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HomeMy WebLinkAbout231-1066-50-000 g © 2 } k1 t & � X $ 7 ° / o @ E w U- ek CD � \ © w c§ o 0 t q $_ 2 \ ; i 8 ° 3 „ a) & £ fm � �� \. 3 \ — 2 t � m 4 -2\ / § k 7 n r ■ ■ o c o « ■ M 2 0 0 0 ■- � 2 [ 000 .. a . 2 < © t ƒ § CO) ■ ■ n; % , CD � ; 2 co go i� PO 0 Q E § e!§ (a Z — " / R \ 7 q m . a • _ ƒ ; 2 N w \ k } �. } § 2 ■ CL $ ƒ ■ z ) U E § e « 2 CA) % � k � R � . / c 0 % ƒ z � � ) � S � ƒ � 2 � $ � 2 tA � K 0 � � o � e < § NO _o �§ %! i ST. CROIX COUNTY r �3 WISCONSIN - - - -- -- PLANNING & ZONING DEPARTMENT Bill N ®N II M ■ Mn�r S T. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson WI 54016 -7710 Phone: (715) 386 -4680 Fax (715) 386 -4686 Wednesday, March 23, 2005 I Marvin Booth 456 Walnut Ridge Drive Glenwood City, WI 54013 Regarding septic inspection for Marvin Booth. Location of Property in St. Croix County: Municipality: City of Glenwood Subdivision or Plat: NA Certified Survey Map: Vol. 11 Pg. 3225 Lot: 9 Address: 456 Walnut Ridge Drive Dear Applicant: A septic inspection of the above reference property was conducted on March 31,2000. This property is located in the NW 1/4 SE 1/4 of Section 23, T30N R1 5W, NA Vol. 11 Pg. 3225 (Lot 9 ), City of Glenwood, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a 0 bedroom home. If you have any questions regarding this, please contact our office at 715.386.4680. Sincerely, Kevin Grab au Zoning Staff cc: file ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT A Owner Al S L/N © 4 Property Address e 10 ij City /State 6 Legal Description: 3 Lot T �- _ Block Subdivision/CSM # t /4 ,� 1 / a, Sec. .23, TjN -RAW, Q of T21e Grp ✓ PIN # r SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer Size ST/PCA Setback from: House Well &5" P/L b Z Pump manufacturer Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: a h Width Length 75 Number of Trenches c; Setback from: House Well P/L Vent to fresh air intake '; ELEVATIONS Description of benchmark O /E4 N9 7 1 V / 6e IN 0 -4 ,4 - rff Elevation Description of alternate benchmark 7`D� L� n - ,Pe--a l - Elevation i Building Sewer �J ST/HT Inlet ff,Z3 ST Outlet 7 PC Inlet PC Bottom Header/Manifold 10 / Top of ST/PC Manhole Cover �-3 Distribution Lines Bottom of System Final Grade Date of installation OS/31PV Permit number 3-' a 2 State plan number Plumber's s' ture � License number, Date 3 1311 00 Inspector 4 LO Complete plot plan p' J a 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 ot y 1�RM 8� to o �u 7 "d,A o�t re 'Z felvc ',4 1 es 4 o ' W r y ' ®r x �11 I, — INDICATE NORTH ARROW —� I r Wisconsin Department ofCommerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count y 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)). 353244 Permit Holder's Name: ❑ City ❑ Village ❑xTown of: State Plan ID No.: Booth Marvin City of Gle nwood CST BM Elev. - . Insp. BM Elev.: BM Description: Parcel Tax No.: . r tso • �i , �. +re - 231- 1066 -50 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ZaT7 Benchmark SS /B Y - s OfI ' v Dosing Alt. BM ZS Aeration Bldg. Sewer 9&V- 3S Holding St /Ht Inlet 6. 42 - c ffl , 1 3 TANK SETBACK INFORMATION St / Ht Outlet TANK TO P/ L WELL BLDG. Air I ntake ROAD Dt Inlet ---� Air Septic t i r NA Dt Bottom Dosing NA Header / Man. �- Aeration NA Dist. Pipe Holding Bot. System At � Y 6 .,q PUMP/ SIPHON INFORMATION Final Grade Cow - Manufacturer emand St cover 3 gZ /tqo, Model Number GPM TDH 1 Lift Fric System TDH Ft Forcemain ngth Dia. H Dist. To well SOIL A65ORPTION SYSTEM BEEft TRENCH Width i Len / No. Tr ches PIT No. Of Pits Inside Dia. Liquid Depth DIMEN I 5 S DIMENSION SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufa SETBACK INFORMATION TYpeO � ti 3(o 3b ` CHAMBER Moe Number: System: OR UNI DISTRIBUTION SYSTEM f 2 Header / Iifold u Distribution Pipe(s) r , x Hole Size x Hole Spacing Vent To Air Intake ✓ O �0 ' Length Pi