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HomeMy WebLinkAbout004-1030-40-000 -0 ao 3: C; O o O r. Cl) M O C. c m c N O co N co L a r 3 r N E-0 ~R rnN 0 Co N Co L O 0 co co CM -0 r- 0 N -p Co N N O N .0. N N C O a ~ a O C) p O O p 0 7 ~ Z c a Z LL f: . E 3 CD O LL c N ui o a.a o a>. N N =O - O U .O CC O Q ~ co a+L L C Q N 3 c° 3 c° > Z Z N r? „ E E O O z d d ` Mc'j rW a m a m i O C z N H a) Z c E c N N O N ch (1) co - CD (D O a O CL N N N • ~ ' N N ~ C ~l a v L g ~ c O~ C O m O O Q O Q w Z I- Z Z I- Z a Z i N 0 C O N co a, 10 m N n m m D 04 co a1 o N y d p n y d 4) `u c o o °o r0 LO G O a CD N c a a .O N N N w O U) fn fn ? O) O (n N fA U O O O O O 0 0 0 Z o o • y a a a a a CL a 0 r g N p (1) M co 7 N J U 9 rn Z 3: rn rn Z ce) - - cl rn M Ariry N 04 M O L ry N CD rn m M Q Z m .o a Q Z o .2 (f) co 04 0) © O C N c co to) rrllrl O N C IV O O 'a) N O O E O' O O co U C U O N T O 6) O Y© O c p 0 c m 0 Q) U) c C _C a a . - M N ' Cpl..; f N M N w v) -t: O N 7 N N 06 N O W Z N f9 ~7 L 'O -O Q) .e"' p 0 O U~ c N C14 c • r. p co M O y p O L 0 0) O p N E N m L O ya O U W O 2 H Z H O N U) v V~ L I E `m E a`r I 0) IL ~,a 3 • CL d l an d y rr~~V £ i C C w 3 C O `~1 A C.) (L ( L) 0 in c) ST. CROIX COUNTY l UJ WISCONSIN ZONING OFFICE M n r ■ ST. CROIX COUNTY GOVERNMENT CENTER _ 1101 Carmichael Road ~ - Hudson, WI 54016-7710 - (715) 386-4680 March 7, 1994 Dale Hudson 820 Main Street Baldwin, WI 54002 Dear Dale: I still need an AS BUILT for the Harvey Thomas system, Town of Cady. Please turn it in as soon as possible. Thanks! Sincerely, Mary T.Jenkins s Assistant Zoning Administrator I LOCATION: CAD . 3 y28.15.206 PRIVATE SEWAGE SYSTEM County: Wisconsin a artm AD In ustr , Labor and Human Relations INSPECTION REPORT Safety and Buildings Division . (ATTACH TO PERMIT) Sanitary rflit GENERAL INFORMATION Permit Holder's Name: ❑ City ❑ Village IR Town of: State PI HOMAS HARVEY ICADY CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 004-1030 A-800 TANK INFORMATION ELEVATION DATA A9300346 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Aeration Bldg. Sewer Holding St/ Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet Vent irito ntake ROAD Dt Inlet TANK TO P/ L WELL BLDG. A Ar 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 Syesatem TDH Ft oss 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 DIMENSIONS DIMENSIONS SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK 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: CADY 13.28.15.206 { n k Plan revision required? Yes ❑ No Use other side for additional information. ll a 3 ~3 SBD-6710 (R 05/91) Date . t Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: w s i : : FL R7%HE SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05, Wis. Adm. Code STATES T/~tRMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 144 68 x 11 inches in size. ❑ CftbC if r vo revi V.,pplication -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 a,- ✓e ~ "mss 5~ 1/4 S'/t~'/4, S /3 T N, R 9 (or W PROPERTY OWNER'S MAILING ADDRESS LOT # / BLOCK # 4,is'~.3v F_ ✓ CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER v~cx L c~ 5=~' 7~'9 7/5 77Z-3Zg 0 CITY NEAREST ROAD 11. TYPE OF BUILDING: (Check one) ❑ State Owned VILLLAGE ❑ Public [N 1 or 2 Fam. Dwelling--# of bedrooms / PARCEL X NUMB R ) III. BUILDING USE: (If building type is public, check all that apply) 3D -4eo 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. ~ New 2. ❑ Replacement 3. ❑ Replacement of 4.E1 Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System Z2' > / ?3 Date Issued 9-/s - B) ~ A Sanitary Permit was previously issued. Permit # V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ SpecityType 41 ❑ Holding Tank 12 ® Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) 172,Z-' ELEVATION e e t Feet VII. TANK CAPACITY Prefab. Site Fiber- Exper. in allons Total # of Manufacturer's Name Concrete Con- Steel glass Plastic pp• INFORMATION New istin Gallons Tanks strutted Tanks Tanks Septic Tank or Holdin Tank Lift Pump Tank/Si hon Chamber Vill. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Number: Plumber's Name (Print): Plumber's Signature: (No Stamps) MP/MPRSW No.: =(7/5' a le, L . /yi.1C~, r- «I`~ ~y-33r78 er's Address (Street, City, State, Zip Code): Plumb IX. COUNTY/DEPARTMENT USE ONLY Issuin A nt Si o S ps) Disapproved 7;;~ Fee (inclu es roue Water e ssue 9 9 9n Surcharge Approved ❑ Owner Given Initial c Advers De rmination 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. r 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. 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 8'f 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) onsinDepartmentof Industry, SOIL AND SITE EVALUATION REPORT Page of 1 and Human Re+ations m 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 St. Croix 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 Harvey Thomas GOVT. LOT SE 114 SW 1/4,S 13 T 28 N.R 15 RN H PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUED. NAME OR CSM # RR 1 CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE MOWN NEAREST ROAD Knapp, WI 54749 (715) 772-3283 Cady 325th St. jx] New Construction Use J Residential 1 Number of bedrooms 6 [ [ Addition to existing building j J Replacement [ ] Public or commercial describe Code derived daily flow 900 gpd Recommended design loading rate .5 bed, gpd/ft2 •6 trench, gpd/ft2 Absorption area required 1 eoo bed, ft2 1500 trench, ft2 Maximum design loading rate .5 bed, gpd/ft2 .6 trench, gpd/ft2 Recommended infiltration surface elevation(s) 92.6 & 91.6 ft (as referred to site plan benchmark) Additional design/ site considerations install 2 - 5' x 150' center-fed trenches 3.5' below 95.1 & 96.1 as contour CL's Parent material till over SS Flood plain elevation, if applicable NA It rS = Suitable for system CONVENTIONAL MOUND N•GROUND PRESSURE AT•GRADE SYSTEM IN FILL HOLDING TAN = Unsuitable fors stem ®S ❑ U ®S ❑ U ®S ❑ U ® S ❑ U ❑ S ®U ❑ S 93U Conventional via monitoring 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 Tre ;g 1 0-7 10YR 3/2 - sil 2 m cr mvfr as if/m .5 t 2 7-26 10YR 5/3 - sil 2 m.sbk mvfr cs 1f/m .5 .E Ground 3 26-35 2.5Y 5/4 f2d 7.5YR 5/6 sl 3 m sbk mfr as if .5 .E elev. 95 .L ft 4 35-41 2.5Y 6/4 - is 1 m sbk mvfr cs - .7 -E Depth to 5 41-49 2.5Y 7/4 f2d 7.5YR 4/4 fs 0 sg ml cs - .7 E limiting W/ stratified 1/211 1nYR 4/4 Is hand 0 41 factor 6 49-57 10YR 4/4 - lfs 1 c abk mvfr cs - .7 E .ted I, ';QM'j,'jh2t in nip > 907 57-90 2.5Y 7/2 - I's 0 sg ml - - .7 F w/ occasional stratified 10YR 616 lfs bands w/ associated inclusions & w/ irreg & discontinuous 10YR 4i Remarks: :76-79 _ ills bands-6 Boring # 1 0-6 10YR 3/2 - sil 3 m cr