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020-1314-80-000
4. o ~3 os~ I o y a 0. ~ I ~ o o III I ~ I m c ~ b O I' Q. co O +1 C L O O ~ I S O X O O L d z C C ~ N ~ m I LL C N L t U 3 I zlt z H E z a z d d a Co 00 04 N F- U) O O z d z d m CD z N I- c -o ~ rn ~ M N 0. _ O N ~ ~ O O U L • CL ro OO N Q O w N zi=z o I z N m £ > N vi ti l6 - ` N ~rl W CL M -Y- O N y i m O UI O E m O O a E U p N N N ti U) 00 Z •,r,i zaaa IL g o Q0 (0 U) - N J U =3 rn rn 0) (D _ T3 rn o 0 0 j Oa) N N N I ,A~ '1 B O O = O~~ N N CO N d d' 6~ W a0 o m QI r m 0 0) ~ii o 00 0 N c o E a) 3 -o " N d o 0 0 I ca O a ~ LO O co O y a r N N N N N J O H O N O O N N N .«r M O III. 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CROIX COUNTY, WISCONSIN Current [_X Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * LEWANDOWSKI, MICHAEL A & DAWN R MICHAEL A & DAWN R LEWANDOWSKI 746 CROSBY DR HUDSON WI 54016 * =Primary Districts: SC = School SP = Special Property Address(es): Type Dist # Description * 746 CROSBY DR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.720 Plat: 2492-ST CROIX ESTATES SEC 28 T29N RI 9W PT SW NW & NW SW ST Block/Condo Bldg: LOT 8 CROIX ESTATES LOT 8 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 28-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 01/10/2002 667802 1811/466 WD 07/23/1997 1156/510 WD 2004 SUMMARY Bill M Fair Market Value: Assessed with: 49631 386,000 Last Changed: 10/29/2001 Valuations: Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.720 49,800 248,800 298,600 NO Totals for 2004: General Property 2.720 49,800 248,800 298,600 Woodland 0.000 0 0 Totals for 2003: General Property 2.720 49,800 248,800 298,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 123 Specials: Amount User Special Code Category 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges 00 27.00 0.00 Total Wx "''lR.sin Department of Industry, SOIL AND SITE EVALUATION REPORT of 3 Laoor and Human Relations C t 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 St. Croft not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I D. # y dimensioned, north arrow, and location and distance to nearest road. pendit<ig' 't " APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY PROPERTY OWNER: PROPERTY LOCATION,.. John Rauchnot GOVT. LOT SW 1/4 NW 114,S 28~~ „ yN,R 1 r PROPERTY OWNERS MA11_ING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM , ° ; ~ ~ 527 Co. Rd. #W 8 na St. Croix Estatel,`'~ CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE 3jfOWN NEAREST ROAD Hudson, WI. 54016 (715)386-3052 Hudson Crosby Dr. New Construction Use (x] Residential / Number of bedrooms 3 ( ) Addition to existing building j Replacement ( ) Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate • 7 bed, gpdMft • 8 trench, gpd/ft2 Absorption area required643 bed, ft2 563 trench, ft2 Maximum design loading rate .7 bed, gpd/ft2 .8 trench, gpd/112 Recommended infiltration surface elevation(s) 95.40 it (as referred to site plan benchmark) Additional design / site considerations alt site = trenches - 94.65' & 92.80' Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ®S ❑ U ®S O U [3S O U 91 S ❑ U ❑ S ®U ❑ S [DU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence I Boundary Roots GPD/ft In. Munsell Du. Sz. Cont Color Gr. Sz. Sh. Bed Trends 1 0-8 10yr3/3 none 1 2msbk mfr gw if .5 .6 1 2 8-17 10yr4/4 none sicl lfsbk mfr gw if .2 .3 iti : Ground 3 17-80 7.5yr4/4 none co s Osg ml na na .7 .8 elev. 95.8 ft. Depth to limiting factor +80" Remarks: Boring # A,. 