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HomeMy WebLinkAbout008-1027-80-000 C) m ° '', 3 V 0 c °: 3 CU o m m H M CD m A O CL c cn s Cm L CD CO d O ►^�+ 7 7 fA SD O J C fD O CD p p �O1 rn n G_ O co O !\ U' D CG C. N ! (: CD v, a (n W =r 00 'I O A 0 lei O O (D O r N N co C1 N co CD 00 00 <, o c D O O O °Y• A'I N y N N fD f_ M N O I CD Cp = M Q 3 m c C I CD .. y N D D o O O_ a CD � Vy x c m -1 CO) A Z m W M m N o co C s Z o r. Z O m �! 1l CD A W p) n CD <N p Q 3 < a_ T c 3 o a� c n Co c v c CD o a D N O N CD ' d N CD 3 3 � > > H 'c a < V� n W a 3 CD a S ti I CD o A CD O O Cb (D li Cn ti 0 O C a 0 3 i ST. CROIX COUNTY ZONING DEI'AIZTMENT %� \;, AS BUILT SANITARY REPORT ` P ORG A Owner rTLt t.. 1 S�►, ,' �'� ; � == Address `-/ 7 City /State e W, v ST CFO, 'f COU00 NGgFF ►G /* ,. Legal Description: Lot Block Subdivision/ SM # V®!- 1 324 �, Sec. lU , T -�' -R /�, W, Town of ti b //e- PIN # 00 K' SEPTIC TANK -- DOSE CHAMBER — HOLDING TANK INFORMATION: Tank manufacturer 9 k f(0- Size ST/PC 3 u Setback from: House S3 Well /6 P/L 3 Pump manufacturer Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road L Vent to fresh air intake 3 - 4 Water Line Meter location Alarm location .I n tt It ' I ?c 4 ee- �,,� , z SOIL ABSORPTION SYSTEM: Type of system: Width Length Number of Trenches Setback from: House Well P/L Vent to fresh air intake ELEVATIONS: Description of benchmark �IdYI �' f / Description of alternate benchmark Elevation Elevation Building Sewer (�� jl�>let — ST Outlet PC Inlet PC Bottom Header/Manifold Top of ST/PC Manhole Cover Distribution Lines ( ) ( ) ( ) Bottom of System ( ) ( ) ( ) Final Grade ( ) ( ) ( ) Date of installation /b /26/ Permit nu State plan number mber ' �.� Plumber's signature License number r Date Inspector 17o i tQ.r Complete plot plan K 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 e � - \ 1 �V .3 l , !) e I L 5 I °, r f✓ f ry INDICATE NORTH ARROW 5-0 C S� Wisc6nsin Department of Commerce PRIVATE SEWAGE SYSTEM y- SafeWland Buildings Division Count INSPECTION REPORT ST. CROTX GENERAL INFORMATION (ATTACH TO PERMIT) SanitaruPf-Ft Personal information you provice may be used for secondary purposes [Privacy L , s.15.04 (1)(m)]. Permit Holder's Name: a Cit [ Villa e Town of: State Plan ID No.: SMITH, JULIE F. EAU GALLE CST BM Elev.; Insp. BM Elev.: BM Description:, f w- dx a,-+ Parcel TdxNo_1027 -80 -000 o� `L 9`� rol A , qe_ U ti TANK INFORMATION ELEVATION DATA A9800386 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Ben a q7— IDel- 0 Dosin Aeration Bldg. Sewer 7 -9L 96 . j olding ��� ->D00 o Ht let r0 g�•33 T SETBACK INFORMATION -/ Ht utlet TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic NA Dt Bottom D olin g NA Header / an. Aeratio NA Dist. Pipe Holding ' l qS 3R Wl Bot. System IPHON INFORMATION Final Grade Manufactu Dem d M el Number GPM H Lift Friction System TDH Ft L oss Me Force Len th Dist. To well SOIL ABSORPTION SYSTEM BED / TREN engt T PIT No. Of Pits Inside Dia. Liquid Depth DIMENSLUNS DIMEN 51 SETBA K SYSTEM TO P/ L B WELL LA /STREAM LEACHING Manu acur INFOR TION Type Of HA odel Number: m: OR UNIT DISTRIB Y TEM S S Header / anifold Distribution Pipe(s) acing Vent To Air Intake Length — I Length Dia. Spacin SOIL COVER ti Fe Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Dep Seeded /Sodded c ed Bed/ Trench Center e /Trench Edges Topsoi Yes ❑ No es ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) y LOCATION: EAU GALLE 10.28.16.140B,SE,NE 476 250TH STREET S5 Ui- S��►�1c W014 oX4 `t _3000 #4 --Nx t ov-AV d a �{a�f f 3Qoo � -E« ►� k. f � � F ncc l X11 I o'olg Plan revision required? ❑ Yes tZ No Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ' CA 