HomeMy WebLinkAbout020-1397-03-002 ST. CROIX COUNTY ZONING DEPARTMENT'
AS BUILT SANITARY REPORT - t
Owner 'S t VPk R l o n s+ru c can Co
Property Address 1 Z2�
City /State -H a d�Y Luz c4c)/ (o
CS Legal Description: `''
Lot Block Subdivision/CSM #
'/a U) 1 4, S e c. (9 3 , Tg" 9-N -RL9--W, Town of PIN # 5l/? 8
SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION
Tank manufacturer tde(S e,r Size ST/PC /cav l G Setback from: House $ Well 6o P/L
Pump manufacturer &-Po s Model A4 F Ha
Alarm location - 140(a {
(HOLDIN KS ONLY)
Setbacks: Servic ad Vent to fresh air intake Water Line
Meter location
Alarm location
SOIL ABSORPTION SYSTEM
Type of system: Ce.J Width - _ Length y Number of Trenches
Setback from: House 37' Well ` ? P/L _d - ' Vent to fresh air intake > fo
ELEVATIONS
Description of benchmark y IrMT , &> _ Elevation X
Description of alternate benchmark !d , dam' _ Elevation
Building Sewer ?' 9 ST/HT Inlet ST Outlet PC Inlet
PC Bottom �. Header/Manifold Top of ST/PC Manhole Cover /6g 9s
Distribution Lines
Bottom of System ( ) D / • 4 () ( )
Final Grade O O ( )
Date of installation / / Permit number 3 & State plan number
• 07 Date 3
Plumber's s>< nature V J ' O E� - 11ki License number �.� / ._..,Lh.��.
g
Inspector hl1
Complete plot plan �
Scale 1"= So'
NOTICE: Provide the following:
• A plah v' ew sketch showing everything within 100 fi,-ef o
• Two horizon aTr.W Obiht3`�Venter of septic tank manhole cover.
• Show alternate benchm if a li able. �� 1
0WJW) IAL LrL -
or
PLAN VIEW IFL- %L ~
�=otZ arc - Sift, �
O NOT U �2i 1"10v
moo" �PPre -T
Ott-
'1lYl s rrp�� �l.Lp l ,
Z9
zs 1 0 11-
Zr0" gyp " \p qtT
� in I Cal
SttE R7' LOOT
r
LtoaBY y v. � p 0'�r -Z PV1`1`1 Snt UCTvRB. 1
Li PVC ' lq�OF U 1.1 OF-44pve,
5 Qe4.46' F:14,
1
� 1 3 Vb
kaj
® 6S 1
N
A
NOTES
•1. Elevati ndNE 6*T]Ea'NQPJAA't%%round elevations unless otherwise note
2. Install permanen markers RE en o each lateral. required)
3. Install 4" observation pipes with approved caps. ( Z required)
4. -Septic tank to be 1oob1600 gallon capacity manufactured by
5. Berich Marrs sv� PtaoyE Ines %6- o' � 01 'ToP Or - Z`' PVC P 1 P E
r
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County:
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)]. 344660
Permit Holder's Name: ❑ City ❑ Village Q Town of: State Plan ID No.:
Town of Hudson
M E e Insp. BM Elev.: BM Description: Parcel Tax No.:
b v `0D 6
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic r �� Benchmark
Dosing � BCJ Alt. BM G, S' 161
Ae ti Bldg. Sewer Ck e r
Holdin Ht Inlet
NK SETBACK INFORMATION
TANK TO P/ L WELL BLDG. ventto ROAD
Air Intake
Septic -.� �0U ( 5 Sd Z j /h/ NA Dt Bottom Q Z
Dosing 1/001 >sQ f ' NA Header/ Man. ,
Aera Dist. Pipe }r D 3 &1 .3
Holdin Bot. System �b
PUMP/ SIPHON INFORMATION lit Final Grade
Manufacturer M,411 Demand St cover . 9F
Model Number 3q, g9PM
TDH Lift j, L rictio Syste Z � TDH, 3 Ft
Forcemain Length L �' Dia. �' Dist. To Well I I
SOI ABSORPTION SYSTEM
ED RENCH Width Length 1 No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
EN I N DIME N
SYSTEM TO P/L BLDG WELL LAKE/STREAD CHING Ma urer:
SETBACK CHA
INFORMATION Type Of + r / M. el Number:
System: m maaZ 7 6( 3�� 754 �� NIT
DISTRIBUTION SYSTEM
Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length Dia. Z r Length Y�7_ Dia. 412 Spacing di I &/ 3s- '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.) Inspection #l: 04A /f1 Inspection #2: jd /zWef
Location: 722 A & B Waldroff Farm R Hudson, WI (SW1 /4, NW1 /4, Section 23 T29N -R19W) - 23.29.19.1727
�� C.C7��OI.t✓ T. �0� l/ �1fY►cg �oS�N•s>til dr
(> BP = pah Gfex rc�e
Plan revision required? ❑ Yes Q No
Use other side for additional inform tion. ZL 06
h SBD -6710 (R.3/97) Dat6 Inspector' nature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
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14 ' Safety and Buildings Division
sconsi SANITARY PER RW#W N 201 B Wa Avenue
Department of Commerce In accord with IL Wis.
