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002-1032-95-000
ti z C ° v C0 o O va O 6% ° ° o 5 O C O ° O N U E j aU N X C to E O OL p Z U c (D w o •- .2 E a a c p w Lv�o U O w U a . rn ti rn� CL (L) c �CF Z v >c�F= O @ 'O o c Z o� z •� o a 7 c E `> m p n p LL c p > It LL c N O C m 0) c0 �mq r�j co Q ON L) C M p M cL U O (n .., O .,, O V T LO T OL Z a m u, H z tZ m o z a U to H r U ll E E tY � M Q N 2 Z Z U Z Z U N o c N c d cv E Nat o ai — m @ — io — N ._ d N ._ N Q) L D N L *� > a a M o o L \j ° 'ooa` -0 N �oo p a` -0 6 E E c N N N � — � 2 i H H N N w o 0 0 = o 0 0 r.a v> a a a m a m Fhi — r p LL t) O O (n N Z Z N r cD 0) C 0) 0) O C O C cn N N m to O rn O v; Z Waft V N o O Q O C N N C �N Op m C fU c c (6 N O r la7 ~r„ co O O Q) N O ' V N d Q 0! O N E E L N H E E N N W o C Q) L L C O O v) Z} N r. o E N I — H E m w Q) tl> co • ^V •+ -. c) c- M 11 O Nr M M to M O � x Z Ji E d cu m a Q) a CL a 1ru w v c °' c °' c L "' 1 U a o h U o Cl) c) I Parcel #: 002 - 1032 -95 -000 12/28/2009 10:57 AM • PAGE 1 OF 1 Alt. Parcel #: 15.29.16.228B 002 - TOWN OF BALDWIN Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - SIMMONS, CHARLES J & CATHIE A CHARLES J & CATHIE A SIMMONS 944 250TH ST WOODVILLE WI 54028 Districts: SC = School SP = Special Property Address(es): ` = Primary Type Dist # Description ` 944 250TH ST SC 0231 BALDWIN- WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 24.000 Plat: N/A -NOT AVAILABLE SEC 15 T29N R16W THAT PT OF NE SE LYING Block/Condo Bldg: SLY OF A LN BEG 2138.5 FT N OF SE COR SEC 15 TH W90 DEG S 1320 FT TO W LN AND Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) THERE ENDING, TOWN BALDWIN 15- 29N -16W Notes: Parcel History: Date Doc # Vol /Page Type 12/20/1990 465078 889/154 QC 05/14/1985 401947 712/166 WD 2009 SUMMARY Bill #: Fair Market Value: Assessed with: 35356 Use Value Assessment Valuations: Last Changed: 04/11/2008 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 14.000 2,700 0 2,700 NO AGRICULTURAL FOREST G5M 7.000 11,900 0 11,900 NO OTHER G7 3.000 12,000 200,100 212,100 NO Totals for 2009: General Property 24.000 26,600 200,100 226,700 Woodland 0.000 0 0 Totals for 2008: General Property 24.000 26,600 200,100 226,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch M 510 Specials: User Special Code Category Amount 010- GARBAGE SPECIAL ASSESSMENT 60.00 es Special Assessments Special Charges Delinquent Char p p 9 q g Total 60.00 0.00 0.00 CO MMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715 - 962 -3121 800 - 962 - 5227 I i _, j ST. CROIX ZONING REPORT NO., 3��13l01 PAGE 1 ST, CROIX COUNTY REPORT DATE: 10/20/69 COURTHOUSE DATE RECEIVER; 10!18 /39 HUDSON, WI 54016 ATTNS THOMAS C. NELSON Zz S OWNER / OWNER: FHA ��c ( -`0 .fir. n -� �.` LOCATION; Box 123, Town of Baldwin f USA COLLECTOR: St. Croix Z o n i n g G1 C// / j ,��? 7`= SOURCE OF SAMPLE! Outside faucet '7 COLIFORM4 0 /100 mt INTERPRETATION! Bacteriologically SAS=E i 9 Y NITRATE -No { 1 ppm Under 10 ppm is safe for human consumption. COLIFORM + NITRATE I r I i i L_ f Al i �I LAB TECHNICIAN: Pam Gane WI Approved Lab No. 19 DF A DEPEpO O A V 1 d h t deans "LESS THAN" Detectable Level Approved by. ® PROFESSIONAL LABORATORY SERVICES SINCE 1952 I f,►� RECE co y� Q S S E P 2 5 1989 .. I �,u ST. CROIX COUNTY ZONING OFFICE J C � ; 1 A 'f � St. Croix County Courthouse V TV 911 4th Street; f �, Hudson, WI 54015 Telephone - (715)386- 4680 The St. Croix Count Zoning Office offers the service of septic County g and water inspections to Lending Institutions, Realty Firms, and private individuals. Completion of this form is essential so that the RroRertv can be located Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning Office, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received. / WATER TESTING---- - - - - -- $ y ----------- - - - - -- -FEE: 25.00 (For nitrates and coliform bacteria) WATER TESTING FEE: $175.00 (For VOC'S) SEPTIC SYSTEM INSPECTION---------- - - - - -- - FEE: $25.00 (Determines if system is properly functioning at time of inspection) Property owner's name Property owner's address Q VJ, Legal De ri tion 1/4 of the 1/4 of Section _ , T N -RI Town // of <A l T I "I Lot Number Subdivision Name FIRE NUMBER ER Color of house lyh;t -P_ Realty sign by house ? _ j lk_ If so, list firm: PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual roqgestiT se vices : w r i�' - /Mara yr7 c Telephone Number REPORT TO BE SENT TO: Closing date h Signature * COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 ---� Colfax, Wisconsin 54730 715 - 962 -3121 800 - 962 - 8378 (WI) 800 - 962 - 5227 f ST. CROIX ZONING REPORT NO.. 32192/01 PAGE 1 ST. CROIX COUNTY REPORT DATE+ 8/07/89 COURTHOUSE �---- I 8/04/89 Cclk HUDSON, WI 54016 ATTN2 THOMAS C. NELSON " a OWNER: Chris 6 Diane Johnson LOCATION: 222195% St., New Richmond, WI COLLECTOR! St. Croix Co. Courthouse SOURCE OF SAMPLE#* COLIFORMI# 0 /100 ml INTERPRETATION: Bacteriologically SAFE NITRATE -N; 4 ppm Under 10 ppm is safe for human consumption. COLIFORit + NITRATE 8 9 CO� ':1 AUC 8 x'989 K ST eRC7;A �IiP�T � y LAB TECHNICIAN: Pam Gane WI Approved Lab No. 19 yO F• \NDEPENDE� S O D V D *� < Means "LESS THAN" Detectable Level Approved by; ® PROFESSIONAL LABORATORY SERVICES SINCE 1952 I ST. CROIX COUNTY WISCONSIN ZONING OFFICE y �r. r ST. CROIX COUNTY COURTHOUSE �JP..:vv e. 911 FOURTH STREET • HUDSON WI 54016 (715) 386 -4680 August 3, 1989 Chris and Diane Johnson 2227 95th Street New Richmond, Wi 54017 Dear Mr. and Mrs. Johnson: An inspection of the septic system on the Johnson property located in the Town of Star Prairie was conducted. At the time of the inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any warrant or guarantee the r°r nt it nul d i rsn _'�- m= eke c - csm T_$ _ - f!"` L --, r' -r R +V - t at 4-1'.r �'.°•Td J +. 1?�a_la� �P vaxtmrsr -�� nrir^^n aspprep l-ff-ir�ct es ©arc �'LT�crct� �?-i±c - i Ohould you have any questions regarding this ;subject, please fee`s free to contact this office. Sincerely, Thomas C. Nelson Zoning Administrator TCN:sa r r G a V f ST. CROIX COUNTY ZONING OFFICE St. Croix County Courthouse 911 4th Street y � ( U Hudson, WI 54016 Telephone - (715)386 -4680 The St. Croix County Zoning Office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals. CQ=le ion of this form is essential so that the property can be__ located. Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning office, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received. WATER TESTING______ _____________ __ - - - - -- -FEE: $ 25.00 S� (For nitrates and coliform bacteria) FEE• $175.00 WATER TESTING • (For VOC'S) SEPTIC SYSTEM INSPECTION - --- -- ---------"-FEE: $25.00 �S (Determines if system is properly functioning at time of inspection) Property owner's name (" h b)o"ll e- As h n k m Property owner's address S "f Legal Description /JL 1/4 of the _C W 1/4 of Section -- ,3 i -� T N -R Town of of Number Subdivision Nam -jpLi) _'t kE' SktAAVL611-�� Box NUMB A FIRE NUMBER-- ER Color of house Loov� t Ll IAJ salty sign by house? L/ If so, list firm: PLEASE INCLUDE, IF AT ALL POSSXbLE, A MAP,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual requesting services : H r' fn')/ k 7I (-h a e a Telephone Number REPORT TO BE SENT TO: Bc, e Closing date C Signature U t r i ST. CROIX COUNTY ZONING OFFICE St. Croix County Courthouse 1 911 4th Street Hudson, WI 54016, Telephone - (715)386 -4680 The St. Croix County Zoning Office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals. romrletion of this form is essential so that the property can be locat Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning Office, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received. WATER TESTING----- -- - - -- $ ---------- - - - - -- -FEE. 25.00 (For nitrates and coliform bacteria) WATER TESTING FEE: $175.00 �/ \ (For VOC'S) �s SEPTIC SYSTEM INSPECTION--------- -- -- -- -- FEE: $25.00 (Determines if system is properly functioning at time of inspection) Property owner's nam Property owner's address /`� S "r — Legal Description /JLK) of the GU 1/4 of Section - •3 I_IcY T N - Town of dv.e.i,k; P_ Ch W g0gL Number Subdivision Name m2j i, "(j , a kp FIRE NUMB= X BOX NUMB A Color of housei.Woc+ 7 ealty sign by house? L,--� so, list firm: He Y- -f Il kV ndi 12 ea /-4"v PLEASE INCLUDE, IF AT ALL POSS LE, A MAP,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING:. Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. I Firm or individual requesting services: H e )/ n ('_,l i2- Telephone Number - 4 REPORT TO BE SENT TO: c, r Closing date Signature i - - o U) o n Co p :. ' n O �i c 3 f c O '9 O I M n j O c cn3 z ;o z owCo y3 c___��, Z o > ao o n y O N d Vt O i s 7 �. 7 a G . S d 3 O w o d N N 1-.1 c CL m y m y o I° CL 3 �+ D �• cD o ^ •� ` 1 N C_ _ O 7 O O m Co w cn m I m C) 3 3 w a —1 " N "s CL cc o a 3 v v o N CD tj c " m cn r ` > > � cn ! g o 0 0 S m o o ° o 0 . C y N L C d Co cn zD ma$I � cncD eo F � CL 3 p c o o s l 3 O L C se I �. O O CD O cfl to co z CO CO 09 Cfi c co o I O o 0 2 y o c Q 3 0 0 0 8 z O O O CD CA Z m n N r- Ch w W I n a c (a �� m v CD m y w _ o N 3 w N m m c �. ' C, 3 y D D o =� D D o 0 d O m O 0 m a ? m a !�• CD rn c c I w m I w m Z CD Z CD ` A O m 0 z o 9 A a a`� m z $ r: g m rn w y m A CD O W O W N j CD �o F o Dn c 0 D a m CD s a o y m Q. o 2 o a nm.� v c u>> 3 v c 3jE; o • te a, �CCDO o a N v v o m 0g)CD �a M cc �� - � - ` D O O 2 00 CD n N 0 to�� co CD � o �O � o CD CD CD o y o 0 ti b (D m do ~ I o p o a CL `$, y b Wisconslh Department of Commerce PRIVATE SEWAGE SYSTEM Count Safety and Buildings Division INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 353196 Permit Holder's Name: y ❑ : Village ❑{Town o State Plan ID No.: Simmons ❑Cit Ch arles Town of Ba ldwin CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 002- 1032 -95 -000 TANK INFORMATION ELEVATION DATA /6r, Z 9 ' ZZ88 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St /Ht Outlet TANKTO P/L WELL BLDG. Airi to ntake ROAD Dt Inlet Air I Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand St cover Model Number GPM TDH Lift Friction System TDH Ft Forcemain Length Dia. Ff Dist. To well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSION SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manuadurer: SETBACK INFORMATION TypeO CHAMBER Model Number: System: OR UNIT DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air intake Length Dia. Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 944 250th Street, Woodville, WI (NEIA, SETA, Section 15 T29N -R16W) - 15.29.16.229B 1.) Alt BM Description= 2.) Bldg sewer length= o % V it a Qy, c. i ro — �nr - -amount of cover = t&,,*+ S +, C AA- - - X %JP O-t� // r • ° .ems I Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. I I ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: __J.M f , j ( i e f a ,.u� ®� i _ r Safety and Buildings Division Vi scons i n SANITARY PERMIT APPLICATION 201 W. Washington Avenue P o Box 7302 Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Permit Number 35 /wo Personal information you provide may be used for secondary purposes ❑ Check if revision to previous application (Privacy Law, s. 15.04 (1) (m)). State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION Prop rt Owne Name (' Propert Location g A. e 2;j .7 , l� r+t r'G y G� t /4 ?,, � 1/4, S 15 T.� , N, R /` -E(or) W Propertt; Owner' Mailin)Add Address q � Lot Number Block Number 77 a, 8 t . Cit , St t QO Zip Code Phone Number Subdivision Name or CSM Number ) -� 11. TYPE OF BUILDING: (check one) ❑ State Owned ❑ It ,} Nearest Road t, ZL Public 1 or 2 Family Dwelling - No. of bedrooms IS IS Tow o f D k 10�w r� S — U Ill BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment / Condo S vl • �- . - 2--28 0 2 ❑ Assembly Hall 6 ❑ Medical Facility! Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/ Factory 13 ❑ Other: specify IV TYPE OF PERMIT (Check only one box on line A. Check box on line B, if applicable) A) 1. Q New 2. ❑ Replacement 3. ❑ Replacement of 4_ 1p Reconnection of 5. ❑ Repair of an ------ System ________System Tank Only______________ Existing System ___- Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 N Mound 30 E] Specify Type 41 ❑ Holding Tank 12 E] Seepage Trench 22 In- Ground Pressure 42 ❑ Pit Privy 13 []Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Requ red (sq. ft.) Prop secl q. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation � ��G . C T ' Feet 1 Feet Cap act VII. TANK in llo s Total # of Prefab. Site Fiber- E INFORMATION g Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic xper. New Exist in structed App Tanks Tank Septic Tank or Holding Tank / :Z o o — I � w PS+C ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ✓ bUb %( ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility Or install on of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plum is Signatur : gL a mps) MP /MPRSW No.: Business Phone Number: Plumber' Address (t eet, Ci , t te, Zip Code): -/ 4!i �JG k. 0 Ae OG a l IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater Datelssued Issuin Agent Signature (No Stamps) pproved Q Owner Given Initial ; ' Surcharge Fee) Adverse Determination ��� 1 /0 z� X. CONDITIO PROVAL / REASONS FOR ISAPPROVAL: SBD- 6398 (R.11/97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS ' 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608 - 266 - 3151. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. 111. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. BOLDT's "W" PLUMBING & HEATING INC. "Serving You Over 45 Years" 820 Main Street Baldwin, W154002 (715) 684 - 3378 Fax (715) 684 - 3144 Date: 10/26/99 To Whom It May Concern; An on -site investigation of the septic system on the Chuck Simons property, located 944 250th Street Woodville, WI was conducted on 10/26/99 e o inspection the sanity system ap to be functioning ro rl At the tim f the pe sanitary y pp 9 P Pe Y for the existing use (See exception * below). The inspection of this sewage disposal system was based upon a surface inspection of said system and did not involve any excavating or chemical analysis. Accordingly, here is the possibility of hidden defects in the system not discoverable by this 9 Po Y Y inspection. Therefore, it is understood and agreed that there remains the possibility of hidden defects in the system which are not discoverable b a surface insp and this inspection does Y Y Pe not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every two to three years. Therefore, the Y P p prolonged life of this system is totally dependent upon proper maintenance of the system and can very depending on the number of people living in the residence, the age of children, work outside the home, and use of garbage disposal. Should you have any questions regarding this subject, please feel free to contact this office. Sincere) � Y, Dale E. Hudson Master Plumber J Certified Soil Tester #220853 * SPECIAL NOTATIONS se System consists of tic tank, which is at Y p normal water levels; a pump chamber, that is in proper functioning order; and a mound that is dry at all four observation pipes. 10/29/99 FRI 10:59 FAX 715 386 4686 ST CRX CO ZONING 10 001 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer q r �� S S i' m M t c m S Mailing Address 1 13mx' /,23 C 3a 161W P7 Property Address f- (Verification required from Planning Department for new construction) � ld � �'h �y.' �Z46 0619,103:),95 ` City /State 8 Parcel Identification Nu mber i LEGAL DESCRIPTION Property Location I�� /., S� ' /a, Sec. 5 , T — 7 N - R L L W, Town of �� PL P rtY Subdivision I Lot # Certified Survey Map # . Volume , Page # Warranty Deed # —6 . Volume ( . Page # S Spec house ❑ yes P� no Lot lines identifiable ❑ yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a rmastv.rplumber, joumeyman plumber, restricted plumber or a licensedpumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than U3 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 stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. ,� , SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of nay (our) knowledge. I (we) am (are) the owners) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed Position 5 form FmffA 1955 -19 UP (Rev. 10- 28-81) UNITED STATES DEPARTMENT OF AGRICULTURE FARMERS HOME ADMINISTRATION QU I TCLA I M CQEE[Do The UNITED STATES OF AMERICA, acting through the Administrator of the Farmers Home Administration, United States Department of Agriculture, CONVEYS and QUITCLAIMS to CHARLES J. SIMMONS AND CATHIE A. SIMMONS, HUSBAND AND WIFE, AS SURVIVORSHIP MARITAL PROPERTY, Grantee, for the sum of SEVENTY —ONE THOUSAND NINE HUNDRED THIRTY ONE AND NO /100 DOLLARS ($71,931.00) all interest in the following described real estate situated in the County of St. Croix, State of Wisconsin, to wit: The Northwest Quarter of the Southwest Quarter (NW1 /4 of SW1 /4) of Section 14 and the Southeast Quarter (SE1 /4) of Section 15 EXCEPT the South 733.3 feet of the West 594.0 feet of the Southwest Quarter of the Southeast Quarter and EXCEPT the North One —half of the Northwest Quarter of the Southeast Quarter (N1/2 of NW1 /4 of SE1 /4) and EXCEPT COMMENCING 2138.5 feet North of the Southeast corner of said Section 15; thence West 90 0 43' South 1320 feet more or less thence North to the North line of said Southeast Quarter (SE1 /4); thence East to the East line of said Southeast Quarter (SE1 /4); thence South on said East line of Point of Beginning all in Township 29N, Range 16W, St. Croix County, WI. SUBJECT TO easement given to NSP. i a This deed is executed and delivered pursuant to the provisions of the accepted offer dated August 24, 1989, and the authority set forth in 7 CFR 1900 Subpart A. THIS INSTRUMENT WAS DRAFTED BY THE UNITED STATES DEPARTMENT OF AGRICULTURE. No member of Congress shall be admitted to any share or part of this deed or to any benefit that may arise therefrom. Dated January 11, 1990. UNITED STATES OF AMERICA (GRANTOR) '/0 w By I - M4 4 ( d o RONAL W. CALDW L, St to bi rector Farmers Home Administration United States Department of Agriculture In the presence of: Francis E. Kuhls I Kathy Bleskey ff G1<MQt^ L— E: Q G M E: M - r STATE OF WISCONSIN > > SS COUNTY OF PORTAGE > I, Susan E. Kohnen, a Notary Public in and for said County and State, do hereby certify that on this 11th day of January 1990, before me appeared Ronald W. Caldwell, State Director, personally known to me to be the person and officer of the Farmers Home Administration, United States Department of Agriculture, described in and who executed the foregoing instrument, and being by me duly sworn, he /she acknowledged to me that as his /her free and voluntary act and deed, he /she executed said instrument for the uses and purposes therein set forth. Susan E. Kohnen, Notary Public My Commission Expires: April 7, 1991 NOV 16 '90 15:50 BALDWIN TELECOM P.2 Porm - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER / TOWNSHIP .! SEC, yap N R,� ', W +roger L, " ADDRESS : N c� ST. GROIX COUNTY, WISCONSIN � SUaDY WON LOT LOT SIZE'. ' / PLAN VIEW Distances and dimensions to meat requirsments of H 63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ix ,P ) y 4o� at .�G, me �+^r' m SO' �OsNo AM D , /Vow r C3 14 % Nb P INDICATE NORTH ARROW 8$NCIII$ARK: Describe the vertical reference point used ._ „•. Elevation of vertical reference point: /pp, ' o Proposed elope 'at site:' SEPTIC TANK: Manufacturer: � �; �s Capacity. /Z..00 ads, r Number of Brings used: ` Tank manhole cover elevation: r Tank Inset Elevation: — Tank Outlet Elevation: Number of feet from nearest' Road: Franc, Side Rear ' — ..