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Home My WebLink About022-1087-50-000 d Pd x 1-4 rt o cn � � 0 "' d 0 ct H En Q H °c H 1 F 00 In In 1 � 00 O In N N H �. F-h n r • H . 0 Parcel #: 022 - 1087 -50 -000 10/05/2005 08:20 AM PAGE 1 OF 1 Alt. Parcel #: 30.28.18.469D 022 - TOWN OF KINNICKINNIC 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 SCOTT H & MELISSA S LINABERRY O - LINABERRY, SCOTT H & MELISSA S 184 HWY 65 RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description * 184 HWY 65 SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 1.350 Plat: N/A -NOT AVAILABLE SEC 30 T28N R18W PT NE NW COM ON S LN Block/Condo Bldg: 18912N 48DEG E OF SW COR NW1 /4 TH N 50DEG E 718.7' TO POB; N 50DEG E 140'S Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 57DEG E 330' TO CEN HWY, SLY ALG HWY 30- 28N -18W NE NW 140' MOL N 57DEG W 298' TO POB ALSO PARCELS A & B AS DESC 1254/13 Notes: Parcel History: Date Doc # Vol /Page Type 12/18/2001 665579 1793/513 WD 06/20/2001 648883 1664/404 TD 07/28/1997 562972 1254/15 QC 07/28/1997 562971 1254/13 TD 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/11/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.350 30,000 192,000 222,000 NO Totals for 2005: General Property 1.350 30,000 192,000 222,000 Woodland 0.000 0 0 Totals for 2004: General Property 1.350 15,000 135,000 150,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 218 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count$t. Croix Safety�nd Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) SanitatlNo.: Personal information you provice may be used for secondary purposes [Privacy Lawxs.15.04 (1)(m)). M"Aff " 'Off : ❑ City ❑ Wmil6kimaTowns hip State Plan ID No.: CST BM Elev.:- / Insp. BM Elev.: BM D script ion: ParceUrt fl87 - 5 5 0 - 000 cM, / s . TANK INFORMATION ELEV ION DATA 6 9 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark . O t• Ie0 t tTD • d r Alt. BM Dosing Lj 4 Aeration Bldg. Sewer Holding St /Ht Inlet TANK SETBACK INFORMATION St/ Ht 6u4el 191.20 1 TANK TO P/ L WELL BLDG_ Ventto ROAD Dt Inlet Air Intake Septic 7_0 ~S� NA Dt Bottom 8a -ro' Dosing �- 15 t N L4 / r NA Header/Man. 14 a0 1 Aeration NA Dist. Pipe 4e- Holding Bot. System PUMP / SIPHON INFORMATION r e S Manufacturer S Demand odel Number Clpa GPM N ✓r TDH Lift-A.10 Friction 1. 2a, System TDH %ZFt � Head Loss Forcemain Length ?0 Dia. 2 tf Dist. To Well SOILABS PTION SYSTEM BENCH Width Len PI th t N Trenches T No. Of Pits Inside Dia. Liquid Depth IMEN STUNS I DIMENSION u SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACHING facture SETBACK CHAMBER `S INFORMATION Type O ��!} 1 .000000 OR UNIT M e Number: System: DISTRIBUTION YSTEM Header / an of Distribution Pi x Hole Size x acing _.Vent To Air Intake 2T Length Dia. Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over c�k 4 Depth Over xx Depth�Of xx Seeded /Sodded xx Mulched Bed / Trench Center ` g Bed /Trench Edges Topsoil Yes No No ns / CO MMENTS: (Include code discrepancies, persons present, etc.) `ipac'wti 05YOZ101 Location: 184 Hwy. 65, River Falls, WI 54022 (NE 1/4 NW 4 3 2 S BM Description = AJ 1.) Aft p �/}- � r - z 2. sewer le - � t • , � • � °t • � 0 9z •S`a � Bldg 9 r r C,c►t�` - amount of cove n , 2• a.3o��3•b c{.4o g 4) to eve q • 3 ° =q�.3 I o �" 4e7.8o' s W S L.... ��.., .. °}� rz n G'�°'""�O�S , s, ° t •�U = `h - 96 Pfan revision required ?' [] Yes No V Use other side for additional information. OS oZ • �q� 114, SBD -6710 (R.3197) Date Inspector's Signature Cert No. _ S 79 Safety & Buildings Division Permit App lication 201 W. Washington Ave. Sanitary PP PO Box 7302 �►�c ®ns�n In accord with Comm U 2I ..