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HomeMy WebLinkAbout020-1102-40-110 I 0 (D ° O m o ~ ~ I d 0 c c o ~ o I 0 0 ~a~ s' o ` E L ~ I C 7 U p 0 O a g 0 45 0) - o -G 3 CD c cc°iooo°po~mwy r w o m y m y c m to m c 3 p; v~ v n am ct o m= ur N m p N O p p N 'Ct N mamma COL C V Q w o cu 00 0 ov c a ~ om rnE v"i o m ~aC p'p •O U(n u m m Cc .0 -0 z ~ L~ a~°°yS3 I c m H 0..~ m c c N> c o $ cotS E c U pL 3 a y m Lo c m e a~ r c c v1 H EZ m 8mm° 8 3 a I Cl) 7 (D Z y C a E N Z Op N ~:t €0 0) - 37 a 0 w M F- U) ^ € C 1 :3 CL O o zv' c~ c c N d Z E O c c -M z U) F- S E r C.~ r- m "2 0) p p to I M 0 01 > ~ m W pI d p fNq C U O c ' c c Y O Ewa 0 0 c Z H z N m E N O +r C ° H d L ~ z ° I ° O O d v m o CO U) to U) ; a Z.-> o a ~ z I •p R aaa IL C p Q U) O 0) a N U) J U G rn rn } I II 7: --t Lo m O _ E D (D m W C m C/) co ^i O_ O p U'j Y! C O CD L C CO C 01 L O m C a ° O O T w O 0) L 0- -0 42 V) 0 O N tpA O U) U N H C a~•- ' ~'~1 O 2 Z N O Z ccl) at a L: IL i E u c c ~1 A u IL Parcel 020-1102-40-110 01/19/2005 04:29PM PAGE 1 OF 1 Alt. Parcel 34.29.19.4081310 020 - TOWN OF HUDSON 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 * NIEDERNHOEFER, LIANE H LIANE H NIEDERNHOEFER 1917 TWILIGHT LNA HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 659 GILBERT RD SC 2611 SCH D OF HUDSON SP 1700 WITC Y ll'N ~ 7 L esc ' Acres: 4.119 Plat: N/A-NOT AVAILABLE SEC 34 T29N R19 4.119 AC PT SW NW LOT 1 Block/Condo Bldg: CSM 8/2117 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 34-29N-19W Notes: Parcel History: S 6 Lo Date D;589037 Vol/Page Type 10/14/1998 589038 1365/477 WD 10/14/1998 1365/471 TI 07/23/1997 2004 SUMMARY Bill Fair Market Value: Assessed with: "f 48438 108,800 Valuations: - Last Changed: 10/29/2001 Description Class Acres Land t31,500 prove Total State Reason RESIDENTIAL G1 4.119 52,700 84,200 NO GI ~p I roYG~ Totals for 2004: General Property 4.119 52,700 31,500 84,200 Woodland 0.000 0 0 Totals for 2003: General Property 4.119 52,700 31,500 84,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 sys rE,l-~ iust~ pro /.S STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER S /V %rL sEiV Q G S~ G,//3t~°7- BPD ADDRESS ~yl7So,y , Cyi'S . .Sy~D/lo SUBDIVISION / CSM# yy~ZD ~a~ Pj 2117 LOT # SECTION 31l T 2-i N-R W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ORIGINAL NOT t- .ST~tT~" C 4n~ 5~ Std rrc SySf -y ~a Ik 4 T r at ~ -f~ +u~e. pro po ff- ~9DD/'7io~~L 2 YEAS I F INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. Y • f 77TOM BENCHMARK: 13 LIPG- . 4 r ALTERNATE BM: ADO SEPTIC TANK / / H Manufacturer: '~VE4e3- a•vclz??e ~j 00.9 do wEi~ ~ ~ Liquid Capacity: Setback from: WellZ Af?E House Other Pump: Manufacturer Model# /r/i9-- Size Float seperation y~ Gallons/cycle: Alarm Location &10f -:Sol; ABSORPTION SYSTEM Width: Length Sy' Number of trenches 3 So ' Distance & Direction to nearest prop. line: Sa '~-o No RdZ` Setback from: well. '~/f House 3S Other (;4~ 77.75_ Building Sewer ELEVATIONS ST Inlet; Y/ ST outlet 5 /jam PC inlet / PC bottom Pump Off Header/Manifold Bottom of system set LD Existing Grade Final grade P/, DATE OF INSTALLATION: /5 / f y PLUMBER ON JOB: 20~~P? 1 Z(~f3R I,CGS7- LICENSE NUMBER: M P R S 33 O 7 INSPECTOR: T"1-1 3/93:jt BENCHMARK: 134,P6-. /}.7- 1j1&2 Ct9~,v~c~ ALTERNATE BM : BOO SEPTIC TANK Manufacturer: /~z4"S 4.ve;4??f 49 No wEe~ ~ ~ Liquid Capacity: 000 .9 Setback from: Wel12`o E House Other Pump: Manufacturer N+ Model# y ~ Size ~iyL Float seperation