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HomeMy WebLinkAbout020-1318-50-000 Q o o �n 03 � I � I n m v rnrn rn am me c c_ :? I N U @ f6 O N O N z @ Co O C C z N R 3 2.2 N LL O 'D Q 25 a? 3 � v � z N N c � � L rn w d m N z O C C7 O z c T d z d' fA c m o N N Of N C IL m O R o y z z o N .. z y N R E T N �+ R _ R C N i N co O G G C 'O R U _ LO O F �V LO CL +►.� a a a *� .. `S N 7 0 N N m m a) M O O O N O — O N O O .} O N_ CL c in �! O 'O N N * 47 • O O c d Q } 0 �+ 7 N C O O O N _C O O co O N o N 3 d O to O O C O N O O c N N p ~ CO c � ? m a 4 4 0 .1 T N C y Y N w c N O O R o 2 = r i o Y to a a w + a d 2 a s c i O C S O 3 R J 020 - SO .- 000 1554 200th Ave. Ben S12 \ New Richmond WI 54017 NE 4SE a S12- T29N -"R20W �-t-�- 3 �. S 3} l town of Hudsen "` / (715) 246 - 6200 lot #5- Hartland N 1 BM.= top of 1" pvc pipe @ el. 100.00' D Alt. BM.= top of 1 pvc pipe C el. 106.35' CN L C f E 5 1o ,' 1� yvol M o z v a 5 psi • p rn cx ,CAwo.�t.o� P S T , yS Wisconsin Department of Commerce y: PRIVATE SEWAGE SYSTEM Safety and Buildings Division Count INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit IX Personal information you provice may be used for secondary purposes [Privacy La s.15.04 (1)(m)], 3445533 7 Per ; NWN E] City_[7 �g CST BM Elev. Town of: State Plan ID No.: E. Insp. BM Elev.: BM Description: tHiUU UUNN Parcel Tax No.: IM-0 �, O 4typ 4 1" P1& Stet's 020 - 1318 -50 -000 TANK INFORMATION EVATION DATA t a, za - I, z3 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark (M • 0 Dosing A4, 9 PA )12.0 Aeration Bldg. Sewer 110-1 Holding St /Ht Inlet Io .9 TANK SETBACK INFORMATION St/ Ht Outlet (o$ • (o I TANK TO P/ L WELL BLDG. Air i to ntake ROAD r)t inlet Air Septic 730 - , NA Dosing NA Header / Man. Aeration NA Dist. Pipe Holding 45'_ Bot. System PUMP / SIPHON INFORMATION Final Grade Manufac Demand o. Model umber GPM TDH L Friction m TDH t L Forcemain it ength Dia. Dist. To well SOIL ABSORPTION SYSTEM K*/(LRg Widtll Length * N . Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSION 3 v� DIMENSION N SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manu ct er: SETBACK CHAMBER S��nks. INFORMATION Type Of M odel Nu ber: System: cbvw . Jr qO OR UNIT , DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe x Hole Size x Hole Spacing s) Vent To Air Intake % Length�G� Dia. __ Length Spacing 7 5O 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 I Trench Center Bed I Trench Edges Topsoil ❑ Yes [] No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) 'T s LOCATION: HUDSON 12.29.20.1623,NE,SE 276 BRANDON DRIVE I - ln*07 Jos. Q - t,n� Saa� .�� Sawt S iN aA4a W6CV� T. !e= /off. d8 ` , lol.gs �01.'F8 ( > :Ja � CAL '� S S Goa�� - -�► � � u1 1 c I�D.O ,00. o S wki� � E i mem�w; 1 t .9.s+, IB " 5�+� ceatl °° ra( �ASaQ - 2 (- °"' �� 5��j U ' rE Plan revision required? ❑Yes No w! Oa �( �} Use other side for ad itional inf9rmatioll. R�'NXU' %VA W_ U S 61+4 Date Inspector's Signature Cert. No SBD -6710 (R.3/97) ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: °. e F i s . 5u e... —........ .... P ....e... ee .. .�_ 1 „e r x s a p t i e .,tee 9 y t � -- --- -- s E E ,gym Sw ll 11 a a ... 5 t „. F y r r .-e.e . ,mm s F s_ x a J t \ i i A t t s � F ter• e .. e. 3 f ti .. �„ ... lz q i I a � t e x s e F ...., _ ,.... . , x Lrz t 4 d � � a ee me § r Risconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM County: INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: ST CR IX Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 344537 Perrrlli}ioJSL s Name: ❑ City [_1 Village Town of: State Plan ID No.: ttilAAjN�KR , HUDSON CST BM Elev.:. Insp. BM Elev.: BM Description: Parcel Tax No.: 020 - 1318 -50 -000 TANK INFORMATION ELEVATION DATA 68 TYPE MANUFACTURER CAPACITY T TION BS HI