Loading...
HomeMy WebLinkAbout022-1048-30-100 0 cn O 3 v n C '1 G ° tD 7 D m ,<'U~ Mm m ,ate n Z 3 Z N CD ~I v N • 7 y O A O j tV N F~1 rr`]/111 o ' N C ro O N W (n 00 CD -9~ w (D C1 N n 7 ! N W O O 0) C. C.f7 O ° j I o D O o ~ 0 :3 G CD S O cn CD D gyp- a o fD CO (n c p. O 0 ~ c N CL CD 0 a O m N O O W O 00 OD a) -4 -4 CL cr z 0 0 0 c~ Z O O O m r C-L Z3 2. > o m M t'D m vl A 0 ;3 fu 77 (D 3 3 ° (D 'I rn CL = 7 Cl) r* Z C co z O o a a CD CD ~ m X m O C C N @ CL a 3 S Z W ..1 CO) O aO A Z n o A Z O O O 7 W A co N) v rL Z p `A .Z7 m OD 3 Z 00 Z CD A W ~ I I CD ~ O CX C 7 j O. G K Cn CD O 'gyp -0 N GJ. I o 3 0. N i~ S Z = O O A N 7 v j CD co~ O O f`0 Cn C.T. CD : 4 N C1 O V CDy N CD Q) CD CL a ti i_ .b N CD 40 W C) gO o p (D Parcel 022-1048-30-100 09/27/2004 12:09 PM PAGE 1 OF 1 Alt. Parcel 022 - TOWN OF KINNICKINNIC Current [XJ' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): Current Owner " HUMPHREY, KEVIN J & SUSAN K KEVIN J & SUSAN K HUMPHREY 1054 TOWN HALL RD RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 1054 TOWN HALL RD SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH I Legal Description: Acres: 4.380 Plat: 1024-CSM 14/3830 SEC 17 T28N R18W SW NE FORMERLY LOT 1 Block/Condo Bldg: LOT 3 CSM 6/1722 NKA LOT 3 CSM 14/3830 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 17-28N-18W SW NE Notes: Parcel History: Date Doc # Vol/Page Type 09/20/2001 657062 1722/62 WD 08/06/2001 653066 1694/322 EZ 07/23/1997 756/613 2004 SUMMARY Bill Fair Market Value: Assessed with: 237,800 Valuations: Last Changed: 05/10/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.380 32,000 170,000 202,000 NO Totals for 2004: General Property 4.380 32,000 170,000 202,000 Woodland 0.000 0 0 All 4.380 32,000 170,000 202,000 Totals for 2003: General Property 4.380 32,000 170,000 202,000 Woodland 0.000 0 0 Total 4.380 32,000 170,000 202,000 Lottery Credit: Claim Count: 1 Certification Date: Batch 121 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 J. ~ To be a cc iplete and accurate soil test, your report must include; 1. Compk 1 description; 2. The use must clearly indicate whetl- this is a residence or commercial project; 3. MAXIMUM rnber of bedrooms or corn use planned; 4. Is this a i or rc,~lacement system; 5. Cornpl Aity rating boxes. A SITS I SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; ff. 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, arid are permanent; 93 Complete all appropriate boxes as to dates, names, addresses, flood plain data, percolation test exemp- tion, if appropriate; Ir formation (such as floo plain, elevation) does riot apply, place N.A. in the appropriate box; 11, ~ the r =n arid place your Curt- if address and your certification number; (,)pies and dis-; re(juired. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN-) DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st Stone (over 10") BR - Bedrock cols Cobble (3 - 10") SS - Sandstone gr Gravel (under 3") LS - Limestone s - Sal HGW - High Groundwater C- Pere Percolation Rate s - V _ eta W - Well is - Fine Bldg Building Is Loamy Sand > Greater Than `sl - Sandy Loam < L s Than `l - Loam Bn ^ 1 #sit - Silt Loam BI _ I k si- Silt Gy _ y cl - Clay Loam Y low scl - Sandy Clay Loarn R sic[ Silty C.