HomeMy WebLinkAbout038-1166-90-000
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FORM - STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER . i .SS TOWNSHIP
3
SECTION T N-R L W
ADDRESS l5 E:~ ST. CROIX COUNTY, WISCONSIN
SUBDIVISION VC &,4-- LOT_ LOT SIZE
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SY EM
A G
o
Z (Q
l t ~d
_-T
IND CATE NORTH ARROW
BENCHHARK: Elevation and description: fhb' .C 1 fl"yw SdL~1y_~
Alternate benchmark
SEPTIC TANK:Manufacturer: W ~~5 6.1V, Liquid Cap. -
Rings used:-Manhole cover elev:1U3 ~-7Final grade elev:
Tank inlet elev.: 1.OZ Z''O- Tank outlet elev.:
No. of feet from nearest road:Front ✓ ; Side , Rear Ft. 02~
From nearest prop. line:Front Side , Rear Ft. 200
No. of feet from: Well Lp, Building: I?
(Include this information in the above plot plan)
(2 reference dimensions to septic tank)
SEE REVERSE SIDE
PUMP CHAMBER
Manufacturer: Liquid Capacity:
Pump Model: Pump/Si on Manufact.: Pump Size
Elevation of inlet: Bottom of tank elevation
Pump on elev.: ump off elev.: Gallons/cycle:
Alarm: Man.: Switch Type: Location
Distance rom nearest prop. line: Front-, Side_, Rear_Ft.
Dis ance from: Well Building
SOIL ABSORPTION SYSTEM
Bed: Trench: Seepage Pit:
Z Area Built A
Width! Length MoD Number of Lines:
L~, o0
Exist. Grade Elev. roposed Final Grade Elev. 2-
Fill depth to top of pipe: Z
No. feet from nearest prop. line:Front Side , Rear Ft.Z~"'
No. feet from well:--J) ~No. feet from building z~
HOLDING TANK
Manufacturer: apacity:
No. of rings used: Elevation of bottom tank:
Elevation of in
No. feet fr444 nearest prop. line:Front Side Rear Ft.
No. fee from: Well , building , nearest road
Al Manufacturer:
INSPECTOR:
DATE PLUMBER ON JOB:
LICENSE NUMBER:
/L1~6L~u> viz S 5/
6/90:cj
a(~
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING
LABOR &'UUMAN RELATIONS DIVISION
P.O. hOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION
ADISON WI 53707 State Plan I.D. Number:
E%, NW4 ,Sec . 2 8 , T 31- R18 of assigned)
Town of Star Prairu ~ CONVENTIONAL ❑ ALTERATIVE
1 th S Holding Tank El In-Ground Pressure E-1 Mound
04 NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE:
7th S N_
William G. Weiss 1-;S84 5' tillwater, MN
BENCHMARK (Permanent refere a point) DESCRIBE IF DIFFERENT FROM PL N: REF. PT. ELEV.: ST REF. PT. EL
~~y~ . z~ . r~ ,:Xr•~C'~ ~A~ ~ talc-z_':>" ~
Name of Plumber: MP/M S o.: County: Sanitary Permit Number:
Gar Steel - 149996
SEPTIC TANK/HOLDING TANK.
R
MANUFACTURER: INLET EL TANK OUTLET ELEV.: WARNING LABEL LOCKING COVE
CAPA TANK
LI UID l
PROVIDED. PROVIDED:
e / J Lpy1C'. P.c ~~~lJ
-Y9 S ❑NO ❑YES LINO,
BEDDING: WE-WILDIA.: VEW MATL.: HIGH WATER - NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH
ALARM: • FEET FROM LINE: / /r! AIR IN T
❑ YES LJ NO ❑ YES O NEAREST U
DOSING CHAMBER:
MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
YES ❑ NO ❑ YES ❑ NO ❑ YES El NO
VENT F GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMB PROPERTY WELL: BUILDING: AIR INLOT RESH
(DIFFERENCE BETWEEN FEET FROM
PUMP ON AND OFF ❑ YES ❑ NO NEAREST
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: MATERIAL AND MARKING:
or excavation. (If soil can be rolled into a wire, construction shall cease until MAI
the soil is dry enough to continue.)
