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Home My WebLink About034-1041-95-000 S TC - 10 4 AS BUILT SANITARY SYSTEM REPORT _ f f I,to OWNER w t kJ t r~ I ~ ADDRESS qbc) SUBDIVISION / CSM# LOT # SECTION _T.QZ N-R W, Town of . ~2/,,, ST.ICROIX COUNTY, WISCONSIN PLAN VIEW e SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM gill v i INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. r BENCHMARK: l~j ~ti~ ~G~(rr~c D~ [~1fX2C P~ ~Q~h{'~ ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: 1~4 jC. q% ev-v_, CTf(ac,~-Liquid Capacity: /O O 6r,11 Setback from: Well House 3 Other Pump: Manufacturer Model# Size 'L rt Float seperation Gallons/cycle: Alarm Location ,c~ct c r ~~o r SOIL ABSORPTION SYSTEM Width: Length 7:5 Number of trenches / Distance & Direction to nearest prop. line: S 'jes~_ Setback from: well: / Y3 House Other ELEVATIONS Building Sewer ST Inlet. 73- ST outlet 3. ~l PC inlet PC bottom l' (0(-) Pump Off g Header/Manifold Bottom of system Existing Grade ~U Final grade S DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR:- 3/93 : jt Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor anq Human Relations ST. CROIX Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.: BELBIN, JOHN x CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No 60 16yd , 6y c5 a CSC G in~ 13i TANK INFORMATION ELEVATION DATA a oz,!9~ 3X TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic tC,/ -5~/'7 CQ Benchmar3s Dosi ng C~ • a.. cy~ Sd ate r. Aeratio Bldg. Sewer ~.OS 33 H St/ O inlet TANK SETBACK INFORMATION St/ Of Outlet Vent TANKTO P/L WELL BLDG. A ir Ito ntake ROAD Dt Inlet Air Septic 30 ' NA Dt Bottom Dosing NA -Man. Aeration NA Dist. Pipe Holdi . Bot. Syste PUMP / N INFORMATION ('Prt" Final Grade Manufacturer GC~(iC/ Demand Model Number ~7~ 2~7GP TDH Lift ID,Oi Friction ,7-7 System~, ,~o TD Ft oss Head Forcemain Length Di a. ,L Dist. To we,', '>1,,6' SOIL ABSORPTION SYSTEM BED/TRENCH Width , Length / No. Of Trenches PIT N f Pits Inside Dia. Liquid Depth DIMENSIONS 5 5 DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING anu a SETBACK CHAMBER INFORMATION Type O , i Moe Num e_ _ System: OR DISTRIBUTION SYSTEM der / Ma f d Distribution Pipe(s) , i x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length -3_Qa Dia. Spacing _JYN SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over „ Depth Over °S xx Depth Of xx Seeded/ Sodded xx Mulched Trench Center / §11104 Trench Edges Topsoil es ❑ No es ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) _V T!v`.~ LOCATION: SPRINGFIELD 18.29 45. 279 , 5 NW, CO. D.vD s 71~ r = ~c) 98 Plan revision required? ❑ Yes []~It(o Use other side for additional information. 