HomeMy WebLinkAbout040-1083-10-000
STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER
ADDRESS
SUBDIVISION / CSM# N4 /6$ 3 , ID-000 LOT
SECTION_ ,2-1_T N-R W Town of
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF-SYS~___ _
a
Y. I ca
pf O INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
e!
BENCHMARK: 2/41 .~44. I
a ►,~.,~~Q, p~
ALTERNATE BM-
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: r,*wt , l~,eo ► Liquid Capacity: ) 00 4? Q
t c ~
Setback from: Well - House Other ,r
Pump: Manufacturer o Model# ~'3 7 Size
Float seperation 15-J A- Gallons/cycle: '
Alarm Location b,.r t
SOIL ABSORPTION SYSTEM If -AJ
w, .
Width: ~ Length 7 Number of trenches
Distance & Direction to nearest prop. line: - ~1 , Ag% LKL.+
OF
Setback from: well: House-, Other
ELEVATIONS
Building Sewer_ y~ ST Inlet: , ST outlet:
i
PC inlet PC bottom t~ , 2 Pump off D a
4 p~ct* .
Header/Manifold /0 i, /y Bottom of system ~c7K`~r'y a
'
Existing Grade 5 Final grade S7
DATE OF INSTALLATION: 30 "9l
PLUMBER ON JOB: o `i'•U
LICENSE NUMBER: 3 2
INSPECTOR:
3/93:jt
'Diepartmentof 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 299019
Permit Holder's Name: ❑ City ❑ Village Town o : State Plan ID No.:
LUNNEY, EDWARD & JOANN TROY
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
>01 ,
040-1083-10-000
TANK INFORMATION ELEVATION DATA a -/38
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic fAN0 Benchmark 0 ~oo,oo
Dosing 6 or7 3 -
Aerati n Bldg. Sewer qjq, 1711. Al
Holdi St / Inlet /01 5 9S '
TANK SETBACK INFORMATION St/ Outlet 0,8•%' S,3y~
TANK TO P/ L WELL BLDG. VAe Intake ROAD Dt Inlet /p q6' 75,9''
f NA Dt Bottom
Septic >S 3 A`0
Dosing NA H>/ Man. Aeration NA Dist. Pipe oy~ , -1,'
Holding Bot. System so'J q~
PUMP /FORMATION Final Grade 3.y4" iva• ~5
Manufacturer Demand q,Q 7'
Model Number e GPM
TDH Liftgo, Friction Syestem a~ TDH /b,V'Ft
Forcemain Length (00, 1 Di a., Dist. To Well Sp "
SOIL ABSORPTION SYSTEM
BED / TRENCH Width Length No. Of Trench s PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS DIMENSIONS
SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHI Manufact
SETBACK CHAMBER
INFORMATION Type O~~uJ o el Number:
System: ytiI-_ AJ4 OR U
DISTRIBUTION SYSTEM
Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length 0 Dia- Length ~W Dia. Spacing y$ )'50
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over , Depth Over xx Depth Of xx Seeded / 5 ea xx,~M/ulched
Bed / Trench Center ( Bed /Trench Edges /d / Topsoil les ❑ No L7 res ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCAT ON: TROY 21.28 19 37B,SE,NW 272 TOWNSVALLEY RD ,
0,
Plan revision required? ❑ Yes ENO a
Use other side for additional information.
SBD-6710 (R 05/91) Date spector s Signature Cert. No
L
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
~g of
72, -
r i ~l-'rte
I
Vs*consin SANITARY PERMIT APPLICATION Safety and Bs Division
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 8 112 x 11 inches in size. t
• See reverse side for instructions for completing this application State sanitary Permit Number
~99o~Q
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
Property Owner Name Property Location
4. PO #A U a A/vIV L y /V Al OE SC 114 1VW 1/4, S ;Lj T 02 $ r N, R t(or) W
Property Owner's Mailing Address Lot Number Block Number
.172 O (.J /J S V 441_ 9
{it ,State Zi Code Phone Number Subdivision Name or CSM Number
V GA- 07 'yo 9 (7~r) aS 045
11. TYPE OF BUILDING: (check one) ❑ State Owned O ity Nearest Road
Village
Public 1 or 2 Family Dwelling - No. of bedrooms pTown OF / o
III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s)
qO -1090 "10 -.0a 0
d
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. 5? Replacement 3, ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an
------System _________ystem Tank OnlyExisting 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 21 ound 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ Tn-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
60®6 ily-5"'Feet . 02s, 7 Feet
VII. TANK Capacity
in gallons Total # of r Prefab. Site Fiber- Ex er.
INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel Plastic p
New Existing strutted glass App.
Tanks Tanks rt
Septic Tank or Holding Tank /;1,7 D !~O O (~.,o~¢.IG. _ 9 El ❑ 1:1 El Lift Pump Tank /Siphon Chamber o0 D ❑ D ❑ El ❑
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name: (Print) 1 Plumber's Signature: (No Stamps) MP/MPRSW No.: Business Phone Number:
Lx,) C,1e). Vecku, Pe- U 4~Z:;v 14 3;2 $7~/s--7 y9i- 73A,;L -
Plumber's A( dress (Street, City, State, Zip Code):
96 7 ~ ✓a S et.." l'i • ` ~ Y 0
IX. COUNTY/ DEPARTMENT USE ONLY
(IncludesGroundwater ate Issue Issuin A nt$I m
Disapproved Sanitary Permit Fee 9 9
pproved ❑ Owner Given Initial Surchargefee)
Adverse Determination /%M c----
X. CONDITIONS OF APPROVAL / "SONS FOR DISA~ROVAL:
/ 46
SBD-6396 (R.11/96) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS '
a
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; vvater 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 Industry, Labor and Human Relations
July 1, 1996 201 East Washington Avenue
P. 0. Box 7969
Madison WI 53707
ULBRICHT & ASSOCIATES
ROBERT ULBRICHT
655 O'NEILL ROAD
HUDSON WI 54016
RE: PLAN S96-02271 FEE RECEIVED: 180.00
LUNNEY, EDWARD
SE,NW,21,28,19W
TOWN OF TROY COUNTY OF ST CROIX
MOUND SYSTEM
The Department has reviewed the above-referenced submittal.
Conditional approval is hereby granted for the system plan submittal. All
noted items must be corrected. The review and approval of the system is based
on chapter 145, Wisconsin Statutes, and chapters ILHR 83 and 84, Wisconsin
Administrative Code, and is contingent upon compliance with any stipulations
shown on the plans. This system has not been reviewed for the code
requirements set forth in chapter ILHR 82 or in chapters ILHR 50-64, Wisconsin
Administrative Code.
This plan submittal approval will expire two years from the approval date, or
if a sanitary permit is obtained, plan approval will expire on the day the
initial sanitary permit expires. The licensed plumber responsible for this
installation shall keep one set of plans with the Department's stamp of
approval at the construction site. The installer shall notify the appropriate
inspector when inspections can be made.
All permits required by the city, village, township or county shall be
obtained prior to installation.
Inquiries should be directed to me at the number listed below. Please refer
to the plan number shown above.
,Si nc ly,
P'ag #ivate Plan Reviewe 0?\\~pAk\u.
Section of P e wage
(608) 266-2889
SBUA-9666(8.05/95)
y-
ULBRICHT & ASSOCIATES CO.
655 O'Neil Road • Hudson, WI 54016 Reg. Designers of Engineering Systems
715-386-8185 Private Sewage Consultants
PROJECT INDEX
DILHR PLAN ID # S96-02271 DATE July 1, 1996
OWNER Edward & JoAnn Lunney PHONE 715-425-5835
ADDRESS 272 Towns Valley Rd. River Falls, Wis. 54022
LEGAL DESCRIPTION Tax Parcel #040-1083-10-000
SE 1/4, NW 1/4, Sec.21, T28N, R19W.
TOWN OF Troy COUNTY St-Croix
CSTM Robert Ulbricht CSTM2482
LOCAL AUTHORITY/ SUPERVISION St. Croix County Zoning Dept.
