Loading...
HomeMy WebLinkAbout030-2006-30-000 /,i S7`4-411Z1~ NOa, ©cT. 3 l N o V, L- I r Si 7-E7 1Z-73 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER JEFF W A (1 1 0 1:~ecfe / DDRESS 6 ~/K37/ 7 S VISION / CSM$ S7 LOT 1 Z L.ut JY~~ IONT N-R W, Town of ST c10s/~~ CROIX COUNTY, WISCONSIN N PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM see s P/07_. ORIGINAL INDICATE NORTH ARROWI Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cove'." I ~ r I f 5 16 e!57 1311 If lo.u 6- 11VO - Go r Ge ~~_e_ BENCHMARK: O ALTERNATE BM: I3 0 T7~ EDGE O7= 4-7" III SEPTIC TANK / PUMP CHAMBER / HOLDING..TANK INFORMATION Manufacturer: Liquid Capacity: i - ~ Ta NoL. Lo T- Setback from: Well House -,f Other Pump: Manufacturer Model# ---Size Float seperation Gallo e: Alarm Location SOIL ABSORPTION SYSTEM Width: 5 / Length Number of trenches Z Distance & Direction to nearest prop. line: ~d do ' LOT L p Setback from: well: ~d 5 House 3315 Other ELEVATIONS ST Inlet. /a 3' 06 ST outlet Building Sewer ~ /0%3,(? / PC inlet / PC bottom i Pump Off Header/Manifold Bottom of system -ae- PLOT Existing Grade Final grade f DATE OF « INSTALLATION: PLUMBER ON JOB: f O QER 7- T- LICENSE NUMBER: */if S 3 3 INSPECTOR: 1k4 ~ 1I ALA,) A) 3/93:jt Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Laborind Human Relations ST. CROIX Safsty and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: b46 5 Permit Holder's Name: ❑ City ❑ Village nn Town of: State Plan o.: X WALLIN, JEFF & BECKY SCHNEIDE ~ C, 4- jeseph CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Jr ` r Benchmark 7 / v Dosing )k 1)t QS.~q Aeration Bldg. Sewer 3g 4 7• /oy,3 Holding St/Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet Q, a ! 103,6: TANK TO P/ L WELL BLDG. Ver!"o ROAD Dt Inl Air Intake Septic {7U 6~/ 9 > /p' NA D Bottom Dosing NA Header/Man. 3 6 3 Aeration NA Dist. Pipe ;0, q r 00444 11,31 S 8. F Holding Bot. System 11,7S 94.x. S 7.L PUMP/ SIPHON INFORMATION Final Grade ~'ay 10,5- Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft Forcemain Length Dist. To Well Fi SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type Of CHAMBER Moe Number: System: OR UNIT DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length 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.) LO TION: St. Joseph.34.30.19W, NE, NE, Lot 2, Highway I 6 / 1.75 13, Plan revision required! ❑ Yes ❑ Nd Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: SANITARY PERMIT APPLICATION z Y ~~a.~nri In accord with ILHR 83.05, Wis. Adm. Code Cos T- 4eG/` K ? STATE/S/~IT/trRYtPERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than p( d -TVWS 8% x 11 inches in size. ❑ Check if revision to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. /V PROPERTY OWNER D PROPERTY LOCATION ul.41l/N /J ~LtifN.¢r~Jt ,/~E%a X/E'/a, S T 30, N, R l E (o .W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # Cp y 3 A GUESS T llwwo CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER E"hE:v P ,4tIPi 4r 55 ? lP /2- fW 101 V e J-,401 3 5 ~77 vo 13 - IL TYPE OF BUILDING: Check one CITY / NEAR ST ROAD ) ❑ state owned 3 O ~OWLAGE : ST. Jds -Ll ❑ PUbI1C l~ 1 or 2 Fam. Dwelling-# of bedrooms - PARCEL TAX NUMBER( S) III. BUILDING USE: (If building type is public, check all that apply) ^ Z~ 3 0 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. [?'New 2. ❑ Replacement 3. ❑ Replacement of 4.E] 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 ❑ Seeepage 