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HomeMy WebLinkAbout022-1093-10-000 o p ° c o I I n 0 ~ I a L c I I I (r III ' ~ I C CD O ° z ~ C LL L N O C O N U C E 4 c a co m v ~ I ~ H I C O ~ L co w a m M F- Z o 76 O z d c m Z v c o rn i-- m a E ' i (1) ca .N 0- 7 y ~ ~ I N C N • N h~ C C _U O Z F- Z N z I o m N E N O lriVr xs N y y a m C v o G G CL N Lo N v) c) E U 0 0 0 n Z E • rv ~ i, a a a I g f° LL (~j O O 0) O O N J V > OOi OOi } M M O N N O N E Q O O u O m_ d N C M O N i51 U O d ¢ m O O C O y y 'y^ O M O ~ N C O 'O C E O 9 LO N 0 '6 0 0 £i C 0 0 pU > O C a a L 0) ~ C c N O N d• rCi Y - O N Lo oo U N a F r O C: ° N C _ • N c W cs y O E s. o M Y j O Z N Z cA 0 ~ I c 7t T r+ E [ l L - E m L: a • a m m r ao On "~1 A ci v r FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER David Wittier TOWNSHIP Kinnickinnic SECTION 32 T 2 8 N-R 8 W SO~J ADDRES 1046 CTH "M" East ST. CROIX COUNTY, WISCONSIN River Falls, WI 54022 SUBDIVISION Rec. in Vol. 870, pa. 479 LOT LOT SIZE-z---- 022 ' 1013, 10-&)o PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 13E Nc P MAe~ ~ - - ELL \ >cLEANOwTs , \f3' 35 _ 3oxEs - i INDICATE NORTH ARROW NoT l0 S~aLE BENCHMARK:Elevation and description: Corner of concrete Alternate benchmark y SEPTIC TANK:Manufacturer: Wieser Liquid cap. i000 ~ Rings used: 0 Manhole cover elev:31 _ 3/4"inal grade elev: Tank inlet elev.: 4131-21, Tank outlet elev.: No. of feet from nearest road:Front , Side , Rear180Ft. From nearest prop. line:Front 75, Side , Rear Ft. No. of feet from: Well 132 , Building: 12 (Include this information in the above plot plan) (Z reference dimensions to septic tank) SEE REVERSE SIDE F t , i s , «kl ' 1 J: ~U I f f j l i iuladturers phi9uid. Capacity: TI ~I I A ~1 Y d 1 Pump' Model t, Pump/Siphon Manufact.: Pump size k4 ~F d f~ e'wst an of inlet: ~ Bottom of tank elevation r °r w r + pot . e~.ev~. PUMP off elev.:Gallone/cycle: Switch Type: Location n4 '1 ~t r itV=*,, from nearest prop. line: Front , Side Rear Ft. Otanct.xom; Well Building I ' 1Y Trench: 4 Seepage Pit: x1~lldth: Length 60' Number of Lines: 4 Area Built ~ ~~'r'T'b`t . RX(rll at, Grade, XloO 1 411.+,10 1 1011 'i ~ ~ 1 11 Proposed Final. Grade Elev. 0 11 6 dopth top of pipe: 18 " 21 u s . .asst troa nearest prop. 1 ine 2 Front Side 6 Rear 6' Ft. A"M T ~~if~r ~ ~ ~ C► fAst from well: "93 ~No. feet from building 401 1, w r' a,.r i. ,G+~taatWss`t ' capacity: ! tx of rings useds„-,,,,, ...Zlevation of bottom tank: bf v . ~ A 44 f A°~`litle relticm' of r I.ri{~~111.~ I ' «M M! ~IwrrF rwl ti Ac r+:"-feet from nearest prop« line • Front Side Rear Ft ~z . { feet fromt well building , nearest road a rx ftnutafturor t 1 f 1 INSPECTOR: 'LUMBER ON Rs }r' ~!y. v ! ,r T ~~a G LICENSE NUMR: PRSW2739 f I y- ~ NP ,N1 5 1l?{. 7 Aqo 4 ~DEPARTUENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING -LABOR & HUMAN RELATIONS DIVISION P.O. BOX'7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION MADISON WI 537 7 State -Plant .D. Number: NE 4,SGJ4,~ec.32,T28-R18❑ CONVENTIONAL ❑ ALTERATIVE (If assigned) Town of KinnicklAn-3 c ❑ east I-J Holding Tank ❑ In-Ground Pressure Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: David 1 C Rd "M"E River Fall 'xI. R 1 PT. ELEV.: CST REF. PT. ELE ,mod BE CH MARK (Permanent re rence point) DESCRIBE IF DIFFERENT FROM PLAN: - 6 Name of Plumber: MP/MPRSW No.: County: nitary Permit Number: Paul R. Cudd 2 St 'x 128 15 / i SEPTIC TANK/ Rj 4 " o! f MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELE WARNING LABEL LOCKING COVg~. i D. PROVIDED. PROVDED: -~SL~ firiyC~ 97. 