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HomeMy WebLinkAbout040-1188-70-000 ST C 104 AS BUILT SANITARY SYSTEM REPORT S' V1 OWNER ,~-n c ADDRESS SUBDIVISION / CSM# LOT # fit' SECTION ST. CROIX COUNTY, WISCONSIN P7 540-W-- PLAN VIEW OF SYSTEM SHOW EVERYTHING WITHIN 100 FE T J x w t s ~r r T; ~tr4 INDICAT TH ARROO ~'1 Provide setback and elevation information on rever of _ 101*4 Provide 2 dimensions to center of septic tank m ole 6b'ti'> zowNGOIFF0 l c~-rJ c~► x ^C. ! © 't BENCHMARK : I VA ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: U /ffie Liquid Capacity: le- en) eD Setback from: We11-60 House l Other Pump: Manufacturer Model# Size Float seperation Gallo C Alarm Location SOIL ABSORPTION SYSTEM Width: -T Length Number of trenches Distance & Direction to nearest prop. line: Setback from: well: House-_24,5~- Other ELEVATIONS Building Sewer ST Inlet; ST outlet PC inl o om Q Header/Manifold Bottom of system / Grade Final grade Existing DATE OF INSTALLATION: PLUMBER ON JOB: $ L ~c LICENSE NUMBER: P A~ `4 INSPECTOR: 3/93:jt I - I• 's parti ` rk>rl 1t7y28 . 9W. , VjyE S A8j 5Y54qkA Wood Ri ounty: Safety Human Relations INSPECTION REPORT ' Safety fety and Buildings Division GENERA (ATTACH TO PERMIT) Sanitary Permit No-: GENERAL, INFORMATION Permit Holder's Name: ❑ City ❑ Village 91 Town of: State Plan ID No.: Elev.: Insp. BM Elev.: , BM Description: 13 Parcel Tax No.: TANK INFORMATION ELEVATION DATA A9400041,5 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark MO, L* Dosing-- 1531,1 99 Aeration Bldg. Sewer 3y 7 Holding St/ Inlet Iv7 93 TANK SETBACK INFORMATION St/jpWoutlet 6.6-7 ~ TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic - 2-D(5 NA Dt Bottom Dosing NA Header/Almr- Aeration NA Dist. Pipe 97. 79 Holding Bot. System 3 ~'7~ ~ PUMP/ SIPHON INFORMATION Final Grade .3j1, 97,52 Manufact rer Demand 17 Model Number PM TDH Lift Friction e Ft 1oss L e Forcem8ln Di a. Dist.Towell SOIL ABSORPTION SYSTEM BED/TRENCH width / Length No. Of Trenches PI Of Pits Inside Dia. Liquid Depth DIMEN 1 N oS - d DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING u er: "114 "A - SETBACK CHA_MB INFORMATION _Type O yf t' Model Number: System: t J R UNIT DISTRIBUTION SYSTEM Header / 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 O Depth Over Depth Over xx Depth Of xx See odded xx Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: Troy.36.28.19W., NW, NW, Lot 57, West Wood Ridge Drive 14 ( C C l) / c / aCZ L S k Lam-" i~ ~ ~-4 Plan revision requlred~` es ❑ No Use other side for additional information 1.5 41 1,91 SBD-6710 (R 05/91) Date Inspector's Signature Cert No. ADDITIONAL` COMMENTS AND SKETCH r SANITARY PERMIT NUMBER: i C~70LHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY lye "X STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ U 9 92X 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 40 -S - %4 41%,S 36 T22f ,N,R Pik &Tor W PROPERTY OWNER'S MAILING ADO LOT # BLOCK # C';17,, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER 7i~ 25 =~I m 0 4-1Q f? I d- e_ ,/~e. R yes 11. TYPE OF BUILDING: (Check one CITY NEAREST ROAD f ❑ State Owned VILLAGE : / 40 -C if ❑ Public F 1 or 2 Fam. Dwelling-# of bedrooms ~RCELTAXNUMBER(5)_ III. BUILDING USE: (If building type is public, check all that apply) 1/0 ff p 7~ - eve) 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 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. R New 2. ❑ 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 9 Seepage Trench 220 In-Ground 420 Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION S® 1 Feet 92, a.- Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New lExisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks strutted Septic Tank or Holdin Tank W v--& C 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 ignature: (No Stamps) MP/MPRSW No.: Business Phone Number: 691/ - 3 Plumber's Address (Street, City, State, Zip Code): IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Mary Permit Fee (Includes Groundwater Mate sue Issuing Agent a ure (No mpsj Surcharge Fee) Approved ❑ Owner Given Initial Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-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 (;ate, and at the time of rene-n:}s any new criteria in the Wisconsin Administrative Code will be applicaLle. . 3. All revisions to this permit must be approved by the permit i:,sumg authority. 4. Changes in uwnership or plumber requires a Sanitary Permi i ransfer R ewal Fors BD 6;399) to be sub 'tte.1 to are county prior to installation. 5. Onsite sf w r„?e systems must be properiy maintained. Th tank(3) must be pu;(l rd " 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 aderr nistrator or the State of Wisconsin, Safety & Buildings Division, 608-~6F-3815 To be complete-anO accurate this sanitary permit applicatiorl must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax nr.mber(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 pe, mit is for tank replacement, reconnection, or repair. V. Type of ;ystem. Check appropriate box depending on system t,ipe. VI. Absorntion system information. Provide all information request<=d !r1 i!41-7. Vil '3' u? it*?attic}!'+ Fiir in tr,e capacity of every new and/or exi~-t tank, list the tot:,I y TtJ-:,r oi tanks ein, name. Indicate prefab or site constru•.ted and lank matey i<ci. ur a!i - sept:c, pr r i ;t= n and holding t=anks Eor this system. Check E f,a,=rir?lertal approva c r i' :auks received experimi-11T i --;uduct approval from DILIH'R. Vlli. ResponsioF ity statement. Installing piumb"r is to fill in name, li-,et+se m--her with appropriate prefix (e.g. MP, etc.,, address and phone number. Plumber must sign appl cation, fc m. IX. County/Department Use Only. X. County/De;,-irtrnent Use Only. ilorr ,,,E tnd specifications not srnalier than 81/2 x 11 in ,hr i~ be submitt(?d th, aunty. The Plans r the following: 1) plot plan, drawn to scale or vrh;''; ~o- frieze 'i, e,i: inn of f;nkf ng tir' tank(s) or t °?er treatment tanks; buildinc Jells, watte , -t w service; streams l?kr pomp or sipho., links: distribution boxes, ~ l ~u~°ikit i1 sy4tF µl,, .t c~~t system area., ai! ou oc ,fon of the bu lgy° ng served; B) horizontal ra=re' H:,~fficai ?leva'ior f:` c C) complete specifications for pumps and controls; dose volum.; elevation differences; fricti.n loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil-absorption system if required by.tfiiecounty; E) soil test data on a 115 form; and F) all sizing informa~ori, - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - GROUNDWATER-SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees] fc,r v num' :=r of regulated prat"ices whi, h c:a. effe--t gruundwalor The, nlorr',es cpUected thro:,g+ he•. e surcha S urlvvda!E r water contamination inves0gativns and establishment ;f'stantjattis SBD-6398 (R.11/88) • PLOT PLA N Lot 57 Scaic C -3o' or 7 LVest_ w and t L'A e- Wel l , v B ® 8y 2 % slope te® ,eIcc. Po l e J~1, /V-J in F_lec, Ale Fle✓, loot, f~LoT L,~ n L o T',5-7 I i II s 7` Cc r© l't g oT 96 ~o T S 7 C~ ~ LL b,,~ eLL' LD ~ 4J~ -e L~ C'S 1=~o vs e- ~Cf -i ~~Dm cot tiieo©~,~ Al- ® D ~1~'dq~y o C l( A is G,cI~A - 6 lh ~ PoL~ N 4L PO LO t PACE OF r U S S e c ` I t) r1 G _TA e n >r A Freeh Air Inlels And Obeervollon Pipe Cr Approved Venl Cap Minimum 12" Above Final Grads Cost Iron Plpe 4" Vent Pipe 20- j To e Marsh May Of Syrlnq wiaU OvOlstrlbullon Tee pipe '0 0 6" 0 Perloraled Pipe Below Be'-Coupling Terminating At o Bottom Of System - 4 t~ 1 SOIL FILL D13TRIMJTIO1.1 PIPE APPROVED SyNTMETIC COVER" -I MATER14 OR q" OF STRAW J OR MARSH NA`J 2" OF AGGR EGAIE j\ ELEV. O` REEj_ R,,/ G` /r1 A li Ts Zx:'LOW O,R1c"WL GtR. pAc OISTFIgl;71JIJ P1.17E TG. AF. AT LERS7 ,r`IIU . j 1. A ~l 2 !)N i L,L O W EII W KyL Aq A Q., L .E A ST l0 1 KX I{ E W Ig,U.T AI O I^O~ E 7N . , WILL BE IIJC S M)Na. 1~'? PEF" 01= EACOOT10N FK011.\ c1?\I(1I,0fkL WILL aE s I r SIGNED: LIGEtiISC 1 .r r 1 f (26 Me A~ E. Cy 7 FetidEZ, A q W r ri.r C3 y6 , CKN 104,ql 4. 41 • . 17'~.. 'pA,cK o~'~r« ~ w ~ ~ R RfA. to'- 6Q ` ra.c SralF ~ ~ to i RI VEWA q fA,aKf•al y. rry !L %A 7 SO' E-- 00 Viiisonsin SOIL AND SITE EVALUATION REPORT Page of bor and Human Relations - Division of Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must include, but St Croix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. a dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATi PROPERTY OWNER: PROPERTY LOCATION Richard Fox GOVT. LOT 114 114,S 36 T 28 N.R 19 FYI PROPERTY OWNER':S MAILING ADDRESS LOT rr BLOCK # SURD. NAME OR CSM rr ~ 84 Woodridge Drive 57 1 Oak Ride Acres CITY, STATE ZIP CODE PHONE NUMBER QCITY (]VILLAGE [TOWN NEAREST ROAD _ River Falls, WI 54022 (715)425-2100 [xJ New Construction Use (x ] Residential I Number of bedrooms 3 [ J Addition to existing building (J Replacement [ ) Public or commercial describe Code derived daily flow 4r;n gpd Recommended design loading rate - 7 bed, gpd/ft2 .8 trench, gpdilt2 Absorption area required 643 bed, ft2 563 trench, h2 Maximum design loading rate __7 led, gpd/h2__-8-_uench, gpd/h' Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations _ Parent material Flood plain elevation, it applicable It S = Suitable (of system CONVENTIONAL tdouND W-GROUND PRESSURE AT-GRADE SYSTEM IN FrL HOLDLYG TAIL, U = Unsuitable fors stem 0) ❑ u ®S ❑ u ®S ❑ u :a! ❑ u ❑ S ®u O S ® u SOIL DESCRIPTION REPORT Depth Dominant Color Motlles Structure GPD!ft- Boring # Horizon Texture Consistence BoLrc4 Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed I I.rt., a, 1 0-17 10YR 2/1 None sit 2 m sbk HM as 2 f --S 1_6 1 w° 2 17-39 10YR 4/4 None sil 1 m sbk r as lvf .4 .5 _ Ground 3 139-52110YR 6/4 None 1 fs 1 f sbk mvfi as - 2 I .3 elev. - r . 97-.2.. it. 4 1;2-108110YR 6/4 None med s 0 m s mvfr ' .7 .8 Depth to limiting factor Remarks: Boring # 1 0-24 10YR 2/1 22 4-36 10YR 4/4 None sil 1 m sbk mfr as 1 f 5 t;::,........... Ground 3 6-54 10YR 6/4 None elev. 97.2 4 4-107 10 .7 .8 It. Depth to limiting factor _ Remarks: _ CST Namu -Pluasu Print Pnona: Paul C.J. Steiner (715) 425-5544 dress. - - - -N8230 Hi4way 65 South; River Falls, WI 54022 rk -7 PHOPEMOWNER _ Richard Fox SOIL DESCRIPTION REPORT Pa .PARCEL I.D. it Boring # [Horizon Depth Dominant Color Mottles Texture Structure Consistence jBour~ary Roots in. Munsell Cu. Sz. Cont. Color Gr. Sz. Sn. ~Gll eo ;7lLt `.h. 3..