mvfr cs 2f/m .5 E. 2 t4 2 6-24 10YR 5/4 - sl 3 m sbk mfr aw if/m .5 E 3 24-41 2.5Y 6/4 f1d 7.5YR 4/4 is 0 sg ml as - .7 .8 e@Ground 95v, ft 4 41-42 10YR 4/4 - is 1 c abk mfr as - .7 .8 5 42-98 2.5Y 7/2 f3p 2.5Y 616 I's 0 sg ml - - .7 .8 Depth t0 w/ it egular 10YR 4/4 lfs bands @ 54-57, 66-67, 73-77, & 83-8 limiting factor ,qaI 177t t le band @ 54-57 s somewhat resists t to pen tration; of er bands & s are t Remarks: weathered SS, poorly sorted, w/ some textural discontinuities indicate lower loading than .7/.8 CST Name:-Please Print Phone: Henry F. Grote ;15-k65-2681 Address: PO Box 57, Knapp, WI 54749-0057 Signature: Date: /10/93 CST Number: 3065 PROPERTY OWNER Harvey Thomas SOIL DESCRIPTION REPORT • PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GP in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed yc4.....31 0-10 10YR 3/2 - sil 3 m cr mvfr cs 2f/m .5 v 2 10-25 10YR 4/3 f1d 10YR 612 sl 2 m sbk mvfr cs if .5 Ground 3 25-45 10YR 4/4 one2p10YR 5/3 sl 3 m sbk mfr' as - .5 elev. 4 45-48 2.5Y 7/2 f2d 7.5YR 4/4 fs 0 sg ml. cw - .7 93.3 ft. Depth to 5 48-72 10YR 6/6,5/8 - scl 0 m - cs - NP limiting dense & resistant to penetration gene ally w/ occasional i lusions 5 5/6 cl & 2.5 8/1 d1 factor 48" 6 72-90 2.5Y 616 - fs 0 sg ml ,7 Remarks: Boring # 1 0-4 10YR 3/2 - sl 2 m cr mvfr as 2f/m .5 4 .2 4-19 10YR 4/3 - sl 2 m sbk mvfr cs 2m .5 Ground 3 19-42 10YR 4/4 - sl 3 m sbk mfr aw if .5 elev. 4 42-85 2.5Y 7/2 f1f 2.5Y 616 fs 0 sg ml - - .7 97.5 ft. w/ 1 YR 4/4 Ifs bans 0 63-67 (this bad has f1 7.5YR 4/2 7.5YR 5/8 ots), & 72-73 Depth to & w occasions s r ie 1 8-1 4' it egu ar 4 4 s s limiting factor Remarks: Boring # Not : for its 1, 2, and the limiting factor is judged to be th depth of t e pit based o gro d water monito ing; the massive s el band i pit B-3 is limiting actor a d -this area, should be avoided If s stem elevation is 3.5' below grade the sy tem bott will gene ally be in s or fs with nomida Ground elev. load ng rat of 0.8 for a t ench system; duet the poor sorting an the variou5 textural changes ft. encountered, CST suggests a trench loading rat of 0.6 per the well -structured 1 which may b Depth to res nt in aces alon the trench limiting factor Remarks: Boring # Note: T tie alternate site for this installation is scribed on 15's by Be Helges n and p rmited as a mo d under St. Croix ounty permit No. 149 83 issued /13/91 Ground elev. ft. Depth to limiting factor i Ll i i I L Remarks: SBD-8330(R.05/92) • 1.• X, let 1~ K V, V OL 1 ~ o ~ t L a. -t qs•3 qT.~ 3 z~ CfA il~~tAaw ~ r~ 9b,1 c{L.l~ UO `l 1. 11.6 S l vA 4 0' CIT,j n M y cX. ems, p abi L M w o d~• v((~t~dla • o w wow(: +vta v.t`~1 l l T 3 u u"~ TIAQ S93 - 03 9 3 X' IV A ~ C n 0 L v - 1 -4 7b ~ t 1 1 0 s n 0 1 1 a 0 z 0 a Department o nduatry, MOP~ITORING" P.O. Box 7969 Labor and Human Relations Madison, Wisconsin 53707 Bureau of Plumbing 1992 REPORT te: ho, a the In inches. Location: Lot No•B oc No DEPTH F OM SURFACE TO WATER/ SE 1j SW 4S 13 /T 28 N/R15kSt»?W NA N OBSERVATION WELL WELL WELL WELL DATE 2 3 1 Township Munic pa ty: Cad 3/14/92 Dr Dr D County: rner's Name: 3/20 _ St. Croix Harvey Thomas Ebenezer oaks, I c- Mailing Address: 3/27 RR 1, Knapp, WI 54749 WELL 4/4 NUMBER : 1 2 3 4/11 - WELL DEPTH : 74" 47" 76" 4/ 17 0 PROPOSED INDIVIDUAL 4/21 O LOT SUBDIVISION Rainfall Data Obtained From: 4/25 Spring Valley, Cedar Falls, Menomonie 5/2 MONTHLY DATA Spring Sept Oct Nov Dec Jan Feb Total(8.5 5/9 5.51 0.98 6.37 0.85 0.57 0.54 14.82 5/15 - - Valley March April May Total (Need 7.6") Average: 2.12 4.07 1.90 8.09 5/22 Provide daily rainfall data on a separate ghost for March. April and May. 5/30 write total rainfall for March. April and May in the above boxes. ARTIFICIAL DRAIMAGS such . Check the site for artificial drainage. If the site is affected by drainage. submit complete details for the drainage system. Indiciate Who will be responsible for maintenance of the drainage system. CH= ON11 ® No artificial drainage O Information regarding artificial drainag affecting this sits. affecting this site is attached. Attach a SBD-6795(115) or SBD-6309 (if a proposed subdivision), for soil V Information and estimated depth to high groundwater using mottlleg. Subai 2 copies of the Groundwater Monitoring Report to the bureau of Plumbing. P.O. Box 7969. Madison, wi 57707 and submit 1 copy to the local authority. TNnTVTDUAI, LOT PLAN-Provide a diagram.showing accurate locations and surface elevations of e monitoring wells. SUBDIVISION-Attach a scaled map showing well locations and relative elevations (1 in. - 100 feet referred). ee att ch p of la - - of : lot pl n s gg sts sys em elm ati ns abo t 3.5' below ont urs H d). - yst m lev ti ns to b a least ' ov th d th o th Mw s ac ord n t Ch. ys. em. ith sy tem elevations 3' e1 w Me contours urs is su es a - ,1_ it sy tom el vat on 9 .1 6.1 wi h s st m e eva io ® 3.1 L er tre ch Con QW FF oil S rim i ma nor an Ar and 'u to e 10 I I, the undersigned, hereby certify that the data recorded and locati, 3 3 9 3 1 of tests reported on this form are correct to the best of my knowled. and belief. Date: CST o: Signature: DILHR SBD-6412(N.05/81) 10/18/93 306 .wy.r..a.r...rr J V-0 \t IL kL Data from Midwest Climate Center: Station: (475335) Menomonie c,ctL s yyyymmdd prcp Z/ g z w • Y 4r (in) 19920301 0.00 19920418 0.00 19920302 0.00 19920419 0.44 19920303 0.00 19920420 0.92 19920304 0.00 19920421 0.98 19920305 0.10 19920422 0.23 19920306 0.11 19920423 0.00 19920307 0.02 19920424 0.00 19920308 0.00 19920425 0.00 19920309 0.72 19920426 0.00 19920310 0.00 19920427 0.00 19920311 0.00 19920428 0.00 19920312 0.00 19920429 0.00 19920313 0.00 19920430 Q-00 3'~ 3 19920314 0.02 19920501 0.00 19920315 0.00 19920502 0.00 19920316 0.00 19920503 0.00 19920317 0.00 19920504 0.00 19920318 0.00 19920505 0.00 19920319 0.00 19920506 0.00 19920320 0.00 19920507 0.00 19920321 0.22 19920508 0.00 19920322 0.01 19920509 0.00 19920323 0.00 19920510 0•.00 19920324 0.00 19920511 0.00 19920325 0.01 19920512 0.26 19920326 0.00 19920513 0.00 19920327 0.00 19920514 0.00 19920328 0.00 19920515 0.07 19920329 0.31 19920516 0.70 19920330 0.00 19920517 0.11 19920331 Qj o,~ 19920518 0.00 19920401 0.00 19920519 0.00 19920402 0.00 19920520 0.00 19920403 0.00 19920521 0.00 19920404 0.00 19920522 0.51 19920405 0.00 19920523 0.23 19920406 0.00 19920524 0.00 19920407 0.00 19920525 0.00 19920408 0.00 19920526 0.06 19920409 0.00 19920527 0.00 19920410 0.52 19920528 0.00 19920411 0.02 19920529 0.00 19920412 0.00 19920530 0.00 19920413 0.00 19920531 0.00 19920414 0.00 19920601 0.00 19920415 0.41 19920416 0.21 Tot/Avg 7.19 19920417 0.00 e - estimated m - missing S93-03931 Data from Midwest