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HomeMy WebLinkAbout026-1048-30-100 e O N O 3 T o d `r1 c 3 'a m v a ;c m 3 ~ ` 1 o CO z m z o~~ x a, ° c n° c n s ou _ R o m m m v w w 3° o ~ rn NO N ~ g y ? a co "S 1 CL N O O c~D E Q A Q O J O 3 a 0 3 H Sr 7 OO C ~y 'a 0 N ~ D m a w Ch w 4 0 o C o 4 ~ CD co a N m D cCl) ° 3 Q m Z T -0 M °p o OC G Oc C O G l~1 n G 0, < w z 0' ~E 3 o > 0 0 9 m a t~ d m v co N m o : II, C N o z z z o D m m O 0 (r • CD m @ N N E (a n OIQ w m z c A .p o CA - ; A z v a O o cn < ~O CD CL z O a c" cnw y Z CL CL M c z a O o I I '1 I ;2 O ,Qa I ~ N ~O V A A 1 b WiswtsinDe rtmentofIndustry, SOIL AND SITE EVALUATION REPORT 9 age_of s Labor and Human Relations ~Q Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but AtA /10 not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or CEL I.D. t dimensioned, north arrow, and location and distance to nearest road. DEC UXTEI APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION VIEWEDfT C Flux k ry'udh~. 1-:::7 PROPERTY OWNER: PROPERTY LOCATION JONWS 11,7/1 .e„ GOVT. LOT 0/4 T E PROPERTY OWNER':S MAILING ADD ESS LOT BLOCK # SUBD. NAM CI ST,AE, / ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE JOf0 N NEAREST ROAD ®C «7/7t O! /.3- (e [ New Construction Use Residential / Number of bedrooms [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow Ag~ gpd Recommended design loading rate _ 7 ed, gpd/ft2 - a trench, gpd/ft2 Absorption area required <s7 bed, ft2 ~5 trench, ft2 _Maximum design loading rate bed, gpd/ft2 L 4trench, gpd/ft2 Recommended infiltration surface elevation(s) fiG- 5 ft (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable ft S =Suitable for system CO VENTIONAL MOUND ROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem 4 S ❑ U 7,71V S❑ U as ❑ U ❑ S U ❑ S SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Ground /d( 5 -7 elev. Depth to limiting factol- 2 Remarks: Boring # Ground elev. ft. Depth to limiting factor r7 F T 7 Remarks: CST Name:-Please Print Phone: Address: Signature: Date: CST Numb 1,2 y PROPERTY OWNER ~~5-c~SOIL DESCRIPTION REPORT Page 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 Ground o~~ ✓ ® 7 eilev. lea A Depth to limiting factor ~y Remarks: Boring # Ground Av" -ft. Depth to limiting factor Remarks: Boring # w~:::~::.:•::::::: ®r /7'.Z /rte'-C- J ~ t Ground ' elev. ft. Depth to limiting fa to 7 Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) # . Soil Test Plot Plan Project Name Byron Bird Jr. Address 141 40,g M 4#3479 Lot Subdivision Date 1 /4 ~ 1 /4SST 3e N/R/ W Township Boring ()Well PL Property Line County BM or VRP Assume Elevation 100 ft. s'1fca~r- System Elevation * H R P 3 ~L a3 ~ ` Scale 1/4" = 10 Ft. When Dimensions en't stated FILED 1 1 DEC 5 1995 ► 5 _ JAN KATHLEEN H. WALSH ~99C Register of Deeds 0\' SL Croix Co., WI fj 537130 SURVEYOR'S ~RECORD co CERTIFIED SURVEY MAP Located in part of the SWi of ::the SWi of Section.16,.T30N,'R18W, Town of Richmond, St. Croix County, Wisconsin, being lot 2 of certified survey map