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HomeMy WebLinkAbout030-2003-80-100 II Q c o j 03 C; 0. 0 ~ I 1 C, O © p' I " N a cC 00 Vj C x C N ~ Z. `C v ' p U o Z > .a C O LL C N O O Y O Q E I V' III ~ ~ ~ I z w I E rn = o z ~ y y I m m c) ° w (L c') z o c o z z p c d o d Z c lp E- O O Z I c E '2 Cl) N ~ 7 O CL O O C • a O O N Q O yU-_- I O CO z co z o N o C,4 z N ~ d E N rn E N > N 10 O N ~ m v U y ~ p o o a m U) n U) ~y Z N N m Ma Z •N m in a a a N E Q g LO CO N m o w m to U m rn } O 00 p O N N N O N ~ ~ N O ~ Q C C rn a U • oC$ d Q } O ~i O ° C O N C O CC o V FO- EO 0 O O 4s O w a) 00 O O L O N N U ('L O O O 00 CL 0- CY) Oi C I- C O O O co co 3 N V a) cy) C N O O Cl) Erb ° L L N I` E CD • co M U~ o N E E U L O M Cn Cn N O Cn O ~ r I V ~ E y I 3 a L: a. • IZ Z .U d y C rr~ c `m 3 3 .5 c ~1 A U a 2 0 rn U STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ~0~ .f bKA SC~ hN t ADDRESS S y l C"f y IAA SUBDIVISION / CSM# LOT # a SECTION 33 T 30 N-R~W, Town of St Tse ~h ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Node MAQWQ ooc Q vv Q o I Vx t7 VQr7 , 8 4 ~QDRUVM 419 IND CATE NORTH ARROW _ I Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: I~ {7 A ~'A{~ (eV I V6 b ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: WIZ 2 KS Liquid Capacity: dQ f') , r Setback from: Wel14Ve(t 56l House -1 Other i Pump: Manufacturer Model# Size Float seperation Gallons/cycle: Alarm Location Q .SOIL ABSORPTION SYSTEM Width: 8 Length Y S Number of trenches Distance & Direction to nearest prop. line: a Setback from: well: OV erz S D House (Q Other 9 Wooer- 96,x3 98,.)3 'END 4.6(0 - 98.0(S ELEVATIONS Cover, 100• 7 Building Sewer ST Inlet : Al 3 T ST outlet PC inlet PC bottom Pump Off Header/Manifold Bottom of system L,OWtPCC' Sy!`rCrh Existing Grade Final grade DATE OF INSTALLATION: \ PLUMBER ON JOB: LICENSE NUMBER: 3W INSPECTOR: 3/93:jt Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Laborant~ HumanRelations INSPECTION REPORT ST. CROIX Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No-: GENERAL INFORMATION Permit Holder's Name: ❑ City ❑ Village ❑ Town of: State PI SCHMIDT, THOMAS & DEBRA X jeseph CST BM Elev.: Insp. BM Elev.: BM Description: , . ~ Parcel Tax No.: TANK INFORMATION ELEVATION DATA 21Z_7n~ TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosin Aeration Bldg. Sewer Holdin StP4t Inlet TANK SETBACK INFORMATION St/ Outlet 91, 1!~g TANK TO P/ L WELL BLDG. Ae Intake ROAD Dt Inlet Y1 Septic >,56 2 NA Dt Bottom y! ,4 Dosing NA Header/ Man. Aeration NA Dist. Pipe Hol Ing Bot. System PUMP /-INFORMATION Final Grade r mand Mawfacture 4=_ Lrg Model Number GP TDH Li Friction System TDH Ft Loss Forcemain Length Dia. Dist. To Well H SOIL ABSORPTION SYSTEM BED/TRENCH Width Length i No. Of Trenches PIT No. Of Pits Insid a. Liqui th DIMENSIONS DIM SYSTEM TO P/ L BLDG7 WELL LAKE/STREAM LCH Manufacturer. SETBACK HEAA ER INFORMATION Type 0 t ~ C5,1 -4 C Moe Number: System: "C, ~9'GJ OR UNIT DISTRIBUTION SYSTEM Header /mod , Distribution Pipe(s) „ x Hole Size x Hole Spacing Vent To Air Intake Length _k_' Dia. Length ~ Dia. _ Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade ms On Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center - Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No qG J COMMENTS: (Include code discrepancies, persons present, c) LOCATION: St. Joseph.33.30.19W, E, SW, Lot 2, 54th Street i Plan revision required? ❑ Yes EyNo ~Use other side for additional information. I,-, 2tf2K=4:;~~~ I I ~ed P SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: i SANITARY PERMIT APPLICATION !i'=~..fti7fl COUNTY In accord with ILHR 83.05, Wis. Adm. Code EO)x STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than " ~c733 8% X 11 inches in size. 5Check 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. PROPERTY OWNER ii PROPERTY LOCATION 11a fr d' 66 Sc, h r~. '/4 S Q Y,,, S 3 T 3v, N, R F E (or) PROPERTY OWNER'S MAI NG ADDRESS I., I-I 5 , tjf4, LOT # BLOCK , y CITY STATE ZIP CODE PHONE NUMB R SUBDIVISION NAME OR CSM NUMBER •/~"~J~\' II. TYPE OF BUILDING: (Check one) CITY d NEAREST ROAD ❑ State Owned VILLAGE ❑ Public ❑ 1 or 2 Fam. Dwelling-## of bedrooms EL TAX NUMBER(S) III. BUILDING USE: (If building type is public, check all that apply) `1 ® ~7 CC ~A /e)O 1 ❑ Apt/Condo LJ c~ 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 130 Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. IxNew 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ 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 300 Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 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 RE IRED (sq. ft.) PRO O E sq. ft.) (Gals 7 1 y/sq. ft.) (Min./inch) ELEVATION ,j $ 1 Feet I Q - 5 9Feet (gc)o I 8Q1V 7 VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New xistin Gallons Tanks Manufacturer's Name Concre a Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank G~ ( t Q 0 1 11 F1 Lift Pump Tank/Si hon Chamber 11 1 VIII. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's SignaUlre. (No Stamps) MP/MPRSW No.: Business Phone Number: Plum s Address (Street, Ci , State, Zip Code). /o 1k, 7 w 35.. )A d ~ WV 0 IX. COUNTY/DEPARTMENT E ONLY Disapproved Sanitary Permit Fee (Includes Groundwater a e ssue jissuingLAenizi' nature (N amps) Surcharge Fee) Approved El Owner Given Initial L~~ Adverse Determination 001- X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(R.08/93) 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 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. ll. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one 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. VI1. 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 monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) S~, R o R B,L` 6 7 PLOT' A I l 1) AM E a6RP ..N_ME~ ~a~mees rz L O C A 10 N----..... C NS Er ~ `~Uy---- )bl Or► NW lot ! P L Arlo CORNQ r j Alt S;fP Nofie : gdeN sa~fi~ h✓ _ J ~v_1 Q ' AV- VAcr~N~ 8rn `.o a~ N o P N w l ofi St4 K@ r~aN 50' y N FRESII AII; Tt~LETS AND 013SE12VA'r10N YI.PB „ CI;QSS SECTION Approved Vent Can Minimum 12" Above I)Np~ GdCppp " . Above Pipe Cast Iron Vend Pipe To Final Grade, Marsh I1.1y Or rSynthetic Cove: i 11(j Min. 2" AggratA it _ I Over Pipe i Distributi-4 _ Tee j pipe I.1 lAA Aggregate Pea f.aratad pipe Qela%./ ~~-oe7 I)cncath Pipe --.Coup).ing Terminating' !ROL•tom.of'System. SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05, Wis. Adm. Code STATE SANIT RY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 0?