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HomeMy WebLinkAbout020-1089-20-000 _0 0 o p M C 0. 0 ~ ~ o N > o Co h U L w 0 o d O 0 C 0 U) 7 N oo-a5~E> L Q "O -0 ca (n 0 co p N O 0 0 0 O 6 > O 21 5'07 E o~ Co Q -O E O C ~ = ~ (D I I C O L E (0 N C N E a w 0..0 o o E c 0 0 E 5.2 0, v) o cva ~ o E o C Z N N 0 U O 7 LL O ° o aoi am 3~ry C Yy N -O`O O C N CO N L 'O ll7 'O o X E C .6O - co a) m 0 V I • m m a o O W E Z = 00 ~ ~ II Z y y M ~ a m 0 c O a O 2 ~ ~I c w U O N 0 0 2 e fq F- e- O O Z c o E m not co N o 0 N (n N C c O U Q Z F- Z Z N CD E a~i N o O_ d• d i O L O G C a 4 0 N Z O Cl = O r~ Z N O 4 O O O Z O • 1rV a a a N a N 0 g C *i 7 C N N 0) 0) 0) 0) N N J U } o M... (D C) co a 0 N LY O r L CL N O N N .`s' Z d Q }u> m ~ I 0 N 4) -Cj N O C W O Q C •O C ~ W W O N U N O 0 0 V ° r 0 m o c a a m ° 6 m~ O ~ c E (D W Lo o o r..~ N a) O N E U N 2~ N ~ F- N • y' O M 2 O N O g~ U7 r V ~ EN d W d ~t EL L a r~• n d o o c r £ L 3 A 0 tin V a 0 ULBRICHT & ASSOCIATES CO. 655 O'Neil Road • Hudson, WI 54016 Reg. Designers of Engineering Systems 715-386-8185 Private Sewage Consultants St. Croix County Zoning Dept. Government Center 1101 Carmichael Rd. Hudson, Wis. 54016 Re: the Dave Delano septic system and soils located at 667 O'Neil Rd, Hudson, Wis. 54016; PIN 020-1089-20-000. Lot 2, CSM 367079, Vo1.4, Pg. 1001; SW,NE, S32,T29,R19W. Town/Hudson. This is to certify that we personally as plumbers/in charge installed this code compliant convenient trench type system in November 1995. See attached as-built reort. Soils as indicated are code compliant for inground conveniental systems. See attached report. This is alsa to certify that we have had the system inspected and it is functioning perfectly. Mr. Delano, our neighbot-has I am aware.has had his tank regularly pumped and serviced since we installed it. If you have any further questions, please contact us. Sincerely, Bob Ulbricht ~`v 01/16/1995 23:01 7153865964 GREENCARE PAGE 01 THE GREEN CARE COMPANY LAWN CARE, LANDSCAPING & MAINTENANCE 667 Oneil, Hudson, Wisconsin 54016 • (715) 306-5964 FAX COVER PAGE SUBJECT: Date 13111,04 #;e 5 ~O 13e d f ut° gays 4~d y LS Q G1 ✓~Ar G1 1G~45 ~%~u 9~ I~ l/~ fr To: ~162'1;7 6 46W From; ZIA A116 Fax Number: / - At: 2 For Info Call: Valce Number: Number of Pages; Fax Number: -FA d j k f'pp l 01/16/1995 23:01 7153865964 GREENCARE PAGE 02 Ll C- Ul. Iq f/,`/~ mod, _ V~-k I-AL u1° Fr" Y 5~~ _ - EXISTING SEPTIC SYSTEM AFFIDAVIT Document Number Name & Return Address T)', ~ kin 1,47 el rie, !-9(-Idstrn ~ r 5'YDI~ Parcel I.D. Number 3.2.28. (9. 3~Z,D The existing septic system which serves the dwelling being added on to must be verified by an acceptable soil report or be inspected by a licensed soil tester for compliance with high groundwater and/or bedrock separation requirements as set forth in s. COMM Chapter 83.10 (2) WI. Adm. Code. The results of that inspection must be made available to this office. If the existing septic system meets these minimum requirements, and is properly functioning, an addition may be added to the dwelling without updating that system. This addition must not, however, encroach upon the required septic system setbacks as setforth in s. COMM 83.10 (1). Property Owner (s) ~ e 1,2 „J-) Property Mailing