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HomeMy WebLinkAbout040-1188-90-008 (2)E S T C - 104 AS BUILT SANITARY SYSTEM RETORT OWNER_-- A-C � TV U(C-�-f�"wLC',5IN VV ADDRESS J(J1 3 Supc�U1Dn R► w- �d� r-0-��. SUBDIVISION CSMV LOT 'i SECTION.7 T.- 41 -Z�N- �W, Town of ST. CROIX COUNTY, WISCONSIN Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manliole cover I BENCHMARK: ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / IiOLDING..TANK INFORMATION Manufacturer:_ (.4 Liquid Capacity: Setback from: Well House- 2 Z r Other Pump��cturer _ Model# Size Float s ration Gallons/cycle: Alarm cation -:'SOIL ABSORPTION SYSTEM Width: Length Number aft tr enches Distance & Direction to nearest prop. line: Setback from: well: NAHouse -5f Other Building Sewer PO inlet Header/Manifold Existing Grade DATE OF INSTALLA PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: 3/93 : jt r ELEVATIONS ST Inlet; ST outlet PC bottom Pump Off Bottom of system Final grade v c.3 6 1 T 2 8 PRWAA Five). Labor and Haman Relations INSPECTION REPORT Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION TANK INFORMATION TYPE MANUFACTURER CAPACITY Septi c Z ao Dos in ig/'O� 6/ Aeration Holding TANK SETBACK INFORMATION TANK TO P 1 L WELL BLDG_ Vent to Air Intake ROAD Septic .�. NA D©sing NA Aeration Holding PUMP/SIPHON INFORMATION SOIL ABSORPTION SYSTEM DISTRIBUTION SYSTEM SOIL COVER ELEVATION DATA A9300133 8' x Pressure Systems Only xx Mound Or At -Grade Systems Only COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: NW NW,Sec.36,T28,N—R19W 0 � �2�:a�1 �ielL (Woodridge ` r 5 SBD-671 d (R 05/91) Date / in pecto Sig }a�urc 7P>u�tt RANITARV PFRUIT APPI lr.ATInN �ILMR In accord with ILHR 83.05, Wis. Adm. Code COUNTY 54— CR-oo /K —Attach complete plains (to the county copy only) for the system, on paper not less than STATE SANITARY PERMIT # 1 73 8% x 11 inches in size. 0 Check if revision to previous application —See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION — PLEASE PRINT ALL INFORMATION. PROPERTY OWNER r*J IC lta4, WIZ— PROPERTY LOCATION W14 3 /c/ r 62,44 e�5 N S IN, R E (or PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # CITY, _^ 0 Ic jum ZIP CODE NE NUMBER PHONE SUBDIVISION CSM I)kUMBER _NVE OR 11. TYPE OF BUILDING: (Check one 0 Cl NEAREST ROAD State Owned Q VILLAGE : —M 6 Z► nF. E]Public [filor 2 Fam. Dwelling- # of bedrooms.— PARCEL TAX NUMBER(S) 111111. BUILDING USE: (it building type is public, check all that apply) 6)01 1 El Apt/Condo 2 El Assembly Hall 6 El Medical Facility/Nursing Home 10 El Outdoor Recreational Facility 30 Campground 7 E Merchandise: Sales/Repairs 11 El Restaurant/Bar/Dining 4 1:1 Church/School 8 0 Mobile Home Park 12 El Service Station/Car Wash 5 El Hotel/Motel 9 ❑ Office/Factory 13 El Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) rV9 A) 1. ^ New 2. ❑El Replacement 3. ❑El Replacement of 4. El Reconnection of 5.0 Repair of an System System Tank Only Existing System Existing System 13) ❑0 A Sanitary Permit was previously issued. Permit # Date Issued V. TYPE OF SYSTEM: (Check only one) Non -Pressurized Distribution Pressurized Distribution Experimental Other 11 Dq Seepage Bed 21 0 Mound 30 E Specify Type 41 El Holding Tank 12 C! Seepage Trench 22 El In -Ground 42 0 Pit Privy 13 El Seepage Pit Pressure 43 El Vault Privy 14 1:1 System -In -Fill V1. ABSORPTION SYSTEM INFORMATION: 'm Al 1 - GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE A 1 L P_G REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/dav/sq. ft.) (Min./inch) ?I ELEVATION .0-OW46 J.0 1 7eet ?,,5-i57Feet V11. TANK V11. TANK NFORMATION INFORMATION CAPACITY in gallons Total Gallons # of Tanks Manufacturer's Name Prefab. Concrete Site Con- Steel Fiber- glass s Plastic Exper. App. New xisting Tanks Tanks strutted Septic Tank or Holding Tank /6-&ry W &�< Lift P amber L FT__ F-1 El El F-1 Vill. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumjker's Name (Print): Plumber's Sig ture: (No Stamps) MP/K4P5*WNo.: Business Phone Number: L 4 PluM!56—r's Ad-dr (Street, City, State, Zip Code): tkl) I of/ LL11 � IX. COUNTY/DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued suing Agent Signature (No Stamps) Surcharge Fee) ,vApproved F-1 OwnerGiveninitial 0//49po I Adverse Determination. X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: (7 L SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber S T C M- 100 'I'11is c-l"licc-ttion form is to be completed p eted in full and signed b t}�n oc,�llcz (;;) of the Property being Y wild. one Y result i n delays Y q developed any inadequacies of the permit issuance. Should this deVeiopmer�t be intended for resale b ow ?louse) , then a second form should be retained , rter/contractor, (spec the proper: ty is sold grid submitted and completed when to this office with the appropriate deed recording. r - r - r - r --- r r r r- - -- - r- :..err � �r.r w.Y�w-------r-w- w Owner of property a !. T-Vl,�°��-ram Location of property_/d1/4��1/41SeCt�oir TN R W Township v Hailing address Address of site subdivision name �Q � ��� �; �2 -�' Lot no , S17 Other domes on property? es Y No Previous owner of property C `0 Total size of parcel, Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property beidevelopedfor (spec ng s %%//��,, � P house)? Yes No volumeL�_tknd Page Number �» of Deeds. as- recorded. with the Register r ... - - sr r .... -«r r r. - rwE rr -r.r rr-.•..r .ram rw-+w.. - w,r..r ... r�r� . ....----.r w. --.s.r wrwr------_�_ INCLUDE WITH THIs APPLICATION 'T"11E ECLL4WI1lG; `�r'111Z�t1Lt�'.t'Y DL:ED w)I icll includes a 1 4CUHT;N� NrOL 11UMBI 11 t THE, SEAL OF THE. REGIS11" �,1� OF DEEDS. VOLU1`�F 1�tD PAGE certi f icci sur ve . In addition, a y, if available; ;would be helpful so as to avoid delays of the reviewing process. old reference ; If the deed description to a certified survey Maps the certified curve shall also be required, Y Map PROPMUY OWNER CERTIFICATION .I(we) Certify that all statements on this fo Lest of ny (Our) }�. rm are true to the knowledge that I (we) am the Property descril.)ed in t1lis information to e) the owner (s) of Warranty deed recorded rm, by virtue of a n the office of the CountyRegister of Deeds a ; Document no. own the proposed site for hie sewage? disposaland that rI (we) j presently obta'lied 311 easement, to run the above described system or I (we) ) ttte construction of said system, and the bed property, for recorsame de LL117o ie f f ice of County Register of deeds s been duly No. as Document (-it sit3 (i gnature of a: �t�� • CO -applicant -- W 12- q-� Date of Signature Date of signature DOCUMENT NO STATE BAR OF WISCONSIN FORM 2-1982 WARRANTY DEED 1016PAu 359 Rolling- Hills Development, a Wisconsin corporation conveys and warrants to.., .Euzene 0. Larson, Don D. Kruzer,__ and Lawrence M. Johnson, Jr., dZbZa Qualm Built Homes T"iS SPACE HESERVED FOR RECOHDING DATA REGISTER'S OFFICE ST. CROIX CO., W1 Rec'd for Record J U N 17 1993 at 2: 00 P . � (T M Register of Deeds RETURN TO I the following described real estate in S t • Croix County, 1i_-._-. State of Wisconsin, Tax Parcel No: Lot Sixty -Eight (68), Oak Ridge Acres to the Town of Troy. 17, F"z, E This is not —homestead property. (is) (is not) Exception to Warranties: easements, restrictions, and rights -of -way of record. 7' Dated this d a y of J XULL H I M, (SEAL) • Richard N. Fox, President (SEAL) (SEAL) • Frances J. Fox, Secretary AUTHENTICATION Signature(s) Richard N. Fox and Frances J. Fox authenticalet) this/ 7-j-'- y of June '19 93 OC. L. Ga ord TITLE.