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HomeMy WebLinkAbout040-1188-90-011 Form - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER L e D ;V j- r; TOWNSHIP T rh V SEC T N-R W ADDRESS ! 02 b 5OU pe4r ST. CROIX COUNTY, WISCONSIN Hof # 71 lu~r SUBDIVISION QQ i A{ Acri%LAT 71 LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of ILHR.83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM B;v C$2 ~ ~ B~ y "y WeQks Tie K N 0 1A e BENCHMARK: Describe the vertical reference point used TQ42 o f Dee- Trawc'lorr., Elevation of vertical reference point: loo., no, Proposed slope at site: SEPTIC TANK: Manufacturer: tv-ee k s Liquid Capacity: hb ae Number of rings used: Tank manhole cover elevation: /(D, Tank Inlet Elevation: clY. G 3 --Tank Outlet Elevation: C/ y/I Number of feet from nearest Road: Front, OSide,(DRear,O _ Feet From nearest property line: Front,OSide,e)Rear,O~~ Feet Number of feet from: well S y , building: TO: I &k UJ S FROM: Q 10 W X& DATE: ~11-7161 PAGES INCLUDING a 5ions to septic tank) THIS PAGE: ~ :E REVERSE SIDE FAX FAX PHONE I. PU CHAMBER Man turer: 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, O Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: x Trench: Width: /62' Length: U Number of Lines: c;,9,_ Area Built: 4200 Fill depth to top of pipe: !e Number of feet from nearest property line: Front, Side, ORear, OFt. i Number of feet from well: Number of feet from building : 02 S (Include distances on plot plan). SEEPAGE T Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or stribution box O been used on any of the above soil absorbtion systems? (Check one). HO TANK acturer: Capacity: Numbe of rings used: Elevation of bottom of tank: Elevation f inlet: Number of feet ran nearest property line: O Front, O Side, O Rear, Ft. r of feet from well: Number o feet from building: Number of feet f nearest road: Alarm Manufacturer: Inspector: Plumber on the Job : Patt ( C J S to I h ,.e DATED: 7/14/ Z13 License Number: Co 715 U 3/84:mj TT 7~11 EE ~rsiTn ~artr~i Qcxflns n ~tt~8.19 NW, AMEWAGEAPDRIDGE County: Labor and Human Relatio Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: 193463 Permit Holder's Name: ❑ City ❑ Village [R Town of: State Plan ID No.: POTITVTCA GREGORY O CST BMnnElev.: Insp- BM Elev./: BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA A9300126 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic L&L 5 6-9 Benchmark Dosi ng Aeration Bldg. Sewer 3y 9 ~S Holding St/Ht Inlet '7, 5L Oiy, ( 3 TANK SETBACK INFORMATION St/ Ht Outlet 17 S 0 q / TANK TO P/ L WELL BLDG. AirI to ntake ROAD Dt Inlet Air I Septic NA Dt Bottom Dosing NA Header / Man. 5), 93, ~ 7 Aeration NA Dist. Pipe 8,755 93, q9' Holding Bot. System G 9a• PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction Syestem TDH Ft oss Forcemain Length Dia. FFii Dist. To well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS - L, 3 DIMENSIONS SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type O CHAMBER Model Number: System: -7 6 OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed/Tr nchCenter Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) ` LOCATION: TROY 36.28.19 NW,NW LOT 71 EAST WOODRIDGE DRIVE N... L Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: i DILHR 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 ❑ ?