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Parcel 018-1020-20-000 05/22/2006 05:01 PM
r PAGE 10F1
Alt. Parcel 10.29.17.151A 018 - TOWN OF HAMMOND
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner
0 - HEINRICH, BENJAMIN R & WENDY J
BENJAMIN R & WENDY J HEINRICH
1067 CTY RD T
HAMMOND WI 54015
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 1067 CTY RD T APT 2
SC 2422 ST CROIX CENTRAL
SP 1700 WITC
Legal Description: Acres: 18.140 Plat: N/A-NOT AVAILABLE
SEC 10 T29N R1 7W SW NW EXC PT TO HWY & Block/Condo Bldg:
EXC PT TO CSM 10/2934 NKA LOT 1 CSM
10/293418.14AC Tract(s): (Sec-Twn-Rng 401/4 1601/4)
10-29N-17W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1116/203 WD
07/23/1997 791/571
07/23/1997 425/15
07/23/1997 /362
2006 SUMMARY Bill Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 08/24/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 26,000 217,700 243,700 NO
AGRICULTURAL G4 12.500 1,400 0 1,400 NO
UNDEVELOPED G5 3.640 3,200 0 3,200 NO
Totals for 2006:
General Property 18.140 30,600 217,700 248,300
Woodland 0.000 0 0
Totals for 2005:
General Property 18.140 30,600 217,700 248,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 210
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
jp -
STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER
ADDRESS //.r- 2211 Ali. ILI
JA -
z:!. D P4 1
SUBDIVISION / CSM# r LOT #
SECTION)(*)' T" ~ _N-R_Z.Z_W, Town of /,,t yn -);n~,
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
i
40'
~v
~ i
17
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK: ld/~1 Cc- S` tZi
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: Liquid Capacity:
Setback from: Well House3 " 'Other
Pump: Manufacturer S er° jj?GGc% o°d l# Size
Float seperation Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
'51 ro- 7--e
Width: Length Member of trenches
Distance & Direction to nearest prop. line:
Setback from: well: / Crc House Other
ELEVATIONS
Building Sewer ST Inlet: ST outlet:
PC inlet PC bottom Pump Off
Header/Manifold Bottom of system
Existing Grade Final grade
DATE OF INSTALLATION: ,/,3 f'
-T
PLUMBER ON JOB:
LICENSE NUMBER:
INSPECTOR:
3/93:jt
Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County:
Labor and Human Relations INSPECTION REPORT' • c:r~OIX
4 Safety and Buildings Division
(ATTACH TO PERMIT) Sanitary Permit No.:
GENERAL INFORMATION 21;8502
Permit Holder's Name: ❑ City ❑ Village Town o : State Plan ID No.:
IHETfIRIC-fi, BEN CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
ego,
TANK INFORMATION ELEVATION DAT A
96C ~4' 02 - s
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark / 7' 16U, eo
Dosing
//'IQ~~h t f I' IGr i'rtc7,. "S
Aeratiory- Bldg. Sewer
Holds St/Inlet
TANK SETBACK INFORMATION St/prE Outlet
TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic >5T >!SO' 114 NA Dt Bottom e?, S
Dosing H NA i:biadw / Man.
Aeration NA Dist. Pipe /7'
Holdi Bot. System Ili} /
PUMP / INFORMATION r?~( Final Grade
Manufacturer Demand -6 `r dd -0
e cam- J'.77
Model Number S~ ? *GPM R did:e€(
TDH Lifts Friction, System ,..d T D H 51 `Ft
oss Forcemain Length 2%/ 1 Dia. 2i F p Dist. To Well 11/__0
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length / No. Of Trenches PI No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS S S DI EN I N
anufacturer:
SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACH
SETBACK CHA R
INFORMATION TypeO he~•r Moe r: Z<z V)
System: Ma 461 F~ 1 O NIT
DISTRIBUTION SYSTEM
Header/Manifold f~ Distribution Pipe(/) , . x Hole Sjef, x Hole acing Vent To Air Intake
Length Dia. Length 3 °oL Dia. Spacing 1
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.)
nr A m~ rnAyg7 n'GSx~~ya ra T(3} ~ n 77
1
SW, AV
.LVI.:AlIll Y~r t1L`l.CdP1V1V11. 1V. G.w «.Ll~Y, NW, CA1 TY X77
C_ l 1 fr v~~ (,tk ~►7~LtAf \ Q''Ye v t G.I k ~jn _ - p '
41
f
+r:S.-yam`. } _
Plan4'evision required? E] Yes B N v /
Use other side for additional information.
