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HomeMy WebLinkAbout020-1327-90-000 9 10 ji STC - 104 MOAB AS BUILT SANITARY SYSTEM REPOR W. 07 OWNER ADDRESS SUBDIVISION / CSM#~ ' ~-s N~ LOT # 7 SECTION a T,N-R_,V W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF S Ce INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: ALTERNATE BM: ~r/~/,~.~L • ~v a t c9,/v - SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: Liquid Capacity Setback from: Well House~'~~ Other Pump: Manufacturer Model# Size Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM Width:_ Length- Number of trenches Distance & Direction to nearest prop. line:_~S_ b~~sT Setback from: well: House Other ELEVATION Building Sewer 1,57_2d7 ST Inlet: b p/. ST outlet:-ed/D/`// PC inlet PC bottom Pump Off Header/Manifold Bottom of system ,0-5 /G5. Z-/ Existing Grade-,/V-/,,5- rade < 5- Final grade DATE OF INSTALLATION: - ~7 PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: 3/93:jt Safety and Buildings Division SANITARY PERMIT APPLICATION Bureau of Building Water Systems V'■~■■■~ 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. l • See reverse side for instructions for completing this application State Sanitary Per- it NN6mbber The information you provide may be used by other government agency programs E] CheLk it revis to revious application (Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION Prop ner Name f Property Location y 1 /4 1)4, S T , N, R i. €Aor) W Property Owner's Mailing Address Lot Number Block Number City, State Zip Code Phone Number Subd•iyjsi n Name or CSM Num er II. TYPE F BUILDING: (check one) ❑ State Owned ❑ !t Newest Road" 11 1/ j ) Public ❑ 1 or 2 Family Dwelling - No. of bedrooms l;n Iowan OF / III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo /3.-n-~r-y lo 2-41. 2 11~. 19 Ug 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. ;Ki 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 Issue V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Oher 1 1 Seepage Bed 210 Mound J 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation ~w Feet . )Feet TANK Ca acit VII. in allons Total #of Prefab. Site- Fiber- Exper INFORMATION g Gallons Tanks Manufacturer's Name Concrete Con- steel glass Plastic APP New Existing structed Tanks Tanks I Septic Tank or Holding Tank / r K1 El 1:1 El ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the nder igned, assume responsibility,for ins't( Ilation of the on ite sewage system shown on the attached plans. Plury+b~er`s Name Print) PlumbeisSig Wre.°(No Stamp EMPRSW No.: Business Phone Number: r ff PI mber's A dress tr. t, Oty, State, Ziptode): r IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Agent Signature (No Stam Surcharge fee) . Approved F1 Owner Given initial _ Adverse Determination r~ ` } X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SOD-6398 (R. 05/94) DISTRIBUTION: Original to County. One copy To: Safety & Ruildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair: V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7_ VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement- Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X_ County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. - - - - - - - - - - - - - - GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. I I 1 - 