Loading...
HomeMy WebLinkAbout030-1032-10-000 c a' o ? 3 3 d o1 ° X01 S w N o ° o� m o 0 co - m iv o 0 • O. ,�» � n N 0)- z n m O m O t0 a c c Al co Ch cn D — S ao ° CD (c z D N a n y W a z (D oo m c_ 3 m c_ y, m a .» ' "' NO CD O N r O ppAA j- l�f L t0 O y d l N C4 w 2 y c0 CD y O C CA lr CL 3 Q z 0 0 0 0 0 c CL gg < 0 0 Z �3- CO) CO) N ? CD 3 04 N 7 o D 0 01 ID M W C P co o 3 D_ o D CD o O CD o. v N 3 m o m m CD m �• Z7 C x _U C (D N N v w d d EL 3 a = 3 z = u3 = o cn a N CL a A o. z OD W W m ro CL � Z 3 � c c Z m N ;u w z A CD A pj W 0. Q CD N y a d o o N o cl. , z = c 3 , CL D c mm z 0 z a � m o 0 w o v CL C D O..i °O Ln N N � N N O f a CD 0• o s c ff z c � d CL Fr s CD ° w to I I � 0 0 CD (D a I tsi O I ts+ O ., e ° a $i 0 O i. C, 0 ' a) o tz � k� / on 0 ƒ 7/ o ° t 0 @ 8 S § CD § o � / M. ¥ % \ , .�{� ®� �E k$§ 7 � ` .k3 [ \ f§t k E E c, 0 2 e ( / ° / / § ± k & 2 = _ -n a CD \ C: , r- / § k CD n r ■ S S % § �. T T o o , . { 0 0 0 � � � ; / g § ■ ■ ■ K § Q o C ƒ / ( @ E 00 , CL 3 c r z 0 ( / o $ $ CD § L § ( . ° 7 3 CL 0 \ k / E / z Q . ■ M 7 OD I § ) CO I ® ; qk± 2 §AF � / \� N ± ( § , \ ) 2 / � \ . . � 0 \ G / § _o �$ §i �/ Parcel #: 030 - 1032 -10 -000 01/21/2005 03:24 PM PAGE 1 OF 1 Alt. Parcel #: 08.29.19.112C 030 - TOWN OF SAINT JOSEPH Current I X I ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner " HORIN, DAVID DAVID HORIN 489 NELSON FARM RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 489 NELSON FARM RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.070 Plat: N/A -NOT AVAILABLE SEC 8 T29N R1 9W NE NE 3.07 AC LOT 1 CSM Block/Condo Bldg: 6/1798 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 08- 29N -19W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 776/167 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 4990 363,600 Valuations: Last Changed: 07/07/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.070 179,500 178,200 357,700 NO Totals for 2004: General Property 3.070 179,500 178,200 357,700 Woodland 0.000 0 0 Totals for 2003: General Property 3.070 99,800 161,300 261,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 204 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 f r_ ntn oi 3d n d C n 3 �° T ' m .. O co 3 Z mow= W � 1 0 N < y O O fl. IV O j O_ O n N WO CO CO c G) O O 7 N C- j Q CL N O O fD C ? o b p� O 7 N O� O O �1 d C (n Z m cn D �' � CD N 3 n CL { o �i o N O N o c O w, 3 z 0 W � CO) N O D �' 3 � v v O O 3 (D !C m fN 7 y N 0) _ d _ N 3 T �O CL .3. O co Z o � co o m� c m O_ o o m CD \ - 7 Y ` J H 1 (�D S C C C 3 � w Cr a z m O D p 2 eD IN w n f o Z -i O� w rn 19 z � 0 3 Z z M br o N (D c� A _ \ � I Q CD m c d n z a CD kli 0 6 O N A r n �o O �n V p L ti Wisconsin Del5artment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 430568 0 GENERAL INFORMATION 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: Horin, David I Hudson Township 030- 1032 -10 -000 CST BM Elev: Insp. BM Elev: BM Description: • Sectionlrown /Range /Map No: M • O r C7p • p CST TS M* roc 08.29.19.112C TANK INFORMATION EL DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic I / ' Z ao h oy Benchmark ' ov , b Dosing � Alt. BM Aeration Bldg. Sewer Holding SVHt I et J 1_7 TANK SETBACK INFORMATION St/Ht utlet Lr TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic O I ? ? Dt Bottom �� • S / IQD Dosing C ad - Header /Man. Aeration n Dist. Pipe Holding S reams , Bot. System • O �p. ° 10 ' .o PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cover GPM 3.(00 1 07- 3 o l Nt �PD LO n � a TDH Li . �, L Friction Loss / System Head TDH • Ft Forcemain T � Len( `� Dia. Z q Dist. to Well SOI B PTION SYSTEM RR NCH Wid th f Length o. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIME115t01qS SETBACK SYSTEM TO P/L IBLDG IWELL LAKE /STREAM LEACHING Manu to r: INFORMATION Type O stem: CHAMBER OR — ^ yp 7 UNIT Model Number: l/ DISTRIBUTION SYSTEM Header/ anifold yt Distribution x Hole Size x Hole Spacing Vent to Air Intake Length Dia ` Length Dia S pacing v0� 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 BedlTrench Center Bed/Trench Edges Topsoil 0 u Yes No ;J I Yes � . ' No COMMEI�jTS: (Include code discrepencies, persons present, etc.) Inspection #1: / ' ZOOS Inspection #2: Location: 489 Nelson Farm Lane Huds n WI 54016 (NE 1/4 NE 1/4 8 T29N R1 9W) NA Lot 1 L Parcel No: 08.29 1.) Alt BM Description 2.) Bldg sewer length = \ � ` C1C:'S 0- 4 - amount of cover = l Plan revision Required? _j Yes JK No hN •• p�s1 t - ' Use other side for additional information. _ ___ to _ SBp -6710 R.3/97 Date Insepctor's Signature Cert. o. 1 1 2 c�J& v+ � Waw "u -- oe, �, C` . A - �4d f — . . - V i sc Safety and 9uildi� :_ T_ 20i W. Washington P.�$o E - STc- x t�rtsin Madison, WI 5 707 - 7162 €€ 5atutar Permit Number (to be filled in by Co.) f�Depart of Commerce (608) 266 151 `13o SAO - I.D. Nu Sanitary Permit Application S tate an mbe c In accord with Comm 83.21, Wis. Adm. Code, personal information y u pro ,§ CROIX COUNTY A may be used for secondary purposes Privacy Law, s15.04( 1)( Z OFFIC Y o' -- ect Address (i different than mailing ad I. Application Information - Please Print All Information S Property Owner's Na me Parcel N Lot / Block # Property owner's M ailing Addreau '� - - I LIcS 2 Property Location i �a it - a - p^ m �2.v City, State Zip Code Phone Number L = ' ,e! '4 Section (circle one) 11, Type of Building (check all that apply) l' �2 T �� N; R E ore ! or 2 Family Dwelling - Number of Bedroo Subdivision Narre CSM Number :.� Public/Commercial - Describe Use ��� q ❑ State Owned - Describe Use ; U )57- � v — � LL .L p ✓t� -••— - ___ _ �` ❑Cif ❑Villa a ownshi of � r III Ty of f Permit: (Check only one box on line A. Co mplete line B if applicable) A. ❑ New S stem _ Y (Replacement System I D Treatment Holding Tank Replacement Only 0 Odier Modification to Existing System B • f CJ Permit Renewal ❑ Permit Revision ❑Change if — ❑ Permit Transfer to New Lis Previous Permit Number and Dace Issued Before Expiration Plumber Owner IV. T of POWTS Svstetn -_- �� - -- - - _ � (Ch eck all tha apply) Nun - Pressurized 1n - Ground ❑ Mound > 24 in, of'suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grate G Single Pass Sand Filter I unstructed Wetland Pressurized [n Ground Holding Tank Prat Filter Aerobic Treatment Unit � Recirculating Sand Filter r _ - La Recirc Synthetic Media Filter X-Leachin Cham:>rr i] Drip Line U Gravel-less Pipe ❑Oth (explain) V, Dis-persal/T Ar ea Informs n: - -r— Guestgn Flow (gpd) Design Soil Application Rate(g Dispersal Area Required (50 Dispersal Area Proposed (st) System Elevation '3 ' x —VI - -- - -- . - Tank Info Capacity in Total mbrr stanu #'ac urtr Prefab Site Steel Fiber Plastic Gallons Gallons of Units , , / /,y� V Concrete Constructed Glass New V" L?��� -! C. Existing I Tanks I Tanks Septic or Holding *rank J ?ed J< y e rAcrobic Treatment Unit I i• _ Dosing Chamber VI I. Responsibility Statement- [, the urldersl�rted, assume res for ail ation of th the attache plans. POVVT shown ou Plumber's Na me u (Print) Plumber's Si gnatute - — !vf PRC Number - [ m 6usirtess Phone Number Q ?/s ber's Add Plum re ss (Street, City, State, Zip Code) VIII. ount /IDe rtment Use Only Approved U Disapproved Salutary Permit 1 ee (includes Groundwater Date Issued sing Agen ignature Stamps) j Surcharge Feel �/ y el Owner Given Reason on for Deni IX. Couditlotts "of Approvi /Ro for Disapproval J����� qq� YS pproval �J l!/k t?�GrI s 1 Septi�tank, eff luent fi r and�y►t `�3•SZ / dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained 1� A&& as per applic le code /ordinances ( / S � j / 7 3• 3 -/ Attach complere Plana (b rho Count y only) for the system oa paper not less than 81/2 x 11 inches in SIZ0 ! SBD -6398 (R. 01/03) ' �. G i�� C» r.'.✓ ���.i�s ��� Tay /� �� T�iyi(/4 � ���D J y a b ,60 Vi H `�0 Q6Xw • � C P �l i 1'r ice' �i �r —� 'erw PAJ ,y ' U 6 T � U H ,BR X u c� O b K W b Q6b 69�t �� rd g os-o e - �r..•.w' y„ ..++�.r..w, � r - r_ V =� y 1r � A Y i� 1.1 .. i • +r.•a.r.r. wr.rr.�rr+.