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HomeMy WebLinkAbout040-1163-91-000 p N m O _'C C m CD N O M E N O C L C 2 C a� 3a~ r'oC7 m E No 0 o mm e ca)L° 3 CU4 m - r � 2 c, - o w o y C(LL)y N 0 mrm. N 3 I I T f6 O m m N 0�1 Opp m� w .1' r- -O 01'2 co'O m a)•O pp O N N O O C Z CMm C.'U (n C U. C D U+C C 3 v o mmE� NO Q vv 0.0 UZ w I 3 co Z N1 > w ''' E N U = O 0 a m to cli N F- Z O Z N FZ- I CD pEi N � I �i ,IIII'I r I Al ° O o Z Z O ICI', N m O cj o iI `n G 0 I a v Q o li N U) N a E z > I'' " 333 EL co 000 .� LL aaa a > a « N � c o N n o J U ' @ (3) CF) Z III N N O N O O 7 II E mIN � a � I I. C o IC) 3 S3 i co N E o w m e m = a o 0 v o ! u> C C _ _O 61 C C C N N N m N N V 1� O 3 O O y d 7 N M 4r� N H I C y Z Z C N (O Li W E E .� t ~ O N E I! 0 0 O 0 O 0 cn • ' N H V � akaljL: aa A 0 a OtoU 02/25/2014 04:59 PM PAGE 1 OF 1 Parcel #: 040-1163-91-000 040-TOWN OF TROY Alt. Parcel#: 25.28.20.634E ST. CROIX COUNTY,WISCONSIN Current X lication# Permit# Permit Type #of Units Creation Date Historical Date Map# Sales Area App 00 O Owner(s): O=Current Owner, C=Current Co-Owner Tax Address: O-ROSE, DENISE MARIE DENISE MARIE ROSE 260 GLENMONT RD *=Primary RIVER FALLS WI 54022 Property Address(es): *260 GLENMONT RD Districts: SC= School SP= Special Type Dist# Description SC 4893 SCH DIST RIVER FALLS SP 0100 CHIP VALLEY VOTECH Notes: Legal Description: Acres: 5.100 SEC 25 T28N R20W 5.104 AC NW SE LOT 1 Parcel History: C.S.M. 7/1940 Date Doc# vol/Page Type QC 10/14/2010 924615 WD 02/05/2008 868358 VAC 10/28/2003 744965 2444/21 QC 07112/1988 439371 816/391 more *=Primary Tract: (s-T-R 4ov<160%) Block/Condo Bldg: Plat: 2 * 1940-CSM 07-1940 040-88 5-28N-20W NW SE LOT 01 Bill#: Fair Market Value: Assessed with: 2013 SUMMARY 235625 231,400 Last Changed: 11109/2009 Valuations: Land Improve Total State Reason Description Class Acres 263,600 NO RESIDENTIAL G1 5.100 96,000 167,600 Totals for 2013: General Property 5.100 96,000 167,600 263,6000 Woodland 0.000 0 Totals for 2012: 5.100 96,000 167,600 263,6000 General Property 0.000 0 Woodland Lottery Credit: Claim Count: 1 Certification Date: Batch#: 207 Specials: Amount Category User Special Code Special Assessments Special Charges Delinquent Cha 0 00 Total 0.00 0.00 //// �.c.s,C.•: �f=t^'i` /9 �� �L.*, .�->-Y<�,_�•j�6�-l� ,% c. �}�' / �✓yr. 5- 9 434445 / c- _.S 7 9 el v N fEdit JAMES o'CON.uELL (\� Re. reds St.Ctc't"a..WI / CERTIFIED SURVEY MAP Located in the NW 1/4 of the SE1/4 of Section 25, T28N,R20W, Town of Troy, Y St. Croix County, Wisconsin. Surveyed for: Eagle Enterprises c/o Del Einess 5100 Edina Industrial Blvd. LEGEND Edina, Minnesota 55435 SECTION CORNER MONUMENT -PRO( 89�3I 18F�E )�1€� SUBVfY MAP O I"X 24" IRON PIPE WEIGHING 1.68 LBS./LIN. FT. SET S 690 3604 "E 329.65' 0 1" IRON PIPE FND. 263.65' 66. 