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HomeMy WebLinkAbout040-1143-50-000 ~ I o (S o° a ~ ~ I M o h N O d 1 j C I d I I W I zo ti c 0 i = 3 ~ 1 E Q ~ c I C c E Of I Z ° I ao > 0 0 •-FN- 0 am o O Z v m Z :t ° Z U) P c E '2 Cl) N cm C as a) CL Of N y • N I' d ~ L ~ O ca 0 z m Z N z 1 N ~ E d m CL a c 1 a a IL -0 (D h w Z co w v) N E C m 00 o z •O I~CL IL IL N IL c m o CD Q U) J U v rn rn z ti =urn ~M° 3 0 0 :3 E :3 N m c d p Z U) co C CD N ~ N j W N C O W N E d N co TO FF V to O N C M A N N O O O O N C fD 4m > 9: N H T O N U N of "0 7n cn o v c a) • ~ V N 2 N u O N O c'Li O O O Z c Z (Q I m r`Iv E V 'c c r A 0 'o U) 0 I Form - S T C - 104 AS BUTiA' SANITARY SYSTEM REPORT OWNER 1/16/e t D s f TOWNSHIP 7r6 v SEC. Ted N-R 20 W OF ADDRESS ST. CROIX COUNTY, WISCONSIN dud rot Gll L _ SUBDIVISION Vo ) 3/G 9~..... LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of ILIM 83 SHOW EVERYTHING WITHIN 100 FEET Or jl 46 gMiaaao' ~buS C INDICATE NORTH ARROW BENCHMM: Describe the ver. t lc: al reference pc lnt used T D oT stk- 40M IF SAR Elevation of vertical referencw point: ~Q(} , Proposed slope at site: SEPTIC TANK: Manufacturer: __Weeks Liquid Capacity: /Z 06 i Number of rings used: C ~Z._ Tank manhu;_e corer elevation: Tank Inlet Elevation: '131;2, Tank Outlet Elevation: Number of feet from nearest Road: Frou ,0 Side 0 Rear, O feet From nearest-pr,•~prA.-L line Front, 0Side, 0Rear, 0 feet Number of feet from: well / ~ , building: _ yb'~ PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pum phon Manufacturer: Pump Size Elevation of in 4et: Bottom of tank elevation: Pump off switch : Ga llons per cycle: . Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear, © Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: A, Trench: Width: Length: (o J Number of Lines:_,_ Area Built: 740 Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, O Rear,O Pt. Number of feet from well: Zoe) Number of feet from building: 7,4- (Include distances on plot plan). fl-,mAi t0ev Q~ 5~ ~~~31 SEEPAGE PIT s efr Size: N be f pits: Diameter: , Liquid depth: ottom of seepage pit elevation: Area Built: Has either a drop b x O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings V Elevation of bottom of tank: Elevation of inlNumber of feet ferty line: Front, O Side, O Rear, OFt. from well: of feet from building: Number Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: Plumber on job: 2jilb-a License Number : 6 3/84:mj DEPARTMENT 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 7c.I,T28-R20 State Plan I.D. Number: X CONVENTIONAL ❑ ALTERATIVE (If assigned) Town of Troy Lot Riverview Dr. Holding Tank ❑ In-Ground Pressure ❑ Mound AL? NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTIO DATE: Violet Ostb 299 River View Dr. Hudson WI 51-opIF-90 10.,06 PIP1 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELE.. Name of MP6780o Cost a Sanitary Permit Nu~mbec cx - SEPTIC TANK/H6k6M A 56) -6,4 '-'C S.T Xdle , u;.) 1 1 MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: ET ARNING LABEL LOCKING COVER nz a ~p/0 0 ~C y / / PROVIDED: PROVIDED: = 9 S~' jot ~ `J,.. ES ❑ NO ❑ YES NO BEDDING: V&"!DIA.: UE-W ATL.: HIGH WATER UMBER OF ROAD: PROPERTY WEL BUILDING: VENTT ESH ALARM: [FIEET FROt_10-1 r LINE: I T AIR INL T: ❑ YES V'f NO :`)6 ❑ YES NO EAREST (s.. 5 A DOS" Pm m a am Emil: MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO GALLONS PER CYCLE: UMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF P F-1 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. J CONVENTIONAL SYSTEM )_r WIDTH: LE NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID BED/TRENCH ry f TRENrES: I MATERIAL: PIT DEPTH: DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: N STR. NUMBER OF PROPERTY WEL BUILDING: VENT TO FRESH BELOW PIPES/ ABO E C,QVER: ELEV. INLET; ELEV. END: f PIPES: FEET FROM LINE: , ,y I AIR INLETS 1 - NEAREST ti g a w P. I MOUND SYSTEM: q' 