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HomeMy WebLinkAbout040-1239-10-000 ST. CROIX COUNTY ZONING DEPAR ` AS BUILT SANITARY REPO RT'9V~ Owner Property Address IoW ~'y ST CROtx City/State /,?,(a c Y Ta l/s <wj ~-OUNTY ZONINGOFRCE ~ ~4U Legal Description: _ r Lot Block , Subdivision/CSM # uk~ S PIN # Dyo - lz 3y-ff-0' S'F t/4 t/4, Sea;21 , T9,,KN-R_L9,W, Town of 7 ro- ,X A T, lot. Id-0 "'I SEPTIC TANK DOSE CHAMBER HOLDING TANK INFORMATION: Tank manufacturer %g; rcyySize ST/PC /o o Setback from: House 16- Well Pump manufacturer vul~~ Model Alarm location a s e (HOLDING TANKS ONLY) Water Line Setbacks: Service road Vent to fresh air intake Meter location Alarm location SOIL ABSORPTION SYSTEM: Type of system: Width Length , Number of Trenches o Setback from: House 74 , Well SY:k P/L Vent to fresh air intake ~3 ELEVATIONS: Elevation Description of benchmark Elevation) o~ `e Description of alternate benchmark .1/a- ST/HT Inlet ST Outlet PC Inlet Building Sewer PC Bottom Header/Manifold 4; Top of ST/PC Manhole Cover Distribution Lines l41 ( ) Bottom of System %O l ( ) Final Grade ( ) Date of installation LL/// fSPermit number State plan number Plumber's signature C✓`~~=- License number o9.;779 ref Date 17 lY / f?' Inspector Complete plot plan r NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VrEw a 6 ~ O ~ INDICATE NORTH ARROW z Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety ahd Buildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 299096 Permit Holder's Name: ❑ City ❑ Village Town o : State Plan ID No.: REGNER, TOM A. TROY CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: l (7(~ /DU e evo. 1-41 e, &-3 040-1239-10-000 TANK INFORMATION ELEVATION DATA 416 - TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. I - i eptic \r1f /O Bench a ~ 3.145 1,13• ©D Dosing Cows b0 17,~ 33 Aeration _ Bldg. Sewer Z _ • x`7. t Inlet 12-o' Holding TANK SETBACK INFORMATION St/ Ht Outlet Vent TANK TO P/ L WELL BLDG. Air Ito ntake ROAD Dt Inlet Air ~ Qr NA Dt Bottom qQ. , eptic 5b - Dosing NA Header / Man. Aeration IAA Dist. Pipe 163 f . vo C Holding Bot. System y z. o~ 1 oo.cr PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand ALt.6M te7 16t I'/ Z-3 '1~1 ~ 7 Model Number ~7v 28`~PM p,h ~•T7 ~p'3j Lift j12 I Friction3 System; 2.5 TDHaj, fFt TDH I Loss Forcemain Length l7 Dia. H;2 I' Dist. To Well SOIL ABSORPTION SYSTEM BED / Width r Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIM / DIMENSIONS LE Manufact er: SETBACK SYSTEM TO P / L BLDG WELL LAKE / STREAM C AMBER INFORMATION Type O , I 107 1 O NIT M Num Systemlylo" DISTRIBUTION SYSTEM Header! Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia Y Length Dia.)/ Spacing Yl/ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center I g Bed /Trench Edges Z,' Topsoil 0i Yes ❑ No Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) !S S 7 -3 C/ LOCATION: TROY 21.28.19, SE Sy 574 COUNTA40KS Is} L7OT 8 0 ~tVWiWer OA r/g Fgc be fA w(sWc 1198, 1ri~C/ 9~S//98 Plan revision required? ❑ Yes ❑ No ' I Use other side for additional information. SBD-6710 (R 05/91) Date Inspector Signature ert. N ADDITIONAL COMMENTS AND SKETCH ` SANITARY PERMIT NUMBER: s i SANITARY PERMIT APPLICATION Safety and sion *bconsin P.O. Box 7969 Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 in x 11 inches in size. S7~CYox • See reverse side for instructions for completing this application State Sanitary Permit Number a9`71% q The information you provide may be used