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HomeMy WebLinkAbout004-1039-70-000 C o °a' o• eF O a ry o ~ I o I 0 N I n N i I a I y 1 ~ I T C I O -o I f0 N C o Z C C ri c p o I =p f4 Cl) z N Z _ O Z a co 0 r o I c o z z m Z d' c o I H r C Z M I v I ~ I c • N -0 o c co 0 Z Z O U O N z I E OM N i ~ U O w', d l0 .L. O f° N N y i C O C 0 a 04 0) U) U) E ow N 0 0 0 a Z O CL (L CL d `O o in O N J U rn rn z 'Wfl N O O O O E M z O O CL z m m Q > ! -0 'o ►~l o U w c 0 r' o r- ° c LO a) O RS O U.) U O C} LO M N y C U ~ p p l 11 O. C N N r O N 3 (n E co V M ui f- C O O O m U a0 T s a~ a F i"'"'1~► i"i (V 0) (a U 00 ai O E U z Cn ' y~y' O U J N O n O ~ I I d E V] a`, (D a 7 a' 4) a 0 CL 7a; 4) *Ali E s c c 0, IL 2 0 (1) L) wisconsi, Department of Industry, SOIL AND SITE EVALUATION REPORT Page / of 3 L %hw-JNAuman Relations Division of Safety & Buildings in accord with ILHR 83.05. Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but .S'/• ~rd t x 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. Oc - /o-,39- '?O APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROP 0 N5 R: PROPERTY LOCATION a GOVT. LOTS 0 1/4P f,J 1/4,S T Z B N,R 15 ;,(or) W PROP TY OWNER':S A!I.ING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 2..1 P 1 _ZDp S D Z~_ • A)'q Al A) 14 CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE MOWN NEAREST ROAD 1 ~ M N- 5,5-l / (6121774--1-99o L° F. p L°o ~ y2d . -#AIIV bc], New Construction Use [ Residential / Number of bedrooms ( ] Addition to existing building j ] Replacement ( ] Public or commercial describe Code derived daily flow 610 gpd Recommended design loading rate bed, gpd/ft2 . -trench, gpd/ft2 Absorption area required 500 bed, ft2 5-0 D trench, ft2 Maximum design loading y rate L s~ bed, opd/ft2 _trench, gpolft2 Recommended infiltration surface elevation(s) J o 2 3 ft (as referred to site plan benchmark) Additional design / site considerations /?/14e Parent material I A 0-- i Y-) 1 dr J-0 + Flood plain elevation, if applicable W,1 It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for svstem 13 S 1? U E as ❑ U C] S I CJ ❑ S g'U ❑ S ,®u ❑ S 'au SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. I Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I Bed Trends 1 0- 14 ) 0 ~~/3 o / a m 5 a YN 4z- a S . Z z-zq 7 rz N C S 0 s L) 7. g Ground 3 1 5~ D Yr- -4 I 0' N. / S o s v N rr, "7 elev.(,e i l6 1 T Depth to limiting factor +`i / tgt Remarks: Boring # 3 ~ • ~ z rn St3f-~ m ~ C cJ a.-0 'IF i-pt- rL 4 r Yk L/ 4e, ~6114 ,5 ii, L l c~ Ground O 28 ~0 /e ~ 0 G S ~ m ✓r/<1- . . ~ / elev. L9 g S8 0& 4&_ Cz F 7 g >z 8 S/ Z W r h~ v aft. ~ /NA- 5 Depth to limiting factor Z$ ` Remarks: CST Name:-Please Print Phone: z'9 Address: Z'~ ZOQ V G~ -h O! 7 Signatu Date: CST Number: Los -A~ Z25 - PROPERTY OWNER SOIL DESCRIPTION REPORT PaW. - of PARCEL I.D. C±(7 L U - '70 Boring # Horizon Depth Dominant Color Mottles I Texture Structure Consistence iBo rxiary Roots eP DT/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ~.2z D ~y413 No /1) C S I 2m~6 IQ ~u. ! •5 •6- Ground 2- .3 0 Q 51 im d ~(f A 0 S v d c~ AAP , Co elev. e c z jo ,5 51,9 s M Depth to limiting factor 33" Remarks: _ Boring # 10-15 )OYK ©/v c- / zn~sr~i - a s 41 Ground ) /4 v~ 4/ 5l S am N iv /1/ . S G elev. g~ ft. Depth to limiting factor 2 w'' I Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # C3 Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel 988 N. Shore Drive C.S.T. 2298 New Richmond, WI 54017 MPRSW-3254 L4) y'g' s 17 Z~I1✓ 1 SLR (715) 246-6200 40 uj Dl r S/ 40 ,W ysl~ r0S4- 97' 1 < « Cornon -!'mod I (5' I l Ll qy 4 ,gyp cl~l 33/ ~P (J10 ~a nn .3 b 1 ys Sn u`~1n QrO p ~,r`~y ~ n L-' N3 13zo' Orr" STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS SUBDIVISION / CSM# LOT SECTION 17 T O? 9N-R IS W, Town of C, ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 3I t1 w #e 066 3 15 i ! ~ar►k uv'►t~ Joe jq~ i c•►~c ~INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. ~ Y BENCHMARK. 4r /MeL n 1 7'P 0-9 SAt / P,7~ 41-1'4;1 ,°cJl ah ALTERNATE BM:.olh. Gw nu,•r.A ~kn R,tie.,,e~~ 4wA.yes Gw°n~m•~ n t r ~ SEPTIC TANK / PUMP CHAMBE / HOLDING TANK INFORMATION Manufacturer: w,=cser Liquid Capacity: C ct Setback from: Well 190 House Other Pump: Manufacturer .Zoel'ler- Model# /4/ Size Float seperation /6 " Gallons/cycle: / 7 Alarm Location i n ~C, temt f SOIL ABSORPTION SYSTEM Width: 7 Length /6'y" Number of trenches Distance & Direction to nearest prop. line: Setback from: well: J S House 3 J o Other ELEVATIONS Building Sewer /bST Inlet: g ST outlet PC inlet IC' G'1 PC bottom l y't" Pump Of f Header/Manifold -2,32- Bottom of system Existing Grade 9.Q o Final grade 0051 DATE OF INSTALLATION: J trwt f- > Q Q 7 PLUMBER ON JOB: Ote- (.c~r 1S~h LICENSE NUMBER: k~E~ ~O INSPECTOR: 3/93 : j t L e~'~'si~i pertl~on try2$.15W, S$1111 TEiE&AGAISTEM County: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division (ATTACH TO PERMIT) sanitary ermit 911.10T 11 'GENERAL INFORMATION Permit Holder's Name: ❑ City ❑ Village IR Town of: State Plan ID No:: ev.' Insp. BM Elev.: BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA A9400108 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Aeration Bldg. Sewer Holding St/Ht Inlet y4,()5 TANK SETBACK INFORMATION St/ Ht Outlet 3, `v' U TANK TO P/L -WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic NA Dt Bottom Dosing NA Header / Man. Aeration ► NA Dist. Pipe Holding i Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand P~i, H -73.o5- Model Number GPM Friction System TDH Ft TDH Lift I Loss ead -1 F T Forcemain Length Dia. H Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS- LEACHING Manufacturer: SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM INFORMATION TypeO 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 SOIL COVERT.., 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 E] No MMENTS: (include code discrepancies, persons present, etc.) CO wr I! LOCAiI ON Cady.17.28.15W, SW, NW, G.T.H. NN G~ Ln Vic ' Jn k ~~4 ! lI ~ll r~ 1r ra i r^tC¢, r It U I S ti Plan revision required? . ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. - SANITARY PERMIT APPLICATION ILHR In accord with ILHR 83.05, Wis. Adm. Code COUNTY IIII~ -Sr C r STATE Q 0gY g_T- -Attach complete plans (to the county copy only) for the system, on paper not less than C,(]Q~ 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. S ~7 _ a a -70 PROPERTY OWNER PROPERTY LOCATION St a t/4 vi;_,; /4, S f T Lp , N, R /.S^- E (Or PROPERTY OWNER'S MAILING AD ESS LOT # r BLOCK # a 8 Dc f a7-v 57- 1 CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER szr 1(6.,2 77Y-Y?Bo . TYPE OF BUILDING: (Check one CITY NEAREST ROAD 11 - / n ) ❑ State Owned ❑ VILLAGE : C."r 14 N /V ❑ Public [A 1 or 2 Fam. Dwelling- # of bedrooms A/ PA L AX h (u ER( 111. BUILDING USE: (If building type is public, check all that apply) o d9 1b 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. 