Loading...
HomeMy WebLinkAbout040-1191-60-000 -0 0 0., p I o O m N o M ~ et rn ~ ' rn m O N N ell O x c i X co y rr) Cl) O U) O v t ti 'o C O ~ L N CL ~ Y I Y j C L i N U N ~ N C Z N O 7 (6 {L C (0 9 ~ p N Q O 3 Cl) v ~ z y N Z O z co d d m l, a N w U) c O I co a~i Z Z H E -a o m M N 3 a) ty Z N U C T U I ~j o CE = v 0 o m Q w z z o z a N l0 ~ ~ N ~ is Y r C4 CL R N N d N c p O D O d E 0 N H H Fy- U o O O O O Z o i N a a a ) *a. a LL 0 (D (D _ N -j Sol 001, a) } Cl) GO N O 0 0 0 (V E N N O 3 ~p d 00 N U) N cn M1~ Vl O vi c o _ v r+ p Cl) N co O N :3 O LO a) 00 r _ > Y Y "6I N N N (D c c a, v o cn co = -0, N ro r~ 00 N O O O~ C N f6 N U rVl O N F- ' Y N O N O ~ r~ 7k w E N v G~ t0 C. y it o L a • C4 a m m c t~`Iwv E 3 = `1 A ciao 0 ~0 r July 15, 1999 ATTN: KEVIN GRABAU ST. CROIX COUNTY ZONING 1101 CARMICHAEL ROAD HUDSON, WI 54016 Dear Kevin, As per our conversation today, enclosed for your file please find a copy of our original house plans. As you can see, we have only two (2) bedrooms on our upper level. Our basement is presently unfinished, but I've enclosed a copy of that blueprint as well, indicating where the proposed bedroom will be constructed. As you indicated, this third bedroom will still be within the acceptable capacity for our sanitation system. I'm also enclosing a copy of the letter I've mailed to Dean Albert for my building permit. Thank you for your assistance in this matter. Sincerely, /tepf osa f^ p c, X July 14, 1999 DEAN ALBERT 296 STATE ROAD 35 RIVER FALLS, WI 54022 Dear Dean, Pursuant to our phone conversation yesterday, enclosed please find a sketch of the bedroom we're planning to finish in our basement. As you can see, we will have a legal window in that room. This is the only area of the basement that we plan to finish at this time. I have already spoken to Kevin at St. Croix County Zoing, and he informed me that we will still be within the acceptable number of bedrooms for our sanitation system. The entire cost of the project should not exceed $2,000.00. Enclosed is my $20.00 check for the permit. Please call me if you have any questions. Thank you for your assistance. Sincerel e en K a 234 Plai iew Drive River Falls, WI 54022 (715)386-7979 (HM) (715)386-8808 (WK) s ~ t~~r ~ - ~aFIM a ~ ' - ~ T''.~~~~ ti E ~6. JYY~yt a ~ o' 4 e~ & S d F L z l Irr. a 1- "n s4' y 3 'o- art e•. r rb 1. r ~ . C + • ty. ~ fay... r err 3 ~01,'i 14' t ~ 9 J { t ,~.1 S., i. ~ rV~F •r n t . y 5 lt. C 'I♦4 ~`i. N~ 1r7f ~ .fry 'J ~ •+c~ ~ e 9 r i4`y ~r~i~ h 4r"~~•r+" 'r r ~ r n r a y~ TY r`17 Y V" f ti~ n d ill: 'a ~a i ~.r R)e e ~ f" err r,~~{ ~t jT'"t~S~~i' ''?F?dl,'WL1 Si/Act'? 1jPafil"'at}~. REy t4 .~f, yA' 1 1r :e~. •l.` t W t.~ f t.7r.,:~ 4< rk1 lt^ r'Nr Y ` i r. .W d11,. o a1•:.,i~ ri I r 1 /1 ✓~S + r Sr4•'" `bRt tfp w fr(„ r J ?t PiAt.r~ t. ~s. rl y: •Er wy~}tr rf' '~tif~ ,ti, ~ ff..~ya3.• iii ..~k:: 2 . ♦ 1 . $ /Z. YI ~fa~~ 'y ,a 1 S i , , ' r5 ~ R f , S .t J 'e'rr.: wf ~ .r . z '}•sr.