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HomeMy WebLinkAbout020-1104-20-000Wisconsin Department of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] HOFFMAN FAMILY TRUST CST BM Elev: jInsp, BM Elev: TANK INFORMATION Description: City TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well TOWN OF HUDSON ELEVA I IUN UA 1 A County: St. Croix Sanitary Permit No: 617873 State Plan ID No: Parcel Tax No: 020-1104-20-000 Section/Town/Range/Map No: 34.29.19.412E STATION BS HI FS ELEV. Benchmark Alt. BM Bldg, Sewer SUHt Inlet St/Ht Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot. System Final Grade St Cover SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No, Of Pits Inside Dia. DIMENSIONS SETBACK SYSTEM TO P/L JBLDG IWELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: IIISTRIBIITION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipes) Length Dia Length Dia Spacing SOIL COVER Bed/Trench Center x Pressure Syst Depth Over Bed/Trench Edges s Only xx Mound Or At -Grade �xx Depth of Topsoil COMMENTS: (Include code discrepencies, persons present, etc.) Location: 598 WHITE OAK DR 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? Use other side for additional information. Date SBD-6710 (R.3/97) Inspection #1: Insepctor's Signature Only fed xx Mulched I Yes Inspection #2: Cert. No. -Zozv (RECEIVED I . / �tY^ati4ir AI I\ / /�" (foe Industry Services Division 1400 E Washington Ave County �� C �p'✓" ' St. Croix County Community Developme t P.O. lox 7162 Madison, WI 53707-7IG2 Sanitary PermitNumber (to be filled in by Co.) 1 Sanitary Permit Application State TransactionNmnber In accordance with SPS 383.21(2), Wis, Adm. Code, submission of this form to the appropriate govemmental unit is required prior to obtaining a sanitary permit, Note: Application forms for state -awned POWTS are submitted to the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposesin accordance with the Privacy law, s. 15.0 1 m , Stats. A Project Address (if different than mailing address) ` / �R/N fl C I. Application Information -- Please Print AU Information Property Owner's Name j _ N r 7� . oN���,► , �� ST c G Parcel # J�o --o o�-t?e Property Owner's MailingAddress Property Location Govt. Lot �, Y<, Section (cireleone T Z�7 N; R /�7 E o V City,State 441)1) 7:C�n/ (i{! t Zip Cade / �7fk, Phone Number H. Type of Building (check all that apply) Lot It 1 or2Family Dwell ing— Number ofBedroom _ _ Subdivision Name / J A Block N ❑ Public/Commercial — Describe Use Q City of _ QStateOwned- Describe Use ❑ Village of CSM Number r / 3/VZ, 1JKTown of �fLt1]�,_Ilir III. Type of Permit: (Ch only one box on Iine A. Complete line B if applicable) r A. ❑ New System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B• Q Permit Renewal © Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number mid Date Issued Before Expiration Otis aa��rry,ds-oZ -- Gay 1V. T of POWTS S tem/Com onent/Device: Check all that apply / ontPnxsutized In -Ground Q Pressurized In-Cttound Q At -Grade ❑ Mound > 24 in, ofsuitablo a ❑ ❑ Holding Tank Other Dispersal Component (explain) ; j)jL4 — TCCetl AJAQL soil ❑ Mound < 24 im ofsuitable soil ent Device