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HomeMy WebLinkAbout020-1166-20-000W O'U600 -000 St. Croix County Planning and Zoning R a9.1q.10ad IDo4Y. Jane II ILtlH4g50 SZ PN Me $ Bftxry IYfofmalwn PRe I^fI wmwma M116 o O eWsxc V' PertYR: ID18 W, >o. l U�Im3 IWRHG T�N RIM WµmIM1. WMry iwm rI RE 1 4M 1l. _ — -- —. - M�I�,G,m�,..onlNx.a q-�r,,.. M,,d � wmar1888MRrnr,s DIMw..l O,-are.W,n.a m9 ,J pamit cwmywm,c o1W.II.e wlGlw RGwn NIR.1 e.e-e iR e.e.em.. s MFund wwlsa. ,,,t xe xw. u BUR Nm4mw�G.a saw amo Gx Y" a Mw. rwerc.W. owlaaos WIMrs l alums canon / 1 I azaw , wit 1W u ADDRESS "T r z ST. CROIX COHNTY, WISCONSIN ST R Community Development /6 1101 Carmichael Road I Hudson WI54016 SOB LOT s/�Telephone 'Tt�SSIZE80 /�Q.$., 654250 RC4Q7 PLAN VIEW Distances and dimensions to meet requirements of ILH% ES SHOW EVERYTHING WITHIN 100 PEEP OF SYSTEM I 0 N..,. N n- * A i v( Si INDICATE NORTH ARROW ECNCHPli Describe the vertical reference point deed/ /o11'P' 7 $.W, eider Elevation of vertical reference point: /OO.ii Proposed elope at site: ate. e.Y Vhone 11538646E0 Government Center, 1101 Carmchoel Road, Hudson, WI500]b SEPTIC TANK: Manufacturer ",,; r If old pspacity: /O00/OOO a. ww�Z2Ga dORZONOSICI01xeWntvwl www Number of rings used: 2 Tank manhole cover elevation: hot.7s- 'jE'leve(j1p n of inlet: Bottom of tank elevation: S mplNscion. �omM4Pit Deelopment 'T101 Carmichael Roadd Hu� Ur ; Telepnggdd `sdgbt-06aDbkaa 715-245 4250 I.rOISHI .w e0 nearest property line: PconOPldegemq� $. — N:mbar of feet from well: Number of fee[ from building: (Include distances on plot plan). SOIL ABSORPTION SYSTM Bed:[noorAtinn/ Trench:�— Width: /6 Length: 3G Number of Linea: 3 Area Buil[:v F Fill depth to top of pipe: O Number of feet from nearest property line: Front, 0Side. o Bear, ©Pt .2 i Number of feet from well: /O 417 Number of feet from building: (Include distances on plot plan). T7.1 -- 9RI0 9 YIT SEEPAGE PIT Sloe: Liquid depth: Area Bufln Number of pits: Olameter: _ Bottom of seepage pit elevation: Nam either a drop boa O or distribution basso been us" on any of the above, moil abmorbtisn mytmml (check one). HOLDING TANK Hanufac Nceu Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Number of feet from well: Number of feet from building: Number of fast free nearest road: Pont. o Side. o Ma[: 0PL_ Alarm Manufacturer: Phone 715.3864680 Government Center, 1101 Carmichael Road, Hudson, W154016 .Dated: www coebork Plumber on job: DEP#m SNT°e rx°usvv, INSPECTION REPORT FOR LABOR & All RELATIONS PRIVATE SEWAGE SYSTEMS no Box n� NR,-$W}.S17,T29N—N19W H$ONVENTIONAL ❑ALTERNATIVE TOWN OF HUDSON ❑Hording Tank ❑rn Boeing Not ❑Mound LOT 103 PARKVIHW IV Sure MET It BUILDINGS BUREAU OF PLUMBING u `niu P. L0A`.p sem H°=,....1. SE., ^ j'i-&J 2:3C r'ScrOF . •102860 u 5432 EL Croix TANK OL 1N6l.^ AlBALTIC , mE6 L E —�L Pira0.`xU�v r, �ev t� a ::...."