PROJECT DESCRIPTION:
A replacement system for an existing 4 bedroom sized
home. Estimated daily wasteflow: 600 gals. All existing
(non-code compliant treatment tanks) tanks shall be properly
abandoned per ILHR 83.03(2). The existing system (overfloviing)
is sited in seasonally saturated soils.
Soils are permiable (.5GPD/ft2) in the upper 12" but
seasonally saturated at 28". A long narrow mound system is
proposed, using 121, of sand fill.
Highly recommended: installer should provide a Zabel filter
at outlet of septic tank, to ensure the longest possible life
of system. The Zabel ji.IAer will provide for the greatest degree
of pretreatment eha ification of the effluent before its
pumped up int~c~,i Ne mo~y ystem.
U10 yyyy..~~~i \\\\\1\\1111111 UIIll►IIr,~U''~
a\4", ~$C OHS,
R~ ROBERT W. .
g0~ N ULBRICHT
pN 01160
t SpF 't HUDSON, WI
ts '110
~R~sp °~iurmnuuuu\\o\\
Pg • 1 ~GVV I EWS S96-02271
Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEW SPECS.
Pg.3 PIPE LATERAL LAYOUT
Pg.4 DOSING CHAMBER CROSS SECTION
P9•5 PUMP PERFORMANCE SPECS
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V" i FORM To E u~ H 100.45'
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MAW E l EVAT'1o0 Uu DER
BETD 99.451
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E, 1.1 Fr. lmvERr o f 21, IAT£R/4IS 100.95
TOP of Rock 101.30'
Fr.
G H , FT. ' Top OF 211 I ATER A IS 101.141
PLAN Vi Ew vF MOUK3D Wirt} 13E v
FORCE MAW A 6 F r
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D15TRlf3u'rloA,3 P, PE N~T-WOR k LAyn(jT-
Total volume capacity of the, \
network= 26.25 gals.
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F o Rc e M Ai &3 X 48" NE5
100 Fr. o f 2 PUG 48
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100.95,
596-022'71
(DER Fc~R ~4TE D Pi PE -DE TAi L-- ~uD CAP
• RexiovE- .411 DRill BLURS Y
PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS ^
P,4 1E `f of S
VEWT CAP
4"C.I. VENT PIPE
WEATHER PROOF APPROVED LOCKING
N 2S' FROM DOOR„ JUAICTIOAI BOX MAMHOLE COVER
WIMDOW OR FRESH 12"MIU. W/ Cv~I~GU~NGi 1AAF1
AIR IkITAKE
lpPr 1"11-40"1 GRADE I -T-16
4" MIAI.
97.80' le"MIN.
CO►JDUIT
48"
~IEU~n
93.80' \ l~~
IMLET PROVIDE
AIRTIGHT SEAL
(I
A
PPROVED JO1N7 A NSI~EK III APPROVED JOINTS
k,//C.I:. Pipr/
`XTEMDIMG 3' I tA II W/C.I. PIPE
~O ( II ALARM EXTEN0ING 3'
OIJTO SOLID SOIL B 89.61 11 ONTO SOLID SOIL 11>
I 1
50" (4.21) i i OIJ
ELEV. 90* 6 FT. I
1 PUMP OFF
1.0'
,fAPk
IE v> f 1D BLOCK
RIStR EXIT PERMIT'ED GUL9 IF TAMR MAMUFACTURER HAS SUCH APPROVAL
SEPTIC E SPEC.IFI'CATIOUS
DOSE
TAMKS MAAIUFACTURER:-Weeks Concrete Prod. IJUMBER OF DOSES: 2
PER DAy
TAIJK SIZE: _l nnn GALLOAIS DOSE VOLUME300
ALARM MAMUFACTURER: T.PVPI Al arm L`p~ IMCLUDIMG BACKFLOW: 317 GALLONS
MODEL DUMBER: CAPACITIES: A=..28_IMCHES OR 4L1.Q._• GALLONS
SWITCH TYPE: Mercury Float B •Z_INCHES OR 4_ GALLONS
PUMP MAAIUFACTURER: Zoeller Co.