� 4 "' CZ VENT PIPE I Z" MTN. 76' F ABOVE G:�ADw S ROM DOUR, WINDOW OR OEATHERPROOF FRESH AIR INTAKE JUNCTION 80X APPRpv�O mash= r ° fi CONDUIT `MANHOLE cov �R RAI. E , I PADLOCK ++ C 1 RISER r r WARI�I N� wABE , l o ll ll _' , y11 H ! WA ~ER TIGHT SEALS r `` GAS- TIGHT: A SEAL PPRBVED ipRROVEO _,�,_„ � JOINTS WITH IPE S' 8 °ALM APPROVE'O P FPE P 0 SIL I D t ON � 3 ONTO ;O.L C ' i # SOLIO. SOIL PUMP OFF BLEU. FT. � RIM EXIT OF: Rz ' D PERMITTED 0, IF TANNK 4ANUFAC7?JRER APPAOVED BEDDING UKDER TANK HAS APPROVAL C0NCRZTE PAD �FECIF :CAT;0N5 S£PTIC r DOSE 1 MANUFACTURER: tsey hUMSER DOSES PER DAY. 1 � TANS; SIZES; SEFI1 _!� GAL, .. ^OSE Vv ^iJJN:E INC; ?ING DOSE �� G��. ,owBaCx: r ;:�;.,, a ...._...,.. M U . —r- cAPA z . s: F A ; .,. j NCwrS = _ GAL SWITCH TYPE: ""—"" 2 INCHES a _j2 .. GA . . .2umP MAwrACTURER ,. - MODEL NUMBER ,, C C = INCHES I GAL. SWITCH TYPE: G A T . 'EQU IRED Di SCHARGE RA T Q GPM PUMP & ALARM w- NG AS : s R I • • HR �, 16.23 WA "ER T: CAL D BE. C�TSiF.?BUiIAN PIPE NIMUM NETWOR MIK SUPPLY PRESSURE � A. 12 rrrT ... 4,.� tEET F'ORCJ:MAIN X :t•�0 Fi /lOG' F. 1 FEiT �FR::TTQX FACTOR FEET �'-O . AL DYNAMIC HEAD s r "E w'; N2ERNAL DIMENSIONS o r WIDTH ER .--, r - - -- •• • ,� . «avZpe oa WEGERER SOIL TESTING P AGE N ' Goulds i�tGE '� czr Submersible Effluent pump r 3871 EPO4 EP45 $pe A L series • Fully submerged in 1 to y designed iar the grade k rt*w a 1w a �� d ui uses- ' Cable Ot ftiminQ l�bridtoyrt 2lld slkieot ' Eflit " >'yitettts MY wibW daMop to Nd tn"w. Nd dutibilMp. Motel; Avwbmo 1sr short k Sid � * "no *411 • H" MN sump ' EPO4 k bras C.d HP, MMI epuere. ArIwNaW snd llad dt Mont >�srn afar R OM, �SOr Y, 8Q kt,1 Sbd Fi i Iladq�igl Roinb. Autamde r P tMt d fbi rate OQ and WN now. SlIOffM • EPOS Si -np11 Phase; 0 S NP, • ertd bwer Pomp: Do I'll hp !i=, 1550 RPM, rFlltTtNlt= hUl�hdiAyblfl betting bull � Overload wRh • Solids Port m. Claw iutMak reset i"w - coviveft 'J•' mgdmum. • P Mw eord:10 foot FCC &4 w design ` n : u>r to �s QPIU. :tinatd , lea SJro wit lx� Qw w= kr ear urnite 0�1 buds: up to 24 f0c wMh Mra prong grounding rnechartkei sal Rrolsctlort, hw� ar■lnar �al�e;1 M NP1: Plug. 000M 20 toot M EPU la p�iler. tANmo. Meow • saak r fin Ot►�. 7 M LIM with Pkft NOWd design for (CSA WW mode! numbers 8�1� ( td t orouqdIng plug ImPMvW pMlbrw4wi. end in or pr •AC °.) •T ntu : PM. ■ Csa Nd iii M RvgW *Tp- , Contlnuouc th8MVp yr meet su • Mr m*Wu. • capabb of runnina re � i ► 1 ���derttsps to a ao � E p ump: P" soft NMIIV ' t • ®bcheuo aft t��N 6 "L i ^ ' Maa w*w sw esrborr- s TO L • IN s poi; to u ' 2 r 0 00 0 a 4 e f1 12 +N1� G�►�, � 3 q,�. OF • r x s ` s11p cg lb m \ T + all C6 CD n ! a r CA) Q n t" Ia a �i n 211 CP c V a� Q � F � Y w ' g 0 cn , . C' c C x �- x —~ �a��� W. CD 8 a � m O C N CD :E I CA cm- N CJt X Q y Q ql x (D m s .' Q - cod Y T e o r"f�ECEIVED OIL EVALUATION REPORT Page YVisconsin Departure d of our Division of Safety and Buil lings in accordance wit 1 Comm 85, Wis. Adm. Code County � I Attach complete site I on p s� tli 2 x 1 inches 7n size. Plan must include, but not limited t : vertica a t t riton ret�ren dint (BM), direction and Parcel I.D. percent slope, scale or c imensions north arrow, and loca n and distance to nearest road. , C. ST. GROIX COUNTY R ed b Date P leaWR[W @ff f n. �� ) Personal information you provide may be used for secondary purposes (Privacy Lew, S. 15.04 (1) (m)). Property Owner Property Location �r r� GovL Lot /I/F 114,O 114 S T 2 1 7 N R E (or W f Property Owner's Mailing Add ss Lot # Block # Subd. Name or CSM# _ ©Qv Oct D-- e- Iso f:�t (vn La v--k 1 © o -) ° 3Z —/° City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road 0 t,v 1 S yep (6 3 113811 u cP�c , .e.eL�� F��� 1 n r EP New Construction Use: ® Residential / Number of bedrooms __ Code derived design flow rate �� GPD ❑ Replacement ❑ Public or commercial - Describe: _ - - - -- - - -' Parent material _- �Q1Z �'^�`�5 -- - - - -_— Flood Plain elevation it applicable _— — ft General comments ������ e% V r 9 ev and recommendations: 1 � Boring # Boring ('� pit Ground surface elev. _ Depth to limiting factor _ z / in. Sol A licabon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #i ' Eff#2 0 oyr31 Zm CS ,S � Uf -/5 D I V , , y - 55.2`' C,f.z�� d Sr i ` �I Boring # Boring ® __ pit Ground surface elev. ,L� ft. Depth to limiting