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HomeMy WebLinkAbout018-1059-10-110 4. o CD ° v 0. o ~ I cz N O y I ' I I I I I n z c LL c O ° p I ~ Q V ~ y r Z ° I Z ~ `w y rn N 04 z a m o I o z v (D z VJU N fV a) N ~ N O c 0 'O U cr- O ° ° z in z Z N z C,4 1 N N y N i d . d m O. W - fD O N d L O C 0 00 c G a a N N Q ° LO H ~ E 'a_ ° Z N > 0 0 0 a z 0 • ►~i m c a a a v, a .0 O N CO rn rn y V1 J V N m O } AV o CZ4 O) m d N Z N Q O o° as Q Z m r 1"" O N y jA a O O C N y C o c O O OM F- N N N C 6 a 0Oj p r L1 C V ~ ~ C ~ C E C ~ N ~(0 I C O = O N C L ~ O O 7 `I co N E N NO qd 7~ ,C O 01 • T' O N = > O y Cn w V a l' 0 CL 76 U t A Ua2 0U)0 ^EPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INCrUSTRY, c DIVISION !_ABnR AND PERCOLATION TESTS (115) MADISP.O. BOX 7969 ON WI 53707 t HUMAiV RELATIONS (1-163.090) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO :BLK. NO.: SUBDIVISION NAME: '/4 V14 /T2.QN/R 171 W Ala In /notq A COUNTY: OWNER'S BUYER'S N ME: JM.C'roiX Q oS ui i USE DAT S OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: IPR FIL D TI NS: E A N TESTS: Residence A//f New ❑Replace 144,. 7 RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: JIN-GROUND-PRESSURE:ISYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM-(optional) ®S ❑U ©S []U ®S ❑U ❑S CCU ❑S ~lU e o ✓e / If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL_ DEPTH T GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTHI&. ELEVATION OBSERVED EST. IGHES TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- a'ns~ - gs~''s~ o" fre , B- Aim e, /'Z / r B- 2 # ZZ Z&~k Y) Lod 4 J B- 7125 > 7,2,,5 FB - -~'~}-IZ''$~s~~• ''f3nsi~l . ZU'~~n PERC ~I ATION TESTS G5f Y ' / -'12,80 S ~,(ol- 17 TEST DEPT WATER I HOLE T STTIME DROP IN WATER LEVEL-IN ES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD PERT D 2 RrOWT PER INCH R P- P- P-. ---i P- P- _ PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori zontal and vertical elevation reference poi is and show their Ipcation on th- plot plan. Show the surface elevation at all borings and the direcVon a'9d perc~e7nt of land slope. $ /28~l1091 ' !3"~ns~/J f✓1''! S j ~1~ ~s ~lo''L ~n /'ve d- V `7 SYSTEM ELEVATION I i I f ' l ~ , QI at ) t I -j- I I f I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME print : y TESTS WERE COMPLETED ON: ADDRESS: ZZ 0 ~ ~ ' ~ P~~ / ~~CERTIFICATION NUMBER: PHONE NUMBER optional): CST SIGNATURE: 3V/3 171S Ile DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) OVER - o+ ~ x -fin W w ~ rt N N o nt ° N0 d 1 1 A L,j ell, W N ~ Q TIgN• HAOId~iD 26.29.17.403A-10 W1//2 NW1 4 LOT 2,HWY 2 WEST onsin epartmen o In ustry, PRIVATE - aE SYSTEM County: abet and Human Relations INSPECTION REPORT Safety and Buildings Division ST. CROIK (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 180279 Permit Holder's Name: ❑ City ❑ Village EXTown of: State Plan ID No.: OSKUIL W C HAMMOND CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: baxt t,1 "f UC tC! L? t 01 8-1059-10-110 TANK INFORMATION VATION DATA A9200358 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ? Benchmark /d0 Dosing Aeration Bldg. Sewer Holding St/Ht Inlet y,9 TANK SETBACK INFORMATION St/ Ht Outlet q. / Cja.O y TANKTO P/L WELL BLDG. Airl tontake ROAD Dt Inlet rl Septic ?