7T E e s O or �" ✓��oF 3 3 E , F E , Q 1o�y _- , , m E e alt e , s s p R WW , .. �. ..r ... wm 4 ff e Vi sconsin Safety and Buildings Division SANITARY PERMIT APPLICATION 2 E. a Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 11 x 11 inches in size. S C G 2"' ,y • See reverse side for instructions for completing this application State S anitary Permit Number The information you provide may be used by other government agency programs 0 Check it revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION PropertyOw Name_ sr� °q (yG �ii4 S 1 > T 2 �/ , N, R ��E'(br) W Property Owner's Malifing Address Lot Number Block Number L! ?G 2s� cs City, State l Zip Code Phone Number Subdivision Name or CSM Number 4ri G d tr r W r - II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ it Nearest Road ❑ vil age Public 1 or 2 Family Dwelling - No. of bedrooms Town OF r- L � r 4 III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo Uv If* 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 E] Church/ School 8 E] 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. Z Replacement 3, ❑ Replacement of 4_ ❑ Reconnection of 5 ❑ Repair of an System S yst em ____________ _________TankOnly______________ Existing System ________ Exi sting -- -- - ystem 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 E] Seepage Trench 22 F1 In-Ground Pressure 42 ff Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation Feet Feet VII. TANK Capacit g allons Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con Steel glass Plastic App New Existing strutted Tanks Tanks Septic Tank or Holding Tank 3ooG W , ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ I ❑ 1 ❑ ❑ ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility or installation of the onsite sewage system shown on the attached plans. Plumber's Name: Print) Plum is Signatur . (N mps) MP /MPRSW No.: Business Phone Number: c e - A 3 7 5' 1 215 - - e, Plumber's Ac dress (Street, Cit p C tate, Ziode): J v L (ifs c ( (G 1v IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (IndudesGroundwater D ate Issued Iss ing Agent Signature (No Stamps) Approved E] Owner Given Initial Surcharge Fee) Adverse Determination �� q — (L lu X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6398 (R 11/96) DISTRIBUTION: Original to County. One copy To: Safety 8 Buildings Division, Owner, Plumber HOLDING TANK SERVICING CONTRACT Contract Da This contract is made between the -- — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Holding Tank Owner(s) Name(s) and Pumper's Name F, Sw1 l' I �ol7ysoNS 5 ,� r We acknowledge the installation of (a) holding tank(s) on the following property: (Provide legal description:) � bF _ = _ S� /� - )l) (✓-- ��lf OF 6 i r N )� 1 t? W �. P nGe 5�3 k4 ------------------------------------------------ 1. The owner agrees to file a copy of this contract with the local governmental unit hereinafter called the "municipality ", which has i signed the pumping agreement required in Ch. ILHR 83.18 (4) (b), Wis. Adm. Code and with the County of S t C!, \_U.� \_X 2. The owner agrees to have the holding tanks) serviced by the pumper and guarantees to permit the pumper to have access and to enter upon the property for the purpose of servicing the holding tank(s). The owner agrees to maintain the all- weather access road or drive so that the pumper can service the holding tank(s) with the pumping equipment. The owner further agrees to pay the pumper for all charges incurred in servicing the holding tank(s) as mutually agreed upon by the owner and pumper. 