Loading...
HomeMy WebLinkAbout004-1037-80-000 M Q. o CY N O o ~O O~CO N I N orn.D E ~ o a~ o v z`ocu 0 .(o y c ~ Ep ° I ao N c O E C N N > N c a °Ec° U ~o ~ 3 N O N E N cC i o c ° a~ a, z ° 0 cc -0 o a C: 0 Z ~ U ° 'V 2 .d 7 U Q CL c o Cl) ~ y I Q' y r C v £ Q W d d ca ~ a co c O I O z v w d Z a 2 O to F- C N z w m 'a 0) N a ° N N ~ N ~ c N ~ c O ~ d m o F- z 0 z N ° N C a C ~ ~ I O N O O ~ R N ~ n G m 0 w c N N O O Q) O G G a a N E ! L y F- N E c U E I'I 0 0 0 z y CF IL IL IL 7 p U) 3 rn rn U) U O o rn rn z *y o CV 0 :3 • O '0 m Y Cl) ao N N U Q :D iv ~ o w p C) U) ~j O -O N C IV O 'O E O O O Lo c V -C LO co a) N C CL m 00 G MUi O E _N C P, (O O 4 Z: O O N L N n 00 M (D r CD CN L2 E *6 O i. O U S O N=i z in L E m a t n ! a w • am'~ m `1V E 'c c A vat oin0 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUS~iY, C DIVISION HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: 7NSHIP/*bWtCTPA-MY: LOT NO.:BLK. NO.: SUBDIVISION NAME: SW 1/4 SW 1/4 16 /T28 N/R 15 Cady - - NA COUNTY: MAILING ADDRESS: St. Croix Richard Hippauf RR 1, WIlson, WI 54027 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DE PT NS: ER ATION TESTS: . QResidence 2-3 NA ❑New Replace I 6/13/92 NA RATING: S= Site suitable for system U Site unsuitable for system CONVENTIONAL: MOUND: rIN-GROUND-PRESSURE:ISYSTEM-IN-FILLIHOLDING TANK: RECOMMENDED SYSTEM: (optional) ❑S ~U ❑S ❑U ❑S MU ❑S Mu ❑S ❑U Mound If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s. ILHR 83.09(5)Ib), indicate: NA ~Floodplain, indicate Floodplain elevation: NA PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED ES IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B-1 72 - No 36 0-36 sil, 36-72 massive sl w/ c3p R-Gy mots detailed description not taken due to bees in pit, but B- soils are clearly unsuitable for conventional system B_ according to current code criteria I B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PER D PER INCH P- P- P- P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION -T T_ _-pitxamned j test of e?~}ngonent3onl . syster> for puPoss df _vrifiing sutabiht _fo c vprtigral I system for purp es {of granting! a recorhnecticiq permit' soils; are. not suitable according to CST( op' io domplete perk test requilred`to verify uitable conditions fora mound system 3 , J Y .ice ~ ~ S ~ _ _ IN E , W f - A F i I, the undersigned, hereby certi he ests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: Henry F. Grote 6/13/92 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): PO Box 57, Knapp, WI 54749 3065 665-2681 CST SI N TUBE: l DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. j DILHR-SBD-6395 (R. 10/83) - OVER - r~ INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 To be a complete and accurate soil test, your report must include: 1. Complete legal description; 2. The use suction must clearly indicate whether this is a residence or commercial project; 3. MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing scale is prefered. A separate sheet may be used if desired; 8. Make sure your benchmark and vertical elevation reference point are clearly shown, and are permanent; 9. Complete all apropriate boxes as to dates, names, addresses, flood plain data, percolation test exemption, if appropriate; 10. If the information (such as flood plain, elevation) does not apply, place N.A. in the appropriate box; 11. Sign the form and place your current address and yur certification number; 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st - Stone (over 1U') BR - Bedrock cob - Cobble (3 - 10") SS - Standstone gr - Gravel (under 3") LS - Limestone 's - Sand HGW - High Groundwater cs - Coarse Sand Perc - Precolation Rate med s - Medium Sand