HomeMy WebLinkAbout020-1102-40-300 (2)Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
Safety and Building Division
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)],
Permit Holder's Name:
City Village Township
TERRENCE & RITA WERTH
TOWN OF HUDSON
CST BM Elev:
Insp. BM Elev:
BM Description:
100.OD
TANK INFORMATION
TYPE
MANUFACTURER
CAPACITY
Septic
Dosing
A
TANK SETBACK INFORMATION
TANK TO
P/L
WELL
BLDG.
Vent to Air Intake
ROAD
Septic
T� �T
Holding
.1�
PUMP/SIPHON INFORMATION Iv - 30
Manufacturer
I..�`ber�1
Demand
GPM
Model Number
115D
TDH
Lift
Friction Loss
System Head
TDH Ft
W.,;3
0.I II
9-1CI
Forcemain
Length
Dia.
Dist. to Well
3e`
_
�'D W61 'fts
SOIL ABSORPTION SYSTEM
ELEVATION DATA
County: St. Croix
Sanitary Permit No:
651219
State Plan ID No:
Parcel Tax No:
020-1102-40-300
Section/Town/Range/Map No:
34.29.19.408D-40
STATION
BS
HI
FS
ELEV.
Benchmark
5-1y
to 77y
.av
Alt. BM
Bldg. Sewer
St/Ht Inlet
SVrTtFultet
Dt-tnte
Dt Bottom
Header/Man.
cicl . 5 y
Dist. Pipe
"SDP of E� F'w,)CJc(.007
Bot. System
��y
lg-Da
Final Grade
St Cover
3.5�
BED/TRENCH
DIMENSIONS
Width \
�
Lengths
�D
No. Of Trenches
PIT DIMENSIONS
No. Of Pits
Inside Dia.
Liquid Depth
SETBACK
INFORMATION
SYSTEM TO
P/L
BLDG
WELL LAKE/STREAM
LEACHING
CHAMBER OR
UNIT
Manufacturer:
1N�z�TXa-rc,
Type Of System:
C,an1 �k:�`j'10`�a � � -9 «�1
�
hj-o V�1� 'i�S� .
Model Number:
DISTRIBUTION SYSTEM
Header/Manifold
Distribution
x Hole Size
I
x Ho cing
Vent to Air Intake
Pipe(s)
Length Dia
Length Dia Spacing
SOIL COVER x Pressure Svstems Only xx Mound Or At -Grade Svstems Only
Depth Over
Depth Over
xx Depth of
xx Se ed
Bed/Trench Center
Bed re E es
Top oil
❑ Yes ❑ No
❑ Yes �o
COMMENTS: (Include code discrepencies, persons present, etc.)
Location: No Address Available 4- L13-CST
1.) Alt BM Description =
2.) Bldg sewer length = z' it)' 4,D t4nk.
- amount of cover = 2 5' o� cn
Plan revision Required? ❑ Yes ❑ No
Use other side for additional information.
Date
SBD-6710 (R.3/97)
Inspection #1:
g V' T� . :10saGTsW l o' Rom f,d0 Of S }HMO
Insepctor's Signature
Inspection #2:
Cert. No.
In
I oil I mwjwwm rVm
g L
Buildings Division
� " "•
.�%
� end
*
SEP 2 6�
.� �1 W. .Washingtonv ., P.O. Bo 716
—7152
N ��.rx,tag ��.�iy t���a �� � C�,
i
Applicati
tale i rams�- t14. n IN um e
In a=rdance wi th SPS 383"-21(21 is. Adrri_ Vie, .szibmission of &w form to the appropriair f!ove; nrr, '_ unk
is required riser tc n mein ? a € ' A lii � . .T,,
p o �. _ -owned 3' � � S are s Ll1^mmtt�d
j t A d crcnt t l rrliai i 1n z dr c ss )
the Lfpartrn nt of S afety and Prof�zlio al Sffrvies,. Pi-.Norial. infonnation you pmvide maN. tr- u,,;L-d f-br sec�ondary
ur uses 3.n ac; ordI vnth the Privacy Lavv, s. 15.04-, i)(m), Sty.
^�
L
Application Information — Please Print AU Information
�� O nl�ri 5 Nye 11b I Lin ik
Parcel :#
ew"I 27 _.M
elL&A-AoI --
0 30
40
Property 0vmcq `'s MOM& Addres�
Proms C�on
�..✓
Sk 1/� j
, A)' F4�'j 4, S f, 0 n. 3 4`1
Ci 4 Tr} tau-
ZIPCode
PY Lc}4i�+ 4•+m b+`�.�1F ..
AJ
Y7✓
T Nil
Subdivision Name,
Type yp a of Building (check a [l that app )
FAN L)wel i tng - N um't cr or. B cdroom5
Lot 9
B-1oc v
Nb ie!/Cm erca a.: - I Lk crib} Use
'--"
_.
V ih �i Lye of
CSM N=b r
nwy tad d< 6f6
LM Type of Permit: (Chock on [v, one bDX On fine A. Complete line B if applicable)
L� N ewv m
❑ p ew elll System m
Tr.,: a ment/Hoi ding Tani - Rep,4ac= eut. C i y
❑ U11). — I�10at-fi eabon to rx ISystem
R.
E !',=t n.-wai v:Flical
❑ C'narlp of T11U ,LiC,
I'=1 L i'Tanw r,-w
Lim Pmvioiz PcimI, Number and Date IssuEd
f Beort ExmMrjon i
eT
�o �6 Z 1L q(
6 l 7�oZ
ITT. Type of POWTS SystcmE-_omponent/Dcvice: Chick all that a ),,)
-Pt Its -Ground 11 Prussu: �ed Ground ❑ At-G c — I�i �rr,.T ��d > 24 In of svftabie soul ❑ Mound < 24 of =table soil
❑ Hol ig T Crier Dispersal CompGn (cxp] ain) PratTr, t erg I viT,-c (explain)
e I r7 F101A d)
Design St}�l Application
1s t Area e uirC$ T 1 Noposed (9
P
y sum El v,alla.
� .,I L 6 i
41 z I
L / D 5�
N T Ian k Info
-
miry m
TOW
# of
moons
Ulorn,
Units
�. c ,
F
64
S �-Dri c cr F cald` Tzmk
111. Responsibilfty, tern ent- I. the andersigned, assume rrstar ns i bUity tvr- i %11ati0n c'f the PffTS shown ua the aIlached iAzaL
Pi urnlbz:i • � N dales (Pt ITli)
plkjrrl }
MPIWIRS uru'61w4
Phorc Numbs
i I i �Y' .� r
l�1/Z — 4 Z dYf
Piumh r`s ddr-es ; (Str&ct, City, State: Zip Code)
PLApproved
I5ap
Permit Fee
1
75-
Dam su.cd
I �2a2
Ag= Sig=&e
111
'fI{ T G 1,• n for
D. Conditions OF pDroNi,A
Q1�iN ER:
�) ��,SjaAj,-I
wI !GS�O`�SYSTE14JI
�2�5 ��o
I _ Septic .��r� k. �f9uar�t filer �r�d r�lspersa� III
q
! Zo
u 1
must b� ser�i�d I main#aid as
man genient plan prawided by plum,
�Oy3 �
0�,A.A L 9(�V1,0-1qkL
2, Ali wtback requirements must be mania ned •.
as per appilicable ewe 1 udlnart c
At=& up compietr p Lane €o r th a sim and su to 1�tt the County onh [art paper t less 611 9 j X 11 inches; ka ziu
)!&^ �,�
�\ r
V' i vlti
BD-63 1111 S a vim. .�� 1� _
E� F�
02
S
Cp ve-t
OP-46 yor C
�fa8�l IV[S�oN
UUUNNoe.. ��lzc9
.... ......
..........
.. .. . . . .. ... .......
x2j "' NOo
flu q0 J` U
', nr 11 mr-
OWNER Tie:1-1P—AM C COL IVF
LUIVIBRV�M.K£, �.p4Eus�4�d, PE
TOWN OF �k�toSvN
SUE_�T 29 N,
ANAND/OR]LOT
C59v�.,��` SUBDIVISION
M A-
E I Al. LIP
v
IF T
TTEIRS UNL-T"-JlJSS REN11 E' J W 11 E '. j I`
E "x
CHAPTER 145.135 (2) WISCONSIN STATUTES
(a) The purpose of the sanitary permit is to allow installation
of the private sewage system described in the permit.
