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HomeMy WebLinkAbout036-1021-10-100 `V O C o 3 0 0 es k.n m o ~c G ~ C N I n ~ a) © 0 V Z a ro 0) 00 c o 'y o I r CO CD a N "O N O ' ro O 3 O p p m (D -o y U ca a) 3 Q N C C N O W p N 0 fa a7 C z >.mya) LL C 3 _ C N 0 L 0 3: O Ii O m C N Y Y Q w U U Z N r- Fr It Z o z m m o c~ w d m ~ z c c U' p v o z d' i c a~i Z ! o ~ .o I (n F- ~ -p N ~ N_ O i CL N a) N C N N C O •N L a ~ ro Q o aa) Q w z m z o N Z N a) C N IL i C V C cD ~y ~ I to N al ~ a) N p O v O a a N Q p V1 m w E w N F H H 4 0 0 0 z •N IL CL IL o C\l 04 a) 0) rn aNi in J U rn o m °o ~ N ~ O o l O C_ O O Co N a) i73 a) O ' i O O i N C m a Q C I a`) ° o a E Lo Q ° c) 3o d aD CL c 1 a rn o c E c c v (D o N C O N O a) 0 0 M H M C C N O ro o a w E ro ro Q • yam' o r o z N i9 0 Cd U)i i6 a . ` a • C d E . m r` 0 i C C w 3 1 1( A C.) a ~ 0 (1) L) REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS DEPARTMENT OF DIVISION INDUSTRY, P.O. BOX 7969 LABOR AND PERCOLATION TESTS (115) MADISON, WI 53707 HUMAN RELATIONS (ILHR 83.0911) & Chapter 145) LOT. NO.: BLK. NO.: SUBDIVISION NAME: LOCATION: SECTION: TOWNSHIP/ MUNICIPALITY: IV / a /T31 N/R 17 (or) W St c_,Ao r, MAILING ADDRESS: COUNTY: OWNER'S BUYER'S/NAM Q O ~CrC~ ~r~a DATES OBSERVATIONS MADE USE R S: IV TS: NO. B ORMS.: COMM R AL D RIPTION: New Replace 1 Residence '3 TN RATING: S= Site suitable for system U= Site unsuitable for system ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOM~ n vEi SYST~E~M:(optianal) s au S S U S U S U ln. F'IESIGN RATE: If any portion of the tested area is in the J If Percolation Tests are NOT required C I QA AT jll- Floodplain, indicate Floodplain elevation: under s. ILHR 83.0915)(b), indicate: ` IJ) PROFILE DESCRIPTIONS 15 CHARAC i5i NUMBER DEPTH N, ELEVATION P BSER EROUND ESTERII FICHES TO EfTK IF OBSIERVED ISEEI ABBRV ON BACK jEXTUREAN ITH I I. HQ- G~b' BKS~JJ ~°~3113- 0-1,2 $k5d b-.2La.% 5,/ ~E-yy 13,519 -72 ~o -~v jBK i0 S 643 J -ZS -;1y 5/ w Sa o - K 3,11 Ail S` ,JAS. 6t St IsJ c S B- ~C 3,3 v -10 B k s l J /D ~a y~3.. s y ,B► s flits S~ Sy j~l~ 1L > B- _S B PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. t -r-81 D PERINCH P Ri D P. / 3)5 Vii. P. 3j* 7 P. 3 , V ► i i 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^urface elevation at all borings and the direction and percent of land slope. 9-7 f r CI SYSTEM ELEVATION _w CA. rptk- L.ocgl~w. oss S~`I~S' H I 1, the undersi ad, hereby certify that t e 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 r orded and the location of the tests are correct to the best of my knowledge and belief. NAME (pri TESTS WERE COMPLETED ON: i{ Q P r, ATION NUMBER: PHONE NUMBER (optional) 91. FIC ADDRESS: CERTI - 'j 12T ~ s CST N TUR .L DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. i nIL.HR-SBD-6395 (R. 10/83) - OVER - 4.1 AS BUILT SANITARY SYSTEM REPORT OWNER Y n~ n S a , , C' TOWNSHIP SECTION A6 T_~/ _N-R_j4? W ADDRESS ~7 ~/74 ST.-CROIX COUNTY, WISCONSIN SUBDIVISION A)1 LOT.AtA__ LOT SIZE l~• t~. 33 PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM elk/ III {7 IV INDICATE RTH ARROW BENCHMARK:Elevation and description: A)a~ Alternate benchmark SEPTIC TANK:Manufacturer: Liquid Cap. ,J&75-t=~ Rings used:-J-Manhole cover elev: 041;4 Final grade elev• `602 Tank inlet elev.: 91,11/ Tank outlet elev.: 9p, 79 No. of feet from nearest road:Front4, Side, Rear Ft.