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HomeMy WebLinkAbout020-1020-60-025 o m °o N o ao 0 bra a d ao m y o o 0 ts o o N o c _0) v 00) C) V L m 3 o E o a) C ca - a t > ~ . m p c'D L U C L °m a) N 01 v,- E• _ a Z€ N c Z y X {L G CL 7 E LL C V) O) N, a)cc CL o'rno H o E Q `o co =v 3 a v Z tll f// O` O` z y y c.) W a m a m o F- U) o o z c c o N o 0 v m 2 c c 91 (D N O N O = m a) N" y a N Q) 4) c •'jvi 01 L O O O N a s a Q o a°i Q I 0 o a) zcnz z m z o z C N d c fD O R ,L iC E N rn I c_o _ N R U L A 7 m y- Q' o m m d N y ` a) N Y ` d C O > d a) C _ al a) L. O p o c c a G G a n m N % Q p N N N y j N m m 7 +y - rr rr - Z n y 3 3 a cn - z° o •N ; ma a a =aaa y a o o N c i- ip. o I D cu N a) ONi (yi I N J U o rn rn z rn rn } a) c N O N N O O O O V O ~--E o r m c U m c a co C d QI Z fn C QI Z fn i0 00 n W y y H H o to c N O O N y G o t N C ~V p a c c E E LO LO Q a) a) y a°i y u°, v a °p T ( v o aU i -e -2 o a s c-0 N V o a) H m V) m ca ul E E 0 a) LO LO 00 w C'j o ! ~ yr ~ co Q) CD ur ~ r r 4 O y N S O O O -E t17 sd.. 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CD c T = o o O N N y N Coil 3 O O LO • c°~ v l 0) N m m CO (D Z) N E E v y, o 2 rn o m m fn o - :z; U) it © rte. 0 m a £ a m a a a a L: m • c~ 0. m 0) a r~ L ~r A U a ! 0 N L)) 0 W C) ViiscunsinDupartmentoflndusuy, SOIL AND SITE EVALUATION REPORT Page >~rL,AWf and Human Ralations f i7lvision of Safety & Buildings « in accord with ILHR 83.05, Wis. Adm. Code COUNTY Afl,-=) complate 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. i; dimanaionad, north arrow, and location and distance to nearest road. _ APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY PF CPERTY 0,'I NER: PROPERTY LOCATION Joseph & Denise Starkey GOVT. LOT SE 1i4 NE 1/4,S 14 T 29 ,N,R 19 xt :tJ. Pf',OPEFtTY C'iJNER':S NIAILING ADDRESS LOT # BLOCiS SUSD. NAME OR CSM N 783_McCutcheon Road Ci7Y, SThJE ZiP CODE PHONE NUMBER l~E~R [~'~t~3at (~T01'/N NEAREST ROAD Hudson WT 54016 (715)3,96-3447 HL:dson IMc Cutchean Prc Ad [ j Ne, Construction Use [ xj Residential l Number of bedrooms 4 [ j Addition to existing building j f~eplacernenf (J Public Dr commercial describe Cole derive=d daily flow 600 gpd Recommended design loading rate .7 bed, gpd/tt2_. 8_trench, gpatr' Abl: orption aria required bed, 42 trench, ft2 Makimum design loading rate bed, gpdr'ft' trench, gpd,it-' Recommended infiltration surface elevalicn(s) ft (as referred to site plan benchmark) Additional deign / site considerations Parent material Flood plain elevation, if applicable ft S `uitablufiif SySlern CONVENTIONAL MOUND iNGROUNDPRESSURE AT-L;',A0E SY:',Itt.f N FiLL h,). U: Unswt role for s stem ER S O U US ❑ U (2S ❑ u S U ❑ S ® U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure I t3c;ring a Mlorizon Texture Consistence E3o:rxtry Roots { in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sth. i 1... , 1 ---1 0-25 10YR 2/1 None sil 2 m sbk mfi 11 VF.. , 5 .6 2 25-46 10YR 5/3 None si.l 1 to s2-.,k mfi as 1VF I .2 .3 (:round 3 46-12 10YR 6/6 None is 0 in sg mfr .7 .8 law. 94_.17((. C,:plh to 6rtri[ifig f"Clur Remarks: Doring r/ 1 0-37 10YR 2Z1 None sil 2 m sbk mfr as 1VF .5 .6 2 2 37-49 10YR 4/6 None is 0 in s mfr as .8 Ground i3 49-57 10YR 6/4 Nona is 0 f s mvfr as _ , 7 .8 elev 9 96.3'-9,. 