*9`1153 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. PROP TY OWNER PROPERTY LOCATION % 1/4, S T,3Q, N, R E (Or '4 PROPERTY OWNER'S MAILING ADDRESS T# BLOCK # CITY, TA E ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER 0 CI VI LAGE : NEAF sT~ROAD 11. TYPE OF BUILDING: (Check one) ❑ State Owned O OiWTOWW OF: ❑ Public 211 or 2 Fam. Dwelling-# of bedrooms PARCEL TAX NUMBER(S) /V•T Ill. BUILDING USE: (If building type is public, check all that apply) a 8~ L_ 030 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 5 ❑ 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. VN New 2. ❑ Replacement 3.E1 Replacement of 4.0 Reconnection of 5.E] 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 l9 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 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 l REQUIRED (sq. ft.) PRO OS ED (sq. ft.) (Gals/day/s . ft.) (Min./inch) qQ Q ELEVATION V50 3 m a 1 0 I Feet ' a°~• 1 Feet VII. TANK CAPACITY Site in allons Total of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concr t Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank O(~U e El 1:1 1 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): Plum is Signatu : (No Stamps) MP/MPRSW No.: Business Phone Number: ourr e -he 3 713 38b-96~b Plumber's Address (Street, City, Stat%Zip Code : 1 01 b W S >~01 0 W ,~7 o IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved S nitary Permit Fee (includes Groundwater [Date Issued Issuing Agent Signature (No Stamps) Fee) Approved ❑ Owner Given initial Adverse Determination 'tea X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(R.08/93) 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 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. fl. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling. Ill. 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 systern. 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 monitoring groundwater, ground- . water contamination investigations and establishment of standards. SBD-6398 (R.11/88) -)OSS Sl-(. I R B,L' 67 PLOTA M h R - '0 - N NAM 0 + D 6 i-iA Sc, h M,, Gl ? _ _ AM )6411 v, 9, ,eS ► L 0 C f 0 N1.5i. i C N S ISM NW M A_ID i' ~ORNQf • gib ~ ~ 1 Alf Vj /0, o ' O S Z:) luau So J w1.1 ote : Wei) 1-r food l e K~ At L 1ev = 00.0 so, T98r~, S sfiPr-BUKO 61-f y N FRGSII AI I: LULETS AND 0DSE11VA'r10N YI.Pr CI203S SECTION Approved Vent Cap Minimum 12" Above I ~lNp~ G~tppP Fin AI I A '-A 4" Cast Iron . Above Pipe ~ To Final Grades Vend Pipe Marsh Hay or Synthetic Covcri.119 Min. 2" Aygr.crj'.il I Over Pipe DistribuLion~ ._........_.I.~ Tee Pipe Aggregate Per•f.oraLad pipe. Beio' w ueneath Pipe __Coupling Terminating' r Qv~ . ` . Rol• tom. of • Sys tem. Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 t-abor;2nd Human Relations Division of Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY St. Croix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, b t not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or ^ PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION py"s'1~ REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATIO Thomas Seim GOVT. LOT 4j 1/4 SW 1/4,S 33 T 30 N,R 19 R(or) W PROPERTY OWNERS MAILING ADDRESS LOT JI; BLOCK # SUBD. NAME OR CSM # 529 Co. Rd. #E ~,q 11 na csm CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE MOWN NEAREST ROAD Hudson, WI. 54016 (715)549-6587 St. Joseph Co. Rd. #E New Construction Usef] Residential /Number of bedrooms 3 (j Addition to existing building ] Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate -.7 bed, gpd/ft2 .8 trench, gpolft2 Absorption area required 643 bed, ft2 563 trench, ft2 Maximum design loading rate _.7 bed, gpd/ft2 .8 trench, gpd/ft2 Recommended infiltration surface efeation(s) 98.29 ft (as refer ad to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system -QgNVENTIONAL MOUND IN-GROUND PRESSURE AT GRADE SYSTEM IN FILL HOLDING TANK U=Unsuitable fors stem n! ❑U ta S ❑U aS ❑U 30S ❑U ❑S ®U ❑S ,GU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure ConsistencelBoundsry Roots GPD/ft in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed rencft X.M. r % ti 1 0-9 10yr3/3 none 1 2msbk mfr gw 2f .5 .6 2 9-23 10yr4/4 none sil lfsbk mfr gw if .2 .3 Ground 3 23-32 7.5yr4/6 none is Osg ml 9w na .7 .8 elev. 4 32-86 7.5yr4/6 none co. s Osg ml na na .7 : .8 102.2 ft. Depth to limiting actor +86" Remarks: Boring # :w 1 0-10 10yr4/4 none 1 2msbk mfr gw 2f .5 .6 2 2 10-23 10yr4/4 none sil lfsbk mfr 9w if .2 .3 3 23-84 7.5yr4/6 none cos Osg ml na ' ...,7 .8 Ground 1015 Oft, Depth to 1, r limiting <<3 factor y yl~;. ti9 i Remarks: CST Name:-Please Print Phone: I 'k Gary L. Steel 715-246-62UD~ Address: 155 -2 0th. Ave., ew Richmond, WI. 54017 Signature: Date: CST Number: 12-13-94 cstm 02298 PROPERTY OWNER 'l'homas Seim SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL I.D. # Boring# Horizon Depth Dominant Color Mottles (Texture Structure Consistence Bouritry Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed !Trench 1 0-13 10 r4/3 none 1 2msbk mfr 2f .5 .6 2 13-29 10yr4/4 none sil lfsbk mfr gw if .5 .6 1 Ground 3 29-83 7.5yr4/6 none Co S Osg ml na na .7 .8 elev. 101.54ft. Depth to limiting factor +83" Remarks: Boring # 1 0-10 10 r3/3 none 1 2msbk mfr 2f .5 .6 4 2 10-31 10yr4/4 none sil lfsbk mfr gw if .2 .3 3 31-83 7.5yr4/6 none Co S Osg ml na na .7 .8 i Ground elev. 101.84ft. Depth to limiting factor +83" Remarks: Boring # 1 0-10 10yr3/3 none 1 2msbk mfr gw 2f .5 '.6 5 2 10-24 10yr4/4 none sil lfsbk mfr gw if .2 .3 3 24-82 7.5yr4/6 none Co S Osg ml na na .7 .8 Ground elev. 100,: 99.ft: DepOM to limiting factor +82" Remarks: Boring # Ground elev. j ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) STEEL'S SOIL SERVICE Gary L. Steel Thomas Seim 1554 200th e. CSTM2298 SE4SW4 S33-T30N-R19W New Richmond, WI 5-40 MPRSW 3254 town of ST. Joseph (715) 24 6200 4 1 of #4 I N 1"=40' BM.= top of NW lot stake at el. 100, 01 Q-5 F k, ids Gary L. Steel 12-13-94 STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County / OWNER/BUYER /ho~- ✓ /'Cc ®~~12~~" MAILING ADDRESS PROPERTY ADDRESS ' v Cal ► (location of septic ystem) Please obtain from the Planning Dept. CITY/STATE T 7"~Iro I PROPERTY LOCATION 5,E 1/4, 5 1/4, Section J-1 T_do_N-R_1.9_W TOWN OF ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER ` 6- CERTIFIED SURVEY MAP , VOLUME, PAGE ac,?d, L 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. 