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024-1026-60-000
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P M /ene E `/ Farms, Inc Mahn 200 T y ► nc�e�a /3778 71x17 N p . 5• . /5668 ` /S '4, .sho e F �� Q p \` 4 •. _ F F ,,a t Fred rc 0 C v % • < \ S,� l o �,r `Z . • • • u Duane /C. • 3 J N S C / a w'4U r,tlN 1 l O % • crro f R tl S v.'C \� vtl0 a Y@ C% Wi % /iarnC bL 00 v /Vew10 Caro �`�. ffav � b son Al a N .. • J V Q �� ('. 16° V (l, 9 �a 111.1 2 L0/5C17 • tl 57W AVE. b S n g M BS .60M Z, W 40 4o �0� 9zB..7 Forms, Inc. tro,�, Snc- D eTohn S. vC / S ;/h hJeber 'P aha dD Karen W <J d¢ y & ° L 17aan u f /y 6O 6O a s �Toan ` t,JenM Whom s v • G✓a /fa M vSmNh N e, Neuman c V /3ar 6a Clyyde s v /z° un y Wiese Toa.�r,e � zoo g t 0 Casey' /sB.73 /39 W L Z a co , son ® Hermance. w a SCfiu 9° l p ' N a D 60. / -' W u C FIB /ores Bros Bo Y y Nea} r Fairmo�r Wa/ •79 • Ja <27- Far lv 23c la C C u v Hei 76uch 60 0 Q u • Zrrc. y � � 3 V v y �' p Lan iq Farms, Sac. AVE f en W V Eugene j{ 0 n L - v Howard ex - BaKKe N • H zscn /ark �TOhn . /Ve ann //7 exe �ordo� SQ.F/ce 4VE. /� /6O et 40 7i7s c.R 40 ¢O aha zo/ ¢° eoo QQ�� ao p �'q es h-os'� o h'P 5 Ruth Tiin Leor� W 8 F sse • Gar 2 No We //s O A d My /and doCr 40 - t y 9 sss6 so • r -a° eta✓ s 40 <✓fiiSFJering �� N 3 bC BO �oW.v'� ao 79 0�� �Sicts lie .�uc . S / M.che //c K, n s Era v m 3 dj d ha�/es 'Koger t o • Swenson Rahn rs u .d C v F o f v, v 17ennr nFh m- a z t a • S K.' ti° sirs /as29 11074 GT9 C C� w 8'CV '•an ro .r - �o /�.� <nk �� .F� c 3 r zs 7 S � s/ S <Rm� Tekse U d�n f; //8.94 F � rdo-< .ari 5 r7Q y ,ray •Tam ra 68 gy C/¢rence ea 6 �y es /ene e7.s.s h� ba L. Sharon J. g v° /coi ,B er ones cS�•�.e•�s °� o Q - B/B Howy Kush ¢/dt Robert q- F5 b¢ a 27 FNa.n°.�d 4 ✓ /so �'Q o ' .asz6 fBO Flus /rum �� � � /semis ,Tacobs °„ anae � h .. E ei /d f vies Sk // tl o cTahns <7u/ie O Z o Th O om o Th°aROS rS?1 / • /eo.a Kerry S. Licht ,e en 9 Hord F n/� L, 4 n /an py 9 son zo �' • Qoen .y KraFt T C�i.00 0h� B.ZS ar Y W.�'A Tm �Rwr St_�'enso.�cken 325.6/ x Freeman •s 223. r7 � Fiances y � /zo \ C o � 4o TnAS� j S SChi /t9 e/R .eo •,n /35.3/ �3 Qr . /s a rQo_ ti e /zo MoTllcke� i �( • B4 . PM C.. OQ0 76.5 a�. ,s// .; - 7l. • Wi//ara' Ott • • obf • • • N� •.. YY • Yleny e Fa7ni!<1 Tusf � /2o Z1 C � /oO Nan _ � j; C /s.3 FJar y cT Char L'Karcn e anc b s 1 o y Ticbst u o e u C NTERV I vE �a /a /son 4tiNer Bar ar¢ AY 9/eXande lan l C Loy e N Ory n L. tl a� h glare f T so /zO tl v tree / /eO Peterson y q o p cTeanne y Ric and rY B uce s /20 Q a°2 Thorn 4o R. Hopp � 63 /99/ Roc Ef rd MQ o 6/s I c. �. ¢O /20 3 sd/ S7CR0 /X PIERCE COUNTY O �tCrox o riy, w,s. o P[ EASANT VAG L EY TIYP. - >I e R/YER TIYP. 1500 1600 1700 1800 1900 2000 2100 MAi Pu / ��� p � S & N LAND SURVEYING o _ SYMBOL OF DEPENDABILITY PROPERTY SURVEYS AND QUALITY IN TOPOGRAPHY SURVEYS • PLAT BOOKS SUBDIVISIONS & ,o y SINCE 1944 CERTIFIED SURVEY MAPS ROCKFORD MAP PUBLISHERS Inc. ALLEN C. NYHAGEN, R.L.S. 4525 Forest View Avenue, P.O. Box 6126 PHONE: (715) 386 -2007 Rockford, Illinois 61125 108 WALNUT STREET - HUDSON, WISCONSIN 54016 r> Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 479430 0 GENERAL INM4MATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Cla comb, Edward & Diane I Pleasant Valley, Town of 024 - 1026 -60 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: OC L a /ob 6 ik k G 19.28.17.156B TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. • 7 6 9 to Septic Benchmark loo z -A 5 ia2 . / as Dosing ` Alt. BM ' • k Aeration {� Bld .Sewer Holding / St1Ht Inlet q � 3 3 1 �.. TANK SETBACK INFORMATION St/Ht Outlet t W BLDG. vent ke ROAD Dt Inlet ✓ �__ �Q� V �'t Z Dt Bottom /� 1 �• 1 Jq! + !1 � Hea r /Man. ` 2. 2 (bo Di 2. �z / Bot. System Final Grade V i PUMP /SIPHON INFORMATION I fi s `� e5'F"• �d t Manufacturer Demand S C e G � P � Model Number ' 21 C 2 o Q U g 0 � / 3� 3 TDH Lift Friction !s Syste Head TDH 1 Ft G `'' , • T� Forcemain Le th Dia n Dist. to Well b SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS �— SETBACK SYSTEM TO jq WELL LAKE /STREAM C G Manufacturer. INFORMATION Type f ystem: M CH OR W t UNIT Model Number. DISTRIB TI N SYSTEM ,.OA Header/M nifold Distribution x Hole Si // Hole Spacing Vent to Air Intake 2 r Pipe(s) Lengt Dia Length Dia Spacing All SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of j xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil i _ Yes I 'f No ( ]Yes j No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: �D / Zf-) US Inspection #2: / b' S Location: 204 County Road W River Falls, WI 54022 (SE 1/4 SW 114 19 T28N R17W) NA Lot Parcel No: 19.28.17.156B�` 1.) Alt BM Description = if Proms., 2.) Bldg sewer length = 3 b 1 � � - amount of cover = f NCILwJ�� ((fit CAI '. Use other revision for Information. o Date Insepctor's Sig ture J J Cart. No. SBD -6710 (R.3/97) Safety and Buildings Division County W a 201 W. Washington Ave., P.O. Box 7162 T isconsin Madison, WI 7 ""' Permit Number (to be filled in by Co.) Department of Commerce (608)24315 1 E: n "C) 79y30 • — r te lan I.D. Number Sanitary Permit Ap io q ��r t; , n _ 116 ? 3:3 In accord with Comm 83.21, Wis. Adm. Code, personal ' f n ou provide J P may be used for secondary purposes Privacy Law, ) Cf=t01X COUN y Proje Address (if different than mailing address) Sf. �60 I. Application Llformation - Please Print All Information 5„ . Property Owner's Na me Parcel # Lot X Block X �JLward 4- 17 �e, Co b 0.24 - Io jk -(d - ooc-) Property Owner's M ailing Address ' - Property Location 0 4 S !4,S �j _u,Secdon a City, State Zip Code Phone Number g RI 1S .54027r �1sa� - 9 34a Tp'� N; R�Eo We) 6 II. Type of Building (check all that apply) Ok G.S (1*''"' S'���'^'• � Subdivision Name CSM Number X1 or 2 Family Dwelling - Number of Bedrooms ❑ Public /Commercial - Describe Use c �^ El /► l State Owned - Describe Use oy n �� �O X �c� ptJ1 W 3 ❑City_❑Village„OTowtuhip III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. X-New System ❑ Replacement System g p y g Y ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: (Check all that apply) ❑ Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil a Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ 5 . - Recircu tin Sand filter J El Recirculating Synthetic Media Filter ❑ Leaching Chamber El Drip Line ❑ Gravel -less Pipe ❑ Other (explain) �� / t V. Dis rsal /Treatment Area Information: Design Flow (gpd) Design Soil Applic ' n Rate( sf) Dispersal Area Required sf) Dispersal Area Proposed (s System Elevation 45o b. 4 jI 450 ti� qq ✓/ VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Q �; Tanks Tanks D iii Septic or Holding Tank ao© i loo e) Aerobic Treatment Unit r G Dosing Chamber Od _ 00 yf 7 v i V �/ j I VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's i e (Prin / ) - Plum is �gature MP / O PRS Number Ius�ness Phone Number F f� is Pi v� OW 5s s ��. 