factor in. Soil A icalion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence I Boundary Roots GPDJft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. # 'Eff#1 'Eff#2 � v 4114 bk 16 6 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 P t) Sign lyje CST Number nil YnGt � G Address Date Evaluation Conducted Telephone Number i L t i Parcel ID # _ _ Page Z of Property Owner _ w r '� ❑Boring # Boring �� ft• Depth to fimiting factor in. Pit Ground surface elev. Sol AoDlicabon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtfP .E E- in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. ry n ❑ ❑ Boring # Boring Depth h to limiting [actor n. ❑ Pit Ground surface elev. _---- Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff Gr. Sz. Sh. 'Eti#1 'Eff #2 in. Munsell (2u. Sz. Cant _ C0101 I I I ❑ Boring ❑ Boring # Ground surface e(ev, ft. Depth to limiting factor _ in. ❑ Sol Aoolication Rate Pit I Horizon Depth Dominant Color) �Red;: D Texture 3Vucure Consistence Boundary Roots GPION in. Munsell lor Gr. SZ. Sh. 'Erf#1 'Erf#2 I I I I I Effluent #1 = BOD 30 < 220 mgiL and TSS >30 < 1 r-O mglL Effluent #2 = BOD < 30 mgJL and TSS < 30 mgiL The Department of Commerce is an equal opportunity service provider. and employer. If you need assistance to aces services Or need m aterial in an alternate format, please contact the department at 608-266- 51 or Ti'Y 58 D -X730 I R.07 /Otll Z PAGEaOF3 NAME: I^ LOT# LEGAL DESCRIPTION.,_VFl/4kOASAT - %R,JqE(or)� SCALE: 1 "= G r t ELEVATION: ly BM 1 DESCRIPTION: BM 2 ELEVATION: v BM 2 DESCRIPTION: " SYSTEM ELEVATION: GI z SYSTEM TYPE: � 1 l b SIGNATURE: DATE: ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGRF-EMENT AND OWNER CERTIFICATION FORM Owner/Buyer 7 & c z L A n e? Mailing Address ��'! BSc, Property Address - (Verification required from Planning Department for new construction} City /State Parcel Identification plumber 0 3 U ' /� 2 " / d' �� LEGAL D E SCRIPT ION , `/ 2 C Property Location 41 ' /., , ZC '/ <, S , T al N -R���, Town of , 5'aAl Subdivision � w _ _ , Lot # _ Certified Survey Map # Ll S � _ Volume � Page # C "7 Warranty Deed # Ila`r' Volume A g;C , Page =# ^ l 2 �� . Spec house ❑ yes no Lot lines identifiable I yes ❑ no SYSTEM MAIN Improper use and maintenance of your septic system could result in its premature failure to hapole wastes. Proper maintenance consists of purrtping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the systern 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 forni6 signed by the owner attd by a rtxaster pltunber, journey iiian plumber, restrictedplumber or a licensed pumper verifying that (1) the on - si to wastewater disposal system is in proper operating condition an&or (.2) after inspection and pumping (if necessat}), the septic tartlk 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 statnd3rds set forth, herein, as set by the Department of CottttTierce and the Department of Natural Resources, State of Wisconsin. Cerification stating that your septic s- stem has been maintained must be competed and returned to the St. Croix County Zoning Office within 30 o ( three y r ex iration date. SIGNAT'UM - A. I.ICA DATE OWNE CERT IFICATION we) certiA statements on this form are true to the best of my (our) knowledge. I (we) ant (are) the ow - n er(s) of t roperiy sctib virtue of a warranty deed recorded in Register of Deeds Office. �, �!,�.�- 1GNATt_1R)`. 5.r APPLICANT " Any information that is mis represented may result in the sanitary permit being revoked b y t he. Zoning Department. " "• •" Include with this application: a staniped warranty deed front the Register of Deeds office a copy of the certified survey neap if reference is made in the warranty deed POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page / of 7/ FILE INFORMATION SYSTEM SPECIFICATIONS Owner " Septic Tank Capacity Z a l D NA Permit a Septic Tank Manufacturer 0 NA DESIGN PARAMETERS Effluent Filter Manufacturer Z Q © NA Number of Bedrooms 4 7 1 Q NA Effiuent Filter Model 0 NA Number of Public Facility Units Pump Tank Capacity ai D NA Estimated flow