/Vo l 67/ 7 7 ' NA Dt Bottom Dosing NA Header / Man. R, ~S y f, 9 Aeration NA Dist. Pipe lug q!, q Holding Bot. System f UrS D. cj PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand 5 L+ 3 Model Number GPM TDH Lift Friction System TDH Ft oss Head Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH width / Length No.Of Tr ches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS /<o 60 DIMENSIONS SYSTEM TO P / L BLD WELL LAKE/STREAM LEACHING Manufacturer: SETBACK CHAMBER INFORMATION Type O Model Number: System: 1; f 71 14- OR UNIT DISTRIBUTION SYSTEM Header/Mani old Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed/ Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.Z LiOCATION: HAMMOND 26.29.17.403A-10,W1/2,NW1/4,LOT 2,HWY 12 WEST 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 i 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 8i4 x 11 inches in size. El c elf regon 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 NER PROPERTY LOCATION % Gtr/e,S TZ9,N,R 17 (or W Q Q C Lo- IA~5 7e" J PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK W 17/240 /1,- 0 CITY, STATE P l ZIP CODE PHONE NUMBER CSM UMBER 571.s 79! T 4? 7~ E3 I 11. TYPE OF BUILDING: Check one CITY NEAREST ROAD ( ) State Owned 0 VILLAGE ~0 ❑ Public ®1 or 2 Fam. Dwelling-# of bedrooms ? PARCEI TAX N u fY~ C, III. BUILDING USE: (If building type is public, check all that apply) 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 80 Mobile Home Park 120 Service Station/Car Wash 50 Hotel/Motel 9 ❑ Office/Factory 130 Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ❑ New 2. X 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: 91,7, jQ 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6, a T VV. 7. FINAL GRADE / REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch)! ELEVATION G9 O<D 96 C) 940 0/05S I Feet Feet VII. TANK CAPACITY Site in allons 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 gel= /Z DO Lift Pump Tank/Si hon Chamber F-1 F1 I F-1 Fj Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) MP/MPRSW No.: Business Phone Number: a ld 47 u n r. (7/5 68y -33 TO Plumber's Address (Street, City, State, Zip Code): IX. CO /DEPARTMENT USE ONLY ❑ Disapproved Stary Permit Fee (Includes Groundwater Date Issued Issuing Ag t Signature No S mp Approved ❑ Owner Given Initial Surcharge Fee) Adverse Determination nn" 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 E 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. 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 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 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.csounty; 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. 1 SBD-6398 (R.11/88) ' t l " APPLICATION FOR SANITARY PERMIT STC - 100 I This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor,(spec house), then a second form should be retained and completed when the property is sold and submitted to this office.. with the appropriate deed recording. Owner of property Q Ilac e L~l 2L ~ Location of property 0 k 14% AMU4, Section z (o , T29 N-R-LZW Township _1671t?129'0A(~I Mailing address 140V 12- AYQrn Inon0 . 6c.6, Address of site Subdivision name Lot number T/ Previous owner of property ~UariQ~~ /'/QY' ~'17~~► 17~~'Rl ~1 Total size of parcel /O/ 0.1r, L°> Date parcel was created _Aug. 2, Are all corners and lot lines identifiable? A Yes No Is this property being developed for resale (spec house)? Yes _No Volume Z Z/7 and Page Number 49-7 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, and 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. 