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HomeMy WebLinkAbout002-1064-90-000 Wisconsin 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 ( 353233 Permit Holder's Name: ❑ City ❑ Village [3 Town of: State Plan ID No.: Beckon, Craig & Vickie Town of Baldwin CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: O /d a 002- 1064 -90 -000 TANK INFORMATION OEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic e 5er' 600 Benchmark D Oa Dosing 6 Alt. BM A Bldg. Sewer Ho S / Ht Inlet TANK SETBACK INFORMATION S�/ Ht Outlet TANKTO P/L WELL BLDG. Air to I ntake ROAD Dt Inlet /— Air �• (.� � Q Septic �� T3! � ! —� NA Dt Bottom Dosing NA Header/ Man. Z, 16 Z Ae A Dist. Pipe Z•39' /6 Z. Z9 ng Bot. System 34 /0 PUMP/ SIPHON INFORMATION 4 P ` Final Grade Manufacturer Demand St cover VDU. Model Number j: GPM /6o TDH Lift Friction System . S' TDH j oss < H Forcemain +Length J0 t I Dia. Dist. To Well SOIL ABSORPTION SYSTEM , -B EQYT RENCH Width I I Length No. Of Tre ches No. Of Pits Inside Dia. th - DIM ENSIONS / DIMEN SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM L m anufacturer: INFORMATION Type Of } / C MBE Number: System: / ' 7 �r — R UNIT DISTRIBUTION SYSTEM Header / Manifold f / Distribution Pipe(s) r ' )/ x Hole Size x Hole Spacing Vent To Air Intake Length — Dia. Z Length�-'� Dia. Z Spacing -- SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only —T Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil E] Yes E] No E] Yes E] No COMMENTS (Include code discrepancies, persons present, etc.) Inspection #1: 0 //'6 / lInspection #2: / /(o/ 9 Location: 748 260th Street, Wood ' le Wi (NEIA, SEIA, Section 26 T29N -R16W) - 26.29.16._ _ _ ! jP 1.) Alt BM Description = �p�D O.�� l �/q ✓q�� 5, ? (� ! B / �� s7 �/ ' 2.) Bldg sewer length= - amount of cover = 3.) Contour q� L (P `/, z UD 'X) A-0-7- Ne v , Plan revision required? ❑ Yes M No Use other side for additional informrtion. Z Q SBD -6710 (R.3/97) Dat Inspector's ature Cert No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: e Safety and Buildings Division SANITARY PERMIT APPLICATION 201 W. Washington Avenue Wisconsin I n P O Box 7302 accord with ILHR 83.05, Wis. Adm. Code Department of Commerce Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8112 x 11 inches in size. ,SJ • See reverse side for instructions for completing this application State Sanitary Permit Number 36"3,R 33 Personal information you provide may be used for se ndary purposes E] Check it revision to previous application [Privacy Law, s. 15.04 (1) (m)]. _�JtSk/ r State Plan I.D. Number 1. APPLICATION INFORMATI N - P ASE PRINT ALL INF RMA N Prope Owner Name erty Location f A o �` c / gI l 1/4, S T 2 , N, R /,6 E (or) Property OwneK Mailing Address Lot Number Block Number 7 4 7 A s�` moo ' City State Zip Code Phone Number Subdiv i n Name r CSM Numb 4 0i - D 3 II. TYPE OF BUILDING: (check one) ❑ State Owned it /� Nearest Road Public or 2 Family Dwelling - No. of bedrooms =i l Tow OF �U.�wi� ©�� S III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo Q 6 ;�- —1 0 6 Z,.; — 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. ❑ New 2 Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5, ❑ Repair of an system __ - - - - -- System ---- --- - - - - -- Tank Only System - - - - - -- Exlstlncl 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 219Mound 30 ❑ Specify Type 41 []Holding Tank 12 E] Seepage Trench 22 In- Ground Pressure i r 42 ❑ Pit Privy 13 ❑ Seepage Pit X 43 ❑ Vault Privy 14 ❑ System -In -Fill &M . ccw� VI. ABSORPTION SYSTEM