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HomeMy WebLinkAbout006-1058-80-100 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)J. Permit Holder's Name: City Village X Township Zaun, Brian C Ion Townshi CST BM E ev: Insp. BM Elev: BM Description: b DO' ~- tom: -~_ TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic ~ / ~ (~ Dosing Aeration Holding TANK SETBACK.~NFORMATION TANK TO P/ WELL BLDG. Ven to Air Intake . ROAD Septic , / ~ ~/ ~ Dosing N ~ ~ S~ Aeration ~---- Holding - PUMP/SIPHON INFORMATION Manufacturer ~ ro ,~ GPm~and Model Number ~ ~~ TDH Lift Friction Loss System Head TDH ~t Forcemain Le h ~ Dia. N Dist. to Well ~ SOIL ABSORPTION SYSTEM -t55 U.I'~- i+19S Z ~ -'a county: St. Croix Sanitary Permit No: 405030 0 State Plan ID No: Parcel Tax No: 006-1058-80-100 STATION BS HI FS ELEV. Benchmark Z ~ (~~ `o () AI BM 0. 3 ioz. ~ Bid .Sewer ~ ~~~ $~.Z- K.3 • ~.QM .~ S Ht Inlet S t Outlet ~~y 't y Dt Inlet ~ Q,~ l A.3 , Z / Dt Bottom J N9~0 P ! IZg ~~ Header/Ma ~ I a ~~ ~5~ Dist ipe bP P` ~ `~. 10 ~ ~37 Bot. ste ~ Z~• S ,3 Final Grade( 2 ~UM ~ 3J ~ '~~ St over . ( - ~'" BED/TRENCH DIMENSIONS Width I L "1 Length y/ ,•/ No. Of Trenches / 2 DIMENSIONS No. Of Pits Inside Dia. Liquid Depth 3 SETBACK SYSTEM TO PI ~ BLDG WELL LAKE/STREA LEACHING Ma fact r~ < 1 CRAM R Y ~Yl~-- INFORMATION Typ Of System: Ra % Z 35 ~ ~ UNIT Model Number: 12 b zs v~ 3 t . I ;r DISTRIBUTION SYSTEM !J3 !~_____ ot,,,4~ DT Header/Manifold Distributio t x Hole Size x Hole Spacing Vent to Air I t ~ ~ Pipe(s) /~ ~ _~ Length Dia Dia Spacing Length SOIL COVER Y Prwcsnra Svs4ams Only YY Mnund Or At-Grade Svstem5 Only Depth Over y Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ~ Z Bed(rrench Edges Topsoil i Yes J No ,.~ ~._ Yes No ^ ^ COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: .S / ~-~ / ~ L" Inspection #2: / / Location: 2476 Hwy 63/e614~Emer}~;,d~,yW~ 154013 SE 1/4 SE 1/4 26 T31N R16W) NA Lot Parcel No: 26.31.16.4056 1.) Alt BM Description =~" i ~~ " " ~ N w ~r 2.) Bldg sewer length = ~~' -amount of cover = \ ~~ `~ - /~ Plan revision Required? Yes o ~~Z,,, I _ II I ~ ~ ~•O Use other side for additional information. ~_.___.~..-~_~p ~ ~~'~- ~--- Date Insepctor's ignature Cert. No. SBD-6710 (R.3/97) .:IJ:~~ T'..:~ vwr--w- J a -ra ram- a a1J~/{{V{f ~aVll In accord with Comm 83.21, Wis. Adm. Code vW ~ Mr WaYY1~.1 LI~IJ~ 201 W. Washington Ave. .~isconsin See reverse side for instructions for completing this application ~ sox ~~ Personal information you provide may be used for secondary Purposes Department of Commerce Madison, WI 53707-7302 ~ 0 ~ ~ [Pnvacy Law, s. 15.04(1 Xm)] ©/~ 6 ~~ _ (Submit completed form to Attach complete plans (to the county copy only) for the system, on paper not less than 8 state ownod.) -12 x 11 inches in size. CountJ~ /' ~ i ( ~ State Sanitary 't Number O Check if revision to previous application State Plan I. D. Number . r ~ ~ ~ X57) 3~ 3d ~L. S~ / 2. L Application Information -Please Print all Information P Location: _ ; ~ ~~ ~" roperty OwnerName J 4- r./ i~ 2 Gc. h/ GG1 S~ll4S~ 1/ ~ 6 ~I ~ Property Owners Mailing Address ~~L~ ~ ~ ~. 