3. The pumper agrees to submit to the municipality which has signed the pumping agreement required by s. ILHR 83.18 (4) (b), Wis. Adm. Code, and to the county, a report for the servicing of the holding tank(s) on a semiannual basis. The pumper further agrees to include the following in the semiannual report: a. The name and address of the person responsible for servicing the holding tank; b. The name of the owner of the holding tank; c. The location of the property on which the holding tank is installed; d. The sanitary permit number issued for the holding tank; e. The dates on which the holding tank was serviced; f. The volumes in gallons of the contents pumped from the holding tank for each servicing; g. The disposal sites to which the contents from the holding tank were delivered. 4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event of a change in this contract, the owner agrees to file a copy of any changes to this service contract or a copy of a new service contract with the municipality and the County named above within ten (10) business days from the date of change to this service contract. Owner(s) Name(s) (Print) i Owner's Signature(s) Su IN F , Subscrib orn to befor o this date: Pumper's Name (Print) Pumper's Signature Notary Publi My commission expires: Pumper's Registration Number 5BD - 7574 (R. 09/88) This instrument was drafted by the State of Wisconsin Department of Industry, Labor and Human Relations AUG -23 -98 SUN 12:02 PM NELSEN WEBER SURVEYING,M 1 715 425 6864 P.01 #1 / 44 sof Wisconsin vepartmentof Industry, H0LD1 K �tVI ENT Safety anO Puildings DIvision L,bpranti Human RQlatlorlS VM ,. 8ureauo49ulldingsend water SystQMs r' Do umentNO/Plan t enti N OT This a g reem ent is made between the This spece ceserved for recording (34% 6 817BIL gpvernniental unit and holding tank ,greeasent Elate owner(s) 7 3 ► 5� kEIT'�f F�� ,. County or Local GovernmentalUnit eioidingTank0svnErCs) $T, CR OIX Co., W1 Rme'rt !w floawrd M nici fir "S"awrJ far- C�f�,i.>w �>��ti� r. t�lr� AUG 1, 1 1998 ! ! w We acknowledge that application is being made for the instailalion of.(a) holding �• 15 tank(s) on the following ,property: (Provide legal land description) ma y' ' A' ! — N r~ I tv at= • ti ,1' z$ h! 6 Aj Ra fitf.e w r aaede Omeb 6N w ort;dt Continued use of the existing preen sas rQywires that a holding tank bs Installed on tact: property fGr the purpose Pf proper Containment of sewage. Also, the property wnriat now i;e served by a municipal sewer, or any other type Of private sewage system as permitted under Ch. Ii.NR 83, M. Adm. Cvdie, Or Ch. t45, Stars. As amindutementtolhe County of tois sueasanitary permit forthe above describedproperty .weagreetodotheta(lowing. 1. Owner agrees to conform to all applicable regvirernents of Ch. IIKR 63, Wis. Adm, Code relating to holding tanks- if the owner T'ailts to have tng. holding tank property Sttv in response to girders +saved by th8 municipality to prevent or abate a huMb heats hazard as descr in s. 254,59, Stars„ the municipality may enter upon the property and service the tank or cause to have the tank to be sarvictd and Charge the owner by placing the charges on thq %ON bill 45 a lipeciat assessor, ent for current services rendered. Tha charges witi be assessed as prescribed by 1.66.60. staff. 