FS ELEV. Septic JZaD Dosi ng W bt%k — (a Aeration Bldg. Sewe A (o 1 Holding St /Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P / L WELL BLDG. Air I ntake ROAD Q_% IQIQ1 ir Septic >3a r / NA Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Ma facturer De ,8t i Model Number GPM(— Z: T Lift Frictio e TDH Ft Forcemai ength Dia. Dist. To well SOIL ABSORPTION SYSTEM j E Width r Length No. Of Irenches, PIT No. Of Pits Inside Dia. Liquid Depth DIME I N 3 VfN' S DIMENSION SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING M u rery- SETBACK CHAMBER -- INFORMATION Type O r Mo e Number: System: OR UNIT DISTRIBUTION SYSTEM Cod " a 8•r8� la O Q Header / n�ifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Lengths Dia Length pacing 7 gQ 1 SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only 3 • L�S Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ es ❑ No ❑Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: HUDSON 12.29.20.1623,NE,SE 276 RANDON DRIVE 4 - t1 z - 4, 74.t ' l o3 z 3 - 4.9 r 8_sf L� ,- I�+S� so o.b•�- s 13 t o, 06 st; 000 Plan revision required? ❑ Yes ❑ Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. Mi sconsin ' Safety and Buildings Division S ANITARY PERMIT APPLICATION 22010 B Washington Avenue Department of Commerce In accord with tLHR 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 81/2 x 11 inches in size. 67, • See reverse side for instructions for completing this application State Sanitary Permit n�ujDtter Personal information you provide may be used for secondary purposes ❑ Check if revision to previDus application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION Property Owner Nam Property Location PE 1/4 E 1/4, S f a T a , N, R (or V1 Property Owner's Mailing Address Lot Number Block Number © o 5 City, Sta a � Zip Code Phone Number Subdivision N or C M Number 1t -L-- o (7 /,S ,3 6 - / II. TYPE OF-BUILDING: (check one) ❑ State Owned It Nearest Road p Public 1 or 2 Famil Dwelling - No. of be drooms ° row a n of /-/� ))X III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 2.?�► 1 ❑ Apartment/ Condo 09 -- 31 — — 600 2 ❑ Assembly Hall 6 ❑ Medical Facility /Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales / Repairs 11 ❑ Restaurant / Bar / Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel /Motel 9 ❑ Office/ Factory 13 ❑ Other: specify IV TYPE OF PERMIT (Check only one box on line A. Check box on line B, if applicable) A) 1. New 2 ❑ Replacement 3_ ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an ______ System _____ -__ System - ______ - __ Tank Only______________ Existing System _________Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) r- / - f0d, 20 r- a :: /01,70 3 /OO � �►-_ Non- Pressurized Distribution Pressurized Distribution Experimental , S_ Other Y �9 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 9 41 [:]Holding Tank 12 Seepage Trench a 4j 22 ❑ In- Ground Pressure 42 C] Pit Privy 13 Seepage Pit _ 8 43 ❑ Vault Privy 14 ❑ System -In -Fill ,�` 3 !-. f-� a 53 VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. tern Ele . 7. Final Grade / ©O Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation 6 /1 , V 0 Z 10 ,;i>eet 16Z Feet Capacit VII. TANK in Ca allo s g Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con Steel glass Plastic App New Existing strutted Tanks Tanks Septic Ta g I aTTK D / ❑ ❑ ❑ 1 ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ 1 ❑ ❑ 1 ❑ 1 ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plum er's Name: (print) Plumb 's Si atur o amps) P MPRSW No.: Business Phone Number: ; W y a kI I I I ddo Plumb r$ddrei Street, City, t e, Zip Code): / N IX. COUNTY / DEPA RTMENT US E ONLY ❑ Disapproved Sanitary Permit Fee pncludesGroundwater E Issu Issuing A t Signature (No Stamps) approved [ Given initial �0 Surcharge fee) Ad verse D etermination /a X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (RA 1 /97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, owner, Plumber Ben Hanke 1554 200th Ave. NE4SE4 S12 T29N -R20w New Richmond, WI 54017 town of Hudsen (715) 246 -6200 lot #5- Hartland N 1 "= 40 ' BM.