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Home My WebLink About020-1335-00-000 r ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner S 11/1 W ( C (- ,F rC Address /C � G+ S i CR04?i City /State L) Q-S e`eV („� COUNTY ZONVNGOFRG Legal Description: ,f Lot 25 Block — Subdivision/CSM # 8 #&114f1) 5 Pk, 1e 1 jE- '/, ; 'A/ Sec. - 4 7 , T t.et N -R Town of N td .0 Zc� t-J PIN # 57 z x.17 '' SEPTIC TANK -- OSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer �tJF— 1 5 F 1 2..•.. Size ST/PC IWO/ Setback from: House ' Well 5 ' P/L - 7S Pump manufacturer Model Alarm location 4 (HOLDING TANKS ONLY) i Setbacks: Service road— Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: T K E MI e H Width Length �� / Number of Trenches Z- Setback from: House 2- &' Well 6 P/L -- - Vent to fresh air intake -'e-' ELEVATIONS Description of benchmark Nt t t- /N "I tz E E ' 8 Elevation OV, o6 Description of alternate benchmark T"o P cat NO OS F ra y N D fi? /''V N / . Elevation Building Sewer 1 ST/HT Inlet - 7 .7 r -gIN Outlet '�, 42.0P Inlet A-1 PC Bottom Header/Manifold - '985 T OP of ST/PC Manhole Cover / 02.2 ' Distribution Lines () $ .�l � '() 2 1, 4 ) Bottom of System( Ny ) 9 Final Grade Date of installation '/ /C /� QPermit number t 3 3 State plan number Plumber's signatur yl. `t', License number S 035 0 Date q /Z FO' Inspector Complete plot plan 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 3 NA iN TREE E I f OQ rD� u �O L V� 1` 7� 'ie i ... . , v 6 V Q i i INDICATE NORTH ARROW Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count y: Safety and Buildings Division ST CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) SanitaryS ?J7 liG3' Personal information you provice may be used for secondary purposes [Privacy La s.15.04 (1)(m)]. P_e�rtjtH9 lder's 1}la(r ❑fifty [] Town of: State Plan ID No.: CST BM Elev_: SArt Insp. BM Elev.: BM Description: Parcel T jy:y0�_1335 -00 -000 0 0 1 oc7 -kre TANK INFORMATION ELEVATION DATA A9800022 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic. Ob w<7 Benchmar 3 1 9 CK.,. Dosing k f , .gm t Oyh7 Aeration BlF'd�,g�Sewer ,5� /Od3 Holding 6 Inlet 7q1 TANK SETBACK INFORMATION I _ Outlet �, `%Fl G7 TANK TO P/ L WELL BLDG. Air Intake ROAD Dt Inlet Septic - 75 / Z)' -Z NA Dt Bottom Dosing NA Header / Man. �* ,�j fig. 5 5_ Aeration NA Dist. Pipe Holding Bot. System g7,r�7 PUMP/ SIPHON INFORMATION Final Grade S.�Z � Z___ Manufacturer Demand Model Number GPM TDH Lift Friction em TDH Ft Loss Forcemain Length Dia. Dist. Towel SOIL ABSORPTION SYSTEM BED /TRENCH Width length No. Of Trenches PIT No. Of Pits Inside Dia. Li lid Depth DIMENSIONS Z DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE / STREAM L ING a er: INFORMATION Type Of ' I / CHAMBER— Model Number: Syste h Zi OR UNIT DISTRIBUTION SYSTEM Header / M nifo ,ld t Distribution Pipe(s)� J ' x Hole Size x Hole Spacing Vent To Air Intake Length i r'S Dia. r Length �� Dia. / Spacing ��►ti/t 5 �t Z, � SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over ,� � Depth Over d xx Mulched Bed /Trench Center 3Z ��(p Bed /Trench es Topsoil No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: HUDSON 27.29.19,SW,NE 731 WILFRED ROAD S (D OA>,,,, J,-, It kA.,, z ri w PlFan revision "k. L ❑ Yes ® No Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature ert o- SANITARY PERMIT APPLICATION Safety ofBuillingWater Systems 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County c St than 81/2 x 11 inches in size. • See reverse side for instructions for completing this application State sanitary Permit Number v 3 Sc o at, The information you provide maybe used by other overnment a e cy progr ms ❑ 3 0 Check it revision to previous (s app on [Privacy Law, s. 15.04 (1) (m)]. - 7 � / W/ rma Rd �C. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION I .0.