HomeMy WebLinkAbout022-1020-40-100
AS BUILT SANITARY SYSTEM REPORT
OWNER 411 11 TOWNSHIP- ah ie ~itiu. ~c
SECTION-__8T V8 N-R l S W
ADDRESS ~9a ~~2e(pu 44'AU-) 0C ST. CROIX COUNTY, WISCONSIN
SUBDIVISION ~l een u
LOT LOT SIZE 35 ~cv-~
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
CoN lee
s r
(o / 1
INDICATE NORTH ARROW
BENCHMARK: Elevation and description : ro off'
Alternate benchmark / /5eP_ kSy
SEPTIC TANK: Manufacturer: (f~
I okS Liquid Cap. J2.A0
Rings used:Manhole cover elev• 5~~' 2~' h
Final grade elev:
Tank inlet elev.:
Tank outlet elev.:
No. of feet from nearest road:Front,X, Side
Rear Ft . -3Z0
From nearest prop. line:Front , Side, Rear Ft.1 1120
No. of feet from: Well SOS It Building: 12/
(Include this information in the above plot plan)
(2 reference dimensions to septic tank)
SEE REVERSE SIDE
I
PUMP CHAMBER
Manufacturer: (~1 S Liquid Capacity: 1000
Pump Model: OSP 33 Pump/Siphon Manufact.: frump Size ~I0
Elevation of inlet: pp~tom levation
Pump on elev.: Pump off elev.:-Gal lons/cycle: 010
Alarm: Man.: f le AA M Switch Type: ' ' ( Location
Distance from nearest prop. line: Front-, Side., Rear_Ft./9 D'
Distance from: Well 50 ~ f. Building 8 G'
SOIL ABSORPTION SYSTEM l"1'10
Bed: Trench: Seepage Pit:
Width: f Length l Z-~ Number of Lines: Area Built S'DO
Exist. Grade Elev. /610 10 Proposed Final Grade Elev. /04 `f
Fill depth to top of pipe: 7611
No. feet from nearest prop. line:Front Side, Rear Ft.&Q
No. feet from well: No. feet from building /00~ rt
HOLDING TANK NIA
Manufacturer: Capacity:
No. of rings used: Elevation of bottom tank:
Elevation of inlet:
No. feet from nearest prop. line:Front , Side Rear Ft.
No. feet from: Well building- nearest road
Alarm Manufacturer:
INSPECTOR:
~
DATE: 7/22./93 PLUMBER ON JOB:
LICENSE NUMBER:_AWkS 3Z6Z_
6/90:cj
w ,
Ii!artrT~~NNIC 8.2$ps~^,A,~z TRAIL,L County:
,Labor and Human Relations INSPECTION Safety and Buildings Division ST_ CROIX
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-:
3
Permit Holder's Name: ❑ City ❑ Village [-Town of: State Plan ID No.:
NIC
lev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
• 160 eb' Zelm &zf /"6-- 022-1 20-40%000
TANK INFORMATION ELEVATION DATA A9300089
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark S ~Z $1, ' >I>S~
Dosi n
Aeratio Bldg. Sewer 9 c~'
Holding St/ Inlet , 99 0& dt•zs'~
TANK SETBACK INFORMATION St/ Outlet
TANK TO P/ L WELL BLDG. Ae Intake ROAD Dt Inlet c /Zv
Septic NA Dt Bottoms
Dosing NA Header / Man.
Aerati NA Dist. Pipe
Holding Bot. System
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer dr Dek and ?oho 5'T
Model Number O ~jp. 3 3 I/:/GPM
TDH Lifts X11 Friction Ulf Syedem TDH 61 Ft
ra _ FFii
Forcemain Length 9~/ Dia. Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width / Leng h No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
a DIME N
DIMENSIONS
y SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING 7nzr:
U SETBACK
~kD INFORMATION TypeO CHAMBER Model Num
System: OR UNIT
DISTRIBUTION SYSTEM
Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
s it ,i i
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 p~ xx Seeded G xx Mulched
-8etWTrench Center BQ4WTrench Edges Ip Topsoil -E] Yes E] No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.) 6,9
LOCATION: KINNICKIN C 8.28.18.116,5 NE,COU E ,lAIL,LOT 3
99.9, ~ ~ - Ica. 6~=>0 _
Plan revision required? ❑ Yes
Use other side for additional information.
