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HomeMy WebLinkAbout024-1006-80-110 ~ 0 3 Oo I N ~ O 4 c ~ I o ~ ~ ~ I t3 o `z N LO I ,o N c w I t > I N I I I 'o N N I o Z c_ c ti WE OF p o 0 o~ I I 3 M I :!t (D w z E z = o z ! `m d a m 04 O U) o I c z I o Z :!t c w m o o fn FZ- ~ I ~ c z -p I d M co Q2 i a V L O I C C O o ED ¢ O Z H Z N ~ z I 4) N co E N L _ Cl) O CL r Y C CO to OD C4 W d N f0 p 0 0 O G G a E N N `p E o o Q O _ 1 U) U) = U N N Z N > 3 a cn p l vi O O O z a c o o p I to J U rn rn z -0 !Z 04 0) cc 'a o 0) co M O N O 'V 0 w E ~I M M_ C~ m c a u' I p U 'p y y m p 'p d Q fn f6 0 H y I O N U O O d N C O O ;c,, j C N w u a I r\ , y p O v ' G Y C o o C 7 CO 1 , N 000 y N F- F- c d n .2 t y~ C CO Y p ,C ! • ~rV)y' O O a S O Z N -f fn ~ I v ~ I L: (L 0 CL -6 .2 w rr`iw~l E c o I l 1 Parcel 024-1006-80-110 05/0812006 10:08 AM PAGE 1 OF 1 Alt. Parcel 6.28.17.35D10 024 - TOWN OF PLEASANT VALLEY Current XJ ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - HACKENMUELLER, JAMES M & SANDRA K JAMES M DRA K HACKENMUELLER 5CTYRDJ ROBERTS WI 54023 Districts: SC = School SP = Special Pro erty Address(es): * = Primary Type Dist # Description * CTY RD J SC 2422 ST CROIX CENTRAL SP 1700 WITC 5,j_ Legal Description: Acres: 2.000 Plat: N/A-NOT AVAILABLE SEC 6 T28N R17W PT SW NE LOT 2 CSM Block/Condo Bldg: 8/2311 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 06-28N-17W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1143/610 WD 07/23/1997 1123/592 SD 07/23/1997 971/156 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 04/10/2003 Description Class Acres Land mprove Total State Reason RESIDENTIAL G1 2.000 24,300 78,000 102,300 NO Totals for 2006: General Property 2.000 24,300 78,000 102,300 Woodland 0.000 0 0 Totals for 2005: General Property 2.000 24,300 78,000 102,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 306 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 DZPARTMEiNT OF INDUSTRY, INSPECTION REPORT FOR `SAFETY & BUILDING LABOR & HUMAN RELATIONS DIVISION P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION S~D'Ift 4W,e c . 6 , T28 - R17 State Plan I.D. Number: CONVENTIONAL ❑ ALTERATIVE (If assigned) Twon of Pleasant Valley Co. Rd. J 171 Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: _ INSPECTION DATE: Kenton Hanson 1573 Co. Rd. J, Roberts. WI BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERE T FROMPLAN: REF. PT. ELEV.: CST REF. . ELEV.: `/r Name of Plumber: P/MPRSW No.: County: Sanitary Permit Number: Wm. Schumaker - 6382 - of 128865 SEPTIC TANK/ " MANUFACTURER: LIQUID TA K I T K OUTLET ELEV.: WARNING LABEL LOCKING C~/- PRO IDED: PROVDED: b 1161600 YES ❑ NO ❑ YES NOS BEDDING:~IA.: MATL.eA TE UMBER OF ROAD: PROPERBIING: VENT T F SH IFROM INE: AIR IT❑ YES O S NEAREST ♦ .c ~ OVER MANUFACTURER: BE R. ITY: MD ODEL: PUMP/SIPHON MANUMFACTUBER OF RER: PROPE RTY WARM WE EDLABEL BU ING:PROVIDED: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO PROVID ENTTOFRESH G LONS PER CYCLE: PUMTROLS OPER NU LINE; AIR INLET: (DIFFERENCE BETWEEN