° os o OWITher ND ONS nEER❑�+Eg .Yor ar..o...,....... PAY .a..;a..., .JNGLaraiddly oy,,o... ONO o.Ea OND 'O.EEDNACENTIONAL sFFERENDEBETYPORN o e Or Acal on If ",I im be ridled har. Or the Cut I dry AACES' An Add Pro I `aL ma. Dignal'Eis UIIEI OF But Chl YM k untl plor peMmmEurar to dome Cht the fill Anal for PROVIDE A DIAGRAM OFSVSTEM And furrow% Intel meope and Ar c S make ar ONREVERSE SIDE. SHOW ELEVA- heyeal anew for Martin, %wrd TIONS MEASURED. OYES ONO �• rapmOY Audi Otl6dOYES ITIN "A 3 ON ONO . .o=., R. a mo ., %�RL .. ,,, ❑.EE ❑xo x OYES ONO PRESSURIZED DISTRIBUTION SYSTEM. SEETRENCH el DIMENSIONS EPA Aid. A ILIV A PC IA ELEVATION ONE DINISFTORM.rr ..,r ..a .. ,.. ,., ,...r,.. AACoNo•` _..o.Eo,. OOE' (I'IN SS,4a ❑YES ONG OYES ONO `REST �3V dire 3.5 I ga(a 30r smma V 15y in1a fee All Pe DILHRSEDErmw mrem zDRERq nargaNaRcrecor I SANITARY PERMIT APPLICATION DILN9 cost In accord with 1118305, Via Again Code Mgroeµrt/n?PEwnnq /Da -Anecn compiare plena lmtne warm copy only)for the spWm,o nPeper not 1099 NBn STATE FLAX 10, NUMBER 8% X 11 Inches In size -USES reverse er de for maruotions for COm IN taring Mia Bob!cell 0n I. APPMCANT INFORMATION- PLEASE PRINT ALL INFORMATION. pET1110X FOR VARIANCE El Es ®x0 MICCERTVO ER PROFERTYLOCAnON M Ry rAScrU%.S T29, N. R/'J Eo RlV gvxER'9MAILINO PODRE89 ¢ fiz LUT NUMBER BLOCKXUMEER E wa«.AC eQR i /03 IP E P T iE Cps HONE NUMBER NEAREST ROAD. IAK o L MARK O /S 2 I III Vul O N 11, ME OF BUILDING OR OBE SERVED: Number of Bedrooms If I or 2 Family OR ❑ Public fSpenty) IN PURPOSE OF APPUCAMR:(Chick only one in pl Crack Al 2, 3 114.if appuceblet 1 aP9Now bOReplacement c 11Replacementof JERenneAion of e[flepelroien system Syntam Septic Tank Only an Existing System Existing System 2 O A Sanitary Permit was previously issued Permits Date Issued 3 ❑ An Existing System has been Impacted and soil conditions meet minimum requirements • O The System is shared by more than one owner/budding Attach Common Ownership Agreement to County Copy W. TYPE OF BV M:(Chick only one In p1 and only am in a) 1. a JZ conventional bQAlternative c El Experimental 2 a []System- b. Q Holding c 0 Pit Privy d ❑Vault Privy e 0 Mound 1 D IOP In -Fill Took V. ABSORPTION SYSTEM INFORMATION: allows one) 1 a ®see 8Red b ❑sea a aTnmh c ❑3m eIn t 2 FERCOLATION RATE 3 AQORP I lcl AREA p ABSORPTION AREA 55YYokA EiRfATON B WATER SUPPLY. Ofinnesperinch) REQUIRED (Square Fach I PROPOSED (Equal Post) 1 C,/SS % Tp�3 T 4,Feet Ell Ought OPutra VI TANK INFORMATION a CItt In gallons In Ilona Tokl pal Manmequn:e Name Praleb site sUel Fiber- Plw¢ Exper New MBn ta Tat Oenone Tanks cret euuMe glass App 00 3✓ VIIPREBPDXBfefMTY STATEMENT Lmeunderelgmd, assume re,30hatffi lm Installation of the private sewage system an", on me BlMched plans ease MF�FRAmeer malc umbsr nmnnr. =2 3 Z".a, ne .L try VIII. BOIL tEBT INFON Gnnrea3cirtev MI Of I fir c Ap".:�i IM.✓ Tp 11A wi.�um _ IX. COUNTYIUEFARTMEXT UBEOMLY ®µproved Puwrmee El Owner6iym alPo ni Pormll eB '� G:e a:� pAgentSi UN IIT /ao,eod a -de ifoz'�tr,.✓ X. COMMENTS/REASONS MR DII�AA P�ROyAL M7" 2 ?