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STC - 104
AS BUILT SANITARY SYSTEM REPO
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OWNER 44,111
ADDRESS odd ¢dz3
SUBDIVISION / CSM# T #
SECTION 2 T ~N-R^/ S W, Town of
r~
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
~A7 d/p is G(
0 7 yb 4{ J~
v e
0 0
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK: 9 s cJf I/
ALTERNATE BM:
EPTIC K PUMP CHAMBE
HOLDING TANK INFORMATION
Manufacturer: e_ /1': Liquid Capacity:
Setback from: Well ~ cr~ House Other
Pump: Manufacturer 'el
a
Model# Size
Float seperation
-Gallons/cycle:
S~
Alarm Location
D !d ~
-:SOIL ABSORPTION SYSTEM
Width: Length
Number of trenches
Distance & Direction to nearest prop. line:
Setback from: well: dZ /
House Other
ELEVATIONS
Building Sewer ST Inlet.
ST outlet
PC inlet PC bottom
- ~~Pump Off - 14 Header/Manifold G' Bottom of system
Existing Grade
Final grade 7
DATE OF INSTALLATION:
PLUMBER ON JOB:
LICENSE NUMBER:
INSPECTOR:
3/93:jt
WisconsiA Departnient of Industry, PRIVATE SEWAGE SYSTEM Coun
v
Labor and Human Relations t ST. CROIX
Safety and Buildings Division INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.:
240750
P(Y ft~,o dersll~,~pe:~NY ❑ City ❑ Village M Town of: State Plan ID No.:
1t71,1t1ts+~L+ AAiiVV-11~-AAVV Forest
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
A9500244
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
Dosi ng
Aeration Bldg. Sewer
Holding St/ Ht Inlet
TANK SETBACK INFORMATION St/ Ht Outlet
Vent
ir Ito
TANK TO P/ L WELL BLDG. A
ntake ROAD Dt Inlet
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
Forcemain Length - Dia. Fi Dist. To Well
SOIL ABSORPTION SYSTEM
RED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS DIMENSIONS
SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
SETBACK
INFORMATION Type O CHAMBER Model Number:
System: OR UNIT
DISTRIBUTION SYSTEM
Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length Dia. Length Dia. Spacing j "
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched
Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.) '46 11<.r;c<"
LOCATION: Forest. 32.31.15W, SW, SE, County Road S
/ r
Plan re~ision 6E u red? ❑ Yes ❑ No
Use other side for additional information.
SBD-6710 (R 05/91) Date Inspector's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH .
SANITARY PERMIT NUMBER:
01 ZZ
i
SANITARY PERMIT APPLICATION Bureasafetyu of and BuilBuilddinng Waater System
teri 201 E. Washington Ave.
In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969
Madison, WI 53707-7969
• Attach complete plans (to the county copy only) for the system, on paper not less County
than 81/2 x 11 inches in size.
• See reverse side for instructions for completing this application State Sanitary Permit Number
yP~
The information you provide may be used by other government agency programs E] Chec~evision ~p evis 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
/4 . 1/4, S T , N, R ,rT (o
Property Owner's Mailing Address Lot Number Block Number
5 r; -
c~ y, State Zip Code Phone Number ubdivision Name or CSM NyMjaw
II. TYPE F BU L G: (check one) ❑ State Owned ❑ Cityy _ Ne st Ro
❑ lllage
Public 1 or 2 Family Dwelling - No. of bedrooms Town OF J~-Ci Q. ...5-
111. BUILDIN E: (If building type is public, check all that apply) Parcel Tax Number(s)
~ «,l - 7® ^?O .-lam-o
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 R
eplacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
System System Tank Only Existing System Existing System
X
B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Xess ize d Distribution Experimental Other
1eepage Bed 2ound 30 ❑ Specify Type 41 ❑ Holding Tank
1 ❑ Seepage Trench 2 -Ground Pressure 42E] Pit Privy
13 ❑ Seepage Pit 43E] Vault Privy
14E] 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. T Final Grade
Re fired sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation
~/50 J - . - ;-Feet / eet
VII. TANK Capacity
in gallons Total # of r Prefab. Site Fiber- Plastic Exper.
