HomeMy WebLinkAbout040-1213-20-000 (2)� TV
AS BUILT SANITARY SYSTEM REPORT
OWNER 5 TA v le TOWN SH I P
S E C T 10 N _T N - R-L,(;- _W ID
ADDRESS -ST. CROIX COUNTY, WISCONSIN
SUBDIVISION LOT LOT SIZE cj-'f `-e 5'
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
INDICATE NORTH ARROW
BENCBMARK: Elevation and description:
Alternate benchmark
1
4 1�1e_ 7`
SEPTIC TANK:Manufacturer: r4Liquid Cap.-z-4
Rings used: / Manhole cover elev: 'Final grade elev:
Tank inlet elev.: Tank outlet elev.:
No. of feet from nearest road :Front , Side., Rear Ft.
From nearest prop. line:Front f Side _, Rear Ft. ;2
No. of feet from. Well. Building`: //
(Include this information in the above plot plan)
(2 reference dimensions to septic tank)
SEE REVERSE SIDE
At
PUMA CHAMBER
Manufacturer: Liquid Capacity:
Pump Model: Pump/Siphon Manufact.: Pump Size
Elevation of inlet: Bottom of tank elevation
Pump on elev.: Pump off elev.: Gallons/cycle:
Alarm: Man.: Switch Type: Locationy_
Distance from nearest prop. line: Front_., Side_, Rear -Ft.
Distance from: well Building
BOIL ABSORPTION SYSTEM
Bed: Trench: Seepage Pit:
Width: Length Number of Lines:�2- Area Built_7 5-a
Exist. Grade Elev, Proposed Final Grade Elev.
Fill depth to top of pipe: -- - 30 e,- _
No. feet from nearest prop. 1 ine : Fronts,, Side, Rear.Ft . ,Z .
No. feet from well: No. feet from building_
HOLDING TANK
Manufacturer:
Capacity:
No. of rings used: Elevation of bottom tank
Elevation of inlet:
No. feet from nearest prop. 1 i ne : Front, Side., Rear_Ft .
No. feet from: well , building , nearest road
Alarm Manufacturer:
INSPECTOR:
. DATE: PLUMBER ON JOB:
LICENSE NUMBER: �
6/9D:cj
LQQ& jAqp �t f I n tr}
.�� ILA
La4or and Human Relations INSPECTION REPORT
Safety and Bvildings Division
(ATTACH TO P E R M IT
GENERAL INFORMATION
TANK INFORMATION
TANK SETBACK INFORMATION
PUMP 1 SIPHON INFORMATION
SOIL ABSORPTION SYSTEM
ELEVATION DATA
BED/TRENCH
Width Lena
No. Of Trenches
PIT
- f Pits+Imn,ide
-of
Dia. Liquid Depth
DIMENSIONSDIMENSIONS
N
SYSTEM T
P 1 L
BLD
WELL
LADE � STREAM,
LEACHINGManufacturer-
INFORMATION
�
( 0
7�
HAABERod
OR- UNIT
umber:
`
System: �
DISTRIBUTION SYSTEM
Header 1
Distr�bt�tion Pipe s}
r
x Hole Size x Hole Spacing
Dent To Air Intake
Length Dia-
Length
Dia- Spacing
le
SOIL COVER
x Pressure Systerns Only xx Mound OrAt-Grade Systems Only
Depth Over
rt
Depth Over Xx Depth Of
Edges 9 ,3:3 Topsoil
xx Seeded I Sodded
❑ Yes [J No
xx Mulched
Yes [INo
Trench Center
c)C;l
ITrench
COMMENTS:
(Include code discrepancies, persons present, etc.)
TT �1
LOCATION: TROY •1.1a LOT BRICK CIRCLE.
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Plan revision required?
/00017
❑ Yes 0410
se other side for add itionaI i nform ation-
sro-F;710 (R OS191)
Date inspector's Signat re
ert- No-
MEN
dw
ALA
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Y4CS rZ#-"-Yfv,4jel jrOL-9i6 1-Y 1"69'0 17
DOCUMENT NO. STATE BAR OF WISCONSIN VORM 1— 19ft!! 1 THiG SPACK WCOERVED F'<J" qtj[r_0@%0jN9 DATA
WARRANTY DEED
q 99043
lo o 1(o3
This Deed, inade between E.ZEKIEL -LUTHERANCHURal .