3 4 57-10 10YR 6/6 o in s mvfr . 7 .8- Depth to '~A cn~ limiting rvA faelor t__ _ _ _ r Remarks: CSI N nu:-Pluasu Print Phonu. ._(715) 425_-5544 1__C...-J 3t-ai?Ge.1r' N2 ~7~ NI 230 Hicnw 65 South- River Falls 4022 DaW: CST tNjr~i S yn du u: - O-U--41 - - --39, IF, 999 PROPERTY OWNER Joseph Starkey SOIL DESCRIPTION REPORT PL ' PARCEL I.D. a Depth Dominant Color Mottles Texture Structure Consistence Barry Roots I+ Boring ;t' = i-iorizon in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sn. r 1 0-26 10YR 5/2 None 1s,gr 2 m s mfr as 1VF-.7 .8 3 2 26-44 10YR 2/1 None sil 2 m sbk mfr as 1VF .5 .6 Ground 3 44-69 10YR-5/3 None sil 1 m sbk mfi as .3 elev. 93.fi7ft. 4 69-122 10YR 6/6 None ls,gr 0 m sg mfr . Depth to limiting factor I Remarks: Laver # 1 is fill from New Addition on house 6 years aqo Boring Ground elev. - f t. Depth to limiting factor Remarks: Boring it Ground elev. I It. Daput to - limiting factor - Remarks: - - Boring Ground elev. ft. Depth to - limiting _ factor r?: rn,4 rk,- PI0r PLA.iV cc Ic 4 I 13M,~~,,rt C~' ir:+1 11+Vr 1 I FJo~~e ~M i l i S h c,n" _ ICI .~^1C s1 .G `~l T~^~,,.r hi.+ ~ CT~~ r~yr~ ~'~j~41` `t"nt r,~ ~ 1•r UC:r\ v \ C r L, P, ()Z"Y+'7fl~i"X)fif~L,lCArc"(~if~"~ IQ(`~I C C AS+)~J~~C..Cs.J~ J^ ..~~~CC',(~Cl~f~~;'l~r '^C, i ~`.~(s r~~~ ! 1 ~ !'t `1 ~ .~J l 1..y y 1 r -.•j~-!. ~ ~ %11 ~ rr f'. ~ r l_'t G,~l , ~r lG.~r A~r•("~t tCtiL 4J„r~Ih ti~s.iC•,C~C r ( ,+r~ r~~rCl` ..l~r i y: a• ~ t r•r r n C. ~.r n4. 1n'~4 ♦ j.,j..~ ~ ~ Y! "All ~ 1•/~r 1~1~~ ~ 1Cr r'~c~i Cft~, !:y r., ,-{lC` YvisconsinDepartmentof Industry, SOIL AND SITE EVALUATION REPORT Page %~bor and Human Relations Divi.ion of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St Croix _ not limit4d to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimun6ioned, north arrow, and location and distance to nearest road. _ APPLICA14T INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY PROPERTY OWNER' PROPERTY LOCATION Joseph & Denise Starkey GOVT. LOT SE 1i4 NE 1/4.S 14 T 29 N,R 19 Pr Ur'EitTY OtivNER :S hif+ILING nDORcc s LOT s BLCCK # SWD. NAME OR CSIM T'> , S 783 Mc . Ci_ztcheon Road It, L ZIP CODE PHONE NUMBER OLI R G:Nktr~A MOWN NEAriEST FtUAD 17pudson WT 54016 (715) 386--3447 Hudson Mc Cutcheon Road [ J Nen Construc6on Use Residential I Number of bedrooms 4 [ ] Addition to existing building tKJ R,:plaa;rnent ( ] Public or commercial describe Code uarivcd daily flow 600 gpd R,~commended design loading rate .7 bed, gpd;'ft2_. 8 _trench, gpo, I,:, Ab~urpt on area required bed, ft2 Uench, i12 Maximum design loading rate bed, gpdjf12 trench, gpd lire' F;ecemnlended infiltration surface elevation(s) Ill (as referred to site pian benchmark) Ada t onal design / site considerations Parent material Flood plain elevation, if applicable it S unable fOr system CONVENTIONAL MOUND IN GROUND PRESSURE A T GW i)E SYSTir'd IN FILL rr:; ; u u tsuit<<i to for system 1 S❑ u TfAS ❑ U DS Gl u o s O u ❑ S DU F-j SOIL DESCRIPTION REPORT i3oriru if Horizon Depth Dominant Color Mottles Structure in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. S,,). Consistence E3cxdry Roots 1 1 0-25 10YR 211 alone sit 2 m sh,.k mfi - _ 5_ .6 _ 2 25-46 10YR 5/3 None sil 1 m sbk mfi as 1VF .2 .3 L-:rour;d 3 46-12 10YR 6/6 None is 0 m sg tnfr `.7 .8 94.17it. Ceplh to limiting - - - I.