leverage) ,0' i fe g aliday Pump Tank Manufacturer Pr�S. er. ❑ NA Design flow (peak), iEstimated x 1.5) ':;�e gal/day Pump Manufacturer O NA Soil Appilcation Rate gal/d4 /ft' Pump Model O NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit NA Fats, Oil & Grease (FOG) 5310 mg /L 0 Sand /Gravel Filter D Peat filter Biochemical Oxygen Demand (00D 5220 mg /L C3 NA ❑ Mechanical Aeration ❑ W Total Suspended Solids (TSS) 5150 mg /L Q Disinfection C) Other: Pretreated Effluent Quality Monthly average Dispersal Cell(a) 0 NA Biochemical Oxygen Demand (600 930 mg /L �qn Cround (gravity) 0 In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L NA 0 At -Grade C3 Mound Fecal Coliform lgeometric mean) S `' u/1f ?Onnl D Drip -Line Q Other: Maximum Effluent Particle Size Y in dla. O NA Off 0 NA Ott: ❑ NA ' O NA * Vsluss typical for domestic wastewater and septic tank effluent. Ott 0 NA MAINTENANCE SCHEDULE Servhw Event Service Frequency inspect condition of tank(s) At least once every: 3 a : (Maxintpm 3 yeah) 0 NA Pump out Contents of tonk(s) When combined sludge and scum equals one -third ?(Ys) of tank volume ❑ NA Inspect dispersal cells) At least once every: month(s) (Maxlnwm 3 Veen) O NA Clean effluent filter At least once every: e) 0 NA � earls) Inspect pump, pump controls & alarm At least ponce every: �-- moth( =) O NA C] ear(s) Flush laterals and pressure test At least once every: month(*) 0 NA '` O serial Others O month(&) ❑ NA At least once every: E3 ear(s) Other: Q NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersai cells shall be made by an individual carrying one of the foh#wing licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Sepitage Servicing Operator. Tank inapections must include a visual inspection of the tank(*) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal "Its) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a flailing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y,) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized oomponents, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report sha ll be provided to the local regulatory authority within 10 days of completbn of any service event. Page 2 of ?/ START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations ate detected have the contents of the tankls) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually oplerating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwis9 disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Cbde: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or: must be taken,; to provide a code compliant replacement system: • A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement arel. Replacement systems must comply with the rules in effect at that time. • A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. W —• T / alua ' o Ong tank ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name S Name Phone L — 3 / Z Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORI Name Name C ( d 2W f� Phone Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. t LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF SAINT JOSEPH COMPUTER NUMBER 030 - 1032 -10 -000 Parcel Number 08.29.19.112C OWNER NAME: First DAVID Last HORIN PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment 489 NELSON FARM RD SECTION 8 TOWN 29N RANGE 19W '/.160 '/.40 Line Description Line Description TOTAL ACREAGE 3.070 PLAT LOT BLK 01 SEC 8 T29N R19W NE NE 3.07 15 02 AC LOT 1 CSM 6/1798 16 03 17 04 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit DOCUMENT NO. WARRANTY DIE1ED T"1s SPAC4 aaesaveD Fop n9C01101 "e DATA STATE BAR OF WISCONSIN FORM I —1Mt I 4 24890 REGISTERS O�FlCE ' ST. CROIX CO., rW ISM bed. for Reoord *M s 24th ..................... d Anrit ., .M 19J7 SRai)aOl[1 E� *9.•...�1t1 Q 4.. an3 •wife•.as..joint ............... rl taanL�i,.. ...... ............................... .............. ............••-- ............... sa 11:30 A r�A. eonveys and warrants to ... Arutid..J. HQXinL..=d.. `_..,,Y4 pB ep Book ...... Eraaceen.