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HomeMy WebLinkAbout002-1003-90-000 F~ . STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER _ i f fah ADDRESS 6-7;3,W Rfdf Q~ u j Llc- SUBDIVISION / CSM# LOT # A SECTION__,2_T_.2j N- C W own of ?at(~i i CRSIN ST. CROIX e141', WIS~ 1 PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM I INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. w s . 7 BENCHMARK: > co ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION ./OC~G> G u Manufacturer: Liquid Capacity: 7 S~~ ~v tp Setback from: Well . ~ House i3( S,oi, ` Other • Pump: Manufacturer Model#,!~S/' 3:-3 Size Hio : Float seperation min Gallons/cycle: 3 Alarm Locations .SOIL ABSORPTION SYSTEM Width: Length 7 Number of trenches Distance & Direction to nearest prop. line: Setback from: well: Z( d2 House 35S Other ELEVATIONS I Building Sewer ►O`f . ST Inlet; %D`I. 5'1 ST outlet PC inlet PC bottom Pump Off ~cb`r.~ of T Header/Manifold,q7. Bottom of system Existing Grade Final grade 'O/, r DATE OF INSTALLATION: h,5 PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: T, ON A 3/93:jt k r 1 ,y A p ~ o$ c~ cs W ~ 1 R r~ rte. 1 1 p~r~~ W L his +'s r part t' tr 2.29 .16• PK Y/W SEWAGE TRA .y~ County: Labor and Human Relations INSPECTION REPORT r' Safety any' Buildings Division / it No-: GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Perm41 4 19*1 Permit Holder's Name: ❑ City ❑ Village R Town of: State Plan ID No.: D ST B Elev.: r Insp BM Elev.:, TM_1_-)-y1( scription: Parcel Tax No.: _ TANK INFORMATION ELEVATION DATA A9300076 -5b" M IA-r'. Qo O rw TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ° a ` -_E° ) Benchmark t. •/s 3.?/' 160i C k to V Dosing .u..._ Cash P 7~ 6 cL L" Aer tion Bldg. Sewer Holding St/Jd Inlet TANK SETBACK INFORMATION St/,W Outlet Ventto TANKTO P/L WELL BLDG. Ve nttake ROAD Dt Inlet 8+~7 Air In Septic NA Dt Bottom L ? 91, ' Dosing >/G NA Header44ie4ex+. 3 , / 2 / Aeration NA Dist. Pipe Z ' Holding Bot. System PUMP / SWMON INFORMATION Final Grade Manufacturer Demand zngr, Model Number GPM TDH Lift I Frictional System L~ TDH 3(~FtY(r/~y 41~u - HHe oss ~ Forcemain Length Dia. ,I„ Dist.Towell>75 SOIL ABSORPTION SYSTEM BED/TRENCH width, I Length / No. Of Tr nches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS S DIMENSION SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type O CHAMBER Model Number: System: Yr,- <J- OR UNIT DISTRIBUTION SYSTEM M if Id 7 Distribution Pipe(s) x Hole Size x Hole Sparing Vent To Air In jke Length Dia Length? Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over i Depth Over xx Depth Of ji xx Seeded mod xx Mulched~ ~ Qed./Tr Center Bed /Trench Edges - / Topsoil E] Yeso El Yes L~l'No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION. BALDWIN 02.29.16.31B,LSW,SE, 110TH AVE. let, YC6 Ic 1,21 rr;a /0ision required? C] Yes [~I0 Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signat a Cert. No ADDITIONAL COMMENTS AND SKETCH - SANITARY PERMIT NUMBER: yr) (~j(f~J6TC.! ~~1~~C.G`l G~%~1 G" * - ti►?T~ ` . -`~'r.