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HomeMy WebLinkAbout042-1099-50-000 7 0 � CD � { j 2 � . ; c9 §2 # « ` E— (D c % , � EE2 « 0 10 f % z_ E§ E� 2 � ) 20 0 ■ a § < R< oE3 \ c N f § § / . co U) - & z / LO § I ) § � \ , \ $ � 7 ) § 7 � �} � \ k k \ � \ � � 3 Its � � k E § I ) o k a § < m _ \ ] K K K 0 " 2 a a a IL \ \ Co 00 o £ f 2 . � \ \ & / E ® i t � < t ± a. z © o S2 O 9 <04 c 1 c ) a e k � $ (D c a o LO 0 4 n @ § ` � ° ° ° B k k ® \ 3 a c & \ \ s E ■ = e S r \ ' ` c - � ~ c ~ o k 0 2 3 § a _ o z $ w z ■ A e a D � � IL � (L � E� � : ka § 0 0 0 2 v ti Parcel #: 042-1099-50-000 02/01/2006 09:28 AM PAGE 1 OF 1 Alt. Parcel#: 35.29.18.552A 042-TOWN OF WARREN 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 DEAN C&GLENDA J HANSEN O-HANSEN, DEAN C&GLENDA J 636 140TH ST ROBERTS WI 54023 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description *636 140TH ST SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 37.000 Plat: N/A-NOT AVAILABLE SEC 35 T29N R18W 37A NE SE&PT SE SE Block/Condo Bldg: EXC PT TO CONSERVATION COMM AS IN VOL 393 P 70 ORD Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 35-29N-18W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 1171/611 WD 07/23/1997 798/241 LC 07/23/1997 393/70 2005 SUMMARY Bill M Fair Market Value: Assessed with: 79832 Use Value Assessment Valuations: Last Changed: 07/12/2005 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 37.900 3,300 0 3,300 NO UNDEVELOPED G5 0.500 100 0 100 NO OTHER G7 3.000 18,000 69,700 87,700 NO Totals for 2005: General Property 41.400 21,400 69,700 91,100 Woodland 0.000 0 0 Totals for 2004: General Property 37.000 21,300 69,700 91,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 128 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 SANITARY PERMIT APPLICATION COUNTYr, � DILHR In accord with ILHR 83.05,Wis.Adm.Code ss7—� Cn fkl X 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. S 3'74�o —See reverse side for instructions for completing this application. PETITION I. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES [9 NO PROPERTY OWNER PROPERTY LOCATION r '/4 '/a, S ,� TA , N, R /$r E(or PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER IBLOCKNUMBER SUBDIVISION NAME iR r fi <` S' - CITY,STATE ZIP CODE PHONE NUMBER 77 CITY NEAREST ROAD,LAKE OR LANDMARK 7 r +4e66Z ❑ VILLAGE : II. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family OR ❑ Public(Specify): III. PURPOSE OF APPLICATION: (Check only one in##1. Check##2,3 or 4,if applicable) OSn 1. a. 1j 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.k Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. 9 seepage Bed b. ❑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): ;75 ? Feet Private ❑Joint ❑ Public VI. TANK CAPACITY Site in g 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 Lj Lift Pump Tank/Siphon Chamber VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system show on the attached plans. Plumber's Name(Print): Plumber's Signature:(No Stamps) M PRSW No.: Business Phone Number: lumber s Address(Street,City,State,Zip Code): Nanfe of Designer: TCsJ VIII. SOIL TEST INFORMATION Certifi r(CST)Name II -- CST# CST' S( tree,City,State,Zip Code) \ Phone Number: LJ G U l 1�G ��� IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved S itary Permit Fee Groundwater ate umg Agent Signature(No Sta s) Approved ^l Wcharge Fee pp ❑ Owner Given Initial L �� � n , Adverse Determination �N X. COMMENTS/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 Kermit 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'h 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 —' included the creation of surcharges (fees) for a number of regulated practices which Wisco tn'S can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried reasurs a 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. 