9 2002 4, T .N, (a) Loth , 8-.- ~' Cm`s State ZiP Code ne Nwnbe~V~-(Y ` C ROIX ~ ~ `~ Subdmsion Name or CSM Number ''~ rr ~ ~ ~ ~ ~ ~n l }~~~rt~ _ 13 Ccc F-~3 Type of Building: (check one) 1 2 F il D ~ p ~;ty ~ or am y welling - No. of Bedrooms : ~L _ ~ Q C~ ~ C / P I ~ ^ Will ~ ' ublic/Commercial (descn~e use):_ ! of ~wn .~ ^ State-Owned ~ , ~ ~~~ `~ 3 f 4~-n.-c.l~-.~ ~1 3 ~ X ~~ ' ~' 3' S~'~zc~ ~ r Rost /~~ ~. ~3 ~~~~~m.~.~z~~-~~,ti C~ - ~ r ~-- 3l ~ o Tax N s~d6~ IIL Type of P rmit: (Check only one box on line A. Check box on line B if applicable) A) 1. 2. Replacement 3. O Replacement of 4. 5. 6. Addition to System System Tank Only S n B) ^ A Sanitary Permit was previously issued Permit Number ys 8 Lssu~ IV Type of POWT System: (Check all that apply) `~ T~~ Gf <E_S ~~ S ~ ~t1~2 ~ /+vt~7L T~~~ (L.~ ~'f~f~ lam. on-pressurized In-ground ^ Mound / ~/ •~~and Filter ^ Constntcted Wetland ~ ~~~ h i d I , essur ze n-ground ~ Holding Tank O Single Pass 0 Drip Line ~ At-gtade ^ Aerobic Treatment Unit O Recirculating l] Other. V. Dispersal/I'reatment Area Information: 1. Design Flow 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolatwn Rate 6. Elevation ~ / Required / Proposed / Rate (Galslday/s9• ) (Minlinch) pf~ Elevation VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks ~ Con- Con- lass New Existing ~l ~`~~ /lU Crete strutted g Tanks Tanks ~~~,~ ^ ^ ^ ^ VEIL Responsibility Statement I, the undersigned, assume responsibility for lation of the POWTS shown on the attached plans. Phan s Naox (gnat) um gaanue (no stamps): MP/MPRS No. us~ness Number ~-- f ~ z 6 ~~~ ~ .. ~-~ .b ' umbels Addr ess Stre et, ity, State, Z ) g e ~C~ ~! Gam- (~' "~ ~`' (J ~ IIL Connty/Departme ~ ` ~ Q~ ~~~~~~ ~~~c~ ~ ' , D 'Fee lu Gro Date Issued St pproved O Owner Given Initial Adverse Surcharge Fa) ~y la S o ,3 U v Determination -N d ~~/Gf/h. X. Conditions of Approval/Reasons for Disapproval: ~~ t 7 ~ ht 5~~~ i'~~" 6.Q. ~ SZ~' ~ 5'~ S ~ZS ~ fz~r.~lL. Yl,b~t .1~cz.,,^ti' d-rt ~w..~.J 7 E1 S~ -~t-h'n~ 6~ 3~. 1 -h, v-u~cfi l~~t~~u~.~d locir~ ~jrs~6Z-- 2~ 1/.s~ S'~t ~v--~-t -Y-S ~ ~ ~ ~n ..~,, i• ~ a t. r tw.- rT-pr~c...+~.•. 3D-6398 (R. 07/00) PLOT PR CT Brian Zaun AD'~RESS 1 :Ida St. Roberts ~ 54023 S SE 1/4S 26 /T 31 N/~ W TOWN Cylon COUNTY St. Croix MPRS Shaun Bird 226900 DATE5/26/02 BEDROOM 3 CONVENTIONAL IN-GROUND- PRESSURE CONVENTIONAL LIFT )00C HOLDING TANK MOUND SEPTIC TANK SIZE ~ 000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1212 # of chambers 39 ,BENCHMARK v.R .Top of Nail in Tree ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 95.2 / ~U~L G~(~ , ~ 9S ; ~~ ~)~,~/ Alt. BM Top of Steel Fence Post @ 100.6' Plans Designed Using Conventional Powts Manual Version 2.0 nVent >6„ Standard Infiltrator of Cover Leaching Chamber with 31.1 ft2 of Area 12" 6' Long 3 Grade at System Elevation c ~ ~ Alt. ~ 110' M 1 10' o B- , cNn ~ Vents 4% B-1 3% 1 Slope 5' 3-3' X 80' Cells with >3' Spacing Vents 5' , B-3 25' DT ST 75~~Q' ~~ ~~~ Pro 3 House PLOT PLAN PRdJECT Brian Zaun AD~RESS 1~: Ida St. Roberts Wi 