Volume "10" Page 2784. L_E_G_E_N_D_ Aluminum County Section North line of the SWk, of the SWk< Monument Found / S89°59'00"W • 1" x 24" Iron Pipe Set, Weighing 1.68 lbs 122.95' Per linear foot D 1" x 24" Iron Pipe Found, Weighing 1.68 lbs Per linear foot / 100' Roadway Setback Line t X Sk, Corner position established from ties, see County Surveyor for ties p• tql 114 / ~lolO, C . . ~ YL" G~ f. N, M7 'LOT 3 Al 0 o N 5.47 Acres \ 4.1 Ln o a) 238,281 SQ.FT. Q) 00 C N fV) L>~ / L L - °'a n 1 / L ° (nl Q) 0 589°33'22"W 541.06' z 270.53' 270.53' n ¢1 Ji c a L 0 LOT 4 LOT 5 N N n ~ `V\• L C4 4- 9 O LLII 4.20 Acres r- 4.22 Acres N i~ -j I ~T Inc. R/W Inc. R/W - - ¢1 L_0 f I N -°o ZD 183,106 SQ.FT. 183,749 SQ.FTm °o ~ zt M. t0 `0 4.04 Acres. o 4.04 Acres u, \ ( I Exc. R/W O. Exc. R/W 10 ^~J• 175,820 \\F m 1751820~SQ N 0 M Q1 Y hAM.arYi 2-178 1 app ld y$) - - - - ~ 1n o o W v~r C4 ....~.I .N. .M.. Z ..J 19 O s1 SW Corner co o Sk, Corner Section 16 N89°33'22"E 541.06' Section 16 270.53' 270.53' )1- 0.54 , 401 y.Y M s.rc.' f 770.541 270.55 7-", S89056' 4 "E 541 .09' M M r^ LI II II 1+7 !?d / South line of the SWk, C , T , I I , G" r' r ;f p~5614011E t qLZ SOdd OT SWnI0A OOh OOZ 0 OS OOT 8£-h6 'ON qor wnueT3 P3 Aq pa44e,ip 4uawnJ4sut styl 1333 NI 31VOS ~o IM ''00 kOJ0 xs sPoeo 10 jals,6ab l7SNN00,0 S3Wy~ Z b66~ 7 8 LTOhS '?M 'puowyota naN anuany 4356 Z9ht Taseo •N uaJex 3 •y uu019 9 1i~IM0 rn ti 91 u0133aS 11 ~ar~L~~ JauuoO IS i9S'60ET W - - - 106'911 IiM 9So68S rn „ J „ H l {MS ay4 8o autT y4noS-7 IiM 9So68S / _ ~99'Z61T _ 3,,07~9So68S _ i60'thS ~LS'TS9 / o W lLZ'9LTT 3uM££O68N o• 7 ..PI~a .0X3 •33 •bS 69'9hZ Z M/d •ox3 saJOy 9•9 o - / M/a 'ouI hOh'T9 M/8 •ouI saJoy 00'9, C; 10 L - •b ( M/a ox3 ~8 S 696'689 o JO o0 I` Z M/a 0x3 sa V hS'ET - .ti "9 / co 0 V 0 < IF- o M/8 •0uI •3j •bS OET 509 0 N .0 ~ Iv 1-4 M/a 'ouI saJOy 68'ET 4- I_I O N ~0 ern £ Z 101 ti% 00%U310, co ins (-n 4,0i v, rt rt ~ .O~' G.~Q lp Ju (4 co ,a:~ A s 0 ge jenoAdL. rCr •saT4 J04 / 0~ p ~enoJdde H JOAanJnS A4unoO aas 'sat4 woJ4 1ePCl£ ulyl!^, paystTge3sa uot4tsod JauJOOS X ° N poplooei aou )I ° autl s o ~oeggaS Aenpeo8 SOOT / pue Buwuoz 3003 JeautT / liwvpd;antsu&40ALUo~ Jad •sqt 89'T 6ut46tan i too a 'qaS adtd uoJI ,hZ x uT o ,-MOD X1080 1S ° -n iS6•ZZT puno3 4uawnuoW 41 C) Mi,00,65068S t uotloaS 4unoO wnutwnlb CMS a43 3O CMS a4; 30 aut1 44 ON 6f& S AIr " QN~OS I ' Vvl 5 STC - 10 4 ^cC~ D AS BUILT SANITARY SYSTEM REPORT R vL V 2 Q 1997 OWNER r ST CROIX UNTY (ZONING0COUNTYFFICE ADDRESS r~ - C-7 RD A PLC A-Z-7,0 AI'IJ 016 SUBDIVISION / CSM# C Sl7 UDL DA~~ X0.2 LOT # 3 SECTION T X30 N-RW, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM P,~pPGS~ W ALL At ay /;Leo Cc. Sc~cE /=Go~ ~ ~ ' ~ ,2-S1~7S TRENL~ES INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: JOP 2 rf ,,/J/ c- &x el- , 1,,v, D ALTERNATE BM: /f` SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: /F 0C I S Liquid Capacity: /BOG Setback from: Well ~1/o r iX House gAl Other Manufacturer Model# Size Float seperation ~cle: Alarm Location SOIL ABSORPTION SYSTEM Width: S Length 75- Number of trenches a2 Distance & Direction to nearest prop. line: SOUTH /S8' Setback from: well: ~Oyr~ House 56 1 Other ELEVATIONS Building Sewer 1? 