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HomeMy WebLinkAbout004-1027-90-000 Q o ~ c; M O m h o o ~ in r. x o ~ I N C O O 'j CO O h O i L ti ~ -3 I 0 m c z ~ ~ o LL C r p ~ 'O 0 j 4 E E 3 co > i', Z y (>O « O O Z y co w a m N Z N O C U~ N U O Z :!t a 0 O Q) (h E N Z5 O N C C ~p 0< < o z CD 'D N _ d N N N ` 3 N y J d m !*~L1 m a 'wq ~ C E g v L) G a L U) V) (n I-- F- CO 3: ° ° o v 3 3 •~a to aaa z 3 O N N J U n 6) rn I'. N } O Cl) (o *~V Y N zr: O rn 0 0 _ N N > O O E ` N Q I~ W ~i d Q a Ni C 1V O O M 01 C O C p c E O N O m O N C_ d CL O O O O r p C E N N N In 7 Y A _ Q) 0 C6 q ;3 r co -0 cli -C a) co E 0 • L~ °o U U (D O N U) v ~ E N w w y a a a w • fl U C C o ~ O R O 3 M O A Ua2 '0 mti o O 0) I li I, I v Ii / . I ~ I ~ I z U. 0 3 ~ I r ! z y w E 7 ~ jj N I- Z ! a Q~ / j ~ O I O z a o I m H r voi Z ~ v E ro 5 C ~ C N 0 L O C O/ w ( j ~ ~ O -(D C i C- COD Z rn E N N 0 CL y Y C O d i O r o o a o rrra 0 0 0 z -(L a a w, ~ m U Ill r Lr) rn ~ o v7 i~ ;'r I ~ a o N m 0 ! ~ oo rn ~ O I y co L i. C).6 0 W d Q in m © a co U) ~w 4 Q G) 11 C E 00 00 0) CD U) CL m a) o o c 05;:z 1 W CO 00 0 15 r N C O ai O N c0 N op m FBI N N >m O m C Oki -8) MN z U51 w # CL • •C~ CL d .V ! d C r~ 7 r A c0 a 2 iii U) ) AS BUILT SANS ITC - TARY 104 SYSTEM REPORT 11 ld~ cc w 3 SS6 OWNER ACv~ ST CROix n s" cpuN~' pPllHGOf~IGti. ADDRESS 7 SUBDIVISION / CSM# LOT SECTION 1;2-_T 2(f N-R W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 90 i M wP (-C.-, to t` INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. r BENCHMARK' 4e ALTERNATE BM: Lo ~D SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: /yJG✓~ Liquid Capacity: Z c, Setback from: Well House Other Pump: Manufacturer n,-' ~ 1 Model# Size Float se eration f p Gallons/cycle: 149 j Alarm Location- k SgOIL ABSORPTION SYSTEM Width: dLf, ~ Length /t1- ' Number of trenches Distance & Direction to nearest prop. line: y~U Setback from: well: House /od Other ELEVATIONS Building Sewer ST Inlet. ST outlet PC inlet PC bottom Pump Off Header/Manifold Bottom of system Existing Grade 1 Final grade DATE OF INSTALLATION: f~ i PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: 3/93:jt Wisconsin Department of Industry, Labor and Human Relations PRIVATE SEWAGE SYSTEM County: Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) sanitary rm. o.: 62364 Permit Holder's Name: 2 ❑ City ❑ Village X1 Town of: State Plan ID No.: LLA JASON CADY -CE CST BM Elev.: Insp. BM Elev.: Parcel Tax No.: BM DescriPtion: /GV 7 / .0, ~y ~_,e ate` A9600173 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Aerati Bldg. Sewer 7 d9 S~'' Holding St/ Inlet _/50 ' TANK SETBACK INFORMATION St/ Ht Outlet y( TANKTO P/L WELL BLDG. Vent to ROAD Dt Inlet Air Intake Septic >/a! ® 1 NA Dt Bottom Dosing NA -M@jWoaMan. Aeration NA Dist. Pipe Holding - Bot. System PUMP /SIPOON INFORMATION Final Grade Manufacturer rna t~emand "l° o-- -T a s ' Model Number pM 0Zp, C-. , ✓ Qd a. cv C-✓ v 27 62:2 TDH Lift (o4 Friction System TDH 15~3Ft He Forcemain Length Dia. 