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n !rn z � H �Y `Y Ate. 0 Q� O � z � � rn c� N J' r •Z � � A Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 488216 0 ATTACH TO PERMIT) GENERAL INFORMATION State Plan ID No: , Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. . 11 r Permit Holder's Name: City Village X Township Parcel Tax No: Mohn, Steven I St. Joseph, Town of 030 - 1040 -70 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: lo '�7PA N 19.30.19.143B TANK INFORMATION ELEVATION DATA TYPE M NjJFACTURERAPITY STATION BS HI FS ELEV. Septic Y Benchmark ^ Li e,k-5 /Odd 0. / 00.9 yap Alt. BM Bldg. Sewer — 7T 9 rj Hol mg_. S t /Ht Inlet /d00 .. /d. 98 cf (o • 9 oat- t 3 Slp . 7Z TANK SETBACK INFORMATION 79 Ft7u - Fe — t $ z,, /( 4J za TANK TO P/L WELL BLDG. o r 5 4t Fe o ,r na e ROAD Dt In �• 1 � �s t • `ft� ep MCIFF r r_ Dt Bottom b H eader/Man. 9 i 1st Pipe lH olding Bo sys •gyp N r � - i , nal Urade t PUMP /SIPHON INFORMATION r •..�, ti anu ac urer uemancl st cover GPM o e um er , �✓ 3.'- Cow mot` Zz 15 Spa. X lum rriction LOSS Syst R ead LoJQ �, ov` L S goo JS.95 5 r , g I r T 1 1 ,. SOIL ABSORPTION bY5 I EM u 'j, P" MENSIONS NO. 01 1 .1. uld. EqUIU Depth ENSIONS : VVr-LL Mid SE I BACK Syl INFORMATION CHAMBER O c � ) UNIT • s. Pipe(s) 1 f . Length - -' Dia Length 'tom• Dia t Spacing - -- x Pressure Systems Only xx Mound Or At -Grade Systems Only Bed/Trench Center Bed/Trench Edges Topsoil Yes No Yes allo COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: SP / / QLe Inspection #2: �o� Parcel No:� 36 .3 9.14''`' Location: 355 145th Ave. Houlton, WI 54082 (NW 1/4 SE 1/4 19 T30N R19W) metes & bounds Lot J __ nn �1 A" ' IoW OK 1.) Alt BM Description + ;' 2.) Bldg sewer length= -7(o c -1e- -t ,o A- a� 70 amount of cover = y g ►1 (_., ! ,- • � .ti.A� 9 N+..I" 9; :,•. ."'nv r4L� t x"� /,. <<'2. j". L'. t� t 1 � CS. i 1 {.bi Ai .. - -- Plan revision Required? ]Yes No 4 �_ f Use other side for additional information 1 Date - F - Irisepctor` igri to = =— - SBD -6710 (R.3/97) // f 0 r t0 I Safety and Buildings Divisio o rYe�fe W. Washington consin Madison, WI 3707 Sanitary ermit Number (to be filled in by Co.) nt of Commerce (608) 26 -3151 6 y TaZ/ Sanitary Permit Application S tate Plan I.D. Numb In accord with Comm 83.21, Wis. Adm. Code, personal information ovi C M co NTY Z �0 7.3Jr may be used for secondary purposes Privacy Law, s15.040XM) dress (if different than mailing address). L Application Information - Please Print All Information 4 355 ) A-- Roe- Property Owner's Name / Parcel # Lot # Block # Property Owner's Mailing Ad \ \ s ✓ f11/ Property Location City , S Zip Code Ty of Building (check Phone Number ° %•, Section C _ 1 cycle II. T T ' jl N; RE o> all that apply) t X l or 2 Family Dwelling - Number of Bedrooms S' Q l acey� ��� eyc �l 2 Subdivision Name CSM Number ❑ Public /Commercial - Describe U ❑ State Owned -Describe Use -�- 93 , 75 ❑City ❑Vill Township of III. Type of Permit: (Check only one boa on line A. Complete line B if applicable) A. ❑ New System � Replacement System ❑ 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. T of PO System: Check ail that a b v , �_ ❑ Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil X Mound <24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter Cl Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recircul g Sand j l ter ❑ i Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) oC A /7 V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rats(gpdsf) Dispersal Area Requir (sfJ Dispersal Area Propos System Elevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New I Existing w Pa t� fL PL S L Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement I, the undersigned, assugm responsibility for installation of the POWTS shown on the attached plans. Plumber's am (Print) Plumber's i MP/MPRS Number Business Phone Number Plumber's Address (Street, City, S , Zip Code idv- VIII. Coun /De artment Use Onl Approved ❑ prov Sanitary Permit Fee (includes Groundwater Date u Issuing ent Sign ❑ en Reaso� Surcharge Fee) 55o . a C � 6 IX. Conditions of ApprovaUReasons for Disapproval J SYSTEM OWNER: 3) Ex� �-,� n y sv�n. v� q Q . seift hmk, aMuent Mier and dispw" cell must all be.tlervices I maintained as per management plan provided by plumber. 2. AN *grow t requiremsnta must be maintained U as pw applc" tole / ordinances. Attach complete plans (to the County only),for the system on paper not kss than SI/2 :11 inches in six SBD -6398 R. 01/03) f ., ,w,:..• fie.« R314WO 0 .43TZY8 Stn .: wt:.a;*0 ?9Q 04 /13,66 f e 7 D - / leas geo � 8S . :f 3 36 i � 1 8 boo i 8 i /J s�iari� T.,�s - iooa fi/ k��s Ime euap s ze e �7 X /13Z4 i a�. I i 99 �. 8 / 9 Awe - � /�,G i "7 �� 2 —21 i Safety and Buildings 10541N RANCH ROAD commerce.wi.gov HAYWARD WI 54843 ■ ■ TDD #: (608) 264 -8777 i s co n s i n �,.co mmerce.wi.gov /sb/ Department of Commerce www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary May 30, 2006 CUST ID No. 224263 ATTIC• POWTS Inspector KIM A 0 CONNELL ZONING OFFICE K.O. CONSTRUCTION ST CROIX COUNTY SPIA 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/30/2008 Identification Numbers Transaction ED No. 1267354 SITE• Site ED No. 712338 Steve Mohn Please refer to both identification numbers, 355 145TH St above, in all correspondence with the agency. Town of Saint Joseph St Croix County NE 1/4, SE 1/4, S19, T30N, RI 9W FOR: Description: Replacement mound, 5 bedroom residence Object Type: POWTS Component Manual Regulated Object ID No.: 1073871 Maintenance required; Replacement system; 750 GPD Flow rate; 22 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 101) P.O �N C w" ti The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes SA and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) T ' referenced above. 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, E COp stats. SE The following conditions shall be met during construction or installation and prior to occupancy or use: Key Item(s) • 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. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • The minimum length of the distribution cell shall be 93.8' to compensate for the convergent slopes on this concave sloping site. • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. i KIM A O CONNELL Page 2 5/30/2006 • Materials shall conform to the requirements of COMM 84. • The existing POWTS must be properly abandoned per s. Comm 83.33 Wis. Adm. Code. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be.obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making hem necessary for code compliance. g ary p ce. 