~CIO Remarks: l3orin0 if 1 0-37 10YR 2/1 None sil 2 m sbk mfr as 1VF ,.5 2 2 37-49 10YR 4/6 None is 0 m s mfr as .7 .8 Ground 3 49-57 10YR 6/4 None is 0 f s mvfr as .7. .8 4 57-10 10YR 6/6 Non o m s mvfr .7 •8 90.39t. /~'O~ Deptfl to - hrrliting C/) f~~cior - h' O_ U Remarks: CST N Tie:-F'luase Print m N Pnone: 715 425-5544 Staille _._118230 Highway 65 utt•t- 'ver Falls Sign du a Date: CST Nuii P80PERTY OWNER Joseph Starkey SOIL DESCRIPTION REPORT PARCEL I.D. Depth Dominant Color Mottles Structure Boring # Horizon Texture Consistence Baxxiary Roots - in. Munsell Qu. Sz. Cons Color Gr. Sz. Sn. 1 0-26 10YR 5/2 None 1s,gr 2 m s mfr as 1VF 1'.7 .8 '3 - 2 26-44 10YR 2/1 None sil 2 at sbk mfr as 1vF .5 .6 Grouno 3 44-69 IIOYR-5/3 None sil 1 m sbk mfi as .2 .3 elev. 91-62ft• 4 69-12 10YR 6/6 None ls,gr 0 m sg mfr 1-.7 .8 Depth to limiting factor Remarks: Laver # 1 is fill from New Addition on house 6 years ago _ Boring # Ground elev. It. Depth to limiting factor - Remarks: Boring # - i I Ground elev. f t. I Depth to limiting factor i Remarks: Boring # Ground elev. I t. ~ I i Depth to limiting factor__. I } PI 0 T P L A. IV ~ - i J i~ 15 a err 1 ~ M ti ♦ h, ^a~l C'~.y { K• .I' Ui:~'\ ci ~ C ~ ;[lCal~,Y'Jl7 .h~~ { ~wn~ ~ ~ COY c,y r~ r-- r I \ nt1;'~ a C~ t/.Jl(! H ~C~ r i r11W ~7•\ r`~'!. ,(~r;'l^IJ r ~n_F!' It -~,.~at ~ ~Jl~^:.l ( lS;^in~,~~^ry,j.~r /a .~'~~~t,,.:Yr .►f,N ~,r„y (i. ,)S. a: r • c.. 1 ~ 4.Y l~ f. i 'r c. C~ c Y'C Coco En ~[i(\ ♦~~;iTTi ,~\n 1 J`i~~.i~~1~i.\ ~ ~,,c1 ~ 5 .fib /Viii. . 1.2 Lis~iQartiust~y4.29.19.9 PR1~A1'5~~~ETEM RD• County: Laborr"and Human Relations INSPECTION REPORT Safety and Buildings Division ST. C IX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: 186508 Permit Holder's Name: ❑ City ❑ Village [R Town of: State Plan ID No.: HUDSON BM E ev.: Insp. BM Elev.: 7BM Description: Parcel Tax No.: 020-1020-60-000 TANK INFORMATION ELEVATION DATA A9200392 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Z,V Benchmark '10~ 1'e"A 49 rng Aeration Bldg. Sewer tCQ Q L Holding St/A Inlet TANK SETBACK INFORMATION St/ VC Outlet 2S. sp' Verit TANK TO P/ L WELL BLDG. Air Ito ntake ROAD Dt Inlet Septic > 5f, > vQ 3S~ NA Dt Bottom /11 Y4, . I g NA Header E$6a+1. 11 3 9d Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade ufacturer Demand t°P T. AV 97W Model Number PM TDH Lift Lrictio System TD Ft Forcemain Length Dia. Fi Dist. To Well SOIL ABSORPTION SYSTEM BED / TRENCH Width Lengt I No. Of T enches P f Pits Inside Dia. Liquid Depth DIMENSIONS ~-Z IMEN I N SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHIN Manufacturer: INFORMATION Type Of CHAMBER / e Number: System: 1Z,) OR UNIT DISTRIBUTION SYSTEM Header/ Ma i4e}d „ Distribution Pipe(s) r 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 it =c// Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center J~ Bed /Trench Edges ~ ` SJC Topsoil El Yes ❑ No El Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION:: HUDSON 14.29.19.94A,SE,NE, MCCUTC/HEON RD. Zz~ :~z z` C C✓~t C o~ Plar ision required? es ❑ No Use other side for additional information. J/ SBD-6710(R 05/91) Date Inspector's Signature Cert No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: I, SAN ITARY PERMIT APPLICATION LHR In accord