W - Well fs - Fine Sand Bldg - Building Is- Loamy Sand > - Greater Than 'sl - Loamy Sand < - Less Than '1 - Loam Bn - Brown 'sil - Silt Loam BI - Black si - Slit Gy - Gray cl - Clay Loam Y - Yellow scl - Sandy Clay Loam R - Red sicl - Silty Clay Loam mot - Mottles sc - Sandy Clay w/ - with sic - Silty Clay fff - few, fine, faint 'c - Clay cc - common, coarse pt - Peat mm - Many, Medium m - Muck d - distinct p - prominent HWL - High water level, surface water Six general soil textures BM - Bench Mark for liquid waste disposal VRP - Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department may request verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a permit. The sanitary permit must be obtained and posted prior to the start of any construction. m4 l Henry F. Grote Wisconsin Certified Soil Tester Post Office Box 57 (715) 665-2681 No. 3065 Knapp, WI 54749 April 3, 1993 Jim Thompson Zoning Office St. Croix County Courthouse Hudson, WI 54016 Dear Jim: Pursuant to ILHR 83.09 (7) (d) 2. this letter serves as notification of intent to monitor observed high ground water at the Richard Hippauf site, SW-SW-16-28-15W, Town of Cady. Two ground-water observation wells were installed through about 1.5 feet of frost and about one foot of snow on March 22, 1993. The wells were installed between the two trenches about sixty feet apart. The well locations were determined by Joe Menter who installed the system. The downslope trench vent pipe measured 36 inches below grade to a depth taken as system elevation. On nominally the same elevations the wells were installed to borehole depths of 78 and 74 inches. Soils at system depths and below were sand and loamy sand with occasional iron-rich sandstone cobbles and stones. I will check levels this season although result acceptance is somewhat questionable due to the fact that wells were not installed prior to March 15 as required. Since the spring thaw had not begun as of installation, perhaps a petition for variance might be accepted to validate the data. Sincerely, 1 Henry Grote cc: Hippauf Menter ~ 9 ~O CD O2~ Perk Tests - Mound and Pressure System Design Ground Water Monitoring Underground Storage Tank Abandonment and Investigation r • Y r Y1~ Q~ ~v T PAGE 28NR.15W SEE 37 AVE. C/iff s .9//ce ^ w• • E~cc R. k ti z~a~ia/ Leslen u/vaney N H f 1717 f177CS e. Lund C ~ ,SF•nysto/7 BCrrlQrll~cTf B¢/77Ctf' //g Otl 0 "a 0 W 0 • Bo 8o Lee f O'eo 1,2 1-a 11;l7e //a /vow v'\ 0,7 l E~ b l'• h o F l17 ro G aTohn cSchuyfs cTohansc/7 /20 O:v 17 ^ Q a v . p v saue~ wb //e~mon k, Az o n b tl Kies-ate /9R SS eta/ /9a.s 3~v 128 oh,7 f Eve/ n Dan C q, 4!0 UK~ 4 ohn 117 ato/ zoo a//esve~d Davis ~va w Hi y Lal/e/n 6s ~ N a~ • a/da /ew os/s 9z othy • F/i7ne Hann tl'~ y. Ftt/ms, Inc. Timm o Enf Inc. i / 4O /495 94 JRD i:c /✓an9 !9 rLuno' /z..sz P/ahn a. 's' Fred Lieb.ie~ z g.77 E sen w ~r `/9 e 63 S • ervn e ua. B 1~ 73s • i36 ~ E C h • B8. 9 ?ete/- zy7.7 • u Hamn n h.- C /ch. < ze s AY ss. s ~s rct.c °n U • Go/die 6 b y Rass RF • v Ne//'e `,D Lo/'eri ~ l h us • Cjeon9e m C/7- ~ ~ Tho.>-.~oson ~ 1. Tei'ii AVE. tl J o • f'efe/-son ~OC_~Snr" y~ 7s 9' efk~ess f Go s h pp F 0 no/ ~s s o 4BC4 0 j p ft • c • • Bo 7z Go s", V d h C7eocye /do ¢o p 0 y Ne~be. i s •w U VCi CO /9°~ Mch¢e/W y ~tl oetecson • sc7yur/ ~a v~ Bentz/dime a ~Y 0 ~.tl0 non y c. Bern- a yi v Kiue9a~ ry 0 h 0 rsa~ /i4zd5C ~i • way ~j os w N V ec,Fe~ 1 v • .°h.i F eex O. 2 P h tl o q •4 • /20 Mary J tTo9nn CStOC.E•//7Q/7 crack V C ,o • ,e0 e/' 0 l ` S'i"uber' cToh~ son tl_Q~. 0 ~ 'yB/ands- ~ ~ ~ Vii/ h Bo ° X345 • tjreenwQ V t1 eta/6o Q /¢o e/n ,y f C / [97 /Q/tct f Firnms I c. Q F O, ~a~7d~a/d CSteofiel/ • Wi//i¢m °'"O • zos ~~W Sonmo~ (7-co-/7 f/a--/d eo qo j a 40 • 79 • tTi , etu/ F°. Hoccsern 1Tohn6o~7 70 /~0 4s p ~ ~~e ~ E~ on s • /°eter • Bo .eicha.