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. Sinc Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Patricia L S ando POWTS Plan Re 'ewer , In grated Services WiSMART code: 7633 (715) 634 -7810, F - 634-5150, M -f 7:45 am - 4:30 pm pat.shandorf@wisconsin.gov cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 t 4 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: STEVE MOHN Owner's Name: STEVE MOHN Owner's Address: 355 145TH AVE HOULTON WI 54082 Legal Description: NE-- SE - -SEC 19 - -T30N - -R19W Township: ST. JOSEPH County: ST. CROIX Subdivision Name: Lot Number: Block Number: �l 0 Parcel I.D. Number: ERO A Plan Transaction No.: Pagel Index and title ESP Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank cX Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot Plan Designer: KIM A OCONNELL License Number: 224263 Date: 04/25/06 Phone Number: 715 - 755 -3145 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 4.01 (R. 09/04) Page 1 of 8 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 500.00 Estimated Wastewater Flow (gpd) Table 63 -44 -3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of - 36 inches. 750.00 Design Flow (gpd) 9.00 Site Slope ( %) 80.80 Contour Line Elevation (ft) 22.00 Depth to Limiting Factor (in) 0.60 In -situ Soil Application Rate (gpd/ft) Distribution Cell Information 93.751 Dispersal Cell Length Along Contour (ft) = 8.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft) 1 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution F Y Pressure Disribution Information network? Enter Y or N (c or e) E Center or End Manifold 2.67 Lateral Spacing (ft) If N above, enter the elevation ft 3 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) = 8.06 ft /orifice 2.00 Forcemain Diameter (in) 40.00 Forcemain Length (ft) Does the forcemain drain back? Y 75.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 6.52 Forcemain Drainback (gal) 6.47 Vertical Lift (ft) 127.17 5x Void Volume (gal) 1.22 Friction Loss (ft) 133.69 Minimum Dose Volume (gal) 14.19 Total Dynamic Head (ft) 38.31 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 1.50 x 1.25 2.00 x X 1.50 x X 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information 1800.00 Total Tank Capacity (gal) 1800.001 Septic Tank Capacity (gal) 58.00 Total Working Liquid Depth (in) WEEKS IManufacturer 31.03 gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 1000.00 Dose Tank Capacity (gal) I PLOY -LOK Filter Manufacturer 21.76 Dose Tank Volume (gal /in) PL - -525 -- dFilter Model Number WEEKS I Manufacturer Project: STEVE MOHN Page 2 of 8 Mound Plan View 1/10 B ::::::: Observation Pipe 3 J ---�- � _ T K .... � A Cl.. W l i - . :: ..... ...................... B . ...:........................... I :.. L Mound Component Dimensions A 8.00 ft E 22.64 in H Mft ft K 9.96 ft B 93.75 ft F 9.50 in z 1ft L 113.66 ft D 14.00 in G 0.50 ft J ft W 26.87 750.00 (ft Dispersal Cell Area 1 1974.53 (fl?) Basal Area Available 8.00 (gpd /ft) Linear Loading Rate 1 9.38 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 83.76 (ft) —� ♦ H ,,,,,,.,.,,. G I F ..:: flis ersai cell 82.47 (ft) Lateral $1.97 (ft) — Invert Dispersal Cell �.. :.:.:.:.:::.::: ......... t :::: 3 Elevation E D 80.80 (ft) Contour Elevation 9.0 °r6 Site Slope Geotextile Fabric Cover Shading Key T — Dispersal Cell See lateral details on 10 Topsoil Cap °- 1.5 ft Page 4 for number, size, "' Subsoil Cap 1 A o a and spacing of laterals. ,1111,,,, © 91111111"14 ASTM C33 Sand 4 F Laterals are equally ®0 Tilled Layer a 0.5 ft Typical Lateral spaced from the o distribution cell's 05 Aggregate o . centerline in the }--- A distribution cell (AxB). Project: STEVE MOHN Page 3 of 8 End Connection Lateral Layout Diagram Center the laterals over the A & 9 dimension •- Turn -up vd ball valve or oleanoutplug E P All laterals are identical IE X Hol es drilled on the bottom of the lateral equally spaced S Laterals & force main of PVC Sch 40 8 (per COMM Table 84.30 - Force main connection via tee or cross to manifold at any point. Number of Laterals 3 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 3.08 ft Lateral Length (P) 92.40 ft Orifices per Lateral 31 Lateral Spacing (S) 2.67 ft Orifice Density 8.06 ft /orifice Lateral Flow Rate 12.77 gpm Manifold Length 5.33 ft System Flow Rate 38.31 gpm Manifold Diameter 2.00 in Total Dynamic Head 14.19 ft Forcemain Velocity 3.91 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Comm Disconnect Electrical as per NEC 300 and -► 16.28 WAC 4 in. min. _ Tank component is properly vented E---- Alternate outlet location Forcemain diameter WEEKS Manufacturer 2 in. Cap acityl 1000.00 Gallons Volume 21.76 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 25.81 561.67 C B 2.00 43.52 P ump off e levation (ft) C 6.14 133.69 76.00 D 12.00 261.12 D Total 1 45.961 1000.00 D ose tank elevation (ft) ,,/ ----- 3 7 ' — Bedding under tank. 75.00 Alarm Manuafacturer ISEPTRONIC INC Alarm Model Number JTM1 Pump Manufacturer STA-RITE Pump Model Number EC2 Pump Must Deliver 38.31 gpm at 14.19 ft TDH Project: STEVE MOHN Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name KIM A OCONNELL Phone 715- 755 -3145 POWTS Regulator's Name ST. CROIX COUNTY ZONING I Phone 715- 386 -4680 System Flow and Load Parameters Design Flow - Peak 750 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 500 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1800 gal Maximum TSS 150 mg /L Soil Absorption Component Size 750 ft' Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 ears Mound Inspect for ondin and seepage once eve 3 ears Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Tum -up Detail Finished • ............. • Grade \ 6 -8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: STEVE MOHN Page 5 of 8 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals (SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet fitter shall be cleaned as necessary to ensure proper operation. The fitter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the fitter when removed from its enclosure. If the fitter is equipped with an alarm, the fitter shall be serviced if the alarm is activated continuously. Intermittent fitter alarms may Indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent fitter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg /L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD 30 mg/L TSS, 10 mg/L FOG, and 10" cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: STEVE MOHN Page 6 of 8 COMPOSITE CURVES STA -RITE' EFFLUENT/SPECIALTY PUMPS CAPACITY LITRES PER MINUTE 0 50 100 150 200 250 300 350 400 450 500 550 90 F 26 80 24 22 70 F C,g K; 0 20 'A 60 18 F ti F� Aso 60, 16 W � 50 W 0 14 c a a W W S C = c 40 ss0 / 12 C H � I F cQ ti yp � 'oyA %y 10 A 30 8 20 N / /,o 6 Fc 4 y 10 ic 2 A 0 0 25 50 75 100 125 150 CAPACITY GALLONS PER MINUTE NOTE.• Please see page 1I for ST.E.P. Plus' Series performance curves. 20 Al/ � f /De re ar etc iC CC AD / � I j 3 / I i I I ' i "7�6 05/16/2006 11:18 FAX 1 715 247 3038 BELISLE EXCAVATING Q 002 f yy Jf'If� ��Cla 7 9s � X lee 3. 79� �S v l'p�rsirrl.