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Home My WebLink About034-1008-20-000 y z ~ c a~ a~ ~°0 N oN C O O U 00 0 r., N c ,O C O N a v ~~co EM N'tE 3a~y3a.N y N N U L L N m~ o carp c 0L.. p 0 vi r c U E O O N 00 -pO cL j 0-0 y• N O A O j N 0 0 N cl. N am a 3 9 Q O C _ c O - 4 N N O 0) N Y L= t4 -Y i .C1 .C. U N C E L N C N Co a N E 7 C: L N LL o 0 O O'000 t L ~O M Na E =5 M ~2 L C (p u m a 3 E C- C U 'C3 O C7 N Eac° E Q °°a'oE~2 °ccaUm N U N CO O V1 O C\l _ 0 E 'O N (n a co C Q) C', N E C E v t- N L) c (D N O O. O l d ~a C U O i O d Z N(2 N E US F- r- V as _ o d N E O U O ~ N N N O L L p N C -0 v m E ~ NV N ~ N ~ L 7 A N ~ N w O. • ►•sl ~ .c C E A Q Q 0 0° OU O ® Z Z c M fC E E N CL m ~y m .0 X~ D o a co N FN- E ci vEi U O O O • ►~.ya o a a a A G. ' 3 in J U C9 rn rn (D " co c0 O O Av > 00 co o O rn 00 L rn rn E N N _ O n 0 0 0 a \ t~5 22 CO N 00 6) `1V ~ ~ w d ~ O C O N a N O O C N N C N O O E a o o C O O Or] O N p H O Q) N N Cz CL 0 0 m O O G N N C_ CL t N N N O- N C U 0\ to C - O O C M N W FL- t OJ O LE 0) co t a N E E N eC E L: m 0 CL CD a c E ~ •c li r- 0 = ~ U a m li O N 0 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER , ,ff ADDRESS 6 SUBDIVISION / CSM 43~-~QQ g- ~O LOT SECTION. T;2!7 N-R__J,-5"' W, Town of f • 2A.16. (a o ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM o E 2,0 p rhb 10 , O'' INDICATE NORTH ARROW 41~ Provide setback and elevation information on reverse of this form- Provide 2 dimensions to center of septic tank manhole cover. 3 BENCHMARK: ALTERNATE BM: - 1,V V SEPTIC TANK / PUMP CHAMBER / HOLDING..TANK INFORMATION / Manufacturer: 4vLiquid Capacity: ~O~a pDD Setback from: Well ~2 6 House '7L ! Other Pump: Manufacturer r/ Mode 19 .SO Size L Float seperation g Gallons/cycle: 2 Alarm Location ;SOIL ABSORPTION SYSTEM Width: Length Number of trenches Distance & Direction to nearest prop. line: Setback from: well: !~3 House Other 3~a ELEVATIONS Building Sewer 6 ST Inlet. 71, ST outlet PC inlet PC bottom Pump Off Header/Manifold O Bottom of system Existing Grade 9S" J'' Final grade DATE OF INSTALLATION: "oZ l f~ PLUMBER ON JOB: ~ LICENSE NUMBER: M A INSPECTOR: 3/93:jt yr 6a ~p~ 3,Qy' part~~stTrLD 04.29.1'KIVAI E3~c ~~lf~i El~lfAvE' County: -A .Labor Human Relations INSPECTION REPORT Safety and Buildings Division (ATTACH TO PERMIT) sanitary ermit GENERAL INFORMATION Permit Holder's Name: E] City El Village Town of: State Plan 1- 54- o.: lJ - U o? _ RPRINGEIRT-D T BM ev.: Insp. BM Elev.: IBM scription: Parcel Tax No.. 014-1 008-20-000 _ syig, TANK INFORMATION ELEVATION DATA A9300264 161"A3 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic /-e_Vr Benchmark _ 3.56 /pd.9 Dosing 1-n f U,/ CL 13, U7 671, 3~l Aeration Bldg. Sewer 77, HHoldiag- St/ Inlet ~a 717S ' TANK SETBACK INFORMATION St/ Ht Outlet Vent ir Ito ntake ROAD Dt Inlet TANK TO P/ L WELL BLDG. A Air Septic > la, >,/OD, -7 ~ NA Dt Bottom ~o< Dosing NA kagLoV Man. 5.s6 ~ Aeration NA Dist. Pipe 5, SS 9~ OZ~ Holding Bot. System 26 PU NFORMATION Final Grade .j~ Manufacturer /'V dr,0"K 6- 4 - 0- errand O\ d 1-s, ~O Pro Model Number S s~ ;OtGPM 13' TDH Lift0,(09 Friction ljO S stem TD LFt 1 Head < 66 Loss ~ Forcemain Length 311 Dia. Dist. Towell>/O~ ~ <u . jSOIL ABSORPTION SYSTEM BED/TRENCH width Length i No. Of T enches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSION SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHI Man urer: SETBACK CHAMBE Number: INFORMATION Type O f X17/01 A Model System: fieu,Jd T DISTRIBUTION SYSTEM Header / Man old q/~ Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dla.' Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over „ xx Depth Of .OVI xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed/ Trench Edges 1-2 ~P l Topsoil ❑ Yes No ❑ Yes ❑ No A-1 e, Y- COMMENTS: (Include code discrepancies, persons present, etc.) ~~~~,r+P``;r LOCATION: SPRY GFIELD 04.29.15.60, SE, SW,110TH AVE. 1 G r C/=t_ Ct f " tI _ ~2 Plan revision required? ❑ Yes ❑ No - Use other side for additional information. 9 W11,91 S D-671 (R 05/9,Yr Date Inspector's Signature Cert - No. 3 / D i ADDITIONAL COMMENTS AND SKETCH 4e i, SANITARY PERMIT NUMBER: SANITARY PERMIT APPLICATION y OILHR In accord with ILHR 83.05, Wis. Adm. Code COUNTY STATE ~@N ARY PERMIj # -Attach complete plans (to the county copy only) for the system, on paper not less than dpS.(JJ 8% x 11 inches in size. ❑ Check i 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. Q 3Q PROPERTY OWNER PROPERTY LOCATION oM S L! / eN SE '/a ,sldS T,Z9, N, R 1-5- &ft) W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # 6 0 7` v 2 CITY, STA E ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER e ~aad c/f s d/,~ 6 s'z/ II. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD ❑ State Owned VILLAG N OF: E s ' Y- v ) ❑ Public ®1 or 2 Fam. Dwelling- # of bedrooms -2 AR L TAX NUM _ 1 Q O 111. BUILDING USE: (If building type is public, check all that apply) D 3 'y / 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. Z Replacement 3. ❑ Replacement of 4.E] 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 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 Q 7S' „3 7 4 , O-f ' Feet /00, ?Feet VII. TANK CAPACITY Site in ailons; Total of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank Mve. _T L, Z a 'e Lift Pump Tank/Si hon Chamber O 1 / 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/MPR8YWd8' Business Phone Number: Plumber's Address (Street, City, State, Zip Code : IX. C UNTY/DEPA TMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater a e is ue issuing gent ture No to Approved ❑ Owner Given Initial Surcharge Fee) ~WGP Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration 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 TransferiRenewal 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% 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 they location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. - - - - - - - - - - - - - - - - - - - - - - - GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) 4 SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations i l:~t;embe.r 1E;, 1993 205 West First titre .t Rout o- ii, Box 8072 Hayward WI 54843 SMITH PL GALE SMTTH ,1228 HWY 170 GI.ENWOOD CITY F;~. 5401:5 RE: PLAN S93-21i13() FEE RECEIVED: 1.80.00 WHIT EN, THOMAS 43 W,4,29,15W SE TOWN OF SPRINGFIELD COUNTY OF ST CROIX MOUND SYSTEM Jhip Dias).:(rtmont has reviewed the above-ceferencecl suiimit.t a t . Condit.i:nal ltproval is hereby ranted for 'the system plan submittal. All noted items must tie corrected. The reviow and approval ct the system is based on chapter 145, Wisconzii.n Statutes,, p:nd chapters; If HR 83 and 84, Wisconsin Administrative Code, and ie; contingent; upon c;ompiiF>nce with any stipulations shown on the plan:. This eystem has ,tot befn revitE,ed f(ir the code requirements set fe: th in chapter ILHR tit or in chapters ILOR 501-fi4, Wisconsin Administrative Code. This plan submittal approval will c:xp. re tw,-, y-ar,s from the approval date:, or if a. sanitary permit_ is obtained, I')1an apprr.-:al will expire on tl~e day the i~it.i3) sanitary permit expires. 'f he lief-used t,)iumber responsible Cor this installation shall keep one set of ? lar►s s. ° th t,110 Department `s stamp Of approval at the constrl:zction site. The irtst tl.;_rr shall. notify t;he- appropriate inspector when inspections can he n1a.d . All permits re;luived by the city, vi.ilage, ~,owrlsiai.t, or county shall. be obtained prior t_i it~stallati.on. Inquiries should be directed to me at the ns,mber 1 -sted below. Please refer to the plan number :shown above. Sincorel, , ~Wastewa.t.J Specialist. Senio# Section -f Private Sewage (71.5) 12f-5-2514 . Friday' n 204F;It/ 1 BBD-7N71R. ~INII y MIENER PA~e /o~lf 111INETE RT. 2 (Hwy. 10) MAIDEN ROCK, WI 54750. 715-647-2311 • FAX 715-647-5181 4 i - t A4 RIM 10 e ~IV1 Pf,l V -FE FxDNA4!',S'6 1 € a ,o - ® c~trdiz i 777, rl.~ 1 i DEPARTMENT OF ! 'i')USYRY LABOR ANO~ HUMAN RELATIONS ;DTVIS&O OF, SAFETY AID BlltDINGS z i 3 e f -s a _ _ , 3 ; - poo Awole - . 60 ~Do se t,41V fe Al -1/ , E ; I . E i a; { 1 E 3 .r - Page 2 Of / Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe Medium Sand G Topsoil F E D C- % Slope PRIVATE SEWAGE SYSTEM Bed Of - 2 %2 Force Main Plowed Aggregate From Pump Layer C ®~.dc~EOfacr~[c~ / I R 77N r D 2.0 DEPARTMENT OF INDUSTRY LABOR AND HUMAN rLoAsf OI,] ,ection Of A Mound System Using F DIVISION OF SAFETY AND BUILDINGS A Bed For The Absorption Area G A L~ Ft, N ;:k~ zm-- rg ~O R B Ft. License Number: M O I- 0m-kiL -t . , 7~ 3 J Ft. Date: 61 K Ft. L /~O F t . W`~: Ft 30, of Observation Pipe-~~f Till l--------- nAA Force Main 10 From Pump Wf Distribution Bed Of 2 - 2'2 Pipe Aggregate Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area 3 21030 I Page 3 ~f P ;ivArE. SE`j%,A E SYS] Eft co it clIio3na C~ Perforated Pipe Detoil r 1 . L ~ L L DEPARTMENT OF INDUS RY LABOR AND HUMAN RELATIONS DIiON OF SAFETY AND BUILDINGS 'vw Perforoled, C RE ONDEN End Cop PVC Pipe Holes Located On Bottom, Are Equally Spaced K`F pvc, Mp,N stribution Pipe Losl Hole Should Be Next To End Cop End C.op Distribution Pipe LOyoul P /7 7cA Ft. I S X /0 Inches Y _ Inches Hole Diameter _ Inch Signed: / Lateral 02 _ Inch(es) License Number: ✓rb 9e? Manifold Inches Date: 7, 9q~ Force Main Inches of holes/pipe Invert Elevation of Laterals ~-ft. -IIE,- S93-21030 PAGE --7Z- OF PUMP CHAMBER CROSS SECTION Aw, SPECIPICATIOMS ' VENT