= top of 1 pvc pipe C el. 100.00' �/1 f / / 3 f F Alt. BM.- - top of 1 pvc pipe C el. 106.35 /'' o�o� (04 P-b(l) alel 411 / /oa,RO 7= 3- ia©� 7 W, s r lo t - to` 0 CS P s p�� •�M DQ Ilzj 4- . W is sin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 l a 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 nearest road. 020- 1318 -50 -000 APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION RE t PROPERTY OWNER: PROPERTY LOCATION Ben Hanke GOVT. LOT NE 114 SE 1i4,S12 T 29 N,R 20 jE (or) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 9 TT 1 YY 0 Fox St. Hartland CI TY , WI 54016 ZIPCODE (,y ?gI' ��eEfl ❑CITY ❑VILLAGE OT OWN NEA R OAD Dr. ] New Construction Use [x] Residential / Number of bedrooms 4 [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate • 3 bed, gpd /ft trench, gpd /ft Absorption area required 2000 bed, ft 1500 trench, ft Maximum design loading rate . 3 bed, gpd /ft .4 trench, gpd /ft Recommended infiltration surface elevation(s) 102.20 ft (as referred to site plan benchmark) Additional design / site considerations trenches spaced to code 4.00' below surface /area of B -5 3.00' below yx ade Parent material gar i al dri mound system recomm elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for s stem M S ❑ U M S ❑ U C� S❑ U CAS El U [3 S ®U ❑ S EI 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 jTmrich 1 0 -12 10yr3 /3 none 1 lmsbk mfr cs 2m .4 1.5 2 12 -24 7.5yr4/6 none sil lcsbk mfr gw 2m .2 .3 Ground 3 24 -42 7.5yr4/4 none sil 2msbk mfr gw 2f .5 .6 10 4 42 -56 7.5yr4/4 none sl lcsbk mfr gw if 1 .4 '.5 Depth to 5 56 -70 7.5yr4/6 none sl lcsbk mfr gw na .4 .5 limiting factor 6 70 -86 10yr4 /4 none vfs Osg mvfr na na .4 .5 Remarks: Boring # 1 0 -8 10yr3/3 none 1 lcsbk mfr gw 2m .4 .5 2 2 8 -21 7.5yr4/6 none sil lmsbk mfr gw: 2f .2 .3 3 21 -45 7.5yr4/6 none sil 2msbk mfr gw if .5 .6 Ground elev. 4 5 -65 7.5yr4/4 none s1=: lcsbk mfr c_ na -,�4 .5 106 ft. rna 5 5 -85 10yr4/4 none of s Osg mvf na .5 Depth to limiting factor l " +85.. COUNTY ~ I Re marks: ZONIN CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -620 .y Address: 1554 200th. AQ., New Richmond WI 54017 c Signature: y ll e9 Date: 5 -26 -99 CST Number: m02298 PROPERTY OWNER Ben Hanke SOIL DESCRIPTION REPORT Page? PARCEL I.D. # 020 - 1318 -5- -000 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends 1 0 -8 10yr3 /3 none 1 2msbk mfr gw 2m .5 .6 2 8 -23 10yr4/4 none sil lcsbk mfr gw 2m .2 .3 Ground 3 23 -33 7.5yr4/4 none sil 2msbk mfr gw 2f .5 .6 elev. 1 4 33 -48 7.5yr4/4 none sil lcsbk mfr gw if .2 -.3 Depth to 5 48 -75 7.5yr4/4 none sl M na gw na .3 .4 limiting factor 6 75 -86 7.5yr4/6 none fs Osg mvfr na na .5 .6 Remarks: Boring # 1 0 -8 10yr3 /3 none 1 2msbk mfr gw 2m .5 .6 4 2 8 -24 10yr4 /4 none sil lcsbk mfr gw if .2 .3 3 24 -45 7.5yr4/4 none sil lcsbk mfr gw if .2 .3 Ground elev. 4 45 -72 7.5yr4/4 none sl lcsbk mfr gw na .4 .5 96.7 ft. 5 72 -96 7.5yr4/6 none fs Osg mvfr na na .5 .6 Depth to - limiting factor +96 Remarks: Boring # 1 0 -10 10yr3 /3 none 1 lcsbk mfr gw 2m .4 .5 5 ?` 2 10 -18 10yr4 /4 none sil lcsbk mfr gw lm .2 .3 3 18 -36 7.5yr4/4 none sil lcsbk mfr gw if .2 .3 Ground elev. 4 36 -72 7.5yr4/4 none sl lcsbk mfr gw na .4 .5 9 6.2 ft. 5 72 -85 10yr8 /3 none fractured limestone na na np np Depth to limiting factor 72" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) I i STEEL'S SOIL SERVICE Gary L. Steel Ben Hanke 1554 200th Ave. C S 9 4 4 � + TM22 8 NE SE S12- T29N -R20W i New Richmond WI 54017 MPRSW -3254 town of Hudsen (715) 246 -6200 lot #5- Hartland N 1 " =40' BM.