Address: r(50::,0 I A)) 5~1 Property Legal Description: Lot # Z CSM/Subdivision SOO-) .l0 0. c? 5 3:. Sec. 32 T z7 N-R P? W, Town of IC,tc-~Cn k-7 I, as the owner of the above described property, hereby affirm that the septic system serving this dwelling meets the above referenced state private sewage system codes. I realize that this addition may cause the existing septic system to become undersized for a dwelling of the resulting size, and I will make this information available to any future parties interested in purchasing this property. Signed: Notary Public Subscribed and sworn to before me on this date: Date: My commission expires: County Approval: Date: s~sr~~ i,~s~//~D~ Nov . ~ r~, ~ ~ y~• ~ ~ , L o f 3 STC - 104 ,D AS BUILT SANITARY SYSTEM REPORT OWNER d C12~/ /PGQ - ~i` ADDRESS 667 I~IVPS OA.) SUBDIVISION / CSM# 3076 7~f UDI Y ! Op ( LOT # '2- SECTION 32- T )-L N-R ` W Town of [T'U1750 + ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM I S~F -s ll~' II .000/~9.J Pv,y &AP - .1 xy 5 ~s o L 4 AJ S d Co I^ lw D ORIGINAL 0 INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. F~O~ T ~Dit°C~ To P e P GO e. ~ o o ~ ~~20.~ A-T S E Tip . BENCHMARK: lElj. _ /00 • Q ' ALTERNATE BM: R14 )4;epti7- G>f-~~v 17. t4. .13 SEPTIC TANK / PUMP / A/919-1-5576Rn) 1,i ee,-,f,Sr -X'A-"= Manufacturer: Liquid Capacity: Setback from: Well House y9 Other SOD I LET 6~-"~'S Pump: Manufacturer Model# Size Float seperation Gallons/cycle: Alarm Location :SOIL ABSORPTION SYSTEM i Width: Length 60 Number of trenches ' Distance & Direction to nearest prop. line: ~ 5 j 4 t~ So Setback from: well: /O(Q House ""50' Other ELEVATIONS 3G o is ex s C D Building Sewer / ST Inlet.: Y~ ST outlet 89.2.8 ~I PC inlet / PC bottom Pump Off 11~ Header/Manifold Bottom of system 8S•5o~ QO l e.C.AJ6j2S) r Existing Grade Final grade DATE OF INSTALLAON O( q I S ` S PLUMBER ON JOB: LICENSE NUMBER: IP►2S 33 INSPECTOR: 11-A 3/93:jt r- ltj* ~ ~ rev o o ~ ~ ~ ~ c L 7~ 7e L A } rn ~t -ts CA go c - Ck. • N oe . f ~aapo~i n y a J lb/ Vl (it OA 7 o o tA 1 O-N y OIZJ v~ moo, - i .o - i _ o aw o ° ~ s nc~ P~ y °r ~rNN to • N ,,~-.4s r z-o 7- LiN r coxw le--L D ) WViscgnsistDepartment ofIndustry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Bbildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION Permit Holder's Name: ❑ City ❑ Village Town o : State PI o.. DELANO, DAVE CST BM Elev.: Insp. BM Elev.: IBM Description: iftlelse ~ Parcel Tax No.: ~U , G8 l~d, Gd a TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV- Benchmark Septic Pre Ca Dosing Aeration Bldg. Sewer Holding St/ V Inlet }t; K SETBACK INFORMATION St/ Vt Outlet Vent TANKTO P/L WELL BLDG. Airl to ntake ROAD Dt Inlet Air l Septic > Sp 9 / NA Dt Bottom Dosing NA Headers ? 7,' / Aeration N Dist. Pipe 99a~ ' 33~ Hotding Bot. System PUMP/ SIPHON INFORMATION Final Grade atfUTLST- Demand ° P -7, Model Number a g r~ TDH Li Friction S stepDist.ToWell Loss Hy Ft F cemain Length Dia. S OIL ABSORPTION SYSTEM TRENCH Width I Length No. Of Trenches PI No. Of Pits Insid Liqui ~pt~i MEN 1 N ®Z DIM N I SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHINIK INFORMATION Typeo / CHA ER Moe Number: /D(p~ O NIT System: d {ys, 176", 1 '-It-61 lid DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s)/ x Hole Size x Hole Spacin ~ir Intake Length Dia. Length s 7 Dia. Spacing ` SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Sys ms Only Depth Over Depth Over xx Depth Of x3, eeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: Hudson.32.29.19W, SW, NE, Lot 2, O'Neil Road Plan revision required? ❑ Yes pH o Use other side for additional information. RTA jt9 SBD-6710(R 05/91) Date Inspector's Signat re Cert. No i ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY sT. ceoi•X STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 444 7?5 8% x 11 inches in size. ❑ Check if revision to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. /v PROPERTY OWNER PROPERTY LOCATION TAU F D,s'WN, AE Yk, S T Zy, N, R E (or W PROPERTY OWNER'S MAILING ADDRESS LOT BLOCK # (ere? O 1.v~e r ( AY n " CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER y /00 / if vfllo,✓ Gl~~. 1r11,01 u )116165 y CS'Al 36-707 5F va( ~ . 11. TYPE OF BUILDING: Check-one CITY NEAREST ROAD ( ) ❑ State Owned ❑ ILLAGE : U O,SG.t~ ❑ Public CJ 1 or 2 Fam. Dwelling-# of bedrooms PARCEL TAX NUMBER() / q III. BUILDING USE: (If building type is public, check all that apply) d Zd L ~U 1 ❑ Apt/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 50 Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1.0 New 2. Replacement 3. ❑ Replacement of 4.E] Reconnection of 5.0 Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit 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 Seepage Trench 22 ❑ In-Ground 420 Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill` Z VI. ABSORPTION SYSTEM INFORMATION: 8S ` 2 r 8~l` ~!'b 1. GALLONS PER DAY 12. 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) P-5. d ELEVATION 14,63, -5-76 1 - Y i Feet ~ 915kb Feet VII. TANK CAPACITY Site in allons Total of Prefab. Fiber- Exper. INFORMATION New xistin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank Om Lift Pump Tank/Si hon Chamber, - - VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) MP_fMPRSW No.: Business Phone Number: RogeFP_T-2llhX14r,7_ 695 O' N~~l /oe 3367 ?/S 3fG• v/s Plumber's Address (Street, City, State, Zip Code): IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sa9dtary Permit Fee (include g rouunnd water Date Issued s ing Agent 'To, ire No Stamps) /1• /~yl 0 1 g n Approved F-1 Owner Given Initial ~ o ee) Adverse D terminatio V -G J X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: UIF SBD-6398(R.08/93) 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 the 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 & 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 anchcomplete 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 in 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 in ##1-7. VII. Tank information. Fill in the capacity of every new and/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% 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 monitoririg groundwater, ground- _S . water contamination investigations and establishment of standards. SBD-6398 R.11/88 1 y o0 00 • rn v~ ~ o rnf N U~ It o d Qs Q3 7 ~j°3W p k - 00 - O ~ LCA r rn m p ~ ~ ? w ci ,,qn 1 _ y- c o r L w iiP~ ctLI 0 v h y o p ~ ~y a Fresh Air Inlets And Observation Pipe Approved Vest Cap Minimum 12' Above lfl