(b) The approval of the sanitary permit is based on
regulations in force on the date of approval..
(c) The sanitary permit is valid and may be renewed for a
specified period.
(d) Changed regulations will not impair the validity of a
sanitary permit.
(e) Renewal of the sanitary permit will be based on
regulations in force at the time renewal is sought, and that
changed regulations may impede renewal.
(f) The sanitary permit is transferable.
History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314
Note: 1f you wish to renew the permit, or transfer ownership of
the permit, please contact the county authority.
SBD-06499 (RI 1/20)
41aa3
................. V
I 1fl[:%'.1 :::
. .. . .. ......... . . ...... ... ... ... . ...... . ... .. .............
..... .....
nL -71 Wl
OP
PSI '�
10
�'� - - �, bad' �
4E
w#
yt
.7ir - a 1/
9 L A I TkC1 M 90119
I
Index & Cover Sheet
Component Manual Design References:
In -Ground Soil Absorption for POWTS Version 2.1 (May 2022-2027)
Pg 1 of 5 Index & Cover Sheet
Pg 2 of 5 Plot Plan
Pg 3 of 5 Dispersal Area Cross -Section & Plan View
Pg 4 of 5 Pump Tank Specifications
Pg 5 of 5 Management Plan
Attachments.0
----._Enc1Iosures:
Pump Curve POWTS Application for Review
Soil luation Report & Site Map
i A of
Eva
1 0
16
Project Name Description
TERRANCE R. & RITA A. WERTH
1wner Name(s). Phone:
Project Address-
Govt. Lot: NA
153 EGERT LANE, LINO LAKES, MN Zip: 55014
661 GILBERT ROAD
SVV El/40fNWEVA.Section 34m_b T 29 N-R 19 E -i r W
HUDSON County: ST. CROIX
-61 020 - 1102 - 40 -300
roject Parcel ID #:
Designer Information
Designer Name. MA*RY JO HUPPERT Phone: 715 - 426 . 1775
25720 FIREFLY LANE, WEBSTER, WI 893
Desioner Address. Zip; -
hollfisterdesign@ouflook.c
1859-007
License Numder:
Remarks.-
Date,
Signature;
,Cli Pq1n4d W61 ure fwu,j trwl on ead)i <u i)r n i I i i
05-26,2023
nL -71 Wl
OP
PSI '�
10
�'� - - �, bad' �
4E
w#
yt
.7ir - a 1/
TYPICAL TRENCH
PLAN VIEW
IN -GROUND DOSED -GRAVITY DISPERSAL AREA
Uniform Elevation Trenches with EZ1203HP Bundle,.-.%.
3-ft Trench (down -sizing credit)
114--
Geatextile
cover -
1T
min. trench
depth
NPIWO In
System Elevatinn - -00 ft.
(typical)
rT%IFI 12
I Ivy P i C-9 1
TYPICAL TRENCH
CROSS SECTION VIEW
{Na Scale)
Provide minimum 3 ft
separation between trenches,
(Show location of inlet ., k-,,wicl pipc on plan view.)
OBSERVATION PIPE DETAIL
(140 SCH6)
Screw - Type or
& .* Finished G rad a
Slro Cap (loose)
(mimed & so aded
4-0 FN(' Pipw�,
Topwi Cover
Tcq! c;f pirw to terminate
(gin. 1 fool)
a( c,,, atyoye finid,;hod gracjo
ti 1 -A x F SUS
LLD 90 .3 pal
Anchunng Devcp
I nfi
S u rface
kINU 1ej 4110 'Observatort pipe stiall be irista4�
PerfOiFated Lateral al jurictjon oetweer, Nwo units 10 ft
Observation Pipe (ty pica!)
(t y P I ca 1) (typlcail) I -
0�
ZZ Z Z Z A = 3.0 ft
(typical)
B= ft awd
INSTALL PER TRENCH:
1 0-ft bundles @ 50 ff EISA/unit = v
+ 5-ft bundles G 25 If EISA/unit = ft 2
�*Z
Proposedl F ISA oer trench ft`
EZ1203H Bundle
1000 / 50 EISAJUNIT - 20 UNIT';c- (typical)
20 X 10 FT, - 200 FT (mfd by Infilv,-itor Systems, I. 210 / 3 TRENCHES - FT, X FT.
Instal I pu rs u a n t to r-- a n i i factu rerj s 1 ns Michms.
(3) 3 70
TRENCHES
Required Infiltration Area Distribution Method:
x trenches = Proposed Total EISA = ft 2
branched manifold [I
WERTH, TERRANCE & SIT
MCIME-A .
GRAVITY -DOSED
SEPTIC / PUMP TANK SPECIFICATIONS
(No Scale)
4 "0 Ver I pipe
>10 ft frorr.
Build,_ng
1 2m for. or 2,0 1, above
FstaUlishod Flood Eevation
(lypi-r-al)
ADDroVad
I k A 11 rN F-1 -7- A L IT. VertCap
Anchor tank(s) as necessary
pursuant to SPS 383,43(8)(g)
Finished Grade
CAPACITIES @ 22-24 gaVin
rM
Volume (gal)
Purn p Tank Liquid Level 36 in
2 4
Force Main DiarTieter in
Force Main Length z- 34 ft
E lectn ca. I rust com ply wtt-
SPS 316 and NEC 300
Weatherpmof
Junction
Bcx
— CondUill
*_i
A
Pump
j
D
Airtfghl Seal
WERTH.
T E R R A N C E-E
& RITA
Extend manhole riser aS neCOSSary
Appitived Locking Manhole
wil h Wam i ng L abe I At la&ed
(typical)
"Min. of 2.0 ft awve
Eglablisr)ed Flood Elevation
Quick 01sconnect I
18' Min
.0 (typical)
W ees— Approved ioints With
p
Herne Approved Pipe 3 ft onto
Solid Ground
(typical)
Alarm
t>_ on
Concrele
're
Block
ILI'
3' Approved Bedd,ng Millen Benoalh Tank
Force Main Void Volume = b gal
[C] Total Dose Volume (TDV) 111,20 gal/dose
< 0 2X design flow + force rli,airl voio volume)
Verb cal Lift = 6 30 TRH ft
Volume = 800 gal
Manufacturer: WI ESE
Pump Manufacturer: Liberty
Pump Model: 253 (See a ttadi ed Quip curve.
Controls/Alarm Manufacturer: SJE RHOMBUS
Controls/Alarm Model: AB TANIKALERT
Float switches containing mercu[y are prohibited.
I I . . . . ............... "I
OEM"
PUMP -OFF
ELEVATION 92-67 ft
INSIDE BOTTOM
ELEVATION = 92.00 ft
34 X 0163 = 5,54 GALS DRAINBACK
111 20 GALS - 5.54 GALS = 105-66 GALS PER DOSS
600 GPD/ 105.66 _'5 68 DOSES F. DAY
98-00 S E 92.67 PUMP OFF Ll 1- a INVF RT
&30 TDF1
5,83 + 0.47 FRIC110N
SEPTIC TANKS):
Total Volume = 1200 gal
Manufacturer(s): WIESER (COMBO)
Install approved effluent filter at the septic tank outlet
immediately upstream of the pump tank inlet.
Filter Manufacturer: POLY LOIN
Filter Model: 525
A,'i sc o-ns i n No arl" nt of Safey & P rof @ s mona I S 0 rV r Ce!&
0 iv is ion of I no wst ry, Se rv!ce s
4
SOIL EVALUATION REPORT
ST CROIX
-ornp@tp site pi an c-n papef not liorim Iman 8 1;'2 me rigs al
nut oo! mil eo lo verltca� ar-C norizonlal tefef ence Mnt e i
&1*11W". rx)nh a-rmw an IJ "ion Ancl cPstsn" la L)a 0 0 21 0 - 0 - 3 0(,,
P1*m%* print all mform-otion Date
w t4r. i SoCond 3 ry Dij rp o w s r 14 01 C j L3 A 5 'rn.,
ropf 1`1 P r::� pe rt'� L F-- Cl Is
T
P R GovT 1.01 N V1v S 34 -�q N IBM "i
:-less
$ x
6 CSNI 'Jig P496'
5E R T LANE
J vi;wage n Nearew Roar
IN 55014 GILBE RT ROAD
hkpw $I Use Cod4a donvad d0sl)n6cm Fate �K) GP 1)
NA fj
Rep-ladmnit LJ Pwbi is w Com merota! - Desm 1 be, r-ooa P an evvar
Hio(#nj m4itefLa 11�- QVIUAL
Ge
r-
neia! comr-)e, 1� i-lei iecommendations NgPAQUNOTRENC�4ES 0, 6 -.OADING RAJE --PUMPING REQ I ED
n Z� �; ne,
I��,wm bai7
Depth Io .motirV Caj�tQt in siev 02 ft
15 67 ft
�)orrinar,,t Loio- jr-scriplion
7 SYR.2
v rin
Tex%oe stfuctire
Gr Sz S�
Lunsit-lence Bojndaf� RwIs
Effa I *Effx2
as 16
14' C S
7 5YR4
-0O
H Cw kz On De PT �i Domir,
7 SYR2 5,3
75YR33
Y R12 5 41-61
rani sudace e,ee 9� 3 7 It Depth to itrnging fa 'or 50 in 910v 95 14 ft
.4 17 ft
Sovi Appicamn RAM
.,lire Consistence Boundary Rom GPD Ft.
