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STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER S
ADDRESS
SUBDIVISION / CSMJ LOT
SECTION
~
T N-R W, Town of Sz~gnhg
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
r
1 ~ ~V
~o7~ 14V
INDICAT1; NORTH I~RRO~'
Provide setback and elevation information on reverse of this foc-m
Provide 2 dimensions to center of septic tank manhole cover
r ,
BENCHMARK:
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK IN ORMATION
r 1
Manufacturer: M ec Liqui Capacity: /e®63-
6s
Setback from: Well- House Other
Pump: Manufacturer Modelg Size
Float seperation Gallons/cycle: 3 6
Alarm Location
SOIL ABSORPTION SYSTEM
Width: Length Number of trenches _
Distance & Direction to nearest prop. line:
Setback from: well: House Other
ELEVATIONS
Building Sewer 9~7 ST Inlet. 9, ~D ST outlet
PC 27 PC bottom a, Z3 Pump of f ~y
Header/Manifold 1066 Bottom of system
Existing Grade Final grade
DATE. OF INSTALLATION:
PLUMBER ON JOB:
LICENSE NUMBER:
INSPECTOR:
5/93: )t
V%MworsinDepartment of Industry, PRIVATE SEWAGE SYSTEM County:
Labor and Human Relations INSPECTION REPORT ST. CROIX
Safety and Buildings Division
GENERAL INFORMATION (ATTACH TO PERMIT) sanitary Permit No.:
Permit Holder's Name: ❑ City ❑ Village ❑ Town of: State PRARIP4
SCHULTZ, BRUCE X
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
S_.
0 TANK INFORMATION ELEVATION DATA(,/
TYPE MANUFACTURER CAPACITY STATION BS HI FSCI ELEV.
Septic ' rr~fsr~ J..y Benchmarks 3,~a M!o
Dosing
Aeratio Bldg. Sewer
Holding St/ Ht Inlet, ' J7'
K SETBACK INFORMATION St/ I,WOutlet
Vent
irIto ntake ROAD Dt Inlet
TANKTO P/L WELL BLDG. A
Air
Septic > U NA Dt Bottom
i
Dosing NA Wggdw Man. i~ dd 9J
Aeration Dist. Pipe 16j, Ir
Hol Bot. System
PUMP/ StPWN INFORMATION C Final Grade
Manufacturer, Demand 61),x n o C OQ
Model Number PN1 , s 95
TDH Lift Friction System <91
TDH 0 Ft
Forcemain Length Z71 I Dia. " Dist. To Well ?D /
SOIL ABSORPTION SYSTEM BED/TRENCH Width Length i No. Of Trenches PIT ide
No. Of Pits Dia. Liquid Depth
DIMENSION S S DIMENSIONS
SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufa
SETBACK r: INFORMATION Type O 2 -Sol CHAMBER
o. a Number:
System: YY 011-cf OR UNIT
C\ i
ti, DISTRIBUTION SYSTEM
Heade Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
a\ Length s~~ flia. Length Dia. Spacing yc~ Gj
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.)
LOCATION: STANTON.10.31.17W, SE, SE, 2,20TH AYE
{
V / /-0 L
p c
Plan revision required? ❑ Yes No
Use other side for additional information. lx~ SBD-6710 (R 05/91) Date Inspector's Signa re Cert. No.
IL
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
t
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SANITARY PERMIT APPLICATION
In accord with ILHR 83.05, Wis. Adm. Code COUNTY
Szl... ~ro~
STATE SANITARY PER IT #
-Attach complete plans (to the county copy only) for the system, on paper not less than -7-
8% x 11 inches in size. ❑ Check if revision to previous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PRO ERTY OWNER PROPERTY LOCATION
U c c L Y. S /0 T,3/ , N, R 7 E (or)
PROPEfgY OWNER'S MAILING ADDRESS LOT # BLOCK #
CITY, STATE ZIP CODE _ PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
Cvs ° 4 ~Jr 7
0 CITY NEAREST
II. TYPE OF BUILDING: (Check one) ❑ State Owned ❑ VILLAGE ROAD
_Z07-
01,
❑ Public E 1 or 2 Fam. Dwelling-#of bedrooms PARCEL TAX NUMBER(S)
III. BUILDING USE: (If building type is public, check all that apply) p (o r®~ .
~S
1 ❑ Apt/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 in line A. Check line B if applicable)
A) 1. fS New 2.E] Replacement 3. ❑ Replacement of 4.E] Reconnection of 5.E] Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
14 ❑ System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE
REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min. inch) ELEVATION
.S~ 3 7 ,r / ♦ N1`" f DO 2_Feet / Q Z Feet
VII. TANK CAPACITY Site
in allons Total of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper.