with ILHR 83.05, Wis. Adm. Code c HN =Z211 STATE SANITARY PER # Atfach complete plans (to the county copy only) for the system, on paper not less than 8% x 11 inches in size. El a6a-o-t- revious application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROP RTY OWNER PROPERTY LOCATION %aN6%,S TO,N,R EjmQ PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # 793 Mc- C CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER 11. TYPE OF BUILDING: (Check one) ❑ State Owned Q->W66%E : j NEAREST ROAD F Mt C41ehegsi~ Ad ❑ Public ®1 or 2 Fam. Dwelling-# of bedrooms 4/ PAR LT N UMBER( S) Ill. BUILDING USE: (If building type is public, check all that apply) Qa 0 ! 16A Q - 4Ld -ad C 1 ❑ Apt/Condo `7 2 ❑ Assembly Hall 60 Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 30 Campground 70 Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 50 Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ❑ New 2. Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit # - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 Seepage Trench 220 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 (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) p ELEVATION / 00 70 6 7 7_0 p Feet Feet CAPACITY VII. TANK Site in alIons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name ncret Con- Steel glass Plastic App Tanks Tanks structed Septic Tank Q /Z VIII. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Ptum tier's Name (Print): Plum ignature: (N Stamps) MPAMPRSW W.: Business Phone Number: P fir 0 Tim y~ )9,4 f2 ff --3y Plumber's Address (Street, City, State, Zip Cod / ~ ~ ` Dr I / IX. COUNTY/DEPARTMEN SE ONLY X❑ Disapproved Sa~tary Permit Fee (Includes Groundwater Date Issued Issuing nt Sign re No stamps) Surcharge Fee) Approved ❑ Owner Given Initial 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 r 1. ..,A. sanitary permit is valid for two (2) years. 2. Yodr`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. pcorate this sanitlary permit application must include: ` To be complete dftd 4 1. Property owner's name And mgkiling ~ddress.t Provide the legal description and parcel tax number(s) of : ,where th"ystem is to be installed..'. - L' Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. 111. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in #1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Eomplete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 81/2 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,ifr . (equired by the county; E) soil test data on a 115 farm; and F) all suing information.' r ° GROUNDWATER SURCHIRG'It ¢ 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 standard's. > SBD-6398 (R.11/88) 7 STC-100 This application form is to be completed in full and signed by O e 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), thenia 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 _ J ~S~nh L Location of-property- /4,, Section _I, T N-R_Z3,W Township ,i~d,-pr, , Mailing address 783 ~~L/p5C l7 ~/S t^r~ ~ i n SyGf~ Address of site _7K3 1>?5 f'„ r., 7 en,. ,4 Subdivision name Lot no. Other homes on property? es No Previous owner of property Total size of parcel /G Date parcel-was created Are all corners and lot lines identifiable? Yes No Is this property 10eing developed for (spec house)? Yes No I Volume ~S f and. Page Number .Seas 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._3</9- ,yn , 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. J'Y9~5f!o . S t re of pplicant Co-applicant } Date of Signature Date of Signature pdf.ourtord, MT*so n""*TMOUSa tTM"" FORM s"`R..r.e ~44 '1 "'rCi~ 9580 ~r denture, blade this 20tH day of June._.., , in dw .Ve>rnOn ..A... V.dY.Xit...