HomeMy WebLinkAbout018-1067-90-100 ST. CROIX COUNTY ZONING DEPARTMENT ..
AS BUILT SANITARY REPORT �!
Owner
Property Address / T/i S?�,
City /State
' G ,
Legal Description: Fri
Lot 2 Block Subdivision/CSM #
V4 SE t /4, Sec. 2e , T 2 N -RAW, Town of ,mod •1! mom+ c PIN #�
SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION
Tank manufacturer , ;�[l,)y ta�,t1 Size ST/PC 146h l 4-0 Setback from: House Well P/L
Pump manufacturer Model Ta •5'
Alarm location �-
(HOLDING TANKS ONLY)
Setbacks: Service road Vent to fresh air intake Water Line
Meter location
Alarm location
SOIL ABSORPTION SYSTEM
Type of system: 1116 &.a -J-- Width S� Z Length e Number of Trenches
Setback from: House L ? e Well Jet- P/L 96 ' Vent to fresh air intake
- z ELEVATIONS
Description of benchmark Elevation 4�rd,
Description of alternate benchmark Elevation
Building Sewer S ST/HT Inlet 9 ?, yr ST Outlet PC Inlet
PC Bottom Header/Manifold /�a?, .- Top of ST/PC Manhole Cover
Distribution Lines O %d2. yd
Bottom of System ( ) iD /, 7/1 ( ) ( )
Final Grade 3 1 K� O ( )
Date of installation / / Permit number State plan number
Plumber's signature
.�" �� License number �;&ZZIZ Date
Inspector Te Al
Complete plot plan �
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NOTICE Please provide the following:
• A plan view sketch showing everything within 100 feet of the system.
• Two horizontal reference points to center of septic tank manhole cover.
• Show alternate benchmark, if applicable.
PLAN VIEW
zo' �'�7
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INDICATE NORTH ARROW
Wisconsin Department of Commerce E SYSTEM Count
PRIVATE SEWA 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)]. 353131
Permit Holder's Name: ❑ City ❑ Village?❑ Town of: State Plan ID No.:
Shery Town of Hammond
CST BM lev.: Insp. BM Elev.: I BM Description: Parcel Tax No.:
bt> I Vn(D A) r/ 018- 1067 -90 -100
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic h pr ` IA Benchmark q, P /d q, 1
Dosing �� Alt. BM
A Bldg. Sewer
olding St Ht Inlet L, 3Z
TANK SETBACK INFORMATION < tiet
TANK TO P/ L jWELL BLDG. Vent oke ROAD _9t Inlet
Septic 70 If f t NA Dt Bottom �a� 9G
Dosing 2 y� NA Header / Man. 7. `/ G ,
NA Dist. Pipe
Z -5' 02.
H Ing Bot. System 3 ' l
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand St cover 10U-
Model Number g f'd 3r - 4.'7GPM
TDH Lift's Lriction System Z� TDH Ft _T_
oss mead [ Forcemain Length 3f Dia. 7 �' Dist. To Well
SOIL ABSORPTION SYSTEM
BED TRENCH Width Len No. Of Trenche PIT No. Of Pits Inside Dia. Liquid Depth
EN I N q DIM ERStM
SYSTEM TO P/L BLDG WELL LAKE /STREAM ING acturer:
SETBACK CRAM
INFORMATION T pe0
System: �-Z lr '� Z � — ORU T
DISTRIBUTION SYSTEM
Header/Manifold Distribution Pipe(s) �� x Ho a Size x Hole Spacing Vent To
� �, r
Length Dia. Z � Length - � Dia. i r - / Spacing (!E 3L /r > �f
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only 7
Depth Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched
Bed /Trench Center Bed /Trench Edges Topsoil E] Yes El No F] Yes E] No
COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: 10 /13 / 0 Inspection #2: (d /!j /#f
Location: 746 160th Street, Hammond, WI (NE1 /4, SE1 /4, Section 30 T29N R17 / W) - 30.29.117.464A
Ge our q.I ` 1d 3tA (�C !6
A#f i/n 2v �OWrwy 0� t'�
6e toe
6 Gowr _
Plan revision required? [:]Yes 0 No
Use other side for additional inforn{ation.
SBD -6710 (R.3/97) Date Inspector's Si ature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
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Vi sconsin Safety and Buildings Division
SANITARY PERMIT APPLICATION 201 Box Washington Avenue
Department of Commerce In accord with Comm 83.05, Wis. Adm. Code Madison, WI 53707 -7302
• Attach complete plans (to the county copy only) for the system, $ less toy
than 8 112 x 11 inches in size.
