HomeMy WebLinkAbout030-2006-90-000
o ~ 3 0
M ti p ° O
° m
a 4 I ~
~ c ~ I
~ y I
0 3
o ~oCO
N Ana- C;
N - O
N a GO O O
X N
~V
'C E N L ~c
O .c0
CL 4)
a 21
O D
7 m
"ts
U f0 •C O
cc U)
O d E 0
y v I
rc
N C T c
N O 'O N
U y U
.D Z ~ a N 4j =O 1 'C 0 4 4
Z
C
C N~ U N L
7
O
IL C 0 C a r O LL
3 ° O E c y
-6 'O rL. U 0 ` C ~ 'O
Q ¢¢s rn°8 EEi Q
M I
3 a) K \
Z 4i H eV
z i.~ O O
a E p
Z `m d
~ z a m a m
Cl)
o
0
O Z a C v
j c w
c w w o
a~i 2 c Z c Z
U) P IM (D Q)
c
cl) co,
N O N
°
(V N C: m
O Q I
O N O w O Q Q .U
Z m z o 2 Z Z O
N Z Z
w
c _0
E
- N
r d N
cl GE)
00 ja N
m d- d N d~ ad. 'O'
v d H w c O N r O O O
O IC O O O G a _O N
cc D D o a Fy E E m
CL N o o
z
000 2 000
•rv 3aCL a oaaa N
a U) \
0 LO
N o vii v W y _
1~ to J C) 2 0) r }
-O N 'O
►v o 0 °I y o O1 O E
- E O =
° a m co c a
ca U) c -i o)
N O U N L
J ~ d Q } (n (0 ` ~ Q Z (n m
2 CL
H c E E
°O 3 If
co LO
=5 C c V d m 0
O p M FO- O O U a. CO,
nM I (O O Y y E c -O \ N
L C m t9 a N U r
W oO rn '-o O m c C-4 0
(D
W r
O N U r 'O N d' N C N O CO
C.' N O ) r N O C L CO n~ r L
.y O M_ 3 N r
O N O M U O"t O w U
• O M fn J Z c 2 U) V N O z c
r \ w ~ I
€ E
V # ~ a
'a d
CL
m
L CL
E` c c c o
A ciao oaci ovic°~
Parcel 030-2006-90-000 03/22/2005 05:09 PM
PAGE 1 OF 1
Alt. Parcel M 34.30.19.373E 030 - TOWN OF SAINT JOSEPH
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): * = Current Owner
* CORBETT, KENNETH C & CINDY L
KENNETH C & CINDY L CORBETT
663 PERCH LAKE RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 663 PERCH LAKE RD
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 3.200 Plat: N/A-NOT AVAILABLE
SEC 34 T30N R19W NW NE LOT 3 OF CSM Block/Condo Bldg:
3/617 i
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
34-30N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1101/45 WD
2004 SUMMARY Bill M Fair Market Value: Assessed with:
5724 211,100
Valuations: Last Changed: 07/09/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.200 95,000 112,700 207,700 NO
Totals for 2004:
General Property 3.200 95,000 112,700 207,700
Woodland 0.000 0 0
Totals for 2003:
General Property 3.200 45,800 104,100 149,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 313
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
I
989t,-986 (S LL) Xs3 r 089V-986 (S LL)
O LLL-9 LOBS IM `uospnH
jif=
peoH Iaepluaae0 LOLL Y d31N301N31NNH3AOJ AiNf100 xioH0 'ls
= rrrnrnrrr
IIaI330 ONIINOZ
NISNOOSIM -
AlNnoo XIOa3 '1S
• AS BUILT SANITARY SYSTEM REPORT 4"4
TOWNSHIP SEC. f T N9 ADDRESS N o , ST. CROIX COUNTY, WISCONS N.
)IVISION LOT LOT SIZE
PLAN VIEW
-Distances b dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
ff IH-
14'
I 'dicate or, Arro' I '
SC, L
QTIC TANK(S) MFGR.. ( I S e I-S CONCRETE STEEL
NO. of rings on.cover Depth DRY WELL
1.NCHES NO. of width length area
i no. of lines width length area
dept to top of pipe •
GREGATE ,~1~5.
tY. RATE_ AREA REQUIRED
12 q~~ AREA' AS BUILT "I
Stiaimer: The inspection of this system by St. Croix County does not imply complete
o-pliance with State Administrative Codes. There are other areas that it is not possible
inspect at this point of construction. St. Croix County assumes no liability for
Stem operation. However, if failure is noted the County will make every effort to
ermine cause of failure.
EASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
`INSPECTOR
DATED I - S PLU11BER ON JOB
LICENSE NUMBER
z i
REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
t 0, 4 1,
• 1 M San.itaxy Pexmit
• , State Septic
•
x
NAME rownship --4-~%). St. Cxoix County
Locatiola /c' Section
SEPTIC TANK • f
Size 000 gatton.s. Numbex o6 'Compaxtmentz
E
D"tance Fxom: Wett fit. 12%, on gxeatex Atope it
~ •
Bu.itd.ing6t.Wettand.6
H.ig hwaten- t . ,
DISPOSAL SYSTEM
Diatance Fnom: Wett (9 it. 12% on gxeatex .6tope 6t.
Bu.itd.ing it. Wettand.a Ft.
Highwatex it.
FIELD DIMENSIONS:
Width o6 txench oZ it. Depth o j xo chi b etow tite/ff in.
Length o6 each tine it. Depth o6 xock oven t.ite ~ in.
Number o6 tines Depth o6 t.ite below gxade 2(in.
Totat length o6 tinis;,Ar)_6t. Stope o6 txench Z .in pen 100 it.
~r 7 Di.6tance between tine.6 it. Depth to bedxock it.
/ Totat absoxbt.ion axea/ _6t2 Depth to gxoundwatex 6t.