CONVENTIONAL SYSTEM: z'
WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID
BED/TRENCH 1 TRENC ES: / MATERIAL: PIT DEPTH:
DIMENSIONS `7 C _o O -
GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. 15ISIFR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH
BELOW ~IPES: ABOVE~OVE ELE ET: ELE~AEND: PIPES: FEET FROM LINE: C AIR INLET:
~7yV: 3 + C% NEAREST ~GCJ / a7 Cp ~v`
MOUND SYSTEM:
Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM
slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW
meets the criteria for medium sand. ELEVATIONS MEASURED.
SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS;
❑ YES El NO ❑ YES ❑ NO
DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF ~T~ SODDED: SEEDED: MULCHED:
CENTER: EDGES:
❑YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO
PRESSURIZED DISTRIBUTION SYSTEM:
BED/TRENCH WIDTH: LENGTH: NO. OF LATERAL SPACING: GRAV PTH BELOW PIPE: FILL DEPTH ABOVE COVER:
TRENCHES:
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. R. PIPE DISTRIBUTION PIPE MATERIAL & MARKING:
ELEVATION AND ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.:
DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO
INFORMATION APPROVED PLANS
❑ YES ❑ NO ❑ YES ❑ NO
PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING:
COMMENTS: FEET FROM LINE:
❑ YES ❑ NO ❑ YES ❑ NO NEAREST 00
CO U CO
/CC
I J,
e 'n in county file for audit.
Sketch System on
Reverse Side. SiGNATU TITLE:
SBD-6710 (R. 06/88)
1
SANITARY PERMIT APPLICATION
o~LNR In accord with ILHR 83.05, Wis. Adm. Code COUNTY
~.d.~,,..e....,..,~...~ St .Croix
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than l q ,?q
8% x 11 inches in size. ❑ Check if revision to pious 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
William G. Weiss SE 1/4NW 1/4,S28 T 31, N, R 18 AR(or) W
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
15584 57th. St. N. 9 n/a
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
Stillwater, Mn. 55082 n/a Red Pine Estates
11. TYPE OF BUILDING: (Check one) El State Owned ❑ VILLLLAGE : NEAREST ROAD
IIL~LL Star Prarie 104th. St.
❑ Public 01 or 2 Fam. Dwelling-# of bedrooms 3 EL Ax R(
III. BUILDING USE: (If building type is public, check all that apply) -2 3 t , 14/. NC f
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
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. B New 2.E1 Replacement 3.E1 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
12Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
140 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
450 495 500 .91 <3 99.5 Feet 102. Feet
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
Se tic Tank or Holdin Tank x Weeks C . P . R [A El Q I El F-1
Lift Pump Tank/Si hon Chamber
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for install tion of the onsite sewage system shown on the attached plans.
Plumber's Name (Print): Plumber's i nature: (No S m /MPRSW No.: Business Phone Number:
Gary L. Steel 3254 715 246-6200
Plumber's Address (Street, City, State, Zip C e
1554 200th. Ave., New Richmond, Wi. 54017
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuin Agent Signature (No Sta )
Surcharge Fee)
AKpproved ❑ Owner Given Initial
Adverse Determination
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly PI b-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 rerawal 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 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 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)
r
I
APPLICATION FOR SANITARY PERMIT
STC - 100
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 UA-A A- 01\ (9t, \Aj E%
Location of Property sc ' VFW 3, Section , T t N-R 16 W
Township aA C
Mailing Address SS'~4 TM sz
Dwtiv N-TE1j_,, MN S S 0 -b-1,
Address of Site X. X)C I O 4- T "
GVv (2-ttCAA M0!-1C , \t!l S4~ 1 to
Subdivision Name
C~ "P► N~
Lot Number
Previous Owner of Property l.s-FP-J ')K/ IDYL
Total Size of Parcel 1C,~1Lrj~~
Date Parcel was Created
Are all corners and lot lines identifiable? X Yes No
Is this property being developed for resale (spec house) ? Yes X No
Volume g9 4 and Page Number 324 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 refer-
ences to a Certified Survey Map, the Certified Survey Map shall also be required.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
PROPERTY OWNER CERTIFICATION
1 (we) centiby that att .6xatement6 on th.L6 bonm ane tAue to the but ob my (oun)
knowledge; that 1 (we) am (ahe) the owner (b) o6 the pnopenty deb chi.bed in xhi.6
.inbonmafii.on bonm, by viAtue ob a waAAanty deed neconded in the Obb.tce ob the
County Regi6teA ob Deed6 ab Document No. 44-7 Go / ; and that I (We) pnebentty
own the pnopo.aed b-tte bon the sewage di6poz .6y6 em (o& I (we) have obtained an
ea6ement, to nun with the above de,6cAi.bed pnopeUrty, bon the con6tnuction ob said
bybtem, and the .same ha.6 been duty neconded in the Obb.iee ob the County Reg.c.6ten ob
Deed6, a6 Document No. 467 0 O / 1.
SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE)
DATE SIGNED DATE SIGNED
` DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1-1982 rNls sFAee RfIIIZW D FOR RECORDING DATA i
WARRANTY DEED
467601 vaL 896 PACE 921. RE
G STER S OFFICE
This Deed, made between Richard
J. Wier and Reed for Record
Diane •.M...•Wier -,-..husban.d e..as•..j.oi-nt-.--_ I
tenants MAR 2 f 1991
M at
Grantor, 3:30 P. M
and.... W..lli,M..G.,....w.e.i.se...and...St.eRhan.je...J.....We ?~s.~,.........
hu sba ri-d...And... w.. f.e...OL.s ma xi, t.a l...s u.rv.i..vQ.r s h i p . Rspt~er of
.p.r.oiler.ty
Grantee,
Witnesseth, That the said Grantor, for a valuable consideration......
conveys to Grantee the following described real estate in CrO1X r'-'T-1_ TO
County, State of Wisconsin:
Tax Parcel No:
Lot 9, Red Pine Estates, Town of Star Prairie,
St. Croix County Wisconsin
i
This is not (is homestead property.
) (ia not)
Together with all and singular the hereditaments and appurtenances thereunto belonging;
And...........Grantors
warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except
i
i
• I
and will warrant and den a same.
Dated this ............If day of
t
I
(SEAL) (SEAL)
. Ri J W' r
I
(SEAL) (SEAL)
• • D.iane.. M.....Wiez...................................
AUTHENTICATION AC NOJWLE C}MENT
i
Signature(s) STATE F
aa.
rmebe~fore .County.
L
authenticated this ........day of 19...... ersonal c me this ......day of
19.7 the above named
Richard J. Wier...and Diane M. Wier,
• -husban.d and..wi.fe........................................
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 instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY
Price & Bruns, Ltd.
1900 Silver Lake Road, Suite 202 / . .
.-New-•$r1'ghton•i .-•MN--•55.1 f•2-----• Notary y, Wis.
(Signatures may be authenticated or acknowledged. Both My Co roomy perv" ate a iration
are not necessary.) Np
date: uftviiuetiC-uffo~d WTA 1 ) (I
ANt3KA'C10M'ry
-Names of persons signing in any capacity should be typed or printed below their signCornmbglOn Er,'•' • " "i 1"3
I•
i
STATFORM No, IW199eNSIN STOCI( NO. 13001
L
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"A Peaceful Rural Subdivision"
y ,~R Offered for Sale
` v
Itl,/rlnX y
team] realty
` Dave Bracht
Jim Moe
715-247-5900 WI
*20% Down Terms Available SOMERSET, WI *Wildlife
*Building Contractors Welcome *Near Apple River
*Electrical & Telephone Installed *No Assessments
*Township Roads *Somerset Schools
Lot #
1. 3.5 ac. $12,500 6. 4.9 ac. $10,000 11. 3.3 ac. $17,000 16. 2.9 ac. $18,000 21. 6 ac. $17,500
2. 3.2 ac. $12,000 7. 2.5 ac. $10,500 12. 2.2 ac. # 14,000 17. 2.4 ac. $18,900 22. 3.7 ac. $16,000
3. 3.9 ac. $13,900 8. 2.5 ac. $10,000 13. 2 ac. # 12,000 18. 1.4 ac. $18,000 23. 1.62 ac. $14,500
4. 2.4 ac. $11,500 9. 8.1 ac. $17,,000_--) 14. 2.1 ac. $14,500 19. 2.4 ac. $19,900 24. 2.1 ac. $14,5(X)
5. 3.1 ac. $12,900 1 . 5. ac. $17,0()0 15. 2 ac. $17,500 20. 3.3 ac. $18,000 25. 1.9 ac. $16,000
.w Mo' ~ 1 11 aeo 10 i
16 14 A
16 807 806 13 1 803 I 802
Sj9LD 605 1
R 17 _ iRt~~ EST~r _S_ /
S®M
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4 -NW 4 23 / 114 4 s
!q 815 8(4 / 80111
zs 8f6 Soo SOLD
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610 817.. \
jog 22 490,
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811 813 k - 1
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612
, 474 8
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MGM$