-Wis. Adm. Code Madison, WI 53707 -7302 Department of Commerce Personal information you pwV c � y 7yjbf or secondary purposes (Submit completed form to county if not [Prytfac , s. J'5 94j state owned. Attach complete plans to the county onl t S ste er not less than 8-1/2 x 11 inches in size. County Stat Sanitary Permit er t revision r ious application State Plan I. D. Number I. Application Information - Please Print all Info ation Location: Property O er Name P w<. G � f. Property Location 4 'I SZ ,� (� `7 � 11 L 1 /4 `( A, ,N, E o Property Owner's Vailing A dress ° s Lot Number Block Number City, State Zip Code `, 1 ° Pbohe Nz►fnber Subdivision Name or CSM Number EL II Type of Building: (check one) ❑ V'ty ige '� I or 2 Family Dwelling — No. of Bedrooms:_ ❑ Town of ❑ Public /Commercial (describe use): I ❑ State -owned C 1 III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest Road S M A) 1. ❑ New System 1 2. RReplacement 1 3. ❑ Replacement of 4.. ❑ Addition to Parcel Tax Number(s) b System Tank Onl Existing System a , 9 0 ^ ^ S9 — O 0 0 B) Permit Number Date Issued ❑ A Sanit Permit was previo issued d • o� 1 S 9 IV. Type of POWT System: (Check all that apply) o 3 X - r Z S 7'F lBzNon- pressurized In- ground , �bt��C n ❑ ound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground (371>) \ 1 a�,..b&-s-t ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At - grade r ❑ Aerobi Treat ent nit Recir ulati g ❑ Other: !� ✓S C eljs —3 x 37 � w 6uh e a Pr V Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Disper lAre 3. Dispersal /trea L 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required�� Proposed I `� Ra (Gai . /day /sq. ft.) (Min. /inch) Ekvation 9 d VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks k �U 1 VII Respcfnsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown o hed plans. Plum er's Name (print) Plu s Signature (nos s): M PRS Business Phone Number Plumber's Address (Street, City , Sta , Zip Code) A 7b It/ VF � VIII County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Is ing Agent Si ature (No stamps) l Approved ❑ Owner Given Initial Adverse Sur arge Fee) I Determination Z 3 IX. Conditions of Approval /Reasons for Disapproval: p 3 " I 'r-4 wer � �'� 4 1 f tom- S� � s AtL � - ql . ` l2 61 I O Geyt/ w� i v� S , lS Ir gvn S► t ,Q.tiS Wvt/t �� heL.0 W�- , ' H,� S 1 y _ 4"J - � � � Aa 4b PLOT PLAYS Page of 3 `Scale 1' M� s rc - st�,,s.� . - D Z Q ban I s �� Q�plac w Ja,*f r -occ Cha�� 120,0 > J eb 3Z. -� 2 r o Is 3 az _ A a ElL. Lop. (31"A -L;d1' M OF MUSE _5'1 WA C — (-�-C� I s q �L 57 6 s 715 -425 -0165 220254 CST Signature Date Telephone No. CST loo. Job NO. PLOT PLAN Page of 3 'Scale lr 'hD e- Q ban 14ed VT Qep(a w im ,016 , �4 lay LI r-o2 Cha��r 12��G Q J qb 17 rr o 3Z_ ' Gr ..•_�Z RZ r LL -4�0Torl. rhIUBE_S - 1U/ -a - :I Oksi:` r?iP__u �= 31ZL C_►z _.1� Z._� C gq S 6 S 44 LI -1 - 7 - 0 I 715 425 - 0165 220254 CST Signature Date Telephone Ito. CST Ho. Job NO. Wisponsin Department of Commerce SOIL EVALUATION REPORT Page of 3 Division of Safety and Buildings in accordance with Corrim85,,Wis. Adm. Code County Attach complete site plan on paper not less th ti lt' `•x 11 inches in size. 'P n must X include, but not limited to: vertical and horiz to erence {dint M), direction and Parcel I.D. percent slope, scale or dimensions, north nd I ¢''-', istance to nearest road. O Z Z - t O Y7 - 50 ,a_E.. Please print formation. ; viewed by Date Personal information you provide may be usedl[Qr�eCond pt,,04. (Priza W s "t5.0i (1) (m)). Property Owner Prop" Location � Ro ` F_b2�. iz� i`J . tiC 1/4 )Uk)1 /4 S 3 0 T Z� N R E (or) Property Owner's Mailing Address t # Block # Subd. Name or CSM# City State Zip Code Phone Number ❑ City ❑ Village Ej Town Nearest Road 21ut21-�'c!