�,.L�'4.,�. feet From nearest property line Fronr,Side {Rear, Number of feat From: well ,� p 0 building.. feet (Include this information of the above lot plan)( �+ p p �t 2 'reference dimenaions to septic tank) SEE RHYRRSE STAR DEPARTMENT OF INDUSTRY INSPECTION REPORT FOR SAFETY & BUILDING LABOR & HUMAN RELATIONS DIVISION P.O. BOX 7969 ON -SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION MADf9ON, WI 53707 State Plan I.D. Number: NEB, SE 4 , Sec. 15 . T29 -R16 ❑ CONVENTIONAL ❑ ALTERATIVE (If assigned) Town of Baldwin 25 ❑Holding Tank El in-Ground Pressure E mound O P IT HOLDER: ADDRESS OF PERMIT HOLDER: INSP ATE- FHmA P.O. Box 123. Baldwin, WI _ BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: RE P PT. E .: CST REF. PT, EL �_/ —;, 7� D ' 9 Name of Plumber: MP /MPRSW No.: County: Sanitary Permit Number: Dale Hudson 6629 St. Croix 128811 SEPTIC TANK /HOLDING TAN MANUFACTURER: LIQUID CAPACITY: TANK INLET E NK OU WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: YES E] NO ❑ YES O BEDDING: Vrik;oDIA.: afE#FFMATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENTT FRESH ALARM: FEET FROM �.— LINE: r t AIR INLET: E:1 YES NO ❑ YES NO NEAREST —► 72 'Q DOSING CHAMBER: r MANUFACTURER: I BEDDING: APA 1TY: PUMP MODEL: P/�}ION MANU A TURER: WARNING LABEL LOCKING COVER //�� PROVIDED: PROVDED: LA-)e e_ & E YES NO dJ �d7 [ ' ❑ NO C3YE6 ❑ NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY / WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN D ! FEET FROM LINE: / _ i AIR INLET: PUMP ON AND OFF L-f = YS ❑ NO NEAR —1 SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: MATERIAL AND MARKING: or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: BEDITRENCH WIDTH: LENGTH: NO. OF DISTR, PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID TRENCHES: MATERIAL: PIT DEPTH: DIMENSIONS GRAVEL DEPTH I 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 ---- 10 MOUND SYSTEM: Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and f;YES ows hrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER I TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; S YES ❑ NO O YES ❑ NO DEPTH OVER TRENCH /BED DEPTH OVER TRENCH /BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: q EDGES: 11 Q � -a /,; ❑ YES 114 o 1�TYES ❑ NO E5' ❑ NO PRESSURIZED DISTRIBUTION SYSTE /2, ).r. , ( c. r '', _ /Cd Sa' WIDTH: LENGTH: pp. o LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: BED /TRENCH / 7a r RENC / rl y 'r./- DIMENSIONS -1 , o f )J MANIFOLD PUMP G 4L MANIFOLD DISTR. PIPE I MANIFOLD MATERIAL: NO. DISTR. DSTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEV.: ELEV: ��nn DIA.: ELEV.: / `` nn (// PIPES: ELEVATION AND (� Y>� ( 3 r �v. �K 6 t U, C t DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATE IAL: VERTICAL LIFT CORRESPONDS TO INFORMATION r' ,I Q 0 i APPROVED PLANS q ES ❑ NO � - 7,5V EPeE9 NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: r / YES ❑ NO YES ❑ NO I NEAREST ► A0 7 Sketch System on Rain in county file for audit. Reverse Side. SIGNA RE: TITLE: r SBD-6710 (R. 06/88) J k =4 r -1 3ILHR ' SANITA RY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code couNTY FAMM STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than El rev i , us 8% X 11 inches in size. Chec i on previ application —See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER I. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. _5 - 0 1 1 1 3 PROPERTY OWNER � PROPERTY LOCATION MC '/a E Nt, S -5� T z ?, N, R j ®or W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # FO- 130 iZ_ CITY, STYE ) ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER� CITY NEAREST ROAD II. TYPE OF BUILDING: (Check one) ❑State Owned 1941 VILLAGE _2�l Ltd 1'y) Z El Public �O An 1 or 2 Fam. Dwelling - # of bedrooms L PARC AX NUMBS ( �y(— III. BUILDING USE: (If building type is public, check all that apply) j� I0 21 /43 `7; 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility /Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales /Repairs 11 ❑ Restaurant/Bar /Dining 4 ❑ Church /School 8 ❑ Mobile Home Park 12 ❑ Service Station /Car Wash 5 ❑ Hotel /Motel 9 ❑ Office /Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ❑ New 2.,0 Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit # — Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21.0 Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals /day /sq. ft.) (Min. /inch) ELEVATION 4r=�, 0� S'00 50 < 25' q 9160 Feet 101 -3 Feet VII. TANK CAPACITY Site in oallons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name C oncrete Con- Steel glass Plastic App Tanks Tanks structed Sep tic Tank or Holdin Tank L00 /2-0 1 Lift Pump Tank/Siphon Chamber O 000 / / VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) MP /MPRSW No.: Business Phone Number: 1Z)a le c - A4a_ V7 I / # z 4 7/� 68� 33 7g Plumber's s e ' ss (Street City State , Zip Code) IX. UNTYIDEPARTMENT USE ONLY Disapproved Sanitary Permit Fee (includes Groundwater a e Issued ssuing gent Signature (No S ps) Approved El owner Given Initial Surcharge Fee) Adverse Determination O X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: SBD -6398 (formerly Plb -67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety 1£ Buildings Division, Owner, Plumber INSTRUCTIONS t 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the Kermit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer /Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608 -266 -3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete ## of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1 -7. VII. Tank information. Fill in the capacity of every new and /or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or Site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County /Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8'A x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains /water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) alt.sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD -6398 (R.11/88) APPLICATION FOR SANITARY PERMIT S T C - 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 j -cf -5 Location of propert / y1/9 57 ;f ' 1/9, Section �� , T Z9 N -R �� W Township Mailing address O 23ox / j Address of site Subdivision name Lot number p Previous owner of property T� , C Q �/�i/ I ✓'fit y�'l0�'' Total size of parcel Date.parcel was created 9 Are all corners and lot lines identifiable? - -Yes No Is this property being developed for resale (spec house)? es No Volume and Page Number /o as recorded with the Register of Deeds. ------------------------------------------------------------------------------- INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER, and the SEAL OF THE REGISTER OF DEEDS. 