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) DEPARTMENT OF INDUSTRY INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR& HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON,WI 53707 NE'4,SE'4jS35j29N-R18W 1:1 CONVENTIONAL ❑ALTERNATIVE (Itfassglnedj jD.Number: Town o Oa4Aen ❑Holding Tank ❑ In-Ground Pressure U Mound S88-03767 NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE. Dean Hanson Route 1 Robed All 54023 BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN. REF.PT.ELEV.: CST REF.PT.ELEV.. Name of Plumber: MP/MPRSW Nn. Cn�nty Sanitary Permit Number. wiUiam Schumaken 6383 St. Cnoix 112784 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY TANK INLET ELEV. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: 1:1 YES El NO ❑YES ONO BEDDING: VENT DIA.: IVENTMATI HIGH WATER NUMBER OF ROAD. PROPERTY WELL. BUILDING: JVENTTOFRESH ALARM FEET FRAM. LINE AIR INLET OYES ❑NO ❑YES ❑NO NEAREST DOSING CHAMBER: MANUFACTURER. BEDDING- ILIOUID CAPACITY PUMP M(IDEL JPIMP SIPHON MANUf ACTIIFi E/l WARNING LABEL LOCKING COVER PROVIDED. PROVIDED: ❑YES ❑NO DYES ONO OYES ONO GALLONS PER CYCLE: PUMP AND CO NTROLS OPERATIONAL NUMBER OF PHOPf.HTV WELL BUILDING VENTLE FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) DYES ❑NO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing t f r 5 H JIIIAMFTEH JIIATIHIAL AND MAHKIN6 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 INO01 IIIISTH PIPE SPACIN(� COVER ,INSIDE DIA SPITS LIQUID BED/TRENCH TRENCHES MATERIAL PIT DEPTH. DIMENSIONS GRAVEL DE TH FILL DEPTH jD!ST R PI PF UISTH PIPE DISTR.PIPE MATERIAL NO DISTR NUMBER QF PROPERTY WELL BUILDING: VENT TO FRESH BELOW PIPES ABOVE COVER E EV.INLI f ELEV.END PIPES FEET FROM LINE AIR INLET. 1 NEAREST- - t• 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 PEHMANENT MAHKFHS oBSERVAnON WELLS _ OYES ONO ❑YES 1:1 NO DEPTH OVER TRENCH BED DEPTH OVER TRENCH BED 11111`111 OF TIIPS(IIL SODDED SEE DFD MULCHED CENTER EDGES E:1 YES. ❑NO DYES 1:1 NO [-]YES E:1 NO PRESSURIZED DISTRIBUTION SYSTEM: BE WIDTH LENGTH TR EONCH E$ LATEHAL SPACING [HAVEL DEPTH BE LOW PIPE FILL DEPTH ABOVE COVER DIMENSIONS -.MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATEHIAL NO T UI STR.PIPE DISTHIBUTION PIPE MATERIAL&MARKING ELEVAT'IDN AND ELEV.. ELEV. DIA. ELEV. JPIPES UTA.. '. DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORHECI LV COVER MATEHIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS ❑YES NO DYES ONO COMMENTS: PERMANENT MARKERS: JOBSERVATION WELLS. ;N UMBE.RDF -PROPERTY WELL: BUILDING: FEET FROM LINE: DYES 1-1 NO DYES ❑NO NEAREST ° Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE'. TITLE. DILHR SBD 6710(R.01/82) Zon'i'ng Admini6t Caton ����� ~� ��.Wisconsin lw []ep2MLm8OtOf Industry, Labor and Human Relations PRIVATE SEWAGE PLAN APPROVAL" aApsrY&BUILDINGS DIVISION office of Division Codes and Application 201 East Washington Avenue P.O. Box 7960 Madison, Wisconsin 53707 WEGI"RER, WEBER, AND ASSOCIATES Owner: DEAN HANSEN P.O. BOX 74 ROUTE 1 RIVER FALLS' WI 54022 ROBERTS, WI 54023 RE: Plan Number: Date Approved: September 6, 1988 ----���� t Received:D September 6 Gallons Per Day: 45� Date eue . ' 1988 Project Name: HANSEN, DEAN - RESIDENCE Location: NE,SE,35,29, 18W Town of WARREN County : ST CROIX Fees Received (Priority Review) : 160.00 The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval in based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped 'conditionally approved' . This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed Alumber responsible for this installation shall keep one net of plans with the mepartment a approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can he made. This approval will expire two years from the date approved or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires . The Section of Private Sewage has reviewed these plans for private sewage system code requirements only. These plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the Wisconsin Administrative node. This approval is for the following components only : - NEW MOUND I i is approval may be made by calling (608) 266-288D. Si PETER E. PHGEL»r � Section of Pr�Kate Sewage � Division of