HomeMy WebLinkAbout034-1033-20-100
T.
STC - 10 4
AS BUILT SANITARY SYSTEM REPORT i~
OWNER
A~/NC Sch, Il;hus':.<~L
n
ADDRESS j
ST cRo tx
GOUNTY
FFICI±
ZONING
SUBDIVISION / CSM#~
SECTION T-,~9 N-R_±!~ W, Town of tc;~c
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
N SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
vJG►
w
C1 Z'
~~{kqs 1-~~~sL
his ►3~d ,
. a3•~dCt
• -)p' ,oF pa h~ Inc
a.. pvt P*1c (ytee~ f;v~
I
A~r ags~Gc,
n FF Gc„~eY v t-
mde 40 INDICATE NORTH ARROW'
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK: To p o F P VC p.'Pt 7 Y2.. _ ►oD
ALTERNATE BM: /Ue w 13. M. I o P p F Lye. (A p 1'- 0 311
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
1000 (0A1 ScP~:c. Ta,k
Manufacturer: P v FF c. v T T Liquid Capacity: gv0 T"A
Setback from: Well 55D' 4 House 1 S~ Other
Pump: Manufacturer H ~JVO MAI;4_ Model# OS P- 33 Size
Float seperation 7 Gallons/cycle: ISq.6
Alarm Location lV f-,Ai }o Pvve,r Pavte.l base me, of ~OVAC
SOIL ABSORPTION SYSTEM
Width: j Length -1 S-Number of trenches I Jock GcA
Distance & Direction to nearest prop. line: E30'
5ov+~
Setback from: well:-100'4 House So. + Other -75" F'rv,v~ P.L.
ELEVATIONS
Building Sewer /0 5" ST Inlet: 10 - ST outlet:
PC inlet PC bottom 15 172~(Pump Off
~ ~ ~1 !DP OF Z.. ~TCVR, ,
Header/Manifold 3' li Bottom of system 3-1p- S YS+L„n CIc VA~"o'n
Existing Grade Li 10Final grade I
FC-00 wcd
DATE OF INSTALLATION:
PLUMBER ON JOB: CLe, '5 3Avc-,r
LICENSE NUMBER: S P Op 110 48
INSPECTOR:
,'nn T~ o~n p SoN
3/93:jt
PAGE S OF
i PUMP CHAMBER CR055 SEC-, 101-j AtJG SPECIFICATIOUS
VEIJT CAP
CA s4AVo APPROVED LOCKIAIG
4"C. I.. vc JT PIPE WEATHERPROOF
MAtJHOLE COVER
JUIJCTIOW BOX
~O FROM DOOR.
12"MIU. ~
wWDOW OR FRESH
AIR INTAKE GRADE I Lj"MIKJ.
18" /M IQ.
COWDUIT
I8"h~IKI.
PROVIDE
I IJ LE T AIRTIGHT SEAL
A
I ALARM
~ I
D
I OK)
*APPROVED i I
c JOINTS WITH I
9.?3 APPROVED PIPE
ELEV. FT. 3' ONTO PUMP--- OFF
D SOLID SOIL
COMCRETE BLOCK
RISER EXIT PERMITTED OWLy IF TAWK MAWUFACTURER HAS SUCH APPROVAL
SPEC,IFI.CATIOUS
SEPTIC E
~`f-Curd IJUMBER OF DOSES: 9 PER DAy
DOSE
A►.1K5 h^~A►JUFACTURER: _
TAIJK 51ZE: 1002 sir 800-~~• GALLOQS DOSE VOLUME ~S 4:~~rl_~Ai~~ S
_ IMCLUDIMG 6AGKFL0W: ,
S ✓ E~ rcrro
ALARM MAUUFACTURr.R:
MODEL IJUMBEK: CAPACITIES: A= 20 IWCRES OR y,~- CALLOUS
SWITCH TYPE: =--,-IWCHES OR GALLOWS
B
~ /CCU~r o1.1.8 ~A=f' /SAG
PUMP MAWUFACTURER: C=-L_11JCHE5 OR GALL0Q5
p INCHES OF CALLOUS
.r •
MODEL KJUMBER: ~
~Gr/lG~/rl• MOTE: PUMP AMD ALARM ARE TO DE
SWITCH TYPE: INSTALLED OW 5EPARATE CIRCUITS
MIIJIMLJM DISCHARGE RATE-- ET
VERTICAL DIFFEREKICE CETWEEW PUMP OFF AMD D15TRIBUTIOW PIPE' F E FEET
+ MJ-11MUM iJETWORK SUPPLY PRES+SUR,E/. . . . . . . . .
