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CROIX COUNTY ZONING DEP AS BUILT SANITARY REPOO\` -, - 1;1 c— Owner K a .3, c To s iow Properly Address O c7 !L 90 C City /State Afoul- o At Legal Description: ti ,r' Lot &A Block _I'_ Subdivision/CSM # T� / A6W t /4 A6E '/4, Sec., T, N -RAW, Town of . % 7a ° Lwil SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer GUeE/L5 Size ST/PC /GYIo/ Setback from: House _3_6-' Well 11,5 P/L 60 Pump manufacturer A1,4 Model IVA Alarm location x/4 (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location — — SOIL ABSORPTION SYSTEM Type of system: TePE/ILe Width 3 Length .S O Number of Trenches Setback from: Metm ZO , Well 6 ,2' P/L _ ©_ '_ Vent to fresh air intake 10 t BLoe- ELEVATIONS Description of benchmark BT17 oec STECL s'!o %VG- Elevation 1 0e , O Description of alternate benchmark I e/ l »,6F4 4- Elevation Building Sewer D ST/HT Inlet %'S , ` ST Outlet 7,5 �;- 6 PC Inlet PC Bottom Header/Manifold Top of ST/PC Manhole Cover Distribution Lines (1) . 57 2 2 () ( ) Bottom of System (1) 73, y�Z ( ) ) Final Grade ( Z9 2 ( ) Date of installation / / Permit number ,3 !Yq(, Z.6 State plan number Plumber's signature License number 22 17VI Date 2 l/5199 Inspector k �r - .✓�- Complete plot plan I t. NOTICE Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW ,� p< L. �'o O /- 3'X,50' 7 Qu «o <nr b �i Z71?A rO2 I N u Ste_ /000 GL. ;S < ✓', 3YIN zhtV E xf srix I J SCAt I � / �n�/N �iEc� ►: INDICATE NORTH ARROW Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count y Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: S1. CROIX Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 344648 Per El Cit ❑ Village Town of: State Plan ID No.: r Ls1Vme: JOSEPH (MRS.) S . JOSEPH CST B Elev.-.- L Insp. BM Elev.: BM Description: Parcel Tax No.: 7 6 6 lea .,-�' ,� ,. 030 - 2058 -80 -000 TANK INFORMATION - ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic r 5 �� Benchmark 5 P2 10 d[� A �G o Ion Bldg. Sewer J Holding &P/ Ht Inlet TANK SETBACK INFORMATION 9/ Ht Outlet 1 6. , ?B s TANKTO P/L WELL BLDG. Ventto ROAD t Air Intake Septic 75Lj 1 / 7 3,5/ NA D o sing NA Header/ Man. 70 q Aerati NA Dist. Pipe a Holding Bot. System 13 PUMP/ SIPHON INFORMATION Final Grade S 3 Manufacturer Demand Cj:Crfj 1 6 . /�1. S Model Num PM TDH Ift Frictio S stem TDH F L oss ad orcemain Length Dia. Di well SOIL AB ORPTION SYSTEM BED / ENCH) Width I Lengt No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMES DIMENSION SETBACK SYSTEM TO P/ L BLDG WELL LAKE /STREAM LEA Manufacture INFORMATION Type O f AMB Model Number: System: ZS 2 ys Q IT DISTRIBUTION SYSTEM Header / Manifold Q Distribution Pipe(s) /� _ x Hole Size x Hole Spacing Vent To Air Intake Length A Dia. /✓'l� Length "� r Dia. /" / N+ Spacing 11 74,9 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: ST. JOSEPH 27.30.20.567A 50 COUNTY ROAD E ��f�'," I ' � BI� Syf�� 1-f GtS�pr `{o� �0 %S �iL ����.�✓,-�� �Q/l�r, � dfs aY h��S rcM^'— GfJ'1J�✓ (IOGI�/ '� "'� 'Zx k,e6 Al ye�, !h 5.,kf[ U/0 r k / 5 41 & G — D T �G4 S�� u�L1C fr 1 A ► 6 - + Govt/ �a4t-/ Sy14ft �Aet/S IV r 14 r�[l.Sf�6�/ C� Aft `bp o4 W��/ s {�, k�eh btile Plan revision required? ❑ Yes ❑ No Use other side for additional information. 1 16 G SBD -6710 (R.3/97) Date Inspector's SigrIdure Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: 2 ; �s t ve i i I 3 i ( g 4 E a E. e e � , .m _.,. .. .. s 3 z 3 ... ..,.. r... .m�. E ,. .. f . _�. _. ................. .�e 4 - r e s 3 i E 9 k t E N i 3 F F a ¢ »w k w E f" e r M _ m i s ! pp { ». x S 3 3 .. r g k E E 3 a LJ v . s , j a ,. ..�....... . s �.. ..... _..�..w.J ,, t .. m.. . vp ..�.r.a.. e. ,,, 4 .m k � �M� 4 v r 4 v s E ¥ k t z �° 10 +�1 + SANITARY PE 6CA 1,1 201 E. W shnlgton Avevision Visconsin In accord with 1 .05 Code ;' -t P.O. Box 7969 } Departfnent of Commerce CE1VF® Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for he; ystem, on paper not les3" County than 8 to x 11 inches in size. t • See reverse side for instructions for completing this icati0 b �� �1 p , ` State Sanitary Permit Num /O ber The information you provide may be used by other government agent 0In�PNINGCiFF;C;E ' E] Check if revi on to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL , R ATI S Property Owner Name perty Location o E �1ia va, T 30 ,N,R,Z E(or� Prope Owner's Mailing Address Lot Number Block Number " City, State Zip Code Phone Number Subdivision Name or CSM Number :5 p vol At a> II. TYPE OF BUILDING: (check one) ❑ State Owned. ,, - e ,., , , , ❑ ity Nearest Road (�( P ublic 1 or 2 Family Dwelling - No. of bedr ❑ To of y 7 /P4 E III. B USE (If building type is public, check all that apply) Parcel Tax Number(s) 9`1. �o. ,�. 