Loading...
HomeMy WebLinkAbout004-1001-20-000 o CD ° O e t7 C! a) • 0. I o I � I ' N I v I f m I I o z U. c _o a � Q I U (0 � a I N L o Fr p Z c\ y y °' a m 04 o f O z v v cn z E C° O N O _ ►�► co O z z z N y c " (N E N L lC 0 Q (5 Y d o O C O D U d E 'NO U N N N N _ o o F- ~ ~ dl 2 N N v O O O z o o f • ►V a a m a � o N co co to U a rn 0) � m o c I O > ml � a. LO I Q •o �, aNi ;n � r_ •p N Q } u7 tp C7 � 7 �j O N C Lo O O CD M OU O O N r- (D C d O O O p L6 30 (n N m 2 N N H _ _ N V O O u; N W -0 in • ?' O O U LL M O z N z cr U) v � W M a it n N tr ` � IV n v 'c c m ' _1 A 0 d l,' o 0 0 � Parcel #: 004 - 1001 -30 -000 03/27/2007 11:40 AM PAGE 1 OF 1 Alt. Parcel #: 1.28.15.12A 004 - TOWN OF CADY Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - FRITZ, MIKKEL A & JENISE A MIKKEL A & JENISE A FRITZ 3220 50TH AVE KNAPP WI 54749 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description " 3220 50TH AVE SC 5586 SPRING VALLEY SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 4.750 Plat: N/A -NOT AVAILABLE SEC 1 T28N R15W SE SW S OF INTERSTATE Block/Condo Bldg: HWY Tract(s): (Sec- Twn -Rng 401/4 1601/4) 01- 28N -15W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 742/664 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 09/07/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.750 44,600 173,800 218,400 NO Totals for 2007: General Property 4.750 44,600 173,800 218,400 Woodland 0.000 0 0 Totals for 2006: General Property 4.750 44,600 173,800 218,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch #: 511 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges" Total 0.00 0.00 0.00 ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner KKe I'✓ I �" Address p+h City /State Legal Description: Lot Block Subdivision/CSM # �i-S- '/+ 5 n ( , Sec. I , T- N_R 1 W, Town of C PIN # 45E TANK — DOSE CHAMBER HOLDING TANK INFORMATION: Tank manufacturerrh; w esfc ✓H Size ST/PC 11.oa / �orb Setback from: House 1 � Well l o P/L, i oo - Pump manufacturer G'�ou ld � Model �/E 3 l i M (f°i'�) Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Meter location Water Line Alarm location SOIL ABSORPTION SYSTEM: Type of system: , u� C Number of Trenches Width 2 Setback from: House ' � -- _ Well P/L, Vent to fresh air intake ELEVATIONS: Description of benchmark 0 0 Description of alternate benchmark -7D 2 Elevation b O e Elevation W.,� ' Building Sewer i , h lS Net b • 17 ST Outlet. J PC Inlet PC Bottom --- L Header/Manifold 100- 7 Top of Manhole Cover 9 Distribution Lines Bottom of System( q q S 1 l Final Grade ( ) O ( ) Date of installation k—dildbPermit number -3-21 State plan number 1 Plumber's ' natureg' License number Date Inspector It Doac 4vJSvn 41 S1.6rut y :& n IA1 DG�f 4v drab{- h, as 4045 Complete plot plan a X 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 benchmar c, cable. Pc L E S st -, c$Pone Vr WWI ©wc�l °l U^ ",� INDICATE NORTH ARROW I qo c)v e Wisconsin Department Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division INSPECTION REPORT Ci'v /X 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)]. 30 Permit Holder's Name: ❑ City ❑ Village ❑ Town of: State Plan ID No.: Mi K I A 1 7j 75_ CST BM Elev.: nsp. BM Elev.: BM escripti n: Parcel Tax No.: w CJ d TANK INFORMATION I EVATION DATA 10(j Q 00 C? i TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic / �a� Benchm ! b 7 �, a •(� /60 Dosing 3. io3 Z Gz� Aeration Bldg. Sewer Holding eV Ht Inlet � (?� "7 TANK SETBACK INFORMATION / Ht Outlet - 3r 1 3 9 ,` 7 r TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet 4 Air I �� tog 13• ?q �' p Septic 1 1� NA Dt Bottom (�, lo• 5 $'S_• � r r Dosing a, NA Header / Man. 103 3.28 1 00. 