2. The owner aglow, pursuant to s. ILkfl 631 a (14), Wis. Adm, code. to have Installed in a new building or new structure a water mater 4pprovratf by the County and State. The water meter shal be installed by a plumber author ized b the State TO tandvct such installations, with said in sta l ta tion complying with State regulations and manufacturers specificallfts, The owner agrees to be financially responsib a for the purrhaS@, irsxtalldtton, Maintenance, and repair of the water meter and agrees to atlowthe munrcipa!ity to enter the above descrisad property on a regular basis to read andror in spectt►1e water meter e- Owner agrees to pay all charges and cost ,nxurrad by the municipality for inspection, pumping, hauling, or otherwise servicing an0 maintaining the holding tank in such a manner as to orevent or abate any human health hazard raused by the holding tank. The municipality shall notify the owner of any costs which shall be paid by tt is nwnu r within thirty (30) days from the date of no tice_ In the event the owner does not pay the costs within thirty 1 ,301 days, the owner spec)frcallyagrees that all the costs and charges may be placed on the tax ro!i as a special asspsstnent for the abatement of a h0fan health hazato, and u,e tat shall be tollrrcte l as provided by law, q,_ The owner except as provided by s 146.20 (3) M. Stats , agrees to contract with a person who is licensed under Ch NR 113, Wis, Adm - Codc, to have the hold tank serviced and to file a copy of the contract Or the owrber't reg v: nth the rnuniei palrty. The owner further agrees to file a copy of any changes to the service cnritrci, or a copy of a now service contract with "e municipality %vithin ten 00) business days from the date of change to the service contract. S. The owner agrees to contract with a pe rson licensed under Ch. NR 113 Wis, Adm. Code, wl o shall submit to the municipality on a semiannual basis a report in ac(ordante with $, IL48 133.18 (4) (a) 2., Wis Adm. Code. for theservicing of the holding tank, in the case of rgQIstration under s. 146.20 (3) (d), St4ts., the owner shall submit the report to the municipality. The munlcrpafity may titer upon tho property to investigate the condition of the holding tank When p ump;l g reports and meter readings rr.ay indicate that the holding tank is net being properly maintainQd. 6. This agreement will remain in effect only until the lot at governmental unit respohsible for the regvlatton of private sewage systems certifies that the property is served by either a municipal sower or a soil absorption system that complies with Ch. ILNR 83 , Wis. Adm. Code. In addition, this 2 1temcnt maybe MNCetled by executing and recording sai tertifr,atlon with tefererice to this agreement in such rnanner which will permit tht; stericeof the Certification to bedt)term by referente to the property, T. This agrien7Qnt shall to binding upon the owner, the herd Of the owner. and assignees of the owner 1'he oYrr @( shall submit the agreement to the register Of deeds, and the agreement shall be recorded by the register of deeds in a manner whieh will petntt 1rie existence of the agteernerit to be determined by reference to this prOpMy where the holding tank is kn5II411 d. Owner {.$) Names) - Print Notelzed Owners) Signatur (s) ~ v`. �• r / -ii Subscri warn to before mgQn this dace: r otary oubiII S�L�t,:YC� tnlcipatOfficial Nama•Print Municipa fical Signature — ��- '""- '"' - - -� � M,0 , 4 u -Print III, i4 Ifivinfotmation you provide may beusedbyottibr ,,ecnme encvnrnnrrmts n. s. c „_ I %cn...,,_„ . AUG -23 -98 SUN 12:03 PM NELSEN WEBER SURVEYING.M 1 715 425 6864 P.02 VOL 1347m009 Part of the S@ 1/4 of the NE 1/4 of section 10 -2e -16 described as foi?aws! Cowwcing at tine NE corner of said SE 1/4 of the NE 114 of Section 101 thant:e South 350 feet; thence W06t 250 feet; thence North .160 feet to the North line Of said $$ 114,:;f the NE 1/4; them East 250 feet to the point of beginning. AND ALSO; flat ecttaiA Fattel of 1Add located fo ik S81 /` of ft NE 114 of Scc6m 10. To-w6ip 28 North. Range 16 Wist, Yown of EU G40, St. Croix Couary, WL%wn& a, more fully desienbed as kZmn: Commeadzg et for KoRlxm com" of said $ea:on 10; thence Sot+th 00 44.01' 56' 6. (Mutrtcd be oa On Smt ciao o► the NE (t4 of said Secdoa 10) a d1xtuce of 1Ga8.19 d4mA N. 86 dog. 50' 34" W. 250,W F-aoocdsd as West), Inc t Me o ). po beglaning of the parcel to be heivin des+cmUd; thettea continue N_ 56 d SW 34" W. 31.56'; ditki a N. 00 deg. 01' S6" %V- 350,40': thenco S. 66 402. 