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HomeMy WebLinkAbout038-1035-10-001 STC - 104 AS BUILT SANITARY SYSTEM REPORT k OWNER ADDRESS, SUBDIVISION / CSM# LOT SECTION T~N-R~W, Town of S~ a-r ~Pr ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 67 Ob BO 1 +1 3 INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. ti BENCHMARK: 0 Olt ALTERNATE BM: EPTIC PUMP CHAMBER HOLDING TANK INFORMATION P~C~Ianufacturer:~ A/z Liquid Capacity: ~ Setback from. Well House _30/5;1v Other Pump: Manufacturer 1>1 t(, Model ~ Size Float seperation Gallons/cycle:© Alarm Location SOIL ABSORPTION SYSTEM Width: Length 69 Number of trenches ,::~F 1r Distance & Direction to nearest prop. line:( Setback from: well: g~ House Other ELEVATIONS Building Sewgfc ST Inlet: .0 1-4- ~ ' ST outlet CIO, PC inlet k. PC bottom&-3. Pump Off Header/Manifold19:-;7 Bottom of system /0/ S_3 Existing Grade 257o` Final gradee!~~ DATE OF INSTALLATION: e: S° /*I t2 PLUMBER ON JOB: LICENSE NUMBER! INSPECTOR: , 3/93:jt ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify thatI have inspected the septic tank presently serving the LI JVA) WDCfs residence located at: /9,5~,~ 4, Sec.TN, R~W, Town of 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 - q! ~ Did flow back occur from absorption system? Yes No)(-(if no, skip next line) Approximate volume or length of time: gallons minutes Capacity: lc~?adIPA-// 6hV Construction: Prefab Concrete-Steel Other Manufacurer (if known) : P~W~R.S Age of Tank (if known): Oki, g.-S ~1~w~6z (Signature) (Name) Please Print wivak Is /(!'ftle) (License Number) ~ `9:2 (Date) Form to be completed by licensed plumber (s.145.06, Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements of ILHR-83, is Adm. Code (except for inspection opening over outlet baffle). Names--Vo 4e-1- Signature P/MPRS 5/88 Wisconsin Department of Commerce SYSTEM Safety and Buildings Division PRIVATE SEWAGE Count bT . CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanita29fnibll1o.: Personal inform~~attion you provice may be used for secondary purposes [Privacy L*Wl s.15.04 (1)(m)]. PgL~ Ho eYNN mXND JUDITH [9+PWn o : State Plan ID No.: COST M lev.: Insp. BM Elev.: BM Description: arcel6ply(L1035-10-001 TANK INFORMATION ELEVATION DATA A9700216 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ` Benchmark ~-179 --O Dosing Aeration- Bldg. Sewer Hold in St/ Inlet I rte y NK SETBACK INFORMATION St/A Outlet 9p' TANK TO P/ L WELL BLDG. ge Intake ROAD Dt Inlet , Yl Septic NA Dt Bottom d h / Dosing NA Hleovp~_Man. • 3F~ e-2, Aeration NA Dist. Pipe (7' ,0 Holding Bot. System PUMP / INFORMATION Final Grade Manufacturer Demand B 3, c/C( Model Number GPM TDH Lift I Friction Forcemain Length Dia. P Dist. To Well > SQ / SOIL ABSORPTION SYSTEM BED/TRENCH Width Length / No. Of Tfenches PI No. Of Pits Inside Dia. Liquid Depth DIMENSIONS (/7 / DIMEN I SYSTEM TO P / L BLDG WELL LAKE/STREAM LEA Manufa . SETBACK Num e, INFORMATION Type O , CHAMBER -Model /S Svc System: Sp 7S OR UNI a~) DISTRIBUTION SYSTEM HeadFrl Manifold Distribution Pipe(s) / I x Hole Size x Hole Spacing Vent To Air Intake Length ~ Dia- Length Dia. Spacing / ~J 3G ' 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.) LOCATION: STAR PRAIRI]J,8.31 18.156A,NW,SE 2227 95T ST Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R.3/97) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH t , SANITARY PERMIT NUMBER: tpw~ 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 cc - than 8 112 x 11 inches in size. J e • See reverse side for instructions for completing this application State Sanitary Permit Number Yo l The information you provide may be used by other government agency programs ❑ Check it revision to previous application (Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION 40 Property Owner Name Property Location ~/4 1/4, S T , N, R E (or) Property Owner' M ing Addre Lot Number Block Number LL2 00 City, State Zip Code Phone Number Subdivision Name or CSM Number Al le4 -0 1, II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ t ~ - Nearest Road ❑ Ciage { own of o ❑ Public 1 or 2 Family Dwelling - No. of bedrooms wa_ I11. 