SBD-6710 (R 05/91) Date Inspector's Signature Cert No.
ADDITIONAL COMMENTS AND SKETCH < 1
SANITARY PERMIT NUMBER:
2
Safety and Buildings Division
~•ia_ri SANITARY PERMIT APPLICATION Bureau of Building water systems
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
SL . Crz rx
than 8 112 x 11 inches in size.
• See reverse side for instructions for completing this application State Sanitary Permit Number
The information you provide may be used by other government agency programs ❑ Check if revision to pre- vio®ap- application
(Privacy Law, s. 15.04 (1) (m)l- State Plan I.D. Number
1. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION
Property Owner Name Property Location
1t7J 1i4 1/4, S Id T a4? , N, R E (or
Property Owner's Mailing Address Lot Number Block Number
Q7 -43 f 5,M 1
City, State Zip Code Phone Number Subdivision Name or CSM Number
d r ` d;21 ( ^ ) " Gam'
II. TYPE BUILDING: (check one) ❑ State Owned ❑ City Nearest Road
VII age CO
IKL Town OF
Public 1 or 2 Family Dwelling No. of bedrooms ~
III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s)
1 ❑ Apartment / Condo el C F" tld'2 e T"
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- New 2. ❑ Replacement 3, ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an
------System System Tank Only______________ Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 ]a Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy
13 ❑ Seepage Pit 43 ❑ Vault Privy
14 ❑ System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1- Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade
Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation
J^ S ..616L f g, 6 Feet Feet
VII. TANK Capacity
gallons Total # of Prefab. Site Fiber Exper.
INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App
New Existing structed
Tanks Tanks ~g
Septic Tank or Holding Tank geox ❑ ❑ ❑ ❑ ❑
_~ff~ I El 11:1 E-]F 1:1
Lift Pump Tank /Siphon Chamber lr=s~ CEO ~S
VIII. RESPONSIBILITY STATEMENT
[,the undersigned, assume responsibility for installation of the onsite se ge system shown on the attached plans.
Plumber's Name: (Print) Plumber's Signature- (No Stamps) P MPRSSW No.: Business Phone Number:
t .~G It Jl►s 4+ 4P `d F-0__ -1/ A
i
Plumber's Address (Street, City, State, Zip Code):
~ ~ 6 l
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Ag nt Signa (No St
Approved ❑ Owner Given Initial SurchargeFee)
Adverse Determination' av//w - /
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SBD-6398 (R. 05194) DISTRIBUTION: Original to County. One copy To: Safety 8 Buildings Division, Owner, Plumber
INSTRUC=TIONS
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 ne°rr 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) W 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 administrato or the State of
Wisconsin, Safety and Buildings Division, 608-266-3815.
To be complete and accurate this sanitary permit application must include:
1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the
system is to be installed.
II. Type Qf building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwehing.
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, rec:;nnection, 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 sen ic, pump/siphon and
holding tanks for this system. Check experimental approval only if tanks received experimental ;product approval from
DILHR.
VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.),
address and phone number. Plumber must sign application form.
IX. County/ Department Use Only.
X. County/ Department Use Only.
Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must
include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic
tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon
tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served;
B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume;
elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section
of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information.
GROUNDWATER SURCHARGE
1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can
effect groundwater.
The monies collected through these surcharges are used for monitoring groundwater contamination investigations
and establishment of standards.
y
I SAFETY & BUILDINGS DIVISION
State of Wisconsin 11 ~2
Department of Industry, Labor and Huma ons
July 3, 1996 222 se
n,A La ssen 54 N
J 5 v~~\ Gf\C~ Jy t`~f
WEGERER SOIL TESTING
421 N MAIN STREET
PO BOX 74 j.., y
RIVER FALLS WI 54022
RE: PLAN S96-40770 FEE RECEIVED: 360.00
HEINRICH, BEN
SW,NW,10,29,17W
TOWN OF HAMMOND 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.
Sin erely,
erard M. Swim
Plan Reviewer
Section of Private Sewage
(608) 785-9348
SBDA-7997 (R. 1184)
Page of 6
MOUND SYSTEM S96-40770
FOR
A 3 BEDROOM RESIDENCE
LOCATED IN THE E 1/4 OF THE N kJ 1/4 OF SECTION T Z L N, R 0 W,
TOWN OF 1~P~► p1y~ SYr, C_"LX COUNTY, WISCONSIN.
