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CROIX COUNTY, WISCONSIN SUBDIVISION � ,\R LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I1HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM t (00 �V <; J k N I x 1 k � 01 I fir' f � � s � s INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Vl} ,Id t_ S 7 Elevation of vertical reference point: Proposed slope at site: SEPTIC TANK: Manufacturer: Liquid Capacity: Number of rings used: _ Tank manhole cover elevation: I Tank Inlet Elevation: (00 . c0 Tank Outlet Elevation: g� Number of feet from nearest Road: Front, V-Y Side,0 Rear, O feet From nearest property line Front 10 Side, Rear,O ` feet Number of feet from: well ;lot 0,49 (Include this information of the above plot plan)( 2 reference dimensions to septic tank) I` SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: _ Pump/S n nu turer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch el tion: Gallons per cycle: Alarm Manufac rer: Alarm Switch Type: Number o eet 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: Trench: Width: S, Length: DC) Number of Lines: Area Built: ,S�a z�- Fill depth to top of pipe. Number of feet from nearest property line: Front, /OrSide, Rear,Opt .� Number of feet from well: Q I Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom f seepage pit elevation: Area Built: Has either a dro box O or distribution box O been used on any of the above soil absorbtion sy ems? (Check one). HOLDING K anufacturer: Capacity: Number of rings used: evation of bottom of tank: Elevation of inlet: Number of feet fro nearest property line: Front, O Side, O Rear, OFt. Number of feet from well: Number of feet from building: Number of feet from nearest road: I Manufacturer: c/ Inspector: - Dated: SO Plumber on job: 7 ` License Number: ��C1' 3/84:mj • 'DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX 7969 BUREAU OF PLUMBING MADISON,WI 53707y NE%,W(u-,S5,T30N—R1 8W [%ONVENTIONAL ❑ALTERNATIVE (Iate Plan I.D.Number Town o4 Richmond ❑Holding Tank El In-Ground Pressure ❑Mound State Hiahway 64 NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Ray and Joan Gard ke 205 E. FiAzt St eet, New Richmond, W1 54017 J, 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: Gary L. Steet i3254 St. Cuix 112734 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER �j PR VIDED PROVIDED ES ONO OYES CONO BEDDING VENT DIA. VENT MATL.: HIGH WATER NUMBER OF ROAD: jPLR OPERTY WELL: BUILDING. VENT T FRESH OYES LAN ALARM FEET ARESTf I O Ij� Q tco* e1/_ I.-wLEr O v ❑YES ONO NEAREST + �J DOSING CHAMBER: MANUFACTURER 7INGS LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED. PROVIDED: ONO ❑Y ONO DYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PROPE TV L BUILDING VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) OYES ❑NO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH IDIAMETE YT T I AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH: LENGTH JNOOF IDISTR PIPE SPACING COVER INSIDE CIA tPIiS LIQUID BED/TRENCH TRENCHES I M EHIAL PIT DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO.D TR NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH BELOW PIPES ABOVE COVER. ELEV INLET ELEV.END PIPES FEET FROM LINE- JA INLET tj I .11. NEAREST—i 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. ❑YES NO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS 1:1 DEPTH ❑NO OYES ❑NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER. EDGES DYES 0 N 1:1 YES ONO DYES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: NO.OF BED/TRENCH WIDTH LENGTH