__'V41 ~ i From nearest,prop. line:Front Side, Rear Ft. ~ s No. of feet from: Well , Building: (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER • I 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: Seepage Pit: Width: /a. - Length 9 Number of Lines:-c2-Area Built//70 Exist. Grade Elev. Proposed Final Grade Elev. /DD, 4;~ Fill depth to top of pipe: oQ No. feet from nearest prop. line:Front , Side Rear Ft p?) S No. feet from well: 61A- No. feet from building 36 HOLDING TANK 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: l/- r~oZ PLUMBER ON JOB: LICENSE NUMBER: LS~+~ 6/90:cj "VpTC;rSSQpaj enfofl'nduNtry10.31.17• PRIVAT~` SEWAGE SY~TEM• RD. H County: Safety Labora and ,Huma Buildinngs D Divisi Reivisi s on INSPECTION REPORT ST. CROIX (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 180262 Permit Holder's Name: ❑ City ❑ Village [3t Town o : State Plan ID No.: SHANNON. PETER STANTON CST BM Elev.: Insp. BM Elev.: BM Description: ~ Parcel Tax No.: 1 0©- O 5Q/I'Y Q. ~ ~ f b4.L" ~ 036-1021-10-000 TANK INFORMATION ELEVATION DATA A9200342 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark lo,y~ Dosing Aeration Bldg. Sewer nn Holding St/ Ht Inlet) q v1 , j!e TANK SETBACK INFORMATION St/ Ht Outlet b68 g, 7 TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic d 6 a NA Dt Bottom Dosing NA Header / Man. 3L Aeration NA Dist. Pipe , 3 9%A Holding Bot. System R+") 1, PUMP/ SIPHON INFORMATION Final Grade 00 Manufacturer Demand Model Number GPM TDH Lift Friction - System TDH Ft Head Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Le gt No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS LEACHING Manufacturer: SETBACK SYSTEM TO P / L BLDG WELL LAKE / STREAM INFORMATION TypeOfTL" CHAMBER Model Number: System: d / D ~0 A)OAI 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 y (j xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center a Bed /Trench Edges I ? Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discre~an4s, persons present, etc.) Plan revision required? ❑ Yes No y~ - Use other side for additional information. f SBD-6710 (R 05/91) Date / 'Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: R ®ILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code couNTY STATE SA TYPERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than / 8% x 11 inches in size. ❑ cdec T.fesion to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPE~ITY OWNER PROPERTY LOCATION r)W Aj r_ '/4,S T.3/, N, R f -7 J& P PROPERTY OWNER'S MAILING ADDRESS _ LO f,# / BLOCK # N , CITY, ST IE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER 'v %l wt 55fejo 7 'VIA - !V q. II. TYPE OF BUILDING: (Check one) CITY NEARE~OADO' F-1 State Owned Q VILLAGE OF: : t /ha~JJ ❑ Public 1 or 2 Fam. Dwelling-~#of bedrooftl5,~ AR LTAXNUMBE ( ) 636 111. 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 12 ❑ 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. W New 2. ❑ Replacement 3. ❑ Replacement of 4.E] Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued V. TYPE OF SYSTEM: ' (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 X 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 5o REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (MMiin.