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HomeMy WebLinkAbout012-1039-70-120 STC - 10 Q AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS A I SUBDIVISION / CSM$ LOT r SECTION_TN-RW, Town of G rr~c r~ C ST. CROIX COUNTY, WISCONSIN PLAN VIER SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM n L /l- ~z,{r D INDICATE NORTH ARROId - 4 form. Provide setback and elevation inform=t ion on reverse of ti IS Provide d imens i-ons to e11 1 0 1 '-:~E~L 1, c tang: manhole cove-, /~o~ L T .~y P 1 , Lt ercr ln~' t~? 17. 3(~ TE VN ~ S+g?M Road county: Labor and Hu n Relations INSPECTION REPORT Safely and Buildings Division (ATTACH TO PERMIT) sanitary r it GENERAL INFORMATION + Permit Holder's Name: ❑ City ❑ Village 1~ Town of: State Plan o.: WPM E ev.. Insp. BM Elev.: BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA A9400022 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ~a 0 Benchmark Dosing Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake 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 BED/TRENCH width I 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 0 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 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 4 Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION # Erin Prairie.17.30.17W NW, ~ NAT, 160th Road a H4 t j (pct'' d t S G' ~.1 t L'S1k, t~ { " `a \ s I •^-4+~. r q`1 1 U a vit at a Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. 77 SANITARY PERMIT APPLICATION =DILHR In accord with ILHR 83.05, Wis. Adm. Code COUNTY S7-- Cro I STATE SANITARY PERMIT ^ -Attach complete plans (to the county copy only) for the system, on paper not less than 8/z X 11 IrIC 191 h@3 in size. 1:1 Chec if re4ious application P -S@@ reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION t- 7 1 w-) %t N&,'/•, S / T 50, N, R / E (or) PROPERTY OWNER'S MAILING ADDRESS- LOT # BLOCK # a, ~ 7 ice`-1e ~ • d~, CITY, STA CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER /V w D /.S -T Jo 11. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD ❑State Owned VILLAGE : o ❑ Public `1 or 2 Fam. Dwelling-# of bedrooms R AX R( 111. BUILDING USE: (if building type is public, check all that apply) Aox _D 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 40 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. New 2.E] Replacement 3. ❑ 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 FTSeepage Bed 21 ❑ Mound 300 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) c~ ELEVATION ~U © o-t9 . / Feet AS S_ Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank O 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 Signature: (No Stamps) MP/MPRSW No.: Business Phone Number: I (A 120 Ill; 1~ s 3 / Q 7- 1# 7!p/lo Plumber's Address (Street, City, State, Zip Code): 9 &f Amer U.L= oa IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature Ps) Approved ❑ Owner Given Initial Surcharge Fee) Adverse Determination /1160 X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: z4 tJjLv-u, SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS r 1. A sanitary permit is valid fdr 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 authorn;y. 4. Changes in owntI-ship or plumber requires a Sanitary Fewiit Transfer/4c;;• -wai 6=i;-- Sj iO 6399) to be submitted to the ;:aunty prior tp instaliation. 5. -Onslte sewage ..y~ferls must be pro;~eriy maintained. Tl~c ;e tic f8nk+~) r tt bs; c a licerisec! pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your focal ci)de tdnii,iis0ator or the" State of Wisconsin, Safety & Buildings Division, 608-266-,385. Tope complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcal tax n inber(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 (:welling. 