Loading...
HomeMy WebLinkAbout040-1245-00-000 6 N RECEIVES STC - 104 DEC 19 1997 e : AS BUILT SANITARY SYSTEM REPORT r ST CROIX COUNTY ZONINGOFEICE OWNER ADDRESS lI r2J SUBDIVISION CSMI Y ay U \ r1 a o LOT SECTION T C~KN-R' Town of ST. CROIX COUNTY, WISCONSIN a" --UU ~6Uv PLAN VIE SHOW EVERYTHING WITHIN 1(0 FEET OF SYSTEM A IS I DICATE NORTH ROW s o_ L- Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARR• D ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: bj\-~~ Liquid Capacity: / 0)56 Setback from: Well House Q JJ Other Pump: Manufacturer Model# Size . Float seperation Gallons/cycle: Alarm Location - - SOIL ABSORPTION SYSTEM Width: Length ` Number of Uie*ek-es Distance & Direction to nearest prop. line: 7`^ Setback from: well: /J A- . House' Other ELEVATIONSz?S g Building Sewer ST Inlet- ST outlet: PC inlet PC bottom Pump Off Header/Manifold ~oyl Bottom of system 7 Existing Grade Final grade DATE OF INSTALLATION: 47 PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: 3/93:jt /isconsirlDepartmentofCommerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division Countv INSPECTION REPORT ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary PermitNo.: Personal information you provice may be used for secondary purposes [Privacy La S.15.04 (1)(m)]. 307601 kt& 1N5ASTRUCTION INC. ❑ Jj~~village Town of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 040°1245-00-000 l vv 1&0 1 31t o l 14 d I TANK INFORMATION ELEVATION DATA A9700518 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic -1N ~Gg c✓ ( ZSa Benchmar 417 -~.gs lp ,9 /Da l ~Aecatie+<1 Bldg. Sewer ` 16ro-7 He"M dMe Inlet 9R. 8/ TANK SETBACK INFORMATION (:57M' Outlet %S TANKTO P/L WELL BLDG. Airlntake ROAD Dt Inlet Septic -Z 3& NA Dt Bottom D"Bi NA Header/ Man. .o 57 e~Cratorl A Dist. Pipe ~p 979/ o Ing Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand ST. M&NlkH.c.E c. 101 7 2, Model Number GPM TDH Lift Friction S em TDH Ft Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM 1,4 ED TRENCH Width I X ~ Length N*--0fi-~s PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS SETBACK SYSTEM TO P/ L BLDG WELL LAKE / STREAM Manufac INFORMATION Type O UNIT Model Number OR : DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) v x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length 7 / Dia. Yr Spacing G "y✓t • 111* 77 E j 4/ _It tw~ I SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth O~ xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed/ Trench Edges ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: TROY 19.28.19,SW,N/W~f323 ST. ANNE'S JARKWAY. ( Plan revision ❑ Yes GSI No Use other side for additional information. (7, LZ °17 J SBD-6710 (R.3/97) Date Inspector's na re Cert No. Y ADDITIONAL COMMENTS AND SKETCH fi SANITARY PERMIT NUMBER: Safety and Buildings Division - SANITARY PERMIT APPLICATION 201 E. Washington Ave. N*Lconsin In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Department of Commerce Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 1/2 x 11 inches in size. 3 l C Y, • See reverse side for instructions for completing this application State Sanitary Permit Number 30766 1 The information you provide may be used by other government agency programs Check if revision to previous application (Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Nu er 1. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION Prope Owner Name Property Location r/ Y t S \_,I 1/4 EV 11 1/4, $ 1 T r N, R lr(or) W Property Owner's Mailing Address Lot Numb r Block Number so h A^ Z' A 1 -1 A214 S ~P City, State Zip Cod Phone Number Subdivision Name or CSM Numbe ( ) II. TYPE F BUILDING: (check ne) ❑ State Owned E] Ity Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms , ° Town of ' w 111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1❑ Apartment/ Condo 0 .4 0 a S~ d a 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 130 Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) New 2_ Replacement 3. E] Replacement of 4_ ❑ Reconnection of 5. E] Repair of an ------System ___System_____________TankOnly Existing System _________ExistingSystem B) ❑ A Sanitary Permit was previously issued. Permit Number / Date Issued /0-jq,cp7 V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 [Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ 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 6 Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation Feet /D 0, 4, Feet VII. TANK Capacity Total # of Prefab. Site App INFORMATION in g Gallons Tanks Manufacturer's Name Concrete Con- Steel Fiberglass- Plastic Exper. New Existin strutted Tanks Tanks Septic Tank or Holding Tank / ~60 ; ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑ VIIL. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for instal tion of the onsite sewage system shown on the attached plans. Plumber's Name: t t) Plumber's Sign are: Stamps) TP/MPRSW No.: Bus~injess Phone Nu/tuber: Plumber's Ac dress (Street, Cit 'St te,Zip Code): N h V C J o/ IX COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Agent Signature (No Stamps) R A rove / Surcharge Fee) pp ❑ Owner Given Initial Q~ Ind Adverse Determination ` 10D 112--00-911 gX. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: SBD-6398 (R.11/96) DISTRIBUTION: Original to County. One copy To: safety S Buildings Division, owner, plumber 1 INSTRUCTIONS t 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: I_ 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 al! 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. net k Pto--r- ~+2 1`n. L r~:a~'V~.LV\ 4.vn rc- swY, Nc.~Y" s ~~7 ) a N K'~ l ~ s d s Hwy (es f oc►~ a '11-0 U4, N Y~ C. mo r'Ld,., C l L Lam ` 1 _ I r~ 1~~s►~o 3 T-~~ /Sx'" l 97 i r I O _ ~ ~ k ~ I I _ i I j ! I F _ _ _ _ _ r - i i i i _ - I i - I _ I _ i j _ _ I _ _ _ _I _ I I ' I' ~ i _ _ _ i _ _ _ i_. I I ~ i _ ' _ r- j i I - - _ _ _ I ~I 7 PAGE- OF_ Gros ,~~~1u1, d A SYSILn'1 he 6h Ak 1111616 And Ob4ofV0,10A Plp• Idlydmun~ !Y' Aaora Apptoril Veal Cap N -2 ..J L.h lM0 .1G 1 U-14 Mal Crod• • s ~~y NwY~ s~~., s 7 20• ~2'AOora Plpr 4' Coal koa o To flndl Oraed Vaal Pip, -2-- wraA Ilo Or S nlAark Corula Over plpjyrapolo OIa1rI0~110a Pipa 0 0 0 Tao b' AYOroOola 04a 841h Pipe ' ° Parlaalaa pl ° pa Balow C0,01AI To.mlaolln0 Al Ballow OF 8yllam j ~Icv..~• 1 on / SOIL FILL DISTRIDUTIOF,I PIPE 2M°FAGGREGATE APPROVED sl)j r-TIC COVCR J'1ATl:Kll,l. OR q" OF STRAW OR tjARSN HAy' Ll•EV. OF...._FE -"0 1. /a AGGRCGATE. DIS'rRIgJTIOU PIPE TU 8E AT ` S AUU AT LCASTLO MCHES BUTLIOMOR >J y2EILICIjrS S BELOW BELOW ORIGIIJAL GRADE FINAL GRAOC ~ I'AMM M DEPrH of FXcAVATIo1.D 1'UKIMM FXOM1 OR16WAL 69ADF. WILL BE pEPrli OF EACAvAnoti r o ~^,I~a1t~gL ~iRAD WILL BE IucHeS IMCHE S SIGUE,O: LICEUSC WUMBER: v DATE: ,L•~ l lv ~f y Teo - Wisconsin Department of Industry, SOIL AND SITE EVALUATION I S .'Labor arrJ' Human Relations Page of Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must County l C include, but not limited to: vertical and horizontal reference point (BM), direction and S T r0 t percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # 0WO-1244 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)). 17. 17 Property Owner Property Location t, r r t C k CUP S L CJl 6 t Tn C Govt. Lot s 1/4 n 1,J1/4,S t C1 T Z,$ N,R Ig (or) W Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 1505 1-4 Lay 45 10 h4, 1 rot. V,ll~.5e City State Zip Code Phone Number ❑ Nearest Road y0l7 (j (S )22gj,•2320 City El Village Town 1'leW~rG~rlon~ Li 1 S 1 „ ro S~. es PKW DNew Construction Use: Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow O O gpd Recommended design loading rate • 7 bed, gpd/ft2 8 trench, gpd/ft2 Absorption area required g5g• bed, ft2 S0•trench, ft2 Maximum design loading rate 7 bed. 9Pd/ft2 $ trench. 