I ~w ~3 - -11
SBD-6710 (R 05/91) Datg~ Inspector's Signature Cert. No.
/C CQJd~~ /
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
i
DILHR SANITARY PERMIT APPLICATION
In accord with ILHR 83.05, Wis. Adm. Code COUNTY
STATE SANITARY ERMIT#
-Attach complete plans (to the county copy only) for the system, on paper not less than ❑
8% x 11 inches in size. Cec if UIUvIous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
S, e-V!2
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROPERTY OWNER PROPERTY LOCATION
'/aNe-'/a, s T , N, R E (o W
PROPERTY OWNER'S MAILING ADDRESS LOT # :311 BLOCK #
?V, V
ITY, STATE ZI CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
0 4~A2 s 3sd~ ~$3 C
. TYPE OF B ILDING: Check one CITY NEAREST ROAD
11 ( ) ❑ State Owned V
TOWN ILLAGE : n ` LQ t
❑ Public R 1 or 2 Fam. Dwelling-# of bedrooms 'PARCEL TAX NU BE ( l
III. BUILDING USE: (if building type is public, check all that apply) /0 w 6,D0
1 ❑ Apt/Condo
2 ❑ Assembly Hall 60 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. 9 New 2. ❑ Replacement 3. ❑ Replacement of 4-E] Reconnection of 5.E] 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 El Specify Type 41 El Holding Tank
12 El 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 ~ q. ft.) PROPOSED (sq. ft.) (Gal3ay/sq. ft.) (Min./inch) ~ ELEVATION
5! Q 1 f • eet O7. Fiat
VII. TANK CAPACITY Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
ZS
Se tic Tank rHoldin Tank /425221 0 El
Tank/Si hon Chamber t( r
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsits sewage system shown on the attached plans.
Plumber's Name (Print): Plum is Signature: (No Sta s) /MPRS Business Phone Number:
Plum s Address (Wet, City, Stale, Zip Code):
5'
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved ermit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps)
Approved ❑ Owner Given Initial Surcharge Fee)
C,
Advers rmin tin
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety a Buildings Division, Owner, Plumber
INSTRUCTIONS
1. , A-sanitary permit is valid for two (2) years.
2. lyour 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. ,y ,.,Alf revisions to this permit must be approved by the permit issuing authority.
4. Changes in ownership or plumber requires a Sanitary Permit 'ransfer/Renev, a? Form (SBLt 6399) to be
submitted to the county prior to installation.
5. Onsite sewage systems must be properly r7!aintained. The at tic tank(s) must ire lTll nped 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. Absorpticn systern, information. Provide all information reques!~~d !ri ##1-7.
VI1. Tank infoc mation. Fill in the capacity of ev,~r r~ew and/or exis,;.~ ~ ar?k, list the t(, al ! ar, ; r umber of
tanks anr_i ;anufacturer's narve. Indicate , t°1c:tr or site construc.'-! _:nd. tank mater i~el. Coinpiot, for all
spry c,uir pisiphon and holdir?g t>.-nks i o_ th:3 SyStE'm. Check c!n approva t:r _b 0 t..inks received
exF;e 'J product approval fr rr, +!Dll_ rP
VIII. Responsibility statement. Installing plurs4-%,r is to fill in narne lirt:~is, r,!,=riher with appropriate prefix (e.g.
MP, etc:.;, address and phone number. Plumber must sign application ;`c:: an.