5,-7 1 ❑ Apartment/ Condo o3 " 80 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 'R 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_ X Replacement 3, ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing S ------ -------- ________________ 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 CffSeepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit • ' 43 ❑ Vault Privy 14 E] System -In -Fill k 6 -} t�t,Wt� VI. ABSORPTION SYSTEW INFORMATION: 1. Gallons Per Day 2: Absorp. Area 3. Absorp. Area 4. Loading Rate 5_ Perc. Rate 6. System E�t 7. Final Grade squired (sq. ft.) Proposed (sq. ft.) ( Is/day /sq. ft.) (Min. /inch) Elevation 0 . (� Z 8 91 Feet acl VII. TANK Ca t in g allons Total # Of Prefab. Site Fiber- Exper- INFORMATION New Existing Gallons Tanks Manufacturers Name Concrete strutted Steel glass Plastic App Tank Tanks rte. tic a Tank O00 Q U E� rs Y.JI ❑ 1:1 El 1 1:1 r ❑ ❑ 1 ❑ 1 ❑ ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) P m er "s Signature: o Sta s) MPRSW N0 Business Phone Number: f s �C� PT Ac dress (Street, City, State, Zip Code): S IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater ate Issued Issuin ent Si nature (No Stamps) Approved ❑ Surcharge Fee) Owner Given Initial � c— - -----" Adverse Determination 0 2c � n � e J X . CONDITIONSAPPROVAL / REASON FOR DISAPPRO„ 'Z l'( t,� f v C • � t.Pf '/ „fil ! cf— , e l,-J SBD -6398 IRA tom) DISTRIBUTION: original to county. One copy To: Safety 6 Buildings Division, Owner, Plumber A J 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 I 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 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 2226 ROSE ST LA CROSSE WI 54603 -1905 TDD #: (608) 264 -8777 i scons i n www .commerce.sta te.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary August 17, 1999 CUST ID No.221741 ATTN: POWTS INSPECTOR ZONING OFFICE DONAVIN L SCHMITT ST CROIX COUNTY SPIA 586 VALLEY VIEW TRL 1101 CARMICHAEL RD SOMERSET WI 54025 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 08/17/2001 Identification Numbers Transaction ID No. 240955 Site ID No. 1 78927 SITE: Please refer to both identification, numbers, Site ID: 178927 above, in all correspondence with the agency. St. Croix County, Town of Saint Joseph NWIA, NE1 /4, S27, T30N, R20W �� i —t_ ` a 3� Facility: Custom Plastic Embedding FOR: i Description: Non - pressurized In- ground System %''!? Object Type: POWT System Regulated Object ID No.: 485930 ' O,9 The submittal described above has been reviewed for conformance with applicable Wisconsin istrative Cq and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or u e: • The leaching chambers must be installed in accordance with the manufacturer's printed instructions, the plan approval and Comm 83, Wis. Adm. Code system sizing criteria. If there is a conflict between the manufacturer's instructions and the plan approval, the plan approval and code requirements will take precedence. • If the existing septic system remains in operation it may need to be evaluated for code compliance if it has not already been completed. • The plumbing for this project discharges to a private sewage system. The approval covers only domestic /sanitary wastes directed into this system. The Department of Natural Resources must be contacted regarding the treatment and disposal of all industrial wastes, including those combined with domestic /sanitary wastes. 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. f DONAVIN L SCHMITT Page 8/17/99 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 08/09/1999 FEE REQUIRED $ 110.00 FEE RECEIVED $ 110.00 erard M. Swim BALANCE DUE $ 0.00 POWTS Plan Reviewer - Integrated Services (608)785-9348, Mon - Fri, 7:15 AM - 4:00 PM jswim @commerce.state.wi.us Wi$MA codO ' ,, SEPTIC SYSTEM for Mr. Joseph Schettle 50 Cty. Rd E Houlton, WI 54082 NW114 of NE114 S27 T30 R2 0 W St. Joseph Township St Croix County Page #I Data Sheet Page #2 Soils Report Page #3 Plan 4 w� Y /P 59 b Y Donavin L. Schmitt 586 Valley View Trail Somerset, WI 54025 715 -549 -6651 MPRSW 221741 8 -2 -99 S py ti DATA SHEET FOR: Mr. Joseph Schettle (property owner) 50 Cty. Rd. E (NW1 /4 of NEU4 S27 T30 R20W) Houlton, WI 54082 (St. Joseph Township, St. Croix County) BUSINESS. Custom Plastic Embedding (Renter) 1 Floor Drain 50 Gl. 5 Employees 100 Gl. 150 Gl. per day @.6GPD Rate Septic Tank Week's Concrete 1,000 Gl. S.T. 250 Sq. Ft. Trench Area Required = 1 - 50' Infiltrator Trench, 8 Infltrators@31.8 sq. ft. ea. @ 6.25 ft. long tMscon,tin Department of Commerce SOIL AND SITE EVALUATION Diviskxt of. Safety and Buildings Page of 3 Bureau,ot'Integrated services in accordance with s. ILHR 83.09, Wis. Adm. Code AthWh Count 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 � , ' percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # 03 0 — a? 05W -do APPLICANT INFORMATION - Please print all Information Reviewed by Date pstawtol kom"011 ybU 1#MW1tio # # big 11#40 fn# M11P.M111141Y Id111v14AM (Plival'y I aw, 10 1 R 04 (1) (m)) . 