54023 SE i/'~ SE i/4S 26 /T 31 N/R W TOWN Cylon COUNTY St. Croix ~ '~~~ ~`~~ MPRS Shaun Bird 226900 ,~,J ' DATE5/26/02 BEDROOM 3 CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT )00C HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFE TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1212 # of chamber 39 ,BENCHMARK V.R.P. Top of Nail in Tree ASSUME ELEVATION 100' Fitter Zabel A-100 ^ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 95.2 / Alt. BM Top of Steel Fence Post @ 100.6' Plans Designed Using Conventional Powts 1 Manual Version 2.0 nVent >6„ Standard Infiltrator of Cover Leaching Chamber with 31.1 ft2 of Area 6' Long 12" 34" Grade at System Elevation ~ * Att 110' M 1 10' o B-2 , M ~ Vents B-1 3% S~ope ~ '~~~ 5' 3-3' X 80' Cells with >3' Spacing 00' Vents 5' B-3 25' DT ST 75'-- ~ 6 ~ 30' ~CGc~.. Pro 3 House way •^ ~ • ~ .,..,,..., v • _..r~ •~t.t. ait~! l,M~ iS sAOt~ p~R =wsOwpx rRl~~e 4sR -AfTAN! ~M ( ~" r'CAIt Cr~v ~ wt~tTKtRrltaar G RA Cl>t 14t'MIN. c:cu~.~,:,~r ~ ~~gs/ ~~• ~~ GOIu rROv,Gi ....~.,.~ I AtllT,p~rt ~tAi. ! ~ • ~ iii j ~I~ R ~ ~ ! Ai.11lt M I *.tQrsrr$~f~rrtt I ~` APRRQVEfl PdPE I . ~' INTO •cln~..,,, ~ ~ 1 a~~ o SGL.IC SOIL. --~ CO~tC RtTC RWCK RlflR tX~"!' rCRwtt'RS~r 4ui.R tr '~'A1JK +~+WIisAC~LtRCR kAf fLiCN 11f1-RO VR{. t ~~ .'r~l311! n~-yuK~-eTUR R:~ ~ Yj~K !~!t : 6 ~ Nt~tOCR ©R ao~li t ~,« ~ . //P„ c ~bAL1.Ogit bOfi- VOL.WMt ~ritRtlt z.:~~.,,.,~:;~,,,,.ac2...._....... ~*~tC,L~01#i6 R~akR~.ew: b~--~v~i f+lri't'CN Tws: -~~^ ~, C+-!*AC1'rf~;: A.~,..~~MitC11C~ OR ~ i1-ti.oN~ :~ 14J~y1MAi'htRr~t / s ~ INi>+!i OR M«oyf •MOO#1. NVMiRR: ~" •~~/~•J,'..-~1te;tif 011 OA1.a0W awITCM T>r-t= /~ D•~+•~.~tKC~R1IOA .~.0*ti.Oltt r'-tN1MYN~ OtRCKA`RflR RA's ~•~i ~~rritl• A*i0 d-I.AItM ARi Td iR ve~rlc~~ ol-rtRRA1C; iit~tw 'urr otr Ord /tNiTAt~tO 01N StlR14ATR C11tRy;Ti IWO OilTRl6t~iT:ou }~Ir~....~, ~..~ f!~'r '' NCTWQI~K l~f/~L~ 'RtiiYR[ + .s~. r ~T at ~oRC~ n~u x ~,~.• , ... , .....y`~ rte~r ~ ~ '~ '~..riRi11R ii~itTl4a~ 1y-e'rOl~t. ~/~ ~ = / . ~ (p ~ ae ~~e~ 0 1 '~ro~rw1, a~w-Mtc r~t~aa~ ~ ~eT b'TtRAlAI. OsMxueaays o ~-wK: 46MbTh // ~-- ~ ;w}atK .,,~,... ~ L~QUEQ OCPTM 1~ i ~arIRpYC Z? ~Of.-r,111)6 1'; 'y~RfflQtL Covt~t ~ ~t1 YY yy~~```` { 1 ~ 1M /'fi11f~ s_ICCN_F' tit1.~w18CR: ~._. ~»o wncsi~~s ~~r :w~ai+N# sw~~ ~+-} ~ ~/+ ata ~-~a~t ~ ~.e »~ ~! wow. a ~ ~a. ~ ~MM f iwtt ~ M~ttlllt ~ wr t~+f AI~M11et 1MIa- ~ "~ dw a ~ ~ ~ ~Iil, ~a~' INOIlr~ials O~ ~~~R'VCf~01'1 ...~.. ~ -__ a~a f~ ~ ~ _ __- ---- 0lta~l 0~ 0 i i 10 1= 1~1 ii f• !0 ~ 04 ar i~R ~ i, ~~t Dana ~1'M?~Mk ~.il2 ~•v tia•r 0~l~MMQ~ 'i' Y~IIIMII~~ A~IIM ~ ~~~~ stn ~ ~~ i, N-aarw~r~k~ ~~,a~ ~~ I ~ 1 14~1A r~ ' 11.111 ~ ~ '~ ~~ ~r~~ f ~ -~- _ 4. 1~1~ ~~ S _~ Z Yi w Y e »~•~•^~ . ~^,u,~ rippuca~iun In accord with Comm 83.21, Wis. Adm. Code ~ ~arety az t:sutlttings Division 201 W. Washington Ave. J~' CODS/n See reverse side for instructions for completing this application ` PO Box 7302 Department of Commerce Personal mformation you provide may be used for secondary purposes Madison, WI 53707-7302 a -~ ~ [Privacy Law, s. 16.04(1 xm)) ©`~ ~ ~, (Submit completed form to county if not Attach com late lens to the coon co onl for the p p ( ty PY Y) system, on paper not less than 8 state OWA~'} -i2 x 11 inches in size County`-W /` ~ State Sanitary Pe 't Number ^ Check if revision W previous application . State- Plan I. D. Number L Application Information -Please Print all Information PropertyOwnerName Location: c? Ji ~.