Safety and Buildings P13P013/0009n/15 cc: DEAN HANSEN Private Sewage Consultant County UW-SSWMP Plumbing Consultant;--- ---0wner ___Plumber --Plumbing Health N aoo'6423/n 10/87) Page 1 cf :�uI I; SYSTT� . F OR A Z BEDROOM FLESIDENCr P OF SECTION 3S , T 29N, R 18W, IN �� Ix COUNTY, WISCONSIN . n. OF w I��.Z Ei� �= INDEX PAGE 1 of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PA GE 3 of 6 PLAN VIEW-CROSS SECTION PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PA GE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE P REP A REL FOR p�t�ti I�F�NSEl\i 1:.0 �s TS , 1"i PREPARED BY mv► �,f..�.......... _ ., ., r.m ARTHUR L. •~ D615P � _ _ _ ra Wis.T' < .._G r .1 GIA L 6 19 3 Job { S88 - 03767 PLOT Scale i —? SONA�S�g�EM NS � R RE�pZ1O Rl, DtiPARE�� fl�sl vs A k svC�C�ES'I''LA W��. LuC.JC°n11►J S � � I Z5o s w .►Q , m J o w�o� LPC�1 SET AT 1�tPP PA x t M^Tt_ 1'100 1J� CpRI.]�'1LS J X1.9S 5- S -- � �9b- So or-2 pVC P2 ( 7 �N B•2 4 N ' i Do 14%T .,owe tilt cT OR D�STvRg `T�}IS Att.�,fl � I 5 EP 6 1933 N� ,TES S &8 - 037 6 7 1. Elevations shown are eristing ground elevations unless otherwise noted. 2 . Install cast iron pipe 3t onto undisturbed soil both sides of each tank. 3 . Install permanent markers at end of each lateral. ( /V required) 4. Install b" observation ripe with approved cap. ( Z required) 5 . Septic tank to be v000 gallon capacity as manufactured by -nch e<ati cr, n *1 O' oxJ 1"x 3" tNpoL� - _ - - •�- .�, �� - -;� . ..-�..:,.,:. r,_ .. ..0 �� �F':=_VJ�: �;;»D1�.1G F1T t�rHlLt. 51��. tl:ors'r iey, 0 Covering �, . Disiribut �on Pipe – Medium Sand _ H � T o P soil `---- I � D _J E 4/ Slope • Bed Of 2 Force Main \ Plowed z From Pump Loyer Aggr e OOl e D 1. O �T- E ) ,Z fT. Cross Section Of A Mound System Using F O R7 A Bed For The Absorption Area G D -�7 aN S-MA p /0 Ft. H 1 - S ;T. ONS SIC . 8 BIZ Ft. �'S 1 11 Ft. Ft. u1� g — G i��r,�,L ° �; Ft. Std 6 19853 �paR� �N fl a L _ -z Ft. ©NpENCIS W Z S Ft. 7I— — Observoiion Pipe l ! ---- ----------- --- -------- i )�Te-�zSi hT A t-------------------- ----------- oppuSl�E —� _ -------- -- - - --- �Disiribution Bed Of 2�– 2 Pipe Aogregote 1 Observation Pipe Permanent Markers 588 - 03767 r. - _ r - c.r —Rz , 1 :1 on Area r c Ph Gc � o F Pertoroied Pipe Deioll Z�" E ndV'er Pv c Fiat �QhA���Cop- w r.Diet loco�e! 0�11 E Dually Spaced i� \S • Q PVC Forct-µDin From Pump Q PVC f tAD ilole Fiat ,� Pipe �11 Lost Holt Should $[J I Nezt to End Cop End Cop Distribution Pipe Loyoul ONS�TE X 3� 1h• ElAZ10N5 Y 3� ) r ABQRAND AS,R Hole Diameter _ Inch MQARNMCNT Laieral QF IN tiY ;>ND Inch(es) pNl SAS' � __�___- CE Manifold 2_ Inches p ES Force Viain ' 2 Inches #DF We uL-5/PIPS �L I 6 " S88 - 03767 ' PLA l fiO t=E _ RDty �EJ3I�S�_ x,2AtQj f:6 D 1 73j-ZS Q C lib LE ZD T3E 1v�XT To '�fiC � P-=- --- . PUMP CHAMBER CRO55 SECTION tAAJD SPECIFICATIONS � E S of 6_ VCWT CAP ti°C.Z. VENT PIPC WCATHER PROOF APPROVED LOCKING JUUCTIOU DOX MANHOLE COVER WITH 2S FROM DOOR, wARN11J6 l.ABr=L .IINDOW OR FRESH 1t MILI. AIR IWTAKE I GRADE CONDUIT -- ti IO"MIAJ. � \ ---------- 5 ONSITE SEWAGJ�Sy,Sj-EM I - . IAI LE T � AIRTI T SEAL Ci I I I i APPROVED JOINT$ APPROVED JOINT A III W/C.I. PIPE w/C.Z. PIPE I II ALARM LXTEUDIM(a 3' OV EXTENOIW4 3' -DEPARTMENT d N TR�r, I UR UM RELATIONS I I ONTO SOLID SML ONTO $01-10 $OIL a OF S ILD S N'o ON C r Q I q 0,o SEE CORRES NDEN -j LLEV . F? _ Cr 9U MP 1 OFF D as.S COLICRETE 9LOCK 3"APPROVED RISER EXIT PLKMITfED OAJLy IF TANK MAIJUFACTURGR HAS SUCH APPROVAL �r 3 00iNQ SPEC.IFICATIOAJS S 8 8 .r 03 a 6.7 DOSE A {JjZy wEl-s— S MUMDER OF DOSES: Z''� PER DA4 TA JK MANUFACTURER: TAAJK 51ZE: 8OO GALLOWS DOSE VOLUME ALARM MAIJUFACTURCR: s .S• -�'--"In SYTi=t-15 ILICLUDINO BACKFLOW: GA�LONs MODEL IJUMBER: C, H4 CAPACITIES: A- 1S ILICHES OIL 29" GALLONS SWITCH TYPE: } Z�JJr�1 B= Z IWCHES OR 34'3G�LLOIJS PUMP MAAJUFACTURCR: GE- ?'11-7��5 C= 6 IWCHES OR � `a GALLOIJS MODEL NUMBER: S s L/ D- �� IMCHES OR 3S3•SGALLOuS SWITCH TYPE: `"���`/ IJOTE: PUMP AMD ALARM ARE TO OE -3�_ yc� INSTALLED OW SEPARATE CIRCUITS MIWIMUM DISCKARCpE RATE GPM a VERTICAL DIFFERENCE DETWEEIJ PUMP OFF AUD.DISTRIBUTIOU PIPE- FEET, + MINIMUM NETWORK SUPPLY PRESSURE . . . . 