than 8 1/2 x 11 inches in size.
�Q�jf, Adm. Co'd /
/RQ�� Madison, WI 53707 -7302
• Attach complete plans (to the county copy only) for ystem, oar of Tess county
IAC.
• See reverse side for instructions for completing thi licatio State Sanitar Perm t N / umber
[Peva Law
ation 04 (1) ( mr l vide may be used for se purpos `�0N/ / ,, ` / ate Plan IeDSNumbeewous application
e U
I. APPLICATION INFORMATION - PLEASE PRINT `
Property Owner Name p4� OCl7 Q11. & Location
( � /a W 1 /4, S a T 9 , N, R
Property Owner's Mailing Addr ss Lot Number Block Number
e LAD Pd
City, State Zip Code Phone Number Subdivision Name or CSM Number
e n ELbz�as
11. TYPE BUILDING: (check one) ❑ State Owned Nearest Road
Public 1 or 2 Family Dwelling - No. of bedrooms Town OF Aud or1 wil 171 IQ
III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) a
1 A artment / Condo d a C) _ �" ' 3 ��' /g ' �-
❑ p
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. XNew 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5_ ❑ Repair of an
------ System ________System______ __TankOnly______________ 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'*20ound 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy
13 ❑ Seepage Pit 43 ❑ Vault Privy
14 ❑ System -In -Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc R to 6. System Elev. 7. Final Grade
L 1 � o / Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation
_ // 1 375 311" (r o't �D�� 7 Feet 103i eet
Vil. TANK in Cap
g Total # of Prefab. S J Fiber- Exper.
INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- S glass Plastic App
New Existing structed
Tank Tanks
Septic Tan 10 .3
6p � � ❑ ❑ L ift Pump Tank,kw�ambar 4X0 1:1 13 40 ❑ 1 ❑ ❑
VI11. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name: (Print) PI s 5 natu e: ( o tamps) MP /PRPRSVtFido-+ Bu iness Phone Number:
NQ 541S 7/5 yas -55
Plumber's Address (Street, City, State, Zip Code
a s`* &t•,v s. l�� 5 v a a
IX. COUNTY/ DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (includes Groundwater :ate ue Issuing Agent Signature (No Stamps)
Surcharge Fee)
la Approved C] Owner Given initial
Adverse Determination 3
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROV L:
_ e low ; ee f-
°' �� �0� �z �C'a-'S�� v� ����C
SBD- 6398 (R.11/97) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the
Wisconsin Administrative Code will be applicable.
3. All revisions to this permit must be approved by the permit issuing authority.
4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD -6399) to be submitted to the
county prior to installation
5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever
necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of
Wisconsin, Safety and Buildings Division, 608 - 266 - 3151.
To be complete and accurate this sanitary permit application must include:
1. Property owner's name and mailing address. 'Provide the legal description and parcel tax number(s) of where the
system is to be installed.
11. 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, Q complete specifications for pumps and controls; dose volume;
elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross sgction
of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information.
-y
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
2226 ROSE ST
LACROSSE WI 54603 -1905
TDD #: (608) 264 -8777
Visconsin www.commerce.state.wi.us
Department of Commerce Tommy G. Thompson, Governor
Brenda J. Blanchard, Secretary
August 19, 1999
CUST ID No.267341 ATTN: Rod Elsinger
WEGERER SOIL TESTING & DESIGN ZONING OFFICE
421 N MAIN ST ST CROIX COUNTY
PO BOX 74 1101 CARMICHAEL RD
RIVER FALLS WI 54022 HUDSON WI 54016
RE: CONDITIONAL APPROVAL
APPROVAL EXPIRES: 08/19/2001 Identification Numbers `.