y Gallons/cycle: Alarm Location •:SOI; ABSORPTION SYSTEM Width: Length Lf ' Number of trenches 3 So e Distance & Direction to nearest pro line. . p. Sa ~ ^jO Rd'L... Setback from: well. L/ . House 3J~ Other • s~~Ti'c TT~K ~ y/~ 7,7S-' Building Sewer ?g,2-1 ELEVATIONS ST Inlet; y/ ST outlet 6, PC inlet / PC bottom Pump Off ~ Header/Manifold Bottom of system s¢~ Existing Grade Final grade P~441-; DATE OF INSTALLATION: /we) / y 1 /y //!711111 PLUMBER ON JOB: 2O B E P? 1 241, 1• C' 7- LICENSE NUMBER: N'l P R Z 3,3 O -7 INSPECTOR: ~1 /-I "'~'I1dA-1 ~ S 3/93:jt Zlup ~ SSG z7Ly 9iST. 114v6- ~9 D,~o~o /you , 7R E~~ G(ti G SGA L C : .2-0 TR EU M A-510ES 1°oTEcT~~~ ~ ~ ~ w t~ T`I p~t-R ~~QRI•c No<or M I h I I 1 v Ors 7"o D,Pa? N i I I 1. ' i /~oX FS 4~ o I ~ 3, S cC~l I I I ~ i `t V I I I I' L„ ~N•d /~o~ 92.3 LL f) I ' boo S1T. (xo ~P~st-~s s~ . 4o Puc r ~ ~,Posr PPooF C~ EQ d SG~i . ¢ D LO of SiDiN (s .9T E/~ v~tiov .~/~l~tL Pa/F 13 316 A~{~ or ~~o~o.sED ye N~ ~ Gv E// 2._~. o ■ Wiscon&n Depaatmentof Indusuy, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION PgXjM,gk Na9nLLY HOIER & LIS HO City ❑ village XQ Town of: State P an I o.: 11102-40-330 CST BM Elev.: r Insp. BM Elev.: / BM Description: Parcel ax o.: /off. 6a TANK INFORMATION ELEVATION DATA S TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosi n Aeration Bldg. Sewer S. Z3~ 9g _v Holding St/Inlet -7 TAJq`KSETBACK St/ICE Outlet 7~~ TANKTO P/L WELL BLDG. ventto ROAD Dt Inlet Air Intake Septic ) J(~ 114_ NA Dt Bottom i Dosing NA Header / Man. NA Dist. Pipe I Aeration zzl_ Ho ng Bot. System PUMP/ SIPHON INFORMATION Final Grade Man urer -Dpmand 77-5 Model Number GPM TDH Lift Friction System TDH Ft Loss For ain Head Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED / TRENCH Width i Lent No. O Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS Jr DIMENSIONS SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type Of .fA....- I CHAMBER Model Number: System: LY , A. J1D no r 'J n 74" OR UNIT DISTRIBUTION SYSTEM Header ` I Distribution Pipe(s) /7 x Hole Size x Hole Spacing o Ai ntake Length{} ~a3 Dia. S~ Length 4,7 1 ¢74;4Dia. 7 Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade ems n y Depth Over ,r Depth Over r, n xx Depth Of xx Seeded/ Sodded xx Mulched /Trench Center P6 1Trench Edges ~76 - `40 Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.)` LOCATION-- HUDSOJ4 34.29. 9..4,08B~10Q,h/SW,N{W~,L_OT 1,GI BERT RD. (~<J.=C-I-j.li-_~~/Y .T Plan revision required? ❑ Yes 040 Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ac 16 „ ss ~Cho 97 17 SANITARY PERMIT APPLICATION COUNTY ~'~~-nom In accord with ILHR 83.05, Wis. Adm. Code S T. 644 X, STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 8% x 11 inches in size. ❑ Check if revision to previous application -See reverse side for instructions for completing this application. STATE ft AN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. S ~q o PROPERTY OWNER PROPERTY LOCATION G I!I! " `!5 NI~ISG~^iV !5&)%N&,A/a,S3~ TN,R E(or PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # G,,,l/3ee r- X v • - ~ CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER Z -7 M.) P .a CJI . s~ro~~ 7!S ) ?P6 Yf -h CSA y4/r2- 6 l elo/, 9 P 0 _T II. TYPE OF BUILDING: y (Check one CITY NEAREST ROAD ~ ) State Owned ~ VILLAGE f W-5'0,~ 7- El Eij Public L71 or 2 Fam. Dwelling-# of bedrooms 3 PARCEL TAX NUMBS (S) J 111. BUILDING USE: (If building type is public, check all that apply) ZQ ' //O Z -z '6 1 ❑ Apt/Condo 11~WE /1l0S 4t`fr'a 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 Z8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel ❑ 'OfficeWeieleT- 13 ❑ Other: Specify IV. TYPE O~ERMIT: (Check only one in line A. Check line B if applicable) A) 1. rJ~/New 2. ❑ Replacement 3.E1 Replacement of 4. El Reconnection of 5. ❑ 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 ❑ Sgspage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 eepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure , 43 El Vault Privy 14 E] System-In-Fill 3 IVE~GyeS X _Co EifGtl,~ VI. ABSORPTION SYSTEM INFORMATION: g2.So fG• SO 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) T/1 5-Q ~SETATION ' 6;-o 7f_d 750 to ! Feet 7S. 0 Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank 00 Oslo l Z- 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) IMP/MPRSW No.: Business Phone Number: 20B67- ?11&1c47- 307!S ~'~G'~'fd'S~ Plumber's Address (Street, City, State, Zip Code): &5.5 D ,-/v 2/ G /RP- 175"0^_) ~j .S ~6 IX. CO TY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing A nt Si u e (No mp Approved ❑ Owner Given Initial ~ ~~rcharge Fee) Adverse Determination l C/ ' X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(8.08/93) 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. t; 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 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 syssterr}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 muss: 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) ! //3 r X92? F- C", l V t o ~ dry ~ ~~~111 CCygyy I ~ o ~ 0 0~ y no w I o i ~~rya~l i /y 61 m o Cj). I N ~ y ~ ti Q. ~y o~ O 594404564 o ~ a Approved Vent Cep Minimum 12" Above Final Grade Above Pipe 4" Cost Iron 3 ~ t^ ,to Final Grade Veal "I' Synlhelic covering min. 2" Aggregate h Over Pipe Distribution 0 0 0 0 0 - Teed Pipe ~qA Aggregate ® Beneath Plpe o - A9#T ti,~ a' a F. Y d. Bottom 01 ;`Se Fresh Air Inlets And Observation Pipe Approved Vent . Cap Minimum 12" Above / Final Grade f/ewb -~J 4" Cast Iron 3Cp " Above Pipe "to Final Grade Vent "4* Synthelic Covering min. 2" Aggregate Over Pipe Distribution - Tee Pipe 0 0 0 0 0 I Aggregate o Perfbroled Pipe Below Beneath Pipe 0 -Coupling Terminating At Bottom Of System ~ysT~~I Fresh Air Inlets And Observation Pipe Approved Vent Cap Minimum 12" Above Final Grade / o _ 40 Cost Iron 3(0 "Above Pipe Vent PlOi 'to Final Grade Synlhetic Covering min. 2" Aggregate ~j Over Pipe Distribution - Tee Pipe 0 !PIpe 0 0 " Aggro Perforated Pipe Below 6 v 8eneoth CaIn Terminating ~ q g At Bottom Of System S ~ UL'BRICHT & ASSOCIATES CO. 655 O'Neil Road - Hudson, Wl 54016 Reg. Designers of Engineering Systems 715-386-8185 Private Sewage Consultants i PROJECT INDEX DILHR Plan I.D. # S94-04564 Date Oct.28,1994 Owner Phone 715-386-5972 _Vi Iv & TyiG NiPIcan Address 659 Gilbert Rd. Hudson, Wis. 54016 Legal Description Site tax parcel # 020-1102-40-110. Lot 1, csm 449209, Vol. 8, pg. 2117. Site address 655 Gilbert Rd. Hudson, Wis. 54016 SW 1/4, NW 1/4, Sec. 34, T29N, R19 W. Town of County ST. Croix Hudson C.S.T. Installer Robert Ulbricht CSTM2482 Local Authority/ Supervision St. Croix Cty. Zoning Dept. PROJECT DESCRIPTION The owners have a home based office in their existing metal pole building, and have local zoning township approval to conduct an office/business. Owners have no employees other than their immediate family (husband,wife, daughter). The Nielsens wish to add albathroom to the shed. Also, they propose to eventually build a new 3 Bedroom (or smaller) home on lot. A common trench system will serve both buildings. Soils are permiable and suitable for a conventional trench system. 