+ FEET OF FORCE MAN X `/+f. FYloo ►xFRICTIOU FACTOR..---L - FEET
- ~Jr
D -
_ TOTAL DyWAMIG HEA FEET
WIDTH iLIQUID DEPTH 39
IIJTERK]AL DIME►JSIO►JC OF 7AK1K: LEIJGTN
Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County:
Lobor andHuman Relations INSPECTION REPORT ST. CROIX
Safety and Buildings Division
(ATTACH TO PERMIT) Sanitary Permit No-:
GENERAL INFORMATION 289487
Permit Holder's Name: ❑ Cit ❑ Villa a Town o : State Plan ID No.:
SCHILLING, WAYNE & TERESA SP INMELD
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
034-1033-20-000
TANK INFORMATION ELEVATION DATA A970 322 9 /9
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
a~'v Septic T G0d Benchmark /GCS,
-e 4
~ Dosing U ~J co Pi ,r /o S C►(p r
Aeration- Bldg. Sewer
St/ Inlet '
x4ls Holding l4 8'~ 1o,3~s~
TAKIK SETBACK INFORMATI St/'I COutlet 01.~
TANKTO P/L WELL BLDG. VAe Intake ROAD Dt Inlet d' ?(11
'7 Septic Q5,' NA Dt Bottom 18711 9/, yZ~
Dosing >SO~ 9D~ Z/~~ ~SU~ NA fMan./pe/.OG~
Aeration NA Dist. Pipe c1,411q vy DZ~
A Holdin Bot. System /G 3, Z3 ~
PUMP / STHON INFORMATION Final Grade
Manufacturer a- f- Demand
Model Number D 5? 33 GPM
TDH Lift Friction Systerrm g~)' TDH Ft
oss Forcemain Length Z3 Dia. FZ r Dist. To Well >V
SOIL ABSORPTION SYSTEM
BED/TRENCH Width 5 i Length r No. Of Trenches No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 7, DIMEN
G manufacturer:
SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM
INFORMATION Type O n IA-- AMBER Model Number:
System: ,e-J oo 7d , OR UNIT
DISTRIBUTION SYSTEM
Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length Length Dia. ' Spacing 36
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 ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)X,4s 8cu c<~ C': ~4 ~rA
LOCATION: SPRINGFIELD 15.29.15.228F,SE,NE 958 RUSTIC RD #3 LOT 2
)eooV
Plan revision required? ❑ Yes [ No
Use other side for additional information. 9
SBD-6710 (R 05/91) Date Inspector's Sign ture Cert. No.
ADDITIONAL COMMENTS AND SKETCH ,
SANITARY PERMIT NUMBER: '
.U^a^ Safety and Buildings Division
SANITARY PERMIT APPLICATION Bureau of Building Water Systems
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. e~o/
• See reverse side for instructions for completing this application State Sanitary Permit Number
The information you provide may be used by other government agency programs E] Check ff revision to previous application
[Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number
1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION
Property Owner Name Property Location
YNi' tt ,1/4 1/4, S T Nr R
Property Owner's Mailing Address Lot Number Block Number
City; State Zip Code Phone Number Sebdirmi&R-Name or CSM umber
o.✓®osaY 41.7- si7 s' S ) 8zs = CS I
II. TYPE O BUILDING: (check one) ❑ State Owned Nearest Road /J
E] [N Public 1 or 2 Family Dwelling - No. of bedrooms ..3 of S/,f1W-e i«O ~vrssc 00Lo 3
III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s)
034 1e33-2.0
1 ❑ Apartment/ Co I ndo
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 OnlyExisting System--- I 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 D? 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-Fil 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) / Elevation
