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AS BUILT SANITARY SYSTEM REPORT
OWNER Wayne Ausen TOWNSHIP St4p'ton
SECTION 3 T 31 N_ 1R 7`W
ADDRESS (9 a l y-t mex . CROIX COUNTY, WISCONSIN
-D,9~ Am 1C 5Yyl) -7
SUBDIVISION- 3.3(. LOT LOT SIZE
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
9004 _
~Ji
r
....R
41
INDICATE NORTH ARROW
BENCHMARK: Elevation and description: 100' Top of 1" Steel Pipe
Alternate benchmark
Weeks Concrete Products
SEPTIC TANK:Manufacturer: Liquid Cap. 1000 Gallons
Rings.used: i Manhole cover elev: Final grade elev:
Tank inlet elev.: 7?- 79 Tank outlet elev.: 9 7- S(v
No. of feet from nearest road: Fronts 3,_ Bide: ~ 1Rear F a'°GU 't
a,.
i
From nearest prop. line:Frontl, Side, Rear' Ft.
No. of feet from: Well
a1 Building: 7
(Include this information in the above plot plan)
(2 reference dimensions to septic tank)
SEE REVERSE SIDE
PUMP CHAMBER N/A
Manufacturer: Liquid Capacity:
Pump Model: Pump/Siphon Manufact.: Pump Size_
Elevation of inlet: -Bottom of tank elevation
Pump on elev.:,_Pump off elev.:______Gallons/cycle:
Alarm: Man.: Switch Type: Location
Distance from nearest prop. line: Front,_, Side_, Rear,_Ft.
Distance from: Well Building
SOIL ABSORPTION SYSTEM
Bed: Trench:2-5'x83' Seepage Pit:
Width: 5~ Length 83' Number of Lines: _2 _ea area Built_
Exist. Grade Elev. 7i•g?s 9~- 95
Proposed Final Grade Elev.
Fill depth to top of pipe: 3/•00
No. feet from nearest prop. line:Frontj 1, SideU Rear t.
No. feet from well: '
-4~1_No. feet from building S/
HOLDING TANK N/A
Manufacturer: Capacity:
No. of rings used: Elevation of bottom tank:
Elevation of inlet:
No. feet from nearest prop. line:Front
Side. , Rear Ft.
No. feet from: Well , building , nearest road
Alarm Manufacturer:
INSPECTOR:
DATE: PLUMBER ON JOB:Rodney Hendrickson
LICENSE NUMBER:JPRS03902
6/90:cj
LOCATION: 3.31.17.STANTON, SE,NE, 245TH AVE.
Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County:
Labor and Human Relations INSPECTION REPORT
Safety and Buildings Division ST. CROIX
(ATTACH TO PERMIT) Sanitary Permit No.:
GENERAL INFORMATION 149302
Permit Holder's Name: ❑ City ❑ Village] Town o : State Plan ID No.:
AUSEN WAYNE STANTON
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
TANK INFORMATION ELEVATION DATA A9200145
S ~
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
Dosing r 3 /z~ /O/, Z
i
Aeration Bldg. Sewer g 97~
Holding St/ t Inlet
a5
TANK SETBACK INFORMATION St/ Fif Outlet
TANK TO P/ L WELL BLDG. Airi to ntake ROAD Dt Inlet
rl
Septic B NA Dt Bottom
Dosin NA Header / Man.
Aeration NA Dist. Pipe
Holding Bot. System
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand S.T Maw
q 91 "1,
Model Number GPM
TDH Lift Friction System TDH Ft
Forcemain Length Dia. Fi Dist. To Well I F
SOIL ABSORPTION SYSTEM
BED/TRENCH Width I Length / No. Of I,renches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSION ~5 33 - oC DIMENSIONS
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
SETBACK
INFORMATION Type O c CHAMBER Model Number:
System: 0.641 p 02) 64 OR UNIT
DISTRIBUTION SYSTEM
Headero6k w0eieil: Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length 19~ Dia. Length T6 P Dia. __44~ 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/resent, etc.)
