HomeMy WebLinkAbout004-1034-10-100
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Parcel 004-1034-10-100 07/03/2007 09:58 AM
PAGE 1 OF 1
Alt. Parcel 15.28.15.227A 004 - TOWN OF CADY
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
01/05/2004 00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
AUDREY J MOLDENHAUER O - MOLDENHAUER, AUDREY J
392 310TH ST
WILSON WI 54027
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 392 310TH ST N
SC 5586 SPRING VALLEY
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 36.500 Plat: N/A-NOT AVAILABLE
SEC 15 T28N R1 5W NE NE EXC CSM 18-4686 Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
15-28N-15W
Notes: Parcel History:
Date Doc # Vol/Page Type
01/05/2004 750726 18/4686 CSM
11/14/2002 698389 2046/398 TI
07/23/1997 441/357
2007 SUMMARY Bill Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 04/09/2007
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 28,000 159,900 187,900 NO
AGRICULTURAL G4 18.000 2,900 0 2,900 NO
UNDEVELOPED G5 16.500 10,000 0 10,000 NO
Totals for 2007:
General Property 36.500 40,900 159,900 200,800
Woodland 0.000 0 0
Totals for 2006:
General Property 35.500 40,900 159,900 200,800
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
\kisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County:
Labor and Human Relations INSPECTION REPORT ST. CROTX
Safety and Buildings Division (ATTAC H TO PERMIT) Sanitary Permit No.:
-
GENERAL INFORMATION 26851
Permit Holder's Name: ❑ City ❑ Village Town o : State Plan ID No.:
~MOLDRTr HAIJER r RON CAD`r
Parcel Tax No.:
CST BM Elev.: Insp. BM Elev.: BM Description:
66
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
"
Benchmark 9 5~ /Gc~•G~
Septic 'eu r: Y r~ cz /~v
Dosing C'~1,,, Gs0 3./S I d0 ,
Aerationt- 4 . Bldg. Sewer
Holding St/)Ot Inlet
TANK SE fACK INFORMATION St/ Outlet
vent
TANK TO P / L WELL BLDG. Air Ito ntake ROAD Dt Inlet
Air
Septic NA Dt Bottom n.. v' 9173
lo•sz, 1t
Dosing NA Header/ Man.
titio NA Dist. Pipe .65
ng -
Bot. System 5S 9~.Ov{
PUMP/ SIPHON INFORMATION Final Grade QZ,
if Manufacturer Demand
Model Number QS:f 3 3 GPM
iF DH Lift 0~k Friction 3) System TDHq,1~ It Loss
'
rcemain Length Dime Dist. ToWellrSo'
o
SOIL ABSORPTION SYSTEM
BED /TRENCH TRENCH Width Length / No. Of Trenches PIT No. Of Pits Inside Di d Depth
DIMENSIONS N / DIMEN I N anu acturer:
SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACF~4N
SETBACKMBER Model Number:
INFORMATION Type O nom.- 5 o O ' OR UNIT
System: M
DISTRIBUTION SYSTEM
Mani old Distribution Pipe(s) / d x Hole Size x Hole Spacing Vent To Air Intake
Length Dia. Length Dia. /T Spacing
SOIL COVER X Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over r, xx Depth Of + xx Seeded/ S~~ xx Mulched
De th Over i P 0/
Topsoil - ?"Yes ❑ No Yes ❑ No
Bed /Trench Center Bed 1Trench Edges ~2 " 1<6
COMMENTS: (Include code discrepancies, persons present, etc.)
T 01
mr, a
c &a Y.1,5_28_15W, NE
, NE, 0T=JT s ~ _ 1 ~c/ 70 ~ ~c~ C~SZ✓~e/'I~
;-.O."Ar TON
.J y f~ t ? ' i ~.J~. J I ~i/ a.d'YV.. ,rg.•6-'CY"'e~.,,I
Ian revision required? Yes No RIP
Use other side for additional information. b
SBD-6710(R 05/91) Date Inspector's Signature Cert. No.
a JQ
!`r ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
l/
Safety and Buildings Division
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 8112 x 11 inches in size.