- MEMBER 9TATE'B-AR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) THfS INSTRUMENT WAS DRAFTEE) BY C. L. Gaylord, Attorney River Falls, WI 54022 (Signatures may be authenticated or acknowledged. Both are not necessary ) ACKNOWLEDGMENT STATE OF WISCONSIN Ss - County, Personally came before me this day of 19— the above named I to me known to be the person who executed the foregoing instrument and acknowledge the same. Notary Public County, Wis. My Commission is permanent. (If not, state expiration date: 1 19 'Names of persons signing in any CapaCdSr-Qu;a be lypeo or prinled below tne+r signatures $B2 NTIF 0021 WARRANTY DEED STATE BAR ©F WISCONSIN Nelco Tax Forms, P.O. &-,x 10208, Green Bay, W1 54307-0208 Form No 7 — 1962 "Ely-UC TA14K IaINTMWIcE AGATZL­. Ste Croix County 0 �114 LE, R 13 U Y E R_ T_ UltT ADDRESS: 19 1 R E No • LOCATION: 11 �R 1_/UCA­'/ _1/41 SEC* -2 2: TOM4 OF: ST&-CROIX COUNTY SUBDIVISION: LOT NO. Improper use and maintenance of your septic system could result f 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 you L."Ut into the system can affect the function of the septic tank as a treatment stage in the waste disposal system; .'3t. Croix County residents may ire eligible to receive a grant to 1401P with the cost of the repl .�,ement of a failing system, whicil was in operation prior to July 11 1978o St Croix County accepted this program in August of 19so, with the requirement that owners Of all new systems agree to keep their System properly maintained, The property owner agrees to submit to the 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 6 P I G .1 ' n proper operating 'condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certif lication f ram 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, ;is set by i-he Wisconsin D11R, Certification form must be Completed and re %.%,-rned to the St. Croix County Zoning officer wit,,?', .30 days q)f the th a year Lilfhpiration date, r SIGNED :�­ DATE:- t. Croix county Zoning office 911 4th Sto Hudson, WI 54016 Wiscopsin Department of Industry, SOIL AND S1 _rE EVALUATION REPORT Page of __ labor 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 St Croix PARCEL I.D. not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or dimensioned' north arrow, and location and distance to nearest road. APPLICANT INFORMATION --PLEASE PRINT ALL INFORMATION REVIEWED BY GATE PROPERTY OWNER: PROPERTY LOCATION k GOVT. LOT NW 1/4 NW 1/4.S 36 T 28 N,R 19 ND(X) Richard Fox PROPERTY OWNER':S IAL©T AILING ADDRESS BLOCK SU60. NAME OR CSM;;oak Ridae Acres 84 Woodr 68 1 - CITY, STATE ZIP CODE PHONE NUMBER >EggXy0otl�AM [SOWN NEAREST ROAD River Falls WT 54022 (715 425-2100 Woodridge Drive. Now Constjruction Use )4 Residential Number of bedrooms 3- Addition to existing building Replacement Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate 4 bed, gpd/ft2l . 5 trench, gpdJft%_ Absorption area required 1125 bed, ft2' 900 _ Vench, ft2 Maximum design loading rate 'bed, gpd/ft2 Uench, gpcwl" Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) elevatic 1 cant more rock is needed to meet state code & system Additional design / site considerations S Flood plain elevation, if applicable ft Re2lacement will have tQ-be a-maind AT -GRADE SYSTEM .(N FILL HOLDIIIS"- JAJr' S Suitable for system CONVENTIONAL MOUND IN -GROUND PRESSURE El S U, U Unsubble tors stem 91 S [I U Ki S 0 U 91 S 0 U (N ❑S C1 U c S U SOIL DESCRIPTION REPORT Structure G P D,1 f Depth Dominant Color Moues Texture Consistence Bojrc�iy Roots Boring # Horizon in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed i 1'fLi xj . ..... if .5 1 0-23 10YR 3/2 None sit 1 m sbk mfr as _1.6 1 m sbk Mfi gs if .5 1.6 2 23-48 10YR 4/4 None sil Giound 3 48-77 10YR NP_ NP-.