~Ad one thousand nine hundred and seventy- eight . between S ......Delia.A..--Yavra,...husband_and...wi-f,e...... _ . fit* per, . _ pai rt ..es of the as&-JQ*A]Ph...To.- Starkey and Denise L. Starkey, _..............._...r, busband and wife, as joint tenants, parties of the second part. Witneeeeth, That the said part Fes of the tirst part, for and in consideration of the sm s- ._APaxtrrfour Thousand Eight. Hundred ($44,800.00) p to thOla . in hand paid by the said parties of the wcoml part, the receipt whereof is hereby acknowledged, ha YO. given, granted, bargained, sold, remised, r--leased, aliened, conveyed and confira w, these presents do give, grant, bargain, sell, remise, release, alien, convey and confirm unto the do second part, as joint tenants, the following described real estate, situated in the County of... St. and State of Wisconsin, to-wit. ? The East half (E~) of the West half (W-~) of the Southeast quarter (SE(C) of the Northeast quarter (NEh) of Section Fourteen F (14), Township Twenty-nine (29) North, Range Nineteen (19) Msst. RAN *f ~r r+ Taxes for 1978 have. been pro-rated pursuant to S74.62 of tbt fe. stats.., so that said taxes, when due and payable, are to be'. I paid-by grantees. ; r P `x J: 'lt'eWbW Frith all and singular the hereditatnents and appurtenances thereunto belonging or in any t~ 'gdsulli, aMalt'the estate, right, title, interest, claim or demand whatsoever, of the said part ies Of dw, -iq low or equity. either in possession or expectancy of, in and to the above bargained premaea, and tlN~r nb &nd appurtenances. TO 110 ve MW to J*OM the said py'emises as above described, ith the hereditantents and appuratnaatoetk, Ad's Of the second part, as joatt;te wts. t , mss[.-. 111 - err y. -a.. -.x, ~•...*tc~c*~ . 7 . 4 'parties „i the heat Wit. ~ -heift, executors and administlato s, du cofivriant. grant, bargain..sml ahim ta:and the tltttW paeaes of the second part. and to and with the survivor of them. his ,tr her heirs intl assign4, that at Otlflt.Ut the eaf3ei111nQ and ih'IIVCry of these Itrl•,t'ill, they are ~111111 a•Vt',I nf lI1P pr.'IIli-l'a .'llrc►1'r tIOW,•asof a gait}, %tire, perfect, absolutc ntul ill,lefi•.t'iltlt• t ~t.ttt ttf inht•rit,ut,in tilt' I lv, in ta't' -i:n;Jf•, tilt) that •>a oom6 afe•free and clear front all inctuuhranct•:: ~t h.ttever, r she above bargained premises in the quiet int,i pe,tce.thit tai tn•• .titI p.irtte. of the se'cuntl liar rr ts, hisor her hearsanti assigns, at,'ain.t;ill kill] ett•r% I.t• r:-m.w Ier:,tn,I.mfulk t'laiminl;the wholeorany." ..06Y,.:.-.... will forever 11'AItItA\•i' A11) I)EF}'A I> ht rrunt„ ,•t their hands and the said}xut . 