~zL .6~'anvo/ wren ~ vonne ~ L /i7°~2 S °ncB f F~an.E q ` ~ y.~. • hauee 79 . JDBo 7as9 w~ l \ ~ • Mo~ivsor7 Os6o~na cSchiibei+ ajS17~/e Qp\ O tl~ ~ izo Fa rm lL 15 ~ ^ i/Shc Oc f ~g/~ Maw .57 c ~1 0 /een ioo ,Tnc L/-S/07&- e✓' cSafhe.• • .y • Qr./ a 40 cToctn f ~ h h ~y) 9 •CO" /20 ~fM b N E son • yndets0/7 C 3• Q 0 2 s7 s y~ 0 ibo vex tl U 0 w b 0 0• CJ 0 w C MH y~m o ti W Ica w~~ ~q`9 ~x o • `~yo /zo Manf= f .9nn a/iei- . 9 V C M CA ~ vFla 2 b e d U l • C~ oxce// f o~mac f Cjenevieve l o o irs-teed ~2 v .c, tl 3 ~ ~1 `W ^ Z tl o /z.s orN • J J oo gO /7i%/e~ ~o ~()t^ I\ l' a O 'l M c'20 i • s / lOnvi7 f pion fl• Lestei O h Z C /PobG/-7` ~ /q/Q/te/',(! /ex,J~ •,yeva~/y %/e/- f3B/-~/ca Oi-io~ £ .urn- haco 2 ~c2fi'iC/Gi. •U~ h FC2b~ fig/.'ci Timm cTensen anevieve s' ow- ~ii7 \ U ePPP Bo Bo /%i//Bi' tQ~ e// .(sto~ ~0 483 • Ma/sE • 70 40 4o C ~ C ~ • V l p E/nine De/m2i' ; 0 0 /Ueisin v~ ~ Ec/ ena b j d G~t y 0 z zo. 7s 9e/ Timm MtL~ ne • 9 ~0 :en V V ' Bo 7 Bo Bboe. CMoya Ce ~(+`v 0 /7 ✓anh w~ Man9a~ct e S117 ~/7¢/Q/ La !/e~r7 • Bo s \ \ N o L. h'anso~ ene r/~,e, Q 79 ~y/o x w 0 Gunde~snn 0 F7~// s C . s 9O` Bo //7 Timm •~Tczdith ev- v tl 9e~na~ d 0 • 0 p d0 W C Ba c[ B/ e~son y f /fa < Ly/e ~ra.»es f C o o 7e eo ~U h'am/of Vj n a Ch/Ysto frf !//i :nia Q~ h ti CS 0 Halton tl 9 !/ate h l~ Lot Vein Ma/ -Li s nn"s f • ,Drys ~V 792 P s son /`/o/aiud p h Lanaib • ~I~ I~ 7/i77m eta/ Bo 71177 °e995~ BacExz~a B/n • d o • 190 440 t~k SAVE. to /2ic170r&F y • /Qodn~ P /'✓m. £ O. Tiaa/off Str2i7/ey Ann cTQCOfs Timm rl % • 6a ~ Bo ~L-E~ 77 eo ~ O/3or7 • ~ameS ~ sn7es • Tho.rsas G. c'23.92 i T /70 Di c/e Mo/denhau- Tim ycn_ M f S1°•in9ac • Bo 90 /0e/ g /`7a~cot7` BO/S/7C Oti Coo/ doi7 f ~s • 4o do a/ 60 • n Mauve/ • Ho%_ a/e Ke~nafh 7y CTi B/ahmei zoo mud ~aQ /i!o 1 Checi ie 69. e/ 0 l 0 016 v .U~~ w/i Q wb ~ T rno/ a g .77 gas ~ /zo • ee _ • ~ 0 \ gO V \ ~ ~ 1 ~ son o'4"O G f 17o Q /gCrCS, Timm 4~, W 0 Q C~ 0 U d , / ~ V L oej'ci/ a i3/-ahme 79 sy / pi V M r~Q tl w J • Bo • \ _'.J > o Nc~% Q /"Jamey. AM ,R~~ / • • 29 • a% Mai• ornel" ~s'erf= /9~3e fce/er ~y v~~ 0 e ~t Cr• • 0 H°~fTan /a/~d Maryf7nn C~ ~ C~ U~ /e Vaeik.- am~nnts . ~'Cat/e/i/reM. C b zoo a/ve p. • ¢ R%cfaicGs d p p 0 yo c/ qp N/ef~/ U' ~i P.ch. tl~ ti\ cTe f C as /s .aouy/as 141 e o ¢ ~Schu/ N z Q V /yam Cam6 ~l~` Q~l~ /oz.s Bo 3 Do.»a cots c • w.tl tl~• • 30/Dine >rof 0rn/d L. g V kveber ~ 77 v O p man 8O W w h N1a~ocie e Ha /ni77o /20 _ Eua /5! 29 tl ~ ~ 7• Tmm v QJ 40 1917w1766e17 /2Q Tohn ch. e /~0 5O b ~W~ 97 do PP 160 f 9da/ ~O b d v %/2as~z- C cSteohan crac E tl h arson • Ga. //"ys,B/ / _ Lee /9c~es, Inc. Fe,' Bc y~ / W Ka ~n~9 a/nP tl q ✓s Inc. • • kegc• ~ ~ 40-9 ~ ~ I~CA IgN• CAo 6.28.15.253A SW SW isco sin Part men o tojstry, PANATE SEWAGE SYSTEM County: ,~L~bn• and.44iman Relations INSPECTION REPORT ry' and Buildings Division ST . C OIX ••Sati (ATTACH TO PERMIT) Sanitary Permit No-: GENERAL INFORMATION 171500 Permit Holder's Name: ❑ City ❑ Village [Town o : State Plan ID No.: IPPAUF RICHARD & PATRICIA CADY CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 004-1037-80-000 TANK INFORMATION ELEVATION DATA A9200267 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet Vent ir Ito ntake ROAD Dt Inlet TANK TO P/ L WELL BLDG. A Air Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft Head Forcemain Length [Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type O CHAMBER Model Number: System: OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) . I n revision required? Yes ❑ No Use other side for additional information. _ '`r s I F544/~ SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. 