• See reverse side for instructions for completing this application state Sanitary P Frm't N u -bber
The information you provide may be used by other government agency programs ❑ Checrc prevlotYs pplication
[Privacy Law, s. 15.04 (1) (m)). State Plan I.D. Number
I. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION " ~CS~~S
Pr rty wngr ~Nao ~C N~ Property Location /
;mss 1/4 E, 114, S S" T N, R ZJ E (or W
Propert Owner's Mailing Address Lot Number Block Number
City, St to Zip Code Phone umber Subdivision Name or CSM Number
w l.J~. z 77 1(11 J >
II. TYPE F BUILDING: (check one) ❑ State Owned ❑ it Nearest Road,.
❑ Village Q
Public 1 or 2 Family Dwelling - No. of bedrooms 3 Town OF d'✓
III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) .2 r7
1 ❑ Apartment/ Condo
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: (Ch ck Only one box on line A. Check box on line B, if applicable)
A) 1 ew 2. Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repai r of an
_ystem ________System___ __TankOnly 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 21gMound 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
js~c) Required (sq_ ft.) Proposed (sq. ft.) (Gals/day/sq. ft-) (Min./inch) 9S Q EI on
Feet
37S 2 Feet
VII. TANK Capacity
in al Ions Total # of Prefab. Site Fiber- Exper.
g Manufacturer's Name Con- Steel Plastic
INFORMATION Gallons Tanks concrete glass App.
New Existing ~ structed
Ta`nks Tanks 00 I- i 'l
Septic Tank or Holding Tank ^ W Q S ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber k it ❑ ❑ ❑ ❑ ❑
VIII. RESPONSIBILITY STATE-MENT
I, the undersigned, assume responsibili for installatio f the onsite sewage system shown on the attached plans.
Plumber's Name: (Pr t) P is Signature: (Noa t mps M MPRSW No.: Business Phone Number:
(a L ~tS- Z1S! Oros 1
Plumber's Addre s (Street, City, St e, Zip CON I"
IX. COUNTY / DEPARTMEN USE ONLY
❑ Disapproved anitary Permit Fee (Includes Groundwater Date Issue Issuing Agent Signature o Stam s)
Approved E] Owner Given Initial Surcharge Fee)
Adverse Determination
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SBD-6398 (R. 05/94) DISTRIBUTION: Original to county, One copy To: Safety a Buildings Division, Owner, Plumber
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit may be 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 sanita-ry 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 8 112 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 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.
HALVERSON BROS., Into
EATING
PHONE 235.0651 1020 NORTH BROADWAY ~j
MENOMONIE, WISCONSIN 547S1 ~lF
a~ r AIIAt eiScP,4
~CA.9 WWAS
bilk ~4~e
0 a
- - - - - - - - - - -
i
SAFETY & BUILDINGS DIVISION
State of Wisconsin
Department of Industry, Labor and Human Relations
May 29, 1996 2226 Rose Stree r,
LaCrosse WI`
, tr
WEGERER SOIL TESTING " r
421 `N MAIN STREET f Ac~r~~r
PO BOX 74 ~P m. vGOF~~
RIVER FALLS WI 54022
RE: PLAN S96-40475 FEE RECEIVED: 180.00
MOLDENHAUER, RON
NE,NE,15,28,15W
TOWN OF CADY 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,
card M. Swi
Plan Reviewer
- Section of Private Sewage
(6b8) 785-9348
cc: ST CROIX
SHDA•7997 (R. 10M)
Page 1 of 6
MOUND SYSTEM
A 3 BEDROOMRRESIDENCE S96-40475
LOCATED IN THE N~ 1/4 OF THE N E 1/4 OF SECTION ~ S, T Z8 N, R 15 W
TOWN OF , -ST-, c_(to,){ COUNTY, WISCONSIN.