Requ.ixed axeaG 6t2 Type o6 Coven: ape ox Stxaw
PIT DIMENSIONS:
Numbex o6 pits Gxavet axound p.it,6yeb no
Outside d.iamet x Depth below .inlet it.
2
Totat absoxb o at a it
A
Axea equixed 6t2 rn
INSPECTED B ITL1
APPROVED DATE / 197 f
-
REJECTED V DATE 197.
I
EH 1.15
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH
P.O. BOX 309
MADISON, WISCONSIN 53701
REPORT ON SOIL BORINGS AND PERCOLATION TESTS /
LOCATION: Section'-~, T31, Ra If (or Township or Municipality ST( 'Tcs L014
Lot No. 3 Block No. County
Subdivision Name
Owner's Name: TO /1X( ~d
Mailing Address ~/P+ r;>~<S 7
TYPE OF OCCUPANCY: Residence No. of Bedrooms Other
EFFLUENT DISPOSAL SYSTEM: NEW X -ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS
SOIL MAP SHEET 7 Z SOIL TYPE S~ Z-
PERCOLATION TESTS
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
P-/ 31~e 141o
P 2- d SP 2 Aor A 3 2, //o 30 SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES
NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
B_~ 7,96 TS/ K4i 8,2- L~Or~~isc f
B_ _3 few "7 ?e"
si oz y~,c, f6~s~. CC'o,~`.a~
B- S 196' A~~ yam ~~,~~t sL ~cv•..
~D ~6 - /aCc9TtiZ~ Z ?C7/ `f 7« f ~Q`` S~ CO~.~ e
PLAN VIEW (Locate perco lat ion tests,so i I bore holes and suitable soil areas.)
Indicate on the plan the location and square feet of suitable areas. Indicate.numper of square feet of absorption area
needed for building type and occupancy. S116"' s4 e rt Indicat,scale
or distances. Give horizontal and vertical reference oints. Indicate slope. _<,v tf°~
Q C r`S .~.u ds`C L
i
c9 ^ _
S
IE6
/B y
Q✓ SC?
4 ~N
o
99-0 S o u / i
I NIE
Li 11,
o o f uu f//N C Y '
rC fC p d Y h S }~e V c° L~ C'
IS-q
I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures
and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct
to the best of my knowledge and belief.
Name (print) /1vr frs~~c/ Certification No.~'l9
Address ZQurt- L/' SO!! c S l
Name of installer if known '
f
COPY A -LOCAL AUTHORITY CST Signature
State and County State Permit #
PLS'67 Permit Application County Per i#
,040~ - . * for Private Domestic Sewage Systems County
*DENOTES STATE APPR(jOAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
J aye Off' ~ ~ /~~Ct~ ~c 17s~/C,~~~ ~ Gt/rrS S4~o ~ ~
B. LOCATION: AlaJ '/4 Section T-jo N, R E (or) Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township
C. TYPE OF OCCUPANCY: Commercial *Industrial *Other (specify) *Variance
Single family _ X Duplex No. of Bedrooms No. of Persons
D. SEPTIC TANK CAPACITY % QnO Total gallons No. of tanks
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete Poured-in-Place Steel Fiberglass Other (specify)
New Installation X Replacement
Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify)
E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate Total Absorb Area sq. ft. 'NA New Alternate (Specify)
Seepage Trench: No. of Linea Ft. Width De th Tile depth (top) No. of Trenches
Seepage Bed: Length Ski ' Width. 2 54 depth (top)--Z~No. of Lines!
Seepage Pit: Inside dial eter Liquid Depth No. of Seepage Pits
Percent slope of land 2? % Seu'1-A wf`,v- Distance from critical slope
WATER SUPPLY: Private 12~k Joint ❑ Community ❑ Municipal ❑
Owners name as listed on EH 115 if other than present owner:
I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared
by the Certified Soil Tester, pp
NAME fl E IV Vl) i S (fH9 / 1;7-04~jAif,Sel& C.S.T. # :SS - `57 7 and other information
obtained from -z- N o l.t? (owner/builder .
Plumber's Signature 44 - MP/MPRSW# ~1 1 Phone #3~6 Plumber's Address n 0 i
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca-
tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors
property. If well has not been drilled please indicate.
. 1
lQT ~~(k' Noy` 5C AC, E
qD
CIA I`p _ g
;4X153
Li Nz✓~r C°
~•d ce
,
} 1 u5 00T 'I'o Sc qhC w ) .m.,
+co
•
I ~
. w
qQ
00
Do Not Write in Space Below - FOR COUNTY AND STATE DEPARTMENT USE ONLY
.;Z 7 Fees Paid: State /0. 00 County - 41-1-' Date
Date of Application 611-Z111*
Permit Issued/ cte (date) Issuing Agent Name r` t-e•-
N0 State Valid* Date Recd
Inspection Yes _
J
t county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (pink copy) 4. plumber (canary copy) Revised Date 7/1/78
8
p ~5 C [I l~l
m FILED
JUN
22 1978 G
~
y
~OHKac R•. ~ _ '
84 D**do P.
3496 sc~jr' ;r--~
-ro 's
0 •
n I z
O O m O BEARINGS AR•E REFERENCED TO THE
C c x c f C.S.M. VOL. N-S 1/4 LINE OF SEC. 34 , WHICH IS
Z z ~N z ITI- RECORDED IN C.S.M. VOL. PG.