~ ~+c `'ED / ~ ,V Property Location ~- Q ~c ~ J 4 ~ \ jG Property Owner's Mailing Address S/_ 114.5 714, S~ ~T SI ,N, (or~ g 2002 ~r ~/ ~ ~ ~ Lot Number Block Number .~ ~ . ~~~~~ C ~ fate Zrp ~e °e Numbe~uNT Subdivision Name or CSM Number ~ " - ~ `' `~`'~`~ ~ c~ - R~~X ~ ~~~~ra~ , 13 ~ F-eS Type of Building: (check one) -~ 1 ~ ~ city ~ or 2 Family Dwelling - No. of Bedrooms : - ~L ,_ ~ Q ~ ~- I Publi /C ~~ ~ ^ Village c ommercial (describe use}:_ ( ~wn of ^ State-Owned ~ . ~?/ ~"/tom c ~~ -~ ~x-?,, c~~i ~C,~ ~t,~ ~ ~ X Oyu ~ `~ 3 ~ S~'~ j~r~r, Road /~ IIL Type of P rmit: (Check only one box on line A. Check box on line B if applicable) ' P Tax N s~~6~ A) 1. 2. Replacement 3. ^ Replacement of 4. 5. SY System Tank Only 6. Addition to B) Permit Number ^ A Sanitary Permit was previously issued Exisdn S g ystem Date ~~ IV. Type of POWT System• (Check all that apply) '~ ) ~- C on-pressurized In-ground ^ Mound ~ ~ Viand Filter rressurized In--ground ^ ^ Constructed w eflara ~ .~~-- Holding Tank ^ Single Pass ^ At grade ^ Aerobic Treatment Unit ^ Recirculating ^ Drip Line ^ Other: V. Dispersai/Treatment Area Information: I. Design Flow (gpd) i 2. Dispersal Area 3. Dispersal Area 4. Soli Application 5. Percolation Rate ~„~..~ / ~4~d / Proposed / Rate (GalsJday/sq. ) (Niin.lnrch) 6. System Elevation 7. Final Grade ~~(~ ~evation VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks ~ -~~ 9 ~ Con- Con- gl~ New Existing ~ `{ ~`t--~' ~ /l U crate sttu Tanks Tanks/~~.; cted VIIL Responsibility Statement I, the undersigned, assume responsibility for lation of the POWTS shown on the attached plans. ' Plumber s Name (print) Plum gnature (no stamps): MP No. Business Phone Number umber's Address (Street, City, State, Z' ) IX, Connty/Department Use n ~ ~ ~ Q~ ~ ~ Disapprov Sanitary Permit Fee (Inclu Gro water Date Lcsued V~ Agent Sign (No stamps) pproved ^ Owner Given Initial Adverse Surcharge Fee) i~~ ~ p ,,~ ~ 3 ~ ~- ~ ` Determination ~f ~Z'(/ X_ (~nnditinnc i.f A.. rr /o...• _ r__ r.e________ !/f/h. -- Jam// ....,avaw v~~a s„~~t(r~s~ v~ai fi~ca~VLJ 1Vl L13IlY~l~OYH~: ~- /~ Sf~ } yZ ~ ! ,ti,-. _r~~-~/rC.. ~~ G ~" . ~ LCT.~I,'^'li jJ~~'L /~,G;-~ 2) Vse S-!~'~~,tl T-vr ~7 I-fY~pEI S~ -Yk-h`h~ 6~ ~~. ~ y-~v ~~- ~Q.id eUG~ ~l rs(6Z-- 3D-6398 (R. 07/i PLOT PLAN PROJECT Brian Zaun DDRESS 15 E. Ida St. Roberts Wi 54023 SE i/4 SE i/4S 26 /T 31 / 16 W TOWN Cylon COUNTY St. Croix 4/18/02 BEDROOM MPRS Shaun Bird 226900 DATE CONVENTIONAL )OOC IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK 3i MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION ARE 12 ~ # of chambe s 39 ,BENCHMARK V.R.P. Top of Nail in Tree //<% ~-~i~?'ri't ii-t~?