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Home My WebLink About040-1222-40-000 ti STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ' Gvc O ADDRESS SUBDIVISION / CSM# r1S e d ~T 0 7 I D~ 1''~/`fd~ LOT # SECTION l & T_2 i~ _N-R_j~? W, Town of T/-4 U ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 1'0 H- 06 GpY454 Q 1 I 8~ J ~ 1 (louse I ~ a B 7 1.2 coo ob a 1 SC/ c Ton R , Yo " - caI" Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. r 1 BENCHMARK: Tb p pT Cnpt ► ~p(lS l4ce< ~l~bY L l~'(% O ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: We -e-k- Liquid Capacity: Setback from: Well House Other Pump, anufacturer Model# Size Float sep ation Gallons cle: Alarm Location SOIL ABSORPTION SYSTEM Width: Length Number of trenches Distance & Direction to nearest prop. line: G(3as Setback from: well: House:- Other ELEVATIONS Building Sewer ST Inlet: ST outlet PC inlet PC bottom Pump Off Header/Manifold Bottom of system Existing Grade Final grade DATE OF INSTALLATION: PLUMBER ON JOB: LO C S P, 11r LICENSE NUMBER: INSPECTOR: 3/93:jt WiS'''a ,,in Department of Industry, PRIVATE SEWAGE SYSTEM County: ST . CROIX 4ab~ Human Relations INSPECTION REPORT Sad and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION PeFALLderJAM)'S & KARA ❑ City Village R Town of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No. go, D /0,0 a TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Benchmark C~ Septic JC S v q $ 9011 Dosing Aeration Bldg. Sewer Holding St Ht Inlet q,V9 87.99 TANK SETBACK INFORMATION St/ Ht Outlet 9 -71 RLI Vent TANK TO P / L WELL BLDG. Air ito ntake ROAD Dt Inlet Air Septic Si /S ~/5 ! NA Dt Bottom Dosing NA Header / Man. /ad< , fsb.os- NA Dist. Pipe Aeration /d y ~g Holding Bot. System 7y-O° S PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand S U 6,6 9i. 3 3 Model Number GPM TDH Lift Friction System TDH Ft Loss Head Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. O Trenches PIT No. Of Pits Inside Liquid Depth DIMENSIONS DIMENSIONS LEACHING SETBACK Manufacturer: SYSTEM TO P / L BLDG WELL LAKE/STREAM INFORMATION TypeO >"5 _D 11 OR UNIT CHAMBER Moe Number: System: yz U N 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 r `f.` xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center [ Bed / Trench Edges j O Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) F LOCATION: Troy.16.28.19W,NE,SW, SOUTHERN PACIFIC - LOT 49 Plan revision required? ❑ Yes ❑ No ~j Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH v. SANITARY PERMIT NUMBER: SANITARY PERMIT APPLICATION ~7L■7~'1 In accord with ILHR 83.05, Wis. Adm. Code cou-5 c STATE SANI 41PE MIT # -Attach complete plans (to the county copy only) for the system, on paper not less than Q_ /J/ 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 Q i s 1 4 fra C'/a :5 /.j) S T , N, R) Y E(at W PROPERTY OWNER'S MAILING ADDRESS LOT # L BLOCK # C e e ~r 7 CITY, STATE ZIP CODE PHONE NUMBER SUBDIV SIgqN NAME OR CSM NUMBER Atdospll U)r y4l !o /vo 5t o 3~ Ald,Zo;e II. TYPE OF BUILDING: (Check one) El State Owned NEAREST ROAD ❑Public [Al or 2 Fam. Dwelling-# of bedrooms PARCEL TAX NUMBER(S) III. BUILDING USE: (If building type is public, check all that apply) D /i® 1 ❑ Apt/Condo "7` 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 120 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. ❑ 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 q,~o 9q E/ cr,/ Date Issued 91y LAW 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 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) 851.00 ELEVATION (000 000 ) eg" A o Feet 87' 0 Feet VII. TANK CAPACITY Site in allons Total of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New lExisting Gallons Tanks Concrete structed glass App. Tanks