- 6 c2d C1 0 = M mfr C-Ts T gs NP NP fif 1s qr 0 m s mvfr 94. 0-9t. 77-10 10YR 6/6 mfr 4 .,5 Depth to 5 100-1 0 10YR 6/6 None is gr 0 m s9 111111ting lictur Remarks: Boring 0-13 1 OYR 3/2 None si 2 m sbk mf r as 1 f • 5 2­ 2 13-42 1 OYR 4/4 None sil 1 m sbk Mf 1 q 1 f .5 �_ .......... 3 42-57 10YR 5/6 c2d C1 1 m sbk- Mf i NP NP Ground elev. 4 57-1 2C 10YR 6/6- None is gr 0 M sg �_ 96. 37 ft.Depth to limiting factor b N `-.. _L - - - -.1 L_ - Remarks : ____�_Y a _Q De a L 1 z Phone: vST Name:—P1ea.,0,u Print Paul C,J, Steiner (715) Jd f eS s: N8230 Highway 65- Riv r Falls, WI 54-022 CST NorrUL clignalure: June 16, 1993 3074 PROPERTY OWNER Richard Fox SUIL DESCRIPTION RLkut-s Page n(_.___ PARCEL I.D. i ' 1 Boring # Depth Horizon P Dominant Color Mottles Texture Structure Consistence f • G 13 L) 1 � Roots - -- in. Munself Chu. Sz. Conti Color Gr. Sz. Sh. Bed Jp i ij► 1 0-11 1 OYR 3 1 None sil b ._ 3 P.rn :.. 2 11- 3 4 10YR 4/4 None s i l 1 m sbk mvf i gs 1 f . 5 t. 6 Ground 3 34-56 1 OYR 5/6 1 f1 sil 1 m sbk mfr gs -- NP_ r NP elev. 98.00... it. 4 56-1 10Yr 6/6 None is qr 0 m sq ml uvpth to . _- Iffl rig factor Boring # 6 Ground Ow. 95.57 ft. Dopth to Iffniting factor 1 0-16 1 QYR 3 1 2 16-40 10YR 4/4 one sil 1 m sk 3 40-57 10 1f1 4 57-12CI 10YR 6/6 None is gr 0 m sc Remarks:.__,._ 1 2 3 4 -14 4 -4 8 8-73 73-1201 10YR 3/ 2 1 OYR 4/4 10YR 5/6 1 OYR 6/6 None None C2d None sil sil Cl i s gr 2 m sbk 1 m sbk 1 m sbk 0 m sg mfr mfr mfr mvf r as gs 2S 1 f 1 f -- *5 . 5 : 6 NP -..-NP--. 4 ; 5 Remarks: " 1 0-15 10 3 2 None sil 2 m sbk mfr as 1 f .4 2 15-46 1 OYR 4/4 None sil 1 m sbk mfr gs 1 f .4 .5 _ 3 46-60 14YR 5/6 1 f1 C1 1 m sbk mfr gs -- NP NP 4 60--10 1OYR 6/6 None is gr 0 m sg mfr -- __ A .5� Remarks: - .. Acres 3 Al elm Elu" 70-1 Ph pea Qur I ty �mWCf Loy- 68 a�,{� PAGE i?�o6F ��'R�s OF �f<)SS VY E6AIE tLEV. OF Ff@0 InIsis And Observallon Pipe Approved Vent Cap Minimum 12" Above Final Gf ado 20 - 4 2" Above Pipe, —4 - Coal Iron To Final Grad* Von( pipe .Worsh Hay Of Stnth4ilc Covering Min 2" Aggregolo, 04of Pipe DISI(lbullo Too pipe 0 0 0 0 P, IP$ PerforG144 PIP* Bator84DA40ih L 0 Co,*,j4Ing Torminaling At Bottom Of SY6111M 'Llf jfJ 1,00 APPROVED S�WT'kETVC COVER a 9" OP S79►�W D1-S-rRIR-1JT1(0Q P1rE TC) BE AT LEAST IUCHES 8CLOW ORkCrIUAL C R A D E: Airs AT Lr—A,STZ10 IUCHES BUT K10 MOKE THA\Q H2- 13F-LOW FIUAL- CPPDF- M-XIMUM DaV-rVj OF 'Ni''AVATtoo e om OKI&WAL (JKAD 7--2(( WILL BE 6,' WC-HES EroF- 1"i1i'16UM OqTli OF EACAVAT100 f K 01A w 14 r W A L A P F. WILL 15C Wc 5 LIC,F-QSC /F- R DAT E: of ___ wis,comm Dopartment of industry, SOIL AND SITE EVALUATION REPORT Page ,L..-,,�>or and Human Relations Division of Safety & BuildiNs in accord with ILHR 83.05, Wis. Adm. Code COUNTY Anach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St Croix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL W. & monsloned north arrow, and location and distance to nearest road. REVIEWED BY DATE APPLICANT INFORMATION --PLEASE PRINT ALL INFORMATION PROPERTY OWNER Richard Fox PROPERTY OWNER"S MAILING ADDRESS 84 Woodridge Drive CITY, STATE ZIP CODE PHONE NUMBER River Falls, WT 54022.wwm� (715 425-2100 PROPERTY LOCATION GOVT. LOT NW 1/4 NW 1/40S 36 T 28 N. 11 19 W) LOT BLOCK SURD. NAME OR CSM # 68 Oak Ridge Acre -Es OWN NEAREST ROAD I woodridqe Drive Now Construction Use Residential / Number of bedrooms 3Addition to existing building - Replacement Public or commercial describe Recommended design loading rate 4 bed,gpd/ft2 .5 _trench,gpdlftL_ Code derived daily flow 450 gpd gpd/ft2 vench, gpclift Absorpbon area required 1125 bed,ft2- 900 _VenchA2 Maximum design loading rate bed, Recommended infiltration surface elevation(s) -,ft (as referred to site plan benchmarks Additional design / site considerations Siif leant more rock is needed to meet state code & system elevati Flood plain elevation, if applicable Replacement will have to a mound - )I. ���: SYSTEM IN FILL HOLC S =Suitable for system CONVENTIONAL MOUND IN -GROUND PRESSURE AT -GRADE C3 S In U E)S tj = unsultablefor System KI S El U 91 S 0 U EIS ou [N S 1:1 U .0.00m" cnii n;:5r.R1PTj0N REPORT Boring # Ground elev. 94. 