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HomeMy WebLinkAbout038-1121-90-400 Q o ~ ° ! h 0 6np a ti m c o Q. 0 m °oN (3N) a r CL N c co H ~ N CY) LO a) Q x O ~ N O rY 0 C ~ y I y N N C Z Ern LL C (0 _2 O 0) a C C O 22 a) 0 p U) E Q oU U Co M O. V N 000 W Z O Z P m 0 CL co Cl) U) 0 c C7 O Z d c co O fn P ~ O Z C 72 0) M N O 0 N a s C C N z~z z N M ; E C C C O H &0 4) 0 O D d :tz 2 N Z Un > m F- H F- cLi N E 0 0 0 d cn 0 o "Ni •o a a a z a _ U 0 g _ C N _ 0 rn rn } *ftwa S O M y C N O O i E O Q Y co m r) 0 C O 3 O N C O O O _ O ~ N C c " Qj -0 O L C 0 12 12 N c c ~f r'''r O 2 N l0 c w N U co N ]rte,) i"i W M `O 7 Z' C M O CI 7i co m U it O M U) O Z N fn r.+ w r T T V €a L CL 0 CL i E C C w C rr~w C 1 A ci af. m I o in 00 FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ~Ml3~2T / / TfZ~ 7EAN TOWNSHIP STAR SECTION__3_0T 3 / N-R_ZE__W ADDRESS/ 47y G % f C -ST. CROIX COUNTY, WISCONSIN C%,nz,g-R rA?r G(Ji S yO S' SUBDIVISION A(/4 LOT LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM N G4' l orbs r ff®usE ~i ~ ~ ~ ~ /clvs X / G INDICATE NORTH ARROW BENCHMARK: Elevation and description: 5rj2j~FL P_/ je Alternate benchmark 5 C,/),Liquid Cap. 166n SEPTIC TANK:Manufacturer: Uj_ Rings used:QManhole cover elev: Y?,?3 Final grade elev: Tank inlet elev.: 7 Tank outlet elev.: 90i~ No. of feet from nearest road:Front , Side, Rear Ft. - From nearest prop. line:Front , Side, Rear Ft. / t# No. of feet from: Well & , Building: 1316 (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE ~ A PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufact.: Pump size Elevation of inlet: Bottom of to elevation Pump on elev.: Pump off el Gallons/cycle: Alarm: Man.: Switch Type: Location Distance fro earest prop. line: Front, Side, Rear-Ft. Dis ce from: Well Building SOIL ABSORPTION SYSTEM Bed: Trench: Seepage Pit: A Width: .S Length Number of Lines:-,2?._Area Built 6'96 Exist. Grade Elev. ~f 9,S Proposed Final Grade Elev. 5 Fill depth 'to top of pipe: No. feet from nearest prop. line:Front , Side, Rear Ft./,Qo Z" No. feet from well: No. feet from building HOLDING TANK Manufacturer: Capacity: No. of rings used: Elevation of bottom t Elevation of inlet: No. feet from nearest line:Front Side , Rear Ft. No. feet from- 1 , building , nearest road Alar anufacturer: INSPECTOR: ( ~ DATE: - PLUMBER ON JOB: LICENSE NUMBER : Q C/~0.:cj Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: S.a HumaA Relations INSPECTION REPORT St. Croix Safety a an nti Buildings Division (ATTACH TO PERMIT) Sanitary Permit No-: GENERAL INFORMATION Se1,NE1,Rc.30,T31-R18,Co.Rd. C 149175 Permit Holder's Name: ❑ City ❑ Village [X Town o : State Plan ID No.: CST BM Elev.; Insp. BM Elev.: BM Description: Parcel Tax No.: 16),6 5 ~e. 4r -439 1121 49 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 1 Dosing Aeration Bldg. SewerE Holding St/ Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet R 100, Vent irIto ntake ROAD Dt Inlet TANK TO P/ L WELL BLDG. A Air Septic L/ ~ Q NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft Forcemain Length Dia. Fi Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Len h No. OTrenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMEN I N LEACHING Manufacturer: SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM INFORMATION Type O ~j`~ CHAMBER Model Number: System: 60 dZ5® 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 xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed/ Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Plan revision required? ❑ Yes ['No Use other side for additional information. SBD-6710 (R 05/91) Date nspector s Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: P . Vim. v,... , e i . I~HR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code