� o0 8ss�8 =� 93, 8 A Tiu I�7�C� C F�/ rtl�r 1�i — / 3 c4 J�iBf�,Jia C ��n�aAcy t / /6t1ua� ���' D - St30 1 ( 9 4 9'1-,4 f t � . RECEIVED Wisconsin Department fComgf ( ' C SOIL UATIOId 85, M. Code REPORT Page�of Division of Safety and B ildings ST. CROiXIB@&M1 nce Co County �.- i Attach complete site ;X 1 inches in . PI include, but not limited to: vertical and horizontal reference point (BM), on d Pamal I.D. percent slope, scale or dimensions, north arrow, and location and distance a Please print all inf rmation. a by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 ( ) (m)). \ E lf Property r Property Location S Govt. Lot ` 1/4 114 S T N R (or) W Property Owners Mailing Address Lot # Blo # I Subd. Name or CSMAr City je Zip Code Phone Number ❑ City Village 59 Town Nearest Roe ❑ New Construction Use:,9 Residential / Number of bedrooms c Code derived design flow rate 75�� GPD �[ Replacement ❑ Public or commercial - Describe: Parent material 4 2 Flood Plain elevation if applicable ft. General comments and recommendations: *s CN Boring # Boring F pit Ground surface elev. __ ft. Depth to limiting facto in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/rf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Efr#1 *EfF#2 J 3 - 3 — -, Boring # Boring pit Ground surface elev. 79.7 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDNf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *091 1 `Etg12 F 7 * Effluent #1 = 80D > 36:5 220 mg/L and TSS >30:5 150 mg/L " Efliuert #2 = BOD _< 30 mg/L and TSS <_ 30 mg/L CST lease Print 1 Signature CST Number Address ate aluation Conducted Telephone Number Cam-✓" ,,.,.. �,� ............... w a; d, Property Owner _ )��� /�Ai Piro? Page of Boring # ❑ Boring ® pit Ground surface elev. zft. Depth to limiting facto in. Soil Application Rate Horizon Depth Dominant Color Redox Descripton Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff ll 'E11#2 F Boring # F1 E] ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Efr#1 *Effif2 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 GPDfff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD > 30 5 220 mglL and TSS >30 < 150 mglL * Effluent #2 = BOD < 30 mg/- and TSS < 30 mgtL 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. 3B - 8330 (R.arroo) { Ys" f 7-2' I I I l' i I 8 j 99 _ / q � ArcIMS Viewer Page 1 of 1 r 1 � IC A r # � R http: //72.21. 230.178/ website /LRPortal /ARCIMS /MapFrame.asp ?PIN= 2/2/2006 r ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address s° Property Address (Verification required from Planning & Zoning Department for new construction.) City /State Parcel Identification Number 6,36 LEGAL DESCRIPTION Property Location _ 1 /4 , _ 1 /4 , Sec. 9, T y N R W, Town of Subdivision , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # , Volume , Page # Spec house yes V Lot lines identifiable es no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. 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 certification 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 Commerce and the Department of Natural Resources, State of Wisconsin. Certification staring that your septic system has been maintained must be completed 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 best of my /our knowledge. I /we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms SiGNA'rtat OF APPLICANT(S) 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. 08/05) VOL EXHIBIT "A" Part of the E 112 Of SW 1/4 and SE 1/4 of Section 19, Township 30 North, Range 1.9 Went, St. Croix County, Wisconsin described as follows: Commencing At the NE corner of said SE 1/4 thence West along the North line of said SE 1/4 1353 feet; thence South on a line parallel to the East line of said SE 1/4 300 feet; thence East on a line parallel to the North line of sai d 1; 1/4 663 feet; thence South en a line parallel with the Sa3t line of said SE 1/4 675 feet; thence East on a line parallel to t.he North line of said SE It 1/4 690 feet to the East line of said SE 1/4; thence North on said Pant line 9 feet to place of beginning. 'TOGETHER WITH a non easement for purposes of ingress and egress ovpr and across a 66 foot wide strip of land lying Sly of and adjacent to the following described line: From the NE corner of said SE 1/4 thence West along the North line of said SF 1/4 1353 feet to the place of beginning; thence continue West along the North line of said SE 1/4, and the extension of said North line, to the Ely end of Cardina) Drive (a town road) as that road presenrly exiqtq. AND Part of the NE 1/4 of SW 1/4 of Section 19, Township 30 North, Range 19 West, St. Croix County, Wisconsin described an follows: Commencing at the E 1/4 corner of said Section 19; thence Weet along the F-W 1/4 line of Sa id Section 19, 1353-00 feet to point of beginning; thence South an a line parallel to the East line of the SE 1/4 of Section 19, 300 feet; thence West on a line parallel to the E-W 1, line of Section 1-9, 80 feet; thence North on a line parallel to the Past line of the SP 1/4 of Section 19, 100 feet to said E-W 1/4 line; thence East along said E-W 1/4 line to point of beginning. "mr - Parcel #: 030 - 1040-70 -000 06/06/2006 03:58 PM PAGE 1 OF 1 Alt. Parcel M 19.30.19.143B 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): O = Current Owner, C = Current Co -Owner O - MOHN, STEVEN R & STEVEN R & MOHN C - PANKUCH SUSAN M PANKUCH SUSAN M 355 145TH AVE HOULTON WI 54082 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description ' 355 145TH AVE SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 20.550 Plat: N/A -NOT AVAILABLE SEC 19 T30N R19W NE SE & NW SE COM NE Block/Condo Bldg: COR SE 1/4 W 1353 FT TH S 300 FT TH E 663 FT TH S 675 FT TH E 690 FT TO E LN Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) TH N 975 FT TO POB ALSO PT OF THE NW SE 19- 30N -19W COM E1/4 COR SEC 19; TH W ALG E -W LN 1353' POB; TH S 300; TH W 80'; TH N more Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 7721291 07/23/1997 658/170 1259/359 WD 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/07/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.500 5,000 133,200 138,200 NO COMMERCIAL G2 1.050 5,100 45,300 50,400 NO PRODUCTIVE FORST LANDS G6 19.000 168,400 0 168,400 NO Totals for 2006: General Property 20.550 178,500 178,500 357,000 Woodland 0.000 0 0 Totals for 2005: General Property 20.550 178,500 178,500 357,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 140 Specials: User Special Code Category Amount I Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 __ f -- u i ___ _ __ -- l g 001 m 0 J @ � m s z I _ z \# I ; , ■ n, o w$ o I E: / )- i E G m © C: g ■ . e E# a,, g m /K§ ƒ/ f'$ §e E g g 0 E E ° § o E c ® � _ 0 © @ z > E A m E �o� R -u ; _ «: °i ; 0 ; ® \ o 2. z CO CO ° i » ¥� § E c � � ■ � 2 M z o o o - '0 1 -31 ■ ■ ■ �' m � $ ECD . }�S / 0 >>o ƒ 7 �- \ z 2 ■ 0 ( ■ « z ■ § R 