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HomeMy WebLinkAbout276-1043-35-102 y O o m O d rw g ~1 m no 3 n td x m \ 1 3 - c r• o ~i Q N C N N 3 c O r m < N Y, y 01 m O F jv z Q m w z3 o CO a w (D a' Q ° CO N O - 10 W C`t \ 1 F- r j O cn < Ci :3 (D W N) 0 .0 N N O 7i rt • l--i (D Z O N N ON <D \ n WD cn t7 ~ D a co (o CD ` z 0 ON o rt N W a co - o H (D O o fl c 00 CD V~Y (D w c n .2 Fl- CD 0 0 co 00 0 I ~ W t o 00 y z :E u, Oo n E b y o D y N 1 o n I \ I LT1 ~ -0 0 0 O Oo O, 7~ m m m it C\ r- c m- m u aD ro cY y A W ` ) 3 ° U N) co r F-3 rt l N D OZ ° w O R O v^ E~' S ti N Q ~ H CD CD O 0 O (D (Cl) v CD j O A Z COD A z O C1 C) Z N M 0 CD m co a z o - Y z m CD m CD A N ~ O XC a CC O CCD O < co :3 T CD (D w c (D7 D O G O (DD N C7 N D O_ O TI O O N T Cn CD n ~ 1 VN T O I N I A ti p O N W v 'o 0 O (D a 0 O_ S Parcel 276-1043-35-102 02/13/2006 10:30 AM PAGE 1 OF 2 Alt. Parcel 36.28.19.322E-2 276 - CITY OF RIVER FALLS 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 O - NATURAL GAS INC, ST CROIX VALLEY ST CROIX VALLEY NATURAL GAS INC 212NMAIN ST RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 1393 N QUARRY CT SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 2.037 Plat: 1592-CSM 6/1592 SEC 36 T28N R19W PT NE NE BEING LOT 1 Block/Condo Bldg: CSM 6/1592 FORMERLY 040-1136-30 (560C) ADD'L HIST 718/387 729/102 EZ-U-1499/285 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 36-28N-19W NE NE Notes: Parcel History: Date Doc # Vol/Page Type 10/07/2002 692996 2002/037 PLE 09/08/1997 1262/448 WD 07/23/1997 1096/420 LC 07/23/1997 1067/308 QC more... 2005 SUMMARY Bill Fair Market Value: Assessed with: 133101 0 Valuations: Last Changed: 06/24/1996 Description Class Acres Land Improve Total State Reason OTHER X4 0.000 0 0 0 NO Totals for 2005: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2004: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount 013-SEWER&WATER SPECIAL ASSESSMENT 1,382.87 Special Assessments Special Charges Delinquent Charges Total 1,382.87 0.00 0.00 Parcel 276-1043-35-102 02/13/2006 10:30 AM PAGE 2OF2 Parcel History: cont. 07/23/1997 760/189 R Form- S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER t..Zi -"t' IIiF Oss cir.. , T I W . TOWNSHIP SEC. 3IU T Z' N-R i'l W - ADDRESS}'. # t-+ 1, ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOTLOT SIZE PLAN VIEW Distances and dimensions to meet requirements of ILH-R 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ,r 1 ~l r\ 7 E s h c ~ l t i i { V L 3 INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: i<Y~ tv Proposed slope at site: SEPTIC TANK: Manufacturer: yVT.lE ('S Liquid Capacity: ~z_rzu Gly, : . Number of rings used: Tank manhole cover elevation: 9:S-'84 Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front,© Side,Q Rear, 0 o" feet .From nearest property line Front, Side,© Rear, O _6 feet Number of feet from: well OVC,Z 16(l' , building: 41-n,l (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE 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: Trench: Width: =C?