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HomeMy WebLinkAbout022-1064-40-400 0 ? 0 0 ? § , , ; 3 « q .E E 'o E_ 7 ® 7 7 7 7 7 0 m> % 8 f w 2 ID ( i @ \ ƒ \ \ ' § § 0. { @ i :z \ \ \ $ k §§ a\% 3 a p r ® 4 / 7 % @ / § CD \ § / A ® ( \ ƒ / 2 § @ E :3 % > / \ G ® i / ® R 8 § a) ^ { CL _0 0 1 / \ a < > 0 r 2 CD CD ° ° \ T R \ \ � . 0 I ) § j j { ~ > § a / \ 'a 0 9 f \ § �0 \� I'D \mk.J fu 3 \ k PO z ^ � { � > > o / 0 \ _ � ° ° 3 \ z { , k z \ � 2 = \ ^ �z z % Cl) a PO [ m © 7 ° : _ \ / z \ » » C) $ \ / � � \ \2± \ _N) § . \\/ 77 % @ / z CD o �a � \f ƒ §2 k � \ \ � � ` f � § � < \ \ eo �§ / \ \ 7 r - W isconsin. Department of Commerce SYSTEM Count SYS PRIVATE SEWAG Safety and Buildings Division INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). 363922 Permit Holder's Name: []City ❑ Village ❑ T n of: State Plan ID No.: Awsumb, Lilie -Jean Kinnickinnic Townsh Imo - 3 ZV - c/Z3 CST BM Elev. Insp. BM Elev.: BM Description: Parcel Tax No.: 60.0 ` tsp,p' rj , c� ,Q = SSE 1 022- 1064 -40 -100 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 1AA L A (LSD Benchmark 3 .3,Z 32 ob Dosing Alt. BM 3. S Z ri -0 Aeration Bldg. Sewer 90 Holding St /Ht Inlet C �� IeZ.q 13 �p (? Of -1111% TANK SETBACK INFORMATION St /Ht Outlet t9) fY 13 Fj$,gj5" Ventto TANKTO P/L WELL BLDG. Ai Intake ROAD Dt Inlet Septic > q0 r 2 r NA Dt Bottom Dosing ->gyp` 65r 5 f NA Header /Man. Aeration NA Dist. Pipe CA) a ` ° (00 ZZ Holdi Bot. System e ilo PUMP/ SIPHON INFORMATION Final Grade s Manufacturer ex Demand St cover 9 . b q 3 gyp' I , 0. ode) Number « � �� GPM �, � �� - -et 1 6 DH Lift ��.`� Lriction (,0 System 2, TDH2o.S''-ft ea Forcemain Length Dia. 3 r Dist. To Well SOIL ABSORPTION SYSTEM BED T Width / Length 2s of( s PIT No. Of Pits We Dia. Liqui epth DIM ( p `` 4 DIMENSION SETBACK SYSTEM TO P/ L BLDG WELL LAKE /STREAM LEACHING Manu ac INFORMATION Type O � ,�' � I Sa � `- OR UNIT CHAMBER odel Number: System: C AWJ DISTRIBUTION SYSTEM IDI " t l((` p( Header / Manifold Distribution Pipe(s) t� it x Ho Size x Hoe Spacing Vent To Air Intake rr u �� � ' ', Lengt Dia. � Length yj 0 Dia. t rc Spacing I 8 r' SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed/ Trench Center Bed /Trench Edges Topsoil I ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Ri Ver Drive Inspection #1: In P /LID Inspection #2: ( I /o3 / ats Location: 1207 s River Falls. WI 54022 (SW 1/4 SW 1/4 22 T28N R1 8W) - 222818347D -Lot 1 ( 2 1.) Alt BM Description 2.) "� So -7 I 3 2.) Bldg sewer length= 1 3' k 4 (g - amount of cover= 3.) contour= a( 4 2>,5*' 1 � �}> �`�` �� COL W : �l �a- a� 1g D'Ve�• r� 10+� ) � PA.. p„�u.w.6o„r � (� � . 2 Plan revision required? ❑ Yes No Use other side for additional information. 2q I L LS 2 �e SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. V r Safety and Buildings Division isconsin SANITARY PERMIT APPLICATION 2 01 W. Washington Avenue Department of Commerce In accord with Comm 83.0 Is.T Madison, WI 53707 - 7162 e Attach complete plans (to the county copy only) for the , on i per no !' County SL than 81/2 x 11 inches in size. o ST C V, E N • . See reverse side for instructions for completing this a tion ate Sanitary Permit Number zoo 3439 Personal information you provide may be used for secondary purposes, 'UN 0 Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. 2 0 /!2/ �/7i/oa cp to Plan Review Transaction Number I. APPLICATION INFORMATION - PLEASE PRINT F 3 a �3 Property caner h4me 6. Propert y I l{ ^o N CkK 5 a a T a8 . N, R e X(or) W Property Owner's Mailing Address Block Number 131� 10 P c►-r We, Cit , State Zip Code Phone Number Subdivision Name or CSM Number a 11C r✓ s 5 I a 4 (!da > V, 47 Cs m S a II. P ILDING: (check one) C] State Owned // C it y Nearest ad Public 1 or 2 Family Dwelling - No. of bedrooms Se ❑ Town OF el W A;, .iv -te e M. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s). z Z. 7- 1 ❑ Apartment/ Condo 6 -2Z -1 0/ -4 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel / Motel 9 ❑ Office/ Factory 13 ❑ Other: specify IV TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. 14 New 2. ❑ Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an ------ System System Tank Only System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 [1 Seepage Bed 21 1 Mound 30 E] Specify Type 41 ❑ Holding Tank 12 F1 Seepage Trench 22 In- Ground Pressure / - / 42 ❑ Pit Privy 13 ❑ Seepage Pit l� / ZS 43 ❑ Vault Privy 14 ❑ System -In -Fill �, 9 VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate S. Perc. Rate 6. System Elev. 17 nalGrade i ?06 Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /nch) Elevation 7 d ✓ 1, 2 4 4 -f 1 02 a Feet Cap acit y VII TANK in Ca gallo Total # Of Prefab. Site Fiber- plastic Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel lass App. New Existing strutted g rsA_ err Tanks Tanks l S O epticTank k 1lo5d In ❑ ❑ ❑ ❑ ❑ � I Pump an ber r X 1 BOG / 7 Ip1 ❑ 11 11 11 13 SPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage em shown on the attached plans. Plumber's Name: (Pr Plu ber's Signatur : (No Stamps) MP R o.: Business Phone Number: C�Y P ,�,° r>o a des 4 2 1 s , 9a.� .?/ Plumber's Address (Street, City, State, Zip Code): l6 4a S S, 7 td ; S4a as IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee .(Incl Groundwater D ate Issued Issuing Agent Signature Stamps) Approved []Owner Given Initial Surcharge Fee) Adverse Determination (v / 00 1!! CONDIT OF APPROVAL / REASONS FOR DISAPPROVAL: 4 �erSt 10a� r` G: I I t (e I ;I - prsor%-r (t-Se 6( / SBD -6398 (R.12I99) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe renewed before fliie.ex( iretion slate, and at a time of renewal any new criteria in the Wisconsin Administrative Code will lie - applicable. ` 3. All revisions to this permit must be approved by the permit issuing authority. 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. Onsite sewage systems must be properly - maintained. e septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. ; 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608- 266 -3151. To be complete and accurate this sanitary permit applica`Eion must include: .r I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to oe installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber into fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County / Department Use Only. X. County / Department Use Only. Complete plans and specifications not smaller than 8 1/2 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; pump or siphon tanks, 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; 0) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and Fj. all sizing information. --------------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 Visconstn a rww.commerce.statemims; Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary June 26, 2000 CUST ID No.220554 A7W.