INFORMATION: 7_ 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 (s . ft.) (Gal /sq. ft.) (Min. /inch) Elevation 3 / i 2 �� f 0 /, ? /403, Feet Capacity VII. TANK in Ca allo g Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con steel glass Plastic App New Existing strutted Tanks Tanks Septic Tank or Holding Tank © 14) ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber 1 'r ❑ 1 ❑ 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' Si ature: o Stamp MP /MPRSW No.: Business Phone Number: Plumber's &ddress (Street, City, State, Zip Code): ? 4 ®a ::L- IX. CO Y / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate ssue Issuing Agent Signatuje (No Stamps) � Approved ❑ Owner Given Initial Surcharge Fee) Adverse Determination 3- " �S `( Liz X��N ITIO�OF PPROVA /REASONS FOR APPROVAL: t 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: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where.the system is to be installed. ll. 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 8 112 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. Safety and Buildings PO BOX 7162 MADISON WI 53707 -7162 TDD #: (608) 264 -8777 iscons www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary October 25, 1999 CUST ID No.267341 ATTN.• POWTS INSPECTOR WEGERER SOIL TESTING & DESIGN ZONING OFFICE 421 N MAIN ST ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 RE: CONDITIONAL APPROVAL Identification Numbers APPROVAL EXPIRES: 10/25/2001 Transaction ID No. 270700 Site ID No. 182969 SITE• Please refer to both identification numbers,' ST CROIX County, Town of BALDWIN above, in all oarresportdenep with the 'a envy. NEIA, SETA, S26, T29N, R16W Lot: 1 Facility: CRAIG BECKON RESIDENCE 748 260TH ST, WOODVILLE 54028 FOR: Description: MOUND SYSTEM Object Type: POWT System Regulated Object ID No.: 497599 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, �� ,. ; : DATE RECEIVED 10/19/1999 s z FEE REQUIRED $ 180.00 m..4 FEE RECEIVED $ 180.00 TER E P S PLAN REVIEWER II T BALANCE DUE $ 0.00 Integrated Services (608)266-2889, M - F, 0745 - 1630 HRS - PEPAGEL @COMMERCE.STATE.WI.US cc: CRAIG BECKON Page of 6 MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE LOCATED IN THE 1/4 OF THE SE 1/4 OF SECTION 6 ,T N, R W, TOWN OF Z3 R` i►U , ST• L` -:�LX COUNTY, WISCONSIN. INDEX PAGE 1 'of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW -CROSS SECTION: �t PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT CIO .PAGE 5 of 6 PUMPING CHAMBER �p /� - PA GE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR PREPARED BY WEGEFZER SO I L TEST S NC AND. co /v ', ,����eo'te�e DES = GI?`! SIEE�V I CE �` P.O. B11I 74 421 K. KAIN ST. t rr a RIVED F YI 54022 � ' ARTHUR L WEGERER P.O. W.T S, ns- 4�, -o1s5 o.q,S P 6iLSWORTN, Conditionally W AP ROVO DEP R ENT 0 MM E DIVISI N FE ND D GS ® � M ' " 19 Qp 1 5 SEE CO_RRESPONQ CE JOB NO. q9 —n r PLOT PLAN • Page of (0 Scale � Cbv`ro�rZ Z,� yob_ �s' • 6 01. M" of NN g.l d = 0 rf) ' L C'�tS`11r1 G _ �XGS � U G SL'�TC _ ��r�. _ �l�z- �F�'�FOYZ .:�Z� Pdre) _ -- J D ri J y Loy- +�C�0�1 Sln -tiTc� .o f ti NOTES •1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. ( Z required) 3. Install 4" observation pipes with approved caps. ( Z required) 4. tank to be \zw3 gallon capacity manufactured by CWT I N 6 'TQS1 t - Pin -�►� ` yr X & S4 6ft-, ki L M TR C . 