7 Plumber's Addre ss (Street, City, State, Zip Code) 04Z S n1 5 r, lei FC(, C.v 40 2Z VII ount /De artment Use Onl Approved ❑ =Reason Sanitary Permit Fee (includes Groundwater Date Issu Issuing g nt Signatur (No Surcharge Fee) 422 6 , O ❑ or Denial IX. Conditions of Approval /Reasons for Disapproval SYSTEM OWNER: I. `So* tarok, et'I►Ilsnt faw and d epoMW col must eN be undm / mihMned ss psr nmogsmeltt plan provided by plumber. 2. AN sobsck requirements must be tr * t Wwd ' at per sppkOW cods / ordkwAm. Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size f SBD -6398 (R. 01/03) # _ PLOT PLA N P 9 2 OF 7 SCA LE 1 -� 40' 'JULFS5 DIME N I N t` 5 L �/ W 4 S I9 T26 -N F 11w s �Z !h I 1 2� `_— V___ r 1 rm pro e, 0 — 1AS74L SER C"� PRa POLYLOK S25 F) LrFR 5e 4^c jow t 2 —� 4 Safety and Buildings 4003 N KINNEY COULEE RD commerce.wi.goV LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 i s co n s i n www.commerce.wi.gov /sb/ Department of Commerce www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary August 19, 2005 CUST ID No. 220554 ATTN: POWTS Inspector CARL P HEISE ZONING OFFICE CARL HEISE EXCAVATING ST CROIX COUNTY SPIA 1042 S MAIN ST 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/19/2007 Identification Numbers Transaction ID No. 1187330 SITE: Site ID No. 703278 Edward Claycomb Please refer to both identification numbers, 204 Cty Rd W above, in all corres ondence with the agency, Town of Pleasant Valley St Croix County SE 1/4, SW1 /4, S19, T28N, RI 7W FOR: Description: Proposed Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1034890 Maintenance required; 450 GPD Flow rate; 18 in Soil minimum depth to limiting factor from original grade System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01 101); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD - 10691- P(N.01 /01). • The pressure network is to be constructed in accordance with publications SBD- 10706- P(NO1 /01) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81)" • 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. Stats. • Inspection of the POWTS installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • Comm 83.22(7) - 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, ude local inspectors. . Condi iolrakv AP"6ROVED CARL P HEISE Page 2 8/19/2005 r Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received S 175.00 Balance Due $ 0.00 Gerard M. Swim POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm WiSMART'code: 7633 jswini@comnierce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 0(0 set 295 COUNTY ROAD SS EXCAVATING c• RIVER 800 829 -3723 "" °�' 715-425-6200 715 - 425 -8466 FAX _ ,/e ,`►...,. Lam: MOUND SYSTEM FOR A BEDROOM RESIDENCE LOCATED IN THE S r ' /4 OF THE 5 jj '/4 OF SECTION Imo, T N, R 17 W. TOWNSHIP OF �� ;,; ,�* �'x 1� _ Si .rte_ COUNTY WI. INDEX Ai Zp05 PAGE 1 OF 7 TITLE SHEET PAGE 2 OF 7 PLOT PLAN Lj���aa'��� PAGE 3 OF 7 PLAN VIEW -CROSS SECTION k.0) � PAGE 4 OF 7 DISTRIBUTION PIPE LAYOUT PAGE 5 OF 7 PUMPING CHAMBER PAGE 6 OF 7 PUMP PERFORMANCE CURVE PAGE 7 OF 7 MANAGEMENT PLAN PREPARED FOR 2 C''t RA Q _ RIVE A s �&Z_Z 1� ..,.,,,c, yr .u,v,r•U1LDiNGS PREPARED BY o f DIVIS�oN S FE7Y AND r CARL HEISE MPRS 220554 �� SEE CORRESPO. 715 -425 -2175 FAX 715 -425 -8466 This plan has been prepared in accordance with the Mound Component Manual SBD- 10691 -P and Pressure Distribution Manual SBD- 10706 -P PAGE 1 PL OT PLA N P� 2 4 F 7 + �� tE 1.�q4'' UIJLFSSD�M�,N ?l41� r J 1 1 , ' 1 81 rm pb�► P.� ce e YJ�1;L a ;A S74 L w/il sER c OVA PUP cdo /goo C ©mec u% /- Lo X25 Fi L*rrR C.P.. 33 tti1` 7� 2 i Designer No Date Non Woven Fil ter Fabric 4" Observation Pipe Perforated �Dis1ributi0n Pipe Below Filter Fabric AS7X C -33 5 0 n d ►� G z. 9 9 • Topsoil �J I % slope i r • i F'IOwt d � F or ce , Ma n Bed Of ids 2 _ Drain Rock From Pump Layer E C res s Section Of A Mound System Using F A Bed For The Absorpt Area G C. A Ft. 6 Ft. Ft. J - Ft. Y, JC. CJ Ft. Alternate Position L Ft. of W �� Ft. Force Main L - I 140b5arvotion Pipe -� C. A I - - - - -- -------- - - - - -- ------------------ - - --41 W Force Moir _ — -- - - - - -- -- - - - - -4 From Pump 3 p Distrib Bed 01 Pipe Drain RocK Obtarvation Pipe Permanent Marker Pipe or Roda Plon View of Mound Using A Bed For The Absorption Areo •� ..) r rt L t t r y . . .LLEA S Distribution Pipe Layout page of / Place the holes at the bottom .. of the d_st.iSutioa pipes at equal spacing, Remove all burrs from the D_pe and holes. Er:c�d the end of eZCh IGter.� up •Adlt the Ze of long cunt or 45' &mzg to a Four s withia i7 incyes of the fiaal ode. Te. ^.-.ira te the e: ds of th c laterals with a valve . threaded plug. Provide aces from fir, , threaded up Cr .,._..I gade for the val re; thre :ded or thr-, ded plv;. CJ DVS Vier M3rrz1, C ._ .. ••ijr13': l )ftr1ln*1fi -b _ L -h P civt 'v ton 'ns I - -C F t HCle S_,5_Ft' Lateral " �- inch (es X 2 '1Inches Manifold " _inches Force Main " inches #of holes /pipe Invert Elevation of Laterals j Ft. 1 X 0 t;' ' ( 1 .29 x Q ' 7L G.P.M. Page,_,2Of •• SEPTIC TANK S' PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS .• '1" WEATHERPROOF JUNCTION BOX APPROVED WIT: CONDUIT MANHOLE CC' W/ PADLOCK - -- - /__WARNING L?._ 4 r Z 18 .IN 6.. MAX.f INLET WATER TIGHT S E.ALS I GAS- TIGHT A C_Sr, ' VAPPROVED r LYLcK 2 5 __f_ JOIN — IS WIT B � APPROVED P 3' ONTO ee`` 22 C ' SOLID SOIL PT ' — �A. T(Z ;' - c NS - -• - -� / LOSS _ S_z-s SEPTIC 1 ec� CAT . �NC� DOSL �'�� GAL. r u FLOWBACK: ll�.��i GAL. ALARM MANUFACTURER: �L�c�r CAPACITIES: A = a.1 s INCHES = GA MODEL NUMBER: p 1 ,SWITCH TYPE: e.+,,,q B = 2 INCHES = 33.5"l, GA AC 7,TREPR 0e MOD 7L, mu mm R . ) & r - V c.- SWITCH TYPE: a,. �\ D = 3,12/g INCHES = G:. REQUIRED DISCHARGE RA 1,g GPM PUMP & ALARM WIRING AS PER ILHR 16.23 v VERTICAL DIFFERENCE TWEEN P OFF AND DISTRIBUTION PIPE 14 FEET + MINIMUM NETWORK SUPP SSURE . . . 3,Z6 FEET + 7 L FEET FORCF.MAIN X_FT /100 FT. • FRICTION FACTOR . FEET T-OTAL DYNAMIC HEAD = FEET 2 I. Z INTERNAL DIMENSIONS OF PUMP TANK: LENGTH WIDTH DIAMETER LIQUID b'r.`rrT 6 : 7 GAL 'R6U.NVi_- N a � HEAD/ CAPACITY ,a - F ZLFR CO CUR VE . 2 .O 26 „ EFFLUENT 24 MoD6L I ! and 7s MODEL - 1S6 2 t � DEWATERING = 70 i ss '• s0 MODEL I 167 I MO061 14 } 4 L I 1M t2 40 I 36 10 YODLL �� I Y006L 177, 136 i I 1 as SEWAGE and DEWATERING 6 -20 orl YODEL ! I i 1st 1• 7 I i I It I YODEL s w 2 { 53, ss, w [7. cb 0 1 GALLONS 1• 20 30 40 s0 601 70 60 I SO 100 !110 LITERS 0 60 160 240 3" 400 �70 1 FLOW PER MINUTE 22 70 �- - -;... I �._ _. m 6 _ :) DEL -- 2 - Is 16 r YODEL Y I— 294 —� - + C 2 -w- - - -- ^— — - -- �� • j MODEL < u I - --r 293 �- la ( p 1 YODEL F - 284 MODEL l ilt '� • 20. «_ . 262 -- - _ is I I I - • T 10 MODEL - r - - 2 a 3280 Old MXWT L&-A GALLONS 10 20 30 40 50 60. 70 60 ! s0 100 +, 110 120 '130 140 i S0 160 *0 160 if0 P. O. Box MW7 _ Lo&dsvd , j(w tx# 4=73 LITERS 0 s0 160 240 320 - 400 460 560 660 720 (922"84737 -- FLOW PER MINUTE f Mound System Management Plan p age r" at Pursuant to Comm 83.54, Wls. Adm. Code ti T The septic tank shall be maintained by an irdivldual corUfied tc service septic tanks under s. 251.44. Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm, Code. The aptrating wdlition of the septic tank and outlet filter shall oe assessed Dt least once every 3 yearn by inspection. The outlet falter shall be Cleaned as necessary to ensure proper operation. The liter cartridge should not be removed unless provisions are made to retain solids In Ute tank tnat may slough oil tho fitter whon removed from its enclosure. If the filter Is equipped with an alarm, the titer shall be seMW It the Cart,n is activated continuously. Intermittont filler alarms may Indicate surge flows or an Impending continuous alarm. The septic tank shall haste Its contents removed when the volume of sludge and scum In the lank exceeds 113 the liquid volurne of the tank. It the contents of the talnk are not removed at the time of a triennial assessment, maintenance personnel shag adf%ise the owner of when the next sorvice needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemica: additives to enhance septc tank performance is gwisrally not requited. However, it such products are used they shall Do approved for septic tank use by the Oepartment of Comm. erce, Safey and Buildings Oivl3lon. Py mp Tan The pump (dosing) tank shall be Inspected at least once every 3 years. Al switches, alarm=. Ind pumps shall be tested to verity proper operation. If an effluent fritor is insallod within the tank it shall be Inspected and serviced as necessary. 4 ound and Pressure P No trees or shrubs should be planted on the mound. Plantings may loo made around the mound's perimeter• and the mound snag be seedad and mutched as necessary to prevent erosion and to provide some protection from frost penetration. TraMc (other than for vegel35vs maintenance) on the mound is not recommended since' soil compaCJon may hinder aeration of the InfiitraCve surface within the mound and snow compaction In the winter will promote frost penetration. Cold weather Installations !Cc:ober- February) dictate that the mound be heavily mulched for front protection. influent qualihy into the mound system may not exceed 220 ringlL 8005, 150 nVA. TSS, and 30 mg/l FOG. Influent now may not exceed maximum deslgn !low specincd in the permit for this installation. The pressuro dtsviruUon system's provided with a nushing point at the end of each lateral, Ind It b recommsr,4ed that each lateral ;A flushed of sccumutatod solids of Icast once evory 18 months. When a pressure lest is performed It sboutd be compared to U:o Initial test 4-an the system was tnslallad to determine If orince eloggk)g has occurred and it orifice deartng Is required to maintain equal dlsUxUUcn within the dispersal call. Coservaticn , ipes within U^,e dispersal cell shell be checked for stnuent ponding. Ponding levels shall be reported to Lhe owner, and any leve s above » Inches considered as an irnJend'ng hydraulic failure requiring addlGonal, more frequent moniforing. an r71 ?his aysten snarl be operated In accordance with Corrrr. 82.84 Wis. Adm. Code, and shall maintained `n accordanca with its' campunent ,manual I53C- 10572•P (R, 669)j and loon or state rules pe ^aining to system mainianSnca and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present hat could cause death. Se ^,tic and pump tank abandonma t shall be In accordance wit, Camm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. 