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HomeMy WebLinkAbout020-1062-50-300 tC c 3: o o C o N 40 c p N @-�a C U 'O O O 21 O `C W @ � O t O O C O Zn OI N O I N G c i C III ca w 'O C L C O M v 3 CL) z E z w o° L N H _ N C C9 N O Z fl N o` yl E � Cr o q O O D O a o © O t N g z z s N Zo M d c N N L � 10 �y a C O o, Z > §- Y) ~ ►N- E, cn � O O O •r L; N m a a � I "i ou�i'' =0 )� rfi J L) mo 0) 0) o O Z O � Fy N � N N N O O _ :✓ Y � � � + v I cu r• �, o � > � v �J Z uI H N O O O C �� -?? N {{{ fir.+ O O N C�� CQ M < O U J' y O Cl) 3 N C m �^ O O L � N O Y N N C ya O C N 00 N N 7 N .-- O aj N c c0 N W O Z5 CO 7 a L T .d E L c c 0 u CL Lot lkIA0✓ S(Aid M 404 :4 f, CERTIFIED SURVEY Located in part of the SWi of the NW} of Section•.23i_" P#,' 9W, Town of Hudson, St. Croix County, Wisconsin. ~'�-- NW Corner Section 23 PARCEL IN LET G ° VOA. 95 R G '. v. o° - - t -- - _ L. S. M, VOL. IQ, G. 2778 US I- WY. 12 J m S89 0 26 1 40 "E 403.35' _ -- - - i North line of the SW% of the NW% v w 'm Ct QudP� S89 °52'42" w c N `fk iS � �� E r � a'4 71f � I � QuO�- C i 95.00' �' p c ¢u� c1 t� c c�ltit4 oa O �Q E •1 P o Ct p O 1 it�C o�o\GP�E 15�'E 106 v N 650 �� o cn m -LOT 1 � 1 ` m c �. S AA o . I�1, o 33' 33' \ o C ' LOT I z PG. 20 i 0_ o w 3.00 Acres 0 v o 130,679 Sq. Ft. 2 i� • Ir_ D I - i >72��� i-` M of 50 1� �' 7j I T, O N89 °5242 "W 370.34' !, N 330.53' N89 °52' 42 "W N N 39.81' m �o co m wN Ic_ 1 0 1r - 0 I v N - :2 N ir - � I n °_ ► LOT 2 �; i(i� 0 W": o 1 -1 j l � 0 m 2 .82 Aces y c v- a o ft s n - _ coo m IM 122,841 jq.. Ft. r ! a IC7 (+ 1� $O /L 1 zC+ ; a o° m a IJ I v ° o ►r - 'v TES J o, Z� J _j j 7 l > � x T CL i� N89 ° 55'09 "W 0. 3.' � �`� L_IN_E__ J1'�I_�_ 1� id�'j�` SEE SHEET 2 SCALE IN FEET 1" = 100' SHEET 1 of 2 SHEETS 0 50 100 200 3C� CERTIFIED SURVEY MAP Located in.'part.of the SW} of the..NWJ_of Section 23, T29N,.R19W, Town of t i Hudson St. Croix County, W isconsin. LEGEND OWNER Humbird Land Corporation Aluminum County Section Corner Monument Found East 1404 First Nationol Bank Bldg. • 1 Iron Pipe Found 332 Minnesota Street 1" x 24" Iron Pipe Set weighing 1.13 lbs. per linear Ft. St. Paul, MN 55101 � p ' g g — -- 50' Roadway Setback Line 150' Roadway Setback Line from Centerline or as shown to MATCH LINE ° 0 SEE SHEET I� !' O 111 m N p IJNPLATTM LANDS � ` �; v S89 °55'09 "E 380.00' � "w N n rn t1' �. d ° cn C � � 0 C> Ir rt ° N I a�'� 'LOT 3 0 o Ln r o I $W O f 1 > W +� - 6 r cr 7 1 —I to o r �.09 Acres lY O 0 W ' _ a I ° ^ 91,200 Sq. Ft. N ` ` rn 1C7 c �f^fl 33' 33' l m r^ ) N89 0 46 1 06 "W 456.56' I 1{ N rt Iv (mil a o ?�, I�) Co i — — — LOT 4 w .� If) Iv 0 D m N , —� a O 1 1 1 2.09 Acres U 1 91,197 Sq.. Ft. TE5 T' c 1 33:00' 490.00' N89 0 46'06 "W 523.00' A Corner UNF-'LAT I ED 't —ANDJ " Section 23 Vol 575 rn !; SCALE IN FEET 1" = 100' SHEET 2 of 2 SHEETS 50 100 200 300 - — - - - - -- Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count INSPECTION REPORT ST. CROIX GENERAL INFORMATION (ATTAC RMIT) SanitaryPermitNo.: Personal information y ou rovice may be used for second ur ses Priva Law, s.15.04 1 m 315868 Y