° Length: Number of Lines:R'z5%k0rea Built: Fill depth to top of pipe: Z_ _0%A Number of feet from nearest property line: Front, O Side, O Rear,O Ft .2_5 Number of feet from well: t %k-njV 100' Number of feet from building: 551 (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, O Rear, O Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Plumber on job:, Dated: License Number: ~ 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 CONVENTIONAL ❑ALTERNATIVE State Plan LD Number (If assigned) COMMERCIAL 1:1 Holding Tank [:1 In-Ground Pressure 1:1 Mound 18505753 NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE. Leonard Kasperzak 12645 W. Townsend St.,Brookfield, WI 53 05 -J3 45 BENCH MARK (Permanent reference pomt) DESCRIBE IF DIFFERENT FROM PLAN REF. PT. ELEV.'. CST REF. PT. ELEV. NE NE, Section 36, T28N-R19W, Town of Troy Name of Plumber. MP/MPRSW N<,.. Cnunty Sanitary Permit Number Paul R. Cudd 77 2739 St. Croix 69653 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.. WARNING LABEL LOCKING V P V ED: PROVID / YES LINO ❑X ES LINO BEDDING. VENT DIA. VL. HIGH WATER NUMBER OF ROAD~~//'')) /PROPERTY WELL-. BUILDING VENT TO FRESH ~IAIR INLET. C ALARM FEET FROM G \ LI 0 (J". EYES LINO E YES ENO NEAREST J l[// DOSING CHAMBER: MANUFACTURER BEDDING: LIQUID CAPACITY PUMP MODEL JPUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED'. PROVIDED: EYES ENO DYES ENO EYES ENO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PR OPERTV WELL BUILDING I VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET. PUMP ON AND OFF) EYES ENO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing NGrH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH LENGTH NO. OPIPE SPA CING COVER INSIDE DIA -PITS LIQUID BED/TRENCH TRE/ MATERIAL: DEPTH DIMENSIONS PIT S ~Uv Co ~'/7 GRAVEL DEPTH FILL DEPTH DISTR PIPF DISTR PIPE DISTR. PIPE MATERIAL. NO. TT NUMBER OF PROPERTY WELL. BUILDING. VENT TO FRESH BELOW PIPES AB(7VE COVER I V LF T E E t5) LINE' AI LET: FEET FROM g~ 61 v( Z NEAREST-----I SS J S~ 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- E meets the criteria for medium sand. TIONS MEASURED. YES NO SOIL COVER TEXTURE PERMANENT MARKERS JOBSERVATION WELLS EYES ENO EYES ENO DEPTH OVER TRENCH BED DEPTH OVER TRENCH,BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES EYES NO EYES ENO EYES ENO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH TRENCHES LATERAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER DIMENSIONS MANIFULD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEVATION AND FLFV. EL EV.. DIA. ELEV.' PIPES. DIA.: DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS EYES ENO EYES NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY JWELL: BUILDING'. FEET FROM LINE. 30 +L EYES ENO EYES ENO NEAREST ).S3 61, T 141 Sketch System on Retain in 115t( file for audit. Reverse Side. SIG TITLE D I L H R S B D 6710 (R. 01182) wls~Onsln APPLICATION FOR SANITARY PERMIT S t- Cr01X COUNTY DILHR (PLB 67) F OEPRRTTEnT O UNIFORM SANITARY PERMIT # InOUSTRV, LABOR 6 HUMRn RELRTIOnS 5-3 -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8/2x 