1 0-14 10yr3/3 none sl 2mgr mfr gw 2f .5 .6 2 2 14-80 7.5yr4/6 none cos Osg ml na na .7 .8 Ground 95. ft. Depth to limiting fa+to ~ il Remarks: CST Name:-Please Print Gary L. Steel Phone: 715-246-6200 Address: 1554 200th. Ave., New Richmond, WI. 54017 42 - Signature: ZL 2L!2~L' 11-4-95 : CST Number: cstm02298 PROPERTY OWNER John Rauchnot SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL I.D. 8 pending Boring # Horizon Depth I Dominant Color Mottles Texture I Structure Consistence ~Bornivy I Roots GPD/ft in. Munsell Gnu. Sz. Cont. Color Gr. Sz. Sh. i Bed iTmmh 1 0-10 10 r2 2 none sl 2m r mvfrl „3..... 2 10-8 7.5yr4/4 none co s Osg ml na na .7 .8 Ground 9~1e~5 ft. Depth to limiting factor +84" Remarks: Boring # 1 0-8 10yr3/3 none 1 2msbk mfr gw if .5 .6 4 2 8-20 10yr3/4 none sic lfsbk mfr gw if .2 .3 3 20-8 7.5yr4/4 none co s Osg ml na na .7 .8 Ground elev. 99.25 ft. Depth to limiting factor +84" Remarks: Boring # 1 0-10 10yr3/2 none sl 2mgr mfr 9-w if .5 .6 5 2 10-96 7.5yr4/4 none co s Osg ml na na .7 .8 Ground elev. 98.55 ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) STEEL'S SOIL SERVICE Gary L. Steel John Rauchnot 1554 200th Ave. CSTM2298 SW4NW4 S28-T29N-R19w New Richmond, WI 54017 MPRSW 3254 town of Hudson (715) 246-6200 lot #8-St. Croix Estates t N 1"=40' BM.= top of 1" steel pipe C el. 100' Alt. BM.= nail in Elm tree @ el.102.7' ( " ~ ~ S► Gary L. Steel 11-4-95 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS S/ G~~"e aR S 7- SUBDIVISION / CSM#_ 7L 1c, t`ns 7--- LOT # SECTION-_7 J- T_~2 Z_N-R__Lf W, Town of , ~j ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVE THING WITHIN 100 FEET OF SYSTEM G Q~y.bo X J IN ICAT NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. T f t BENCHMARK: S~/y~ e s l~ ALTERNATE BM: A,c SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: lyI r yy Liquid Capacity: 1,-V67 Setback from: Well! House Other Pump: Manufacturer Z__e2,4Ae,h Model#_ Size Float se eration P Gallons/cycle: Alarm Location- /Ya a _ t SOIL ABSORPTION SYSTEM Width: 3 Length -5-7 Number of trenches 2 Distance & Direction to nearest prop, line: Setback from: well: c L House ~O 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: PLUMBER ON JOB: l LICENSE NUMBER: INSPECTOR: 3/93:jt Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County LaVorandHumanRelations INSPECTION REPORT ST. CROIX Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: 262493 Permit Holder's Name: ❑ City ❑ Village Town of: State Pla n ID No.: RINIKER, WADE XQ CST BM Elev.: , Insp. BM Elev.: BM Description: Parcel Tax No.: A9600151 TANK INFORMATION ELEVATION DATA G~~G TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 1 W&JC_54cr~rn id d Benchmark ' i Dosing Gl~ - toSU C 3, ►vI rHiding ation Bldg. Sewer - St/ Ht Inlet / ~9,ss TANK SETBACK INFORMATION St/ Outlet tTANK TO P/ L WELL BLDG. Aiir Inake ROAD Dt,Inlet Septic >..5j { /7f4 NA Dt Bottom Dosing ter NA -Header fem. -2~ Aeration NA Dist. Pipe 7 i x,/02 Holding Bot. System S i PU P / S WON INFORMATION Final Grade Manufacturer e Demand -60") C77 Model Number 14 C?~? GPM Z 4, TDH Lift Friction $ystem_ TDH /6~- Ft > n, Forcemain Length Dia. Dist. To Well >60 SOIL ABSORPTION SYSTEM RED/TRENCH EWidth Length i No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSION 5 a DIMENSI N STEM TO P/ L BLDG WELL LAKE / STREAM LEAC Manufact SETBACK INFORMATION TypeO n~o~ 3Q CHAMB Mode r. System: ~y~J--. OR U IN DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe(s)r / x Hole Size x Hole Spacing Vent To Air Intake i Length Dia. Length ~S Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Depth Over ~~Dep t h Over xx Depth Of xx ed / Sodded xx Mulched Bed/Trench Center ed/Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.)ts { LOCATION: .29. 9W, SW NW OSBY DR A , OT R_ 01 C~ O~G, ~L.C2.tr Gj-7~~-~G.