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Saiety & Bui,wngs Division
SOIL DESLrdPTION REPORT P.O.8ox 7969
Wiseconsin Urpartment of Industry, Madison, WI 53707
Labor and Human Relations (Attach Soil Profile Location Map - To Scale - On A Separate, Signed Sheet) Page of
3~~ - ~~p ~p y Parent Matena ?~P9~
r we uauon Date urrant Lan use or veYeU~~ Es D/
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uatomer Nam cv /Tt~ / ~l~~Z {zSQST
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y ystem-L-O mg Rate/ in a ons Pggr q. Ft. Per sy /
Ounty ax ante No. STief)ly !'OM,! 4TW = - • O RI -v
pe
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ystem eometry an Dept
Lot Lega Descnpuon Zyv a W
yrJ vG~, S~ I r 7, l~ - Remarks: clayskins Loading
Depth Dominant Color Mottles Structure res H and other GPD/ft.2
Horizon -
In. Munsell u. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots 9oCS
/3 /0 Y, e 316 j 2-f
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z~ 72
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6 Loading
Horizon Depth Dominant Color mottles Structure Remarks: clayskins In, Munsell u. Sz. Cont. Color Texturr Gr. Sz. bSh.,C Consistence Roots 8o`u~n
Sr ores. jSd other GPG•i
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Structure Remarks: clayskins Loading
Horizon Depth Dominant Color Mottles
In. Munsell u. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Boundary ores Hand other GP<D~/ft.2
CF S D C, S ,wt~ S -
2- t s jiPrw-t CS - c~
ROVED
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for a conventions s®
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- Structure Remarks: clayskins Loa ,ng
Horizon Depth Dominant Color Mottles
In, Munsell u. Sz. Cunt. Color F Gr. Sz. Sh. Consistence Roots g2 ~sr ores Hand other GPD/f.z
3W sw
4 0-15 /0y" 16
/ S M,pdJ.Cot~.0S-e /S
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Structure Remarks: clayskins Loading
Horizon Depth Dominant Color Mottles
/0 l 9 3 /s Gr. Sz. Sh. Connsistence Roots Bre da ores Hand other GP~ .z
In. Munsell u. Sz. Cont. Color Texture
y,~ i 2_ f, Is f sb,~ MFR '
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Ht?MESffE SEPTIC PLUMBING CO.
O 055 O'NEIL RD., HUDSON, Wi5.5Q16
Ca ROBERT ULBRIGHT s r
AS. MASTER PLUMBER LIC. NO. 3307 M.PAS.
o- ZL Pl. WTALLE:i & CEWNER LIC. I1J.ODfi83
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rAdditional Remarks: 1-1--l- ;4S-e- ~i'T ~~soi~iPT; o A3 s rWjf--
Olv c>c_~2 'S i;(~ SE'S 7~t c,- , e oAe Gv~,v>r U-
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Uther Site features:
go 4,11
limiting factors/Depth: CST Signature Date Signed Telephone No. CST Y
s SOU 8130 IN 01,90) d ~
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~ RT I FIED SURVEY MAP
{
Located in the SW 1 /4-NW 1 /4 and NW 1/4-SW 1/4, Section 19,. T29N, R 19W ,
Town o udson, St. Croix County, Wisconsin
Surveyed for:
Wm. Giese Ev Carte
Rt 5
.Hudson, Wi. 5 6
4.; .
STRAWBERRY POINT
vp,
20' UTILITY EASEMENT
t it N7lo3T'E) CURVE DATA
J, l 641d = 9045'20
P' Aso 4i~ _ 126 e2 6 6' R = 166.00'
N W CORNER 33~ 701 CHORD= 28.23'
SECTION 19 n~9 N Op, 49.85'' N N S8043'10"E
MATHEMATICAL LOCATIQN 6~ 0' \Q~~°' ' i►~ No\ (R 38°00'20"E )
NOTHING SET ~9 ~r1 w •
/ 00
i~/`` a6 eF► n! t CURVE DATA
600 F?~ SQL' D=42° 16'od'
R- 233.00
CHORD= 168.14'
as GQ~ C TIFIED SURVEY AP se (R 834050027E
)
r ro Q" - VOL4, PAGE '94 u, O'' 004 0`` ~qw\
o /
y B' 427,362 SQ. FT. mf~iaP ~VFTma -LOLL
~a rn 1330 ( 9.81 ACRES) TO °bli!' '
o,
$ s~3" MEANDER LOT ( % sA°'F"e og•
W4E
Ca 10.97 Ao ESQ . 80085 gA $ 190 8~ SQ. FT Os p'aF 3 / •
88 X50' ~
v O
5 9 CURVE DATA
ro rn 1 4.37 AQ tE
p~ 0 1 / S. • p=16°37'40"
~ Ra 1277.90 -
w a'~ w c CHORD =369 gg6
9POINT OF BEGINNING + •04.86 / S58°42'26~ W
P SUBJECT TO 66 ACCESS ` 3 " 5238.94'
662.73' EASEMENT 13.4.57' N89o 14'35"E AST WEST 1/4 SECTION LINE
ONUMENTED LINE OF N89058'47"W / 14- 0
W 1/4 CORNER OCCURATION i OFNTHENSW I/4-NW V4R E I/4 CORNER
SECTION 19 SECTION 19,
T 29 N, 819W UNPLATrED LANDS
T 29 N,R 19W
N
SCALE IN FEET C IN
n ~
QA ,
0 200" 400 600' Y a F' L 910
LEGEND COUNTY SECTION CORNER MONUMENT 0 m a DEC 30 1965
Comm
IRON PIPE FOUND
;r I" IRON PIPE FOUND n i drk QmWj,
O 3/4" X 24"STEEL REINFORCING BAR $ 0 Wmam"k
pW€(GH.ING 1.802 LBS./LINEAL FOOT SET. 0
• 3/4 "%24"STEEL REINFORCING BAR
WEIGHING 1.502 LOS./LINEAL FOOT FOUND.
(R--) PREVIOUSLY RECORDED DATA
r
Vol. 6 Page 1618
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FILED 10
~ SEP021998► 11 FSURRd(~~;~5 8f 3 1 THLEEN H. wRegister of DP 3 ~ ;
SL Croix Co., wi CERTIFIE MAP VEYOR'SRECORD
LOCATED IN THE SW 1 /4 OF THE NW 1/4 SECTION 19, T29N,
R 19W, CITY OF HUDSON, ST. CROIX COUNTY, WISCONSIN.
\ II
THIS MAP HAS B APPR VED BY CITY OF D N. LOT 4
/
PATRI IA A. DOTSETH, CITY CLERK
DATE: ,19 / \
LOT 3 \ \ /
/off/
" /CURV166.00, E DATA ' R=BO'
_0
TTOPCOFPIPE• \ LL=28.26?0„
A
ELEV.= 692.66 CHORD=28.23'
lQ'I E r
~i AUGUST 8,1998 :jFl HORD=S 8043,
iP R S 8°00'20"
687.7 WATERS EGDE s,X Tan Outs S 1335L' Yo"0" E
AUGUST 6,1998 \LOT 2
p0, LOT 1 7.~37_a i /
\0 s ~ "r~s V (BN~ 10 Y LOT 8
s° s tr e 76054 10 V,
~tKi0i 1 `~SSO ~U"..fl. w
TSEPTIC
NK 1'~P Cc0°~o~~`S':~~~
ON OO, `~O ° ro 0..~
0"o
0 T 13 e* N. o
N 1Z I
Op S. 40.236AS.F + • • • 6°'1• a00
"cl 90 `SHED s ~~l dI
POINT OF p F ENNEL~ sr ~~L' • 6'S` I
BEGINNING WELL <1 •y°'
LOT 12 s soh, •
2.298 ACt N 76054 10 E
~~.I,I
10'6 j00,120 S.F. qv_l h1 ~ok, D0~ D ~`6 112.0
LOT 11
c~ 123. N 39054' 10" E ~Q
LOT 8 v',~~, 9 ' ~0~',~1~' 2~62~ I LEGEND .51 1\
\ \ 91 1°02. 09' 59 • W) 246 39)I COUNTY SECTION CORNER 0
\ \ 0 S 7 744:1,4 8u W I MONUMENT, BERNTSEN CAP,
~ LOT 7 (R 5 7to03 1 I FOUND.
R=60 (RI • 1" IRON PIPE, FOUND.
S 47-23' 56
Zr \ G~ \ `b 115.2 7' i LOT 7 i 0 2" IRON PIPE, FOUND.
w a \ v~ 0 1"X24" IRON PIPE, WEIGHING
LOT 6 I I 1.68#/LINEAR FOOT, SET.
LOT 6 o 1"X30" IRON PIPE, WEIGHING
BLOG~K 1 1.68#/LINEAR FOOT, SET.
w ( / 5 I
J I LOT Z/ ® 3/4" IRON ROD. FOUND.