'dotal estimated daily wasteflow from the proposed 3 bedroom home (and office in barn) will be 450 gals. The existence of an office for the immediate family will not, of course, increase any residential wasteflows. Soil; design loading rates are .6 GPD/Ft2. 750 sq.ft. of trenches is required. 1 Pg.l PLOT PLAN VIEWS Pg.2 SYSTEM Cf, ECTIONS & SYSTEM PLAN VIEWS `O~~u~p►rnar A# X15 `41,y, 8~ 9'a7 ~ TT MIN S94-04564 .M v 4 • I SAFETY & BUILDINGS DIVISION State of Wisconsin epartment of Industry, Labor and Human Relations October 31, 1994 201 East Washington Avenue P. 0. Box 7969 Madison WI 53707 ULBRICHT & A SOCIATES ROBERT ULBRI HT 655 O'NEILL OAD HUDSON WI 4016 RE: PLAN S9 -04564 FEE RECEIVED: 120.00 NIELSEN, VILLY SW,NW,3 ,29,19W TOWN OF HUDSON COUNTY OF ST CROIX NON-PRE SURIZED IN-GROUND SYSTEM The Department has reviewed the above-referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items ust 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 Administrati a 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 he construction site. The installer shall notify the appropriate inspector wh n 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. Sinc y, Peter E. Pagel Plan Reviewer Section of Private Sewage (608) 266-2889 SUD- 1423(R. 01/91) 4 4 92 09 CERTIFIED SURVEY MAP LOCATED IN THE SW1/4 OF THE NW1/4 OF SECTION 34, T29N, R19W, TOWN OF HUDSON, ST. CROIX COUNTY, WISCONSIN U N P L A T T E D LANDS W LINE OFNWI/4 N0°06'35"E 2644.94' U - GILBERT ROAD_ - w L' S0°06' 35"W 336.85' w w ESQ°Q$ 1~W)- - N C*7 S0006'35"W 336.82' IF-33 Ln W ' z H O ox zy~ g to 10 g 7rdzM H on b70 I~r• ~wx `0 Gz n £ LL) z l- m Z H G Lo G X-- -3 PO F 1 0 A. ° a. H E ` r• N P. 00 V) 41 oho En CQ cn I d I C F o iw ° c~ Ki c~ InI~ (n; I 1+ °o V1 Ln cr i+ t, In Ln I I I H 0 C) w (D W N m H w o 1 4-- I~ C ~ O W 1-t m rt P. rt H. O O IrQIGt-d 7I n ' r~~t 1a o~ oov F- oo Wcn I~~,,I' Iin a IH_ p,wCL lol00 N r 00 F' o o C I N io a% 7d F .L In I O ON - °a°a rw t~ Q n . n ON v, C=7 00 I+ 1+ - H ~ ~ v N A O - r• co G I ~ F' ° 9 o O F-' W I CJ In O ° < d ON J O A x IH o ° N0°06'35"E 336.40' - Iz ° 286.96' 49.42' - AL- r• I ~ - ASSUMED BEARINGS REFERENCED cr: F~ ° N o rn TO THE WEST LINE OF THE w N W1/4 OF SECTION-34, WHICH ° F- O i° BEARS S0°06' 35"W oH I-q cn loo En '-3 m :K w 41 I+ N N S m ko O~ K = CD It H r ti > C1 H 'r1 r A W O ~ N <<- ~zo ~00 no ° yJ00::c r=l o °o ° N ~ x z !7 M Ili- q Ci >1 H C 00 CD I 0100 z0cy. Z vi EDIE LANE _ w ON n % w t-n NIT w ~ t-I w v,lrol t'0 tri w ° 1+ i+ to G~ cn F trJ ~I• I 00 H cn I°o ' . _ O I d I H° Iw I v I ' 119 o N0°06'35"E 335.91' FILED Iola - 161.17' 174.74' G 1 Izl~ I U N P L A T T E D L AN D S I JUN271989• Z - - - - JAMEfi O'CONNELL FbgbW of b cra& oms 2117 ~ Q VOLUME 8 PAGE ~i.'T~ ~ I~l~,l°ESS lv ✓~S Gi~l3~~'T . A Wisconsin Department of Industry, SOIL AND SIT _E V AL k1:AT 1 O N RE T Page ~ of 3 Labor and Human Relations s: Division of Safety Buildings in accord wit tLHR 83.05, WiS. Cod -5 ' COUNTY T Attach complete site plan on paper not less than 8 1/2 x 11 inch i Z~t~ must include, bu not limited to vertical and horizontal reference point (BM), directio a of slope;-'scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest roa . ° 1020 - //O Z - y0 ' old APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATIO REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION -4 L/S / I~ / 4r-452541 GOVT. LOT 5&) 114 411e) 1/4,S 3yT 19 N,R /9 E (or) W PRO& S owNE T E L0Y # BLSSAJ W y2Ao 5 R// P p o 7 CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE OWN N WEST ROAD 1f upSd-v 4-'1S . yD~G (~/S) 3~~ -$~7Z UPS O ,3 . I Vf'New Construction Use [rv)'Residential / Number of bedrooms 2 -3 [ J Addition to existing building [ ] Replacement [ 4-fublic or commercial describe_ Code derived dally flow gpd Recommended design loading rate l bed, gpd/ft2 • ~i trench, gpd/ft2 Absorption area required bed, ft2 7-~D trench, ft2 Maximum design loading rate~_bed, gpd$ ~trench, gpolft2 Recommended infiltration surface elevation(s) 5-0-Q &C /o w ft (as referred to site plan benchmark) Additional design / site co lions WSE 7r6AJCti £ s C3 ) S ' k S o ' E'A a- cu/ Dp...o P R 01, U r' s l` P i g yT ro Parent material 5CS - .5'~wS f s chf ETEit Flood plain elevation, if appliEable 41,74' it ov w LSU =Suitable for system U CONVWIONAL ^ MOUND u IN G_ U ESSURE AT_GRA~ Q TFJuI MI FlLL Q SIWG TANK =Unsuitable le for system 0-5 l!d'S []~3~ ~ [~'s 0 SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence BourdW Roots GPD/ft in. Munsell 11u. Sz. Cont. Color Gr. Sz. Sh. Bed tench E i 0-/7 /orb 31Z _ s cs 3 -2 -3f /0 yle 1~~ e.57 _57 2- 7 2- s/ fsd,~ ~s y S Ground 3 y ;75yP f13 rylev. a ft. 7 7, -Y y s 4, S n+~ 7 Depth to limiting factor Remarks: Boring # /7" ye 4,7~e Ground elev. 17 2-O ft. Depth to limiting INAL factor-~~ Remarks: CST Name:-Please Print 1P0~E1-P7-- ~LAe j0.A 7- / Phone: Address: Signature: Date: CST Number: - -Te-e X3 0, U A 1,0j,3 -S q2,0 PROPERTY OWNER SOIL DESCRIPTION REPORT 2 3 PARCEL I.D.# d2.0 - //02 - y4 - O Page of Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence BourXby GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Roots 3 2 s /f s6~ 3 t Bed Tiencfi q 2 -~L /0 VyP 2-,* iie ~wfif e5' S Ground ('s y o tr elev. s Unit' S , X76.30 ft. Depth to i limiting factor Remarks: Boring # ~2 /4 yiP 3~Z s 144 Z ,P9 ~ 7 Ground elev. 5'~ • a ft. Depth to limiting factor Remarks: Boring # z fs~ ~,fi~ S 31c . S 3 7,S y~ Y 3 ~ L~ sd,~ ~S /7G • S - ~ Ground ~~(1 ~Sy /S / f elev. ft. Depth to limiting factor y Remarks: Boring # Ground elev. ft. Depth to limiting facto Remarks: con ooonio nc mop w ~ cJ~ v~ Q 03 c c J ~ o 0 0 INIAc O w 00 r33 d • o p~ W ~ ~ ~ o ~ ZA 2 449209 CERTIFIED SURVEY MAP LOCATED IN THE S141/4 OF THE NWl/4 OF SECTION 34, T29N, R19W, TOWN OF HUDSON, t'`• ST. CROIX COUNTY, WISCONSIN U N P L A T T E D L A N D S Y," W. LINE OF NWl/4 N0°06'35"E 2644.94' - - - - - - w r, 4 w GILBERT ROAD- w SO°06' 35"W 336.85' w w - - - - - - - y £ W S0°06'35"W 336.82' w z y 0 N M F- W H O ZH--g toFd ~ ~O W 70 A O F..; z n n A r ~O W z z H F-,. F- t r ra z G w r- 4- H 0 o aoaH a 4 11 P. N N• co ~ ~ oho ~ oho cn Idlc 00 I0l0 lti C> (n I o N i+ ~ I+ I o to In Q d t' to Ln I~IvIH N n - ow m tom w0 wo I I~ n c Icn o w m m ~ m H w o -p- 1H y rt Fl. rt H. I N l b t*1 M I t*~ o o :j :j 0 0 v, c) i C-) ;7 00 0m oom H oo ~ ~ IWI• I~ I~ wa w a r 00 00 ICDIH FJ H a I'3_ N z 1 tl M I ~ 7d 4-~ l ON o m - 9 9 w a £ C7 E (7 rn In trJ co I+ I+ ~ ~ E y w - - -~O p 1 1 z 4- F✓ N co - N - U i•w ~O F-' O ° O H W a, < I d O • Irk - F~ O O A I~ ° ° o N0°06'35"E 336.40' ;o I°z to ° 286.96' 49.42' - j o o ASSUMED BEARINGS REFERENCED w N o o TO THE WEST LINE OF THE - NW1/4 