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STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER
//rte~, ~,/,r/• ~i
ADDRESS7~~`
SUBDIVISION / CSM# d y C .~%~l LOT #
SECTION 2-1_T-!;~' ) N-R 1'r W, Town offj~,?~_s
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
Sy~f'7
oar
wG
R~
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
r
BENCHMARK. C2 S e-1 5-
ALTERNATE BM:
SEPTIC
TANK PUMP CHAMBER HOLDING TANK INFORMATION
Manufacturer: ~f«•lA~T N Liquid Capacity: Zc~~
Setback from: Well Z"- ,`lebuse S Other
Pump: Manufacturer f,1 Model# Size
Float seperation Gallons/cycle: ZS-.X
Alarm Location
SOIL ABSORPTION SYSTEM
Width: Length Number of trenches /
Distance & Direction to nearest prop. line:
Setback from: well:~`HIluse/D Other
ELEVATIONS
Building Sewer ST Inlet. ST outlet
PC inlet PC bottom Pump Off
Header/Manifold Bottom of system
Existing Grade Final grade
DATE OF INSTALLATION: J~
PLUMBER ON JOB:
LICENSE NUMBER: -~Z
INSPECTOR:-
3/9 3 j t
:
Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County:
Labdeand Human Relations INSPECTION REPORT ST. CROIX
Safety and Buildings Division
(ATTACH TO PERMIT) Sanitary Permit No-:
GENERAL INFORMATION
Town o : State Plan o.:
P FINK,de DONNA: & RABFDY WITTHUS City [I Village R
CST BM Elev.: Insp. BM Elev.: BM Description: St Joseph Parcel Tax No.:
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
Dosing
Aeration Bldg. Sewer
Holding St/ Ht Inlet
TANK SETBACK INFORMATION St/ Ht Outlet
TANK TO P/ L WELL BLDG. Vent to ROAD Dt Inlet
Air Intake
Septic NA Dt Bottom
Dosing NA Header / Man.
Aeration NA Dist. Pipe
Holding Bot. System
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand
Model Number GPM
TDH Lift Friction System TDH Ft
Head
Forcemain Length Dia. Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Liquid Depth
DIMENSION DIMENSIONS
SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
SETBACK CHAMBER
INFORMATION Type O Model 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
!n
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
I
COMMENTS: (Include code discrepancies, persons present, etc.)
3._-
j3, LOCATION: St. Joseph. 34 . 29.19W, SW, SW, Lot 4, County Road~~
x1x
Plan revision required? ❑ Yes ❑ No
Use other side for additional information.
SBD-6710 (R 05/91) Date Inspector's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
3
e
SANITARY PERMIT APPLICATION
In accord with ILHR 83.05, Wis. Adm. Code o
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than 1:1 Z4 Q)
81A X 11 inches In SIZ@. Check if revision to revious application
-See reverse side for instructions for completing this application. STATE PLAyN I.RX i UMBF„8
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. J~''~(f1(~ U ?~1C~
PROPERTY OWNER PROPERTY LOCATION
GJ Y.Sk,1 Y., S,-? T a N, R E (or)
OPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
444/,4, 4/ c 5'M
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
II. TYPE OF BUILDING: Check One CITY NEAREST ROAD
( ) ❑ State Owned 0 VILLAGE' 0 TOWN , _j el,~9
❑ Public Ud1 or 2 Fam. Dwelling-#of bedrooms PARCEL TAX NUMBER(S)
III. BUILDING USE: (If building type is public, check all that apply) O
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
40 Church/School 80 Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 90 Office/Factory 130 Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. Q New 2. ❑ Replacement 3. ❑ Replacement of 4.0 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 ❑ Seepage Bed 21 ® Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In-Oround 42 ❑ Pit Privy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
14 ❑ System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE
REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION
19~s"6- / - lle 1l' SYJFeet l~ -d Feet
CAPACITY
VII. TANK Site
in allons Total #of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper.
INFORMATION New istin Gallons Tanks oncrete glass App.