96P• 97 YES ❑ NO ❑YES O BEDDING: VEI*BIA.: -YGWYMATL.: HIGH WATER UMBER OF ROAD: PROPERTY WELL: BUILDING: VENT T ESH ALARM: FEET FROM LINE:' Np~l / AIR INL ❑ YES NO ❑ YES NO NEAREST MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMPMODEL: PUMP/SIPHON MANUFACTURER: WAORNING FABEL LOCKING COVER PR E ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: AER TO FRESH FEET FROM LINE: ET: PUMP ON AND OF) ❑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 MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID BED/TRENCH / TRENC ES: MATERIAL: PIT EPTH: DIMENSIONS dI- D GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DI TR. P P ,pTERIAL: N ISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: EV,I LET: EV. ND: ~yi~,~ ~uC qo /yt- PIPES: FEET FROM LINE: r AIR INLET: z.u~'9zvz LZ•7t7 Lf/57n;'~D-a? NEAREST~~ S:IJ, S 7075 MOUND SYSTEM: ®9/,g ~9 9~ 2s 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 ❑ YES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ❑ YES ❑ NO ❑ YES ❑ NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS:00 FF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.: ELEVATION AND 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: 1 FEET FROM LINE: A5 eA ❑ YES ❑ NO ❑ YES ❑ NO NEAREST----* f .5 -7 fain in county file for audit. Sketch System on TITLE: Reverse Side. SIGN LIFE: SBD-6710 (R. 06/88) J_ SANITARY PERMIT APPLICATION DILH~ In accord with ILHR 83.05, Wis. Adm. Code COUNTY .a.,.,..e......., St. Croix STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than E] 7n/ 8% x 11 inches in size. Cfeh i vis o to evious 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 David Wittig NE t/4 SW '/a, S 32 T 28 , N, R18 )edQjo W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # 1046 CTH "M" East CITY, STATE JZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER River Falls, WI 54022 715 425-266 Rec. in Vol. 870 P g. 479 II. TYPE OF BUILDING: (Check one) El State Owned O VILLLL.AGE . • NEAREST ROAD innickinni CTY M East ❑ Public ®1 or 2 Fam. Dwelling-# of bedrooms 3 PARCEL TA NUMBE R( S) 111. BUILDING USE: (If building type is public, check all that apply) 22-1093-10 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. ❑ New 2. ® Replacement 3. ❑ 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 12 © Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: SYST ELEV. 7. FINAL GRADE P. V 1. GALLONS PER DAY 12. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) 172-0 V. S ELEVATION 450 1200 1200 0.38 Class 4 ?/'o CR>feet Feet VII. TANK CAPACITY Site in allons Total #of Prefab. Fiber- Exper. INFORMATION New F-xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank Wieser 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): m er's Signature: (No Stamps) MP/MPRSW No.: Business Phone Number: Paul R. Cudd MPRSW 2739 15 425-2049 Plumber's Address (Street, City, State, Zip Code): Rt. 5, Box 364, River Falls, WI 54022 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater a e ssue suing A em Signature (No Stam s Surcharge Fee) Approved ❑ Owner Given Initial / 094 A7 Adverse D t rmination C~ ` 7~ X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD41398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety 8 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 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 file' 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 81/2 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) 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 David Wittig Location of Property NE j% SW 1, Section 32 , T 28 N-R 18 W Township . Kinnickinnic Mailing Address 1046 CTH "M" East River Fallsl WI 54022 Address of Site Same as above Subdivision Name None Lot Number Previous Owner of Property Georae and Hilda Lovell Total Size of Parcel Approximately 2 acres Date Parcel was Created 1955 Are all corners and lot lines identifiable? X Yes No Is this property being developed for resale (spec house) ? Yes X No Volume and Page Number 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. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPFRTy OWNER CERTIFICATION I (We) centi 6y that att ~6tatementd on thi,6 bonm ane true to the best ob my (oun) knowtedg e; that I (we) am (are) the owner (d) o6 the pro pW y dez e i.bed in thi6 inboAmati.on bonm, by vi tue ob a waAAanty deed neconded in the Obbice ob the County RegiAten o6 Deeda a3 Document No. ]_1Lj_Q'7S 3,3 ; and that (We) pee s entty own the pnopoaed bite ban the sewage d zpo.a .ate (om4 (we) have obtained an eabement, to nun with the above d"cA bed pnopehty, bon the conbtnuat%on ob dai.d aybtem, and the .same hab been duty teco&ded in the Obbice ob the County Reg.caten ob Veedd, ab Document No. 5/5 8 S33 1. .SIGNATURE 010 OWNER SIGNATURE OF CO-OWNER (IF APPLICAB ) r DATE SIGNED DATE SIGNED DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR-AND -PEMPLATION TESTS (115) MADISOP.O. BOX N W 53707 KUMAN RELATIONS (1 HR 83.0911) & Chapter 145) LOCATION: SECTI OWNS /MUNICIPALITY: OT NO.:BLK. NO.: SUBDIVISION NAME: NE~4 SW 1/4 3 /Tz?N/R)BE(o to~MJ")JtC_ _ ?jEr_'wuoL.870 P 44-) COUNTY: MAILING ADDRESS: 1046 C4Y-1 y ~•11ST' ST - ~ 1X t w ~T~i'1 G RL F:6LI,_SW S Y0 z Z USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPT ON: I PERCOLATION TESTS: ~K PROFILE DESCRIPTIONS: Residence ^3 N Pv ❑New Replace IL 6 _-z,?-cP p __2 - 3- c?o RATING: S= Site suitable for system = Site unsuit for system loq 3~ 1 0- V~V r ONVENTIONAL: MOUND: IN- ESSURE: SYSTEM-IN-FILLHOLDING((TAA~N'~K: RECOMMENDED SYSTEM: (optional) [Z S ❑ U M S ❑ U ®S ❑ U ❑ S 2 U ❑ S ~J tJ 4r TR13.1G4ieS - QftC S'x lsoN 6 If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: >\l 1~. Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO R UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 1 z S .y ~pIJ L -7 Z s~ ~ Z o~ Z B- Z 68 q4. 6 8 , B- 3 -2L/ ~tZ,.S A ,AA B- B- B- PERCOLATION TESTS TEST DEPTH . WATER IN HOLE TEST TIME DROP I WATER LEVEL-INCHES RATE MINUTES } f NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD3 PER INCH P_ 'i Z 1VO 30 31 11/L 6 11/L6 L4 P- 7 Z D 3Q1, 3) 1/16 V s~ 40 P- P_ PLOT 3! "!I 6 S'S g P- P- 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 loca''t~io,n on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. Ol g Z.o V AI.o ~~6E GI X7-1-~-,Zl w LT s J SYSTEM ELEVATION Dal . s (0 90. s i ~ a ] `18N►- ew~ st-_ I-0C^- l~ DSO S0O-TA tl: ~ ~~R. Olt c~~g F = 2 vp' I-J LST" OF `1-tt4Z tJE- C-OtuJ tt-R - n F `7'48_% N3Eliy-,SL)/Y O X 1~ 3 ' ~ !o i A 2 ~ D(?`rWrrLL _ T r E S 1 "S Li F_ E . E N' , t-1$ Td ~t cT 1 h1" ~tv S c PC t-~ l o' 5 tEC 3 Z 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. WEGERER SOIL TESTING NAME print): ANIJ TESTS WERE COMPLETED ON: DESIGN SERVICE _ -)-3-90 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): P.O, DOX 74 421 N. MAIN ST. C__,~r 0 0 O S 7 6 ! S - ~zS-4J b S RIVER FALLS, W1 54022 CST SIGNAT RE: 715-425-0165 111 DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester., 1 QF Z DILHR-SBD-6395 (R. 10/83) - OVER - INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 To be a complete and accurate soil test, your report must include: 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 3. MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing scale is prefered. A separate sheet may be used if desired; 8. Make sure your benchmark and vertical elevation reference point are clearly shown, and are permanent; 9. Complete all apropriate boxes as to dates, names, addresses, flood plain data, percolation test exemption, if appropriate; 10. If the information (such as flood plain, elevation) does not apply, place N.A. in the appropriate box; 11. Sign the form and place your current address and yur certification number; 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st - Stone (over 10") BR - Bedrock cob - Cobble (3 - 10") SS - Standstone gr - Gravel (under 3") LS - Limestone 's - Sand HGW - High Groundwater cs - Coarse Sand Perc - Precolation Rate med s - Medium Sand W - Well is - Fine Sand Bldg - Building Is- Loamy Sand - Greater Than 'sl - Loamy Sand < - Less Than 'I - Loam Bn - Brown 'sil - Silt Loam BI - Black si - Slit Gy - Gray cl - Clay Loam Y - Yellow scl - Sandy Clay Loam R - Red sicl - Silty Clay Loam mot - Mottles sc - Sandy Clay w/ - with sic - Silty Clay fff - few, fine, faint 'c - Clay cc - common, coarse pt - Peat mm - Many, Medium m - Muck d - distinct p - prominent HWL - High water level, surface water Six general soil textures BM - Bench Mark for liquid waste disposal VRP - Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department may request verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a permit. The sanitary permit must be obtained and posted prior to the start of any construction. SOIL DESCRIPTION FORM Attach Soil Prot Ott Location Ms On a Su orate Shoo I CL T• Vl~ w LINEAR LOADING RATE: 1 8$ PURPOSE k.AC'kal falT SYSTl~j SLOPE: L, O b - 0 qL ` w ~ GL~~ ~ ASPECT: S Zo K.) DESC,RIPIION BY 1: I DATI ~V ),j ez Z(?, I qq o-~ CURRENT LAND USE:--- COUNTY/STATE: ST ` CSZ-01K CoU~' Z ; `A_) VEGETATIVE COVER ~Tr!1 S S LOT DESCRIPTION 3;i~l of , `/q Sw/1V 5,i~tC3-'Tz?NiRIBwDRAINAGE CLASS: ThL A3 O F ~J ILJ 1 C I =1AW 1 ( Q GALLONS PER SO. FT. PER DAY s c> LOCATION: PARENT MATERIAL(WDEPTH SOIL SERIES; O LT 5 0 (El wRI20N OEPTH MATRIX COLORS MOTTLES TEXTURE STRUCTURE CONSISTENCE CLAYSKINS/ PORES ROOTS PH .BOUNDARY REMARKS in moist Gr. Sz. Sh COATINGS F3o I C'pc/SV-Fr \ O- l ~oyR 3A _ si`) 1'F3~} Al U L{~ Z 1Z=31 ~OyR3l - 51 ~ ZmSbl'c nt ~h c S ~.6D S)' 1 ~'sbk w``~ o.Yo 3 3)--2 Z 1o`~1CZ 3J - Z3 0 I~IG Z. • ~ µ o-lZ Io`1R 311 S j) Sblz Gn v o.Yo z t2. z.9 lo~Cz3~ _ sil Zmsb GS o'eD 3 23-6 S IZ 'l R 3! - S l S b rit a • Sul 6 3 0-,L3 Iri 11Z3J1 S) 1 !~'Sblrz h1v 9~ d•yo Z 13.~J1 Z3! - Sl) Zms~lz. ),7 CLAD o,613 3 yl-b R31- sj I 1 sbh >vl ~s o.L10 by-~y I~y23/ S)') m OTHER SITE FEATURES/NOTES: z-Z9- so aoo s~~ n~,~t Z of LIMITING FACTORS/DEPTH: Signature Date CST Al HORIZON DEPIII MATRIX COLORS MOTTLES TEXTURE STRUCTURE CONSISTENCE CAA INGSS/ PORES ROOTS P11 ' BOUNDARY REMARKS in. nnist Cr. Sx. Sh . OTHER SITE FEATURES/NOIES: I m6e- of_ Signature Date CST N LIMITING FACTORS/DEPTH' DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION P.O. BOX 796 N WI 53709 AgOR AND PERCOLATION TESTS (115) MADISO HUMAN RELATIONS (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: OWNS /MUNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: NEB/ sw1/ 3z /Tz?N/R)8E(o `cam-VQN0I t~►-1C- - T .~tJUo~.