v v z v 0 PG. _ AS N 01°-00'-00" W
zD - o- - Z z
-o p N 010-00'-00" W 445.45' N-S 1/4 LINE
z W °D Z
D r 412. 45'
co ;o a) -0 v o
I
0 U) m m N I W 0
brow ~
<n m z .0 O =
4r1 ~
z D -n N M W f 1 r
(n T ()D 0
4 ° r o -I I
O W W v D• mI m
z v , z ;D
z N p m AI A
U) tD to 'I
L" o
'CD r Dv
cn m
m Z W O I W I: V
OD r
m
-n W
Am m co 1 o I z~
co 412.45' I I Z
{ N 01°-00'-00" W 445.45
P
1
O m FUTU kE 66' ROA_DWA_Y_ _EASEMENT Obi Z T
I OD
- -N 0I0-00'-00" W 445.45 0o I rn Frl
87.57' l '
c - 412.45` i N .r
To .4
.zz - 533.02' - - - - - ? ~fi' I Z
r ~ o - 1 A .W ~
-DI . N p, W I N cr
m RI
r O ;u
-11
c co W.
m
W D I rcn
w APPROVED m co
° m N N; OD
0 d cn I -I
co IS MINOR SUBDMSIOM I _
co ~U_N 2 21978 ~pR0l7At Of M N APPROVAL FflR -i W 1 p
°
GOES NO 5Y5TF1d. o_ 2
'r N 1
D ROIX GUV G LDING 51Ti OR SEPTIC
ST• C Plh BU1 EFE I
z ' PARKS
MM Il'~. R TO H62 •Q D
~ • v a
GoN► PREH ZONING
co
• cn co
WKD S 010-29'-06" E 533.00' I
500.00 z
m
i
m
to w
N 0 I (►I
r
w I
c r o° z
4 g o o _ I m
z o
I
0
Q
D N I o
0 ;v
(pi
500.00' - - - - - 1 I
w~ .`126.94' - 373.06'----
4 S 010-29'-06" E 533.00' 3
• SMALL TRACTS
71
vOL., 3 rE 617
CERTIFIED SURVEY MAPS rn - n
m
~V
ST. CROIX COUNTY, WI.
STC - 104 1
AS BUILT SANITARY SYSTEM REPORT
OWNER Kew e C'IN Coto-Ir 1~
ADDRESS 603 ?-,Rc-h .p Q q p
SUBDIVISION / CSM# LOT #
SECTION 34 T30 N-R_1! _W, Town of St- ~0S1p
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
3 Bev avUr,
Non.+c
33
o wo
gp~ SeP'h~
(R3l
0 800 Sal
PMT PtChp*nuKR
MvNw~
Q30
N
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
i
C' ~~Yh
BENCHMARK: 0 6 V E'tv flee ON <t-X )&)Ijq
ALTERNATE BM: l
WS2iD 0 I
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer:
We S Liquid Capacity: 00
Setback from: WellvV S701
e House Sc " • Other
Pump: Manufacturer Mode I#
53 Size
_-->)Float seperation
Gallons/cycle: a3 • 5-
Alarm Location
I N O 4 -t
m0uWfl
:SOIL ABSORPTION SYSTEM
Width: a 3 Length (p R ► roc
Number offs
1
Distance & Direction to nearest prop. line:
Setback from: well: Pq) OS'
House_ Other
ELEVATIONS
Building Sewer Q
ST Inlet; ~ ST outlet 913Q~
PC inlet 33.99 PC bottom 89. g$
Pump Off IL43
Header/Manifold ROCK
9` p Bottom of aqumiwm 9S, 3)
Existing Grade
Final grade
DATE OF INSTALLATION:
PLUMBER ON JOB:
LICENSE NUMBER:
3 UY
INSPECTOR:
3/93:jt
Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County:
Labor and Human Relations INSPECTION REPORT ST. CROIX
• Safety and Buildings Division
(ATTACH TO PERMIT) Sanitary Permit No.:
GENERAL INFORMATION
PeLFioQ[S;arr1gEN & CINDY E] City El Village R Town of: State Plan o.:
CST BM Elev.: ' Insp. BM Elev.: BM Description: 7C Parcel Tax No.:
ash
TANK INFORMATION ELEVATION DATA c _ 0 P-+JCs>~s
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic S .yn Benchmark
Dosing G~~!~=x.S .~G j ~GJ qa✓: 4
Aeratio71- Bldg. Sewer
Holdin St/ Ht Inlet 0 ,
TANK SETBACK INFORMATION St/ Ht Outlet
TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic NA Dt Bottom L
Dosing NA EILMan.
Aeration Dist. Pipe
Holdin Bot. System 'Sl 4--/
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand ol~r br g
~ a V'-_
Model Number -1,' 53 GPM
TDH Lift+(ya" I Lrictiono (q7 System TDH .31 IFt
Forcemain Length Dia. Fa " Dist. To Well >/c'-b
SOIL ABSORPTION SYSTEM
BED/TRENCH Width , Length / No. Of Trenches PIT No. Of Pits Inside Liclui th
DIMEN I N 5 s DIMEN I N
LEAC Manufacturer:
SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM
INFORMATION Type Of .I( µ CHA BER model Number:
System: M --SO C P~ /SU OR UNIT
DISTRIBUTION SYSTEM
FW*x+@r 7 Manifold ~/j ~1 Distribution Pipe(s) x Hole Size' x Hole Spacing Vent To Air Intake
Length Dia- Length ~7a Dia.Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched
Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: St. Joseph.34.30.19W, NW, NE, Lot 3, Perch Lake
Plan revision required? ❑ Yes Ej- o /
Use other side for additional information. Ile s
SBD-6710 (R 05/91) Date Inspector's Signature Cert- No.
•a~ =Safety and Buildings Division
SANITARY PERMIT APPLICATION Bureau of Building Water System!
