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HomeMy WebLinkAbout040-1188-90-006 Q) 9 o! ° I > Ir ^ Q n N Q M (0 a) X 76 fi r 2 .2, 2 Y U m -a a Y C Q) 0 (D v> S' 'n y ~C:)1 a O) V C - O N LL. C N •C O ~p ~ N I N N Q ~w I m v 3 z E z o z d y F a co z I a z v u o N in z r W a~ E 0) cu a C N N cn C (0 N ll p w O a L -C ny N p` C 0 4 O N Q " N z F z Z o N ~ pN N C d N O L - d O Q w m O p~ n` a 3 o N COO a~ H H FN- N 0 0 O 2 z ••v 5 aaa a - 7 O (n O O O N (n J U o rn rn } q„y o `n o 0O ~ tl N > ~ N N U O ~V w Q C. N W N C E V) C r.+ O O C C L, O O S_,'' O O O N C N Cl O O O O C 7 Y a - N L 30 co C C C O C ad ~ O L O N • i✓'~ O co F- CJ O UJ r® :Q ~ a a w ' '~9 m y c r`h~ey ~ E ~1 A 0 a 2 0 in 0 ~j AS BUILT SANITARY SYSTEM REPORT i OWNER Lk A-L ! LK &(14 A'?! 6~rOWNSHIP d SECTION--,?,6 T K-U N-R-2W ADDRESS L~ oX ST. CROIX COUNTY, WISCONSIN SUBDIVISION dAk ~ CE 6Cc"-' S LOT LOT SIZE Lo PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM d~o2~o t>g '0 -21 - L5 1Y) J v you 17- 6 igx 6~ _ b~ w t L~ M Z' A INDICATE NORTH ARROW BENCHMARK: Elevation and descr piioon: 70-1P 6~vt~ v 0 u ~L~TY Bak Alternate benchmark ~E dO A$-f 6t" I4 1- C SEPTIC TANK: Manuf acturer : lit/ 51~7-/t5 Liquid Cap. Rings used:f-Manhole cover elev:5'inal grade elev: 257 Tank inlet elev.:-V, 4(` Tank outlet elev.: qZ. 23 No. of feet from nearest road:Front✓; Side ,Rear Ft. From nearest prop. line:Front2~; Side , Rear Ft. i No. of feet from: Well , Building: (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE { PUMP C ER Manufact r r: Liquid Capacity: Pump Mo 1: Pump/Siphon Manufact.: Pump Size Elevati n f inlet: Bottom of tank elevation Pump o~ el 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: Length Number of Lines: Area Built,.ILV Exist. Grade Elev. 222 Proposed Fi al Grade Elev. Fill depth to top of pipe: c; No. feet from nearest prop. line:Front , Side , Rear Ft. No. feet from well:,A) No. feet from building / HOLDING TANK Manufactu r: Capacity: No. of rin used: Elevation of bottom tank: Elevation inlet: No. feet rom nearest prop. line:Front , Side , Rear Ft. No. feet rom: Well , building , nearest road Alarm Manufact rer: INSPECTOR: DATE: PLUMBER ON JOB: / LICENSE NUMBER: M~ S,7/ 6/90:cj 1A Wr att1TR9fXrAs4~,28.19.819P&A'j,5rWjGj'S'Y MVRIDGE D County: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division ST. CROIX (ATTACH TO PERMIT) Sanitary Permit No-: GENERAL INFORMATION 180302 Permit Holder's Name: ❑ City ❑ Village ❑yown of: State Plan ID No.: WT TROY BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: Od, w O 040-1188-90- TANK INFORMATION ELEVATION DATA A9200383 D 9Z TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic d Benchmark gtz Do Aeration Bldg. Sewer / Z. Holding St/?