Tanks Septic Tank .2 60 2 Ov / li(f P t VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plu Si nature: (No s) MPAAPPAW. a: Business Phone Number: R,_,/C1!1 S n - Gti ( C 7P~a J~/~ T Jam- 'J+~_e7~`~ Plumber's Address (Street, City, State, Zip Code : z '71/ _e /-.2/1C w ~a IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanita Permit Fee (Includes Groundwater ate Issued Issuing Agent Signature (No Stamps) Approved El / Surcharge Fee) Owner Given Initial &(J AA-- Determination V X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(R.08/93) DISTRIBUTION: Original to County, One Copy To: Safety 8 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. 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. Vlll. 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) ' 1 1Ot P~nn 7rencks S is s r ~~®ce1Ke"~ BBQr /00.0 ~~01`~ rPPric~ _ r r~ GaYaS< 1 ( f~DuSC t y Bec; R. 87 J .2CXJ ~v1 SeJDtie To,ek /j N/rst TreKCrt 84;D0~ !5ySle.- /7 E~C~~/dT/L+L Larr 7'~ekcl~ 8~•'z0` f 1 / ►'to W,'/l ~ee to ~9ew B~K,k Amr k iEle v. 90. o ~u w~~ pec~use o # e~V Nc¢u n ~Gca; Benck Mav k TOloof n Y Roor NQr Lt~~ Ae{d b&ta( Bore- yolQs to RV.,,f One By Art W,?ey- a j - 5- 93 for Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page L of Labor W. Human Relations 1 .4 7 Diuisicn oftafety & Buildings in accord with ILHR 83.05, WiS. Adm. Code G/u -ov ` -6 S` COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but 5t C O t 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. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION e5 GOVT. LOT e 1/4 5 IV 1/4,S/t T Z8 N,R `y eNe PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # .3 C ' . 'Z/ 91 - G l e St 'f ~ .,i CITY, STATE ZIP CODE PHONE NUMBER ZrOWN NEAREST ROAD W 1 > r D .5 u c ~4 New Construction Use [X Residential / Number of bedrooms [ J Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 400 gpd Recommended design loading rate bed, gpd/ft2 trench, gpd/ft2 Absorption area required bed, ft2 trench, ft2 Maximum design loading rate bed, gpd/ft2 trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U=Unsuitable fors stem ❑S ❑U ❑S ❑U ❑S ❑U ❑S ❑U ❑S ❑U ❑S ❑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 Trench 1D r &3 M-94 5 i S Ih r C5 A J. G o YR 3 s ' ~,2 sbk m (r C s ! . G .3- Ground j -y /D rR b S 7 elev. 1-f - s to Y a S - . 7 f\ z1 Depth to limiting factor ? 93 Remarks: Boring # 31 3 Al 01,,p S ~ 02 s 1t4 c5 .?v 9' 0 C 6 YR 3 S ~ 02 ~ $ b ~r -5 L) Ground 3rZ-YX1QYR S S ` 7• ev. .Z - /0 ye (o T/ l tt. Depth to limiting factor Remarks: CST Name:-Please Print Phone: Address: ~fll Signature: Date: 30 CST Number: 7 -30 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. ..ni: •.'••.L: Bed Trench Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. 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) ~'1ot I')n►~ 88L31 /GO.C'La jfPrl~~' Vorac~ J I i~ r aL j ? r flc~~t.e R. a y 87 !,.2C:O a1 5 c6r-'c To I,i( ~~L • !`~/~'~1C P/K E~/~1 A✓e % la,i i•~' ke, lO kel gc?/t~k NL4r~ F`f V. /~e t' e ✓ Q ~~tn~ bzc.~, e Gt el~~c{«:: ~ ~ l~'zw 13e/,ck IUlvi'k Tod e, f 13urki..,,t' f/ee, c(/ I&LAI DC)pe ryG/&,S TL,.' f f 4Vc lA t ttl/lN QY 14 p F W,e y e,^ d.. 9 - 9 - r~ /-to r W3consin Department of Industry, SOIL AND SITE EVALUATION REPORT Pa e Labom r4 Human Relations g L of .2, Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code C M r -h c COUNTY TYAttach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but Jf C / O r 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. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION ties d GOVT. LOT r 1/4 S ,~V 1/4,S& T ;Z, N,R ?y Elve PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SG10 UBD. NAME OR CSM # 1 C G r~ Lf 3 / I.:.