• Rod Eslinger ZONING OFFICE CARL P HEISE ST CROIX COUNTY SPIA 1042 S MAIN ST 1101 CARMICHAEL RD RIVER FALLS WI 54022 - �' \ HUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/26/02 pEC�O Identification Numbers z _ Transaction ID No. 325423 Site ID No. 194984 SITE: _: ' , \A 2 ' t Please refer to both identification numbers, Site ID: 194984 above, in all correspondence with the agen St Croix County, Town of Kinnic ' ZC�oU Q` SW1 /4, SWIM, S22, T28N, R18W >, Lot: 1, FOR: Description: New 6BR Mound Object Type: POWT System Regulated Object ID No.: 670362 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Adm. Code. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(d), Wis. Stats. i A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /instal lation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. TcDe= serely, DATE RECEIVED 06/20/2000 FEE REQUIRED $ 200.00 Sorenson FEE RECEIVED $ 200.00 Wastewater Specialist BALANCE DUE $ 0.00 (608) 785 -9336 dsorenson@commerce.state.wi.us WiSMART code: 7633 cc: GORDON AWSUMB ! MOVE THE EARTH CARL HEISE EXCAVA71NO f 1042 South Main RIVER FALLS, Wl 54022 CARL P. HEISE (715) 425.2175 " Owner MOUND SYSTEM Pon i BEDROOM RESIDENCE as LOCATED IN THE Sig OF THE SW9 OF SECTION ? 2 , T2LN, R TOWN OF �w►v���C►w�u �? CRoix COUNTY, WISCONSIN. INDEX w.PAGE 1 of 6 TITLE SHEET PAGE 2 of 6 PLQT _PAGE 3 0f 6 PLAN SECTION AGE 4 of 6 DISTRIBUTION PIPE LAY -OUT. PAGE : 5 6 PUMPING GIHAMB-ER x' PAGE . 6 of 6 PUMP ` PERFORMANCE CURVE i PREPARED FOR 13 0 q- YA 1?M w wA r � _ ALL 5 4 y E. Y___h1 4 s . e ` PEP E , 4 Car ® s e 5 59 CST 33.14 - MPRS , 3378., :':...2 Z.0 ... . 1042 South. Main St'reat River ralls,Wl 54022 Y i P G- _C �R, DZ):N A.W SUM p_ PLOT PL.4 N . t �F r�- i u1�tL� elk _'G.l�t ► ►v G �(iasSl�Ooc( TREP- EL. f oo,o' r rn - 1650 6Pt S 4TIv LSD GAL S t(�IC+ 7 N �.' Horss q 'PvL 1200 Ga1p P ScWAGE SYSTEM c r � C ®ndidonall 0 PP ROVED s Ivislo k n N OF SAFETY AND BUILDINGS a Y SEE CORRESPONDENCE a� L#T i . J v Designer No Date Non -Woven Filter Fabric 4" Observation Pipe Perforated rpistribution Pipe Below Filter Fabric r ASTM C -33 Sand Topsoil Slope % Bed Of ; 2 Force 10 Gin \ `y t Drain Rock From Pump Layer D PRIVATE SEWAGE SYSTEM Cr Section Of A Mound ' S stem• Using E F .15 Conditio Bed For The Absorptio Area G �0 • .v A Ft. h_1.5_ A1 6 125 Ft. DIVISION OF - SAFETY AND BUILDINGS I Q Ft.. ra J R_ D Ft. SEE CORRESPONDENCE K 10 Ft. Alternate Position L 145 Ft. of Force Main 4J -— Ft' 1 i J 14'Observaiion Pipe —%N _ K A - _- - - - - -- Force Main W �_ o - - _ _ From Pump 3 p Distribution Bed Of Y 2 %2 Pipe Drain Rock :40 b a r v a t 1 o n Pipe Permanent Marker Pipe or Rode Ll Plan View Of Mound Using A Bed For The Absorption Area M& ra r nr- e Designer _ No Date Perforated Pipe Deta ` n d V "= �perto►oted End Cop ,y PVC Pipe �.o'�� a R Last Hole \ Holes located On Bottom Are Equally Spaced Q PVC Force Man From Pump Q PVC • Manifold Pipe <4:; Distribution d►lternate Position Of Pipe Force Main From Pump Lott Hole — Should Be In End Cap Near The Crown Of -The Pipe. End Cop Distribution Pipe layout z p �' �„�•,+. t..� �`f \Y r��. (: \ � r , �'�.� �: r. 1 Vii..`, wt �/ -,-vAj E SU AGE SYSTEM " Hole Diameter Inch onditionally teral,,, Inch(es) r Manifold " 3 AF )PROVED Force Main " 3 Inches JF T DIVISION Of SAFETY AND BUILDINGS � q- 0q 1 a Holes /Later a SEE CORRESPONDENCE - �-- �* PUMP CHAMBER CROSS SECTION Pa .. ge. of Min. Z Vint Pipe with cap 210' from door, window or fresh air intake Vent Cap Weather Proof Junction Box Approved ticking manhole cover w/ warning label f . 12' MIN Final i l A\ / Grade 4' MIN I p j 18' MIN Conduit njuit 15* MIN .' 