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040-1022-90-200
County: St. Croix Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT Sanitary Permit No: 552307 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)). Permit Holder's Name: City Village X Township Parcel Tax No: Troy, Town of 040-1022-90-200 Enloe, Charles J. "Chuck" CST BM Elev: Insp. BM Elev. BM Description: Section/Town/Range/Map No: 5,41IOD A(4- 3rv\ 5a,4':L. Ia 05.28.19.78A20 TANK INFORMATION ELEVA ION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Q•g3 755 _ CJ~• J Alt. Bldg. Sewer Aeration P 14 b Holding St/Ht Inlet r Far ~►'Sh, UHt Outl t n a:j TANK SETBACK INFORMATION ;br k7~~ y •~?'3 TANK TO Pfb, \ WELL BLDG. Vent to Air Intake ROAD DtInlet Yw~ Dt Bottot ~5 • p Septic f Q /aZ •g U Header/Man. Aeration Dist. Pipe I IALAV _►9.9 Bot. System dI Holding 7. Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Cover _ GPM Model Nu er ll~a r TDH Lift Friction Loss System Head TDH Ft Force Length Dia. Dist. to well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches ( _ PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS .3 ~ ` r z 1I..~.G~.~s.d SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: I r-ra•._ INFORMATION CHAMBER OR N' TypeQJSy~st UNIT Model Number: ` DISTRIBUTION SYSTEM riexll - p~(J `JS Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Int ke ~C Pies Sa Length -2 ✓ Dia Length Dia ` Spacing w SOIL COVER t x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bedlrrench Center ti -7 Bed/Trench Edges 1 Topsoil Yes No YES No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / Z-/ LA-t inspection #2: Location: 479 Tower Road Hudson, WI 16 (N 1/4 SE 1/4 5 T28N R19W) NA Lot 4 Parcel No: 05. 8.19.78A20 13b W-0 S •c. $ ' Go Jew, d b foe. (bJced~ t1-~-- 1.) Alt BM Description S 2.) Bldg sewer length -amount of cover f 7l Plan revision Required? x Yes KNo Use other side for additional information. Insepctor~ Signatuy 111 Cert. No. - Date -0-6710 (R.3/97) L - . Croix Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St Safety and Building Division INSPECTION REPORT Sanitary Permit No: 552307 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: city Village X Township Parcel Tax No: Enloe, Charles J. "Chuck" Troy, Town of 040-1022-90-200 CST BM Elev: Insp. BM Elev:, BM Description: Section/Town/Range/Map No: 05.28.19.78A20 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header/Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM CHLEACHING AMBER OR Manufacturer: INFORMATION Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) 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 Topsoil Yes E No 0 Yes ]No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: / / Location: 479 Tower Road Hudson, WI 54016 (NW 1/4 SE 1/4 5 T28N R1 9W) NA Lot 4 Parcel No: 05.28.19.78A20 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? Yes Ej No - ---~J ~ _ F T_ Use other side for additional information. Cert. No. Date Insepctor's Signature SBD-6710 (R.3/97) Safety and Buildings Division County 2Dt W. Waddngton Ave., P.O. Box 7162 C"!!t?3X 1 7Msin Madison, WI 53707-7162 Sanitary Permit Number (to be filled to by Co.) 155 -7 State Transaction Number Saeift y Permit A ad" in accordamx with s. Comm. 83.21(2), Wis. Adm. Code, stitiiimission of this form to the appropriate goverhritertta7 ` unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned PO Project Address (if different than trailing address) submitted to the Department of Commerce. Personal information secon , n purposes in accordance with the Privacy Law s. 15. 1 m Stats. 7 lower L A n I a' - Pkase Print AN Ia Property Owner's Name Parcel # Property Owners Mailing Address Property Location ~ 4 _ ZO ST.~UIXt.;uulv~F-ICE l/ rJ 8ZONING Govt. Let Cit)> State Zip Code Y. Section ALAI - (circle one T N N; R /9 g 11. Type of Building (cheek all ihai apply) t # vision Name Subdi ig l or 2 Family Dwelling -Number of Bedreams J Block # 0 Pubhck"imerciat - De=ibe Use 0 City or - El Number ❑ Village of ❑ state owned -Describe Use ® Town of T/Lo 2 A;~~ t,J 1 ~ ~ ~-1 to a 1H. Type of Permit: (Check a* ouL-box owfine A. Complete- fine 0' apptkable A. 0 New System ® Replacemexmt System 0 Treatment/Holding Tank Replacement Only ❑ Other Modification to Fainting System (explain) List Previous Permit Number and Date Issued 07 7 B. ❑ Permit Renewal 0 Pert Revision ❑ Change of Plumber 0 Permit Transfer to New Before Expiratioa Own" t IV. Type of POWTS S st E! t/Deviee: Cbeck all that ekt H Non-Pressurised in-Ground D Pressurised in-Ground D At-Grade 0 Mound ? 24 in. of suitable soil 0 Mound < 24 in. of suitable soilt . --6e-cS Holding Tank Other Dispersal Component (explain) ❑ Pretreatment Device (explain) Area Required (sf) Dispersal Area Proposed (sf) System Elevation Design Flow (gpd) Design Soil Application Dispersal 7 D Vt. Tank Info , Capacity in Toted # Of Man Gallons Units acturer l/W o Gallons /✓Ir`S6R /ivER 04A'=7A U y New Tanks FadstiogTasks ~GLY6tK 3'o2St'Nt~ ✓ rL U ii w C7 a F Septic or 1iol8iag Tank Dosing Chamber VII. Responsibility Statement- 1, the andersiped, Assume reapoasibitity for hotanation of the POWTS shown on the attaehed Plaos. Plumber's Name (Print) Plumber's Si MP/MPRS-NumIII! r Business Phone Number 3 /s-- awme Plumbe s Address (Street, City, State; Zip Code) is VYII. oaa Ilse rtcaent Use Only Permit Fee Date ssaed lssuin gent Si pproved Disapproved Reason for Denial 2- z4 /L IX. ConditkpF9g"p0"%ERms*ns for Dbapproval 1. `Septic tank, effluent filter and dispersal cell must all be services t maintained as per management plan provided by plumber. 2.• AIEselback requirements must be.maintained Amad! eweemplew P60I ere syseearaa8 et bW# tw&e EoaMr a* eel pared notleeoetao-8 mrs a 14 0e`etbe sim SBD-6348 (R. 02/09) Valid thru 02/11 e : 0 mil/ e✓a/ua ~io~~ -rojA) lQaad x.'sb'r/~9 ~~dc Ei~' E C/~o✓/t.5 8".78dr En/c~ /A{oA-re. 5 iOvc tt.~&M• ZLI'C 47 9 Two boa d I /~i~oAa~liD CONC/ZVE Am- rtA C4AaWFA,Lahr /~ocr~v/< PL h/u e fvr>, cJ/. SYOx So`~S CFrLuEM Zr47eR, EXZ-rT-LNG Y "i°vC ErF~at.✓7 /a~vf, Q gwYy.SC"Gy S~ S rk To /.