Transaction ID No. 241280
Site ID No. 179082
SITE: Please refer to both identification numbers,
Site ID: 179082 above, in all correspondence with the agency.
St Croix County, Town of Hudson
SWl /4, NW1 /4, S23, T29N, R19W
Lot: 3, Subdivision: Evergreen Estates
Roger Roenfanz -Unit 1
FOR:
Description: New 3BR Mound; 1 Side of Duplex
Object Type: POWT System Regulated Object ID No.: 486339
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED.
The following conditions shall be met during construction or installation and prior to occupancy or use:
• A Sanitary Permit must be obtained from the county where this project is located in accordance with the
requirements of Sec. 145.135 and 145.19, Wis. Adm. Code.
• Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with
the designated county official in accordance with the provisions of Sec. 145.20(d), Wis. Stats.
A copy of the approved plans, specifications and this letter shall be on -site during construction and open to
inspection by authorized representatives of the Department, which may include local inspectors. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction/installation /operation.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
Sincerely, DATE RECEIVED 08/11/1999
FEE REQUIRED $ 180.00
FEE RECEIVED $ 180.00
Dennis R. Sorenson BALANCE DUE $ 0.00
Wastewater Specialist
(608) 785 -9336
dsorenson @commerce.state.wi.us WiSMAR' det 7ti33,'
•
• , Page of 6
MOUND SYSTEM
A 3 BEDROOM
LOCATED IN THE is- V 3 1/4 OF THE MW 1/4 OF SECTION ? 3 , T l'� N, R_LjW ,
TOWN OF , COUNTY, WISCONSIN.
L bT 3 0 F E\) e1 z G 1Lt,N L '�
INDEX
PAGE 1 'of 6 TITLE SHEET
PAGE 2 of 6 PLOT PLAN
PAGE 3 of 6 PLAN VIEW -CROSS SECTION
PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT
.PAGE 5 of 6 PUMPING CHAMBER
PAGE 6 of 6 PUMP PERFORMANCE CURVE
PREPARED FOR
RECEIVED
AU I 1 1999
ETY & BLOGS DIV.
PREPARED BY
WEGEF� E: FR SO I L . TESTS p4 (a
AND. '\5�»»»
DES I Gh.! SEF�V I CE ARTHUR L P.O. BOX 74 421 N. KAIM ST WEGERER
RIVER. FALLS. VI 54422 �u s woa 715-4225-0105
IG
Mph
JOB NO. R9- Lg7--3-E
PLOT PLAW
� Page 2— of
(�
Scale 1"=S0 "= So ' r
vsl4 \2_
•
"tZ- u.t,
lOU.p' dti 3 /y 1tvh" IPI
E.E*L Wl';
bo ►voT ev PtYtT l lhov
T WIS pcQ1,� tOl , �i a te\
i
o i / o\Z D
I CO a•Z /
I z C_' MLMtL4 ?Ujw st`� RT LMT � r
V1
I I �ta�84 S v . ► '
i to of 5 00 45 r- �''�,� `j S"TR- uCTvRe .
2 Y� o I ( 4 11 PVC I&OFAi" t
t i
1�bVj�j f
tpt(`f`a
s op ,
lidit
C
ACI
Ot SO z
ON :
E �'� SPA-- _
R,RE k� Ft 110 F
rl 2p
NOTES
- l. Elevations shown are existing ground elevations unless otherwise noted.
2. Install permanent markers at end of each lateral. ( Z required)
3. Install 4" observation pipes with approved caps. ( Z required)
4. tank to be ltoo1660 gallon capacity manufactured by
WtRN_&eiz O-W 0_iZ . WLPCY
5. Bench Marks s� �bve - tnEN. lbo. p' - orj ToP of Z" PVC P i p E
6. Divert surface water around system to prevent ponding at the uphill side.
Page 30f 6
Approved Synthetic Covering
1�gTM c 33 Distribution Pipe
Medium Sand
�G
Topsoil _ H F Elev'. ti O 1 _ - 7
3 E D
b
2 % Slope
Force Main Plowed
Trench of 2 " -2 z" From Pump Layer
Aggregate
Undisturbed D `• o Ft.
Soil E l- t)?, Ft.
Cross Section Of A Mound System Using F o• S Ft.
I Trench For The Absorption Area G 1•a Ft.
A _ Ft. H t!- S Ft.
B C ) Y Ft.
I 20 Ft.
Linear Loading Rate= L4_"19 GPD /LN FT J Ft.