INDEX
PAGE l '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
w~LS~N, w1 s4oz~ MAC i~ys
SAFETY & SLOGS,
PREPARED BY
WECCFERO I L TESTING®'6tv1~
G~ Sys AND. p so
11 cam
5?
~ B01 74 421 K. MlK ST. ;
~~yy S ARTHUR L. 1~ f':0 It T WEGFR£R
I11fBI'il.l.S. MI 54022 • i D-3t5P
,tom wrs. t
9i~iP~_ S I GL
py,°lrs - 'BN
GO
5~E
JOB NO. q 6-10
PLOT PLAN
• Page Z of 6
Scale 1"= yc '
590 404"75.
X wkrO-
' 3 8D21~
~ vs
t'n.'`t Hx~p Kk- ~ S-nAU G
~'Mv12 S `tu 6E Prbr bWW,
~S GaAE,
i
tn, 3~_L CI.L•m~ uvT- Lv/►=~osT S~~@
~bs'o~ y"PVC
~r'ltrJ. LIZ cou~>
1
0
N16~{~ 3lt~' ply CL 19 S p~ Zy Pu OF q~
-LO God
Pv e Pt PE 15.1
31
~ zS ~ pp fl
~L q 3 3, ~ Z ~1
//2g
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. ( z required)
4. Septic tank to be boo bSa gallon capacity manufactured by
In IAL, w ~s 't2ry , , ti 0-
5, Bench Mark SEC' . ",,,j
6. Divert surface water around mound to prevent ponding at the uphill side.
Page 3 Of
Approved Synthetic Covering
~sTM c 33 Distribution Pipe
Medium Sand
Topsoil F Eiev'. ~TS,O
D -
~I
3 E
u
\5 % Slope
(Force Main Plowed
Trench of k"-2k" From Pump Layer
Aggregate
Undisturbed D k .O Ft.
Soil E 1.1 S Ft.
Cross Section Of A Mound System Using F o• 'iS Ft.
1 Trench For The Absorption Area G N•o Ft.
A S Ft. H I- S Ft.
B IS Ft.
I ZZ) Ft.
Linear Loading Rate= b•Z GPD/LN FT J 6 Ft.
Design Loading Rate= a.ZyGPD/SQ FT K ~ Ft.
L q`1 Ft. wr v~swPE k--t s ti of `7sLL---
Position of Force Main W 3 Ft.
L
~ ~ -Farce
B K tvtain -
A St- - -
w
Distribution Trench Of 2 2
Pipe Aggregate
l 1
Observation Permanent
Markers
Pipes
(Anchor securely)
Mound Using I Trench For Absorption Area
Page L Of
Perforated Pipe Detoll
0
J"~L.d View
)Perforated
End Cop./) PVC Pipe
Install permanent-marker
at end of each lateral
Holes Located On Bottom,
Are Equally Spored
Q End Cap
PVC Force Main
tDistrioulion,
Pipe
Lost Hole Should Be
Next To End Cop
Distribution Pipe Layout P 34-5 Ft.
X Inches
y Inches
Hole Diameter '1Y Inch
Lateral 1 l~Y Inch(es)
Manifold Inches
Force Main Inches
# of holes/pipe VL
Invert Elevation of Laterals q 8-5 Ft-
Place lst hole ~S" from tee with succeeding holes at 36~ intervals.
Last hole to be next to the end cap.
Combination Septic;Tank and
PUMP CHAMBER CROSS SECTION AMID SPECIFICATIONS' PAGE S OF
VE►J7 CAP WEATHER PROOF
JUJJCTIOU BOX
4'C.1. VENT PIPE APPROVED LOCKING
lO' FROM DOOR. MANHOLE COYER wJ
-,AmoOW OR FRESH wAQt.JIIJG LABEL.
AIR IWTAKE caapu~r
T
) 1j i
I
tL q• q s f ~ GAA `I' mu.
- I
~ le'rllu.
