Loading...
HomeMy WebLinkAbout040-1188-90-008 I STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNERl Ul-~`' ~T7 (,(((~~O 7~yLC~s ADDRESS 3 5w) U« DIZ SUBDIVISION / CSM# 2 (p6 LZ: 4-C(Z,Ce--S LOT # SECTIOT- 'Z% ~N- W, Town of 2 ,*4~ ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 12 4 AJ o bg rn Sao 1 t}1 ~ _ l,~ 9 ~ 1 or1 o ZS PC D INDICATE NORTH ARROW I 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 /y House Other Pump acturer Model# Size Float s~ration Gallons/cycle: Alarm 4!.Zcatjion .SOIL ABSORPTION SYSTEM Width: Length Number of trenches Distance & Direction to~o// nearest prop. line: Setback from: well: lyA 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: f -vv y TV LICENSE NUMBER: 7 INSPECTOR: 3/93:jt L0(iA 101*&rtrrll) % oA1ija$@,C . 36 , T28 . WRM S{ <6rEi§1P£'. E%ive) County: Labor and Hbman Relations INSPECTION REPORT Safety and Buildings Division CT?OTX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Perm it No.: 193 4 73 Permit Holder's Name: ❑ City ❑ Village EVown of: State Plan ID No.: v.: Insp. a Description: 1i Parcel Tax No.: -fv.a) ' TANK INFORMATION ELEVATION DATA A9300133 8 as TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Ido.46 Dosin _ . 57 off. 3 96• 3 r Aeration Bldg. Sewer (Q, ye Holding St/ V Inlet 7 6 L/g TANK SETBACK INFORMATION St/yf Outlet TANKTO P/L WELL BLDG. AirI to ntake ROAD Dt Inlet A-A Air I Septic NA Dt Bottom yl 4- Dosing NA Headerthfta-, Aeration Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade 93.6 Manufacturer Demand Model mber GPM c 3,77 7.~ TDH Lift Friction stem TDH Ft 9,z For emain Length Dia. Dist. To el SOIL ABSORPTION SYSTEM I BED/TRENCH width / Lengt / Of T enches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS No. DIM N SETBACK SYSTEM TO P/L BLDG WELL KE/STREAM LEAC G Manufacturer: C INFORMATION yP T e 0 Gul i /174- del Num er: System: ~ - I 114A -2 HAMBE OR UNIT q7~j DISTRIBUTION SYSTEM 60 It S, Header / Mae4e4d , Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length g~ Dia. --I-/ Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over p ii Depth Over xx Dep Of xx Seeded / Sodded xx Mulched Bed /Uemh Center q-2- Bed /T-rem Edges Topsoil ❑ Yes ❑ o -1 Nn COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: NW NW,Sec.36,T28,N-R19W (Woodridge Drive) at- lee 4247 revlslon eq Ired? ❑ Yes No Use other side for additional information. 9 9 SBD-6710 (R 05/91) Date „ Inspecto Si ~ re Cert No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: /,t 4 SANITARY PERMIT APPLICATION 70ILHR 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 ❑ 43 y-13 8% x 11 inches in size. choc 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 IDG a 10tiAt- Ef I.- PROPERTY LOCATION ( &Lr 61 iN V/'/a (NI/a, S , N, R E (or PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # x $'uA.) vim o ,~S~ J r'n`Lf ZIP 7COPE ,0 ZL PHONE NUMBER SUBDIVISION~I/~utE OR CSM M~~ / n CITY II. TYPE OF BUILDING: (Check one CITY =ayj ~N~EAREST RO/A`D El State Owned VILLAGE ; vW1uA6r- D I MN R~: ARCEL TAX NUMBEK(b) ❑ Public 'Tor 2 Fam. Dwelling-# of bedrooms, P i /')O 111. BUILDING USE: (If building type is public, check T11 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. INN 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 REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/d sq. ft.) (Min./inch) g 7 ELEVAT ON V 2 • [ t /Feet eet VII. TANK CAPACITY Site in gallons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New istin Gallons Tanks Concrete