~'Y 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 e k W'/a Uj %a, S 3 T e&, N, R E-* PROP RTY O ER' MAILING ADDRESS LOT # BLOCK # CI, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME O CSM NUMBER F is SY i %2r papa Oak 46-* Acyes T A A II. TYPE OF BUILDING: (Check one) State Owned NEAREST ROAD 'D 01 r, -e 9Lt I r C S I AD Gr ❑ Public 1X1 or 2 Fam. Dwelling-# of bedrooms R TAX Nu III. BUILDING USE: (If building type is public, check all that apply) Dq o- j / Sig 1 6D ) 1 E1 Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 100 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. ❑ 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 0&1 1 REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION 4;62)(0 J.2-00 s - C72 • 116 Feet Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New lExisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or .Q.. e , q VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plu r s l lure: (No tamps) MP/MPRR"o.: Business Phone Number: 00q I e-,&_ 796 Q C S ~1h P Plumber's Address (Street, City, State, Zip Code 'r wr&h I 'C- r AaIts WT IX. COUNTY/DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Agen tamps ❑ Approved ❑ Owner Given Initial Surcharge Fee) 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 r ~ 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 renUXal any new criteria in the lVisconsin Administrative Code will be applicable. 3. All revisions tc• this permit must be approved by the pt rr,it issuing authority. 4. Changes in oW rc;rship or plumber requires a Sanitary ? ~rmit Transfer/Renewal Form (SB.) 6399) to be (7ubmitted to tl;- :,ir, r!ty prior to instatiation. 5. -On;;ite sr ,_e ayt:~sns must be praper,y maintai,.ecf. tanr:,s) mu3t i)e by a lipensed pur's.^csr :._1her,,E krer necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code ac IT inistrator or the Sta`:e of'i'Visconsin, 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. Ill. 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 8,f system. Check appropriate box depending on system type. VI. Fbao-P!ic- system information. Provide all information requested in f 1 VII. Tank -lf,nt!atior. Fill in the capac;ty o' every new and/or existing taxi>s st t!ie tc-tal gallons, number of tanks ar trnufacturer's name. Indicoio prefab or site constructed air lik rnaieriai. Cor. r letey for all sent r,/SVion and holding tanks ILA' this system. Check experimt -,"fl rival only l.anks received ex 3e F,ruduct approval from Dit_HR. VIII Rpspemsir iiity statement. Instailirltl plumber is to fill in name, lice -r-nbe, ,vim 3rrp op, re prefix (e.g. Et,:.l, -~ddres > and phone number. Plumber must sign app li~.:,,t n a:ir rn. IX. Cnuniy/ ),epartment Use Only. X. Cour0y./`e~)artmr:nt Use Only. Came !e-t- r _ a.ind specification.; ricdt -tiller than 8'/z = :..r, ~ = r'd~;sa be ;ubntitftti ~o 1h:., county. The F}lanc r , t € -je the, fo;!CWlrlg -i,l. draw , tC Scat.;. r'" t ' t'ii,~lE fQ ~ nF . T dt c n of he"d! 7 ? =-eptic tar'k ~s) or t 'ie %Y F;(t tar ks, NET Nor ~!,ater service; pump or -,ipho,i `Jistrib!_!tion boxes - yYs ci!.~ el'vler~ System of the bu, ,"aJ .°",,di, B) hc'rizolita _ ,ai -le. elerf.o m+c C) co,n;)le;c spec.fications for pump: and controls, dose vo t.. t v&-_,n dirferumces; iric;i.,,n loses; pump performi.ince. curve; pump model and pump manufa(.turer; D) cr,7)ss se 'Z on of the soil absorption system if required by the county; E) soil test data on a A,6 form; and F) all sizing information. _r GROUNDWATER SURCHARGE 198,-3 `A^ sc•)r: ;in Act 413 included the creation ,.