168 of the bra part haVe ; June I ► t't 78 day of iii. .T; Fy $i1p11ed, SmW and Delivere(I in Presence of Vernon D. aura _A,_ Vavra c: 11" bye mei !his 20th day of June A. R. 19 70 r .rdOb:.D.. Vavra and Doris A. Vavra r husband and. wife; 46 be. the 1imain 0 who executed tht• fmc;zoin}; in,troment anti acknou le,lee,d the %amp. nsdCxv4oent drafted r n~ It~'ultlic. ('punt)'.. ll art L. Loberq. . j N r ^f,r a .T Vy tly ' . r••, ~a,~ t e. Mar .r, :uo~1~ e'tt~:at..:,ut r~t,tres. 19 a ~ 1Yy11yyyNrt~ wW • . , ~ • v. r • Ib ,1M'V ■ = ' ~ a ptatates Wn thot a# 1n•trutw.nte to he receed.d sbdl have plainly printed or tyawttt•n th•eaw/ fla ~eMta, /~q}•, wltpe•rati an nMary • . .y ~ is .I C W LLJ L.LJ 6 i 1 L; Y _ t I air / - tV C C u 'r'• O L N Q,' ;7 CO -C 0: 21 r-s ` t im" S T C - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County ' OWNER/BUYER c 1o-,c,a , L n I i e ,4 ADDRESS FIRE NUMBER 7ty.3 CITY/STATE Zic ZIP- ~`-S(G/(o X /I/ PROPERTY LOCATION: 1/ , i/4, SECTION- /Z , T,J.9.--N-R 2 W TOWN 0 F__~7Gt~5nv~ , 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, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix zoning a certification 'form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1). the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/tae, 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: - 2 - St. Croix co. Zoning office 911 4th St. Hudson, WI 54016 `VisconsinDopirtmentof Industry, SOIL AND SITE EVALUATION REPORT L,Lur ,nd hlurnan Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St Croix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. I; din-wnsioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY Pi0P PTY GYirvER: PROPERTY LOCATION Joseph & Denise Starkey GOUT. LOT SE 1/4 NE 1/4,S 14 T 29 N,R 19 PRGPEf iTY OINNER':S MAILING ADDRESS LOT # BLOCK 4 j SURD. NAME OR CSM a 783 Mc _C_ utcheon Road - CITY STATE ZIP CODE PHONE NUMIBER @&J ' tA'21:k GOWN NEAREST ROAD Hodson WT 54016 (715)386-3447 Hudson Mc Cutcheon Rc4Id (j Nevr Construction Use (xj Residential I Number of bedrooms 4 Aodi(on to existing building _ , _ t; j Replacement ( ] Public or commercial describe Code derived daily flow 600 gpd R.a;ommended design loading rate .7 bed, gpd/0 .8 -trench, gpa Ili" Abzcrption area required bed, ft' trench, h2 Maximum design loading rate _bed, gpd/f12 trench, gpd, ii Reconunen&cd infiltration surface elevation(s) ft (as referred to site plan benchmark) AdaiGunal design /site consideration,, Parenl material Flood plain elevation, if applicable i► S Saiiably for System CONVENTIONAL MOUND IN-GAOUNDPHE5SUFE AT-GriADE SYSffwf IN FILL Nu_ ~ U- Unsullad,e fors stem as E U :E S❑ U [as 0 U El S 0 U 0 S D U 0 SOIL DESCRIPTION REPORT Depth Dominant Color Mowes Consistence E3ot.r" Root i:ioring f-forizon Texture Structure t in. Munsell Cu. Sz. Cont. Color Cr. Sz. Sh. ii c, 1 _ 1 0-25 10YR 2/1 None sil 2 m sbk mfi .6 2 25-46 10YR 5/3 None sil 1 m sbk mfi as 1Vr .3 0uilU 3 46-12 10YR 6/6 None 1s 0 m sg mfr .7 - - - 8 ulc;J. s 94..17it. Laolft to lullilillg - I;,ctor Remarks: Goring it - - 1 0-37 10yR 2/1 None sil 2 in sbk mfr as 1 VF I_. 