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HomeMy WebLinkAbout040-1146-50-000 (2)St, CroixCounryPlanningandZoning Wednesdqjy, January, 10, 2007 at 3:50:43 PM Detail Sanitary Information Page I of I Computer #: 040-1146-50-000 Sub/Plat: metes & bounds Section: 13 Parcel #: 13.28.20.576A4 Lot: TN/RNG: T28N R20W Municipality: Troy, Town of CSM: 1/4 1/4: SW 1/4 NE 1/4 . . ...... ------------------------ Owner: - - ------ - - ----..... - ------- ------ - - -------- - -------------_ ------- ------------------ -- -------------------------- - ----------------------------- Marzolf, William 274 Salishan udson, WI 54016 . . ............ - - - -- ---------- ------ - ... ------ - ------------- -------- ----- — ----------- - -----------------------_ -- - ------ — -- - -------------------------- State Permit: 193483 Issued: 06/30/1 POWTS Dispersal: Non -Pressurized In -ground Permit: New -2 County Permit: 1 0 Instaile 106/06/1994 POWTS Detail: POWTS Pretreatment: Bed- Seepage Bedrooms: 2 NA WI Fund: Notes Issuer/inspector As Built Plumber Other Requirements, Additional Notes Money Owed Tom Nelson Yes Steiner, Paul Ulbricht to Steiner data from notecard $0.00 parcel includes 040-1146-70/.576B - owner mailing Jim Thompson Signed Off: Yes address is in Woodbury per RPL Maintenance Scheduled Pump Date Pumped I st Notification 2nd Notification 3rd Notification 2/3/2007 6/6/1997 2/3/2004 0 W4consin Departn-went of Industry, SOIL AND SITE EVALUATION REPORT Page of Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code TY COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but 0 U PARCEL I.D. not limited to vertical and horizontal reference point (BM}, direction and % of slope, scale or e dimensioned, north arrow, and location and distance to nearest road. / 60 -Velb APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION -RCVIWED BY DATE PROPERTY OWNER: PROPERTY LOCATION (Z' _� 3 Z �,3 1 4 �� . T 1/4 1/4,S T Z N,R Z-0 E (O(S- - El-3N-0 �> - PROPERTY OWNER-S MAILING ADDRESS LOT # BLOCK# SUBD.NAME ORCSM# ,6 067��, T T# BLICK E L sh�Isli CITY, STATE ZIP CODE PHONE NUMBER ❑CI []VILLAGE MTOWN NEAREST ROAD New Construction Use Residential / Number of bedrooms Add1b.Qn to existing building Replacement Public or commercial describe Code derived daily flow 6 o C) gpd Recommended design loading rate � bed, gpd/ft2 �_ L trench, gpd/ft2 Absorption area required VZo� C bed, ft2 1 0 trench, ft2 Maximum design loading rate S bed, gpd/ft2 0, (*-trench, gpd/ft2 Recommended infiltration surface elevation(s) -S � PNC-%C' 3 fl F: 3 ft (as referred to site plan benchmark) Additional design / site considerations VZJZ CQ1 " M&)U�et) � v.4 ex.) 7- © �) el"i. �3 P%?-3t> 4 G. 94 u eL- Flood plain eievation, it applicable ft Parent material S k �n S - 7S=- -Suitable for system CONVENTIONAL MS 0U MOUND OS EJU IN -GROUND PRESSURE INS ©U AT -GRADE &S El U SYSTEM IN FILL OS -1 u I 0S, C HOLDING TANK EIS IZU j U = Unsuitable U Unsuitable for SOIL DESCRIPTION REPORT Bodng # Horizon Depth Dominant Color Munsell Mottles Qu. Sz. Cont Color Texture Structure ctu re Gr. Sz. Sh. Consistence Boundbry Roots G P D/ft2 Bed Try in. 5 Ground Z 1 _19 l I-/ \a_ 3 j fo )n U f-1. elev. Depth to V 1Z V /y limiting factor Remarks: Boring # PROPERTY OWNER Oky'Ob 4 CAJDT�� SOIL DESCRIPTION REPORT PARCEL I.D. # "Im"Now Page of Boring # Ground elev. ft. Depth to limifing factor Boring # Ground elevi, . !Nloo ft. Depth to limiting factor "101 Boring # Ground elev. . a, 6 ft. Depth to limifihg factor �r 9 tD Boring # Ground el'ev. ft. Depth to limiting factor Horizon Depth in. Dominant Color Munsell Motues. Texture Chu. Sz. Cont Color structure Sz Sh. Gr,Bed Consistence Boundary Roots G P D/ft2 Tmr& =NNW 006 y lov� y" U S v Z9- q 5 -)*S%1Z Y*4/� I s vj�s z S5 M C T o_ s a. q5.1:OS a v p- V /y yn 6S-q I v/ Remarks: (N—N-Z- I ZS%-1 v Z4 -Z- ck," � V" f 0. 