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HomeMy WebLinkAbout032-1076-95-110 ST. CROIX COUNTY WISCONSIN ZONING OFFICE x x e x Non ■ - `.e ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 June 16, 1994 Ms. Kristen Dixon Bank of Somerset P.O. Box 220 Somerset, Wisconsin 54025 RE: septic Inspection for Dave Marson Dear Ms. Dixon: An inspection of the septic system for Dave Marson's property was conducted on May 31, 1994. This property is located in the NW; of the NE, of Section 34, T31N-R19W, Lot 1, Town of Somerset, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a four bedroom home. If you have any questions with regard to the above, please do not hesitate in contacting our office. Sincerely, Mary J1. Jenkins Assistant Zoning Administrator mz (C(Dply STC - 104 AS BUILT SANITARY SYS(EIR ~4 l j~ r w'>1 OWNER t..~`ti,.t, i y ADDRESS v fi't' i ~ , 4 SUBDIVISION / CSM# LOT # SECTION :E~Z TZZN-R_Z5~_W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM I G' ye / = ya so~.~ d9ur,C 911" INDICATE NORTH ARRO l „ Provide setback and elevation information on everse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: --A)-.-,,,-, Liquid Capacity: 1, Z.~ Setback from: Well gS: House 13 Other Pump: Manufacturer Model# Size Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: Length /)p Number of trenches Distance & Direction to nearest prop. line: ~l^ Setback from: well: HouseOther ELEVATIONS Building Sewer ST Inlet G7 ST outlet PC inlet PC bottom Pump Off Header/Manifold S;',~ _ Bottom of system Existing Grade -R Final grade DATE OF INSTALLATION: 1 PLUMBER ON JOB: r~ LICENSE NUMBER: Z2 t'"y INSPECTOR: 3/93:jt oartn S'st 34.31.19%IVRTE%VA-8ES~ STEWnty Roa C nty: Labtp and Human,Relations INSPECTION REPORT Safety aqd Buildings Division 9WIX (ATTACH TO PERMIT) sanitar r it GENERAL INFORMATION Permit Holder's Name: ❑ City ❑ Village R Town of: State Plan o.: CST BN v.: Insp. BM EI v.: BM Description: ~i Parcel Tax No.: ir/DO ®97. ~lsD'7. TANK INFORMATION ELE ATION DATA A9400029 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. _7/ 7,~ c Septic 0 0 Benchmark, Dosing 2 rte., P. 7 g7,9 Aeration Bldg. Sewer Holding St/Ht Inlet 9S',~7 TANK SETBACK INFORMATION St/Ht Outlet y~z 4},W}' TANK TO P/ L WELL BLDG. vent`to ROAD Dt Inlet Air Intake Septic ;;'/60 a 3 ✓a 7~ A Dt Bottom Dosing NA Header/Man. /Dia/ Aeration NA Dist. Pipe /0,a'("' Holding Bot. System //,07 ge,~ PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand 11✓,j6Avj q7. Model Number GPM ITDH Lift Friction System TDH Ft Loss mead ~Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED /TRENCH Width / Length 1 No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 0 D DIMENSIONS SYSTEM To P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type Of I CHAMBER ~ Model Number: System: WIC 1 ?d L1 y OR UNIT DISTRIBUTION SYSTEM Header/Mani old 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 -2Do , Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Cf 7-`1 Cl J LOCATION:Somerset. 34 .31.19W NW NE Lot 1 uny Road I / .3 07 Can revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710(R 05/91) Date Inspector's Signature Cert No. SANITARY PERMIT APPLICATION ®fuqR In accord with ILHR 83.05, Wis. Adm. Code co lmr"_ PERMIT # STATE SANITARY -Attach complete plans (to the county copy only) for the system, on paper not less than C` (-St 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. PROPERTY OWNER PROPERTY LOCATION '/4 t/4, S T , N, R Or)~O PROPERTY OWNER' ,S MAILIN ADDRESS LOT # BLOCK # c i 7;/ Z CITY, STATE G ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER a II. TYPE OF BUILDING: (Check one) ❑ State Owned VILLAGE : NEAR RO ❑ Public 14J 1 or 2 Fam. Dwelling-# of bedrooms --i PARCEL NUMBER(S) III. BUILDING USE: (If building type is public, check all that apply) vs- /OD 1 ❑ Apt/Condo 20 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 4.0 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 3o ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (MinA ch) ELEVATION Feet Feet VII. TANK CAPACITY Site INFORMATION in allons Total # of Prefab. Fiber- Exper. New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks strutted Septic Tank or Holding Tank - Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installs on of the onsite sewage system shown on the attached plans. PNam (Pr Plumb is gn re: RS ) MP/MPRSW No.: Business Phone Number: PI m is Address (Street, City, State, Zip C e : r! IX. COUNTY/DEPARTMENT USE ONLY nt Signatur (NOS ps ❑ Disapproved Sa ary Permit Fee (Includes Groundwater ate Issued Issuing 'IT Approved El Owner Given Initial Surcharge Fee) Adverse Determinationj~" ~c'~ 2 X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety s Buildings Division, Owner, Plumber INSTRUCTIONS t 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 authcriy. 4. Changes sn ownership or plumber requires a Sanitary Permit Transfer/Renewal Fcrsn> B , 6399) to be submitted to the county prior to installation. 5. Onsite se e systems rnust be proper iy -maintairreci The -ptic tank;;.` r,, .,,f be 1-_, er iE~ iace%rsed pumper wh -never necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage systen), contact your icica! .;c d r.drr-toistratsr or the State ot'Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: I. Property owne'r's name and mailing address. Provice the legal description and parcel tax 01.mber(s) of where the system is to be installed. II. Type of building being served. Check only one and complete #F of bedrooms if 1 or 2 Fa.rr•,ily Dwelling. Ill. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, -econnection, 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 g,ilcin s, number of tanks and manufacturer's. name. Indicate prefab or site constructed and tank material. Compete 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 3% 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; (lose volume; elevation differences: frict.icil 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 gro,^dwater, pro; _ nr- water -contamination investigations aicfrl establishmEM1 of standards. - SBD-6398 (R.11/88) STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER of MAILING ADDRESS PROPERTY ADDRESS ~ -y - ~ f _X ` (location of septic system) Please obtain from the Planning Dept. lse~ CITY/STATE / / T PROPERTY LOCATION_ 1/4, 1/4, Section, T N-R W TOWN OF ST. CROIX COUNTY, WI SUBDIVISION A" LOT NUMBER CERTIFIED SURVEY MAP AZ Z j , VOLUME , PAGE , LOT NUMBER Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: 7<~~I /s~i y DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 STC-100 This application form is to be completed in full and signed by the of%!ner(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 Location of property 1/4 1/4, Section R T3/ H-R W .Township - J61177 f- Hailing address ~x -/>S-`/ max- , f-, Cam, S~i•b2. Address of site Subdivision name -Lot no.. other homes on property? yes___ No Previous owner of property V`~df~~~; ~-cws~ n Total size of parcel _ /S~, Date parcel was created Are all corners and lot lines identifiable? T Yes No is this property being developed for (spec house)? Yes No Volume go and Page Number _ 6- G as recorded,with the Register of Deeds. 