0Sb X-7-T" Feet /06. Z Feet
VII. TANK Capacity gallons Total # of Prefab. Site Fiber- Exper.
INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App
New Existing strutted
Tanks Tanks
Septic Tank or Holding Tank GOD Q0o / ,D )-fAr Aril! ® ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber ;'S'b ❑ ❑ ❑ ❑ ❑
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Na e: (Print) Plumber's Signature: (No Stam s) MP/11AR9ri~f No.: Business Phone Number:
~f<.Cd` - z_.? 7 /S 171- .ALL
Plumber's Address (Street, City, State, Zip Code):
IX. COUNTY/ DEPARTMENT USE O Y
❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate ssue Issuing A ent Si nature o ps)
Approved ❑ Owner Given Initial p h Cj Surcharge Fee)
Adverse Determination OU 1G8
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SHD-6398 .(R. 05/94) DISTRIBUTION: original to Cnunly, One copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS
1 . A sanitary permit is valid for two (2) years.
2. Your sanitary permit maybe 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 nt rne,ar*l ilir4g~ad Tess. 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; 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.
t
S97-30777 Page- -Df L
PRIVATE SEWAGE SYSTEM ~
ENDEX AND TITLE SHEET s9~ ~G ~OF
Property Owner(s): .•01'.✓E ~,yi~ ~ewe ~O
Project Name: l~y.✓E- ~cs/it s ..mac s97- 3o y77
OG
Project Location: ~us ria o~~
31na Aidross
.S S s Z
os tion
own or Mw i4aay
fir. L County
Contents: Page is 7
Page 2: _ li L a r li'L.i.✓
Page 3: G Glass a 7-io.,i o ~~•ro
Page 4: M0Uvi ~w1v (//E6/
Page 5: . uiY.s ~.S/a s~~ LAOdI - ftt rro ✓
Page 45: ~.>.o ~R~oA~•I.✓ge Lu vyf'
Name: i6 Ow / ,-z er Signed:
Credential Number: /JO e s-17 Date: 7-
Address: Al r a?s
Phone Number:
P.O.W.T.S.
CondidonalliP
APPROVED
9WOKKINFOOMM"
s
, F k'j
.~,,~.#v".e.a r
d 1~
r
~1~ T/ f~M~7~1~is{
t~ii~Cl+~c:.`:~►~~
T
a
.4 P4
n\ \:a ~t A off.
R
0
0
DV
~ a
c ^
; f
st,
1 Q~
7
~ q
C \ ti~
a
a
~ a
R
b
1 ~ I
0
~ ~c2
m
to n
~w
w
b Cl)
fJ W
a
I.A M ~ L
k ~ "I r 'r n ~
co co
ri
CQ
cr
~ n
z d
H
I
.c
.ti
ro
0 4
Z Z
e
l~ I Lv
O
I~
H
■
m:3 1 t 1 t
b i ~1
4
-4' P.
L ~
h (D ~ i
w ~e ~ b
F
o h
d ~ R
0 ~ ad I
O r I
rd M1 r•
~ .NK- ~ I
M.
.k k Q 14 I 0
: l
e
00
'C ; w
1 T N m
1 ~
w t ~ w y
N
W 1 ~t v b m
k
o o " w t 7C
0:3 M w
~aW ~
n u, M i
fD R
~w
c(D
. n w p.
hh
PAGE 4 OF
PUMP CHAMBER CROSS SECTI01•J AND SPECIFICAnokiS
VENT CAP
oit SCN. Va
'i"C.Z. VENT PIPE
T WEATHERPROOF APPROVED LOCKIAIG
r JUNCTION BOX MANHOLE COVER (,j&k -T I
~ /O FROM DOOR, IZ"MIU. LaQ,rtn~ ~
WINDOW OR FRESH I
AIR INTAKE
GRADE I
I `1" MIf,J.
COIJDUIT
18"MIN.