//iinch) ELEVATION ~f 1170 Al 38 al T 21 Feet /00.9 Feet VII. TANK CAPACITY Site in alIons Total # of Prefab. Fiber- Exper. INFORMATION New Existing Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App. Tanks Tanks structed Septic Tank or Holdin Tank 00 G O WQ rf, i+G 1 0 1 11 . -LL-f -1 1 El Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. ure: (No Stamps) /MPRSW No.: Business Phone Number: gp4 Plumber's Name nnt): Plumber's Si CalUIrow~, ~s~~ 7/s avr,-5135' Plumber's Address (Street, City State, Zip Code): 1949 .5= G a~ IX. CO JJNTYIDEPARTMENT USE ONLY ❑ Disapproved Mary Permit Fee (Includes Groundwater Date Issued Issuing gent Sign re (No S ps Owner Given Initial Surcharge Fee) )4'Approved ❑ AdverseDetermination ~G Z 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. 1*06r-sanitar • 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 subfW ted to the county prior.to installation. 5. OnsMd sewage =systems musl•be properly maintained. The septic tank(s) must be puriiped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If r u` have questions concernin t i` yo g your onsite sewage system, contact your local code adrhinistrator 'or the State of Wisconsin, Safety & B4gdings Division, 608-266-4 15. y f . To be pr' pt?,* and-accurate this+sanitary permit application `must include: 1. Property owner's naMeendtiailing acititpes. Provide the legal description and parcel tax number(s) of where the system isjo 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 y tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all r',, 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'f 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 nufacturer; D) cross section of the soil absorption system it, " required by1he county; E) sv41 test data on-pa f&form; and F) aellWairtg',informalsk.' Gili-du 1D~A7~q-51 CHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. J' ',,The vOies 0116cted through these surcharges are used;for monitq,r,ng groun~dpater, grounEi ; water contamination investigations and establishmentof standards. t SBD-6398 (R.11/88) 3 1 G STC-100 This application form is to be completed in full and signed by the owner(s) of the property being Bevel o ed. will onl p any inadequacies y result in delays of the development be intended for resale bytowissuance. ner/contr ctor,) spec house), then a second form show p ld be ret the ained and completed property is sold and submitted to this office with when appropriate deed recording. owner of property r h ca w n o r• Location of property_e_1/4 r"1/4t Section ~ L_, T_'LN-R W Township -t&-- Mailing address - i 7? 7 C;L±L N j%a.h P~r~~ $ydb 7 Address of site 41 Subdivision name Lot no. Other homes on property? yes - No Previous owner of property Ndlp coo k Total size of parcel 3. 4 ,:~-7 qc r,e a -s Date parcel was created 9 S -3- Are all corners and lot lines identifiable? 'r Yes No Is this property being developed for (spec house)? Yes tNo volume=and Page Number _l9 as recorded. with the Re iste { of Deeds. g r INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NURBER, VOLUME AND PAGE NUMBER & THE SEAL Or THE REGISTER OF DEEDS. certified survey, if available', would be helpful I o asdtoloavoid 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._/~7~? and that I we ) own the proposed site for the sewage disposal system orr I e(we) obtained an easement, to run the above described the construction of said system, and the same haso beert, for n duly recorded in the office of County Register of deeds as Document No. l ,w % igna, ture of app~licant Co-applicant Date of Signature Date of Signature DOCUMENT.NO. STATE BAR OF WISCONSIN FORM 3-1882 THIS SPACE RESERVED FOR RECORDING DATA QUIT CLAIM DEED 486735 vo~' 96 n COOL REGISTERS OFFICE a SE CROix IM, wi A. Read for Record AUG 0 41992 quit-claims t Q vt v~ n, Yr C at , v 11:15 AN P e-A e- X- -DI C, h Y\. C> "-N - ~S lc~ P-4 o e ~R inter @9 the following described real es ate in !5SA C. r O t 1( County, of Deeds State of Wisconsin: RETURN To I' Tax Parcel No: I' Co~I`l.rne~cihc~ ~~I 17e NE Coylne'c C:1 i S a~c~l Sec~r~r~ l~;~khence I.