.... .. OF RIVER FALLS __..1_-- --------- ....... MA JIN 3
----- --- ------- ---------------------------
--------------------- ---------------- ------------- ------ ------
--- ------------- -_------------ Grantor, and
§And CYNTHIA Je 5AATU
husband and wife, __gs marital survivorshin vrover
--------------------------- ----------- ------------
----------------- --------- ---------------
--------------------- ------ ................ -------------------------------- , Grantee,
Witriesseth, That the said Grantor, for a valuable consideration ......
--------------------------------------------------------------
conveys to Grantee the following described real estate in Cr)c)]'x 1; RETURN To
County, State of Wisconsin:
Tax Parcel No. -
Lot 6, Red Brick Addition, Town of Troy,
St, Croix County, W*
isconsin,,
14
This ------- iS nOt
holnestead property,
(is) is not)
Together with all and singular the hereditaments and appurtenances thereunto belonging-,
And --------- Ezekiel Lutheran Church of River Falls
----------_-------- __ -----------------F.-
------------------ ---
Warrants that the title is good, 'Indefeasible in fee simple and free and clear of encumbrances except
................. --------
rRMICipal and zoning ordinances
9 easements for pubi3c ut], i es, and
building restrictionS of record
and will warrant and defend the same.
Ihited this ......... ------ -------- --------- day of ........ .. ......... 1-1U11-3-�-
----------------------------------
OF
L6[N RIVER FALLS
...... -------- -------------- (SEAL)
---------------------- --------------- (SEAL)
------ ------------- ------------------- _By-* .... Randall-T-. Cudd_,t__R�rg_:s,j4.ep_t__._
------------------------ (SEAL) ....
-0-44ve..... ................ (SEAL)
--------------------- Luane Davis, Secretary..
- ------- --- ....... ...... ....... .......
AUTHENTICATION ACKNOWLEDGMENT
---------- ......
STATE OF WISCONSIN
i ......,..
° 0 � i
} . Y #
56
�#
'1c,42
w
12.30
1691,579 SO. FT.
t r . ACRES
Ar0
1159073 SQ F T. 5•
.64 ACRES S7*702 SO. FT. 9
TEMPORARY y — D• O 2.01 ACRES
-SEE DETAIL ELOW
TO BE REMOVED PO � .
D EXTENSION.
s
i
0)
262.91 #
po
'+ S89020,02"w 530.914 ccy
y
sowcv
r y
i+ oft
1�
., A
7pg,
.
F
133 813 S. FT. •� c
3.07 ACRES
QD
87,14 9 S 0. F T. o
��12
2. ACRES ��
'<ro —2 2 5.00 2N• M 4
'0 0
L � - ,
JOINT DRIVEWAY 4 —225-00'
0 (n
/�y��
f
1�iif�
a.
x 7
10
ch
- I--'�
c
SO. FT. �
. ACRES_
1-2
4 0 8 Tp I70 S Q. FT. W
.00 ACRES
}87*475 SQ. FT.
.01 ACRES ui
• 0
CsLIbnsin Deparb-rent of Industry, SOIL AND SITE EVALUATION •
Labor and Human RelationsREPORT Page of
�. ion of safety & Belding in accord with lLHR 83.05, Wis. Adm. Code
UNTY
s •
Attach complete site plan on paper not less than 1 11 inches in size.
Plan u# include, but
not limited to vertical and horizontal reference point 13)r direction and % of slope, sole or PARCEL I.D.
dimensioned, north arrow, and location and clista�n a to nearest road.
APPLICANT INFORMATIDN—PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
Fy-/
B�RPERTY OWNER: PROPERTY LOCATION
AJAJJ,.5 L ia- GOVT. LOT 114 PIWI14,S q T Zci ,N,R l Ca
PR ERTY OSM11NG ADDe.&A) RLOT � 8OIC.CGN� ffR iG y { �
1
�joc-A14 W�
CITY, STATE ZIP GODS PHONE NUMBER ❑C[TY [jVILU1GE MOWN NEAREST QAD
5 l ( S) 8 `r 1`i G�' Ci ro%G
New Construction Use 04 l esidengal 7umber of bedrooms dd�tr- • on to e)asgnbuilding
J Replacement Public or commercial describe
Code derived daiy how gpd Pecammended design loading rate bed trench
Absorption area required bed, ft2 trench 112 Ma)drnum i
de jr1 loading rate ted. gpdAft2#renC, Pd
Recommended iniiltraWn surface elevation(s) � Zfk as referred to site plan benchmark
Addifiona.l design I site considerations
Parent rnaferia! Flood plain elevation, if applicable h
Citable for system CONMMOR& MOUND IN -GROUND PRESSURE SIT RAGE SYSTEM! Flf.�. HOLDINGTANK
U= Unsuitable for system ❑ U ❑xsU U E I i S❑ �S 2ru Ds BU
SOIL DESCRIPTION REPORT
Boring
Ground
elev
Depth to
limiting
!N �
Baring
Ground
el��ft
Depth to
}imidng
iacta
MR
I I ----
man
mm
ram'
PROPERT YOWNER
SOIL DESCRIPTION REPORT
Page 6k.- of
PARCEL I.D. #
Boning #
Horizon
Depth
in.