IX. County/department Use Only.
X. County/Department Use Only.
Complet- -igns and specifications not smaller than 8% Y 11 inchYS n- :r t-•a Submitted to the county. The
pl ns n1c,.' ;!rciudt. !hf; following: A) plo, Elan, irawn to or M-ith c
; ,lete Lr.,caticn of
hoist a septic tank(s) or ether t.reatme it tarks iate, ,-naics, wafer service;
streacis ;?!)rj hake-, pump or siphon lank9, distribution ooxts, -I as^c~}rr_il r' -,-tr.ms reo;aceryienl system
areas, !!-s location of bu nq served, R) he rizur l' ii -n.' rE!f..,rE
• L) compic~ae specifications for puhrps and controls, dose vo:ume; elevat' r! tfe ences; fricti;,n loss; pump
perforniaice: curve; pump model and pump manufa(.turer; D) cross sect`on of the soil absorption system if
required bystL county; E) soil test data on a 115 form; and F) alLsizing information.
- - - - - - - - - - - - - - - - - - - - -
GROUNDWATER SUhCHARGE
1983 Wisconsin: Act 410 included the creation of surcharcles (fees) for a number of
regulated pr,-.ctices which ran effect groundwater
The rnanies collected through these surchargeswo used for _ie ;,tC rs r;;i +dwatf nro ~n:
water rontamination investigations and establishment'of stan.aards:
SBD-6398 (R.11/88)
. ~o-f--~ 2:" S~~ ~ ~a glow
ro,4L Of 1riLnwrG CJ(b 1 K COG, ,
-P 1bf P~m
LE- cE~) c~, cotAlee.
L1 =emu cts pwr S a~~ 2tba
-4~
SPLcs cam. o
i z s o 50.[.
lei DO 9
25' 1 x.15 vK Q ~a.l s.7
• Pc.
2 - 9X Q3y2.,-~~.,~.. RECE D
MAY 0 3 93
rno~ s. a,f- SA , & BUI INGS
C-4 144
~4,:,
3-00794
S 9 a Q,
I/ dr
P
794•
993-00
00
L o~ 3 S/e-ep a~~d
o ~-J H of K ki a~ S'f Cro K C~
Perforated Pipe Detail
End View
)Perforated tRow
_ End Cap PVC Pipe rEMOEK To 4RAOE
I Holes Located On Bolton.
Are Equally Spaced
PVC Force Moon
From Pump
ENp CAP
I P '
RECEIVED
. g
Distribution MAY 0 3 1993
Pipe
Last "ale Should Be SMEW & BUILDINGS
Next To End Cop
Distribution Pipe Layout r
P z S
r S „ /A
X _ a-0.
Y~
C~ Hole Diameter Inch
Signed:
Lateral Inch(es)
License Number: NPeSW 3ZJ-2, Manifold Inches
Date: /v 5- A7 Force Main " Z Inches
Holes per pipe 2/
QNStTESE~INAGESY3TEM Invert Elevation of Laterals /03 Ft
T~ rr _
CM&Ma4 ' . 593-40794
IMP IRO 13
DEPARTMENT OF 0 U TRY, LABOR iL0 M 3 RELATIONS c 9
D r;~t
r
'aE CORRE NDENCE
1~v~oO
Sf. Cna ll r, Cbl--~
Synthetic Covering V
.~Ss Distribution Pipe
p UMedium Sand
w H -~c F-
p Topsoil
LU z - - G.
0 O (J) i~
CC 3 % slope
p Bed Of ~z - 2 %Z Force Main Plowed
\J Q Aggregate Frum Pump Layer
W
W RECEIVED
Cross Section Of A Mound System Using MAY 0 3 1993
a AAr ' For The Absorption Area SAFM & BUILDINGS
D
L 9 - 0 794
7- F-
YZ~ Observa lt4 Iipe-~
J i3 - - K
A •I -I. .
t Force Main
W From Pump
1 -
,Distribution Bed Of i - 2 i-
Pipe • Aggregate
I
Observation Pipe Permanent Markers
Plan View Of Mound Using A 1144 For The Absorption Area C
Y
IQ Z' lZ•5" K I w s 2S
B =I~ J' 1.5'.5
00'7 9 4
S(33
C
r)y [3
r
l~l,
t
Oil .