Tanks Tanks structed
Septic Tank or Holdin Tank 60 r- A7 Gt'ale F-1 I R n F-1 F
LiftPump Tank/Siphon Chamber ~®d L
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: (N Stamps) PRSW No.: Business Phone Number:
Plumber's Address (Street, City, State, Zip Code):
G c ~
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing A mps)
, charge Fee)
Approved ED Owner Given Initial (ya
Adverse Determination Ca
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398(R.08/93) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
a
INSTRUCTIONS -
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new
criteria in the Wisconsin Administrative Code will be applicable.
3. All revisions to this permit must be approved by the permit issuing authority.
4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be
submitted to the county prior to installation.
5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed
pumper whenever necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code administrator or the
State of Wisconsin, Safety & Buildings Division, 608-266-3815.
To be complete and accurate this sanitary permit application must include:
1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of
where the system is to be installed.
II. Type of building being served. Check only one 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.
SBD-6398 (R.11/88)
SAFETY & BUILDINGS DIVISION
State of Wisconsin
Department of Industry, Labor and Human Relations
August 25, 1994 ZUl East Washington venue
P. 0. Box 7969
Madison WI 53707
ULBRICHT & ASSOCIATES
ROBERT ULBRICHT
655 O'NEILL ROAD
HUDSON WI 54016
RE: PLAN S94-03393 FEE RECEIVED: 180.00
FINK, DONNA
SW,SW,34,29,19W
TOWN OF ST JOSEPH COUNTY OF ST CROIX
MOUND SYSTEM
The Department has reviewed the above-referenced submittal.
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.
1 Sinc y,
e r Page
Plan Reviewer
Section of Private Sewage
(608) 266-2889
SBD-8423 (R. 81/81)
ULBRICHT & ASSOCIATES CO.
655 O'Neil Road • Hudson, W1,54016 Reg. Designers of Engineering Systems
715-386-8185 Private Sewage Consultants
~,27 cam/ c~~
PROJECT INDEX
DILHR Plan I.D. # S94-03393 Date 8-25-94
Owner Donna Fink/ Randy Witthus Phone 612-653-7597
Address 4691 Allandale Dr. White Bear Lake, Minn. 55127
Legal Description
Lot 4, CSM Pending. 13.51 acres. SW 1/4, SW 1/4,
Sec. 34, T30 N, R19W.
Town of County
St - jos.epj~- St. Croix
C.S.T. Robert Ulbricht CSTM2482 Installer
Local Authority/ Supervision
St. Croix County Zoning Dept. 'I
PROJECT DESCRIPTION
New construction, for a 4 bedroom sized home.
Estimated daily wasteflow: 600 gals.
Soils are permiable (.4 GPD/ft2
but very restricted below
25" because of very firm, almost massive soil consistency. Soils
are seasonally saturated in this region. A very long narrow
mound system, curved to match the convex slopes is proposed.
The mound will require 12" of sand fill.
Y AUG. 2 5 1994
Pg .1 . PLOT PLAN VIEWS
Pg.2 SYSTEM CROSS SE ONS & SYSTEM PLAN VIEWS
Pg.3 PIPE LATERAL LAYOUT
PgA DOSING CHAMBER CROSS SECTION I
n"M
Pg .5 PUMP PERFORMANCE lp~iON.0
SPECS
~y9a~,,~'S I G~~
ntnntnnnunno~~
S94-03393
0
v
