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HomeMy WebLinkAbout040-1125-30-400 (2)STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS -.�I& IV " _ C !% 15 LOT SUBDIVISION CSM# SECTION.,) T N -R- (W Town o f -re ST. CROIX COUNTY, WISCONSIN -0" 1 - .. \ il� Provide setback and elevation information on rev Provide 2 dimensions to center of septic tank m I PC,ile BENCHMARK:: hL f ALTERNATE BM: _SEPTIC TANK PUMP CHAMBER HOLDING TANK INFORMATION Manufacturer: &Is Liquid Capacity: Setback from: Well S& 4- House Other Pump: Manufacturer Model 7 P Float separation Gallons/cycle- Alarm Location SOIL ABSORPTION SYSTEM width : Length V,Number4 /S -7 of trenchers IV Distance & Direction to nearest prop. ;i �'-�; ,w from: well: House "', Other ij Building Sewer PC inlet Header/Manifold Existing Grade ELEVATIONS ST Inlet . ST outlet PC bottom Pump Off Bottom of system Final grade ­7 DATE OF INSTALLATION: 142'-f- I PLUMBER ON JOB: LICENSE NUMBER: 7 ?_q_ INSPECTOR: 3 / 9 3 t r"t. C 0 RU M 19 . 5) 2 2 V InAq On VNEV�V_b �5y STEM Labor and Human Relations INSPECTION REPORT Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Permit Holder's Name: D City E] Village [Town of: TRO A-% .1p-P. RTC14 TZD H 1,0TS J Y 777M Elev. Insp. BM Elev.: BM Description-. AN County- =-. Sanitary Permit No.: 1 A 93q 0 State Plan ID No.: Parcel Tax No-- 0 A 0 0 040—__L125-3 Lk TANK INFORMATION ELEVA I 1UN DA I A A _% -If _r " " " — 9 ZZ2 TYPE MANUFACTURER CAPACITY STATION BS HI ELEV. Septic Benchmark Dosing Aeratio-h— Bldg. Sewer <7 7 X41' 22- '. St Inlet Holding TANK SETBACK INFORMATION St/,,0f Outlet ?7o 6b qeO?- TANKTO P L WELL BLDG.ROAD Dt Inletj Intake 201, Septic NA Dt Bottom '>A - _ j NA , 76 Man. Dosi Ing Aeration NA Dist. Pipe / 6y/.' 7 Holding Bat. System PUMP StM*QU INFORMATION Final Grade Manufacturer Demand 1p Model Number GPM TDH Lift Friction S stem TDH Ft Ls5 �r6ad n Length ,4 ForcemaiDia. Dist- To Well"> SOIL ABSORPTION SYSTEM - BED/TRENCH width Length f No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS _7 I DIMENSIONS LEACHING Manufacturer: SETBACK SYSTEM TO P L BLDG WELL LAKE /STREAM CHAMBER Model Number: INFORMATION Type Of _217, - -11, /W_ -, , I 1 11 1 System: /'', I I' I q� _� I > &,", P 74- OR UNIT DISTRIBUTION SYSTEM r / Manifold Distribution Pipe(s) x Hole Size X Hole Spacing Vent To Air Intake Aivaile L e n g t h Dia- Length Dia- Spacing .-`� SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Dep Depth lth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed / T*ZgV�_Center B e d / �� g e s Topsoil LL>es No �s ❑No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: TRit OX 3 41 8.1j.52%2E,SW,SW, LOT 3F CO. RD. M,)6 � .� / �C�c'..•L'f� � . /�s 7 k" t5 1�e i IL Plan revision required? C] Yes Use other side for additional information. t SBD-6710(R 05/91) Date Inspector's Signature Cert. No- 4AAMCNXIMn M �1111 70ILHR SANITARY PERMIT APPLICATION 99�ff1=J0T1ftkUW In accord with ILHR 83.05, Wis. Adm. Code —Attach tomplete plans (to the county copy only) for the system, on paper not less than 8% x 11 inches in size. —See reverse side for instructions for completing this application. I. APPLICANT INFORMATION — PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION Y45UJ Y49 S T cD�: 45 PROPERTY OWNER'S MAILING ADDRESS LOT # So SS L,;,�+i� ic�aod LK'f' Pd 3 C�l I M M-1% 11 f% jr%L I i A &A r- CITY, STATE ZIP CODE PHONE NUMBER �OR CSM NUMBER 11. TYPE OF &ILDING: (Check one)[3 CITY El State Owned VILLAGE TOWNOF: nPublic L",Z'j 1 or 2 Fam. Dwelling—# of bedroom4, PARCEL TAX NUMBER(S)v COUNTY STATE SANITARY PERMIT # ElCheckif rwsi-ogn�t/ooprevious application STATE PLAN I.D. NUMBER 's g 3 - q0 169 � 9 No R BLOCK # NEAREST ROAD Ca i, gd, %V1' 111111. BUILDING USE: (If building type is public, check all that apply) O 0 _ ! /� � _ �� 1 LJ Apt/Condo 2 ❑Assembly Hall 6 ❑Medical Facility/Nursing Home 3 ❑Campground 7 ❑Merchandise: Sales/Repairs 4 ❑Church/School 8 ❑Mobile Home Park 5 ❑Hotel/Motel 9❑Office/Factory 10 ❑Outdoor Recreational Facility 11 ❑ Restaurant/Bar/Dining 12 ❑Service Station/Car Wash 130 Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. X New 2. DReplacement 3. ❑OReplacement of 4. ❑El Reconnection of System System Tank Only Existing System B) E]A Sanitary Permit was previously issued. Permit Date Issued V. TYPE OF SYSTEM: (Check only one) Non -Pressurized Distribution 11 ❑Seepage Bed 12 ❑Seepage Trench 13 ❑Seepage Pit 140 System -In -Fill Pressurized Distribution 21 X Mound 22 IJ In -Ground Pressure Experimental 30 El Specify Type 5. 0 Repair of an Existing System Other 41 El Holding Tank 42 1:1 Pit Privy 43 0 Vault Privy VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 12. ABSORP. AREA 13. ABSORP. AREA 14. LOADING RATE 15. PERC. RATE 16. SYSTEM ELEV. 17. FINAL GRADE qs-o 1 REQUIRED (sq. ft.) -5 -7 PROPOSED (sq. ft.) 2 -1 (Gals/day/sq. ft.) (Min./inch) ELEVATION 1 S' G 4)- <tl - 02�'- ot y I() 4t6 q Feet ic)(030 Feet V11. TANK INFORMATION CAPACITY in gallons New Existing Total Gallons # of Tanks Manufacturer's Name Prefab. Concrete Site, Con- Istructed Steel Fiber- glass Plastic Exper. App. Tanks Tanks eptic Tan r Holding Tank X W00 El F -1 D F -1 �MP�um Tan ioon Chamber A L8j r-1 , El El Vill. RESPONSIBILITY STATEMENT 1, 4e undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Pl4ber's Name (Print): Plu ber's SignatunE4'(N _%Stamps) MP/MPRSW No.: Business Phone Number: -ev PI tuber's Address (Street, Q , State, Zip Code): C±-J) IX. COUNTY/DEPARTMENY USE ONLY F1 Disapproved El Owner Given Initial Sa itary Permit Fee (includes Groundwater Surcharge Fee) Date ssued issuing A nt Signa pproved Adverse Determination X. CONDITIONS OF APPROVAUREASONS 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 sanitary pe rm it is valid for two (2) years. 2. Four sanitarr 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 submitted to the county prior to installation. 5. onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your vnsitewage system, contact your local code administrator or the State of Wisconsin, S4fety & Buildings Divisipp,.- 608-266-3815. . To be c"ete and accurate this sanitary permit application. must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is- to .be jnst4l led: II. Type of b"fjifding being served. Check 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 gallons, 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. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, 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 soil absorption system if required by the county;.: sod te4t-data on a 116-:form; and F) all sizing information. 1 GRGUNDWATE111 SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges 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 Western Regional, Office 2226 Rose Street LaCrosse, Wisconsin 54603 WEGERER SOIL TESTING & DESIGN Owner: RICHARD LEE BOX 74 23055 LITTLE WOOD LAKE RD RIVER FALLS WI 54022 GRANTSBURG WI 54840 RE: Plan Number: S93-40169 Gallons Per Day: 450 Project Names, LEE, RICHARD Town of TROY Date Approved: April 19, 1993 Date Received: April 15, 1993 Location: SW,SW,33,28,19W 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 upon 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: - NEW MOUND Inquiries concerning this approval may be made by callin(6 n - Sincerely, GERARD M. SWIM Section of Private Sewage Division of Safety and Buildings PPP039/0009n/25 cc., RICHARD LEE M01M A 0 5-931a, 8 z 0 C--)---4 ; M0X cn -< 7 73 LO X Private Sewage Consultant 5 HD .6423 (R. 0 1 /9 1) r Page � of b MOUND SYSTEM FOR A BEDROOM RESIDENCE LOCATED IN THE 1/4 OF THE SOU 1,/4 OF SECTION 33, T Z8N, R 19 W r TOWN OF _r `�>,.Q, , S-r. iC.. COUNTY, WISCONSIN. ThTnUV PAGE 1 of 6 TITLE SHEET FA GE 2 of b PLOT PLAN PA GE 3 of 6 PLAN VIEW -CROSS SECTION. PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of b PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURATE PREPARED FOR �zNcl VA Nam', LEG wge 2 la -W WE E=-:F-R E: F;Z �C3 3E 1___ TE=-:!ST T C 3 AND --+ F.G. Box 74 421 K. KAIK ST. RIVUF FALLS. Wi 54022 715_4�,s- IL " =-, : AR ; li.'