~,,Yt ~C:.~~ Q~{~G-~G~~=-• c ✓ --~t~ C`G;',,C.c,~'. Plan revision required? 93"~es ❑ No Use other side for ad 'Tonal info ation_ 7 Z/ SBD-6710 (R 05/91) Q c( Date Inspector's Signature Cert No ADDITIONAL COMMENTS AND SKETCH r SANITARY PERMIT NUMBER: x c S s ; S 1 j i i 1 " ~~i iilrs Safety and Buildings Division 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 than 8 112 x 11 inches in size. 5~ . C-l'olff • See reverse side for instructions for completing this application State Sanitary if nitary Permit Number The information you provide may be used by other government agency programs ©,6 ~ revision to revious application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION Property Owner Name Property Location ~ Vhj r as B 1/4 1/4, S oho T r N, R E (or)a-, Property Owner's Mailing Address Lot Number Block Number City, State Zi Code Phone Number Subdivisio ame or CSM Number II. TYPE F BUILDING: (check one) ❑ State Owned Ity Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms 5 EI EI( Towne own OF Ill. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo b.. - j 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. E, New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an _ System System Tank Only Existing S stem 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 210 Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 [RSeepage 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 S. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation y~G J G~. s 7 d G / Feet 9,F S Feet VII. TANK Capacity INFORMATION in gallons Total # of Prefab. Site Fiber- Ex per. Gallons Tanks Manufacturer's Name Con- Steel glass Plastic App New Existing Concrete structed Tanks Tanks Septic Tank or Holding Tank ! ri 1:1 ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber e ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No Stamps) P/ PRSW No.: Business Phone Number: IQ " 1!,' c t! 3FG - 311 Plumber's Address (Street, City, State, Zip Code): D 7,0 e d ` IX. CO NTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate slue Tsuing A nt S gnature (No St A roved Surcharge Fee) pp E] Owner Given Initial Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-6398 (R. 05/94) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit 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=26b-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. ' II. Type of building being served. Check only one and complete # of bedrooms if l or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V_ Type of system- Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2:K 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. Safety and Buildings Division vtG~iiR 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 , than 8112 x 11 inches in size. r~ • 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 i isibKtbYirdviotie~ a lit [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Property Owner Name Property L ation ~i tr J 1/4 1/4, S T z N, R ,,::?E (or W Property Owner's Mailing Address Lot Number Block Number Q eJ S T 4:~-L s- j/ 1451`7e City, State Zip Code Phone Number Subdivision Name or CSM Number II. TYPE F BUILDING: (check one) E] State Owned ❑ City Nearest Road Vi lae Public 1 or 2 Family Dwelling - No. of bedrooms E] Town OF ~t G~.9a-J C e s b III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 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: (Check only one box on line A. Check box on line B, if applicable) A) 1. g[ 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 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 rtA 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) 1!!Pv _Y Elevation Feet 3 19, " ,Gl - ff Feet TANK Capacity VII. in Total # of Prefab. Site Fiber- Exper gallons Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App INFORMATION . New Existing strutted Tanks Tanks Septic Tank or Holding Tank /w, WLJ--Ste ' ❑ 1:1 ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ El ❑ El ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. 