5aptic or pump tank manhole risers, access risers and covers should be inspected for water llghtt w Ind soundness. Kass openings used for service and asaOssmer+t shall be sealed watertight upon the completion of servlee. Any opening deemed unsound, defective, or subject ;o failure must be replaced. Exposed access openings greater than 8- Inche3 In diameter shall to secured by an effective locking device to prevent occidental or unauthorized entry Into a tank or camponent. Contlnoongy Plan It are septic 'rank or any of its components became defective the tank or component shall be repaired or replaced to keep the system in proper operating condition, It the dosing lank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of Use same or equal performance. If the mound component fails to. accept wastewater or begins to discharge wastewater to the ground surfacs. It will be repaired or replaced in Its' present location by increasing basal area if toe leakage occurs or by removing biologically dogged adsorptlon and dispersal media, and related plping, and replacing said components as deemed necessary to bring the system Into proper operating condition. Questions on the operation or maintenance of this system should be directed to the County Zoning office at '5,9 — 080 or to the licensee' plumher who installed the system. RD ` I /J - Wisconsin Department of Commerce TION REPORT Page l of Division of Safety and Buildings �Wis. dm. Code . County Attach complete site plan on paper not len must include, but not limited to: vertical and horizontal reference point (BM), direction and Pa `I/ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 7 - Q Z �ij — �p 0 �� Please print all information. view Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Govt. Lot SJ5 1 /4SO)/4 S T 0 2 N R E (o W Property Owner's Mailing Address tot # I Block # I Subd. We C stm _ City Sta Zip Code Phone Number Cl C' ❑Village � Nearest Road I 66�' IM Llt-) ❑ New Construction Use esidential / Number of bedrooms Code derived design flow rate .�v GPD Replacement �- �f Public or commeraal - Describe: n t /l�c.� / Flood Plain elevation if applicable � AI-Ze - General comments S / e (Qi ✓��1� -/ ! G (3 / and recommendations: �" � -h.Ltrt.vn � ITI Boring # Boring 0 it Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. �1 'Eff#1 'Eff#2 0 Boring # ❑ Boring 0 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/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 26 It- G Effluent #1 = BOD > 30 1 220 mgfL and TSS >30 < 150 ' Effluent #2 = BOD < 30 mglL and TSS < 30 mglL CST Name (Please Print) Si re CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 �- —0 715- 246 -4516 Property Owner _ Par I ID # Page of ® Ong # ❑ Boring O P i t Ground surface elev. ft. Depth to limiting factor <� in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. n 'Eff#1 `Eff#2 L F-I 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/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-I ❑ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 1220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mglL 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 608- 266 -3151 or TTY 608 -264 -8777. SBD -8330 (8000) I Soil Test Plot Plan Project Name ` Edward Claycomb Shaun Bi Address 204 Cty Rd W River Falls Wi 54022 CST 226900 Lot ------ Subdivision South Soil Test Date 6/5 5 SE 1/4 S W 1/4S 19 T 28 N /R W Township Pleasant Valley Boring 0 Well PL Property Line County ST. CROIX BM or VRP p Assume Elevation 100 ft. To of 1/2" Pipe System Elevation 99.8' *HRPSame as Benchmark Cty Rd W Scale is 1 = 40 unless otherwise old House noted Burned down 150 98.5' i 10'13-3 60' 50' 98' -1 B 1% Slope 0 ' 250' hJ 698' Property Line 400' 08/24/05 WED 08:12 FAX 715 386 4686 0 001 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer O t � (P F—_ 1 ` C 0 M Mailing Address 2- R_ V -tr F l l S W �- Property Address S �-- (Verification required from Planning & Zoning Department for new construction.) City /State �.%� �V Parcel Identification Number LEGAL DESCRIPTION Property Location R_!/ - Town of _ Subdivision , Lot # Certified Survey Map # _ , Volume _ Page #� Pa ge Pa �G S Warranty Deed # Volume , � Spec house yes no Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to liandle wastes. .Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed. pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a ceitiflcation form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if .necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Conunerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be complered and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the hest of my /our knowledge. I /we ant/are the owner(s) of the property ;scrib above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT DATE * ** Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department,'" Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 09105) Stock No. 11063 Imam= �oc39g�c�`468 DOCUMENT NO. • S 4831A AMER'S OFFICE SATISFACTION OF REAL ESTATE MORTGAGE — BY LENDER ST. CR00(CO, W1 RkdlorRead The undersigned Lender certifies that the following is fully paid and satisfied AU 19 1996 Mortgage executed by EDWARD B CLAYCOMB & DIANE L CLAYCOMB, 9:30 A. M HUSBAND AND WIFE AS SURVIVORSHIP MARITAL PROPERTY 'K-Vj.. -R J.f.ti. of D"cle to Lender and recorded in the office of the Register of Deeds County, Doc. 493906 ST CROI X Recording Arse Of Wis., as No. (F IX 989 (Records) (i � 295 Neme and FWumAddress in (VOI of (M &4U on (page) M-1ARD CLAYCGvB & DIANE L CLAYCCNB I covering the real estate described below. 204 CTt RD W A PARCEL OF LAND LOCATED IN THE SE1 /4 OF THE SW1 /4 OF RIVER FALLS, 'H'I 54022 SECTION 19, T28N, R17W, PLEASANT VALLEY TOWNSHIP, DESCRIBED AS FOLLOWS: BEGINNING AT THE S1/4 CORNER OF SAID SECTION 19; THENCE N 00 07'50 "W 656.00' ALONG THE EAST LINE OF SAID SW1 /4 OF SECTION 19' THENCE N 89 12' 20" W 698.00'; THENCE S 00 07' 50" E 656.00'; THENCE S 89 12' •l Identifi N =- E 698.00' ALONG THE SOUTH LINE OF SAID 3,Y1 /4 TO THE POINT OF BEGINNING; EXCEPT THE EAST 33.00' FOR PUBLIC ROAD. ❑ If checked here, real estate description continues or appears on attached sheet STATE OF WISCONSIN Dated August 14, 1996 County of PIERCE THE FIRST ONAL PANK OF RIVER FALLS NAME OF LENDER i This instrument was acknowledged before me By ' on Augu 14, 1996 Title VICE PRESIDENT I by CAlE A VINEY & JULIE C MM ER, , DALE A VINEY (Ne,nee d Pa•a as VICE PRESIDFVI &ASSIST! USMENf Attest (type d - 00rdy. e g.� — Pat" wm. )• ��S Y THE FIRST NATION!( . lJ.