~e L}rr iwvo GaNAa/Jliv ~i{oAarEO C'i9n[ZCTE/1 Fvit Q i9~, T o{ j r~ /'asn atE /iru/lc" e .nt Tiees .S6 - I ^ \ a 5pkpo 4 drtvt wo y j C~+c~c 6C 4~P /oca~: ~Y~ or' v I Pa~IGn~ I asltrec ° ~ f h~i,•cd EJcP~'•-r,<cu.ti: f f 1V G c :Bow CsnuL/• ~ ~ f ~ elt~ f lc7~cD X,fI.a/N.:T ofS.T ~r V? I f h I ~ Poor ~'i5~•n~y dis~e/SwPCt~/ f ( / r at: /dX.~S'r~•/Ern~idC i .~~Uab~cld ~ d3~ 6afl4et GAO 'Q Po /e I . . 16 1 4C >c i LcC:.%. r /0RaPoSED as,-&um. CELL Two (.t) 7/VAlckES/ 66 [,,r s1wao AT 9fr ov CBivT6a /'G. oC vFJ/ 1 + CONVENTIONAL POWTS DESIGN INDEX AND TITLE SHEET Project Name: 479 Tower Road 3 Bedroom Replacement Conventional PO TS Owners Name: Charles J and Jody R. Enloe Owners Address: 479 Tower Road, Hudson, WI 54016 Site Address: 479 Tower Road, Hudson, WI 54016 Project Location: Subdivision: CSM Vol 17, P 4472 Legal Description: NW1/4 SEI/4 S5 T28 NR 19 W Parcel ID Number: 040-1022-90-200 Plan Transaction Number: Index and Title Sheet Page 1 Site Plan Page 2 Dispersal Cell Sizing Calculations Page 3 System Cross Section Page 4 System Management Plan Page 5 Filter Specifications Page 6 Treatment &/or Filter Tank Cross Section Page 7 Parcel Map Page 8 Septic Tank Maintenance Agreement Page 9 Certification for Utilization of Existing Septic Tank Page 10 Warranty Deed Page 11 Attachments: Soil Evaluation Report Master Plumber Restricted Service: Gary Zappa, Dent. of Comm. Credential #222373 Signature: Phone No: (715) 386-2850 Date: 3~ Page 1 of 11 •.fir/ e✓¢/aa6c,,, -7-om)w Aad ♦e-,Xl.36.,n(,y/n~~~dc E/ice ol-AWS CJ,~✓/e.51.78a/ En /cC. ~~Aorta 5 Avc zAc4w&✓r Lzivs 479Twe.- /~ito~vsEd avvC q,67E' rZA 04nZsTA WON 41104aK c)/. SYdk S"o~S EFrLuF~✓T f.747ER,EXZ. 7-rVZ, ~'"-Oovc Er7z v&,vr &,e, O pwYy.SCl'V, 601~ S 77;' ' 3-- Cur v vo To GA~iQ~D T ,ei /`~/{oAatt O CAr,Q 1Tf/l Fv/t Q i94-); T. o{ ry, /'os ~acE /-r ru tc C/sE Crr,, r C, , .S6 4 nt Ti<cs 4z) 64'x,'°" o Pa/. *,000 -/o32-y0 ~ Tv c C~ tjt,-/1rj' 3. /8 !i G/EMS ~Ir \ ~ aspk*t4E dim viay j t:G„ce, be ~~i /ccwE: ~Y~ or t Pa~,l~;.ir ..r- I asltrta o ~ t buy; cd EcJcP:•~,cC4tid 1 -r- a ~ Eyi3finq I' ~ 1 1 i G ¢nc : Bef~ sepb-c t 6~ , v eicu = /cYa,cD' I.ErE•A(n. 70 afS.T v± 1 , h 4.1 Pore vl 4, i Sked ots ~1 I ~i ,o C races Z c mac- 1 L cC.:.. _ "RoPoszo /J s/,7-As/ 1 CkLL Two (1) 71VWCkEs) 66 L.F. (r6 glaC- c Y CIWIV,5&ZS A6z 7Ae1vclq,r-s s1019clD AT 9fr ov CB~vTER of oFJi i l DISPERSAL CELL SIZING CALCULATIONS 1. (3 bedroomsx 100 gallons estimated flowx 1.5 design factor) = 450.00 Gad design flow 2. Infiltrative capacity of native soil= .07 avd/sa.ft. 3. Absorption area required: 642.86 sa.ft. 4. Absorption area as proposed: 650 20sg ft (32 chambers total) i~" Infiltrator "Quick 4"=20.00 sq.ft. EISA per chamber, Infiltrator "Quick 4" end cap r) = 5.10 sq.tt, EISA sq.ft = (2 pair endcapsx5I = 650.20 sq.ft. sq.ft/20.00 = 32 chambet~'r~guired kDw Number of trenches: 2 Trench Width: 2.83' `french Length: 66.00' Trench Spacing: 9.00' on center Total system w/6' trench spacing 12.00'x 66.00' Pg. 3 of 11 soil &mg P6,oo -ft. 71 ft Tot PS,6o-f'/ T l ft Td Final G(ade 4' Sda" 40 P/. oc f* PVC Vent Pipe ft w4h vent cap a00 4TTl Leaching 72t~fr Tot Chamber System Eleva' cft ft X, 00 ft )Bow S~ t etrptlon Sv~tent Plan &,69 ft IT 1 1111 ft 0o ft teaching Trench 1 IIIIII At Chambers 4" Dia. Trench 2 Header Vent Or Observation Pipe t e whkm Chamber Snecif o-42ns A.vrsA~ Manufacturer And Model ..T r Ary& - 7 EISA Rating.~o• y sq ft per chamber Soil Application Rate e22 gpd/si ft 992.0 gpd Design Flow : 0,7 Soil Application Rate + 0.0 EISA = 2./. Chambers ~L~r i°. Fva CoAr = rows of chambers each. Page _-f _ of Coaveadowd Septic System Memagearerat Pisa Ptnuattt to Comm 83.54, Wis. Adin. Code General 4 ; The conventional septic system shall be operated in accordance with 22f4 Wis. Adm. Code, and shall be maintained in accordance with coal manual SBD-10705-P (N.0110 T. All local and/or state rules pertaining to system maintenance and maintenance reporting shall be compiled Segue Tank Septic tank servicing mechanics comply with Comm. 83.54(lXe). Septic tank to be located within 150' of service pad, with bottom of tank to be < 15' below service pad elevation. The operating condition of the septic tank shall be assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in the tank exceed 1 /3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48, Stats. If 'the contents ofthe tank are not removed at the time of assessment, maintenance personnel shall advise the owner of when service will be needed to maintain less than 1/3 scum and sludge accumulation in the tank. The operating condition of the outtet filter shall be assessed every six months for the first two years of system operation and once every two years or as needed alter that The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough oft the filter when ftMVed foam its enclasUM If die filter is equipped with an ale m, die filter shall be serviced if the alarm is activated. Septic tank manholes risers, access risers, and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed water tight upon the completion of service. Any opening deemed unsound, defective, or subject to lhihtre must be replaced Exposed access openings greater than 8 inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank abandonment shall be in accorrdence with Comm8333, Wis. Adm. Code when the tank is no longer used as a POWTS component The addition of biological or chemical additives to enhance septic tank performance is generally not required. If such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Soil Absorption CeH Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for vegetative maintenance) over the system is not recommended. Soil compaction may hinder aeration of the infiltrative surface within the system and will promote frost penetration during cold weather months. Cold weather installations (October-February) dictate that the system be heavily mulched for frost protection. Influent quality into the system may not exceed 220mg/L BOD5, 150 MG/L TSS, and 30 nWL FOG. Influent flow may not exceed maximum design flow specified in the permit for the