00' • I" 0.D. IRON PIPE SCALE IN FEET 1'x•100' 0' 25' 50' 100' 200', I WW F 1-oo QI LOT WO MY MY � 222348 SO. FT. °` zyzo >-I I 4 5.104 AC. - Wvao WIt01 INCLUDING RIGHT- 0 >I(0j tp �I ti - OF- WAY K F N OO OI(D 'I ip !D _ _j I t0 ` ozz ylp.l N M O M i=y° -W i I -W ,o 160899 SO. FT. �0 > cr I-yD Wj"'I .r 3.69 AC. %Irmo 4,IJ M _ EXCLUDING RIGHT- - Z tol mzoa 101 0 pt .. OF - WAY _ t W t0 W h. W�>1 0 W a� 01 O CO . N¢ rn 1 I W MI/INgp� W to - 3 001 O ��'�� / i� a, 3 tO10 Z 'c'1 'I :1�t HARVEY G. t o ° JOHNSON - - o Z p 5-1899 = o o Z HUDSON 1 z to W IS. ° • NI/4 CORNER f 0 SECTIOI`j. 25 ` V' �2 S88° 66# 28"E 263 ' —o� - .7O 6 k oil Wu 329.71 ZW O +'j" zvW GLENMONT RpAp_ o> W z o ti - - - - 269.68` _ o N89 56. 5 I E S89° 56' 57 ".W 329.69 SOUTH LINE 0 657.31 I OF THE NW 1/4 OF THE $ _UNPLATTED LANDS_ SEI/4 z � • t W i IRON PIPE TO BE SET AT CORNERS M � �.ppErr S1/4 CORNER c_ 588 o 36� 28"E DETAIL NOT TO SCALE SECTION .25 °z 60 CCOMEHENSW PAM PL4NNM T28 N, R 20 60.11 ' CtJ111" S89° 56' 57"W i Detail of parcel to be dedicated as Town Road right-of-way. - w87-/3,Z 2 �wG Vol. 7 Pg. 1940 I ST. CROIX COUNTY x, WISCONSIN a. ZONING OFFICE 796 2239 (HAMMOND) 425-8383 (RIVER FALLS) HAMMOND, WI 54015 January 15, 1988 Division of Safety and Buildings Bureau of Plumbing P . O. Box 7969 Madison, WI 53707 Dear Sir : Ala An on site investigation for the LeRoy and Jodi Jensen property located in the NW 1/4 of the SE 1%4 of S-ec-tTun tt-,T2tW-R-20W,Town of Troy, revealed suitable soils at a depth of 2 feet, below which bedrock was noted . This site should be suitable for a mound system. Should you have any questions regarding this subject, please feel free to contact this office . Sincerely, Thomas C. Nelson Zoning Administrator rc r PARTH!IENT OF R�., � � 'SAFETY& BUILDINGS INDUSTRY, SrWeIL, 'D ( ON SOIL BORINGS ANI DIVISION I LABOR A"° PERCOLATION TESTS 115 P.O.BOX 79139 HUMAN RELATIONS. ESS MADISON WI 63707 IH63.090)&Chapter 145.045) �� ' i I TOWNSHIP/ O N0. LK.NO.: SUED VI 1 7�/qy I NL� �j 4 25 ITzB N/RZVE( w TROY C. S. I�1. E,t.b f�r'.J � COUNTY: M . StcRO(K Le ipo 3 rOD, Trvxr v L1_3 7.z? 6'1cvX v,esr ut a 7 ^V DATES OBSERVATIONS MADE tom► DESCRIPTION: G uResidsncs 3— 4 f(f, d New ❑Replace I *ATINC:S.Site suitable for system Um Site unsuitable for system NV N : MfO''UUND:((�'�'t���� IN ROUN S M• -FILL OLDING TANK:RECOMMENDED SYSTEM:Ioptional) SoQ�-fGT S ©U as DU ❑S ©U ❑S D S � )4 o U.v v O,v[_y — Tc MPROVAL 13y COOA� If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the ` tNIdK s.H63.09(5)1b1,indicate: Floodplain,indicate Floodplain elevation: PROFILE DESCRIPTIONS 904-ING TOTAL P H T R NOWATER-INCHES HARACTER OF SOIL WITH THICKNESS,COLOR,TEXT TURE,AND Ot:PTH. NUMBER DEPTH IN, ELEVATION BSERVED H TO BEDROCK IF OBSERVED SEE ABBRV.ON BACK. r r l �• �, �, O 3. L , 1'3�' . .OR• J. 2.7— /`/` $N-Gy. S1 PeNse IAJDED 56"Cli LD 1,O' SATAA'kp / /O ' nK 2_ 6 ' ? �1_ jr.2— 7.0, > 3 U AT 3y. O' fR,1c.7dRE0 . tj > 4 Bu" Z. st A?-3, s 17. - f .. i lil�7 3 i 2v- ? .3 i.o ' 3N- y y. S t 1. 33' �u S I , A r �.3 • -cR�+�r. 