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HomeMy WebLinkAbout030-1019-10-200 o co) p 'D " C� l 0 d f c m 0 y1 m m m � I m ►. \ m 3 _ y G) x m o w cn o i • cn w CA) N L t0 O J W N Cam) V CO w @ � (D ` C D N G7 o o c. "I 1 0 0 0 0 o 0) 0 D o o 0 0 0 I °o w 3 c o° o CO 0) 7 O O d A V ? :!� N Q a O @ Cn V W N O C f O CT N O O O O c; *„ z O O zt ( \ co 00 � �" 5 N N C CD 0 0 0. n r N N m o o co cA 0 c O O 0 O. < �• a) 'D OA !- < A Z N to N a ',! o D o a v o (D (D < M N 3 v Cl) A p Z Z O o - D D o c 0 � � 0 N 0 d • cn @ N CD o c 3 �• o 3 m m N - ' - 1 CA 0 c p Z m a A Z O (D C) 3 N .. O_ (n --1 cn C (D � p Z 3 a ;Q 3 Z N Z CD A I 00 (A N D oma 0 a 0 0 3 m o' - CL - 1 m c U) c co Z + 5 • p O p N 0 x 3 E; am t a X v CD � N O O 0. a•� 0 ID (D y tv Q N V CD A � o A w o b m o, � o I 00 CD H /Wisconsin Department of Commerce E SYSTEM Count PRIVATE SEWAGE Safety and Buildings Division INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 353302 Permit Holder's Name: ❑ City ❑ Village ❑ 7iown of: State Plan ID No.: W ilson, Gre I St. Joseph Township CST BM Elev.; Insp. BM Elev.: BM Description: Parcel Tax No.: v U p d „/ >< 1 030- 1019 -10 -200 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic s 2.0(, Benchmark �D oS.ao cs0 . Dosing �U d Alt. BM Z 3 A Bldg. Sewer a Ho cl � 't Ht Inlet lo, 3 Od- TANK SETBACK INFORMATION TANK TO P/ L WELL BLDG. Ventto ROAD Air Intake Septic -1 ldb Z / Z NA Dt Bottom 9 Dosing >160 Z NA Header /Man. A ra Ion „- — A Dist. Pipe Holding Bot. System 2J lol• T 3' PUMP/ SIPHON INFORMATION \: Final Grade Manufacturer Demand St cover L U2 Z Model Number p� Z GPM ,BM l6 TDH Lift 3 Frictior1 � �' System S TDH f Ft oss Forcemain Length , ` Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS / Z DI SYSTEM TO P/L BLDG WELL LAKE /STREAM NG Man er: SETBACK CHAM INFORMATION Type O U del Number: System: 2 ' ' (SQ l l O i1NIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) i/ x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length �Dia. Spacing �/ 3 SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx'Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ o ❑ Yes ❑ No JNW S COMMENTS (Include code discrepancies, persons present, etc.) Inspection #1: (t) /S /Do Inspection #2: I4 1 00 Location: 1166 42nd Street Hudson, WI 54016 ( SW 1/4 NW 1/4 T29N R1 9W) - 5.29.19.80A - 20 - Lot 4 1.) Alt BM Description= (4 o.� ,.� 5 t4.,-/ 'f¢ 2.) Bldg sewer length =zls �) ;�s� fv ex4..oQ d�w�s(%oQ sari �o - amount of cove = /�"' r a a,wf �ron 'rock. 1uRS 4- a Q s�a..ce. 3.) contour= )'01.0 ' S Qsc{ -0- = I ��• D� P �) a tw 1( 1 4.4 1. 4, Plan revision required? ❑ Yes No Use other side for additional inform tion. I S� ( $ Z (v -] SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. I� ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: e € € . f „ m 3� 3 � n � d e e 1 S i .. x s S g ,,.. ,. ...o,.. ... ....me. 3 - e�md t e e w v e d. a s � s — 4 — w. i F } F d [ q ¢ e , € �a e €,.-.-.. � i S { e® e m ........ ..... - € e s i , i $ m... - _M 3 r € € € a E S a t Safety and Buildings Division ��iSCOnS %n SANITARY PERMI 1 201 W. Washington Avenue Department of Commerce In accord with Comm Ir. Admode ° f Mad son, WI 53707 -7302 • Attach complete plans (to the county copy only) forth system, oft less, , unty than 8 112 x 11 inches in size. e C 20l a "" to Sanitary Permit Number • See reverse side for instructions for completing this aphltcatiori ?