1 ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: d s ~ILH N SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY i STATE SANITA PERMIT# -Attach complete plans (to the county copy only) for the system, on paper not less than 1 8'f x 11 inches in size. ❑ c Lk7f A(vOprevious application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. a -go SKI TOPERTY OWNER PROPERTY LOCATION Y" S / T , N, R I E (Or R-f Peru Y0,*, PROP RTYOVJNER'S MAILING ADDRESS LOT # BLOCK # CITY, STATE ZIP CODE PHONE NUMBER. SUBDIVISION NAME OR CSM NUMBER 111 15"Ah GUI`s Z -7 1 is 10 11. TYPE OF BUILDING: (Check one) F] State Owned VILLLLAGE NEAREST ROAD =N OF: TAX Nu ER( ) ❑ Public 1 or 2 Fam. Dwelling-# of bedrooms PARCEL III. BUILDING USE: (If building type is public, check all that apply) ®a C t _ 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) 1.0 New 2. ❑ Replacement 3.E] Replacement of 4. ~Q 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 Aa710 A L77 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 2S Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: P/,s, & Aj 7' 5'4' 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. ARE 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 ` (50 /000 Feet Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New Existing Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank 2t9© M#dtv~'STu~y Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plum er's Name (Print): mber's Signature: (No Stamps) QkAAPRSW No - Business Phone Number: Plumber's Address qStreet, City, State, Zip Cc J~;i-o V, ro 4f Club- I~~OJ~toil/I'~ L!/•S ✓~`f IX. COUNTY/DEPARTMENT USE OWY' ❑ Disapproved Sanitary Permit Fee (Includes Groundwater a e ggue Iss ' gnat r L. XApproved ❑ Owner Given Initial Surcharge Fee) 7-/ 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 i , 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 purnper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local --ode 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 i -iformation. 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, pumpisiphon 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 13% 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 differen;es; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the sail 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 usec for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) DEP,~RTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, , DIVISION LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 HUMAN RELATIONS \ / MADISON, WI 53707 (ILHR 83.09(1) & Chapter 145) LOCATION: SE TION: TOWNSHIP/MtWtt7P`AZKY: OT NO.:BLK. NO.: SUBDIVISION NAME: SW 1/4 SW 1/4 16 /T28 N/R 15 W Cady - - NA COUNTY: MAILING ADDRESS: St. Croix Richard Hippauf RR 1, WIlson, WI 54027 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: ONS: ATION TESTQResidence 2-3 NA ❑New Replace 1PROFIL 6/13/92 NA RATING: S- Site suitable for system U= Site unsuitable for system ONVEQQNTI NAL: MOUND: IN-GROUND-PRESSUR : SYSTEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM:(optional) ❑J ~U 1S [:]U EIS MU EIS MU EIS 0U Mound If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: NA Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED ES GHE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B-1 72 - No 36 0-36 sil, 36-72 massive sl w/ c3p R-Gy mots detailed description not taken due to bees in pit, but B- soils are clearly unsuitable for conventional system B- according to current code criteria B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIODY PER INCH P- P- P- P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION fit !