CoUN y STATE-SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than M.k8% x 11 inches in size. E] ceviisiontopreviousapplication -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPE TY OWNER P TY LOCATION E E 1 '/4 '/4, S 3, T, , N, R E (or PRO 122q co, A). r, NA PERTY OWNER'S MAILING ADDRESS LOT # BLOCK # AA /T CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER Uli II. TYPE OF BUILDING: (Check one) CITY : NEAREST ROAD State Owned 0 VILLA GE - ~D C =N OF 41AVAJ ❑ Public 11 or2Fam. Dwelling-# of bedrooms AR EL TAX. NUMBER(S) 111. BUILDING USE: (If building type is public, check Z11 that apply) ©38 _AZ I _'YO 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 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. El New 2. VN Replacement 3. ❑ Replacement of 4.E] Reconnection of 5.0 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 9 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 (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION .77 Feet 1116 , Feet Vila. TANK CAPACITY Site in allons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New istin Gallons Tanks oncrete strutted glass App. Tanks Tanks Septic Tank or Holdin Tank E% De I 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. Plumber's Name (Print): Plum Signature: (No Sta s) M SW N • Business Phone Number: S: I/ Plumber's Address (Street, City, State, Zip Code). IX. COUNTYIDEPARTM NT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued sing Agent Signature (No Stamps) Surcharge Fee) Approved ❑ Owner Given Initial Adverse Determination `y 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 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 prope rly'mainta Add. 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. It. 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'/s 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-8398 (R.11/88) ' 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 2 Location of property - 1/4 &_Z1/4, Section, T _3/ N-R1fW Township J la r - '0=G! i rl Mailing address I'i 2 ,S V ter,, e'-f 1 tj.t S7 Address of site rn P g f o y Subdivision name _ Al n k Lot number M '7 A? Previous owner of property a -h e- Total size of parcel YC 1412o-< s - -n //a C Date parcel was created IVY r~~~ Are all corners and lot lines Identifiable? _Yes No Is this property being developed for resale (spec house)? Yes N0 Volume pia and Page Number a~~,r as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which Includes a DOCUMENT NUMBER, VOLUME AND PAGE NUNBSR, and the SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I(We) certify that all statements on this form are true to the best of my (our) knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warrant gd7recorded in the Office of the County Register of Deeds as Document No. y ; and that I (We) presently own the proposed site.for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the same has been duly recorded in the Office of the County Register of Deeds, as Document No. Signature of Owner Signature of Co-Owner OR Applicable) 3 'IL4j I Date of Signature Date of Signature No. Wanunt► D.W. (MATS OF WIDO(WININ) ►uNIAW by H. H. Wma Co. NO i 279751 This Indenture, made ais say of March , a. D., 19 6 s between Elsa Green Shillcox, also known as Elsa G. Shillcox, a widow and unmarried, part y , of the first part, and ob rt a i ejean n o is A Maitrejean, parries of the second part. nust)anhrfd w~rfe, as' o n tenants, Witnesseth, That the said part y of the first part, for and in consideration of the sum of -one Dollar and other valuable consideration in DOLLARS to her in hand paid by the said part ies of the second part, the receipt whereof is hereby con- f essed and acknowledged, ha s