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HomeMy WebLinkAbout004-1005-20-000 (2) Parcel #: 004-1005-20-000 04/21/2008 08:32 AM PAGE 1 OF 1 Alt. Parcel#: 03.28.15.34 004-TOWN OF CADY Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): 0=Current Owner, C=Current Co-Owner JOEL M IHRKE O- IHRKE, JOEL M 3081 60TH AVE WILSON WI 54027 Districts: SC = School SP = Special Property Address e : *=Primary Type Dist# Description *592 25 SC 5586 SPRING VALLEY ( 66 b(jZ SP 0100 CHIP VALLEY VOTECH (j� a j7r 12i/kji_ea G7VL4A {'v---d- Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 3 T28N R15W 40A NW NE Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 03-28N-15W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 1102/207 WD 07/23/1997 1100/424 WD 07/23/1997 856/607 2008 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 03/31/2008 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 28,000 52,900 80,900 NO PRODUCTIVEFORSTLANDS G6 38.000 114,000 0 114,000 NO Kil -g2A, V`-'6/"—" Totals for 2008: General Property 40.000 142,000 52,900 194,900 Woodland 0.000 0 0 Totals for 2007: General Property 40.000 142,000 46,000 188,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch#: PRGRM Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 )12, ,nsin Department of Commerce 1 1 �5� County: ;ty and Building Division PRIVATE SEWAGE SYSTEM St. Croix INSPECTION REPORT Sanitary Permit No: 395184 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Versonalinformation you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Ihrke,Joel Cady Township 004-1005-10-000 CST BM Elev: Insp.BM Elev: BM Description: ►bp.of 1�o.o �.4.-1c,� . ,. — 10# ( 43081 moo ' �v& . TANK INFORMATION ELEVATION DATA " 3.Z'¢• f C. TYPE MANUFACTURER CAPACITY STATION BS HI _' FS ELEV. 6 Septic — rNtw P Benchmark �� �S 0 lie,, � � �c7t��6�� z.s.—LA.. L,a,D.J Dosing (____ CaC41,-%-it4 J Alt.BM Aeration Bldg.Sewer � C v'w,k�' "I fkl Holding ) St/Ht Inlet 1 / 12 .411 S7-3y `fir St/Ht Outlet TANK SETBACK INFORMATION • TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic I , Dt Bottom 1 }/� ao - a )( .3'( in.V( Dosing j Header/Man. IA �-) try -� }a togs- S8•gOi Aeration -- Dist.Pipe P.18 a 37: y)0. s St-EC, Holding Bot.System 11.tos' 1 a Final Grade e( PUMP/SIPHON INFORMATION .i �<L1 14,Q (Z, + Coves-_ oafye.- f Manufacturer /,,' , aemand St Cover Q / ) .� CI ,j' GPM �.21 l2 Mo Model NumberIIMMIEr lMi ,b`.�J�,IF - TDH Lift Friction Loss System '-:. TDH Ft .. gi0 - (.2V G •5b 5 v 1 •14 Forcema. \ en th Dia. Dist.to Well ~0.•t ' 2 h SS9�IL ABSORP 11F SYSTEM I LZ.r•1' - • )2 �EDJTf2tfICH Width Length f r No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth J D ENSIGNS /cr, r 7J 6\(� SETBACK SYSTEM TO P/L )BLDG WELL LAKE/STREAM LEACHING Manu urer: INFORMATION Type Of System:u. CHAMBER OR „ > 1 ' /6' \ UNIT Model Numbe. I11 DISTRIBUTION SYSTEM ,?..u„ .r S1 . Header/Manifold , Distribution j !t x Hole Size x7-tet€ ,,Spacing Vent to Air Intake .0 Plpe(s) (�� 41/ Length 3 Dia Length 3T•1] Dia f /2. Spacing 3' 2 LI 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 Topsoil I.J Yes U No A Yes it No 8cOMM TS: (Include code di cre encie�s,persons pr ent,etc.) Inspection#1: 0$/ 23/ 01 Inspection#2: W) tkaa. -cs-'64-P k.c c� a..t ivA.Wec L1 Ala.., -r-U) ) Location: 3081 60th Avenue Woodville,��il WI 5402"8(NE 1/4 NE 1/4 3 T28N R15W) NA Lot Parcel No: 03.28.15.33 1.)Alt BM Description= w,s+"-^66- ��CNN4r•`` __ 3i I 2.)Bldg sewer length= •,. (5~�I (-4 v.. i+A�", -amount of cover= 1. I �` Plan revision Required? (...