� z , �.: y, - 55 3 3 O.Z. Personal information you provide may be used for secondary purposes :, iN" Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. �tii4�i4�1 {i;4 tate Plan I.D. Nu er _ \ I. APPLICATION INFORMATION - PLEASE PRINT ALL MAT 22 11 r//I __rlo J Prope Owner Name „# ation 1 /4, S T P, , N, R' 9 E (or) W Property Owng.Vs Mailing Address Lot Number Block Number /vao City Slate Zip Code Phone Number Subdivision Name or CSM IVytmber i q;(> C ( ) d l 11. P B ILDING: (check one) ❑ State Owned ❑ !tr Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms p Town old rat L - Ill. BUILDING USE (If building type is public, check all that apply) Parcel Tax �- N 5 . 1 [] Apartment / Condo 1 0 — 1 0 r / — ' © 2 ov 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash S ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. [New 2, ❑ Replacement 3_ ❑ Replacement of 4, ❑ Reconnection of 5, ❑ Repair of an _______ystem________ System _ ____________Tank Only______________ Existing System ________ Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 aMound 0 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pr sure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION S YSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq ft.) Proposed (sq ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation S� A Feet O .S Feet VII TANK Capaci in ga 5 Total # Of Prefab. Site Fiber- plastic Exper. INFORMATI lIo Gallons Tanks Manufacturer's Name Concrete Con- Steel glass App. New Existing structed Tanks Septic Tank r Ing Tank O W ® ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siph Chamber ❑ 1 ❑ I ❑ 1 ❑ VIII. RESPONSIBILITY S ATEMENT I, the undersigned, assume responsibility for installation of the onsite semuage system shown on the attached plans. PI er's Name: (Print) Plu is Signature: ( tamps) VPRSW No.: Business Phone Number: 1 71S -? Plumber's Address (Street, City, State Code): IV V7 f. �.•�L IX. COUNTY / DEPARTMENT USE ON ❑ Disapproved S nitary Permit Fee (Includes Groundwater ate slue Issui Agent Signature (No Stamps) 'Approved ❑ Owner Given Initial Surcharge Pee) Adverse Determination 6.257 2'��Z X. CONDITIONS OF APPR VAL / REASONS FOR ISAPPROVAL: - = z SBD -6398 (R. 4199) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes•in ownership or, plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division,.•608 266 - 3151. To be complete and accurate this sanitary permit application must include: t: `.Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VL Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. )nstalling plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number:, Plumber must-sign application form. IX. County / Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inth6 rl�iusl be submitteclAo the county. The plans must include the following: A) plot plan, drawn to scale dr with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and cohlMs; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D)' cross section of the soil absorption system if required by the county; E) soil test data on a 1 15 form; and F) #1 sizing information. - ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264 -8777 visconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary January 20, 2000 CUST ID No.5176 ATTN: POWTS INSPECTOR ZONING OFFICE RED CEDAR PLUMBING & HEATING ST CROIX COUNTY SPIA 4792 STATE RD 25 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 01/20/2002 Ide ntificati Transaction ID . 