3 �-�-� �a � �. �I� -- s � � �.-� barU�. _ . s WIN 'S 5 14 2 LZ Vo I ► �! S�� cis � � o � 1(3 4 R y/v UN S 5 Von Remarks: Ll T- -Z 3 Doiv- 3 v 1Z lif s) 1 `sb �. CS o, t4 aj 11 1Z y/y fMIFAW Remarks: • tiemarks: SBD-8330(R..05/92) 4 d Le itz a PLOT PLAN SCALE 1 "= SO ' w sati- Page 3 of 3 L u �- Z. r � fjT L- T I s I pzgt) M tMA-) Au Fi etbS . . V 5 p' is r, CST Signature Date Signed Telephone No. CST # •W=onsin Department of Industry, SOIL ANDSITE EVALUATION REPORT Page of Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY S T, AD W Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but C V not limited to vertical and horizontal reference point (BM}, -direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER- \AK.ZV �130Q I PROPERTY LOCATION _S GOVT. LOT 1/4 1/4 IS 13 T Z S . I IN I R ?� E (0(�_ PROPERTY OWNER'-S MAILING ADDRESS LOT # BLOCK# I SUBD. NAME OR C.SM # 'N\ \ _Z_� V � � � \1 � G C- T__1)I ZA U e-1 E — N>k4yT C)F- shu:��kw CITY, STATE ZIP CODE PHONE NUMBER DCITY []VILLAGE MTOWN NEAREST ROAD Z:-) S -7 COUG-7 �ftt!� New Construction Use Residential / Number of bedrooms Addi�kn to existing building Replacement Public or commercial describe 4 Code derived d* flow 6 -0 0 gpd Recommended design loading rate C) • bed, %xW _9( trench, gpd/ft2 AbsorpWn area required )-M C bed, ft2 V�0 0-_ trend,, ft2 Ma)dmurn design loading rate 0 • S bed, gpd/ft2 av (a trench, gpd1ft2 Recommended infiltration surface cqevation(s) 5 Ear PNC-�c 3 c+F- 73 fit (as referred to site plan benchmark) Additional design / site considerabons Parent material. sft1V46I)ocir 0�(Mk sP%k,31> 4 c:3,94VEQ, Flood plain elwation, if applicable N ft S = Suitable fbr system CONVEWIONAL MOUND W-GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TAW U = Unsuitable fdr Mtem 0 S 11 U WS EIU Ws 0 U NS El U QS E3U El S IZU Boring # Ground elev. Depth to limiting factor Boring # 't� ank 2 Ground elev. t�4 b - 6 ft Depth to hmibng factor 7 8'I SOIL DESCRIPTION REPORT Horizon Horizon Depth in. Dominant Color Munsell Wftles Qu. sz. cont color Texture Structure Gr. Sz. Sh. Consis� Bounchry Roots GPD/ft2 Bed Tmnch ) L 1 5 � S S Z L L - L 2 iSbk �n �1- �s �.S o.b 34 'S1 C- 5 bHr M U f-1. C S Z YAO S V/Y — S 0 s9 rn � o. � o,a Remarks: 00 V% S *Py" mmmon"N" Remarks: CST Name:--mease Print Phone: Arthur L. Wegerer 715 -4 2 5- 016 5 erer Soil Testing & Design Service-P.O. Box 74 River FallsWI 54022 Signature- Date: CST Number: a"e4� 93 -0 -:S -is )--18-73 M00576 PROPERTY OWNER SOIL DESCRIPTION REPORT a Page of 1 PARCEL I.D. # _ {- . Boring # Horizon Depth Dominant Color Mansell Motdes Texture , Chu. 5z. Cont. Gofaf' i F' . -;:: Structure Cyr z Sh: Consistence Boundary G P Dlft 2 7 Roots Bed Twich 'LSLti7ti7G 1i rhy' Q ... ..:d -..• i 1I . '+ f ►+ . � Q + ► Ground � 3 Z Z� g 1 � �, --� s � � Y, u elev. I- �t• Zq- 4 5-)• S �! z ye)� `...�. ) s j �S cl S Depth to ept S - �[5 6� C� `� [a y I .