ET FROM PUMP ON AND OFF ❑ YES ❑ NO NE NG: SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: D 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 I TRENCHES: ( M RIADIMENSIONS ~1~. GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: N 1 NUMB ER OF PROPERTY WL: BUILDING: VENT TO FRESH BELOW f;IP :r( ABOVVE OVER :V/Rf1LET: EV. END: PIPS: FEET FROM LINE: AIR INLET: C/ U~~ ~ t f~ I-Irp , Q . ~i NEAREST MOUND SYSTEM: Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thr ound systems to make certain that it ON REVERSE SIDE. SHOW ES ❑ NO mee a criteria for medium sand. ELEVATIONS MEASURED. SOIL C R TEXTURE: PERMANENT MARKERS: ENO WELLS; ❑ YES ❑ NO ES ❑ NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: DEPTHS YES El NO E:1 YE❑ YES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL DE H BELOW PIPE: FILL DEPTH ABOVE COVER: BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: N0. D R. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & RKING: ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.: ELEVATION AND DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: PONDS TO INFORMATION APPROVED PLANS ❑ YES ❑ NO ❑ YES ❑ NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENT FEET FROM LINE: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST f'6J oo* / /DAY /O C /C //may` in in county file for audit. Sketch System on Reverse Side. kIGNURE: ~ TITLE: SBD-6710 (R. 06/88) SANITARY PERMIT APPLICATION 13 TULHR In accord with ILHR 83.05, Wis. Adm. Code COUnt mom STATE SANITARY PERMIT -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ 8% x 11 inches in size. c e lion to previous 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 7` '/a ='/a, S T,7 r, N, R / E (or 1 PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # ,r7,5 C / d--, CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER k~h el f11*5 13 YG J - r-- II. TYPE OF BUILDING: (Check one) 1-1 State Owned ❑ VILLAGE - NEAREST ROAD iC Y .t. t T O: Y%s e-, I W V ❑ Public ©1 or 2 Fam. Dwelling-# of bedrooms PARCEL TAX NUMBER(S) 0a Q - 100 - 3-0-000 Ill. BUILDING USE: (If building type is public, check all that apply) ~C 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 40 Church/School 8 ❑ Mobile Home Park 120 Service Station/Car Wash 50 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. ® New 2.E] Replacement 3. ❑ Replacement of 4.0 Reconnection of 6.0 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 ® 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) ij ELEVATION 6 ~-ISC~ 9~ C1 a t ca ~ 11 7 7, Feet tors . Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New xistin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank l0 0 r t,~r~ u Lift Pump Tank/Si hon Chamber. FRI Vlll. 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 Signature: (No Stamps) MPRSW No.: Business Phone Number: W i ! /4~at ~"GEEi?trZf e1^ lj Gf Plumber's Address (Street, City, State, Zip Code): 3~'_~c~av.v s..