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HomeMy WebLinkAbout040-1059-70-000 STC - 104 AS BUILT SANITARY SYSTEM REPORT, rn OWNER , ' t°b1 S 9 ADDRESS b % OLINTY ?C3ivA;3t~-'RGE ° "Z SUBDIVISION / CSM# LOT SECTION T N_R~W, Town of Tlre ST. CROIX COUNTY, WISCONSIN 61`6 , 10 5-~ PLAN VIEW ` SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM )Owl h5jl yo' xw~/l INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. DENCHMARK: 41 1) 1 t)oe cY" J ALTERNATE BM: TIC TANK / PUMP CHAMBER HOLDING TANK INFORMATION Manufacturer: ,ir,Q~UJ?57 Liquid Capacity: ~C Sly / Setback from: Well-2L' House Other Pump: Manufacturer_ Model# Size . js Float seperation Gallons/cycle: Alarm Location rj SOIL ABSORPTION SYSTEM /Y17~1t~tlC'J~GQ/ //zii"s Width: 3 Length Number of trenches Distance & Direction to nearest prop. line: f "-'zj(° S Setback from: well: 49 House %w Other ELEVATIONS Building Sewer ST Inlet: --j ~ ST outlet: PC inlet PC bottom Pump Off -Header/Manifold ) Bottom of system Existing Grade Final grade W,yq-f') DATE OF INSTALLATI PLUMBER ON JOB: LICENSE NUMBER: 331 INSPECTOR: ilvd 3/93:jt Wisconsir'Departmentof industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 299147 Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.: CHRISTENSON, TOM TROY CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax 40 U r too, o a- C i t c GAY 040-1059-70-000 TANK INFORMATION _Ser\/V-~C100VeELEVAT N D TA A970 46 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic P IDVp Benchmiar1 too Dosing w/ (oaa6e Aeration Bldg. Sewer ~`J f 5 Q'$ 3 Holding S' /A Inlet SSA ~S'7 TANK SETBACK INFORMATION St/ Ht Outlet Vent TANK TO P/ L WELL BLDG. Air Ito ntake ROAD Dt Inlet Air Septic Zp ' -I~'1(,p NA Dt Bottom Iecc Pis- Dosing NA Header / Man. 3,66 q9 NA Dist. Pipe (P•1-7 5-51 ~ 56 ~ 9?all 4g Aeration Holding Bot. System y.&' `/.Zt~ ~ 3.% r ~s► E2 PUMP/ SIPHON INFORMATION Final Grade ~j,2S~ 2- Qp L 3Z ~`D /J°-6 °1 Manufacturer Demand Mar • Model Number GPM TDH Lift1q.~ Friction I -1 Systerr~, TDH15Z7'Ft Forcemain Length X5CO7 Dia. Dist. To well SOIL ABSORPTION SYSTEM BED TRENC Width Length / No. Of Trenches PIT No. Of Pits Insi e Di Liquid Depth DIME 3 SV DIMEN I N LEACHING Man acturer: SETBACK SYSTEM TO P / L BLDG WELL LAKE /STREAM CHAMBER e tuber: INFORMATION Type O * i2+ NO, OR UNIT System: M4 DISTRIBUTION SYSTEM .Sldewm ler c Ino,m be r'5 - V um S, eV-+y'enG Header /Manifold x Hole Size x Hol Spacing Vent To Air Intake , Asir > Z~f . Length Dia. 't Length ~ 14, 34 Spacing SOIL COVER x Pressure Systems Only xx M nd Or At-Grade Systems Only Depth Over Depth Over xx t-th Of xx Mulched Bed /Trench Center T ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons prese , etc.) LOCATION: TROY 15.28.19.227F.227J,SE,NE 690 GLOVER ROAD Lfv~-f d l~sede" Plan revision required? ❑ Yes ❑ No LEER/ Use other side for additional information. FT SBD-6710 (R 05/91) Date Inspector's Signature ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: Safety and Buildings Division Visconsin SANITARY PERMIT APPLICATION 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 Department of Commerce • Attach complete plans (to the county copy only) for the system, on paper not less count 8' CI~ID~ than 8 1/2 x 11 inches in size. Sanitary Permit ►vuer . Ol QI`N • See reverse side for instructions for completing this application State The information you provide maybe 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. APPLI ATI N INFORMATION - PLEASE PRINT ALL INFORMATION l Property Location N, R E (Or} Prop ert Owner N , ' op _1/ $ T ICA son Pro ertw er's Mai ddresss Lot Number Block Nupbgarr C State / Zip C P u er Subdivision Name or CSM Number ) qn ` ( M ZAI4 Ill. TYPE F BUILDING: (check one) ❑ State Owned El it~ Nearest pad Public 1 or 2 Family Dwelling - No. of bedrooms ~ Town OF Ill. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) ~V Z 1 Apartment/ Condo ~ 2 E] Assembly Hall 6 Medical Facility/ Nursing Home 10 Outdoor Recreational Facility ❑ Station Bar// Dining 3 Campground 7 C] Merchandise: Sales/ Repairs 111 2 Service Restaurant/ 4 E] Church/ School 8 E] Mobile Home Park ❑ 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) New 2. Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an A) 1 ❑ Existing Sstem ExistinSy-stem - --------------Tank_Only--------------- System B) ❑ A Sanitary Permit was previously issued. Permit'Number Date Issued V. TYPE OF SYSTEM: (Check only one) 3 j, $ 4!t a Ah i ' X b. 01a l k0i1 Non-Pressurized Distribution Pressurized Distribution Experim ntal Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 Seepage Trench 3v XJgD 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 1-4< bt ' ~p ^~h' ~t ' lf~~forS 43 ❑ Vault Privy 14 C] System-In-Fill `f` 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 Req 9S q- ft.) Pr qqo~ d (s ft (Gals/d /sq. ft.) (Min ./'nch) 9~.Z Eleva Ion Feet Feet r • VII. TANK Capacity Site Fiber- Expec in gallons Total # of Prefab. Manufacturer's Name Concre Con- Steel glass Plastic APP INFORMATION New Existin Gallons Tanks strutted Tanks Tanks Septic Tank or Holding Tank Dh~ ~ ( El 0 ❑ 0 Lift Pump Tank /Siphon Chamber D El ❑ El ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. -3 Ph N7 Business one b 11- U Plu b LA'K sSi nature: (N S m s) PRSW No.: PI ber's Name: (Pri ) 9 (;~3 7Z 6 kA Plumber's Qc dregs (treet, City, Sta Z' 1, to-egr Code): r ~n {w~ (`y V Z c IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved S nitary Permit F e (Includes surcharge Fee) Groundwater ate issued issuing Agent Signature (No Stamps). [Approved ❑ Owner Given Initial F11' y-q-7 Adverse Determination X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber SBD-6398 (R.11/96) INSTRUCTIONS Y 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 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. ' ten so4 ~jt T ro 16100 PLOT PLAN Page 3 of 3 3- 3 y x ~o h~~ SCALE 1„= 30 J azh i ~~1ra~arS tree ke s 1° 10 ~ t0 ~ 5 s. l ~ a , hob "tw- GM2h6 e S ~M1 uv. B~ e.Z. S I J Sao`-a ~~PuC. lvy')• ~ fl J ~ b fi ~ New J _ \O ' o 2 d ALL I X31•'1 - l~ ~ ~ C~`~. FW~12 NtT Gt'tSz.