Loading...
HomeMy WebLinkAbout032-1070-70-000 Q c I 3 0 D O m C o ~ I N o I I _N C Z C LL o I 4 I I co Z N O O Z r ~ ~ d Co N O C C7 U O Z C w U O .N-p c Z N H m N~ ~ ~ v I N I c a U o I C O co p ~ Q w I Z F- Z p I N ~ Z 0 O N M II N ~ j O) al a! co LL U) O. m w c M O y d a) w O ' v O G a n~ N LO E 0 U) (n 0) Z H I-' O O ° 0 0 0 n z° •~„i yaaa fA J U (n m rn tl+ O M O Ip~iV C p O O O C) C) m y O 0) cs ~ ° co d co a) } CO co l~l ~r N O w 1~ O O h N7 C CC °i p Lll C O 0 O O O, E C, CC) rr O M m O E O- 'a N N O O O Y C O N M E v O IS _ O c (V 04 o L.: O E U ~ CO p N co • y' O N CA N O ' N ZL=3 ` (n O C6 . v CA v £ a • U O. d O 41 C E 15 `~1 A U a O V') U 0)~j W"ssclmsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page / of li6or and Human Relations X67' 7 Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but -5y not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. 02- APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY p, DATE /dr / , nl A PROP RTY OWNER: PROPERTY LOCATION GOVT. LOT 1/4 110 z T N,R ~(or , 0y) AF -5/,j PROPERTY OWNER':S MAILI G ADD ESS 'LOT # BLOC # SUBD. NAME R M # , - 7i 2 CITY, TA E ZIP CODE PHONE NUMBER ❑C , VILLAGE JOTOWN e-A NEAREST CAD ( ) _ - New Construction Use 1A Residential / Number of bedrooms Addition to existing building [ ] Replacement [ ] Public or commercial describe Code derived daily flow er gpd Recommended design loading rate J/ _bed, gpd/ft2 57- trench, gpd/ft2 Absorption area required bed, ft2 ~ trench, ft2 Maximum design loading rate _/y bed, gpd/ft2 -S trench, gpd/ft2 Recommended infiltration surface elevation(s)l~ ft (as referred to site plan benchmark) Additional design / site considerations Parent material - jg dZOQ L?6.,2-5~,~Flood plain elevation, if applicable ft S S Suitable for system 1 7 CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U Unsuitable fors stem ®S ❑ U JAI S ❑ U ® S El U ® S 1:1 U ❑ S ®U El 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 Trertch 1....- j 7- /4 Ground ` elev. ft. - Depth to limiting factor -9 Remarks: Boring # r Ground elev. b.F - - ft. Depth to limiting factor Remarks: CST Name:-Please Print ✓ Phone: Address: 14,1 Signature: Date: CST Numbe : 3 PROPERTY OWNER SOIL DESCRIPTION REPORT Page ~tof= PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. nt. Color Gr. Sz. Sh. Bed Trench \R: Ground elev. ft. Depth to limiting fact 7 ~ Remarks: Boring # Ground j elev. ~&o- ft. Depth to limiting factor >92 Remarks: Boring # «S 3 Ground I elev. V 7 ft. Depth to limiting factor ?9,2 Remarks: Boring # y:'ti vv Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) f - e~~ . _ ~i XJf-/JC.y f~~h°is'• 7`~a~ /~S~.s~.F, lz(/Q~O ~ x ~o~~~; o~~, / ~ G C~1 ~ ~ ~s~T/~io,-a? _ _ ~ ~ ~ ~ i S s / t 1 P 3 n °z ,3~ is o / ~©t ~ a~ ~o~,~ 30~~ -~o>.C.iJz ~3~~~~. tea/. vl=W 1\iV//lllVllll/ YV1 J`!V1/ t - - N00°40'07"E 2640.37' - - - U) R/W N000 23' 24"E 66.00' 66.00' c7 WEST LINE OF THE SW 1/4 "I N In _ _ _T - - - - - - - - 1 O I••_ 21n 676.55 S.T. H. r! 113511-- 1897.82' / N _ o m I W m f*1 Nrn ••I aop ' /909. ? i 60 8 fuA i 0 93 953,, ~z 60~ 2; D £ N p O / N I 6\ o W W r 11 0 Asa 1-11 X0-x, ()o W A O - F)" Lt z l< in &D 0 LA I(D 090 -4 jC>j I I (per OO tr 0) 65, _ W <)4 c1N O 0. • 0 = tr fjy` m roEn rororo r z C I -u / Z5 rt G c rr C) O 1 'A Z WW N m I~a~l :3 aP- z 10~ jr- Cn ^ m y 00 6~ F N> = 0 0 ,,.I m A O ` .I , O W Z m