installation. , Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner. Levels above 4 inches indicate an impending hydraulic failure requiring additional, more frequent monitoring. Contianeaev Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. Excessive ponding within the dispersal cell will be eliminated by installing a new soil absorption cell to bring the system into proper operating condition. Questions an the operation or maintenance of the system should be directed to installing plumber, Gary Zappa at (715) 386-2850, or the St_ Croix County Zoning Department. Page -f of EFFLUENT FILTERS P=MdOK "The PL-525 has 525 linear feet of 1/16" slots. It has an automatic shut off ball. When the filter is removed for cleaning, the ball will alftillrV "m Accept, PVC eel ens:on n.nnir float up and temporarily shut off the system so the effluent won't leave the tank. No other s filter on the market can make that claim!" n1,.r°` Illlglof 1 SM. slob ~ Rated lo. o.e. 10.000 GPO Accept. A" 6 V SC"O 40 Pipe 1 .'.a,.'. Ges d.ll.clo. Aulomnic snuo.best when fill.. • b reme.ee i "The PL-122 has over 122 linear feet of 1/16" slots. Rated for 1500 gallons per day, and Accepts l/s"PVC "nche e can be manifolded together with other PL- Al.- 122's to double or triple the GPD. It has an Switch 122 0-41., h automatic shut off ball that stops flow when the filter cartridge is removed for cleaning. Comes complete with it's own housing, no gluing of tee or pipe and no extra parts to Fill., 4'"y nn I P" Adaa. D1e. buy. l ;zi G.s o.11o.- Aulo..UC Shus.O" Bell Wh.n Fowls Aemo..d From T.nY Order # M_ odel # lJescript on List Price PK-525 PL-525 Effluent Filter System 203 50 PK-122 PL-122 Effluent Filter System 62 yti 6-10 A ge 1 a32 I v V Cl f~ m A 71 ,ax DAD F rnz In r Z r- U) rn I Oim > i 02" r- > 1., NN N Jco 372 2 Zm 6., w.r." --4 m 'or- a r~ D = m D n OZ O \ m 18" MIN. 'n / M < Fr'L N A m I A C D r 'C \ D 0 ~ r 37" I 0 21" a = 22 m D: o m O x o ~ m n ~ D D D N Tl 1 ;o N r D ~ m (l+ m A 1n m D r _ n rn-U0 ZD m m n (1) r --1 0Cm m D D M C'1 --rj C/) 0 D D D Z r r O~ Z , o FILTER CANISTER DETAIL SCALE:3/4" = t' REv NO DATE MIEBER CotCAETE r DRAWN BY:SWT J Z SEPTIC MANUAL W3716 US HWY10. MAIDEN ROCK, W1 54750 DATE: JANUARY 2008 REV. JAN. 2008 800-325-8456 FILE: SHEET 13 Pq. 7W11 i t 7 1 1 4 6 0 VOL 77 PAGE 4472 KAT11LEE1,T H. MIL-SIT- REGISTER OF DEEDS ST. CROIX CO., MI CERTIFIED SURVEY MAP RECEIVED FOR RECORD 02/27/2003 01:45PM REC FEE: 13.00 COPY FEE: 3.00 LOCATED IN THE NWI/4 OF THE SE 1/4 OF SECTION 5. PAGES: 2 OWNERS: T28N. R19W. TOWN OF TROY. ST. CROIX COUNTY. CHUCK ENLOE WISCONSIN. INCLUDING LOT 2 OF A CERTIFIED SURVEY 479 TOWER RD. MAP RECORDED IN VOLUME 10. PAGE 2766 AT THE ST. HUDSON, WI 54016 CROIX COUNTY REGISTER OF DEEDS OFFICE AND LOT 1 Q SHIRLEY ENLOE OF A CERTIFIED SURVEY MAP RECORDED IN VOLUME 5. c a F- Z 475 W 1=0 HI TOWER RD. PAGE 1258 AT SAID REGISTER OF DEEDS OFFICE. w m w S HUDSON, WI. 54016 Lu z ° a O w CO LOT AREA TABLE - c RT° zoo ERIC HOHNSTAOT V a N C Q 'g- ¢ Q 459 TOWER RD. Lot # Description SO. FT. ACRES X o LL O W HUDSON, WI. 54016 LOT 3 130,680 3.000 C I N, _ ¢ I.- LOT 4 TOTAL 138,694 3.184 06 U m 2 c Cr w Q LOT 4 EXC RW 133,549 3.066 ; o < 3 w SURVEYOR: LOT 4 EXC R/W & 110.935 2.547 ° n v~ 9 z,ao~ DOUGLAS J. ZAFILER EASEMENT a - ¢ F ul S & N LAND SURVEYING, INC. LOT 5 INC RW 150,659 3.459 6 w O W 2920 ENLOE STREET LOT 5 EXC RW 145,941 3.350 co U) Z HUDSON, WI 54016 [L( 9)U 9 II OO M4L~OO 1P 4 - - .Q)uI 2 Q u X40 -R00 [3M~OG]C - g~3_°laG3L3 [U 1 a2 0oc~fV7~` V O - o o EAST-WEST m)U~,?-[~-Jom-\ I LS JOINT ACCESS QUARTER LINE 0 0 d0Lo_ 9 - (N90.04'095k.71- ROAD TOWER ~w -N88°5709"E - - - - - - rn - - - - S88°57'09P 1611. 78 315.01- 66.0v 323.14 FOUND IRON EST -389.14'- N IS S07°351571E EAST RQ~~ -2 QUARTER S88°39'52"W 704.14' oo iv 1 .89' FROM QUARTER CORNER FOUND IRON IS N - ELL c 4 COMPUTED CORNER SECTION 5 S02°41'54"E 1.44' Zoo ~n1Cs~ POSITION SECTION 5 FROM COMPUTED d g N- 8 OUSE Cn Z w j POSITION w o ~°'m A COO Z 0 O ~a LOT 5 LOT 4 0) yJ g v O N 4~ ® All in SHED ;0 CA) cb i m Qi~ 1 H USE - - - - - - - - - - m r,3 m 8 WEI?- -389.13'- lO 1 ~ i~ rJr O 126.55' 6 00 m 238.76' iZ7 I Uo GD N88°51'07"E 431.31' I[M] 0 1~ V :I \ O 8 8805 ~n1 (71 o A v Z HOUSE 1 .588°6 7 '07"W i~ I CiI w Q o 4D O I > I mm I I L~S 88051, 07' W ® Cori C~ir 202.76' 4 LOT 3 CO) 122.78' !7 1 NOO°00'00"E S88°56'28"W 431.30' ( 0 R LINE OF THE WEST ~aP ~1 1~~D aD~ I OF THE SE F/4 HE NW1/4 0WHIED aff PLM9 UCn - LEGEND NOTE: EASEMENT TO BE USED FOR INGRESS FOUND ALUMINUM COUNTY AND EGRESS TO LOT 3. SECTION CORNER MONUMENT FOUND 1" OUTSIDE DIAMETER IRON PIPE SCALE IN FEET 1" . 1 50' O SET V X 24" IRON PIPE (1 'OUTSIDE DIAMETER) WEIGHING 1.13 LSS. PER -mlia LINEAR FOOT 150 0 ISO 0 FOUND RAILROAD SPIKE ( ) PREVIOUSLY RECORDED THIS INSTRUMENT DRAFTED BY: WES ANDERSON ® SEPTIC VENT JOB NO. 6114-01 DATE: 02/152002 REVISED: 4/24/2002 EXISTING DRIVE SHEET 1 OF 2 SHEETS Vo1.17 Page 4472 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 25:,;t,';- Mailing Address ,44''! 2 rbw-d Zc28a, Z21a-arar, ,.-X&IV6 Property Address (Verification required from Planning Department for new construction) City/State , ~ . Parcel Identification Number 2jgg2 /c 2 ~c~la~Uc7 LEGAL DESCRIPTION Property Location ,6d&/'/,, , fE Sec. TJN-RyW, Town of Asa Subdivision , Lot # Certified Survey Map # Volume 17 , Page # Warranty Deed # Volume Page # o? 7 Spec house ❑ yes IN no Lot lines identifiable 9 yes 0 no SYSTEM MAINTENANCE 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 a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, joumeymanplumber, restrictedplumber or a licensed pumper verifying that (l) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days o the three year expiration date. ' ~ • f Q.fl.r.DC.. l .~l SIGNATURE OF PLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the prop described above, by virtue of a warranty deed recorded in Register of Deeds Office. o ~ . l 3i f SIGNATURE OF PLICANT DATE Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department.****** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTI'L'IZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the following residence: owouzr,, ✓ooy Z-,,wr (Street address) Y29 Tow~Q 1,4,c s-ylocated at: ,v,✓ '/a, c_'/,, Section Town ge- N, Range Z R W, Town of &~Uy , St. Croix-County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of Cd'ft -84.25, and it (the ) appear(s) to be functioning properly. SP'S 3 Z Most recent date of inspection or service If J. Did flow back occur from absorption system? Yes No_y,' (if no, skip next'line.) Approximate volume or length of time:.-- gallons minutes Tank Capacity: 'X0,70 64,L Construction: Prefab Concrete Steel Other Manufacturer (if known):,~~;,,~ Age of Tank (if known): R Q Permit number (if known) (Licensiff b r ignature) (Print ame) 7 d ?7.~ (Title) (License Number) MP/MPRS D /2 (Date) Form to be completed by licensed plumber (Dept of Gomme~ee ChaptO k ~ d S and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 9/2008 APJWO. a M ED 284.1 sic; ''F'ATE 8- ALE OF %aSCONSIN VO" -2 --LW2 66.9 :4-1;298 KiIS £PS OfFICE 7:illia 3, . !ti' , St. afld S~+i_s3 y. •.._Ea4ua ,..sa •apc~ ,apc4- cr r•Tc°; ll' Co., vnc Vile, - =.'C}_ =i Re,a 6 ?lass 23c.h ~a.•." i April h 53 rr=rr,-s ?Gas- a~ r1~ .i. ea ),,~_.a da?g._R-_..s~3oz. G1 3:40 P jL husband and sriTe, ais_.joaac._.Crea~a3ts„ . i :tr:9:,9ra~w ~t:crva.,.3 ~1:s..t ae ...~s.a •Cras.:._.... _ --tauA._b. Tax F'sn-el No: A parcel of i.aed iqucaced to the COW 1/4 of t!)e SE 1/4 of S+ecti,r S. TZ8N-',RL9'5L°. Toyr. of Troy, 5t. C:cclx Colancy. W-ksconsin, described as follows: Cocmencing at the £ 114, corner. of soid .SacE'i.-n chence West (assumed bearing referenced io the East-West 1 /4 Section Zine. be_ri_og Wese) t618.66' along said E-W 1/4 Seeziun line to the point: of b•eglar-Lng; rbon`_ contUtui,ng, West 123.14' along said E-W line; thence South 286.06,; thence East 323.141; thence North 286.G6' to the point of beginning; containing 92,437.4 sq. ft. or 2.122 nacres, and being subject to all easements. restrictions, covenants and r ncu-mbraainces of record. including the right-of-vav of Tower. Road as shown above. - 't'i'ns Ls not hetim tsad property. ;(M M cs as a=) F:xe.'-d'rtin>Ta t.. aarras/tits: ! day of t~ t ~ t a~: Jr. (SEAL) ~4-1(SE-A1. kLl lllbam J. ~ n~Loe~, Jr. (SEALi C i ~I~GC ~ t;E~I.. - ShirleA. Enloe AUTHENTICATION ACKNOWLEDGMENT Sit,.vature(s) STATE OF WISCONSIN ss. ' Count-. autheneicntc•d Lhis at e.` 19 Personally came be;ov^ me this _day of .:rtl.....•.._.. t°.4r.... the above name,! - . -r 7_G-. -a cor.•.......... TITLE: MEMBER STATE BAR OF WISCONSIN . (if rot. . . authorized by g 706.06, Wis. Stats_) t iCae known to be the ~ o y'~o person d% cu the ft2regoing instrument and ackniivdge-toe's' C•Jt / Jr`•-S I • S7~~~\{{///J l~~~~+ NT JA (J AA-F'iE0 9Y r ' ` f V!! / . .T~~-.-__....._ tL..✓~. .+.."vJ I\\\JJJ -~~~✓k \/tom- J rrrtrt(/fJ - f - ti.,tar Puhlic %V;!:, (Signatures may he authenticated or acknowledged. Both .)r ('nmmission is pcrmancrK. knot. state c::, iratir•n are not nec"nary.) - date' is t!) , c •Vsm.~ n( Gr,+J ra ,i~nia~ i., an7 c~L Or ar .i<. ~.:d E~ ::'pr•S in V•t tab :h• it ,;a r.n:::~-. STATE $AR OF WtSCONSI ~IOCI( No. 13002 NCUn1e.Cir.,aanr~ FORAf No. 2 - a."Z 2274 Wisconsin D artment orgn~rctMt SOIL EVALUATIQN~%)1 f D Page 1 of 3 Division of Sa ty and n9 s" kY ordance with Comm 85, Wis. t4d0. Code L "a 1 A.C.E. Soil & Site Evaluations Attach plet G an 8'%x 11 inches in size. Plan must St. Croix include, t and horizontal reference point (BM), direction and percents a or dimemsions, north arrow, and location and distance to nearest mad. Parcel I.D. W-1022-90-200/, ~9 AI-P Please print all information. Re sewed y a e Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). l '1 Property Owner Property Location Charles J. & Jody R. Enloe Govt. Lot NW 19 SE 1/4 S 5 T 28 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 479 Tower Road 4 na CSM Vol. 17, Pg. 4472 City State Zip Code Phone Number I City _j Village !e Town Nearest Road Hudson WI 54016 715-386-6462 Troy Tower Road ion Use: J Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD f/ Replacement J Public or commercial - Describe: Parent material Glacial Outwash Flood plain elevation, if applicabje Na General comments and recommendations: Site suitable for conventional POWTS dispersal cell with 0.7 gpd/sq.ft./day loading rate. Proposed trench elevations to be 79.00'& 80.00' (5'- 6' below existing grade). Boring # J Boring 601 Pit Ground Surface elev. 83.28 ft. Depth to limiting factor >117" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10yr3/2 none sil 2fgr mvfr as 2fm 0.6 0.8 2 10-20 10yr4/6 none sl 2fsbk mfr cw 2fm,1c 0.6 1.0 3 20-31 10yr5/4 none sil 2msbk dsh cw lfm 0.6 0.8 4 31-47 10yr5/6 f2d 7.5yr4/6 sil 1msbk mvfr cw 1vf,f 0.4 0.6 5 47-117 10yr5/4 none s Osg dl - - 0.7 1.6 Comm. 85..30(3)3 applied to discount redox. features associted with tension saturation of weak silt loam soil. Boring # J Boring 4-1 Pit Ground Surface elev. 86.22 ft. Depth to limiting factor >126" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10yr3/2 none sil 2fgr mvfr cs 2fm,lc 0.6 0.8 2 10-19 10yr4/4 none sl 2fsbk mfr cs 2fmc 0.6 1.0 3 19-24 7.5yr4/6 none Is Osg dl cw lfm 0.7 1.6 4 24-64 10yr5/4 none s Osg dl aw - 0.7 1.6 5 64-98 10yr4/4 none strat s Osg dl aw - 0.7 1.6 6 98-126 10yr6/4 none s Osg dI - - 0.7 1.6 Silt loam tonguing observed extendi horizons #2, 3 & 4 extending from approx. 10" - 64". Tongue ranges from 18" - 28" in width. Edges of sit displ redox. con ntrations associated with tension saturation - not idicative of ground water. * Effluent #1 = BOD? 30 < 220 g/L and TSS 40 < 150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Si ature: CST Number James K. Thompson 3602 Address A.C.E. Soil & Site Evaluati Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, Wl 54020 1/10/2012 715-248-7767 Property Owner Charles J. & Jody R. Enloe Parcel ID # 040-1022-90-200 Page 2 of 3 a Boring # -I Boring .e Pit Ground Surface elev. 83.07 ft. Depth to limiting factor > 115° in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-11 10yr3/2 none sil 2fgr mvfr cs 2fm,1c 0.6 0.8 2 11-16 10yr4/4 none sl 2fsbk mfr cs 1fm 0.6 1.0 3 16-24 7.5yr4/6 none Is Osg ml cw 1vf,f 0.7 11.6 4 24-93 10yr4/6 none s Osg dl cw - 0.7 1.6 5 93-115 10yr5/6 none S Osg dl - - 0.7 1.6 -7 t ~5 Silt loam tonguing observed extending through horizons #3 & 4 e nding fro appro . 