~a9 a~,~, r t~ 9 ~ Air •y „<,f Y+~2~ , ~ ~*y y" t'~~; L ;i 1 S ,r r hf ~l ~ a rr..,~l ~;'4 L - ,.w 6' 1•'{ ik'C R . s rN ~r '~TT'7!4 t~ ~ 3,~ 4~~~ A ~{~r r} y~f ~~''`'~'tl•Y 1 f t~• , y,• i; ~ t♦ (~Al r}/~ '~~i✓Yt •t `nR ~•i i 1 ~ {'t.~ 1~.r♦ ~My,~~y,~,~.t«y,,ry~ ~ >,«r~'y{r~'t~"~~`}~ <>r dI xr.r. i:~ ~ ~d.!{+Jr, r• ~G4 sr1 r~~ 37 Y ;i Y~t ~ ~ hyy~tt~6 'r ~ np { ' a 1 _ 'T r! +a ~ ' '.~1•.f~i~r ' ;1' tt~'•1 ~'y}. ~-!"r ~ r ; b '47 N}„ 1 t~ ~ {'w •Sh t ' .y / ' _ -ya ~l+t: ,~^tht 4~ r v 1 '~rd r ~ r41 1. , lrlf .i 'i'tAf '2Ar r A'.~S ,yy7~~ l , t ~+t ~,rt , _ s't rri •'ly'~"YP.+Wi~+++4 5 t~ ~ S M j4 ) y . t~ ~ ygf. ) t~r+'°ir r. ~a , r y~j~ ~ g7~ 2~ St , v~~f~ ! r• 1 ~i , ' r r lk~s ;t, t r ; . 4 . MS .s tii S.r xYrf14, ~ 'A~'"~' r t+~ r ~r r i+7~iv } f ,t r" . < t r N:. ' Y ' , + ~,~t•r` ~ t . ~ , a6y-t! •u 1t ~ ti " ~ +i ~ c. ,a~YAX ar ,r f CHI !lµ Y'ra y r M G 7 L yy n ~ s ~ '~J rr a r h. ~r~ tynr t" i ss( j' .y r ;ki 4 +;If + `~r yL ~ i. r t d~ 1 ~ _ t, ~..~~,.~'•yl"~trt'~! .;~~te ~~Ii Fir Ty, LSM1~ ~•'^'tr •1 ~ '.7"ikw,.rrar~ ,,,~f t .i{ t , P ',7~N,. { h ,?t~•t tN yr u y~~ t 7, 'r 5 e C..• 1. r,r1. ~relt '^,S4 k• Sr uFtil l(a 1 Z r tri < kv j~' t{'~~" v 15td ~ k 11 N. t" .rt •V N. r ~'tl' . S • '.~~~t ~ ! F ;,'.~,,r ~t ~~~tr'4' ~ t ~YA llv t .4, !Lr r'1 ~E f'`" rtVk4~'t''r~j •i ti: 1♦l Li AA i ~ ~t~ r" tArr" r 'x { r~ rv'; u E 7 < r ¢ + . f : t i V'.. i < 4 4jXr~ + ~ ~ ~ Y` t< pr t [ ~ yrr rr „Jj~.tt ~ r tt.,r. t tt. j .Y~ ri tl ~ t t y tt 5 S'''? rl 1 F ~ i t,. r.! c F , qr,/ r +aCY~+ + th,njy~Y . , '4 '•c` S 5 ,..w 1i¢~ y; t <..vr f4i V.. ~4y t ~ t t... t• a ,2, ,~f.7"~~t~, r~MNg "i ~ ~ k + t y0~y,{A ~7 ~ / wl .'jam ~ >r i t X+•i'. "i' y .rr. °;,,t~~ ,~(J~ :~4~ 5 ,fie w .S ~ fi y r~' ~"f t ' +g7~ v, v.r,M ~t Nl. , •.'y~, ~ ~'S y 'r • !ihyl~`. : ° Ott } ~t"'~ <<< < Ntaj4,~4 ~ ° t.+~f rt t S ~ w r ria r.. h ~'7♦ a,a' 'rt' C 'k A f S I~{y<'}Tr'XNrTAkrl „]I.~ ! Y l~ ~l. 7. - . / ' W Y•CJf 10 S 1, ,i "~x j ro NZ ) ♦ f.~ `✓Y•t Y1 7 s ~t h•fC 5~. StI~ Yn}A ./a ' Al r T i ' l Ali. p g 1U 11 STC - 10 4 REc~i~E~ ? AS BUILT SANITARY SYSTEM REPORT 2 1g9~ f EB 1 S OWNER i) - T 'Fox 49 ZpNlNO ADDRESS ,f.~/ +~~j s, I SUBDIVISION / CSM#_ LOT # SECTION_T<~N_R_W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM J~ r~ r iyINDICATE NORTH AR OW Provide setback and elevation information on reverse of this f rm. Provide 2 dimensions to center of septic tank manhole cover. ,Q/vr l BENCH4ARK• d ,ry ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: Liquid Capacity: Setback from: Well / House 17 Other Pump: Manufacturer Model# Size Float seperation Gallons/cycle: Alarm Location -:SOIL ABSORPTION SYSTEM n Width• Length ~j~ G; - Number of trenches Distance & Direction to nearest prop, line: Setback from: well:- House- Other ELEVATIONS Building Sewer. ~ST Inlet. ST outlet PC inlet PC bottom Pump Off Header/Manifold-77c 9g, 49 Bottom of system ~-g y ~a Existing Grade Final grade DATE OF INSTALLATION: - PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: ~c! 3/93:jt L taber Department of Industry, Safety an Hu n Relations PRIVATE INSPECTION SEWAGE REPORT SYSTEM County: ST. CROIX Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Permit Holder's Name: ❑ City ❑ Village aTown of: State Pla KOSA, STEVE X CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Aeration Bldg. Sewer ~v cC 3 ' Holding St/Ht Inlet ~<~3' 9rCp a i TANK SETBACK INFORMATION St/ Ht outlet Verit TANKTO P/L WELL BLDG. Airito ntake ROAD Dt Inlet G Ar Septic >a 5 7 ya 5' NA Dt Bottom Dosing NA Header / Man. / / v U 9c- y5 8.3 , / C./ 7 ' Aeration NA Dist. Pipe O- -57 9 q:z Holding Bot. System T L S 97. PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Lrictio System TDH Ft Forcemain Len Dia. H Dist. To Well SOIL ABSORPTION SYSTEM DIMENRENICH Width , Length No. Of renches PIT No. Of Pits Inside Dia. Liquid Depth 5 DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION TypeO CHAMBER Moe Number: System: 4~K-ck~ l O /0/4 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-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center ' Bed / Trench Edges c7 c -~f 6 Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: TROY.24.28.20W, LOT 6, PLAINVIEW DRIVE Plan revision required? ❑ Yes [No Use other side for additional information. aZ 9 , SBD-6710 (R 0511) Date nspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: t Safety and Buildings Division ~•i~~■'~i SANITARY PERMIT APPLICATION Bureau of Building water systems 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. • See reverse side for instructions for completing this application state sanity Perrpft-Number The information 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 Propert ner Name Property Location v4 y 1/4, S T , N, R E (or Propert O?wn 's M 'I Address Lot Number Block Number J _ ,e I City ate 1 Zip Code Phone Number Subdivision ame or CSM Number ( ) II. TYPE F BUILDING: (check one) ❑ State Owned ❑ ity Neare t Road ❑ Village r 10/ Public 1 or 2 Family Dwelling - No_ of bedrooms Town OF III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 040 l/,?/ 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. fZ 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 ® 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. Pert. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./'nch) >t/ - 9k;2,5_ Elevation 6. )t- VII. TANK Capacity in gallons Total # Of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Existin strutted Tanks Tanks Septic Tank or Holding Tank - ® ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber =OA I ❑ ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for 'nstallation of the onsite sewage system shown on the attached plans. Plum is N me: (Pri Plumber' ig atur • (N amps) MP/MPRSW No.: Business Phone Number: 5-9 Plumber s Address (Str et, Cit State )p Code): IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sani ary Permit Fee (Includes Groundwater ate Issued issuing Agent Signature (No Stamps) pproved E] ] 7~ Surcharge Fee) A Owner Given Initial p (SJ( /VI oCrY ~(T~ Adverse Determination X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: &*C~6398 (R. 05194) DISTRIBUTION: Original to Count Y. 