9Pd/ft2 Recommended infiltration surface elevation(s) 97 ° ft (as referred to site plan benchmark) Additional design/site considerations - Ul. G.GIC~PR~ J ro c-k To Mcar n b-j n 44 Z- A CPC Parent material p V4wask Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank to 'W U El S U U = Unsuitable for system IP S El U -91 S ❑ U MS ❑ U Ins ❑ U ❑ S SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 1 0-32 10 )(112 312 n o•% c 5.1 in 9 bk IM Jpr w .2 .3 i. 31-53 I0ya54 IN S.I tcsbk riP, w 1 •Z' •3 Ground 3 53`9 7• S a. 4/6 h o o t S d S r% rtc, n c- .7 elev. LLO-1-4 ft. Depth to limiting factor in. Remarks: Boring# 1 0-13 1012 312. none 2.1,sLU r- ,r w 2 F .Z • S Z Z I3__1% 1 o I IL 5b, n 0 *%,t S 1 c510 ri I ,.o S . Z . 3 3 28-4-7. 5 l k 10)4 n o n t /S o S rn I w r) k .7 Ground y LLS-q5 1t)fL y~~ nun TS MVjP1 u7 nti .y . S elev." Ipb85ft 5 ~ 7•S 2 41y rlu~t $ a oS n~ nti •7 .8 Depth to limiting factor r °1 Vin. Remarks: j~►.ce Q,, ,e. _s" cl 9s" 7•.1 NaW- off' hor•~.o", CST Name (Please Print) Signatur Telephone No. 1A !!-/7-S7 -7 IS LC/C-L1/S¢ 4.o rec. t e.~ o ~ Address Date CST Number IL4 3Z I ZV S~ nv-,a csJ./7o 1605 SOIL DESCRIPTION REPORT ti 3 PROPERTY OWNER Page ~ z of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 3 6-11. t o Q 3/2. ►10 < S. I l ms b K mf'r tj Z 1= . .3 I~y1 12.41 to R 514 ho.,e $.I 1 c56 r1~( W 1 r~ :2 3 Ground 41-98 $ 09 r'1 h h 4. . 7 , . $ elev. jc 1llkft. Depth to limiting factor - Lj Remarks: Boring # Ground elev. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Structure GPD/ft2 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color` Gr. Sz. Sh. Bed , Trench Boring # Ground elev. ft. I Depth to limiting factor in. Remarks: Boring # Ground elev. ft. . Depth to limiting factor in. Remarks: SBDW-8330 (R. 08/95) L o + 0 5 } . (~nnc) ~e.r K Way z 2 S N Y r v J M res aE^Ce L QV / y$' 7So 1 Zo ~ ~ 63 Ids t1 1 1` nonTTr~c.Tio,~ ~..c w Vq n Lj Yq S e, c, 19 T 2 S N R lot LJ s e. G c I''_ 'LI o/ Lo 0 Tv-o.~ v { I ~5 e t3(+~ F'v~.nds~~on cdtc~e aj r S 1 10 L-3 C- S~ Anr\c~ I\ g let 1,1,00 a 0 o~ I g' Lis ~r r i C p'St~~ L,o~ -Tr 0V c q~ o0 Thu\~ o~ h Sh1~ I ~ 1,~rn GX -on~o 0 Wisf00hsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 aw and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. Croix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. 0,Ar 7 to 76 --gro APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Derrick construction, Inc. GOVT. LOT SW 1/4 NW 1/4,S 19 T 29 ,N,R 19 k (or) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 1505 14y, #65 10 na Troy CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE ENOWN NEAREST ROAD New Richmond, WI. 54017(71$ 246-2320 Troy St. ANNES Parkwa New Construction Use [x] Residential/ Number of bedrooms 4 [ ] Addition to existing building [ ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .7 bed, gpd/ft2_trench, gpd/ft2 Absorption area required 858 bed, ft2 750 trench, ft2 Maximum design loading rate ._bed, gpd/ft2-__8_trench, gpd/ft2 Recommended infiltration surface elevation(s) Qs-6n ft (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash 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 ❑ U ❑ S IOU C36 ❑ U ❑ S [RU RIS ❑ U ❑ S I RU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 1 0-12 1 Oyr3 1-1 none m na cs if n .2 2 12-30 10 r4/4 none sil m na 9W if np .2 Ground 3 30-84 7.5 r4/6 none ms osg ml na na .7 .8 elev. 99.0 ft. Depth to limiting factor Remarks: Boring # 1 0-12 10yr3/3 none sil lcsbk mfr cs if .2 .3 2 2 12-33 10 r4/4 none sl lcsbk mfr gw if .2 .3 Ground 3 33-80 7.5 r4 6 none ms