�.. S limiting factor 6S--(l I Y /y Q Arj oil" Remarks: Boring # L 4 Ground elev. .. Depth,to limiting factor , 7 q1 C�-kz_ -1�� Q a. 0. L V. U F-q Z. S,-j it Y/ ti �z-L 1a�iz�ly �.-S = 1 Remarks: Boring # LL �: r���ti••ti'�: Ground elev. $ a. 6 ft. Depth to limiting factor �r 9 D'► c> - L a. v-5o.L 6-7 Q01 V Y 0-55 (0 6,i Remarks: Boring # i Ground el'ev. ft• Depth to limiting factor Remarks: .. .. • . ,�., ._ .. , ., � . ,, �.� ! - , . 55D-8330{R.45192}; i LQ c-N-v-L w 4 d Sr.z. I P_ 16%tvU____Q s P-b . LJ/L6TN CST Signature PLOT PLAN SCALE 1 SO V-SR-11-W __ Page -]S of � PVT LST- �,S f,—,ps.-um %,ZA,AN�H QF S:HsTemz NTZ ELeu, s c 7 15 4 2 5,-zjD-L6 5 M00576 Date Signed Telephone No. CST # S T C 104 AS BUILT SANITARY SYSTEM REPORT OWNER k)j� [LI L � - ADDRESS SUBDIVISION CSMV LOT SECTION �3T N-R � W, Town of ST. CROIX COUNTY, WISCONSIN Provide setback and elevation information f01-111 on reverse of this Provide 2 dimensions to center of septic tank manhOle c0v01'- r -j BENCHKARK : ,, �► e e. ALTERNATE BM: SEPTIC TANK f PUMP CHAMB ER / HOLDING TANK INFC3RMATION Manufacturer: Liquid Ca paci.ty /O1 - Setback f rom : Well House ,- other Pump: Ma ufacturer Modell Size Float sepera 'on Gallons cle: A 1 a rm Location SOIL ABSORPTION SYSTEM . Width: Length Number of trenches Distance& Direction to { nearest prop. line: Setback from: well: Hou se Other ELEVATIONS Building Sewer . ST Inlet . ST outlet PC inlet PC bottom Pump Off Header/Manifold Bottom of system Existing Grade Fina l grade DATE OF INSTALLATION: PLUMBER ON JOB: IT) i 5PY' LICENSE NUMBER: INSPECTOR: 3/93:jt LOCATION: TROY 13,28.20.576A-4,SWINEINORTH COVE RD. i Wiscor-iri Department of Industry, PRIVATE SEWAGE SYSTEM Labor and Human Relations INSPECTION REPORT • Sailty and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION x N%RZ 01W r,'s VMe: i & PATR I C IL A a , Jm?)n village E] Town of: CST BM Elev.: Insp. BM Elev.-. BM Description: 70 7o TANK INFORMATION TYPE MANUFACTURER CAPACITY Septa c 0. 01 7 Dosing Aeration Holding . ....... ...... .. ...... . . I j TANK SETBACK INFORMATION TAN KTO P 1 L WELL BLDG. Vent to Air Intake ROAD Septic X, NA Dosi ng NA Aeration Holding PUMP/SIPHON INFORMATION i Manufacturer—-, Demand Model Number t GPM TDH Lift Friction T D L s Head Forcemain Length. -1y, a_ Dist. To Well County: S a ni t a r y 1304A "!J State Plan ID No-: Parcel TaY"..'"I" A9300145 ELEVA I 1UN UA I A STATION BS HI FS ELEV. Benchmark 9 Bldg. Sewer Z St/inlet —20 St 1 W Outl et Dt Inlet Dt Bottom -76d Header Man,- Dist- Pipe 00, Bot- System Final Grade 700- SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches P I T No. 0 f Pits inside Dia. Li ul oth DIMENSIONS DIMENSION anu a e SYSTEM TO P L BLDG WELL LAKE/STREAM iLEACHIN�!!��� r: SETBACK ­- INFORMATION TypeOft,\ Syst 43Z-,�, 3 Z OR UNIT C H A M BER—Model Number: em: t I DISTRIBUTION SYSTEM H e a d e r4*=xft= Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia- Spacing "Z? Length Z-� D 1 a. (�/-- q_ - — -- SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Sy s 0 S e�7 S awa­ Depth Over Depth Over xx Depth xx At-Grade /Sodded xx Mu c. y s ] 0 Y No Bed /--T��enter Bed /Tfj�r�dges Topsoil Yes E] No Yes L�T.