OF SECTION-34, WHICH r r Ln BEARS SO°06'35"W H H Cn iC» n fn y cn<M M ;K L.) X I+ -i N rv 9 Z 4 o I+ z y ~L wOO - <c vo ~ co Jy~00Z F~~oxcz ry o ° 0 y >En xdcn N ~ ° z > C11clr Z O H °o vw, o ololo 0 C-4 In .P H t7i EDIE LANE u~i t z x ¢ ~ Fxj W %lo NI° Io w y►y to tri I+ ~~lcn N M z co I P R+ F- Iw I IdItri , I 119 °o N0°06'35"E 335.91' IHI~ - z 'L 161.17' 174.74' FILED il I UNPLATTED LANDS 8 JUN271989s' 2 I JAMEF, aCONNELL 8 PAGE 2117 VOLUME /fvl~So,✓ Gv/,S' . .S ~DlE, Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of 3 Labor and Human Relations Division of Safety 6 Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY T. S eV-0 ,X Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. OZD - /ia Z - ~/0 i~d APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: / PROPERTY LOCATION j L/S GOVT. LOT 50 114 VW 1/4,S 3yT 19 N,R /9 E(or)W PROPERTY OWNER':S MAILING ADDRESS LO/T # B OOCK # SUR . NAME OR v0% P 1 / l 7 CITY, STATE ZIP CODE PHONE NUMBER CITY []VILLAGE OWN NEAREST ROAD ttvOSa-v ~/S . yoiG (7/S) 3,f~P 2- V1 UPS o ,.1 Cry'/,C3E/t T New Construction Use VI'Residential / Number of bedrooms Z- -3 [ ) Addition to existing building l 1 Replacement (*j--~ublic or commercial describe ANUS &/krTE fY4",,O, Code derived daily flow JT 9Pd Recommended design loading rate / bed, gpolft2 • ~ trench= gpol(t2 Absorption area required bed, 112 7~D trench, h2 Maximum design loading rate bed, gpd/tr2 ' trench, gpdAt2 Recommended infiltration surface elevation(s) sue- /,C /o w R (as referred to site plan benchmark) R Ox "Di S T Pi Bu1w Additional design /skeoDDons WSJ 7reNCdA'F s C3) S So ' CA q'- W/ Dr-op Parent terial 505 4 -Saws S C#E7- ~ Flood plain elevation, I applif able It o w S = SUitabl@ ON System ~an►iO ^ MQUNQ ✓O U IN GROG U PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TMq( U = Unsuitable for s stem 11r1dd 5S I!~'S LJ'.~ ❑ C U O S Ceti' O S Elm- SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed roxh i 0-/7 /ore 312- - IT / " & " cs 3-f - •P 2_ 17 3 /o fle y s/ 12-,;.n /,h, 7i( es / s Ground 3 y= y 75 yie t' 3 -5-1 l~S iWIlit° ms's y S 1 5;6 y~o - ft. - 7,5 y y S o,S n~► - 7 Depth to limiting factor Remarks: Boring # 49-P /o /p 312- S1 A/ fie cs .1' f . Y S 2- - y 7 s 0 A'* s/ Z-f- Sl,~ cs if SI F 'M 2 Y, Ground 3 . S / f elev. ,7`/ 20 ft. Depth to limiting factor / Remarks: T Name:-Please Print Phone: 3, _ Address: 4//~~p Signature: Date: CST Number: pa%e/ _ 3?1'p T~~~ 93• d PROPERTYOWNER_ SOIL DESCRIPTION REPORT ? 3 PARCELI.D.t 02 - 2- y0 - O Pte of Boring # Horizon Depth Dominant Color Mottles Texture Structure GPD/ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.~ Bour~ry Roots Aj Z f ' r 3 Bed rend, S Ground 13 elev. 75 r--- s . / { v/~ S 576.30 it. Depth to fimiting factor Remarks: Boring # ~ yre 3/2- s /4. ye 13 Ground elev. Depth to limiling factor . Remarks: Boring # s q Ground ~~l! 7SJ/ Y16 /S 1,40 elev. _ .5fZ ft Depth to limiting factor Remarks: Boring # i t 131 Ground el(v. fL Depth to limiting factor Remarks: con owmio ne/n•)% //3~ T .Pty r- ~ . w ~ Q Pj G ui w o ~ d ~ d o 'tee ~ n T o ~ r c J o 0 0 0 ~c y O wo ,Zb o y b tZ q, a a m Z, 0 ~ i o k m y H ,off i, m Zh - - 4`1 -kV STATE BAR OF WISCONSIN FORM 1-1982 THIS 5PACL FESERVEO FoR RtCOROINO DATA CSOCUMENT NO. WARRANTY DEED 449584 845Pkant; REGISTER'S OFFICE ST. CROIX CO., WI This Deed, made between Reed fCr Record c.a.rmi c-ha.ei-. Re-~id~n.lwial...Gcp.up...... -nc- JUL 111989 . - - - _ Grantor, at 1:05 ?M and. _11i-11y- H.