�s I w1 1 sgozZ I ( - ) �3 ) 4zS \-uu3QY fv)Ulc I s` * GS ❑ New Construction Use: ® Residential / Number of bedrooms 3 Code derived design flow rate W S GPD ® Replacement ❑ Public or commercial - Describe: Parent material 'S'R'h VF* ,` tD S Flood Plain elevation if applicable General comments and recommendations: l S (-�- S C.Q1 L3 Z'RC 3 � X .1 - t . S Lo AJC W \Tb} 6 v �J I'M O N l G NF CAA e L`r` f S t b l,jyti P k1Z Lk CH 13e S 44 g k D EL'P . a Boring # ❑ Boring ® pit Ground surface elev. a L 4 .� ft. Depth to limiting factor a in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 - )o'iVZ_ z - s i 1 Z -Fs 6 VL \JYt cw Z m-tvz316 - s I Z►nsbk wl f7 e� - . s e 3 3b 3 tp vz t'/6 Y 5 1oL2 5!6 - D S9 M I _ .s -9 ILl c0U S 1 S ° �o s � s1 GJrtL�vTg 1L u S I& U .� -T 91.5'+ ❑ Z Boring # ❑ Boring Z• ® pit Ground surface elev. () 1. U ft. Depth to limiting factor 8 9 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I o -� t�Htz -3lz si I Z.sb� mil- cw )v� .S .C6 le3 m Ute 4 4 L/ LO 1i R S! � _ �s O h `a witk ' Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Sign lure CST Number Arthur L. Weger t11-L1� 220254 Address W e g e r e r Soil T e s t i n g & Design Service ate Evaluation Conducted Telephone Number 421 N. F-lain St. River Falls, WI 54022 L 4 ``�`U I 715 -425 -0165 Property Owner ! 2 E�'l IU17 Parcel ID# 0 - �-Z 1 10 - S Page Z of 3 Boring # ❑ Boring ® Pit Ground surface elev. a 6 _ ° ft. Depth to limiting factor 7 6 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 I o -� 10 3l - s I 2 - FS b 1z Yvi'F1r cw )v� ' -F3 3 39� 1�� — is 1CSh YrlU`F1- y' sb )o , 1%z S/6 — `Fs o s9. 0 a,� t� � F-1 Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 y ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 60$- 266 -3151 or TTY 608 -264 -8777. S13D4330(RAM) • • , PLOT PLAN r-3 of 3 (Scale 1' =30 ' 9 'A z x 8�1*a IS``'Titk.� q6 —� — qG B 3 y 'd.\ rj r Ir R2 a _z 4Z 'nZZE S 2 I I ez_ 030. o' oar_ JdM i oF- MtjsE S c DI-v G -- (}�L T_. C1►.i .►?ry > .S ' �ZU►"1 S`2C� - fzC 1 A . C, ( S °L s7 b s -1 -C I 715- 425 -0165 220254 CST Signature Date Telephone No. CST No. Job NO. I Combination Sept, c; Tank and PUMP CHAMBER CROSS SECTIOIJ ARID SPECIFICATIOAIS ' PAGE OF -VELIT CAP WEATHER PILOOF JUI cTIOU Box - 't C.I. VEUT PIPE r OL33DUi APPROVED LOCKING � 10 ' FROM DOOR, MA COV ER P xv .ifFiDow OR FRESH A�IUTAKE s tj °MIK 6RA • � .�. 119 Mlu. t � . y�tus�Lxhrn.� pipe 11JLE T PROVIDE I - ---- AIRTt6HT SEAL APPROVED JOIW7 A I I ( APPROVED JOINT: W /C.I. PIPCOR Tank constructio I / W/C. PIPE Poc shall comply with _ ALARM ILHR. 183.15 and 33.20 Rs I I i I o,J C I t t LL FT _ -� . PUMP -� OFF D COUCKETE BLOCK 3'* APPovz-b IZISCK EXIT PERMMED OULU IF TAWK MAUUFACTURE BEDDI R HAS SUCH APPROVAL I2Q F�p01 NsA SEPTIC f SPEC.IFICATIC)US DOSE ' TAUK /AAUUFACTURER: ��` IJUMf3ER OF OOSES:� -.- pER pAy TAWK SIZE: 1 LZ'J'J I bS0 GALLOWS D05F VOLUME r ALARM MAUUFACTURER: S "� IS INCLUDI1JG BACKFLOW. 1 S � GALLONS MODEL WUMBER: 1 p 1 �� CAPACITIES: A= IuCHE5OR 30 6 GALLOAIS SWITCH TUPC: �12e z-Lf Q = Z IUCHES OR `� y G( LLOIJ5 PUMP MAMUFACTUKEK: �VL S C= 9 IUCHES OR 1S3 GALLONS 381 � o MODEL MUMBER: D� I OR by b GALLOUS f SWITCH TYPE: IJOTE: PUl1P AUO ALARM ARC TO bC MIUIMUM DISCKARGE RATE GPM INSTALLED OM 5EPARATE CIRCUITS VERTICAL. DIFFEILEAICE DETWEEU PUMP OFF AUD,DISTRIBUTIOIJ PIPE.. �� ~S FEET + MIiJIMUM METWORK SUPPLY PRESSURE . ; .. � 2 _ •SS O FLET + 9S f EET OF FORCE MAIM X ` � � F oo rxFKICTIOU FACTOR..