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 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. eplacement 3. ❑ Replacement of 4, ❑ Reconnection of 5, ❑ Repair of an _____System _____5 stem __TankOnly- 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 2Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 2 ❑ 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 Reouired(s. ft.) Pro o_sed (sq. ft.) (Gals/da /sq. ft.) (Min./inch) Elevation -f Feet .Feet VII. TANK Caa in gallons Total # of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existing strutted Tanks Tanks Septic Tank or Holding Tank ❑ ❑ El Lift Pump Tank /Siphon Chamber t~ El 1:1 VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installa on of the onsite sewage system shown on the attached plans. Plumber's lwn (Print) Plu~y(at No mps) MP /MPRSW No.: Business Phone N7umbber: IA/z- , - ~e~l I > I er's Address (Street City, Sta ip Code): IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sangry Permit Fee (Includes Groundwater Date Issue Issuing Agent Signature (No Stamps) 114proved Ft] Owner Given Initial Surcharge Fee) 0 O Adverse Determination 0 X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SHD-6398 (R. 05/94) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Divi ion, 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 online 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 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; 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. SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Commerce June 269 14 .77 113040 East. Green Day Street JL'IlE JVVr. A J!law arlo ATI 154166 nL((IRM, m "ON JR UJV 6!3 t1wn APHE'R 'n'I 154001 lE: PLAI: 00 977-JOV17 LEE PEC AITTED: 130.00 1OLF L-YP;i. N~,yE,~,32,13;; TO N Or .~iTtlr P :t1I P I E Court I O JT CROI X MOUINID CY1011Ei The Department has reviewed the at'iove-retcicriceu submittal. Conditional approval is hereby granted for the system plan submittal. All rioted Items must be corrected. 1 review and appro"r'ai of file system is based L or, cAja 1 AC ra"isc lnsin Statutes, chapters Comm II5 •I and n U4A, 2"ai_.._sco pter 145, and chnsin Administrative Code, and is contingent upon compliance with any stipulations shiwn on the plans. This system has not been reviewed for the code requirements set. forth iri chapter Comm u4 or in chapters II,IiR 50-64, Wisconsin Administrative Code. This plan submittal approval will expire two years from the approval date, or If a sanitary per Wit ib obtained, pian approval will enplre on the day trio initial sanitary permit- expires. The licensed plumber responsible for this instaiiatLon shall keep one set of plans with the Departments stamp of approval at the construction site. The installer shall notify the appropriate inspector wrien inspections can be made. All permits required by the city, "village, township or county shall be Obtained prior to installation. 1 Inlquiries should be directeU to me a. th11 e rlu~lber listed bLO L elow. Please refer to the plan number shown above. Sincerely, t. R )lest 1 flTLlllirls0l"1 Plat! Reviewer Section of Private JCwage ;7115% 1544-JV41 SBD-7897 (R.11/96) PLOT PLAN PROJECT Lynn Wolf ADDRESS 2227 95th St. New Richmond Wi 54017 NW 1/4 SE I/4s 8 /T 31 N/R 18 W TOWN StarPrairie COUNTY ST. CROIX 6/10/ 3 MPRS Shaun Bird 3532 BEDROOM DATE CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND XXXX SEPTIC TANK SIZE 1000 Gallons LIFT TANK SIZE DOSE TANK SIZE 800 HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 375 BED SIZE 8' X 47' L BENCHMARK V.R.P. Base of Siding ASSUME ELEVATION 100' ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 101.1 d Scale = 1/4" = 10' B-3 Area 25' 5% o Below Slope Mound to Remain ❑ Undisturbed B-2 Well ~ She Mound to be B-1 