'M c -I-o.3 a j 3, 3 ` 3, 3 o ' ��-. `5 sy. sr 1, I. S• ��►_ �r S, 1, 1' 1( • -DK I 5470- A^*eo g A T 3,, ` 4o S'.O' Lt M E S't'M EEa e o UAa T1 I000 PERCOLATION TESTS DEPTH . WATER IN HOLE TEST TIME I W LEVEL-INCHES ER INCHES AFTER SWELLING INTERVAL•MIN. MINUTES--- INCH 1P.7 I k i P: I To c o r .f 4 rf e.�- w 2 o u,u 13 u f IZ co .0 T s 'T o rl oUAJ Colwr O R i F I C.})y Ao o i 13o i A-1G *PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances.Describe what are the hors• 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 IWW slope. YSTEM ELEVATION '1•o S3 E DeZ>r R M 1 its @ D A rt e R -fu R` l a_ '�E sir t Ps Cr._ ' f • i 4 k 4 M ^ND Tr' S11111 50 L I �1 . ' . P M - r t co L_ -- k 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 strative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. ; ME k i (print): HOMESITE SEPTIC PLUMUNG CO. TESTS WERE COMPLETED ON: RT.3 OWEIL RD..HUDSON,WIS SE PT'• ROBERT ULBRICHT CERTIFICATION NUMBER: PHONE NUMBER(optionaq: ASTER PLUMBER LIC.NO.3307 M.P.R.S. 2 y �Z_ 341 (p CST SN IG zV 1BUTION:Original and one copy to Local Authority,Property 0,•�ner and Soil Tester. ENT OF IT &CUILUIIVUO RY DIVISION ,ACOR ANO PERCOLATION TESTS (115) P� 2- MADISON,-WI 3 07 009'U (1,163.090)RELATIONS (H63.09(1)&Chapter 145.045) ATI� ,, SECTION: a T �.:BLK,NO.: SU��SIGON.NAME: ,Jjg) /4 / y5 /T Z1 N/R1 E(or)W ITOWNSHIP/mmetpAmy: TRol►' �C! COUNTY: BU ER'S NAME: MAILIN ADDR S '� 5+CRoi X j&eoy 7017) TE:AJ 5EN 1372-7 67&,,uAvfst AW•So. YS-fa4e-� ^IAO,<J USE DATES OBSERVATIONS MADE NO.3BEDR IAL DESCRIPTION: TESTS: Residence r N,4, New ❑Replace ' r /I - �� ]'. p ■- �? RATING:S=Site suitable for system U=Site unsuitable for system f ONVENTIONAL: MOUND: IN-GROUND-PRESSURE:S STEM-IN-FILL OLDING TANK:RECOMMMEN SYSTEM:(optional) osou �s0u as �u as au 0 s21u y If Percolation Tests are NOT required DESIGN RATE- (If any portion of the tested area is in the under s.H63.09(5)Ib),indicate: GG/f S S Floodplain,indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROU NDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIG HE TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) !� c' G,P j r"', 1.33• U-i�•�. 6y. S• , •s �Ar- , AEwW B6 6,0 ' 7 ,� ' 3. 3 wj�.��. Ok-&yam= 1. s 'SATOW&d 1.4. OA3. st . B-7 G,o 1/' D 3. 0 X4 S1 set 4 TE0 , I �, � 8 1.s BN-SJ! s' ' S ,a , : d�. o d. B- �0 i 5 S 3.S �, ,f.Ri. oR-6y.tivts ,s cs I.s s"tWR�l o sl r B-� • 5 ' 1.S ' Di'g,,,. Si � If T 1� ut- B/O 2- 5 �lGy ' ?�— ' 2� 5 • �•2, 5�' - fR4cTn,se*-v /- 16-S .►r ,Z, v ' /075 .75'x&#- P-4?/ 0-") ,7s '41.a. ?y, � B 2. D s ' o,�. Co v,Q s-e- 5/ . o ' -���a.e .".C_ of tip CS PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATPER IINCH ES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. P O I P- 16t 00 30 Z VI& Z 2-P- P- Y o/.f0 ' P_ P• Ov' PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances.Describe what aro 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. .5,4No/Rock IN- r_RfACE 10 -2 ,0 ' f SYSTEM ELEVATION /N t9C R T O F I " S't R Q V T toN �� E = /� 2 • S i � - I _ ' �co�..�• � py S�T� j/�i��F:cr�T'ro-v ' � A.u°,°-,e!r���__ o I�' �N ,, 5T. CRoi, X Co>J.