2916 Site ID No. 18624 SITE: Please refer to both identification numbers, Site ID: 186243 above, in all correspondence with the agency. ST CROIX County, Town of SAINT JOSEPH; 42ND ST, SAINT JOSEPH 54082 SWIA, NW1 /4, S5, T29N, R19W Lot: 4 Facility: GREG WILSON 42ND ST, SAINT JOSEPH 54082 FOR: MOUND SYSTEM, 600 GPD Object Type: POWT System Regulated Object ID No.: 645245 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. The following conditions shall be met during construction or installation and prior to occupancy or use: p.� •�' 1. This plan action is subject to designer comments on the plan. condi.tlo 2. The orientation of the mound system must be such that the mound's longest dimension is perpendicular 00 to the direction of maximum slope.„ 3. Vehicular traffic is prohibited in the area 25' beyond the down slope edge of the mound. 'WENT 4. Maintain well and waterline set backs per COMM 83.10(1) and 83.14(4)(a). D A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits �— required by the state or the local municipality shall be obtained prior to commencement of SEE GORRI`' construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerel DATE RECEIVED 01/19/2000 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 PATRICIA L SHANDORF , POW S PLAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (715) 634 -7810, FAX: (715) 634-5150, M -F 7:45 AM - 4:30 PM PSHANDORF @COMMERCE.STATE.WI.US WiSMART code: 7633 A ` e ' Greg Wilson - Mound Transaction # Location: Lot 4, Waldroff CSM SW 1/4, NW 1/4, Sec. 5, T 29 N, R 19 W Town: St. Joseph County: St. Croix Date: January 17, 2000 Owner: Greg Wilson Address: 1000 Colonial Drive Hudson, WI 54016 Plumber: Kevin Lannon Signature: .S. License # MP 224229 n all Attachments: 6748 -Plan Review Application \ SBD 8330 com E D ING$ l �PONDENCE v e 1: cover page l 2: calculations J /� 3: plot plan 4: system cross section 5: plan view, lateral detail 6: pump tank exit detail 7: pump curve page 1 of 7 • System Calculations One family residence bedrooms Loading rate gallons /sq ft per day Depth to ground water �� 2 8 in Depth to bedrock > 3 in Cross slope % Force main length ft of �' in Manifold /header length N ft of in Drainback �' gallons Lateral length Z @ 4 ft of � in Lateral elevation 1 °2 ft ( bottom of pipe) Lateral hole size 4 in @ in ft) spacing ° holes /lateral, ° holes total Lateral volume �`� gallons 2 3 . Z S �i Total lateral discharge rate gp m @ ft head Elevation difference �t�' ft i Friction loss 2' zg ft @ gpm Total dynamic head ft Pump /siphon A' gpm @ � ft of head Manufacturer "``�`-S �' g }1 Model # l= S Dose volume gallons Lift /siion tank �r ��.°i� `"�� � , �o gallons Septic tank , gallons Measurement pump on & off �'� in Height alarm from tank bottom , b" in '^ Reserve capacity g allons g calcs page 2 of 2/13/1999 16;22 17152351 056 REDCEDARPLUMBiNG PAC ZI y N P A g 4 . p r � o vi b Q _ r - �----- .� P- �- - l 6 .r..�. O G' P r E dLCL I. ` ' 0_11 14 1 \,.% l Z I LI •aX a.., , I d 2. S� � v � 3 O 1 1 , �u2.p nn Baal to i••bcoA lay \ 0. a.•.. 1 0 1. p ct a I r r y � Z 2 •Q' ► 0,3 � E— E VLO -lam X: `/ {�, S T Y.f.` � SOON (O Y v►: V � 1 ♦� QJV ✓� 3+`M`�, ` ✓r oT 44o4r 0- tQ.vw.: •w}C Z i o•h �� o i Iron \c o 1 �, z �' V � Sad+ � - j - f.t- � tv \ ti`Y O p�f..; M• S� Q I � �• �' I Z V ' Z .� I I S� V I I S� O I S. Q I Q.A. a c,S�..