P Y rY P I Y O( )]• Permit Holder's Name: City ❑ Vill ge Town of: State Plan ID No.: LACASSE, RICHARD HUDSON CST BM Elev.: Insp. BM Elev.: BM Descriptio ParceIT �x2NQT a 62 50 -300 TANK INFORMATION ELEVATION DATA A9 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing /r Aeration Bldg. Sewer •— Holding St /-Ittt Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANKTO P/L WELL BLDG. Air to I ntake ROAD Dt Inlet ir Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe 3_0 Holding Bot. System � PUMP/ SIPHON INFORMATION Final Grade Manufacturer �� �./�.. ..,�- Demand Model Number GPM TDH Lift Friction System TDH Ft ad I oss Forcemain Length Dia. Fi Dist. To wen SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSI SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type Of 17 CHAMBER Model Number: System: ,.,_ .a '' > � � 1 " 1 OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia- Length Dia. Spacing '7 " 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 I Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION• • LOT 1 HUDSON 23.29.19,SW,NW 871 KELLEY ROAD — 81I' ' `) Plan revision required? ❑ Yes N/o Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: e , 3 x x , S j E t t t � , e e x 1 a t ; v r Z 4 t t I w I, v t 9 , ._3 d r s t t t i E Y s ee J' P t 4 � n0 l • Safety and Buildings Division SANITARY PERMIT APPLICATION 201 E. Washington Ave. Vi sconsin In accord with ILHR B 3.05 Wis. Adm. Code P.O. Box 7969 Department of Commerce Madison, WI 53707 -7969 i i • Attach complete plans (to the county copy only) for the system, on paper not less County j than 8 1/2 x 11 inches in size. S 7`< . • See reverse side for instructions for completing this application State Sanitary Permit Number 3►�8ro 8 The information you provide may be used by othergovernment agency programs ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I 1. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATION qe -fib Property Owner Name Property Location r SWv4 ,r1 1/4, S Z 3 T 2 4' , N, R/-,p E (oro/ Property Owner's Mailing Address Lot Number Block Number ! D A City, State Zip Code Phone Number Subdivision Name or CSM Number ? I. TYPE OF BUILDING: (check one) ❑ State Owned ❑ it� Nearest Road ❑ VII age Public t or 2 Family Dwelling - No. of bedrooms 3 Town of � o III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) a 1❑ Apartment/ Condo 6 2 4 1 S� o 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 S ❑ Hotel /Motel 9 ❑ Office/ Factory 13 ❑ Other: specify IV. TYPE OF PERMIT (Check only one box on line A. Check box on line B, if applicable) A) 1. (New 2. ❑ Replacement 3, ❑ Replacement of 4. ❑ Reconnection of 5, ❑ Repair of an Sysstem --- - _ - - - - -_ 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 (Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System- I n- Fi I I 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 3 75 1717 , - 7 - 1 - Feet ld'l TS Feet Capacity VII. TANK in g allons Total # of r Prefab. Site Fiber Exper. INFORMATION g Gallons Tanks Manufacturer Name Concrete �O " Steel glass Plastic App New Existing