Design Loading Rate =a• Z GPD /SQ FT
K It Ft.
L ley Ft.
W 3 Z Ft.
L
J Force
— —_ — — —(3 —_ —_ —_ — —_ K Main �—
w oPP t��
Distribution Trench Of 2 - 2 2
T Pipe Aggregate
Permanent
Observation Markers
Pipes
(Anchor securely)
� � eta �'
OII�
SMound Using I Trench For Absorption Area
0 tr
V1510N
RESPONp
SSE CpR
r
Page Of 6
Perforated Pipe Detail
, / "" L,d View
Cap Perforated
End Co c6 PVC Pipe
�' as
Install permanent-marker
at end of each lateral
Holes Located On Bottom,
Are Equally spaced
Q End Cop
v�iA`G'� SY$�EM
.ta •Tonally
PVC Force Main c V
Dlstrlaution
En ppD gar
Pipe rVrsr0N SA4 �/
Lost Hole Should Be \� �' C
Next To End Cop R REspo l -N
SSE
Distribution Pipe Layout
`1S_1 Ft.
X 3S Inches
Y 3 S Inches
Hole Diameter I N Inch
Lateral IL[Z Inches)
Manifold Inches
Force Main Z Inches
# of holes /pipe ,.N.- rko
Invert Elevation of Laterals -Z Ft.
Vex \. V : l$ ?Z X2.37 Cllr GP►�
11 l �
Place lst hole z from tee with succeeding holes at 3 S ti intervals.
Last hole to be next to the end cap.
' Combination Sep -ric- Tank and
PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS ' PAGE 5 OF
-VEKIT CAP WEATHER PROOF
Juu C T IOU BOX
4"C.I. VENT PIPE: APPROVED LOCKING
� 10' FROM DOOR.. MAWHOLE COVER t�IV
.lINDOW OR FRESH wARNII.I� L.A�EL.
AIUTAKE co,aDu�r
tR
tj
15 /A111.
WA IN. 1'`� ---- - - - - --
--
PROVIDE I - -- --
IMLE T AIRTIGHT SEAL
• 8 AFFL�S ' � I I v
APPROVED JOIMT A I I APPROVED JOI)JT:
W /C.T. PI PE DR ank construction I I W/C I PIPE�Po�
P ` 11 comply with . II ALARM
.. a 3.15 and 83.20 8 I
c o 14 C
O �V�� GS c LEU S Pi .� fY - -
N ^ PUMP OFF
j
QN� COIJCRETE
V�� LNG
eLocK
SE 3" APPRovF
R►SER EXIT PERMITTED OQLy IF TAWK MAWLIFACTURICR HAS SUCH APPROVAL gFOp
5PECIFICATI0k1S
SEPTIC LpCZ -1bUO
DOSE W\Zs Z. Co•JCTZ-� AIUMBER OF DOSES: 3 -83 PER D" TALIK MANUFACTURER:
TAWK :,IZE: lOOCU 1 00 GALLOWS DOSE VOLUME r
ALARM MA►JUFACTURG.R:
S.5 , Z�c'T�n SS•{S`Ttpj I S INCLUDIME, DACKFLOW 3.b GALLONS
MODEL WUMBER: \K)` h1w CAPACITIES: A= �$ IMCHESOR 30 1 •O GALLOIJ5
SWITCH TYPE: EIZCUC`�( B = Z INCHES�OR 33 `T 4LLOU5
a X33 $
PUMP MANUFACTURER: IUCHES OR GALLOWS G:
MODEL UUMBER: P'1E y0 D- $ j NCHES OR GALLOWS
SWITCH TVPE: � Z "� MOTE: PUMP AMD ALARM RE TO DE O
M11JtMUM DISGKARGE RATE 3 GPM
INSTALLED ON SEPARATE CIRCUITS
VERTICAL DIFFERENCE DETWEEW PUMP OFF AUD- 015TRIBUTIOM PIPE.. \ S3 FEET
+ MI►JIMUM AIETWORK SUPPLY PRESSURE , ; .. 2 5 0 FEET
t up FEET OF FORCE MAIM X Z�
-I FRICTIOLI FACTOR.. y FEET
.l
Y r>:
TOTAL OtIIJAMIC HEAD = 18 -7 FEET
Pump chamber DIAMETER 3b►,
IIJTEKLIAL DIMLW510W1 OF TA1JK: LENGTH ;WIDTH ;LIQUID DEPTH
BOTTOM AREA — - 231= GAL /INCH
AS PER MANUFACTURER 16;77- GAL /INCH
P� o�C,
E4� Series M"M
4 HP Effluent
and Drain Water Pumps
Performance Curve
MODEL ME40 EFFLUENT PUMP
CAPACITY LITERS PER MINUTE
0 50 100 150 200 250 300 350
40 12
35
30 10 N
' W
LL W
H 25 8
Z
= 20 6 Q�
W
J _
Q 15 ate. J
H
O 4 O
10
5 2
0 0
0 10 20 30 40 50 60 70 80 90 100
CAPACITY GALLONS PER MINUTE
1101 Myers Parkway, Ashland, Ohio 44805 -1923
419/289 -1144 FAX 419/289 -6658 Telex 98 -7443
K3326 7/91 Printed in U.S.A.