�_ — Property Owner Name Property Location SR ki ,, 4J t/4 1/4, S Z„'7 T Z , N, R/ 0' E (or W Pro erty O�er's Mailing Address Lot Number Block Number ® tS' / City, State Zip Code Phone Number Subdivision Name or CSM Number yv�ft N u-, 1 I , " f (3 gc ) - 2.7 LA1V! 0:5 - PAh i ill E 6G� ��• II. TYPE OF BUILDING: (check one) ❑ State Owned E] C ity Nearest Road Public a 1 or 2 Family Dwelling - No. of bedrooms E] Village of �L) C , Iy Lt)I F12.E III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) ^ 7 A 9 1 p 17 7O 1 [] Apartment / Condo d Zd - t - 00 7 1 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. ❑ Replacement 3. E] Replacement of 4 E] Reconnection of 5. E] 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 ❑ 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 -In -Fill VI. ABSORPTION SYSTEM INFORMATION: / 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System lev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft -) (Min. /inch) i Elevation 1 s - < , 0,3 <Uca •a eet /DZ,3Z. Feet Capacity VII. TANK in Ca allons Total # of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existin structed Tanks Tanks epticTank /fro ! U — )Cc I Sz"A'o- r � ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ I ❑ I ❑ I ❑ 1 ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No Stamps) MP /MPRSW No.: Business Phone Number: MjKf Plumber's Address (Street, City, State, Zip Code): 0 ?4'.-s N O NT Ems. P jllpi AF_ U_� ! o IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater D ate I ssued Issuing Agent Ignature (No Stamps) ]Approved ❑ Owner Given initial 0 K Surcharge Fee) O�� I z-(1-116 �O Adverse Determination /5 4 X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: SBD -6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber In f I tLF A , 7-7-z� 8 ApMmp. 5 t /. 9q .5 0 03 r f 6AU IN TACc IV 0 , 06 SlAt j . All. '.9 < le Lot nor 3 ji r4- A? 7 . . 1 _ o o (� w 4 o t � � O W I 0 tl A I M Z i I qlg Z I { [L lkl I o LL Lil I I f I t �--- J LL I U a I W Cf) IL v � I I w � I a I j O ID W I w U ` � I Z tj- W 1 °- Wisconsin Department of Industry SOIL AND SITE EVALUATION L?jjor and Human Relations Page �_ of Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than S 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. # Y _ Ow _ l 0 L( 40 APPLICANT INFORMATION - Please print all information. , Reviewed by Date Personal information you provide may be used for second -0 wposes (Pri"* La s. 15:0R:(I) )). Property Owner -ti r �; i_, Pr*rt Location Richard Stout - r .rs Go4_t_ SW 1/4 NE 1/4,S 2 7 T 2 9 ,N,R1 9 R(or) w Property Owner's Mailing Address _ { F'+ 1 Lot # _ Block# [ Subd. Name or CSM# ST CRO 1353 Awatukee Trail - TY 30. dlands Prairie City State Zip Code orpkNumber, OF E Ity ❑ Village U Town Nearest Road HudsonWI 4016 ( 1'j.49- 6731 Hill Farm Road [ New Construction Use: ( Residential / Number of bedrooms 3 4 Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow - 6 - 0 0 gpd Recommended design loading rate _. 7 bed, gpd/ft - -g trench, gpd/ft Absorption area required 8 5 $ bed, ft 7 5 0 trench, ft2 JJ Maximum design loading rate 7 bed, gpd/ft gpd/ft Recommended infiltration surface elevation(s) 9 7 7 2 �7 7J -ft (as referred to site plan benchmark) Additional design /site considerations Parent material Glacial depo sit Flood plain elevation, if applicable ft S = Suitable for system I Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for s I [iN s ❑ U ER s ❑ u ® S ❑ U ® s ❑ u ❑ s ® U EIS FO U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed ,Trench 1 1m bk 2 -48 10yr4/3 none s 1fgr ml cs if .5 ;.6 Ground 3 8 -9 10yr4/6 none elev. s DSg ml C s - .7 .8 101 _49 ft. Depth to limiting factor 9 6 in. Remarks: Boring # 1 _ 2 2 -46 10yr 4/3 E S 1 fgr CS if .5 .6 3 46-91 10yr4/6 none ns Dsg 1 CS - .7 .8 Ground 10 3 -2-0-ft- Depth to — - -- - -- -- — — - - - - - - -- — - -- -- -- limiting factor Remarks: CST Name (Please Print) Signature Telephone No. r Address Date CST Number 77,1 ),c 9',/./ `/ /a 7 / _;2 2 1 of a PROPERTY OWNER Richard Stout SOIL DESCRIPTION REPORT Page 2 of � l PARCEL I.D.# 3oring # Horizon Depth Dominant Color Mottles Structure 2 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3 1 0-11 10 r3 2 none L l mabk mfr MR 2f 2 . 10-- - -8 10yr4/3 none fs 1fgr ml cs 1f .5; .6 around 3 38-E9 10vr4/6 none ms os ml c flev. — — 101 ..