-y l L CITY, STATE ZIP CODE PHONE NUMBER n^'T" ~W6 "8E MOWN NEAREST ROAD W It 1, ( ) __j Yo S Ott ero Pa C, I New Construction Use [X Residential / Number of bedrooms [ J Addition to existing building Replacement [ ] Public or commercial describe Code derived daily flow 4 00 gpd Recommended design loading rate bed, gpd/ft2 trench, gpd/ft2 Absorption area required bed, ft2 trench, ft2 Maximum design loading rate bed, gpd/ft2 trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U=Unsuitable fors stem ❑S ❑U ❑S ❑U ❑S ❑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. Bed Trench >'':_.::<:<' p- l Y 3 s art r C S . 6 o~ l/-3S DYR 3 6 s 02 sbk m ~r C.5 I . (o Ground 3 l,DrR q14 b S M C - elev. 17~2.Gft. Y y a s rn ( - 1 Depth to limiting factor „ Z 73 Remarks: Boring # -12 33 iV ss k cs 2v . 5d b ~r c LIZ - . Ground Z /o r R S S 7, nley / ft. e r!v s j Depth to limiting factor Remarks: CST Name:-Please Print Phone: 1-12 s ti Address: ~t yvz 3o ys f 0_r Falls .37 Signature, Date: CST Number: c ~ c~~3d~9y 36 7`~' - ~ P1ot ~1nr, ~ UYri jr~ Draw F rclcr Tw encLS J B8 t3r /00. c p TreiA OL r l! ~ ' ! flog+ze r i 1 y h BJ I.2 P)0 a/ se6T';c Tor rC Sy/sfe - /evef ,:,•t zc' f J~~ J A 'e w t' le /•~l~~e ~e'/P1GeCPI+tFiai A~^~G rir,l! /V2ec l~ BE3nt 11 N rvy' ~ E v. 90•0 , a c. s v /l'c 13ee,c Ill vrk To19o f (34sk-., r Fioor L ATW pert Pd lin c+y28.19W, N RATE~Wd 5 Vtlf rn Paci •o nty: r• Lab njd-Iuman Relations INSPECTION REPORT Safety ty andleuildings Division (ATTACH TO PERMIT) Sanitary Permt 145 'GENERAL INFORMATION Permit Holder's Name: E] City ❑ Village R Town of: State Plan D o.: Wim Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA A9400107 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 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 Syestem TDH Ft Forcemain Length Dia. FFii Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSION DIMENSIONS LEACHING Manufacturer: SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM INFORMATION Type O 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 Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: Troy.16.28.19W, NE, SW, Lot 49, Southern Pacific 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 LI DILHR COUNTY In accord with ILHR 83.05, Wis. Adm. Code St Croix STATE V I( W RMIT -Attach complete plans (to the county copy only) for the system, on paper not less than 00- 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. PROPERTY OWNER PROPERTY LOCATION James & Kara Fall NE % SW S 16 T 28 , N, R 19 W BLOCK # PROPERTY OWNER'S MAILING ADDRESS LOT # 3 Crestview Drive 49 CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER Hudson, WI I It 54016 Glover Station 3rd Addition II. TYPE OF BUILDING: (Check one) 1-1 State Owned NEAREST ROAD Southern Pacific ❑ Public ®1 or 2 Fam. Dwelling- # of bedrooms _4__ PA TAX NUMBER(S) 111. BUILDING USE: (If building type is public, check all that apply) 040-1222-40 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 100 Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 80 Mobile Home Park 120 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.E] Replacement 3. ❑ Replacement of 4. ❑ 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 42 ❑ Pit Privy 130 Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 12. 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 600 858 Feet 99 M Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name oncrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plu m s 'gnurq; ( o S mp MP.SBfi+l~lo.: Business Phone Number: Paul C.J. Steiner C~ 6780 _ Plumber's Address (Street, City, State, Zip Code): I IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanita Permit Fee (includes Groundwater Date su is ui g Agent Signature (No Stamps). pproved ❑ Owner Given Initial / Surcharge Fee) ~ 7 { 1 Adverse Determination ` . CONDITIONS OF APPROVALIREASONS FOR DISAPPROVAL: SBD-6398 (formerly Pib-67) (R. 11/88) 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 Sawtary Permit Transfer/Renewal Form (SBO 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. 