~Gre S\p~ U►~ ~ 1.1,5E , 601 GLO EV- R~►'KA . NaT ~c•o GLOUI~N CtA _ PAGE cF PUMP CHAMBER CROSS SECT ION AND SPECIFICATIONS VEUT CAP 4"C.Z. VEKIT PIPE WEATHERPROOF APPROVED LOCKIKIG > JUUCTIOKI BOX MANHOLE COVER 25' FROM DOOR. WINDOW OR FRESH I2"MIU. AIR IAITAKE I I GRADE ( `i~ MIIJ. CONDUIT _ 18"M(AJ. \ INLET PROVIDE AIRTIGHT SEAL i (I I ( I I ( I ALARM B I 11. I *APPROVED ( I om JOINTS WITH I ELEV. FT. APPROVED PIPE 3' ONTO PUMP OFF D SOLID SOIL COIJCKETE BLOCK RISER EXIT PERMITTED OIJLy IF TAUK MAIJUFACTURER HAS SUCH APPROVAL SEPTIC F S EGIFICATIOUS DOSE a/,' ~f r9 2 TAIJKS MAWUFACTURER: NUMBER OF DOSES: PER DAS TAWK SIZE: 15';9 GALLOIJS DOSE VOLUME / ALARM MAUUFACTUKER: IMCLUDING BACKFLLOW: " cGALLONS i MODEL IJUMBER: /~to d/~~ ~t~ CAPACITIES: A = RICHES OR CC// ALLOUS SWITCH TYPE: gc INCHES ORGALLONS II PUMP MAMUFACTUREK: h C= IMCHES OR <nn GALLONS I MODEL WUMBER: ` D=l& INCHES ORII GALLOWS SWITCH TYPE: pl~CuU, MOTE: PUMP AMD ALARM ARE TO BE MINIMUM DISCHARGE RATE GPM INSTALLED OM SEPARATE CIRCUITS VERTICAL DIFFEKEMCE BETWEELI PUMP OFF AMD DISTRIBUTIOW PIPE.. /D FEET + MIIJIMUM METWORK SUPPLY PRS-SURE . 2.5 FEET FEET OF FORCE MAIN X FJ~ FRICTION FACTOR. FEET I o FL ET TOTAL DyWAMIC. HEAD FEET IUTERUAL DIMEWSIOUS OF TA1JK: LENGTH ;WIDTH -;LIQUID DEPTH SIGNED: 1 II f\rr Pp~g E 6 OF- Goulds Submersible Effluent Pump 3871 EP04 EP05 V"~ APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- components. tic cover with integral handle • Homes Available for automatic and • Farms Motor: manual operation. Automatic and float switch attachment • Heavy duty sump • EP04 Single phase: 0.4 HP, models include Mechanical points. • Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, built in overload with preset at the factory. rated oil and water resistant. automatic reset. ■ Bearings: Upper and lower SPECIFICATIONS • EP05 Single phase: 0.5 HP, FEATURES heavy duty ball bearing 115 V, 60 Hz, 1550 RPM, construction. Pump: EP04 built in overload with ■ EP04 Impeller: Thermo- Solids handling capability: automatic reset. plastic Semi-open design 3/4" maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING ` • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. O. Cara ianStandardsAssociation • Total heads: up to 24 feet. with three prong grounding 0 Optional 20 foot ■ EP05 Impeller: Thermo- Discharge size: 1112" NPT. plug. P (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in "F" or "AC".) rotary/ceramic-stationary, three prong grounding plug improved performance. BUNA-N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 1040F (40°C) continuous superior strength and 140°F (60°C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 • Capable of running dry without damage to s 30 - _*--5 GPM - components. Pump: EP05 s 25 FT • Solids handling capability: o 25 maximum. W - - - i-- • Capacities: up to 60 GPM. s 20 • Total heads: up to 31 feet. i • Discharge size:11/z"NPT. Z 5 - - - - i- - - i • Mechanical seal: carbon- rotary/ceramic-stationary, a 4 15 - i r- EPO o - - - - - - - - .i - - s BUNA-N elastomers. - • Temperature: 3 10 1040F (400C) continuous I f - EP04'. 140°F 600C intermittent. 2 - 5 0 00 10 20 30 40 50 GPM L L i i i i 0 2 4 6 8 10 12 ml/h CAPACITY ©1995 Goulds Pumps, Inc. Effective May, 1995 Q'AA71 -1 Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations Diviston of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x fi-i&Fes in sl Ian must include, but S~'. not limited to vertical and horizontal reference point p), direction and p pe, scale or PARCEL I.D. # dimensioned, north arrow, and location and dista to nearest road. q o - 0 59 APPLICANT INFORMATION-PLEASE ±NT ALL I c, PRfDON R IEWEDBY DATE II 7 PROPERTY OWNER: l