INFORMATION New xistin Gallons Tanks Concrete struct glass App.
Tanks Tanks
Septic Tank or Holdin Tank 0 47, 4 0 t° G/4 /l
Lift Pump Tank/Si hon 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): Plumber's Sig attire: (No Stamps) MP/MPRSW No.: Business Phone Number:
-9 -3
Plumber's Address (Street, City, State, i ode):
IX. C UNTY/DEPARTMENT USE ONLY
❑ Disapproved Sry Permit Fee (includes Groundwater Date Issued Issuing Age Sign 15 Approved ❑ Owner Given Initial `~urcharge Fee)
14 Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398(R.08/93) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS ,
I ,
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new
criteria in the Wisconsin Administrative Code will be applicable.
3. All revisions to this permit must be approved by the permit issuing authority.
4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be r
submitted to the county prior to installation.
5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed
pumper whenever necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code administrator or the
State of Wisconsin, Safety & Buildings Division, 608-266-3815.
To be complete and accurate this sanitary permit application must include:
1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of
where the system is to be installed.
II. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling.
III. Building use. If building type is Public, check all appropriate boxes that apply.
IV. Type of permit. Check only one in 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 in ##1-7.
VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of
tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all
septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received
experimental product approval from DILHR.
VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g.
MP, etc.), address and phone number. Plumber must sign application form.
IX. County/Department Use Only.
X. County/Department Use Only.
Complete plans and specifications not smaller than 8% 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, ground-
water contamination investigations and establishment of standards.
SBD-6398 (R.11/88)
SAFETY & BUILDINGS DIVISION
State of Wisconsin
Department of Industry, Labor and Human Relations
April 19, 1995 2226 Rose S eye yj
La Crosse 54W
WEGERER SOIL TESTING
421 N MAIN STREET
PO BOX 74
RIVER FALLS WI 54022
CC,
.q~
RE: PLAN S95-40264 FEE RECEIVED: 180.00
SCHULTZ, BRUCE
SE,SE,10,31,17W
TOWN OF STANTON COUNTY OF ST CROIX
MOUND SYSTEM
The Department has reviewed the above-referenced submittal.
Conditional approval is hereby granted for the system plan submittal. All
noted items must be corrected. The review and approval of the system is based
on chapter 145, Wisconsin Statutes, and chapters ILHR 83 and 84, Wisconsin
Administrative Code, and is contingent upon compliance with any stipulations
shown on the plans. This system has not been reviewed for the code
requirements set forth in chapter ILHR 82 or in chapters ILHR 50-64, Wisconsin
Administrative Code.
This plan submittal approval will expire two years from the approval date, or
if a sanitary permit is obtained, plan approval will expire on the day the
initial sanitary permit expires. The licensed plumber responsible for this
installation shall keep one set of plans with the Department's stamp of
approval at the construction site. The installer shall notify the appropriate
inspector when inspections can be made.
All permits required by the city, village, township or county shall be
obtained prior to installation.
Inquiries should be directed to me at the number listed below. Please refer
to the plan number shown above.
Sincerel
rard M. Swi
Plan Reviewer
Section of Private Sewage
(608) 785-9348
8124R/ 1
SRDA-7807 (R. 10194)
e
M Page of 6
MOUND SYSTEM
FOR
A 3 BEDROOM RESIDENCE
LOCATED IN THE SC 1/4 OF THE S 1/4 OF SECTION 10 T a N, R 17 W,
TOWN OF S'Y 1~`N N , ST• C-?ttlX COUNTY, WISCONSIN.
