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022-1054-70-200
County: St. Croix Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Sanitary Permit No: Safety and Building Division INSPECTION REPORT 538796 0 (ATTACH TO PERMIT) State Plan ID No: GENERAL INFORMATION Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Parcel Tax No: city Village X Township 022- 1054 -70 -200 Permit Holder's Name: Klnninkinnic, Town MotZer, Brian Section /Town /Range /Map No'. ti CST BM Elev: Insp. BM Elev: BM Descripon:, n M �� 1 8.28.18.301 B ELEVATION DATA FS ELEV TANK INFORMATION CAPACITY STATION BS HI TYPE MANUFACTURER Septic � Benchmark � � r i 12. �... G . n. Alt. BM ul � J - 3. 7 4 77. Z GOO b v 760 �✓ Bldg. Sewer �; ► �`ti'�e�' St/Ht Inlet Holding St /Ht Outlet TANK SETBACK INFORMATION Vent to Air Intake ROAD Dt Inlet TANK TO P/L WELL BLDG. Dt Bottom Septic . Z14 /b Z � _ Header /Man. Dosing x.,6 4 , Dist. Pipe Aeration 9 • 7 Bot. System Holding Final Grade PUMPISIPHON INFORMATION Demand Y St Cov J 3, 5 9 1 7. Z Manufacturer e-:5 GPM � � aloe. ��•E- 'f � 5 9S • $ Model Number A 4 // stem Head . L TDH �. Et C� &A— �t0�71Q Ai. TDH Lift . 0 Frictio�L L SY 7 • L Forcemain Length Dia. Z Dist. to Well SOIL ABSORPTION SYSTEM No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth BEDITRENCH Width Length %-- DIMENSIONS '' 'S 1 tee LEACHING Manufacturer. �^ p/L BLDG WELL LAKE /STREAM CHAMBER OR ` SETBACK SYSTEM TO - /� UNIT Model Nurpber � INFORMATION Type Of System: ` �^0Q.1 'o C A> /9� S7 DISTRIBUTION SYSTEM R• • x Hole Size x Hole Spacing Vent to Air I take Header /M ifppld Distribution Q g,# q Pipe(s) � Dia Spacing Length V t Dia Length SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only xx Mulched xx Depth of xx Seeded /Sodded Depth Over •� Topsoil Yes � No es No Depth Over Bed/Trench Edges Bed/Trench Center y 6 Inspection #1: / / Inspection #2: / / COMMENTS (Include code discrepencies, persons present, etc.) Parcel No: 19.28.18.30 B Location: 1032 Quarry R d River Falls, WI 54022 (NE 1/4 SE 1/4 19 T28N R1 8W) NA Lot 2 w s /1 1 � O, 1.) Alt BM Description = C. � O new ff• 2.) Bldg sewer length = A GST b� - amount of cover = Plan revision Required? Yes No L Geri No Use other side for additional information. -- Date Insepctor Signatur SBD -6710 (R.3197) cCEIVEO COM e }n/f gp Safety and Buildings Division County �! U : -u� 2 JFICC 01 W. Washington Ave� PO Box 7162 :S-/. , l , v t 't ree �� Madison, WI 53 I OUN Sanitary Permit Number (to te filled in by Co.) epartme gAW" NING 0 G ? :` .' JJ Sanitary Permit Application State Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriat emmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned PO are Project Address (if different han mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary /� u oses in accordance with the Privacy Law, s. 15.04(1 m , Stats. ?Z l v r I. Application Information - Please Print All Information It RE CEnmn � Property Owner's Name Parcel # ` JU 0 620 1 , Property Owner's Railing Address Property Location / Q ST CROP a PLANNING g Z COUNTY Govt. Lot City, State Zip Code Phone Number [Se's 1, 54— , j4— AY., Se.tion uc le one GAG/ T�N; R49Eo f II. Type of Building (check all that apply) Lot or 2 Family Dwelling - Number of Bedrooms Subdivision Name Block # El Public/Commercial - Describe Use .1401 ❑ City of El Owned - Describe Use CSM Number / ,/�L� ❑Village of T J own of c� w / 9 �— 9 4 - / r III. Type of Permit: (Check my one box on line A. Complete line B if applicable) A ' ❑ New System eplacement System ❑ Treatment/Holding Tani: Replacement Only ❑ Other Modification to Exist ing System (explain) B. El Permit Renewal El Permit Revision ❑Change of Plumber El Permit Transfer to New List Previous Permit Number t nd Date Issued Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that apply) w. J n- Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil ❑ Mound <24 in. of suitable soil G +� ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. DispersallTreatbent Area Information: Design blow (gpd) Design Soil Application ate(gpdsf) Disper Area Required (sf) Dispersal Area Pro pos (st) S Elev of n l -U L / J J F.S , ) .S la VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units �, c New Tanks Existing Tanks Septic or Holding Tank J . Dosing Chamber T 7 5-o � VII. Responsibility Statement- I, the undersigned, assum possibility for installation of the POWTS shown on the attached plans. Plumb�ame (Print) :;� MP/MPRS Number Business Pho Number Plumber's Address (Street, City, tale, Zip Code) VIII. County/Department Use Onl Approved isapprove FPermit Fee Date Issued Issuing t Signature iven Reason i r.Denial �� IX. Condi fteasons for Disapproval I, . IC tank, eftluint filter and -dispersal cell must all be services / maintained as per management plan provided by plumber. 2,.: # Ill struck to 04mients must-be maintained Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 ill inches in size SBD -6398 (R. 02/09) PLOT PLAN PROJECT Brian Motzer ADDRESS 1032 Quarry Road River Falls Wi 54022 NE 1/4 SE 1/4S 19 /T 28 N/R 18 W TOWN Kinnickinic COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 7 /5/1 1 BEDROOM 3 CONVENTIONAL IN- GROUND PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE750 DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1157 # of chambers 57 IL BENCHMARK V.R.P. Top of dose tank co ASSUME ELEVATION 100' Filter B r ❑ BOREHOLE O WELL H.R.P. Same as Benchmark EM LEVATION 95.1/95.0/94.9' 5' below qrade Well Existing 3 50' edroom House Plans Designed Using 30 ' Len, Conventional Powts 30' Manual Version 20 �—► 6 „ uick4 Standard -W Weiser Combo Tank of Cover eaching Chamber * ith 20.0 ft2 of Area B.M. 8ft ^2 /pair of end caps 4' Lon Scale is 1" = 40' 34" Grade at System Elevation unless otherwise noted A " valve is to be ins led and allow B-4 the se of both syst s 40' l� , 120' 0 ' 3 -3' X 78' cells with 0 >3' spacing EP 40' 18' X 84' bed, failed 2% slope el 8 B -3 Vent B -2 Vents 100' 99.5' 93' Property Line 100' 100.5' Quarry