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Page of
Labor and Human Relations Y, bUlL AN OHT
Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
GO f ~ ~o COUNTY
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but
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. 67-s GN .S~'ff U6/P i'fP t•} T/O.v
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: Gf#Rr PROPERTY LOCATION
GOVT. LOT SE 114-5-6- 1/4,S T 2F N,R 9 E (or) W
PROS TY OWNERS MAILING DDpESSS v~ LOT # BLOCK # SUBD. NAME OR CSM #
~i .v1.}✓o~2 - ~mvv7~y DKS
C TY, STATE ZIP CODE PHONE NUMBER ]CITY QVILLAGE MOWN NEAREST ROAD
/eI016k. Fit 11 S , W l' SYo12- (16) y2S - 9032 Tit' o e0VW7z y OXCS RIO
[ New Construction Use (lCJ Residential ! Number of bedrooms Addition to existing building
j Replacement [ ] Public or commercial describe d
Code derived daily flow X00 gpd Recommended design loading rate bed, gpd/0• 3 trench, gpd/ft2
Absorption area required bed, ft2 trench, ft2 Maximum design loading rate yid bed, gpd/ft2 - 3 trench, gpd/ft2
Recommended infiltration surface elevation(s) ft (as referred to site plan benchm k
Additional design / site considerations SE>~ 0AE-WefRe-5 - 215 TEL'-va" T'/ ~ X14 p a- ~y
Parent material 5L5 ~Z - d~ s~ LT S pi.~+f~Ts Flood plain elevation, if applicable ti, It
IS = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN ALL HOLDING TANK
U= Unsuitable for system ❑ S [@U l S❑ U E3 S ZJ U ❑ S ®U ❑ S au ❑ S U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Botxtdary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tmnch
a:<'•> p-/O %0 /t' 3/2- ShlC Orr Ufie C S s S G
F /0 yie 0 f shy ~,v►f~p s .4-f , z '3
Ground /3, 1-31 /O ye 411y 2,.wr, R '15
y f
i0o ft. 3 4o ,4e Im fl' c s lv F . S
Depth to C y~' &0 /0 Yie S~G f' f M, / , .3 .
limiting
factor
Remarks: /~/pi'ZO~ "G /9-' %i f/ ~PES7.ibi`e- i,o j .
Boring #
6h& lk4 pV~0_ C.5
13, y-- 30 / o pe ter, 6,e 4Vrre e5 /vf
Ground
elev. 13t 1,7
d s/ 7- S y~ - s/ D, G, y~ a s ` ,.5
Z 7 ft.
Depth to 441 y~
limiting
factor
Remarks:
2 Phon
CST Name: Please Print "BITE SEPTIC PLUMBIN
A
Address: c. T
i ROBERT ULBRiGHT
` Signature: iS. tR 3 ?I-UMBER LI . NO. 330 Rate: ;a CST Number:
' L'? DESIGNER LIC. N 0 1 7_ ZY~2- NJ .
i
PROPERTY OWNER .4,
SOIL DESCRIPTION REPORT Page 2~
PARCEL I.D. ff G D f - ` ' /~'~►/r TO/p CO 4160 7XI d4
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh.
t .3 z Bed Trench
Ske C5- of s
k
,
t E /0 y2 2, f, 5ke /M f< ~s /L/-F - 5 . G
Ground 13, 00`27 /0Y'e y (P 511 L,f, SbK f1t', CS /Vf
elev.
-37 /U yie ~/~~j s~
/0%0 ft. 132 )
2
Depth to 37- y /O yle y /o y~ F SG I , f ,r,., ,w, u f
limiting
factor a
.37
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
7-1
Remarks:
Boring #
,t
Ground
elev.
ft.
Depth to '
limiting `
factor
Remarks:
Boring
Ground
elev.
ft.
f,
Depth to
limiting
factor -
Remarks:
M-8330(R.05M)
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Wisconsin Department of Industry, PRIVATE SEWAGE SYSf EM County:
Labor and Human Relations INSPECTION REPORT ST. CROIX
Safety and Buildings Division sanitary Permit No.:
GENERAL INFORMATION (ATTACH TO PERMIT) 268575
Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.:
DAGGETT, PATRICK & SUZANNE TROY
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
ELEVATION DATA A2610285
TANK INFORMATION
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
Dosing
Aeration Bldg. Sewer
Holding St/Ht Inlet
TANK SETBACK INFORMATION St/ Ht Outlet
TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic NA Dt Bottom
Dosing NA Header/ Man.