~: Loam mot les se San:'Y ~Y w/ sic - Silty C fff r, fine, f~ Y'c - Clay cc - common, pt: Peat nrm - Many, merir.;r m - Muck d - distinct p - prominent HWL - High wa Six general soil textures surface r, for liquid waste disposal BM Bench Mark VRP Vertical Refi t TO THE OWNER: T' is soil test report is the first step in securing a sanitary permit. The county or the Department may request v{ rri-ation of this soil test in the field prior to permit. issuance. A complete set of plans for the private system and a permit application rnust be submitted to the appropriate local authority in order to c>~ a perrnit. The sanitary permit must be obtained and posted prior to the start of any construction. D~PAWI-MENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, 1 C DIVISION P.O. BOX 7969 LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TOWNSHI UNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: sw 1/4W4/ 1`~ /T N R is E ca I xw-sLG Vr_j)jN IC COUNTY: OWNER'S UYER' NAME: MAILING ADDRESS: \Z1 I^~? S`T • GRA~X ~IPV.~IEL U 1SS~ly R) U~1Z 1=i4 U.. ttiJ/ 51/ 0 ZZ USE DATES OBSERVATIONS MADE I NO. BEDRMS.: 1COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PER OLATION TESTS: 5<Residence N A "New ❑Replace /3!/$6- 8~~9/86 gf 19~$(, RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND•PRESSUR_E: SYSTEM-IN-FILLHOLDRECOMMENDED SYSTEM: (optional) CIS ~U DS ®J E1~ ~J ®u ~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: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL D PTH TO GROUNDWATER-INeftM CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH•ttrk ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) to q•y' ~o~,o' > Q. y' ~.0'~3~ Gv s\~s;Z.z' Zan be~sE L ;o.s'~t Bn~s w/ B-_ _ -~-ivSE SPOTS ' Z.5'`78~ S ;~•S`~~ GrCS •2.~~23h GMh1~ 11 ~l•o' 10~1~ 6' . > q.o' o•~' 8n Grs1 Ts ; Fd.Z' `CSn'Fs - B- 1z .cam' ioz.o' t.1 VV- o cry l.,S' 0.9' Mt RBrI Gw S )TS • z• 6' BA rLsk IS vas w ~ zlh~ S 3h z»sE L , B- b, ~oo.o' t 7 •6' a. b' 3r s 1 T5 ; Z.S ' 8r1 G►~ ~s ; 3.s 'f $h 'F'S w/ Gr )y 1oz.3' tt L~ ; 1.9' Brl Gr~f's ; S~' `t8n~s 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 -PERIOD 2 PERIOD 3 P- P_ S~ 6 " bP Z P - 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 a t tion reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of la 8 f Itil L~l k GY Cl . ION Cal ej'r - I ov s Olt 'Z~ s 1 a `n 1 _WY i~ i ice{ i° t ! ~ E I'll -vil-tZ ~b\ _ ~•4 _ r -T~ ~loS_ \ ~~b ~2kt~1o3- ~9 own j~►~i~ t; vr' ~c 96, ' yo o~I I ~URrCE' bl2flAi!f~ti - i _ T 4 t 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: Cz-T`t)1~ L. ~J CGL1z ~ - !9 - ADDRESS: 1~ L30X. Z'Z CERTIFICATION NUMBER: PHONE NUMBER (optional): I- L w o M-04 I rN S4101) S-)6 I-) tS-(4ZS_ 9AY CST SIGNAT RE: aq&u DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. ~'NISIS Z OF DILHR-SBD-6395 (R. 02/82) - OVER - a PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: V Trench: I L. Width: 12. Length: S?-' Number of Lines: Z Area Built: 6,24 Fill depth to top of pipe: 4ZZ0 Number of feet from nearest property line: Front, O Side, O Rear,0 Vt. Number of feet from well: Q~ `O i Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: - Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, 0 Rear, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: Plumber on job: T License Number: t P 7 3/84:mj T ~ t f Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ~pNZ~L Cam. 1--~E.tJ: TOWNSHIP P~2Nt•1zE K3 A~i,J^1.L, SEC. 1'7 T 28 N-R!'