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HomeMy WebLinkAbout020-1100-00-000 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER 114,4/Pe SDI 3 8~P 37G ADDRES 690 /S i4egE~° R~ ff c~QSO-~ w/S . Z yoi 60 SUBDIVISION / CSM# LOT ~b SECTION, 3/t T Zf N-R /f W, Town of L4 v '2-- T) ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM I S~~ ~trT~~~0 70-414, INDICATE NORTH ARROW Provide setback and elevation information on reverse of this-form. Provide 2 dimensions to center of septic tank manhole cover. I GU i~a d3 :~5 4el /f a T BENCHMARK: / ALTERNATE BM: 00 0 w~cv S pTT c T~~~ - CvE S Co.u 40e77 - 0 ON SEPTIC TANK / PUMP CHAMBER / !ui ES~R CovG,e JL_ (IELV ~•G . - l~1E~1~S Co-Ia•1 71-2 049 - Manufacturer: / e lD Liquid Capacity: Z&a Setback from: Well 6,0 House r Y5 Other Pump: Manufacturer 00el11EX Mode l# Size 1/06/ Float seperation l0',~ Gallons/cycle: 2e Alarm Location 'y 1,"V0 S,6_ i f~tJ~ S ~~4GG~. ~ X 7 Z 3 T~ :SOIL ABSORPTION SYSTEM i Width: S Length ~Z Number of trenches 3 Distance & Direction to nearest prop. line: 40E5 T i i Setback from: well. House * 1490 Other ELEVATIONS Z 2 Building Sewer ST Inlet: - ST outlet PC inlet PC bottom Pump Off Header/Manifold Bottom of system Existing Grade Final grade DATE OF INSTALLATION: Q PLUMBER ON JOB: WM - r-T ~L~ r C LICENSE NUMBER: , /"oeS 330 7 INSPECTOR: V 0^ PMA,7 r ~S S 1 Z~'J I~it,Cl~ 3/93:jt©~ Parcel 020-1100-00-000 01/19/2005 04:50 PM PAGE 1 OF 1 Alt. Parcel 34.29.19.402D 020 - TOWN OF HUDSON Current [XI ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): Current Owner " SCHINDLER, DOUGLAS A & SUE R DOUGLAS A & SUE R SCHINDLER 680 BAKER RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 680 BAKER RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 5.000 Plat: N/A-NOT AVAILABLE SEC 34 T29N R19W NE NE LOT 10 AS SHOWN Block/Condo Bldg: ON CERT SUR MAP IN VOL I PAGE 94 ORD Tract(s): (Sec-Twn-Rng 401/4 1601/4) 34-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/15/1998 583057 1340/396 WD 2004 SUMMARY Bill Fair Market Value: Assessed with: 48407 224,100 Valuations: Last Changed: 04/29/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.000 58,000 115,400 173,400 NO Totals for 2004: General Property 5.000 58,000 115,400 173,400 Woodland 0.000 0 0 Totals for 2003: General Property 5.000 58,000 115,400 173,400 Woodland 0.000 0 0 Batch Lottery Credit: Claim Count: 1 Certification Date: Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 pi ll ERVEYOIRNCORUECORD 3260(9) . NORTH LINE OF NE 1/4 - SECTION 34 NE CORNER SECTION 34 S 89° 53' E 1317.39 T 29 N, R 19 W 392.00 567.00 358.39 ' 190 05 0 0/1 POINT OF N E 1/4- NE 1/4 BEGINNING W M LOT 9 -OD -rn LOT 10 W _ LOT II ~O o co o LO 0 r-: 5.0 ACRES $Q o N 5.22 ACRES o\ O~ z Z to ^O <o~ LOT 12 co v 6.23 ACRES ~ `r W NORTHERLY RIGHT- OD Z OF- WAY INE Oo p6 _ a Ya 6 oh 392.00 88.4 -IOO 3 u- -CO D _ _N 69°58' W - 80.40' o z NORTHEASTERLY -O O J TRUE RIGHT-OF-WAY LINE o (n BEARING - - -TOWN ROAD - Q Ui 3 Fo ~csSSS%~`~ LOT 13 w _ SCALE 5.01 ACRES L tr io® 50' ICo' LEGEND 1 1 N 0°08 E %9 t-3h 62.37 ~ o°o o - 1" X 24" IRON PIPE WEIGHING 1..68#/LINEAL FOOT. I 1 e~ 570.25 C'47 I N 89° 58 W - SECTION CORNER MONUMENT I ( LOT 14 CURVE DATA TABLE I I- EASTERLY RIGHT-OF-WAY LINE Curve 1-2 R = 266.00' I t g-~ U rrr1rrra ft Central Angle = 90 ° 06' I I \V' Chord N44°55'W 376.51' n F,dGON Tangent BearingN0°08'E Ak '#"19T5 i' N FRANCIS H. Lot 11 R = 266.00' Lot 13 R = 266.00' to "aft «oNrvKt 1 0s zN UVWW x e~ ntral Angle = 30°14'50" Central Angle = 30°02' yew, ti = a