~...,.`' 1 0-22 10 2 1 fx _ 2 2_45 10 4 f? m as I . LL_ - 1 of 5 ! . 6 Ground ___3_45-63 10YR 6/4 None s,cir 0 m s mvfr as _ elev. .7 1.8 elev. 97.321t. 4 3-108 10YR 6/4 None med s 0 m sg mvfr .7 , g Depth to liniiting factor Remarks: Boring # k°>ar€z:< 1 0-24 10YR 2/1 None sil 2 m sbk mfr as 2 f _.5 .6 µry:4A 2 24-43 10YR 4/4 None sil 2 m sbk mfr as 1vf .5 - .6 Ground 3 43-61 10YR 6/4 None mud s ' 0 m s mvfr as .7 '.8 elev. 4 1-106 10YR 6/4 None 97.6 fl med s 0 m sg mvfr .7 , g Depth to GmiGng - - factor Remarks: Boring # 1 0-36 10YR 2/1 None sit 2 m sbk mfr as 2 f .5 ..6 2 36-60 10YR 4 4 None sil 2 m sbk mfr as 1vf .5 .6 _ Ground 3 60-72 10YR 6/4 None s,gri 0 m sg mvfr as .7 .8 elev. 4 2-108 10YR 6/4 None med s 9 0 m sg mvfr - .7 , g I..32f1 - Depth to tirruting _ (actor Remarks: Boring # Ground elrw. - - It. I Depth to - = i- tirt factor _ - i Remarks' - - SEW to SEPTIC TANK MAINTENANCE AGREEPIENT St. Croix County a r' OWNER/ BUYER ROUTE/BOX NUMBER '-,Fire Numbs ZIP ~ CITY/STATE PERTY LOCATION, /=Ok, Section Z T No R~-W, 3' PRO Town of r _ St. Croix County. Lot number_j~- Subdivision e)AY _ 't- Im roper use and maintenance of your septicsyystemai~~ ld res It in con- its premature failure to handle wastes.,-Po pp sists of pumping out the septic tank every thWhatyearspor sooner, if needed, by a licens'ed' 'se t'ic tank um er. u into you the system can a eat t e7 unc on o, the septic tank as a treat- ment-stage in the waste disposal system. . St. Croix ;County residents'maa'be eligibltofrecfailinggrantefor a maximum `of 60% of the cost.of replacement 1978 St.. Croix County ' wh c was in operation prior to-July l accepted this program in August to keep thewith the ir systemgproperly that owners of all new_ s s~e~ agree p maintained. owner agrees to submit to St.. Croix mCoounty Zonisr a pZonin , p' The property h~ certification form, ;signed by the owner and by pumper veri- systempumispin proper journeyman plumber,°resiecWastewaterrdisposallicensed fying + that (1) the on s operating condition and (2)•after inspection and pumping (if sec- the se p is less than 1/3 full ofdglsdgri rdtoc~' essary) p approximately 30 Y p Certifi ertification form will be sent three year expiration. 0 I/WE, the undersigned have read the above requirements and agree h.. - w to maintain the private sewage dispose system in WisconsinaDepartt the standards set forth, herein, as s by ment of Natural Resources. Certification form must be completed ti Croix County Zoning Office w thin 30 days and returned to the 5t. of the three year expiration.da SIGNE " . DATE 3L I9`f St. Croix `County Zoning Office 911 .4th, St, Hudson, WI 54016 386-4,680 ;w. Sign,. date and return to the above address. r • S i C ~ 100 This application form is to be completed in full rind signed b~ the owncr(s-). of the property being developed. Any inadequacies- will only result in 'delfts of the Y 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. rr--wrr w: owner rrrrrr of propertyo S is Location of property W~1/4 ltla)l Section-'3 T ]:'H W .Township !Mailing address Address of site/f. Subdivision name/~C Lot no. other homes on property? yes__2S_-__H0 Previous owner. of property /L-04L Total size,of parcel Date parcel was created ' Are all corners and lot lines identifiable? yes` No in thin proporty.buing developed for (epee house)? Yes No