2.5 0 FEET SO z 2LIFT,�/ c + FEET OF FORCE MAIN X 100FLFRICTIOU FACTOR.. 1 ' 1 FEET 6 1988 6 16 TOTAL DtJIJAMIC. HEAD = FEET " , IWTERAIAL DitALUSIOU� OF TAWK: LENCPTH —;WIDTH —._;LIQUID DEPTH Y3C-)-rr o vl rt e `/ GH t, /1 ti►C-14 R5 PAR ?-I PA K3 F-ACT'VMt--Iz = 6Rt-/ /JJGM 1 OTAL IEEAD IIn4 E-E - � � .— NNN N N .-�► MMON MMON O O O � N O O O n o n m r O oo D Cn s p 00 r.,. ir N rn O O Z w r Cl) Ul O Zy t1 m 4h, rn � 0 z C Cc' � cn O m -v � o C N 9 O O cn N N O Oi CD N SL' 6 193 y W CO TOTAL HEAD IN METERS S 8 8 - 0.3 '7 6 '7 STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER 41 Nk�,Ci ' �;P%'] &I t _A —Te. NL k �f i �`'„ ROUTE/BOX NUMBER %�14 1 �L /o� y FIRE NO. CITY/STATE T LY AkS (t)I ZIP PROPERTY LOCATION: 1/41/4, Section , TAN, R_& W, Town of LA_`-yu%0eja , St. Croix County, Subdivision , Lot No. Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a LICENSED SEPTIC TANK PUMPER. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. g P Y St. Croix County Residents MAY be eligible to receive a grant for a MAXIMUM of $3000 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 verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), 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. I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Department 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 ` t/&V1+k'&_' DATE St. Croix County Zoning Office St. Croix County Courthouse 911 4th Street Hudson, WI 54016 (715) 386-4680 Sign, Date, and Return to above address APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owners) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by r 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 ,(_7ttim 'W'Fa C4 Glety"114 Zem, Sc'� Location of property 1/9 l/9, Section __sS , T c�`,� N-R__ W Township YAy-y-e ,-t S E Mailing address a /Y-C, KG Zy2 SV64 Address of site Subdivision namedL C Lot number n07" Previous owner of property @T1� Total size of parcel J V ckcee 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 ZCIIS --and Page Number L ,3 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 references to a Certified Survey Map, the Certified Survey Map shall also be required. ---------------------------------------------------------7--------------------- PROPERTY OWNER CERTIFICATION I(We) certify that all statements on this form are true to the best of my (our) knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warrant deed recorded in the Office of the County Register of Deeds as Document No. 73 d 4l S L-) ; and that I (We) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the same has been duly recorded in the Office of he County Register of Deeds, as Document No.� ) . " Signature of Owner Signature of Co-Owner (If Applicable) Date of Signature Date of Signature 79SPA'J.241 STATE BAR OF WISCONSIN FORM it-1< 2 , ) � �'• DOCUMENT NO. I �� TNIS SPAC:n RESERVED FOR RECORDING DATA j LAND CONTRACT r 432686 I Individual and Corporate �(TO BE USED FOR ALL TRANSACTIONS WHERE OVER +125,000 7S FINANCED ACT TRANSACTIONS),NSACTIONS)NON-CONSUMER RCG'M'S ONI E _ ST. CROIX CO,, WI Rse'd for Reoyd_ Lucille Hansen, a/k/a contract, by and between .-:-...-•--•------ ------------------------------------- (;' 1 Lucille G. Hansen, a single p-_rson DEC 3 1987 ("Vendor", i Whether one or more) and-----Dean Craig Hansen and Glenda a} • M VC) Jean Hansen, husband and wife, holding as survivorship ' marital ro rt - - ....._.... . ._..X ("Purchaser", whether one or more). I; R�pMnofQ Vendor sells and agrees to convey to Purchaser, upon the prompt and full per- formance of this contract by Purchaser, the following property, together with the i rents,profits,fixtures and other appurtenant interests (all called the"Property"), in__------St.