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 OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑ YES ❑ NO ❑ YES ❑ 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: ELEVATION AND ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.: DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑ YES ❑ NO COVER ❑ YES ❑ NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: E:1 YES E] NO E] YES ❑ NO NEAREST ~l► i Tin- a r t r r C A ll " p 1° {r' ~c~t,. J~'aCL✓ i1 °t tF t f ..l ~ Z (o le / I 12~~,f 10 4/ Sketch System on R i~ in county file for au It. f G~ i Reverse Side. SIGNAT E: TITLE: SBD-6710 (R. 06/88) DILHR SANITARY PERMIT APPLICATION couNTY In accord with ILHR 83.05, Wis. Adm. Code STATE SANITARY PERMIT -Attach complete plans (to the county copy only) for the system, on paper not less than J ~~J'^~ 834 x 11 inches in size. ❑ Chick 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. PROPERTY OWNER PROPERTY LOCATION Vi ol et 0-st-by NE % NE %,S 1 T28 , N, R 20 Mr) W PROPERTY OWNER' MAILING ADDRESS LOT # BLOCK # 299 River View Dr, 1 - CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER Hudson WI 154016 715 386-3320 Vol. 316 Pa e 298 NEAREST ROAD II. TYPE OF BUILDING: (Check one) ❑ State Owned tAee Riverview Dr. ❑ Public ®1 or 2 Fam. Dwelling-# of bedrooms 3 PARCEL AX NUMBER(5) 1-28-20-573E Q (40 ^ IN 3 `'(J- (90 III. 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 80 Mobile Home Park 12 ❑ Service station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ❑ New 2. X❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.0 Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit # - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 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) c~ELEVATION C~ 7 .58 1 3 Feet /G,'y3 Feet V1111. TANK CAPACITY Site in allons Total of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name oncret Con- Steel glass Plastic App Tanks Tanks structed Septic Tanko; WeWna Tank- /660 GY~o UJeC h's VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plum ' nature: N Stomps) MP/MPR6W No.: Business Phone Number: Paul Steiner C' 6780 715 425-5544 Plumber's Address (Street, City, State, Zip Code . t 5 65 E. Woodridge Dr. River Falls, WI 54022 IX. CO TY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued issuing A ent Signature (NO Sta Approved ❑ Owner Given Initial Surcharge Fee) [ Adverse D ermin tion 1:5-//7 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. 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. Checkexperimental 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'/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawl to scale or with complete dimensions, 'ocation of holding tank(s), septic tank(s) or other treatment tanks; building sewers; sells; 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; (Jose 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. numbr:r of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring grOUndwater, ground- water contarnination investigations and establishment of standards. SBD-6398 (R.11/88) . APPLICATION FOR SANITARY PERMIT 8TC-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 Lot resale by owner/conttactot,(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. of property V /6lef Cis t bV Location of property IVI-114 fif .1/4, Section T- -R.,?y V Township )rf~ Nailing address c:,?