Volume and Page Number q4~3 as recorded. with the Register Y:. of Deeds. , rrrw-Y ~+.ww ~--------------------r---rrr------rrr-rrrr-rrrrrrr.Yrrrrrrr~ 114CLUDE WITH THIS APPLICATION THE FOLLOWING: A WARIUUITY DEED which includes a DOCUMENT NURDER, VOLUHE AND PAGE 21U2lLtSaR A. T1 sBAL OF THE IU;GIST&lk 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 nt referencon-to a coeti tied 'survey map# the certified`survey'Hap shall also be required. PROPERTY OWNER CERTIFICATION I(wc) 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 b virtue of warranty' deed recorded in the office of the county y Register of Deeds hso Document 116. and that I we) own the proposed site for the sewage disposal system "or,: Ie,(.We) obtained, ran; easement, .,to run the above described-property,-foe tile construction of. said system,, and the. same" "hael bean`` duly recorded "icn `tile office""of county Register of deeds` as No., c 3 Document Lure of-..;appl cant Co-applicant pate. of S nature bate of Signature DOCUMENT NO. TATE BAR OF WISCONSIN FORM 2-1"2 THIS SPACE RESERVED FOR RECORDING DATA WARRANTY DEED 495993 VOL 999PAGE 46e~ 3 i _ REGISTER sRolling Hills Devp~ment, In'c a ST. am (~Q, VA Wi cousin cornorAri,,,, Ree'dforReW x. MAR 111993 ; conveys and warrants to Ross g k o iates of at I:IS `Nu Raver Falls! Wiscor~jlin Ltd. t~istlsrdOMtle t' RETURN TO the following described real estate in $ t. Croix County, I State of Wisconsin: Lots Fift?} Seven (57) and Fifty Eight (58), rax'rcelNo: Oak Ridge Acres to the Town of Troy. t ~'5 i ' tl:~~,NSFEIx S 1 l 1 This_ is nOt homestead property. Ps) (is not) Exception to Warranties: ! easements, restrictions, and rights-of-way of record, if any. Dated this a7 t"! day of Jan r (SEAL) 44 •Richard N. Fox, President SEAL) (SEAL) • S*7'f DQ/+ S A-/; c • Frances J. Fox, Secretary AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATEOFwtBG'e"eiPf FLORI A ss. authentltAted this County. day of Personally came belora ms this Janttarv day of 192_ the above named Richard N Fox and Frances J Fox TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 708.06, Wis. Stals.► to me known to be the persons who executed the THIS INSTRUMENT WAS GRAFTED Br f egoing instrument and acknowledge the same. Lauri J., Gaylord, Attorney River Falls, WI 54022 (Signature' may be authenticated Notary Public ounty, Wis. are not necessary.) acknowledged. Both My Commissi n is per f not, fa "MkaftL, date: f My Corr? misslo xpirelt Names of persons si9nm9 m any capacity should 49 typed ol,:pnnted below their s,Qnaturq • WARRANTYDEED •hp,q••~ C m' STATE MAN OF WISCONSIN Neleo lax F Fo rm No 2 - 1982 ortns P.O. Box 10209, Groan Say, VA "W"" Parcel 040-1188-70-000 03/01/2005 05:01 PM PAGE 1OF1 Alt. Parcel 36.28.19.810 040 - TOWN OF TROY Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): Current Owner HANSEN, KEITH O & JULIE R KEITH O & JULIE R HANSEN 65 W WOODRIDGE DR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 65 W WOODRIDG DR SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY OSS Legal Description: Acres: 0.000 Plat: 2237-OAK RIDGE ACRES SEC 36 T28N R19W LOT 57 OAK RIDGE ACRES Block/Condo Bldg: LOT 57 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 36-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 08/17/1999 608706 1449/473 WD 08/25/1998 585728 1351/165 WD 07/23/1997 1076/292 WD 07/23/1997 996/463 WD 2004 SUMMARY Bill Fair Market Value: Assessed