191 SBD-6710 (R 05/91) Date Inspector's Signatur Cert. No. l ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: I SANITARY PERMIT APPLICATION * r~'al`■~ir~ In accord with ILHR83.05, Wis. Adm. Code COUNTY ST. CROIX STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 9/ P9 9 'v 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. S94-41310 PROPERTY OWNER PROPERTY LOCATION SW ' NW t 18 T 29 N R 15 W B N /a /a S JOHN BELT PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # N/A N/A 971 CO ROAD D CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER WOODVILLE WI 54028 1(715 698-3045 N/A CITY NEAREST ROAD 171 _ II. TYPE OF BUILDING: Check one ( ) ❑ State Owned ❑ TILLAGE S rin field Co RD D ,123 TOWN OF: ❑Public ®1 or 2 Fam. Dwelling-# of bedrooms 3-- PARCEL TAX NUMBER( S) II. BUILDING USE: If building type is check all that aPPI ( 9 tYP public, _ Y) 034-1041-95 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 80 Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 130 Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ❑ New 2. ❑ Replacement 3. ❑ Replacement of 4.E] Reconnection of 5.0 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 220 In-Ground 420 Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 140 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 450 REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION 900 900 .5 N/A 100.5 Feet 103.75 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 100 1 1000 MIDWESTERN PRECAST Lift Pump Tank/Si hon Chamber 65 1 650 MIDWESTERN PRECAST F-I Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumb is Signature: (No St ps) MP/MPRSW No.: Business Phone Number: BENNIE HELGESON MPRS 3215 715 772-3278 N-4 1 09 T Plumber's Address (Street, City, State, Zip Code : W1229 770TH AVENUE, SPRING VALLEY, WI 54767 IX. C LINTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signa ps) proved ❑ Owner Given Initial F® W Surcharge Fee) l o 'nl -4 1 Adverse Determination CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(R.08/93) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS ' 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at 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 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. If. 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 6-'fz 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) Cl O 10 .0 c. m `L R U 9C cl ~ 1 r r 4 a r. r` is ep0- W - ` r LUU CD C / 0 o / o- a 7 w" ~I S 9 31 ' ~1i°~C'S' .3a / 5- Page Of Cross Section Of A Mound Using A Trench For The Absorption Area Mtnh-Sand Fill Jl F - Ole-J. lot. o soi t 3 E D 3r2S Trench Of )I" - 2h" Aggregate, -o Plowed Layer 6" Below Pipe, Covered;With D ~ Ft. Straw, Marsh Hay..Or;,,.S thetic Fabric E ~ • Ft. G Ft. _ F $0 Ft. H Ft. j 1 Pla*i iQ"w bvG d Using A Trench For The Absorption Area Force Main -71 Distribution Pipe Permanentj-Markers Observation Pipe o W - A r' B - K \Trench Of h" - W Aggregate I L - r A Jr 't. I • ~a Ft. K I I .q Ft. W Ft. B 7 S Ft. J$ _ Ft. L28,t Ft. N.n License Signed: -Number: lyl Pf2~ 72-) 24 S Date: _ rv -1 ~ -e- 0 r~---". 310 'VA Te- ~-?V. PIPE e.~ c`S.• r( AT CUrJ Or EM1CH LhTL-RAL "~u0 t1aP. Q ~+/\J~ _ P1.f~E PTIJD f.'St~ ~'Ca uFt~~y SPA::.t~ . pVC ' FR-OT-i Tau E'1 P -PU C- t-AT~.hLS P~.I~CE VtST 1t0~.