V. Dispettsanreatincut Area Information: EL 7- A D— ill w , Design Flow (go) Design Soil Application Rate(gpdsf) Dispersal Area Required (so Area ed ystcrn Elevation e17 VI. Tank Info Capacity in Total ll of Marufaclt�ure{r�� ' /UG' 1 0 77 I �1.3r Gz Gallons Gallons Units / ^a a oAt UIN, New Taaks E�dsting Tanks P e•vl o o • L � /, c �� F1-� aU sty m wV w ' Septic err, 4diaq.T, * � Jz O i r EeAST Dosing Chamber VII. IResponsibil Statement" [, the aadersigacd, assor ume respo 'bility r installation of the POWTS shown on the attnched pinns. urn sName(Print) Plum 'igna MPIMPRS Number Business Phone Number WALb 93i387/5�L '�.-62en Plumber's Address (Street, City, State, Zip Code) �5 C',T.1 F. S s ROD F VI11i. Coun /De riment Use onl ❑ Approved Q Disapproved ❑ Chvner Given Reason for Denral Permit Y� Issues uin Agent Signature thy¢q(top}jyrovalJ)tcasonsfor Disapproval 3)�IYJ „f a. _ � 1. Septic tank, effluent filter and GM 6e. s" a ds � •'1aet c�1`a,C,T` T dispersal cell must be serviced /maintained woe �.-a`it'� as per management plan provided by plumber _t/J 2. All setback requirements must be maintained pt�a�rt�� W&iN. az� NCi allNllt;dUle C:fk,R.'/t3ft3FTYi91it'tPS'msnrra:a3mrcmaaa:ad�w[ mer:odmry oopaperiinf 1/27t11inehl3inilxa� .. — 1 6�- IMQ.c,�i�✓tt�rAce.. 4 SRD-6398 (R. 08/14) Oq) )o t ta.w% i a) 5o 1 tC zi r w'u s C�1 crs� Z, Hllhu[ �Wklu APR 14 4M St. Croix County Community Development • �1 -' 2 6f 5 AN 54'g LxLhn',F 601 -H U rj,5011 02p _. l I oql 20 ..040 Azle z10 A c s .Je i�- YIL Ter fi J L a ,of ..._ .. _ ...... ...._..._. 1�� PAGE 1 OF 5 Index & Cover Sheet Plot Plan Dispersal Area Cross -Section & Plan View Pump Tank Specifications �� ��iL� `�r� POWTS Application for Review - Soil Evaluation Report & Site Map Filter Owner Name(s): 7�Nk Owner Address: Zip: ay41 1411 Project Address: rI Lot. U}� Township: �irh 9/4 of �S 1/4, Section 3'-1 , T Z-�j N-R ) �' E ❑or W Q Project Parcel 1®#: County: 5T� c=NG'r>C t- a r •11181111 hollisterdesign@outlook,com License Number: 1859-007 Remarks: Signature: signature required subm�ted copy. ai7p,-oyol stam p. Date: �� �1, RECEIVED APR 14 2020 St. Croix County Community Development i -s BNl. = Coc� �AAI rFMOIOTMILY Xvp �r, sgIg �ttl rTe 64K DR• +! U bso j l5� i7gK• J�.�• �eh�t,WlC� +0 .O 1864 kjl NN. r^'f � 1 2 cF -5 EOM l99c/ -7-�,5T Q � m 11— M L1 I O �- r U ® W Wiwi a c, N � -0 L ® c: a� O o ® ^ M W a 0. 9 _ mm �t o0 U m U.. 08 w m ac �r too LL S c N U �E PAGE 3 OF 5 I I I y I I n n mo► 7 U1 0 U � W T O � J Z MIN APR 14 2020 St. Croix County Community Developr 4 I. �WLEVPMvm,!mwm , 1 p,,_, Wit_. .,.t,•. _t .t.' ttw kirlCAU NORM rr ' ; INFILTRATOR ••- �+✓ilt1�..�Gii�f2 X1i1'.il 71t.!k!r' pi ::;� t2!!;1 i'f.►!^__� :!'