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. Vlll. 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; (lose 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) . , ~ ~ v t Pla n I` s~r`i f B M ~Z 100.0' oh 3~y P~~ n t wl ~a'~ ~ S/owe - p ~~z t. 1 ~P arme. ~ . fh is s ~ I 0 c1loo "',J) 3~0' Wisconsin Department of Industy, SOIL AND SITE EVALUATION REPORT Page I of 3 bor and Human Relations 1 i*n of Safety Buildings in accord with ILHR 83.05, Wis. Adm. Code COU iv S'f'•G~sJ1X Atfach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but PARCELLD. # 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. REVIEWED BY DATE APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION PROPERTY OWNER: PROPERTY LOCATION C • ~`t E DE1-~N S SCktU L- Z GOVT. LOT NE 1/4 SW 1/4,S 16 T -Z8 .,N,R l9 E (00W PROPERTY OWNEV--S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # -7 l0 tJ. t"l~tly gT- L401 - 6tD~~l?R :31fM N 3~d WbDCTIOt`f CITY, STATE ZIP CODE PHONE NUMBER E]CITY []VILLAGE DOWN NEAREST ROAD z l-Pct LS W 1 S~ozZ (CIS) 14LS sod'nt~MQ ptvctF:-1 C~- New Construction Use Residential / Number of bedrooms y Additi. n to etastin building [ ] Replacement Public or commeraaf describe w Mtft ot= Ot t a ►u tYUf=r IF 8-L, y , S d b Code derived dally flow 60o gpd Recommended design loading rate o.77 bed, gpd/ft2 or•b trench, gpd/ft2 Absorption area required 9St bed, ft2 tad trench, ft2 Mabmum design loading rate o • 7_bed, gpdflt 0.6 trench, gpdt t2 Recommended infiltration surface elevation(s) °r S O C'e Z, 3 4 It (as referred to site plan benchmark) Additional design/ site oonsiderabons s t~oT~ ~o f n~sl-kr ~~'R QN nf~GE 3 Parent material S ED t"E" . JT ov Ne SAID G R ~°ru e?t Flood plain elevation, if applicable N A • ft FNAL. ONVemo U MOUND II-ROt ND PRESSURE AT-GRADE SYSTBA M FL L HOLDING TANK S = Suitable for system C U=Unsuitable for system ®S ❑ INS ❑U ®S ❑U ®S 11U IRS ❑U ❑s oil SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Bourlby GPD/ft Boring # Horizon in Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Roofs Bed ier& O-4 10`'12 3/3 S1 \ Z~ Silt 1vt` ~r ~ CS Z'v~ u,s 0.6 Z 9-36 \o-{R 3J6 st Z-`~Sbk w,'f>.- c S 1v~ o• S 0.6 3 3b-~t6 -).Sy2 Y/(, Gh is v s ti„t e S n.~ n•$ Ground elev. - p .1 o • C8-b ft. y y6-93 ]~`1 R Y] y Depth to - S v sg ELIE] 1 limiting facto ~ 93 Remarks: si 1 z-~ s'l>►2 n`F~- CS z„f b Sso b Boring # , O -1 O 10 `-t (L 3 / 3 t~Z luf o_s o 6 2 _ Z D \o`1tZ316 S1~ Z'PsbVc YA Gs 3 zp-L17 \wyRY/to - \-~s o :S -j CS o-s o.~ Ground elev. y-_ 103 my (c V)y S o sS w, )1 \o~ . \ ft lo Goofing >fac L Remarks: T Name:--Please Print Arthur L. We erer Phone. 715-425-0165 g rer Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022 Date: CST Number: Signatwe:L~~ ~3-y 5-5-93 M00576 116PEOYOWNER 'V-4E - Setty~TZ SOIL DESCRIPTION REPORT Page? I A.RC4I.D. # D/ ft Depth Dominant Color Mottles Texture Structure Consistence BourrW Roots E.d oring # Horizon in. Munsell Qu. Sz. Cont Color GrSzSh. BTrerxh o_ 9 1 Opt 2 3! 3 - s S Dtit F~• c S z o. S 6 round 3 zz-So 104tR Y/6 - ~`FS o SC5 cS - o~S v t, lev. q att. y SO-98 16ytZ Y1 S o s5 Yvt 1 0,7 )epth to ' uniting , actor Remarks: 3oring4 0-9 trN4V- 313 t3 2ui o-S ~ ~ Z ~ - zy l U `t R 314 s i I z ~ s b>z >h c s ) v ~ ~ • S ; o. 6 O lu`7R 516 - S O S9 ~ 1 - •~7 3 Zy-96 Ground - alev. )8-`f ft. } Depth to i limiting `actor Remarks: 3oring # O-$ l~`1R- 313 SO ~ 2-- 5 k Zv ` S Z g_ 20 1•S `7Q 3!y t1 s o S 9 `M 1 C S o, 8 1162 3 ?