Road Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 7/6/11 Owner: Brian Motzer Location: NE1A SE1A S19 T28 N,R18W 1032 Quarry Road River Falls System type: In- ground absorbtion system(conventional) Manuals Used: In- ground absorbtion system (version 2.0) Pressure Distribution Manual (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4 -5. Maintanance and Contingency Plan 6. Utilization of Existing Septic Tank Form 7. Pump Chamber Cross Section 9.11 Soil Test 12. Survey Map 13. Deed Signature License numb e 226900 PLOT PLAN PROJECT Brian Motzer ADDRESS 1032 Quarry Road River Falls Wi 54022 NE 1/4 SE 1 /4S 19 /T 28 N/R 18 W TOWN Kinnickinic COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 7/5/11 BEDROOM 3 CONVENTIONAL IN- GROUND PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE750 DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1 157 # of chambers 57 IL b BENCHMARK V.R.P. Top of dose tank cover ASSUME ELEVATION 100' Filter B r ❑BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 95.1/95.0/94.9' 5' below grade Well Existing 3 0' Bedroom House Plans Designed Using 30' L Conventional Powts 30' Manual Version 2.0 t--► 6 „ uick4 Standard -W Weiser Combo Tank of Cover eaching Chamber * ith 20.0 ft2 of Area ft B.M. 8^2 /pair of end caps 4' Lon Scale is 1" = 4�� 34„ Grade at System Elevation unless otherwise noted A 4" valve is to be installed and allow B -4 the use of both systems 40' 120' 0' 30' 3 -3' X 78' cells with 09 >3' spacing 1PI 40 , 18' X 84' bed, failed 2% slope 80' B -3 Vent B -2 Vents 100' 99.5' 93' Property Line 100' 100.5' IF Quarry Road Cross Section of Quick, 4 Standard -W Leaching Chamber Typical cross section for 2 of 3 cells Quick 4 Standard -W Leaching Chamber with 20.0 ft2 of Area per Chamber 5.8ft ^2 pair of end plates To be >1' above grade Finish grade elevation Typical Installation 100.0 t Vent /� Grade 4„ 4' ,A/30/34 Septic Tank , jY , en �� 5' 4 ' Long 1 „ Grade at System Elevation 3 4 Grade at System Elevation 3 4 19 Spacing 5' 3 -3' X 78' Cells Observation tubeNent Same on other end To be located on end of Cells 4_ � % A B System elevations: C A__95.1 B 95.0 19 chambers per cell C___94.9 ST. CROIX COUNW SEP'T'IC TANK MADgMANCE AGREEMENT AND OWNERSHIP CFIAMCATION FORM Mailing AM -mss 3z - a� PropettY Address _ Depar tment for now const<uction) (Verification required from Planning & Zoning 71? °?0z) city/state Parcel Identification Number _, - / Q 1 1a ,Ste. T Z2N W, Town of / P Location � /a See./ Lot # Subdivision �-� Volume � 1 page #� Certified 3nrvey Map # i , Volume Warranty Deed # Page # 7 " 9 not lines identifiab y� o Spec House �"� / � y�� v � s r I rwnTi�N Alyt"'ti' AND L N- D CFR r,k Tmprol?ar use and maintenance of your septic system could result in its Premature, a �� li to to ba han pumper• dle wastes. Proper What you the system can affect the put into maintenance ccnsists of pumping out the septic tank every three years or soonar, if needed, by of the ea septic tank m a treatment stage in the waste disposal $Wtoem. Owner• e nse�p,o�nsabilities are specified s red i §Comma. 83.52(l) and in Chapter 12 - St. Croix CovntY Sanitary Cddinme to aubmdt to St. GYoix County Planning & Zoning Dept a certification farm, sighed by the The p"' p ow� agrees l pumper ve�S'48 that (1) the on-site owner and by & master plumber, journeyer pb�, restricted p mbar or a licen wastewater disposal system is in proper operating condition and/or (2) after bapection and pumping (necessary). the septic tank is Iess than 1/3 full of sludge. is azui agree t t o rmuatam the its sewaSe sal system with the Vwe, the uindersigmod have read the above requke�n and the of Natural Rena .:hate of Wisconsin• standards set forth, h as sat by the Depsrtadent of Cor a roWmtd to fire St. Croix County Planning & Certification stating that your septic $yat�em has been mainta must be comp Zoning Demrtment witbin 30 days of ft three year won daft. knowledge. Uwe ardare the owner(a) of the Uwe canopy that all statements on this formate true to the beat of mylour property described above, by virtue of a waxmnty deed recorded in Register of Deeds Office. Number of bedrooms � / /�f� DATE SIGNATURE OP APPLICANTS) ** *Any infornlation that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Tnchade with this application a recorded warranty deed from the Register of Deeds office and a copy of the certified survey map if reference is made in the warranty deed. ("V. 0 8105) Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the sy -atem. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 Contingency Plan Option #1. If system fails, determine cause of failure, use alternate area and install new system in tested replacement area. Option #2. Install system at a lower elevation, by removing chambers, removing bioniat, a it new system. L ption#3 No adequate area is suitable for replacement area, and system elevation cannont be lowered. I C 3. Replace any other failing components as needed. Plumber: Shaun Bird 715- 246 -4516 St. Croix County Zoning 715- 386 -4680 Pumper Tom Mondor 715- 246 -5148 Shaun Bird #226900 ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK 'f'tj:i -s is to certif that I have inspected the septic tank presently serving the r►ct� 1� 0'r� residence located at: Section �`, T�N, R W, Town of , rLj[ i Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced: 'le /v—i c2o �� _-._ P) d flow back occur f om absorption system? Yes No (If no, skip next line) Approximate volume or length of time: gallons _ minutes, capacit Construction: Prefab Concrete_ Steel Other Manufacturer: (If known) :,��y�l,(�, Age known),: ( (Name) Please pr int (`Pitle) (License Number) gate Form to be completed by licensed plumber (s.145.06, Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) Y1 -umber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank to the b of my knowledge will conform to the requirements of ILHR 83, W' . Adm. Code (except for inspection openin over outlet baffle). �i'7 r� Nam `,�/1 Signature MP /MPRS li L-� 6' C.