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Parcel 040-1227-60-000 11/17/2004 01:55 PM
PAGE 1 OF 1
Alt. Parcel 13.28.20.1114 040 - TOWN OF TROY
Current ❑X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units
00 0
Tax Address: Owner(s): * = Current Owner
* VINCENT, DONNIE & JENNIFER
DONNIE & JENNIFER VINCENT
290 SALISHAN DR
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 290 SALISHAN DR
SC 2611 SCH D OF HUDSON
SP 1700 W ITC
Legal Description: Acres: 2.100 Plat: 2432-SALISHAN
SEC 13 T28N R20W PT OF GLS 1 & 2 LOT 6 Block/Condo Bldg: LOT 06
PLAT OF SALISHAN 2.10 ACRES
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
13-28N-20W
Notes: Parcel History:
Date Doc # Vol/Page Type
05/04/2004 761579 2564/415 WD
10/02/1998 588299 1362/347 WD
11/14/1997 568538 1277/05 WD
2004 SUMMARY Bill Fair Market Value: Assessed with:
588,000
Valuations: Last Changed: 07/22/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.100 170,000 446,700 616,700 NO
Totals for 2004:
General Property 2.100 170,000 446,700 616,700
Woodland 0.000 0 0
Totals for 2003:
General Property 2.100 154,000 411,900 565,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 140
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT
1 f l;
S l
Owner 34ux_-e,&4,a, //0 At -e r
Address .SO ~ ~D ( ~ s'T R ~ - ,1
City/State lYudsan Ir /l0 1, t c c of ~Legal Description: ~F/oF
Lot Block _ Subdivision/CSM # 1 f ° ~a S~ `
'/4 %4 ,Sec. J3, T a$ N-R ao W, Town of Trod PIN# o 0 0 - aov
?,8. Zv. I 1 I
I';.
SEPTIC TANK DOSE CHAMBER HOLDING TANK INFORMATION:
Tank manufacturer ty ee s e r Size ST 000 Setback from: House 13 Well 60 P/L
Pump manufacturer Mode
Alarm location
(H ING TANKS ONLY)
Setbacks: rvice road Vent to fresh air intake Water Line
Meter location
Alarm location
SOIL ABSORPTION SYSTEM:
Type of system: T/t I kra for Width 3' Length 2, -4- Number of Trenches 3
Setback from: House 3 S Well __Za~ P/L Vent to fresh air intake > 80
ELEVATIONS:
Description of benchmark 7-6 J9 elf Elevation
Description of alternate benchmark sow P, k !ec( Elevation VS
Building Sewer Y q( 3 ST/HT Inlet 'Fs- q o ST Outlet ~Y° E2 PC Inlet
PC Bottom Header/Manifold 839-522 Top of ST/PC Manhole Cover 8f3-22'
Distribution Lines ( ) ( ) ( )
Bottom of System O '73-7,5,
O ( )
Final Grade O % Z `f E) O ( )
Date of installation Iz- 15-1 27 Permit number State plan number `r
Plumber's signature License number 7 (0,y Date 3
Inspector
Complete plot plan Or
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 VIEW
30 38r
too sue`'
-4D
Nk
INDICATE NORTH ARROW
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County:
'Safety and Buildings Division ST. CROIX
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT) SanitaryEe 5113%
Personal information you provice may be used for secondary purposes [Privacy La S.15.04 (1)(m)). L y
❑ .Citv 4 village Town of: State Plan ID No.:
BRUHolder's LNZE: HOMES I TM
CST BM Elev.: Insp. BM lev : BM Descr ti on: Parcel TIY4lb-1227-60-000
4Z. I A2 .l .i ~ vL- c
TANK INFORMATION v ELEVATION DATA A9700491
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic W ~ e5ef Benchmark S 07, 8412,1
Dosi ng
Aeration Bldg. Sewer ?q1 3
Holding St/Ht Inlet (ap ~~r7. I
TANK SETBACK INFORMATION St/ Ht Outlet gyp 52.
