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HomeMy WebLinkAbout191-1020-40-000 a o O ~j h w ~ I cz o i N q O i ~ I ~ I I I i I y I T a`~i I 'a z° I c LL ~ I 0 3 E ¢ I M CIL 0' y fn = O z ~ II C%j a co I- Cn M o I o z a N O 1 fn H r ! N Z m M c L O 0 Z Z O o N z 1 ~ c I N AQ cc E d H w ` C O m L N 0 G d D N U) U) E z ^ = aci w o d o o z IL t~l n o vii o 0 'i D fA J U c 0) 0) Y ,rte ml ~ a I N O z ca 12 ~ ~ Q Z U) O I R I O O r ~ O C N C O M O m N L) C N V D O I ~O E EY c -o~ v N O C `y C N pp MN O' N N a) C> ((p M .4+ 4) 'o Z' E- N co U) M> O z z U V ~ d m a EL ` a 4 • a d d c ~ t A c°~a~ !ov~L=) Parcel 191-1020-40-000 02/09i2006 03:14 PM PAGE 1 OF 1 Alt. Parcel 35.29.15.122B 191 - VILLAGE OF WILSON Current X1! 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 - MOSER, JAMES A JAMES A MOSER 1140HWY12W KNAPP WI 54749 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * WILSON ST SC 5586 SPRING VALLEY SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 35.000 Plat: N/A-NOT AVAILABLE SEC 35 T29N R1 5W SW SE EXC CSM 12/3500 Block/Condo Bldg: ALSO ALL THAT PT OF THE NW SE LYING S OF THE SLY ROW HWY 12 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 35-29N-15W Notes: Parcel History: Date Doc # Vol/Page Type 08/11/1998 584835 1347/495 QC 07/23/1997 873/263 07/23/1997 823/386 07/23/1997 817/622 2005 SUMMARY Bill Fair Market Value: Assessed with: 89934 Use Value Assessment Valuations: Last Changed: 08/04/2005 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 25.000 2,900 0 2,900 NO AGRICULTURAL FOREST G5M 10.000 20,000 0 20,000 NO Totals for 2005: General Property 35.000 22,900 0 22,900 Woodland 0.000 0 0 Totals for 2004: General Property 35.000 22,900 0 22,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWIJER - ~:-.J lU\, Mp Se f- TOWNSHIP .I~/'/rte ,~e , by1- ld SECTION_j4a_T.S;Z N-R 16W ADDRESS Wi' /So A) RT * I ST. CROIX COUNTY, WISCONSIN w o SUBDIVISION LOT LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM MOOOJ, 5Y-57eM w ~y Zo` 120' /0C70 ! v Aq )P ~v 5 p "T 0411L c3's - I We II N 1 INDICATE NORTH ARROW BENCID4ARK: Elevation and description: gTe-e L Alternate benchmark SEPTIC TANK:I•tanufacturer: tire- e*9 iquid cap. /ao 0 Rings used:-LManhole cover elev: /d~<jf 'Final grade elev: /©2, Tank inlet elev.: /0Q, 3 Tank outlet elev.: /0 25 No. of feet from nearest road:Front,3C), Side/Do; Rear`"- Ft. From nearest prop. line:Front~/Ooo Side /00, Rear Ft. IIo. of feet from: Well Building: ~4~ f- cti 7- ( Include this information in the above plot plan) .(2 reference dimensions to septic tank) SEE REVERSE SIDE CC) > ~r~,~ 7 PUMP CHAMBER Manufacturer: hjN1V,0ST" ?re-C05r- Liquid capacity: 76P Pump Model:Sio Al Pump/Siphon Manufact. : /4 ue-t., Pump Size Elevation of inlet: q jT,,-,,073 Bottom of tank elevation Pump on elev.: Pump off elev.:W allons/cycle: Alarm: Man.: 91 F-Lee lro Switch Type: Mstev 0,~ Location t Distance from nearest prop. line: Frontgov, Side 2?, Rear-Ft.- Distance from: Well /7S Building 14110 SOIL ABSORPTION SYSTEM Bed: Trench: Seepage Pit: Width: s Length Number of Lines: Area Built Exist. Grade Elev. 9_Proposed Final Grade Elev. ` 20 Fill depth to top of pipe: No. feet from nearest prop. line:Front Side , Rear Ft. No. feet from well: 10V No. feet from building HOLDING TANK Manufacturer: Capacity: No. of rings used: Elevation of bottom tank: Elevation of inlet: No. feet from nearest prop. line:Front , Side , Rear Ft. No. feet from: Well , building , nearest road Alarm Manufacturer: n INSPECTOR: DATE: PLUMBER ON JOB: LICENSE NUMBER: ~6 6/90:cj AWad 31y DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING - LABOR & HUMAN RELATIONS DIVISION . P.O. BOAC 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION W 0§6."9eC.35 T29 -R State Plan I.D. Number: + ❑ CONVENTIONAL ❑ ALTERATIVE (If assigned) Village of Wilson HW . 