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNER MAILING ADDRESS Leonard Kasperza.k 12645 W. Townsend it., 3rookfield, Wl 530(5 PROPERTY LOCATION )OffX ~n7 XlXXXXX Troy 1'Y a. 1/4N O 1/4, S 36 , T28, N, R 19 rxjwkW TOWN OF: LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER Quarry Road TYPE OF BUILDING OR USE SERVED Commercial-Storage Garage E 1 or 2 Family Number of Bedrooms. ❑ Public (Specify): THIS PERMIT IS FOR A: FXJ New System ❑ Tank Replacement ❑ Repair ❑ Replacement Soil Absorption System ❑ Revision ❑ Privy Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. ❑ Seepage Bed LX Seepage Trench ❑ Seepage Pit ❑ Holding Tank ❑ System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued - E An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total # of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity 1200 1- X Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer: BJieser Concrete Products, lnc. IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): Class 1 891 1 , 000 [5~ Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber (Print): Si atur . MP/MPRSW No.: Phone Number: Paul R . Cudd iPRSti42739 1(715)425-2049 Plumber's Address: Name of Designer: .Rt. 5, Box 364 ~ivcr Falls, V J! 54022 Charles Kozel COUNTY/DEPARTMENT USE ONLY Si natur of Issuing A ent: Fee: Date: ❑ Disapproved C ~L l Owner Given Initial / Approved Adverse Determination Reason for Disapproval: Alternate course(s) of Action Available: DILHR-SBD-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398 To be complete and accurate the permit application must include: 1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in a city, village or town); 2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.); 3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks. 4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of square feet to be installed; 5. Complete the section on water supply; 6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi- fication, place your license number in the space provided and sign the permit in the signature block; 7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the permit; 8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation. Failure to comply will void the sanitary permit. 9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable. 10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system, depth of the system, type of system. 11. All revisions to this permit must be approved by the permit issuing authority. 12. A complete plan including a plot plan, drawn to scale or with complete dimensions. 13. Horizontal and vertical elevation reference points that are permanent and clearly shown. 14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s) to system, building sewer and vent observation pipe(s). 15. The permit issuing agent may require a cross section drawing of the effluent disposal system. TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning your system, contact your local code administrator or the Bureau of Plumbing, DILHR, State of Wisconsin. PLOT PLAN Sca le 1`501 3S~.o~ - - - 4- - - - - - - - , a~ Pwtc ` S'.