201 E. Washington Ave.
In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969
Madison, WI 53707-7969
• Attach complete plans (to the county copy only) for the system, on paper not less County
than 8 1/2 x 11 inches in size
See reverse side for instructions for completing this application State Sanitary Permit Number
a~9 74/ n r rams t application
The information you provide may be used by other government age cy p og ❑ Check it revision to prey ous app
IPrIvacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number
1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION
Pro erty Owner Na Property Location
/4 1/4, S 3!1 T 34 , N, R f ~f E (ort
Pro fie Owne ' ding A d ess r Lot Number Block Number
MCity, tae Zip Coe Phone Number Subdivision Name or CSM Number
II. TYPE F BUILDING: (check one) ❑ State Owned E] ity Nearest Road
p Village
Public J~k 1 or 2 Family Dwelling - No. of bedrooms Town OF
111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) LJj p
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. ❑ New 2. VReplacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
System '_NSystemTank 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 RMound 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy
13 ❑ Seepage Pit 43 ❑ Vault Privy
14 ❑ System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1.*Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate S. Perc. Rate 6. System Elev. 7. Final Grade
Re fired q. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./* ch) Elevation
J V 9b11 t S - Feet Feet TANK Ca aclt
VII• INFORMATION in gallons Total # of 's Name Prefab. Site Fiber- Plastic Exper.
New Existing Gallons Tanks Manufacturer concrete Steel
struCon- cted glass App.
Tanks Tanks a
Septic Tank or Holding Tank ' Q MA 0 /1 ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber boo Q ❑ ❑ ❑ ❑ ❑
Vill. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plum s N~Print) Plumber's Signat : No Stamp) MP/MPRSW No.: Business Phone Number:
ia, oLi TZIS -38 -2646
Plumber's Address (St eet, City, State, Zip Code) • `Q~
~L
- z A -1
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Sant ry Permit Fee (Includes Groundwater ate Issued Issuing Age Si nature( tam
AA/P'Proved E] Owner Given Initial Surcharge Fee)
Adverse Determination
X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL:
SOD-6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber
7
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit fray 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:
I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the
system is to be installed.
II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling.
III. Building use. If building type is public, check all appropriate boxes that apply.
IV. Type of permit- Check only one on line A. Complete line El 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 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 purrs 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.
Xl
SAFETY & BUILDINGS DIVISION
201 E. Washington Avenue
P.O. Box 7969
Madison, Wisconsin 53707
State of Wisconsin
Department of Industry, Labor and Human Relations
I
i
September 29, 1995 1340 East Green Bay Street
SUITE 300
Shawano WI 54166
HOUNEE STII2 & SONS EXCAVATING
JIM BOUME S'IER
1070 HWY 35
HUDSON WI 54016
I'
RE: PLAN S95-31281 FEE RECEIVED: 180.00
CORBETT, KENNETH
NW,NE,34,30,19E
70M OF ST JOSEPH COUNTY OF ST CROIX
MOUND SYSTEM
The Department has reviewed the above-referenced submittal.
i
Conditional approval is hereby granted for the system plan submittal. All
noted items must be corrected. The review and approval of the system is based
on chapter 145, Wisconsin Statutes, and chapters ILHR 83 and 84, Wisconsin
Administrative Code, and is contingent upon compliance with any stipulations
shown on the plans. This system has not been reviewed for the code
requirements set forth in chapter ILHR 82 or in chapters ILHR 50-64, Wisconsin
Administrative Code.
This plan submittal approval will expire two years from the approval date, or
if a sanitary permit is obtained, plan approval will expire on the day the
initial sanitary permit expires. The licensed plumber responsible for this
installation shall keep one set of plans with the Department's stamp of
approval at the construction site. The installer shall notify the appropriate
inspector when inspections can be made.
All permits required by the city, village, township or county shall be
obtained prior to installation.
Inquiries should be directed to me at the number-listed below. Please refer
to the plan number shown above.
Sincerely,
Ross J. Fugill
Wastewater Specialist
(715) 524 7:45am - 4:30pm
SJUDA-MAU (R. 1044) k84 -
KEN & CINDY CORBETT
3 BEDROOM RESIDENTIAL MOUND DESIGN
PLAN ID# 895-31281
REVIEW DATE: SEPTEMBER 29, 1995
PROPERTY LOCATION: PROPERTY OWNER:
NW1/4 NE1/4, SEC. 34, Ken & Cindy Corbett
T.30N., R.19W., Tn of 663 Perch Lake Rd.
St. Joseph, St. Croix Hudson, WI.
County, WI. 54016
INDEX TABLE
cz"~ w PAGE 1 OF 9 TITLE SHEET
i- o U PAGE 2 OF 9 WORKSHEET
~Je C3 W PAGE 3 OF 9 WORK SHEET PG. 2
'w Q p ` PAGE 4 OF 9 PLOT PLAN
w ac 2X PAGE 5 OF 9 MOUND CROSS SECTION
° ~ PAGE 6 OF 9 DISTRIBUTION PIPE DETAIL
0
w u) PAGE 7 OF 9 PUMP CHAMBER CROSS SECTION
Q ~ PAGE 8 OF 9 PUMP SPECIFICATIONS
PPAGE 9 OF 9 ATTACHED SOIL EVALUATION
o r~
> ? w y
U. to w
PREPARED BY:
w
Jim Boumeester
c 1070 Hwy. 35 N.
Hudson, WI. 54016
(715) 386-9020
SIGNATURE: MPRS 3404
DATE : f a S 1
5_ 31,81
S
r
r67 Zap
WORKSHEET
ABSORPTION AREA SIZING
1. Daily wastewater load 450 Gpd
(3 bdrm)(150 gal/bdrm)
2. Depth to limiting factor 38"
3. Land slope 4%
4. Infiltrative capacity
of soil at system elev. 1.2 gpd/sq.ft. ASTM C33 med. sand
area required 375 sg.ft.
bed length (B) 75'
bed width (A) 5'
MOUND DESIGN
1. Mound Height: 2. Mound dimensions:
fill depth (D) 1.0' end slope (K) 10.5
(1+1.2)/2 +.75+1.53 = 10.05'
downslope fill depth (E) 1.2 total length (L) 96'
1.0 + (.04% X 51) (75) + (2 X 10.5) = 96'
I
aggregate depth (F) 0.75' downslope width (I) 10.5'
(1.2+.75+1)(3)(1.14) = 10.09'
cap and topsoil depth(G) 1.0' upslope width (J) 7.5'
(1.+.75+1)(3)(.89) = 7.34'
cap and topsoil depth(H) 1.5' total width (W) 23.0'
10.5 + 5'+ 7.5' = 23.0'
3. Basal Area:
Basal area required 900 sq. ft.