EXISTING 20' UTILITY EASEMENT
3 0° UTILITY EASEMENT
ki o (WIDTH SHOWN)
1i M I / / ` \ ' I EXISTING DRIVEWAY
I of 2/ __JJ
EASEMENT V.1074, P.448
6I 3 J I I LOT 4 \ \ I (R S 71-44159- W) PREVIOUSLY RECORDED AS
60 N m/ w II-- I LOT 1 o z
O 6oil I I C.S.M. 0
oI ° 33'K3 _ .J I VOL. 6 w° ~t p w
° =10 I PAGC 1618 z ~ N m
BIZ W 1/4 CORNER LOT 3 mlvl
SECTION 19 o6c.14578 O6 SCALE IN FEET w``O
WNOF-W
I I
T29N, R 19W o' 30' 60' 120' 1a0' 3 ? ~ M Ilk
EAST _WEST 1 /4 SECTION LINE_ ~ N z N - ~Q
_N8 9 ° 14' 35" E 5238.94' E 1 /4 CORNER Z W° a or
(R N 89°21' 42" E 5238.82') SECTION 19 Q z w vi 00
T29N, R19W ~~"'^z
THIS INSTRUMENT DRAFTED BY DARIN FLATER PAGE 1 OF 2
VOLUME 12 PAGE 3512
Fo rm - S T C - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP U~G~Sw~ SEC. T !E N-R g W
a5
ADDRESS A veST. CROIX COUNTY WISCONSIN
uds LA
Y616 - 5
SUBDIVISION Sfrr LOT LOT SIZE
i
PLAN VIEW
Distances and dimensions to meet requirements of I1HR 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
I
a ~
iv 6
y ,
INDICATE NORTH ARROW
a '
BENCHMARk: Describe the vertical reference point used )'S4eJ~-t
Elevation of vertical reference point: El ~U?) Proposed slope at site:
SEPTIC TANK: Manufacturer: W_Rc Liquid Capacity: Lp2~4 1
Number of rings used: Tank manhole cover elevation: /d/
Tank Inlet Elevation: , Tank Outlet Elevation: /9,9, Number of feet from nearest Road.: Front, Side0 Rear, O feet
--From nearest-property line Front,0Side,/AQKRear,0 f&t
Ncnntgr of feet from: well building: /
(Inc is information of the above plot plan)( 2 reference dimensions to septic-;-#h110
l SEE REVERSE SIDE•
f~
}
' f
PUMP CHAMBER
Manufacturer: 4 Liquid Capacity:
Pump Model: Pump/Siphon Manufacturer: Pump Size
Elevation of inlet: Bottom of tank elevation:
Pump off switch elevation: Gallons per cycle:
Alarm Manufacturer: Alarm Switch Type:
Number of feet from nearest property line: Front, O Side, O Rear, Ft.
Number of feet from well:
i Number of feet from building:
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed: Trench:
Width: Z'k Length: S O Number of Lines: Area Built: /
Fill depth to top of pipe: C1
Number of feet from nearest property line: Front, Side, a Rear,O Oi~t. (v
Number of feet from well:
Number of feet from building: c~
f SInclude distances on plot plan).
SEEPA0E _PI~
Size: Number of pits: Diameter:
Liquid depth: Bottom of seepage pit elevation:
Area Built:
Has either a drop box O or distribution box O been used on any of the above soil
absorbtion sytems? (Check one).,
HOLDING TANK A)
I
Manufacturer: Capacity:
Number of rings used: Elevation of bottom of tank:
Elevation of inlet:
Number of feet from nearest property line: Front, O Side, O Rear, Ft.
Number of feet from well:
Number of feet from building:
Number of feet from nearest road:
Alarm Manufacturer:
Inspector:
Dated: Plumber on job:
License Number: /S
3/84:mj
Srtrj{bp~~j,st~,9.29.19.6 A~S~T~67r_ _ LOVE,~515'►WBARRY County:
i an % lings DivisioRelationsn INSPECTION REPORT ST. CROIX
ildi
(ATTACH TO PERMIT) Sanitary Permit No-:
GENE INFORMATION 193457
Permit Holder's Name: ❑ City ❑ Village [*Town of: State Plan ID No.:
V4W ANDREW HUDSON
v.: / Insp. BM Elev.: BM Description: Parcel Tax No.:
SQ rr QS 020-1131-10-000
TANK INFORMATION ELEVATION DATA A9300117
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Z,~)- C ZSD Benchmark 16.0/" la !o .1
Dosing 61)A- • 13,3V'
, 35/ c~7 G
Aeration Bldg. Sewer
Holding St/ Inlet , /D 9 , 91
I
TANK SETBACK INFORMATION St/ I#( outlet
Vent
TANK TO P/ L WELL BLDG. Airito ntake ROAD Dt Inlet
Septic NA Dt Bottom
SY' /
Dosing NA Heade_ 99 ~{S
Aeration NA Dist. Pipe 6,65 97,36e
Holding Bot. System -17 D' V. V/
PUMP/ SIPHON INFORMATION Final Grade s ~
Manufa turer Demand
Model Number GPM
TDH Lift I Friction em t
Loss ead
Forcemain Length Dia. Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH width Length No. Of renches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS /Z I -5.;2 DI _Tt
SETBACK LAKE /STREAM NG Manufacturer
SYSTEM TO P/ L BLDG WELL
INFORMATION Type Of /J,zty CHAMBER
Fn Z, / Number:
System: / OR-" IT
DISTRIBUTION SYSTEM
Header / - Distribution Pipe(s) „ Size x Hole Spacing Vent To Air Intake
Length 1~ Dia. Length 56 Dia. Spacing ,
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Onl
Depth Over Depth Over xx Depth Of xx Seeded dded F Mulched
No
Bed/ Trench Center Bed /Trench Edges Topsoil es E] No ❑ Yes E]
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: HUDSONf,19.29.19.625,SW,NW, LOT 1, STRAWBARRY DR ~
S
'f' / ~ w~'! l/1!7 GJ` "r`~-4.,.-°•'".. l~ .fib" , - / ~la.t..~;.~ . (Jl~-j~ d ~°`«°y..~...,~ Gt-r
Plan revision required? ❑ Yes S44_0
Use other side for additional information. o
SBD-6710 (R 05/91) Date Inspector's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
,
DrHR SANITARY PERMIT APPLICATION COUNTY
DIL
S In accord with ILHR 83.05, Wis. Adm. Code s t Cr r0I X
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than 3 it -57--,
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
~r ec.`7 5W t/a )U W S J T A? , N, R /91, r) W
PROPERTY OWNER'S MAILING DDRESS LOT # / BLOCK #
A
a u G J At
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUM R
M W-r Yo/ S-trCIA^S bar Y
II. TYPE OF BUILDING: Check One CITY NEAREST ROAD
( ) State Owned 4QWN VILLAGE OF: : tkc15 f-r- Came I-rte 'iL)
❑ Public U1 or 2 Fam. Dwelling of bedrooms ~ PARCEL Ax NUMBER(S)
111. BUILDING USE: (If building type is public, check all that apply) _-2 o _ 1 0 3 l
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 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. New 2. ❑ Replacement 3. ❑ Replacement of 4.0 Reconnection of 5.0 Repair of an
System System Tank Only -E7xisting System Existing System
B) A Sanitary Permit was previously issued. Permit # 93 ~S! Date Issued 6 ZO 2Z .7-3
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 K Seepage Bed 21 ❑ Mound 30 ❑ 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) ELEVAT ON
lP 0 d 9&1V 9r 1 99'3 Feet /00eet
VII. TANK CAPACITY Site
in allons Total # of Prefab. Fiber- Exper.
Manufacturer's Name Concrete Con- Steel Plastic
INFORMATION New istin Gallons Tanks
Tanks Tanks strutted glass App
Septic Tank or Holdin Tanks / eZg~ e r F1 I I El
Lift Pump Tank/Si hon Chamber
Vlll. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation o the onsite sewage system shown on the attached plans.
Plumber's Name (Pr' rlumkler's Signat re: (N Stamps) WP/MPRSW No.: Business Phone Number:
L n wars T 1,56-3 71s- a 46-S/ S
y- eakL_,~~j
Plumber's Address (Street, City, Se, Zip Code):
/1 rIs'
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater a e ssue Issuing Ag t Signat o Sta
pproved E] Owner Given initial Surcharge Fee)
_ I C A A 4-it-
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 a Buildings Division, Owner, Plumber
INSTRUCTIONS f
1. A sanitary permit is valid for two (2) years.
2' Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new
criteria in the Wisconsin Administrative Code will be applicable.
3. Ail revisions to this permit must be approved by the permit issuing authority.
4. Changes in a)wnerstrip or plumber requires a Sanitary Permit TransferJRenewal Form ~SFD 6399` to be
subruAttec to the c-ounty prior, to. installation.
5. Ons'it sewage systems must'b6 properiy maintained. The tank(s) ML!st be pwr!ped t-y a licensed`
pumper, whenever necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local cede adminisiratoe'or the
State of Wisconsin, Safety & Buildings Division, 603-266-3815.
To Lie 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.