~1,~~°"'"~'~`"'y e' ~trE'lzr~,` cl / Ae, cl/ wl .3 I' ~ _ 1 Parcel 002-1003-90-000 04/27/2005 03:11 PM PAGE IOF 1 Alt. Parcel 02.29.16.31 B 002 - TOWN OF BALDWIN 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 * CLEVELAND, DANIEL D & ROBIN C DANIEL D & ROBIN C CLEVELAND 2256 110TH AVE WOODVILLE WI 54028 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 2556 110TH AVE SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 7.840 Plat: N/A-NOT AVAILABLE SEC 2 T29N R1 6W SW SE LOT 1 CSM 3/830 Block/Condo Bldg: ORD TOWN BALDWIN Tract(s): (Sec-Twn-Rng 401/4 1601/4) 02-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 09/09/2003 739258 2403/411 WD 03/26/1998 575810 1309/118 WD 07/23/1997 987/623 WD 07/23/1997 987/622 WD more... 2004 SUMMARY Bill M Fair Market Value: Assessed with: 41941 127,300 Valuations: Last Changed: 11/02/1999 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 7.840 14,700 70,900 85,600 NO Totals for 2004: General Property 7.840 14,700 70,900 85,600 Woodland 0.000 0 0 Totals for 2003: General Property 7.840 14,700 70,900 85,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch 510 Specials: User Special Code Category Amount 010-GARBAGE SPECIAL ASSESSMENT 45.00 Special Assessments Special Charges Delinquent Charges Total 45.00 0.00 0.00 SANITARY PERMIT APPLICATION 01L HR In accord with ILHR 83.05, Wis. Adm. Code COUNTY ST. CROIX STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than El 0~ j 8'//z x 11 inches in size. cneck f r sion o previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. S92-40999 PROPERTY OWNER PROPERTY LOCATION N&kb__B ; L;~ SW '/4 SE '/a, S 2 T 29 , N, R 16 E (or 1o PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # 2556 110TH AVENUE N/A N/A CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER WOODVILLE WI 154028 715 698-2148 830 II. TYPE OF BUILDING: (Check one) ❑ State Owned O VILLAGE NEAREST ROAD CC] =N :BALDWIN 110TH AVENUE ❑ Public ©1 or 2 Fam. Dwelling- # of bedrooms 3 PARCEL TAX NUMBEK(b) III. BUILDING USE: (If building type is public, check all that apply) 002-1003-90 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. KI Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5-0 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 0 Mound 30 ❑ SpecifyType 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 450 REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION J%0 375 7%0 375 1.2 N/A 99.43 Feet 101.68 Feet CAPACITY VII. TANK Site in allons Total #of Prefab. Fiber- Exper. INFORMATION New xistin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank 1000-1--1000 1 MIDWESTERN PRECAST 1- ~1' r_1 L]+ 750 1 MIDWESTERN RE El 1 1:1 Lift Pump Tank/Si hon Chamber 750 VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumb ' Signature: (No Sta s) MP/MPRSW No.: Business Phone Number: BENNIE HELGESON 3215 715 772-3278 Plumber's Address (Street, City, State, Zip Code : W1229 770TH AVENUE, SPRING VALLEY, WI 54767 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Iss ' Agent Sign atur o Stamps) P(Approved ❑ Owner Given Initial Ak a4l Surcharge Fee) Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) 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. 