CAP 4"C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING JUNCTION BOX. MANHOLE COVER 25' FROM DOOR, j WINDOW OR FRESH 12"MIU. :p AIR INTAKE GRADE y" MIN. / x1l S r1 _ IB"MIiJ, PRIVATE SE\N&qV S U4 7=1 ki. h. A p 1 IAILET p FUG R i<1 L . I III V y DEPARTMENT OF INDUSTRY LABOR AND HUrtF;ELAT{'ONS I II APPROVED JoINT A DIVISION OF SAFETY AND BUILD IN Ss I III APPROVED 301V1, W/C.I. PIPE I 1I ( W/C.I. PIPE EXTENDING 3' I II ALARM EXTEa101~IG 3' ONTO SOLID SOIL I 11 ONTO SOLID Sol LE O SPON c NC i I I oN I. ELEV. Z9D/F T. ROPERLY BED ALL TANKS.' ILHR 83.15(4)(c) WAC PUMP OFF A CHOR TANKS AS NECESSAR.y,, L, 1 I=HR 22 1 14) (b) CRETE BLOCK RISER EXIT PF-FMITfED OIJL4 IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC SPEGIFICAT11064 " DOSE 6 DD -AUKS MANUFACTURER: v ~~Se WMBER OF DOSES: _PEP, DAy TANK SIZE:1L~DT1 4~ 6DO GALLOWS ` ote. VOLUME 10°K VO~~ VUL. M e AJ . ALARM MANUFACTURER: S.T~ ~,e~ / 6 114CLUDING BACKFLOW:._ GALLONS tt 3U5 MODEL IJUMBER: /z/ 1 : A=/ A L - J oz y ~'~►~AC1T E$ - iAICNES OR ~ L Ou i SWITCH TYPE: M ~R C'G1 I INCHE3 OR GALLONS .<•c~ M A OR .1.~_~L LO7 PUMP MANUFACTURER: O H MODEL NUMBER: D= ~ .iNCF~kS OR GALLONS -57P D .6-0 SWITCH TYPE: S.T LL e G' Z'Ro DAD t: PlIMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE-2;?,-Of rpm INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE DETWECIJ PUMP OFF AIJO 015TRI6UTI6f.1 .FEET 3; E ET + MIIJIMUM NETWORK SUPPLY PRESSURTE F 2:► T„_- + 32-7 FEET OF FORCE MAIN X F/ . FE ET 5. ZZ loo fEFRiCYloli . TOTAL DYNAMIC HEAD , FEET 3z- y: ~•~3-2 30 INTERNAL DIMEIJSIONL OF TAIJK: LEIJGTH ~i1~T1D•H " ;LIQUID DEPTH ~ "o, / 7 /p SIGNED: ~ K/.e/ LICEMS 11 6E R. P~o ~0 .DATE:z4oLz /v EFi W OSP33 OSP33AB SPZ50W&100H MAX. SOLIDS 5/8" SPHERE MAX. SOLIDS 5/8" SPHERE MAX. SOLIDS 3/4" SPHERE 1 /3 HP 1 /3 HP 1 /2 AND 1 HP 1750 RPM 1750 RPM 3450 RPM Y • Available in automatic or manual • Available in automatic • Available in manual or automatic • Non-clog bronze impeller • All bronze construction • Automatics feature reliable • No suction screens to clean • Non-clog bronze impeller diaphragm pressure switch (1 /2 HP), • Oil-filled, double ball bearing motor. • No suction screens to clean wide-angle float switch (1 HP), both with built-in overload protection • Oil-filled, double ball bearing motor with piggyback plug-in • Carbon/ceramic faced mechanical with built-in overload protection • Dual shaft seals standard. Seal fail- shaft seal • Carbon/ceramic faced mechanical ure sensor capability available (wired • Great for septic tank effluent, shaft seal to alarm device) on manual pumps elevator pits, high capacity sump • Reliable diaphragm switch • Non-clogging 2-vane cast iron service, industrial circulators • Completely field serviceable sewage-type impeller • Reliable diaphragm switch with • 1-1 /4" NPT discharge • Rugged cast iron construction piggyback plug-in • 1/3 HP, lo 115V • 1 /2 HP (SPD50H) and 1 HP • Rugged cast iron construction (SPD100H) motors. Ball bearing u • Completely field serviceable construction and oil-filled 1 NP Mel, lynge opt.) _ f • 1 / ' _jVv -Aid T1"1 tlis 3bV-end 30 •fy1/3 HP, i 0- 5 or - q .1:HP 1o hd 30V, 460V or b. r=''`.Ex+k A($''+. fir s~f`' ~ 'r~ ' ~~L"",t 82 Iu 44+ +fl ~ 24 E'. L 92 i_ D Q 8 8 X16 1 - - 0 0 10 20 30 40 60 60 .0 0 10 20 30 40 50 60 00 24 48 72 96 120 144 CAPACITY-U.S. G.P.M. CAPACITY-U.S. G.P.M.APm(-U.S. G.P.M. ,r--210 3 0 4 i` WSCONM SOIL AND SITE EVALUATION REPORT Page-,ofd DILHR in accord with ILHR 83.05, Wis. Adm. Code COUNTY • d V*ffk U CF 61/1.WlHA7QL - Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but C Ol not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or P CEL I.D. # o dimensioned, north arrow, and location and distance to nearest road. 0 OQ g o?o APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWS BY DATE PROPERTY OWNER: PROPERTY LOCATION GOVT. LOTS 114 s'A~/1/4,S T ,29 N,R /.3AWW PROPERTY OWNER:'S MAILING ADDRESS LOT # BLOCK # SUED. NAME OR CSM # CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE OWNV NEAREST ROAD 6/_ ' ' 00 od ej; !,v ' (7lr) 6~- .s';2 SP /c° //D -7`/f VQ_j [ J New Construction Use [XI Residential / Number of bedrooms [ J Addition to existing building pQ Replacement [ J Public or commercial describe `Code derived daily flow S'O gpd Recommended design loading rate _ Nfl bed, gpd/tt2trench, gpd/ft2 Absorption area required bed, ft2 trench, ft2 Maximum design loading rate _&A-bed, gpd/ft2_&4 trench, gpd/ft2 Recommended infiltration surface elevation(s) It (as referred to site plan benchmark) Additional design / site considerations " o SI-0 Vol ?