~h`= ~ 9 SZ
Plan revision required? ❑ Yes No p~
Use other side for additional information. s Z (n:log-
SBD-6710(R 05/91) Date Inspector's Signature Cert. No.
a
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
QILHR SANITARY PERMIT APPLICATION
In accord with ILHR 83.05, Wis. Adm. Code COUNTY
St. Croix
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than
8% X P I.Vf 11 i nches in size. ❑ evlsla~n tOrevious 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
Wayne Ausen SE Y4 NE '4, S 3 T31 , N, R1 7W E (or) W
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
Rt 1 Box 338
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
Star Prairie Wi 54026 (7154248-328
II. TYPE OF BUILDING: (Check one) ❑ State Owned VILLLLAGE NEAREST ROAD
❑ Public 2 5th Ave
X N B )
®1 or 2 Fam. Dwelling,# of bedrooms -3- PARCEL
III. BUILDING USE: (If building type is public, check all that apply) 03G , 100-5'-
1 ❑ Apt/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground N/A 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
40 Church/School 8 ❑ Mobile Home Park 120 Service Station/Car Wash
5 ❑ 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. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.E] Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit # - Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 IN Seepage Trench 22 ❑ In-Ground 420 Pit Privy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
14 ❑ System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE
REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION
450 825 830 .55 Class 2 95.35 Feet 98-35 Feet
VII. TANK CAPACITY Site
in alIons Total #of Prefab. Fiber- Exper.
INFORMATION New Existing Gallons Tanks Manufacturer's Name oncrete Con- Steel glass Plastic App
Tanks Tanks structed
Se tic Tank or Holdin Tank 1 00 1000 1 Weeks Concret
Lift Pump Tank/Si hon Chamber F-1 F-1 Ej M
VIII. RESPONSIBILITY STATEMENT
1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Print): Plu tier's i nature: (No Stam ) MP/MPRSW No.: Business Phone Number:
William Pfannes 6222 (715-7p5-3962
Plumber's Address (Street, City, State, Zip Co
h
IX. COUNTY/DEPARTMENT USE ONLY
Groundwater Date sue Issuing gent Sign No Sta
❑ Disapproved Sa itary Permit Fee (Includes ~'urcharge Fee)
Approved El Owner Given Initial
Adverse Determination
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & 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 enewal 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 (S130 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:
i
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.
ll. 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 ranks 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 wains/ mater 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; close 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)
ATTACHMENT # 2
• i
STC-100
This application form is to be Completed in
the OWlIct(s) Of the full and signed by
will only result in delpys~ofbheg developed. Any inadequacies
development be intended for resale e by issuance. Should this
house), then a second form should be r inedrandncompletedCwhen
the property is sold and submitted to this office with t
appropriate-deed-recording`--- he
owner of property WAYNE AUSEN
Location of property SE 1/4 NE 1/4, Section'--, T 3- 1 7W W
.Township ANTON
Nailing address A4
/ ~0 33
of ,T S 4'Gl 7
Address of site 17y I35 I)eel- U.~
X -I/ 7
Subdivision name
Lot no.
Other homes on property?
YeS~_No
Previous owner of property LG
Total size of parcel
Date parcel was created a -tt.• ~9~2
Are all corners and lot lines identifiable?_
Yes No
la this property being developed for (spec house)?-4-,-Yes No
volume 94L and Page Humber _
of Deeds. as recorded, with the Register
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A WAIUUJITY DEED which includes a DOCUMENT NURDER, VOLUME AND PAGE
11U11[3I:;R F< x H SEAL OF E. T11C 1tEGISTEIt OF DEEDS.
certified survey, if available', ;would be helpful I o asd toi avoid
delays of the reviewin
references to a Certified survey If the deed description
sliall also be required. Y Mapi the certified Survey Hap
PROPERTY OWNER CERTIFICATION
I(we) certify that all statements
best .of on this form are true to the
the ny (our) knowledge that I (we) am (are) the owner (s) of
property described in this information form, by
warranty deed recorded in the office of the Cont Regis of a
Deeds as Document 11o.f1 1 p[f Y Register of
o,:n the proposed sitQ , and that I (we) presently
obtained an easement, torrulne thew abo ei d scrib system o er I (we)
p P rty, for
recorded in cthenoL iceao~f County and the same lies been dul
140.
x
I! ATTACHMENT # 4
DOCUMENT NO. I WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA
STATE BAR OF WISCONSIN FORM 2-1982
481604
.914PAGE 64
- REGISTER'S OFFICE
x co,, wt
Blanche E. Ausen, a single person sr cROi
Reed for Record
APR 0 6 1992
-
conveys and warrants to Wayne- E. . Aus . en and - Paula M. Ausen cT 1: 55 P M
,
g
husband.od.raife_,_..as._.mar.itaJ ._pr.QpQx_Ly.vth.-rihts of
survivorship-----
Register of Deeds
RETURN TO
.