11. 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 rn ##1-7
VIE T._tr~k lnfc-rmation. Fill in the capacity of every new and/or exrcl, tank, iist the total gallors, r• umber of
'tanks and manufacturer's narrle. Indicate prefab or site construes. I <nd tank material. (':gym^l ;tP 0r all
septic, pump/siphon and holding tanks for this system. Check v-_,; n1 r;tal approval only if :arks received
experimental product approval from DR-HR.
VIII. Responsibility statement. Installing; plumber is to fill in name, rir~,,~se nL!rnber 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 spec fi.ca.tior.-• not smaller i:han 131/2 X 11 t: 1, c must be subrnittnc, to thr county. The
plans must include the folloyr=-,g: 4) plot plan, drawn to scale: Or w;J, complete dinner? > c~°;s;, 'cication of
holding tank(s), septic tank(s cr cs:her treatment tanks; bLJ,A1 ,C;+ tr~ ,ve!ls; water rrEa~, i.fater service;
streams and lakes; pump or siphon tanks; distribution iu> P:,; Aso!„t,on systp!~r+ -c-pi<it =-rrer system
areas; ar•d $he location of the Est .served, 13) horizon*w , ica. elevation raf-rer',(' .'(;ints;
C) complete specifications fo;- purrips and controls; c'ose vci_irrt_; elevat,on differences; friction lose,; pump
Performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system. if
r` required by the county; E) soil test data on a 115 form; and F) all sizing information.
- - - - - -
GROUNDWATER SURCHAFMIE
1983 Wisconsin Act 410 included the creation of-surcharces (fors) for a numl:),r of
regulated practices which can effc;ct grOUndwatei.
The rucr es col;ec`~-d through theses{,rchargez. ate. used for i,;on;t - src ' d,v'nte*water'ccinfamination investigations and establishMET11 of standards.
SBD-6398 (R.11/88)
f I
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All 11
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lop
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PAGE OF
CrvSS Sec~lun o~ Zcf) SyJern
Fresh Air InIals And Observation Pipe
/'_f Approved Vent Cap
Minimum 12" Above
Final Grade
20- 42" Above Pipe _ 4' Cast Iron
To Final Grad• Vent Pipe
Mush Hay Or Synthetic Covering
min 2' Aggregate
-
Ol~ ion over Pipe
Pipe
- Too
lp• 0 0 0 0
6" AggreaI o's
a Perforated Pipe Below
Beneath Plp•
-Coupling Terminating At
Bottom Of System
p~~ P os e IJ ~I r,kl ttg r~, el t
.SOIL FILL
01STRIBUTI01,1 PIPE
APPROVED ~IMTF1ETiC. COVER
° MATERIKt- OR 9° OF STRAW
OF A6GRFE GAIE _/o, / OR MARS" VA A,3
leOF12-P AGGREGATE 4,
ELEV. aF 9g,3 FEAT
DISTRIa~JT1OM PIPE TO BE AT LEAST lUCHES BELOW ORIGIOAL GRADE
AIJV AT LEASTZO MCHES BUT KIO MORE THAM 42 Mr-HES BELOW FILIAL GRADE
/e IMUM DEPTH OF EXCAVATiop FRoM 0A1&VVat 6KADE WILL BE '3 INCHES
NuHIr►uM Mnt of ExcaVATi®N MOM CW\I(,IbqL 694o€ WILL BE INCHES
SIGHED:
LICEWSE AJUMBER: 1J 6--3
DATE: .Z2 ,-2
Wisoonsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page Of
Labor and Human Relations
Division of Safety & Buildings in accord with ILHR 83.05, VViS. Adm. Code
COUNTY /
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
E v C ~ GOVT. LOT 5r,) 1/4 N 0;1/4,S T 2 AR [ of ?M(gr) W
PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
S a b F lr R li p
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ILLAGE JUOWN NEAREST ROAD
q-0 (v (7s) - s &6 .S0k7 n b ~ k
[ New Construction Use [,A Residential / Number of bedrooms [ ] Addition to existing building
Replacement [ ] Public or commercial describe
Code derived daily flow G OG gpd Recommended design loading rate ~7 ed, gpd/ft2 , 8 trench, gpd/ft2
Absorption area required 6?5' _ bed, ft2 5 o trench, ft2 Maximum design loading rate t 7 bed, gpd/ft2 , 6 trench, gpolft2
Recommended infiltration surface elevation(s) 6 a ° It (..ass referred to site plan benchmark)
Additional design / site considerations Ron i /15 5 /m] , 14-rS_A
Parent material 5i~-an-„„ Flood plain elevation, if applicable .-v as It
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem S 11 U IMS ❑ U ff)(S ❑ U % ❑ U ❑ S fall ❑ S 211
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 Ouch
~x -/z- ld E- a m 9 r rn ~ cd a rn , s ra
lfw 7 .9
Ground 3 &A) 7,sylz')~/(o 07-;- f- a -S,% !o 60 /i 1,7 ,8
elev.
-3& ,z 3 !2 a+-rz s a s rn / >ti~ , 7
Depth to - r M ✓ aP
limiting
factor -v 7 4
8 r 7 6B ~2 't/8 ysvria Cr1 S 0 5"'~ M l G *v)4 r? .
1001 Lvbl- 1 7
Remarks:
Boring #
, to
amgr MV4 aid m 1.6
ra a ~
-ZB 7, r n 1I 41 P,4-6.) m 7 9
Ground h 07.7,± S ~ S 1~y1 / 0 VW • 7
ele 5 71.5 ~ 3/z ~-n ev -C 67 3 / (a'--J e, ix 7 118
Depth-to 0 r2~/tom es S D-5m ~i Wg 7 ,8
limiting (p G~ ~5 rL `f/® yva>~ ~v S d s !~i'~ / ~o r.~ r'~9- 7
factor
S o S ryy /V INS , 7
Remarks:
CST Name: Please Print
Address:
Signature: Date: CST Number:
-~~-y3 ~s~~zz98
PARCEL I.D. # C.II
Page Z- of 3
Boring # Horizon Depth Dominant Color mottles
in. Munsell Qu. Sz. Con t. Color Texture Structure Gr. Sz. Sh. Consistence Bard3Y Roots GPD/ft
IM:tBed Trench Z v~ 7.s ~Zcsn /S o s
Ground elev. -r 7,
Depth to 7
fimifing -.39 2.5 3/~ h 0-,, e S
factor S
l(i p~~ L° S 4 Sow
7 1,6?
Remarks:
Boring #
I
I
i
Ground
elev.
ft
Depth to
limiling
fact r
Remarks:
Boring #
13
Ground
elev.
ft
Depth to
limiting
fact
Remarks:
.Boring #
Ground
elev.
ft
Depth to
limiting
fact
Remarks:
38D-6330(R.05/'92)
STEEL'S SOIL SERVICE
Gary L. Steel ve
C.S.T. 2298 E (Z 4 87 R New Richmond, WI 54017
MPRSW-3254 S W N k) Yq- S ) 9 7-9 _ P) 9 J (715) 246-6200
---o w +-a a S ►'1
tCA ~ ~
N '
~~~e b y N
s4wK ~00~ k3 Y-7
C I~
I
~ I
4•a 1 , of
.y I
93
,'bocuMENT No. WARRANTY DEED ,TNIS SPACE RESERVED FOR RECORDING DATA
STATE BAR OF WISCONSIN FORM 2-1982
494G38VoL 992PAGE~ ,
REGISTERFFICE
Everett F. Carter and Ann T. Carter, ST.CROD(CO.oWI
divor-c-ed-•and••.unremarrfed................................................ Recd for Record
~ FE B 3 1993
at 8.30 M'
conveys and warrants to ..Andrew..Ga..Mayer 1
I
Reglsta of Deeds
-
RETURN TO
-
the following described real estate in ' oiX ....County,
State of Wisconsin:
Tax Parcel No:
Lot 1 of the Plat of Strawberry.Point in the SW 1/4 of the NW 1/4
of Section 19-29-19.
TOGETHER WITH an easement for ingress and egress over the following
described property:
Part of Lot 11 of the Plat of Strawberry Point, Town of Hudson,
St. Croix County, Wisconsin, described as follows: Commencing at the
most Westerly corner of said Lot 11; thence N40 degrees 371E 100.46'
along a Northwesterly line of said Lot 11 to the point of beginning;
thence N40 degrees 371E 50.001 along said Northwesterly lot line;
thence N77 degrees 371E 125.821 along a Northwesterly line of said
Lot 11; thence Southeasterly along a 166.001 radius curve concave
Easterly whose chord bears S8 degrees 0012011E 28.231 and the right-
of-way line of Strawberry Drive; thence S12 degrees 531E 1.85' along
said right-of-way line; thence S77 degrees 371W 63.791; thence
S40 degrees 371W 79.771; thence N49 degrees 231W 60.00' to the point
of beginning.
Grantee understands and acknowledges that the Township of Hudson or
the City of Hudson (in the event of annexation) may construct a road
to township, or urban standards over the Northw4sterly 66 feet of Lot 11
of the Plat of Strawberry Point following the utility lines as laid out
This i s...no.t.......... homestead property. on said Plat.
