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Home My WebLink About012-1043-80-000 f j 2 k c q0 $ 2 & � 2 i § « 5= 0 J\ � / 0) 2 \\ � f § . , 0 LL 45- � f � � � � / § E . ) V _ § \ a m c . \ � :!t 2 z 7 / 2 j 0 (D m § IDI o \ c § \ o 2 < - Q : zez 16 .. } \C, CN u £ ° U) � 3 § 8 S <\ 2 k % k § k z > 0 0 0 a a a ) \ E 5 k 1 k k o � � - - z z E ' I o 0 ) g f \ ƒ ƒ ) % G @ 2 ° § 0 9 $ Q § ® ) a )_ k CO k_ § % 0 c j \ \ f / k 2 2 2 k = \ . K / \ � z kip » > � \ § LU § 0 2 ) ) k \ � ® � « " ) co 2 « a i I - , _ .- , " # E 2 k a a § / 0 o 0 t io w o . � Y Parcel #: 012-1043-80-000 01/11/2007 04:47 PM PAGE IOF1 Alt. Parcel#: 19.30.17.286C 012-TOWN OF ERIN PRAIRIE Current X' 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 SHERRY R KLINGER O-KLINGER,SHERRY R 1551 CTY RD G NEW RICHMOND WI 54017 Districts: SC=School SP=Special Property Address(es): *=Pri Type Dist# Description * 1551 CTY RD G SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 5.000 Plat: N/A-NOT AVAILABLE SEC 19 T30N R17W NW NE LOT 1 OF C.S.MAP Block/Condo Bldg: VOL I P 209 5AC Tract(s): (Sec-Twn-Rng 401/4 1601/4) 19-30N-17W � N Notes: Parcel History: V� Date Doc# Vol/Page Type 07/23/1997 07/23/1997 5331377 2006 SUMMARY Bill#: Fair Market Value: AAessed with: 155982 279,800 Valuations: Last Changed: 11/07/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.000 53,000 220,900 273,900 NO Totals for 2006: General Property 5.000 53,000 220,900 273,900 Woodland 0.000 0 0 Totals for 2005: General Property 5.000 53,000 220,900 273,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 138 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 OWNER �� TOWNSHIP SEC. T N-R 47 W ADDRESS ;3 ,K ST. CROIX COUNTY, WISCONSIN SUBDIVISION -,a- LOT LOT SIZE V- ` PLAN VIEW Distances and dimensions to meet requirements of I•I,HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM �7 6y w INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: 44-4 � Proposed slope at site: SEPTIC TANK: Manufacturer: Liquid Capacity: nod fi ate—._ Number of rings used: Tank manhole cover elevation: /&4,F S Tank Inlet Elevation: % Tank Outlet Elevation: z5?z Number of feet from nearest Road: Front,W Side,0 Rear, O �&2 feet From nearest property line Front,O Side,.0 Rear,O �� ` feet Number of feet from: well led" —, building: (Include this information of the above lan lot P P ) ( 2 reference dimensions to septic tank) SEE REVERSE SIDE � s PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manuf urer: Pump Size Elevation of inlet: ttom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of Zfr rest property line: Front, O Side, O Rear,0 Ft.of feet from well: Number of feet from building: nclude distances on plot plan). SOIL ABSORPTION SYSTEM ,/ Bed: Trench: `/� Z)Width: Length: Number of Lines: 2 Area Built: F6 Sd Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, 0 Rear,0 Ft Number of feet from well: Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Numb of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a d p box O or distribution box O been used on any of the above soil absorbtion tems? (Check one). HOLDING ANK Manufacturer: Capacity: Number of rings used Elevation of bottom of tank: Elevation of in t: Number of f t from nearest property line: Front, O Side, O Rear, O Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector• Dated: �' ZT�� Plumber on job: Or. License Number: 3/84:mj r"0fPA'FiTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX 7969 BUREAU OF PLUMBING MADISON,WI 53707 NWT, NE 4, S19,T30N-R17W KNCONVENTIONAL ❑ALTERNATIVE State Pian I.D.Number: Town of Erin Prairie D Holding Tank ❑In-Ground Pressure El Mound 1;4:14;7W - P_ j co Rd a NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Mark & Sherry Klinger Route 1, Box 48, New Richmond, WI 54017 BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: ICSTFIEF.PT.ELEV.. Name of Plumber MP/MPRSW No.: County: Sanitary Permit Number: Gar L. Steel 3254 St. Croix 106115 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.: TANK OUTLET ELEV_ WARNING LABEL LOCKING COVER PROVIDED. PROVIDED. DYES ONO DYES ❑NO BEDDING' VENT DIA.. VENT MATL.'