'Plumber's Name: (Print) Plumber's signature: (No Stamps) / PRSW No.: Business Phone Number: ,u as -3 Fe ow Plumber's Address (street Z Code): 11 417, Ica IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sa tary Permit Fee (Includes Surcharge Groundwater ate Issue sung Agent Signature (No Stamps) Approved E] Owner Given Initial , Qa.. I,. Adverse Determination 1 1 'r -0 X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: v L/ SBD-6398 (R. 05/94) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit 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 sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check onlyone 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 exist;ng 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. ItI2 A ~cS~ f t'y' O A; lee ct l/l N'i v t i 0 0 C` t i V~ j f I f I 1 1 j f.1 "sir.'!/ Sys i j PAG F GF PUMP CHAMBER CROSS SEC T IOIJ AMD SPECIFICATIMS VCUT CAP 4"C.I. VENT PIPE WEATHERPROOF APPROVED LOCKINIG > 25' FROM DOOR, JIJUCTIOIJ BOX MAMHOLE COVER WINDOW OR FRESH I2"MIIJ. AIR IUTAKE GRADE 4" MIM. I 41 I B" h11 AI. CONDUIT-/ I WLET PROVIDE AIRTIGHT SEAL I / * A I ICI I ~ I I II ALARM 6 I II i I o *APPROVED I oN JOINTS WITH I I ELEV. FT. APPROVED PIPE I 3' ONTO PUMP ti OFF D SOLID SOIL GOAICRETE BLOCK RISER EXIT PERMITTED OAILy IF TAAIK MANUFACTURER HAS SUCH APPROVAL SEPTIC f SPECIFICATIONS DOSE TAUKS MANUFACTURER: ~JUMBER OF DOSES: PER DAM TAWK SIZE: 9$` (Q So GALLOMS DOSE VOLUME /~i2. Co. SG =l/? ALARM MAMUFACTURER: A.- e- Ue4a-SeWt- INCLUDIMG BACKFLOW: ` r e e GALLONS MODEL 1JUMBEK: D~` y CAPACITIES: A= /7t4lmcnESOR 14J GALLOWS SWITCH T`,IPE: ' o~2Z P/~ppC gc ~7•.t4 IMCHES OR ~E A GALLOWS PUMP MAMUFACTURER: C.-ice v IWCHES OR 11 //GALLONS MODEL AIUMBER: D- j INCHES OR .G~1J~GALLONS SWITCH TYPE: lh? ,eA- c NOTE: PUMP AMD ALARM ARE TO DE MIAIIMUM DISCHARGE RATE GPM ,INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF ARID DISTRIBUTION PIPE.. FEET + MIAIIMUM NETWORK SUPPLY PRESSURTT,E~/. , , • • , . • • . • `I + FEET OF FORCE MAIN X ~F/pp IrT.FRICTIOU FACTOR. '-W FEET TOTAL DtA AMIC HEAD = 12t FEET IUTERUAL DIMEIJSIOWS OF TA►JK: LENGTH ;WIDTH -;LIQUID DEPTH 51GNIE 0: / - - LICENSE ILIUMBER' &9 1;_r_ ~ DATE: 2 l P PVG I- OF HEAD CAPACITY CURVE 3 7/8 6 1/4 30 MODEL "98" 4 5/8 ter' r 8 7 2 A I 3 5/8 kD 6-20 v O 15 1 b .S3 4 3/16 o g 4 O 10- 10 ~8 O$ 1 1/2-11 1/2 NPT 2 5 0 U.S. GALLONS 10 20 30 40 50 60 70 80 VIERS 80 160 240 0 FLOW PER MINUTE TOTAL DYNAMIC HEADIFLOW PER MINUTE EFFLUENT AND DEWATERMM CAPACITY 12 HEAD UNITSIMIN FEET METERS GALS LTRS 5 1.52 72 273 10 3.05 61 231 31 15 4.57 es 9170 5 516 20 6.10 zs 95 L 3 / Lock Valve 23' L 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 Standard all models - Weiht 39 lbs. - H.P. 1 Rodoperated 2pole mecnanicatswitch. noextemal control required. , Integral 2 Single piggyback mercury float switch or double piggyback mercury. float 98 Series Control Selection switch Refer to FM0477. Model volts-Ph Mode Am Simplex Duplex 3. Mechanical alternator 10-0072 or 10-0075. M96 115 1 Auto 9.0 1 or 1 & 7 - 4. See FMII712, for correct model of Electrical Alternator. "E-Pak" N96 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 D96 230 1 Auto 4.5 1 or 1 d. 7 - duplex (3) or (4) float system. E98 230 1 Non 4.5 2 or 2 A 6 3 or 4 iA 5 6. Far (4) hole "J-Pak". itniction box, for watertight connection or wired-in Eirn- plex or duplex operation. 