(is) (is not)A
Exception to warranties: easements, restrictions and rights-of-way $ } E
of record, if any. F
Hate is ` day of February 19..9.3..
t
n
4_Stt~.A~ X_ kl_._(SEAL) . .o. ct.b.-.0 ...................(SEAL)
Everett F. Carter *Ann T. Carter
......................(SEAL) ....................................................................(SEAL)
•
AUTHENTICATION ACKNOWLEDGMENT
. F. Carters STATE OF WISCONSIN
Signature s) Everett.
Carter ad.
. . St. Croix County: -
Ann
authenticated this day of._February-_..1993 Personally came before me this ....1St..... day of
' n February / 91J 3- the above name)
::l~S..
rter, Ann .......Carter
. N~ ~ N
.....~veret..
'
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not .
authorized by 1706.06. Wis. Stats.) to me known to be the person . s_....... who executed the
foregoing instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY
Kristina Ogland
. Attorney-.at•• Law.............................
Notary Public County'. Wis.
(Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration
are not necessary.) date:. 19.........)
•Nantea of persons signing in any capacity should be typed or printed below their signatures.
STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc.
:tLM
t:1T1i:1A:1 C A4 MIT
Sr.. Crv i» Cuunc~r
OWNERI3UTM- 4Z w Ca. /~~►-yc-~L
MOUTI130.°_ NUMBER. /(017 tAgaG L- t-+y 7tre 4umber x),,X
CIT7/ST.tT= 77405-0N4 W-V ZIP 5VO/7
P^7PERT7 I.OCAtTMON: 5w 't. AIL4J I. Sac=ian 9 T 29 ,,1, it I9 'j,
Town of )V4OS(O kJ St. Croix CDUnC7,
5MqW~7L~y
Subdivis Lon ir`l' r
Lo c number
,oAjS /7E Da/lt3S /S
Sic $ S wP i2n~ L44 4C f vos o Aj
Lmpraper use Xnd maincenance of your septic syscam cauli result La
4C3
Premature failure ca handle jasess. Proper maLneanance con-
sists or pumping ouc the septic canic aver7 cares years or sooner,
L= aseded. by a Licensed seactc canic oumver. ghat you puc Lnco
the syscam can at acc Cho Cuncciun of the septic canic as a c.eac-
none seage La Chen Jasea cUsvosal svseam.
St. Croix Caunc'r residents Mate 5e ali.gtbla to receive a grant cor
a rnaxm_m O d 60% j e the Cost u i rsvlacamene of a failiag system,
which was La aperac ion prior to .lull L. L478. St. Craix Cuuncl
aecepead this program La Austust of L980, wtch chea requiramene char-
owners of all clew 9v9s agree Co keep cha=r syscoms properly
maiacaiaed.
T`te proper-? owner agraes Co submit CO SC. C--at: CuunC7 Zoning a
csrci=-cation fora, signed by Cho owner and by a =as-car plumber,
lour oyman plumber. rascrtccad pLumber or a Licensed pumper wart-
f?taq chat (L) the on-sica wasctiawacer disposal system Ls:Ln procei
operaciag condition and af'car insaecCLon• and pumoLag. (L_ nec-
essar7) , =!Iw septic tank is Less than L/3 full of sludge and scum
Car_if_caeion form Jill be sane aporoximaeal7 30 days prior co
three year ezpiracion.
I
1:41!;Z. Cho uadersLgned. have read cite above requirements and agree
co cnai :caim the ot_•race sawago disposal syscam Ln accordance •atch'
Cho standards sec for_h; harei:t. as sac by cite WLsconsin Depart-
mane of lacural lasources. Carzi_°icacion fora *use be comoLecad
and returned co the Sc. Croix Councl Zoning Of_Lae within 10' days
ac the three fear ez?ir~~cioa data. 00,
S ire. Gr
Sc. Counc-r an-n:4 U l ! sae
7.U.
4amftto-C. '17. 341 a L 3
7 7
APPLICATION FOR SANITARY PERMIT
S T C - 100 '
This application form is to be completed in full and signed by the owner(s) of the
property being developed. Any inadequacies will only result in delays of the permit
issuance. Should this development be intended for resale by owner/contractor,("spec
house"), then a second form should be retained and completed when the property is
sold and submitted to this office with the appropriate deed recording.
- - - - - - - - - - - - - - - - - - - - - - -J,/- - - - - - - - - - - - - - - - - - - - -
Owner of Property 24,0&SW / ~A)6lL
Location of Property , ~4 jqVJ tt., Section ~q T 29 N - R 1 W
Township 064Os0 10
Mailing Address `(p 17 LAwaz L AVE
/7 U'o _5(op 6uX -S7-/O ! (o
Subdivision Name 7-
Lot Number /
Previous Owner of Property ~IoC-ax T
Total Size of. Parcel AC-1
Date Parcel was Created" I di 9
Are all corners and lot lines identifiable? Yes No X
Is this property being developed for resale (spec house) ? Yes X No
Volume R 9 and Page Number 'Z-7 as recorded with the Register of Deeds
INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING:
1. Warrant
2. Land Contract
3. Other recordings filed with the Register of Deeds Office
In addition, a certified survey, if available, would be helpful so as to avoid delays
of the reviewing process. If the deed description references to a Certified Survey
Map, the the Certified Survey Map shall also be required.
PROPERTy OWNER CERTIFICATION
1 (We) cent ()y that af-e statements oh this 4otcm ante •tn.ue to the best off( my (ouA)
Iznowf.edge; that I (we) am (ahe) the owner (s) o{ the pnopenty desc&ibed in .th.ivs
inAonmati.on 4onm, by vi t_ue o4 a wann.anty deed Aeeotded in the 044.i.ee oA the
County Req%Aten Deer/t, as Document No. A19V 638' : and that I (wo )
pt"- en tt y own .th.e ph.oposed site 4on. the sewage ispob system (on I (we) have
ob.ta.i.ned an. e. m me.nt, to hunt w4th..th.e above de~seAihe.d pnopeAty, Kon the
conA-t,taction v{ sa.i.d s yste.m, and the same has been du.P_y ne.eonded in the 046ice
oA ,the. County Re.gis.teh o4 Deeds, as Document No. !~9j to 34? .
SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE)
&-3-4?-tp
DATE SIGNED DATE SIGNED
STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER
ADDRESS
SUBDIVISION / CSM# LOT #
SECTION. T N-R W, Town of
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this-form.
Provide 2 dimensions to center of septic tank manhole cover.
. .
BENCHMARK:
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING-TANK INFORMATION
Manufacturer: Liquid Capacity:
Setback from: Well House Other
Pump: Manufacturer Model# Size
Float seperation Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
Width: Length Number of trenches
Distance & Direction to nearest prop. line:
Setback from: well: House Other
ELEVATIONS
Building Sewer ST Inlet: ST outlet
PC inlet PC bottom Pump Off
Header/Manifold Bottom of system
Existing Grade Final grade
DATE OF INSTALLATION:
PLUMBER ON JOB:
LICENSE NUMBER:
INSPECTOR:
3/93:jt
I -A
c -
I~ 1 a
Qu e v
5
CZ *t %0
S
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G
a- "q X ~ .
I
i ~ ~ S a ~e 1 o
►y i
e
I
1
J G~ ~ II
~
<,ti
~ ~
. °CroSS S~c~'IOf, p~ ~ ~e1~ S,~st•r'~-~
• • Q Y~d~J ~o Yl~q t r
y
froth Alt Inla1► And OD►►rvollon pipe
J1y r x
• UGfsO~'1~ - /~Q~~ Approvle Vent Cap
• ' {/lntmum 12' ADOYI
rlnel Grad.
20. 42' Above Pipp _ 4' Cost Iron
To Met Orede Vent Pipe
w.rn NeT Or Srntn.tk Cevvtny
1wift 0 er2plo'prepale
Ot~nt►vllon
Plp! e e e --Tee ►
5' Aoare'ete !