• See reverse side for instructions for completing this applicatin State Sanitary Permit Number
Personal information you provide may be used for secondary purposes r ❑ ChecR `q revision to previous application
[Privacy Law, s. 15.04 (1) (m)]. State:}�I I.D. plu2tber —a
I 8
I. APPLICATION INFORMATION - PLEASE PRINT ALL I FORM
Prope Owner Name cation
/ e Y� ei l'1 ev� S'c ,rJa(j C ti /a S T , N, R E (or'
Property Owners Mailing Address of Number t ` °•, Block Number
7 5 r
City, State Zip Code Phone Number Subdivision ame or CSM Number
a lolnd Ar &_dp I ( > G 5 1n
II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ !t( Nearest Road
❑ VII age
Public Z 1 or 2 Family Dwelling - No. of bedrooms 5 Town OFXX
III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) �G
1 E] Apartment/ Condo l Q / °6 / o - lat)
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. 0 New 2 ❑ 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 Number Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non - Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 ®,Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In- Ground Pressure r r 42 ❑ Pit Privy
13 ❑ Seepage Pit 1 43 ❑ Vault Privy
14 E] System -In -Fill c too .-+-D I M
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
�1/15 3 7,6 3? 5 .r c� 1 41,7 Feet la, 2 Feet
VII. TANK Capacity
in gallons Total # of Site
INFORMATION g Gallons Tanks Manufacturer's Name Concrete con Steel Fi ber - ass Plastic Appr_
New Ex structed
Tanks Tanks
Septic Tank or Holding Tank b /dQ6 j �s le y ® ❑ El El El
Lift Pump Tank /Siphon Chamber X 1 ❑ 1 ❑ I ❑ ❑
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: ( S amps) PRSW No.: Business Phone Number:
.q Sc k n4 a lfa y
Plumber's Address (Street, City, State, Zip Code):
le sc:�o w
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuin Agent Signature (No Stamps)
Surcharge fee)
pproved ❑ Owner Given Initial t �
Adverse Determination t 3 o2g. -CM 1 /0 -T'
X. CONPIT ONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SBD -6398 (R. 4/99) 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 1 e 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.
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 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, Fist 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.
• Safety and Buildings
PO BOX 7162
MADISON WI 53707 -7162
I sconsi Tommy G. Thompson, Governor
Philip Edw. Albert, Acting Secretary
Department of Commerce
November 12, 1998
CUST ID No.267341 'r r �1.!' ; ATTN PO WTS INSPECTOR
WEGERER SOIL TESTING & DESIPN X .9� ZONItiG OFFICE
421 N MAIN ST ST CfjGfx ST CROIX COUNTY
PO BOX 74 "OoNTV 11,0I.-' CARMICHAEL RD
ONING OFFICE
RIVER FALLS WI 54022 ; ,` f)SON WI 54016
RE. CONDITIONAL APPROVAL >_ Identification Numbers
APPROVAL EXPIRES. 11/12/2000 Transaction ID No. 189550
Site ID No. 163576
SITE• Please refer to both identification numbers,
ST CROIX County, Town of HAMMOND above, in all correspondence with the agency',
NEIA, SE1 /4, S30, T29N, R17W
TERRY & SHERYL SCHNABL
FOR:
Description: MOUND SYSTEM
Object Type: POWT System Regulated Object ID No.: 435281
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.
IR ,
DATE RECEIVED 11/02/1998
FEE REQUIRED $ 180.00
P GEL , OW PLAN REVIEWER 1I FEE RECEIVED $ 180.00
Integrated Services BALANCE DUE $ 0.00
(608)266-2889, M - F, 0745 - 1630 HRS
PEPAGEL @COMMERCE. STATE. WI.US
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e
a
Page of 6
MOUND SYSTEM
FOR
A 3 BEDROOM RESIDENCE N�V 0?
%))Fa u
LOCATED IN THE NE 1/4 OF THE SE 1/4 OF SECTION ,T Z9 N, R 1 W,
TOWN OF Rp -1 w1 ltin COUNTY, WISCONSIN.
loT Z. nF
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
PA GE 6 of 6 PUMP PERFORMANCE CURVE
P.O.W.T.S• PREPARED FOR
Conditionally
AP ROVED
DEP TMEN OF MMER E
DWISI N f SA TY D BU INGS �RY'1 v-1 J 1�O , 1 j J S4UI S
SEEgCORRESP DENCE
PREPARED BY
WEGEFREF Z SO I L TEST I NG
AND. �oN
L3ES I GR! SE RV I CoNs�
P.O. BOX 74 421 K. KAIK ST.