54 New 2.E] Replacement 3.E1 Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit - 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 Prlvy 13 ❑ Seepage Pit Pressure 43 ❑ Vqult 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 400 -S-00 .S'-1 .So' /c) 0. Feet Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New lExistin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank I ZS~ C..! tf1 r` =E IF PIE: =1 . F1 1 11 Lift Pump Tank/Si hon Chamber )L SO t 1 Fj Vlll. 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 Signature: (No Stamps) MPRSW No.: Business Phone Number: M: L64 ( (F o, t, I r (J 1'~' 7r r- Plumber's Address (Street, City, State, Zip Code): (0 g" c IX. COUNTY/DEPARTMENT USE ONLY' X ❑ Disapproved Sanitary Permit F (Includes Groundwater Date Issued lssu ng Agent Signature (No Stamps) Approved ❑ Owner Given Initial ?hJ Surcharge Fee) Adverse Determination ~40 I . X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: (formerly Plb 67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety S 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 the time of renew:4.1 any new criteria in the Wisconsin Administrative Code will he applicable. 3. All revisions to this permit must be approved by the permit issuing authcriwly. 4. Changes in ownership or plumber requires a Sanitary Permit TranSfe-.,' wal Form (SSI) (3399) to be submitted to the count] rr;cr to installation. 5. Onsite se:vxge systems it ust be property rr,a;ntaired. The septic, ttank,(s) m. ,t t>e f .~tFlr~ed ~4ci~rised' pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, cc)ntact your local code A irr i istratcer or the State of Wisconsin, Safety & Buildings Division, 606-266-3815. To be cgmplete and accurate this sanitary permit application moist include: 1. Property owner's name and mailing address. Provide the legal description ar,d parcel tax r . .her(s) of where the system is to be instalted. II. Type of building being served. Check only one and complete of bedrooms i; 1 or 2 Famsly _a~veliing. Ill. 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, -ist th ~ total gallons number of tanks and manufacturer's name. Indicate prefab or site constructed and 'Lank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if ranks 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 131/2 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, vocation of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wens; water mains`Nater 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 absorclJon system if required by the county; E) soil test data on-,a $j._form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a nom'.