structed Tanks Tank Septic T M Milk 10 D O l t _tj ❑ ❑ ❑ ❑ ❑ kd ump Tan ber 6 570 .r/ ❑ ❑ ❑ ❑ ❑ VIIII SPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite se ge system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature o tamps) PRSW No Business Phone Number: rsz S '`i a nz a r 0 ?I �' � G — /2 / Plumbers Address (Street, City, State, Zip Code }: if 7,d G J C t IX. COUNTY / DEPARTMENT USE O NLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issui g Agent Si nature (No Stamps) 0 Surcharge Fee) ❑ Approved Owner Given Initial I t o O O / f Adverse Determination V / 0 X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: $BD 636 (A 11/96) DISTRIBUTION: Original to County. One copy To: Safety 6 Buildings Division, Owner. Plumber i - SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Commerce April 4, 1998 Field Operations Bureau 13 East Spruce Street Chipewa Falls, WI 53729 WERGERER SOIL TESTING & D PO BOX 74 { RIVER FALLS WI 54022 AP-1, aO,X 998 RE: PLAN 98 -20466 ���_ ��NG o FEE RECEIVED: 180.00 LA CASSE, RICHARD SW, NW, 23, 29, 19W TOWN OF HUDSON —L COUNTY OF ST. CROIX MOUND SYSTEM The Department has reviewed the above - referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based on chapter 145, Wisconsin Statutes, and chapters Comm 83 and 84, Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter Comm 82 or in chapters ILHR 50 -64, Wisconsin Administrative Code. This plan submittal approval will expire two years from the approval date, or if a sanitary permit is obtained, plan approval will expire on the day the initial sanitary permit expires. The licensed plumber responsible for this installation shall keep one set of plans with the Departments stamp of approval at the construction site. The installer shall notify the appropriate inspector when inspections can be made. All permits required by the city, village, township or county shall be obtained prior to installation. Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Sincerely, roy G. nsky Wastewater Specialist Senior Field Operations Bureau ljansky@commerce.state.wi.us (715) 726 -2549 Fax (715) 726 -2544 Voice SBD -7997 (R.11/96) 9 Page of 6 MOUND SYSTEM REC EIVED FOR MAR z 3 1998 A 3 BEDROOM RESIDENCE SAFET � Y & BLU(,S D iv. LOCATED IN THE SbJ 1/4 OF THE Nw 1/4 OF SECTION Z3 ,T N, R 11 W, TOWN OF 6�J , S1 CRO IX COUNTY, WISCONSIN. (LOT 1 OI= �—* SI" I ` U 0U. 11 Vfrci 3Z INDEZ PAGE 1 'of 6 TITLE SHEET' PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW -CROSS SECTION PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT .PAGE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE P.O.W.T.S. PREPARED FOR Conditionally APPROVED LCI 1Z� `� C�S$� DEPARTMENT OF COMMERCE Z Z-O U t��CLJ LI°r1VE DIVI ION OF SAFETY AND BUILDINGS 1'tvDS , LU f SkL o I (, EE RRES �NED N l PREPARED BY W EG E F�Ei}� S Q 2 L. TEST a���e�n�>►�ga�y � b DES = Ghl�SERV I CE # �!