(LOT I OF ism UvL_ 10, P9 . Zg3y
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
w I s u o Z 3 ji/l `
31996
& B4 DOs 0/V
PREPARED BY
WEGEt~ER SC3I t_ TESTING
AND .
Pt,IVATE SSY %V9rMhi S1E=f~~! I CE c.', ~ s
'~t ~~6r'174 421 R. IIIiIK ST. s APTNu. °
Coin w ® • YJEGI=itER
IVE}? FnLLS~.Af(I 54022 ~ t asiSP 1 ~
4 5~[J -v165 ~ ~ K15Y1'tie7T11,
• WIS. °
®@7. OF INDUSTRY, LABOR 3 HUMAN RELATIONS ~
Of SAF O BUILDINGS 41S I GN
pwmQN ~
~iS!lii1~,19►
SEE CORE ONDENCE
JOB NO. 6 -1 6 I
OF b
S-960"40770
t
i ~ R..v~ t 1PE
~j
111
r
03 ~ 98
~R L \J
I
,y ~RoU P~~E Levations unless otherwise noted.
:h lateral. ( Z required)
~ved caps. ( Z required)
Lty manufactured by
O
-event ponding at the uphill side.
Page 3 Of
Approved Synthetic Covering
v) ST" C 33 Distribution Pipe
Medium Sand
_ H_
Top
~o.
soil F Elev. 0,
3 E D
b
l~ % Slope
Force Main Plowed
Trench of k"-2k" From Pump Layer
Aggregate
Undisturbed D N •O Ft.
Soil E Z Ft.
Cross Section Of. A-Mound System Using F 0.8 Ft.
Trench For The Absorption Area G N•,o Ft.
A S Ft. H I- S Ft.
B IS Ft.
I \S Ft.
Linear Loading Rate= GPD/LN FT J ej- Ft.
Design Loading Rate= p.-_~-GPD/SQ FT
K VV) Ft.
L 9 S Ft.
Position of Force Main----______ W Zg Ft.
J ~orce~
B K Main,
W Distribution Trench Of 2 - 2'2Y
Pipe Aggregate
I
Observation Permanent
Markers
Pipes ,
(anchor -securely)
Mound Using I Trench For Absorption Area
Page Of
Perforated Pipe Detail
0
End View
End Cop) . )Perforated
b`cA' PVC Pipe
aS`
Install permanent-marker
at end of each lateral
Holes Located On Bottom,
Are Equally Spaced
Q End Cap
* PVC Force Main
Distnoution
Pipe
.Last Hole Should Be
Next To End Cap
Distribution Pipe_ Layout
P 3y.S Ft.
X 3 L Inches
y 3(0 Inches
Hole Diameter )/Y Inch
Lateral 1 DIY, Inch(es)
Manifold Inches
Force Main " Z Inches
# of holes/pipe \Z
Invert Elevation of Laterals 98.5 Ft.
\ Zx N. k-, tq .~3 y x Z_ zg,v g Gpl
Place lst hole J8 from tee with succeeding holes at 16" intervals.
Last hole to be next to the end cap.
Combination-Septic;Tank and
PUMP CHAMBER CROSS SECTION ARID SPECIFICATIOMS ' PAGE s OF D
-VC IJT CAP WEATHEK PROOF
JuNCTIOLI BOX .
4'C.I. VENT PIPE APPROVED LOCKING
10' FROM DOOR, MAWHOLE COVER >NCM
.WINDOW OR FRESH ? I.vP`RtJING LABEL
ALP, INTAKE t cosJpulr
tj !
4, MIU.
~t °t 8 1 i
i WAIN.
PROVIDE I
IIJLET AIRTIGHT SEAL I !
- A ! I ( APPROVED JOINTS
46- ;RPROVED -101,37 +~1=>r~~S
Wf C.I. PIPi`aR W/C.I. PIPE~PnC
Tank construction ALARM
shall comply with 1!
ILHR (83.15 and 83.20 es ! I
0M
C !
