HomeMy WebLinkAbout030-2094-80-000
ST. CROIX COUNTY ZONING DEPARTMENT
AS BUILT SANITARY REPORT
Owner
Address oZ
City/State
Legal Description:
Lot ) 7 Block Subdivision/CSM #
Y. A)F-'14 , , Sec. , T_ILN-R_Z Town of ~5T PIN # Q fl ao f V - 1~_ _
SEPTIC TANK - DOSE CHAMBER HOLDING TANK INFORMATION:
i
Tank manufacturer Size ST/PC >Ooo/ Oo Setback from: House _10 Well - P/L
Pump manufacturer Model /37
Alarm location
(HOLDING TANKS ONLY)
Setbacks: Service road Vent to fresh air intake Water Line
Meter location
Alarm location
SOIL ABSORPTION SYSTEM:
Type of system: Width Length y 7 Number of Trenches
Setback from: House 7~ Well P/L Vent to fresh air intake
ELEVATIONS:
Description of benchmark T& 5 ; Elevation J3 9s
Description of alternate benchmark J f ~v E G.•.~ Elevation ?,7r.
Building Sewer _ r V d) ST/HT Inlet ) 311 ST Outlet PC Inlet / T, S,
PC Bottom ! 7, 30 /Header/Manifold 1 /a Top of ST/PC Manhole Cover
l
Distribution Lines { } 30 ( )
Bottom of System ( ) 3, 9 y ( ) ( )
Final Grade { } ( )
Date of installation S i 2Permit number 0 R 112 $ I State plan number S22
yaflg
Plumber's signature License number 111, / 7 VS4 Date / /
Inspector T.tiw
Complete plot plan
NOTICE: Please provide the following:
• A plan view sketch showing everything within 100 feet of the system.
• Two horizontal reference points to center of septic tank manhole cover.
• Show alternate benchmark, if applicable.
PLAN VIEW
1
~p 30
ys_,
1•
1 w'
~R.
INDICATE NORTH ARROW
NOTICE: Please provide the following:
• A plan view sketch showing everything within 100 feet of the system.
• Two horizontal reference points to center of septic tank manhole cover.
• Show alternate benchmark, if applicable.
PLAN VIEW
N
1 30~
1.
INDICATE NORTH ARROW
Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County:
,Labor and Human Relations INSPECTION REPORT ST. CROIX
Safety ano Buildings Division
(ATTACH TO PERMIT) Sanitary Permit No.:
GENERAL INFORMATION 284289
Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.:
THROW, TOSHA MARIE ST JOSEPH
CST BM Elev.: Insp. BM Elev.: BM Desc iption: Parcel Tax No.:
~J n ~ tea/ 030-2094-80-000
TANK INFORMATION ELE TION DATA s T 7
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark 3 6~
PL'Gc
Dosing n / wt (.ryi'. 3.75
Aeration- Bldg. Sewer 3 O 9D, 37
Holding St/Ht Inlet
TA K SETBACK INFORMATION St/ Ht Outlet 111,4
TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet ti A
Air Intake
Septic NA Dt Bottom .SAS
Dosing NA Rsa4w Man.
NA Dist. Pipe
Hin Bot. System 3 9 7
PUMP INFORMATION Q 6:PM, Final Grade
Manufacturer[Demand
Model Number E33 36 t P
TDH Lift p0 A `riction, 17 1 System 110 TDHyFt
Force main Length )I Did. F~ " Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length,,/7 . No.Of T enches DIMENSIONS P1T No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS
LEACHIN Manuf
SETBACK SYSTEM TO P / L BLDG WELL LAKE /STREAM
INFORMATION Type 0 e, r ; CHAM Mode
O IT
1 A_
System: yy<4,4
DISTRIBUTION SYSTEM
Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length Dia. Length Dia. Spacing 1 5/ yp
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: ST JOSEPH.29.30.19,NE,SW HIGHLAND VIEW LOT 17
/(.E CcL11~A
Plan revision required? ❑ Yes ❑ No
Use other side for additional information.
SBD-6710(R 05/9°1)) Date Inspector's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER: r
e ~
Safety o and Bu ilding Water Systems
v.■`~■■~ SANITARY PERMIT APPLICATION Bur 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 8112 x 11 inches in size.
• See reverse side for instructions for completing this application State Sanitary Permit Number
agz/,9 V
The information you provide may be used by other government agency programs ❑ Check it revision to previous application
[Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number
1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION 62 7 _ ~C> P% 3
Prop y Ow er Name Property Location
~ 1/4 .S LL( 114, S a T~ N, R or)
Property Owner's Mailing Address Lot Number Block Number
City, State 1 Zip Code Phone Number Subdivision Nam or CSI~(I Number t
II. TYPE F BUILDING: (check one) E] State Owned City Nearest Road
❑ Village
E] Public 1 or 2 Family Dwelling - No. of bedrooms Town OF Cdr
III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s)
1 ❑ Apartment/ Condo - o / LI - 0
2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10E] 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. X New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
------System --------System Tank Only______----- Existing System _________Exl--- -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
11E] Seepage Bed 21 ,Mound 8 1 x L/7 v /.j,~ l , 30E] Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22E] In-Ground Pressure 42 ❑ Pit Privy
13E] Seepage Pit 43 ❑ 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
Require. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./in ch) Elevatiory
Feet Feet TANK Capacity
VII. INFORMATION in gallonTotal # of Prefab. Site Fiber- Exper.
Gallons Tanks Manufacturer's Name Concrete con- steel glass Plastic App
New Existing strutted
Tanks Tanks
Septic Tank or Holding Tank Q~~ OCt a ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name: (Print) Plumber' ignature: (No Sta s) PRSW No.: Business Phone Number:
Plumber's Addre s Street, City, State, Zip Code):
yc-~t a r ~l z s~
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Sa itary Permit Fee (indudes Groundwater ate Issue Issuing Agent Sig re (No Sta Sps)
Approved ❑ Owner Given Initial SurchargeFee)
Adverse Determination _Q~~ X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
.98 (R. 05/94) DISTRIBUTION: Original to County. One copy To: Safety 6 Ruildings Divi.ion, 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:
I. 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 online 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 8 112 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 it 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 SAFETY & BUILDINGS DIVISION
State of Wisconsin
Department of Industry, Labor and Human Relations
February 25, 1997 2226 Rose Street
La. Crosse WI 54603
WEGERER SOIL TESTING
421 N MAIN STREET
PO BOX 74
RIVER FALLS WI 54022
RE: PLAN S97-40083 FEE RECEIVED: 180.00
THRON, TOSHA
NE,SW,29,30,19E
TOWN OF ST JOSEPH COUNTY OF ST CROIX
MOUND SYSTEM
The Department has reviewed the above-referenced submittal.
Conditional approval is hereby granted for the system plan submittal. All
noted items must be corrected. The review and approval of the system is based
on chapter 145, Wisconsin; Statutes, and chapters iLHR 83 and 84, Wisconsin
Administrative Code, and is contingent upon compliance with any stipulations
shown on the plans. This system has not been reviewed for the code
requirements set forth in chapter ILHR 82 or in chapters ILHR 50-64, Wisconsin
Administrative Code.
This plan submittal approval will expire two years from the approval date, or
if a sanitary permit is obtained, plan; approval will expire on the day the
initial sanitary permit expires. The licensed plumber responsible for this
installation shall keep one set, of plans with the Department's stamp of
approval at the construction site. The installer shall notify the appropriate
inspector when inspections can be made.
All permits required by the city, village, township or county shall be
obtained prior to installation.
Inquiries should be directed to me at the number listed below. Please refer
to the plan number shown above.
Sincerely,
Oraerd M. Swim
Plan Reviewer
Section of Private Sewage M4q
(608) 785-9348 lV~
SUDA-7997 (R. 10194)
S97-4 ~ 3 Page of 6
MOUND SYSTEM
FOR RECEIVED
A 3 BEDROOM RESIDENCE
FED 2 4 1997
SAFETY & BLDCS. DW
LOCATED IN THE NF 1/4 OF THE Sw 1/4 OF SECTION T 3U N, R11 W,
TOWN OF ST_ S~tF Sr. cR1JLX COUNTY, WISCONSIN.
INDEX
PAGE 1 'of 6 TITLE SHEET
PAGE 2 of 6 PLOT PLAN
PAGE 3 of 6 PLAN VIEW-CROSS SECTION
PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT
PAGE 5 of 6 PUMPING CHAMBER
PAGE 6 of 6 PUMP PERFORMANCE CURVE
PREPARED FOR
SYSTEM
NAOE
STt~l.wrr~iz, ►-~iv ssoaz ~ f
t0los
30
7 4c-'09
PREPARED BY E M y
zel®~fE`rQW~ J
„
GEEZER SOIL TESTING „~,~~~,s 4~,
AND.
~ T.~; •a:-~
DES = GEN SEFt~1 I CE
e
• ARTHUR L.
$ 0^`-pR L
F.O. 201 74 421 K. 11AIK ST. Gll:Yi _,FTH,
RIVED FXIS. III 54022 was.
0
o` •
715-425--01b i o
mar wssu;m"
JOB NO. a - 3 0
PLOT PLAN
Page Z of 6
Scale 1"=4p '
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~vp o'F L-C)T ~f1RAJ~SZ
Flo ~
"-T- 1.1 Ave
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NOTES:
-1. Elevations shown are existing ground elevations unless otherwise noted.
2. Install permanent markers at end of each lateral. (L required)
3. Install 4" observation pipes with approved caps. ( 2 required)
4. -Septic tank to be Woo 16So gallon capacity manufactured by
YA t ~~w~`s ZV t~~~3r ~1 S r ~ ) nj e .
5. Bench Mark SEI~: "Cj v e
6. Divert surface water around system to. prevent- .ponding at the uphill side.
Page '-10f 6
Approved Synthetic Covering
Rs~-r~ c 33 Distribution Pipe
Medium Sand
H _ _ G
Topsoil F Elev. \ \ Z - S
-J "
E D
"
3 `
„
b
Z % Slope
Bed Of 2M 2 -2 (Force Main Plowed
Aggregate From Pump Layer
D \-o Ft.
Cross Section Of A Mound System Using E \-i6 Ft.
A Bed For The Absorption Area F o-$ Ft.
G • o Ft.
A 8 Ft. H \-S Ft.
Linear Loading Rate= •~o GPD/LN FT B 4-7 Ft.
Design Loading Rate=0.4 GPD/SQ FT I V~ Ft.
J g Ft.
K 10 Ft.
A! tei-I rate +os4t4w)- L (,1 Ft.
-of--
Fo Main W 3Z Ft.
L
TO bservation Pipe
8 \ K
F Ir--- - - - -moo'
- Force Main
Distribution Bed Of 2M- 2 2
Pipe Aggregate
I
Observation Pipe Permanent Markers
(Anchor securely)
Plan View Of Mound Using A Bed For The Absorption Area
Page Of 1
Perforated Pipe Detail
0
End View
Perforated
End Copt As PVC Pipe Install permanent-marker
sooc6
at end of each lateral
Holes Located on Bottom,
Are Equally Spaced
Q S
PVC Force Main
i
Q
PVC
Manifold Pipe
Distri ution
Pipe
Last Hole Should Be I
Next To End Cap
End Cap
P Z Z Ft.
Distribution Pipe Layout S y Ft.
X Ll8 Inches
Y V$ Inches
Hole Diameter )IV Inch
Lateral Inch(es)
Manifold Z Inches
Force Main Z Inches
# of holes/pipe
Invert Elevation of Laterals \\3.0 Ft.
Place 1st hole -L4 "from center of manifold with succeeding holes
at 1-1$'intervals. Last hole to be next to the end cap.
Combination Sept:ic;Tank and
PUMP CHAMBER CROSS SECTION AMD SPECIFICATIOMS ' PAGE 5 OF 6
VENT CAP WEATHER PROOF
JUKICTIOIJ DOX
H"C.I. VENT PIPC APPROVED LOCKIMG
lO' FROM DOOR. MAKIHOLE COVER K71'IH
AtR wP►RNIAlG L14pEL
.iKIDOW OR FRESH
IjJTAKE cwapulr
J t i
I I Y" MIIJ.
I IB'Mlu.
lh _
PROVIDE I
IlJLE T AIRTIGMT SEAL
I II v
APPROVED JOINT 84PFL~S A I I ! APPROVED JOIAITS
I I ( W/C.I. PIPE4Pvc
W/C.I. PIPEOR Tank construction I ICI
ALARM
shall comply with .I I
I
ILHR 133.15 and 83.20 B I I
i I ON
C I I
c~Y..'l5 I
LLEV. FT. PUMP
~ OFF
D CONCRETE
Ezzu. 92, 00 DLOCK
3" APPRwei
RISER EXIT PERMITTED OIJLJ IF TAIJK MA►JUFACTURCR HAS SUCH APPROVAL. BEDDINQ
SEPTIC E SPEC.IFICATIOAIS
DOSE NUMBER OF DOSES: 3• S3 PER DAy
TANK MANUFACTURER:
TANK SIZE: GALLOWS DOSE VOLUME r
GALLONS
ALARM MAUUFACTUFCLR: S'J' ~~u S`4.S'TLy1S IWCLUDIN6 BACKFLOW: SI
MODEL KIUMBER: CAPACITIES: A= IKICHES OR 30~ CALLOUS
SWITCH TYPE' B= qZ IIJCHES"OR _L G( LLOU5
PUMP MANUFACTURER. C=IUCHES OR S3 CALLOUS
MODEL WUMDER. 33 D- 9 INCHES OR_ 6y GALLONS
SWITCH TJPE: I'~ CCJj2 IJOTE: PUMP AMD ALARM ARE TO BE
MIMIMUM DISCHARGE RATE GPM INSTALLED OM 5EPARATE CIRCUITS
. Zo.ZS
VEKTICAL DIFFERENCE BETWEEN PUMP Off AUO..015TRIBUTION PIPE.. FEET
t MIKIIMUM METWORK SUPPLY PRESSURE . . . . . 2'52 FEET
+ 155 FEET OF FORCE MAIN X 1.61 F/ofrFRICTIOIJ FACTOR.. z. SO FEET
io
TOTAL OJWAMIG HEAD = ZS'Z 5 FEET
Pump chamber DIAMETER 381
IWTERWAL DIMEIJ610LIf OF TAWK: LEKaGTH - ;WIDTH - ;LIQUID DEPTH
BOTTOM AREA 231= GAL/INCH
AS PER MANUFACTURER GAL/INCH
ME Series
1/3 through 1-1/2 HP
Effluent Pumps
Performance Curve
CAPACITY LITERS PER MINUTE
O 50 100 150 200 250 300 350 400 450
100
90 28
BO M 24 v7
70W
w~OO 20 M
LI- 60 ?
Z 0
Q 50 M$~$ 16 w
W_ 2
Q
40 M~$O 12 O
F-
O
f-
30
2S. ZS 6
20 X33
10 4
0 0
0 10 20 30 40 50 60 70 80 90 100 110 120 130
CAPACITY GALLONS PER MINUTE
• 1101 Myer; Parkway, Ashland, Ohio 44805-1923
M"19
419/289-1144 FAX 419/289-6658 Telex 98-7443
K3327 8/92 Printed in U.S.A.
-w, aw
Givision of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
St. Croix
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 PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORM - INFORMATION REVIEWED BY DATE
PROPERTY OWNER( -TAA Z(~ I PROPERTY LOCATION
Jo Ann Persico Bruce GOVT. LOT NE 1/4SW 1/4,S29 T 30 N,R 19 xR
PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM tt
#328Co. Rd. #F 17 na Highland Hills phase II
CITY. STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE KFOWN NEAREST ROAD
Hudson, WI. 54016 (715 386-8236 St. Joseph Co. Rd. #E
J)"ew Construction Use Residential 1 Number of bedrooms 3 (I Addition to existing building
[ I Replacement [ ] Public or commercial describe
Code derived daily flow 450 gpd Recommended design loading rate • _'bed, gpolft2 •6 trench, gpd12
Absorption area required 375 bed, ft2 375 trench, ft2 Maximum design loading rate . 5 bed, gpdm2 •6 trench. gpdnt2
Recommended infiltration surface elevation(s) 112.50 It (as referred to site plan benchmark)
Additional design / site considerations na
Parent material glacial till Rood p9n elevation, if applicable ana It
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN RLL HOLDW,
U = Unsuitable for svstem I ❑ S ®U -q~S ❑ U I ❑ S ®U I ❑ S ® U I ❑ S (3U ❑ S
SOIL DESCRIPTION REPORT
I Depth (Dominant Color I Mottfes Texture Structure Consistence Roots GF
Boring # Horizon in Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 1&txclay bee
1 1 ~0-12 10yr4/2 none 1 2msbk mfr gw 2m .5
mm% 2 12-27 10yr5/3 none sil 2mgr mfr I gw If .5
Ground 3 27-37 7.5yr4/4 none sl lmsbk mfr 9w na .4
elev. c 2p /.5yr5/2
111.5Qt. 4 37-84 7.5yr4/4 7.5 r5/8 sl lmsbk mfr na na .4
Depth to
limiting
factor
37 I
Remarks:
Boring #
1 0-10 10yr4/2 none i 2msbk mfr gw 2m .5
2 0-20 10yr4/4 none sl 2msbk mfr gw if .5
3 0-26 7.5yr4/4 none sl 2msbk mfr 9w na 5
Ground
elev. 4 26-60 7.5yr4/4 none sl lmsbk mfi na na .4
111.5Qt.
~ X991
~AR 4
limiting
factor
+6011 ( G
Remarks:
CST Name:-Please Print Gary L. Steel PhOm: 715-246-6200
Address: 54017
1554 2(JQth. Ave. New Richmond, WI.
Date: CST Number:
Sgnature: 6-27-S4 cstm 2298
Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page I of 3
Labor and Human Relations
Division of Safety & Buildings in accord wit . Adm. Code
COUNTY
St. Croix
Attach complete site plan on paper not less than 8 1/2 as in si„ Plan Jude, but
not limited to vertical and horizontal reference point (B ectio 1 gfrslope, c or PARCEL I.D. #
dimensioned, north arrow, and location and distance rest road
REVIEWED BY DATE
APPLICANT INFORMATION-PLEASE PRINT INFdI iZ'*IdN J 3
PROPERTY OWNER: ` PROPE CATION
Jo Ann Persico Bruce Peterson p OT NE 1/4SW 1/4,S29 T 30 N,R 19 x>I~(or) W
PROPERTY OWNER':S MAILING ADDRESS BLOCK # SUBD. NAME OR CSM #
#328Co. Rd. #F na Highland Hills phase II
CITY, STATE ZIP CODE PHONE NUMBER ❑VILLAGE [)TOWN NEAREST ROAD
Hudson, WI. 54016 (715 386-8236 St. Jose h Co. Rd. #E
[yPew Construction Use Residential / Number of bedrooms 3 [ J Addition to existing building
j J Replacement [ J Public or commercial describe
Code derived daily flow 450 gPd Recommended design loading rate • S bed, gpd/ft2 •6 trench, gpd/ft2
Absorption area required 375 bed, ft2 375 trench, ft2 Maximum design loading rate bed, gpd/ft2 trench, gpd/ft2
Recommended infiltration surface elevation(s) 112.50 ft (as referred to site plan benchmark)
Additional design / site considerations na
Parent material alacial till Flood plain elevation, if applicable ana ft
HOLDING TANK
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL
U = Unsuitable fors stem ❑ S ® U nS ❑ U ❑ S ®U ❑ S ® U O S 13U ❑ S 13U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed rends
1 r 1 0-12 10 r4/2 none 1 2msbk mfr gw 2m .5 .6
:gy
2 12-27 10 r5 3 none sil 2m r mfr if .5 .6
Ground 3 27-37 7.5yr4/4 none sl lmsbk mfr 9W na .4 .5
elev. c 2p 7.5yrb/2
111.51ft. 4 37-84 7.5yr4/4 7.5 r5/8 sl lmsbk mfr na na .4 .5
Depth to
limiting
factor
37"
Remarks:
Boring #
1 0-10 10yr4/2 none 1 2msbk mfr gw 2m .5 1.6
2 2 0-20 10yr4/4 none sl 2msbk mfr gw if .5 .6
3 0-26 7.5yr4/4 none sl 2msbk mfr gw na .5 .6
Ground
elev. 4 26-60 7.5yr4/4 none sl lmsbk mfi na na .4 .5
111.5Qt.
Depth to
limiting
factor
+60"
Remarks:
CST Name:-Please Print Gary L. Steel Phone: 715-246-6200
Address:
1554 th. Ave. Ne Richmond, WI. 54017
Signature: Date: CST Number:
, a'~
l! C l~ 6-27-94 cstm 2298
PROPERTY OWNERPersico/Peterson SOIL DESCRIPTION REPORT Page 2. of 3
PARCEL I.D. #
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Barxk~ry Roots GPD/ft
in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. Bed (Trench
1 0-7 10 r4 2 none 1 2msbk mfr cTw 2f .5 1.6
3 ,
2 7-21 10yr4/6 none sil 2msbk mfr gw if .5 1.6
Ground 3 21-48 10yr4/4 none sl 2msbk mfr gw na .5 I.6
eev.
110!70ft. 4 48-6 7.5yr4/4 fif 5yr4/4 sl lmsbk mfi na na .4 .5
Depth to
limiting
factor
48"
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
F-7
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
FT
Remarks:
Boring #
Ground
elev.
ft.
i
Depth to
limiting
factor
i
Remarks:
SBD-8330(8.05/92)
PROPERTY OWNER Pers ico/Peterson SOIL DESCRIPTION REPORT Page 2-• of 3
PARCEL I.D. #
Boring# Horizon Depth Dominant Color Mottles Texture I Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed I er&
1 0-7 10 r4/2 none 1 2msbk mfr 2f .5 1.6
3
r 2 7-21 10yr4/6 none sil 2msbk mfr gw if .5 .6
Ground 3 21-48 10yr4/4 none sl 2msbk mfr gw na .5 .6
eev.
110I70ft. 4 48-6 7.5yr4/4 fif 5yr4/4 sl lmsbk mfi na na .4 .5
Depth to
limiting
factor
48
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
•x.Y;e::
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev. j
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(8.05/92)
STEEL'S SOIL SERVICE
Gary L. Steel Highland Hills phase II 1554 200th Ave.
CSTM2298 lot #17 New Richmond, WI 54017
MPRSW 3254 NE4SW4 S29-T30N-R19W (715) 246-6200
t town of St. Joseph
N
1"=40'
BM.= top of NE lot stake at el. 100,
40 C) 14-
89,
~ownSla
1 pr b~ r<3- i
Gary L. Steel
6-27-94
FROM 04-83-97 08:14AM TO 17153869391 415 P.212
RTC - 100
This application form is to be completed in full and signed by the
owner(s) of the property being developed. Any inadequacies will
only result in delays of the permit issuance. Should this
development be intended for resale by owner/ contractor, (spec
house), then a second form should be retained and completed when
the property is sold and submitted to this office with the
appropriate deed recording.
Owner of property TQ~V-la
Location of property_,VE .1/4_5W1/4, Section 21 T 30N-R_jy W
Township - Jose ph Ma i t ing addres s
Address of site
_ h►1~ V
Subdivision name ` Lot no. C7_._.
Other homes on property? _Xes__No
Previous owner of property e, "Clm v V 'W
Total size of property Y_`,~1',•r.t
Total size of parcel 13 Ac,
Date parcel was created _
Are all corners and lot lines identifiable? _X Yes No
Is this property being developed for (spec house) ? A Yes __No
volume 1190 and Page Number 322 as recorded with the Register
of-Deeds. 1.AA)fi ctrv~
INCLUDE WITH TRIB APPLICATION THE FO1LOWrX68
A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE
NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a
certified survey, if available, would be helpful so as to avoid
delays of the review+ng process. If the deed description
references to a Certifl®d Survey Map, the Certified Survey Map
shall also be required.
PROPERTY OWNER CERTIFICATION
I (we) certify that al.l statements on this form are true to the
best of my (our) knowledge that I (we) am (are) the owner(s) of the
property described in this information form, by virtue of a
warranty deed recorded in the office of the County Register of
Deeds as Document No. , and that 1 (we) presently
own the proposed site for the sewage disposal system or I (we)
obtained an easement, to run the above describcd property, for the
construction of said system, and the same has been duly recorded in
the office of the County Register of Deeds as Document No.
Signature of Applicant nt Co-Applicant
Date of Signature Date of Signaturc
FROM 04-03-97 08:13AM TO 17153869391 415 P.1/2
STC- 105
SEPTIC TANK. MAINTENANCE AGREFMEl^TK'
St. Croix County
OWNEPJBMR shu. ~r-~otr i Th_%
MAII.JNG ADDRESS _
PROPERTY ADDRESS
(location or septic s m) Please obtain from the Planning Dept.
CITY/STATF HOW AO r,.) W; S92 AL t3,__ PROPERTY LOCATION 1,',4, 04 1J4, Soctiou , 'T 3 D -N-RW
TOWN OF~ ~s Y o2L ST. CROIX COUNTY, WI
SL'SDMSION il~r,a ~j~,y S LOT NUMBER
eE MAP , VOLUME PROEc~4__yQ LOT NI;~MBER
~Impropet use and maintenance of your septic system resuld result it, its premature failure to handle
wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed
by licon%ed septic tank pumper. What ynU put into the system carpv, afl'wt the function of the septic tank
aK a treatment stage in the waste disposal system.
St. Croix County resident may be eligible to receive is g. ant for a rnaxirnum of 60% of the cost
of replacement of a failing systett), whirli wan in operation pri3. to July 1, 19? 8. St. Croix County
accepted this program in .August of 1980, with the rrquirement tl;: t owacts of all new systems agrcc to
keep their system properly maintained.
The property owner agrees to submit to St. Croix Zoning a "ilification Conn, signed by the owner
and by a mater plumber, journeyman plumber, restricted plumber or a Iicestsed pumper verifying that (1)
the on-site wastowater disposal systena is in proper operating condition attd (2) after inspection and
pumping (if necessat'y), the septic tank is less than: V3 full or" sh-Age and scum.
VWe, the undersigned have read the above requirem ants and agree to maintain the private !trwage
disposal system in accordance with the standards set forth, Herein, as set by the Wisconsin DNR,
Certification stating that your septic has been maintained must btu completed and returned to the St. Croix
County Zoning Officer within 30 days of tbo three year expiration date
SIGNED:
DA'It: ~ -
St. Croix County Zoning Office
Government Center
110! Carmichael Road
Hudson, Wl 54016 11/93
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i STATE BAR OF WISCONSIN FORM( 11 - 1931"
1 LAND CONTRACT
i Indi.Idual aed Coryo,vte
5 GA3
!i ITO BE USED FOR ALL TRANSACTIONS WHERE OVER REGISrER5 OFFICE
DOCUMENT NO I 535.00013 FINANCED ANr` IN OTHER NON-CONSUMER !
ACT TRANSACTIONS) -------_I ST. CROIX C 1 . Ya II
Contract, by and between -Highland Hills rJUL: IT 1996
a PartnershiD. -
i ("Vendor", at 10:45 AM
whether one Or more) and Tacha -_rMron,
Fbolsterof Ceeds
("Purchaser", whether one or more).
Vendor sells and agrees :o convey to Purchaser, upon the prompt and full perfor-
mance of this contract by Purchaser, the following property, together with the rents,
li profits, fixtures and other appurtenant interests (all alley the "Property"), in THIS SPACE RESERVED FOR RECOR O DATA
St. Croix County, State of Wisconsin:
NAME AND RETURN ADDRESS
I~
I~
~j (Parcel Identification Number)
i!
l
Lot 17, Highland Hills First Addition to the Town of St. Joseph, St. Croix
11 County, Wisconsin. ~f
_ $ XIMI§fER
l
it This 1S not
homestead property.
u XW )
IS nOt
I~
Purchaser a reel to.purchase the Property and to pay to Vendor m place Vendor directs
the sum of 0 1 • CD in the following manner. (a) S 4.000.00
at the execution of this Contract; and (b) the balance of S 36 0W • OO , together with interest from date
hereof on the balance outstandin, from time to time at the rate of ei t percent per annum until paid in full, as follows
j Commencing on the 27th day August, 1996, and on the22t:h day of each and every month
j thereafter, equal monthly installments of principal and interest in the amount of
I' $344.16.
Provided, however, the entire outstanding balance shall be paid in full on a before the 2 h day of
July ,19 98 (the maturity date).
Following any default in payment, interest shall accrue at the rate of per annum on the entire amount in default (which shall
include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance).
Purchaser, unless excused by Vendor, agrees to pay Vmonthly to Vendor amounts sufficient to pay reasonably anticipated annual taxes,
special assessments, fire and required insurance premiums when due. To the extent received by Vendor, Vendor agrees to apply payments to these
obligations when due. Such amounts received b the Vendor for
by payment of taxes, assessments and insurance will be deposited into as escrow fund
or trustee account, but shall not bear interest unless otherwise required by law.
Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any amount may be prepaid
without premium or fee upon principal at any time
w
In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long w the unpaid balance of
principal, and interest (and in such case accruing interest from month to month shall be crated as unpaid principal) is less than the amount that said
indebtedness would have been had the monthly payments been made as first specified above; provided that monthly payments shall be continued
in the event of credit of any proceeds of insurance or condemnation, the condemned premises being thereafter excluded berefrom.
Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except:
`t..
l
Purchaser promises to pay when due all taxes and assessmcnts levied on the Property or upon Vendor's interest in it and to deliver to Vendor
oa de3 Ad receipts showing such payment.
Purchaser shall keep the improvements on the Property insured against loss or damage occasioned by fire, extended coverage perils and
cnch ot'ser hazards as Vendor may require, without co-insurance, through insurers approved by Vendor, in the sum of $ - NIA-
but Vendor shall not require coverage in an amount move than the balance owed under this Contract. Purchaser shall pay the insurance premiums
when du`_ The policies shall contain the standard clause in favor of the Vendor's interest and, unless Vendor otherwise agrees in writing, the
ongtaal of ail policies covering the Property shall be deposited with Vendor. Purchaser shall promptly give notice of loss to insurance companies
and Vendor. Unless Purchaser and Vendor otherwise agree in writing, insurance proceeds shall be applied to restoration or repair of the Pr. petty
damaged. provided the Vendor deems the restoration or repair to be economically feasible.
Purchaser covenants not to commit waste not allow waste to be committed on the Property, to keep the Property in good tenantable
condition and repair, to keep the Property free from liens superior to the lien of this Contract, and to comply with all laws, ordinan%;ts and
regrtatioas affecting the Property.
Vendor agrees that in case the purchase price with interest and other moneys shall be fully paid and all conditions shall be fully performed
at the times and in the manner above specified, Vendor will on demand, execute and deliver to the Purchaser, a Warranty Deed, in fee simple, of
the Property, free and clear of all liens and encumbrances, exce t any liens orf w nc mbrances createdby the ac or default of Purchaser, and
exceyc --Fast~enti~~ tr?ctions a-Q of ~Lw_0r if an any,
Purchaser agrees that time is of the essence and (a) in the event of it default in the payment of any principal or interest which continues for a
period of days following the specified due date or (b) in the event of a default in performance of any other obligation of Purchaser
which continues for a period of days following written notice thereof by Vendor (delivered personally or mailed by certified mail);
them the entire outstanding balance under this contract shall become immediately due and payable in full, at Vendor's option and without notice
(w Bich Purchaser hereby waives), and Vendor shall also have the following rights and remedies (subject to any limitations provided by law, a
addition to those provided by law or in equity: (i) Vendor may, at his option, terminate this Contract and Purchaser's rights, title and interest in the
Property and recover the Property back through strict foreclosure with any equity of redemption to be conditioned upon Purchaser's full payment
of the entire outstanding balance, with interest thereon from the date of default at the rate in effect on such date and other amounts due hereunder
(in which event all amounts previously paid by Purchaser shall be forfeited as liquidated damages for failure to fulfill this Contract and as renal for
the Property if Purchaser tails to redeem); or (ii) Vendor may sue for specific performance of this Contract to compel immediate and full payment
of the entire outstanding balance, with ;nterest thereon at the rate in effect on the gate of default and other amounts due hereunder, in which event
the Property shall be auctioned at judicial sale and Purchaser shall be liable for any deficiency; or (iii) Vendor may sue at law for the entire unpaid
purchase price or any portion thereof, or (iv) Vendor may declare this Contract at an end and remove this Contract as a cloud on title in a quiet-title
action if the equitable interest of Purchaser is insignificant; and (v) Vendor may have Purchaser ejected from possession of the Property and have a
receiver appointed to collect any rents, issues or profits during the pendency of any action under (i), (ii) or (iv) above. Notwithstanding any oral or
wrixtrn statements or actions of Vendor, an election of any of the foregoing remedies shall only be binding upon Vendor if and when pursued is
titi pition and all costs and expenses including reasonable attorneys fees of Vendor incurred to enforce any remedy hereunder (whether abated or
not) to the extent not prohibited by law and expenses of title evidence shall be added to principal and paid by Purchaser, as incurred, and shall be
included in any judgment.
Upon the commencement or during the pendency of any action of foreclosure of this Contract, Purchassr consents to the appointment of a
receiver of the Property, including homestead interest, to collect the rents, issues, and profits of the Property during the pendancy of such action,
and such rents, issues, and profits when so collected shall be held and applied as the court shall direct.
Purchaser shall, not transfer, sell or convey any legal or equitable interest in the Property (by assignment of any of Purchaser's rights tinder
this Contract or by option, long-term lease or in any other way) without the prior written consent of Vendor unless either the outstanding balance
payable under this Contract is first paid in full or the interest conveyed is a pledge or assignment of Purchaser's interest under this Contractstalely as
security for an indebtedness of Purchaser. In the event of any such transfer, sale or conveyance without Vendor's written consent, the entire
outstanding balance payable under this Contract shall become immediately due and payable in full, at Vendor's option without ttotice.
Vendor shall make all payments when due under any mortgage outstanding against the Property on the date of this Contract(except forany
mort3age granted by Purchaser) or under any note secured thereby, provided Purchaser makes timely payment of the amounts then due under this
Contract. Purchaser may make any such payments directly to the Mortgagee if Vendor fails to do so and all ^ tyments so made by Purchaser shall be
considered payments made on this Contract.
Vendor may waive any default without waiving any otb^r subsequent or prior default of Purchaser.
All terms of this Contract shall be binding upon and inure to the benefits of the heirs, legal representatives, successors and assigns of Vendor
and Purchaser. (If not an owner of the Property the spouse of Vendor for a valuable consideration joins herein to release homestead rights in the
subject Property and agrees to join in the execution of the deed to be made in fulfillment hereof.)
Doted this N6 - day of Jules
H-ighland Hills, a Partnership
(SEAL) ~:A ' O~ (SEAL)
JoAnn Persico, Individually and as Tosha M. Thron -
Power o Attorney or Bruce Peterson
aM Roger Ruelin (SEAL) (SEAL) i
AUTHENTICATION ACKNOWLEDGMENT
mss) STATE OF WISCONSIN
ss.
St. Croix County
audwatkated this day of _,19- Personally came before me this day of
T111 W , l9__% the above named
1nAnrt PPrgicn TnfJi1irit1a113 arci ac Prwer
• -rueSm fpr_ Bogor
P.-nice Reteimon and TnIE: MEMBER STATE BAR OF WISCONSIN Ruel s.. ,,.,a Toghia M lbron
(If not,
authorized by §706.06, Wis. Stats.) to me known to be the persons the
. MP