- D..._Ho rin husband.. and..wife. ..................... ...... survivarshi p,..mari tol -- prop .. ............................... ............................._...---.....---....---•-••----....._...._...._....... ......................._....... arrul". ro .....................................•--•-----•-••-•----.....---........ .....--- ....................... ................................. ............................... . ....... ...... ...................._.......... t Croi tthe follow ing described real estate in ....r�_...z ............. . x .......................County, State of Wisconsin: TaxParcel No: ..... . ...................... Part of NE 1/4 of NE 1/4 of Section 8, Township 29 North, Range 19 West, St. Croix County, Wisconsin described as follows: Lo Certified Survey Map filed April , 987 in Vol. "6 ", page 1798, Doc. No. 424452. rulm IFANS E This ....... ls ................ homestead property. (is) (is not) Exception to warranties: Subject to easements, reservations and restrictions of reOord. Dated this ......_..._ fir .................. . day of ............. Papri l ............. ............................... 19...37.. .................. .................................... (SEAL)a,�% -!4 ��?r.........(SEAL) • --• ................................ ............................... • .&ONALP..K_..._S.P.A�G£Na A .... ................. 1..................... (SEAL) �..... EAL) I . • ................................... .........i........_............ . D PANGE.... ERG v AUTHENTICATION ACKNOWLEDGMENT Signatures) .......................... ' ... ............................... STATE OF WISCONSIN j� -------------------------- -- -- ------------- _----------------------------------- St. .._. Croix ....... County. as. authenticated this ........ day of__________________________ ------ Personally came before me this . -- -day of A Prig -............................. 198.7 ... the #Wve named ................................................ .. ............•- --- ----•- •..... a . Ronal4 __ R.. ._Spdzaseziber.C.E._�nd.._Re].nzes I. li TITLE: MEMBER STATE BAR OF WISCONSIN .............................................................. - ---------------- (If not, ............................................................ .................................................... ._._._._.._....... l authorised by; 706.06. Win. Stats.) to me known to be the person .-s ........ who executed the s ing tru and acknowledge the a 4 THIS INST!!UMlNT WAS DnAFTEDNJO ER D. 13 / RR�tii 0� it ExE >?HEPI..tL..._ALINEAP. T^ N O TARY PUBLIC \ . ...... ..... H13f�SlJi1s...I9T .S�Qi3 �T�____________________•_____ Notary Public ....... S......CrO1X County, Wis. (Signatures may be authenticated or acknowledged. Both MY Conimission is penman nt. (If not, state expira}�i n j are not necessary.) date: G� �� 19 _ _...) •Naaws of pa wan sinning is any capacity should be typed er printed below their signatures. hlClaasrtLaesly� - - - -- . °Tw 'so ° x>t A x °O �9 NSTM Stuck NO. 13002 .,......r... J) r , 1 � FORM N0. 985 -A HCt!'Cn rry® 8 Stock No. 26273 �* in AWN 01 4 OWNER AND SUBDIVIDER: RONALD R. SPANGENBERG & West � CERTIFIED SURVEY MAP 0e LOCATED IN THE NE1 /4 OF THE NE1 /4 OF SECTION 8, T29N, R1 9W, S _ -C,S_M_VOL___ = _ PG. __ LOT _16_ - -I— C.S_M_VOL. — __ PG. T 15 - - _ EXIS TOWN ROAD N 89 540. 00' 205.00' 65.00 270.00' w 270. 00' u, W oo 0, SOUTHERLY RIGHT-OF-WAY LINE 0 W UO F- .-- W N Co Z (n f cr N C n Q1 C; LOT 1 N LOT 2 W 3. 07 AC. ± 4.11 AC.t Z v 3 133,.825 S.F.± 179,106 S. F.t _ _Z I- rn 00 LL Q �I O m HOUSE tO z N 2 � W 01 in Z Q: z 1 W Ln W ~ JI ° W LA 2 " n N N O LL Co O WI WI W F- I z I : I'- I- I Q M F' I k ZI � APPROVED a1 H a I � O, W =I N rn DI "' APP 1. o 5 ". C? JiX C OUA41 y N N COMP C "ENUVE PARKS P1AfvtMNG �'1 N limo 2o"41NC, e - C COMM1TTE6 M Z 0 N89037'50 "E 175.00' 496.34 i 110. 00 65.00 270. 00 N W 89 445.00' 0 o POINT OF BEGINNING o r- N �o o UNPLATTED LANDS c Z n EAST LINE OF THE NW1 /4 OF THE NE1 /4 N �50 1326. 65' LEGEND SOUTH LINE OF THE p 1 "x24" IRON PIPE WEIGHING NW1 /4 OF THE NE1 /4 1.68# /LINEAL FOOT SET. • 1" IRON PIPE, FOUND. COUNTY SECTION CORNER SCALE IN FEET MONUMENT, BERNTSEN CAP, FOUND. 