Oen.el% Pipe ° Perlereted Pipe below
o -Ce.gtino YuminUtnO AI
Bottom Of System
ILIC.0 Ion
SOIL FILL
DISTRIBUTIOM PIPE
• 74 APPROVED .svil-uCTIC COVER
OR 9" OF S'rFtA4J
2" OF AGGREGATE
'x'~, OR MARSFI R&J
L'E V . OF ~ 0 Plz-2r/a AGGRCGI%T ~P•V i,~
F EE Y
OISTR16UTIOW PIPE TO BE AT LEAST IUCHES BELOW OR1GIMAL GRADE
AQU AT LEAS'I'to 11JCHcf, BUT 1.10 MORE THAN tit IMCI1ES OF-LOW FIfJAL CMADE
MAXIMA Da i OF F-XC.AVATIOP FROM ORibWAL 6RAK WILL BE -.2- IIJCHCs
7vHirluM OEM of EXCAVATION rAOM u~I(,WAL GRAPF- WILL »c ay INCs.ICS
StG1.1C0:
LICCuSC t1uMeE12:
DATE:
twat r Wisconsin Department Relation Relations SOIL AND SITE EVALUATION REPORT Page 3 of
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. #
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
Lv Carter GOVT. LOT SW-4 1/4 NW 1/4,S19 729 ,N,R19 7R(or) W
PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUED. NAME OR CSM #
66 Strawberry Ln. 1 n/a n/a
I W ST ATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE RJOWN. NEAREST ROAD
Iu so, WI. 54016 (715)'386-5669 Hudson Strawberry Lin.
ki New Construction Use [X[ • Residential / Number of bedrooms 3-4 [ [ Addition to existing building
[ ] Replacement [ [ Public or commercial describe
Code derived daily flow 450 gpd Recommended design loading rate . 7 bed, gpd/ft2.8 trench, gpd/ft2
Absorption area required 643 bed, ft2 563 trench, ft2 Maximum design loading rate . 7 bed, gpd/ft2 .3 trench, gpd/ft2
Recommended infiltration surface elevation(s) 98.18 it (as referred to site plan benchmark)
Additional design / site considerations additional borings to soil test of 4-1-92
Parent material stream terrace Flood plain elevation, if applicable n /a It
S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U= Unsuitable fors stem I~ ❑ U
30 S
~@ ❑ U S O U S❑ U ❑ S ~U ❑ S fr U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texfure Structure Consistence Botxtdary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed rench
J>. •ar
6 1 0-13 1 3 2 none sl. 2/f/sbk mvfr c/s 2/m .5 .6
2 13-24 10yr4/4 none sl. 2/m/sbk mvfr g/w 1/m .5 .6
Ground 3 24-60 7.5yr 4/6 none Is. 0/sg ml g./w n/a .7 .8
elev.
101.36 4 60-82 10yr5/4 none cO.s. 0/sg nl n/a n/a .7 i.8
Depth to
limiting
factor
i
t
f
,
Remarks:- enil taQYa Anna sky clear sunny temp +20 f
Boring #
1 0-12 10 r3/2 none sl. 2/msbk mfr c/w 2/m .5 1.6
r 7 2 12-24 10yr4/4 none
sl. 2/m/sbk mvfr g/w 1/m .5 .6
3 24-36 7.5yr4/6 none Is. 0/sg ml g/w 1/f. .7 .8
Ground
elev. 4 36-66 1 r5/4 none co.s. 0/s ml. /w n/a .7 1.8
19~ 98
5 66-80 10yr5/4 5yr3/4 on rock
Depth to S. 0/s ml n/a n/a .7 .8
limiting
factor
66" L
Remarks:
CST Name:-Please Print Pho Gary L. Steel 715-246-Q00
Address: 1
4 2 AV: I~ew Richmond LL _.54017
Signature: _ .
-1.3. 7?O~STNumber.
.1 1
PROPERTY OWNER Ev Cartnr- SOIL DESCRIPTION REPORT Page 4 of 4
PARCEL I.D. #
Boring # Horizon Dapth Dominant Color Mottles Texture Structure Consistence Bandary Roots GPD/ft
In. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. Bed Trerxh
8 0-12 1 3 2 none Lore 2 m sbk mfr /w 2/m .5 .6
2 12-24 10yr4/4 none sl. 2/m/sbk mvfr g/w 1/tn .5. .6
Ground 3 24-52 7.5yr4/6 none Co.s. 0/sg ml g/w n/a .7 .8
elev.
99.441 y 4 52-75 10yr5/4 water at 52" S. 0/sg ml n/a n/a .7 I.8
Depth to
limiting
factor
Remarks: _ site suitable for in-Around pressure sytem,
Boring #
Ground
elev..
tt.
Depth to
limiting j
factor i
Remarks:
Boring # !
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
i
Ground `
elev.
tt.
Depth to
limiting
factor
Remarks:
j i_, ~t✓r.. v.. Madison, W1 53707
WisconsM bftpartment of Ind atio Page of
~.Labor ar-l human Relation, (Attach Soil Profile Locn Map - To Style - On 11 Separate, Signed Sheet)
hreol M
~O ateaa s
wtwn au uram un u» ofv "~e`i:NES
fop~sr-~ eY.1r011
Zrr +rmlr ~'y' ~S rJ CJ'rI~TLe~ a oweu roux w.ler
u110~m)tr rtN Q,1 e ~N opfe Sol ~ 6"'0
r d S71PAu>/3~~'ie y - ,yltem Loa my Hate u\ a Derr 'tr q. t. tr ay,~f I~ S 7
opt an A,pect
~ar.r a aru -r~
J / ~ ~ ' ~ V~ • tlem OewneUy M Utpt l
of eya eunplwrl r W Taws OF ri/tJOSO t1 s--~~Z Loadin
r por sac,' 1 Q r T Z Remarks: clayskins Goading
I' Mottles Structure
In. Munscll Qu S: Cont. Color Texture Gr. ,t. Sh. Consistence ~o BoC~ar eoret off and other
Horizon Depth Dominant color
44 M 2- _
?Ile
2. 16, 4p -I
L14 P0,0
skins Loading
x'14 VA 71/0•1.) -
- - Remarks: clay
ore% ' Mottles Structure
horizon Depth Dominant Color u. Sz. Cont. Culor exture Gr. S-z. Sh Coniistencr Roots Ooundary_ u ocher rP
In.. _ Munte~ t ] ~s / f 5~~ /1vf t~l~, Z..vt Q s
0-13 10Y1- .4 ve
4 41
Y4 V
y Vs- Remarks:•claytkin% F
ma-ww Suucture - ' Horizon Depth Dominant Color Mottles tn, Munscll u. Sz. Cont. Color TextuSh Roost BC nda poret pH snd other r -Fw/s
Sh C 44, y 1-0 Z.w.. _ s
6) /0
z, 2.7-lep 7-S' 0S d~-~ ;;ew ul try CS
A4, PC
0.1 `t:-' YM r Y om /
77.
l//1 r/ON - Remarks: clayskins ~Lo~adingN
7 Monies Structure ~ ^w ores Hand other .GND/1t.?
Horizon Depth Dominant Color
In. Muntell u. Sz. Cont. Color Texture Gr. Sz_Shy Consistence Roots 80Sry
~0 3, s l f 56,E ~1a~ v'ie' G
S-30 /oyrf a f~ /r
0-sy /0►,(' S~d S ''''''cam s .►rp~ S. f ~_f
/0 Yt
r ,
11
25*
Remarks: clayskins --Loading
Structure
tiu .z
dion+ Depth Dominant Colo Mottles
I 1 In. Munscll u. Sz. Gont. Color Texture Gr, Sz. Sh. ,Consistence Roots Ooundry mores pH and other - GPD/lt
yip L Z f . ~S 1, { S/~ M+ll~le 7n'' es
Ics
HOMESI'f E SEPTIC PLUId81NG CO. ,S
i oy.0'NEIL RD., HUDSON. WIS. 54016
fiOB[RT ULBRIGHT 7l' 2• `/S?
f
I ;f, 1.1ASTC R PLUMBER LIC. NO. 3307 M.kf;.S.
' tI In ALLE't S OF-SIGNER LtC. II0.000Gt
uoAlll Atfnarkf
Nor /Iy ~a~.ts . • ~ '/.~,~c,~•!•~o-e ~u~ s Ivor ~~.tEv ~~r.. ~t.~.,;~ D-~ ~
-e` :o4J.c~t_w 's ✓,y r., s t• v cv .ter
Gyoop A~ 7x
7~ESrxori 1~1u tM,`4•Si~ufif'%~ tf' A,t llfdr- rZ) tiSTr of
y 7,
oU~ 49 ~~•r s 7-0
oleo uru r> S 7'r.c S S ~ti ~s~D ev
~T?~ ti ~-~o•v t! IA.)
Other Site featurm
CST /
Uate S. nrJ 3 Telephone No,
lnmtingfactorsiDepl : CSI Signature 9 i
N
%so-lijo IN 910"1
'A ~ ~ ~ ~ r t 3~~ rE
O~
N
? t o , T ,v to ~L
• In 1"
(b
S
`O r-
' 111"'
1 0
c ra
n b ; -
L IN
t
c
o
JZ w r. 'r 'o y Ut L.. L R V
O. O O C (a, r 16
r~ t
DILHR SANITARY PERMIT APPLICATION
In accord with ILHR 83.05, Wis. Adm. Code COUNTY
7 5f 6 y- d, v
=now
STATE SANITARY PERMIT #
-Attach corrfplete plans (to the county copy only) for the system, on paper not less than ❑ 1~ 41 S"
8'fi x 11 inches in size. Chec 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
Qr SW %4 NW%4,S To7,N,R /9 or)W
PROPERTY OWNER'S MAILING AgD SS LOT # BLOCK # -j tA A(0/7 44 re / v e 1
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR t;SM NUMBER
O O/7 S7)`Pywb:4r» rot r~
II. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD hh
State Owned VILLAGE p/'1 5 M w 13.4 V.