~-33 \~`(lL 5l/(, S O S9 vv) 1 c S - u•1 0' 8 Ground elev. y 33 1OYR Y/6 ~s O S9 Yvt I - o S b IS.0 ft. Depth to limiting factor Remarks: Boring # 0-9 to 2 S t 2-f Sbk '~r• 2S 2v o- S o• z q--L9 -~•s~Q 3/ cam. ~S o s w► J S Ground elev. L/ P-go it.,) Ilk V/L - ~S O S 9 wt ~ _ d. S o• L ft. Depth to limiting '7 90 Remarks: ;BD-6330(A.05/92) o 1 IN } PLOT PLAN Page 3 of = LuT ~-1 q \q3 b~ „Sb° S i 5t~9 L-L IM-0 oti 3/,46 PvC Z.,L LT, Q~)- tS hw G eluvtp~,~z S M 0 81"1 0.. 9q.3 3' o.-3 3jvva I WE NT ~~r3T z S ' (--1 + S \i sT-e)-t ft tt5A wl. . So a 0 N ~,o°u8~3~~w 3io' _ __A,~_ s~ sty T_-T 13vzt c y Btiz ten) Prr eL, qs• o 11J `~L~L MLzR OF 32. L-11 11~JIVO.L ♦ovv UA-X--'NL F-r- OF S'wtpt liLOvC!}L'S Zq" 1 N S m 1U o ~-TL~z r~ I rub o ►'~T )--A(Z LA'0 fi t. C Y O b") s`i ST1;~1 kpUlkj 5 ° lAjCs asw STtUC'DuN ----tic UL.OV s'~IZ~T r X H 93 -4y ~ ~y S-S-O13 11 S Li -L 1 5 IM\~O57V CST Srgnature Date Sig ne Telephone No. CST # SEPTIC TANK MAINTENANCE AGREEMENT ~ St. Croix County _ r OWNER/BUYER ~o,_ ~ ) - o Fire tiumber__,_ _ d ROUTE/BOX NUMBER " w CITY/STATE o 6 PROPERTY LOCATION:'. Section T.0 N, R_ W, St. Croix County, Town of Subdivision Lot number• Improper use and maintenance sstmaintenanceem could its premature failure to handle of pumping out the septic tank every three years or sooner, if needed, by a licetstdes*eunct onno umpr. astaitreat- the system can a ec ment'stage in the waste disposal system. St. Croix County residents m of eligible a grant a maximum of 60% of the cost .of whic 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 .a . ys'tems agree to keep their system properly maintained. The property owner agrees to. submit to St. Croix County Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or.a licensed pumper veri- fying that (1) the on-site.wastewater disposal system is in proper nec- operating condition and •(2)•after inspection and pumping less than 1/3 essary) the septic'•kbe is Certification form will three year expiration. y 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 Depart w ment of Natural Certification form f,~icet within 30edays V and returned to the S of the three year expiration date. r SIGNED / DATE St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 386-4680 Sign, date and return to the above address. you APPLICATION FOR SANITARY PERMIT STC-100 This application form Is to be compll Wilts onlydteaulteln delay: of the property being developed. Any Inadequacies the permit IdeuenCe. Should this development be intended got sesali by ined and cometd when t#the property Is sold second should this officetawith the completed appropriate deed recording. - - - - - -------r - Ownst of property Location of property kw-1/4 Si"-:~ -.1/l,, section Township r~ Maliing address C~e~ v L La . Address of site 3 ~o -s cc~~ C. subdivision name loy~ Lot number aq Previous owner of property „ bt_nnVe Total also of parcel 3 - Date parcel was created At* all cotnats and lot lines ldentltlable7 __Yes ~J(o is this property being developed for resale Cspec house)T__Yas e Yolswe ___and Page Number as recorded with the Register of Deeds. - - - - - - - - - - - r - - INCLUDE - - - r r - - r • - WITH THIS APPLICATION THE FOLLOWINGt A WARRANTY DASD vhich Includes a DOCUMINT NUMBER, VOLUMs AND FAGS NUMSSR, and the BRAL OF THE REGISTER OF DEEDS. In addition, a certified survey, it available, would be helpful so as to avoid delays of the reviewing process. It the deed description references to a Cet:tifled survey Map, the Cartltled Server Map shall also be required. PROPERTY OWNER CERTIFICATION I(vs) cettity that all statements on this form are true to the best of my (out) Rmovledgel that I Iva) am (ate) the ownerts) of the property described in this lntocmatlon form, by virtue of a warranty