28'- 63". Tongues range from 18" - 40" in width. Edges of sil display redox. concentrations associated with tension saturation - not idicative of ground water. '7\ ❑ Boring # Boring w ~ q I Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots QPQM! in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 'Eff#2 I i I J Boring Boring # F-1 J Pit Ground Surface elev.. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots .D/f' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 I I Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 mg/L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an altemate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) A.C.E. Soil & Site Evaluations Towti'' ~Qoad ~EXi3Ei'n ~dc e%` Cloy/[.S B~edy En/oc 47 9 7ow*-moan/ /-Aucu,r% c,)4 ,5w.,20 0 0 liwY5%6e 6o c, S, 7;7611; ,e /9c-); T, of ,1-y, Y.~„ p~,ncTres 56• aivi,,co/ 90 -,260 ~NTv~ o 6cl 3. /8 Gras a s l~o•Cf. d rtvt ~a i ~U ~ 1~ J 1 4~P~i •rO~~~ of nq 4sltrec t~ 0 ~1 - I _ bur%cd Ec/ya/.~a•rcCab~e park. r f~,,•1'J r r I 1- -tj E Ov I ~j G wage: 6af60" ' ' CsnciL i i C! stP'~ c g~ , v ln~. f~sswm ~ r ~ o~' e Icy : /cb GD' *zfI&• ANN.: Top o{S,T. 1 1 I o I IH ~ L Poor ~x1s~:.,,y ar;s~crs.QCc,!l i m a 16X.~s'.r~/ ~Id' rb3~ Pole 6vvl4cc 04O.&SO t I I of Q O Sked oi~ m~ m C2cC-~ T~ee,s 4 /GS EO ec sb Lot1:nc 38 3' So a.-14 6 - 3 a,E3 r v o a~i o 0 3 0 C) 0 6% I! O 64 ~ I c I N 0 N CD vo N X i s ° ° -0 !I 0 ~ I c ° o o I ; N f6 E LO > O ( p I N aU N I to ~ 3 O O O O ° C 7 t0 = O N LL O O 0 t - /i w d U N N a 0 0 4L) 0 a n c) 3 M N .i W-O y z U! > W I E O O> O fn O Z~ am CO N- Z I a Lr) 0 Z :!t N O y p N Z O) 7 N D7 O N (D 0 :3 I O?. 'C N N U N OR i. N N N U) O O N N N - O L t ~ O N d N ' ~ V7 O c o I c N o d Q - ~i - Z c z Z m z O I a I' c y c ~ I m N N o m I m v ~iN R Z. In l0 L m ~ O - O N- N C .9 ? C to y Q d j Q. D .2+ (7 > O o a d I Ma D a a E CL CL ~ N ~ H H F d cc z V> -NO H IN- Fes- a CL a a m a a s o CL ° Cl) B -w t 00 00 O W t N N O a) 7 m U 3 o z O 3 } o F- a G N OM io-~l A~ O N 0 M 5 O N N V C. N d N Lo [0 = ~c ml rn a) ° O) U O N N azvn L ar~n o~ (0 c. m -t '0 0 O N Q o l ? 0) c ° a°i ' c u a °o 0 0 0 1 ` rn c m . E L _ m to M m v C%4 04 04 rn l v N raj 3 I t C (O N U C CO N Y I N N O N o U . Z -a LO Lo C C) 0 7 (D co 0 CO 'D 0 CO E 7 r- try') ~ V L6 C Lo O >1 O W M° z N= rG • 1V O O F- W LO O z -W Z V1 y m€ a I € a I at a a IL c °.3 c d C v c c 3 ',3 0 m 4~ Q V a I; i 0 U) U 0 Marcel 040-1022-90-200 04/20/2005 02:37 PM PAGE 1 OF 1 Alt. Parcel 05.28.19.78A-20 040 - TOWN OF TROY Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): Current Owner " CHARLES J & JODY R ENLOE ENLOE, CHARLES J & JODY R 479 TOWER RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 479 TOWER RD SC 2611 SCH D OF HUDSON SP 1700 WITC 3 Legal Description: Acres: 3.184 Plat: 1654-CSM 17-4472 FKA CSM 5/1258 /03 SEC 5 T28N R19W PT NW SE (2.12AC) LOT 1 Block/Condo Bldg: LOT 04 OF CSM 5/1258 NKA CSM 17-4472 LOT 4 (3.184AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 05-28N-19W NW SE Notes: Parcel History: Date Doc # Vol/Page Type 02/27/2003 711460 17/4472 CSM 07/23/1997 663/299 2004 SUMMARY Bill Fair Market Value: Assessed with: 26284 239,300 Valuations: Last Changed: 07/19/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.184 64,000 175,800 239,800 NO Totals for 2004: General Property 3.184 64,000 175,800 239,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 383301 CERTIFIED SURVEY MAPW 28N R19 Located in the NW 1 /4 of the SE 1/4 of Section 5 T , TOWN OF TROY TOWER ROAD W 1/4 cprner centerline SEe ctioc n o5rner Section 5 - - - - - WEST 323.14' T28N, R19W 9° 9°o N89 38'05"E 323.15' 0 °O, 0 h, 33,E 900O00.0 o r$ a9 N 0 x g o I° U) N -1 z = m 1z s LOT 1 o i~ m 0 1 m r ID M = li 0 Z! M ~1 924,37.4 sq. ft. / 2.122 Acres 10 0 o m N I Z a) Z N (including right-of-way) ID r D 0 2 I~ (4856.8 sq. ft. within R /W) o io z z z D lz IN rM A ly N N M m 3 OI ~ ~ f ° m OL - D rn M z c G) x itD to APPRC~VE`'R M I 1983 ,•Z m m ~ "~f D aw, MAR 0 41983 ° lmil y m K O z 1 m Si. CRGiX CZU:-7Y p ~ y COMPREHENSIVE PARKS PLANNING _ AND ;E(3t4ING COMMITTEE m M W M 000 s :-1 90 ° o `z o. East 323.14' b R SCALE IN FEET i I 0 20 40 60 60 120 1"x60') Description A parcel of land located in the NW 1/4 of the SE 1/4 of Section 5, T28N, R19W , Town of Troy, St. Crpix County, Wisconsin, described as follows: Commencing at the E 1/4 corner of said Section 5; thence West (assumed bearing referenced to the East-West 1/4 Section line, bearing West) 1618.66' along said E-W 1/4 Section line to the point of beginning; thence continuing West323.14' along said E-W line; thence South 286~06'; thence East 323.141; thence North 286.06' to the point of beginning; containing 92„437..4 sq. ft. or 2_122 acres, and being subject to all ease- ments, restrictions, covenants and encumbrances of record, including the right- of- way of Tower Road as shown above. I, James E. Rusch, registered Wisconsin Land Surveyor, hereby certify that I MAY 1 8 2004 _71 1 4E.0 ti VOL 17 PAGE 4472 ti T ~ :7 KATKEEN H. WALSH iD REGISTER OF DEEDS _ ST. CROIX CO. VI RECEIVED FOR {tECORD CERTIFIED SURVEY MAP R02/27/2003 0EC FEE: 01:45PM : 13.00 COPY FEE: 3.00 LOCATED IN THE NW1 /4 OF THE SE 1 /4 OF SECTION 5. PAGES : 2 OWNERS: T28N. R19W. TOWN OF TROY. ST. CROIX COUNTY. CHUCK ENLOE WISCONSIN. INCLUDING LOT 2 OF A CERTIFIED SURVEY 479 TOWER RD. MAP RECORDED IN VOLUME 10. PAGE 2766 AT THE ST. U. HUDSON, WI 54016 CROIX COUNTY REGISTER OF DEEDS OFFICE AND LOT 1 OF A CERTIFIED SURVEY MAP RECORDED IN VOLUME 5. O Z °C SHIRLEY ENLOE O 475 TOWER RD. PAGE 1258 AT SAID REGISTER OF DEEDS OFFICE.,- k ~0~ w : m HUDSON, WI. 54016 o ° Z ~ O LOT AREA TABLE T, , ui cc o ERIC HOHNSTADT 459 TOWER RD. Lot # Description SQ. FT. ACRES w O 2 HUDSON, WI. 54016 LOT 3 130,680 3.000 f- LOT 4 TOTAL 138,694 3.184 cr,' ' w w Q LOT 4 EXC RW 133,549 3.066 Co 0) SURVEYOR: LOT 4 EXC R/W & 110,935 2.547 Z O o DOUGLAS J. ZAHLER EASEMENT p~ 0 K S & N LAND SURVEYING, INC. LOT 5 INC RW 150,659 3.459 Z 00 2920 ENLOE STREET LOT 5 EXC RW 145,941 3.350 HUDSON, WI 54016 LOT 9 I LW UL T 4 dOU OCR @43. to ~Uo C~G° 003 o U3OM[N.