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HomeMy WebLinkAbout004-1075-60-000 Q o (D p M C O c a O C O ' F- N 'o N N CL V -C L fC c O C O - 0. O V r - co U O. O N O z O N N O N •U C ~ 7 f6 N c LL cp O 0 t6 a> 'O O O E d a LO U) I E v I' £ o z 00 a C 'a m m IN- Z o I c C9 -a iu O 2 d ce m Z d' ~ c o fA F- O Z c E o 91 ch a c O O N U) N (D C ~ N •N L L O c E O E, O w z ° F Z (0 z N ° v y r _c E N i R c ~y J. d R w 0 c (D , N N_ y O OO (0 D IL N ~1 Z o) F- F- F- = (D U N O O w•i ~ , cn a a a i a ~ ~y r ' r h► O O N N to J U III L rn rn > ZV! O N 00 cj C) M rl- oo E C- ~ 'O N N .cs~ O Sri Q d d r O O O N C ® tQ 6 a O N N C nn O S" O O c O~ Yr M 3 3 p> y 'O N O U') ui o W c S c a\ I- CJ - w O 3 tt: 't w i~l N 01 (D p m N O N p m U 00 z O N d' U) • r' O M U U N ~ I ~ E d m CL 7 tk S. O T a • a 1 Q u n. 2 O ) v r ti A r ST. CROIX COUN WISCONSIN ZONING OFFICE 1 M N N N N ■ - r~r~~ ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road = - Hudson, WI 54016-7710 (715) 386-4680 SEPTIC INSPECTION / WATER TEST REQUEST FORM Please specify desired test(s) & remit appropriate fee with application. Outside water lines are often turned off during winter months, making access to the home necessary. Please make r~ arrangements with this office to insure that entry can be gained. 0 Water (VOC's) $185.00 Septic $50.00 0 0 Water (Nitrate & Bacteria) 45.00 Nitrate & Bacteria n Water (Lead Concentration) 21.00 retest $15.00 J' Owner: e C C-Iay`l - Requested by: A-uop- cy 1 L_-r, V G Address: 4 3 ~-76 _ S- Address: SAa1hic, U ZIPS ZIP Telephone Ng: (_LM 779. S-7/& Telephone W: (2LI3 d34= &9t/ 1V eA l/ -U_bpt_ Property address (Fire If & St~r/eet) : a7n S ~(Pj / 001 Location: N►•W ' S Sec. , T a N, Rj~_W, Town of 14-nLf Realty firm: ,,Lock Box Combo: Closing Date: a4, icl+ - ~31- )A , 1 c,7,,, TO BE COMPLETED BY PROPERTY OWNER PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORMS Water sample tap location: Is the dwelling currently occupied? X Yes 0 No If vacant, date last occupied: Age of septic system: 40 f Septic tank last pumped by: 2S0vL Date: Previous Owner's Name(s): Have any of the following been observed? ❑Y ON Slow drainage from house. ❑Y ON Sewage Back-up into dwelling. VfY ON Sewage discharge to ground surface or road ditch. IXY ❑N Foul odors. Other comments relative to system operation: I certify that the above information is complete and true to the best of my knowledge. 11 OWNERS SIGNATURE: DATE: g 7 1/94 OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION IN a ijr- TO BE COMPLETED BY INSPECTION AGENCY System design &/or permit on file? OYes ONo Soil series per SCS Soil Survey: sheet # Type of soil absorption system: OBelow grd OAt-Grd OMound Approx. size 'X ❑Gravity ❑Dose OPressurized Ft.2 ❑Bed ❑Trench ❑Dry Well ❑Holding Tank ❑Outfall pipe OBSERVED DEFICIENCIES 00ther ❑Unknown Septic tank Setbacks: OHouse OWell OProp. line 00ther Dose tank Setbacks: OHouse OWell ❑Prop. line 00ther ❑Locking cover OWarning label ❑Pump/Floats OAlarm OElec. wiring Soil Absorption System Setbacks: OHouse OWell ❑Prop.l.ine 00ther ❑Ponding: ❑Discharge: General comments: I INSPECTORS SKETCH OF SYSTEM LOCATION N Inspector Title ST. CROIX COUNTY WISCONSIN ZONING OFFICE p r r p p r M p ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 July 16, 1997 Audrey Geiger 43 270th Street Spring Valley, WI 