INDEX
PAGE l 'of 6 TITLE SHEET
PAGE 2 of 6 PLOT PLAN
.PAGE 3 of 6 PLAN VIEW-CROSS SECTION
PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT
.PAGE 5 of 6 PUMPING CHAMBER
PAGE 6 of 6 PUMP PERFORMANCE CURVE
PREPARED FOR
V3I-Z\3 c.F Scmv~TZ
P, o- \3UX 43
\ARw'1mO1v0, w~ s'b15
PREPARED- BY
WEGEF;t EF:;t SQ I L - TEST I NG r's+6.ls11.c„.0
m
®
`~~j 4►®
AND.
I3ES Z C14
SI4=E~~1 I CE.• Lti
i ARTHUR L.
WEGER.ER
F.R. BOX 74 421 N. KAIK ST. = D-675 P t
S 6LLSWORTH,
RIVED FALLS. V1 54022 Wis.
715-4~.r-0Ib5
1111111111• hV
GO~~►
JOB NO. G 5 8
PLOT PLAN Page Z• of to
Scale 1"= 4 O '
em 4-Z - e-L, 99.7 0►v IQ H, 3/y` Dlq.
Quc \>>p~ wlLr~.
Q~v °J
E3Y"1 ~ - LSL, L U U • 0 cam, o ~ - ' " ~ 1 ; ^ 5 f., . i_
G "N ~ OF
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vsz 1U eE a,-T lkms T -as' Flom wto_Vw > . cot
11 A 1-k
Q~1.U4P.
►N N of
SE CORK
zzo -M »ve.
NOTES:
1. Elevations shown are existing ground elevations unless otherwise noted.
2. Install permanent markers at end of each lateral. ( Z required)
3. Install 4" observation pipes with approved caps. ( Z required)
4. Septic tank to be lbob /b5ogallon capacity manufactured by
5. Bench Mark S t'~t3oUF
6. Divert surface water around mound to prevent ponding at the uphill side.
Page 3 Of 6
Approved Synthetic Covering S 9 5 w 4 o 2 6 4
tmS1M c 33 Distribution Pipe
Medium Sand _
Topsoil _-H G F Elev. \o(3. Z
3 E
b I
Z % Slope
(Force Main Plowed
Trench of 2" -2 2" From Pump Layer
Aggregate
Undisturbed D 1-~ Ft.
Soil E Ft.
Cross Section Of A Mound System Using F b. Ft.
I Trench For The Absorption Area G N•a Ft.
A S Ft. H I- S Ft.
B -1S Ft.
I \5 Ft.
Linear Loading Rate= GPD/LN FT J a Ft.
Design Loading Rate= p.IGPD/SQ FT
K VO Ft _
L q S Ft.
httrr"oke Position of Force W Z$ Ft.
L
J ~ Fuse
B K -
W Distribution Trench Of 2 2
Pipe Aggregate
> -"';,.E r--WAGE SY TEM
Observation Perma t J iti~na v
J
Pipes Mark
(Anchor securely)
DEPT. 01 INDU i HU RELATIONS
DIVIS OF AND I INGS
R
RR NDENGE
Mound Using I Trench For A s ptioP
t Page y Of (O
Perforated Pipe Detail
0
End View S95-40264
Perforated
End Copt PVC Pipe
t _ `la~~C,CrGo
as
Install permanent-marker
at end of each lateral
Holes Located On Bottom.
Are Equally Spaced
Q End Cap
* ti PVC Force Main`_
Distnoution
Pipe N~
Last Hate Should Be P
Next To End Cap
Distribution Pipe Layout
P 3S Ft.
X S 6 Inches
Y SL Inches
Hole Diameter JIV Inch
Lateral fitly Inch(es)
Manifold - Inches
Force Main " Z Inches
# of holes/pipe $
Invert Elevation of Laterals Ft.
~k l l1 = 0. 3~ KZ= lj.lZ GPVJ %MYj
Place lst hole Z£3't from tee with succeeding holes at 56t
" intervals.
Last hole to be next to the end cap.
Combination Septic.Tank and
PUMP CHAMBER CROSS SECTION AND SPECIFICATIOUS ' PAGE S OF
VEIJT CAP WEATHER PROOF
Ju►JCTIOW BOX
4'c.I. VENT PIPC APPROVED LOCKING
10' FROM DOOR„ MANHOLE COVER P%-IIV
',JIMDOW OR FRESH wARN1AIG L.tKOEL
12"MIIJ.
AIR IMTAKE a COiJDU1T k~ 4'
L1. I,~p f I Y' MIN.