~ v SOU, IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (18urohe g roue Water Date Issued ing Agent Signature (No Stamps) Approved ❑ Owner Given Initial X/--QQ Adverse Determination / X. COND ITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: . SBD-6398 (formerly Plb-67) (R. 11/68) 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 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. Vlll. 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, groLind- water contamination investigations and establishment of standards. SBD-6396 (R.11/88) APPLICATION FOR sAHITARY PERMIT • 9TC-100 This application form Is to bo conplatod In full and algned by the owntt(s) of the property being developed. Any lnadoquacles x111 only tesult In delays of the parmit issuance. -Should thls development be intended lot tesolt by owner/contractot,(spec houas), thon a second torn should be retained and completed when the property is sold and submitted to this office vlth the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of property e,✓1~'- o Location o[ property xzz „1/f, section T„ 11-R1~Y Township i~Q asw~-1_ Ma 111 n g address e 1 AZ'V- Address of alts 4i c' Subdivlslon naewe • Lot nuebet Previous owner of property Total sire of parcel a,Mas Data parcel was created fTac/ /3 /r'7 e At$ all cornets and lot lines Identifiable? on 110 Is this property being developed for resale (spec houae)T`_Yas 110 Volume 7EG~and Page Humber -49-Z as recorded with the Aeglstat of Deeds. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - INCLUDE VITH THIS APPLICATIOH TIIQ FOLLOVINCI A VAARANTT DEED which Includes a DOCUMaHT HUMOIR, VOL(1MR AND PAOR NUmawn, and the SaAL OF TIIR A M STER OF DUDS. In addition, a cettitied survey, It available, would be helpful so as to avoid delays of the reviewing process. If the deed description teterencas to a Ceitlflad Survey Map, the Certified Survey Map shall also be required. PROPERTY OVNER CERTIFICATION )(ve) certify that all statements on this form are true to the best of my (out) knovitdgej that I (we) am (ate) the owner(s) of the property described in thle information form, by virtue of a warranty deed recorded In the office of the county Rtglatat of Deeds as Document No. yam/ -72r3 I and that I (wel prtstntIy own the proposed alto for the sewage disposal system (at I (ve) have obtalned an easement, to tun with the above described property, tar the consttuctlan of sold system, and the same has been duly recorded In the office of th"Ohty Aeglster of Deeds, as Document No. Signature of owner Signature of Co-Owner (if Applicable) Date of Signature Date of Signature 77, 7- flare wo" 000111110111 BOB x '110 Isom PIK 766%u'69 ST. am GiMA.. _ ftdt !or as 0 ' r pl Deed s. Of the estate of ~ 9iC 0- - i Deveden r f. ~ D N_ HA without.warrant ,w Grantee. Kenton D..Hanig '~2 T fork Ave . #90b. Books iwd "a atow in Edina,- MN __55435 f,~it'11tm+w~ J Tax Parcel No: - ?boss parts of the West Half (W 1/2) of the Northeast Quarter (NE r :A-A), Section six (6), Township Twenty-eight (28) North, Range ; 3"enteen (17) West, described in Volume 5 of Certified Survey !laps Page 