INFORMATION Gallons Tanks Manufacturer s Name Concrete Con- Steel glass App.
New Existing structed
Tanks Tanks 10
Septic Tank or Holding Tank 6G Gc> ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name: (Print) Plu er' ignature: (N a ps MP/MPRSW No.: Business Phone Number: 1-3 31 Y -4;?- 6 746A
Plumber' Address (Street, Ci~,j+, St te, Z C de): to~
b I
IX. COUNTY/ DEPARTMENT USE ONLY
❑ Disapproved Sa tary Permit Fee (Includes Groundwater ate ssue Issuing A ent Sig ature (No tam )
Surcharge Fee)
4proved ❑ Owner Given Initial ~
Adverse Determination
X. CONDITIONS OF APPROVAL / REASONS OR DISAPPROVAL:
t a_ ~e
SEID-63 B (R. 05/94) DISTRIBUTION: Original to County, 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 requiresa 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 primped 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-
IL 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 ail 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 notsmaller 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.
SAFETY & BUILDINGS DIVISION
State of Wisconsin
Department of Industry, Labor and Human Relations
July 28, 1995 401 Pilot Court, Suite C
Waukesha WI 53188
BIRD, BYRON JR
896 68 AVE
AMERY WI 54001
RE: PLAN S95-50999 FEE RECEIVED: 180.00
HILL, ANTHONY
SW,SE,32,31,15W
TOWN OF FOREST 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.
Please note that the homeowner should be advised to watch water consumption
due to part failures of mounds 8 feet and wider.
Inquiries should be directed to me at the number listed below. Please refer
to the plan number s{-gown above.
Si rely,
Julia A. Lewis
Private Sewage Plan Reviewer
Section of Private Sewage
(414) 548-8638 7:45 A.M. 4:30 P.M.
1759R/ 1
cc: HILL, ANTHONY
SUDA-7987 Ix. 10/941
-
PLOT PLAN
PROJECT Anthony HUI ADDRESS 9101st St. Lot 23 Glenwood City Wi 54013
SW 1/4 SE 1/4S 32 /T 31 N/R 15 W TOWN Forest COUNTY ST.JCROIX
w
c
MPRS BYRON BIRD JR. 3318 DATE 7/5/95 BEDROOM 3
CONVENTIONAL IN-GR D PRESSURE CONVENTIONAL LIFT HOLDING TANK
I
MOUND )000( SEPTIC TANK SIZE 1000 Gallons LIFT TANK SIZE DOSE TANK SIZE 800 Gallon
HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 375 BED SIZE 8'X 47'
BENCHMARK V.R.P. Top of 3/4" Property Line ASSUME ELEVATION 100'
❑ BOREHOLE (DWELL +H.R.P. Same as Benchmark
Property Line SYSTEM ELEVATION 100.2
Scale = 1/4" = 10' %
Slope
Note: Area 25' Below
system will remain
rn B-2 undisturbed B-3
8 B.M.
0
r OB-1
5' I
Note: System will be
installed along
/DT
contours Tanks will be
ly Bedded n
0
c
O Well
cL
Pro 3
SYSTEM Bedroom Gara e Old
House House to
be torn
Down 1Y
a
DEPT. OF INDUSTRY, LABOR & H(J? f.N I` l +lv0 Privy
jID1SION OF SAF Y AND BUILDINGS
Note: Privy will be
Removed
SEE C RESPONDENCE
k:
Y-
Page _ Of
Straw, Marsh Hay, Or
Synthetic Covering
Distribution Pipe
r.'arS+,. Sand
6" Topsoil " o
E D
3
A% I
ii
% Slope
Bed_ 0f_2r- 2 i2 Force Main Plowed
Aggregate Layer
(6"-Below Pipe)
D Ft.
Cross Section Of A Mound System Using E /I ~8Ft.
A Bed For The Absorption Area F .'7Z Ft.
G I Ft.
Signed: A Ft. H ~a Ft. Z
B Ft. l/`~•e /OD'~~
License Numb : K r Ft.