�RI e9,qqgXes4peSWnjMejqCyRqtH-) COVE RD*-, &jC�Ur 2 Plan revision required? E] Yes D-40 Use other side for additional information. SBD-6710(R 05/91) Date inspector's Signature Cert No, A( 96 oil SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code —Attach complete plans (to the county copy only) for the system, on paper not less than 81/2x 11 inches in size. —see reverse side for instructions for completing this application. I. APPLICANT INFORMATION — PLEASE PRINT A.L.L. INFORMATION. PROPERTY LOCATION PROPERTY OWNER 14,IfR _U;44A PROPERTY OWNER'S MAILING ADDRESS LOT # 10 , COUNTY o("I( STATE SANITARY PERMIT 0 / Ft,0.3rrc re Check if revision to vious application STATE PLAN I.D. NUMBER 1 &11 1. 04- T -499 N9 R 2,C) E (or) W BLOCK �# NAME OR CSM NUMBER ZIP CODE PHONE NUMBER SUBDIVISION CITY, STATE r 0 �j-�` P � 1 I�1i ' NEAREST ROAD CITY ett7 ne) ❑LJState Owned 171 VILLAGEr�O . TYPE OF BUILDING: (Check 0 M TOW 0 r11r-al PARCEL TAX NUMBER(S) F�P"hlic LtJ 1 or 2 Fam. Dwelling—# of bedrooms 111. BUILDING USE: (it building type is public, check all that apply) � �.f 1 El Apt/Condo 0,5 2 ❑Assembly Hall 6 ❑Medical Facility/Nursing Home 3 ❑Campground 7 ❑Merchandise: Sales/Repairs 4 ❑Church/School 80 Mobile Home Park 5 ❑Hotel/Motel 9 ❑Office/Factory 10 ❑Outdoor Recreational Facility 11 El Restaurant./Bar/Dining 12 ❑Service Station/Car Wash 13 ❑Other: Specify only one in line A. Check line B iapplicable f ) IV. TYPE OF PERMIT: (Check 4. Reconnection of 5. Repair of an 3. 0 Replacement of Svstem New 2. 0 Replacement Tank Only Existing System Existing A) 1 System System Date Issued B) A Sanitary Permit was previously issued. Permit # V. TYPE OF SYSTEM: (Check only one) Other Non -Pressurized Distribution Pressurized Distribution Experimental 41 Holding Tank 11 [� Seepage Bed "O�) 21 0 Mound 30 SpecifyType 42 Pit Privy 120 Seepage Trench 22 in -Ground 43 Vault Privy 130 Seepage Pit Pressure 14 0 System -In -Fill X 3 6 V1. ABSORPTION SYSTEM INFORMATION: 4. LOADINGS A TE 5. PERC. RATE 16. SYSTEM ELEV. 17. FINAL GRADE ELEVATION - ER DAY 1. GALLONS P 2. ABSORP. AREA REQUIRED (sq. ft.) 13. ABSORP. AREA PROPOSED (sq. ft.) (Gals/da'q. ft.) (Min./inch) 2. 70 3o, Feet 300 71 1 1 Feet ­7 — VII. TANK I CAPACITY I in allons Total # of Manufacturer's Name Prefab. Site Concrete Con- Fiber- Steel glass Plastic i Exper. App. INFORMATION xistin New xisting Gallons Tanks strutted Tanks Tanks 740V ......... . ;i 6wom-A — M S!Pptic Tank 0 11�111 6e4__rz� Lift pump Tank/Siphon Chamber VI". RESPONSIBILITY STATEMENT e onsite sewage system shown on the attached plans. responsibility for installation of the I". RESPONSIBILITY STATEMENT L1,the undersigned, assume responsibTili MP/MpRSW Na.: Business Phone Number: Plumber's Signature: (No Stamps) Plumber's Name (Print): 33 o ` j �' ROA oV, r Z/ Plumber's Address (street, City, Slam, Zip Codej; &3- C Ix. COUNTYIDEPARTMENT USE ONLY issuing Agent Sian S HD t Fee (Includes Groundwater ate ssue Disapproved Sanitary Permit Surcharge Fee) d0b Ow o Approved e> E] owner Given Initial tion I Adverse Determination 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 sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the ex it r criteria in the Wisconsin Administrative Code willR ati°n date, and at the time of renewal any new be applicable. 