1329 and the following described parcel: Commencing at the Southeast corner (SE) corner of land described in Volume 5, y Certified Survey Maps, Page 1329, thence North 000 101 05" West k, .25 feet, thence East 320 feet, thence South to the North line of Uish"Y 94, thence Hest along the North line of Highway 94 to the Beet line of said Northeast Quarter (NE 1/4), thence North along said Vest line to the South line of land described in Volume 5, thence East along said South ~•r Certified Survey Maps, Page 1329, line to the point of beginning. ' # EXEMPT 77.25 (11) poe"d swoomm" by tW deed does Convey to Grr- +4w all of the estate sad Interest In the pra/ae1/ tirrrie~ as 80eieRM Wd booo * law is Deeednes do&*, and Is if the estate and interest in tie PeWeetf wlk~ 1M MWMA W Am aeedrd' , 2nd Any of January lsa.7.. i# • k ,y ~F R -Kenton D. Hanson . ' " _ e Personal Eeprowntatin I1 ' . etaeaad laws .....t w. p, . AOTZENTICATION AC=NOWLSDOMMUT K- Slse(~> of Kenton D. -Hanson-•-- STATE OF WISCONSIN SS. i g . . -.......County. 2nd ' 17 Personally came before me this day of the J uar~l.. 8... anaed , {3 l d A. Losby.. *Dnal It . TiTLN. UMBER STATE BAR OF WISCONSIN _ . . if ay~iNd bf ~ 70A.OQ. Wis. $tats.) to me known to bethe person who eaoeo»W .tM -t p l foregoing instrument and acknowledged the same. ; T14I6 )NiTRUMaN1 WAS DItAFT[D BY . Don.. Los i Eau Clai.•e,... WX........5!~N? _ . Notary Public .....Conaty, Wis. 1 (Signatures-may-be authenticated or acknowledged. Both My Commission is permanent. (It not, state ee:pir~tioa . 1• are not necessary.) date: 1l.........) i oosom at earasaa Wang in any capacity should be typed or printed below their eianetcrp. - ST.tTF BAR Or WISCONSIN NO. FORM Na. 5 -010 stea j STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER f£.vfc~,.1~~~ so T ROUTE/BOX NUMBER AP12 ,9Qek6~a~~s !✓fw FIRE NO. CITY/STATE ZIP PROPERTY LOCATION: s 1/9 ~f/ 1/4, Section f~ , TaLZ- N, R C7 W, Town of ,U ~asr,•7`Aa /&A:z. , 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 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 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 ,'fG c~/ -riyr9e~j-✓ ~J DATE 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 DEFARTM~NT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: OWN UNICIPALITY: OT NO.:BLK. NO.: SUBDIVISION NAME: Sw'/ K WE 1/4 6 /T 2a N/R 1-7E (o C~~ st~►vT v R to_ - COUNTY: MAILING ADDRESS: S73 C T f] - + Sy sc. Uzwx ~--I)" 1 ~Nmst,y Burs w/ -S ~oz USE DATES OBSERVATIONS MADE NO. B DR COMMERCIAL DESCRIPTION: TESTS: PROFILE DESCRIPTIONS: PERCOLATION Residence 3 N - ONew ❑Replace RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: S TEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM: (optional) NS DU RS ❑U LAS ❑U ❑ S ZU ❑ S OV Z T ielucos- Lav~" S'x su'LzAj 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: • ~-t, Floodplain, indicate Floodplain elevation: /v PROFILE DESCRIPTIONS BORING TOTAL DEPTH R UNDWATER-INCHES CHARACTER F SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION -OBSERVED TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 1 -~6 1on.Z ~av~ S P 6E Z o~ Z B Z n S 01 L 13- -2 B- B_ PERCOLATION TESTS TEST DEPTH , WATER IN HOLE TEST TIME DROP I WATER V L-IN HES RATE MINUTES NUMBER INCHES AETERSWELLING INTERVAL-MIN. PERIOD PERIOD PERIOD3 PER INCH P. 1 2- MrA 31CA 71 fa '%311 I, 3'7 P_ Z Z Juo 30 3/ y V0 P- 3 Z wo 30 3/v 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. IAJ1 17 IN t_ 1ZRK/h1 P" L N l OuIj S f SYSTEM ELEVATION pp on.o C~ 9s 0 ~st`t c o F1 us it > o' 0R~7T1 OF 1 _ S _rS~ i -1 fj - + " NE h ' ` ~ to ti Lo 5 C ttii . T OX y S ~ N S ( b' tw . tt_ O p' S' c P. I C ~ 4 xyiiii 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 Wisconsin Administrative Code, and that the data"f(I6fded`and the location of the tests are correct to the best of my knowledge and belief. w; TFSTIN NAME print . AND TESTS WERE COMPLETED ON: k\-l1l_40 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): 0 ZT 0 0o s~6 p1S_(1ZS-oJ4s p. 0. BOX 74 493 N - uAINST, .RIVER FALLS, WI 54022 CST SIGNATURE: F 715-425-0165 90- 7-1B DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. L DILHR-SBD-6395 (R, 10/83) -OVER - hl~ 6E J QF r SOIL DESCRIPTION FORM A tack oil Prot 110 OC MIND 10 061`414 Shse 1-'tm Nt'z S oKa 2 2 s 8 G1o PURPDSE:1►~l_V SAIL Pt~$0 5 SLOPE, DESTRIrr1DN BY ~R'T1-FUR L wEG _ ASPECT- So l ~-D 1J ~V , R 4 CURRENT AND USE: OATCt SIT. Cpu'.'\ X UQ 1J ln.1 VEGETATIVE G.-MA S S COUNTY/STATE: LOT DESCRIPTION:'PT• VF P. 1'7w nDATUAPP w- L ~1~C-AIA1~D ~,`W 1. p$~RJ 1- `f I\ l_L~ GALLONS-PER S FT. PER DAY i fl 5 LOCATION: 1 v ?•JiC\'t11v SI ` PARENT TERIAL s SOIL SERIES1 HMIZON DEPTII MATRIX COLORS MOTTLES TEXTURE STRUCTURE CONSISTENCE CLAYSKINS/ PORES ROOTS Pil -BOUNDARY REMARKS in, moist G St. h S \301 G ) o-VL I" Lz1z - s i I ).'Fsbk Mfg 5w Z 1Z. 3Q ~oykz.3/6 - sj 1 z»Tsbk ri1fM 3 s 3 39.57 s yR y/b s 1 1`f sbk ~n v ~-5 '/A ~s l `fs~k >n v`41, $o2\w6 Z _ 0-1Z. IOyR 2 !2 - sj l~sbk wl~h C3 CA., Z IZ- y$ 1o`tR 3A ZmSAtiz m-fl. vs 3 U~ -S $ \ o~ iz y/C - s I 1'~ s bk w~'fr cs L4 s8-~s ~u'-tR.a/ - ~'g I sbh rnv'fi 0-~3 \uy(2. 2.lZ S 1 1~ 1`E5 bh N'1`~t^ -gw Z 13_yl. lo`~R 3/6 - S0 2~nS1~12 M'Fh eS 3 U1-Sy ~uyR s/8 - 1 s 1'~S1a1rz )rTv`QI~ cS lacr-lo rus y o O 1 C14R z lz 5)) ) S 61L !n`~Ct, Z )0-3 Z lo`~.Iz 3 l6 - S) I Z 5 b12 3 3i-y ~.SyR VA - s 1 1'~ sbk wI'f~ - cs to°le ~ L/ ~ olZ) ~ S 1 0- `Z o YR Z t Z - S-0 1 1 J 6k Yn'F►^ w Z ~Z-zy 1~'7R .3/G SO 7Zn S b?z m fk - S~ 1'FStik T,s~T„ a5 3 2y-yo 1tmp- 3/4 y Yo-t \LwlR s/6 ~g )'Fsbk lnv'~• OTHER SITE FEATURES/NOTES: Dt- )1-~ y- 9 0 000 5-)6 'F~~~e? of Z LIMITING FAFTORS/DEPTH: Signature Date CST 0 ~ ' ~ ~r~~~( .~YF'.~ % ~C ~ ~C.' c'V 'G..i✓~ s t B#J ~C"J`'. 1, l N 1 y~ v U F~ f gel" Ada 7 i f i r 1 ~ E ~ 1 ~y 719g1~' , W1 rJAMES'O'CONNELL 4 5 (177"Deeds 9 Qf r1-;i.i n. W1 CERTIFIED SURVEY MAP O ~~J! KENTON O. HANSON r Part of the Southwest 114 of the Northeast 114 of Section 6, Township 28 North, Range 17 West, Town of Pleasant Valley, St. Croix County, Wisconsin. N 114 COR. SEC. e, r 28N, R 17W, Owner's Address: /couNrrsuRvEYoR'SMON.) I 7220 York Ave. South - i I Apt. 312 ? - - - - - - - - - - - Edina, MN 55435 J w 0' 66'0 i 2 10.0 q I+ 00• L O At... V OL • 5, PAGE /329 UNPLA rT TED LANDS Z 6 6• I ~ o N 891 49'5S 'E 129. 