Chord = S74°50' 35"E 138.80' RivE Chord = S14°53'E 137.84' .p VRV.L~' 600 ft Lot 12 R = 266.00' Central Angle = 29°49'10" tiO (v 0 Chord = S44°48' 35"E 136.88' 3Q f- 9 r, $URJ SURVEYED FOR: Kenall Builders, I-94, Hudson, Wisconsin 54016 A parcel of land located in the NE1/4 of the NE1/4 of Section 34, T29N, R19W, Town of Hudson, St. Croix County, Wisconsin, described as follows: Beginning at the NE corner of.said Section 34; thence S0°08'W (true bearing) 884.76' along the East line of said NE1/4; thence N89°58'W 570.251; thence N0°08'E 62.37' along the Easterly right-of-way line of an existing town ro d; thence Northwesterly 418.30' along Northeasterly right-of-way line of sdiYlexisting town road on a 266.00' radius curve concave Southwesterly whose chord bears N44°55'W 376.511; thence N89°58'W 480,40' along the Northerly right-of-way line of said existing town road; thence N00081E 557.831; thence S89°53'E 1317.39' along the North line of said NE1/4 to the point of beginning. I certify that the above description and map are., correct and that I have fully complied with the provisions of Sec. 236.34 of the Wisconsin Statutes.' Date: March 5, 1975 FRANCIS H. E - Map. No. 5- 35 1 Volume 1 Page 94 r l~ Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page / of 3 Labor and Human Relations - Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY T. e5•Po~ X Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but S 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. 10 Zo - IlQd -ao -pe D APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIMBY DATE s~ X95'3 PROPERTY OWNER: PROPERTY LOCATION /it?~ crA///'Soiv GOVT. LOT /V,6 1/4N,5_ 1/4,s 3YT ay N,R IE( PROPEF(rYQWNER'.S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # (D KO ~ CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE QfOWN NE^AR€ ST ROAD f /f Ul.2SoAol 4VI, 5 I/OfC, (1i~ 3&,- yG2- HvV5o,~/ l3~lif'E/P RO [ j New Construction Use [ kResidential / Number of bedrooms y - /91U5 [ j Addition to existing building ikreplacement [Public or commercial describe_ L- e"SZD D,>r' 4:~VF_ - Q Gtii %1>.C°~'-v Code derived daily flow gpd ~ Recommended design loading rate bed, gpd/ft2 trench, gpdtft2 Absorption area required bed, ft2 ~'fO trench, ft2 Maximum design loading rate bed, gpd/ft2 ' d trench, gpd/ft2 Recommended infiltration surface elevation(s) s-?-Q P 3 ft (as referred to site plan benchmark) Additional design / site considerations A40,-CeS ,6 - 5, 7-- Aw /PC Gw%t°E 1-11-7- /00-O s r 71 u Parent material -5C-5 &61 2011k !,A R D r Flood plain elevation, if applicable ft TTY acs w S S =Suitable for system CONyEl4 f10NAL MOUN U IN GR~N ❑ D U ESSURE ALT-GRADE SYSTEM IN FII ❑ HOLDI TAW S NG U = Unsuitable fors stem 1dM El U Q-T [[~-S CC'S ❑ U E3 S (J SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/11 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed tertdi 0 -/0 10YX 2-12 S/ 4,*4 she lk" lrfip f S G 4z 10-1S /OvA 3/7 S/ ~s /-F s •G Ground 3, 1S- zy /0 YX izy S/ z,f, 5 hK 44.1 R CS I U'f , S G 0/, elev. / ~ fl 132- y3 75 y/? y~lQ /5 0 , 9R r►M v f !2 ax-, < 7 . 00 Depth to /O rS -0 F- /`~°'T Av /c' ,2.0,v 13 h A !9i'SCo u VoU DS aF limiting factor y-'j o'/~e y /y 5, / 1, f, 56K .~.~-f, • Q i , 2 3 ' iao C 3,0 i.zo /o y/p 5/9 • 7 Remarks: Boring # 2 < A- (9 - /o YX L/Z S 2f, sbk iw,f i, C S 2t s G /0 yP- -3 ,Sb 41, U~ 2 Cs 2vt .5 . L Ground 73 V3 2-6 7, S M 15 /WVf ke 3 2- n -34, / /e Sh,C .wi f Z , 3 /o%el Depth to limiting factor Remarks: ! CST Name.-Please Print Phone: ' Ro 3 F,e r- 7.