12 ❑ Holding Tank ❑ In-Ground Pressure ❑ MoundG- .ry NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Jim Moeser RWilson WI /-16_ - BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.: @ f" q q 14 .1a 4tJ jam: t<.t iEW P Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Joe Menter 5658 St. Croix 128850 SEPTIC TANK/HOLDING TANK: jJ6 1%.4 04 MANUFACTURER: LIQUID CAPACITY: TA F V.: TAN L EV.: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: /ov0 VOW7 bJYES ❑ NO ❑ YES NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM: FEET FROM LINE: AIR I,L ❑ YES ❑NO ❑ YES NO NEAREST----10- ~a-V DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: (~~f'f ( Sr ❑ YES ❑ NO 1 c54 liJ a Sj~d rtt• DYES ❑ NO L7YES ❑ NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERAI L: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF YES ❑ NO NEAREST--* 10V ~S '/'40 1"'e" ~or SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIETER MATERIAL AND MARKING: or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN ~~_/iL f/~/'V~r- the soil is dry enough to continue.) CONVENTIONAL SYSTEM: BED/TRENCH WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER PIT INSIDE DIA.: # PITS: LI TIH: TRENCHES: MATERIAL: DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV. INLET: ELEV. END: PIPES: IFEET FROM LINE: AIR INLET: NEAREST MOUND SYSTEM: Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ®YES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ZIYES ❑ NO YES ❑ NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHE CENTER: EDGES: l~ IL~~ t ❑ YES E?tFO El"VES ❑ NO YES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: 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: FEET FROM LINE: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST- 0 Retain in county file for audit. Sketch System on Reverse Side. SIGNATUREj TIT SBD-6710 (R. 06/88) [aTOILHA SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUN STATE SANITARY PERM # -Attach complete plans (to the county copy only) for the system, on paper not less than A 8'A /z x 11 inches in size. /C2 ❑ Check if revision to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. D - PROPERTY OWNER PROPERTY LOCATION r'/` aQ-S 2 r SIA/ - '/4, S TA , N, R / E (or(;)_ P OPEBTY OWNER'S MAILING ADDRESS LOT # BLOCK # ~~FF goal - 1 l y U l~~c tom- ~ CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER r` 145YAP 7 II. TYPE OF BUILDING: (Check one) ❑ State Owned tf 0 CITY VILLAGE t NEAREST ROAD 1-71 4OWN QF: M) i oAj S1 -T~ / lG J Z ❑ Public VX1 or 2 Fam. Dwelling-#~ of bedroom PARCEL AX NUMBER(S) 111. BUILDING USE: (If building type is public, check all that apply)_ 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. ❑ New 2. Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 K 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) ELEVATION q,c 0 75 '37-5 1 4 /0/1 oZ Feet 0p;2' Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New P-xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Se tic Tank or Holdin Tank /000 / ,Wues1' (Jr`e-,C$ST Lift Pump Tank/Si hon Chamber D ttai•U+aS'T VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): P ber's Signat re: (No Stamps) PRSW No.: Business Phone Number: Plu b i' Addres (Stre City, State, Zip Co e) IX. COUNTY/DEPARTMENT USE ON ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuin Agent Signature (No Stamps) Approved ❑ Owner Given Initial Surcharge Fee) Adverse Determination v 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 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. 11. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points;u 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) APPLICATIOH FOR BAHITARY PSRHIT 9TC-100 Thls applicatlon form is to be conplatod In full and signed by the ovntr(s) of the property being developed. Any Inadoquacles aril only result In delays of the pttmlt Issuance. -Should this development be Intended tot resale by ovntc/contcactoc,(spec house), thcn a second farm should be retained and coxplatad when the property Is sold and submitted to this office with the appropclate deed recording. Own:t of property e A~ S&V Location at property 1/4 Township eJ_J, Hailing address U • Y / . Address of alto i/ / Z svbdivlalon name Lot number Previous owner of property &C~ I E ► A x Total else of parcel ✓~U ye s Dane parcel was created Are all cotnets and lot lines Identlflablet -Yes _ Wo is this property being developed for resale (spec house)T__Yes 110 Volume __and Page Number as recorded with the Aeglstec of Deeds. INCLUDB WITH THIS APPLICATION TIIE FOLLOVINCI A VAAAkXTY DYED which Includes a DOCUMENT NUMBER, VOLUME AHD PACE RVMBIR, and the BEAL Of THE MISTER OF DEEDS. In addition, a eettltled survey, it available, would be helpful so as to avoid delays of the tevlavin9 process. It the deed descrlptlon references to a Ceitlfled Survey Hap, the Certified Survey Hap shall also be tequlred. PROPERTY OWNER CERTIFICATION I(ve) e.rtlfy that all statements on this form are true to the best of my (out) knovledgtl that I two) am (ate) the owner(s) of the property descclbed In this Jnformatlon form, by virtue of a warranty deed recorded In the office of the County Regletst of Deeds as Document No. _1f2 SC, 6 . A and that t (Ve) presently own the proposed Nita for the sewage disposal systea+ (at I (we) have obtnlned an easement, to tun with the above described property, for the constructlon of said nyatem, and the same has bag" ~ i xacarded In the ottlce of the Covnty Register of Deedi, an Document No 1 2 19 J T.rr~f7 s19 ute of Owner Signature of Cc-Ovnet (II Applicable) 90 Date of signature Date of S/gnatuce I qy 't a. ,ys• ,F- a r~ x t., tea:,' ~a kC•i ~.cw. t '~~r ~~t Ii ~a k ~ Y•f i Y , ~ a .M....t r z'; • a, , • a• oll, 3 1 f w k ~5 J1~~r!1 i ~ _ w tea.. ~y„R......•w~il~i1~~ r r v 117 SEPTIC TANK MAINTENANCE AGREEIIENT St. Croix County OWNER/ BUYER u s o 0 I~ R ~ ROUTE /BOX NUMBE Fire I;umber 55/u2 M CITY/ STATE ZIP 7 ( J ~~s a .z l,tJ- ~D Sections. T N• R 5 W. PROPERTY LOCATION:* k Town of 1f r St. Croix County, JZ/ J s Subdivi s ion Lot number Improper use and maintenance of your wasteseptPronertmaintenancescon-in its premature failure to handle sists of pumping out the septic tank every three years ut sooner, if needed, by a licensed''se t'ic tank um er. What you p into the system can affect the .unct on o, t e•septic tank as a treat- ment-stage in the waste disposal system. St. Croix Count residents-may be eligible tfrecfailinggra tefor of sys, a maximum of 60% of the cost-of replacement wh c was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix County Zoning a- certification form, signed by the owner and by a mater plumber, veri- journeyman plumber, resitecWastewaterrdisposalcsystempisper in proper fying that (1) the on s if nec- essary), condition and •(2)•after inspection and pumping the septic tank isless than 130fdaysdpriordtoc~. Certification form will be sent approximately three year-expiration. y 0 I/WE, the undersigned have read the above requirements and agree 0 tem to maintain the private shewae bysthe WisconsinaDepartth ~ the standards set forth, ment of Natural