~='/L 4 Z/A/ale9 h e c/ Parent material GL A C/.4 L t'~Ll Flood plain elevation, if applicable It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE FAT-GRADE SYSTEM IN 1 HOLDING TANK U= Unsuitable fors stem ❑ S ® U ® S ❑ U ❑ S C2 U ❑ S 1R U ❑ S U JRS ❑ U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends Ground C "kO_r ~3 elev. gy~Lft. - Depth to limiting factor 19, Remarks: # f~a R Q N 57`1C frV wh aiy w e-- Boring # ' -.2 .1!E = .4 ' VO-40 2•_,r 2r C S C M Ground 5- lev. q/,6 it. Depth to limiting facer O _ _ V /7 va w 7"- Remarks: . 110A i .7-0/y .5t CST Name: Please Print L e s J 7..1 Phone: o2 Address: A 2 w 1767 6t w O o~ B/ X" J el.? Signature: / Date: CST Number: X68' ,PROPERTYOWNER T6hf SOIL DESCRIPTION REPORT Page? of 3 PARCEL I.D. ar' / 2 O Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trey F F5 43 Ground /,2- Z /yJ/d SG aS6k C ✓FS elev y it. Depth to 1 limiting factor J~ Remarks: ffOX/,a ion/ 5' y &.,h ell w e 7 ' Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: 0 1 - - - - - I - I - a i - R i I ' I I i I I i I L i I, I I I l I ~ i, ~ C , I ' I I I I ! ' i I I I I _ I_ I i I I ~ I _ I I I I I I I I ~ I I i I ' I I I 'I i I I- r F ~ I I I I , ~ I I I I~ ~ I ~ I I i ~ I I I J ~ j r r I I I I ~ i - I I I I • I I ~ i II f r I I I I I I r I 6 I _ I J I I I ~ I I I ~ I I I N SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County ' w OWNER/90'i R Z d 0-A .S_. 17 L 7&_ A/ 0 ROUTE/BOX NUMBER ' 9!i 6 - //O ✓ e Aire Number ~ d to d CITY/STATE ,,j/ ZIP c PROPERTY LOCATION:'._,_r- k, 90k, Section, T~N, Town of PR~'N Fl el-dl 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 's'e t'ic tank pumper. What you put into the system can affect the .unction- og tine septic tank as a treat- ment-stage in the waste disposal system. St. Croix County residents-m„,.,Z be eligible to recieve 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 .sys't'ems agree to keep their system properly maintained. Y Zoning to St. Croix Count a The property owner agrees to. submit owner and by a mater plumber, certification form, signed journeyman plumber, restricted bcted the 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. 0 I/WE, the undersigned have read the above requirements and agree 0 to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconnssi Depart- b ment of Natural Resources. Certification form must completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration. date. / SIGNED DATE St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 386-4680 Sign, date and return to the above address. STC-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 house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of property -r!j PAW A S kJ Location of property!2~• 1/4 .5 Wl/4, Section T_gg'N-R /-4'-W Township S,t7,QiN sr-~ L d ~T Mailing address _ 9L/ 6 - /~Q ~ de Address of site -5-4M -f subdivision name Lot no. other homes on property? yes-__4_No Previous owner of property ZJS,S e ~~o iq S en/ Total size of parcel _ ~O C e Date parcel was created / Ll Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)? Yes No Volume /33 and Page Number ~42t/' as recorded. with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER & THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available; ;would be helpful so as to avoid delays of the reviewing process. If the deed description references to a certified survey Map, the Certified survey Map shall also be required. PROPERTY OWNER CERTIFICATION I(we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No. e 7 0ii , and that I (we own the ) presently proposed site for s ewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of County Register of deeds as Document No. -2-2-21- 7/ i. - biz Signature of ap~licant Co-applicant 5-~gnat! 3 Date oDate of signature i Stack No. 13011 _ w MATS BAS OF WWONM - MM 11, DOCUSAM NM VOL ~~J 33 =~°E ~ ~ LUM co""' w4wwar W4cmpomia --y,,~~ TM SPAM RESgWo FOR RECORDMA DATA n x . OO,~a~ Russell Thorsen' an Luci a sen REGISTERS OfHCE~ ' Thor on husband and wife as joint tenants and 'r" ST. CROIX Cgs,WIS. ("Vendor". Rec'd.for Record M 'r wl»Hnraoeamaniaad n day 0t August A.D. 19 p`Parchaser'..whether one or mars}. ac Ss 30 A t~ Nor: ' 7-1 - Vendor sob and agrees to convey to Purchaser, upon the'prampt and faR perfor- mance of this caatesct by Purchaser, the foltowing property, together with the agMar at 3 z r' nuts. profits. fiztoses and other appurtenant interests (alt called the "PropeRty"1 St cxni x , Canty, State of Wisconsin::, r' yk . `u :xr a[iUIkU TO ;!