104)002- 7. Two (2) hob "J-Pak". for watertight connection or splice. CAUTION For khlomlaawh on additional Zoeller products refer to catalog on Combination Starter, FM0514; AN ieakaaatkm of controls, protection devices and wiring should be done by a Quali- Pippybaek Mercury Swfthees, FMINT7; Electrical Ahmuk r, FMOM Mechanical Alternator, road licensed electrician AN electrical and safely codes should be followed inelud- FM0495; Ali- Package, FM0513; SuniWSewage Bask". FMoa7; and Sknpiex Control Bar, hV the most recent National Electric Code (NEC) and the Occupational Safety and FW73Z Health Ad (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. 601(16347 L dsv ft KY 402W-047 Manufacturers of . SHIP 7n 3280 ofdiirs lane tmisvr7le, Ky 4me QL!4LlTY U.4IP5 lhCF e'' Z171-11-1, (502) 775-2731 9 1(900) 928-PUMP Wisconsin Department Industry, Labor and Human Relations SOIL AND SITE EVALUATION REPORT Page, -of L, 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 includa 11 t. croix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale dimensioned, north arrow, and location and distance to nearest road. -1314-80 A> WED DATE APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION PROPERTY OWNER: PROPER CATI N- i 5 Neal Krz aniak GOVT. LCF- 1/4T_ t/4,S 2$T N,R 19 for) W .AW PROPERTY OWNER':S MAILING ADDRESS LOT # Sl9Hl*JI.tNAME OR CSh<L# 11736 177th. St. 8 'S~F-Io iX(B ates CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑ WN , WREST ROAD Lakeville, M. 55044 (612)898-2566 Crosby Dr. New Construction Use [x] Residential / Number of bedrooms 4 [ ] Addition to existing building [ j Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate • 7 bed, gpd/ft2 . 8 trench, gpd/ft2 Absorption area required 858 bed, ft2 750 trench, ft2 Maximum design loading rate .7 bed, gpd/ft2 .8 trench, gpd/ft2 Recommended infiltration surface elevation(s) 95.20 ft (as referred to site plan benchmark) Additional design / site considerations alt. site=97.54 using alt. area bm. Parent material outwash Flood plain elevation, if applicable na It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U=Unsuitable fors stem INS ❑U ®S ❑U ®S ❑U [?FS ❑U CAS ❑U ❑S ®U SOIL DESCRIPTION REPORT 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 -14 10yr2/2 none 1 lfsbk mfr gw if .4 .5 s' 2 14-18 10yr4/4 none sicl 2mgr mfr gw if .4 .5 Ground 3 18-84 7.5yr4/6 none co s Osg ml na na .7 .8 elev. 99.22 ft. Depth to limiting factor +84" Remarks: Boring # l ~-7 10yr2/2 none 1 lfsbk mfr if .4 ' .5 F,?< 2 2 -19 l 0yr4/4 none s i cl i f sbk mfr gw 1f .2 's .3 3 19-80 7.5yr4/6 none co s Osg ml na na .7 .8 Ground elev. 97.92 ft. Depth to limiting factor 80 Remarks: CST Name:-Please Print Phone: Gary L. Steel 715-246-6200 Address: 1554 200 Ave., ew i Mond, WI. 54017 Signature: Date: CST Number: 5-28-96 cstm 02298 <111~ PROPERTYOWNER Neal Kryzaniac SOIL DESCRIPTION REPORT Page of,, PARCEL I.D.# 020-1314-80 Depth Dominant Color Mottles Texture Structure Consistence Bounday Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench ....fir, n:.:.:3 f 0-12 10yr3/3 none 1 lfsbk fr 2f .4 .5 :h. 2 12-30 10 r4 4 none sil lfsbk mfr gw if .2 .3 LIM Ground 3 30-84 7.5yr4/6 none co s Osg ml na na .7 .8 elev. 98.12 ft, Depth to limiting factor +84" Remarks: Boring # `....h,...... 