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HomeMy WebLinkAbout020-1285-60-000 ~ O 3 O ao p Efl C ~ I O O N N ' h C4 Q C M ~ U ~ I M co - O a 9 O) C LL C M O_ t0 LL ~p > Q O 3 ~ 71t a> 2i Z H Z O : O O m d O N F- Z d m c 0 C U C O Z 4 p m 2 c O !A F- m m z c O 0 -1 O M O N 0. > O O cn N C N CL U L O U c C O U O l i O Q ? O Z F- Z o N a z o r N E N 7 R w C E !0 a! ` f0 I X p a w- U` C 'I. O U N d d ON U) O c c a U m E n I U (n co - 3: 3: 3: d N O ~e Z 0- IL IL a O IL y (mil p y D M M 131 1~ N J U L O2 _U N O O O O N N 00 O 0O 5 ~ M N a v m aNi ~ O m Q } O LL 1 O O E T C E co (0 0) O O M C W O O N' 0 0) 0 0. 00 O O Q7 Q C C a m N N r -2 'Z V O 00 O~ X C o o c O 7 M O C M C N Cl) a) N 7 pMj C', y E (0 m U z U) 4i E '9 ID v a`, co ! a #t a I! L: a w • a E i C C w 3 A ca a 1, 0 in ( Parcel 020-1285-60-000 08/28/2007 11:49 AM PAGE 1OF1 Alt. Parcel 21.29.19.1383 020 - TOWN OF HUDSON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner O - PATRICK, MITCHELL L & LYNN M MITCHELL L & LYNN M PATRICK C - %ST CROIX CUSTOM FAB %ST CROIX CUSTOM FAB 589 SCHOMMER DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 589 SCHOMMER DR SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 2.010 Plat: 2496-ST CROIX INDUSTRIAL PARK SEC 21 T29N R19W PT N1/2 NE1/4 LOT 6 ST Block/Condo Bldg: LOT 06 CROIX INDUSTRIAL PK 2.01AC ST CROIX CUSTOM FABRICATING ASSESSED BY DEPT OF Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) REV-MFG 21-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1025/627 QC 07/23/1997 1020/21 WD 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/05/2007 Description Class Acres Land Improve Total State Reason MANUFACTURING G3 2.010 0 0 0 NO Totals for 2007: General Property 2.010 0 0 0 Woodland 0.000 0 0 Totals for 2006: General Property 2.010 55,400 389,100 444,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 v , STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER~iPO/~( ~GtSTc~~vl / /~/S - ADDRESS /7~s/Jro.✓ SS'QJ6 SUBDIVISION / CSM# 'X Z4AZn~&55DarFe16--14 LOT # SECTION . T-;)q N-R / W, Town of /4'J50A) ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM rl o.v/rrl ~R . ~FN c NNI ARr(- i '011 or Ar Aj E- l aT ~P.vtR ELEV. 90e7. lei S~ .~8~/~~ poste a ~~K~•v ~ ~ 0kCA,AJo447-1:iv50Q,-r-F10,A fj.AJd Al i At T- ED w- 41-7' _7.~sOA.4no'v 0611 r&A-7-1V Aj VE INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover- i r BENCHMARK : l "S/~'p,~ ~QE LIT Al -,c-. !~f'DAK-er`/ ~oP.VE~ E46 V. lv Jr- 6 " ALTERNATE BM: ~ti/SN / av/! ~~c ✓ 9/~ `/y SEPTIC TANK / PUMP CHAMBER / HOLDING..TANK INFORMATION Manufacturer: &Jlelg ~ Liquid Capacity: iS4C- lorfc C~fF'/CE ~/S~iNG Setback from: Well ?,g,oo " Hau~e ~Y" sa' 6r ~9. oo " Pump: Manufacturer A/A Mode l#A/4 Size A114 Float seperation A Gallons/cycle: Alarm Location n/A .SOIL ABSORPTION SYSTEM Width: Length S/' Number of trenches Distance & Direction to nearest prop. line: )1,)vfr14 lam" OGf/CF ~ QC.I~tQ~,i) Setback from: well : y , oo' House 96 Sv Ott y 5'o,ao ELEVATIONS Building Sewer 913-00* ST Inlet. 911,s y , ST outlet PC inlet 1\14 PC bottom A/A Pump Off AIA Header/Manifold y'D 5~~ Bottom of system 908. 9S Existing Grade / SS_ Final grade 3S DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: 3/93:jt L+ 0ATJ0Hprtbi>iW0NL QA.29.19 ( 90RE ~~'+~YSTEM County: Laborland Human Relations INSPECTION REPORT Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Sanitar unit Permit Holder's Name: ❑ City ❑ Village R Town of: State PI UIAXSX) T g scriptio . Parcel Tax No.: e.2.0-1285-6e ee TANK INFORMATION EL A ION DATA A9300189 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Q 91 q 015 90 Dosing Aeration Bldg. Sewer (-Ds j 06 Holding St / Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. Ventto AirIntake ROAD Dt Inlet Septic yl S r a y NA Dt Bottom Dosing NA Header / Man. ~,g3 9Dq, q ,r Aeration NA Dist. Pipe Holding Bot. System 105 90 "r5 PUMP / SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Lriction System TDH Ft Forcemain I I Length Dia. Fi Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length I No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSION 5 2 LEACHING Manu acturer: SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM INFORMATION TypeO tt. CHAMBER Moe Number: System: 7/1E') 1/U OR UNIT DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length _~L Dia.W/' 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.) s LOCATIONt';HUDSON.21.29.19 (SCHOMMER DRIVE) r I ~ \ ra~ $ ro ~ rs~ 4 v y~ , ~ Plan revision required? ❑ Yes ❑ No 4/- Use other side for additional information. 