- �,� FEET -- TOTAL OyUAMIG HEAD = FEET Pump chamber DIAMETER k IWERLIAL DIMEWSIOtl OF TAUK: LENGTH ;WIDTH ;LIQUID DEPTH BOTTOM AREA - 2 31 = GAL /INCH Goulds Submersible Effluent Pump 3871 EPO4 - EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: •_Capable of running. lubrication and efficient _ strength, and durability, dry without damage to heat transfer . components . ■ Motor Cover: Thermo las- Effluent systems p . tic cover with integral handle Farms Motor Available for automatic and g • r. and float switch attachment • Heavy uty sum • EPO4 Single phase: 0.4 HP, manual operation. Automatic points � p 60 Hz, 1550 models include Mechanical 115 or 230 V. Float Switch assembled and • Water transfer ■ Power Cable: Severe d uty RPM, built in overload with • Dewatering preset at the factory. rated oil and water resistant. automatic reset. ■ Bearings: Upper and lower SPECIFICATIONS • EP05 Single phase: 0.5 HP, 115 V, 60 Hz, 1550 RPM, FEATURES heavy duly ball bearing Pump: EPO4 built in overload with construction. E PO4 Impeller. Thermo- • Solids handling capability: automatic reset. plastic Semi -open design 3 /; maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal rotection. • Total heads: up to 24 feet. with three prong grounding p Co. Canadian standards association • a size: I V NPT. plug. Optional 20 foot ■ EP05 Impeller: Thermo - Discharge plastic enclosed design for (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with improved performance. end in P or "AC".) rotary/ceramic- stationary, three prong grounding plug BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 0 F (40 °C) continuous superior strength and 140-F (60°C) intermittent corrosion resistance. • Fasteners 300 series METERS FEET ; stainless steel. 10 • Capable of running dry without damage to s 30 -► scPM components. Pump: EP05 e - 1 - 2-5 FT • Solids handling capability: Q 7- 25 i 3 /; maximum. a W. i • Capacities: up to 60 GPM. _ ; • 20 Total heads: up to 31 feet. 6 • Discharge size: 1'W NPT. 9 z 5- Mechanical seal: carbon- 0 15 rotary/ceramic- stationary, a 4 C BUNA -N elastomers: - - --;- - - - -- - - -- -- - ,- - - .EPOS - - - -- , • Temperature: '- 3 10 �. 104 °F (40°C) continuous } -- .- .f.� -.___ _•__ - -.. - ..._ ..._. _ _. ._... _.y_ -_. 140-F (60°C) intermittent 2 _ -- 00 10 20 30 40 5o GPM L 0 2 4 6 8 10 12 W/h s Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567 -P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number MOM Number of Bedrooms Design Flow - Peak (gpd) Estimated Flow - Average (gpd) Lit Septic Tank Capacity (gal) Soil Absorption Component Size (W) 2 — �w�„�oa�5 Type of Wastewater Do estic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) 0 Maximum Influent Particle Size (in) 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the gtic t tank and outlet filter shall be assessed at least once every 3 years by inspection. Th filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 • v Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep- rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. -�Y � ��6 —q(O OR) 3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address �j P 5 Property Address { (Yuificatiou requicrd fi Phming Department for acw coamuctioa) 1(4� 14e eA-z h P 2 1 c�ity/State / `P � !� Y �S - Paned Idcutification Ntunba O��,Q�' LEGAL DESCIt 7TON Property Location /YC t, ft /, sec. ' Town of Subdivision `----- Lot # - Certified Sarvey Map # •� �-- r Volume . Page # Warranty Deed # J Cs c> 7 Volume rage # Spec house ❑ yes V1 no Lot lines identifiable - ;S yes ❑. no SYSTF,M MAN•CE coaldz=a1tmrts ocasists of p � • ....: tohandtewaste 's.Properaraimacaanee cvcq �a affect�e dim oa of 8be I if ncedcd by s<Yiocasodpampm What y0m pat.i do bye system upcLCtaak�as.a fc�im�t� in t4ye arasted�spora�,ayst�, - . - - - P.r%xx(' cW0m agm= to vemit to SL O nix 7-4 a g Dcpat iL ccatff=tion foam, uga c by tba cwor.a and by- a • Pz�odpl�a�icroriti+ oca9odP: mnpectrcafping >fiat(I6yeoaaitow'asticwator u m proper opc�iag eomMon andlor(2)1ftcrMVOct an tad pumping CIf no y ), the t cpt ic, tank is icss fh= in Lull of dmdgc. Y*,,6 the o adc =k me dhm.