_ R 4 aa�� sssc�easm t �� I G JOB NO . q Z Page -L of 6 PRIVAT Co, Es MWAM API DEPT. OF INDUSTI DIVISID 01 SEE a 11� C� CL NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. L4 required) 3. Install 4" observation pipes with approved caps. z required) 4. Septic tank to be \(3d o gallon capacity manufactured by V--� 1 � SE'R- 5. Bench Mark 6. Divert surface water around mound to prevent ponding at the uphill side. -) - L,-jLz'I-L bD q� VYr LLzi�--7 So' 1�T t-S-r 7-'-I, St��:T)C- -Mtort. Page 10.- of L Approved Synth� tic Covering Distribution Pipe Medium Sand -- Topsail F D 3 E EWAGE PRIVATE S % slope ConclitionallY Bed 0 f 2 Force Mc,n 2 Aggregate From PUMP AIJI)Ii OHS �Yl OE", CW 1141JUSTRYs LABOR & ""MAX OF WM Cross Section Of A Mound System Using Bed For The Absorption Area NCE SEE A 'Ek Ft. Linear Loading Rate='�-L GPD/LN FT B L4-7— Ft. Design Loading Rate= GPD/SQ FT Ft. Ft. Ft. G -.,.Elev- Plowed Layer D V o Ft. E Ft. F S Ft. G F t - H Ft. Plan View Of Mound Using A Bed For The Absorption Area End Cop (D Lost Hole Should Nexi To End Coy End Cop Perforated Pipe Detail 'Z� 0 End View )erforated WC Pipe Distribution Pipe Layout 'VATE SEWAGE SYSTEM (`-f')nditionally R011ED DEPT. OF INDUSTRY, LABOR & HUMAN REIATIONS DIVISION OF SAFETY AND SUI S SE CORR ?I N NCE Page �J_ Of j(a_ Install permanent -marker at end of each lateral Holes Located On Bottorn, Are Equally SPOCed P Ft. S L] Ft. X Y8 I n c h P,-:; y q8 Inches Hole Diameter )lq Inch Lateral I Inch(es) Manifold -L Inches Force Main -L Inches #of holes/pipe � Invert Elevation of Laterals JDY-Ij Ft. Place Ist hole ZLI" from center of manifold with succeeding holes at YS" -intervals. Last hole to be next to the end cap- PUMP CHAMBER CRO55 SECTIOM AMD SPECIFICATIOMS PAGE OF 4 C.I. VEKIT PIPE: Z!5' FROM DOOR, W1tiJDDW OR FRESH AIR WTAKE lkJ LE T APPROVED JOIN T/ LLLV, qs,-) s F T. .0..�- V C U T CAP WCATHEK PKOOF JukJCTIOU 60X 12-0 A I LJ. APPROVED LOCKING MANHOLE COVER WITH WARNING LABEL A GRADE 4 0 AIM. � � �� MIu. COWDUIT—o"�1 P PROVI E RC) PRIVATE SEWAGE ft)*T&SEAL conditionalli �� ALARM t:D IDEpT. OF INDUSTRY, LABOR HUMAN RELATIONS DIVISIO OF SAFETY 00 ILIDINGS u OFF SEE CO IDENCE IFU 9 so C0klCFLLTL f5LC)C.K APPROVED J0104" KISER EXIT PF.R M11TED OWL"J IF TAWS, MA)JU FACT U RFo-K HAS SUCH APPROVAL 5 PC-C, I F I C AT I C11 S DOSE TALIKA MALJUFACTUFLs:R4.-mw-ftw� KIF DO UMBER OSES: P L K DA4 TAWK : IZL: -ISO GALLOWS D05L YOLLIME AUU FACT U F: ALARM ML R TEM S IklCi-UDlkl& 5ACKFI-OW" 7Z-C�, GM.LONS MODLL WUtABE:R* Z, -LikICHES OK CAPACITIES-4 A —�6 1, - GALLOW5 SWITCH TtIFL: 5 = Z WCHESOK LiO4).G�LLOL45 ���AAJ NT 6 Pump MA0JUFACTURZR* C, IWLHES OR GALLOWS MODEL IQUM5EK'- D INCHES OR -z'>6c" GALLOMS 5WITCH TyPF.: MOTE: PUMP AKID ALARM ARC TO bE MIMIMUM DISCHARGE SAYE, ` �� .GPM IN5TALLLO ()Q 5EPkRAT�. CIRCUITS VLKTIC&L WFFLKLWL� C)LTWLLW PUr"\P OFF PiPL.. F E LT + mwoAUM KIETWORK SUPPL%J PRESSURE 2-50 FLLT + � S - FL ET 0 F FQ R c rL mAi m x ) F YlooFT.FKlCTl0" FALT06k- 0. Ll 16 FEET TOTAL OtIUAMIL HLAD FEE DIAMETER �& TtA"> DIMLWSIOIQOF TAwK: LEKA&TH -----.;WlDTH 6LIQUID DEPTH BOTTOM AREA 231- GAL/INCH f-0 GAL/INCH AS PER MANUFACTURERc) :� U7 I _ CCW .LLJ� 30' 8 25'- 20 (i} Z 0 4 J Q Q 10' 5' fl 77:1 $N(SE HEAD/CAPACITY CURVE MODEL 97 4 4 I 1 I ZH. a US 10 20 30 401 50 60 70 GALLONS LITERS 0 so 150 240 FLOW PER MINUTE TOTAL DYNAMIC HEAD/FLOW PER MINUTE EFFLUENT AND DEWATERING CAPACITY HEAD UNITS/MIN FEET METERS GAL LTRS 5 