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 yyy►►► Z 7X6o4,"5 444 76 VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) . ELEVATION ~O -7&40 • G /0 Feet 0.3- Feet VII. TANK CAPACITY Site in allons Total #of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New istin Gallons Tanks Concrete structed glass App. Tanks Tanks Septic Tank or Holding Tank Kgnv- Lift Pump Tank/Si hon Chamber CO.t>t~,C 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 Signature: (No Stamps) MP/MPRSW No.: Business Phone Number. izpB~r' ZcG (31~ ~Gf,,,T- ~~3?~~`' ► 330 7 7/f' 3f6 ° Plumber's Address (Street, City, State, Zip Code)- & 5 6 ' Nit r4, - f1~U ~Sp CU/. S 496140 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater at y/[~Eiji ng Agent Signature (No Stamps) Approved Owner Given Initial Surcharge Fee) -4 1. 4-0ay1f Adverse Determination ` 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 y a rs 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. 11. 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. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. { 1 i SBD-6398 (R.11/88) + II ~ r N rr, LA o 1 w ~ ~ b t I ~T yo \ 6- y 1.1 y Q o o I o o d d~ (n O 7 3 N \~v. - \ \ \ \~ll ~'\T ~C'\ ~ M W I v. 1 I 1 l ~ 1 r I ► CN. I i Fresh Air Inlets And Observation Pipe T Approved Vent Cap Minimum 12" Above Final Grade _ 4" Cast Iron • 2, " Above Pipe Vent Pit P to Final Grade a r Synthetic Covering min. 2" Aggregate Over Pipe Distribution Tee Pipe 0 0 0 0 0 • Aggregate o Perfbrated Pipe Below Beneath Pipe o Coupling Terminating At Bottom Of System SyST . . Fresh Air Inlets And Observation Pipe Approved Vent Cap Minimum 12" Above • Final Grade too. S^ 4" Cast Iron 3(~ "Above Pipe Vent Pipe 1'o Final Grade F Marsh Hay Or Synthetic Covering Min. 2" Aggregate Over Pipe Distribution Tee Pipe '_'0 0 0 0 0 11 (p " Aggregate a Perforated Pipe Below Beneath Pipe Coupling Terminating At o Bottom Of System ' 4r5 T - ,Y • r OF SAFETY & BUILD ,,~P REPORT ON SOIL BORINGS AND DIVIS. rINO ~ P.O. BOX '/UU, H RELATIONS PERCOLATION TESTS (115) MADISON, WI 53707 (1-163.090) & Chapter 145.045) A C N: SECTION: TOWNS HIP/M Y: LOT NO.: BLK. NO.: SUBDIVISION NAME:. /rL/ 34 %T30N/R19kqor)W St. Joseph n /a n a n /a COUNTY: WN ME: MAILING ADDR SS: f Tedd` •Drenth Bpx 203 Fairboult, Rim 55021 USE DATES OBSERVATIONS MADE @EDR : COMMER A DESCRIPTION: PROFILE DE NS: pE'~`bTATION TESTS: ~~Qialdence 3 n/a New ❑Replace 9-11-89 n/a a RATING: S- Site suitable for system U- Site unsuitable for system 1s ENTI NAL: MOUND: JIN-GROUND-PR UR.: SYSTEM-IN-Fl LL HOLDING TANK: RECOMMENDED SYSTEM: (optional) []U ❑ S Lail ES ❑U❑ S gU ❑ S [A split level trench It Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5)(b), indicate: class 2 Il Floodplain, indicate Floodplain elevation: n/a decimal's PROFILE DESCRIPTIONS page 42 •OND2 @ORING TOTAL DEPTH T GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH ~I NUMBER DEPT!' XX ELEVATION OBSERVED ES I H TO BEDROCK IF OBSERVED iSFe ASBRV. ON BACK.) B-.1 7:'25 103.49 none >7.25 .67bl.1. .83bn.sil. 1.00bn.s.1. 4.75bn.l.s.&gr. B.'2` 7.25 100.49 none >7.25 .92bl.1. .83bn.sil. 3.00bn.s.1. 2.50bn.1s.&gr. I 3 6,59 100.49 none >6.59 .50bl.1. 1.42bn.sil. 1.00bn.s.1. 3.67 bn. l.s. B. B- `z B- fo alteria' .t,.. sys em see 115 from 1985 B. 4 PERCOLATION TESTS - r s TEST DEPTH. WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES A TERSWELLING INTERVAL-MIN. PER INCH -P- P. se desija-i rate P- P P- PLO"L-A` : Show-focations of percolation-tests, ~uil borings and the dimensions of suitable soil areas. Indicate scale or distances Describe wh:,t arts thu-IiQrl zontal and %Vrtieal elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. 