19-417,61 ; and that I (We) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the same has been duly recorded in the Office of the County Regis/t)r of Deeds, as Document No. V Signature of Owner Signature of Co-Owner (If Applicable) 'Date of Signature Date of Signature WARRANTY DEED THIS INDENTURE, Made by Irma Tostenson and Harold Martin and Ruth Martin, his wife, grantors, hereby convey and of •8 Thousand warrant to Wallace C. Voskuil, grantee, for the sum Seven Hundred Fifty (;750.00) Dollars, the following tract of 11and in St. Croix County, State of Wisconsin: All of the West One-half of the Northwest Quarter (W* of NWC of - - - Section number Twenty-six (26) in Township number Twenty-nine (29) North, of Range number Seventeen (17) West, St. Croix County, Wis- consin, and the West thirty (30).acres of the East One-half of the Northwest Quarter (E* of NW}) of Section number Twenty-six (26) in Township number Twenty-nine (29) North, of Range number Seventeen (17) West, St. Croix County, Wisconsin, lying and being North of the right of way of the Chicago, St. Paul, Minneapolis and Omaha Railway Company as located October 4, 1901, containing One Hundred (100) aores more or less. That the said grantors, Irma Tostenson and Harold Martin are two of the children and two of the heirs at law of Neal Martin, now deceased. That the said grantee, Wallace C. Voskuil, agrees to pay all taxes assessed against the above described premises for the year 1940. IN WITNESS WHEREOF, The said grantors have hereunto set th#ir hands and seals this 20th day of July, 1940. In the Presence o ~ . t 7 A~~o ~ ) ~ ~ ( SEAL ) ' Irma T015 on 1 o ~ar'~ 'T f4LA.~"~ . ) 'Y ( SEAL► ) Harold Martin AL; ) (SE Ruth Martin STATE OF OHIO ) j • ss Marion County ) Personally came before me, this day of July, 1940, the above named Irma Tostenson, to me known to be the person who exeouted the foregoing inst ent and ackuwled the same. 7- PUblic-Marlon ary o ~j M Commission expires ~9 y`~ STATE of oxi0 ) as Marion County ) _ Personally came before me, this :;6e day of Ju'y, 19402 the above named Harold Martin and Martin, his wife$ to me known to be the persons who executed the foregoing instrument and aaknowledged the same. f ary u c,r on o., io -711 y Commission expires 1 I i 1 i j 1 w , r No. 200. Warranty Dead-To Husband and Wife as joint Tenants, Published by Eau Claire Book & 8tationory Co, 4:. IF 'EGG ts.: {nbe tttirC; Made this 19th day of September, in •thyear of our Lord, one thousand nine hundred forty betty` en ',10.'P. Reebink, a eiggle.man, part y of the first part, and Wallaod C. Voskuil-and Marion Voskuil husband and wife, as joint tenants, and the survivor of them in his or her own rigkt ; AtUCOettb, That the said party of the first part, for and in consideration of the sum of Cris ('1.00)-------- - - - - - - - - - - - - - - - - - Dollars, to him in hand paid by the said parties of the second part, the receipt whereof is hereby con- fessed and acknowledged, ha s given, granted, bargained, sold, remised, released, aliened, conveyed and confirmed, and by these presents do es give, grant, bargain, sell, remise, release, alien, convey and confirm unto the said parties of the second part, as joint tenants, the following described real estate situ- ated in the County of Ste Croix , Wisconsin, to-wit: All of the West Ones-halt of the Northwest Quarter (W* of NWJ) Of SeoVion number Twenty-six (26) in Township number Twenty-nine #29) North, of Range number Seventeen (17) West, St. Croix County, Wis- oonsin, and the nuthe mber aTwenty-six t (26) the Northwest quarter e (E* thirty of NW}) 3of Section of Township Lumber Twenty-nine (29) North, of Range number Seventeen .