1 ^ ropedy Owner // Property Location M ICS S h e Govt. Lot 1%lij 1/4 IVJ�114,S T,3O ,N.R 4 Q,0 gllwd) Property Owner's Malling Address Lot # Block# T Subd. Name or CSM# N4 /V/1 1V'4 CI State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road w.Z ae (7�s > S'V9- 7* C o❑t New Construction Use: ❑ Residential / Number of bedrooms Addition to existing building o,l Replacement c y� ® Public or commercial - Describe: C[c S �Ov►� p�wS ��C �� Qc>/�i rva a Code derived daily flow .J v gpd n�-y, Recommended design loading rate bed, gpd/tt - d/ft trench, gp Absorption area required DQ bed, ft 57, tren it 2 Maximum design loading rate ± ,' bed, gpd/fts gpd* t Recommended Infiltration surface elevation(s) 71 a0 it (as referred to site plan benchmark) I Additional design /sfte considerations ./ /� ' /LrS'1� use .�. �: ��,�- ,at�or ��o�.,^►.. Ghd+•.6ax bCG.�...t• O wl Parent material 0&' AJA1 4 P A& Flood plain elevation, if applicable /VA it S w Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in FIN Holding Tank U . Unsuitable for system Q( S El U IR S ❑ u 1f s El ® s ❑ u B{s ❑ u [I off u SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench Q 312 'L C&" . Ground 3 -Y4 7,S' � / 51'a 7 C . A. Depth to r S L .2 L r- ""' ; • limiting factor a Remarks: Boring # O� D hr+ Ground Y C 0 Depth to limiting factQr -yin. Remarks: - - CST Name (Please Print) Signature Telephone No. Address Date CST Number yy/ "gyp PRbPERTY OWNER M -1-01W �i SiG �e/T/� IL DESCRIPTION REPORT Page rt) g of 3 PARCEL I.D.if e Boring Horizon Depth Dominant Color Mottles Structure 2 g Texture Consistence Boundary Roots In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench Ground 3 �$w V/ 4 fi n. 7.S Q VAL �-- 'L -Psl w P. 9.) S ' Dep to 2, J /y L hi r limiting factor Remarks: Boring # Ground elev. I. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # Q , Ground ft Depth to limiting factor in. Remarks: Boring # i . Ground elev. ft. — -- , Depth to limiting factor In. Remarks: SBD -8330 (R. 07/96) ■ I ' ■■ ■■ ■emu■ , ■■■ E■■ ■r� 'M ■1 /E� AMU mmil!!N ■ MEN ■■■ ■■■ ■E N■ ■N ■w ■EOM N ■■■■ENoRz .. ONES OET02 NEON 010 NEON ■ NNW F, MORE ■■■■ BONE - = .- . , - = ■E■■MEmm mm�, MEMPSAR In, mmum III MI No ME mmml n mom him 11111 MINI lam IIIIIIIIIIN IMEMES Ills W 1111111 1 11MEN ONO IiY� loom lmmm immm Immm No 10ME ME 1M7M11l7;��MOM wiscon' of Commerce SOIL AND SITE EVALUATION Din of Safety and Buildings Page of Bu eau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size PI must --I- County include, but not limited to: vertical and horizontal reference point (BM), directionApd ' r S I C ' percent slope, scale or dimensions, north arrow, and location and distance �yfad. ti' rcel I.D. # APPLICANT INFORMATION - Please print all informatiog ', 4 , ' , f die d by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15,Q� ( pY ± �- f c Property Owner ti M rs, s� je ' )Wvt. Lot f� 1/4 N,'1/4,S.2 T,3, ,N,R 69 v VW, V Property Owner's Mailing Address _ foot VI ' 99 Subd. Name or CSM# State Zip Code Phone Number ❑ City ❑ village Town Nearest Road N-A" 14) X08.1 c 21s 5394 7* , - C v ❑ New Construction Use: ❑ Residential / Number of bedrooms Addition to existing building t�l Replacement ® Public or commercial - Describe: Cu 5 > y,,j 1 14" 74 G 6 edo/i +1 e Code derived daily flow S O gpd Recommended design loading rate J bed, gpd/fi .� trench, gpd /ft Absorption area required J00 bed, ft' o? trench, ft Maximum design loading rate bed, gpd /ft 2 _. & _j�_ trench, gpd /ft O t Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) �1 / Additional design%site considerations MLt S k u se _n P 14r-ai l L.. C 1 tar, be-7 LCC� ,14Jo 0 ,e QA Parent material 611 4 P lei Flood plain elevation, if applicable N1 ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system Xf S El W S ❑ U 9 S El U ®S ❑ U kS ❑ U ❑ S kr U SOIL DESCRIPTION REPORT Boris # Horizon Depth Dominant Color Mottles Structure GPD /ft Boring Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Ground 3 P Y -y,Q 7 S o7/ elev. Depth to limiting 1 factor `31 f 1 31 in. Remarks: Boring # Ground 1 l-f y 7i !e /+'t tom^ C l.J . . b -deft. , Depth to limiting -/W fact r in. Remarks: CST Name (Please Print) Signature Telephone No. - 7 .Gn -► 4s T, Address Date Date CST Numbe PROPERTY OWNER � yoae .X �e/Tt� IL DESCRIPTION REPORT g o Pa PARCEL I.D.# 03O "— 02 0' 29 Borin # Horizon Depth Dominant Color Mottles Structure 2 g Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench sit Ground �•.. �le / L , ! 7r Q ft. 7 S f2 1 a71�51 l� W► n �r lnJ Depth to bk M t r- limiting a� factor 'I. / in. Remarks: Boring # ........................... .......................... ........................... Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # ; ......................... ......................... .......................... ......................... ........................... Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) • t �d3 o f 1 � 8 4 V f a '2 1 31 � - 17 8 5 laf -- _ �`• �X i5 iin [' �f Q� I I I , I _ I , I � �I � I } �s _ S � � 'J � �i� # /e ..Sho p� �I n { k a ' , ! r , , , ' i : JID 1 ST CROI K COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer zjoy -ia Jll &# — TTG1 4 � Mailing Address �"0 G `/ A Q Property Address � CT�y 120 L� (Verification required from Planning Department for new construction) City /State Ak U l-rQM cy /` - Parcel Identification Number 030 --,t -SO LEGAL DESCRIPTION Property Location YW %4, A7 ' /,, Sec. AV , TAO N -R Town of e asp Subdivision ,� . Lot # Certified Survey Map # Volume . , Page # Warranty Deed # 3 o� Volume G O , Page # 13 Spec house ❑ yes M no Lot lines identifiable 13 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 master plumber, 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. 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 owners) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. A 4a gLCL- ely / 9 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 rGFf -x.-99 TH_1 '. l Cl a" IFILTRATOR SYS71 "S 'lk% 1 -S6C +383 +6'3 F 02 Mr■ �J SYSTEMS INC The world ieader to chailibor techne;ogy` January 20, 1 999 Tarr) Schwil' 5+36 Val ey 'view gala Somerset, Wi 54025 Qeor Mr. Schrriti Thank you 4or your concern rega ditivp tree Ouriol detain of our char nber ISochfleld sys*enls. T fr�iv ally we f'nci teat le•achfields are burled ai rather sha law depths due to the aerobic conditions which arc lovorable there, Ircreci5ed depths moke if 6 for neecied oxygen to diffuso irlto 1h. SJr rounding soils and pf ovi5;01 are rccommender fo; ailawincg this: t,ansfer to tokr_, place (one recommendation would b tc ve the ysterr. 7hls serves crs o vehielO in wr:ich Ur can be t ansporfed, tc• trio tranc hes. (do no' off6pa'e arty s #rucrurul probic ns -v proposed design. A rc•sider)ticl fre burial death of 6' is not u!ncornrwt ri. in `fact we ha' mono sy:tcros insidled at these depths in Colomdo. Again thank you for your concern cn�j if I can b_: of on-/ fur'her ossistarce piense call our Technical Wcs cnd 5ery 'lees Crept. 800 -22 -4436. Sinccxc;11y, Ron L Mira Technical Consulont cc: Jeff Iverson, lnfiitrctor Systems inc. C0�'pv�rliP OUr'v 4 o £. F'S F<rs: FuGC . PCl, 5 768 « 7! '5"1%^1C)" C, OC475 . e6O .sey-...', 1 Frx (rec; Wiscprsin 9epartment of Commerce SOIL AND SITE EVALUATION / Qivisjot? of Safety and Buildings Page ( of 3 Burg,%u of Integrated Services in accordance with s. ILHR -8&0 Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in svie` Plan must ' unty include, but not limited to: vertical and horizontal reference point (B direction nd'& s�i �� L percent slope, scale or dimensions, north arrow, and location and st�tq a to ne FE ti Para I.D. # APPLICANT INFORMATION - Please print all info on. k Revfe�ed by Date Personal information y ou p rovide may be used for seconds u T ''' y p y second purposes (Prlva y L ,. , s. 15.04 { M . 1 1 Property Owner L'` r}r�fion .govt. Lot lVt,,1114 N 1/4,S a T 3D ,N,R 'o lEft W Property Owner's Mailing Address L t Bloc {5f0 ` Subd. Name or CSM# City State Zip Code Phone Number rd _ ❑ City ❑Village � Town Nearest Road ❑ New Construction Use: ❑ Residential / Number of bedrooms Addition to existing building Replacement bi or commercial - Describe: i ., (, ��%/; h pb i Elf -3 s i P A, Code derived daily flow �� gpd Recommended design loading rate gi bed, gpd /fi _ trench, gpd /ft Absorption area required W % bed, ft /0 9 trench, ft Maximum design loading rate bed, gpolfi . O trench, gpd /ft i+ Recommended infiltration surface elevation(s) FCC 1/ y It (as referred to site plan benchmark) Additional design /site considerations e beA.c, k t p ' , Parent material GtJ l L h �� hFl od plain elevation, if applicable /Y ft S = Suitable for system Conventional Mound In Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S U ZS El U ❑ S L�rU ❑ S kr U ❑ S 4 U ❑ S WU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed '. Trench ve cis P A /ov 2 ),/ Ground &j 3 r-P ir✓ o7` b elev {- Depth to limiting 1'� .� r / 0 — factor ° -7_in, Remarks: Boring # a . M . Ground 6 k l ,.2 e ft. d 7S S� /�✓ �5 ,., b� ✓ �- Depth to limiting factor c?(in. Remarks: CST Name (Please Print) Signature Telephone No. Address / Date CST Number /E CO / �it.✓ /1^Gr r c�7 "! P� - S4i� [/ �, 7�b� �� - �.c�" 9 c.? 7 ' 4 5'.2 _h'�OIL DESCRIPTION REPORT ^ PROPERTY OWNER P &L 0320 �e P Page o PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench A0 31-2 Ground z5w 2,�� If fit. .2 — VAP e.2 _3 Depth to G 7 limiting factor .26 _in. Remarks: Boring # /f E c o c' TR b ed . 4 -OP Yhe Co - Z 0 4e Q roof Ground P 41 2 4 r'Z G' C f v r � elev. / .�t f ft. P C T C i� G /'I , O e l Depth to f lc B limiting r0 �� re 17 ._ ° 7�/ie o / Sre ea_ factor Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench Boring #� c Ground n c4 Xp elev. od Depth to r" S� /4 7 Ii Cfi r Gl>� / 4r i► 7 , rs- r- limiting P (,� n S </ e !h S �� /T'r' S e ��r �r r Cl/ factor in. Remarks: Boring # 7" � � /��, r+ �'iG+ -• � �j�rt G✓'A `p �U " / r E+ -..I� Gar+ i G w�- . Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) r _ e I j i - '� I t i i aZ i I 3 30 , 4a 9 on ph lqP BrP7 ogo -- o `ti`s( ' A r Mrs, ep �+ Sc, lr � �e � f""I b y 1 10 cr .a!7 c,✓r s(40.2 t5' /lam OI fi t'- �YO.zs— l� �=1 f i -•� �..,� �� ST. WISCONSIN NTY ZONING OFFICE ■ w r N ST. CROIX COUNTY GOVERNMENT CENTER " ■ ■�, 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 January 11, 1999 Wisconsin Department of Commerce ATTN: Jerry Swim 2226 Rose St. LaCrosse, WI 54603 RE: Mrs. Joseph Schettle's onsite soil verification, NW '/4 of the NE ' /a, Sec. 27, T30N R20W, Town of Saint Joseph, St. Croix County, Wisconsin Dear Jerry: have reviewed the soil report for Mrs. Joseph Schettle, filed by Tom Schmitt, ID #227429 and have conducted an onsite soil verification of this property on December 10, 1998. My findings have verified that the soil conditions as reported by Mr. Schmitt are accurately described. The soils at this site are suitable for subsurface sewage disposal with a loading rates of 0.5/0.6 GPD /sq.ft. Mr. Schmitt will be submitting a petition for variance under Comm 83.09 (2)(f) Color patterns not indicative of soil saturation for this property. Mr. Schmitt has identified suitable soil conditions that would provide an adequate treatment zone for wastewater prior to discharge to the environment. I do agree with Mr. Schmitt's synopsis of how the mottling occurred. This property is approximately 200 feet above the Ordinary High Water Mark (OHWM) of the St. Croix River. also recommend that the embedding activity uses recirculated water to reduce the potential wastewater load entering the proposed system. If you have any questions regarding this issue, please contact me at the number listed above. Sincerely, rw 6 ��e Rod Eslinger Assistant Zoning Administrator cc: Tom Schmitt file AS BUILT SANITARY SYSTEM REPORT OWNER r7dt - S '.;yN r 7 G i7 TOWNSHIP 57t SECTION — T , UG N -R -W W ADDRESS 30 C -% `l /?D k� i ST. CROIX COUNTY, WISCONSIN C 4 i j2 Al O L 5�/ �h' SUBDIVISION LOT LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM gA i 9 138 5X59 f5G i colt elz INDICATE NORTH ARROW BENCHMARK: Elevation and description: 7 /3 d A C A E1 LL Alternate benchmark SEPTIC TANK:Manufacturer: (�C T S Liquid Cap. IOdO Rings used: 964 g .Manhole cover elev: '., ` Final grade elev: Tank inlet elev.: 3 2, L outlet elev.: C L l No. of feet from nearest road:Front_, Side , Rear Ft./-50 From nearest prop. line:Front , Sides, Rear Ft. 3 No. of feet from: Well 5 Building: 1.2 (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: W C r Liquid Capacity: ?QQ Pump Model f3) Pump /Siphon Manufact.: j= Pump Size Elevation of inlet: 9? ,j6. Bottom of tank ele4atiorn 2 S - Pump on elev. %,9 / Pump off elev.: Gallons /cycle: Alarm: Man.: 1 t Z1e 1 At 4 Rjj Switch Type: Location Distance from nearest prop. line: Front_, Side, Rear_Ft. 53 Distance from: Well 1:2 S Building SOIL ABSORPTION SYSTEM Bed: Trench: Seepage Pit: Width: Length 5 7 Number of Lines: Built 2G Exist. Grade Elev. Proposed Final Grade Elev. Fill depth to top of pipe: 72 No. feet from nearest prop. line:Front Side , Rear-�LFt.��, No. feet from well: jQ0 No. feet from building 1 t 9 HOLDING TANK Manufacturer: Capacity: No. of rings used: Elevation of botto"man Elevation of inlet: No. feet from nearest line:Front , Side , Rear Ft. No. feet foam: ° Well , building , nearest road Alrs&m Manufacturer: INSPECTOR•_ DATE — // --j- / / -- _ , PLUMBER ON J OB: 7 LICENSE NUMBER: 3d S 6 /90:cj �v rs'r artmt�r`�t'efllr� y PH 27.30. 1Vjfi %t AM SYSTEM . E County: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division ST. CROIX GENERAl�INFORMATION (ATTACH TO PERMIT) San itary Permit No.: Permit Holder's Name: ❑ City ❑ Village ❑ of: State Plan ID No.: CH T LST. JOSEPH CST BM Elev.: r Insp. M Elev.: BM Description: Parcel Tax No.: ` -!;� �``��Yt Q �_� 030-2058-80-000 TANK INFORMATION ELEVATION DATA A9200395 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic � �� Benchmark Dosing Ae Bldg. Sewer Holding St/ F elnlet v 961, TANK SETBACK INFORMATION St /A Outlet 9 ' TANK TO P/ L WELL BLDG. Ai Intake ROAD Dt Inlet X z0� s 6 Septic h ?c�J, ��� �' ,,� NA Dt Bottom's" Zo7 s Dosing 55'b / ���� /)N' NA Headed llAa 7 f ' NA Dist. Pipe 9' Holding Bot. System g•Y�'. 