99.99=upper trench SYSTEM ELEVATION 96.99=lower trench Jr6 1r. fe., 0 -Z L , 5 p -77 1, the undersigned, hereby certify ;I:mt the suit 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 late recorded and ;he location of the tests are correct to the best of my knowledge and belief. NAM print : T TESTS WERE COMPLETED ON: Gary L. Steel 9-11-89 A : CERTIFICATION NUMBER:HOF- L NUMBER19ptional): 988 N. shore Dr., New Richmond, «i. 54017 _ 2298 15-?46-6200 - CS•f SIGNAT' Zz,-&j -0-4e~ ~igmal and one copy to Local Authority, Property Owner and Soil Tester. \02182) OVER - - f .w... OF - REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS DIVISION E LATIONS P.O.--BOX 7969 PERCOLATION TESTS MADDISON ISCI-. • , WI 53707 . 0j&3.0911)-& Chaptar1457.0451~ N. ~r 6EMON: 4OWNSHI MUNICIPALITY: OT NO.:BLK. NO.: S DIVISION E: c. Py /T311 N/R/~E for r~ 3~0? )UN l Y QWNER'SS BUYER'S NAME: ~IN ADD ES : I. isk D:.T2:3ESC9VATIONSM•DK E 1NO.BEDRMS.: COMMERCIA[-DESCRIPTION: PROFILEUE-SZ-A PY16N_7.1!2 FICOLATIO TESS. ~ANew I! _ ~ ~1•`q 1404 S- Situ suitable for system U- Sltu unsuitable for system F n``!.i•~L f~K/`'~/7sh.P (J/SG o+„ ikNTIONAL: MOUND: IN-GROUN&PAESSURE: STEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM: (optional) Us Zu 1 t~s ❑u as ®u 1as FAU as ®u I•vi"culuuun Tests are NOT raquiredr°''•`, DESIGN'PATE: It any portion of the tesied area is in the ow a.H63.09(51(b), Indicate: ! Floodpla+n, indicate Floodpla+n elevation: r o PROFILE DESCRIPTIONS UI~ING TOTAL " ER-IN s CHARACTER OF SOIL WITH THICKNESS, COLOR- TEX CURE, AND DEPTH 0 OBSERVED BSERV~Q OT BEDROCK IF OBSERVED SEE ABBRV. ON BACK.) n.Nv11~ER D 13-/ F V 1- rs •T, rA N L ~'7i 8a L L .vs . 7-1 a 1 TS , 7,' T Aw L .rS .3 • v 1 rs , -7 , rv,r. .:t, ,v ,ass, • o ; ' B-y s,7 9`I 4 Al oA~P, t D Fwl off. f' - 3.4o , 671 i 3 B L 'r* r 7, 7A..' 1• cr 1, d- 8- s.9 p a~J PERCOLATION TESTS TEST -DEPTH WATER IN HOLE TEST ME DROP I WATER LEA L-INCHES RATTER INCH ES ,4UMBER MtfE"Vg AFTERI SWELLING INTERV L-MIN. -PERIOD r1c 7 r 9 I +.OT PLAN: Show locations o4 percolation tests, soil •gorings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- •mal end vartical elevation reforance point; and show their location on the plot plan. Show the surface elevation at all borings and the direction and percant-_ I land slope. - ~ , NSTEiM ELEVATION t N'. kip 40j' d r P11l ! e S E A Llkle ' w ~!kP v• as ~S V ~ I I t I. Lot, N :IP Ile the undersiUriie.i, herahy carufy than ti ,dministrative Coda, and that 11.3 dapl jdcordad and the to rect to the best of my knowledge and belief. JI LAME pri t {J,( TESTS WERE COMPLETED ON: r %DDR&SS ~y CEgpT-IFI r.I N t BER: PHONE NUMBER apt QAd CST SI U rr= AN: Original and one copy to Local Authority, Pro pa r and Soil Tester. r + 395(R. 02182) -OVER - , /y S N dr_ . yc NE COR. SEC. 3 4 372 A r I ok. 595.27 ~ , ~ • c/ w 10 U0 T 3 f! s`yA s N fb 372 E EVE V4 /V 114 w o I < LOT 2 'i h ~f 3 72 C 1[1 f > 592.33' N I LOT I i " 3726 x' , 3 1 FORM NO. 985-A M.GMillr.r Wnpyry® ~ 2 FILED JUN `51979 } JAMES O' CONNELL 1.