~.q Z I
LLCV.9 FL PUMP,, --i
y OFF
D CONCRETE
DLOCK
3" APPROVE[
RISER EXIT PLF marED OWLS IF TAIJK MAIJUFACTURCK HAS SUCH APPROVAL gEOOI
SPEC.IFICATICIMS ~1LL
SEPTIC E
DOSE I'llDI)I=SM-oj 1~2 ST IJtJMBER OF DOSES: 3' Q7 PER OAy
TANK MANUFACTURER:
TANK 51ZE: Zb00 ` 6SO - CALLOUS DOSE VOLUME t
ALARM MANUFACTURER: SAS' d s!tS~~1~tS- INCLUDING BACKFLOW: GALLONS
MODEL NUM6ER: Nw CAPACITIES: A= IS NICHES OK 30 6 GALLOIJS
SWITCH TyPC: 1" 1iE%G jyJ1f 8= Z INCHES'OR GrLLOU5
PUMP MANUFACTURER: 2-2 .QM ~ ' G= -7 INCHES OR "21 GALLOIJS
MODEL MUMBER: S7 D INCHES OR MV GALLONS
NOTE: PUMP AMD ALARM AA TO;~
SWITCH TYPE:
MINIMUM DISCHARGE RATE Z8'o8 GPM INSTALLED OM SEPARATE CIRCUITS
VEKTICAL DIFFERENCE DETWEEIJ PUMP OFF AUD.-DISTR16UTION PIPE.. 7'SS FEET
+ MIIJIMUM NETWOKK SUPPLY PRESSURE . ; . . . . . 2.52 FEET
• ♦ 35 FEET OF FORCE MAIN X ,`_L F oortFKICTION FACTOR--C) S10 FEET
TOTAL DyUAMIL HEAD "FEET
DIAMETER
Pump chamber _
IIJTLKLIAI. DIMEWSIOLIf OF TANK: LENGTH ;WIDTH ;LIQUID DEPTH
BOTTOM AREA 231'= GAL/INCH
AS PER MANUFACTURER = GAL/INCH
. 6 of ~a
" 41% 6'%
HEAD CAPACITY CURVE 45/6
F W "57" "59" SERIES
45/6
25 0
_ 1'fi -111h NPT
43/16
6 20
t]
Q
W
U
15-
z
0 4 915/16
J I
O p.
F 10 _
33/32
2 Z& Do
5 TOTAL DYNAMIC HEAD/
FLOW PER MINUTE
EFFLUENT AND DEWATERING
HEAD CAPACITY
UNITS/MIN
0 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
i
CONSULT FACTORY FOR SPECIAL APPLICATIONS
a Piggyback Mercury Float Switches *Available with special cord lengths of 15',
available. 25', 35' and 50'.
Variable level long cycle systems a Alarm systems available.
available. a 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 Vohs-Ph Mode Am Simplex Duplex 3. Mechanical alternator 10-0072 or 10-0075.
M57/59 115 1 Auto 8.0 1 or l &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"
D57/59 1 t 4.0 .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. forwatertightconnection brwired-in simplex or
2 pump operation, 10-0002.
7. Two (2) hole "J-Pak", for watertight connection or splice. to- 3.
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, Ali Installation of controls, protection devlcesandwiring should bedone byaqualHled
FM0514; Piggyback Mercury Float Switches, FM0477; Exectrical Alternator. FM0486; Mechani- licensed electdclao. A0 electrical and safety codes should be followed Including the
cal Alternator, FM0495; Alarm Package, FM0513; Sump/Sewage Basins. FM0487; and Simplex most recent National Electric Code (NEC) and the Occupational Safely and Health Ad
Control Box, FM0732. (OSHA).
RESERVE POWERED DESIGN
For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump.
MAIL T0: P.O. 8OX 16347
` Louisville, KY 40156-0347 Manufacturers of. . .