&_W ADDRESS I7-1 tN~ 3~~ fem. ST. CROIX COUNTY, WISCONSIN SUBDIVISION /Jf 1q LOT /1I rA LOT SIZE 415'X ZPS' v PLAN VIEW Distances and dimensions to meet requirements of IIHR 83 0 Lb 14 ~g3 I SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM n S S f 'A \ . R U C 1 1987.c MENG OFFICE a ~ aroma. I-~OIAS E ' t W ElL INDICATE XRTH ARROW BENCHMARK: Describe the vertical reference point used _5QIKE 1, P4Vzg . 6RAuaJC~ :xt4 V 9kh LA Elevation of vertical reference point: 166,001 Proposed slope at site: Z% SEPTIC TANK: Manufacturer: WT.E5Yc2 Liquid Capacity: Iwo "t.! OT'l Number of rings used: 43- Tank manhole cover elevation: (O5, 52, Tank Inlet Elevation: 161. 2-4 Tank Outlet Elevation: 100.91 Number of feet from nearest Road: Front,O Side,@ Rear, O 611ew- 1061 feet From nearest property line Front, 0Side ,ORear,O Oqw- 1W feet Number of feet from: well 406' building: 2-0 (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE DEPAFITM. NT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS L,48OR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 , NE14 ,S17,T28N-R18W 10 CONVENTIONAL ❑ALTERNATIVE StateSPI n I.D. Number: SW I-4 (if nild) O gf Win ickinnic ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound oc NAM1 Or PERMIT HOLDER: DDRESS OF PERMIT HOLDER: INSPECTION DATE: Daniel G. Denissen A21 North 3rd, River Falls, WI 54022 _~J dv BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.: Name of Plumber MP/MPRSW No.: r,u"y: Sanitary Permit Number: Thomas H. Cody 6593 St. Croix 92483 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY. TANK INLET ELEV.: TANK OUTLET ELEV.' WARNING LAB L LOCKING COVER PROVIDED: PROVIDED'. ❑YES ❑NO ❑YES ❑NO BEDDING: VENT DIA.' VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM FEET FROM LINE: AIR INLET ❑YES ❑NO ❑YES ❑NO NEAREST DOSING CHAMBER: MANUFACTURER: 7ING L IQUID CAPACITY. PUMP MODEL. PUMP/SIPHON MNUFACTURERWARNING LABEL LOCKING COVER PROVIDEDPROVIDED: ES ❑NO ❑YES ❑NO ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PROPERTY WELL BUILDING. VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE Ala INLET PUMP ON AND OFF) ❑YES ❑NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moistureat 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.) MAIN CONVENTIONAL SYSTEM: WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER INSIDE CIA. SPITS LIQUID BED/TRENCH TRENCHES MATERIAL: PIT DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR. NUMBER OF PROPERTY WELL. BUILDING: VENT TO FRESH BELOW PIPES. ABOVE COVER: 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. YES ❑NO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS ❑YES ❑NO ❑YES ❑NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. SODDED. SEEDED MULCHED CENTER. EDGES: ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH TRENCHES: LATERAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE JMANIFOLD MATERIAL. NO. DISTR jD:STRPIPE DISTRIBUTION PIPE MATERIAL & MARKNG ELEV.: ELEVDIA.ELEV.PIPES DA_ ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS ❑YES ❑NO ❑YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE: ❑ YES 1:1 NO ❑ YES 1:1 NO NEAREST Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE. ITITLE. DILHR SBD 6710 (R. 01/82) Zoning Administrator INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION r r 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; Ill. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement, reconnection or repai r; 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'/z 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 Groundwater included the creation of surcharges (fees) for a number of regulated practices which Wiscorr in's can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried treasure 5 is used in your building is returned t". the groundwater though your soil absorption system or the disposal site used by your holding tank pumper. 11 The monies coiie•cted through these surcharges are crediled o the groundwater fund adminis- tered by the Department of Natural Resources. These fun zs are used for monitoring ground-t vn,_ate~, gr_ur- iwater contamination investigations and est;tblishment of standards Ground\vatGr, s worti, protecting. 3o-sags ;,=,.cs;r3s~ (~y SANITARY PERMIT APPLICATION COU TY O'LHR In accord with ILHR 83.05, Wis. Adm. Code C~Jx STATE SANITARY PERMIT # 83 -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 ~j 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑ YES l,dJ NO PR ERTY OW ER PROPERTY ILO,CATION CkG , oeK SS~s1 S'011, /V£. %a, S I q T~ , N, R E (or) 10 PR PERTY OWNER'S AILI ADDRESS LOT NUMBER BLOCK NUMBER S DIVISION NAME . 3 o C s n4 C AY, STATE r+ . ZIP CtO,DE PHONE NUMBER CITY NEAREST ROAD, LAKE OR LANDMARK t trey- u W S Li a ❑ VILLAGE : KI k k ~~a II. TYPE OF BUILDING OR USE SERVED: 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. 1% New b. E1 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 3.0 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. E1 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. ❑ 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): Q L 3 0( 10 Feet 1Z Private ❑Joint ❑Public CAPACITY VI. TANK in allons Total of Prefab. Site Fiber- Exper. Manufacturer's Name Con- Steel Plastic INFORMATION New xisting Gallons Tanks Concrete structed glass App. Tanks Tanks Septic Tank or Holding Tank ¢ S Q ® ❑ Lj I El ::F: D Lift Pump Tank/Si hon Chamber ❑ ❑ VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name (Print): Plumb r Signature: o St p /MPRSW No.: Business Phone Number: (05q 3 ( ) 0!q1?-335'41 6 c4kv ~ P tuber's Ad es Street, City, SKLI Name of Designer: o ©a L VIII. SOIL TEST INFORMATION Certifie Soil Tester (CST) Name CST # CS ' A RESS (Street, City, St , Zip Code r Phone Number: L O IJ![u d ")f L4 Ot G, IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater Date Issuing Agent Signature (No Stamps) Approved ❑ Owner Given Initial 1/10S charge Fee Adverse Determination U ' Qv~~w-/- ~((C✓J / h C_ 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 I 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 Rev. Daniel G. or Claudia D. Denissen Location of Property SW ~Z NE 14, Section 17 , T 28 N-R 18 W Township Kinnickinnic Mailing Address 905 B South Sycamore River Falls, WI 54022 Address of Site Town Hall Road River Falls, WI 54022 Subdivision Name T Lot Number 1 Previous Owner of Property Glen M WiQse & Lola M. Wgise Total Size of parcel 7.47 acres including road R/W Date Parcel was Created 0 CTO Lib R 8:119 8(o. Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume 6 and Page Number 1722 as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and pa&te 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. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPFRTy OWNER CERTIFICATION I ((ale) centiby that ate statements on thi,6 bo&m ace t&ue to the best o6 my (out) h.nowtedge;.that 1 (we) am (ahe) the owneA(,6) ob the p&openty deg nibed in this .in4o&mation botrm, by viAtue ob a wajrAanty deed &eco&ded in the 046dce of the County Reg"telc o6 Deeds a6 Document No. 18,793 ; and that I (We) p&esen ty own the phoposed date {o& the sewage dizpoz system (o& I (we) have obtained an ea6ement, to tun with the above de6cAibed p&opentty, bo& the constAucti.on of said .6y6tem, and the dame had been duty &eco&ded in the 046.ice o4 the County Regi.6te& ob Deed6, a6 Document No. 18,793 h L SIG ATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) October 13, 1986 October 13, 1986 DATE SIGNED DATE SIGNED NO* ....wwwi.•+w..... «k..... .~Y...« .............L....+.. lisp "il. 7 Ss sl, poi . N i 1rt'°`° 'rtT of wr Of rocosd, i anr, # a *00 Mwr ofA........ O~CVb~! . .K.. . • ...Ml AR.. . ` • -.i. . (8ZAL). . f 1. a i UU'fl[oAl=or Aos>rowzaaera r: JAZ -Pie _ke Mew. me, - 1►I#CONfiN « low ~ s y 1M ~RIL 4 w.M~ M~~t • «r~ 'tom w "'nr'11M , dw the . ihs x11 ~M. W~71 ~r ldrri 1N14. Mr•.~..► , 1~ .-i "y. ST C- 305 SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County o y H OWNER/BUYER Rev. Daniel G. or Claudia D. Denissen M ROUTE/BOX NUMBER905 B South Sycamore Fire Number CITY /STATE River Falls, Wisconsin Z I P 54022 PROPERTY LOCATION: SW NE !4, Section 17-28,18T 28 N, R 18 W, Town of Kinnickkinnic St. Croix County, Subdivision Lot number 1 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 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 ti three year expiration. o :Z: l I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with H the standards set forth, herein, as set by the Wisconsin Depart- ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days i of the three year expiration date. - Q SIGNE Ah « I DATE OctnhPr 13, 1986 I St. Croix County Zoning Office P.O. Box 98 x Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. INSTRUCTIONS FOR COMPLETING FORM 115 - SRD - 6395 To ' a complete and accurate soil test, your report must include: 1. C legal description; 2. Th r_;e section must dearly 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 ARE 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; 8. (flake sure your benchmark and vertical elevation reference point are dearly shown, and are permanent; 9. 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 apa lat x; 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`x) BR - Berl,rsck col: Cobble (3 - 10") SS - Sar gr - Gravel (under 3") LS - Li i tone *s - Sand HGW - H' 1-i Groundwater es Coarse Sand Perc - F -tion Rate coed s Medium Sand W - Vv t; fs - Fine Sand Bldg - Br Is Loarny Sand ) G- Than sl Sandy Loam < L n 'I Loam Bn - B. ; sil - Silt Loam BI - Li. si Silt: Gy - Grs; *cl - Clay Loam Y - Yellow scl Sandy Clay Loam R - Red sicl - Silty Clay Loam mot - Mottles sc- Sandy Clay wl - with sic - Silty Clay fff few, fine, faint Yc Clay cc - common, coarse pt - Peat rnm - Many, medium m Muck d - distinct p - prominent HVVL - High water level, Six general soil textures surface water for liquid waste disposal BM - Bench Mark VRP Vertical- Reference Point '.7 TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Departmen* may re<luest 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, DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, . DIVISION BOX HUMAN LABOR'ANVA PERCOLATION TESTS (115) MADISON WI 7969 (H63.090) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP UNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: sw '/4 /a )-7 /T mN R