osg ml na .7 .8 elev. / 99.0 ft. .J" Depth to limiting ` ! n factor 1 ° 00 - +80 Remarks: ZONINGOFFICE y CST Name:--Please Print Gary L. Steel Phone: 715-246-6200j~ Address: 1554 200t Ave., New Rich d J,mWl 54017 Signature: Date: 6-3-97 CST Number: m02298 PROPERTY OWNER Derrick const. SOIL DESCRIPTION REPORT Page 2 of~ 3 PARCEL I.D. # ©-4D Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft Boring # Horizon in Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends 1 0-12 10yr3 3 none sil lcsbk mfr 9w 2f .2 .3 2 12-20 10yr5/4 2p7.5yr5/8 sicl m na gw if np .2 Ground 20-84 7.5 r4 6 none ms os ml na na .7 .8 elev. 98.9 ft. Depth to limiting factor +84" Remarks: H-2 less than 11 Boring # ' n .2 2 16-26 10 r4 4 2 7.5 r5 8 sicl m na if n .2 3 26-82 7.5 r4 6 none ms os ml na na .7 .8 Ground elev. 98.6 ft. Depth to limiting factor Remarks: H---') 3-ess than. ' Boring # 1 0-12 10 r3/3 none 1 2cpl mfi cs 2f np .2 5 2 12-24 10 r4/4 none sil m na gw if np Ground 3 124-33 10 r4 4 c2d7.5 r5 8 sil m na if n .2 elev. 4 33-84 7.5 r4 6 none ms os mvfr na na .7 .8 99,1_ ft. Depth to limiting factor +84" Remarks: H-3 less than ' Boring # Ground elev. ft. " Depth to limiting factor Remarks: SBD-8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Derrick Construction, Inc. New Richmond WI 54017 MPRSW 3254 SW4NW4 S19-T29N-R19w (715) 246-6200 town of Troy lot #10-Troy Village 1 N 1"=40' BM.= nail in Pine tree C el. 100' Alt. BM.= top of 2" pvc pipe C el. 100.15' g 6 i Alf• ~q, ~ i yr A7-n off. Gary L. Steel. 6-3-97 SANITARY PERMIT APPLICATION 20 eE andBs lion Visconsin In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Department of Commerce Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less Count than 8 1/2 x 11 inches in size. tt. • 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 ❑ Check if revision to previous/application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION Pr erty Owner ame Property Location R p 1) W c Sw1/4 Nw1/4,S JCJ T ,N, 7 117,T-1 ^S (9 cpkfl~ t; Property Owner's M fling Ad ress Lot Number Block Number a City, State Zip Code Phone Number Subdivisior}A~e or CSM Number O G ('7(5 ) r ' II. TYPE F BUILDING: (check one) State Owned it~r earest R d n a kW vll age Public 1 or 2 Family Dwelling - No. of bedrooms Town OF S I III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo C) S -©0 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, j New 2. E] Replacement 3. E] Replacement of 4. E] Reconnection of 5. E] Repair of an System________System_____________TankOnly____Exi-----yst-- ____Exi-----yysem 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 g Seepage Bed 21 ❑ Mound 30 ❑ Specify-Type 410 Holding Tank 12 ❑ Seepage Trench 22 ❑ 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 Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation I ~ Q„SO also A:r t ? C'1.5. 7 Feet p C ' Feet VII. TANK Capa y in gallons Total # of Prefab. Site Fiber- Plastic LExper. INFORMATION Gallons Tanks Manufacturer s Name Concrete Con- Steel glass New Existin strutted Tanks Tanks Septic Tank or Holding Tank 1Q30 -e ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Piu ber's Name: (Print Plum er's Signa re: ( Stamps /MPRSW No.: Business Phone Number: Plumber's At dress (Street, City, Stat , Zip Code): " Li c,- 9 4 syvo 0 IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved San"tary Permit Fee (Includes Groundwater ate Issued Issuing Agent Signature (No Stamps) KApproved ❑Owner Given Initia / 17-17)l Surcharge Fee) Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-6398 (R.11/96) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1 _ A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable- 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3151. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on 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. ST. CROIX COUNTY WISCONSIN ZONING OFFICE M r r p r ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 August 5, 1997 Wisconsin Department of Commerce Plat Review ATTN: Leroy Jansky Box 8911 Madison, WI 53708-8911 RE: Onsite soil verification, lots 10 & 15, Troy Village, Sec. 19, Tn. of Troy, St. Croix County, Wisconsin Dear Leroy: I have reviewed the soil reports for the above mentioned lots in Troy Village subdivision, filed by Gary Steel, CSTM #02298 and have conducted onsite verifications for those lots. My findings have verified that Mr. Steel's findings are accurate. The soils located at these sites are suitable for subsurface sewage disposal with soil loading rates of 0.7/0.8 GPD/sq.ft. If you have any questions with regard to the above findings, please do not hesitate in contacting our office. Sincer ly, am es K. Thompson Assistant Zoning Administrator CC: Gary Steel file ;WisconsihDepartment ofIndustry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations -Division 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 11 inches in,size. Plan must include, but St. Croix 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. 040-1245-00 APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Derrick Construction Inc. GOVT. LOT SW 1/4 NW 1/4,S19 T 28 N,Rlg xE (or) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 1505 Hy. #65 10 na Troy Villa e CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE KrOWN NEAREST ROAD New Richmond, WI. 54017 (115)246-2320 Troy St. Annes Pkw. [ New Construction Use Residential / Number of bedrooms 4 [ ] Addition to existing building Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .7 bed, gpd/ft2.8 trench, gpd/ft2 Absorption area required 858 bed, ft2 750 trench, ft2 Maximum design loading rate .7 bed, gpd/ft2 .8 trench, gpd/ft2 Recommended infiltration surface elevation(s) 95.70 ft (as referred.to site plan benchmark) Additional design / site considerations na Parent material outwash 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 for s stem ® S ❑ U ❑ S C2U ® S ❑ U ❑ S Z7 U ®S ❑ U ❑ S CRU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 -10 10yr3/3 none 1 2msbk mfr 2f .5 .6 l 2 10-22 10yr4/4 none sil lcsbk' mfi gw if .2 .3 Ground 3 2-84 7.5yr4/6 none m s Osg ml na na .7 .8 elev. 99.0 ft. Depth to limiting f+84 Remarks: Boring # 1 -10 10yr3/3 none 1 2msbk mfr gw 2f .5 .6 2 2 0-31 10yr4/4 none sil M na 9w na np .2 3 1-84 7.5yr4/4 none m s Osg ml na na .7 .8 Ground elev. 99.0 ft. Depth to limiting factor +84" Remarks: CST Name:--Please Print Gary L. Steel Phone: 715-246-6200. Address: 1554 200th. New Rich and WI 54017 Signature: Date: 7-17-97 CST Number: m02298 PROPERTY OWNER Derrick Const.,INc. SOIL DESCRIPTION REPORT Page 2 T of 3. PARCEL I.D. # 040-1245-00 Depth Dominant Color Mottles Texture Structure Consistence Botr>vary Roots Bed Trench Boring # Horizon in. Munsell ()u. Sz. Cont. Color Gr. Sz. Sh. Bed rerxh 1 0-12 10yr3/3 none sil 2msbk mfr gw 2f .5 .6 2 12-30 10yr4/4 none sil M na gw if np .2 Ground 3 30-84 7.5yr4/6 none m s Osg ml na na .7 .8 elev. 99.1 ft. Depth to limiting factor +R4" Remarks: - Boring # ' 1 10-14 10yr3/3 none 1 2msbk mfr gw lf .5 .6 2 14-20 10yr5/4 none sil lcsbk mfi gw if .2 .3 3 120-27 10yr5/4 flf 7.5yr4/4 sil M na gw na np .2 Ground elev. 4 127-80 7.5yr4/6 none m s Osg ml gw na .7 .8 g$ . 7 ft. 5 80-84 7.5yr4/6 none co s Osg ml na na .7 .8 Depth to limiting factor +841 Remarks: H-3 less than 1.00' Boring # 1 0-i0 ;.Oyr3/3 none 1 2msbk mfr g-' 2f .5 .6 5 2 10-24 10yr4/4 none sil lcsbk mfr g,-,T if .2 .3 3 124-32 10yr5/4 fif 7.5yr4/4 sil lcsbk mfr gw if .2 .3 Ground elev. 4 32--84 7.5yr4/6 none m s Osg ml na na .7 .8 98.7 ft. Depth to limiting factor +84, Remarks: H-3 less than 1.00' Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Derrick Construction, Inc. CSTM2 3254 WIWI S19-T29N-R19W New Richmond, WI 54017 town of Troy (715) 246-6200 t lot #10-Troy Village N 1"=40, BM.