54767 Dear Mrs. Geiger: An inspection of the septic system on the above property was conducted on July 15, 1997. At the time of the inspection, the system was found to be failing. Effluent was seen discharging to the ground surface. I have issued a violation, which is enclosed. I am also sending information on the Wisconsin Fund grant program, along with an application. Should you have any questions, please contact me at the above number. Sincerely, Mary 7Jenkins Assistant Zoning Administrator CC: File STC - 104 6 9 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS 4~ 7~ S1, SF ► 7 { STC SUBDIVISION / CSMf - F Z LOT ~ SECTION N-R Town of ST. CROIX COUNTY, WISCONSIN VIEW. SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ~h ~~sr., > PU r 10 1A &0 fl fy INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. r 13ENCHMARK: 447 /W. 1 ALTERNATE BM: :SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: l~iiV p-o'f "~-PI-Q ca-s-70~- Liquid Capacity: Setback from: Well House Other Pump: Manufacturer .Modell Size Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: Length eLI Number of trenches Distance & Direction to nearest prop. line: > Setback from: well: J & House S~ Other ELEVATION//S Building Sewer ST Inlet: ST outlet: PC inlet PC bottom Pump Off Header/Manifold Bottom of system Existing Grade Final grade 93 U7 C DATE OF INSTALLATION: PLUMBER ON JOB: ~5 LICENSE NUMBER: INSPECTOR: 3/93:jt WisconsinYDepartment of Commerce PRIVATE SEWAGE SYSTEM CounttT - CROIX 'Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanita7d'y2f0o.: Personal information you provice may be used for secondary purposes [Privacy w, s.15.04 (1)(m)]. Permit Holder's Name: ~ACjWE] Village ❑ Town of: State Plan ID No.: GEIGER, EUGENE & AUDREY EE~suuzz CST BM Elev.: Insp. BM Elev.: BM Description: Parcel(3{I4Q-1075-60-000 100"o .D' TANK INFORMATION E EVATION DATA A9700264 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic o 1200. A& Benchmark Dosing Aeration Bldg. Sewer qc~ Holding St/ Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet b 5_~ TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic 5 h/ ~8 NA Dt Bottom Dosing NA Header/ Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft oss Forcemain Length Dia. H Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width 1 Length ( No. Of Trenches PIT No. Of Pits Inside Liquid Depth DIMENSIONS 16- DIMENSIONS LEACHING Manufacturer: SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM INFORMATION Type Of CHAMBER Mode Number: System: OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed / Trench Edges Topsoil C] Yes E] No E] Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) End _ s h 12 LOCATION: CADY 31.28.15.491A,NW,SW 43e0jdeSTREET 2 Y-5= 95Y 7.2- 5,7 " o '*/,7'- q3,17 ADZ = !?3,?4_~ 3,o o, 5y Cj/, L 3 v _1159 1 q, 70, 90.6 a So i. 1.0.x. ql 5~ Plan revision required? ❑ Yes ❑ No Use other side for additional information. E u ( SBD-6710 (R.3/97) Date Ins a pr's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH r SANITARY PERMIT NUMBER: Ali«ir"i SANITARY PERMIT APPLICATION Buereaauu oand f of B uildildinWater S singWater Butems 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 8 112 x 11 inches in size, (f r6 i y'_ • See reverse side for instructions for completing this application State Sanitary Per it Number The information you