54 . 34' E. 3146'; thcoec 5, 00 d -, i 55' E. 350.00 (teemcd©d as South) to t6. point of begi.2niug, wa w g p M saes; h4 kbjeU 0 ems of r&4rd_ Safety and Buildings 2226 ROSE ST LACROSSE WI 54603 -1905 isconsln Tommy G. Thompson, Governor Department of Commerce William J. McCoshen, Secretary August 12, 1998 —� CUST ID No.267341 A WEGERER SOIL TESTING & DESIGN 421 N MAIN ST 1 P BOX 74 r . G O ,. RIVER FALLS WI 54022 �o °x RE: CONDITIONAL APPROVAL .. APPROVAL EXPIRES: 08 /12/2000 �`� ! Identification Numbers Transaction ID No. 132985 Site ID No. 157111 SITE: Please refer to both identification numbers, Site ID: 157111 above, in all correspondence with the ST CROIX County, Town of EAU GALLE agency. SETA, NE1 /4, S10, T28N, R16W JULIE SMITH Co ptic FOR: Description: HOLDING TANK Object Type: POWT System Regulated Object ID No.: 415926 D� p`'4 S The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. 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. S The following conditions shall be met during construction or installation and prior to occupancy or use: • In the county where this project is located in accordance A Sanitary Permit must be obtained from the with the requirements of Sec. 145.135 and 145.19, Wis. Adm. Code. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(d), Wis. Stats. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, DATE RECEIVED 08/10/1998 A le r_­ FEE REQUIRED $ 60.00 HERMAN J DELFOSSE , PLUMBING PLAN REVIEWER FEE RECEIVED $ 60.00 Integrated Services BALANCE DUE $ 0.00 (608)789-5535, MON - FRI, 7:45 AM - 4:30 PM HDELFOSSE @COMMERCE. STATE. WI. US _ HOLDING TANK Pa ge of 3 For A 3 Bedroom residence LOCATED IN THE s OF THE NE � OF SECTION to ,T Z9 N, R l6 W, TOWN OF � � , S G I,aC COUNTY, WISCONSIN. RF INDEX AUG FQ SgFETY 1 0 1998 . PAGE 1 of 3 PAGE 2 of 3 PLOT ET . e / S• D/ PAGE 3 of 3 HOLDING TANK SECTION V PREPARED FOR U1(� Z s o `rr} s r. w i s q oz --b litionally , ROV ED MENT OF COMMERCE JF SAFETY +40 BUILUI`k ,; PREPARED BY C RESP NDENCE 132985 WE:G3ERER SCk I L- AND DES = C3P4 SERV I C:E F.O. BOX 74 421 N. RAIN ST. gC.0 F1( t RIVER FALLS. NI 54022 715- 425- 0155'rr�N wN ARTHUR L. WEGERER 6915 P EILSW / R�TN • • e I G JOB NO. r � PLOT PLAN Page Z of 3 SCALE 1 "= 50 ' t I i i ° 1 n. 3 M N i N i O 60'0V LA Pie TR ► 1rc� k y o 1 I - I ° 13 298 5 3� -86' �4 HOLDING TANK CROSS - SECTION Approved Weather Proof Vent Cap Junction Box Approved Locking Manhole Cover 4° C.I. -- With Warning Label Attached Vent Pipe j Minimum 12" _ I Final Grade } 4" Minimum ( Approved Joint 18" Minimum Water Tight' r � Seal \ High Water ' 1 � Alarm Switch SPECIFICATIONS _ _ _ - - _ _ T TANK New L__ Existing Approved Join Manufacturer. ultbv���Tg1ZN � sT J VQ w/ C.I. Pipe Blind C.I. Tank Size: 3 chop Gallons E. f _ Extending 3" Plug ALARM Manufacturer: S .'I ka_j_ZcMo Onto Solid So Model Number: 1u l 1 ( °R �-'c QI'P � Switch Type ►� L�,�Z� - ( NUMBER OF BEDROOMS 3 GALLONS PER DAY gS1J 3 of Bedding Under Tank 182985 85 Labor and Human Relations Department of Industry Labor SOIL AND SITE EVALUATION REPORT Page N of 3 • and Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), directio V of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to neare R I DB DAT i o ' OO �� Z� - a O '- ` APPLICANT INFORMATION— PLEASE PRINT ALL t!fi?