• \ X11
INLET PROVIDE I
AIRTIGHT SEAL I I i I /
~7`iQ n,
~.4Srr1 uC 1`TUo SA, U~u i i I I
*l A CorvtPCy Gc1~ Com tr7 S3• /9 I I I I
iq N 3. Z I I I ALARM
a I II.
I
0 *APPROVED I OIJ
JOINTS WITH I I
CLEV 93 8 F7. APPROVED PIPE
3' ONTO PUMP ` OFF
D SOLID SOIL
COMCRETE 6LOCK
~ /t f4VL
RISER EXIT PERMITTED OIJLy IF TAW MAMUFACTURER HAS SUCH APPROVAL
SEPTIC E SPEGIFI-CATIOM§
DOSE ~ O
TAWKS MAMUFACTURER: /%/Dr✓rlr'E.,,v ~~~lG.~rr NUMBER OF DOSES: 9 PER DAy
TANK SIZE: AOGO'.f r Zi0-6S.' GALLONS DOSE VOLUME
ALARM MAUUFACTUKER: S E~LEC3".~o INCLUDING 6ACKFLOW: ~SS.9•'Y/°/LO GALLONS
MODEL NUMBER: leo0/ CAPACITIES: A= d0~_UICHES OR d~ GALLOWS
SWITCH TSPC: ew g _INCHES OR IV-0 GALLOWS
PUMP MAMUFACTUREM ✓6'r,0/lersrr1e. ,YNtr/^ C.=~-INCHES OR GALLOWS
MODEL NUMBER: /"SP J3 D- INCHES OR GG GALLONS
SWITCH T`JPE: Z; ~WCaAY MOTE: PUMP AMD ALARM ARE TO DE
MINIMUM DISCHARGE RATE dsWS GPM INSTALLED ON SEPARATE CIRCUITS
VERTICAL DIFFERENCE BETWEEN PUMP OFF ARID DISTRIBUTION PIPE.. /0-0 FEET
+ MINIMUM NETWORK SUPPLY PRESSURT,E/.. . . . . 2.5 FEET
+ FE ET OF FORCE MAIN X ~sF/pOFLFRICTIOW FACTOR.. FEET
TOTAL DYNAMIC. HEAD ILFEET
IIJTERNAL DIMEWSIONZ OF TANK: LENGTH 1S ;WIDTH ~-.;LIQUID DEPTH
75x~3g= $3fs.g6 22.07
Z-- 3 I
EFFLUENT PUMPS
♦ ♦ ♦ Performance,
OSP33
113 HP - MAX. SOLIDS SM** SPHERE -1750 RPM
• Available in automatic or.
manual.
• Completely submersible.
20 Non-clog bronze impeller.
• No suction screens to clean. '
• Oil-filled, double ball bearing
Z motor with built-in overload'
protection.
„ Reliable diaphragm switch with
piggyback plug-in.
• Rugged cast iron construction.
' Completely field serviceable.
A FULL
ST A IISV 1 1/2" NPr discharge.
Es AT 27W U
° 0 10 20 30 w 50 E°
U.S. GALLONS PER MINUTE ~
SPD50H/SPD 100H
1r2 and 1 HP - MAX. SOLIDS 14" SPHERE - 3150 RPM
a Available in manual or 1 V
automatic.
• Dual seals standard. Seal
failure sensor capability
r , available (to be wired to an
i~.Ia4 1' Y
alarm device) on manual pumps.
~ NOV. 7]0 ~ Open two-vane sewage type ; • : ~xpt;~;
impeller.
'w Pump shaft and all fasteners are
a
m r
z>sA„„.4,„ stainless steel.
• 1 /2 HP (SPD504 and 1 HP
IE (SPD 100H) motors. Ball bearing
construction and oil-filled.
° ° m w in 2" NPT discharge (3" flange t+
.0 0
U.S. GALLONS PER MINUTE optional). T'
SKHD 15 0
11d HP - MAX. SOLIDS 3/4" SPHERE - 3450 RPM 4
Semi-open thermoplastic
j impeller.
W ,p 1 1/2 HP, oil-filled motor.
11 Pump shaft and all fasteners are
stainless steel.
-'e
• 1 1/2" NPT discharge.