~xam ned u t west af existing, cQn ent3on it ..sy5tert _ for purposes ._qf v rimming suitabilit)(. ar conventional. system for purposes of granting a reconnection permit'- soils are not suitable according t01CST opinion complete 'perk test required to verify suitable conditions for a mound system ~c • `SON tht,~G=t /V F i I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: Henry F. Grote 6/13/92 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): PO Box 57, Knapp, WI 54749 3065 665-2681 CST SI TURE: l DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. I DOCUMENT NO. STATE BAR OF WISCONSIN-FORM 1 WARRANTY DEED 318668 eoOK 503 owkl35? THIS SPACE RESERVED FOR RECORDING DATA I! THIS DEED, made between _Robert J _Richardson and Mary Ann SGIeRO x co., WISE Richard on,--husband and wife_rld each in-their own_right,_- Pec'd for Record this__26th day of--- $ePtit---A.D.19-33 ana Richard_G._ Hippauf,- Sr and Patricia M. Hippauf,_husband t----8s30 A. M. t _and. rife .as-joiner -tenants, - - - - - - r - - - Grantee, _ Witnesseth, That the said Grantor for a valuable consideration One-_($lsQQ)_ egfstefOf W "es Dollar and other. valuable_ consideration,_ conveys to Grantee the following; describedrealestatein _ St. Croix--.--.County, RETURN TO State of Wisconsin: The West One-Half of the Southwest Quarter of Section 16, Township 28 North, Range 15 West, excepting ther - from a strip of land of uniform width off the north end of said eighty containing 721 acres, more or less. Tax Key It _ This is homestead property. I This deed is given in full consummation of that certain land contract by and between the parties dated September 29, 1969 and recorded in Book 459 at page 570, bearing document 299864 in the office of the Register of Deeds for St. Croix County at Hudson, Wisconsin. w i I ' ~ 11 Tut;et her with all and sin ular the hen•ditamonts and ap cur U~nances thcrrunto brl And Robert J. Richardson and Mary nn Richardson warrants that the title is t,ood, indefeasible in fee simple and tree and clear of encumb and will warrant and defend the same. Executed at _ -Spring Valley, Wisconsin this - _-21st day of September , 19 73 . SIGN AND SEALED 1N PR1?SF OF % LIDS Rober J. Richardson l t C ~~cn ! Q., Lo I,- (SPAL) Barbara Rude-sill f Ma Ann Richardson ZLj a~ryG~~2~ (SI-AL) Marlys BolAmeester (SEAL) Signatures of _ Robert J. Richardson and Mary Ann Richardson authenticated this - day ,1 1973 Title: Member State Bar of Wisconsin or Other Party Authorized under Sec. 706.06 viz. _ STATE OF WISCONSIN i Fierce - - - - County. Personally came before me, this 21st, day of September - 19 73. , the above named _ Robert J. Richardson and Mary An_n_ Richardson to me known to be the person S who executed the fore t,,oing; instrument and acknow ged the same. This instrument was drafted by Barbary Gavic, Richardson & Skew _ L Attorneys at Law Notary Public _ County, Wis. Spring Valle Wi. 54767 • Y~ gLIG.: The use of witnesses is optional. My Commission (Fkp rc'9).(F,.•t~ler 13,- 1976. 'F 17,~~'~~ , Names of persons signing in any capacity should I- typed or printed below their signature-11" narnuear ~r M WARRANTY DEED-STATE 13AR OF WISCONSIN, FORM NO. I - 1971 ii SAFETY & BUILDINGS DIVISION 1 State of Wisconsin Department of Industry, Labor and Human Relations PRIVATE SEWAGE PLAN APPROVAL Western Regional Office 2226 Rose Street LaCrosse, Wisconsin 54603 RED CEDAR PLSG Owner: RICHARD HIPPAUF 1120 N BROADWAY RT.1 30TH AVE MENOMONIE WI 54751 WILSON WI 54027 RE: Plan Number: S92-40537 Date Approved: July 10, 1992 Gallons Per Day: 450 Date Received: June 26, 1992 Project Name: HIPPAUF, RICHARD - RESIDENCE Location: SW,SW,16,28,15W Town of CADY County: ST CROIX The plumbing plans and specifications for this project have bets., reviewed for compliance with applicable code requirements. This approval rased on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code:. 