Installed Along Existing 3 the Contours Bedroom House m Existing Powers o 1000 Gallon T DT Septic Tank Tank to be Properly Bedded and Provided c~ with Approved P VV T Warning Label Co I onally AP ROVED --_~I - P ENT Of COIIM Ill" DIVISION 0 SAFQV AND I IN C-11 j SEE C RRESPONDIE " Squaw Lake S°3061 a C:Tvcl, Wm~ Jbservat,;, Pipe Perforated Non-Woven Filter Fabric Below File: Fabric ~Dislribullon Pipe ASTN C-33 SQnd'--~ r 4 " Top soil _ -4-N-== G b r -1-~ 6). Slope Force Main 'Flowed Bed Of 2 -2 Drain Rock From Pump Layer Cress Section Of A Mound System Using E a`-r-- A Bed For The Absorption Areo F . F A Ft. Conditionally s F t - ROVED A P ENT OF COMMERCE JAI F t . DEPARTM DIVISION OF SAFETY AND W110lN" t~ Ft. L F t . SEE GORRESPONDENCE F t . J 4Observolion Pipe e - K a i I I I.- - - Force Moin From Pump ~Dislribulion " Bed Of %Z - 2 z Pipe Drain Rock I Observotion Pipe Permonenl Morker Pipe or Rods Pion View Of Mound Using A Bed For The Absorption A97 w 80617 PAGE OF VIO. ,\J Page Of Distribution Pipe Detail For A Lateral Network PVC Force Main Di S[ ;Cion Pipe T.S. P.O.W. Conditionally ~ -"-FVC Manifold Pi peAP ~~~VED DEPARTMENT OF COMMERCE DOF SAFETY AND OUILOINGa ASEE CORRESPONDENCE X~ Last Hole Should Be Next To End Cap ~Y P Ft. S 5 Ft. X-, Inches GA Y3 b Inches Signed: (V I Hole Diameter Inch License Number: Lateral Diameter Inch(es) Dace: Manifold Diameter O~ Inches Force Main Diameter Inches a Holes Per Pipe_ Invert Elevation Of Laterals 1,iLJi1J' t• S.97-30617 PL1P°1P CHAC'\P ER CR055 SECTIOIJ AU -PECIFICATIOI!S VENT CAP ti C.i. °C - AP FROVED LOCKIRJG WEATHERPROOF _ JUNCTION BOX MAKJHOLE COVEF'. J.4k wIMCO'w J~ ~ RESH 12MIU. 1 i AIR IIJTAKE GRADE y„ MIN. I COQDUIT na ~ 11, . R(f ~pROVtDE P 11JLET VRTI&HT SEAL I -T Ap p CDMMER I III AND BUILDINGS DE gAFEI"! A D{VISION OF I I I I gpONDENCE. I II ALARM e SEE Cop I I I I I *APPROVED I I oN ~ JOINTS WITH I I ELEV~ ~FT. APPROVED PIPE 3' ONTO PUMP OFF D SOLID SOIL CONCRETE BLOCK a . 4twit- ~ M SUG;i APPROVAL RISER EXIT PE ITTE O Ly F WK MAIJUFACTU ER HAS s./~fe rzcti r a<.c,K-~uw EPTIC f 5 P E C,I F I CAT I OKI 5 DOSE TANKS MANUFACTURER: QUMBER OF DOSES: PER DAy TANK SIZE GALLONS DOSE VOLUME O ALARM MANUFACTURER: INCLUDING 6ACKFLOW: GALLONS MODEL NUMBER: I~ CAPACITIES: A= c-~IMCHCS OR O GALLOWS SWITCH TtlPC: r ti~ IC 13 IWCHES OR qQ GALLONS PUMP MANUFACTURER: (7 LA-/ r 3B?~ C= IWCHES OR 130 GALLONS MODEL NUMBER: D INCHES OR 12-0 GALLONS SWITCH TYPE: I:..C < ✓ MOTE: PUMP AND ALARM ARE TO DE MINIMUM DISCHARGE RATE, 7, : -GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE CETWELU PUMP OFF AND D15TRI5UTION PIPE.. FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . 2.5 FEET + -ff- FEET OF FORCE MAIN X ~ F/pOfT.FRICTION FACTOR.-2,4 FEET C -30617 1 7 TOTAL 09WAMIC. HEAD = FEET v INTERNAL DIMENSIONC OF TANK: ILtEidG'rF~r 7 ;LIQUID DEPTH 1 51GKJE0: LICEOSE NUMBER: DATE: Submersible Effluent Pump i EP04 3871 EP05 of APPLICATIONS • Fasteners: 3X series • Fu iy submerged in high ■ Motor Housing: Cast iron stainless steel grade turbine oil for for efficient heat transfer, Specifically designed for the • Capable of running lubrication and efficient strength, and durability. following uses: dry without damage to heat transfer. ■ Motor Cover: Thermoplas- • Effluent systems components. tic cover with integral handle • Homes Motor: Available for automatic and and float switch attachment • Farms manual operation. Automatic • EP04 Single phase: ' 0.4 HP, models include Mechanical Points. • Heavy duty sump 115 or 230 V , 60 Hz, 1550 ■ Power Cable: Severe duty • Water transfer RPM, built in overload with Float Switch assembled and • Dewatering preset at the factory. rated oil and water resistant. automatic reset. ■ Bearings: Upper and lower SPECIFICATIONS • EP05 Single p lase: a„) ill' FEATURES heavy duty ball bearing 115 V, 60 Hz, 1550 ifl M, Pump: EP04 built in overload will constriction. w EF'04 Impeller. Themlo- • Solids naraliu~; .;ipability: automatic