glass App. Tanks Tanks strutted Septic Tank or Holdin Tank 6-64 K F-I Lift P amber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plum is Name (Print): Plumber's Sig lure: (No Stamps) MP/MffBVIFNo.: J Business Phone Number: 6n Plu bar's Addra (Street, City, State, Zip Code): -CL of t IX. COUNTY/DEPARTMENT USE ONLY [0] Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued suing Agent Signature (No Stamps) Approved ❑ Owner Given Initial Surcharge Fee) D ,a f9 A v D r n o~ 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 Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all. septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with 8ppropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 81/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tarks; building sewers; wells; water maim.:/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115-form; and F) all sizing information. - - - - - - GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater.. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. - SBD-6398 (R.11/88) • STC-loo This application form is to be completed in full and signed the owner(s) of the property being developed. Any inadequacies will only result in delays of the c]evelopment be intended for resale permit issuance. Should this house), then a second form should be ret inownectractor,spec edrand ncompletedtwhen the property is sold and submitted to this office with the appropriate-deed- recording. Owner of property 4q, i -rl/ A3 c Location of property/ D 1/4 10V114, Section TN-R~W .Township A C/ ]flailing address Address of site C9 a Subdivision name _0 4-k, l2(~6r✓ 46A 'r-> Lot no. Other homes on property? yes_.2~_No Previous owner of property r- k Total size of parcel Date parcel was created Are all corners and lot lines identifiable?_ Yes No Is this property being developed for (spec house)? _~_Yes Volume z6L ~ No bpd Page Number _ as recorded. with the Register of Deeds. INCLUDE WITH THIS APPLICATION T11E rOLLOWING: A WARIUVIi'Y DLED which includes a DOCUME 11U1•iUIR & THE. SEAL OIL THE r , , ~ NUtiDER, VOLUME AND PACE certified THE. 711E ItEGISTbl OF DEEDS. In addition, a 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 ray (our) knowledge that I (we) am the property described in this information forfi b e owner(s) of warranty deed recorded 'n the office of the County virtue of a Decd; as Document 110. 0 0 County y of own the proposed site for li sewage di p salt system or I (we) obtained an easement ( ) presently the construction of + said run the aande the same described has property, for No. been dul recorded office of County Register of deeds as Document Signature of 'a 1 f3ul(-t Jk;, p~ cant Co-applicant Date of Signature Date of s gnature- DOCUMENT NO. STATE BAR OF WISCONSIN FORM 2-1962 THIS SPACE RESERVED FOR RECORDING DATA WARRANTY DEED 5009' it if r0! 1016PAGE359 REGISTER'S OFFICE ST. CROIX CO., WI Rolling Hills Development, Inc., Rec'd for Record a Wisconsin,corporation JUN 1 T 1993 at 2 : 00 P. M conveys and warrants to Eugene 0. Larson, Don D. Kruger, (,,,,,,,a and Lawrence M. Johnson, Jr., d/b/a Quality Regis ter of Deeds Built Homes RETURN TO the following described real estate in St. Croix County, I State of Wisconsin: Tax Parcel No: Lot Sixty-Eight (68), Oak Ridge Acres to the Town of Troy. F This is not homestead property. (is) (is not) Exception to Warranties: easements, restrictions,'and rights-of-way of record. Dated this / 7 fh day of J KULLP~ ---IN