l I Ul m o1 cn X\- r 1 I Ln F' 0 to N H ~p tA1 I~' IW A p VI a m P n a ~o1 or m a` z _ x7 O A _ Z EAST LINE OF SWI14-SWV4 N ` N (n b H CJ• O _to _ 0) = n w ro n 0 03 IC 0 tl P, :j m O A z r u O n (D fi Z 2 In v m Ir ro N D\ I~ D W 500.23'24"W 429.63' A 0 ti ro I - -4 fD I-j OWl Ln 2` W A m Z Im 0 A J O I~ I~ `I n m Io N 7 CL 2 1 Itn a m rn N• a d= rn W C Jr- \A g 1> - (Ai O I D N IU1 K iZ G I'< 7m Co at T ID rn Ir Io IO 0 to m = ly `A f~. to rn ,z I IF- w 0 m CD W >E F I•~ A I N A N V (D N ID D t O 0 l N r 0 l - J 10 W m L m O N000 56' 19"E 590 69' > 639.51' A n N y REC. AS NO-30'E 626.10' to y rt REC 593.10' 591.76' m ..1 1 r1 11r S01002'19 W 641.01' C) I to C O r TEAST Q7 A m -1 Ln I- In . of ~ I~ IC N I O z .4O m A IOD II~ (A u) 626.86' ~m~ ? a 0 0 25' 44" W 702.14' p zA LINE OF THE SE 1/4 OF THE SW 1/4 lD N m f ~m - y-93 MAY 2 0 1996 54279 7~ IVEY0111 Y CRQCOUNT 'S RECORD 1996 CERTIFIED SURVEY MAP AKpR>i~ENH.wN Located in Part of the Southwest Quarter of the Southwest Quarter and part of the SGCcoixCoCeW~ S Southeast Quarter of the Southwest Quarter all in Section 25, Township 31 North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin. Being Lot 7 of Certified Survey Map recorded in Volume 10 Page 2775 WEST LINE OF THE SW 1 /4 WEST 1 /4 CORNER SEC. 25 N 00'40'07" E 2640.37'--- 11117- i 11 r Ir- Prepared for and at the request of of W/5 ( 1-D IC 1 10 Lindale Development Corporation 11 cn Cy ~d iC) 10 1. i-i 964 192nd Avenue DOUGLAS J. 2 I irv I. i I P New Richmond, WI 54017 ZAHLER 2 IJ 1o I g Drafted by. James M. Broult S-2145 Cf) 711 01 La" 0o R 0 (D I' jf 1(n I0 y o 0. a a 095 s 0 0 1 -------L IJI~ IK: 100' v a\ ~O 3 x a N O O Np. r• Z I I~ i0 i~ iO I~0 IU•i -n rri Z y ~ 0 0 , O 7 ' i~ I~ I 5 ~g / N 02'17'4,3 E i o~ c 40 00 i o i~ IJ I• Ilv N116.2~265 - 0 2.74.99' i = ° m w' 5' o rn I I -I 100 , = o co 0~ 1 Z 1c o~ 3 IZ5 Z c < 0 I- \ v Z w I D 00 m ° N E- 9- " I IC) CAN M' M M n I r' I Lq -14 0 r4. -40 14 I rn I 00 A 1 I~ l`~Ns ' ~ Ir G) o z ~ CO iK II- ` rn I I L" \ N 1z I U1 Ui c,1 I I- 0 1 o ccO c I N I rl Lo I IJ I0. 1 ICn 1 ~ Z 0 1V) I I I m O W - 429.63 - g r I 1~ 10 A , m i< I \ N 00'23'24" E 1 O I- O GRAPHIC SCALE F O n 0 i 0 r 0 50 150 300 450 600 a I~ z 1 N U? 000 .-II= N 00 - - - - I- - - L4 =6mmillIll CA 0~ 0) Ip ! Vi ! i ( IN FEET ` I G-) 01 ) 1 1 inch = 300 ft. o II- O I I C77 I II- A N oIZ Ii orn a I( I~ w 4 (A V) GO APPROVED _ 1 co R-N 00'30'E 626.10' 0 - ;mo if I N 00'56'19" E ti_ N r i N Z 01 3: I 639.51'-- Q o O I //~~p~ p V1 , - --590.69'-- e - I APIA 2 9. 95l (D/) N i I - --ss1.~s'-- Z I ~ M M 50 ~I 1- 641.012--I co 0 rn I \I~\I s 01 ro2'1 s" w I Cf) A s'r . CROIX couzJr z° u R=N 00'30'E 593.10' 1 i co 1" am roh®nsive Ptm** p N M g !,y Zering anti m 0 i0 10 ~ Parks Ca~'M 0 0 = I i- I_, I W s~" ..mot m if ,%ot recorde-d _ - 0 -n :;1 a STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ~ ADDRESS 307 Su.r, SUBDIVISION / CSM# LOT r# SECTION D2.5 T N-R-- W, Town of So r,, p r s e.T ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM .o I a l~ 4 y ao'-~Jl ' C INDICATE NORTH RROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. f r$ p J Qp r BENCHMARK: ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: Wiese Liquid Capacity: /dzo Setback from: Well nr,4- House ~j Other Pump: Manufacturer Model# Size Float seperation Gallons/cycle: Alarm Location -.SOIL ABSORPTION SYSTEM Width: Length 95 Number of trenches a Distance & Direction to nearest prop. line: Wa&-J, So Setback from: well: Np. House S/ Other ELEVATIONS , Building Sewer ST Inlet. 