2 § � 7 z � \ k " { » C o 2;2(fo a LQ.0 2L 0 ®a{ D a / C &� } » 3 : 2ƒoEof�o0 A f«E /052 § / �, # U).0 M Nik � « N �,� ��n =� m� ®_ > »< }2 W j 2.3 3 CLk § _«- �a&Eƒ�§� ) 0 = 95R §8m} qb \ ƒcr CD C, C 2 � <0 2 2 � � 0 o � CD t / ? § k CX & , � NUMBER 86 -V -83 LETTER OF NOTICE OF VIOLATION Certified Mail /Return Receipt Requested -; DATE- September 15, 1986 Mr. Chris Hudachek 429 W. Pine LOCATION: NWT of the SE of Section 1 9, Stillwater, MN 55082 T30N -R19W, Town of St. Joseph Dear Mr. Hudachek As required under the ST. CROIX COUNTY ZONING ORDINANCE, notice is hereby given that you are in violation of Article 6 .2 of the ST. CROIX COUNTY ZONING ORDINANCE, of the WISCONSIN STATUTES, and /or of the WISCONSIN ADMINISTRATIVE CODE. The violations noted are invalid sanitary permits and the following actions should be taken by octoher 15, 1986 Contact a licensed plumber to obtain new sanitary permits, and have the system installed in the time limit given. The first violation is noted as having occurred August 28, 1986 and any penalties provided for in the ST. CROIX COUNTY ZONING ORDINANCE shall be applicable as of that date. Please feel free to contact this office, for we are available to assist you in clarifying this matter. 1 Yours truly, THOMAS C. NELSON Assistant Zoning Administrator TCN:mj j cc: Town Clerk District Attorney Leroy Jansky, Private Sewage Consultant Parcel #: 030 - 1040 -70 -000 01/06/2006 10:20 AM PAGE 1 OF 2 Alt. Parcel #: 19.30.19.143B 030 - TOWN OF SAINT JOSEPH Current X I ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Current wner, = Curren Tax Address: Owner(s): O C nt O C t o-owner C O - MOHN, STEVEN R & STEVEN R & MOHN C - PANKUCH SUSAN M PANKUCH SUSAN M 355 145TH AVE HOULTON WI 54082 * = Districts: SC School SP Property Y Addresses ) Special Pro : Prima Type Dist # Description * 355 145TH AVE SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 20.550 Plat: N/A -NOT AVAILABLE SEC 19 T30N R19W NE SE & NW SE COM NE Block/Condo Bldg: COR SE 1/4 W 1353 FT TH S 300 FT TH E 663 FT TH S 675 FT TH E 690 FT TO E LN Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) TH N 975 FT TO POB ALSO PT OF THE NW SE 19- 30N -19W COM E1/4 COR SEC 19; TH W ALG E -W LN 1353' POB; TH S 300'; TH W 80'; TH N more Notes: Parcel History: Date Doc # Type 07/23/1997 L i/359 91 'Yet wk - J�(li JA e 07/23/1997 y (�et7 WD 2005 SUMMARY Bill M Fair Market Value: Assessed with: 83440 392,500 Valuations Last Changed: 07/07/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.500 5,000 133,200 138,200 NO COMMERCIAL G2 1.050 5,100 45,300 50,400 NO PRODUCTIVE FORST LANDS G6 19.000 168,400 0 168,400 NO I Totals for 2005: General Property 20.550 178,500 178,500 357,000 Woodland 0.000 0 0 Totals for 2004: General Property 20.550 178,500 178,500 357,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 140 Specials: User Special Code Category Amount I Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 i NoTiAIs) — V/oa ,A�t7 ON DEPARTMENT OF INDUSTRY INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 ❑CONVENTIONAL ®ALTERNATIVE I State Plan l.D. Number: ssigned El Holding a Holding Tank In- Graund Pressure 1�i Mound 8402632 NAME OF PERMIT HOLDER: J ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Chh us Hudacheck 429 W. Pane, Stittwateh, MN BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF, PT. ELEV.' NW SE Section 19, T30N -R19W, Town ob St. Joseph Name of Plumber MP /MPRSW No.. County Sanitary Permit Number: GoAu Zama i St. Croix 49493 SEPTIC TANK /HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.: JWARNiNG LABEL LOCKING COVER PROVIDED: PROVIDED: OYES ONO ❑YES L BEDDING: VENT DIA.: VENT MATL: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH FEET FROM ALARM. LINE: AIR INLET: OYES ❑NO El YES ❑NO NEAREST DOSING CHAMBER: MANUFACTURER [ 71 LIQUID CAPACITY PUMP MODEL. PUMP /SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ONO ❑YES ONO ❑YES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER G PROPERTY W . I VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LI AIR INLET: PUMP ON AND OFF) DYES ONO NEAREST' .SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN' CONVENTIONAL SYSTEM: WIDTH: LENGTH JNO . OF DISTR. PIPE SPACING. COVER I J INSIDE DIA. #PITS. LIQUID SEE)lTRENCH TRENCHES MATERIAL: PIT DEPTH: . RINIEI GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER ELEV.INLET ELEV. END. PIPES. FEET FROM " LINE: AIR INLET: NEAREST MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- OYES El NO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEXTURE PERMANENT MARKERS: OBSERVATION WELLS OYES 1:1 NO 1:1 YES ONO DEPTH OVER TRENCH /BED DEPTH OVER TRENCH /BED DEPTH OF TOPSOIL. SODDED SEEDED. MULCHED. CENTER EDGES. DYES ONO I DYES ONO DYES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: AtryD�fTCSILRH WIDTH. LENGTH. TRENCHES: LATERAL SPACING: GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER. MANIFOLD PUMP MANIFOLD DISTR. PIPE J MANIFOLDMATERIAL.JNO. DISTR, I D ISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING. ELEV.: ELEV: CIA.. ELEV.. PIPES. DI A.: I.EVATION AN � 0 HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL. VERTICAL LIFT CORRESPONDS TO APPROVED °FR/1FST °IOI j PLANS. DYES ❑NO DYES ONO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER M LINE ERTY WELL: BUILDING: DYES 1:1 NO — ]YES ❑NO NEARES Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE: TITLE: DILHR SBD 6710 (R. 01/82) wlsconsln APPLICATION FOR SANITARY PERMIT DILHR C OUNTY ��� oERRRTmEnTOF (PLB 67) UNIFORM SANITARY PERMIT # InOUSTRV, LRBOR 6 MUMRn RELRTIOnS 9 Al 9 3 — Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'hx 11 inches in size. —See reverse side for instructions for completing this application, PLEASE PRINT PROPERTY OWNER M ILING ADDRESS Z 6o r PROPERTY LOCATION Y: VW 1/4 St 1/4, S tV J3 N, R E (or& TO F: ' OS PA/ LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAS R OAD,LAKE OR LANDMARK STATE PLAN I.D.NUMBER G TYPE OF BUILDING OR USE SERVED K 1 or 2 Family Number of Bedrooms. 3 ❑ Public (Specify): THIS PERMIT IS FOR A: M New System ❑ Tank Replacement ❑ Repair ❑ Re nt Soil Absorption System ❑ Revision ❑ Privy Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. / l//VD ❑ Seepaye Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank System -In -Fill ❑ In- Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued ❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump Tank /Siphon Chamber Holding Tank capacity Manufacturer: IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: X Mound ❑ In- Ground Pressure Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity l Lift Pump /Siphon Chamber 1 4 000 A Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): 13 . 