__CrO1X----------------------------------------- County, State of Wisconsin: ;RETURN TO - I Tax Parcel No. .................................. �I i See Exhibit A attached hereto and made a part hereof. i I i I I I j I This .._1_s. not homestead property. (is not) I Purchaser agrees to purchase the Property and to pay to Vendor at a.place_designated_by-•vendor the sum of $---125 00-00................................... in the following manner: (a) $....30{000-.00.......................... j at the execution of this Contract; and (b) the balance of $_.95,000-00................... together with interest from date I• hereof on the balance outstanding from time to time at the rate of....SP—VP...ri__(7%).............•.... per cent per annum I until paid in full, as follows: annual payment of $13,115`l6 . 10, commencing one ( 1 ) j year from date hereof, and on the same date of each year thereafter. -7 g 20 JC) i Provided, however, the entire outstanding balance shall be paid in full on or before the_.10-.Ye3rS--------fig I ifram..date..bereof........, wi------- ( the maturity date). Following any default in payment, interest shall accrue at the rate of---------% per annum on the entire amount in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire j principal balance). it Purchaser, unless eycused by Vendor, agrees to pay monthly to Vendor amounts sufficient to pay reasonably antici- pated annual taxes, special assessments, fire and required insurance premiums when due.To the extent received by Vendor, Vendor agrees to apply payments to these obligations when due. Such amounts received by the Vendor for payment of I! taxes, assessments and insurance will be deposited into an escrow fund or trustee account, but shall not'bear interest i unless otherwise required by law. Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any amount may be prepaid without premium or fee u p on principal at an y time after______Ja-n U-r - -•--.- 188 ... (6= In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long as the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be treated I I` as unpaid principal) is less than the amount that said indebtedness would have been had the monthly payments been I! made as first specified above; provided that monthly payments shall be continued in the event of credit of any proceeds ; of insurance or condemnation, the condemned premises being thereafter excluded herefrom. II Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser. for examination except: I Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall II ` ,be retained by Vendor until the full purchase price is paid. Purchaser shall be entitle to take possession of the Property,on.....ddte•Of•Ug ing..................... ye_..,.•. �I Ii *Cross Out One. l__�._.---._..._......__ .._ _. ._....._ ........._. ._ _ -.... ......... __. �I IICMmaCanpnq® STATE. BAR OF WISCONSIN FORM N o. 11—198 Stock No. 1.�0.1 •.• 'L • •saanteu8�s a1a41 e�ot, •"►.1�,t (• .......6T ........................................................ callp pa3utad ao padAl aq pinogv d;!asdaa bus ut 2UjU3!6 SUM 4 jo catu (•Baessaaau IOU sae uotl8agdgt� }s•:you ;l)•Juauswaad st uotssttutuo0 AK g4og pagpajmou�las ao pa4satluaglns ail Bew saanlaugtS) •9 J -------------- Z11.7 allgnd BasloN •------••----••--- ----•••--•--ZOObS•-�-•---••• = JJ 44.._ XOPMODOW •V seulOLU AS Q31JVtla SVM LN3wnH1SN1 SIHl C? ' �._ 8 apus qlouus ar palma uan po; h paj vvw o oad al aq of utAou3i aut o3 (•s4slg •stM '90'90L § Bg Paztaoillne • ............^_--•--•------•--••---•- -----•-------•-•--------------- ---------•--•-•---••--•••-••-..._ •lou 3I) - ................. ............. >. ., *,»- " . NISNOOSIM JO 8d8 51ZVSS Halal aw :a'IZIZ .............................................. uasueH near epu010 pu>; ' •uasueHte�� ueaQ �uasueH aTTiOn7....... •-------•-----------------•-•--•---------------•--•-•--••---• --------•-•----••- pautsu aeoge aqj ----L86t 4._..._..-rT--•--•a.�aQ ,...... Asp � .gJ jag lls d ....•61 ---------------•-----------3 p------- .gJ Pte+ it 4J o Bs --•--° st aw aao eases � uosaa - o s et sat ua ne BJunoO--------------------------------------X1030 •-4S ,Be ItIISI!IOOSIM 30 511VZS ............................................................ (s)aanleugtS Xmil ocli ImONZOV M011VOIIKKKInv -•• ............. .................................................................. uasueH -u..ar epuaT0 ---- - - ---- ...._••-•............... ...u�sueg' �Yex� ue L8 6T ................................. � �� I ..-------- ;o Bep --••----------------- stgl Palg(l (•;oaaaq ;uatullgln; uj apew eq % peep aq; ;o uo!lnoaxe aye ut utof o4 saaa w pus Blaadoad loafgns ay; Uj s4ggta Pga49awoq esealaa o; ujaae4 sulof uotlgaapjsuoa algenlee a aoi aopuaA;o asnods ay;6;aadoad ay; ;o aaumo us ;ou ;I) •aassgaand pus aopuaA ;o surtess pus eaossaaans 'sae.49Jusm as legal 'satag ay; ;o sggauaq sill of aanut pus uodn gutputq ail flays JasaJuo`J sty; jo ewes; UV •aassgaand ;o ;lns;ap aotid ao Iuanbasgns sayjo Aug gutetem ;noq;tm llns;ap Aug amum Bent aopuaA •lasaluoO stgl uo apew sluawBed paaap!suoa aq llegs aasegaand Bq spear os s;uatunsd [Is pus os op of elte; aopuaA ;t aa21ezlaoy(t ay; of Bllaaalp s4uawAud Bans Aug anuut Bsut aassgaand -pu qu oO stg4 aapun anp uagl slunoucs aq;jo Juautded Blaw14 sm igw aassgaand Paptnoad 'Bgaaagl paanaas alou Aug aapun ao (aassgaand Bq palueag a2u2jxow Aug ao;Idaaxa) Jagaluoo stq; ;o slip aql uo B;aadoad aql ;suisgs gutpuslslno allv2pow .iuv aapun anp uagm s4uauiAud llg a4vw llggs aopuaA •aatlou Inoyltm uotldo s,aopuaA 19 'lln; ut algTaAvd pug anpBjoletpa-wt awoaaq llegs laealuoa still, aapun olgeBed aauslsq guipuslslno aatlua ay;'Juasuoo ual;tam 9,aopu8A Inotl;tm a3ueBaeUO3 ao else 'aa;susal gans Aug ;o Iuaea aql uI •aaesyaand ;o ssaupalgaput us ao; Bltanaas su Bolos laealuOD stgl aapun Isaaalut s,aasugaand ;o luawuglssg ao agpald s at paBaeuoa lsaaalut ail; ao jln; ut plgd Ism; st 4osa4uoo sql aapun algeBsd aauslsq 3utpus4s4no aq-4 aaglta ssalun aopuaA ;o luasuoa ua44tam aotad aql Inoil;!m (Bsm aaglo Aug ut aseal Waal-guol 'uotldo Bq ao IagaluOD still aapun slgBta s,aassgaand ;o Aug ;o Iuaiuugtess Bq) Blaadoad sqj ut lsaaalut algeltnba ao legal Aug BaenO3 ao jlas 'aa;susa4 IOU llsge aasegaan l 'laaatP lleys Ianoo ayl se patldde pus plaq aq llsgs paloalloo oil uagm s4goad pug 'sanest 'sjuaa qans pus 'uotlas gans ;o Bouapuad aql gutanp Blaadoad aq; ;o elgoad pug 'sanest 'sluaa atll loalloo o; 'Jsaaalu► pealsawoq gutpn[out 'Blaadoad eyl ;o aaetaaaa s ;o luoutluiodds eql of s;uaeuoo aassyund 'laealuoC) still ;o aansoloaao; ;o uotlas Aug ;o cAfouapuad aql Butanp ao luawaauawwoa ayl uodp •luautxpnt Aug ut papnlaut aq llsgs pug 'paaana -ut se 'aasegaand Bq pled pug lsdtautad of papps aq llsys aauaptea affil 3o sasuadxa pug msj Bq paltgtgoad IOU Iualxa atll of (IOU ao palsgs aaglagm) aapunaaaq Bpatuaa Bus aaao;u8 01 paaanoui aopuaA ;o sae; sBauaol4e elgsuossaa gutpnlaut sasuadxa pus slsoa ljg pus uotleg!ltl ut pansand uaym pus ;t aopuaA uodn gutputq aq Bluo llggs satpawaa gutogaao; agl ;o Aug ;o u0tlaala us 'aopuaA ;o suotlas ao sluatualels ualltam ao leao Aug gutpuslsgltmloly•aeogs (et) ao (tt) '(t) aapun uotlas Aug ;o Bauapuad aql 8utanp sltload ao sanest 'sluaa Bus Iaalloo o4 paluiodde aaetaaaa a aegil pug Blaadoad aql ;o uotssassod woe; pa43ata aassgaand aesg Baw aopuaA (e) pus !jugat;tugtsut st aasegaand ;o lsaaalut algaltnba aql ;! uotlas alin-lamb a ut alltl uo pnolassslaga1u02) stgl 8eow3a pus pue us 48 laea4wo still aaelaap Be- aopuaA (et) ao :;oaaayl uotlaod Aug ao amt d asagaand ptedun aatlua aqj -10i mel is ans ABU[ aopuaA (ttt) ao :Bauatat;ap Aug ao; alggtl aq llggs aaesyaand pus ales Imatpnf Is pauo14ane aq lleys Blaadoad aql Juana gatgm ui 'aapunaaaq anp slunowg aaglo pug llnejap ;o alep aqI uo lea;;a ut a3sa sill Is uoaaagJ lsaaalut gltm 'aaueleq gutpualslno aatlua aql JO Iua-Bed llnj pus alatpaw-t ladwoa o; I3ga4uOD still ;o aauewao;aad atjtaads aoj ans Be- aopuaA (tt) ao !