ARTHUR L
RIVED FALLS. MI 54022 WEGERER
asps r
715 -4L ,-OI6J ELLSWORTH.
°�► ��S I G N E4
i
JOB NO. ��3
PLOT PLAN
• Page Z of (o
• Scale 1"= kAp '
I
12o>v a IZ LOT COPtuL--rQ V?t .
C sfw� -moo DoT ��sltiza� �,or }
Lo Z
I
t `o
1%
�
IV
"' .\ 6 > ' e' cam= . ► u V .1 O
i
��.l004 \ �• v ss'o� z'�a�c Fh. N oT 1 s � —
N
'LO aF y �PV C
I ti
Qo DoT
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�•v'Ll,l.. 10 �� 'RT l.�'ST S4' 1 Y-�',�VY.�� �� Pik' lS.�ST ZS �F�?�r, - ���J�c.
NOTES
•1. Elevations shown are existing ground elevations unless otherwise noted.
2. Install permanent markers at end of each lateral. (/ required)
3. Install 4" observation pipes with approved caps. ( Z required)
4. Septic tank to be 1 000 1 6S Ogallon capacity manufactured by
5. Bench Mark SE1�7 fln o U e
6. Divert surface water around system to prevent ponding at the uphill side.
Page _3 0,
x
Approved Synthetic Covering
rrs C 33 Distribution Pipe
Medium Sand
Topsoil = —_ _ ^_ F Elev'.
E D.
b
% Slope
Bed Of -- 2 2 Force Ma Plowed
Aggregate From Pump Layer
D k 1 3 Ft.
E ► -06 Ft.
Cross Section Of A Mound System Using F 0.$ Ft.
A Bed For The Absorption Area
G \.O Ft.
A S Ft. H \-S Ft.
Linear Loading Rate = " GPD /LN FT B U1 Ft.
Design Loading Rate= o.\f .GPD /SQ FT j Ft.
J ° a Ft.
K 1p Ft.
L V� Ft.
Foxes - �q n_ W -1 - Ft.
Observation Pipe
�--- 8 K
A
I• - - - -- ----- - - - - -- ------------------ - - --�� Force Main
W O 7 - - --
Distribution Bed Of 2N— 2 z
Pipe Aggregate
I
Observation Pipe Permanent Markers
(Anchor securely)
Plan View Of Mound Using A Bed For The Absorption Area
Page H- Of
Perforated Pipe Detail
0
End View
) Perforated
End Cap. o � \e �` PVC Pipe Install permanent
(� I -4 s �o�` at end of each lateral
yr
Holes Located On Bottom,
Are Equally Spaced
Q S
PVC Force Main
P
PVC
Manifold Pipe
w
Distri ution
Pipe
Last Hole Should Be I
Next To End Cap
End Cap
P ZZ. S Ft.
Distribution Pipe Layout S
Ft.
X 3 b Inches
Y Inches
Hole Diameter "Y Inch
Lateral 1 ' Inch (es ;.
Manifold Z- Inches
Force Main ?, Inches
# of holes /pipe $
Invert Elevation of Laterals [0Z.Z Ft.
Place 1st hole from center of manifold with succeeding holes
at 36" intervals. Last hole to be next to the end cap.
Combination Sept,1c; Tank and
PUMP CHAMBER T
BER CROSS SECTION WD SPECIFICATIONS_' PAGE S OF
- T CAP WEATHER PROOF
juMCTIOW BOX
4 VENT PIPC APPROVED LOCKING
1O' f ROM DOOR. MANHOLE COYER P'JIV .
iiIIJ OR FRESH wARt.�ItJG LP.HEC
ALIUTAKE .1: cosatw>tr
s
;. tj
l� 0, eMIN r'R"
IL
� � 1 e r► u.
y�lllsl>t'�huN PIPC PROVIDE - - --
. AIRTIGHT SEAL
Ir i I I I v
i34FFLsS I I I APPROVED JOINT:
APPROVED JOIAIT A
I II w /C.I. PIPE�PDC
W /C.T. PIPirbR Tank construction I II
ALARM
shall comply with
ILHRk (83.15 and 33.20 a I I
i OtJ
C ! I
Can. S3 I
LLEV. — f T. PUMP - -�
OFF
D Co RETE
BLOCK
3" APPRae.