~ tt d R~pbtr of Deeds Wluonsin ' 8 SR Goix ty C, CERTIFIED SURVEY MAP NE CORNER SECTION 34 T 3ON, R19W COUNTY MONUMENT N 1/4. CORNER FOUND P.K. NAIL FOUND NORTH LINE - NE 1/4 S 88°45 3111W w 668.401 N IL) LEGEND M - i U_NP_L_ATT_E_D LANDS_ in O 0-.7511 X 2411 IRON BAR WEIGHING i NOTE: ENCROACHMENT TO BE REMOVED M 1.502 LB8'./ L.F. SET I cn i ; N 88° 451311 E POINT OF +-SECTION CORNER, BERNTSEN CAP I BEGINNING I 421 90 595.27' o~ )E EXISTING FENCE BARN I N L0 HOUSE❑ N V_ OD N SCALE IN FEET I N 3.936 ACRES I 3 0 100 200 300 400 i I CD ;I- N 88° 4513111 E NE -NE I t _ 597.331 1 O c~D 1 z of I U') V)l zl I 421 S89°11'1211W m pi N Q~ i Q 8.001 C6 ZI JI QI 0000 rro J I O 0 (D ~ I 501 ° 5.676 ACRES It p I w o, I = O co w Z~ H! I N N w w i I DD F- ww ~i I Y to z M a' LL. Z ci i Z J W I N 8804513111 E V) a' 3 1 ~~.w m I I I ~ 3 592.331 z o'N`~ ~ ~ o I ~ w ro co ~ x m Jo F- O 0 Lo N O N Z Z N c/) (A CD 0) Q m Lu I I N w 4.000 ACRES N D X. N = W I U o SOUTH LINE OF NE-NE RF I h a ~ m I 501 00 314.921 I I I S 89° 0115011W 594.441 I I NOTE: EXISTING FENCE TO BE REBUILT ON 1/4-1/4 LINE I I I I I 1 UNPLATTED LANDS E 1/4 CORNER THIS INSTRUMENT WAS DRAFTED BY I 3/411 IRON BAR SCOTT B. LOHMAN FOUND APPROVED Jai N 21 1979 ST. CROIX COMPREHENS1v: AND ZOr11;JG COMMIrue APPROVAL OF THIS MINOR SUBDIVISION DOES NOT MEAN APPROVAL FOR BUILDING SITE OR SEPTIC 5 OVAL ySTEM. REFER TO H62.20. Vol. 3 Page 81.6 Description r A parcel of land located in the NE-1 of the NE-1 4 of Section 34, T30N, R19W, Town of St. Joseph, St. Croix County, Wisconsin, described as follows: Commencing at the NE corner of said Section 34• thence S 88045'31" W (assumed bearing referenced to the East line of said NE,, bearing assumed S 1013'32" E) 668.4o' along the North line of said NE4; thence S 1013'32" E 305.15' to the point of beginning; thence S 1013'32" E 998.90' to the South line of said NET of the NE-41; thence S 89001'50" W 594.44' along said South line to the East right-of-way line of present County Trunk Highway "I"; thence N 0048'48" E 548.80' along said right-of-way line; thence S 89011'12" W 8.00' along said right-of-way line; thence N 0048'48" W 447.25' along said right-of-way line; thence N 88045'31" E 595.27' to the point of beginning. Subject to easements of record. Containing 13.612 acres, more or less. I, James E. Rusch, registered Wisconsin Land Surveyor, do hereby certify that I have surveyed and mapped the above described property; that such plat is a true and correct representation of the exterior boundaries of the land' surveyed; and that I have fully complied with the provisions of Chapter 236.34 of the Wisconsin Statutes, the St. Croix County Subdivision Ordinance, and the Town of St. Joseph Subdivision Ordinance to the best of my professi-)nal knowledge, understanding and belief. James E. Rusch Wisconsin Lan;#lrs rveyor -137." Stevens Engin ,Inc. 1409 Coulee Road - Box 321 Hudson, Wisconsin 54016 May 1, 1979 This map is hereby approved by the Town Board of the Town of St. Joseph. - (Date) wn Clerk Owners & Subdividers: Albert & Lois Reller Rt. 2 . Hudson, WI 54016 J ~ • r JAVEC L . rte. R~J -i w x S-13'u 1 River Fali s IS, Wis. • < W'06660 N~ SU RJR one ~/tf t1ttON~~ Volume 3 u16 .9 s v J i W. S T C - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER ~t A/~~~ ADDRESS &1157 FIRE NUMBER 2- 7 CITY/STATE 14 V ZIp S✓~' ~✓Z PROPERTY LOCATION:/VC 1/4, W16-114, SECTION 3/ , T N-R_ff__W TOWN OF ___J St. Croix County, SUBDIVISION cs m 3 5" 7 ?d 3 LOT NUMBER 3 . 