- 99 Ri Baer ieu) Dr - N U C/ S Qn Address of site tS am,,. - Subdivision name Lot number Previous owner of property Total also of parcel / C rl-s Data pateel was created At* all corners and lot lines identifiable? x_Yes ____No is this property being developed lot resale (spec house)? as 0 Vol"" 316 and Page Number 2 c l? as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which Includes a DOCUMENT NUMBER, VOLUME AND PAGE NUNSYR, and REGISTER OF DEEDS. In addition a certified survey, if the REAL OF THE available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. p sh PROPERTY OWNER CERTIFICATION i(Ye) certify that all statements on this form are true to the best of my (out) knowledge; that I (we) am (are) the owner(s) of the property described in this Information form, by virtue of a warranty dead ecorded in the office of the County Register of Deeds as Document No. Ao~pzk • ; and that I (We) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the same has been u~y recorded in the Office of the County Register of Deeds, as Document No. .3d 1. r Signature of Co-Owner (If Applicable) ;9~nzs-tute of Own it Dot of Ignatuce Date of Signature e, 298 Par Foiat 339-WARRANTY DERD--TO JOINT TUNANTS. (Section 230.4$ Wisconsin Statutes.) s a cr'm[c---~-= I NUMBER This Indenture, Made this 1.7.t11.............................. dayOL..................... Ja?Au~krY................................... .A.D.,IS...:_ j between...... J. •,Kenne11!,-0§tby_and-- V1o1et.-TL..__. stbyl.-_hiswife__..__-__... j 242308 ✓ -------------------------------part..ieSof the first part, and .....O1s7reI1..i 1?sr.... t._SandherL~-._his-_vri £e as joint tenants, parties of the second part. WITNESSETH, That the said part_i.e.6 of the first part, for and In consideration of the sum of..,:..QDa...dollax..a.1751..IlA.l~Q9..._(. 1..DQ)....ald ot.1.mr....Valuable ..~.szYlsS.cl~r~ t.~ te....,_them ..........................in hand paid by the said parties of the second part, the receipt whereof is hereby confessed and acknowledged, ha Ye-...given, i granted, bargained, sold, remised, released, aliened, conveyed and conflrmed,..and by these presents do give, grant, bargain, sell, remise, release, alien, convey and confirm unto the said parties of the second part, in joint tenancy, their heirs and assigns forever, the following described real estate, situated in the County oL S ._.Craix............_.....................and State of Wisconsin, to-wit: All that part of Government Lot one (1), Section one (1), Township twenty-ci„ht (28) North, Range twenty (20) j Nest, and that part of the Northwest quarter of the Northwest quarter (Nti+ Nti34) of Section six (6), Township twenty-eight (28) North, Range nineteen (19) Viest, described as follows, to -wit: Beginning at a point on the westerly right of way line of the C. St. Y. itii. & 0. Hy. where a line drawn parallel to and two hundred thirty- sisc and five-tenths (236.5) feet east of the west line of said Northwest quarter of the Northwest quarter (15V-$ 1,10) intersects said westerly right of vray line, and ri}nning thence southwesterly by a deflection angle of 46 241 measured from said parallel line Five hundred sixty-two (562) feet, more or less to the easterly shoreline of the St. Croix River; thence northwesterly along said shoreline to a point where a line drawn parallel to an One Hundred seventy-five (175) feet northwesterly from the line just described intersects said shoreline; then ,-e northeasterly along said parallel line Five hundred. thirty-four and six-tenths (534.6) feet to a point on said railroad right of way line where said parallel line intersects said right of way line; thence southeasterly along said right of way line One hundred seventy-five and fifteen hundreths (175.15) feet to the point of beginning. Excepting therefrom the northeasterly thirty (30) feet thereof over which, however, the grantees shall have a right of way for purposes of ingress and egress. All of the sane lying and being in the County of St. Croix, State of iisconsin, and containing, 2.12 acres, more or less. Also a right of way over a thirty (30) foot road, the center line of which is described as follows, to-writ: Beginning at a point on the westerl right of way line of 4isconsin State Highway #35, said point being-. Seven hundred thirty-five (735) feet south i of the north line of said Section sir. (6), and running thence west on a line parallel to and Seven himdred thi ty five (735) feet south of said north line of said Section