reset. plastic Semi-open ow'1w, '/4" maxi a un1. • Power cord: 10 loot AGENCY LISTING With pUlTlp out V81U.S l0l • Capacities up to 55 GPM. standard leng,h, 16/3 SJTO mechanical seal protection. SP Canadian Standards Association • Total heads: up to 24 feet. with three prong grounding • Discharge size: V12" NPT. plug. Optional 20 foot EF05 Impeller. Thermo - • listed model numbers length, 16/3 SJTW with plastic enclosed deign for end in "F" or "AC". • Mechanical seal: carbon- improved performance ) rotary/ceramic-stationary, three prong grounding plug BUNA-N elastorners. (standard on EP05). th Casing and Base: Rugged provides • Temperature: thenioplastic design provid 104°F (40°C) continuous superior strength and 140°F (60°C) intermittent. corrr~sion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10- • Capable of running dry without damage to 9 30 ~~.._5GPM components. 2.5 Fr • I a Pump: EP05 25 - . I _ • Solids handling capabilit Y o 3/4"maximum. - - Ca acities: a to 60 GPM. I • p p 6 zo • Total heads: up to 31 feet. • Discharge size: 1'A" NPT. Z Sr i. carbon- 1 Mecnan :,al sea,, EPO y ry 4 rotar /ceru~iic-stationa BUNA N elastomers. 0 I 5 • Ternpeiatuip: : I 10 104°F(40'C) continuous EPOa ~ 14011F (600C) intermittent. z t s -i - - - - 0 00-- ---10 C _210._ - 310 -40 O !f GFMI L 0 2 ; 6 8 10 12 ml/h CAPACITY G: 1995 Goulds PUMPS, Inc. Elluclive May, 1995 83871 A/i--oonsin-Department of Commerce SOIL AND SITE EVALUATION Division. of Safety and Buildings Page of Bureau of°Integrated Services in accordance with s. 1LHR 80.09, Wis. Adm. Code 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 reference point (BM), direction and, percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # 62-f03~ =l C7 00/ APPLICANT INFORMATION - Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). _ i Property Owner Property Location Govt. Lot 1/4 /4,S T N,R E (o Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# Ci State Zip Code Phone Number ❑ city El Village Town Nearest Road 117 1 CJp J%< i L /l/~j o iti l.(J / a 1 L~ " . l y, I< - Z;' ❑ New Construction Use: residential /Number of bedrooms Addition to existing building .Replacement Public or commercial - Describe: _ Code derived daily flow gpd Recommended design loading rate 411-bed, gpd/fe- -trench, gpd/ft2 Absorption area required _bed, ft2trench, ft2 Maximum design loading rate pIbed, gpd/ft2 trench, d/ft2 Recommended infiltration surface elevation(s) 101.1 ft (as referred to site plan benchmark) Additional design/site considerations ji, Parent material Flood piain elevation, if applicable ly ,T - ft Lu = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tanlu = Unsuitable for system ❑ S U AS ❑ U El S 'U I J S U ❑ S ❑ S ~ 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 fad Depth to limiting f tgt Remarks: Boring # ~Vq ! C"L 4/41 Ground 5 r ! 1 v ft. Depth to limiting fac r in. Remarks: CST Name (Please Print) Sitgnature 5 r 9 r + rh Address rr r Date CST Number J v SOIL DESCRIPTION REPORT PROPERTY OWNER.,~~. Page r PARCEL I.D.# Boris # Horizon Depth Dominant Color Mottles Structure 2 9 Texture Consistence Boundary Roots QPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench _ / Ground elev. Depth to limiting f'2,~ 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: SBD-8330 (R. 07/96) Soil Test Plot Plan Project Name Lynn Wolf Byrop Bird Jr. Address 2227 95th St.-~~_ -z. New Richmond Wi 54017 CSTM #3479 Lot Subdivision Date 6/10/97 NW 1 /4 SE 1/4S8 T 31 N/R 18 W Township Star Prairie Boring O Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft.Base of Siding System Elevation 101.1 * H R P Same as Benchmark 10, B-3 Lot Size = 898' X 300' 5% Slope B-2 0 60' Well 18, 40' 10 Shed , 60' *B.M.28' 16' 10 B-1 25' L- 00. 