94 k 4 t' 4~ SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: SANITARY PERMIT APPLICATION 7 UILHR In accord with ILHR 83.05, Wis. Adm. Code COUNTY -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ 8% X 11 inches In size. eck 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. PROPE TY OWNER PROPERTY LOCATION v a•y+ /4 T/ c~.t/ A/,!57% AX6 S `o 71 T ?q, N, R /q E (oilg) PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # ~9 (I NA CI , STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME 99R CSM NUMBER />So.u Syo/ / " 3 -12e// ST ,PO/x V _C-iVTU/j4- t45 /,+L 11. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD ❑ State Owned VILLAGE O5 ON ~c nld~n'/E/T Q XPublic ❑ 1 or 2 Fam. Dwelling-# of bedrooms - A TAX NUMBER(S) III. BUILDING USE: (If building type is public, check all that apply) cr0 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. ❑ Reconnection of 5.E1 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-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-in-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 12. 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 S9C7 931~. SS r• Feet 9/~?- <Feet VII. TANK CAPACITY Site in alions Total # of Prefab. Fiber- Exper. INFORMATION New lExisting Gallons Tanks Manufacturer's Name Concrete structed Con- Steel glass Plastic App Tanks Tanks -1 F1 n F1 Septic Tank or Holdin Tank Tanks /6{ s- / G✓i~SE Lift Pump Tank/Si hon Chamber 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 Si ture. (No Sta MP/MPRSW No.: Business Phone Number: ®~4 MQiC 339 (Ws, _5 Z, - 'So PI mber's Address (Street, City, State, Zip Code): /V '44 IX. COUNTY DEPARTMENT USE ONLY ❑ Disapproved Sa tary Permit Fee (Includes Groundwater ate Issued Issuing Age t s re (N tamps 0~ Surcharge Fee) Approved E] Owner Given Initial a q 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 wilii 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. It. 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. Vlll. 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 incl:.ade the following: A) plot plan, draws 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 boxps; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal acrd 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 nun-,Ih , Jf regulated practices which can effect groundwater. The monies collected ilrtougli these surcharges arcs used for rrianitoring growidwater, ground- water contamination investigations and establishment of standard SBD-6398 (R.11/88) STC - loo This application form is to be com leted the U ner s p In full and signed by ) of the property being developed. Any inadequacies will only result in delays of t permit issuance. Sh d this development be intended for resale byowner/contractor t 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 1 r 1 , 4-, KP,~ ~ 'Pok( i 6L_ - Location of property& 1/4 __1/4f Section Township aroSb Hailing address Address of site J C rnr, Subdivision name 4,cro`1 Lot no. Other homes on property? yesrV'*~_No Previous owner of property -Lb() HaS've, Total size of parcel a OQLCS~es Date parcel was created Are all corners and lot lines identifiable? I/Yes No Is this property being developed for (spec house)? Yes _►✓No volume and Page Number as recorded. with the Re iste of Deeds . q r INCLUDE WITH THIS APPLICATION THE FOLLOWING: - A WARFU1ITY DEED which includes a DOCUMENT NU2iDER, VOLUME AND PAGE, NUMBER & THE SEAL OF THE. REGISTkit 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( the property described in this information form, by virtue sof of warranty deed recorded in the office of the county Register of Deed; as Document No. _ a Vet ion own the proposed site for the a ages disposalt ystem) err I e(we) obtained an