deed recorded in the Office of the County Register of Deeds as Document No. ) and that I (Val ptesently own the proposed site for the sewage disposal system (or i (we) have obtained an easement, to tun with the above described property, tot the constcuctlon of said Py tem, and the same has been duly tecorded in the office of the my Reglat t ds, as Document No. r, 1. r S gnatu e 'of owner ig ature of Co-Ovnst tlf Applicable) i R. ~ 4 Fate o signature Da a of signature T STATE BAR OF yVIc,CONSIN' FORM 1 1982 I!I THIS SPACE RESERVED FOR DOCUMENT NO. WARRANTY DEED i f)043 - PacE REGISTER'S C. M B e and Dennis R. ST, CR41X C This Deed, made between ...........Y_.............-......................... I ReC'd for R .schatz.,..each..in.-thei.r._awn-.right, I V1 N • Grantor, 1:15 and.... Jatllas-: Fall._alld _Kaaa.. ...as_.rparl. lvo lp_.__. i at . ~i Grantee, - - - - Regtstet 0 D i Witnesseth, That the said Grantor, for a valuable consideration...... I~ RETURN TO C M Bye conveys to Grantee the following described real estate in St.._.QrojX.......... I PO BOX 167, Rive? Gounty, State of Wisconsin: ~L54022 Tax Parcel No: III Lot #49, Glover Station Third Addition, in the Town of Troy, j! St. Croix County, Wisconsin. Subject to easement for driveway shared with Lot 50 as shown on the recorded plat. i This S_,nOt....._..... homestead property. (is) (is not) I i Together with all and singular the hereditaments and appurtenances thereunto belt j C. M. B e and Dennis R. Schultz warrants that the title is good, indefeasible in fee simple and free and clear of encumbrai municipal and zoning ordinances, easements for public utilitie i building restrictions of record, and will warrant and defend t e same. Dated this day of ~I (SEAL) . C. M. Bye (SEAL) Dennis R. ACBNOWLEDGMEN Signature STATE OF WISCONSIN (s) ss. St. Croix County. authenticated this ........day of 19....._ Personally came before me this 7~0 6.frr- 1913 ti C. M. Bve and l~enni s.. R= Schu • J . ty C..~rw~~c. it Grantee, Regl3ter of Deeds asseth,, That the said Grantor, for a valuable consideration...... RETURN 70 C M Bye i~ ' .ntee the following described real estate in St. Cmjx........_. ; I! of Wisconsin: 1!P0 BOX 167, River Falls WI 54022 ~I Tax Parcel No: ~i, 11 Glover Station Third Addition, in the Town of Troy, i K County, Wisconsin. to easement for driveway shared with Lot 50 as shown i' ecorded plat. li I!. I is..not........... homestead property. I (is) (is not) er with all and singular the hereditaments and appurtenances thereunto belonging; C. M. Bye and Dennis R. Schultz . the title is good, indefeasible in fee simple and free and clear of encumbrances except Ll and zoning ordinances, easements for public utilities, and ~I restrictions of record, I -ant and defend the same. -e!. . , U._.. 11 day of 6 19? I~ (SEAL)..... =•-•--•.....•-••--•..(SEAL) ii I~ ...M...$ye (SEAL) . (SEAL) * Dennis _R Schultz ~!I AUTHENTICATION ACKNOWLEDGMENT I, STATE OF WISCONSIN ss. i St. Croix County. tt i this ........day of 19------ Personally came before me this ../I.---------- day of I'; , 19 the above named ~I - - - ~~_.M_L..~Ye._and.Dennis R. Schultz MBER STATE BAR OF WISCONSIN t, • ......--_...._.._.,~:-:•`~`r..~tttt,+ ' !i,.„77; ized by § 706.46, Wis. Stats.) to me known ~tb Vts0 ~ who executed w.,. toregoin ~ihAk& A'~ and 9Oknci~v~edge the same. lSTRUMENT WAS DRAFTED BY ye rr...f y at Law Notary County, Wis. ' may be authenticated or acknowledged. Both My Commissionr~ris •~g~man6pt. (if not, state expiration li ) isary.} date: hLt I19......... :ns sivninR in any capacity should be t>•Ued or printed below their siunatureq. ' Wisconsin Departrnent of Industy, SOIL AND SITE EVALUATION REPORT Page I of 3 Libor 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 81/2 x 11 inches in size. Plan must include, but PARCELI.