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HomeMy WebLinkAbout040-1204-40-000 � I 0 C � � I °o I N a I a i O w O I tl I I s, T C y O � � I C Z C IL c E O O` 3 N I � Q "@O i ( (D :!t CD w Z G N Z w C Z d co N a m o I O Z a Z o o N H a E N c C •� a U) L O O O Z m Z w N zI cly d Q t6 E N (�1 N ` O \l > y N lo- V cca .0 a �r aZ z° m •N LL aaa ►� a "i 0 o vii L 0, rn U) J U rn rn Z M _ E m m c a I N N _m I OO LO Q1 C N D a p O O O O ,',,,; C N E G N C 4N N N H O` co �, = Z r N � tD O C ef' C N • �' O N H (A O Z m .� C4 a a Sit a u IL • cl ad ,2 d E t A vat 0Uiv • Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER � Sa {�`f�Y d TOWNSHIP �Q� SEC. �S T , N-R _W ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION Ql�,�, �) , c� Gc /YG, LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of ILHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 5 ,a t 0, 3b' �2'G"� GG i H o v5a we 1 INDICATE NORTH ARROW IL BENCHMARK: Describe the vertical reference point used 'T'G, 7�0 bAlrme, ida i� si��4 q�•?L Elevation of vertical reference point: ) 00. oo Proposed slope at site: ° a SEPTIC TANK: Manufacturer: w t e5e(9 Colic- Liquid Capacity: Number of rings used: 2 Tank manhole cover elevation: 9 Q Tank Inlet Elevation: 9L,SG Tank Outlet Elevation: Q/,2 Number of feet from nearest Road: Front, side ,O Rear, a a tJ O feet From nearest property line Front,OSide,ORear,f feet Number of feet from: well wlG ' , building: ) o� (Include this information of the above plot plan) ( 2 reference dimensions to septic tank) __ —__ SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons 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). 3 � z SOIL ABSORPTION SYSTEM b Bed: ✓ Trench: _6-3 -6 Width: 12 Lenith: Jr3 Number of Lines: 2 Area Built: 4 Fill depth to top of pipe: 40 Number of feet from nearest property line: P�Front, 0 Side, O Rear,apt .J Number of feet from well: SH i Number of feet from building: 3 0 (Include distances on plot plan). 6 Tto" Get F I'S ,0 0 ?4� OI.iS��+.w e rL. SEEPAGE PIT F FL. Size: Number of pits: Diameter: , Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, ( Side, O Rear, OFt. Number of feet from well: y Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: Plumber on job: License Number: 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 MADISON,WI 53707 State Plan I.D.Number: SE 4j NE 4i S25,T28N-R19W ® CONVENTIONAL ❑ ALTERATIVE (if assigned) Town of Troy ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound E ADDRESS OF PERMIT HOLDER: INSPECTIO T : James Santoro Route 5, Box 28A, River Falls, W1 54022 BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF.PT.ELEV: Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Carl P. Heise 3378 St. Croix 119418 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: 00 t� Lo,Cod ,a9 YES ❑NO ❑YES XLNO BEDDING: VENT DIA.: VENT M TL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FR SH (` j ALARM: FEET FROM !� L,NE. AIR INLET: ❑YES NO V*"" ❑YES O NEAREST-► i< 1 V✓ �- DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: P PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVDED: ❑YES ❑NO ❑NO ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PRO n EL : BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET: PUMP ON AND OFF ❑YES El NO NEAREST---011- SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAME ER: AT RIAL 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: BED/TRENCH WIDTH: LENGTH: NO.OF DISTR.PIPE SPACING: COVER INSIDE DIA.: #PITS: LIQUID TRENCHES: MATERIAL: PIT DEPTH: DIMENSIONS &ELEV.INLET:GRAVEL DEPTH FILL D EPTH DISTR.PIPE DISTR.PIPE MATERIAL: NO. TR. NUMBER OF PROPERTY WELL BUILDING: VENT TO FRESH BEL W PIPES: ABOVE COVER: LEV.END: PIPEf.� AI NLET:D a CT� NEAREST�� vl �� o0 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 I 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 I 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: 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----Oil' i Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE: TITLE: SBD-6710(R.06/86) Zoning Administrator (ZD'L R SANITARY PERMIT APPLICATION COUNTY . CRol 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 STATE PLAN I.D.NUMBER 8%x 11 inches in size. –See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION–PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES n No PROPERTY OWNER PROPERTY LOCATION Z ra es cj rp S F % TN I:- %, S o?5 T2 , N, R C1 E(or)A PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME e 4 PI CITY,STATE ZIP CODE PHONE NUMBER Ej CITY NEAREST ROAD,LAKE OR LANDMARK I )"k J90 /S —4Z- VILLAGE: 7(Z rt)ao, em 12 r 11. TYPE OF BUILDING OR USE SERVED: o440- 10N—e40-000 Number of Bedrooms if 1 or 2 Family f3 OR ❑ Public(Specify): III. PURPOSE OF APPLICATION: (Check only one in#1. Check#2,3 or 4,if applicable) 1. a. I^New b.