C = 1 5 - 4 INCHES OR -31.,7 GALl01J5
MODEL IJUMBER. 137 1/2HP D=_12_1 INCHES OR 243 GALLOIJS
SWITCH TYPE: Piaavback Mercury Float MOTE: PUMP AND ALARM ARE TO BE
MINIMUM DISCHARGE RATE _ 50 GPM INSTALLED OM SEPARATE CIRCUITS
VERTICAL DIFFEREMCE BETWEEM PUMP OFF AMD DISTRIBUTION PIPE-._10.35 )FEET fiAA* SrECS •
4- MIUIMUM METWORK SUPPLY PRESSURE . . . . . . . 2.5 FEET EAC(A-
+ -100_ FEET OF FORCE MAIN X a-& /oo FCFRICTION FAC.TOR.3 - 98 FEET
- 4~~rls 20 C/A~S.
TOTAL DyJMXMIC. HEAD = l6....83_ FEET J
round
1UTERUAL DIMEIJSIOMS OF TAIJK: LENGTH -/--;WIDTH 84" 50" `
- ;LIQUID DEPTH
s9s-o 22'71
P s 5
HEADI a
CAP 115
ACITY 34110
32 105
CURVE-
00 30 1-
9S
28
90
26 - 85
EFFLUENT 21 MODELI
and a 22 75 MO DEL 189
DEWATERING = 70
U 20
65"
a
Z 18
0 55
J
18
H 5o MODEL
O 183 MODEL
F- 11 45 188
12 40-
35
10 MODEL
30 137; 138' ; . MODEL
SEWAGE and ° 25
DEWATERING 529
l MODEL
15 MODEL 181
4 7
10
LL 2 MODEL
5 53, 55,
s-
57,59
0
GALLONS 10 20 30 401, 50 60 70 80 9o 1' 00 1
110
21
75 LITERS 0 80 180 240 320 400
to FLOW PER MINUTE
20 70 ~
0 19 - MODEL
295
ss
x Is
V sa
14 45 MODEL
294
i O 14 10- I
i MODEL
` C 10 283
30 MODEL /
294
~ 25
MODEL
- X96-0 22,71
9 2o" 292
18
4
,e MODEL OELLE,I~ O_
e 297, 299 I
0 I 3280 Old Mithn Lane
GAUD 10 to :d~ 36 _j 80 00 70 00 to 100 110 120 130 140 bil 190 1110 190 Ito P.O. Box 16317
I 1 I I Loulsvft Kentucky 80216
Ulm a 1e iw 240 120 40e 4ee eeo e40 720 (502) 778-2731
FLOW PEA NMI I
"137" Cast iron Series
"139" Bronze Seder * HEAD CAPACITY
~ : I~u~TCiwu
Wisr5onslnl Department of Industry, SOIL AND SITE EVALUATION
Labor and Human Relations Page l of -3-
Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis.
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County
include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. #
040-1083-10-000
APPLICANT INFORMATION - Please print all information. r ed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner Property Location W
Edward & JoAnn Lunney Govt. Lot SE 1/4 NW 1/4,s 21 T 28 N,R 19 E (or) w
Property Owner's Mailing Address Lot # Block# Subd. Name or CSM#
272 Townsvalley Rd.
City State Zip Code Phone Number Nearest Road
River Falls Wi. 54022 (715 ) 425-5835 ❑City [:3Tllage Town Towns Valley Rd.
❑ New Construction Use: KI Residential / Number of bedrooms 4 Addition to existing building
k] Replacement ❑ Public or commercial - Describe:
Code derived daily flow 6 0 0 gpd Recommended design loading rate -9 bed, gpd/f?- -6-trench, gpd1ft2
Absorption area required 500 bed, ft2 500 trench, ft2 Maximum design loading rate • 5 bed, gpd/ft2 . 6 trench, gpd/ft2
Recommended infiltration surface elevation(s) s_e_epq - 3- 100 . 45 " it (as referred to site plan benchmark)
Additional design/site considerations S i t e c o i f- a h 1 P n n 1 yr f n r mon rl type sTS t em .