~ plQG3[ - - - - EAST-WEST I LS-- JOINT n O~ ~O ACCESS QUARTER LINE I ~~7n o ~_ro1~o 9 G71~ o 0 (N90'o0'00"w) _ V P, l~ GS~J ` _ TOWER W -N88°57'09°E 5282.71- ROAD _ - - - - rn - 0, S88°57'09"W - 161 .78' 1 -315.00'- AA,. 323.14' FOUND IRON P i -389.14'- IS S07°35'57"E EAST WEST v -2 QUARTER ~ S88°39'52"W 704.14' _ ro 1.89' FROM QUARTER CORNER FOUND IRON IS o @ ° WELL 'k COMPUTED CORNER SECTION 5 S02°41'54"E 1.44' o~ o o Imo Oro POSITION SECTION 5 FROM COMPUTED w o 0o I!Q~W,-~ o OUSE 0 y y Z 8 POSITION N w °q f 9m.9 LOT 4 O o Ca m o N LOT 5~ I,n L~10~ W o °w_ o 0 -ja Cr O ~ A3 Cs3 / ~ ( .I--S--HIED W V W o Z N (D W 9) m I N o A H USE ~m m \ J N 171 WEL ° -389.13'- IC9 i 126.55' 66.00. co 238.76 i C9 IT CA4 w 1 N88°51'0 "E 431.31' O 84.37' I~ v A O S88°51'07"W;~ oo I ♦J1 v Z HOUSE D O i oo I IC: n W o !D O O i° i0° jO iO 4 o~"S co C3 ® 0~0~ b ~~060 u ~ ~ a 88'51'07'W N C~y IFe) 202.76' i LOT 3 a O I C~ 122.78' W , W NOO°00'00"E 888°56'28"W 431.30' I\EAST LINE OF THE WEST UMpgAUUCED R° HpDr) I 20 RODS nF THE NWi /4 ` Parcel 040-1022-90-200 12/28/2005 08:45 AM PAGE 1 OF 1 Alt. Parcel 05.28.19.78A-20 040 - TOWN OF TROY Current ! X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - ENLOE, CHARLES J & JODY R CHARLES J & JODY R ENLOE 479 TOWER RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 479 TOWER RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.184 Plat: 1654-CSM 17-4472 FKA CSM 5/1258 /03 SEC 5 T28N R19W PT NW SE (2.12AC) LOT 1 Block/Condo Bldg: LOT 04 OF CSM 5/1258 NKA CSM 17-4472 LOT 4 (3.184AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 05-28N-19W NW SE Notes: Parcel History: Date Doc # Vol/Page Type 02/27/2003 711460 17/4472 CSM 07/2311997 663/299 2005 SUMMARY Bill Fair Market Value: Assessed with: 102181 249,100 Valuations: Last Changed: 07/19/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.184 64,000 175,800 239,800 NO Totals for 2005: General Property 3.184 64,000 175,800 239,8000 Woodland 0.000 0 Totals for 2004: General Property 3.184 64,000 175,800 239,8000 Woodland 0.000 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: Category Amount User Special Code Special Assessments Special Charges Delinquent Charges 00 Total 0.00 0.00 383301: CERTIFIED SURVEY MAl P Located in the NW 1/ 9 W 4 of the SE 1/4 of Section 5 T281 TOWN OF TROY TOWER ROAD W 1/4 Section 5 rner centerline ~ 1 /4corner ection 5 WEST 323.14' T28N, R19W 16.06' 14.00' , '90. 9oa N89 38'05"E 323.15' oo, i .110 T Y p~0 ~e ~0 ° m N ' v o D N m z c Ic ~p N Z Z= N y ~ 1 LOT 1 o i~ i 1 ~ ~i C 2.122 _ Ii -t ° $ ~0 92437.4 sq. ft. / Acres N iv o m rn (including right-of-way) W z 0 i o Z 1r (4856.8 sq. ft. within R /W) 12 A p IZ _ y z z z G) 'O TJ IN N N I rn M ; cc QD 4 °f m :0 M C P/ o m m z MAR I~~ w APPROVE) ~ m zM ~ rn M ~IMY~ 01983 i1► D m X MAR 0 41983 U) CID z m ST. uoix C'U: -7Y v v, COMPREHENSIVE DARKS PLANNING 2 AND 20NING COMMITTEE rn M rn ~ °o so. A 00, a East 323.14' J SCALE IN FEET 0 20 40I 610 60 1210 I I"- so') Description A parcel of land located in the NW 1/4 of the SE 1 /4 of Section 5, T28N, R19W , Town of Troy, St. Croix County, Wisconsin, described as follows: Commencing at the E 1/4 corner of said Section 5; thence West (assumed bearing referenced to the East-West 1/4 Section line, bearing West) 1618.66' along said E-W 1/4 Section line to the point of beginning; thence continuing West323.14' along said E-W line; thence South 286..06'; thence East 323.141; thence North 286.06' to the point of beginning; containing 92„437..4 sq. ft. or 2_ 12.2 acres, and being subject to all ease- ments, restrictions, covenants and encumbrances of record, including the right- of- way of Tower Road as shown above. I I, James E. Rusch, registered Wisconsin Land Surveyor, hereby certify that I Y SYSTEM REPORT C AS BUILT SANITARY ) OWNER C/✓t~ c~C` ~i;, /t>;; TOWNSHIP` _SEC. STI-RJOW ADDRESS- CROIX COUNTY, WISCONSIN. SUBDIVISION/ ,Q.= LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM VIM 6 1 ` ~ J e 3 i 11 L ap I di at N r 1h rr w v A"9' BENCHMARK: (Permanent reference Point) Describe: Elevation of vertical reference point: 0 c`7 Slope at site: r SEPTIC TANK: Manufacturer: ~r Liquid Capacity: OCR Ap~: Number of rings on cover -Tank manhole cover elevation: J Tank Inlet Elevation: Tank Outlet Elevation: PUMP CHAMBER Manufacturer: Number of gallons Number of gal. pump set for a cycle gallons; Total capacity of distribution lines gallon: size of pump head; gallon per minute- horsepower ibrand name of pump and model number Type of warning device HOLDING TANK: Manufacturer Number of gallons Elevation of manhole cover Type of warning device DEPAR M~ENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR 4UMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 Number: OCONVENTIONAL ❑ALTERNATIVE (11 aSteteuiPlpned) ed) ❑ Holding Tank O In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: JADDRESS OF PERMIT HOLDER: INSPECTION ATE: Enloe, , Chuck RR#3, Tower Road Hudson WI BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: JCST REF. PT. ELEV.. NW, SE,-,, Sec. 5, T28N-R20W Troy Township Name of Plumber: OPWPRSW No.: 1County: nitary Permit Number: Anthony Zappa 1614 St. Croix 34787 SEPTIC TANK/HOLDING TANK: MANUFACTURER: / ^ LIOUIDCAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: PHOVIDEDLA P OVING COVER WrY/ ~r..,.~ IV ~Q~)• 51 OYES ONO 1OYES ONO BEDDING: VENT DIA.: VENT MATL.: HIGH W NUMBER OF ROAD: ROPERTY WELL: BUILDING: VA R T TO FRESH ALARM: FEET FROM u7 0 ! 