� ;_..,:'.:',.;t'. � •Always cleaai and free of fries • Bundles are quick to instWl, saving costs on heave rnachiner�! and labor • Modular consti'uction allows conTligurations to match trench dimensions for most system shapes and sizes • Engineered for optimal storage and absorption efficiencies Ability to contour along sloped sires and around trees or landscaping • Lightweight system is perfect for repairs and tight job sites Easily hand-cailied into position reducing time and labor + 5' or 10` lengths with simple snap, internal couplers • Easier cleanup at the job site with the elimination of stone • Manufactured from recycled materials rather than a mined natural resource • A wide variei}� of diameters and configurations to meet any installation professional's needs • ApprOVed in many Jurisdictions with an increased efficiency rating, reducing drainfield size • Backed by the leader in the onsite wastewater industry 4 by INFILTRATOR i=or'tlrchnica{ assistance, {nsia{{atian insfructions o� oustemer service, If infiltrator Systems at 80E3,689,775qWE'. =tAMM IM1,11 Available in 7, 6 9 10`, 12, 13 and 14 diameter bundles. Single Pipe Systems 070i P-GEU 0801 P-GE-O 1001 P-GEO 1001 LPP-GEO Horizon#at Sys#ems 1201P-GEO 0705H-GEU 1003H-GEO 1203H-GEO 1209H-(aEU 1201 L.PP-GEO 0904H-GEO 1006H-GEO 1203HP-GEO 1303H-GEO 1401P-GEO 1002H-GEO 1202H-GEO 1206H-GEO 1402H-GEO Vertical Systems 1002V-C,EO 1006V-GEO i 2G4V-GEO 1003V-GEO 1202V-GEU 1206V-GEO 1004V-GEO 1203V-GEO 1402V•-GE0 Triangular Systems 1003T-f�FO 1203T-GEd 1303T GEO t�otc-s: 1. Other systems include 12� squafe alai i t?' and 32' b=d rystams. Bed size >.vii drtate itte number of bundles. 2. System dimensions are dependent upon bundle diameter and configuration. S. LLP Ps for `Lou' Pressure Pipe° in which a prey-aurized disc :button papa is eleld instaiied «thin the co nl�aied papa. A. tntemal pipe and couplings meet the requirements of AS TM FAM. 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'Goy 7%� Old Saybrook, CT 06�'t5 a?�J �+77 7t)CXJ + Fhv 850.577.70di www,ezilowfp.corn www.f ntiltretarsystems.com For technical assistance, Installation Instructions or customer service, cal! l�iitrator Systems at f3txi.688.7759. Ins Ilsaar i� a rey'+�tered trds:r.�r�s o ittfa(ra(:,r 5}'�tcrns inr_ Irf.tactcr : a •e�'stsrew i�3da'�.;rr: in Fr2.n:.s.lrtS;lt3tor S}r5t2ms tnc. is a resist^rsd lrademik in Pdtn;.e. 0 20E4 tnittat�• 'stems Iro. Frnxd 11 U.S.F "Gt 4 410?ArJ•l ESTABLISH VEGETATIVE COVER FILTER FABRIC 12" EZflow BUNDLE (TYP.) EZflow 1203H - GEO 36" MIN. TRENCH WIDTH NOTE: w PRODUCT CONFIGURATION AND INSTALLATION W DEPTH MUST COMPLY WITH APPLICABLE 0 REGULATORY REQUIREMENTS. NATIVE BACKFILL 6" MIN. COVER OR PER CODE 4" PERFORATED PIPE Sint%Tech titter 4\'elasiW: 1455 Lexamar Drive An+ Entail: sales{ir;gag-simlech.com Boyne City, N11 49712 Fax: 231-5824324 Offices 231-582-1020 FILTER Toll Free: 888-999-3290 Slat/Teeb Filter's Last Line of Defense Fen• more info erul to The Sim/'T'ech pressure filter, with its unique design see videos, visit and mounting location, allows the filtering screen to «����.simtcchtilterxnm he scrubbed during pump operation, providing M1y maximum maintenance intervals with untnafclie<I performance capabilities. The litter screen is a type 316E stainless sleet ^ with .062" (1/Tb") diameter holes. Optional socks �� .. are available for finer filtration. The screen is 3 1 inches in diameter and 18 inches long, with 41% open area. This large open area (69.52 square inch- t� ? es) allows the filter to operate at up to 83.8 gallous l r=r Per litinute:it 1 psi. With features like these even a 95% plugged screen will keep your pressurized sys- r; tern well protected and working properly. 