Climate Center: 19► Station: (471308) Cedar-Falls Hydro yyyymmdd prcp i q i o 1 (in) 19920301 0.00 19920418 0.00 19920302 0.00 19920419 0.15 19920303 0.00 19920420 0.88 19920304 0.00 19920421 2.10 19920305 0.00 19920422 0.25 19920306 0.32 19920423 0.00 19920307 0.00 19920424 0.00 19920308 0.00 19920425 0.00 19920309 0.90 19920426 0.00 19920310 0.18 19920427 0.00 19920311 0.00 19920428 0.00 19920312 0.00 19920429 0.00 19920313 0.00 19920430 0.00 19920314 0.00 19920501 0.00 19920315 0.00 19920502 0.00 19920316 0.00 19920503 0.00 19920317 0.00 19920504 0.00 19920318 0.00 19920505 0.00 19920319 0.00 19920506 0.00 19920320 0.00 19920507 0.00 19920321 0.20 19920508 0.00 19920322 0.43 19920509 0.00 19920323 0.00 19920510 0'.00 19920324 0.00 19920511 0.00 19920325 0.20 19920512 0.33 19920326 0.00 19920513 0.00 19920327 0.00 19920514 0.00 19920328 0.00 19920515 0.00 19920329 0.34 19920516 0.31 19920330 0.00 Z } 19920517 0.64 19920331 0.00 19920518 0.00 19920401 0.00 19920519 0.00 19920402 0.00 19920520 0.00 19920403 0.00 19920521 0.00 19920404 0.00 19920522 0.43 19920405 0.00 19920523 0.43 19920406 0.00 19920524 0.00 19920407 0.00 19920525 0.00 19920408 0.00 19920526 0.00 19920409 0.00 19920527 0.00 19920410 0.20 19920528 0.00 19920411 0.60 19920529 0.00 19920412 0.00 19920530 0.00 19920413 0.00 19920531 0.00 19920414 0.35 19920601 0.00`_ 19920415 0.62 19920416 0.00 Tot/Avg 9.86 19920417 0.00 e - estimated m - missing S93-03931 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDING` INDUSTRY, _ DIVISIOr AND PERCOLATION TESTS (115) P.O. BOX 7961 HU*AN RELATIONS MADISON, Wl 5370 (ILHR 83.09(1) & Chapter 145) LOCATION: `SECTION: /~,S_~ ( ) ~ TOWNSHIP/ UQIC)PALITY: 1T11BLK.NO.SUBDII ION NAME: COUNTY: OWNERS UYER'S NAME: CMA L N DDRESS: ' I USE DATES OBSERVATIONS MADE " NO. BEDRMS.: COMMER A SCR PTIO PRO DESCRIPTIONS: A N TESTS: 2//Residence --3 41/1 2Nw ❑Replace >/2~' f z iy-7Z / RATING: S= Site suitable fors stem U= Site unsuitable for system Rx_ v 2 S` A" ha ti C r ON❑VE T 0 MOU s: ❑u IN-GD S P~U E: SYaSTEM-IN-FILJ,-HOLDING TANK' RECOMMENDE SYSTEM: (optional) If Percolation Tests are NOT required DESIGN RATE: uu If an ~u /I any portion of the tested area is in the IV A under s. ILHR 83.09(5)(b), indicate: N Floodplain, indicate Floodplain elevation: N !ll1 PROFILE DESCRIPTIONS BORING TOTAL PTH TO GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERV_D S G E TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- / n 6"J31 SL -rs iy " L -7'' .J 1' 6'1 X 41 C- G 61 s 4- is / -7 • 5 L c `4 / 8', y 1,5 1- t~ Via" J5n SL r) r" j, ►Fe FS C~i,j ~c7 ^1,J B- B- ~JD P79, 7 IT" Lok es B- 71 c 16 B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. -PERIOD 1 PERIOD PERIOD PER INCH P- -e 10 ` 81- -7 .2 y P- 3 If t t 3-/4 7 p- , t L 1 P. _ P-.2 99 6-7 P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the ho zontal and verfAcal elevation reference points and show their location on the plot plan. Show the suxface elevation at all borings and the direction and perce of land slope. / ' mot' C&% SYSTEM ELEVATION i I PD)W I l h ~(r I 1 f-~ r e ; SCE' I I I~' I S '1 ~~l~ 51a Y S I h I, the undersigned, hereby cerFify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsi C Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (pri TESTS WERE COMPLETED ON: PVt 4l ( r2 A RESS: CERTIFICA ION NUMBER:- PHONE NUMBER (optional CST SIGNA RE: i DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. -HR-SBD•6395 (R. 10/83) -OVER - x Laand}lumrnR lationsustry, SOIL AND SITE EVALUATION REPORT Page? of 3 boi bivision 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. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Harvey Thomas GOVT. LOT SE 1/4 SW 114,S 13 T 28 N ,R 15 NRq W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # RR 1 ISIA CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE ETOWN NEAREST ROAD Knapp, WI 54749 (715) 772-3283 Cady 325th St. jx] New Construction Use k ] Residential / Number of bedrooms 6 [ ] Addition to existing building [ ] Replacement [ ] Public or commercial describe Code derived daily flow 900 gpd Recommended design loading rate •5 bed, gpd/ft2 .6 trench, gpd/ft2 Absorption area required 1800 bed, ft2 1500 trench, ft2 Maximum design loading rate .5 bed, gpd/ft2 .6 trench, gpd/ft2 Recommended infiltration surface elevation(s) 92.6 & 91.6 ft (as referred to site plan benchmark) Additional design/ site considerations install 2 - 5' x 150' center-fed trenches 3.5' below 95.1 & 96.1 as contour CL's Parent material till over SS 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 fors stem ®S ❑U ®S ❑U EIS ❑U ®S ❑U ❑S EIU ❑S ®U Conventional via monitoring SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont Color Texture Gr. Sz. Sh. Consistence Bourldahr Roots Bed Trertch 1 0-7 10YR 3/2 - sil 2 m cr mvfr as 1f/m .5 .6 1 2 7-26 10YR 5/3 - sil 2 m sbk mvfr cs 1f/m .5 .6 { Ground 3 26-35 2.5Y 5/4 f2d 7.5YR 516 sl 3 m sbk mfr as if .5 .6 elev. 4 35-41 2.5Y 6/4 - is 1 m sbk mvfr cs - .7 .8 95.1 ft. 5 41-49 2.5Y 7/4 f2d 7.5YR 4/4 fs 0 sg ml cs - .7 .8 Depth to „ W/ StratifiOrl inyg 4/4 is I limiting factor 6 49-57 10YR 4/4 - lfs 1 c abk mvfr cs - .7 .8 7 57-90 2.5Y 7/2 - fs 0 sg ml - - .7 .8 w/ occasional stratified 10YR 616 lfs bands w/ associated inclusions & w/ irreg & discontinuous 10YR 4/4 Remarks: 76-79 _ ifs bands L8 Boring :1 0-6 10YR 3/2 - sil 3 m cr mvfr cs 2f/m .5 .6 -4::::::_,.H `t 2 2 6-24 10YR 5/4 - sl 3 m sbk mfr .5 .6 k.:$ 3 24-41 2.5Y 6/4 f1d 7.5YR 4/4 is 0 sg m s - 7 .8 Ground elev. 4 41-42 10YR 4/4 - is 1 c abkr gas .8 95.8 ft. 5 42-98 2.5Y 7/2 f3p 2.5Y 616 fs 0 sg .8 Depth t0 w/ it egular 10YR 4/4 lfs bands @ 54-57, 66-67, 75-77, & 83-8 Z k limiting aVi, o factor qR,, t e band @ 54-57 s somewhat resista t to pen tration; of er Qty fs are" Remarks: weathered SS, poorly sorted, w/ some textural discontinuities indicate Tower°'bading than .7/.8 CST Name: Please Print Phone: Henry F. Grote 715-665-2681 Address: PO Box 57, Knapp, WI 54749-0057 Signature: \CA Date: CST Number: 9/10/93 3065 PROPERTY OWNER Harvey Thomas SOIL DESCRIPTION REPORT Page 2 at 3 PARCEL I.D. # Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench 1 0-10 10YR 3/2 - sil 3 m cr mvfr cs 2f/m .5 .6 2 10-25 10YR 4/3 f1d 10YR 6/2 sl 2 m sbk mvfr cs if .5 .6 Ground 3 25-45 10YR 4/4 one2p10YR 5/3 sl 3 m sbk mfr as - .5 .6 5YR 5/8 elev. 4 45-48 2.5Y 7/2 f2d 7.5YR 4/4 fs 0 sg ml cw - .7 .8 93.3 ft. Depth to 5 48-72 10YR 6/6,5/8 - scl 0 m - cs - NP .2 limiting dense & resistant o penetration generally w/ ccasional i clusions 5 5/6 cl & 2.5 8/1 01 factor 48" 6 72-90 2.5Y 616 - fs rOsg ml - - .7 .8 Remarks: Boring # 1 0-4 10YR 3/2 - sl 2 m cr mvfr as 2f/m .5 .6 4 2 4-19 10YR 4/3 - sl 2 m sbk mvfr cs 2m .5 .6 Ground 3 19-42 10YR 4/4 - sl 3 m sbk mfr aw if .5 .6 elev. 4 42-85 2.5Y 7/2 f1f 2.5Y 616 fs 0 sg ml - - .7 .8 97.5 ft. w/ 1 YR 4/4 lfs bans @ 63-67 (this bad has f1 7.5YR 4/2 7.5YR 5/8 ots), & 72-73 Depth to & w occasional str tified 1/8-1/411 it egu ar 1 YR 4 4 s n s limiting factor 5- Remarks: Boring # Not for its 1, 2, and the limiting factor is judged to be th depth of tie pit based o gro d water monito ing; the massive s 1 band i pit B-3 is a limiting actor aid this area: should be avoided Ifs stem elevation is 3.5' below grade the sy tem bott m will gene ally be in s or fs with nominal Ground elev. loading rat of 0.8 for a t ench system; duet the poor sorting an the variou textur l char ges ft. encountered, CST suggests a trench loading rat of 0.6 per the well structured 1 which may b Depth to res nt in aces along the trench limiting factor Remarks: Boring # te: The alternate site for this installation is scribed on 15's by Be Helges n and p rmited as a mound under St. Croix ounty permit No. 149 83 issued 55/13/91 Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) CSC-Sw.IS•L4 `\s VA 06 Mw..~ ql~.g N Z qj•~ Aty C1 to ,1 o q - J- 16 Ti -t Ci- - 2.- 5 ~ x \ fib' e+w. - - 1 Y 4h, IL OIL ~*VA w o ....t~l fit- l $'S ! s~ •►~.~L ~l~~s` 4 \ le, ►w 44 -31-1 ID T 06 :s.N epartment of in u i 7969 Labor and Human Relations MONITORING P.O. Box REPORT Madison, Wisconsin 53707 Bureau of Plumbing 1992 Note: ho a the in inches. Location: Lot No.B oc No DEPTH F tom SURF CE TO WATER/ SE k SW kS13 /T 28 N/R 15 URI)) W NA OBSERVATION WELL WELL WELL WELL _NA Township Munic pa ty. DATE 1 2 3 County: Cad er s Name: 3/14/92 Dr Dr D St. Croix rHarvey Thomas 3/20 - Mailing Address: 3/27 RR 1, Knapp, WI 54749 WELL 4/4 NUMBER: 1 2 3 4/11 WELL DEPTH : 74" 47" 76" 4/17 PROPOSED INDIVIDUAL 4/21 SUBDIVISION O LOT Rainfall Data Obtained From: 4/25 Spring Valley, Cedar Falls, Menomonie 5/2 MONTHLY DATA Spring Sept Oct Nov Dec Jan Feb Total 8.5 5/9 Valley 5.51 0.98 6.37 0.85 0.57 0.54 14.82 _ 5/15 March April May Total (Need 7.6") Average: 2.12 4.07 1.90 8.09 5/22 Provide daily rainfall data on a separate sheet for March. April and Nor. 5/30 write total rainfall for March. April and May in the above boxes. ARTIPICIAL DRAINAGE Check the site for artificial drainage. If the site is affected by such drainage, submit complete details for the drainage system. Indiciate wh will be responsible for maintenance of the drainage system. CNRCR OUR: ® No artificial drainage O Information regarding artificial drainag affecting this sits. affecting this site is attached. Attach a SRD-6395(115) or SDD-6309 (if a proposed subdivision), for soil " Information and estimated depth to high groundwater using mottling. Sub■i 2 copies of the Groundwater Monitoring Report to the bureau of Plumbing. P.O. box 7969. Madison, wi 53707 and submit 1 copy to the local authority. INDIVIDUAL LOT PLAN-Provide a diagram showing accurate locations and surface elevations of e monitoring wells. SUBDIVISION-Attach a scaled map showing well locations and relative elevations (1 in. m 100 feet referred). ee att ch p of la - - Ot : lot plan s gg sts sys em elm ati ns abo it 31.5 ' below ont ur d) _ yst m lev ti ns to b a le st 51 ov th d th o the Ws, ac or n tLE Ch. YS em. ith sy tem el vat ons 3' el w tie contours is su es d: 6.1 with s st m e eve io ® 3.1 Lower tre ch C 1_ it sy tern el vat on 19 9 .1 Q 1 oil S rim i Ma nor an Ar and jurctule T • 0 rc 041 I. the undersigned, hereby certify that the data rec r ed and locati, of tests reported on this form are correct to the best of my knowled; and belief. Date: CST o: Signature: DILHR SBD-6412(N.05/81) 10/18/93 3065 LSD-sw.~~-z4-w - t Ct C - S °l T.1 - 3 11-1~ - l RT. Sot T > 5Z9 N o $ 3.1 n t a.~- «1C ~a.~,.` `nay -t b L: c 1 ~-O U ~C1 a.+t %le- e J e Data from Midwest Climate Center: ~s'Sr - S Station: (478080) Spring Valley yyyymmdd prep ~4 .g Z (in) 19920301 0.00 19920418 0.00 19920302 0.00 19920419 0.19 19920303 0.00 19920420 1.24 19920304 0.00 19920421 0.36 19920305 0.15 19920422 0.24 19920306 0.00 19920423 0.00 19920307 0.13 19920424 0.00 19920308 1.20 19920425 0.00 19920309 0.00 19920426 0.00 19920310 0.00 19920427 0.00 19920311 0.00 19920428 0.00 19920312 0.00 19920429 0.00 19920313 0.00 19920430 0.00 3.3 2- 19920314 0.00 19920501 0.00 19920315 0.00 19920502 0.00 19920316 0.00 19920503 0.00 19920317 0.00 19920504 0.00 19920318 0.00 19920505 0.00 19920319 0.00 19920506 0.00 19920320 0.00 19920507 0.00 19920321 0.39 19920508 0.00 19920322 0.00 19920509 0.00 19920323 0.00 19920510 0•.00 19920324 0.00 19920511 0.10 19920325 0.00 19920512 0.06 19920326 0.00 19920513 0.00 19920327 0.00 19920514 0.00 19920328 0.00 19920515 0.00 19920329 0.39 19920516 0.49 19920330 0.00 2.2 19920517 0.00 19920331 0.00 19920518 0.00 19920401 0.00 19920519 0.00 19920402 0.00 19920520 0.00 19920403 0.00 19920521 0.00 19920404 0.00 19920522 0.84 19920405 0.00 19920523 0.12 19920406 0.00 19920524 0.00 19920407 0.00 19920525 0.00 19920408 0.00 19920526 0.00 19920409 0.00 19920527 0.00 19920410 0.52 19920528 0.00 19920411 0.00 19920529 0.00 19920412 0.00 19920530 0.00 19920413 0.00 19920531 0.00 \tto\ 19920414 0.00 19920601 0.00 19920415 0.72 19920416 0.05 Tot/Avg 7.19 19920417 0.00 e - estimated m - missing r Data from Midwest Climate Center: ~z1tStation: (475335) Menomonie ,,.4 z yyyymmdd prcp z/ y m . Y 4r (in) 19920301 0.00 19920418 0.00 1 19920302 0.00 19920419 0.44 19920303 0.00 19920420 0.92 19920304 0.00 19920421 0.98 19920305 0.10 19920422 0.23 19920306 0.11 19920423 0.00 19920307 0.02 19920424 0.00 19920308 0.00 19920425 0.00 19920309 0.72 19920426 0.00 19920310 0.00 19920427 0.00 19920311 0.00 19920428 0.00 19920312 0.00 19920429 0.00 3 19920313 0.00 19920430 0.00 19920314 0.02 19920501 0.00 19920315 0.00 19920502 0.00 19920316 0.00 19920503 0.00 19920317 0.00 19920504 0.00 19920318 0.00 19920505 0.00 19920319 0.00 19920506 0.00 19920320 0.00 19920507 0.00 19920321 0.22 19920508 0.00 19920322 0.01 19920509 0.00 19920323 0.00 19920510 0'.00 19920324 0.00 19920511 0.00 19920325 0.01 19920512 0.26 19920326 0.00 19920513 0.00 19920327 0.00 19920514 0.00 19920328 0.00 19920515 0.07 19920329 0.31 19920516 0.70 19920330 0.00 19920517 0.11 19920331 Q.00 19920518 0.00 19920401 0.00 19920519 0.00 19920402 0.00 19920520 0.00 19920403 0.00 19920521 0.00 19920404 0.00 19920522 0.51 19920405 0.00 19920523 0.23 19920406 0.00 19920524 0.00 19920407 0.00 19920525 0.00 19920408 0.00 19920526 0.06 19920409 0.00 19920527 0.00 19920410 0.52 19920528 0.00 19920411 0.02 19920529 0.00 19920412 0.00 19920530 0.00 19920413 0.00 19920531 0.00 9 19920414 0.00 19920601 0.00 19920415 0.41 19920416 0.21 Tot/Avg 7.19 19920417 0.00 e - estimated m - missing V-o.