7 8 ST Inlet: G, 6,8 ST outlet: PC inlet PC bottom __y A Pump Off Header/Manifold 96r6)= Bottom of system 9~ 80 Existing Grade 0 Final grade 98, D DATE OF INSTALLATIO ~9 9 7 PLUMBER ON JOB: LICENSE NUMBER: 3 ,;2-0 INSPECTOR: 3/93:jt Wiscgnsin Department of Commerce PRIVATE SEWAGE SYSTEM County 'ST. Safety and Buildings Division CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) SanitarvP~rAiltAlq.: Personal information you provice may be used for secondary purposes [Privacy L , s.15.04 (1)(m)j. LL yy 11 Eve 33 SEIDLINd Na YeATRICK ~ ~ Wy E] Town of: State Plan ID No.: CST BM Elev..l oo Insp. BM Elev.: BM Description:TOn o-r C- F. PG Parcel T6""* 1048-30-100 ~r TANK INFORMATION ELEVATION DATA A9700477 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic wt-r- BenchrT)?Tk 3.1c, /o3%; 100, Dosi ng Aeration Bldg. Sewer (D -(,;6 I T'7 Holding t ig Inlet 1.Z~ TANK SETBACK INFORMATION S©/ 16 Outlet 7 521 °1(6 , 37 TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic -1 n 22 7 ZZ' NA Dt Bottom Dosing NA Header/ Man. 9 .v2 Aeration NA Dist. Pipe vl -7`I 79,1 qf, o 91.a q1' 7 5-8'3 1 s 7 Holding Bot. System q.ri '104 q -Sy 'IV. 92- PUMP/ SIPHON INFORMATION Final Grade S. ZS' g - 4P 7 Manufacturer Demand ./V Model Number GPM TDH Lift Friction stem TDH Ft oss Forcemain Length a. Dist. To Well SOIL ABSORPTION SYSTEM BED RENCH . width + Length No. Of Trenches PIT No. Of Pits Inside Di Liquid Depth DIME N 5 -75 2- DIMENSIONS SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACHING Mau cturer: SETBACK INFORMATION TypeO CHAMBER M el um er: System y,V 4100, soy n a OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole ize x Hole Spaci g Vent To Air Intake Length Dia. Length _1L Dia. _YL Spacing -(,-L I ± f 2 S~ SOIL COVER x Pressure Systems Only xx /Mound Or At-Grade Systems Only Depth Over Depth Over Depth Of xx Seeded/ Sodded xx Mulched Bed/ Trench Center Bed /Trench Edges 1XI soil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons pies nt, et LOCATION: RICHMOND 16.30.18,SW,SW 1525 CTY RD A Hov sl✓ Cpv: -f rUc_+lort ✓ z)-t S4 a &,c ct~ -lime- O-' 10fellbv/ Sew - fi o d 15~ Plan revision required? Yes ❑ N ~ 97 ~ ~ 3 Use other side for additio al Information. SBD-6710 (R.3/97) rIA A-L 110`20-' 97 Date Inspector' Signature Cert. N ADDITIONAL COMMENTS AND SKETCH - , SANITARY PERMIT NUMBER: SANITARY PERMIT APPLICATION 201 afety and E. Washington ADivision NVisconsin In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Department of Commerce Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County c~t- than 8 1/2 x 11 inches in size. 5 - C"ro )X • See reverse side for instructions for completing this application State Sanitary Permit Number The information you rovide may be used b other government a enc ro rams 4!~Jeq y p y by g y p g ❑ Check 1r revision to previous application [Privacy Law, s. 15.04 (1) (m)). 