15 S ,Y'8914.915S' E 471.471 ^ 2 f - r 8. 7- 217.28^ 80,72' CHAIN LINK FENCE O h RI S 89. 49.33•W 2/7.28 N O h o a 66' PRIVATE ROADWAY w O M CASEMfNT REC. /N °v OF 4? o VOL. 890, PAGE 175, 3 a , I o DOC.#465 401 2.00/ ACRES a Q ST. CRO/X COUNTY ZI o 87, 164 So. Fr. W v RECORDS Q 4I -j o o ° W 0 0 ~I ALL 8EA1?1N6S REF. TO TH£ WI "1 O NIS 114 L I NE OF SEC. 6, ° QI T28N, R /7W, ASSUMED ~I J S114 COR. SEC. 6, r281Y, IN 00.00,00"E R 17 W, /COUNTY Q ZI SURVEYOR'S MON.1 J J ZI SCALE / /00' 0 50/00' 200' 300, ~~g~ S 89. 49 55 'W 209.87 IINPLATTED LANDS CURVE DATA CURVE CHORD BEARING CHORDL. ARC RAVIUS CENT, ANGLE /ST TAN. BEAR. 2ND TAN. BEAR, 1-2 S64.44'05"E 56.69' _58.59 66.00' 30'52'00 N89.49'53"d( S39•/8'05'•E _ 3. 364 44' 05 97.06 100.32' //3.00' 50.52'00" S 39• /8'05"E IN 89 49' S5 "E 4-5 N64.44'05"W /53.75' /58.91' 179.00' $0.52''00 S89. 49 55" N391 /810511W O Indicates 1" iron pipe weighing 1.1.3 `,,``I~II1 t 11111!/~y,I lbs./lin. Ft• set. i OIndicates 1 1/2" iron pipe Found. C~~ • Indicates 1" iron pipe Found. ~••~--"'•-r` / r • LAURENCE'•;: Dated: December 8, 1990 Laurence W. Murphy = m W MURPHY Registered Land Surveyor 07 S 1713 Vol. _~_!~arie 1 1 CA • : RIVER FALLSy. " Certified Survey Maps WISC. Q St. Croix County, Wisconsin u rjir9F~'••'•.•.•••••'SJ ,,v CA10 SHEET / OF2 IND"S DEPAP~ENT T.~M , OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS NDi9STRY DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX N W 5739069 HUMAN RELATIONS (ILHR 83.0911) & Chapter 145) LOCATION: SECTION: WOWN UNICIPALITY: OT NO.:BLK NO.: SUBDIVISION NAME: Sw 1/ tJE 1/ s /T 2a N/R 1-7E to pL sF1~,'t- v fl - COUNTY: MAILING ADDRESS: S7 3 C -T N - + S y ax . Ct?.a X 1-c l 1~ 1~~ S 0)v o8 0Z_TS w ! S ~o i 3 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMER IAL DESCRIPTION: 17ffnUFFILEE-13MESCRIPTIONS: TESTS: Residence 3 N . I C$New ❑Replace Ili- `3 11_ y_cju RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM: (optional) ®S ❑U S ❑U CAS ❑U ❑ S 0U ❑ S Oll Z `rj o atoms- C.M s'>< r su'~oK,c 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: P\. Floodplain, indicate Floodplain elevation: - PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-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 6 \ ob . Z 1v0~ ? L s pit &E Z o F= Z B- Z --IS 01L B- L y >-2 B- S ~Z ~g.q t > g z B- PERCOLATION TESTS } EST DEPTH WATER IN HOLE TEST TIME DROP IN WATER L V L-IN HES RATE MINUTES f NUMBER INCHES AFTER SWELLING INTERVAL-MIN. -PERIOD 1 PERIOD 2 PERIOD PER INCH Z- MrA 3b 71(6 \3111. 37 P. 1 P. Z Z luo 30 'V 3/ 12(0 P_ 3 Zy Pilo 3~ 3!v ~1 111t L1 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. 