-i J `a-c to ~8 ~ • Data from Midwest Climate Center: t~l 'i► Station: (471308) Cedar-Falls-Hydro yyyymmdd prcp i ` qt o } (in) 19920301 0.00 19920418 0.00 19920302 0.00 19920419 0.15 19920303 0.00 19920420 0.88 19920304 0.00 19920421 2.10 19920305 0.00 19920422 0.25 19920306 0.32 19920423 0.00 19920307 0.00 19920424 0.00 19920308 0,00 19920425 0.00 19920309 0.90 19920426 0.00 19920310 0.18 19920427 0.00 19920311 0.00 19920428 0.00 19920312 0.00 19920429 0.00 19920313 0.00 19920430 0.00 19920314 0.00 19920501 0.00 19920315 0.00 19920502 0.00 19920316 0.00 19920503 0.00 19920317 0.00 19920504 0.00 19920318 0.00 19920505 0.00 19920319 0.00 19920506 0.00 19920320 0.00 19920507 0.00 19920321 0.20 19920508 0.00 19920322 0.43 19920509 0.00 19920323 0.00 19920510 0'.00 19920324 0.00 19920511 0.00 19920325 0.20 19920512 0.33 19920326 0.00 19920513 0.00 19920327 0.00 19920514 0.00 19920328 0.00 19920515 0.00 19920329 0.34 19920516 0.31 19920330 0.00 19920517 0.64 19920331 0.40 19920518 0.00 19920401 0.00 19920519 0.00 19920402 0.00 19920520 0.00 19920403 0.00 19920521 0.00 19920404 0.00 19920522 0.43 19920405 0.00 19920523 0.43 19920406 0.00 19920524 0.00 19920407 0.00 19920525 0,00 19920408 0.00 19920526 0.00 19920409 0.00 19920527 0.00 19920410 0.20 19920528 0.00 19920411 0.60 19920529 0.00 19920412 0.00 19920530 0.00 19920413 0.00 19920531 0.00 1.% 4 19920414 0.35 19920601 0.0 19920415 0.62 19920416 0.00 Tot/Avg 9.86 19920417 0.00 e - estimated m - missing Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of Labor 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 St. Croix 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 Harvey Thomas GOVT. LOT SE 1/4 SW 1/4,S 13 T 28 N.R 15 ( H PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUED. NAME OR CSM # RR 1 CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE MOWN NEAREST ROAD Knapp, WI 54749 (715) 772-3283 Cady 325th St. ,jx] New Construction Use J Residential ! Number of bedrooms 6 [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 900 gpd Recommended design loading rate .5 bed, gpd/ft2 •6 trench, gpd/ft2 Absorption area required 1800 bed, ft2 1500 trench, ft2 Maximum design loading rate .5 bed, gpd/ft2 .6 trench, gpd/ft2 Recommended infiltration surface elevation(s) 92.6 & 91.6 ft (as referred to site plan benchmark) Additional design/ site considerations install 2 - 5' x 150' center-fed trenches 3.5' below 95.1 & 96.1 as contour CL's Parent material till over SS Flood plain elevation, if applicable NA ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TAN U=Unsuitable fors stem ®S ❑U ®S ❑U ®S ❑U ®S ❑U ❑S ®U ❑S ®U Conventional via monitoring SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon Texture Consistence Boundary Roots In. Munsell (~u. Sz. Cont Color Gr. Sz. Sh. Bed Tre 1 1 0-7 10YR 3/2 - sil 2 m cr mvfr as 1f/m .5 E 2 7-26 10YR 5/3 - sil 2 m.sbk mvfr cs 1f/m .5 E Ground 3 26-35 2.5Y 5/4 f2d 7.5YR 5/6 sl 3 m sbk mfr as if .5 .E elev. 95.1 ft 4 35-41 2.5Y 6/4 - is 1 m sbk mvfr cs - .7 .E Depth to 5 41-49 2.5Y 7/4 f2d 7.5YR 4/4 fs 0 sg ml cs - .7 8 stratified 1/211 1171YR 4/4 ls hand 12 41 limiting 6 49-57 10YR 4/4 - lfs 1 c abk mvfr cs - .7 .8 factor tG-P8140 _rQ_t_JQ_A _1P P] 7 57-90 2.5Y 7/2 - fs 0 sg ml - - .7 .8 w/ occasional stratified 10YR 616 Ifs bands w/ associated inclusions & w/ irreg & discontinuous 10YR 4/ Remarks: 76-79 84-86 which do n. 1: resist W-enetlatiull Boring # 1 0-6 10YR 3/2 - sil 3 m cr mvfr CS 2f/m .5 E \k2 2 6-24 10YR 5/4 - sl 3 m sbk mfr aw 1f/m .5 .F 3 24-41 2.5Y 6/4 f1d 7.5YR 4/4 Is 0 sg ml as - .7 .8 Ground glev. 4 41-42 10YR 4/4 - is 1 c abk mfr as - .7 .8 95.8 ft 5 42-98 2.5Y 7/2 f3p 2.5Y 616 fs 0 sg ml - - .7 .8 Depth to w/ it egular 10YR 4/4 Ifs bands @ 54-57, 66-67, 7 -77, & 83-8 limiting factor '48' t e band @ 54-57 omewhat resistant to pen tration; of er bands & s are t Remarks: weathered SS, poorly sorted, w/ some textural discontinuities indicate lower loading than .7/.8 CST Name:-Please Print Phone: Henry F. Grote 715-665-2681 Address: PO Box 57, Knapp, WI 54749-0057 Signature: Date: 9/ 10/93 CST Number: 3065 PROPERTY OWNER Harvey Thomas SOIL DESCRIPTION REPORT Pd PARCEL I.D. #I - v4 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ' Y `,...3.,..4 1 0-10 10YR 3/2 - sil 3 m cr mvfr cs 2f/m .5 2 10-25 10YR 4/3 fld 10YR 6/2 sl 2 m sbk mvfr cs 1f .5 Ground 3 25-45 10YR 4/4 one2p10YR 5/3 sl 3 m sbk mfr' as - .5 5YR 9/A elev. 4 45-48 2.5Y 7/2 f2d 7.5YR 4/4 fs 0 sg ml. cw - .7 913.3 ft. Depth t0 5 48-72 10YR 6/6,5/8 - scl 0 m - cs - NP limiting dense & resistant o penetration generally w/ occasional i lusions 5 5/6 cl & 2.5 8/1 61 factor 48„ 6 72-90 2.5Y 616 - fs 0 sg ml .7 Remarks: Boring # 1 0-4 10YR 3/2 - sl 2 m cr mvfr as 2f/m .5 4`. 2 4-19 10YR 4/3 - sl 2 m sbk mvfr cs 2m .5 mom 3 19-42 10YR 4/4 - sl 3 m sbk mfr aw 1f .5 Ground elev. 4 42-85 2.5Y 7/2 f 1 f 2.5Y 616 fs 0 sg ml - - .7 97.5 ft. w/ 1 YR 4/4 lfs bans 0 63-67 (this bad has f1 7.5YR 4/2 7.5YR 5/8 riots), & 72-73 Depth t0 & w occasional stratified 1/8-1/411 lr egu ar 1 4/4 s bends limiting factor Ayt Remarks: Boring # Not : for its 1, 2, and the limiting fact r is judged to be the depth of t e pit based gro d water monito ing; the massive s el band ii i pit B-3 is limiting actor aid this area; should be avoided :ti•?~~tifvi<1v If s stem a vation is 3.5' below grade the system bottom will gene lly be in s or fs with nomina Ground elev. load ng rat of 0.8 for a t ench system; duet the poor sorting an the various textural changes ft. encountered, CST suggests a trench loading rat of 0.6 per the well -structured l which may b Depth to res nt in aces alon the trench limiting factor Remarks: Boring # Note: Me alternate site for this installation is scribed on 15's by Be Helges n and p rmited as a mound under St. Croix ounty permit No. 149 83 issued 113191 t•,, ..,may, `1~~..~ Ground elev. ft. ~ I Depth to r limiting factor Remarks: SBD-8330(8.05/92) / ` • A Klrvt ~0 L a~ Kw ~ ~ a ~s ~ iv -Z ctS.3 S qT.1 I 3LJ ~ II S TA -3 ~ - %40 h CL -4- Cgs •S~ T- n 2 - S 3. e.J.... t JQ U ` , o all NI ~J N frI ~N 0%%. • i L O *JM T > Na $IAQ d Witi onsin D4partmentof industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT St. Croix Safety and Buildings Division i (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATIONSE4,SW4,Sec. 13,T28-R15,325th St. 149183 Permit Holder's Name: ❑ City ❑ Village ® Town of: State Plan ID No.: Ebenezer Oaks, Inc. Cady S91-40728 CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 004-1030-40206 TANK INFORMATION ELEVATION DATA Z TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet Vent TANK TO P/ L WELL BLDG. Air Ito ntake ROAD Dt Inlet Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft Loss mead Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS LEACHING Manufacturer: SETBACK SYSTEM TO P / L BLDG WELL LAKE /STREAM INFORMATION TypeO CHAMBER Model Numer: System: OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Did. 