Parent material Flood plain elevation, if applicable N! A ft
S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank
U = Unsuitable for system ❑ S ® U S0 U ❑ S KI U ❑ S ® u ❑ S I U ❑ S flu
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 1 0-8 10YR/3/3 loam 2msbk mvfr. cs 3f .5 .6
2 8-1 10YR 3/4 sil. 2fsbk mfr. cs lvf .5 ;.6
Ground 116-H 1 YR 4
elev.
10 0-0-ft. _ 7. C3 d s l 1 f bk mfr. _2 15- Depth to
limiting 5YR 5/6
factor
2 8 in.
Remarks:
Boring #
. 2 loam 2fsbk mvfr. Cs 5 ~6
2 2 12-14 10YR3/3 m loam lmpl mfr. asw if .4 :.5
3 14-29 10YR3 4 sil. 2msbk mfr. Cs 1f 1.5 '.6
Ground 44 29-3 7.5YR4/4 - 5YR5 6
elev.
99.64. ft. 5 39-4 5YR4 6 m3
10YR6/2 ;
Depth to 1QYR 444 J-,
limiting
factor
29 n. Remarks:
CST Name (Please Print) Si nature Telephone No.
Robert Ulbricht 715-386-8185
Address Date CST Number
6-12-96 CSTM2482
f ,
PROPERTY OWNER TjinntmSOIL DESCRIPTION REPORT
~ Page 2 of 3
PARCELt.D.a 040-1083-10-000
Boring # Horizon Depth Dominant Color Mottles Structure 2
- in. Munsell Qu. Sz. Cont. Color Texture Consistence Boundary Roots
Gr. Sz. Sh. Bed Trench
3 1 -12 10YR 2/3 [loam 2msbk vfr. cs 3f ,5 6
2 2-1 10YR3/3 oam 2fsbk mfr. cs 2f .5 .6
Ground 3 9- 10YR3/4 il. 2msbk mfr. cw if .5 !.6
elev.
98.95 ft. 4 30-4 10YR 4/4 c3d SL lfsbk mfr. .4 :.5
10YR 6/2
Depth to
limiting
factor
3 0-in.
Remarks:
Boring #
Ground
elev.
n.
Depth to
limiting
factor
Remarks:
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD/
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
Boring #
Ground
elev.
ft. ,
Depth to
limiting
factor
in.
Remarks:
Boring #
j ,
Ground
elev.
n. '
Depth to
limiting
factor
in. Remarks:
SBDW-8330 (R. 08/95)
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STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER -P-:70W d1k-,12D ~ r-T) 1' ) t='
MAILING ADDRESS 27 Z -1'D iAjN<. LLa R-p R ( VOL 540 2 Z
PROPERTY ADDRESS
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE
PROPERTY LOCATION- 1/49 f 1/4, Section, T__Zff N-R_Ly__W
TOWN OF -T)Q.O"f ST. CROIX COUNTY, WI
SUBDIVISION , LOT NUMBER
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 be completed and returned to the St. Croix
County Zoning Officer within 30 days of the three ye expiratio te.
SIGNED:
DATE: tC!~ s 1 g. Q ~I 7
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
8 T C - 100
This application form is to be completed in full and signed by the
-owner(s) of the property being developed. Any inadequacies will
only result in delays of the permit issuance. Should this
development be intended for resale by owner/contractor, (spec
house), then a second form should be retained and completed when
the property is sold and submitted to this office with the
appropriate deed recording.
Owner of property JJWAP-0 Z--d (,_U1j M5Y
Location of property P_1/4_ 1/4, Section _,T_2,JLN-R-L~_W
Township -Tto "e Mailing address 272 TDVI/ -eAllp(L~~ PD
\ a. E LL S 101/ i
Address of site AMC
Subdivision name Lot no.
other homes on property? Yes No
Previous owner of property ~ j-j1,
Total size of property 6 aP
Total size of parcel
Date parcel was created
Are all corners and lot lines identifiable? Yes No /
Is this property being developed for (spec house) ? Yes ✓ No
Volume .3 9 "7 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. 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.
aSignatuApplicant -Applicant
Fl/a/ 9 '7 I /f1fA
Date of Signature Date of Siqnature
• Ito s 1, w..+..v o..a s1or. rora. (ssArs OF wvCONSDO r"Med a am as, s.r a w.~sns a
is.a &W14. W1& statutr) rem Ub.