1 - - - -- - -- - / I Inlet _ 1r Approved f \1 11 vide Ai Pro I I I Approved . • Joint A ! Joints # IVf E SEWAGE SYSTEM i I l Alarm o ndtfionaddy - 1 1 - / 1 L� • ROVED Pump\ i I o i ELE fr. Of SUM AND pHLDiNGS � off i, ELE ft ' crete Block IRF -0 V approve 1pedding material under tank SPECIFICATIONS Note: Pump ,and alarm are on separate Number of Doses: Per Day Wi :circuits as per ILHR 16 s. Ad !Code Gallons Per Day /# of Doses: Gallons <> 2s Volume of Backflow: 84:194 Gallons c f' ?,O� Gallons y. Tank Manufacturer: Total Dose Volume: 'N1 ► � we s?' .� e " 5 Tank Size: `" 00 Gallons " Alarm Manufacturer. U cc*� Capacities: A 23,q inches or Gallons r. Model Number: V V B �._ inches or 5�.9 Gallons C �.' inches or 3 Gallons mp Manufacturer: Z o V L F_ f D inches or 167. Gallons Pu Model Number. Total �_ inches or ! 1� 9b ? Gallons E Minimum .Discharge Rate GP �, ,��_ 88• . ,Vertical Difference Between Pump Off and Distribution Pi p : e• ............ ' L .j-Ft. Minimum Required Supply Pressure: + 2_5 Ft. Ft. .......... . + Ft. 230 Ft. of Force Main x 1,5 8 Friction Factor /140 Total Dynamic Head = 17.01 Ft. D �o G e t h to inlet q 3 q ' internal Pump Tank Dimensions: Length , Width M Signature: License Number Date ,. � r S> 3 ,. aA' :i��, t'�^F �. .. ,�,� i r HEAD/ ¢¢ W x W LL CAPACITY 34 110 ZoELLER C 0 32 105 30 CURVE 95 28 ` 26 85 �- EFFLUENT 24 80 MODEL and O 75 MODEL 189 DEWATER/NG TO 165 V 20 65- Q Y 18 60 55 _ FJQ- 18 50 MODEL' 163 MODEL Y I 14 45 188 12 40- 35 10 MODEL MODEL 30 - 137,139 ' + ; SEWAGE and 165 �. >' DEWATER/NG s o, 5-z - _ m OD 15 - Mf3DEL 40 2 MODEL i 5 53, 55, 7 59 0 80 • GALLONS 10 20 30 ; 40 50 60 70 % 80 SO 100 110 LITERS 0 60 160 240 320 400 TS , FLOW PER MINUTE 70, 60_ MODEL , . 295 6S U f 50 a 14 MODEL n 12 40. tQ �10DEL `.293 O k MODEL r 284 4 MODEL" r 6 20 282 10 MODAL 7 ffzzz1. O 2 s� ;A. 267. 268 x x , ° 3280 Old Millers Lane _ GALLONS + - 10 40 30 40 50 60 70 80 90 100 110 120 130 140 150 160 170 180 180 P.O. BOX 18347 Louisville, Kentucky 40218 LITERS 0 8W, 160 240 320 400 480 560 640 720 (502) 778 -2731 - FLOW PER MINUTE s�` Wisconsin Qepartment of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page ! of Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than,8;/ >rtin z . n must County include, but not limited to: vertical and horizon ) {' ence p*t (BM), epfi and 5 / C Yot JL percent slope, scale or dimensions, north arrow, d locIpy>ff �d rest road. Parcel I.D. # APPLICANT INFORMATION - Pl# "Prix" 11vmr . l Revie ed b Date Personal information you provide may be used for li, l ary purpo%ej ( Law, s. 1 () (m)). ums 3a Property Owner r\ ZONifyGOFtGE perty Location Go v 0 >n its ovt. Lot S W 1/4 5 w 1/4,S 2 2 T pi $ ,N,R Property Owner's Mailing Address 8 / Lot # Block# Subd. Name or CSM# ) rrn n — S WI G Uol II 3102 54310440 City State ZI6 Code Phone NumberCi t �❑ Village Town Nearest Road ❑ New Construction Use: O Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow 4 gpd Recommended design loading rate . S bed, gpd/ft a . & trench, gpd/ft Absorption area required - 750 bed, ft 7 S 0 trench, ft Maximum design loading rate ©.5 bed, gpd/ft ©, to trench, gpd/ft Recommended infiltration surface elevation(s) 9 9 . ft (as referred to site plan benchmark) Additional design/site considerations M o w to d G x/ 2S Parent material L ) 1= SS 0 v -.m V o\ o vn T *I Flood plain elevation, if applicable S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holdinnz U = Unsuitable for system [D S 10 U ® S [3 U ❑ S (0 U ❑ S ®U El 12 U El SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD/ft g Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench D U Y b Le YYtT el ev. G rou nd nd 3 I I 7- 5 Y 2 5/4 I l Yin b m 0 3 3LZft. q 26_ o r Depth to limiting fa t r in. Remarks: Boring # 1 0 -9 "1 6 1!R 3/7- ; 1 vhs 1< Ck S 1 } 0 5 '0. 