~7tJ P q-) COUNTY: MAILING ADDRESS: 10 q 6 C-TN 4 )vJ y t--"S7- ST - ~~Ulx v t w 1T-CIr R► U ~ ~ - S 1-i S yU Z Z R USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: TESTS: - 3- 90 [Residence N ❑NewteReplace 6-Z9-90 RATING: S- Site suitable for system U- Site unsuitable for system CONVENTIONAL: JMOUND: IN-GROUND-PRESSURE: S STEM-IN-F►ILLOLDING TANK: RECOMMENDED SYSTEM: (optional) S ❑U ~S ❑U ®S ❑U ❑S LZU ❑S yTREi~vC1}gS- qftCla S'x f,Ci ' LQ,.,J6 If Percolation Tests are NOT required If any portion of the tested area is in the * ` under s. ILHR 83.09(5)(b), indicate: DESIGN RATE: • Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL P H T R UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION BS RV 0 EST. HIGHESf- TO BEDROCK IF OBSERVED ISEE ABBRV. ON BACK.) B- 1 Z g S. L/ Apr.) E '7 Z E Z OF Z. B- Z 68 a4.6 If ~ ('8 f, B. 3 -2 L/ ~tZ.S 6y B- B- PERCOLATION TESTS = DEPTH. WATER IN HOLE TEST TIME DROP I WATER L V -IN H RATE MINUTES TEST NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD P I D 2 PER INCH P- ) Z tv0 3p 31 11/16 1146 P. Z ~ 3 0 P- V /16 u lj~ 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. Ql 012.0 (~2) 9'1.0 ~~SE g OrTIEZ)- LT S) J SYSTEM ELEVATION O gl'S a 4o.s moo I' w kFS O rc' IzAJ r .@,p Ltj wz o r. r 0-C Aj cti!57 Is -T t. _ j a - - - - - x ~ ~ a ~ ~ 1 f ~ L,o s c.N -moo/ --.--1 -{1---'~ - i i M stx.~-1 _ I ~ ~u - L I tJ Itv sc L t so I seal 3Z 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 lose ion of the tests are correct to the best of my knowledge and belief. WEGERER SOIL TESTIN NAME print TESTS WERE COMPLETED ON: DESIGN SERVICE _ '-)-3-90 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): P, 0, BOX 74 421 N. MAIN ST. CST- RIVER b 7 ! S - ~Z S-~l b S FA 1 W1 54022 CST SIGNAT RE: 715-425-0165 (j~ 1 Q DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) - OVER - SOIL DESCRIPTION FORM Attach Soil Prot Ile Location Ma On a Su grata Sheet! CLIENT wlTT1 e LINEAR LOADING RATE: 1 -la$ - PURPOSE ~~`V ~~4~hC C~~~JT S'/ SLOP 3 -/C) Tn ~Jo DESf.R1PTI0N BY ZL ` W GL~ ASPECT: DATI `Zl?l 19 ~yd~ r CURRENT LAND USE' ST-w C~-[~'~f' ~x , Z I IAJ J VEGETATIVE COVER' 'Tal ,~--S COUNTY/STATE ~VU LOT DESCRIPTION:' SM.:,ZMMJ Rt8w DRAINAGE CLASS: w 0,L ~R -T-bLJ13 Q F ItdNAJ 10- I=IAJAJ 1 e GALLONS-PER $9. FT. PER DAY: 'o ` 3$ LOCATION: PARENT tV1TERIAI(s)/DEPT11 SOIL SERIES: HORIZON OEPIii MATRIX COLORS MOTTLES TEXTURE STRUCTURE CONSISTENCE CLAYSKINS/ PORES ROOTS PII •BOLINDARY REMARKS in an st Gr St. Shp COATINGS $o 1J G I aPb/SQ.FT. o- l 1o`9 - 3Jt - st 1'FSbh v g~ Z. 1Z~-3) 10y~31 - 5 1 ZlrlSblz h~~'► c-S p.6-tj .Fa 0 KX. Z I o-l~Z Iu`tR 31t - s ' j ~ sblz ~n v cam., o.~o Z t2 -Z9 toy tz j 1 - 51 1 Z m s U'~ c S ° bn s i t l~ s b m ~a 3 2-9-6 8 11 IQ~l CZ 31 - 6 3 1 0-13 l0`l123A S)• 1 Sblrz h\j yo Z ~3.y1 -3 1 - S1 z Sbk )-7,6, Cw ° 613 6y-~ lOyIZ ! s)) L~ Yl OTHER S1TE FEATURES/NOTES: ~•,/.l1Jtit/L 6 - z 9- 9 o a oo s n~ G~ Z of Z - Signature LIMITIN( FACTORS/DEPTH: Date CST k t a F - I itwt,~~!! 'tea 1s»:tB~..Itusbgt Q Grantsk 7W Vw ~ • a M fiea~r• s s ~aq eeder to, M"UM To - : i~. f - . to 6ranbe tbs fiilB.ls de.erib.d real..aa in ...BxA__7•M XiLA /Sf ltd" ' amiss 04"". Staft of a►bommhs X59 / M OF M hORDU3T Ql1*I= (0*) OF THE sanmWEST (SK) OF S=ON THIRTY iwD (32), T IIP 1*TM- Tax Pared No:..» =128) M=_ RMZ EIMM (18) MT, described y st t 4~, st ja center of said Section 32 at an iron pipe stake; thence West alag. Y` the Fart and West 1/4 line of said Section 32 a distance of 279.0 feet to ikon p ftels In the fence line; thence S00 27'E a distance of 95.9 feet to an irgn Sipe std#O; . qqe M111179E a distance of 56.0 feet to an iron pipe stake; thence S16 33 W a disiaow '4 " i 0 feet to an iron pipe stake; thence S56 27'E a distance of 175 feet, more or led, 494center of the highmy; thence Northeasterly along said highway centerline to a ott the North and South 1/4 line of said Section 32; thence North along said Nmr ;i a1Nj Sao* 1/4 line to point of Beginning at the center of said Section 32. 