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HomeMy WebLinkAbout032-2072-80-000 "O O e� C T O H ~ O e d O C C h '— O 'O O N N � op m N L O � N O N a m j O Z j 6 'C LL C: O w co 3 Q a� 3 v � r Z 6i CD N U) O of d Z a m CD M � � � � C � O _O Z c Z c o O Z E N C m N n of P%b CD � C �i c 0 `0 O O Z co Z a N w �l o m c N V n N E N v CL w w O C N M 4 Cif C O O O G G d D o — N h w Q o Go to to N � U .� — Lo X555 ° 64 z c •N �aaa IL 7 Q o co co rn rn y � o } O N 0 N O N O O p E co CD C n- O Cl) 41 Q } In 00 O O C C l y C O 0 I. a0 h H V O N N N W i.a N O O m 1 •C c Co v CO p N O W N 7 N_ O N_ LU N M E 7� w V = O a U O Cn 0] M O Z Cn r \ m L cd m c � a� _1 A 0( 2 0 U) v SIC Ix COUNTY Wirt 352414 SURVEYOR'S RECORD CERTIFIED SURVEY MAP SW 1/4- SW 1/4 - SEC. 13, T -30 -N R- 20-W N p5 . pN�PN V 9� 0 S 89 °- 24'- 00" E 717.31' ' �Do le w Z J j o W N 0665A 3 N V�Dw�SlON O � � MAN °RS vA� F °R N o Z_ C 1 � . ` O O N 1. .- 4 a Pee pV N ° M_P Sy4 i1 y I - w� J m 'DO � ,� S 24' -00 'E ?� ; S 89 24'- 0.0" 500. 00' `S90 Lo J� � I O APPROVED - w �S S9 6 •� o N O of O .m 4, , to co LOT 2 ', �.•A, 0' N OCT 17 1978 ' ' Z N 3.3 0 /� , S 89 24'- 00 °E /o l 65.00 O o ST. CROlX L v it o o l o 4v,' Q C0MP„EHENSIV2 PARKS PLAP:NING YA�y AND ZONING COM O S 89 l 0 N29°- 56 =24 °E 31; 24 -00 E 651.00' \� 72.44 w 1A �. N �} O S 89 -24' -0 'E o 0 N 30.00 O C co In LOT 3 N O N = N 3.73 Q. 3 0, 90 V %" F D. N 890- 24' -00 "W 65.0 SW COR. TI 5.35' -- �. SEC. 13 SOUTH LINE CO. MON. SW 1/4 .. VPNaS ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner -Y RREF Address f' r City /Stat 6 , 1 r ` �-1/ . -:, J ? �+ 1998 S7 CR03X COUNTY r Legal Description ' ,\ ZONINGOFFICE Lot --? Block :4L - Subdivision/CSM # � :, "; . >_ _ ___ _. , -.. •� '/+ '/+ , Sec. z,3, T,&N -F,-2oW, Town of PIN # 0 SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer _J� ��_ Size ST/PC da / Setback from: House Well P Pump manufacturer Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM: Type of system: Width 4— Length , �4 Number of Trenches Setback from: House ,-7-,?g well fm Vent to flesh air intak ELEVATIONS Description of benchmark Elevation !g�l� Description of alternate benchmark Elevation Building Sewer _ 2,:L2 ST/HT Inlet ST Outlet 9 ZZ PC Inlet 9G, s% PC Bottom Header/Manifold �� . , _ Top of ST/PC Manhole Cover 9G. Distribution Lines Bottom of System Final Grade Date of installation / / P rmit number 3e y� State plan number �� Plumber's signatur - - 6 License numbe Date 11z / Inspector Complete plot plan Or t a Department Bui n e of Commerce g s D ivision PRIVATE SEWAGE SYSTEM County: � af2 a D INSPECTION REPORT ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) SanitaryPgrLr, Personal information you provice may be used for secondary purpose L s [Privacy , s.15.04 (1)(m)). .S UU // UU CE fie�o�i#kln der,.s,pl f LCitwll� ff Town of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description: , L' I' Parcel T I r . dtl 2072 -80 -000 TANK INFORMATION ELEVATION DATA A9800079 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. epti '�,� Bench rk Dosing 1.0 1Dl.