~~ 3~P r'C h T 7/,S- 3 Z- 1 Address: C° S$ 0 'NErL RD. Hvv1ar1) St-101(p y Z -`13 1 Signature: Date: y ( i i , ~ v~ Nbrjs TO c~r/ST1'v'I sys,E-4-1 ;s S/'rE GU / / /~C Cry U~iP~` L T .S TAI L f cwt . ~ PROPERTY OWNER ~~~~l,10.✓ SOIL DESCRIPTION REPORT Page Z of PARCEL I.D. #t Boring # Horizon Depth Dominant Color Mottles Texture Structure ConsistenceBoundary Roots Gw~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ranch p- 0 Vie 2-1 :5 Z.f, 5hC "-6e cS 3-(- . S G 3 .>/3, -~a &P Ye Ground 1-32 0 75 yie lS 4-f, Jri~ a -C ~Uf - 7 elev. 3•Ivo ft. 33 z . 3 C i 0 /o y,~ S/~ -s 0. , S rw~.Q i • 7 • ,P Depth to limiting factor 7Z Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. i Depth to limiting factor Remarks: con ooonio ^cmrn /~-kE- boo ~s (S~io o/S wI ~S ~i,Zr. 1 S s-fvlaE-u T S I i Poll 4/~T-lPf1oW ^ ~~a ~S y w N rn m v, LA °o w d z Z o m m v ~ I G ~ rn 0 O O o 0 8 m V, GcJ65 T LO T li I b f ~l ~ 3 _ °o H SA o Jl~ O ~ aG' 1 ns ~ w ~ o W I ` 77R E.,v G~ vet- Ti o ,v S 7,Pfvr/- FiA.I t / TOP edixe,f HF,4D~,e vE r p sYsrF,~,~ epVZ7p o a O and ~y-~~• ~'s•ooz 3 . ......30 „ ~ - t tz~ IAN 9, Z Z i ~ " w ~n ion X01 ~I n I ~ i ~ y I l i i t i t N l i I I I Iv r ~ rc1 ~ q1 ~ I I 1 W Q IR ' i I I I ~ C O I~w b~ l jJ I ~ J~~^ N^ C a Q I~~ I • I • I ~ A W •tA 4T 3 y a~ ° C o w~, IIi I 6 w "It hh 0 r I y U1 6 b d ~ ~ M as N J Q o W LQge% 'sTQ#p ,t Pe§9us,~y4.29.19.4 XTfjJVMffJySWFA 10 County: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division o.: GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary -Permit Permit Holder's Name: ❑ City ❑ Village R Town of: State Plan o.: S BM E,ev.: ~ Tlo,oz nsp. BMEI BM Description: Parcel Tax No. _ _TANK INFORMATION ELEVATION DATA A9300277/4/0" TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic C~ Benchmark Ge Dosing r~ Aeration Bldg. Sewer Holding- St Inlet TANK SETBACK INFORMATION St/yd Outlet Ventto TANKTO P/L WELL BLDG. Air Intake ROAD Dt Inlet j4,32 Septic ~>14z) NA Dt Bottom Dosing 7~G~~7 Q -60~ X NA Header/Man. Aeration NA Dist. Pipe 93, H Bot. System PUMP/INFORMATION Final Grade Manufacturer 7 r Model Number G161 1GPM 19P Ile TDH Lift 0 0 Friction .,g; System TDH3,1c3 Ft Z3 P Forcemain Length r Dia.,P" Dist. To Well 7~~( iqlf M67 SOIL ABSORPTION SYSTEM BED/TRENCH Width Length / No. O renches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS I N SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING a r' SETBACK CHAMBER Mo el Num INFORMATION Type O ` System: ` z,,C4-< .JQ lj -/Go UNIT DISTRIBUTION SYSTEM Header/ Distribution Pipe s)~ Size ~ole Spacing Vent To Air Intake Length i ` - Dia. Length ~J Dia. Spacing I SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over 11 7~ xx Depth Of xx Seeded / Sodde xx Mulched Bgl./'rrench Center .;-Trench Edges 2510 _3 Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATIO : HUDSON 34. 9.19.402D,NE,NE,BAKER, LOT Plan revision required? ❑ Yes W-N'6 ~ 1(z 4.3 Use other side for additional information. SBD-6710 (R 05/91 ~ Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND. SKETCH SANITA MIT NUMBER: L 3y x:70' ro =7017 LHR SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05, Wis. Adm. Code c~'cX, STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than ! qQo ?A 8% x 11 inches in size. ❑ Check if revision to previous application -See reverse side for instructions for completing this application. NO ATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. ^ 030 U7 PROPERTY OWNER PROEgRTY LOCATION / E or W M X llrSG && %4AT-Y4, S 3 1 T 2f , N, R/Q PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # Q X~o /0 CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER V0 ( r 19s0..a Gi/. ~~1CU~o 3 ~ G 02_,0 - 110C) - 0000 C II. TYPE OF UILDING• peck one) El State Owned CITYLLAGE A NEAREST ROAD L~!I Public CJ 1 or 2 Fam. Dwelling-# of bedrooms I TAX N1 III. BUILDING USE: (If building type is public, check all that apply) Q 2Z - OC/ 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ ampground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 WeZrpcit/School 8 ❑ Mobile Home Park 12 El Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check onl in line A. Check line B if applicable) A) 1.0 New 2. Replacement 3. ❑ Replacement of 4. ❑ 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 ❑ ppage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 Iii Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-in-Fill r+r4, ~ 1i(70 VI. ABSORPTION SYSTEM INFORMATION: J1.0 ~O t . O 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE 7f', REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gasps/day/sq. ft.) (Min./inch) foo•© ELEVATION 7 fo /0 S o ° d .97-0 Feet ~O!• O Feet VII. TANK CAPACITY Site in gallons Total # of Prefab. Fiber- Exper. INFORMATION New lExisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank CO leco 06 Z_ Ltd Lift Pump Tank/ r fCV'v /Ove 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: (No Stamps) MP/MPRSW No.: Business Phone Number: A&V- ZMit1467- ~ I ( 3 Plumber's Address (Street, City, State, Zip Code) le' &.575' 0 ~~r~ ~D,✓ w s' ~'f'O IX. COUNTY/DEPARTMENT USE ONLY Disapproved Sanf ry Permit Fee (Includes Groundwater a 7el s ue Issuing a lure Stam Approved Owner Given Initial Surcharge Fee) Adverse 5.-- Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-8398 (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. 11. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system..Check appropriate box depending on system type. VI. Absorption systerri 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 manufactwer'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 pret»c-(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) Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page Lof 3 Labor and Human Relations Division of Safety & Buildings in accord with ILH R 83.05, Wis. Adm. Code • COUNTY Attach site an on ST GiPO/ Jr plan paper not less than f31/2 x 11 inches in size. Plan must include, but PARCEL I.D. # i not limited to vertical and horizo.ital reference point (8M), direction and % of slope, scale or dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED B" DATE PROPERTY OWNER: PROPERTY LOCATION /i(/e 6!Al// SON GOVT. LOT /VE 1/4 N,'- 1/4,S 3/T -L y NR I E ( iV PROPE NER':S MAILING AQDRESS LOT I BLOCK #I SUBD. Nr'14E OR CSM # b~0 E_( 120 . /0 CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE R OWN, NEAREST ROAD UIJSO,.~ !c,~/, 5 51dr (9is) 3~'G - yG z Hv/~So,t/ /3,145 P R. New Construction Use[ kr'~Iesiden6al /Number of bedrooms y ' s 1 [ J Addition to vdsting building jP]~cet tent [Public or commercial describe 4"e t;"S'FO ~•fr CAE Q GLii %9.C~E•v Code derived dairy flow gpd ~ r~ 2 - Code design loading rate ~ bed, gpd/ft2 french, gpdjft2 Absorption area required _ bed, ft2 ~O trench, 112 Maximum design loading rate ~ bed, O g d french, gpd/R2 Recommended infiltration surft~ce elevation(s) s-f-a- 3 ft (as referred to site plan benchmark) Additional design / site consid':rations -5-64 t?e lo-,o - 5, 7z- w• Gy~~~t°E <fT ~y.N~o STfiT-'o-J Parent material SC S G C4 f3 u R L- In A R D T' Flood plain elevation, if applicable ti1~- It ' r'TE oci 4. S S = Suitable for system ffr~ L2MOUNQ -f U IN GROyND PI~RESSURE AT-GRACE _1 U tsar l~ FU L p SING U = Unsuitable for system S C~'S '=10 SOIL DESCRIPTION REPORT depth Dj.,,inant Color Mottles Structure sten _ GPD/ft Boring # Hori: n: it Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. 