5 .6 2 37-49 10YR 4/6 None is 0 to s mfr as .7 .8 Ground 3 49-57 10YR 6/4 None is 0 f sue- mvfr as .7 .8 elev. 4 57-10 10YR 6/6 None is o m s mvfr .7 .8 90.391. Depth to limiting factor Remarks: (IST N oiv:-Ploase Print Phone: ~ L. 57151 425„554.4. N8230 Highwa 65 South; „River Falls VII 54022 Signaru;u. ~ ~ Dana: C5 Nurn.;r:, l PHOPEPM OWNER Joseph Starkey SOIL DESCRIPTION REPORT FUJI-, PAFICEL I.D. a Boring Horizon Depth Dominant Color Mottes Texture Structure Consistence Boundary Root:: in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sri. 1 0-26 10YR 5/2 None 1s,gr 2 m s mfr as 1VF .7 .8 3 2 26-44 10YR 2/1 None sil 2 m sbk mfr as 1VF .5 .6 Ground 3 44-69 10YR.5/3 None sil 1 m sbk mfi as .2 .3 elev. . _ _ 93-6211. 4 69-12 10YR 6/6 None ls,gr 0 m sg mfr I .7 .3 Depth to I 'r-7 limiting factor Remarks: Laver # 1 is fill from New Addition on house 6 years ago _ Boring Ground - elev. Depth to limiting factor Hemarks: Boring r1 --l I I Ground elev. it. Depth to limiting factor Remarks: Boring # i, i Ground elev. ft. Depth to limiting factor PI0 T PLAN Sca~~ 1 r ~,lJ~,~ Ai Nos, /p" a PI0T PLAN SCo~C .30 n~1v.. n.~ci!frc.~ 1 hv, 1 r J3 Ai , . Not N Nousc 013, 7v '~l~1• ~J iJ~ Tt~. c7r G~t~;"G(.>,'S c~c'. "SQ~; "~{"t')(tti'l . GC r.r•r~~:% f'}'` {C y 1r tt ~ C)h i i ^r A `Clr l:r-(4 ~'~'C^.Y { ~n .1 `f,ln :a_iC [ ~ trr+.n ) y .ti ~Al nor ~ REPT131 HUDSON ST. CROIX COUNTY ZONING PAGE 1 11/04/92 16:37 REQUESTS FOR INSPECTION WORK SHEETS FOR: 11/ 5/92 AREA: JT Activity: A9200392 11/ 5/92 Type: CONVSEPT Status: PENDING Constr: Address: HUDSON 14.29.19.94A,SE,NE, MCCUTCHEON RD. Parcel: 020-1020-60-000 Occ: Use: Description: 186508 Applicant: STARKEY, JOSEPH L & DENISE Phone: Owner: STARKEY, JOSEPH L & DENISE Phone: Contractor: STEINER, PAUL CJ Phone: Inspection Request Information..... Requestor: STEINER, PAUL Phone: Req Time: 14:11 Comments: c~"U6 Items requested to be Inspected... Action Comm nts Time Exp 00012 FINAL INSPECTION - - / 0 n.,). Inspection History..... Item: 00012 FINAL INSPECTION i I Wisconsin Department of Health and Social Services P;W, #67 3/70 Division of Health ~Ak SEPTIC TANK PERMIT APPLICATION 715 TYPE or USE BLACK INK r7 /Y~ A. OWNER OF PROPERTY G Name Address '(Street, city, zip Code) Be LOCATION OF PROPERTY WfNRE SYSTEM WILL BE CONSTRUCTED ALTERED OR EXTENDED COUNTY 07 C Check One: /~c N` ~W L~Xit j✓ Z- G`7-v ~ZZ c4Zl UJC 1? 7~J CITY VILLAGE LEGAL DESCRIPTION --TOWNSHIP C. IS LOCAL PERMIT REQUIRED FOR THIS WORK? "YES NO PERMIT NUMBER D. SEPTIC TANK CAPACITY Gallons NEW INSTALLATION REPLACEMENT ADDITION MATERIALSs Prefab Concrete Poured in Place Steel Other NUMBER OF TANKS TO BE INSTALLED: E. TYPE OF OCCUPANCY Cheek Ones One or Two Family Residence L~ Commercial Industrial Other Specify) Number of Persons to be Accommodated Number of Bedrooms F. APPLIANCES, ETC: Food Waste Grinder YES NO Automatic Clothes Washer YES -~-NO Dishwasher YES ---NO Automatic Potato Peeler YES NO Other (Specify) G. MASTER PLUPSER MAKING INSTALLATION Name: Addresss License Number: MP Signature of Applicant: - - MP RSW Address: H. (To a Completed by Issuing Agent) Date of Application p 7 x ® Fee Paid $ UAL~ Permit Issued (date) 07 O Permit Number JI 9 1. Agent (Name) Q . Fort Town, Village, Cit , County, etc. (Specify) Note: The application cannot be considered for filing until all of the above questions are answered and the fee paid. Agents will fomard application, the fee of $1.00 for each septic tanx and the third copy of the permit (canary) to the Division of Health. Cheeks and money orders should be made payable t%. the Division of Health. Do not write