4 ,p t This bsa.Maed Property. Tagelber vklt BSI Bad Singular the I slitaments and appurtenances thereunto belonging. Ani..:., . i *A So tkit is ped• h W4086b in tat "ple and free and clear of encumbrances except eageMgltss i reetcletians, s+N K iiations9 and covenants, if any of record, and highway rights of "vey and vin warrant earl defend d. Same. /U ra. Is- i( DMM this day of...--. Y.. I . -(SEAL) (SZAL) George A. Lovell . - i; -(SEAL) -...ISl.AL) Hilda. F.. Lovell J AVTRXNTICATION ACKNOW LSDGMZNT ,i SipMnee(a) STATE OF WISCONSIN ~j g ss / j2 J . .L.-. 5" -A t/,C - astbastieated this day of 19 Personally came before me this ------------16 * 19..9.Q the above small r Hilda.-F. -Lgyell--... - TITLE: MEMBER STATE $1►j{,AF WISCONSIN (lf not, 1, authorized by § 70608;'Wia.. o me known, he the person - who execute the T fnrpeoipl instrument an nrk t sa - THIS INSTRI~r{ Y Wqa DNAFTtD BV~ 's ' 41 Et#arF. ) Davison & 1~ack ' River Fall 54021 Not'q•- Public County, Wis. \T Vor,nl;csinn i> permanent. t l f not, state expi tlisn (SiRnsturt~s may he ~rlltii ~fed,'IU~•?eicm.u•led~md. Isnth P+ are not necessary.) Ntn•r., dnt s7itaesM of penosa shMiat in any capa-vty nh,.;a•I '.w tNj,"1 ❑t•d L,1- +h,it =ire., .r - •I N&URAIMTT 1000MID STATE BAR OF W1S470%-i\ Wi.ran.la Leal Ned Qk &M roses No. I I"a Dlilrraiw. II I~ j DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1-1988 I TNta arAC. REI,ERVED FOR RECORDING DATA j~ WARRANTY DEED 5 $S .33 6 1, $70 'q 77 I recorded M ~iq~ 15 PM I~ jl This Deed, made between .George Lovell a/k/a I! l) George A. well, and Hilda' Lovell k/a Hilda F. ~I Lovell x husband__and. wife - Grantor, ! i and....-Uavid.M. Wittig and..Amanda L. Wittig,.. husband and wife as survivorship. marital property Grantee, Witnesseth, That the said Grantor, for a valuable consideration...... One.. dollar-. and. -other.. good. _ and..valuable..cons ideration....._... ' RETURN TO conveys to Grantee the following described real estate in ...A crpix County, State of Wisconsin: PART OF THE NORTHEAST QUARTER (NFAI) OF THE SOUTHWEST QUARTER (SW 4) OF SECTION THIRTY TWO (32), TOWNSHIP TWENTY- Tax Parcel NO:-..., EIGHT (28) NORTH, RANGE EIGHTEEN (18) WEST, described as follows: Beginning at the center of said Section 32 at an iron pipe stake; thence West along the East and West 1/4 line of said gection 32 a distance of 279.0 feet to an iron pipe stake in the fence line; thence SOO 27'E a distance of 95.9 feet to an iron pipe stake; thence S56027'E a distance of 56.0 feet to an iron pipe stake; thence S16033 ?w a distance of 56.0 feet to an iron pipe stake; thence S56027'E a distance of 175 feet, more or less, to the center of the highway; thence Northeasterly along said highway centerline to a point on the North and South 1/4 line of said Section 32; thence North along said North and South 1/4 line to Point of Beginning at the center of said Section 32. This ....--.15 homestead property. (is) X14XW0 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 easements, restrictions, reservations, and covenants, if any of record, and highway rights of way and will warrant and defend the same. Dated this . day of ..y..........................., 19..90... !~r"._ . (SEAL) •-•----(SEAL) George A. Lovell . (SEAL) ........(SEAL) ....H lda...F...L~ove1.1........... AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN .........County. authenticated this day of 19 Personally came before me this -.day of May 19.