5. Bench Mark 6. Divert water around system to prevent.ponding at the uphill side. Page 3 Of 6 Approved Synthetic Covering t�sTM c 33 Distribution Pipe Medium Sand - H —�G Topsoil F Elev. 101 • �S —J I D - 3 E 3 % Slope b Force Main Plowed Trench of 2" - From Pump Layer Aggregate Undisturbed D 1.0 Ft. Soil E Ft. Cross Section Of A Mound System Using F 0.8 Ft. 1 Trench For The Absorption Area G N••o Ft. A S Ft. H S Ft. B - )-S Ft. I 10 Ft. Linear Loading Rate = G O GPD /LN FT J a Ft. Design Loading Rate= o.\f GPD /SQ FT K 10 Ft. L () S Ft. W 2.1 Ft. L d Force K Mai A L ° s- -- -- - -- — — - W Distribution Trench Of 2 - 2 2 Pipe Aggregate Permanent 1 Observation Markers Pipes (Anchor securely) Mound Using I Trench For Absorption Area Page `l Of Perforated Pipe Detail 0 End View Perforated End Cap `ey PVC Pipe t _400. and` Install permanent at end of each lateral Holes Located On Bottom, Are Equally Spaced Q End Cop * ti PVC Force Main Distribution Pipe Lost Hole Should Be Next To End Cap Distribution Pipe Loyout P Ft. X 3 Inches Y 3 o Inches Hole Diameter 1 Y Inch Lateral 1 < < Z Inch(es) Force Main Z Inches # of holes /pipe S Invert Elevation of Laterals Ft. N `{ Place 1st hole �S from tee with succeeding holes at 3 O intervals.. Last hole to be next to the end cap. PUMP CHAMBER CR055 SECTION ARID SPECIFICATIONS ' PAGE S OF VEIJT CAP . '1 "C.1. VENT PIPC WEATHER P ROO F APPROVED LOCKING MANHOLE - ' 10' FROM OooR, JuIJCTIOAJ 80X COVER WITH WARNING LABEL wINDOW OR FRESH 12 MIU. AIR INTAKE GRADE I I `i' " I CONDUIT 18 "MIN. � ---- - - - - -- r,--F PROVIDE I — - -- IlJLET AIRTIGHT SEAL I I APPROVED JOIAIT A Tank construction shall comply ; � APPROVED Jo1NTS with COM14 83.15 and C011M 83.20 1 I I I ALARM 6 .I II I I I ON C •( I LLEV. FT. PUMP � OFF 0 e OLD z I COWCKETE BLOCK 3" APPlRW9D RISER EXIT PCRMI'ITED OIJLtJ IF TAWK MANUFACTURER HAS SUCH APPROVAL I UDDINQ SPEGIFICATIOKJS D05E e,.l. 3. Z5 TANK MAAIUFACTU0.CR . w IJUMBER OF DOSES: PER OAS TAWK SIZE: GALLOWS DOSE VOLUME t ALARM PANUFACTUK&R: IkICLUDIN& OACKFLOW: ��o``F GALLONS MODCL ►.!UMBER: CAPACITIES: A= � I IZ INCHES OR ��'$ GALLOWS SWITCH TZJP9: 5= z INCHES OR y 4LLOL15 PUMP "MUFACTURER: � C = $ IWt11E5 OR tib0.4 GALLOU5 MODEL NUM9ER: �$ Ds \1 INCHESOR ���' GALLONS SWITCH TYPE' MOTE: PUMP AND ALARM ARE TO DE MIWIMUM DISCHARGE RATE 3 S•I GPM INSTALLED ON 5EPARATE CIRCUITS VERTICAL DIFFERENCE DETWECU PUMP OFF AAJO.- 015TRIBUTION PIPE.. Y ''� S FEET f MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . 2 FLCT FEET OF FORCE MA X 2 ` q 3 F o Fr FRtCTto►J FACTOR.. 3 ' J FEET TOTAL DYNAMIC. HEAD — ' l3 FEET DIAMETER t IMTERLIAL DIMEWStok.!i OF TAIJK: LEMGTH ;WIDTH *LIQUID DEPTH BOTTOM AREA - 231- GAL /INCH AS PER MANUFACTURER - ZO. , GAL /INCH i • U., HEAD CAPACITY CURVE 3 7/8— 6 t/a �= 30 MODEL "98" 4 5/8 8 25 3 5/E = 6 0 Q U + L 15 O ! I 4 l4, l3 4 3/16 10 I 2 3S. � g 1 1/2 -11 1/2 NPT 0 U.S. GALLONS 10 20 30 40 50 60 70 80 LITERS 80 160 240 0 FLOW PER MINUTE TOTAL DYNAMIC HEAD/FLOW PER MINUTE EFFLUENTAND DEWATERING CAPACITY 12 HEAD UNITS /MIN FEET METERS GALS LTRS , r 5 1.52 72 273 10 3.05 61 231 15 4.57 45 170 4 3/16 20 6.10 1 25 95 Lock Valve 23' _ SK1102 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and • Variable level float switches are available for controlling single supplied with an alarm. and three phase systems. • Mechanical alternators, for duplex systems, are available with • Double piggyback variable level float switches are available or without alarm switches. for variable level long cycle controls. SELECTION GUIDE Standard all models - Wei ht 39 Ib S. - Y 2 H.P. 1. Integral float operated 2 pole mechanical switch, no external control required. 