�4 Of R�£Ft FALLS Title ASSISTANT VICE PRESIDNET (Nol d b" d ` ' 1 t �• , JULIE C MOELTER s ' This instrument was drafted by. Notary Public, Wisconsin PI' ,,,,N•• JANET KOCHENDORFER My Commission (Expires) (* 12/12/99 (rYE OR PRINT) 'Type or print name signed above. s w isconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85. Wis. Adm. Code County Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must L include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. v C percent slope, scale or dimensions, north arrow, and location and distance to nearest road. (� 74 1 n Z _ 0 v Reviewed by Please print all information. Personal information you provide may be used for secondary purposes (Privacy Law. s. 15.04 (1) (m)). Property Owner Property Location �y T � �N R /_) E ( W i Govt. Lot r J , 1/4� I4 S /7 Property Owner's Mailing Address Lot # BIB Suod• �1�nZ G' Sta �Zi Code Phone Number C' ❑Village Near t Road C+t P i �C.lt� ❑ New Construction Use esidential I Number of bedrooms Code derived design flow rate 7.3-0 GPD Replacement Public or commercial - Describe: Parent material Flood Plain elevation if applicable General co mments S� l l� � ►� ��- and recornmendabons: �J f Bo IZI Boring # ring �— ft. Depth to limiting factor in. S iption Rate It Ground surface elev. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •Eff#1 ER#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. M Bod ng # U Boring � r, t Pit Ground surface elev. �• ft. Depth to limiting factor 0( in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIft? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff #1 •Eff#2 Effluent #1 = BOO > 30 220 mg/L and TSS >30 < 150 ' Effluent #2 = BOD < 30 ng1L and TSS < 30 Si re CST Numer b CST Name (Please Print) 226900 Bird Plumbing, Inc. Shaun Bird Tele hone Number Address Date Evaluation Conducted p /,. Q J 715- 246 -45 1008 192nd Ave, New Richmond, Wt 54017 C7 e . a Property owner Pa I ID # Page of ❑ Boring Borin # g )n. © Pit Ground surface elev. � ft. Depth to limiting factor � Soil ication Rate Horizon Depth Dominant Redox Description GPD Texture Structure Consistence Boundary Roots At? in. Qu. Sz. Cont Color Gr. Sz Sh. 'Eff#1 - OW Iq 1 F gyri #� ❑Pit Ground surface elev. ft. Depth to limiting factor i^. Sal Application Rate Horizon Depth Dominant Color Redox Desaiptron Texture Structure Consistence Boundary Roots GPD/M in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 Boring F # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit T 1, on Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Routs GPO/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Eif #1 - Ert# - 2 • Effluent #1 = BOD, > 30 1220 mgA- and TSS >30 < 150 m9 ' Effluent #2 = BOD, < 30 mgll. and TSS < 30 mg1L 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 608- 266 -3151 or TTY 608- 264 -8777. 5864730 (8600) Soil Test Plot Plan ect Name Edward Claycomb Sha ird dress 204 Cty Rd W River Falls Wi 54022 M #226900 Lot ------ Subdivision South Soil Test Date 6/5/05 SE 1/4 S W 1/4S 19 T 28 N /R W Township Pleasant Valley Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 1/2" Pipe System Elevation 99.8' *HRPSame as Benchmark Cty Rd W Scale is 1" = 40' unless otherwise old House noted Burned down 150' 98.5' 10' B -3 60' I 20' 50' 98' B -1 . * B -2 B 1% Slope 20' 250' 698' Property Line 400' r i EXCAVATING 285 COUNTY ROAD SS RIVER FALLS w. 540 22 800 -828 -3723 715 -425 -6200 , 715 - 425 -8466 FAX _ q 000 D d. err IoM . D � S ���, -. 1 i � � .. T � F i i � ah, �,. � 4 !. � .,� V f w � � e � � , � • `. 'fir b 0 .. � 9 a.., ,. *_ ,� y y 't�. y � � � i it Parcel #: 024 - 1026 -60 -000 04/20/2005 01:22 PM PAGE 1 OF 1 Alt. Parcel #: , 19.28.17.156B 024 - TOWN OF PLEASANT VALLEY Current LX'li ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): " = Current Owner * EDWARD B & DIANE L CLAYCOMB CLAYCOMB, EDWARD B & DIANE L 204 CTY RD W RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description " 204 CTY RD W SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 10.010 Plat: N/A -NOT AVAILABLE SEC 19 T28N R17W IN SE SW COM S1/4 COR Block/Condo Bldg: SEC 19, TH N 656 FT, TH W 698FT, TH S 656 FT, TH E 698FT TO POB EXC E 33 FT Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) FOR RD. TOWNSHIP PLEASANT VALLEY. 19- 28N -17W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 958/192 07/23/1997 797/286 07/23/1997 741/404 07/23/1997 724/75 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 25237 134,600 Valuations: Last Changed: 05121/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 9.010 47,700 53,700 101,400 NO PRODUCTIVE FORST LANC G6 1.000 2,400 0 2,400 NO Totals for 2004: General Property 10.010 50,100 53,700 103,800 Woodland 0.000 0 0 Totals for 2003: General Property 10.010 50,100 53,700 103,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 144 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 � 3 rL I E � l ti 3 V, x 1� 1 305 xao 3'150 I° 8 T I � R4Ll IP5 MIAM w�L.. I r I lit o � ZZ 1111111(./ r I a `t EP3 I iZ I ? S N 0 ' •I wl1 • 0 • O O 0 -1N o - M � i I 3560 - E i 3060 3060 LMO ♦ ♦ - - ' I In 1 i I w4Iu3PS war ■.�.. I i ! I � r g i 1 o 4- i EP3 - v �" L�� 4 31 t-- E: I I ` $, I I 3660 -6 I 10 •0 J' i Wisconsin Department of Com" UATION REPORT Page ` of Division of$afety and Buildings RE g1w: T in ccordance with M1118 dm. Code mint Attach comp lete site Ian on aper not I than 8 °1�/� 14 in es in size. PI n must (' PI P P r ; rbhcel t directi nand parcel I.D. but not limited to: vertical and h P j include, percent slope, scale or dimensions, north 'T C f cation and distance t nearest road. Please print all inferrgtoltjo���'V7r R Date 1=Fi�� 0 Personal information you provide maybe used for secondary purposes (Privacy Law, .15.04(1)(m)). 2l Property Owner Property Location Govt. Lot �l= 114SW/4 S T N R E (o W Property Owner's Mailing Address Lot # Block # Subd. Narr or CSM# AIJ City Staw Tp Code Phone Number Cl El Village Neare t Road tj j ❑ New trucdon Us ' esidential / Number of bedrooms _ Code derived design flow rate .sv GPD Replacement Public or commercial - Describe: -- - - - - -- -1 n - -- - - — Flood Plain elevation if applicable i7 ft General a nd recommendations: S �, � y �z s 2 IZI 4 Boring Boring # 9�i ft. Depth to limiting factor in. ///� -it Ground surface elev. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 _ 2 J, , 6 / d J /r 0 M Bodng # Q, Boring it Ground surface elev. /* = ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff #2 2- els • Effluent #1 = BOO > 30 < 220 mg& and TSS >30 < 150 • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) I re CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 5 7-- ,..�`} 715 - 246 -4516 Property Owner _ Parcel ID # Page of a Boring # ❑ Boring Pit Ground surface elev. �J �' 3 ft. Depth to limiting factor ___L___— in• Sail �ti� � Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlfF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 7 C] Boring a Boring # in. Pit Ground surface elev. ft. Depth to limiting factor Sal ication Rate ❑ Horizon Depth Dominant Color Redox Description Texture StnKture Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •EflW ❑ Boring Bonng # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil icow Rate F Horizon Depth Dominant Color Redox Description- Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff #1 •Eff#2 • Effluent #1 = BOD > 30 1220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOD < 30 mg& 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 608 -266 -3151 or TTY 608 -264 -8777_ SBD8330 (RAM) Soil Test Plot Plan Project *Name Edward Claycomb Shaun Bird Address 204 Cty Rd W River Falls Wi 54022 CSTM 00 Lot ---- -- Subdivision North Soil Test Date 6/5/05 SE 1/4 S W 1/4S 19 T 28 N /R W Township Pleasant Valley Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 1/2" pipe System Elevation 97.9' *HRPSameasBenchmark 698' Property Line Scale is 1" = 40' unless otherwise noted 100' B -3 50' 98' L * 30' 97' B.M. 100' 30' B - 10' 2 B - 1 96' 400' Old House burned Down! 7 %Slope 656' Property Line IIF Cty Rd W Parcel #: 024 - 1026 -60 -000 06/21/2005 08:05 AM PAGE 1 OF 1 Alt. Parcel M 19.28.17.156B 024 - TOWN OF PLEASANT VALLEY Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * CLAYCOMB, EDWARD B & DIANE L EDWARD B & DIANE L CLAYCOMB 204 CTY RD W RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 204 CTY RD W SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 10.010 Plat: N/A -NOT AVAILABLE SEC 19 T28N R17W IN SE SW COM S1/4 COR Block/Condo Bldg: SEC 19, TH N 656 FT, TH W 698FT, TH S 656 FT, TH E 698FT TO POB EXC E 33 FT Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) FOR RD. TOWNSHIP PLEASANT VALLEY. 19- 28N -17W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 958/192 07/23/1997 797/286 07/23/1997 741/404 07/23/1997 724/75 2005 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: P IZ9) YOB Last Changed: 06/03/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 9.010 47,700 13,000 60,700 NO PRODUCTIVE FORST LANC G6 1.000 2,400 0 2,400 NO Totals for 2005: General Property 10.010 50,100 13,000 63,100 Woodland 0.000 0 0 Totals for 2004: General Property 10.010 50,100 53,700 103,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 144 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel #: 024 - 1026 -60 -000 04/13/2007 08:33 AM PAGE 1 OF 1 Alt. Parcel #: 19.28.17.156B 024 - TOWN OF PLEASANT VALLEY 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 - CLAYCOMB, EDWARD B & DIANE L EDWARD B & DIANE L CLAYCOMB 204 CTY RD W RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description ' 204 CTY as- Legal � SC 2422 ST CROIX CENTRAL ��� t( l SP 1700 WITC / yl�ilN Legal Description: Acres: 10.010 lat: N/A -NOT AVAILABLE SEC 19 T28N R17W IN SE SW COM S1/4 COR Block/Condo Bldg: SEC 19, TH N 656 FT, TH W 698FT, TH S 656 FT, TH E 698FT TO POB EXC E 33 FT Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) FOR RD. TOWNSHIP PLEASANT VALLEY. 19- 28N -17W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 958/192 07/23/1997 797/286 07/23/1997 741/404 07/23/1997 724/75 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations Last Changed: 04/20/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 9.010 47,700 129,800 177,500 NO PRODUCTIVE FORST LANDS G6 1.000 2,400 0 2,400 NO Totals for 2007: General Property 10.010 50,100 129,800 179,900 Woodland 0.000 0 0 Totals for 2006: General Property 10.010 50,100 129,800 179,900 Woodland 0.000 0 0 Lottery Credit Claim Count: 1 Certification Date: Batch #: 144 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 r DEPAR';)di4ENT OF REPORT ON SOIL BORINGS AND SAFETY &BUILD, VI INJSTRY, CC DIVIS BOX 7t LABOR HUMAN REDLATIONS PERCOLATION TESTS (11J) MADISON WI 53707 (H63.090) & Chapter 145.045) LOCATION: SEC ION: /45' NS IP UNI IPALITY: T NO.: BLK. NQ.: SU IV 6 N NAM 4) /T9 NIOE (o T�T Y: � OW R' BUYER' AME: MAILING ADDRESS: , ) & �_j USE IN DATES OBSERVATIONS MADE NO. B D .: COMMERCIAL D CRIPTION: PROFI E DESCRIPTIONS: ER N ESTS: Residence ❑New Replace � Q o lf� RATING: S= Site suitable fo system U= Site unsuitable for system a CON M�ND: ❑� IN- GROUND ti U V RE: S�STEM- ILHO RECQM � �D SYSTEM:1 ptiona C 4W 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: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER- INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- C eo f ej S , q Lo W ra B- � 311 Al eff F 3.a6 ,;s B Jso 46 B- C �iple4 to S'a e w B- 3 Id/ d 1V0 , a � ��6 �� w e B- Cr Ipteli ie d S S lo 44 R f/ha 7S a PERCOLATION TESTS TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL - INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL -MIN. PERIOD 1 PERIOD 2 PER PER INCH P- 3 0 ' '' / x /11 0 i , P- C' P -_ P_ PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indic— 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 elevalinn at all borings and the direction and percent of land slope. SYSTEM ELEVATION ( e5 ___ -- ( .� x r�- , I to t � , 1 �. .- je S f P � ; IIIC _ _ k_ [ S i 3 _ ... s -lo- _ _. F I, the undersigned, hereby certify that the `eIst r on thig,Form were made by me m accord with the procedures and methods specified m 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 COMPL TED ON: Dpa ��� a2 '• , AD S /f� (,p V CERTIFICATION UMBE : PHONE NUMBER (optional): D o u� U/! 