TRENCHES LATERAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE IMANIFOLDMATIRIA1 NO DISTR DISTR PIPE DISTRIBUTION PIPE MATERIAL&MARKIN(, ELEVATION AND ELEV.. ELEV.. DIA. ELEV.. PIPES DIA: DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERT PLANS ICAL LIFT CORRESPONDS TO APPROVED DYES ONO 1:1 YES 1:1 NO COMMENTS: / PERMANENT MARKERS: OBSERVATION WELLS NUMBER OF PR OPERTV WELL BUILDING FEET FROM LINE ❑YES ❑NO -]YES NO NEAREST � d r to 7(3 Sketch System on Retain in countyile for audit. f( Y Reverse Side. SI GNATURE. TITLE. DILHR SBD 6710(R.01/82) Zoning Admini tAatoh SANITARY PERMIT APPLICATION COUNTY -jC3D1LHR In accord with ILHR 83.05,Wis.Adm.Code St. Croix STATE SANITARY PERMIT## 112734 —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 I. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE E YES NO PROPERTY OWNER PROPERTY LOCATION Bay and Joan Garske NE '/4 NW '/a, S5 T , N, R (or)W PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER 111LOCKNUMBER SUBDIVISION NAME CITY,STATE ZIP CODE PHONE NUMBER LJ CITY NEAREST ROAD,LAKE OR LANDMARK 1 (715 246-5020 O VILLAGE chmond St. Hy. 464 II. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family 2 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. RiConventional 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.ki Seepage Trench c. ❑ Seepage 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): class 2 500 500 97.16 Feet Zi Private ❑Joint El Public VI. TANK CAPACITY Site in allons Total ##of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New xistin Gallons Tanks Concrete stCon- glass App. Tanks Tanks Septic Tank or Holding Tank x 1000 1 Weeks C.P. Lift Pump Tank/Siphon Chamber ---- -- ❑ Li 1 ❑ ❑ VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the privat sewage system shown on the attached plans. Plumber's Name(Print): Plumber's ture:(No St s) WMPRSW No.: Business Phone Number: Gary L. Steel 3254 1 (246-62PO 715 Plumber's Address(Street,City,State,Zip Co Name of Designer: 988 N. Shore Dr. , New Richmpnd, 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 Ric hmond, Wi. 54017 715 246-6200 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) ®Approved ❑ Owner Given Initial Surcharge Fee Adverse Determination $120.00 $25.00 8-4-88 . X. COMMENTS/REASONS FOR DISAPPROVAL: P&n appnvved by Many J. Jenk yo SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber • 4 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; IL 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'/s 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 Ground star included the creation of surcharges (fees) for a number of regulated practices which Wisco irtra can effect groundwater. The surcharge took effect on Jule 1, 1984. All of the water that buried rea"su.r.e is used in your building is returned to the groundwater through your soil absorption u system or the disposal site used by your holding tank pumper. a 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. a3D E398(8.03/86) 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 Ray & Joan Garske Location of Property NW k NE h;, Section 5 , T 30 N-R 18 W Township Richmond nailing Address 205 E. First St. New Richmond, Wi. 54017 Address of Site R.R.#2 New Richmond, Wi. 54017 Subdivision Name n/a . Lot Humber n/a Previous Owner of Property Alano Society of N.R. Inc. Total Size of Parcel s% T gC2e S Date Parcel was Created 211 _ % _8 7 Are all corners and lot lines identifiable? x Yes No Is this property being developed for resale (spec house) ? Yes _ x Volume '7_f and Page Number � 7s 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 Hap, the Certified Survey Hap shall also be required. PROPERTY OWNER CERTIFICATION 1 11k) co-t_ti.6y that ate statements on this ohrn cute cue to the but o6 my (ouh) hncwC¢dge; that I (we) am (an¢) the ownen(.