with: 27602 194,700 Valuations: Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 35,000 160,100 195,100 NO Totals for 2004: General Property 0.000 35,000 160,100 195,100 Woodland 0.000 0 0 Totals for 2003: General Property 0.000 25,300 148,000 173,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 515 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 _ L 00, •'TYisconsin Oepartment of Industry, SOIL AND SITE EVALUATION REPORT Page _ of ' Lzor 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 inches in size. Plan must include, but St Croix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. Ir dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Richard Fox GOVT. LOT 114 114,S 3 6 T 2,9 ,N,R 19 kmw PROPERTY OWNERS MAILING ADDRESS LOT it BLOCK s SURD. NAME OR CSM o 84 Woodridge Drive r; -7 1 Oak Ride Acres CITY, STATE ZIP CODE PHONE NUMBER OCITY (]VILLAGE (]TOWN NEAREST ROAD River Falls, WI 54022 (715)425-2100 (xj New Construction Use (xI Residential I Number of bedrooms 3 (J Addition to existing building j J Replacement ( ] Public or commercial describe Code derived daily flow 45n gpd Recommended design loading rate • 7 bed, gpdift2 •8 trench, gpd/O Absorption area required 643 bed, h2 563 wench, h2 Maximum design loading rate '7 bed. gpolh2~g_trench, gpd/ft= Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOL144 IAI A u= Unsuitable fors stem ®S O U Es O U ®S O u :as O u 0S ®u IDS IR U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure G~u`ft` Boring # Horizon in. Munsell Du. Sz. Cont Color Texture Gr. Sz. Sh. Consistence Bourmy Roots Bad i IrE+a, 1 0-17 10YR 2/1 None sil 2 m sbk ._6 1 2 17-39 10YR 4/4 None sil 1 m sbk m fr as 1vf 4 .5. Ground 3 39-52 10YR 6/4 None Ifs 1 f sbk a - 2 .3_.. elav. a,, r 92-Z ft. 4 152-108 10YR 6/4 None med s 0 m s 4~ r ' - rt=? . 7 _8 Di;pth to limiting {M factor ti 0l Remarks: 9 F~cF Boring # op, 1 0-24 10YR 2/1 _ None 2_.>. 2 4-36 10YR 4/4 None sil 1 m sbk mfr as Ground 3 6-54 10YR 6/4 None 1-2 .3. elev. 4 54-107 1 .7 .8 97.2 It. -I-- Depth to - limiting factor Remarks: CST Namd:-Plaasu Print Paul C.J. Steiner Pnona. (715) 425-5544 :+kirass: N8230 Ukjh~w 65 South; River Falls WI 54022 _ °ignatuw: Data: CST Nwmt.or-.__. G 2/15/93 3074 __1+, PROPERTY OWNER Richard Fox SOIL DESCRIPTION REPORT Page PARCEL I.D. i Boring# Horizon Depth Dominant Color Mottles Texture Structure ConsistenceBoixtry Roots GNU;I;'_ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bea ;'In, y1 W 1 0-22 1 2 1 -as 3 2 2-45 1 1vf 5 !,6 _ Ground 5-63 10 6/4 None ffed s 0 m s mvfr as .7 1.8 elev. - 97.321t. 4 3-108 10YR 6/4 None med s 0 m sg mvfr .7 .8 Dapth to limiting laclor Remarks: Boring # 1 0-24 10YR 2/1 None sil 2 m sbk mfr as 2 f .5 .6 <; ..4...>< 2 24-43 10YR 4/4 None sil 2 m sbk mfr as 1vf .5 .6 Ground 3 43-61 10YR 6/4 None mad s ' 0 m s mvfr as .7 .8 elev. 4 1-106 10YR 6/4 None med s 0 m sg mvfr .7 .8 97.6 It. Depth to - - IiO~iUng factor Remarks: Boring # 1 0-36 10YR 2/1 None sil 2 m sbk m fr as 2 f .5 .6 2 36-60 10YR 4/4 None sil 2 m sbk mfr as 1vf .5 -.6 Ground 3 60-72 10YR 6/4 None rred s,gr 0 m sg mvfr as .7 .8 elev. 4 2-108 10YR 6/4 None med s 0 m sg mvfr .7 .8 98-UIL Depth to - Grru6ng factor _ Remarks: Boring # Ground elev. it. Depth t0 i~--- linuling factor Remarks: SOD-8330(R.M92) PLO T PLA N Lot 57 Scab. I" • of 7 We-it v B ® By _ ~ ~ q sloe ® Q, j Q ~s X35 rlec'. Po I e IV-, I I'm Elec Ale 'Clod. 100.0' c _ ~r 307,Y