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 C] Yes C] No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710(R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH r SANITARY PERMIT NUMBER: DILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY .~...,...a....,...~..,~ ST. CROIX STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than Jf~t3 1:1 //C. 8% x 11 inches in size. Check f r v previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. S91-40728 PROPERTY OWNER PROPERTY LOCATION EBENEZER OAKS INC SE % SW Y4, S 13 T 28, N, R 15 E (or)/#/ PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # RT 1 CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER KNAPP WI 54749 715 772-3283 II. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD ❑ State Owned ❑ VILLAGE : CADY 325 STREET ❑ Public ❑ 1 or 2 Fam. Dwelling-# of bedrooms 3 A EL NUM ER() odd 111. BUILDING USE: (If building type is public, check all that apply) ( / 6o4--103U--"l d 1 ❑ Apt/Condo 2 ❑ Assembly Hall 60 Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 40 Church/School 8 ❑ Mobile Home Park 120 Service Station/Car Wash 50 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. 0 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 300 Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION 450 375 376 1.2 9 99.32 Feet 101.82 Feet Vil. TANK CAPACITY Site in gallons Total # of Prefab. Fiber- Exper. INFORMATION New F-xisting Gallons Tanks Manufacturer's Name oncret Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank 1000 1000 1 MIDWESTERN PRECAST Lift Pump Tank/Si hon Chamber 750 750 1 MIDWESTERN PRECAST EM - E] L] _I 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' Signature: (No S ps) MP/MPRSW No.: Business Phone Number: BENNIE HELGESON 321_5 715 772-3278 Plumber's Address (Street, City, State, Zip Code): W 1229 770TH AVENUE, SPRING VALLEY WI 54767 IX. COUNTY/DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signat Stamps) ^ Surcharge Feel Approved ❑ Owner Given Initial C) 1 1 01 Adverse Determination G l 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 sa nitaiy permit is valid for two (2) years. 2. Your sanitary pe., Mit may be renewed before the expiration date, and at the time of renewal any new criteria m the Wisconsin Administrative Code will be applicable. 3. All revisicns 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 property maintained. The septic tank(s) must be pumped.by a licensed pumper whenever necessary, usually every 2 to I; 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. It. 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 81/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, 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- wafer contamination investigations and establishment of standards. . SEC?-6398 (R.11/88) • APPLICATION FOR SANITAAT PERMIT 9TC-100 This appllcatlon form is to be corlplntad in lull and signed by the ovner(s) of the property belnq developed. My lnadoquacles will only result In delays of the prrrhlt lesuance. -Should thlfs development be Intended for resale by ovner/contrsctot,(spoc houoe), than a second form should be retained and completed vhan Lila property Is sold and submitted to this office with the appropclate deed rtcordlnq. Ovnir of property Ebenezer Oaks, Inc. Harvey and Andrey Thomas 1/2 Location of property last 1A?4 `SW 1/4e 8ectlon 13 728 Nor t *_.L5 y Tevnshlp Cady Halilln9 address P.O. Box 14, Wilson, WI 54027 Address of site Rt. 1, Knapp, WI 54749 lubdivlslon maw! • Lot number Previous ovner at property Frances C. Anderson Total sl:e of parcel 80 Acres ' Date parcel vas created Art all corners and lot lines Identifiable? x-__X___•Yes o Is this property being developed for resale (spec hauls)?--- a11 xxx No Yolnr+r 907 and page Ifumber 585 1111 recorded with the A49111tet of Deeds. - --••--------------•-----------------------M------------------------------------- A VAARKXTr DRID which Includes l a THIS CHUH2211p THE I L VOLVT 2 ANDPAOI NLrXIZR, and the BIkL or Tilt 118018TER OF DR2D9. In dddltion, a certIIIad autvey, it available, would be helpful so as to avoid delays of the reviewing process. It the deed description references to a CettlLied lucvey Nap, the CattlLled Survey Nap shall also be requited, - five PROPERTY OVIIER CERTIFICATION 1 certify that all statements an this form are true to the best of My (our) xnovledgtl that I (we) am (ace) rile owner(s) of the property described In this Information form, by virtue of a warranty deed the County Register of Deeds as Document Ito. 471116 recorded in the office of presently own the proposed alto for the newage disposal a atelm and that t fuel (or I obtalmtd an easement, to run with rile above described prop erty, (we[or ) have of the e Co t ynntn of ■stsystem, and the same has been duly recorded In the office of y poL Deedsj as Document No. , Inc. ic. zer Oaks 11lgnatute o Owner President 81gna t• of c -ovner ( Applicable) 9-12-91 9-12-91 Date at signature Date of 919naturs VOL W I I~A~[ DOCUMENT No. STATE BAR OF WISCONSIN FORM 11-1982 THIS SPACE RESERVED FOR RECORDING DATA LAND CONTRACT 9 Individual and Corporate BE FOR ALL WERE OVER ISgFINAN ED AND IN OTHERNNON-CONSUMER 4711.16, $25 000 ACT TRANSACTIONS) / - REGISTERS OFFICE ST. CROIX CO., WI , by and between Frances C-. Anderson Contract, Recd for Record ("Vendor", JU!_ 0 11991 whether one or more) and..Ebcnezer _Oaks,-•Inc a corporation at 4:05 P.M oC r~A ("Purchaser", whether one or more Register of Deeds Vendor sells and agrees to convey to Purchaser, upon the prompt and full per- formance of this contract by Purchaser, the following property, together with the rents, profits, fixtures and other appurtenant interests (all called the "Property"), in St --Croix County, State of Wisconsin: RETURN TO East Half of Southwest Quarter (El-2 of SW 4) of - Section Thirteen (13), Township Twenty-eight north (T28N), Range Fifteen West (R15W) Tax Parcel No------------------•--•-•--•-------- L i This --ig_.not homestead property. (is not) a lace designated b Vendor Purchaser agrees to purchase the Property and to pay to Vendor at . the sum of $.._9QI000 :QQ..................................... in the following manner: (a) $ 5! 