- 6-2-n. Depth to imiting actor , Remarks: 3oring # 1 -6 10 r3 2 none L lmabk mfr ;4 2 -40 10y none fs 1f r M1 s if .5 3 0 -9 10yr4/6 none ms DSq Til s - .7 .8 Ground Aev. 10 2 -.32n- Depth to imiting actor m in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # 1 -10 10 r3 2 none L 1m bk 2 10-33 10yr4/3 none fs 1fgr M1 CS if .5 .6 5 3 8 -9 .10 r4/6 none ms DSCF M1 CS Ground elev. 100 _72 ft. Depth to limiting factor -9 Lin Remarks: Boring # Ground elev. n. Depth to limiting factor in. Remarks: SBDW -8330 (R. 08/95) r ` o V • a I d d Y ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer S,4A4 M I LG.F r?'_. Mailing Address B-0X' >f_ / -S l Property Address 73 / c-t_ ' / &e.— Fitt lD c t=S "� (Verification required from Planning Department for new construction) City /State 140 AD S -o R( L- t Parcel Identification Number O 2 O- 13 3 :S" 4 a� LEGAL DESCRIPTION Property Location S u) ' /a, N '/4, Sec. Z 7 , T A N -R 9' Town of �� d :; Ili subdivision E AD LA N.r� t W i , Lot # - . Certified Survey Map # S! I o I ( , Volume 4. , Page # 9 Warranty Deed # S '7 4o / , Volume 1 g `f , Page # 3 78 Spec house yes ❑ no Lot lines identifiableM yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards.. set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to St. Croix County Zoning Office within 30 days of the three year expiration date. J 2 . 11� SIG TURF OF A PLICkNT DATE ":.. _ OWNER CERTIFICATION f.; 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 propt . ty described above, by virtue of a warranty deed recorded in Register of Deeds Office. SI AT OF X L - ICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed v 1�61.� STATE BAR OF VVISC000SIN F(.11M 2 — 1995 D OCUMENT NO. W A Y f:I E�D .....vim. _ RICHARD O. STOUT .wm �r r Icf T I t . R , .ix C ®1 WI conveys and warrants to SAM E. MILLER Rrt'd trr ArrrP FEB 0 9 1998 8:00 A Re * of Deeds the following described real estate in St. Croix County, State of Wisconsin: RETURN TO Lot 30, Plat of Badlands Prairie, a 3 Town of Hudson, St. Croix County, r0 13 Wisconsin, except that part of said lot described within Parcels B and G attached hereto. Parcel Identification Number (PIN): Part of Lot 31, Badlands Prairie in the Town of Hudson described as Parcel F attached hereon. SF 'PER This is not homestead property. (is) (is not) Exception to Warranties: easements, re4trictions, rights -o y, and covenants of record, if any Dated this day of _ ,i9 98 p e �� (SEAL) (SEAL) * Richard O. Stout (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ss. St. Croix County. authenticated this day of 19 Personally came before me this day of G1r�l ' 19 98 the above named Richard O. Stout TITLE: MEMBER STATE BAR OF WISCONSIN (If not, Y + �_to me known to be the person who executed the authorized by § 706.06, Wis. Stats.) foregoi stru F acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY NOTARY I'U3L.1C QAX Janet P. Stout Awatu ee Tr. Hudson, W i . 54016 Notary Public County, Wis. (Signatures may be authenticated or acknowledged. Both are not My Commiss n Is perma, ent. (If not, state ex ra lon necessary.) kt.) date: * Names of persona signing in any capacity should be typed or printed below their signatures. SB2 NTF 0021A WARRANTY DEED STATE BAR OF WISCONSIN Nelco, Inc., P.O. Box 10208, Green Bay, WI 54307 -0208 Form No. 2 -- 1996 dARCEL B UL `9 A parcel of land located in part of the SW1 /4 of the NW1 /4, and in part of the SE1 /4 of the NW1 /4 all in Section 27, T29N, R19W, Town of Hudson, St. Croix County, Wisconsin; being part of lots 39, 35, 34, 33, 32, 31, and 30 of the Plat of Badlands Prairie recorded at the St. Croix County Register of Deeds Office; further described as follows: Commencing at the NW corner of Section 27; thence S89 11 E, along the north line of the NW1 /4; 1298.49 feet to the east line of the Plat of Badlands Prairie; thence S00 "W, along said east line, 1311.61 feet to the south line of lot 40 of said plat, also being the point of beginning; thence N89 0 59 1 06 "W, along said south line, 4.35 feet; thence S00 "E, 27.50 feet; thence N89 "E, 1224.89 feet; thence N78 "E, 72.99 feet; thence N89 11 E, 