~ r 9(SSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL +H.R.P. Same as Benchmark ~' SYSTEM ELEVATION 95.2 C~~im-t ~?yT Alt. BM Top of Steel Fence Post @ 100.6' Plans Designed Using Conventional Powts Manual Version 2.0 Vent >6„ Standard Infiltrator of C ac g am r with 31.1 ft2 of Area ' 6' Long 12' 34" Grade at System Elevation a ~ * Alt ~ 110' M 1 10' o -2 M Vents n, ;p ~ ~ ~ ~ 3% Slope __~_ 5' ' ~ ~ ~ 3-3' X 80' Cells with >3' Spacing ~~ ... - 00' ~ ~~ ~~ .,:, r ' S - ~l o '., Vents~~ 5' ..e.,ti.~~ 8j ,, Pro 3 l~"~~ :u~X'.~? ;~~-t, t`Z.,;_,,~,- ~.... Bedroom - __ __ House .~ Wisconsin Department of commerce SOIL EVALUATION REPORT page __j_ of Division of Safety and Buildings in aernrrlanne with Cnw.... QA lAR~ A.1.., r....l.. _ - __ Attach complete site plan on paper not less than 8112 x 1 t inches in size, Plan must County C / CAD .x InGude, txR not limited to; vertical and horizontal reference point (BM), direction and pere:enS slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D ~~~- ,~a'0 ~~ Please pr/nt all information. vi by Dat4 Personal intamalion you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ` ~~, -^ ~G~; 2 ~- ,~ G~ ~~' Owrtar Property Location t Govt Lot S,~ 114 s~1l4 S,~ 6 T 3~ N R l ~ E (or Properly Owner's Marling Address Lot # Block # Sutxi. Name or CSAA# ~+ ) ~, City State Z'ip Phone Number ~ ~Y ^ Village own Nearest Road New Construction Used Residential /Number of bedrooms ~__ Code derived design flow rate Sd GPD Replacement ~ PubNc or commeraal - Desaibe: ____~ ,_ .._ _ _ _ _ _ _ P ~ ~ W--~- -'. Y arent material ~~ c • __c~,Q/ Flood Plain elevata n if applicable ~~ R. General cbmmertts _ and recommendations: Sri s {f~,.~ e l~2 (} c~/L.t,(rv ~, ~... __ -- __ .. .. - -- y _.~___.-..._ __r....~ .........n ~~... ~~~~ ,,. 5011 ICatIOn Rate Horizon Depth Dominant Cdor Redox Description Texture Stnrcture Consistence Boundary Roots in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. •E~~ •Ef~ - ~ ~Z ~~ a ~ ~ .~ a.~ ~~ r . Boring # Boring Pit Ground surface elev~~! ~ ft. Depth to limiting factor „~~O in, SoN icatiott Rata Horizon Depth Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots t3P DMF in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. •EtY#1 'Et/#2 r~- ~ r Iz ~,~' ~rl•.~ ~ ~ ~~ d . ~ ;'/ - rmuerrs rf~ = tsuu, ~ "su < !20 ntg+L. anO TSS >30 < 750 mgrL • Etthiertt #2 = BADa < 30 mglL and TSS < 30 rttglL (Please Prhtt} $Igna ~{ ~~ Address Date Evaluation Conducted Telephone Number rya ~7 l 9 Z~ ~9ire. n.l ~crJ 1~,~ .,J' S Y ~), ~ 3- / ~-a~ ~ ~ s-~~ d-~(~ ~ ,b S k i. ~ Property owner 1ivL -~-- ~ ~~~,~~ti Parcel lD # '~i ~_/U~~ ? ' ~l+~ -/C.C;~ Pe9e _~ of ~~ ^ Boring # ^ ~~ , 3 ®` Pit Ground surface elev.~~~ fc. Depth to limiting fa«Ar J (/ D~ ~, Shc ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence toundary Roots t3P DlfF in. MunseN Qu. Sz. Cont. Color Gr. Sz. Sh. 