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0
~ovvp sukvEya,PS ~ /`~G~~S~E" ~ - /3.v1 SET Top
sp err T
PREC~rs T
SE-pTi c TANK
T Yom} el IDS
o 4 60
New 0 to
PREe t5 T , 00
Tors[. OF
L ECEIVED
a
AUG 2 5 19%
72, -AU OF BUILDING
SURE
WATER sysTEUS
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B,5 fe'•F6~ 594- 033 93
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ROSS. SECTIOQ OF MoUAJD wi Ttj aeD
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j I y A55Eg-5ATE'
1~t ST Ri(3uT~oa
G, TNicksFSS pip sysr~M
Of T°PSOiL elcvArio,J
V)Ji FO`2M Toe- ,1, 11 H k, 102.5u
%
ROO MED. 1B • 9
SAwD ,
plowEl~ To p Soy
i
uN FORM
8 % SIOPE FoRcE EIEVA Boa U)jDER
MAW
101.50'
1.0 FT, - F-LEVATloa S
F 1.5 FT. • lmvF-R'r OF 1 1/4" )AT£RA (S 103.0
F _ Rn FT-
• Top of Rock lo~.~oG 1 . o FT•
H 1.5 FT• • TOP OF- 1 1/4" IATERAIS 1
a•
!e A1t,. OF MOUJJD wir" 13ED
:k
ytiy
FvRcs: MAW
6.0 FT•
I k 'f I 4 85 Fr
.kn
T 17 Fr
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C3e~ of ~i
PVC CAPpEp A I ~-u 53 PEI ATE'
0BSERVArtOki AUG 2 5 1994
Pipes
BUREAU WATER SYSTE S
PERNMAas WT M A2 KERS
RECO RED BASAL Ageh = 'PAI'~y whSrFF'low - hnn 15 0
SolL. o#xfilnQA- of •
C ApAci ry SQ. Fr;
PROPOSED BASA4 AReA = X (A t 1) S94• O33 9a
\ 195 5
8 5 X ~6 • t 17 1
CP-uTRAL, MANi FO p DiSTRt'BU TIOAJ pipe uerwoP. k
P 1
1
PVG CENTRAL Di5'tR►13UT1013 LATERAIS i
MAN%Fot0
ENS CAP S
I Ir-+ X x
1( x i (pUG FORGE
i
LAST "O1E S HA ll C3E
NAT TO END CAP FT.
09 01 D Vo j UM E FOR 25
dF 2" FORCE MAiI3 4.1 gAl<
XavERT' E IEVgno&)
A1~~ 2 51994
PERFORarrED PIPE DErAi L
Holes 10CATFD Dx3
G .G,-r ram S H A 1 t BE'
`I VARiAQL.E `.y V hlly SPACeD.
I Y z..
P 41 Fr DI Ahe Te R 1/4 ~N .
L ATERA L 1 1/4 ~N
R 36" '
MANI Fo~D 2 IN
60 ~NchES Foecr MAik)
Y 42 II~1 cl~E S OF IWE5/ P i p ff 9
DISTRi (3UTIoN DNSCHAR&e RATE PER LATERAL 10.53 GAf
TOTAL TISGtiAR C,E RATE / NczrwOR k 42.12 GrAL, / wo ,
S94- 033 93
ope~ . 3 04 5
i
i
i
PLIMP CHAMBER CROSS SECTION _AR1D SPECIFICATIONS PA E of S
VENT CAP
4"C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING
7 JUIJCTIOW BOX MANHOLE COVER
25' FROM DOOR. 12"MIN. w/ 4iAgN1~(! IW I
WINDOW OR FRESH
d AIR INTAKE
S~AD~ ~~EU~►T/On/ ' GRADE I y°MIiJ.
zls
IB"MIN.
104.0' CONDUIT
5.0'
99.01 INLET PROVIDE I
I
-7
APPROVED JOINTS
APPROVED JOINT A ~N ( W/C.I. PIPE
W/C.T.. PIPE 0
'f( J I A RM EXTENDING 3'
EXT_NDI',G 3' ~0 ONTO SOLID SOIL
01JT0 LuLID SOIL B 95.7
3.3' ~ON
C
ELEV. FT
OFF
BLOCK
H
t,6-VA fio
95..45' RISER EXIT PERMITTED OIJL4 IF TANK MANUFACTURER HAS SUCH APPROVAL
SEPTIC E 5PECIFICAT IOKJS
005E
TANKS MAWUFACTURER: Midwestern Precast IJUMBER OF DOSES: 4 PER DA-4
TAWK SIZE: 1000 GALLOMS DOSE VOLUME
INCLUDING BACKFLOW: 154 GALLONS
ALARM MANUFACTURER: S -1 E1 rt n
MODEL IJUMBER: 101 HW 120V CAPACITIES: A=16 INCHES OR 400 GALLONS
SWITCH TYPE' M r'n rg Float B= 2 INCHES OR 9_ GALLONS
PUMP MANUFACTURER: _Rol 1 Pr ('n _ r-= 6.2* INCHES OR 154 _ GALLONS
MODEL NUMBER: CIR 1,l2KP 119V D=15-8 INCHES OR 'AQ GALLONS
SWITCH TYPE: Pigayhack Mexcur+ shat NOTE: PUMP AUD ALARM ARE TO BE
MINIMUM DISCHARGE RATE 45 GPM INSTALLED ON SEPARATE CIRCUITS
VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPER 0 FEET -rAok TPECS .
+ MIAIIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . 2.5 FEET 6AG(A, 1 0~'
+ 25 FEET OF FORCE MAIN aZ_FyoFtFRICTIOU FACTOR.. 22 FEET
- - 25 ~A>'s•
TOTAL 09MA.MIC. HEAD = q- 32 FEET
INTERNAL DIMEMSIONS OF TAWK: LENGTH 8'7° ;WIDTH h' 1 " ;LIQUID DEPTH
hz%ovmlVE
i
A 21 St ~ 594-0339_2
BUREAU 01F I IL.00 4
rri '
.ld HEAD CAPACITY CURVE 3 7/8 6 1/4
MODEL "98"
30
t 4 5/8
25 f3 I t
Q 3 5/8
'I l~7 6 20 m
O + +
15 4 3/16
4
i. 0 10
1 1/2-11
2 1/2 NPT
:I
5 -
OwAft 4 E 1)
0 6CLLOFW14
U.S. GALLONS 10 20 30 40 50 60 70 BO f>t C
LITERS AUG L Q4
80 160 240
FLOW PER MI14UTE OF V ; eqnpmG
I
TOTAL DYNAMIC HEAMFLOW PER Y'r,UTE
: , EFFLUENT AND DEWATERING
i _
7
.I CAPACI'i Y 12
~
HEAD UNITS/MIN
~i
' FEET METERS GALS LrRS 1
5 7.52 72 231
10 3.05 fit 73t -
15 4.57 45 it0
20 6.10 25 05 - 3 5/16
dr
Lock Valve
t
CONSULT FACTORY FOR SPECIAL APPLICATIONS
4 Electrical alternators, for duplex systems, are available and • Mercury float switches are available for controlling single and
supplied with an alarm. three phase systems.
Mecthanical alternators, for duplex systems, are available with or . Double piggyback mercury float switches are available for
without. alarm switches. variable level long cycle controls.
rf
p,
F+!
SELECTION GUIDE
Standard all models -Weight 39 lbs. - I/~ H.P. 1. Integral float operated 2 pola mechanical switch, no ex1omal control required.
- 2. Single piggyback mercury float switch or double piggyback mercury, float
98 Series Control Selection switch. Hefei to FM0477.
Model Volts-Ph Mode Am s Sim lex Duplex 3. Mechanical allernalur 10-0072 or 10.0075.
M98 115 1 Auto 9.0 , 1 or 1 & 7 - 4. See FM0712, for correct model of Electrical Alternator, "E-Pak".
715 1 Non 9.0 2 or 2 & 6 3 or 4 5 5. Mercury sensor float switch 10-0225 used as a control activator, specify
098 230 1 Auto 4.5 1 or 1 & 7 - duplex (3) or (4) float system.
6. Four (4) hole "J-Pak", junction box, for watertight connection or wired-in sim-
"E98 230 1 Non 4.5 2 or 2 & 6 3 or 4 & 5 plux or duplex operation, 100002.
7. Two (2) hole "J-Pak", for watertight connection or splice.
I CAUTION
For information on additional Zoeller products refer to catalog on Combination Starter, FM0514; All installation of controls, protection devices and wiring should be done by a
quali-
Piggyback Mercury Switches, FMO477; Electrical Alternator, FMO486; Mechanical Alternator, fied licensed electrician. All electrical and coley codes should be followed incfud-
FM0495; Alarm Package, FM0513; Sump/Sewage Basins, FMO4e7; and Simplex Control Box, ing the most recent National Electric Code NFC) W y
. FM0732. t+ ( and the Occu lionil Safer and
aahh Act (OSHA).
RESERVE POWERED DESIGN For'unusual conditions a reserve safety factor is ernglneered into the design of every Zoeller pump.
MAIL T0: P.U. BOX 16347
t' Louisvd; , KY4 0256-034 7 Manufacturers of...