ISE (or ~t~,►~ ~c tz ~~Ntc ~~~~s csr~ COUNTY: OWNER' BUYER'S AME: MAILING ADDRESS: Z1 3 H~ !I-W, 1X b~►v IC L ~SS~►J 1\3E LS W 1 SVoz,Z USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: 1PERCOLATION TESTS: Residence -3 ~•t~. Q>_ ❑Replace I~_31-86 $-19-8b g-l4-a~ RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: r1:1 YSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) ®S ❑U ❑S I S ❑U S OU ❑S ZU If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: J V , A" I Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-I CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH W. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B 1 p. S' tio1.o' NoN~ `w+ T(Z Z•C)--) 'Bh Sj 1Ts; z.Z'Bh G~SI ; S-6' &h L~E~vse s, w1 4~CZP 1.~ s ' 8 Rr.~ s +t MGT @- o• s' o-S'8~, si I TS; S•a' lZv-3-, vsR\f -oer~asa L NWoY @ 3 1•S'!B\ sit TS ).,I '8>`si)JzBh Gt-SC);2.Z.'RShZgust S.c~' \oS•o` ~I IhoY e 1.0' 0.~1' ~l ;1.3'`•( Bhsc); R18 , De--~ SE _L B- S S \ O y~~~ e o .6' o. 6.' +l o• °1 ' 2 Bh 'btq-jsQ L 6 Z.0' 9$.o ' I tiwo~ c3 0. m. S ''attG'y b~I si 1 Ts Pte, Zh ,6_WS'E Cil- S I B- Z. W q 3 y Z. 4^ o• 6 B>l S i B hno~L- o.q '72~fir_bh G~sl TS ?_ek\ b~9uSfc` S1; 0•6'&I ~s w/GV •S•3'1,\Gl+T 13h E~ \)'FS 0vcL,EUr De',sL. lV•9 ' I.~'Dt~.$rG~sITs;1.S'1~8h'EL ig,5/'L)Gtt7 B11 B- -FS PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD PER INCH A;z-e/. P- 4- .Z AS peR \ L1{ 83.09 S) Q) 3 102,•8 P- 3 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. \ N V'T1 N L, It $,O ' 7=*dF 8-Z G~R,4VEL PlT SYSTEM ELEVATION cS-Me►vT 1,~0 . s' 7 ) ~ X811 ~ ~ ~~~L d~ d r I Ff $1 B1~ t N 13 10 WZp 4 am ) L \Z)(►~i, 1r t y I tJOP 4~R~ ~~.u' ~ o►J S H E I i Z Q~ ScAt e 1+) = 4& e ccevT As Srtctt-j" SEA I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): R- vim L. ~sGm TESTS WERE COMPLETED ONQ `LO_ a~ ADDRESS: 4 RO)c ZZ (o I`- CERTIFICATION NUMBER: PHONE NUMBER (optional): E=_ LLSwo1Z LU k4 u1 S~6 VZS-016y CST SIG TU E: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) OVER - DEPARTMENT OF ON SOIL BORINGS AND SAFETY & BUILDINGS. INDUSTRY, REPORT DIVISION LABOR AND C P.O. BOX 7969 HUMAN RELATIONS PERCOLATION TESTS (115) MADISON, WI 53707 (H63.090) & Chapter 145.045) LOCATION: SE TION: TOWNSH UNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: sw 1/4 N4 t_) Jz-$N R l$E (o A11-11C.tr-J""cC ptzors c Isr~- COUNTY: OWNER'S UYER' AML: MAILING ADDRESS: ~ZI S'-, c~lx ~►~>J~EL G.- V GIZ t=-~ L..L wl 91/ 0 2 Z USE DATES OBSERVATIONS MADE __jNO. BEDRIVFS.: COMMER IAL DESCRIPTIONrPROFI D SC IPTIONS: PERCOLATION TESNew ❑Replace N A ~ ~6- g/~9/86 8l 19 6 RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) ®SCIU Os~l ®S DU DS ®U [--Is RU 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: Il Floodplain, indicate Floodplain elevation: ► v AN PROFILE DESCRIPTIONS BORING TOTAL DEPTH T GROUNDWATER-INeft 9• CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTHtfbk ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B 10 q.y' ~~~.eJ' 5 Ol• y f \.o ~3r GvS1Ts;2.z' R.an bej,~E L ;0.5'`-{ bn'Fs w/ l~T1SE SPOTS ' Z.5'`-1'8h s ;o•S'hh Gres •Z.~BhGrrnal4 1\ '✓l.o' \ZA-6' 11 > q.o' o•~'8nG}s1Ts;8Z'`CS~,'Fs B- z ~oz.o' ~I vh o @ 1 • S' 0 9' Rah 6►^ s JTs • z• b' Bn ~us>; vfs w si s 1 B- \3 l~• 6' \oo.o' t f 7 .6' o b' 3r s 1 TS ' Z.S' BA GV cs w/Gr- l~.