4 20' Existing 3 Bedroom House 2' 125' to East Property Line Deck 30' T 10' Assumed Area of Current Drainfield 0' Squaw Lake 897-3o~'17 Wisconsin- Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of Bureau oi`Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code 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 reference point (BM), direction and C o n percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # ® v~ 8 -1o3r 1 o eo/ APPLICANT INFORMATION - Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location n~ Govt. Lot d 1/4 ,e_114,S T N,R Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# Ci State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road ❑ New Construction Use: residential / Number of bedrooms_ Addition to existing building .Replacement Public or commercial - Describe: Code derived daily flow J19 god Recommended design loading rate bed, gpd/ft2 Ltrench, gpd/ft2 Absorption area required 325- bed, ft2 _trench, ft2 Maximum design loading rate A a bed, gpd/ft2-A el-trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design/site considerations I © r Parent material 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 ❑ S U A's ❑ U ❑ S U ~!j S U ❑ S filv ❑ SJ4 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 a7m V, ,Z Z i C am. . s ~5 Ground 3 ,7 Depth to limiting f t , in. Remarks: Boring # -3 0-2A 5'~Y 11-51& 01-13 J r Ground 6 f PIA 424K' ;d ~Vft . ' Depth to limiting fa r in. Remarks: CST Name (Please Print) 1bnature Telephone No. Address Date CST Number PROPERTY OWNER 410 /7- SOIL DESCRIPTION REPORT 4 Page Of 67 PARCEL I.D.i Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary fflRoot in. Munsell q Du. Sz. Cont. Color Gr. Sz. Sh. Ground ele~v.~ `~c Depth to limiting in. Remarks: Boring # Ground elev. ft. ' Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # Ground , elev. ft. ' Depth to limiting , factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD-8330 (R. 07/96) Soil Test Plot Plan Project Name Lynn Wolf Byrou Bird Jr. Address 2227 95th St. New Richmond Wi 54017 C M #3479 Lot Subdivision Date 6/10/97 NW 1 /4 SE 1/4S8 T 31 N/R 18 W Township Star Prairie ❑ Boring ()Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft.Base of Siding System Elevation 101.1 * H R P Same as Benchmark 0' B-3 Lot Size = 898' X 300' 5% 60 Slope B-2 0 Well 18' 40' 0-41 10 Shed 60' *B.M.28' 16 10 B-1 25' 20' Existing 3 Bedroom House 2' 125' to East Property Line Deck ' t0( T 10' Assumed Area of Current Drainfield 0' Squaw Lake I G U 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 Location of property_jV1/4-Sj~ 1/4, Section, T_.V N-R W Township ~e Mailing address Address of site Sclt-w~ Subdivision name Lot no. other homes on property? Yes No Previous owner of property a'z~ Total size of property ~1,' 7C Total size of parcel Sc+µ Q~ Date parcel was created Are all corners and lot lines identifiable? X Yes No Is this property being developed for (spec house)? Yes >,~,'_No Volume. and Page Number 6'30 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 recot4ed n the office of the County Register of Deeds as Document No. S~.53~za 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 office of the County Register of Deeds as Document No. t'5-3 95'Z a g ure of App ant Co-Applicant / Date of Signature Date of Signature STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County JU U0~ OWNER/BUYER MAII.JNG ADDRESS OPROPERTY ADDRESS G/" (fit/ 5~^^ i (location of sepY'c system lease obtain from the Planning Dept. CITY/STATE I& -0 / 7 PROPERTY LOCATIOrf/G11t-`~ 1/4, 1/4, Section T_N-R~W TOWN OF 5 ff C XA ; 2 ST. CROIX COUNTY, WI l~ SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAP , VOLUME /PAGE 6~3 ; 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 hi 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: ; ej, 15~ DATE: :z St. Croix County Zoning Office ' Government Center 1101 Carmichael Road 11/93 Hudson, WI 54016 t Vey 1`~15rwcEbn t UOCUMENT NO. STATE IJAlt OF WISCONSIN P014M ll -11tt1Z 1' LAND CONTRACT Iadivwve &ad C' rprdq 5. 