~ ` 0, EL S ~ ~ b 15 -J j 2.17.0'x' PLUtABNG RECEIVED c E P Q ~ ~;r ~ EtAttoNSl ~ 4 1985 I Aeon pINGS OF PLUMBING BUREAU OEPART~4EI,,T INDUSTRY r 1Y DIV N OF ~r SEE C~RRF` °0 FENCE 85057 53 1eJat? 0 n S 3ar,:, n are ex stiP. gr ou 'dl elevations un es~s Ot't ~r:~'_ lOt rSt l!- cast iron OiDe 31 on- --a-A- o 'u 'istuT ~Nd soil bot'h' s 01_ T^is iae Sri ?cur rYd c,=~. ( recu Sep ,i^ tar:., to be ~a on c aaa -i ,y as m__ uiacture~ Garage catch basin X 100 = 100 ;Pd __mpl ogees 6 X 20 = 20 gpd - - 50 "otal 270 gpd _us 5i gal. min 750 _ zal capacity required 1020 gal. 7K A :20C AIMM `.vIESER CONCRETE SEPTIC TV & - - Aoz~c2tion area Lass _era Tate 7ranco nyszw~ 07age catch basin X 2.0 X 05 = _ ioyees 6 X 0.4 X 65 = 396 sa._ t. Q_!"- K 45 _ 165 US! 2 _ EACH 51 X 1001 -__'r R GENE E)oi1985 PLUMBING BUREAU 8505'53 L4 1 7 --NI -t: i JE. S . 2 OF PROJECT DATA OF 4 PLOT P LA E 1985 p~U~161NG BUREAU ~ssls~b~®Q pj~ ASSO G 1 t 's• C S t.! TT T • 0 IV 3OY 7; G 2 1 1". 1 S F- o® S • CHARLES s b KOZEL o ° * E-09415 ° w RIVER FALLS, WIS. p T DE ""i T nnT;i EL E OF BUSINESS = i ' _ - LEGAL DESCRIPTION 7~7 1.3 F_I/V-,UE ~ ; ~F SE .3`"T Z,uu; 2t9w ~^1)L3k I j-!, LA! ! lZ~L!S w.~pf jMS~yD ST. u~ SCR toILT lG ADDRESS 8 J A.RC, i IECT, ENGINEER, ,~E:;<*Z ADDRESS _L4 Z) ~X3 ST.- ?LUMBER OR DESIGNER t^ F::~ . c ;fit ZIP c`4''„- - TELEPHONE !!UMBER -I I 1, S- ^J i o y Check aporooriate building usage s)-and fill in the information recuested opposite each usage listed. Please consult Section H 62.20. Existina building New building ✓ Addition impartments and condominiums Number of bedrooms Ss`mbIv hall . . . . . . . . . . . Seating capacity 3ar . . . . . . . Seating capacity of meals served Sow. i i ra a i 1 ev Number of lanes ( ) With bar CamOground and camping resorts . . . Number of sewered sites Number of unsewered sites Total number.of sites _ Camas ( ) Day use only --Number of persons ( ) Day and night Number of persons Ca tchba5 ; n. Number l _ Church ( ) No kitchen Number of persons With kitchen Number of persons Dance hall . . . . . . . . . . . . . Number of persons Dining hall . . . . . . . . . . . . 'lumber of meals served daily Doq kernels . . . . . . . . . . . . Number of enclosures O 1985 Drive-in restaurant . . . . . . . . Inside seating capacity RING BUREAU Car-service "Dumber of car sp~C Dumo station . . . . . . Number of dump stations -Tai ^D s ( total of all Shifts; Number of emClcyeeS - %10te1 ) Cottaq_es . . . . 'dumber of units with 2 persons per unit Number of units with 4 persons per, unit r _ _ 1i; ber OT dOC tors , nurses medl ca l of ;umber of office Personnel ber 0f patients ~u~~ UarIKS iber of sitcS 'lurs i nc ^Omes . . . . . . . . . . . `dumber of beds _ parrs . . . . . . . . . . . . . . . .Number 0f persons - T0'l_,-s 1 Sno:e. - _ na 0a la 7y i^Dish:;asheryandior dis586'.® 5rz 3 24-Hour service =Y. _ -.Lai number of CUSCOmers JcnCo i s . . . . . , i.,lber of classrooms ; Ue3 ) _rc Se' sGrviCe c r`/ . . . . . . . Otal number c. macnines ~ar'11Ce S 3 '.0n. vum.oer o cars served daily _ r C'~S._ "lumber 0` cersons _ 7 re ar ir~,ce- YeS _ no t'she? ves n`, - - .,rcr~r^c e t an c 'el ding, tank _an _ - - - in , S.. snuare ee n c nes 7 o T ` renr r~eS G „ o -n - - 7-1 ^r OT „re h e c Ur.'e r ^ p - G t c. square eet w i d t h PnaLh o~ ~ y F he depth _-Cpl= v? c -.:,~ai souare ~eet outside diameter ceoth below inlet 1-c al depth from top to bottom of pit _ F0 : DEPA n 1 MEN-AL USE ONLY c;. ana ure of person com,~l e ~ no corm: r e F-) a 1 IJ ST, Zip S o - ephon idumber S- Z S- O 1 6 > ) I ~„Z. 16" M #W. p Ilw^ Lv - T L~-=3 AT a - I y`, PV C ta~ae 3505753 RECEIVED t\ \1 l S E P (J 4 1985 PLUMBING BUREAU ,i ~I) 4- - 4 '~Q-%^ ..,112 _ i PLUMBING TIONS r INDOST R , L I ABOR A N UILDINGS I S, Y Aft DEPARTMENT 0' iJ 0 FNCE co ~1. ~PnND ®1 L H R Safety and Buildings Division PLAN APPROVAL. Bureau of Plumbing P.O Box 7969 ❑ General Plumbing Planf Madison, WI 53707 ❑ Private Sewage Plans Telephone: (608)266-3815 Plan Identification No. i-- j0 L~' ;Gallons Per Day jr " PRIORITY PLAN REVIEW ONLY Plan Review Fee Received Petition For Variance Fee Rec. Project Name Project Location - Street No. or Legal Description Co? F1 City L] Village ❑ Town of: The plumbing plans and specifications for this project have been reviewed for compliance with app cable code requirements. This approval is 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 plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. ❑ FOR GENERAL PLUMBING PLANS: 3a 3b 3c 3d 3e 3f 3g This approval will expire two years from the date approved below. If construction has not commenced before the expiration date, new plan approval must be obtained. ❑ FOR PRIVATE SEWAGE PLANS: (1) (2) (3a) (3b) (4a) (4b) (6) (7) This approval will expire two years from the date approved below or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. The Bureau of Plumbing has reviewed these plans for plumbing and/or private sewage code requirements only. All other system reviews must I,,- submitted ' Comment, By: James Sargent Bureau Director If Questions Plans Approved By: Date Approved: Contact CC I I Private Sewage Consultant ❑ Plumbing Consultant ❑ Environmental Health -J County ❑ Local PI ❑ Facilities Need Analysis `>e( tion I_i UW-SSWMP ❑ Plumber ❑ Department <?f Agriculture n111 !R-sBr,-6099 N. 01it35) Owner ❑ Oth ~r RIVER FALLS VETERINARY HOSPITAL, LTD. 1055 EAST CASCADE AVENUE RIVER FALLS, WISCONSIN 54022 JOHN R. BERGGREN, JR. V.M.D. TELEPHONE 425-2348 ahis 1i to certify that the Troy township City of Liver Falls Extra Territorial Commi.sslon acted favorably c; tie Leonard Kas perzak pro je t. oh?Z h. 3erggrergKr. ~1, ve.r ,'alts Lxtra Temittori.al 't C I U ll 0 w to e r o e ~ r ca p a r t -Oc4ation of ?rope rtY 36 i' 28-N R-19 ..-.,w ..i,..ek,_Q-,F-,--._.._..._..__,-._.____.__...._ Mailing Adilress., Brookfield, Wisconsin 53005 - ~ubdis~~aa~,.otA Piutrara Lot Number Yuvioua Owner of llrol ei. c.y Earl S. Sumner, Kenneth Sumner, Merle r_ Xicaelson 'cataai_ size of Pa3rCe1 50 35-5 a.~°.