rr, PR P$t LOCATION -M" C t1'\Zl S `i~Tly S 0 1.99 S E 1/4 ~J 1/4,S 1 S T Z-3 N,R 19 E (or) W PROPERTY OWNERS MAILING ADDRESS COUUMVIA NTY L ~ BLOCK # SUBD. NAME OR CSM# ^ 6 9 o G l-t)UqIZ CITY STATE ZIP CODE ONE N ❑VILLAGE ~J1 OWN NEAREST ROAD 'JY ~.IU~1Z ~LtS~IJI SIFUZZ [ ] New Construction Use [kJ Residential / Number of bedrooms [ ] AdditiQn to existing building Replacement [ ] Public or commercial describe Code derived daily flow y So gpd Recommended design loading rate - bed, gpd/ft2 trench, gpd/ft2 Absorption area required c~OD bed, ft2 --)SC) trench, ft2 Maximum design loading rate 5 bed, gpd/ft2 6 trench, gpd/ft2 Recommended infiltration surface elevation(s) seF Pte, t Z o~ 3 ft (as referred to site plan benchmark) Additional design / site considerations ` ! Parent material s 1 S MjM Fn.JT- W01 Flood plain elevation, if applicable ►J. R . ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem 19 S ❑ U ® S ❑ U ®S ❑ U WS ❑ U ❑ S C51 U ❑ S J~j U 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 TW& ::::>.::1.::.>;_€ 1 0_ l 9 l p~ Z l z - S i l Z S b ~'~t- c~ \ • 5 .1, MEMO Z \q-3q to`i2 316 t1 Z►n S~k "t►- cw - 5 Ground 3 3918 SY2 Yl6 M U i- - ' S 6 elev. N%\, S ft. Depth to limiting factor I Remarks: Boring # ) 0-16 \o~.Q zfz - stl Z`Fs~lz w~~~-- cw lv~ -S •6 z:< Z Z ►6-38. 1bHiZ 3/6 SlJ Zm S mif C~ - 5 i 5-63 ~.S YIZ q/6 ~S \csV~ mv`ft- ew S b Ground ft. Y u -88 10 `i IL YIy v~ s I o V), L) I~ - -`I ele5 v. 9f8 - Depth to limiting factor Remarks: CST Name:-Please Print Arthur L. W e e r e r Phone: 715-425-0165 e'gerer Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022 Signature: Date: CST Number: : R7- ~Sb !G z3~ M00576 PROPERTY OWNER C``rRt.ST~7.iSDrv SOIL DESCRIPTION REPORT Page?. of 3 PARCEL I.D. 4 0'1O - I O S9 - 7 0 Boring# Horizon Depth Dominant Color Mottles Texture Structure. Consistence Bax>dary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tmr& 3 p_Zp ~r~, -tR Zlz - St Z~Sb1T w, V Ground 3 4f-67 S tt(Z- V/,4 - \`~S c Sbk bn V V CI) - • S elev. 98.0 ft. 6~-mil l0 ~tR Y! - \45 Depth to limiting factor Remarks: Boring # vt-- to - 1"1~s3tu~ S1 QZ at 8,3 s Ground S S ' U~rv wuu v~ R elev. ft. Depth to 1 w L)H S `a limiting t ti,1=~ 1Z. Ss S is factor 6 ~i 1 1vCl S ►-j L`T'Tl b v►.+' 1TS n JZ Q J4 \S Cz V l 1L Remarks: 6 x 8.qy'~ LtDvC3`-j~- 0!=Pcf.ti luw~Z1 So.Gy~ CT~Ztct LEn{ ot= 6 ~►-LTa~ Boring # A w n'yl:'i'k? p \ \ri4 -I SO S Q Pr C O NCR `Pt k d 1$ C R ~D v c O+U ~e Ground elev. \•$3~ hitpT{ = 3u5 Li~ lZ ft. 3eS - b c S Depth to t n' , L c3 limiting factor 01Z. I !/vS L Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks' - - PLOT PLAN Page 3 of 3 SCALE 1"= 30 ' 0 1 0 ~ s S U ~`rp(~ L~ 1 w' wtuo. G MZh 6 F S'r1uv. B`~'') e•Z ITL 5I I e1,9r8 ~ fl/ 2 J 0 J J ti00a > ~ ~ ALL r'l - l n o. 0' D►J CCU., i_ FWU1Z ~'tT Gt'rSzn:GE s10~ ~c~t.1R ~ 1'lovSE 690 s l GtAV~ R~rrA . NoT To swt,~Z 2D _ G~-3Sb L-3C 715 ) 42A-01 65_- 1400576 CST Signature Date Signed Telephone No. CST # Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page I of 3 Lahr and Human Relations - Division of Safety a Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must include, but 12~ `J 1k not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. O y - 10 59 - APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION Rr1 DBY DATE PROPERTY OWNER: PROPERTY LOCATION C YMI S `T~ S ►V Gg#rF.1: S E 1/4 K 3E 1/4,S VS T Z$ N,R 11 E (or) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM'# 6 9o GL~V~12 ~.o~D - _ _ CITY STATE ZIP CODE PHONE NUMBER OCITY QVILLAGE DOWN NEAREST ROAD IZloe51Z 1'mLS~LJJ s'FpzZ ()Isl qZS-6886 1-~io~t Gwv ~ ~t~*b New Construction Use [,x] Residential / Number of bedrooms (j AddiiiQn to existing building . pQ Replacement [ ] Public or commercial describe Code derived daily flow y SO gpd Recommended design loading rate - bed, gpd/ft2 trench, gpd/ft2 Absorption area required ` I OD bed, ft2 S o trench, ft2 Maximum design loading rate, S bed, gpd/ft2 • lo trench, gpd/ft2 Recommended infiltration surface elevation(s) sew Pt~-G~E Z 0~ 3 ft (as referred to site plan benchmark) Additional design / site considerations \1 Parent material <3iLni S t?niwl tom.!"" i jJ: z Srir r~ i -n Flood plain elevation, if applicable Q. A , It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem L~ S ❑ U ®S E] U ®S ❑ U @S ❑ U ❑ S [ U ❑ S @U 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 Trends 1 0- t 9 s p y i l z - s Z s b v~~` cs s h . Z 1q-3~ to`12 316 - ~ 1 1 Z. ~ S bk r~~t- c w - 5 • ~ Ground 3 39 S Ytz Y/6 - 1 `~S 1 es h~ n1 u ~t- - S . 6 elev. 10\. S ft. Depth to limiting factor ? _)8" Remarks: Boring # 1 0-►6 \oyQ zCz - s21 Z'FS~~ mph c~ 1~~ -s ~ .6 >-.Z._.V> 2- 16-38 t~~Q 3/6 3 5-63 ~.SYIZgA ~S \L's mv'~t^ ew S I- Ground elev. Y u -88 1 O Y R yly v4 s O Vn 1J ~1 - -4 X8.5 ft. Depth to limiting factor 85 'Remarks: CST Name.-Please Print Phone: d Arthur L. We erer 715-425-0165 degerer Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022 Signature: Date: CST Number: C_~1Z7~titZ_.~ K _3L `77 M00576 PROPERTY OWNER Q-'Cr _.t.ST'k--.1SDry SOIL DESCRIPTION REPORT Page? of 3 PARCEL I.D.# 0\V0 - I OS9 - o Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boux'ldary Roots Bed Trench 0-10 y tZ - s f Sbk t- C L" S L Ground 3 Ll 1-0 1- S Lr R V1% ~~CS s ~k yn v (t- C w - S elev. 98.0 ft. r{ 6~_~~ t0 1-t(Z Y/ - ~~s WtU'F't- • 3 y Depth to limiting factor Remarks: Boring # ,.~•w:::~••<:::• t~ _ vE 'to - ~s S i u ~ s 1 Q Z 83 s Leo 3 v o~► 2 c s c . ....w`; Ground S ~"uu~ UL R elev. ft. Depth to - ) w STKt F- © C ►-ti ,ZS a limiting t ti !Z S `-t S l 4' S factor C~ ~TS~.C'1vCt ~ tti L`T1't b vrv lTS n - 1Z~'1-1 L' 4 ~S ~Z l~ l 2 Remarks: 6 >1 LtivaII}. 0!= ~Mth y►vL?~ So.6y~ C-M-vf t L 1i} 01= 6 v►~~T~~ Boring # ..>•<.:>.w z ' ~ D E ~ ~ e S w L•R! b~ 13 Lev 1SO sWPr Cq~O Y~R``R X b l $ C~~OU~ u+u Abe Ground elev. \•831 C ►v~OT-A = ~Q, S L~~v lZ ft. Depth to 3 o S b c S y~ t,,. , LEA limiting I CZ: factor 1 ~vS L Remarks: Boring # : •.`:;tz::<«<::: ' DOS 111 1 VS NZ- Ul1Z ss... . s Ilk Ground elev. ft, Depth to limiting factor Remarks: PLOT PLAN Page 3 of 3 i _ s . SCALE 1" 30 ' e. I - - r1~N• 6M21rGF e•Z ,TL 4 ~.3 • I iL98 ¢j J 0 J J p z.o 1.00 ~1"l - L'~ U, o' C3►.