-•E ffs -0
Effal
T
4T
a jj C
0 02 5
C 7 '4. arm(:" t Pleas* Print i Signature
NIARY JO HUPPERT �Hohi,.3ter's Suil Tosting & De I n
41 224832
Address Dato Eviaiwaticr) Lofiductec eny) one N imue r
2,5720 Firefly Lane, Webster. Wl 5A89. ()q ?n ?n?j 715 - 426 - 1775
F- MI ue nt a 1 :t aOD - 30 .4 2 2 M9 L
*E:RTH TERRANCE R &RITA A pop 2 at 4
D Bof Ing 79
(qpd G r oij rd wrlaice e E --:,factor eiev 94 16
Bcf I ng
$oil AppiicattQn 'Rate]
W"" 1 1, LJVIW%p I i 6rwl i q i in r o 4 %.v %ji Lji I %IFU%JJlk Lea PWtl4dF' V '% LLAI w
_POP 64%rL"l r.
in klunwi Ou, Az Corit CVof
Gr SZ Sh
'EMS I
-Eft2
0-43 7 5 y R 3 12'
1 I-mSbk
cis 30-co 0 7
1 6
la 7 5YR3 3
ds CS
0
S - :19 7 5YR2. 5 1
0-co 06
a
-7 9 4Y R-1 4 S
7
r"Orlzorl ks a our,*C A Harr zon 4M
n tu�raffi above It
-97- - -Ll
m F
0 Boring
Ek��r: rjjQ V, Pill i5it,ound surface eO, Dopin to ilmlling factor in erev
—nri7nr rl&nth o Onr-manT Coltif R&dnx 'L'lptcrinliorm Toxr-ire Strur-lure Consistence Boundar-v R O(x GP[) Fl-
Gro�jnc swirlace e;ev tt Depth" to 111MIlling fact(X I M , 60V
Soil Appiicalion
Gp[) F't
-
"orizon Depth :)orrinanT C;o,Llr Recox Descripoor fie lkiire StIrLi1-# clure Onsistence Bojnaar� RWs
BOD -- 30!S '20 mg L and TS,-, :- 30 s 7:50 Mg L
R3
id
440
k C... 4.- -
A
c
S
RECEIVED Way
'705
06/23/2023
I ["lox 7162
Al 53707-7162
Sanitary, Perryfit Applic�eit!.Otl
In acI_-irdance --d"- ":,'21(2). Wis, Adm. COLIC, SlIbIlILY11011 ;till 11:1 -cippropritile!poverililiciit�iI mlitt
J IT d p ri (i r to ")'i; I! I,, I I i,-, 'i I 1a r% - p,L- ni i N A 11catior3 I( )nn,, k')r I%A PO I' S III I Ill 1QkJ
'-;
P'l; P
I I Si
C. N 11) 1 ic "I t W 11 [1 fi) r Ill III irb11 1 1 ca S e PI i r I t A II I F1 fo 1. 1110 t o F1
Terrance n . &_.ita A. Werth
A
k �dtlhj d i
15 3 E g, e rt Leans
I 1 1% S U'de P hone N Lill'-
St Croix
S-AN-2023-136
I Utry PCI III 1 11 � r" I lk,r (to ht ti I by Co.)
State Tr-wsadioii Number
F'ip.l O-C t A r lcl I'i. s i ff�t than inailing address)
661 Gilbert
020-1102-40-"00
1--dUdson, wi I54016 _4A N W Y4, Section 34
I I T.' J)U '11' 1111 ild illql (ACA It 11 1 IlAi -.111 I)IV)
4
M 11 1.%s
1) 1 i OCow 1 r erci al — D-� s cri h � L "'NQ
_Fiate Owned — Describe Use
1)'V'P9 A R F_ or W
S I I kid i P4 - ion m Nae
�
L�Yjty of
7vill gc of
-1 HHnqnN
Ak
I 11. Ty 1) v I I f VONN I'S PC1-Ill it: I ('' 11 vc I, v it h e v N vw" r "Rep 1.'I ce ill cii. C" a 11 d ot lie], 11) 11 c-,ll I li I e on I ne A. Check one box on line B. Complete Ilan
C If
C "' .' '..�r�i
I I! C, 21 '7 ' -weatiliclit UllI t (explain)
I�j 111 to 1A ncp System ('explaill) ��lditional Pi
El
ti I IL L dA -G ro!. I I' (A
El izenev,-.mBe 1"6
FX1}11-aiI%')r1
Mound IndividLial Site Design OtherType (explain)
D_ , I hange (A),liber ElTria nsfer to New Own4. ist Prc,. W-ui% 11�i -i, Ii \"iAifl1L,i ILA Date
W. Dispersal/-Freatnwnt Ai-eA -Lind 'F�ink Informa(ion: Y_ 14
1) k pe sal A re a 1-1 ro posed f) S te Ill I :" �,il_1011
I L�a R wred (SO
t '.�
Un
a i li'k s
Aj
CA
CUMBC
'151 1t. -1: 1 kild. r t 1 "Ink 1200 1200 vm'
800 800
V S i I) i I %, ff I. I 11�pl h I I I 'I I FS sh (P w n (i n t h e a c I a c h ed 1) 1 a i-i s. ResponsitAlity Statement- I,( j
its
1 , �_WIS F P ":'L' I- I 11C I
MICHAEL RODEVVALD 931384 715-4-25-6200
.... ....
--SF`)' RMU-.1-1 FALLc3' WI, 54022
11 [11 1)(Lj): I rLj Ill 111 se Ojj ly
. . ..........
II111c ''� �1 ?^:'1��11[11
Perin it I "Ce, I
L fl 20 2, -
T1 3
ILL I I It "I 1_� I k �[ I•R D
JaoL�
SY STE M OWN E R.
1. Septic tank, effluent filter and dispersal cell vichz 6 C).', 6;pbl
i4d,, -6 c)
must be serviced i maintained as per �eA C,�ww& -,'wQ do"
managewnt plea, provided by plumber.�/6�
6Lt �e�rL4�
MALat- 84
2. All setback requirements must be maintained 6— &,t^
0
ns per applicable c de / ordinances.
.�l 1.1 ell to 40111 1111viv f Ph are for 1 by w3p1 ;1111] 1111 ill i r i t,i i 1i v 'ounty only an paper not lesstitan jaja WL I I iri vhcin size
02 dr * � -ilA
� kA�
PAGE 1 OF 5
In -Ground Dosed -Gravity Plan
Index & Cover Sheet
Component Manua! Design References:
In -Ground Soil Absorption for P4WTS Version 2,1 (May 2022-2427)
Pg 1 of 5 Index & Cover Sheet
Pg 2 of 5 Plot Plan
Pg 3 of 5 Dispersal Area Cross -Section & Plan View
Pg 4 of 5 Pump Tank Specifications
Pg 5 of 5 Management Plan
Attachments: Enclosures:—_
Pump Curve
POWTS Application for Review
Soil Evaluation Report & Site Ma
KM
WA
Project Dame 1 Description
Owner Name(s)TERRANCE R. & RITA A. WERTH phone: - -
LANE LINO LAKES, MN zip: 55014
ow
ner Address: 15� EGERT � p .i
Project Add
ress: 661 GILBERT ROAD
NA SW Lw]'.1/4NWEll/4,34 29 � 19 E or WGovt. dot. of Section , T� ��-�R
- . HUDSON County: . CROIX
Tov+rnsh�p. C y
Project
Parcel ID #: 020 - 1 02 - 40 - 300
esigner Information
Designer Name: MA, R ' JO H U PPS RT
Designer Address,. 25720 FIREFLY L
E-mail: holfisterdesign@outlook.co
c
License Number:
Remarks:
Signature:
Phone: 715 _ 42 - 1775
'' EBSTER, Wl Zip: 5.4893
•H �" i
ry +yf °P4
1
N,
Date: 05 - 2612023
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.301 OCAYRI
IN -GROUND DOSED -GRAVITY DISPERSAL AREA
Stepped Elevation Trenches with Quick4 Standard-W Chambers
3-ft Trench (down -sizing credit)
SOIL C ER
Highest Trench -
System Elevations = 94.00 ft;
TYPICAL TR.'---NCH
CROSS SE i lON VIEW
o Scale)
.Q a
3411 Q
(t ical} • • ' r
l`Y I'n.o� ,Q
O
Lowest Tr h (as applicable)
93.50 .75
ft;
ft; _ I ft;
ft
Provide minimum 3 ft
separation between trenches.