'Cons~ Y Roots Bed Trench 0-/U /uY•,e 2-12- S/ ShK ve.?P - f S .G ,4 - /0-/S OVe .31 S/ Z•~, shk .►,~fg 9~ 5 i f . S •G Ground /3. /S- 29 /o YX Y y s/ 2,f, 5 h,C 4,K -f R C5' 1 of , S •G elev. /o/, Go ~Z 1 y_ 3 7. S y,? ~le - /5 O,' yR no 1. f R C2 < 7 1 Depth to P TS R,'T IA., R,,2a v 13 ~ A X ' "34 DS o ~ ri/ f limiting k---* „ y-3 ? / O y/e S /y Sr / f , f, Sd,C' irr f , " Q ti i Z I , 3 ' - G' 3? /uj /o y/e 5/9 s s r- - • 7 ' I d Remarks: Boring # Z C~ - /o YX J-/z S 2 f, s bK f C S 1 . s , G 4-- -l3 .!,/o YR 3/y - s/ 2• ,sb k v~ c C $ 2vt ' , Ground elev. /3z /G -s/ She ;swt f i' Q i , • 3 Depth to Imiting y --f-- - /'9_ i T_ i~ Remarks: _ T Name.-Please Print Ra &FR T Zlz-oR i'c A T Phone:' 3 Z ?.5 r Address: SS d iU E r'L RD • H v Olv S 0l ~a - Z ' `i3 C STM Signature: ) A. Date: _ CST Number: a4- NbTEs To SysT~~f wstv L/fT /,U,y ;''~1 T:c>,tJ ' PROPERTYOWNER~ ~~f 6~l,10.✓ SOIL DESCRIPTION REPORT - Page Z of ' PARCEL I.D. o Dept, II Dominant Color Mottles Structure GP -2 Boring # Horizon in. ! Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sri. Cons~s~noe Bourd3y Roots Bed rends p- d i z-2 z.f; 5AC C5 3 f , S . G / - z<.~ ~D yie i Ground 132 ~s y,e elev. Depth to C i2o /o y,~ 51(f C' S rvM • 7 ; •CP limiting i factor Remarks: Boring # j Ground elev. ft. Depth to limiting factor Remarks: Boring # i Ground elev. _ . ft Depth to i limiting i factor s Remarks: II Boring # ±I rx3 Ground elev. It. Depth to limiting factor Remarks: con ooonro nc1no, rdr7y O~~Ly w~ ~ f ~o~ ~-s r~-yfi~-s SGr<,o o/S GJ/ ,-.t,~S) ~,Qil. 2 S s-fv -v T S I, • y y w N m v,~-~ ~ o w ^ m L L- ~ ~p ~p I p ry a N v op ~o Q ~ rn Z W 0 0 8~ ~ o 6v65 T LD T i I u • i h o~~ I y L o~ w ~ k 0 L • aJ 7k Ilk) r tNj Q o O W v ~ ~ ate' W ~ w i ILH~[t*.08 (2) PROJECT INDEX SHE ST P Owner M~9R~t' Cdr! //rso.v ~~S = 3~?l - ;,1 y Address Site Location Alc. Nt~ Stc7-2 j w Tacv~ af NvDSo sT cR x r0 UA3ry Project Description y o~~ c~~~- <fo,P e' (-4 ZO,P6 ti) A,-.s /f /:541-1- , A-) 6- /3& D./1i~/, si'Z~IJ Co.vVE JTio-iA L T3L P) SL P1 I'C_ S, l/S 7-EA1 Soi L I l.~ ~5 (.8 GpD Ift.~) - f3uT ti~2 10C,A-r10.3 Wf!( RfQUrPC- • ~ , L,F~ Pv~P ST~1Tioti1 . soy/S ~3Cve.t~-CL, ''t"(.2 f,Ai'c i'z6-. S~STE-A-i Y ~to, C copy bi u -t v E- V It f} I'S 1 &4e % Q v T o ti o X Page 1. Flot Plan & System Plan View Page 2t3 Goss>Section of Soil Absorbtion System Page Lift Pump Cross Section VVED Page Pump Specs. ESTIMINTtD UAIL Y I.-)ASE F1owS - a FR.oM y Re ZM HO A-, hod pc~P S . _ I-F P2 3 t 5 3) - S c ° o w I' d-GL o M E A L 5- Z S S-!ojq ,3 't S c I A s s R/`i _ zj f~?~'f...-•».r &i, / Z aosEarw. fob d S~qJ 600 2. 5= 1 y / C~ i G D ULBRICHT D1160 HUDSON. ims. T o Tit L U) A ST E F ~ pt,v - -7 9 Z a-t' ,,Wkwi,;FSIG O ~~IIIIIN~~ S93- 030 95 4t)+o-o- SO F 105-0 Y' s k l •R xi N i • k ~ I . y ~y w N rn m v~~oa~ ~ Z \ Q o °O W O \ 7C o rn Z~--T NIX ~ ~se ~s o O o ~ ~ R ~~o Gv£S T Lo T "C'NO W-11 o~~~ Q NG v~ ~ W© O Q D R C n~0~ Ql~~n w cn n o~ R m 3 1 a 12 r _ A, In G C c i D o f to o L _ ~ o I o y -1-i - f11 V% - r i Ian: a~ I I R x I I J, III rtr o w r I V 1 1 I , R, > r,~ i I I I I O '1 ni Z I I O' ' O I° x C . 111 1 1 I t C ~ l u a ~ ' I I I + t ~ a ~ o~ C L ~p ~ I l t l i w O ~ 1 O ~ i I I I I I ~ H Of ONY . 