by other government agency programs p Check if revision to prevl s application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION 7 3d' Property Owner Name Property Location 57~Ar1i41/4, S T g , N, R E (orCJ~ Property Owner's Mailing Address Lot Number Block Number x5 City, State Zip Code ~(Phone Number Subdivision Name or CSM Number II. TYPE F BUILDING: (check one) ❑ State Owned !t Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms 2 0 TOWn OF III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel /Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. 4 New 2. ❑ Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an System --------System Tank OnlyExisting System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurised Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 g[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 Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation 4~S(J 3 7 .,4/.4_ S Feet D d Feet VII. TANK Ca in gallons Total # of r Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existin strutted Tanks Tanks Septic Tank or Holding Tank ,oe e ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber d (o ~SlJ / kj~ ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sew a system shown on the attached plans- Plumber's Name: (Print) Plumber's Signature: (No Stamps) WPI'MPRSW No.: Business Phone Number: Plumber's Ac dress (Street, City, State, Zip Code): d 9d z~ 4,ef IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Agent Signature (No Stamps) JA Approved ❑Owner Given Initial 9 Surcharge Fee) < Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: sBD-GM (FIt 1/96) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, plumber Y 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. 111. 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 13 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. f SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue P.O. Box 7969 Madison, Wisconsin 53707 State of Wisconsin Department of Industry, Labor and Human Relations July ~4, 1997 1340 East Green Bay Street SMITE 300 Shawano WI 54i66 WEGERER SOIL TESTING 421 N MAIN STREET PO BOX 74 RIVER FALLS WI 54022 RE: FLAN S97-30816 FEE RECEIVED: 180.00 R. EGN ER. TOM SE, SE, 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 Comm 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 c(,de requirements set forth in chapter Comm 82 or in chapters ILHR 50-64, Wisconsin Administrative Code. - The orientation of the mound system must be such that the mound's longest dimension is perpendicular to the direction of maximum slope. Also, the area within 25 feet of the mound's downslope toe must remain undisturbed by anything, including the force main. 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 starap 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 he obtained prior to installation. Inquiries should be directed to me at the number listed bet-.w. Please refer to the plan number shc-wn above. Sincerely, ~Q rE Marl Schultz Plan Reviewer Section of Private Sewaqe 1414) 424-3311 4 716R/ 2 i~ `J SHDA-5928 (x. 19/94) t 4 page 1 of b MOUND SYSTEM ~Rl 3 FOR .c` G! tC'jG A BEDROOM RESIDENCE -30816 S 9'7 s LOCATED IN THE SE 1/4 OF THE SE 1/4 OF SECTION ~-1 ,T_Zb, N, R 19 W, TOWN OF ~'Zp~ S~i`• C\Z.O1X COUNTY, WISCONSIN. INDEX PAGE 1'of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN .PAGE 3 of 6 PLAN VIEW-CROSS SECTION ; PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE o ~N,~'sally p• d~~,on O PREPARED FOR colt MMER~~Gs g~WIED ~1}-0►-~ ~ S A. R. ~N ~ .AMEN pN Z' Y, IDt X51 pN\Skolk c;la- 0 1 SP0 PREPARED- BY WEGER.'EFR S O I L - TEST I NG SS/y AND. IDES I Gh! SEF:ZV I CE NmwRL WEBERER D9f5 s. F.O. BOX 74 421 K. FAIN ST. el~s wis. ~ RIVED. FALLS. V1 54022 • IG14 N! JOB NO. a -Z-10 ~r~ ~ ~'~1 ~q Aj~ /R ~ i ~R ~y ♦ + t1~ ! ?f ~y:.