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. REVIEWED BY GATE APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION PROPERTY OWNER: PROPERTY LOCATION 0--M • W-t I` be"f-.11S SCli ko t-Z GOVT. LOT NE 1/4 SLO 1/4,S A. T Z-6 .,N,R L9 E (O PROPERTY OWNER'-.S MAILING ADDRESS LOT # ,LOCK # SUBD. {NAME OR CSM # 7 L 0 N. %-'y H-L~ 1 5T- &Lok.)eZ sl'k~W 3 wbz rp O N CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE MOWN NEAREST ROAD tUL-~iZ Zit l S W 1 54 % 1IL ( 715) 44 Z 3 - 8J 61 isou'rAQW V_*VC t F C_ New Construction Use Residential / Number of bedrooms [ ] Addit't n to eAstin building ] Replacement [ ] Public or commercial describe tiN Irtr o>: at t s had vF 8Z, y , S a Code derived daily flow boo gpd Recommended design loading rate 0..1 bed, gp1/ft2 -'6 trench, gpdAt2 Absorption area required 8S% bed, ft2 two trench, ft2 Ma)dmum design loading rate -7 bed, gpd/ft2 o.6 trench, gpcw Recommended infiltration surface elevation(s) S. o s~ z 3 a ft (as referred to site plan benchmark) Additional design / site considerations s ~oT~ l~ I/vsj-rr-%_eTL aN nhGE 3 Parent material S EL ME14T otJ t?t S ftNjD 4 G R jw tFL Rood plain elevation, if applicable N). A ft S = Suitable for System CONV MOUND Ml GROUND PRESSURE AT-GRADE SYSTEM MI FILL HOLDING TMUCC U = Unsuitable for stem ® S ❑ U ® S 1-1 U ®S ❑ U RIS ❑ U f&S ❑ U ❑ S Nil SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft Boring # Horizon in. Munsell GQU. Sz. Cont. Color Gr. Sz. Sh. Bed ruO )l 0-1 10`~l l2 3l 3 S 1 \ Z `F S"1-' wl T1- a-S Z u'4 c ~ s o - to rAm y' Z q-36 l0`tR 3/6 - St S6K Vn`~►, OS \v~ 0-S O.6 Ground 3 ~~-4~ 7•S L1R Y/4 - Gh 13 v S 9 CS 0.1 O • i elev. C)8-b ft. y Y6-93 W-I R y/ - S c., sg m 1 - o'~ 0•~' Depth to limiting factor 7 013" Remarks: Boring# 1 p_10 ~~~-ttZ 313 si 1 Z.-~s bk niv- cS Zuf c,--S o-b Z x Z ►OZD \o~-1iZ3/6 s1~ Z~sbk cs 1u~ o.s o-6 3 z~o_~L~ 2 Y!6 1-~s o s g W C S o s o, Ground elev. y) _ 10 ) Q,`1 2 V / y - S o St _VA \oo . \ ft. Depth to limiting bctor > Remarks: T Name:-Please Print Arthur L. Weerer Rhone: 715-425-0165 g rer Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022 Signature: L/~~~ n Date: 5 9 CST Nwnber: M00576 PROPERTYOWNER ~~-t~ - SelFU`TZ SOIL DESCRIPTION REPORT Page Z 0,3 PARCEL I.D. # T • Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 0-9 l~~-ttZ 3 !3 Zi 5s k U1 cS ZU,~ r, o,6 Z 9-ZZ ~OyQ '~/6 - S► 3IbK ~n'F►- C..S )uf v,S 13,6 Ground 3 zz-SO lO4R S5 L elev. ft. y 50-95 tom z Y/ - S o S~j wi I - o,7 10 Depth to limiting factor ~9g Remarks: Boring # It-,47- 313 - SL Z`FSbbc h~`r~1- t3 2ui •S o-b Y` Z 9- ZY l U -t R M. S I Z `F S bh a- Ground 3 Zy-c) 1vyR VA - S U S9 M - 0,-7 U.S elev. 9t3-`f ft. Depth to limiting facto „ W. Remarks: Boring # o-$ »`1R 313 Sl Z`f Sbk `NL`~h a-S Zv o S 'o-~ 44 ~i.4 ~,•rJ.~'ti 3 ~:.v:... Z 8- Zo 1-S ~Q 3!y Cpl s o s 9 w1 cS - v-~ i o, 8 h 3-33 tort ti ~/6 S a s9 rvt CS _ u•7 o• 8 Ground elev. V 33 7$ 1 x'-12 ~{/6 - `F S O S9 4v1 1 - o S ' v ; qS. ft. Depth to limiting factor Remarks: Boring # , 0-9 ti~~2 313 S1 ` 2 F'S~k TM 2S 2v o-S o• 3 28- 37 1UYR Y/4 S U S h'1 e S - o•~ u' Ground elev. L/ 3-)-$D tiv yR VAC ,r QZ-Z ft. L Depth to limiting 17 90 Remarks: SBD-8330(8.05/92) PLOT PLAN Page 3 of ' 3' LuT ~-l q `u3• v ~ b S i 1_. L1 tJ en IM-0 at'a 3jtl* 1>1-)O- Z3 g.6 ~ ~ ~ ~ ~ you 8.1 n , 19 6, A 0 SM Z1.. q4.3 3 oha 31v'` Pva Wisconsin Department of Industy, SOIL AND SITE EVALUATION REPORT Page I of 3 ` ',abor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY 'ST•G~IK Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but PARCELLD. # 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. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION 0-M • W-i e-- '1JSU 1 S SC1ct 0 L Z GOVT. LOT ME 1/4 SW 1/4,S /b T .,N,R k9 E (06 PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 7 ID f"3. ST- . 4 01 - 6'-ovf?R S'WPwj 3 1~~D l'(10N CITY, STATE ZIP CODE PHONE NUMBER OCITY [3VILLAGE MOWN NEAREST ROAD Ftui iz 514oi.Z tuts) ELLS _ 8 61 _T`iZo`f 1SW'rh1_NW VftCtFcc New Construction Use ( Residential / Number of bedrooms S/ Add' ' to etas ' .btu I 1 Replacement Public or commercial describe ti►.~ MVA* op Oh 2 0 >u qqEw •oF 8z, y , 5 dl_ Code derived daily flow 6130 gpd Recommended design baling rate o .-1 bed, gpdAt2 0 b trench, gpW gpdjft2 Absorption area required 9S'b bed, ft2 tin trench, 1112 Mapmimh design loading rate o -7 bed, gp(/ft2 0.6 trench, Recommended infiltration surface elevation(s)1211 S. 0 C <3 N, Z, 3 Q `f) It (as referred to site plan benchrn* Additional design / site considerations sEe1 d"M M IivSY#r-%_t.L *W tOksE 3 Parent material S tD )"E"li-jT puL 5f Nib q G R/1v ct. Rood plain elevation, if applicable N • A It S = Suitable for system CONVEN110NAt. MOl1N0 WROUNO PRESSURE AT-GRADE SYSTEM N FLL HMDM TANK u=Unsfatable for ®S ❑ u ®s ❑ u IRS Du RIS 11 u S ED ❑ s ICI u SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Botndary Roots GPD/ft2 in. Munsell QU. Sz. ConL Color Gr. Sz. Sh. Bed mndh 1 O-9 10`123x'3 S1\ Z`F Sb* w0p ' C-S t"vA 0.s o•6 Z 9-3b loyR 3/6 - si I sbk c S lv~ o• S a 6 Ground 3 3~-tlb -).S'-1 R Y& - Gh 3 v S g h~ 0S 0.1 0'$ elev. q8-B ft. y 5[6-93 IDy R y1 _ S U Sa, m 1 - Q , 0~' Depth to limiting factor N 7 q3 Remarks: Boring # o-lo ~o~tQ 313 si z'FSbk wNi4- cS Z~f o.S o•6 Z Z to z~ 1o`IR 3/G SO Z'PsbVc 1lvtGs 3 ZA_41 Non tz 11/4 1-~s o s g N') C S o s o. b Grotmd elev. y7-to 10112 Vjy - S C> S-j •ti,n \o~ -1 ft. Depth b limiting Remarks: FNewine.-Please Print Arthur L. We erer Phone: 715-425-0165 rer Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022 e.L/~~~ ~ Date: CST Number: - ~3_y S-S-93 M00576 PROPERTYOWNER VAli~ - SC1AU`-TL SOIL DESCRIPTION REPORT Page? of 3 PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Qr. Sz. Sh. Bed reach s.i S):,k U1 cS 2,u•~ b. s ~-6 F-2 9-Z Z to ~-f Q I6 - s Z`F3 b1T 1 u f o, s 0.6 Ground 3 zz_SO 1rj4M 4//(, ~`FS o Sg ~ ~ cS - o~S u h elev. ~Q_3ft. y so-98 loy2 Y/ - S o.Sc) m 1 - o•~ 10% g Depth to limiting factor8 Remarks: Boring # 313 - 51 2 `f sbtc Yr7'Fl~ cS 2~'~ u •S l 0- f, y Z 9-Z~ lu`1R M. Ground 3 2,y-96 luyR VA, 0•?~ o,$ elev. °1g•`f ft. i Depth to limiting acttoor6 Remarks: Boring # " :~v ) O-$ l~l`1R 313 1 Sl Z`FS~k `M`~h a-S zui o•S o-L S Z, 8- -S ~tZ 3!y GA-l S C., S - 3 -zU-33 tz ~/6 - S o s9 _ u.7 ; o• 8 Ground M` CS elev. y 33 10 LfIZ YA - ~s o Sy V►1 j - o. S , ~ ; 6 ft. Depth to limiting factor i I Remarks: Boring # ~ o - 9 tio~ 2 313 s t l Z'F S~k ~ 2v~ o•S o• ate, N:< '~1h 43 tw •S`tR 3/ Gr S O 5 Y,'1 S - u.1 d, > Ground 3 _ 37 I O Y B YA S V g yn) e 5 del' l'ev. ft, L/ 3~-~ Lv ye V/41; - `FS O S vn _ d. s o• L Depth to limiting 7C~0" I Remarks: SBD-8330(R.05/92) / a r PLOT PLAN Page 3 of _3 LuT L4 q L4 10 `q3 r ~ b S hnLl N01ftL ~ / yt-1~ sbS TAM S , g.6 / / ~ ~ you 07 0.4 / \ - Cl 4 e-x. t S ham, G ~o~u ~ovtz S r~ Boa / 0 8M g9.33,oN 3iv'pva Z \L w/Lft-M ~°Cbv S B NT l _ov r -2s, ~ Z()►'~ S y s ~T-eti'1 t'rCt to WLZ.I. . c.. Sp 4c . , J~ 0 ~b N $ 14 S' 3-7 310 ~ `ro > ti srn "catk S1*'-Lrh of VS 1 ,_1 m 4 , wx4s'1-rrtL SQ c=T Rilb C (4 'at%-Lm) PrT a qs•.a_'. ~l..l~C~.._._►~'{~'tX1'~'Il~1M .~LZ-~ COVE oUC,m 'T1~YC Dis77Lt@uT7u~ P1l~l'`S. I" WQ: `PMZlIt OF N32, L!, S v& , 11vS1*1.L ~uVQ UxxEftC. r-T. OF S'Wib -T?-ekuC IfeE 3 2y.'l is INT rA-L lc~, uwNs LOP LsU(; F . C y >30") I Tk"L.l.l 1U ~j~~12H) hda Sov~~ 2t6,S~• ~J. Ln~"LgN S 1ZeTc,W y r x r 51'f~ ,~o• 93 -4y s'7V CST Signature Date 5 gne Telephone No, CST #