Date: 7- X- L _ Ft. , ~~~i - Z
,G. 93 ~
l4
Z~ Ft.
PRIVATE SEWAGE gYST I Ft.
W~ c in Ft .
L
DWI
k'.
DE T. OF IND TRY, !LA OR HIUM iN F1 Al. 10 NS Observation Pipe ~
SIO OF AF T9 Y ANi~ BU1i.r!";; K
S E F~ PSt'
~ j
6#_-
-J_-------_-. --------------.W o ,i
Distribution Bed Of 2 %N
-
-Pipe z 2
I Aggregate
Observation Pipe Permanent Markers
Plan View Of Mound Using A Bed For The Absorption Area
PAGE Cr
I
PUMP CHAMBER CROSS SECTION AND SPECIFICATIOUS y j
r
VENT CAP ,
y"C.I. VENT PIPE
WEATHERPROOF APPROVED LOCKING ` j
~~rj~ JUIJCTIOtiJ BOX MAN WIT I~ COVER L.A13rL
FROM DOOR,
WIWDOW OR FRESH 12"MIU.
)
I Al
I TAK
AR E
GRADE
I N+I~/ z4"o . 'i° MIN.
L-- 18"h111J.
CONDUIT
18'MIAI.
~ 111
PRIVATE SEt/ 4&,%jSTE M I
IAILE T I III
A
AP Rut t., I III
d HI,t,' I I ALARM
DEPT. OF INDUSTRY, LABOR RP P,TIONS IVISION OF SAF ANL >3 I~ uu;; I 1
o APP OE oN
ELEV. ~ _ _ I
3' ONTO OFF
D SOLID SOIL =o20
CONCRETE BLOCK ;t
a
Op RI E EXIT PERMITTED ONLY IF TAWK MANUFACTURER HAS SUCH APPROVAL.
5E0riC E s PE C, I F S cAT10AJ s /CAI
.r
DOSE ~
TAWKS MAAIUFACTURER: P WUMBER OF DOSES: PER DAy
TANK SIZE: d r~ GALLONS DOSE VOLUME
ALARM MAUUFACTUKER: - INCLUDING OACKFLOW: GALLONS
I
MODEL WUMbER: - L-V CAPACITIES: A--_O~ UJCHES OR GALLOUSS3s
SWITCH TSPC: Sri a o INCHES
B OR GALLOWS
PUMP MAIJUFACTURCR: ALL /10
~INCHES OR GALLOIJ$IZ'7
MODEL NUMBER: l - D=21 INCHES OR - M GALLONS
SWITCH TYPE: - 5~:L.g e,~~d~S~ ~D WTE• PUMP AND ALARM ARE TO BE
MIUIMUM DISCHARGE RATE GPM INSTALLED ON SEPARATE CIRCUITS
VERTICAL DIFFERENCE BETWEEN PUMP OFF AMD DISTRIBUTION PIPE.. FEET
♦ MIy~UM NETWORK SUPPLY PKESSSUFLIE . . , , " . . 22.5_ FEET
♦ FEET OF FORCE MAIN X(~:.~ /oo rtFRICTIOU FACTOR.-L-- FEET
TOTAL Dy1JAMIC HEAD FEET
IMTERMAL. DIMEUSIOUS OF TANK.: LENGTH 2 _
;WIDTH _.2 LIQUID DEPTH
31GUEO: LICEAISE MUMBER: a `-S-
DAT E: .
Page Of
::Distribution Pipe Detail For`A.Four Lateral Network '
- f-1
Alternate Position Of a=>: End Cap
Force Main
PVC Distribution Pipe PVC Force Main
PRIVATE GE SYSTErvIl
Hol Equally Spaced
PVC Manifold Pipe's tom
P P [10 V E D
S lll'F INDUSTRY, LABOR & HUMAN RELATIONS
V ION OF SAFET AND BUILDINGS
r, a iyz X 2
SEE CO . ESPONDENCE
* Last Hole Should Be Next To End Cap
Y 4.• P,22 , t
Ft.