Spring loaded mechanical seal
° w with carbon and ceramic faces.
1 Pump-out vanes on rear shroud. I il °o to zo I w of impeller.°
a w W to Dual seals. Seal failure sensor
U.S. GALLONS PER MINUTE capability available (to be wired
to an alarm device).
:'r
M
Vtlisconsin Department of Industry, SOIL A VALUATION REPORT Page -4-- of _
Labor and Human Relations
..Division of Safety & Buildings wl 05, Wis. Adm. Code
fPARCEL UNTY
Attach complete site plan on paper not le h 8 1/&t 6 s in si n must include, but
not limited to vertical and horizontal refer point (BM), direction and lope, scale or I.D. #
dimensioned, north arrow, and location a stan~tNn2ar?stj9" 034-1033-20
VIEWED BY DATE
APPLICANT INFORMATION-PLEA INT AktUNWIMATI
PROPERTY OWNER: ZONNN O v PROPERTY LOCATION
Wa e Schil in GOVT. LOT SE 1/4 1/4,S 15 T 29 N,R 15 fdpr) W
PROPERTY OWNER':S MAILING ADDRESS £ lj~ LOT # BLOCK # SUED. NAME OR CSM #
N1203 939th. St. 2 na na
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE MOWN NEAREST ROAD
(715) 879-4416 S rin fie d
[x] Rustic Road-
New Construction Use [x ] Residential / Number of bedrooms 3 [ ] Addition to existing building
[ ] Replacement [ ] Public or commercial describe
Code derived daily flow 450 gpd Recommended design loading rate • 4 bed, gpd/ft2 •5 trench, gpd/ft2
Absorption area required 374 bed, ft2 375 trench, ft2 Maximum design loading rate .4 bed, gpd/ft2 .5 trench, gpd/ft2
Recommended infiltration surface elevation(s) 103.20 ft (as referred to site plan benchmark)
Additional design/ site considerations system el based on contour line of el 102 20
Parent material sandstone uplands Flood plain elevation, if~applicable na ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem ❑ S (d U RIS ❑ U ❑ S ®U ❑ S CR U ❑ S ® U ❑ S I RU
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 Trench
1 1 0-14 10 r 3/3 none 1 2msbk mfr cs .5 .6
2 14-26 10 r 4/4 none sicl 2msbk mfr CQFW if .4 .5
Ground 3 26-38 10 r 4/6 c2 7.5 r 5/8 sicl m na gW na np .2
elev.
103.6ft. 4 138-55 10 r 6/6 Sandstone Residuum na na na np pp
Depth to
limiting
factor
26"
Remarks:
Boring #
1 0-10 10 r 3 2 none 1 2msbk mfr gW 2f .5 .6
. 2.... 2 10-30 10 r 4/4 none sici 2msbk mfr 9W if .4 .5
Ground 3 30-50 10 r 6/6 c2 7.5 r 5/8 Sand,, one, Resi uum na na n np
elev.
100.00ft.
Depth to
limiting
factor
Remarks:
CST Name:--Please Print Gary L. Steel Phone: 715-246-6200
Address: 1554 200th. A New Rich nd WI 54017
Signature: ZL=;;i' Date: 6-20-97 CST Number: m02298
PROPEMYOWNER Wayne Srhillin SOIL DESCRIPTION REPORT Page 9. Qf
PARCEL I.D. # 0'14_-1033-20
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench
>v:; 3
2 8-30 10 r 4/4 none sicl 2msbk mfr 9w if .4 .5
Ground _ mfr na .2 .3
elev.
100.Oft. 4 144-65 10 r 6/6 c2 7.5 r 5/8 Lime tone Resi uum np np
Depth to
limiting
factor
301,
Remarks:
Boring #
Ground
elev.
ft.
Depth to -
limiting
factor
Remarks:
Boring #
Ground - -
elev.
ft. -
Depth to f
limiting
factor
Remarks:
Boring #
Ground - t--- _
elev.
ft.
Depth to
limiting ! i
factor
I
Frei-earl, :
SBD-8330(H,05/92)
STEEL'S SOIL SERVICE
Gary L. Steel 1554 200th Ave.