� Septic -Dose Tank Cross Section And Pump erfo p rman a SpeCif cations T Tank Manufacturer _ _ `- 1'tlralc Model Number Pump Manufacturer P - - - -- -- p Model Numb - otaf Tank Cap acity Pum M � G Max. Bury Depth s Z� Alarm Manufactu - Alarm Model Number Switch Type �, F ilter M anufacturer _ — �---- r� Total Dynamic Head (T;D:H) -Feet _ Filter Model Number ,� _ Elevation Head Distal Pressure - -- ^� Minimum Pump _ p �erf`ormance Requi Network Loss red Force Main Loss GPMi Ft TDH To - 'r Outlet Manhole lain. 4" Above Grade With - � - - -- Locking Device. Inlet Manhole � t Manhole Min. 4' Above Grade 6" Below Grade Sealed Watertigh Mounted With Lock�ir.g Device V Weather -proof ''` °■' " ""` Finished Grade Junction Box ar r r, ■w Vent Min. 12" • Above Grade Discoimect With Vent Cap Means •> >:•: • : 1 ✓. 1 ••11,•,1 e . ., <, !,} ;,, . 1. Outlet Filter Inlet �__ ---- -- Inlet Baffle Switch Se n s and A g Reserve Capacity '.; /4" Tank Volume GPI 1 Dimension Inches Volume Gal. Weep (reserve) A B H,oyleo X. (alarm) B. 2 e Off El anon (dose) C j t C (dead) D Ro om Total �i j'° ? ° i : D Elevation 1 >TTT��< �'f—C • > I ice•• >• >I.1 >c> �It • I • t i !•} } >,•, >, Y,1, •, / • }, > , , � > : > I I t > t 1 l > • 1- �>�{�`•11 >•!• >•����!•�•i 1�•� ,! J GENERAL INSTALLATION: The septic /dose tank is bedded and back filled in accordanco , manufacturer's product approval specifications. Maximum depth of bury as specified by the manufactur may not be exceeded without prior approval. Manhole covers exposed to grade have an effective locking devict (padlock) installed piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridg the tank excavation "and the sleeve is sealed watertight. Electrical service complies with NEC 300 and Comm IQ& 02/051.,.1 page of ME40 SERIES 4/10 HP Effluent and Drain Water Pumps r POWER & FLOAT CORDS PLUG DIMENSION'S Quick- connect. watertight Replaces switch assembly fittings are interchange- for manual operation. able, replaceable from _ �R L. pump exterior. �� �l _ h r roc BUILT -IIJ OR PIGGY-BACK MECHANICAL FLOAT SWITCH Mercury -free. go. angle operation ` , gT �....... I * .. f �f MOTOR HOUSING Jt1 i r - - - - Cast iron for efficient I l hs .l - heat transfer. 1 " I E _ OVERLOAD SWITCH Built-in to protect against r overload conditions. 4/10 HP MOTOR S n - r I 21 r, ai - 1500 rpm. 60 H2. 115 or ..' Y r k 230V. single phase Oil �– -_ cooled and lubricated. — -- F f_- x Fla RMART SHAFT SEAL -- r Carbon, ceramic faces. r.I i t t t PERFORMANCE CURVE CAPACITY LITERS PER MINUTE VOLUTE/DVELLER SEAL RING u Maintains high efficiency � ,r and reduces recirculation, J 1 replaceable. 3 3 0 ENCLOSED TWO VANE IMPELLER High efficiency, passes HIGH EFFICIENCY ABS 1 /a" spherical solids. with VOLUTE ' _ °. stainless steel wear ring. Corrosion resistant. Passes '/<" spherical solids. I THRUST WASHER, SLEEVE NPT discharge, BEARINGS Enhance smooth operation a and extend pump life- CAPACITY GALLONS PER MINUTE K3319 10101 ��� F E. Myers, 1101 Myers Parkway, Ashland, Ohio 44805 -1969 Printed in U S A " 4191 289 -1144. FAX 419 /289 -6658: www.fernyers.com q Myers (Canada). 269 Trillium Drive. Kitchener Ontario N2G 4W5 I iSOYINKI 519 %748 -5470 FAX 519,'748 -2553 Pentair Pump Group �o 1568PAu. 427 STATE BAR OF WISCONSIN FORM 2 - 1999 t WARRANTY DEED KA THLEE N H REGIST H. DEEDS Document Number REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Craig C. Pechacek, a single person,_ RECENIED FOR RECORD - - - - -- — .--- ... - - - - -- — IP -19 -2000 2:00 PM — —� — WARRANTY DEED Grantor, and _ Brian T. Motzer and Laura L. Z , SINGLE — CE RTPT Il _ .— CERF COPY FEE: PERSONS AS JOINT TENANTS COPY FEE: TRANSFER FEE: 1102.50 RECnRD?NG FEE: 10.00 — PAGESa - 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in _ St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Lot Two (2) of Certified Survey Map in Volume Ten (10) of Certified Recording Area Survey Maps, page 2738, as Document Number 514453, filed in St. Croix Name and Return Address County Register of Deeds Office on March 23, 1994, being located in the Northeast Quarter of the Southeast Quarter (NE1 /4 of SEI /4) and the 5� CR01X 75 O 109 N. M AI N MG. PO Southeast Quarter of the Southeast Quarter (SE1 /4 of SE 114) of Section RIVER FA1,La S, ST WI 64022 Nineteen (19), Township Twenty -eight (28) North, Range Eighteen (18) West, Town of Kinnickinnic, St. Croix County, Wisconsin. Subject to Quarry Road right - of - way over the Easterly portion as shown on 022 - 1054 - 70 - 200 said Certified Survey Map. Parcel Identification Number (PIN) This is homestead property. (is) i�i00 Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this — 1� day of December — 2000 — — —. — -- Cra' - C_P echacek - -- — —. AUTHENTICATION ACKNOWLEDGMENT Signature(s) Craig C. Pechacek, a single person, STATE OF WISCONSIN ) ) ss. County ) authenticated this / d —� ay of December 2000 / — — Personally carne before . the this - - _ — day of the above named + Kristina Oglan — TITLE: MEMBER STATE BAR OF WISCONSIN — -- - to me known to be the person(s) who executed the foregoing (If not, instrument and acknowledged the same. authorized by § 706.06, Wis_ Stats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Ogland Notary Public, State of Wisconsin Hudson, 1 54016 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ) Names of persons signing in any capacity must be typed or printed below their signature. Information ProresHonaia company. Fond du Lac. Wt 800- 655 -2021 WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2 - 1999 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Code county c p v Attach complete site plan on paper not less than 8 1/2 x 11 inches in,�. Plan mu e i*` include, but not limited to: vertical and horizontal reference point (B a nd - Parcel I. D. percent slope, scale or dimensions, north arrow, and location and distance itrpad. G .