1 I i; t}+ I+ f; j a~ ~ i i : /A/ . .300 Labor and H44An RetaL "au n • • v v r . n r v n v . • ' • ..n. v. , 01vision of §Afaty & BUMra g in accord with II.HR 83.05, Wis. Adm. Coda u Attaoh complete site I,an on paper not less than 8 1/2 x 11 inches in size. Plan must inolude, but St • Croix not limited to vertical. ntd horizontal reference point (BM), direction and % of slope, $0610 or PARCEL LD. « dimensioned, north tow, and locaton and distance to nearest road. pgnding APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Brid a a n GOVT. LOT W4 1/4 SE~/4,8 29 T 29 N.R 19;xf w) W PROPERTY OWNERS MAILING ADDRESS To BLOCK# SUED. NAME OR CSM rr 37 a $i F t Ad n. 11736 117th. St.' CITY, STATE ZIPCODE PHONE NUMBER CITY VILLAGE SOWN NEAREST ROAD T.akevilla, M. 55044 (612 985-5000 Hudson Crosb Dr. Exj Now Construction the be j Residential / Number of bedrooms E I Addition to existing building E E Replacement E j Public or ownweial Cade derived dairy Haw 450 gpd Recommended design loading rate . 7 bed, gpolft2 .O trench, gpW Absorption area required 643 bed, f}2 563 trench, R Maximum design loading rate._! 7 bod, gpd/ft2 •8 ttorlctt, gpolft2 Reoommended infiltration sudsoe elevation(s) _ 10515 ft (as referred to site plan benchmaN Additional design! site considerations trenches spaced to code 3.0' below surface el. Parent material otxtwash Flood plain eievation, it applicable - na fl S ■ Suitable for 8~shem CQNVEI'tfiiNAL 1v10UNA tN•L3RuUlVI PiiES9URE ATGRADE SYGTEM IN FN.L HOLDINs3 TANK U Unsuitable tat s hem ®S E l u ®S o u ®S ©U E S CJ U ®S o t) CIS tau SOIL DESCRIPTION REPORT Depth Dominant Color fVON0S Texture Structure Z✓pr~ipAno9 Botirtti~ry Roots GPD/t Boring # E lorixan In Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0-4 10yr4/3 none s1 2mgr mvfr CS 2f .5 .6 gZ 2 4-16 1.0yr6/4 none sil l.fgr mvfr 9w if .2 .3 i 3 16-84 7.5yr4/6 none mta Osg m1. na na L-7 .8 Ground eleY~ 108.5 K. f)epth to T. - Uminrhg factor Remarks, Boring # FL_ 0-6 10yr4/3 none S1 2mgr mvfr cry 2f .5 .6 ti S- t' M:: 6-27 10yr6/4 ricrn` sil lfebk mfr r if .2 1 .3 2 _ tr.a"s, 27-88 7.5yr4/6 mono ma Osg ml na na .7 .6 Ground 104. h, - Dow to IimiGng facia +8f3" Remarks: - Phone: CST Name:--Aeess Print 715-246-6200,_„ : - _ Addrees: 1554 200th, ve. , NeW ftic Zd, WWi.. 54017 _ i)ate: aT Numhm S'~nattXS: g_21-9 cstm 02298 PROPEMOWNf tt Rridael and DIAIr „CQ bwn- mcatonir v own ncr vn v PARCEL I.D. 8.__ _ zandincr Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistenoe 8atxicWy Roots `GPD/f In. Munsell Du. Sz. Cont Color Gr. Sz.'Sh. Red MWO S 1 x -5 10 rQ 3 none _ el mvfr .6 2 5-17 10yr4/6 none eil lfgr mfr 9w 1f .2 .3. Ground 3 17-84 .5ry4/6 none ms OBg nt1 na na .7 .8 J01. Z ft. Depth to hmiting E ~ ' fac o4r +9 a R8ni8rk8: Boring # X. -Q 0yz4/3 none sl 2tngr mvfr Cs 2f .5 t .6 2 -22 10yr4/4 none ail lfgr mfr gw if .2 ~ .3 3 2-80 7.5ry4/6 none ms Osg ml na na .7 .R Ground eiev. ' Cpl .1 ff. WPM to iimtdng NOW Soring # 1 -12 10yr3/3 none sl 2msbk mvfr CS 2f .5 i .6 k 5 2 12--80 7.5yr4/6 none ms Osg ml na na .7 .8 1 Ground 619v. i 4.5 ft. { i Depth to limiting factor ' +801' Realarks, t3prinG # .,M I Ground elev. I 1t. Depth to >'mit;ng factor f Romarks: - ~an ~a~nrri.ab~zt 14W STEEL'S SOIL SERVICE Gary L, Steel Hridgeland Dev. Co. 1554 200th Ave. CSTM2298 NE%SEk S29-T29N-Rlgw New Mohmond, WI 54017 MPRSW 3254 town of Hudson (715) 246-0200 lot #37--St. Croix Estates 5eocnd hddn. N 1"=40' BM.- top of mid lot survey stake 9 el: 100' I ~DSS 1055 +4L- t° s rn Vol 1-6 Mil 17-07o ,ACC - a~ a '3po' Gary L. St el -21-96 --2 9 Ae ~ ~ r~ i✓,~ ~s,~ Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations Safety and Buildings Division INSPECTION REPORT ST. CROIX (ATTACH TO PERMIT) SanitaryPermitNo.: GENERAL INFORMATION 284253 Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.: CALAWERTS MARK HUDSON CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 020-1327-90-000 TANK INFORMATION ELEVATION DATA 97 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet Vent irl to ntake ROAD Dt Inlet TANK TO P/ L WELL BLDG. A Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft Head Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type Of CHAMBER Mode Number: System: OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing 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 ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: HUDSON.NE.SE.29.29.19W 719 CROSBY DRIVE Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: I SANITARY PERMIT APPLICATION BuSafetyreau o off Bui BuiildinWater System! ng Water 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County 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 E] Check it revision to previous application [Privacy Law, s. 15.04 (1) (m)]. 7/1 J pmv,~,,Kp .r / State Plan I.D. Number 1. APPLICATION INFO MAT ON - PLEASE PRINT ALL INFORMATION pen Pro ner Nme Property Location 1/4 1/4, S T , N, R a~l(or4 Pr perty wneI s al ing Address Lot Number Block Number CI t to Zip Code Phone Number Subd i me or CSM Num er ~Q ( ) <1:G11, - II. TYPE F BUILDING: (check one) ❑ State Owned ❑ City Near Road ❑ Village Public 1 or 2 family Dwelling - No. of bedrooms Town OF. III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo ag. aq. /9. i7o X-C-?7 - 90 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. KNew 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 ~ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 Seepage Trench 22 ❑ In-Ground Pressure 42E] Pit Privy 13E] Seepage Pit 43E] Vault Privy 14E] 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./inch) Elevati n Feet eet VII. TANK Ca in gallons Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel lass Plastic App New Existing structed g Tanks Tanks Septic Tank or Holding Tank E] ❑ El El ejTb 1 4" jZhj::~ Lift Pump Tank /Siphon Chamber ❑ ~ ~ EI F1 VIII. RESPONSIBILITY STATE-MENT 1-1 I, the ders ned, a~su a responsibility for i a atio oft a ons'te sewage system shown on the attached plans. uPluenber'sA e ame: ri Plum Ign o Sta ps MP/MPRSW No.: Business Phone Number: ress I, State, I o e): IX. COUNTY /DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee 9 9 9 (Includes Groundwater Date Issue Issuin A t Si 2E? pproved F1 Owner Given Initial Surcharge fee) GL1 A~ j A dverse Determination ; X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: SOD-6398 (R. 05194) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1 . A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. 111. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. i jys I 1 i j , , I I i { ; ~ I ; i I ! I I I ; I i I ! , I 4 I i j I I li 111 I , -j- -f j , I f t i I i_ j ' i ~ i I I I I I I I t I i I { I 4 ~ f ► I 1- j ~ r i_ I{ j I I i I I j - . • 1 I I r f I { I I} f M ~j I f j i j } ~ ll Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 4- of -3-- Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY ' Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or P t 0 # R dimensioned, north arrow, and location and distance to nearest road. / end'• " APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION R WEDBY.: ~.A PROPERTY OWNER: PROPERTY LOCATION Brid eland Development Com an GOVT. LOT NE 4 1/4 S ' f S 29 T; -2~.; ,N,R 19w W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUED. R CS(#; 11736 117th. St.' 37 na St. `>Jsts" Addn. CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE [MOWN i iAaEyS - D` Lakeville, M. 55044 (612 985-5000 Hudson r• [X] New Construction Use Residential / Number of bedrooms 3 Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate .7 bed, gpd/ft2 .8 trench, gpd/ft2 Absorption area required 643 bed, ft2 563 trench, ft2 Maximum design loading rate • 7 bed, gpd/ft2 - 8 trench, gpd/ft2 Recommended infiltration surface elevation(s) 105.5 ft (as referred to site plan benchmark) Additional design/ site considerations trenches spaced to code 3.0' below surface el. Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ® S ❑ U ® S ❑ U ®S ❑ U ®S ❑ U ®S ❑ U ❑ S fRU SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Bouirday Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0-4 10yr4/3 none sl 2mgr mvfr cs 2f .5 .6 If .2 .3 2 4-16 10yr6/4 none sil lfgr mvfr 91%T Ground 3 16-84 7.5yr4/6 none ms Osg ml na na .7 .8 elev. 108.5 ft. Depth to limiting factor +84" Remarks: Boring # 1 10-6 10yr4/3 none sl 2mgr mvfr cs 2f .5 .6 2 2 16-27 10yr6/4 none sil lfsbk mfr 9w If .2 .3 3 127-88 7.5yr4/6 none ms Osg ml na na .7 .8 Ground elev. 109.5 ft. Depth to limiting factor +88, Remarks: CST Name:-Please Print Gary L. Steel Phone: 715-246-6200 Address: 1554 200th. Ave. , New Ric ond, WI. 54017 Signature: Date: CST Number: 8-21-96 cstm 02298 PROPERTYOWNER Bridqe1,and pov ;n SOIL DESCRIPTION REPORT Page.2 - of PARCEL I.D. # bending Depth Dominant Color Mottles Texture Structure Consistence Bouidary Roots GPO/ft Boring # Horizon in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed TmrK:h1 0-5 10 r4/3 none sl 2m r mvfr 2f .5 .6 La 2 5-17 10yr4/6 none sil lfgr mfr gw if .2 .3 Ground 3 17-84 .5ry4/6 none ms Osg ml na na .7 .8 elev. 107.2 ft. Depth to limiting factor +84" Remarks: Boring # 1 -4 0yr4/3 none sl 2mgr mvfr cs 2f .5 .6 ti 2 -22 10yr4/4 none sil lfgr mfr if .2 .3 gw 3 2-80 7.5ry4/6 none ms Osg ml na na .7 .8 Ground elev. 104.1 ft. Depth to limiting factor +8 Remarks: Boring # 1 -12 10yr3/3 none sl 2msbk mvfr cs 2f .5 .6 5 2 12-80 7.5yr4/6 none ms Osg ml na na .7 .8 Ground elev. 104.5 ft. Depth to limiting factor +80" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) ' STEEL'S SOIL SERVICE Gary L. Steel Bridgeland Dev. Co. 1554 200th Ave. CSTM2298 NE4SE4 S29-T29N-R19w New Richmond, WI 54017 MPRSW 3254 town of Hudson (715) 246-6200 lot #37-St. Croix Estates Seocnd Addn. N 1"=40' B1.= top of mid lot survey stake C el. 100' I<o5S ~ nyS 4,1 Lo S,rn Ito Vvl9-P5 J951 I 17-07o tf- 5 l EpL V 0 4300 Gary L. Steel 8-21-96 FROM : Composite Construction Systems PHONE NO. 715 386 9878 Feb. 19 1997 09:23AM P02 . a, M)" PIP[ r(NA p•16u rh•'o a•• 'w •.'t' O rCw•-J-rv a•pvao-w, O w' T~ of 161vAtc vPA. 16.71 64•[11 JA ftC. •2' KC aror town!!' ro flail 13H 49' NJatM LIN( 8 rNt N1.Il J/ !M1 {rl/l, {CS ltE9.2"28'E 14, LOT 4,2 LOT 41 11 LOT 29 +c+t' Re 1" [1v1, i ~ atoLas ACREA .tor 'o. n. i 111.111 •T 'T.tl1 H l* ~ yl ; 1 I - 1 r. r r •'r ` LOT 30 = LOT 40 R. , .l .••t1 '.6 Si n _ a:16t1 a r l ,y { l) +c. 149 1'v l LOT 31 a'Ylt tl'1 ul.of' ~ ~ ~ ! • {01' i = 16:1u ~ •,1 t. . 1 ' , 1.06 i^ MAY. _ 19{.op ~ Lod' 39 1 a};.'O '3. PT ,a it r ',a• acs[' , r ~ ~ IQ ; , III +,:1-•+ / J M FL • , i Ll I •1 y . f~~.r• LOT 32 LOT 33 IT . tt ',r ? 1 ` Y 'Y 1.16f 16:•1} M ~~t ~ LOT 316 r'•' 1 A.P•! { }3 R IL:r1 t: . r r I F: h111111 Is* 0 its Lt F ~ LOT 37 ' ~ , ~ . •v'elt _ _ ~~z:':• •f ¢ 1616 ~•It aae! ~ arr ` Ift.1}l n L07 36 s 0 t•: L. =.h l:P[/ Na'•at Y{•t Nt.l1 b .•y.at= t0 R ae.:-7 1616 n. ti ~I . - ~ . , ; r• LOT 35 LOT 34 _l zd x s a I. a::t[ a s a l t.` Ni{{ 1116 Y{'{ Pat,m w1 0's 4 lll.ll 1:.-- .,K >r pK. .y{ul A •K KI•l. 11:. to Sill g'Yd'N 1121.11 DIRECTIONS: FROM 1-94 TAKE EXIT TWO (2) LEFT/NORTH ONTO CARMICHAEL TO COUNTY ROAD UU zSDONTURN ERRZGHTWNAND SIDE~,UFUTHENROADTO PROPERTY WHICH is Drod1 Hll ct`~v Klt Lo. `O`Ol .e Y_ n r~ ' I b Badlands Rd. ~ ~foplo~ • q _ SON ~ n Co, 4' a g V SUBJECT is eo pr. f1 - lenN 6k r. ~g ~,4pp. V ~,J t~, 4 q4 }A"1 fr111 h11 EIlIT2 'T9 Exlfc 0 {uONN{ IIG C Pi a v s•r r Ora t'. @a STC.105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County ONvm~r~V BI NL' R .......»,u..uw.._..-........--...... r.._ MAILING ADDRESS PROPERTY A]D)DRIi':fiS ~ eas o Obtain rom the Planning Uept. (laceti o septic cy1-;7-. CITY/S►TATE F'ROP>r1iTXYaOCAT ON 1/4, 1/ + 5cctiur> ) -,N•I2___f W 'SOWN OP ST. CROIX COUNTY0 W1 .b SUBDIVISION LOT NUMMER r CERTMEUSi3RVEYMAP VOLUME-,; PAGE, LOT NUMBER Improper use and maintenance of your septic system could result in its premature failure 1r, handle wust;,s. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment t;tage in the wuto disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of fsp% of ilia cost of mplncamont of a failing system, which was in operatioa prior to July 1, 1978. St. Cru,+c County ac-ccpted this program in August of 1980, with the requirement that owners of ail new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning n certification fern,, si~rnr.~l lay the owner a,id by a +nater plumber, journeyman plumber, restricted plumber car a hconsad pumper verifying that (1) tho on•sito wnstowntcr disnosol system is in propor operating condition and (2) after in%puc ion and pumpiod (it necessary), ilia stplie tank is less than 1/3 full of slwdge and scum. UWo, tho undtrsignod hmve read the above requirements and agree to maintain the private sewage disposal system in accordance with tho standards set forth, herein, as sct by the Wisconsin UNR. Certification stating that your septic hAS been maintained inust be completed and returned to the St. Croix County Zoning Officer within 30 days of the throe yanr expi ation date, SIGNED. Ole DA'M: _ . St, Croix County Zoning Office Government Center 1101 Cnrmiehael Road Hudson, W1 $4016 11193 F.E&-19-,!.T WED 09 A2 AM BELI6L.E EXC 715 247 3036 P.01 sT0- 100 This application form J.s to be. completed JI) full and signed by the owner(c) of the property being developed. Any inadequacies will only resu.l.t: in delays of the i~C~rmit isskjar'06. Should this development be intended for ree&.ale by owner/contractor, (npcc house), then a second form should be retrained and completed wht:rl the proporty is sold and submitted to this office with the appropriate steed recording. .------Ww___'.'........---'•..,-uurr.«w...,_+rr-w. ..l uurr-----------ru Cwnor of property X,cac:ation of p petty 5 11/4, Section Townsh ip 41>.Z-.-- Mailing addrnt;a ~r.. Address of site„-71 sl.~ Subdivision name Lot no. other homes nn property? Yes- >n No Previous owner of property Total size of property Total size of parcel Date parcel, was created Are all corners and lot lines identifiable? -Yes -_No Is this property being developed for (spec house)? Stes No Volume and Paqe Number as r.-euorded with the Register rf Deeds. .wNYYY..1 .w p.r v.r.YW YYYr W•-r WrWw. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DURD which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMUR AND THE SEAL OF THE REGISTER OF DEF,DS, In addition, a cortifiod survey, if available, would be helpful, so as to avaid delays of the reviewing process. if the deed description references to a Certifiod Survey Map, the Certified Survey Map shall also be required. .,...r..,......,.......~r.w..rrv.r.......r ,.-.....,-.-...~--..-,__-.r.,.-......-........,...w....•...,.....~.....r.r r r -....__....,_._.....-..,,...rw.r...........` PROPERTY OWNER CERT7 PTCATION I (we) cortri.fy that all sta.temento on this form ate true, to the best. of my (nu r) knowledge that I (wc) am (are) the ownex(S) of the property doscribed in this information form, by virtue of o whrrant:y dyed recorded in the office of the County Register of Deeds as Document No. and that I (wee) prasent ),y own thn proposed site, vfror,•^the sawcige d,i.sposal system or I (wc) obtained an easehient, to run the above dGsrr'ibed property, for the. construction of said system, tend the sana has been duly reco)'ded in tbox office of the County Register of Doeds as Document No, S191IAturc 0 Applicant Co-Applicant -I'V My? --10 /o 555550 HL 1 6 2 DOCUMENT NO. STATE BAR OF WISCONSIN FORM 2-1982 WARRANTY DEED ` 4EGIS7E, F $T, (;Rol, tiJ., I wed Im RwX4 Bridaeland Dcyelonment Comaanv. a Minnesota co4wafim • FEB 12 1997 tit 11:30 A. !f conveys and warrants to -4 Idv.k Mark Calawerts t~yiaYx d t~dCa the following described real estate in St. Croix County, State of Wmmosin pn,Ofs Lot 37 St. Croix Estates 2nd Addition in ft Town of Hudson, SL Croix County, Wisconsin. TRANSFER This is not homestead property. Exceptions to Warranties: Dated this . 20th _day of Jan=M 19-_, ` (SEAL) (SEA1-) • IK if (SEAL.) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signatures authenticated this day of STATE OF MINNESOTA 19 Dakota Canty Per came before me, this -Ift-day of ' 1997 the above named ImmM TTTL.E: MEMBER STATE BAR OF WISCONSIN Neal Kn_rveia► (If not authorized by 706.06, Wis. Stats.) This instrument was drafted by to me known to be the person who v=uted the ' . Com0wy foregoing imtromeat and the some. 29141 Icenic Tr S•drp ter.,; MN 55044 ~tJ /lam (Signatures may be authenticated or acknowledged. *Darla J. Bauer Both are not necessary.) Notary Public DAM Canty, MN My commission expires January 1, 2000. OAAIA J. SAllE11 ' ft11IAS~ PIgLM'itrtitld~A &=A COLIM OmwAm on t ns.frt. ft. m .