= top of tel ped C el. 100' Alt. BM.== top of 12" pvc pipe @ el. 99.80, 5 I AM Gary L. Steel 7-17-97 STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER _ _l-ty1U~- ~~S'fr~~ CAD , L tV C~ MAILING ADDRESS V7<3`/ Cr ,c ~~Yt t.~,~ry~ 0 ~1 ~y11 -1 PROPERTY ADDRESS IM (location of septic system) Please obtain from the Plannin Dept. CITY/STATE _ t-~AOS Q-rA , VS/S cc ~.l nI l PROPERTY LOCATIOI!y tl V-4 1/4, Section T -Zk N-R W TOWN OF ST. CROIX COUNTY, WI SUBDIVISION Vl LkA6-UC LOT NUMBER VC) CERTIFIED SURVEY MAP , VOLUME , PAGE , LOT NUMBER Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must a completed and returned to the St. Croix County Zoning Officer within 30 days of the three year ex r ion date. SIGNED: DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 S T C - 100 . This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of property DERIZICA~, GOM spM ~ffj Ott Co, , l va V Location of property§-1/7, N W 1/4, Sectidn AM , T 2't-N-R_W Township/ Mailing address (0 S 1~1.~w c~► w~ o ~D \44Z S 40 V -1 Address of site 05C*4~ kJT Subdivision name -Y ~VyL.Lp.L-wer Lot no. l4 Other homes on property? Yes__&_No Previous owner of property Crt/~ l op M!S! T Cph-~ Total size of property -~k-G1-10 Total size of parcel t-}-- Date parcel was created ~tlp~ ''La ~q9 -l Are all corners and lot lines identifiable? _X Yes No Is this property being developed for (spec house) ? A Yes No Volume 12-41 and Page Number 'JS S 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) an (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in he office of the County Register of Deeds as Document No. 9u7ol Ct-1~o , and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of the County Register of Deeds as Document No. Si Adre f ZAppl~~~ ant Co-Applicant ~6 -!z -9-7 Date of Sianature n~~ ov c w! ru 14:12 FA:: 715 386 4687 G STF,li U DEEDS Rt ~C~01 g Ylpt. dG ~ 0I~ I v , WAPJUNrY DEED r Wcuxwr W. We I)md, ar e a bolwe w TROY r)EYh:Wk'.D►# NT juva ia Awes CORPORA►MN, a Mid corpocation, GO~ 20d MAI c 7 DERlttt C()1 'lt'RIICn0N CO., INC., A Wacw iA cDrp moo t, Gr titer, 3 :13 P fi t vw•a► wunewigh, That tlse mW Gra0zor conv"S 10 ("sang: the fullvwitag deacrbW ral,estate in St,. G"mft :r. y, State at' wl=we l; count b Lot it) a p.hrs "O' 'o@ 'l'ay 'V'illage is >ha Tow-of Troy. St. Cick Subgwet * Vat1wa ow of Coveaviah (,.mditiow and Ttes HCdo s Ew Tax Parcel No. Tray rVi11r0e, JW%WW in 6'01:1241 pypL-258, as t*W. Nn 559,'9fi~ REI"IJRId 11'Q (~10'~ .'t aaad the frwol wv6w of Gdf Coiinm Covarwut 4 C . . Fasarwmb, MoWW.ip i,01. 1241, psp '301, as Dot, 'Not S59069 Rat+ert W. Mudge l304 469 an as rppeari * M .t nPiue of tiro ROOAw of tier :Yt. I~3 ~,~so NVI 5401 Croix coiudy, Vwwdda, and sich other eaa swats, maamm4ma. e r oticm ud mwtraticw', of raved, or In we. Apr 7p~_ y,,.nnr.... ero . , Togfdw wi% a ,ww sins ft heradi -are matrd a uxlenanm themunta belonging, Aod . C~f1tOt' vats is dthdt tale title iS gc)W, amble in fee simple " free: and clear of enciumbrs , AW well. wa -mt and ddfenst same: c Dated tens GY of lily, 1997, 'IlWv DEVELOPMENT CORPORATION S. Cook, Presydent. ST. MOM COUNTY' p~~ Am WJbm w "Aty of May, 1997: dw above =wad Troy Dav el0pu mt Corpmadon, a Mimew4a corporsdoa, by. chadew S. cq&, ift fPresrdwat, to M.lowwa to odd PuWa who agrOAtsd ilia forego ng irtiytett tWt and acimo4dwigwi am am, being *wL=d so to do. 1XIS M. -MV-44M DRAFI!M BY: art W. Mit~gfwA AttMM A+` Saw .v I hc, State cd' W~sc6t1SiA 1.10 2nd SL, P.0. RM 469 lrijr i<oraunission+xpires)~ ~ Rudsect WI $4016 a -fu r w v . 