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; (lose 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 (8.11/88) L ib(b and isin Human Department Relations Industry, L SOIL AND SITE EVALUATION REPORT Page _ of ,.1bd► Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY , Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but J n 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. - 0 - (1 APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION cc #1A Ll GOVT. LOT S t,t l 1/4 S 61/4,S T N,R (o E ( r) W ' PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # s-6- O ► , CITY, ST TE ZIP ODE _ PHO NUMBER CITY VILLAGE WN NEAREST ROAD 11 -n C' J u f' I 5411D [ ] New Constuction Use [Residential /Number of bedrooms 33 [ ] Addition to existing building jj Replacement [ ] Public or commercial describe Code derived daily flow y O gpd Recommended design loading rate gy bed, gpd/ft2_. 6~trench, gpd/ft2 Absorption area required 100 bed, ft2 ?SO trench, ft2 Maximum design loading rate , S bed, gpd/ft2 , 6 trench, gpd/ft2 Recommended infiltration surface elevations q qo y sf tna ft (as referred to site plan benchmark) pip.r t~c d 0Fj 17.1. Additional design /site considerations " 5a w w, eR r t c.. p.,=~AS t ' ® A Ili P- A C, r- / . 8 3 ~ Bed t'x 7 V' Parent material oC'er Flood plain elevation, if applicable A) ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for s stem ❑ S CND ~ ❑ U ❑ S CI-u- ❑ S ❑ U ❑ S Cam' 8-S` ❑ U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont Color Texture Gr. Sz. ShConsistence Bour>dary Roots Bed Trerxh . l 'y R r » 4 S Y c) I S 8Q 47 ~_d L') Ground 3 I- l v1~ s w. s 6 r v' C A) elev. Depth to limiting factor ILI FsT 77 Remarks: Boring # '7 ~k / Ground ' yC~ w, ivy r C ~J AhO elev. elev "i3 w ~ . . C -3 -7' s YK S' c L 5 Depth to limiting factor , ILI Remarks: ro% A" Loon CST Name:-Please Print le- Phon : -e Address: 11 Signature: Date/: CST Number: ` _ a------ T a c3 ' 9 PROPERTYOWNER SOIL DESCRIPTION REPORT Page ot-, PARCEL I.D. # eC q C Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft Boring # rizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench qt, (U 1Z 4- Lk v, Ground ``3 15 f o l1 5~ o j k CL") 9 elev. vn~ q ft. - f ► . S i2 6-- BSc 3 < 15 WIC Depth to limiting factor, IS E~6t Remarks: Boring # ~u + , v ►r, ~ a-~~ l vy►'Z .S ~ ~ 5~ _ u ~ v UL Ground rn 3 e l e v . ft. 4 s ~►2 -7. 2 + S C I 3 c. Sd vt~~s ' 0 f Depth to limiting factor t-a+, Remarks: Boring # o ~/j r ( a v I o' L y f` J I cs7 'f S b r ~..L W ►x 3 W Ground 3 t% o i, 6 h elev. ft. Depth to limiting factor R ~j N.~.~ Remarks: Boring # jiv }7i Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) d N r V' ~ pn q ~ r J C moo cl 92 o s ~ 1 v a 10 J S d ~ 3 ~ o vl~ 1- r v' /6 qr d ,.9y012 1 u a r Cj 0 < ~ Ut L y J F4 y c..