Aeration NA Dist. Pipe
Holding Bot. System
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand
Model Number GPM
TDH Lift Friction System TDH Ft
oss mead
Forcemain Length Dia. Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS DIMENSIONS
LEACHING Manufacturer:
SYSTEM TO P / L BLDG WELL LAKE / STREAM
SETBACK CHAMBER
Mode Number:
INFORMATION Type O OR UNIT
System:
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-Grade Systems Only
Depth Over Depth Over xx Depth Of F xx Seeded / Sodded xx Mulched
Bed /Trench Center Bed/ Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: TROY.21.28.19W, SE, SE, TOWNSVALLEY RD
Plan revision required? ❑ Yes ❑ No
Use other side for additional information.
SBD-6710 (R 05/91) Date Inspector's Signature Cert. No.
ADOTrioNAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
Safety and Buildings Division
^~~E~••' SANITARY PERMIT APPLICATION Bureau of Building Water Systems
~.R 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 1/2 x 11 inches in size. St. Croix
• See reverse side for instructions for completing this application State Sanitary Permit Number
a (08Is9s
The imTrmation you provide may be used by other government agency programs ❑ Check it revision to previous application
[Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number
1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION
Property Owner Name Property Location
Patrick SE' 1/4 S;, 1i4, S 71 T 28 N, R 19 E (or) W & Suzanne Daggett Property Owner's Mailing Address Lot Number Block Number
991 E Hazel St. 6
City, State Zip Code Phone Number Subdivision Name or CSM Number
River Falls, WI 54022 1(715) 4256567 County Oaks
11. TYPE F BUILDING: (check one) ❑ State Owned El Ot~ Townsvalley earest Road
❑ VII age
Public 1 or 2 Family Dwelling - No. of bedrooms Town OF Troy rd
III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s)
d4/C1 -/,221 --CoO
1 ❑ Apartment/ Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash
5 ❑ Hotel /Motel 9 ❑ Office/Factory 13 ❑ Other: specify
IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable)
A) 1.] New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
____System System Tank OnlyExisting System _________Exlsting 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 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
450 376 376 0.3 100 Feet 101.5 Feet
VII. TANK Capacity site
in gallons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper.
INFORMATION New Existing Gallons Tanks Concrete glass App-
New
Tanks Tanks
Septic Tank or Holding Tank 1 QQQ 1 0 )0 1 Weeks ® ❑ ❑ El ❑ El
❑ ❑
Lift Pump Tank /Siphon Chamber 800 800 1 Weeks Prefab Conc ❑ ❑ El El
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibilit for installation of the onsite sewage system shown on the attached plans.
Plumber's Name: (Print) P is S natur : ( o amps) 7WWP9;;;V.: T(715) ess Phone Number:
Paul C.J. Steiner 720 425-5544
Plumber's Address (Street, City, State, Zip Code):
118230 945th st. River Falls WI 54022
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Sant ry Permit Fee (~ncludesGroundwater ate ssu Issuing Agent Signature (No Stamps)
Approved ❑Owner Given Initial CO Surcharge Fee)
X Adverse Determination N X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SBD-6398 (R. 05/94) DISTRIBUTION: Original to county, One copy To: Safety s 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, 608-266-3815.
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 is to be installed.
II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling.
III. Building use. If building type is public, check all appropriate boxes that apply.
IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair.
V. Type of system. Check appropriate box depending on system type.
VI_ Absorption system information. Provide all information requested for numbers 1 through 7.
VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and
manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and
holding tanks for this system. Check experimental approval only if tanks received experimental product approval from
DILHR.
VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.),
address and phone number. Plumber must sign application form.
IX. County/ Department Use Only.
X_ County/ Department Use Only.
Complete plans and specifications not smaller than 8 112 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.