. .
.
.
.
.
.
described..
he following...
. real.estate in ........-St. Croix .
the*
County,
State of Wisconsin:
Tag Parcel No:
I! The East Half of the Southeast Quarter of the Northeast Quarter (Ej of SEJ of
NEB) of Section Three (3), Township Thirty-one (31) North, of Range Seventeen
j' (17) West.
jl
FEE
EXEMPT
I~
i
1
I! This is not _ homestead property.
(is) (is not)
Exception to warranties :
it
r
j Dated this day of March _ 199.2...
li (SEAL) ' r..... I ............-.....-......................(SEAL)
I I
Blanche E. Ausen
(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signature (s) STATE OF WISCONSIN I
ss.
St. Croix
•----•--...---••-•-•--•----•--......__County.
authenticated this day of 19.-..._ Personally came before me this .../_If.------- day of
_MaXCb 19.92 the above named
Ausen•••-•••--•----•-••----••....-•-•----••••-•--
M
TITLE: MEMBER STATE BAR OF WISCONSIN
not .
authorized by § 706.06, Wis. Stats.)
to me known to be the person who executed the
j foregoing strument-and acknowledge the ame. II
THIS INSTRUMENT WAS DRAFTED BY `%M`-
Reinstra, Van D k & Needham, S.C. i
201 South Knowles Avenue, Box 127 ...-..Shar_on..G....$a1Ce>•~k
'I --NP_w--R1chmond-,--*I----- 34.01-7............... Notary Public
II County, Wis.
j (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration
are not necessary.) date: December 5, 93
19...._.._.) li
*Names of persona signing in any capacity should be typed or printed below their signatures. I
WARRAN'rY DEED STATP RAFL AF WFlxv tt,im.c Wiscnrtsin 1 venal Rlan~ Cn Inr
f
DOCUMENT NO. WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA
STATE BAR OF WISCONSIN FORM 2-1982
I
v
Blanche E. Ausen, a single person
-
Wa ne E. Ausen and Paula M. Ausen,
conveys and warrants to _._X
.husband-and, .wife,__as..mari.tal.. property--with rights
.survivoxship------- - .
-
-
.RETURN TO
the following described real estate in St. Croix y
. . ........Count
State of Wisconsin:
Tax Parcel No_
it
The East Half of the Southeast Quarter of the Northeast Quarter (E} of SEJ of
NEJ) of Section Three (3), Township Thirty-one (31) North, of Range Seventeen
(17) West.
i;
~I
I
i
I i
~ I
I
is
I
I
li
i
I
,I
ii This is not - homestead property. I
(is) (is not)
I
Exception to warranties: I
~I
Dated this _...7-T~ - day of March. 199.?. II
~~CC t r~C t. C L L~~J
(SEAL) (SEAL)
Blanche E. Ausen
- _ _
(SEAL) _ .(SEAL)
I'
- -
~I -
i
I!
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN II
I ss.
St. Croix
II County.
I
authenticated this ________day of___________________________ 19 Personally came before me this _day of
March___.---------------------- - 19_9_---_ the above named I
B1anPhP_--E --users
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, . -
authorized by § 706.06, Wis. Stats.) to me known to be the person who executed the
foregoing i strument and acknowledge the a 1.
THIS INSTRUMENT WAS DRAFTED BY
Reinstra, Van Dyk & Needham, S.C.
- - -
201 South Knowles Avenue, Box 127 *....Sb~ar.o.n G.. Ba1Ce.i^ek
..Nlew--R-irhmond-;--W-1-----5.4-G1-7....................... Notary Public St, Croix County, Wis.