~K.. the above named ------George-_A._• L,ovell..and---------------------------------- ......Hilda.. F.__Lovell.......•-••-•-••--...-•••••......-•....-•-•- TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by $ ?06.06, Wis. 5tats•) S . who executed the to me'known o he the person . for6goi instrument an a kn I ,g t sa e. THIS INSTRUMENT WAS DrAFTrD BY Edward F. V]ack, Davison & Vlack River Falls, W! 54022 7-/-• Notary Public . 'YG.I!r.........County, Wis. (Signatures may be authenticated ar acknowledged. Both My Commission is permanent. (if not, state expiration are not necessary.) date: /I.)- 19.X.) •Namea of Persons sirninR in any cn Paeity should he typal nr printed hebnv their RignntnreR. WARRANTY DEED STATR BAR Or WISCONSIN Wl=rn.n.in I•eral Blank Co. Ine. FORM No. I-1982 Milwaukee. Wis. 1 SEPTIC TANK MAINTENANCE AGREEMENT g St. Croix County ~ r p, OWNER/BUYER David Wittig o ROUTE/BOX NUMBER '1046 CTH I'M" East Fire Number CITY/STATE RiV6r Falls, WI ZIP 54022 PROPERTY LOCATION:*.— SW k, Section _3 2 1. T 28 No R18 , Town of Kinnickinnic St. Croix County, Subdivision Lot number. Improper use and maintenance of your septic system could result in its premature failure to handle wastes.--Prover maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licen's'ed 's'ept'ic tank pumper. What you put into the system can affect t -e unct on of the septic tank as a treat- ment-stage in the waste disposal system. St. Croix County residents-may _ be eligible to recieve a grant for a maximum of 60% of the cost.of replacement of a failing system, whit 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 'sys'tems agree to keep their system properly maintained. The property owner agrees to. submit to St.. Croix County Zoning a certification form, signed by the owner and by a mater 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. H 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 Depart- W ment of Natural Resources. Certification form must be completed •d and returned to the St. Croix County Zoning Office within 30 days of the three year expiration.date , SIGNED' ;)10 0 DATE St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 386-4680 Sign, date and return to the above address. DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, C DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX N WI 53707969 HUMAN RELATIONS (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: OWNS MUNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME: NE 1/ sw!/4 3z /Tz$N/RJ8E(o `cam-►ti~10- ~r_1/1310)c - .i►~Vo~.87o P kr) COUNTY: MAILING ADDRESS: 1046 C•T}) y4'v tFnST ST'- ~ 1~( ~ l~v l L~ w 1T1-1 G Rl F:;j)LI.S Gv S yQ L Z USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: I ROFI LE DESCRIPTIONS: PERCOLATION TS: &Residence ❑New Replace 6 -z,?_90 '7 3- 90 1' 1 RATING: S= Site suitable for system U- Site unsuitable for system CONVENTIONAL: jMr021 t~UND: IN-GROUND-PRESS E: S S EM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM: (optional) S ❑U S ❑U ®S ❑U ❑ S MU ❑ S OU Ll'TR&vC!ieS - eflCi4 Srx f,o LO 1J 6 If Percolation Tests are NOT required DESIGN RATE: If an any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: 1V • Floodplain, indicate Floodplain elevation: N.A. PROFILE DESCRIPTIONS BORING TOTAL DEPTH T R UNO ATER-INCHES CHARACTER O SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HI(3ATS TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 1 Z 5. y 1~~r`1 rr -7 2. S t~ s E Z o F z. B- Z 6~3 9 4 . 