Q SHIP TO. 3280 Ot' P.4ii;rrs Lane t~ n
Louisville, KY 4,,::16 QG.4I/7Y LIMPS s INCE
(502) 718-2.731 « FAX (*502)114 3624
7Tryr-9Yt-....,, _
S94= 033 93
Wisconsin Department of Industry, SOIL AND SITE 'L U
Labor and Human Relations E Page ! of
Division of Safety & Buildings in aCCOfd with I
L iR'03 0;,,.W,ts Adm Code
COUNTY
V4g61
Attach complete site plan on paper not less than 8 1/2 x 11 inched h size. Plara mast include, butt
not limited to vertical and horizontal reference point (BM), direction%aatf ,Yo o slope,rscale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road'
APPLICANT INFORMATION-PLEASE PRINT ALL INFO RMA~FQa REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
paw.v,+ i GOVT. LOT SA-, 1/4 Sw 1/4,S 3 / T 3o N,R ! 9 E (or OW
PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
j CITY, STATE ZIP CODE PHONE NUMBER
/.vti.f~ $Etl~ LQ /yN $5/27 (G/t) 6,-6-3 - -75,F7 []CITY T ~E~~ OWNw y R 1 15
jk j eew Construction Use
[ Y'Residential / Number of bedrooms ~ (]Addition to existing building ~
j ] Replacement [ ] Public or commercial describe
Code derived daily flow gpd Recommended design loading rate y bed, gpd/ft2 trench, gpd1ft2
Absorption area required bed, ft2 52~O trench, ft2 Maximum design loading rate bed, 9
pd/ft2 ~Jr trench, gpti1ft2
Recommended infiltration surface elevation(s) see P5 - 3 ft (as referred to site plan benchmark)
Additional design / site considerations 411 7E67- S/7,525 5017-,W1,5- OWZ / /:~e 141,94wO S!/S 726.44 -
Parent material Sc5 yt. - s,~T. sEpr:,~,..TS oat fiy/. Flood plain elevation, if applicable ft
S = Suitable for system CONVENTIOw~ MOUN IN GROUND PRE RE AT GRADE SYSTEM IN R HOLDING T ANK
U= Unsuitable for system ❑ S Lj7'17 D U p S pvu p S p p S [j DS
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Baxd3y Roots GPD/ft
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed rt-
si/ / f'sl>,~ ~Psy c5
'13 / o- /t %P 31-3
z~ , v s
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elev/
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SSS
Remarks:
Boring # Ye 313 511
h~ f,~ Y
s
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$
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Depth to
limiting
factor
Remarks:
T Name: Please Print ~D 6 gfW T e,4 7- Phone: 71S 3 8G
dress:
csT~y .2 y~z
Signature: ~ Date: CST Number:
U 7
S
PROPERTYOWNER SOIL DESCRIPTION REPORT Page Z of 3
PARCEL I.D. #
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourxfary Roots GPD/ft
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed rends
0-8 to 313 sdk' ~►+7-'. CS 3'r
_
Ell 26 /0 Yle 31,:~o 5//
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p s s/ YV f 5 j& dt VA
Ground 3 2LIa - 3 /oyiP 311,
elev.
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factor
2-6_
Remarks:
Boring # / p -y /D y,P ,3/Z si~ f 5,6,E 414'7~e
Ccv - Y S
2
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Ground
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9~ ft S
Depth to
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Remarks: _ U~i~y wE , ,q/~yoS T .S 7-0,,PAT6 y /?'r G&) Boring #
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2- z1o 6 Xle J13 51-1 -2 4, <11
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Remarks:
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STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
R/BUYER ti 6 "n~~ -f'
O WNE
L f~ pp
MAILING ADDRESS J ..Y d -7
PROPERTY ADDRESS d~ a-
(location of septic~~sys~~te ) Please obtain from the Planning Dept.
CITY/STATE
PROPERTY LOCATION 1/4, J Z,) 1/4, Section 7 T <30 N-R Iq W
TOWN OF 077 --7-0, 5~~1 ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMBER
CERTIFIED SURVEY MAP , VOLUME ICJ , PAGE,~q,3 1, LOT NUMBER
i
Improper use and maintenance of your septic system could result in its premature failure to handle
wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed
by licensed septic tank pumper. What you put into the system can affect the function of the septic tank
as a treatment stage in the waste disposal system.
