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HomeMy WebLinkAbout020-1068-20-000 v o 0 er ~ I C I O O N b N O w V a ~ C;'y x EO W Y z ca C LL. C ca O rn a O I I 3 Cl) ~ y z iii w E cn o o c z `m a m N I- Z c C7 ~ O_ Z d c N CUi Z ~F II , O c F a C may] ~ ~ m ~ f0 N N N ~ 'JJ O O ~ d CO N N O z co z O N Z C) 0 N r c o R E It N C a G .M w 2 O O L 06 ooCL m I U) - 0) E O N- m E o F X333 d'm O O O •N = a a a a 0 N o m Oi '~iy to J U '0 Oy C 0) co d N O m N O CO N N Ico ~d a} ~ I O O I,. J C (n 0) C) 0 E LO 0 (D 9 06 :D i O 3 C y c C a 0 o o L CO N F- 0 N N c c co N N O O C C y y 5 N N N (sy~,~ O N O z n 0 0 0 o N o m o E Z c y N N i' o N 2 d o FO J) '2 Z> O i C J a D a • c~ c w I' y Q IL 0 U) Parcel 020-1068-20-000 01/12/2005 05:13 PM PAGE 1 OF 1 Alt. Parcel 24.29.19.259B 020 - TOWN OF HUDSON Current ❑X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * PAGELS, DANIEL M & LAURIE L DANIEL M & LAURIE L PAGELS 868 BADLANDS RD HUDSON WI 54016-2278 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 868 BADLANDS RD SC 2611 SCH D OF HUDSON SP 1700 W ITC Legal Description: Acres: 3.980 Plat: N/A-NOT AVAILABLE SEC 24 T29N R19W NW SE COM SW COR E Block/Condo Bldg: 126.25' TO CEN LN TN RD N67DEG E 615.71' ON CEN LN TO POB: N 533.83 FT E 384.75 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) FT S 371.9 FT TO CEN LN TN RD TH S67DEG 24-29N-19W W ON CEN LN 417.44 FT TO POB Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 2001/586 W ID 07/23/1997 883/71 07/23/1997 772/420 2004 SUMMARY Bill M Fair Market Value: Assessed with: 48182 242,500 Valuations: Last Changed: 10/29/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.980 59,000 128,600 187,600 NO Totals for 2004: General Property 3.980 59,000 128,600 187,600 Woodland 0.000 0 0 Totals for 2003: General Property 3.980 59,000 128,600 187,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 213 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER a~ r_~> TOWNSHIP b ~ SEC. 02~1 T N-R/~ W T ADDRESS 11DD ST.CROIX COUNTY, WISCONSIN &f_6ro( SUBDIVISION LOT LOT SIZE - PLAN VIEW Distances and dimensions to meet requirements of I•IHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM i I II ~g C lG I6 ~ ..z INDICATE NORTH ARROW BENC Describe the vertical reference point used d. O G Elevation of vertical reference point:- Pfoposed slope at site: 0e .SEPTIC TANK: Manufacturer: Liquid Capacity: Z ~q Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: yl~_j a Tank Outlet Elevation: 9 V- 6 Number of feet from nearest Road: Front,Q Side,(D Rear, O feet From nearest property line Front 10 Side,O Rear, O ~f feet Number of feet from: well 6 , building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE s •I" PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, 0 Rear, 0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM j Bed: Trench: Width: Length:4,~l~ Number of Lines: Area Built;~v? d~y~. Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, Rear,0 Ft ✓ O Number of feet from well: o w c Number of feet from building: 30Z (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sYtems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: y Inspector: Dated: Plumber on job: Ile! y. License Number: 3/84:mj LOCu.AW1OkertRNWQRS4t 19 ,PRIVATE 5E'mr?Y5Peg' DS RD County: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division ST. CROIX (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 180294 Permit Holder's Marne: ❑ City ❑ Village [Town of: State Plan ID No.: e Insp. BM Elev.: BM Description: Parcel Tax No.: ( 0 O 0 lfoj,tQ wj ~J- 020-1068-20-000 TANK INFORMATION ELEVATION DATA A9200377 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 2tk S 00 Benchmark Jy a_4`4 Dosi ng Aeration Bldg. Sewer Holding St/11 Inlet 7 70 Y. S V TANK SETBACK INFORMATION St Ht Outlet TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic (D NA Dt Bottom Dosing NA Header / Man. 9, 7 9d, yS Aeration NA Dist. Pipe ~j, qy , a ;3 Holding Bot. System g yy PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft mead Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width d Lengthu No. Of T nches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS /D DIMENSIONS SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type O ;)-I CHAMBER 0/4 Model Number. System: -3 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 ~t Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges ! Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepanciies, ersons present, etc.) ATION: HUDSON 24.29.19.259,NE,SE,SEC.24,BADLANDS RD. grA Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R 05/91) Date spector's Signature Cert. No ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ' 'I =17E~ILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY ~ :51 1 AR ERMI # ` - STATE J -Attach complete plans (to the county copy only) for the system, on paper not less than 7~/J 8% x 11 inches in size. ❑ cf revis ion to p evious application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION r ek Y. %a, S ;2 tj T , N, R E (o PROPERTY OWNER'S MAILING ADDRESS LOT BLOCK # J'Y9 / Cl STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER ovor, II. TYPE OF BUILDING: Check one CITY NEAREST ROAD ( ) ❑ State Owned ❑ VILLAGE : d Bch ❑ Public ®1 or 2 Fam. Dwelling-# of bedrooms EL TAX NUMBER(S) Ill. BUILDING USE: (If building type is public, check all that apply) 0 2© G d b t9 d 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. C~ 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 300 Specify Type 41 ❑ Holding Tank 12 Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 14. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE ,r1 REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION ;;"d2 a 7 OaZ Feet 74_, ' Feet CAPACITY VII. TANK # Site in allons Total of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New isti Gallons Tanks Concrete structed glass App' Tanks Tanks Septic Tank or Holding Tank d Lift Pump Tank/Si hon Chamber El I F1 F] I R 1-1 VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumb Name (Print): r Plum Signature: (No Stam r P/MPRSW No.: Business Phone Number: 7 roar ~1 fir. j S s~?Gl Plum 's Address (Street, City, State, Zip Cod IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved nitary Permit Fee (Includes Groundwater Date Issued Issuing A e No m ) YApproved El Owner Given initial Surcharge Fee) Adverse Determination /0 f Z X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb4M (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. Xsanitary permit is valid for two (2) years. 2. Y6ur`san'itafry"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 ubmiftd to the county prior to installation. 5. Ohsite 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, `e 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. ll. 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. 5 VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. 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 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system- if required by the county; E) soil test data on a 115,form; and F) all sizing information. GR61JNDWA*R'' URCHARGE _ 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) STC-loo This application form is to be completed in full and signed b the ot~ner(s) of the property being developed, An inade s will only result in delays of the permit issuance. Should athis development be intended for resale by owner/contractor,(spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate-deed-recording. Owner of property for , l Location of propertylL 1/4 =1/4, section Township f u Hailing address Address of site Subdivision name Lot no. Other homes on property? yes ,No Previous owner of property c~ r•,S ova Total size of parcel Date parcel was created y' j D Are all corners and lot lines identifiable? X Yes No Is this property being developed for (spec house)?