( Le 1.9 ' F3 vi GI- ~f's ; S~' `tell s B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RAT ES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD -PERIOD 2 PE PER INCH P- P s 1 aF Z P 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. \ N 111-1 Pc L- c~~r\ co~f~lr - 1 00.5 ' - SYSTEM ELEVATION 1}t L~ t ' 1.. . 1 - ± {8\ itqu iEL 16 EL It, t - - I - - - I Ec.loo CE o ~ ~ l i L I L t I I I j ! ~ ! I I l 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): TESTS WERE COMPLETED ON: L. (IJG_Ge-zL~. B-194(~ ADDRESS: ra pX, ZZ CERTIFICATION NUMBER: PHONE NUMBER (optional): F=L_L_SVj0Tt-n !,L) 34 S76 (4ZS_ ol6y CST SIGNAT RE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. ~P of Z DILHR-SBD-6395 (R. 02182) -OVER - - 1 OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABORAND PERCOLATION TESTS (115) MADISON WI 53 07 HUMAN RELATIONS (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP UNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: sw/~q/a 1-7 /T MN R 118E (or ~1,~►J 1 e k ) NNtc Q~Us~-~ csr~l COUNTY: OWNER'S BUYER'S AME: MAILINGADDRESS: S~~G~Uc b►v L_ C=. ~ssEN 1° ~=-~uS w s~~ ~Z USE DATES OBSERVATIONS MADE NO. .DR IAL DESCRIPTION: PROFILED S RIPTIONS: PERCOLATION TESTe 3 1ti ~ fi , blew ❑Replace I'7_31-d6 ~ a-I.9-8b a -19- 8~ RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE:SYSTEM-IN-FILLHOLDING TANK :RECOMMENDEDSYSTEM: (optional) ®S I D S ~U 'S ❑U EIS ZU ❑ S ~U ~z~ x sZ' S~ DESIGN RATE: If Percolation Tests are NOT required If any portion of the tested area is in the , ^ . under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: J~ PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-IfVS CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH W. ELEVATION OBSERVED EST. HIGHS T TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 1 0. S' tio1.o' NoN~ r,o~ @ Z•~' o•~'Sn Si ITS; -z._21Br) GV•S) ; S•G' Bh De`rjSe `'Ps Lvl B- 4Zi2PLE S j p mk-b s 2 6. 3' .o' n MoT o S' o.S'F3nsi I Ts; S•8' Z, virR~r oEoaSE L B- 3 6. 1' %o6. Il hnoT @ 3.3' 1.5' 31 sit .Ts •1•` 'Bhsil;o.~' R8r► G1,-sc1•2.1'R8h DaZ \Z)S•o' ,l moY Q 1.0' ,V3'`f:BbScl; 3.3'123ti, i>~,se_ L B- S 1. \ O O ' h,~ e o . 6' o. 6' I t o, g ' 2 Sti. '4EA1g6 L t3ti, s~ s`E GI- s l 6 Z.w CI a "Zs I l hnol c3 O, S' CD. S "Z\zGy bit Si } Ts ; -2 -3 ' P,-. B- -7 -z. 4' 0, p, 't y Z,(4 ^ o• G' t, 1.8 -Byl si B- 8 S' 1oS p' t. `%oj-iA 3.2' d.9 '-b'r_Bn 6t-sl TS ; 0.-7 2@h 0eVSE S) o•6'b'rt Ps w/Gr •S•3'LIGHT 13h P -AZ"T S $SiCuEl YU~vsE) ~oS.S' 9 ' b" ,GvsITs; 1 S'i~$h ~ L ;8.5! B- 'L)~rrr Br PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. P RI t P RI D PERIOD PER INCH ZC•Ev. P_ ) t{- S' - 'Z AS P L!{ 83 09 S L 3 10z•a P_ 3 3, - 3! \ 8 1 $ 3 col .y' 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. 'Pa-,c) ' 7-Z*Va@ 83 (szoo')EL plT SYSTEM ELEVATION cE~-i~T tibo • s' , j 7 ell S j I I Ilk I i ~ I~ _I I r hC.4.1~-CE ~1 .l-.I ~I -c`P! f D h/.uPtl DS, i h~l0 . ; I I , IN 1 sf I ' L I!_cE 1 WIC f~~oiJ : StrlETQ.N 13_._ _ I t>T2u Ns I w p ` j IA I ~ , ~ I 1 l0-1~ - - - : i , , IR ! CL NI I Ro 3' m j ~ ~ I ( j ~nCf1'iIOT-t ~ $S ~ I SCAB 1'I = 4D EXCEPT AS St-tc,wr l SEQ. 