›/..).4mA( q Use other side for additional information. No 0�( �� I tj3 SBD-6710(R.3/97) TTI_ to • I sepctor's Stnature_„Q... Cert.No. A ' 30 co.z AOe____ Safety and Buildings Division County • • 201 W.Washington Ave.,P.O.Box 7162 St. Croix Vsconsin Madison,WI 53707—7162 Site Address J Department of Commerce Summit Rd 3o t (oO�h @, Sanitary Permit Application =;:'" --;,-'-- Sanitary Permit Number In accordwith Comm 83.21,Wis.Adm.Code,personal information you.ptovid e' eck if Revision 39 may be used for secondary purposes Privacy Law,s15.04(1)�ryii: `/ ,��� U r I. Application Information—Please Print All Information 7' 1`l� State P I.D.Number'-rM�Ev �j Z n. . / '' iJ 66110 Property Owner's Name C;'2 I Parcel-Nn ber ` Joel Ihrke u k Jiff 2 /' ?11p1004=1b 5-10 / 3. it. 1 S .33 oT CROIX �y Property Owner's Mailing Address d COUN'Y Propeiq cation ()f� +was.-!�-0C�0 592 250th y, zorutNGOFFICE :. ,. / I\ 1/4, NE'/4; S3, T28N, R15W City,State Zip Code Phone '. C l�`-'.\ ,' Number Block Number Woodville, WI 54028 715-698- I9 1 1 Subdivision Name CSM Number Pvt o �5 H. Type of Building(check all that apply) ❑City X 1 or 2 Family Dwelling-"Number of Bedrooms 3 vwc {tien44.. ��,]• ❑Village ❑ Public/Commercial--Describe Use '-U�'I'I^ Ll& Xtownship Cady-- CI State Owned Nearest Road /_,,,i . It Rd (� , I III. Type of Permit: (Check only one box on line A(numbering scheme for internal use). Complete line B if applicable) A. 1 X New 2 CI Replacement System 3 Ill Replacement of 6 ❑ Addition to For County use System Tank Only Existing System B. CICheck if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that applyxnumbering scheme is for internal use) ni 44 u loon-Pressurized In-Ground 21 X.Mound 47 u Sand Filter 50 u Constructed Wetland I 22❑ Pressurized In-Ground 41❑ Holding Tank 48❑ Single Pass 51❑Drip Line / 45❑ At-Grade 46❑Aerobic Treatment Unit 49❑Recirculating 30❑Other CbeTO C.3 V.Dispersal/Treatment Area Information: Q.Aolve t, fktoQ -- --LIP-0`1 Design Flow(gpd) Dispersal Area Dispersal Area Soil Application Percolation'T System Elevation Final Grade Required Proposed Rate(Gals./Days/Sq.Ft.) Rate Elevation (Min.11nch) 450 450 ft2 450 ft2 .5 in situ N/A 88.25 90.04 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks l __ve-Ste1C-- Septic 1000 1000 1 Midwest ram X Pump Chamber 650 650 1 X VII.Responsibility Statement- I,the undersigned,assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name(Print) Plum ';7ttu,re MP/MPRS Number Business Phone Number Lyle Myers /0 2` e/ ? (715) 643-2520 Plumber's Address(Street,City,State,Zip C `y� ' E1556 Stade Rd 64 Boyceville, WI 54725 . County/Department Use Only 71/ Approved El Disapproved Sanitary Permit Fee(includes Groundwater Date