Dia - Length f Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over ti Depth Over xx Depth Of xx Seeded / Sodded xx Mulched Bed /Trench Center �� Bed /Trench Edges Topsoil [] Yes [I No El Yes C] No COMMENTS (Include code discrepancies, persons present, etc.) Inspection #1: O'S/31 / Inspection #2: -4 421 Walnut Ridge Drive, Glenwood City, WI (NW 1/4, SE1 /4, Section 23 T30N -R15W) - 23.30.15.904 1.) Alt BM Description= 2.) Bldg sewer length =12.0 r r - amount of cover = y 1 a 5.;tt C01041 Plan revision required? ❑ Yes R. No Use other side for additional information. O 3 1 SBD -6710 (R.3/97) Date Inspector's Signature Cert No Safety and Buildings Division Ai scon W n SANITARY PERMIT APPLICATION 201 W. Washington Avenue In accord with I . P O Box 7302 Departrpent of Commerce LHR 83.05, Wi Adm. Code Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8112 x 11 inches in size. C • See reverse side for instructions for completing this application State Sanitar Permit Number 3 6 2 Personal information you provide may be used for secondary purposes E] Check if revision to p fevious application lPrivacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Propert Owner Name Property Location V /4 1 /4, S ,2� T _ . ?o , N, R /- NW) W Property Owner 's Mailin I Address _ _ Lot Number Block N Cit , State Zip CodV `17/.�umber Subdivision Dame or CSM Nu ber II. TYPE OF BUILDING: (check one) ❑ State Owned c] Ity Nearest Road Village Public 11 or 2 Family Dwelling - No. of bedrooms Town OF0 e& wood -de 1 4.. # rr e0 III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 E] Apartment/ Condo e�.3i �Ov e '"'J�0 4 DO 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. K New 2. ❑ Replacement 3_ ❑ Replacement of 4. ❑ Reconnection of 5_ ❑ Repair of an _System ________System _____________ Tank Only Existing S ______________ Existing System ________ gyrstem B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 5Q Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit f f 43 [] Vault Privy 14 E] System-In-Fill e2 S _tS VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6 em v. 7. Final Grade / Re uired (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation GOO 7j O ji 0,--- Feet X00, Feet Vll. TANK Capacit allo s Total # of n Prefab. Site Fiber- Exper. INFORMATION New Existing st Gallons Tanks Manufacturers Name Concrete u Tanks Tanks Septic Tank or Holding Tank ❑ I ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ I ❑ I ❑ 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) A "s Signature: ( Stamps) MP /AINo.: Business Phone Number: Plumber's Addr ss (Street, City, State, Zip Code): ki p G IX. COUNTY DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Signa ure (No Stamps) Approved Owner Given Initial • Surcharge fee) [I ,1 .14?g- Adverse Determination oC.ZJ�r X. CONDITIO OF APP OVAL / EAS FOR DISAPPROVAL: p► I • C�. d� WA04. I . CAIaX Cfz `Q �,e.+e/ > ' o� /liu SBD- 6398 (R.11197) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber ' V fAl O- O Liv Q i► i � I I i {{, 1 i - - -- - - - - -- 1 -'�. ' - ° k'- - - - - - -- - - -- - -- - -� ©v im ZA jtl 17 - �2 'X - 2 5 -- - - - -- - - - - - lvl e -- - -- — - - - — �- - - 7a t-T- -T- P i� �� .Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety amd Buildings Page / of Bureau 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. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and S/ O /' percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # ,7/- APPLICANT INFORMATION - Please print all information DA viewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner / Property Location y f �d O ��7 Govt. Lot W 1/4 1 /4,S� T ��!" 