Resources. Certification form must be completed •o and returned to the St. CroixdCounty Zoning Office within 30 days of the three year exp SIGNED ` DATE CIO 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, DIVISION LABOR AND PERCOLATION TESTS (115) MADISON W 7969 flUMAIV' RELATIONS 772-4704 ULHR 83.09(1) & Chapter 145) LOCATION: SECTION: TOWNSHIP/ OT NO.:BLK. NO.: SUBDIVISION NAME: SW 1/4 SW 1/4 35 /T29 N/R 15 w Springfield - - NA COUNTY: MAILING ADDRESS: St. Croix Jim Moser RR 1, Wilson, WI 54027 USE DATES OBSERVATIONS MADE A STS: NO. BEDRMS.: COMMERCIAL DES RI07T I I DESCRIPTION PROFI LE - S: QResidence 3 NA ❑New QReplace I 10/14,16/90 NA RATING: S= Site suitable for system U= Site unsuitable for system L CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: T]S TEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM:(optional) ❑S EA EJS ❑U aS aU au DI au Mound If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: 30 min/in (211/hr) Floodplain, indicate Floodplain elevation: NA Sheet 72 As sl PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. EST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 1 60 • 0 -55 0-10 10YR 3/2 sil 2 abk m-c mfr, 10-26 10YR 4/4 sil grading B- to sl 2 sbk m-c mfr, 26-33 10YR 4/4 sl 2 sbk m mf (note occasional gr 10-33), 33-43 10YR 6/4 mfs w/ f2f Gy mots w ve y n- mots, 43- 6 s irreg ar an 1/2-211 thickness), 44-48 10YR 7/3 m s degraded SS w B- occasio al inclusions dk Bn sl, 4E-60 wk cemt SS R 2 45 99.8 45 26 0-8 dk Bn sil, 8-24 Bn sil grading to sl (irregular from one B- side of pit to other: to 27" nort side &_2411 south side), 24-45 It Bn mfs (degraded SS) w/ f3d R mots below 26 3 40 98.8 No 31 0-7 dk Bn sil, 7-20 Bn sil (gritty w/ s) grading to sl w/ B- occasional gr, 20-31 Bn s, 31-40 s w/ f1f R mots 4 37 99.7 No 29 0-10 dk Bn sl, 10-22 Bn sil (gritty w/ s) grading to sl, 22-29 B- Bn s w/ occasional gr, 29-37 Bn s w/ f2d R-Gy mots becoming c2d R-G mots 32-37 113- PERCOLATION TESTS TEST- DEPTH , WATER IN HOLE TEST TIME -DROP I WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH P- P- P- P P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION 100.7 0' sand fill on 99.7 contour as upslope edge of rock bed) site is mostly sod field w/ some old garden patches and has Ur.d orm;.topagraphy daw> slope w/ variable complex topography upplope & . ` contsupport ~a-mOund-8~ srt ail -aceomodate a long & - well narrow strructuctgnuredr s~.l install s1 a,51 above e: 75alegrrged. SSbed . won readily our, site.limit4ng factor i s__wk cemtedl SSER__below medium fine:-sand- BR-and -sand 4re typically 10YR 713 w/ sflme ? higher`chrgma yellow browns possibly frorq residual SS colors but possibly mottling from perching above the e n dopth>~Note . preSimnary pits to east of house site al~out200' show mottling in sl WJabo.~e s~al7.iawaB~t__i _ TN w/ seasonal saturation e~stimated,-at _12-2411). I n Ti~~ to °install er p -8 e emp6r ry trailer ' s- sidence while hose is construct d l ter; rio e new service but of House t be dee under` are e so install, septic tank deeper than required try.sefviG~.tr it .t receive effluent from deeps service later [ i e I t see attached pege 2 for plot plan E : I 3 R i 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: Henry F. Grote 10116190 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): PO Box 141, Menomonie, WI 54751 3065 879-5367 CST SIG A URE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. page 1 of 2 DILHR-SBD-6395 (R. 10/83) - OVER - INSTRUCTIONS FOR COMPLETING FORM 115 - SOD - 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 '1 - 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 verificatio it test