000 00 at the execution of this Contract; and (b) the balance of $_-_-35,0.00 ,together with interest from date hereof on the balance outstanding from time to time at the rate of.. Len (10) j per ent pNate nnum until paid in full, as follows: quarterly payments of $2,245. 89 commencing 9b clays from hereof, and on the same date of each third month thereafter. Vendor agrees, upon receipt of the sum of $1,000.00 per acre, with a minimum of 5 acres, in addition to the quarterly payments referred to above, to provide a warranty deed in partial satisfaction of this contract provided, however, that said released parcel shall be a regular parcel contiguous to the public highway and further provided that Purchaser shall pay for all costs incidental thereto. Quarterly payments will continue at times and in the amounts stated above,but interest shall accrue on the reduced rirl~l ePU balance. rov , owever, the entire outstanding balance shall be paid in full on or before the.five..years..... f fran--date . he.r_eof._._.___.__, M-------- ( the maturity date). Following any default in payment, interest shall accrue at the rate of .._12 % per annum on the entire amount in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance). Purchaser, unless excused by Vendor, agrees to pay monthly to Vendor amounts sufficient to pay reasonably antici- pated annual taxes, special assessments, fire and required insurance premiums when due. To the extent received by Vendor, Vendor agrees to apply payments to these obligations when due. Such amounts received by the Vendor for payment of taxes, assessments and insurance will be deposited into an escrow fund or trustee account, but shall not bear interest unless otherwise required by law. Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any amount may be prepaid without premium or fee upon principal at any time after jMpU r-y 1 92 t7dP~. In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long as the unpaid balance of principal, and interest (and in such case accruing interest frolg LGlVio hL§h`all be treated as unpaid principal) is less than the amoulyu t indebtedness would have been had t44WAK ]ayments been made as first specified above; provided that`~iim°y payments shall be continued in the event of credit of any proceeds of insurance or condemnation, the condemned premises being thereafter excluded herefrom. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except: Vendor shall furnish one updated abstract of title prior to full satisfaction of this land contract, until which time Vendor shall retain possession of the abstract. Purchaser agrees to keep the premises in the CRP program,and to hold harmless Vendor from any loss sustained by Vendor as a result of purchaser's failure to do so. It is agreed that Vendor shall receive 1/3 of 1991 CRP payment, and Purchaser to receive 2/3. Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall be retained by Vendor until the full purchase price is paid. date hereof. Purchaser shall beentitled to take possession of the Property on 19 *Cross Out One. ii LAND CONTRACT-Individual and STATF BAR OF WISCONSIN Wisconsin Legal Blank Co. Inc. Corporate FORM No. II - 1982 Milwaukee. Wis. i ST C- 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER Ebenezer Oaks, Inc. /Harvey & Audrey Thomas ROUTE/BOX NUMBER Rt. l Fire Number CITY/STATE Knapp, WI 'LIP 54749 I East 1/2 PROPERTY LOCATION: it, SW 1L, Section 13 T 28 N, R 15 Town of Cady St. Croix County, Subdivision , Lot number Improper use and maintenance.of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What youIpcit into the system can affect the function of the septic tank as a treat- ment 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 systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on- site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. 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- ment of Natural Resources. Certification form must be, completed and returned to the St. Croix County Zoning Off.k,;e within 30 d s of the three year expiration date. Ebenezer Oaks, nc. S I C. N PresidentY 1) AT 1: 9-12-91 St. Croix County Zoning Office P.O. Box 98 Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. DEWARTMENT DUS RY, OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, C DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX 7969 HUMAN RELATIONS N WI 5370 (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: TOWNSHIP/ UNIC PALITY: L:91 .SUBDIVISION NAME: SC.1/-SWY TagN/R15E( )W C~ COUNTY: OWNER'S UYER'S NAME: MA11 ADDRESS: _ST C901 T'k0Vy\'A' 4/ USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIA ESCRIPTION: PROFILE DESCRIPTIONS: PER ATION TESTS: Residence New ❑ Replace 7 /1 Q j Q RATING: S= Site suitable fors stem U= Site unsuitable for system POL-'~ -jZ_ 14r /4k CON~V EA ENTIONA~t' MOUND' IN-GR a OUND-PR: SYSTEM-IN-FILkHOLDING TANK ECOMMENDED SYSTEM: (optional) EA SS 20 SS 20 ❑ S DT I vL OL If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: N4 /A/A PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) r, S„$/ SL Ts /q„ -7 61 S B- I G F~ a~ C"tN S 3" /3 ~ 5 c is / "Ag, SL 9"44-8h S 21A. md- C I s, , a~SL is aa' J~~ SL If Q F-S r/Vol- B- / L 3 ~u,i a ~s 6S" Lt 7~S a B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH ► 3- 3- P- 23 ti P- , tit L 1 P- , 3-7 P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the suXface elevation at all borings and the direction and percent of land slope. / Sall d (_JJA der SYSTEM ELEVATION ow,, mT r u~ - , y - B3 . . . s+e $ Owl E lops. we _ . - t1 , , I _11~ • ra ~N , 0.~ 1 "hP~, Syn I - FP~ -_40 Q s 71 7 E i a z I . v _ TIC h I, the undersigned, hereby cer~fy that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (printi- r TESTS WERE COMPLETED ON: QKVtt ~t ro _r ® 7 / A PRESS: CERTIFICA ION NUMBER: PHONE NUMBER (optional): S )c n 9!Z 17 CST SIGNA RE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. .1-HR-SBD-6395 (R. 10/83) -OVER - I "'°TRUC P'-'NS FOR O LETI( C OI 116 - SBO - 6396 To be a coi-° . acrd soil test, yor. report r e- 1. Complete 1 2. The use se+ li tNi's is a . s or Coeur ojec,t; 3. MAXIMUM rr~ . rrs .,A use olalim 1; 4. Is 'his a rrevv e r ' rr 1 xyst:ern; S, Complete the s£< ty ratting boxes-;, SITE' IS SUITABLE FOR A HOLDING Tk ti < ONLY IF ALL OTHER SysTEW-b 'RE RULED CUT BASED U SOIL CONDITIONS; 6. PLEASE use the abb,.. revi atierrss sht3t~ri.a. t~ ee., e for vv-itiny profile descriptions and c rg the plot plan, 7. MAKE A LEGIBLE diagram azcur-ately Iocatinj your test locations. Drawing to sc.''z: is preferred. A separate sheet may be used if desired; 8, Make sure your benchnr aik and ve tical elevation re fere:ace point are Clearly