easement, to run the above described for the construction of said system, and the same hasopbeen,duly recorded in the office of county Register of deeds as Document No. signature of apcant Co-applicant Date of lgnature Date of signature _ _ , l r.... .1p. - Iv WARRANTY DEED 501802 rni 10-nu 21 This Deed, made between ....Sai.nl:..Gi;azx..Xantuxfas.............. ST. CROiX CO., W1 I a..MinnasRz..ztexal,..D.ar.tt~ezshi.R Recd for Record . Grantor, J U L 6 1993 'I and.....Sz ~xn~x.: ~uS.tAm: kabx.i.ca>ni.on,., .Zn~.. at 8:05 A, M W1t11 Grantee, IRegisterofiDeedg esseth, That the said Grantor, for a valuable consideration...... conveys to Grantee the following described real estate in St_..Croix........... R[TURN TO The First National Bank of H son County, State of Wisconsin: 307 2nd St Lot 6, St. Croix Industrial Park in the Town of Hudson, St. Croix County, Wisconsin Tax Parcel No i i I I This is..no~....... homestead property. Oa) (ia not) Together with all and singular the hereditamenta and appurtenances thereunto belonging; And.......Sainz..GXQIX..)IBTiCl3x~,S ..........................................."""f warrants that the title Is good, indefeasible in fee simple and free and clear of encumbrances except easements and restrictions of record and will warrant and defend the same. 1 -e_ Dated this day of u-c.~ 19..53... .....................................................................(SEAL) ::Sainn:,.Cxnix..V nt res. ....(SEAL) • /L /G.'.7 . I (SEAL) ....G~~~~~•/~.~~ (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF MINNESOTA Hennepin..................County. as. authenticated this ........day of 19...... Personally came before me this .....Z`.. day of 19..9 the above named TITLE: MEMBER .C `rt.4-~ ER STATE BAR OF WISCONSIN 5o-c-cr >t Cvci ................t~...: - P.F........................ (If not . authorized b y § ?06.08, Wis. Stats.) to me known to be the p a son 5 who ecuted the foregoing instrument d ckno 1 e the THIS INSTRUMENT WAS DRAFTED BY Notary Public county, ~ (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) date: #Name$ of parsons eltalnR is any eapanity should b0 typed or printed below their elfin NOTARY PUBLIC-MINNESOTA RAMSEY COUNTY WARRANTY DEED STATE BAR OF WISCONS MY,oMMifsion ePVAEIE%,tk9 tai lank CO. Ina FORM No. I -1984 S T C - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER I~~IfOQ,~~ ADDRESS S'39 FIRE NUMBER CITY/STATE--" ZkC r-) ZIP_ "SH d PROPERTY LOCATION: AIZ-_1/4,IVE 1/4, SECTION, T_.JLN-R.L_W TOWN OF_~~~ , St. Croix County, SUBDIVISION 0\k/~~`"' 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 a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification 'form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1). the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/Ile, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix Co. Zoning officer within 30 days of the three year expiration dat . SIGNED: DATE:-- St. Croix co. Zoning Office 911 4th St. Hudson, WI 54016 Wisod'►.in Department of Industry, SOIL AND SITE EVALUATION REPORT Page I of Labor and Human Relations Division of Safety 8 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 r ➢ x 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 Q E (or) W 51''CA0I X lr C.f % A7 5 iCA T /d GOVT. LOT /q ~ 1/4 /J ~ 1/4,S'2/ T Z N,R 19 PROPERTY OWNER':S MAILING ADDRESS LO g BLOCK # SUBD. NAME OR C M # 41L iC S-- Cho rx 1V us R I A L CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑V LAGE OWN NEAREST ROAD ( ) 14j"bS6 sJ CT N to New Construction Use [ ] Residential / Number of bedrooms [ ] Addition to existing building j ] Replacement IV Public or commercial describe Code derived daily flow gpd Recommended design loading rate 0 bed, gpd/ft2 trench, gpd/ft2 Absorption area required bed, ft2 trench, ft2 Maximum design loading rate 0, 7 bed, gpd/ft2 trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable ft S = Suitable for system CO VENTIONAL MN~gUND IINyROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING T K U= Unsuitable fors stem S ❑ U l31 S❑ U NG S❑ U WS ❑ U Ill S❑ U C3 S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench / lQy~2 C 2 O. 0.S V I 16Y4 4L-z- r -9 Z 01 Ground B i'>t~~ S tL. SID ri~'I r O•S° O,t; elev. 90 6,1 `~ft. r .l 0$ 0, .6 1 - 137 i oyR, 4 4 Depth to limiting f Ctor Remarks: Boring # 0A 16.5' .L7.146olAyp *14 Ground elev. IOA ft. Depth to limiting 7 fa tour Remarks: CST Name:-Please Print ilA~ Phone: _ r~.. 