18'MIN. \
PROVIDE I INLET AIRTIGHT SEAL I I
5~ ~ ~F~~~S ~ I I I I
APPROV[- I,I~roT A I I APPROVED JOIIJT.
Waw/C~; •'WFr x T k construction I III w/C.z. ►IPE PU
EXTINDI tso 1 comply with i i ALARM ONTO N3oL D SOIL
° bO 115 and 83.20
0010 I I
I I 4~ Ow
C
LEV. I,O`3 FT PUMPS --1 OFF
CO►JCRETE ~
EL °L O.O O BLOCK
5
136' AvPA_
KISER EXIT PERMITTED ONLY IF TAIJK MANUFACTURER HAS SUCH APPROVAL- BEDDING
SEPTIC f SPEC.IFICATIOUS
DOSE lf" A\Ow1Q-$W
TAMK MANUFACTURER 32~ NUMBER OF DOSES: PER DAy
:
TAWK 51ZL : 1000 / (0SD GALLOWS DOSE VOLUME I
ALARM MANUFACTURER: S' J • U 5~1$~l l S INCLUDING BACKIFLOW: GALLONS
MODEL WUMBCR: tOt CAPACITIES: A= y IMCHCSOR 30~° GALLOIJ3
SWITCH TYPE' B= z IUCHES OR 3(J 4LLOLIS
PUMP MANUFACTURER: C= IIJCHES OR 13~ GALLONS
MODEL NUMBER: 57 D=~IUCHES OR ZZ GALLONS
1ti,vm - 1. C1
SWITCH TYPE: ~~-C'u MOTE: PUMP AMD ALARM ARE TO bC
MINIMUM DISCIiARGE RATE GPM IN5TALLED ON 5EPARATC CIRCUITS
VERTICAL DIFFERENCE DETWEEN PUMP OFF AUD..DISTRIBUTIOM PIPE.. 16Z FEET
+ MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . 2.52 FEET
6S FEET OF FORCE MAIN X d'1b FYofr.FRICTIOU FACTOR-. G'~q FEET
TOTAL OtIUAMIC HEAD FEET
Pump chamber DIAMETER
L I) 'I
INTERNAL DIMENSIOW~ OF TANK: LELIGTH ;WIDTH ;LIQUID DEPTH 'l
BOTTOM AREA - 231= - GAL/INCH
AS PER MANUFACTURER \1:0 GAL/INCH
c6~ (Z' or
4ii 614
> HEAD CAPACITY CURVE 45/s _
w w "57" - "59" SERIES
W 4s/a
25-
_1'h - 11'h NPT
43/16
20 I
W
S
V 15
a
z
C 4 l2. 91S/16
J
F
° 10
7 Z 33/32
2
5 TOTAL DYNAMIC HEAD/
FLOW PER MINUTE
EFFLUENT AND DEWATERING
HEAD CAPACITY
UNITS/MIN
0 FEET METERS GAL LTRS
US 10 20 30 40 50 5 1.52 43 163
GALLONS 10 3.05 34 129
LITERS 0 80 160 15 4.57 19 72
FLOW PER MINUTE 19.25 5.87 0 0 1
CONSULT FACTORY FOR SPECIAL APPLICATIONS
. Piggyback Mercury Float Switches *Available with special cord lengths of 15',
available. 25', 35' and 50'.
*Variable level long cycle systems *Alarm systems available.
available. a Duplex systems available.
Standard cord length - automatic 9 ft. SELECTION GUIDE
Standard cord length - non-automatic 15 ft.
1. Integral float operated mechanical switch, no external control required.
2. Single piggyback wide angle mercury float switch or double piggyback mercury
57/59 SERIES Control Selection float switch. Refer to FM0477.
Model Volts-Ph Mode Amps Slm lex Duplex 3. Mechanical alternator 10-0072 or 10-0075.
M57/59 115 1 Auto 8.0 1 or 1 & 7 - 4. See FM0712 for correct model of Electrical Alternator, "E-Pak".
N57/59 115 1 Non 8.0 2 or 2 & 6 3 or 4 & 5 5. Sensor mercury float switch 10-0225 used as a control activator, with "E-Pak"
D57/59 1 Auto 4. 1 or 1 & 7 - duplex (3) or (4) float system.