0-9t. Di.pth to lifiliting Liclor Boring 2 Ground elev. 96,37 ft. I F Depth Dominant Color mottes Texture Structure Consistence Bojxriry Roots Becl I 1ki Horizon in. Munsell I Qu. Sz. Cont. Color Gr. Sz. Sh. ► 1 0-23 1 OYR 3/2 None Sil 1 m sbk mfr as 1f 5 6 - 2 23-48 10yR 4/4 .....None S11 1 M sbk mfi qs 1 f .5 .6 3 48-77 10YR 5/6, c2d _C1 M mfr CIS 4 77-10 10YR 6/6 fif 1s, qr 0 m sq-_ nTv r gs NP Ng 5 100-110 10YR 6/6 —None ls 9 r 0 m s9 mfr A 5 Remarks: PROPERTY OWNER Richard Fox PARCEL I.D. # SOIL DES(,' flPTION FiEPORT Page Ground clev. 98.00 ft. Uqth to 101-oting faO.1or Boring # Ground elev. 97.98 ft. Depth to limiting factor Ground elev. 194,25 ft. Depth to 11IT116ng factor Doring # 6 Ground elc.v. 95,57 ft. Dopth to lowling factor Horizon Depth Dominant Color Mottles Texture Structure Consistence Ba� Roots G P u, i ;= i n. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Aai4j] 1 0-11 10YR 3Z1 None sil 2 m, sbk mf j__ T 2 11-34 1 OYR 4/4 None sil 1 m sbk Mvf i gs 1 f .5 6 3 34-56 10YR 5/6 1 f 1 S11 1 m sbk mfr 9S NP, NP 4 56-120 1 OYr 6/6 None is 0 M sq— M1 A .,5 Remarks: 1 0-16 .10YR 3Z1 None 2 3 16-40 40-57 10YR 4/4 10YE 5/6 None 1f1 S 4 57-12C 10YR 6/6 None Remarks: -14 1 OYR 3/2 None sil 2 m sbk mfr as 1 f e5 6 2 14-48 10YR 4/4 None sil 1 m sbk mfr gs 1f .5 o6 3 48-73 10YR 5/6 c2d C1 I m sbk mfr gs NP NP 4 73-120 10YR 6/6 None is cir 0 m sg mvfr .4 05 Remarks: System has to be he-I,Qw 75"_ 1 0-15 10YR 3Z2 None sil 2 m sbk mfr as 1f A 5 2 115-46 1 10YR 4/4 L_ None sil 1 M sbk- mfr gs if .4 5 3 146-60 1 10YR 5/6 1 ifi C1 1 m, sbk mfr_ gs NP 4 160-10 10YR 6/6 None is cjr 10 maw M Sg mfr *4 1 *5 5 Remarks- 000-8330(R.Ori/92) %1.0 4- (7,W L, I I 49 m f IV. /oo' T"? of �re-ep Ph o�, e P�a�• P)o } P lo o 69 OoK R)dtt Acres 020 f I orive Way (,�" )IN a� I B3 Gairdo6c /4 oc. s c I Re- p6ce� v -c:� I � t � I 8 M 0 June 17, 1993 Richard Fox 84 Woodridge Dr. River Falls, WI 54022 RE: Soil Report, Richard Fox Location: NW'/NW',S.36, T.28N., I -I R.19W., Tn. of troy, St. Croix Co., WI Certified Soil Tester.- Paul Steiner, CSTM# 3074 Date of evaluation: 6/16/93 Dear Mr. Fox: After reviewing the above described soil report, it has been determined that an onsite soil verification must be conducted in conjunction with this office as allowed by s. ILHR 83-06(4)(a) WI Adm. Code. The purpose of an onsite soil verification is to verify soil suitability for onsite sewage disposal. The verification may result in a different size or type of septic system than that shown on the soil report. As a result, neither sanitary nor building permits can be issued for this property until the soil verification is completed. Sincekr-ly, Ja s Thompson s ss K. Zoning -mr istant Zoning Administrator CC. CST file Wls,:onsln Department of Industry, SOIL AND SITE EVALUATION REPORT Page Lzbor and Human Relations Division of Safety & BuildINS in accord with ILHR 83.05, Wis. Adm. Code [COUNTY Attach complete site plan on paper not less than 8 1/2 x I I inches in size. Plan must include, but St Croix PARCEL I.D. 0 not limited to vertical and horizontal reference point (N), direction and % of slope, scale or "'north arrow, and location and distance to nearest road. I d1mansioned, I REVIEWED BY DATE APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION PROPERTY LOCATION PROPERTY OWNER: PROPERTY LOT NW 114 NW 1/40S 36 T 28 N,R 