1 w
f
t
.
• • . /.moo 3 S lQe..~ y . ~-oG l o u.~ b: _ . .
PUMP CHAMBER. CROSS SECTION AUD SPECIFICATIOkIS '
4.
VENT; CAP
4"C. I. VENT PIPE
WEATHER PROOF APPROVED LOCKING
JUAJCTtON BOX MANHOLE COVER
25' FROM DOOR,
wIMDOW OR FRESH -"-4? Mill
AIR' INTAKE
GRADE. I
4" MIM-
'
CONDUIT
t8"MIN.
! 11~
PGV OVIDE ~Q ( III -
IMLE T
4p- AL
APPROVED JOIN-r/ A ~5`~ ~I III APPROVED JOINTS
W/C.I. PIPE Q \,0\ I I) I W/C.I. PIPE
EXTENDIU& 3' ~~Q I II ALARM EXTEMI)IMG 3'
ONTO SOLID SOIL B ^y Q• y_ I I I ONTO SOLID SOIL
~ 4 ~ (t O i I om
c .
~~.~o I I CEIVED
LLEV..10Z FT. PUMP OFF Q Q 3 1993
V COIJCRETE BLOCK & BUILDINGS
' 3" API'RovEO
RISER EXIT PERMITTED GNLy IF TAIJK MAAIUFAGTURER HAS SUCH APPROVAL 13EDOINCi
SPECIFIGATIOfJS 005E
SEPTIGq~fICJ® S93-00794
TAIJKS MANUFACTURER: -i HUMBER OF DOSES: PER DA4
v+w.✓ TAMK SIZE: /000 GALLONS DOSE VOLUME
ALARM MANUFACTURER: LJP J iz Q! S / - INCLUDING SACKFLOW: 2O~ GALLONS
~ HL~ LwC.. ~'Q
MODEL NUMBCR: ld 1 CAPACITIES: A= IUCNES OR GALLONS
O SWITCH TYPE: Lu>2l'GU-PN ~A = Z INCHES OR ~'3L_.....GALLONS
L.
wq PUMP MANUFACTURER: _"Ano C. = bmwa JCHES OR ZUT GALLONS
MODEL IJUMBER: ®s 1P- 3 3 D = CHES OR GALLONS
SWITCH TYPE: ~icC &Ar!A MOTE: PUMP AIJD ALARM ARE TO BE
MINIMUM DISCHARGE RATE •SO GPM INSTALLED ON SEPARATE CIRCUITS
VERTICAL DIFFERENCE BETWEEN PUMP OFF AIJO DISTRIBUTION PIPE.. •Q FEET
+ MIIlUIIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . 2.5 FEET
+ _1- FEET OF FORCE MAIN X 3.9 FYo►T.FRICTIOtJ FACTOR...a!~2 FEET
TOTAL OyQAMIC HEAD 9
= - 457FFEET
ILITERNAL DIMEIJSIONS OF TAWK: LENGTH _LLZ-;WIDTH C3 r ;LIQUID DEPTH
SIGUED: I - LICEOSE UUMBER:I~IPS IZ DATE: 15'/9-3
EFFLUENT PUMPS
Features and Performance
-NOMINEE 0SP33.
/3 HP - MAX. SOLIDS 5/8" SPHERE -1750 RPM
• Available in automatic or
24 -
manual.
• Completely submersible.
-o Non-clog bronze impeller.
• No suction screens to clean.
1e ~y 011-filled, double ball bearing ^
' motor with built-in. overload
protection.
112 - • Reliable diaphragm switch with
piggyback plug-in.
Rugged gist from construction.
FULLLMD + Completely fleld serviceable.
AMPS AT t{ 115V. + 1 1/2" N 1, discharo.
fl4 AT t30V.16 '''`.6
)1 Y
° 0 10 20 30 10 W do 7
" U.S. GALLONS PER MINUTE ,
SPD50H/SPD 1 OOH
/11 OWN! 1 HP - MAX. SOLIDS 314" SPHERE - 3450 RPM
s
• Available in manual or r
automatic.