16 r± ad R ~ ~ o y 1 ~ -P G a n ~ 1 ^ rt 'O \1 Cj to C " ,ti11 1 c O` I ti I y 11 Hp ~o 0 4 0 v ~ 74 $ N, N I'D - 3 0 9 tA y 41 - n Fresh Air Inlets And Observation Pipe Approved Vent Cap Minimum 12"Above Final Grade /o 3. o _ 4" Cast Iron 3 <o " Above Pipe Vent pipe' -to Final Grade Synthetic Covering min. 2" Aggregate Over Pipe Distribution s64 .z7zy - Tee Pipe 0 0 0 0 0 (a Aggregate 0 Perforated Pipe Below Beneath Pips o Coupling Terminating At ' Bottom 01. System ' sys no ID SON OSS P o~QPR~~~~ Pis N S93-03095 . GpP Fresh Air Inlets And Observation Pipe Approved Vent Cap Minimum 12 Above Final Grade /020 Cost Iron Above Pipe 4N Vent Pipe' -to Final Grade Synthetic Covering ~ Min. 2" Aggregate Over Pipe Distribution sA s?X1 Tee Pipe 0 0 0 0 0 Aggregate o Perforated Pipe Below 5 y57-6,cl Beneath Pipe 0 Coupling Terminating At OEM Bottom Of System ' L I . , I I 't of S Fresh Air Inlets And Observation Pipe Approved Vent Cap Minimum 12".Above Final Grade ld/.O 4" Cast Iron 36, 'Above Pips Vent Pipe' -to Final Grade Go W dip ~,v ff- Synthetic Covering tin. 2" Aggregate Over Pipe Distribution rte 219 - Tee pipe 0 0 0 0 0 StAggregate o Pertbrated Pipe Below Beneath Pipe o Coupling Terminating At ' Bottom' 01 S.YCAM Sys r~~ 5~ _ VOW V P~~ 01 1 V;Wo 5~ y S93-03095 r l t s 1 Y N1+, { Va ~D ~a /V.AlC .~D ' o~ Pvc fo cc 2, 2 541 MBE.R CROSS SECTION AND flt f} E F S PUMP CHA VEWT CAP H C.Z. VENT PIPE LOCKING WEATHER PROOF HOLE COVER JUIJCTION BOX &,,V PAA)( lA/3El ?-5' FROM DOOR, 12"MIN. - WIIJDOW OR FRESH ' 1 AIR INTAKE 1 I i y°MIN. / ~Et/~17~ON GRADE ~ yR~v~ 1 r 1~ , I ~ le'Mlu. /00,0 CONDUIT-- 5.0 95.0 PROVIDE L IhIl1E T AIRTIGHT SEAL nli ( 1I1 APPROVED JORITS 1V APPROVED JOIMT A Ir15~a1,) tA I I i W/C.I. PIPE W/C.I. PIPE 0 ► I I ALARM EXTENDING 3' EXTENDIWG 3' ~01-f 5 I (r ONTO SOLID SOIL 7 I I ONTO SOLID SOIL B q0. i y~5) I ( I ON I c ELEV. FT. t __J I PUMP OFF r ~ D f 1.~ BLOCK-+; IEV>fi f lo ,J - RISEI: `=XIT PERMITTED OMLy IF TAWK MANUFACTURER HAS SUCF~ APPROVAL 7"o7-4 L Al,'i- y ArI45TfF1G4~ - 7 ~ Z SPEGIFI'CATIOUS SEPTIC E 1 DOSE C{>~~J~$ CU.UGLL7 WMBE TAWKS MANUFACTURER: ~rO` DOSES: y PER DAJ TAWK SIZE : /OOO GALLOWS DOSE VOLUME p ? ZQ(p ed'. INCLUDING BACKF4©W: GALLONS LEVEL i►I/1Rr~l ALARM MAA►UFACTURER: . L• V CAPACITIES: A= 30.4 INCHES OK (000 GALLONS MODEL MUMBER: E R C V R Y F' I OL E E=- - INCHES OR //0 GALLOWS SWITCH TYPE: ZO C I I E 1r2 C,= la-5 IWLHES OR 2_-- GALLOWS PUMP MAWUFACTURER: Q I GALLOWS MODEL NUMBER: Ii p 1) 0 U 1 D INCHES OR T ? V-8/1-C& ~1t7P j'QY F1Oh7 MOTE: PUMP AND ALARM ARE TO BE SWITCH yPE: INSTALLED OW SEPARATE CIRCUITS MINIMUM DISCHARGE RATE Z-5 GPM "rAA.)►' STECS FEET VERTICAL DIFFERENCE BETWEEW PUMP OFF AWD DISTRIBUTIOW PIPE../HIS FEET EAG~ Of' - P - + MINIMUM ~JITWORK SUPPLY PRESSURE . . . FEET OF FORCE MAIN X //O F>1 IFRICTIOU FACTOR.. 'S 5 FEET' p-40A I S I9• ~ ~ Ads IC. HEAD FEET TOTAL Dy1JAM pou t).D ' 51 pf INTERNAL DIMEWSIONS OF TANK: LENGTH ,l/-;WIDTH LIQUID DEPTH /i ~EP 1 7 1993 S93- 030 915 BUREAU OF BUIL:ONG r' I. r VMTER SYSTEMS N HEAD CAPACITY CURVE 3 7/8 6 1/4 2 MODEL "98" 30 4 5/8 - 25- 33 3 5, ftfta% 3: 6 20 zz~ O 15 4 3/16 4 e 0 r 10 i 1 1/2-11 1/2 NPT t 2- 5 X U.S. GALLONS 10 20 30 40 50 60 70 80 LITERS so 160 240 r 0 FLOW PER MINUTE r~ TOTAL DYNAMIC HEAD/FLOW PER ldiIIUTE EFFLUENT AND DEWATERING CAPACITY 12 HEAD UNITS/MIN FEET METERS GALS LTRS 1 5 -1.52 72 273 ! - 10 3.05 81 231 15 4.57 45 170 . r 20 6,10 25 95 _ 3 5/16 Lock Valve 23' i ' CONSULT FACTORY FOR SPECIAL APPLICATIONS ' { Electrical