(17) West, St. Croix County, Wisconsin, lying and being North of the right of way of the Chicago, St. Paul, Minneapolis and Omaha Railway Company as located October 4, 1901, containing one hundred (1.00) acres, *pre or,lesse That the above is the true and oorreot•oonsideration and that the same is less than one Hundred ($100.00) Dollars. ! s Zogstitt"With all and singular the hereditaments and appurtenances thereunto belonging or in anywise apps wing }d, all, the es#ete, right, title, interest, claim or demand whatsoever, of the said part y j of. t e,#rst pa f,, either in law or equity, either in possession or expectancy of, in and to the above bargain- t i ,_t e he&¢dAtaments and appurtenances. %F&V"q~b to * the,~said premises as above described with the hereditaments and appurtenances, t{~ # # ties pis, ~ eys~gond part, as joint tenants. b tb P. He.ebink, a single man., part of the first part, for his heirs, executors and administrators, 'do es covenant, grant;~bargain'and agree to and with the said parties of the second part, and to and 1 e a(xsv or of thew, bis or her heirs and assigns, that at the time of the ensealing and delivery of bge.preonts,.. he is well seized of the premises above described, 7717 77_7~- as of a good, sure, perfect, absolute and indefeasible estate of inheritance in,.the law, -in fee simple,tand that the same are free and clear from all incumbrances whatever . and that.the above bargained premilges, in the quiet and,peaceable , possession of the said parties of the y second part, as joint tenants, against all and every person or persons lawfully claiming the whole or arty part thereof he will forever WARRANT AND, DEFEND..:,. In Witntoo Mbtttot, the said part y of,the first part ha s h reunto set hi0 hand and seal this 19th day of Septe Signed, Sealed and Delivered in Presence of (Seal) C..~........ . _ „ „ (Seal) . z : _ (Seal) %tote of wioconoin, St. Croix ss. County. Personally came before me this 19th day of September , 1940 the within named C. P. Heebink, a single man, e4 iy t• to me known to be the person who executed the foregoing inst ment and acknowledged the same. C../_~t =s L-le. ..„QrO NotB:`y Public........................... 7 Rol IF, !P- My commission expires..... (To be filled Wif signed by a Notary Prblie) a } 1 a 4~ ~To OT t ?py4 it C! ti b ~ ei i GS A a' O t~ i ~ ~ ro O i rd w , u a,, 'h A ~ , f b h H p ro. f t ~"'rr ° i 4 ~•1 W `w . o p. ! m H h IMP, r ti CIS cd 0 No. 75P»-Sale of Real Estate 9f Persons Under Legal Aisab AiLf, 1) ev i br Guardian. Oapter 290, ourt :StCroix County r' Ion County C .Stte cif W sc , 4= . WMREAS, On application to the County Court .............."........County, Wisconsin; Donald' Martin, a minor, to 'sell all right, title and iiSterest of - : » » •,w•,•_..... » in and to the real estate hereinafter described EX Rft3MXxI*x such proceedings were had that the undersigned was duly authorized as Gu neral...................................... ~agea~i~~p®cieitkoa~6tsa~ I guardian to proceed in said matter; and whereas, the undersigned, as such guardian, has done or caused to be done all things necessary and required to be done by law in such cases made and provided, before conveyance of such real estate may be made; and whereas, the undersigned,.-W.illiam.... Ha<rbo.,as such guardian, was duly authorized by order of Court herein dated on the ..............2nd.... day of................. Augu$.t._ MAP-, to execute, acknowledge and deliver to Wall acs,,..C.....,, Vo sku i 1......... _ ~ - .......................................................................a deed of cenveyance of all the right, title and in- II ..........................•----............................................-..