'he plans are stamped 'conditionally approved'. This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county snali be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. This approval will expire two years from tine date approved or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. The Section of Private Sewage has reviewed these plans for private sewage system code requirements only. These plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the Wisconsin Administrative code. This approval is for the following components only: - REPLACEMENT PETITION NOTE: Conditionally Approved. The conditions o-F the approval are that monitoring wells be lnstcl led on each side of airC' to a depth of 3 -Feet below the bottom of the existing soil absorption system and that monitoring be conducted in accordance with s. ILHR 83.09(7), Wis. Adm. Code, with the results forwarded , 7 r^ -15,-? rk_i-t 1^e at lie r n~+ ri t_ q ! y first r d e ° nr ! ~f-re In add ti^,r, sign of failure and a code-comp lylr,-,-; system must them be installed. Inquiries concerning this approval may be made by call-ing (608) 185-9343. CRn AA:1'1 iR 111/R11 SAFETY & BUILDINGS DIVISION J State of Wisconsin Department of Industry, Labor and Human Relations RED CEDAR PLBG Page 2 Sincerely, GERARD M. S IM Section of Private Sewage iv4sion of Sa+ety ~rri Pt ; 1 -1;rirc PPP039/0009n/37 cc: RICHARD HIPPAUF „X Private Sewage Consultant I SBD 6423, R. 01/911 SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue e.u. box l aba Madison, Wisconsin 53707 State of Wisconsin Department of Industry, Labor and Human Relations July 9-,-092 RICHARD HIPPAUF RURAL ROUTE 1 301"1-i AVENUE WILSON WI 54027 Petition No. S92-40537-P Dear Mr. Hippauf: Private ~e~3af~ Jyste1 j SW,SW,16,28,1'.,!,t Town of 'ady, St. Croix County, WI Your petit-i w d variance ; rion ILHR 83.10 (2), Wisconsin Administrative Code, has been b gyred. The r!rle hs-ir" nn?1i~nnns{ _ r. n .n bo ~i mln1'"."um o,' v-,r+i l feet of soil between the bottom of i a~,i-orption system and high groundwater. i-- r:'c uc, : v it lililEC1 USr 31cuff Xi.`. ti y a ~Ltti which is less t~ian 3 feet a~~ov c pending groundwater level monitoring results. The following comments were made in the petition analysis: 1. irs rt:vie¢rir~~ ` e pe'c ~i that the request was si-i,tilar to other Petitions acce. t'Ed by z~ii apartment under petition numbers 90-01996, 90-02178, and 90-015 4 l. 2. Based on the precedent est.sa:'I s" s c nv the previous petitions, this petition for variance is being processed as permitted by Wisconsin ~r~ction 10' Departrfiental Action: Condit-,,)n l D r'oval. well iristul 0ii .:ach side of and Ienth ^f 3 ",ni torn of the existing soi 1 :i.,:-orpti on u ciis .:.i}SSi (fir"iii; itccor-dance wiiA, S. IL!i;( (7), 1-`iic -f-Firn, Trr -,,Idij-;n_rr rS n~ use must be discontinued at the 4irst sign of failure and a code-cmpl,ying system must then be installed. SRU 6928iR.o1ro1o AM& SAFETY & BUILDINGS DIVISION ' ^1)" F W P.O. Box 7969 V Madison, Wisconsin 53707 State of Wisconsin Department of Industry, Labor and Human Relations A Richard Hippauf Page 2 July 9, 1992 -t This approval is granted with the understanding that all of the petitioner's statements and any conditions of approve! cited above will be carried out. Prepared by: Gerard Swims n Departmental Signature:( Date: ti. _ Richard er, rctec Director, Office of Division Codes a4 Application GS:,,- 3WPP1 cc: Leroy Jansky, Private Sewage Cor,su t tint - District 