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, W1 54016 11/93 • v 1 i V V 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 ~T /nla 12 9!= /Ci/Y)/CL T Location of property 5E 1/4 aj 1/4, Section T 76 N-R / W Township Mailing address Address of site Q ~~{cl~yN L{/I 5`i'~I/6 Subdivision name Lot no. Other homes on property? Yes No Previous owner of property'nZna :,2 Z~/ Selm Total size of property Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)? Yes ✓ No Volume //'>/-,O 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. f-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 offi~ce] of the County Register of Deeds as Document No. - - - - - - - Rn- - Signature of pp icant Co Applicant Date of Signature Dat of Signature Mgr2 3 KATyCfEN 199S P 11 R istero1p ea SH Cron Co s v 1 WI ~ ? ov 529251 /y CERTIFIED SURVEY MAP Located in part of the NEa of the SWa of section 33, T30N, R19W, Town of St. Joseph, St. Croix County, Wisconsin. OWNER Tom Seim N 529 County Trunk "Ell C4 Hudson, Wi. 54016 a CE- 0 d T r• \ N I 7 ■ c rt MAY 2 5 'y5 LOT I < o - M CERTIFIED SURVEY MAR „ - - 3.1 CROIX COUNT,( VOL. 4, PG. 901 OT I :ornprehensive P annir °o a v CI. ED SURVEY MAP Zoning and ,,fir-c ~ Ir- I~ y rt \ - - - - - Parks Committee VOL. 4 , PG. 902 If not recorded _ within 30 days of approval data LEGEND I\ 11 -4oproval shall bo ALUMINUM COUNTY SECTION qua void MONUMENT FOUND 0 N I/4 CORNER • I IRON PIPE FOUND ,r v SECTION 33 0 1")( 2411 IRON PIPE SET, WEIGHING Ir.) ;0 I I 1.68 LBS. PER LINEAR FOOT. D I I ~ v b b M r x EXISTING FENCE LINE V (A /I /I 1001 RQADWAY SETBACK LINE M rn 0 N / w 0 2 C O ~ A Ile ~o Ifrl n irn Sir°2i5> , o Ir Ifn m ``CO to I n j z/ / O F 63813 _ - IC7 r /Ln 0 LOT 2 cn ~ ~ r IG~ I~ ; N p 3.12 ACRES z I< /0 T rTi m 135,934 S0. FT. y IN I-< ~Fs~• +r0 I0 ® `d w~e~ z+4' I S 7q °2 r un z 21581 0' LE C 9 h6 p9 0 12, a of ~~"1 ~ ✓ ~ 6 5~ 20 w I ~ m LOT 3 iU \v ~ `r3`- 3.37 ACRES G~~i JSOf~, J- ~~C1 O O, 146,718 S0. FT ~ /~i/ z WIS. 0 tl. pf ,NeNI~ K 1E~ n 33 o 3i~q All) / ° 3Lt R~ ybs3 < 3 10 V\, ~ - SI/4 CORNER SCALE IN FEET ® ( SECTION 33 N65037'< "W 100 50 0 100 200 300 70.51' 1 SHEET 1 of 2 SHEETS VOL. 10 PAGE 2922 a CERTIFIED SURVEY MAP Located in part of the NEa of the SWa of Section 33, T30N, R19W, Town of St. Joseph, St. Croix County, Wisconsin. OWNER Tom Seim 529 County Trunk E Hudson, Wi. 54016 CURVE DATA CURVE LOT RADIUS CENTRAL CHORD CHORD ARC TANGENT TANGENT NO, NO, LENGTH AM BEARING LENGTH LENGTH BEARING BEARING APPRO EO 1-2 3 80.00' 37008'15' 582038'27.5'W 50.95' 51.85' N78047'25'11 564004'20'W 2-3 3 80.00' 50017'58' S89013119-W 68.00' 70.23' 564004120-W N65037142-W MAY 2.3'$3 4-5 3 255.64' 41042'32' N44046'264 182.01' 186.10' N65037'42'11 N23055'10'W 6-7 3 167.00' 17029-24' X15010128-W 50.78' 50.98' N23055'10'W N06025'46'W 8-9 2 167.00' 57039'52' N22024'10'B 161.07' 168.07' N06025'464 N51014106'B ST. CROIX COIJN, (;omprehensive Plann.'a Zoning and Parks Committer if not recordacl within 30 days(-6f approval data approval shal!ib'-.3 TOWN OF ST. JOSEPH CERTIFICATE I hereby certify that this Certified Survey Map is approved by the St. Josh Town Board. Clerk Date {•i r SHEET 2 of 2 SHEETS VOL. 10 PAGE 2922