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, 608-266-3815. 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 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. wwfk- ~c l o 4 ~ b .2.vQ ~5 T E~~ v y -re e,3 FS Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of Labor and Human Relations Division of Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY ST, G,PO~'X 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. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTYeWNER: 130Yk5e ; PROPERTY LOCATION 57-Z=7J& GOVT. LOT $E 1/4 50 1/4,S 2YT Z9 N,R Z a E (010 PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM If/& 6 lfVI 14 D,P ~ Glzpl`V ~ i DG-tS- CITY,, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE OWN NEAREST ROAD v~So ✓ l-t>/. r: aW& ( 715) 3P(0 - 7 ?7 T R o ' t A w u Ii: LJ [pr'New Construction Use [ iesidential / Number of b6drooms 3-1 [ ] Addition to existing building [ ]Replacement f o ? [ ] Public or commercial describe Code derived daily flow -(000 gpd Recommended desior,' bed, gpolft2 trench, gpolft2 Absorption area required P bed, ft2 S S '7 trench, ft2 Maxim- _bed, gpdAt2 ' 9 trench, gpd/tt2 Recommended infiltration surface elevation(s) 45AR- 2 olan benchmark) Additional design/ site considerations SEA N o Parent material S45 Q/ - 5104'ts livable til/f' ft S =Suitable for system v918 ❑ UL i1 p ❑ SYSTEM S IN ❑ S ~ T U =Unsuitable for s stem Ly" 11XLFSS'/laic" .SY0/P E3 Depth Dominant Color bi-day Roots GPD/ft Boring # Horizon in. Munsell k Bed tench ...:•..ti. Z 2ow% O-~ ~o /Z P~. , S (v - ~s sf , s lo Y,e 313 Ground If- 3 /o YX y ,t,~ a cJ - - 5 elev. /D4•72 ft. 7- S /D M 1 IWI 2 a cv 184 Depth to 5yp- 3/4/ of Z07 _ ~~yvl Lt] limiting -7 factor or a 11k,5111 Remarks: / Boring # 0y3 /0 y/2 Kvi~L 7cX a-S 2t -)p A~ Ground d/~~'2o.J elev. ft. Depth to limiting factor r/ Remarks: ~d-voip CST Name:-Please Print P-0 Ert T u L d Phone: 715 3 ~r J0~ ddress: FS drr0 Cs T-Af L gaOZ_ 0:_....,., - 9. saseclates Date: CST Number: i f PROPERTY OWNER 1t, DS SOIL DESCRIPTION REPORT Page? of PARCEL I.D. # LD -?r-` ~t 6',Sd Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft In, Munseil Qu. Sz. Cunt Color Gr. Sz. Sh. Bed ranch /a 1,1 - k~ 7-.3 z /0 r 31,3 /s / ~1si 4 cv Ground 3 - 1-0# Sly ~tti 0414 GQr2 f1 Q C u elev. n Depth to limiting factor > Remarks: (J- Boring # 3 /Oy /4/3 5/7 H' fl 4vfL Ground io% elev.-ft. A*yj 1/40 GZ IRA e-,5 - to - i~ yid S/lP C15 . O' S Depth to limiting factor a ~a"e✓ ~jpGi~ . Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor ' s . ' tip G7 ~ v~ o s °0 \ crt J Z. N ~ O N \ r 0 V, r rr( W Lon - N z\ o r V1 U~ m rn m 3 / S~ rn , . vim. • ~ c,. / ~ °O \ 10A C 1 0\ 1 0~ I I °O v ul Z Wisconsin Department of Industry, SOIL AND SITE EVALUATION Page / of Labor and Human Relations Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and ST'• C R 0 ! percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # N/ 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 QwAs; vSO YE k Property Location STEVE O.