given, granted, bargained, sold, remised, released, aliened, conveyed and con- firmed, and by these presents do es give, grant, bargain, sell, remise, release, alien, convey and confirm unto the said partigs of the second part, their heirs and assigns forever, the following described real a- tate, situated in the County of St. Croix and State of Wisconsin, to-wit: The North one-half of the Northeast Quarter (N'k of NE4), the South one-half of the Northeast Quarter (S3~ of NE34), and the East one-half of the Northwest Quarter (E~ of NW4), all in Section thirty (30), Township thirty-one (31), Range eighteen West (18W), according to the United States Govern- ment Survey thereof. I Together u7ith all and singular the hereditaments and appurtenances thereunto belonging or in anywise apper- taining; and all the estate, right, title, interest, claim or demand whatsoever, of the said part y of the first part, either in law or equity, either in possession or expectancy of, in and to the above bargained premises and their hereditaments and appurtenances. To have and to hold the said premises as above described with the hereditaments and appurtenances unto the said part ies of the second part, and to their heirs and assigns FOREVER. Andthesaid Elsa Green Shillcox, also known as Elsa G. Shillcox, a widow and unmarried, for herself, her heirs, executors and administrators, does covenant, grant, bargain and agree to and with the said parties of the second part, their heirs and assigns, that at the time of the enscaling and delivery of these presents she was well seized of the premises above described, as of a good, sure, perfect, absolute and indefeasible estate of inheritance in the law, in fee simple and that the same are free and clear from all incumbranees whatever, and that the above bargained, premises in the quiet and peaceable possession of the said part ies of the second part, their heirs and assigns, against all and every person or persons lawfully claiming the whole or any part thereof she will tact forever WARRANT AND DEFEND. In Witness Whereof, the said part y of the first part ha s hereunto set her hand and seal this Fouatrt4 day of March , A. D. 19 65 Signed an led in Presence of LEE J. BIANco _ _ (8040 NOTARY PUBLIC - CALIFORNIA Elsa ~Gre Shillcox, also known as PRINCIPAL OFFICE IN ' ab Cox (Sew) LOS ANGELES COUNTY My Cotn`Bission Expires January 25, Bianco - - (dew) LolaRee Hull This instrument drafted by Berryman, Diaher & Johnson i H.D. Bart% U~t ` 41 µl 1, MinneBOta r' , e I + \J 2 CA ;r oCn 6961 'Sl tienuel sa{Idx3 uom!mwoj dw 6'~f"6I `a '~~~i:~Ssa~sdza uoesntuuuog Rlf A1NnO:) S313°JNV SOl `R;unog NI DLUO 1V4I:)NMa TTp0 _._.._s a [~5ug ..sT)I o114nd fi1v;oK VINbOJIIV:)' :)IlBnd AVV10N 2 OONVfe 't 331 -awns ay; PaOPalmouYan Pun ;uarunj;sus Busofigiol ay; pa;naaxa o-ycn uos.sad a-q; 9q o; umoul pill o; 'XOJT [TLj$ *,J ES , 'P9Tz2uu= PuE mop-Fm R D uMOUX osli? xoaTTTgS u9920 EsT3 S9 61 `-Q -V ` goagyq PauUnu anogn a-q; Pai sp un~oux osTE 'xoo T '.z.~ft PuE APT& TT.gS u0920 EsTa u~ ~1QO0D~13e~1 ,.ebuv eoZ X11 a;a;S a l0A STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER _ f- 7` c9 / S ( G7 ~/'c' ROUTE/BOX NUMBER _/G~ FIRE NO. CITY/STATE r2 ZIP PROPERTY LOCATION: F 1/4 & 1/4, Section 3, T -3,/ N, R_.ZZ_W, Town of S l a St. Croix County, 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 for a MAXIMUM of $3000 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 restricted plumber or a licensed pumper verifying that Plumber, wastewater disposal system is in (1) the on-site 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 form 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 Department 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 DATES. St. Croix County Zoning