in the field prior to permit issuance. A complete set of plans for the private sewage system ubmitted to the appropriate local authority in order to obtain a permit. The sanitary and EM_ t app)e_,'1' p ?t t-be ed prior to the start of any construction. i Jim Moser - Mound Location: SW 1/4, SE 1/4, Sec. 35, T 29 N, R 15 W Town: Springfield County: St. Croix Date: October 18, 1990 Owner: Jim Moser Address: RR 1 Wilson, WI 54027 Plumber: a Menter Signature: License # 5658 Attachments: 6748-Plan Approval Application County on-site 115 page 1: cover 2: calculations 3: plot plan 4: system cross section S 9 p 5: plan view, lateral detail 6: pump tank exit detail 7: pump curve page 1 of 7 SYSTEM CALCULATIONS One family residence 3 bedrooms Percolation rate min./in. ~S,5 Depth to groundwater 7-(- in. Depth to bedrock in. ` Up-slope Mme. N • w; Bed-site slope %G ~•s Doan-slope % Z 0 ft. of in. diameter Force main length Force main drainback gal. Elevation difference ft. between pump/si*on and distribution system Force main friction loss 4r- ft. @ gal./min. Total d3mamic head ft. Punp/siiV[on ZS G.P.M. @ ft. of head Manufacturer Model # S- Dose volume 1\ 6 gal./ Measurement pump on g off ~'O4 in. Lift/si)hon tank gal. Septic tank gal. Height alarm above tank bottom O4,• Lateral length Z @ 35~1(e ft. Of 1~/¢ in. diameter Lateral elevation ft. bottom of.pipe (°91 J Lateral hole size in. @ in. spacing (4, $ holes per lateral, holes total Lateral volume gal. Total lateral discharge rate 1 g•~ Z G.P.M. @ 2•S ft. head page Z- of o f LA, -77 L,A ~ • ~ 3 ail ~ oS c PP ~ ' ^1Q/J M 1 3 7' JA p ~ c 2 ~ rH too ` N Q ! LOW- X ~w -',~y'~ r. ~t ZJ L%%Mf ♦kt W. ,pi`Ow, Y e~~ 1 ~ ~•a t Qsv. tuo.~ t 16, ~opa~~1 w,..~ ~ b s..~t e :1 1 ' 2.1. n \ K- 4 A! ak 23.0 f qt~ ,,2, IL Al ~X, CA 1 , MINI IUN~ aJa k $ ~L. 1o.b' L- s~ Ir 1 x'11.' k ~ L , ~ T Q.b ,w \ ~ ab ~ Q.r.~ w.. s•b K ate, s ~ :v ~.i. 'TV r T O. 4+ P~C C ' 1. O~ \ 0.~ Lh ~ ~ fl.Jlr M►~• v~ ~ C ~ ~ 11 g T~~ ~ Q•N~ 0 ~ ~I ~ G {t ~ Put "J., S t I s' I:t'I~ s~`li I S b `~4 I S 4'/4 • ~~4•. 01.1 s 1 .~t ~ ~ ca...+ o,, b o~ o 1:.,..y ~ S le'/4 ~ o.x s..T 4 .b91~ V L, JL\ V'vr ii F S90-40664 . If IVI_-t t { , QCs. ..i: S o ..y ' 1J ZN ( VEAJT CAP `%.Z. VENT PIPE ' WEATHER PROOF APPROVED LOCKING JUAICTIOAI BOX MANHOLE COVER 25' FROM DOOR. N wARN~N WINDOW OR FRESH `Z t LAQrssL- AIR IIUTAKE t GRADE t 4„ Q.\e~. ~~so.le I COUDUIT - - 11 PROVIDE t or AIRTIGHT SEAL I III ~ S ~g t v 1l,, ` ~'A~• 0.BS~0.~LT a1- ( I~I APPROVED JOINT 1~ ~e e.^ I I (I W/C.I. PIPE t Vr I III ALARM EXTEMDIUG 3' T~ I I I ONTO SOLID SOIL I > ON Il..o4" gttz-- i I PUMP OFF B LOCK ~w ci 3 AF'PK~UEa g`F1>btN~- v+~t.p 'T'ANK "►'i~EGn~~ c , L tic.. 1 ~gQ^' .4 , 5 A /may, ti aT UNS ' 44 u a I Q , , e~+ f , a t- - r7 3 1 to ~ - - - - ~ ~ W W I I I I - - - - - w - • LLI i r-i i 00 -J 0 ~ N Q Q ~ (7 W W yi 10 j . _ ~ , Irv J iJ ' ..1• (oll-l r A i 3 s `4 ~ a'te' 41 N 2 0 Cam' N o ~ Q 3 ~O d 0 r A=P f` r r~ ~l 0 sp DARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS I NDUSTRY, c DIVISION P.O. BOX LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS 772-4704 (ILHR 83.0911) & Chapter 145) rLOCATION: ECTION: IP/ OT NO.: LK NO.: SUBDI VISION NAME: SW 35 29 N/R 15 gfield NA MAILIN ADDRESS: `I . Cro Jim Moser RR 1, Wilson, WI 54027 ~t y l1 VV~tS USE DATES OBSERVATIONS,MADE NO. BEDRMS.: COMM R IAL DES RI TION: FILE DESCRIPTIO A TS: [X]Residence 3 NA ❑New Replace P 10/14,16/90 NA 7 RATING: S- Site suit le for system U Site unsuitable for system V " ' d 17 12 V ONVENTIONAL: OUNI- IN GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK: F~IFCQMM D SYSTEM: optional) ❑S E]U EIS ❑U []S EU ❑S El U ❑S [Efl]U Mound 