(t Inlet TANK SETBACK INFORMATION St/ Outlet Z3t TANK TO P/ L WELL BLDG. AirI to ntake ROAD Dt nlet rl Septic Zo#,2 NA Dt B Do' NA Header h Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade 13, 2,3t Nlanu!act ur Demand ' 7` f 79 luj(s° CG Model Number GPM TDH Lift Friction tem TDH Ft Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length r No. Of Trenches IT NQ-Qf Pits Inside Dia. Liquid Depth DIMENSION ,~3 D S 11F I I N SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACHI Manufacturer: SETBACK INFORMATION Type O i CHAMBER odeI Number: System: IA OR UNIT DISTRIBUTION SYSTEM Header / a4icif,11 ! v Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length j V Dia. Length _&O Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over rLn n xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil E] Yes El No E] Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: TROY 36.28.19.819,NW,NW, LOT 66, WOODRIDGE DR. 4, j 40 Plan revision required? ❑ Yes o Use.other side for additional information. /Z SBD-6710 (R 05/91) Date Inspector's Signatu a Cert. No. ADDITIONAL COMMENTS AND SKETCH u Y SANITARY PERMIT NUMBER: F r SANITARY PERMIT APPLICATION :ZDILHR 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 ❑ A 8% x 11 inches in size. prev iou s 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 (A AL /Ua N(V14, s T ZF, N, R 12 E (or 7 S MAILING DREn LOT # BLOCK # PROP CI W. STATE ZIP CO E PHONE NUMBER SUBDIVISION NAME OR CS~/M NUMBER let U~vG~jL- Z..Z Z 71) 5W-S O r- 9(L `F~5' CITY NEAREST ROAD L:I 11. TYPE OF BUILDINO: (Check one) ❑ State Owned O VILLAGE : ® ~al6E ❑ Public K1 or 2 Fam. Dwelling-# of bedrooms3- PAR E TAX NU M ) III. BUILDING USE: (If building type is public, check all 7;;9 d ~D Q 1 El Apt/Condo l 0 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. sruaw 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12, Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) p 6 ELEVATION 7t b'i s„ r^Feet 3r. Feet 45 L *f ~ VII. TANK CAPACITY Site in allons Total #of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name oncrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank - Lift CN~t~FGt Lift Pump Tank/Si hon Chamb El I El F-1 F1 =M] ~ =EEII VIII. 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 ignature: (No ps) MP/MRRSW Nb.: Business Phone Number: 6 .(/C ZT Plumber's Address (Street, City, State, Zip Code): i5-wt w IX. COUNTY/DEPARTMENT USE ONLY L] Disapproved Sanitary ermit Fee (Includes Groundwater a Issuing Agent ignature (No Stamps) Surcharge Fee) 41 Approved ❑ 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 r 1. A sanitary permit is valid for two (2) years. 2. Your sanitdry.permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fil:! 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, vocation 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; rew+acemert system a( as; and the location of the building served; B) horizontal and vertices' elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufai.turer; D) crops section cf 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 rumba r of regulated practices which can effect groundwater. The monies collected through these surcharge,n are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (8.11/88) STC-100 This application form is to be Com let . the o1;'ner p ed in full and signed by (1t) Oft the property being developed. I in will on " ade development be delays of the permit issuance should thi Y 9uathis house) intended for resale b