~ d ~ CD 6 p 4 S C6' r- a, ^^o l,.J tom-' Iii 1 Y QO r o ~3 d ~ ~ o ~ i uh cr' ecj DXA VV\6L" Page Of Cross Section Of A Mound Using A Trench For The Absorption Area a_ _ H b 7 Medium Sand Fill ~I F - 6N Topsoil q 3 r 3 E D ' LPG g26a' p~X,qpTfiert% Of 1•1N ~1t3P Aggregate, Plowed Layer 6 Be jOAA Cov d With D 183 Ft. ar nthetic Fabric E a ~03 Ft. G ~ Ft. ~~,p31QNS p~~N F Ft. H • S Ft. Q o~ HU all %.A 0 F 11 ~~S 'Vol •g~ S oN0 S cog RE Plan View Of Mound Using A Trench For The Absorption Area Force Main F Distribution Pipe Permanent Markers Observation Pipe o - A, 6 W i' B K \ Trench Of - 21-2" Aggregate I j' L A 'S t. I Ft. K j Ft. W ~7 Ft. 13--7,5- Ft. J~ Ft. L Ft. License Signed: Number: J Date: e) G 5 c~ ~ r , P a 1 U• L1n0. 0--- Cj1D / . k. i .4T e=U'J Or' i=f1CH LhTL'RAI. Q ZFoLES W^.KT:'J O/J c+JTt]H Or -21.PE A~jD r:Rc 1=_OUFv.v SPAagm . 2 All / pV C-- .cr-'FORCE A 11J ' FR-01-1 Tau h P "PVC"'1 ATc-R/~L5 P~hnt Lhs'T ltOLt fa ~xT -M Euc> CRP ~J~S7R\$uT7~iJ: ptsSE .1)3Lro~iT_-_. PGA c,`(S~M p 3b. S F7. p~t~v a~E onally x 3 C°nditt ro" vow Y 2 IN. R y- p UR ~ 0 a of SW p Op Y\ULES/P1PE- gEE GGR~ 11JV . ELEV. of LATaA L.S lelo, 0 T= r- " pL P:cE t s7- KU1-E 1~ FXwl TEE wJ?H SO Cc.E`~lAJG HDLe fi-r-Yp. l JJ EkIJK .S . A pla Y ~P I kL I'~nQ i PAGE OF PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS VENT CAP jy 9 a+ 'i"C.I. VENT PIPE ' WEATHER PROOF APPROC KING JUNCTION BOX MAM1405 COVER 25' FRCP DOOR. Ln L(c_ WINDOW OR FRESH 12"MIU. I AIR INTAKE GRADE I Y" MIIJ. I / Vsxv f sell S OIJDUIT \ - 18=MIIJ. 11 low- E LET ~,j► ~O J I 134 VIDE INLET AVM IRTIGHT SEAL I I gOR g0 I I APPROVED P`~~ W~C.=. PipgJOINT A pF ~Asms 35 Sp I III APPROVED JO~WT! Q p S~Og GE. I I I 1/C.I. PIPE EXTENDING 3' N I II ALARM EXTENDING 3' ONTO SOLID SOIL.. ~ Go~~~sp i i I ONTO SOLID SOIL SEE I ON PUMP-~ OFF D CONCRETE BLOCK } RISER. EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL 1000 Gal SPEC.IFICATIOkJS EPTIC AND - ' OSE TANKS MANUFACTURER: co S Lo.` IJUMBER OF DOSES' PER DAy TANK :,IZE : GALLONS DOSE VOLUME: 9`7. S GALLONS ALARM MANUFACTURER: 1^ IP Lro S`t43 CAPACITIES: A- (G INCHES OR 00 GALLOUS MODEL NUMBER: I O I HUB B= a INCHES OR X17. C GALLOWS SWITCH TYPE: C= -Lo.INCNESOR / 9.7 . CALLOUS PUMP MANUFACTURER: ~ da ~ " /~~Tl L D= INCHES OR was' CALLOUS MODEL NUMBER: 0:-)I' :3"t NOTE: PUMP AND ' ALARM ARE TO BE SWITCH TYPE: Me1,Y(..ni Ff0Qt INSTALLED ON SEPARATE CIRCUITS PUMP DISCHARGE RATE GPM VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. FEET + MINI UM - NETWORK SUPPLY PRESSURE . . 2.5 . FEET + FEET OF FORCE MAIN X - LSY F~ ' 2 . 2 ioopxFRICTION FAGYOR..~-~ FEET TOTAL 09MAMIC. HEAD = Z.L FEET ' << IIJTECZNAL DIMENSIONS OF TANK: LEtJGTH3;WIDTH 15 Z ;LIQUID DEPTH 0 SIGNED: LICENSE NUMBER: DATE: to G A _ - , ~In -elf i►v~av. SECTION 100 + ~Q~-Q-(~AT(C DIMENSIONAL DRAWINGS o~la3al~l -;z, DATA PUMPS ~ --~--z PERFO DA T`C_ I e) MODEL: OSP33 SUBMERSIBLE SUMP PUMP -MAX. SOLIDS 5/o" SPHERE -1750 RPM Lit. No. 113.5 348 L" TOTAL J HEAD •'/,o HP MOTOR IN FT. 24 22 y FgOc ~ 20 I- H ~A9 18 ~Ty 16 14 121 1- 10 6 - FULL LOAD AMPS AT 115 V. 4 6.5 2 0. 10 20 30 40 50 60' U.S. GALLONS PER MINUTE ' 319 MODEL:OSP33 4 7 0 43/8 O 0 51/4 91/4 4 ' 0 . 