Quick4 Standard-W `
w/ End Cap Observation Pipe
(typical) (Show location of inlet / outlet pipe connection on plan view.) (typical) TYPICAL TRENCH
Install per manufacturers
instructions. PLAN VIEW
(No Scale)
I o A=3.0ft
- f I 11 _11 111 all i* j a 11 l j k (typical)
46
B = a ft
INSTALL PER TRENCH:
( ical) Quick4 Standard-W Chamber
600 gpd / 0.7 LR = 857.15 FT. (typical)
20 EISA/U N IT = 42.86 UNITS OR d by Infiltrator Systems, Inc.)
43 OR 44 MIN. X 4 FT. = Install pursu to manufacturer's instructions.
Quick4 Std-W @ 20 ft2 EISA/ch ber = 220 ft2 172 FT.
6 (4) 3 FT. X 44 FT. TRENCHES
+ Pairs of end caps @ 6 ISA/pair = ft2
= Prop per ose ISA trench = 226 ftq
2 Required Infiltration Area = 857.15 ft2
4 — 904
x trenches = Proposed Total EISA - ft2
Distribution Method:
RESET
TERRANCE & RITA WERTH
PAGE 5 OF 5
In -ground Dosed -Gravity Management Plan
IMPORTANT:
The owner of this in -ground dosed -gravity system shall be responsible for its perpetual operation and maintenance
pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this
system shall be considered a human health hazard if not maintained in accordance with this approved management
plan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in
accordance with SPS 383.52 (3), Wisc. Admin. Code.
Maximum Dispersal Area Operating Limits:
Design Flow =
•11
g pd; BO D5 <_ 220 mg L"1 ; TSS <_ 150 mg L"1 ; FOG:5 30 mg L"1
Inspection Checklist INSPECT EVERY 3 YEARS
o type of use
o age of system
o nuisance factors (i.e. odors, user complaints, etc.)
o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.)
o material fatigue (i.e., leaks, breaks, corrosion, etc.)
o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes)
o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.)
o extent of ponding in distribution cell prior to dosing
o dosing irregularities - if applicable (i.e., pump re -cycling, float switch settings, etc.)
o electrical components - if applicable (i.e., wiring, connections, switches, controls, timers, alarms, etc.)
o distribution lateral or lateral orifice plugging (measure lateral distal pressure — compare to design specification)
o surface discharge of effluent or sewage back-up into structure served
Maintenance Checklist
MAINTAIN EVERY 3 YEARS (or when necessary)
o Septic and dose tanks) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis.
Stats. when the volume of solids in the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) or
as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code.
o Effluent filters) shall be inspected every 3 years and shall be cleaned when necessary to remove any
accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12
months.
System maintenance reports shall be submitted to the proper local government unit in accordance with
SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to:
Name of individual or company: Bettendorf Excavating
Local government unit:
Phone: 715 - 425 -6200
ST. CROIX CO. COMMUNITY DEVELOPMENT Phone: 715 - 386 - 4680
Local government unit address:
HUDSON, WI
ZIP: 54016
Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin.
Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code.
No product for chemical or physical restoration of the POWTS may be used unless approved by the department in
accordance with SPS 384, Wisc. Admin. Code.
Contingency Plan
In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to
a plan submitted to the appropriate agency for review and approval. A failed in -ground dispersal component may be
abandoned and replaced by a code -complying dispersal component in a pre -determined area of suitable soils.
System Abandonment
If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code.
PAGE 4 OF 5
GRAVITY -DOSED
SEPTIC / PUMP TANK SPECIFICATIONS
4"0 Vent Pipe (No Scale)
> 10 ft from
Building Electrical must comply with
12" Min. or 2.0 ft above SPS 316 and NEC 300
Established Flood Elevation Extend manhole riser as necessary.
(typical} Weatherproof
Approved Junction Box
. Vent Cap Approved Locking Manhole
IMPORT T. with Warning Label Attached
(typical)
Anchor tank(s) as ne ssary Conduit
pursuant to SPS 383.43 (g) 4" Min. or 2.0 ft above
Established Flood Elevation �
(typical}
Airtight Seal
Finished\de J�
-- Quick Discon
CAPACITIES @ 22.24 gal/in
Depth (in)
Volume (gal)
A
21.5
478.16
B
2.0
22.48
[C]
4.5
100.08
D
8.0
177.92
*Pump Tank Liquid Level = 36 i
Force Main Diameter = 2 /in
Force Main Length = 4 ft
B
Weep
Hole
18" Min.
0000 (typical)
Approved Joints with
Approved Pipe 3 ft onto
Solid Ground
(typical)
a
Alarm
On
[C PUMP -OFF
Pump off a ELEVATION = 85.67 ft
D
Concrete INSIDE BOTTOM
Block ELEVATION = 85.00 ft
A. • o ..
3" Approved Bedding Material Beneath Tank
7 99 49 FT. X 1.39/100 0.68 FRI ION FACTOR
Force Main Vold Volume = gal
49 FT. X 0.163 = 7.99 GALL S FL WBACK
[C] Total Dose V4<ome (TDV) 100.08 gal/dose
( <� 0.2X design flow + force main void volume) 94.00 - 85.67 FT. = 8.33 FT. + 0.68 FF + 0.50 INVERT =
--� 9.51 TD H
O
9.51 600 GPD / 92.09 GALLONS = 6.5 SES PER DAY
Vertical Lift ft -
PUMP TANK:
Volume = 800 gal
Manufacturer: WIESER
i
SEPTIC TANK(S):
Total V me = 1200 gal
EW�� �Wanufacturer(s): WIESER
Pump Manufacturer: GOULD
WJ2
Pump Model: PE41
(See attached r�i m p curve.)
Controls/Alarm Manufacturer: SJE RHOMBUS
Controls/Alarm Model: AB TAP 4K ALERT
Float switches containing merwry are prohibited.
Install approved effluent filter at the septic tank outlet
immediately upstream of the pump tank inlet.
Filte anufacturer: POLYLOK
Filter Model: 122
]Uberty Pump so
250_P1 R1/17/2018
LITERS PER MINUTE
0 20 40 60 80 100 120 140 160 180
25
�01
15
5
aI
0 10 20 30 40
GALLONS PER MINUTE
OO Copyright 2018 Liberty Pumps Inc. All rights reserved. Specifications subject to change without notice.
7
6
0
3
2
1
-L0
50
Iibe�tY
Pumps
13 P-812,
Ll
4" CAST_ A - L
nil
TOE V! E IV'
4" CAST —A —Sip
(_—I
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Li
ly-
A 77G
11 LET J "L E T
_4
CIL
-r-71
VPUMP PAD
WLP1200/800-MR I JI o
TANK SPECIFICATIONS
0 CL
LL
DIMENSIONS:
uj
Lu
x 8
WALL: 3"
CL
n_
0 0 TTOM. 3'
COVasER: 6
MANHOLE: 24" I.D. PRECAST CONCRETE RISER
HEIGHT- as
LENGTH: 13'— 8"
ay
WIDTH: 8'— 0
BELOW INLET: 41"
LIQUID LEVEL: 36"
WEIGHT: B070M 14,800 LBS,
C,
COVT�R 8,170 1_13S.
aNLET AND OUTLET:
4" CAST —A —SEAL BOOT OR EQUAL GASKET
INLET AND OUTLET BAFFLE AND FILTER:
C
WISCON SIN. SEE DETAIL #10
(OTHER STATES SEE CHART)
Lcr
LiQUIlD CAPACITY: 33.46 AL IN f SE P n c)
22.24 GALN (PUMP)
LOADING DESIGN. 8'-0' UNSATURATED SOIL
TANK CAN BE USED AS:
SEPTC / HOLDING / PUMP OR SIPHON
COVER: MIX DESIGN #8 (INO FIBER)
TANK: MIX DESIGN #9 (SMALL FIBER)
CUSTOMIZED TANKS:
FOR CUSTOM TANKS CONTACT WIESER CDN"'%,RE7E
<
<
REVIEWED BY
REVIEW DATE
CL
SIDE MEW DRAWINC;S SUBMTTTED_
[APPROVED FOR APPROVAL
A9PROVED BY: SH E E7 7 -7,
By Glen Schlv;eter at 11:07 aSHEEm, Jan 18, 2022
APPRC'.\iA!. DATE:
OF
4 '�ODLCiS 'AEECIED BY:
TANKS ARE MANJFACTURED TO MEET OR 'E'XGEED AM C-1227 REQUIREMENTS
Sr. CR N ry SANITARY SYSTEM File #:
Office Use Only
OWNERSHIP/ADDRESS FORM C•eatea212a=1
Community Development Department will utilize this information to provide the property owner with
information regarding operation and maintenance of your new or replacement sanitary system! This
information will be provided as part of our ongoing efforts to protect public health, your well, groundwater,
surface water, property values, and county resources. Once approved, this completed form and educational
information will be sent to you by email.
Owner/Buyer
OWNER/BUYER INFORMATION
TERRANCE R. & RITA A. WERTH
Mailing Address
City/State/Zip
153 EGERT LANE
H U DSON, WI 54016
Phone Number (required) 651-485-9197
Email Address (req uired) T46737@ICLOUD.COM
Parcel Identification Number
(found on the property tax bill)
020 -1102 - 40 - 300
NEW SYSTEM: LEGAL DESCRIPTION
Property Location SW /4 , NW 1/4 , Sec. 34 IT 29 N R 19 W, Town of
p y
HUDSON
Subdivision Plat: NA , Lot # 7
Certified Survey Map # 791401 , Volume 19 ,Pa e # 4967
Warrant Deed # 1138438 (before 2006)Volume , Page #
Y g
Number of bedrooms 4
New Property Address
(Staff Initials)
Spec house 0 yes E no Lot lines identifiable E yes 0 no
OFFICE USE ONLY
(Verification of new address required from Community Development Department for new construction.)
(Date)
This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications.
New System: Include with this form a recorded warranty deed from the Register of Deeds Office and a copy of the certified
survey map if reference is made in the warranty deed.
Community Development Department — Land Use Division
715-386-4680 St. Croix County Government Center 715-245-4250 Fax
cdd@sccwi.gov 1101 Carmichael Road, Hudson, WI 54016 www.sccwi.aov
1138438
BETH PABST
REGISTER OF DEEDS
STATE BAR OF W I SCONS IN FORM 7- 2000
TRUSTEE'S DEED
Document Number
Liane luhl Haler, as Trustee of the Lis Hoier Nielsen Irrevocable Family
Trust for a valuable consideration conveys without warranty to
Terrence R. Werth and Rita A. Werth, husband and wife as survivorship
marital property, Grantee, the following described real estate in St. Croix
County, State of Wisconsin:
SEE ATTACHED EXHIBIT A
Dated this August 27t" , 2021.
Trustee
m4;r�T�i7il+i9g7q �4
AUTHENTICATION p'�� �� S.f j• 8
�� •� • •. a� ��� PEA
•
� • p
Signatures) n1A
� • 4
authenticated this co
4,'°1• Z
P �Y
OF
g'r yam••.•..• � 4��'i�
TITLE: MEMBER STATE BAR OF WISCONSIN
(I f not,
authorized by 5 706.06, Wis. Stars.)
THIS INSTRUMENT WAS DRAFTED BY
Larry S. Mountain, Attorney at Law
-----------------------
(Sianatures may be authenticated or acknowledged. .Both are not necessary,)
"Names oi'persons sianino.in any capacity must be typed or printed below their signature
ST. CROIX CO., WI
RECEIVED FOR RECORD
09/ 07/ 2021 08:02 AM
EXEMPT#:
REC FEE 30.00
TRANS FEE 390.00
PAGES: Z
**The above recording information
verifies that this document has
been electronically recorded
& returned to the submitter
Recording Area
Name and Return Address:
Land Title Inc.
2200 W County Road C, Suitc 2205
Roseville, MN 55113
4373 7� ........
020-1102--40-300
Parcel Identification Number (PIN)
............
Liane luhl Hoier
S
Trustee F
ACKNOWLEDGMENT
STATE OF WI SCONSIN }
COUNTY ss.
Personally came before i-ne this 27th day of
Aucrust 2021
Liane luhl Hoier, Trustee
the above named
to me known to be the person(s) who executed the foregoing
instrument and_a _ y nowle 4 th ne.
f
*44erLwV J . Bune �
Notary Public, State of i nsin
My commission is permanent. (If not, state expiration date:
TRtJS'1'EI-l'S DEED
St. Croix County 1138438 Page 1 of 2
STATE BAR OF WISCONSIN
F ORNI No. 7-2000
LT File No. 643375
EXHIBIT A
Parcel 1:
Lot Seven (7) of Certified Survey Map recorded in Volume 19 of Certified Survey Maps, page 4967 in the
office of the Register of Deeds for St. Croix County as Document No. 791401, located in part of the
Southwest Quarter of the Northwest Quarter (SW 1/4 of NW 1/4) of Section 34, Township 29 North,
Range 19 West, Town of Hudson, St. Croix County, Wisconsin, and further described in Affidavit of
Correction dated July 6, 2021, filed July 6, 2021 as Document Number 1134051.
Parcel 2:
A non-exclusive easement for ingress/egress purposes, appurtenant to Parcel 1, as established by Grant
of Easement and Joint Access Maintenance Agreement filed as Document Number 1133230, as more
particularly described, limited and set forth in said document.
St. Croix County 1138438 Page 2 of 2
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• &'-5' PLATE HEIGHT • ENTIRE LOWER LEVEL I NOTEW
(UNLESS NOTED OTHERWISE) I PROVIDE DOUBLE TOP
• PROVIDE V2' GYP. Bp. •BASEMENT CEILING I CHORD BEARING FLOOR
TRUSSES •FRONT OF
4 ALLOW SO SG2FT. (MAX) OPEN CLG. AREA HOUSE ITYP.)
FOR MECHANICAL, FIRE BLOCK TRW SPACE
• PERIMETER OF OPEN AREA
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FOUNDATION CONST. NOTES v
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• POURED CONCRETE FOUNDATION, VERIFY I
ALL WALL DIMENSIONS w/ FOUNDATION I Q
CONTRACTOR
• ALL EXTERIOR FOUNDATION DIMENSIONS
ARE TO OUTSIDE OF EXTERIOR FOAM
BOARD INSUL. OR SHEATHING, FOUNDATION I
TO BE HELD IN WHERE NOTED/SHOWN I
• PROVIDE 2' RIO FOAM BOARD INSULATION
• EXTERIOR FOUNDATION WALLS 4 1' R5
FOAM BOARD INSULATION AT INTERIOR
SIDE OF FOUNDATION WALLS (TYP.) I
I
• INSULATION 4 AIR BARRIER TO BE CONT.
OVER TOP OF FOUNDATION WALLS (TYR)
I
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9
DOOR 4 WINDOW NOTES
• GENERIC WINDOWS SPECIFIED, VERIFY
ROUGH OPENING SIZES FOR DOORS 4
WINDOWS w/ MANUFACTURER
• WINDOWS with'*' REQUIRE A SASH
STOPPER (TYR)
• ALL WINDOW 4 DOOR OPENINGS TO HAVE SHEET
(2)2x10 4 GRADE HEADER or BETTER O
(UNLESS NOTED OTHERWISE)
• TOP OF RO. FOR ALL WINDOWS ON
LOWER LEVEL TO BE b'-I0 1/2' FROM OF 7
FLOOR (UNLESS NOTED OTHERWISE)
UASEMENT FINISHING PL,4N v4'•I'-0' CADD FILE •
®COPYRIGHT 20W-2023 NOTICE, ALL RIGHTS RESERVED 1352 SQFT. FINISHED BASEMENT AREA 23"
CROIX DESIGN and DRAFTING, INC.
55'-S'
4'-0' 15'-4'
V.S.
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16, Or- (TYP-)
• 24 O.G.
--------
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DOOR 4 WINDOW NOTES
• GENERIC WINDOWS SPECIFIED, VERIFY
ROUGH OPENING SIZES FOR DOORS 4
WINDOWS MANUFACTURER
9
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CONTINIL XS TO CORNERS
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CONTINUOUS TO CORNERS
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(UNLESS NOTED OTHERWISE)
• TOP OF P.O. FOR ALL WINDOWS ON
s" �E�n LESSNO HE WISE)
®COPYRIGHT 2012-2016 NOTICE, ALL RIGHTS RESERVED
CROIX DESIGN and DRAFTING, INC.
A
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MAIN LEVEL PLAN I/4'•I'-m'
1642 SOFT. MAIN LEVEL
14
Wisc.onSin Depanment of Commerce SOIL EVALUATION REPORT Page t of —3—
Civisjon of Safety and Build ngs
in ac-cordance With Comm 85 is. Aom Code
Ccxinty
Mjs
incJude. but no( limited to verlical and hoflizontal reference
Atta ch com p] e te sits elan or ;,-. a rx.-, r r i ot 1 es-5 1 ha n F 1 )1`2 x dionand t Parcel LD
percent siope. scale or d limen sions, now arTocafion and distance to nearest rjad.
020— //6)2, -<-/O
Please print i i0jjjN 0 8 2004 Date
Pamonal information you provice may be usied f pokes. (Privacy Lao, s 15 04 (1) (m)) or
Pmp" 0"e r 7 P'r-�)perty Location
G04VI to!" 1/4 E (oo ,7t,Ar "If 1"JIA S �/T N R
Prcperty Owner's Mai liN Abdlress Los Block # Ste. N-arne or CSKIP
CAY State Zip Code Phone Number C.
ity Village 0
lily
14 New Gccstrucbon Use' esidential � Number cif bedrooms Ce de�nved design flow rate —7--� GPD
Replacement El Public cjr oommeri:-,aal - Describe.
Parent materiia Flow Plain elevptby if appl.icable &-77it z7 t,
General comments e---y
and reoDmn-�rdatjon
oe
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Bing #
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depth
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Effluent #1 = BOOS > 30 < 220 m9l and TSS >30 < 150 mg& 'Effluent #2 z- BOD d, < 30 nogg``. and TES < 30 mw�VL
CST Name Flieaw Prat) Signa CST Numbef
Bird Plumbing. Inc. Shaun Birdw..226900
Address, Date Evaluaiiion Conducte-.,, Teiepnone Ni,jrrber
1008 192nd Ave, New Richmond, W1 54017 715-246-4516
P ro peq der Parcv-d ID Page of
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Effluent #1 = BODE > 30 < 220 mg)1- and TSS >30 < 150 mq,'L r-- M Ueril #2 :: B 005 �S 30 nigk any T 1,3S < 30 mql
-
The 1),epartment of Cornmerce is aii equal opportu,n] ty scr�. ice pmvider and employer, If you need assiSldnce to access serer iccs or
nccd matchal in an alto ate fbirrnat, pl-ease contact the depirimew at 608-266-3 151 or 17Y 609-IMA-9777,
Effluent #1 = BODE > 30 < 220 mg)1- and TSS >30 < 150 mq,'L r-- M Ueril #2 :: B 005 �S 30 nigk any T 1,3S < 30 mql
-
The 1),epartment of Cornmerce is aii equal opportu,n] ty scr�. ice pmvider and employer, If you need assiSldnce to access serer iccs or
nccd matchal in an alto ate fbirrnat, pl-ease contact the depirimew at 608-266-3 151 or 17Y 609-IMA-9777,
r�
Soil Test Plot P n
Project Name Lis Hoyer Nelson
�un Bird
Address AC;Q (-',ilhort Rd.
Hudson Wi 54016
Lot 4 Subdivision
SW 1/4 N W 1/4S 34 T 29 N/R1 9
R"
V CSTM #226900
Date 6/6/04
Township Hudson
O-r r MnIv
Boring 0.' N,Vell PL Property Une L;ouniy b
BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post
System Elevation 93,1/92-3 *HR'Same as Benchmark
Alternate Benchmark Top of Survey Iron @ 97.0
M
Parcel#: 020-1102-40-300 02!2812008 10,02 AM
PAGE 1 OF 1
Alt. Parcel #, 34.29 19 408D-40 020 - TOV,,N OF HUDSON
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Ap pJ7 11cation Permit # Permit Type
04/05/200 Dr- 00 0
Tax Address: Owner( ): 0 = Current Owner, C - Current Co -Owner
0 - NIELSEN, LIS H TR
LIS H TR NIELSEN
1 91 7 TWILIGHT LIB
HUDSON WI 54016
Districts.- SC = School SP Special Property Addlress(es�: Priii'lary
Type Dist # Description (36-1 (�ILBERT PAD
C 2611 HUDSON
SID 1700 WITC
Legal Description: Acres: 3.508 Plat: 4967-CSM 19-4967 020-05
SEC 34 T29N R 1 9W S"I NW 9. 79 ACRES LOT 1 Block/Condo Bldg: LOT 07
CS%,1 7,1806 & LOT 1 CSM 7/1813 NKA CSM
19-4967 LOT 7 (3-508) Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
34-29N-19W
. RN
2008 SUMMARY
Valuations:
Description
RESIDENTIAL
Bill #:
Class
G1
Parcel History'
Date Doc # Vol/Page Type
08/31 /2006 83-3474 Qc
04/05/2005 791401 19/4967 CSM
07/23/1997 816/122
Fair Mt i-kct VZflkw.
Assessed with:
Last Changed: 05/30/2006
Acres Land Improve Total State Reason
3 -,-5 0 8 78,000 a 78.000 NO
Totals for 2008:
General Property 3,508 78,000
Woodland 0.000 0
TotL-Os for- 2007,
General Property 3.508 78,000
Woodland 0.000 0
Lottery Credit: Cie-i'lm C0L1,t1t 0 Certification Date:
Specials:
User Special Code
0 78,000
0
0 78,000
0
Batch 4:
Category
F.4%7 no=
Special Assessments Special Charges Delinquent Charges
Total Mo 0.U0 0 00
Audio Video Planners
Ault, David
434 Hale Ave - Ste 160
Oakdale, MN 55128
Bus: (651) 747-8081
Mobile: (612) 730-6207
Bus Fax: (651) 747-8141
E-mail: dault@audiovideoplanners.com
B & L Land Development
Geissinger, Barb
PO Box 333
Balsam Lake, WI 54810
Bus: (715) 485-3351
Mobile: (715) 222-3023
Bus Fax: (715) 485-3335
Baillon, Paul
E1404 First National Bank Building
332 Minnesota Street
St. Paul, MN 55101
United States of America
Bus: (651) 222-5555
Bus Fax: (651) 222-5556
E-mail: baillon@usfamily.net
Bast, Kernon
948 LaBarge Road
Hudson, WI 54016
Bus: (715) 386-0217
Home: (715) 386-7775
Bus Fax: (715) 386-8660
Baypoint Development
Fassino, Mike
757 Packer Drive
Hudson, WI 54016
Bus: (715) 386-0902
Bonte, Ron
Cornerstone Ridge
10 11 170th Street
Hammond, WI 54015
Home: (715) 796-5240
Mobile: (715) 760-1126
Bus Fax: (715) 796-2519
Brightkeys Building & Development Co.
Mill, Jiro
707 Commerce Dr. - Ste 410
Woodbury, MN 55125
Bus: (651) 501-6500
Mobile: (612) 221-0540
Bus Fax: (651) 501-6600
Christensen, Kurt
Home: (715) 386-6340
Mobile: (612) 812-1084
Bus Fax: (715) 381-6764
La
Dalstock LLC
Dalton., Steve
816 1 B6th St.
Roberts, WI 54017
Home: (715) 749-3538
Dalstock LLC
Stack, Bill
1748 112th Street
New Richmond, WI 54017
Home: (715) 246-4112
Mobile: (715) 760-0219
Derrick Construction
1505 Highway 65 South
New Richmond, WI 54017
Bus: (715) 381-3423
Derrick, Steven
1438 County Road G
New Richmond, WI 54017
Bus: (715) 246-3120
Environmental Moldings
Sherman, Bill
703 Pine Street N
Hudson, WI 54016
1
Germain, Mike
Grand Properties LP
822 Germain Lane
Hudson, WI 54016-7066
Bus: (715) 247-5900
Hawkins, Mike
1418 Winding Canyon
Caty, TX 77493
Pam Quinn 1 2/27/20081:55 PM
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CERTIFIED SURVEY MAP SURVEYlR:
LOCATED IN PART OF THE SW1 /4 OF THE NW1/4 OF SEC11ON 34, T29N, R19W, TOWN OF HUDSON, ST, CROIX DOUGLAS J. ZAHLER
COUNTY, WISCONSIN, BEING LOT 1 OF A CERTIFIED SURVEY MAP RLCORDED IN VOLUME 8, PAGE 2217, LOT 1 S & N LAND SURVEYING. INC.
OF A CERTIFIED SURVEY MAP RECORDED IN VOLUME 7, PAGE 1806 AND LOT 1 OF A CERTIFIED SURVEY MAP 2920 ENLOE STREET
RECORDED IN VOLUIVIF 7, PAGE 1813 AT THE ST. CROIX COUNTY REGISTER OF DEEDS OMCE. HUDSON, VA 54016
NOTE:
NO ADDITIONAL PLATTED NW COR. PREPARED FOR: OWNER:
+SEC. 34
LOTS MAY TAKE ACCESS BILL SHERMAN LIS HOYER NtELSEN
FROM THIS EASEMENT 703 PINE ST- N_ 659 GILBERT RD.
UNLESS ALL STRUCTURES �'� HUDSON, W 54016 HUDSON, N 54016
ONFORM TO APPLICABLE
0 -1-OT'2 C.S.M. IN VOL. 6 PG. 1626
Cmi
SETBACKS AND COUNTY 00
cn
ROAD STANDARDS ARE JOINT LO�f I I UNPLA'FTED
ACHIEVED- I I FACCESS r, r, wnF ACCESS KjOn -A A'A r- "C_ y A Ni F%Q
U-
0
LASLML T FOR LOT 'I S89059'43'PE 1315.46'
r
SHED ENCROACHES
LEGEND
:3 y:
6
ROACHES 3'
FOUND ALUMINUM
COUNTY SECTION
z
co
-SEPTIC LOT
CORNER MONUMENT
A VENT _* 6
FOUND I" DIAMETER
BERNTSEN STEEL
&-4
w
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26473 I LJ
ENCROACHES 4k
I pl- lj' IRON PIPE
FOUND Sl 2'
SURVEY MARKER
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FOUND I" OUTSIDE
DIAMETER PIPE
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r 231.73'
268.%32' FROM SET 1'
N88*58'56wE IRON PIPE
IRON
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05'33mW 0.76' FROM' SET
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1" IRON PIPE
RECORDED BEARING (CD3 ........... jj� 1pll. " p 1 f, y I"
SHEET 2 N89`59`43"W 781.71
AND/OR DISTANCE (N89*44'46"E) w
.3 LOT ui
A
LOT 4 Cj'
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,ff
EXISTING BUILDING 3.00 un AbA I \ N ------------
W co OD U)
A
ir r" LOT2. LO'f 3
'P' A
z 0(,A ------------ ------------
EXISTING DRIVEWAY 26%63 j�i
C) (3 LO ro p
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SET lry OUTSIDE DIAMETER BY V-) r- LO 0 ro
co co T_
o 11 eq 04 Ir- 0
18" LONG IRON PIPE, WEIGHING L---.-33'33 zo p 4 V)it
1.13 LBS. PER LINEAR FOOT p 0 N8957'42'E CJ3.M. IN VOL. 8 PG. 2117 Ell /4 Obi.
6 6'-; - 3,3. 00"'::' 0 WELL ---------- SEC. 34
to z 00�--<
.......................... ROADWAY SETBACK I 49.
INN Wl /4 COR. 520-00 4731.02'
(100' FROM RIGHT - OF -WAY) SEC. 34 n
-H S89*57"42W 533. LOT AREA TABLE
2m IRON PIPE FOUND (N89'56'40"F) -H
SEPTIC VENT
Lot # Description SQ. FT. ACHFS
N85*59'57"E 0.69' FROM - .-EAST-WEST 1/4 LINE
SET 1' IRON PIPE LOT LOT 4 INC RW 96P644 2.219
13
SCALE IN FEET 1 200 LOT 4 EXC RW 87,335 2.005
PLAT OF STEWAR_1_1kS- ADDYFION LOT 5 INC RW 89,423 2.053
=NEW LOT 5 EXC Rat 87.245 2.003
200 0 200 S89*57'42'wW 5264.02' LOT 6 INC RW 267,142 6.133
THIS INSTRUMENT DRAFTED BY: WLLIAM KANE LOT 6 EXC RN 256.807 5.895
JOB NO. 6427-01 DATE-- 06/09/2004 REVISED: 06/21/2004 LOT 7 EXC RW 152,827 3.508
Parcel 020-1102-40-200 Olilgi'2005 04-31 PM
PAGE 1 OF -1
Alt. Parcel #: 34-29-19,408D 020 - TOWN OF HUDSON
Current X ST- CIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address:
Owner(s): Current Owner
LIS H NIELSEN
'NIELSEN, LIS H
,659 GILBERT FAD
HUDSON W1 54016
Districts, SC School SP Special
Property Address(es):
Type Dist # Description
659 GILBERT RD
SC 2611 SCH D !IF 'HUDSONI
SP 1700 WITC
Legal Description: Acre S4 . 9-790
Plat: NiA-NOT AVAILABLE
SJL-2�291\11 1 19W SW NW 9,79 ACRES LOT 1
-
Block/Condo Bldg:
CSM 7/18-0-1 & LOT 1 CSM 7/1813 1
L-At�
Tract(s): (Sec-Tern-Rng 40 1/4 160 111-'4)
34-29N-1 9W
foot :
Parcel History:
Date Doc # Vol/Page Type
07/23/1997 816/122
2004 SUMMARY Bi I I Fair Market Value: Assessed with:
176,400
Valuations: Last Changed: 10/29/2001
D cz; c r i p t i o n C lass Acres Land Improve Total State Reason
RESIDEN G 1 6 C IJ 58,700 7 7.8 0 136,500 N 0
Totals for 2004:
General Property 6.280 58,700 77,800 136,500
Woodland 0.000 0 0
Totals for 200 3 -
General Property 6.280 581700 77,800 136,500
Woodland 0,000 0 0
Lottery Credit: Claim Count: I
Specials:
User Special Code
018-RECYCLING
Certification Date:
Special Assessments
Total 27.00
Batch #: 136
Category
SPECIAL ASSESSMENT
Amount
27 00
Special Charges Delinquent Charges
0.00 0-00
425548
CERTIFIED SURVEY MAP
NW CORNER LOCATED IN PART OF THE SWI OF THE NW J OF SECTION 34, T29N, R19W,
SECTION 34 TOWN OF HUDSON, ST. CROIX COUNTY, WISCONSIN.
T29NF R19W
89044146"E
843.951
CERTIFTED SURVEY MAP VOL 69 PG. 1626
---------------------------
S89044146"W
T 471.51'
I
CD
CD
0
co
LOT I
Z_
41-1 rri 152,824 sq. ft.
3.51 acres
NJ
This lot is being deeded to an adjoining
3C
owner. Title to this lot may not be
transferred to anyone other than an
adjoining owner without approval by the
Town of Hudson and the St. Croix County
Zoning Committee.
470.761
N89"4414611E
unplatted lands owned by platter
C) I
V) C:) 1 :3
0 Ir-
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FILED
MAY 121981
1"Is 01 CONNIELL
IN FEET
UQWW Of Dwadj
-SCALE
sk cn4x cown f)"
L a
w6cmjjr
100 50 0
-V
3,
OWNER
Elmer Fyksen
1 -4
805 Vine St.
Hudson, Wi. 54016
0-1 107
4P-
' 4
VJ Ul
RJRa
W� CORNER
SECTION 34
LEGEND
I k-1
T29N, R19W rt- rD
St. Croix County Section
Corner Monument
44— M 0
0 CD
1" iron pipe found.
0 --m CL
CD
c2
Ill x 2411 iron pipe weighing
1.68 pounds per
0
linear foot, set.
W" 0
A P PROS
ye
Volume 7
Pa 1813
MAY 1 J 1(
this instrument drafted by Douglas Zahler job no.
85-49
AND 70NIeNG
I OOK
wisoorr;m Departrwt of Comnerce SOIL EVALUATION REPORT Page
Dwtim of Safety and Buildings in a0cmCianem with Gorm 85. Wis. ,Adm. Code
Cj0U*
Attach cornOete site plan on paper not Tess than 8 1 01 t 0, f:2"
rL s than I J1 panzx-4 i n
irdWe, but not hmited to, verfirzi and ho'zcrAW ret ence
ho;j al )2
pement Wope. scale of di . rnenskwm. north a bon and d istan ce to n L;- arest d. 020-414
A
j
Please Pont i Ir o-
r 4 P (Pt*ary Law. & 15 04 (1)1
ftmonal irOwmation yw provide may be used f P 4
Lt
P-0 G round surface e I e v/,/
Depth to hmiting factor
0=11
re Con5tstence Ekyjr)c
Sh.
Doing Z " K71
Depth to fimifiw�g fx'Aw
Pi! Ground sorface ele
Ball
kz�<xi Rate
Horizon
DepO
Dw*wnt Cokm
RAdox Descroon
Texture
Structure
Consilsience
Boundary
Roots
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im
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> 30:: 2M qxA 'woj 90 EfRuent 02 = 90D!-e 3�6 M-_r�q ;aM T&R e- 30 ffwffl.
C37 Ndrnv (PIMM PW) Signal CST Number
B1r-(J PlUnihinq, Inc. Shaun Bird 226900
ooB 1192nd Ave. New Richmond, W1 54017 715-2 46 - 45 16
Page— —,Of -. - — --
pamel 10
Ropwly Owner
Ewoerg# D Bonng Depth j() Iiinniting faC10( 0
434aLind surf am e48v.
-,AN.FeN, I
Wng # D U06N DaW to Wn" faclor ---- in. -��Pac� Rate
0 P,, Curmnd surface elev.
GPDff
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in. Munse U. z
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QLJ, Sz. COM, cotof Gr. Sz Sh- I -EMI
in. Mu"Seg I I ttltt— I I
>30 < 150 rno'L, Lffk*nt #2 = BSI 130 rrvgk and TSS < 30 mqL
Effluent # i -= BOO > 30 220 mg/L and TSS
The Department of Commerce is alrk I opponunity scrvice provider and employer. if you need assistance to access vices or
need material in an afterMte fornut, please contact the department at 608-266-3151 or TTY 008-264-877'7-
I
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14"1
1
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So1*1 Test Plot P
Project Name Lis Hoyer Nelson
Address ilbert Rd.
Hudson Wi 54016 CSTM #226900
Lot 4 Subdivision Date 616M4
SW1/4NW1/4S34T29 N/R19 W Township Hudson
F-1 Borilig G Well PL Property Line County ST. CROIX
66 BM or VRP Assume Elevation 100 ft., Top of Steel Fence Post
System Elevation 93-1/92.3 *HRpSame as Benchmark
Alternate Benelitnark -Top of Survey Iron @ 97.0
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LEGEND
CERTIFIED SURVEY MAP
SURVEYOR:
LOCATED IN PART OF THE SW1/4 OF THE NW1/4 OF SECTION 34, T29N, R19W, TOWN OF HUDSON, ST. CROIX
DOUGLAS J. ZAHLER
COUNTY, WISCONSIN, BEING LOT 1 OF A CERTIFIED SURVEY MAP RECORDED IN VOLUME 8, PAGE 2217, LOT 1
S & N LAND SURVEYING, INC.
OF A CERTIFIED SURVEY MAP RECORDED IN VOLUME 7, PAGE 1806 AND LOT 1 OF A CERTIFIED SURVEY MAP
2920 ENLOE STREET
HUDSON, W1 54016
RECORDED IN VOLUME 7, PAGE 1813 AT THE ST. CROIX COUNTY REGISTER OF DEEDS OFFICE.
NOTE:
NW
NO ADDITIONAL PLATTED SEC.34OR. PREPARED FOR:
OWNER:
LOTS MAY TAKE ACCESS BILL SHERMAN
LIS HOYER NIELSEN
FROM THIS EASEMENT
703 PINE ST. N.
659 GILBERT RD.
UNLESS ALL STRUCTURES
win LOT 2 HUDSON, WI 54016
C.S.M. IN VOL. 6 PG. 1626
HUDSON, WI 54016
CONFORM TO APPLICABLE
9------------ ---------------------I------- ---------------
r'LOT 1
i Ul®TPLATTED
RE ROADSTANDARDSARE
0 JOINT
ACHIEVED. ACCESS 66' WIDE ACCESS I (N89'44'46"E)
------------------------
I I,AXT".
FOUND ALUMINUM
COUNTY SECTION
CORNER MONUMENT
FOUND 1" DIAMETER
BERNTSEN STEEL
SURVEY MARKER
FOUND 1" OUTSIDE
DIAMETER IRON PIPE
RECORDED BEARING
AND/OR DISTANCE
b�lT��1:111I��IPIr
EXISTING DRIVEWAY
IEASEMENT FOR LOT 7 I �+ I -------------
0 S8959 43 E 1315.4fi
w \ SHED ENCROACHES 6.1282.46
z • _33,00 : -�- SEPTIC VENT ENCROACHES 3 - - - - z o LOT 5
p H 17 LJ------------
Lu
ao �' w w �to a e SEPTIC LOT LOT W H\ z 3w w
N
;--, CID®A VENT 3 6 z w� r-
2
N N Wi rfi �_� ENCROACHES & " 7 0 o �f
w w M rn ri 9• %^ 1 IRON PIPE 0 '00 N
FOUND S12
Ln O S89 59'43"E $0 08'44"W 1.00' 1" IRON PIPE FOUND N15' � � li
c° Q 3 -33.00' : 268.32' ' ; FROM SET 1" 05 33 W 0.76 FROM SETS p
0 o C �n 231.73' ' ' N88'58'56"E IRON PIPE 1 IRON PIPE 'q;
Z Q n �f
... z o = SEE DETAIL SHEET 2 N89� 9'43"W 781.71' 1 Ail/ H
— .
o; • L T (N89 44 46 E) I W
2.3.63 I L®T 4 �f� W
AA
W; "t89'50'43"E ->: a s w LOT 2 �� LOT 3 �,;
JLn All
to n 0 to
rn------------------------
SET 1" OUTSIDE DIAMETER BY jj
i
N
N
� LOT �^ _�
o o �, � 1 �fr
18 LONG IRON PIPE, WEIGHING
to Q 4 194.19 »
0 cn j
z
1.13 LBS. PER LINEAR FOOT
o N89 57 42 E
C.S.M. IN VOL. 8 PG. 2117 1 E1/4 COR.
ROADWAY SETBACK LINE W1/4 COR.
6
6;
33.00' 0 WELL 4900'-=:
• .
---------------------------------��-------- 1 • SEC. 34
—r I 4731.02 ---Jfs
(100' FROM RIGHT--OF-WAY) SEC. 34
S89*57042"W 533.00' 1
I LOT AREA TABLE
2" IRON PIPE FOUND
�
(N89 56 40 E) I �
I
SEPTIC VENT
N85 59 57 E 0.69 FROM
0
1 N
EAST -WEST 1 /4 LINE 1
I Description SQ. FT. ACRES
I Lot # P
SET 1»IRON PIPE
LOT 13
LOT 8 LOT 4 INC RW 96,644 2.219
LOT 4 EXC RW 87 335 2 005
SCALE IN FEET 1 " = 200'------------9 ------------ '
1 YLAT OFb I I WART AIJ"l 1--01\T
LOT 5
1NC RW
89,423
2.053
--------------------------------------------------------
LOT 5
EXC RW
87,245
2.003
200 0 200
, Ftt>A%j CT r> C.ar'R-RECCTnoN S89'57'42"W 5264.02'
LOT 6
INC RW
267,142
6.133
THIS INSTRUMENT DRAFTED BY: WILLIAM KANE -Vor, NO. It34D51 't[b�Z.bZ.I
LOT 6
EXC RW
256,807
5.895
JOB NO. 6427-01 DATE: 06/09/2004 REVISED: 06/21 /2004
LOT 7
EXC RW
152,827
3.508
a�
0
a
v's
0
m
0
TTT
VJ
0
0