1 1 . a. r,. v...1,'A* .1W, RJ:- - tt`i it'N Wo 4 SAFETY & BUILDINGS DIVISION State of Wisconsin Depa onmerce August 22, 1997 `J.~' ' `f` 15837 USH 63 `l Route 8, Box 8072 Hayward WI 54843 ~ ! l STEEL, GARY a~ 1554 200 AVE NEW RICHMOND WI 54017 ?O~i~'7~,~tLr~ RE: PLAN 597-02912 ~O/C~ r . Ffifi RECEIVED: 80.00 TROY VILLIAGE LOT 10. SW, NW, 19, 29, 19W TOWN OF TROY _ COUNTY OF ST CROIX MOUND RESTRICTION WAIVER The Department has reviewed the above-referenced submittal. The Department has reviewed the request to waive the restriction on the above referenced property. This request is supported with information that indicates this property is acceptable for development with a soil absorption type private sewage system. Therefore, the Department waives the above mentioned restriction and has no objection to the development of this property provided that the private sewage system is constructed in • accordance with the applicable requirements of Chapter Comm 83, Wisconsin Admistrative Code. Conditional approval is hereby granted to waive the mound system restriction provided the following condition(s) are met: 1. That the release and waiver of this lot restriction be incorporated into a correction instrument under s. 236.295, Wis. Stats. This should eliminate future questions regarding the restriction on the recorded plat. This approval does not include review of the design for the proposed private sewage system. All other applicable criteria, as contained in chapter Comm 83, Wisconsin Administrative Code, must be met prior to issuance of the sanitary permit for a project at this site. All permits required by the city, village, township or county shall be obtained prior to installation. Inquiries should be directed to me at the telephone number listed below. Please refer to the plan number shown above. Sine rely, roy G. an-sky astewate Specialist Senio Field Operations Bureau • (715) 726-2544 CC: Plat Review St. Croix County Zoning 189 ,a VOL 1?93, PACE AFFIDAVIT OF CORRECTION TROY VILLAGE REGISTER'S OFFICE I, James D. Filkins, Registered Land Surveyor, ST. CROIX CO., WI S-2246, hereby certify that the Plat of Troy Rec d d for tar 1998 Village, recorded in Volume 6 of Plats, Page FEB U41998 89, Document No. 559959, St. Croix County Registry, located in the Town of Troy, St. 9:30 A M Croix County, Wisconsin, shows Note No. 5 on Sheet 2 which states "The following Lots Re :tee of Dead. must have mound systems: 1 through 10, 15, 16, 18, 19, 21 through 45, 47 through 49, 51 through 55, 59 through 64, 69 and 70." This note is hereby changed to read as Francis H. Ogden follows: Ogden Engineering Co. 113 West Walnut St. "The following lots must have mound systems: River Falls, WI 54022 1 through 5, 16, 18, 19, 21 through 45, 47 through 49, 51 through 55, 60 through 64, 69 and 70." Dated this 3 day of $2li~ZY , 1998 Parcel I . D. Number SCS//i Ja P-FZii'llkins S-2246 i11 V JAMES D. State of Wisconsin ) FiLKINS - ss.~ County of-2"/2 RIVER F • O SUR Personally came before me this `d day of~ a unta~ , 1998, to me known to be the person who executed the foregoing instrume and acknowledged the same. HE sAr My =*,,on Expires -2 00 ROTARY - e - 7~l ST. CR IX COUNTY ate, PUBLIC APPROVAL CERTIFICATE Approved for recording by the St. Croix County Zo' ffice Date 2 y- 98 This instrument was drafted by James D. Filkins, Ogden Engineering Co. 113 West Walnut Street, River Falls, Wisconsin 54022 vvlsconsin" Oeparm,*nt of Indusuy, SOIL AND SITE EVALUATION REPORT Page 1_ of I Labor and Human Roiatuons Division of Satety 3 6u k*ngs in accord with I LHR 83.05. Wis. Adm. Code COUNTY Attach complete site plan an paper not less than 8 1/2 x 11 inches in size. Plan must include, but ST. CROIX not limited to vertical and horizontal reference point (8M), direction and % of