Issued Issuing Agent Signature(No Stamps) Surcharge Fee r 1 L❑ Owner Given Initial Adverse z�� (( t. 1 / Determination J IX.ACanditio4 Approval/Reason for( Disapprovali I/ '1 t`�� `i 1 6214 rrtvim !'i` yvsiable., Par e ui el l`�'`441464avi44, �I�(` p4'� - (Av1 f4A- if 3vuwrl • n-ecor�,������7� 4 et,4,1, ri, 14, ))tryitd , A ch mplete pir €to the County only)for the system on paper not less than 81/2 i 11 inches in size Safety and Buildings r 401 PILOT CT STE C WAUKESHA WI 53188-2439 TDD#:(608)264-8777 Wsconsin www.commerce.state.wi.us/sb www.wisconsin.gov Department of Commerce Scott McCallum,Governor Brenda J.Blanchard,Secretary July 12,2001 CUST ID No.227618 ATTN:POWTS Inspector ZONING OFFICE THOMAS GUSTUM ST CROIX COUNTY SPIA N13450 937TH ST 1101 CARMICHAEL RD NEW AUBURN WI 54757 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/12/2003 Identificatio ► ..• s Transaction ID Ns 661423 SITE: Site ID No.632956 JOEL IHRKE Please refer to both identification numbers, SUMMIT RD above, in all correspondence with the agency. TOWN OF CADY, 54027 ST CROIX COUNTY NE1/4,NE1/4, S3,T28N,R15W FOR: DESCRIPTION: MOUND, 3 BEDROOM OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 802240 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. The following conditions shall be met during construction or installation and prior to occupancy or use: This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10691-P(N.01/01)and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10706-P(N.01/01). In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition,the owner must insure that the operation,maintenance and monitoring duties as described in section VIII of papnd component manual are complied with.A copy of this information must be given to the owner upon co tior�6f4Ie project. Maintenance information must be given to the owner of the tank explaining th eriod' i� $ isr is required.Access to the filter for cleaning must be provided per Comm 84 produc rova140"p1` A Sanitary Permit must be obtained from the county where this project is located in aetqr, ce wifh the requirements of Sec. 145.135 and 145.19,Wis. Stats. U,,, 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(2)(d),Wis. Stats. THOMAS GUSTUM Page 2 7/12/01 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. In granting this approval the Division of Safety&Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance.As per state stats 101.12(2),nothing in this review shall relieve the designer of the responsibility for designing a safe building,structure,or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below,or at the address on this letterhead. Sincerely, FEE REQUIRED$ 175.00 FEE RECEIVED$ 175.00 4 P BALANCE DUE $ 0.00 JULIA A LEWIS-OSBORNE POWTS REVIEWER 2,INTEGRATED SERVICES WiSMART code:7633 (262)548-8638, FAX: (262)548-8614 JLEWIS@COMMERCE.STATE.WI.US Mound System pg 1 of 7 Cover Page RECEIVED JUL - 9 ?O91 SAFETY& BLDGS.DIV. Project Name: Joel lhrke Mound Owner's Name Joel Ihrke Owners Address 592 250th Woodville, WI 54028 715-698-2984 Legal Description [NE 1/, j NE 1% Secl3 i T n2nN, R 15 lj W 1• Township Cady County Saint Croix • Subdivision Lot# Parcel ID# 004-1005-10 Table of Contents ®F pg. ® � 1 Cover page %mows Da �� 2 Mound Sizing Calculations GUSTUM $ 3 Pressure Distribution Layout and Dynamics • li 1201 f / 4 Dose Tank Calculations ►It / i1 5 Management and Contingency Plan ��4' 6 Plot Map 7 Pump Curve Specifications total#of pages: 7 Designer Name: Tom Gustum License#: D1201 Date: 7/3/2001 Ph. #: 715-658-1344 6;0 046, Signature: Mound System Design Methods Used per"Mound Component Manual For Private Onsite Wastewater Treatment Systems"(Version 2.0)SBD-10691-P(N.01/01) per"Pressure Distribution Component manual for Private Onsite Wastewater Treatment Systems'(Version 2.0)SBD-10706-P(N 01101) Spreadsheet provided by: 3bAdvisement N12486 220th St,Boyceville,WI 54725 Ph:715-643-6068 email:3ba©3badvisement.com s Mound System Page 2 of 7 Mound Sizing Calculations Project Name: Joel Ihrke Mound Site Conditions Design of Entire Fill Project Type: 1 or 2 Family Dwelling • Cell depth at upslope edge (D): 9.0 in. Slope: 5 % Cell depth at downslope edge (E): 12.6 in. #of Bedrooms: 3 Distribution cell depth (F): 9.5 in. Depth to limiting factor: 27 in. Cover thickness over edge (G): 6 in. Absorbtion rate of fill material: 1 gal/ft2/day Cover thickness over center(H): 12 in. Absorbtion rate of in-situ soil: 0.5 gal/ft2/day End slope width (K): 8.1 ft. Effluent quality Eff#1 11. Fill length (L): 91.2 ft. Max BOD effluent value: 220 mglt Upslope width (J): 5.4 ft. Max TSS effluent value: 150 mg/I Downslope width (Toe) (I): 8.3 ft. Fill Width (W): 19.7 ft. Design of the Distribution Cell Basal Area System Design Flow: 450.0 gal/day Basal area required: 900 ft2 Distribution cell width (A): 6.00 ft Basal area available: 1073 ft2 Distribution cell length (B).: 75.0 ft Area of Distribution Cell: 450.0 ft2 Observation Pipes Contour Elevation of Mound: 87.50 ft Location from end of cell (Z): 12.5 ft System Elevation of Mound: 88.25 ft Final Grade of Mound: 90.04 ft Mound Plan View / Observation Pipes Z —yl w �K o Distribufion Cell I B A k—K--,- /)-T 1 y Tilled Area/Fill Material r. I---_ L '--I Mound Cross Section Final Grade - Observation Pipe Synthetic Fabric I''' G Distribution Cell __. System Elevation II, IV s,d, I � ik ¢ Cover Material I Lateral D s E Invert Fill Material '" Tilled Area i\ Slope Forcemain System Contour Notes: Fill material to consist of ASTM C33 Sand Distribution cell aggregate to comply with Comm 84.30(6)(I) Synthetic Fabric covering on cell per Comm 84.30(6)(g) Distribution Cell to have minimum 6"aggregate below lateral and 2"above. Mound System Page 3 of 7 Pressure Distribution Calculations Project Name: Joel lhrke Mound Lateral Layout Lateral/Manifold Design Lateral elevation: 88.8 ft Lateral diameter: 11/2 V In. Rows of Laterals: 2 • Lateral spacing (S): 3 ft Manifold type: center 12 Lateral to cell edge: 1.5 ft Orifice diameter: 0.125 . In. Lateral discharge rate: 7.83 gpm #of Laterals: 4 System discharge rate: 31.31 gpm Distal Pressure: 5 ft Manifold diameter: 2 11 . In. Lateral Length: 37 ft Manifold length: 3 ft Orifice Spacing/Distribution Forcemain Friction Loss Orifice spacing (X): 24.00 Inches Forcemain length: 100 ft Orifices per lateral: _19 Forcemain diameter: 2 In. Avg. ft2/Orifice: 5.92 ft2 Friction loss in forcemain: 2.098 ft Lateral Side View a Manifold \Lateral \Lateral r x l' x 't x X x ir x Xx/x4' x X x X x X x X x / ' .:< Lateral Length Lateral Length Lateral Plan View i - Lateral Length - -4 T urn-up w/ball valve or cleanout plug T () a) I S (o) I o .i_ Orifices on bottom of lateral equally spaced PVC laterals and forcemain to comply with specifications per Comm 84.30(2)(el Forcemain connection via tee or crass to manifold at any point Clean Out Detail Observation Pipes Clean-out plug Final Grade or ball valve Watertight cap / or plug Lawn Sprinkler Box Slot Note:Closet Collar 6"Minimum may be used in Long Sweep 90 place of 3l8"bar or two 45's 3J$"Bar Lateral _ I Plot Map r 3 J J� r 2 \ , - ,.).',g :I e l U°� �°J � o J ::::‘,2) :::---rnm �l i N11 \e‘-tP ___ a�oy/. 'cY co 7 i m o CO a I M I o = m wi W )I .j..: U Eco o CO Q 7 I--ks U r ; <-- r..... 4 x.rn 1 co pto ._ Cr I o o I rn M> a �,o } oa to dd8 '-----.0 a;:r a) Q co 8 m m hilIF— N m S. N CO c L a re E1 S� m Q El CO' 2 -5_ / Y X o r. N. Z O 1— 8 w _ 0 J _IQ ot II II 7 5 co I coPg6of7 0 I 0 T m . - .- ., , . , P(oxp (\AA-1k_,, . e....c.`, -c-,c c4...4,ov‘..5 Engineering Details - SHEF40 Performance Data 40 30 SHEF40 Pump Characteristics Pump/Motor Unit Submersible 20 Manual Models SHEF40M1 SHEF40M2 Automatic Models SHEF40A1 SHEF40A2 (S�(v `D, Horsepower 4/10 10 cvk Full Load Amps 12 6.5 Motor Type Shaded Pole(4 Pole) R.P.M. 1550 0 1 D 20 30 3j3`4 " 50 60 70 Phase 10 GPM Voltage 115 230 Hertz 60 Total Head (feet) 10 14 17 21 25 28 30 35 Temperature 120°F Max.Fluid Temp. (m) 3.0 4.3 5.2 6.1 7.6 8.5 8.8 10.7 NEMA Design A GPM (US GPM) 70 60 50 40 30 20 10 0 Insulation Class A (liters/sec) 4.4 3.8 3.2 2.5 1.9 1.3 .63 0 Discharge Size 1 1/2"NPT Dimensional Data Solids Handling 3/4" Weight 28 lbs. 3-7/8"--. 6-5/8"(168.27) 1.All dimensions in inches. (Metric for Power Cord 18/3,SJTW,20'std. (9u.42) 5"(127) international use). (30'optional) (9842> et- 2. Component dimensions may Materials of Construction ,,sk: i '_ ,/� vary± 1/8 inch. Handle Stainless Steel 3_I8. Air ^Q l olscHnR�E 3. Not for construction purpose Lubricating Oil Dielectric Oil (98.42) 1-1/2"NPT unless certified. Motor Housing Cast Iron - FLOAT SWITCH 4. Dimensions and weights are Pump Casing Cast Iron approximate. Shaft Steel Mechanical Seal Faces:Carbon/Ceramic )', 5. We reserve the right to make Shaft Seal Seal Body:Anodized Steel revisions to our product and their Spring:Stainless Steel specifications without notice. Bellows:Buna-N ,. Impeller Engineered Thermoplastic ::5 Upper Bearing Bronze Sleeve Bearing (288 92) " ' _ 10-3/16" (258 76) Lower Bearing Single Row Ball Bearing Bottom Plate Polyester Coated Steel ) 1 3-5/8" Fasteners Stainless Steel 5 (92.07) 2 (50 8) Legs Engineered Thermoplastic _t_ ) • In 101998 Hydromati©Pumps, Ashland,Ohio. All Rights Reserved. rir HYDROMATIC" -Your Authorized Local Distributor— PENTAIR PUMP GROUP P —e____ 7 0 - 7 1840 Baney Road Ashland,Ohio 44805 Tel:419-289-3042 Fox:419-281-4087 Web Site:www.pentairpump.com v,�1r sru4 ESN ,,, SALES OFFICES IN ALL MAJOR CITIES AND COUNTRIES $ ..1� .7.7 _ Cerra}�'ed Refer to"Pumps"in the yellow pages of your phone directory for your local Distributor �� 1.1\ -1 Item#:W-02-6680 1 198 5M �O.0#kri t, Wisconsin )epartment of Industry, SOIL AND SITE EVALUATION REPORT Page / of 3 Labor andtiuman Relations ' , .C'Kis ort of Safety&Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than VIA( 11 ;inches P.in,size.' an must include, but C e() t V not limited to vertical and horizontal reference PPoyr?t?.($M),direction arid*" 3tope,scale or PARCEL I.D.# dimensioned, north arrow,and location and di atcc�'to neare 'road. 6c4 - /06 5-IO APPLICANT INFORMATION-PLEASE Pi ALL 'I ORMATION N REVIEWED BY DATE PROPERTY OWNER: MAI. 1 5 1t5 '7.s'ERTY LOCATION _ _ (9 ST CAW t, .LOT i{/C 1/4 Nt 1/4,S 3 T a 3 ,N,R I S E(oCW` ��� 1 �� # nowt SUBD.NAME OR CSM#�/; PROPERTY OWNER':S MAILING ADDRESS C 111114TY .� C f<i JCIIAli44R10E 1L,f� /�'� CITY,STATE ZIP CODE Nell iL a i� ■CITY DVILL GE Rf6WN NEAREST ROAD G.)06)e/v 'Gle L�, 64<0..y (7/s 'ar :l e c c , 5 L&VV.un,+ `R.:: , [1--(New Construction Use [Residential/Number of bedrooms 3 [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 1/5-0 gpd Recommended design loading rate , S` bed,gpd/ft2 . Go trench,gpd/ft2 Absorption area required 7C(D bed,ft2 -7cc. trench,ft2I Maximum design loading rate • bed,gpd/ft2 . trench,gpd/ft2 Recommended infiltration surface elevation(s) gv,9 k" 1oc.- 4 Rcc( RA (as referred to site plan benchmark) Additional design/site considerations L e-eeQ "'x 7 C--- 6 ck 'C Z // le, 4 Parent material S-// ea,/,-- 7// Flood plain elevation, if applicable .I.I/f ft S=Suitable for system CONVENTIOIAt. MOUE IN-GROUND PRESSURE AT-GRADE- SYSTEM IN F HOLDING TAf�1F U=Unsuitable for system ❑S 0 U jrS 0 U CIS C9"U ❑S L�U ❑S L11J ESU SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 Boring# Horizon in. Munsell Qu.Sz.Cont.Color Gr. Sz. Sh. Bed Trench 1 0 �c /1��'P� •� � 1 .4,, vvt e r- t�K.l?'c� Ct.K.t) i{� , S .,E: 4 ................ "6-' /o1 e - s i 044k h,tbcv ") rf . c , 4. Ground '3 /";.2I� y f?& . , — 4M) I- r - 7 elev. ft. '( :�J-7 ) I C `Y 6 R� -SV c e. S�bk p't4 - 5- Depth to limiting factor Remarks: Y /doe/2t., , k1 a-S roc,c.1,e.4ks . c C:_ 9 r `' Bonin # _� /)'/ 5/ � ,..A C.v bvkkic)v C. us �i4 - C . 4, t v& iiiiiii::.: .::. e--Z� ie, Y, v - s t I 62 0,1 ((�- 5 ( i 4- , s gikamaiii Ground e �� IC y k_ /c y t I•.-v (i ) S ( c sb it, IAA v-C c,� elev. ft. Depth to limiting factor '4 Lt) Remarks: 3 fi riz.G ). k.6. -k)e<AC s ®- SL CST Name:—Please Print • Pho Drv.v.t-e , e[ ',cso�- �7 (S 77�- 07`� Address: tit) /..),:,2 q 7 20-T 4, Au,-- se,(,) 0°._)\-,7 u__) . s,,,.? ,'? , Signature: Date: CST Number: Pa5 ..z., 3 of 3 # Pied Pico, V... ( Wvww. J o..,. I Thk-Lce_ C-S" I 3o9e7` Su r,,, ,;f K�.. I wBIt0,,0 2.1- �/-- -� ,- ' , 1- __, . 1 v F I ate. 3a,' A 1 i\I i i3 � /Flo1 Fl.--,ot/\ SCa.[T0.b1� \ f P-ec,- 1 3c- r sle f.-. v '°_I • B.M F U.Q. P. ►oo.oo . 14/ . \i se, Y L/a,-g. R:bbcw, sr. 20" D.0 . N1.4 k- Tv-.ec. (s" 4& e-.- 64-«.r..c-- Ccanh r Elea. 87. y CGi.-e " = vv EK c€ie f As S kcr. 8b Ak.ve5 +prole_ 0,10 ice - +/4Se- Lo /,o^ - o%d t .r-rox RY-- l iJ E t-- J `ri � \-:, .. Y i L C _\ VV _ f C 1 ti M \l <-- , .-'.\ _. cJ ST CROIX COU l 't SEPTIC TANK MAINTENANCii AGREEMENT �a rz� AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address 56/7 1' 4-h it Property Address .O'I (eo , (Verification required from Planning Department for new construction) City/State 0O Pe-)/L lt_ / Parcel Identification Number e9 MBE' r O sT DF.SCRI flQ Property Location ��l t1a t- y, Sec. 7 , T 2 , Town of ,tom - ��_. , Lot # ._____-•�-• Subdivision - -'- Certified Survey Map # Volume _.. , Page # � � Volume . tl .- _,_, � z� -2Warranty Deed # _ "� , -, --•----=� Page #... Spec house 0 yes,'no Lot lines identifiable 0 yes 0 no X§111 r x s srnrrF11ANCEer Improper use and maintenance of your septic system could result in i ti premature failure to handle waste- pint maintenathence consists of pumping out the septic tank every three years or sooner,if needed by a licensed pumpe What can affect the ftrnetion 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. Vwe, undersigned have read the above requirements and agree to maintain the ptrivltte sewage esdisposal i to of Wisconsin.system with the standardsCertification set f ttu nt of Cotmuerce and the Department o f set fotttt,herein,as set by the Departure Office within 30 stating that your septic system has been maintained must be completed and ratumed to the St.Croix County Zoning days of the three year exp" Lion date" /6( DATE SI ATURE O APPLICANT nr3„� Ia Cti'.RTYT'ICATION I (we) certify that all statements on this form are true to the best of my £Deeds knowledge. edgc I (we) am(are)the owner(s) o desc bed a ve,by virtue of a warranty deed recorded in Register the pr perty ( / DATE IONA - OF APPLICANT An information that is nnis-represented may result in the sanitary permit being revoked by the Zoning Department.'`***** s**+�,« Y ** Include with this application:a stamped warranty deed from the ILeiister of Deeds office a copy of the certified survey map if reference is made in the warranty deed fly"u"'-IN'l .° WARRANTY DEED •-• ....or STATE BAR al.' WISC :A ONN FORM 2.-- t°62 V.I1Pir a ,.. 52:3:-.;9,5 vn 110'), )ii7 Sear Maysack, a single person, -,..:',17,:aV..inx.:11 NOV 9 1994 , I 8:10 A. - cOn 14 and warrants ') . Joel M. thrke, a single re::son, . ,.... ".) ' ,,,.-4 . . . , crzENs STATE SAM 140 NIa'n '74 the following deAcrihed real estate in •-•'-t• Cruix •Xtnitine, WI 5-1C28 County. State of Wisconsm: Tax Parcel No: . . . N 1/2 of NE 1/4 oC Section .3-2S-13. VP° This 1S POt homcktead prererty. ( (n, not) Exception to warranties: Easements, restrictions .1nd rights-of-way of record, if any. Dated this 4th November , iu94 day of '1 SEAL .. .... ii ' • Sean Maysack (SEAL) (SEAL, .. , .. . .. .. .. .. .. . .. . . il 1 II 4 l! ALTTHENTICATION ACKNOWLEDGMENT Signature(s) . .. . STATE OF WISCONSIN 1 -St.......CrOiX County. authenticated this day of , 19 Personally came before me this . 4th day of November. .... .. .. i 19 94.. the above named single person I • 1 11 TITLE: MEMBER STATE BAR OF WISCONSIN , ... .. . .. . (If not, .... . . .. . . ...... ... . i I authorized by § 706.06, Wis. Stats.) to me kn - to be the.person who executed the forepvtlig in trirthent and knowygeith, same. ..........je THIS INSTRUMENT WAS DRAFTED BY (-74: ltt I tRij641 , u-4-4.4.,^ nrAnnA .../ 7, .if rs. Tsarkeaseri WisconsinDepartment of Industry, SOIL AND SITE EVALUATION REPORT Page / of 3 Labor and Human Relations Y ; 0ivijon of Safety&Buildings in accord with ILHR 83.05,Wis. Adm. Code COUNTY ' Attach complete site plan on paper not less thapr8 1/2,X:1111nbltie 'in 5'; e. Plan must include,but not limited to vertical and horizontal reference'p4?nt,(B%1),directio .0. of eteslope,scale or PARCEL I.D.# dimensioned, north arrow, and location and diS1a►lce to'��nearest r. ad. 6C 4 - /00 5--'/O •APPLICANT INFORMATION-PLEASE'PRINT AL` NF P TI' REVIEWED BY DATE PROPERTY OWNER: --• '"''OPERTYLOCATION .4' - j�''•VT.LOT A1C 1/4 AJE 1/4,S 3 T ,N,R I S E(o PROPERTY OWNER'S MAILING ADDRESS . OT E # BLOCK# SUBD.NAME OR CSM# 4/ 4 /t' , //4- CITY,STATE ZIP CODE P • ►UMBE' 4 LIT ❑CITY ,VILLAGE 6WN NEAREST ROAD j (� C:t�Occioo-C=LC e), 54/o:. y %-i_a//�DiI' # ,- c cf_c/7 �(,�uv.Uni+ RCS. [ ew Construction Use [`1esidential/Number of bedrooms 7 [ I Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow IFS bgpd Recommended design loading rate , s bed,gpd/ft2 . / trench,gpd/ft2 Absorption area required ,0--) bed,ft2 7cc1 trench,ft2 Maximum design loading rate • bed,gpd/ft2 . ( trench,gpd/ft2 Recommended infiltration surface elevation(s) SV,9 e' �ac.k q1 (as referred to site plan benchmark) e.� Additional design/site considerations (, ‘Q .,.r .7 s- ,_o<L -r� / , L Parent material S-// O(EI �`/ Flood plain elevation,if applicable /9/1 ft S=Suitable for system CONVENTIOyAC MMOODU IN-GROUND P SSURE A❑T-S DE .- S❑YST M IN FI H❑OLDING TA U=Unsuitable for system ❑S Q U l�5 ❑U ❑S Lf11 SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 Boring # Horizon in Munsell Cu.Sz.Cont.Color TrenchGr. Sz. Sh. Bed Trench MgaMig - //c 1 V ) l V S i y / v.i Sf — s 1 vvl s�ik kr v'S V (- cAJ f . Ground /�.-;/ /a y PI; - 6') .S P M c.r- Vvt r A LAJ - . -1 , . . elev. -r.)<4, — ft. `{ .2J- k � _ ysi / o `(P . /o YR � S� %. e S i k t� - f _ Depth to limiting factor � r / s Remarks: 4( idar Z 2 F,v. 1')aS PC&G.,/, .u1- . q C Boring# _ t°C lipiii :::.::: jc, f - Stl . i,+�sLLv11i._ I t� , S , � -c,V /O y= ; /cy,2 s, (Utl S 1 c sbk IAA v- c,-- - , / . 5- Ground elev. ft. Depth to . limiting factor S Remarks: 3 t•—• iz.G .. IA c,.., -Ve k4_,-k e;K sc. CST Name:-Please Print Pho� �c v.v,, e et ,so�_ 7 t 5 7 72 - 30" Address: �� / 02. `� 7707- Au Q- w ", 00 1 \-e U, . 5e 7( Date: CST Number: Signature: 5-_�? - y 5- 3d 9y ra� .._ 3 ,,f 3 �� Pic),-( Nk�h r / ENV - D e_j r _... At__ /18o,' 1-c _-A;. ih 1-"C/tG-<- e itile/isr 7rnioe•F/7 /a.t 7 ----) VI n C I I I 1 1 ?. L i I 1' i\14 : .iy j , 6 Fla-) • y og ,,v.. 1. -I-�� yr3 �-- el a 5 c,, l� Mectit ... i �rec. \ ItC I ' 77 \ /TQ SIo1"--- \ /°v , B.M U.'Q. P. /co,oG . Sp,k 0/0„g. R;61,0,, Iv. .20" C),;,_ N10 k. Tir-ee. 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