~EST 3►~,~1 -'ee,4 C"'"^a he tinc,rkln ~~he I , 6-3;~ sc-,J & nl E Y e31 n k, n~ Cb ~ ~ ~ S 6, C,c ►p~-~ o~► +herce So3f, 3y i N r ~y3,Fs6 "e~-f ' -~ke-vace LJ 9- ST 37fo, `10 _4 ~ A- kevtce R7 H yqS. 00 -P L 1• ne C:> ~ h e +ke n ce -'4s T S C~.I C~ ~oY 1~ C~\ -V\c S CL t'CQ ~ l'n Q -e' I r1✓i ~ V, ACL cJ ( p, M )L VOy e- "~.C9O7 oc eE~ r ~ +o ~t5h f YN Ce. n Su6,Cc-~ ~U .P~Se~ne~c~Sil Y~S-~vlCd-c dN S S ~ 4 L 01d4v~ c~- S O S Y e co`C cQ . 1 -150 GQ e SGr~ b etQ CLS G 5 rn 40+ 1 U'Di FEE This 1 9; r%h-•homestead property. (is) (is not) Dated this a day of 11fIIttiPMRT 19~-- yet!r~ ldelwe~ (SEAL) (SEAL) -i'„`-, J <-rt9T,e (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN S7. C re ~ i1 County. SS. authenticated this day of '19 Personally came before me this 4 V tk day of i~ n , 19~the above named u o/~ t,:C od~ •a.x~, TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person S ~ 6 h ax~cuted'tt1~//j7 authorized by § 706.06, Wis. Stats.) foregoing instrument and acknowledge ese. °i THIS INSTRUMENT WAS DRAFTED BY C 0 A'jt V ~ pU C, County, Wiw!' MyaCommission is permanent.` (If n + s b••~@xRJiA*6 (Signatures may be authenticated or acknowledged. Both y~ are not necessary.) date: ALgt'`sr sy..° 4j 'Names of persons signing in any capacity should be typed or printed below their signatures. S83 NTF 0023 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County .R-t<e. S h ce ►1 n ar. OWNER/BUYER k ADDRESS: 7 9 7 O Q¢Q,p fckjr,,~_W'rFIRE NO: LOCATION: /Jr--_1/4,, A)E_1/4, SEC._ Jo T_ 3/ N-R /7 W, TOWN OF:- Sf~n-fb y~, ST. - CROIX COUNTY I 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/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: I DATE:__ l 1 St. Croix County Zoning office 911 4th St. - Hudson, WI 54016 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION -LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX 76 N WI 53707 HUMAN RELATIONS l (ILHR 83.0911) & Chapter 145) 60CATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME: N- ~4 /b /T31 N/R 17 (or) W s~ N COUNTY: OWNER'S BUYER'S/NAME. MAILING ADDRESS: '+.chai+ ~dfl /7 i-S 00 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: 1X New DESCRIPTIONS: 1PERCOLATION TESTS: K Residence N L~New ❑Replace ,y RATING: S= Site suitable for system U= Site unsuitable for system S '-S x a w CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECO//pMMENDED SYSTF~M:(optional) S ❑U S ❑U S ❑U ❑ S U F1 S U N rN V lJ " DESIGN RATE: If Percolation Tests are NOT required If any portion of the tested area is in the under s. ILHR 83.09(5) (b), indicate: 1 qSs. Floodplain, indicate Floodplain elevation: N PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST. HIGHEST- TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B o -/a $k5'd 15A-6 B- X06, o-IV FK s/J /a ~5 BaS~ ~S-95' 5;;p -&,U 5 B- S /b/ dIV- o - K Si/1 9 -mss A" S:/ 23- ss A% S-l- - B- .16 3'_'? A) cam- w s 0 -/0 t K5 s, y Yol S w flwas Ste. B- PERCOLATION TESTS I TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PER PER INCH P_ / 3>S /UO P- ,3., I c P_ :3. -7A 4F RAIL 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 9-7/ C`t Pi H l I . p r►r~ 4 50 E E 0, pa4l