~f surcharges (fees) for a nurrLier of rey:s : tee r jchres Which can effect rgrr,undwa.",,i. Tfle . Cnies collected thrGUyh ttrn.e si.rcha ~ - ;:r•;: :d5ej for mini t ; t;'ater, croun--"- watei _t;etmination '-nVesligi:i,s os and estai'1 ishnnieni of Stc9ri ar,~IS. 1 I SBD-6398 (R.11/88) . APPLICATION, FOR SANITARY PERMIT 9TC-100 This application form is to be completed 1n full and signed by the owner(s) of the property being developed. Any lnadequaeles will only result In delays of the permit Issuance. -Should this development be intended tot tesala by owner/contractot,(spee house), then a second form should be retalned and completed when the property Is sold and submitted to this office with the appropriate deed recording. - - - - - M - r-- ----r----~~-~~~--~-- Owner of property (,~,.~yory L aiea,4 i-u Agn G~y~ Location of property AIW- X/4 L'.L._.1/4, laetlon ~3 6 T ag~•Rr~7 Y Township Mallin9 address 0=0 k1b0d dfe~ ~r. 0 _00 CC9-- • Address of site DG GC Jai L4 2 G ✓ e_5 subdivision name, Lot number 7 ■ Previous owner of property S V eael oglm epr- -Z7,1 L. r /y5X/so O?t 5 Total else of parcel Date parcel was created . ~J1o Ace all corners and lot lines ldentillableT , an is this property being developed toe resale taper house)? as =~10 Yalu" and Page Number ~ as recorded with the Register of Deeds. - - - - - - - - - r - - - am - - - - - - - - - - - - - - M" INCLUDE -r r rr r- - - - - r - -rr----------~-~-• WITH THI9 APPLICATION THE FOLLOWING$ A WARRANTY DBBD which Includes a DOCUMENT NUMBBRp VOLUME AND PAGE NVMBzxr and the BRAL OF THE RBOIBTBR OF D22D9. In addition, a cettlfled survey, It avallable, would be helpful so as to avoid delays of the reviewing process. it the deed description references to a Ce=tltled survey Nap, the CattIliad survey Nap shall also be required. PROPERTY OWNER CERTIFICATION I(we) certify that all statements on this form are true to the best of my tout) knowledge; that I two) am (ate) the owner(s) of the property described In this In[otmatlon form, by virtue of a Warren( riled In the Office of the County Register of Deeds as Document No. and thatXtwe) obtainy own the proposed site for the sewage dlaposal system (at (we) have ob a Hedeil n t a easement, to tun with the above described ro ect roc the construction of sold systemr and the same has been duly recorded In the office Of he County 91 tot of Deeds( as Document No. ! gnatute f Owner 1 ature o Co-Owner III Applicable) i ~g z a TA 11 efY9.2, Date of signature Date of Signature SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/ BUYE 4, Ah n RY ~~0 L- h w 0 ROUTE/BOX NUMBER ' O -Glocel14ye PN.. Fire Number rt a~ DP t y,ev' ~ w yo CITY/STATE ZIP T_ /G PROPERTY LOCATION:'. ' k,~k, Section T o?15 N, R / / W, Town of St. Croix County, Subdivision AX kd9e Lot numbers - -1. . Improper use and maintenance of your septic system could result in its premature failure to handle wastes.- Prover maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed'septic tank pumper. What you put into the system can a ect the function of the septic tank as a treat- ment-stage in the waste disposal system. St. Croix County residents may 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 'systems agree to keep their system properly maintained. The property owner agrees to submit to St.. Croix County Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and .