Six (6), twenty-three hundred eighty-one and nine- tenths (2381.9) feet. This conveyance is made on the condition that the premises be used only for residential purposes. I i TOGETHER; with all and singular the hereditaments and appurtenances thereunto belonging or in any wise appertaining; and all the estate, right, title, interest, claim or demand whatsoever, of the said part..ies....of the first part, either in law or equity, either in possession or expectancy of, in and to the above bargained premises, and their hereditaments and appurtenances. TO HAVE AND TO. HOLD the said premises as above described with the hereditaments and appurtenances, unto the said parties of the second part, in joint tenancy, and not as tenants in common, and to their respective heirs and assigns FOREVER. AND THE SAID -Yi.Ql .t... S...3-df.Q........................................................... for..._thee-lygs,_, h heirs, executors and administrators, do ..............covenant, grant, bargain and agree to and with the said parties of the second part, and their respective heirs and assigns, that at the time of the'ensealing and delivery of these presents...thS}[...are ..............well seized of the premises above described, as of a good, sure, perfect, absolute and indefeasible estate of inheritance in the law, in fee simple, and that the same are free and clear from all Incumbrances whatever I . and that the above bargained premises in the quiet and peaceable possession of the said parties of the second part, as joint tenants, and their respective heirs and assigns, against all and every person or persons lawfully claiming the whole or any part thereof............. they .................will forever WARRANT AND DEFEND. IN WITNESS WHEREOF, the said part of the first part ha.._V _...hereunto set.......... their hands...... and seaLS.... this.__.._1.7th.z.............. day of January A. D.,1n...55.... J. Kenneth Ostb~ - . . Ostby (SEAL) j Signed and Sealed in Presence of J. Kenneth - l kt...........................---...--.--........(SEAL) L. V. Hanson Violet N. Ostby Z.~...V~• J Harisori- (SEAL) Pdarilyn Heckel hgari3 He-bkel ........(SEAL) STATE OF WISCONSIN, ~I ss. •S-t- C.mix ....................county. Personally came before me, this 1.7th. ...................................................day of............................. January- ° , A. D.,1J......55., the above named.....J.....Kennetli Ostby.e i to me known to be the person..S_.who executed the foregoing instrument and acknowledged the same. Received for Record this 2 th...4 ..............---...........day of, Januar...Y. 11.1 ....................AI...I Yoe'.~......... A.D.1911? at..........'..kl....o'clock..A -.M. A. F. Yoerg Davaal Hope (SEAL} Notary Public 51,r . gxs?.ix ............................County, Wis. H.....-•-•--.................. Register o[ Deeda. My Commission expires---•----. Feb......_II.................... A. D., 12....55.. Deputy. V) H ST C- 105 r H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z d a rn OWNER J-B~ V/©I o f D s ~~7V ROUTE/BOX NUMBER o2 99 9weeyjPw Pr Fire Number CITY/STATE 'LIP 3- 31tol PROPERTY LOCATION: Al~f 14, Section T N, R W, Town of Tro v St. Croix County, SubdivisionO.L. 1 [/o( 311,f.Z3p, Lot number ' I I Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you pit into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. H E I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x H the standards set forth, herein, as set by the Wisconsin Depart- 10 ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. ~ SIGNED DATE St. Croix County Zoning Office P.O. Box 98 Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. DEPOTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND P.O. BOX 7969 HUMAN RELATIONS PERCOLATION TESTS 115) MADISON, WI 53707 (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: TOWNSHIP OT NO.:BLK NO.: SUBDIVISION NAME: -al 6 12aga 29A NE NE 1 /T2 