/0.n Qy, nburs y�J 7Ad auuwwlmrmerry noml 19 W DISTRIBUTION Original One CWy To Buneu NPicro, Oxner. pi INFORMATION 3 INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION TO THE APPLICANT. I This sanitary permit is valid for We (2) years, 2 Your sanitary permit may be renewed before the Cape 911an date, and at the time of renewal any new criteria In the Wisconsin Administrative Corte will be applicable, 3 All revisions to this permit must be approved by the permit Issuing authonty A new permit may be needed J there is a change In your building plans, system location, estimated wastewater POW (number of bed- . etc ) depth of system, Or type of system, d Changes in ownership or plumber reolres a Sanitary Permit TranslerlPenewal Form (BBO(Sped to be regarded to the Count' prior to installation, 5 Private sewage systems must be properly maintained The septic rankle) should b0 pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 3 If you have questions concerning your private sewage 5"'em, contact your local Code administrator or the Stale of Wisconsin, Bureau of Plumbing, P 2WMI5 To be complete and accurate this sanitary permit application must include I Property owner a name and mailing address Provide the legal description where the system is to be installed, It Type of building or use served It public is checked. Inmate type of use h a 10 unit apartment. 30 seal restaurant etc) lips in number of bedromw It but is a one or two family dwelling) III Purpme of application Check only one In ql Complete g21f permit is for tank replacement, reconnecOm or redi IV Tye of system Cb%k all appropriate boxes depending an system type Check experimental Only it project is in mnlurctlon with University of W aeco V Absorption system Information Provide all information extended in p16, VI Tank information FIII in the capacity of every new and/or existing tank, Irsl the total gallons to be matalln, umber of tanks and manufacturers name Indicate prefab or site constructed and lank material Complete for all septic. Ulf imphon chamber and holding tanks for this system Check experimental approval only if tanks received experimental product approval from Dil VII ReecamnbIlty statement. Installing plumber is to fill in name, license number with appropriate prefix (a g. MP, etc ), address and phone number Plumber must sign application form FIII In designer name If applicable. Vu1 Sol] test information Certified soil lestdra name, codification number. address and phone number IS Counryloepadmant use Only. % Comment area for use by counts or Carbon given when application is disapproved Complete plans and speclflcabons not smaller than 3% x 11 inches must be submitted by the county Thus Plans must include the following AI plot plan, drawn to awls or with complete dimensions, location of holding lank(sl, septic tanks) or other treatment tal building sewers, wells, water maina/Water earnCe, streams end lakes, dosing or pumping CNmbere, distribution boxes, if absorption systems, replacement system areas, and the location of the building served! , 8) horizontal and vertical elevation reference points, CI complete specifications for pumps and canlrols, dose volume, elevation differences, friction loss, pump perform ande curve, pump mortal and pump manufacturer. Of crass section of the sell absorption system it required by the county, EI wall test data on a 115 form GROONOYMTEB SURCHARGE On May 0, fail 1983. Wisconsin