(7S) (6S1
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SOL
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4 SOLI) $
~9 l 1" 6 799 3 /
ti }f i) 4 Sla P134. 798 / 795
12 M E R ET i 1' ' r- _ J ,1` 1 G
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STAR' N 114-S ,
1 ~ JeMrrNWury.~ ,y ~ ~ `
o -PR_A11RIE \r( 794
797
New o a.714 `
¢ SomlrSet r13, 11''~• Richmond ` 4 1 1
796 I 793
S .f.,, J 1. ,i• L
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MIKE 34941 $41AU
£ . S. LA. yo4• at 4qq ! !4
4 7 .U 10 11 S0, 3ID ( I S ► OhD 473E
LO 1 LOT 2 J 1 LOT 3 LOT .4
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STC - 105 r
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SEPTIC TANK MAINTENANCE AGREEMENT o
St. Croix County z
d
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II~Lt~M
OWNER/BUYER
ROUTE/BOX NUMBER 154 N Fire Number
.CITY/STATE 45TIL,>N'~~t., ZIP
PROPERTY LOCATION: ` E~ Section 1100 T 'll N, R t~?) W,
Town of St. Croix County,
Subdivision V'D FbPAES Lot number
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 pumper. What you pdt 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. yo
E
I/WE, the undersigned, have read the above requirements and agree En
to maintain the private sewage disposal system in accordance with x
H
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 within 30 days
of the three year expiration date.
SIGNED
DATE
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.
T~lt~l.7~! r~s~ttr UIV+atUiv
MADISP.O. BOX ON W15370
•JSTRY, PEW"'OLATION TESTS (115)
-%1307A 1\14D ~I~a~.ATIONS HR 83.09(1) & Chapter 145)
O O S! M MUNICIPALITY: ' OT NO. BLK UBD IVt CO E:
V4 X W14 -A e~ /T HIPIA (o Gf
OU TY: AILIN ADD S: Z;
C
DATES OBSERVATIONS MADE 4' 3` 3
USE
NO. SEE T 0
New ❑Replace Cs
V -
~Residence T` 41
/
RATING: S- Site suitable for system U- Site unsuitable for system
ON EN I AL: MOUND: JIN-GROU : S N-FILL OLDING TANK: RECOMMENDED SYSTEM:loptional)
@S ❑U S'S ❑U S C]U EIS U D S U
If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is In the O
under s. ILHR 83.0915)(b), indicate: . Floodplain, Indicate Floodplain elevation:
PROFILE DESCRIPTIONS
TEXTURE, AND DEPTH -AZT BORING TOTAL ELEVATION P H R UNDWATER-INCH S TCHAR O BEDROCK F O SIERVED IS EI ABBRVSON BACK.)
NUMBER DEPTH IN. 08 V
i
4a7 51-2 B A
o - ,des yam. a 5~~•~ ~ y~
D
moo ~oa•a 7%b
74 0~.
7.2
7,;L P 445,010 y 0-5,
PERCOLATION TESTS
RATE INU ES
_TEST g-
TD'EPTH/. WATER IN HOLE TEST TIME DROP IN WATER V INCHES
NUMBER AFTER SWELLING INTERVAL-MIN. rTD PERINCH
G -s
P.
P. ,G
P-
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 $,~6
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lip
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1, 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 Wisco sin
Administrative Code, and that the date recorded and the location of the tests are correct to the best of my knowledge and belief,
RAMI pr nt : ITESTS WERE COMPLETED 9N:
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ADDRESS: , CERTIFICATION NUMBER: PHONE NUMBER (options!):
DISTRIBUTION: Original and one copy to Local Authority. Property Owner and Soil Tester.
f)II lift SRT)Ji395 IR. 10/83) - OVER -
STEEL'S SOIL SERVICE
Gary L. Steel 988 N. Shore Drive
C.S.T. 2298 New Richmond, WI 54017
MPRSW-3254 Wm. G. Weiss (715) 246-6200
SE NW4 S28-T31N-R18W
town of Star Prarie
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5 Gary L. Steel