3. All revisions to this permit must be approved b the permit 4- Changes in ownershipor lumber Y P mit issuing authority. P requires a Sanitary Permit Transfer/Renewal Form �S8 submitted to the county prior to installation. D 6399) to be 5. Cnsite sewage systems must be properly maintained T Pumper whenever necessary, usually r� he septic tank(s) must he pumped by a licensed Y every s. if you have questions concerning your onsite sewage s Division 9 System, contact your focal code administrator or the State of Wisconsin, Safety & Buildings , 6fi8-2fifi-38 1 5. To be complete and accurate this sanitary permit application pP must include: !. Property owner's name and mailing address. Provide the' legal description and parcel tax number(s) of where the system is to be installed. ll. Type of building being served. Check only one and complete P ere # of bedrooms If I or 2 Family Dwelling. Ill. Building use. If building type is Public,, check all appropriate lV. Type of permit. Check onlyone in li ,� boxes that apply. n�, A. pee line 8 if permit is for tank repfacerr�ent re repair. Complete liconnection, or V. Type of system. Check appropriate box depending on sy stem type.Vl. Absorption system informa#ion. Provide all information requested in #1-7. Vll. Tank �nfoi'matic�n. Fill in the capacity of every new ar?d!or existing +. �i tanks and manufacturer's Harris. indicate prefab or site' Y��nl�, list the total gallons, number ��f septic, P P P to constructed and tank material. Complete {���- ��Jl P , pum /s; hon and holding tanks for this System. Check; ex4 �!"aF�"� .M ,� t r experimental product approval from DILHR. e .tai ap ro gal or fy I tanks received t1111. Responsibility statement. Installing plumber is to f!! in MP, etc.), address and phone number. Plumber must ame, license number with appropriate prefix (e g. IX. County/Department Use Onl Sign application form.Y X. County/Department Use Only. Complete plans and Specifications not smaller than 8% x 11 plan, draw inches must be submitted to the county. The plans must include the following: A} plot P n to scale or with complete dinnensians, location of holding tanks}, septic tank(s) or other treatment tanks hail . streams and lakes; button boxes; pump or siphon tanks; distil ding sewers; wells; water mains/waterer service; s; soil absorption systems; replacements system areas; and the location of the building served; 8} horizontal and verb f Y ern C) complete specifications for pumps and controls; dose v cal elevation reference points; plume, elevation differences; friction lass; pump performance curve; pump model and pump manufacturer; D cross P required by the county; E} soil test data on a 115 ; vss section of the soil absorption system if 5 form, and F} all sizing information, GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of f surcharges regulated practices which can effect groundwater.g (fees) for a number of The monies collected through these surcharges are-Aised for monitoring groundwater, ground- water contamination investigations and establishment of standards. S8D-6398 (R.11188) 1 riOME&TE SEPTIC Pt.MAG M j _ 80 aNEIL FO.."Ut4+0N, WiS. 5016 .. ! A RT UL 3M, "T C Sr 4# Z � ` WNL Ik A" PLUMBER uC. NO.3X7 M.P.R.& . WALE.ER Si DESIGNER uC. NO. OOM S G y .L� • ZQ @.TO BE R - LOCATED 7a o • _ POWER STEM POLE 6j, /,Z/ : a o 3.2 5' a,P ti PROPOSED' BLUFF �%D L 1,+ E 5 C T 6 a 8 0 T 7 OM OF SLOPE GO O Af - �- 40 J / i 42 PROPOSED wErL L7- EX STING 30 ROADWAY EG S RE Al T E PpwE R ,t ELF UA-Tt'ooS B, 701, Co0 B 2-o,7 7 j yy f3 3 7/ -7 S �7o 41� sysr��-t ���v�rou v+r/a.Aj G fol , a i Fresh Air Inlets And Observation Pipe Approved Vent Cap Minimum 12" Above Final Grade 's. #4--p 4170 3 Above Pipe mro Final Grade • Morsh 'Hay Or Synthetic Covering • Min. 2" Aggregate Over Pipe Distribution 5-e4 - 2-72-9 Pipe 000,0� i 11 Aggregate Beneath Pipe .:!5 /S TjfA 4" Cast Iron Vent Pipe' --.