Inches
w Y om?-1 echo r
Signed:-:,'
j Hole Diameter Inch
License Number:f
` Lateral Diameter 1 Inch(es)
5==
Date:
Manifold Diameter Inches
Force Main Diameter Inches
..w t~
v.~ + 'S
# Holes Per Pipe
r~
'
Invert Elevation Of Laterals ~~Ft.
3 3 ,~q 1 ~
I ' CAI! ,
r
C ItY
a1
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.,.,..ee.........::..<.,:,:c..:;:.::::;.:::..;;:;>:.::.;:.::~ it
c2e
HEAD/CAPACITY CURVE
TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE EFFLUENT and DEWATERING
EFFLUENT AND AND DEW DEWATE RING
WARNING: Model 185 should not be subjected to
less than 30 feet TDH.
31
I7
32 I 05 TOTAL DYNAMIC NEAKAPACRYPER MINUTE
t~ EFFLUENTAND DEWATERING
30 33.33
95 SERIES 57-59 98 137-179 161 163 165 195 186 18B 1B9
2p - FT. M G.I. Lb, G.L -LB. G.I. Lt,. G.I. LV. G.L Lb. O.L LuL U Lb. G.I. Lb. C.I. La& Gal. Lb•
90 S 1 52 41 161 72 273 104 394 106 401. 61 231 61 231' 1d 220 133 587 155 .587:
26 a5 _ 10 305 34 129 61 271 79 300 100 .776 61 .231 61 271 Sb 220 118 $60 151 $72
117 ID 77 45 170 64 212 91 344 60 227. 60 227 S8 .220 142 537 145 349
74 60 20 4.10 23 91 36 136 62 310 59 223 60 227 S8 220'. 136 515 140 530:
75 23 1,62 ' 8 90. 74 280; 57 216 Si 223 Sb 220: 129 494 131 503
9 27 186 30 914 65 246 55 208 SD 2N 90 340 58 220 121 AM 127 451-:-
z
J 70 40 12.1.9. 46 174 46 172 55 1206. 75 295 36 220 105 -397 114 431f
20-7- 50 14.24: 21 90: 33 125 51 191 N 119 N Y20 90 N1 100 379
165 60 1929 15 57 43 161 36 136. 55 220 71 269 15 32
a' 9 60
j 70 2,11 5 30 114 10 ;.35 52 197 51 191 70 286'