Office St. Croix County Courthouse 911 4th Street Hudson, WI 54016 (715) 386-4680 Sign, Date, and Return to above address DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY; DIVISION LABOFJ AND PERCOLATION TESTS (115) P.O. BOX 7969 HUMA UMAN"RELATIONS \ / MADISON, WI 53707 (H63.090) & Chapter 145.045) LOCATION: SECTION: TOWNSHIPkpQi(~}Q Y: LOT NO.: BLK. NO.: SUBDIVISION NAME: NE %E ~ 4 30 /T31 N/R 18E (or) W Star Prarie n/a n/a n/a COUNTY: OWNER'S NAME: MAILING ADDRESS: St. Croix Robert Maitrejean 11974 Co, Rd. #C, Somerset, Wi. 54025 USE NO. BEDRMS : JCOMMERCIAL DESCRIPTIO DATES OBSERVATIONS MADE Residence PROFI E ONS: ATION TESTS: 3 n/a ❑New EgReplace (8-20-8-20-91 RATING: S= Site suitable for system U= Site unsuitable for system ONVENTIONIAL: MOUND: IN_ -GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) 2S ❑U ®S ❑U CAS ❑U ❑ S ®u S D conventional If Percolation Tests are NOT required DESIGN RATE: ny portion of the tested area is in the under s.H63.09(5)(b), indicate: n/a [F:loodplain, indicate Floodplain elevation: n/a e imal' PROFILE DESCRIPTIONS page 19 0nC2 BORING TOTAL PTH TO GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH W. ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B-1 7.33 100.42 none >7.33 1.25bl.1. 1.33bn.s.1.&gr. 4.75bn.c.s.&gr. B-2 6.75 99.62 none >6.75 .50bl.1. 1.50bn.s.l.&gr. 4.75bn.c.s.&gr. B-3 6.92 99.72 none >6.92 1.00bl.l. 2.00bn.c.s. 3.92bn.c.s.&gr. B- fB- dprinmll TESTS T DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES NUMBER lf§MS AFTERSWELLING INTERVAL-MIN. P Di RI D RATE MINUTES 02 PER INCH P-1 4.00 none 3 6 6 6 <3 P- 2 3.20 none 3 6 6 6 <3 P-2 .3.30 none 3 6 <3 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 96.42 t _ ( F I -.r `V ' TH , r , I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print TESTS WERE COMPLETED ON: Gary L. Steel 8-20-91 ADDRESS: CERTIFICATION N BER: PHONE NUptionall: ~ - 6 -6200 1554 200th. Ave. New Richmond, Wl. 54017 2298 715 -6200 CST SIGNA I U DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - 00, - - - - - ~l- - - - - i- - - - p ~ q9 00 - ~Po e - goo 'Vol I Je - 77 ~ f sT ~r I g -/V - - olf 00, LIE --t oil r} Dew I ~ ~ ~II I II I'; III; III I I I ~ I I I, I I, I III i I ~ I I ~ II ' I i ; I I I 11 II I I I I I ~ I I II I I I I I I , - ~ I, I I I gi, I I I II ~ I I I I I I I I. I I ICI I I I I I I j ~ , I j I I~- I ' li I I I _ I I I I I I I I I I ~ I ~ ~ I I C I I 1 I I I I I I I t _ f I I I ~ I I i , I I I ~t I I II I I I I I I I , i ! i 1 I I I I ~ ~ ~ j i I i I I . , ICI ~ ~ ~ I i , i I I i i -Y i I ' I 11 I I I I, I II j l III I I II I I III. I I I~- II i I I j ~I i. ~I , I ! I I I i I I II ~ ~ I ~ I I I l ~ i I j 'I 1 I I II 11 I ! i I I I I I C I ~I - I I I I - - I II ~ ~ I ! ' I I I' I li I I~ I I I I ' II' I' I I INDUS INDUSTRY, , OF SAFETY& BUILDINGS REPORT ON SOIL BORINGS AND LABOR AND P.O. BOX 7969 HUMAN RELATIONS PERCOLATION TESTS (115) DIVISION (H63.090) & Chapter 145.045) MADISON, WI 53707 LOCATION: SECTION: TOWNSHIP ~/1E !/4 30 /T31 N~~18f (or) W Star Prarle~Y LOT NO.: BLK. NO. SUBDI VISION NAME: n /a n a n/a / COUNTY: OWNER'S NAME: St. Croix Robert Maitre can MAILING ADDRESS: J 1974 Co, Rd. #C Somerset, Wi. 54025 USE NO. BEDRMS.: COMMERCIAL DESCRIPTIO DATES OBSERVATIONS MADE Residence 3 PROFILE DE C1:: 111:11 1 : R A ON TESTS: L-IN 1 n/a El New Replace 8-20-91 8-20-91 RATING: S= Site suitable for system U= Site unsuitable for system N CONVENTIOAL: MOUND IN-GROUNDPRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) S ❑U ®S ❑U ~S ❑u ❑ S ®V S conventional If Percolation Tests are NOT required DESIGN RATE: under s.1-163.09(511(b), indicate: n/a If any portion of the tested area is in the Floodplain, indicate Floodplain elevation: n/a decimal' PROFILE DESCRIPTIONS a e 19 OnC2 BORING TOTAL D PTH TO GROUNDWATER-INCHES CHA ACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH M. ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B-1 7.33 100.42 none >7.33 1.25bl.1. 1.33bn.s.l.&gr. 4.75bn.c.s.&gr. B-2 6.75 99.62 none >6.75 .50bl.1. 1.50bn.s.1.&gr. 4.75bn.c.s.&gr. B 3 6.92 99.72 none >6.92 1.0 )1.1. 2.00bn.c.s. 3.92bn.c.s.&gr. B- B- 6- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME NUMBER S AFTERSWELLING INTERVAL-MIN. PERIOD t DROP IN PERODE2 EL-INCHESP R RATE MINUTES P-1 4.00 none 3 6 6 PER INCH P-2 3.20 none 3 6 6 <3 P- 2 3.30 none 6 6 < 3 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 96.42 r -4- ft r F 7 r r p, . l 10 4,- A _4 I 1 - r- t t i ~ ~ - a i i 3 € t : r r S r t i t > F I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures o Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and beli th~ % ified in the sin C~c NAME (print): S q, Gary L. Steel TESTS WERE COMPLETED o ADDRESS: 8-20-91 1554 200th. Ave. New Richmond, Wi. 54017 CERTIFICATION N BER: PHONE NUMBER (optional): 2298 715- 6-6200 CST SIGNATU DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) -OVER - ~ %UCTIONS FOR COMPEETINC - 115 - SBD - 6395 To be a coif curate soil test, your report n^ 1. Complete k gin, 2. The use s,, t iy indicate whether this is nce or commercial project; 1 MAXIMUM ar cornrnerciai use 1. 4. Is A SITE IS S R A HOLDING 13th IF ALL OR 5. C - -Y;- P -D CUT BASED ON SOIL CONDITIONS: hown here f 7r vritincl profile descriptior's the plot plan; PI SE use the at A N, ~'E LEGIBLE - - accurately ' -our t<=St locations. D, 1, r ; , sired; vertical el ~ference point a shown, and a as to (I addresses, m a, perco` i ti 'propriate; 10I plain, 1) does not apply, A. 11. your certification number; # THE ;tribute as ALL S IL_ TESTS MUST BE FILE i LC7TY WITHIN 30 DAYS CrOMPL_" ABBREVIATIONS FOR CERTIFIES} SOIL TESTERS 'es a: _a j BR rock 1 SS :i s1/ I . 1 f3 r ~ , ~sd BI b Gy - G, C )an, Y Y' ;lav Loam l' Clay Loam mot P.' idy Clay w/ I'y Clay fit i v mm - Pi d p - W1L Six ge. it xtures r, BM for i;tft,ici G- disposal VRP . TO THE OWNE : test 4"ei i5 IIL MAR - A 19% FILED ~ JAN 2 1996 ► ~ KAtHLEEN H. WASH 538 042 SURVEY Ro ReD1 r of Duds 2 St Croix Co., IN) CERTIFIED SURVEY MAP I~ bold ROBERT AND DORIS MAITREJEAN Part of the Southeast 1/4 of the,Northeast 114 of Section 30, Township 31 North, Rance 18 West, Town of Star Prairie, St. Croix County, NE CO R. SEC. 30, T 3/ N, R /a W, Wisconsin. (COUNTY SURVEYOR'S MON.) Owner's Address: PRIVATE DR/VEWAYEA;SEMENT 1974 C.T.H. "C" VOL. 1153, PAGE j80 Somerset, WI 54025 UNPLA TIED LANDS 5'.t SHED £NCRDACHNENT (SHED TO r b 8E REMOVED I T-M H S 89. 4/' S8"E 346.64' M ISO' 41 I 2 ~ h)SFIED I- L-_0-T= -57 ~ c 'W/ ° to t r-- ; O ~ V' ^ M 2.392 ACRES / / 4~ J ra I S.O. FT. ROAD srraAC/K h /`a ? R N 82' 35' 37"f ~ lltl /NE j a QOl h 76.59' /00, Q' / ;L/ ~p ARAGE i OI ` 1. 2 3 WELL ~ J ^ DRIVEWAY W O d - - DWELLING h i Z h 0 4` N O p. / \ 01 LOT 4, C.S.M., 0 / OV/ z VOL. 8, PAGE 2260 PRIVATE ROAD EASEMENT SHOWN ON v .4 f . C.S.M., VOL. 8, PA6E 2260, NO VEHICULAR ACCESS TO L OT 5, UNTIL DEDICATED AS P `y L/y A TOWN ROAD. This instrument drafted by Laurence W. E//4 COR. SEC. 30, T3/N,R/BW, Murphy I COMPUTED POS/T /ON) 0 d' y'S.f date -aI z1 3~ be SCALE / '700' 0, 25' 50' /00' 150' 200' 300' ``,,~1111111ffp40 `,lope' 0 NSA yo' ti 0 Indicates 1" x 24" iron pipe weighing 1.13 lbs./lin. ;'LAUR NC ft. set. = • • Indicates 1" iron-pipe found. W M RjP i 0 0 Indicates 2" iron, pipe found. ~ N •.:••I FALLS 713 ,r • • Dated: September 19, 1995 v". J WISC' Vol. 11 Page 3034 ~''t LAN S' Certified Survey Maps N~aa~l~♦~♦ St. Croix County, Wisconsin. Laurence W. Murphy L Registered Land Surveyor "Mmofte SHEET 1 OF 2 A 1 r