. HIGH WATER NUMBER OF ROAD: PROPERTY WELL. BUILDING. IVENTTOFRESH ALARM FEET FROM LINE. AIR INLET ❑YES ❑NO OYES ONO INEAREST DOSING CHAMBER: MANUFACTURER BEDDING. LIQUID CAPACITY PUMP MODEL. PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: OYES ONO OYES ONO DYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH Oid (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) OYES ONO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease until FORCE the soil is dry enough to continue.) I MAIN CONVENTIONAL SYSTEM: WIDTH: LENGTH NO.OF JDISTR.PIPE SPACING COVER INSIDE CIA tPITS LIQUID BED/TRENCH TRENCHES MATERIAL: PIT DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR.PIPF DISTR.PIPE DISTR.PIPE MATERIAL. NO.DISTR NUMBER OF PR QPERTY WELL BUILDING VENT TO FRESH BELOW PIPES ABOVE CO ER. ELEV.INLET ELEV.END. PIPES FEET FROM LINE. AIR INLET NEAREST-� MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. OYES ONO SOIL COVER ITEXTURE PERMANENT MARKERS OBSERVATION WELLS OYES 1:1 NO ❑YES NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SOCDED SEEDED MULCHED CENTER. EDGES DYES ❑NO DYES ONO DYES 0 N PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH TRENCHES LATERAL SPACING GRAVEL DEPTH BELOW PIPF FILL DEPTH ABOVE COVER DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL N .PIPE DISTRIBUTION PIPE MATEHIAL&MARKING ELEVATION AND ELEV.. ELEV.. CIA. ELEV.. PIPES DIA.. DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS DYES FIND 1:1 YES NO COMMENTS: PERMANENT MARKERS: OWEL LS NUMBER OF PROPERTY WELL. BUILDING FEET FROM ILINE. OYES 1:1 NO ❑YES ONO NEAREST 5 r Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE. TITLE DILHR SBD 6710(R.01/82) Zoning Administrator I SANITARY PERMIT APPLICATION COUNTY 7 01LHR In accord with ILHR 83.05,Wis.Adm.Code St. Croix °. =OE STATE SANITARY PERMIT# /O to//,S- 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 Mark & Sherry Klinger NW '/4NE %, S19 T30 , N, R 17 xff(or)W PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME R.R.#1, Box 48 n/a n/a n/a CITY,STATE ZIP CODE PHONE NUMBER CITY NEAREST ROAD,LAKE OR LANDMARK New Richmond Wi. 54017 n/a E]017 : Erin Prarie Co. Rd. i'#G II. TYPE OF BUILDING OR USE SERVED: 0/7 —70 Number of Bedrooms if 1 or 2 Family 3 OR ❑ Public(Specify): III. PURPOSE OF APPLICATION: (Check only one in#1. Check#2,3 or 4,if applicable) 1. a. ❑ 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. conventional 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. ❑ seepage Bed b. RR Seepage Trench c. ❑ See a e 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): 30 900 900 97.86' Feet RPrivate ❑Joint ❑ Public VI. TANK CAPACITY Site in aa ons Total #of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks strutted Septic Tank or Holding Tank 1000 1 Weeks concr2l-e— ❑ ❑ Lift Pump Tank/Siphon Chamber --- ❑ ❑ VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private s wage system shown on the attached plans. Plumber's Name(Print): Plumber's nature:(N mp /MPRSW No.: Business Phone Number: Gary L. Steel 3254 715 246-6200 Plumber's Address(Street,City,State,Zip C Name of Designer: 988 N. Shore Dr. , New Richmond, Wi. 54017 VIII. SOIL TEST INFORMATION Certified Soil Tester(CST)Name CST# Gary L. Steel 2298 CST's ADDRESS(Street,City,State,Zip Code) Phone Number: 988 N. Shore Dr. New aRichmond Wi. 54017 V15 246-6200 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater at Issuing Agent Signature(No Stamps) ®Approved ❑ Owner Given Initial urcharge Fee / p Adverse Determination X. CO MENTS/REASONS FOR DISAPPROVAL: 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 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 GroundtB[ included the creation of surcharges (fees) for a number of regulated practices which Wisco Eri'S a can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried [ec`tSt1rO::: is used in your building is returned to the groundwater through