(2).after inspection and pumping (if nec- essary), the septic-.tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year-expiration. H I//Wf~, the undersigned have read the above requirements and agree o to maintain the private sewage disposal system in accordance with the standards set forth, herein, as.set by the Wisconsin Depart- ment of Natural Resources. Certification form must be completed •d and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. .SIGNED- DATE ~2 -e ( 3 St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 386-4680 Sign, date and return to the above address. 'K"a ~H=R wPo~"'~', SOIL AND SITE EVALUATION REPORT P490 - of Division of Salary 8 Buildings in accord with II-HR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not lass than 8 V2 x 11 inches in size. Plan must includa, but St. Croix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. 9 dimensioned, nonh arrow, and location and distance to naarast road. _ APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATrON GOVT. LOT NW V4 NW u4,S 36 T 28 N.R 19 )x=r Poliyka PROPERTY OWNERS "LING ADDRESS LOT i BLOCK i Su60. NAME OR CSM a 120 South Pearl 71 Oak Ridge Acres CITY, STATE ZIP CODE PhONE NuMBER GOWN NEAREST ROAD River Falls WI 54022 (715)425-8008 1 Troy Count Road MM New Construction Use JXj Residential I Number of bearooms 3 (j Addtion to existing DuiWing (J Replacement (J PuDlic or commercial describe - Code derived daily flow 600 gpd Recommended design loading rate . 5 bed, gpdrft2 .6 uencn, gpatn- Absorption area required 1 .200 Dad, h2 1 , 000'vencn, h2 Maximum design loading rate .7 L~Cd, gpdr42 .8 trench, gpan= Recommended infiltration surface elevation(s) 92.4 It (as relerred 10 site plat Dencrunark) Additional design/ site considerations Additional rock will have to be used. Parent material Flood plain elevation, it appli=le _ N/A It S = Suitable for system ConvENTIO" MOUND w•GR000 PRESSURE AT."01 SYSTEM vi f" nO~OCw IiJd1 U= Unsuitable lots stem RIS O U ®S O U ®S O U ®S O u O S ®u 0S O U SOIL DESCRIPTION REPORT Oeptn Dominant Color blowas Texture Structura Cwss;stence 8ovrAry Roots GPUJIt - Boring rY Horizon in. Munseli Qu. Sz. ConL Color Or. Sz. Sn. 6~u I1~1r,.. 1.... 0-14 10YR 2 None sil 2 M Pl mfi as if .5 _ ..6 2 14-41 2.5YR 5/0 2P 5YR 5/8 sicl 1 f sbk mfr as NP I_NP Ground 3 41-52 10YR 3/4 1 f sil 1 f sbk mfr as NP -1 NP ehv. 91,fi2IL 4 52-61 10YR 6/4 None s gr 0 m sg ml as .7 ' .8 Qeplo to 5 1-110 10YR 6/4 None s O m s ml .7 .8 tintiting I:,clor Remarks: Rys m oth Min 70" Bottom of laver # 2 Very Wet; # 4 & 5 DrY Boring 1 1-20 10YR 3/2 None sil 2 m sbk mf i as if .5 1 _6 2,.•'> 2 20-39 10YR 4/2 None sil 1 f sbk mfe as if .2 .3 Ground 3 39-51 10YR 3/4 None sil 1 f sbk mfr as .2 .3 elev. 4 51-63 10YR 6/4 None s gr 0 m sg mi •7 .8 96.861L 5 3-113 10YR 6/4 None s gr 0'm sg 1111 - - •8 Depth to r factor 219 Remarks: CAM W CST Ncma -Pldasa Pant Pnorw• Paul C.J. Steiner ' (715) :425-fi544:` - :~lydss: J N823-0 Hi hwa 6 - River Falls WI 54022 :.~n;awa: .r s C J _ D+aa May 25, 1993 -f"-" x:3074 rayc PROPERTY OWNER Grp Polivka SOIL DESCRIPTION REPORT PARCEL I.D. v Roots CNU;Ir Texture Corls,stenoe 8ournUry B .0 ; Iruai DePth Dominant Color MoWes Suucwra Gr. Sz. Sn Boring # Horizon in Munsell U. Sz. Cone Color b_ 1 0-12 10Yr 2 2 .::.:3:;..' sil 1 f sbk mfr as if .2 j .3_ 2 12-51 10YR 4/2 None sil 1 f sbk mfr as .2 ~ .3 - 3 51-65 10YR 3/4 None Ground a-- 98.29-11. 4 65-80 10YR 6/4 None S O m s ml as 7 0cp1h to 5 80-13 10YR 6 4 None S lin sling - faC.lOr Remarks: 6. . Boring # if 1 -10 10YR 2 2 one 0-53 10YR 4/2 None sil 1 f sbk mfr as if 2 _:3_ ° 4".. 