>er of regulated practices which can effect groundwater. The rnonies collected through these surchargos are used for nlon ',c rir> , gro. ,dam-;;ter ra, << nc"- Nkater contamination investigations and establishment of standards. W SBD-6398 (R.11/88) i _ L ` 3 0 1 v goo tos 1L V) '%f v n 10 a 6 J V b J i 4 M T 1 N Q. Km3 a s S • C4 SSA ~ ~ ~ ~ ' to _ ~ ~ \ 4 c~ 4 v . ~ o ~,1 -r' 1 PLUMBING C.njitionauy [R-PROVED Perforated Plpa Oetoll DEFT. 0 . I TRY, LA804• 3 HUMAN ARATMN3 i RMNA SAFE 0 S` tl,,,SP.N.ENCE V r ►orforeted EN Cop PVC Pipe NMq Let alert 04 60110so d Are EW011 "ad f PVC fora Meiw - t PVC Mo#fald Pi" • Alt ~°1,t Poi n ~f Oisl~ilIlion Forc MWf1 Plpe Lost 140111 should Be INrt To FAW Cop 510. RS I" Cep Distribution Pipe Layout P _ Ft. , R- S X Inches X= Y Inches w Hole Diameter I Signed. Lateral Inch(es) Ba a• License Number: r-4 Manifold - -Inches I • Force Main " 2Inches Date. of - holes/pipe jKr,%, . P P, Hekr' . a Invert Elevation of Latera15.40 U,.-Ft. 894 2013 0 Straw, Marsh Hay, Or 4 Synthetic Covering Distribution Pipe Medium Sand H G s • Topsoil F 31 E D Force Main Plowed Layer 5 Slope Bed of -A" Aggregate Cross Section of a Mound System Using D Ft. A Bed For The Absorption Area E.~-~. Pt. P.79 0 A~ Ft. G 1 Ft. B S_,S _Ft• H!_Ft. Signed:s~~..a0 K /z% L---Ft• Lam,( _Vt. License :_Iti►~, p L '00 I FFt. t. Date: y w Ft. p`vM81NG' 7a ~w e l c T 10 ►tia' 'pwr+er ~Q~ NS . ® EU►S60 p~ MAN R %A601% S NEB. ®F 1NON 5~y ANN 11.OIN. . Alternate Position of NIV Force Main"~ L I I J Observation Pipe N A Forc Main ~ - - wMw- W Distribution Pipe of"-2%" Aggregate observation I .Pips Permanent Markers-i Plan View of Mound Using a Bed For the Abiorpt on Area S94-20130. • ' PUMP CHAIABER CROSS SCGTION AUO SPECIE CATIOUS VC WT CAP • M'C.I. VENT PIPC • ' WCATaCR /ROOM A!favicO L.OCKI" •wMC1'la►1 dolt L.C COVCR ' .7 , , - ®1 iv Itam wait. wimaow oa rgg#,w. I _ . AIR IMTAKE _ . • • I ' ones PROVIOC I I I ' IIJLCT , IfiIIT jr" I II APPROVCO Jowl A c c rL+a` *PPROVCa rI W/C.I. FIVE. „ ,a" I III W.%. IPC EXTCWOIN6 3' ALARM mG 041TO 1;01.10 ROIL : R a py REj pT60NS • , ; 1 ~ SQ0 • o TRY 1.A80~. HuM tNa8 .sdn p I I MA CLEV. ~~f G°sRESP°N° POMr-.. Q►F . 77, - co~cRtrt e~ock • . ~ • .RISC.& • CluT tCRMItEco 171JL.y W. TANK AAW lot"* 3 w i~►GTWICR•' t1AR ~ ~ICM MFILOVAI. nPMbwc~ • SPECIFICATIONS i TANK / J C r r l . . PLK QA P.Mm y M/WYfAtTliitClt• _ ~ TANK W : - GA"OLJ R OO$R 110L.LIMc a urcw~u~~.! ~ ~~o ' s s e c AII '►cKr~Awi L. 1~1A11y/ACTYRCR• r'« . MOOCL I~WMKR: _ CARAL1TILii ;NOO N Ww10 • •WITGM TSlR: f^-+ ~ ~ ..IYCMiS gR fiAL1.0 PUMP MA111IFACTYRER: L « CA~I•i~..~W 9~ 1..OA1. MOO~L 1WNOtR. ar 1.43 is a k~ ii OR -44 I~e•- Morro ; PIINR #40 #J.A M ARt To Oi. - a1WITCM TYPi: . ~ N1141MYf► 01iCMA~ IIATi....~...•~iPM • 4W SfiP,~►R11Ti GIRC1gT; WERTICAL OIIfER W UTW[W -FW Off Aldo GATR101ITIOM MK..• .3 . FORT •r'. + MIIJlAUl4 • IJCTWORK 6UFPI.y PllCiiYRt . • • • • • • : 3.. F.CV~rT + JlKf AuT Or iORC9 MNIJ X LLB ` .FifwItFRICTIOII i1$..lWF9CT y2 T. IoTAL ou"c •mcAD• • a~8s - 201 3; 59 4 IIJTERIJAL DIMLW6"6 OF .TAWK: 6r6W`TN.,,~,..,.....;WIDTN •....r.~.~~~.14Y10 C~PTH i r f JAN 19 '94 01:45PM ABLE DISTRIBUTING CO 715 8488269 HEM/CAPACITY CURVE EFFLUENT and DEWATERING WARNINQ: Model t1111 should ad he 001ect0d to 1088 thlia SO lost TON. T► DYMPO MUDMAMM MR WOM 11 W4 9 :1` rti n / 11 x ; i;,;'+ 5... " 'r, b { t►rb it N~:. 2M 151M.02 1111 11 sr IV Isis' 32 too • 30 e os ~ Q ~ a 25 go 26- 65 OS aptLJ~ ' p. 24- 75 22 7 a 20 65 t68 op, 10 16 ~ t63 I so 14: 12 105 10 tea b ~ _ . tst - t 8 tee 4 ~10 Gal 2- k S 13 131i 1 50 )OR 4 a y i0 110 110 1 1 140 1 U.S. GALLONS 10 20 30 40 2iO 320 400 6i0 640 50 1 o FaW PER MINUTE ~y Wnts- Far Head Capacity on MOM 112,1ndu#rial pptuma-explosion proooi pump{ see FM0210. Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT v Page % of Obar and Human Relations tivision of Safety & Buildings in accord with ILHR 83.05. Wis. Adm. Code COUNTY Y, C2 1 Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but PARCEL I.D. # not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or dimensioned, north arrow, and location and distance to nearest road. 00 1039- q0 APPLICANT INFO RMATIO N-P LEASE PRINT ALL INFORMATION REVIEWED BY DATE PROP 0 N R: PROPERTY LOCATION J: t Z"/ 0__ GOVT. LOT 114A) f,J 1/4,S /7 T Z B N,R 15 X(or) W PROP TY OWNER':S A!I.ING ADDR SS LOT # BLQCK # SUED. NAME OR CSM # 'z...~ 0 I So ` Z-_ . N 0ti 4)14 CITY, STATE ZIP CODE PHONE NUMBER ❑CITY []VILLAGE MOWN NEAREST ROAD lr- MN• 55// (6/2.) 77 -49IfO L° ~p L-o, New Construction Use Residential / Number of bedrooms [ ) Addition to existing building [ ] Replacement [ ] Public or commercial describe Code derived daily flow a00 gpd Recommended design loading rate _r-bed, gpd/ft2. 6r._trench, gpo1ft2 bed, gpd/ft2; _trench, gpd/ft2 Absorption area required 5-00 bed, ft2 5_0 O trench, ft2 Maximum design loading rate • ~ Recommended infiltration surface elevation(s) ) 0 2 33 ft (as referred to site plan benchmark) Additional design / site considerations 174 Parent material I A e-l, yl I r + Flood plain elevation, if applicable vr/.r+ ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for system ❑ S to U ® S ❑ U ❑ S 15K ❑ S erU ❑ S ,ef ❑ S 'aU SOIL DESCRIPTION REPORT Boring # Horizon Depth DominantColor Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed Trertdi 10- 1 z, 1 rz 3/25 1110 a M515/-< r' 4Z_ a S. 2_ z-zq rZ, N S o s l~ D -J 7 , g N Ground 3 9- 50 a yr- 4/( a a N G= 15 elev.&B for Depth to limiting factor Remarks: Boring # d -1z- /0 r~ 3/3 o CF S/ z 1'kl5z3 m ~4, Cc,) a-Q ~~Z D l2 5 Ground elev. G s 8_S8 D 2 4l cz P7~ ,z g -S' / Z rN r wt v W A- Va . 5 !aLfft. Depth to limiting factor Remarks: CST Name:-Please Print r~ 1 Phone: Address: 2oQ q~ vG/~ g O/7 yya~ f-- Date: CST Number: Signatu e: -F- 77 -~.PROP.PRTYOWNE r, u Hit + SOIL DESCRIPTION REPORT Page 2 of f PARCEL I.D. I(.) -3c) r2o Boring # Horizon Depth I Dominant Color i Mottles Texture I Structure (Consistence ~Bounctly I Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I Bed (Trench Z s rn I. rL -2Z 0 ~~~3 I zmsre~Z , 5 Ground 2- 3 o R s~ d rrlr= ©s v WL . S" . elev. 6 c z rv Depth to limiting factor 33 " Remarks: Boring # 0-13 loYK 3(7 ©NC~ / zmSr~~ r~ J a s yP 6- l a vty `tl ~ 5/ S am d N rl/ 6' Ground elev. g~ ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) STEEL'S SOIL SERVICE Gary L. Steel 4 988 N. Shore Drive C.S.T. 2298 i~ y~ $ ? Zry JV g 5!~ New Richmond, WI 54017 MPRSW-3254 (715) 246-6200 40 W K FF 0y k rrsl I (05'", I1 G' L ~;1/(~ 3j ~A O ► 0 6.2 51O i~ y5 , --o eo. Rd, `Ns I~za. STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNERBUYER~ L ~t MAILING ADDRESS ) -~).C So ) c'R P et l~ W'9 0) PROPERTY ADDRESS 35-7 C7' J y ' V (location of septic system) Please obtain from the Planning Dept. CITY/STATE PROPERTY LOCATION 1/4, ML 1/4, Section, TQ j? N-R_j_G W TOWN OF ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAP , 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 you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. i 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. SIGNED: 444, ,.y DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 01 APPLICATION FOR SANITARY PERMIT STC - 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 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 Location of PropertySection 17 , T_2_2_N-RW Township ~.QA_U Mailing Address Z~ g b-eC--::.o S+. ~e w At A) s Address of Site 0 Subdivision NameOY~2 Lot Number Previous Owner of Property Total Size of parcel 12.0. Lie Date Parcel was Created 1 Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume and Page Number 3 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 refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION I (We) cent 6y that att 6tatemen6 on th.i6 boAm ate true to the best ob my (out) knowCedge; that I (we) am (ane) the ownen(,s) ob the ptopenty descA bed in this inbo.kmati,on Bohm, by vi tue ob a waAAanty deed tecokded in the Obbice ob the 1 County Regi6ten ob Deeds as Document No. D ; and that I (We) pnesentPy own the pnopoa ed .6 to ban the .6ewage diz poz d y em (ox I (we) have obtained an easement, to nun with the above descA bed pnopehty, bon the constnucti.on ob •sai.d bystem, and the .same has been duty kecokded in the Obbtce ob the County Register ob Heeds, as Document No. ~I (a 0 7h 1. SIG4AT%E 01P OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED DOCUMENT NO. II WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA j~STATE BAR OF WISCONSIN FORM 2-1982 516076 lived for Rggmmi w feasssurvi ors . h namar taY----ro ert~lan husband and l 1~9~ i. , 1"p' i. - - Stephen . . . .P- - - . - MAY f j ~ 9:00 A ' tt L._.. ._.uctlt j conveys and warrants to _ Jeffrey .Sco.................. and--We-ndy Kay - - - - - - - . " Lucht,.. husband-.and- wife,--- I i! - - - - - - - I'I RETURN TO . - - - - - - - - - . . I~,' _ '.I St. Croix _ _ -I the following described real estate in ....County, - i~ it State of Wisconsin: Tax Parcel No:..----•-------------••------•- i i i Sz of NWk of Section 17-28-15. ii I ,I it I I This is-.not homestead property. (is not) i Exception to warranties: Easements, restrictions and rights-of-way of it record, if any. I Dated this . day of - - 19..94... -..(SEAL) (SEAL) Stephen S. Beckman - - - - -----...----------...--.(SEAL) ~J _....-.(SEAL) j A Ii Lynette M. Beckman - * ~i i AUTHENTICATION ACKNOWLEDGMENT I' Signature(s) STATE OF WISCONSIN ss. St. Croix • - Ili County. authenticated this day of 19 Person ly came before me this ......day of Pei son 1994___- the above named S. _ Beckman--and- Lynette M. * _clar►an, husband -an_ _wif e 2 - - TITLE: MEMBER STATE BAR OF WISCONSIN I !I (If not, l authorized by § 706.06, Wis. Stats.) to me known to be the person S i the egoing instru ent and ack 0 q~7+py~~pe ya s THIS INSTRUMENT WAS DRAFTED BY • L1Vr/ - [~!N/!lC ~i - - ' - - - - Kris.tina Ogland_----•------------------------------- Attorney at Law - Notary Public ~ County, Wis. My Commission is permanent. If . not, state expi tion ii (Signatures may be authenticated or acknowledged. Both are not necessary.) date- -----------------~-"---&J-- 19--- ) I 'Names of persons signing in any capacity should be typed or printed below their signatures. it WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc. J 12- V U 3 ~l G 9 '~z JJCL+ ~r i o ~ \S T--) (S7. Af I' r w t i LI; ~