=d tc abm togd me& and ag=to W 60 pdvatc scwago dill systamv m f staadaids b by Dot of Qonmycnoe tad t5e Dot of rTataai gross, State of W Glcttificatioa 6ltYOC[rt q ldcs Y st=hasbo cnmainbimodmastbcoxVIdodand =WmOdtodcSLI uc. Officewithin30 of thew c�fion dale-- Y SI USCE OF APPLICANT ! DATE O��NER CLR11h'IiCAMON I (W) oat:iiy t6K all statcmcats on this fo= am hue to &c best of my (our) knowlodgc, I (we am (arc) the ovmm(s) of del tre. by virtue of a warranty flood ivoorded is Rcgisccc• of Doody Office. TURB OF AP CANT / �it� DATE «« « «s« Any infounstion that is mis-r tcd may=* in the sanitary Permit being tcvoked by the Zoning Department. • «• • •• «« Indude Frith tuts apPticatfoa: a cumpod wucaaty dood ¢mm the 1tcgiv= of Doody of toe a copy of the certified aavcy map if mfcnnoc is made in the warranty dood „ . �_ � , F � , �, .,�: �' .. � f�.. ''�; �' 'C '�� SuT� ;a :7C'�k��+ 4t�•C =�i� atb•.dAt ci 5629 11 STATE BAR OF WISCONSIN FORM l6 — 1982 LOCt1MENT NO. VOL U 74PACEa3 II St CROIX CTY, W% . Lo Forehand :JUO 2.8. 199 t, as Trustee of 10:00 A Rose Ward Family Trust t¢ l M«yl,ra..,r aee s for a valuable consideration conveys withcut warranty to —~ Roy J. Forehand and Lois J. Forehand, husband and wife as survivorship marital property I � HIS SPACE RESERVED FOR RECORDING DATA - — �� - �NAaaE AND RETURN ADDRESS Grantee, r the following described real estate in St. Croix County. �) C. L. .O. O G aylord {►t L aw State of Wisconsin: p.O l P Box 46 iI River gals, WI 54022 <' See Exhibit "A” attached hereto and - - -- � II incorporated herein. u PARCEL IDENTIFICATION NUMBER �) I li FEE I i II Dated this 24th _day of July .19 97 +� ROSE WARD FAMILY TRUST i �t 1� (SEAL) (SEAL) • Lois Forehand iI Tn• tee Trustee AUTHENTICATION ACKNOWLEDGMENT State of Wisconsin, ti Signature(s) ss. - Pierce Coun " authenticated this day of , 19_ Personalty came before me this 2 t h day of July 19 97 the above named Lois Forehand f« TITLE: MEMBER STATE BAR OF. WISCONSIN t I (If not, authorized by §706.06, Wis. Stats.) �q yni ktown to be the person who executed the foregoing nt and ackrtowled the sa THIS INSTRUMENT WAS DRAFTED BY C. L. Gaylord, Attor p ren M. Engel _ ` River Falls, W I 54022 V Natli�cPtlt>tic, Pierce Counry,wrs. r (Signatures may be authenticated or ack.•,)wledged. Both are not My commission is permanent. (if not, state expiration date: t.�cessary.) 6 -24 -2001 • Names of per'i As vgntng in any capacity should by typed er pcirtH below their signtures. I� �i STATE BAR OF WISCONSIN Wisconsin Legal &arc Co.. I TRUSTEE'S DEED Wis. I form Yo. t6- 198Z M'?waukee• "`SST¢ ' M VOL 1?54PA rko . t EXHIBIT w A" Parcel k That certain parcel of land located in the Northeast 1/4 of the Northwest 1/4 of Section 30, Township 23 North. Range 13 West. Town of Kinnickinnic, St. Croix County, Wisconsin, more Wy described as follows; Commencing at the West 1/4 comer of said Section 30, thence N 43'Z5'38"E 1892.39' (recorded as N 48'09'E IS91. N 49*02'E), thence N 50')7'38"E 716.97 (recorded as N 1 5 0 * 1 l'E 718.70' and N 50 to the POINT OF BEGINNING, of the parcel to be herein described; thence N 34!2'-"-!2*W 145.00' (recorded as N 34!46V); thence N 38 * 00*52"W 200.31' (recorded as N 38':477W); thence N 34 3)1"'' 153.44! (recorded as N 34'55"W