shown, acrd are permanent; 9. Complete all appropriate boxes as to dates, names, addresses, flood plain data, percolation test exernp- tion, if appropriate; 10, If the information (such as flood plain, elevation! sloes not apply, place N.A. in the appropriate box; 11. Sign the form and ;dace your current address and your certification number, 12. Make legible copies arid distribute as required. ALL. SOIL TESTS MUST BE FILE'S WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COlirlPt_ETif)SV- ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st Stolle (over 10") BFI Bedrock cots - Cobble (3 - 10") SS Sandstone gr Gravel (under 3") LS - Limestone= Sar-<= : sr High Grot.rndvuatei es :_.C„ ca<=r:f -'e,rcolat.ion Rate rtte £1 'Ti Md wel1 Kr _ " i , SC! )OM (CI 'i.rF1 me sic Silty Clay fff - few, fine, faint - "'Ic Clay CC £:ommvn, Coarse p't peat n) in Many, medium . m M"Ick d - distinct: p pr"orniner?t. - I-A VVL High water ieveH, surface water BM Bench Mark =JRP - Vertical ter:ference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department may request verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a permit. The sanitary permit must be obtained and posted prior to the start of any construction. (mil a~ ar t~ - _ _ Cy 21 xo~ -r e- Slops. i f) 1 '12 8 L a"sue.. 30 RECEaVLLj 0 59~ 4v SEP, a lyy ~ 87d AFE, r r n~ U~~~~ © R,~ o n S4 -e EI{o. `13.37 7so Sc~.l~ I"= Ito' ~ ~ t~XC As S h C Lc*\. 38S 80 ~}c~s X30 SYSTEM AG ONS~~~ SSW ~ ~ 105.1, iooo c~.l 3 Red RO~pS s¢pw Now. ~°0 g A~Q NU1~1~S 4~pA~~~"~v~ Oti J;tJ~~ Qf i111 ll g~~ QQg Well 4o b c. `f'o 54,~~~r ?ask ~u~ 5a' i',2o►w r►ov~~~~ Ai2U~ ~ ~ (3 EWE Z.F2 OAkS, 1 kic Pape- of _ Straw Marsh Hay, Or K Synthetic Covering . 4 7 Distribution Pipe Medium Sand H o ,40 Topsoil Lee, J- f F I q. 3p -J I E ~ D 3 d 5 Slope • ONSITE SEWAGE SYSTEM Bed Of 2N- 2;. 2 Force Main Plowed Conjitionally Aggregate From Pump Layer D I Ft. V Lo APPRO'sh"' Cross Section Of A Mound System Using E Ft. F 75 Ft. Bed For The Absorption Area ` QEPARTiV~CiJI Q~ II~DUS~RY, ~ Agp~ N0 DIN RELATID~ A ~S G I Ft. IvISION. S A Ft. H S Ft. S i c,MdQOR B Ft. License Number: /S K 10 Ft. Date: 7 Ft. j Ft. Alternate Position I )3 fFt. of Force Main W Q9 Ft.' - L Observation Pipe g K r------------ --------_1~ A i W T----.-- - - I N N Distribution Bed Of i - 2 z Pipe Aggregate i Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area E b e, E ZE f) OA KIS/ 2NS 11 4640728" Perforated Pipe Oetall / 0 End View .End Cap )Perforated b\e:1 PVC Pipe ~oo5\oo~° Permanent End Markers lY s Holes Located on Bottom are Equally Spaced v * PVC Force Main * From Pump . PVC ENO C.4 P Manifold Pipe Pvc. Distribution... Pipe Last Hole Should Be Next To End Cap ' ONSITE SEWAGE SYSTEM Distribution Pine Layout ctional//)q P DD C o~ A PROVEW P,' R 10N RELATIONS S OEp4q,-0AENT OF IIvnIsStRY. ~~R AND INGS ` V SIO14 S X SEE CORRES FiOE~tCE i Y Signed: Hole Diameter Inch 101, License Number: Lateral " Inch (es) Date: _3 _4 Manifold " Inches ~tlac~ Idol e, a 'r Force Main " Inches w. TI=E w tt~% It- of 4b1es~P,~ C~ ~r~ hates - - ~~lhf~v vC~~S. .TNu..Eltu. of t as l~bl~ b e., h~ x1' Co~A , L.a~e►-a~1S 0 eaEkIE:zEe OArgl Tuc, PAr i ;r g AP 'CHAME,:R CR055 SEr-!C'J AIJG G0ECIFICA'r1O VEIJTCAP A~~ 07 6~~s! `i"C.L VEVT PIPE WEATHERPROOF APPROVED LOCKIMG -frT 25' FROM DOOR, JUNCTIOIJ BOX MANHOLE COVER WINDOW OR FRESH 12"MIU. AIR INTAKE GRADE I `I" MIU. • colJOUIT ' AG 11~ IAJLET S'q OVfDE GHT SEAL I I i I I O jItio APPROVED JOImT :A ( I APPROVED JCu I W/C.I. PIPE EXTENDING 3' 043 1 W/C.I. IJ4~4I~N ~~LA~1GtaS I ((I EXTEWDPUG 3 ALARM OWTO SOLID SOIL B bok Nt;S ( II ouro sou0 sc c ~'JS~RY ' l1U.D~ p,Tt,IT0J v I. I oIJ ` cMs ELEV. LOFT p!!Cti I ca SEE ' PUMP OFF D. COUCRETE BLOCK ~•y.~, RISER EXIT PERMITr'ED OJJLy IFTAUK MAUUFAClTURER AS SUCH APP(R~O VAL I.Vw 0..I f~GIC~ ~ `~(y~ SEPTIC E SPE GIFICATIOUS (OU •eov DOSE ~J AS TAAIKS MAAIUFACTURER: C~~7 -riftc.~JUMBER OF DOSES: J PER DAB DcGe_ TAAJK SIZE:- GALLOUS DOSE VOLUME ALARM MAUUFACTUKER: IPJCLUDJNG SACKFLOW: GALLON: MODEL NUlAitit - . Elec r S CAPACITIES: Aoile:'~IMCRES OR 360 GALLOU SWITCH TSPQ; _ B ICHES OR ..AIL, GALLCL: PUMP MAAJUFACTURER: C it l r-. I _IIJCHES OR 101 cALLOI.' MODEL UUMBEK' (C Q L D = 2 FICHES OR .22-fl' GALLON: ' SWITCH TYPE: ~~W:s /-I e-VQ ICXkOTE: . PUMP AMD ALARM ARE TO BE OM SEPARATE CIRCUITS MIIJIMUM DISCHARGE RAT£ GPM 1(4)-q FEET VERTICAL DIFFEREIJCE BETWEEU PUMP OFF AUD DISTRIBUTION PIPE.._1(4)-q.~FEET + MIIJIMUM IJETWORK SUPPLY PRESSURTT.✓E/.. . . . . . 2.t~5~y FEET + 370 FEET OF FORCE MAIM X +-s-F--FYoo►LFRICTlOu FACTOR.. y 3 FEET' TOTAL OyWAMIC. HEAD = 1.1, 63 FEET' 11JTERRIAL DIME1JSlO1Jt OF TAIJK: LE1JCaTH 22 ;WIDTH ;LIQUID DEPTH SIGNED: LICEUSE JJUMBER,. - DATE: Vee)-/ • ! SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations PRIVATE SEWAGE PLAN APPROVAL Western Regional Office 2226 Rose Street LaCrosse, Wisconsin 54603 BENNIE HELGESON Owner: EBENEZER OAKS INC W1229 770TH AVE RR 1 SPRING VALLEY WI 54767 KNAPP WI 54749 RE: Plan Number: S91-40728 Date Approved: September 10, 1991 Gallons Per Day: 450 Date Received: September 3, 1991 Project Name: EBENEZER OAKS INC Location: SE,SW,13,28,15E Town of CADY County: ST CROIX The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped 'conditionally approved'. This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. This approval will expire two years from the date approved or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. The Section of Private Sewage has reviewed these plans for private sewage system code requirements only. These plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the Wisconsin Administrative code. This approval is for the following components only: - NEW MOUND Inquiries concerning this approval may be made by calling (608) 785-9348. Sincerely, t GERARD M. SWIM Section of Private Sewage Division of Safety and Buildings PPP039/0009n/35 cc: EBENEZER OAKS INC X Private Sewage Consultant S11D-8483 iH. 01/811 ST. CROIX COUNTY WISCONSIN t' N 1 4M { ` its ZONING OFFICE h w {dry ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 rr, (715) 386-4680 Aug. 26, 1991 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An on site investigation of the Harvey Thomas property, located in the SE 1/4 of the SW 1/4 of -Sec. 13, T28N-R15W, Town of Cady, St. Croix County, revealed 24" of suitable soil requiring an additional 1' of sand fill. This site should be suitable for a mound. Should you.have any questions, please feel free to contact this office. Sincerely, Thomas C. Nelson, Zoning Administrator cj n " h n~ M ND 00 qj ~ s 0 Oo ~ 1 M O 1 1 10 1 1 ``4- 00 N 1^04 V 1-F~ tq 1^- + ° n Q O ~ M oz M yin Q 00