15,q5 90(/'1 State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Property-Owner Name Property Location EAEWC LC 14 LU 1/4, S C T 30 , N, R e E (or~ Property Owner's Mai Iin Address Lot Nu er Block Number l G City, State Zip Code Phone Number Subdivision Name or CSM Number ( S> 537130 11. TYPE BUILDING: (check one) ❑ State Owned City Nearest Road I/[] Village Public 1 or 2 Family Dwelling - No. of bedrooms Town OF 111. BUILDIN USE: (If building type is public, check allthat apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 6. 02 epZ 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 Q 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 _ [W New 2. ❑ Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an ------System------__System _____________Tank Only Existing System B) 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 11E] Seepage Bed 21 Q Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 RrSeepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 13E] Seepage Pit 43 ❑ Vault Privy 14 Q 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) Elevation 750 '"72TO s 5Py 8D Feet ,0 Feet VII. TANK Capacity Total # of Prefab. Site Fiber- Plastic Exper. INFORMATION in Gallons Tanks Manufacturer's Name Concrete Con- Steel glass App. New Existing strutted Tanks Tanks Septic Tank or Holding Tank ~+~r r ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑ VI11. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plum r Signature: (No S s) Business Phone Number: Plumber'. dress (Street, City, State, Zip Code): Erb r/e Son &M, - ~ o IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater ate Issued Iss g Agent Signature (No Stamps) % XApproved ❑ Owner Given Initial Surcharge Fee) I Adverse Determination 10 U X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-6398 (R 11/96) 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, 608-266-3151. 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 systE!m 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 smallerthan 8 1/2 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; vfater mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; 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. 51" jJ~ U CNT ~ 1/YS/~ccTianr p/~ L IT-A,,g o - ~ 30 3a J`}D'PRovcv covER, 0 DRA/ o of f~ / a OG/c ~o ` S ysjC/4/ e4, ~y,go y ®('RoposEb cvELL NoUs~ N /zoo Gc. S. 3~ 0 P a~ 0 o 07 gs i4GT A -5X26-' 7-AawC./fES to, J ~ r By l f ~6 \ ! 63 CA 46 0' 81 13/7 Top ` /911G p pc el, /w /fL7a 5 7-c-e4- "P 6- e['98q A08' sou-sq p2o/~~aTY n!~ Acr 1317. 01?Aawe- Fa/1. //-X 97 1-9R/4w. TG? 1 G E//~G/Nlr zl- 2 S cff I`7dn~0 , ~,{1/`- tSorr~2 sc- CU.