s then a second form should be retainedrand -completed when the property is sold and submitted to this appropriate deed this office with the -----------------record------------------- . Owner of property ~cT Location of property rU = ~=-1/4 1 Section ~ EL, T22S~N-R .Township DW Hailing address ~ /cf_~,-~ Address of site A- d Subdivision name [!0 ~C PZ~SLot no. Other homes on property? -yes__C=No Previous owner of property (C X Total size of parcel Date parcel was created 2 Are all corners and lot lines identifiable? I s this '-"-------yes ~_No property being developed for (spec house)? .yes of Dee_~_J bnd Page 2tufiber No of Deed as recorded. with the Reqis ter - T14CLUDE WITH THIS APPLICATION THE FOLLOWI7 A Iallttttlttl•.Cy ULLU which includes a DOCU i G. MENT 11UMBEIR & TIII• SEAL or THE 1LCGISTrR of DEEDS. In ad iAND PAGI; certified survey dela s , if available; ;would be helpful so asd to avoid y s the reviewing process. references to a Certified survey map If the deed description shall also be required. , the certified Survey Hap PROPERTY OWNER CERTIFICATION I0,1e) certify that all statements best of ray (our) knowledge that I (We this form are true to the the property described in this informati n form the owner(s) of warranty deed recorded , by virtue of a Deeds as Document T1o, in Iye Office of the Countw own tlle proposed site for the sews e' and that I eRe9ister of obtained own tied an easement 9 disposal system) orr Ie(we) construction of ,said run the above described the recorded in the office of Countm' and the same haeopbeen duly No, y Register of deeds as Document Signa ure of ~8 P~1 ant Co-appl cant a Z_ 9 D ate of S na g ture bate of s gnature DOCUMENT NO. STATE BAR OF WISCONSIN FORM 2-1982 THIS SPACE RESERVED FOR RECORDING DATA WARRANTY DEED l 489865 vo 974PAGE 361 REGISTER'S OFFICE ST. CROIX CO., WI Rolling Hills Development, Inc., a Wisconsin Reed for Rewd corporation OCT 13 1992 at s:3o A. M conveys and warrants to Eugene 0. Larson, Don D. Kruger, and Lawrence M. Johnson, Jr., d/b/a Quality Built Homes C~ Register of Deeds RETURN TO the following described real estate in St. Croix County, I State of Wisconsin: Tax Parcel No: Lots Sixty-Six (66) and Sixty-Seven (67), Oak Ridge Acres to the Town of Troy. ~RR~;SFi~ This is not homestead property. (is) (is not) Exception to Warranties: easements, restrictions, and rights-of-way of record. Dated this 12th day of C. (SEAL) (SEAL) • Richard N. Fox President (SEAL) (SEAL) Frances J. Fox, Secretary 1a AUTHENTICATION ACKNOWLEDGMENT Signature(s) Richard N. Fox and STATE OF WISCONSIN ss. Frances J. Fox County. authenti ated is 12 f day,o October , 19 92 Personally came before me this day of 19 the above named C. L. Gay ord TITLE: MEMBER ST TE BAR OF WISCONSIN (If not, tome known to be the person who executed the authorized by § 706.06, Wis. Slats.) foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY C. L. Gaylord, Attorney River Falls, WI 54022 Notary Public county, Wis. (Signatures may be authenticated or acknowledged. Both My Commission Is permanent. (If not, state expiration are not necessary.) date: , 19 Names of persons signing in any capacity should be typed or printed below their signatures. SB2 • NTF 0021 WARRANTY DEED STATE BAR OF WISCONSIN Nelco Tax Forms, P.O. Box 10208, Green Bay, WI 54307-0208 Form No. 2 - 1982 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER~C (`C GI ~Ct~~ ~~~X ADDRESS: ~f FIRE NO: LOCATION:/ 1/4, AJ W 1/4, SEC. q+2-eN-R_~? W~ TOWN OF:-- (S ST.