RISER EXIT PERMITTED OWLy IF TAW MAIJUFACTURFFK HAS SUCH APPROVAL aEDD
SEPTIC f
SPEGIFICATIC)US
K li MA NUFACTURER: 1 � / �� ` `� NUMBER OF DOSES: 3 ' S PER DAY
TANK 51ZL : 1WC5 L L-S l O — GALLOWS DOSE VOLUME z
ALARM MAwuFACTUR.C.R:
INCLUDIMr, OACKFLOW: \ �� GALLONS
MODEL I.tUMBER: lO �W CAPACITIES: A= 1 c J INCHES OR 3� CALLOUS
SWITCH TYPE' � B= ? IMCHES`OR ` G(LLOIJS
PUMP MANUFACTURER: GO U L C r ILILHES OR 13 b GALLOIJ
3011P�S
MODEL HUMBER: D - lO IN`CHHES OR 110 GALLOWS
SWITCH TPE: C -U2=� ARE MOTE: PUMP AMD ALARM TO DE�
Y PL
MIMIMUM DISCHARGE RATE 3, ' `� GPM INSTALLED ON SEPARATE CIRCUITS
VERTICAL DIFFERENCE DETWEEU PUMP OFF AtJO..DISTRIBUTION PIPE.. l '37 FEET
+ MItJIMUM WETWO SUPPLY PRESSURE , .. .. 2 S FLET
+ SS FEET O F FORCE MAIN X L-),4 F � FKICTIOU FACTOR FEET
100 FT.
_3
TOTAL Dy1JAMIG HE:AO = t (3 - fEET
DIAMETER —
Pump chamber 3 II
IIJTERLIAL DIMLWSIOWJ 1 OF TAAIK: LELIGTH ;WIDTH — ;LIQUID DEPTH
BOTTOM AREA 231= _ GAL /INCH
AS PER MANUFACTURER -- - Vl - GAL /INCH
' Goulds b o�
Submersible
Effluent Pump
9- u
3871 EPO4
- EP05
APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron
Specifically designed ned for the stainless steel. grade turbine oil for for efficient heat transfer,
• Capable of running lubrication and efficient strength, and durability.
following uses: a to heat transfer.
•Effluent systems dry without damage ■Motor Cover: Thermoplas-
• Homes components. Available for automatic and tic cover with integral handle
Motor: and float switch attachment
•Farms manual operation. Automatic
• Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical points.
• Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty
• RPM, built in overload with rated oil and water resistant.
Dewatering automatic reset. preset at the factory. .
Single phase: 0.5 HP, ■ Bearings : Upper and lower
• EP05 S heavy duty ball bearing
SPECIFICATIONS 115 V, in 60 le phase:
0 RPM, FEATURES
construction.
Pump: EPO4 built in overload with ■ EPO4 Impeller: Thermo-
• Solids handling capability: automatic reset. plastic Semi -open design
3 /a" maximum. • Power cord: 10 foot with pump out vanes for AGENCY (LISTING
• Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. SP Canadian Standards Association
• Total heads: up to 24 feet. with three prong grounding n EP05 Impeller: Thermo-
• Discharge size: 1 NPT. plug. Optional 20 foot (CSA listed model numbers
• Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in "F" or "AC ".)
rotary/ceramic- stationary, three prong grounding plug improved performance.
BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged
• Temperature: thermoplastic design provides
104 °F (40 °C) continuous superior strength and
140 °F (60 °C) intermittent. corrosion resistance.
• Fasteners: 300 series METERS FEET
stainless steel. 10 _
• Capable of running
dry without damage to s 30 ; T--► . GPM -
components. -- - t-zSFr j
Pump: EP05
• Solids handling capability: 0 7 25
3 /, maximum. W - -- - —� --t- -- - - - -- - -- - --
• Capacities: up to 60 GPM. s 20
• Total heads: up to 31 feet. j tg •3 j
• Discharge size:l'/z "NPT. z 5 - -- i -- - -_ ____
• Mechanical seal: carbon- ' _
0 15
rotary/ceramic - stationary a q -- EP05
BUNA -N elastomers.