3 K Private El Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber (Print): Signature: MP /MPRSW No.: Phone Number: ; 32 o (36) 2850 Plumber's ddress: Name of Designer: COUNTY/ DEPARTMENT USE ONLY Signature pf Issuing Agent: Fee: Date: El y Disapproved 6 0 �, L/ El Owner Given Initial : 6,md / & .� " y Approved Adverse Determination Reason for Disapproval: Alternate course(s) of Action Available: DILHR -SBD -6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398 To be complete and accurate the permit application must include: 1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in a city, village or town); 2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.); 3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks. 4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of square feet to be installed; 5. Complete the section on water supply; 6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi- fication, place your license number in the space provided and sign the permit in the signature block; 7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the permit; 8. Change of ownership or lumber requires a Sanitary Permit Transfer Form 67 -T to be submitted to the county prior 9 p p q Y ( 1 ty p to Installation. Failure to comply will void the sanitary permit. 9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable. 10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system, depth of the system, type of system. 11. All revisions to this permit must be approved by the permit issuing authority. 12. A complete plan including a plot plan, drawn to scale or with complete dimensions. 13. Horizontal and vertical elevation reference points that are permanent and clearly shown. 14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s) to system, building sewer and vent observation pipe(s). 15. The permit issuing agent may require a cross section drawing of the effluent disposal system. TO THE OWNER: This is .valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning your system, contact your local code administrator or the Bureau of Plumbing, DILHR, State of Wisconsin. Department of Industry, Labor and Human Relations � ""�`°""' Division of Safety & Buildings Z�DILHR Bureau of Plumbing P.O. Box 7969 W'=USTP„•LFNB0P6 ,^MLA 10nS Madison, WI 53707 Tel. (608) 266 - 3815 IN ALL CORRESPONDENCE REFER TO PLAN IDENTIFICATION NO. NA " F PROJECT / ONLY - ❑ GENERAL PLUMBING PLANS Q 2 Fee Received: LO Priority Plan Review Only �J 3 C� � MCITYORK T WN CO NT aS 4e t Examination of plumbing plans and specifications for this project has been completed. In accord with Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code, the plumbing plans and specifications are approved contingent upon compliance with the stipulations shown on the plans. Please review your code for the requirements of each code section noted. The licensed plumber responsible for this installation shall keep at the construction site one set of plans bearing the department's stamp of approval. The installer shall also notify the appropriate inspector of when required inspections are to be made. y be In granting this approval, the Division of Safety and Buildings does not hold itself liable for any defects in plans or specifications, plan omissions or examination oversight, and reserves the right to order changes or additions if necessary. This approval is based on Wisconsin Administrative Code requirements. It shall be necessary to obtain and fulfill the permit requirements of the city, village, township or county in which this installation is to be made. Failure to obtain local permits will automatically void this approval. For Privats Setva0e Systems Qnfy: Sincerely, This approval is va lid for two years or if will be valid until tho expiration &.,te of the initial James Sarg t sanitary permit. Bureau Dire or N � DAT 5 Z2 cc: DPS -GQ Owner H & R & Rec. San. Section Local PI Plumber Bur. of Health Fac. & Services ount Other DILHR SBD -6099 (R. 05/82) r E u Department of Industry, Labor and Human 'Relations 1 J 5 C O Division of Safety & Buildings D ' L H Bureaof Plumb P.O. Box 7969 MIOUSTRV, LFN30R 6 MlMIRII FWAJW 0nS r O n Madison, WI 53707 MRl'7 /� `�Te1. (608) 266 -3815 . `c L 6 , 0� Iu LL CORRESPONDENCE oFf REFER TO PLAN ENTIFICATION NO. NA // OF PROJECT h r S tJcYQ -05 � ,' A E ONLY - ❑ GENERAL PLUMBING PLANS 3 Q Q Fee Received: Z7 : LO AT ON 9 Priority Plan Review Only S� CITY 09 WN COUNTY d F+ r Examination of plumbing plans and specifications for this project has been completed. In accord with Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code, the plumbing plans and specifications are approved contingent upon compliance with the stipulations shown on the plans. Please review your code for the requirements of each code section noted. The licensed plumber responsible for this installation shall keep at the construction site one set of plans bearing the department's stamp of approval. The installer shall also notify the appropriate inspector of when required inspections are to be made. y In granting this approval, the Division of Safety and Buildings does not hold itself liable for any defects in plans or specifications, plan omissions or examination oversight, and reserves the right to order changes or additions if necessary. This approval is based on Wisconsin Administrative Code requirements. It shall be necessary to obtain and fulfill the permit requirements of the city, village, township or county in which this installation is to be made. Failure to obtain local permits will automatically void this approval. Sincerely, For Private Setvage Systoms Only: This approval i v afid for two Years or it will be valid snail James Sarg t tho expiration date of the initial Bureau Dire or sanitary permit. <rS / /�/ � DAT cc: DPS -< Owner H & R & Rec. San. Section Local PI Plumber Bur. of Health Fac. & Services ount Other DILHR SBD -6099 (R. 05/82) 1 0 JW G r -rNDE A SHE SITE: S !y 7 0� DES - DESI&)j A Mou Sy-STEM For P Eip)"i4131E SiL5 with SEAso y SA W PATED Zok3 5 A T - 33 Th s i A mew S ysrE M F01 R . u 0 e l0't 0 2 0. 1 Aa. - FARM pA r c c L. . A New 3 BEDROOM NO ME - I5 PIA�JmEO . LDAi Ly eSTi MATED wA STEIOAD 15 LIS0 V A Is . V PA( E 1 PLOT P IAN VIEI05 PAG 2 :SY ST EM PIAN VIEW � CR O55 SE CT IO" GE 3. PPE L-AT ERAL LA.y60-r t- � TAk) t� S PAGE M � 11 � I 51 PHo '�C PAGE 5 . f� S _P �,��.2 , �� � � Ga i PLUMB 6A u � L. I C EM SEE N o /7/s2.►^ 3a SIT• n PL o PLAt, VItt Vv m rn WF5T LOT L i.vE ssw 300 " > � Cole /00 ScAI E I " = 30 M 4. 3t U PROPOSED w�II b o pRopozj) 3 AkP,914 't �. H ovsE s Tr � � s �9 ApPaou�o /aoo S ?ATF — CO) /tPP.PovEt� 73 pf. S�phFO v r AAik f1 - r ✓ 3 FD.PIE Hil %N L A SZ -� � 2 ,j -� � � ,�► y�j -,. a /I /23 $4 r S� r � CST r " . Y /.3� C •S.� Tod d -f 2. s UEJe T. o 3 oo fo -/.t/ o. Page — Of _ vr3SE POT v , o f'1AiN pip DeT DOWN s IoPED Q E Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe U4 ;� Medium Sand °�.. H Topsoil ________ F E D 3 � V U 0 0 0 o _ - //.