6 $ r~ B- 3 -2 L/ S 6 y , B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP I WATER LEVEL-INCHES RATE MINUTES } t NLA48ER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 P RI D PER INCH P. l z N>J 3 0 31 "/16 "4 6 Lf P- Z O 30 3) "/1 3) 440 P- 3 2. N~ 3 O 3! \1/16 41 1B 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. Q cZ•.O (t 91.D ~~6E 9 0rrzE)^,Zi~ LT S) 1 SYSTEM ELEVATION d Qo. s eo o Zlno I` ws p ra tug eTl _..4~-- _I T_ ~s V- l i '14 j 3 I i t_.u ~ S Ghl ~ I I _--l t ~ lPt? 9d ~ ► ~'~20~i ~ 'thy ou - L i 3 , y ~'ldI r~~' ~M i 1 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 loce ion of the tests are correct to the best of my knowledge and belief. WEGERER SOIL TESTIN NAME print : ANU TESTS WERE COMPLETED ON: DESIGN SERVICE _ ')-3-90 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): P. O, 1 OX 74 421 N. MAIN ST. C -S T_ 0 IJ O S_) b 71 S- V? _S_0) 6 S RIVER FA 1 W1 540?2 CST SIGNAT RE: 715-425-0165 DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. G~ 1 Z DILHR-SBD-6395 (R. 10/83) - OVER - SOIL DESCRIPTION FORM Attach SO{1 Prot lu Location Ma On a Su orate Sheet) v`~ w LINEAR L INC RATE: 1 . B $ ~4 3 °!o ro PURPOSE: `V SY SLOP ' ~ `V L - w ~ GL~~~ ASPECT: S Zo ~ 41.E _ - DESCRIPTION BY `ry ~ - G)~Zp DATA.. ~V~~ ZGJ ~ g 4yd.~ CURR NT AND USE: COUNTY/STATE S ^ C IX couu t Z VEGE ATIV COVER ) ,~/l -SI.W1/ SEC!,ZMAJ RI8w DRAINAGE CLASS: waL- 1J~z1~ LOT DESCRIPTION:" Off` LOCATION: 1 OF ~ ! C imIA- ( L' GALLONS-PER S Q. FT- PER DAYt - 3 Tb `+w~ t ' PARENT FVITERIAL(s)/ PTH SOIL SERIESt OT'T-~~1~'OLT 51 HORIZON DEPiH MATRIX COLORS MOTTLES TEXTURE STRUCTURE CONSISTENCE CLAYSKINS/ PORES ROOTS PH -BOUNDARY REMARKS fo en t Gr Ss, Sh COAT NGS GPD/SQ.q. ENL~ L! G Gw o • 41 5!~ 1'Fsblz }''l U - \ D- l ~oyR 3/1 Z. 1zr31 ~Oy~3l - 5 ) ZrnSblz mph cS 3 31-~ Z 1 o~-tCi 31 - I o-I-i. ID%lR 31 - S I 1 sblz ~n v 10 y Z \z -Z 9 ►0'2 CZ j 1 _ 5 i) Z m s U G S bD 3 Z9-6 S IW-l R. 31 e-%w o . ~a 106 3 0-13 10`1fz311 S1 1 S~Yz h7v 9w (Z,yo Z 13 . yJ I O`~ R~ ! - S L z)n s bk ),,7 `Fi., C L.v o , 6D 3 x/1_6 Jo`,1h.3/ - S~ 1 Sbk yvl C o.L~o 6y-~ IoyR / i OTHER SITE FEATURES/NOTES: / .L~Ll'LWI~ 6-z9- 9o aoo s~~ nnbe? of ~ Signature Date CST 8 LIMITING FACWRS/DEPTH: ' 'f '~~A~UIp t~ 1TT1 G Owmerds name San. Permit No. H63.05 PLOT PLAN Show: Location of building served A Dosing chamber 0 Septic tank Vertical/horizontal efge2 ce-point Building sewer System elevation is Q 9).S_ G) 90-S E' Effluent system Well 1~1.q Replacement system area Property lines w/in 501 of system Distribution boxes Scale = X11=30 , or dimensioned N,q Pump and controls: Mfr. & Model No. Vertical Lift Size Force Main Friction Loss T. D. H. Vol. Dist. Pipe Gall-per Min. Gal. per Cycle Place check mark in appropriate box, indicating item is shown on plot-plan below: Vh -tz_~: ioo.o' oiv CoRUe%. O sr CAN CVZ~~ \}ovSE 14 tusmc.~ lDOO 6RL S lY,n k i s T~uc SLPTP o_ 3S`OF PAR c0U6 y'~P bC Q ~`D , la HE RaRNU ou ~ro S6~ -0l(LOh~ 46 V"PVe A%Z PER Co~E. PLPE ~ Y~PV C ve3r Z _ - b' 4PL~11't~ DlS1R18UTr0l.) 80K v- bo , - C 3 \ZEm'D 3 ~ ' 6 Y'~PV c FJr7m PV c w+~a• i 83 t~ 5 Ntia, pipe By the granting or approving of the above plan, or upon the event of a subsequent permit being issued, SteCroixCounty and theSt.CroixCounty Zoning Administrator, does not assume or hold itself liable for any defects in plans or specifications, plan omission, examination oversight, construction, or any damage that may result in or a installation. MPRSW 2739 July 20, 1990 um r s signa ure icense o. Date -v s; . Nye Gill z I FE-1 6 G _ Ski L Ft.L ~ rL'LA1 vaka Qe~,.9o.5 i 2" of F ~6C.T r.-Pr _~1S3R1$U~7 .-l 1rj--8E 1iT1 1 1` l ctfES SetLQw :~iR~s~ti~tl r~ h? L5-_---- AsT i i i - MPRSW 2739 July 20, 1990