'r Dist. To Wel SOIL ABSORPTION SYSTEM BED/TRENCH Width I Length ! No. Of renches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSION S I S ,S DIME SYSTEM TO P / L BLDG WELL LAKE / STREAM LE G Man cturer: SETBACK INFORMATION Type O nd OR UMBER o ber: S stem: vh DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length 2L Dia. 2 Spacing 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 Bed/ Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: CADY.12.28.15W, NE, SW, 45TH AVE n /i Plan n revision required? ❑ Yes No Use other side for additional information. SBD-6710 (R 05/91) A ^ t- ! F``_`^ r G /C D r yctk~~- a dCert~tf .Yr _ J ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ~dld dsv wt, ta.J, w,~.r - /G.7! Jr~.~cl. i ~~'■i.ii i SANITARY PERMIT APPLICATION B Beau oan Buildis fBuilding WaterlSystem! 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 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. J~ Cr • See reverse side for instructions for completing this application State sani2e] rn.t~Numb~j~ 1 The information you provide may be used by other government agency programs ❑ Chec:i o previous apphtfafion"j~/ [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Property Owner Name Property Location J .o C~ Ila A1,5 1/4 sw 1/4, S T ag , N, R / E (or) (0 Property Owner's Mailing Address Lot Number Block Number P.O, City, State Zip Code Phone Number Subdivision Name or CSM Number w ~ o ( 7 7%6 S-597 II. TYPE OF BUILDING: (check one) ❑ State Owned [I City Nearest Road ❑ Village Public 1 or 2 Family Dwelling - No. of bedrooms Town OF c qd eve 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. I4 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 (R 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 O Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation /SO 7 Feet Feet VII. TANK Capacity in gallons Total # of Prefab. Site Fiber- Ex er. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel Plastic p New Exist in strutted glass App. Tanks Tanks Septic Tank or Holding Tank / coo El ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber 60o 1 / (1 ® ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibili for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) P s Signature: (NOS ps) rP/MPRSW No.: Business Phone Number. rlcZ Att 5666 /S - ~3 - C'SI Plumber's Address (Street, City, State, Zip C IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved tary Permit Fee (Includesrroundwa,er Jate Issued Issuing Agent Signature (No Stamps)` Approved ❑OwnerGiveninitial CrV Surcharge Fee) Adverse Determination ~ X. CONDITIONS OF APPROVAL/ REASONS FOR'DISAPPROVAL: SBD-6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To: Safety & BuilJings 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, 608-266-3815. 