�- % Slope 0000 I I aUo_ i �{ Plowed Bed Of 1 - 2 -2 1 • Aggregaty Layer 5A�3 R Fc I -___ SHTs To To ENTER D � Ft. A!►ow For P oODW& E 2 - Ft. Cross Section Of A Mound System Using A Bed For The Absorption Area F • 73 Ft. f oQCE NO r 1A/ S //.4!/ G / � Ft. l3 I3e1�DED u % N/�7 uM o /g" � /or,J A, _ Ft. N, _)5.. Ft. x%Nie-aek y k,4 nE AND r- Y 7 Ft. twit l/I 5 A DFAlsi ) 131vE COW STRUCTio k) i, 12- Ft. 6 T yl� O F 0411 F ROm 911Y L ?/ Ft. To / _ Mc�u�vD � _.._ Ft. Alternate Position I /9 Ft. of 3 Force Main W 32- Ft. i Observation Pipe—, 6. K L ------- - - - A� �___________ _.. __.__._______--- _ -. -•� !o __-- T-----==--------------------------------- I W Distribution k3cd Of 2- 2 %2 Pipe Aggregate Observation `Pipe Permanent Iviorkers y "PSG — CA/�jOED /oosE . STEEL R E /Nfo,PC1AJ6— RODS s URFAcE Plan View Of Mound Using - A.. >Bed For The Absorption Area P ? Page _ Of Perforated Pipe Detail End View Perforated End Cap y' PVC Pipe f ' c b � °ce <�0 Holes Located Cn Bottom, lY �\ Are Equally Spaced X S P Q PVC Monifo!d Pipe Distribution Alternate lFu�a 11- O` Force Main :ice su�.sv TAN 1C Pipe SIoPEJ3 - ups:!@ to PPEVEA3 t Last Hole Should Be Next To End Cap t'REEZtAIy of FjPkpED WATER . End Cap Distribution Pipe Layout p 2 -3 Ft. R 6y s 32 " X 3 0 I nches Y L / Inches Signed: Hole Diameter ! Inch Lateral [ Inches) License Number: Manifold t' Inches Date: ,� �g Force Main Inches # of holes /pi,r* Invert Elevation of Laterals Ft. C� G %V ES x / = P M 1.8 ,roTAl 657 trFD o .4 1,t y W, 4 sf E` 16,41) = 4 1 6 111A I P ` i 90 p���� PA UA - T e $t`i1���y F IoPT, to AcT SIPHON TANK 'P ) 5 E T N i �y�l . S�A�F •9PP/�au�D l.� /� s�2 Tgvk M ETER To R 5 a 5 i pk o , , 3' s A<J1 o D 1? A w D o . � SET T4PoO�k \ N : s;�11o,v V c k)T / Br 5er iN 74'N,� CAP / tf 7- Me7i!V /J/� /d/� 70 DE /iUFh' 4" Cast Iron Hub I0 24" dia iao / /o ckrp C0w�e . / \ / NOTES . 1. All reinforcement Grade d C \0 40 steel and 6x6 - 10 It I,1" MiN04J� n n : � n � , welded wire mesh "� LAC stAle� �t�E� ;i 1 2. Concrete compressive strength 4000 psi minimum 3. Inlet: 4"" Cast Iron Hub Discharge_ 4" Cast Iron Hut 4. Siphon: Miller 3" 4 ° Automatic siphon -_ 4" C.I. Vent. wate _line 5. Storage: 21.47 gal /in S FLohT FaT t� 6. Discharge_ 279 gal /dis- w water line charge � i 3 P UL Z��4.. Z t3 1 FOiPCE` , A 1,4 .J P e 8 4" DIA. n N--- v v F y 1 cC /F11, 7r i0 A) of 51 p116A) s ;L Q ` R U ,e2 O � d l RE 1 D ,p r 1 F F G� �• ; -�a y" y" p ut n Xr� c f 1-: THE MILLER 3 ", 4 ", 5 ", 6 8" Standard Design Single Sewage Siphons 4 .. - o • •e HIGH WATER LINE ° (V .a . 0 'o 0 A ° • D., o D LOW WATER LINE o 0 p. .D A v o. • L Reducer, discharge pipe, and back vent and ow bow, are p - o •- ;. not furnished or soldby Rex - .e o PFT Division, Vitrifned file 6: P pipe and fittings are ymera ly a . v ;a used for this purpose Approximate Dimensions in Inches and Average Weights in Pounds Diameter of Siphon • . • . , • • , • . A 3 4 5 6 8 Drawing Depth . ...... .. D 13 17 23 30 35 Diameter of Discharge Head ............ C 4 4 6 8 8' Diameter of Belle. B 10 12 15 19 21' Invert Below Floor. E 5'I: 7% 10 23 30'1 4Q Depth of Trap F . 13 14'f.."� Width of Trap - .... G 8-3/8 ';1t 14 16 25-5/1 Height Above Floor .....: ... H T/4 t1.3/4 9'�4 11 16 y Invertto.Discharge=D+E +K J 20 25x4. 33 44 47,7' „ Bottom o€ Bell to Floor .. K 3 °' 3 3 4 3 Center of Trap to End of Discharge Ell L 12'h '14% 17 19 25 Diameter of Carrier . h S 41 L. - 4-6, 6 -8 8 -10 8 -12 Average Discharge RateG.P.M 72 165 328 474 950 Maximum Discharge Rate GAM ...... , .. ` 6 227 422 604 1400. Minimum Discharge Rate G.P.M..:., ..,. :. . .. 48 102 234 340 500 Shipping Weight in Pounds ............. ... 60 150 210 300 800 Detail Drawing 1 F ............... , . 373 374.2 375 376 378.2A Note: —Two single Siphons of this type set side by side in the same tank will alternate. See page 4 for description of operation. The draft "D " will be 1” to 2" less in this case. Siphons listed C here are carried in stock and can be shipped promptly on receipt of order and payment. The drawing depth "D" may be reduced in certain cases by special air piping. Contact the manufacturer for these special applications. MP 17.. • ,1 E� 4 ' x " a tie cr''"s �r i� ut tit'"" , , r s f X; APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner /contractor,( "spec house "), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of Property (""?/-Ile Location of Property � '4, Section 1 , T 30 N - R Township Mailing Address Subdivision Name Lot Number Previous Owner of Property GG Lam` Total Size of Parcel Date Parcel was Created Are all corners and lot lines identifiable? No Is this property being developed for resale (spec house) ? Yes x No Volume Page Number 7 ©•. as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING 1. Warranty Deed 2. Land Contract 3. Other recordings filed with the Register of Deeds Office In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the the Certified Survey Map shall also be required. ------------------------ PROPERTY OWNER CERTIFICATION 1 (We) c ektiby that att statements on xhd,s bonm ane tAue to the best ob my (out) hnowtedge; that I (we) am (cute) the owneA ob the pnopehty descAi.bed in this .inbonmation bonm, by vi tue ob a wa.4Aanty deed n.econded in the Obb.ice ob the County RegiA teA o b Deeds as Document No. 3 ? ; and that I (we) pnes entt y own the pnopo.6 ed site bon the sewage di6 posat system (o& 1 (we) have obtained an easement, to nun with the above du u ibed ptopen ty, bon the cons-tAucti.on ob said system, and the same has been duty neconded in the Obb.ice ob the County•Reg.csten ob Deeds, as Document No. ). SIGNATURE OF OWNER SIGNATURE OF CO -OWNER (IF APPLICABLE) 3d / DATE IGNED DATE SIGNED 1 `l . i n �i STATE BAR OF WISCONSIN —FORM I1 UC�CUMENT NCI. .� LAND CONTnACT-- Iadlvidaal aas Vol 6J8 �HWE Corporate H E9ERYfD f OR RECOROING DATA TN19 SPACB R 352"4 Contract, by and between -.?d REGIST6R5 OFFICE JqY570.. K.._Frayaley_...h tea. .xif ------ •________ ___ __ _______ _____ ST. CRJIX CO., Wks. �. ..._ -- - ---- • - - - -- ----".._ .....- •---- • .... ............... (I Rec'd. for Record thin, Qt _.- _- - -• - -- -------- - -•. -- h v;•h:,_her one or more) and..- -____ j *tpph Y_____________ ___ _ __ day of Januar3' A.O. 1983 .. .................. - ........ - -_ («Purchaser", whether one or more). V .odor sells and agrees to convey to Purchaser, upon the prompt and full per - of this contract by Purchaser, the following property, together with the j�qb1w of per, rent , t4 profit.4 fixtures and other appurtenant interests (all called the "Property"), $t. rOi�C __ county, State of wisconsin: _ ..- ...._. . ....... TO ChcLYles B Harris- RETURN TO Charles � ,.., _ >,.)r`� ion of the East One Half (Fh) of the Southwest arterRIOIAM L &HARRIS (,c A.) of Section 19, and all of the Southeast QU P O Box 1S1 -- Hudson, WI 54016 of Section 19, all in Township 30 North, }range 19 West, - Cr�unty, wjsoansan which is described as follows. �iIncing at the Northeast corner of said Southeast qua. & fa) ; 'renee +vest __. 