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HomeMy WebLinkAbout020-1346-10-000 i ST. CROIX COUNTY ZONING DEPART 1 AS BUILT SANITARY REPORT Owner SA M IntiC tcf%Z_. e� � R ECEIV ED Property Address 7/$ 7 C .,* 1 .E -- M9 S City /State H D <,d M LU ( YG' 6 ST C+O+X COUNTY ZMINGOFFICE Legal Description: Lot // Block Subdivision/CSM # ��- i # // 6///F c 7 / f ' Q' '5W W 1 /a � /a, Sec. t_(_ T�1_N- R_���num of �-I J.O_S t� AL PIN # 0 0 0 �'�"� y�e l SEPTIC TANK DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer W Z 13sF OF-.. Size ST/PC Z $ / Setback from: House Well COQ " P/LL Pump manufacturer — Model �- 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: FCC N Width Length Number of Trenc�es .� Setback from: House 1 / 3' Well `' P — � S Vent to fresh air intake I S ELEVATIONS �J Description of benchmark 'TO d F �D �� � i � �� � C��J���,d�✓ � � . S' � Elevation/ Description of alternate benchmark 7 0 P C�F t ICS K D ECO N A I C , fl/ 0, SQ Elevation /d .074 -,., Building ldin Sewer 5.33 = 0, AT/HT Inlet = 7 ST Outlet 2Z �g' 38 PC Inlet PC Bottom Header/Manifold q 94 " p of ST/PC Manhole Cover 2 2' Distribution Lines ( ) 14, Z- je' ?Y ( ) l 7 Z ' �f , $`� () / Y. 7 7 " 10 Bottom of System ( ) (( 1 0Z:- 'V ) (i1"02 = �5 �'� ( ) (l� = �y ► Final Grade () to -0c) ; ,7 ( ) 14, 00 Date of installation /( 1 99 Permit number V State plan number Plumber's signature V�I r �Jo►.�.e,(� License number 2 Z D (w Date �� Inspector 6-11 / Complete plot plan or i NOTICE Please provide the following: • A lan view sketch showing everything within 100 feet of the system. p g � g Y • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW Ted" 0 'At It lr4n T-4 r� 4 f A a T "'? y INDICATE NORTH i Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM County: INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) SanitaryPerm IX 3445 Per information you provice may be used for secondary purposes [Privacy Law s.15.04 (1)(m)). Per Holder's MILLER SAM [3 City_ ❑ ill Town of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description: t1UD 1V Parcel Tax No.: 00 s�( c 020 - 1346 -10 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic �.. r Z�V Benchmark 5,'G lo5 /0 0 Dosl b0 p� OF Aeration Bldg. Sewer 57 /00. K 3 Holdin t Ht Inlet . 9S 9 d - 73 TANK SETBACK INFORMATION P/ Ht Outlet, 3 JA TANKTO P/L WELL BLDG. Vent to e ROAD Septic 9 q! f N f Z"� I NA Do A Header / Man. y 96 Ion NA Dist. Pipe d1-r Bot. S ystem � Holdin 9 , PUMP/ SIPHON INFORMATION Final Grade sy e- r S b S nufacturer and r Model Nu GP TD Lift L System TDH Ft Forcemain Length Dia. H ist. To wel SOIL PTION SYSTEM / r5 BE91TRENCO Width Leng No. Of T enches PIT No. Of Pits Inside Dia. Liquid Depth / l DI 3 DIMENSION SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM G Man a urer CH M R r INFORMATION Type 0 _ Mo N e System: F J /( 3 r NIT ; , DISTRIBUTION SYSTEM d' Header/Manifold � Distribution Pipe(s) r x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length 60' ? ; - ' Dia. Dia. _ ,4�1 Spacing N ZQ r 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.) LOCATION: HUDSON 11.2; 61,SW,SW 718 PACKER DR — HOMESTEAD LOT 11 � - g e // -r f �l (, e-" 3� we ke'f iw a 40 Plan revision required? ❑ Yes ❑ No Use other side for additional information. (I V r t hd SBD -6710 (R.3/97) Dale ,pector's 5 in ure Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: I e o I r e I . t t e e e a x e e .- � E w k 1 t t 1 e a e � s 1 E a } 3 3 t m 3 3 g e, i 3 ? j f t 3 E � a t Q x } f F e E i F .. ......... . . :... n.. .,. ,.., e .. ....., -....n q ... . »,,. ., .. ,..., . , , ., a ..... .. „ . .� ,. .. .. .... , -. a } 4 i s r 3 2 3 e , } e aP �,- srl oj \, Safety and Buildings Division SANITARY PERMIT APPLICATION 201 W. Washington Avenue Vi sconsin In accord with ILHR 83.05, Wis. Adm. Code P O Box 7302 Department of Commerce Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County / than 81/2 x 11 inches in size. 4. CI'O f • See reverse side for instructions for completing this application state sanitary Permit Number Personal information you provide may be used for secondary purposes Cneck _ revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATI N Property Owner m e � Property Location (� (�I14 /4, 5 � T 29 , N, R1g E (o Property O ner's Mailing Address Lot Number Block Number Bo X 1S/ Aft , State Zi Code Ph Number Su Nisi n N me or CSM N tuber S yo�y3 Ivan 149 TO . TYPE OF BUILDING: (check one) ❑ State Owned it N arest Road g p Village # DS aw A M E,c.- P&I 11 /4 Public 1 or 2 Family Dwelling - No. of bedrooms Town OF III BUILDIN U E: (If building type is public, check all that apply) Parcel Tax Number(s) /f Z9. / f, 126 1 ❑Apartment /Condo / 3 k4- to Cy 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,j New 2 E] Replacement 3. E] Replacementof 4. F] Reconnection of 5_ ❑ Repair of an /`_`_System System Tank Only Existing System Existing System B) A Sanitary Permit was previously issued. Permit Number ?4if Date Issued V. TYPt OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed _ 21 (:]Mound 30 E] Specify Type 41 ❑ Holding Tank 12 Seepage Trench L� t4 22 ❑ e s In- Ground Pr re -1 42 ❑ Pit Privy 13 E] Seepage, Pit TK I K� 11- 19 o � x 6 �. 7 S 43 ❑ Vault Privy 14 ❑System- In- Fill��" µ s S I: 1. g Sgf !!� /D E_ V.) IN EA- VI. ABS ORPTION SYSTEM INFORMATION: 1. Gallons Per Day Rquired bsorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade to t� � ir (sq_ ft.) P p�o (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) c �1�, levation V rT 4 .- 5 ! r .� O Feet '7A O Feet VII TANK Cap acit y in gallo s Total # of r Prefab. Site Fiber Exper. INFORMATION Gallons Tanks Manufacturer Name Concrete Con- Steel glass Plastic App New Existin strutted Tanks I Tanks Septic Tank WE'` ❑ ❑ ❑ ❑ ❑ Li ber r ❑ 1 ❑ 1 01 ❑ 1 ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT I, th undersigned, assume responsibility for installation of the ons sewage system shown on the attached plans. Plumbe Name: (Print) / / Plumbp Sig tur jWp a MP No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code): �q c70 IrJ 6 o� c) V/ IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater D ate I ssued Ilssuin Agent Signature (No Stamps) Approved ❑ Owner Given Initial Surcharge Fee) Adverse DeterminationtJ X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: / dn1kn - .X1 ei• SBD- 6398 (R.11197) 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. 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 81/2 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 Division V sconsin SANITARY PERMIT APPLICATION 201 B Washin in Avenue 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 1/2 x 11 inches in size. Co 1 • See reverse side for instructions for completing this application State Sanitary Permit Number 3 A?,5;28' 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 �— Propert Owner Na Property Location F A_ So i4S 1 /4, S TN& , N, R r E (or Pr erty OwMr's Mailing Address Lot Number Block Number ��� Cit , State Zip Co Phone Number Subdivision Name or CSM N e I 162 NOME _-S SWIK3,1w! . TYPE B ILDING: (check one) ❑ State Owned E] its crest Road Public 1 or 2 Family Dwelling - No. of bedrooms ° own of V 9D r & m- III BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) n - jai 10%1 1 E] Apartment/ Condo 4!>Z 3 v(, — (o l _ co o 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) New 2. E] Replacement 3. ❑ Replacement of 4_ E] Reconnection of 5. ❑ Repair of an __System -------- System _____________ Tank Only______________ Existing System ________ Existinq System B) E] 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�aSeepage Trench LEA( 22 ❑ In- Ground Pressure / 42 ❑ Pit Privy 13 ❑ Seepage Pit a wri L-T &OTO A + 3 x 7 C 43 ❑ Vault Privy 14 ❑ System -In -Fill A r► S / 0 F t4 ZA t VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 13. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev 7. Final Grade Required (sq. ft.) Proposed ( q. ft.) (Gals/day /sq. ft.) (M /inch) / ✓ Elevation, S� 6 4 ,, r 59 Feet 9 yo d Feet Ca acct VII. TANK in allo g Site Total # of Prefab. Fiber- Exper. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Exist in structed T Tanks - epticTan 1000 � /d�'.,� ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ I ❑ 1 ❑ 1 ❑ I ❑ ❑ VI11. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumker' Si natur (No Sta MP /MPRSW No.: Business Phone Number: Plumber's Address (Street, City, State Zip Code): 4 0 F D V 1 (, w 1 %. wf IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved S nitary Permit Fee (Includes Groundwater ate ssue Issuing en Signature (No Stamps) �A roved Surcharge Fee) pp []Owner Given Initial � c ! Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: 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. 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, 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 81/2 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. Tf A 1) Lod 7/S Pha Et Daive TF w � t, w"44 /P L 9 z- 7 A/ A t h -F e 3 3,- LOT - z . c rN Sy r Sir 0 �� � i � za AI &T4-; E3 L jVA 173 Vic PHONE Pro 1 V ' "� • •V 1 a E '. E Z C r-- N x (0 N N L c fl y C cf) O O j o x N O Q w a co In/ Q y cz 3 O O C C c O N p F— clf 1 co V U »� C C 'O O 0) > a ch N O N X 4_ Q) t N c�U (�0 .� O i 4 J aI m ct7 > x m N N O U C'p U O c C3 .� C Q O O O v) : CL • • • • NJ ,T �n �! a•'. 4 � C ~ i cV w i V '4T, N � _ a � �-� C `� � p... �.__ h V U COP .: v Ila O E 8 a .�,. v U ® I Z . o W 3 O U N c .Q U ° ° W E co m . g Q (Z �- 1 � W �' y 2 r Cl 'H ffi C 7 In � ml J d Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code _Environmental By Design Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D.# APPLICANT INFORMATION - Please print all information. Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Re ' By O p� Property Owner Property Location L I Q MILLER, SAM Govt. Lot SW 1/4 SW 1/4 S 11 T 29 N,R 19 W Property Owner's Mailing Address Lot # Block # Subd, Name or CSM# TROUTBROOK RD 11 Homestead City State Zip Code PhoneNumber E] City Village ®Town Nearest Road Hudson WI 386 -8692 Hudson Labarge New Construction Use: Residential / Number of bedrooms 3 ❑Addition to existing building Replacement Public or commercial describe Code Derived daily flow 450 gpd Recommended design loading rate .7 bed, gpd/ft .8 trench, gpd/ft Absorption area required 643 bed, ft 562 trench, f1 Maximum design loading rate .7 bed, gpd/ft .8 tr ench, gpd/W Recommended infiltration surface elevations) 88.75 ft (as referred to site plan benchmar Additional design / site consideration Parent material loess over outwash sands Flood plai n elevation, if applicable ft S= Suitable for system Conventional Mound In -Ground Pressure AT -Grade System in Fill Holding Tank U= Unsuitable for system ® S ❑ u ® S ❑ u ® S ❑ u ❑ S ® u ❑ S ®u ❑ S ® u SOIL DESCRIPTION REPORT Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Bounda Roots GPD/ft2 Boring# in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench 1 1 0 -11 1Oyr2 /1 - sil 2msbk mfr cw 2f .5 .6 2 11 -28 1Oyr4/4 - sil 2msbk mfr cW if .5 .6 Ground 3 28 -44 1Oyr4/4 fld5yr6 /4 sil 2msbk mfi cw -- - - elev 97.32 ft 4 44 -57 7.5yr4/4 - s Osg ml cw - .7 .8 Depth to 5 57 -71 7.5yr5/2 fld5yr5 /8 sil 2msbk mfi cw - - -- - -- limiting 6 71 -120 7.5 4/4 - s Os ml - - 7 8 factor g Remarks: 2 1 0 -18 1Oyr2 /1 - sil 2msbk mfr cw 2f .5 .6 2 18 -29 10yr3 /2 - sl 2msbk mvfr cw if .5 .6 Ground 3 29 -40 10yr4 /4 - is 2fsbk mvfr cw - ~� �S r .Ys elev 91.22 ft 4 40 -110 7.5yr4/4 - s Osg ml - - 7 8 Depth to limiting factor ok 110 S �' Remarks: CST Name (Please Print) Signature; 5 Telephone No. Thomas C. Nelson `��� 715- 246 -2454 Address Environmental By Design Date CST Number Ref # 1432 120th Street, New Richmond, WI 54017 8/18/98 227387 68 I� PROPERTY OWNER: MILLER SAM SOIL DESCRIPTION REPORT ® Page 2 of 3 PARCEL I.D.# Environmental By Design Depth Dominant Color Mottles Structure GPD/ftz E rizon in. Munsell Qu. Sz. Cont Color Texture Gr. Sz. Sh. � onsistence Boundary Roots Bed 'Trench 3 1 0 -22 10yr2 /1 - sil 2msbk mfr cw 2f .5 .6 2 22 -44 10yr3 /2 - sil 2msbk mfr cw if .5 .6 Ground elev 3 44 -48 7.5yr4/4 - s Osg ml cw - .7 .8 94.91 ft 4 48 -130 7.5yr7/6 - s Osg ml - - 7 8 Depth to limiting factor a Remarks: 1 0-10 4 1 10 3/2 sil 2msbk mfr cw 2f .5 .6 2 10 -25 10yr4 /4 - s1 lmsbk mvfr cw if .5 .6 Ground elev 3 25 -35 7.5yr5/6 - s Osg ml cw - .7 .8 98.44 ft 4 35 -37 7.5yr5/4 - cs Osg ml cw - 7 8 Depth to 5 37 -105 7.5yr6/4 - s Osg ml - - 7 8 limiting factor >1 Remarks: ,r 1 0 -18 10yr2 /1 - 1 2msbk mfr cw 2f .5 ! .6 2 1847 10yr4 /4 - sl lfsbk mvfr cw if .5 .6 elevund 3 47 -57 10yr7/2 f1f5yr6 /4 sil lmsbk mfi cw - +►�" 94.72 ft 4 57 -80 7.5yr5/4 - cs Osg ml cw - 7 8 Depth to 5 80 -124 7.5yr6/4 - s Osg ml - - 7 8 limiting factor 47 -57 ck Remarks: Ground elev Depth to limiting factor Remarks: ENVIgONMENT BY DE51GN 1432 120th STREET, NEW RICHMOND, WISCONSIN 715- 246 -2454 PROJECT NAME HOMESnAD Imo' PAGE 3 DESCRIPTION SW % SW 1 /, SECTION 11 T 29 N, R 19 W TOWNSHIP Hudson COUNTY St. Croix 0 Iv �eT 12 2,75 c.- cr-{s P r I M 'c", L7 rh t Q3 ;� r v —r. .3 r- �` U �. j SCALE I"= Tom Nelson BM 1. /J o /C& csTMO 2605 � boo P P BM 2. 7Te1e p 11a j,c ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 5/-94 AA ( L, L-,r Mailing Address ab X 4 (,S Property Address /� je_ C' AA _ (Verification required from Planning Department for new construction) City /State 4 y Q,S ON LO ( Parcel Identification Number LEGAL DESCRIPTION Property Location S L0 %4, w '/4, Sec. , T_j1_N -R1_q_W, Town of 14 00-S d &I 'Subdivision k in Lot # CerliCed Survey Map # Volume , Page # Warranty Deed # -7 4 , Volume Page # _ . Spec house yes ❑ no Lot lines identifiabyes ❑ 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 master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Itwe, 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 St. Croix County Zoning Office within 30 days of the a year expiration date. Ll 'MGW ATURE Of AAP DATE -41 0WNER CERTIFICATION : is I {we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the pro escribed abo e, by virtue of a warranty deed recorded in Register of Deeds Office. /Z / NATURE 01? ' PLICA 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 ~ •,I; STATL. BAR (IF %VISCO \SIN F0101 I - 19b2 " • .r _a r. .cN.,.` ,os Iltcoen.na o.r� W DE? This Deed, n.Pde b,tween L. is i 1 1 ie and `aoht. R. t,,il l ie, husband and M A R Grantor, 10: .10 A. .,nd yam E. `tiller, a .si n r;le. p.er , Gr•Intec, Witnesseth That the said (;rantor, for a valuable con31derat,on - NciVna ro co.iv,,s t•, Grantee the folluwu.g dessrbed real estate in S-t,, Croix C ,unt), State of K•Isc( nsln: See attached description. Tart 1 .►reel tiu: ... ............................... . TRANSFER This is not.... . homestead property. (Is) (Is not) Together with all and singular the heredltaments and appurten..nces .crreuntu bt. urging; and Ronald L. Willie and Naomi R. Willie warrants that the title is good, ualefe;..rblt in fet simple and free and clear „f encumhr:,,ltes except easements, restrictions, and rights -of -way of record, :,nd will wan ant and dciend tie i,me. uatcd till. day of `larch 19 9 (SEAL) '�'ti`� �� L. c1 ' �.� �* c (SEAL) _ Ronald Willie (SLAL) -/�' e '..0 / L.G LcC (SEAL) . Naomi R. Millie AUTHENTICATION ACKNOWLEDGMENT Signature(s) ..... _ .. .._ _ ............... STATE OF %%ISCONSIN % ss. - .............. .......... ..... ._. - ...... ............... ) C.. C roix .._. ... County. , uuthcnticated this ..._day of ,. 19._... Persona came beG.re me this .!r1 .....day of .......... ....... ... Hs(KCh., 19 9b.. the above named ..... ................ . ............Ro -na l.d...l..,._W i.l tie ... and ..... .. - ........... • _ .... _. .......... .... .... NAQm k..R,... 41 lie ................- TITLE: NIEIIBER STATE BA It (-F WISCONSIN (If not, ... - .... _ -. _ _ authorized by 9 7(i6.C N Stc,t. — to me known t„ i,e the per -,-n .S.. ...- who executed the foregoing instr -ment and..q}k the same. THIS 'N aTRUMZNT WAS D, .f I ED BY �•.\ .... ... -B L S .. .. .. C. L. Gayl-ord,.. Attorney ......._ —� 7►- _. _ • Irl( r2 IC _ River Fal is W.I 540.22 1 1 � t� r ... ....... Not :,�•t• Put „`r � .i..._k.'S. county, Nis. , '.�I n ati.r. - n ::y be IL,t), Jly (`On,uuskinn I , pfirnlphrnnt. klf ndt, .tutu expiration ..r; u„t I:,•., ..,ry.) date: > '..f” .ices/ /r," 19 0 :) %CARKA%TY DEED art. i. tit OF N'1�,'II \ >I?J K. L•' :.I I::.,.. V. ,'.� L•c. i I <<:r. r•arcEI of land located in the SE -1 of tf:e 51; - the ;V-1 /:. and in part of 1; 4 of the SV -1/4 of Section 11, Township 29 North, Fr,nEc 19 heat, 'loan of Hudson, being further described as follows: 6 etanning at the S -1/4 corner of said Section 11; thence hb9 29'03 "� , along the South line of the S►•: -1/4 of said Section 11, 237F.39 fEet; thence NO2 2F 06 i:, 1322.62 feet, to the 'north lire of LhE S-1 /2 of the $1: -1/: of Section 11; tFC S�� said North line, 2446. , feet to the North -South 1/4 line of said r � Section li; thence SOU 34'16 "i:, alone said North - South 1/4 line, 1325.6:, feet to the point of beginning. ParcEl contains 73.32 acres (3,1y3,674 Square Feet) and subject record. to all EasE-•Er,ts of Together with and subject to an easement for ingress and egress located in part of the SW -1/4 of the S1+ -1/4 of Section 11 and in part of the St. - 3/4 of the SE - 1/4 of Section 10, all in Township 29 Kurth, RantE 19 Vest, Town of Hudson, being, further described as follows: Corr at the 5-1/4 corner of said Section 11; ti- -, E . M9 29'03'%, along the South line of the St•: -1 /4 of said 237e.39 feet; thence K02 26'06 "6: 1256.54 feet to the point of bcg.innini; thence continuing NO2 1i 'Oo "►:, 66.06 feet to the Korth rk& of the S -1/2 of the S1: -1/4 of said Section 11; thence Nb� 35'50 "1,', along the Korth line of the S -1/2 of the SW -1/4 of said Section 11, 179.26 feet to the NE corner of the SE -1/4 of the SE -1/4 of Section 10; thence NS9 41'39 "1;, along the North line of the SE -1/4 of the SE -1/4 of said Section 10, 1318.24 feet to the West line of the SE -1/4 of the SE -1/4 of said Section 10; thence S00 25'39 "1;, along said test line, 66.00 feet; thence S69 "E, on a line being 66 feet distant Southerly a,-,d parallel to the North line of the SL -1/4 of the SE -1/4 of said Section 10, 111 8.32 feet to the E line of said SE -1/4 of the SE -1/4; thence S69 "i; on a line U inc 66 feet distant Southerly and parallel to the North line of the of the SW -1/4 of said Section 11, 162.54 feet to t}•� oin (9 t of heginnint. ParcEl contains 2.27 acres 5,9..6 Square FEEJ a n d is subject to right -of -way for towr. road c ,a subject to all easements of record. (Scott P.oad) and ^:.r forec7r - 373.x' 301433// 11141'4'/ WIf q 10 .W 104'14'/ 11441'4'1 r 1 111.14' IY•11Y1' . 311.14' 3I 10 15.11• lu.N' {514)'740 wblv1s'S ` 11.11 1 111.14' 17 34.01 u4ra4 113 u.w' 4.34' w•11'u41 n/4u•u•I 11.14 lA 111.14' 01 1A.M' alm 45147'11.54 1r1.11' 114.4' UI 504 "'U'I 1 111.11' 11 111.14' 0 af 511.0' SN-U' NS e444'u•I 1 411.14' IS 111.14' 3641'33 MAI U,S 14.50 ULU' 50 N1 ! 1 UJ." "41 '131.14' I1 50 MM N.M' 141 N0141I1'1 43)." 1004 433.11' 11414'14 S 4 0 'i 02.15' 50.0' 01 14011'4'1 1) 1 0).11' 4/01{'44' XLW 1014'0 50 0.14' 0.14' 14 100"'33'1 l Il•" l 11).04' 13 "'17 n3 No 30H'11 a1 oun 14.11' 151.11' Q0"'31 14141.04'1 )) 1 756,77' 31 7:w 14 a011'a.54 311.0' us.N' 140M'04 N1 r If•1f 1 31).11' 11 I. HEWN 4 144 041.04' 114.34' 4741 34, 7a.w' 11 g3 fts lse 15.13' 11.4 14 111 �} ©' , / ©� -1 110.40 3/ af4Y31.59 335.4' 111.31' 14141'09 11043 � m 1a.IN U a3 311.13 311.11 13041'11'1 115451111'/ V ! 110.14' 11 10011'119 41.77' 41.75' uS41'll't tN UNPLATTED ! ANDS WXTW LIW a rw sys air "a 9mm S99' 3S' 50't 2449.54' ero.00' se.00' 4" M' 910.q 7 Ao , �'.3 e 0 s D am I oars � 1 A I I �� lo9.oe9 10 R I 1.« 4014 217 11.11 AC) I . 102,L11 son 119.5 t10e,me so.") 1 ® ( 2.23 AC 1 8 � 12.e, ` 1 197,097 N n 1 •J 1 •'l l IN,� I•• as• i 4 •�° e, �. 6 3w •Ors Z" .CR3 i� V '. 4� WAU 30. n. *SAW IQ FT + tr / Rrr 30 •t ��. � / � 1r ti ✓ ''�� /• �, - ' �..,.�. 16 •, v as 13' �\ f 1 u ,41 ` 4. low ' .ar3 330 us lewd e`\\J D D n �i ".4 $ ee '°.rr. y ,3r 33 . / sae 1 1 u4.taa sa / 1 esr / 922 ti 1 ! M 704 w 1 1 \ 436 43 1 0 i y y e'W. 1 41✓1 �,� Ms , 4n &can l 96.0 IQ? 1 T i 4 •o �» .Or3 m - r 9 J * . O rr ear. F ^\� ~` • 'k lr air ,. Vk sb�' . �-- All C 40 o"I DR IV E S "'{ �+••' �� 14r _ 2.57 ACRIES ZO I yy I - ♦ ; 7 A x \ 112A66 so. ►L A. 90Y91 �. ^, I _96.09 =FT Le ACM 3t.= 310 r'031M \ -1,41 07 41' I / !07 ♦1' M/ 714' 404. *Wr" LINE OF rla awv4 %89'29 2379.39' UNPLATTED LANDS --- - - - - -- - - -- a� % = = =: LOCATION SKETCH .0 J r ST. CROIX COUNTY WISCONSIN ZONING OFFICE I r n n a n ■ a ■ ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road `•' �_' Hudson, WI 54016 -7710 -- r (715) 386 -4680 Fax (715) 386 -4686 May 31, 2000 First Federal Attn: Tammi 201 S. Second Street Hudson, WI 54016 RE: Septic Inspection for Sam Miller located at 718 Packer Drive, Homestead (Lot 11), Town of Hudson, St. Croix County, Wisconsin Dear Tammi: A septic inspection of the above referenced property was conducted on November 11, 1999. This property is located in the SW '/ of the SW '/4 of Section 11, T29N -R1 9W, Homestead (Lot 11), Town of Hudson, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a four (4) bedroom home. If you have any questions regarding this, please contact our office at (715) 386 -4680. Sincerely, J n Sonnentag Zoning Technician /sm cc: file