�sC ®NSyy P.D. BOX 74 421 K. KAIK ST. r wecEREa • RIVED FILLS. V1 54022 = ELLSWORTK 715 -425 -0165 nt- � C� a� .S I G 1; " ® 3 -1 C1 - q JOB NO. Page 3 Of Approved Synthetic Covering 1�sTM c 33 Distribution Pipe Me4iom Sand � Topsoil � 1 F Elev. 99.7 S _ 3 E �; D - e b % Slope j ( Force Main Plowed j Trench of k"-2k" From Pump Layer Aggregate (undisturbed D Ft. Soil E 1 :.Z\{ Ft. Cross Section Of A Mound System Using F O- $ Ft. I Trench For The Absorption Area G N - Ft. A _� Ft. H S• S Ft. B 9 y Ft. I Z Ft. Linear Loading Rate =U •79 GPD /LN FT d $ Ft. Design Loading Rate= o- --GPD /SQ FT K Ft. L Ft. Alternate Position of Force Main ----- - _____ " W Z Ft. L B K W � — - - M Distribution `� Trench Of 2 2 2 Y Pipe Aggregate Observation Permanent 1 Pipe Markers ir (Anchor securely) i Mound Using 1 Trench For Absorption Area Pag Of �6 Perforated Pipe Defoll 0 End View Perforated End Cop. ot�i PVC Pipe as t Install permanent at end of each lateral Holes Located On Bottom, Are Equally Spaced Q End Cop Q � * PVC Force Main i. Distribution Pipe Lost Hole Should Be Next To End Cop Distribution Pipe Layout P y 4 - Ft. X 37 Inches y 37 Inches Hole Diameter '!y Inch t� Lateral nch(es)' Manifold Inches Force Main 2 Inches l of holes /pipe \S Invert Elevation of Laterals �Sx1.17= �' 1 .SSk2= 3 S,1 G pw� Place lst hole ) J zfrom tee with succeeding holes at 37 intervals. Last hole to be next to the end cap. Combination Sept. .c; Tank and PUMP CHAMBER CROSS SECTION. AMD SP1CIFIcATIoms' PAGE S OF b - .VEIJT CAP WCATHEK PROOF JuIJCTIOIJ aox 'i`C.Z. VENT PIPC APPROVED LOCKING ' FROM ODOR, raw,w, MANHOLE COVER 1Vt'T1'I • wA NIb1G LA EL, :hWDOW OR FRESH 3 R 8 ALP, IIJTAKE P b "A I �l. �O H ` M IN I `f�MIN. V j Iv Alm. y "It�s�e�na� PIPC PROVIDE -- • LET _ "' '(-AIRTIGHT SEAL 1 I II APPROVED JOIIJTS APPROVED J01IJT 84t =t=t�5 A W C.I. PIPE I I w /C.I. PtPE��c / Tank construction I i ALARM shall comply with -PaRR ('33.15 and 83.20 Is i I ON C i 1 c,� I LLCV. �1.'�' T PUMP --� - -J OFF D COIJCRETE • �O BLOCK 5 3 APPRcr, = RISER EXIT PLFM)ITED OWLy IF TAUK MAIJUFACTURCR HAS SUCH APPROVAL � 1NE SEPTIG E SPCC, IFICATIOMS DOSE N�} t'1� NUMBER OF DOSES: 3'07 PER DA: TA W K MAWLIFACTURCR: TA W K :,IZE : X 1 65 GALLOW DOSE VOLUME r ALARM MANUFACTURER S.S • � r' Q S�'IS'" �S IIJCL-UDIIJG 6ACKF GALLONS MODEL ►.!UMBER: IZA \AW CAPACITIES: A= ►L2— JUCHESOR 3iJ� GALLOIJS SWITCH TYPE: g IIJCHES`OR G(LLOU5 PUMP MA GOV l.p $ C =� ILICHE$ OR 1 S3 GA LLOU5 MODEL NUMBER: 0= �_ IIICHES OR 1 S 3 CALLOUS MOTE: PUTAP AMD ALARM ARC SWtTCN TAPE: TO 5L _ MIIJIMUM DISCHARGE RATE 3 S ' I GPM IN5TALLED OW 5EFXRAT1 CIRCUITS VEKTICAL DIF FERENCE DETWEEU PUMP OFF AUO.DI5TRIBUTIOIJ PIPE.. 9 ' - S FECT + MINIMUM NETWORK SUPPLY PRESSURE , , . , , .. , . 2 SO FEET • FEET OF FORCE MAIN X 'Z'�43 FYofl.FRICTIOU FACTOR - FEET TOTAL DtIU&MIC HEAD = > > '� FEET Pump chamber DIAMETER I t IUTERUAL DIMCIJSWW� Of TAIJK: L.ENbTH ;WIDTH ;LIQUID DEPTH BOTTOM AREA — 231= GAL /INCH AS PER MANUFACTURER = k • GAL /INCH Goulds 1Gr--r 6 OF h Submersible Effluent Pump r EPO4 j EP05 APPLICATIONS •Fasteners: 300 series • Fully submerged in high n Motor Housing: Cast iron Specifically designed forthe' stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. . •Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- • Homes