and N 34 '46V), thence S 84'32'55 "£ 316.64% thence S 5025'05"E 210.38% thence S SO 140.15' (recorded as S 50'11'W 140.00') to the POINT OF BEGINNING, containing 1.135 acres or 49,427 sq. k, being subject to easements of record. (For purposes of this description all bearings are referenced to the EasvWest 1/4 line of Sec. 30, assumed N 38 i3*42"W) lM 4 Parcel 3: That certain parcel of land located in the Northeast 114 of the Northwest 1/4 of Section 30, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin, more My described as follows; Commencing at the West 1/4 corner of said Section 30, thence N 49 I392.39 (recorded as N 49 * 09 - E 1891.20' and N 002.1); thence N 50'3738"E 716.97 (recorded as N 50'1 1'£ 718.70' and N 50'14S); thence N 50')7"38'E 140.15' (recorded as N 50'1 1'£ 140.00'), to the POINT OF BEGINNING, of the parcel to be herein described; thence N 44'52'48"E 30.38' thence S 62706'30"'E 114.42% thence S 33 29-99' (recorded as S 32 thence S 56 50.00 (recorded as S 57'0 7E); thence S 33 66:00' (recorded as S 32 thence N 56')." 180.00' (recorded as N 57 to the POINT OF BEGINNING, containing 0.304 acres or 13,237 sq. ft., being subject to easements of record. (For purposes of this description all bearings are referenced to the East/West 1/4 line of Section 30, assumed N 38 23*42"W) AS BUILT SANITARY SYSTEM REPORT OWNER _RG� TOWNSHIP SEC . ZO) T r N, R,/9W ADDRESS 4 � ST. CROIX COUNTY SUBDIVISION LOT LOT SIZE PLAN VIEW Distances & dimensions to meet requirements of H 62.20 SHOW EVERYTHING WTTHTN 100 FEET OF SYSTEM 1 C c �s I di 40 -thl Arrow j SCALE! i SEPTIC TANK(S) 1666 MFGR. CONCRETE X STEEL N O. of rings on cover Depth PUMPING CHAMBER SIZE PUMP MFGR. — DEL NO. GALLONS Per Cycle TRENCHES NO. of ength area + BED NO. of lines width length - length are depth to top of pipe _ NUMBER OF FEP E PITS Outs1 e diameter total pit area AGGREGATE PERK RATE A REA REQUIRED AA AS BUILT Disclaimer: The inspection of this system by St. Croix County does not imply complete compliance with State Administrative Codes. There are other areas that it is not possible to inspect at this point of .construction. St. Croix County assumes no liability for system operation. However, if failure oted the County will make every effort to determine cause of f GREASES AND OILS SHOULD NOT BE DISPOSED THROUGH YTEM. IN DATED 2� 0 PLUMBER ON JOB o LICENSE NUMBER a� ` �. �� s �: .. {; .. . ... �R. v'� F ' .. .� ... � el r . _ 1 . '' /, .. .. � ,. ... ., .. .. , . .. ... ,:�.i.i ... �, ,�, .... ... .... ..... ..._.. .......�....... . . . _ ti' . ��.,... �� is {� .S �.s �M�.�: 3'i s �. t �� ✓ ! .) y ,. .., .. .. ... . ..... ...- ...... .... .w � - /1 A .......,.,.. ... ..... v �. ..... _ .�.�. �.....�_.. l ..'. .� ' i• � "{ .... n........ .��..,sR ��rr.« ..�. _.. .r -em +. .r ,..' � � f a � HMV' 7. REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM' San.itany Penm.it _� 3 ` 1Z o 5 c wh Sta S P p.t.i, c! ` t � NAME Townah.ip /� = - �,_�� 5 Cno.ix County Locat.iom /��_ ��L�Section — SEPTIC TANK -- Size Z� ga•t•ton.a Numbers o6 Compaktmentb I D"tance Fnom: We.t.t (o 6t. 129 on. greaten ,a.tope it Bu.i.td.ing 3 d 6t. Wet,tanda � . #. Highwaten a it. DISPOSAL SYSTEM . D.iAtance Fnom: Wet 12$ of greaten e.t ope fit. Bu.i.td.ing 2 it. Wet.tand.a Ft. • H.ighwaten it. FIELD DIMENSIONS: - Wt&th o tnench� _ it. Depth o no ok be.tow ti..te - Z -in. S 7 Length o s each tine -S/ 6t. Dep o noo oven tit e Z .i n. ` Number o6 tin e.6 3 Depth o6 t.i.te be.tow grade lG .in. Tota•t .length o 6 .t.i nea /.S � it. S.tope o .trench -- in pen 100 it. D"tance between tine-6 A t. Depth to bedrock fit. Tota.t aba oxbt.ion area &Z f - 6t 2 