--
• Temperature: 3 10
104 °F (40 °C) continuous - - - -- — - - -- - EPOa - - -- - - - --
140 °F (60 °C) intermittent. 2 t I
5
1
0 00 10 20 30 40 50 GPM
L -L 0 2 4 6 8 10 12 ml /h
CAPACITY
0 1995 Goulds Pumps, Inc. _ Effective May. 1995
Wisconsin Departrnent of Industry, I le(a) L 1TT ET EVALUATION REPORT P of 3
Labor and Human Relations 0 —
Divis of Safety & Buildngs i rd wr� I10-113 83 .06, Wis. Adm. Code
COUNTY
Attach complete site Pl on paper riot �t `F�l�b n 81/2 ffln size. Plan must include, but not limited to vertical and horizontal ref point BM), direction and % of ,
scale or PARCEL I.D. #
0wa o ti -q o
dimensioned, north arrow, and location eft r�7 _ S -106
APPLICANT INFORMATION -PLEA INT AftTIAO RMATION,I REVIEWEDBY DATE
PROPERTY OWNER: �: ' ROPERTY LOCATION
i V3 a.Y S Q-t A-3 L GWF±0T >vF va Se 1/4,S 30 T Zq ,NR 1Z E (04i)
PROPERTY OWNERS MAILING ADDRESS 5 LOT # I BLOCK # SUBD. NAME OR CSM #
- Iqu X ST - Z —
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY []VILLAGE ®TOWN NEAREST ROAD
) fi" "'0 X 111 sgols ( l S3-17 VA MOki I \ �p TV ST.
K New Construction Use D4 Residential / Number of bedrooms 3 [ J AdMqn to existing building
[ J Replacement ( J Public or commercial describe
Code derived dally flow gpd Reco mlended design loading rat - bed, gpi:W trench, 9pd*
Absorption area required 3`1 S bed, 11 a-- S trends, ft IuNaAmlrm design loading rate • S bed, gPd* ' 6 trench, gpd/ft
Recommended infiltration surface elevation(s) \O 1 It (as referred fA site plan benchmark)
Additional design/ site considerations w'10 w / 8'Y- q g Q6 , M I &v . i ' o F- S" j-t LL .
Parent material sue- u- Rood plain elevation, I applicable fl • ft
S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTB�r IN FLL HOLDING TANK
U = Unsuitable for terra 11 S ®U 0S ❑ U El !9U ❑ S EAU IDS ®U ❑ S IRU
SOIL DESCRIPTION REPORT
Boring # Horizon Depot Dominant Color Mottles Texture Structure Consistenoe Bandary Roots GPD /ft
in. Munsell Qu, Sz, Coat Color Gr. Sz. Sh. I Bed
I O_LO ��`1R ZlZ sit Z FS�1� wt'Fh CS - S .L
Z 1 -Z-1 LO `t 2 3J L si ( Z. F Sbk m'F!- Cw -S
Ground 3 2,1 S`tR 3l _ 5 cSu1t
elev.
X It. y 3y -SY s `t►z 3/y ;s�R sJs; sc� o wt`�;
Depth to
limiting
factor
3�1 "
Remarks:. G�oUh1D ,Z S�a�r yfiT 3 i,
Boring # O -1 O tp•-I ti 2 L 2 s 1 1 Z�sb�
Z Z L�z3 \o� ►Z ��L si I Z'� w,`F►- c�v •S b
3 23 33 S `t Sl - s I l 0-S
Ground
elev. Al - S'l IZ 3) y - � l . S'r a S /g i
106- It
Depth to
finuting
factor3 ,
Remarks:
CST Nam« - Please Print Arthur L. We erer 715- 425 -0165
eg%rer Soil Testing & Design Service -P.O. Box 74 River Falls,WI 54022
Date CST Number:
°l1 -l'Zp - 2 S -> -�l7 M00576
PROPEMOWNER SOIL DESCRIPTION REPORT Page _�- of 3
PARCEL I.D. #
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bouxdry Roots GPD /ft
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Wendt
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2 16 _1 , . 1Z�`1kZ 2 f M F, - ck,,
Ground 3 Z 6 -3 y -� • S 2 3 / - S e-s �� m�i- c -- . S
elev.
�bn eft Q, —
Depth to j
limiting
factor
i
Remarks:- -'� byPtfi®Z S'R�it RT 3y
Boring # ,
.13
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
13 i
Ground
elev.
ft.
Depth to i
limiting
factor
Remarks:
Boring #
j .
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{
Ground
elev.
ft.
Depth to
limiting
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Remarks:
SBD- 8330(8.05/92)
PLOT PLAN Pa 3 of 3
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CST Signature Date Signed Telephone No. CST #
Wisconsin Department of SOIL AND SITE EVALUATION REPORT Page \ of 3
Division of safety a atmngs in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan mud include, but ST . CtZO'1 yC
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road. O 1$ - l 0 61- CI O
APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
I Ll���l GWF-LW 1vSZ� 1/4 Sg 1/4 3D T Z-9 ,NR Q E (
PROPERTY OWNER'S MAILING ADDRESS LOT # I BLOCK # SLED. NAME OR CSM #
'1q0 1.60 Y�V Sr- Z — C.S.wt-
CITY, STATE DP CODE PHONE NUMBER OCITY QVILLAGE ®TOWN NEAREST ROAD
w►wlo_k�. ,wI sgot. ()fSO4 &_ 5a - ) - 7 y HOKJt�' I \ ) . o ` 1f %T -
K New Construction Use Residential! Number of bedrooms 3 [ J Ad&Qn to ebsbng buikling
[ J Replacement [ J Public or commercial describe
Code derived daily flow gpd Recommended design loading rate - bed, gjxW trench, gp W
Absorption area required 3n S bed, ft2 3-1 S traxk ft Mabmum design loading rate • S bed, gpd/ft ' 6 trench, 9pdN1
Recommended 'infiltration surface elevations) \ O \ • - 1 It (as referred ID site plan benchmark)
Additional design/ site consideratiors +n O UtiD w / 8 ' X k4 - 1 ' 8 QZ� • M 1 v . 1 ' o F S F::- LL .
Parent material ft-t- "T1 Ll Flood plain elevation, d applicable Iry fl - ft
U= Unsuitable f� sys � SS ® 19 $ 8 ❑ U ❑� c S ( PRESSURE A S 2U 0 S IOU L 0 S IRUU
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure C.orsisbernce Boundary Roots GPD /ft
in. Munsell Qu. Sz Cont Color Gr. Sz. Sh. B� rrierO
0 - 1p`LR ZLZ S Z'F S�tz'FH CS - S .`
Z 1 b -Z. LO `t2 3JL st I Z Fs yn'F>- cw •S
Ground 3 ZI -3 y -) - S `1 R 3 l - s ti � c S Vet µ1 �f. C S _ _Y .S
elev.
X 01.1
It SL12 sJ?,
Depth th
limiting
factor
3y"
Remarks.. G OU�p 1 Z S A C 19 T y r , \
Boring # ' 04 O 1�y,1i Z (2 S l l Z'� wu'F►- e S _ . S . L
Z Z 1623 10`1 2L` si I - J3b M ct" •S b
Ground
3 �3 33 1 •S �11Z 31 - �1 l e..s ti��f � eS - •�l •s
elev. 33 -S3 S y IZ 31 y � S it S /8
1 �ft
Depth to
limiting
Remarks: GL? o l,n �l�i.�,p�Z S�PcEe� fj't 33` .
CST Naw Pdm Phow
Arthur L. We erer 715- 425 -0165
egerer Soil Testing & Design Service -P.O. Box 74 River Fa11s,WI 54022
Data -`� cj 7 CST Nil p 0 5 7 6
PROPERTY OWNER S C0_ '1f.1 SOIL DESCRIPTION REPORT Page of 3
PARCEL I.D. # o L13 - �,o 61 - q
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft
In. Munsell Clu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
3 0 -1 1O`1 R Z( S I Z Sb4 Yh — Fv
lo�tz o/ L T)
Ground 3 Z� -3 y '� • S y fZ 3 / - S e s X12 m�i- . S
elev.