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 Certified Survey Map shall also be required. ------------------------------------------------------------------------------- PROPERTY OWNER CERTIFICATION I(We) certify that all statements on this form are true to the best of my (our) knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the Office of the County Register of Deeds as Document No. -7 O / 9!} 7 ; and that I (We) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the same has been duly recorded in the Office the County Register of Deeds, as Document No. ). Signature of Owner Signature of Co -Owner (If Applicable) Z Date df Si nature Date of Signature u Mi r r qmwtw or the - southrw - (.90) of seo# Com s RP1` #iooW .3 feet" Or 'QNR;~ o tblt $alt* MltMtt` me acwt aw 6f 11cU"bowir Ommw m o of 2 4) I * PAO t oo: der of saiad. section 15; llsaric. Me`st §' !!!, to t e xim of laid sawgiert Quarts % #o a to QaWtor Owwwo sow on i as d �Y �. ier, ft. crosxco., rz. sysiscr TO eftnt 19. TRA t ! 1 y a 4f R. a - betti ACKMMUMPAR" a •iti. M mdds 9th dry of Ap it ,19 . AiApvp R. Traynor and Janis R. Traynor f to aw ka to be du pecaam who emem" to -.sMr � 1A18llOri •,w! .. - , 9, I. - �' ^ ,f C�o�tty;l�rtowaMt � . �. i tit�tlrrtOaAN by the United States Department of Agriedtum. = ...............r+�rw� ' SAM es bpi tM arw of tho Onstan. ib IND aftua m. ai AIM OD/f bdw dwk dpimbmliL, Yl ttj� NE l SOM 1NIS-40" ILI • z En H' 9 STC' 105 r r 9 H SEPTIC TANK MAINTENANCE AGREEMENT H St. Croix County z d a OWNER /BUYER q,/,9? ,r _57 ROUTE /BOX NUMBER Fire Number CITY/ STATE �'� �U /i?, ', ZIP Z, PROPERTY LOCATION: VE S�r 1 4, Section 1-5 , T N, R JZ W, Town of a 10140 j7 , St. Croix County, Subdivision /V Lot number /yA 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. 1 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 plumber, restricted plumber or a licensed pumper veri- 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 0 I /WE, the undersigned, have read the above requirements and agree N to maintain ,..the..private sewage disposal system in accordance with x the standards set forth, herein, as set by the Wisconsin Depart - v 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 C N E D DATE 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. i QEPARTMfNT OF RE PORT ON SOIL BORINGS AN D SAFETY & BUILDINGS INDUSTRY, _ ___ _ _ ___ DIVISION LABOR AND PERCOLATION TESTS (115 P.O. BOX 7969 HUMAN RELATIONS MADISON, WI 53707 (ILHR 83.090) & Chapter 145) LOCATION: SECTION: OWNS UNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME: �F �/ st V/ '\S /T �9 N/R J6 E (oI K�_owliv — COUNTY: WNEFr BUYER'S NAME: V S p A MAILING ADDRESS: P.O. 30x- LZ.3 ST•C�AIK PhR► MS \`}dale ?K�HWI3 w SV Oo Z USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DE RIPTIONS: PERCOLATION TESTS: II L J�Residence y N, A ❑ New Replace I I s _ z , go 1 S — Z 3— c 1 0 RATING: S= Site suitable for system U= Site unsuitable for system S l � $� � H Trhm PSI�w ON 5 - 2 - CONVENTIONAL: MOUND: IN- GROUND - PRESSURE: SYSTEM- IN- FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) D S �U ®S DU D S 1U D S NU 10 S DU I - \ALat G tu,�vw wh I ESGN RATE: If Percolation Tests are NOT required D If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: N ` f\ F loodp l ain, i n d icate Floodplain elevation: A PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER - INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- B Z �. O V B- 3 y o a S.6 S B -y 1 6 9S.Z t 8 B- I B_ PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL - INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL -MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH P_ \ \.Z N% 3b \�tlt6 5! S /16 4 48 P- Z tz we 30 Iiit 6 S/fa til 6 4 P- 3 Z 3D 9l66 S 3 P- P- 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 , 4 9. 8 , �( 63 FIR-e- MIN-3 Sl SYSTEM ELEVATION �1`�11y �.• 0l= s�sti sv�87tz�T�M E E , Pte, -2 of `3 T oZ _ loo T P)-U N tN E , E E E E n E 0 Sl E 3 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 (prin : A�� TESTS WERE COMPLETED ON: S -Z3_90 DESIGN SERA/InE ADDRESS: CERTIFICATION NUMBER: IPHONE NUMBER (optional): P 0 BOX 74 4 N MAIN ST cSY noo S�(, 7JS -�tLS -x165 RIVER FALLS W I 54022 CST SIGN 715-425-0165 a�� - DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. l `6AE ` d( DILHR -SBD -6395 (R, 10/83) — OVER — „ rteI P y'F' N .OR, COMPLETING FORM 115 - SBO - 6395 _tl %a a.xir q lau ohd n awal 4 -_;i St M.dY r Pon ._ ” .i. ,tea.. < floc plant a 'ell t, t ,.„:i1. 1.[ €• .. . is a €'r3'i G r C`3r'"Yi'M e , cal, E J, r Is ..,i ,CSrt2 ,t .., nirt. r €,v t, r ..a womoshin r .Y npnoxw. AS! T . . . Y S U TABLE P A H(A Fl 1 1 ML ER Q S T i_'.'.•,..i E 14 t 1 L LL) C.' T. !',.,r 7 0 S(,Fi1._ C,,, Ng L" 1 J 10 3 °fiS $i: i ti r.,w �t2,.? ,ils <. o.ij hc i.'tY ..! "SI Cll pro f in j %3i, .t ,d'1n ',d1f4 ;rlsl t1 . !' � C..: fv. t... P e f .;£`x .1 n ,in ..a r, t'y Ls., .i, Y "w' 'ts �f. _z�:ClE�ts �,,,,� .. o f, aii W t. on ion runce point arp <.ha ? g no d Yq E o w,r .zt , 9, C4yuhn 0 1 . , . -x ?p r i ,_.,. ...,ms i?. o Men name Miss, i?'and p(al €; .ax t f,.>1W 3,. W MY" ' AT If ! h ..'. fM x.., ,. tse 11, bp w Kim i1 .o i iac y' t r .,,.air n, ,ts ms W ya w car?..fiL,ab s number; t . IM.d< ,ait) ., E.f3 �.? .., «II,. A�, gt'i:z }ttt.. an . i n.t3.'¢',f..f.. ""°L1._ SOI 1 r S "i `J aaH SI E `; P €L i) i,fF I THE A BBRE VIATIONS FOR CERTIFIED f 3 AFT ij = S ari's Separaies wid TextmE es ether Syt7'6buIs 5 W ) l SS LS Lmlemwe Is Sall! H 'Gki%l High - awl ,, , t . :¢ %im! F is, _.._ Loony ,..� ea I To ' -- T Win En dt,f ' ,. =f. AMw -. _ MW ED Um, m , li',L SHW cm c C iay 0 °-- pni. rT°fiYt - 4 X .I`'i' uE Y Y iie's V RP V ..t`.9 `p TO THE OWNER: This soil test report is the first stein in socuriny a sanitary permit. The countiy or the [Xpar,, nent may request verification of this soli iest in the fieid prior to perrnit issuance, A complete scat of plans For hw, private sewage systern and a permit , lpplication roust be almhteal to iho appropriate local authority in ;)racer to i Main a permit. The sanitary pKmit must be caiat'ainecl and pos prior to the man o f a ny comtnichnn. i PLOT PLAN Scale 1 "- 3o' � �X�SI�►v6 �'Fw.ttS ?E CdDt OR F- 040uetl, S N to of y "�wC � i p r 1 -10uSE �SS�oF 2��� \ VC j l !