$) o6 the phopehty deschi.bed in tha in4olmation 6oAm, by viAtue o6 a waAh.anty deed neconded in the 066.ice o6 the CotuLiyy R¢gusteA 06 D¢eda ah Document No. ��f7 ; and that I (we) c.un the pitopoded bite. bon the sewage digs ors b As em (on I (we) have obtained an ¢"Cmf t, to nun with the above deAcAi.bed pnopehty, bon the conAtAucti.on o6 aaid dyatem, and the dame ha.e been duty Aeconded .tn the 066tce 06 the County Reg.i.eteh o6 Petds, as Pocwnen,t No. ) SIGN 01? OWNER SIGNA OF CO-OWNER (IF APPLICABLE) 8- 5 - 3- - 3 - DATE SIGNED * DATE SIGNFTI i�i.N M1 t 9 V ` �[r 3r ..rM.•�1�s#'>talf.�arorprq��.ik .................. ................................ .....,.... .... �'iv w. •. ..www+.s.•.......................w � ..r...?.............. ' /�e ` .i.......$�,.,.• iY............. _ AIL TIN FIN �r th! of Oerti.fied,•Survey Map, filed October 12. ; ' ' -4Wtiti44 Surrey Maps, page 1898, as Doavw�et� a.°P14ft ot, Use ftrtbeast Quarbor of tiM i d� SIMIt) -and the Ilorthwest Quarter of the ' � 08 Vft) of Section Five (5) , Township Thirty � t gfitNrn (18) Hest. wF ..... I muff y� FF " want e . : We .............. ................................. ft of ..._..... .October..................... ..... ......... �t--• AMWO SOCIETY OF ITEM RlIftal ID z ..;x. ........ • ....Steve.:f. lttrsCtl t... s- .: ......... ....... SO . w. •osxowranasss�r� ............. st. Croix OL owes, I we Ibb .......w........ i� It�. pe� �: . . t! i.. .....-....._.w :.. �'ian to we..know aRi►ts sss Qr,wisv�iii� ' resat and of ems►�ai�s a �;,,�.- , I r W< .�; li�II • • H z . cn . a r ST C - 105 r a H SEPTIC TANK MAINTENANCE AGREEMENT 00 St . Croix County z d a H OWNER k&idbM Raj & Joan C'arske � ROUTE/BOX NUMBER 205 E. First Fire Number ,/, CITY/STATE New Richmond, Wi. ZIP 54017 PROPERTY LOCATION : NE 1&,NW 14, Section 5 T30 N , R18 W, Town of Richmond St . Croix County , Subdivision n/a Lot numbern/a . 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 put into I` 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. Ho E I/WE, the undersigned , have read the above requirements and agree E to maintain the private sewage disposal system in accordance with M, the standards set forth , herein, as set by the Wisconsin Depart- v 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 Q 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 . 'MENTOF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUST INDUSTRY, DIVISION 'LABOR P.O. BOX 76 HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 (H63.090)&Chapter 145.045) LOCATION: SECTION: TOWNS HIP/A8I��Y: OT NO.:BLK.NO.=SUBDIVISiON NAME: NIP. �� 5 /T 30 N/R181 (or)W Richmond rnla n a UNTY: OWNER'S MME: MAILING ADDRESS: St. Croix New Richmond Wi. 54017 USE DATES OBSERVATIONS MADE L_;PNO.BEDRMS.: COMMERCIAL DESCR77PNew PROFILEDESCRIPTIONS:IPERCOLATION TESTS: Residence 3 n/a ❑Replace ( 3_24-87 n/a RATING:S=Site suitable for system U=Site unsuitable for system ONVENTIONAL: MOUND: IN-GROUND•PRESSURE: S STEM-IN-FILLHOLDING TANK:RECOMMENDED SYSTEM:(optional) ®S ❑U ®S ❑U ®S ❑U ❑S x❑U ❑S A conventional 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: Flood C1aSS 2 plain,indicate Floodplain elevation: n/a decimal' PROFILE DESCRIPTIONS page27 BxC2 BORING TOTAL PTH TO GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH NUMBER DEPTH IDS ELEVATION D OBSERVED E HES TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- 1 7.66 100.91 none 6.91 .83bl.1. 