final Grade i~ •„t.._./^J/Sf7~E1~ 91P~~~ Above Pipe 4' Cost Iron -to Final Grade Vent "W i ~ Syniklk covering win. 2' Aggregate Over Pipe -Tee 0 Oill►Ibulbn -[06000 Pipe I ~ l~ o Aggregate t a Perforated Pipe Below j Beat ON Pipe 0 -Coupling Terminaling At s y s rE.y Bottom Of $1616w \l W Fresh Air Inlets And Observation Pipe Approved Vent Cap J Minimum 12' Above Q it Final Grade ~ ~IUISH~D GRr1-f> TRt=0cH- 8~•0/ Above Pipe 4' Cast Iron 1o final Grade Vent pipe' Synlhelk Covering min.2 Aggregal• Over Pipe Distribution - Tee e pipe 0 0 0 0 0 • Aggregote o Perforated Pipe Below Beneath Pipe Ilk 5 YS T~ ~-1 /~U . o -Coupling T•rminoling At Bottom Or s.ret•m 0 tiW I'. v ~tl vo .V U ~W vj r Wisconsin 'Department of Industry, SOIL AND SITE EVALUATION Labor and Human Relations Page of Division of Safety and Buildings in accordance i h s. IL HR 83 09, Wis. than B 1/2 x 1County Attach complete site plan on paper not less rInc include, but not limited to: vertical and horizontal referencrection percent slope, scale or dimensions, north arrow, and locateito n~i x,road ~ Parcel LD. # O Z O /o 9> Y 2©- llZ~o APPLICANT INFORMATION - Please print al eviewed by Date Personal information you provide may be used for secondary purpos 15.04,f p (m)). Property Owner Pro by L ~ Q Govt. L 1/4 /VE 1/4,S 32 T 2 / N,R 9 E (oro Property Owner's Mailing Address ~o # ock# Subd. Name or CSM# City State Zip Code Phone Numb or Nearest Road t city El Villa Town y El ty evpso Zvi. .574,1046P ( 7i5 )36 ri L.) T~ ❑ New Construction Use: esidential / Number of bedrooms `3 Addition to existing building [replacement ❑ Public or commercial - Describe: Code derived daily flow gpd Recommended design loading rate ed, gpd/f?- _--q trench, gpd/ft2 Absorption area required ad, ft2 trench, ft2 Maximum design loading rate _L' bed, gpd/02 19 trench, gpd/ft2 Recommended infiltration surface elevation(s) she p9 S O ft (as referred to site plan benchmark) Additional design/site cons ons WSE 2- -_'`Aee--1S - 44e-Ci 5 >e_ S 7 Parent material SCS P0 /Of " Si L1- /o,ssS Flood plain elevation, if applicable ft &7V 47V f- Conve tional Mound In Grou ressure AT Grade re in Fill olding Tank S = Suitable for system rr- 11 1 _J- U Unsuitable for system❑ s Ld'u S❑ u ❑ s u ❑ U ❑ S U SOIL DESCRIPTION REPORT /1, //0 A10T W11177EA Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2 9 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed, Trench I : /D!l 3-f N z /-17 /D ye y 3' c'~,y crrt 174sA66` ~4 / cS L-F N ; N Ground 3 - A0 y~ Z O dsA e s (v 2334 elev. CS y 7 :.,9 ft. - /Of Sl /,141 OFA010 I"- Depth to limiting factor 7 pain. ' Remarks: Boring # 0-"3 /0 Ye 211' 5/7 2- -f Sh/-, 6&A is [3-f z 2 3-2 ~o y - S/ -2-F41e WS S14 5- s ;,611 3 /p y 5i/ Z,ia ~S~ CS . s Ground - O 516 $ ~.y t C$ i . -7 ~ " elev. S - ft /O - P S. s G{ 7 . Depth to limiting UKIV factor 7 ~ -in. Remarks: CST Name (Please Print) Signature Telephone No. i2o3EieT Z1/,6~iGG17 JK ZZegfI 3 P6 -,?195 Address Date CST Number Uibricht & Associates yA yPL 655 O'Neil Rd. Hudson, Wis. 54016 SOIL DESCRIPTION REPORT PROPERTY OWNER Page Z of, ' PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Structure 2 Texture Consistence Boundary Roots GepItt in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 3 / - l is 3 3 ~Dy 12--V1 ~`~l/ > ce Li CS 2- -F- N z - /0YX 511 2- h~ 17 CS I E -2 ; . nG Ground 3 7~ S`Y $ ~M1 G $ i 7 d' elev. Depth to limiting factor Gamin. dd--'' Remarks: Boring # Ground elev. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # Ground elev. ft. ' Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to V1 f limiting factor in. Remarks: SBDW-8330 (R. 08/95) y oo o 00 • 0 0 0 N ~ c- rn O N 0 ~ y Y 0 CIO °a ° m o~ m o y O C o ~ o V1 0 ^ 70 1LA t - N e ~ ~ o N n ~ ~ trt - sT, w mss, ` a X j C \ FASO:. i ~TV _ 71f GGl f17 ~ ~ C Q c h5 T G o T L w ip~-Gvcc~_ a FORM NO. 985-A FILED 0 CT 15 980 i~6r~t!"rr J JARES O'CONNIIL Roomw of D°°d# Or ft "x comfy, N 1/4 CORNER CERTIFIED SURVEY MAP s 8 SECTION 32 W LOT 2 CERTIFIED SURVEY MAP RECORDED IN VOL. 2, PAGE 366. ;o o (F ECO DED AS S89005'55" W) - N S 8 00 4311 256,23' 55.01 67. 4' 133.46' 393.73' ' N 32°,6$28' o oy0 , o o~~ f RECORDED AS THE NORTH U e9 LINE OF THE SW-NE LEGEND POINT OF BEGINNING N 45 4-- COUNTY SECTION CORNER MONUMENT a • I" IRON PIPE FOUND i° FENCE cQ ljj ° 3/4" X 24" ROUND STEEL BAR WEIGHING N 1.502 LBS. /LINEAL FT. SET c M SCALE IN FEET In n W m° (o Z 0 100 2 00 30 a Z N 1 ~ o (I"= 100' 1 CD W z V* 1.6406 ACRES z z p Q) 14 z 0 LO W W 1 e LLJ v v W `~O N a ~ I N _z lvn N 00 fA o W ^ I 1 W- ^ Z o . ~ I M -Z V) QI N z=t H JI 1 Z Wl (n Wy 01 Qua W 1 /00 O M .n N 4°49' di - - I~ 1 03 W 21960' 'n a ` N CS O U N L~ M- V, ~r-I I [1 O O O O 173024'39" lnl V M co t- \O SE-NW 1 II m SW-NE OI I 3 3 3 3 6 s' It I~ >I 3 01 z o~ ?n in M I I--I r-I 0 0 ' HOUSE z1 J I W ` ` ` ' N cQ ~O N l~ I 1.5303 ACRES 0 ~ I H W ca ca 11 j4 1901" Z _j i Q I l - I ~I I E H - OD C+\ O~ Qll i I wl ~Gf ( 7"x'5 2 r4 oo r-i o I OI I I S89°24'03W 264.73' ~I -t ~ N N ~~I II I I 'I I •I JI EQ 01 0 I II Qj H 0 00 00 00 I I II aI ° I ~ ~ ! I N 19 r-i rl r-I r-1 I I wl I .l 3 Is, IFo hI'A 1.3042 ACRES #,P Ol Cub '6~ - °0s M T1 N M P) ° N 89° 24103° E 272,591 N 0 6 i6' I pq 1 I UNPLATTED LANDS APPROVED. I S 1/4 CORNER =15 1980 SECTION 32 T 29 N, R 19 W ~S~T. CROIX COU1~1Y ~ ►1A>yNINq This instrument was drafted by John p1 w. To"15vt PAXKS iWrAt Vnl.. 4 pane 1001 Amish, • FORM NO. 985-A • N.CMI,ItLanpvry~ • ~ 3 FILED 7 0 CT 15 880 3670 19 JAMB O' CONNEII bp4Nr of Deeds CD 6f" GNa comfy, OI Wheauk N I/4 CORNER CERTIFIED SURVEY MAP s g SECTION 32 LOT 2 CERTIFIED SURVEY MAP -to W s s, / RECORDED IN VOL. 21 PAGE 366. N (~ECO DED AS S89°05155"W) M 0 S 8 °0 4311 256.231 -IA 55.0 M 67. 4' 133.46' L393.73' N 35°41'28° W ~ °o y ^ o RECORDED AS THE NORTH 12.68 0 I 0-- 9~` LINE OF THE SW-NE LEGEND POINT OF BEGINNING i 4- COUNTY SECTION CORNER MONUMENT N • 1" IRON PIPE FOUND M FENCE INnF lU ° 3/4" X 24" ROUND STEEL BAR WEIGHING No 1.502 LBS. /LINEAL FT. SET a N SCALE IN FEET ° O irk ~V o enTTleees" W o Z 0 100 200 300 Z a 2 O cco (I"-100' (D W 0 ~ 1.6406 ACRES a W .3 U CC f!) I W 3 U. (LI ~°v v W / N z (a z cv U) _ M a a ° CW7 PG O tn1 m~z Z Z - t~j O)l W Z' CE-I WW a i IN ! Z WI N aQI Qua 0 UJI 1 MN 4049'o.3--W , in a N o o Zv a I I C\j M 219.60 jo P~ o (n m r') d1 / foT ~~7 C7 O N O O 1 I 173o24159" LoI v r 00 L` 1 co SE-NW m SW-NE I 1 v;l 01 3 1 0 3 3 3 3 ' 66 ' o I~ >I = 01 H O O O CO W o lz HOUSE zl CID N J 1 ~ U W N O M c\j II 2 -1 ~ c 0) I E I 0 If\ M 00 I I 1.5303 