~. d ~~w a ~ a y ~l ~ y 4M1 ~ ~a t ' a- j.y y~ t, _ y~, °y- 3~ 4:,~ ' @~ G;.# PLOT PLAN Page Z of- to Scale 1 yD r ~S. 0A, 4 4 ~C Su66Q~'jlcn Lib c^-1-pow 4j s O G f 2 e ~ J N / {Q•" o {t J o ~ ' y N ~~o DoT eo~Pae7' oR ~S1U26 T ~g n \`L L,..na_ T_ - N ~ qs I ` 5~ N }N!1 N EE_ COrV~O~Z N,l... 4q . S B 1 CIS B-3 Bo~1Or i OF i„Cbl 8Mclg8 3°lo eZ ~op° et 10p 5' OTES: -1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. ( Z required) 3. Install .4" observation pipes with approved caps. ( z required) 4.-Septic tank to beVW316oo gallon capacity manufactured by ~ CO1J CQ,~~ pTt,op~ eTS. 5. Bench Mark 1 ~pD•D OrJ Toles oF, 3)q a TttiK3 von--L pI.Pt! w/woo;z~ L 6. Divert surface water around system to. prevent-.ponding at the uphill side., Page 3 Of 6 Approved Synthetic. Covering 19sT*~► c 33 Distribution Pipe Medium Sand Topsoil F Elev. \00. S D - 3 E b 3 % Slope ` Force Main Plowed Trench of 2" -2 Z" From Pump Layer Aggregate Undisturbed D 1.O Ft. Soil E VNS Ft. Cross Section Of A Mound System Using F o-% Ft. 1 Trench For The Absorption Area G N.a Ft. A S Ft. H i- S Ft. 6 `1S Ft. I ~ S Ft. Linear Loading Rate= b•Q~ GPD/LN FT J 8 Ft. Design Loading Rate= 0.3 GPD/SQ FT K 10 Ft. L °tS Ft. W Z`3 Ft. L Force f B K Main A ~c- - - - - - - - --s ~'f' W Distribution Trench Of 2 - 2 2ti Pipe Aggregate I 1 Observation Permanent Markers Pipes (anchor securely) Mound Using I Trench For Absorption Area Page y Of 6 Perforated Pipe Detail 0 End View , Perforated End Cop.) PVC Pipe (t~_ ;p GC lY as,~ Install permanent marker at end of each lateral Holes Located On Bottom. Are Equally Spaced Q End Cop P ~ ti PVC Force Main Distnoution Pipe Lost Hole Should Be Next To End Cap Distribution Pipe. Layout P ~U S Ft. X 3 6 Inches Y 3l' Inches Hole Diameter 11y Inch Lateral )~/y Inch(es) Manifold Inches Force Main Z Inches # of holes/pipe 1Z Invert Elevation of Laterals N%1.0 Ft. NZx 1.1`1= lV.6y.V 2-= 24-(4 c pr, Place lst hole from tee with succeeding holes at 3 6`' intervals.. Last hole to be next to the end cap. Combination Septa c;Tank and PUMP CHAMBER CR055 SECTION AMD SPECIFICATIOUS ' PAGE S OF - - % WEATHER PROOF -VEW7 CAP JUIJCTION BOX ti'C.I. VEKIT PIPE APPROVED LOCKING 1O FROM DOOR. MAWHOLE COVER k4-21V WARNIAIG LPtOEt. '.~IIMDOW OR FRESH S COSJDVIT AJ-A-I IJI A K E 1 Yr AIM. ' cVAA, I i IL3IrliK1. PROVIDE UJLE T AIRTI&HT SEAL 30.FF~~S I I APPROVED JOINT APPROVED JOWT A I III W/C.I. PIPE~P'c W/C.I. PIPLaR Tank construction I Ill ALARM shall comply with I II ILHR 133.15 and 33.20 a I I ON C I I 1 CLLV. S3 ,S FT PUMP , OFF D COIJCRETE 9LOCK 3" APPRO' gEppING TIED OWLU IF TAWK MANUFACTURER HAS SUCH APPROVAL. RISER EXIT PERMI ...~~~LLLLLL SPEG_ IFICATIDKJS SEPTIC f 3 DOSE WT C `JiJCI~~~' ►JUM(SER OF DOSES: PER DAZ TA►.IK MA►IUFI►CT'URER: Z TANK SIZE: IJJD J rJU GALLOWS DOSE VOLUME IWCLUDIKIG 5ACKIFLOW: GA%.LOnIS 'E . Ci~ `Tl~ J ALARM MAt,IUFACTURER: J . 30-x. MODEL LtUMBER: \ t~ ✓J CAPACITIES: A= IAICHCS OR GALLONS Z IIJCHES°OI~ Z3'~ GALLOWS SWITCH TUFF: ~-Lr B C ~L/ IUC11E5 OR GALLOWS PUMP MAIJUFACTURCR: a$ 106, O=INCHES OR GALLOWS MODEL WUMBER: ''~l1YCl.