34 Aeration NA Dist. Pipe 1o3, Holding Bot. System IIz PUMP/ SIPHON INFORMATION K4 Final Grade Manufacturer quv De v�, 1�, Model Number �EC�3 -96GPM iW &b 1V 3, (,Co} Do TDH Lift 13.q -7 Lriction 4 It Wterrt2 � TDH'�, Ft . 27 1 Forcemain Length 1o3 I Dia. FFiix) Dist. To Well SOIL ABSORPTION SYSTEM BED ENC Width °t Length No. { Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIME ' C DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEAC G Manufacturer: INFORMATION Type of j�/ y�/1 OR UNIT CHAMUE Model Number. S stem "t DISTRIBUTION SYSTEM Header / Manif9ld Distribution Pipe(s) f / Hole Size x Hole Spacing Vent To Air Intake 0 Length •J Dia. S� Length `l r•S Dia` 1' Spacing -8- 1 i! C/ Y S� SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only FBed pth Over TBed Depth Over xx Depth Of « xx Seeded/ Sodded xx Mulched /Trench Center IZ�t� /Trench Edges Topsoil 12 9ye5 Yes ❑ No COMMENTS (Include code discrepancies, persons present, etc.) 32,7,0 5j5 T11- /X PVC 07X4 -1-7-1) '7746 97.59 � b• i va ,SSA ,5:Qq •� 12 v �.eole/ +a re P-a c-4 C Ik" t k 4w K /2 ►� S' t( .:h - r Fram de tic N�� rO7 it Plan revision required? [fetes ❑ No Use other side for additi nal information. SBD-671 0 (R.3/97) 4 AVt Vjp Date Inspector's9griat p er ICS ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: I Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count )ST . CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanita 11 $ersonal information you provice may be used for secondary purposes [Privacy 1- s.15.04 (1)(m)]. Permit Holder's Name: I lab�o Village E] Town of: State Plan ID No.: FRITZ, MIKKEL c CST BM Elev.: Insp. BM Elev.: BM Description: Parcel 0049- :1001 f!�/CJ TANK INFORMATION EL NATION DATA A9800099 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic r 2z/0 Benchmark �, �� � Dosing �-Zc M 4 Aeration Bldg. Sewer Holding St/ 4f Inlet TANK SETBACK INFORMATION St /)4t Outlet TANK TO P/ L WELL BLDG. Air I to ntake ROAD Dt Inlet Air 3,7y �• p Septic 6A NA Dt Bottom S� Dosing NA Header / Man. ?j f Aeration NA Dist. Pipe ?i• 3,v Holding Bot. System p 3 r PU INFORMATION Final Grade Manufacturer Demand 7, 6 ' Model Nu a i9 �GPM M G 3 (Oa TDH Lift Friction System TD L oss H ead Forcemai nj Length 1 Dia. f Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length , ��� No. Of Tr ches PIT No. Of Pits Inside Liquid Depth D IMENSION o DIMEN SETBACK SYSTEM TO P / L BLDG WELL LAKE / STREAM HI Manufa INFORMATION TypeO ' A� % � O A NIT a N um er: System: u�l DISTRIBUTION SYSTEM Header / a Id a Distribution Pi (s x Hole S e x Hole S acin Vent To Air Intake i Length Dia. �`' Length p �Dla. Spacing CJ 5 g SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over 1 � 'l g Depth Over xx Depth Of i xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Top oil �y Yes ❑ No Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) 5 9 }' q7- LOCATION: CADY 1.28.15.11B,S,SW 3220 50TH AVENUE��'`� 12-7 ° q 't'r_ � 4 - n �-�� �- < -.P "(` r �.f :✓..�. V[..�s11i - -7. -? 0 dt !J �° C Ck' �- cif `f /c' Cr �Q.uE31 GfCfc �7F1} LX_ r11 li— T 4 ? ten J7ri • `r�G 'l gy V-4--le �' p `` 'Iplan required? Yes ❑ No Use other side for additional information. F I FJ I IJ SBD -6710 (R.3/97) Date Inspector's Signature Cert. No ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: yVW �t i t vi�FiR Safety and ofBuil Building atr D SANITARY PERMIT APPLICATION Bureau of Buildin Water System: 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, Wl 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 81/2 x 11 inches in size. "X • See reverse side for instructions for completing this application State sanitary Permi Number The The information you provide may be used by other government agency programs ❑ Check i l revision ]�re aQicatioo [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION PLEASE PRINT ALL INFORMATION 1 7/ ?5 Property Owner me Property Location / r S %tom► Sttca t /4, S j T ,Z$ , N, R /,s ii(orl Property Owner's Mailing Address Lot Number Block Number 77, 4V City State Zip Code Phone Number Subdivision Name or CSM Number i s 7el 1 7 1 (7/5 )772 ' Z36 IL Y BUILDING: (check one) ❑ State Owned 0 Cit Nearest Road �5 ❑ village C Public or 2 Family Dwelling - No. of bedrooms Town of / � 41 d Ill. BUILDING USE (If building type is public, check all that'apply) - Parcel Tax Number(s) 1 ❑ Apartment/ 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 box on line A. Check box on line B, if applicable) A) 1. ❑ New 2. p4eplacement 3. ❑ Replacement Of 4_ ❑ Reconnection of S. ❑ 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) Non - Pressurized Distribution Pressurized Distribution . Experimental Other 11 ❑ Seepage Bed 21 EIlOund 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 9'?, 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 c� 00 5.0o _'O© • 3 /V1 Feet Feet VII TANK Cap acit y in g allons Total # Of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Existin Tanks Tanks t�J ": y. strutted Septic Tank o o ing Tank 12.001 / .ZOO I ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /OG"O I ❑ 1 ❑ 1 ❑ I ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the on site sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No Stamps) MP /MPRSW No.: 1 ! ness Phone Number: a le �> crtXS'a�, . c �,-✓ 2�Ca8 5 3 .l 68 .3378 Plumber's Address (Street, City, State, Zip Code): Gtr / / IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuine Signature (No Stamps) Mpp ❑Owner Given Initial A roved Surcharge Fee) !I eo ` Adverse Determination L © V /ft E) CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6398 (R. 05194) DISTRIBUTION: Original to county, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. a 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority_ 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608 - 266 -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 on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, and p p , 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 8 1/2 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 r►sconsr►n Tommy G. Thompson, Governor Department of Commerce William J. McCoshen, secretary April 08, 1998 CUST ID No.6306 ATTIC• POWTS INSPECTOR BOLDTS PLUMBING AND HEATING INC 820 MAIN ST PO BOX 87 BALDWIN WI 54002 RE: CONDITIONAL APPROVAL Transaction ID No. 71759 APPROVAL EXPIRES: 04/08/2000 SITE: Site ID: 5499 ST CROIX County, Town of CADY S1 /2, SW1 /4, S1, T28N, R15W MIKKEL FRITZ FOR: Description: MOUND Object Type: POWT System Regulated Object ID No.: 11257 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes listed in the regarding line above. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Adm. Code. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(d), Wis. Stats. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /instal lation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. When making an inquiry or submitting additional information, please refer to Transaction ID No. in the regarding line. Sincerely, % DATE RECEIVED 04/07/1998 FEE REQUIRED $ 180.00 *GRD M SWIM, POWTS PLAN REVIEWER FEE RECEIVED $ 180.00 Integrated Services BALANCE DUE S 0.00 (608)785-9348, MON - FRI, 7:15 AM - 4:00 PM JSWIM @COMMERCE.STATE. WI.US BOLDT's i7VLL 1 ,iJ V LJV 1 PLUMBING & HEATING INC. "Serving You For 40 Years" 820 Main Street Baldwin, wi 54002 1 7 (715) 684 -3378 Fax (715) 684 -3144 0 759 Date: — Mound System For A q Bedroom Residence Located in the 5.k of the '/4 of Section / , TZLN, RZLW; Town of ��t'y , _ r �- L � County, Wisconsin. Index RECEIVED Page 1 of 8 Title Sheet APR _ 1 1998 Page 2 of 8 Soil Evaluation Page 3 of 8 Plan View -Cross We.' I)bfi BLDGS. DIV. Page 4 of 8 Distribution Pipe Layout Page 6 of 8 Pump Chamber Page 6 of 8 Pump Performance Curve Page 7 of 8 Plot Plan Page 8 of 8 System Plan Prepared For: P.o. °Wa Co 1101 -3 7�Z_0 5 �. co tiw 7/5 - 7 7 Z, - P � ? r � ��� V�1UN aNO�NC� Prepared By: SEE GORRE Dale Hudson Certified Soil Tester / Master Plumber #220863 r� Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of Bureau of Integrated services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach coat ete site on County pl plan paper not less than 8 1/2 x 11 inches in size. Plan must � Include, but not limited to: vertical and horizontal reference pant (BM), direction and 5 G o X percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # APPLICANT INFORMATION - Please print all Information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner / Property Location V 0 / T r t Z Govt. Lot ,5 %Z i�tf S'td 1 /4,S ' T 7 ,N,R f) (or N�/ / Property Owner Mailing 's Maili Address Lot # I Block# Subd. Name or CSM# City State Zip Code Phone Number ❑ City ❑ Village Z Town Nearest Road 1)1'. (77Z) 3,7 36 ccidv ❑ New Construction Use: Residential / Number of bedrooms 7 Addition to existing building y 5 Replacement C Public or commercial - Describe: _ Code derived daily flow 00 gpd Recommended design loading rate ' bed, gpd/ft -� trench, gpd/ft Absorption area required PO bed, ft 5 042 trench, ft Maximum design loading rate _ 1 _ ` bed, gpd/ft2 e 5 trench, gpd/ft p � Recommended infiltration surface elevations} ft (as referred to site plan benchmark) Additional designtsite considerations / �r Parent material S i �f�( s� 0�, ��9�/� Flood plain elevation, if applicable Nh ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ s ®u ,® S ❑ u ❑ s ,� u ❑ S ,® u ❑ S 'N U ❑ S "N u SOIL DESCRIPTION REPORT Boris # Horizon Depth Dominant Color Mott Texture Mottles Structure GPD /ft Boring Consistence Boundary Roots in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench /r 6 -8 0 YX 31 A4 4e, -S: r� a s 3m 'Z ' •3 Z 8 -i- o Yk Y - 3 one- ',- si 1.1-7 cw 17-: Ground 3 -3 D YK 1q 7• SYR Y 1 - .Z m 5 - `/ ; 966fL Depth to limiting factor in. Remarks: Boling # l 0-9 /o YR Z ; �3 Z I6 % y � o e. r_4'.) 3 - /o Y9 Y-1 e- s j Z sL m-F a j1> Z . 5 Ground ''f S /o YR " i y C Z of 75 V8 -5 ' 2 m s .�r `� ; •J elev. 1 1.5I I Depth to limiting factor 25 in. Remarks: CST Name (Please Print) / Signature 1/ Telephone No. Jj- 't 1e Z Hu/,'�Sa Address Date CST Number Zv - 57� Ba glZ 0 ?53 PROPERTY OWNER /1t L �ri �L SOIL DESCRIPTION REPORT Page of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. S h. Bed , Trench 1 3 1 / O 0 /O YZ. A/ ") G Si I 19 Sii r 4 5 3 - : Z -ZZ io Yk y / /Jar,- & s.' d K .3, ' Z- ; '3 Ground 3 ? - Z -3q /D MR y C zo! - 7•5 m SL-K /-Y� _P" elev. IJ - I -• Depth to limiting factor 2 Z in. Remarks: Boring # 13 2-14 . ` 1 /° YjR 31z o✓r , :E, S Y a S fin, ° Z : 2 0 /U o r, f� S� / 1,122 5_0 �' ,r C w 3 -2- . ,,3 Ground 3y .S1 �/Y�Sb / ,0, ✓ y- , elev. Depth to limiting f ator Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # E3 Ground elev. ft. ' Depth to limiting factor in. Remarks: Boring # 13 Ground elev. ft. Depth to limiting factor ' Remarks: SBD -8330 (R. 07/96) Page -3 Of Straw, Marsh Hay, Or Synthetic Coverina ' Distribution Pipe Medium Sand H 995 Topsoil L = - -= ---- = - -- = - =-- -- �. = 3 1 i E I D �oici 175 d � � J -1 2 /o Slope Trench Of 2"- 2 Force Main Plowed Aggregate From Pump Layer Undisturbed D Z,0 Ft. Soil E Z, /0 Ft. Cross Section Of A Mound System Using F - 7-5� Ft. 2 Trenches For The Absorption Area G 1-o Ft. A; :5 Ft. H Ft. B &-y Ft. .Signed: �5 Ft. License Number 2ZOe 53 K / Ft. Date: -3-3 L% 6 Ft. J -.5$ Ft. Alternate Position of Force Main I /Z -5 Ft. �. W 3 Ft. . L I � . r K ! C �-- - - - Force Main W kOs va tio� Permanent pes Z Markers ____ -_!