1.25bn. s.sil. 4.83bn.l.s. .75gy. mot.si . B- 2 7.00 100.67 none >7.00 .75bl.1. 1.25 bn.s.sil. 2.67bn.s.1. 2.33bn. c.s. B- 3 17.00 100.66 none >7.00 1.08bl.1. 1.92bn. sil. 1.25bn.s.1. 2.75bn. c.s. B-4 7.00 100.26 none >7.00 1.00bl.l. 1.83bn.sil. 1.50bn.s.1. 2.67 bnx.s.& . B- 5 6.91 100.57 none >6.91 1.08bl.1. 1.83 bn.sil. 1.50bn. s.l. 2.50bn.c.s. B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH P_ P- P_ n a s e design rate P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION 97.16 31 :k0~I x tA\ _ k � `3�-`-I tN e I ft ) I,the undersigned, hereby certif(�&4tt soijtests r eported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code,and that thded and the locatipmo the tests are correct to the best of my knowledge and belief. NAME(print): ` TESTS WERE COMPLETED ON: Gary L_ St-pel ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): CST 05NATU E: L � - DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) —OVER — L_ Ray & Joan Garske W4NW4 S.5-T30N-R18W ' Richmond, township �o s� 12-0 I 000�\A TO svp-�\C- A -I lee (�Q�m 12 -s [ALP i pi �G Z7Zg k 1r 7 Gary L. Steel 988 N. Shore Dr. New Richmond, Wi. 54017 MPRSW 3254 Od - I i e0 !NI - A 1 to' 3 c o 11 _ t I r- r DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTRY, c DIVISION HUM N RE4LATIONS PERCOLATION TESTS (115) MADISON WI 53707 (H63.09(1)&Chapter 145.045) LOCATION: SECTION: TOWNS HIP/ {8Lq6dY: OT NO.:BLK.NO.: SUBDIVISION NAME: NE 5 /T30 N/R18f (-r)W I Richmond In/a n/a n a COUNTY: OWNER'S MME: MAILING ADDRESS: St. Croix Rc)(-JetV New Richmond Wi. 54017 USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: II PROFILE DESCRIPTIONS:1PERCOLATION TESTS: Residence 3 n/a �New ❑Replace L 3-24-87 n/a RATING:S=Site suitable for system U=Site unsuitable for system LL CONVENTIONAL: MOUND: IN-GROUND-PRESSURE:S STEM-IN-FILLHOLDING TANK:RECOMMENDED SYSTEM:(optional) ®S ❑U ®S ❑U ®S ❑U ❑S ]U ❑S x❑U conventional If Percolation Tests are NOT required DESIGN RATE: 9 If any portion of the tested area is in the under s.H63.09(5)(b),indicate: Class 2 Floodplain,indicate Floodplain elevation: n/a decimal' PROFILE DESCRIPTIONS page27 BxC2 BORINGI TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER IDEPTH ljX ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- 1 7.66 100.91 none 6.91 .83bl.1. 1.25bn. s.sil. 4.83bn.l.s. .75gy. mot.si . B- 2 7.00 100.67 none >7.00 .75bl.1. 1.25 bn.s.sil. 2.67bn.s.l. 2.33bn. c.s. B- 3 7.00 100.66 none >7.00 1.08bl.1. 1.92bn. sil. 1.25bn.s.l. 2.75bn. c.s. B-4 17.00 100.26 none >7.00 1.00bl.l. 1.83bn.sil. 1.50bn.s.1. 2.67 bn.c.s.& . B- 5 16.91 100.57 none >6.91 1.08bl.1. 1.83 bn.sil. 1.50bn. s.l. 2.50bn.c.s. B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH P- P- P_ n a s e design rate P-- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION 97.16 le �4-- kd d I 6r� E _ . 9 �� _ y r l tN E , �. . . ._ 3 E 4-4- i a _. _- __� � j I I`.,....._" ... S �:� i tt � }.. ..., ..... r ,.,._..�..._..„_ ........ _ ii .F5 ri I 4 l y F MAP I,the undersigned, hereby certif t the soiI vDaporied dQ,q is form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code,and that the recordeft{ a locati0:n--cqI the tests are correct to the best of my knowledge and belief. NAME(print): '� � � TESTS WERE COMPLETED ON: Gary T.