ACRES O 1 H U) m ca Cf) 174 19101" i Y v R-BIK Z a I Q W I D_ E-A I II I I 01 1 ' oz ° I QI I i Uj1 a Lr\ co ~ ~ I QI I I S89°24'03"W 264.73' ~ CU N CV I C) I I .I LLJI I I I QI - H o° °o o° °o I II n-I z 0 Q ti r` II N 3 zl II .a°' 1.3042 ACRES of OI 1° h F y, 1 out°~ 6~ M - 0O@ O O 68 rd N (y) N 69024 , 03" E 272.591 N o I 616 ~ UNPLATTED LANDS APPROVE' I I S 1/4 CORNER 15 1980 SECTION 32 T 29 N, R 19 W ST. CROIX COW Y G /lArrruN3 This instrument was drafted by John R p'' *r0;4jN PAR0 V-l pq ffA 7007 STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNEPJBUVM -PA V C7 4 H A P-Y MAILING ADDRESS Cv -7 O ,u2('6 ew• PROPERTY ADDRESS .5 d-zv~_ . (location of septic system) Please obtain from the Planning Dept. CITY/STATE PROPERTY LOCATION 5&) 1/4, Ne 1/4, Section 3 T 'L N-R ~y W TOWN OF q(J ©g- ST. CROIX COUNTY, WI SUBDIVISION 3 X070 v 0~ • P ~1, . l d o l LOT NUMBER 2- CERTIFIED SURVEY MAP , VOLUME I PAGE , LOT NUMBER 72- 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 year expiration date. SIGNED: DATE: St. Croix County Zoning Office Government.Center..... _ ~ _ _ 1101 Carmichael Road Hudson, WI 54016 11/93 i 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 2AIlk- ~ /W y y",~W? Location of property -sue 1/4 N& 1/4, Section 32- T 2( N-R 19 W Township Mailing address Address of site Jam - 6c) Subdivision name CSC 3 47 6 7 17 UQ Lot no. 2 Other homes on property? Yes No Previous owner of property Total size of property "f6y5, Total size of parcel f ^gGcG S Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)? Yes Volume and Page Number /00/ 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. 3 470 7 9 , 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 • DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1-1982 THIS SPACE RESERVED FOR RECORDING DATA WARRANTY DEED voi 668 This Deed, made betwee .larian_J_.__.Kin.... REGISTERS OFPlC~ .a.- ingle_won, an ST. CF401n CO., W15. Recd. for Record-'this 9orh and Davi_c_l R Delano and Mary--M'.._.Delanoi - Grantor, day of July A•D.1983 husband and wife as joint._tenants at :00 P . .2-- Grantee, Witnesseth, That the said Grantor, for a valuable consideration_.___. ISOM& of D«de -----$45.,.000.00------- - conveys to Grantee the following described real estate in t_•_..Cr.o i X R" TD County, State of Wisconsin: Lot 2 of the Certified Survey Map - recorded in the office of the Register TazParcel No: of Deeds for. St. Croix County , Wisconsin on October 15, 1980 in Volume 4, Page 1001, Document #367079. TRANSFER $-131A.0 FEE This is homestead property. XuX~i bid Together with all and singular the hereditaments and appurtenances thereunto belonging; And Marian J. Kinney + a single..woman warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements of record, if any. and will warrant and defend the same. Dated this _ ...1 5th 19. day of -July - - 83.... . . - - (SEAL) Y± l .~.ua .,t- (SEAL) MARIAN J. KINNEY - - - - (SEAL) - (SEAL) - AUTHENTICATION ACKNOWLEDGMENT Signature (s) STATE OF WISCONSIN ss. St.................................... .Croix County. authenticated this day of 19 Personally came before me this • 15 t.h day of - 4_..y - - 1 19 . 