` s yoz New 6Yd17 ~%~~sw 3zo3- Wisconsin Department of Industry, SOIL AND SITE EVALUATION tiabor and Human Relations Page -/-of Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal referenc ction and erof' percent slope, scale or dimensions, north arrow, and a 'o a~ Rparest road. Parcel I. D. # /0 1/30 _R) 100 APPLICANT INFORMATION -Pleas ;'It all "MWW1. R viewe by Date Personal information you provide may (npurposes be used for sec (Privacy Law, s. 15.04: / I Propa-~ rty Owner P Location . a ST CRQiX Gn~. of 1/4 d1/4,S /0 Tao N,Rw w tejkg Property Owners Mailing Address ZONINGOFRCE Lpf Block# Subd. Name or CSM# 10-AA ~e lYi~ . J'XI 1/0/ 3023 City State Zip Code Ph ugn e Z Nearest Road S~ccr` ra f~ j~1 7/r ❑ City ❑ Village m Town WNew Construction Use: ® Residential / Number of bedrooms_ Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow ~(JQ gpd Recommended design loading rate 7 bed, gpd/ft2 . trench, gpd/ft2 Absorption area required bed, ft2__7 _ trench, ft2 Maximum design loading rate . 7 bed, gpd/ft2 - trench, gpd/ft2 (as referred to site plan benchmark) Recommended infiltration surface elevation(s) 3 7'. ~ ft Additional design/site considerations Parent material 104 f L.J4 5 Flood plain elevation, if applicable N.4 ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system C9 S ❑ u Cgs ❑ U COS ❑ U Ws ❑ u S❑ U ❑ S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench /O 16p,311 -?.p ~ - -2 d- /D S,'/ M ~ '41 /'r 9,L/ Ground 3 y 6 „f-/V Jeff Depth to limiting f ctor +xin. Remarks: Boring # l D-/O / 311 1 din r rr, CS '?p . a~y6 s S Ground elev. Y S ft. Depth to limiting factor f fin. Remarks: CST Name (Please Print) Signature Telephone No. 7.4-o,"14 SC-171171 t~ 1r al Address Date CST Number Se~' SOIL DESCRIPTION REPORT ~ PROPERTY OWNER ly Page ~ of PARCEL I.D.# CQ b /DO Boring # Horizon Depth Dominant Color Mottles Structure 2 in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench l - 6 /D -311 L Q? r 177 6 C 1P Ground j 9 SAK :_8 s S e ev. Depth to limiting factor Remarks: Boring # O-8 &OF s S PA/ &2 A Ground ft. Depth to limiting fa or tin. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # in Mier C -7~ .~-90 Ground /O~ LLft• Depth to limiting factor *gain. Remarks: Boring # Ground elev. ft. , Depth to limiting factor in. Remarks: SBDW-8330 (R. 08/95) Pie 3of' 3 , t N. gam. 6 A.70,c,o /14. Q m= Zp vI P I"s zl p~ rC. 48. sue' S\o~igc Q S Jn( I /4 fy( rr` Rrs By g3 ~Bs'1 k ►33' I~8 99' 73 J 16= /if iV lJ rc~ `~`y PO 5~kmj,H St-J+ S~/ly s /d 7'-MN RIYA) cS % ttl oy©/ o S-'8,6 Ila Ile. ~ I 4t3 SorzerSe,-, ~i . r4la-) S' r1 (7~ s) S-~/ r- 6 6~~ /0-3-~7 Wisconsin Department of Industry, SOIL AND SITE EVALUATION Page of Labor,and Human Relations , Division of Safety and Buildings crsrtl~lce, s. ILHR 83.09, Wis. Attach complete site plan on paper not less than 8 ;~/2 x .11 inches si Plan mils County include, but not limited to: vertical and horizontal deferehce p action arid,.