�f(INA�ION„t L 7 � r ,,'• ti PROPERTY OWNER: FROVER TY LOCATION �� �� SI�LIF �• S�'1CT}} °� ` _.!:�r.r F81ff.t0`f S� 1/4 N�1 /4,S )0 T ZS ,N,R b E(o PROPERTY OWNER':S MAILING ADDRESS C ' TV BLOCK # 1 SUBD. NAME OR CSM # CITY, STATE ZIP CODE PHONE ReovVI, , `" []CITY ❑VILLAGE E TOWN NEAREST ROAD 1'j0 UIL_ � INI SVoLb ()IS) �� )b ( j New Construction Use PQ Residential / Number of bedr •Y' [ J Additign to existing building ( Replacement [ ] Public or commercial describe — Code derived daily flow `1 SD gpd Recommended design loading rate — bed, gpd$ - trench, gpolft Absorption area required — bed, ft2 — trench, ft Maximum design loading rate — bed, gpd /ft trench, gpd/ft Recommended infiltration surface elevation(s) _ ft (as referred to site plan benchmark) Additional design / site considerations �'�N ` U I n-1 G I f`'1O' Parent material L\.)ZsS (3 \,j E%z c 1 - TV LX— Flood plain elevation, if applicable tV • 4 , ft S = Suitable for system CONVENTIONAL I MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for s stem [IS & U El (ffU ❑ S O U ❑ S ®U ❑ S ®U ®S 111.1 SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon Texture Consistence Batrxf<try Roots in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. B a Trench 312 Ground elev. NA ft. Depth to limiting factor, q Remarks: _ 1K) 0 R ti y Boring # >�� 1 ° -�' �u�2 — sib Z��bk �'Fr �s _ • €�� Z K y 13 �z. 3 I \ csb `{'� S _z • 3 1,0 R S�1RS� Ground elev. t ft Depth to limiting factor Remarks: CST Name: %sePrint Arthur L. We erer Phone: 715 425 - 0165 egerer Soil Testing & Design Service —P.O. Box 74 River Falls,WI 54022' Sgnature: � ���� � � S � j 8 � Date: --� , �� � `�� CST Number 5 7 6 PROPERTY OWNER S1"1IN SOIL DESCRIPTION REPORT Page Z of 3 — PARCEL I.D.# Oob— 1 — Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tnrrh tiW-t 2 31 Z %i ZWL b vn ` �S - , s . (, Z q -ZI 1u yrZ y� czP 5kszc�lc. Ground 3 ?-1 - \40 1U `IR y/3 elev. ft. Depth to limiting factor� Remarks: 7u� ►�'t'4 Boring # - o. s '1 CL 2 ' Lo`1Rv�3 � sii Ground • Z elev. NA ft. Depth to limiting factor Remarks: Boring # El Z Ground elev. N A ft. Depth to limiting factor 1� Remarks: VV U `f ' Boring # lo�ttL 3IZ E 2 to l�\- �•rz - �� s 4Q- `4 6 � s 1 - Sr i 1� s�ti m- Ground elev. 1N'A ft. Depth to limiting factor Moo Remarks: SBD- 8330(R.05/92) F t , PLOT PLAN Pa of 3 SCALE 1 "= 50 ' y � a.s B. 6 I � � o ! � � I O srvn e T b1 T x s. A � I \ 1 o - C k�tL 1 11c ` �� , � Z�l -`� � � >� (715 ) 425 -0165 14 00576 _ CST Signature Date Signed Telephone No. CST # Wwonsin DeparUnent of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 I , and Human Relations Divisioreof Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but Ste, Q_ 1 �`V 1X 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. 0 - 1p Z _ a O APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION R D DATE Z z g PROPERTY OWNER: PROPERTY LOCATION Sv L 1 F S'I-1 C�}J GOVE:tOT S E 1/4 N IE' 1 /4,S 10 T S ,N,R ) b E (00 PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # _ zl- Z j0 `m S'T — CITY, STATE ZIP CODE PHONE NUMBER []CITY ❑VILLAGE MOWN NEAREST ROAD 11Jx)'b\)IU bvl Svoz b ()is) b987 3 4Yq Ef)v (Sr1 ALE Zso 1)-1- ST. () New Construction Use Pq Residential / Number of bedrooms 3 [ ] Addib.Qn to existing building Replacement (J Public or commercial describe Code derived daily Bow q SO gpd Recommended design loading rate — bed, gpd/ft - trench, gpd/ft Absorption area required — bed, ft — trench, ft Maximum design loading rate - bed, gpd /ft trench, gpd/ft Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations �`�o 1� 1 �► G Tf��lz R O U 1('�. Parent material LuesS o v E1z c \ - v t uL Flood plain elevation, if applicable N • A . ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSU7 AT -GRADE SYSTEM IN FILL I HOLDING TANK U = Unsuitable for s stem EIS (R U EIS ICU I ❑ S O U ❑ S ® U EIS ®U ® S ❑ U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon Texture Consistence Botrrary Roots In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 0 _1 1p�R 3I - i ! 2 s blT w CS - t: > ::*: l0`lR_ Vh � �•S'-tczS st `� s�k �M �1- — Z 3 Ground elev. NA ft. Depth to limiting facia,, q Remarks: IV 0 Boring # I lD`1IL V � �1R S /�O � 1 i \ cS�12 yet `{ - k .. . 4:..... . 4?.... Nt' Ground elev. I ft Depth to limiting factor 8� Remarks:. CST Name: — Please Print Arthur L. We erer Phone: 715 - 425 -0165 A ddress: Soil Testing & Design Service -P.O. Box 74 River Falls,WI 54022' Signature: Date: �. CST Number: �- �_r M00576 PROPERTY OWNER s SOIL DESCRIPTION REPORT Page - Z .of PARCEL I.D.# 0 0 1 b— kk�L7 - 813 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounclary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench \4`q 3 1 O - 9 1 u`12 3 ! z Z q -ZI )A 4 R- L / CAP S Lt FL /! Ground 3 Z 1u `1 V/3 k , csl n� vn `�i — 1J1� . - Z elev. ft. Depth to limiting fact a Remarks: Boring # 1 0 _`f t,u �i � � ! z - s i � Z•�sbk w,. �F�- � s � . s , t. 3 u! u�tz y Ground elev. NA ft. Depth to limiting facto � Remarks: )QV Boring # _ b,I b nz io �tSi 51 Z Sft 1 �S writ — . .3 Ground elev. tN L ft. Depth to limiting factor 1� Remarks: VV U pri Boring # 6 Z to Z� l o` - 1 fZ V cZ � s` 1, (4 6 _ I kN S11 s 1 1� s�ti wig . z Ground elev. M*A ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) PLOT PLAN Pa of 3 SCALE 1 "= SO ' Lv 7 i $.s I � $•y I I h � �I I �l �I Lu B � i O � 0 I Grl[Z_ pR1U�w�{ I I ! I I C iti�.L 3t•ed' �8- ►Sy ( 715 ) 4 .5 -m (,S 1400576 CST Signature Date Signed Telephone No. CST # f , ST. CROIX COUNTY WISCONSIN ZONING OFFICE - ST. CROIX COUNTY GOVERNMENT CENTER ^ M wwNNpwllw -- None 1101 Carmichael Road Hudson, WI 54016 -7710 -` - -� - (715) 386 -4680 NOTICE OF VIOLATION August 6, 1998 NUMBER 98 -V -18 LOCATION: SE Y., NE Y., Sec. 10, T28N -R16W, Tn. of Eau Galle, St. Croix Co., WI PIN # 008 - 1027 -80 Julie F. Smith 476 250th St. Woodville, WI 54028 RE: Failing septic system Dear Ms. Smith: As required by the ST. CROIX COUNTY ZONING ORDINANCE, notice is hereby given that you are in violation of § 254.59(2) Wisconsin Statutes, COMM 83.01(2)(c) Wisconsin Administrative Code, and Article 15.03 of the St. Croix County Zoning Ordinance. This system has failed under the definition in § 145.245(4)(b) & (d) Wisconsin Statutes. This violation was first noted on July 30, 1998— the date the soil report was received in this office. The violation noted is discharging sewage into zones of saturation and to the surface of the ground. The soil and site evaluation report submitted by Art Wegerer (CST #576) dated July 29, 1998 revealed that the existing system is located in non - compliant soils. An on -site inspection on August 6, 1998 revealed effluent discharging to the surface of the ground from the drain field vent. If fines and or forfeitures become necessary to bring about the abatement of this violation, they will be assessed as of that date in accordance with Chapter 145.12(4) Wisconsin Statutes. REQUIRED ACTION: Within 90 days of this notice, contract with a licensed plumber who will design the septic system and obtain a sanitary permit through this office. The septic system must be installed within 90 days of this notice. Please contact me if you require clarification of this matter. Sincerely, �?d 4L�X� Rod Eslinger Assistant Zoning Administrator ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer eDrcL 't. Lt Mailing Address _q 2&- 2 5 t Property Address rxGk c (Verification required from Planning Department for new construction) City /State V, o (r v (/ -e-- �` Parcel Identification Number f -1 LEGAL DESCRIPTION Property Location S6 '/4, N % a, Sec. D T 2 N -R / U W, Town of L e- c., e� All e Subdivision , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # 5" ? G � 3 , Volume /3 2, Page # Spec house ❑ yes ❑ no Lot lines identifiable ❑ yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a 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. 