•CROIX COUNTY SUBDIVISION: 9 S LOT NO.-- n 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. (910 4 SIGNED: l i. DATE : St. Croix County Zoning Office 911 4th St. _ Hudson, WI 54016 Wiscarisin Department of Industry, SOIL AND SITE EVALUATION REPORT Page \ of 3 Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY ST. 'Z'V- A L-X Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. 00- 1 I $ -90 _60 6 APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Qum l 0cm QV L 5 GOVT. LOT UI,,j 114 N W 1/4,S 36 T Za N,R 19 E (o~W PROPERTY OWNER':S MAILING ADDRESS LOT # T BLOCK # SUBD. NAME OR CSM # N2T3 30x 66 - o~1r~ CztDGE Rc2e`s CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE IRTOWN NEAREST ROAD Z>u rteus SVoZZ. (ols) 4 zs-zlzZ Z-1~p wao~cz~osE U7~1ut= j~ New Construction Use Residential I Number of bedrooms -3 [ j Addikn to ebsting building j j Replacement [ j Public or commercial describe Code derived daily flow Lk S O gpd Recommended design loading rate o...4 bed, gpc!0 0 - s trench, gpd/ t2 Absorption area required `ZS bed, ft2 00 trench, 11:2 Ma)amum design loading rate c -y bed, gpd$ 0. s trench, gpdAt2 Recommended infiltration surface elevation(s) S e13 P1'c6e 3 OF 3 ft (as referred W site plan benchmark) Ack0mal design / site considerations -M ~ c-M eS I'2r R.e C-O M ki &JDtED Parent material o u*T-w r %S t`t Flood plain elevation, if applicable fy A • It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT GRADE SYSTEM IN FILL HOLDING TANK U=Unsti le fors tern Ims ❑u L$S ❑u ®S ❑U ®S ❑U OS ❑U ❑S P U SOIL DESCRIPTION REPORT Boring# Horizon Depth Dominant Color Mother Texture Structure Consiswnce Boundary Roots GPD/ft in. Munsedl Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench E3 Z!z - Si \ z sbk `yn'F-V es o.S 76 Z \-Z6 1r3 t C_ 31q - S 11 2- 3 bk m~ C- S 0.5 0.6 Ground 3 z$-Sy \o `-I V_ 3/6 1 S C Sb\c vn v eS 0.4 0. S elev. q'i-la ft. lsv--)8 tZ''m V/ W\ o. s o. ~o Depth to y eD+v ~v S Fek> > Z 1.-S Sri 02Ts limiting factor 8 Remarks: Boring # 1 0-11 ZO`12 Z/z Stti Z`Fsb1~ `m`Fw cs o.S 0 6 2 2- t\-31 10'?R 3/yr - s\~ 2_~ Sbk y,~ ~h cS o.S o-JL 3 31-SB luL1R 3/(. - S C Sbk -M U F►- cS a•y o.S Ground elev. sg - 86 1 O `i R Y/V - s O S yv) ~ o . S o. 6 °13-aft 9 10 Depth to ~ s ` uo`~ ft 13 I W ~ . limiting sA factor > 86 '=ss~ Remarks: 02 T Name:-Please Print p~ ke , Pho e: Arthur L. We ever T 15-425-0165 gerer Soil Testing & Design Service- ..6 ox 74 Ri er Falls,WI 54022 Signature: +p r_~ 4 t0' CST Number: d( s-P.30, 14°tz yet o 0 576 PROPERTY OWNER QQJKUI M -eSy0,--T SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL I.D. # O 0 - 1 l$ $ - 0 - 00 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bouxlary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed reach t 3 1 o-t8 v0-i 2 Z-1 -L Stil -'FSb1T yr\ GS o.S o.6 Z ►8-3S to `2(Z- 31y Si 3bk mcS o. S o-{, Ground 3 3 S S0 to V 2 3J 6 - S C S bk vh vj c S O. y o.S elev. 9Z.2. ft. So $Z )0`22 y/St `~S O S9 w1 1 O- S o• Depth to L~ S P` rr N u TLs ft 1 limiting factor 8Z Remarks: Boring # o-1Z lo~t2zlZ - s11 Z,~k M~~ es o•S€o.b y Z 1Z-Z~ 10`iQ 31y - Sly 2 f 3~lr W -A eS o.S n.