40" W Property Owner's Mailing Address Lot # I Block# I Subd. Name or CSM# a l'J L City State Zip Code V Phone Number City ❑ Village ❑ To ^ ym Nearest Road �,o ©d 1' New Construction Use: Residential / Number of bedrooms Addition to existing building Replacement ❑ Public or commercial - Describe: Code derived daily flow �d t� gpd Recommended design loading rate _bed, gpd1ft gpd/ft Absorption area required AD bed, ft 2 75:�2 trench,)t Maximum design loading rate bed, gpd/* trench, gpd/ft Recommended infiltration surface elevation(s) 6 ft (as referred to site plan benchmark) Additional design /site considerations /� Parent material 6 P /_ 14 a / �►- / 'y A l / � A Flood plain elevation, if applicable 9 ft S = Suitable for system I Conventional Mound In -Ground Pressure I AT-Grade System in Fill Holding Tank U = Unsuitable for system W ❑ u WS 0 u ®s ❑ u j D u ❑ s ®u CIS ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench i Gro ev. to 52.5{0 limiting fa ctor n 1 ' m. take - 6 ►v� vk+a�tQ ( o?; . Remarks: Boring # Of V a i � �._ Ground ' elev. � Depth to limiting factor >,la R emarks: CST Name (Please Print) Signature Telephone No. r2 Address Date CST Number 8' w G e wood 4, / / PROPERTY OWNER M/ )?I/ Br107`�i SOIL DESCRIPTION REPORT Page �h of J 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 3 o- �, r ' am s -/e/ J s " M ,4 ' '.S Ground p elev. Depth to limiting facto Remarks: Boring # LV Ground g elev. Depth to limiting fa to 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 # 0 -J - 2 511— 2ylirM I) A S P M ,s Ground 9 e le v. , ft. Depth to limiting factor >_ 11-in. Remarks: Boring # i3 Ground elev. ft. Depth to limiting factor in. Remarks: SBD -6330 (R. 07/96) • 1 /}l B —f, — L /�/ ei i — - - 77 - _�.— - --� _ I , s L1 SYSTEM ELEVATION AND SIZING CALCULATIONS Below Grade Aggregate Soil Absorption Systems Permit Number 11/29/99 Date X °X" Gravity Distribution only 1 Pressure Distribution 3 ft Suitable Soil 1 6 in Aggregate Depth 2 4 in Nominal Pipe Diameter 600 gpd Estimated Daily Peak Flow 0.80 gpd /ft Wastewater Infiltration Rate 750.0 ft Minimum SAS Size 96.00 ft Proposed SAS Elevation Soil Surface Acceptable Finished Grade EL 3 (ft) Boring Grade Limitation SAS Elevation (ft) System Minimum Maximum Number Elevation (ft) Depth (in) Lowest Highest Elevation? 98.50 100.33 1 103.38 104 97.71 101.88 No Cut required 2 100.33 107 94.41 98.83 Yes 3 98.75 101 93.33 97.25 Yes 1. Depth of suitable soil required below the infiltrative surface for treatment. 2. Depth of aggregate below distribution pipe. 3. Based on chosen system elevation, and aggregate depth. The addition of fill for cover or the reduction of finished grade may be required to meet minimum or maximum code standards. Personal information you provide may be used for secondary purposes [Privacy Law, s.1 5.04 (1)(m)]. SBD- 10553 -E (R.05/98) ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/BkqW l � / A 91/ / /V A� O L6 Mailing Address T��4 /- lV U f /�L�� �►' Property Address (Verification required from Planning Department for new construction) � City /State C Nun d o. d/ 7'� t�/ � i Parcel Identification Numbe r LEGAL DESCRIPTION clt�y _ o d f ��G � O y Property Location h/ 41 /a, .5�. /., Sec. ��, T�D N R„��W, �e�et�so �f/ Subdivision Gt/ Al U GI 7 R /0 9 c° , Lot # Certified Survey Map # 3 Volume Page # Y>- .�2 Warranty Deed # - S j Volume Page # S-5 Spec house V( yes ❑ no Lot lines identifiable JK yes ❑ no SYSTEM ANCE 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 lumber , J ourne Y�►P P ' lumber, restricted lumber or a licensed p umper verifying that (1) the on -site wastewaterdisposal system P 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. I/we, 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 statin g that Y our septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 ys of the three ear iration date. , l /aJ 7 NATURE OF kP ICANT 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 i f w recorded in Register of Deeds Office. the roe described ve, b v rtue o a warranty deed re o g P rtY Y h' O SIG14ATURE OF APPL CANT DATE * ** D * * * * ** * ** 