19 E (w) 1111 Richard Fox i___ 1PROPERTY OWNER"S MAILING ADDRESS LOT BLOCK # SUBD. NAME OR CSM ' Dr 68 -1--- Oak Ridge Acres 84 Woodr id e Drive ZIP CODE PHONE NUMBER aOWN NEAREST ROAD CITY, STATE I River Falls WI 54022 EMONA10010 (715 425-2100 woodrid2e_ Drive -Troy_ Now Construction Use Residential I Number of bedrooms Addition to existing building __- Replacement Public or commercial describe bed, gpd/ft2 5 trench, gpd/ft2 Code derived daily flow 450 gpd Recommended design loading rate 4 /ft2 Absorption area required 1125 bed, ft2' 900 _ Uench, ft2 Maximum design loading rate bed, gpd trench, gpd/h,- Recommended infiltration surface elevation(s) i- --ft (as referred to site plan benchmark) elevatic AdditionaJ design/ site considerations Significant more rock s needed to meet state code & system Parent material Flood plain elevation, if applicable ft M CONVENTIONAL KiOUND IN -GROUND PRESSURE AT -GRADE SYSTEMFILL HOLD11NO Suitable for system '!K U U Unsuitable for system NIS 0 U 91 S ❑ U El S [1 U [NS ou 0S tu [I S _qOIL DESCRIPTION REPORT I G P D!l L Boring # Horizon Depth Dominant Color Munsell Moues Cu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boxcciry Roots Bed Vri,i iI-i in. 1 0-23 1 OYR 3/2 None sil 1 m sbk- mf r as 1 f .5 .6 2 23-48 1 OYR 4/4 —None sil 1 m sbk Mf i 9S if 5 .6 Ground 48-77 1 OYR 5 f 1 f C1 0 mfr 9 NP_ 94. 0-9t. 4 77-120 1 OYR 6/6 None is CTr 0 M Sq mvf r 4_-! 5 Depth to limiting Lxtor Remarks: Boring # 0-13 1 OYR 3/2 None si 2 m sbk mf r as 1 f 5 *6 2 2 13-42 1 OYR 4/4 None sil 1 m sbk Mf i gs 1f 5 .6 3 42-57 1 OYR 5/6 None sil 1 m sbk Mfi NP NP Ground Clev. 4 57-1 2C 1 OYR 6/6 None 1s cjr 0 M sg mvf r A. -, - _ ; I 5 ___ 96.37 94_ Depth to limiting factor V Remarks: Phone: to Print SST Name --Plea , _J711 Paul C.J. Steiner 5- Addra,Ss, N8230 HiSb�gy 65LRiver Falls* __Wj an22 019naturti: Date: June 16 1993 CST Niurrltj�. 3074 PROPERTYOWNER Richard Fox SOIL DESChji-J11014 REPOFir Page -of- PARCEL I.D. # r Manes Texture structure Consistence Rants G f' u��f Depth n Color Dominant C Boring # n Horizon �n. Mansell Liu. Sz. Cont Color Gr. Sz. Sh. Bed tn,� 1 0-11 1 OYR 3 1 None sil 2 m b ra— - ::: 2 11- 3 4 1 On 4/ 4 None s i l 1 m sbk mvf i as 1 f . 5 .6 l Ground 3 34-5 6 1 OYR 5 6 1 None s i l 1 m sbk mf r s - �- . 2 ._ 1 3 98. 00 ft. 4 56-�12 1 r OY 6 6 / None is 6 m s M1 -�- -- .4 , 5_ uv pth to- lin-iiting factor Remarks: Boring # 6 1 0--16 1OYR 3 1 None - 4 2 16-4g 1 YR 4 4 None 1 s i l 1 m sbk mvf i s 1 f . 5 _._6. _. 40-57 10 5 6 N - Ground elev. 4 5 7-12 14YR 6 / 6 None is gr 0 m sg m1 -- -- . 4 - _ Q�] {} J / w 98 ft. Depth to limiting factor Flu l lal M-D- Boring # 1 --14 14YR 3/ 2 None s i t 2 m sbk mf r as 1 f . �._._ . 6 2 4-48 10YR 4�4 n s i 1 Noe 1 m sbk mf r gs 1 f . 5 .6 3 $-73 10YR 5/6 None s i t 1 m sbk mf r SIS Ground elev. 4 3-120 1 gYR 6/6 None is gr 0 m sg mvfr -- -- .4 .�_ .5 ..__ 94,25 ft. Depth to factor Remarks:7 5 Boring # Ground ft. C opth to .�-- 1I I1 iltl ng factor Remarks: LL S0D-833o(R.a5/o42) 1 o � Nco Lot Oak Acrr.; S Cale, f = C20 i3� j�ous•r *ti *lam ov" T,pc>� Gre--r P r,� SIN �1 �j s OAfK ]RIDGE _ 2z 21 r, a rl 14 0 146JI;X ftn P. •• r r t. 5Cug_ i x Co,t .0W ice• TO c i' _.ram ACRES Co.)ad �I Joe P 0- 2,J) Aar-.��..��...,. 4JA • �•�! M iAM /!!i My A•M !liY10 to to'to .cb _' r fe - 6* ;e.- IF 104 4 //• � * . �{ ► .�_ ..ram 00f • i / b� , " !s� Its �L ji ` � �* � 3� ! �' i r•ii # !►+ to, � r 40 1p If c `� /' 76 ... 