E57/59 230 1 Non 4.0 2or2&6 3or4&5 6. Four (4) hole "J-Pak", junction box, for watertight connection orwired4n simplex or
2 pump operation, 10-0002.
7. Two (2) hole "J-Pak", for watertight connection or splice, 10-0003.
57 Series - Wt. 27 -.3 H.P. 59 Series - Wt. 29 -.3 H.P.
CAUTION
For information on additional Zoeller products refer to catalog on Combination Starter, All Installation of controls, protection devless andwiring should bedone byaqualified
FM0514; Piggyback Mercury Float Switches, FM0477; Exectrical Alternator, FM0486; Mechani- licensed electrician. All electrical and safety codes should be followed Including
the
cal Alternator, FM0495; Alarm Package, FM0513; Sump/Sewage Basins, FM0487; and Simplex most recent National Electric Code (NEC) and the Occupational Safety and Health Act
Control Box, FM0732. (OSHA).
RESERVE POWERED DESIGN
For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump.
MAIL T0: P.O. BOX 16347
Louisville, KY 40256-0347 Manufacturers of. . .
SNIP TO: 3280 Old Millers Lane
® OE"ER O~ Louisville, KY 40216 p
(502) 778-2731.1(800) 928-PUMP `Q7V&IrY PL/MF8 SIIYL'E lya7J
FAX (502) 774-3624
Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page ) of 3
Labor and Human Relations
Divisidn of Safety & Buildings in accord with ILHR 83.05, e
COUNTY
IN, Attach complete site plan on paper not less than 81/2 x 11 inches in ' e. must include,
not limited to vertical and horizontal reference point (BM), direction s a or* ! PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest rorN APPLICANT INFORMATION-PLEASE PRINT ALL INFO` EWEDBY DATE
PROPERTY OWNER: bE1~+tvi~ SCc4~ S l~ P TY,
j3 tZV CE SCt-~1 3v y W1JO T 3A N,R 1-1 E (or W)
PROPERTY OWNER':S MAILING ADDRESS OT# B # AME OR CSM #
1- Zat) X 3
CITY STATE ZIP CODE PHONE NUMBER OWN NEAREST ROAD
'r~-r~wfr-ICV~In wf Sum s (7)hs))g6. z3o9 ti ZZ O `"Vt hue-.
(J~ New ConsWction Use [>q Residential / Number of bedrooms 3 [ ] Addition to exissfing building
[ ] Replacement [ ] Public or commercial describe
Code derived daily flow S O gpd Recommended design baling ray - bed, gpolft2 0 - L trench, gpolft2
Absorption area required 315 bed, 112 3_Z S trench, ft2 Mabmum design loading rate C S flied, gpdW c • 6 trench, gpo1ft2
Recommended infiltration surface elevation(s) ys Cl. Z It (as referred to site plan benchmark)
Additional design / site considerations why w/ S ' Y-l S' cb - r-f I h-". I' OF S f" kjts~' R LL .
Parent material S An `f L b Ali TILL Rood plain elevation, if applicable N • h - It
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TAPE(
U =Unsuitable for stem ❑ S 0 U as ❑ U ❑ S ICU ❑ S [$U ❑ S ®U ❑ S Q U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourxfary Roots GPD/ftin. Munsell QU. Sz. Cont Color Gr. Sz. Sh. Bed tertttt
Y"
1 O-l0 1~~~ Z-IZ - si I Zw,s~
1'
Z 10-141 10 411- 31 - S l ] is P x Yh ~1• 8~ t,~ S o-1.
Ground y PI Z R. 3 ! ~ l s o~►-~ w~ i _
w z 16 ns
elev.