- C,, percent slope, scale or dimensions, north arrow, find location - 'distance to nearest•r6d. parcel I.D. # f v . APPLICANT INFORMATION - Please print all infemita oh. ' T wed wed Date Personal information you provide may be used for secondkr ' purposes (Pnir~e ~r r ,~1tb•o'f (1) Property Owner Property Location Gdvt. Lot Sw 1/4541 1/4,S/~ T30 ,N,R/,p 4Wr) W Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 002 0 ve 3 1W Csvzi e / / . _f c22,? City State Zip Code Phone Number Nearest Road 6 (74r ).2q. ❑ City ❑ Village Town 'pro New Construction Use: .i'Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow &0 gpd Recommended design loading rate _ ,2 bed, bpd/ft2_19_trench, gpd/ft2 Absorption area required 2 bed, ft2 7M trench, ft 2 Maximum design loading rate ~ 7 bed, gpd/ft2__,P-trench, gpd/tt2 Recommended infiltration surface elevation(s) 7 -5~1 'P0 ft (as referred to site plan benchmark) Additional design/site considerations t1 Parent material i, S 4 Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system us ❑ U T~rS ❑ U [OS ❑ U 1~rS ❑ U ATS ❑ U ❑ s 4 U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Ground 3 5 5=~6 rn elev. Depth to limiting fact pr Remarks: Boring CS ,e Ground ~lev _ ~ft. Depth to limiting a in. Remarks: CST Name (Please Print) Signature - Telephone No. aM s ~f~ s sue- / Address Date CST Number C),, 2, r / - solo 5 ^Y JW 1/ Ale a PROPERTY OWNER kf Qe~~,,e -5e SOIL DESCRIPTION REPORT / y Page of PARCEL 11.1134 X lcc /00 ' Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots Mft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Ground elev. ft. ; Depth to limiting factor in. Remarks: Boring # Ground elev. ft. ' Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # Ground elev. ft. Depth to limiting , factor 'n' Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBDW-8330 (R. 08/95) R~ ✓,'S i On S ltio r,:J,'h 9 /`f ~07/' T / Oy+ a / p, ,g e 3J 3 ores ~'o ~ lie Or'~ ~ Soi ~ ~4f y~nu~ QYO Pvc p►~~ ~L. ~c~D, Do \Vol So~1 By 133 a10~ 73 rte} 3 ~,i 33 age 381 - 1~ ~vb S©u.~ ~ I"ffl~Q r Z~he ~Y1 ~a iJ r a r; C'S Tai yo/d 9 .S/K 73o,1(,e/h Sp( Z, o4 3 2~ a FILED , tl DEC 5 1995 ► KAntm i wum d~ >St Crobc 21 J. ~`7~.30 40 .a co CERTIFIED SURVEY MAP i.oratud in part of the 6141 of the SW1 of section 16, T30N, R18W, Town of itichmond, St. Croix County, Wisconsin,, being lot 2 of certified survey njop volume "10" Page 2784. LEGEND Aluminum County Section /North line of the SA of the SW Nonuwnt found 122.951 • 1" R 24" Iron Pipe Set, Weighing 1.68 lbs / Per linear foot 0 1" x 24" Iron Pipe Found, Weighing 1.68 lbs Per linear foot yy• 'l~tt'.~w' 1401 Roadway Setback Line j lye X Corsener position establishedfromr ties, e County Surveyor for ties. / ~',Q' f/',• r~' AIA..T Cr/•. ~C)/ 07 r 'LOT 3 Hurlir:+1, • / y~ v,~ 5.47 - Acres "~.t r~,~.,•~.;. S o 238,261 SQ.FT. 'g,' +s. r CAI I r o N / 589°33122"W 541.06' _ ZI 270.53' 270.531 SYS LOT 4 LOT 5 0 o w N 4.20 Acres 4.22 Acres / T ~ _ Inc. R/W Inc. R/W m o u ¢I l_\l 1 o $ 183,106 SQ. FT. 183,749 SQ.FT419 -5 co in '%VL C3 01 1D 4.04 to 8 4.04 Acres Exc. R/W Exc. R/W `✓~J~. \l 1 ~1750820 SQ.FT. $ 1751820 SQ.FT. 2-178 4' it E 0 $ ....:f ..............o .