! Wisconsiri'aertment of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3
Labor - nd Human Relations
Divisio of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
St. Croix
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but
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. 020- 1330 -30
APPLICANT INFORMATION— PLEASE PRINT ALL INFORMATION RXW"EY DATE
PROPERTY OWNER: PROPERTY LOCATION
Richard laCAsse GOVT. LOT SW 1/4 NW 1/4,S 23 T 29 N,R 19 : k(or) W
PROPERTY OWNER':S MAILING ADDRESS LOT i# BLOCK # SUBD. NAME OR CSM #
1220 Oakwood T-n. 3 na Evergreen Estates
CITY, STATE ZIP CODE PHONE NUMBER []CITY ❑VILLAGE [QfOWN Mdroff REST ROAD
Hudson, WI. 54016 (715 549 -5693 Hudson Farm Rd.
[x] New Construction Use [x ] Residential / Number of bedrooms 3 [ ] Addition to existing building
(] Replacement [ ] Public or commercial describe
Code derived daily flow 450 g pd Recommended design loading rate np bed, gpd /ft . 2 trench, gpd /ft
Absorption area required na bed, ft 375 trench, ft Maximum design loading rate pp bed, gpd /ft .2 trench, gpd /ft
Recommended infiltration surface elevation(s) 101.70 ft (as referred to site plan benchmark)
Additional design / site considerations system el based on contour line of e1 100.70
Parent material glacial drift Flood plain elevation, if applicable na ft
S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem I [IS ®U RI S ❑ U [Is ®U ❑ S IR U ❑ S ®U EIS
® U
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft
Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
..................
.................
..................
.................
1 0 -14 10 r2/2 none 1 2c pi mfr qW if n
2 14 -33 10yr4 /4 none sil lcsbk mfr gw if .2 .3
Ground 3 33 -49 10yr5 /4 c2p 7.5yr5/6 sil lcsbk mfr gw na .2 .3
elev. 4 49 -65 10yr4 /6 c2p 7.5yr5/6 sil /fs lcsbk mfr na na 1.2 .3
1
Depth to
limiting
factor
33"
Remarks:
Boring #
1 0 -15 10yr2 /2 none 1 2csbk mfr gw if .5 ' .6
2 2 15 -32 10yr4 /4 none sil lcsbk mfr gw if .2 .3
3 32 -48 10yr5 /4 c2d 7.5yr5/6 sil lcsbk mfr gw na .2 .3
Ground
elev. 4 48 -60 10yr4 /6 c2d 7.5yr5/6 sil /fs lcscbk mfr na na .2 .3
1
Depth to
limiting
factor
32"
Remarks:
CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200
Address: 1554 200th. 6ye., New Richm nd WI 54017
Signature: Date: 9 - 9 - 98 CST Number: m02298
Richard laCAsse 2 *' 3
PROPERTY OWNER SOIL DESCRIPTION REPORT Pageof�
PARCEL I.D. # 020 - 1330 -30 kh
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
1 0 -13 10yr3 /3 none 1 2fpl mfr gw if np .3
3
2 13-27 10yr4 /4 none sil lcsbk mfr gw if .2 .3
Ground 3 27-42 10yr5 /4 c2p 7.5yr5/6 sil lcsbk mfr gw na .2 .3
elev.
1 y p y a 4 42 -68 10 r4/6 c2 7.5 r5/6 sil /fs lcsbk mfr n na .2 :.3
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 Richard 1554 200th Ave.