C. (SEAL) / Co- • Richard N. Fox, President (SEAL) rv (SEAL) • Frances J. Fox, Secretary AUTHENTICATION ACKNOWLEDGMENT Signature(s) Richard N. Fox and STATE OF WISCONSIN ss. Frances J. Fox County. authentica this 7f yl I June 19 93 Personally came before me this day of 19 the above named .C. L. Ga ord TITLE: MEMBER TATE BAR OF WISCONSIN (If not, to me known to be the person who executed the authorized by § 706.06, Wis. Stats.) foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY C. L. Gaylord, Attorney River Falls, WI 54022 Notary Public County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) date: , 19 'Names of persons signing in any capacity snould be typed or printed below their signatures. SB2 NTF 0021 WARRANTY DEED STATE BAR OF WISCONSIN Nelco Tax Forms, P.O. Bcx 10208, Green Bay, WI 54307-0208 Form No 2 - 1982 SEPTIC TANK MAINTENANCE AGRE1r. -IT St. Croix County OWNER/BUYER _rL__ A6 ~LT wcr5 ADDRESS: R® 4( 1//t'~:~AIRE NO: LOCATION:..,/U(AJ 1/4, (,(J 1/4, SEC._ 7j(p T ~g N-R~ TOWN OF: 'Tt2~ l~ ST.•CROIX COUNTY SUBDIVISION:_ C L d -C2~f LOT NO. (z e Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you )ut into the system can affect the function of the septic tank as a treatment stage in the waste disposal system: St. Croix County residents may be eligible to receive a grant to help with the cost of the re ltcement o p of a failing system, which was in operation prior to July 1, 1978. St Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to the St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman. plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating 'condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certification from will be sent approximately 30 days prior to three year expiration. I/WE, the undersigned have read the above requirements and agree to maintain the private sewage disposal system-in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification form must be completed and ret..urned to the St. Croix County Zoning officer witl,,i, 30 days of the thr a year expiration date. SIGNED: 1. ' DATE: St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 Wiscopsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page _ of Labor and Human Relations D;vision of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code - counmr Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but St Croix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. If dimensioned, north arrow, and location and distance to nearest road. _ REVIEWED BY DATE APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION PROPERTY OWNER: PROPERTY LOCATION Richard Fox GOVT. LOT NW 1/4 NW 1/4,S 36T 28 N,R 19 )Wl'// PROPERTY OWNER':S MAILING ADDRESS LOT 9 BLOCK 9 SUED. NAME OR CSM u 84 Woodridge Drive 68 Oak Rid a Acres _ CITY, STATE ZIP CODE PHONE NUMBER DT 'stStl bFk[YOWN NEAREST ROAD River Falls WI 54022 (715 425-2100 Woodrid a Drive ~j New Construction Use Residential I Number of bedrooms 3 (J Addition to existing building J j Replacement J Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate .4 bed, gpd/ft2 .5 trench, gpd/ft2 Absorption area required 1125 bed, ft2 900 trench, ft2 Maximum design loading rate bed, gpd/ft2 trench, gpd/ft2 Recommended infilVation surface elevation(s) ft as referred to site plan benchmark) Additional design /site considerations Si if icant more rock is needed to meet state code & system ele vati Replacement will have to 1p a mound Flood plain elevation, if applicable It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT GRADE SYSTEM FILL HO SING 7 UUK ~U ❑ L~ S ❑U ❑S l1 =Unsuitable for system ®S ❑ U ®S ❑ U ®S ❑ U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Botr y Roots P D!Boring # Horizon in. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. ~BG ed I R0 0 i sil 1 m sbk mfr as if .5 r1 1 0-23 10YR 3/2 None t 2 23-48 10YR 4/4 None sil 1 m sbk mfi s if .5 .6.- 2d - Cloud . 3 48-77 10YR 5/6 c elev. gs NP NP 94.0-9t. 4 77-10 10YR 6/6 f1 f is crr 0 m s tnvfr Depth to 5 100-1 0 10YR 6/6 None is gr 0 m sg mfr .4 :.5 limiting factor Remarks: Boring # 1 0-13 10YR 3/2 None si 2 m sbk mfr as if .5 ' .6 2 2 13-4 10YR 4/4 None sil 1 m sbk mfi s if .5 .6_ 3 42-5 10YR 5/6 c2d c1 1 m sbk mfi NP NP - 'Ground 9 lev. 4 57-12 10YR 6/6 None is gr 0 m sg - OiIN6 •5 9e. 37 Depth to 1 w limiting N T factor G Remarks: Eystern has to be at " bel w d i level 8 NON CST Name:-Please Print Phone: I Paul C.J. Steiner 71 A'19=q Address: N8230 Hicrhway 65• River Falls, WT 5402 Sgnature: C Date. June 16, 1993 CSTNumbur: 3074 PROPERTY OWNER Richard Fox SOIL DESCRIPTION FILPvi,+ Page -of PARCEL I.D. t Depth Dominant Color Mottles Texture Structure Consistence Bounciary Roots GPUift-'_ Boring # Horizon in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. Bed , I«i al 1 0-11 10YR 3 1 None sil 2 3 2 11-34 10YR 4/4 None sil 1 m sbk mvfi s 1f .5 11.6 Ground 3 34-56 10YR 5/6 1 f1 sil 1 m sbk mfr s NP- I NP UK ~ 98.00 It. 4 156-120 10Yr 6/6 None is cfr 0 m s ml 4 U%:pth to limiting factor Remarks: Boring # 1 0-16 10 3 1 -None ---5 _:~6 - 4 2 16-40 10YR 4/4 None sil 1 m sbk mvfi s 1f .5 3 40-57 10 5 1f1 N ,___NP._ Ground elev. 4 57-12 10YR 6/6 None is gr 0 m sg ml 1.4 .5 97.98 ft. Depth to IimiGng factor Remarks: Boring # 1 -14 10YR 3/2 None sil 2 m sbk mfr as 1f .5 6 5 2 4-48 10YR 4/4 None sil 1 m sbk mfr gs 1f .5 6 _ 3 8-73 10YR 5/6 c2d cl 1 m sbk mfr s NP NP_ Ground elev. 4 173-120 10YR 6/6 None is gr 0 m sg mvfr .4 :5 94.25 It. Depth to limiGng _ factor Remarks: System has to be below 75" Boring # 1 0-15 10 3/2 None sil 2 m sbk mfr as 1f .4.-..o-5 6'' 2 15-46 10YR 4/4 None sil 1 m sbk mfr gs 1f .4-.-.5.. 3 46-60 10YR 5/6 1f1 cl 1 m sbk mfr gs NP 7NP Ground elev. 4 60-10 10YR 6/6 None is gr 0 m sg mfr .4 !.5_ 95.57 ft. Depth to limiting factor Remarks: - S80-8330(R.05W) HO Y to o L o t (o ~ Ua h Acres . Scale PO' ~ 6m pr~~e way l~rllh ~We ~I G ora00c 71S} u''d xis f,i c~ goa : C )gou5 O c~ S C t i /3.5 'x 2y' SY31em, Pleu 8 9.57' 4 ~ ®~G 516~e i= i w ~ M o~ N d I ~2 Top o CM" J cA o~ N~o Y!a, Lot (o Oah 'dot r4fa~ ES -.)cal VA' POO kjo t g li` 0 Z p G7` G Nil Ila, V1 1 \'t EIV. IO~~ ~llu / Il 1) Of r `Z I Q PAGE OF CrC)SS ~ec~Ion cs Zep Frach Alr Inlela And Obaarvollon Pipe 1 Approved Yam Cap ' Mlnimum 12' Above Flnal Grade 20- 42' Above Pipe -4' Cad Iron To Final Grade Von( Pipe Marsh Hay Of synthetic C.'e'l,,q "ln. 2' Aggregate Over Pipe o1. pipe an o 0 0 -Too pipe 6' Agoregat• _ a Pertaaled Plp• Bator o -Covpling Terminating At i Bolcom Of System ~ c57 P~p~vSC 1J ~Inkl ``qr~,~1{ ~~cJ•'.T ion .SOIL FILL DISTRIBUTIOM PIPE APPROVED SINT4ETIC: COVER c~, ,o o """-MATERIAL OR 9" OF STRAW ors ,%GGR AGATE OR MARSU HAy L e !e OF 12-Z/, AGGREGATE a P DIS-rRl5lJTI0W PIPE TO BE AT LEAST _ IUCHES BELOW ORIGIIJAL GRADE AVU AT LEAST20 I.JCHES BUT 1.10 MORE THA1J 42 INCh'S BELOW FINAL GRADE M, XIMUM © rvi OF EXCAVATioo nom oRI&INA1. 