=C P-CL, M�1 P 1 iJ Q eXxs - v N G r-15 CZ I W ZL j B1 Y c a w���tiv�5 sl-re to i- � J � N 97 At ? e SOIL DESCRIPTION FORM Attach Soil Prollic Location Map On a Su arate Sheet) gl1E TN�� (� R��'I t S7tZA71oca LI LOADING GRATE: PURPOSE �AW>'�"C� FO • AQlii SJT QESCRIPTION BY S�►C�TN L WL GL ASP ECT : S DATE: CURRENT LAND USE• _ COUNTY /STATE : T G CX\2XJ1"t ' VEGETATIVE COVER ��h SS — raw `jR -LS�S LO DESCRIPTION: Nl_ ST Std `SrTZcjlJl Rlbw DRAINAGE CLA OD�T�-y WELL ��IItJEfl GAL LONS PER Sp. FT. PER DAY � '� \G FIT O LOCAi lON • Z. S SOIL SERIES; L1T�1 $ I �CI�RV S Su�3 PARENT MATERIAL(s) /DEPT11• �{ �G14TL�►"/ HORIZON DEP111 MATRIX COLORS MOTTLES TEXTURE STRUCTURE CONSISIENCE CIAYSKLNS/ PORES ROOTS pi •80LINOARY REMARKS in. ( plo I s 0 G . St. Shp COATINGS )L 1 ` . v. pmz.6y. ea _ S l ` 1.'F h �^ ► �► - 0. S 5 ct S 3 10 -te »4 P. y � Dirt. QW S S Ec. I 1�9p- YYtT►" 0.S Z 5 -12. 10 s�k mfg, 0.5 tt. •Q;v. _3 Z -2Q, t - otiTZ %4 nt�' � z:o -� u �•s�rtz 3� 30� wG 3 6y a�u s I 1 .� ,� � �,� a; s toti�ata _. Z 5_ �S ivK `r.QN. S1 �'FS�Iz n 0.5 3 Z �s °t`• eN can S I 1 S lot `M 22_ �l� �.S �tR 3i �3o�Z11v6 V Ok. ZY $N 3 - 1 11 4 y i I lfSb h c S L4 IZ_ )6 ova 3t C 3 Sc 1 � h2 �a io o r 1 wi o S01 t_ eo 1, G Ll mlWVWJkL ZJ rU 3 t.�1 1,� , m 6 /..r M % E-LU S(Jt I A LL- - al 7 '$ wigm LA o R w � tGJV f �D) Lo ti G A Cl • 1 2 �U u Ulu Foh V U A L 1"a UAL %4 )�5 OTHER SITE FEATURES/NOTES: ^ — ( / / w L(_ nnGe 3 of 3 Date T K LIMITING FACTORS /DEPTH: Signature CS I IKXT120N OEPIII MATRIX COLORS MOTTLES TEXTURE STRUCTURE CONSISTENCE CLAYSKINS/ PORES ROOTS P11 BOUNDARY REMARKS Sn (RIO ist Gr. Sz. Sh COATINGS I I OTHER SITE FEATURES /NOTES: ?P% G� Signature Date CST 8 UNITING FACTORS /DEPTH: State of Wisconsin Department of Industry, Labor and Human Relations PRIVATE SEWAGE PLAN APPROVAL SAFETY & BUILDINGS DIVISION Office of Division Codes and Application 201 East Washington Avenue P.O. Box 7969 I I I Madison, Wisconsin 53707 WEGERER SOIL TESTING & DESIGN Owner: USDA - FMHA DONALD E. BRUE, COUNTY SUPERVISOR P.O. BOX 74 P.O. BOX 123 RIVER FALLS, WI 54022 BALDWIN, WI 54002 RE: Plan Number: S90 -01839 Date Approved: July 19, 1990 Gallons Per Day: 600 Date Received: July 9, 1990 Project Name: USDA - FMHA Location: NE,SE,15,29,16W Town of BALDWIN County: ST CROIX The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped 'conditionally approved'. This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. This approval will expire two years from the date approved or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. The Section of Private Sewage has reviewed these plans for private sewage system code requirements only. These plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50 -64 of the Wisconsin Administrative code. This approval is for the following components only: - REPLACEMENT PETITION - REPLACEMENT MOUND Inquiries concerning this approval may be made by calling (608) 266 -2889. Sincere , PETER E. PAGEL Section of Private Sewage Division of Safety and Buildings PPP013 /0009n/ 4 cc: USDA - FMHA Private Sewage Consultant _County UW -SSWMP _Plumbing Consultant sBD -saes (R. osias) — Owner Plumber Environmental Health a Staie of Wisconsin ` Department of Industry, Labor and Human Relations ~ SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue Jul r P.O. Box 7969 Jul 1 8, 1.x90 Madison, Wisconsin 53707 Arth6r L. Wegerer Ilegerer Soil Testing 11'esi gn P. 0. Box 74 NveiA Falls, .;'I 54022 P l a n 1.11). Wo. S9t3 -01 33g -P Dear rjr. adegerer: lie: 0"SDA — R t3.nsi to Sewage Systei NE,SE,I5,29,16W Tarn of Baldwin, Sit. Croix County, III Your° ptti ti on for variance to section ILHR 03.23 (1) (d) , Wisconsin Adininis'trative Code, alas been reviewed. The rule being peti ti oncc requires a hound systei.I sit to have a i - ai ninun of 24 inches or suitable natural soil. The variance requested was to install a refs' acel=,ent iaound systevi on a site with 10 i nches of sui tail e natural soil. The foll corrri►ents vi r� in ade i the petitiun an" lysis: 1. In revi ewi n;, the petition, it was noted that til request was si:iii 1 ar to other peti tions accepted by thi departi,i en t unaer petition nui;Ibers S81 03304, a09 -03:;1 "3, and S90- 00072. 2, Based on the precedent established. by the previous petitions, this petition for vari anise is bei nc; processed as penii tted by A sconsi n Statute Section 101.02 (6)(9). ilepartr :.ental Faction: ,approved, This approval is ;ranted with the understan6ing that all of the petitioner's staterrlents and any conditions of approval cited above wil be carried out. Prepared by: cter " , age i PI an Exarsi Tier inn "s Se%, ge :Sec ti on (60 3) 266 -2889 ' i 4 k:. SBD -6928 (R. 10/87) S tate of Wisconsin ` Department of Industry, Labor and Human Relations SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue Arthur L. Wegerer P.O. Box 7969 Page 2 Madison, Wisconsin 53707 July 16, 1990 kviewed by: � 7 2 Saco :oc wei"ler,"'PL, CPSS Environiiiental Engineer - Supervisor, Onsi to Sewage Plan/Plat 'Review Departmental Signature: ( �`� _ Date: -7 _11 , /f ( R -d t. Meyer rcr_ ec L Director, Office of Division; Lodes and Application fEP:0639r E nc . cc: Leroy Jansky, Private Sewage Consultant - District Chippewa Falls Thomas N'el son, Zoning Adini ni stratar - St. Croix; County O.S. Departrlent of agriculture, Owner SBD -8928 (R. 10/87) I Page 1 of 6 MOUND SYSTEM FOR A 1 BEDROOM RESIDENCE LOCATED IN THE 1JEI r V OF THE S� OF SECTION `S , V -"9 N., R 16 W, TOWN OF 8�c� -�w�ry , sT. crZ4 COUNTY, WISCONSIN. INDEX PAGE 1 of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW -CROSS SECTION PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR dl t3A4DwlI�,_w 1 S�c�o2 ,. �. 6 �3 e ��goat� N� CSC ®N�o �oyo PREPARED BY �e `�•.••'" .• e ;• ARTHUR L. ® ; WECERER = W E CD E F< E F-< E..r- C3 I 1 E r._,.r- - F I N G 0.915 P ELLSWORTH, AND =D FEE G I Gh9 E;1=Fc'w' I CE ••• NN••N •A P.O. BOX 74 421 N. MAIN ST. ��gfNflOM� RIVEfi f " � � AGE SYSTEM 5 _ 3E _ q c3 115- .1 165 �r�� ;� �:� ,i, N OF- Tio DEPARTMENT IN' �FrEEZ J iNG Job DIVI SEE CORRESPO ENCE PLOT PLAN Page Z- of � Scale 1"= - 30' y or - LA PV C , P � V I PEQ Cdfl� pj� Rai0�t4, S N i `� v 1SS of z� Svc J 1=o RCS 1�1 R 1 N � y� _D Ga 1 ti �\ H qg o � O- N ° Pi 97 B 3 \ Cod � °T 2 , 9Z � Cl 2 0 lit Qi� lop � � 3 9s �� NOTES 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each ( +�- required) 3. Install 4" observation pipes with approved caps. (_ y required) 4. Septic tank to be \2.00 gallon capacity manufactured by QrZk�Z c-kSr, DQQ 5. Bench Mark )!.ZLe,), 1po,p' pu 'MP of wtS-L N4etb. 6. Divert surface water around mound to prevent ponding at the uphill side. - 7. "N'S ! >J `[titE 1�pl1tvt5 A24% 1'n $ E GvT �Lli S1 �.JtT> y THE L�UC SNr ►PS I1.