Dominant Color
Munsell
Moles
Chu. Sz. Cont Color Texture
Structure
Gr. Sz. Sh.
CMS�Stence MnJ3y
Roots G P D/tt2
Bed Tmnrh
3
0- 7
Za YX
A
V, (Vol%
7;- F
AV YX
f
w
P
C
71/
•
•
Depth to
•
rhibng
■
b0of•
■
■
•
Remarks:
Boring #
JT.
/20
A4016)
Ground
•
-11 r-od
IAP
&Poo
Depth to
limitng
J. W r7
•
Remarks:
Boling #
Oq de
Ak�
•
51
13
4
?00-
Ground
_R
•
3V'0 16P
YA�
\r
Depth to
limifin•
Remarks:
.8oning #
LL'Km
l
Ground
elev.
tL
Depth to
11mitng
factor
Remarks:
t
), ) L I'j 9
: C
=7 3
0
--N! jai
N
S T C - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER Ta 0P4
ADDRESS FIRE NUMBE
IM
CITY/STATE 46Ad34-'rX . I k.111 -zi 49
PROP'ERTY LOCATION:5C- 1/4, N'AJ 1/4, SECTION T.2J, 14-R
TOWN OF Tf-c Y' St. Croix'County,
SUBDIVISION LOT NUMBER Z.,
Improper use and maintenance of your septic system could
result in its premature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three
years or sooner, if needed by a licensed septic tank pumper. What
you put into the system can affect the function of the septic tank
as a treatment stage in the waste disposal system.
St. Croix County residents may be eligible to receive a grant
for a maximum of 60% of the cost of replacement of a failing
system, which was in operation prior to July 1. 1978. St. Croix
County accepted this program in August of 1980, with the
requirement that owners of all new systems agree to keep their
system properly maintained,,
The property owner agrees to submit to St. Croix Zoning a
certification 'form, signed by the owner and by a water plumber,
journeyman plumber, restricted plumber or a licensed pumper
verifying that (I). the on -site wastewater disposal system is in
proper operating condition and (2) after inspection and pumping (if
necessary), the septic tank is less than 1/3 full of sludge and
SCUM.,
I/We, tl)e undersigned have read the above requirements and
agree to maintain the private sewage disposal system in accordance
with the standards set forth, herein, as set by the Wisconsin DNR.
Certification stating that your septic has been maintained must be
completed and returned to the St. Croix Co, Zoning officer within
30 days of the three year expiratio ".date.
S I G N ED
DATE:
St. Croix co. Zoning Office
911 4th St.
Hudson, WI 54016
S T C - 100
This application form is to be completed in full and signed by
the owner(s) of the property being developed, Any inadequacies
will only result in dnlayg of the pormit issuance. , Should this
development be results for resale by owner/cohtractor,(spec
house), then 'asecond form should be retained and completed when
the property,is sold and submitted to this office with the
appropriate deed recording.
---------- ------- --------
Owner of property C't�-to
Location of property 1/4 Nk) .1/4, Section ►T,'� IN-R W
Township
Mailing address J/-
LI—If
Address of site
Subdivision name--,.. 91eLk Lot no.