--------.......in and to said real estate ; I terest of said _ minor xX_%Ix NOy(~; THEREFORE, I, the said. W...IIIAAM....Barb.o._ by authority of the court,above n&yh4 t and in my capacity as such guardian, in consideration of the premises and of 9i~$ Thoudin Three Hundred Seventy-f ive Dollars to me in hand,paid by the said .t ............c f..:....:..........,........:........... V.Q.iskull do hereby grant and c Y .to the said AIl aG e.... C...... Yo.a 1.4ti.l.............................................. ti s off the sat . . minor, ..P9n,a? . lYlaY' ..:.i.' ' » in and to the following described real estate (I el 4- y, Wisconsin, to-wit An undivided one fourth intere : in the CIL, ~ount i. 1.4 . a { ~ All of the West One-half of the Northwest Quarter (Wj of NWJ)• of Section .nt, , ex-•.~ e,nt ix..,~ 3.)_...in.... Townsi p _.number,. -Ta wnty:! nine.....(.29.1..Aor..tho...._ot.... r I3a,ge..nter' seventeen (17) West, St Croix County, Wisconsin, and the O t Y w - Q.) aare:s ...add.... the.:..East :...Qne.-half....inf.:.the....~I.ar..lahwa.a t.~. ~uart.er.... (E "A -of Seot'ion number Twenty-six (26) in Township number Tw.enty- ' ..o$.... g&.... numbe-r---Seventeen.....{.l' 4'es G..j......gt-v.... ar-L0•iac•-••Caunt•Y, Wisconsin., lying and being North of the right of way of the.Chioago, ...4 PRUI .n-G apo'lis--an ~d -Omsha... Rat lway.._•- o up~rny....as,*,.1•ocat.e.a ober 19Q1~ oontainin One Hundred (100) acres, pr less. Ki. h • -S:d }.1,. Y'. lea ^~C+ Str X1'.4 x~ ~'T, - ~ f...- t; ~ -~.~j; . ~ . . F+ o EA pi 6 m a ? . a A' 'I i r seaTdxa uolssTwtuoc) SIAI •~S ottand.fir~{dH /-r 7 .1 7~D . .ptusaao~u XIVoglnu eqj jo anI.ttn Aq auras aul palnoexa au........ ° 3ugj pa8papiou3jou puu juauinalsut Sutosaaoj aul palnoaxa oq& uosaad aqj aq of uenoux aui ol 'uutpaunO roa; 3g -tti T Z j jyj " pauluu anoqu au3 . o 'fu ST 6i6I V -V p 8u3 j II d , aui aao auzuo uuosaa ,za qma ~das •~C3unop x.T.o..z.D _ • •ss NISNOOSIA& ao alylS xxx•..aacacacccaa~xflgc~x~„ aouTm... .....,~.u g ...pZBUOQ......... #.74~►~Itlc1l9t7..~1 a uBtpaBnO .z atz~ fl... sB ~ ~NCI~ • ('IvaS).......... IF~ • Jo aouasoad uI Oi~ 6~ .Taq a jo Aup u48t siu3 'ptusaaoye 'uvtpaun-b..........._...... _ .......bq .B~.... t Z j1 .............ptus Jo tugs puu puuq alp SSalgj IM H G a S T C- 105 r a SEPTIC TANK MAINTENANCE AGREEMENT C St. Croix County z d a OWNER/BUYER / C1~~000° vs ROUTE/BOX NUMBER W ~z Fire Number CITY/ STATE_z/S0?,>V/y) onor , ZIP PROPERTY LOCATION: Section T Z'7 N, R. W, Town of~St. Croix County, Subdivision Lot number /VX Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank Pum er. What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents may be eligible to receive a grant for a maximum of 60% of'the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition.and (2) after inspection and pumping (if nec- essary), the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. y 0 I/WE, the undersigned, have read the above requirements and agree L to maintain,.the.private sewage disposal system in accordance with x the standards set forth, herein, as set by the Wisconsin Depart- v ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office wi iin 30 days of the three year expiration date. SIGNED t U AE St. Croix County Zoning Office P.O. Box. 98• Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign,.date and return to above address. L ; SOIL AND SITE EVALUATION REPORT DILHR 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 r0 / u not limited to vertical and horizontal reference point (8M), direction and % of slope, scale or PARCEL I.D. 0 dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY ONNER PROPERTY LOCATION l GOVT. LOT10, /4,S Z6 T 29 N.R ~7 11 PROPERTY GNNEFY MAILING ADDRESS LO # BLOC SUBO. NAME 0~ ~S ~r w / Z /V CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE CWOWN NEAREST ROAD aninnrgol, Zj", s oi5 (7,,A 6-2-773 Cl~n/~oi? I2-, New Construction Use, Residential / Number of