Vent
irIto ntake ROAD Dt Inlet
TANK TO P/ L WELL BLDG. A
Air
Septic _5D, 3 CDC L15-1 NA Dt Bottom
Dosing NA Header / Man. g~ g?j9. 2
Aeration NA Dist. Pipe
35 d39 /5
Holding Bot. System 0 "7 9319' %5"7
PUMP/ SIPHON INFORMATION Final Grade ?q2 48'
A14. 9^A
Manufacturer Demand
G t . ~Z 8'4S i~8`
Model Number GPM Sf_lyi,,„~,Lo,, zFj Ffy3 22
TDH Lift fiction "kVstem TDH Ft
Forcemain Length"._..-Dia. Dist. To Well
SOIL ABSORPTION,SYSTEM
BE REN H dth t Length / No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIM G 3 DIMENSIONS
SYSTEM TO P/ L BLDG WELL LAKE / STREAM LEACHI Manufa rer:
SETBACK FER
INFORMATION Type O t / ~ ~2 CHAMOR UNI o el Num e . _
System. K ltn 12. d
Fr«NO I TRIBUTION SYSTEM
,lo Header / Manifold /11' Distribution Pipe(s) , x Hole Size x Hole Spacing Vent To Air Intake
Length Dia. Length (PZ5 Dia. L* Spacing Z
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth)bf xx Seeded/ Sodded xx Mulched
Bed/Tr nchCenter Bed /Trench Edges ti Tops ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: TROY 13.28.20 GOVT LOT 2 290 SALISHAN DRIVE
lnsfzl/~►r v5
2 f 'Pu Cc~
v
~ `~.s~
PI n ' revision require ❑ Yes L~ No
Use other side for additional information. H f
SBD-6710 (R.3/97) Date Inspector Signature No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
*6~onsin SANITARY PERMIT APPLICATION 201eE. Wand a hnllgtonnAve lion
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 12 x 11 inches in size. St Croix
• See reverse side for instructions for completing this application State Sanitary Permit Num er
zqq/7
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 I ORM TI N -PLEASE PRINT ALL INF RMATION
Property Owner Name Property Location Gov t Lot
1'U~ 1/4 1/4,5 13 T 28 N, R20 W
Property Owner's Mailing Address0 ,fe S Lot Number 6 Block Number
U -9L e
City, State / Zip Code _Sy6/ Phone Number386-,4951 Subdivision Name or CSM Number
( 719) p
II. TYPE F B 1 DING: (check one) El State Owned [aim, Nearest Road
Public 1 or 2 Family Dwelling - No. of bedrooms 3 Town DF Troy Fast Cove Road
III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s)
1 ❑ Apartment / Condo 040-1227-60
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. Lg New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5, ❑ Repair of an
-----System System Tank Only______________ Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 410 Holding Tank
12 ❑x 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-
450 900 900 .6 837.7 Feet Feet
VII. TANK Capacity gallons Total # of Prefab. Site Fiber- Exper.
INFORMATION g Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
New Existing structed
Tanks Tanks
Septic Tank qtjoq
1000 1 Wieser ❑ ❑ ❑ ❑
,Wki2jj"~X 1000 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.
Plumber's Name: (Print) Plunjbp 's Signatur tamps) rffl6kV No.: Business Phone Number:
Paul CJ Steiner 1(715) 425-5544
Plumber's Address (Street, City, State, Zip Code):
N8230 945th Street: River Falls WI 54022
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved nitary Permit Fee (Includes Groundwater ate Issued Issuing Agent SiQnaaaturree/(No Stamps)
XApproved ❑Owner Given Initial 1916 00 Surcharge Fee) /7` 97 p
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.
11. 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 a!/ 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.
~w
NC'PC~zCt~L►~ , 0-00p hvi)
Owner's name San. Permit No.