450 gal./0.5gal./sq.ft./day per CSTM = 900
Basal area provided 1125 sq. ft.
(751)(51+101) = 1125
Linear loading rate 6.0 gal./linear foot
450 gal./75' = 6.0
it
S95-31%81
PRESSURE DISTRIBUTION NETWORK
1. Distribution pipe sizing:
Lateral length 35'
Lateral size 1 h"
Lateral spacing NA
Sidewall separation 30"
Hole size 11
Hole spacing 56"
Holes per lateral 8
Dist. network discharge rate: 18.72 gal./minute
(2 laterals)(8 holes/lateral)(1.17gal/hole)
2. Manifold sizing:
Location Center
Length NA
Diameter NA
3. Force Main:
Diameter 2"
Length 30'
Flow rate 18.72 gal./min.
Friction loss .186
(301)(.68ft./100ft.) _ .186ft.
4. Total dynamic head:
Min. supply pressure 2.50'
Verticle lift 6.0'
friction loss 0.168'
Total dynamic head = 8.67'
5. Pump selection:
Manufacturer Zoeller
Model number 53
Discharge rate /8.7,Z goPlm%n, a t 8.67'
6. Dose chamber:
Manufacturer & capacity Weeks 800 gal. concrete
liquid depth 42" @ 19gal./inch
Sizing:
A) One day holding capacity 16" = 304.0 gal.
B) Alarm setting 2" = 38.0 gal.
C) Dose volume + flow back 6.5" = 123.5 gal.
112.5 gal. + (.164 X 301) = 117.42 gal.
D) Reserve storage 17.5" = 332.5 gal.
TOTAL 42" = 798 gal.
595-31281
.3G
Own fir: Coca-~ 6")
~';•~d'y C'or6Q Lob 3 CSol do- 3 6/7
CoG 3 %oer-c.~', Sce. 3~ -r- 30n.,
Ao. T. ov' st. .Tose/~- ~
N Sea:~e : / ` 410
~4~a ye
♦ c ze r/ 'o,~ - - - - -
EX: s~i~ui
3 3cdre~m
dwel~4F"~
Lda-K 14 L4=cenakt ~).rr(. -.Ala.;6
-Eop aFGl.~„,(y'rt-Lc¢ elCG~nawt
door. ELe t • io3. o(c,'
T-'0 6e r"eu5ed or rr~0~4re d w„6-4 °
eL¢
qat meek Code. J- ctn.~o oC
ST, ou*Ltk c 99.40
✓Q rr E ~o:~vQ . ECet = /~d ProPaaee~ ff Cl~ ~9,
~Jum~O C.~am/pLr
-e-d be Q6a" Co"e d c" S 30' l-r Z.",54a, Flo , i
PRIVATE SEWAGE SYSTEM 6-i
Iffonaliliona[[ty
Ar"'PROVED
DEPARTMENT OF INDUSTRY, LABOR AND HUMAN RELATIONS 595-
DIVISION OF SAFETY BUILDINGS
SEE L RRESP0N0ENCE
02~/. 36
r
Page S Of-l-
Cross Section Of A Mound Using A Trench For The Absorption Area
Medium Sand Fill J1 ° F 6" Topsoil
3 E D
Trench Of 23-,* Aggregate, Plowed Laver
6" BelpAIJAM SEWA IEWNSTEM D 0 Ft.
Straw, Mars Hay Pr Synt is Fabric
ondifionc E Z Ft. G Ft.
F 0.75 Ft. H S Ft.
APPROOVED
DEPARTMENT OF INDUSTRY. LABOR AND HUMAN REtATIONS
DIVISION OF SAFETY AND ETU LWNGS
u
A Trench For The Absorption Area
Force Main
Distribution Pipe
Permanent Markers Observation Pipe
i
A,, 0
W I B I K
\ Trench Of li" - 2z" Aggregate
I
L
A 6.0 Ft. I /,0, s- Ft. K /p.5 Ft. W .03.0 Ft.
B 75.0 Ft. J L Ft. L 9G.0 Ft.
Page G Of_y_
Distribution Pipe Detail For Two Lateral Network
Holes Located On Bottom
Are Equally Spaced PVC Force Main End Ca
=i~
~
*
-T X X PVC Distribution Pipe
P P
X
* Last Hole Should Be Next To End Cap
P 37.5 Ft. Hole Diameter Inch
X s749 Inches Lateral Diameter Inch(es)
Y SG Inches Force Main Diameter a Inches
# Of Holes/Pipe 8
Invert Elevation Of Laterals 96.6- Ft.
PRIVATE SEWAGE SYSTEM
CIO italilio na fly
oulk
fft-
DEPARTMENT OF INDUSTRY. LABOR AND HUMAN RELAT'ONS
D1ViSION OF SAFETY A, BUILDINGS
L-
SEE 1.0 RESPONDENCE
sg~-31,81
PAGE Z CF
• PUMP CHAMBER CROSS SECTIOU AIJG SPECIFICATIOkJS
VENT CAP
`i"C.I. VE:\.IT PIPE
WEATHERPROOF APPROVED LOCKINIG
JUNCTION BOX MANHOLE COVER
> 25' FROM DOOR,
WINDOW OR FRESH 12 MIU.
AIR IAITAKE
GRADE
I `1" MIIJ.
I ~ I B" /'KI IJ.