2. Single piggyback variable level float switch or double piggyback variable level, 98 Series Control Selection float switch. Refer to FM0477. Model Volts -Ph Mode Amps Simplex Duplex 3. Mechanical alternator 10 -0072 or 10 -0075. M98 115 1 Auto 9.4 1 or 1 &7 — 4. See FM0712, for correct model of Electrical Alternator, E -Pak. N98 115 1 Non 9.4 2 or 2 & 6 3 or 4 & 5 5. Control switch 10 -0225 used as a control activator, specify duplex (3) or (4) D98 230 1 Auto 4.7 1 or t & 7 — float system. 6. Four (4) hole J -Pak, junction box, for watertight connection or wired -in E98 230 1 Non 4.7 2 or - 2 & 6 3 or 4 & 5 simplex or duplex operation, 10 -0002. 7. Two (2) hole J -Pak, for watertight connection or splice. CAUTION For information on additional Zoellerpmducts referto Catalog on Combination Starter, FMO514; Piggyback All installation of controls, protection devices and wiring should be done by a qualified Variable LevelSwitches, FM0477; Electrical Alternator, FM0486, Mechanical Alternator, FM0495; Sumpl licensed electrician. All electrical and safety codes should be followed including the most Sewage Basins, FM0487; and Single Phase Simplex Pump Control/Alarm Systems, FM0732. recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. f _ MAIL TO: P.O. BOX 16347 ` Louisville, KY 40256 -0347 Manufacturers of. . OELLER SHIP TO: 3649 Cane Run Road Louisville, KY 40211.1961 Q irr PUMPS ,SE /9,79" PUMP !O (502) 778 - 2731.1(800) 928 -PUMP FAX (502) 774 -3624 ftconsin Department of Commerce SOIL AND SITE MLUATION Page 1 of 3 Division of Safety and Buildings in accord with Comm 58 05, W is. Ad Code r� Vii, A.C.E. Soil & Site Evaluations Attach complete site plan on paper not less than 8'h x 11 inches in sine. Plart�mast County include, but not landed to: vertical and horizontal reference point (BM), directibmhnd St. Croix percent slope, scale or dimernsions, north arrow, and location and distance tb nearest i Parcel I.D.# APPLICANT INFORMATION - please print all informatralt uter1 002 1064 - 90Da Personal information you provide may be used for secondary purposes (Privacy Law, s.'15':a4 (1) (m)j vu - 7`" y F2660 �roperty`L �fir.r 6 Govl. Lot NE 1�/4 /SE 1/4 S 26 T 29 N,R 16 W Mailing Address Lot # ''-_,_ . Black #. Name or CSM# eet 1 CSM Vol 2, P . 364 City State Zip Cod e PhoneNumber E] City L] Village ZTown Nearest Road Woodville WI 54028 715- 698 -2723 Baktwin 260Th Street ❑ New Construction Use: Z Residential / Number of bedrooms 3 ❑Addition to existing building Z Replacement ❑ Public or commercial describe Code Derived daily flow 450 gpd Recommended design loading rate 5 bed, gpoltt� 6 trench, gpolft Basal area required 900 bed, ft 750 trench, W Maximum design loading rate .5 bed, gpdr .6 trertch, gpd/W Recommended infiltration surface elevation(s) 101.85 at 12" above 100.85' contour ft (as referred to site plan benchmark) Additional design / site consi deration s Excessive slopes and very limited soil conditions result in the tested area being the only suitable area for a system Parent material Glacial outwash Flood plain elevation, if a plicable NA ft L S= Suitable for system Conventional Mound In Ground Pressure AT - Grade System in Fill Holding Tank U= Unsuitable for system ❑ S M U ® S ❑ U ❑ S ®U ❑ S ®u EIS ®U ❑ S M U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure Consisten Boundary Roots GPDffV Boring# Horizon in Munsell �. Sz. Cont. Color Texture Gr. Sz. Sh. Bed Trench 1 1 0 -5 10yr3 /3 None A 2fcr mvfr cs 2f &m 0.5 0.6 2 5 -15 10yr5/3 None sl 2msbk mfr cs 2f,lmc 0.5 0.6 Ground 3 15 -28 10yr4/4 None heavy s1 2msbk mfr cw 