8-3 the above named Marian J . Krone x a single woma n y TITLE: MEMBER STATE BAR OF WISCONSIN (If not, _ ~ authorized Ey 3 706.06, Wis. Stats) E, son to be the person who executed the in and ackn led the same. THIS INSTRUMENT WAS DRAFTED BY HEYWOOD,CARI & MURRAY - - - Hudson, Wisconsin S4016 pds - . a/'''IV -s----E- Notary Public - ---St. Cro1X ----County, Wis. (Signatures may he authenticated or acknowledged. Both My Commission is permanent. (Tf not, state expiration are not necessary.) date: -/r-.~------••------ 19 ) •Names of persons signinz in any capacity should be typed or printed below their signatures. WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin L-I Bla.k Co. Ina FORM No. I - 1982 Milwaukee, Wis. STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS /~v/~So,,~ 4~ ~ S, Syor~ SUBDIVISION / CSM# 3676 7 100 ( 2 ~-sd LOT # SECTION-? _T N_R `f Town of wopie'J (Z I. ST. CROIX COUNTY, WISCONSIN PLAN VIEW A SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM .4 S INDICATE NORTH ARROW Provide setback and elevation information (,n vrr;" of this form. Provide 2 dimensions to center of Frpt Manhole cover. v T l aec _ ToP o F co~~~ e o o SE Ti BENCHMARK: A/J/2o.~ 47- to . /O0•Q ' 11LT'EF2NnTE BM_ .13 SEPTIC TANK / pyl! $Mi+ / F~AT,nTtrrs Manufacturer: A/P4~~57 .~1 1,eee lsr - Liquid Capacity: /Uao Setback from: Well House4// Oth { -'-0 T G~;,, Pump: Ianufacturer - ~ Model 4 Size Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: ~ Length (00 Z - Number of trenches Distance & Direction to nearest prop, line: Z 5 r '6 E f 4 ~o So . Setback from: well: /O House y_ -S~ Other ~'S£7eS I ELEVATIONS 3G" 6P Building Sewerj,y~1 0 / • Inlet . ST outlet a ~8 PC inlet ----1 PC bottom Pump Off Header/Manifold--- - Bottom of system 005, 5'0 / o \ dl- Fxi,,titlg Grade S)1.6( / Final grade DATE OF INSTALLA,1'I ON : PC) U . (y ^ 's ~(q S PLUMBER ON JOB: TOBCi- l- ZtLeP-,-C~- l LICENSE NUMBER: 330-7 It V _r C d c c ~ r< ' A7 t -15 - Tl> ~ m ur 3) ~°mo L ~n o, w N U 0 h ~ O ~I o O O tA C-N ~jl w\ y 7 e ~ R~ t 0 Cl aw ~ ~ ~ y o nc~ ~ n y r ' ~ p r N vl egsT Z-07- <'o,P~J ~i~LDI Wisconsin Department of Industry, SOIL AND SITE EVALUATION Labor and Human Relations . Page of ; -~a Division of Safety and Buildings in accordance With s. ILHR 83.09, Wis. Attach complete site plan on paper not less than 8 1/2 x 11 Inches in size. Plan must County Include, but not limited to: vertical and horizontal reference point (BM), direction and s 4- Include, slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # oz o- /oP7 -24o - o-oo APPLICANT INFORMATION - Please print all Information. Reviewed by Date Personal Information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location o r IE11WO Govt. Lot SW 1/4 1/4,S 32 T / N.R E (or Wo Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 110,EIZ- 1- 36 -76 ft City State Zip Code Phone Numb pr Nearest Road f 0-✓ Gv/. --',41046, (7/5 >3OV4 -1`~y.5 ❑ city El `/u ^j Town ~.vEi L ❑ New Construction Use: esidential / Number of bedrooms 3 Addition to existing building eplacement ❑ Public or commercial - Describe: Code derived dally flow Y~L/' gpd Recommended design loading rate , gpd/ft2 ' ? trench, gpd/ft2 Absorption area required bed, ft2 trench, ft2 1 Maximum design loading rate, 9pd$ j trench, 9PW Recommended infiltration surface elevation(s) •51"- 3 ft (as referred to site plan benchmark) Additional design/site cons ons uSE Z mss 5 Y- S 7 Parent material 5cs pl' 1IDf 51 Lt /.06S7S Flood plain elevation, if applicable ft rolp ressure AT-Grade Syste In Fill Holding Tank Conve Clonal Mound - /t1 In Grou S S = Suitable for system I U = Unsuitable for system U❑ U ❑ S U1' El u 1:1 S ❑ U El S U SOIL DESCRIPTION REPORT iY1 = A10 7- A%-f17-7ez7 Boring # Horizon Depth Dominant Color Mottles Structure GPD/f(; In. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Rests Bed , Trench '7 3 z /-i1 /o y csy A6& d16 cS 1-7F N N Ground 3 -334 /0 f LP Si~ Z 6 G SA e5 17C 5 . CIO elev. ft A-5 -e,4. /o fie 5,1,~o 0 els -7 Depth to / S~ s• A / 7 limiting factor Remarks: Boring # i0 yie / $i~ z fShe .5~ z Z 3_1f /o ezle Ground - p /(y S ~iNf ~iC CS • -7 v elev. S• .7 ' ft. S - so -YP . 7 P Depth to limiting )i factor -7 fD-In. Remarks: CST Name (Please Print) Signature Telephone No. o3E~eT Zf~,6~P%~~r ZGGQt! 71,4-- 3 RG-F/So S Address Date CST Number Ulbricht & Associates x_ 2 9 /f'f~ e$P'V A *"JO 2-- 655 O'Neil Rd. Hudson, Wis. 54010 o° i Y PROPERTY OWNER SOIL DESCRIPTION REPORT. ~ 3 . Page ;_of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots Gep/ft2 In. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. Bed . Trench 3 is YI? 3 3 cD~l 7~1~ 7`~l/ > LJ CS 2-F N Ground 3 7, S VR 5/(/ elev. ft. - rD y le S, d S . 7 Depth to limiting factor Remarks: Boring # Ground elev. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD ft2 in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # Ground elev. ft. / • Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor In. Remarks: SBDW-8330 (R. 08/95) I Z w y °O °o • ul It ~ ChA z ~ o u ~ tv~,\ cn ~ G y ~ 1 O It a o y F b N . I S: Ibx -f ~,~SO NZ/ 4F 45 T G o T w i,P~ -tom c~_ ~ h O ~ 1 U1 ~ O ~ ~ t 1 y a• FORM NO. 985•A FILED OCT15 980 367079 JAAES 01 CONNLiLL ft"WOr *I Deeds k Qm to C°wly, Of Wbm& N 1/4 CORNER CERTIFIED SURVEY MAP s 8 SECTION 32 LOT 2 MAP RECORDED RIN IFVOL. 2.1 R PAGE 366. N (FIECED AS S89005'55' W) M 0 S 8 ° 0)J4. 11 256.23' 5503' i 67. 133.46' • 393.73' ' N 352068 8" W o °ya 1 16 o~1; ♦ RECORDED AS THE NORTH a n`O o+ 09 LINE OF THE SW-NE LEGEND POINT OF BEGINNING N 4- COUNTY SECTION CORNER MONUMENT d • I" IRON PIPE FOUND FENCE No Ltl ° 3/4' X 24" ROUND STEEL BAR WEIGHING ti N 1.502 LBS. /LINEAL FT. SET o m o SCALE IN FEET O _ `0 N o 3 0 100 200 30 N 1 (I"-100' z V. to 0 1.6406 ACRES a zW z w W lt/ o I Wa N ZyN N ; N 0 w S I H r I Z~ Z N W1 IyJ1 M W y 01 6 a 1 W 1 O N 404910.3 - ` / Ln o M J1 ! 7n W 21960 t"315 m M , C\j O o n1 ' o o 1 / th Q)1 W I 173°2439° In1 U M Co N \10 SE-NW m SW-NE ' ► a ~1 .J 6 >I 3 N j 3 3 3 3 I o 'RL~ _ o I Z m H ' I HOUSE zl J I W O O~ x 1 1 -I N c~ w `8 m U'N 1 I 2 0) OR 0 ' oW i p aq °ir~ M °co r-q I 1.5303 ACRES O I H 174 19'01' 1* IF k IpL Z a A zi N, o 1"~ o ~ ° U\ r-A I ~I I i Ld a00o 4 (S I QI I I S 89°24'03" W 264.73' N N N Iii ~ JI I 1,J I i v1 - I Qj ~H 9 0 0 0 I J I I I N r I r I , I .-1 II w 3 I jfo b119 1.3042 ACRES spF Of - °9s I O~ otj `d N M N 89° 24'03° E 272.59' N 0 616 I I I UNPLATTED LANDS APPROVED- . ~ I S 1/4 CORNER IM 15 1980 SECTION 32 T 29 NI R 19 W ST. CROIX COUh1Y This instrument was drafted by John P3 1o.Vt ►ARICS ►t~NNIN+~ o:+1No cOfwrv(%A Vnl „ 4 Pa nP 11001