= top of 1" pvc pipe C el. 100.00' Alt. BM.= top of 1" pvc pipe C el. 106.35' recommended system for system longivity would be mound J� Q ,Ot 3 cc;P r e A%j ,+ 112 Gary L. Steel 5 -26 -99 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Ow �-iBuy ::] .._ � % 4 Mai n.g Ac d -, v ; s 9 ° 'SI Pral arty A:!�(a ;ass �. _ Ar, #a—y -T_.. ,06 � , z ))( o (Verific rtion required from Planning Department for new construction) Cit.s State _ &.C t2 a _ 'Lul Parcel Identification Number LE t A D Ir ;:'I ' RIPTION Pros arty Loc ll �Dn � ' /., �� ' /a, Sec. 1,�,, T�N -R_2�2W, Town of Sub ivisioi . �6� �, y�l , Lot # _ Cea !fled E u r ey Map t , Volume , Page Wit ranty :0;,! d # � ,:),2 . !Volume 1 �� � , Page # 5_.(2,_5 — Spe house (:::! ;yes A_nc Lot lines identifiable E' yes El no SX. E : , 1 4 +, INMN_A j 10E Imp] O v::i use and ma: atenanceof your septic system could result in its premature failure to handle wastes. Proper n�. + ;tenance cons I. of pt 1ez.l,.r i.g out the s ptic tank every three years or sooner, if needed by a licensed pumper. What you put into J r system can; ?feset the f ri ; .tion of the septic tank as a treatment stage in the waste disposal system. The ;imm;a ; orty owner .sgrees to submit to St. Croix Zoning Department a certification fppn, signed by the own :: � ; nd by a mast rplumb i. nneyman p lumber, restricted plumber or a licensed pumper verifying that (1) the'on -site wastewaterdispc * t system is in !roper o pe r1i ing condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 313 full : i sludge. Uwe the and „r, ; ii tied have re; td the above requirements and agree to maintain the private sewage disposal system with th , .andards set f :A herci;r , -i s; set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. C.:, t ification state ; that yi ni : ii sptic system has been maintained must be completed and returned to the St. Croix County Zoning; Offict ithin 30 days )f the tl urn , s: t qaj expirat on date. SIGI TURK APPLICAT rr DATE OV �i ER ( "I , I : TIFICAT'ION I (w r) itify that al' statements on this form are true to the best of my (our) knowledge. I (we) am (are) the <; F ier(s) of the l opemty ce is i.bed above, by virtue of a warranty deed recorded in Register of Deeds Office. ff Ai APPLICAl IT DATE Any ir.ir�: rmation tha is mis represented may result in the sanitary permit being revoked by the Zoning Departmt: l elude v�A Ii gmis applies tion: 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 WL AV STATE BAR 01- WISCONSIN FORM 2 - 1982 WARRANTY DEED DOCUMENT NO. R F F I CE Glen E. Johnson ST. , CROIX CO., W1 itpr": f,r "mog"d r JUL 13 1998 10:00 A M conveys and warra to L jami n 0L,,-Ra:nkP--,-U1d-Jenrt1f ftA-1 - -----Hanke-,--hus, e,,as--siu3Livjorship---- !ULI, THIS SPACE RESERVE.) FOR RECORDING DATA NAVE AND RETURN ADDRESS the following described real estate in Count-.. State of Nkliscon5in: L 02 1a2--50--QW-- PARCEL 1OENT&iCATkON NUMBER Lot 5, Plat of Hartland in Town of Hudson TRANqFER This is not homestead property. It (is not) Excepmon tv wsrrawic;;: Exi-ting highways, easements and rights of way of record. P4 Dated this day of A.D., 19 98 (SLAQ (SEAL) -Glen IF. Jabnson----- (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) state of Wisconsin, avzhenti,a,z:d this --- day u[ Personally ;.imc b:Iore me ,his day of 194 8 the above named TITLE: MEMBER S,,A!F BAR ().F WISCC)NI (If -t,thorized by ',WI)(. Wr. Stats') . T 0 to rut -i w Iv .X--- the person Who eCL11ed th;foteguing S ; " A - 0 i'HIS INSTRUNiEtN i WAS DRAFTED 6 -C 1-4 t6sT c. --oq�r-_ - Cfluffly' wis 304_ buws t -3 Notary P` tbh (Signatures may be authenul I or jwmiauent. -,U n St to ex ninon date necessary:) F,rm N.. 2 - 11492 LOCATED IN PART OF THE NI 12 OF THE NE I/4 OF THE COUNTY, WISCONSIN, BEING LOT 4 OF CERTIFIED SURVE COUNTY REGISTER OF DEEDS OFFICE. PLAT CONTAIN 1 = 0T I VOL. 6 E(. 