3910 i$26.eee IR rINAN!'PI,iAND IN UTIIIIRNNNONI-CON.UMBRII f- AVM IRAN" MONB/ _ HEGIST: ; I, ST. CRS;,, i Contract, by and between ....Wolf Mar ne~..In&:a,a._„...... it iUcdlaHOW i i nngsQta. Corporati on EC (I 31 1996 ("Vendor", , whether one or more) and........ nn MWOI,f„n¢._;l~ith, A WQ~f I L 11:00 A. M as..mair.i.tal..&urviY.ouhi.p..prape rty I~ -~Kv+,1..... - Uk ("Purchaser", whether one or snore). Aefltstet act Duda Vendor sells and agrees to convey to Purchaser, upon the prompt and full per- 0 formance of this contract by Purchaser, the following property, together with the (I rents, profits, fixtures and other appurtenant interests (all called the "Property"). in .................~1 County, state of wieeonsin: I 4~ woi~ 17 Attached Exhibit A Tax Pared No 038-1035-10 i I Z TRANSFER ii ~l ~i I• This .....1.S................... homestead property. !I (is) (is not) ! Purchaser agrees to purchase the Property and to pay to Vendor at ...their..deSi naliGn 1 the sum of $.One..HUndred..f. ttty..Thj)M5,aAdTMA 11tH f$K ........-U- at the execution of this Contract; and (b) the b!ag dr together with interest from date VA611Mhs 7 hereof on the balance outstanding from time to time at the rate of per cent per annum until paid in full. as follows: li In monthly installments of Eight Hundred Seventy Seven Dollars and 96/100ths ($877.96) ~I or more, each, commencing on February 1st, 1997, and on the 1st day of each and every month thereafter, for Thirty (30) years until January 1st, 2027, at which time i; the entire remaining balance, including interest thereof, shall be due and payable. Provided however, the entire outstanding balance shall be paid in fun on or before the...._...111........... day of J.-nary..ND2 ................smix...... ( the maturit. date). Following any default in payment, interest shall accrue at the rate of % per annum on the entire amount in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance). Purchaser. unless escused by Vendor, agrees to pay monthly to Vendor amounts sufficient to pay reasonably antici- paUnt annual taxes, special assessments, fire and required insurance premiums when due. To the extent received by Vendor. Vendor agrees to apply payments to these obligations wben due. Such amounts received by the Vendor for payment of taxes. aaaesaments and insurance will be deposited into an escrow fund or trustee account, but shall not bear interest unless otherwise required by law. Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any amount may be prepaid without premium or fee upon principal at any time afterFebruary._ISt....... 19.92... (oR) xol~l~acltl~xDt,xltiL)~lti{I1b~1tI>tllttJilt?j>JElbltlp~tltlllltlhtottK~rdhlslfdtiHCliRltotltllaxrxxx In the event of any prep .%-ment, this contract shall not be treated as in default with respect to payment so long as the unpaid balance of principal, and interest (and in such ease accruing interest from month to month shall be treated as unpaid princil .1) is less than the amount that said indebtedness would have been had the monthly payments been made as first specified above; provided that monthly payments shall be continued in the event of credit of any proceeds of insurance or condemnation, the condemned promises being thereafter excluded herefrom. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except: is it and t• deli~r t yiyeawdbr M de-it" due all umm a" mand soeeiPta 'end" le+iei as the Property or u;~oa Vender's interest Nb-IiMW mock payment. Purchaser shall k-_ep the improvements am the Fberaft insured against less or dawars oyioned b go% wt. tended aoveeage perils all such other hazards as Vicar new require. without oa-uasuraweer through insuma yp,,,W br Vendor. in the swan at slifflA.. i.naurable-ralmb" Vender shall a" romquin than the balance owed under this Contraet Poo classes ii pay the P n is h +paikkt mere contain On standard dame in favor of the Venders iwiawadt insurance eazi when dun. Ta /alien shall of all policies covering the Property shall be depmwiaa wmule motion Vender otherwise shall hall ogress is writinagg.. the eJose to