provide may be used b other government agency d Y. Y Y Y programs ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION /fi- Property Owner Nam Property Location 4 ISI 1 /4 J~`~-o(J) 1/4,S T N R E (or Property Owner's Mailii Add ess V ST Lot Number Block Number ity,St to rjadet W/ r Zi o'~ ~Jumber J1~ ubdivision Name or CSM Number ( -.1w. TY OF BUI DING: (check one) ❑ State Owned Cit~ Nearest Road ❑ Public 1 or 2 Family Dwelling - No. of bedrooms -,04 ❑ Town OF Ca 7 g J_ r•e4e7' III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 I~ , 1,14 1 ❑ Apartment/Condo no 7"' 4a 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 5 ❑ 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 Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing 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 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 Weepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System-In-Fill Q.i 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) C QAa Elevation e lv l Feet _ Feet VII. TANK Capacity _ in gallons Total # of Prefab .e Fiber- Ex er. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel Plastic p New Existing strutted glass App. Tanks Tanks Septic Tank or KU"rgg-ra-7n ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) PI tube "s Signal tur o Sta s) 'fDTWMPRSW No.: Business Phone Number: Plumber's Address (Street, ty, State, Zip Code): ~ a~i &1/ .16 72 IX. COUNTY / DEPA TMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (!ndudes Groundwater Date Issue ssuing Agent Signature (No Stamps) [Approved ❑ Owner Given Initial Surcharge fee) I Approved X Determination lyd 11-,21--771 X. CONDITIONS OF APPROVAL / REASON FOR DISAPPROVAL: SHD-6398 (R. 05/94) 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 expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3815. . To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV'. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/'or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 112 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service-, streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; Q complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve,- pump model and pump manufacturer; D) cross section of the soil absorption system i'1 required by the county; E) soil test data on a 115 form; and-F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act-410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected' through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. A' SANITARY PLOT PLAN +t - l~ Scale V* 0 NERS 11AME ~v' SANITARY PERMIT NO. BENCH MARK( A) #i MOO- C6>,#,;,7 S-dl c// Y)EPTIC TANK AV #2 PUMP TANK SYSTEM ELEV. A 73~ ' EXISTING TANKS B ~e WELL t NORTH v 4;/1 i' / C ' PROPERTY LINES NOTES- REPLACEMENT AREA row- fild 1,160 -5± 1 90 Q -7Z4 --o /go see - 6 ~ o - ` ' ' - SX dd - o ~ MPRS 3186 647-4682 P MBERS SIGNATURE LISCENSE NO. PHONE DATE Wisconsin Department of Industry, SOIL AND SITE E V A L UAJ,kN.,R E PORT Page of 3 Labor~jnd Human Relations s t? Division of Safety 8 Buildings in accord with ILHR COUNTY ry ST. CZU UC Attach complete site plan on paper not less than 81/2 x 11 inche n e. Plan mds linCtt b not limited to vertical and horizontal reference point (BM), direct) a ` % of `slope, s.