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 isto 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 into 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. ego% SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations May 15, 1996 2226 Rose Street La Crosse WI 54603 HALVERSON BROS 1020 N BROADWAY MENOMONIE WI 54751 RE: PLAN S96-40374 FEE RECEIVED: 180.00 CEBULLA, JASON NE,SW,12,28,15W TOWN OF CADY 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. Sincerely, rard M. Swim Plan Reviewer Section of Private Sewage (608) 785-9348 SBDA-7997 (R. 10/94) S96-40374 Jason Cebulla - Mound MAY # a S96-40374 i l Location: NE 1/4, SW 1/4, Sec. 12, T 28 N, R 15 W Town: Cady County: St. Croix Date: May 16, 1996 Owner: Jason Cebulla Address: PO Box 192 Hammond, WI 54015 Plumber: Lawre a Dahms Signature: ~2c.~L c f Q_ License # MP 5666 Attachments: 6748-Plan Review Application SBD 8330 page 1: cover 2: calculations 3: plot plan 4: system cross section 5: plan view, lateral detail 6: pump tank exit detail 7: pump curve page 1 of 7 [ f d ib v A+ a a System Calculations One family residence bedrooms Loading rate 0,6 gallons/sq ft per day Depth to ground water 71- Zto in Depth to bedrock >16 in Cross slope J~s % Force main length (00 ft of Z in Manifold/header length A ft of in Drainback (4.124, gallons Lateral length @ -k"°•o ft of Z in Lateral elevation k01•4.. ft (bottom of pipe) Lateral hole size '14-- in @ (00.0 in ( S' o f t) spacing i holes/lateral, % holes total Lateral volume gallons Total lateral discharge rate ti~•T gpm @ ft head Elevation difference ft Friction loss 0 ft @ g gpm Total dynamic head 2t 0, S~ ft Pump/si0on Z 0 gpm @ Z- ft of head Manufacturer Model # Sw S 3 Dose volume gallons Lift/si~hon tank G w gallons Septic tank %cmr-a gallons Measurement pump on & off ~•S in Height alarm from tank bottom in Reserve capacity 34"36 gallons talcs page Z 0 f - ~ A-i O K VLb 1 `q - ~ ` o ~T o...~ N ~ - S W ~ 1 Z • Z ~ ' l S- W 896-4 037 4 QJM V :'~C C Aft 4 4?o r1 / `N Swbff+ 1 ( n 1 w~ /F ~ o►.F~,..~Gn - ~Xl ~ ~ e y~Q ~-'4 o %.4) teak n M e ~ ~$70 ~ Lim ~ ~ ~ ; t~ ~ ' S CVqp 4L a. o~ 4L %Ow~ 0. Mt ~~t 9~`Ow Zu 3 r ee.IL ~ ZS~ n 461- s~~, loi.~l- ~ e ~ 3 eQ s.~ . l cro.q ~ Atr.~ w..a ` \ b i..~oco:1 3 ~,Ow q1W •vt ~q.9 ems. .r' 10.10 ~ ~-S~ O `I lo•br C11.•2•r . k'. y ~ ` S + ~ e.\ Q a...b ea. .4 : u.~ 1.~} on. (Jt ~ u~,~ l~ aa, t v n..l. + o JJ ~ .Xt~ 4f•, V L e.w. f.~ Oda i py v ~i-TOM wY.1~ S o v. o} Y o.1~ 4 1 Y a T~.•. ' ~ ~rM~ OJIr•~X T ~ ~..:.~w. Z.. S ( t ~ o w~ ~ e i Y u c. K ~ •~✓1 ~}-Duct w•o.: y 9w c- in- ~•O r • ~~g. 1~ 0`1 +-t o , ..t a.~..X cn..