CSTM2298 Wayne Schilling New Richmond, WI 54017
MPRSW 3254 SE4NE4 S15-T29N-R15W (715) 246-6200
town of Springfield
Or rt lid'( L~ k V►c-
N
1"=40'
BM.= top of 2" pvc pipe C el. 1001'
Alt. BM.= nail in Cherry tree C el. 106.15' ~q,
J
X_
kA ~
AA
Gary L. Steel
6-20-97
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 I'L~ n-2 -J~Lrx-sd Q Sc%i
Location of property 1/4 C 1/4, Section ,T 92N-R 1-5 W
Township S~ r i l►,# -j Ma ' 1 ing address
4194ef-h eloacy, Mal ow
Address of site A43776 ie2p," P 16 ~
m~
Subdivision name - Lot no.
Other homes on property? Yes_X_No
Previous owner of property !1749y &56- IPid,12-
Total size of property &,D!'D.Y /Z1
Total size of parcel
Date parcel was created
Are all corners and lot lines identifiable? _Yes No
Is this property being developed for (spec house) ? Yes No
Volume and Page Number 114y as recorded with the Register
of Deeds. am P _ ----'64 /Yo~
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 cent'
ily that all statements on this form are true to the
bes of my our knowledge that I die 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. 5(a 1(43;L- , and that I ej;j) presently
own the proposed site for the sewage disposal system or I QED
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.
Signat re of Applicant Co-Applicant
cola-~ l'y ~
Date of Si' gnature Date of Signature
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER LA, Sc h ij ~~/-~S A Scf~. dlt'
MAILING ADDRESS Q q 413 11WM~ 7
PROPERTY ADDRESS
(location of septic system) Please obtain from the Planni g Dept.
CITY/STATE~e~ GcJ'~ (~i c/-~
PROPERTY LOCATION 1/4, A/6 1/4, Section 1 T 2 N-R__Z.5-'_W
TOWN OF S f i ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMBER
CERTIFIED SURVEY MAP , VOLUME , PAGE , LOT NUMBER
Va l antic, -T P1 v
Improper use and maintenance of your sip i~ systel coi d 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: GJ E t:~k~~ ,
DATE: 7
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
PELKE PLUMBING Fax:715-672-5267 Rug 6 '97 12:52 P.03
siS 2,06 261i P. ®A
1•IaY-12-97 09158 PI'I (1-1311 PReM i CR NR
M:• PILED
FEB glew
AAL if C,@
CERTIFIED SURVEY MAP Neecow-
15
- OWNER AND SUBDIVIDER; iECTICN
K.IRCHHEINCR, INC
GLENWOOD CITY, WISCONSIN
Located in tha SE-NE of Sac ion 15-2g-15I 1 :
es.. CEATME Q ZURVEY'
YOL UME.12,;PAGE 434,,4
tc~.cNe : n
• '1w * 89'1404"W J64: I
2/0 X &A" IT111616 Oda PT
•a• OrlSs,■• 4.909 160!_/
SiCT10■ tOINLA' AlfOl11 :O N,
Nf 'O 2.00 •ClIE:1 (F1[Cl. A/M) z+
SCALE IN FEET T 100 . C O
11.146 ACRES iNGL. Aral I
o sae tad ~ t $ Q ~
go I
, m too
• I
N 401,eWw sa,.se ,n ;
APPROVED 397.50r
E , "
Sradley-`J. Canaday, N 2 • 4 , ' ■ _
:ieronsin LandSurvepoZ ;n ACRES (ExCL RM d~ !o o
•
lew: ACRES P CL. 1111W
:tevens Ertg inears Inc.
409 Coulee Road a
(
:udson, Wisconsin 54016 10
09 lip rolM► or rtol0ON4 s
•a~' I a .