> PARCEL I.D. If dimensioned, north arrow, and location and distance to nearest 4 ad APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION. REVIEWED BY DATE PROPERTY OWNER: f?f]QI?ERTY LOCATI 99, k V G~X~ ~'11VD PCV4>CC(~. ~1G l~2 Gttt~ 11t W 1/4,S3 N T Z8 N,R LS E ( PROPERTY OWNER':S MAILING ADDRESS LCT UBD. NAME OR CSM Sl 3 Z-1 O `Rt ST• I 0!~'r CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE ®rOWN NEAREST ROAD SPRuhiG vKl,c.E4 1kv1 sU) 6IclIS)»6-s-) 16 CI D`-{ Z'?p `flt ST. [ ] New Construction Use [4 Residential /Number of bedrooms 14 [ ] Addition to existing building [xj Replacement [ j Public or commercial describe Code derived daily flow b bo gpd Recommended design loading rate bed, gpd/ft2 a - 3 trench, gpd/ft2 Absorption area required bed, ft2 Z00o trench, ft2 Maximum design loading rate S bed, gpd/ft2 ° • b trench, gpd/ft2 Recommended infiltration surface elevation(s) SEE- L- C)C)W uhf -1:iA 6 t 3 It (as referred to site plan benchmark) Additional design / site considerations CZliZit t t3-Qb Stkt-L .OkJ `T\ ! C-0es • S kT- S' x J5 o' Parent material L vz-% S Flood plain elevation, if applicable f 'a • li • It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANI U=Unsuitable fors stem ®S ❑U ®S ❑U 1XS ❑U ®S ❑U ❑S ®U ❑S 19U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Botx>daly Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trer>ch 31 Z S l 1 Z m S b k vv% Q. S - o• S o. l D -9 vzs -1 ~z :x.41 n' <I~~<> Z °I -"ZO t.p 2 Y l Z s i I Z S ►M `F r c s - o- s o Ground 3 ZO-a13 w `t IZ I/(" S 1 I ZF3 b k `F1- cs - 0-S o. 6 elev. ~S bk _ Cj. b' 70 l0 It R ~!6 - s i I o,,~ 1~►1~t- - : o. Depth to c S t o `-t. 6 l-1 s t l T tt'I-s limiting factor Oy Remarks: Boring # j - s l Z" Sb1T h1 `F►- a.S - o.S I o. Z' Z 8-ly 1z m Y!'2 1 S11 2 F bvt c-S - aZ 3 14-3~ ~~`?2 3/6 SO Z~sblrt wl fit, aS o.S 0.6 Ground elev. 3$-6$ U `itZ 3/G S 1 I v..~ 1~t `~'I. - 0. Z C1 I.s ft. 3 Depth to 4/S 10`L (3 Si ~T c_.o S limiting grg fact Remarks: CST Name:-Please Print Phone: Arthur L. We erer 715-425-0165 ergerer Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022 Signature: Q 3 - 1.13 Date: l 1 _ Z! _ Cl y CST NumbMe : 00576 PROPERTY OWNER C~EL.Gk2 SOIL DESCRIPTION REPORT Page' 2- of PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0-La Looms 31Z Z sbk wi~v. a,S - o,s o 6 LN Z ►p-39 16.12 I!6 2, Sbk c.s - o,s 0.6 Ground 3 -~3 LO `ttZ S i l cgb1~- _ p, Z elev. C~s . S ft. Z ftl ~v S l~ cz to t3 s I L'r Co Air Depth to ~Lg r.oh1~`p~7N v `R L ~~twT- c S ~-r c.U*~_7b limiting factor 3 << -ftix *t- %QN1t_tw4A/S w vvt S \-t S 113 t 6 ( h 0 . C 'ti I t o A- U= op ~ Q-v UQ" Remarks: Boring # s? `.o►~'D t G OF 0.3 Gn D ISO, is ,kN 1 ' IX r. 1vRft Ground S L "IN4 -1 8IF) Al G o U T T3 L w elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # w:.::.: Ground elev. ft. Depth to limiting factor Remarks: SBD-6330(R.05/92) PLOT PLAN Page 3 of 3 SCALE 1"= k tJ L 14 0b2*1 ~ ,lou.0 0~ $oT`(pto OF S ~D1A~G. RQS L 0Gsj cF ul 6 5 -)0/0 tL al S s I. s~riC 1 vYz - all to ~.3 SC N B • Z \ 0 0 ►~TE Tb t u sTti~l.LNI fit` S WLL S -RLe~jc1N eS, L*Ktl S'x 8o' L.uh.r G, M~ N. b' A i~R~T, kr `ni'b DUwu SLL)J~ `M D~~tK LADE `ME N e-L(-U "Ou S 3 '1't"i~ OF L`©iv S)nZuC-`Pl+ij, t- 4.i Y r ~ °13 _27 3 (715 ) 425-01 65_- M00576 CST Signature Date Signed Telephone No. CST # Wisco4in Department of Industry, SOIL AND SITE EVALUATION REPORT Page I of 3 Labor~and Human Relations Division of Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY _V..