❑ Replacement c. ❑ Replacement of d.❑ Reconnection of e.❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit## Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in#1 and only one in#2) 1. a. Wonventional b. ❑Alternative c. ❑ Experimental 2. a. ❑System- b. ❑ Holding c.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. X Seepage Bed b. ❑Seepage Trench c. ❑See age Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): p _ 7�. Q Feet X Private ❑Joint ❑ Public VI. TANK CAPACITY Site in allons Total #of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank D GCt ` El Lift Pump Tank/Siphon Chamber ❑ ❑ VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name(Print): Plumber's Signature:(No Stamps) MP/ PRSW Business Phone Number: else 3 715- 4 S'a OIS Plumber's Address(Street,City,State,Zip Code): Name of Designer: / o'l o't S. M.ak 57' QV U­,,, Foils 340 t f cr Vlll. SOIL TEST INFORMATION Certified Soil Tester(CST)Name CST# V 0 6 in V 1 h,,r t T 55--0 a 6 CST's ADDRESS(Street,City,State,Zip Code) Phone Number: IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) buApproved El owner Given Initial �Zu rchar�ge Adverse Determination V X. CO MMENTS/REASONS FOR DISAPPROVAL: NJ SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION TO THE APPLICANT: 1. This 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. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 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. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed pumper whenever necessary,-usually every 2 to 3 years; 6. If you have questions concerning your private sewage system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 608-266-3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description where the system is to be installed; II. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in #1. Complete #2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in #1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. 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. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. 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; dosing or pumping chambers; 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. GROUNDWATER SURCHARGE i On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was the result of over 2 years of steady negotiation and public debate. The groundwater bill Ground included the creation of surcharges (fees) for a number of regulated practices which Wisco C)ItS a can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried Tel�3&tit t? is used in your building is returned to the groundwater through your soil absorption system or the disposal site used by your holding tank pumper. The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- t water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398(R.03/86) APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, ("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of Property 0)& Location of Property _ _ A/L- _k, Section r , T , , N-R cL Township i PI)u Mailing Address ' o4 Address of Site �t/CJ ( A Subdivision Name Q �rtiiJrFi .� �CkL _ . Lot Number Previous Owner of Property V)R/-, i ,L, G �1(l en —Lz Total Size of Parcei --� ,9;'�,5� h 0 Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes Volume and Page Numb=/ Y7 - as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and P P a e number, and the i Seal of the Register of Deeds. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION I (We) ceAti.6y that a t 6tatement6 on .thi.6 6onm ahe th.ue to the best o6 my (ouh) knowtedge.; that I (we) am (ahe) the own en(�s) o the no ent dens chi.bed 6 p in � inhonmati.on onm b y p y e 6 y -chtue o a wa�.ant deed n 6 ee econded �.n the 0 Co Re ' y e 6h.ice o6 the .eaten o County 9 Veed�s ass Document cement Na, 4q(06,7? ; and that I we n own the pnopoaed A to bon the 6ewage dihpod ays em (on I (we) have)obtai.ned an easement, to nun with the above deacA bed pnopenty, bon the conatnuction o6 eaid d yetenl, and the same haA been duty neconded in the 066ice o6 the County Reg.ia.ten o6 Veedd, ab Doemnent No. ) , S GNATURB OIL OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED ... - DOCUMENT No. I - WARRANT DEED THIS SPACE RESERVED FOR RECORDING DATA I j i 1 STATE BAR OF WISCONSIN FORM 2—1982 REGISTERS GFFI .T j ST. CROIX CO., Vj Virgil Delander a/k/a Virgil E. Delander and ;I R @C�CIi ...................................................... for Record Patricia M. Delander a/k/a Pat ricia Delander, j . -----------•--------------------•----•-------••... F"� J husband and wife r I`tl l at 11 :10 A. M I conveys and warrants to _-James G. Santoro and Linda L. jf,7 Santoro, husband and wife as ............. l Re9isterofDeeds -------------- ......--------------------------------------- ------------------------------ I marital---Property----------------•---------. . 'i .................. j I ............................................... _... _. ------------- •-•--------- •-------•----•-------------•-----------•--------•----•---•--------•-••---- !I RETUR1�,091X VALLEY T-"L- V ,VDCU5 C. ......... .......••--------•-----•---•-••-••-•..................---•--.................................. ......... ...............•---•-------------------------••---------------..._................................ the following described real estate in ......St. Croix .........................................County, li State of Wisconsin: i� Tax Parcel No- ------------------------------ li !I i' ii i Lot Four (4) , Plainview Acres in the Town of Troy. �I it This deed is given in satisfaction of the land contract between the �! parties dated April 1 , 1985, recorded April 3 , 1985 at 8 : 30 a.m. I' I, in volume 708, page 634 as document number 400811 . I I� TRANSFER N-V I, FEE I! li ii� is not I; This ............................ homestead property. fib) (is not) I i Exception to warranties: I' easements, restrictions and rights of way of record, if any. II Dated this 6.01----------------------- day of --•------ March 19..89... --•----------- •---------------••------•--•--•-------- (SEAL) a-.--!_�.�r'x�_: '� ..........(SEAL) j ----------------•----------- ....... ............................. Vi g 1 Delander .a/k/a..Virgil E. _ / n Delander ---------------------•-----•---•---....-•--•-•-•----•-----•---------(SEAL) - '/®q I I, l _..o.<«:�.. . G��=---'�=r----- .....(SEAL) I . Patricia M. Delander a/k/a Patricia i --------------------- Delander !! AUTHENTICATION ACKNOWLEDGMENT II ! I !' Signature s STATE OF WISCONSIN P ss. ! -----------County. I authenticated this --------day of--------------------------- 19...... Personally came bafare me>: iis 4__._...day of ml�2�! .'1°� s��.�l , 19 `1 the above named ---•- - Vir it Delai E a -- Delander and.- atrici�;M'' ------------------- r TITLE: MEMBER STATE BAR OF WISCONSIN Delander z'1/WAa��tri�i a slander ---------------------- ti ---------- -------- +►-----•-•---------- i (If not, ------• -- --------------------- - -• p ° .................. authorized by § 706.06, Wis. State.) - d- -- x j to me known to b tha; a bfP__..__.__�F w4 executed the foregoing instrum6pt$r"f4,acknowledlkthp'same. THIS INSTRUMENT WAS DRAFTED BY t�rA�gTF Off, OF bV 15 s Jose h D.---Boles, Attorne at Law �sfa g R -` �I - y------ River Falls, WI 54022 (I ---------------•-------.......----------------•---•---•---•...._......-•-••-.... Notary Public ------ - ------�------Countt Wis. 1 (Signatures may be authenticated or acknowledged. Both My Commis ion is permanent.(If not state expiration are not necessary.) `7 I date: = �...-1., .......... 19....... .) *Names of persons signing in any capacity should be typed or printed below their Signatures. J �MGIT1�ar STATE FORM BA No. 2 ISi 82SIN — _-----StOCk NO. 13002 _ — H 9 STC - 105 r a H SEPTIC TANK MAINTENANCE AGREEMENT o St . Croix County x d _ 9 OWNER/BUYER, n rr`] � , Cfl�`CY� ROUTE/BOX NUMBER Fire Number + CITY/STATE ►UC' �' �,u`� zIP PROPERTY LOCATION : SE Section ZS" TN, R—L-Cl—W, Town of 7 St . Croix County, Subdivision ! ' Lot number. 