~ 3 2M-SL 10 Y 2. 3/6 - S 1 C- 3 ~ Yn U'F , S Ground elev. y Sb-8`o I0 14 2 V/y _ ~S-S\ `eS~~ o-y o.S q~ ft. Depth to limiting factor Remarks: Boring # o.s 0 6 SON". ~-~3 l0`i2 z L Z s i Z`FS>,k v~`~1. c-S Z \'S-30 to Lit 31y - S) Z `FS ~lT ~'"1 'F~^ C S o. S 0.6 3 30 39 1~`~1Q 3/6 s~ 10- Sbk Yn v o• y 6•S Ground elev. U 39-$0 1 u Y2 ~/y ~S D Sg o. S o. b ft. Depth ID limiting factor > So" Remarks: Boring # E3 Ground elev. ft. Depth tD limiting facto Remarks: S8D-8M(R.05/92) PLOT PLAN Page 3 of 3 SCALE 1"= 30 ' i I woc~pR~DGE• 1!s21uC West- 8!~ .a8.6` av 'fia/-gw► _ ~.~oo.o' o-.) Zap. b~- G12~~J v►.~pl3l2GRUU►~,p of u'~0~2G2UUN0 ~`h~1~ Qox v~-►~.rry tux ~ ~z~~ k 1 IL t-4 ~~oust `CO O1 P}T L1vA3T Z$' PRAM YmIJsie S`-~S~ A~Lt`q, WALL "tai t?, RT SST Sp' r=-lzo M Ste! Shs1~1 . 0 fy yT~' l-0 11~SlYt ~\.~c _ s 1 b ~ ~'RRT W~"lT~-1N ~L Sv~T~cAI~ R'R~A f S~tvv.►'N. L►'~-F ~c~s I ~13LAAQgLope ~ C~,} L3LLSl1 P'C'T'1 l1 N S+_T.L 9 3 ? ~v~~ w G dD~► 5 r-t ~ N srQ,uc'nufJ , I . V' lF~j l_oT Ll.u S s'M1,, e ~FoCc~ C.o>v 51'Q_u cTiurr , r3.3 E 93 3 G Z- Z Ito, SepVZ-9, "Y Z (-Ils)y2,5-Ol6S V~tuos~6 CST Signature Date Signed Telephone No. CST # Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page \ of 3 Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY ST• C.QsJ Gx Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # ro dimensioned, north arrow, and location and distance to nearest road. 00- 1 M-q O _06 APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION QUVN k_L'rq L3UL L_Y EkUt'1 ~ S GOVT. LOT NL-,3 1/4 Nw 1/4,S3L6 T 2r8 N,R I q E (o l PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 'S a% Y, -7 66 - o1a,%yr- CzLDGE Rc2es CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE ]MOWN NEAREST ROAD pwj etc S k3 SVOZ2. (-)IS) 4.ZS-7_lz2 '~gp 1LA-*'oo'bV_Lbr.E -Decue j New Construction Use Residential / Number of bedrooms 3 [ ] Adddiqu to existing building j j Replacement [ ] Public or commercial describe Code derived daffy flow q S o gpd Recommended design loading rate __o.,_4 bed, glxW 0 . S trench, gpdtfi2 Absorplon area required ~ VLS bed, ft2 OO trench, ft2 Mandmum design loading rate o • 4 bed, gpd/rt2 0 • S trench, gpdtft2 Reoanrttended infiltration surface elevation(s) S EIS- P1'rsi-~, 3 of _:aft (as referred to site plan benchmark) Addltionail design ! site corusiderations TQ-e,1J c-M E S PCQC RIE~. c.0" n 0-J .DtD Parent material o UyAAj R S N Rood plain elevation, if applicable -1a • It S = S"e for Sy8tEKtt CONVENTIONAL MOUND KGROUND PRESSURE AT-GRADE SYSTEM IN RILL HOLDING TANK U=Unsww*for tern ®S ❑U [as ❑U ®S ❑U 0S ❑U ®S ❑U ❑S MU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consist) Bound3y Roots GPD/ft, in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed rent 1 Z/z - S),\ z~Sbk e- S o.S o:b z to~tLz 31Y - si I Z~3"ok wcf - cS o.s o.f. Ground 3 Zg-sy \o `1 Z 3A S \ C A c yr~ v `S o• a 0-C' elev. q51-$ ft L,F SX7$ to`12 V/ - ~S v S~ , o. s o. b Depth to y trvu tv S Felv \ ZL I S sn T s limiting factor 8 Remarks: Boring # 10 ~1 zlz S t ti Z sbk `n-L c S G. S o. b 1 0-11 2 Z 1\-31 10`12 31Y Ak CS o.S o.b 3 31-SB 1u~2 3/ie - s1 lcsbk rnu~►- cs 6.V a•S Ground elev. Lj s$ - 8b l O `1 R YA/ - S S S Yn~ C). S o. 6 013.3It Do b S L t~o`TE ~ D I t~ ~ . limiting facf3or y 86 Remarks: TName:-Please Print Pie Arthur L. We erer 715-425-0165 eg rer Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022 Signature: Z_ z i 6 Date.' 3 0' 1 °l z CST p 5 7 6 PROPERTY OWNER wvt~~l b`1~LT SOIL DESCRIPTION REPORT Page of PARCEL I.D. # O 1{ 0 ' 1 Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Try 7- rn'~ ~s o, S o, 6 Z 18-3S 10 `ZQ 3JV - S1 Z J~k YYL'~1~ CS 6-S 0,6 Ground 3 3S SD IQ 'ttz 316 - s 1 cSbk v, \j eS o.V 0"S elev. n9Z.7- It. &D-$Z ►0`22 Yl%l - `I-S s~ yn °•S ;o.~ Depth to L~ S h r u uT`?- Pl R limiting _ factor > sz Remarks: Boring o.S 0.1. y Z 1Z-Z) IZ'1Q. 31y - sly 2'F3~k vr•'F1. eS 0•S =n•L 3 Zn-SL IOY2 V4 - S~ 1C.Sbk YnU~~, Ground y Sb-$D 10LfIZ V/y _ ~S- S~ `O-S OZ Yn ~J O•y 0.5 Depth to limiting factor Remarks: Boring # 1 v-~3 l0-te Z L - S L Z`~S~k wti`FI. GS o• S D. 6 . 6 Z ~3-30 10 4t 31y - S t Z `FS~lq Yvl c S o. S' 013S 3 30-39 101-1t- 3/6 s CS~k w► v~~, aS o y 6•s Ground elev. U 39-$0 1 p Y2 L//y `FS a Sg f^~ o• S €o• G q3•Z ft. Depth to limiting factor > SO ' Remarks: Boring # i Ground elev. ft. Depth to limiting factor Remarks: SBD-MO(R.05/92) PLOT PLAN Page of 3 SCALE 1"= So ' woc~p~~pG~• U~.IUC W ffs-r cy 8wl -eL.g8.6` O+u IMP/ V-WL'\oo.o~ 'm I> OF u"'OG~tC1VN0 Z% ~R@~J vuOlTQ6Rl1vw,A v rtLlly la0x C t# Z~~ ~`ti ~ t `ry sox TM\3'nma roust 1U 0S RT L-m3T ZS' F"" ltouSt sLts"~ AxLQ''N- WeLt- -M vat-- Pr-r 0 q ~t.q.y 8 I N gZ'Prll. 1~ju 1 L1.t~1~p~-L Q X1.9 3_ I I ~T of S' W ~ A~ ~~0 1 gees sue- Lek3T i J b' t~'I~PrRT Wt`+;-,+IM 1 S~iwty. ~ ~c~e 3~v 0~ ~T ~e I s~ ~~LC ~sR ~ro~ poww stuPe AGE, rtJ ~`«~'~l. Prrv~ i a'S ~ ~ L'i~1Z1vArT~ ~`iS'T~77 S 1U'aK31~* k1..CsU t1C IU S m- g 3? I Tv 'hr-- r~ e~ I 3~!iv'~LuvG Clp)VS1~uc~j01V, 5'l~'~► V IERIPy (uT Lw e-s 5 m 1 N I ~ Cow 5'~RU c'T1pN , I) r &3.3 kL°12z -'-8 Z 9 9 ' ETt- q-3 3 5 Mf Utz-. iIto, ei74 ~ Sep„ Z 14 Z IS) X1 z O/6 S Moos- 6 CST Sianature _ Date Sione Teleohone No. CST # t\i p e { ~ ~ a I! U Fes' ` I lo~ REPT131 TROY ST. CROIX COUNTY ZONING PAGE 1 12/02/92 17:36 REQUESTS FOR INSPECTION WORK SHEETS FOR: 12/ 4/92 AREA: JT Activity: A9200383 12/ 4/92 Type: CONVSEPT Status: PENDING Constr: Address: TROY 36.28.19.819,NW,NW, LOT 66, WOODRIDGE DR. Parcel: 040-1188-90-006 Occ: Use: Description: 180302 Applicant: QUALITY BUILT HOMES Phone: Owner: QUALITY BUILT HOMES Phone: Contractor: NELSON, ROGER Phone: 273-4444 Inspection Request Information..... Requestor: NELSON, ROGER Phone: Req Time: 14:12 Comments: c~66 Items requested to be Inspected... Action Comments Time Exp 00012 FINAL INSPECTION Inspection History..... Item: 00012 FINAL INSPECTION I