bedrooms Replacement ( ] Public or commercial describe AZZ - Code derived daily flow49~00 gpd Recommended design loading rate., gpd/ft2 trench, gpd/ft2 Absorption area required 91 o bed, ft2 trench, ft2 Maximum design loading rate bed, gpd4t2 trench, gpd/ft2 Recommended infiltration surface elevation(s) It (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, it applicable ft S = Suitable for system CONVENTIONAL MOUND INGROUNDPRESSURE AT-GRADE SYSTEM IN RLL HOLDING TANK U= Unsuitable tors stem S❑ U JW S ❑ U J' S0 U RD U ❑ S JN U ❑ S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bouxiay Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trend- /oY s2-- No e, 2 m sb d1 r o:5 .Ln dl #r o. S! 19 ©Y o J7 & Bel j I m e 56 Ground vn e Sl._ ✓ ps 1Mvt 0• elev. 'ev 9y,4tL 36 io y'? O1? m5" o J s 9 011 td I 01-7 Depth to ,2~ry /I~YiC' / 3 o t? (5 CS 0 J S3 oil rn o,7' limiting factor I Remarkss Boring # ,9 S l~y>~ : z, o 2 m s6~ Qll r»~r. Er, 2 boy/ on r»c s~ all0-fr o S • I~g /a~ 5 b c~J~ S'~ / /Y! r ~S lmVt~' O•.j Ground elev. /DYR -WC, 4 m < o, S d I rn / 0.71 93' L ~i Depth to /0.Y~e Y3 O n e C S o, S3 o11 M o .7 limiting Z No rvmS O, 5 01/ r4I 0.7 factor - - I Remarks: CST Name:-Please Print Phone: Address: oz Signature:; ~ Date: CST Numbor: 3 3 Depth Dominant Color Boring # liorizo in Munsell (au. Sz. Mottles Texture Structure Consistence Bcu-day Roots GPD/ftF Con( Color Gr. Sz. Sh. 2 Bed •,Trend' Alp 4 if, 211"C Ground elev D / m r Ob rr Avy- 0.5 97~z9 fl. /0/ 7 gp -Alon e, 0 :S 6,71 Depth to limiting /9Xg Alone CS O S oil M1 0,7 factor Remark's: Boring # 13, Ground elev. Depth to limiting factor Remarks: Boring # ~g:,~~y `iii::+•i i j;N ~pp< Ground elev. Depth to limiting factor Remarks: Boring # Ground elev. fL Depth to limiting factor -i Remarks: LIAMES D 9 90► 0 pp ELL 4623oS roix Co,, WI S L C ti / \ Unplatted Lands J Variable N00°0212511W West line of the NWt of Section 26 Width N0000212511W 425.351 200th STREET 200th 'STREET _ 96.481 N 2119.081 N0000214111W 437.89' a~ f z n C-> (n z n N u, w / o M. a ° U s = _ " 0 03 t In O z a= It n 0 0 0 co r u, cn w rn rt o ° r D o w o -3 -3 CD -j- 4- co LO - O~ o + r ] cD r cD N 9 (n (D O I W r 1 - w w (D N "7 rt O 0 N n N M N N co O lD N N (D (n _ O C W Q N -0 Ln V I M T 7 d m t--i I C C 3 .w-. I ~ y rt n rt 1 Cn O o r~ N 1 D_ C - I C C ~ a o_ 'm y t-I 7 > N N rt 0 O N ~D lD _ 00 LL I 0 o c o i~ 0 0 1 O C2 z 1'° Fh a w w °o_ S000191 3311E 519.231 F" ' 483.281 ° 0 M- 35.95'-~ - `DO a D w T r- b r- oo _ l x o 1 d 0 IL :3 r is G 1 1 0_ O) IN W N •r r N O, I E W N ' a rt D o m (n a O C) 0 -j ?0 Ln (n 1-h 0 C, co to LO Ir Cn 0 r, co C) D LiJ N w w o ~o ri, f1 p~?i El A M LO Lo C--) d~, m rim CJ~ S 2"'3 w ao m rt n rte' w (n o 0 a z --I F- =3 1-4 ~~'a i m I>t' T fD T A 0 Z N r r 0 P---4 0:) L0 LO O rt 0 M N V z 03 0 1-h t= o_ ° G r ~)„y,,, o - 7 rh C/7 N ,IF. C. OM rt Z C IG fD 38.971 < .~~wYitil':ivJ•+`~, 477.671 z T South 516.64' N off' 3 6(1 I 0 0 a 0 G Unplatted Lands N.f(D rt (D .`S 0 • rt o- co 0 ^ ° N LO - Cn -p- _ M SEP 17 1999 ° m x ST, CROIX COUNTY o N E o C'OMK*H~VSI VE PARKS Pi.ANNINC_ ~p " = co AND?0N~NGCO,MMITTEF z O N O (D = • T .Z7 (n z N - O O oz ~ • c m co = E >v (D rh• o •v ° o w o r n v D Q- C 7 d 1 C c-1 0 -3 .J • O CD = D r~ W 0 rt p 7 N C 0_ N '7 O tTJ W O •O N ° -0 O rt E 7E W ~ ~ t+• -h D -1 H O C ^ x fD L] ~ 00 o r ~ r Cn = ° M lD C N i9 D m o H fi z pi z t1] Bearings are referenced to the o H north line of the NW} of Section 26, assumed to bear N8903014311E. w 0 0 VOLUME 8 PAGE 2271 ~o 8 Z x-- LLzz SOdd 8 SWDIOA a n3 o► N o a A 'SUIT j o Nosanli hN 16 r = . 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