9 ST outlet 93, ! PC inlet PC bottom Pumv Off Header/Manifold 93.3 Bottom of system Existing Grade 9 $•'j~ Final grade 9X;9' DATE OF INSTALLATION: PLUMBER ON JOB: P7-k~~ LICENSE NUMBER: 156,3 INSPECTOR: 3/93:jt V iscOfsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division Y (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 262420 P is N W. 1; ❑ City ❑ Village Town of: State Plan ID No.: SOMERSET CST BM Elev.: , Insp. BM Elev.: BM Description: Parcel Tax No.: , , ~ s ,Zr, y A9600128 TANK INFORMATION ELEVATION DATA G-/// TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosi n9- Aeration Bldg. Sewer c~ Holding St/ Inlet TANK SETBACK INFORMATION St/#t Outlet TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake 7 ___C37 Septic >50 Q/,¢ NA Dt Bottom t Dosing NA Headert#a4err Aera Dist. Pipe Holding Bot. System /a sLs PUMP/ SIPHON INFORMATION Final Grade MamAiixt.Lrer errand a r Model Number GPM if F L action System TDH Ft ead TDH Lift Forcemain Length Dia. Fi I Dist. To well T-1 SOIL ABSORPTION SYSTEM BED/TRENCH width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS d l'? DIMEN I N SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHI INFORMATION Typeo CHA ER ~anufacturer: umber: System: tferi~- S ~Sbc). y OR'UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grad ems"Onty Depth Over O Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center S~ Bed / Trench Edges Topsoil E] Yes ❑ No E] Yes El No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: SOMERSET.25.31.19[~,SW, 5W, 191ST AVE 41 f-A f-' r i ~~l ' f. a t l~ Y 4 - l ' r O~~t Plan revision required? ❑ Yes 2_1gO / q Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert No ` Safety and Buildings Division vr`~R SANITARY PERMIT APPLICATION Bureau of Building waterSystems 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 81/2 x 11 inches in size. .S • See reverse side for instructions for completing this application State Sanitary Permit tNNumm r O The information you provide may be used by other government agency programs ❑ Check it revistoT nT6pieviOUs application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATI N ocation Property`O)roner N~me S Property LW 1/4, S 3 q 7 T , N, R E (or Propert tOwner 's Mailing Address Lot Number Block Number City, State© Zip Code Phone Number Subdivision Na or CSM ber f Z S` o A~ ~N C `fit Cn r (1/S ~ -535 . to rt „Q v le,,,Aa TYP F B ILDING: (check one) State Owned C] ityy est Road II. ❑ Village Public 1 or 2 Family Dwelling - No. of bedrooms 3. Town OF So 30 111. BUILDING SE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo D3 A- r7O -170 J 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1.j New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System ------System System Tank Onl-- Existing System .........Existi 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 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) EI vation 10 944 1 dv j 5 AJ 7o7- A Feet ~S'S Feet TANK Capacity Site VII. INFORMATION in gallons Total # of Prefab. Fiber- Plastic Exper. New Existin Gallons Tanks Manufacturer's Name Concrete struttedCon- Steel glass App- Tanks Tanks Septic Tank or Holding Tank b O A LU