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 after inspection and (2) 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 ffice within 30 days of the three year expiration plat ' r SIGNED: DATE : L j St. Croix co. Zoning Office 911 4th St. Hudson, WI 54016 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 owner/contractor,(spec house), thensa 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 ajiffff Y64-,~a2~ Location of property ivc 1/4 y~ 1/4, Section ?/V, TIC N-R L/ W Township Mailing address 3 41-4s 7- ,Ate&A/ ± /$rv - S S 3 Address of site 0-?. 3.. ff!~t- ' 5 OAf6 , e7 Subdivision name ` 1111 ' 35__77 7f 6/3 ~LOt no. . 2Z Other homes on property? °yes ~ No Previous owner of property l Y1~ P Total size of parcel 5 - 76 kot3/V P X16 Date parcel -was created Are all corners and lot lines identifiable? =Yes No Is this property being developed for (spec house)? Yes yNo Volume X633 and Page Number yg 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. Sig t e applicant C app cant Date of Signature Dat6 of S ature nocu~-m NT NC,) WARRANTY DEED IFIIED 111? R!. L]1•IC: DATA e STATE RAIL OF WISCONSIN FORM 8-1982 j : 5,.523 ' 1073Ms 2 9181 Ted.d 0. Dr_en th and Tami J,. Dr.en th, CT. Ct;CX CO., W t:. husb,and._and- wife, Pas:'dforF:,wrd APR 11 199 convey, and warrants to Jeffrey. S. Wallin, a single. ~ 10:3x0" A.'~ ~ person, V _ . . - t 4 ` fia~Ia,or of Das:'li the following described real estate in . (01- (County, - 9; State of Wisconsin: Tax Parcel No: Part of the NE1/4 of NE1/4 of Section 34, Township 30 North, Range 19 West, 'St. Croix County, Wisconsin, described as follows: F Lot 2 of Certified Survey Map filed June 25, 1979, in Vol. "3 page 816, Doc. No. 357779. ALSO, part of the NE1/4 of NE1/4 of Section 34, Township 30 North, Range 19 West, St. Croix County, Wisconsin, described as follows: Commencing at the NE corner of said Section 34; thence S101313211E 559.69 feet to the point of beginning; thence continuing S1013'3211E 747.53 feet to the South line of said NE1/4 of NE1/4; thence S89001'5011W 668.4 feet along the South line; thence N101313211W 711.35 feet; thence N88045'3111E 668.4 feet to ? the point of beginning. 0 30 3 4) 00 This -_-Js not homestead property. XXXX (i,s . not ) Exception to warranties: Easements, restrictions and rights-of-way of record, if any. Dated this Y day of 19 94. (SEAL) (SEAL) - ' _ - T 0. Drenth (SEAL) (SEAL) • Tami J. Drenth y7 a' AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN 4 ss. A. St-•---Cro-1X--- _.Count}'. authenticated this day of------ 19 Personally came before me this day of 1991... the above named r .--Tedd_.9..-..Dr-ent_h-_and Talui.-J.___.... Erenth,--hus.h3_nd---and -wife.,-------- - TITLE: !MEMBER STATE BAR OF':ISCONSIN - - (If not- - - _ -----/.Rl-.Wf-_. - authorized by 706.06, Wis. Stats.) b-§ to nie known to he the person9lffct 1~. c the fore ng trument , . ncknow p~ j~q[~tlc THIS INSTRUMENT WAS DRAFTED .1 i Kris-tin-a- .Qgland. - Alice.- Jo - - y CoI nors Attor Ic - - y At Law - - Not:r Public Cour.!v, Wis. (Signatures may be authenticated or acknowledged. Both My COmmiszJon is permanent. (If not, state exp ration are not necessary.) date: - •Names of pers...^.B si8ning in any cat.,.,-ity sh-'d be t3;,,,1 - Printrd h-1- thy.