�,T �o,�rr�4- _r_ 4�! r' i i , _ - 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): jmoi(E SEP11C PLUMUNU CO. TESTS WERE COMPLETED ON:: �. 3 O'NEIL RD.:HUDSON:MS.54018 IseQT• i _ i ` ADDRESS: ROBERI UWRICHI CERTIFI ION NUMBER: PHO NUM E o tional): -*',Itk PLUMBER LIC.NO.3307 M.P.R.S Z �Z— ( CST SIGNATURE• DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) -OVER - If m v • o �N S PERCOLATION TESTS IIS REPORT ON SOIL B R C� pEl �r�csS �ot- ar Poor FLAN PRoTEcT t• D. j DArr- i3�yERS . 500 , LERoy 7c-AjSth) I HOMESITE TESTING CO. RT.3, O'NEIL ROAD BOB ULBRlt;jj iriuCiyOol, WIS. •.r 54016 es r ST-02 y02 i PROPOSED %oosE m os r Lie 2� Fr. o,t m etr, "oar •911- TEST AAC,4S•, PRoPOSE0 WELL Mvsr LIE S0 FT Olt / vAr F-fol" '41.4 rE'sr A.M.45. e = Q/jceh(E /��f O = EXisrlV 6- DELL X � �EQG /AC�►f/GN/f � s NCNB Ad9E�E0 o,Q S�aVEL /.3c�ES BM VFRfic,�� ,QEfERt-wcE Poi�r' To/� of � „ ��PE IS ' BAs 1— OF RORe /0 LE GE N D e&VhroN of I/Of. kEi. /0 0, 0 ' L% �, J T H E ES J SL Qu%J&RS 15° I 3i 1 'PRopes V v c oP rouN v 33 . �9 V 46/ rot �� uh r1oN 79 GO 3 $ �5 ueQT • 2�+0 N/VE RT• , REF. pr• W RAF• 4T. � , TOP of bo 75 3o . ffz o iQ B` cowo p , V. 3�/ $ •� - 150` '• �g So ii � _ �j�5 (�PPRbXiMATE�Y �S 10 d� E��E FR o a5 IRON x Parcel #: 040-1163-91-000 06/27/2006 12:35 PM PAGE 1 OF 1 Alt. Parcel#: 25.28.20.634E 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): O=Current Owner, C=Current Co-Owner SHARON, &JANET TOMLINSON TANSOM O-TANSOM,SHARON, &JANET TOMLINSON 260 GLENMONT RD RIVER FALLS WI 54022 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description "260 GLENMONT RD SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 5.100 Plat: N/A-NOT AVAILABLE SEC 25 T28N R20W 5.104 AC NW SE LOT 1 Block/Condo Bldg: C.S.M. 7/1940 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 25-28N-20W Notes: Parcel History: Date Doc# Vol/Page Type 10/28/2003 744965 2444/202 VAC 07/23/1997 816/391 07/23/1997 803/260 06/18/1981 371547 631/094 QC 2006 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.104 71,500 190,300 261,800 NO Totals for 2006: General Property 5.104 71,500 190,300 261,800 Woodland 0.000 0 0 Totals for 2005: General Property 5.104 71,500 190,300 261,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 207 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 i Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT �ifoti ��I,c�So,✓ D ZS 21 OWNER J Q� I-11U.OA) TOWNSHIP /W SEC. T N-R � S -ri-c�o.y r ADDRESS ST. CROIX.COUNTY, WISCONSIN }: } r -L--� d fit,. ��/�S ���5' • . , SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of ILHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM + 7 V s r # f Y V o r g • r r f f. INDICATE NORTH ARROW To OF /O BENCHMARK: Describe the vertical reference point used -'ffT 0f `41DU4-`12 7"O E— Elevation of vertical reference point: Proposed slope at site: C? 90 Ca Lf So SEPTIC TANK: Manufacturer: e"OWC-? Liquid Capacity: Number of rings used: (/")Tank manhole