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HomeMy WebLinkAbout040-1179-50-000 ry c °-0' ° v p 6 o c I N 0. 0 V w rn ti U) n O u7 LO ti LO O O N ti 0 0 fy ~ I Ce) T co y c c o 0 N 1 i Z °c a)0 Li C E o m 3 o o0 L) c I Cl) Z w C, E N Z = O z a m N H fn O Z C 0 d Z : C to H r c N d E N Q O N U) C c (O O O O N ' N d U t R f6 N c 0 N 0 Z F- Z ° Z o N Z I M O M U m m _ a16i rn x a a O 10 NO O 4 N 0 o a LO -E~ U) E 333 ELP •N ~paaa a c O 7 O (a N J U rn rn Z lo a) am v ° o co O £ N N O O •p , m d M O O m O) N U a m Q U) 0 LO 0 N N U) v 0 O N C M O O ° U O O d 7 N to p N O t-. N N N V O O O U L Lo n c c Q Q C 1 N N Cl r 0 O ¢ c O O C N V W~ ~ n ayO.r N H H N n I` M O N 2 _ co O to E E s • O O N H C9 O Z N (n €a • c~ 'o d a~ d `N y E ~ c c ~ A c°~a~ ;0 vid y t_ FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER /o' TOWNSHIP SECTION_,2,1{_T 8 N-R 241 W ADDRESS 9Y 5 t'tprr <4 ST. CROIX COUNTY, WISCONSIN aS SUBDIVISION S/~1 1/0/ 7 6ea4 3-DO LOT / LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM p _ - - - ~Q rec. ra 1 x- 7 (6).c, (A)C~ INDICATE NORTH ARROW e BENCHIMARK:Elevation and description: ora7 Alternate benchmark SEPTIC TANK: Manuf acturer : 0,_c k s ~f, P Liquid Cap. oa)o ~ Rings used: D Manhole cover elev: Final grade elev: Tank inlet elev.: Tank outlet elev.: No. of feet from nearest road:Front k , Side , Rear Ft. /aa t From nearest prop. line:Front , Side X , Rear Ft. No. of feet from: Well S'r , Building: (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE t 1 PUMP CHAMBER / ~/J Manufacturer: IVly Liquid Capacity: Pump Model: Pump/Siphon Manufact.: Pump Size Elevation of inlet: Bottom of tank elevation Pump on elev.: Pump off elev.: Gallons/cycle: Alarm: Man.: Switch Type: Location Distance from nearest prop. line: Front_, Side_, Rear-Ft. Distance from: Well Building SOIL ABSORPTION SYSTEM Bed: Trench: ~ Seepage Pit: Width: Length ~ Number of Lines: Area Built•(96o Exist. Grade Elev. i?. -5v Proposed Final Grade Elev. V.'. 5© Fill depth to top of pipe: No. feet from nearest prop. line : Front , Side , Rear.Z_Ft . ,~/.3 ' No. feet from well: MO' No. feet from building J> ' HOLDING TANK Manufacturer: A~IA 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: INSPECTOR: DATE: 0 - 3) S o PLUMBER ON JOB : / LICENSE NUMBER: -?Z2-/ 6/90:cj I L 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 MADISON, WI 53707 State Plan I.D. Number: SW w , NW 4 , Sec . 24 , T28_R20 WCONVENTIONAL El ALTERATIVE (If assigned) Town of Troy Lot 1E1 HOI IngTank ❑ In-Ground Pressure ❑ Mound DA A OF MIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Tony Gruber 245 Cove Rd., Hudson, WI O BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: F. . ELE CST REF. PT. El-Y (Xt 1 0e N e ogf P umber MP/MP1SW_N4 County: St. Croix SanitarvN yt1urnber: toer Timm 22 ([~F / [F SEPTIC TANK/HOLDING TANK: a ormcm Ccvek %0'" =99./3 3rd' S" MANUFACTURER: LIQUID CAPA Y: TANK I LEV.: TANK OUTUET ELEV.: WARNING LABEL LOCKING COVE PROVIDED: PROVIDED: S ~"D f YES ❑ NO ❑ YES NO BEDDING: VE#'FDIA.: ViW MATL.: HIGH WATE MBER OF ROAD: PROPERTY WELL: BUILDING: VENT FRESH - C.0, ALARM: FEET FROM LINE: f , * AIR IN ET YES NO ❑ YES NO NEAREST OSIN HAMBER: MANUFACTURER: BEDDING: APACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVDED: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONA NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF ❑ YES ❑ NO EST -110- SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENG DIAMETER: MATERIAL AND MARKING: or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: 9s, WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID BED/TRENCH I / I TRENCHES: MATERIAL: PI DEPTH: DIMENSIONS S 6 l.0 cr /o? W GRAVEL DEPTH FDISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. I TR. NUMBER OF PROPERTY WELLO) BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER- ELEV. INLET: ELEV. END: y` a. ff, Ll Q PIPES: FEET FROM LINE: AIR INLET: ~ G NEAREST CfD 30 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; ❑ YES ❑ NO ❑ YES ❑ NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED THS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES E] NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH: NO. OF LATERAL SPA GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MAT NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEVATION AND ELEV.: ELEV.: DIA.: ELEV.: S DIA.: DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION ED PLANS ❑ YES ❑ NO O PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST, I'd .tires X-~ r d S' ~n Cl n li(r_~, 3 n d rtt^ Cam] j CD, cJ cv ~d' O? cam?' 