`- 8 :=r~rea. WARRANTY DEED RTA - N' 1 ~ n ~ ST. CROIX COUNTY WISCONSIN - t ZONING OFFICE o x n n x x x■ ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road - - Hudson, WI 54016-7710 (715) 386-4680 November 30, 1994 Jeff Wallin and Becky Schneider 1273 County Road I Hudson, WI 54016 RE: Septic Inspection for Jeff Wallin and Becky Schneider Dear Mr. Wallen and Ms. Schneider: An inspection of the septic system for Jeff Wallin and Becky Schneider property was conducted on November 1, 1994. This property is located in the NE; of the NE, of Section 34, T30N-R19W, Lot 2, Town of St. Joseph, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a three (3) bedroom home. If you have any questions with regard to the above, please do not hesitate in contacting our office. Sincerely, I ~ Mary enkins Assistant Zoning Administrator js r N N O O N O O t! ti Q d04 E09 Q GFY d09 h Ol i N O ~ C C ~Y O O N N V= (D N C - C 0) L c y t C O O N O) L N L C y O _2 4)U) 0) N ~ S N a)L N ,U C ~ N sL N U c O O CD M Q) CU CL (L) 4) ELL m a 3Y c ° a~~ 3Y c ° a~ c° Y _ a° ~T x Iwo € ~~o T°?cn ?i€ y o 3~ c'?v3 y o 3~ c v c c "a J 4) 0- to ~ 0- y ~ ~ y ~ ow 0 m 0 G y > y C ° J FL N C fA U 'D -,D.- ° J . N C cn V 01 N N Y € N l6 N T N 5 c0 N (D Y € m d T4) f0 N C! C° a` c N L Q.L. C~ O cc - y C L o :S 0) C cp o d'O Y u 0) CD > (D CO 3 C N - aNi pE E~N wf6 aait> m oyE `c 1°aait>2 I 0 r- Co 2 8:2 -5 z :3 r- co =0 -0 z 8 U) 'a .0 CD . 0 .0 c .0 a) L~ 75 4) V Lo LL mc D O O M OO C 7 E a o 0. O' E M O)~ C= E a 0 a .0 :3 O ~ ° f0 :2 V to C'O 3 ~oh c o€ a) a) cc ooh o c Q w Lai m L o 00 n W r°. c a t Q m r- U d m c a- I 3 M I Z E O Z r 00 Z d y ~C°.,w am c') H Z 0 0 o z a c w w o y a°i Z 16 1 ° c c z v E '2 C ` M c aai O y L 0 L O a ~ O o Q Z1-z z z 00 R E N N O N CD a MI ed~ a~L 3 0 3 s j G G C a o c 76 ° °c c Z N> O = L C L C w (L > > Z CL D Z CL (L a. cn ~i a o co J V 20) 0) 4) Z 4) Z v v 'mil ! .0 N O N O O 0 80 Q E 0 0 O d > > N N O (L co (A r- v m y a~ Q rn ) 00) rn Q M ~ w Q ~ ~ Q Y in z Cl) ca Q~ CO z in 0 1~ O cJ y~j y °0 3: 1-- w e E E Q 6 F- 04 warn m ~a0l c rn c M M .C N c C lc6 N C C N V O p +-O N 7 C ° y O d O Ca N O O co SN N' C7 C N vl O Z E C L • O co (n N 04 O Z C d fn z C 0. r2 fn ' :R E V1 d € a a a 0 CL ~~`Iwv E c c -1 A Vat i0 aiU i0 . 'I~I' FILED 60 s JUN 2s 1979 y~ ~ A's O' CONNELL ~ ST. GROiX COUNTY aftmw of Deeds SURV R,S RECORD aR Cy, 8 wk=min CERTIFIED SURVEY MAP NE CORNER SECTION 34 T3ON, R19W NI/4 CORNER COUNTY MONUMENT FOUND P.K. NAIL FOUND NORTH LINE - NE I/4 S 88°45' 31"W yIv- 14 w 668.40' N - LEGEND- i if) L_A_N_D_S- ih O 0-.75" X 24" IRON BAR WEIGHING I i NOTE. ENCROACHMENT TO BE REMOVED M 1.502 LB9./L.F. SET i I cn 1 i N88°45'31"E POINT OF -SECTION CORNER, BERNTSEN CAP I 42' $ 595.27' Ob BEGINNING ri+r-~r V EXISTING FENCE I a~~ IIII'~~~~ BARN F O~ I 0 1 ti f t~ HOUSE❑ 3 CALE IN FEET I N N S 3.936 ACRES 0 100 200 300 400 I 3 It N88°45'31"E -NE-NE I 597.33' 0 1 z c~ V6 `Y-►J1 zl 1 42' m S89°11'12W 1 pL / ~ o~ N ; a 8.00' 06 a ~o o I = 50 5.676 ACRES w CI I O w Z.Z I- I N N W C QI 1 d r f'I ww JI I In 2 M li z 0.I I Z J S_ J I a N88°45'31'E In ZI Ot 1 A w u, xw =)I I iv I co u. 592.33' zOM 1 et O it w ; co <Z0 0 m N I O fV p cy LID z <Z I O I z a 4.000 ACRES ~m" p cr 1 o Bo mw< V) = W I U a 0 SOUTH LINE OF NE-NE ° I h F~ a I- m I 50' 314.92' 279.52' `h9o I I S 89° OIS0"W 594.44' I II 2NOTE EXISTING FENCE TO BE REBUILT ON 1/4 -1/4 LINE I I I I I I i { UNPLATTED LANDS E 1/4 CORNER THIS INSTRUMENT WAS DRAFTED BY I ~ 3/4" IRON BAR SCOTT B. LOHMAN FOUND APPROVED ~N 21 1979 ST. CROIX W COMPRIHENSIV. 