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, -E;connection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorptionn, system information. Provide all information requested in #1-7. Vil. Tank information. Fill in the capacity of every new and/or ex:611ng t,a -ist the total , l~.jrnber of tanks an,; manufacturer's narne. Indicate prefab or site const-ucted ann.' tank male, ii,l. f sr l ! !t(- for ali sepsis. pun-ip/sipiion and holding tanks f- this system. Check exp rir,: > ,i.J pprova ,lks received expe+ 'srrienta.l product approval from Dil_'ici Vii: i espons &ii ty staternent. installing pmrn_,ur is to fill in name. liceese nu-mbe, Wltr prefix (e.g. MP ztc.';, : , dress and' phone number. PlLmber must sign applicat c;rtn. IX. CountyY'Department Use Only. X. County/Department Use On,y. Compete ,)lans and spec f :ations not smaller than 8% x 11 inches must be :jbrr?tt'> ,aunty. The t;ia i, n,, :oclude the fat o ,g A~) plot plan dY jw". to sc;.*ie .,r "ior. of 110: ding -1nk(S), SEptiC to .k(s, ctr other treatrrie?,t'.anks; buildE ri wet!'., wr :Jt - service; 5`=.ie~:!!~t5 cnd lakes; Gump (7+ S!f~hs~,, fankc .te,t S4S1@!Tm . , distribution boxes t , ; e arras; and the location of °`le `u. rir ed, 8) horizontal C) complete; specifications for pumps- -and controls; close volume, ~-:ovation Ua?er~,;~r; iC.t rr loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil ate:;,r,r,?t on 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 surcharces (fees) for a r1Um ier c) regulated practices w :,,h can effect groundwater. Tne z1 e., cJ t,. ted tI ughA11, J r Si.fcharcles are used for ri1,-m;to:,, ie, or >:i'. W24f'i'a'(intarnjflc'tt3ri lIt k tik,it7 af!1-ns and establiShroen': of starnijar0 SBD-6398 (R.11/88) STC-105 SEPTIC TANK MAINTENANCE AGREEMENT nn St. Croix County OWNER/BUYER 4_-V+ere r r ba rcc ~T• Tu s J a,kt J ~O MAILING ADDRESS 1 2 6 8 T l e r Dr PROPERTY ADDRESS 1(0121 16 O* h A Ve . (location of septic system) Please obtain from the Planning Dept. CITY/STATE 4teuLJ R t C,~ 4U yLC W r PROPERTY LOCATION N&J 1/4, NUJ 1/4, Section T_3 !2_LN-R__LL_W TOWN OF E r i vi i ST. CROIX COUNTY, WI SUBDIVISION Loo LOT NUMBER Z. CERTIFIED SURVEY MAP , VOLUME 9 , PAGE 44.7~O, LOT NUMBER 2 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/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: laua /J~11' wao DATE: a ' Y St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 i STC-100 This application form is to be completed in full and signed b fthe owner(s) of the property being, developed. .Any inadequacies will only result ~n delays of the permit issuance. d Should this evelopment be intended for resale by owner/contractor,(spec house), thenla 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 Eve v✓4ee6 P. 4e e5urba ra T 'T S d a Location of property LV 1/4 NW 1/4, Section 1-1 Township Erin h Pra l r Mailing address A rv /~c cj-, ryj 0 K c( 5~0 l7 Address of site (.6~ ( 6o a , Aje uo /71 cA rYL&w-d WL 5~0 17 Subdivision name Lot no. Other homes on property? yes X No Previous owner of property _ &Ii a, R;10 a Total size of parcel x•51 CICPCS Date parcel -was created !'Are all corners and lot lines identifiable? K Yes No Is this property Peing developed for (spec house)?„Yes _X~._No Volume and. Page Number °`(0 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 & TnE. 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 bee st of my (our) knowledge that I (we) am (are) the owner(s) of property described in this information form, by virtue otc a warranty deed recorded in th ice of the County Register'of Deeds as Document No. (we) presently and that I own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described the construction of said system, and the same hasopbeen,duly recorded__,in the 'ffice of county Register of deeds as Document No. z P ez, ~IL`L• p,s•GGt.