3, t This performance product assures quality effluent ..':: in with lower TSS levels, keep ing 1, your pressurized "- systems functioning at 100%o efficiency. Engineers and desianers can specify the Sini/Tech pressure titter to safeguard and assure systems will Vortex action function as designed now and in the future. The Sim/Tech pressure filter is perfect for both residential and commercial applications. High flow -rate manifold. N-Tultiple filters calf be assembled into a nianii'oid to miflatc high strength effluent systems. At the max flow -rate of 83.8 ` gpm, ltcatlloss for a clean filter is .21 psi or 1/2 foot and head - loss for a 95% plugged filter A s .85 psi or 2 feet. r BB99 O3290 84 h c F 1 PARLWANIAMM;�ABINN CEI3. CATI®N STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the following residence: (Street address) 6"?9 d0ftimc 64K :T Alve located at: , �w %4, .3 V4, Section ?5, Town -W N, Range / 7' W,_ Town of .Jj wL<�O1V , St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of SPS. 384.25, and it (they) appears) to be functioning properly. Most recent date of inspection or service .�2� TZo J9 Did flow back occur from absorption system? Yes No (if no, skip next line.) Approximate volume or length of time: gallons minutes Tank Capacity: I �,7 00 Construction: Prefab Concrete V. Steel Other u. Manufacturer (if known): .M) UUSTEN//t i Age of Tank (if known): I ja Permit. umber Of knowA 12Y Signature) A AjC-t#�t��.'�01��� � {Print Name) (Title) (License Number) A'/MPRS (Date) Form to be completed by licensed plumber (Dept of Safety and Professional Services Chapter 305 and s. 145.06, Wisconsin Statutes} or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 2/2012 WisconsinDepanmentoflndustry, SOIL AND SITE EVALUATION REPORT +^•..�. Page � Of � Labor and Human RoUtiors o: ion of safety a Buitdm@s in accord with ILHR 83,051 Wis, Adm. Code AHach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL 1.0.I dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION REVIEWED BY rtVnSoa� Lc3l. Shot GOUT LOT Sr u 114 5 1/4,S 37 T y ,N,R (� E LOT eI BLOCK rI SUBD. NAME OR CSM I Ps+RCeS`L. aoy ohk BIZ • (vjlNow COnstrudion Uso j•")'Residen6ai 1 Numbor of l�dr0orrts � ``�' ((Addition to existing (wilding (( Reptaccement Public Or commercial describe Code derived da ry llow4 gpd n� C Recommended design loading rate / bed, gpdIO • trench, opal Abswplion area requited /� bed, bZ 3ltrench, 0 Maximum design loading rate ��bed, gpdrd2 • g trench, gpdAt2 Reooimmended infiltration surface elevation(s) it (as referred to site plan benchmark) Additional design Isite considerations Sg� EiUG"6S o S/O !v D.tdD 134 A' 0301*ST.F'I;e r10 � Parent material SC S 6 (e " P j A i r) of t a r p 5 Flood plain elevation, it applicable Y• It S � �Jitabi" f� SyStem ��mfkt ttOUVD N!diROUNDPAESSIIAE AT(iRAOE SWEIA pl r1J. F30L0 U= Unsu,table for system ft�S ❑ U t D U Ci S U CI U 0 U C7 S SOIL DESCRIPTION REPORT aev. lepth to mi0ng 4. torJ'r oaring # �'3:�zFist 3raund dev. %pth to m tiro ,r Remarks: r� 1,9 yx 13 G �p 3 l5 OC d.