'he- l�oith, line of said Southeast quarter (SE 1,353 feet; thence South on a line f :.1< to the Past line of said Southeast quarter (S1 4) 300 feet; thence East on a line :. i:: '..�_ •' 1 :o the North line of said Southeast quarter: (SFk) 663 feet; thence South on a line with. the Eazt line of said Southeast quarter (SF..4) 675 feet; thence East on a line - _ - 71 1;'. 1 .q1_ to the North line of said Southeast quarter (SE 4) 690 feet to the East line of said r2aart.er (SE 4) ; thence North on said East lisle 975 feet to the place of beginning.. r; .cel col - ita.ins 20.01 acres. A n:un- •- ccryecl��rave easnt for. purposes of ingress and egress over and across a 66 -foot Fi_r.n of land lying southerly of and adjaceXit to the following described line: - r?! the lvcax-theast corner of said Souta - least guw. t.er (SE 4) thence West along the North >a said Southeast quarter (SE,4) 1,353 feet to the place of beginning; thence continue aiorg the ibrfh 1uie of said Southeast Quarter, and the extension of said North line, to r-md of Cardinal Drive (a town road) as ttdt road presently exists. This easement �� nti nue until s ki time as a public road s1uall. be constructed which is contiguous. try descr bed in Paragraph 1 above, at which tune all rights pursuant to this easement tf a �i r late aa shall revert:. to Vendor, his heirs or assigns. This ._ - -_ --- nt?t __ -- homestead property. (iz) tis Awt) ce. as_ Vendor shall - de to u� Purchase, agrees to purchase the Property, and to pay to Vendor at .SkiGh_�i1? __..___.__ ,um of $_- __:�:..,. ^ v;,�,..Od -------- - - - - -- ---- - - - -•- - - - - -. in the following manner: $... 5s O11. OQ-------------- •---------- - - - - -- i�Slt2rig rat t11e eaelutia:a of tills contract, and the balance of $__.. 1,.0QQ,>QQ__ __ ______________ _•_. together with interest from date h2reuf on such portions as remain from time to time unpaid, at the rate of-- ______- LQ ----- ____________ per cent per annum, x;a it ;.: in full, as follows: Equal monthly payments in the amunt of $ 431.17 to be paid to V'cIldor with the first such payment due one month fram the date hereof and similar payments to be made on the same date in each succeeding month, or, in the event that such succeeding ,oath does not have such date, on the date closest thereto in such month. Provided however, that the entire principle amount, and all interest due thereon, shall be paid in full within four (4) years fran the date hereof. H H y ST C- 105 r 9 H SEPTIC TANK MAINTENANCE AGREEMENT 0 St. Croix Count z Y 0 O W N E R / B U Y E R ROUTE /BOX NUMBER Fire Number CITY/ STATE 1 7 �r X - ZIP PROPERTY LOCATION:, kl '4, �4, Section, T 3o N R 9 w Town of 5 St. Croix County, Subdivision Lot number Improper use And maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents m_ y be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman umber, restricted lumber or a licensed pumper veri- Y man P P fying that (1) the-on -site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. H o E I /WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x H the standards set forth, herein, as set by the Wisconsin Depart - 10 ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. S I G N E DATE C ounty Zoni St. Croix C y g Office P.O. Box 98. Hammond, WI 54015 715- 796 -2239 or 715- 425 -8363 Sign, date and return to above address. DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY &BUILDINGS INDUaTRY, DIVISION L 'Ab,OR AND PER N TESTS (115 MADISON W 53707 HUMAN RELATIONS apter 145.045) 5 LOCATION: SECTION: ILOT NO BLK. NO.: SUBDIVISION NAME: a uu1 �/ �/ l 9 /T 3v N/R 1? E ( P /f- pA�r ev ,P,fw /F - Zo• / .4c�.c COUNTY: OWNER'S BUYER'S NAME: 2 N DRESS ��• Glo • c i s v10,4 E' °a/ �' 9 E- S %/ �I -TES'. ��c, • � �Z USE / DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIA CRIPT N: PROFILE DESC IP IONS: ER CATION TESTS: Residence 3 A/ ❑Replace �(.�� ✓ RATING: S= Site suitable for system U= Site unsuitable for system c.> s 33 A�l£�y � 1y!l�flrSU;� /E YO ;L 3 IO r ONVENTIONAL: MOUND: IN- GROUND PRESSUREVSYSTErvl-IN-Fl LI LOLDING TANK: RECOMMENDED SYSTEM:(optional) osou RISE osau ❑sou os ©u lq 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: Flo i ndi cat e Floodplain elevation: /A) DRGtHt&P FT PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER -IN T. CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH .. ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- S 0 If /0.2 3 a� ' 1 0,f'40 -6y. s; / yZ - f • 3N • % , -2- CY- 43,j 5 C/ Wig ft-4* fAis MOI -PRO,. 3.0 S 43'Q,u -6 V 1. �s' bj - . s,' ,�! yr. y yi' • Qa B- Z- 0 7 y ;t r- 3, o P V / W �Fl*It fl+!,) -r• o#1111- .Aj fs f o N, 3,0,P ' B- � 3 6 l ioZ *&' > I D • 3,)• Z .G9 &•/I.81'AW. V1, 3 ~--Of. s/ . . */ -- 1 s w y , a / y3 . ' d IrivC, 7` aQ -�• .y�fs fee'" B- SA7 A >�D AIX. 02 ScG , 51 3 5-f 7 owAzt:o . S . C/q y co /spy , D/nr H 0 fS . B- 4 Sd /L S J'&0&111FV Af,* y 13 — J Py PERCOLATION TESTS * TE , eaw y 1jwj- TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL - INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL -MIN. PERIOD I PERIOD 2 PER D PER INCH P- P- 2 5 f, 7 P -_ P- 20 ♦ . G P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate 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 elevation at all borings and the direction and percent of land slope. -TV VERT OF /o/ SYSTEM ELEVATION , _.�._ _ a _ E _ . _ _ . P / i t •OT�- e , tN zA• I I I � e � 1. a 3 E 3 i I , 'A . I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print : CO . TESTS WERE COMPLETED ON: STATE APPROVED SITE EVALUATIONS (PERC TESTS) / ADDRESS: MINNESOIA LICENSE NO. 00663 CERTIFI ATION NUMBER: IPHONE NUMBER (optional): WISCONSIN LICENSE NO. 55-02482 .9 BMW W1 3016 CST SIGNATURE: - :26 6114 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 - SBD - 6395 To be a complete and accurate soil test, your report rrrust include: 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 1 MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement system; 6. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and compietinc the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A, separate sheet may be used if desired; 3. (Make sure your benchmark and vertical elevation reference point are clearly shown, and a e permanent; 0. Complete all appropriate boxes as to dates, names, addresses, flood plain dala, percolalicra test exemp- tion, it Fappropriate, 10. If L : info,mation (such as flood plain, elevation) does riot apply, plat N.A. in the appro ; }riate box; 11. Sign the form and place your current address and your certification number; 12. bake legible copies and distribute as required. 