$1)t Govt. Lot SE 1/46760 1/4,S Z7 T N,R z-D E (or) OW Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# city State Zip Code Phone Number Nearest Road f lI SDI S~/Q/l0 (7i5 ) 7f 77 ❑ City'PD Village L~ Town /~%(JU/mow [eNew Construction Use: Residential / Number of bedrooms 3 - 7 Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow &DO gpd Recommended design loading rate ' ,7/ bed, gpd/f12 trench, gpd/ft2 sOd trench, tt2 Maximum design loading rate ' _Z11 bed, gpd/ft2 trench, gpd/ft2 Absorption area required ~Od bed, 112 Recommended infiltration surface elevation(s) ti~~5 - SEE P!~ 3 It (as referred to site plan benchmark) Additional design/site con 'derations SITE f°je iNCU'V1~ aid/ ~~Q S1A //~s1NGF ~~j4q°Q (J~/G Parent material $Cjr 8 vl~lu$ iN ~o.P,I°EcT~)/ !ts r~O ~M . Flood plain elevation, if applicable Nf tt S = Suitable for system Conventiioonaall Mound In-Ground Pressu a AT-Grade System in Fill Holding Tank 1 U = Unsuitable for system ❑ S L!'1 U ❑ S [~I U ❑ S u- ❑ S 0-15- 1 ❑ S ,L-`-,'D/ ❑ S SOIL DESCRIPTION REPORT N p NOT ~WHI f z) ` Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 15-4/ /oye 3/~ /s ;1~ • -7 • p yr e fie C'w i C Y , S 2 -16 /p 316 S/ M ,eS L' w • -7: 00 Ground 3 -e/ yl~1 $ /C 9y elev. It uo~D) s. a s k- ~s . . Depth to C v Z N limiting J 7'd t7 S~~Q r ~1'~~ Ci 0 Mn' G` U PP P factor 5---In r0L4ih6; Iel ~sT lte;Lt F t ~o rf°,PF vG /6T1oAJ Remarks: Boring # ha ode e§ 00 F 3 PY-33 55 /oY y s iP ass a s - ' ? Ground S-( f R C 2 C © C1 / ' ; elev. -7, S yp 9f' S1?-_ft. Depth to limiting factor 3~in. Remarks: ~~P/ ~STti IrT~o~$ CST Name (Please Print) Signature Telephone No. IPO~EtT 74 L 9 P CCkT- Gw -~rs3~~ P lplp Address Date CST Number 1 7 _ 6 C /7S'TiIf -2.- L{ Q2 PROPERTY OWNER SOIL DESCRIPTION REPORT Z , Page of ' PARCEL I.D.# Lb T ~L C I~O l X 1 0 6-Er- Boring # Horizon Depth Dominant Color Mottles Structure 2 in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench 3 o-S /o ye 3 s /MI s6,~ k cs -7 2 5-33 o ds ~S 1f- ,7; 60 Ground 3 - 7.5-ye y/ L"_ S s ~~s/✓i~ ~►n~ a s - G~ -J~ elev. ' 10 3, Z.5- ft. _ /o /,P 5 S.r' a 69 1h, : N 2 ~ Depth to limiting factor in. 5SS Remarks: Boring # 2 io S ~f Ske /PAfR a-.s 2T , s 3 l0 tle 5 C, S O, 5 ,7'-(26 Ground elev. 7S ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/fit in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # 0-7 IVYXI 3~ - •s1 ?f Shkl IW-fR 25 ' 1 f , S : , G - 1Q /o / Si/ z 4 -,41 Q s z f- N ~0'1 1.4" 4e Ground /D l y 7.5 Y 1 S /vf f.' a 5 _ ' ~S Depth to /D l Z 44411 limiting Sy~ X/5 factor ~Z in. Remarks: ArSTi 1?7_/ON 5 A7- 7 ~l iN T Boring # 69-09 loy 2~1 J_ /a ,e 3l3 s m& -fie es' .32 ; . 3 /o /13~ ~v ET / ~n~ ~rf a s g Ground JJ I~ elv. /03 l fts l O v 5 G~ j Depth to limiting factor 7 f0-1n• Remarks: /QU/F COVGl~ 49- Ind Li'E(~ SBDW-8330 (R. 08/95) t ov~~7 00,0 Po s r .tr c O T G o0&A,* 6", ~.fST" Lo 7-L 1 w srr sa , 8~ 13 30' Ib~O • 33 l 8~ uRvtD Houup / r, CONTou/2 GiwlE '03.75-' 1 SlopF s 2090 I a yam- I ~ o. l POs T f 7- S E 40 7- coiPN EJe , OF 741v 131 ~ _ ~ S'vs's~s TAD ,~I ovv ~ sys r~ ~ to I STC-105 I SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER S-~e_ V P.. 1~~,~.1Q MAILING ADDRESS $ t (c G rrx,r.