� SMoo Remarks: GST Namo:•-P16di0 PINt �0 �a Phone: ?lJ�' 3F6.. Addross: G*55 ' .00, 4 ef L P D• . li-v ©So.a 3�/✓ gnafwe:�.�� Me:ko to, , y op test APPn OOn vORtionat PROPER'iY PARCEL16C Boring # 2 :3LN Grourxt elev. Depth to rimiting IaClot . of Ground e10v. Depth to limiting factor Boring # qi'':� G:a�ra�''•S,S Ground elev. ?•o R. Depth to limiting IaC�I� „ Ruin # x Groun:t elev. tt. Oepm to Gmiling laclor • 1 � • . , .,31 ,: , Remarks: I ryemarscs: s i i NOrtlaritS: eon anm.o nc.oe4 ,i - 2Y8.o lV o — �Cl�v�tTr0Aj _ // d 13.5 //© D �' Sv��ESTEU SySTE� N 3 10 LO T A a: Aj toa• O peo/�oseo //vttES %7� r 120 7(0 1 13y 50 1 7.6' ,o• 0l�a FoU,u9, Alov5 -Fzv.r l'aa- y,rR,t' to f3S/ YDr r Q STC a 104 ,., BUILT SANITARY SYSTEM REPORT OWNER ''J C� 11 s E n� .• �: rc DDRESS su'aulvlsxoN / cst�t� cud \W r \ fX- S lit CTION ST. CROIX COUNTY, WiSCONSIN _ PLAPi VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEY�i .q� �l �,�✓ bca.... t� PJt�v' 3Z� t��,✓� �Sa,q. .�, INDICATE PIOR`1H ARROW �{�'��' Provide setback and elevation information on reverse of this form• lip Provide 2 di.mensions to center of septic tank manhole cover• 0 BENCHMARK• SEPTIC TANK / PUMP C16 MBtR / HOLDING TANK INFORMATION Manufacturer*, :e5ler-n Preeasl Liquid Capacity: /dLcr� Setback from: Well /'i "0• House Other Pump: Manufacturer 4m.)//J,, i;lrr./ Model# �!r/ '�� Size ;'__` Float seperation A2 Gallons/cycle: j-� f .Ca.-1 n.., tC'cR• lei av Alarm Location!-s•"�,o SOIL ABSORPTIOII SXSTEM Width• � �;�/ Length %���. Number of trenches � Distance &Direction to nearest prop. line:_.___ Setback from: well House Other ELE�lATIOATS l Building Sewer Or ST Inlet. ST outlet PC inlet; PC bottom Pump Off Header/Manifold fi1,'�}' Bottom of system Existing Grade Final grade t DATE OF z1�STALLATION: PLUMBER ON JOB: .• ,'rlc �; - -t: l e� .l r'!:. .' �� LICENSE NUMBER: ~��,'-`a,-jy..),� It.r,,, �y��� •r�.,z Nr�,...._t;tir<' �.•<_ INSPECTOR: 3/93: jt 4$'X's�ilp'arta�^f4?itt • 29.19W, _abor and Human Relations Safety and Buildings Division GENERAL INFORMATION Stu X:N Dr 1 3AYEEWAGV STEM INSPECTION REPORT (ATTACH TO PERMIT) Permit Ho der's Name: '— ❑ City ❑ village JR Town of: tvT e II:ip.tjrvI 8M Description: LANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing It Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. AirIntake t° Au ROAD Septic NA Dosing NA Aeration NA Holding PUMP /SIPHON INFORMATION Manufacturer 1W Model Number TDH Lift Friction f" Demand GPM TDH Ft Forcemain (Length I Dia. � Dst.Toweu SOIL ABSORPTION SYSTEM ELEVATION DATA County: Sanitary Permit No 208974 State Plan ID No.: Parcel Tax No.: A9404097 STATION BS HI FS ELEV, Benchmark Bldg. Sewer it / Ht Inlet it/ Ht Outlet Dt Inlet Dt Bottom Header / Man. to Dist. Pipe Bot. System Final Grade // -7 r' `f I LIP Cis BED /TRENCH DIMEN ! NS VIII BED /TRENCH DIMEN ! NS VIII Width Length No. Of Trenches piT DIMENSI N No Qf pits Inside Dia. Liquid Depth SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION TypeO System CHAMBER OR UNIT Mode-- N—T umber; low v ui31t(IC3tJ1llJiV JTJItM Header/Manifold � Distr length _ -_ Dia Over SOIL COVER Spacing length `__ Dia x x Hole Spaung x PreSSure SySt@tT15 Only xx Mound Or At -Grade