~ signature of applicant Co-applicant Date of Signature Date of Signature. I~ it.flJ%]A.r.L Vi4 -0,°~ri`I~~, i YI~L 101SPAGE 608 II DOCUMENT NO. WARRANTY DEED THIS SPACE RESCRYiO. FOR:- RLC04ROING DATA STATE BAR OF WISCONSIN FORM 2-1982 501552 REGISTER'S OFFICE ST. CROIX CO., W1 Michael W. Riley and Susan M. Riley, husband Rec'c for Record and wife! as marital property with righia-.o£ JUN 3 0 1993 :12:05 P. w- conveys and warrants to sett P aLY3- r t' ...B_XbaXa.J..._Ramwsseu,..Its. Joint..t rants.....-----•---••-•. RETURN TO the following described real estate in St...........CrOiX County. State of Wisconsin: Tax Parcel No: ____-r-._-_______.._. Part of Northwest Quarter of Northwest Quarter (NW 1/4 of Nf1 1/4) of Section Seventeen (17), Township Thirty (30) North, Range Seventeen (17) West, described as follows: Lot 2 of Certified Survey Nap Piled April 21, 1992, in Volume "90, page 2476, together with and subject to a 66 foot Private Roadway Easement as shown on said Certified Survey Hap. r M $ to This -.is -IIOt homestead property. (is) (is not) Exception to warranties: June 19__93.. Dated this day of 14 . (SEAL) (SEAL) . Michael W. Riley i - - (SEAL) •..~~._•l-' rI (SEAL) Susan M. Riley . • ACKNOWLEDGMENT Signature (s) _ r -a es rlri 6~ this;'I -day of.... - 11P6 Personally came ~beefore me this -----_...day of ,je-. 1933--- the above named s - ' Michael- •''~•--a...-Ir (Ii not. . SO 2 `a authorized by 06.06, Wis. Stats.) h~ to me k to be the foreg ' g instru ck 6e f Re >HaeT . THIS INSTRUMENT WAS DRAFTED BY kVS'I1 Tf~.. l)YK yy D11~liP~M ! Y 41 a;G New R7ar...-_54017 Notary blic (Signatures may be authenticated or acknowledged. Bot My Commission is permanent. (If not. stat76expiration are not necessary.) date- ---------------•--19 Ldy ) Ccmmiss_+on-Expires jam== - - *Names of persons algalag in any capacity should be typed or printed below their signatures. Wisconsin Legal Blank Co.. Inc. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2 - 1982 Milwaukee. Wisconsin r. _r. :g-,Z.:..,. u1 M~":'i~•- try:'- iiF rCu StA~. "',•i+,`.. N FILED APR2 119921 5 JANIES O'CONNELL 482292 sc c~ co., wi, ~ CERTIFIED SURVEY MAP o~ Located in part of the NW144 of the NW14 of Section 17, T30N, R17W, Town of Erin Prairie, St. Croix County, Wisconsin. LEGEND NL~ `o 0 1" x 24" Iron Pipe Set, weighing 1.68 lbs. per linear foot C E r y Roadway Setback Line rn Existing Fenceline 41 rz d n Septic Vent U C C O d 41 „ OWNER d o Michael Riley o 1627 160th Avenue rnZ co SMALTRACT UNPL_ATTEQ '.A,NrL-)'New Richmond, WI 54017 t M I L_ 4' 0 C.S. M. I VGA (U co O (n Nye Corner of NW Corner of L `n' T I v T 2 Section 17 Section 17 16 OT H AVENUE 1" x 24" Iron 2" Iron Pipe Found - - AG.-Res. Pipe Set, from, North line of the NW} county ties. 89°36' 28"E I 589036' 2811E 1011. 571 S89°36' 28"E 562.59' 454.98' 300.01 1317.58 _ S89°3628"E 529.36' ~S890 36'28"E 422.29' _ 0 ' o O°. U I M 'r~~i s Cl) .`,l I M .a... ~I I A 3 i [N o o we l I I-I - 2 O 9 N- _ O•_ N o (Y, M O M C1 M House O N O O _ 33 -j I o 5.51 Acres Inc. R/W W Z- n o n N Z _J1 240,162 Sq. Ft. o o _ U)I <1 - >w~ CJI A 1 v 4.79 Acres Exc. R/W H Y o °0 0 U~ I a+ 1.33' 33'1 I 0) 208,563 S q. W W ;50 50'; oar Z QI q• 8.89 Acres Inc. R/W a °0o 00 -j I S89036'2811E 559.66' 387,419 Sq. Ft. _ d ® °o w 41 C~ W ? 526.661 33.00 ' i © N 7.90 Acres Exc. R/W 1111 f -I 00 c 344,129 Sq. Ft. CO X- Lo oQI CO CO 0 CJ I o; °o``° ° oo _J1 0 ° co Q I o (n W 11 I I 6.28 Acres Inc. R/W =01 _J 273,581 Sq. Ft. W ~ W W J 1 5.93 Acres Exc. R/W w ao 00 _ rn _ rn rn - 258,330 Sq. Ft. o co 0 00 00 0 0 0 0 0 0 0 (l) I °O °O C14 °o - 409.00' - 610666 33.0011 33.00 376.00' S89°51'44"W 1019.66' UNPL.A TEC L-AN S I 1} SCALE IN FEET ?