() Ix 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 v G~~ Er FpvO NU%lZZ!,-r G( l.G l-2 GC)V t YT 1Ii 1/4 SW 1/4,S3I T 2-b N.R lS E (ok PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM 3 Z~ O `Rt ST. - CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE ®gOWN NEAREST ROAD SPCUNJG vtRL ( %j Ikw) SW-)0 C)IS))_)T ~6 C_f~DK Zoo `Ttf ST. (J New Construction Use [4 Residential /Number of bedrooms 4 Additi.Qn to existing building 1>1 Replacement [ j Public or commercial describe Code derived daily flow b loo gpd Recommended design loading rate bed, gpd/ft2 a - trench, gpd/ft2 Absorption area required bed, ft2 Zooo trench, ft2 Maximum design loading rate S bed, gpd/ft2 ° • trench, gpd/ft2 Recommended infiltration surface elevation(s) St's rJnw oaf 6 t 3 ft (as referred to site plan benchmark) Additional design / site considerations Cz~ccvu~t ~►v0 S`t~KLW~1 @y C-"s - S afi- S' x 90 Parent material L,o -S S Flood plain elevation, if applicable 'N N • ft S =Suitable for System CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN RLL HOLDING TANK U = Unsuitable fors stem ®S ❑ U ®S ❑ U IX S ❑ U ®S ❑ U ❑ S ®U ❑ S 191.1 SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Bounclary Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed rench r3 -9 o -1 tz 31 Z s i t Z m s b k Q- S 0, S 0. Z 9-2o io11 IZ siI Z~Sb~ mfr c5 - o-s o_L Ground 3 zo, to 1 - 1Z m. s i I Z'F3 Mt Vgil- cS - o- s o. L elev. 'I, ~sbk - a6.5 ft. L( 7o U3 `lR S t~ Depth to -to rv S 1 `b 6 S t (T tt'I'S limiting factor 0" Remarks: Boring # 1 0- ~ X1r3\_1 I Z - Sit Z M 4vt a.s - o.s o. ~ Z Z $-~y 10`112 yl2 1 S11 2 F 1'` R.S 1 - o-Z 3 )4-3$' L0 `7 t2 3/6 Stl ZQSb~t >,rt cs o.S 0.6 Ground ~sb~ _ elev. 3$_6$ t 0 Y2 3 o. Z als ft. 3 Depth to N$ UY-1 6~ 3 Si 1.T C.O S limiting fact, Remarks: CST Name:-Please Print Phone: Arthur L. [de erer 715-425-0165 ergerer Soil Testing & Design Service-P.O. Box 74 River Fal1s,WI 54022 Signature: Q 3 Z~ 3 Date: ) j_ Z i_ C1 CST Num ec M00576 L_ atd~ L-5~ PROPERTY OWNER GElGkM SOIL DESCRIPTION REPORT Pa { ge ~ of ~ PARCEL I.D. 4 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Try 1 p_l0 ►oHt~ 3l2 sil Zwt Sb m`F - o.S 0-~ Z 1039 LO`11Z 3/(, ` S 1 ~ Z~Sbk 1M.`FI- cS O,S o• ~ Ground 3 -~3 LO'7►Z 3r'6 _ S i l cgbk - 0.2 o l~ ~H elev. OLS . S ft. Z covItri ~v S lp l ;L- s c0 per Depth to N g c on)~~-r,v p< v L 2twr e S limiting factory w 113 16 13 h v , »3~r C ti 1 t c.A- U= O P tt~ Gt } k•e1u.~. Remarks: Boring # ~p FV (S OF O. 3 Gn D S (a (S PM t Ground S L "Pj4 -1 8~ ~l l G IPM o ~U T 13 w evCiK -s. elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # a Kw%b.2h: Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) ' PLOT PLAN Page 3 of 3 SCALE I"= oQ' wtrt.~ x Ll e~2k? 1 - -•10u.~ o~ goT'~pri OF S IDtfUG, R.QS t oou cF se~nc.Yz x 8.1 gO s.3 ~I N to\~N r L ~a 1 S \ 0 0 s t. S TtZ t ► cN ~s, kMC~j S' Y. 8(Zi' LO)v G, t lus`.