11/ (� I SI ? t� CST DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. , DILHR -SBD -6395 (R. 02/82) — OVER — � � � INSTRUCTIONS FOR COMPLETING FORM 115 - SB[} ' 6395 � To b*a complete and accurate soil te\Lyour report must include: 1. Complete legal description; %. Tha use section must clearly indicate whether this is =nidenceorcommercial project; � l MAXIMUM number nf bedrooms or commercial use planned; 4� Is this new or mp|acornantsyuem; �— 5. Complete the suitability rating boxes, A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED 0N SOIL CONDITIONS; 6, PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7, MAKE A LEGIBLE diagram aonu,am|v locating Your test locations. Drawing to scale is preferred, A separate sheet may be used it desired; 0. Make surc your benchmark and vertical elevation reference point are clearly shown, and are permanent; B� Complete all appropriate boxes as to dates, names, addresses, flood plain data, percolation test ,xcmp' tiun 10. If t information (such as Mood plain, elevation) doanocamdy place N.A.in the appropriate box; 11. Sign the for m and place your current address and Your *ertificoionnumber; 12. Nbko legible copies and distribute as wnuirod. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ` ABBREVIATIONS FOR CERTIFIED SOIL TESTERS � � Soil Separates and Textures Other Symbols � st — Stone (over 10") BR — Bedroc b Cobble l0^> SS � ro — Sandstone — 8, — Gravel (under 3") LS — Limestone °s — Sand HG0 — High Groundwater � cs — Coarse Sand Pem — Percolation Rate mcd s — Medium Bond VV — Well b — Fine Sand B|dg — Building Is — LoamySond > — Greater Thin °d — 8andyLoann ( — Less Than l — Loam Bn — Bruin "si| — Si|c 1-oom 8| — Black si —5i|t Gy—Gmy °o| — Clay Loam Y — Yellow vz| — Sandy Clay Loam R — Red sid — Silty Clay Loam mot — Mottles oc — Sandy Clay w, — with do — Silty Clay �� — few, fine, faint ° — Clay — oo — common, coarse ' or — Peat mm — Many' medium C11 — Muck d — distinct � . p — prominent � HVVL — High water level, ° Six general soil textures surf ace water for liquid waste disppm| BM — Bench Mark ' VRP — Vertical Rcfcmnow Point � ^ TO THE OWNER: � This onii /ex report isthn f|ou step in ,acuhny n sanitary permit. The rounty nrth, Department maymqucx ve,iUcwbon of this uzi| test in the field prior to permit ixSuaocc, Acnmpieta set of plans for the private sewage oym*m and a permit application must be submitted to Ghe app/opiate local avthorky in order to obtain a permit. The sanitary permit must be obtained and posted p'iortn the start of any construction, ' — SOIL AND E EVALUATION REPORT Page / of 3 t La. and Human Relations — Division of Safety r;< Buildings in accord with ILHR 83.05, Wis. Adm. Code I}AR&SS o f SITE: toy ,f G(> �,v� e / IS, w/ . Syo Z z COUNTY s /— Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or I PARCELI.D.# 'i dimensioned, north arrow, and location and distance to nearest road. ON Si %E APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION 14ar'FiTif REVIEWED BY DATE 3 1— ?2- PROPERTY OWNER: pERgL 6ME GOi9,v �O PROPERTY LOCATION co/Pp, G' /D J1.y C 14 i C'OM, 3 GOVT. LOT 5E 114 , 560 1 /4,S /9 T 2? ,N,R / 7 E (or) W PROPERTY OWNERS MAILING ADDRESS OR BLOCK # SUBD. NAb1E OR CSM # P -?7 D` / �4GiPE5 CITY, STATE ZIP CODE PHONE NUMBER E]CITY E]VILLAGE RROWN NEAREST ROAD z (715) YzS— 2 o q 3 j� /E�iS�►�T' 1/414E [ ] New Construction Use P(I Residential / Number of bedrooms v o [ j Addition to existing building Replacement (] Pu 'c or commercial describe Code derived daily flow y.�d gpd (M ° U"'O) Recommended design loading rate • S bed, gpd/ft ' G trench, gpolft Absorption area required 3 7 S bed, ft2 -375' trench, ft Maximum design loading rate S bed, gpd /ft ' G trench, gpd/ft Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design /site co rations s' �`E Sui'TS /�` CivtY Foil° �-!D U.v1� •s/�S 7`L��1 Parent material -S �� yti 5 �f'S� F, 5/ Flood plain elevation, if applicable /V� ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ❑ S Q U I MS i] U [is m U ❑ S M U 0S .O U [Is � U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Barxiary Roots GPD /ft X in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed rend ,.. ' !� O -� ioy��/3 S/ f s,6 s s z^.. S G �. -/� o /,e y/y — S/ 2 f S6,t' BPS, S �,.., - - Ground 8, - 25 ioYX S/ 2, f, S 6 t/j cs' (f elev. f, 3 : ft. z 5- 37 7�yp s/G R sip s/ / �,P �i✓f e QS /f y S Depth to C , (.D /Dy/�' C-13 -y 51g SS D U 9if E*� �T 10 SS �V/ it1 limiting factor „ UKMINI�L z5 Remarks: 11 1 0 �flzo4j C - CvE,fetV CEVCTJ7,C si9'vD s T ©a . Boring # o -a /0J6 c? 313 51 Z,`F, S . S 3,a - 's- ................ . G f, s -7r,e �s f 's G Ground ,/ elev. �Z 3 y -`/i /0 le /r R SDI s/ Z, � S6 'ii-, �,P �s 7� s • c 9 ZO ft. �i 7,t ec C Z 60 /0 ye 6/3 Depth to limiting fact 3 Remarks �o ?iuE S�DEGafi // SE >T �f CST Name: — Please Print 655 O'NEIL RD., HUDSON, WIS 54016 Phone: 3A/ ,� S PS A ddress: ROBERT ULBRIGHT co i - fl LIC. NO. 3307 M.P.R. I Signature: /J1(C ,, �Lt j t `A:J_EP �. DESIGNER LIC. PJO. 00663 Date: R 31— � CS2 !�" 'r'�'q s6 PROPERTY OWNER _A 1 oc'T15. 4 D4j— SOIL DESCRIPTION REPORT Page_of PARCEL I.D. # /D 4 – ff�,Y• W Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft , in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Boundary Bed Trench .x' r 0 149 y 3.3 S Z, f, 6 /o Ye 4/y s11 1, f, S6� �S �i C.5 _3.., s G Ground B 5 y3 yK r �7 S s� 2, ,►►•r, S h,� 4-1 7Z s elev. -70 ft. Y2 y� 2 3 -sS ��, J`.e, r s /V f Depth to t, limiting factor y c! Remarks: Boring # .Cntiti Y:iv::i•:j i IM Ground elev. 'i ` ft. Depth to limiting factor i" t Remarks: Boring # i : »•,'•:ire. i / 2 " Ground elev. ft. Depth to limiting h factor Remarks: Boring # Ground elev. ft.. — Depth to limiting factor Remarks: - 8330(8.05/92) y n ► DC mC7N W u°�y'mv % fA V` ' N o N w N m r ° co °o _ • - Q . N "o N 4 , I N Y h m N a\ � •u e � n � R o t, ORIGINAL NIL-: �T 1 StT"E EVALUATION REPORT DIL HR in accord with ILHR 83.05, Wis. Adm. Code asm:vaw`wr.ruvac COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. I dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER - y - �CCa/��om(� - CZI,Q S PROPERTY LOCATION E !gym c/ GOVT. LOT 5 1/4 5 114,S 1 / T G ?