0' 100' 200' 300' This instrument was drafted by Walter J. Gregory. Vol. 6 Page 1798 Parcel #: 030 - 1032 -10 -000 08/24/2005 08:49 AM PAGE 1 OF 1 Alt. Parcel #: 08.29.19.112C 030 - TOWN OF SAINT JOSEPH Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner DAVID HORIN O - HORIN, DAVID 489 NELSON FARM RD HUDSON Wi 54016 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description * 489 NELSON FARM RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.070 Plat: N/A -NOT AVAILABLE SEC 8 T29N R19W NE NE 3.07 AC LOT 1 CSM Block/Condo Bldg: 6/1798 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 08- 29N -19W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 776/167 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 05/31/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.070 179,500 266,000 445,500 NO Totals for 2005: General Property 3.070 179,500 266,000 445,500 Woodland 0.000 0 0 Totals for 2004: General Property 3.070 179,500 178,200 357,700 Woodland 0.000 0 0 I Lottery Credit: Claim Count: 1 Certification Date: Batch #: 204 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 1 ' p 8 FORM N0. 985-A r / C \ , Stock y No. 26273 U m P Ea 4211 ' � � � ! �� AP 87 ,., 419 OWNER AND SUBDIVIDER: RONALD R. SPANGENBERG of CERTIFIED SURVEY MAP 8 4 e LOCATED IN THE NE1 /4 OF THE NE1 /4 OF SECTION 8, T29N, R19W, S _PG._ _ LOT 16 _ _ _ I _ C_S.M_ VOL. _ _ PG. T 15 _ EXISTING - _TOWN _ - ROA N 540.00 ' 205. 00' 65. 00' 270.00' 270. 00' ;n W �+ SOUT ERLY R GHT -OF -WAY LINE OZ� U O `U m 1 C4 00 Z N F-�' c \, M � O LOT 1 N LOT 2 Z 3. 07 AC. ± 4.11 AC.± V 133,825 S.F.± 179,106 S: F.± LU Z Q1 0 r+ ca ni N I LL f W o ca O m HOUSE 1O ZI V) 2 � W DI U J z z w w F- JI ° c Ln = N I-. N O LL ° W I N N �i LU LU Z � .) F_ I � M F Zi � APPROVED a W =I N zi M I APR 14 1987 CROIX COUNry N CV CO."4EHEHStVE PA.'' N k.S PiAhltNNa M o ANO 20N►NG C06(GUTTEi M O z N89 °37'50 "E 175.00' 0 496.34' 110.00' 65.00 2270.00' w 89 37' 50' W 445. 00' c POINT OF BEGINNING V) - o o "' UNPLATTED LANDS c z M EAST LINE OF THE NW1 /4 OF THE NE1 /4 N 89 °3 50 "E 1 326.65' LEGEND SOUTH LINE OF THE p 1 "x24" IRON PIPE WEIGHING NW1 /4 OF THE NE1 /4 1.68# /LINEAL FOOT, SET. 0 1 IRON PIPE, FOUND. COUNTY SECTION CORNER SCALE IN FEET MONUMENT, BERNTSEN CAP, 1111M1111 — i FOUND. of 100' 200' 300' This instrument was drafted by Walter J. Gregory. Vol. 6 Page 1798 na _ f • AS BUILT SANITARY SYSTEM REPORT ;ER , TOWNS1111 5 C &�: - SEC. T N, R W j. ADDRESS �. , ST. C':; "*X COUNTY, WISCONSIN. . 7DIVISION L � , LOT 'OT SIZE PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ; i nidi, ate North Arro � S c. f> 'r'TIC TANK(S) Moo MFGR. W� s CONCRETE STEEL NO. of rings on cove Depth DRY WELL NO. of width length area .J no. of lines width length area depth to top of pipe -, S REGATE i/ 4a 4 "'I s RATE AREA REQUIRED AREA AS BUILT f laimer: The inspection of this system by St. Croix County does not imply complete ,�liance with State Administrative Codes. There are other areas that it is not possible ;inspect_ at this point of construction. St. Croix County assumes no liability for item operation. However, if failure is noted the County will make every effort to .ermine cause of failure. _`:ASES ARID OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. ' - INSPEC TH DATED — Y 7,9 PLUMBE ON JOB Agile 1 LICENSE NUMBER Zfg mac' 5 r z..._ + REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM San.itany Penm.i State Septic NAME Township J" � ��, �,�; . SZ. Croix County Locat.iort % o� !