- Steel- ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): 9A8 N- Share Dy- New Ridblaond, Wi_ 54017 910 1/ -71 CST 91 TU E: DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) —OVER — { Y INSTRUCTIONS FOR COMPLETING FORM 115- SRD - 6395 To be a complete and accurate soil test,your report must include: 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 3. MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS AR E RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A separate sheet may be used if desired; 3. Make sure your benchmark and vertical elevation reference point are clearly shown,and are permanent; 0. Complete all appropriate boxes as to dates, names,addresses, flood plain data, percolation test exemp- tion, if appropriate; 10. If the information (such as flood plain,elevation)does not apply, place N.A.in the appropriate box; 11. Sign the form and place your current address and your certification number; 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st - Stone (over 10") BR Bedrock cob Cobble (3- 10") SS - Sandstone gr - Gravel (under 3") LS Limestone s - Sand HGW - High Groundwater cs - Coarse Sand Perc - Percolation Rate med s - Medium Sand VV -- Well fs - Fine Sand Bldg - Building Is - Loamy Sand > -- Greater Than 'sl Sandy Loam < - Less Than 'I - Loam Bn - Brown `siI - Silt Loam BI - Black si Silt Gy - Gray cl - Clay Loam Y Yellow sci - Sandy Clay Loam R - Red sicl - Silty Clay Loam mot - Mottles sc - Sandy Clay s,r - witlr sic - Silty Clay fff fevv, fine,faint N Clay cc - cornmon, coarse p t -- P(at mm - Marry, rnedium m - Muck d - :distinct p - prominont HWL - High water level, Six general soil textures surface water for lirluid waste disposal BM - Bench C,iark VRP Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit.The county or the Department may request verification of this sail test in the field prior to permit issuance. A complete set of glans for the private sewage system and a permit application must be subrnitted to the appmpriate local authority in order to o"')fain a permit. The sanitary pr;rmit mast be obtaliwd and posied prior to 'ho start of any corrstrr.rction. FILED . Mats 0• lh 431023 a"hfw c �; CERTIFIED SURVEY MAP S5�Located in the NE1/4 of the NW1/4 and"theNW1�4 of S'ecticaf 5 _cT3©N; ,R18W,C'To*a 6f,1--Ricbm6dd; (.S-t' Croix County Wisconsin, USA UNPLATTED LANDS L (231') r--NORTH-SOUTH 1/4 SECTION LINE-n m in TOWN ROAD �40 NO°18'33"W M 226.04' NO 018'33"W M 300.71' I y 0 m_ O In `rte v �pz SI/4 COR ER (30 NO°IB 33'W i., M M NO°18'33".W 285.29 b/ Q� SECTION S W M 193.03 N EXCEPTIO N zrnH co VOL. 32 a �o 33' 33' a pp 38 "' - w M (y _M N N h 0 O ly 0/ O M °I / ,,. M o1 N NSE N v �00� o OD m \ ap O on M /00, O 3 y 13 2.00' pp n w w NO° 18 33 ),(�� u o a3a3 ro ° oo °vo in r, w 3� P _ H U-' F. _ W o /' W 8 d M N W K K I° —yam W O a o a 0 J ey U. to 0 - ~ 0100 M 0 / mm � z_ w o a y °1 J O J 0z ti x M Z 0 01 Surveyed For: 0 z 0 n/ / Alano Society, Route 5, N A M o �o• � n v a a � �/ New Richmond, Wi. N W W fa 0 00 z/ 01 W LEGEND ZI I c °I M - Section Corner Monument z •aezti0 Lq9 p 1"X24" RolInd Iron Pipe �o,°� , X40 weighing 1.68 lbs/Lin. Ft. oa / set. o- \ • 1" Round Iron Pipe Found v" y Q —L T 2 —', (231') previously recorded information r sy tl / al .� CLUB 1-9 y 133' 33' 3 °� Note: Lot 2 contains 77,011 Sq. Ft. 0n ' Z mN ; „ �P (1.768 Acres) Including R 0 W, U. o ha, �' 4 58121 Sq. Ft. (1.334 Acres) Excluding ° z R 0 W 0�`t{1��I1 ,1e x a a lo y HARVEY Q. s Z =� / JOHNSON HUD 8 98 AND MOWN*@MUM= if 10 Zn °N Bearings r6''P`ef6nced to the North line of 00 1 0-j 7 the NW1/4, assumed N89 29'51" v►- ez zw Z y Vol. 7 Page 1898 THIS INSTRUMENT DRAFTED BY, H.G.JOHNSON 487- 1271