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 Stvne (over 10 ") BR - Bedrock col, - Cobble (3 - 10 ;, ) SS - Sandstone gr - Caravel (under 3 ") LS - Lirrwstonea *s - Sand HGW - High Groundwatei cs - Coarse Sand Parc - Percolation Irate med s - f0'7 dium Sand t/U - bled is - Fine Sand Bldg -- Buiidinsj Is - Loaniy Sand -- Greater Th Fci 'sl Sandy Loam Less Than 'I - 1_-arra 'in - Broo, n sit Silt Loam Eat B!e,ck S Sill, G Graa; cl Clay Loam `r' Yeiir-y'v scl - Sandy Clay Loarn R - Red sic( - Silty Clay Loam mot - Battles sc; - Sandy Ciay Im - v.it =a sic _. Silty Cl <y fff - fr ti ,fir;;.,. faint ` c — cla'v CC ..._ COtr]mwi t €3rarse - ol - Prat mm - many, rn -_. Muck d ._. distinct p - prom en? HVVL - High weutoi e-vel, Six cfen;ral soil textures surface Jvater for liquid vraste disposal BM - Ben di rvtirk' , VRP - Vertical Reference Point 0 TO THE OWNER, Tni :rC)i� test re port is he first Step in se cut inq a sam - Lary X3£,i snit i he "(sunty o the Depavirnen may request til,c:a'ion of this, star lesi ii, .t. field srrior to paean f A sett of plans fe the private s�' - " ge /sl.em and a permit r, pplica_i i r:wr ', h.� si3 to the appropriate local autl'larit/ in 'to, ob# ' l'n „ ncrolit. Tine sandw y' permit miust tie'orm ;i i,d and I)osted fn or to the, start of any con.<tructiori' : REPORT ON SOIL BORINGS PERCOLATION TESTS IISS ` CWI S 11V44 chi- 1 0,0,0 PLOT PI-AM PROSEC T r. O. zo i DR rE NOMESiTE TESTING TESTING CO. T . 7 O _ R .3, O'NEIL ROAD BOB Ul.B 'IC:� allUSON, WIS, _ 54016 e57 S.S- 02 y�Z PROPOSED HovsE Moi Lie Z.!� Fr. OR MORE rfa i4LG TEST ,PEAS', PRO osr wELL M v$r or ,5O Fr. O,Q J'tD:PE FiQOy ALG TEST ��PE/9S, • = swoel R Pars p = EXisT��1 wE�L X = PEeG 1ocgr1ovf )( = HANP Rojjc�PE0 ow S -4OdEL Bowes r ` 11oei2 . B VC,er14+L. .PEFEREVeir POI 7 s SA,.rE 4 S U-',p j. opy 1d r 5z w , Yolez_S 7 lz 3 LEGEND el Ar dw OA yar. IfEF Pr. /0 49. o o,v 3 , O 11OA4 " os� T�� f p7iyak P so no7Earlk� P ;off oink � 7 FT • M 3$ o T x i 13, 0 oe r N X k 133 I 123 " - -� �. Yo ' -►- Cy- o o A � c H o o 1/3 h 4- 0 P y ST. CROIX COUNTY W I S C 0 N S I N ZONING OFFICE 796 -2239 (HAMMOND) 425 -8363 (RIVER FALLS) HAMMOND, W1 54015 May 11, 1984 Division of Safety and Building Bureau of Plumbing P. 0. Box 7969 Madison, WI .53707 Dear Sir: An on site investigation for the Chris Hudacheck property located at the E' of the SW14 of Section 19, T30N -R19W, Town of St. Joseph, St. Croix County, revealed suitable soils at a depth of 33 inches, below which seasonable high ground water was noted. This site should be suitable for a mound system. Should you have any questions, please feel free to contact this office. Sincere. Thomas C. Nelson Assistant Zoning Administrator TCN:mj WISCONSIN DEPARTMENT OF INDUSTRY, LABOR AND HUMAN RELATIONS DIVISION OF SAFETY & BUILDINGS, BUREAU OF PLUMBING P.O. BOX 1969, MADISON, WISCONSIN 53707 Verification of Exception Status for an Alternative Private Sewage System In the County of St. Croix Location E� SW 114, Sec. 19 T 30 N, R 19 7 l`xxzz� W Town X 4 St. Joseph Street Address XX Lot No. Block Subdivision Landowner's Name: Chris Hudacheck The application for this site is for: © new construction use. ❑ replacement system use. If this is NEW CONSTRUCTION USE, the alternative private sewage system is: 1,Ato have one of * the first five approvals guaranteed for this year. This is number 59 - 04 of those applications. (Use one of the first five quota num ers ssued to you.) I l one of the applications needing a quota number. The quota number assigned to this application is - - [.1for one additional homesite on a farm to be occupied by a parent, child, grandchild, sibling, niece, nephew, or first cousin. for an individual lot for which a sanitary permit was issued but was later ruled unsuitable due to new or changed soil criteria established by the department. (.]for an application on file prior to February 1, 1980. L]for a lot that meets the criteria for a conventional private sewage system. If this is a REPLACEMENT SYSTEM USE, the alternative private sewage system is replacing: ❑ a failing conventional soil absorption system. ❑ a holding tank that was installed and in use prior to February 1, 1980. ❑ a privy that was installed and in use prior to February 1, 1980. If this is a REPLACEMENT SYSTEM USE and the lot meets the criteria for a conventional private Sewage system, check here. I certify that the above information is true and accurate to the best of i knowledge. Name Thomas C. Nelson - Signature County Official Title Assistant Zoning Administrator Date May 11, 1984 DILHR -SBD -6158 (R 12182) d STATt bF WIS CONS IN -MVIR NT OV INDUMt , LARdR 6 HUMAN RELATIONS DIVISION OF SAFETY & BUILDINGS - BUREAU OF PLUMBING P.O. BOX 7969 - MADISON, WI, 53707 APPLICATION FOR THE USE OF AN ALTERNATIVE SYSTEM Location: Township yKyNKTyyyX E2 A SW ;4 19 T 30 N/R 19 gJ 92g kV St. Joseph St. Croix Street Address: Subdivision: County: Landowners Name: Mailing Address: Chris Hudacheck 429 W. Pine, Stillwater MN 55082 I (We), the undersigned, hereby make application for an alternative system on the above - described premises. I recognize that the above premises are not suited for a conventional private sewage system. If approval is granted, I agree to have the system installed in conformance with the Bureau's approval of plans and specifications. I further understand that an alternative system is more complex in nature than a conventional private sewage system and as such will require detailed inspection during construction and monitoring after the system is put into use. I agree to permit both county officials charged with administering county sanitary ordinances and Bureau employes or other authorized persons to have access to the above described premises at any reasonable time for the purpose of inspection the construction of or monitoring of the system. I further agree to either personally or by my agent contact the proper county official to arrange the time and date to begin construction of the system. I understand that this application does not permit me (the applicant) or my agent (the contractor) to begin installation. If the system is approved, the Bureau will send the applicant a letter of approval which authorizes construction of the alternative system after all necessary permits have been obtained. I agree to give notice to any subsequent buyer that an application for an alternative system has been made and if installed, that the premises are served by an alternative system and further agree to give the buyer a copy of this application. The Bureau accepts this application subject to this understanding and subject to all the conditions and obligations set out in this application. Signature of Applicant Date STATE OF WISCONSIN Subscribed and sworn to before me SS. COUNTY OF This day of 19 Notary Public, State of Wisconsin DILHR -SBD -6413 (N. 05/81) My Commission Expires: