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HomeMy WebLinkAbout020-1359-15-000 • ' Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count y 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)). 353184 Permit Holder's Name: ❑ City ❑ Village [R Town of: State Plan ID No.: Town of Hudson T BM Elev.: sp. BM Elev.: BM Description: Parcel Tax No.: ' r 1 aD ( n 04 ew, 020- 1359 -15 -000 TANK INFORMATION t I ELEVATION DATA t(, a- t9' )-t t TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic p �' OD Benchmark Dosing �Ir Alt. BM � oZ Aeration Bldg. Sewer ©.(v `�3•bZ Holding St /Ht Inlet (, q3•�S ` TANK SETBACK INFORMATION TANK TO P/ L WELL BLDG. Air I to ntake ROAD Git Air Septic > /va 4— R NA Dt Bottom /5. 3 0 Dosing �vn' �E It NA Header / Man. 5: }O C it. SS Aeration NA Dist. Pipe y, (�,.3a if l 6.32— 6 -f�S Holding Bot. System .$° 0 PUMP / SIPHON INFORMATION Final Grade z/ 10 OD .►S Manufacturer ,Q Demand St cover �0 Model Number �j� GPM lip� DH Lift g q3 Friction 14 System TDH q.�k Ft ead Lo5s Forcemai n Length �C) + Dia. Fi t `r I Dist. To Well SOIL ABSORPTION SYSTEM (LZ)Ck,,J,, ea , a.•t . TRENCH Width Length No. f T enches PIT No. Of Pits Inside 1547 Liquid Depth DIME N �- DIMENSION SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manuf W yyer: � SETBACK f✓''�`+� INFORMATION Type O CHAMBER 6 M e N umb er - System: Cp O OR UNIT 7 /O r` DISTRIBUTION SYSTEM Header /Manifold Distribution Pipes) x Hole Size x Hole Spacing Vent 7o Air Intake Length Dia. g Di a. c +ng — 34 SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS (Include code discrepancies, persons present, etc.) Inspection #1: // /3 /9 9 Inspection #2: e d Location: 949 Meadowood Lane, Hudson, WI (NW1 /4, SW1 /4, Section 16 T 9N -R19W) - 16.29.19.2111 . ; 2e- 4 s y9164-• r «na a . An sox, 6 � 1 • � C� L�) Ayr r� �s � �,�� � a aAaA- 1T w►a- 10 ' �,eot.Qs "�"r �.`�+I.w.Q a�apsat�, }u 2) pd yb gr P s t r�ce��xeQ CSr Plan revision required? ❑ Yes No l� a 9 � ` Use other side for additional information. J {P Lj SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. r 1 ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: m m w v i 7 � t � g . s f 9 2 ( t a 1 f x q im jj 3 } s a 1 I t 1 �. �_ _... t b - .�,.a.d., +d .wm....,,,, ,u.�.ay .... ., ,...,..�.. a $¢� .............rs ..,e.e. .....,.... ....,... €.- —L Wisconsin D2,partment of Indust P a g e 4 of 4 Industr SOIL AND SITE EVALUATIQN- REPORT 9 — Latand Human Relations Divi n of Safety &Buildings in accord with ILHR 83.05, W Adryt: Code ' A COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must inc", but �j St- Croix not limited to vertical and horizontal reference point (BM), direction and % 6f . slope, wale or PAR I.D. # dimensioned, north arrow, and location and distance to nearest road. I a ;; 94-1029-30 APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATIOf� ST ci;;.,.k FkD BY DATE 0 . --10 PROPERTY OWNER: dPl R lPeNCE L,aCasse Custom Homes, Inc. G : LOT.. I 114.:,5W, 29 N,R19 bc(or) W PROPERTY OWNER':S MAILING ADDRESS LOT # C # U gg . �- OR C# 52 1 McCutcheon Rd. 15 Rarkwoo AME S M d Meadows CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE :]TOWN NEAREST ROAD Hudson, WI. 54016 X115)381 -5405 Hudson I McCutcheon Rd. �c J New Construction Use [ Residential / Number of bedrooms 4 [ J Addition to existing building j J Replacement [ J Public or commercial describe Code derived daily flow 604 gpd Recommended design loading rate • 7 bed, gpd /ft • trench, gpd /ft Absorption area required 858 bed, ft 750 trench, ft Maximum design loading rate • 7 bed, gpd /ft - trench, gpd /ft Recommended infiltration surface elevation(s) 96.45 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system 7 MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem S ❑ U I ❑ U ®S ❑ U [8 S ❑ U ®S ❑ U ❑ S L� U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trancfl 1 0 -18 10yr3 /3 none 1 2msbk dsh cs 2f �. LN 18 - 10yr4/4 none sil 2msbk dsh gw if .5 .6 Ground 3 39 -96 7.5yr4/6 none co s Osg ml na na .7 .8 elev. 10 ft. Depth to limiting factor + 96" Remarks: Boring # 1 0 -11 10 Y r3/3 none 1 2msbk dsh cs 2f .5 .6 7 2 11 -26 10yr4 /4 none sil 2msbk dsh gw if .5 .6 3 26 -96 7.5yr4/6 none co s Osg ml na na .7 .8 Ground elev. 1 100 ft. Depth to limiting factor + Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. Ave,,NWw Richmond W 54017 Signature: Date: 10 -26 -99 CST Number: m02298 (57) 12122� l PROPERTY OWNER SOIL DESCRIPTION REPORT Page of PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boaxdary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. — Depth to - limiting factor Remarks: Boring # Ground elev. ` ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) STEEL'S SOIL SERVICE Gary L: Steel LaCasse Custom Homes, Inc. 1554 200th Ave. CSTM2298 NWkSWk S16- T29N -R19W New Richmond, WI 54017 MPRSW -3254 Unin of Hudson. (715) 246 -6240 lot #15- Paxkwood Meadows This soil evaluation vas conducted to satisfy a zoning requireant, it may or nay not be suitable for your uoe. The location of the test may or may not be as nboen as permanent lot lines were not established at the time the test was conducted. N 1 13m.= top of 1" pvc pipe @ el. 100.00 Alt. BM.= top of 1" pvc pipe 0 el. 99.10' s iti� �s' �5` 167 .p 4 Gary L. Steel 7 -6 -99 I _ Safety -ori Buildirios Qyision V is co ns i n SANITARY PERMIT II . ATION 204 W. Washington Avenue O Box 7302 In accord with ILHR Adm. Code Department of Commerce Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) forth em, orf pper'nbt less County w r than 8 112 x 11 inches in size. t t State Sanitary Permi * T it ' • See reverse side for instructions for completing this a ation ; A_ 5 : � Personal information you provide may be used for secondary p , urposes — I Check if rewsl 4reviou Icatlo [Privacy Law, s. 15.04 (1) (m)]. 1 9 ' �DNI : 9 9 1 OG�ao "'� "i ° State Plan I.D. Number I. APPLICATION INFORMATION - PLEASPRINT AL WORM RMATIbN Property Owner Name Property L 'tion 114. _ 1/4,S L T , N, R E (or Property Owner's Mailing Address Lot Number Block Number 6 Ill 1 10. 15 City, State Zip Code Phone Number Subdivision Name or CSM Number LJ) �r > A- M6 o II. PE BUILDING: (check one) [:1 State Owned - I Nearest Road Village Public 1 or 2 Family Dwelling ms - No. of bedroo own OF Lk 5 Q III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) j L . 1- . M - 24 F 1 ❑ Apartment/ Condo I n 3.5 7 — 1S - 0 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. (New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System S�rstemTank 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 glSeepage Trench N I C) SiOCL40 64t ] In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill - VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate S. Pert. Rate 6. System El Zett 7. Final Grade equired (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) in. /inch) p Elevation 2— a — 940, �/ /UC H Feet Ca acct VII. TANK in allons Total # of Prefab. Site Fiber- Exper. INFORMATION New Existing Gallons Tanks Manufacturers Name Concrete strutted .Steel glass Plastic App Tanks Tanks eptic Tan n 1(X0 I L ® ❑ ❑ ❑ ❑ ❑ Pump a /Si{ewChamber ❑ 1 ❑ I ❑ 1 ❑ 1 ❑ Vft - IM SPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsitQ sewage system shown on the attached plans. Plumber's Name: (Print) Plum Signat e: (No Sta RSW No.: Business Phone Number: / � � I Plumber's Address (Street, City, State, Zip Code): j N IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate Issued Issui Agent Signature (No Stamps) Approved [:]Owner Given Initial Surcharge Fee) Adverse Determination Z Z ov to Z�Q k— X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: /, ' '- - 2-­e C SBD- 6398 ( R.11/97 ) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber A . 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. n h in ownership tuber requires a Sanitary Permit Transfer/ Renewal Form SBD 6399 Cages o s por I pu q y ( ) 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_ LaCasse Custom Homes, Inc.. NWkSWk S16- T29N -R19W town of Hudson lot #15 -Park rood Meadows This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted. N --ww 1' EM.= top of 1" pvc pipe 0 el. 100.00' Alt. BM.= top of 1" pvc pipe @ el. 99.10 s 01 0 J n 0' m IS 1- 16'r 2.N �T %S' /5 4 Wj a C 800 �� �� - - - -- "^ LKOSS SECTION AND SPECIFICATIONS 4 " CI VENT PIPE 12" MIN. A80VE GRADE 6 - � TS' FROM DOOR, WINDOW OR WEATHER PROOF FRESH AIR INTAKE JUNCTION BOX WITH CONDUIT APPROVED FINISHED GRADE 4" Cl RISER MANHOLE 1 6" MIN. W/ PADLOC ABOVE G ADE WARNING 18" IN. 6" MAX. MI? ISIS -. INLET 0 e , WATER TIGHT SEALS --� AS- ' 4 " k i ��• I GH T ; CI PIPE BAFFLE A EAL V 3' ONTO +'► APPROVED, B `4" ' ALM JOINTS w/ SOLID —T— + ON PIPE 3' 0 SOIL C SOLID SO! PUMP OFF ELLV. FT. �' I ' FF ** RISER D PERMITTED �.7 IF TAyK 3" APPROVED BEDDING UNDER TANK HAS PPRAS APPRi1? HAS SPECIFICATIONS CONCRETE PAD, �CPTIC / DOSE ` ._ . .ISIS ISIS -- -- - .............. . TANK MANUFACTURER: NUMBER DOSES PER D TANK -SIZES: SEPTIC AY. 103 -- SIZES: SSIZE.- -� GAL. DOSE VOLUME INCLUDING GAL. FLOWBACK: r ALARM MANUFACTURER ZO q 7 AL MODEL CAPAC I _ NUMBER: A SWITCH TYPE: - V� INCHES ��.oS B 2 INCHES ��� PUMP MANUFACTURER - MODEL NUMBER: � C = INCHES = y�o� SWITCH TYPE: K£OUIRED DISCHARGE RATE D - INCHES C' GPM PUMP E ALARM WIRING AS PER ILHR 1 (VERTICAL DIFFERENCE BETWEEN PUMP OFF ' + MINIMUM NETWORK SUPPLY PRESSURE 'AND ?3 .DISTRIBUTION PIPE , 6 ` _,L�Q_ FEET FORCEMAIN X FTI100 FT. FRICTION "' FEET FACTOR . FEET TOTAL DYNAMIC HEAD FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH FEET � WIDTH pIAMeTER LIQUID DEPTH IGNED LICENSE NUMBER 11 Tn_ i Goulds Submersib Effluent Pump _s C� 3871 EPO4 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- • Homes components. tic cover with integral handle Motor: Available for automatic and •Farms manual operation. Automatic and float switch attachment • 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 • Dewatering RPM, built in overload with automatic reset. preset at the factory. rated oil and water resistant. SPECIFICATIONS • EP05 Single phase: 0.5 HP, ■ Bearings: Upper and lower 115 V, 60 Hz, 1550 RPM, FEATURES heavy duty ball bearing Pump: EPO4 built in overload with construction. ■ EPO4 Impeller: Thermo- • Solids handling capability: automatic reset. plastic Semi -open design AGENCY LISTING 'la" maximum. • Power cord: 10 foot with pump out vanes for • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal rotection. • Total heads: up to 24 feet. with three prong grounding p Canadian Standards Association • Discharge size: 1 NPT. plug. Optional 20 foot ■ EP05 Impeller: Thermo- (CSA listed model numbers length, SJTW with plastic enclosed design for • Mechanical seal: carbon- g improved performance. end in "F" or "AC".) rotary/ceramic- stationary, three prong grounding plug 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 ►�f -5GPM components. Pump-.EP05 8 �— 25 Fr • Solids handling capability: c 7 25' 1 /d' maximum. 4 • Capacities: up to 60 GPM. s 20 • Total heads: up to 31 feet. • Discharge size: 1' /z" NPT. z 5 l3 ►3' • Mechanical seal: carbon- } rotary/ceramic- stationary, ° 4 15 BUNA -N elastomers. o EPOS • Temperature: 3 10 104 °F (40 °C) continuous _ tXs EPO4 140 °F (60 °C) intermittent. 2 5 1 c/- 0 00 10 20 30 40 50 GPM I I 1 I I 0 2 4 8 E 10 12 m'th CAPACITY c� 1995 Goulds Pumps Effeclive May. 1995 B3871 — Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 .Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. CRoix 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 , s ; qad'�-- -,, 4 2 - - / _ Oo a APPLICANT INFORMATION- PLEASE PRIN �A r C;lIQ1iMATION`'`.,, REV WED Y I DATE PROPERTY OWNER: h , fLrfiI r P10 ERTY LOCATION Richard LaCasse- LaCasse Cus ','Hanes, Yit4T C OV7 LOT NW 1/4 SW 1 /4 16 T 29 N,R 19 )E (or) W PROPERTY OWNER':S MAILING ADDRESS i J !" 1 1 1 L �T. BLOCK # SUBD. NAME OR CS %# 521 McCutcheon Rd. 0 Q 1 na Parkwood Meat ows 1. CITY, STATE ZIP CODE P NE NU /X [�CIT ❑VILLAGE [x]fOWN NEAREST ROAD Hudson, WI. 54016 l7�'�) - �lla5 ,. Hudson Mead owood Ln. c ] New Construction Use [x] Residential / Nu r 4 [ ] Addition to existing building j ] Replacement [ ] Public or commercial ° Code derived daily flow 600 gpd Recommended design loading rate • 7 bed, gpd /ft trench, gpd /ft Absorption area required 858 bed, ft 750 trench, ft Maximum design loading rate .7 bed, gpd /ft trench, gpd /ft Recommended infiltration surface elevation(s) 96.45 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicable na 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 C S ❑ U CA 13 U LA ❑ U El S 1 U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0 - 10yr3 /3 none 1 2msbk mfr cs 2f .5 .6 2 17 -30 10yr4 /4 none sil 2msbk mfr gw 2f .5 .6 Ground 3 30 -90 7.5yr4/6 none co s Osg ml na na .7 .8 elev. 10 ft. q y Depth to limiting factor +90" f Remarks: Boring # 1 -8 10yr3 /3 none 1 2msbk mfr cs 2f .5 .6 2 €< 2 8 -26 10yr4 /4 none sil 2msbk mfr 9W 2f .5 .6 U 3 26 -90 7.5yr4/6 none co s Osg ml na na .7 .8 Ground elev. 1 10 ft. Depth to limiting factor +90" Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. e New Richmonig, WI 54017 Signature: Date: 7 -6 -99 CST Number: m02298 PROPERTY OWNER LaCasse Custom Home SOIL DESCRIPTION REPORT Page 2 -of 3 PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bwclay Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0 -9 10yr3/3 none 1 2msbk mfr cs 2f .5 .6 <...3... 2 9 -28 10yr4 /4 none sil 2msbk mfr gw 2f .5 .6 Ground 3 28 -84 7.5yr4/6 none co s Osg ml na na .7 .8 elev. 99.8 ft. Depth to `�� Z limiting factor +84" N0 v Remarks: Boring # 1 0 -10 10yr3 /3 none 1 2msbk mfr gw 2f .5 .6 ................. 4 2 10 -25 10yr4 /4 none sil 2msbk mfr gw 2f .5 .6 3 25 -88 7.5yr4/6 none co s Osg ml na na .7 .8 Ground elev. 100.4ft. — Depth to -- limiting factor +88" 1 { Remarks: Boring # 1 0 -8 10yr3 /3 none 1 2msbk mfr gw 2f .5 .6 5 2 8 -25 10yr4/4 none sil 2msbk mfr gw 2f .5 .6 3 25 -84 7.5yr4/6 none co s Osg ml na na .7 .8 Ground elev. 9 9.3 ft. Depth to limiting factor + 3`�• L Remarks: Boring # ................. Ground elev. i ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel LaCasse Custom Homes, Inc. 1554 200th Ave. CSTM2298 NWISWg S16 T29N - R19W New Richmond, WI 54017 MPRSW -3254 town of Hudson (715) 246 -6200 lot #15 Parkwood Meadows Y _ or nia This soil evaluation was conducted . to satisfa z�oni equire a not be su Epr our use. The N 1 =40' BM.= top of 1 pvc pipe C el. 100.00' Alt. BM.= top of 1 pvc pipe C el. 99.10' 4 - pA �Y 1 g ' 1 � z � 4k 1 6 2. G�2 Gary L. Steel 7 -6 -99 ST CROW COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer 1 4r d65f-, 1 U lwe--5 l &G Mailing Address Property Address (Verification required from Planning Department for new construction) City /State u ci 5 cj Parcel Identification Number 6w nsL" -r n 'sue Phi G�1 �'I e QnS LEGAL DESCRIPTION Property Location ' /., S Lk) `/,, Sec. 7 , T -R_Z�_W, Town of Subdivision 5 � A�,r K �� o�cG 1'l1 ����cl � S Lot # Certified Survey Map # /�' , Volume '� , Page # Warranty Deed # GAP7T v(o , Volume 16.57 Page # S - Spec house ❑ yes U.Kio Lot lines identifiable yes ❑ no ` SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three ear piration date. z r/ � GNATURE OF APPLICANT DATE OWNER CERTIFICATION 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 o ty described ove, by virtue of a warranty deed recorded in Register of Deeds Office. J (D / all' S GNATURE OFXPKICANT 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 j; STATE BAR OF *WISCONSIN FORM 1 - 1982 (� 612486 WARRANTY DEED KATHLEEN H. WALSH �+ REGISTER OF DEED DOCUMENT N O. ;I �;�U' PA i ST. CROIX CO., WI GE 5 -. - -1� RECEIVED FOR RECORD Howard LaVenture, three - fifths This Deed made between I 10 -21 -1999 1:20 PM (3/5) interest in and Arlene LaVenture, two - fifths (2/5) interest in, as tenants in common. WARRANTY DEED I! EXEMPT N 17 I! Grantor, CERT COPY FEE: and T a(' c ct c COPY FEE _aga Ciinm Hnma T it � nr _ '� TRANSFER : FEE: RECORDING FEE: 10.00 i PAGES: 1 Grantee, Witnesseth That the said Grantor, for a valuable considerati I; II THIS SPACE RESERVED FOR RECORDING DATA conveys to Grantee the following described real estate in St. Croix - -_ . ._ County State of Wisconsin: NAME AND RETURN ADDRESS 2. l i LOT 15 OF PLAT OF PARKWOOD MEADOWS, TOWN OF HUDSON I� , ST. CROIX COUNTY, WISCONSIN ,i oa o- 1359 - 15 - 006 PARCEL IDENTIFICATION NUMBER This deed is given in partial satisfaction of certain land contract dated February 19, 1999 and recorded in Volume 1404 Page 616 as Document Number 598116 which was subsequently assigned by assignment dated May 28, 1999 and recorded in Volume 1431 , Page 352 as Document Number 604323 i' This is not homestead property. !' XW (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And Grantor warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except n all liens, covenants and restrictions of record, if any and any liens or i; ;I encumberances created by act or default of the Grantees I and will warrant and defend the same. 21st October 99 Dated this day of 19 J I!. YW SEAL (SEAL) + + Howard LaVentur (SEAL) (SEAL) 0 + Arlene LaVenture AUTHENTICATION ACKNOWLEDGMENT i Signature(s) State of Wisconsin, ss. ST. CROIX County authenticated this da f ' 