'Efl#7 'Effff2 O-~ o ~3 ~ ~ ~ ~ . ~; ~7 ~, ^ Pit Ground surface elev. ft. Depth to limiting factor in, ~ k~ltion Rate Horizon Depth .Dominant ~ RedoxDescrfption Texture Strudurs Consistence Boundary Roots GP D/ff; in. Mansell Qu. Sz. Cor-t. Cdor Gr. 5z, Sh. •Efflfl 'EtT#2 ^ Pit Ground surface elev. ft. Depth to fimifing factor in. Shc Ncstion Rate i•forizon Depth Dominan! Redox Description Texture Sirvdure Consistence Boundary Roots O in. Munsetl Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 ' Eflfuartt #t = BOD, > 30 < 720 mgR and TSS >30 < 750 mglL • Effluent #2 = BODa ; 30 mgA. and T33 : 3D rr>Bll- The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBA-6130 (R.NrfO) '~ . ~ ~ Soil Test Plot Plan a Project Name Brian Zaun Shaun.- Address 15 E. I DA St. Roberts Wi 54023 #226900 Lot ---° Subdivision ------- Date /13/01 SE ~/4 SE ~/4S 26 T 31 N/R16 W Township Cylon Boring 0 Well PL Property Line Count ST. CROIX BM or VRP Assume Elevation 100 f : ~~ Top of Nail in Tree /~ C ~ ; ; , ~_~~ ~~ ~ ~~ ~ System Elevation 95.2 *HRP Same as Benchmark Alt. BM Top of Steel Fence Post @ 100.6' 4~ -~ a~ ~; ~ _~~ ''J ~ ~, t~ 110' ~e A1M. ~ , ~ 10' ~,o -2, ~0~ ~~ t, 8' 4% B-I. Slope 0' 9 S' 800' ~ '~ 30' ~3 2 ,- ;~- <~, ~> .~~-- Pro 3 Bedroom House .~ , ~ I ~C~' ;,~ ~_ ~~ ST CROIX COUNTY SBPTIC TANK MAINTENANCE AGRBBMBNT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer ~~ - ~ `'~. ~ ~~ '^ T Mailing Address a ~r ~ G !-~ ~ y ~ 31~ U ,~ ~in... C ~a ~ e~ 5y d ~ 3 properly Address %(o ~~ ~' ~~" ~ ~'` " (Verification required from Planning Department for new construction) ~.D City/State Parcel Identification Number ~D 6 - /ll S^ ~ - ~~ _ J ~ LEGAL DESCRIPTION property Location 5~ %., ~ '/., Sec. o?~ . T~~N-R, f~,_W, Town of ~~ g'~ ~ _ ,Lot # ~: , . Subdivision Certified Survey Map # ~ .Volume '"'-'- ..Page # ~J Warranty Deed # ~y~.s `~ d ,Volume ~~ j ~ .Page # 3a ~ Spec house ^ yes Lot lines identifiable~C:Lyes ^ no ii~ ~ SYSTEM MAINTENANCE Improper use and maintenanceof 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 mast~rplumber, journeymanplumber, restrictedplumber or a licensedpumper verifying that (1) 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. Uwe, 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 of the three year expiration date. ~l~~~a- S A OF APPLICANT DATB 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 property described above, by virtue of a warranty deed recorded in Register of Deeds Office. _.~. _.. f i / i ~ A F APPLICANT DATE artment. ****** ««*«*« Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Dep "'` 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 ~~;~,~~_~-~# ~f0 SD ~~ Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4.Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 Contingency Plan 1. If system fails, determine cause of failure, use alternate area and instal( new system or install system at a lower elevation. 2. Replace any other failing components as needed. Plumber: Shaun Bird 7i 5-246-4516 ~~, 7/.