~. ar `01 ! o 1:» e ~ ~9 O .o o~~ w ` ~ ~ t~ W ~v S e~ 1 WEATNERPitOtJF LOCKING*COVRR JLNGTION "V, orACOa~IacT-~ 4" C.t. Il'%pVX 4slrw'fti L'o f *'V777 i x. PIPC o wolbtup"D SOL. Z4" t.D. YicIJT LOW M41~y0L8 4 tAlw. Ak"r wGty ZOO ~ NO:t p/IR01fLQ A C.Z. FIF 1:T QONrS WFLES 3' owo PIPS Q 2" IImicSZum ON -46 ECTIOMi GAO Lev, ~ 1 •~i OzF • PuNP COQ c"rc • ~v j,6toGC I Ll `$3.O SEPTIC SPECIFI'CATIOI~IS mw~ DOSC TA1JK MAIJUFACTIIRCR: • yL` IdUMeER OF DOSES: PER. D" TAIJK SIZC: 6ALLOMS DOSE VOLUME \t1 ALAR P1ANNiACTV4tR: IMCWDING GACKPLOW: GALLONS AODCL AWMOCR: 1p K CAPACITIES: A= U-' ( wcAES OR 343.6 GALLOIJS SWITCH Tupt: 13 = IkICNEs ox ZT.T GALLOWS PUMP MAIJUFACTURCR: ""°"O` C iuCHES OR \ 2 WLLOUS MODEL WUMOCR: S w Z 3 On INCHES OR \b GALLOWL SWITCH TWPC: M PUMP AIJD ALARM ARE TO DE MILIIMLIM DISCHARIA-RAT'C \'8 6PM INSTALLED 01J SEPARATE CIRCUITS VERTICAL DIFFEREWA OCTW69M PUMP OFF AUO DISTRIOIITIOIJ PIPC.. );+61 FEET + MINIMUM NCTWOKK'-S0PPI.V ►RCSs►uRE FEET + o FEET OF FORCC MAIN X r' ~ %r" nFRIC'fIOQ FACTO&.ir FEET • TOTAL oukAMIC HEAD as Z..~ 1 FEET OTERNAL DIM&W6iO1J4 Of TANK: LENFiTH;WIDTH ;LIQUID DEPTH 16" • rc 'OIL a+( • i~ ► I 1 4 e 011 f-1-11 - Performance Data 32 Pump Characteristics Pump/Motor Unit Submersible Manual Models SW25M1 SW33M1 W za LL Automatic Models SW25AI SW33Al a 1/3 HP W - S Horsepower 1 /4 1 /3 U 16 Full Load Amps 8.0 10.0 2 1/4 HP J Motor Type Shaded Pole (4 pole) Q R.P.M. 1550 e Phase 0 1 Voltage 115 Hertz 60 0 0 10 20 30 40 50 60 CAPACITY-U.S. G.P.M. Operation Intermittent Temperature 120-F Ambient Total Head (feet) 4 6 8 10 12 14 16 18 20 22 24 NEMA Design A 1/4 HP 44 41 36 33 29 26 23 18 12 6 0 Insulation Class A GPM 1/3 HP 47 45 43 40 37 34 30 26 22 16 10 Discharge Size 1-1 /2p NPT Solids Handling 1/2y Dimensional Data Unit Weight 30 lbs. I All dimensions in inches Power Cord 18/3, SJTW, 10' std. 3-1/2 5-7/8 Z Component dimensions may (20' Optional) 4-1/2 vary for 1/8 inch 3. Not for construction purpose 1-1 2 NPT unless certified 3.1/2 0 DISCHARGE Materials of Construction ` 4 Dimensions and weights are approxunole S On/Off level adjustable Handle Steel 6 we reserve the right to 3' 1/2 make r evnlons to our lubricating Oil Dielectric Oil produas and their Motor Housing Cost Iron specifications without rrotice Pump Casing Cast Iron Shaft stow - - - _ + Mechanical Seal Faces: Carbon/Ceromk - Shaft Seal Seal Body: Anodized Steel Spring: Stainless Steel 9; Bellows: Bum-N PUMP 10-1/8 ON 9-1i2 Impeller Thermoplastic Upper Bearing Bronze Sleeve Bowing DISCHARGE HEIGHT Lower Bearing Single Row Ball Bearing 3-1/2 3 OF PUMP F Strainer/Base Plastic Fasteners Stainless Steel AURORA/HYDROMpTIC Pumps, Inc. 1840 Baney Road, Ashland, Ohio 44805 (4191) 289-3042 06/14/96 09:26 WRTSON FORSBERG-ERICKSON HUDSON 001 I, it ?i %t TTIAJ: ~I F osa0, bultd. 