6 14 N5jovo ~ t1 Address: Signature: !`I Date: Z p3 CST Number: 1~ 4 PROPERWOWNER S°sCRet,yC-OS-Icyh SOIL DESCRIPTION REPORT Page I of 3 PARCEL I.D. # Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench 11 Ground elev. 103,31 ft. Depth to limiting factor Remarks: Boring # AA 7.s y d - L. I s k r~,~r C . 4 0.s" 0.7 03 A9-/I-Z 16YKP iA Ground elev. &A,- _7t ft. Depth to limiting factor /4,93 Remarks: Boring # A 4 ioYR 3 / -4 4/3 10 '7 0 Ground elev. 103.79 ft. Depth to limiting fa for Remarks: Boring # 13 Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) loool~i CAI i~ i C J fy _ stn a. `r a 1. ap I- cb. °o - - Q C`~~►h~ LS,pf3 .5E . I I ✓ i a0 ~ t ~ 1 t c,t ~4 C~o V ~ r G PUL f f CP F SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations July 26, 1993 2226 Rose Street La Crosse WI 54603 ZAPPA BROS EXCAVATING 715 6TH ST N HUDSON WI 54016 RE: PLAN S93-40784 FEE RECEIVED: 240.00 ST CROIX CUSTOM FABRICATION NE,NE,21,29,19W TOWN OF HUDSON COUNTY OF ST CROIX NON-PRESSURIZED IN-GROUND 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. Sincerely, erard Swim Plan Reviewer Section of Private Sewage (608) 785-9348 cc: Leroy G. Jansky SNn-was M. 01/91) • T. N ~ IN i ,n Z Z -c o Z~ ~ R~ n 1 s h, h s o ~ p~ ~14 r I E V, j v 1~w p CA m m " to o ~ i a 1 A ~ 10, t 0 ew t v de n 6n m i doSs not ~s sci►~oidi apPsov tkeam of e ~ vUis Ad a d ii.'~di-e submitt3i. p and ~i~ee ittSeGtiun lan tan ~}eterr,'tioe `+~izetl:ec to wised for that plum irs 1eq o o U ° W ^ b o N e0 .e Oft M zt' a R " Aift ' G G ~ ce) z \tlftA P, r) NA 'y 1 r 3 3 a ~a e b 3 b ~ e z c h i z h k ~ n a o a ~-0 X10\ s Z g Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page I of S Labor and!-Wman Relations 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 CEL I.D. # not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or ~ W94 CE dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED-BY DATE PROPERTY OWNER: PROPERTY LOCATION c S ; ICAO f x cl 5 ; M ~d IC A-1 /Q. GOVT. LOT n(L t/a 1/4,S '2 / T Z N.R 7 E (w) W PROPERTY OWNER':S MAILING ADDRESS LOT,# BLOCK # SUBD. NAME OR Cp # CITY, STATE ZIP CODE PHONE NUMBER ❑CITY EIV LAGS OWN NEAREST ROAD ~j C r N Ul. New Construction Use[ J Residential / Number of bedrooms (J Addition to existing building j J Replacement rVf Public or commercial describe Code derived daily flow gpd Recommended design loading rate Q • bed, gpd/ft2 05S trench, gpd/ft2 Absorption area required bed, ft2 trench, ft2 Maximum design loading rate 0, 7 bed, gpd/ft2 03 trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL M UND INS PRESSURE AT-GRADE SY TEM IN FILL HOLDING~~T NrfK U = Unsuitable fors stem S E3 U S ❑ U S ❑ U WS ❑ U S 13 U El S PrU SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft Boring # Kfton,' in Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 4/11 Al 2- o Ground S <<. 5~~ 1 ~•S ~,6 r elev. - 13Z 'O 4 4 Depth to limiting Remarks: Boring # 4 Z . -17 ? rY c; r~ l 0 S O.6 -7 10 Ground elev. /qA.IQ ft. Depth to limiting ' fact Remarks: CST Name:-Please Print Phone: "T, 0 :S s Address: Signature: Iyr Date: Z /9--? CST Number: ,•r •aY~\ •PROPERTYOWNER`- I-6ze,jxC-`'"N,"h FA4 SOIL DESCRIPTION REPORT Page -Z of 3 a PARCe4I.D. # Depth Dominant Color Mottles Texture Structure consistence cots GPD/ft Boring # Horizon in Munsell Qu. Sz. Cont Color Gr. Sz. Sh. BoWal/ Bed Trends Ground elev. 16339 ft. Depth to limiting factor i ie'63 'I Remarks: Boring # 7:3y~ 'z Io 3~3 SI slag n,~r r- 1 S p,6 f) A Ground elev. J ;lg ft. Depth to limiting factor y >I,g3 Remarks: Boring # Z K 4 2, ,&K g 'z.1- 3 10YP,44 d M.OA a .7 d. Ground elev. 103.7 9 ft. Depth to limiting > faqtor~ O Remarks: Boring # }:y Ground elev. ft. Depth to + limiting factor Remarks: SRn-a33n(P N;/Q9~ 1 E J C'o z~ 0 , q u cb - - J ~ ~ ~ hi -C-S'~l ~ 1 ~ ( Xj 1 111^^^ CIO 'o M13 y y Q 60 41 40 v 2 G 1- 1~.1 FAQ r- 3 U d- CP J .r Q 07 v