~-a~6 ~ Sly 8 %~ r~~z Shaun Bird #226900 ~5754~ 4~ y DOCUMENT NO. ~~o~ 1.30 ~ oacF462 ~ `~~- STATE BAR OF WISCONSIN FORM 3 - 1982 QUIT CLAIM DEED /~ Cif ~ ~ - / G'~C4J - hj'~J ~~J~ Wavne Gordon Karis, a single man, quit-claims to Donna Joanne Karis, a single woman, ~dlJ the following described real estate in St . CroiX County, State of Wisconsin: ~'he Southeast Quarter of the Southeast Quarter (SE 1/4 of SE 1/4) of Section 26 , T31N, R16[~T, except the west 426 feet thereof; together with an easement for ingress and egress over the Easterly 10 feet of the driveway as presently laid out and traveled. REGISTt:~R'S~~ QFFICE ST, CROi7C CO,, *;A/I MAR 2 0 1998 9:30 A (----.....~. R~~ I~ster o/ 4aedr ~~ THIS SPACE RESERVEp FOR RECORDING DATA NAME ANp RETURN ADDRESS Owen R. V7illiams P.O. Box 417 ~~~ Amery WI 54001 006-1058-80 PARCEL IDENTIFICATION NUMBER This Quit Claim Deed is pursuant to a iudgment of divorce entered in St. Croix County on July 8, 1997 as #96 FA 156. ~~~' ~' ~ ' 0 p• ~ ~'~ ~ ~.,~~ ~ ~~ ~ ~ '~ ~~ ~~ . ~ G ~. ~ ~ ~1lYtis i S riot homestead ro ert . P P Y (is) (is not) F # ~, Dated this (~V \ day of _~~ ~ "~G 1 , 19~d: * Signature(s) AUTHENTICATION Wayne Gordon Karis (SEAL) ~ i~/t! _yvc~'~~~~r!•li'u, (SEAL) * PTayne Gordon Karis (SEAL) (SEAL) au enti fed chi ~ 'd of ~~1~~ C1 , 19~.~' Guy T. Ludvigson TITLE: MEMBER STATE BAR OF WISCONSIN (1f not, _ authorized by §706.06, Wis. Scats.) THIS INSTRUMENT WAS DRAFTED BY Owen R. Williams, attorney P.O. Box 417, Amery WI 54001 (Signatures tnay be authenticated or acknowledged. Both are not necessary.) ACKNOWLEDGMENT State of Wisconsin, ss. _ _.__ County. -- Personally came before me this day of 19 ,the above named to me known to be the person who executed the foregoing instrument and acknowledge the same. Notary Public, County, Wis. My commission is permanent. (lf not, state expiration date: 19 ) • Names of persons signing m any capacity should by typed or primed below their signatures. STATF. 8AR OF WISC:nNSIN Wisconsin Legai Blank Co , inc l;Utr C.LAII`t Dt:1:D 1'vnn No. S' 1982 MJwnukbB. Wrs . L'JL .11J~~PAGE ~22 STATE BAR OF WISCONSIN FORM 2 - 1999 642540 WARRANTY DEED KATHLEEN H. NALSH Document Number REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between _ William L. Drawer and Victoria L. RECEIRED FOR RECORD ~ - Draeger, husband and wife, -- - _- - ------------ 04-11-?001 9:30 RM - _ YARRAMTY DEED Grantor, and Brian Zaun EXF.!fPT A - -'-- -- -- CERi CEiPY FEE: - ----.----- COP'! FEE: - -- - -- - - ------ -----..- _ TRIWSFER FEE: 135.00 - - RECG3DI4G FEE: 10.00 -- - - - - -- -- --•- --- - PAGESa,. 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix _ County, _ _ Stale of Wisconsin (if more space is needed, please attach addendum); Recording Area The West 426 f eet of EI/4 of SEI/4 of Section 26, Township 31 North, e 16 West, St. oix County, Wisconsin. Name and Return Address (i WESTCONSIN CREDIT UNION Together with an easement for ingress and egress over the Westerly ]0 feet P.0• BOX 269 of the driveway as presently laid out and travelled. NEW RICHMOND, WI . 54017 006-1058.80-100 __ Parcel Identification Number (PIN) This _is not -~- _ homestead property. Exceptions to warrattties: Easemensts, restrictions and rights-of--way of record, if any. OE) t`s not) Dated this l.P~ day of Aril , 2001 • _-- !