0,A'eKS 1'LAN,JIN* AND ZO'-'"G COMMITTEE APPROVAL 01 11115 MINOR SU6DIVI SIGN Q DOES NOT MEAN gppROVAt BUILDING SITE OR SEPTIC SYSTEM. FOR REFER TO H62.20, Vol. 3 Page 816 A ST. CROI X COUNTY WI SC0 N S I N S 1 ZONING OFFICE At'' 796-2239 (HAMMOND) 425-8363 (RIVER FALLS HAMMOND, WI 54015 August 24, 1983 Division of Safety and Building Bureau of Plumbing P. 0. Box 7969 Madison, WI 53707 Dear sir: An on site investigation for the Louis Volrath property located at the NEB of the NE14 of Section 34, T30N-R19W, Township of St. Joseph, St. Croix County, revealed suitable soils at a depth of 2.2 feet, below which seasonable high ground water was noted. This site should be suitable for a mound system. Should you have any questions please feel free to contact this office. Yours truly, Thomas C. Nelson Assistant Zoning Administrator TCN:mj STATE OF WISCONSIN-DEPARTMENT OF INDUSTRY, LABOR 6 HUMAN RELATIONS DIVISION OF SAFETY 6 BUILDINGS - BUREAU OF PLUMBING P.O. BOX 7969 - MADISON, WI, 53707 APPLICATION FOR THE USE OF AN ALTERNATIVE SYSTEM Location: Towns hip/K64M 4Y-W. X NE~1 NE~[S 34 T 30 N/R19 Xgc("~W St. Joseph St. Croix Street Address: Subdivision: County: Landowners Name: Mailing Address: Louis Vo_lrath c/o Earth Sheltered Homes,St.Croix Fall I (We), the undersigned, hereby make application for an alternative system on the above-described premises. I recognize that the above premises are not suited for a conventional private sewage system. If approval is granted, I agree to have the system installed in conformance with the Bureau's approval of plans and specificationd. I further understand that an alternative system 13 more complex in nature than a conventional private sewage systen and as such will require detailed inspection during construction and monitoring after the system is put into use. I agree to permit both county officials charged with administering county sanitary ordinances and Bureau employes or other authorized persons to have access to the above described premises at any reasonable time for the purpose of inspection the construction of or monitoring of the system. I further agree to either personally or by my agent contact the proper county official to arrange the time and date to begin construction of the system. I understand that this application does not permit me (the applicant) or my agent (the contractor) to begin installation. If the,system is approved, the Bureau will send the applicant a letter of approval which authorizes construction of the alternative system after all necessary permits have been obtained. I agree to give notice to any subsequent buyer that an application for an alternative system has been made and if installed, that the premises are served by an alternative system and further agree to give the buyer a copy of this application. The Bureau accepts this application subject to this understanding and subject to all the conditions and obligations set out in this application. Signature of Applicant Date STATE OF' WISCONSIN Subscribed and sworn to before me SS. COUNTY OF This day of 19~ Notary Public, State of Wisconsin My Commission Expires: DILHR-SBD-6413 (N. 05/81) WISCONSIN DEPARTMENT OF INDUSTRY, LABOR AND HUMAN RELATIONS DIVISION OF SAFETY R BUILDINGS, BUREAU OF PLUMBING P.O. BOX 7969, MADISON, WISCONSIN 53707 Verification of Exception Status for an Alternative Private Sewage System In the County Of St. Croix Loc at i on NE 1/4, NE 1/4, Sec. 34 T 30 N, R 19 L(XWXW Lot x st. Joseph Street Address 2 661ock Subdivision er' Louis Volrath The application for this site is for: new construction use. ❑ replacement system use. If this is NEW CONSTRUCTION USE, the alternative private sewage system is: IX-1 to have one of the first five approvals guaranteed for this year. This is number - - of those applications. (Use one of the first five quota num&ers i ssue-l-tu you. ) one of the application~gneedlp a v ota number. The quota numher assigned to this application is - - ~..1for one additional homesite on a farm to he occupied by a parent, child, grandchild, sibling, niece, nephew, or first cousin. ifor an individual lot for which a sanitary permit was issued but was later ruled unsuitable due to new or changed soil criteria established by the department. 