� Aeration Bldg. Sewer ' Holding St /Ht Inlet 5"'7 �3 -D TANK SETBACK INFORMATION St/ Ht outlet TANK TO P / L WELL BLDG. Air Intake R AD Dt Inlet e is ' ��3 f I I �Z' NA Dt Bottom Dosing NA Header/ Man. Aeration NA Dist. Pipe Holding G 7 Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand �� �wl�cc i1 s q Model Numbe GPM T TDH Lift Friction System TDH Ft m Forceain L a. H r Dist. To Well SOIL ABSORPTION SYSTEM L OY TRENCH Width • 2 5 7 I Length ,/ No. Of Trenches PIT No. Of Pits Inside Dia. Liquid D th EN I N ` DIMEN I N SETBACK SYSTEM TO P/ L BLDG WELL LAKE / STREAM L Manu r: INFORMATION Type O r OR UNIT CHAMBER Mode Num er: Syste DISTRIBUTION SYSTEM ea er anifoI Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Int ke r � Length -iaL Dia. Length - Dia. N Spaci 6 +4s T~1 !�N �� SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx D f xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench E dges i j'6soil No COMMENTS (Include code discrepancies, persons present, etc.) LOCATION: SOMERSET 1 3.30.20.779D3,SW,SW 1512A 23RD STREET 1. Z 3 5rwr z 7 1 4- L,.� J �- r,..'� °la C�z I >�.I c d A f. pis. Ckoa � � (��(�� Plan revision required? ❑Yes No Use other side for additional information. I �(Xol SBD -6710 (R.3/97) Date pector's Signature Cert No. Safety and Buildings Division ` isconsin SANITARY PERMIT APPLICATION 2 01 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Department of Commerce Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Permit Number The information you provide may be used by other government agency programs � Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. a s - k w State Plan I.D. Number L APPLICATION INFORMATION N - PLEASE PRINT ALL INF RMATION Prope Owner Name Property Location 19 t/4 1/4, S T , N, R f�(or� Property Owner's Mai ing Address Lot Number Block N y umber Cit , Sta ,� Phone Number Subdivision Name or CSM N m ber r� Zi Ut�- tvy) p Cod PIT- II. TYPE F B ILDING: (check one) ❑ C] State Owned It Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms -� row OF Z 111. BUILDING USE (If building type is public check all that apply) Parcel Tax Number(s) _ 13.3 0. O. Ll ^,? 1 E] 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. [S New 2 ❑ Replacement 3 ❑ Replacement of 4 ❑ Reconnection of 5 ❑ 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 N Seepage Bed 21 ❑ Mound 30 Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure l 1 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 Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /' ch) Elevat r 'on Feet Feet VII. TANK Capacity INFORMATION in gallons Total # of Manufacturer's Name Prefab. Site Fiber- plastic Exper. New Exist in Gallons Tanks Concrete Con- Steel glass App. structed Tanks Tanks e ti 1:1 El El 1:1 El Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, thl undersigned, assume responsibility for in allation of the onsite sewage system shown on the attached plans. Plu a Na e: t) Plum r' n r o ) MP /MPRSW No.: Business Phone Number: r Plumber' Ac dress (Stf�et, ty, State, Zip Code): / o jr 3 'e' IX. COUNTY/ DEPARTMENT USE ONLY E] Disapproved Sanitary Permit Fi (Includes Groundwater ate ssue Issui ent Signature (No Stamps) Approved E3 Owner Given Initial n ,,��tt Surcharge Fee) r q Adverse Determination R � io # f f a i6 e X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6396 (R.11/96) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber S� S i I I, �S C 4 a� Wisconsin Department of Commerce SOIL AND SITE EVALUATION bivision of Safety and Buildings Page —/—of Bureau of Integrated Services in accordance with s. ILHR 83:•09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 jhches in