• i Distribution Trench Of 2 N— 2 2 M � Pipe Aggregate Mound Using 2 Trenches For Absorption Area I i Page_ Of S Distribution Pipe Detail For A Four Lateral Network Alternate Position Of-", End Cap Force Main i P PVC Distribution Pipe PVC Force Main P X,-.,Holes Equally Spaced PVC Manifold Pipe On Bottom X S J�X X 2 Last Hole Should Be Next To End Cap + 5 Y P Ft. S 9.6 Ft. X !:;0 Inches Signed: Y (� d Inches Q,�- -�l � Hole Diameter Inch License Number: ZZO F5,3 Date: -3-3 Lateral Diameter Inch(es) Manifold Diameter - Inches Force Main Diameter 2— Inches I Holes Per Pipe Invert Elevation Of Laterals Ft. s ®ego' Page 5 Of g COMBINATION SEPTIC TANK /PUMP CHAMBER 4" CI Vent Pipe with (No Scale) Approved Cap, +25' _Approved Locking Manhole Cover From Bui ldings With Warning Label Attached n Weatherproof Approved _ Warning Label Junction Box Vent Cap 12 Minimum n mum Final Grade 6" Minimum 4" Minimum V Ma ximum Quick 4" C.I. ` Disconnect 18" Minimum { Insp. Pipe -- 1/4" Weep Hole Baffles i Approved Joint , A w /C.I. Pipe Extending 3' Alarm B Approved Joint Onto Solid Soil On 6; w /C.I. Pipe C Extending 3' .C? Onto Solid Soi Off D Conc. Block fig` $S�7 3" of Bedding Under Tank Note: Pump and Alarm Are On Separate Circuits Number of Doses Per Day Gallons Per Day/ of Doses: Gallons Volume of Backflow: ....... + 1e,. Gallons Tank Manufacturer: Total Dose Volume:........ /Gallons Tank Size-Septic/pump: /z.oc, Ga 1 ons Alarm Manufacturer: S T Model Number: Capacities: A go- /!? inches or ltll•/ Gallons Switch Type: 1 r + B inches or . Gallons Pump Manufacturer: G'� u / + C inches or Gallons Model Number: 3QS'T GJEo �i� L_ CtJ� + D /2, inches or2 Z.6 Gallons Minimum Discharge ate: mil• Total ..... _ / or ?.?q Gallons Vertical Difference Between Pump Off and Distribution Pipe: O Feet Minimum Required Supply Pressure:... ........... � .. ....... +,._Feet /C-p Feet of Force Main x �'2' Friction Factor /100Feet: + qE eet i Inch Diameter Force Main Total Dynamic Head: ... =IL-• Feet Internal Tank Dimensions: Length Width Liquid Depth__YL Si9nature '✓� nor✓ License Number - Date f "16 Oerformance Submersible Effluent .Curves Pumps METERS FEET 90 MODEL 3885 25 w SIZE 3 /4 " Solids WE,SH 70 = 20 WE,OH J 0 - WE07H 15 50 WE05H 40 10 30 WE03M W E - 0 - 3 - ' L — 20 5 10 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM I 1 1 1 0 10 20 30 m'/h CAPACITY �GWLDS PUMPS, INC. SEWCA FALLS NEW YM 13148 METERS FEET 120 MODEL 3885 35 SIZE 3 /4" Solids 110 WE15HH 100 30 j 90 25 a�a 70 W — ' S 20 J H � O f- WE051iH 15 40 10 20 5 10 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM 0 10 20 30 M3 /h CAPACITY 0 1985 Goulds Pumps. Inc _ Effective July, 1985 f" s G-C -'Z��� /��C� Z L- C) ?513 -3-31 � v 03885 r 0 b � � Ch I O Ir c� L- o o bol V I 9 9 N � p � N T' - w O� Z N n a a o bJ Iri Q � 3 � A o � a 0 o 1 V s O Q . tt •�1 W/` o S L LA t ti 9 N� n j N LAs 74 o x „�- rA $ (� kA BM Z I o 9 v � Q � 3 LAJ 1 o N Qq N �• .. o � WI`sconsin Department of Commerce SOIL AND SITE EVALUATION Division,of Safety and Buildings Page of Bureau of integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code complete site Ian on r not less than 81/2 x 11 inches in size. Plan must Count Att&ch com P P Pape include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and 19j; n nyi d'ist8nce to nearest road. parcel I.D. # APPLICANT INFORMATION - Pleas all " fthlm on. Re 'awed by Date ,� r+ rd7 Personal information you provide may be used for se o r purposbs { j w, S. 15.04,11 (m)). Property Owner c s Prop rty Location - � 1 993 G o Lot l 1 /as T Vq ,N,R y (or)o Property Owner's Mailing Address `% COUNTY Lot i Block# Subd. Name or CSM# 3L �� �(�-- ,,i ZONINGOFFlCE > A1 AX City S�tate Zip Code (Lin$' _ber � .