• SAFETY & BUILDINGS DIVISION
State of Wisconsin
Department of Industry, Labor and Human Relations
January 21, 1994 2226 Rose Street
La Crosse WI 54603
WEGERER SOIL TESTING
PO 74
RIVER FALLS WI 54022
RE: PLAN S94-40029 FEE RECEIVED: 180.00
DAGGETT,PAT
SW,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 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, a
erard Swim `
Plan Reviewer
Section of Private Sewage
(608) 785-9348
2401R/ 1
SBD-6423 (R. 01/91)
S 9 4 4C 10,2
L Page of 6
MOUND SYSTEM
FOR f
A 3 BEDROOM RESIDENCE
LOCATED IN THE Sw 1/4 OF THE SE 1/4 OF SECTION 21 , T Z8 N, R 19 W,
TOWN OF 1-'-,o l_{ , Sr. CCZ_UIX COUNTY, WISCONSIN.
.oT (z OF Cvv)v'm_Lf ORIzS SvL3D/UtSiUrj>
(
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
PREPARED FOR
4 Z ►v . ~E~1~1Z1* ST.:
IU~-R FA~LS,WI Sq0- 1
PREPARED BY
WEGaF;t IF-=FR SO I L TEST I NG
AND.
DES I GF`i SF=F;tV I CEA~-~y
P.O. BOX 74 421 K. KAIK ST. Of
RIVER FALLS. YI 54022
ARTHUR L.
715-4~ rOi6 i WEGU l a.
CtaMATH.
wpa.
RECEIVED ~'P•®~ I G 1;
0
JAN 2 0 1994
SAFETY & BLDGS. DIV.
- 4
JOB NO. q Y
S 9 4 4 4 0 2 9 Page 3 Of b
Approved Synthetic Covering
Distribution Pipe
Medium Sand
_ H - G
Topsoil. F Elev. 10(3.0
E D
3
i
Z % Slope Trench Of 2~- 2~2 Force Main Plowed
From Pump Layer
pjii%?AT SEWAGE SYSTEM Aggregate
, D l.O Ft.
Co daL! E 1, y Ft.
zJ011 Oak
ss Section Of A Mound System Using F O-$ Ft.
U LABOR ~ Rgpijotches For The Absorption Area G X-o Ft.
DEFT. OF INDUSTRY, t3U1lDINGS A - Ft. H S Ft.
DIVtSIa" DF SAFETY Ft.
B ~Z
PONDENCE C Ib Ft.
SEE C R
Linear Loa ing Rate= y~ GPD/LN FT I ~Z Ft.
Design Loading Rate= 0.3GPD/SQ FT J 8 Ft.
K l\ Ft.
L 61 Ft.
W L4 O Ft.
L
J B K
Observation Permanent _
Pipes Markers - - J~ L-rJr12-Tz5 p-r
(Anchor securely) Force/ oPpo S !Tw
-
- VDistribution - -J Main
VV Trench Of ~2 ~ - 2 2
Pipe Aggregate
I
Mound Using 2 Trenches For Absorption Area
S94 40029 Page qOf to
Perforated Pipe Detall
0
End View
Perforated
End Cop. y" PVC Pipe Install permanent marker
oRce at end of each lateral
~S
Holes Located On Bottom,
Are Equally Spaced
Q S
PVC Force Main
Q
PVC
Manifold Pipe
Distri ution
Pi e
Last Hole Should Be I
Next To End Cap 1
End Cop
P 2.f Ft.
Distribution Pipe Layout S b Ft.
X 4 Inches
~tJAG SYSTEW Y Ll8 Inches
. ~ adti®nal Hole Diameter `/Y Inch
Lateral 1 Inches;
4
• `l Manifold Z Inches
VAX a'as Force Main 2- Inches
LABOR ~ A r@auS Force Main Z Inches
INDUSTitY,
Of
DEPT. p~V1S1 DF sRfETY # of holes/pipe
PONOEWcs Invert Elevation of Laterals 1013-S Ft.
SEE
Place 1st hole -D-0 from center of manifold with succeeding holes
at 4 8 intervals. Last hole to be next to the end cap.
PUMP CHAMBER CROSS SECTION ARID SPECIFICATIONS PAGE S OF b
S94 40029
VCMT GAP
4"C.I. VENT PIPE WEATHER PROOF
APPROVED LOCKING MANHOLE
r-T
JULICTIOW 60K COVER WITH WARNING LABEL
10 'FROM DOOR, IZ•MIU.
wIIJDOW OR FRESH
AIR INTAKE 1
GRADE ( 40 MILL
iR 5 $
I6' MIAI.