alternators, for duplex systems, are available and • Mercury float switches are available for controlling single and supplied with an alarm. three phase systems. j P Mechanical alternators, for duplex systems, are available with or • Double piggyback mercury float switches are available for without alarm switches. variable level long cycle controls. d ~A . ASELECTION GUIDE ' 1. Integral float operated 2 pole mechanical switch, no external control required. Standard all models - Weiht 39 lbs. - 1/21-1. P. 2. Single piggyback mercury float switch or double piggyback mercury, float 98 Series Control Selection switch. Refer to FM0477. Model Volts-Ph Mode Amps Simplex Duplex 3. Mechanical alternator 10-0072 or 10-0075. M98 115 1 Auto 9.0 , 1 or 1 & 7 - 4. See FM0712, for correct woclel of Electrical Alternator, "E-Pak". ' N98 t 15 t Non 9.0 2 or 2 & 6 3 or 4 & 5 5. Mercury sensor float swiioh 10-0225 used as a control activator, specify D96 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- dr 'E98- 230 1 Non 4.5 2 or 2 & 6 3 or 4 & 5 plex or duplex operation, 10-0002. - 7. Two (2) hole "J-Pak", for watertight connection or splice. 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 safety codes should be followed inctud- FM0495; Alarm Package, FMO513; Sump/Sewage Basins, FM0487; and Simplex Control Box, Ing the most recent National Electric Code (NEC) and the Occupational Safety and FM0732. Health Act (OSHA). 1 RESERVE POWERED DESIGN 1 For'unusual conditions a reserve safety factors Ernifgigineered into the design of every Zoeller pump. t MAIL T0: P.O. BOX 16347 Louisvit%e KY 40256-0347 Manufacturers of . ~"1LE~i' D. SNIP ; 3280 0 Millers lane t~ l9.?.9 ~ Louis vide, KY 411216 16 ,QUAI/TY 4406,09 /NCF J To (502) 778-2731 • FAX(502) 774-3624. „tP 1 7 1993 593- 030 95 BUREAU OF 3 T[:ii""S ~NATER SYSTEM= i i ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT n FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify vthat I have inspected the septic tank presently serving the R//~ !l~',;o•,✓ residence located at: 1/4, N~ 1/4, Sec. , T Z~N, R W, Town of t7ZJ~.~OA./ Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced ~y" r -36 -f~ Did flow back occur from absorption system? Yes vNo (if no, skip , 2 next line) Approximate volume or length of time: gallons minutes Capacity: Construction: Prefab Concrete Steel Other Manufacurer ( if known) : 4u S~ 24 , /OVV POX Age of Tank (if known) : I f 7~ (Signature) (Name) Please Print (Title) (License Number) (Date) Form to be completed by licensed plumber (s.145.06, Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements of ILHR-83, Wis. Adm. Code (except for inspection opening over outlet baffle)..r Name ~o/3~T A(4kr Signature C PRS ~~O 7 5/88 HOMESITE SEPTIC PLUMBING CO. 655 O'NEIL RD., HODSON, WIS. 54016 ROBERT ULBRiuIaT "I)S. MASTER PLUMBER LIC. NO. 3307 M.P.R.S. !d. INSTALLER & DESIGNER LIC. N0. 00663 t' S T C - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER ADDRESS D PAP FIRE NUMBER CITY/STATE ZIP PROPERTY LOCATION:46 1/4, `4/91/4, SECTION 3/ , T ~i N-R-ff-_W TOWN OF St. Croix County, SUBDIVISION' , 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, whicn 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 Co. Zon g Officer within 30 days of the three year expiration a e. SIGNED:, DATE:_ LO St. Croix co. Zoning Office 911 4th St. Hudson, WI 54016 STC-100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies .will only result in delays of the permit issuance. should this development be intended for resale by owner/contractor,(sPec house then a second f orm should be retained and completed when the property' is sold and submitted to this office with the appropriate deed recording. ~p Owner of property Location of, property /Ve 1/4 ~~1/4, Section 3y , T Lf N-R/!