\a9 • ft 3 c n►v S w e g~ w 1 5 ~-i a o f :TS
Depth to
limiting
fa for
Remarks:
Boring # p . S o. b'
I o _q 10`L%;t- z-L2 Sil ZmSbk~>^ cS _
El Z Q-3O ~v`-t.cZ j~Y - sal Z~`sbk wf`~'~- ~-5 o-f~ II
-)•S4R 31 s 0%Vk Wt PC {
S o s rn
Ground 3 36_S9 S -1 t z - W! -~-S `'l R s i t
elev. 3 S~K►vh w~Tr:` [Ys 01
C0.1 ft
Depth to
limiting
factor
30''
1--T
Remarks:
TName.-Please Print Arthur L. We erer Phone: 715-425-0165
dress:
egerer Soil Testing & Design Service-P.O. Box 74 River Fa11s,WI 54022
Sgnature: Date: CST Number:.
as-Sy Z-31 _a s M00576
PROPERTY OWNER SOIL DESCRIPTION REPORT Page of 3
PARCEL I.D. #
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Clu. Sz. Con. Color Gr. Sz. Sh. Bed Trench
Z 8 z8 ♦lp K~z 3c St.l Z(?sbk wl fM S o.
-7. S KV!-.3 \ s O~ l
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Depth to
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Remarks:
Boring #
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Depth to
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Remarks:
Boring #
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Boring #
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SBD-8330(R.05/92)
PLOT PLAN Page of 3
SCALE 1"=
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C& v d, 3_31 -cls (715 ) 4L-0165 M00576
CST Signature Date Signed Telephone No. CST #
Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page l of 3
Labor and Human Reladons
Division of Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY QAtokx
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but
not limited to verficat 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: '40ZA VIS SkCAQS l't~ PROPERTY LOCATION
8 ~Z v cry SCtN LIZ 3v Ggx. L9~- SE va SE va,S •l0 T 3A N,R 1-1 E (or W
PROPERTY OWNER':S MAILING ADDRESS [T] BLOCK # SUBD. NAME OR CSM #
IP •o,aox 3
CITY STATE ZIP CODE PHONE NUMBER ❑CfTY ❑VILLAGE 'OWN NEAREST ROAD
't Yct"t►~c q lut suUIS (7ts)-)%,23b9 s'rn' %nN Z.Zq hue'.
New Construction Use [>q Residential / Number of bedrooms 3 [ ] Addikn to existing btuldutg
[ 1 Replacement [ l Public or commercial describe
Code derived daily ADW SO gpd Recommended design boding rate _ bed, gp(W 0__3r frendt, 9Pd
Absorption area required 315 bed, 112 3 S trench, ft? Winum design loading rate o S bed, gpd$ L- -6 trench, 9P02
Recommended infiltration surface elevation(s) O fl-1• Z ft (as referred to site plan bendtmark) -
Additional design 1 site considerations W1ty „vu7 -v/ 5 'Y--) S `f1+•C~ucE1 - 1M I . 1 ' o IF Sihk& Ft LL.
Parent material S AKjw-f - L e hm TI L~ Rood plain elevation, I applicable N N - ft
S = Suitable for system dxNJVmONAI MOUND IN•G MI) PRESSURE AT-GRADE SYSTEM K FU HOLDING TANK
U= Unsuitable for stem ❑ S IR U ®S ❑ u ❑ S OU ❑ S WU ❑ S INU ❑ S O U
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
Boring # Horizon in. Munsell Qu. SZ. Cont Color Gr. Sz. Sh. Bed reach
U3 1 0-10 to`1~ Zl Z - st Z W, Sb W, +V_ _'S - o-S 0:1.
s i t Z js b1x w` i t &tj o- S o- L
Z, 10-~1 I 13 4T?_ 3l
Ground 3_ . 41--)Z S/a n s
elev.
\ot. S R 3 Cw S C ! w 1 zs"k 1P, _ a o
Depth to
fiMng
favor
Remarks:
Boring # , 0 _ct X0`1 R Z-L 2 - S11 Zm Sbk as _-111
Z Q-3o 1.oKR Sty si1 Z'~sbk w,~'~- b1,,, v-5'•. o-~
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S4
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s
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30°
Remarks:
T Name.-Please Print Arthur L. We erer Phone' 715-425-0165
egerer Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022
Signature: 01 S- S Date: CST Number:
M6. - - _ .0 16_ .
PROPERTY OWNER CNN %.:T L SOIL DESCRIPTIOWREPORT Page? of 3.
PARCEL I.D.
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Baxxiary Roots GPD/ft
in. Munsell Qu. Sz: Coat Color Gr: Sz,,Sh• Bed Trerch
Z >3 Z8 1o -1 %z Icy S1•) Z ?s.bk...;Incaw o. S a. t,
3 Z ~.sKtz3 ~l s O~ wt
Ground -~2 S ~.S`tR.s16 s 1
elev. l
Depth to
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Z
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j
Remarks:
Boring #
b i
Ground l
elev.
ft.