1 10-12 10yr2/2 none 1 lcpl mfr gw if np .2 4 2 12-30 10yr4/4 none sil lfsbk mfr 9w if .2 .3 3 30-84 7.5yr4/6 none co s Osg ml na na .7 .8 Ground elev. 101.44 ft. bm #2 Depth to limiting factor +84" Remarks: Boring # if 1.5 .6 1 10-10 10yr2/2 none 1 2mgr mfr gw 5 2 10-20 10yr4/6 none sicl 2msbk mfr gw if .4 .5 3 20-43 7.5yr4/6 none co s Osg ml gw na .7 .8 Ground elev. 4 43-46 10yr5/4 none fs lcsbk mvfr gw na .5 .6 101.04ft, bm #2 5 46-88 7.5yr4/6 none co s Osg ml na na .7 .8 Depth to limiting factor +88" Remarks: Boring # 1 0-8 10yr2/2 none 1 2msbk mfr gw if .5 .6 2 8-20 10yr4/4 none sil lfsbk mfr gw na .2 .3 6 3 20-84 7.5yr4/6 none co s Osg ml na na .7 .8 Ground elev. 100.54 ft, bm#2 Depth to limiting factor + " Remarks: SBD-8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel Neal Krzyaniac 1554 200th Ave. CSTM2298 3254 SW4NW4 S28-T29N-R19W New Richmond, WI 54017 town of Hudson (715) 246-6200 lot #8-St. croix Estates N 1"=40' BM#1= top of SE lot stake C el. 100' for Area A BM #2= top of NE lot stake C el. 100' for area -5- ~U7 )11' r R.t 25 Gary L. Steel 5-29-96 osa) PuBt-Ic 158"\,N `7 ~tEo--- Noe 09 47.66 _ 35 ti «659 . Q 2 48. 6 09, 58 _ UP 0) . tom- LL d~_ W V I a: a~ <t 1.tyy _ O N N O o C,j 0 0 \l I ' 00 in r ~ ~ cn ~u t~- to w .K 0 w w LU ( . E' ~ o iJ U) I$ © U M V ti Q Cl) 4`11 mow} N N Cif O Z V O 170. 00' `r ~ 00 w WIM OF SECTiON.28 - STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER - • MAILING ADDRESS JS~ Attit r ~f1Q4oIV 5 t G ~rx~sc'.,~ t~}-J PROPERTY ADDRESS c (location of septic syst m) Please obtain from the Planning Dept. CITY/STATE: -1 a PROPERTY LOCATION SW 114, NW ,1/4, Section TQ _X& _ -R_ jg W 'OWN OF __la ~,~n• , ST. CROIX COUNTY, WI SUBDIVISION __s•1-,,..~,~ ~'S~'`.,~ LOT NUMBER R CERTIFIEDSURVEY 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 acid 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 year expiration date. SIGNED: DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11193 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 UI30.aL A. Sq Q~ ~ rt,w Location of property 6t.~l/4 NW 1/4, Section T LI N-R W TownshipRL&Aso,ti mailing address /S'~~! ~11Amt +4y, tiv St~- Address of site Subdivision name S-f^ Cro -,w Lot no. -A Other homes on property? Yes_ No Previous owner of property ~,.do L2e aelg, Total size of property Q. 7X ACIV-•4w Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Y Yes No Is this property being developed for (spec house) ? Yes K No Volume and Page Number --f/jr as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION TILE 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 purvey 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.'3 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 h~~h. + rrf ~tint~~~t it*~ r f Siritwifiirp DOCUMENT NO. STATE BAR WISCONSIN FORM 2-1982 . THIS SPA RESERVED FOR RECORDING DATA WARRrrATY DEED.... _ ` m.n pi. s t'i ~~TEVi'*SQFF1%t ~!'7~O Co., ~WW1 Bridgeland Development Company, a Minnesota corporation K" 'd for Record JAN 5 1996 conveys and warrants to Wade J. Riniker and Lisa L. Riniker. 1:10 P. husband and wife +r RETURN TO the following described real estate in St. Croix County, State of Wisconsin' TAX PARACEL NO. Lot 8, St. Croix Estates in the Town of Hudson, St. Croix County, Wisconsin. a This is not homestead property. (is) (is not) Exceptions to Warranties: Dated this 18 day of December . 19 95 (SEAL) (SEAL) (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signatures authenticated this day of STATE OF MINNESOTA '19 Dakota County Personally came before me, this 18 day of * December , 1995 the above named TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by 706.06, Wis. Stats.) This instrument was drafted by to me known to be the person who executed the foregoing instrument and acknowledged the same. (Signatures may be authenticated or acknowledged. *Darla J. Bauer Both are not necessary.)