2°tI
H63.05 PLOT PLAN
Show:
FF Location of building served F-41 Dosing chamber
Septic tank Q Vertical/horizontal reference point
System elevations 24 8 1.1
Building sewer
Effluent system Well
t Replacement system area Q Property lines w/in 50' of system
Distribution boxes Scale = = SOS , or dimensioned
Pump and controls:
Mfr. & Model No. Vertical Lift Size Force Main
Friction Loss T. D. H. Vol. Dist. Pipe Gal.-per Min. Gal. per Cycle
Place check mark in appropriate box, indicating item is shown on plot-plan,below:
w~ - IN . so' F~tol" 1 utmtt m a
x w~ ZS' SeVnc -rro%ht
g,4 B3
3 Pro"
ltov se %Z`OP V"pv a 1000 GeV- W%O km e4vt4um SeTI e-
Zs'oC ~"pu L
2S~ ~ J
hN..
h ( ~ J
v~'~x f
-11. 5 OF 5,.d -e winGlor
I Il`rp aR L t~~}9IUCo
g i'I t't ~~l L o+v 8 6 H '~'~M T LUT LL"
3~t{4fl14~. PUC ~tp~
By the granting or approving of the above plan, or upon the event of a subsequent
permit being issued, St. CroixCounty and theSt.CroixCounty Zoning Administrator, does,
not assume or hold itself liable for any defects in plans or specifications, plan
omission, examination oversight, construction, or any damage that may result in or
after 'nstallation.
Plumber's igna ure icense o.
Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page X of 3
Later and Human Relations
Division of Safety & Builclings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but Ste' C1QM u(
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. If
dimensioned, north arrow, and location and distance to nearest road. O 40 - I *Z2.7-60
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION RI~Wy ~v BY DATE
t. `l~-l,t 11.13•
PROPERTY OWNER: 'r L %LSOIv , c-kip p ~t PROPERTY LOCATION
C`p STEUE)N3 CVOb GOvT. LOT Z 1/4 - 1/4,S 1I T '2Z N,R Z o E
PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
% k Zp P W E- r.LD G bZz1 U t E P U1fi OF S^-tS K•fTrv
CITY, STATE ZIP CODE PHONE NUMBER []CITY (]VILLAGE MOWN Z~Sr AREST ROAD
CU,v W SVOLZ (*7fS) u2S_ Z1S-7 colic Qaft-b
[>Q New Construction Use PK] Residential / Number of bedrooms qSO [ ] AdditiQ,n to existing building
j j Replacement [ J Public or commercial describe
Code derived daily flow q9Q gpd Recommended design loading rate S bed, gpd/ft2 • 6 trench, gpd/ft2
Absorption area required °t~ bed, ft2 5 d trench, ft2 Ma)dmum design loading rate S bed, gpd/ft2 •6 trench, gpd/ft2
Recommended infiltration surface elevation(s) 8 31- 7 ' ft (as referred to site plan benchmark)
Additional design /site considerations ~~4v1M~1rvD 1 }-to S gcr - Lb UuF c-r-4 Vt L-( EM MG '13 0zs
Parent material St L'M SNDUhQ%Pf OJOz S el:Gti Flood plain elevation, if applicable ti - A ft
S =Suitable for system CONVBMONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem ®S ❑ U ®S ❑ U CI S ❑ U ®S ❑ U [q S ❑ U ❑ S RU
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Barry Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed rerrtt
s Z 9-3~ ~.S'to - ~s` ~esu1T \nnv-~, eS .
Ground Ground 3 b 37 1 v 316 - G~ 1►y1 S b~ m U-14- C-S - 1-1 • S
elev.
.UL) .6 ft. 4 _37-9D 1 O`Z R Y - S l7 S wl - • Z
Depth to
limiting
factor
Remarks:
Boring #
Z 9.35. ,.s vcz Y/Y 1 cSbt2 ~nU~. ~5 _ • s
Ina
3 5-89 to~t~-~llY - SSG os~ rv►t - •g
Ground
elev.