1-t n Pi L R, _T*-wjkM `-~rGa (D, 98.0 Z Q C J~ SYS,T}EM_ E_LEVATION_ pp on • o C~ 9S,0 ~4'uSE ~J~tL ~ t> .40 'Q 0" OF SITe Sl`T'L l pG p~ s 3 C*0 t_ Y---Z fti/51_,_, rL{~, yr v%dn " d E I r-i~l' Q. L~D• 0' OQ I'r 2 Ih ~ 1 ~ s~t~ ~y AWE 1 ~ 1 ~Z tN "CYz~.I~ItC 1 -j L P - ► }u~a 8E . .4 q~ t ~ f i k t 6 ~ e Sc..1~-I_C l1t ~[o' see.. G 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 AND TESTS WERE COMPLETED ON: 1\4 ` q Q, ADDRESS: DESIGN SERV ICE CERTIFICATION NUMBER: PHONE NUMBER (optional): eS'C' 000 576 7)5_c~ZS_olb5 • • R-OX74 491 "AIN ST, L RIVER FALLS; WI 54022 CST SIGNATURE: / 715-425-0165 IiY 0/ z~ B DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. 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 1Y') 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 fs - Fine Sand Bldg - Building Is- Loamy Sand > - Greater Than 'sl - Loamy Sand < - Less Than 'I - Loam Bn - Brown 'sit - 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. L- SOIL DESCRIPTION FORM Attach Soil Pro 1 e Location Ma On a Su nets Sheet) )\N S uN LINEAR LOADING RATE: 2 -2 S CLTENT PURPOSE TE~3ALk3'h''E FOfL SOIL At3th"-pW 5'j T5I SLOPE; 8'10 - Sow _ DESCRIPT ION BY: 14 RZ_r4 uR. I._ . lAJ EG G'iR ASPECT: OAT[: ~Oy \3 19 CURRENT LAND USE: COUNTY/STATE ST C-Fw\X CgVa~lY ; W VEGETATIVE COVER: Cl-"SS LOT DESCRIPTION: V`T•' OF Srv 1!S/- IJ E;/! SI?c• G, TZS K-~; P. 117IV DRAINAGE CLASS' w~-L U1"11JLTD LOCATION ~WJJ 01- ~l- 5~1T V ~ LL~~ GALLONS' PER Sp. FT. PER DAY; IJ - PARENT MATERIAL s / PTI : SOIL SERIES; HORIZON DEPTH MATRIX COLORS MOTTLES TEXTURE STRUCTURE CONSISTENCE CLAYSKINS/ PORES ROOTS PH • WUNDARY REMARKS in, moist Gr St. h COATINGS 3b~ G ) ~o~rRz~z - s i I ) sbk 'm gLA,l z A __14 \oyR 3/6 - si 1 Zin56k rn-(k 3 s 3 39. S~ S''7R y/b S 1 1`~ able Yn U'F h cS L S7.7~ -S /A ~S `fSb4t NI v'41- $o21NG Z o-IZ 10`>R Z!Z - -s 1`FSb1z 101'F1^ C3 C., Z ~Z- w JOyR 3/6 - sj Z.ms)* vrI'F►~ cS cS 3 y~-58' to~IR L/A. - s l 1_f sb►z mfr L4 S6.1s Wlk8/z - S I`~sbh ~e w~ 3 ~ 0-\3 \o~aci. z. !Z - s) 1 1`F5 bk 1~t`F►^ ...9L" -L )3-y1 lZmR 3l6 - Sid 2p,56k mfF- CS 3 UJ-sy l~y[t 5/8 - 1 s 1~s~1~z riv`Q>r cS sy-~8to~rR ~!6 - 1`Fssk >~u~~ QflR N G y O o ) 0`-1R 2- - SO T,5 6 tz lyl'FN g''~ z. 1o-3Z 10`-LIZ 3l6 - s i) ZmSbk ~`F►^ cw 3 3Z-v ~•SyR y/6 - 51 1 S~k w,'FI,. _es o°le cm*,Ue-L L/ y4-1-1 to,ltz s/g - 1s ~`~sbk w►vfh ~o1Z) ~ S o- ~Z l o YR Z t Z - S)) l ~f J hk 1''1 'f h 9'~-~ Z li-Zy lo`1R 3/6 S) 2_A7 s b k >n CIL4, 3 Zt/- Y 0 1 I,y t2 3 /6 - s) 1 15 hk II'A'F~` ~ S y L/b-$` lt]`-1R S/6 - '~S )~Sbbt 1nU'Ft-. OTHER SITE FEATURES/NOTES: G ~G>GT.JL`cv~ ~ ) 1-) y- 9 0 0 ~0 5'~~ nn of Z LIMITING FACTORS/DEPTH: Signature Date CST 8 Vila- OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS DIVISION INDUSTRY, LABOR AND PERCOLATION TESTS (115) MADISON W 7969 HUMAN RELATIONS (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: OWN UNICIPALITY: OT NO.:BLK. NO.: SUBDIVISION NAME: SW 1/ NE 1/ 6 /T N/R 1-7 E (o pL spiv r v pt v~fav - - . - COUNTY: MAILING ADDRESS: S73 C-T-H•'S'y !