� ,N,R I - 7 W PROPERTY OWNER'S MAILING AD ESS /!,- / . u'. `, `e dd • LOT N BLOCK N SUBD. NAME OR GSM A /D A CITY, STATE -/ ZIP CODE PHONE NUMBER []CITY VILLAGE N NEAREST J ROA ) [) New Construction Use [ 4+-Mildential / Number of bedrooms _ 3 �)f_f CS? jv�<placement ( I Public or commercial describe Code derived daily How gpd Recommended design loading rate bed, gpd/ft trench, gpd/ft Absorption area required bed, ft trench, f1 Maximum design loading rate bed, gpd/ft trench, gpd/ft Recommended infiltration surface elevation(s) It (as referred to site plan benchmark) Addifional design / site considerations Parent material Flood plain elevation, if applicable h S = Suitable for system CONVENTIONAL I MOUND INGROUNDPRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ❑ S ❑ U ❑ S ❑ U ❑ S ❑ U ❑ S ❑ U ❑ T ❑ U ❑ S ❑ U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure GPD /ft in. Munsell Qu. Sz. Cont Color Consistence �y Roots Gr. Sz. Sh. Bed Tmncl Ground ,(S /4/ ,Zo — elev. ft. C Z0_ Z< r. 2 h� J% ( 6.a l imiti ng to - C_ zs- 5/9 r 2c4 c�b6 z. S 6/' m Z , factor C Remark's:__6 - L sr"' . w/ w .o t'6) 30 Boring # 4: ` a:$ :r Ground elev. ft. — Depth to - - -•— limiting factor Remarks: CST Name: — Please Print Phone: Address: _ Signature: Date: CST Number: I I ST. CROIX COUNTY WISCONSIN ZONING OFFICE ;.rye ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 - (715) 386 -4680 Aug. 31, 1992 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An onsite soil investigation of the Federal Home Loan Mortgage Corp. property, located in the SE1 /4 of the SW1 /4, Sec.19, T28N, R17W, Town of Pleasant Valley, St. Croix County, WI., has been conducted with the assistance of Bob Ulbricht, CST# 2482. This onsite revealed suitable soil for onsite sewage disposal to a depth of 25" while meeting the requirments of the A + 4 rule. This site should be suitable for a replacment mound septic system having 12" of sand fill. Should you have any questions, please feel free to contact this office. Sinc ely, mes K. Thompson Assistant Zoning Administrator cc: file ` ST. CROIX COUNTY `1 WISCONSIN x ZONING OFFICE ? ST. CROIX COUNTY COURTHOUSE .... 911 FOURTH STREET • HUDSON, WI 54016 - - (715) 386 -4680 Aug. 31, 1992 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An onsite soil investigation of the Federal Home Loan Mortgage Corp. property, located in the SE1 /4 of the SW1 /4, Sec.19, T28N, R17W, Town of Pleasant Valley, St. Croix County, WI., has been conducted with the assistance of Bob Ulbricht, CST# 2482. This onsite revealed suitable soil for onsite sewage disposal to a depth of 25" while meeting the requirments of the A + 4" rule. This site should be suitable for a replacment mound septic system having 12" of sand fill. Should you have any questions, please feel free to contact this office. Sinc ely, mes K. Thompson Assistant Zoning Administrator cc: file Labor and Human Relations Z 17 C_ C v A L. U A f f v N M C r V 1'f I rage of I ' .Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code 't fjdlW&fS of 517E , toy 1 % w �,v� e 1.4115, 4,1/j, Sao Z z COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but S T G not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. p,V Si %E APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE 2-7- :1 Thos, so.v $- 3 PROPERTY OWNER: DE,Pr4L ffb.�1� Goipv �v,P, fE PROPERTY LOCATION `j CO/t io- O�b Ti.y G /,q � COAf i¢GE �T GOVT. LOT _'i5 1/4 5W 1/4,S/9 T 1.< ,N,R � 7 E (or) W PROPERTY OWNERS MAILING ADDRESS LOT # I BLOCK # I SUBD. NAME OR CSM # C�vT Z/ �'E4G �STAT� �9� T.19`YTo,v if'1> D 7 Dr- /O 4Git?ES CITY, STATE ZIP CODE PHONE NUMBER ❑CITY []VILLAGE EFOWN NEAREST ROAD �'*X 1rft //s GU /S . s% 7 2 (715) yis 7 o93 PX�4 141/c ' y, Gu [ J New Construction Use [,YJ Residential / Number of bedrooms 3 [ J Addition to existing buil tg JA Replacement [ J Pu 'c or commercial describe Code derived daily flow �-` gpd Recommended design loading rate ' S bed, gpdAl? G trench, 9Pdj4 Absorption area required 3 7 S bed, f1 3 2 S trench, 11: Maximum design loading rate S bed, gpd$ ' G trench, opa Recommended infiltration surface elevation(s) 3 ft (as referred to site plan benchmark) Additional design/ site co rations S' �E SUI f44 - 1& - /E- av4 y 1� 10e 1 OA"AO SYS T &.--Ai Parent material SC- lQ 7J S ti D 5 �� �� 5/ Flood plain elevation, if applicable S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT-GRADE SYSTEM IN FW. HOLDPIG TANK U = Unsuitable for stem ❑ $ U $ ❑ U ❑ $ �) U ❑ $ U ❑ S � U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence �dyy Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Tmnch 2,f sh ..:�� � /8 o y 1e y/y — S./ ? f, sdr ci?sG► S �,�.,, . S - G Ground 8 .2, f, s b G� CS t -f elev. 9� 7Z ft. : s- 3 7�y 3 n „ , q f 4-4 vfk as ! f , y =, S Depth to C 37 /o yre -�-l3 S � 5 1 P ss D of 9w cE : r o 5 5 7 '� �u limiting ' factor „ Remarks: ffD/P'ZO u C - lyE. f GE�4�yTt D si9.�p sT ov� , Boring # 2 f, /OYe 3/3 S/ d S S 3 .rH ,3 7 s yR y/� Ground elev. / yiP 2 �'+�, 1�_ C Z -� /0 ye (,1 , a, S %a' S S O,Uf y,� cr.�.•r�v SS NP N� Depth to limiting [� factor ,. 3 Remarks: ACTiuE S�DFCa�t // SF,iO�jG fGCc� '4T Sd r TName:— Please Print Phone: Err O�NEIL RD., HUDSON, WIS. 54016 Address: ROBERT ULBRIGHT WIS MASTER PLUMBER LIC, NO. 7 Signature: 4 „_ �,�..t.t!NN. IN; FALLER & DESIGNER LIC. NO.00663 Date: (P 72 CSrN u mber: Z PROPERTYOWNER �o,�T� • �Dd'/U SOIL DESCRIPTION REPORT Page Z of ' PARCEL I.D. 0 /D A�t — ffivr. ICJ Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /fit in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed ranch o -iZ 1,9.,e -313 - s, z T 5 ,mss s �� .,5 G 3 iw, 1 2- - .Z S to y,P Y/7 S./ 1 f, Stitt, Ground B s y io y ,� ,� /y "'i , s elev. -Go Yle �/3 �"; g - s S ; N Depth to I limiting factor t Remarks: Boring # i 7 Ground elev. ft. Depth to I 6mlting _ factor Remarks: Boring # Ground elev. it Depth to limiting factor Remarks: Boring # ,., scs# Ground elev. ft I Depth to limiting factor 1 y t z F c" O9 \y fs nYj �Ncz) O N N i C O N kA !� a N �o � N ' 0 \9 i � J N Dt � en m � fi y N R I Z a o 4 Ic 0 w In o ;I fri d � o x�. I 3- cry RD. 6 u