�,�IW � 1 \ 0... \ : v.Q.. � l'J (� . Q i . � � • o ' / 4. .,.. s o� � ' WEA'1'NERPROOF JUNCTION LOCKING�COVrLR �c 41i441V MJG A pNICK 0 -- 1 4" C.T. lwsrlct�oNO�ww►6 – _"r' G -r-� -� � 6,. s� I T2• 1�.\,. Tnm7T1 —� :.I. GIPS 3' [TO NDI6TuRBED 4 "C.'E SOIL. 24" Z.D. Yr~ NT ' c�F.Inw/ M4►iIIOLE „� 3 ' � M►a. i.I,Ir.�r pplpao"o 1 c.s. P►► SKGT 'G1N'r6 W FLES 1 AL 3' 0•+ 0 I- Pift _ IS 2 ,. ON — �cp�STLI1[l'► ,rtNECT10Ni�a �— � GaouKO Lev 4 v _ CIGF 5 6 S ,�S pwyP GOKCRcrc . Lz Lev. E3co CK SEPTIC E SPEGIFI'CATIOUS o DOSE �(; \-`ra -�.1 4 TAWKS MAMUFACTURICK: (DUMBER OF DOSES: PER DAB (Zoo- �c�C'� TAWK SIZE: GALLOWS DOSE VOLUME 1 ALARM MANUFACTURER: S E �O INCLUDING O ACKF{.OW: N g � GALLONS MODEL NUMBER: + O CAPACITIES: A= 2*4 IWCHES OR 4$ � Z GALLONS V_' SWITCH TYPE: B= IWLHES OR 4 �' GALLOU PUMP MAQUFACTURER: C9'o�` _S C= �g I WLHES OR GALLOWS MODEL WUMBER: 'vv t O S D a IN:: HES OR I 'L 6 GALLOIJ SWITCH TYPE: Vh � MOTE: PUMP AWD ALARM ARE TO BE MINIMUM DISCHARGE RATE`_G►M INSTALLED OW SEPAdATE CIRCUITS VERTICAL DIFFEKE BETWEE►! PUMP OFF ARID DISTRIBUTION PIPE„ I �'�S� FEET i + MINIMUM NETWORK SUPPLY PKESSUR . . . . .. . . . . 2 ' S FEET Z. + �` FEET OF FORCE MAIN X I., F I.OrtFRICTIOW FACTOR. 2g FEET z � ^^ TOTAL DYNAMIC HEAD = FEET I►JTERNAL DIME.NSIOWS OF TAWK: LENGTH �`c ` ;WIDTH - ;LIQUID DEPTH M ODEL 1 MO Vertical •0 • . • 1 M �� :r • � .�, 1 GOULDS �. I Pump Specifications 1 /3HP METE FEET 10 { - -- - — — - 1 MODEL: 3871 Up to 40 GPM _ I Discharge size 1 NPT 9 10 � I Solids: 3 fa" maximum 25 r---- •- r ---�-� Motor 7 Single phase: 115V 6 20 x ' ' f Materials of Construction _ Brass /thermoplastic 15 EPOS — Features and Benefits t0 1 ' —? *Top suction eliminates :— impeller clogging. 2 5 — i - 1 — - EPOa 1 • Corrosion resistant 1 - construction. 0 � ,° zo z° _c +o w us3wi • Float actuated switch. 0 2 b 6 10 12 rw1w CAPACITY METERS FEET T`- 25 MODEL DVP03 Pump Specifications Features and Benefits _ ' /,U and '12 HP • EPO4 impeller- semi -open design ° 6 20 U to 60 GPM with pump out vanes to protect 5 p mechanical seal. 15 ____ __ _ -- — - Maximum head to 32' n 4 Discharge size 1 NPT • EP05 impeller - enclosed design 0 3 1 0 --�- — — — Solids: ' /1' maximum for improved performance. 2 5 �_ __ — ___ _ Motor •Rugged glass filled thermoplastic ° 1 All motors feature ball casing and base design provides bearing construction. superior strength and corrosion 0 0 0 5 10 15 20 25 30 35 40 U.S.GPM resistance. Single phase: 115V 0 2 4 G e 1om • Cast Iron motor housing for cAPACirY Materials of Construction efficient heat transfer, strengm. Cast iron and durability. Thermoplastic Stainless steel . Corrosion resistant threaded stainless steel shaft. • Availably f& automatic and manual operation. • CSA listed models available i I All Models are designed for continuous o ration and feature stainless steel hardware. c o ^Ya Wisconsin Department of Industry SOIL AND SITE EVALUATION Labor and Human Relations Page 1 of 3 Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. # 030 - 1019 -10 APPLICANT INFORMATION - Please print all information. Re iewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location David J. & Julie A. Waldroff Govt. Lot SW 1/4 NW 1 /4,S 5 T 29 ,N,R19 7rxf *w Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 398 River Road 4 Proposed CSM City State Zip Code Phone Number Nearest Road Hudson WI 54016 ( ) El Ct)r ❑Village ® Town 42nd Street r ® New Construction Use: ® Residential / Number of bedroo �dcjon to existlr building ❑ Replacement ❑ Public or commercial - Describ Code derived daily flow unknow o>7 corrSr�e d�sign loading rate 1 . 