_yes K No Volume-l~gnd Page Number -Z-/ of Deeds, as recorded. with the Register INCLUDE WITH THIS APPLICATION THE FOLLOWING: A tv11,ItItAtlTY DEED which includes a DOCUMENT r 1 U1~iI3LR NU 2iI3P. & THE SEAL OF ~ R~ VOLUME AND THE It PAGa certified surve 1JGIS71;I2 of DEEDS. In addition, a y, if available; ;would be helpful so as to avoid delays of the reviewing process. references to a certified Survey Map, If hceertifi d 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) th the property described in this information form, b y e virtue of warranty deed recorded in the office of the Count of a Deeds as Document Ito. y Register of -72- and th I we o~:n the proposed site f r the sage di p salt (we) ) or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been du recorded in th office of County Register of deeds as Document No.__~~, ~1! 7 Si`g'nature o ap~licant Co-appl cant C; ' Date of Signature Date of Signature EMmML mat WitneassM, 2w *0 mw to OMAN** hawlM bow" nd NOW is SWOOP art of tM MsttMst owner that of secti 249, =0111} r p, - . . Croix asawww'sloosm"aO *Bog at MINGWOMMIM n.f to the 1KACRAW MTN Ol.Q.1.)i 'tb~llea ~ , 3att>t for 371.# I to the li st ~Mti fro f4w 38i.v# . 'd pra rod for Vogt t#..o. s sx'so" as3~tias oo~tWlMi sot` ° T or SWUMM a CUD . " is set moll To d Oil" APP~ r, 9 11 ANY., r ~y ~Nt wrrMt ad1 it rrw~ .........tMAL1 ti1vON ..+w...w.-. i~r..... • ! tea. r'•:- ass ►~:a> AOXHO• $TAU or waoo»t 1sh1+ i ...r/w. »-w•.:.. r~. M: XEMM INATS 9" 0f WtiCOl SIN ltati.) 1a<~a Idly d!.M' Mi M~ br"°w~u►r~. Cali • ~ w*wwbdxmL be* MW aatrse+tlesW o'_ ~l x, . w bog* dwWd Ow IMP" boo* SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER_ PA- ADDRESS: 5~ /5 116'0 • ~~torb A~on ~ FIRE N0: LOCATION: 1/4, jk 1/4, SEC. T N-R l TOWN OF:- ti ~So~s, ST. • CROIX COUNTY SUBDIVISION: LOT NO. ` 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 to help with the cost of the 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 the St. Croix County Zoning a certification form, signed by the owner and by a master 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. Certification from will be sent approximately 30 days prior to three year expiration. 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 form must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED:_ 1J Gnn(:~ IDATE: St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION P.O. BOX HU AN REDLATIONS PERCOLATION TESTS (11J) MADISON W 53707 ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: WNS /MUNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME: /l N/R/ E (r► u ~sd - O15UNT : / MAILING ADDRESS: USE DATES BSERVATIONS MADE / NO. NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: IPERCULA-TICYN TESTS: Residence LkNew ❑Replace - q_ G~ RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM:(o Tonal) 21S DU ®S DU MS DU ❑S [OU DS SU o If Percolation Tests are NOT re uired DESIGN RATE: 4 I If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BAC 1945 //11;L 4~7 1,-7e _/X A0 ':5 114 B- B- B- :Q-e PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER i'21MIM AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH P- 3 - 3 nq 0 P- t7'` 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 _ - SN E o , r r 1 3 ~ z E " r 4 i 1 - 0~~_ \Y? I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and me ods 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 : f TESTS WERE COMPLETED ON: ~j 1RESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): Nopt CST SIGNAT E: 1: Original and one copy to Local Authority, Property Owner and Soil Tester. x395 (R. 10/83) - OVER - 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 10") BR - Bedrock cob - Cobble (3 - 10") SS - Standstone gr - Gravel (under 3") LS - Limestone 's - Sand HGW - High Groundwater cs - Coarse Sand Perc - Peecolation 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. PLOT PLAN PROJECT' ayi ~ADDRESS/®a ~B.ifGr~ r~. k #U). /T,y N/y W TOWN COUNTY G o MPRS Byron Bird Jr. 3318 DATE BEDROOM CLASS PERC % CONVE ONAL~IN- OUND PRESSURE CONVENTIONAL LIFT MOUND_ HOL NG TANK SEPTIC TANK SIZE LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ABSORPTION AREA _ Zaai PERC RATE -!L_BED SIZE /-:K,rc ► Benchmark V.R.P. Assume levation 100' Location of Benchmark * H. R. P. ,tox"-.t ct , C] Borehole Q Well Scale Feet 0 Perc Hole System Elevation 7A Uent 12" Grndp- I TYPAR COVERING . 