i ✓ ~ 1:1 1:1 11 ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ D El Q VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans- Plumber's Name: ( ) PI tier's Sign ture (N Stamps) 7MPRSW fNo_.: Business Phone Number: N-CIX L , P -71S Q Vlo S-1, IS Plumber's Address (Street, City, State, Zip Cod C'~ M 0 Al (,j S 0 h IV t IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sa itary P rmit Fee (includes Groundwater ate Issued issuing Agent Signat re (No Stamps) i surcharge Fee) f XApproved El Owner Given Initial {/G- Adverse Determination Ido X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: SOD-6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Divi ion, 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 nevv 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. ,J 6. If you have questions concerning your, onsite se~7vage 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 mLst include: 1. Property owner's name and Trailing 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 i ine 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 8 112 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 ; I 6 , , i + 51, i S + t +M6 Y'` 0 + ' i a e , t { ! , f - L f ~ I - f Tom'-"~'_ a,--~•. - 1 ~ ~ I , t + S its. , i -a j ~ , + t , t ~ ! 1 s f t i ' i , li 1.0 i t 3*6,> / L,,,1^1 PAGE OF Li Sys A CrUSS Sec~lon o SysTen- Fresh Air Intels And Observation Pipe . Approved Vent Cap Minimum 12' Above Final Grade 20- 42" Above Pipe -4* Cad Iron To Final Grade Vent Pipe Marsh Hoy Or Synthetic Covering i - tsln. 2' Aggregate . Over nPipja Olitrlbutlon I t Plpe -Tee ! BaBeneath a Perforated Plpe Belo r o -Coupilne Terminating At Bottom Of S1614te Pru~ose~ Anal gr, / • ~I~~•.~ tom SOIL. FILL DISTRIBUTI0f P E • APPROVED StfW 11ETIC COVER 0K AK~sN HAy OF STRAW Q~ OF g6GR AGATE cJ 9"70F E op ~ -2t/Z A G REGATI- DI•STRIBt:JTIOU PIPE TO BE AT LEAST -4 IIUCHES BELOW ORIGIAJAL GRADE A►JU AT LEAST20 IAICHES BUT k10 MORE THA1.1 42 IUCNES OELOW FINAL GILADE MAXIMUM PaPTH OF EXCAVATimj F'RoM oKI&NAL 6KAcF- WILL BE IUC14ES MIKIMUM 9EPt-H OF EACAVATIOM F.RO1M. ~tfs1WAL CAW WILL. 6E -L- INCHES SIGFJED: LICEU5E DUMBER: _ JSI!~3 DATE: ,Wisconsin, Department of Industry, SOIL AND SITE EVALUATION Lat~or;h-d Human Relations Page of Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Attach complete site plan on paper not less than S 1/2 x 11 Inches in size. Plan must County Include, but not limited to: „vertical and horizontal reference point (BM), direction and S T, percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # APPLICANT INFORMATION -Please print all information. Reviewed by Date Personal Information you provide. may be used for secondary purposes (Privacy Law, s.15.04 (1) (m)). Property eP roperty Location Govt. Lot r&I 114S&I 1/4,S ~s T 3 f N,R E (or)(& Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# ROZ S A4.41..: Cl State Zip Code Phone Number Nearest Road 1-4 0 2 S._ . ('~f S" El City Village Town 3S' 1✓j,- -Y I © New Construction Use: ® Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow yso gpd Recommended design loading rate _,'/--bed, gpolft_ J__trench, gpd/ftz Absorption area required /12-5- bed, 0S00 trench, ft2 Maximum design loading rate bed, gpd/ftz . S trench, gpd/ft2 Recommended infiltration surface elevatlon(s) 7 A, Z ~ tt (as referred to site plan benchmark) Additional design/. ite ~nsidera ions Parent material 19 b Flood plain elevation, if applicable ft Holding Tank S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill T u Unsuitable for system ®.S El u ~s El U R.s El u ❑ S ®u ❑ s O u ❑ s E01-1 SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench l / o•S o 3/i SG %raQ aw Ivy S, man 2 --/S. 