6, Chippewa Falls Thomas Nelson, Zoning Administrator - St. Croix County Henry F. Grote, Certified Soil Tester - Knapp i SRD 6928 iR.011911 SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue P.O. Box 7969 Madison, Wisconsin 53707 State of Wisconsin Department of Industry, Labor and Human Relations Ju V .1, L RICHARD .1,11PPAUF RURAL 1.L ROUTE 1 30TH AVENUE 11 r,ILSO~~ ;I 54027 Petition klo. S92-40537-P Dear 'Ir. Pir,)pat!f: Re: Richard N ppauf - Residence Private Sewage System 5",5S"1,16,28,151' . F; Tov(n of Cady,11.1TIIX ounty, V You! r petition for a variance to section ILN%t 33.10 (2), Wisconsin sA, i . 't icJtratlVe Code, has been eYielwe,a Ack , The rule being petitioned requires that there be a minimum of 3 vertical feet of soil betieen the bottom. of a sail absorption system and high groundwater, l The variance requested was to allow the continued use of an existing svster which is less than 3 feet above soil mottles, pending ending groan&rater level monitoring results. T,he folloewing comments ;Mere made in the petition analysis: 1. In revi ewi no the petition, it- was not;Dd that the reaul st was sir;-Al ar to Y 1 other Petitions accepted by this department under petition numbers 90-01., O1b, 90-02178 , and . 90-01534. r~2. Based on the precedent established by the previous petitions, this etition for variance is being processed as permitted by liisco+~sir ,5tatute Section 101.02 (6)(S). Departmental Action: Conditional Approval. The conditions of approval are that monitoring wells be installed on each side of and to a depth of 3 feet below the bottom of the existing soil absorption system and that monitoring be conducted in accordance wits s. ILNR 83.09 (7), 11is. Adm. Code, witb results forwarded to this office. In addition, system use must be discontinued at the first sign of f? a code-complying System Must then be installed. O ~o e f Lyi tip ~ N J~ ~l IJ / ~ Z sso secs a. oiryI I I SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue P.O. Bo: 7969 Madison, Wisconsin 53707 State of Wisconsin Department of Industry, Labor and Human Relations Hippauf R a 4ul" c I C49', This approval is granted r4'ith the understandin,l that call of the petitioner's nroval cited t~, yov~ will be carried out. state rents and any conch ti or.s of aA. Prepared by: Gerard Depart:, ^'t '1 ental Sic;n:~tur.~• . Gate: 7 ~ Richard L. P'N er; rcnl' Director, Gifice of Division Codes and Application 'S: r i 11I i u,>. - G, yr P1 Enc. cc: Leroy Jansky, Private Sewage Consultant - District 6, Chippewa Falls Thoras Nelson, Zoning hdr:inistrator - St. Croix COLinty Henry fed it Tester - Knapp SBD 6928A. 01/911 0+~~ SAFETY & BUILDINGS DIVISION a State of Wisconsin Department of Industry, Labor and Human Relations ->r .V„ i rN` n.; ht~,C^ V.`... 'a ?:ose S- -eet ~z C: RU CEDAR 3G Owner . R '120 N BROADWAY RT _ . 30TH ..1V= MENOMONIE WI 5475'; WIL,~. N1 54027 RE: Plan Number : S92-40537 1992 lops Per Day: I-50 ;Da e ce veg . _ 92 Pro,iect Nature:?IP?.AUK, RICHARD - RESIDENCE _ocat on SW,SW6,5W CRI Town of CAD T`)e plumbing plans and spec,ficatio".s for this proTect have beer. :-evi&.: for compliance with applicable cc<--Ie requirements- Tlis app-cva =s cased -x Chapter ,45, Wisconsin Statutes and the Wisconsin Administrative Code. The p.