Depth' Io, ,
limitng'
Uctor
i
Remarks:
Boring #
i
V
13
j
Ground
elev.
ft. ~
Depth to
limiting
factor
Remarks:
Boring #
III
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-9330(R.05/92)
3
1 Page of 3
PLOT PLAN
SCALE I"= L110 '
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CST Signature Date Signed Telephone No. CST #
Feb, c'? '95 15:55 k:LENHE SALES INC TEI '15-68 -45071 F'.
• S N LAND SURVEYING*
HUDSON f WISCONSIN 54016
(715) 386-2007
Nome Dennis R. Jacobsen
Address 512 Sycamore Avenue
Marshfield, WI 54449
Description A parcel of land located in part of the SE1/ 4 of the SE1/ 4
of Section 10, T31N,'R17W,•Town of Stanton, St. Croix
County, Wisconsin; further described as follows:
Commencing at the SE corner of said Section 10; thence
N69035'30"W, along the south line of the SE1/4 of said
section, 1001.58 feet: to the :7Q' nt of begi.,ng; thence
continuing N89o35'30"W, along said south line, 259.88 feet
to the northwesterly right-of-way of the abandoned Chicago
and Northwestern Railroad; thence N61u56'56"E, along said
right-of-way, 295.60 feet; thence S001124' 30"W, 140.87 feet
to the Point_ of,beainninq. Parcel contains 0,42 Acres
(18,305 Square Feet).
Above described parcel is subject to right-oft-way for town
road (220th Avenue) and all easements of record.
k
PROPOSED gERTIFIED SURVEY NAP
5
~ti31 n t4~~p0
m ~pY r
N V O
Corner of \ N89°35'30"W
Section 10 100.00'x_
O GD ~
220TH AVENUE 9 r
1361.54 _ 159.88 M M 1001.58'
N89°W N89035130"W 259.881 N8989°35130"N
South line of the SE} of Section 10 y
SE Corner o d
Section 10
C~
EXISTING FENCELIN£
ALUMINUM COUNTY SECTION
MONUMENT FOUND
stots of Wisconsin ) 0 IRON STAKES DRIVEN
County of St. Croix ) ss. SCALE OF MAP - I INCH A 60 feet • IRON STAKES FOUND
ij Allen C. N ha en , registered Wisconsin Land Surveyorido hereby certify that
on . October 12 19„",, I surveyed the above described and mopped property according to
the official records and that the accompanying map Is a correctly dimensioned representation to scale of the boundarles,that
all buildings and Improvements lie wholly within the,1gpN.ndory lines, and that no encroachments by adjoining owners appear
from said survey.
Map No. 92-50 r'..y...':.
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STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St Croix County
OWNER/BUYER raCP_ - Pr -}r 1ST eC Sc°Pn t 4~ Zf _
MAILING ADDRESS P. Q . 3&y 43 Jturnmc)(A U) 5UD1S
PROPERTY ADDRESS ' ? 12 2 A0 '7_h A, N -
(,ocation of septic system) Please obtain from the Planning Dept.
f
L
CITY/STATE-~tv-
PROPERTY LOCATION 5E 1/4, 54E 1/4, Section j~ T_aL_N6 f 2. W
TOWN OF d- CdOn ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMBER
CERTIFIEDSURVEY MAP , V JI.UME , PAGE , LOT NUMBER
Improper use and ma-►tenance of your septic system could res~ilt in its premature failure to handle
wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed
by licensed septic tank pumper. What you put into the system can affect the function of the septic tank
as a treatment stage in the waste disposal system.
St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost
of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County
accepted this program in August of 1980, with the requirement that owners of all new systems agree to
keep their system properly maintained.
The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner
and by a mater plumber, j--:im4,,yman 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 •lbove 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 Offs(;.; within 30 days of the three year expiration da z.
SIGNED: 7
DATE:
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
8 T C - 100
This application form is to be completed in full and signed by the
owner(s) of the property being developed. Any inadequacies will
only result in delays of the permit issuance. Should this
development be intended for resale by owner/contractor, (spec
house), then asecond form should be retained and completed when
the property is sold and submitted to this office with the
appropriate deed recording.