Depth to gnou:ndwaten 2 T o Coven : Pa en: S aw tn Requ.ined area �t yp � Pap 0x DIMENSIONS: Numb en o ot -4 Gnave.t around p.itb yea no Out.6 ide d t. Depth b e.tow .in.tet abb 6t Axea %eq.", -ked __ .._ �t em INSPEC -8 CC TIT / APPROVED ,DATE 2 19 7 ('0 1� REJECTED ,DATE 197_. ILI r _ r Y\ 1 ( i I f EH. 115 Rev. 9178 REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION: /4 „ / <, Section N,R.aE [o W Township or Municipality �r Lot No. , Block No. County �• %� S ubdivision Name Owner's /Buyers Name: 4i �r7 Mailing Address: 1 !! ' TYPE OF OCCUPANCY: esidence X _ No. of Bedrooms COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW REPLA EMENT_ALTERNATE SYSTEM DATES MADE: SOIL BORINGS PERCOLATION TESTS �arl SOIL MAP SHEET / ,( NAME OF SOIL MAP UNIT P O a Itcd 01 PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- SINCE HOLE HOLE AFTE INTERVAL BER INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN /IN fin P- �' ! t 4 S' C. AtV P _ N " b"s D 0 / 11/ P- P- P- SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK l OBSERVED ESTIMATED /HIGHEST / IF OBSERVED IN INCHES B- C !' 7,6 If C 6 !I ,9l s ! IN n B- B- B- PL AN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the to atic� a square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy P In icate sc le or distances. Give horizontal and vertical reference points. Indicate slope. • .•�� Ply, .►e e_ 0. ; frescfiT Q �eQ[�T �!� � �_ .� -eon �. �� ►'�� r . _ _ _ m. e PAP,_. $_,44 lfw _ °= , Pre Ie 3 a N mac' 1 , � 0ese ,' S 3 be e ( Ait . F , , t s i r r e 4 t s , 4 u i e I, the undersigend, 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 location of test holes are correct to the best of my knowledge and belief. Name (print) III ' Certification No. Address e S .Name of installer if known Copy A —Local Authority CST Signature _ J J I 1 1 IM i r - ll f t State and County State Permit PL1367 Permit Application County Permit , for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: � ou Fe e & n d 11tL P' oe F 411S O i l J B. LOCAT N: % W '/d Section O T o� N R E or Lot# -Cit Subdivi n Name, nearest road, lake or landmark Blk# Village Township K I a 1 C. TYPE OF OCCUPANCY: Commercial *Industrial *Other (specify) * Variance Single family _e *IC Duplex No. of Bedrooms 3 No. of Person D. TYPE OF APPLIANCES: Dishwasher YES_ NO Food Waste Grinder YES NO # of Bathrooms Automatic Washer YES NO Other (specify) E. SEPTIC TANK CAPACITY 40 VC Total gallons No. of tanks *Holding tank capacity Total gallons No. of tanks New Installation Addition _ Replacement X Prefab Concrete *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2) Total Absorb Are sq. ft. New Addition Replacemen System Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches _ Seepage Bed: Length �t Widt Depth C � Tile Depth AF No. of Lines 3_ �) Seepage Pit: Inside diameter Li uiA6% 7 q �eptn Tile Size Percent slope of land 49% Distance from critical slope N A I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH -115 prepared by the Cer tifi d Soil Tester,] , NAME Gv C.S.T. # ��y and other information obtained from (owner /builder). C Plumber's Signature MP /MPRSW# 50 Phone Plumber's Address PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). Ir VN i e__ pre s 3 " _ rca 3 Nseot Tcrfc Yo_bC'eC ffl . �7 `bed be re 6c ed_ a lines th 4 W lank_ Do Not Write in Space Below FOR DEPARTMENT USE ONLY Date of Application = - Fees Paid: Stat Co nt Date Permit Issued /R (date) �_ - Issuing Agent Name Inspection Yes No Valid# Date Recd 1. county (whi copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 611176 r ST. CR01 X COUNTY tt 3 WI SC0 NSI N m g ZONING OFFICE 796 -2239 E P.O. . 