components. Available for automatic and tic cover with integral handle Motor: and float switch attachment • Farms manual operation. Automatic points. • EPO4 Single phase: 0.4 HP, •Heavy duty sump models include Mechanical • Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, built in overload with preset at the factory. rated oil and water resistant. automatic reset. ■ Bearings: Upper and lower SPECIFICATIONS • EP05 Single phase: 0.5 HP, FEATURES heavy duty ball bearing 115 V, 60 Hz, 1550 RPM, Pump: EPO4 built in overload with ■ EPO4 Impeller. Thermo- construction. • Solids handling c a p ability. automatic reset g p ty: plastic Semi -open design AGENCY LISTING 3 /a` maximum. • Power cord: 10 foot with pump out vanes for • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. A• canaclian Sb Awdadw �� • Total heads: up to 24 feet. with three prong grounding w EP05 Impeller: Thermo- • Discharge size: 1 NPT, plug. Optional 20 foot (GSA listed model numbers • Mechanical seal: carbon length, 16/3 SJTW with plastic enclosed design for end in "F or "AG ".) rotary/ceramic - stationary, three prong grounding plug improved performance. BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 1 • Capable of running dry without damage to s 30 components. Pump: EP05 e • Solids handling capability: a 2s maximum. 4 ' 7 w • Capacities: up to 60 GPM. o s 20 • Total heads: up to 31 feet. Z • Discharge size: 1IN NPT. . z 5 • Mechanical seal: carbon- o 15 rotary/ceramic-stationary, -1 4 BUNA -N elastomers. o • Temperature: +- 3 10 104OF(40°C)continuous 140°F (60°C) intermittent. 2 3 ; 5 1 OL 00 10 20 30 40 50 GPM Yr 0 2 4 b 8 + 110 12 WM '> CAPACITY s! ©1995 Goulds Effecifve May, 1995 83871 f - Wisconsin Department of Industry SOIL AND SITE EVALUATION Labor and Human Relations `�f�' e / of 3 Division of Safety and Buildings in accordance with s. ILHR 83.09, Wiq'4.,� Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must G o V i Include, but not limited to: vertical and horizontal reference point (BM), direction and S percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Par6el - 111. #` 41�1 <� 'a APPLICANT INFORMATION - Please print all information Reviewed f N, Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). i , Property Owner 332 R",V ,rSoT+ Property Location A `14AVp e2y . Sr 7 -- Govt. Lot 1/4 - z3 T Z`j ,N,R ) y E (or )(F) Property Owner's Mailing Address Lot # I Block# Subd. Name or CSM# City State Zip Code Phone Number Nearest Road Sr- �itvL ,N,v 55101 ( (o (2 222 - 5-555 El ci ❑ Villa Town [B New Construction Use: esidential / Number of bedrooms 7 Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow [00 0 gpd Recommended design loading rate bed, gpd/fl2 3 trench, gpd /ft Absorption area required Soo bed, ft 2 SO O trench, ft 2 3 Maximum design loading rate bed, gpd$ trench, gpd /ft Recommended infiltration surface elevation(s) S-at l q . 