-- Nie-ls8n-arui. Lis...H-.---N.i-e-l-setsT---•------- _.husband.. an, wife. as-.marital sur.ui-worship---------- rnPertY . p . Grantee, Witnesseth, That the said Grantor, for a valuable consideration...... {}p----........-------------------------- RETURN TO Carrmiclxae-1. Res-idant-i-a- ro conveys to Grantee the following described real estate in St.....CrQ-1-X.......-. County, State of Wisconsin: A parcel of land located in the SW% of the Tax Parcel No: NWi of Section 34, T29N, R19W, Town of Hudson, St. Croix County, Wisconsin, described as follows: Lot 1 of CertiFied Survey Map Filed June 27, 1989 in Volume 8, Page 2117as Document No. 449209.. f~ SPF~ ICU FM This - is not homestead property. (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; Carmichael Residential Group, Inc. - - And... - warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and rights-oF-way of record, iF any. and will warrant and defend the same. 89 June 19.- - day of - - Dated this Carmichael Residential Group, by: (SEAL) .(SEAL) (SEAL) _-(SEAL) AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN Signature(s) - - St. Croix County. ss. authenticated this _-__._day of---------- 19.- Personally came before me this 3.n -(lay of nanAd 1-`II Ju ne , qv, - TITi.F Nl,FM 3ER STATE BAR OF WISCONSIN (If not. authorized by ; 706:06, Wis. Stats.) to me known to be the Boron t'fr oinq in-trumr,nt al U•61IO%V- lc tl I I. NAS DP NF; F') BY - Kristina Ogland Lundeen Attorney at Law Alice J. leischaA*t"PUb''C St C ragl4te of VAST!?S o « ~•~t:: I hlir t • r ,-w-inn , ~'^rnliratrd ~~r a nnc!1 •I Ctl? t June 9 3 r~,rnl n- ~ I I' , r date. 'TATit ftAfi OF Wis('()].Ir WARRANTY DP_F.D tORN n. 1-17•f2 r_1~"' !1•Itar 5/ 7Z7 lclXt S T C - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER j[~Y ADDRESS_cp~ FIRE NUMBER CITY/STATE_4~ZL'ao"') / . ZIP PROPERTY LOC~TION: 's~ 1/4,'") 1/4 , SECTION--Lt, T Z( N-R W TOWN OF if v /?Xl St. Croix County, SUBDIVISION 45sIl Y 2°f 4101 ? P6 - 8 LOT NUMBER __L_. 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 a 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 Co. Zoning officer within 30 days of the three year expiration dat SIGNED: DATE : St. Croix co. Zoning office 911 4th St. Hudson, WI 54016 ry , J STC-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 own e r/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. ( ! Lis /l/ 146/S',~ Owner of property ' Location of, property 5401/4 A.,04.1 1/4, Section 3 /1"', T N-R 2_fW Township t+u DSc-A3 Mailing address Co s ,,f 6,- t D {-t-y.) S e. D 4~ I. 5 q0 Address of site S Q ` ' - D Subdivision name no. Other homes on property? yes /No _ 'uT `T~~'`f Previous owner of property NU 6__ F~// A `s,~ B40 Total size of parcel 7~ l S Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)? Yes No Volume 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 & 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 o: Deeds as Document No. , and that I (we)'presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has, been duly recorded in the office of County Register of deeds as Document No. 