3' PUMP/ SIPHON INFORMATION Final Grade Manufacturer i Demand �T Model Number` 7 GPM TDH Lift �. Friction 0q System 0 11. Ft Forcemain Length ��' Dia. Dist. To Well >_5e SOIL ABSORPTION SYSTEM �S BED /TRENCH Width , Length No. Of T enches PIT No. Of Pits Inside Dia. Liquid Depth y, DIM 5 NI N SETBACK SYSTEM TO P/ L BLDG WELL LAKE / STREAM LEAC G Manufacturer: INFORMATION Type Of , , , CHAMBER el Num er: `- System: e /G /(id �>/lj OR UNIT DISTRIBUTION SYSTEM Header / Marrifefd Distribution Pipes; x Ho Size x Hole Spacing,.. Vent To Air take Length � / Dia. Length / Dia. Spacing o` SOIL COVER x Pressure Systems Only xx Mound Or At -Grade S s Only Depth Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched Bed /Trench Centek Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS (Include code discrepancies, persons present, etc.) -)(- S /7'(m e =_ LOCATION: ST. JOSEPH 27.30.20.567A,NW,NE,CO. RD. E Plan rev Ir5'on equlred. ❑ Yes Use other side for additional information. SBD -6710 (R 05/91) Date ' Inspector's Signat re Cert. No. SANITARY PERMIT APPLICATION 75iLHA I n accord with ILHR 83.05, Wis. Adm. Code COUNTY ST E SANITARY PItRMIT# -Attach complete plans (to the county copy only) for the system, on paper not less than -1 � - 1 8% z 11 inches in size. c if 4, ious application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATIO - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION Y4 Y4,S TN,R E (or W PROPERTY OWNER'S MAILING A LOT # BLOCK # CITY, STATE f I ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER c II. TYPE OF BUILDING: (Check one) 1:1 State Owned VILLLLAGE *. NEAREST ROAD E ❑ Public V 1 or 2 Fam. Dwelling —# of bedrooms 3— PARC ) 111. BUILDING USE: (If building type is public, check all that apply) 1 ❑ Apt/Condo 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 in line A. Check line B if applicable) A) 1. El New 2. pi 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 ## — Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 � Seepage Trench 22 El In-Ground 42 ❑ Pit Privy 13 Seepage Pit Pressure 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. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals /day /sq. ft.) (Min. /inch) ELEVATION Feet 9WP. Q Feet VII. TANK CAPACITY Site in allon Prefab. Fiber- Exper. s Total # of Con- Steel glass Plastic App INFORMATION New n tin Gallons Tanks Manufacturer's Name Concrete Tanks Tanks strutted Se tic Tank or Holdin Tank /1000 t � Lift Pum Tank/Si hon Chamber V VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plu is Signature: (No Stam ) /MPRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code): SAX " thf g - W TA IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater a te Issued ssuin Agent Signature Stamps) Approved ❑ Owner Given Initial Surcharge Fee) .. 1 1 1 N Adverse Determination X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: SBD -6398 (formerly Plb -67) (R. 11/88) 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 aO the 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 (S3D 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 licansed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your !ocal code administrator or the State of Wisconsin, Safety & Buildings Division, 608 -266 -3815. 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 in 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 in ##1 -7. VII. Tank information. Fill in the capacity of every new and/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, purnp /siphon and holding tanks for this systerm. Check experimental approval only 4 tanks received experimental product approval from DILHR. Vill. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County /Department Use Only. X. County /Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the count` /. 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 r ain- „ water service; streams and lakes; pump or siphon tanks; distribution boxes; so!! absorption systems; replacement system areas, and the location of the building S_? R) horizontal and vertica” elevation reference points; C) complete specifications for purrrps and controls; dose volume; elevaticzt ditferen - -es; friction loss; pump performance curve; pump model and pump manufacturer; D) cross sect'nn of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing Wformation. , GROUNDWATER SURCHARGE 1930 b " :isCon ;in Act 410 included. creation of surcharges (fees) for a numh::r of regulated pr,ectices which can cffoct groundwater. f€�t :nor t-ln ;!acted through surcharges , F- used for monitoring grocw�dw, +ter, c f:?und- water €�ni, tarnmation investigations and estahtishmeml of standards. SBD -6398 (8.11/88) howl J . / r1o1v 6L PA O `l 300 ��Qa4'��Sln 36�. a� �o T IV .Q i e s7 ems' sy �t Al i, k�N .2 X ? Tl�Eivc�Es ° fo — s .� T tjous� a Qr i. Z-7 �' ��� © B/`9. Top ©� OACK ORAL fceT P o i. D RA / co of Gll TTLE , h 3 flrr/�so.v GL o - 55%0/6 7/� r - t r - 0.7-5 Sv rCR 51 T TL E pL]h�F CHP.r ^.BAR CEiG�S SEC - A CPECIF I�!- T "10 " -`_ VEI.IT CAP 'i" C.I. `E• PIPE . APPROVED LOCKIP.IC: WEATHERPROOF JIJUCTIOIJ BOX MAIJHOLE COVEF. 