~~y7y 0 100 200 40 I~~ y v j t Oil" "j, 1,4 .Tw r : r This instrument drafted by Fran Bleskacek Proj. 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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. -le e APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PR ERTY OWN PROPERTY LOCATION er, of GOVT. LOT 1/4 r/ 14,S T API Z,-.7 E PROPERTY OWNER':S MAILING ADDRESS LO # BLOCK# SUBD. NAME OR CSM # CI STATE ZI ODE PHONE NUMBER CITY [-]VILLAGE GOWN NEAREST ROAD log&Z New Construction UseJ Residential / Number of bedrooms [ ] Addition to existing building Replacement [ ] Public or commercial describe Code derived daily flow -&`0 gpd Recommended design loading rate bed, gpd/ft2 r f/- trench, gpd/ft2 Absorption area required/,~77a o bed, OZe-00 tench, ft2 Maximum design loading rate --bed, gpd/ft2trench, gpd/ft2 Recommended infiltration surface elevation(s) - to ft (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable 49!:2a ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT RADE SYSTEM IN FILL HOLDING TANK U = Unsuitable forsystem 12 ❑ U 19-S U J5s El U As ~U ❑ S [WU ❑ S ;'U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 07 o jr G ° S Ground w ~l elev. OF 10, ft. Depth to limiting factor Remarks: Boring # Ground lev. 7-> ft. Depth to limiting factor 3- Remarks: CST Name: Please Print Phone: -1-7 46: zo-ol-c i Address: Signature: Date: CST Number: PROPERTY OWNER SOIL DESCRIPTION REPORT Page of, PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench :•ti 44: Y,1V -,Y0 Ground elev. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor F-T Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # 4ti: Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) 99, -TI 1 IPA ilk ►Q All ~ti PLOT PLAN PROJECTEUere-4-f J 5 A4kar-,441 ADDRESS ~r, NW 1 /4 N u) `j 1/4/S /7 /T 30 N/R l 7 W TOWN ti12,,y~ i a COUNTY 5? Cra„c C o MPRS Byron Bird Jr. 3318 DATE v? - /b -9 BEDROOMS CLASS PERC CONVENTIONALX IN-G ND PR SSURE CONVENTIONAL LIFT_ MOUND_ HOLDING TANK SEPTIC TANK SIZE LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ABSORPTION AREA _ PERC RATE BED SIZE 16. Benchmark V.R.P. Assume Elevation 100' Location of Benchmark H.R.P._ M Borehole Q Well Scale _ Feet O Perc Hale System Elevation Vent 12M TYPAR COVERING ■ 12" 3' 4 s, D 3, 1 6- Sewer Rock 12' u Ile ~ ~9y y- ' /00 f DEPARTMENT OF REPORT ON SOIL BORINGS AND /S E &BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 HUMAN RELATIONS 1 / MADISON, 1 53707 (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/ Y: LOT NO.: BLK. NO.: SUBD ISION NAME: N114 1/$M1/4 17 /T30 N/R17Tr,(or) W Erin Prarie 2 n/a n z COUNTY: OWNER'S/BYNAME: MAILING ADDRESS: St. Croix Michael Riley 11622 160th. Ave. jTew '?ictflond, Wi. 54017 USE DATES OBSERVATIONS MADE I NO. BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE DESCRIPTIONS : ER OLATION TESTS: Residence 3 n/a 83New ❑Replace 3-16-92 3-20-92 RATING: S= Site suitable for system U= Site unsuitable for system J)F CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) ] S E:] U ®S U S U S E3U conventional trench ®S ❑ U If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: n/a Floodplain, indicate Floodplain elevation: n/a decimal' PROFILE DESCRIPTIONS page 37 JsB BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTHVK ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B-1 7.42 103.15 none >7.42 1.17,7.5yr3/3, 1. 6.25,7.5yr4/4 s.l. B_ 2 6.67 101.90 none >6.67 .67, 7.5yr3/2,1. 2.50, 7.5yr4/4,1.s.,3.50,7.5yr4/ S. . B_ 3 7.75 103.10 none >7.75 .83,7.5yr3/2,1., .92,7.5yr4/4sil., 6.00,7.5yr4/4 .1. 