1.52 56 212 10 3.05 46 174 15 4.57 35 133 20 6.10 15 57 Lock Vale 23.75' (3 Cf= Ca 3 5/16 I' - 11 NPT CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available • Mercury float switches are available for controlling and supplied with an alarm. single and three phase systems. • Mechanical alternators, for duplex systems, are avail- • Double piggyback mercury float switches are available able with or without alarm switches. for variable level long cycle controls. Standard All Models - Weight 33 lbs. - 1/2 HP 97 Series Control Selection Model Volts -Ph Mode Amps Simplex Duplex M97 115 1 Auto 12.0 1 or 1 & 7 — ___ N.97 115 1 Non 12.0 2or2&6 3or4&5 D97 230 1 Auto &0 1 or 1 & 7 r__E97 230 1 Non 6.0 2or2&6 3or4&5 SELECTION GUIDE 1 Rntegral float operated 2 pole mechanical switch. no external control required 2. Single piggyback wide angle mercury float switch or double piggyback mercury float switch. Refer to FM0477. 3. Mechanical alternator 10-0072 or 10-0075. 4. See FM0712 for correct model of Electrical Alternator, -E-Pak". 5 Mercury sensor float switch 10-0225 used as a control activator, specify duplex (3) or (4) float system. 6. Four (4) hole "J-Pak" junction box. for watertight connection or wired -in simplex or 2 pump operation. 10-0002. 7. Two (2) hole "J-Pak for watertight connection or splice, 10-0003. CAUTION For information on additional Zoeller products refer to catalog on Combination All installation of controls, protection devices and wiring should be done by a Starter, FM0514, Piggyback Mercury Float Switches, FM0477: Electrical Alternator. qualified licensed electrician. All electrical and safety codes should be followed FM-0486: Mechanical Alternator, FM0495. Alarm Package, FM0513: and Surnpl- including the most recent National Electric Code (NEC) and the Occupational Sewage Basins, FM0487. Safety and Health Acl (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump l 3280 Old fillers Lane Manufacturers of .. . t; p- P. d. Box 16347 • Louisville, Kentucky 40216 ,. 502 778-2731 • FAX 50� 774-3624FINZIff �9 i l' 119.4 r ,c5 7 Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page N of Z Labor and Human Relations r Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY �X Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but COUNTY T' PARCEL I.D. # not limited to vertical and horizontal reference point (13M), direction and % of slope, scale or dimensioned, north arrow, and location and distance to nearest road. 3 - 3 0 APPLICANT INFO RMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE IPROPERTY OWNER: PROPERTY LOCATION F. \ Q�\ N zbt.. v► SVI--S 1/4 'SW 1/4,S 3,1 T -Lla N,R l C1 E (ore PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SURD. NAME OR CSM # ZIO.SS �.ITJ-LZ 7S C-S" UOL. ­71 CITY, STATE ZIP CODE PHONE NUMBER [:]CITY [:]VILLAGE OTOWN NEAREST ROAD W I Sq�?qo (-))SI 8 8 9 - -2-)ql 1 e_'* . 't-j . New Construction Use Residential / Number of bedrooms AdditiQn to existing building Replacement Public or commercial describe Code derived daily flow L150 gDd Recommended design loading rate <3, q bed,gpd/ft2. trench, gpd/ft2 r- - Absorption area required bed, ft2 3-i 5 _trench, ft2 Maximum design loading rate - bed, gpd/ft2 trench, gpd/ft2 Recommended infiltration surface elevation(s) 1 ft (as referred to site plan benchmark) Additional design / site considerations Parent material L Qs'�s s Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL MOUND IN -GROUND PRESSURE AT -GRADE U = Unsuitable for system EIs 0 U 2S EIU Os RU El S 0 u SOIL DESCRIPTION REPORT Boring # Ground elev. 0 ft. Depth to limiting factor " I " Boring # Ground elev. ft. Depth to limiting factor SYSTEM IN FILL HOLDING TANK El S [ffU El S �T U Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont Color Texture Structure 'Consistence Gr. Sz. Sh. Bouirchry Roots G P D/ft2 Bed Tud V I- -W At/ TTZ VQ r L C fl�'*7t UQ C Tr 143 3*r 1�� �J S kT-P - Remarks: Ulm Is =mom Remarks: :ST Name: —Please Print Arthur L. Wegerer Phone:.715-425-0165 �Idress: egerer Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022 .1. 