� (f Please print all information 'aNN / /// Revi by Date Personal information you provide may be used for secondary purposes (Privacy lgA / (m)) Property Owner —7 Prope tion Z 5 /- i ev Govt. Lot E 1 /4 2�1 /4 f T Z R / E (or Props Owner's Mailing Add Lot # Block # Subd. Na or CSM# City S,rtate�y Zip od Phone Number City ❑Village Town ear st Road ❑ New Construction Us Residential /Number of bedrooms Code derived design flow rate GPD Replaosment P or commercial -Des 'be: Parent material A T.�LZtLQ� rya/ Flood Plain elevation if applicable - -- -- ft. General comments S and recommendations: 6. C / System Type G- I!u System Elevation ! S1 ( J F 1-1 Boring # E] Boring /� r -a Pit Ground surface elev.! � , ft. Depth to limiting factor in. Soli Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. i 'Eff#1 'Eff#2 a _7 I �, ---- Uv ----�- J 60 It r /t # Boring � f j J -�--� Pit Ground surface elev. , + ft. Depth to limiting factor ln. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 31Z 72-32 �---- ��� i A f s 01 + • i Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST flame (Please Print) S' ` �/ CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54d �.-s �� 715 - 246 -4516 Property Owner _ Parcel ID # Page of ❑ Boring r — Is] Boring # Pit Ground surface eiev. _ft Depth to limiting factor — in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= 'Eff#1 'Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 12 .01 ❑ Boring Boring # Ground surface eiev.ft Depth to limiting factor_ in. Soil lication Rate Pit Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 'E GPD/f1? E in. Munsell Qu. Sz. Cont. Color Gr. Sz Sh. � G EE l Z$ [] Boring Boring # ft. Depth to limiting factor in. ❑ Pit Ground surface elev. Soil Application Rate Horizon ' lepth Dominant Color Redox Description- Texture Structure Consistence Boundary Roots GPDtff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS _< 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 -264 -8777. SB D4330 (R.6=) Soil Test Plot Plan Project Name Brian Motzer Sha ird Address 1032 Quarry Road River Falls Wi 54022 CKIII #226900 Lot 2 Subdivision -- - - ----- Dat 7/5/11 NE 1/4 SE 1/4S 1 9 T 28 N /R W Township IUnnidcinic Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of manhole cover on dose tank System Elevation 95.1/95.0/94.9 *HRpSameasBenchmark Well Existing 3 0' Bedroom H ouse , 30 30' Weiser Combo Tank B.M.* Scale is 1" = 40' unless otherwise noted B -4 40' 120' 30' 30' B -1 40' 18' X 84' bed, failed 2% slope 80' B -3 Vent B -2 100' 100' 99.5' 93' Property Line 100.5' Quarry Road 07- 05- 11;14:10 17152468906 # 3/ 4 r FILEV MAR 2 � '199 ` 11 JAMES O'OONN =31.4 514453 SL aaOC CERY IFIED SURVEY MAP --------- -- - - -- LOCATED IN THE NE 1/4 OFTH SE 1/4 AND THE SEI /4 OF THE SEI /4 OF SECTION (9.TZaN, R18W, TOWN OFAINNICK1NNIC, ST. CROIX CO-, W1. E 1/4 COO. S EC, 19 P yvAwep_FOR! _ COuNTY MONUMCNT 6i5NAL0 gNOMARaA PAU 0 FOUND). 0 i Iq 1 I MI o IN CERT -_I.FiEn SU MAP ` ' ✓JL_ J ?3. 269Q 6 >, • 406 9 ° � • r -loo+ �� N8T C ZING$ ARTS REFERENCED N CP57' LINE OF THE NE 1/4. IRf GORa HEARING] ,� 1 I Al °g, 1 a s� a e 1 In 31 N 1 I MI v • � a n 1 V 431 = 4 y /� I v � b f0 L V T 2 1 Io I7 W )3. 60 ACRES t P1I F �. fg6f,4>Zfl so.FT.1 I �. °1 ,95 PC.iC. RDAs R.O.W. 9 1i 1 ~ ( 4 5 31, 6 0 3 84• FT. I 4 1 �: ... N66 31 , >•sv.va• su1LDiN4 SLTaACK �• LIN£ 1 0) A Pepait. NOIMTfi n N 1 ~ . \ LOT 1 . APPROVED o• IC1 c 10.60 ACRES ' 1 � y 1 0 �! w , 1401, 690 SO.FT.1 �• 'h 1 14. 16 AC. EXG. R.O.W. 1 O'b I. �. W 1 1441,69$ SO. FT's + o '4. RIM 23 V4 1 �• � � 431 �� -I -� )� ST. CRUD[ COONTY 1, � C: onrlprohu3ls +vf+ pi81N14 0 8 �� �3 1 331 zonbv mind 4 • , 2 6 .93' Parks Coaml lfes CL KW JOB.i6'j• 1 g�{n 15 W 737. � 1 lfiwttwCOfdt 1 4 Ni 1 n x wmun 30 dm *v ��6aeo9sai>n , Ih ova sa " � taNPI�ATTEG LAND o 0 i'F • O O• SET 1 "1[ Qa•' IRON P11.1p WCI6MINe I.1 3 LOS. pCR LINEAR POOT, S• iFsryq s E coR. s EC- Is. w SPRING VALLEY I I' (CH ISLEDIW "1N r wi5 •■ ] IReN rl!•a FouNa. CONCRETE FOUND) �`��•[ s ue` VOLUME 10 PAGR 2738 SCALE 1 ■ 200 ` JAMES M, R S�f80�— O' Ipa 200 400 NEI.aeN- wsCSR (_AND SURVEYING RI FAhig • MENOMONIE fag 9 + =3 MIs INSTR DRAFTED B Y J.W. SHEET 1 OF 2 il= Toll Free 888 - 999 -3290 Mailing Address Office 231 -582 -1020 1455 Lexamar Drive, Boyne City, MI 49712 Fax 231 -582 -7324 Email simtech a freeway.NET Web www.eau- simtcch, coin INSTALLATION & SERVICE INSTRUCTIONS INSTALLATION: When installing an STF -100, screw filter into discharge port of any pump that has a 2" National Pipe Thread. Pumps with a smaller discharge port may be adapted to fit. When installing an STF -100A2 a tailpiece and male adapter will need to be added to the inlet end of the filter to the desired height and a 2" union will need to be added to the outlet end of the filter. Always install the filters in a position where they can be easily serviced. * *Always use caution when starting threads to avoid cross threading * *. Plumb force main into the 2" sch 80 PVC union. * *We recommend that the union remain together during gluing to insure that glue or cleaner does not ruin O -ring or sealing surface * *. SERVICE: Service of filter screen is dependent on usage as every system is unique. For most residential systems we recommend inspecting the filter within the first year to determine the necessary service intervals for the filter. In high volume systems we recommend inspection within the first 6 months to determine necessary service intervals for the filter. Once the service interval is determined it should be consistent unless something changes in the system. Always inspect the filter screen for any damage or corrosion and replace if necessary. If our STF -101 service alarm switch has been installed and adjusted properly it will alarm when the filter requires service. It should be serviced no less than when periodic pumping of the septic tank and pump chamber is performed. Servicing will be more frequent if using any one of our optional filter socks (600 micron, 150 -190 micron, and 100 micron). Check your local health department for septic system servicing recommendations. If the screen becomes clogged before the periodic pumping requirements, a high level alarm or light will indicate the