COWDUIT -
~
PROVIDE I
IIJLET T ^V~r~~~~C S~ecvj~l6HT SEAL
APPROVED JOINT A rTank co ~yshall comply I ( APPROVED JOINTS
with approved w Ai •15 VEY83.20 ( L~
pipe extending ' j II ALMA
3 feet onto q'
solid soil. & NUAN M4GSELATIONS I ON
IRY' LABOR H` ' I
Both sides of C OF INDUSTR VIP
tank. DEPj. pIVl31 OF SUETY
C L E V. SL:== f T. PU P -
OFF
R NpENGE
D SEE C
~L g y, 00 COUCRETE BLOCK
APPRWfI
gEDpIµG
RISER EXIT PERMITTED OWLI IF TAWK MANUFACTURER HAS SUCH APPROVAL.
SPECIFICATIOAIS ~1L
DOSE 1-}RY WEEnt. S . 3. y
TANK MANUFACTURER. NUMBER OF DOSES: PER DAy
TANK 51ZE: 8oO GALLOWS DOSE VOLUME 1
S.S. L~"[~Q SVSTEIS INCLUDING 6ACK►LOW: X57.3 GALLONS
ALARM MANUFACTURER: E
MODEL LIUMBER: 1 Ol Mw CAPACITIES: A= I to INCHES OR 312 1 GALLONS
SWITCH TYPE: I1 L'11C-uR- ( 8= Z INCHES OR 39' 34LLOL15
PUMP MANUFACTURER: F-e- MLteS CA). C. 6 INCHES OR ~5-1 ' 1 GALLONS
MODEL NUMBER: MR-7 4 0 D- \5 INCHES OR may' GALLONS
14'1"2CU ~ \S-*-1- Z. 80S-
7-SWITCH TYPE: NOTE: PUMP AND ALARM ARE TO OE
MIIJIMUM DISCHARGE RATE. 7&"A GPM IN5TALLED OLI SEPARATE CIRCUITS
FEET
VERTICAL DIFFERENCE DETWEELI PUMP OFF AUD_OISTRAbUTIOIJ PIPE.. \S.-Ls
+ MIAIIMUM NETWORK SUPPLY PRESSURE . . . . . 2.50 FEET
+ %VD FEET OF FORCE MAIM X - FYOfLFKICTIOU FACTOR-. Z" S`a) FEET L-(^~7J~~1J•w~L- -1~I"I `S~
TOTAL DtIIJAMIC HEAD = Z~ LET
DIAMETER 164 ,I
IMTERWAL. DIMLWSIOW~i OF TAWK: LEW&TH ~_;WIDTH --.;LIQUID DEPTH
BOTTOM AREA L4 'S-S6 - 231= I q 6Y GAL/INCH
AS PER MANUFACTURER = GAL/INCH _
S94 400~,~~
M E40 Series MYM
4/10 HP Effluent
and Drain Water Pumps
Performance Curve
MODEL ME40 EFFLUENT PUMP
CAPACITY LITERS PER MINUTE
0 50 100 150 200 250 300 350
40 12
35
10 (A
W 30 W
LL- g ~
Z
Z'25
z
W 20 o 33 6 q~
2
Q 15
Q
es 4
F 0
- Z-e -Do
H
10
2
5
0 0
0 10 20 30 40 50 60 70 00 90 100
CAPACITY GALLONS PER MINUTE
F.E. Myers, A Pentair Company • 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 EVALUATION REPORT Page \ of
Labor and Human Relations
Divi<ion of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
'ST. et~.o i X
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
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
ACT 4 S U Z P~rv IV E kG 6 ETT GOVT. LOT S W 1/4 S E 1/4,S 2-1 T N,R 14 E (0 )
PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
L{ Z N , PLPcfZL S7. - C-bQ" `i ciAks
D
D
C 5STATE ZIP CODE PHONE NUMBER [:]CITY ❑VILLAGE MOWN NEAREST ROA
xot~_ RI_LS W S4ozz (7)S) yLS- 6561 ~zo C-o~ s DR.