p 16 5! 16 60 -2135 14 S7 45 170 n 106 S4 .204
50 00 21.17; 12 121 2 IT 17 110
100 0049? 15 68 21 79
t1 45 110 :;200,
r 2e a 30
iz 10 L9(k V&* 19.25• 23' 26' 66 97' 73 115 91 112
1 e~
tp
so
ss L%'~y ce~~%i~
t8
a 15
6 ~~l P
I61
4 15 166
7 96
G HEAD/CAPACITY CURVE
y / 4 3 .IJ
f~17'S
0 SEWAGE and DEWATERING
10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160
80 160 240 320 AGO 480 560 640 WARNING: Model 293 should not be subjected to
0 FLOW PER 41NVIE less than 15 feet TDH.
TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE
SEWAGE AND DEWATERING
SERIES 252 266 261 266 262 264 292 293 284 298 406•
FT. M. Gal Lw Gal Ltre Gal 'a Gal Ltn Gal Ln Gal Ln Gal Ltre Gal Ltn Gal Ltre Gal Ltre Gal Ltr9
5 1;52` 90 341>< 128 -484:':`: 128 f> 128 484 130 492 180 .!691 140 530 : 196 742 225 '.:852. 400 1514
10 60 221` 89 ..337': 89 .337. 89 337 95 360' 158 598 124 .'469 181 685' 205 116'. 350 1325
G
15 ~4 5T 22 5 85 50 189:: 50 ':189 50 189 63 298 135 611 106 401 130 >492 165 :...626. 185 : 700 300 1136
20 Stb::`: 10' 38 10 38!:: 10 38 33 125 106 401 88 ,333 119 450: 150 ,568168 636 250 946
7s
77 25 7.q I. 76 288 68 257 106 I'401 136 ..515; 153 580. 200 757
70
30 9,14 43 ` 163 47 378 90 340 121 >468 140 530 150 '568
III 20
' 40 12.195 `19 50 189''. 94 .356, 115 435
1B 50 1524
58220 89 337
16 55 60 18129.:; 13 49 59 223
'A- 70 21.94 f 25 95
$ 50-
s LOckValii 18' 21.5' 21.5' 21.5' 26' 35' 42' S0' 62' 77' 40'
3Y
F '7 10 ,
Y 10
to
p 293
75
6 70
282
i5
10-
7B4
7 762 797
5
766. 67,' 69 791 295
0
V.S. CULLONS 10 20 50 40 60 UO 70 80 90 100 Ilp 170 130 Ia0 t>D I60 I701p019 700 71 770 730 NO 250 260 270 80 290 300 710 310 330 31 350 M 370 380 390 400 11(
LITERS
0 80 160 710 MO 100 app 360 610 770 900 880 960 1010 .170 1700 1780 1360 1110 1570 I
FLOW PER MINUTE
' ''sconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page _ of
*abor and Human Relations
Ditsion of safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY
~C
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
PROPERTY OWNER: PROPERTY LOCATION f4~_
GOVT. LOTI/4 1/4,S/ N,R `,''E (odS:~
PROPERTY OWNER':S MAILING A RE LOT # BLOCK # SUED. NAME ~lo►'+C Si2awr,
1o L..~e:VCL 494F3 --I 16~ c&k
Cljyff TATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE RTOW NEAREST ROAD
[ ] New Construction Use [ Residential / Number of bedrooms [ ] Addition to existing building
K Replacement [ ] Public or commercial describe
Code derived daily flow Sv gpd Recommended design loading rate bed, gpd/ft2 Z trench, gpd/ft2
trench, gpd/ft2
Absorption area required bed, ft2 trench, ft2 Maximum design loading rate -bed, gpd/ft2 ~
Recommended infiltration surface elevation(s) 7 02- ft (as referred to site plan benchmark)
Additional design / site considerations
Parent material si I Flood plain elevation, if applicable A'1 ft
S = Suitable for system CONY I AL MO ND 7IN-GROLINURESSURE AT-GRADE SYSTEM I FILL HOLDIN K
U= Unsuitable fors stem ❑ S S❑ U l S U ❑ S 1I U El S U ❑ S U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence BourxWy Roots GPD/ft
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed TwIch
4+•`4
C? _12 LO M,~Pz 4
Ground 3 ✓ / 6 .2 ~r 4
ALUf _t. y 5 y 7 s ,s s rv, X
Depth to
limiting
x.3..2
Remarks:
Boring #
a
14 41:)d
0- 6 7 S
Ground
elev.
9 ft.
Depth to
limiting
Remarks:
CST Name: Please Print lbw Phone: V-6
Address: 9_6 A J-e-r i s Y 0
Signature: Date: CST Number:
~~3- Z'5- ZJ
i
PROPERTYOWNER SOIL DESCRIPTION REPORT Page ' of
PARCEL I.D. #
1
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
Ground
elev. Of'
~ft. y S 6 Sr, 5l i I
Depth to
limiting
~t~
Remarks:
Boring #
M.
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
;
Ground
elev.
ft.
Depth to
limiting
factor FT I
Remarks:
Boring #
..Ground-.l-
elev.
ft.
Depth to
limiting
factor
Remarks:
i~ SBD-8330(8.05/92)
Soil Test Plot Plan
Project Name Anthony Hill Byron Jr.
Address yl~
Glenwood City &Ifr
r~ CST #3479
Lot Subdivision Date 6/3/95
Sw 1 /4 SE 1/4S32 T 31 N/R15 W Township Forest
❑ Boring O Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft Top of 3/4" Property Line
System Elevation * H R P Same as Benchmark
300' Property Line
60'
Slope
B-2 B-3
ON 80 20 M.