0 . Box 2 Hammond, WI 54015 April 22, 1980 D 0 Mr. Thomas A. Wang 1009 W. Maple River Falls, WI 54022 Dear Mr. Wang: We cannot accept the percolation test, EH 115, for Roy Forehand, in its present form. You have forgotten to give the following horizontal measurements either by sole or by numerical distances: 1. Distance from house to Bl 2. Distance of tank from house 3. Distance of tank from boring 4. Distance of well from borings 5. Distance between borings. Aside from that, it is a very good looking, easy to read, report. Sincerely, f THOMAS C. NELSON Ass't. Zoning Administrator TCN : j h ATT: EH 115 I E (,� � 1 1 1 5 Rev. 9/78 c REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOMAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION: If ' /.,"I /4, Section —k T-2Q1N,Rj1E (orlW�Township or Municipality Lot No. Block No. I. = • County -�• Su ivis�on Name _ =, Owner's /Buyers Name: d c . , Mailing Address: j w L f • ` , — } TYPE OF OCCUPANCY: I Lsidence __ No. of Bedrooms COMMERCIAL ` EFFLUENT DISPOSAL SYSTEM: NEW REPLA EMENT ALTERNATE SYSTEMOTWR = DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATIO ,{ TESTS are SOIL MAP SHEET �f NAME OF SOIL MAP UNIT J(P` 19 i' /g ., of PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTE INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 a ' �' Ah 16 s A e `, 3 . `' 6 'I , S ' t C dP " s " aL o I P— P— P— SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES 13— 0 16 11 ,91st >A0 9 19 161S B- B— e- PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the an lo t igp� square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy �y . Inicate s le or distances. Give horizontal and vertical reference points. Indicate slope. tk7 �• rBKc:� tJ PriescnT ode I-T tC,��' S * i t S } , �N � i ol Set Pa ff 3 _ , _ _ + ; _ 're Moved i r 1 D. e ` .pl t b A9� be clip scold, ! _ G l� 1 I ' A - 1, the undersigend, 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 location of test holes are correct to the best of my knowledge and belief. Name (print) Tb t ic a t s I Anj Certification No. Address ffi a - ,o e P opi d rbl i Name of installer if known EH 115 Rev. 9/76 . t. REPORT ON SOIL BORINGS AND PERCOLATION TESTS Y WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION /a, T�N, R.1E (orCW3Townshipor MuniciNality ' ��' /a, Section Lot No. , Block No. County � 'i� i S�. t u ivrsron Name -� Owner's /Buyers Name: 4 Mailing Address: w I �' ''' ca C 1 TYPE OF OCCUPANCY: esidenceNo. of Bedrooms COMMERCIAL \ ' EFFLUENT DISPOSAL SYSTEM: NEW REPLA EMENT- ALTERNATE SYSTEM OTI4 R = 1>1 DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION ,{ TESTS SOIL MAP SHEET �� NAME OF SOIL MAP UNIT �N, �!Q i' �Q A PERCOL ATION TESTS TEST I DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL RATE BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- P- P- SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES B- � 7 4 ( n 6 "le/ . n B- 8- PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the Ian tJie lo ti a square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy S A Indicate sc le or distances. Give horizontal and vertical reference points. Indicate slope. �� . rr&011C A If well t , �. �. Presvir �a j c ' te Dl�r �C N4 r 1A Pipt r e_ tle f -0 s e- V% ti ., �N �♦ , s 4 i i &3 - a si .- ._.}ee�1�" $� 4 to . _ be re moved f I ON _. ; ._...� __.�__• �a _ •96 _., **bet Npkced . 1 0; th �'4 n n k s { , l , 1, the undersigend, 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 location of test holes are correct to the best of my knowledge and belief. Name (print) Certification NO. Address r,0 A Name of installer if known J /f' AAA,