11/4 STD. PIPE THD. 25/16 [--4- 43/0 N07 E: CASTING DIM. MAY VARY ± 1/e k ST. CROIX COUNTY ti~4 WISCONSIN ZONING OFFICE ~t y 1. i 'A ; ~ ~ a i s ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 .W October 6, 1992 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An onsite soil investigation of the Neal Dittman property, located in the SW1/4 of the SE1/4, Sec.2, T29N, R16W, Town of Baldwin, St. Croix County, WI., has been conducted with the assistance of Bennie Helgeson, CST# 3094. This onsite revealed suitable soil for onsite sewage disposal to a depth of 14" while meeting the requirements of the A + 4" rule. This site should be suitable for new construction utilizing a mound septic system having 22" of sand fill. Should you have any questions, please feel free to contact this office. %Sincely, CV% hompson Assistant Zoning Administrator cc: file ST. CROIX COUNTY w WISCONSIN ZONING OFFICE AMY ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 October 6, 1992 DILHR Bureau of Building Water Systems La Crosse Regional Office 2226 Rose ST. La Crosse, WI 54603 To whom it may concern: Please find enclosed an onsite soil report verification of the Neal Dittman property, located in the SW1/4 of the SE1/4, Sec.2, T29N, R16W, Town of Baldwin, St. Croix County, WI. Bennie Helgeson requested that I Fax this to you as he has this site scheduled for plan review Oct. 9, 1992 under plan I.D.# S92- 40999. If you have any questions which I can help clarify, please do not hesitate to contact me. Sinc ely, es K. Thompson Assistant Zoning Administrator cc: file ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 October 6, 1992 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An onsite soil investigation of the Neal Dittman property, located in the SW1/4 of the SE1/4, Sec.2, T29N, R16W, Town of Baldwin, St. Croix County, WI., has been conducted with the assistance of Bennie Helgeson, CST# 3094. This onsite revealed suitable soil for onsite sewage disposal to a depth of 14" while meeting the requirements of the A + 4" rule. This site should be suitable for new construction utilizing a mound septic system having 22" of sand fill. Should you have any questions, please feel free to contact this office. Ssince ely, orK es K. hompson Assistant Zoning Administrator cc: file STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER e j ~i--~vhun ROUTE/BOX NUMBER -2- /16-rti Aue Fire Number 1 I CITY/STATE LI)OrIAUi ZIP `546';4 II PROPERTY LOCATION: SW Sections, T ~ N, R /G Town of dtoin St. Croix County, Subdivision N/A Lot number Al /A Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists 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 treat- ment 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 systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. 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 Depart- ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNED 1) ATE ? - St. Croix County Zoning Office P.O. Box 98 Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. APPLICATION FOR SANITARY PERMIT y 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 f. 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. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - r Owner . of Property 'Location. of Property 4t) W- 14, Section a , T~ N-R~ W Townshipc_~W V-\ Mailing Address r~J(p I I C~ ~V'~~f' - lac,3 0C1 C) (i Lk) f:) 4v Address of Site ~~Ame- ~ Subdivision Name _ NIA Lot. Number NJIA Previous Owner'.of Property Total Size of '.Parcel 87 o_c A-e-S --.,Date Parcel was Created 7- 79 :Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume'. and Page Number ,96p, 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 refer- ..ences.to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION 1 (We) centi.by that att •dtatemen.ta on this Bohm ahe t.&ue to the but ob my (oun.) knowledge; that I (we) am (ane) th.e ownen(.a) ob the pnopWy dean bed in thi6 .i,nbohmation boom, by vi tue ob a wahAanty deed neconded in the Obb.ice ob the County RegiAten ob Deeds as Document No. 3-6:!; and that I (We) pneaentty own the ptopo.s ed z to ban the sewage dZz po aZ d ystem (ox I (we) have obtained an easement, to nun-with the above dacAi.bed pnapenty, bon the const)cucti.on ob said :•ayatem, and the .same had been duty neconded in the Obb.ice ob the County Registeh ob <':.Deeds, as Document No. ) . SIGNATU OF, OWNER SIGNATUOF CO-OWNER (IF APPLICABLE) :;,DATE SIGNED DATE SIGNED onsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of ;and Human Relations - bi li - of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach` complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but 4 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 ;it /P GL GOVT. LOT ..S 1/4 4,S 2 T oZ N.R I t'o E (r) W 111% A 1A PROPERTY OWNER':SMAIUN ADDRESS LOT# BLOCK# SUBD.N OR CS `s . O CITY, ST~TE ZIP CODE PHONE NUMBER ❑CITY ILLAGE WN NEAREST ROAD kc~ 1 r W 646 Z,~ (7/5) 7 J e L~ [ ] New Construction Use [ Residential / Number of bedrooms- :3 [ J Addition to existing building jq Replacement [ J Public or commercial describe Code derived daily flow Vt 66 gpd Recommended design loading rate bed, gpd/ft2_ . L_trench, gpd/ft2 Absorption area required, 100 bed, ft2 5'0 trench, ft? Maximum design loading rate S bed, gpd/ft2 .6 trench, gpd/ft2 Recommended infiltration surface elevation(s) , 4 '7 S 4 s4-t.,a ft (as referred to site plan benchmark) Cy ro4j EI. 9'9' u.ww.., 6.,tj, .lrt3.d 94e Additional design/ site considerations .;V' ,Sa un CQ,e r Ltn p, Fa (1 < e d- P~ es r- / . 8 3 Bed ;5'V-7N' Parent material S Flood plain, elevation, if applicable /J ft S =Suitable for System CONVENTIONAL MOUND IN -GROUND PRESSURE AT GRADE SYSTEM IN FILL HOLDING TANK U =Unsuitable fors stem El S l7~ ©Sr0 U ❑ S l ❑ S ~U ❑ S LLB' t~ S' ❑ U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon Texture l Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr:'Sz. Sh. Bed Trent Ll 2 ~c 57 Ground -.1 to w. S 6 r Lj elev. r I 10 ESL -.3 , 5 7. "`3w s~ ro Depth to limiting cc 0 factor ILI " ~c0 n 5sk-d 0z -n I C) CIO x Remarks:m o Boring # Lk 5- .5 Lk fy~ /0 ye 9;~ 3 1 y ao o 11, 1Z 1~- Y r, K> r c L.J Ground w.~p a el ft. o -3 \ S Yee ` S• c L -6 k I. Depth to limiting factor lL~l' Remarks: CST Name:-Please Print r7 1 3Z) 7 Address: c~ .7 ILI' ignature: Date: CST Number: ILI. PROPERTYOWNER- )jCct ( f, AY,,,g,-- SOIL DESCRIPTION REPORT Page - of PARCEL I.D.# 0O Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft In. Munsell Ou. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Bo~u~clary Roots Bed Trench M-1113 r5 V,, EA J~ b6 GA)r round I S 1-6 o %d elev. 3 q ft. s 6L Depth to. limiting factor, Remarks: Baring # s . S 4 1 - IoyCL ;L Ground 3 a elev. If -7. r Y kA C 3 C Sb vv,~ fif ft. Depth to limiting factor I-all Remarks: Boring # 0 L R s G~ ~J u f i, 3< n 1.r w. 3 W Ja:f -3 s ' Ground elev. tL. Depth to limiting factor Remarks: Boring # M,.,., Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) b -6 o CD b T t Mac ~ Y O ~ W m V~ r s T SG 1 f f-N; T o + ~ _ As G T f 4 • ~ h a W ~ W ~ G n+ vf' FAN--sJ - I i CERTIFIED' SURVEY MAP N0. 83o 0 Part of the Southwest 1/4 of the Southeast 1/4 of Section 2, Town 29 North, Range 16 West, Town of Baldwin, County of St. Croix, State of Wisconsin, as described in Volume of Certified Survey Maps, page 830 as Certified Survey No. 830 358426 D ! ~ ~ 0 d UNP AT ST. CROIX COU URVEYOR'S xISTI G BLDGS S 870 30' 05" E 588.60' ~O3s. 89° 50. 25 19a 3 0- N Cl/ M t- NORTH M Ui • - 3/4" x 30" IRON p N ROD WEIGHING w r~ O BRG. REF. TO THE. WEST C5 0 1.502 LBS/L.F. (DD as°lav `n LINE OF THE SEI/4 OF J0~ 2n° 22' lo" N 86040,00"W SEC.2, T29N, R16W N ASSUMED BRG. 96 UNPLATTED.05 N 00 05' 54" E LOT 1 LANDS. W W m J 't cp 7.84 AC.= N CALE IN FEET to cD Lo d 3 o r1 6 M 3 0' 100' 200 300' O pC M O Z if) UNPLATTED ~ry o °O o LANDS N to M M °t 468.15' se°57'2' _ - in - N 86 59 37"W E S 86° 59' 37 E -SE N. 2670.04 S I/4 C 0 R- C. 2 T29N, R16W SOUTH LINE SE COR 7SEC2 3/4" z• 30" IRON ROD SE 1/4, SEC.2 T29N, A UNPLATTED RAIL ROAD SPIKE • LANDS SURVEYOR'S CERTIFICATE I, LEON R. HERRICK, Registered Land Surveyor, hereby certify that I have surveyed, divided and mapped a part of the Southwest 1/4 of the Southeast 1/4 of Section 2, Town 29 North, Range 16 West, Town of Baldwin, County of St. Croix, State of Wisconsin, more particularly described as follows: Commencing at the Southeast corner of said Section 2; 8 9 Thence N. 860 59' 37" W., 2,202.97 feet; A 10 Thence N. 010 57' 50" E., 33.00 feet to the point of beginning; FILED Thence N. 860 59' 37" W., 468.15 feet; Thence N. 000 05' 54" E., 6:63.97 feet; JUL 18 197x. Thence S. 870 30' 05" E., 588.60 feet; ~ O ~ ~L Thence S. 020 39' 30" W., 235.72 feet; ft cox Cow,,,,, Thence N. 860 40' 00" W., 96.05 feet; B VVt =do Thence S. 010 57' 50" W., 433.23 feet to the point of beginning. E Said parcel contains 7.84 acres, more or less. That I have made such survey, land division and plat by the direction of A. I. Cronk. That such plat is a correct representation of all the exterior boundaries of the land surveyed and the subdivision thereof made. That I have fully complied with the provisions of Chapter 235 of the Wisconsin Statutes and the subdivision regulations of the Town of Baldwin and the 0 Iity of St.`Croi.x in surveying, dividing and mapping the same. ti DATED THIS DAY OF 1979. f LEON R. HERRICK, R gistered Land Survey r - t~-'Q'ED 'APPROVAL OF THIS MINOR SUBDIVISION • DOES N"T M_AN APP.;CVAL FOR J U It I 1 1979 BUILDIAG S,T.: OR SEPTIC SYSTEM. REFER TO H62.20. ST_ l y COI' rttHENSIV[ Pk.~nS YLANNINf,~ VofimC 3 Page 830 AND 'ZONING COMMITTEE