E 3 DID_ j n - ~ ~C Qty ar. ors s~`~~ 10 p - ~ 3 3 3; E E z l ~x ~-T 1, the undersi ed, hereby certify that t e 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 r 10 ?d and the location of the tests are correct to the best of my knowledge and belief. NAME (pri TESTS WERE COMPLETED ON: Z U A. D~JQrj y' ~ 9 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): Ccl S 53 71 S 0/ •7 CST N TUR Jr' DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R, 10/83) - OVER - " 'L.ET =~M 115 - , IF ALL 1- F4 "Al ION i i TOTHE01 Th' soil test reps - :urirg a sa n ._,.y ^y rec nest ve, -arioe of this s :_eid prim to permit i .ic- c, _ private system and a -plication must bE, eider to of i i a permit, The sai 1 rrnit l and )osted (prior ° ,,icI n. it I I I 1 ~ ~ i I I ~ I I + I t I , I I I I t ~ _~I I I I 1 I I , , ~ I I t I I i 1 ~ I ~ t ~ I ~ ~ t I t I 1 , I , I I i , 1 I --L - I f } l -lI - R1 At Z4, /I iT3~ ✓7~J I _ r I - _ _1 ! i r I I i t I + ~ I rt ~ { r I 4ee I F Y`tQ1 uS I , + I I I I _ 1 I 9ax - I + 4 1 I I ! t PR~ I ~ i r I~ 1- I r , i i i ~ 1 i I + 1 I t ~ I ~ - A , I 1 I--i ' I -i t ~i - - -1 - -I- - - I - I - 1 t ~ , ' I l- ' - - 1 ' j a 4- 4 4- ~ t ! { I I ~ ! 1 l I- -3f 1 I I V i__ ! t F 1 _ f- , I I , I I I ~ I , I I ! i + ; it I t , ~ 1 ~ ; 1 , 1 I ! I I + . I ' I I i i i~ l I I ~ I I ~ l ' i I ; i 1 ~ I I I I , , , I t c I ~ i f ~ 1 I ~ t 0~ , t , i I I I ~ I i ' I y i -1 t - - I I, I I : 1 'I I i I I I I 1 t I ; ! I I fi ~ L 1 - --I r t I T - I It ~ ~ 1- f G - _ I ~ r I I I ~ i I I ~ I I ~ I I 1 I I l ' t 1 I I I I I I I i : ~ I I i ~ I-- h I f i ' I I I I I I l t I ~ ~ I I I i I I C U S S S C C I U r1 Q T' /"-1 U C 17 J~ S I~ ~ n-~ 17 97 ~t Rd Fresh Air Inl.i. And ODsuvollon Pip• Dow-r .r k ,sy0p~ ~ADprorid V,nt Cop Minimum 12" AUOr, fl-01 Grad. 20- 42' ADor. Pip' - 4" Carl Iron To Final Or.., V,nl PIP, Mare Hor Or SrntMlk Co vlny win r, r 2 Pipjyr•9ol. O Oi11l IE.Ilon Pip. 0 0 0 - T,. ti Ayyr,yol. Banaal4 PIP. o P.rlorrl,d PIP, (J.I.r o Corpltnp T,rminallnp Al 6.Il.rn 01 STrirm ~.~cJ..71or1 ~ / SOIL FILL DISTRIBUTIOvI PIPE 'C APPROVED SS )JPAETIC COVCR 2"of AGGREGATC '11ATERIM- OR 9" of STRAW OR MARSH HA-j ELEV. OF 7. FEES" Je' OFl2-2t/p AGGREGATE - DISTRIDUTIOU PIPE TU BE AT LEggT _ oZ7 INCHES BELOW ORIGIIJAL GRADE AQU AT LEASTLO IMCHE-e BU7 1.10 MORC THAIJ 42. IAICNES 13ELOW FI►JAL GRADE MAXIMUM DWH OF EXCAVAT100 FROM ORIGWAL (j Ati~ WILL BE IIJCHES Il" MUM CKF "N of EACAVATIC" r-KOM 0 I16INAL GRAPE WILL BE INCHES S I G IJ E p: ~~if(~f1'') LICEUSC DUMBER: /JrGJ DATE: - - TTa REPT131 STANTON ST. CROIX COUNTY ZONING PAGE 1 ll/A5/9' 16:32 REQUESTS FOR INSPECTION WORK SHEETS FOR: 11/ 6/92 AREA: MJ Activity: A9200342 11/ 6/92 Type: CONVSEPT Status: PENDING Constr: Address: STANTON 10.31.17.133,NE,NE, LOT 1, CO. RD. H Parcel: 036-1021-10-000 Occ: Use: Description: 180262 Applicant: SHANNON, PETER Phone: Owner: SHANNON, PETER Phone: Contractor: POWERS, CALVIN Phone: Inspection Request Information..... Requestor: POWERS, CAL Phone: Req Time: 11:11 Comments : Items requested to be Inspected... Action Comments Time Exp 00012 FINAL INSPECTION I Inspection History..... Item: 00012 FINAL INSPECTION Parcel 036-1021-10-100 06/19/2007 03:39 PM PAGE 10F1 Alt. Parcel 10.31.17.133A 036 - TOWN OF STANTON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - SHANNON, PETER C & DEANNA M COOK PETER C & DEANNA M COOK SHANNON 1795 CTY RD H DEER PARK WI 54007 Districts: SC School SP = Special Property