30°o
0
'
30'
~ n
40 40
O
a
cn ,
75'
Well
1,5 9
Pro 3
Bedroom Old House
house Wage to be Torn
own
10
Vy
532130 ~ ~
Jul
Flo - 1
MN' y 199$ ~
Sy 9
SC 0
CERTIFIED SURVEY MAP Q0
j o
Located in Part of the Southwest Quarter of the Southeast Quarter Section 32, Towns orth,
Range 15 West, Town of Forest, St. Croix County, Wisconsin.
NORTH 1/4 CORNER
SECT. 32, T.31 N, R.15 W
Z Prepared for and at the request of S/3~ Y s`1:
i RONAI.D F "
°0 Lawrence and Janis Meyers
2766 HWY 64 1nHtvS "tl`.I
Emerald, WI 54012 ° 5 ~~s6
C J OWNER. ,C,;AFNy 4 z
wif .1
l o Drafted by. James M. Brault r 0
00, tv
I m er~8q~~tyf=t
I
I
UNPLATTED LANDS
FENCE
I ~
- - - - N 89'37'20" W 435.60'----
-
0 I \ -
t
o Ln % I
N N 1 ~ ~
I
o I
o ~ N l
Z
LOT 1 0
INS 10
ID " I 1
jD
I
I~ N 70TAL AREA I Im
Iv 1.34680 sq. ft. 100' ROAD SETBACK LINE Ip
Ir O .100 ocrss Ji (SEE REPORT) ONj m Ir
I
I ~Z
- IZ
i0
°W 7oTAL AREA ExaumviG R.aw L4
I
o 114256 o~ s HOUSE TO BE REMOVED i o
o °
I °
FENCE I /f RIGHT OF WAY SE CORNER OF SECT. 32
I S 89'37'20" E 1 435.60 T.31 N, R.15 w
I T
1\ g CENTERLINE OF C.T.H. S I CENTERLINE OF DRIVEWAY. j
_ o 2216.30'
~ S 89'37'20" E c 435.60' -
VOL.-4541 PG_ 262 C_T_H S SOUTH LINE OF THE SE 1/4 i~
Pte, -
2651.90' - r - -
SOUTH 1 /4 CORNER S 89.37'20" E
SECT. 32, T.31 N, R.15 W UNPLATTED LANDS 'ROVED
JUL 12 '951
BEARINGS ARE REFERENCED TO THE SOUTH LINE OF THE
SE 1/4 OF SECTION 32 TOWNSHIP 31 N., RANGE 15 W.
WHICH IS ASSUMED TO BEAR S 89'37'20'E 'ROIX COUNTY
~;Oioorehenslve PlarVIII,
County Section Corner Monument NO TH Zoning wW
of Record. Found Aluminum Monument Parks Committoo
• Set 1" x 24" Iron Pipe weighing
1.68 pounds per linear foot. riot recorded
GRAPHIC SCALE witnin 30 days of
0 Found 1" Iron Pipe 0 50 100 150 200 •100roval dato
x-x x Denotes-Fence
i'Wvval Shah
( IN FEET ~
1 inch 100 fl.
NOTE: The parcels shown on this map is subject to State, County and Township
laws, rules and regulations ( i.e. wetlands, minimum lot size, acces to parcel,
etc.). Before purchasing or developing any parcel, contact the St. Croix County
RON JOHNSON LAND SURVEYING Zoning Office and the appropriate Town board for advice.