3 ( IQO- 15 ft (as referred to site plan benchmark) Additional design /site considerations SATE �PEQvi.E�'� �10 - 7)/ S/'S Parent material � S� �ijl0 % Si� 5i%�� 5�i yE�TS Flood plain elevation, if applicable '��� ft S = Suitable for system Conventional , El In- Ground Pre AT -S rade U System in Fill Holding Tank U = Unsuitable for system ❑ S (2 S U El l�'l7 ❑ S ❑ S Lal U ❑ S SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft2 in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed ,Trench o -Y ioyt? 313 SiL 2f5 hx 505 CS 1.4,,,. ,5 Ground 3 3 fOYX zl $L / 7 S CS — ,, S elev. 7. Go ft. 2 y /0 Y/ e6 L S / f ,e Cs tv Depth to 's Y l e 7 : limiting factor Remarks: Boring # o �o i re y 3 sly 1 4 , n 4t? -,e C s Z -f 2. Z 3 S -31 1 10" 3 17 C . 3 Ground J - J ' .ex S/ r— S 0 E d_Q_ q -C - 9 - d I elev. P S /CL D 2, y�? Depth to /� limiting s7''17f 7 1/ uP &L7 1/ o ce 0 1 -5 37 /re factor ,3-Lin. Remarks: CST Name (Please Print) Signatur Telephone No. Ro6ie7 4' 13rP/cArT 7 /S= 3 P6 - VIP S Address Date CST Number r �c Private $swage Consultants 055 O'Neil Rd. Hudson, Wis. 54016 ORIGINAL 4 ko 5 S aAX, 0 10 0,0 Lo 7. A, PROPERTY OWNER SOIL DESCRIPTION REPORT ? Page 2 of `� PARCEL I.D.# A0 Boring # Horizon Depth Dominant Color Mottles Structure 2 in. Munseli Qu, Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed ,Trench /OYiP 3/3 54 aos! 4 L -/lo 10 31 ZI /ash s �i Ground -3 elev. 10 2 n. l' � G CV Clc) Depth to 1 1"e ` • , S limiting I CL Q � factor sass Remarks: Boring # o io /o ,e 3/ SG ; L Ground - 41 IM elev. Depth to limiting factor In. / Remarks: .7� Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # Ground ; elev. Depth to limiting factor ' Remarks: Boring # Ground elev. n. Depth to limiting factor in. Remarks: SBDW -8330 (R. 08/95) W . Zrs. wY 1 f3 Q3 lO . c.� 1 i. 70 BS j $CAGE 30 CA �'� �o�,ti,•v�� �o v-�� s Ys7 n1 i 4�' / & Id- 'l S4 ,0d - /%I/l 1 0 0 , 76 Ulbricht & Associates Private Sewage Consultants 655 O'Neil Rd. Hudson, Wis. 54016 BZ 1 _ goo ua � �orzM 0 r CO a +o V tz 1 L I iu E� X0 r iii /g 3 a r c s' 33 ............ _ 330 / ,47 s w Z-0 E'i�v, �I eX Wisconsin pidrtment of Industry SOiL AND SITE EVALUATION Labor and Tian Relations. of Division of Ioty and Buildings in accordance with s. ILHR 83.09, Wi Attach con rte site plan on paper not less than 8 1/2 x 11 Inches in size, plan must Include, b!. A limited to: vertical and horizontal reference point (BM), direction a percent sk 1 i and distance to a t�? P mo Y A APPLIC, fir INFORMATION - Please print o . � j a vlewetl 6 .v Date Personal IN oJon you a used for seconds purp PrIvac Law � ,04 secondary rp t Y hl'.N, liep Z-"j vf� G4.f' 3 srp ° v 9Slla �'�= ?ila.s 23 T Z ,N,R ! a (or Property C us is Mailing Address Lipt # ck 5u4d'. Name or CSMtf City State Zip Code Phone Number N, ; r Nearest Road l 5510 i (col�)a2�- 5555 I11age Town M r,+tructlon Use: LfResldential / Number of bedroome 7 Addltlon to existing building ❑ Repl! rribnt ❑ Public or commgrclal - Describe: Code de rd dally flow W049 gpd Recommended design loading rate bed, gpd /ft ' -5 trench, gpd /f1 Absorptl area required O bed, ft Sd 0 trench, ft 2 Maximum design loading rate / bed, gpd /ft ' ' trench, 9010 Reoomr ei'ed Inflltrallon surlace elevatlon(s) SCR. P� . I