Act 410 was signed into law This legmlatmn is more commonly known as the groundwater promotion law. This change in statutes was the result of over 2 years of steady negotiation and pubic debate The groundwater bill Gr0mytl �aa r Included the creation of surche gee (fees) for a number of regulated practices which WflicK'w" "J _ re Can affect groundwater The surcharge took effect on July 11931 All of the water that bur2d r sused in your building is returned to the groundwater through your set absorption ystem or the disposal site used by your holding tank pumper yt r The manma collected through mesa surcharges are credited to the groundwater mod admmis tared by the oe earMent of Natural Resources These funds are used ter monitoring ground- water, groundwater contamination investigations and establishment of arendarm Gmunawater, II'a worth protecting sexual (A dwilt ST C R /,gPf.if/.SION MR SMIL% nity Development s'�=k a T C - 100 1101 Carmichael Road I Hudson SSA 54016 �r TY Telephone 715 386-46801 Fax 715-245-4250 Is .pollee 1 i be camviet ed 1n full and efgnld by the ounsr(d�W.WS)lWi,gov opertT b - dequacies will only result in delays 0[ the people isuance. hind this development be intended for resale by conedmntracter, ("epee e^), than a second fore should be retained and camplated when the Propatty IS Id and subalttad to this office with the apptopOLate dud recording. -- --- --- - - - -- -- met of Ptcparty--C- e» All r matldn of Pro/party A/E 4 Su/ k, Section _/ 7 T24N-R��i7 pmship oh . ailing Address 4e-o" B x 99' F rn" '440Lis.> SiY-ncYa/L loran. of Site o6/ky'i -arol Cc A - r Actual c/i4do/ron UY .ro'O/G ubdlvfelmn Rss ja/,E at access ravines /03 ravines Omer of wroperty. %%ere / /✓W% Deal Sees of festal /-06 7 lY a r s ate Paetal was created .re all comers and lot Moss identifiable? �_ Tee No a this proporty being developed for resale (epic Musa) T Too No '.Lase S and Page Number 1 2- recorded with the Register of Duds. INCLUDE WITH "IS APPLICATION THE FOLLOWING: warrants Dead which Includes a forecast number, voluse and pare number, and the Sul of the Register of feeds. to addition, a certified survey, if available, would be nlpful as as to avoid delays of the reviewing process. If the deed description mfso- incu to s Certified Survey Nu, the Certified Survey Nap shall also be required. PROPERTY OIUNER CERTIFICATION IWeI ctntt y th C fl�N lhdk' &004/PNWIM" inau(edgel �at 1 Ti�Q (�'I ' iE Man'v%i f�� 05 {he pn pw.ty deecubed in this ,n d0nmatton down, by t ue ad m W"' A �.t de d Aa � d dd at 04tce ad the m[ Rtedatsa ads" Oocume i Ntl pgv4! wn t%ie paapraed area d n the emwge duipo6 aua Ion T fowl have obtained awl go .m we„t. to w u the.above der btd p OpaAeq. and the enmumrfin" It ea:d ICY" ti 116080l. T Coax C.OUll WSCON h4 _- _. ._... ST C Community Development . 1101 Carmichael Road I Hodson W154O16 Telephone 715-386-46801 Fax 715-245-4250 IRl0J6eff I wwwsccwi.gov e my nor,rn -14 1 u i ... ":...... ... .....1.1 , My .w wa...;IN.�.."P�_ tea,, Hearn hu,•�•//v.wyyu��,99.00 II�P��.•,wvnr •roe�6� W ra��anh. VINT ryuu :CISIVINITATE Or Saba CLERK -'STATE OF xanxautry ?, � +for ^t;::'d Y ,� �.. P.' .. nu, lul �iI lq. 1 ,ti.