• PROVIoE I
iM LE T ~ AIRTIGHT SEAL I III
• I II
APPROVED OINT 3aPF~~S A I I I APPROVED JOINT; JO
PIPE i III W/C.I. PIPE4w
W/C.I. Tank construction ALARM
shall comply with I II
ILHR (83.15 and 33.20 B I I
I I ou
c
gz
LLEV. 31FT. PUMPS "
` OFF
D COUCRETf
9 Z. OCR BLOCK
3" APPR,
- RISER EXIT PERMITTED OULtl IF TAWK MAUUFACTURER HAS SUCH APPROVAL gEDOINis
SEPTIC E 5PECIFICATIOAIS
DOSE Mlpw ~~sr IJUMBER OF DOSES: PER DAy
TA1JK MAUUFACTURCR:
TANK SIZE: "300 1 6 SO CALLOUS DOSE VOLUME r
ALARM MAUUFACTUILI`R: S'S kTt. eMD S`2S`TEM S IIJCLUDIUfa BACKFLOW: GALLONS
MODEL JJUMBER: 10 1 1~►~.~c, CAPACITIES: A= l~ IWCHE5 OIL 30 L GALLONS
SWITCH TYPE: ! B = IUCHES"OR gV_ G( LLOAJ5
PUMP "MUFACTURER: CINCHES OR "1 GALLOIJ5
MODEL UUM6ER: S~ D- > > INCHES OR \ tl_ GALLONS
SWITCH TYPE: MOTE: PUMP AMD ALARM RE TO IDE~
MINIMUM DISCHARGE RATE GPM INSTALLED OM SEPARATE CIRCUITS
VERTICAL DIFFERENCE DETWCEU PUMP OFF AIJD."DI5TRI5UTI0U PIPE.. S.SS FEET
f MINIMUM WETWORK SUPPLY PRESSURE 2.50 FEET
L
+ ZC) FEET OF FORCE MAIM X sZ1-F 00FLFRICTIOU FACTOR. 2-2'_?- FEET
. = TOTAL OtIUAMIC HEAD = =--'Y FEET
Pump chamber DIAMETER
ILITERUAI. DIMLIJSIOWP OF TAWK: LEWGTH _ ;WIDTH ;LIQUID DEPTH 3...~..._
BOTTOM AREA - 231= GAL/INCH
T>S PEA? MANUFACTURER = 1~ O GAL/INCH
0'F
4% 6'%
• W HEAD CAPACITY CURVE 45/8
-
~ 5/8
W LL "57" - "59" SERIES *4.3/16
25
A 1'h - 11'h NPT
20-
6-
Q I
W
U
15-
~ Q
z
G 4 91$/16
J
F
o t0
8 Nra 33/
2-
5- ~,e$
TOTAL DYNAMIC HEAD/
FLOW PER MINUTE
EFFLUENT AND DEWATERING
HEAD CAPACITY
0 UNITS/MIN
FEET METERS GAL LTRS
US 10 20 30 40 50 5 1.52 43 163
GALLONS
10 3.05 34 129
LITERS 0 80 160 15 4.57 19 72
FLOW PER MINUTE 19.25 5.87 0 0 s
CONSULT FACTORY FOR SPECIAL APPLICATIONS
. Piggyback Mercury Float Switches *Available with special cord lengths of 15',
available. 25', 35' and 50'.
. Variable level long cycle systems *Alarm systems available.
available. . Duplex systems available.
Standard cord length - automatic 9 ft. SELECTION GUIDE
Standard cord length - non-automatic 15 ft.
1. Integral float operated mechanical switch, no external control required.
2. Single piggyback wide angle mercury float switch or double piggyback mercury
57/59 SERIES Control Selection float switch. Refer to FM0477.
Model Volts-Ph Mode Am Simplex Duplex 3. Mechanical alternator 10-0072 or 10-0075.
M57/59 115 1 Auto 8.0 1 or 1 &7 - 4. See FM0712 for correct model of Electrical Alternator, "E-Pak".