'I.sYRy13 - s~ .2,~a~ m aS ,3 G Ground 3 - 7, W3/9. elev fc Depth to limiting factor , in. Remarks: Boring# 1 6-7 g $L R G ~iW h% ~y sr .1~ 7. S-YR il3 sc B F a l .r;, G In L Ground elev. Z 1 fL Depth to limiting a tor in. Remarks: CST Name (Please Print) nature Telephone No. • /E 8 GL3 Address Date CST Number 3 /SFo s7"t SOIL DESCRIPTION REPORT , PROPERTY OWNER Page •Z • of PARCEL l.D.fi Boring # Horizon Depth Dominant Color.. Mottles Texture Structure 2: In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Consistence Boundary. Roots Bed , Trench SL IFsB~r !n-e- w s" Ground _l1 3 SL jlhsl3i~` M M? y ,5'~ elev. 9~S.fc Depth to limiting factor Remarks: Boring # 4j 'y 3 -/go 7 sY 3/ -S . Ground elev. 98'r ft. ' Depth to limiting factor Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # p. /j /G esa S1 FSA1 A 0Uj Z . r? /3 SL .2 F see a,$ 7S1 31 SC h,L ,S;. Ground elev. Depth to limiting factor 7A,$- In. Remarks: Boring # Ground elev. ft. Depth to limiting factor In. Remarks: SBDW-8330 (R. 0"5) Sw Swszs ?3 i AI R t S w s-n, 3 va _9 Te- Lai LeT 4,.4 EJ No7~- aM q-,y4~ Noose /husT ~('c .?~'~ian+ Cve /1 a,vt r.~t S'a ' s6 RiPeq I ~-I /c SfaP-C S8' i 7r~ Q t 1 ~ o. ~ tom C 1 y8' 31 Wisconsin I?epartment of Industry, SOIL A'~-° ~WAL~*TION Labor and Human Relations Page of Division of Safety and Buildings in accotlh(``Wlth S;JLHR 8 r , Attach complete site plan on paper not less than 8 1/2 x 11 inchss'ih size. Plan must C° ty _ include, but not limited to: vertical and horizontal reference poin~ (14M), directioir apd ' S percent slope, scale or dimensions, north arrow, and location and distance' to nearest road. creel I.D. # APPLICANT INFORMATION - Please print all infor ".26 7. r.evieEwed by Date Personal information you provide may be used for secondary purposes (Privacy L ` srt q.04 (1),{m))., r` Property Ow er ocation Q,1~ vj Govt. Lot g&l 114S~/ 1/4,S.24- T N,R 75' E (or)(& Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# S 3 CiY 'j- State Zip Code Phone Number El Nearest Road L✓,p, of o ZS.• (7f g- )~4!7__5i - City Village Town 3S~ ® New Construction Use: ® Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow q-31) gpd Recommended design loading rate i bed, gpd/ft2 ~ S_ trench, gpd/ft2 Absorption area required 21 bed, ft2 1360 trench, ft2 Maximum design loading rate bed, gpd/ft2 . S trench, gpd/ft2 i Recommended infiltration surface elevation(s) Z+ Z ft (as referred to site plan benchmark) Additional design/ ite considerations Parent material 19- ib Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In-Ground Pressure AT Grade System in Fill Holding Tank u= unsuitable for system E&S El u s❑ u C$ s❑ u El s B u ❑ S Z U ❑ s ® u SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench l v- ' 0 3/z S G l J'C14 C r W la, 1 , SS 141 2 =is ~.sY2yI3 s~, .2~~~Z vF aS ~6 G Ground 3 7 5~~3/y S1 1/"slele MCIA I elev •'y . S Depth to limiting factor //S'_in. Remarks: Boring # S f 3 st B Mb'2clf aS I .r G Ground elev. e/ft. CM, Depth to limiting fa for prin. Remarks: CST Name (Please Print) nature Telephone No. 6437 Address 7K Date CST Number _V6 6 SOIL DESCRIPTION REPORT PROPERTY OWNER Page .1 of 3 PARCEL LD.