~ ✓ ~.u~ 17y- t PROPERTY ADDRESS / a,,L,_a2 ` /location of septi system) Please obtain from the Planning Dept. CITY/STATE - PROPERTY LOCATION 1/4, SUD 1/4, Section T P f N90 W 'SOWN OF :y ~ ST. CROIX COUNTY, WI SUBDIVISION Cre tY ~e-~e~Sr~ LOT NUMBER CERTIFIED SURVEY MAP VOLUME PAGE , LOTNUMBER Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must b completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expi tion dat SIGNED: DATE: --T St. Croix County Zoning Office Government Center 1101 Cann ichael Road Hudson, WI 54016 11/93 • B 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 j 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--------------------------------------- Owner of property rte- b-ry .K-ca Location of property ]6r--_1/4IS W _1/4, Section ,TM_N-4n,@a_W Township ' t-e-py Mailing address _~„.a,~ J.-a1.~ ri c- Address of site 3 jj ilea Subdivision name Cy" 1K jr1,clic Lot no. other homes on property? Yes No Previous owner of property A Le„X F bb& Total size of property Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)? Yes _ _No Volume /Is S- and Page Number --'ye- 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 7 9g A , and that I (we) presently own the proposed site for they 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. Sig u e 7-.-Applicant Co-Applicant , 0t/f/ Onto 'Of Sion7till-n T)Atp of CirrnntiirP 71 DOCUMENT NO. WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA 53890G STATE BAR 0 ONSIN Y-O M 2 -1982 VCL~PAGE l FIE. .,:•Ti. Alex S. Kosa and Edry L. Kosa, husband and Rad for R ;ord w..fe............................................................................................ JAN 2 5 1996 ia$ Q: 3o P. f~9 conveys and warrants to ......Stephen•• A•...Kosa..and C ...Dj, ne...M,...Kosa hwaband...axid...wife ...as..mar.itaI....... ~ aagssior o! beads prope-r.t-y--------------------------------•-•-----..-•.. RETURN TO ~O Alex Koss- Svc < the following described real estate in $.t:,....Cr0j C .....................County, State of Wisconsin: Tax Parcel No: This deed is a correction deed changing that deed between the parties hereto dated December 281 19951 and recorded in the office of St. Croix County Register of Deeds on December, 29, 1995 in Volume 1155, page 388 as doc. no. 537988, by addition of the following statement: "The parcel shown on this document as part of Lot 7 is being added to Lot 61 all in the Plat of Croixridge, in the Town of Troy, to create one parcel, and this transaction is thereby exempt from Chapter 18 of the St. Croix County Land Use Regulations pursuant to Section 18.05(A)(3)." FEE This is...not........ homestead property. EXEMPT -4%) (is not) E&&ji*dh*t& *ft*ii4Yb& Dated this ............25th day of Janua2 1896..... ---(SEAL) - (SEAL) Alex S. Kosa :..../~O,QrtL,. (SEAL) ( Edry (SEAL) Kos 1 AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN St. Croix ss. i:: t_..r.._,..