U� 1 S) ft (as referred to site plan benchmark) Addttlon IElsign /site consideration $ /�� Parent r eriat �� Flood plain elevation, if applicable �� h $ = rt�;abie for system Convenllonaf . Mo�un . in•Ground Pressure . AT•Grad..e��/ System�in Raiding Tank U = 1 witabla for system ❑ S 2 LJ s❑ U CIS ❑ S i� U C3 M U CIS SOIL DESCRIPTION REPORT Boring ; Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots QFD /tt2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench e f,, idIllf 313 51`. z f S hk c O5 Cs P., , .�. Ground 3 33 /a YX Y Z 81ev, D to S le D s , � limiting factor Remarks: Boring o %o t ' 3 S' /G / 4n AZ 4 Ground y0 /a S/ -5 Q E -C .r- ? Depth to S'�tT // vl�f �I 7' Cl� S 1.� -4/ /C limiting factor C',ffD.cJ CGS - rl�-rUiP/f7` - 1 - Lin Remarks; '( CST Na (Please Print) Sign atur Telephone No. X g 7— Liz 7rh' 3. F - 9/1P S Address Date CST Number -per• ., vio riont a Associates PrlVtitY Sewage Conlsuitantt! 856 O'Nell Rd. Hudson, Wis. 54018 ORIGINAL 4 g, 01'.0+ 0 T . ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT ! AND OWNERSHIP CERTIFICATION FORM i )) Owner/Buyer 1Z. rl , G R- 16- , Mailing Address / ,?- Z, o n ig I !, Property Address '7 J o% (Verification required from Planning Department for new construction) City/State &d Sa`.0 Parcel Identification Number 4 2 0 - ! 4 4; 2 - -S-6 - 34 LEGAL DESCRIPTION Property Location _� /a, �_�` /,, Sec. 7 - TAN -R-AW, Town of 4 J5 ` Subdivision t �v- Z f S (r. , Lot # Certified Survey Map # S' -'5 9'/D 1 , Volume Page # 3.2 3 ` Warranty Deed # S FY; . Volume /23/ . Page # f 2 ,�? Spec house El yes ❑ no Lot lines identifiable Dyes ❑ 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 qw, s been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days date. /z LICANT 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 the property of a warranty deed recorded in Register of Deeds Office. 12 IGNA 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 I a copy of the certified survey map if reference is made in the warranty deed I I I r ^OV DOCUMENT NO, WARRAMTY DEED J STATE BAR OF W:S;"- NS1N FORM 2 —IM VOL ��� a'�f � �i 580842 i -3 Ij HUMBIRD LAND CORPORATION M i r ! .U?Nl a nne i sates Corp oration •- � ��F�E ........... .. . . ....... .... , X C W! r pgnorrd ....... _. -_ .... ....- ............... 11998 cunvoyx tuxl warra ,. Rj,�,��X� W, - LaCasse_ and Grace. J. - i LaCasse, . husband. .and..wife _ ...... ....... ....... 10:00 A M .......... L Re lahw d Ceoils �' . ............ .._..... � - n[T T ..... .. ..................._.. the following described re:d estate in ,.S) .., Croft - - - •, County, -- '— State of Wisconsin: Tax Parcel No: ................... .......... Part of the SW 1/4 of the NW 1/4 of Section 23, Township 29 North, Range 19 West, St. Croix County, Wisconsi—, described as follows: Lot 1 of Certified Survey Map filed April 17, 1997, in Vol. "11", page 3234, Doc. No. 558109. , T oi�SFER rw This _ not homestead property_ I 1W (is not) z ^;A- Fxcei)tion to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this .. ............. •- 5 th ...................... day of - -- - -- June ---- ............... .................. 