•am mWt.faL~ r �n I Food, Hudson, WI 54016 "WFOCIVJAME9 E. RUSCH 'f°V SURVEYI MwFi&eb� cddmsaw co HUDSON. WISCONSIN ST. C (K,X C IT( ItTIAM Community Development Telephone 1101 Carmichael Road Hudson W154016 '715-386-4680 Fax 715-245-4250 www sccwi gov fmvnua cnisrs+Ti i K.Aw 'Y sm YnYr...1rr«U. MATIA.p....4AI&M 1.. T494,. ixxrm. x U.CI SOTAA , ' ux. om X. msAI -I AL, A mC�mY.a wm Y / wWe UNn [li 1T.... ufYMPu 6..AA. wumyrr�.w�Ufub ul&rm.ALIA IWI+u in STAi ISTYY Yi lrjiU I.Ilu+suW�+.ylu+WwUf�W"T+ �'#jYA�. wW w++�WrAAA .9 = I.,T CA; n+..r f�.1.TVu rlf-1 .uh �r. x1rOW11N.114 vi wive WxeUAY�um� WWW'f la.""ur. q Wkf M.WI Y. NY W.W[um. Jai u.alry ur. WYV.^IF MATS MITIMPIP KITYPIPAPUIMPSAMPOPW h u wuilft xT1��i�T lu.met*AAAxwY IIL 1u.u� 154 "',10 SAAAA LT f.is„.u.n A,, _ TY �, ^T M.WlTumir i%TU�1�iJi r riiKIM I".N; Owme,Vol 1"0 '1Yr..FW..+l"1 U.1.'u IT, i1T.W •Im'�W�YifU.ATITi�x.e I70i 16R lf. I IYlVAn w.. w iIY:»;Nu� x u. �m Ti 4,11 � WmxMuTifi N..6' T If" .14 W1 Yn. MU+%.t P�;A mPAT uwl a 1 u..vp..rni.. u Al WA u..1.. u.u. u Ow WAI w�rAtTw r sYb.W Ii W..W u lly TATO .. uu lU MA.n Y WI..0 TU 5L uu. w.t.!WI.I o.. o.u�mTw Yq ii Nw.u. il+uY p u.sM o,ww. IT* "ITTl9.+0, ' �-� Awd n pAMk I..ml. 1401 rOAK + cwxT+;xIX�uiy TvlcxnIla T. olllJWA �"i" xw... T.uu1...w wq 2.,....... •. .c ..CA".T .Ix. o. o........ w ArAn ...:: sexnw wuluT.sa nuw.vT1—ox�'� w,...PA, :m+cA.'.,.�'n°^.:... IT n..l. C.A. c....r c..n.ww.. e..n.. Phone )15 38646W Government Center, 1101 Carmichael RffiO�1� �016 WAVIV sii coy wTvvv ta[ebookormhtcouxem ; oov a�,Fdd@sciT S T C- 105 SEPTIC TANK MAINTENANCE AGREEMENT St_ Croix County OWNER/ BUYER$2/JJ ALllp/ ROUTE/BOX NUMBEROF xI AO/�ZiZ Fire Number_ CITY/STATE lo/4///6,n !yZ Zf%f-e/O/G PROPERTY LOCATION:�i k. 50V/ k. Section/7 T_m �N, Ad_aJ Town of #&ZdJ N !!�� . St. Croix County, Subdiviaio 4aeAidx!L"19 Lot number AQ 3 . Improper use and maintenance of your septic system could result In Its premature failure to handle wastes. Proper maintenancecan- state of puaping out the septic tank every three years d sooner. if needed. by a licensed peptic tank pumper. What you putinto the system can affect the fenced n 0f the septic rank as a treat- ment stage inthe waste disposal system. S[ Croix County residents may be eligible to receive a grant for maxima of 60% of the cost of replacementoffailing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program In August of 1980. with the requirement that 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 plumbs journeyman plumberrestricted plumber or a licensed pumpsveri- fying that (1) the on-af[e wastewater disposal system is In proper operating condition and (1) afterinspection and pumping (If nec- essary). the septic tank Is less than 1/3 full of sludge and scum. Ceftlflcstlon form will be sent approximately IO days prior to three year expiration. I/YE, the uniersigned, have read the above requirements and agree to maintain the private sewage disposal systemIn accordance with s the standards a forth.herein, as set by the Wisconsin Depart- ment of NaturalResources. Certification form must be completed and returned to the St. Croix County Zoning Offkpe within 30 days of the three year expiration date. ��9n SIGNED F%rl i71J , P�EQaL� St. Croix County Zoning Office P.O. Box 98 Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address ,►.rr J..