your soil absorption o 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 signdd 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 G V-. Z�V- 4�LLV-tJ Location of Property � ) kk, Section , T -N-R_�- W Township �_ `tom-'G N V- Hailing Address ��, \ X l g Address of Site ,MQ Subdivision Name Lot Number Ai Previous Owner of Property Total Size of Parcel Date Parcel was Created Are all corners and lot lines identifiable? ` Yes No Is this property being developed for resale (spec house) ? Yes No Volume �� and Page Number -a-Q2L--- as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and page number, and the 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 WOO cv,%ti6y that a t A tatementrs on ,tit" 60AM ane tAue to the but 06 m y hncwtedge; that I (we) am (she) the otune k) 0,6 the pnopehty dezmi.bed in .thiA .in601mation 6o4m, by viA-tue 06 a wahhant deed n¢eonded in the 066ic¢ 06 the County RegiA ten o6 Deeds ass Document No. a and that T (we) pheaen,tty o+un .the p4opoded site 6oh the sewage. di�spo's ZTA em (on 1 (we) have obtained an eauser+ent, to nun with the above deAcAibed pnopeAty, bon the eon tAuc,t.ion 06 adid 4 yd.tem, and the eame ha4 been duty kecokded Xn the 066tce 06 the County RegiA teh o6 Deeds, a4 DOCUMen.t No. IZL� SICNATM Q1 01WER OF SIGNATURE 0 CO-OWNER (I APPLICABLE) DATE SIGNED DATE SIGNED it ' 1 f A s a w F' � -_ _ } z - cn ' H a ST C - 105 r r a H SEPTIC TANK MAINTENANCE AGREEMENT o St . Croix County z d a OWNER/BUYER Ly�' ROUTE/BOX NUMBER �ox Fire Numbej /10_ CITY/STATE L'.Z21IcAYVl vn d \�`cQ CIS"S�� ZIP �►�p l PROPERTY LOCATION : _, �li �, Section_, T ]?QN , R _W, Town of �n.�cc��r; e_ St . Croix County , Subdivision Lot number l 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 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 0 E I/WE, the undersigned , have read the above requirements and agree to maintain the private sewage disposal system in accordance with x the standards set forth , herein, as set by the Wisconsin Depart- ment of Natural Resources . Certification form must be completed l�\ and returned to the St . Croix County 'honing Office within 30 days of the three year expiration date . SIC ED Z 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 . DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTRY, DIVISION I,ABOI3 A14 REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 (H63.090)& Chapter 145.045) LOCATION: SECTION: TOWNSHIP Y: LOT NO.:BLK.NO.: SUBDIVISION NAME: Nw 14E 1/4 19 /T30 N/R 171(or)W Erin Prarie I n a n a n a COUNTY: OWNER'S BLS MAILING ADDRESS: St. Croix Mark & SherLry KlinjZer R.R. 1 Box 48 New Ricbmond, USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTIO PROFILE DESCRIPTIONS: PERCOLATION TESTS: residence El Replace 3 1 n a 4-25-88 4-26-88 RATING:S=Site suitable for system U=Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUNDPRESSURE: SYSTEM-IN-FILLHOLDING((TTA�A,,N'�K:RECOMMENDED SYSTEM:(optional) S ❑U HS ❑i S ❑U ❑S ®U ❑S Egi conventional If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b),indicate: n/a Floodplain,indicate Floodplain elevation: n/a decimal' PROFILE DESCRIPTIONS a e p g (�+ JeB BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH NUMBER DEPTHI XX ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B-1 7.00 101.19 none >7.00 .75bl.1. 1.33bn.sil. 4.92bn.s.l. B-2 7.41 101.44 none >7.41 .75bl.1. .83bn.sil. 5.83bn.s.l. B 3 7.09 101.88 none >7.09 .67bl.1. .92bn.sil. 5.50bn.s.l. B- B- B- PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD PER INCH P_ none 30 3 24 2% 12 p- 2 3.58 none 30 1% 1 1 30 P_ none 30 2- 2 2 15 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 97.86 1,,-`m t W4 I V� _w�.m, ,tis-4�_Lai a . _ I I 7mm .. .I...___ _- � � _ _._� _� _�_ �.,._, _ � __� � ? J__ __- 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: Gary L. Steel 4-25-88 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): 88 N. Shore Dr. , New Richmnd, Wi. 54017 2298 1715-246-6200 CST SI 6A XAJ RE: Z xb�?