~ 1JE)C'T' Zb CAP ~J~S~R1BuT7C3J: PIPE .1)~4D~iT_='-. r P 3b• FT. r' ~ ~ X J~ tn1. Y iN. FORCE 'Yl R 1!J 1 -It-- 1i(3LES1PJ P` 11JV, F-~EV. CF LAT6'P,J',LS p~r~cE t sT HOLE g FPOr1 TEE w1-rH su cc A) G HflLE::S LAcST 1-- LE `(D AfEXT" ?O E C~3 D Cf'cP• Page Of 1 0 COMBINATION SEPTIC TANK/PUMP CHAMBER _ ' 4 1 3 4" ci Vent Pipe with (No Scale Approved Cap, +25' Approved Locking Manhole Cover From Buildings With Warning Label Attached Weatherproof Approved _ 'Warning Label Junction Box Vent Cap 12„ Minimum Final Grade 6" minimum 4" Minimum i ► 6" MTaximum 41, C.I. Quick 18 Minimum T Insp. Pipe Disconnect 1/4" Weep ► - Hole Baffles LJ LJ ~ i Approved Joint "z A w/C.I. Pipe r r., f Extending 3' Alarm ~V , Onto Solid Soil B Approved Join On 61, w/C.I. Pipe Extending 3' C Onto Solid So Off 64 D Conc. Block 3" of Bedding Under Tank Note: Pump and Alarm Are On Separate Circuits Number of Doses: Per Day Gallons Per Day/f-oT-Doses: /2. Seal Ions II Volume of Backflow:....... +.Gallons Tank Manufacturer: , ~(,,ve ~r Total Dose Volume Gallons Tank Size-Septic/Pump: a Ions Alarm Manufacturer: Model Number: Capacities: A 1$ inches or-3r)6 Gallons Switch Type: + B inches orb Gallons Pump Manufacturer + C 7 inches or la 7 Gallons Model Number: 387( + D i nches or /9_-).?S-Gallons Minimum Discharge ate- 7~0 .y 2 GPM Totai:....= inches orjSn llons Vertical Difference Between Pump: Off and Distribution Pipe:Q,63 Feet Minimum Required Supply Pressure: a.~Feet ~Zj Feet of Force Main x ./,S~Friction Factor/100 Feet: +4-2LyFeet _Inch Diameter Force Main J/ Feet Total Dynamic Head: ...=ff, Internal Tank Dimensions: Length g~ Width Liquid Depth 3 gy 1? 6',tl. ~e Signature-` License Number 3 ~5' Date I b-13 H MODEL: 3871 Submersible>~r~, 13 }y SIZE: 3/4" SOLIDS Effluent Pump RPM: 1550 HP: 0.4 METERS FEET S 9 4 .0 41 3 1 0 8 i 25 .._.1- - - - a 6 20 a 5 I Z 15 4 g 10 - F- 2 5 1 - 0 00 10 20 30 40 50 GPM 0 2 4 6 8 10 12 m'/h CAPACITY [QGOULDS PUMPS, INC. SENECA FALLS NEW *fM 0148 Effoctive Octobof, 198P 0 1988 Goulds Pumps, Inc. SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE PRINTED IN U.S.A. Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Lahor and Human 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 inch s I clude, but St. Croix not limited to vertical and horizontal reference point (BM), dir t 00 or PARCEL I.D. # dimensioned, north arrow, and location and distance to ne. t ad.~~ APPLICANT INFORMATION-PLEASE PRINT ALL 'I ORMATI(I XIS ' REVIEWED BY DATE PROPERTY OWNER: epROPERTY LMAtl John & Barbara Belbin G OT 1/4 NW 1/4,S 18 T 29 N,R 15 XX W R. PROPERTY OWNER':S MAILING ADDRESS LOT 9C # SUBD. NAME OR CSM # 971 CTHW I'D" NA CITY, STATE ZIP CODE PHONE NUMBE e` ❑CITY E] LAGE MOWN NEAREST ROAD Woodville WI 54028 (715 ) 698-3045 :-pringfield New Construction Use [x] Residential / Number of bedrooms 3 [ ] Addition to existing building Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate -9 bed, gpd/ft2 6 trench, gpd/ft2 Absorption area required 900 bed, ft2 750 trench, ft2 Maximum design loading rate •5 bed, gpd/ft2 .6 trench, gpd/ft2 Recommended infiltration surface elevation(s) 100.5 ft (as referred to site plan benchmark) Additional design / site considerations install 5' x 75' rock bed mound on 99.0 as upslope edge of rock w/ 1.5' sand fill Parent material loess over till Flood plain elevation, if applicable NA It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for s stem ❑ S XO U as ❑ U ❑ S )Q U ❑ S U ❑ S U ❑ 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. rBe Trench 1 0-8 10YR 3/2 sil 2 f sbk mfr 2 8-18 10YR 4/4 sl 2 m sbk mvfr cs 1 f/m .6 3 18-23 10YR 4/4 c2f .5YR 4/6 sl 2 m sbk mvfr cs 1f/m .5 .6 egGround 10YR 6/2 99V0 ft. 4 23-32 7.5YR 4/4 c2d R-Gy is 1 m abk mvfr cs 1f .7 .8 5 32-35 dense till Depth to limiting fa,~$gr Remarks: Boring # 1 0-10 10YR 3/2 - sil 2 f sbk mvfr cs f/m .5 ':.6 6 2 10-18 10YR 4/4 - sil 2 m sbk mfr cs f/m .5 .6 3 18-30 7.5YR 4/4 f2d 10YR 6/2 sl 1 m sbk mfr cs if .4 .5 Ground e98. v. 3 ft 4 30-43 7.5YR 4/6 c1d 5YR 5/8 is 0 sg ml - .7 .8 . Depth to limiting factor is" Remarks: CST Name:-Please Print Phone: Henry F. Grote 715-665-2681 Address: PO Box 57, Knapp, WI 54749-0057 Signature: j Date: CST Number: 8/17/94 3065 PROPERTY OWNER John/Barb Belbin SOIL DESCRIPTION REPORT Page 2 of, PARCEL I.D. # Depth Dominant Color Mottles Texture Structure Consistence Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bourbary Bed Trerxh 0-11 10YR 3/2 - sil 7 2 11-23 10YR 4/4 - sil Ground 3 23-28 10YR 4/4 f2d R-Gy sil elev. 98.5 ft. Depth to limiting factor 23" Remarks: hand boring Boring # .n:.;:::,:.; A 5' 75' rock bed mound ca be installed on 9 .0 as u toe edge o rock total upslope width o 8.7' will clear U g trees total downslo a width of 12.6' + ' total endslope width if 11.9' will give ' setbac to west L/ & clear big tree east Ground es im a volumes: elev. sand- 118 yd ; dirt- 126 ds• rock- 14 ds ft. Depth to limiting See pre minay report for B-1 to B-4: outside system a ea factor cc: ansky Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) L a 4- 3 3. o ~I r SOS ~ r ~ t I N I o~`'r J 10 1 I ~I 1 ~ i STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER JOHN BELBIN MAILING ADDRESS 971 CTH D , WOODVILLE WI 54028 PROPERTY ADDRESS ,AMe- (location of septic system) Please obtain from the Planning Dept. CITY/STATE WOODVILLE, WI 54028 PROPERTY LOCATION SW 1/4, NW 1/4, Section 18 T 29 N-R 15 W TOWN OF SPRINGFIELD , ST. CROIX COUNTY, WI SUBDIVISION NSA , LOT NUMBER CERTIFIED SURVEY MAP , VOLUME , PAGE , LOT NUMBER I 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: ^tO~ DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 STC - loo 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 JOHN BELBIN Location of property SW 1/4 NW 1/4, Section 18 T 29 N-R 15 W Township SPRINGFIELD Mailing address 971 CTH D WOODVILLE, WI 54028 Address of site SAME AS ABOVE Subdivision name N/A Lot no. N/A Other homes on property? -Yes No Previous owner of property j32 I✓~A2C-An: A &,A80 Total size of property 71 a Total size of parcel Date parcel was created Are all corners and lot lines identifiable? X Yes No Is this property being developed for (spec house) ? Yes X No Volume ID5,2 and Page Number 467 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. 0985 -7 , 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. ti t/ v_ 7Z, 11,4,~ T nature of g nature plicant Ao-Applicant /®/i7/gq 1 /0 -2 -~y Date of S lcrnaturP hate of S i anature • * oocuMENT No. WARRANTY DEED THIS 6►ACg RE6rnV6O JfOR REGOROINO DATA • STATE BAR OF WISCONSIN FORM 2-1982 109857 voi 1(l52PArA 425 REGISTE]R' ST. CRO.M.D_.DRABO..AND.MABfARETA.I...CRARO.,.HUSBANA.