PHONE # 268-2601
P.O. BOX 194, AMERY WI 54001
Sheet 1 of 2
Vol. 10 Page. 295-5
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER
MAILING ADDRESS O o /2 ~ ~ {Lo~
PROPERTY ADDRESS
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE
PROPERTY LOCATION V4, 1/4, Section T N-R ,LS'_W
TOWN OF ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMBER
CERTIFIED SURVEY VOLUME- PAGE LOT NUMBER
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 yoz pt 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 be completed and returned to the St. Croix
County Zoning Officer within 30 days of the three year expiration date. c
SIGNED: /
St. Croix County Zoning Office '
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
This* application form is to be completed in full and signed by the
owner(s) of the property bed 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 fUf
Location of property 1/4 1/4, Section, T, _N-R d~
Township- Mailing address 9i ~42-3-
G`
Address of site o
Subdivision name Csn~ /O. -29575- Lot no. I
Other homes on property? Yes_2<_No
Previous owner of property C,1 l~ c 7 c `rJ-Gym r -
Total size of property y 3 ACT
Total size of parcel
Date parcel was created "
Are all corners and lot lines iden ifiable? -y-Yes No
Is this property being developed for (spec house)? Yes _,_,2~f No
Volume 4_k and Page Number,5 2W 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 th-1490'"information form, by virtue of a'
warranty deed recorded in the office of the County Register of
Deeds as Document No.' 1 .2 and that I (we) presently-
4-7
own the proposed site for the sewage disposal system or I (we)
obtained an easement, to run the above described property, for the
construction of said system, and the same has been duly recorded in
the office of the County Register of Deeds as Document No.
• f
r
Signature of plicant Co-Applicant
Date /6f nature Date of Signature
t .
a /
iI •I>OCWti!-:NT N0. WARRANTY DFtD THIS RE'+ERVEt. IOR RECORDING DATA I'
~i STATE BAR OF WISCOC. IN FOR:.i 2-1082
ii 5312 ii Vi.!!. "
I 111~OPaji r
.
li Lawrence R. Meyer, a/k/a Lawrence Meyer and i
I Jan.is.....Keye 17. 1995
. _.M•...M.ey.e.r...a/k/a.-Janica-.Mey.ar,- k~usband. rI. 1995
and-wife
3:15 P. ~
II convey, and war :silts to ...Anthony R.- Hlll. and Rhonda J. .s,.a:e•ti ,~.,,:.1:'•e..t. ~
Hill
. husband.,and mi.fa- pprshlp marital Rg3'srotl:.: , ,
property
I
.
L /~~i cL'~t/ulLl1
,
the following described real estate it $t• Croix 2J2
...............................................County,
State of Wisconsin:
Tax Parcel No:
1i Part of the Southwest Quarter (SW..) of the Southeast Quarter (SEk) of
li Section Thirty-two (32), Township Thirty-one (31) North, Range Fifteen
i! (15) West, more particularly described as:
'I Lot One (1) of Certified Survey Map 2955, in Volume 10 of ps, Page 'i
s~ 2955, as Document No. 531130.
II ;f
it
Fa
Thi: is not homestead property.
!i (isr(Is not) II
ii II
Exception to t••,rrlnties: Subject to easements and rights of way of record,
municipal and county zoning ordinances, if any.
f i
II Dated this JU [ l day of July 19 95 . !
I~
II i
.(SEAL) (SEAL)
.
ii awrence~yR.7Meyer
.(SEAL) //7 (SEAL)
anis M. Meyer
AUTHENTICLITION ACKNIOWLEDGMENT
I' I
Signature(s) STATE C-P WISCC`:SIN
SS. ,
7L County. i
sS.t.,. ..Croix
authenticated this ........day of 19...... PvrFunally came before me thi Tq..... day of
July 19--9---. the above named
Lawr-ence_-R-....Meyer. &..Janis.-M....Mey.er
TITLE: M :MBER 13TATE BAR OF WISCONSIN
I (If not........... • • -
authorized by Wis. Stats.) to hie I;nn n to be
ht: person S..... who executed the
fer trumd acknowlTHIS I",STRUMF,dT WAS DF.AFTED BY NMY .sm a --Franci-s..X.. Rivard--------------- Glenwood City WI 54013 C .
i1 . .County, Wis.
::ot:::: P::h::c r 31
(Signatures may be aut! cncicated or acknowledged. Loth ItY "IlWil"-Vil is petownent. (It not, ,tate expiration
are not necessary.)
~i
'awes of perilins signing in nny. capncity should be typ,' or 9rinted be:- :sir <iCn^ :r II
bV1
WARRIOM DEED ST,I.M DAR OF W-,7COX =1~ 5rpn5in Legal Blank Co.. Inc.
FOP:? No 1- . - tddb aukee.'.ViS70ns.n