'Fo._c c. a . Sketch System on in in county file for audit. Reverse Side. SIGNAT E: TITLE: SBD-6710 (R. 06/88) SANITARY PERMIT APPLICATION 01L HR COUNTY Wis. Adm Code In accord with ILHR 83 05 STATE SANITARY PERMIT -Attach complete plans (to the county copy only) for the system, on paper not less than 1:1 la? 4100 Z',ious 8% x 11 inches in size. 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 a ...v r G A`1/4 $(V ,f/4, S 'Z T ZY, N, R 2C) (or W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # o7y v2 rfJv/ CITY, TATE, ZIP CODE PHONE NUMB SUBDIVISION NAME OR CSM NUMBER u S/U l 1 oi- 7- ` CITY N AREST ROAD II. TYPE OF BUILDING: (Check one) ❑ State Owned VILLAGE : c/ e 7 OF: L/ ❑ Public ®1 or 2 Fam. Dwelling-#~ of bedrooms - PARCEL Ax NUMBER(S) k1L -Oc QqO- 117'f- 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/Facto 13 ❑ Other: Specify ice/Factory IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. New 2. ❑ Replacement 3. ❑ Replacement of 4.0 Reconnection of 5.0 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 1-1 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 6(.)b (o W (D t. cs r 3 '5. 5O Feet 5,7S, 54 Feet VII. TANK CAPACITY Site in allons Total of Prefab. Fiber- Exper. INFORMATION New )Existing' Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank / Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plu is Name (Print): Plumber's Signature: (No Stam s) ~NPlN~pBS10l~l0.: Business Phone Number: Plumbe s Ac)Ftr (Street, City, State, Zip Code): 11 / r- Z IX. COUNTY/DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuin Agent Signature (No Si mps Approved I ❑ Owner Given Initial / Surcharge Fee) Adverse Determination 119109 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. 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; 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) r _ ,.:M.~,~w.:~... , ..yaw.......~.....:.~W.,..~.,...~.~..~:~..,,... _ _ _ APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the .property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractq:r,("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property Location of Property Section , T 2 N - R 1,2 W Township Mailing Address Subdivision Name C;~7 ~di kl~C Lot Number Previous Owner of Property K/•~~/a~''( ///y/~"~ Total Size of Parcel 90 .Te4ed Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes X No C.SVolume je, and Page Number 33.0 as.recorded with the Register of Deeds yDxca j1c& s??7, /ad. A& &._2 / INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed Contract 2 Land 3. Other recordings filed with the Register of Deeds Office In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (We) eti6y that aU etatementb on thda 6oAm are t u.e to the but o6 my (our) Iinowtedge; en that 1 (we) am (ane) the owner(o) b6 the pnopeAty de6cAi.bed in .thi.a in6onmati,on 6o4m, by vihtue o6 a wah arty deed Teconded in the Oj6.iee o6 the County Regitlten o j Deeds as Document No. / / ; and that I (we) pn ea en tt y own .the pnopai e.d s.ite bon. the & ewage poiaX..a ys tp n (on I Iwe) have obtained an ea6emen:t, to nun with the above deaendbed pnopeAty, bon .the conetnuction.o6 ea.id eyatem, and the same hab been duty neeonded in the 066ice o6 the County Reg-i6t.en. o6 Deeds, as Document No. IGNATU F WNE SIGNATURE OF CO-OWNER (IF APPLICABLE) i DATE SIGNED DATE SIGNED DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1- 1,9112 THIS SPACE RESERVED FOR RECORDING DATA I' WARRANTY DEED ~jr~r~ 1 I, 461146 'JCL 8/ (PAGE621 _ C i' This Deed, made between --Willlaln._F_.