® ZAIZZLff fff. SHIP T0: 3180 Old Millers Lane
Louisville, KY 40216
(501) 778-2731.1(800) 928-PUMP QUAL/TY PUMPS FlNCE
FAX (502) 774-3624
Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3
Lgt~,7 and Human Relations
Divi.#.an of Safety & Buildings in accord with ILHR,83.05, Wis. Adm. Code
COUNTY
Attach complete site plaKon paper not less than %81k/2`xx)1'1'/inches in 'Size. Plan must include, but St. Croix
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and dis road. 018-1020-20
APPLICANT INFORMATION-PLEA ~qI( TION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
Hank Fogelberg GOVT. LOT SW 1/4 NW 1/4,S 10 T 29 N,R 17 m€ (or) W
PROPERTY OWNER':S MA!1_ING ADDR ~ y of i ` LOT # BLOCK # SUBD. NAME OR CSM #
275 192nd. 'L , csm pending
CITY, STATE ZI C y NUtVlB ❑ ITY ❑VILLAGE OTOWN NEAREST ROAD
Star Prarie, WI. 54 00 1Hammond Co. Rd. #T
[4d4ew Construction Use (x Reside 4 ! + r 3 [ J Addition to existing building
[ J Replacement [ ] Public or co
Code derived daily flow 450 gpd Recommended design loading rate .4 bed, gpd/ft2 .5 trench, gpolft2
Absorption area required 375 bed, ft2 375 trench, ft2 Maximum design loading rate .4 bed, gpd/ft2.5 trench, gpd/ft2
Recommended infiltration surface elevation(s) 98.00 ft (as referred to site plan benchmark)
Additional design / site considerations contour line r el. 97.00
Parent material ground moraines Flood plain elevation, if applicable na ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable for svstem ❑ S ®U AE S ❑ U ( ❑ S 10 U ❑ S sJ ❑ S ®dl ❑ S Eli f
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure Consistence Bot mbly Roots GPD/ft
Boring # Horizon in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. Bed Trttctt
Lj 0-13 10yr3/3 none 1 2msbk mfr if . 5 .6
2 13-31 7.5yr4/4 none scl 2msbk mfr gw if .4 .5
. yr5 sicl 2msbk mfr na na .4 .5
Ground 3 31-72 10yr5/4 c2p 7.5yr5/6
elev.
97.6 ft.
Depth to
limiting
factor
31"
s
Remarks:
Boring #
1 10-10 10 r3/3 none 1 2msbk mfr CIW if .5 .6
'v 2 2 10-33 7.5yr4/4 none sl 2msbk mfr 9W if .5 .6
3 33-52 7.5 r4/6 2pr / scl lfsbk mfr na na .2 .3
Ground
elev.
97.6 ft.
Depth to
limiting
factor
33"
Remarks:
CST Name:-Please Print Phone:
Gar L. Steel 715-246-6200
Address: 155 00th. Ave_-, w Richmond, WI. 54017
Signature: 4-6-95 Date: cstm 02298 CST Number:
PROPERTY OWNER HaNK Fogelberg SOIL DESCRIPTION REPORT Page t., of 3
PARCEL I.D. # 018-1020-30
I GPD/ft
Boning # Horizon I Depth i Dominant Color Mottles Texture
I Structure Consistence
I I Bounclary Roots
in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. I Bed iTmnch
1 0-13 10yr3/3 none 1 2msbk mfr gw if .5 .6
3
2 13-31 &.%YR$?$ NONE SCL 2msbk mfr gw if .4 .5
Ground 3 31-57 7.5yr4/4 c2p 7.5yr5/6 scl lfsbk mfr na na .2 ~.3
elev.
i
95.4 ft.
Depth to
limiting
factor
31"
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
•xaw•::
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
i
Remarks:
SBD-8330(R.05/92)
STEEL'S SOIL SERVICE
Gary L. Steel 1554 200th Ave.
CSTM2298 SW4NW4Hanks S10-FogelbergT29N-R17W New Richmond, WI 54017
MPRSW 3254 town of Harrmlond (715) 246-6200
1
N
1"=40'
BM.=top of 1" pipe by power pole @ el. 100'
b
67
38y LeN ~~W \
n d's
.ol
33~ 1rzc~
/
LLV
17
1
Gary L. Steel
4-6-95
toll
J PILED
,~a 1995
CA. to
5249910
C ER T I F -T EO S UR V E Y MAP
Located in the Northwest quarter of the Southwest quarter and the Southwest Quarter
of the Northwest quarter of Section 10, T29N,R 17W, Town of Hammond, St. Croix
County, Wisconsin. Owned by: Hank Fogelberg
NW corner 275 192nd Street
Section 10 I North line 9f the SW 1/4 of the NW 1 /4 Star Prairie, W i.
(P. K. nail set) I Unplatted Larids - - I 15
I S 89'50'080E 1269.83'
I
I5d
45'
\
v\ w
a SLOT 1
I_ rn
LEGEND 790.,.164 Square Feet(18. 140Ac. N • z a
- Section corner I N m ~i m m
N
monument -I "T IT a
IN N
Drainage course - z
• 1" x 24" iron 133 S 89'59'28"E w 3 0
pipe weighing ao L0 7. 1266.15' 7, _ cnl
1.68 lbs. / lin. cv ~ aI
ft. set., INN P
N :w J
z _ O OI
Fence line ; H ZIZ L® T 2 N Z 1111
787, 883 Square Feet (18.087 Ac.) Jc1
.i
cNO N a En a.