02v-'7 DESIGN RATE: If Percolation Tests are NOT required If any portion of the tested area is in the NA under s. ILHR 83.09(5)(b), indicate: 30 min/in (2"/hr) Floodplain, indicate Floodplain elevation: Sheet 72 As sl PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO R UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED ES . HET TO BEDROCK IF OBSERVED ISEE ABBRV. ON BACK.) 6U 8 0 55 0-10 10YR 3/2 sil 2 abk m-c mfr, 10-26 10YR 4/4 sil grading B- to sl 2 sbk m-c mfr, 26-33 10YR 4/4 sl 2 sbk m mf (note occasional gr 10-33), 33-43 10YR 6/4 mfs w/ f2f Gy mots w ve y n- mo s, - s irreg ar an 1/2-211 thickness), 44-48 10Y 7/3 m s degraded S w B. occasio al inclusions dk Bn sl, 4E-60 wk cemt SS 2 45 99.8 45 26 0-8 dk Bn sil, 8-24 Bn sil grading to sl (irregular from one B- side of pit to other: to 27" nort side & 24" sou h side), 24-45 It Bn mfs (degraded SS) w/ f3d R mots below 26 3 40 98.8 No 31 0-7 dk Bn sil, 7-20 Bn sil (gritty w/ s) grading to sl w/ B- occasio al gr, 20 1 Bn s, 31-40 s w/ flf R mo s 4 37 99.7 No 29 0-10 dk Bn sl, 10-22 Bn sil (gritty w/ s) grading to sl, 22-29 B- Bn s w/ occasional gr, 29-37 Bn s w/ f2d R-Gy mo s becoming c2d R-G mots 32-37 B- PERCOLATION TESTS DEPTH . WATER IN HOLE TEST TIME DROP 1 WATER L V L-I H S RATER INCH ES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. -PERIOD 1 P RI D P P- P- P- P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION 100.7 (1' sand fill on 99.7 contour as upslope edge of rock bed) _ site.is mostly.sod!field w/ some old garden patches and has uniform-topography dowoslope of desi.ga contour w/ variable complex topography upslope well structured sil &..sl above degraded SS will readily support a mound & site-wi-11 aecomodata a long & narrow design - install a 5' x 75' rock bed on 99.7 contour site limiting factor is wk cemted SSBR-below medium fine.sand BR and sand are-typically-10YR 7/3 w/ -some higher chroma yellow browns possibly from residual SS colors but possibly mottling from perching above the BR-`which is variable -in depth (Note: preliminary pits to east of house site about 200' show mottling in tN - sl above shallow BR w/ seasonal saturation estimated at 12-2411) plan is to *install temporary trailer as residence while house is con t~ n6 a eua service out of 1h u5e o e eep u , er garage so install septic tank deeper tha fired tq ~gT s2_.tti Teceivtw. _ effluent from deep service later Cb ti see attarhPd oaoe 2 for plot plan i r /U y a I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the proce ures 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: Henry F. Grote 10116190 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): PO Box 141, Menomonie, WI 54751 3065 879-5367 CST SIG URE: lz~ ;MZ DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. page 1 Of 2 :)ILHRSPDA395 (R_10/83) - OVER - o Ci a C ..t LAb J tA 4000 -71 0 94 i r 1+ ! N r ~ s d d go ri 4 + r' rJ 0 3 a. sp DEPARTNT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUS1if1Y, DIVISION LABbR AND Supplement to P.O. BOX 7969 HUMAN RELATIONS previous PERCOLATION TESTS 115, MADISON, WI 53707 115 (ILHR 83.0911) & Chapter 145) 772-4704 LOCATION: SECTION: TOWNSHIP/fattffdl-tPfltF~1': OT NO.: BLK- NO.: SUBDIVISION NAME: SW ~ 4 SW V4 35 /T29 N/R 15 IN Springfield - - NA COUNTY: MAILING ADDRESS: St. Croix Jim Moser RR 1, WIlson, WI 54027 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: 1PERCOLATION STS: Residence 3 NA ❑New Replace I NA 11/3/90 RATING: S= Site suitable for system U= Site unsuitable for system ` ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM: (optional) ❑S EM OS ❑U ❑S ❑A ❑S ❑X U ❑S ❑U Mound 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: NA Floodplain, indicate Floodplain elevation: NA PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO ROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HHIGR_EST_ TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- See p evious 115 for oil profiles B- B- B- B- B- PERCOLATION TESTS TEST . DEPTH . WATER IN HOLE TEST TIME DR 1 WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES' AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD PERIOD PER INCH P_ 1 24 No 15 1 3116 1 15/16 16 P No 5 1 6/16 1 2116 1 2/16 4.4 P 0 1 -1) 12/16 1-5/16 1 , P- P-P-1 - P-21 - P-3 nntn~- 99.7 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 100.7 ~ 1 I See previous 115 fo' di cussior - - i ( t f See attached page 2'for revised plat plan . , ~ I . 3 E t ~ i I d a a a , ; i { i F i I— r 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 dministrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. AME (print) 7 TESTS WERE COMPLETED ON: Henry F. Grote 1113190 DDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): PO Box 141, Menomonie, WI 54751 3065 879-5367 CST SIG A URE: ISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. page 1 of 2 ILHR•SBD-6395 (R. 10/83) - OVER - ~ J of to 3 s t pi , s^ J d ro r j r Q;~Na}15 N Jll~iQ ~ (e ~o Y 3 tj o. C d C o j Q a% 77- x fo% • t rrl 9<2 i~ d y DEPA"TMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDU~fRY, DIVISION LABOR AND Supplement to P.O. BOX 7969 HUMAN RELATIONS previous PERCOLATION TESTS (115) MADISON, WI 53707 115 (ILHR 83.09(1) & Chapter 145) 772-4704 LOCATION: SECTION: TOWNS HIP/Po4HtdW~' : LOT NO.:BLK. NO.: SUBDIVISION NAME: SW V 4 SW V4 35 /T29 N/R 15 : w Springfield - - NA COUNTY: MAILING ADDRESS: St. Croix Jim Moser RR 1, WIlson, WI 54027 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: A ESTS: Residence 3 NA ❑New Replace I NA 7 1113190 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 EU ❑S ❑U ❑S ❑U _]S ❑U ❑S DU Mound 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: NA Floodplain, indicate Floodplain elevation: NA PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGH TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- See p evious 115 for oil profiles B- B- B- B- B- PERCOLATION TESTS TEST, DEPTH , WATER IN HOLE TEST TIME DROP 1 WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PER 0 Dt PERIOD 2 PERIOD PER INCH P 1 24 No 15 1 3/16 1 15/16 16 P_ 0 P_ 5 --22r- NO 1 121 16 15/16 1 b ..5 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 100.7 See previous, 115 for discussion See attached page 2'for revised plot pan 0 I ' i- I 41 _4 , E 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 dministrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. AME print : TESTS WERE COMPLETED ON: Henry F. Grote 1113190 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): PO Box 141, Menomonie, WI 54751 3065 879-5367 CST SIG A URE: ISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester, page 1 of 2 HR-SBD-6395 (R. 10/83) - OVER - i A o f t tir f r ~ J ~S J ~ 9 r .f r r0 0 r Ct, Do 3 dos o-. o n t z 154 i d r1 a d ST. CROIX COUNTY Yk, WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 Oct. 30, 1990 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 i Dear Sir: i An on site investigation for the Jim Moser property located at the SW 1/4 of the SW 1/4 of Section 35, T29N-R15W, Town of Springfield, St. Croix County revealed suitable soils at a depth of 26" below which seasonable high ground water was noted. This site should be suitable for a mound. Should you have any questions, please feel free to contact this office. Sincerely, O" ames K. Thompson Assistant Zoning Administrator cj