= ppZ• F~ SWITCH TYPE: MOTE: PUMP AUD ALARM ARE TO bC _U~ INSTALLED OW SEPARATE CIRCUITS MIAIIMUM DISCHARGE RATE VERTICAL DIFFERENCE DETWEEIJ PUMP OFF AUD._DI5TRIBUTIOW PIPE.. FEET 2. so t MIWIMUM WETWORK SUPPLY PRESSURE • • • • ' ' ' . . FEET U p3 + ZSO FEET OF FORCE MAIN X i'b` FyorEFKICTIOU FACTOR.. FEET TOTAL Dy1JAMIC. HEAD -6 FEET DIAMETER Sti ~I . Pump chamber 'WIDTH ;LIQUID DEPTH 11JTERiJAL OIME.WSION~t OF TAWK: LEWGTH - 231= GAL/INCH BOTTOM AREA AS PER MANUFACTURER = 81- GAL/INCH Pr Giv 6 OF b M E40 Series 4/10 HP Effluent and Drain Water Pumps Performance Curve MOQEL ME40 EFFLUENT PUMP CAPACITY LITERS PER MINUTE 0 50 100 150 200 250 300 350 40 12 35 10 to 30 W W LL 8 E 25 Z ~ Qp 20 6 W 2 J z 8. og a 15 O 4 la- F- O F- 10 2 5 0 1 L 0 0 10 20 30 40 50 60 70 80 90 100 CAPACITY GALLONS PER MINUTE 1101 Myers Parkway, Ashland, Ohio 44805-1923 419/289-1144 FAX 419/289-6658 Telex 98-7443 K3326 7/91 Printed in U.S.A. Wisconsin Department of Industry, SOIL AND SITE EVALUAT \,- V Labor and Human Relations Division of Safety and Buildings in accordance with s. ILHR 83.0 i,-�, ;!:,L 4°,- Page of �._: {1i la n Attach complete site plan on paper not less than 8 1/2 x 11 Inches in size. Plan must only' 2 include,but not limited to: vertical and horizontal reference point(BM),direction and V ! E �� iriz percent slope,scale or dimensions,north arrow,and location and distance to nearest road. t S CRUTA • •=1 I.D.#COUNTY , ZONy �,iNGOFFICE .. APPLICANT INFORMATION - Please print all information. Re' Date Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). �� Property Owner �/ Property Location 1 L 41/fiRgA)C� W, NOW/ (rneei'v )\ Govt.Lot SE 1/4 s� )1/4,S I T 1 ,N,R 19 E(or)0 Property Owner's Mailing Address / Lot# Block# Subd.Name or CSM# Ai730Z eco Th kr. e 47 400,'i at. - CouuTWy o/ties City State Zip Code Phone Number ,—,/ Nearest Road Ri i,t I� FA I S I to i. 1 St{O)1. 1 ('7/5 ) )..5. -7 3Z El City ❑ Village y town I root-PPr ales' TRoE New Construction Use: Residential/Number of bedrooms 3 +O' Addition to existing building N/� NOT PE,P�f�T j) ❑ Replacement El Public or commercial-Describe: /t///P Nb yea_ T 1�EC0 y.�s v1� Code derived daily flow 4'00 gpd Recommended design loadingrate ' ' bed, d/f12 ' `� C 9 gp trench,gpd/ft2 Absorption area required S� bed,ft2 5-eV trench,ft2 Maximum design loading rate ',J bed,gpd/ft2 /G trench,gpd/ft2 Recommended Infiltration surface elevation(s) sue- pg ,3 ft(as referred to site plan benchmark) Additional design/site/sit co ations � -Q vi/PEL7 #') '�' R 120 Go 1-1 0 U A..) 5)/$ T C�-t Parent material L S B Z Dw� 4-5S/fA'T/j16-- - S(7- 5e0meE,v7S �/T A emu, �{ Av --<4;0Py—C6,4 y �/7 Flood plain elevation,If applicable ft S Suitable for system Conventional Mound In-Ground Pressur AT-Grade System In Fill Holding Tank U = Unsuitable for system ❑ S IB u (,V�s ❑ U El S i u ❑ s 1 11 ❑ s Li} ❑ S []'U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/it2 :x in. Munsell Qu.Sz.Cont.Color Texture Gr.Si.Sh. Consistence Boundary Roots LJ1 Bed , Trench / o- /oye 3/1_ - - s,/, z 4..sti,t,-- 4 i ,e ,c 2 - ,s. -6, 2_ 9'3 /O y,e -3/3 S,/ 2 f 54,/ 40{ie cs i f ,S. ,C. Ground 3 /3.3 /Dy,P y _ 5, 2,t,,+ • S' • C. elev. / /�� �, MaT/ �S /7- Oft. y 3V- 5sz /00 y/7S Yee 5/9 Sc L o, tin. M''-f,- — 'u A/t°1 / Z,. mar 1)��Depth to —. ` / — ; limiting factor - \/_____In. Remarks: Boring # / a-C, /o yA' 3/a-- Si/, Z 4415it n+,v fR 7 S .1 , S ' . G ' 2, '. 