sib �yt County include, but not limited to: vertical and horizontal reference point (BM), df►eeiibM'a . Z� �_ i X percent slope, scale or dimensions, north arrow, and locat n end distance to nearest road • ° nn Parcel I.D. # yy T APPLICANT INFORMATION - Please print ahl'in '; a iewe b Da Personal information you provide maybe used for secondary purpose (F Macy LI'6� #1'��'l ). s'F I /yg � . Property Owner r . ProperkX Lotion dwA. ` 1/4 1/4,S T N,R E (or)g Property Owner's Mailing Address Lot # Block Subd. Name or CSM# City State Zip Code Phone Number ❑ ad City ❑ Vill ge (� Town Nearest Road ( ) Z7 '� New Construction Use: Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow 6 gpd Recommended design loading rate bed, gpd /ft , ,; trench, gpd /ft Absorption area required ,5�5 — ,q bed, ft ft Maximum design loading rate bed, gpd /ft gpd /ft Recommended infiltration surface elevation(s) 91�) 1? ft (as referred to site plan benchmark) Additional design /site considerations Parent material ) _Z Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system 2 S ❑ U ©S ❑ U [RS ❑ U [As ❑ U ❑ S ® U ❑ S 21U SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD /ft g Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench ` S Ground _ el �� ft. Depth to limiting ; factor in. Remarks: Boring # Ground el v Depth to limiting factor � in. Rem arks: CST Name (PI se Pri ) t Signature ' Telephone No. Address 1 Date CST Number %_, L / / 3 Now / `�� c so� , i i o gar 13 ys , D ,8jy eY INDU RTP < «:NT OF REPORT ON SOIL BORINGS AND SAFETY &BUILDINGS (NQUSTRY; DIVISION LABOR A ND PERCOLATION TESTS 1 115 ) P.O. BOX HUMAN RELATIONS 1 / MADISON, WI 53707 3707 (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: OWNSHIP/ OT NO.: LK. NO.: SUBDIVISION NAME: � 1 /4 5W 1/4 13 /T 3 0 H /RZ OE (o SD H ��sET 3 c s•`? COUNTY: MAiLIN ADDRESS: ST acl k 13 R u c E 3A uE P 1 .76 - z 6 �e4 1 i iF' 4ilc Ao ��4,�v� /c , 1 4�N . Ss j z USE DATES OBSERVATIONS MADE Residence NO.B MS: 1COMMERCIAL DESCRIPTION: PROFI DESCRIPTIONS: PERCOLATION TES 3 6� y . f� New ❑Replace I /��1,Qi/ 3 q �O /�fi / —/ yf 0 ' RATING: S= Site suitable for system U= Site unsuitable for system ONVENTI NAL: MOUND: IN- GROUND- PRESSURE: SYSTEM -IN -FILL OLDING TANK: RECOMMENDED SYSTEM: S� E © s ou s ou E] s ou a s ou o s u T,6�ti� s tio?i-- If Percolation Tests are NOT required DESIGN RATE: 4 If any portion of the tested area is in the /��, under s. ILHR 83.09(5)(b), indicate: GLf s Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL P H T R UNDWATER- INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED E HE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- l f, b ' 9Y , l 9 / > g, 4 ( /'0 s 4,,, s ) / 0 , s o Ty s, S. 0 B. y i% f , 73 ' � ' ' /'0 s �'V" y- S d i S ' L4 • 8J ' ' S Y. 4 0 , J 1 ' �/}NOEQ 1 �N. s/ y. S %�� ZfV sgND w s 0'1' S J /Oz 4' i.40 �N /3..1 -S 5 / /� 2.0' BN-1 Y. sil , s ' cI a� sr B- 0 >� 1 '/.5 sA v a ?t -v - Fu�I S. " 4TRi 5 a 3� Q t /•D�D.�Q.