��, Section T,? N,R/ /W SEPTIC TANK Size -- C gattonA Number 95 CompaAtmentA Distance FAOm: Wet (�-�,:` it. 12 %, on g n eat eA 4tope it BuiZd.ing _ it. Wettand.s H.Lghwaten %— it. DISPOSAL SYSTEM Distance FAOm: WetZ 80 ix. 12% on gneateA st ope 10 '4 it. Bu.itd.ing _ it. Wettand<s Ft. H.ighwateA it. FIELD DIMENSIONS: Width o6 ttench it. Depth o b Aock be.tow t.ite .in. Length o6 each tine 5 D th o6 hock oven Cite .i n. Numb en - o 6 Z in e.a a th o6 t.iZe b etow grade in. z T otat .length ob ti nes it. Slope o6 tAeneh in pen 100 St. Dis tance b etween t ines Depth to b edno ck it. Tota.b abdonbt.ion area 6t2 Depth to gxoundwateA it. Requ.i.Aed area it PIT DIMENSIONS: Numb e& o6 pits GAav et around pits 6/ yes no Outside d,i.amexeA G it. Depth below inZet it. 2 Totat abz oAbt.ion area it z AAea Aequ.iAed gz rn INSPECTED Bjdgt TITLE APPROVE /J ,DATE 1979. REJECTED ,DATE 197_ State and County State Permit P LB67 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: B. LOCATION: /I Ag '/ �� Y4, Section , TI N, R (or) Lot# _City Subdivision Name, nearest road, lake or landmark Blk# Village A /J / Township E!S C. TYPE OF OCCUPANCY Commercial *Industrial *Other (specify) *Variance Single family _ X Duplex No. of Bedrooms No. of Persons I C - D. TYPE OF APPLIANCES: Dishwasher h YES NO Food Waste Grinder_YESXNO # of Bathrooms�NK Automatic Washer _YES NO Other (specify) E. SEPTIC TANK CAPACITY /00- � Total gallons No. of tanks / *Holding tank capacity Total gallons No. of tanks New Installation )C Addition Replacement _ Prefab Concrete X *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) _ 2)___3) • S Total Absorb Area sq- ft. J New A Addition Replacement *Fill System C P I Aw � Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches Seepage Bed: Length ,?46' Widt ' Depth " Tile Depth J6 No. of Lines -3 Seepage Pit: Inside diameter iquid Depth Tile Size Percent slope of land o L Distance from critical slope tro I- 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 Ce ified Soil T ter NAME C.S.T. and other information obtained from o- owner buil er . Plumber's Signature M RR 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). g z' l _ �ia�orad lf�,►ar�0.4L X in •=106• =' ' 6Gy� Do Not Write in Spac elow FOR DEPARTMENT USE ONLY Date of Application J ; Fees Paid: State /0, Couryt to - C Permit Issued /Rejesud ( ate) Y-3 �Zf Issuing Agent Name A,.&I Inspection Yes -4-INo Valid# Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) i Revised Date 6/11/76 i ~ � ° � � ♦ � !l '` �� I \' � � � e } ._ ♦ -. A � �. 1. C S �, , � ` .. .. .. � e-_ --. j I �� � � ° ' .J,,,...,,,,. '7/ ti � •.� � �: < ,�,� 1 ''; Y _..�_..._ "s _ _. ...- --..v.. __.__ � ... ._.. __.. i EH 115 , WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH ' r P.O. BOX 309 t MADISON, WISCONSIN 53701 A664, REPORT ON SOIL BORINGS AND PERCOLATION TESTS � ` / � ` � LOCATION: CSI %, 4, Section I , T N, R ///I IP(or)6kownship or Municipality -�1• J ��d� Lot No. Block No .����•�• /���* sO.4� County Sty Cst�``x R CNj yj So y�s G b v r} ame Owner's Name: Mailing Address: Q9 02- �cf�s� TYPE OF OCCUPANCY: Residence x No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW X ADDITION REPLACEMENT DATES OBSERVATIONS MADE :: SOIL BORINGS 9' P TESTS x'.22 -24 SOIL MAP SHEET - 2Z F_ 9 p � SOIL TYPE j9�'� !/s `C'C�SudO.v �i9s�F�Y �CA9/ti PERCOLATION TESTS TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE CHARACTER OF SOIL NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN /IN P I S re- L ,rho y' y 0 ZQ P - 2 y � see ,9 6t o 'Z ,ID -3 SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) B- / G " G 774(>' / / o ? o "-r a v 2V`, , y0 .OS+6�r, . 7 6., y � S J- 10 s B r> q6 h L 6`' //? 11 1 /V "S4 .°' 9 ts y Kit PLAN VIEW (Locate percolation tests,soi I bore holes and suitable soil areas.) Indicate on the plan the location and square eet of suitable areas. Indicate nuqp��be� ppf square feet of absorption area needed for building type and occupancy. 6lSp� 2�® Sss.`,Cltb (� Af-u Aa- Indicate scale or distances. Give horizontal and vertical reference t i e slope. L ,v Z i s I N c1° h , y ovo e4 a-d Y s C o I, the undersigned, hereby certify that the soil tests reported on 1his form were made by me in accord wit tht Arocedures 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 belie y. 0 Name (print) r Certification No. �� '�5? Address A li A 4, 4 0. 1 S Name of installer if known CST Signature ROPY A —LOCAL AUTHORITY __ _ _ __ i ___ __ f _ - `, � . ", c .. r r < < ,��, , _. , t i � ... l;` w.,_ - � ' . l .. r � ._ i .�_ r'i c �,. ;_ _ _. _ ._ _ .. _. __ _ _ _ - ..._ _. _. _. ._ �._ __. __ _______h. _. �� -, -. �, w � . tea �_. r' r �. `� � �