~tix r ; Y 1 SAj of SWk of Section 4 ft of N k of Section EXCEPT W 2, rods thereof, N 30 acres `of NW3r of N4J' of Section' 9, , ALL in 29-15 -f- - -2' Tax Hey No. The vendor agrees that commencing January 1;;1982, that uporc the request a the purchaser, parcels of twenty. acres.or more-Shall be released upon the. payment of ,$800.00 per acre, all payments received t0 be applied to the outstanding principal balance thus reducin said principal-balance by x!' ike w` amount. -If the-parcel to be released.shal 'incline they farm buildingi'ar ho the Land Contract shall be paid iu full with the, vendor then, executing and delivering to the `purchaser, a warranty deed's, is fee simple, on the property All additional. abstracts, deeds, partial releases or;legal costs incurred' because of any partial releases shall be-{paid for by"the purchaser,'F All rents being received on the property shall.be pro-rated as'of the date , g as per paragraph five Pa8a two of the addendum of the farm 0ffei:5 of closing to Purchase as signed by the; vendor on. July 6' 1981. ~ Tmar k- Y SAYS ~ Yy~~~'~}£j ~ e~~ ' •f . This. ,,-l- ishamel toad property. ' 4 Purchaser agnm to purchasethe Property. and to pay to Veudw at such pt~p As re a s onatt dir e c t e d ti the sum of = 4. , 000.00 io the following manner: i 43-000-00 at the execution of this Contract, and the balance of s1Q2,4~ 04 together with interest hom date It } paid` har`sd on such portions as remain from time to time uapaid,.at the rate of 8% Y per cant per annum,. nndl Said principal and interests shall be payable in semi-annual payments of $5,132.00, beginning on the first day of February, 1982,,;and semi-annually thereafter, provided theentire purchase.money'•and interest shall be fully paid on or, before February 1, 199. Itbeing the specific 171 intention of the parties hereto that. the entire purchase money.and`interest e,_ amortized over a twenty year period with the full and final balance to._be.. du r on or before fifteen years from-, the date of the first 'semi-annual payment.., -Mt ! iC{I~ZOC101411oF1t s Payments shall be applied first to interest on the unpaid balance at the rate fied and then to prindipaC Any amount may be prepaid without premium or fee upon principal at any time after rla 9 of closing .110_L_ e X 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 land in such case accruing interest from month to month shall be treated as unpaid principal) is 1sse than the amount that said indebtedness would have been had the monthly payments been made as first specified above; provided that mthly payments shall be continued in the event of credit of any proceeds of insurance or condemnation, the con- damned premises being thereafter excluded herefrom. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examine tionkept: Should the Vendors fail to make any mortgage and land contracd None payments as they become due, the Purchaser shall have the right to make said payments directly, with the balance owed under this cont c to be then reduced by a like amount. 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. Purchaser shall be antitled to take possession of the Property on ate of closing ,19 81 Out cos (To Be Used in Non-Consumer Act Transactions) i~ *crow LAND CONTRACT - Individual and l;arpor.fA -STATE BAR OF WISCONSIN, FORM NO. 11 - 1977 437 w~•• - 1. 'h,'}''~py~ p ~ f, ti A, ~~».3i ,r ~"',..d f 7 ~j"/fi f r ~ N V to t or upon Vender's newt in p D t6 pay when due an lobos and ouaessmenta kvW on the Propert it and s to Vss~ on *Eiww receipts soei! p~1'ment. x- Ponhasee sd►>i Ioeejl the impeavemsn damp occasioned e:tsetMd Vasdor red r. it against loss or s iaaotee~s Dyed6~ " =oi~ without cWnsurssc% throu& < a% I penis , hpt, Vendoo sMI not raquirs CpV~aA amount more than tY haYtor -rnsura in the ouzo when des. The sha8 antes *8 daatieAasaw ; pavedn1Awifs Purchaser shallpa~r theinwnanosprams ~Intd~ai and. nnieses Yenr~e Othec,rfia f~eea in wdttng. the ori=lnd of all polidN o0weint As plopoo is foyer oti the jfasdor'e shalt ba with Yandor. Purch~aster shaltInsurance peompttlr~to e ed °Lat~i shvt=~~ to restoration or r'spair of the PrOPa tY a ~eg~ree in ~r's~R'atio¢ t0 Dt ea• :f .,k^,?k ~ °i'?'~Y damspd~ o commit waeiar aw:lusts. to be committed on the to the =t=' 10! to the fees fMm NOW superior Ron of this t° fsoantao~d~ocad )leap- z yy _71 W_" i obsreat and other moneys shall bs in11I► paid and sn conditions sW ho fiiE demand azwote and Yeodor agrws that P the purcb.epOe. _ Psrelaar. a ~ , on nt deliver to do ~q r pertccrosd will on and in the manesd. alt liens and encombeanoN. liensas Warrant~► aficnple4 of the Praprt~r t ssem~raeosf Y W' -tons and r by P~uchaseryana " created .ti p4 3v -77777-71 when dun: or is t Phrcbassr !three is of Lhe essence cabs otdefault in the payment of any principal or interest - of Purchaser, and such default shall oonthme for a period oC '4" t1w-perimmanced-464, oll the mqy~ atassfia option, the contract at an end, all rights of the PurchaNr ender this sorb- ' 