2 2 9.19 '1aYR34 f w , 3 19 5 L 4 Ground q a9- ) 0 L 561Z elev. eft. I Depth to limiting factor -ZaJin. Remarks: CST Name (Please Print) Signa re Telephone No. Car p, �l e l 4;; 4' Address Date CST Number 1642 S- : 57" R cr R IBS V i 40 al i 0 2Zo 5 I PROPERTY OWNER G"Jop wSUyH) SOIL DESCRIPTION REPORT Page—?,—:Of PARCEL I.D.# Boring Horizon Depth Dominant Color Mottles Structure 2 g in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots r 1,,4 Bed ,Trench os , Ground 3 119 5 C — O, Z 0,3 elev. Auft. 4 24- 10 Y - LS 6 - - - Depth to limiting ; factor Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # ; E3 Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ll Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) PG 3 OF 3 • GORDON AW SUMS PLOT PM N 24.15 AC SCAL E i -/00,0 J QN �Q "b k �FeKCe. Sowf�t �ru�e l: C.GrI 6Y �OwNd FROM : OFUEUEI.OPP'ENT PHONE NO. : 6124321136 Jun. 27 2000 0E:01AM P2 ST CR COUNTY SEPTIC TANK MAWTMANCE AGREBbO "I' AND OWNMR U CER'I`MCATION FORM Mailixtg Address o v ✓+ — s ` gy �a 7 Very property Ad&6U � - SCI .r - i v`•C i..- O•f �verifioatina "Rubw erase Piamias Departs em for new constrt►ciioet -_- - CYty/Stau ' N t � w•'Z. Parcel Ida lficution Number Property Location 2W %. see. 22= T l •R W, TOWn of e k, Subdivision Lot # Cerli#�ed St{n*ay Map # �, - L.' . Voltune �- - _ -- . Page # , - .c e aE�< R►m:ma<ty Deed # . ., Volume page # Spec boup U yes d no Lot Buse identifiable no Imptvper tae and >z�eaamoe of yotu septic system oouid result in its proaatut+e t�tlt�re m bands waste. � etaintaaaaoe coU$JM of pttq ing art that sVdc taaic every. tb,•ee yews or miner. if ended by a H=n d pumper. Wbat You Put solo the ttyOM ears aged tbo Aawd= of 66 septic U& 'u s t tie Is 90 warts dispasat system. The property awow Wm to submit to 9t C mm Z ckS Departmeat s osteWcadan fortes domed by &a awow a" by a mss pltms6e�.leurmY pi . m eioodpiwmbef oc a liaena"Pampa v"Wing that (1) the on -site wastvW"W&Poai sys M is to pYOpa opealtwg eoc&dn *oftr ('3) da Impecdon and putaping,(if aaoe�wty), the teak is km d= to fall of nudge. Um the undmiped We mad *e above requh meats sad agree to roaintala tbg private sewW dopoW sysom with the 9%aftt & W loath, bmia, by tm Dop nwatof Cvmmuoe sad. tho Dopt+rmt of Nab=l gesoucam, Stato of 'W'iwowbs Catifiwtiv statbog that yanr.septic ryMM ha been Matntained Wot be aimptet6d and ratmraad to the St. Cl0h Ceemty Zoning ORW within 36 drys .three Year evi m ion date, MONA'SMB AMUCANP DATE OWKM CERrWIC&n= I (sus) corttfy that su Katemoats on tint Perm are rues to the bast of ray (our) imowisdss, I (we) am (are) the ewn+n(s) of the p dmmUd ab&n. by vistas at a' werearnty dead ieoorded is Register of D686 MO. 910" IVA8 =tW A'PUCANT IIAT* srssss �, iafortsution that is lair- oeps+erestcsd msy result'i:s qu nrunitary petodt bailee rsvuksd by tbs Zoalrrg DGpaftataat. "'" a • ladu& with .&J3 sppt csGont a alamlrsd warranty deed aeon tbs Xmgidffuf DO*& office a OWY of &a -OKIMW sam soap it ftfWW" 'is roads is tale ftiiitlty deed Yo1.1499PAGE 82 STATE BAR OF WISCONSIN FORM 2 -1999 Document Number WARRANTY DEED 620399 KATHLEEN H. WALSH REGISTER OF DEEDS This Deed, made between _George S. Lange ST. CROIX Co., WI RECEIVED FOR RECORD 03 -31 -2000 9:00 AN Grantor, and Lilie -jean AwsU lnb, a marritc IfARRAFITY DEED EXEMPT I CRT COPY FEE: -- COPY FEE: TRANSFER FEE: 375.00 Grantee. PAGES ING FEE: 10.00 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix State of Wisconsin (if more space is needed, please attach addendum): , Recording Area Part of the SW 1 /4 of SW 1/4 of Section 22, Township 28 North, Range 18 West, St. Croix County, Wisconsin, described as follows: Lot I of Certified Name and Return Address Survey Map filed May 13, 1996, in Vol. 11, Page 3102, Doc. No. 543646, 0 22 - 106440 -100 Parcel Identification Number (PIN) This Is not homestead property. Exceptionsto warranties: Easements, restrictions and rights -of -way of record, if any. 00 (is not) Dated this ?