2 Co-/y /0M 3/3 — S//. z f sot• .vim f/2 cs 2-f ' 5 ; .G 3 /� ��-/oVie 3//�/ .s/ ln,.t 4� tihf/' 2 S / F. .S , ,/( Z-c�'/ y/` y/�! S y ��L� 57 , ,iLYr 'N'�,Q • 3 ' ' Ground �. elev. / /c�,yO ft. /O y/ec @2--- in T/' , S5 a . Depth to ' limiting factor \3 a- in. Remarks: CST Name (Please Print) RO(3E(2 T" (, (? ' Signature Telephone No. f3 c ri T K�>� i 7/5= 386-(5' 3S Address Date CST Number UlhrlchLik Aaanrlates -' / - i c! csrAf 29 e 2- Private Sewage Consultants 655 O'Neil Rd. Hudson,Wis. 54016 • PROPERTY OWNER SOIL DESCRIPTION REPORT Page 3' of R_ PARCEL I.D.ff /or p Boring # Horizon Depth Dominant Color Mottles G Dlft Texture Structure Consistence Boundary Roots P 2 In. Munsell Qu.Si.Cont.Color Gr.Si.Sh. Bed ,Trench 3 ; / o ( /o ye 3/.1-. S/ .24ti, 54k of e Cc Z ,s !,""/f /o'/,e 3/3 s 2f G s6k �►�F,�. CS IF , S •elev./ Ground `/� , Y y/�` 3/� jg,' J`�/� 2.w4 h/� � �, !J �y�G /oy4 1/ 1 C s /,� 5// /vf,s4e 4441 . 3 Depth to - - /4/ 4 '.�- 4.44-ek limiting factor • 3// in. S 5'S Remarks: Boring # ro;x Ground elev. ft. , Depth to limiting factor In. Remarks: Horizon Depth Dominant Color Mottles Texture Structure GPD/ft2 in. Munsell Qu. Sz.Cont.Color Gr.Sz.Sh. Consistence Boundary Roots Bed ;Trench Boring # Ground elev. ft. Depth to - limiting factor in. Remarks: Boring # • Ground elev. ft. Depth to -' limiting factor _ In. Remarks: SBDW-8330(R.08/95) 3M SC r: Top Df 3/r " -/i, Ive41G pi`:.2.... -/ U,4 TiOa = /00. D ' WES T__� 1 • fi UN + : rn , m r �o , N 1 a a LA C t o Z r m o m 1 01...f O. O w. ss C\ Z) - 4 t 0 o R c ,P 1 ' ' Dir OQ I. Z L IA R it e (h 11 \ 1 • 0 if O W N — c " 41-- 0 ?..q t„.z. Z—__m‘ I/ ft o4-3 O O 6- (A U Cr) O o 4, \. i 3 COC) I\ Q h 0 ' 41 N N h �N o t9 (D �S . N �b 9 47 ', 6.0 •SS Fc S • s� R�3. 60 • Fz 9 0•t'l to � �` o N 21 Ilk Et 6 Li (n / N G in CA \".......,\ N .� m W ....-\ in____,. / 0 Q j ` O I 11 M K Q Co a i - � 0'1e\ ' rnzi N, tr ,�s o _ o s `_ �' )- _' l \i N, y 0 /9 i vl n N —7 . • -9, t It ,\ v.) ., • 01.5i'. ,...: Li co li o ci CO tY Q ko cr: '° -: .......\. pc• 0 /../e.‘ts-i• /0.9 i h 4/ 4' , o `^ N. • N\ 001 0 h •�) k\ \0 EZ 8y o in'' rbo6oN _ - -- --_ _` _ \ N � 8 N\ II all \\\ \ \ N. \ \ \ t\ \\ �` O M C/3 CO � � .\ t`\\ N � W Q CD \ \ 0 \\ 4\\\ `\ Q _ � c0 v \\ �\ \ � \ \ ti M \ CO \ \ p m • lfD N '` �\ \ rL �gZ N\ p0 , p o � o N .. . \ Qz .4. �• ,1 \\ p0 ( 1 1 0 £Z p9 t, 91 O 05 •2/e ,..„oo,00. J ,� \isi ` 0 0 09.6 I Q -N \ 10 u i Oti '06r c CC v \�' I{7a60N ' c O o `.� Q . o aivw oo t F� Q 4 aD m O N c Sx V 0A---__ o I lu U N O O O � m W ,O O „, 1t7A O i� M 10 1\ O Q , • 11l ltn 1 In 4. N. \z COI o Z. w o co l • Q\l1 W 1 \ -' • J tJ \ ULBRICHT & ASSOCIATES CO. 655 O'Neil Road • Hudson, Wl 54016 Reg. Designers of Engineering Systems 715-386-8185 Private Sewage Consultants SPECIAL NOTES TO THE BUYERS/ BUILDERS, REGARDING SEPTIC SYSTEMS AND SOIL TESTING ON LOTS #8 THROUGH 20 IN COUNTRY OAKS. All of the lots evaluated will require mound type septic systems. With only a few exceptions, the soils across the 1st Addition to Country Oaks had very fine weak textured silt loam in the upper 121, of topsoil (a soil loading rate of .3 GPD/ft2). These low soil loading rates will require larger trench type mound systems by design codes. Trenches can be no wider than 48". It is suggested, to the installer, if a 4 bedrm. home is proposed, some test areas provided may not be lonig enough for a single 41x125' trench, in which case a wider mound utilizing two tenches 41x 63" may be more suitable. CAUTION: since all of the soil test sites are very heavily