Other homes on property?
yes <-- _No
Previous owner of property 6�e42 Lf" d -fill
Total size of parcel Z) c� c i,-ef
Date parcelwascreated
Are all corners and lot lines identifiable? es No
Is this property 1peing developed for (spec house}? Yes �.No
Volume and Page Number as recorded with the Register
of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A WARRANTY DEED which includes a DOCUMENT NUMBER,, VOLUME AND PAGE
NUMBER & THE SEAL OF THE REGISTER OF DEEDS. In addition, a
certified survey, if available, would be helpful so as to avoid
delays of the reviewing process. If the deed description
.references to a Certified Survey map.. the Certified Survey Map
shall also be required,
PROPERTY OWNER CKRTIFICATION
I(we) certify that all statements on this form are true to the
best of my (our) knowledge that I (we) am (are) the owner(s) of
the property described in this information form, by virtue of a
warranty deed recorded in the office of the County Register of
Deeds as Document No. . and that I (we) presently
own the proposed site for the sewage disposal system or I (we)
obtained an easement, to run the above described property, for
the construction - of said system, and the same has been duly
recorded in the office of County Register of deeds as Document
No.
signature of a,licant
Date of Signature
Co -applicant
Date of Signature
Wis,t�nsin D,*�artr-ent of Industry, SOIL AND SITE EVALUATION REPORT Page Of
L,ab6r and Human Relations
Divisi,:'i. of Safety & Buildings
in accord with I LHR 83.05, Wis. Adm. Code
COUNTY
Attach complete site plan on paper not less than 8 1/2 x I I inches 'In size. Plan must include, but
PARCELI.D.
not limited to vertical and horizontal reference point (13M), direction and % of slope, scale or AR ELI ZD
dimensioned north arrow, and location and distance to nearest road. 747
0 WE a
APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION rREV,EW.. 'rGATE
PROPERTY LOCATION
PERTY OWNER: �ri� N,R
vt" GOV"T- LOT 114 P�/�114,5 T *or
L
PROPERTY LOT YI
EPRQPERTY OWN :S MAIL ADDRESS SS LOT # BLOCK#. S Ut). N R,qS #
]CITY
C ]VILLAGE �J'VI NEAREST �OAD
ITY.S[]ITYITY, STATE Z!P CODEPHONE NUMBER EEI-e-
-111y
I -It L- 2 7� LA i7r?
N
e Re
w pla
C
R c 0
�e "
M
e
New Constucfion Use Residenbal, Number of bedrooms AddNon to existing building
eplacement Public or oommercial desailbe
boder 11 bed t g pd/ft2 -
ode derived daj� flow � �O gpd Recommended design loading rate trench, gpd/ft2
C e �Ile
_Sorp 1 0 r '!5 bed, ft2 trench, ft2 Maximum design loading rate bed, gpdM2 trench, gpdjft2
RecommendedAbsorption area required 44, 0*
7, 7 ft has referred to site plan benchmark)
infiltration surface elevation(s)
Additional
design Addifional design I site consid-erabons
Flood plain elevation if applicable ft
Parent material AL
t m r
-GRADE HOLDING TANK
S i
S I jor CMENTIONAL MOUND IN -GROUND PRESSURE AT SYSTEM IN FILLS Suitable for system S [I U V7 S Cl U 29 S 0 U El S ffU [IS au
UU U suita le tjU Unsuitable forsystern NS E1U Iola
SOIL DESCRIPTION REPORT
Boring #
Ground
eln%r
%0 -T.
Depth to
limiting
fa
Boring #
Ground
elev.
ft.
Depth to
limiting
laa
R e m arks:
212V
r
tow
—7
vu'
ILI
Remarks:
,ST Name: --Please Print 4,
kddress-
/0 3-5 IV
Signature, t
4,Vj5V,, tv, i
mum=
-73
C) Phone:
14,3
CST Nupnbqr:
00 4 y If �f
PROPERTY OWNER -aF 76
:fa6d 116 /1
SOIL DESCRIPTION REPORT
PARCEL I.D. 8
P,
age
Depth
Boring # Horizon in.
A:PL- 7 10
Dominant Color
MU nsell
Mottles Texture
Qu. Sz. Pont Color
Structwe
Gr. Sz. Sh.
#
Consistence: GPD/ft2
Baxxtry Roots
Beds
6 `ilv
YK
r.41
ki
Id
2, to
Ground C
.........