(Signatures may be authenticated or acknowledged. Both My Commission is permanent. (11' not, state expiration
are not necessary.) date: -.--December- S, 199----
*Names of persons signing in any capacity should be typed or printed below their signatures.
WARRANTY nF.F.n STATh ]3Att OF W1bUl~NSiTi Wisconsin Legal Blank Co., Inc.
ATTACHMENT #3
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER WAYNE AUSEN
/796 3s ~
ADDRESS : V~elr-1-4t 41-T- ',(-pp FIRE •
NO.
Is -
LOCATION: SE _1/4, NE _1/4, SEC.= _T 31 N-R 17 Wl_
TOWN OF: STANTON
ST.•CROIX COUNTYYes
SUBDIVISION:- LOT NO.
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
put 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 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 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
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 returned to the St.
Croix County Zoning officer within 30 days of the three year
expiration date.
SIGNED: DATE:
St. Croix County Zoning office
911 4th St.
Hudson, WI 54016
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
'IN`DtJSTRY, DIVISION
P.O. BOX 76
LABOR AND PERCOLATION TESTS (115) MADISON WI 53707
HUMAN RELATIONS
(H63.090) & Chapter 145.045)
LOCATION: SECTION: TOWNSHIP/MCLITY: LOT NO.: BLK. NO.: SUBDIVISION NAME:
S1 1/4 NY4 3 /T31 N/Rl71K(orl W Stanton n/a n/a n/a
COUNTY: OWNER'S NAME: MAILING ADDRESS:
St. Croix Wayne Ausen R.R.4r1, Star Prarie, Wi. 54026
USE DATES OBSERVATIONS MADE
TESTS:
NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION
Residence 3 n/a Clew Replace I 2-25-92 n/a
RATING: S= Site suitable for system U= Site unsuitable for system
r2s ONVENTIOIN-GROUND•PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional)
❑U ®S ❑U RS ❑U ❑ S ~U ❑ S ®U conventional
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: class 2 Floodplain, indicate Floodplain elevation: n/a
PROFILE DESCRIPTIONS page 5 JSB
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN. ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
13- 1 86 99.0 none >86 -13 10yr3/31.,13-3510yr4/4sil.,35-867.5yr4/4s.1.
2 85 98.35 none >85 -1010yr3/31.,10-3010yr4/4si1.,30-857.5yr4/4s.1.
B-
3 90 98.60 none >90 -13-10yr3/2,1.,13-3210yr4/4,sil.,32-90-7.5yr4/4,s 1.
B-
B- 4 83 98.45 none >83 -12-10yr3/3,1.,12-29-10yr4/4,sil.,29-837.5yr4/4,s 1.
B- 5 82 99.25 none >82 -1410yr3/2,1.,14-2810yr4/4,sil.,28-827.5yr4/4,s.1
B_
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PE RIOD2 PERIOD PER INCH
P-
P-
P-Bee defflign rate
P
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 points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope.
SYSTEM ELEVATION 95.35
3
A, _
~H
j
~ ~ .L j E l ~ I t
1 f _
t
J_ -
ji' ,
b
1, the undersigned, hereby certify that the soil tests reported on this f e 'L= accord with the procedures and methods specified in the Wisconsin
Administrative Code, and that the data recorded and the location of t A— correct f~yb of my knowledge and belief.
NAME (print): TESTS WERE COMPLETED ON:
Gary L. Steel EVE 2-25-92
ADDRESS: dD ERTIFICATION NUMBER: PHONE NUMBER (optional):
1554 200th. Me., New Richmond, Wi. 17 `Z 2298 171577 246-6200
ST SIGN RE:
COUNTY
zOA(ING oF~rcE w
DISTRIBUTION: Original and one copy to Local Authority, Property 9 r n I e
DILHR-SBD-6395 (R. 02/82) - OVER -
INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395
To be a complete and accurate soil test, your report include.