+:ata Parcel ijau Cra hued a1 L °a c to r° t; r ti I cT u, L, t: l Q t is 4. e i Tiii,A.ude with thLr., application orie of thu. follow C,ertif.ted St;rvaiy Hap . Deed .Land Cuatra.c-,t, or t lose r:gica C ` ocaran cat wllIiich describeS chu. property PROPERTY OWNER CERTIFICATION 1 (We) caartity di t a'I i aat9rnertts on this torin ire true to the best of fray (our) ~:.nowledga; thaat I (eye) ani (are) the owner(s) of thra pr,--iperty described in this inforrnation loan, by virtue of a warrar*t•y ciesVrsrded in the t3ftir.e of ties t ,':.aunty Hegistar of Duo3ds as Document tNo.-Y~1}~~~ ; end that I (we) presently own the proposed site for ilia sewage diiposaal F.ystani (or I (wry) has'Ju Jit,ained an easur emit, to run with the tAxwa descnbod property, for ilia canatruction of Faaid system, and the saanae has beer's duly recorded in tare :.)fticv 0 rfae Countv Register of Doody, arb Do(urnunt 3o, iiiGN.sp7sJfMF.-. SDF 0*.M~lts@1 ilsiriATlchf. OF CG w, i,.a: N eflf.F1 k 1..1;C,61E) v CA cn ".g m? om'0! ` o v u, w w m cC n o w ° o 44 M. =T Z eo c o < : 3 c co co p = a, "n to °npo °~CDw WOD m CD :E CD 0 a U) 0 CD CD :3 CD ? CDmo0 o m o 3 a o oo w o CD cncowo o I =T 2 CS ° 3 c c3oao zn ac Q p :7 j m w cn_ w oc~ woo M=,rt - CD 0) m w ~ -owo-.-o_0 < ID C cn D C - cp i N o n- w n O =cam °oCDM C o w o ~a Q ~ w ~a (D to ° w cn ~ Z D 9 0 CD (n CD * 6- OD w --j m -1 j0; ~9MCCDNa D o a m En 17 CD 8- ; 1 o CA °W~o0 QNm mN~o. cow N a a C 0~ (D ~ C R1 ~~o cnCDww 3-i 0 acs oa~us o :3 m 0) X CD 'COD ~ c o c m~ co n N N 0 3 n c Qc c f= R1 aof omN0 w aaaa-► ao ma Q M w c' s CD co n C cn m e CD (D ~ 2 c N O G) co 7 p 0 0 N D m z CD p co ; C n o c w C , ( ~ ~D w w n ; n 7 0 a =r c CD = o p v n= 3 0 :3 p _"'3 fp .tea n a (D O to o < D) a ` - m CD Co 0 W 0 l DEPARTMcENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILD( IND:U,STRY, DIVISI P.O. BOX LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP MUNICIPALITY: LOT NO!: BLK. Nom'SUBDIVISION ME: N£ '~NE~ 36 IT28 NIRI9 E (or W TROY COUNTY: OW BUYER'S NAME: MAILING ADDRESS: sr. CRO/X Leonard K,~sperzak 12645 T!,,. Townsend St. Brookfield ',,'I 00 USE DATES OBSERVATIONS MADE NO. Bffrq$ COMMERCIAL DESCRIPTION: (PROFILE DESCRIPTIONS: PERCOLATION TESTS: ❑Residence / STORA GE GARAGE ®New ❑Replace 7- /0 - as 7 RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURSYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) MS EV S LIU ES [[is zu CONVENr/OVAL TRENCHES 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: CLASS I Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOFP E A DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON B CJZa 7 l 696.95' NONE 7 7./' an sl (4.69 Bn s/ and gr (2.5'9 F~ B gr B'9 -1- 6 q 6. 3 B17 s l 14.5') an s l and 2 . 3' 897.15' 3 7 4 ' 900.28' 7 7. 4' 8n s9 8'9 Bn /s I/. /'9 Bn s (4.5 I 7. 5 8n 0.9'9 Bn s l ( 0. 6') Bn s and gr 7.5 ' 906.28 B- 4 B- 5 7.5' 9 03.83' rr 7. 5' an s / ( 5.29 B n s and g r ( 2. 