�0L-jfL L( y -SO S yfZ 3/y `�.SItR Slg —
Depth to
limiting
factor
Remarks: GLZoyrv>Z, kvPTM'Z S cF PVT 3q
Boring #
a
Ground
elev.
ft. ,
Depth to
limltlng
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
; ,Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD- 8330(R.05/92)
PL P LA Page 3 of 3
SCALE 1 "= L1O '
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CST Signature Date Signed Telephone No. CST #
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer
Mailing Address /
Property Address 7 44 ) �0 +k �}
(Yuificatioa requirod from Planning Dcpartmcat for new construction)
Cit3atate _ ti oC �` Parcel Identification Number C / g ' 06 _f — — l On
LEGAL DESCRIMON
Property Location /I/"E.- y, s4_ y�, Sec. 2 ,0. T -R W, Town of W. �* m d
Subdivision s Lot
S
Certified mTey Map # �� G'O' y
. . _ ,�_ Volume , Page # 3a24:�'
Warranty Deed Volume /®e.2- . Page # 11fa
Spec b Ouse (3 yes ❑ no Lot Imes ideatifiable [$ yes ❑. no
S YS T E l �' I�� 4 fA NTE Ni 4 NC E
1MpMQper=e1nd=2iMf4nMWc �y,�Kpfic CouldnmkiiLitsptr atatiefa irCetoI�aadiewasLcs.Propera Ocaanoe
out &C a boa of tie tMkCV=y d= yC= or ifacededby itNc=cdp=p= Whaynu pat.mto the_ system
rcpbia taati fccatmcatstag�e m the �raste�osaisys�.. .. - _
lb-' Y owner am= to submit St. CL o& Zoning Department iL catiscation loan, signed by the 4w= and by a
. ' P��yasaaplumbcr; s�ctodpbrmbcro�c": 1i�ocascdp�pervrtfYing6tat( ij$ i, eoa�itavrastewatcrdtsposalsyszcm
is is PmPcl opcmlu g condition an(yor(2) after=Pmtioa tad pumpmg.Cif y). the scpt r- tanlcis less tbaa m dull of shrdge.
V*c. &c undcrsko have sad rite above =qd=qcnft and agmoe to ma;-W, the pmrate sewage disposal system with *c stand,ids
id focd� h=k s set by tie Dqatned of Cmma+oe and the DTaft cat of N du rd Resoamvcs State of Wisconsin.. certification
StIft Your septic System bas bocce maiata>ned amt be compldod and mcbumed to the St. Croix.Cotmty Zoning Office wid is 30
days of the;,G= yCar lion date.
y .
SMAfbn OF APPUCANT DATE
OWNER CERTIPTCA.TION
I (we) oatlfy dW all srtat=cats on this form am true to the best of my (our) Imowledgc. I (we) am (arc) the owner(s) of
�e dese %ed above. by virtue of a wananty decd mnoor&d in Register of Deeds Office.
SI U JI OF APPUCANT
DATE
« « « «s« Any information that is mis4R'c acatcdmay mcsult is the sanitary permit being invoked by the Zoning Department. ««t
ss Indude with this application: a stamped warmaty dood from the Register of Dec& o1rce
a copy of the oatlfcd survey map if rofcreaec is made in the warranty dcod
ss ss 'VOL 1092ma 186 FJIUN i � T � ' `1 O1994r
et 8 :30 AAA #A
WARRANTY DEED
(WISCONSIN) IM��aarelDe+di
MOLTZEN FARMS, INC. ,Grantof,of
CLARK County, WISCONSIN , CONVEY and WARRANT to
TERRY D. SCHNABL and SHERYL L. SCHNABL, Joint Tenants
ST. CP.OIX County,
Wiscoadn,for the sum of THIRTY -FIVE THOUSAND FIVE HUNDRED AND N01100 ------------
($35,500 ), the following tract of land in ST. CROIX County,
WLnonsin,towit: Northeast Quarter of the Southeast Quarter (NE % -SEk) of
Section Thirty (30), Township 29 North, Range 17 West.
lb®ether with easements, restrictions and rights -of -way of record, if any.
Wkwas the hand and seal of aaW Grantor this 3rd day of
June ,1994.
n `
In the presence of: �C
MOLTZEN FARMS, INC., PR DENT (SEAL)
MOLTZEN FARMS, rtqC.t SEERETARY'�
(SEAL)
(SEAL)
ACKNOWLEDGIWENT
STATE OF WI NSIN1 }`
°
COUNTY OF , . • ........, , ,f i +�! .
Personally n , �bJ 3 Fd day of June , 1994 , the above
(of wWdn)named': , jM/1t 'ltd Ida G. Moltzen
to me known to be the persons who executed the foregoing (or within)
instrument and ac sadne� E
.�7��
MY oommhaMtt expires: 4 • — C Mtwy publk
ca""ty. wisc(miw
ED
8
19
560049 to
CER11F'IED 'SURVEY MAP s
Located in the Northeast Quarter of the Southeast Quarter of Section 30, Township 29 North, Rang
West, Town of Hammond, St. Croix County, Wisconsin.