_W Township Mailing address Pfd. 4 c~IS S' Or- (!~P. Address of site -s subdivision name Lot no. other homes on property? yes v No Previous owner of property V De,- 7 Total size of parcel 3 v S Date parcel -was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)? Yes No Volumw-.: O and Page Number l= as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: f. A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER & THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid. delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. 14 PROPERTY OWNER'CERTIFICATION I(we) certify that all statements on this form are true to this 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. 3 ? 9 COO 5 , and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has, been duly recorded in the office of County Register of deeds as Document No. . V ti Signature of applicant Co- pl ant Date of S gnature Dat of gnature Il ~M41iY, Cmp.ry~ STATE BAR OF WISCONSIN - FORM 2 p(!CUMENT NO. r 422 WARRANTY DEED vC~ 6r ~O Ja THIS SPACE RESERVED FOR RECORDING DATA 09 REGISTERS OFFICE Vernon G. Voght and Lois I. Voght, CO., W16. husband and wife as oint tenants Recd. for Rrcot'd Mt: 5th - day c+f Aug_aa 19$2 conveys and wt.rrants to Mark H. Gall ison and at 10 :05 A • ~ , Kimberly J Gallison._husband and wife as ioint tenants - Rwtatws - p AN TO St. Croix County, o the following described real estate in State of Wisconsin: Tax Key No. Part of Northeast Quarter of Northeast Quarter (NE4 of NE4) of Section Thirty-four (34), Township OTwenty-nine i(29) North, Range Nineteen (19) West being Lot Map filed March 25, 1975 in Volume 1, Page 94. This is homestead property. (is) (is not) Exception to warranties: Subject to easements, reservations and restrictions of record. August is 82 Dated this day of (SEAL) (SEAL) G VOGHT - VERNON . (SEAL) (SEAL) ~ LOIS I. VOGHT d ENT ~1Ue H-' r CAT TON ACKNOWLEDGEMENT ! r Signatures authenticated this day of STATE OF WISCONSIN ss. 19~-Z ' St. Croix County. Personally came before me, this !T -T kol 2nd day of August t° 82 the above named j TITLE: MEMBER STATE BAR OF WISCONSIN ""Mt. ) Vernon G. Vo ht This instrument was drafted by STEPHEN J. DUNLAP to m9 own to be the person - who @xecuted the foregoing in. Hudson, W1SCOSl? St t and acknow ed the s ns:: T A r, r' (Signatures may be authenticated or acknowledged. Both are not Bett e J necessary.) of persons signing in any capacity must be typed or printed ppiow their signatures. Notary Public Courltt'Wis. My Commission is permanent. (If ry0~state expi..titt ate: •Namsf Jan- u_-a -5 • . I ~9 86 St«k..No. 13002 WARNANTV DEED:- STATE BAR OF WISCONSIN, FROM NO. 2 - 1971 ST. CROIX COUNTY WISCONSIN ZONING OFFICE 1-7 1 r x u r n r r r ST. CROIX COUNTY GOVERNMENT CENTER rA`r 1101 Carmichael Road - Hudson, WI 54016-7710 (715) 386-4680 November 23, 1993 To Whom it May Concern: An inspection of the septic system for the Mark Gallison property, located in the NE, of the NE k of Section 34, T29N-R19W, Town of Hudson, was conducted on October 6, 1993. At the time of the inspection this septic system was found to be code compliant for a four bedroom home. Should you have any questions, please feel free to contact this office. Sincerely, James Thompson Assistant Zoning Administrator mij O