114CLUDE WITH THIS APPLICATION THE FOLLOWING: A WARItA ITY DLLD which includes a DOCUMENT NUMBER, VOLURE AND PAGE HUMB R It Till's SEAL Or THE REGISTL•'11 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 refeiencos to a Cortified Survey Map, the certified survey Ma shall also be required. PROPERTY OWNER CERTIFICATION 1(we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document Ho. 1q/ y7 d' 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 dame has been duly recorded in the office of County Register of deeds as Document Signature o ap:licant C appl cant w 2ZS C.'/ Dat-. of Signature Date bYs -S-r- - gnature CD ~ ! FILED OCT 0 61992x' Z JAMES Co edsL 9 Reg SL Croix Co•,WI O 48954 _ N CERTIFIED SURVEY MAP ROBERT R. LAWSON! Part of the Southwest 1/4 of the Southeast 1/4 of Section 27 and the Northwest 1/4 of the Northeast 1/4 of Section 34, Township 31 North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin. S Indicates 1" iron pipe found. O Indicates 1" x 24" iron pipe weighing 1.13 lbs./lin. ft. 5~\ set. R 0 Indicates previously recorded data. Each parcel shown on this map is subject a to state and County laws, rules and 5e w•\ regulations (i.e., wetlands, minimum lot ? c g size, access to parcel, etc.) Before o W c \Z purchasing .or developing any a to \ \ 6 parcel contact the St. Croix V, N County Zoning Office for advice, ° 3 y u Q, \ c o f Z ~ o q \Q w w_ \ \N W Q 14 Q) % 1Z \ r` \ 2 W W x ~5~ r ~I r ~:L W , ` 'K 0 5~`• Wow ~I \ w a~_. `OTO \ ? o Z 2 N Q Z \ N 114 COR. SEC.34, N\~\ \ \ O /001 200' 3001 5001 T3 IN, R/9 W, \ ( COON rY S41RVEYOR'S r MON./ \ `SCALE IN FEET / YOa111f1//l M LOT 1 y O /5.242 ACRES \ \\t \ ` d•~ ~I _ 4, a 663, 953 SO. Fr. \ \ s = Jr ~UR ? ;t 12.398 ACRES EXC.ROADWA)A` \ \t.~ rT1 i W 2 y 540,036 SO. Fr. 3 S oo' %;R ER ALL J~ A b 0itc~ L A No S 01•~• ROV ED M` ~1 50 i.. APP' m 3 ^ iv 1 ~o r 1 Z N Laurence W. Murphy OCE' O O 9Z; h , K HIGHWAY SETBACK 1 c INE e ro 1 Registered Land Surveyor m I ~ e O1 0 ST. CROIX COUNTY o ~ 1 ~ w1 N :;ornprehensive Planning Owner's Address: z ( \ 1 Zoning and 61e.I0 /2 22 - 1, yo,• 1902 60TH Street Parks Committee 1 2.09' ro' Somerset, WI 54025 603.79 Rl603.T4 / 1 1~ 8 ` It not recorded Phone- 1- 715-247-3727 ~9se~ t~ within 30 days of - N89•04'58 "w 713.97'R(S88.061W/ approval date m e approval shall be m UN PL A r T ED LANDS ' :►uU & void a a S I 14 c o R. SEC. 34, Dated : 25 March 1985 r3/N,R/9W, Revised: Oct. 5, 1992 (COUNTYSURVEYORS This instrument drafted by MON./ Laurence W. Murphy Vol- 9 Page 2548 SHEET 1 OF 3 Certified Survey Maps St. Croix County, Wisconsin DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1-1982 THIS SPACE RESERVED FOR RECORDING DATA _WARRANTY DEED 51478 VOL 980PAGE 607 REG1SiR4 OPPICI This Deed, made between --Robert.•R._Lawson-_and................ ST. CROIX C'0•4 W) Virginia..N...Lawson. d der Record Rep° . N 1 21992 Grantor and...... avid..K...Mar-a9u..and._Mel.inda..,1,...Macaon...husband-•----•--• at 12:30 P.M ......and-.Wif e.-As.. Aurviv%rShiF..Maxi.tal.. pxopexty..-•• a . R~bia~f 0 - Grantee, Witnesseth, That the said Grantor, for a valuable consideration...... RETURN TO conveys to Grantee the following described real estate in ...St.... Cx_olix..Caunty Heywood & Cari County, State of Wisconsin: P.O. Box 229 Hudson, WI 54016 Part of the Southwest Quarter of Southeast Quarter - - of Section 27 and Part of the Northwest Quarter of Tax Parcel No: Northeast Quarter of Section 34, ALL in Township 31 North, Range 19 West described as follows: Lot 1 of Certified Survey Map filed October 6, 1992 in Vol. "9", Page 2548. FEB This is..not........ homestead property. Jitk (is not) Together with all and singular the hereditamenta and appurtenances thereunto belonging; And........ gtantars,...Robert..R-..Lawson..and..Virginia..N_...Lawson .warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except - and highway rights of way of record. Further excepted from the warranty of title is the portion of the subject property lying West of a fence shown otl- the Certified Survey Map and will warrant and defend the same. Dated this thL........... day of liovelaber.................................... 