~_-= are stamped 'cc^',dit4onally approved' _ This approve ! is contingent upon _ 'ante 4vith any stipulations shown on the plans. All items that ane noted mast ices =-rected_ All permits required by the city, village, township or county wall be c_ aired prior to construction. The licensed plumber responsib-e for this irsta__ation shall Keep one set of plans w°,th the department's approval stamp at t7e construction site. The installer shall not"iLy the appropriate inspec`c- 4nen inspections can be made" This approval will expire twc- years from the date approved or if a sar'7_.ry permit is obtained, it will expire the day the initial sanitary permit expires_ The Section of Private Sewage nas reviewed these plans for private sewage system code requirements only. These' plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 cf the Wisconsin Administrative code- This approval is for the following components only: - REPLACEMENT PETITION NOTE: Conditionally Approved. The conditions of the approval are that monitoring wells be installed on each side of and to a depth of 3 :feet below the bottom of the existing soil absorption system and that monitoring be conducted in 9 ordance with s. ILHR 83.09(7), Wis. Adm. Code, with the results forwarded 0 ILHR office- In addition, system use must be discontinued at the first .si failure and a code-complying system must then be installed. c ning,.this, approval may be made by calling (608) 785-9348. N ' 2 ~ v, 2cQ 90 ~ 4 o"~ f SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations -E,aAR DL-9G' nc`-e y C=RARD M. 13' IM Sect;, of Pr4vate Sewage ' ,vision of Safety and Bull d4nas PPP039/0009n/37 RICHAR A~. ;vat_ :~ewage Cons- Itan, i SBD 6493:R. 01/111 SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue P.O. Box 7969 Madison, Wisconsin 53707 State of Wisconsin Department of Industry, Labor and Human Relations July 9, 1992 RICHARD HIPPAUF RURAL ROUTE 1 30TH AVENUE WILSON WI 54027 Petition No. S92-40537-P Dear Mr. Hippauf: Re: Richard Hippauf - Residence Private Sewage System SW,SW,16,28,15W Town of Cady, St. Croix County, WI Your petition for a variance to section ILHR 83.10 (2), Wisconsin Administrative Code, has been reviewed. The rule being petitioned requires that there be a minimum of 3 vertical feet of soil between the bottom of a soil absorption system and high groundwater. The variance requested was to allow the continued use of an existing system which is less than 3 feet above soil mottles, pending groundwater level monitoring results. The following comments were made in the petition analysis: 1. In reviewing the petition, it was noted that the request was similar to other petitions accepted by this department under petition numbers 90-01996, 90-02178, and 90-01584. 2. Based on the precedent established by the previous petitions, this petition for variance is being processed as permitted by Wisconsin Statute Section 101.02 (6)(g). Departmental Action: Conditional Approval. The conditions of approval are that monitoring wells be installed on each side of and to a depth of 3 feet below the bottom of the existing soil absorption system and that monitoring be conducted in accordance with s. ILHR 83.09 (7), Wis. Adm. Code, with results forwarded to this office. In addition, system use must be discontinued at the first sign of failure and a code-complying system must then be installed. SAD 6628 i R. 01 /61 i SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue P.O. Box 7969 Madison, Wisconsin 53707 State of Wisconsin Department of Industry, Labor and Human Relations Richard Hippauf Page 2 July 9, 1992 This approval is granted with the understanding that all of the petitioner's statements and any conditions of approval cited above will be carried out. Prepared by: Gerard Swi Departmental Signature: Date: Richard rc ec Director, Office of Division Codes aA Application GS:2013WPP1 Enc. cc: Leroy Jansky, Private Sewage Consultant - District 6, Chippewa Falls Thomas Nelson, Zoning Administrator - St. Croix County Henry F. Grote, Certified Soil Tester - Knapp j } SBO 61028 (R. 01m I,