K New Construction Use Residential / Number of bedrooms [ j Addition to existing building
j j Replacement [ ] Public or commercial describe
Code derived daily flow 60o gpd Recommended design loading rate ° •3Y bed, gpd/ft2 trench, gpolft2
Absorption area required Soo bed. A2 Soo trench, fl? Maximum design loading rate o - q bed, gpcW S trench, gpd/ft2
Recommended infiltration surface elevation(s) ~3 6 ' ft (as referred to site plan benchmark)
= zO
Additional design/ site considerations w10uf"O w t`11A 8' K6 3 B~ M I N~~ u~1 1 r of SfNb F' LL T.
Parent material "P_s s o w evL TILL Flood plain elevation, if applicable N-A, ft
S =Suitable for System CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem ❑ S 0 U 0S ❑ U ❑ S [RU ❑ S WU ❑ S ICU ❑ S I~$U
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure Consistence Baxt lay Roots GPD/ft
Boring # Horizon in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed tench
o-b 10~-t2 313 s L Z`F5'bk `FH
<4::,....:• Z 6-30 LO `Z2 3![, - SL~ ZFSbkT1,+ ~S o.S o.6
>oLl 231L t~ -s -res'(b s~-1 0~ -~~--►r►`~i s - _
Ground 3 ~o-3S
elev. `
Wb.a ft.
Depth to
limiting
factor
30
Remarks:
Boring # _
i~....: 1 0-8 1b`12 3!3 51~ Z'FSbk ~t^ GS t e.go.L
;~,::...:..r
Z'> Z $_29 Lb `22 3/fG Sj c-\ ZfSbk vn~~ T2 7J
3 29-6b 7.S~r2 s!y ~I~tu ILYK2 6!~ Sel o~.
Ground -
elev.
'\.bla ti ft.
Depth to j c I "I
limiting t,O~~N y,c,L
factor `
9
Remarks:
T Name:-Please Print Arthur L. We erer Phone: 715-425-0165
eess:
rer oil Testing & V Design Service-P.O. Box 74 River Falls,WI 54022
Signature:G~ C) 3 \S_3 Date: CST Number:
-3u-9 3 M00576
PROPERTY OWNER ~I-, G G eT SOIL DESCRIPTION REPORT Page Z 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
LD`-tlZ 3~3 S Z'FS~n wtiF, CS lv d.S 04
l1-~O I, `?2 3/6 - Sj c. Z'FSb1~ tin Fh CS 1v~F o.Y 0.5
Ground 3 y~_s~ -S ~f2 3! 1-F sly s~ OW, V4'r
~ro~st a 61W /C. I Tt
elev.
~pL. Z ft.
Depth to
limiting
factor ~D
Remarks:
Boring #
Ground
elev,
ft.
Depth to
limiting
factor
Remarks:
Boring #
q 4.
Sy.4n\\Y.•.•;..n
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(R.05/92)
PLOT PLAN Page 3 of 3
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(715 ) 4?q-oI69 _ M00576
CST Signature Date Signed Telephone No. CST #
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER 1a-~ ri c~~ ~u ZAP ~~i ~a e
MAILING ADDRESS •F f}zi2e a 13 fy~,k
LA Sig 60, Cou~r C~.IC 4-17el 7ny
PROPERTY ADDRESS
(location of septic system) Please o tain from the Planning Dept.
IIS W
CITY/STATE ! WK
1/4, Section
-
PROPERTY LOCATION ~ 1/4, T
TOWN OF ST. CROIX COUNTY, WI
LOT NUMBER --10-
SUBDIVISION r~ U P X75
M g
VOLUMEPAGE LOT NUMBER
CERTIFIED SURVEY AP
improper use and maintenance of your septic system could result in its premature sooner, ailu if nee le
wastes. Proper maintenance consists of pumping out the septic tank every three years 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 pump fre erns leg that (1)
the on-site wastewater disposal system is in proper operating condition and (2) P
pumping (if necessary), the septic tank is less than 1/3 full of sludge acid 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.