5 INLET: OYES NO ❑Y NEAREST DOSING CHAMBER: MANUFACTURER: BEDDING: LIOUID CAPACITY: P P MODEL. PUMP/SIPHON MANUFACTURER: WARNING LA L,! L IN VER PROVIDED: P V D: DYES ONO OYES ❑ S NO. GALLONS PER CYCLE: PUMP aNO P A NAL: NUMBER OF PROPERTY WE I t G: VINLE T R LINE r T: 0 7s (D IFFERENCE BETWEEN FEET FROM PUMP ON AND OFF) Y NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture a e depth of plowi g LENGTH: I IAMETER MATERIAL AND MARKING or excavation. (if soil can be rolled into a wire, construction shall cease u til FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH: LENGTH, NO. L R. PIPE SPACING: J I INSIDE DIA. IT LIQUID BED/TRENCH TRENCHES / Z04:11,R! PIT DEPTH DIMENSIONS L EPTH FILL DEPTH DISTn I F DISTR. PIPE JOISTH. I MA IAL. N BE OF WELL: BUILDING: V NT TO FRESH BELOW PIPES: ABOVE COVER. ELEV. INLET ELEV. END. PIPES. FEET FROM LINE: AI I~,LE ~(~cQ G{ Z is. 1/ (9 7 a~ NEAREST 7-L MOUND SYSTEM: Mound site plowed perpendicular to slope Check th texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound s st to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets t riteri for medium sand. III TIONS MEASURED. OYES ONO OIL COVER TEXTURE. PERMANE MAR RS: OBSERVATION WELLS YES NO OYES ONO DEPTH OVER TRENCHIBED DEPTH OVER TRENCH/BED PT OF TOPSOIL r DDED. SEEDED. MULCHED: CENTER: EDGES. ❑ ES O OYES ONO OYES ONO PRESSURIZED DISTRIBUTION SYSTEM: AB VE COVER: WIDTH LENGTH. N OF LATERAL PACING GRAVE EPT BELOW PI F RI- DEPTH ED/TRENCH ENC S. +ENSIONS MANIFOLD PUM MA IFOLD DISTR. PE MANI LD MA ERIAL NO DISTR. DISTR. I DISTRIBUTION PIPE MATERIAL & MARKING ELEV. ELEV.. DI ELEV.. PI S DIA.' ATION AND U,-. RIBUTION HOLE SIZF HOLE SPACI G HILLER CORRECTLY COVER MAT IAL VERTICAL LIFT CORRESPONDS TO APPROVED ❑ PLANS INFORMATION Y VN DYES ONO 1POPERTY WELL: BUILDING: COMMENTS: ERMAN M OBSERVATION WELLS: NUMBER OF LINE, FEET FROM YES 1-1 NO DYES NO NEAREST 01, t0 1 e~. 6 16 -o g, 2 lg7.51 I o7 4 ia2.z5i 2' . 4 S CAP r D- !S - dyN V-j a. 01 ( 9 t . f Icca v 1--72- Sketch System on a ain in county file for audit. Reverse Side. SIGNATURE I LE - DILHR SBD 6710 (R. 01/82) fir x & " "05 7- M 6-c- / o F c - P4 6rEs GaiN~E~TEST (e,v ~iTio,vs .Sv v u y, Y~ SAFETY DEPARTMENT OF REPORT ON SOIL BORINGS AND & BUILDINGS MUSTRYi DIVISION P.O. BOX 76 LMOR AND PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS (H63.090) & Chapter 145.045) LOCATION. SECTION: ~~j OWN SHIP/MUNICIPALITY: OT NO.: BLK. NO.: NAME: or T'- /t 70/4. PAR Al P) 1/ 1/ 6' /T4d N/R20 E (.,(OT COUNTY: • V_ZlCk R'S BUYER'S NAME: MAILING ADDRESS: 5i.cifox t'N1-45- ,era TDWFif 0,050A.) DATES OBSERVATIONS MADE USE I PROFILE DESC QTIpONS: ER~~ NATION TESTTS: NO. BEDRMS.: ICOMMER IAL DESCRIPTION: ANew ❑ I,WI j L //p3 N ~ [Residence ~ Replace 1111 SCS ~ 13 v,Pkla4t S~9.t11~~ L Di9~ RATING: S= Site suitable for system U= Site unsuitable for system r ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: S STEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) os ❑u RIS ❑u ®s ❑u as au as au O.UdENro,vr}/ 14 ~/ss4Fi . If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5)(b), indicate: Floodplain indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (S E ABBRV. ON BACK.) F' •1641. sL, d2c Q,~ . ~s B- I ll 10V 33 1'h~ //0 B- / 91 y to ~ v c 0107 )14- > 3® P~-a,~ ~s cs w.e~ o VOQ^ 1044'- of p, r, A SilA och,e* S Kivc pies, co Ay B- 10,4 j w, 01'6T. OR-6- . MOTS "XZ why o~S vE~. 4T PEpd-A 1 36" 7/0 Sy': Nor- S6~fsoay~~~ S~,u~P7 0 -,Ov- SG, /O"" s- /3 a lO / 73 8e~w v~{,„ 3 aci ur C144 i ff O.P• ~+o T'S 5 36 POD DE S A) PERCOLATION TESTS TEST DEPTH, WATER I TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES > 40 (42- Y-7 NUMBER INCHES AFTERS NG INTERVAL-MIN. PERIOD 1 PERT D2 PEHI PER INCH P- 8 ,3' i P- ) G P , D Z CP P- P- _ PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. /jo77,q, 1 or 1gs-P &XmW-leAl S4&IR ~>'E-~~93fr ~e~ouJ //Ei T/rAL R.*.P.poi NT SYSTEM ELEVATION / P. ar /E(!f}7io.V J~ '776-7 Fr FT ._F fiV M `I ihlq n Z • a m 1 7T 00 7t, I3 ASE t M4 •o P _7-1_6s_ 10 i e INSTRUCTIONS FOR COMPLETIN! FORM 115 - SRD - 5395 1 be a c ~d accurate sail test, your iepoi ude: tion; clearly , whether this is a residence of r;omrnercial pr( 3. ler%AIidi(iIVI of bedroom r commercial use planned; 4. I! is a r lent system; 5, C mplete th i rating boxes. A SI E IS SUITABLE FOR A HOLDING TANK ONLY IF ALL SYSTEI ULED C E -)N SOIL CONDITIONS; b. r `e sh f( . ,writing profile descriptions and cor rs plot plan; i r i acc r y ioCating your test locations. E awing tC eferred. A ~ ry be 4.: „`,'slrr enchmt artcl ves-t r,m reference point a shov~.n,n~nt c_ )priate boxes as mes, addresses, flood pl data, pc ;-nfa- 1C .;u', as flood plain, ~ does rw- A. in th. ile box; 11. Si ace YOUt' current add id ynul- ( t` LlI sir; 12. M ' -pies and distribute as ' - i '.d. ALL 1,' TESI; MUST BE -'ITH THE .'I-ORI-iY WITHIN 30 MAYS OF COMPLET,. "I JIATIONS --RTIFIED SOIL TESTERS 1 I T xtures Other Symbols 1(}"? BR co13 SS gr 3") LS - I s HGVV - r Pere VV . Bldg s - f fly Sand > sl - 'y '-wire al Bn sil I_oarri Bi _ si - Gy C= y Y - L , nlrit vv[ 'I f ` Ill?'"` - HVVL ~ l r B MI - VRP t t 1~ P.~Cry .z o f DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS DIVISION INDUSTRY ~ 1 P.O. BOX 7969 LA$OR AND PERCOLATION TESTS (115) MADISON, WI 53707 HUMAN RELATIONS (H63.090) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: IF ft 70 Gee d ,V w '/4 '/4 3' Tiff N/R,4°E (o - IRO COUNTY: OWNER'S BUYER'S NAM MAILING ADDRESS: Sfi• Cho/•X G~vr~G,~ 2.v G0g- 0•.3 TDli),~ AX00 DATES OBSERVATIONS MADE USE NO. BEDRMS. COMMER I (PROFILE DESC IPTIONS: E EAT N TESTS: : AL DESCRIPTION: Qp2 Residence [New ❑Replace Z /LO J RATING: S= Site suitable for system U= Site unsuitable for system D SYSTEM: (optional) r ONVENTIONAL: MOUND: IN-GROUNDPRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDEAtyt_ ~ s ❑u a s ❑u ©s ou a s au a s ©u- If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation. PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, !ELEVA TI ON OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) %j~ sgrutdf IXEEA✓ cGA i,' i s ICJ C r off- 6 13,4 A,P/W m POTS 7 13 V, t/At 2- Pete "/3A). B- 1 B- B- B- 6- PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 P R PER INCH P- P- P- P'- P- P- _ PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION - o 51e e_2~t_ I o//I/ o%._. _0 BOA %5 ( o N GUT f1inJ _ 1 3 al-T i , E , U,upi[ U,~R~~ X 3 is E ~ • ~ f~; - ~~:~~i~~ A 10400 4UQ _ A-1-Y- /tilt r ~ i I RUCTIONS FOR COMPLETING F RM 115 - S D - C To be a cornplet{ d accura' your report mr 1. Coinpletr r' 7tion; 2. The use cl arly whether this is a residence or commercial