Owner of property 8( LAO e 4 P[z-t(C 6z s c y i)-c-t-z. _
Location of property S~ 1/4_S 1/4, Section I~ T_3 N-R 1 -7_W
Township Mailing address
Address of site j 7 6;?_
Subdivision name Lot no.
Other homes on property? Yes_L_No
Previous owner of property .BiQ.A&
Total size of property A
Total size of parcel
Date parcel was created
Are all corners and lot lines identifiable? Yes No
Is this property being developed for (spec house) ? Yes '
Volume f~f7 and Page Number as recorded with the Register
of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE
NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a
certified survey, if available, would be helpful so as to avoid
delays of the reviewing process. If the deed description
references to a Certified Survey Map, the Certified Survey Map
shall also be required.
PROPERTY OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the
best of my (our) knowledge that I (we) am (are) the owner(s) of the
property described in this information form, by virtue of a
warranty deed recorded in the office of the County Register of
Deeds as Document No. 0- 7 r. 17,E , and that I (we) presently
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.
S~76y'
Signature of Appl' t Co-Applicant
Date of Signature Date of Si nature
,
J : 527698 State Bar of Wisconsin Form 2 - 1982
WARRANTY DEED
Q
DOCUMENT NO. VOL 1i 17rP,[382
,w ~asoer
REGISTERS OFFICE
Brad L. Anf inson ST. CROIX CO., WI
Reed for Re-co-11 APR 11 1995
9:30 A.
conveys and warrants to Bruce A Schultz and Patricia K.
Schultz husband and wife,
10 THIS SPACE RESERVED FOR RECORDING DATA
- NAME AND RETURN ADDRESS C~Y,~
the following described real estate in St. Croix l
County, State of Wisconsin: 'I
I
I
(Parcel Identification Number)
~I
All that part of SE4 of SE4 of Section 10-31-17 lying Southerly of the Nly
line of the abandoned Chicago and Northwestern Railroad Right of Way EXCEPT
commencing at the S4 corner of said Section 10; thence S89 35'30"E, along the
i. south line of the SE-14 of said Section, 1201.42 feet to the point of beginning;
thence continuing S89°35'30"E, along said south line, 320.00 feet; thence N00 24'30",
E, 350.00 feet; thence N89°35'30"W, 320.00 feet; thence SO0°24'30"W, 350.00 feet
to the point of beginning
I
(Continued on reverse side of deed)
R{
(This deed is being re-recorded to correct the legal'
description.)
I~
This is not homestead property.
XM (is not)
Exception to warranties: Easements, restrictions and rights-of-way of record, if any.
Dated this - 7th day of April 19 95
I'I
(SEAL) Z- (SEAL)
I
Brad L. Anfinson
(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN
St. Croix SS.
County.
iI
authenticated this day of , 19 _ Personally came before me this 7th day of
April 19 95 the above named
Brad L. Anfinson it
II
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not,
authorized by §706.06, Wis. Stats.) to me known to be the person who executed the
Connie M. Gullixson
Notary Public foregoing in ~ument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY j
State of Wisconsin
Kristina Ogland Connie M. Gullixson
Attorney at Law Notary Public St. Croix County, wis.
(Signatures may be authenticated or acknowledged. Both are not My commission is permanent. (If not, state expiration date:
necessary.) 12-14 19 97 )
'Names of persons signing in any capacity should be typed or printed below their signatures.
WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc
FORM No. 2 - 1982 Milwaukee. Wis
AND EXCEPT THE FOLLOWING:
A parcel of land locac?d In pare 'Df
of Suction 10, T31N, R17W, Town of Stanton, St. Croix
county, Wisconsin; further described as follows:
COTT!ncing at the SE corner of said Section 10; thence
N89 35130"W, along the south line of the SE1/4 of said
section, 1001.8 feet to the point of beginning; thence
continuing N89 35'3014, along said south line, 259.88 fit
to the northwesterly right--of-way of ~he abandoned Chicago
and Northwestern Railroad; thence N61 56156"E, along said
right-of-way, feet; thence
to the pc -
(18,305 Square Feet).
Above described parcel is subject to right-of-way for town
road (220th Avenue) and all easements of record.