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 , I if needed , by a licensed septic tank pumper. What you put into the system can affe—ct 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 0 E. I/WE, the undersigned, have read the above requirements and agree N to maintain the private sewage disposal system in accordance with H the standards set forth , herein, as set by the Wisconsin Depart- b ment of Natural Resources . Certification form must be completed and returned to the St . Croix County Zoning OffkVe within 30 days of the three year expiration date . SIGNED ")C DATE u fr 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 . "he D OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTI!)UST RYY,, DIVISION LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP LOT NO.:BLK.NO,: SUBDIVISION NAME: .5'.F. . 1/ 1/ z.SS /T2PN/R17E (o ) T/�oy Pt-A vre-LJ Ac zs COUNTY: BUYER'S NAME: MAILING ADDRESS: S Gt D/ X /M 'I L ,Sim t 7/0,e C� 7lv v�M d,E1Z 4>O Ql�Q U,e SS/.z USE DATES OBSERVATI NS MADE t NO.BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE DESCRIPTIONS: PER LA ION TESTS: � L�JResidence '3 N4— New ❑Replace ��i4iP�Gt / 2/- �S &i>' RATING: S=Site suitable for system U=Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE:Tfl N-FILLHOLDING TANK: RECOMMENDED SYSTEM: i ©s au s ❑u o s ❑u u o s au ovv��f; � G XsZ If,Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5)(b),indicate: �!/j�SS --L Il Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS //J BORING TOTAL DEPTH TO GROUNDWATER-. CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- / cos" 102 -FY' /74&— 7/0.x " s-s_ ti � s . B- L 0 ✓ B- 3 /o/ - > /D S 3 �.t,,� c w f /s P o :Bj] �- �d �.5 y 3 -�y 0'4" o B-5 S' /o� 3� )4,- > aN s,' G 7r1 A) cs ��- Gy Io�1�'+ P� �C30 - Gy J, z B-G SS 3. 3.y �� , w f�,, ��. Mo ><s PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER AFTE SWELLING INTERVAL-MIN. PERIO_T 1 PERIOD PERT D PER INCH P- Of d P_ ---___ J J•1.'1.:; 9 PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil a orng.0 et. fl r pewzh,±��a�tttvarce72hhee�hhon- zontal and vertical elevation reference points and show their location t plan. Show the surface ellevati.A. Ta� ��d3��iT�CTiMtjat wAlt of land slope. N W I Ro,J •'—.)- FT• r fAMC-e•13 SYSTEM ELEVATION '70 yo i�aE 2C� / 'rA,,jr sysrEM To c� LU M l �c ` rf P3 �s, TN J s- o � ��Fs- a /o m r r 70 (3, sEr c 5 T- s rbVN� 5 Lt1 V9 /POtJ Lor /Raid VoI-T" 130x'6-160 - 90.E Cie L) = i0�).D so. coT- 4q'r3F 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specifie 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 (pript): HOMESITE SEPTIC PLUMBING CO. TESTS�WjERE COMPLETED ON: �— RT. 3 O'NEIL RD., HUDSON, WIS. 54016 " lca� Z/- P f ADDRESS: ROBERT ULBRICHT CERTIFJ-,CATION NUMBER: PHONE NUMBER(optional): WIS. MASTER PLUMBER LIC, NO. 3307 M.P.R.S. > 5 —oL d{ L "r6 '�/�S V101111, t'10-04ftt -- CST SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) OVER -- PLOT PLAN 34 -. 3_ BoX.2 B A - _MAX __�fPP._ ��►V�`�FTT�FABRIc __ -_ PE MIN- 401-Awou so D A GryBF �- I� l&F, _�- 70' �7 i 3 G' 3 ti i o'zr W I 12'3 ti r (aD tlt r CC Q2 �[ Pf P E X5�1�KE 1'L• h o l000 GAS LLI 0.00 40• D 88 � 20' N Q p Ranos ED 14auSE cs o �RoPos6a WELL � l i f, Parcel #: 040-1204-40-000 10/18/2006 09:17AM PAGE 1 OF 1 Alt. Parcel#: 25.28.20.950 040-TOWN OF TROY Current X ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): 0=Current Owner, C=Current Co-Owner JAMES G&LINDA L SANTORO 0-SANTORO,JAMES G&LINDA L 167 DELANDER DR RIVER FALLS WI 54022 Districts: SC=School SP=Special Property Address(es): "=Primary Type Dist# Description ` 167 DELANDER DR SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 2.828 Plat: 2332-PLAINVIEW ACRES SEC 25 T28N R20W 2.828A PLAINVIEW ACRES Block/Condo Bldg: LOT 04 LOT 4 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 25-28N-20W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 835/477 07/23/1997 708/634 2006 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Changed: 07/22/2004 Last Chan Valuations: g Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.828 55,700 197,200 252,900 NO Totals for 2006: General Property 2.828 55,700 197,200 252,900 Woodland 0.000 0 0 Totals for 2005: General Property 2.828 55,700 197,200 252,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 122 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00