20m 0.4 0.5 elev 100.58 ft 4 28 -96 7.5yr4/6 m2d5yr5 /8 vfs,ls,sil 0 m mfr - if N.P. 0.2 Depth to limiting Horizon #4 consists of several layers of Osg s &gr., Om vfs, om fis, 2med.pl sil, & om sl too numerous to define as individual horizons. Redcudmorphic factor concentrations observed at interface of many horizons a mdox depletions found within vfs & sil bards __T E:��� 28" Remarks: Z 1 0 -5 10yr3 /3 None sl 2fcr mvfr cs 2f &m 0.5 0.6 2 5 -15 10yr5/3 None A 2msbk mfr cs 2f,lmc 0.5 0.6 Ground 3 IS -36 10yr4J4 None sl 2msbk mfr cw 2f,lm 0.5 i 0.6 elev 100.92 ft 4 36 -90 7.5yr4/6 m2d5yr5 /8 vfs,ls,sil Om mfr - if N.P. 0.2 Depth to limiting Horizon #4 consists of several layers of Osg s &gr., Om vfs, Om fis, 2rned.pl sil, & om sl too numerous to define as individual horizons. Redaodmorphic factor concentrations observed at interface of many horizons and mdox depletions found within vfs & sil lands 36' — Remarks: CST Name (Please Print) Signatu : Telephone No. James K. Thompson 715- 248 7767 Address A.C.E. Sor7 & Site Evaluations Date CST Number Ref # 340 Paulson Lake Lane, Osceola, 54020 9/22/99 3602 1112 I PROPERTY OWMM Craig Bmkon SOIL DESCRIPTION REPORT Rage 2 of 3 PARCEL. IIDS 002 - 1064-90 A.C.E. Soil & Site Evaluations Depth Dominant Color Mottles Structure GPDi� E rizon in. Munsell Qu. Sz. Cont Color Texture Gr. Sz sistence Boundary Roots Bed ; Trench 3 1 0 -4 10yr3/3 None sl 2fcr mvfr cs 2f &m 0.5 0.6 2 4 -12 10yr5 /3 None A 2msbk mfr cs 2f,lmc 0.5 0.6 Ground elev 3 12 -35 10yr4/4 None s] 2msbk mfr cw 2f,lm 0.5 0.6 100.61 ft 4 35 -88 7.5yr4/6 m2d5yr5 /8 vfs,ls,sit 0 m mfr - if N.P. 0.2 Depth to limiting — — factor Horizon #4 consists of several layers of osg s &gr., Om vfs, om fls, 2med.pl sii, & Om sl too numerous to define as individual horizons. Redocdmorphic 35" concentrations observed a interface of many horizons and redox depletions found within vfs & sit hands Remarks: —_ 4 1 0 -5 10yr313 None A 2fcr mvfr cs 2f &m 0.5 0.6 2 5 -21 10yr5/3 None s] 2msbk mfr cs 2f,lmc 0.5 0.6 Ground elev 3 21 -44 10yr4/4 None A 2msbk mfr cw 2f lm 0.5 0.6 100.3 ft 4 44 -83 7.5 yr4/6 m2d5yr /8 vfs,ls,sil Om mfr - if N.P. 0.2 Depth to limiting factor Horizon #4 consists of several layers of Osg s &gr., Om vfs, Om fts, 2med.pl sil, & Om sl too numerous to define as individual horizons. Redoodmorphic 44" concentrations observed at interface of many horizons and redox depletions found within vfs & sil bands 17� Remarks: 5 0 -6 10yr3 /2 None sil 2mcr mvfr cs 2f m.c 0.5 0.6 2 6 -18 10yr4/3 None A lthinp] mvfr aw 2f,1mc 0.2 0.3 Ground 1 F elev 3 18 -36 7.5yr5/6 m2 cl Om mvf - - N.P. 0.2 60.0' ft Depth to limiting - factor 18 Remarks: Ground elev Depth to limiting factor Remarks: ., Fence NxelAvo. 3oD.c�' w\ U ! � � LA .,t 1 `r' a (A $u \ to !4, R 3 n 4 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer _ R �. i s, � - l j, c ' ��, � -e C Mailing Address 7 ,/ ;P - 2 a '` �i ,S — Property Address -4, (Verification acquired from PUnaing Department for new coastxuction) city/state Parcel Identification Number 6 j ©•G�C� © � ` 1 D LwAL DESCRIPTION Property Locatioac y < , S �, - ml<, Sec. a, , T 2 N - R f W ._ �2_ , Town of Subdivision Lot # Certified Survey Map # 21 7 Volume . Page # 6 q Witranty Deed # ` Volume O -�- . Page # 3 Q 7 Spec house ❑ yes ❑ no Lot lines identifiable ® yes ❑. no ?i�l�A�?: �� .'spr�ai�.tp� Con'ft G �c ,f Pb g a of t�e� � � � � or sooner, if needed by t Ikensed pu t y put into the system � teal; a urge in time waste d4osa1.9Acm, Tx ' owner =gees to submit to St Crab: Zoning Depa tment t. =ffic alion form, signed by t11e own�et and Imp : pPlamb�roeilio�dpearpervrafy�g� (1) tlue onaitaarasfcsva�rdrsposaispsberii U is proper opeatting oondrt m andlar (2) after boa and pungft.Clf IIeOe�=Iy). the t optic tank-is less d=n in firU of nudge. ywr odbave read the above mai�iac Vosd system with the standards . bmckis so by &e of Coa=WWC and the Departmeat of Naturd R,esoamcs State of Wisconsin.. Uecb'£cxtioa that: Y= septic systma his beennuinuined tOmpkted and rctanmed to the St Croix.Couaty Zoning Of ce wid a 30 days-of the throe year cq*adoa date. V ) b ck fy j . 11 SIGNATURE OF APPLICANT / I Z� DATE OWIR• CERZ�TCATION Y (wc) oetify dw all statcmcats on this form are true to the best of my (our) Imowledge, I (we) am (arc) the owner(s) of desedb above by virtw of a warmuty deed r000rded is Register of Deeds Office. SIGNATURE OF APPLICANT I DATE s «s « «« Atw information that is miSATrrsented may result in the sanitary permit being invoked by the Zoning Department «sssss «« bdude rrith this appGation: a stamped warranty decd from the Register of Dads office a copy of the certi&cd survey map if reference is trade in the warranty deod I ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have in spected the septic tank presently serving the �E G/� -e ,�.�� /�� /1 residence located at: Section T�N, R W Town of ,41 z- Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced: /� z/z Did flow back occur from absorption system? k Yes No (If no, skip next line) Approximate volume or length of time: gallons minutes Capacity: Construction: Prefab Concrete Steel Other Manufacturer: (If known) : `e S - e- Age o f Tank (If known) : (Signature) (Name) Please print /7/A ? ;73 (Title )v (License Number) // 11; Date Form to be completed by licensed plumber (s.145.06, Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements of ILHR 83, Wis. Adm. Code (except for inspection o ening over outlet baffle). Name �./ — 'z Signature MP /MPRS Al 1 9 y DOCUME:JT NO. STATE BAR OF WISCONSIN FORM 3 -1988 TO-IS • .ACC RcscRV90 FOR RCCORDINS G`ATA QUIT CLAIM DEED 435374 w54 8 � R EGISTER'S co F VI I I CE .. ............................. Rec'd for Reco►d ............ . . .• ....... • ....... ._.......... .. . ... ...... ....... - . •.............. iwkR w 1 bb ................................ ... ....... ....- quit - claims to .......Vi ... 8:30 A M --- -. - - -- -- ....... -- •-- •---- ...._- I ............ .... .._................. . �o� the followinz described real eetate in . ...... St....Cro. ................... County, State of Wisconsin: R[TURN T.) Tax Parcel No: .............................. Lot One (1) of Certified Survey Map recorded in Volume 2, page 364 of Certified Survey Maps in the office of the Register of Deeds for St. Croix County, Wisconsin, subject to existing highways, easements and rights -of- way of record. The above described premises contain 4 acres more or less. This deed is given pursuant to divorce decree granted between the above named parties in St. Croix County Circuit Court on January 11, 1988. F - ,k This -- -- .- _- .......is...... homestead property. (is) (is not) Dated this .... ..................... .... day of March -• - - ._............... r n 19 - 8 8 . . ..... _ ....... .... ....... - - -- .............. -- - - --. - -- - -.(SEAL) .... ... ................. . �J � ._(SEAL) ' . - - ... .. - - - - - Michael W' ....... ............... ...... . .....- ..(SEAL) ..... .. .......................... ....... .........................