45 - most a sec tai amounts paid by Purchaser her etIndec forfeited, the same to remain Vendor's p as rental of aid to fulfill this agreement; and Vendor krthwith and without and+ led damages for the 6901i compm* ' notice have od""reentry; or. at the option of Vendor and' without notice to Purchaser, notice being beree h waived. the anionai: of unpaid prindpaf elll be d°tO have become due and payable; in case such option s dew the and interest togetllpe with `4~, which map be or have been paid by Vendor as herein authorized with areemeats at the r*aJoces Woll be collectable in a suit at law. car by foreclosure of this contract in the same whole of nt~pald bad.'beee`due at the time when any such default ooenrsd, and the hr with unprdd ylrincand intsrest' afi the sums so disbursed with interest as afareNid. In cNS aif ' ' Ilerentuder~ whether abated or not, all expenses, including reasonable attarasy's hl- a6 in case of lud~e°t shall be included therein. alt become Mme as incurred; r 'r jjpon j' ' ' tar during the pendency of+rnf action of foreclosure"of this Contract, Purchaser consents to the ap• ' the Including homestead interest, to collect the rents, issues. and profits of the Property. poiatt Property, issues. and collected shall be held and applied as the court during thi apeuch action. andin& re?nt,4 profits when so !hall ~ - a` d ' " ' . ,r shall be b~` neon and Insure to the benefits of the heirs, legal representatives, ancoessors sad V r AR a, a~ If not an owner of the property the spouse of Vendor for a valuable consideration joins herein z assigns of VAS~~ is the auset agrees to join loon of the deed to be made in tu>Tdimaiit- l aasesteai bj. alai in the eaecu to rderse is alc ~ x~ ' • ~ 19 gl ,i ~ ~ 1>ereof.) ti KUS r Jlated day _ y- 'RY usae21,Tho ens ,a/k/e RussellYM.' Richard W. Whitten PEAL) sea (SEAL) r r x~: L,3 i11 Tit '~tsen~. . ~ ~ ✓ ~ r ~ , UTHENTICA ACKNOWLEDGMENT STATE OF WISCONSIN Siva q>ees ticated this Ai1son ' " ,1$r $1 of the above named i _ Ryaeof arsen. a/k/a=Russell IM. ,F..., : County: ti ti ThorseW, Lucille Thorsen,, and',Richard. personally ~amebefore me. this day& *•TM i r t es IS the above named /I H a to me known to be the person _ who executad the foregoing TI : MEMBER STATE BAR OF WISCONSIN instrument and acknowledged the same ill not.. e authorized by 1706.06, Wis. Stets.) -County, Wis. This instrument was drafted by , Notary Public My Commission is permanent. IIf not, state ertration data Reskar ' 1S T .An a 125 N. Main St.- R{yer Falla~ WI -5-402-2 (Signatures may be authenticated or acknowledged Both are not necessary.) The use of witnesses is optional. *Names of persons signing in any capacity should be typed or printed below their signatures. r ST. CROIX COUNTY rt WISCONSIN C '_{y`p~ N t h ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 /yYs aAjlr- llm(au,n d May 10, 1993 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An onsite soil investigation of the Thomas Whitten property, located in the NW,NW,, S-9, T.29N., R.15W., Town of Springfield, St. Croix County, WI., has been conducted with the assistance of Gale Smith, CSTM# 1768. This onsite revealed suitable soil for onsite sewage disposal to a depth of 30" while meeting the requirements of the A + 4" rule. This site should be suitable for new construction utilizing a mound septic system having 12" of sand fill. Should you have any questions, please feel free to contact me at this office. ince ely, mes K. Thom son Assistant Zoning Administrator cc: file ST. CROIX COUNTY WISCONSIN Y yy ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 - (715) 386-4680 May 10, 1993 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An onsite soil investigation of the Thomas Whitten property, located in the NW;NW;, S.9, T.29N., R.15W., Town of Springfield, St. Croix County, WI., has been conducted with the assistance of Gale Smith, CSTM# 1768. This onsite revealed suitable soil for onsite sewage disposal to a depth of 30" while meeting the requirements of the A + 4" rule. This site should be suitable for new construction utilizing a mound septic system having 12" of sand fill. Should you have any questions, please feel free to contact me at this office. ince ely, mes K. Thom son Assistant Zoning Administrator cc: file ppppr-- I o w c /.tom m ID (n L S= N C S S cn (D 2 cn ~o :1 SL O m 3 3 A 3 cti cn O h~ N N N Q "O "6 U S O N 4 O (D O O l7 O O n ° ~ O O v O N 3 O 7 N * 00 .w-'- ~y 7 N N > O C N) O D (D N Ln { D fD P' M ! V m y `r' d 00 - W w cri C: j V N N L.w`', O N D I 3 00 ` co ID II (o C', IZ (D co C (0 (D G)- n O C ~~yy m A w a N 0 N 0 "ft. O O O 3 N N N 1' O w N Gt w N ~~11 N ZZ o D D o O o 3 3 a_ CD m w m Co CD N O Q (D N C w CD :E