~Niio O~►K i~vE `T?t `nz N ~-~3v fi~ s 31 3 ~ PrT \-t"(~ OF 00,-jS'n2.Uc-,P()~j, r r X13 -27 3 o~' ll- Ll-~~ ( 715 425-0169 1400576 CST Signature Date Signed Telephone No. CST # STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER P1~I+G'~~ 9L 7~~1/ (~-"E[Oll° MAILING ADDRESS 0;~~~ S-7yg i w ra / Sy~O PROPERTY ADDRESS -51IN (location of septic system) Please obtain from the Planning Dept. Sy7~ CITY/STATE ~r1 h G / Q !l e y (Vi PROPERTY LOCATION /06 1/4, SW 1/4, Section / T~N-R~W TOWN OF CQd y ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAP , 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 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 date. SIGNED: DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 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 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 .4&7ee q Walm t;q C'r Location o?9V erty 1/4 1/4, Section ,T~N-R1 W Township Mailing address 4~3 Sf Address of site mime' ag 4 Subdivision name /W Lot no. Other homes on property? Yes___X_No Previous owner of property lfli Total size of property l3Z Qcfp-3 Total size of parcel /37 le' Date parcel was created Are all corners and lot lines identifiable? _X Yes No Is this property being developed for (spec house) ? Yes __X _No Volume tD-7 and Page Number 2 d-O 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 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 the office of the County Register of Deeds as Document No. 7 o 3 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. Signature f Appl' ant Co- plicant 01- d"- 17 7--ld J ?7 Date of Signature Date of Signature S.. d-13 Quitdl im Deod-Short Form. (STATE OF WISCONSIN) (Sec. $36.16, Nis. Statute) Form No. 13 Fuiflishod by Eau Claim Hook & Stationery Co, V '~[?jj~ p - .-jam - Z 1 ~i- . „~L //+~.~+,r j1 ~h.r.. D Y V;Yoj~ :os w,Made by Eugene Geiger grantor , of St. Croix County, Wisconsin, hereby quit-claims to Audrey Geiger II grantee , of St. Croix County, Lliscon:in, for the i' sum of Une (Sl. 0U) dollar and other valuable - Dollars, the following tract of land in St. Croix County, State of Wisconsin: ~f I I` I South ',Jest fractional Quarter (S4 frl. 1/4) of forth ;lest fractional Quarter (14W frl. 1/4); Section 31; i North West fractional Quarter (NW frl.' 1/10 of Sout) Jest Quarter (SW 1/4) Section 31, EXCEPT a tract of 1 :nd d ( ,cr d as follows:: Commencing at a point in the North r .,(st cor,l or- the _S1;4 _i/a+ _o f PM 11#-of-maid Se'(~!tion `.31.then ce _.~out'it 17 r<;c.:i feet; thence Westerly 15 rods to a point 15 rolls ctrl 1'i 112 rods South of starting point; thence Northwesterly 25 rodl~ to i point 37 rods West and 3 rods and 14 feet South of this .mot :rt_in point; thence Northwesterly 18 rods to a point 55 rods l°Jc:~t and 1 112 rods South of the starting point; thence Borth 1 1/2 rods; thence East 55 rods to place of bef,innin,,, cont,iininV 3.4 acres. The South boundary of the above described ti,,i(, t :i ~ the= center of the highway known as the French Creek I ~i This deed is executed for the purpose of cre;itins, Joint tenancy between the parties who are husband and wife. j j Consideration for this deed is less than $100. u0 , therre_f or,(, 11o I~ U.S. Revenue Stamps are necessary. II F i. it I In MiMm5 Ziltijtrrot, thesaidgrantor ha s hereunto set this hand and seal this ~ 7th day of September , A. D., 19 6 4. ~I Signed and Sealedirf Presence of III .(SEAL) C Richard P. Rivard (SEAL) _ - { r GCS t~ - (SEAL) Zelma Mouw ~j j~ iytate of C2Iifeleonofn, I ss. St. Croix County? Persoa113c.cme-be#+i~s7r tH3b'-- D.> 19 fi ij i the above named Eugene Geiger . j ~i to me known to be the person who executed the foregoing ' strument and acknowledged the salve.