2 bed, gpd /ft 1 • 2 trench, gpd/ft Absorption area requir 6 %ed, ft ? trench, ft2 m axiom 4F /' ding rate � • 2 bed, gpd/ft2 1 ' 2 trench, gpd /ft Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design /site considerations /'` ® /CF Parent material glacial till Flood plain elevation, if applicable N/A ft �I S = Suitable for system Conventional Mound In Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S ®U � S ❑ U ❑ S ® u ❑ S ® U El S ® U El S 0 U SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD /ft 9 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench <::;' 1 as 2f . 5 '0.6 1 0 -1 10 r4 2 None Sil 2fcr mvfr 2 10 - 1 10 r5/4 None Sil 2msbk mfr cs 2f .5 '0.6 Ground 3 17 -2 10yr4 /4 None SiCl 2fsbk mfi gw if .4 ;0.5 elev. 100-4-4-ft. 4 23-3E 10 r4/4 None // Sil 2fsbk mfr cw -- .5 -0.6 Depth to 5 8 -5 10yr4 /4 'f 2d 10 3 & Sil I Om mfi cw -- .P ;0.2 limiting _ 7 . yr & -- -- -. L 6 0 8 10 r4/4 me 10 r5 3 SCl Om mvfi .P fa or m. Remarks: Boring # ,,. 1 0 -1 10yr4 /2 None Sil 2fcr mvfr as 2f .5 '0.6 2 2 10-1E 10yr5/4 None Sil 2msbk mfr cs 2f .5 ,0.6 3 18-2E 10yr4 /4 None SiCl 2fsbk mfr gw if .4 :0.5 yr Ground 4 —6 10yr4 /4 10 r5/3 Sil lfsbk mfr cw -- .2 0.3 elev. 5 0 -8 10yr4 /4 CP7.5yr4 /6 SCl Om mfi 44 -- -- .P 100 ft. Depth to limiting factor 28fri. Remarks: CST Name (Please Print) / ' nature Telephone No. Michael R. VanWey 715- 386 -9020 Address Date CST Number 1070 Hwy 35 N., Hudson, WI 54016 5 -3 -97 3447 i PROPERTYOWNER Waldroff, David SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL I.D.# 03 - 1019 -10 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ; Trench 3 1 0 -12 10yr4 /2 None Sil 2fsbk mvfr as 2f .5 '0.6 2 2 -28 10yr5 /4 None Sil 2msbk mfr Rs 2f .5 ,0.6 Ground 3 8 -38 10 r4/4 None Sil 2msbk mfr aw if .5 -0.6 elev. strat. 10L.52ft• 4 8 -56 10yr5 /4 f2d 7.5 r4/6 S1 2csbk mfr -- -- .5 0.6 Depth to limiting factor 3�m. Remarks: Boring # k „ * *NOTE: S veral borings ATaluated throughout ro e t . P ofile no M � ported due to s'milari y to borings 1, 2 & 3. Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /fl in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # »: r W Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBDW -8330 (R. 08/95) " a - = A co z _ rl . L ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Lk C� Mailing Address acX:> (.O' cy, 1, -� alr f W sc_4 ('X3Z s/O ) (Q Property Address I 50-i (Verification required from Planning Department for new construction) kP City /State &CYI Parcel Identification Number e — 10 1 9 I 1 3 c ' 0 LEGAL DESCRIPTION Property Location �Z %., ' / <, Sec. , T,22_N -RJ3_W, Town of Subdivision Q�aD��e C S M , Lot # �. Certified Survey Map # ( ° C � �� , Volume , Page # _31n Warranty Deed # _ (� 1 �(� , Volume 7� , Page # Spec house ❑ yes X no Lot lines identifiable A yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle 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. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, 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. Uwe, the undersigned have read the above requirements and bgree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. OC7 SIGNA OF A11fPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property describe above, by virtue of a warranty deed recorded in Register of Deeds Office. ,0 0 Z!f!!f AE O APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed Vni. 1470PAGE381 6:31 - STATE BAR OF WISCONSIN FORM 2 - 1998 KATHLEEN H. WALSH REGISTER OF DEEDS WARRANTY DEED ST. CROIX CO., WI This Deed, made between David J. Waldroff and Julie A. RECEIVED FOR RECORD Waldroff, husband and wife. 11 -12 -1999 1:50 PM Grantor. conveys and W EX EMPT DEED 17 warrants to Gum L. Wilson and -Lisa Marie Wi),F husb CERT COPY FEE: and wif a COPT FEE: TRANSFER FEE: Grantee. RECORDING FEE: 10.00 PAGES: I Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (The "Property "): Recording Area AA Name and RettWlel r1 0: 0'181') 7 - j Edina Realty Title 400 South 2nd Street Suite #115 Hudson, WI 54016 n 1019 - to -2,00 Parcel Identification Number (PIN) This is not homestead property. Part of the SW 1/4 of the NW 1/4 of Section 5 -29 -19 described as follows: Lot 4 of Certified Survey Map filed July 22, 1997, in Vol. "12 ", page 3301, Doc, No. 562723. TOGETHER WITH AND SUBJECT TO 16.5 foot wide trail easement as shown on said Certified Survey Map. This deed is given in fulfillment of that certain Land Contract dated July 28, 1997, recorded August 4, 1997, as Doc. No. 563337. Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this 2`7't % day of October, 1999. a J. Waldroff • J e A. Waldroff "t 4AUTHENTICATION ACKNOWLEDGMENT Si mfe(s)r'� h id ., ) SS. Waldroff and Julie A. Waldroff. STATE OF WISCONSIN an d ) ,e `W authenticated this County ) daty'pfltobet, 11)99. Personally came before me this_ day of ' 1999, the above named ' Mary E. Cahalan V to me known to be the person(s) who executed the TITLE: MEMBER STATE BAR OF WISCONSIN foregoing instrument and acknowledge the same. (If not, Notary Public Pierce County, WI authorized by § 706.06, Wis. Slats.) , My commission expires 06118/00. Notary public, State of Wisconsin My Commission is permanent. (If tat, state expiration date: THIS INSTRUMENT WAS DRAFTED BY - ) Attorney Kristina Ogland Hudson, WI 54016 (Signatures may be authenticated or acknowledged. Both are not necessary.) .Names of persons signing in any capacity should be typed or printed below their signatures WARRANTY DEED SFA7E BAR OF W ISCONM FORIA No. 2 INFORMATION PROFESSIONALS COMPANY FOND OU LAC, WI 800455.2021 0 1 > �+ QA M � •+ it ' O r w ®® 10 — et go A I` h C N a i r r i , I b 1 ! y. 4 E l _ y. fi N - t P 1D �...� N �' j s K t • '+. a try e �� M •� t i i M � Me N` ,. of 1 * it w �. J ..., -. w �• �8 e t ~ 2 V � •� � r .v �8. t • 2 r W w r A � yi 1`�i' � m t � � •r � ;• + � C . _ �r �� • �� { � � �� � w x � ��, t � a' s � a r �. m r � � `,� -� r - . r � � `- ' a ` �" ;�- -- �; o � � y ' �) i t r • .. - M �. �� ~ i ' r' �-- � .e- 0 m >, p i ^ ' r . .' w � t; i _ �' a � .� J i �{ 1 3 OU� 562723 THIS INSTRUMENT DRAFTED BY ED FLANUM JOB NO. 97 -58 ■ o • BEARINGS ARE REFERENCED TO THE 8 N WEST LINE OF THE NW1 /4 OF SECTION 5, ASSUMED TO BEAR N00 "E O 2 (i1 a s �> �. CY) m A °DX 0 ?� n �� * ST '�l ;u 0 N z me tx, l� 8 � D mo m - n �+ z m zv z 25 > > 0 0 0 0 0 O z z G) C) = O Z m G7 Z m UNPLATTED LANDS 33 33 TR BROOK ROAD WEST LINE OF THE NW1 /4 min "� � >> - - - � — �� S 00'31 17 W 763.09 w V N o 0 31'17" z 445.00 31 8.09 ' a 1902.09' N z Z 00 412.00' S 00'31'17" W mo 1730.29' 318.29' w 6 00 IC N N� � . Z O ZZ L4 - z -,I too �. . . L . 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