19.9.2... . (SEAL) • • Robert R. Lawson ..................••---••-------....._(SEAL) • • Virginia N. Lawson AUTHENTICATION ACKNOWLEDGMENT Signature(s) ...of.-Robert.-R..-Lawson-aa,d.---------- STATE OF WISCONSIN Virginia N. Lawson ss. County. authentica us _ L~a of_.... November...... 1992-- Personally came before me this ................day of - 19 the above named L_.x_- ti • TITLE: EMBE TATE BAR OF WISCONSIN • (I! n authorized 706.06, Wis. Stata.) to me known to be the person who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY HEYWOOD & CAR.I by Samuel R. Cari P-.rO•.•-Sox--229Y-•HudsonY--gI------- 4414--------------- Notary PuLlic _._...County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) date: 19.........) * ames of persons signing In Say capacity should be typed or printed below their signatures. WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Co. Inc. FORM No. 1-1982 Milwaukee. Wis. Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page / of Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Aitech complete site p4an on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION GOVT. LOT AIA) 114 S 1/4,S3 T N,R it (orb PR PERTY OWNE ':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # S- t~ CITY, TATE ZIP ODE PHONE NUMB R ❑CITY VILLAGE WN NEAREST OAD 1 ) s- jxJ New Construction Use [ ] Residential / Number of bedrooms [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flower gpd Recommended design loading rate bed, gpd/ft211~.__trench, gpd/ft2 Absorption area required Rgo bed, ft2 y5-0 trench, ft2 Maximum design loading rate -q- bed, gpd/0_.~trench, gpd/ft2 Recommended infiltration surface elevation(s) 99 G ft (as referred to site plan benchmark) Additional design / site considerations - - Parent material AL- - - Flood plain elevation, if applicable ft CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK rU:=SUunisuitable table for system fors stem EIS ❑U EIS ❑U EIS ❑U ❑S ❑U ❑S ❑U ❑S ❑U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon in. Munsell Qu. Sz Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench A ,9 11-36 16 yz' -3-4/ _'V14 Ground 3 O_q w .SS elev. , ft. Depth to limiting factor >K- tl Remarks: Boring # 3 Ground - 1 l lev. ?JiA ft. Depth to limiting factor ti > 91 VA ,t Remarks: CST Name: Please Print P o Address: / Signature: Date: CST N er: PROPERTYOWNERA11E SOIL DESCRIPTION REPORT Page-of PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundaty Rock GPDff{ in. Munsell Qu. Sz. Pont. Color Gr. Sz. Sh. Bed Trench ki} /77 Ground 1-7-5--751 --5- q1 V 164 - A-7 elev. ft. - 92 Depth to limiting factor Remarks: Boring # .;2 9.-aQ Z4 YZ L20- 9-Q Ground elev. Z& ft. Depth to limiting factor > Remarks: Boring # ~~ti}•~:•;ii:}:iii 14 Ground ' ev. Y,KL ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) ; I 1 ~ f , I I 1641 I I I , I I ~ I l I ' , : I I i d w i ~ I j w I I I ; i I ~ I i j T_ I I I ' f ! 1 I I I I I I ! 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BE pp I IJ G H E S 1'UN11'►uJ~ ©EPT t OF EACAVATION FO^ 0 I141WgL GRAPE wit.. sc ~ INcHCs SICrIJCO: LIGCUSC IJUM8C11: ~ , 3Akll I 1Ae TOO OT ~d I 3 i i i e /~wL~iC O ~~~16SRD U1i'll /lab ~ ,t3ivi m~~~ z