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 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 DA E OWNER CEATWICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. I- 6t,, V- Am, / lfka SIGNATURE OF APPLICANT D TE * * * * ** 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 7:3 Slalt: 13,1 Wisconsin form 1 1 9 82 i .3 ( I I 1"ARRAN*1'1'l)vE1) DOCUMFNT NO, CROIX CO,, WI TIIISDEFD, nodet Patrick M. Mahoney and ' f"r "';qk')rJ Melinda S. Mahoney, husband and wife MAY 2 0 1998 9:30 AM and Julie F. Smith, a single person THIS $PALE P!SEA �Ell FUA PE ZUnDR1G DATA WINESSET11, �I*Ilal ti sa id G ran t or , f a valuable coils ideratiol I I T ETUM ADORESS ATIN, M� Dept. COIlVeYs to Gr the (011(m ing described re e.q in St. Croix F 13, W01131 11410 live, 1,11s county. Stale of Wisconsin: PO Box 166 Part of the SE 1/4 of the NE 1/4 of Section 10-28-16 liver Fads: W 54422 described as follows: Commencing at the NE corner of ---- -- -- ---- --- 1 008-1027-80-000 said SE 1/4 of the NE 1/4 of Section 10; thence South - P^e--FL 1 NUMBFR 350 feet; thence West 250 feet; thence North 350 feet to the North line of said SE 1/4 of the NE 11A; thence East 250 feet to the point of beginning. AND ALSO: That certain parcel of land located in the SE 1/4 of the NE 1/4 of Section 10, Towmship 28 North, Range 16 West, Town of Eau Galle, St. Croix County, wi,-consin, more fully described as follows: Commencing at the Northeast comer of said Section 10; thence South 00 deg. 01' 56' E. (assumed beating on the East line of the NE 114 of said Section 10) a distance of 1668.17'; thence N. 96 deg, 59' 34" W. 250.00' (recorded as West), to the point of beginning of the parcel to be herein described; thence continue N. 86 deg. 59' 34' W. 31.86'; thence N. 00 deg. 01' 56" W. 350,00% therwe S. 86 deg. 59' 34" E. 31.86'; thence S. 00 deg. 01' 56" E. 350.00 (recorded as South) to the point of begir-ning, containing 0.256 acres; being subject to e:�rnents of record. TRVSFER This is holueslead Properly. (is) (is not) $ F E Together with all and sing the Ilerejitaments and appurtenances ibereanio, bel And Grantor warrant! that the title is good, iodefe3Sihle ill fee maple and free and clear of zrvcu-.ibrarwec except Easements and restrictions of record. and will warrant alt4defend the sani:. Dated this day of 98 (SEAL) (SEAL) - Patrick M. Mahoney _ (SE (SEAL) AL) Meli S. M ahoney AUTHENTICATION ACKNOWLFI)CMENT Signature(s) STATE OF WLSCONSIN P ko I SS. authentic aced this day of 19 -"J Coun(y. Per-wnzlly carne before me this day of ff" , 19 98 U)e above named Patriz( Y. Mahoney and Melinda S. Mahoney 'rITLE: MUNIBER STA'I U BA'k 01: WISCONSIN (If no(, authorized by Section 706,06, Wisconsin Statutes) to late kr%)wn to he t1le person S who executed the foregoing insimment and a-knt wI d e the same. THIS RISNRUMENT WAS DRAFTED BY Michael H. Foreck Attnrney Eau Claire, Wisconsin Notary �1&-EA Notary ni•isc County. Wis. (Signatures 10"y be - die"t i —eJ or acknuwtedgcd. Both are net necessary) My C44"tni":o" is Pt'Inianela. (if not, SI'Ite expi(afikml date: • Nantes of ,r.,pj signing ii' any capacity Owul be typed nr printed 1,0,— d,ti, sig,, uc,