7. fo j, im .4 IIIIR II17 1 IIkw 4k I I4 L I II-L' 4jj I4Q- ee At ITI zv. I,4K W'4 Sr .v If,4 T4- IIlilt I;ra a* 0 0 AM" 5-0 o F*1b 67 V State Permit �2 C1 7) State of Wisconsin and County Uniform Permit Application for Private Domestic Sewage Systems 'In k-LIM'Unty 9 K -1) 0 Number Number A. LOCATION OF PREMISE WHERE SYSTEM WILL BE CONSTRUCTED, ALTERED OR EXTENDED Name (One: LEGAL DESCRIPTION: o64 -5T Y, --VILLAGE (Sec., Lot, Block) ��4 C.TIPW A C CITY - TOWNSHIP T / 2Z&f___L_ Y_ MAILING ADDRESS B. OWNER OF PROPERTY 00% (Street, City, Zip Code) Name ADDITION C. SEPTIC TANK CAPACITY . ICC P-Gallons NEW INSTALLATION REPLACEMENT — No. of Tanks MATERIALS: Prefab Concrete 00000"' Poured in Place Steel Other ___; D. TYPE OF OCCUPANCY No. of Bedrooms One or Two Family Residence No. of Persons to be Accommodated - Commercial Industrial Other (specif y) E. APPLIANCES, ETC.: Food Waste Grinder —YES --A<NO Automatic Clothes Washer —YES NO D ishwasher YES --k—NO Other (Specify) /tyr 44F7 F. EFFLUENT DISPOSAL SYSTEM NEW 00"" EXTENSION _—, ADDITION —REPLACEMENT Seepage Trenches: No. Lin. Feet it —Trench Width Pepth Number of Lines Jf j5e#1 No. Lines Seepage Bed: Length Width Depth Tile Size ww Seepage Pit: Inside diameter Liquid Depth 4$11". 0/ direction G. Percent of slope of land _-0-5--e-10 # I r OV4 1. Tile Depth ---/A H. Indicate Slope of Land & direction of slope on sketch PERCO LATION TEST r— And Soil Type Indicate Soil map number Le I In h a e Test Time Drop In Water Level Inches minutes W t r Hours Water 1 r Nextto Last To Fall Test Depth Character of Soil Since Hole in Hole Interval Second to t Period Period One Inch S Wetted 1 Overnight in Minutes Last Period Las Number Inches Thickness in Inche 1 st coun and stallati permit recM in HOLES IN THE AREA IN WHICH THE SYSTEM IS TO -BE INSTALLED RECORD DATA FROM MINIMUM OF 3 TEST S 0 1 L B 0 R I N G S - Minimum 36" Below Proposed Absorption System Boring Total Depth Depth to Ground Water Depth to I Bedrock I Number Inches � Observed Estimated Observed Estimated 1 Character of Soil with Thickness in Inches I I I STALLED RECORD DATA FROM MINIMUM OF 3 BORE HOLES IN THE AREA IN WHICH THE SYSTEM IS TO BE IN (COMPLETE OTHER SIDE) Name of Owner — 7., JEAL_��'Lz MWEP let County Permit No. FPERCOLATION TESTS I t n . 'ftT 1, the undersigned, hereby certify that the Percolation Tests reported on this form were made by me or under my supervi-,,io in accord with the procedures and method specified in Section H 62.20 (3), Wisconsin Administrative Code, and that 'che dat recorded and location of test holes are correct to the best of my knowledge and belief. OW) ?011 4- r NAME _13xCV 17r Print) TITLE REGISTRATION NO. .__S, or MASTER PLUMBER LICENSE 0. 4) .1. 0 ADDRESS VJV DATE OF TEST SIGNATURE --------------------------------------------------------------------------------------------------------------- MASTER PLUMBER KING APPL.!§ --------------- -------------------- --------------------------------- ATIO MP Signature: License Number: MP RSW For: Provide sketch below of system (employer) (Include direction and percent of slope and all applicable distances) 20 PLAN VIEW (Locate Percolation Test & Soil:Bore Holes) 15, 10 5 0 5 10, 15, 20 25 PROFILE (Indicate Groundwater or bedrock where applicable) 2 3 5 71 $ilk 8 9 101 .Note: The -application -cannot-be -considered -for -filing -until-all of the -above quest -ions-are - answered -and the fee pa id Do not write in space below — FOR DEPARTMENT USE ONLY Date of Application Fees Paid State County Permit Issued/RtjZ&ed (date) - . I �_ Issuing Agent Name Inspection Yes No Valid No. Date Rec'd DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI. 53701 — Revised 4-1-73 /e i000. L Jul- % fs IVY, (AV i---- IFIr/ 414- /t- � Pk 6k7 y ea L-4i a 14001 ol --'- " - -t-'-- -- 4- -- - , _ _ � _. __ . A,� A f-I , "; t - u vrk/ ly '00