• Dual seals standard. Seal
"MPB LOAD
failure sensor capability
b A o available (to be wired to an
: 25f M alarm device) on manual pumps.
[ • Open two-vane sewage type
30 impeller.,
@ g ~o • Pump shaft and all fasteners are
1D iT.P!A, is stainless steel.
711
• 1/2 HP (SPD50H) and 1 HP 4`.
iQ (SPD100FO motors: Bail bearing
construction and oil-fllled.
0 0 -10 1 1 1 1m 140 • "2" NPT discharge (3'" flange
U.S. GALLONS PER WNUTE optional).
SOMEONE ~r.
SKHD 150
t HP -MAX. SOLIDS 3/4" SPHERE -3450 RPM
V 1 }
• Semi-open, thermoplastic`
- impeller.
1zo + 1 1/2 HP, oil-filled motor. w
• Pump shaft and all fasteners are `
E0 { ta"n stainless 'steel. n t*
- - M O 1 1/2" NT discharge.
.~1«0"0
Spring loaded mechanical seal N"
220v. 600.
AM11 At O with carbon and ceramic faces. V'
.IW. 211 , r..~
- F Pump-out vanes on rear shroud
W .
4 •
of Impeller.
° ,o zo ,o so eo Tc • Dual seals Seal failure sensor
U.S. GALLONS PER MINUTE capability available (to. be wired
to an alarm device).
%
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 crmit issuance
p ,Should this
development be intended
for
resale by owner/con'
tractor,(spec
house), then Ia 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 L
Location of property5_1/4 NP-114, Section , T~ N-R_4~>W
Township L,460~t_
Mailing address 'V9"9 SlQ~2~_9u -/4&"
A ~ C.g) I
Address of site 4:1~ J
Subdivision name_ LZ) Lot no.
Other homes on property? yes _No
Previous owner of property
Total size of parcel
Date parcel -was created /~cLy c~Q Z f Cf
'Are all corners and lot lines identifiable? iJt _Yes No
Is this property being developed for (spec house)? Yes ANo
Volume Ito, and. Pa a Number as
g.[_ recorded with the Register
of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
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.
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(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. L~;LQ,A C7~;- , 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 the office of County Register of deeds as Document
No,
a
ignature of applicant Co-applicant
~ /gam •
Date of Signature Date of Signature
FROM EDINA REALTY HUDSON WISCONSIN E
DOCUMENT NO. WARRANTY GEED THIS SPACE RESERVED FOR RECORDING DATA
4.
STATE BAR OF WISCONSIN FORM 2-1982
'V-O'-
498f 03 rvoL 1007PAGE 219
f REGIS _ER 'S OFFICE
Rgber.t..R.....Richt.er...a/k/a,- Robert... R.ichte.r ST.CROIXCO.,M
_ Reir'd for Rewyd
' MAY 6 1993
8:30 A•
conveys and warrants, to ,.fir. 1..... ~ ~_..?lC1d...A42t) d A........... M
.........Hi I.I.....husb.and..and...wif.e
r
-
R6TURN TO
the following described real estate in .:.S.t.,....CroiX ................CountY.
State of Wisconsin:
Tax Parcel No:
Part of SW 1/4 of NE 1/4 and Part of SE 1/4 of NE 1/4 of Section
8, Township 28 North, Range 18 West, St. Croix County, Wisconsin
described as follows: Lot 3 of Certified Survey Map filed March
22, 1991 in Vol. 8, Page 2331, Doc. No. 467470.
TOGETHER WITH AND SUBJECT TO the right of ingress and egress over
the road right-of-way as shown on Outlot 111" of Certified Survey
Map filed March 22, 1991 in Vol. 8, Page 2329, Doc. No. 467468.
.00
This ig.-not....... homestead property.
(is) (is not)
Exception to warranties. easements, restrictions and rights-of-way of
record, if any.