&M..WIF);,..............•.--•-------. Recd DEC Y, A 3:40 conveys and warrants to AND BARBARA L_ THOLIN, HUSBAND AND WIFE.a . R6TURM TO Farm Credit Services of NW Wisconsin CA P.O. Box 199 River Falls, Wisconsin 54032 the following described real estate in ST.--CROIX .....County, State cf Wisconsin: Tax Parcel No: s . ai. THE W1/2 OF NW1/4; _ SECTION 18, T29N, R15W, ST. CROIX COUNTY, WISCONSIN. SUBJECT 1t: EXISTING HIGHWAYS, EP.SEMENTS, AND RIGHTS OF WAY OF RECORDS. t This 19 homestead property. T (is) per) 'Y Exception to warranties: Dated this day of DECEMBER 19. 93.... ' .................................................(SEAL) . . . • (SEAL) CRABID (SEAL) . (SEAL) • MARGARETA J • • CRAW AUTHENTICATION ACKNOWLEDGMENT Signature (a) STATE OF WISCONSIN " Yb l as. Ly County. ~ 7t authenticated this day of 19...... Personally came before me this ~(iay,2f, DE~1 iBER.._.....• 19-91- the &Wve anted,,' BOG C - , MAR~ARETt1.,]._.GRl~$S2__...__:.:~nA! •-'..s . t1 y - ti _ is TITLE: MEMBER STATE BAR OF WISCONSIN J .....7 (If not, authorized by Q 7u6.06, Wis. State.) to me known to be the persons............ w'i•exfp the ! . ' : ~ - fore oing instrument/JaT'~ld,.aack~no/tw.ledget the}~+qe. Tl THIS INSTRUMENT WAS DRAFTED BY k`.!_.!!................YYY_.vvv~~~llLC(VNV!!••YJe_YYY~r...:,,..l.t;..,.r L.A. Woltman/Farm Credit Services River Falls, Wisconsin 54022 VSO/ County, Wis. l Notary Public (Signatures may be authenticated or acknowledged. Both My C pml'ssyion iispverrmaneentt.~(If not, state exp' n are not necessary.) date:w .---4•L~•-- ~ 1~) •Names of persons signing in any eapoelty should be typed or printed below their signatures. STATE BAR OF WISCONSIN Stock No. 13002 H MIIwrCarK+rM~ FORM No. 2-- lost O -0 00 0 y°9 ao ao 0 !r a' o w g a I C~ O O N T C N O p N ''00O LL c O C ~ =p N -0 0 E Q c U Co M ~ w I 0o N Ll m r ~ cn I N O N o z d m u O I ~ N N F- r (D z a N c M N K N ~ c Al .o _ L Q Z Z O z N N E I N N m I N 00 CL w w c c U) rJ 0) d O C. `l co LO -t o O G Ll E Co U) 2 M F- F- F- EL x Z o n 0 0 0 • na ! ai a a a CL 7 C N I' MAA~I ! !7 N 04 y O ~L. , c6 O r .T N r~ O N T ~ m N ~y o Q > O O c N c O Lo O F- c O N U 0 0 0) r- Q E r ►r _ ~ N V yw , N O cA O' 'D LO E In w _c _N O c O N N O - O L r - N C Z a) CU ~ F- c CU O C') 2 O. ! N CO C3 Vi O E ~i U • yin' O fn CO N O z N Z=i CO = I r0 ~ 'I 4i E V # M xt a • CL ~ '2 a L 'c c ~1 A ca= !ov)ci i Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations Division o1 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 St. Croix not limited to vertical and horizontal reference point (BM d % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distant 't' r d APPLICANT INFORMATION-PLEASE Phil L INF M REVIEWED BY DATE CIR PROPERTY OWNER: PERTY LOCATION John & Barbara Belbp / LOT SW 1/4 NW 1/4,S 18 T 29 N,R 15 XXW W PROPERTY OWNER':S MAILING ADDRESS 49s4 # BLOCK # SUBD. NAME OR CSM # 971 CTHW "D" NA CITY, STATE ZIP CODE`, ' PHONE NOMBER ` ITY ❑VILLAGE MOWN NEAREST ROAD Woodville WI 54028 (715 A-3045 1117)" [ j New Construction Use [ X ] Residential / IN of bedrooms 3 [ ] Addition to existing building Replacement (j Public or commercial desaibe~ u.A. Code derived daily flow 450 gpd Recommended design loading rate _ 5 bed, gpd/ft2. _ trench, gpd/ft2 Absorption area required 900 bed, ft2 750 trench, ft2 Maximum design loading rate • 5 bed, gpd/ft2 .6 trench, gpd/ft2 Recommended infiltration surface elevation(s) 100.5 ft (as referred to site plan benchmark) Additional design /site considerations install 5' x 75' rock bed mound on 99.0 as upslope edge of rock w/ 1.5' sand fill Parent material loess over till Flood plain elevation, if applicable NA ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for s stem ❑ S XU U as ❑ U ❑ S Q U ❑ S U ❑ S U ❑ S U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Y Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trend 1 0-8 10YR 3/2 sil 2 f k 5 2 8-18 10YR 4/4 - sl 2 m sbk mvfr Cs 1f1m .5 .6 Ground 3 18-23 10YR 4/4 c2f 10YR 6/26 sl 2 m sbk mvfr cs if/m .5 .6 99 V0 ft. 4 23-32 7.5YR 4/4 c2d R-Gy is 1 m abk mvfr cs if .7 .8 5 32-35 dense till Depth to limiting fagg Remarks: Boring # 1 0-10 10YR 3/2 - sil 2 f sbk mvfr cs f/m .5 1.6 \4 C 2 10-18 10YR 4/4 - sil 2 m sbk mfr cs f/m .5 .6 3 18-30 7.5YR 4/4 f2d 10YR 6/2 sl 1 m sbk mfr cs if .4 .5 Ground ev.3 ft. 4 130-43 7.5YR 4/6 c1d 5YR 5/8 is 0 sg ml - .7 ..8 Depth to limiting factor _ ate Remarks: CST Name:-Please Print Phone: Henry F. Grote 715-665-2681 Address: PO Box 57, Knapp, WI 54749-0057 - Signature: Date: CST Number: 8/17/94 3065 PROPERTY OWNER John/Barb Belbin SOIL DESCh,eTION RLPORT Page 2 of-3 PARCEL I.D. # Depth Dominant Color Mottles Texture Structure Consistence Roots GPD/ft Boring # Horizon in Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Boundary Bed Trends 0-11 10YR 3/2 - sil 7 2 11-23 10YR 4/4 - sil Ground 3 23-28 10YR 4/4 f2d R-Gy sil elev. 98.5 ft, Depth to limiting factor 23" Remarks: hand boring Boring # A 5' 75' r ck bed mound ca be installed on 9 ?.0 as u toe edge o rock total upslope width o 8.7' will clear b .g trees total downslope width of ' ' total endslope width f 11.9' will give ' setback to west L/ & clear bi tree east Ground estimated volumes: elev. sand- 118 yd ; dirt- 126 ds• rock- 14 ds ft. Depth to limiting See p elimina y report for B-1 to B-4: outside system area factor cc: ansky Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) I y ~ i I ~ I I 4- C4 J f i 3, I I r eJ .41 t s i J4 ' I. Y ' 1 I I -43 i kA I J d: SIC ' I ; i i j Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Lrlfor and Human Relations s Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Preliminary (soils only) St. Croix Attach complete site plan on paper not less / x es in size. Plan must include, but not limited to vertical and horizontal reference'p~ _ t and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and locatioyt and distance t ear REVIEWED BY DATE APPLICANT INFORMATION-PL`E-ASE PFU T kcx lw0 ION PROPERTY OWNER: PROPERTY LOCATION John Belbin GOVT. LOT SW 1/4 NW 1/4,S 18 T 29 N,R 15 *(W W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 971 CTHW "D" - - NA CITY, STATE ZIP CODE ~ PHONE NUM ❑CITY ❑VILLAGE )DOWN MHW REST ROAD Woodville, WI 54028 (715,. - Springfield D [ ] New Construction Use kx] Residential / Number of bedrooms 3 [ ] Addition to existing building Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate_bed, gpd/ft2 .6 trench, gpd/ft2 Absorption area required 9nn bed, ft2 75n trench, ft2 Maximum design loading rate s bed, gpd/ft2_trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations Parent material t nacc n iar till Flood plain elevation, if applicable NA ft S = Suitable for system CONVENTI AL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ❑ S U us ❑ U ❑ S Q U ❑ S Q U ❑ S ~l U Q S ❑ U possibly SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Bounds I Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0-5 10YR 3/2 - sil 2 f-m sbk mfi cs 2f .5 .6 2 5-12 10YR 3/2 - sil 2 m sbk mfr cs if .5 .6 3 12-22 10YR 5/3 2p 5YR 5/2 sil 2 m sbk mfr gs if .5 .6 Ground 7.5YR 4/6 elev. ft. 4 22-30 7.5YR 4/4 c3p R-Gy scl 1 m-c sbk mvfr - if .2 .3 Depth to A + 4' lacking butstructure & topograp y suggest relic mots limiting factor 0-12 s ow reticulated YR 4/6 decyed org nic matt r high chrom as Remarks: Boring # 1 0-3 10YR 3/2 - sil 2 m cr mvfr cs 2f .5 .6 "1 2 2 3-9 10YR 3/2 - sil 2 f sbk mvfr cs if .5 .6 w/ reticulated 5YR 4/6 decayed rganic m tter Ground 3 9-18 10YR 5/3 c2p 5YR 6/2 sil 2 m sbk mvfr cs if .5 .6 elev. ft. sil is gritty w/ s has occasional g ; sbk pa is to pl Depth to limiting 4 18-30 10YR 5/4 c3p R-Gy sl 1 m sbk mvfr - if .4 .5 factor w/ gr & occ c b Remarks: CST Name:-Please Print Phone: Henry F. Grote 715-665-2681 Address: PO Box 57, Knapp, WI 54749-0057 Signature: Date: 8/6/94 CST Number: 3065 PROPERTY OWNER John Belbin SOIL DESCRIPTION REPORT Page 2 Of 3 PARCEL I.D. # . 1 , Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounday Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0-5 10YR 311 - sil 2 f-m sbk mvfr cs if .5 .6 3 7.5YR 6/2 2 5-13 10YR 5/4 c2p 7.5YR 5/8 sil 2 m sbk mvfr gs if .5 .6 Ground 3 13-30 10YR 5/3 c3p R-Gy sicl 1 c sbk mfr - if .2 .3 elev. ft. Depth to limiting factor Remarks: Boring # 1 0-2 7.5YR 3/2 - 1 2 f cr mvfr cs 2f .5 .6 2 2-6 10YR 3/1 - sil 2 f sbk mvfr cs if .5 .6 4 w/ reticulate 5YR 4/6 decayed organic matter Ground 3 6-27 10YR 5/3 c2d 7.5YR 5/8 sil 2 m abk mfr cs if .5 .6 elev. ft. 4 27-34 7.5YR 4/4 c3p 7.5YR 5/8 sl 1 c sbk mfr - - .4 .5 Depth to limiting factor Remarks: Boring # All 4 pits lack A + 4", but CST opinion s that s it structure will support a to /narr w mound w Reque t state onsite to verify organic matter as ause of A horizon high hromas disc ss options Groun -water monitori g for a mound is a possible plan here Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) w J DV~•~ Q. 1 `a~C ~~a...