841.8 It
Depth to
limiting
face
`Remarks:
TName:-Please Print Arthur L. We erer Phone. 715-425-0165
Ad:
egerer Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022
Signature: 44~ Date' kV 0 [ Ii CST Number:
C d ~ 9-7-Al i 97 M00576
PROPERTYOWNERVft-VISW, CUbD ;t Cut> SOIL DESCRIPTION REPORT Page ' Z ,of 3
PARCEL I.D.# 04 0- V-?-Z-7-60
ti
Depth Dominant Color Mottles Structure . GPD/ft
Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench
3 0-\S co H m Z! 2 - 1_ z b ous •'s
Z 1 S Z0 Zo 4 ce- L 2 ~ s ~k vv%, - cQs ~ • S . ~
Ground 3 ZA-Z9 tO`zfl- 3l6 - S~ l IT m eg •~1 •S
elev. ~.s yR Y/6 - 1S ~`FS O S CS ' S
8y 1-9_ ft. Z9-y. S 9
Depth to S 4s-bs ~o"tl2- Y! _ S ~I g o s1 CS 's
limiting
factor 6 6S _ 9 I D y R Y~ - S p S -1 • S
Remarks:'Cxr 'KUK-Q- 1~ 1-~~ `l3 -tz~SPQ~ZT' ~Y Mr- FVt V' 'rUsU-j, cvOD K CVpp o►JF+(_Q.
.Boring #
0_11 102 ZL2 Z'FS~k w~' QS S
Z 11-2y t O 1Z 3/ i, L Z s bk m d, s • S
Ground ~ Ztf.'Z~ 1 p y R- 3 / 6 ~ s ~ ~ Uh wt V CS -5
elev. 4 fL v~` - 1s 9 `FS O S 9 1~) CS ~ • S L
ft.
S 4Z-6Z lb ylZ V1 S4' O S5 M -L
Depth to
limiting f,2- 91 14 `l iL V/ S S9 I •Z
factor
Remarks: Per 133 .
Boring #
0~ 11 ~ V ~ Z I Z - S~ Z r,'1 P I ~"ti'1 ~ I- g.S - ~V P O. Z
5 Z 11-zu lO ~•t Cz 3/(~ ~ St f Z`~-su~ h1 ~1- eg _ - S • ~
Ground 3 20 -y ~ 1 b H Q_ ~ / _ 'F s ~ 1 C S blt, 1vt v 'Fh e - • • 5
elev. -Cl 2 b CL l S 0 s rvl _ 1 E3
2.o ft.
Depth to
limiting
tQr Z,
fac
°'ll
Remarks:
Boring #
Ground
"elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(8.05/92)
PLOT PLAN Page 3 of 3
SCALE 1"= &O
3>- v3E to Sir AT IQR-Tf' z.s' FIW" -SyIs M'1 S.
O d.~
y; _w su
O S_ -_Bw13- t.sZ:l'`o-N
S-I -LS < 161 b % Q)1~ C' = S F ~~.+A IIS ~ .
O ^ b cone'
RL.
/i MlREi12 RA,
BM'1 YrZ -
9
13x1 ~ 1 6, y - - - - B-3 Q
I I
36
DR
t w S e Su t`t-P~b t'f SZ ~A MW 1N 1~ ! i~ l
ZS I Ptr~p ►x ureRw
B~ 3 'JF"ec~ ~T 1 oT L INk
9.~-361
afaa n% c~- 1ti~ ~-t ,~I► 19 9 '7 (715 ) 4?-5-01 65 M00576
CST Signature Date Signed Telephone No. CST #
Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of 3
Labor and Human Relations
Division of Safety & Buildings in accord with IL.HR 83.05, Wis. Adm. Code
COUNTY
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but PARCEL I.D. #
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or 046-
APPLICANT dimensioned, north arrow, and location and distance to nearest road.
INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: N-b 1j -LSptu , c_rp 0 ~t °LvOD PROPERTY LOCATION
CAp ST-Eb0\3 CAD GOvT. LOT Z. 1/4 - 1/4,S 13 T Z$ N,R 'Z-0 E
PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
Snl tS K-fv
1\_L0 p I N!`' r_LDG blzlu E - P UA'i- o'F
CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE NTOWN NEAREST ROAD
lZ I,v~1 W S 0L7- DI S) 4. IS- Z'1 S 7 IVIST_-CauE 2oakD
[>Q New Construction Use PC] Residential /Number of bedrooms DSO [ ] AdditiQp to existing building
j ] Replacement [ ] Public or commercial describe
Code derived daily flow u,.SZ gpd Recommended design loading rate S bed, gpdfft2 6 trench, gpd1ft2
Absorption area required 01 0'Zi bed, ft2 -1 S O trench, ft2 Ma)amum design loading rater S bed, gpd/ft2 • I- trench, gpd1fl?
Recommended infiltration surface elevation(s) 8 3 '1- 7 ' ft (as referred to site plan benchmark)
Additional design / site considerations 'RRtQ"M q"lrvp Irk -m) st M-Lb UV Fiuj 4MVz L_MMN G CytIft") a EfLS
Parent material Si M SM1MQ j'i• ojeu S ~t6a Flood plain elevation, I applicable 1~3- -10\ - It
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM M FILL HOLDING TANK
U=Unsuitable fors stem ®S ❑U ®S ❑U WS ❑U 2S ❑U CAS ❑U ❑S ~U
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
Boring # Horizon in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Ier&
Z s t Z +ablrt rn ~tir cS - S
Ground 3 3 b 37 10 `-t tZ 3 f, 61~ 5 h'1 S X12 YYl U`fl- S
elev.
$U).6ft Lf 37-9D Vo`ttz Yl S O S~ w1
Depth to
limiting
factor
Remarks:
Boring #
k~) Li S Z _ 5
Z Z 9-35 s yR Y/Y ~s~ 1 ~sb(2 ►~nu'~. ~5 •S
3 S-89 toKtz-~l~t( - SSG oS~ v~~ - •-t
Ground
elev.
%q I.S It
Depth to
limiting
factor 'Remarks:
T Name:-Please Print Phone. 715-425-0165
Arthur L. We erer
eg%rer Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022
CST Number. _
Signatue: R7-at I Date: 11 ''U,- III L997 M00576
PROPERTY OWNER 4KLU5W I CQOb Cupp SOIL DESCRIPTION REPORT Page "Z of
PARCELI.D.1f_ ON 0- 12-27- 60 `
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bardary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed r-S
3 0-~ s ~o ~ z.! 2 - L 2,ouS . s
Ground 3-7.9 to It R ,316 - S l C S lyk tg •y elev.
8141.9 ft. 29-qS -)•S `1 R VA - s
~S '6S O S w~
9 cs 6
Depth to S 4s-b S ~o `-t t?_ y! s ~`fS o sq w~ cS • s
limiting
factor _
7 91 ` 6 6s - 9 t p ~-Y~ S p s ~1 --t • g
Remarks:N'R' qUPc~.c Mc"C~17 1- l$ A 3 - -,Z oN r -ay M Q Ft %-z vlft~, CUs Utv, r c, p n K cc p ou F Lia .
Boring #
o-tZ ~o\-► 2 ZII - L Z~ s bk ruti
13 Z 1'Z -2y j O y tZ 316
L Z `F s b tT wX oL s - , s I
Ground 3 Zy. za 1 p y R 316 s ~g bh V eg •y 1..S
i t ft. Z$-~I 2 S R-, 1s 4 ,Fs O S g 1v1 CS , S
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limiting
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i
Remarks: S K~'r 1-~1z Y,3' per- 133
Boring #
s,
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$ elev.
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Depth to
limiting
Remarks:
Boring #
'i
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
S8D-8M(R.05/92)
- PLOT PLAN Page 3 of 3
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CST Signature Date Signed Telephone No. CST #
Nov-14-97 11:16A Cabinet Concepts 1 612 438 3495 P-01
• 4
Standard Erosion Control Plan
for 1 & 2 Family Dwelling Construction Sites
According to Chapters ILHR 20 & 21 of the Wisconsin Uniform Dwelling Code, a soil erosion control plan needs
to be submitted and approved prior to the issuance of building permits for 1 & 2 family dwelling units in those
jurisdictions where the soil erosion control provisions of the Uniform Dwelling Code are enforced. This Stan-
dard Erosion Control Plan is provided to assist in meeting this requirement.
Instmctlons:
1. Complete this plan by filling in requested information, completing the site diagram and marking (J) appropriate boxes
on the inside of this form.
2. In completing the site diagram, give consideration to potential erosion that may occur before, during, and after grading.
Water runoff patterns can change significantly as a site is reshaped.
3. Submit this plan at the time of building permit application.
Site Diagram Scale: 1 inch = f Oo feet
EROSION
CONTROL PLAN
LEGEND
PROPERTY
LINE
EXISTING
DRAINAGE
- O I
TEMPORARY
R DIVERSION
FINISHED
DRAINAGE
/ LIMITS OF
GRADING
oi. SILT
I EA FENCE
R
STRAW
? _ BALES
GRAVEL
Y•
VEGETATION
O SPECIFICATION
G TREE
PRESERVATION
ArtcA _J IDSTOCKPILED
SOIL
Please indicate north
by completing the
arrow below.
Z I
%Ar
-N~
_J I
PROJECT LOCATION Lot 6, Salishan Drive, Salishan Development, Troy Township
BUILDER Bruce Lenzen Homes, Inc. OWNER Bruce Lenzen Homes, Inc
WORKSHEET COMPLETED BY Bruce Lenzen DATE 11/14/97
C-105
SF:I' I I 'PANIC NJAIN•I'IsNANCI AGIZf:I;MF.N T
Sl. Croix County.
(1\~'Nf•.IZ/It(I1'h:IZ ~r _ ~ _:~T - i
MAII,IN(; ADDRESS
/ -_C't~r?_- _ t✓`z- ,
t Sri c tM't or 1 V*f-
PROI'h:R"IN AUURF,SS d`~
(Im ari„n of septic system) Please obtain From the Philn[nl; Dept.
1,IZO111•,IZ IN LOCATION6c' e t{ oo4 I/4 Section I _ _-N 1Z w
c- -
TOWN ) 0 ST. CIZOIX COUN'T'Y, WI
r'I;R"III II.USItIZVI?Y N1AP , VU1XIMI? L'A(.:Is , I,O'1' NIIM131;lZ _
Improper use and nlainlrnrulce of your septic system could result In its tttcniature failure to handle
was(e~;. Ploper main(cnance consists of pumping, out the septic tank every three years or sooner, it needed
by licensed septic rank pumper. What you put into the system can affect the function of the septic tank
as a tlcatnl,-nt slag;c in the waste disposal system,
St Croix County residents may be eligible to receive a grant for a maxim m of 60% of the cost
of replacement of a failing; system, which seas in operation priot to July I, 1978. St, Croix County
accepted this program in August of 1980, with the tequiretnent that owners Mall new systems agree to
keep their systcnl properly maintained.
'I he propclty owner ag wes to submit to St. Croix Zoning a certification ludo, signed by the owner
and by a plater pluniber, journeyman plumber, restricted plumber or a licensed pumper verifying; that (1)
the on silt wastewater disposal systcnl is in proper operating condition and (7) after inspection and
pumping (if necessary), the septic tank is less than 1/3 full of sludge and scant
the undersigned have read the above requirements and agree to maintain the private sc%vagc
disposal syslenl in accordance with the standards set forth, hereih, as scl by the wisconsin DNR
('eltIhcatloll stating (lilt your septic Ills been 111ifintallled inilst be co111ple(ed and l('turned to the St Croix
Comity 7.oning Officer within 10 days of the duce year ex ion date
SIGNED:
)All;:
S1 ('Ioix (otnity 7.oning, Ollie e
(iovemil ill ('clitel
1 101 (';i,inlrhai I Road
I lad :on, AVI '0010
~r
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.
r 1
Owner of property dCA- r ( C~
Location of property 1/4 1/4, Section __,T_AT N-R. I, W
Township Mailing address I !J,0 Address of site
Subdivision name Lot no. 46
Other homes on property? Yes No
Previous owner of property l h e
Total size of property n1 , 3cl-cs
Total size of parcel
Date parcel was created ~e c ~1 y
Are all corners and lot lines identifiable? _ Yes No
Is this roPertY being developed for (spec house)? No
Volumc 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. .53 and that I (we) presently
own the proposed site for the wage 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 Applicant Co-Applicant
lll~-Q'7
Date of Signature Date of Signature
DOCUMENT NO. WARRANTY
o MQ. ~,(~iscons:n Corp.
Edward J. Harrison III, Steven G. Cudd, and Jeffrey P. Cudd, d/b/a
Salishan Partnership, conveys and warrants to Bruce Lenten Homes, Inc., R EGA T E OFFICE
the following described real estate in St. Croix County, State of
Wisconsin: ST, CR0}X Co.. W1
Rpa'd for R@PgN
NOV 14 1997
Lot 6, Plat of Salishan in the Town of Troy, St. Croix County,
Wisconsin. 8:45 A M
Re (star of Deeds
TRANSFER
.
NAME AND RETURN ADDRESS
FEE
MIDAM 600 2 dA p80N
S
Hudson W1 54016
040-1227-60
Parcel Identification Number (PIN)
This is not homestead property.
Exception to warranties: easements, restrictions and rights of way of record, if any.
Dated this day of November, 1997.
(SEAL) (SEAL)
C~j
Edward LJ. lHarrisoo II Z-iZeven G. Cudd
(SEAL) r (SEAL)
J fr tCrNOWLED(
NT
AUTHENTICATION ME
illrr~~s
Signature (s) STATE OF WI'SCeNSIV )
)
C-C-O K ss.
COUNTY )
authenticated this day of 19 Personally came before me this ~t day of
Q
- N00-9 !Mlc~cc 2 - the above named
Edward J. Harrison III 19
to me known to be the person(s) who executed the
foregoing instrument and acknowledge the same.
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not,
authorized by §706.06, Wis. ::tats.) ~I
Notary Public L`ooK County, wti'
THIS INSTRUMENT WAS DRAFTED BY:
My commission is permanent. (If not, expiration ate:
Joseph D. Boles AV Q isY~dJ )
Rodli, Beskar, Boles & Krueger, S.C.
P.O. Box 138 "CH ICIAL SEAL'
River Falls, WI 54022 rIE?C}UES !)AYILA
i(OTARY PUBLIC, STATE Of ILLINOIS
MY COW ISSION EXPIRES 08/09/00
Cpl7PAGEdns ACKNOWLEDGMEN%•`Q~/Ln
.
STATE OF WISCONSIN ) G
~ COUNTY
~tx
ersona. l came before me thug day of
VQ fYl1Z
19 `f the above named
Steven G. Cudd
to me known to be the person(s) -1 the
foregoing instrument and acknowledge..••e sAine.
`e`E?Q1
SU k)
Notary Public H N - County, Wis.
My commission is permanent. (If not, expiration date:
ti c v~ , 29
7% STATE OF WISCONSIN )
ss. Z r :U
I COUNTY > 4
* ~ersona ly came before me th' day, of
IV AQ m ~ 19. i 'the.aboANamed
Jeffrey P. Cudd X 5 P
to me known to be the person(s) who executed the
foregoing instrument and acknowledge the same.
Notary Public rol(~, County, Wis.
My commission fs^permanent. (If not, expiration date: