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HomeMy WebLinkAbout002-1018-10-000 -0 0 Q o o N p ov> c I h °o I N N i N N I L c m C I E aNi a a z o c ti c m I ~ ~ v I o, I I I v C.O. zI c~o w E Z o ,t T z y y O z a co N o I o z d w o M v I [If C O Z Z o I N : C N ~ 0 N d w w O 0 c0 ~ w d~ a~ M g o° I U ~I o C a L 01 N CL U) •rNV R a a a ►'~i a c c m 3 J U rn o rn Z _ Imm 13 cO Cl) L CD N Q a N N SP S~ ¢ } V) o W 7 w O 0 N N C w 00 C -0 C E N O O O N 00 N N p p l F. E E 'Cy N N_ V p O cD G N 0 C 0 M 0 'o I~ N N '_0 C ~ v00i O E ~ U~ O I • 7a O W N W 0 •3 O O Co 2 N 0 Z 0 - Z -7 Cn 0 cl c £ V ~ a; ~0 j y a it d a w a d V d c rr~~ d `~1 A U as 2 0 (a 0 Parcel 002-1018-10-000 03/26/2007 09:41 PAGE 1 OF 1 F 1 Alt. Parcel 09.29.16.120 002 - TOWN OF BALDWIN Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - HANSON, DAVID L DAVID L HANSON 2383 110TH AVE BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 2383 110TH AVE SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 9 T29N R16W NE NE TOWN BALDWIN Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 09-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 04/10/2001 642458 1615/517 QC 07/23/1997 1193/_ WD -0/- 1/13 s- ,v-ell 2007 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 10/25/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 25,100 222,900 248,000 NO AGRICULTURAL G4 36.000 5,900 0 5,900 NO UNDEVELOPED G5 2.000 200 0 200 NO Totals for 2007: General Property 40.000 31,200 222,900 254,100 Woodland 0.000 0 0 Totals for 2006: General Property 40.000 31,200 222,900 254,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch 510 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 002-1013-30-000 03/26/2007 09:26 AM' PAGE 1 OF 1 Alt. Parcel 06.29.16.87B 002 - TOWN OF BALDWIN Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - WIPIJEWSKI, MICHAEL G & CYNTHIA A MICHAEL G & CYNTHIA A WIPIJEWSKI 1129 HWY 63 PO BOX 632 BALDWIN WI 54002 Districts: SC = School SP = Special Prope// F Address(es): Primary Type Dist # Description ` 112/HWY 63 SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 4.170 Plat: 3651-CSM 13/3651 SEC 6 T29N R16W PT S 1/2 SW FRL 1/4 Block/Condo Bldg: LOT 4 BEING LOT 4 CSM 13/3651 4.170AC Tract(s): (Sec-Twn-Rng 401/4 1601/4) 06-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 06/07/1999 604517 1432/317 WD 07/23/1997 836/177 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/27/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.170 33,200 105,400 138,600 NO Totals for 2007: General Property 4.170 33,200 105,400 138,600 Woodland 0.000 0 0 Totals for 2006: General Property 4.170 33,200 105,400 138,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch 516 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page I of 3 Labor and Human Relations D'nlsion of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but 5Y' C [ K 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 INFORMATION-PLEASE PRINT ALL INFORMATION REVtEWEDBY DATE PROPERTY OWNER: S" ~ PROPERTY LOCATION ~1~C'~ GOVT. . LOT LOT U1R__ 1!4 NE 1/4,S 9 T Z-°t N,R 1 6 E (or) OW 1~.01.1.~ F S ti•l 17R/ PROPERTY OWNER':S MAILING ADDRESS I ~k`/_ LOT # BLOCK# SUBD. NAME OR CSM # ~o l l Ylf ftuE . - - CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE ggrOWN NEAREST ROAD ~~~Dwlly 1W t svooz- (-)IS) 6W-VLo1-1 3p,~-cwt t,3 l\13 IM Prue [A New Construction Use pq Residential / Number of bedrooms 3 [ ] Additign to existing building [ ] Replacement [ ] Public or commercial describe Code derived daily flow `1So gpd Recommended design loading rate - bed, gpolfl2 ! 3 trench. gpol9 Absorption area required 31 S bed, ft2 3, S trench, ft2 Maxi mum design loading rate o . S bed, gpd/ft2 ° • 6 trench, gWt2 Recommended infiltration surface elevation(s) 9 9, o 1 _ft (as referred to site plan benchmark) Additional design / site considerations riuun,p 0--t; s' xis ` T.t Kj C* w, t" ,1 ' o F Sri Fl ~,t_ Parent material S "'s-f LOr\M Tt o _ Flood plain elevation, if applicable N - A - ft S = Suitable for system CONVI3NmONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for system ❑ S ®U ®S ❑ U ❑ S ®U ❑ S IZU ❑ S ICU ❑ S U SOIL DESCRIPTION REPORT Depth Dominant Color Mollies Texture Structure Consistence Bounday Roots GPD/ft Boring # Horizon in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. Bed rerxtt p n,r- E t~: ~ _Z_ ~ ` S~k wt V N a-S Z,u~ D, S p , ~o~Q 31 Z S-1 9 ~o~cZv~y - sil ~~sbk wt~~, cw )u' ,o,s o.L Ground -S 19-Z81SyZ 31 Y - S \ ~cSbk r-~v~~ CS 1u~ o Y o•S elev. ~Z ~.SYRS/t3 q~_6ft. y Z~-38 7•Sy3 3/y fD`iCL 61 Z. S o wt~r d,s - - Depth to S -61 `1 2 3 l y Lr S Q)W% w►'~1 mkt - limiting factor F-t!~Kj L") `O Lst P Ac e D V t!'ZL 1 L C ~'Pt l~ f} G L C-Li' IU L w t , 14 ly s kv- e-oh'r S Remarks: Boring # a. S Z a. S o my ~1, u Z"v Z S-t9 1~yR y/y S1 I Z`fsbh wl'F~ ew ►~f v, S o.6 3 Icl-3Z ~•S11R 3/y - S s b1z "\A- cS to o.Y o• S Ground S y 2S/g ^elev. y 3L-6y Sye 3/y z Ltr SI o M~V-wtu4e 61 S Depth to /V U 1-1 , P) S S pmia ve limiting factor Z~ 2) Remarks: CST Name:-Please Print Phone: Arthur L. We erer 715-4-2 5.-016'5- ' egerer Soil Testing & Design Service-P.O. Box 74 River Fall's WI .54022-. ` Signature: Date: CST Number: C114, - 9 3_Z3S 9-Z9-93 M00576 3 PROPERTY OWNER gr"t ~`nq SOIL DESCRIPTION REPORT Page of PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Roots GPD/ft g in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Boundary Bed Trends s..y.~ 1 0_6 1O`'t~ 3~L Sl Z SU1Z YnU`f 0..S Z~`~ 0•S o.l. t% aw.r, 1 'f 1~ e S v o, S v. Z 6-111 1oyQ yly Sl Z S~k wr Ground Z! -30 -s ye 3/y S) 1 C S l~k m ~ S 1 v'f o Y U .S elev. 1 -S IM s! g ~►b. o ft. y 3o s y2 y Lets) Lets) v~f>^_t~~; Depth to limiting factor Remarks: Boring # w Ground elev. ft. Depth to limiting factor Remarks: Boring # n:. iy t Ground ' elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ' ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) PLOT PLAN Page 3 of 3 SCALE 1"= ru 2140 T1F 5r. ~ l l b Pru ~ ~J P~ 0 a. v o W(.1.p'OKJ 6°1t(GN ajy"D)R - Pv e Pi aIE wIInj t_R'fl4 . R \ < 8.1 ~ x-96 (41 \ ` tv - Ou DoT tvnP~T oR _ J w~ L 1S Le cep 1 ~~~~`T14~ttS T V1= h-~uv►~p s )o ~ME Nr L sr z S' F"j j A-ybtAw . g3.,z3S C) - Z9- 93 ( 715 ) 425-C1 65 mo0576 CST Signature Date Signed Telephone No., CST # STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ~A V I'd l 4+ i`~? ADDRESS f w+ R got SUBDIVISIO~Nj / CSM# LOT # SECTION ` T N-R ► W, Town of 184 1101. irk- ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET O STEM a~ `6 INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. i BENCHMARK: f ~ 06 ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: h,as-4 C r h Liquid Capacity: /6 GG, `SD Setback from: Well House e/WM Other Pump: Manufacturer,,?, r, t f G Model# c~ Size Float seperation O Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: Length Number of trenches Distance & Direction to nearest prop. line: 20 Setback from: well: House ISO Other ELEVATIONS Building Sewer ST Inlet: ST outlet: PC inlet PC bottom 1 Pump Off ~O (0 Header/Manifold Bottom of system Q Existing Grade Final grade IOU. DATE OF INSTALLATI N: PLUMBER ON JOB: LICENSE NUMBER: J INSPECTOR: 3/93:jt Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division ST. CROIX (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 284151 Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.: HANSON, DAVID BALDWIN CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic (txv,(~ ""I/ Benchmark Dosing mcit"I'l C60 u Aeration Bldg. Sewer /Ur 'S 4~~Sy Holding St/Ht Inlet lA yS TANK SETBACK INFORMATION St/ Ht Outlet vent ir Ito ntake ROAD Dt Inlet TANK TO P/ L WELL BLDG. A Septic y<p S 1 NA !St ;J' Dt Bottom $ Dosing > (-aro r Acv' NA Header / Man. Aeration NA Dist. Pipe q Holding Bot. System ~•~/S' 9g,g a ' PUMP/ SIPHON INFORMATION Final Grade n✓l r Manufacturer Demand Model Number qq GPM 1 64/ TDH Lift Friction l,l Systema 9 TDH ~)V Ft oss ead Forcemain Length Dia.aHHu Dist. To well SOIL ABSORPTION SYSTEM BED/TRENCH Width Len t N0.Of T ches PIT o. Pits Dia. Liquid pth DIMENSIONS /I g~5, DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE / STREAM LEACHING Manu r: SETBACK INFORMATION Type O Model Number: System: lv i OR CHAUMBE DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length ')A9 Dia. ( Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Ofk xx Seeded/ Saud- xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes R-4 011yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: BALDWIN.9.29.16W, NE, NE, 110TH AVENUE (~3 3, 5z - ~Plan revision required? ❑ Yes ❑ No ~I Use other side for additional information. ~P SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: All ~ e s Safety and Buildings Division ~~■a.r.r. SANITARY PERMIT APPLICATION Bureau of Building Water System 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. 01~~►~ -5L - • See reverse side for instructions for completing this application State Sanitary Per it Number 15 The information you provide may be used by other government agency ro programs A y y y p g ❑ 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 Pro Owner ame roPert ocation Y Pgvt N-~~}~ S~ X1/4 1/4,S R T N,R 16 E-I(or) W P Property Owners Mailing Address Lot Number Block Number 9-3102- ~v r h- .~v6 City, State Zip Code Phone Number Subdivision Name or CSM Number 13u l</wr h tt/, s 1 '1-l CCU II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ cit( l Nearest Road -3 Public 1 or 2 Family Dwelling - No. of bedrooms o Town of 13 10 h A414 SII. BUILDING USE: (if building type is public, check all that apply) Parcel Tax Number(s) 1❑ Apartment/ Condo 0 2 U - b 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. IA New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an ------System System Tank OnlyExisting 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 t 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.) Pr osed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation 3 7 S~ 7 O 5 3 l Feet l00-5- Feet VII. TANK Ca in gallons Total # of Prefab. Site Fiber- Plastic Exper- INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass App. New Existing strutted Tanks Tanks Septic Tank or Holding Tank tl/ 1 GL L 1~ e- tr~ef 6e~ l~ ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber G 5 U ( t ❑ ❑ ❑ ❑ ❑ Vill.,-RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility fo installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber' ignatu Stamps) /MPRSW No.: Business Phone Number: So e- Stq _ r7 Plumb. is Address ( tr et, Ci y, State, Zip Code): IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issue Issuing Ag nt Signatur (No Sta S) A roved Surcharge Fee) pp ❑ Owner Given Initial /0// 7 Adverse Determination £J X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: (R. 05/94) DISTRIBUTION: Original to Counly. One copy To: Safety & Buildings Division, Owner, Plumber t~ 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- 11 . 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 VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, nL: m)!cr' of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Con:ple:e for .~::atic, pu np/siphon and holding tanks for this system. Check experimental approval only if tanks received experir-,e it .3 .>roduct approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropr ats~ ;)refix (,;~.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County / Department Use Only. X. County / Department Use Only C. rn;;rlate Pans and sperifications not smaller than 8 "/t x 11 inch -a n s - Lie sul. r, ttF cl to if Pity T ie plans must oh follow 1T: -,lot clan, Jr&d~, Lo >cale o~'tn'it i COr7lpietP ~l c!:S(~."'_., OCc ~IC;`~ ! irig tcnk(5), septic c 1 J Iaa' c.. ar ,.5; bii S; A'w%__r r. air'., p. =ci ak pun)p or siphon r_ . .V O?'!'~; S~II O`pr,rt, 5; replaCPr'teni ~jSLE.f?~ _ _''?E lo(,.? the bl.l1l1Jir1Q sEPrved; C'V, ;r>'' c, ,r ir'(5 i•: t:nlpl _ c `E:'; f'I; ( )ntrc. .I (.`S< volu m e; CUric'.; pal _ i.-: .i-;': r il`f, f, (.~)E.rC%SS section, if r",U ~ d the (r linty E) sui! }.2st daia o'i a ,4,,. ) ;:zincl In*ormatlon_ GROUNDWATER SURCHARGE 1983 Wisconsin Act 4 0 included the creation of surcharge:> (fees) for a number of ref Ulated prac ti(~ ~ vvhich can effect groundwater_ The monies coiiected through these surcharges are used for monitoring groundwater cGntam nal.iol r,vestications and estabiishment of standards. SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations October 4, 1996 2226 Rose Street x La Crosse WI 546th _•R ' WEGERER SOIL TESTING 1M 421 N MAIN STREET PO BOX 74 RIVER FALLS WI 54022 RE: PLAN S96-41294 FEE RECEIVED: 18 . HANSON, DAVID NE,NE,9,29,16W TOWN OF BALDWIN 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, and M. Swim Plan Reviewer Section of Private Sewage (608) 785-9348 SUDA-78971x. 10/841 Page of b EGE~~ED S96-41294 R MOUND SYSTEM FOR 1 1996 A 3 BEDROOM RESIDENCE SpF~ 61.5 • D1V • . • LOCATED IN THE NE 1/4 OF THE 1/4 OF SECTION 9 TZ9 N, R ~b W, TOWN OF Q I~L~ I/ul~l) ST- C~UIX 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 YS PREPARED FOR lQ NAQ MA'~~ FYn-. Sptt N S 01.) 7- 3 b Z 80 -ni iN U@', oo2el • X%0uysOf'SpF o z k'~ 5~~ GO J' PREPARED BY LdE43EFZEFt SO = L TEST I NG AND. ~ke~ DES = GIniSlE~V I CE ~v ~es Otis g F.R. BRX 74 421 N. KAU1 ST. ARTKIq L WEzir F;ER { RIM FALLS. 1R 54022 715-4255-0165 'W's Q6 bb1ti~` ~ g - Z-8 AIL JOB NO. ~b X63 PLOT PLAN Page Z o f . b Scale U t 9Z • f ~ ofd ~ ~ 3!y„p~A. Svc ~lPe 1 w O F o ' ~ Nl DO SOT Cp1~ Pn'e-T ~ •1 5 r^'~'~' DR ~ISTv~zq IL nrJ'1 J `nt'tS 'Pn2l3A ~ . of y puC ~,5~ 2 NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. ( Z required) 3. Install 4" observation pipes with approved caps. ( 2 required) 4. Septic tank to be\wa 6S0 gallon capacity manufactured by 5. Bench Mark SQ:~ Prli~oUF •6. Divert surface water around mound to prevent ponding at the uphill side. Page 3 Of Approved Synthetic Covering Distribution Pipe Medium Sand H IG Topsoil F Elev. c~ - 0 -J E t' D 3 U % Slope ~C-~1 ftw Of 2 z Force Main Plowed - Aggregate From Pump Layer Undisturbed D \-o Ft. Soil E 3 Ft. Cross Section Of A Mound System Using F o $ Ft. I Trench For The Absorption Area G a Ft. A s Ft. H I- S Ft. B S Ft. I IS Ft. Linear Loading Rate= I,.o GPD/LN FT J 1 Ft. Design Loading Rate= o.3GPD/SQ FT K lo• S Ft. L 016 Ft. -Ai ter W 7--1 Ft. L Force B K - Maii - A - ~~-Z~. W Distribution Trench Of 2 '2 Pipe Aggregate I Observation Permanent Markers Pipes tAnchor securely) t~10~~ - Y'1~V1v\~ \.S~}u L'~tV~, U~ S l..pp~ - S~ 1?~~C; Z O!~ Mound Using 1 Trench For Absorption Area Page Of Perforated Pipe Detail 0 End View )Perforated End Cop-, `i PVC Pipe _ as Install permanent-marker at end of each lateral Holes Located On Bottom, Are Equally Spaced Q End Cop Q ~'t * ti PVC Force Main DIStrtbution Pipe Last Hole Should Be Next To End Cop Distribution Pipe Layout P 3y S Ft. X J ~o InchPs y 36 Inches Hole Diameter Inch Lateral 1 Inch(es) Manifold - Inches Force Main 2 Inches # of holes/pipe \'Z Invert Elevation of Laterals 94-S- Ft. \Z,x1.1~: I~,I.oYy j, GPkj Place lst hole from tee with succeeding holes at 3 64 intervals. Last hole to be next to the end cap. Combination Sept c"; Tank -arid PUMP CHAMBER CROSS SECTION AK ID SPECIFICATIONS ' PAGE OF 6 VENT CAP WCATHEK PROOF JUAICTIOU BOX '1"C.I. VENT J~t_ APPROVED LOCKWG '_.10' FROM MANHOLE COVER k"Jiv :/IIJDOW OR FwR(2tJ11JG LA gEL AL IIJTAKE S cosJpu~r I .r lj I I I8' MIU. 18"MIN. \ ' 11~ PROVIDE I IAILE T AIRTIGHT SEAL ' ~ I 1 APPROVED JOIWT 3gFF~~S A I I i APPROVED JOINTS I W/C.I. PIPE4KPUC W/C.2. PIPEOR Tank construction I ICI ALARM shall comply with I 1 I ILHP x,3.15 and 83.20 d I I ow C I I I CLEV. FT. PUMP OFF O COLT KETE LTL 8-1, 00' 5LOCK 3'• Aa~k RISER EXIT PERMITTED OWLIJ IF TAWK MANUFACTURER HAS SUCH APPROVAL gEpplµ` SEPTIC E SPEC.IFICATIOAIS 005E T A W K MALI UFACTU RC R:MVbI`lQTMVN IBS- NUMBER OF DOSES: 3'~ b PER DAU TANK :,IZE: V~500 / &SO GALLO►JS DOSE VOLUME z ALARM MANUFACTURCR: INCLUDIIJG 5ACKIFLOW: `3~" GALLONS MODEL 1JUMBER: 1~~ w CAPACITIES: A= IUCHE5OR &ALLOWS SWITCH TSPC' B= Z IUCMES'OR =L GrLLOL15 PUMP MANUFACTURER: Z0~2' Z Co, Cs S IUCHES OR GALLOIJS MODEL UUMBER: qa D- INCHES OR GALLONS SWITCH TYPE: C_ul_Lf DOTE: PUMP AMD ALARMnAAR O bE `O MINIMUM DISCHARGE RATE GPM INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFERENCE .DETWCEU PUMP OFF A1,10-DISTRIBUTIOIJ PIPE.. W10-1 FEET + MIIJIMUM mETWORK SUPPLY PRESSURE 2'52 FEET b l F T. 6I + 1O~ FEET OF FORCE MAIN X /OfLFRICTIOM FACTOR. FEET TOTAL OtIUAMIC HEAD = 1S'~8 'FEET Pump chamber DIAMETER _ 3a INTERLIIAL. DIMEWSIOLl f OF TANK: LENGTH ;WIDTH ;LIQUID DEPTH " BOTTOM AREA 231= GAL/INCH AS PER MANUFACTURER © GAL/INCH - Apr OF HEAD CAPACITY CURVE 3 7/8 6 1/4 MODEL "98" 30 4 5/8 e I A 3 5/8 3 rD 6- U + + ~ O a tS 7g 0 15 4 3/16 4 10 ZS O$ 1 1/2-11 1/2 NPr 2 5 0 U.S. GALLONS 7-201 30 40 50 60 70 80 LITERS 80 160 240 0 FLOW PER MINUTE TOTAL DYNAMIC HEADIFLOW PER MINUTE EFFLUENT AND DEWATERING CAPACITY 12 HEAD UNITS/MIN FEET METERS GALS LTRS 5 1.52 72 273 10 3.05 61 231 3t 15 4.57 45 170 20 6.10 25 95 3 5/76 Lock Valve 23~ CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and • Mercury float switches are available for controlling single and supplied with an alarm. three phase systems. • Mechanical alternators, for duplex systems, are available with or • Double piggyback mercury float switches are available for without alarm switches. variable level long cycle controls. SELECTION GUIDE 1. Integral float operated 2 pole mechanical switch, no external control required. Standard all models - Weight 39 lbs. -'/2 H.P. 2- Single piggyback mercury float switch or double piggyback mercury, float 98 Series Control Selection switch. Refer to FM0477. Model Volts-Ph Mode Amps Simplex Duplex 3. Mechanical alternator 10-0072 or 10-0075. M98 115 1 Auto 9.0 1 or 1 & 7 - 4. See FM071Z for correct model of Electrical Alternator, "E-Pak". N98 115 1 Non 9.0 2 or 2 & 6 3 or 4 & 5 5. Mercury sensor float switch 10-0225 used as a control activator, specify D98 230 1 Auto 4.5 1 or 1 & 7 - duplex (3) or (4) float system. 6. Four (4) hole "J-Pak", junction box, for watertight connection or wired-in sim- E98 230 1 Non 4.5 2 or 2 & 6 3 or 4 & 5 Alex or duplex operation, 10.0002. 7. Two (2) hole "J-Pak", for watertight connection or splice, CAUTION For information on additional Zoeller products refer to catalog on Combination Starter, FMO514; All installation of controls, protection devices and wiring should be done by a quali- Piggyback Mercury Snitches, FMO477; Electrical Alternator, FMO466; Mechanical Alternator, fied licensed electrician. All electrical and safety codes should be followed includ- FMO495; Alarm Package, FM0513; Sump/Sewage Basins, FMO487; and Simplex Control Box, ing the most recent National Electric Code (NEC) and the Occupational Safety and FM0732. Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO. P.O. BOX 16347 ` L.orr Wft, KY 4025630347 Manufacturers of... Z L/W O SNIP TO 321, Old Millers lane 1 O O`/ g `L LouisvrlLe, KY 40218 QUAL/TY PUMPS iVLE /9.79 O: (502) 778-2731-e. 1(800) 928 PUMP FAX (502) 774-3624 Wisconsin Department of Indus", SOIL AND SITE EVALUATIONREPORT Page I of Wr 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 81/2 x 11 inches in site. Plan must include, but ST` GIP-0 [ K not limited to vertical and horizontal reference point (BM), direction and %.of slope, scale or ARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road;`, APPLICANT INFO ON-PLEASE PRINT ALL I N REVIEWED BY DATE PROPERTY OW ER: ~L)f'~V 1-S Q) ROPERTYLOCATION ,0W 1~,~ L L 1 GUVL. LOT 1/4 P<1E1/4,S q T Zq N,R 6 E PROPERTY OWNER':S MAILING ADDRESS ~`1~Yf #W.: BLOCK,#, . NAME OR CSM # It-to l l ftuE CITY, STATE ZIP CODE PHONE NUMBER ❑ OWN NEAREST ROAD t-~p~Lpwtlu t1.W t StfooL ())S) 6671y-yu~7 3Q,~ cwt f.~ 1\O' PN~ - [~Q New Construction Use ]5C] Residential / Number of bedrooms 3 [ ] Additif~n to exisfing building [ ] Replacement [ ] Public or commercial describe Code derived dally flow LSD 9Pd Recommended design loading rate - bed, gpd/ft2 3 trench, gpdtft2 Absorption area required _~1 S bed, ft2 3l S trench, ft2 Mabmum des-7 loading rate o • S bed, gpolit2 ° • 6 trench, gpddt2 Recommended infiltration surface elevation(s) 99,o I ft (as referred to site plan benchmark) Additional design / site considerations Y" L)L)k b • w iTA S ' x --~S ` Tzt%j 01 j m tti , l ' o F- Fr t,t, Parent material s P~-p~ t I~t~tM T t Rood plain elevation, if applicable N A ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for stem ❑ S ®U ®S ❑ U ❑ S ®U ❑ S ®'U ❑ S QZU ❑ S U SOIL DESCRIPTION REPORT Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Bouxlary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Tench S vz''tR 3]Z 5t :Sb Wt v~~ aS 2,uj D,S p,6 o• L s'b wt c w I f P's Ground 3 19-ZB nSy2 3111 - s 1 1CSbk ~S \u+ o-y o.S elev. l' ~Z ~.$YRS/8 q~ eft. 1 Z$-38 7•S`fP_ 3/y a rota 6!t S 11 Q)141 mfr d,5 - - Depth to 5 -6I S -t 2 3 Cy limiting factor 5 Fl~kj w\_ ptti PACeb 12Ln L C_&tUAG(-Z w I T11-4 Z8 \Z 'V !V s e-oh`r- S Remarks: Boring # , tY; 1 0- S to`'tR 3 /i - St Z`~Sb►T Ynv O-S Zug C" S o• I, kRK 2.45 Z S-19 IOyR Y/y - St 2'fsbh wt'~►- cw ]vf o. S': 0.6 3 >.q-3Z ~-SyR 3/y - S l 1 ~s b>z ~n~`~rr` c8 lu ~ o-y o• S Ground elev. y 3L_6y S'i P_ 3/y , 5yR3113 m'f►--►.~~'; - - - 98•a ft. tu~re t,rt L~ sl o~. Depth to S Pv u T'k P )s S tl il:l vt: rimiting factor __T 3 z" Remarks: CST Name:-Please Print Arthur L. We erer Phone- 715-425-0165 Address: Soil Testing & Design Service-P.O. Box 74 River Fa11s,WI 54022 Signature: ~~pp Date: CST Number: d, %3_Z3-1) -Z9-93 M00576 11- c4z~*y Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of 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 C~ [ x not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or P D # 2 dimensioned, north arrow, and location and distance to nearest road. J APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION IEWEDAY ATE PROPERTY OWNER: PROPERTY LOCATION ~y 1 O S t'~"hl GOVT. LOT U~ 1/ 1/ ,Gir 'Z 6J M R (ory 3W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # S . AME OR CSM CITY, STATE ZIP CODE PHO~E NUMBER []CITY []VILLAGE ZCtNt 13RLlvu~ ,w t sut,oz (~I )-yu173P,~ awl 11 c• New Construction Use [ Residential / Number of bedrooms 3 [ ] Addition t g j ] Replacement [ ] Public or commercial describe Code derived daily flow L1SD gpd Recommended design loading rate - bed, g;xW trench, gol? Absorption area required S bed, ft2 trench, ft2 Mabmum design loading rate o S bed, gpd/ft2 6 Bench, gpolft2 Recommended infiltration surface elevation(s) 9 0), o ~ It (as referred to site plan benchmark) Additional design/ site considerations Y-l uun~'p" w ► M S ' x -~S ` "Mev at} - w~ ,1' o F SPcr,~ Fi vt- Parent material S t >~-t l z^m ~-t Flood plain elevation, if applicable N -P\ ft S = Suitable for System CONVENTIONAL MOUND IN-GROUND PRESSURE AT GRADE SYSTEM IN F1 HOLDING TANK U = Unsuitable for stem ❑ S ®U ®S ❑ U ❑ S O U ❑ S 171) 11 S MU ❑ S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bouxialy Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench kyt%•4 ~4?: iii Z S10 k m y a.S zj o, S b cw 1vf o.S o•L Ground 3 19-ZS ~Sy2 3/ Y - S 1 \ cSbk cs 1U+ o•y O• S elev. ft. y Z~-38 ~•Sya 3!y f ►oKR 61/a s o~ mfr ds - - Depth to S -61 S `i it 31y lr S wt'l(1-- mf)- limiting factor 5 Fl-no w VO,n- p q oeD \_)C1 'T) C EAV A G L P~-P~rU L w 1 N to`L V ly s NI) + e_tNTS Remarks: Boring # 1 0- C. ~rz"-.2. 3 /Z St l ~-`FS~bC 'Mva-S Zu'~ o. S p, b ~h :v titC?<i~:t < Z: Z 'S -19 loytz Y/y - Sl~ 2'FSbk wt`~~ ct," [v~ o.S o•6 ~ 3 ICI -)•SyR 3Cy - s 1 10-,5 bLz. "Ui\' CS lu ~ o.y d• S Ground elev. 3L_6Y S 4 2 3/ ~ ~'SyRS/$ m`F►--Yh`hi g8 • ft 4 y e~ t uti e 6 r L s s l o Depth to S Pi U Tl Pf S S F~I30 V Cr limiting factor 3'Z~ Remarks: CST Name:-Please Print Arthur L. We erer Phone: 715-425-0165 ergerer Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022 Signature: Date: CST Number: `%3 _Z3S-Z9-93 M00576 PROPERTY OWNER gf"t t-nq SOIL DESCRIPTION REPORT Page Hof' 3 PARCEL I.D. # " Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1~ 3~Z S 0 - Sb ~ S Zv`F 0•S 0•( 3 1 6 `-t~Z lI Z `F lotie y!y SO -2 5 r~►~~ eS Ivy o.S a.L Ground 3 Zt-30 -'S y2 3/y S) C S~k m v~~ cS 1v'f o y o.S elev. 1dl~.SyR S[g U w,`~1 r+~~ - °Ib, o ft. L] 3v-b0 S vv- 3/y d ytZ 6 [ Z 01S) Depth to limiting factor Sir Remarks: Boring # t Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor "Remarks: Boring # Ground elev. ft. Depth to limiting factor L I I I-- I L Remarks: SBD-8330(8.05/92) PLOT-PLAN Page 3 of 3 SCALE 1"= 30 ' o• Z ri►i 7-0 2110 T)f Sr. _ ~ l l b ~ Prv I I 3 h ~J v ~ P~ 0 d Ft?1uCE* . x, ' 00 95 a. o QTt SOU. p' 0K► (z. "1t16N ~2vv"b) R . i~ ~ Pv e p1 P~ w~~ LR'1T} . \ \ 30' O f41R \ 9\ DuT. OF- ~k.W.V c~ ~1.. 44 , p 1 \n-96 ~l fv1 \ ~ I ~i ~nTPri~T OR cr~~ 1 S o f -SU ~`i14 <3'R S T C11= 1~-~ uv~4p , O \ S`N Z-t~ `~T41 s !'tRlsvq ~ - `^~~l,l._ kS L% v~ s To !fir LL 4A sr 7- S' Fv-o w, w,ou,,o . g3,z3S .~3'L~ -1-~ 9 Z 9 3 (715 ) 4 2 5- n 1 h_4- M0 0 5 7 6 CST Signature Date Signed Telephone No. CST # Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page I 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 5`T". 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 INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY GATE PROPERTY OWNER: PROPERTY LOCATION F S 1" 1 17-14 GOVT. LOT 1/4 NE 1/4,S 9 T Z9 N,R [ 6 E (orcwb PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUED. NAME OR CSM # o l l `rtt (f-vN . - - CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE OWN NEAREST ROAD Q3PSLDwI/v Ik) l SvOoz- (-)I S) 6By-yu1 7 f'j 1\0 `(ti- Ptuc. ~Q New Construction Use [JCJ Residential / Number of bedrooms 3 [ ] Addition to existing building [ ] Replacement [ ] Public or commercial describe Code derived daily flow L1SD gpd Recommended design loading rate - bed, gpd/ft2 3 trench, gpd1ft2 Absorption area required S bed, ft2 3, S trench, 11`12 Maximum design loading rate o . S bed, gpd/ft2 ° • 6 trench, gplW Recommended infiltration surface elevation(s) 9 q • o ~ ft (as referred to site plan benchmark) Additional design / site considerations r'-f b0n,p• w 1)-A S' ><~S 'rzeAj g* - w, It- ,1 ' o F SN*j,, , Ff k, L_ Parent material S "-'s-f LrNv\" Tt \_k_ Flood plain elevation, if applicable ft S = Suitable for System CONVENTIONAL MOUND IWGROUND PRESSURE AT-GRADE SYSTEM IN FILL. HOLDING TANK U = Unsuitable for stem ❑ S ®U ®S ❑ U ❑ S O U S I U ❑ S I~ U ❑ S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color mottles Texture Structure Consistence Bandary Roots GPD/ftin. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed p2r1d1 Z S_ l 9 o t2 v /y S i I S b 1~ c w ) u f o. S o• L Ground 3 )9-28B Sy R. SlV - S` ~CSbk w,v~V eaS lv+ o-y o•S elev. ~`Z ~.SYRSlt3 gZ.6ft. y Z~-38 7 SyQ 3/Y Er /0`22 Eli S (Z) 141 mfr ds - Depth to 5 'l$ -61 `t 2 3 !y lv S Owe `M ~1-- m'~i limiting factor 5 Ff-sui L-j Q LL P A C ep U C~1Z ~1 C ~`R V~ G ~ Vz"L-i"NiU L w 1 Z 23 ~o `1 \1 Iv S to- e--rlk-r S Remarks: Boring # S 1r3'-A2 3 /Z - 5t1 Z`FS~t~ my zu, S o S_I / 2 sbh wt ~w Ivy o, Z Z 9 )oya y y - sit S o•6 .Y 3 1q-32 S'7R 3/y - 5 1 1 S bl2 vnv F~ cS Iv o.y :o-S Ground 5'1 RS/g elev. 4 3Z_6y S `9 e 3/y 0 1W-1It 61 t p.•~ 98-9 It. Depth to S km PJu T-1 P )s S "t1 : limiting factor 3'Ztt Remarks: CST Name: Please Print Phone: Arthur L. We erer 715-425-0165 egerer Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022 Signature: ~~pp Date: CST Number: d. 9 3_Z3S 9-Z-9-93 M00576 PROPERTY OWNER %1`1 SOIL DESCRIPTION REPORT Page ? -of 3 PARCEL I.D. # Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounclry Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Witii3htivi' r g.g 3 1 0-6 loti~z 3!Z - l 1 Z SUYZ 1^n s- - a-s ZU`t• o.s u. Ground 3 2.1-11Z, ee 5/y m \I cS 1\J1 o Y o•S elev. U 1 SyQ stg °fb, o ft. 7 30-b0 S V2 3/y dill YR 6lt L9S) Uw, Depth to limiting factor Remarks: Boring # Ground ' elev. ft. Depth to limiting i factor Remarks: Boring # 4I a;Y•t~i4>: vk4'; 4 M1 ' i Ground elev. ft. ' Depth to limiting factor I Remarks: Boring # Lwt ;y..ti; :,.bx{ Ground elev. ft. Depth to limiting factor L 6- Remarks: SBD-8330(R.05/92) PLOT PLAN Page 3 of 3 SCALE 1"= 30 Z. m To ZY o T* 3r. tlp Avg _ - - I ~J 51 Pt 0 tsL CID ~ a, v^ 6r ~ o , Q2,o"oh►t ~ ~v3o"oRlt ~ 81'1 - Tt- VO rJ 'O+u 6 ° t1IG N --VV 'w P) p~., e p1 Pt w►•st•y LR1'1.1 . \ 30o hk 96 0o<.OF `C1~ eva HL• 4Q,p n A.1 ~ eTL 00 6 '-~96 \ y/ lei NoTp>~e-T oR L`er~ 1~~~~ .S~iv`~14~RST VF w►up D!S`Sv~L~ `Tr41s ~t•Rli1q E IVo aE Arr LLs sr z S' Fv uw, w,out, . X73-.z3S 9 ; Z9- 93 (715 ) 425.-0165 M00576 CST Signature Date Signed Telephone No. CST # STC-105 SEPTIC TANK MAINTENANCE AGREEMENT / St/. Croix County OWNERBUYER / 119 4 S ° a MAILING ADDRESS 2 3 ( 6~- 0 C b o t~ PROPERTY ADDRESS Q 3 13 1 ) D 14~ Ait~ 2 (location of septic system) Please obtain from the Planning Dept. CITY/STATE 13 a /a/ a/ '^f h ttl` S PROPERTY LOCATION NC 1/4, N!L 1/4, Section 1 T N-R l W TOWN OF 13 u /a( w n ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAP , VOLUME , PAGE , LOT NUMBER Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the S roix County Zoning Officer within 30 days of the three year a tion date. SIGNED: jJ DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 . S T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in 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 0 el v ('d l l g Ai S" C' A-L Location of property /a14 1/4 Nl~- 1/4, Section T N-R W Towns ip 8 4 /d W I"j Mailing address '2 3 k'6 3 4 i- y a '2- j34 Address of site a 3 9 3 110 44' tl- Vf . Subdivision name Lot no. Other homes on property? Yes L--No Previous owner of property Total size of property 110 Total size of parcel 40 Date parcel was created Are all corners and lot lines identifiable? ✓yes No Is this property being developed for (spec house) ? Yes No Volume 1/1,3 and Page Number as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER 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 reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No. S-Y 7235 , and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of the Coun y Register of Deeds as Document No. 235 Signature o pplicant Co-Applicant A0 . Date of Signature Date of Signature C10C~IJMr-(`.' WARRANTY DEF0 STATE BAY` OF tVl, l't,` 1:, Fv: w _ 19h l35 vat E' S t Edward Lawrence Hanson and Phyllis L. 'Janson, husband and wife AUG 5 0, r co- : (n,l ..rra,:ts to QaviQ L, Hanson, and Joan ?4_ at 9:30 A. Manson, husband an wife, as survivors1hip marital property the followin, descrihe,l real est-te in S t; Croix State of W',sconsin: Tax Parcel Rio------ - - The Northeast Quarter of the Northeast Quarter (NE4 of NE4) of Section Nine (9), Township Twenty-Nine North (T29N), Range Sixteen West (R16W). 4~' is not This homestead prohert}. X*;K) (is not) Exception t„ wa.-anties: Easements and restrictions of record. L , zl~ Dated this ~ day of ✓ - is 90 . C_ (SEAL) Gc ~E - G c X u FA 1, Edward Lawrence Hanson (SEAL.) (SEAL, Phyllis L. Hanson AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE d"IF WISCONSIN _ - - - St- Croix County. SS' authenticated this ---day of , 19..._. Fc ?c came before me this day of 12.. 7-'r 7 - - Edv. rd hawrenc6 1laTtson A-i NZ Ph ltis_t Ha so _ - ~4, ~ . ~ y, TITLE: 'SIFNIBER STATE BAR OF WISCONSIN J , (If not. - . ~Q authorized by 706.06, wis. stat5J 4 to ti_ k < a to be t .e pe c`r, _ d fo , -i. r-^ I. A- -aa and .tt•1 TH:S IWTRUMENT WAS DRAF`EO nY - ~ 'f /'e` ,%Q` t• 1 Thomas A. McCormack - Raid(win. WT 54002 _ - ,S - L_