19 Personally came before me this 21st day of October ' 19 99 , the above named + Howard LaVenture and Arlene LaVenture TITLE: MEMBE TATE BAR OF WISCONSIN (If not, aut zed by §706.06, Wis. Stats.) to me known to be the person s who executed the foregoing trum t and acknowle same., INSTRUMENT WAS DRAFTED BY i r / )od & Cari, S.C. by Walter Hodynsky Heather M. SuFdter + , ist St. PO Box 125 Hudson, WI 54016 - -- Notary Public, ST CROIX County Wis. be authenticated or acknowledged. Both are not My commission is permanent. (If not, state expiration date: 3 -16 -2003 � ' J in any capacity should by typed or printed below their signatures. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co.. Inc. Form No. I — 1982 Milwaukee, Wis. 2 + 5' N 89 °46' 00" W 1261.4' 216.00' �(�O 200.00' 2 �' � N W�$7.40' 218.00' 216.00' �'' a rn Q 0 ' 216.00' 216.0 U' 3 Z °46' 00" W 5 e. it8 - rn J 5.15' I ' 7 o w o 2.099 ACRES 91,438 S.F. B.3 p = I- � B -2 B B=5 $� v- " Q :3. I� . 3 B,2 3 0 �"i $ f . a ' 00 W 39'l. ! i' B -1 . � - 8, � ' In v► 185.01' ,^ B -1 tn� r`� vi� in F� 12 B•5 �� Ln 13 ° Ln �,$ -.- 10 0 1 1 0 2.508 ACRES 2.505 ACRES 0 109 2.565 ACRES z 109.126 S.F. EASEMI 3 2.985 ACRES ,228 S.F. z CUL -Di z -2 0. = 130,035 S.F. z 111,738 S.F. AUTOM 2.101 ACRE in 1 � UPON 91,519 S.F. h � 1 9 N z w \ --� 373.1 v G v 5l - 1 - 2 1 6.00' S 89 ° 53 29 1 � � 451.73 1 20.00 in 2 I V B -3 G� ' • � r. _ M ' N C3' ' _ -- - � - _ M N 89 °53' 29" W 400.03' M _ _ .450 ACRES � I 6a �'�� � � - .._� � 20' 08,716 S.F. / ,, 50 , 6 50 , N g w w 3 ' ri a °tip 'i; ;$. ,°' M�,' �M 14 N / �1ry pomp: :oio 2.755 ACRES , :Ng 120,OG0 S.F. 13.00 - - -- -- -- i is z ' -'�-5 - -- ^ B-5 1 I g r: b �- -20' 38 4�•2' � B Io w 2.928 ACRES I N 127,564 S.F. g.4 $ I $ 1 $S 89 °53' 29" E 1 1 c o 9 0.8�� �� W O 2 8 . .1 AQIQ.Q. , N 54 3. 25 2.419 ACRES r 180.00' :w 212.77' 105,385 S.F. N 89 W. ;N 3907' Q t w o DRAINAGE :� Q W ° EASEMENT �., n 2.5 . ACRE :o Q 4; to lc� i... b�.1 t ....... ..... I 180.00' ° cy I : w N 89 53' 9 2" � W 3 0 r I N 8 • ';Se 2.389 ACRES to � N 89 W :400.00' $ $ 104,082 S.F. w- 250. 0' .1, •. 150.00' C4 ! 2.320 ACRES P -i A ?•'�'' 101,066 S.F. N 89 °53' 29" 3 ,°n w ? ' 5' 392.77' S' M iv ' 0 4 50' 44 5 . "� , N . �-� g °° 16 189 � 29" W '� 404.42' o $ $ I 1 2.525 ACRES N ;° x C 1 109 S.F. O L M 1 B-4 0.6 °; a ° 2.389 ACRES to. -$;� 104,082 S.F. I B�II 8 4 •a9" W w 26 w c 1 z 2.322 ACRES w l -�� t• in I Q B•3� M 101,140 B�4 sib s ,� N 89 °53' 29" W I J I i B•5 M: N Bo w B-4 e 5 392.77' t3- 00 $ 1 - o ; $ oo i { I FAX ST. CRODC COUNTY ZONING OFFICE 1101 Carmichael Road Hudson, WI 54016 (715) 386 -4680 DATE: TO: Fax Number. Name: FROM: Fax Number: 386 -4686 Name: Number of Pages Including Cover Sheet: IF COMPLETE AND LEGIBLE INFORMATION IS NOT RECEIVED, PLEASE CONTACT: NAME: TELEPHONE NUMBER: ST. Wi OIX COUNTY ZONING OFFICE p N p p N INN ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 -- (715) 386 -4680 February 10, 2000 LaCasse Homes Attn: Robin 521 McCutcheon Road Hudson, WI 54016 RE: Septic Inspection for Richard LaCasse located at 949 Meadowood Lane, Parkwood Meadows, Lot 15, Town of Hudson, St. Croix County, Wisconsin Dear Robin: A septic inspection of the above referenced property was conducted on November 3, 1999. This property is located in the NW'/ of the SW' /4 of Section 16, T29N -R19W, Parkwood Meadows, Lot 15, 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, A— Kevin Grabau Zoning Technician /sm