1. Complete legal description;
2. The use section must clearly indicate whether this is a residence or commercial project;
3. MAXIMUM number of bedroor > or commercial use planned;
4. Is this a new or replacement sy, -1;
5. Complete the suitability ratin(, . A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL
OTHER SYSTEMS ARE RULE' DUT BASED ON SOIL CONDITIONS;
6. 1? ASE use the abbreviations shown here for writing profile descriptions and completing the plot plan;
AKE A LEGIBLE diagram accurately locati ig your test locations. Drawing to scale is preferred. A
irate sheet. may be used if desired;
<;,e sure your benchmark and vertical elevation reference point are clearly shown, and are permanent;
9. C:ornplete all appropriate boxes as to dates, names, addresses, flood plain data, percolation test exemp-
tior, if appropriate;
10 i-formation (such as floo-' plain, elevatio=i) does not apply, place N.A. ate box;
1 I . ii and place your cur -it address and your certification numb,,,;
1.' c>pies and distr. as required. ALL SOIL TESTS MUST ~E f D WITH THE
LOCAL AUTHORITY WITHIN DAYS OF COMPLETION.
A€ ;EVIATIONS FOR CERTIFI D SOIL TESTS
Soil Separates and Textures Other Symbols
st - St:ona (over 10") BR Bedrock
cob - Gobble (3 - 10") SS - Sandstone
gr Gravel (under 3") LS Limestone
s - H: - High Gro
cs - C Sand F' Percolation
med s - Sand - Well
Xis ie Sand B 7 - Building
is - Loamy Sand > - Greater Than
sl Sandy Loam < - Less Than
II Loam Bn - Brown
sil - Silt Loarn BI Black
si - Silt Gy - Gray
cl - Clay Loarn y Yellow
scl Sandy Clay Loam R - Red
siel - Silty Clay Loam mot - Mottles
sr., - Sandy Clay w! - with
sic - .::17y Clay fff few, fine, f<
C. y cc - cornmon, t
rat nrm - Many, n
rn - d - distinct
p - prominent t
HVVL - High water level,
` -1 Textures _ surface w4;
iv& e disposal BM - Bench M-,rl;
VRP Vertical R ce Point
TO THE OWNER:
T t rt is the first step in securing a sanitary permit. The county or the Department may request
)n of --)is soil test in the field prior to permit: issuance. A complete spat of plans for the private
system and a permit application must be submitted to the appropriate local authority in order to
obt i a permit. The sanitary permit most be obtained and posted prior to the start of any construction.
PAGE 1 OF 3
TITLE SHEET
FOR: Wayne Ausen
Rt 1, Box 338
Star Prairie,Wi 54026
PROPERTY LOCATION:SE NE SEC 3 T31H R17W,Stanton Township,ST.Croix County
PAGE 1: TITLE SHEET
PAGE 2: PLOT PLAN
PAGE 3: SYSTEM CROSS OF TRENCH
ATTACHMENTS:
1. 115 PERCOLATION TEST
2. STC 100
3. STC 105
4. DEED (DOCUMENT N0.481604)
5. HOUSE PLANS
DATED: 4-13-92
w LL A ANNES MP 6222
Box 552
Dresser,Wi. 54009
715-755-396
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PAGE 3 OF 3
CROSS SECTION OF A TRENCH SYSTEM
4" Cast Vent 12"
Soil Fill
Approved
Synthetic Cover Aggregate 2"
Above Dist.Pipe
4"Distribution
Pi e
6"of 1/2"-2-1/2'
Algregate
Elev of 95.35 Feet Be ow Pipe
Distribution pipe to be at least 36 inches below original grade
and at least 20 inches but no more than 42 inches below grade.