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 f reference is made in the warranty deed a copy of the certified survey map t r ty ' '00LMENT NO. STATE BAH OF WISCONSIN FORM 11—'992 rHis SPACE. RESERVED FOR I:ECOROINd OATA WARRANTY OEEO 54 4 354 to ,� r � � " +,t •: RE GISTER'S OFFICE -- $t C"G Il X CO., VIII This Deed made between _ Rec'd for Racord It 1 pv a MWARTZBA ,__ 2 9 1996 1 1 A SINGLE PERSON and '•"�"c= Grantor. al 9:30 A. yy � � MARVIN C B N bNO �A N_4 - BOOTH, � 1ti�`*w�• 041 WUCQAWa AN0 WTFF F., • 13INT TENANTS R Of 911 Deal' 4 Grantee, W itnesseth That the said Grantor, for a valuable considerat RETURN TO 1ST NATIONAL BANK conveys to Grantee the following des cribed real estate in. ST. CFOIX CO. - OF GLENWOOD Cc :nry,Stateof Wisconsin: 204 E. OAK ST. LOT 36: Out "36" Glenwood. Begin.ing at the SW corner of the Section 23- 30 -15, thence B along Tax Parcel No 211 -10' 7 - 60 &_ S line of said of sub- division 40 rolls; thence 231- 1037 -70 turning right angle n 462 Feet, thence turning rightangle W rods; thence turning right angle s 462 feet to place of begining, excepting highway on W side above described land. LOT 37: NE Quarter of the SE Quarter (NE 1/4 of SE 1/4) lying West of highway; Also E half of NW Quarter of the SE Quarter (E 1/2 of Niel 1/4 of SE 1/4); Also SW Quater of the NW Quarter of the SE Quarter (SW 1/4 of NW 1/4 of SE 1/ ) except a strip of land sixteen and one half (16 1/2) feet wide 'on West side: Also S half of NN Quarter of the NW Quarter of the SE Quarter (S 1/2 of NW 1/ of NW 1/4 of SE 1/4) all being in section number twenty three (23) township number thirty (30) North, of Range number Fifteen (15) West. T This IS NOT homestead property. (is) (is not) Together with all and singular the hereditaments and appurienarces thereunto belonging; And — warrants that the title is good, indefeasible in fee simple and free and (:sear of encumbrances except and will warrant and defend the same. Dated this 40T14 day of MAY t9 96 (SEAL) t- (SEAL) JUDY A SCHWARTZBAUER (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF vVtSCONSIN $s. authenticated this day of 19 St_ Croix County. Personally came before me this � 10th day of to , 19 SL the above named — _ Judy Schwartzbauer TITLE: MEMBER STATE BAR OF WISCONSIN (If not, t0 me N ift Per who excuted the authorized by § 706.06, Wis. Slats,) foregoing inrt�n�f ckri i e the same. THIS INSTRUMENT WA3 DRAFTED BY ; � LA WRENCE M. LIGHTFIELD • ' Li _ FIRST NATIONAL BANK OF GLENWOOD Notary Pubt K St— C County, Wis. (Signatures may be authenticated or acknowledged. Both My Cmrssie�l arn, io r j t (11 not, state expiration are not necessary.) date iRsr _ "'' t9 97 .) Names of persons signing in any capacity should be typed or printed below their signatwes. 581 N1F OOTG ` WARRANTY DEED STATE BAR OF WISCONSIN Nelco Forms, P O Box 10208, Green Bay, WI 54307 -0208 li FORM No. 1-1902 FORM NO. 985-A 9 hso - r ., • Stock No. 26273 AR 2 5 � 199 3 6964 M � n�c��, �► R wq ��ISter CERTIFIED SURVEY MAP NO. 3225 VOLUME 11 , PAGE 3225 *� MC A PART OF OUTLOTS 36 AND 37 OF THE ASSESSOR'S PLAT OF GLENW000 CITY, AND LOCATED Nd PART OF THe N.W. 1/4 OF THE S.E. 1/4, AND PART OF THE N.E. 1/4 OF THE S.E. 1/4 OF SECTION 23, T.30 N., R.15 W., CITY OF CLENW000 CITY, W S3 \ r Q 3 0 .� 0 (a Z 44 NORTH IS REFERENCED TO THE NORTH Z og N O �a. \ —SOUTH 1/4 SECTION LINE, WHICH IS W v o ASSUMED TO BEAR 500'13'05'E. ll! z x a vi N \m Lu ��., is io / Z 3,3 3'333y3 3 o ~ , ° n �4) 1 111�11uu11YUUlp� /p co Cs `ch _ / �� v� / � o t cd � Jam! ? l � • W•.(``�Nh':1�'`:1 Nl�'`j tn O - -- 269.14 r �j� 2 x o p F__ ._._v ,___•' ___.,•____;.___ 500'13'OS"E O =O. to 4 � g vi � = cs 313 '3131 3 3 1 >4 .- �� NjiD I • M i I i� f- im1�n�i�i;'I:n�Nl:nlul(� Ir 30'3 �i,� ••..... t-in�o r i� N N : /���/ / /7 / /1) / /ry1111111111111 \ \ 1• ,...... + i -••. 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