/ ., - day of Marcb 2000 • Geo a S. Lange • AUTHENTICATION • ACKNOWLEDGMENT Signaturc(s) George S. Lange STATE OF WISCONSIN ) ) ss. _ } authenticated this Z County day of March 2900 Personally came before me this day of the above named + Kristins Ogland — TITLE: MEMBER STATE BAR OF WISCONSIN (Ifnot, to me known to be the person(s) who executed the foregoing authorized by 0 ' W is. s. Stets.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY • — Attorne Kristine Olan Hudson, W 54016 — Notary Public, State of Wisconsin (Signatures may be authenticated or acknowledged. Both are not necessary.) My Commission is permanent. (If not, state expiration date: 'Names of persons signing in any capacity must be typed or printed below Iheir si nature. ' g kft, lion Pramsionais Company. FerW du t.ae. WI WARRANTY DEED STATE BAR OFWISCONSIN ecoasszo2t FORM Na 2 - 1999 i CERTIFIED SURVEY MAP LOCATED IN THE SW 1/4 OF THE SW 1/4 OF SECTION 22, T28N, R18W, TOWN OF KINNICKINNIC, ST. CRO I X COUNTY, W I . PREPARED FOR NORMA JEAN THOWSON W 1 CORNER OF SEC. 22. (POSITION FROM TIES). NOTE: BEARINGS ARE g REFERENCED TO THE SOUTH 3 L I NE OF THE SW 114.. _ g (ASSUMED BEARING) Co N O UNPLATTED LANDS o I .............................. y � � REC. AS N89 17' 24" E 0 1 h _ S y 89 °55' 39`E�2�89' v — o : hWM to S 89 °54' 25'E ....t�.. O HIGHWAY SETBACK O /� ��]�/1V 208. 70' LINE ED ° p J i 1� O Z� : Q: W S 89 °55' 39' E o 3 Q- 2 ^ a N M y 13 .0PLAIN .4ANPq y e LL ' -j ' $ ST. CROIX COUNIN cc: R : w " 0 Comprchensive'PMamk W : ° S 58 Zoning anti LOT ( 201.29' Parks ComnAMv $ 24.75 ACRES Z ( 1, 078, 160 SO. FT.) if not recorAW W a 24.37 AC. EXC. Rita Within 30 dai" ( 1, 061, 446 S0. FT. ) approval rfa* o w A approval shap'bw& gs. otdl it veM O � 2 � ..a SW CORNER OF SEC. te a+ 22. (1' IRON PIPE S 1i4 CORNER OF FOUND) SEC. 22. ( COUNTY MONUMENT FOUND) N 89 °22' 29'W 1279. 76' 1371 79' N 89 SOUTH LINE OF THE SW 1i4 MMATTEPAARP 0 IV 110 Ow SET I' X 24' IRON PIPE WEIGHING �} JAMES M. 1. I3LBS PER LINEAR FOOT. WEBER � S- 1804 SPRING VALLEY ' WIS. ; o 0 300 �1 %�'��°� 300 600 900 �e qty JAMES M. O GRAPH l C SCALE —FEET DATED N - }I ' � DAY –'? S� L SHEET I OF 2 96-38 THIS INSTRUMENT DRAFTED BY JIM WEBER FPO�l OFVEUELOPPIENT PHONE NO. 612432113E Jun, 27 2000 08:02FM P4 t. C. R 7N its- `PlS• C E R T I F I E D SURVEY MAP LOCATED IN THE SW 1/4 OF THE SW I/4 OF SECTION 22, 126 -4, RIM TOWN OF KIMCKINNIC, ST.CROIX COUNTY, WI. _ W I/4 CORNER OF SEC. 22. (POSITION FROM - 1 T+ES ). NOTE: BEARfNGS APE REFERENCED TO THE SOUTH LINE OF THE SW i /4. (ASSUMED BEARiNG) UNPLATTEO LANDS I w REC. AS NB9' IT' e4 "E � n 6 68 ° ¢5'3B'E4,5 8 R p 4!C rt� 9 HWAY 9E 7B1 �+ 208L I NE 3 n a: Lj H I ti Z): S 89 °55'38'6 �f ;Z to: k Y o 6; W a I 1? /^2oI,Z91 6 E _$ g 24.75 ACRES N Y (I. 078. 