Prepared for and at the re4est of: NORTHEAST CORNER
OWNER: SEC. 30 -29 -17 \
Terry and Sheryl Schnabl (ALUM. CO. MON.) I 1
740 160th Street is
Hammond, WI 54015 NI i OR
Drafted by. Kristi A. Eylandt I rl wl
Count Section Corner Monument ao101 N
of Record 1 N1 LO EL I I w
• Set 1" x 24" Iron Pipe weighing I oI MN of O I I O I
a minimum of 1.13 pounds per U L AN D S -A Z1 wl . I - v N�
linear foot. 1 (j I gl s r 1
01 °I P
M= Measured As I
NORTH LINE OF THE NE 1/4 OF THE SE 1/4 I of � o 1
R= Recorded As >1 ° 66'I h
-- --- - - - - -N 8938'54" E 5313.79'- - - - - --
-- --
0 - - - - - -N 89'38'54" E 1314.34'--- - - - -�-
- - - -- 725.00'- - --
589.34' - - -'�/ 1 -- - -- 692.00'
\\ 'o .o TOTAL AREA LOT 1 I \ \ w
00
195,750 SF./4.49 ACRES j II \ \
C N rn N AREA EXCLUD. R.O.W.: oN I \
V �M I 3 186841 SF./4.29 ACRES 33.00 -N 1 1 \ I w
i
N 692.00'
S 89'38'54" W 725.00'
Ci z I T °o TOTAL AREA LOT 2 ip E'
195,750 SF./4.49 ACRES 1 00 l
Z N AREA EXCLUD. R.O.W. : 33.00: NN
o� d W 1 I 186,841 SF./4.29 ACRES �� I In I �I W
ZI t I � \ /, - -- 692.00' - - -�_ �� \ I0 j WI ( N'
-' r- - I / � - - - S 89'38'54" W 725.00'- - - : —� I I I � Z LU
LOT 3 sEPnc i I
a1 TOTAL AREA
3 : ® D I I o I '�
P I 1,329,726 SF. / 30.53 ACRES SHED I
IBC' 0 \ QI
N �I
:D1 � N I AREA EXCLUD. R.O.W. W ; I to g m W o I
r 1,304,295 SF. / 29.94 ACRES j ; oII N Z ��
Z o ��s�e.saemo « Z ®• � I N l
I �
LIJ ZCjG r I W � o
9 -7 Q WELL : 0 w 1 i 1
r i• I I O 01 �
RONALD F. * : I o I �o 1 2
_ I in I I r (o1�
2 JOHNSON 100' BUILDING SETBACK I ro 11 1 0 V-1 AMERY. LINE (FROM R.O.W.) \�; 0 I v1 Q
wls. : i N I I j
!{p� 160th St. R. 0. W.
;� S 0e o� 33.00. 1
-- - - - - -- -128 .6 '--- - - - - -- /I 1
— — — — — — — — — — — -
- -- - - - - - -M = S 89'48'31" W 1315.69' - - - - -- - 3
R = S 89'48'30" W 66,1 I
1 SOUTH LINE OF THE NE 114 OF 7HE SE 114
I LOT 3 n l � I
CS 0
M M I
DOC_ NO. 505545
1 VOLUME 9 PAGE 2684 1 /
------- - - - - -- SOUTHEAST CORNER \ /
1 SEC. 30 -29 -17 \ /
(FND 2" 1. P.
NOTE: The parcel shown on this map is subject to State, County and Township
laws, rules and regulations ( i.e. wetlands, minimum lot size, access to parcel,
etc.). Before purchasing or developing any parcel, contact the St. Croix County
Zoning appropriate Office and the a ro riate Town Board for advice.
JOB #97035 250 0 250 NO TH
Prepared by:
A & E GRAPHIC SCALE
LAND SURVEYING & CIVIL ENGINEERING SCALE IN FEET: 1 inch = 250 feet
Phone No. (715) 246 -4319 BEARINGS ARE REFERENCED TO THE EAST LINE OF THE
109 East Third Street, P.O. Box 325 SE 1/4 OF SECTION 30, TOWNSHIP 29 N., RANGE 17 W.
New Richmond, WI 54017 WHICH IS ASSUMED TO BEAR S E.
00 4"
0 E
Sheet 1 of 2
Vol. 12 Page 3268
V
4 0
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IN
I �zs
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