Yl^,
❑ Public Y-t' 1 or 2 Fam. Dwelling-# of bedrooms AR ZION W: 44ig ds
L TAX NUMBEK(S)
111. BUILDING USE: (If building type is public, check all that apply)
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 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1.~ New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit _ Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ® Seepage Bed 21 ❑ Mound 30 ❑ 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
dy 660 REQUIRED (sq. ft.,)t) PROPOSED (sq. ft.) Gals/day/sq. ft.) (Min./inch) /8, ELEVATION
°T 8(° ` • N 7g ?Sd Feet /0 . - Feet
VII. TANK CAPACITY Site
in gallons Total #of Prefab. Fiber- Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tans Tanks structed
Septic Tank or Holdin Tank als a k- .
Lift Pump Tank/Si hon Chamber I + El I Ej 1:1 1 F-1 - El LJ
=F==F
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Prin Plumber's SignatreOTZA^-A-~ Stamps) UP/MPRSW No.: Business Phone Number:
Ga u t n Pa tie r.~ IS~3 71s- a*-a``ss,
Plumber's Address (Street, City, State, Zip Code):
17419 ,rte .,4e Aiij 4ar- .5
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved S itary Permit Fee (Includes Groundwater Date Issued' issuing Age t Sig a No S mps
Surcharge Fee)
Approved ❑ Owner Given Initial 1
Adv rse 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. Yrouk sarritawper€rit may be renewed before the expiration date, and at the time of renewal any new
criteria in the Wis(;ur,sin Administrative Code will be applicable.
3. All revisions to `'h",s permit must be approved by the permit issuing authority.
4. C harm -y in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBC) 6399) to be
subm tef o the 4o Lnty prior to instaliatiQp.
ma stained. The tank(s) must be" ptilti - 1 a lic:en ed
5. onsli?% systems must be' proper. i
pumper whenever necessary, 'usually every 2 to 3 years. _
6. If you have questions concerning your onsite sewage system, contact your local code d_' or or thb '
State of Wisconsin, Safety& Buildings Division, 60,3-266-3815.
T..ol be complete,andf ccurate 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 `bb`in964li9d.'
11. 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 intcrn^ation requester, In #1-1.
V11. Tank information. Fill in the capacity of every new and/or existi- tank,'ist the total gallonE. '?umber of
tanks and manufacturer's name. Indicate prefab or site cor st uz;t-. d and tank material. Comr:ete for all
septic, pump/siphon and holding tanks for this system. Check t:w erimentai approval only it tanks received
experimental product approval frcrn DILHR.
VIII. Responsibility statement. Installing plumber is to fill in nan,+:~. li:rrtse 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.
vorT'[?:0e plans and specif;catiorl5 not smaller than BY2 x 11 inches r?u,~t he submitted to the county. The
plans must include the foiiowing: Al plot p!an, drawn to scale or with o~ople"e dimen -ians, ~oc tion of
hosdir,g ink(s), septic tank(s) or r,,ther treatment tanks, building sk:,vurr , raelis; water mainsiwater service;
streams and lakes; pump or siphon tanks; distribution boxes; soil :b4r,< +ri ,re svsterns replacement system
areas, and the location of the bui!d;n- g served, B) horizontal and vertical r'.Iev_l i reference points;
C) complete specifications for pumps and controls; dose volume; elevation dilferences; friction loss; pump
performange curve; pump model and pump manufa urer; D) cross s ction of the soil absorption system if
re wired b the count E) , soil test dat a a'*jk Jor and F).a11 kf nfofmati '
A Y Y; n
GROUNDWATER SURCHARGE
1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of
regulated practices which can effect groundwater.
The monies octlected thirough h*Se-,S+J%charges are use,,! fn 9!c.tjnd;,
waler',~.br#tamfnlt;,G I hives!! rions and establishment oT
.
*
1 e
SBD-6398 (R.11/88)
JLD HR SANITARY PERMIT APPLICATION COUNTY
In accord with ILHR 83.05, Wis. Adm. Code
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than
8% x 11 inches in size. ❑ Check if revision to pre4ious 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
%4 %,S T N,R E(or)W
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
i
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
El ITY
VILLAGE ' NEAREST ROAD
II. TYPE OF BUILDING: (Check one) ❑ State Owned ❑
❑ Public ❑ 1 or 2 Fam. Dwelling-# of bedrooms T AR EL TAX NUMBERO
III. BUILDING USE: (If building type is public, check all that apply)
1 ❑ Apt/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
30 Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. ❑ New 2.E] Replacement 3. ❑ Replacement of 4.0 Reconnection of 5.E] Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit _ Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In-Ground 420 Pit Privy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
14 ❑ System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. GALLONS PER DAY 12. ABSORP. AREA 3, ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE
REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION
Feet Feet
VII. TANK CAPACITY Site
in al Ions Total #of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper.
INFORMATION New xistin Gallons Tanks Concrete structed glass App.
Tanks Tanks
Septic Tank or Holdin Tank
Lift Pump Tank/Si hon Chamber 1 t
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Print): Plumber's Signature: (No Stamps) MP/MPRSW No.: Business Phone Number:
Plumber's Address (Street, City, State, Zip Code):
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (NO Stamps)
A
roved Surcharge Fee)
pp roved owner Given Initial
Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
D-63f~8 (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 date; and at the time of renewal any new
criteria in the Wisconsin Administrative Codo will be applicable.
3. All revisio,)s to this permit must be approved by the permit issuing authority.
4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Rerr,-.wal Farm ( I-D 6399) to be
submitlF- to the, county prior to instaila ion.
5. O n,>ite sewage systems must be properly maintained. The sc-pti: tank(s) m,,,s! be ltcM , d by a licensed
purnper A:vheneve.r 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 systen, information. Provide all information requested in ##1-7.
VII. Tank inform i-its ,ii ins capacity of every new and/or c, xfsfirg tank ;ist the total number of
tanks any: a rufacturer's name. Indicate prefab or site constructed and tank material. Complete for all
septic, pu siphon and holding tanks for this systern. Check t:,r F -imental <:.,proval orl, it tanks received
ax.perimei :roduct apps-uvai from DILHR.
Vlll. Responsibility statement. Installing plumber is to fill in name, lir,r-nse number with appropriate prefix (e.g.
IMP, etc.), address and phone numb~,,!i, Plumber must sign appiic Lion torrn.
IX. County/'Department Use Only.
X County/Department Use Only.
Complete plans and specifications not smaller than 8% x 11 inches mist be submitted c, the county. The
plans must include the following. A) plrt plan, draAr, to scale ^r 'ovith cctr iplete dirne,nsi Dris, location of
hoinr ,ra tarl'c(g? sep<i:, tank(s) or other treatment talks; building we!!s; water ai-,t; w:,ter service;
s1.~-,am- wlf-r I_ak• ~`!!rr.p or siphon tanks; distribution boxes! soil j , .r)" ^fltlr? systenl`>; )lid!; r`f'!lt system
w13 s . i,..:r; of iIie -Du 'tun C .i#..rved; horizontal and Yii:;ts iatlon r'e 'r , ,
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 prac?ices which can effect groundwater.
The rsFc-vies roilected through these surcharges are usc~d'f>r !11 71,- i , g°;s; -Tvate,, r r9nr(-
watef contarnination investigations and establishnler;t i stan•; }.''CfS
SBD-6398 (R.11/88)
+ :EffILHA SANITARY PERMIT APPLICATION
In accord with ILHR 83.05, Wis. Adm. Code COUNTY
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than /
8% X 11 inches in size. ❑ Check if revisi on 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
T , N, R E (or) W
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
CITY NEAREST ROAD
11
II. TYPE OF BUILDING: (Check one
El State Owned ❑ VILLAGE ? , ('3
t
❑ Public ❑ l or 2 Fam. Dwelling-# of bedrooms- AR EL Yfh M R(
111. BUILDING USE: (if building type is public, check all that apply)
1 ❑ Apt/Condo
2 ❑'Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational facility
3 ❑ Campground 7 ❑ Merchandise: Safes/Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. ❑ New 2.E] Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit # - Date Issued
V. TYPE OF SYSTEM: (Check onlyone)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 El Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
120 Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
140 System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE
REQUIRED (sq. ttJ PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION
C Feet Feet
VII. TANK CAPACITY Site
in allons Total #of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper.
. . j
INFORMATION New Existing Gallons Tanks Concrete structed glass App'
Tanks Tanks
r
Septic Tank or Holding Tank
Lift Pump Tank/Siphon Chamber
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Print): Plumber's Signature: (Np Stamps) MP/MPRSW No.: Business Phone Number:
Plumber's Address (Street, City, State, Zip Code):
e1JA
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved-- Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Sign re (No S mps
¢f 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 8, Buildings Division, Owner, Plumber
INSTRUCTIONS '
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new
criteria in the Wisconsin Administrative Code will be applicable.
3. All revisions to this permit must be approved by the permit issuing authority.
4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be
submitted to the county prior to installation.