__ ur__and__________________ REGISTERS oI-1 (CE IIe]~ga1~e..D. Mr ST. CROIX CO., WI Recd for Record Grantor, AUG 0 61990 and. Anthony- -P.__G.ruher_-and .-Lynn ._Marie__Gruher,__hushand-__.__ Ot 11:05 AM and__wif e _ _as_-survivorship_ -marital--proper.ty--------------"-----"--------- Grantee, .9ister of Deeds Witnesseth, That the said Grantor, for a valuable considera n L I RETURN TO St . CrO1X ~f conveys to Grantee the following described- real estate in RE f CC County, State of Wisconsin: I ,tao SG G,ie d'sa~ , J ~a LOne (1) of Certified Survey Map in Volume 2 of I Certified Survey Maps, page 330, as document number Tax Parcel No- 336888, filed in St. Croix County Register of Deeds office on November 30, 1976, being a part of Lots Fifty-five (55) ! and Fifty-six (56), St. Croix Cove Subdividision No. 3 in the Town of Troy. it Together with a nonexclusive road easement for ingress and egress lying on that portion of the Westerly 66 feet of Lot 56 St. Croix Cove Subdivision No. 3 lying adjacent to the westerly boundary of the property conveyed. i IRAN 5~ $ 4S• v II ~I II ! is not ` This homestead property. ) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And------ zantors..William--F-•--Murr..and_.Max•gare-t--D_--Mu-rr------------------------------------------•-------•------• warrants that Me title is good, indefeasible in fee simple and free and clear of encumbrances except I easements, covenants and restrictions of record, if any,c,3nd mineral rights and will warrant and defend the same. ! " 4- Dated this day of --------August-----------------------------------------•-•- 19..910... -----------------------------(SEAL) ---------(SEAL) I William F. Murr i i, (SEAL) - r a et D. 1~Iurr (SEAL) II g ! AUTHENTICATION ACKNOWLEDGMENT Si ature s Uie'Q, STATE OF WISCONSIN 7 cac~t /7v~¢yt St. Croix F County. authenticated this Lday of . _V --19fO Personally came before me this day of August 19__9.4__ the above named - - William- F•.__Muxx__an.d-_Maxgare.t_.D..__Murr--- - TITLE: MEM R STAT BAR OF WISCONSIN ! (If t, author- 706.06, Wis. Stats.) to me known to be the person s. who executed the ! foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY HEYWOOD and CARI by Samuel R. Cari P:~: $ox 2z~9~ Hudson; Wi------54016--------------- Notary Public St.--.Gro-ix--------- County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) date- 19--------•) 'Names of persons signing in any capacity should be typed or printed below their signatures. WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Co. Inc. FORM No. 1 - 1982 Milwaukee. Wis. S T C 105 • r y H H SEPTIC TANK MAINTENANCE ACREEMEN'l' St. Croix County v 9 ~~w--- H err /yI. ~ e . . OWNER/BUYER ROU''E/IiUX NUMiiEI( Fire Number cvrY/STA'cE~l~lGl~sv' _...__...___._.l1Pr 7z!~ I'I(OPlill`I'Y LUCA S lit/ 1 A ^l , , s is c t. i 0 n. T _ , ''IUN: w. 'r own of St. Croix Cuun'ty, Subdivisiu11 Lot n-umbe-r • I Improper use and maincenance 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 sceptic tank Lu! r, What you ptit into the System can affect the function of Ilse septic Lank 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 ln.operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requlrell) ent.thac 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•wustewater disposal system is in proper operating condition and (2) after inspection and pumping (it 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 0 three year expiration. 0 I/WE, the undersigned,-have read the above requirements and agree CA to maintain the private sewage disposal system in accordance with, H the standards set forth, he'rei.n, as set by cite Wisconsin Depart- meat' of Natural Resources. Certification form must be completed and returned to the St. Croix County 4Zn6,COJfLfk_e within 30 .days of the three year expiration date. SIGNDALE St. Croix County Zoning'Office P.O. 11OX 96. Hammolpd; WI 54015 715-7.16-2239 or 715-425-8363 Sign, date and return to above address. DEPARTMENT OF REPOT ON SOIL BORINGS D SAFETY & BUILDINGS ' INDUSTRY, DIVISION •LABOR AND PERCOLATION TESTS (11 P.O. BOX 7969 HUMAN RELATIONS