Systems Only 14 t To Air Intake Depth � De th Ovet r'' d/Sodded xx Mulched Bed /Trench Center f �t�ri Bed /Trench EJ es ��t? � Y p t-j See 9 Topsuil veseJ El No ❑Yes [] No COMMENTS: (include code ffiscrpancies, personsIII, I present, etc.) 1C,,7ION: Hudson.34.29.19W, Whyte O&l�/hDrivB -Ws �+ _IN It r111���_`are. W, IJ T 4. Plan revision required? ❑ Yes ❑ No Useotherside foradd itionaI information. SSU-6710 (R 05/91 ) Date Inspector's Signature �.a- . ul i fr L P,O �J C� 0 P ,. svr coR. SEC. 3 22 c 0 v 25 3f3 F 343.20 �ss.az' s w 111- s w ir4 4�20 AI7DENDUti P - Legal Description for Offer to Purchase dated January 31, 1994, signed by Vance A. Haesemeyer A parcel of land knotrn as Parcel 47.4 located in the Plori:hwest Quarter of the Northwest Quarter of Section 3, '.Pownship 28 North, Range 19 S9est, Town of Troy, and in tixe Souths•�est Quarter of the Southwest Quarter of Section 34 Township 29 North, Range 19 West, Town of Hudson, described as follows: Beginning at the Northwest corner of said Section 3; thence North 0 degrees 28 feet 30 inches East (true bearing) 451.52 feet along the West line of said Section 34; thence East 248.05 feet; thence South 36 degrees 10 feet East 584.03 feet; thence South 57 degrees 50 feet West 169.22 feet along the Northwesterly line of a Town road; thence Southerly 353.6 feet along a 268 foot radius concave Easterly, chord bearing South 20 degrees 3 feet 40 inches West 328.32 feet along the Westerly line of said Town road; thence West 343.20 feet; thence North 0 degrees 21 feet 30 inches East 418.48 feet along the West line of said Section 3 to the Point of Beginning. ROgO QUITCLAIM DEED TITLE OF DOCUMENT DOCUMENT NO. WHEN RECORDED MAIL TO: TSI-Recording Dept. 662 Woodward Avenue Detroit MI 48226 PARCEL ID NUMBER: 020110420000 This instrument was drafted by: Leila Hansen, Esq. 9041 South Pecos Road, Suite 3900 Henderson, Nevada 89074 REGISTER OF DEEDS T. CROIX CO., WI RECEIVED FOR RECORD 05/01/2015 8:00 AM EXEMPT # 16 REC FEE: 30.00 PAGES: 2 **The above recording information verifies that this document has been electronically recorded & returned to the submitter W'I J/ � l" � �,\ Recording Area Nancy K. Hoffman and August John Hoffman, wife and husband, as joint tenants with right of survivorship, Grantor, QUITCLAIMS TO Nancy K. Hoffman and August John Hoffman, as Trustees of the Hoffman Family Trust, dated March 4, 1996, Grantee, THE following described real estate in Saint Croix County, State of Wisconsin: PART OF NW 1/4 OF NW 1/4 SECTION 3, TOWNSHIP 28 NORTH, RANGE 19 WEST AND PART OF SW'/4 OF SW 1/4 OF SECTION 34, TOWNSHIP 29 NORTH, RANGE 19 WEST DESCRIBED AS FOLLOWS; LOT I CERTIFIED SURVEY MAP FILED DECEMBER % 1996 IN VOL. 11, PAGE 3192 AS DOCUMENT NO. 553104, ST. CROIX COUNTY, WISCONSIN. MORE commonly known as: 598 White Oak Drive, Hudson, Wisconsin 54016 EXEMPT from Transfer Tax under Sec. 77.25(16), Prior Recorded Doc, Ref.: Deed: Recorded Wis. Stat BK PG Doc. No. SUBJECT TO: Restrictions, Conditions, Covenants, Rights, Rights of Way, and Easements now of record, if any. TOGETHER with all appurtenant rights, title and interest. THIS IS (you must make a selection): Homestead