5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed
pumper whenever necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code administrator or the
State of Wisconsin, Safety & Buildings Division, 608-266-3815.
To be complete and accurate this sanitary permit application must include:
1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of
where the system is to be installed.
IL 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'h 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 numb=~!r of
regulated practices which can effect groundwater.
The monies collected through these surcharges are used for monitoring gre. ,rydwater, gicun.d.-
water contamination investigations and establishment of standards.
¢ SBD-6398 (R.11/88)
Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 3 of 4
Laba!andr .;Man Relations _
Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
' - COUNTY
St. Croix
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
Ev Carter GOVT. LOT SW4 1/4 NW 1/4,819 T29 N,R19 XIK(or) W
PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
866 Strawberry Ln. 1 n/a n/a
STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE DOWN NEAREST ROAD
I
t~u~Son, WI. 54016 (715)`386-5669 Hudson Strawberry Ln.
ki New Construction Use [x] Residential / Number of bedrooms 3-4 [ ] Addition to existing building
j ] Replacement [ ] Public or commercial describe
Code derived daily flow 450 - gpd Recommended design loading rate • 7 bed, gpd/ft2.8 trench, gpd/ft2
Absorption area required 643 bed, ft2 563 trench, ft2 Maximum design loading rate .7 bed, gpd/ft2 .8 trench, gpd/ft2
Recommended infiltration surface elevation(s) 98.18 It (as referred to site plan benchmark)
Additional design / site considerations additional borings to soil test of 4-1-92
Parent material stream terrace Flood plain elevation, if applicable n/a ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U= Unsuitable fors stem I" ❑ U ARS ❑ U iRS ❑ U 0S ❑ U ❑ S faU ❑ S iaU
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
`...6...... 1 0-13 10 r3 2 none sl. 2/f/sbk mvfr c/s 2/m .5 .6
2 13-24 10yr4/4 none sl. 2/m/sbk mvfr g/w 1/m .5 .6
Ground 3 24-60 7.5yr 4/6 none Is. 0/sg ml g./w n/a .7 .8
elev.
101.36, 4 60-82 10yr5/4 none co.s. 0/sg nl n/a n/a .7 :.8
Depth to
limiting
factor
)R9.
Remarks: soil t-PRt dnnP 1-15-93, sky clear sunny temp +20 f
Boring #
1 0-12 10yr3/2 none sl. 2/msbk mfr c/w 2/m 1.5 1.6
7 2 12-24 10yr4/4 none sl. 2/m/sbk mvfr g/w 1/m .5 .6
3 24-36 7.5yr4/6 none Is. 0/sg mI g/w 1/f .7 .8
Ground
elev. 4 36-66 1 r5/4 none co.s. 0/s ml g/w n/a .7 .8
100.8 a
5 66-80 10yr5/4 5yr3/4 on
faces rock S. 0/sg ml n n/a .7 .8
Depth to
limiting
factor
v
{
Remarks:
CST Name:-Please Print Phoge' 2~OG rJV f~
Gary L. Steel 715-246LZ
Address:
1554 200th. AV. New Richmond Wi. 54017
Signature: r
1-23- j~ ^ 29 ST `L
PROPERTY OWNER Ev Carta t SOIL DESCRIPTION REPORT Page 4 of . 4
PARCEL I.D. #
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots G PD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tnerch
1 -12 1 3 2 none L. 2/m/sbk mfr /w 2/m .5 .6
8 .k
y;...... 2 12-24 10yr4/4 none s1. 2/m/sbk mvfr g/w 1/m 5 .6
Ground 3 24-52 7.5yr4/6 none Co.s. 0/sg ml g/w n/a .7 .8
elev.
99.44ft. 4 52-75 10yr5/4 water at 52" S. 0/sg ml n/a n/a .7 ::.8
Depth to
limiting
factor
2"
Remarks:.. site suitable for in-ground pressure sytem
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
~.:,vti \:i}:•}:::iii
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(8.05/92)
-V'L. c""'""' Madison, WI 53707
Wisconsin [apartment of industry,
(Attach Soil Profile Location Map - To Scale - On A Separate, Signed Sheet) _
labor ark Iluman Relations page / of
s ~ M q_l
O , r+ uaUOn D+u urlenl Un Urt or Vt(lttalwe orer Parent Mauna
/fr+,~ ~f,EtS ~v `'!1/eTiE/e P am E tratwn
ttmuttJ~ a ow~ ii un water
utto`m,t~r~/ rtu pA ~Q GdJ / Vpsoti 4!i , 5yo/C~ b
d ^rr~~`~~~~~ .yflemloa ~nyRaltm a onrPntr q. l.Ptr ay ZE r '7
at Arco No
J ^ : , f Tit°til~sl s z C /
Zpu,: G~O/ ope an Aspect
ST" Y, t ~f ysum l eumtuy an Dept
tot tepa Dercn~ eon T Zy~ / W -row-"" df Ii/vDlO J S.r Q~Z
ter vo r $ G • 1 C(, r - Remarks: clayskins Loading
Mottles Structure H, and other GPDIh.~
Horizon Depth Dominant Color
In. Munsell u. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots 8o~nsar Dores p
61
/0 Ye Y-2- 2- j
bY,e 316 0
s o (f,
*79 -r6
Ii 24 _Ir
- - / c-/- v4 Pe U
,
_ Remarks: clayskins Loading
Moles Structure ores 7i and other GPs)/It
Horizon' Orpth Dominant Color tt Roots /S G
In Munsell U. Sz. Cont. Color Texture Gr. Sr. Sh. Consi_tence Bo~r -
d_ , -3 y~ f, /5 1, f sb,- .--P4 r. f4 2-A
S
13r S 4 r2 S /Y CX
7, 5 le S/
L7 a _ - - - - - _ - - =-1
1 ~/C vim, i nil Mottles J - Structure - ounda Roresrk : alndskins GPD/h 7
Horizon Depth Dominant Color
In. Munsell U. Sz. Cont. Culor I Texture _Gr Sz. Sh_ Convstence Roots B - G
D_~ p 4"" v /'k'_ Zcwt = S
8 - 2-s / AYR
Z aZ-3lo 7,5
'e _ - -1- d - r S ~.<Auf 04 CS
1-3 Loading
Structure Remarks: clayskins
Horizon Depth Dominant Color Mottles ores H and other - _GPD110 -
In. Munsell u. S Cont. Color Texture Gr. Sz. Sh. Convstence Roots Bo~r~ry
Co u rP'w /S
/s w, ► S
30-SV -114
S '
y-gyp /o Y"e S/F 5 -
i - - - Remarks: clayskins Loading
r;urizon Depth Dominant Color Mottles - - Structure
In. Munsell u. Sr. Cont. Color Texture Gr. Sz. SSh. -Consistence Roots B ~ndn(d'ary ores Hand other GPD/ t.
i
f s I,T
L 2
I yIp 2-
1 , d
~S
/0 Y4 31ep
C
1-101'k-SViE SEPTIC PLUtABING CO.
HUQSONWIS54016
.
ROBERT ULDRIGNT
,;<i },gn;TCR PLUMBER LIC. NO. 3307 M.P.R.S.
tl Ith:,Tl,LLE-{ R DESIGNER LIC. in. 006w t .
L
~ i}+ddrtional Remarks:
~1ta ~1
~i ~ U~oof~ s' fl T ` ~ o~vvc~e 's i,U s~•s r~ c'~ ~v .vrr- ~xcr-.
.0t At
i
OVA 4314170K Se7Z7- s 770
Co tt u~ti ID.U~ L /N d ee Ux.,, r/ _C sys r~~ S,¢S~D Oct 9 ~ Z/SF•
r
Uthnr Site Features:
~ ,
Z'~V?M CST M
CST Signature Date Signed Telephone No.