F,ob. 2 , 1982 -a 5 89.14"04"E 364_S0' ar► i •
r - - - - - - - 39.50 1
CERTIFIED BURVEY VOLUME 2 PAGE 463
I ----•----...1......--
A parted of land lok:atad in the SG% of the NC]I'i of Section 15, I
T29N, R1519, Town of Springfij1d, St_ Croix County, Wis. , being
pert of that CersifiQcl Survey Map recorded in Volume 1, page
290, being further dv%%jrib.ed os follows: bl
Commencing at the E•~ car»t.:r of Section 15: thganL:c W0900'58"W I CL
PELKE PLUMBING Fax:715-672-5267 Aug 6 '97 12:51 P.01
vi-.248PAc
~vl.s3 STATE DAR Or WISCONSIN FORM 2'- 1982 i
WARRANTY DEED
DOCUMENT NO,
1REGISTER'- OFFI-E
Mary Pryor Moon, a/k/a Mary Mood, a/k/a Mary ST. CROIXCTY.,W1
oot,, a a ary ose Ron, a. Mar Rose Pryor
-WCharioRe irc eider , as ' a orney-in- aC r-JUN 2 1 1991,
conveys and warrants to ayne Schilling an_ Teresa 2-45 P A
Schilling, husband and wife,
a~r
090mr of Desda
THIS SPACE RESERVED FOR RECORDING DATA
NAME AND RETUnN ADDR as
the following dcscribed real estate In St", Croix _ County. ~
Stele of Wisconsin;
(See Attached Exhibit 11Ai1) aP%ACIIL roeNTiFic„rt*N Numeen
y,r•+., . ~1.JId
TRANSFER
FEE
This is not homestead property.
XUX (1...6
Excepllonto-arrahties: Easements, restrictions and rights-of-way of record, if
any.
Dated this LY day of )LtiP
r
_ (SEAL) (SEAL)
_ Charlotte 0_ Kirchheiner, as
attorney-in- aCt or Mary r pr
• P. Moon, a/k/a.Mary Rose Moon
f.k.a. Mary Rose Pryor
AUTHL• NTI CATION ACKNOWLEDGMENT
Signature(s) State of VVakX $5x, bHZO
/I ss.
1 Mrl G' Count ,
authenlicated this day of , 19 PerSChally came before me this day of
T
June 19 97 _ tha 4brwe nornotl
PELKE PLUMBING Fax:715-672-5267 Aug 6 '97 12:52 P.02
- voL1248PAu375
EXHIBIT "A"
1,r.1t.:q 1 end 2 of n Cerv.itfir_,,9 Slrrvr.Y r).►p, narltrneht Numlpsr 375Vfi5
,
rPr.0+dwc] .Ln Vo,luntto 4 t+xyr. 1,149 4- ,of 215i,d Mafia in Lhr tZehiat.,tr of 1)taa-a-
0(:,(jr':' in 9t.. Croix rcajlnth7, Wiwrtynnin. Dooming in Sfnction 1'i. 'rown0-&4:%
29 Nvr:t'h, rtange 15 We.r{t: ,in 1:1tr 'l'our, or Rpei,ngf:i,alrl, Sl. x,roix Cr~llnt:y
W i. s rt..) it r,t ) r) -
A J:lar. l: caf Lot- 1 of a C_orL ifi.ed Si+rvey Map, Dor!lrrl►ent. N+arnl)r_r 3351)55
C~C:vCrir.~l Iit VoIumr: 1 page 290 of malt Maps in th(pi Rai,ginu.r.r t,f Deed&
office in f7 1_, C'ro]x counhy, Wi.scongin, 1o(-ated ir+ par'L or the tiouth
Half of tha+ Northeast Quarter 1.+11 S2rtioh 1%, Tnr.►ne)+ip 29 North, Rart~-
l.5 Wrgt, Town or sp)•ingfiel.q, St.. Crnix County, Winconsin described -as
follows:
ComrePnc,i.ng at the BanL- QIXa+•(:er corner nf, ilai.rl Rr,r;tJot-, 1.5; thefice, on C'
hearing, a)n►,ag F..hp Pant limo of the South half of Lhe Novtlleaasl•,