Property NOT Homestead Property When the context requires, singular nouns and pronouns, include the plural. Dated this day of Nancy K. Hoffman � � STATE OF W! S L, o h S I tL ) 20J � ACKNOWLEDGMENT COUNTY OF S roL' 201 X ) ss This instrument was acknowledged before me on this �a day of /I_I , 20 j� , by Nancy K. Hoffman and August John Hoffman. NOTARY SEAL REBECCA K PLU�iER Notary Public State of Wisconsin Signature of Notar al Officer Title (and Rank) l l MY Commission Expires: �//6 /,16 1.0 St. Croix County 1011384 Page 1 of 2 1 EXHIBIT A -LEGAL DESCRIPTION Tax Id Number(s): 020110420000 Land Situated in the County of Saint Croix in the State of WI PART OF NW 1/4 OF NW 1/4 SECTION 3, TOWNSHIP 28 NORTH, RANGE 19 WEST AND PART OF SW 1/4 OF SW 1/4 OF SECTION 34, TOWNSHIP 29 NORTH, RANGE 19 WEST DESCRIBED AS FOLLOWS; LOT 1 CERTIFIED SURVEY MAP FILED DECEMBER 9,1996IN VOL.11, PAGE 3192 AS DOCUMENT N0.553104, T. CROIX COUNTY, WISCONSIN. Commonly known as: 598 White Oak Drive ,Hudson, WI 54016 St. Croix County 1011384 Page 2 of 2 Kevin Grabau From: Sent: To: Subject: Attachments: Follow Up Flag: Flag Status: Bettendorf Excavating - Mike Rodewald <Bettendorf@dishup.us> Monday, April 6, 2020 12:36 PM Kevin Grabau Hoffman Permit Hoffman Replacement Submittal.pdf; WD 1011384.pdf Follow up Flagged Kevin, Attached is a permit application for a replacement drain field for Hoffman's. We are going to keep the original 2 trenches and add 3 runs of ezflow's up the slope & weaving around the trees. I'm going to shorten the forcemain and install a d-box to give the ability to shutoff individual trenches. Pressure filter is going to go in the pump tank. Julie has processed payment on my credit card. Receipt # XD8A Michael Rodewald Project Supervisor/Estimator Bettendorf Transfer & Excavating 285 County Road SS River Falls WI 54022 715-425-6200 715-821-6229 (cell) i ti 55303"4 LOCATED IN THE NW 1�4 OF SW I/4�pOF THE SW I/4 OF � o 'T N 900 00' OO" E oLO M �o�N N o N y M Z 0 U Ld w ♦� N o 4 w x z; w U, _z J W ! /4 COR. SEC. 34 !6LED DEC 0 9 1996 lisp KATHL[EN H, IvALSH Rc• :>iur et Deads St. Croix Co., Wl CERTIFIED SURVEY MAP THE NW I/4 OF SECTION 3, T28% R19W, TOWN OF TROY AND SECTION 34, T29N, R 19W, TOWN OF HUDSON, ST. CRO I X CO. Win 48005, _ 5. 69_ ACRES (24T 849 SO. FT. ) HousE 0 VENTS PREPARED FOR: VANCE HAESEMEYER I N THE •�A NOTE; BEARINGS ARE REFERENCED TO THE WEST ?q� LINE OF THE SW I /4 OF SECTION 34. J(�Q ASSUNED BEARING v5A pp ���`,� 00. G� ; 's DRIVE SOUTH LINE OF THE SW I/4 OF SECTION 34 epee NORTH LINE OF THE N I/4 OF SECTION 3.•^ — ebb bmr re7r-nsive Piannit Parks Committee of not reca:decE .vv.isl 30 days of a roval date appra ai Shall be nvlt ••nits �—NORTHWEST GORNER SECTION 3 ' �•_.•'' 2� �- ( COUNTY MONUMENT FOUND) --' - ---- _ \69(� \�i•• v S HIGHWAY SETBACK LINE O c 5O 00 /O P`` � Z . r4. ✓g �s �F 6 / `� 406. �3 j / / 1 / m000be ev au*Rp.LrAmTTI;R..L.ANDA LOT z /'wee be / O - SET 1 " X 24" IRON PIPE M 2. 50 ACRES WEIGHING 1. 