34 000 tov ON Ito 40 r �• ■ 1 >Z 78 eat 0 43 so dip gig 4f ' * - - ' ­_ ' oil N. • t / \ 4r 14 /A 1 /! ' 45 g 54 12 r■ 83 �3 RECEIVED 52 1 3 MAY 2 6 1988 50 2 'H M it d w� ■ A •! �+� ►� " r r w w w - - _ . _ � .. � _ _ .. _.. . _ . .. � N � _may_ _ _ . _ � _ _ _ _ � � .. _ _ ..... � _ _ .. _ .. � • �� ........rr.L ipariment of Industry, ,human Relations 3uildings Division ,of Plumbing action ate 9/ rerniges PL er Plumber Narne and Address neyman Plumber/Soil Tester er's Name and Address ge - 7-- of -z__ DILHR INSPECTION Leroy Jansky P.S.C.' REPORT 13 E. Spruce Street Chippewa Falls, W1 54729 (715) 723-8786 Legal Description &4yffownship County 5 LAJ 3 t 7 ko Y -5 7—t 122-10 IX Master Plumber Firm Name and Address Plan I.D. No. Sanitary Permit No. ( Check all Original: Copies to: % that apply) 3-6192 (R. 11 /8,5) District EI DILHR O Plumber Licensed Person's Narne(s) and License Number(s) Signature of Responsible Licensed Person (only one needed) Sigpago of Plumbing Consultant rivate Sewage Consultant ,P 4A I / w Elr et � r �� �onty/Local 16 sconsin Department of Industry, 4 bor and Human Relations fety & Buildings Division reau of Plumbing pection Date Ij "E- me of Premises 0 AK P- t QGE- A C kZS - ftr)-r ister Plumber Name and Address DILHR iNSPECTION Leroy Jansky P.S.C. REPORT 13 E. Spruce Street Chippewa Falls, Wl 54729 (715) 723-8786 A4&-eLegal Description G4yffownship County WWI-,3G/ -181 Iq L',j � 0%--f S—C (- Master Plumber Firm Name and Address Plan I.D. No. Sanitary Permit No. t1i'l,weyman RwabeT/Soil Tester Licensed Person's Name(s) and License Number(s) vner's Name and Address 14-7 age r 01 Ll— Check all Original: Copies to: `thatapply 7an-rzia,)(n 1imrN nilztrirt n nil. HR n Plumber X0 St. Cr 0 County ����ning and ZQnin oix Tues(I(q, Alai�ch 01, -7005 at 5:06:51 Pill Pa.(xe I of'] Detail Sanitary Information Computer #: 040-1188-90-008 Sub/Plat: Oak Ridge Acres Section: 36 Parcel #: 36.28-19.821 Lot: 68 TN/RNG: T28N R19W Municipality: Troy, Town of CSM: 114 114: NW 1/4 NW 114 Owner: Quality Built Homes 91 W. Woodridge River Falls, WI 54022 State Permit: 193473 Issued: 06/22/1993 POWTS Dispersal: Non -Pressurized In -ground Permit- New County Permit: 0 nstalled: 08/05/1993 POWTS Detail- Bed - Seepage Bedrooms: 3 WI Fund: - etreatment: PGVITT Pretreatment: NA P e Pr Notes PILJ m Inspector As Built Plum Other Requiremcilts Additional Notes Money Owed $0.00 Not determined Unknown Nelso Roger 0 t data off notecard -see archives Signed OffNo Maintenance 40tific Lion Notification 3rd Notification cheduled Pump Date Pumped 1 st Notific tion 2nd N Scheduled 8/5/2005 Wisc -,nsit) Doparunent of Industry, SOIL AND SITE EVALUATION REPORT page 01--_ - nd Human Relations 1vislon of Safety & Buildings ILHR 83.05, Wis. Adm. Code )PI-1, I in accord with COUNTY Attach complete site plan on paper not less than 8 1/2 x I I inches in size. Plan must include, but C St Croix not limited to ver.lis.-val dnd horizontal reference point (BM), direction and % of slope, scale or F—PARCEL I.D. dimensioned north arrow, and location and distance to nearest road. REVIEWED BY DATE �+ APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION PROPERTY OWNER: Richard Fax PROPERTY OWNER':S �AAILING ADDRESS 84 woodridqe Drive CITY, STATE ZIP CODE PHONE NUMBER River Falls, WI 54022 (715 425-2100 WWE.000� wavx� PROPERTY LOCATION GOVT. LOT NW 1/4 NW 1/40S 36 T 28 N,R 19 E (v) ''r _ LOT 9 BLOCK # SUBD. NAME OR CSM 68 1 --- I Oak Rje Acres NEAREST ROAD woodridqe Drive - Addition to existing building _. New cons Use Residential / Number of bedrooms 3.__ Replacement Public or commercial describe ft2 Code derived daily now 450 gpd Recommended design loading rate 4 bed, gpdjft2 5 -trench, gpdJ 1) Absorption area required 1125 bed, h2' 900 trench, ft. Maximum design loading rate bed. gpd/ft2 trench, gpd/fti- Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considera6ons Si f icant more rock is needed to meet state cede & system elevati Parent material Flood plain elevation, if applicable ft ( H CONVENTIONAL MOUND IN -GROUND PRESSURE AT -GRADE SYSTEM N FILL )LDIN3 IANI� S = Suitable for system KI S El U 91 S U 91 S U ms Ilu [IS 6u ED S '6 U tj = Unsuitable for system SOIL DESCRIPTION Boring Ground elev. 94 * 05(t. Depth to 11111iting 1�clor Boring 2 Ground elev. 96. 