N57/59 115 1 Non 8.0 2 or 2 & 6 3 or 4 & 5 5. Sensor mercury float switch 10-0225 used as a control activator, with "E-Pak"
1 A t 4. 1 or 1 & 7 - duplex (3) or (4) float system.
E57/59 230 1 Non 4.0 2or2&6 3or4&5 6. Four (4) hole"J-Pak", junction box, for watertight connectionorwired-in simplex or
2 pump operation, 10-0002.
7. Two (2) hole "J-Pak", for watertight connection or splice, 10-0003.
57 Series - Wt. 27 -.3 H.P. 59 Series - Wt. 29 -.3 H.P.
CAUTION
For information on additional Zoeller products refer to catalog on Combination Starter, All Installation of controls, protection devices andwiring should be done by a qualified
FM0514; Piggyback Mercury Float Switches, FM0477; Exectrical Alternator, FM0486; Mechani- licattsed electriclao. All electrical and safety codes should be followed Mcluding the
cal Alternator, FM0495; Alarm Package, FM0513; Sump/Sewage Basins, FM0487; and Simplex most retard National Electric Code (NEC) and the Occupational Set* and Hplth Act
Control Box, FM0732. (OSHA}
RESERVE POWERED DESIGN
For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump.
AWL TO. P.O. BOX 16347
Louisville, KY 40256-0347 Manufacturers of .
® O OI SNIP T0: 3280 Old Millers Lane
ZAZZIF)f Louisville, KY 40216 a
(502) 778-2731.1(800) 928-PUMP QUALITY PUMP9 AFINCr IA317 9
FAX (502) 774-3624
Labor aannddHuum nnRelatio~"S`~' SOIL AND SITE EVALUATION REPORT Page 1 of 3
' Division of Safety Buildings in accord with ILHR 83.05, Wis. Adm. Code
b COUNTY
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must i a
not limited to vertical and horizontal reference #
point (Blu), direction and % of slope, Or
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVI DATE
F L Iq.~`~
PROPERTY OWNER: PR ~y TY I% ATION
l~ 01J 1't O D U .1/4 N~ 1/4,S N,R k S E (o4► )
PROPERTY OWNER':S MAILING( ADDRESS LO BLOCK SUBD° NAME # _
CITY, STATE ZIP CODE PHONE NUMBER N NEAREST ROAD
t.~~~S~►J , tivI S4oZ7 - 14 4~~, • 3LO -Tit 5T,
[ ] New Constriction Use [XI Residential / Number of bedrooms 3 [ ] Addition to existing building
~Q Replacement [ ] Public or commercial describe
Code derived daily flow kASO gpd Recommended design loading rate - bed, gpolft2 trench, gpd1ft2
Absorption area required 31 S bed, ft2 3-)S trend., ft? Maximum design loading rate o -S bed, gpd/ft2 0 - L trench, gpd/ft2
Recommended infiltration surface elevation(s) 98-01 ft (as referred to site plan benchmark)
Additional design / site considerations S ` _VZ C.N , "I A, . 1 ` 01= S1R~ F1 ~ t_
Parent material SPcr`n~ S~OtJ E Flood plain 0evatlon, if applicable t' a. R , ft i
S = Suitable for system CONVENTIONAL MOUND "ROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U= Unsuitable for stem L IS Q U OS O U [IS O U [IS ®U 0S O U 0S ® U
SOIL DESCRIPTION REPORT i
i
Depth Dominant Color Mottles Structure GPD/ft
Boring # Horizon in. Munsell Qu. Sz. Cunt Color Texture Gr. Sz. ShConsistence Botrxby Roots Bed Tench
_ .
f ~_q ~b`12 3/ 3 S Z>+n Sb my CS ().:s o'
x> r:. Z q -Z v l 0 `l tZ V/ V o• b
C2t~
Ground 3 Z8-SO I b Lt li . g ti s Jg g O
elev.
aq • o ft
3 N O w FLT 51
Depth to V 1'rs - i~ U
limiting
faCtDr
ZS `
Remarks:
Boring # _
0-8 10`~IZ 313 S1 ZMS10c `B`FI- e S - o.So.