Limiting Faclors/Deplh:
t90 0)30 IN 01090)
0
it
3- ~
0
c o
r ~ Z ?4f~
'I
o /jsus ie
/0/>'
,n C
e ~
~ O c
1
I
e
~1 r 1
In rj6
t I a
y - r-41 k
T '
r
0 G3
L-.z
.00D
c.. -c w Y _ p 2. J Z R`
It
Tt T, n
r ~7Dnao o
c
YN
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~ I b O ~ ~ ft~ ~ls
b
cl,
_t
wt~ v..~••.. Madison, WI 53707 rtment ' labor ar-f Ilum an Relatfonsduury, Page of ' -
(Attach Soil Profile Location Map • To Scale - On A Separate, Signed Sheet
ParentMatena t
J r lvaion Dal-- ~'reN lan Utt or Vtprtatwt ortr 5 G
1', 1 7iP so
'iu rrrttl ::~j! C ~TL P n f tvauon
rfj~.trmategt; a ow~ ii un water
~ppAA tl GAJ /~vpsoti Lvi . Ss~oiG. S
J~ICr1 Lf~~t!-~/~ / rtl¢m loa any Hatt in • ont Ptnr~t t. Per +r~£,f~ S r 7
, aru Fio. a t , f Teti/-~t~ S ' O n
■
Zou..w C 46`01y, f. - - _ opt an AtPeCt
v tJ / t Of t ' ~ Y- {j ~ - _ yttem 4nurntuy •n Uept
lot tepa oe,cnptron W 7`OLJ ✓ O/- f/vOlo r .2- - s-- Loadin
Remarks: clayskins - g
r r Sir- 1 q '
Mottles Structure ores pH arttf other GPD7ft.z
Horizon Depth Dominant Of _ (a
M. Munsell u. Sz. Cont. Color Texture Gr. Sz. Sh. Consis_ e1~c? A ° Bo~Sa`
1, it ;ham iMrlf/.~
/o Y,P S'
%Oye 3/G /S
.4 -Y
Loading
11A 7-1 '
- - _ _ Remarks' clay skint
uoilt
Mottles Structure ore% r,11 ando.her
In. Munsell u. Sz. Con1. Color AA Gr. St. Sh_ Consistence Roots _ ftoQ~L s'
HID rizon prpth Dominant Colo( T
0 31& 57
-2 s 4ura Cf . 00
f 1 .33 7. SyR yG _
C ~z '7SyR
Remarks:'clayskins Load;r.y
Structure ores pH and other GPDIIt?
j HoY rizon Depth Dominant Colo( Mottles
In. Munsell -le r_Sz. Sh Consistence Roost B~t•' p -
(u. Sz. Cont. Culor --xture G
F /s f, sh C 44, v r i>
0Y
8.z r-
z/4) yR~ -
L 2 3~0 ~ C 5 ' 5r . ~ ~ ~ r• JjCS1 ~ C ~ tT
Al,
Remarks: clayskins Loading
'IF 'v
De GPD71l.~ -
Structure ores H and other
th Dominant Color mottles
Gr. 5z. Sh. Consistency Roots Boundary
Horizon l
In. . U. Sz. Cont. Color 1.1-le
Mun~____ -
;1V"
0-)5 /o yR 31 441 v'_
. /-s
L-f-
-30
-
. s.
~5 0,
a 3, f1,7 A.) - - - - -Y r - - - - Loading
I _ - - Itrmarkt: ciayskins
Mottles Structure
tiurizon Depth Dominant Colo( u. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Oounda~ ores Hand other GV t.f
In. Munsell
pit
/Z - 10 1 3
13
HOMLSfi E SEPTIC PLUMBING CO.
O'NEIL RD., HUDSON, WIS. 54016
IIOHEHT ULDRIGHT
r;; ?.16STC R PLUtABER LIC. NO. 0307 M.P.R.S.
i +n ;Tnl_LC"l R DESIGNER LIC. 110.00GS3
A
~dditionil Remarks:
&qs 40
Nor s AT" ~C a~v.,vt*•7e s
OVA 7-0
_ Tro,~,} ~N Leo v-v D S~ rr _c S~',S' r ~ " Bfsirv
Ulher Site features:
i
72, ZIP2-
+ Uate SignrJ Telephone No. CST /
Li cling Factors/oeplh: CSf SSignature
t m ~ n
-.00.1.130 IN 011901 d Q I
70 ~ ~
O
11 y
O
i
r
R
~ O
e v' A
Oco ~ C
~ b ~ • N~ s~s~ra o ~ ~
Jr r
6 70 c b
O ~ p y 144[ ~ c'° ~ j % _ A Q~ \
Tia
03
1 - - -i ca1
p t n
o t,
(z L-,;o
le -
Os -v Q a G o
' °o 00 0 x o .
I O °O
N
t` ~ ~ ~ q c ~ p ~1 0
t %4t:
7
_ .~_f
. ~ n ns H ~ ~ ~
Z ~
WWiib onsHumr RntofIInndustry, SOIL AND SITE EVALUATION REPORT Page 3 of 4
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 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
Ev Carter GOVT. LOT SW4 1/4 NW 1i4,S19 T29 N,R19 x>£r(or) W
PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUED. NAME OR CSM #
66 Strawberry Ln. 1 n/a n/a
I ST TE zip CODE PHONE NUMBER ❑CITY VILLAGE KJOWN NEAREST ROAD
lu so , WI. 54016 (715)'386-5669 Hudson Strawberry Ln.
kiNew Construction Use [x) Residential / Number of bedrooms 3-4 [ ] Addition to existing building
j ) Replacement [ ] Public or commercial describe
Code derived daily flow 450 gpd Recommended design loading rate • 7 bed, gpd$-13 trench, gpd/ft2
Absorption area required 643 bed, ft2 563 trench, ft2 Maximum design loading rate.7 bed, gpd/ft2 .8 trench, gpd/ft2
Recommended infiltration surface elevation(s) 98.18 it (as referred to site plan benchmark)
Additional design/ site considerations additional borings to soil test of 4-1-92
Parent material stream terrace Flood plain elevation, if applicable n /a It
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT GRADE SYSTEM IN FILL HOLDING TANK
U=Unsuitable for system 115 ❑ U S ❑ U S ❑ U S ❑ U ❑ S ~U ❑ SU
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 Tmnch
k 1 0-13 1 3 2 none sl. 2/f/sbk mvfr c/s 2/m .5 .6
2 13-24 10yr4/4 none sl. 2/m/sbk mvfr g/w 1/m .5 .6
Ground 3 24-60 7.5yr 4/6 none Is. 0/sg ml g./w n/a .7 .8
elev.
101.L38, 4 60-82 10yr5/4 none co.s. 0/sg nl n/a n/a .7 :.8
Depth to
limiting
factor
_?$2_
Remarks:- sail tests done 1-15-93, sky clear sunny temp +20 f
Boring #
1 0-12 10yr3/2 none sl. 2/msbk mfr c/w 2/m .5 `.6
117 2 12-24 10yr4/4 none sl. 2/m/sbk mvfr g/w 1/m .5 's.6
3 24-36 7.5yr4/6 none Is. O/sg ml g/w 1/f. .7 :.8
Ground
elev, 4 36-66 1 r5/4 none co.s. 0/s ml /w n/a .7 .8
( ft$
5 66-80 10yr5/4 5yr3/4 on rock faces Depth to S. O/sg m1 n/a n/a .7 .8
limiting
factor
Remarks:
T Name:-Please Print Phone:
Address: Gar L. Steel 715-246-6200
1554 2 . AV,&,__I ew-Richmond, Wi,. 54017
S' nature:
s3 [;rat. 5T Number:
1-2393 2293`
PROPERTVVWNER Ev CarttsP SOIL DESCRIPTION REPORT Page 4 _of 4
PARCEL I.D. #
Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence BourrJary Roots GPD/ft
in. Munsell ()u. Sz. Cont Color Gr. Sz. Sh. Bed Trends
>S 1 -12 1 3 2 none L:. 2 m/sbk mfr /w 2/m .5 .6
2 12-24 10yr4/4 none s1. 2/m/sbk mvfr g/w 1/m .5 .6
Ground 3 24-52 7.5yr4/6 none co.s. 0/sg ml g/w n/a .7 .£3
elev.
99,44ft. 4 52-75 10yr5/4 water at 52" S. 0/sg ml n/a n/a .7
Depth to
limiting
factor
521,
Remarks: site suitable for in-ground pressure sytem,
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
13
Ground
elev.
It.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-9330(R.05/92)
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CroSS S~c~1of-, o~ IJC17 SyJer-)
Q nd /teW Co Ulr1qye r
X4/7 " 414 Aa4 Fraih Air Inialt, And Obtsfyclifon Pips
I `t uds~ ~z ' ~~0~7 j ADpror64 V.nl Cap
/ Nlntmum 12- Abo.e
final Grade
• 20- 42" ADb.a Plpr _ 4- Coil Iron
To final Orede Vent flips
' Mw1h Ito? Of synth
'win 2- Aggregate -
O.er Plpa
OIIIr lbrlton •
Pip,, o 0 0 Tee '
ti- Aggrsgala
~emelA Pipe o Pulorsted Pipe Belo.
o Co.pting Terminating At
Iloltom Of System
Pro 0 c ID P'(11,1
SOIL FILL
DISTRIBLITIO►.I PIPE
j+ APPROVED ,SyJ pACTIC COVCR
'M1AT~RI1~t OR 9" OF STaAw
2' OF hGGREGAll E -r„ OR MARSH 1tAj
'^Y L 0F2'/2 AGGRCGATE
ELEV. OF I6' FEAT--~
3 3'
DIS'1-RIB'JTIOU PIPE TO BE AT LEAST IIJCHES BELOW ORIGIIJAL GRADE
AUU AT LEAST ZO IIJCHES BUT 1,10 MORE THAf.1 42. Mr-RES OELOW FILIAL GRADE
rIAMMUM DaPtH OF EXC-AVATIO0 FROM ORIGINAL 6c)"\K WILL BE -.2_ IUCHES
MINIMUM 05PT-1i OFEACA\/ATIOJ H\OM C,~I('If1AL- GRAPE WILL BC ay 1IQCHCS
SIGUCO:
LICCUSC AIUMBER:
DATE: Ito
I