25' F R -A 0 00R. W�wA�t/V /N� L�►it WIKICOW OR FRESH 12 "MIU. I AIR IAJTAKE GRADE i 4��MIN. COQDUIT `�- I13 ° hIIN. PROVIDE I �l INLET AIRTIGHT SEAL - 7 NT W /C.S. PIPE A I I APPROVED JOItJTS APPROVED JOI W/C.I. PIPE ( II I II ALARM EXTENDING 3' EXTENDING 3' I II ONTO SOLID SOIL OWTO SOLID SOIL b i I I ON C I ELEV. 6 f FT. Pump----- - -� OFF D CONCRETE BLOCK RISER EXIT PERMITTED 0WLy IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E „ SPEC IFI'CATIOUS DOSE IJLIMBER OF DOSES: PER DAy TANKS MANUFACTURER: TANK SIZE. __ &) GALLONS DOSE VOLUME: ALARM /yA1,lUFACTURE.R: :�%l�i -�! dP,4 IMCLUDING OACK FLOW - .— GALLONS MODEL NUMBER: CAPACITIES: A= INCHES OR - ,2 GALLONS SWITCH TYPE: r'C �i B= _INCHES OR 3 GALLONS PUMP MANUFACTURER: �`��`� t- 12 C= . �� _IUCHES OR /23� CALLOUS MODEL NUMBER: 1 32 D- !.2_INCHES OR 2- GALLONS SWITCH TYPE: L. N NOTE: PUMP AMD ALARM ARE TO BE INSTALLED ON SEPARATE CIRCUITS MINIMUM DISCHARGE RATE__32 GPM VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. Yl 'i FEET + MINIMUM NETWORK SUPPLY P7RE�/SS�URE��. . . . . . . . . . _ { 1� •1J FEET OF FORCE MAIN X L.tS�6._ F/00►LFRICTIOAI FACTOR.: � ° "4 FEET TOTAL Oy1JAMIC HEAD = 4, FEET I i NT ERNAL DIMENSIONS OF TAIJK: L"1= '`'sC="!'H 6.0 — ;WIDTH --- ;LIQUID DEPTH , SIGIJED' DATE: LICEIJSE ►DUMBER: / -` Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor anctAquiman Relations 4vision of, afety & 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. APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Joseph Schettle GOVT. LOT NW 1/4 NE 1/4,S 27 T 30 N,R 20 for) W PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 1230 Hy. 435 n/a n/a n/a CITY STATE ZIP CODE PHONE NU M BER []CITY [ EROWN NEAREST ROAD Hudson, Wi. 54016 (71� 549 - 6790 St. Jose h Co. Rd. #E [ ] New Construction Use [x 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 /ft2 •8 trench, gpd/ft Absorption area required 643 bed, ft2 563 trench, ft Maximum design loading rate • 2 bed, gpd /ft2 . 3 trench, gpd/ft Recommended infiltration surface elevation(s) 93.27 ft (as referred to site plan benchmark) Additional design /site considerations area to be excavate to 93.27 pipe to be at el. 95.27 or higher Parent material Glaciofluvial deposit Flood plain elevation, if applicable n/a ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem I ❑ U �❑ U us 13 U ❑ S 93U ❑ S fR U ❑ S 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 Trends 1 1 0 -9 10yr3 /2 none L. 2/m /sbk mvfr c/s 2/f .4 .5 2 9 -20 10yr4 /4 none sil. 1/f /sbk mfr g/w 1/f .2 .3 Ground 3 20-38 10yr4 /4 none sil. 2/f /sbk mfr g/w 1/f .4 .5 elev. 98. ft. 4 38 -66 10yr5 /3 none sil. 1/f /sbk mfr a/w 1/f .2 .3 Depth to 5 66 10yr5 /4 none Co. S. 0 /sg ml n/a n/a .7 .8 limiting factor > 120" Remarks: Boring # crusneci 1 0 -9 10yr6 /4 none lim rock n/a n/a c/s n/a .0 .0 2 0 -11 10yr3 /2 none L. 1 /f /gr. mvfr C/s 1/f .2 .3 2 3 3 11 -41 10yr4/4 none sil. 1/f /sbk mfr g/w 11f .2` .3 Ground elev. 4 41 -64 10yr5 /3 none sil, 1/f /sbk mfr a/w 1/f .2` .3 9 5 64-120 10yr4/4 none co.s. 0 /sg. 7 n/a .7 .8 Depth to limiting factor �y _k 1 Remarks: I _ `jr_ , ,�> o CST Name: — Please Print -> GarV L. Steel 715 -246- AA 1 t4 200th. Av , New Richmond,, WI 54017 ' Signature: D te. �, II Number: 10 -24 -9 [ ti PROPERTY OWNER Joseph Schettl & SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL I.D. # .--- - Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourx Roots GPD /ft in. Munsell Qu. Sz. Cont. Colo r Gr. Sz. Sh. Bed Trends 0 -13 1 r6/4 none crus d limestone pkg, lot, c/s 1/f .0 .0 2 13 -24 10yr4 /3 none sl. f' 1 n/a g/w 1/f .0 .0 Ground 3 24 -66 10yr5/4 none sil. 1 /f /sbk mfr a/w 1/f .2 .3 �Iv,B 4 66 -12 10yr4 /4 none Co. s. 0 /sg ml n/a n/a .7 .8 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 1554 280th. Ave- Gary L. Steel C.S.T. 2298 Joseph Schettle New Richmond, WI 54017 MPRSW - 3254 Ma4NE4 5.27- T3011 -R20W (715) 246 -6200 St. Joseph, township r i (9, y 10 0 1- o �� IA (4t I 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 nearest road. APPLICANT INFORMATION— PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Joseph Schettle GOVT. LOT NW 1/4 NE 1 /4 27 T 30 N,R 20 for) W PROPERTY OWNER':S MAILING ADDRESS LOT # I BLOCK # I SUBD. NAME OR CSM # 1230 Hy. #35 n/a n/a n/a CITY STATE ZIP CODE PHON N t�MB E q [:]CITY ❑VILLAGE ®SOWN NEAREST ROAD Iiu$son, Wi. 54016 (71 549-6790 I St. Joseph Co. Rd. #E [ J New Construction Use [ Residential / Number of bedrooms 3 [ ] Addition to existing building j x] Replacement [ J Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate • 7 bed, gpd/ft2 .8 trench, gpd/ft Absorption area required 643 bed, ft 563 trench, ft Maximum design loading rate • 2 bed, gpd /ft2 .3 trench, gpd/ft Recommended infiltration surface elevation(s) 93.27 ft (as referred to site plan benchmark) Additional design/ site considerations area to be excavate to 7 pipe to be at el. 95.27 or higher Parent material Glaciofluvial deposit Flood plain elevation, if applicable n/a ft S = Suitable for system CONVENTIONAL I MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ISM ❑ U 06 11 U 06 