10.98 feet to the west line of the SW1 /4 of the NE1 /4 of said section; thence N00 "E, along said west line,13.01 feet to the north line of said plat; thence N89 59'06 "W, along said north line, 1303.28 feet to the point of beginning. Above described parcel contains 35,016 sq. ft. (0.804 acres) and is to be deeded to an adjoining landowner. PARCEL G A parcel of land located in part of the SW1 /4 of the NE1 /4 of Section 27, T29N, R19W, Town of Hudson, St. Croix County, Wisconsin; being part of Lot 30 of the Plat of Badlands Prairie recorded at the St. Croix County Register of Deeds Office; further described as follows: Commencing at the NW corner of Section 27; thence S89 0 55 1 18 11 E, along the north line of the NW1 /4; 1298.49 feet to the east line of the Plat of Badlands Prairie; thence S00 "W, along said east line, 1311.61 feet to the north line of the Plat of Badlands Prairie; thence S89 11 E, along said north line, 1303.28 feet to the west line of the SW1 /4 of the NE1 /4 of said section, also being the point of beginning; thence S00 °00'01 11 W, along said west line, 13.01 feet; thence N89 11 E, 394.98 feet to the northerly right -of -way of Maple Lane and the point of curvature of a 303.00 foot radius curve, concave southerly, whose central angle measures 13 whose chord bears N83 11 E and measures 68.73 feet; thence easterly along said right - of -way and the arc of said curve 68.88 feet to said north line of said plat; thence N89 "W, along said north line, 463.25 feet to the point of beginning. Above described parcel contains 4,286 sq. ft. (0.098 acres) and is to be deeded to an adjoining landowner. t VOL F•ARCEL F FROM LOT 31 TO LOT 30 OF THE PLAT OF BADLANDS PRAIRIE ` A parcel of land located in part of SE1 /4 of the NW1 /4 of Section 27, T29N, R19W, Town of Hudson, St. Croix County, Wisconsin; being part of Lot 31 of the Plat of Badlands Prairie recorded at the St. Croix County Register of Deeds Office; further described as follows: Commencing at the NW corner of Section 27; thence S89 11 E, along the north line of the NW1 /4; 1298.49 feet to the east line of the Plat of Badlands Prairie; thence S00 11 W, along said east line, 1311.61 feet; thence S89 0 59 1 06 11 E, along the north line of said plat, 1275.63 feet to the northeast corner of said Lot 31; thence S00 11 W, along the east line of said Lot 31, 16.39 feet to the point of beginning; thence continuing S00 along said east line of Lot 31, 342.53 feet to the northerly right -of -way of Oakley Road; thence N90 14.00 feet; thence N00 339.80 feet; thence N78 °E, 14.27 feet to the point of beginning. Above described parcel contains 4,776 sq. ft. (0.110 acres) and is to be deeded to an adjoining landowner. r , . w w co V) w 00 00 z 0 W w z __.! ui U O Q N - . 0 L6 �r 0) W O) Ld li w O co C �QQ Y Z O o O 00 oN N N O e- 16.39' P 77 w N00'06'24 "E 339.80' co M W O d C w o z ►� U ° 0 N ._..J � N N V) cr- Q cl -- -- 27.16' Z PARCEL "E" cr o) 0 S00'32'30 "W 331.83 00 � d w 3 N z N co W ui 0 o) 225' ;n Ln � °° oo V) Z Z '� _ _ s -.1 co ST. CROIX COUNTY WISCONSIN ZONING OFFICE N N „ „� N N �� p ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 May 26, 1998 First Federal Attn: Maureen Hudson, WI 54016 RE: Septic Inspection for Sam Miller located at 731 Wilfred Road, Lot 30 of Badlands Prairie, Town of Hudson, St. Croix County, Wisconsin Dear Maureen: A septic inspection of the above referenced property was conducted on April 23, 1998. This property is located in the SW %4 of the NE' /4 of Section 27, T29N -R19W, Lot 30 of Badlands Prairie, Town of Hudson, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a three (3) bedroom home. regarding hi lease contact our office at 715) 386 -4680. If you have any questions g g t s, p Sincere Rod Eslinger Assistant Zoning Administrator /sm FAX ST. CROIX COUNTY ZONING OFFICE 1101 Carmichael Road Hudson, M 54016 (715) 3864680 DATE: TO: Fax Number. Name: FROM: Fax Number. 386-4686 Name:J Number of Pages Including Cover Sheep IF COMPLETE AND LEGIBLE INFORMATION IS NOT RECEIVED, PLEASE CONTACT: ` (� NAME: V(I� TELEPHONE NUMBER: J &'p'