Dated this ............3 hl` day of ........May..............._...................................., 19.._93 i
i ..(SEAL) ...................................................(SEAL)
Robert K. Richter a/k/a~
96 b 6it Af fiter
(SE,AL) .(SEAL)
y~+;; 1 , t I
AUTIflCtTI4jA4d1T i A'CHNOWLEDGIMENT
Signature(s) fiOY?2L°t A_i»~1CS STATE OF WISCONSIN
a/k/a Rob4r'~t R. Rii'~hter ss.
li...................
.
the following described real estate in ..........5.(;,....C)rA.i3~ ................County,
State of Wisconsin:
Tax Parcel No
Part of SW 1/4 of NE 1/4 and Part of SE 1/4 of NE 1/4 of Section
8, Township 28 North, Range 18 West, St. Croix County, Wisconsin
described as follows: Lot 3 of Certified Survey Map filed March
22, 1991 in Vol. 8, Page 2331, Doc. No. 467470»
TOGETHER WITH AND SUBJECT TO the right of ingress and egress over
the road right-of-way as shown on Outlot "1" of Certified Survey
Map filed March 22, 1991 in Vol. 8, Page 2329, Doc. No. 467468.
0
This i..s no.t homestead property.
(is) (is not) J
Exception to warranties. easements, restrictions and rights-of-way of
record, if any. a
i
Dated this .h~ day of Ma................. , 19.. 93 ~I
......''`.K' (SEAL)
. . (SEAL,)
Robert K. Richter a/k/a
R6 bert7Richter
.r...... (SEAL) (SEAL)
t,
J
AUTII104TICA110 0W'ACKNOWLEDGMENT
Signature(s): 9abi~1 Rlt: ter STATE OF WISCONSIN
a/k/a Robdr R. Righter as.
.............ia:..,................
..............County'
authenticated this . :..d'a Y Y:.-........, 19.;:.9 3 Personally came before me this ..day of
19........ the above named
........1
+ Kristina Ogland
TITLE: MEMBER STATE BAR 0P'1 IStON9lN
.
(If not, .
authorized by 4 708.08, Wis. Stets.) to me known to be the person who executed the
foregoing instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED hY
` Kristina Ogland
Attorney at f~aw
Notary Public ......County, Wis.
(Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration
are not necessary.)
date: 19....... )
* $Names of persona signing to any capacity should be typed or printed below their signatures.
S T C - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
c t
WN E UY ER_ `C_chi
ADDRESS 4/D FIRE NUMBER
CITY/STATE t= ZIP_ SYDZ-3.
PROPERTY LOCATION: ~1/4, 1/41 SECTION _I__, TS~2 N-R_~X? W
TOWN OF. '41. 0
~ K.~..~K It St. Croix County,
SUBDIVISION 04 , LOT NUMBER 3
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.
Thee 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. Zoning officer within
30 days of the three year expiration date.
SIGNED:
DATE: 5 1.2 4119,1
St. Croix co. Zoning office
911 4th St.
Hudson, WI 54016
Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3
rLabor a_nd Human Relations
~DivisiohofSafety & 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 St . Croix
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
Keith Hill GOVT. LOT SE 1/4NE 1/4,S 8 T28 N,R18 y,5 (or) W
PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
Box 18366, 232 Lathenbach Ave. 3 n /a Slee Hollow
CITY, STATE IPP CODE PHONNE NUMBER ❑CITY ❑VILLAGE EROWN NEAREST ROAD
W. St. Paul, PW. 55J9 ( n/fit Kinnickinnic Coulee Trl.
] New Construction Use [ Residential / Number of bedrooms 3 [ ] Addition to existing building
j J Replacement [ J Public or commercial describe
Code derived daily flow 450 gpd Recommended design loading rate XcL bed, gpd/ft2__ltrench, gpd/ft2
Absorption area required bed, ft2 375 trench, ft2 Maximum design loading rate N/P bed, gpd/ft2 . 3 trench, gpd/ft2
Recommended infiltration surface elevation(s) 1-01.82 ft (as referred to site plan benchmark)
Additional design / site considerations low la er to be done witha chisel plow to depth of 16" minimum
Parent material glacial. till Flood plain elevation, if applicable n /a It
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem ❑ S MU J~NS ❑ U ❑ S xE] U ❑ S N@ U ❑ S a ❑ S EN1
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
1 0-5 10yr3/3 none L. 1/f/sbk mvfr c s .4 .5
2 g/w 1/f 1?1,P .3
5-16 10yr4 /4 none sii 1_ . 1 / f /p1 mvfr
Ground 3 16-28 10yr4/4 none sil. 1/f/sbk mvfr g/w 1/f 1.4 .5
elev.
100.32 ft. 4 28-50 7.5yr4/4 c2d Svr S scl. 2f sbk mfr n/a n/a .3 .4
Depth to
limiting
factor
28"
Remarks:
Boring #
1 0-6 10yr3/3 none L. 1/f/sbk mvfr c/s 2/f .4 .5
2. 2 6-14 10yr3/3 none sir. 1/f/pl' mvfr g/w 1/f r%'p .3
3 14-26 10yr3/3 none sil. 1/m/sbk mvfr g/w 1/f .4 .5
Ground
1
.4
elev. 4 126-50 7.5yr4/6 2d, 7.5yr5 2/f/sbk mfr /a .3 1
1.00.82ft.
Depth to
limiting
26~r 15
ES=A
Remarks: rr fLI
CST Name:-Please Print Phone:t 4 6200
Gary L. STeel
Address: 1554 200 Ve. New Ric ond, WI . r 1 _._r 1
Q 9-w-u-
Date: CST Number:
Signature:
3-5-93 2298
PROPERTYOWNER Keith Hill SOIL DESCRIPTION REPORT Page 2 of 3_
PARCEL I.D. # r
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence BouncUy Roots GPI)/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
4 3
1 0-6 10yr3/3 none L. 1/f/sbk mvfr c/s 2/f .4 .5
2 6-25 1 4/4 none sil. 1/m/sbk mvfr /w 1/f .3
Ground 3 25-48 7.5yr4/4 c2c'7.50r556~ s1. PZ mfi n/a n/a .3 .4
elev.
99.62 ft.
Depth to
limiting
factor
411
Remarks:
Boring #
a .
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
ti ::•iYiiitiii:
\k~ i\ti
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(R.05/92)
STEEL'S SOIL SERVICE
Gary L. Steel 986 N. Shore Drive
C.S.T. 2298 Keith Hill New Richmond, WI 54017
MPRSW-3254 SEk;NEk-S8-TM-RMW (715) 246-6200
Kinnickinnic, township
i
i
0
(v /
V(_1101
li
3
ST. CROIX COUNTY
at WISCONSIN
ZONING OFFICE
ST. CROIX COUNTY COURTHOUSE
911 FOURTH STREET * HUDSON, WI 54016
(715) 386-4680
i
i
March 8, 1993
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 property being purchased by
Kieth Hill, located in the NE1/4 of the NE1/4, Sec.8, T28N, R18W,
Town of Kinnickinnic, St. Croix County, WI., has been conducted
with the assistance of Gary Steel, CST# 2298.
This onsite revealed suitable soil for onsite sewage disposal to a
depth of 33" while meeting the requirements of the A + 4" rule.
This site should be suitable for new construction utilizing a mound
septic system having 12" of sand fill.
Should you have any questions, please feel free to contact me at
this office.
(Sinc'e`~ely,
Fames 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
March 8, 1993
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 property being purchased by
Kieth Hill, located in the NE1/4 of the NE1/4, Sec.8, T28N, R18W,
Town of Kinnickinnic, St. Croix County, WI., has been conducted
with the assistance of Gary Steel, CST# 2298.
This onsite revealed suitable soil for onsite sewage disposal to a
depth of 33" while meeting the requirements of the A + 4" rule.
This site should be suitable for new construction utilizing a mound
septic system having 12" of sand fill.
Should you have any questions, please feel free to contact me at
this office.
Since ely,
mes K. Thompson
Y Assistant Zoning Administrator
cc: file