—Z DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. HR-SBD-6395 (R.02/82) —OVER — INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6396 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 nevi{ or replacement systern, 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; 0. PLEASE use the abbreviations shown here for ;Waiting profile descriptions and completing the plot plan; 7. (MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scales is preferred. A separate sheet may Ite:used if desired; B, Make sure your benchmark and vertical elevation reference point are cleanly shovrn,and are permanent; 'd. Complete all apI t«priate boxes as to dates,narnes,addresses, Ilood plain data, percolation test exemp- tion, if appropriate; 10. If t,ae inlormabon (suchras flood plain,elevation)does not apply, place N.A.in the appropriate box; 11. Sign the form and place your current address and your certification number; 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL. AUTHORITY WITHIN 30 DAB'S OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols s - Slone (ave( 10") SR Bedrock crab Colahle (:3- 10") SS - Sandstone gr _- Caravel (under 3") LS - Limestone -�s - Sand HGtftr High Groundwater r;s - Cr "!= e Sand Perc Percolation R ale s cI s - M�Jdi arr; Sand W - Well fs Fine Sand Bldcp _ Buildincl Is - Loarny Sand > Greater Than sl - Sandy Loam Less Than 1 Loam Bn -- Rrc)wrI sit - Silt Loam B1 Black s Silt G - Garay }cl - Clary Loam Y YeIIov" sO - Samiy Clay Loam R iced sic1 -- Silty Clay Loam mot. - Mottles 'A: - Sandy May w1 - vvit1) iC Silty Clav ff J"{, line, faint Ci< �rTinron, coarse or Peet ITatr - Many, medium, Mock d .... distinct p -- prominent H W L High water level, Six yer-teral soil leXtUres surface water for licguid waste disposal €3M - Bench Mark VRP Vertical Reference Point Y TO TIME OWNER: This wd rest report is the first step in securing a sanitary permit, The county or the De partrnent rnay request � vet {ication cif tl-i;s sail tes,, in the fielcl prior to parroil issmance, A complete set of plans for the, private se""vage systern and a permit application rnu"t be srrhn,it[ed to the eappiopriate local awhorip/ in order to obla"I a t-serrrrtj. The >r'Juv y perm;! must be obt<tm.d and ,=owd pi for to tN. s'at r ear srno-e,c„��tr€actir�n. 3 Mark & Sherry Klinger NW%NE4 S19T30NR17E town of Erin Prarie r 0 50 Glc��fn�-�S n- 83.1 qq Nod S 644 l� 10 00 2p 01 S67 PA`e w z?tf nxH Ga L. steel L" lj-16el 988 N. shore Dr. New Richmond, Wi. 54017 'L MPRSW 3254 i? So" CROIx COUNT FILED L.---ijif�'LfIOR'S RECEORYD JAN 201976 1ARES o,Co"ELE NWRE CERTIFIED SURVEY MAP I&OWW Of D9*41 64 CMIS ty, Parcel located in Northwest Quarter of 61 Northe&st Quarter of Section 19#T 30 Nt R 17 W' Erin Prairie Township, St. Croix County: Wisconsin. N 'lq corner of .Se c on 19-30-17 ;2 C. T + p, 5'0.o o 'y 8 - Rlw ,9 ,0A-5 W 41 2.T.0 0 0 0. 4 3;. R-/- of bey1*n*71'n9-' 00*,q8'E of A/. coe %y //Ale - :e S. 00 09cres \ ��'`� tA/� 3-3 - 4j 0 V) Pipe Te 0. &tz 5'0 0 W DESCRIPTION: Beginning at a point on the west line of said northwest quarter of the northeast quarter of Section 19-30-179 said point being o n the south right-of-way line of C.T.H. "G" ; thence with said right- of-way line N 89 221 E a distance of 425. 00 feet; thence S 000 481 E a distance of 512.50 50 feet; thence S 890 221 W a distance of 425-00 feet;i;thence N 00 481 W along the quarter line a distance of 512-50 feet to point of beginning, the above described parcel containing 5.00 acres, more or less. CERTIFICATION: I hereby certify that I have surveyed and divided the lands shown hereon; that the map and description shown hereon are true and correct representations of the lands as surveyed; and that I have fully complied with all the provisions of Chap. 236-34 of Wisconsin ZStaZt and mapping said lands. Survey for Warren Smallidge 0 Ns" James R. Grubb ber 24 1975 Registered Land Surveyor Vol. I Page '-Sit APPROVED Certified Survey' Maps St. Croix County, Wisconsin 74 ST. CROIX COMPREHENS! E VA; As 12-17-75