160 S0. £T. J app `✓ W y 114.37 AC. EXC. R•W � 1, 06 446 SO. FT. J y� A \ N a G>6i WE 44AA( ,r^ - '�111 o` r ✓�: ,,� c°�, SAN Sd' Co(fNER Of VCC, It 4 .Wae 22. ( f" IRON Pr>F �. s S !i4 CORNER OF FUUNO) \ �� '�• .4£C. 22. (COUNTY 11 ,JjJ�, 14, anti MAUMENT FOUND) —� 'EARN ' i , N 09r2 57 W. L SOUTH L JNf OF TXC SW 1/4 y e X 24" IRON PIPE:WE'IGHING J5.6S' PER L WEAR F00T: 4 e. 7t t w , 1.Iarlr, �r�u FY 1 300 0 300 600 9.00 + r r JAMES M. - A 04 vR�IPNlG 5Cr7ZE —FEET NELSEN -KUER LAND SURVEYING DATED THQ Z-4 - DAY OY' , 1bB6. ` 86 -38 THfS IN37RUAfffJT URAF7LD yY J/M WEE+ER SHEET I OF 2 `` I -7,( Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPO 1; of 3 Labor �r�d Human Relations — Division of Safety & Buildings j in accord with IL.HR 83.05, Wis. Adm. Code cb'`} Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, �. not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or .� L .D! ,'i7 dimensioned, north arrow, and location and distance to nearest road. ST APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION ?r�iC�. DATE PROPERTY OWNER: tJ uPt-wl q PROPERTY LOCATION p'.., .... L":D 2G E L R N G E -GAtf . LOT S� 1/4 SW ,StZ ,N,R 1� E PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK If SUBD. NAME OR CSM # �S�69 s. 1S' s} . CITY, STATE ZIP CODE PHONE NUMBER ❑ M []VILLAGE [MOWN NEAREST ROhD Npvw-� I M S SW I (6 12) y3 6 - 31 W7 1 �,lN►.) �C td tNr�./ lC Z z (X] New Construction Use [JC] Residential / Number of bedrooms _S [ ] Addition to e)dsbVuikfing [ ] Replacement [ ] Public or commercial describe m o2 m (--) — AILly Code derived daily flow SO gpd Recommended design IoWing rate 0.3 6 bed, gpd/f 2 - trench, gpd/ft Absorption area required 3 S bed, 11 31 S trench, ft Makimum design IoWng rate o - S bed, gpd/ft 0- � trench, gptle Recommended infiltratioi surface elevation(s) L o L . b It (as referred to site plan benchmark) Additional design / site considerations M b'Jr j'b w / 6 'x 6 3 ' 8 e1. " 1N . Z' OF Sit Aj%.'2' F, d. t� Parent material Flood plain elevation, if applicable ty • A - ft , S = Suitable for System CONVENTIONAL MOUND "ROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for stem [I s IOU ID'S 11 U ❑ S 8� U [IS ®U ❑ S ®U [is WU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence B rdary Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. g� o -1 lu`1� Z Si ti Zm S�1 w�.`Fy. CL S o.5 0J_ �1 . 1- 3 0 0 �t lz 3 J -- O- S 0. Z L � s Zvn Sbk wt�t. ew � IJ Ground 3 30-40 S - IQ s/ ` — C°. \ S �',� m `�l- L S o Z 0.3 elev. 10 ) fL U 1 46- tL 613 Do to limiting factor Remarks: Boring # ; Z Z g 2V sI ZMAV V" cw o.S o. Ground elev. 13 - LAR - - - — — qt 1t Depth to limiting factor Z S" Remarks: T Naae: Please Print Arthur L. W e e r e r Phone. 715 egerer Soil Testing & Design Service - P.O. Box 74 River Fa11s,WI 54022 Sgnattee: G Date: CST Number: 46 - og M00576 PROPERTY OWNER - P�n►GE SOIL DESCRIPTION REPORT Page L of PARCEL I.D. # • Boring # Horizon Depth Dominant Color Mottles Texture Structure Cbnslstence Bounrcclary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench i3 Z 5 I Z S V k wL 47 2 - 7-3S 1.3 '-I rL I) L � , ; � z-h1 SU hit �� GLJ o - o. b Ground Z 3S -y0 S `Z 2 3A QA Yyl S b k wt `E' � -I ft. y L10 , 10 —t Depth to • limiting factor Remarks: Boring # Z. S 1 , Z S �I r S y Z -3S 1C�`2fZ 3l6 S) Z vn S�1-c wL'�'i� i -- Ground elev ft. Depth to ` limiting factor Remarks! Boring # E3 i Ground f elev. ft. ` Depth to limiting factor i Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SRD- a33nfR o5ra�1 PLOT PLAN Pa of 3 SCALE 1 "= yD ' "G\iRi lv BF. AT U_ ST ZS' Fir-o" M w)vJ b , ��L a Y �� • t �� ct h zq. fic-22 I-Ur \S loo ' weal' of 1�pvti.D F� -►�E- ►.SOT 1�R0��'Ty LINE at 4 `��. Q► `'� - p one 9��'c4tGN, 31U����A. � P v c I'AM t—" g zs 9 CL i c-0u�� 31 r'L Loa. 6 et.too� 89 a.y u c 452.84 r 6 ao >' x 2y , std p r dd 2�1•"1 Pre. s9' �z,z9.