PRIVAl-E SEV4f GRU I±
18"MIM. nditionally
iitona
IULET 1 ( Al
4i EA.L I I i I f
l w ~4 I 1 /
DERARTMENT OF INDUSTRY. LAEOR AND HIJklAN RELATIONS I I I ~
* I DIVISION AF SAFE fY AND B 'LDINGS I 111
I I I ALARM
I II
SEE CORRESPONDENCE
C *APPROVED I oN _
JOINTS WITH I
CLEV. FT. APPROVED PIPE
3' ONTO PUMP OFF
D SOLID SOIL
CONCRETE DLOCK
RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL
SEPTIC E SPECIFICATIOUS
oosE
TANKS MANUFACTURER: WEEKS CONCREI;E IJLIMBER OF DOSES: 4 PER DAB
TANK SIZE BUD GALLONS DOSE VOLUME
ALARM MANUFACTURER: S.J. Electro systems INCLUDING BACKFLOW: 123.5 GAUOnIs
MODEL NUMBER: 101 HW CAPACITIES: A= 16 INCHES OR 304.OGALLOUS
SWITCH TYPE: ----Ll,ry B= 2 INCHES OR 38- OGALLO►JS
PUMP MANUFACTURER: Zoeller C= 6. 5 IkJCI,4ES OR 123. GALLOWS
MODEL NUMBER: 53 D- 17 • 5 INCHES OR 332. SGALL0IJS
SWITCH TYPE: mer-Gury NOTE: PUMP AMD ALARM ARE TO DE
MINIMUM DISCHARGE RATE 12 ;12 GPM INSTALLED OW 5EPARATE CIRCUITS
VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. 6_0 FEET
+ MINIMUM NETWORK, SUPPLY PRESSURE • , 2 5 . . . FEET
11
5_ 31~
30 FEET OF FORCE MAIM X ~_F/ooFLFRIC71ou FACTOR.. 168FE9
= TOTAL Dy1JAMIG HEAD FEET
INTERNAL DIMEWSIONG OF TANK: LEUGTH ;WIDTH ;LIQUID DEPTH 42"
19 GAL./inch
51GUE D: LICENSE NUMBER: DATE:
lJy 0 0 Ir 7
I
HEADICAPACIW CURVE
EFFLUENT 8c DEWATERING TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE
1, , I slss 'I
SERIES 5759 98 1371139 161/4161 16314163 16514165 16514185 1864166 18814188 18914169
3+ _
',t0 - PT_ kL. GAL LTH GAL LTR' GAL LTR CAL LTR GAL 'LTR GAL 'LTR GAL.LTR'. GAL LTR GAL'LTR GAL ITR
J7 ,05 5 1,52 q .163 72 273 93 352 106__ 401. 61 231 61 231 58 220 1ss 587 154 587
10 3.05 34 .129., 61 ;231 79 '299 100 ]78 61 231 61 231 56 229 148 640 151 372
100
15 4.67 19 72 45 1T0 64 242 91 344 60 227:: 60 Z27 58 220.. 142 537.. 145 6N
95 20 6.10 25 95 36 136 82 310 59 223. 60 227 58 136 1 140
26 25 7.152 8 30 74- 280 57 218. 59 223 56 220 128 484. 133 503
90 30 9.14 65 246 55 206 58 '220 90 340 58 22D- 121 12T
481
26 BS 40 12.19 46 174.. 46 112 55 206 75 283 58 2201 105 197: 114 431
SO 1524 21 80 33 125 51 191 58 219 58 220 % 341' 100 ' 379
1+ B0 60 18.29 15 57 43 161. 36 136 58 220' 71 2e9'' 85 322
75 70 21.34 30 114 10 38 52 197' s1 19Y 70
22 186. _ 2"
7D .I6fi 80 21.36 14 5] l5 170 26 106 S4 204
s 90 27.43 32 121 2 8 37 140
u 2p 65. 100 J0.48 -
i 65 416 I 1s 68 21 79
110 3240 7 16 8 30
B 60
Lock Valve: 1925' 23' 26' S6' 66' 8T 7J' 115' 91' 117
< 55 163,
t6 - 416 WARNING: Model 185/4185 should not be subjected to
50 less than 30 feet TDH.
14 :5 NOTE: For Head Capacity on Model 112, Industrial
2 40 column-explosion proof pump, see FM0219.
fi5,4 t 85
SS
i9
JO - ! t
169,4189
8 ; 15 -
6 ~0
61,4161
/ IS
8 tft77 166.4,66
,o
5
42 4 57 55 tJ7,139
U 57.59
U.5 Cx~OM9 ,0 7 JO O 50 60 70 W 90 ,00 ,10 ,20 ]O 140 50 160 S 9 5 - 3 1 ~IJ~
U7CR5 60 T60 24D ]20' 400 '4L0 560
0 FLOW PER UnUIL
.315 c,P.FK.'
W SEWAGE & DEWATERING TOTAL DYNAMIC HEADICAPACITY PER MINUTE
a
22 SERIES 262 266 267 268 28L4282 28414284 292/4292 29314293 29414294 295/4295
70 - _.._y FT, M: Gal. LM Gal. L" Gal. LOS Gal. Lt17: Gal. Ltro Gal. Ltr4. Gal.ltrs.' Gal. ltrs. Gal. Ltrs Gal. Lps.
20 ! s 1.52 90 311 128 !8/. 128 484 124 ta4 170 492 180 681: 133 503 196.7!2 225 852
- 10 3.06 60 227 89 337 69 317 89 377 95 360 1 15s 6% 116 43! 161 686 205 776
IB D _
- --1-- 15 4.E7 22.5 86 50 189 50 189 50 189 63 238 ; 135 611 100 378 130 492 165 815 185 700
55 - - - - - + - 20 6.10 10 ld 10 38 10 36 l3 125 :106 401 87 322 119 X58 150 568 168 6)B
,4 5p . _ - _ - I i._ I- 30 9:14 - 76 281 66 1 106 4W 126 615 153 680
,a ° s I }
4J 163 46 174 90 340 121 466 170 530
40 1419 26 % 50 189 9• J56 115 735
i 12 - 50 15.24
Se 220 89 337
1, Js- - __I _ 60 1629 1J 19 59 22J
t0 - 70 21,34
25 95
6 195,4295 Lock Valve: 18' 21.5' 21.5' 21.5' 26' 35' ]9' S0' 62' 77'
25 ~ f
_ -
WARNING: Model 293/4293 should not be subjected to
less than
6 - - e4.4z64 15 feet TDH
4-.p 261.4282 - . _
j
1 i ~ I 191,4797
1 162 1256.767.68 2.. I95295I- -_t-^.-
I I
19°.4 9<
5 ~ I f2 .;5 e°OS
5 Lw.tD 5 ~ D 2D 30 <Di 5p 60 lC 60! 9p tD01 t2C 130 .ate Its 60 7D0 7t _
CI S C }
~ 710 230 7<D 750 14. J1,1 15( 74'. S t D ] t':D 65 SAD 39. c'.
-Y _
60 240 J20 rt____+__ 1
°60 560 54C 720 800 ISBD 2
400 960 ~DaO 2... ..--~7D0 '78r '36C t44C 'S?.'
Sr Sc
Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page / of 3
Labor and Human Relations
Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUN 1
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or P .D. #p~
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION EI)ttP Z 7 1 AT ~14D A,
PRO74 TY OW ER: PROPERTY LOCATION CU,
A/ I _j1_
G U GOVT. LOT 1/4 Alf 1 T t "G~ -42
'Al LPROPZI NE S GAD SS LBLOC SUB E
S TE P CODE PHONENUMBER CITY ❑VIL G OWN N
CIA S ~ O/L /5r W >o t°/YG a~2
New Construction Used Residential I Number of bedrooms 3 [ ] Addition to existing building
Replacement 9L [ ] Public or commercial describe
Code derived daily flow. T :p gpd Recommended design loading rate 5bed, gpd/ft2 L trench, gpd/ft2
Absorption area required YO bed, ft2 7fJ trench, ft2 Maximum design loading rate , S bed, gpd/ft2 trench, gpd/ft2
Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark)
Additional design / site consi erations
/V ;4
It
Parent material s, /f 241 5 C ,ti Sy.~ Flood plain elevation, if applicable
S = Suitable for system CONY IIOONAL MOUND IN-GROUND PRESSURE AT-GRA E SYSTEM IN RLL HOLDING TANK
U = Unsuitable for system ❑ S 0 "S ❑ U 11 S tau El S U ❑ S ~u ❑ S tl
SOIL DESCRIPTION REPORT
Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Bouindiry Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Treridi
-77 2- -o
F ~13 co
Ground 3 5 tZ y / /1 r~ 4/ 6 H'I c (,j - •S
?T,~G f y r`- ` 5-ye N s /l~`i S` ,terS6~ M✓r. C Nl S
Depth to S p~ Sya y s + l ~ >o a 5/,
limiting
f L
Remarks:
Boring #
_S G
/0 y/1
lit 7/,7 5 7
p,~r
ft. Sbk jmv C w - e/ S
Ground
ele 51R `1 Nan, S lam, sh N~✓ C v
5 b`+- c y 5 I d lo yfe~ p S~ N'1a r 3 y
Depth to
limiting
f oli
Remarks:
CST Name:-PI Pr'nt Phone: 01 F
ddress: fl " L-Q
Signature: ~ a..' Date: 6 ~ CST Number,
_X,* t1 kPI) V4Z
PROPERTY OWNER SOIL DESCRIPTION REPORT Page _of-
PARCEL I.D. #
Depth Dominant Color Mottles Texture Structure Consistence Bouxivy Roots GPDift
Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tench
t., _ Z L Dec. S,' A** H7v TAJ
S
,01
Ground 3 33 4v / /D /Z R s5
Depth to
limiting
fact , ,
Remarks:
Boring #
LMA
l
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
tt< ?'u
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(8.05/92)
s
l6 ~
v
i
sys v P~ =~~a•4 f
r
83
Z
37
7n'
13
i
i
~ 8
•
F IL 0
ED
JUN 22 1978 ~ft
Alin o
RONbl / CONkELL
°1D ..d
SR ~ c; C+nnly i 0 •
349611
-1 -n 0 0 o z
c Z mx c BEARINGS ARE REFERENCED TO THE
Z z f C.S.M. VOL. 3 N-S 1/4 LINE OF SEC. 34 , WHICH IS
v v 2~ v m RECORDED IN C.S.M. VOL. PG.
PG. AS N 010-00'-00" W
z - z - m 7-63.2-
. z
D = C) , z
r m -p Q /
rnz O N 010-00'-00" W 445.45 N-S I/4 LINE
Z co co z
D r- 4j2.45'
co ;o co °
p to m - , 1 z
m
1 N~ I w O
x r r cn bt° w ;o
N m Z~ d O =
1 O O
N z D m w r I r 74 w v OD B O O i z
I
A ° r O m
I
c 00 w o D. --i l m
m J . Z n _
> -i to p. p m ? 1 A
cn (0 X N I
C7 p O I
r
i cn m
v I I :c
c D O z
z o
w 0 i w .