4 7.16 101.00 none >7.16 .58,7.5yr3/2 s.l., .75,7.5yr4/4sil. 1.83,7.5yr3/4 l.s B_ B_ 5 6.59 101.65 none >6.59 .58,7.5yr3/2 1., .75,7.5yr4/4sil. 4.92,7.5yr4/4 s.l. B- decimal' PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INIUM AFTERSWELLING INTERVAL-MIN. P RIOD 1 PERIOD2 PERIOD 3 PER INCH P-1 4.25 nnoe 30 12 1 Z4 - 24 p-2 4.20 none 30 2 4 4 P-3 3.00 none 30 3 2 2 P P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION 98.90 r r ~I(Pp - l ( I i r wIN 3 3 t of I 71- i, I IF l c X3'1 ! E E , I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the proc dur s and1petIN0 sec iQ2n thews onsin si'et~ Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge, elief. ,)T , ~C?IX w NAME (print): TESTS WERE C TED Gary L. Steel 3-20-92 ZON1.NGO FICE ADDRESS: CERTIFICA 10 N N R(optional): 1554 200th. Ave., New Richmond, Wi. 54017 ~29 6-6200 CST SIGN E: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. D I LH R-SB D-6395 (R. 02/82) - OVER - i INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 To be a complete and accurate soil test, your report must include: 1. Complete legal description; 2 The use section most clearly indicate whether- this is a residence or com n project; 1 MAXIMUM number of bedrooms or commercial use planned; 4. . ,i. a new or replacement sy . Cc the suitability ratinw _ A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OT: `=R SYSTEMS ARE RULEC OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A separate sheer ray be used if desired; 8. Make sure yo enchrnark and vertu rrc,~ point ar _r own, and are permanent; 93 Complete ' )riate boxes as to da s, names, addresses, flood ply ' -~rcolation test exemp- tion, if appro 10. If the inforr h as flood plain, elevation) does not Aace N=A. in the appropriate box; 11. Sian the f(-- yor.rr current address and your certif' M number; 12. Make legible ° distribute as rerluired. ALL SOIL TESTS MUST BE FILED 1NITH THE LC)CAL AUTHO.; Y WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st - Stone (over 10") BR - Bedrock cob Cobble (3 - 10") SS - Sandstone gr Gravel (under 3") LS Limestot *s - Sand HGW - High Gr:r iter cs Coarse Sand Perc - Percolat,;,n e need s - Medium Sand VJ - Well fs - Fine Sand Bldg Building is Loamy Sand > Greater Than #sl Sandy Loam - Less Than I - Loam Bn - Brown sil - Silt Loam BI Black si - Silt Gy Gray cl - Cray Loarn y Yellow scl - Sandy Clay Loam R - Red sicl - Silty Clay Loam mot - Mottles SC - Sandy Clay w1 - with sic - Silty Clay fff - few, fine, r Ic - Clay cc - common, pt Peat rnrn - Many, nee,, rn - Muck d - distinct p prominent HULL High waw 1 Six general soil iextUC surface w for liquid waste BM Bench Ma t VRP - Vertical R+ Point TO THE OWNER: T! s report is the first step in securing a sanitary permit. The c ii t e Departmei y request v, i of this soil test in the field prior to parm'' ,~suance. A got„ _ -t of plans t :e private ~m and a permit application must be s ' r the appropr to local authority order to of a permit. The sanitary permit must be obtained i-,)d posted prior to the start of any r ion. ST. CROIX COUNTY WISCONSIN CA- ~ ZONING OFFICE I p p N p p p■ rOrNf ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road _ Hudson, WI 54016-7710 (715) 386-4680 May 3, 1994 Ms. Janeen Benoy Bank of Somerset P.O. Box 220 Somerset, Wisconsin 54025 RE: Septic Inspection for Everett and Barbara Tysdahl Dear Ms. Benoy: An inspection of the septic system for the Everett and Barbara Tysdahl property was conducted on April 19, 1994. This property is located in the NW; of the NW, of Section 17, T30N-R17W, Town of Erin Prairie, further known as Lot 2 of Certified Survey Map, recorded in Volume 9, Page 2476 as Document No. 482292. At the time of the inspection this septic system was found to be code compliant for a four bedroom home. Should you have any questions, please feel free to contact this office. Sincerely, Mary J. ki s Assistant Zoning Administrator mz P-D r,