-- AUTHENTICATION Signature(s) William L. Draeger and Victoria L. Draeger, husband and wife, -----'-'- authenticated th' ~dey of Aril ~ 2ppl + Krishna Ogland TITLE: MEMBER STATE BAR OF WISCONSIN (If not, _ authorized by ii 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Krishna Oglaad Hudson, 154016_ (Signatures may be authenticated or acknowledged, Both are not necessary.) 'Names of persons signing in any capacity must be typed ar printed below thei. WARRANTY DEED ~ r ~~- + Willis ~L,. D aeger_ -- -- •Victoria L. Draeger ACKNOWLEDGMENT STATE OF R'ISCONSIN ) ss. _ -___ County ) Personally came before me this ___ day of --.- -- - the above named to me known to he the person(s) who executed the foregoing instrument and acknowledged the same. ' + - --- - - Notary Public, State of Wisconsin - My Commission is permanent. (If not, state expiration date: 18Lare. Irdormalion PrWusiaiele Compuiy, Fdkl du LaC, Wi 900aSS2U21 10 3'fATE BAR OF WISCONSIN FORM No. 2. 1999 ~,r~ 1~79PA~E523 Village of Deer Park and Town of Cylon by Jennifer Johnson, Grant Administrator, Community Development Block Grant, quit-claims to Wayne Karis a/kla Wayne Gordon Karis the following described real estate in St. Croix County, State of Wisconsin: ~ I ,, ~~ l 'Je n' er o so , Gr t Administrator unity ev lopment Black Grant Vil ge of Deer Park and Town of Cylon The West 426 feet of the Southeast Quarter of the Southeast Quarter (SE-1/4 of SE-1/4) of Section 26, Township 31 North, Range 16 West, St. Croix County, Wisconsin. The purpose of this deed is to release the parcel described above from the Assignment of Land Contract dated November 4, 1985, and recorded on December 4, 1985, in Volume 727 of Records on page 572 as Document No. 407585 and is only a partial release of the Assignment of Land Contract. This is an exempt transaction pursuant to Wis. Stats. 77.25(10). This is not homestead pro rty. Dated this ~ day of~l~~~, 999. AUTHENTICATION Signature(s) authenticated this _ day of . 19-: signature type or print name TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by' 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Timothy J. Scott BAKKE NORMAN, S.C. -New Richmond, WI Es 15917 KATHLEEN H. WAL5H REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 12-22-1999 9:55 AM EUCTLANIM DEED 10 CERi COPY FEE: CDDY FEE: TRRNSFER FEE: ~S:IIIO FEE: i .00 Name and Return Address BAKKE NORMAN, S.C. P.O. BOX 50 NEW RICHMOND, WI 54011 006.1058-80-100 (Parcel Identification Number) ACKNOWLEDGMENT STATE OF WISCONSIN ST. CROIX COUNTY l7.ecc~,.bar Personally came before me this ~_ day of Neeera4:ef, 1999, the above named Jennifer Johnson to me known to be the person(s) who executed the foregoing instrument and acknowledge the same. L ~ ~ signature /. 1 ~ type or print name ~ ~ ~ ~ ft e w t `1 Notary Public Sl. Croix County, Wisconsin My commission is permanent. (If not, state expiration date: I - a 3 , tee J aooo 'Names of persons signing in any capacity should be typed or printed below their signatures. JULIE A NEWVILLE Notary Public State of Wisconsin Inlwmation Professionals Company Fantl du Lac. Wisconsin 900655.202