cover elevation: 103, 2-9) Tank Inlet Elevation:/00, 1 8 Tank Outlet Elevation: �� O• Number if feet from nearest Road: Front,©Side Rear, O > 2-00 feet From nearest property line Front 10 Side,QRear,0 feet. i � 1 Number of feet from: well 5 , building: 22 (Include this information of the above plot plan)( 2 reference dimensions to septic tank -f. SEE REVERSE SIDE �t/$D AAA PUMP CHAMBER Id Manufacturer: �6,�1 �'�-' Liquid Capacity: 0 I �S 7� Pump Model: Z �d��� k Pump/Siphon Manufacturer: "� � Pump Size 1Z HP S j 14l f"71-C q Elevation of inlet: �� Bottom of tank elevation: Pump off switch elevation: / � ' /0 , y Gallons per cycle: Alarm Manufacturer: # lip tl ' 4-m d Alarm Switch Type: U. r x � Number of feet from nearest property line: Front, O Side, Q Rear, Ft✓_O Number of feet from well: • Number of feet from building: 2, 7 (Include distances on plot plan). SOIL ABSORPTION SYSTEM IA1d l i Bed: �/ d 3,f Trench Width: Length: Number of Lines: P Area Built: 1-- F T Fill depth to top of pipe: I 'y LV ""7 Number of feet from nearest property .line: Front, O Side, © Rear,0 It s Number of feet from well: 10 7 Number of feet from building: ' (Include distances on plot plan). SEEPA PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or stribution box O been us on any of the above soil absorbtion sytems? (Check one) . HOLDING TANK Manufacturer: apacity: ' Number of rings used: levation of ttom of tank: Elevation of inlet: Number of ft property line: Front, ide, O Rear, 0 Ft. _._r.__ • f feet from well: feet from building: Number of feet from nearest road: Alarm Manufacturer: oo Inspector• Dated: Plumber on job: S Or' A License Number: g-D HOMESITE SEPTIC PLUMBING CO. 655 O'NEIL RD.,HUDSON,WIS.54016 ROBERT ULBRIGHT 3/84:mj WIS.MASTER PLUMBER LIC.N0.3307 M.P.R.S. MINN.INSTALLER&DESIGNER LIC.NO.00663 , Q Of LT {SLOT }?L- ^Z orc9- 3a /0 � 6 l B T b � n� 5 , 0 3 �s Y D Af Alf ets i f �d , �o� r►'I' . • �Ew r �` plea, - /d3,0 ppN po`'s T YPA- flAol el / -7Y 0 0 sod a� ' V � �0F7ER Patio 3 �� ion// � � 7'�I,uSo,✓ �7jj�''�E J I HOMESITE SEPTIC PLUMBING CO. 655 O'NEIL RD.,HUDSON,WIS.54016 ROBERT ULBRIGHT - WIS.MASTER PLUMBER LIC.NO.3307 M.P.R.S. \ MINN.INSTALLER&DESIGNER LIC,NO'00663 �� S a 0 ► - �' .. CROIX COUNTY 7ST. rr WISCONSIN ZONING OFFICE r r r r r r r r r ■, ; M8ST.;'CR61x COUNTY GOVERNMENT CENTER 1101 Carmichael Road rac_-- <• ` z r -7710 oFicF , --� (715) 386-4680 SEPTIC INSPECTION_/-� TEST REQUEST FORM Please specify desired test(s) & remit appropriate fee with application. Outside water lines are often turned off during winter months, making access to the home necessary. Please make arrangements with this office to insure that entry can be gained. 0 Water (VOC's) $135. 00 0 Septic $50.00 :( Water (Nitrate & Bacteria) 45.00p,! ` 0 Nitrate & Bacteria in Water (Lead Concentration) 21 .00 retest $15.00 1 c Owner: .fie• , (or v.