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13
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elev. Z$_6D lb`i 2 1. S LIZ Sts V" U'~►~
93.3 ft - -
Depth b 4 S ti~ 3 IRT
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facts F
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Remarks: i
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: 6 _ 1 D Date: CST Number:
S 2 0-~~ M00576
PROPERTYOWNER U10~.~1t~V~2 SOIL DESCRIPTION REPORT Page ?-of_ .
PARCEL I.D. #
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence ,Boundary Roots GPD Trench
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
3 o-S 1o`-11Z -5 3. - S~ Z1r1S v~'fl- 41S 0•7 o•
Ground C-5 bk YVl v~. C -S
elev. lp R 3/ CZ
`3•Z ft. 33-V~ -1 -S'1R sle
Depth to S ~b4,3 l w-1 SA, YnU'~'1~
limiting
factor E7 NJ 6r~
Remarks:
Boring #
I
Ground
i elev.
ft.
Depth to e
limiting
factor
i
Remarks!;--
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
i
Remarks:
Boring #
Ground
elev.
y ft.
Depth to
limiting
factor
Remarks:
SRD-R3301R 05/921
PLOT PLAN Page 3 of 3
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STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER
MAILING ADDRESS c3 9 2 / d
PROPERTY ADDRESS J V c A 7
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE
PROPERTY LOCATION & 1/4, Y jE 1/4, Section 'Ii 12 S N-R 15 W
TOWN OF 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 St. Croix
County Zoning Officer within 30 days of the three ye xpiration date.
SIGNED:
DATE: 7 ' ~Z - °J(p
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 62 AN\
a~~ r
Locationofproperty.&A- l/41/4, Section 15- ,Taff_N-R_Z~ W
Township Cyr-e .l Mailing address -31-o
Gy -5- Y'oa 7
Address of site
Subdivision name Lot no.
Other homes on property? Yes No
Previous owner of property✓✓Q.rt/~-erJ
Total size of property
Total size of parcel
Date parcel was created J
Are all corners and lot lines identifiable? Yes No
Is this property being developed for (spec house) ? Yes X _No _Ab Volume and Page Clamber 315f 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. ~Qq/ 9_Z"f'/ , 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 County Register of Deeds as Document No.
Signature of Applicant Co-Applicant
Date of Signature Date of Siqnature
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all) hui~agl ualllj•aadSl To palulld SlulV ld aetsq flags papJu a1 ay of S)IJ uvlIut tIa iuyl sapleo~d salnlrl4 u1,uo,111M I'll 10 '11 1ti 69 noll'aS'
- tit , . u~l un~;~lnlttlo~ .~1~ 'C_J v =Uosjo (l h I ),I D11 :M1 h,P IL1110
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Iinlrn ,L~oc I 11 1
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S9 6t '.(I 'v - Zr zd~ 11, .~rj~ ha ll >>tlr s Il.,;
pue t; InlI'y 111:t_n1~. I.t~ olun,~.lal~ OA 1:11 1.11A ~s.111 oyl )11 SaY 1-o" I pwt` ,lilt 'jO-01011'%\ SSJaj1~11 ul
'U.A;'IJA(I (I\V .1'\%'21 1VA1 11)AI1-luf III {i~,l-la~li I.wd
Cur. alnil~~ .)III 'ituItill :iIllipwi sulls.l.l11 ttr,r-r.ul .C1.,.~a puc III! t•u111,~,! '~u:~i,L Inn! -_:!.ly i.nt .i~, ant '~iurll.tl inulf ~r
I-n:~l Ir,Iri.l.es :ult {o pnls; .1111 to u1n~~.1«:IxI ,,I1ti,Lm.1~1 iINU 1.;110, .1111 111 ~:.I,Init.nl i~,,luc~,.uvl .i~~,11c .nll 11'111 Ini1'
'.tdatlletl.~~ s.t.;l!e111uut.>ti! II'-: ,,uu .r.1.il a.1e ,Ituc= -Ir:l
WARRANTY DEED .-=`I'o husband and WIN as Jolnt'l'cnants FORM 3'%7 Iltovieca) « •uc
. ~Itlt _dav of . 1',
This Indentureri1 in tk year
, Made this. _
_ . L - ett_ie
Sixt e:i rht Ilct~tietrrt..... Lvcrc tt llansct _ n ~ZI _ nd