need for service. If system is equipped with a "pump on light" that stays on longer than normal, this also may indicate a need to service filter. To service filter screen, unscrew the 4" cap. Pull filter screen from canister and wash out thoroughly in appropriate location with proper protection. In some cases an additional filter screen allows quicker service allowing the dirty filter to be washed later at the shop. Note that in cold conditions the filter cap may be difficult to remove. Keep the filter in a warm area or pour warm water over the cap before removing. Once the filter is installed in the tank it maintains a stable temperature and removing the cap will not be a problem. If the system is equipped with our Service Alarm Switch, the filter screen does not need service until the Service Alarm Switch activates a light or audio alarm. We still recommend that the filter be inspected once a year for damage or corrosion. NOTE: The total dynamic head loss of the system must be increased by 0.5 feet of head to overcome friction loss through the filter. SERVICE ALARM SWITCH The alarm switch is available in three pressure ranges, low head, medium head, and high head. Installation is simple, on SIM /TECH FILTER systems, remove %4 plug from base of filter chamber and connect tube fitting. Next, run the tube up into the tank riser and connect to service alarm switch. The alarm switch is fastened to the side of the riser via the nylon strap provided. Run alarm wire to alarm box. The service alarm switch can be wired with its own alarm or with the high water alarm. Pressure adjustment is made by removing the end plug, and inserting the 7/32 allen. Clockwise increases pressure. One turn equals approximately 3 PSI. The low head alarm switch comes factory preset at 8 PSI and is completely field adjustable within it's range (3 to 24 PSI). We recommend the use of a ball valve when using an alarm switch. Once you have installed the filter and alarm switch, the ball valve can be closed off to simulate a plugged filter so that you can make sure the alarm switch is working correctly. * ** *TRY OUR LID /SCREEN REMOVAL WRENCH. Our wrench holds filter lid firmly and hooks screen for easy removal and installation. Made of PVC plastic. Installation Service Instructions. doc R) W 00 H I I U �J F� 0 V I V) V � o�� F7 H TI O 70 M �Q MV) D D TJ "(-) £ m -I C -' M --i w r r D C C mo °z =— I -D-9 nj F9 m D (- - D F7 F9 C l - ' - 1 (� DO low* 4P- (4 -,j -j� FT] D MF z o --IF 3z m `"1 0-1 d N O(�D N o 75 o R) F9 FT I c� co 19 FILED o s MAR ?, 0 1994 •' 1 r JAMES O'CONNELL ,q 45 C '17 Register of Deeds 51.43 SL Croix Co•, W 1 / CERTIFIED SURVEY MAP LOCATED IN THE NE I/4 OF THE SE I/4 AND THE SE I/4 OF THE SE I/4 OF SECTION 19, T28N, R18W, TOWN OFKINNICKINNIC, ST. CROIX CO., W1. E 1/4 COR. SEC. 19 PREPARED FOR: COUNTY MONUMENT DONALD AND MARGARET PAUSCH O N FOUND). a - i i m�o IH Cr ici� aU .9 MAP 6 ✓Jr_. J , Pv. 2 6 A I NOTE' BEARINGS ARE REFERENCED 9 r•- 100'x+ Q� t T.k EAST L INE OF THE NE 1/4. (RECORD BEARINGI , 1 9'' I 6 �o0 p 6s ' A 3I o I a I WI �n I S 1 • (/1 1 vI b In CO O Q • � LO T 2 10.60 ACRES 1461,625 SO.FT.) 9.9E AC.EVC. ROAD R.O.W. I I R (433,363 SO.FT.I I I W N 1 QI b C l Ifl I Im ^ Z N '6 °31'15 "E 793. ^+, Q \ T 5 9. B 4 I 3 3. B fl' 10, J �• I I � I 0. BUILDING SETBACK O z' LINE 1 APPROX. NORTH, cli N ' h \ LOT 3 " o 1 APPROVED '^ '* 10.60 ACRES ' W14 'z N 1461630 SOFTI � , . . • 1 a 0 W m 1 0442 692 SO, FOT')W MAR 2 3'941 1 I 1 ST. CROIX COUNTY • juu �I C omprehensivo PlamOr o �3 '33 I ZovAng and ¢O I l Z 28.93' Parks Committee a� T08. 6S' 7 S86 °31'!5''W 737.56 �N? If not recorded ^! 3 within 30 days exit �ot4380930p�� approval daft 4 UNPLATTED LANDS C':," 9a�� I N -tpprov8l shag be N, & void Oz SET I "X 24" IRON PIPE WEIGHING t,13 LOS. PER LINEAR FOOT. s6�4 � SE CDR. SEC. 19 SPRI — G. VALLEY f •s 1 "IRON PIPE FOVND. fCHISLED "X "IN 5 „�,� tiV1S• f ���� CONCRETE FOUND) VOLUME 10 PAGE 2738 SCALE 1 ' 200' JAMES N. WEBER S- 160 40' NEL SEN- WEBER LAND SUR VEYING O ` 100 200 0 RIVER FALLS - N£NONONIE 04TH �,�a 94 THIS INSTRUMENT DRAFTED BY J.W. S EET I OF 2 O o > 0 0. o er I' c I °o I N N v 4 I c; I I 1 I I III LL c a I I z N I 00 (� _ e 1 G L Z y y rn N w a m �- z 0 o Z d c 0 1 w m z d o, z 1 u� ►- E c p_ O cu C •'"'� a O— N 0 m Z m Z = 0 1 N CO z M E N A N m N U,) .. O m N ! m — I IL _ O O Rj G M d O N C Q p �j fA d1 M � N N N w Z N! F F F Q- Z *� (6 Z O O 0 0 0 1 •� LL m m m c IL ii :: in�c o-- r ti 0 o N x3 rn cn 0 O M N R Q C O U w o c C� co A O l o o U a) (L a a N N 11 U j\ s, �' Y N E E c a) Lh c c a) c a) p v co 0 O jZ N L O W U L r- F gj • L 04 c_ a) a o E U N p Y d N 0 N Z (n r v � I Va w m y a #t a a v rr ` � ir� i y E .3 3 0 Z- V STC - 104 �GEI'v� n AS BUILT SANITARY SYSTEM REPOR OWNER U> ^vwT:�, { . rid r ADDRESS i L �1,i r Y :' y , SUBDIVISION / CSM# LOT SECTION _T Z 1 N -R W, Town of N A / I A'Al (C �• ( 4:TJ'4 ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Li -hj LL tINDICAT / Provide setback and elevation information on reverse of this Provide 2 dimensions to center of septic tank manhole cover.` BENCHMARK: C5�- P G o 4- e-6 n - J TO. D ALTERNATE BM: BA 5 S q! i 7 SEPTIC TANK / PUMP CHAMBER. / HOLDING.TANK INFORMATION Manufacturer ,(� � ���'" . Liquid Capacity: Z 5 v ''?`!� Setback from: Well House Other PC 14 ' Z Pr Pump: Manufacturer /I/�C� ^��. -5 - Model# _. . w Float separation Gallons /cycle: Alarm Location 4vrtr /f' t �.. �, . �: SOIL ABSORPTION SYSTEM ' Width: Length Number of tzarzh9s Distance &Direction to nearest prop. line: t Setback from: well: "' House � Other ELEVATIONS Building Sewer ST Inlet: I O ST outlet. PC inlet PC bottom_ . � Z Pump Off Header/Manifold � r (o.3 Bottom of system Existing Grade Final grade- DATE OF INSTALLATION: PLUMBER ON JOB: a LICENSE NUMBER: INSPECTOR: 3/93:jt Wisconsin Department of Industry PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 268577 Permit Holder's Name: 7KC �NNICKINNIC ty E] Village Town of: State Plan ID No.: PECHACEK, CRAIG CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: A l TANK INFORMATION ELEVATION DATA AQrnn t111 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Vj/ e &,/ nG. 2 Benchmark /.,V/ Dosing cttt ��rn -� . M k Anfl Aeration Bldg. Sewer �a i Holding St1W Inlet /,q, TANK SETBACK INFORMATION St1 Outlet TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic ��(j� 73 A)4— NA Dt Bottom 4 � a Dosing NA Headed_ u13 Aeratio NA Dist. Pipe 96 , 3� Ho Bot. System 35 PUMP / STPIMMLUFORMATION Final Grade Demand ' � " T � , Manufacturer e �rS !c C r/�/ g� �� Model Number C e� GPM TDH I Lift a.) Friction 4�( System TDH �.