Address(es): * = Primary Type Dist # Description " 1795 CTY RD H SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 3.687 Plat: N/A-NOT AVAILABLE SEC 10 T31 N R17W PT NE NE BEING LOT 1 OF Block/Condo Bldg: CSM 9/2496 3.687 ACRES Tract(s): (Sec-Twn-Rng 401/4 1601/4) 10-31N-17W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 962/197 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 05/05/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.687 25,000 176,200 201,200 NO Totals for 2007: General Property 3.687 25,000 176,200 201,200 Woodland 0.000 0 0 Totals for 2006: General Property 3.687 25,000 176,200 201,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 126 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 036-1021-10-000 06/19/2007 03:41 PM PAGE IOF1 Alt. Parcel 10.31.17.133 036 - TOWN OF STANTON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - COOK NOLE R & DIANE G TR NOLE R & DIANE G TR COOK 1797 CTY RD H DEER PARK WI 54007 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 1797 CTY RD H SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 36.313 Plat: N/A-NOT AVAILABLE SEC 10 T31N R17W NE NE EXC PT TO CSM Block/Condo Bldg: 9/2496 Tract(s): (Sec-Twn-Rng 40 1 /4 160 1/4) 10-31 N-1 7W Notes: Parcel History: Date Doc # Vol/Page Type 04/02/2004 758503 2540/293 QC 2007 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 04/16/2007 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.313 17,000 218,500 235,500 NO AGRICULTURAL G4 33.000 5,800 0 5,800 NO UNDEVELOPED G5 2.000 1,400 0 1,400 NO Totals for 2007: General Property 36.313 24,200 218,500 242,700 Woodland 0.000 0 0 Totals for 2006: General Property 36.313 21,300 218,500 239,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 129 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Ale Cl 3 2 &2 -2 0, 7 a 42 ~ 485JL39 CERTIFIE D SURVEY MAP LOCATED IN THE NEJ OF THE NEJ OF SECTION 10, T31.N,.R17W, TOWN OF STANTON,ST. CROIX COUNTY, WISCONSIN. ® II I N SCALE i = 100 LEGEND 100 50 0 100 Found county monumewntst of record, aluminum cap in concrete. Bearings are referenced to the p Set 1" x 24" iron pipe north line of the NE1/4 assumed weighing 1.68 pounds per to bear east. linear foot. x Fence SE6CR0 U1-~P 1~~ -IANQS_ NE CORNER - SECTION 10-3.1-17 NORTH LINE OF C . I , fu 1 H I' 198~$9.94 EAST 34875' w WE 811 FENCE POSTCCUIES , CORNER-IRON PIPE SET EAST 350-81' RD. R/W LOO' NORTH OF POSITION SHOWN. V, it W 0 i! C 0 C p FILED APPROVED JUN r g 1992•• 0 BUILDING SETBACK JAMES O'CONNELL ,1U1V 2 6 `92 Q o Q' St Cfer Crobc oGD Wl SL QI d- d• i . LOT I Q ST, CROIX COUNtf Y j! C b J 10omarehensive P(4nnin~a i I Zoning and o 160,622 SQ. FT. \ W UJParks Committ" 3.687 ACRES _ 1 j 0 INCLUDING R/W p i~_i I If not rocorded O 149,079 ..S Q. FT, b N al W!" 30 days,of D- O ZI d- 3.422 ACRES 0 c ZI approval dato ~I EXCLUDING R/W M ~I approval shaft be nub & void N ,~~eostte~o+lla4y ~ e WEST+ RONALD F. g• ; 376.40 0 ,'o. N y AN1F; c...,. 1 UNPLATTED LANDS WI~a. ° N4 ~b '•t'P,pHfrPAtil%~x'b COUNTY GENERAL NOTICE: Each parcel shown on this map is subject to state and county laws, rules and regulations ( i.e. , wetlands, minimum lot size, access to parcel, etc. Before purchasing or developing any parcel, contact the St. Croix County Zoning Office for advice. OWNER SURVEYED BY. Diane Cook A & E Land Surveying 1797 Cty. Rd."H" P.O. Box 325 Deer Park, Wi. New Richmond, Wi t 54007 54017 This instrument was drafted by Paul Gibson VOLUME 9 PAGE 2496