of our Lord, one thousand nine: hundred and _ Y-
lIcut nn, Iris wife, - - -
_part i.crs of the first hart,
and l:onal(1 1'. Mol_denltauer Mid Audrey J. Mofdenhauer,
_ Of
1tt iaiYrl ancT k-6 as ]olot tlal t5, parties 0 tltc ;ecun'Cl:lraiT:
Witnessetll, That the said part k's - - Of the first 1%,Irt, fur and in con:,idcration of the Sum of
t+
N inc, 9'In,n:;ancl I' ive llun(Ired (!~`),50I1.00) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Dollars,
to ahem in hand paid hY the. will parties of the second part, the receipt cdhcic of i, he li l)v confcs~ed and
acl:nu~clcd~.tl'd, ha v(' cil, fir;uricd, Ir,II ;.lined, mold, realised, Icic;i Icd, ,clicnc'd, n,nvc\ ("I :Ind' confirmed, and I
these presents do give, grant, bargain, Sell, realise, Iclc•asr, :clicll, c-cm%c)' and confirm unto the -,aid parties of
S t . ('ro i-x
the second part, as joint tenants, the follo'Win dcscrihe(1 real estate, :;iluated ill tile, Coulitv of',
and State of X isconsin, to-wit.:
No>'theast Qua 1, Ler of. NovLlic'asl- QLUJ 'tet:~ (Nl,',, of NE'%i) of SeOt_iclrt I _i_I t(,ull
(LS), T~rcvnsh:ip 'l'wenLy e-i.;.1tt (~f;) North, of 14111(('o L'i_t_tuelt (15) 1%,c sL, St.
(:I'() _x Cotlll Ly, W i ScottS_i.n.
al l_%real_ c's Uatc L;Ix(`, I (W the year
Sec ort(I 1rtrL a;.;t_'ec to Pay
I!c 1u11,L !es of Hie
1') 0 .
ST. CROIX COUNTY
WISCONSIN
L ZONING OFFICE
r r ■ n ■ u ■ ■ ■ M..■e ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
yF" f mot - - ' = Hudson, WI 54016-7710
(715) 386-4680
f
NOTICE OF VIOLATION
No. 96-V-20
May 15, 1996 Location: NE,, NE;, Sec. 15,
T28N-R15W, Town of Cady, St.
Croix County, Wisconsin
Ronald Moldenhauer
392 - 310th Street
Wilson, WI 54027
Dear Mr. Moldenhauer:
The St. Croix County Zoning Department has determined that the
septic system serving the residence at the above described location
is a Category II failing septic system as defined by Chapters 145
and 146, WI Statutes. This is evidenced by the discharge of sewage
to the surface of the ground. This system is hereby condemned as
it constitutes a violation of Section 146.13 WI Statutes, s.ILHR
83.03 (2)(c)(e) WI Adm. Code and 15.04 St. Croix County Ordinance.
A sanitary permit should be obtained by June 15, 1996 for a new
replacement septic system, and the system should be installed and
in use by July 15, 1996.
You may be eligible for partial reimbursement of the cost of
replacing your septic system through the WI Fund Program. There is
a qualifying income limitation of no more than $45,000 total
household income for the year 1995. You may check this from your
1995 Wisconsin tax returns. If you filed Form 1, use the total on
Line 5, Form 1A, Line 8, and Form WI-Z, line 1. Should you wish to
apply, please fill out the front page of the enclosed application
completely making sure to include the tax parcel number (from your
property tax statement) and the Register of Deeds document number
(from your warranty deed). Return the application along with a
copy of your 1995 Wisconsin tax returns, and the application fee of
$50 to the Zoning Office. Application may be made as soon as the
permit has been issued for your new system, but no later than
January 15, 1997.
r
Failure to comply with this order will result in this office
seeking enforcement through Circuit Court as allowed by Chapter
145.20 (2)(f), WI Statutes and/or through the issuance of a
citation in the amount of $250 per day for each day the violation
continues beyond the deadline given. This violation is noted as
having occurred May 8, 1996.