m O I w r
-1 T1 N
"m m CD
I I Z ~
v m
~ a I I :m ~
- 412.45' 1
co
N 010-00'-00" W 445.45'
I
O rn FUTURE- 66' ROADWAY EASEMENT i z ' -
I OD I z
N 010-00'-00" W 445.45 00 I m r
c 87. 57' - - 412.45' - - i N r
.z - 533.02 - - - - - - t ~i~ ;D •z C
r Co
° I A i
~
N o , W AA
I . (n
~9. m W r 16 m m C
o x O O o I nC
N ED o D I Oml -
001
<
Ar?p ~ N N w
N a N ~I 0N1
1918 w AS -4 co APp\ ,~N 2 2 ~PROVAL OF TH►S MINOP SOVAL low -1 W I O
BOSS NOT MEAN _
I °-I Z <
D co g1, CROIX Cud O ILDtNG SjT OR SEPTIC SY T J -
1 I 1
I
uvi w Co ASD ZONAo COMMA h' $EFER 70 H62.20•
S 010-29'-06" E 533.00' m
500.00 t z
m
UI x I W
N C7 W
A r I p ~
o z
m v o 0 m
Z0 N I p
r ~ . ~`;s ONl X ~ w I z
CD o
'00 1
,.Y ID I w v
•"t 1.1 J Kr,~,J O V
'o 0
✓ .y \
.....~1~a' _ 500.00'
.,126.94 373.06'
S 010-29'-06" E 533.00'
SMALL TRACTS
v,
VOL. 3 arjE 617 <
CERTIFIED SURVEY MAPS ?
.ST. CROIX COUNTYo WI. m
0
- II
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF AN EXISTING SEPTIC TANK
This is to certify that I have inspected the septic tank presently
serving the ~QN C, NPR CyIt'l residence located at:
N Nom' Section T30 N, R 1Q 1 W, Town of
5t - SaStp}~ Upon inspection, I certify that I have found
the tank and baffles to be in good condition, and it appears to be
functioning properly.
Last time serviced: (y)
Did flow back occur from absorption system?
Yes ~ No (If no, skip next line)
Approximate volume or length of time: gallons minutes
Capacity:
Construction: Prefab Concrete Steel Other
Manufacturer: (If known):
Age of Tank (If known):
O (Xri~ Qf M au rvKeeAf
(Sign ure) (Name) Please print
imRst-w plume. YY1PKSo3Noy
(Title) (License Number)
10 Date
Form to be completed by licensed plumber (s.145.06, Wisconsin
Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative
Code)
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Plumber (applying for sanitary permit) Certification:
In accepting the above statement regarding existing septic tank
condition, I certify that the tank to the best of my knowledge will
conform to the requirements of ILHR 83, Wis. Adm. Code (except for
inspection Qopening over outlet baffle).
Name Tim JJO~.I I Q $ C R- S ignatur MP PR iO
Ili
f
STC - 105
i
SEPTIC TANK MAINTENANCE AGREEMENT
P
St. Croix County
O WNER/BUYER p
MAILING ADDRESS
PROPERTY ADDRESS
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE
PROPERTY LOCATION " 1/4 1/4 Section r N-R µ
TOWN OF 64 J~; J~,Qh ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMBER
CERTIFIED SURVEY MAP , VOLUME, PAGE,/,Z:Z, 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.
i Ilte property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner
i
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 xpirat ion date.
SIGNED:
f
Si, Croix County /.oning Ollice
I Government Center
i
! 1101 Carmichael Road
Hudson, WI 54016 11/93
t .
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 / 4S eVV Vx f An C . Co ,r 6z t- aj 61 ya ~
Location of property NW 1/4 NE 1/4, Section :5 _LN-RW
Township,:A- Mailing address Za4&.
44111J-:~o A)
Address of site
Subdivision name Lot no.
Other homes -cn property? Yes ✓ No
Previous owner of property Orre &r fPz
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 11Ql and Page Number Dy~lf 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 -he reviewing process. 'Jif the deed description
references to a Certified Survey Map,' the Certified Survey Map
shall also be required.
PROPERTX 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. j-J'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-A3p la t
f Date of Signature Date. of Signature
w
'I
DOCUMENT NO, j WArf~A~ITV DC~D T.I. SRACE RESERVED FOR RECORDING DATA
STATE BAR OFAAff11WIIMS'C,IO1NISING FORM 2-1982
1
ii
vnL1(,rasFd-45 - -
Ahleece. M.-- Morten._and- Lorre V Morten husband and I' . Croix (10. ~ I II
wife, Ra. j for t;&wrd
I
. - -
OCT 3 f 1994
conveys and warrants to Kenneth C.. Corbett and Cindy .L . _L1 AAA 11:00 A
n~
~I _ -----•-Corbett,. husband--and -wife- . - - I
- . -
- -
-
RETURN TO
. -
the following described real estate in - St. Croix County,
State of Wisconsin:
Tax Parcel No:
Part of the NW1/4 of NE1/4 of Section 34, Township 30 North, Range 19 West,
~i St. Croix County, Wisconsin, described as follows: Lot 3 of Certified
Survey Map filed June 22, 1978, in Vol. "3", page 617, as Doc. No. 349611.
ii
I
MANSFEE
I
i
This s homestead property.
(is) XXM)
Exception to warranties: Easements, restrictions and rights-of-way of record,
if any. ~
bated this October I9. 94_.
day of -
------.(SEAL) - ..._/./.!_~._-------(SEAL)
* Ahleece M. Morten
(SEAL) - (SEAL)
* Lorre V. Mort n
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN
St. Croix SS.
County.
authenticated this day of 19----.. Personally came before me this _~3_ __.-.__day of
___-_-__Qr
-tQber...... 19.94__. the above named
Ahleece_M.__Morten and Lorre V. Morten,
husband- and-- wife ~I
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not,
authorized b
by § 706.06, Wis. Stats.) _ _ JOy_ _onwr&
to me known to be the p ~,}~fCexecuted the
f e i g instru t and a $sayle.
THIS INSTRUMENT WAS DRAFTED BY consip
1 Q H/!
I
Kri.sti.na_-Ogland-•------------------------------------ *
-
Attorne at Law
y Notary Public - - --County, Wis.
(Signatures may be authenticated or acknowledged. Both My Commission is IImanent.(If not, state expiration
are not necessary.) date: - . (0 19~~
*Names of persons signing in any capacity should be typed or printed below their signatures.
WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc. ~I,