insurance n wee Vendor. Purchaser s promptly sin rat of Nam cespanies and Yendsr. Unless Purchaser and Waer.r otherwise agree is writing. Insurance pro raeveaIs "I as ee applied .r I r~ repair of the Property d~apB, prwwidsd the Vender deans the restoration or reL.air to be asas' feasible. Purchaser covenants net to commit waste sour aim -anew to be cammitted on the Property. to k the in good tenantable eonditieh and repair to keep than its tree from liama w amP Property to eeanply with au laws, w4wmw s and' rag Asuawe aiw~ the Property, ! to the lip of this Cewtsasfe and d shall be Vender agrees Irat In can "be purchase prim wM boiewst and other moneys shall be full paid and all condition fully parts -1 at the Liam and is the sommar isne specified. Vander will on dames the PureAsser, a N►aeeeaety Dead, in lee simple, of do Pi~ execute and d.uver to any Ikons as eRRr. from and slew of all loan and encumbrances, exempt encumbrances created by the act or dafisai at lsrchaser, and exempt: ....:''wrckw~er .per that Is of ~ . interest -hick ax Barr as hfor a a 0..... awl Sub is the event of a default in the psyaaaen/ of any principal or period of rays SW&.iiM the specified dace date er (b) in the ava L of a default in } performance of any ether obligation of Purchaser wheel messes for a period dap following written netiee thereof by Vendor Weil moved personally or mailed bt ewsidh di snail), than the entire outstand ader this ematrest shall became inumadiateiy yen and parable in fuW. wt eat balance w VWmdm waives), and Venda shall also have the following aai L sewali lion (aaaanbdjert to without any laeti i (which Ovid d d bylawherby addition to tavo provided ig law or is renal s his na thistioasnet an pan ) In rights, tine sad Interval, in the Property wail (recover the an~ at i tr ~ his back th. terminate h rmia a to this Cure with and puts ith any egret of lemptim to be eewditiened t'urehaser's full poloond of the entire outstanding hi strict w foreclosure Inter"& the fresh the dale of default at at rule &aeffect on such dwteaasialisrasssua4dweAwunder (inwhich event al aanouats prsvi m{r ppawid y Pwehaa+~r shall be Weited as liquidatd -2- for failure to fuiftu this It" of the p t~ ~rtalk to )rewtitad sealer now ass for specific performanContract OW ce Vi this ~kayltofap default nand other ing bwkale~ With interest Lberrom at the rate in ettwL an the date of reaewa ft vin' hereunder. in which event Use li oprrLy shall be aaeLlW.ld at judicial swim and Purchaser A" be unbie for any deficiency; or (in) Vender easy some at law for the entire unpaid or (iv) Yewaler am~y declare thin Contract at a tai aoi this raetas s seerase pries in any psrl,ien action if ore egullabk Internet of Purchaser In ineigodraraatt: and (v)reendor may have ay have adasen o ejf tied. in from gwisl.tRy of the Property and have a receiver appointed to callect any, wants. Issues or n'ng the any adieu order (i). (11) or (Iv) &=.JNOlwithatandi any profit during the pendency of men a say of the becoming remwr shag sell be binding oral ew linen when po statements or actin of Vender cook of any including moon"* *Uwmya fees of Vawdor iaeur oiv~r it and whew puceaaed in ter (view and aP~ ends and pp~ extent mat ProkAltsd by law sad expenses of tin evi~~ainill be added wader (and psi .b.w or mat) a the Burred. and sh.a be iwd.dad In any Judgment Principal and pan by Pnrebeaar. as V. UaPpon the co"wf"m" meMMi or du tree to the wsba"t rseaiver of cis P of +4 action of fenelesun of this Central, Pwrebaser awMb the Pam~r durhyr the pendency of were Ml tiow~ want leeaaa'ated intereai a collect tr. rents, isares, soul everts of applied as i , cssrt shall direct Bests. leaves. and profits when a• ewneeled shall be held ad Purchase' shall not transfer, sell w convey nay loan" our wgwstable interest in the P of Purchasers rights under this Contract or by eptisw. bneE.ieras Iasse or in any other w~r~ (br'ssag~wrt ot.nr conveyed t in a eader maims