(waapaa o4 slle; aassgaand ;t Blaadoadd aq; ao; jeluaa 99 pug lasaluoO stgl ll!jln3 o; eanite; ao; sagewgp paleptnbil ss palta;ao;: aq llegs aassgaand Bq p!Bd Bjsnoteaad sluno-s ilia luaea gatgm ut)aapunaaaq anp s;uno-g aaglo pus aJsp gans uo lea;;a ut alea aql le Ilnvjap ;o slip aql woe;uoaaagl lsaaalut ql!m 'aauslsq gulpug;s;no aatlua aqj jo luatuBed jln; s,aasayaand uodn pauotl!puoa aq of uoild-apaa ;o Bltnba Aug yltm aansolaaao; IapIs gBnoagl 31ogq Blaadoad aqj aaeooaa pug Blaadoad ayl ut lsaaalut pug alltl 'slgBta s,aaseyoand pug JaealuoO still alsutwaal 'uotldo sty Is 'Bew aopuaA (t) :Bltnba ut ao msl Bq papteoad 89044 04 uotltPPe ut (mej Bq papteoad suotleltwtl Aug of laatgns) satpawaa pug slggta gutmollo; aql anvil 0sle flays aopuaA Pug '(saetsm Bgaaaq aasegoand yotgm) aatlou Inogl!m pus uotldo s,aopuaA Is 'lln; ut algaBed pus anp Bla4gtpaw-1 awoaaq jlggs losaluoa stql aapun aauslsq 2utpus4sino aatlua aql ua4l`(Its- pat;tlaaa Bq papaw ao Bllsuosaad paaantlap) aopuaA Bq;oaaa4l aatlou uslltam gutmolloj sBep ----Gg--;o potaad s ao; sanutluoa gatgtA aasvgama ;o uollggtlgo aa44o Aug ;o aouswao;sad ut llne;ap is ;o 4uaea aql ut (q) ao alap anp pat;laeds aill gutmollo; eBep-b9----- ;o potaad s ao; sanutluoa gatgm Isaxnut ao'lsdtautad Aug ;o luautBsd aql ut ;ing;ap g ;o Iuaea aql ut (8) pug aouassa aql ;o st atutl lsgl saaags aasegaand ...............•------••-•-•--•••---- ------••-------..._..-•-•.........-------••------...-----•---...--------.._..•.---..._... - ...._---••-----•--•-------•--•--------••----------••-------•---•-•-•--...•-•---••••-•-•--•.................................••--•---•-------•_._..__..__....---- ---•-•--- -----•--._...---••---------------------------•------ ___-----------_-_----------------------------------_------------------------------ '�aa ----• "---------------------------------------------------------------------- - ................................................ :Idaoxa pug 'aasegaand ;o line;ep ao Jas aqI Bq palsaao saoueaq-noua ao suatl Aug ldaaxa 'saousagwnoua pug suatl fig ;o aeaja pug aaaj 191aadoad aqj ;o 'aldwts sej ut 'paa(l BlusaasM s 'aaesqUnd aql of aeegap pug alnoaxe 'puswap uo MAL aopuaA 'pagtaads aeoge aauusw sill ul Pus sawtl aql le pamzo;sad Alin; aq ljeys suotltPuoo jje pus pled Alin;aq llsgs sBauow aaglo pus Jsaaa4ut gltm solid asstlaand 844 assa ut ;aq4 eaaaXs aopuaA Blaadoad sill gullaege suot4ejn2aa pus aeouautpao 'smsl jig gltm Bjdwoo of pug 'losaluoO still ;o Usti aql 04 aolaadns suail woe; aaa; Blaadoad eql daati of 'atedaa pus uo14tpuoo algs4usual poo8 m B4aadoad agl daaij of 'Blaadoad ail; uo pal41wwoo aq of 8;sem molls IOU alsem J!ttiwoa 01 IOU 9;usuaeoo aassgaand algtsga; Blleatwouooa aq of mudaa ao uotJsao480a aqj swaaP aopuaA aql papteoad 'pagstttep B;aadoad aql ;o atudaa so uoilsaolsaa oI patldde aq jjsys spaaaoad aausansut 'gutltam ut saaeg astmaaillo aopuaA pug aasegaand ssalun •aopuaA pug eatusdutoa eauaansut of ssol ;o aatlou aetg Bjldwoid llsgs aassgaand •aopuaA glum paltsodap aq llsils Blaadoad aqj Bulaaeoa satatiod jig ;o leut2uo aql 'eutltim ut saaaee astmaatilo aopuaA ssalun 'pug J90aalut s,aopuaA aql ;o noes; ut asngla paspusls a44 ute4uoo llegs eatatjod aqj •anp uagm swntwaad aausansut 8qI Bad ljsys aaeailoand •4asaluoO still aapun pamo aauslsq aqj us4l aao- lunowe us ut egeaaeoo aacnbaa Jou ijsgs aopuaA lnq anTPA aTgesnSUT TTri ! 3o tans aqJ ut 'aopuaA Bq Paeoadde eaaansut gBnoagl 'aausansut-oo Inoyltm 'aatnboa Beut aopuaA es epaszsq aaglo lions pus sjtaad egsaaeoa papual. -xo 'sag Bq pauoiseaoo agsump ao ssol Isulage paansut Blaadoad aql uo elueut— d-! ailJ dead lleys aasegaand •IuawBsd gans gutmogs eldtaaaa puewap uo aopuaA 01 aaetlap of Pus J! Ut 19eaalut s,aopuaA uodn ao BJaadoa a I Uo pamal 9lua-ssasse us s8 a anp ua sd of saetwoad aassgaand •pno bqM saxeq a4le= Teak T le `k'ec� o-4 3aseuzxnd •sai,43ed auq uaamlaq paaejoad uaaq anew saxt?q aaegsa Te83 L86T DEPARTMENT OF REPORT ON SOILA DIVISION ORINGS AND SAFETY& BUILDINGS__ INDUSTRY, — __—___ _ _ ___- _ 1 P.O. BOX 7969 LABOR AND T 115 N WI 53707 TESTS MADISON, HUMAN RELATIONS PERCOLATION ) , (ILf•IR 83.0911) & Chapter 145) JLQCAT SECTION: NSHIP/ L TAI :131- SUBDIVISIO A F9 I/5" �/ 3 5 /Taq N/R t A f or Tom l ��1J/ LINTY- NER'S AILING A RE } ♦ e USE DATES OBSERVATIONS MADE ,��ff COMMERCIAL RIPTION: New ❑Replace IPRIIL DES I-PTI S: E� L JION ES.T [Residence /I a(� RATING:S=Site suitable for system U=Site unsuitable for system CONVENTION MOUND^❑A IN-GROUND R�E: SYSTEM-IN-FI�eLHOELDING TA . RC OMMENDED SYSTEItloptional) DESIGN RATE: [under Percolation Tests are NOT required I If any portion of the tested area is in the s. ILHR 83.0915)lb►,indicate: Floodplain,indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (S ABBRV ON B C 5 ' B- f O & O n sib 1 n5i � .5, 7 /a ens ,Q a OK nsr ns> , 05 , B� ,60 5,0 /o 43n6 /y 8 ;, O k, v� s a l 1 n s 11, ! s . B3 50 5.1 3 /2 s s- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RAFTER INCH ES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. P RI 1 PE I 2 PER P- 0 CI P- P_3 -14 i i6, / i 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 A& M4 �D E 3 i 1 E 1 zn-q b I J Q _ . e P _ 3 P E F �B-a y- ... �., ao° E _ _ ! oter F P ' f0WrJQ F E 3 7 E E 3 3 E E -�e.�-hereb � r I,the undersigned, y certify that the soil tests reported on this f Jere ma me in accord with the procedures and methods specified in the Wisconsin Administrative Code,and that the data recorded and the location of the Lests are correct o the best of my knowledge and belief. NAME(print): TESTS WERE OMPLE ED ON: CA // / I -S'S/ ADDRESS: CERTIFICATION NUMBER: P ONE NUMBER(o CS SI f�AT I E: I DISTRIBUTION: Original and one copy w Local ut A y,Property Owner and Soil Tester. DILHR-SBD-6395(R. 10/83) —OVER —. INSTRUCTIONS FOR COMPLETING FORM 11 - SBD - 6395 _ To be a £2(,>rk1}:tle,o�<€n d a£cu9'ate SC.iaI test,yoisr"rcr)vrt 5 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or corruraercial project; 3. MAX IMUPVI number of bedrooms or commercial use Planned; 1� 4, Is this a new or replacement system; B. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A s-1 -1 13I NG TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; - PLEASE use the abbreviations shoevn hare fw writing profile descriptions ancf 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,desire£1; F €,i, Make su€e your he r€ch;i?ark and vertical elevation rcfi rence Point are clearly shown,and are permanent; . Complete all appropriate boxes as to dates, names,addresses, flood plain data,percolation test exernp- 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 „rlacr>Your current address grid 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 tither Symbols st — Srone (over 10") BR — Bedrock cob Cobble (3- 10") SS Sandstone gr — Gravel (under 3") L — Limestone *s Sand HGVV High Gro€aradwater (-" _ E'parse Sand' * Perc -- Percolation Rate €toed s _ Medium Sand l'ti -- Well is Fine Sand Bldg Building is - Loamy Sand > --- Greaten Than 'si Sandy Loam) Less Than Loam Bn _.... Brown �ssl .- Silt Loam Bi — Black — :gilt Gy ..... Gray c C'ay Loam Y — Yellow S,,mdy Clay I..oa€') R - Red <si,I ty Clay.Loam ,€pit' I lotticrs sc - Sandy Clay w/1 .... with .sic — Silty Clay t ffi — few,fine, faint » c Clay cc common,coarse, Pt — Peat mm — Many, nrediurn rte Muck d — distinct P - pro I€)Ir-ran4 IAWL - High venter level, Six £4eneral soil textures surface.,,zater lgtr liquid ^;asle dsspo:sr+ BM - Bencl€ Mirk VIRP ._.. Vertical Reference Point FF F 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 soil test in the field prior to permit issuance. A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a permit, The sanitary permit must be obtained and posted prior to the start of any construction, ST. CROIX COUNTY RR WISCONSIN nL,y ZONING OFFICE ST.CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON,WI 54016 = (715)386-4680 August 29, 1988 Division of Safety and Buildings Bureau of Plumbing P. O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the Dean Hansen property located in the NE 1/4 of the SE 1/4 of Section 35, T29N-R18W, Town of Warren, revealed suitable soils at a depth of 35 inches, below which high groundwater 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 I