� vc ]:t Ja•l 11Ty 16, ■fit. All E ■� yi, r_., �rmsr.Esnsmro al i `�FALL t TESTS �JJrf.aauba ,'��i1..1i1—ra'Pv.,ralurvarr�ua esre���WLLs1J919�i ��0®I . rl l...nm.PLOT PLAN PON rr,.n of y" """iltcy O,Ny"by" Oil lly. nra. CO r.. ole;'aM Po,.ilibl, ,..myl r.rrrn.,r_,..,.IIarm, Obbis ON, , ArFFAANOO° :: Om NO Por_, SYSTEM ELEVATION 9 7 / �a \ yyy ; i r a 3 �14 r, � { --�- - -e. ° a ¢¢¢-1 e ° I i�- — — —_ R P 'IIIIIT(, m VM1one ]]53H60640ment Carmic a¢Nca.r7 u enfer�id I�M UNrrYwtl,Nnp. will, NO M nil rrW nPo"N en ON brm rnnn Ov OF In rmJ rMwandun.M. FF., mrtluy M rM wital .Iw.rnr' ,SFAN°bW mulm°°^•^^^.r'estWrPotM�aremntea armwm. .Iw.PoPoll.r. reem:aw go Smm m"ll r ?.k V;�w;vf�Tia Ir IOTx IP3 syaAm tw.= d 8.M. lat V..i. Notlz Rdf, Pn: T at tM�S_W. o ser.q ca r kb ) o Tar<z (T .T 6o1fcm Elv. =9zl'1 5�a/� V✓'= io' Ms93z 97. 1 16T r.rr<.r tep e4 a I" la P;Ps Q�V rnT W4'•{<- .•;io c. r 5p, M M'. I to r - i—a-r xt/P3 Al f'— 5?72 I WA ge CMA�Y x c- l05166PiIC TAXR MAINTENANCEACRBBMBNTG St. Croix county coif � \ ORRER/BOYB0. /LL/AM /`i C_-0L/ /ER p ROOTRIBOX NUMBER_9AIFX D Fire Number qd CITY/STATE NUD SOA/ All ZIP S4A/1 PROPERTY LOCATIOX2 kf� h& 5OQ Section J? T �� N, R?nl Town of ate. St. Croix County. p• Subdlvls1ioam ,LO,.. Lot number 11.>>. I•proper use and maintenance or your septic systemouts result In its premature failure to handle waste@. Propermaintenance con- sists Of Pumping out the septic tank • ery three years or if no dad. by a licensed septic pumoes_ What you patIntothe gotta c OTct thtreat- function of the septic tank as a cat - neare meat stage inthewaste disposal system. St. Croix County ruldents may be eligible to receive a grant far maximum of 60Z of the cost of replacement of a falling system, which wasIn operation prior to July 1, 1928. St. Croix County eeptad this program In August of 1980. with the requirement that owmer$ of all systems agree to keep their systems Properly maintained The property owner agrees to submit to St. Croft County Zoning e certification farm, signed by the ownerand by e tr plumber, Journeyman plumber, restricted Plumberor a licensedpumper veri- fying that (1) the on -pits w stewater disposal system Is in proper after operating condition and (2) inspection and pumping (it n - ary), the septic tank is less than 1/3 full Of sludge and um. certification form will be sent approximately 30 days prior to three year expiration. I/W8, the undersigned,a have reed the abase requirements and agree to maintain ivt Private aerei disposal system In orlon with eFe s s iM standards eat forth, herein, a set by the Nlstonsln Depart- v nt of Natural Resources, certification f tbe completed aad returned t the et. Croix county zonin (e is •w tt hi 3o s Sys Of the three Far expiration date. NIGER DATE_ 4 0 St. Croix county Zoning Office P.O. Box 98• XAsmond, NI 56015 715-796-2239 or 715-625-8363