'e, ~ Sign ,all'ure of applicant C applicant Da a of Signature Dat6 of S ature roX a a~"~ gr)fq o- o o r~ reQ>vr S kpes RECEIVED o JUN 1 5 2004 Z z ' - -ST.CROIX000NTY 0 • cn 0 ► • ZONING OFFICE ~N o N~ O I z (n I o 0 Z ° > N m m N v_m Nm 00-0 ° a r*t O o Do w-c' m N N mo ~ 2 ;cu ~ ; c m BEARINGS ARE REFERENCED TO THE ::1 n m zz < zz m z zz C WEST LINE OF THE NW1 /4 OF SECTION v O Z ~ a r. z' z z f- N D m 34, ASSUMED TO BEAR N00'07'17"E rn m S -zi ~-c1 ~m zOM G7~ Zr°*1 zN m r. 0.C >;v cn0c-nrZ ~~~C7 z -zi 0 zM o D 0 gm zz~ 2DmzzpOp Z n N - s OD I A m-v -f m -1 mp D ~,iFncci > (>~z> ~p p to O N °M ~ cll ns -on r >;u n ~ NC~~ N a m m p --1 7C D- q N it co - I z r z °o No v5 am $ ~ SMALLTI2ACTS z>8F--i2 °_=zzz m ~ ? pp - D z 0 m D cn ' 0: v c (NO'06'35"E 2644.94') o° N~ m m r < ~*t r ; 0 -I •°m N00'07'17"E 2644.80' o C o mteD .o -n GILBERT ROAD ~ `n M~~ z - WEST UNE OF '''~cr-Dm N ~'p rn m y c~►1. SO'06'35"W) THE NW1/4 _ rn N -4 T-66 1- rn NOO-0791-7 f.26 _ CA 282.09 6 313.17 t 10: _ 1983.54' D 0 r N 0.6' w 282.069 §,jpp Vf 313.17' ! 3 m o (A co O p 5Z pp Q . ~ Z r Wv~'7 N Z.$w......W. 00 i r r ' 'o NO0'0717"E c,! 661.23: 0 :s CA rn M qhR Vf' y/ i rnv r' m w m I ~YP i 310 ' Q -Ni -E' 4 0 / - - --rJ- - - I ~ i lV rn ;dz o r? a at I ►=j W C x,15 r ` ! i -4 ; C v i > z W 3„Z •9 yZ Sg z 1.-- j 8 m rqi ; ~ u 'A rn 1. W to ~m ~ i. Q~CQ'' ic V 40t0 r N 9`41 2 0 '0 A M 0 N -Q -4;1~ 0 0 0 $ m4q 352.48' . 2-5:1 i 22 1 N 17, z j> ; -0w 2.1 f 287. ' > j 2N OD----~ Q oo c i (NO'06'35"E 336.44') > 0 i t rn rn S00'07'17"W 00' ! 0 ^z o > o N > i n 336.44' 0*07'17+ ! n (A P: 'o V5 z ?a to F4 v O Mol co IS 3E C; iN .0Q< N iQ l IN / ^ S2:2 I (11 IQ\ PrMn POgg IZ 00Z 00 -Nm ' N>r. I Q W rn ~(o COW oD°'0 I i $i IQ v°iwr n~ _ z z m m m D v II ~ Q d r~1~ vijN 0600061060060 6 r 0 r i 1 ' ODD y 0 U z m P."o 91 j "a 0 60 x X m z rn z X z ~v 'A c, rnt x -4;0 > ;o 70 ;o ;u ;o ;o ;o go I w. ; Q g o MONUMENTED (no y EAST UNE c v0i r'n- 0 c ("o = N N c' Pp N ~L 0-3 :2 T cn OF SWl /4 OF 0 OD 00 Oo to n 0 E V) 0 z° o Cn N --j co v rn p NW1/4 z r~ in g in 00 00 N w m N00'00'19"VV ~ p Zz ~ m A N cn w cr A I, rn -i ',,.C~a S00-15'12"W I t"; b ~ Z cn m° N Q 324.38' I; r $ v o c= w p rn N N N N D I..~> r m m o m 1.11CD.r000N 0 iv; 00 Ln CD z N 0 to w w ° w (A (0 N Z. SHEET 1 OF 2 SHEETS V • 4-4-9209 CERTIFIED SURVEY MAP LOCATED IN THE SW1/4 OF THE NW1/4 OF SECTION 34, T29N, R19W, TOWN OF HUDSON, ST. CROIX COUNTY, WISCONSIN U N P L A T T E D L A N D S W LINE OF NW1/4 _ - - - - - - - - - 21°06'35"E 2644.94' 1 w GILBERT ROAD- S0°06'35"W 336.85' w N w S0006'35"W 336.82' w Z H C') Ow z 31 g tyro 8 ~ztz w O .o w x O ~ z ono ~owz zH N. N~ E J--- rri z c: W C A y ~ I-.~ O a o a l-• a z ,,y w N H. 00 a` ono cn oo to I d I < C> Iw ° 0 It h; I0I0 (n o F~ I+ 'H" I+ i o v, Ln a a, r v, I~)v1H C-' c Icn o w n W n m H °o I V I N La-' I~ o o rt n~ o o I"Ia ID lo R 19 0 0 0 oc o 00 o_ o cn iLo l• co IPj w w w r co 00 1°IH C-1 I H_ a a .O ~O I C) IV z n cn F, ° ° o m I 7y ON rn ;v F✓ ~ to ON n O O (D ~.aI- a F•w Crftl l a < n i C) D\ In 00 I+ 1+ - H Q E E v IV C37 - _-t~ A n z •r` r o H. 00 - F- G I ~ N o a ° o N w I tv Q n o 0 I H - o o JA x IH o ° ° N0°06'35"E 336.40' ~ i~ ra ° 286.96' 49.42' F- N• I r c!= ~o r N ASSUMED BEARINGS REFERENCED w N o o TO THE WEST LINE OF THE N W1/4 OF SECTION-34, WHICH C:) Ln r N rnr BEARS S0006'35"W o x 9 I00 r a.o0 HHcn I cn < m n Cn C*1 ; : W 4~ I+ rJ N m \.O ON doo r X- wN po tT3 a CC- " z 0 Li~~ >~00`Oz.' z Iv o z G7 CTJ N - - r z ~+q HtTJto:r-l cn -N > U) ~d tn ° co o (o y ~X\ N V ol<ir z 0 ti 000 O O .O N ~IrIH t~ N z I-< rn EDIE LANE w o~ ~ a to r x 0 41 I+ 1-n 0 4-1NI loo I" Idltcn° Iw 1 ;19 °0 N0 ° 06' 35"E 335.91' ' 161.17' 174.74' FILED I0I, 1 U N P L A T T E D LANDS 8 JUN271989► 2 - - - - - JAMES aCONNELL Register of De" st cft Co., w) VOLUME 8 PAGE 2117 to Q