Maximum depth of excavation from original grade will be 44 Inches
Minimum depth of excavation from original grade will be 36 Inches
NI LLI RN P'FANNE HP 62272
Box 552
Dresser,Wi 54009 System Designed by;
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' 47"4* New Richmond
OLFUS IMPLEMENT INC. Granite Works
CANNING PHONE: 446-4011
CORPORATION
qq~
PHONE: 246-6565 DEERE MARKERS - MONUMENTS
BRONZE TABLETS
NEW RICHMOND, WISCONSIN NEW RICHMOND, f
NEW RICHMOND,
54017 WISCONSIN 54017 WISCONSIN I
dR % rt npn Deoa'(r.mert of trduitry. ~)UIL UC:)%_tUr t tvrc I%LI vn r
Labor and human Relauont = U lot
(Attach Soil Profile Location Map • To Scale . On A Separate. Signed Sheet) r.tadrson.:t
Page
CLXT04RKVA evil. DAle ctlre'BlT IMO Us& Vw"N" IanBlr Narl~ d we►Kf R n/r+da
H=e Ausen cro land outwas TA0 n~qa
_
crrv STATE He MUM s.sS t Vw oror s
R.Rs~31, Star Prarie, Wi. 54026 St. Croix 4
Sf ► 114 NE 3 1 17 T~Stanon Tµe 0. s~
DORM 114 1 CSMI
k LCIT n/a 13LOCK n/a sueotvlsioN n/a XNSW -Ree1ACe
B- 1 Houton Depth Dominant Color Mottles Structure Urntttn9 Faclorr Laan9GPD•sq. M.
In Munsell u. St. Cont. Color Texture Gr. St. Sh. Consistence Roots Boundary Depth Trench Bed
1 -13 10yr3/3 none 1. 2/m/sbl mvfr 2 C none .3 .2
Elcv = 2 3-35 10yr4/4 none sil. 1/f/gr mvAi 1/f G none .0 .0
99.0 3 5-86 7.5yr4/4 none s.l. 2/m/sb mvfr 1/f n.a noen .6 .5
Q. HorTton Depth Dominant Color Mottles Structure Umrtln9 Faclorr Loa6n9.GPDs4 R.
In, Munsell u St. Cont. Color Texture Gr. St. Sh. ffConv,.Ifence Roots Boundar Depth Trench Bed
1 0-10 10 r3/3 none 1. 2 m s2 f C none .3 .2
Elev 2 10-3 10yr4/4 none sil. 1/f/ r 1/f G none .0 .0
8.35 3 30-8 7.5yr4/4 none s.l. 2/m/sbk mvfr 1/f n /a none .6 .5
M
I Houton Depth Dominant Color Mottles Structure UrnItIn9 Feeler/ Loadtn9G13Dse N.
B-3 In, Munsell u. St. Cont. Color Texture Gr. St. Sh. Consistence Roots Bounds Depth Trench Bed
1 -13 10yr3/2 none 1. 2/m/sb mvfr 2/f C none
Elev = 2 3-32 10yr4/4 none sil. L/f/gr mvfi 1 f G on
8.6 3 2-90 7.5yt4/4 none s.l. 2/m/sb mvfr /f n/a none .6 .5
Morison Depth DomtnantColor Mottles Structure Umntnp Facterr Leaan9CPOrsq.R.
B-4. In. Mun ell u. St. Cont. Color Texture Gr. St. Sh. Consistence Roots Bounds Oepth Trench Bed
1 -12 1 3/3 none 1. 2 m sb mvfr 2/f C none .3 .2
Elev = 2 2-29 10yr4/4 none sil. 1/f/gr mvfi 1/f G none .0 .0
8.45 3 9-83 7.5yr4/4 none s.l'. 2/m/sb mvfr 1/f n/a none .6 .5
Houton Depth Dominant Color Mottles Structure Llmltlnq Faclorr Loaran9GPDosq. R.
B-5 In. Munsell u, St. Cont. Color Texture Gr. St. Sh. Consistence Roost Boundar Depth Trench Bed
1 -14 10yr3/2 none 1. /m/sbk mvfr /f C none .3 .2
Elev = 2 4-2 10yr4/4 none sil. 1/f/gr mvfi 1/f G none .0 .0
99.2 3 8-87.5 4/4 .none s.l. /m/sbk mvfr 1 f n /a none .6
Additional Remarks: RECOMMENDED SYSTEM TYPE: b 1111,
page # Soil series JsB &yf~~
lot 20 arrpql Nl~A
plot on back' 12!7 . k
~FIce
Other Site Features: 11
95.35 2-228-92 f11 5 ► .46-62.00 9.2.92
Sysicm Elcvation w cure OsleSrgned Telephone No. CST •
Gary L. teel, 1554 200th. Ave., New Richmond, Wi. 54017
CST Name (Print) City 61619 Zip
AIC)
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