'ate 6 - /Y- 4 6 Aer- , 15 He /VOUT ~ iMle s~cf6~`~e 40mmt 4e p.s o,r PrIvper~ in Cad ~~..csla=p sedi•n ~Z is :,F . n ~ AL r , ;0 O Q o } 1 o 00 too Y Wiscgnga Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations CiJision of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY St. Croix Attach complete site plan on paper not less than 8 1/2 x n size. Plan must include, but not limited to vertical and horizontal reference poin i ~ aj,~olk of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and dist t s rdad.. APPLICANT INFORMATION-PLEASE $1 Nii9RMAT107V1;, REVIEWED BY DATE PROPERTY OWNER: PERTY LOCATION Jason Cebulla +GQ LOT NE 1/4 SW 1/4,S 12 T 28 N,R 15 ACM W PROPERTY OWNER':S MAILING ADDRESS # BLOCK # SUBD. NAME OR CSM # PO Box 192 ► `;viii:. e s;3 'CITY, STATE 7IP CODE - N 1 ~+(A- CITY ❑VILLAGE MOWN NEAREST ROAD Hammond, WI 54015 7.1 x;796-5467 r Cady 45th Ave. [x] New Construction Use I< ] Residential/ Numbe ` 3 [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate .5 bed, gpd/ft2 .6 trench, gpd/ft2 Absorption area required 900 bed, ft2 750 trench, ft2 Maximum design loading rate .5 bed, gpd/ft2 .6 trench, gpd/ft2 Recommended infiltration surface elevation(s) 100.9 ft (as referred to site plan benchmark) Additional design / site considerations install 5' x 75' rock bed mound on 99.9 as upslope edge of rock w/ 1' sand fill Parent material loess over SS Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ❑ S EkU as ❑ U ❑ S ERU ❑ S O U ❑ S f3U ❑ S )MU 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 Tre & 1 0-5 10YR 313 - sil 2 m cr mvfr cs 1f/m .5 .6 2 5-19 10YR 5/4 - sil 2 m sbk mvfr - gs 1m .5 .6 Ground 3 19-27 10YR 4/4 - sicl 3 f-m sbk mvfr cs 1m .4 .5 elev. 7.5YR 4/6 87.0 ft. 4 27-34 10YR 4/4 f2d 10YR 613 scl 0 m - - - NP .2 w/ considerable gr & occasional cob & s Depth to limiting factor Remarks: Boring # 1 0-6 10YR 313 - sil 2 m cr mvfr cs 1f/m .5 .6 :IX 2 6-21 10YR 5/4 - sil 2 m sbk mvfr cs 1m .5 .6 <:_z< 2 10YR 613 3 21-28 7.5YR 4/4 m2p 5YR 5/8 scl 0 m - - - NP .2 Ground elev. 88 ft. lacks 24" suitabl soil Depth to limiting factor 2111 Remarks: CST Name:-Please Print Henry F. Grote Phone: 715-665-2681 Address: PO Box 57, knapp, WI 54749-0057 . Signature: Date: CST Number: 10/7/95 3065 PROPERTY OWNER Jason Cebulla SOIL DESCRIPTION REPORT Page ~'of.,3 PARCEL I.D. # 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 0-6 10YR 3/3 - sil 2 m cr mvfr cs 1f/m .5 .6 2 6-17 10YR 5/4 - sil 2 m sbk mvfr cs 1m .5 .6 Ground 3 17-26 10YR 4/4 - sl 2 m sbk mfr cs 1m .5 .6 elev. 99.3ft. 4 26-32 7.5YR 4/4 c2d 10YR 613 sl 1 c sbk mfr - - .4 Depth to limiting factor ?All -L Remarks: Boring # 1 0-5 10YR 313 - sil 2 m cr mvfr cs 1f/m .5 .6 4 y 2 5-17 10YR 5/4 - sil 2 m sbk mvfr cs 1m .5 .6 3 17-27 7.5YR 4/4 - sl 2 m sbk mfr cs if .5 .6 Ground 5YR 4/6 elev. 4 27-36 7.5YR 4/4 f2d scl 0 m - - - NP .2 1ni _4 ft. sidewall see @ 32" Depth to limiting factor 27" Remarks: Boring # 1 0-4 10YR 3/3 - sil 2 m cr mvfr cs 1f/m .5 .6 5 2 4-20 10YR 5/4 - sil 2 m sbk mvfr cs 1m .5 .6 3 20-28 7.5YR 4/4 - sl 2 m sbk mfr cs if .5 .6 Ground elev. 4 28-36 7.5YR 4/4 f2d SYR 4/6 scl 0 m NP .2 7.5YR 6" 99.3 ft. - - - Depth to limiting factor 28" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) y c t ,j( ~30ti ~bk~\q- ~,01 J~0.Y NQ-~SW~1Z'Z~'lS W ~kno Cqa^_> a-~ r aa.S) rp Q- 3 r4 Q-4 o i.4) cot.") C a rz, r &Q.v U o--.