5ignature'. Date- R CST Number: 1�3 Y--1 136Z *Z) M00576 PROPERTY OWNER SOIL DESCRIPTION REPORT Page of, * i PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bou Roots O P Dlft in. Munsell Chu. Sz. Cont. Color Gr. Sz. Sh.Y Be d T r+ench .'y Ground elev. ft. Depth to limiting factor Remarks: Boring # i� : . :S '�y�y.•�ti y1�ti Yti Z S'L.' Ground elev. ft. Depth to limiting factor Remarks: Boring # I " Lt�S•. �L � f rr L ti.•�. LtiHL4•.�i•��: . �.: �i7r Ground elev. f t. Depth to limiting factor Remarks: Boring # Ground ' elev. : ft. Depth to limiting factor Remarks: SBD-8330(R.05192) PLOT PLAN SCALE 1 Page of 2- Nr�t,�USq ptv,3*,C� '7 LOO �XM-VA �s r U C'n A. r LwL q-) ef E40 -T r. 1-1 z 9 C? CST Signature Date Signed 7C SIB 21 -1.11,11, ................... I-- C) I M-I� 715 42-5'--Ol 6 1 M00576 Telephone No. CST # rJ_MEN_1_ OF 1:1 11A%ND HUMAN RELATIONS REPORT — ON SOIL bURINUb ANU DIVISION P.O. BOX 7969 PERCOLATION TESTS (115) MADISON, WI 53707 (I LH R 83,090) & Chapter 145) LOT Na.:SUBDIVISION NAME: UM14b"I LOCATION: SECTION: I 1�= UNICIP Ll I T 1/4 �Aj 1/4 -3, T R 19 E (o C!- !E� :C) U� M E R! MAILING ADDRESS: WNE UYER'S NAME: COUNTY;. DATES OBSERVATIONS MADE USE FILE DESCRIPTIONS: ERCCL,121, 0 TESTS: IRR I IS, 4,L DESCRI 7BEDR COMMERCIAL PTION! LKIN e W ❑ Replace Us � cIiNj S ►00 RATING: S= Site suitable for system U= Site unsuitable for system CONVEN - TIONAL: MOUNT I IN -GROUND -PRESSURE: ISYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) [� S r\2u S ElU El S MU 1:1 S 'GU Q S.1�v- If Percolation Tests are NC'! required DESIGN RATE: If any portion of the tested area is in the under S, ILHR 83.09(5)(Izi), indicate YN-2i * J��\ - I Floodplain, Indicate Ficociplain elevation: PROFILE DESCRIPTIONS B 0 RING BORING TOTAL TOTAL DEPTH TO GROUNDWATER -I -E CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER U BER NUMBER DEPTH Pt, DEPTH ELEVATION OBSERVED EST, HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV, ON BACK.) G y S' T Ts i 2 "B Y, S i � Z. 1 P�r Z - 6 'Z� EYJ S Y-� —a C>' `7 p1rL �Y 5 1 _FS ?�)'n B- PERCOLATION TESTS TEST NUMBER _LITNC_HEJ P P- P - T H DEPTH DEPTH INCHES j WATER IN HOLE WATER 7 ERSWELLING AFTE _ RSWELLING TQ� TEST TIME INTERVAL -MIN, 7's Q) DROP IN WATER LEVEL -INCHES RATE MINUTES PER INCH Z Z­7 PERIOD i S 0. P E R I Q Q 2 s 1 f (� PERIOD 3 1 l P_ P_ P_ PLOT PLAN: Show jocat!".;ns of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori, zontal and vertical elevaiic')-) 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, �o )D j Aj cs is I SYSTEM ELEVATION V — L eV r S tN ors )I-_ r= F3 - V-1 M 7­ - ------ T_ 60 sic, 3 1, the undersigned, hereb4 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. NAME (print): t-AJ C—G TESTS WERE COMPLETED ON: ADDRESS x. ZZ CERTIFICATION NUMBER: PHONE NUMBER (optional): S� L4 Z_S_ 0j LAJ CST SIGNATUIRE: DISTRIBUTION: Original and one copy to Local Author ityi-Property Ow�er and Sol] Tesw, DILHR-SBD-6395 (R, 10/83) OVER — 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 pormit issuance, Should this development be intended for rpqnln h%? rAUSF I L E- D 5 80 IS of CONNELL 440978 do co RjgIjjw of Doodo crols CM01y, , WLW=�Xmk t�v", CERTIFIED SURVEY MAP -I- -\ LOCATED IN THE SWI/4 OF THE SWI/4 OF SECTION 33, T28N, R19W, TOWN OF TROY, ST. CROIX COUNTY, W I S C 0 N S I N - OWNED BY. -t�-rV TOM 8 SUE OURMOOD z%vf/4 COF?fIE17 SECTrotl 33. V PT. 3 iCOLIPIF)' MON MENT FOUND) NNE U N P L A T T E D L A N D S RivEr? rALLS, %VI 5-1022 NORTH LINE OF TI4F 5 w S W 5 8 9 3 7 30 W 13 1 8 . 05' 5' � 7 -J, Y4 3 5 8 . 0 5 7 4 0 0 0 22 0.00 D. 43 Oti CD hn LOT 2 0 7. 