2 1 f sbk mfr 3 3 3-62 10YR 3/4 None sil Ground s 0 m s ml as • 7 _8_ elev. 4 2-67 10YR 6/4 None 95.37IL 5 7-130 10YR 6/4 None s gr 0 m sg ml . 7 .8 . - Depth to Gnuting lactor Remarks: Boring # 6 - 1 0-13 10 2 2 Non 2 13-60 10YR 2/2 f2D sicl 1 f sbk mfr as if NP 3 0-120 10 2/2- M3P s 1 Ground 21~V. 95.25-1t - Depth to . iinuting • lactor Remarks: Boring N 1 f ....•.6 . 1 0-10 10 2 2 None sil 2 m bk mfr .5 2 10-51 10YR 4/2 None sil 1 m sbk mfr as if .2 .3 :......6 . 2 . 3 - 3 51-63 10YR 3/4 None sil 1 m sbk mfr as Ground 0 m sg ml as .7 I .8 elev. 63-7 10YR 6/4 None s 9x 96.14._ It 4 6/4 None s 0 m s m1 • 7 1.8 5 70-13( 10YR Oapth to -5 _ rill Ming -r IWO Remarks: nnn. annnin' 'h - - - Co - - ~Y rb I t~► X5 Rt 71 (y I n n 1 n~ 4 a D ej ~ I 1 ~ V Ih C+ I I vS I n z ~ O A ~ A ro C~ M1 ~ G c ~ cU ~ Lft N v: • wiaconsinDup,utnw,ntof lnduswy, SOIL AND SITE EVALUATION REPORT Page-01-- - L4WI W4 Hum:+n Ruw6Ons Division of Satuty t18W►oings in accord with ILHR 83.05, Wis. Adm. Code COUNTY St. Croix Attach complete sits plan on papar not less than 81x2 x t t inches in size. Plan must include, but PARCEL I O. i - - not limited to vanieal and horizontal reference point (BM), direction and % of slope, scale or dimensioned, nonh arrow, and location and distance to nawast road. - - O:+Tc r7iWEO By APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION PROPERTY OWNER: PROPERTY LOCATION GOVT. LOT NW V4 NW 114,S 36 T 28 •N•R 19 XWU _ PROPERTY OWNER':S hWUNG ADDRESS LOT s 8LOCt( n Su 60. NAME OR CSM 120 South Pearl 71 Oak Ridge Acres CITY, STATE ZIP CODE PnONE NuMBER P4D4><$bC GOWN 7-County EAREST ROAD River Falls WI 54022 (715)425-8008 Trov Road MM New Construction Use Ix] Residential I NumCar of Deorooms 4 I) Aadfion to e;< sling °u4ng I I Replacement ( ) Puolic or conuncrcial aescri Code deriwaa daily flow 600 gpd Racommenaad design loading rate .5 bad. gpdrn2 .6 vancn, gpalt2 Absorption area required 1.200' bt-d, h21; 000'vencn, n2 Maximum desgn loading rate 3.7 Ud. gpwn2 -8 uencn, gporr12 Rrxommenaea inlilvalion surface elevation(s) 92.4 It (as relented to sta plan Darmnark) Additional design I site considerations Additional rock will have to be used, Parent material Flood plain elevation, il appl caola _ N/A n S - Suilaole for System COnVENTIQ," 1.10un0 w•Ciiouno?1`0SuRE AT•Cimr. SrslEra ut f" "Co:.'. IA.n u= Unsuilaole lot s scam ®S O u ®S O u ®S O U © S O u 0S Elu 0S O u SOIL DESCRIPTION REPORT Depth Dominant Color htow6s Texture Structure CorlSistenCe Y Roots G"Unt=- Doring Horizon in. Munsell Gu. Sz. Conl. Color Gr. Sz. Sn. Diu law. 1 0-14 10 2 one sil 2 M Pl mfi as if .5_ -.6 2 14-41 2.5YR 5/0 P 5/8 sicl 1 f sbk mfr as NP l NP Ground 3 41-52 10YR 3/4 1 f 1 sil 1 f sbk mfr as NP I NP elw: ' T 91,611t. 4 52-61 10YR 6/4 None s gr 0 m sg ml as .7 .8 D~plh to 5 1-110 10YR 6/4 None s 0 in s ml • 7 •8 uniting laclur Remarks: qv-,t-em Depth Min 70" Bottom of laver # 2 Very Wet; # 4 & 5 Dry Boring ~ 1 1-20 10YR 3/2 None sil 2 m sbk tnf i as if .5 T :6 2 20-39 10YR 4/2 None sir 1 f sbk mfe as 1 f .2 .3 Ground 3 39-51 10YR 3/4 None sil 1 f sbk mfr as .2 ..3 elev. 4 51-63 10YR 6/4 None s gr 0 m sg ml as .7 ( .8 96.861L . 5 3-113 10YR 6/4 None s gr 0'm sg - .7 •8 Depth to knifing factor v ! Remarks: ro C5T Nynd -Pwuu Pont -4 Paul C-J. Steiner .425-554 «kltes: : ~ ~ v N8ZIQ Hi hwa 6 River Falls WI 54022 :4n:avw: Cf Orb its, 'L 3074 PROPERTYOWNER Greg Polivka SOIL DESCRIPTION REPORT PARCEL I.D. p Suuctura Roots t31't)' f Depth Dominant Color Moores Texture Of. Sz. Sn.