1596 O j o ��l N189 ° 04'17"E �4Y �^� � NW04' 17 402. $6' 31 1354.81' C, t2 Z O /00' "� ?e W LOT 4 LOT ' 1.43 AC. 2.01 62,290 SO. FT. 87,701 / /'LOT 5 43 'a W 1.67 AC. 72,619 SQ. FT. `�'� 2 Iv 1 % r �Al v `� 'Vol 1 2 O ; \/ -' S89 "W 355.28' O � � 1 Ic") m LOT 6 9 s \ � m O 1.39 AC. ir 1 ro 1 v 60,464 SQ FT. � N °D a.,�6 \ 1b cy 1:0 "' LOT 7 , N LOT 8 iv y ICS m y�1 �9 1.55 AC. 3 1.08 AC. 67,570 SQ. FT. N 47,250 SO. FT. 0 0 M ap h O n Wiscon �In Department of Industry SOiL AND SiTE EVALUATION Labor and Human Relations Division Pag of g of Safety and Buildings in accordance With s ILHR 83.09, Wis. Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County -' include, but not limited to: vertical and horizontal reference point (BM), direction and S 'Pa . percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. APPLICANT INFORMATION - Please 5 rint all information. `/��7 . P Reviewed � ~ ate Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ,V Pro / e p rty Owner ,7� .viS � TO,t°�tJ ST�tD .4�e.+D P Location _ � T1OM�'S N/ S I Govt. Lot /VE 1 /4 SC 1 /4,'k -j ?. T ,N E (00 Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# , 7-;Z7 Ap • �/ARTG�N1� City State Zip Code Phone Number 7�Jr� Nearest Road ttUp kJ 54vib t3�G) - �z79 El city U ❑� iu49 a l� Town /MAAJPa -4_J 1�,P• L'7 New Construction Use: Bliesidential / Number of bedrooms 3 y Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived dail flow ��0 �/� No7 (Z G e 0mmw A) E ,/ Y 9Pd N Recommended design loading rate //p bad, gpd /tt • 7 trench, gpd /ft Absorption area required bed, ft 20D trench, ft2 Maximum design loading rate bed, gpd/ft • S trench, gpd/ft Recommended infiltration s _5� N�-� �2 �piU �. p�i- - 3 it (as referred to site plan benchmark) Additional design /site consi tions 2 1, 1 6 - /U1 Je 40 W Tl� �'� 1 �G(�C S C 3 Parent material SCS 7 9 L AjO Flood plain elevation, if applicable y� it S = Suitable for system Conventional ,M,ou`nd in- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system Ifs El U LA's 1:1 U (c�3' ❑ U Q-3 ❑ U ❑ S [�j ❑ S SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Consistence Structure GPD /ft Texture B In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 0 -7 /O f/,4 2/.1-. - �O�}y l 'FS�1i� ihn >C� • � • S Ground 3 - 3 7•S 0 L,y, J A-1-F elev. O r S — /f 416- . mss-14 Depth to limiting factor pIn. D Remarks: Boring # 0 ,e .2 f 1 Y S /f S6 A fP C 4 Ground elev. Depth to limiting factor 7 S?�_in. Remarks: CST Name (Please Print) Signature Telephone No. R 0R E R r 2{itf3R i CA T � 7�5 = 3 06 - 8 i85 Address Date CST Number Private Sewage Con tiln e $55 O'Neil Rd. Hudson, Wis. 54016 ORIGINAL NOTE: Because of snow /ice cover over ground, the installer (designer) will need to determine exact system elevations for multiple long narrow trenches only after he can verify actual surface elevations and contours (currently buried on day of test under snow). Installer will need to carefully layout trenches using transit /level before he can propose trench sy � m elevations for sanitary permit. V PROPERTY OWNER SOIL DESCRIPTION REPORT Page Z f .oi PARCEL I.D.