346331 }
568 PAU56~
VOL
(~1 ~tg ~r pn p, Made by William K. Woodruff and Catherine E. Woodruff,
Minnesota
grantor s. of Ramsey County, Vt!xxaab% hereby conveys
and warrants to '
Edward J. Lunney and JoAnn F. Lunney, husband and wife,
as joint tenants '
grantee S. of St. Croix County, Wisconsin, for
the sum of One ($1.00) and other good & valuable considerations
the following tract of land in St. Croix County, State of Wisconsin:
That certain parcel of land or tract of real estate located in the
northwest quarter of Section 21, T 28 N, R 19 W, Town of Troy, St.
Croix County, Wisconsin, being a strip of land parallel with and
lying along the west side of a Town Road, bounded on the north by
the south line of the northeast quarter of the north west quarter
of the northwest quarter of said Sec. 21, and bounded on the south
by the, north line of a parcel conveyed to Edward J. Lunney and
JoAnn F. Lunney as recorded in Vol. 397 at page 384 in the
Register;o'f Deeds office of said county, parcel to be herein{
conveyed 1110re fully described as follows: From the northwest
corner of said Sec. 21 go easterly along the north line of said
sec. 21 a distance of 1040.5 feet to the centerline of a Town Road;
thence S 210 511E along said centerline a distance of 1417.4 feet.
to point of beginning for parcel described herein; thence S 880 57'W ,
along the north line of said Lunney tract a distance df 253.9 feet
to the northwest corner of said Lunney tract; thence N 210 51'W
parallel with said centerline to a point on the south line of said
northeast quarter of the northwest quarter of the northwest quarter
of said Sec. 21; said point-lying 253.9 feet west of the center of
said Town Road; thence east with said south line a distance of
253.9 feet to said centerline; thence with same S 210 511E to point
of beginning REGISTERS Offia
ST. CRom Co', WIL 7.
TRANS ER Recd. for Record $ds3lst-
day of Jan. A.D. 197J
FEEE M.
- Reghttu of 0. s T..
3n Mitntbo M4tmt, the said grantors bawl= hereunto set their hand s and seal s this ~
p
day of August / ? . A. D., 19 7 7.
Signed and Sealed in Presence of
WILLIAM f'
F.AL)
ti CATHERINE E. WOODRUFF
WILLIAM H. CIAPP (SEAL)
---.(SEAL) PATRICIA A. KRAMER ~
MINNESOTA
si;tdit of l{~X
Ramsey Co=rT as
Personally came before me, this day of August A. D.. it 77 .
the sbore named William K. Woodruff and Catherine E. Woodruff
to we known to be the persons who executed tho foregoing instrument and ackno lodged the same
. n f-_ . n
DOCUMENT NO. 1i.WRl1r~TY t~~td yy~~
. S C ST A l 'E OF NVlS('0NSlN! - F6R%1 rJ
THIS ,.F c( S-"i:VffD FOR R1.CO;:DING DATA
THIS INDENTURE, Diaflc by i ;s
. it, II
Grantor d I- (',unity, 11'i".:nr ;n, Lrrc(t) 1IlI ,u;;l 'Ali trtnts
~ r
I
,;runev acTL'it4i 70
of I Couuty, Wiscun,:in, for the sum of
~'C5111'1 il- Y! lf i' 1 ; 1 y itJ.-
0 0
the following tract of hu:(l ill \Vi,cunr iu;
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(SEAL)
SI(;hI1) AND NE:11,171) IN PRESENCE OF
IIi 1(1( ~~.Irulc 1 ...Lt.~ch
i
Elmer Laatsch - ~ _i,;T;n,t,) ~
STATE,, OF \V1SC:0NS'71,
ss.
h
St cro ix _ ! ounty.
~I
PcnFonally came before me, this 9th rlav of September 1..>, 1O