-- Tee b Perforated Pipe Below 0 Coupling Terminoting At Bottom Of System ` Vvi*tconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of Labor And Human Relations Di'vision of Safety & E�ljildings 4 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 CCU �5 NT not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. V I V� REVIEWED BY DATE APPLICANT INFO RMATION-PLEASE PRINT ALL INFORMATION F PROPERTY OWNER: za// PROPERTY LOCATION 0" '�X --A115rI il GOVT. LOT -5140 1/4 �1/41S '_3 T PN)R 2 0 E (or) W PROPERTY ROPEERTY OWNER':S MAILING ADDRESS LOT # BLOCK# SUBD.NAME ORGSM # Op CITY, ITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE ®TOWN NEAREST ROAD TY' 0 New Construction Use [A] Residential 1 Number of bedrooms Addition to existing buildin t ] Replacement j Public or commercial describe Code derived daily flow gpd Recommended design loading rate bed, gpd/ft2 Y trench, gpd/ft2 Absorption area required Y-71 _ bed, ft2 trench, ft2 Maximum design loading rate bed, gpd/ft2 k trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations ���'`� '�����'�'' �`��� �'� � �` �'� .s,�'Sr��-�-a '� �''� � Parent material Flood plain elevation, if applicable I S = Suitable for system CONVENTIONAL MOUND IN -GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for system ri S U MS E1U MS EIIJ El S El U 01 S 0 U 0 S U ly�_j I Ground elev, 10 /' &0 ft. Depth to limiting facto0r. /01 . C Ground elev. 7o�n. Depth to limiting factor 011, SOIL DESCRIPTION REPORT Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ft2 . Bed 'Trench 0 /0 yle Z... 5� /U." 2-f '7 3 2- lo /0 i�/� S/O -- s ,'mil , S �� �s i . % y �-�s eye siy s , e, s �-� - - . � � Remarks: � dySiCL'!�� t Ic systl Pam_qrkcz- PROPERTY OWNER- SOIL DESCRIPTION REPORT PARCEL I.D. # Page ofw Boring # Horizon Depth in. Dominant Color Munsell Mottles Texture Qu. Sz. Cont. Color Structure Gr. Sz. Sh. consistence Boundary Roots G P D/ft7-- Bed Trench 7 Ground 3 �- � �a y,� s�� _ - S' � ,,,,,, � :� : - d? � , 7 •�% elev. 17 Depth to limiting factor Remarks: Boring # ................. .......... 77 441 57 ................. .2o-3s2 lo yl S5 45?�e Ground lelev. ------ -- -S' c s � -P _ - 7 ,� -700- 4 ft. , Depth to 01, limiting fac r Remarks: Boring # .... ............... rX 31--�-- ........... �Zt 75 <7 ............. ...... .......... A, 7: Ground elev. 4 70L.-L2-- f t Depth to limiting factor f� 2, OF Remarks: Boring # ............ ... I ........... ...... Ground elev. f t. Depth to limiting factor Remarks: SBD-8330(R.05/92) HOMESa SEPTIC PtUu:BJNG CO. O'NElL R()., -HUD N, WIS. W t y - t R()BERT UL8Av,' HT � S M& MASTER PLUMM UC. NV. 3307 M.P. . . ItAff�1, ISTALLER & DESIGNER LIC. NO. 0 603 ` , , f • 1... L' � F ��F � i! �j 2-0 -70 22 ell PROP OSED ? fffii3#€ I 42 /e � f Fx:STING zf? S 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 resale by owner/con'tractor,(spec Douse), thent,a.secand form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. ---------------- -------- ------ ---------- Owner of property WILLIAM J.r SR. & PATRICIA A. MARZOLF Location of property-_1/4 .1/41 Section 13 T 28 N-R 20 w Township TROY Mailing address RT. 31 ST. CROIX COVE, HUDSON, WI 54016 1' e_e -_ - RESIDENCE -------- 1863 SELBY AVE., ST. PAUL, MN 55104 Address of site Lk Subdivision name N/A Lot no. Other homes on property? yes X No Previous owner of property PRESENT OWNER SINCE 1971 Total size of parcel 1.16 A Date parcelwascreated 1971 'Are all corn . ers and lot lines identifiable? X -Yes No is this property being developed for (spec house)?