El ❑ Sc 93U [IS U ❑ S )MU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell C lu. Sz. Cont. Color Gr. Sz. Sh. Bed ITiench 1x 1 0 -9 1 3/2 none L. 2/m /sbk mvfr c/s 2/f .4 .5 C 2 9 -20 10yr4/4 none sil. 1/f /sbk mfr g/w 1/f .2 .3 Ground 3 20-3E 10yr4 /4 none sil. 2/f /sbk mfr g/w 1/f .4 .5 elev. 98. ft. 4 38 -6 10yr5 /3 none sil. 1/f /sbk mfr a/w 1/f .2i .3 Depth to 5 66-12C 10yr5 /4 none Co. S. 0 /sg ml n/a n/a .7 .8 limiting factor Remarks: Boring # Cl sne :n 1 0 -9 10yr6 /4 none lim rock n/a n/a c/s n/a .0 .0 �2 2 2 0 -11 10yr3 /2 none L. 1 /f /gr. mvfr c/s 1/f .21 .3 3 11 -41 10yr4/4 none sil. 1/f /sbk mfr g/w 1/f .2 .3 Ground elev. 4 41 -64 10yr5 /3 none sil. 1/f /sbk mfr a/w 1/f .2 ' .3 9 Depth to 5 64 -1 10yr4 /4 none co.s. 0 /sg. ml n/a n/a .7 .8 limiting factor >1 Remarks: [Addr T Name: — Please Print Gar L. Steel 715 - 246 -9�5 4 20 0th. Av , New Richmond, WI 54017 gnature: y (�� D': Number: 10 -24 -91 Z% PROPERTY OWNER Joseph Schettl &^ SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL I.P.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tn 0 -13 1 r6/4 none crushed limestone pkg. lot. c/s 1/f .0 1.0 .x 2 13 -24 10yr4 /3 none sl. f' 1 n/a g/w 1/f .0 .0 Ground 3 24 -66 10yr5 /4 none sil. 1 /f /sbk mfr a/w 1/f .2 .3 9. 8 9. 4 66-120 10yr4 /4 none Co. s. 0 /sg ml n/a n/a .7 .8 Depth to limiting factor Remarks: Boring # W Ground elev. ft. Depth to limiting factor Remarks: Boring # o:" �c.�:�<zi:: ^.:•. Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: S8D- 8330(R.05/92) STEEL'S SOIL SERVICE 1554 280th. Av Gary L. Steel C.S.T. 2298 Joseph Schettle New Richmond, WI 54017 MPRSW -3254 NW4NE4 S.27- T30N -R20W (715) 246 -6200 St. Joseph, township 19 L Jm- i� b r qew�> ' pr 0 ,1` r \ v «• -yYl fl1-' I I I _F1 l STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT t. Croix County OWNER /BUYER 7 5s ger/ate 6� N � r r� ROUTE /BOX NUMBER ,k WlU 3 5 FIRE NO. CITY /STATE U 5a,�_���� /�_ �6r� ZIP PROPERTY LOCATION: ,&W1 /4 & 1/4, Section :23_ T ?& N, R Town of �Si „ &Te # , St. Croix County, Subdivisio , Lot No. IVA 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 SEPTIC TANK PUMPER. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County Residents MAY be eligible to receive a grant for a MAXIMUM of 3000 of the cost of replacement of a failing system, tem which was in operation $P 9 Y , prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of ALL NEW SYSTEMS agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning 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 (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. I /WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Department of Natural Resources. Certification form must be completed and returned to the St.Croix County Zoning Office within 30 days of the three year expiration date. Q SIGNE DATE i J IV St. Croix County Zoning Office St. Croix County Courthouse 911 4th Street Hudson, WI 54016 (715) 386 -4680 Sign, Date, and Return to above address S T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner /contractor,(spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. ------------------ - - - - ----------------------------------- Owner of property r�/74 -//,e 7 -, 6F Location of property /4 &,E 1/4, Section �2�, T _20_N -R_,2&W Township Mailing address CA 5d � Address of site .5 CTY 0 Ac 4 7 Subdivision name YVA Lot no. IVA Other homes on property? yes No Previous owner of property Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Yes _ No Is this property being developed for (spec house)? Yes _)C_No Deeds .l and Page Number y of i-3 as recorded. with the Register of De --------------------------------------------------- INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER & THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I(we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No. 38 C _ , and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of County Register of deeds as Document No. ig ture of applica t Co- applicant 91 Date of Signature - Date of Signature REPT131 ST. JOSEPH ST. CROIX COUNTY ZONING PAGE 1 10/29/92 09:31 REQUESTS FOR INSPECTION WORK SHEETS FOR: 10/30/92 AREA: JT Activity: A9200395 10/30/92 Type: CONVSEPT Status: PENDING Constr: Address: ST. JOSEPH 27.30.20.567A,NW,NE,CO. RD. E Parcel: 030 - 2058 -80 -000 Occ: Use: Description: 186511 Applicant: B & J CO INC, C/O JOSEPH SCHETTL Phone: Owner: B & J CO INC, C/O JOSEPH SCHETTL Phone: Contractor: SCHMITT, DONIVAN Phone: 568 -4948 -------------------------------------------------------------------------------- Inspection Request Information..... Requestor: SCHMITT, DON Phone: Req Time: 11:10 Comments: / /; / Items requested to be Inspected... Action Comments Time Exp 00012 FINAL INSPECTION -------------------------------------------------------------------------------- Inspection History..... Item: 00012 FINAL INSPECTION