�d„`t �� C�Cs„�oy� Requested by: Address:A(,o C � h�%r _ Address: C ia4u. Lt 1. _ZIP.EF � _ ZIP Telephone N°: (7L5- ) q2 _fig,j-aj Telephone W: ( ) Property address (Fire If & Street) : geo Location: ; , ;, Sec. , T N, R W, Town of Realty firm: Lock Box Combo: Closing Date: 0q0 _ 11 W- q 1 -000 af;, a8, a0. 0 y4-1, TO BE COMPLETED BY PROPERTY OWNER *PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORM Water sample tap location:6,A5ac 6,4 Is the dwelling currently occupied? Yes 0 No �P If vacant, date last occupied: Age of septic system: Septic tank last pumped by: Date: Previous Owner's Name(s) : Have any of the following been observed? OY ON Slow drainage from house. OY ON Sewage Back-up into dwelling. OY ON Sewage discharge to ground surface or road ditch. OY ON Foul odors. Other comments relative to system operation: I certify that the above information is complete and true to the best of my knowledge. v OWNERS SIGNATU DATE:, 1 /94 C-lleo�ed 7h/qg OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION 1N L J Ej TO BE COMPLETED BY INSPECTION AGENCY System design &/or permit on file? OYes ❑No Soil series per SCS Soil Survey: sheet # Type of soil absorption system: OBelow grd ❑At-Grd OMound Approx. size ' X OGravity ODose ❑Pressurized ❑Bed OTrench ❑Dry Well Molding Tank 00utfall pipe OBSERVED DEFICIENCIES ❑Other OUnknown Septic tank Setbacks: ❑House OWell ❑Prop. line ❑Other Dose tank Setbacks: OHouse ❑Well. ❑Prop. line ❑Other ❑Locking cover OWarning label ❑Pump/Floats ❑Alarm ❑Elec. wiring _Soil Absorption System Setbacks: ❑House OWell ❑Prop. line ❑Other OPonding: ODischarge: General comments: N INSPECTORS SKETCH OF SYSTEM LOCATION Inspector Title - --- -- --- ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 - '---— (715) 386-4680 �I July 17, 1998 Jan Tomlinson 260 Glenmont Road River Falls, WI 54022 RE: Water Test Results for Jan Tomlinson and S. Tanson located at 260 Glenmont Road, Tn of Troy, St. Croix County, Wisconsin Dear Ms. Tomlinson: Enclosed are the original water test results from Commercial Testing Laboratory for a water sample that was taken at the above referenced property. If you have any questions regarding this, please call our office at (715) 386-4680. Sin ely, Rod Eslinger Assistant Zoning Administrator Enclosure sm COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715-962-3121 800-962-5227 FAX - 715-962-4030 4 ST, CROIX COUNTY ZONING OFFICE REPORT NO.: 67149/01 PAGE i ST.CROIX CTY GOV.CTR REPORT DATE: 7/93/9$ 1101 CARMICHAEL ROAM DATE RECFIVED! 7108/98 HUDSON, WI 54016 ATTN: JIM THOMPSSON II I OWNER: Jan Tamlinson / S. Tanson LOCATION: 260 Glenmont Roadt River Falls, COLLECTOR: Rod Eslinger DATE COLLECTED: 7-07-96 TIME COLLECTED! 3SO4pm SOURCE OF SAMPLE: Kitchen tap DATE ANALYZED:7-08-98 TIME ANALYZED: 2:043pm COLIFORM,MFCC: 0 /100 mt INTERPRETATION: Sacteriqi.ogic:aLLy GAFF NITRATE-N: 5.3 ppm Above 10 ppm exceeds the recommended Public Drinking Water Standard. CoLiform Bacteria/100 ml Nitrate-Nitrogen, mg/L LAD TECHNICIAN: Pam Gane WI Approved Lab No. 19 4 Means "LESS THAN" DetectabLe Level Approved by!