slope, scale or PARCEL I.O. dimensioned, north arrow, and location and distance to nearest road. . APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION E. 1/2S 24T 28 NR 20 W TOM RUEMMELE & JOHN AND BARB RUEMMELE GOVT. LOT 114W 1/2S 19T 29 NR 19 -644" W PROPERTY OWNER':S MAILING ADDRESS LOT # -Steel( SUBO. NAME OR GSM a 260 COUNTY ROAD F 10 TROY VILLAGE CITY, STATE ZIP CODE PHONE NUMBER CITY (ZVILLAGE OWN NEAREST ROAD HUDSON WTSCONSTN 54016 (715) 386-2M--- TROY ST 44495 1:4400 D< New Constn=w Use (X j Residential / Number of bedrooms 4 ( Addition to existing bwlding j I Replacement ( Public or commercial describe Code derived daily flow 600 gpd Ret ornmended design loading rate bed. gpd/ft2 - trench, gpdM2 Absorption area required SOO bed. ft2 ~D O trench, fit Maximum design loading rate D • 5 bed. gpd/tt2 d, b trenct, gpdM2 Recommended infiltration surface elevation(s) BY DESIGNER It (as referred to site plan benchmark) Additional design i site considerations $~E /VD TES 4/Y O~c9E 3 Parent material ~16S5zrLG y7 d oTLri~3iy Flood plain elevation, if applicable N/A It S - Suitable for System CONVENnONM. MOUND IN&GROUNO PRESSURE AT-GRADE SYSTEM FILL HOILM TANK U -Unsuitable for system 10 S (fu I us ❑ u ❑ S N ~ D S o u I CS ~ U I C S ou SOIL DESCRIPTION REPORT Depth Dominant Color Mottles StructureCorts GPD/ft Horizon+ in. Munsi Qu. Sz. Corn Color I Texture I Gr. Sz. Sh. I IBouxtvy Roots Bed ITierdt Boring 4 I 1 I 1 Al I 0-8 lOYR 2/2 I 1 2msbk mfr i 2vf-8 0.5 0.6 288' 2 8-20 IlOYR 4/4 I 1 2f-msbk mfr I gw lvf 0.5 0.6 Ground 1 120-31I10YR 4/6 ( sil 12msbk mfr L w I lvf 0.5 0.6 elev. 2 131-401 10YR 5/4 7m1d 5YR 5/8 sicl 3mabk mfi ( cs lvf 899.11t. 40-72I10YR 5/6 flf 10YR 3/4 I S Osg ml ( lvf Depth to limiting I fatiof ~ I 3111 Remarks: Boring # A 0-30 10YR 3/1 1 2msbk mfr ci 2vf- 11 0.5 0.6 `64=< B11 30-43 IOYR 4/6 lfs Ilmsbk mvfr cw 2vf- 0.5 0.6 Ground B12 143-51 10YR 4/6 flf 5YR 5/8 lfs lmsbk mvfr cw 2vf- - elev. B2 51-70 lOYR 5/6 I m3d lOYR 7/2 901.0 It. 5YR 5/8 sil 3msbk mfi cw lvf C 70-80 10YR 6/6 cld 10YR 3/4 s Osg ml Ilvf Depth to limiting factor 4311 Remarks: CST Narne:-lease Print JAMES 0. FILKINS Phone: (715) 425-7831 Address: OGDEN ENGINEERING CO., 113 WEST WALNUT ST.. RIVER FALLS. WI 54022 Sigamure: Date: CST Numbw: l~ ~7 CSTM03988 PROPERTY OWNER SOIL OESCRIPTION REPORT Paqe 2 of 3_ PARCEL I.O. S. Bonng # Horizon) Oepth (Oominant Color I Mottles I I Structure f I GPO/ft in. Munsell pu Cam Q)IM Texture Gr. Sz. Sh. I I Roots aec 1Trerc~ A 10-15 10YR 3/2 sl 2m-csbk mfr cw 2vf- 0.51 0.6 36 B1 15-33 10YR 4/4 sl 2csbk mfr gw 2vf- 0.5I 0.6 B21 33-40 10YR 5/6 sil 2msbk mfr cw 2vf 0.51 0.6 900. 9tt. B22 40-47 10YR 5/6 f2f 5YR 7/2 YR 5/8 sil 2msbk mfr cw 2vf Depth to C 147-77 10YR 6/6 f1d 10YR 3/4 s Osg m1 lvf IM19 fagot 40" 1 Remarks: Boring # 2f fs Ground elev. Oeptlt to 1 1 lirrnhng factor 1 1 Remarks: Boring # I 1 I ( 1 1 I i 1 L Ground 1 1 1 elev. It. I 1 I 1 Depth ►o limiting factor 1 I 1 Remarks: Bonng # I 1 Ground elev. ft OMM to lirttiting fa= I Remarks: SBO~OIR.061oQf PAGE 3OF3 NOTES: SITE PLAN PROVIDE MINIMUM OF 1' SAND BETWEEN BOTTOM OF BED AND EXISTING GROUND. MOUND TO BE A MINIMUM OF: 25' FROM DWELLING; 50' FROM WELL; 5' FROM LOT LINE. ST SCALE: 1" = 40' ~tiN~s - I ~ UT/G /T; Q ~ - ~ B--3G7 I 4 / L_°T a-z 88 Q gEi✓~L// ~iC 7'0 AP o 4 T /N ewe ELT = 89~ 86 mar / OGDEN ENGINEERING CO. JAME . FILKINS, CSTM03988 / Civil Engineers & land Surveyors DATE: 7 113 w. Walnut St. River Falls. WI 54022 (715) 425-7631 SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Commerce 1 L : r l .v 1 i~. 'r-.I,'"_: `1 li i_i". z. C i.. -i !.'I_• 1.)ti_ _ ;C!i ..Y i=.. t,` 1 I?~~i 'Pil .l. '"1 ~`'].l-~ ~ ~ _ '•T ~!`~]111 "~1 ~i s.i= 1G; ~.i.,._,r,_ t .:I~L~ a d l,S.t r l! 7 r - , ;t. 1 L + i 1. f. i SBD-7997 (8.11/96)