# GD /�7J' :, R AV ?T� -AND Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 E , in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench 3 / o- o yR 3 h- . Ground 3 0 he /� S A SPje n K-- 'P— elev. —� F9-LZ Depth to� / limiting factor Remarks: Boring # I f 5 c it.) . S Ground elev. Depth to limiting factor Remarks: Horizon Depth Dominant Color Mottles Texture Structure ry GPD /f Consistence Bounds Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # / 0 -7 40 Y 2 / 1 -- M^'rp— CS o 3 X / f3 c s zf • q; •s 3 �-9 0 VR V S 2tw, /h, -f' cS 1 f ,s Ground elev. Depth to limiting factor In. Remarks: Boring # Y r Ground elev. ft. Depth to limiting factor . - in Remarks: SBDW -8330 (R. 08/95) IMPORTANT NOTE TO OWNERS & INSTALLER: All the ;.finer tgxtured soils (lo(aMs' i is ,� 1 etc. ,. can & will be easily smeared Or compacted even by backhoe bucket during trench construction. When this occurs premature failure will result. As per ILHR 83.13 (4), the installer MUST be very careful to properly hand rake the sidewalls & bottoms to re- expose all of the soils natural structure. Minn. even recommends that scarifying devices be mounted on the sides of the bucket. Only in this way can treatment & absorption be most enhanced for normal longer system life. k 0 t � rr I l k ION OM I INI r � t N vi r p� 0 O y a I O _ N s s S ULBRIGHT & ASSOCIATES CO. 655 O'Neil Road • Hudson, WI 54016 Reg. Designers of Engineering Systems 715- 386 -8185 Private Sewage Consultants Re: Soil Test Sites, and Sitin g Your Home. To Owners/ Developers, Please be aware: All of the systems for lots #4,5,6,7,8 in Hartland Subdivision (tested under winter conditions March 11th & 12th, 1996) will require very large TRENCH TYPE conventional systems because of soil permiability restrictions.Conditions across other parts of each lot can/ and may require entirely different on -site treatment systems. Also, as required by state codes, an equally large replacement area has to be left intact UNDISTURBED with proper set -back distances to the well, other structures, etc. as deemed by code. Less space is required if the owner were to install a mound type system (i.e. no replacement area is required for mound type systems). Please understand, that in the process or procedure of selecting the actual homesite, if the owner will be using the soil test areas as provided and recorded by the seller /developer, the following is very critical: The installing plumber you select, or a registered designer or engineer should meticulously layout and plot the system as indicated from the soil report. And an equally large replacement area should be plotted out. Further information to be supplied by the owner is necessary in order to determine the actual exact size of the system. The final size of the system is dependent upon >the gals. of wasteflow to be generated from the proposed size of the home. The County Zoning Dept. must review the owners final house - plans; only then can the installing plumber determine the final size of the proposed system. All of this has to be carefully addressed before a builder and owner can safely choose one's precise homesite. Often times the original soil test area, provided for subdivision approval by the seller as required by County Zoning Dept. ordinances, is not in an area prefered by the eventual buyer, or perhaps the size of the buyers home may require a 'larger test area. New or additional testing may be required, since a septic system by law has to be laid out exactly within the recorded spot tested; it cannot be shifted out of the area recorded with the zoning dept. Finally, it is our recommendation (and of most consciencous installers) that when soil permiability on a site is very slow (.5GPD /ft or lower) to install a presurized, dosed mound -type system. It is the concensus Of most officals that mound systems will generally outlast in- ground conventional system (average life 10 -15 years). This is a very important option to cautiously consider. Remember, the two most important systems you will be depending upon for many many years to come is your well and the quality of your septic system. Robert Ulbricht Pg. 4 of 4.