� PLhc E . Page 3 Of 6 14 at TCS.is W aF Straw Hay, Or Apat�ve� Synthetic Covering Distribution Pipe i =u-'v- X00.3 Medium Sand Topsoil F ELEV. 9 ,1 I D 3 E ' q °!o Slope 12,'.- i" Plowed Trench Of 2 i Force Main Aggregate FrAm Pump Layer Undisturbed d �' 3 FT' Soil E — :s 1 �T Cross Section Of A Mound System Using F a 2 Trenches For The .Absorption Area G V. o FT- A 3.5 Ft. H )-S FT- L.� b et I2.. l- ftl Au G IZ.AC'M = � 2 GPU /Lio f=r/rR ca - 'D�SIGtV t► '' =o,ZZS GtP1 ' /IjQ FT, .1 '2 Z Ft. .1 . 1"i Ft. c frT CBt�set ao p .ZS 6pblsQ FT� J 1� Ft. K 15 Ft. - L xoz. Ft. Alternate Position of Force Mai n —•--`___. W 48 S Ft. L J � K Observation _ Permanent C Pipes Markers Force Main From - _ -_ -_�_ -- - -- - - - - - -�--�� c ,.($'� Pump W l� \Distribution 7i 0 Pi - / a ,.•^ O'EPA Gl,� \CIO G S Mound Using . 2 Trenches bsorption Area ' I Performed Pipe Deiall End Vie ) Periofoied End Cap- PVC Pipe PER?'iANE+JT H AR1—GR 0 o Hole! Located Gn Bottom. I lJ' J ° ��s� ° Are E auolly Spaced S � Q PVC Force Moin From Pump PVC Monifold Pipe \ U Ist „bullor i Pipe Lost Hole Should 6e Nezl - lo E0 CO I End Cop Disiribuiion Pipe layout P 3�F• O �T. ES eSON X . 4S 1h - 1 • OA ' 3� Y q Inch Hole Diameter Inch(es) v >, t, ;� ' "''• V� l Lateral 1 '� C +� r, 2 Inches 1. .. i ;,,: �`�G n Manifold Force Main " Z Inches SSE lrov ART ELF iR�oN of L�rq?lr�S lD0 - 3 PL rtA p -3 C::: �"�fRNSFtSLD i51`Tfi S- - A ' PUMP CHAMBER CROSS SECTIOM AND SPECIFICATIOIJS ��E S o •i VCMT CAP 4 "C.I. VENT PIPC WEATHER PROOF APPROVED LOCKING — 41 '7 JYWCTION 60 MAIJHOLE COVER WITH 25' FROM DOOR, W1�RNIN6 LABEL wIAJDOW OR FRESH le/41U. AIR IWTAKE I CrRADC, ( N" MILL WAIN. COIJOUIT — - - -- 10 "MIAJ.� - -- - - - - -- IIULET SP RT VIDE SEAL APPROVED JOINTS APPROVED JOINT A >44 ;i ti I p C w /C.Z. PIPE t I ( I W /C.I. PIPE OR PV EXTENDIW O 3' ° . "� S" I I ALARM OWTO 1i01-10 iOII. b � I I CIW J EN • i I ELEV. FT. �(Qt� PUMP -� _ -� OFF r COIJCKETE 5LOCK i 3" APPROVED KISCK EXIT PERMITTED OWLy IF TANK MAMUFACTURER HAS SUCH APPROVAL I TI �Al — �`j .31 SPECIE 11 CA S iJ TA MAAIUFACTURER: � C�izt.�/tS IJUM9ER OF DOSES:— Z � PER c" TANK 51 GALLOWS DOSE VOLUME ZLI l ALARM MAMUFACTURLR' S •S- Z['RO SkST'i S INCLUD1Wfs OALKfLOW: GALLONS MOOCL LlUMDER: CAPACITIES: A= C INCHES OR '� GALLONS SWITCH TSPE: IUCHEE OR SZ ' g' GjuLLOIJS PUMP MAWUFACTURCR: z ° � = �' C: INCHES OR 2Ll'1 GALLOUS MODEL NUMDER: 13, On ` INCHES OR 3 � 3 �. GALLOMS SWITCH TYPE: MOTE: PUMP AMD ALARM ARf TO DG MINIMUM DISCHARGE RATE 41, tZ GPM INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFERE DETWEEW PUMP OFF AIJO.01STRibUTIOw PIPE.. -2.- Z FEET + MINIMUM NETWORK SUPPLY PRESSURE .. . . ..... . . 2 FLET I + 'SS FEET OF FORCE MAIM X 11 F Yo ftFRICTIOU FACTOR.. '' L Ia FEET .� TOTAL D JAMIC" HEAD = ' FEET • D1 Fll"I E'�L� R � it . INTERLIAL. DIMLWSION OF TAWK: LENCaTH 91 k ;WIDTH 6 ? 4 ...;LIQUID DEPTH 3 9 _ Z3aTToI -I AIZ A 39 C,Pr1, /1/uCll 1�S P �S1 }�► A !J U C�V CLC"12 = G F� U X 110 C H 4 r - W w I"' W 2 U TOTAL DYNAMIC HEAD FEET/ HEAD CAPACITY CURVE METERS MODEL 137 -1 SERIES CAPACITY GALLONS /LITERS 36 HEAD CAW TY UNITS / tAIN 8 FEET METERS GAL I LTRS 25 5 1.52 104 394 a 10 3.05 79 300 = 15 4.57 64 242 2 6 20 20 6.10 36 136 a 25 7,62 8 30 Z '0 26 7,92 0 O 0 0 15 ��•� 4 10' 2 5' , 0 U.S. 10 20 30 40 50 60 70 80 90 160 110 GAL LITERS` 130 160 240 3 O 400 0 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS 0 Three phase pumps are available in 200/208V or • Mercury float switches are available for controlling 23OV. single and three phase systems. • Electrical alternators, for duplex systems, are • Double piggyback mercury float switches are avail - available and supplied with .an alarm. able for variable level long cycle controls. Mechanical alternators, for duplex systems, are • Long cords are available in lengths of 15 - 25 available with or without alarm switches. 35 - 50 feet. • Combination starters are available. • Simplex and duplex basins are available. SINGLE AND THREE PHASE UNITS 1 ,y 0 ;� 9 137 Series 139 Series Cast Cord Cord Iron Volts -Phase Wt H.P.* Amps Length Bronze Volts -Phase Wt H.P. Amps Length M137 115 -1Ph Automatic 47 1/2 10.4 10 ft. M139 115 -1Ph Automatic 51 1/2 10.4 10 ft. N137 115 -1 Ph Non - Auto. 47 1/2 10.4 15 ft. N139 115 -1 Ph Non -Auto. 51 1/2 10.4 15 ft. D137 230 -1 Ph Automatic 47 1/2 5.2 10 ft. D139 230 -1 Ph Automatic 51 1/2 5.2 10 ft. E137 230 -1 Ph Non -Auto. 47 1/2 5.2 15 ft. E139 230 -1 Ph Non -Auto. 51 1/2 5.2 15 ft. H137 200/208 -1 Ph Automatic 47 1/2 8.4 101t. H139 200/208 -1 Ph Automatic 51 1 1/2 8.4 10 ft. 1137 200/208 -1 Ph Non -Auto. 51 47 1/2 8.4 15 ft. 1139 200/208 -1Ph Non -Auto. 1/2 8.4 15 ft. i Three phase units require a control switch to operate an external magnetic or All installation of controls, protection devices and wiring should be done by a combination starter. licensed and qualified electrician. All electrical and safety codes should be followed For information on additional Zoeller products refer to catalog on Combination in addition to the most recent National Electric Code (NEC) and the Occupational Starter, FM -514; Piggyback Mercury Float Switches, FM -477; Electrical Alternator, Safety and Health Act (OSHA). FM -486; Mechanical Alternator, FM -495; Alarm Package, FM- 513; and Sump/ Sewage Basins, FM -487. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is an engineered /design part of every Zoeller pump. 3280 Oid Mllim Lane Manufacturers of .. . P.O. Box 16347 Z AIL-MAff A CZ7. Loukafe Kentucky 40216 a Or p PB /NCE (502) 776 -2731 JO /A"ry ST. CROIX COUNTY WISCONSIN 'y ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 _ - (715) 386 -4680 w June 4, 1990 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the Farmers Home Administration property, located at the NE4 of the SE- of Section 15, T29N- R16W, Town of Baldwin, St. Croix County, revealed suitable soils at a depth of 10 inches using A +4 rule. This site should be suitable for a mound. Should you have any questions, please feel free to contact this office. Trely, K. Thompson Assistant Zoning Administrator cj i State of Wisconsin \ Department of Industry, Labor and Human Relations SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue July 18 1990 P.O. Box 7969 s Madison, Wisconsin 53707 Arthur L. Wegerer Wegerer Soil Testing & Design P. 0. Box 74 River Falls, WI 54022 Plan I.D. No. S90- 01839 -P Dear Mr. Wegerer: Re: USDA - FMHA Onsite Sewage System NE,SE,15,29,16W Town of Baldwin, St. Croix County, WI Your petition for variance to section ILHR 83.23 (1)(d), Wisconsin Administrative Code, has been reviewed. The rule being petitioned requires a mound system site to have a minimum of 24 inches of suitable natural soil. The variance requested was to install a replacement mound system on a site with 10 inches of suitable natural soil. The following comments were made in the petition analysis: 1. In reviewing the petition, it was noted that the request was similar to other petitions accepted by this department under petition numbers S89- 03304, S89- 03318, and S90- 00072. 