S)uarter or paid Sect-Jon 15, referenced t,l the liearingm oltuwrt ,",n a
Cert•iried Survey Map, vncumcnt Nuittlaer 375065, rr,.,nnrtio*d in volunte 4
page- 1149 in spid County, Paor.r.h 0 dC(areea 00 ►nii-iut.eg 50 aolnondu Wec,t
a diatanr:a or 263.()0 feet; L'hene.-rt, aIOng the south I i.ne of Lot 2 cif
vald MAp and part. of the north I ins of Let. 1 of a Crrl:l.firrcl Survey
Mnp, Document- Number 343373, r-ecordad j,n Vo),ume. 2 1?age 463 itt said
CounLy, North 89 dc-grece 14 tuinW4-ce 114 9pr.nnda Wext. a distance of
397. Fill feet to the nout'hwe.a1: corner of Lot. 2 of said Map, thj y bei nq
the point of heginninrj of the p~.rca,1 to be denoribed: thence,
csohti,nuinq slony the rtorL•h line of Lot 1 c+r said MAp recorded Volume 2
page 463, NQrLF+ 09 dcgcece 14 mi.nkites 04 gPr_.ondq W,sAt:' A ciimt:o++ce Cat
161 ,50 frnt 1:o the nort.Aiweat• r•..c,rnrr r,f lnral: maid lot 1) therms, Alcirig
1.111. we?ut. 1 ilte of laps, said Not 1 , so►ath 00 degrees 00 mitiutc m 5l1
■ rcondu Pant a dietanrsw of 263.40 feet. tm t.hrt motith rivt corner of lar&L
riaj.d r.a)t J. thin also hel.11g on ChC` oouth lints Of Lol.: 1 of a Certified
3ut'vey Mop, Iluc milartL• Number 335055, recorded in Vnl+jmn 1 page 290 in
gain r_nullty; thrnar., along the )3011111 L'i'nft of. Lot 1 of aaj'd Map
i-ecorrled in vt)ltune 1, pago 270, North 89 degrees 14 ntint,+tew 04 sme-lon(1N
West a digt-artr..e of 310.39 feet; t•henCe North Qt.) degr#-.wn 00 rninut_nR 50
$econ•.ur 6gnRt a distance: of 742.1,2 feet; thence South 119 deg-
fees 14
minut.e% 04 socondst Fasl: a distance of 479.09 feet to the northwest
r:orncr of said Map in Valutne 4 r,ar3e 1.149; thtinnn, plont3 the west 1ir+,y
or l,+pt Rai.ri Map, South 00 degx',aea 00 minutes 50 sec<►hd!v I;arat A
distanc,e !if 479.1,2 fs*.ek I:n thp. point of beiiinninq. Cont.aini.nq 113,612
Rqurbt•e feet, (7.2 acres). 5u1Pjc-,:l. l:c, ail eaeemer►ts. rest.rict.iorts a1,r1
ro~F:n,~nt. of rind:-rd'
*From : GLAUS BROS. CONTRACTING INC. PHONE No. : 715 672 6496 Jul.14 1957 3:30AM P02
s•
. 1DN1•T11~ Ian •~exe
i
' I
I
0/0 tY l
BEDROOM Z LOFT
tt•s x to.l may., I t7.1 x u-T
its
MIN 446 101t W&L
Mill 116 -
CORL
- l01
O 0041 _
Iti
'sto er 1/a '
a
w ~
BEDROOM 3
n-3 K 11.4 I >
I
r
I
~(al•163Q
IIPNI.3t1~ _
1}~•~ 1//~ M7 •i 3 1 .
I
'r iyao~,e~xJ'A
5 110 A f71S1S pJitT7
t s ~.'t p y r, i
P ~J
w.
apt - -X- - -
_ Q aow
JI, E•,tt
Yw
5! ~ • ,0]1'!tS'!A
e
~J - - 5
aQ ~ t (Qr ~ ~
1 1 \
Mai
,oT.air •rs:H ~
r
4
'Frorn GLAUS BROS. CONTRACTING INC. PHONE No. : 715 572 8496 Jul. 14 1997 8:31AM P93
t
TO 0&4L~4& Fr
t'~ 6~z - s~9s /
c~
_
3 k ~ _
y sh~~