�0`Ft Forcemai n Length O Dia. / Dist. To Well SOIL ABSORPTION SYSTEM BED /TRENCH Width ` th No. Of Trenches PIT .0 Pits ;In Dia. Liquid Depth DIMEN I N i Leng s DIMEN I N SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACHING cturer: SETBACK CHAMBE Model Numbe . INFORMATION T ype O X12 oS - 41y— OR U System: II "�U�u 7 3 a DISTRIBUTION SYSTEM Header / Distribution Pipes) , ,� x Hole Size x Ho To Air Intake Length 11z-- Dia. Length Dia. ('� Spacing SOIL COVER x Pressure Systems Only xx Mound Or At- de ems Only Depth Over Depth Over xx Depth Of xx Seeded / Sodde Bed /Trench Center Bed /Trench Edges Topsoil ❑Yes ❑ No El ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) -Ef , .gt*..c. --r"( LOCATION: KINNICKI NE, SE, QUARRY RD / ��ti�r- ri�.� -rr�, l� -�n�it �'►a��� ��d7� �-- �l. � S . �� c.er� -rr vl� Plan revision required? (:]Yes LK No Use other side for additional information. SBD -6710 (R 05/91) Date / Inspector's Signature Cert No. Safety and Buildings Division ; SANITARY PERMIT APPLICATION Bureau of ' Bu 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 81/2 x 11 inches in size. ►` • See reverse side for instructions for completing this application State Sanitar Permit Number The information you provide may be used by other government agency programs ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Property Own pert Location C:IV ) f C CC—K C, 1/4 � t /4, S `I T , N, R Ig E (040 Property Ovvqer s Mailin Address Lot Number Block Number Ot State Zip Code Phone Number u iv i ame CSM Num t''t V � �ts_S tom( S(ro z Z ( - Q / ,� II. TYPE F BUILDING: (check one) E] State Owned [I it� Near E] est Road 3 VII age �CvJN j li'. ��•!N CJI.d Oe Public 1 or 2 Family Dwelling - No. of bedrooms Town of Ill. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash S ❑ Hotel /Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT (Check only one box on line A. Check box on line B, if applicable) A) 1 New 2. E] Replacement 3_ E] Replacementof 4_ E] Reconnection of 5. E] Repair of an - __ ystem System______'_______ Tank Only______________ Exlsting system _________Ex -- - System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 KSeepage Bed 21 ❑.Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 []Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) 9 Feet Elevation 4� 5-0 �� J . r, Feet VII. TANK Capacity site INFORMATION in gallons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- plastic App - New Existing Gallons Tanks concrete strutted glass App Tanks Tanks Septic Tank or Holding Tank K EJ ❑ El ❑ Lift Pump Tank /Siphon Chamber 1 ❑ 1 El ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plu er's Name: (Print) Plumber's Signature: (No St a MP/ Business Phone Number: oe PI mber's A dress St v re t, City, State, Zip Code): J v e E-! IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sa itary Permit Fee (Includes Groundwater at Issu d Iss ing Agent Sign to (No Stamps) X Approved ❑Owner Given Initial Surcharge Fee) Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6398 (R. 05/94) DISTRIBUTION: Original to Counly, One copy To: Safety & Ruildings Division, Owner, Plumber fecffACC MIA o x 3 8 t- X 4v B/4 f ` . PAGE OF C r�SS Jec�1 0 0 o r Jy5ter� I Fresh AIr INS16 And Obcervatlon PIp• ^ �--- Approved vent Cap Minlmum 12 Above Final Grod• 20- 42' Above Pipe _ 4' Cast Iron To Final Grad• vent Pipe Marsh Hoy Or SyntMtk Cowring I min 2' Aggregate Over Pipe Distribution Pipe 0 0 0 0 0 — Tee 6' Aggrego o Perforated Pipe Below Beneatn Pipe - Capiing Terminating At Bottom Of System I p ��Poze� �If1kl qr� < SOIL FILL DISTRIBUTI01'.1 PIPE APPFCOVED S�VPETiC COVER ° ~- MATJ:RIAj- OR 9" OF STRAW I OF A6GRE6ATE OR JjARSN HAy a (e OF 12 -Z /Z AGGREGATE DISTRIatJTiOU PIPE TU BE AT LEAST IUCHES BELOW ORIWQAL GRADE AID) AT LEAST?-0 IUCHES BUT IDO MORE THAI) H2 IUCNES BELOW FINAL GRADE MAXIM WN OF EXC -AVAT1 ,0 0 FRoM oKi &w+aL 6KAoF- WILL BE �b IU CHES MIKIMUM 9Ef 1"ti OF EACAVATtoN PROD 0 ( WILL BE _ INCHES SIGIJEO: LICEUSE ►DUMBER: �-3� a DAT E: ii PAC,F GF PUMP CHAMBER CROSS SEC T IOIJ AKJG SPECIFICA VENT CAP `I' C.I. VENT PIPE APPROVED LOCKIMG WEATHERPROOF � 25' FROM DOOR, JUMCTIOU BOX MAMHOLE COVER WINDOW OR FRESH 12 "MIU. AIR INTAKE 1 GRADE I 1 I y" MIM. � COUDUIT -- 18 "MIAI. v � \\\ ---- - - -- -- 11� IMLET PROVIDE I - - -- _T AIRTIGHT SEAL *� A I I I I ALARM d � �I I *APPROVED I Om /� JOINTS WITH I I ELEV. 90 ' QT. APPROVED PIPE I 3' ONTO PUMP- ` pFF D SOLID SOIL COAJCRETE BLOCK RISER EXIT PERMITTED OWLH IF TAIJK MAMUFACTURER HAS z s PP�R /76 SEPTIC E SPECIFICATIOAIS DOSE TAIJKS MAAIUFACTURER: ���� IJUMBER OF DOSES: PER DAy TAWK SIZE: GALLOUS DOSE VOLUME �- ALARM MAAIUFACTURER: TA Auc,n-+ IIUCLUDIMG BACKFLOW: ZS GALLONS MODEL kJUMBER: CAPACITIES: A= Z IMCHES OR r GALLOWS SWITCH TYPE: Z g = IUCHES OR GALLOKIS PUMP MANUFACTURER: ` G 's C = _L.L= �AILHE5 OR Z 2 � GALLONS MODEL 1JUMDER: D= INCHES OR GALLOWS SWITCH TYPE: MOTE: PUMP AMD ALARM ARE TO DE MINIMUM DISCHARGE RATE GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEAI PUMP OFF AMD DISTRIBUTIOM PIPE.. �� FEET + MIIJIMUM NETWORK SUPPLY PRESSUR // " . , . " . . , 4 FEET + FEET OF FORCE MAIN X F /pp FtFRICTIOW FACTOR.. 