# BoringHorizon Depth Dominant Color Mottles Structure G D/ft2 # Texture Consistence Boundary Roots in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed Trench Q-.7 io !?3/, SL j/seK t ",) /b•-• 2 >-is' 2. /t4 .dll eaS /F / Groelevund -3 Ir..no �.S /li/ r" Y .S[ /PseK ls4 --- 1dF 4S,G(oft Depth to limiting factor 711O in. Remarks: Boring# / (a s" kYR3/2 — S2 // t( . Y ;S' 19 -I5 ? Y'Y1 v/3 S ,,7,c5e.e. h ir' iP uS >Y . S—' , 6 fi-Aft 7.S-Ye31 Y Sill so.S., ,,c /d' •S Ground elev 8:S./ft. Depth to limiting factor V* (Vin. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed , Trench Boring # / C' l� /Uwn_ S< /FM< Qtc> , Y ;/ S'_ z >;lzo )5119W3 34 02F5e hiviCR aS ,s— ,�. 3 a„its-7 pye 31 y _' 5L ,4i ,s Ground elev. Lft. Depth to limiting factor ',/ls in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBDW-8330(R.08/95) Ica�� Pia r P/a h 01/7/9/ S C}r //t. Siivvy 2S73I II? CA, CST 3vo9 tor 3 .$o/n et.i eT Tu 2 S)' M., 4-/-c 9'2, 2 ' am. # / lop P � �,t� Lau , ,•r Tp ,/ Prk 4A,L4I 9'7 v4 �► z oc,.rn O Lt-,_c If e`}, — — LTI.f 3-ooS" At,'eS A I>20 Nort � yG tiousz Masi' 4c c'�icn• Gi<//r1vzr, t So ' i ems' 13-1 R��l�e��,<h it a pe s, 4-- SLc f e sgr �. Sy` �s= iv ' a:m ion r r Lindale Development Corporation 964 192nd Ave New Richmond, WI 54017 715-247-3079 OWNER it Pik -1 H IyEI ELaPI M /of s. 1917 F f-iY:-. yit~ ~ R C M ~y~, b• ..iNir'v-.ems fat -950c :h se ~ :iF::• ',i l Ypo th f1erE :u l ~ 35 ' 64 Trees S~mersei M Lot # 1: 3.5 Acres, one-half wooded, well, level lot ---$19,000 Lot # 2: 3.01 Acres, some trees, SE slope---$16,500 (Sold) Lot # 3: 3.005 Acres, gently rolling ---$18,000 Lot # 4: 3.163 Acres, rolling, secluded---$19,000 Lot # 5: 3.017 Acres, wooded background, some trees, excellent view---$19500 (Sold) Lot # 6: 3.005 Acres, southern exposure---$19,000 Lot # 7: 3.216 Acres, one-third trees, sloping, secluded, southern walkout--$19,000 ELECTRICITY, PHONE, NATURAL GAS, CABLE AND PUBLIC ROAD TO ALL LOTS ALL LOTS PERKED FOR CONVENTIONAL SEWER SYSTEM; PROTECTIVE COVENANTS PROVIDE FOR: LAND USE, DWELLING SIZE, ACCESSORY BUILDINGS, AND NUISANCE CONTROL 1196 I STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County y. ` a ' , 1 1~ ~t S OWNERBUYER ~n iVIAImG ADDRESS 3 07 $ ~ r I PROPERTY ADDRESS -7I D' 9 f J / L 'may o y (location of septic system) Please obtain from the Planning Dept. CITY/STATE S a Vv\.Q r^ jd-_-.Qk-0 ~ -q O a-s' PROPERTY LOCATION :SW 1/4, c,J 1/4, Section 5 T--14~N-R J W TOWN OF SAO w"'Q ors z- ST. CROIX COUNTY, WI SUBDIVISION L LOT NUMBER CERTIFIED SURVEY MAP , VOLUME_ PAGE 309 LOT NUMBER 7 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, h in, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must completed and returned to the St. Croix County Zoning Officer within 30 days of the three year te. SI DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 S T C - loo 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 /`i/4 ,f Location of property. ieJ 1/4 S iJ 1/4, Section T_3_ N-R__L!~_W Township M go, s,e j Mailing address 3 7 7 S u K K!