N N O 0 0, N N O N A p Z m 0 (n 3 CA C: 0 _ O (D 0 1 N Z •(n O C O N .O nO CD y 3 cn -I P CD ° m N N N W Z (A a C a 3 i> ° In (D 0 CL C/) cp N O D ? O w D1 n (D 3 D 3 C n y O d C 7 S 0. w <T O (Q (D Qp S, T '.I (D 3 w O Z O O'0.5i~ ° j Ci (D (D o 2 N o' CD fl_ J m O V w Od°O O O O S2~ m a y N (D -0 y t D) w 7N (D 3 V tV O O O ~ o0 A ~ ~ b O (=D A a ti Efl 0 r O O 2 a o ro I O v - VnBANKvcn Vr WELLS FARGO , N.P. RE\iEIV E® HUDSON, 54016 • ~ ' 0759119 1988 FOR DEPOSIT ONLY 06 ST. CROIX COUNTY IWA JUN 20 0 1 L E ALUATION REPORT ACCT #3877919724 #2184 110tn Department of Comm erc ST. CROIX COTn -accorda ce with Comm 85, Wis. Adm. Code Page 1 of 3 Division of Safety and Bui in Gustum Septic Service Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. O /~11 Please print all information. dV Ofd R sewed D Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~zv24 e Property Owner Property Location Whitten, Tom Govt. Lot n/a SWIM, SW1/4, S4, T29N, R15W~y, Property Owner's Mailing Address Lot # Block # Subd. N e or CSM edk' 1 2946 110th Ave. n/a n/a N/A f ~mlzla - , City State Zip Code Phone Number City jj Village > Town arest Road Glenwood City WI 54013 715-265-4521 Springfield 110Th 8treet- New Construction Use: _VI Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial~-Describe: SPA r TtG Flood plain elevation, if applicable n/a ft. rent material glacial till Scc p~ General comments Part oW acres. ecommend oun system along 100.0' contour! and recommendations: Boring ~c F1 Boring # Pit Ground surface elev. 100.7 ft. Depth to limiting factor 15 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 1 0-5 10yr3/2 none sil 2mgr mvfr as 3f 0.6 0.8 5-9 10yr3/2 none sil 2msbk mvfr cw if 0.6 0.8 3 9-15 10yr5/4 none sil 2msbk mvfr cw - 0.6 0.8 4 15-21 7.5yr5/4 c2-3d 10yr7/2 gr. sil 2msbk mfr cw - 0.6 0.8 5yr5/6 5 21-38 7.5yr4/6 cap yr 2 gr. scl 2msbk mfr - - 0.4 0.6 Syr5/6 Boring F id Boring # Pit Ground surface elev. 97.2 ft. Depth to limiting factor 16i in. Soil Application Rate 2 Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boun try Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-5 10yr3/2 none sil 2mgr mvfr as 3f 0.6 0.8 4-1 2 5-9 10yr3/2 none sil 2msbk mvfr cw if 0.6 0.8 3 9-16 10yr5/4 none sill 2msbk mvfr cw - 0.6 0.8 4 16-21 7.5yr5/4 c2-3d 10yr7/2 gr. sii 2msbk mfr cw - 0.6 0.8 5 r5 6 5 21-38 7.5yr4/6 c3p 10yr7/2 gr. scl 2msbk mfr - - 0.4 0.6 5yr5/6 Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 5.30 mg/L and TSS <_30 mg/L CST Name (Please Print) Signature, CST Number Tom Gustum All~ 227618 Address Gustum Septic Service Date Evaluation Conducted Telephone Number N13450 937th St. New Auburn, WI 54757 5/19/2006 715-658-1344 SBD-8330 (R.07/00) >w Property Owner Whitten, Tom psrref ID'#" " Page 2 of 3 3 , Boring ]Boring # 100.0 ft. Depth to limiting factor Pit Ground surface elev. 9 16 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "E02 1 0-7 10yr3/2 none sil 2mgr mvfr as 3f 0.6 0.8 7-1 /2 none sil 2msbk mvfr cw if 0.6 0.8 3 10-16 7.5yr5/4 none gr. sil 2msbk mvfr cw - 0.6 0.8 4 16-30 7.5yr5/4 c2-3d 10yr7/2 5yr5/6 gr. scl 2msbk mfr cw - 0.4 0.6 Boring F-1 Boring # A Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •EfF#1 •Efl#2 F-1 Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Ef#2 ' Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 <-l 50 mg/L " Effluent #2 = BOD5 30 mg/L and TSS <_30 mg/- The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-877 i SBD-8330 (R.071001 Gustum Septic SerWce i I I O OD i I I I I I I I driveway u -4 o cl) u n = I r o m r r ,m CO) 8 8~ v m o 4 I 3 t I g g m ' o I I, 0 Er $ $ I I v w o CA I I T I O I I ,I I ~I I I I ~ o co w b3 m o v i > N I Q w w o I ~ 1 I ~ CD i n3 ~ ; I ; as - c a _ I (D A J $ ai -2 W I g I o Z C.%) D oo n p I I ST. CROIX COUNTY WCONSIN PLAN NG & ZZOM G DEPT. tt tr It u rt r r"" ST. CROIX COUNTY GOVERNMENT _ 1101 Carmichael Road Hudson, WI 54016-7710 f~- (715) 386-4680 FAX (715) 386-4686 COUNTY ON-SITE VERIFICATION FORM m 110A &Y, g eb ~ ,ate ~s pertyOvner,~, J Pro rtyLocation W-1177 Garet. Lot t, 4 5V/ 1 4 S T Z M R E (or) Property wn ers Mailing AIdre Lot # Block # Si bd. PIam3 a ill, lei, jInAw C W>a COY state Zip Code ' Phone !dumber ❑ Cily ❑ Village i5FaP.'vn tgearet Raad WerrConstnrctio Use: f3zsidential Number of bedrooms Code derived design floe: rate E] Replacement E] Publicor commercial -Describe: -__-__R-oo____ - --GPD Parent materi /lliy( ~ - Z CZd Plain elevation I applicable Gf t. eneral comments and recommendations: q- 9 C// rr /i / nZd r. ll Baing ~ Boring Qiyllf f/j ipte L ® C~ ❑ Pic Ground surface eyv..__ft. depth tolimiling 1bclor-------- in. Sail Deplh Dominant Color Redox Descriptian Texture Structure Consistence Boundary Roots GPDtf~ Rate In. Muni Qu. Sz. Cont. Color Gr. Sz. Sh. 