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: LAJGG ~1Z 8- i 9- 8G ADDRESS: L~ RvX ZZj CERTIFICATION NUMBER: PHONE NUMBER (optional): I=LL Swot's w 14 O 571. -)IS - U '-Olby CST SIGIyATU,IZE: Df5TRIBUTION: Oi i.unal and one copy to Local Authority, Property Owner and Soil Tester. DI1_ HR-SBD-6395 (R. 02182) - OVER - I 61 41.'78 9t N} Corner r n m Section 17 SCALE IN FEET N a T28N, R18W o• Cn co o. Now" 'T1 N d C d a 100 50 0 100 ' Cr T m z = v N O O to p1 m v ~ Cn 7 N O m rt 1 7 Cn W 10 CD C CD 0 C ME C! N s C A m = m m unplatted lands owned by others N ac O r• rF• I , rt ~i S8901713911W 415.00' d rt -h North line of.the SW} of the NE} „ s cn c m m o z rt d m S tT rl• rt s c I T rl~ O O n " N 1 ~ 1n U z = n m ID rn o s u o FILED A ~~r81986 N frl O I C1 ` O N 4 qq, R 'T1 N U S O m r- ~ s_ - c rt M N co C1 d f V n' to rt ~ -I O c rt d ° 1 -3 x E 1 C -3 = 1z 3 N n N D O O O U1 I rt = -f~ v LOT 1 Irt rt X ~o 1 m O 0 -3 I O U m Qi I N O O = (P 1 r-- N c 7 r w fi I= d rt v 0 I2 m 325,576 sq, ft•)INCLUDING ROAD R/W ~N ~ ~ cn w 7.47 acres ) m = `Y I= d rt m Cf 3111471 sq. ft.) a Q- o to )EXCLUDING ROAD R/W 1 _ N 7.15 acres CD C-) D 1 O O l0 1 c n I I I I rt N 7 o, O 1 c~ 1 I rt m co x I m g I 1 7 N O `--n ~ ~ v 1 N = O' O I I .5--. C (A C L" lJl R = 1833.61' - = 12055143t1 i C8 = S00037'48.511E o :3 (A N i I C= 412.871 o a o L = 413.75' h N I 1st tan. S07°0514011E co ° _ I2nd tan. S0505010311W a 't rn I 1 co I t; 1~1c; o uCT 0 I 1 < m 1 m t r, (.I 1 1. C?Glr, lC)UrJ1Y ' rn II COMP,ctHMSM FA%1,S VU44"140 " N m I J3 33' 1 AND ZONINO COMMITTEE 30.961 N 384.041 ' N89°1713911E 415.00' cn r unplatted lands owned by platter r Sb Corner Section 17 Volume 6 Pale 1722 San. Permit No. Owner's name H63.05 PLOT PLAN Show: Location of building served N A Dosing chamber F71 Septic tank Q Vertical/horizontal reference point Building sewer System elevation is Effluent system f Well BE KT l-ES-VST Sd 'Soulrg FA C-r-- Replacement system area Property lines w/in 50' of system A t Distribution boxes [a Scale = 1 L40 I , or dimensioned Np, Pump and controls: Mfr. & Model No. Vertical Lift Size Force Main Friction Loss T. D. H. Vol. Dist. Pipe Gal. per Min. Gal. per Cycle Place check mark in appropriate box, indicating item is shown on plot plan,below: N dntp- . 1 { s-N-L SE'? C -rt7jk w t-M ou TLAjT ELEV . \OZ•S ' T A~W W ~t2 C>?AU 1T~-f ~ ~i'tvR..E ~EPLRCE►''iQUT S~CZ.E~ . ly~`tE : 'Do ~-r ~c cry v ETC oTZ . ~ 1 S o f . LN tilz~, SeRr-E CED,7 36, .8 00 ~~.~A A1J ~~EV. owEFic 00 1~'1"P[N 1oZ.S ~Q- ~~.'a• .2 ynv1EVaT "'PVC 'OIPM i L4 -tDrQc- VOOOGRL WiESER 's~6'.YtiN. P liRP tsBri't1-CfL~.l4;; P~iPt.r4R Rl~avE GP~.ci~r.~D CouC. SEPl7C -t)►ah L \ . ~ ~ ~-Hf2p g Bra ~Z- E~. 1oZ.~3' o►~ sp~kE 1~ R8ovE . C-~l~ov~A 1N a•' ~1.1~ I 44 iJo-[E.= NOES i is ~00o f E. O N LoT L.ltiJ;S L kS ' By the granting or approving of the above plan, or upon the event of a subsequent permit being issued, St.CroixCounty and theSt.CroixCounty Zoning Administrator, does not assume or hold itself liable for any defects in plans or specifications, plan omission, examination oversight, construction, or any damage that may result in or after nstallation. .t~ci3 3-2L3-'~ icenseno. D- - a e P um r s signa ur T,r,N,. 3 . ~1J1 ~L G . 17E~J ~ S S ~ N '7> V--,) Utz ~Jh MC CROSS SECTIDU - OF A BED 5-13STEM y~ plB N 3E,c..t S N i~ SOIL FILL -t 2-"0F AGGREGATE ? - T FMS ~ 'p 2 DISTkIBUTIOU PIPE _ APPROVED 590THETIC COVE G~1~rc N - o -moo MATERIAL OR 9" OF 57RAW \"1~~C.'ZOoIoS~O~~ OR MARSH HAS ` I DF72-2~ °AGGREGATE , ELEV. OF ag•~ FEET. DISTRIBUTIOIJ PIPE TO BE AT LEAST ~7 .INCHES BELOVJ ORIGIUAL GRADE AQD AT LEAST 20 INCHES BUT KIO MORE THAKI 42. IKICHES BELOW FIAIAL GRADE MAXIMUM DEPl"H OF 1=XCAVATIOU FROM OKIGIWAL GRADE WILL BE q, Imc-HES ` MINIMUM DEPTH OF EXCAVATIOU FROM ORIGIUAL GRADE WILL BE ay INCHES SIGHED: LIGEIJSC 1JUMBER•