1-1for an application on file prior to February 1, 1980. [Afor a lot that meets the criteria for a conventional private sewage system. If this is a REPLACEMENT SYSTEM USI:, the alternative private sewage system is replacing: a failing conventional soil absorption system. L__Ja holding tank that was installed and in use prior to February 1, 1980. E a privy that was installed and in use prior to February 1, 1980. If this is a REPLACEMENT SYSTEM USE and the lot meets the criteria for a conventional private sewage system, check here.1_1 I certify that the above information is true and accurate to the best of my knowledge. Thomas C. Nelson Signature Nane County Official Title Assistant Zoning Administrator Date August 24, 1983 DILHR-SLID-6158 (R 12182) - - PArRTMEN-I UI ~l REPORT ON SOIL BORINGS AND SAI-L I Y 8t U DIVISION jDUST.HY, BOX -~110R AND, i PERCOLATION TESTS (115) MADISON W 5370 JMAN RELATIONS (H63.090) & Chapter 145.045) )C A/ A I )ON ST TRSTN- OWNSHI MU ICIPALITY: OT NO.: DLK. NO.: SUBDIVISION NAME: T30 N R/ E (or A P ,)UNTY: 5WiVEIi1S7lf0rn'S NAME: r _~...L~~ !1._841 I ~ l rII ~ ~ ~ P ~ y c:; , /P S t ^ DATES OBSERVATIONS M DE Gd NO. BEDR COIV1T)11 L`RIPTIO PRA11Erl5E~OFilpl`f S: S: ;Residence New OReplace / .r 93 1/ A A' f ,STING: Sm Site suitable for system U- Site unsuitable for system IVVENTIONAI.. MOUND:- IN-G~OUNDPftESSU SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) -IS E/A I VAS CCU '~u EIS EIS ®V l r Pe,colation Tests are NOT required DESIGN ATE: If any portion of the tested area is in the der s.1-163A9(5)(h), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS )RING TOTAI. R-INCHFS CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH ~AAHER D[.rrW QDSERVED BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) S . , A N , n, L 04 Ay V?%~k ljL T--,.7 TP ,v 4 .7,' 9' /V 7' s r; r: tea. S Gr l _I fi 0 tip 3.0 00 ,v L i yr I/ dN i/ I rFAn f ) i GT~.'~, 7A.~C , 415 mod- • 5 A' SZ, W, i V/ Nt9/b a' S - /lrl c . ia7 7 ~ . 1~7 0' PERCOLATION TESTS TF-,Tf- C7f_PTHN~ WATFR IN HOLE TEST TIME DROP IN WATER LEVEL-INCHCS RATE MINUTES ,UMBER rraCrrt^s AFTf_N SWELLING INTERVAL-MIN. _P PER INCH L? 951 0 OT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe whet are the horl- ral and vertical elevation reference points and show their location on the plot plan. Show the surface elevatio all borings and the direction and percent land slope. YSTEM ELEVATION 7o R_ f - oe 4- ~I %s r6 is 4.1 N, P fry n p 2 - - w -01 i I - the undersigned, hereby certify that the eats reported on this o m were ma me in eee s pro r s 71713 In ins Micconlin-1 iininistrativu Code, and that the data recorded and the location of the tests are correct to the best of my knowledge Ond belief. AMF prii r TESTS WERE rr4MPLETED ON: p ` 3 i DR CERTIFICA I N INJUMBER: PHONEc_NUMB R optional): .-IS 5"1 S SI U :I iSTRIBUTION: Original and one copy tj Local Authority, Property Owner and Soil Tester. ILHA-SBO.6395 (R. 02/82) OVER -