SIGNED: i
DATE:
St. Croix County Zoning Office
Government Center
1101 Carmichael Road 11/93
Hudson, WI 54016
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 -tY1GL I
'SLt,' Ah VK. P-a 91e fi"r"
Location of property SE 1/4 ,1/4, Section T o17 N-R_j_ft_W
Township Mailing address dzy-e-1 4.Z.
i wit! ~S l~1 i 5gW_C)-
Address of site Cbw~N 0& Loi- (0 c2 3 4%4 1 A, It A. O°
Subdivision name COlt.hYV Lot no.
other homes on property? Yes ✓ No
Previous owner of property rauo*y L &kj t0w*zerAhe
Total size of property J. 00 Y Q e
Total size of parcel o~. D Mre
Date parcel was created
Are all corners and lot lines identifiable? ✓ Yes No
Is this property being developed for (spec house)? Yes ✓ No
Volume CM 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 the office of the County Register of
Deeds as Document No. A 1r, , and that I (we) presently
own the proposed site f 6i 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.
y °1 ~3 Imo,
l~~
Signature of licant Co-Applicant
10 e
Dat of Signature Date of Siynature
• DOCUMENT NO. 9989ACE 10
WARRANTY DEED I TNIS
496312 s►A~.E RESERVED ►OR RECORDING DATA
ISTATE BAR OF WISCONSIN FORM 2 -1962
Country Oaks, a Wisconsin Partne-..-,--• ~F
rship by-Laurence
SCR 004rN:,
W. Murphy and Norwood A. Ecklund
Ree'dfoeReaoird
. MAR 2 3 1993
conveys and warrants to ..P$tri=k_.M..-Daggett„and„$V?anAE.,M~.._.. „ $;30
. DRSSekx~--hue}zsnsl..ansi-.~ife_-as.-awwivorship..sarital.__._..._
Pi•QP~i tX
Rof Daft
- RETURN TO
FAA RF
do fogowing awcr%w real estate in roan C_.-....Cosnty.
saw of Wisconsin:
Tars Pared No: . . .
Lot 6, Country Oaks, in the Town of Troy, St. Croix County, Wisconsin.
TRANSF0
s 4, -
ME
I~
This ia nOt homestead property.
WF (is not)
Eseeption to warranties:
eassaents, restrictions and riShts of way of record, if any.
Dated this day of March
19.9
COUNTRY OAKS
_...(SEAL) -104 .
(SEAL)
y
(SEAL) \SEAL) 01 ' Norwood A. Ecklund
AUTSBNTICATION AC=NOWLBDGMBNT
Sissatnra(s) STATE OF WISCONSIN
ts.
rigxre............. county.
authenticated this _._.___-day-of 19 Personally came before me this -15rhday of
arch , 19...93. the above named
-
' Laurence W. Murphy
TITLE: MEMBER STATE BAR OF WISCONSIN Norwood A: Ecklune ::'fr► y
(If not.
-.w
authorized by § 706.08. Wis. State.) . :
o u* ~
to me known to be the person V
d ;
0
o ng instrument and acknae. w • v
THIS INSTRUMENT WAS DRAFTED aY J O
Josenh D_ - f f rgy._X.1cCsrdlg.--- ~j Ix
Continuation of Abstract No. A4920
From the 26th day of January 19 93 , at 8: 00 o'clock in the A M.
of the land described as:
32 -
LOT SIX (6), COUNTRY OAKS IN THE TOWN OF TROY.
St. Croix County, Wisconsin.
- 33 -
County Oaks, a Wisconsin WARRANTY DEED
Partnership by Laurence W.
Murphy and Norwood A. Ecklund Dated: March 15, 1993
Recorded: March 23, 1993
- to - at 8:30 a.m.
In Volume 998, page 10
Patrick M. Daggett and Suzanne Document Number: 496312
M. Daggett, husband and wife as Transfer Fee: $56.40
survivorship marital property
This is not homestead property.
Subject to easements, restrictions and rights-of-way of record, if any.
Conveys same land as shown at entry 32.
- 34 -
Patrick M. Daggett and Suzanne REAL ESTATE MORTGAGE
M. Daggett, husband and wife as
survivorship marital property Dated: March 16, 1993
Recorded: March 23, 1993
- to - at 8:30 a.m.
In Volume 998, pages 11-12
The First National Bank of Document Number: 496313
River Falls, a U.S. Corporation Consideration: $14,500.00
This is not homestead property.
This is a purchase money mortgage.
Subject to restrictions and easements of record, municipal and zoning
ordinances, current taxes and assessments not yet due.
Mortgages same land as shown at entry 32.
- 35 -
The 1992 Real Estate Taxes are paid in full (Computer numbers: 40-1084-
50 110, 40-1084-80 110 and 40-1084-95 100).
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