wooded, extra careful planning and site preparation is required. Great care will need to be taken in removing trees and brush without disturbing the fine delicate silt loam topsoil. If the site is carelessly disturbed, the'Zoning Dept. will reject the site and require costly new testing and designing! Do not allow anyone to drive across or compact or distuyb the topsoil. Consult with the Zoning Dept. Inspectors, a qualified plumber, or designer for advice on how to properly prepare the site for mound system construction. The owners/developers have provided a complete approved soil test area, registered with the zoning office as required by subdivision ordinances. It is difficult to imagine today where a future buyer prefers to build upon a lot. Common sense is used to select a site at this point. If the buyer intends to utilize the test area, careful planning between the owner and septic plumber (or designer) is very important. Careful planning with qualified designers/ installers is critical. THe final actual size and shape and location of the septic system is dependent on the size and type of home proposed. Test areas large enough for a 3-4 bedroom home has been provided, but a larger home may require new or additional soil testing. The septic system can not be shifted outside of the recorded test area. pg. 4 of 4. 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 _ K a3 Location of pro erty 1/4 1/4, Section ,T,; N-R_Z_E_W Township )PLO ~L-- Mailing address Address of site SIr o40W Y"t, tpl do -A5 .4- Subdivision name 0Il-~I Lot no. Other homes on property? Yes No Previous owner of property _J-.A? Total size of property e,0vX,C~S Total size of parcel Date parcel was created 7--5 V 9,!t Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house) ? Yes _ 'No Volume J94 and Page Number -23.3 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. 6-7 3~9 , 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. Signature of pplicant Co-Applicant Date of Signature Date of Signature r STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNERBUYER~ WG MAILING ADDRESS 90 X 9S°11 L,ah•ea- PROPERTY ADDRESS 7 y Cv u Z L&-- - t (location of septic system) Please obtain from the Planning Dept. CITY/STATE PROPERTY LOCATION 1/4, S 1/4, Section / T_.Z_f N-R_Z f W TOWN OF ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER C~ CERTIFIED SURVEY MAP _9 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 year expiration date. 27;~7_ re_~ SIGNED: DATE: -/f St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 4 r 565398 STATE BAR OF WISCONSIN FORM 2 - 1982 WARRANTY DEED DOCUMENT NO. VOL 17264 PACE Ra Gale Robert L. Macke Laurence REGISTER'S OFFICE Murphy and Norma J. Eckl ST. CROIX CO,. WI property, cReee'~d Iforc Record comes and warrants to Thomas A Regner, a Gi nal a JGr 1 V 1997 8:3'0 A M Register of Deeds THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS the following described real estate in St. Croix County, G State of Wisconsin: (iF L PARCEL IDENTIFICATION NUMBER Lot 8, First Addition to Country Oaks. in the Town of Troy, St. Croix County, Wisconsin. This is not homestead property. XXNX (is not) Exception to warranties: Easements, restrictions and rights-of-way of record, if any. Dated this 1 day of September A.D., 19 9 7 . (SEAL) (SEAL) ~'l J rence Murphy ~~TbrJ. cklund (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signaure(s) Laurence Murphy, State of Wisconsin, ss. Norma J Ecklund County. A- -r