St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost
of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County
accepted this program in August of 1980, with the requirement that owners of all new systems agree to
keep their system properly maintained.
The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner
and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1)
the on-site wastewater disposal system is in proper operating condition and (2) after inspection and
pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum.
11We, the undersigned have read the above requirements and agree to maintain the private sewage
disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR.
Certification stating that your septic has been maintained must be completed and returned to the St. Croix
County Zoning Officer within 30 days of the three year expiration date.
SIGNED: G
DATE: Al 7
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
r
S T C - 100
This
application form is to be complete
d 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 e'l"I'
Location of property Stj-i/4 Sld 1/4, Section Ji--/ T3~_N-R W
Township J7- Mailing address z16 gl p/~,~~ 'Dr--
C Go ofG[ l
Address of site Y aa- k
Subdivision name Lot no.
Other homes on property? Yes No
Previous owner of property ZZ
Total size of property S/ aC_rt.5
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 /0 and Page Number Y-31 as recorded with the Register
of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE
NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a
certified survey, if available, would be helpful so as to avoid
delays of the reviewing process. If the deed description
references to a Certified Survey Map, the Certified Survey Map
shall also be required.
PROPERTY OWNER CERTIFICATION k
I (we) certify that all statements on this form are true t( 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. S~~ L1, cam , 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.
Sig e of Applicant Co-Applicant
Date of Signature Date of Signature
DOCUMENT No. STATE BAR OF WISCONSIN FORM 1 - 1982 THIS SPACE RESERVED FOR RECORDING DATA
WARRANTY DEED
IIIF"
523099
VOL IJO PA9E. / -
.
This Deed, made between Malo Dudens- single- wo(ilan.-•-. I ST. OIX CO,,
P'i for Record
Grantor, NOV 2 1994
and-----Randy Witthus__ASI_.AQnna._A_Fink,-.-aa_jaint__tenant p
A 3:5~ f_
I Grantee, I
Witnesseth, That the said Grantor, for a valuable consideration-----_
_
conveys to Grantee the following described real estate in St-Croix----------- RETURN TO
County, State of Wisconsin:
Part of SW-14 of the SW4 of Sec. 34, T30N, R19W, Town of
St. Joseph, St. Croix County, Wisconsin, described Tax Parcel No--------------------
as Lot 4 of a Certified Survey Map filed'in -the Office of the
St. Croix County Register of Deeds in Vol. 10 of CSM'S
Page 2831 Document Number 522628 ,
I
This i s not . homestead property.
(ice (is not)
Together with all and singular the hereditaments and appurtenances thereunto belonging;
And . Grantor
warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except
easements, covenants, restrictions and Highway Rights of Way of record.
and will warrant and defend the same.
Dated this ----------------Zko day of 6L O~LT ~UU 19_94...
t
(SEAL) - • • - - • - - --...--•--------•--•---....(SEAL)
* alo. Duden...._.._..------------...._..--•---••--....
--.-----(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) •.._Malo__Duden STATE OF WISCONSIN
ss.
~ ---------------County.
authenticated this day of October 19.94_ ///,~yyP~~erson ly ame before me this .--e ....day of
^!~'fl~~---------------- 19.`.l_ the above named
L
Samuel R. Cari
R
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not,
authorized by § 706.06, Wis. Stats.) qq v-~+c-~'g to bete person who executed the
~ nst and acknowledge the same.
NQTARY
THIS INSTRUMENT WAS DRAFTED BY W ~ ►T ..07 ~K6.is
Heywood & Cari, S,-C.., _.by..Samue.. R. Cari
. • •
* -
P.O, Box 229 --Hudson- W--- 54016 Notary Public County, Wis.
(Signatures may be authenticated or acknowledged. Both My Co fission i ermanent. (If not, state expir i n
are not necessary.) date: 19.. )
*Names of persons signing in any capacity should be typed or printed below theli signatures.
r V
O
69 l FILED
OCT 1 9 1994+-
522628 g JAMES O'CONNELL
Register of Doeds
SL Croix Co., W1
CERTIFIED SURVEY MAP
Located in part of the SWq of the SWQ of Section 34, T30N, R19W,
Town of St. Joseph, St. Croix County, Wisconsin.