'Elffil 'Effi _y ,e 31-& k- 2 2 3 s'/ Z k MA- C rh. are,,: F53 hnAg* sui ng x Ila w1e& 2a2 of- aryhj4 L21r 'e 3.i"dIs ❑ Pit Ground surface elav. ft. Depth to limiting factor in. Horizon Depth Dominant Color Redox Descriptlon Texture Structure Consistence Boundary Rods Sat Application GPi Rate in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. TIM *042 o R3 5 1 2,~r6~ rn es Z w . S 7- d lr~o~ Cum k dr pb CsT #G 6~0~ ✓ RECEIVED '01sconsin SOIL EVALUATION REPOR JUN 0 1 2006 #2183 290th Department of Commerce in accordance with Comm 85, Wis. Adm. Cod Pa 1 of 3 I ST. CROIX COUNTYGust m Septic Service Division of Safety and Buildings Attach complete site plan on paper not less than 8%: x 11 inches in size. Plan must ColInty St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Please print all Information. ft Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). R ! Property Owner Property Location U Whitten, Tom Govt. Lot n/a SW1/4, SW1/4, S4, T29N, R1 Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2946 110th Ave. n/a n/a N/A G a C/ro ? Co Wy City State Zip Code Phone Number Lj City _fj Village A Town Nearest Road Glenwood City WI 54013 715-265-4521 Springfield 290Th Street idw t±' New Construction Use: _(y Residential / Number of bedrooms 3 Code derived design flow rate 45 GPD Replacement J Public or commercial - Describe: Parent material glacial till Flood plain elevation, if applicable n/a ft. General comments Part of 80 acres. Recommend mound system along 100.0' contour. alnj recommendations: V D(~ ~rPrv~c. Il o Aw >J C-60,6-;A O ; 4.e.. ❑ Boring # Boring Pit Ground surface elev. 100.0 ft. Depth to limiting factor 14 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 *Efr#2 X~ 1 0-4 10yr3/2 none sil 2mgr mvfr as 3f 0.6 0.8 2 4-7 10yr3/2 none sil 2msbk mvfr cw if 0.6 0.8 3 7-14 10yr5/4 none sil 2msbk mvfr cw - 0.6 0.8 4 14-18 7.5yr5/4 -3d 10yr712 7,5yr5/8 gr. A 2msbk mfr cw - 0.6 0.8 r5/8 2 gr. scl 2msbk mfr - - 0.4 0.6 5 18-30 7.5yr4/6 7cap.5 yr5/8 2 Boring # Boring f Pit Ground surface elev. 98.6 ft. Depth to limiting factor 13 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-4 10yr3/2 none sil 2mgr mvfr as 3f 0.6 0.8 A,k 2 4-7 10yr3/2 none sil 2msbk mvfr cw if 0.6 0.8 3 7-13 10yr5/4 none sil 2msbk mvfr cw - 0.6 0.8 f2 3d r5/8 2 gr. sil 2msbk mfr cw - 0.6 0.8 4 13-20 7.5yr5/4 7 .5 r5 8 5 20-28 7.5yr4/6 c3p 10yr7/2 gr. scl 2msbk mfr - - 0.4 0.6 7.5yr5/8 Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 <.30 mg/L and TSS <30 mg/L CST Name (Please Print) Signature: CST Number Tom Gustum 227618 Address Gustum Septic Service Date Evaluation Conducted Telephone Number N13450 937th St. New Auburn, WI 54757 5/19/2006 715-658-1344 CRn-Ri io lR 071001 Property Owner Whitten, Tom Page 2 of 3 . F A3 Boring# r Boring Pit Ground surface elev. 101.1 ft. Depth to limiting factor 1$ m• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 *EfW 1 0-5 10yr3/2 none A 2mgr mvfr as 3f 0.6 0.8 2 5-8 10yr3/2 none A 2msbk mvfr Cw if 0.6 0.8 3 8-18 10yr5/4 none A 2msbk mvfr Cw - 0.6 0.8 4 18-21 7.5yr5/4 f2-3d 10yr7/2 gr. A 2msbk mfr Cw - 0.6 0.8 7.5 r5 8 5 21-27 7.5yr4/6 cap 10yr7/2 gr. sd 2msbk mfr - - 7.5w5/8 0.4 0.6 Boring ❑ Boring # Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 F-1 Boring Boring # pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 <150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services 4 need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8771 9nn-8110 M n7/00i Gustum Septic Service I OD 00 - ;GGAS 4106Z ~o 0 .i ` m m 00 m c m r r y Z m 8 S v 4 0~ -Z, -A ~ I n a $ - - m r 0) a l< c ~o 0 D m ~ ~ y ~p O O (n CTl O co O O W c T %OZ adoIS -Q° W 0 1 6.7 ~ 1 ~ %q adoIS 1 I I i I I r w 1 ~ O w 1 1 1 n c f I { t Q a 0-9. ,x (D W~ god a W' tD N o ~ ~ $ a 2 00, D W n v Parcel 034-1008-10-000 08/22/2006 01:14 PM PAGE 1 OF 1 Alt. Parcel 04.29.15.59 034 - TOWN OF SPRINGFIELD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner THOMAS H,&KATHRYN M OTTO WHITTEN O - WHITTEN, THOMAS H,&KATHRYN M OTTO 2946 110TH AVE GLENWOOD CITY WI 54013 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 4 T29N R1 5W SW SW 40A Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 04-29N-15W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1091/010 WD 07/23/1997 914/127 07/23/1997 786/522 07/23/1997 633/438 2006 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 04/14/2006 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 38.000 2,850 0 2,850 NO UNDEVELOPED G5 2.000 100 0 100 NO Totals for 2006: General Property 40.000 2,950 0 2,950 Woodland 0.000 0 0 Totals for 2005: General Property 40.000 3,300 0 3,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00