19.48.... ............. .......... • ......._..... •- -'... _ _ - _(SEAL) fIUMIRO..LA13A...C.O. .QR� _ON._.... (SEAL) .. ...... .. . ....... ...... Austin 3. B llon, President _ __(SEAL) ...................... . ... (SEAL) +1. ..................... AUTHENTICATION ACKNOWLEDGMENT Signature(s) ........ ............. STATE OF �INi14ESO A ........ - " .............................................. •................ ss. ........... ..... .........Count nut ienticated this .__.....day os ............. ,• , __.......... __ 19 __ Personally came before me this ... 5th ....... j of .. ^_ - .. -- ... June .......... ................. 19.98.._ the abcve named Yti ....................... ......... ............ .................................... .Aus.t<izkJ,_. B�?Il ony._.President. qf ,- Humb.rd -Land Cor oration TITLE: MEMBER STATE BAR OF WISCONSIN ..... ... .....................•-..---...___....-_._.._... _.._.•_ ....................... 1 (IP not, ............. •• .......................----- ' • authorized by 1 706.UG, Wis. Stats.) • to me known to be the person ............ who executed the foregoing ins trunten THIS INSTRUMENT WAS DRAFTED BY R �. ;} rat l � N C ry_ 1 V ...._ _I'tUMBIRII - • I.EIND . CORPORATION - - •- 1 � � '- '�•- t:�;.•i�.e; #.. ------ ----- ----- _- - ----- -'- \ y/'', 4 i ,}�a Ch! Ct_)u?r CY _ AhFCrn.v. ix}'; a ja^rr t. Paula.,':,!- nne . -_ sota.• _ .� mo Notary Public ---- . `........D}tYftY, M MN #" (Signatures may be authenticated or acknowledged_ Beth Dly Commission is Permanent.(If not, state expiration ; are not necessazy.) Januar 31 2000 date: .... )'... ' ... .... .............git9;_..... - .) , ' •Names of persons ,Ixnint in any cnpncity sh be typed or prisW jelnr Ib. it .�iannUrrrs, `— ' ^ - - -_ • -__' o• _ ,. • ..... .......... ........ f..:. ,...Hein i nn•• t" .. =9 5 . ..0 � � sii .i�K��..�ip&�'�:;✓ e� ' � .." i'Bre 'A ['Jr .� - - - - _ — .,. w Mar FILED va v 9R 17 19 < %C 9. WSW at 558109 CERTIFIED SURVEY MAP Located in part of t e SWi of the NWi of Section 23, T29N, R19W, Town of Hudson, St. Croix County, Wisconsin. NW Corner Section 23 P/ A R IN LOT 2 z V01 . 955, PG. A l .. S. M, r1a 0 -4 C) t %J - . 1- - 1 7 78 6 - - ---- 11 c2 t P reviously Recorded as VOL. 10, V1 N89 t I US Hwy I rii S89 —403.35' LIS North line of the SA of the NWk Ln W 4 BENCHMARK C: 9 Masonry nail in (D S89 370.341 :3 power pole 275.34 95.00' Elev. 929.16 t PERMANENT LIMITED C) EASEMENT 0 0 CD co m LOT ......� ................... C> C� CD S' m. 929,0 0 � 0 o' 33' 33' 0- Ic 0 M= LOT I LD PG 90-7 X o 0 ID 3.40 Acres Ln I 0 1 0 CL C) 0 1'48,136 Sq. Ft. 1> m -DO Ac. Exc. Esmt. 0 Ln z 130,679 Sq. Ft. I r M t1j 0 Ln t N89 370.34 330.53 - F ' N89 0 52'42"W of 39.81' N �_ al cc co tl):E (Z 0 ir— CD co C) > (A a) r--* 0 Ct -3 12� C> 0) 71 - Ct Cn W m 10 any CA r C a CD LOT 2 a It 10 01 C (a. 0 -3 > I Fri X Ct a' Ct 1-1 , r— -*:; a 0 Ct -7 = (b 1- 1 1 r o 2.82 Acres Ev 0 Cr 0 -h r -'b . CD CD m 1-< ..l 2 Sq.. 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