69AeF. WILL BE CIMCHES MKIMUM gCfT1i OF EACA\/ATIOM FROM. C 141WAL (Q;Rapf- WILL BE IMCHES SIGIJEO: Ell DATE' _~(L .Z Wiscoriflm Department of Industry, SOIL AND SITE EVALUATION REPORT Page - of Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Croix Attach complete site plan on paper not less than a 1/2 x 11 inches in size. Plan must include, but St PARCEL I.D. a< not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or dimensioned, north arrow, and location and distance to nearest road. - BY GATE APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED PROPERTY OWNER: PROPERTY LOCATION Richard Fox GOVT. LOT NW 1/4 NW t/4,S 36 T 28 N,R 19 XXK1','/ PROPERTY OWNER':S MAILING ADDRESS LOT rt BLOCK +t SUB D. NAME OR CSM z 84 Woodridge Drive 68 Oak Ride Acres CITY, STATE ZIP CODE PHONE NUMBER N1bQyVMM[3OWN NEAREST ROAD River Falls WI 54022 (715 425-2100 Woodridge Drive New Construction Use Residential / Number of bedrooms 3 Addition to existing building O Replacement Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate . 4 bed, gpd/ft2 .5 trench, gpd/112 Absorption area required 1125 bed, rig 900 trench, ft2 Maximum design loading rate bed, gpd$ trench, gpd/ft2 Recommended infiltration surface elevation(s) It (as referred to site plan benchmark) Additional design / site considerations Si ificant more rock is needed to meet state code & system elevati Replacement will have to a mound Flood plain elevation, if applicable It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM FILL HOLDI.N( TA►4K t1= Unsuitable fors stem ®S Flu ®S O u ®S ❑ U Is oU 0 S U ❑ S Ell. SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Baxxny Roots GP7P ~ in. Muns ell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ITrc+ a 1 0-23 10YR 3/2 None sil 1 m sbk mfr as 1f .5 1_.6.__ 1 2 23-48 10YR 4/4 None sil 1 m sbk mfi s 1f .5 .6 Ground 3 48-77 10YR 5/6 c2d C1 __D - v. -M-tw 94.OSft. 4 77-10 10YR 6/6 f 1 f is 0 m s mvfr gs 5 100-120 10YR 6/6 None is gr 0 m sg mfr . Depth to 4 5 limiting factor L] - i - - Remarks: Boring # 1 0-13 10YR 3/2 None si 2 m sbk mfr as 1f .5 .6 2 2 13-4 10YR 4/4 None sil 1 m sbk mfi s 1f .5 .6_ 3 42-5 10YR 5/6 c2d cl 1 m sbk mfi s , NP NP Ground I - 9Gele37 4 57-12 10YR 6/6 None is gr 0 m sg .5 ft. Depth to o, 2 1893 limiting factor sT C Remarks: " w d i level t~ ~ to be CST Name:-Please Print Phone: - G Paul C.J. Steiner 71 XA, Address: N8230 Highway 65• v Oate: June 16, 1993 CST Number: 3074 °~gnature: PROPERTYOWNER Richard Fox SOIL DESCRIPTION REPORT Page -Of - PARCEL I.D. x Depth Dominant Color Mottles Structure GPU~t~' Boring # Horizon Texture Consistence 8arriary Roots - in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed ,T n-1 ---r 31 0-11 10YR 3/1 None i m i _ 2 11-34 10YR 4/4 None sil 1 m sbk mvfi s 1f .5 1.6 _ Ground 3 34-56 1OYR 5/6 1f1 sil 1 m sbk mfr s NP_ I NP Uev. 98.00 ft. 4 56-12 10Yr 6/6 None is 0 m s ml 4 .5 D,:pth to limiting factor Remarks: Boring # 1 0-16 10 3 1 ----None 4 2 16-40 10YR 4/4 None sil 1 m sbk mvfi s if 5 .6 Ground 3 40-57 10 5 1 f1 NP elev. 4 57-12 10YR 6/6 None is gr 0 m sg ml .4 5 97.98 ft. . - Depth to Iiniiting factor L--- L Remarks: Boring # 1 -14 10YR 3/2 None sil 2 m sbk mfr as if .5 A _ 5 2 4-48 10YR 4/4 None sil 1 m sbk mfr gs if .5 .6 3 8-73 10YR 5/6 c2d cl 1 m sbk mfr s NP NP Ground elev. 4 3-120 10YR 6/6 None is gr 0 m s g .4 5 94.25 ft. g Depth to limiting factor Remarks: System has to be below 75" Goring # 1 10-15 10 3/2 None isil 2 m sbk mfr as if .4 .5 6 2 1 15-46 10YR 4/4 None sil 1 m sbk mfr gs #NP 4 .5 3 46-60 10YR 5/6 1f1 cl 1 m sbk mfr gs NP Ground elev. 4 60-10 10YR 6/6 None is gr 0 m sg mfr 4 I .5 95.57 It. Depth t0 limiting factor Remarks: S©D-8330(R.05/92) P)o t P )o L t 8 Oak R I'd% t Acres SCra)e 0'.0 1 i (3 M Way i X~✓ G. 13y lv ~ l)-- (7,W ( Garao e )f ousc PouSC ®az /3..5'X 2 SyJtcm, Flcu 8 9.57 ~v Mound oo, I Re 6Cep,e;,Y v f3M Elu ~ Top of 61,e"- i Ph n 1, C P ea, G . 