3 FEET TOTAL Dy1JAMIC. HEAD = FEET 20 6A IpC - A- l?jctf IWTERKJAL. DIMEWSIOKII: OF TAKJK: LEKIGTH ;WIDTH ;LIQUID DEPTH SIGIJE D : LICEKJSE HUMBER: 6,77_.I n4 K SSM33 PERFORMANCE CAPACITY LITERS PER MINUTE 0 20 40 60 80 100 120 140 160 30 Jill — 9 25 - 8 7 cr. w w Z 20 6 w w 15 5 0 4 w 10 _ J O 3 Q F- F- 5 — 2 O — 1 0 0 0 5 10 15 20 25 30 35 40 45 CAPACITY GALLONS PER MINUTE Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page ` of -3- Labor and Human Relations Division of Safety & Buildngs in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but 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: PROPERTY LOCATION (:- P" I G GEN`T-.L-6FF N)kE� 1/4 Se 1/4,S \ T Z.8 ,N,R L8 E (or IN PROPERTY OWNER MAILING ADDRESS LOT # I BLOCK# SUED. NAME OR CSM # CITY STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE GOWN NEAREST ROAD 1 S<[.OZ_ ( (�2s - 9L8'Z Ntr.kilC f k3 K lC! ©uf c" 1Z� [New Construction Use pQ Residential / Number of bedrooms 3 [ ] Additin to existing building [ J Replacement [ ] Public or commercial describe Code derived daily flow y S0 gpd Recommended design loading rate - bed, gpd/ft !� • 3 trench, gpd/ft Absorption area required _ Soo_ bed, ft 11 trench, ft Ma)amum design loading rate_ - -S bed, gpd/ft Tench, gpd/ft Recommended infiltration surface elevation(s) S- S ft (as referred to site plan benchmark) Additional design / site wnsideratioris D M M X16 3 - DOSED _�C S . M 1� S' x t v o' Lo" G . Parent material SI L 31MI VI % r SA Flood plain elevation, if applicable �J • It S = Suitable for system J CONVENTIONAL MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDMIG TANK U= Unsuitable fors stem I C4 S ❑ U IO S❑ U ®S ❑ U ® S ❑ U ❑ S ®U [is EI U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bound 3y Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed ITrench SlI ZM Sb12 `��` 1- C LQ - •S b Z �1 -ZS V (3 cZ 3l L i - ca, j Ground 3 z S S `i R 3! - s 1 \C- Sbk -(3W1 mvir -�, elev." O ft — Depth to lZ l)1J O 1'cLL 80�z i :'j G S limiting fac tor 3� Remarks: Boring # 102 2, Z )I !. Ground elev. O F)•3 It Depth to limiting s factor CRCIX. P-1 Remarks: t9 FFtC1< CST Name: - Please Print Phone: Arthur L. We erer 715 egerer Soil Testing & Design Service -P.O. Box 74 River Falls,WI 5+027 Signature: _ _ _ Date: _ CST Number: ? ��- 195 8 = M60576 PROPERTY OWNER SOIL DESCRIPT S C R I P N 2- TIO REPORT Page of 3 PARCEL I.D. # i. Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft i .. .... in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench :;> - LIn , S Z 1t1 Z� 10`22 zv( - S Z abh wl'ck Ct," . g 1, Ground s om elev, o t 8. ft. Depth to limiting factor ? �5 i Remarks: Boring # , � 1 t�- l.O 1 O` 1i z L Z � s t � Z m S l�h wt ►.. C.,�.v _ , S - i, s t'J z. �sb4� w► `��- e1,,� , s b S `2f2 31 C��-s or� rn w►- ` 3 •�. Ground elev. i 93 - ft. Depth to limiting factor '? Remarks: Boring # .n ME Ground elev. X8.5 ft. Depth to limiting factor Remarks: Boring # i M 4M-M p Ground elev, ft. Depth to limiting factor Remarks: SBD- 8330(R.05/92) PLOT P LAN Pa 3 of 3 SCALE 1 "= 1 4 1 71 ' I E:L 91 z t�Lg98 r; � x � '.s , o I p I o r ♦ S I 8 I iI Ll I k g �cvv s Pt�A L `C� 1 8 1 ;;z �c�F pvr-tP 2 lv t 1L Dv� �p S'T3Tt bo )V C (715 425 -01 65 M00576 CST Signature Date Signed Telephone No. CST # 00 FILED o 7'.2 ,c,7 2 ",47 MAR 2 3 1994 11 JAMES O'CONNELL Register 01 Deeds 51.4453 SL CfOIX CD Wi CERTIFIED SURVEY MAP N LOCATED IN THE NE 1/4 OF THE SE I/4 AND THE SE I/4 OF THE SE I/4 OF SECTION 9, T28N, R18W, TOWN OFKINNICKINNIC, ST. CROIX CO. ,WI. E 1/4 COR. SEC. 19 PREPARED FOR: COUNTY MONUMENT DONALD AND MARGARET PAUSCH O:N FOUND). 0 - 1�f CcPT) r i c? 9JRVr:Y IMAP ' Ay 5 VOL. 9 PG. 2690 ro d: A I Q� NOTE.' BEARINGS ARE REFERENCED 9 P- 100' ►' 0TH EAST LINE OF THE NE 1/4. (RECORD BEARING) I 3' I 6`00A Q3691 9 I M �3 3'I v a I _ I al O W N W W I rq 12 I Q 1 10 co O Q n Ir) I Ip W Z L O T 2 ? Q• 10.60 ACRES (461,625 SO.FT.) y 9.95 AC.EXC. ROAD R.O.W. I I a (433,563 SO. FT. ) ) I w N I • Ol tp M 1 0 w W m ' Z. N86 °3115 "E 793.73 1 �+' !—• Q' \ 759.84 ' I .,189 ' J: , I °I a• BUILDING SETBACK Z' \ LINE I N�� A PPROX. NORTH 3 L_ n o N \ LOT 3 APPROVED 10.60 ACRES I W1r 1 • W Z a ! (461,630 SO.FT.) I = O 1f f., W ' 10 (442,692 SO.FTT.)W ro 1 ' MAR '�}J 2 ' N' Q Q• I . � a • ow 'h I ST. CROIX COUNTY Z _ W � l 1 00 ' Comprehensive PiaMit 0 ' �3 1331 Zoning WW 2 8.9 3' Parks CoFntmifte a.0 I ao 4q LL 708.6 S 8 6 31 ' 1 5' W 737. 5 8' I N: If not recorded N 13 within 30 dWs e ` o`0eaei� approval da* I I KI o I A 'r •r C n I n Kj n c 1 t I STC -105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER _Lk ( ,(� , l / 6 P�cff C MAILING ADDRESS f/! �D�� l � S Rf vcg(- PROPERTY ADDRESS ZD 3 /`1 (location of septic system) Please obtain from the Planning Dept. CITY /STATE I L k y eA- FA (-�- e '`J ( S � "? PROPERTY LOCATION WC- 114, F 1/4, Section _, T _L2_ N -R _2�& W TOWN OF t ,�J nJ`S ! A)/ C - ST. CROIX COUNTY, WI SUBDIVISION C f4 , LOT NUMBER CERTIFIED SURVEY MAP _ 9 VOLUME _, PAGE , LOT NUMBER 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 licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 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 1980, with the requirement that owners of all new systems agree to j 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 mater 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/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration da . SIGNED: Cv DATE: l 6 (. St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 i� 8 T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner /contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. ------------------------------------------------------------------- Owner of property r - i� f �K Location of property /vim 1/4 S' & 1/4, Section _,TN -RW Township IC i Aj NIct /AW l - C — Mailing address �4 1 / CA / `FPS & S-r u6rL Z Address of site 0 3Z d2 ck44#�V K D Subdivision name C �i �,� / f� Pg c2 Lot no. Z Other homes on property? Yes No Previous owner of property PO N A P A U SG tl Total size of property Total size of parcel C Date parcel was created _D Are all corners and lot lines i entifiable? Yes No Is this property being developed for (spec house) ? Yes No Volume �z,and Page Number as with the Register of Deeds. ------------------------------------------------------------------- INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid`: delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in th office of the County Register of Deeds as Document No. S M9 7/ , 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 the County Register of Deeds as Document No. Sigilature of Applicant Co-Applicant Date of Signature Date of Signature TNIS 9rACE RESERVED FOR RECORDING DATA DOCUMENT NO. STATE BAR OF WraCOR81N FORM 1 -1982 it WARRANTY DEED S14871 � . - - - - -- -- - - - - -- = = - -- —— b—'� -- E �o 6IS'E'S OFF -- ST. CRCIX C®., This Deed made between . DQil (..,T . •.. .0 Ch__.anS--- - -._.