OM"
/1
/0 Y,
Depth to
limiti•
ng
facto;
------
■
■
•
■
Remarks
•
1
Boring #
•
X1
YJ
Ground
1A0 Y)
oil
Depth to
rhibrig
•
•
■
Remarks:
Boring #
o /ir
13
lo Ae 2,1,
1
Z
4 1 -1-r Zo
y)e
Ground 341' A
0 Y11
51 P61
Meg-
dw
AW fe
I.
moo
Depth to
lirrdfing
f�c
Rpmnrke-
.Boring #
13
Ground
elev.
tt
Depth to
UmMng
Facbr
> Lao
Y 1`�hJ I -y-- 8� ._
X7-
„� �83 � �
61-- , L c,,, , - �,�v
'6
w
cu
f
".0
56
w. r
ie d 2
4
'•a{.fir
r
T �
Y
0
5.
0
115v073 SO. FT.
2.64 ACRES 57s 7'SQ. FT. v
CUD Amu X" CUL—DE-SAC2. 1 ACRES
(SEE DETAIL BELOW
TO BE REMOVED UPON
C 0 EXTENSION. r
i
� 1
} 1
S 89°2 ' 2" W 530.91'
in
�.gr
' 799
0 r y
• 41
df
i
133 813 S . F T. . • r
. T ACRES
cog
3 •
ao
in
2.9 ACRES �U) 7
_ '/-�!
- r .� i 4/ 4
ey��#./
ro wo
$°"2" E
'rH&
t -- [,
LlC— — to
S8° 2`2" W
JOINT DRIVEWAY u
L
y
•
A m
D
CL
i
I
w
40
CD
1 0.
;-98#565 S. FT. GD 12 cy 0
2.26 ACRES�`' 87a 17" SO. FT. �
2.00 ACRES
87s.475 SO. FT. �
i 2. C! ACRES
1
y
Z.
" IRON PIPE FOUND y IS
0 1 " X 24" IRON PIPE WEIGHING
IGHING * ...... *``100 0
1.68 LSS. / LIN. FT. SET. 1y SUFZ"] -7
126s.cd i PREVIOUSLY RECORDED 116110�
INFQRNIATION
SCALE IN FEET II = I00'
0' 25` 50` 100' 200' 300
Y�
� PLEMD "*'
I I I I . . ,
JAV,
5 19 G "t G
440 /- 9-/,f iZ) /4011
AIR 4 .s- jf.�X 10 /'9 l f -$}
'41. /.?1
/d&
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jr41L-
CERT-TF-TED SURVEY MA171
Located in the SE 1 /4 of the -N oaf -Section 8, T Z 8N , R 19W , Town of Troy,
St.Croix County, Wisconsin*
Also known as Lots b and 5 of the Plat of Red Brick Addition.
NI/4 CORNER
NOTE: This map is a sale or exchange of SECTION B
� - T28N, R19W
land between tab adjoining propertyo Q , 4
owners . Town or County approvals ] . a �, r _-,
axe not required per County 7 S ` ,5.Sj 01 a
Ordinance 18.05(A)(3) , o
�?8 . �� �. to
Surveyed and mapped under the
direction of :
Gerald & Erlene Barriault r
464 T ownsvalley Road LOT 5
Hudson, Wisconsin to
fri 93, 103 SOU ARE FEET 3, 33'
and (2.137 AC,)
Dennis & Cindy Saathoff
444 Red Brick Circlep
Hudson, Wisconsin.
r m
Bearings referenced to the Forth- -V 9 0 .!
South quarter section line, 0 m I
previously recorded as 0% "'.'L' 0 Lq
1
so 10`00 t21 "E . A", / z
' f PREVIOUS W �I
Qi P LOT LI N Ecc U4
a1
d01
83* ��,� ���.9�' csa9azo'oz"WI..•," ..-ca68.00..'..• • -. 1 pC�
270,94 q
N 2' 10 -36
i
C r" `
128,455 SQUARE FEET WI
� J
�r �f 2.949 ACA
JI
NOTE HERE IS A ICE wIDE 4
irk RAINAGE AND UTILITY
EASE M�ENT ALONG THE
ROAD R.-O.-W. L I N ES .
7 89" 20' kit"W Z
W 3I
p
--� PUBLIC ROAD
CURVE IN'FDRMATI4N
RADIUS= 420.00
LENGTH= 373.85` � ON �i�
CHORD = 361, 63 �
N 556 09 58 it W
LEGEND JOHNSON
0 1" IRON PIPE FOUND ; S--1Q�9 r ` SIf4 CUR.
" FIUD O L SEC. 8
DRAFTED BY: Jk/6'
VOLUME 10 PAGE 2795
4J4-2321