_Yes X No Volume 479 and. Page . Number 70 as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER & THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I(we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No. 308034 1 and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction ,of said system, and the same has been duly recorded in the office of County Register of deeds as Document No. 308034 Signature of applicant JUNE 281 1993 Date of Signature Co -applicant - JUKE - 28, * 1993 Date Of Signature S T C - 105 SEPTIC 'TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER WILLIAM J.r SR. & PATRICIA A. MARZOLF ADDRESS ROUTE 31 STO C'ROIX COVE FIRE NUMBER NOT ASSIGNED YET CITY/STATE HUDS-ON , WISCONSIN Zip 54016 PROPERTY LOCATION: �1/4 r_._.,.__1/4 r SECTION3 T 28 N-R 20 W TOWN OF TROY , St. Croix County, SUBDIVISION N/A , LOT NUMBER N A • 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 pumper. What you put into the system can affect the function of the septic to as a treatment stage in the waste disposal system. P tank 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 1980r 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 water 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 um in p p g ( 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 date. r S I G N E D• I 6' DATE : JUNE 2 8 r 1993 St. Croix co. Zoning Office 911 4th St. Hudson, 'WI 54016 And the said...:.._., G. gorge-,.Bernard.-.M.azzo.lf.;:...Sx..,.,....and..Ella...Ann..Marzolf,..his .wife, . ' 4 " part.�.eS .uf the first Dart, .. ... ... ..... .them' for.,themselve.s.,./ .-heirn, executws a'nd administrators, do......... ,_-......covenant, grant, bargain, and agree to and with the said parties of the s,-cond part, and to and with the survivor of them, his or her heirs and assigns, that at i11i� tillle of the c 11tieal ng and dviivery of these. prosents _.they Were'......, %%.ell seized of Ilse lgpn, ,jseal)(W(% 1 described, as of a good, sure, perfect. absoliitc and indefcaasil,le estate ref inheritail(v in the lain, ill f('(- and thM the S�lillt' are fret and c�letir frail) all inCt1�111►rnlims, whatever, s ' _ . r .__..._... .......... ... .'- - -- - -- -._ ....... ,... _. .. .. ..-...... ,......-...... ,. _. .... ......._•.. • •__--__-_-_..-......._...........- .... J._ _.. ... ... -.... _......-.�-... - and that the above Uargaitled prcnlisei in the quiet and 1waveable possession of the said parties of the second part, as joint tenants, his or her heirs alul-ISs1g,113, .E(;ain- t- .ill r1110 every person or persons lawfully claiming the whole or any part thereof, - :__. they«gill forever WARRANT AND DEFEND. G. In 'Witness Whereof, the said part . ies of the lirNt part havie hereunto set ..their. ,, ., halids ..,lnci seal: _ .thi1; ----- - 22nd d��y of ..:_. Septembex---------- , A. D., 19 7..1 . 9 e- i r l � ► r ,fir - � I! /// ''• (,it�" ,rY:✓-ic _�3C�'r�'-�. 3�:.�1, Signed, Sealed and I c 1l� c�rc 1 ill Presence c ticf c f � Georg B rnar Marzolfl Sr. Y` ` � «- r .................... ..................._. .-..- ......_........... _....... ... ........(S '11) .. " Ella Ann Marzolf fff ............. . ..