37 ft. Depth to limiting factor Remarks, Phone. "ST Name: --Plea; Print �a 1 ) 42 Paul C.J. Steiner � y 65 e 5 02 2- CSTALrnLur'. C, i9nature: RiK N8230 HkDate., June 16, 1993 3074 PROPEM OWNER Richard Fox PARCEL I.D. # SOIL i-.;' i.--,-'jCRIPTIUN Ft LEF, Page Boring # 3 Ground elev. 98.00 it. Uvpth to lffl-66ng factor Ground elev. 97.98 ft. Depth to Iffluting lactor Boring # 5 Ground elev. 94.25 ft. Depth to 111TIlOng f a c for Boring Ground elev. ft. Depth to 111111ting factor Horizon Depth in. Dominant Color Munsell Modes Chu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boitary Roots G Uil I Bed A R i 4j i 1 0-11 2 11-34 1 OYR 3k1 1 OYR 4/4 None None sil 2 m sbk S11 1 m sbk Mf I My i a 2 9 S -,6 1 f .6 3 34-56 1 OYR 5/6 None s i l 1 m sbk mfr gs -- . 2 4.3 4_ -,5 4 56-120 1 OYr 6/6- None is qr 0 m sq ml Remarks: 1 0-7:16 1 OYR 3Z1-- Nong ail 2 m ---sbk mfi as 1f -.-5- 6 e5 e6 2 16-40 1 OYR 4/4 None Sil 1 m sbk Mvf i gs if 3 40-57 10 5/6 None zii 1 I M sbk Mfr 4 57-120 1 OYR 6/6 None is cjr 0 m sg Ml .4 5 Remarks: 1 1 0-14 1 OYR 3/2 None Sil 2 m sbk mfr as 1 f .5 ...6 2 14-48 1 OYR 4/4 None Sil 1 m sbk 1 mfr gs 1f 5 6 3 48-73 1 OYR 5/6 None sit 1 m sbk mfr SIS 2 3-.--. 4 73-120 10YR 6/6 None is gr 0 m sg mvf r A 05 Remarks: S stem has tQ, be--belcu 7511 Remarks: %1" B 8 3 3 0 (R. 0 r.1 9 12) P)o� ?)oo o Ook Rildtt Acres Cole- �M �3 lb s e j�ousv (r� G •4 • h 49M Eiv" boo' Top of Gl'e-tp Ph 0), C p� Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Lab-ir and Human' Relations ­w ,AKDivision of Safety & Buildings in accord with ILHR 83.05,.YVis. Adm. Code COUNTY COUN' Attach complete site plan on paper not less than 8 1/2 x I I inches in size. Plan must include, but not limited to vertical -and horizontal reference point (BIVI), direction and % of slope, scale or PARCEL I.D. # dimensioned; rforAth arrow, and location and distance to nearest road. REVIE AWED BY APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION F PPPPERTY WNER: PROPERTY OWNER':S. MAILING(ADDRESS CITY, STATE ZIP CODE PHONE NUMBER Page of PROPERTY LOCATION GOVT. LOT 1/4 fia) 1/4,S3 6 T 94' ,N,R LOT BLOCK# SUBD. NA # OCITY E-1VILLAG E:CM JNEARESOOAD Z:, � idyl DATE V4•filew Construction Use qResidential / Number of bedrooms Addition to e)dsting building I I Replacement j Public or commercial describe Code derived daily flow gpd Recommended design loading rate bed,. gpd/ft' trench, gpdtftl Absorption area required bed, ft2 trench, ft2 Maximum design loading rate bed, gpd/ft2 trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design I site considerations Parent material Flood plain elevation, if applicable ft S =Suitable for system CONV(,- MOUND - IN -GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK' U =Unsuitable for system Bt"t-1 t4❑U El S 1:1 U 0 S 1:1 U E-Is [I U Os 0 U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Struc Boring # Horizon in. Munsell Texture Horizon Qu. Sz. Cont Color Gr. Sz Ground elev. ft. Depth to limiting factor C -1 6/ c4L r 11 C/-- Z,-�A An fz S = 09E� 2 Al . ZZ; Z, 9 �Vmmmm =mom 'M lm 4 Im Initial:` Date �o 02 .3 PROPERTY OWNER SOIL DESCRIPTION REPORT, Page- of PARCEL I.D. # Boring # Horizon Depth in. Dominant Color Munsell Motdes Gu. Sz. Coat Color Texture Structure Gr. Sz. Sh. Consistence BoLrdaty 2 Roots GPDIft.. Bed ranch Ground Z3-4 62�L elev. t 5 r Depth to --' t/ ' limitingfackw � V r ■ • ■ Remarks. r; 0 At.. ' Boning # S • • • • • Ground • ■ • : elev. • : f : Depth to Gnuting factor soil pit locations IM T3 ��.3 ry a-Z