- R � R �� .M. argar. et--- C...._�.au_s.cbhusband - - -and._ if.e -_ -and-- ------- - - - - -- . Harr iat. Maa..F,iynck - - - - a /k/a... Harr .ie.t..M.....Ei.y.nck.,...... APR 4 1994 8. as... t. enan. ts_.. in... cn---------------•----------- •----- r ---------- - - - - -• Granto , and..Cr - g...C�...P ec.haee.k�. a single. _.Person._.._.. ........... ............. .------ ....._............... - -- ...--------...---....... ..--- ..........._...---- ... - - -• rr . Grantee, Witnesseth That the said Grantor, for a valuable consideration..._.. ..-.... .................................................. ...........__..........:.__... _. _. . _. RETURN TO conveys to Grantee the following described real estate in ............ _.... .. ..S- t.....Cx Ql.x_......... County, State of Wisconsin: 'g Lot 2, Volume 10, Page 2738 of Certified Survey Map, as Doc. No. 514453, Register of Tax Parcel No -•--------------------------------- Deeds' office, St. Croix County, Wisconsin, being located in the NEk of the SEk, of Section 19, T28N, R18W, Town of Kinnickinnic. �djSs_� This is no t..._.. homestead property. (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; i And .... Grantars .................. •-•- - -................... .• -•--- ................_............ ...................--- ......... .................... warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions, and rights -of -way of record, if any, and will warrant and defend the same. � Sf" Datedthis ............. ..................... day of ---------------------------- •- ......... ---------- --- -- ----- - - - - -, 19. -94.. .... I .!.����LSEAL) (SEAL) ...... VV * ...M..r&a_. e.... C. Paunch (SEAL) . -•• -- • ... ...........( .............. ...._ (SEAL) * ..................................•------- ••-- .................... * _..Harr.ie.t.. Mae -..E.iynck,,---------- .... - - -- a/k /a Harriet M. Eiynck AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ss. ..........................•------••--•------..... .--- ...--- .....---------- •• - -•- C t. . C:r n i x C:nunty. /o el ea S O F - A Gi.e S Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of 3 Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY sr. Cleol)x Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but 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. REVIEWED BY DATE APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION PRo 'ERTY'jWNER: PROPERTY LOCATION eRI+I'& 1 /4 CEk GOVT. LOT � j e 1/4 SE 1/4,S I I T L- N,R 6 E (or) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # Gael 19 �e 5r P RR OF Z if 57 - CS.N PE -VA01 A.) 6— "�TY STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE OWN NEAREST ROAD .Ri l/Eoe I Sy022.- (% 80 �f�N.v / 'Gk�:v c,,�' G ozmRgy [.-)New Construction Use [ 'Residential /Number of bedrooms () Addition to existing building ( ] Replacement [ I Public or commercial describe Code derived daily flow 45100 gpd Recommended design loading rate ' S bed, gpd$ ' �O trench, gpd/ft Absorption area required 500 bed, ft2 500 trench, ft Maximum design loading rate — 5 bed, gpd/ft ' �° trench, gpd/ft Recommended infiltration surface elevation(s) s'� Pli ' 3 ft (as referred to site plan benchmark) Additional design / site considerations TC.ST 49y' f S S u i T A01(r "L EOP M ooA3 D S y S7 -.ti S Parent aterial SC ` !? SAT R E b 6- otk A M Flood plain elevation, if applicable ft 5 h S = Suitable for system CONVENTI MO D IN GROUND PRESSURE AT - GRADE SYSTEM IN FI L HOLDING T�K U = Unsuitable fors stem ❑ S [� 0 Q"S ❑ U ❑ S C ❑ S fae O S [� Q SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Tfench �b y 12 S/ 2,f; 56,E 4- C5 - y� 7,5 Yk 2 y/y — /s 0, �,, y ,� ,,,r ,e e s Ground G , yy GS 7, 5 yk / 16, �.'st' S�� s � 1 - 9�e iw►f i ✓ . y , S elev. i0 Depth to limiting factor „ Remarks: �C h4 S '¢ C G4 Y lOpv T eV T Boring # �_ /o ea yR 3�2 S/ 2,1, 54& ,w, -f C.V { .:Z$< T3, /d- �/ /o Y y /`� — s/ 2 . - 5h& �►�,f R Cs 3f 13 �o 7,5 yR tsir /5 0, g � .��2 �S . 7 � Ground y,P�wEd lev C G 6 G0 /OYP 3 /f/ „F� y wt= s/ -f, y� nMf I ,-- . y s /0 .0 ft. 5h Tv ATr-D Depth to limiting factor 6, sss //-OR r zo-v c A� s vCA y 17 1 611 c�.t / coti 7 �-- Remarks: _ CST Name _ Please Print o .�-�— Phone: 1i5 3 6 " P/4 Address: i M 1/6 / -.L 1- g y C'5TM ?*SZ O 9 i I 1 (4 1 i I Scn�t ; 30 I • _ /3�4�� ���TS k r a a l h � { r i r Opt" ('00 f3M 3 Ur - R7. • PT SE1' : Pa,E P° Tat) OF ga " z� to I, 1f/3ouE" 1 , f /e !/i4 T/O , J /6010 — 83AO — (L8/Z0 ')J1 G6C9- O8S'HHl1c 'Jalsal l!oS pug aaum0 AuadoJd 'A1!joylny le3ol of Ado:) auo pug leu!GejO N011f18181SH 8f11 `JIS 1 yy (leuo!idn)838WfiN 3NOHd :H38Wf1N N Ilt/ 1311830 S _ :S 3 OQi :NO 03131dW00 383M S1S31 ' wud) 3W la!laq pug aGpalmou)l Aw to lseq ay1 of 13ajjo3 aae sisal ayl to uo ayl pug paplom elep 9 411e41 pue'ap00 an!lejls!u!wp wsuo3s!M 941 ul pa!j!3ads spoylaw pug sa.inpa3ojd ayl yl!m pJ033e u! aw Aq apew ejam wjo% S1141 uo paluodej sisal llos ay1 le41 Al!luao Agajay 'pau8!siapun ay1 Ir y IC -- j- -.t / 7 ' ! srd y ,,iA4K.i V J. ev t NOI1dA313 W31SA! 1ueoied pug uO!13aJ!p 0 41 pug s6u!joq lie le uo!lenala eoe11ns 0 41 moyS 'ueld )old ay1 uo uo!le3I �!a o 1 adols puel 1 4 mo 4 s pus slu!od e3ua�a ;e� uo!lenala le3!l�an pus !slue !goy ay1 aye leym aq!j3sa0 sa3ueu!p jo ale3s ale3!pul seaae l!os algel!ns }o suo!suaw!p ayl pug s6u!joq I!os 'sisal uo!lelo3jad ;o suo!le3ol moyS :NVId LO'1 'd 'd y � � 'd L' d F C /!! 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