~;7. CZ of X 1-c t w'1 ~N S ON oS EATS W / S 1./0 Z USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: C$ STS: ®Residence New ❑Replace RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: S S EM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM: (optional) ®SEU RS❑U CAS❑U DS[ U DSa Z~x,c~_~., S'xrs13 'L.o+Q ~ If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s. ILHR 83.0915)(b), indicate: • Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH T R UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIWWST- TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 1 ~6 11 o;4.Z ~o~~ c~ s p6E Z OF Z B- Z S a6-o S B- 3 g 1~ 1% - L > -2 y B- 1.0 t"s , % ~i > -7-7 B- S 8 'Z ~g.q r > 8 i - 64 B- PERCOLATION TESTS } TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES f NUMBER INCHES' AFTER SWELLING INTERVAL-MIN. PERIOD T PERIOD PER INCH P- 1 Z No 30 I) 2j `3111, 3-7 P- Z Z No 30 .3/ '1/ V0 P_ 3 Z ivo 3D 3/V ~l "/t Sl 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. V 98`O ~ TLQ ittm ►-r'Co L tV tC~)V cm. Q S SYSTEM ELEVATION (D 0/1) .0 C~ qS.o _ c o o oR j ~3s ► o i 4- - t t Q ~ I i !k, JJ~ o S- e NE~ lite 4 y ~ t o Lo s d C tru • 6c ( S ~ ua . _ i 9• i i b' to . , i I i 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 Wisconsin Administrative Code, and that the data i*6irded and the location of the tests are correct to the best of my knowledge and belief. NAME (print p WEGERER S- AO TESTS WERE COMPLETED ON: k\- l\4- 4 p ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): eST 000 S'7(. 7)S-VZS-OHS p.% BOX74 401 N - MAIN ST, RIVER FALLS; WI 54022 CST SIGNATURE: 715-425-0165 90 - Zl 0 DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR SBD•6395 (R. 10/83) - OVER - 6~ J .r DESCRIPTION FORM SOIL Attac Sol Prot u Locat Ion NO On 0 Su amts Use ~C I m to KNZ S o NJ LINEAR ING 2.2 5 c4 PURPOSE: f ZON" M' FjdL SOIL Awls &W 5 SLOPE: $ 0!o DESCR1PflON BYA P-M-BUR. L 60,3 4E7_6 SMM ASPECT: SoV 1'N , wri 1J~v • ~3 X440 CLIRRENT LAND USE; COUNTY/STATE: S C ~X UQIJ w VEGETATIVE COVER: LOT DESCR PTION:'pT• OF SW -Nell 5R. TZS AJj P. 1`7 k! DRAINAGE CLASS: W LrL,L 'V'),"jAJeb LOCAT ON: OF: X-ZlLE_ (tSpN T V Mt trLt: GALLONS- PER S FT. PER DAY t fl ' q s PARENT MATERTALM/DEPTH: p SERIESt IJIChIAJ S) I T1 JI ASS IfFAUg" MIORIZON DEPTH MATRIX COLORS MOTTLES TEXTURE STRUCTURE CONSISTENCE CLAYSKINS/ PORES ROOTS PIP .00DARY REMARKS in G St, UP- COATINGS >30~1 uG 1 -L^ o- vL o-tR. Zt Z - s i I ) 'Fs A>t mf g w 2„ 1Z. 34 ~o`yR- 3 /6 - s 1 ~ 2,N►Sdk 1~'1'FM g S 3 39-5" ~,SyR y/b S) 1`~Sbk YM1 U~'h ~S I _J. so~u6 z o-lZ l~`fR 2.lZ - si l 1`Fsblz w1'F~ gw Z 1Z- Y8 IOYR 3/6 - s~ Zmsblz vn'F►- es 3 q .s $ y/6 - s I 1~C s bk'Fr cs L4 s&--is m)'IR8/Z - ~ g \b 1z v`Fio, ~3o x>G 3 Z 13-%41 1o`1R .4A - si ZMn36w- 1► fi- IdS 3 y)-Sy 1~`-~R 5/8 - 1s 1~slahz 1+~v`~>^ cS Sy-~~ I~~tR 6l6 ~R rus y o-)o ~oyti 7- Z_ - 5 i 1 ) s b►z M-6, Z 10-3Z lo`ZTz 3I6 S)) Z Th 3 b12 ~')`Fh Cw 3 3Z- y S `I R y!L - s 1 1'~ SIX m f~ _ ~ s to °lo ~rzw~ U 44-71 to~tR s/ e - 1 s 1~ s bk \j ~01~1 ~ S AWY '?-I z - s i 1 ~ 1,k . m `fh w. 3 Zy-y0 1o~/R -3/6 - S 1'~Sbk ~'1'f1^ aS 14 yd,.t- 1uwrci s/6 ~s )'Fsbk inv . OTHER SITE FEATURES/NOTES: L%~~ ~ 11-~ y- 9 0 000 57~ ~n~~? of Z LIMITING FACTORS/DEPTH: Signature Date CST N