30 K ti June 17, 1993 Richard Fox 84 Woodridge Dr. River Falls, WI 54022 RE: Soil Report, Richard Fox Location: NW,/NW;,S.36, T.28N., R.19W., Tn. of troy, St. Croix Co., WI Certified Soil Tester: Paul Steiner, CSTM# 3074 Date of evaluation: 6/16/93 Dear Mr. Fox: After reviewing the above described soil report, it has been determined that an onsite soil verification must be conducted in conjunction with this office as allowed by s. ILHR 83.06(4)(a) WI Adm. Code. The purpose of an onsite soil verification is to verify soil suitability for onsite sewage disposal. The verification may result in a different size or type of septic system than that shown on the soil report. As a result, neither sanitary nor building permits can be issued for this property until the soil verification is completed. Since ly, Ja s K. Thompson ssistant Zoning Administrator CC. CST file Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page _ of Ldbra and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code • COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St Croix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. i dimensioned, north arrow, and location and distance to nearest road. _ APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Richard Fox GOVT. LOT NW 1/4 NW 1/4,S 36 T 28 N,R 19 E (or) v! PROPERTY OWNER':S MAILING ADDRESS LOT aY BLOCK # SURD. NAME OR CSM ay 84 Woodridge-Drive 68 Oak Rid a Acres CITY, STATE ZIP CODE PHONE NUMBER bQXUA00C[ fOWN NEAREST ROAD River Falls WI 54022 (715 425-2100 Woodrid e Drive btJ New ConsUuclion Use Residential / Number of bedrooms 3 (j Addition to existing building (j Replacement (J Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate .4 bed, gpolft2 .5 trench, gpd/ft2 Absorption area required 1125 bed, ft2 900 Uench, ft2 Maximum design loading rate bed, gpol0trench, gpWft2 Recommended infiltration surface elevation(s) It (as referred to site plan benchmark) Additional design! site considerations Significant more rock is needed to meet state code & system elevati Parent material Flood plain elevation, it applicable ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM FILL HOLOIN IA14K U = Unsuitable fors stem ® S ❑ U ®S ❑ U ®S ❑ U f~ S ❑ U ❑ S U ❑ S n U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Botr>cr+ry Roots GPD!ft2 Boring # Horizon in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bea ~lrc,.:t 1 0-23 10YR 3/2 None sil 1 m sbk mfr as 1f .5 1_.6.__ 1 2 23-48 10YR 4/4 None sil 1 m sbk mfi s 1f .5 _6__ Ground 3 48-77 10YR 5/6 f1 f - - elev. 94.0-91. 4 77-12 10YR 6/6 None is cfr 0 m s mvfr 4 Depth to - hmiting factor _ Remarks: Boring # 1 0-1 10YR 3/2 None si 2 m sbk mfr as 1f .5 .6 2 2 13-4 10YR 4/4 None sil 1 m sbk mfi s 1f .5 .6_ 3 42-5 10YR 5/6 None sil 1 m sbk mfi s NP NP Ground 9g1e37 ft. 4 57-12 1 OYR 6/6 None is gr 0 m sg mvfr .5 r~ Depth to limiting V~~~ ~-7z factor Remarks: CST Name:-Please Print Phone: Paul C.J. Steiner (715 CA o Address: N8230 Hi hwa 65: River - - Si Date: CST Numbur; 62~1.,~gnature: Cl _June 16, 1993 3074 PROPERTY OWNER Richard Fox SOIL DESCRIPTION REPORT Page _of r' PARCEL I.D. it Gf urfr-' . Depth Dominant Color Mottles Structure Texture Consistence Boundary Roots Boring # F711-34 in Munsell Ou. Sz. Cont Color Gr. Sz. Sh. Bed " -11 10YR 3/1 None sil 2 - 0 3 10YR 4/4 None sil 1 m sbk mvfi gs 1f .5 ;.6 _ Ground 3 34-56 10YR 5/6 None sil 1 m sbk mfr s .2 I.3. _ elev. . 