~ Boausy B`0 ' Ix' Boring Ir Horizon in Munseu Ou• SZ- Cant. Color -a cz 3 0-12 10Yr 2/2 n 1 r as if .2 , .3 2 12 sil 1 f sbk mfr 10YR 4/2 None Y None sil 1 f sbk mfr as .2 (.3 3 51-65 10YR 3/4 Ground elev. 8° 98J.9-I. 4 65-80 10YR 6/4 None s 0 m s ml as oapth to 5 80-13 10YR 6 4 None S Gnuling laVtor Remarks: ,5_-•-• 6. . Boring # if 1 -10 10YR 2 2 None 4n.'' 2 0-53 10YR 4/2 None sit 1 f sbk mfr as 1 f 2 3 3-62 10YR 3/4 None sit 1 f sbk mfr 3 Ground' s 0 m s ml as .7 ; -8 - elev. 4 2-67 10YR 6/4 None 95.37 14 s gr 0 m sg ml .7 .8 - 5 7-130 10YR 6/4 None Depth to Gnti~ng _ law Remarks: Boring # 1 0-13 10 2 2 Non if NP . 213-60 10YR 2/2 f2D sicl 1 f sbk mfr as 5 E~- 3 0-120 10 212 M3P i 1 Ground _ elav. 95_.25..IL - Deptn to unuting . factor Remarks: Boring N on sit 2 m b mfr as if .....6 0yR 2/2 .,....fi...' 2 10-51 10YR 4/2 None sil 1 m sbk mfr as 1 f .2 .3 3 51-63 10YR 3/4 None sil 1 m sbk mfr as Ground 0 m sg ml as .7 1 .8 1M.W. 4 63-7 10YR 6/4 None s 96,JD-If. s 0 m s ml •7 .8 _ 5 70-13 10YR 6/4 None ob-put to 4uu4r1g 1:11:tW :d~ woo( to O" ~ ~I Y I ki I -r- n ° O A O ~ ~o C 5A O ~ ti s S I C -~G S.J A v tc (Zrz n ~ ~ f';1 ~ ~,1,: 1 r ! j - a -si. w r<.,V:. a •t , 7- s ?ii`Ka ~ i v - 'l DOCUMENT NO. STATE BAR OF WISCONSIN FORM 2-1982 THIS SPACE RESERVED FOR RECORDING ..ATA _ WARRANTY DEED 0-L 500139 ~ 101:~PAGE 309 REGISTER'S OFFICE ST. CROIX CO., WI Rolling Hills Development, Inc., Rec'dforRecord a Wisconsin corporation, a/k/a Rolling Hills JUN 3 1993 Development, Incorporated, a/k/a Rolling Hills DevelOnmen Corp. at 110 a A•M conveys andwarrants to Gregory L. Pol~.vka and LuAnn J. 9 >G,,,.,A Polivka, husband and wife as survivorship Rq0ster of Daft marital property RETURN 1tR FA!!S STATE BANK alj~g 022 124 S. SEC& ST. i:m the following described real estate in St. Croix -County, State of Wisconsin: Tax Parcel No: Lot 71, Oak Ridge Acres in the Town of Troy and part ,of Lot 70 of the Plat of Oak Ridge Acres, located in Section 36, T28N, R19W, Town of Troy, described as follows: Beginning at the SE corner of said Lot 70; thence NO°07'E 9.00' along the East line of said Lot 70; thence Northwesterly 23.56' on a 15.00' radius curve conSave Southwesterly whose chord bears N44 53'W 21.21'; thence N89.53'W 120.00'; thence Southwesterly 23.5 on a 15' radius curve co8cave Southeasterly whose chord bears S45 07'W 21.21'; thence SO O7'W 9.00' along the West line of said Lot 70; thence S89 53'E 150.00' to the point of beginning. S 'Pis - This is not homestead property. (is) (is not) Exception to Warranties: easements, restrictions, and rights-of-way of record, if any. 1943-- Dated this 27th day of Mav OLL G LLS D V NT, INC. (SEAL) (SEAL) -Richard N. Fox. President (SEAL) /A_dA-mz it (SEAL) J. Frances Fox, Secretary AUTHENTICATION ACKNOWLEDGMENT SignaVFces chard N. Fox STATE OF WISCONSIN 8S. J Fox County. aut ticated this 19 Personally came before me this day of 19 the above named Lauri J. Gaylord TITLE: MEMBER STATE BAR OF WISC NSIN to m e known to be the person who executed the (If not, authorized by § 706.06, Wis. state.) foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY r.- T.- Gaylnrd. Attnrnav 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 shoui0 be typed or printed below their signatures. S02 NTF 0021 WARRANTY DEED STATE BAR OF WISCONSIN Nelco Tax Forms, P.O. Box 10208, Green Bay, W154307-0208 Form No 2 - 1982 Q~ i 3 I I I a I~ _ W ~I J v'~ -0 ~ C 3 ~ C U ~T (J I I L~ i. 0. ~ I 0 U l a U1 I r ~ c ~ a ,i) LI C 0