F.aCasse
CSTM2298 New Richmond, WI 54017
MPRSW -3254 SW4NW4 s23- T29 -R19w (715) 246 -6200
town of Hudson
lot #3- Evergreen Estates
N
1 =40'
BM.= top of2" pvc pipe C el. 100'
Alt. BM.= top of SE lot stake C el. 102.40'
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Gary L. Steel
9 -9 -98
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer /��"i /z I�OC�/i L C na 7,
Mailing Address ��� /�9��2 y /&'L) ;a, 4jD56A1
Property Address WW 4-D A MP 1: JA M r - � W
(Verification required from Planning Department for new construction)
City /State Parcel Identification Number
LEGAL DESCRIPTION
Property Location 5 1 /4, N LQ '/4, Sec. 2- . T _N -R„] 1 _W, Town of "5
Subdivision D T 3 6 7"RT1- S Lot # 3
Certified Survey Map # _ . Volume , Page #
Warranty Deed # 11. ,Cg,5 3 , Volume J9 Page # �! S
Spec house V yes ❑ no Lot lines identifiable yes ❑ no
SYSTEM MAINTENANCE
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the function of the septic tank as a treatment stage in the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
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 year expiration date.
S/ �� �-0 $�� 0 I 1
SIGNATURE 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
the property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
rt eg 431?
zr
SIGNATURE OF APPLICANT DATE
* * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * **
•* Include with this application: a stamped warranty deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
I
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VOL 1448PAGE118 ,�►oa�'4°
STATE BAR OF WISCONSIN FORM 2 - 1998 KATHLEEN H. WALSH
REGISTER OF DEEDS
ST. CROIX CO., WI
This Deed, made between LaCasse Custom Homes Inc..-- RECEIVED FOR RECORD
Grantor, and 08- 10-1999 10:15 AM
Silver Ridge Construction Comoanv - - -- W40vtNty bWu
LXENP
Grantee. CERT COPY FEE:
Grantor, for a valuable consideration, conveys and warrants to Grantee COPY FEE:
the following described real estate in St. Croix _County, State of Wisconsin TRANSFER FEE: 309.90
RECORDING FEE: 10.00
(The "Property "): PAGES:
Recording Area
Name and Return A dress
020-1330-30 & 020-1330 -40
Parcel Identification Number (PIN)
This is not homestead property.
Lots 3 and 4, Evergreen Estates in the Town of Hudson, St. Croix County, Wisconsin.
Exceptions to warranties. Easements, restrictions and rights -of -way of record, if any
Dated this day of August, 1999.
LaCasse Custom Homes, Inc.
* Richard W. UCasse, resident
*
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN )
^w
)Ss.
authenticated this _ day of :!; 4OP4 County )
aLL
Personally came before me this day of
• August, 1999, the above named LaCame Custom Homes,
Inc.. by Richard W LaCasse, President
TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be th¢ person(s)
(If not, who executed the foregoing instrument and acknowledge the
authorized by $ 706.06, Wis. Stats.) same. ►
THIS INSTRUMENT WAS DRAFTED BY - •'���`�� r
Attorney Kristin Ogland '
Hudson, WI $4016 No b ,State of Wisconsin
(Signatures may be authenticated or acknowledged. Both are not My Comjn Ission is permanent. (If not slat expitt e)da neCt39a ry.) O (v . �•) pUBL
*Names of persons signing in any capacity should be typed or printed below their signatures
WARRANTY DEED STATE BAR OF WISCONSIN
FORM N0- a - 1"I
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ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
r N % �� ■ N ■ rr�6 ST. CROIX COUNTY GOVERNMENT CENTER
,. 1101 Carmichael Road
Hudson, WI 54016 -7710
(715) 386 -4680 Fax(715)386 -4686
May 1, 2000
Silver Ridge Construction Co.
Attn: Roger Roenfanz
811 Harbor View Road
Hudson, WI 54016
RE: Septic Inspection for Silver Ridge Construction Company located at
722 A & B Waldroff Farm Road, Evergreen Estates Lot 3 — East Side,
Town of Hudson, St. Croix County, Wisconsin
Dear Mr. Roenfanz:
A septic inspection of the above referenced property was conduct 10/2711999. This
property is located in the SW'/ of the NW'/ of Section 23, T29N -R19W, Evergreen
Estates, Lot 3 (East), Town of Hudson, St. Croix County, Wisconsin. At the time of the
inspection, this septic system was found to be code compliant for a three (3) bedroom
home.
If you have any questions regarding this, please contact our office at (715) 386 -4680.
Sincerely,
a
;on Z Sonnentag
Zoning Technician
/sm
cc: file