4 5_ 98.00 It. 4 56-12 10Yr 6/6 None is crr 0 m s ml u,:pth to - limi6ng factor " Remarks: Boring # ~-.6 1 0-16 10 3 1 N n 4 2 16-40 10YR 4/4 None sil 1 m sbk mvfi s 1 f 5 .6 3 40-57 10 5 6 __._3 Ground ml , 4 5 elev. 4 57-12 10YR 6/6 None is gr 0 m sg 97.98 it. Depth to IimiGng factor Remarks: Boring # 1 -14 10YR 3/2 None sil 2 m sbk mfr as 1f .5--.6 5 2 4-48 10YR 4/4 None sil 1 m sbk mfr gs 1f .5 :6 - 3 8-73 10YR 5/6 None sil 1 m sbk mfr s N--.4 .2_.3-- Ground 5 elev. 4 3-120 10YR 6/6 None is gr 0 m sg mvfr 94.25 It. Depth to limiting factor Remarks: t-o be helow 75" Boring # Ground I elev. Depth to IimiGng factor Remarks: SBD-8330(R.05192) NO )oo Lot 69 0, Rle e►^ca S Dole / ~O 13y g3 10x/1 (T`pw P l l ~xis1 m~, Iry OU5 L ~ SI b~ E. %r Y., ~1 J I~ x n B IYI ~ I V . loo ~ Tcp rj refr Ph-"~'! pr~, a OAK RIDGE 2/t ,•s/1 t • s+jv: , r .00-91 .0 ACRES r1 L.%_.. . 23 . . -66 olre- Town 4 T~t0y,SI. Croix Co, Wk 70 i 71 1 'J t • 17 7 3D 29 28 = 2 i 26 •f = b r? 1 t/ - _ t • ~O c a~ J • 2. 16 1 l/ • v V4, v 74 • s• • ~.r • Y: d, 83 M 67 I 69 k 1 14 46 v • r• 6•L .1. ti E • • /NK • 1•~• 37 ; mss. • r uat a,i e to ti .r ~ rr•• . rt ` _ = 76 Y 34 r 12 77 39 4ta''411 ~ I I L I- . • A ^Iw11. L•NJ Lf-so 40 •Y • = I. I 10 r i • .••1• i • .•1~ • ..a uacu i O • 41 011% • LN wP • • • w w •1•. ''.i • O ~ Y , t 50 e 1 • 37 a so -**4 45 t 34 1 ~t ~ a J L 53 j $3. i, t 4 RECEIVED s 02 t1` -66 MAY2 61988 50 I I SAFETY & BOGS. In x1 j C7 as so 'a 4 ' ers•v :..q 1 I I 1 'T rr DILHR ;apartment of Industry, INSPECTION Leroy Jansky P.S.C: ` luman Relations duildingsDivision REPORT 13 E. Spruce Street of Plumbing Chippewa Falls, WI 54729 ,ction ate (715) 723-8786 61 / a Premi es A 4mms-w Legal Description Oity/Township County )A-V- f?lt A-cfZ-Fs -PLA+ , 5w/ NVj , 3z81 IC?W -IkoY 57-~ cP.~/X er Plumber Name and Address Master Plumber Firm Name and Address Plan I.D. No. Sanitary Permit No. neyman Plumber/Soil Tester Licensed Person's Name(s) and License Number(s) er's Name and Address ?Vla CS U 8 tT i 1 -CIO a, a% ro~ tiz-a'U'rm -Z& 40, ge Z' Of Z-- Signature of Responsible Licensed Person (only one needed) Si at of Plumbing Consultan rivate Sewage Consultant Original: COPles to: ( that Check allapply) ` 1-6192(R.11/85) District 0 DILHR 0 Plumber Wn r o my/Local I ,s . r D I L H R sconsin Department of Industry, INSPECTION Leroy Jansky P.S.C. bor and Human Relations fety & Buildings Division REPORT 13 E. Spruce Street !reau of Plumbing Chippewa Falls, W 154729 peclion Date (715) 723-8786 tJf_ 81es me of Premises gees-oc Legal Description Giiy/Township County OAK RtCUGE,ACRE-% -R,. cr SW ,Nw,-Y.,--18,tgw -R:,-O-( ST ,c P-0yK ester Plumber Name and Address Master Plumber Firm Name and Address Plan I.D. No. Sanitary Permit No. ti ieyniekm Soil Tester Licensed Person's Name(s) and License Number(s) CALL 4ElSF- CS- r--* ~ K c. ^ vner's Name and Address _ CN fjR~, x Fit S Et, 147 _ ~t 4d r^ A-s 13 SLSO H fZ%V P-(;r-P.U-S VJ - S402-L- C A~ l-Fr lsU-- l ~i I Z - .4 V&J C hC I !0A Z all, I'A 4,t4 z 3 - L Oat G 5U c y c V 6 c Of L~ Signature of Responsible Licensed Person (only one ¢d) a < 9e Signatu of Plumbing Consulta ivate Sewage Con u(fa~t to: ( Check all Original: Copies that apply/ an_aioo ra var% nictrict n nil HR n Plumber CKO r u W/Local In . 0 Ot