-.,. ,,i- 25th ao of "roCUM~NT NO. WARRANTY DEED r` STATE OF WISCONSIN FORM 9 V o.. 11 J 5 F. G : 3 8 8 THIS sPAcE REMYRD FOR 1t MRDiNC DATA 537981 N z C, T IS IN ENTUR ,M de by Alex S. Kosa and n ST. CPIGfXC©.,IN Edry KosaM ius~an an wi es, f M-_M for Rword ! DEC 2 9 1995 grantors of St. Croix _ County, Wisconsin, hereby conveys and warrants 12:00 to Stephen A. Kosa and Diane M. Kosal husband and wife, as marital property boo grantee S RETURN TO of St. Croix _ County, Wisconsin, for th&dkfh *f QQ,A,% ~t- good and valuable consTderatfon fC z V 3 the following tract of land in St. Cho i x County, State of Wisconsin; Lot 6 and that part of Lot 7 of the Plat of Croixridge located in the SW,= of Section 24, T28N. R20W. Town of Troy. St. Croix County Wisconsin described as follows: Beginning at the Northeast corner of said Lot 7;1 thence S28 0011611W 450.961 along a Southeasterly line of said Lot 7; thence S6300311611W 192.371 along a Southeasterly line of said Lot 7; thence N26P5614411W 22.001 along the NortheasterlyIright-ef-way line of Plainview Drive; thence N6300311611E 113.601 along the Northwesterly line of said Lot 7; thence N1903812811E 441.651; thence S8901911011E 143. 1 along the North line of said Lot 7 to the point of beginning.) Together with and subject to a roadway and utility easement over a parcel of land 66 feet in width being parts of Lots 5.1 6 and 7 of said Croixridge Addition described as follows: Commencing at the Northeast corner of said Croixridge Addition being the Northeast corner of said Lot 6; thence S1'361251tE 421.35 feet along the East line of said Croixridge Addition and the East line of said Lot 6; thence 9188'23135"W 290.94 feet along the line common to said Lots 5 and 6 of Croixridge Addition to the point of beginning; thence S6300311611W 207.47 feet; thence N2605614411W 66.00 feet along the Northeasterly right-of-way line of Plainview Drive; thence N6300311611E 207.47 feet along the line common to said Lot 7 and Lot 8 of Croixridge Addition and the Northeasterly extension thereof; thence S2605614411E 66.00 feet to the point of beginning. 1 1 Together with and subject to easements, restrictions, reservations and covenants of record, and subject to the added covenant, running with the land, that no additional residence may be constructed on any part of Lot 7 herein conveyed. Acceptance of this deed shall be indicated by its recording with the Register of Deeds and shall automatically and irrevocably make the Grantee, his successors and assigns a member of a non-profit, non stock corporation known as CROIXRIDGE HOMEOWNERS ASSOCIATION and entitle him to +he ibenfits and privileges of said Association and bind him to the terms.) conditions and obligations of said Association. $ T SBA§FER IN WITNESS WHEREOF, the sal r.s_-ha Ye_ hereunto set their hands and seal s this 28th day of December , A. D., 19 25-._ . SIGNED AND SEALED IN PRESENCE OF (SEAL) Alex S. Kosa (SEAL) Edry L. Ko (SEAL) (SEAL) STATE OF WISCONSIN, ss. S+. CrntY - County.