Sincerely,
Mary J. Jenkins
Assistant Zoning Administrator
Enclosure
cc: Clerk, Town of Cady
Corporation Counsel
File
ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
u ■ ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
- Hudson, WI 54016-7710
(715) 386-4680
i
NOTICE OF VIOLATION
No. 96-V-20
May 15, 1996 Location: NE4, NE4, Sec. 15,
T28N-R15W, Town of Cady, St.
Croix County, Wisconsin
Ronald Moldenhauer
392 - 310th Street
Wilson, WI 54027
Dear Mr. Moldenhauer:
The St. Croix County Zoning Department has determined that the
septic system serving the residence at the above described location
is a Category II failing septic system as defined by Chapters 145
and 146, WI Statutes. This is evidenced by the discharge of sewage
to the surface of the ground. This system is hereby condemned as
it constitutes a violation of Section 146.13 WI Statutes, s.ILHR
83.03 (2)(c)(e) WI Adm. Code and 15.04 St. Croix County Ordinance.
A sanitary permit should be obtained by June 15, 1996 for a new
replacement septic system, and the system should be installed and
in use by July 15, 1996.
You may be eligible for partial reimbursement of the cost of
replacing your septic system through the WI Fund Program. There is
a qualifying income limitation of no more than $45,000 total
household income for the year 1995. You may check this from your
1995 Wisconsin tax returns. If you filed Form 1, use the total on
Line 5, Form 1A, Line 8, and Form WI-Z, line 1. Should you wish to
apply, please fill out the front page of the enclosed application
completely making sure to include the tax parcel number (from your
property tax statement) and the Register of Deeds document number
(from your warranty deed). Return the application along with a
copy of your 1995 Wisconsin tax returns, and the application fee of
$50 to the Zoning Office. Application may be made as soon as the
permit has been issued for your new system, but no later than
January 15, 1997.
Failure to comply with this order will result in this office
seeking enforcement through Circuit Court as allowed by Chapter
145.20 (2)(f), WI Statutes and/or through the issuance of a
citation in the amount of $250 per day for each day the violation
continues beyond the deadline given. This violation is noted as
having occurred May 8, 1996.
Sincerely,
Mary J. Jenkins
Assistant Zoning Administrator
Enclosure
cc: Clerk, Town of Cady
Corporation Counsel
File
i
STC - 104
AS BUILT SANITARY SYSTEM REPORT
ST C,
OWNER Oyl / e~
ADDRESS- t
7
SUBDIVISION / CSMJ LOT I
SECTION T_-~?N-R W, Town of r4~
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
i
lGna fa I
Po 1
l INDICATE, NORTY A•1 ROW
Provide setback and elevation information on reverse of this .form.
Provide 2 dimensions to center of septic tangy; manhole cover.
BENCHMARK:
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: /ll Liquid Capacity: Op p
Setback from: Well 3W HouseOther_
Pump: Manufacturer Model #
~ Size
Float se eration
P Gallons/cycle:_zz_i_
Alarm Location
:SOIL ABSORPTION SYSTEM
r
Width: Length f Number of trenches
Distance & Direction to nearest ProP• line:
Setback from: well: House Otber
ELEVATIONS
Building Sewer / U,7 ST Inlet. ST outlet
PC inlet PC bottom Pump Off
Header/Manifold - Bottom of system
Existing Grade - Final grade
DATE OF INSTALLATION. \
PLUMBER ON JOB:
yr,
LICENSE NUMBER:
I
INSPECTOR:
3/93:jt