�6i - --- 46 -08 c l 4 C ( 715 ) 42 5 -01 65 M00576 CST Signature Date Signed Telephone No. CST # Wisconsin Department of Induso, SOIL AND SITE EVALUATION REPORT Page of 3 labor and Human Relations J Division of Safety & Buildirgs in accord with IL HR 83.05, Wis. Adm. Code COUNTY inches Attach complete site plan on paper not less than 91/2 x 11 in size. Plan must include, but not limited to vertical and horizontal reference pant (BM), drection and % of slope, scale or. PARCEL I.D. # dmensioned, north arrow. and location and dstance to nearest road. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: M tIPLM A PROPERTY LOCATION G F-b 2G E G9VT 1 S►0 1/4 Sw 114,S ZZ T Z8 ,NR 18 E (wj�b PROPERTY OWNERS MAULING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # vS7t,4 S. 1S ` 51 . 1 - 4ROpos� c.s.wt_ CITY, STATE ZIP CODE PHONE NUMBER ❑CITY []VILLAGE MOWN NEAREST ROOD I MN Ssoot (612) y36- �IQ I I 2 %,",- INN e, [�Q New Construction Use [,>V Residential / Number of bedrooms 3 [) Addifikn to e)dstalg building j ) Replacement [ } Public or commercial desaibe Code derived daily flow u SO gpd Recommended design loWhg rate o -3 6 bed, gVW - trench, gpd/It Absorption area required 31 S bed, ft _ 3- ' S trench, 0 M;W mxn design batfing rate 0 S_ bed, gpif/R 0• L trench, W * Recommended infiltration surface elevations) l O Z . 6 It (as referred to site plan benchmark) Additional design / site considerations I" l t- VhlO w / b ' X b 3 ' 8 e " I" . Z' of S?4M1' f =t h_ t- Parent material L I' " S ov tm Flood plain glevation, if applicable ' A • It ` S = Suitable for system CONVENTIONAL MOUND &GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U - unsuitable for s ❑ S IO u s 11 u ❑ s 01.1 ❑ S ®u ❑ S ®u 11 s WU SOIL DESCRIPTION REPORT i Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Rey Roots GPDlft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed rft� ::row" w 1 0 - lu�� 3 tz — S' \ ZWn S)bW, CL — o.s o. Z - 1-30 lo% -ctZ 3lG — SO Zwt Sbk M Cw - o• S 0.6 Ground 3 �0 - 40 � `t2 S/ L — 1 \ S �k m `�1- e S o.Z o. 3 elev. co U 14a �oLtR 6 13 — 15�3� — — — — — Depth ID limiting Remarks: Boring # ov 1 S _ o • S ` c Z Z $ -2A Vzl �l(, Sl ZM S�� wh�L CLAJ o. S o. 6 - S zo -ZS Z.SYP sly - C� S�k Wt i - Grour d elev. 2S- )WY/7 1.13 — gi t Depth b limiting facror Z S" I� Remarks: TNane:— Please Print Pine Arthur L. We erer 715- 425 -0165 eg Soil Testing & Design Service -P.O. Box 74 River Falls,WI 54022 Si n*w: Date: CST Number M00576 OWNE rvGE SOIL DESCRIPTION REPORT Page Z 3 PROPERTY OWNER g _• of PARCEL I.D. I Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary -Roots GPD /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trer>d? 3 ° -7 kj`j 3 Z sl 'Z W1, Sbk w `{��- °v D.S:: o. 1 7 -3 SO Zh1 SU W o: S o, � Ground Z 3 S _y0 S `Z R S% G1 � Yn S b k wt. k c S elev. 101-1 •-1 ft. y 40 Depth to biting fa 0 Remarks: Boring # - � 0 -1 <o`- 1,tZ3lZ � S1 � Z�Sb v�'�'I- °�-S - o•S o.� 4 Z 7 -3S 1�`i 3l` s 1 ZM Sblz rn�'H CS i 1 3 3S - LS ? - - Ground elev ft. Depth to limiting i factor II 3 s I� Remarks! Boring # i Ground elev. ft. i Depth to { limiting { factor S Remarks: Boring # • Ground a elev. 1 ft. Depth to limiting factor Remarks: I �pn- R33nfR nR /091 s PLOT PLAN Page 3 of 3 V SCALE 1 "= yD' WtTLL •, 1 1, 1, Jv' if k ti' R ST LIMB or 2t1. tvcRg LET \S loo ' We3T' o>= "Ov) Ft�e.�- NOT P1zoP -�`(y UNE �L 44 6 �? v c p�pF W /hroo� t_h'ni r g, L �-_L 'Loo - CohPhc - - -- �25, DtS ),j �tts T OR I 31� ' l2oT�"'1 OF Q� • 102.6 � . t3 • 3/ ' ` Lt.too� 89' .a 0 0 4S2.84' Zog.)o' a °. 0 W X 2p"OIL 9 2 , �• o � I 46 -08 C L (715 425-0169 M00576 CSTSignature Date Signed Telephone No. CST #