\ ❑ City ❑ Village ,Z Town Nearest Road �f ❑ New Construction Use: ® Residential / Number of bedrooms Addition to existing building >;5 ,X Replacement ❑ Public or commercial - Describe: Code derived daily flow 4:�00 gpd Recommended design loading rate ° _ bed, gpd/fP trench, gpdfft Absorption area required bed, ft2 jOO trench, ft Maximum design loading rate '� `f bed, gpd/ft2 e — trench, gpd/ft Recommended infiltration surface elevation(s) ���1 ' ft (as referred to site plan benchmark) Additional design /site considerations �I Parent material 5i f / v Gy1i�r'lC Flood plain elevation, if applicable A/ ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system C3 S 0 U 0 S 01 U ❑ S A U TEIS ❑ S 2 U ❑ S"N U SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD/ft g Texture Consistence Boundary Roots in. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench • k' 6 - 8 0 le. ne, .Y " as J ?m •Z ' 3 Z 8 -r o Y - 3 one cw 3 trq ; Ground -3 b y 7:5W /F� Z ms 't . � , ele 46�ft. Depth to limiting factor .L -in. Remarks: Boring # Z - /b % l o e- s f /r7 -47� �W-('- aw 3-In ' •.3 Ground S ,3 /o W 4 'Y C Z o1 •5Y /$ S / Z ,-� S •�r 7 , ' S elev. Depth to limiting factor �S in. Remarks: CST Name (Please Print) L / Signature Telephone No. a le 1Yul�lSo r",, c 7vt� S-6 ?y — ?Z Address Date CST Number PROPERTY OWNER ► 1�e �ri / Z SOIL DESCRIPTION REPORT Page ` of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Muns ; ell s � Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench E 0 - S /oY %'Z 'Al o) e Si /r Sh r 4 S 3 -2- Z •ZZ /DY)P `/ /J o ^- e — Si M C w .3 3 Ground ..�' 233 M YR y C L 7.5 S z m /� t r 24' elev. , Depth to limiting factor 2 Z in. Remarks: Boring # El Z -$ iQ>�e Ale A c1 Si� S Y C3 jm m Z , ij 7 -14. /o - �S / o _c r/ G W 3.77 -Z ; '3 ? �3 l03'�P y nc Sn�s✓ C CO 2 Depth to limiting or in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # ; a'f , Ground elev. ft. ' Depth to limiting factor ' Remarks: Boring # Ground elev. ff. Depth to limiting factor ' Remarks: SBD -6330 (R. 07/96) s O N w � o v s Vt N O Is �k p 1 I c' � � o to NV _ lI r, N d 0 0 w o , 0 z ` �# 3 LA " L o � a N op N • . o W S T C - 100 This application form is to be completed in full and signed by the owners) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended p n ended 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 Location of property S �Z - 19ft SW 1/4, Section ^ , T S N -R /j W Township Mailing address .3Z- 070 �o 'i�✓� , 7 4 1 2 Address of site y ,, e Subdivision name X1,4' Lot no. Other homes on property? Yes ✓ No Previous owner of property 10Z r• i e> �: t,. ��jrGlf', v- ; 14 �7&r y v G r Total size of property 90 �'� -Ps Total size of parcel "e rem Date parcel was created c.J rt e T Are all corners and lot lines identifiable? ✓ Yes No Is this property being developed for (spec house) ? Yes L , - No Volume 7 - I M and Page Number 19Cl as recorded with the Register of Deeds. ------------------------------------------------------------------- INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND 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 o fice of the County Register of Deeds as Document No. /3l�5� 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 the County Register of Deeds as Document No. Signature of Applicant Co- Applicant Date of Signature Date of Signature STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER /BUYER ROUTE /BOX NUMBER S'y f'yye FIRE NO. 3� 0 CITY /STATE -- ZIP s4'' -1 4 1 ? PROPERTY LOCATION: S Y VA .:5 Gtr 1/9, Section , T 2 S N, R 45' W, Town of �1y , St. Croix County, Subdivision X4� Lot No. 