~....................M. i '95; SW Corner 0 c Sly Corner Section 16 N8903312211E 541.06' Section 16 270.53' I~27_0_,531 270.541 270,551 89°56'40"E 541.09' M innir M SOUth line of the SWh C T . H G + r I;iSB9056140"E STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER ~~T2~ J ~ old L l~L~rt/ MAEUNG ADDRESS 2~Zd `S&147_67 A /07/J At"" - 57,4 6q~1,7Y PROPERTY ADDRESS f y f' s'7 ~s r L / y ,tc , (location of septic syst mease obtain from the Planning Dept. CITY/STATE CD u,C~~7Y PROPERTY LOCATION 5L 1/4, SW 1/4, Section T_10 _N-R__Z&_W TOWN OF ~J l~11 C-9 y) a,-IL , ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER-3 . CERTIFIED SURVEY MAP,6'3 7 j 30 ' VOLUME J, PAGEp , 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: C~7l St. Croix County Zoning Office Government Center i 101 Carmichael Road Hudson, WI 54016 11/93 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 recprding. Owner of property PA-7-1?_1c4 `J, ~ ,D~ ek p#L Location of property ~5 ~ 1/4 6 !,J 1/4, Section T 3d N-R / _6W Township elclw mow Mailing address Address of site " subdivision name L boa 3 Lot no. Other homes on property? Yes ~c No Previous owner of property <,-LEA) A. Q,45rL f~A2~,cl /✓J Q/Q6 _ L Total size of property 51 Z7a ~ Total size of parcel Date parcel was created /a Are all corners and lot lines identifiable? _IX_Yes No Is this property being developed for (spec house) ? Yes No Volume _1,VA and Page Number--! 1 f 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 th office of the County Register of Deeds as Document No. ~-s y9 , 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 o Applican Co-Applicant /O/, 0/p 17 1O l0 X) Date of Signature Dat o Signature l 0 O OA 554449 STATE BAR WARRANTYIDEEDM 2 - 1982 DOCUMENT NO VOL I SPACE PACE a V _ GCw Z-5'3 i~•i ^ C k~ Glen A Basel, a/k/a Glenn A. Basel and ! R rdtorr. cuts Karen M Basel husband and wife, as tenants in common, JAN 15 1997 conveys and warrants to Patrick J Sei dling and is 10:45 A.'. Deborah L. Seidling, husband and wife, f ~h`, sue. `K as survivorship marital property, F; Fi~yistaru:u~v THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS the following described real estate in St. Croix County, Century 21 Premier GroUV'~._ State of Wisconsin: 1237 N. Knowles AVG. P.O. Box 286 New Richmond, WI 54017 026-1048-30 100 PARCEL IDENTIFICATION NUMBER Part of the SWk of the SWk of Section 16-30-18 described as follows: Lot 3 of Certified Survey Map filed December 5, 1995, in Vol. "11", Page 3023, as Doc. No. 537130. St. Croix County, Wisconsin. TRANSFER FEE i This is not homestead property. (NXX (is not) Exception to warranties: Easements, restrictions and rights-of-way of record, if any. Dated this 2nd day of January A.D., 19 97 r ~L st (SEAL) (SEAL) * Glen A. Basel, a/k/a Glenn A. Basel Ka en M. Basel (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, ss. St. Croix County. day of authenticated this day of 119 ]rrrcona11v, can•o before me this _ 2nd % 97C nlA-L, JF60r r~ZAAl y ~rPl~ tYE/~`T ~ //►~~/~~CT/a/k /°/rte OWAAFF 30 " ~'A~pRov~o MIA OQMX ® R nRai4 o C S ysTEr7 cc, 9y-8o r IQ r~ BS /Ado GL S•r, / PRopasea / ° S~ /yOUSr e3~~ 715icrc AWS l % sCAi, •r S~ l3/7 7c-,o ,2 *pve- pip L, cc- lea0 p St Al T 4►/7 7-0 s?EEL pyE K . s'~aB SOcf7-A ARo/oe-,er y L1440- Acr OP7. s' c Tr A IVEO ~3~0,~