13LBS PER LINEAR ( 108, 930 SO. FT. ) / / FOOT. • &1" IRON PIPE FOUND. N x COUNTY SURVEY MONUWNT. go 33' t1«�tM to I� G O'ye. 3J��a ^/Sey a no ebeg JAMES� IMe i7 w © WEBER'; MM N 90000' 00"W 343.20' \ \ S-'it�ra we SPRI�1G VALLE'f gcv I /— W ! /4 COR. SEC. 3. s Wis. t a. N / ` z UNPLATTED„LANDSnote 100 O 100 200 300 GRAPHIC SCALE — FEET SHEET I OF 2 95-165 THIS I NSTRUh�ENT DRAFTED BY PAUL VOGEL VOL. 11 PAGE 3192 ��'•*3ctcdW.3�rc'; DAMES Mot WEBER S-1804 �~ NELSEN-WEBER LAND SURVEYING DATED TH I S Lele"' DAY OF Ste', 1996 REVISED I ?°'-r't\+ z.. +At 5; Ph cec�2 `f t z F + 3 WisconsinDepartment ofIndustry, SOIL AND SITE EVALUATION REPORT tabar and Human Relations oMelon of safety a BuOdings in accord with ILHR 83,05, Wis. Adm. Code Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plait must include, but 5T GffDi•X not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. K dimensioned, north arrow, and location and distance to nearest road. r7l //O ?O� 0 APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION REVIEWS Y ATE PROPERTYONNER: 130yeR: PROPERTY LOCATION IG I*/AAWJE i/A*= 4F.GfF_Vi=R GOVT. LOT SW 1/45k) 114,S3yTZy N,R lq EI a r� t. Syot 3�G-3y7? I Hvas [vj�New Construction Use (Residential / Number of bedrooms 3' (j Additiondo existing building () Replacement [) Public or commercial describe We derived daily flow �% 0 gpd Recommended design loading rate f bed, gpdO, trench, gpd/0 Absorption area required /� bed, tt2 S4 trends, h2 Maximum design loading rate gybed, gOM2 • rQ trench, gp W Recommended Infiltration surface elevations) ft (as referred to site plan benchmark) Additional design / site considerations &S4 04(aC5 o Mow 4 a A' ,l?i STiPi;sv Tzd a �rgg y,�! nt material SGS (�(e {� t a t r~ D _ S Flood plain elevation, it applicable N• ft pD, Ground elev. ft. Depth to limiting IaC�, Boring # Ground etev. /Olr� ft Depth to limiting CONVFNYIONAL MOUND IN-GROIX�IOPRESSURE AT•GRAOES.Y,,S�b1 Mt FILL HOI.DI SystBm +_Gd�S C7 U Ga'S C] U �'S` ❑ U �'3' ❑ U I�5 [J U. ❑ S SOIL"DESCRIPTION REPORT - Horizon Depth in. Dominant Color Munsell Mottles Qu.Sz.Cont Color Texture Structure Gr, Sz. Sh. Conaktarm Bardry Roots I GPD/ft Bed tends /o yle 3/2-- AT �.4"IF T46 07 OL. -y /aY� ) �-�.=�--- , /s �,,w, • R Mr vie • s Z-.w, . ? • �' Remarks: This tr9st efts A�PP`AOYF.D far fR ctinvelntional se�dc systt�m. d�IGINAL PROPERTYOWNER V• HAe5t=KeYt!S SOIL DESCRIPTION REPORT PARCEL I.D.1 Depth Dominant Color Moms Structure Consistsn Boring # Horizon in M/u�nsell Qu, Sz, Cont Cola Texture Gr. Sz. Sh. /O R Z $ �� Ground elev. ---- s , d+► _ S 4 d /07. /o n. (, 75 ,e y Depth to limiting factor q� 69 , G 7 Boring # Ground elev. Depth to limiting factor „ 74%Q_ Page �" of 3 Roots GPD/its Bed rrtn& rtemarKs: 2 - , S s ZF.7� r r 3S /o • 7 •� s Remarks:. 2 + Boring # Ground C . elev. J/O • b tt. Depth to limiting facto „ Remarks; Boring # VP In - Ground elev. ft Depth to limiting factor can onqAto Dy 2 + Boring # Ground C . elev. J/O • b tt. Depth to limiting facto „ Remarks; Boring # VP In - Ground elev. ft Depth to limiting factor can onqAto Dy f H a f N4 0 0 s S vgg E STeV S y ST EAA 133 ioo TAcN c ot� I00. 0 pRo/�os�0 f�}IE51T� .. z5 n%•,i.yv� 10190 �S ,s Ilk Fouvv, A/ors f 1,',aE �R�P.i'Ev /dY • 57�,E�/ fe�vcr �pCT- - Cou.vTi S t�,Pa YoOQ 'S MOV vAfE4AI T-. raP of Mo.vati,��vT = ioo, p 1� 1 L pit-ietE/ 3� F C4,0 ~)