% i~r, C L'/ t ? !t, M c~.< SZ Q 3 o-~ S 05/21/98 10:18 $ COUNTY CLERK STC-105 SEPTIC TANK MAINTENANCE AGREEMNT St. Croix County OWNER/BUYER Ce bullam. MAu,mG ADDRESS d - r3aK PROPERTY ADDRESS (location of septic system) Please obtain from the Planning Dept. MY/STATE PROPERTY LOCATION PE 114,_.2w 1/4, Section _ j a T a FS' N-R /~W TOWN OF ST. CROIX COUNTY, WI SUBD)<VISION N a I,OT NUIVIB>gIt p CERTIFIED SURVEY MAP YOLUMEA1Y, PAGE ~_d ,LOT NYIM BER Improper use and maintenance of your septic system could result in its premature failure to handle 'w'astes. 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 mad 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. 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.Sasoh 'E, (ie LL"(0. a-d Wel,as 01- esm-tsk: Location of property NE 1/4 S4J 1/4, Section /A ,T a$ N-R /S W Township ~etc~y Mailingaddress ~0.8gt /QZ Aft'"okd Address of site Subdivision name-- - Lot no. Other homes on property? Yes No Previous owner of property L.o:us z2fan cle Total size of property Vo a,- Total size of parcel YO acres Date parcel was created- Are all corners and lot lines identifiable? Y< Yes No Is this property being developed for (spec house) ? Yes ~e,, No Volume and Page Number yt O 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 re(Tui ed. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No. J-2 (p 4.3 , 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. S gnature of Applicant o- pplicant Date of Signature Date of Signature OOCVMENT NO i ST 1TE GAR OF WESCOrM$i FORM 2-1982 r ;••4:.F r SF F•: sr'1,•<3 CA7A l i WARRANTY DEE[? F. 7 .1148ps7 U I 0 i Louis Zupancic and Jane E. Buncium, h.usband..- - I, NaV I 0 '199 and wife I f - - - 9:30 A. Jason R. Cebulla and Melissa _ :Ottveisand Nana-'e to _ _ 11 Ae~t:rct M_ KoranSKi , L'nrorr'~~Tm)iv;duals, as Dirt Tenant. j€ acs the following Cescnped real estate .n = St . Croix - _Y~ Courtly. r' E.~rc jk W € Tax Parcel No. 004- 1 027-90 ~I The Northeast one-quarter (NE 1/4) of the southwest one-quarter {~4 (SW 1/4) of Section 12, Township Z8 North, Range 15 West. i TRANSFER `I r ? 1 is not This - homestead property. ost (,a not) E>upr~pn ~p Warrant~03: i i 31 October 04tvd Irra day of 19s5- {SEAL) - -15EAL € _Louis Upancic - Jane E. Bungum € (GEAL1 ---,SEA+ 1 i r i AVTHENTICATIQl4 ACKNOWLEDGMENT it .,I Sr~]~dtur@ESIw_ _ - _ STATE OF WI5CGN3IN F ~ I St_ Croix Count y k.` :3 aUthFnl+C3tM1 ih~~.-..-_Qdr OI 19 Pgr .C(-L JWfn ba I..r4` r"e t: 3 _-Q ay of i~ H''- i ~'~9~lhe ~44ve namea ii Louis Znpanltic and Jane Z. - - Bungum, husband and wife j { TITLE: MEMBER STATE BAR OF WiSCONSiN _ _ ;j