14 A C R E to (n z S 1 3 10 , 9 14 S 0, FT.) L,_ OT 3 to Q. o.7- 16 ACRES 47 13 12 , 07 7 SO, FT.) co 1 C\j h > W E N 3 T 2 5 3 3" W S 63 3 6 180.001 E 510.8f; 0 4 fence ?r Co LOT I �° LOT 4 a tn 11.40 AC RES I ti 3(\j�. 1627,45A SQ.FTA 1.56 ACRES Cn 0 13, 19 AC. EXCLUDING ROAD O 1 98, 722 SO.FTA 0 W (574, 603 SO. FTA J. TO x 8 E a. U. 0 (Dow N890 39' 05" E Gal. 2 11 0 z L1 " - 1) SEE NOTE: , ul ON ON SHEET: 3r 3 2 OF 3 RT I F 1 E 01 S R ,, E y .44.t P . . . . . . . . . . . . . d. T Uj tn 0 66' WIDE ROADWAY - a EASEMENT. - ----15- Np _ a ........... I S FE NOTE SHEET 2' OF 3 66, 2 0 0. 0 G 2 13 - r- �W. �26 - Q'— N1313"00'40" E N89c'26' 40"E 2 79.68'10 —C —.T—.H— N 139 0 2 6 '40 E 1 5 6 14 SEE DRIVEWAY AGREEMENr ON SIfEE T 2 Of 3 Z Uj cc) /VS, 0 = SET 1"s 24" IRON PIPE WEIGHING 02 / W-A"VED Aj Wn 1.13 LOS. PER LINEAL FOOT. tn z = I" IRON PIPE FOUND. AUD 3 0 M8 JAMES M. wo WEBEn JAME3 I M."'/ WEBEF1 z S M-,.D( com ry S - IB04 t 'i nj (A SKIING VALLEY WIF PJ eb WIS, 3t NOTE: BEARINGS ARE REFERENCED TO✓C • TIIE WEST LINE OF THE SWI/4 df TEASED ON RECORDED BEARINGS). 44/ P- O-L,—.- -; 10 S U % SCALE 1 2 0 0 JAMES M. WE"ER S-11904 — 71 DATE WEGERER, WEBER a ASSOC, SHEET E E T 1 0 F 3 1) Nq�.'c\ k,B- 0 100 200 40 W REVISED Jw A--,�—x6, ( 9 -�5 8 a ea 22 THIS INSTnUMERr DRATTED sy &WL-a-latotfloss-, V6Wff 7 PAGE 2017 S T C. - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER Richard H. Lee ADDRESS �16 Coun:Ly--Rds M FIRE NUMBER- 516 CITY/STATE ZIP �0�� PROPERTY LoCATION: S-1jV 1/4,r SW 1/41 SECTION-33. T28 N-R19 �w TOWN OF --Trc)y r St. Croix County, SUBDIVISION C S I M.Zk�'7 LOT NUMBER. 3 I L011 Improper use and ma.J-ntenance 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 pumper. What I 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 60% 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 198o, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification 'form, signed by the owner and by a matey 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. I/lie, 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 DNR, Certification stating that your septic has been maintained must be completed and returned to the St. Croix co. Zoning Officer within 30 days of the three year expiration dat SIGNED: DATE: St. Croix co. Zoning Office 911 4th St. Hudson, WI 54016 TWS SPA I RE,4ENVED tuft IRE -J)PO' N4 DADA DOCUMEN1 NO WARRANTY DEED STATE BAR OF WISCONSIN FORM 2-1982 fit 977 30000 490639 REGISTERS OFFICE mood,. ST. C"X C0.8 NM Dwayne Thomas, Burmood and Maryp.uer . Bu . _ ._ _ . . . i hed 6 Remd Husband and. Wi,f-e, and each in his - and -,o-r own _r ight I ! OCT 2 8 1992 conveys and warrants to Richard H. Lee_ -an.d.. L.o Lee,, A. is J. 8:45 Husband and..Wife,.holding as survivorahij,. marital property.- ts&w of D"& RLTtjRN TO .......... ... . ...... the following described real estate in St Croix. ...... ...... ...... County, Mate of Wisconsin: Tax Parcel No: ................ ......... Lot Number Three (3) of that Certified Survey 'Kap as recorded in the office of the St. Croix County Register of Deeds, in Volume 7, rage f the Southwest nt No. 440978, as located in the Southwest Quarter o 2017, as Document -Three (33), Township Twenty -Eight (28) North, Quarter (SWISWO ©f Section Thirty etual W1. Along with a perp Range Nineteen (19) West, Town of Troy, St. Croix County, vehicular easement for ingress and egress over that 66 foot wide roadway which services, This deed is given in full and final satisfaction of that certain Land 90Contracatt between the -arties, dated December ZED, 1 990, recorded December 26, 19, 8:30 A.M., in Vol. 889, Page 244, as Document No.465125, Office of Register of Deeds for St. Croix County. the property and is more specifically described on the above stated survey map. Stare of \A[isconsin County of St. Croix I hereby certify that this instrument is a ft., true and correct COPY of the document on f i �R,, A N 1,� FEh and of record in my office and has bee2 -57*01 compared by nm FEE a rc h-..24 19 93 This nQt- ------ homest(:!ad property. James O'Connell Register of Dee +�`� / (is) (is not) James O'Connell Register of Deeds Exception to Easements, warranties.* restrictions, and rights -of -way of record, if a 26th day of Dated this - ----- ....... (SEAL) ---- ------------- (SEAL) AUTHENTICATION Dwayne Thomas Burmood . . . ................... Signature (3) of Dwa ---------------- and Marysue Burmood ----------------- - ------------- - Marysue f..Octok>er aut sated this -------- Ay . ......... ......... ., 19. 9 2 *-a I ------------- .._..., 19.92_ A. Beskar ­------------- --------------------------------- ­- ­ ....... - TITLE: MEMBER ,STATE BAR OF WISCONSIN (If not, -------------------------------------- ----------- --------- authorized by j 706.06, Wis. Stats.) October, 19 92 . (S E A L) Dwayne Thomas Burmood (SEAL) marysue Burmood ACKNOWLEDGMENT STATE OF WISCONSIN I N ss. ........ .... County. � Personally came before me this day of 19__------ the above named ------- ----------- _ ------------ ----------- -- .......... - -------- ------­---- --------------------- --------- - ------- ......... ----------- --------- ---- ------- ----------- ­1 ------ ----------- to me known to be the person ------- - w�o executed the foregoing Instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY ------- ------ Leo A. Beskar�_ -------------------­-------- 0 - --- --- I - - ...... ....... . ..... Rodli., Beskar & Boles, S.C. ---------------------- Notary Public ---- --- (-ountv, Wis. ----- River- - F-alls'. .1ft--540-2-2 ---------- - My Commission is pernianent.(If not, state expiration (Signatures may be authenticated or acknowledged. Both 19 are not necessary.) date: -------- - --------- ---------- - *Names of persons signing in any czPatitY should he tyPtl or printed b0ow crew �-4n%turt,4. WISCLosin Legal Blank Co Inc WARRANTY DEED STATE BAR OF WLSrJNSIN Milwaukee Wisconsin F0FLK Na. 2 -- 1182 ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, W1 54016 (715) 386-4680 April 1, 1993 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An onsite investigation of the Richard Lee property, located in the SW 1/4 of the SW 1/4, Sec. 33, T28N-R19W, Town of Troy, St. Croix County, has been conducted with the assistance of Art Wegerer, CST #576. This onsite revealed 2.1 feet of suitable soils. This site should be suitable for a mound system. Should you have any questions, please feel free to contact this office. Sincerely, Thomas C. Nelson Zoning Administrator cj ST. CROIX COUNTY WISCONSIN ous ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET 0 HUDSON, WI 54016 (715) 386-4680 March 23, 1993 Division of Safety and Building Bureau of Plumbing P,O, Box 7969 Madison, WI 53707 To whom it may concern: Cow An onsi m te investigation of the ToBurmood grope ty located in the SW 1/4 of the SW 1/4, Sec. 33, T28N-R19W. Town of Troy, St. Croix County, has been conducted with the assistance of Art Wegerer, CST #5760 onsite evaluation revealed established high water table at 2.1 feet and zones of saturation at 2.6 feet. This site should be suitable for a conventional mound system using 1 additional foot of state approved sand* Should you have any questions, please feel free to contact this office. Sincerely, Thomas C. Nelson Assistant Zoning Administrator cj DEPk NCR RREPORT ON SOIL BORINGSAND L,akN F�NTOF , AND W PERCOLATION TESTS (115) HUMAN RELATIONS (1LH R 83.090) & Chapter 145) SAFETY & BUILDINGS DIVISION P.O. BOX 7969 MADISON, W1 53707 LOCATION: SECTION: OWNSHLEAAUNICIPALITY: LOT NO.: BILK. NO.:JSUBDI VISION NAME: S tA,) '/4 S, W 1/ -3 -_:� /T zA / R 19 E (o T;P-Z1--r _�S I (2. S " COUNTY: U5F_ DATES OBSERVATIONS MADE NO_BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: �iesldence �� P\ KNew D Replace I � �k t � RATING: S= Site suitable for system U= Site unsuitable for system T1-: wy 'fesx, K3 Q-LZ vo ONJ S - Z V - 8 '0 CONVENTIONAL: [:]STIONAL: MOUND- IN_ -GROUND-PRESSURE: SYSTEM-IN-FILLIHOLDINGTANK: IRECOMMENDED SYSTEM: (optional) r_7­3 2 U S Lj S ZU S Q Ul - QU El S mil! C0,3�_);6-t I G F1 G �ok_)#%j P5 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: IN- Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING NUMBER TOTAL DEPTH M ELEVATION DEPTH TO GROUNDWATER-INC+feS- OBSERVED —EST. HIGHEST CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH BEDROCK IF OBSERVED (SEE ABBRV. ON BACK,) B- Lj I 1 0,9 ' Z�� czly 712 -S ; N .1 13q S 0 �er-j SE� s I \4 , an 's I -B- L4 P�T 2 .9 . 0 1�� �t Ca- %y, 'S TS '1 7. 0 / 13 YN S F3 S QQSIE:� I QNwjt 1`3 -:- c>.-)' t�At 6-Ly TS ; 1 - S' 'a-Asj 1 ; , y' 3 r� s B- B- B- PERCOLATION TESTS TEST NUMBER DEPTH INCHES WATER IN HOLE AFTER SWELLING TEST TIME INTERVAL -MIN. DROP IN WATER LEVEL -INCHES RATE MINUTES PER INCH PERIOD 1 PERIOD 2 PERIOD 3 P_ 7 -Z r__21 1;4 1 t )51/6 P- 1 1(3 S I Lb 1 >>y Illy P_ P_ P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimen 5jons of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on thXplot plan. Show the surface elevation at all borings and the direction and percent of land slope. �sL C) Q T ES P,- � k- SYSTEM ELEVATION 61 0, S. S, 0 OF "7 H(� QC- OF -Pia Sw //V SLAJ C9 Lo M OU)',Xtj - lopJ 12��L 11:� e G�7 F� r L LZIV3 7- S a t N A J V !SC/k LC- I"= 60 ' S e C, 33 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 - DEPARTMENT OF INDIJ T`�I, LpP,DR AND HUMAN RELATIONS REPORT ON SOIL BORINGS AND PERCOLATION TESTS (115) IILHF 83.09(l) & Chapter 1051 SAFETY & BUILDINGS DIVISION P.O. BOX 7969 MADISON, WI 53707 LOCATION: SECTION: OWNS UNICIPALITY: LOT NO.: BLK. i'0 SUBDIVISION NAME: 1/4 1/ — Tz /R E c w R COUNTY: WNER' UYER'S NAME: MAILING ADDRESS: _ys -,Q1�- -� DATES OBSERVATIONS MADE USE .Asidence NO.BI;DRMS.: '� COMMERCIAL DESCRIPTION'. New Replace PROFILE DESCRIPTIONS: _ PERCOLATION TESTS O TE w `f f c-r 1 �� i s apt cv S_ �- RATING: S= Site suitable for system f~: NV-ENTIONA.L' MOUND' 1VEU"UL�U U= Site unsuitable for system IN-GROUND-P(RREESSURE: SYSTEM-INN--FILLIH OLLDII TANK: RECOMMENDED SYSTEM::(op?ional) _,�FI ����`� `a,�"�'1 ESa U S t� i`�� f 1 ._ If Percolation Tests are NOT required DESIGN RATE i under s. ILHR 83.09(5)(b), indicate. PNIN� If any portion of the tested area is in the Floodplain, indicate Floodpiain elevation - --- PROFILE DESCRIPTIONS ,BORING NUMBER TOTAL DEPTH M�ZI., ELEVATION DEPTH TO GROUNDWATER-I OBSERVED EST. HIGHEST CHARACTEH UI- SUIL. WI I H I HIUNINtbb, �u�vrs, i LA i Urir, IA NU Utw l H TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) ' 1 �� Z.r a,g1 Uri i %.,e 5�• 's ; 7- 0 IBYS s,`1 c, DVc CiY s i ; 7S ; 1 • S ` 'Z A s 1 ; 2. L/ s } B B- TEST NUMBER P- P- P- P- P- P- rtKGUCH I IUIV I cZ)I a DEPTH INCHES WATER IN HOLE AFTERSWELLING TEST TIME INTERVAL -MIN. DROP IN WATER LEV - (;Hco RATE MINUTES PER INCH PERIOD 1 PERIOD2 PERlOo 51/6 30 SIL6 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 slopz. � C+U►J�j CJ� S � G1tiJ SYSTEM ELEVATION 1T-e- so' S. 2T IS S, Q w ���Sl'j f!y - SLV � /p,3 a• 1 va,iiEE rat PrT Ltd S T. 2.S 1 [S a Y^►ov�b. W L l� t3r i_tm r so' +� �tN 11t= 60' S EC :2t3 I, the undersigned, hereby certify that the soil tests reported on this farm were made by me in accord with the procedures and methods specified in tier 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 (print): ��� TESTS WERE COMPLETED ON: EE� Z, __ ___ — -� — ) ) - ? ? x. �CERTIFICATION NUMBER: PHONE NUMBER(optional): CST SIGNATUR : DISTRIBUTION; Original and one copy to Local Authority. Property Ow�er and Soil Tester, DILHR-SBD-6395 (R. 10/83) OVER