~ S~.a. Nw_ fig. Z~- ~U GZ"tdw L`-" i ►3.3 I, i F/~ II Ct- ».ooDC- ~o... n C. 1h 1 Jz ra Q GTkw Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations Dvision of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Preliminary (so?1ess St. Croix Attach complete site plan on paper inches in size. Plan must include, but not limited to vertical and horizontai q) ~bction and % of slope, scale or P ARCEL I.D. # dimensioned, north arrow, and locaance nearsy~oad. REVIEWED BY DATE APPLICANT INFORMATION-P INT A , INFdi* TION PROPERTY OWNER: ~f PROPERTY LOCATION John Belbin i GOVT. LOT SW 1/4 NW 1/4,S 18 T 29 N,R 15 >&W W PROPERTY OWNER':S MAILING ADD ~S$, c LOT # BLOCK # SUBD. NAME OR CSM # 971 CTHW I'D'R. NA CITY, STATE Zt COplti PHONE NUM ❑CITY ❑VILLAGE )DOWN NEAREST ROAD Woodville, WI 540 ~0" 1,4.1- 715 S rin field CTHW D [ ] New Construction Use kX] Residential / u r of bedrooms 3 [ ] Addition to existing building V$ Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate s bed, gpolft2 .6 trench, gpd/ft2 Absorption area required 9nn bed, ft2 7Sn trench, ft2 Maximum design loading rate - s bed, gpd/ft2 _ f trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations Parent material i na¢c near t i l l Flood plain elevation, if applicable NA It S = Suitable for system CONVENTI AL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U=Unsuitable for system ❑ S 9'U S❑ U ❑ S U El S U ❑ S U Q S E3 U possibly 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 Trend 1 0-5 10YR 3/2 - sil 2 f-m sbk mfi cs 2f .5 .6 2 5-12 10YR 3/2 - sil 2 m sbk mfr cs if .5 .6 3 12-22 10YR 5/3 2p 5YR 5/2 sil 2 m sbk mfr gs if .5 .6 Ground 7.5YR 4/6 elev. ft. 4 22-30 7.5YR 4/4 c3p R-Gy scl 1 m-c sbk mvfr - if 2 .3 Depth to A + 4' lacking butstructure & topograp y suggest relic mots limiting factor 0-12 s ow reticulated YR 4/6 decyed org nic matt Er high chrom s Remarks: Boring # 1 0-3 10YR 3/2 - sil 2 m cr mvfr cs 2f .5 .6 2 2 3-9 10YR 3/2 - sil 2 f sbk mvfr cs if .5 .6 w/ reticulated 5YR 4/6 decayed organic m tter Ground elev 3 9-18 10YR 5/3 c2p 5YR 6/2 sil 2 m sbk mvfr cs if .5 .6 . ft. sil is gritty w/ s has occasional g ; sbk pa is to pl Depth to limiting 4 18-30 10YR 5/4 c3p R-Gy sl 1 m sbk mvfr - if .4 .5 factor w/ gr & occ b Remarks: CST Name:-Please Print Phone: Henry F. Grote 715-665-2681 Address: PO Box 57, Knapp, WI 54749-0057 _ Signature: Date: 8/6/94 CST Number: 3065 PROPERTY OWNER John Belbin SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL I.D. # y Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft Boring # Horizon in. Munsell ()u. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3 1 0-5 10YR 3/1 - sil 2 f-m sbk mvfr cs 1f .5 .6 2 5-13 10YR 5/4 c2p 7.5YR 6/2 sil 2 m sbk mvfr gs if 5 .6 YR 5/8 Ground 3 13-30 10YR 5/3 c3p R-Gy sicl 1 c sbk mfr - if .2 .3 elev. ft. Depth to limiting factor Remarks: Boring # 1 0-2 7.5YR 3/2 - 1 2 f cr mvfr cs 2f .5 '•.6 2 2-6 10YR 3/1 - sil 2 f sbk mvfr cs 1 f .5 .6 w/ reticulate 5YR 4/6 decayed organic m ter Ground 3 6-27 10YR 5/3 c2d 7.5YR 5/8 sil 2 m abk mfr cs if .5 .6 elev. ft. 4 27-34 7.5YR 4/4 c3p 7.5YR 5/8 sl 1 c sbk mfr - - .4 .5 Depth to limiting factor Remarks: Boring # All 4 pits lack A + 411, but CST opinion s that s it structure will support a to /narrow mound Reque t state onsite to verify organic matter as ause of A horizon high hromas disc ss options Groun -water monitori g for a mound is a possible plan here Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) r> >3- 3 10 /S -ln~o Ct, ~o....*Q q Q <5°?0 GTkw 6~3°~3