CURVE DATA 1-2 AREA OWNER
Radius 1839.86' Lot 2 Malo Duden
610 County Highway "E11
Central Angle O1°45'28" 3.38 Acres Inc. R/W
147,325 Sq. Ft. Hudson Wi. 54016
Chord Bearing S88°53'091'E
3.05 Acres Exc. R/W
Chord length 56.44' 132,789 Sq. Ft.
Arc Length 56.44' lot 3 co o M
c n1
Tangent Bearing S8800012511E 4.30 Acres y T 7..
187,186 Sq. Ft. H r Ic
Tangent Bearing S89°451 31L.-S89 r~, s 'a (v
°
PA R VOL 54 r , PG. 308
1~ . 0
°55-17_id
' " 726.20' v- T
d 0
32.181 347.39' 346.03' 34.03' C/) IL rt _
s I` o o -380.171- _ 760.231 -380.061- y m o o d
v~i• 1'Jt 0 w C7 m o -n
IF- w Cj z N x o W o
I i> 0 1 U7 IF- i w °o r m o n rr
-i rt LOT 2 co ~ LOT 3 rm °~T
c I (~l :r rv m o
`o tCl I~ 6. N i Z N
0
In - V tTj
n I .i I W 'E -
1 -1 Lo
1> I ► N89°42' 3611E
t I L4, 1 I
a :t.: ~t• . I c,~ If 1 1°_ ...+x27: 00 378.76' I 0
o I 1-1 d58.19' 320.57' 250.00' 0
m N87045' 45"E 628.76 o Ho 0
-n APPR o o
- L4 N) co
CD o tcl~rJ o° I- w 0
Icr,1-► v,
r
001 1 9 94 ~ ~ ~ o
m
o - m -
00)j
c: X OU TY
Cet:;:.tehetisiv Pldrx~l,s
/ r
w ? OllttlC) ail( I n I~ w{ -
P.; Ccrnmittoo Ip n
co 11` v U)
I N S 02
9
I t>> i o I~ _ 8
r {t -,)t rq(:oided rn o r 131. 26,
t II -7t N r m I N _
.iI,`` 4 days of
" i v, ~ w I I N r
d!7'11•w RI dQto tCo fil - I
-•JIjt ooll lon S703515011E
old 9.901
all J'•
S~ or n ner 2
1^ +Ar. Section 34 N90000'0011E o
M - - _
co Ut
LEGEND 962.541 ~l I . • 11` I
Aluminum County Section Monument Found South line of the SW}
0 1" Iron Pipe Foun6 UNPLA TED LANDS
0 111 x 2411 Iron Pipe Set, weighing 1.68 •,•.1
lbs. per linear foot r,f,,ty?t-v
- 1001 Roadway Setback Liner
R.L.LEII C.
+ Existing Fence Line 1 14Y11 0r-I'l A
p Septic S"1'107 I r,
SCALE IN FEET
N-1 I s.
_~t•) 100 50 0 200 400
< 17
dF mtQ
Belllt;c~
SHEET 1 of 2 SHEETS
VOLUME' 1.0 PAGE 2831
Y ~
69 Continued
SURVEYOR'S CERTIFICATE
I, Allen C. Nyhagen, registered Wisconsin Land Surveyor, hereby
certify, that by the direction of Malo Duden, I have surveyed,
described and mapped the land parcel which is represented by this
Certified Survey Map; that the exterior boundary of the land
parcel surveyed and mapped is described as follows-
A parcel of land located in the SW1/4 of the SW1/4 of Section 34,
T30N, R19W, 'T'own of St. Joseph, St. Croix County, Wisconsin;
further described as follows:
Commencing at the SW Corner of Section 34; thence N90000'00"E,
along the south line of the SW1/4 of said section, 962.54 feet to
the ant of begirnning; thence continuing N901100'00"E, along said
south line, 356.05 feet; thence N00o18'03"W, along the east line
of the SW1/4 of the.SW1/4 of said section, 1315.54 feet; thence
N89057'16"W, along the north line of the SW1./4 of the SW1/4 of
said section, 597.52 feet; thence S00031'28"E, along the east
line of a parcel of land recorded and described in Volume 547,
Page 308 at the St. Croix County Register of Deeds Office, 301.16
feet; thence S89055'17"W, along the south line of said parcel of
land, 726.20 feet; thence S00031'28"E, along the west line of the
SW1/4 of said section, 395.49 feet; thence N87u45'45"E, along the
north line of Lot 1 of Certified Survey Map recorded in Volume 3,
Page 843 at said office, 628.76 feet; thence'S02014'14"E, along
the east line of said lot 1, 320.50 feet; thence S78029'11"E,
along the north line of a parcel of land recorded and described
in Volume 900, Page 351' at said office, 131.26 feet; thence
N01001'18"W, 446.15 feet; thence N90000'00"E, 216.28 feet; thence
S01001'18"E, 523.67 feet; thence S87o27'08"W, 24.24 feet, thence
501024'20"E, along the east line of said parcel of land recorded
in Volume 900,'Page 351, 217.93 feet to the point of begin n:i~_
Above described parcel is subject to right-of-way for town road
(60th Street), County Trunk Highway "E" and all easements of
record.
I also certify that this Certified Survey Map is a correct
representation to scale of the exterior boundary surveyed and
described; that 1 have fully complied with the current provi. -:ions
of Chapter 236.34 of the Wisconsin Statutes and the Land
Subdivision Ordinance of the County of St. Croix in surveying and
mapping same.
Each parcel shown on this map is subject to State, County and,
Township laws, rules and regulations-(i.e., wetlands, minimum lot
size, access to parcel, etc.). Before purchasing or developing
any parcel contact the St. Croix County Zoning Office and
appropriate Town Board-for advice.
VOLUME 10 PACE 2831
I
~I
i
•
69 Continued
CERTIFIED SURVEY MAP
Located in part of the SW4 of the SW; of Section 34, T30N, R19W,
Town of St. Joseph, St. Croix County, Wisconsin.
OWNER
UN PLAT-I E_D LANDS Malo Duden
North line of the SW{ of the SW{ 610 County Highway "E"
Hudson, Wi. 54016
N89°57'16"W 597.52'
IUi tm w 0
F"
iii rn N
I C) - C°
LOT 4
10 1- N89°55'17"E
10 34.03'
13.51 Acres _jNc. R/W
588,354 Sq. Ft. w o IL
CAP 0 13.01 Acres Exc.. R/W o 1
rn l-3
i n N ° 566,583 Sq. Ft. t~ N
Iv
o 0o W °+I -I i o m
c a
r' a rt If~1 rt -3
I-I I V a s r
un o H r io
~ N C N• In
B 7
N90°00' 00"E
216.28' o w s 'v ~
APPROVED OH I~ ~ m
i 7
o = IC _
rJ vi
" ~o m
C:1 C)
k OCT 19,'94
QWo
- m
o n rt
o rt T
N ~
t✓•~r,~ni2~`1i;^•.DI;~E I(~ltlt;tt'!!t W
•,t bliit1b ism ~
v
r•
N
N t(91wC~Rddef88d S87'} 7' 08"W
'4`tit~i9t,ib~thays~of 24.24'
c
B
>~rriv
uht',shaU be
rt r
n o..~ irj N ~ Ui C . ,
0
O C-"
w ~ 0
V N
n r v w
rt n` iD
Q LO N i S8904515311E
0 o - o
N90 00i00nE 357.251 N9000010011E
Pl Q A
- N90°00' 00"E 356.05' -v S} Corner
962.54 South line of the SW
d { 1318.59
-
Section 34
.
. e I. I-. 11 ER ll
0
~~S1~19060/~~~~i UNPLATTED LANDS
; CNA .
N
H
M3
SCALE IN FEET
100 50 0 200 400
♦j~ D S L)
III ~i
/IIIOt11~
S11I ET 2 of 2 S11EFTS
VOLUME 10 PAGE 2831
I
69 Continued
TOWN OF ST. JOSEPH CERTIFICATE
I hereby certify th t this Certified Survey Map is approved by
th Joseph FT Board.
CIerIt Date
VOLUME 10 PAGE 2831
~ lil
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