either the outstanding balsam pueraii. wander this Ceatrset is first paid full er the interest pledge or moinnow t of Purchasers iwlereaa sandier this Contract soley as security ter an Purchaser. to the event of any such transfer, ante or balance parable under thin Contract shall become ' twee and a able In s written a dr s the enter thou~ediag balance, payable shall make all payments when due waderaww monortgage payable is fun, at Vendor a spoon on the notice thin Contract (except for an nee outstanding against the Property on the date t, makes Linnet y granted by Paraaser) or wader any rele secured tMrebs. Previdd Pw►eramer r Payment of the amounts then due under this Csmiwort Purchaser may make any own payaments directly to the Mortgagee it Vadsr fags to do me and all paymeata sot any by Purchaser gran be Bmwsid.red this Contract payiuwts made en Vender may waive any default without waivieyr aaew etier, subsequent or prat default of Purchaser. All terms of this Ceatraet shall be binding span ar here to the benefits of the half*, legaj weeuwrs sad "signs of Vender and Purchaser. tit use sm weer of the seprMenal, poomon of ewwsideratlew Joys reeved to release homestead ul In do alidset Property and Vender for a valuable ram to Joi dame to to made In flMment berooL) • In the axeawt:aa of w n.ead this .................31st............. day a December. . Wolf Marine t~..94... . Inc. by.it's President Lynn W. Wolf(SSAi.p . (SiAL) 1 f' (SEALA J............ ' • AUTENNTICATION ACKNOWLNDOUZNT Signature(s) * rATN OF NUC=m f Minnes Yashi n s.. authenticated this ......day oi •is.._ ----.-».».---ter Personally came baton mew .trim =.r,.!>k II,.g4..»the ~e named yTITLE: VENDER A.-...(rX STATE BAR OF WISCONSIN • (if not. authorized ~!!'.!_L.:M~ u: 4r... d oc EXHIBIT rwrt or xw 1/4 or a! 1/4 or u.atia,n 'lbn,,, p 71 xoXtb r Croix County, Wisconsin deaorlbed .es follova, ~+~q • ~~e ~a Kest, se. 'ti Or swid section e, thence Se4'40.5O.f &19M the 0=101 at the a line 32 36 Coat ' oar th4noa N00.07032"W 1313.29 feet, tbenoo S47'a7•2A%V 397.09 "000203449 70.91 Coati thence x00022026ox 369.49 Ceetj th C* eme thehaa 132.49 toot, th4M0 - x57'32*1&07t 172.48 feet to the t O xb"Inning, ~r thence N00.07.3209 160.00 Cootl tb000e 8&OJ27.140S 4918 93 teat to the beginning or a xeander lira? :hence 824.460288N al 47 teat, thence 826.84.28"it 108.83 feet to thi and of eai4 mo ndarr line; thwnce M74.270320N 113.44 toot, thence K8504703201f 174900 Coati thence N68.53.326W 338.13 test, thence Slib'18*aaop 51.12 toot to the point of beginning, togsther with all land lYjAS bat"ga Ue r 11 end the waters edge at aqu4V Laks. Subject to a 30.00 toot ride easement for ingress, an4 egress puiposoa by others, the Conterlina of which ss described a/ follows, 1/4 corner of Section Of thence 888.40030": along the S"tion line 322.30 lest, thence x00007032mW 1313.29 toots thence !147027014"x 377.03 Coati thence N10'02.2611Z 70.91 Coati thence x00.22.2&"= 389.49 feet, thence 1t60'40•280E 132.49 feet; thence NSVW2669 172.46 feet; thonce•N85016028"E 51.62 teat, thence 868.53.32"t 3SS.U toot, thence 885047032"S 143.90 twat. to the beginning of said oenterlinet tba&we x09042•28ox 134.06 toots thence R3304s•26"S 32.66 toot to the "sad Of said oooterline. Together with and Subject to a 64.00 toot wide easement located in the x= 1/4 of SW 1/4 end the x11 2/4 of SS 2/4 of said Section 8; the Canterline being further described as follows: Ovaseuoing at the 8 section at thence 86804003001 _ 3✓4 corner of ems N00607.32"W 1913.29 feat) thence ll~ 7#1 01 Section, 05 tline 32.3S oot to the a iJ ing or the Centerlines thence x10.02•=80= 70.91 ~'ti thence K0062202603 oo3a .49 Ceat, thence N60040•28"p 132.49 feat? thence X157.32028"S 172.48 Coati thence N55•1802849 172.48 toots thence x33.160284t 31.62 Coati thence 5666530320= 355.15 feet? thence 86504703103 2.58.97 teat to the and of said Centarlina0 Which eaaaaant will be hereinattar knova as the Northeast road.