<<< rr 4.{.�..._�' �. �_.� :. ...__...(SEAS) __....._...............................°.-..........._...:.. ._.... .......... ...................... ........- ................... ...--' .(51 AL) MINNESOTA STATE OF �eX� ...... Ramsey..- ._County. Personally c.tnie before me, this 22.r1d. _ clay of._....S.eptamber................. , A. D., 19.7_l tilt' above named George --- 13erna-rd. Ma�;.z �,f ,.. Sr. ---- and- Ella_..Ann._Marzalf.,_..his --- wife ---.- - ---- ---------- -- - -' ----- --. ......... -- - ... ...... -------.--.... --. -- ._,.------._...._._.. _....._..,....-•--._....._........--.-•-- •- -' •- , to nle known to he the person S __u-llo executvd the foregoing instrument Inc! acknowledged the satne. :.';,��;`•.,r:. 167 ,r G .......... { is4 :a► •t,�:�,, ,.°. J'' Notrary ��ic;.........._.......' .: ,.....-C'o in ,'.%'1 .' a a >tiy Commission expires ................. , 19...... a� (Sectlost 59.51 (1) of the Wisconsin Statutes Provides that all Instruments to be recorded &hall have lain) typewritten thereon the d plainly printed ac namee o[ the grantors, grantees, witnesses nn notary) y _,..� - -..r, z - �!-,P•Lwm'•NC a». j._r.,�,r7cf� ".-.u-.�-�*.�.:r:.•.:-•-rrr.:�a,�n.'^4•-'i'ti,.?-r -- . r. r764"p�.�."M.s, r�;. _ �....�c .... .-.., ,c�*� .. ":,r. °"ar%r';�."-.aw^a-+•-"�"`rt-- `_-�'_—. _.-_ -,. .. __ ..y�_,�. - . ....., �. r �,w....r- �::�_- ��..-:ems ,.. -:- :-..r "=-,..--� .ti , - , __. ,••,.;• - .. 1 .. - _ . .. - � .-+.�#�1 '�� 1 - �}! _. - ---..,i.,r�+., '" - r 1 .w ob 1 i i O •� W �{ i i 1 , f ' C r © U ; •� �� ; i� 'r A iiM a Ri 1� j 1 , ` E 71 9tate of WbD y of St. Croix I hweby certify that this instrurnMt is a,f true and correct copy of the document on NIS and of record in my office and has bee0 compared by me. Att.d June 23 0' Q�gir of Deed DeputY DATED IN GOVERNMENT LOTS 1 AND 2, SECTION 13, T28N, R20W , TOWNSHIP OF TROY, ST . CRO I X COUNTY, W I SCONS I N � a d SAL I S H- N PARTNERS i I P S$96"►d00*L rENTC0 NORTH LINE OF Gov'r Cor � 1s3'Ci0"E 200U0' .. — ... ... _ . i - %--- hl r UNPLATTED LANDS 0WNED ,BY, OTHERS � '+n N S88004'17"C 60 Steven G. C udd LOC,QTIQN SKETCH Jeffrey P. Cudd o S &r10. r � s :. s0 100.00, r •� :� - 13 i CtM wli a ./ L U r P' (��y IVO a ' /0 s 3.9 5 ACRES I w 1 f 167, A 40 SQ.FT. Y 3.2x#44a S4. FT� I 0,ENT � Z NOTE.- OUTLOT I 1 _, a E L d S RE,SERYEp FOR A cc 1�, .,ar.o6.3g E _ r �.... I rt71�tAOt4 �� _ REAftONAt� 4i4EA FOR THE N00QO'00"E60 2' I ' O �, 1 5Q 1 2,64 ACRES `s (115,101 50. FT. i � •�_ i � r 2. 60 AC ExC EASEMENT -� o Hy�v `,_,_�.'�• �- 1A . , i NGRE S AND EGRESS / V7go,�~, I I13, 290 SO FT 1 0 O 11' #b9 r� �t EA f M'E 4 T MCANCER LINE 930n O'+� y►?i �.ti,,k,..� W A 0 L 66 WIDE PRIVATE ROAD EASEIwEmr. I - I 1 8V1L01NG-SEr8AC)k r � OUTLOT -2- r I PIN k 4.4 7 ACRES 714 3 5 1 _►._ N970 38'1-11 100 too - li�-r SLUFF I �IaiE aUr�l?i 2 15 FQA I �2 12 STORM WATER DETE.vr1oN �"A o a, ti 55 WrDr Dar:Ewa� EaSE�+E+ur � i SASIH- �. rd ACCESS Lor I k I 3 CID �Era1� 3 � �� _ o I 0 3.7' ACRES � 3 1 � � $ 3b°OQ o0 t: � ' g ] t164,326 as Frt +, S6 {R _`� Q r n5 6 Q t 'V H 8* 2 9 5 S W � � `^ O 27 711 + \ � �,�] � � � - � - `" - ._ Y - - - - 1vBB°23 55•xY - - - 340 r2, __ - j"w _ �, � _ _ NB9',7[7'37 2104 06' rO 'WE11AIMP L1rv£ f! 1214' Try rE.RS EDGE1 - - — - -_ S0L'��' LINE OF GOO 4dr 2 EAST COVE ROAD rErd rllE_7 5?1r?V�Y N�; VOL5y PG. 13lr ,- S ;PC" 31 59 'w t`=- n+� SHEET j QF 2 SHET LA