ZI
:N8905110V' xE w
i
45.00'
East-West 1/4 Section line
i N 8951'09"E 3924.53
W1/4 Corner h 1262.48' '
Section 10 I 4~ :Point of beginning E1/4 Coriaer
W.K. nail set) w
i in • oo Sec. 10
I Ito o :Y®~ (Berntsen cap)
I to : a In 3 In
N 785,696 Square Feet (18.037 Ac. )
Qi I o v : Lw _ S 8 04~~J,6"
Zi10 Z N$9°54'15"W • w 65.00.
10.00' . 3
ZI (NI m. co - cn
C\j
Bearings referenced N $ " NI
to the West line of I S 89'5'30"E z 3 LL oI
a
the NW 1 /4 of Sec. i o 1086.30'- 0 zl
10, assumed I I 0 / Ji
vj;o
Z ~I
NR4~~M~''4~D I m //07/- 4
1W w 882,094 Square Feet (20..250. Ac;r) n o O = ~I
_ rn cn a,
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
X-\OWNER/BUYER C 'yC (
AM ILMG ADDRESS \
PROPERTY ADDRESS 7 eD /T d~ T:0
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE FA, M~`'~ s.d et [ y ~ ~
PROPERTY LOCATIONSA/ 1/4, Wh)_ 1/4, Section /6F, Tat_N-R ? W
TOWN OF ff, 7ytO,t~ ST. CROIX COUNTY, WI
SUBDIVISION LOT NU 13ER
5~;i 9 910
CERTIFIED SURVEY MAP , VOLUME/, , PAGE 6 OT 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.
VWe, 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 year expiration date.
NSIGNED:
DATE: - ik -
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, \\'l 54016 11/93
S T C - loo
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 .'de d
r`•f~Y','G`Z
Location of property 1/4 1/4, Section ~T_g~N-R'17 W
Township _AT OW y&I,,A-'~t Mailing address fat (n/:La'r'A 2
I t 41-dL M.~q 8 G,1 r
Address of site M/-7 C 0 ~'aG kC-
Subdivision name G 1 5; /yi Lot no.
Other homes on property? Yes No
Previous owner of property ILI,L,,, o.2 E?! he~ol
low
Total size of property luCL-
Total size of parcel .~-Qafoc3
Date parcel was created
Are all corners and lot lines id ntifiable? V-Yes No
Is this property being developed for (spec house) ? Yes k~ No
Volume Z 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. 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.
Siqnat' oft Applica /
t 1 nt Co- pplic nt
Date of Signature Date of Signature
.02/05/96 MON 11:13 FAX 1 715 386 9174 FNB HUDSON IA002
Shtc Wisconsin Form 2 1982
538355 WARRANTY DEED
DOCUMENT NO. 1157PAGs
~ Fr s111~L9 l:~`:!:I
Hank D. Fogelberg, a single person,
- JAN 8 1996 j
A.,
- - - ' 11:30
_J.
Ben amin R. Heinrich an d-Wen
conveys .end warrants to _ - - is , !,N c•9 1
d and w~ as survivorship ,
huffs a,
Heinrich
'
rtlarrta_1 groper y_,_
T1-115 ,,,PACE aE'oBRVEO FOR RECOROING nAl'A
Bf~
NAME AND PETURN ADDRESS
the following described real estntc in _ St. Croix
County, State of Wisconsin:
(Parcel Identification Numbcr)
Part of SW1/4 of NW1/4 of Section 10, Townsbi.p 29 North, Range 17 West, St. Croix
county, Wisconsin, described as follows: Lot 1. of Certified Survey Map filed
Jude 81 1995, in Vol. "r10", Page 2934, Doc. No. 529910.
i
j
TRAts FEB I
T11is _._1S- not homcstcnd property.
( (is nit)
Exception to warmatics. Easements, restrictions and rights-of-way of record, if any.
_ 19_95
Dated this day of Decem er
(SEAL,) -Z-~- ! (SEAL)
Hank D. Foge bezg
(SEAL) (SEAL)
AUTHENTICATION AC KNOW LEOGMENT
STATFOF WISCONSIN
St. Croix
I~
Z ~ 4b
authemicatcd day of 19 . Personally came before me this - day of
nPCpmtler - ' 1 9.95_ tha above named