pr, 3. MAXIML of iedrooms or cornmE 'al use planned; 4, Is this lent sYSt»ITS; 5. C rating boxes, A S SUITABLE FOR A HOLDING TANK ONLY IF .ALL. :SLED D ON SOIL CONDITIONS; d' " ho profile descriptions and c,, :e plot plan; 7. ac iy your test locations. G (erred. A ii 8 Y( I vertical elev rir,n reference point: ai c t. 9 1 s ~ all appio xes as to dates, narnes, addresses, flood [A 'n p_ . ,proprlate; 10 ii 'ormation (sigh as flood plain, elevation) does not apps ill t1r, lx; 11. I'll and plr your current addres -d your certificat:,}n n 12= K r'istiibute as ALL SOIL TEST rtlTli i-HE L(. `ITHIN 30 DAYS G; MY]PLETION. f1ATIOI . ' . ERTIFIED SOIL TESTERS 6 T tares Other Syrnbols 1011) F - cob 1011) 1 qr 3"J L *s HGVV I - rile 'S - Ig Is - r Sand G psi; Y E mot f;r t;". Mill d L 1? c . DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS .INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISON W X 7969 HUMAN RELATIONS (H63.09(1) & Chapter 145.045) LOC_AJI SECTIO~TZe N/R (or TOWNS HIP/M~~CIPALITY: LOTNO.:BLK.NO.: SUBDIVISION NAME: 'P A CO NTY: OWNER'S BUYER'S NAME: '/fM'AILIINNG ADDRESS: X13 TDur~~ 0 - f/vPso v Ct~is Sya~ 6 USE DATES OBSERVATIONS MADE INO.BEDRMS,:ICOMMERCIALDESCRIPTION:I PROFILE DESCRIPTIONS: PERCOLATION TESTS: OResidence i New ❑Replace I - P3 4 Z - RATING: S= Site suitable for system U= Site unsuitable for system R NVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) KS ❑u Ks ❑U ]S []U ❑ S ®U ❑ S 2u '~ez If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the ~ under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST. GHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- B- ,sec B- B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERT D 2 PERIOD PER INCH P- P- P- P-_ P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. LOGAT/(1~ Of- ,S'U~P!/r y0~ S /44 c. 4Q T ljPQN S 8N € E i rou cl/ X i 3 o 4~_ i f r.- 434" -ft xzzt I I ~3a' I L I 6,e~1vL Icy ~y E of W 1 _1 ~ Ink, a f t INSTRUCTIONS OR C)MPLETIN FORM 116 - SRI - : To be a CO r )lete and accurate sail test, your repor` ut1e: 1. Compl( 1; 2. The case rly indicate vrl,. t is is rice or -.-ial project; 3, MAXil`~Irooms or con use pl, . r , system; 5. g -)xes. A' =i SUITA` FOR A HOL IN( Ti _Y I.._ ALL _ED OC BA'-,-:D ON SOIL CONOITIr S; 6. , shoe r v~riting profile des -i{ ._nd conil, a plc_,' plan; ` acct ly locating your test ocaiions. L' A sire..!; =td vertical elevation referen point art all al opriate boxes as to dates, names, < 1 flood pls )propriate; , rrnation (r, ri ft^ e elevation) do gs n the form and Lit jr address and your fit) copies =)d as re(juired. ALL L TESTS ` l 'ST BE f ITH THE a( I)THORiTY Wl , -.YS OF COMPLE', . i,,_„_VIATIO FOR CERTIFIED OIL TESTERS f Textures Other Symbols 10.1) EAR B 'rock col) - I. 10•') SS gr - i I iunder 3") LS L , HOUR -f, Ferc - F - ' `a`t' V fs Bldg B Is > r s I < L I - _ Bn rii Bi Gy R _L mol - 'lay vvI' - 6C ifi - - p H'AJ L BM VRP APPLICATION SAFETY & BUILDINGS INDUSTRY, OF FOR SANITARY DIVISION LABOR AND PERMIT P.O. BOX 7969 HUMAN RELATIONS (PLB 67) MADISON, WI 53707 Attach plans for the system on paper not less than 8% x 11 inches in size. Include a plot plan that is dimensioned or drawn to scale. Horizontal and vertical elevation reference points must be shown. All appropriate separating distances and physical characteristics as specified in chapter H-63, Wis. Adm. Code, must be shown. An index page or each page must be signed, sealed and dated by the designer. If designed by a Master Plumber, the date, signature and license number must be shown. A legible reproduction of the soil test report or the owner's copy must be included. Property Owner: Mailing Address: -O 601J CffucK ~~~oE T 3 Wf~ o/5~1xJ t/ "v Property Location: City, Village or Townshi County: /X t/aS iT Ni R 21\6\ E (or) W /f UJ~,sD,t~ L20 Lot Number: Blk No.: Subdivision/Name: /f Nearest Road, Lakye oar Landmark: State Plan I.D. Number: R9 wl- s l~%UI~Ey /~j OBI r~ /f f ?D~s~/Z /`a (If assigned) A TYPE OF BUILDING Number of El Public* ❑ Variance* El Other (specify)* A0. Vn Bedrooms: 1 or 2 Family *State Approval Required. F -3 TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify) SEPTIC TANK CAPACITY HOLDING TANK CAPACITY LIFT PUMP TANK/SIPHON CHAMBER MANUFACTURER: E /t)Gt.2 _e_ UUC-TS EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): ❑ New ❑ Replacement ❑ Experimental " Seepage Bed ❑ Seepage Pit (P'3 ~ 1P'X3s ' ❑ Alternative (specify) ❑ Seepage Trench Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner): Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber: Si re: MP/MPRSW No.: Phone Number: Plumber's Address: Name of Designer: COUNTY/DEPARTMENT USE ONLY Sig atu 'of Issuing Agent: Fee: DAPPROVED Sanitary P~rmit Number: ~D dam" ❑ DISAPPROVED 3 Reason for Disapproval: Alternate course(s) of Action Available:. Change of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to in- stallation. Failure to comply will void. the sanitary permit. DISTRIBUTION: White-County, Canary-Bureau of Plumbing, Pink-Owner, Goldenrod-Plumber DILHRSBD-6398 (R.07/81) p~ _ TE os PLB (o7 SO f T and RO K I~~' s 4ee t0 S EC71 O N P(A N 5 tw k~ k 1* oRr y (~©kt 3 13 ~Uj ►v o ohTF YE~vr ~ n, ~oRG ~ !I ~ ' ~ fi • SiDEr.J.I//s - ook~eA// IrjQ' fo CXAc1 41U) / - - I ~oPt L ~o T~p~l3ED / 3s 130i h StATr A'/~/~,Povr l~ ~ 5 f r o' L~~avo S~/ SEi°lic vote ~ ~ ouS~ BEAST 1 y Ff ni Y" c aeaposev 10W0.7e6 1- C HUC ~ ~iV LOE~ J-OU)C/Z ,eep - /0 / • 3 l~f vDSv,v NW1 Sri 5er.S' T-LfN /e 20 cv O p2o/~aSEV wt ~c y y GNED St pRA~~ f' t o / . a~ Fresh Air Inlets And Observation Pipe Approved Vent Cap Minimum 12° Above Final Grade u 'r A J A 41I Cast Iron , 44 t n i 01 r y ~~RE 3 + • I3aJ1 • 7~' X 3 0 ~ ~ ~ II ~6 ~ ! ii' - - - - - - - - - - - - - ! Odt-;e A/~ ISibf'o c.4~T Nw I _ I /3oPt CT° T~J~ ~ ~3FD / 35 ~ V i fr. a' G~iew S~J. S~Plio R " C ' mid r hous n GEASf ~y Ff ~ y,. e.s • r~RaPoSed 10jp Q 725-6 7- )VVME T'occ~E2 ,P~Q - RT 3 /f vdSo~J L f1V ie 2-o w O PQo/aaSE v W t 73 roc fq,v,C ok S%GNtD 5tp ~;Ctv LrcENse Fresh Air Inlets And Observation Pipe Approved Vent Cap Minimum 12" Above Final Grade ~EAyr ~y+, Bur ]YLOR~ 4" r:nst Irnn