N/R ► - Troy- COUNTY: MAILIN A DRESS: USE DATES OBSERVATIONS MADE NO. BEQRMS.: COMMERCIAL DESCRIPTION: i7mm O ' Residence J ❑ New ~ Replace L 11 RATING: S- Site suitable for system U- Site unsuitable for system Sijvs 73 ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM: (optional) ®SOU oSEA 2SOU EISCU oSOU Z0 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: 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 It T. HE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B-1 112 96.05 none see attached sheets B-2 114 96.45' none " B- g e B- B- PERCOLATION TESTS TEST DEPTH. WATER IN HOLE TEST TIME DROP I WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 P 1 P- 7 Y r V ),-e 3 P- Z2 -717?- P- P- 79" 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 89.60' Sep plot plan - ~ r 1 ^7- i.. _ __T l _Qf_ hi' • deth ~ to su _ NOTC OT1• it _ t. rBeeause r of thel- j itable j' so~is t the _ inst4l er _tI Mein systems w}111have to have 3;'l' of irock_„ nder_.pip - -.j _ l.._.... t . 421' cover over) pi s r ini drain] eld area. _ ! _ r - I i ! 1 i I- - _ r I- I 1 1 I 1 t i j f I I I T 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: Paul C.J. Steiner 5/11/90 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): Rt 5, 65 E. Woodridge Dr. River Falls, WI 54022 3074 425-5544 CST S E: C DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHRSBO-6395 (R. 10/83) - OVER - - SOIL DESCRIPTION FORM Attach Soil Profile Location Me One Sc ersto Sheet! CLIENT: Violet Ostby LINEAR LOADING RATE: PURPOSE replacement of sewer system SLOPE: less than 2 % DESCRIPTION BY: Paul Steiner ASPECT: DATE: 5/11/90 CURRENT LAND USE: T gum COUNTY/STATE: St. Croix County-Wismnsin VEGETATIVE COVER: LOT DESCRIPTION: One acre 175 feet wide DRAINAGE CLASS: LOCATION G L 1 as in Vol 316 page 298 GALLONS PER Sp. FT. PER DAY: PARENT MATERIAL s /DEPTH: SOIL SERIES: HOR12ON DEPTH MATRIX COLORS MOTTLES TEXTURE STRUCTURE CONSISTENCE CLAYSKINS/ PORES ROOTS P in. moist Gr. Ss. Shp. COATINGS 0-11 10YR 2/1 - sil 2 f sbk mvfr 11-21- 10YR 4/2 - sil 2 f sbk mfr 21-60 lOYR 5/4 2 d sicl 1 f sbk mfi 60-112 10YR 6/4 - crs car 0 - - ml Elev. 96.05' HORIZON DEPTH MATRIX COLORS MOTTLES TEXTURE STRUCTURE CONSISTENCE CLAYSKINS/ PORES ROOTS in. moist Gr. Ss. Shp. COATINGS 0-15 10YR 2/1 - sil 2 f sbk mvfr 15-26- 10YR 4/2 - sil 2 f sbk mfr 26-69 10YR 5/4 f2d sicl 1 f sbk mfi 69-114 10YR6/3 - crs r 0 - - ml Elev. 96.45' 3 HORIZON DEPTH MATRIX COLORS MOTTLES TEXTURE STRUCTURE CONSISTENCE CLAYSKINS/ PORES ROOTS in. moist Gr. Sz. Sh . COATINGS .0-14 lOYR 2/1 - 14-28 lOYR 4/2 2 f sbk mfr 28-70 -10YR 5/4 f 2 d sici 1 f sbk mfi 70- 116 10YR 6/3 - crs r 0 - - mi Elev. 96.85' (t. • A's 41) VOL. '.fl(otti 298 PLO-7- P L-A lJ S~JSiSM S4aLE : Y 4 = 30 BM, = -fop OF' STONE STEPS loo' 3.1 ' Roc. k.. BEt•ow p~,~ES IN DP.P,N~/oGO pa lv& ,wc~✓IG~ BZ FIELp 12/n bs. l 82 / ~ ~~a ~kiVt 83 PLO D,eyNC~a. 1 Ncw looo4rAL. 41A0-%C SE PT/cam OLIO ~tPTicr Taurc ~ ~$M q w~. ~ House i sb > r O 7 m F- i ~ O -Z"~ m ~ O z M a rj p LA v m n LA n tG z M O N F- O a G] m vt ~ C CD H •P I \ O') O I I I r~ r L~ ° ~ N N 61 N .P L~~ N O O O \ LTJ ° m O Ul O "d H r ~;s ~4 ~-3 O O O O O S Cl) m C~ cn ~-C ~C ~C • ~C ~ H y ~J ti td ;d ;d 0 O U1 C Z H y 61 Ul N O m x ~ \ \ \ r\- r H P A N J O CrJ R ~ ~ z Ln C ~n y rn ti ~C I rfi I I 'b a I' I I LQ N 1 N I I I O O r+ of n cn m cn N n r. Fl. H. C) H N F- LQ CA O N N M O fp I rh rh rh (n 0 Cl) Nn N N Cf O m N LA H N. A 11 I t5 t5 t5 ? ° O r m a m -V m ,mot r I 7r rY rY m N 7,t > ~ m 7 E5 r 3 z LA T M w m o n pm I- F It r -l G O f1m < C O m N 0 ~ N. rh r C ~1 m A 4 y j z N r^ n momomom m , 0-01 v z H I rn I I d a (T. L • As 41) VOL. ~Jlot~ 298 PL.A ~ 5 ~5 i E M Fc,EV- 8q. 6D ~ YY SGl1L6 S ,70 am. = 70p or STONe 5T6P5 .roo ►Vo-T6 = 3.1 Rock aaLw FIFES W Dea~uF/~l-D p2,v `rcvled s2 Y,6 R Di2auJ ~ ~ s 12'x bs. / I I a DRivc Wool a 8y 63 PLO s M ~ loco 4-AL. SEPTtc. TAL)W- J f K,4Lo Houser K s J zo °Io Sc.o PIS