2. Based on the precedent established by the previous petitions, this petition for variance is being processed as permitted by Wisconsin Statute Section 101.02 (6)(g). Departmental Action: Approved. This approval is granted with the understanding that all of the petitioner's statements and any conditions of approv 1 cit d above will be carried out. Prepared by: l it - e er E. Pagel Plan Examiner Onsite Sewage Sec ti on (608) 266 -2889 SBD -6928 (R. 10/87) State of Wisconsin ` Department of Industry, Labor and Human Relations SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue Mad ison , Wisconsin Arthur L. Wegerer Madison, Wisconsin 53707 Page 2 July 18, 1990 Reviewed by: am Rockweiler, PE, Environmental Engineer - Supervisor, Onsite Sewage P an /Plat Review Departmental Signature: /,/ ;� l,� r , �. Date: RTchar L. Meyer, Architect Director, Office of Divisio Codes and Application PEP:0639r E nc . cc: Leroy Jansky, Private Sewage Consultant - District 6, Chippewa Falls Thomas Nelson, Zoning Administrator - St'. Croix County U.S. Department of Agriculture, Owner SED -6929 (R. iGIB7) State of Wisconsin ` Department of Industry, Labor and Human Relations I PRIVATE SEWAGE PLAN AlyP &OVAL. SAFETY &BUILDINGS DIVISION G" ()ff ire of I)iv i :ion Codes and Application 201 fast Washingtoo -Avenue P.O. box 3964 = Hadison, Wisconsin 53707 WE GERE R SOIL TESTING & DES IGN Owner: U SDA FMHA [retNs.i..G E . - BRUE, COUNTY SUPFRir I SOR P.Q. Box 74 F.O. BOX 123 RIVER FALLS, i4I 514022 gAi.DWIN1, WT 54002 RE: Plan Number: S90 -0183s Pat:: ttppruvti €: July 14, .14 Gallons per Day: 600 Date keeeivell; 3u7y 9, 1990 .proje+ct Nair: U -SGA . €`MH.� l.os. it.iern: Nf,SF,I ,29,to i ~Towm of'i1Ai.19WIN County: ST CRfjlX The 'Plumbing plans and sprr,ification for this project havil fieen reviewed tar compliance with applicable ;cods: recut i reruen t :. This appr -ctv =t l is based an tvhalster `'145; ; Wisconsin Statutes and the iii a.,>}tts its Admin i s irat i ve Co de. The plans cat e s tamp ed rto lid it io - naily approved'. Thif, approv it is corttis vent upon colrip'f Iance wi Lit any S tipUldijons shctwrt un tilt! p1jri�.. All i t.rarrr: :hr3 ar rtstF_ =} rrtu t i.,t,: rtir re> is�� . /131 permits required by the city, i:ourity :hall be, o4tainet1 pr.lpr'U tonstructIon The IlLen ed pltuober rest.ttmibl- for tills lostAl .� ? Ai0tr shall keeF one set of liiaris� with tot, dc:f�arinrent's approval stattip at tre�4 z cans ructipri "g;ite. Ttte installer shall notify - the appropriate inspector lwfi ik_n ; inspctianstan be ode. ThiS7approvai w1`Il expire two years from the date approved or.,if a sanitary Y permit is obtained, it will expire the day the initial ;artitary. p mil The Section of `Private Sewage hss reviewed these plan for private sewage system code requirements only. These plans have riot, been reviewed fur the code requirements set forth In Section IL14R 82 for general plumbiiiu or in Chapters 50 64 of the `Wisconsin Administrative code. This approval is for the following componerits only: REPLACEMENT PETIT16N REPi_ACI`WNT M 6UND Inquiries concerning this appruval may tie !!lade iiy c:tl 1 ing (608.) 266 2fs69- Sincere , P .TE E PA� H ; Section of Private Sewago Division of Safety and 611ildingy PPPOI 3 /0009th 4 cc: USDA - FMtHA -- - Private Sewage Coitsuitant county UW SiNmil Pltimliing sso6423(R.08/88) C��risuitrtizr Ylutttt�s r _ Envir =�ritrt��iicai Health State of Wisconsin ` Department of Industry, Labor and Human Relations i! g u s t 2, ' 1 990 SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue P.O. Box 7969 Madison, Wisconsin 53707 Donald E. 3rue, County Supervisor U.S. Departraent of Ajriculture Fargmrs lhorire Adiii ni strati on P.O. Sox 123 3ald►ain, 6!I 54002 Peti ti vrr ado. S90 839 Oear 1 1 1r. Bruo: Re: USDA, F01.A - Residence Onsi to Sewaye Systein NE:,SE,l5,29,1:;10 Town of Baldwin, St. Croix County, 41 The petition for a variance requeste to section :33.10, (1 ) and 63.23 (1 )(d) of th e +isconsin Adi;rinistrative Coin was considered on July 30, 1970. The petition has been approved. The rules require tha,c a soil absor system be located no closer than 50 feet to a well ar►c; a itaound systeio site shall have a iiinirlu 24 inches of suitable natural soi 1 . The variance requested was to install a repl acer►ent tiound system with the upsl ope trench being J feet f rolia an existing well. The Departrient of Natural i,:sources (ONPR) had previously granteu approval to the well setback. An addliti onal variance vaas requested to install a re <l acre ;rrent round systein on a situ With 10 inches of suitable natural soil. All of the data and statecients surx;d tte,u on be ial f of ti►e petitioner were considered. This variance is specific to tl e subject p et ition and cannot be used for any additional inodificati Please ignor our previous approval letter fur this ;project dated July 16, 1. j" S incerely, J � Di rec tor, Office of .liw si`tJn Codes ano Applicatio:a , t 608) 266-0030 it) 1: PEP: D(10e cc: Leroy Jansky, Private Sewa�e ,1onsultint - ui-strict Cfhippewa Fails Thomas Nelson, :.- -rang Adninistrator - St. Croix County Arthur L. Ueger - Designer SBO- 6928(R. 10187) N A b , .o-,a FV ri b — N w� 1" aX` N¢ U No-.L C u c moli X 0 p5f8-,6 I l o-,oi Ilo-,oi Uo-,ez M �. I L i i I N n 0 . 1 �✓ na'1£ I16"IL � nV'IL - 1' r 4 WOON IPMAI"1 I 1 i I I I I I 1 1 1 I 1 I 1 i 1 I I I I 1 1 i I I I 1 I I I I I I I I I p 1 1 I 1 1 1 I 1 I t 1 1 I 1 I 1 1 I I 1 1 1 I 1 1 I I 1 11 u�l£ 11 11 w II 11 11 = w 11 A r II II 1_ IL „9-.L IID a 1 w a s 118`'IL N s I2f524DEM A •iv �•1�1� its O I 1 I 1 1 1 1 S com 0 osso k !s r o ,o-,os l