3') B- SOIL MAP SHEET 91 PERCOLATION TESTS BURKHARDT SATTRE COMP. TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RAPER INCH ES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD( PERIOD2 PERIODS NONE 30 4112 12 5 " 5 114 " 6 P_ I P_ o 30 4 718 " 5" 4 112 " ' p- 2 P_ I P- 3 30 5" 5112 5 3181, 6 P_ = : C) J 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 / T I AL A SEE SKETCH SYSTEM ELEVATION REPL ACE MEN T B 82 5' WRENCHES ~ - B.ACKHO~S P 9T P2 !A PERC. HOLE _EDGE BANK B - C QUA RR Y ROAD ) O I "IRON_ PIPE FOUND A 0Q O _ Q //RO(j' P/PE,SET, s _ s 842 3 SUITABLE AREA t~ 9000 50, FT B/ P/ f I ' ' c- \ p5 I X SPOT EL E(! tH 897.27' 50 _ 00 I ~y I3 0, 1 C, a 900.26 - y5 y0 b I C 904. 14 ~r I- X / a ~ p 000.3 _ mom-- 9. - yg 1q B5 b 6` 41 r 400 •~6 SECOR.'NE 114 NE 114 Al - - - r A - - 00 0Z M~ 9 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: LAURENCE W. MURPHY 7 - - 85 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): R/ BOX 36A RIVER FALLS W1. 54022 55 - 2445 425 -9032 CST SIGNATURE: / r DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. V , DILHR-SBD-6395 (R. 02/82) , 'ER - i &era EVIi'LL a'as [Mr a„~#e&w ,w3 leq~d e}ae.,x>LI d _11.41,';) ~ JAIlk, U .4`. &i .,l 4T ,ts6Y,a.:.,1 s Or Sc, + Or :3 -R S`r`SF EMS ARE i,t~LU d F C "W~CJI' 4> il) _EASE use =(1f_ ahb€ "ovia :'om s' for t i%!rC oCllr;: >A31{.( f;:;;7 f7t ()i C?(:!Y€q L[#., pIGt i'. . K I_# ~ _ t tr as , f,='t'it , r~{t#3~ a .#tE€ t , { r, ai loro F-f r r t t,ca ~I! fit;;, ;t.. c'1w E-9 r3i a. (dial C,£ ly€.(!f` )hIc (3 10 TM~ F Sandy Loam _c„lt7l r loy tr!v r. 11,41 IN DUS'fM OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS NDUSTRY, , DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX 76 N WI 53707 HUMAN RELATIONS (H63.090) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP MUNICIPALITY: OT NQ.: BLK. NO, SUBDIVISION NAME: NE '/4 NE '/4 36 /T23 N /R 19 E (.4 W n TROY / COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: sr. CROIX Leonard Kasper7ak 126115 vv. Townsend 3t. Brookfield, 1 53005 USE DATES OBSERVATIONS MADE NO. BED COMMERCIAL DESCRIPTION: r~ PROFI E D TIONS: A N TESTS: ❑Residence STORAGE GARAGE LJNew ❑Replace 7- 5 - 85.6 - 85 RATING: S= Site suitable for system U= Site unsuitable for system CN/IMOUND: ~U IN-GROUND~ P❑U RE: SYSTEM-I©ILLHO~LDING TfjrNK: RECOMMENDED YSTEM:(optional) _ UUSS UU S S U S ~U CONVENTI,ONAL If Percolation Tests are NOT required DESIGN RATE: e F If any portion of the tested area 'q.in the under s.H63.09(5)(b), indicate: CLASS / Floodplain, indicate Floodplain elvv ion: da PROFILE DESCRIPTIONS t' BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COL XTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) / 7. 7' 906.52' NONE 7 7, 7' 8n / 0.49 an s/ /'1 Bn Is 3'1 an s(3.9'J B- B- 2 7. 5' 905.84 " y 7 5' an / (2.0') an s/ (0.7') an s ( 4.8') 3 8.3' 907,65' 8 31 an / ( 1.9') an s/ (O. 9') an /s(/.6') an s and yr (3.99 B- 4 8.4' 908,51' " 8.4' an / ( 2. 3') 8n s / ( 1. 