~ CCU C~~ _ I FWOR. ~T Gt'r5z-~.G~ s~p~ ~UUR i 1jpvS E 4p 6qo i Gt,ov~ `2ii'kA . S S~iI,L~- RD q~-3sb 715 42.5-0169 1400576 CST Signature Date Signed Telephone No. CST # STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER ~ 1°`j S 1 `~yI Sb YI MAILING ADDRESS 67 D 9/ 6 U er eU /l ! d e i, I-e- PROPERTY ADDRESS /'0 (location of septic system) Please obtain from the Planning Dept. CITY/STATE (()e r F~113 IJ," 5~led d PROPERTY LOCATION 1/4, Y` 1/4, Section l~ T A 0 N-R2~t__W TOWN OF d ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIMDSURVEYINIAI' ,VOLUME PAGE , LOTNUMBER 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 maintain ust be completed and returned to the St. Croix County Zoning Officer within 30 days of the three y77 xpirati n te. t SIGNED: ]A t4d4W DATE: 0 St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 8TC- 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 6 9 1 ten so 4 Location of property 1/4-N 1/4, Section ,5 ,TPS'- N-R1_W Township Tlt6 Mailing ad ress 6,40 C'le'pe kd. ' 19 ~jl*5'Q?~ Address of site 3Q h4 r Subdivision name "-I' Lot no. Other homes on property? Yesc X No Previous owner of property A Total size of property I s G2~,/'C°S Total size of parcel Date parcel was created J&cn e- 075 Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house) ? Yes No Volume c` and Page Number _ as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as document No.,&?j-qt9_C , 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 offic of the County Register of Deeds as Document No. M1 Signature of Applicant Co-Applicant Date of Signature At-P n f . nnar6„-ea ii DOCUMENT No. ln' STATE BAR OF WISCONSIN- FORM 2 ER ED FORDEED 327404 e 524 PA, 95 THIS SPACE REESWRTY RECORDING DATA By THIS DEED, RQ"ling-Hills Developmeol, Inc., roc=GiSTERS OFFICE a Wisconsin Corpo-a_t _Qn_ ST. CROIx CO., Wis. Recd 1% Record thls_.ktb, ~y of_?u*q A.D.1975 Grantor convevs and warrants t(. Thomas G_ Christenson and Marguerite t}, Christenson, husband and wife ,----~i~5 ,•M, as joint tenants - of r "'10 Grantee S for a valuable consideration _ O n e D o l l a_r_„_ and Other Good and gETUgN TD Valuable Consideration the following described real estate in County, State ofWisconsin A parcel of land located in the Southeast Quarter 'fax Key x - (SEk) of the Northeast Quarter (NE4) of Section This is nonhomesteadproperty. Fifteen (15), Township Twenty-eight (28) North, Range Nineteen (19) West, Town of Troy, St. Croix County, Wisconsin, described as follows: Commencing at the East Quarter corner of said Section 15; thence South 890 16'55" West (true bearing) 522.50 9eet along the South line of said North- e8st Quarter (NE4); thence North 0 26' West 184.84 feet (recorded as North 0 43'West 183.0 feet) to the point of beginning; thence North 0 26' West 258.66 feet; thence South 890165 " West 100.00 feet; thence SoU~h 0026' East 258.31 feet; thence :forth 39 29' East (recorded as North 89 11' East) 100.00 feet to the point of beginning. TRANSFER FE1i Exception to warranties: c• it River Falls, Wisconsin ? N•- Executed at--River _ _ this_✓~a~ d 4 II ROllIr HILLS ► -ilC. Y : C! Ica. SIGNED AND SEALED IN PRESEN( OF _ •'S(` SEAL) Richard N. Fox, Presit~eJnt _ v' t r S' (SEAL) J. Frances Fox, Secretary ' -(SEAL) (SEAL) Signatures of ichdrd f+. and J. Frances.. Fox.. - - - authenticated this = ;i 15 r - D. Petee Seguin Title: Member State Bar cf Wisconsin ArXX*XIPXr*X Authorized under Sec. 766.06 viz. (2 STATE OF WISCON` ! Personally came before m _ day ,f 'he above named to me known to be the person - - d !h,- ;.,ro-going instrc .,:nt and ackr-.'edged the same.