(SEAL) ' _ ......... ........_...................... ...... ..... • . .. .... . .. . .. ......... ........ ............. -..... -- ---- -- AUTHENTICATION ACKNOWLEDGMENT -------•------•-- ----- --- •- ------------ -- - - - - --- STATE OF WISCONSIN - •----•-------------•------...------•----.....---- .....••------ •• ••-- • •.. - -• -- St. Croix .................................... County. 1 authenticated this ........ day of ........................... 19_..,._ Personally came before me this .9:::_ __�d+iy' �f: . -- ....._ -- March- ..- •-•-- --.-_, 19 -_ -88: th&rhbove_aakgk4 Michael - W. Hennessy 9 J t • -- .1:.:---- -- - ---- -- -j- •---••---...._.--••---•----....--- ••----------- •--- --•--- -- - - -• - -= TITLE: MEMBER STATE BAR OF WISCONSIN • - -- (If not, - -- •- -...... r• °;r authorized b y § 706.06, Wis. Stats.) -- --••• ----- -- -- ----- -•- - -- --- • ---=-- - • - -• - _ - -• to me known to be the person .....___ --- who executed the g ;ns /A A nd ac he same. 1 w lll edge THIS INSTRUMENT WAS GRAFTED BY fore � tru - ��-(.,.-. i L AOA... PAA1.. No.vitzke,. Attorne T y--- at -•Lak • Iris A. Nadeau Amery, WI 54001 - .... ­.­1 •-----••••--••-------....-•-•---------- ••-- •- •- •---- •--- - -• - -. .... .................................... Notary Public ...... St—Croix -- -•- _ - - - -- _County, Wis. (Signabires may be authenticated or acknowledged. Both My Commission is permanent. lIf not, state expiration are not necessary.) date: -- 7-28 .... - - -•- ....................... , 19.91 ---•) QUIT CLAIM DEED STATE BAR OF WISCONSIN wisc.nsln L'RSl Blank Co. Inc. FORM V.. t CERTIFIED SURVEY N0. 364 -- 339717 nL Part of the NE4 of the SE- of Section 26, T29N, R16W, Town of Baldwiof St. Croix, State of Wisconsin. E ti UNPLATTED LANDS I 6600' EAST I/4 COR. SEC. 26, T29N, R16W. TOWN In .•�•.•••••••.••••••••••••••• g� I OFBALDWIN, ST. CROIXCO g K N 0 580.80' z Z: ° � p p 33.04' I 13 N 01, 0 -1 • �• O J. 4 4 I Q • W W • LOT I -J • W 10 s ° o : ' I oW W • ? d 174,240 S0. FT, o z • Q • G' U) 4.0 ACRES ! • ~ h O I • Zp�I W• 00 W NQ Q • N �• Cr 3 M1 W W E Z • i W J• __nn V • 1 a � • �j V- B • I • • OA ? O ; • Z W Z 0 • J • 580.80' 00, • f ( _• S 870 00 E : a UNPLATTED LANDS 4- •.•• .••.. • •••• .......... 6600' ( LEGEND SCALE I 0 3/4 "w 30" ROUND IRON ROD 1" = 150 FEET WEIGHING 1.502 LBS /L.F. 0 75 150 300 450 APPROVED N►'PP�Y pf THIS MINOR SUMVI APR 2 7 1977 r. sc. -aax cour+rr COMP.teHEN51Vfl PAN13 NA0410 AND 20 11 4" COMwm I, Thomas G. Kuester, Registered Land Surveyor, hereby certify: That I have surveyed, divided, and mapped a part of the NE-I, of the SE4 of Section 26, T29N, R16W, Town of Baldwin, County of St. Croix, State of Wisconsin, more particularly described as follows: Commencing at the East 4 corner of said Section 26; Thence South 10 feet; Thence N 87° 00' 00" W 33.04 feet to the point of beginning. Thence continuing fJ 87 00' 00" W 580.80 feet; ` y�,01NS� Thence South 300 feet; Thence S 87 00' 00" E 580.80 feet; IT s Xr= Thence North 300 feet to the point of beginning. Said parcel contains 4.0 acres more or less. Sum t That I have made such survey, land division, and plat by the direction of Dick Timm. That such plat is a correct representation of all exterior boundaries of the land surveyed and the subdivision thereof made. That I have fully complied with the provision of Chapter 236 of the Wisconsin Statutes and the subdivision regulations of the County of St. Croix, and the Town of Baldwin in surveying, dividing, and mapping the same. Dated this %; V day of 1977. Volume 2 Page 364