0') an s and y r ( 5. B- B- 5 8.5' 909.47' " y 6.5 Bn / (2.3') Bn s( ( 4') an s and yr ( 4.8'J B- SO/L MAP SHEET 91 PERCOLATION TESTS DAKOTA LOAM TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERT D 2 PERIOD PER INCH P / 3.22' 5 MIN. 3 3/4 " 3" 3114" 2 P- 4 P_ 2 2.54' 1 5 MIN. 3 318 " 3112 " 4 1116" 1 P- p_ 3 4.35' S 5 MIN. 4 112 4 374 4 9116 / 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. IN/ r141 903.30 ' SYSTEM ELEVATION REP. 904.70' ~BALIKH E klT SC L / 5 P C H~OLE i } iSuIrA8~, E AREA 5800 SOFT. ~ . I/" IRO P/RE FID. /RO~P/PE S T _ V.R. - ~OP /RONP~PE i_ 2 B ELEV. 08.77' 2 IO' B4 40 / 2 QUARRY ~D : . l r BI13 I ) f J_ I P3 i P - 1 t , I ( - O I Q ' PV O' B 5 40 I Bx ~ SIE CIO R. NE )/4 E 114 I ~ i I O ( ' i 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: L AURENCE W. MURPHY 7-8 - 85 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): RI BOX 36 A RIVER FALLS W/ 54 022 55- 2445 CST SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester./ )ILHR-13RD-6395 (R. 02/82) - OVER - 1 `t INSTRUCTIONS FOR COMPLETING FORM 115 - SRU - 6395 1<i tae ,t coir.foW aiod - t lea ,u rt'r.t, I a ,rlcludr: 1_ C;r;mplet~' (r~q<ti ~It~,eril)ta,r;_ 2 1 her use -xcctioo 101lst pit h l; ;n- t or 00114„(',rt.i:d project; MAXIMUM nurnber of bodrooIrls cr (;ufrttTte~trldi use I>laIIIwd; 4 k this a nevv or repi.lo rnent >ystrnn _ t"milf(:te tfltt',ttrt,ihility 1~.Hml hoxe<_ A ,7JTE 1S SLAIA i!_.t I JH A HtLE)IN6 J"AIVK Of,ji_Y If Al I_ r I HER SYS1 i M& ARF ROL1: D (A i hAALU ON WIL CONDITIONS: "I I ASE ttst>i,A=~ crl; '.ncsvvo h 'w for statloj pock descriptions anti complutlaq ow at, plow; 1 1AAKI: A I.F(,IBLF dawam at:curatdy la mhg your test locations. Drawing to scale is plefeirt:d. A "Brett Indy lit- t 'rd if dialled; y~uu~ [I...~r`Ir;,., h acto 'I(~t'il Ir:Minl t:it.itowa Ixnnt =arcs clearly st"non, anti at, iaellu;tna d, (1 all applopiiade hoxes as to dares, narlles, flood plain perc, 1,11 lot) h"A exf~lllp A a., 11 ,,ppropri;ttcr; + 1, t1w ullormtrtrcnt (A"Al IkOXf plain, elevation) do(a not apply, pla(ai N.A..t the w% I i . Slr;n the iorm aiid Taut" your .:i address anti yoru'certification nuniber; ' 1(ake lagible cov"A anal distribute an rafuired. ALL SOIL. TESTS MUST BE FILLD 4^JITII I"HL J+'rAI Orr I; Whi i A rlllt 211 In <<7F +'t HIP 1. t I~IC , AtANIVAJIATIONS FOR CERTIF=IED SOIL TESTERS hod WW- " WA 1"(~" no Ur 50"41, rttl, Ct;[,i,l„ i'i AT,, A Sanrlstono y; C,t avg.: Curiclva : ' i LS - LIITi@astow - Saud i 6V - Htgti Giouilcfwae,i :tlt;.j `i atua lr"dI f iat swl.i I;~t?ti tiuifdin<; I. ! „atrr ~ ';,.ctrl t:,raater i~hzau I S,utdy Loam Lh,w 'I Loam Fart _ Si,,, it ~'i LoUm B. b S it Gy C rrl',~ to - C iicv 1, '"till y Iiov'v a r;lltil} ~(uirit I Ff~.~ r,I Silty C K LOWI of - Ivit)III ;t. se' c y 0'i y - L. i tl 4 ,.t. - SAY Cady III _ te"v iri , :-c COI III! ''P'0 ,it ,e IH0) - I`lldtty, [rli Iii f`! rj tlM1111cl Ii pro(i. tI'VVL - N,tih vvatci f~errl, ';w I me waw fair i'-i , (#c,1)tl,a1 BM - 13"mh Pt-'Iark vHI:, TO THE OWNER: TV S) l test report Is the first StIAP in seCU"I'q a sanitary permit. The county or the: Department may request Vol iAciltioo of tills soil test hi ow Add I,riot to IIC*rrnir issltaiwu. A complete-. stet of plaru for the Iti ivalu, ;uvvJ )Iii: system and a permit apphc2it rui mta,.i Ire sutallated to tier: iplaofirime local authority fit order to IA 11aR1 0 it! at K FIW ~WJIN , -I Wit tnusi. o' (Iid'i 1, i(d «i rld ')Wted (hef)t (o HO St Itt Uf tiny I I,I:tii lIctIf,)I.