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, which was in operation 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 9 g p 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. SIGNED ` DATE y / St. Croix County Zoning Office St. Croix Count y Courthouse 911 9th Street Hudson, WI 59016 (715) 386 -9680 Sign, Date, and Return to above address a ti n 60ft 11AX 0 y went volt f Ik -- IM tMU spi a cMaivsn ft* +tteol�►Ra► sur; Dow M,orie Ielei . r Mar y A! f JIM Marya, Lis Ola 1 11 . j* 8:30 A x, ,,_ � ..-r �(iraIIiOr, F , Tres 0� +etl eapTS g a tti� ^ - f Duty ......... wa. "tire SON Grantor, Air d edlvikbk eoaaideration (( ` (fey ## ea e{ u�rbn descri rest state in t asrua� ro u, g . �i46Y y' � #ant t �' 'K' `' Ta: Parcel No: ;lie+ :southwest Quarter SW1 /4 of the Southwest Quarter SW1 /A and xY Southea Quarter SEI/A) of the Southwest Quarter SWI /4, IN Section One (1) Township Twenty -eight (28) North, Range ftsen (lS) West, TOWN OF CADY, St. Croix County, Wisconsin, CEPT.'those parcels conveyed to the State of Wisconsin by Dead dated July 14 1957, and recorded in the Register of Deeds Office for St Croix County, Wisconsin July 24 1457 at 1 P.M., in Volume 344 of, Records, Page: 6, as Document No. 231328. .11"S is not This ................ _ homestead property. (is) (is Wit) Together with all and singular the hereditaments and appurtenances thereunto belonging; Aniail 008 ................... ............................... ............. ............................... .. .................. Warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and roadways of record; and will warrant and depend the same. Dated this ...... ._. . ............................. day of .................. taum el........_. ................_....._......_. . ...4eat'i ...... (SEAL) . !!t4!!°* L) --- orie Wheeler . Lisa M. eeler �kj'` •- • ......... ......................... • (SEAL) (�J .. f ... - - -... ... ' Y M .. ...... ._ y ...................... a E. yer 4 (SEAL TSEIYTI T ' � ACHN LRDG& f3 81pature(s) ............................. ............................... STATE OF WISCONSIN La Crosse - -- °------• . ............... .........County. authenticated this ........ day of ........................... 19 .... Personail& c�ee before me 4kis ..... .......day of • ............. ... .. ......••• ...... 19 the above named Mar1orie_ WhQeler,- - hSory. J�__�yerl.�a..Wr.._�- •--------- ---------- ---- - ----------- - - - - -- - - - -•- ............................ Meyer, as attorney for each c'`itsgna TITLE: MEMBER STATE BAR OF WISCONSIN Mieeler, Lisa M. Wheeler.. Ma�-�'Vii � (If not, . ........................................................... and Paul. C . �._..._...... : i!4 �s. authorized by $ 708 -06, Wis. Stets.). 3 (fi }he to me known to be the person _._......._. arho qEu fore ing instrument and sckno Iedge ('A same_ THIS INSTRUMENT WAS DRAFTED BY L "'wj` •� Howard F. lbedinga, 114EDINGA LAW FIRM ���'� =�- a a.. �� �Ol f � ......... ............................... a -, _.......................... ... ..............r._:_ t . ... I rm Menomonie,-- Wiscons ..4751- Nota Po -,iic .- _.Crosse .... .. ............ .. County, Wis. (Signatures may be authenticated or acknowledged. Both My Commissipn is permanent. (If not, state expiration are not necessary.) dat ^: p- .._..: .Y. ......_ _ ........ 1999...) •Names M D+c!ons signing in any capacity should be typed or printed below their siynst:ues. ItCsw�e�Ca+v>r+. M STATE BAR OF WISCONSIN T 211 N. i — I9aY Suck No. 13M