in space below FOR DEPARTMENT USE ONLY 1. DATE RECEIVED 1 U - 1 7 0 ACCEPTED BY RETURNED (Initials) (Date) Se Correa.) -7 6~1 FEE RECEIVED ✓ VALID. No. g PERMIT NO* es or No REVIZWZD BY APPROVED DATE (Initials) Yes or No COMPLETZ OTHER SIDE I SEPTIC TANK PERMIT NO, '2Z RsP0RT ON SOIL PERCOLATION TEST A N D S O I L B O R I N G S TO DIVISION OF HEALTH - PLUMBING SECTIdN P.O.Boz 309, Madison, Wis. 53701 Pursuant to H 62.20, Wis. Administrative Code P E R C O L A T I O N T E S T Test Depth Character of Soil Hours Water Test Time Drop in Water Level ohes Minutes Number Inches Thickness in Inches Since Hole in Hole Interval? Second to Next to Last o Fall let Wetted overnight in Minutes Last Period Last Period Period Ono Inch Example P - 0 361, To Soil ION Clar 26" 25 Yes or No 30 1 2 I L2 1/2 60 72 RECORD DATA FROM MINIMUM OF 3 TEST HOLES Compute size of absorption area in accord with H 62.20 Wis. Administrative Code. S 0 I L B O R I N G S- Minimum 361f Below Pro osed Abso Lion S stem Boring Total Depth Depth to Ground Water Depth to Bedrock Number Inches observed Estimated Observed Estimated Character of Soil with Thickness in Inches Example B - 0 7249 729, Black To Soil 12" C i$111 Sand 181E Gravel 241 94 vUU J©~ RECORD DATA FROM MIN XIM OF 3 BORE HOLFS TYPE OF OCCUPANCYs RESIDENCE: Number of Bedrooms OTHER: (Specify) Number of Persons POOD WASTE GRINDER: Yes No = Dishwasher: Tea No -'`-'Automatic clothes Washers Yes No EFFLUENT DISPOSAL SYSTEM: NEW EXTENSION ADDITION REPLACEMENT Tile Size No.Lin.Feet Trench Width Depth Number of Lines Seepage Bed: Length Width Depth Tile Size No. Lines Seepage Pits Inside Diameter _7 Liquid Depth 1, the undersigned, hereby certify that the percolation tests reported on this form were made by me or under my super- vision in accord with the procedares and method specified in Chapter H 62.20 (13), Wisconsin Administrative Code, and that the data recorded and location of test holes Are correct to the best of my knowledge and belief. NAME C w ~0 /N TITLE / ~E Type or Print REGISTRATION NO. or MASTER PLUMBER LICENSE NO. ADDRESS P DATE SIGNATURE ' q.~ -7 73-7 3 2 rod s f N CERTIFIED SURVEY MAP SECOR.' 14 SE 1/4 - NE 1/4 - SEC. 14 1 T29N R 19W CO. MON. BEARINGS REFERENCED 5 A THE NE 1/4 OF LONG THE EAST LINE OF gyp. C '-(ASSUMED N 00°--0709W ) McCUTCHEON RD. 329'30 ~ N (TOWN ROAD) N89°-12'-62"E NORTH LINE OF m N89°-2e-OdE _ O1 THE SE 1/4-NEI/4 -0 690- 12'- 52" W 666.60, / - -r - - ~/N 89°-25- 'S.'E \ 10.5 329. T Ali ` EAST LINE OF THE . LEGEND EXISTING -EI/2-WI/2-SEI/4-NEI/4 HOUSE o--- I°X24"IRON PIPESET. ' WT. 1.68 LOS./LIN. FT. ~O,NOg= m --EXISTING FENCE At~~p - N z '0 0 r oz m 40 40 m s Z w CLRTIFICATE OF THE m ro OF DSO ~ WEST LINE Of THE _ N LOT I w E I/2-W I/2 -SE 1/4 - NE 1/4 w 9,9 2 A. I, do hereby certify that a this Certified Survey 14ap c° has been approved by the w Town of Hudson this day of ,w N4 0 y • GENE C. Town Clerk of Hudson SHAFFER , ~C HS U °N WIS. APPROVED p w• , <,9NO SURJ~~ d 5',, W111 MAR 1$1980 14 .5 17' ST. CROIX C-)O"Ty w s 69'- 21 % 25" W QOIAPREHENSIVE r'+KS PLAN' x,09 ZONING tUMMIT SOUTH LINE 327.90, OF THE NE 1/4 SMP~~., pC~ 2 IOd 0 5d IOd 200 ~R SCALE IN FEET 9 I"= 200' VOL. _-_PAGE THIS INSTRUMENT WAS DRAFT CERTIFIED SURVEY PJAPS T ST. CROIX COUNTY, WI.