� -Si �S' �SJ' S: /� �,p'�3Al B- S/I ¢S' 1& �Z > �� Q 7 -fA. �3,f of S w r� * W s .i e -s' �.o� /0 3• � y , /'0 'De- .Sa'I Z s� BN• S�l� /.S '3v. F�; Q A,,,P s Ba. B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL -MIN. PER100 PE RIOD PER INCH P_ P_ P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot / plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION. L.D to Tp F.F_,; ek 70 , �l i p�G� TXF.t; Gl t, Ss, 70 / SiF Pk_0T PLC � R S %DC ' This test site APP;ROVEb for a conventional septic system,. S " -y ./ 10 a 0 i i N S -f Pt l l P R 'f40 �i t zv t H 13 €p 74 S,�- Z-va 6, .Ufi�°��v �� s C w/ 'b P-0 p Q 0 X D I's7 TO 04 4 X /--Ii 2,e SiDt��/ �/ /f I-Q.S0 P � i 6 A ' Tl° f ATM a 'j 7' ,- -4 STJP T,t} S O j O�F�,e ANT T� X 7 vie° z' S ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Ownermuyer ilri D R I G H e L_& EAU Mailing Address o r? 2" 6e Av& o A 712N Property Address Sony -- , �ej cation required from Planning Department for new construction) City/State W Parcel Identification Number 60, L E GAL DESCR Property Location 5A) '/4, 5L� ' /a, Sec. 3 , "1 Z, 0 N -R o�_W, Town of 504.1 Subdivision , Lot # �J Certified Survey Map # Volume 3 , Page # 0 Warranty Deed # ¢6636 Volume _ , Page # Spe house O yes 9 no lot lines identifiable kyes O no SYS = 'EM 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 affixt 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 o�Amer and by a master plumber, journeyman plumber, restricted plumber or a 1 isensed pumper verifying that (1) the on -site wastewater di ;posal 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 d!ys the three year expiration date. SIGNATURE OF APPLICANT' 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 described above, by virtue of a warranty deed recorded in Register of Deeds Office. GNATURE OF 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 a copy of the certified survey map if reference is made in the warranty deed .­ Will IIL - � " •� Q' T � � N 00 °- 52' � 7" E I REG. AS N 00 ° - 55'E) 668.50' SW I/4 s z w 0 � .B 222.63' 222.63' 222.94' O y m raa • �� 4 �G O 70- y r U r to >• fi NOD n"0 � M n >R O co c < 0 70 A o I m z a ...Q O - W N 1 �= In Im 1. ri T O • I -� fq i i / " / 1. rn n -X a w r w o A D m o In C L 1 C • .l° . C p .Gy Z Q p w ♦, r�AIIIyI�y � ry rn u 4~ , ° rn •� •�a N � : ff O ♦ G to -- b :�.4 • :9 L eo - N •�o� .y u y ai u N a w a �y .,p la 60 0 49 an I� 0 d ... -- -- - - --- - --- •- . µu � L NOIAm ti° �6hY S01 ° 02' - 55 °W e . i (t� to , 4 . 70.0d _ 90.00' y 7il )„ •J J. i ��j, O ♦ 1 c . a 31 .60 --- 7 4 Ta - ti o \♦ 9. OC' 1 90.00' I 222.50' as Y a e s cm -0 z JJ s .♦ �Y1��� JJ �• ti w Se o i�—t I 1, a, \ t • � i V 4 ,� rn Gy N =. . • so � N $ s v •� � 1 n • a M R T �) w w 41 ti f w ' - a • A cn » ; - N 01 -OT St 446.00' - • V1 O < i rn zo UL w '� • • ri 0 Q I O .rte w'r ; c T i • O y 'nl r. - • Q V i t s 2 A � O �� � a • o .. 44t - 00' -- --�_ _ � y _ _ 22110_ � _ V R • vI � 222.!0' •a �� t CIO- I3' -oo'T tta.9d • ROAD • wow -ar*ca '• �a.+w & - - - - - - - - - - - - - - - - Waft n "Ci - - - - v \v w ` ST. CROIX COUNTY WISCONSIN ZONING OFFICE A r r r p r r -- ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 " (715) 386 -4680 July 10, 1998 Hartman- Homes Attn: Becky Hartman Somerset, WI 54025 RE: Septic Inspection for Bruce Bauer located at 1512A 23rd Street, Lot 3, Town of Somerset, St. Croix County, Wisconsin Dear Becky: A septic inspection of the above referenced property was conducted on June 10, 1998. This property is located in the SWA of the SW' /a of Section 13, T30 -R20W, Lot 3, Town of Somerset, 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. If you have any questions regarding this, please contact our office at (715) 386 -4680. Sin ely, Rod Eslinger Assistant Zoning Administrator Am