T MADISON, WI 53707 (ILHR 83.0911) & Chapter 145) LOCATION: SECTION: TOWNSHIP/ OT NO.: BLK. NO.: SUBDIVISION NAMA: ~w V/ NL,,'/ 7-1TzciN1Rzcf (o W `Tie I csM o 2 4 330 COUNTY: MAILING ADDRESS: Sr4Q014 ~ ~v@ER USE DATES OBSERVATIONS MADE NO.BEDRMS.: ICOMMER IALDES DESCRIPTION] 115ROFILE DESCRIPTIONS: PERCOLATION TS: Residence uNK New ❑Replace ~UN~ / 1/990 ~UNf; /_"q rLS 4 O/- < -su ~I~S Coe yOT1~/.l'~ RATING: S= Site suitable for system U= Site unsuitable for system CONVENTI❑~ . MOUND: ~U IN-GROUNDZ S aU f3E: SYSTEM-IN~-FILLHt[I S SANK: ECOMMENDED iort,~ L& If Percolation Tests area NOT required DESIG RATE: I If an portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: LL+~SS Floodplain, indicate Floodplain elevation: NQ 1. PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH Mg, ELEVATION OBSERVED HET TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) I B- f 8.33 q~ ~S iJor~~ > 33 Z.,B~sLTS 20 NFS ,%,"$Q',cs~L..e I'I B- 3 9,S8 679 ON S.5Q q"B~St i a 2 „$rtN C-~ 67 B~P~IcS~Gt~ III B- Z 7.67 9d,SC NoNc > 7.~ Ls~TS 12"Ek J 8PWc14&P- B- 4 $.s e,SC No c 8S° /o"S/LSLrs z3~~$aNFs 7o''~aticS~t„e ,r B- sS Z~ 73 NOf.I~' ZS /9 8~5L "$R~ r{~ 20~>P~~QN►'~/S ~gr~~~~ =~C,yC B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DR 1 WATER LEVEL-INCHES RATE MINUTES NUMBER UIAMtES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD PERIOD PER INCH P_ 3.K Nd+► 5 Z >7 > <3 P- 3• NN w 19R. CG 3 > > Z < 3 P- 3.2 0 v 13 Z > 2 > < 3 P- P- LEE 4'Tl0 AT 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 boJ,ings and the direction and percent of land slope, Na [6T (ORn11` p SYSTEM ELEVATION. ~S. Sa°~~ ! { } Lo • - ~ M ► _~P) 4`A _ T a , ~7- T i ~ Q ~ I E i P_ .30.1 ,1 I 'N p ZZ. ~ P fi 1 r .-1..__ e._. ..4---- . _ _ - - v_ T' { 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 recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: jlp'y&yAG~(~/so~ -~o14 Axsah,"!Su OVE`~~,.,C. INL Joule 1990 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): o SE~~~~ 34g 4~ 6 oFU CST SIG URE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD•6395 (R. 10/83) -OVER - S L/~G~-~r • . TIMM EXCAVATING JOB SHEET NO. OF Z Route 1 Box 192 ✓ DATE 8 WILSON WISCONSIN 54027 CALCULATED BY (715) 772-3214 (715) 386-5443 MPRS #3224 WI MPCA #696 MN CHECKED BY DATE SCALE ............................................i........ . ...i........... i.. r~ ~Y CD iLC'Jlt ~Y i - W : . I . i r1 . . \ , . . : _ v > j I' rr4.._ 44 . . 0 t rf~ L~t f . ..M \y \ - \ ~j~ 1/Qn.t~ frJSti> ~r • r }c .7 '_I7r, re °l6 PRODUCT 205-1 ~>Inc.,Groton, Mass. 01471, To Order PHONE TOLL FREE I-800-225-63W Joe rl~C /cam/ TIMM EXCAVATING SHEET NO. ~ OF Route 1 Box 192 r` - WILSON, WISCONSIN 54027 CALCULATED BY 11koz- DATE S EJ (715) 772-3214 (715) 386-5443 MPRS #3224 WI MPCA #696 MN CHECKED BY DATE SCALE J~,.~ lug t~ . ~r L t, + . . {~J l : ~fE C Lz $v S . 6 tE r . PRODUCT 205-1 Inc., Groton, Mass. 01471. To Order PHONE TOLL FREE I-BDD-225-6380 i Parcel 040-1179-50-000 02/15/2011 12:00 PM PAGE 1 OF 1 Alt. Parcel M 24.28.20.712 ST. CROIX 040 - TOWN OFTROY Current ❑X WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner 0 - GRUBER, ANTHONY P ANTHONY P GRUBER 245 COVE RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 245 COVE RD SC 2611 SCH DIST OF HUDSON SP 1700 WITC Legal Description: Acres: 2.700 Plat: 0330-CSM 02-0330 040-76 SEC 24 T28N R20W LOT 1 OF CERT SURVEY Block/Condo Bldg: LOT 01 MAP IN VOL II P 330 BEING PT OF FORMER LOT 55 & 56 ST CROIX COVE SUB #3 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 24-28N-20W Notes: Parcel History: Date Doc # Vol/Page Type 07/20/2005 800906 2847/279 QC 07/23/1997 877/621 2010 SUMMARY Bill M Fair Market Value: Assessed with: 82645 398,900 Valuations: Last Changed: 11/09/2009 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.980 109,800 292,700 402,500 NO Totals for 2010: General Property 2.980 109,800 292,700 402,500 Woodland 0.000 0 0 Totals for 2009: General Property 2.980 109,800 292,700 402,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 311 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00