%_0 Dl. S S o Address of site / % S7 S s ~T l~~- 'oc S Subdivision name Cc;. e Lot no. Other homes on property? Yes ✓ No Previous owner of property _ \(-),p n\ L y_,1 ('c) ^ 2 Total size of property ctcrre,~ss _ Total size of parcel ~.y Date parcel was created o? 9 Qi / _ Are all corners and lot lines identifiable? Yes No Is this property being developed for ('spec house) ? Yes ___No Volume 1/7✓- and Page Number3 / 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 ffice of the County Register of Deeds as Document No. E's9 aK ?Z,~ , 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 o licant Co-Applicant Date of Signature Date of Signature r ~ 542798 CERTIFIED SURVEY ~ MAP z lapR2 a 1996 LEEK H•W~-SH Located in Part of the Southwest Quarter of the Southwest Quarter and part of the ~FtTMepislerofDeeW1 S Southeast Quarter of the Southwest Quarter all in Section 25, Township 31 North, $tCtulx~~ Range 19 West, Town of Somerset, St. Croix County, Wisconsin. Being Lot 7 of Certified Survey Map recorded in Volume 10 Page 2775 ,v WEST LINE OF THE SW 1/4 WEST 1/4 CORNER SEC. 25 N 00'40'07" E 2640.37'--- -.1=~.. Ir- Prepared for and at the request of 0~ vV/S I I I-p 1~ I 10 Lindale Development Corporation ' A`' 0 I IG~ 10 964 192nd Avenue 41 A I I I• I~ New Richmond, WI 54017 0 co DOUGLAS J. N s 1 J 1 Im z 215 s Iv 0 -bc. Drafted by. James M. Brault 1~C * ~~Q I CY) ~ ' HUDSON, \ o po• p I cn to WIS. 0, ~ s!N 1 Ln 0 Lt, ;U -11 -n (1) < 10 (D o 0 -0. 00 F; M5 r-ICn 0 a ate 2 : - ----1---IIJi-~lO X00 v0 a W :°3x i to I 10 Ir- IJ 10 IU1 © • . - r' 3 N FL cp I I I, 10 z w w r " O 7 0 ~ 7 03 o iw Iv i~ iN N~16r5~266 0 0274799' E ° m w ~ ' ~ 0 L4 C ' I le -3 2 Dao n I r IC V v 3 3 41 ON t- - - IC - - - p0/ j m IZ C W R N m 10 r. I< 03 N o o c o. C'0 10 V; CD -n co 0 1, > r- 7- GO V z~ Awo~ i-0 in wa,~ v N Im° cn i ~ ° OD z co to. a I r- I I rn cvn Jai ` 1~'' ~r Z 0 I~ 41 cp q IN I~ ` 0 ----i--- I IJ 100 1 D IC7 i~ ' i Z O I Vl I m p o u r - v1 w - 429.63 g N 00'23'24" E I 0 a O I I- O t' GRAPHIC SCALE ~ Z I W j 0 50 150 300 450 600 ~1= N 00 - - - -IN-- I W I< W I -04 1~ I C I~ rn I G7 ~ (IN FEET ) o Ir- j rn I If' 1 inch a 300 ft. O I I P s I Ln 10 u 'IZ I 1 000 ICD 1~ L4 (4 N a7 Im I I I J'I n? *R -N 00'30'E 626110' IN io ' v v PPRO'(~ V E N 00 '56'19" E r/ 639.5l'-- --590.69-- tv v APR 29:961"W co co ~ - --5s1.7s'-- Y+ C MM rn 1- --641.01_-I C7 ()D 0 rnl 11~ S 01'02'19' W I' / z ST. CROIX COUNT- V 8 0 00 RiN 0030'E 593.10' I i = Z z Pfawl* O N Q rR I N~ Ir- I O V 0 Zoning ate Parks CornrtiitlE09 r- C) o Ln 10 zcno if not recor&A voi_ 1175PAGE 37 WARRANTY DEED Document Number MISS- - S OFMRFI0 CROIX O Y., Va Redd for Roca:d APR 2 9 1996 i Return Address 4.30 P . CIA Re of D8Gd3 Parcel I.D. Number: Lindale Development Corporation conveys and warrants to Karl E. Mathys and Marie E. Mathys, husband and wife, the following described real estate in St. Croix County, State of Wisconsin: Part of SW1/4 SWIM and part of SE1/4 SW1/4, Sec. 25-T31N-R19W described as follows: Lot 7 of Certified Survey Map recorded in Vol. 11 of Certified Survey Maps, page 3085, as Doc. No. 542798. i This is not homestead property. Exception to warranties: Easements, restrictions and rights-of-way of record, if any. Dated this 2A"- day of April, 1996. t y Lindale Development Corporation (By 116zll' (SEAL) Dale Schafer, Secre AUTHENTICATION Signature(s) - Dale Schafer authenticated this day of April, 1996. Kristina O land TITLE: MEMBER STATE BAR OF WISCONSIN THIS INSTRUMENT WAS DRAFTED BY: Attorney Kristina Ogland Hudson, WI 54016