2" 12" 31 4 6 D 3' 3' (D 3' I s " Sewer Rock i 12' 18' 8 a~ 14 a r I.ABOR AND P.O. BOX 190 E-LATIONS PERCOLATION TESTS (iii) MADISON WI 53707 HUMAN R RE (ILHR 83.090) & Chapter 145) Lrr:ATIO TOWNSHIP/WdWC"tt-T-y OT 0.'BLK.NO.: SUBp VISION poY 5i~' % -7Y %T ~ftll E I N UDSO.,j COUNTY: MAILING ADDR S: s>< cea'X A,( USE - DATES 013SERVATIONS MADE NO. B UR CO A I TION (j(~Resielance /v New ❑RePlace s'J, /7 / S'C) 3 RATING: S- Site suitable for system U- Site unsuitable for system (3NVEP T IONAL: MOUND: JIN-GROUND-PRESSURE: S STEM•IN•FILL SOLOING TANK: 14C f DE0,0 e D SYSTEM: pj~~ l) O/ + S DU S DU S DU Ds U Ds MU Sc• ~VOT E E[ w ~ 11 Percolation Tests are NOT required DESIGN RATE: It any portion of the tested area Is in the t under s• ILHR 83.09(5)tb), Indicate: G/~i(•SS Floodplain,'indicate Floodplain elevation: PROFILE DESCRIPTIONS HCIRING TOTAL DEPTH T R UNUWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED TESf_ TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B O q 2 l r 'k p D S ' /•i//-' , 5- - of<. a~ • s' aN. sl y o r.-4,u s / 9,~/ /~•1~ / 7 9 /0 ~/Oi}MI /,O' D,f'B4.S ~ 1.S' ~N. Sr' B. CP Q 7t N • S Q,a . Si 3 . i O . ~..c.Q . . B 13, . S a 51, S qq " /'cp Tr. Qa -SY c5 /.p A3-Sy. Z, o ,5 ) 13.~ p' 7~''~'G.' > 9 So'o~- /s, , s' ati. s, 2.s' o s O o' cs B- }~EI2C PERCOLATION TESTS DEPTH . WATER IN HOLE TEST TIME DROP I WATER LEVEL-INCHES RATE INUTES NUMBER ?NOW" AFTERS WELLING INTERVAL-MIN. P RIQD 1 P RI PER INCH P. 7 6,0, .71 'd ` O ~ /y I S Q.. ~O P. 5.5' 947--172 . C ' 3 Co P o` G •S P. P. I PLOT PLAN: Show locations of percolation tests, soil borings and :he 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 !wrings and the direction and percent ii of land slope. ~~~-S.7••• /A ~,V CCt. - O S• SYSTEM ELEVATION. } 4/i ~M5.57- ' This test site 'APPROV90 _ for a conVahti6ha1 `9bpti6 •systorrl: Rs _ ~6_ 73-, M ?,rSf'_~ ~/~tE~C(PS iti o,t°DEi~ 7-0 f~/4Xi~-t/ate` SAD W fle" 17X ocT W,65:_ Soy%S "111K ~i.rr' i S' ;vo T /41fV IN3'1-4L1_t2'r'oj WIll sue'? - ~g47xrF?e,,1` f /'s•~. v i.v oFi~= f!~'P.~o ~ . 2 ~ ~ • c 'Tah S D i L A.. I, the undersigned, hereby certify that the soil tests reported. on this form were made by me in accord with the procedures and methods so''ecified 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. HOMESQI- SEPTIQ PLUMBMCO-_ NAME print!: N6O'NEILRD., HUDSON, V08. WIS TESTS WERE COMPLETED ON: I s' /7 /t^1 d ROBEA%ULBRIGHT AUUHESS: - S. MASIERPIAINIBERCIf:1V0 330TM.PA$ CERTIFICATION NUMBER: PHONE NUMBERioplionall: MINN. INSTALLER b DESIGNER UC. N0.00663 Ly~Z ~17~^~/fir S CST SIGNATURE: `ISTRI13UTION: Original and one copy to Local Authority. Property Owner dndf Sod Tester. Z O j prfGr- j ...r, rnr.,••,ne in Inrelit 1 Z- • o vM c~,pr ; E C~ r o L 0 LQ ~d ~ ~ln 'tea /r ~e ~ 3 s kA L ~ m M ills I -cam n 1~ _w~. • r ~ r _ I r I h r / y/ Cl p / / / ~ r x O v / r r °yj Ga t1n ~ OO b~', ' x i U R - N bj ~ O p 0 wZ L~'~FST .[p T L REPT131 HUDSON ST. CROIX COUNTY ZONING PAGE 1 .10/21/92 15:02 REQUESTS FOR INSPECTION WORK SHEETS FOR: 10/22/92 AREA: MJ Activity:'A9200377 10/22/92 Type: CONVSEPT Status: PENDING Constr: Address: HUDSON 24.29.19.259B,NE,SE,SEC.24,BADLANDS RD. Earcdl: 020-1068-20-000 Occ: Use: Description: 180294 Applicant: PAGELS, DANIEL M & LAURIE L Phone: Owner: PAGELS, DANIEL M & LAURIE L Phone: Contractor: BIRD, BYRON JR. Phone: 268-7616 Inspection Request Information..... Requestor: BIRD JR., BYRON Phone: Req Time: 13:10 Comments : /,'.ad Items requested to be Inspected... Action Comments Time Exp 00012 FINAL INSPECTION Inspection History..... Item: 00012 FINAL INSPECTION jElPAO-MENT OF REPORT ON SOIL 1309 AGS AND SAFETY & BUILDINGS iNDUSTRY, C DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX N WI 539069 HUMAN RELATIONS 62-641 zl04476 of r,--51- OOvC 5-1(- kO- (ILHR'83.09(1) & Chapter 145) i~sT 'v07- f/s~li0 LOCATION: SECTION: TOWNSHIP/I"NIUIPALI !-'Y: OT NO.:BLK. NO.: SUBDIVISION NAME: NW ~ SLR ~ 2-/T4 H/R ! 1 E (r) W Gs 11 y ? 3.5' ,rs ~l s COUNTY: MAILING ADDRESS: s ya 5-1.649(, 141 G~~so~ ~sEii~,e~ 7/"f Rd 14 u V ,,T 0,J 4J IS USE ~o ^ D ca co DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: _ y o f s lqw/m Residence New ❑Repl+ace La . \ RATING: S= Site suitable for system U= Site unsuitable for system Scs C ~T I~ V R K~1 Q Or ONVENTIONAL: MOUND: IN-GRQUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM: (optional) P S Qu 0 S au cJ S 18111 a S Qu ❑ S au MO(_)ti o s STS If Percolation Tests are NOT required DESIGN RATE: I If any y portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: G~i.~SS ~ Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH T R UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST. HE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- r l 0 ~O > - ~ a . 5,,* ~ -5 S ~ S('/ B- S S AA- J o u c S/ 5 S ? XJ s ' L 8/ S r 2, D' R W- lo> -7, o' 6X- B- 17'7 p 3 , 5 ( Sr'/ (cv i JLt V4,119S O F S'/ 3.0 ` 3r' . Si MA•N'/ _,v . -Dr'ST. OR15J. 1 B- / B D /O/ %Le 5 D 3 5 S , 0~ a. s; , s' 1 o,- R.5 --S/ s; 16 6AI 5' Z D ' c. - 3a - . - " w h ~ 1 . Ro AA Daley. .-coT S 3,o ' S0 U R Cre 0 u,0,4 €4 ~v4 T- B- I. V..'_ LI• 1 . S 1 . PERCOLATION TESTS } EST DEPTH. WATER IN HOLE TEST TIME DR I WATER LEVEL-INCHES RATE MINUTES f NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD -PERIOD PER INCH P- / 10 kv_ 30 126' / 4 / 2d P. Z Z e> i7 3 1 ► a P_ 20-- O Y i o 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 elevatiocn~ at all borings and the direction and percent of land slops. O,p/~-~-~ ! O,~ o~ ~/D l/~ ~ fJ Gr~-S' .J 7~ S•T ' ~Df' SYSTEM ELEVATION. I o E fl~ ~n /',t,~ QY QL~n Q~,~/l,uS-~►111~ cos-c,~.~~,~v~v sYS7 74o,-l' F6 t- )Lfo 0 ti D ' i SSE QLoT- p~~~ P b7 0,E- ~sc Sl' ~ .3 TIC $ V I "r +t (3 l E Ic0 ►Q Co,t> U e N T r'0 t~ iC c /rv - 5 R p v .rJ Sir-7- ~tr,E~ Y S s T ~ S ' ,,ThI$ teak NO APPROVE) ' fo r is 11%TWW tic system. ( See expltmtion. rop- 1, 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): Homan Epic PLUMBING CO. TESTS WERE COMPLETED ON: 655 O'NEIL RO„ HUDSON, WIS. 54016 -f- 17 - I 1 SQ ADDRESS: -ROBERT UL9aGMT___---- - - WIS. MASTER PLUMBER LIC. NO. =7 MR-R.8. CERTIFICATION NUMBER: HONE NUMBER (optional): DESIGNER LIC. NO. 000 P MINN. INSZAL! ER A Z yYZ CST SIGNATU E: Ze4w,/ DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. ff r~~ ` 3 DILHR-SOO.6395 (R. 10/83) - OVER - cEPARTMENT OF REPORT ON SOIL BOEINGS AND SAFETY & BUILDINGS INDUSTRY, C DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.0 * N WI 53707 HUMAN RELATIONS (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: TOWNSHIP/?dtJI0ICIPAtFFY: OT NO.. LK NO.: SUBDIVISION NAME: 1/4 5E- 1/ -1Y /T 1-f N/R 11 E ff uDS OAJ ,y 0 COUNTY: MAILING ADDRESS: s--/.C&tx 4l I-AlPifd-o sti~,E~ ~i~ 3,t s~ H uosa,,7 &ois_ USE 3,06 - to DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DES RIPTION: ESCRIPTIONS: PERCOLATION TESTS: Residence 13 1 New ❑Replace 7- - / T ;,C) SCS Ste( ~~-t H ~ T ~ 0 If -P- itab1a for system U Site unsuitable for system RATING: S= Site suitable ONVENTIONAL: MOUND: IN-GROUND•PRESSURE: SYSTEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM:loptional) S ❑U S ❑U S ❑U ❑ S U ❑ S Elul co/ '~5,4ep sox i7l/ 5& "07E w 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: GG*sS _--4E7- Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO R UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST. HES TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) r 11 S ` 171e- /ot~ s o/<.61. ,v. S'/' e-~ y', p q2, S'l Ito > 9, o /s' 8,~. s/ yo ' ?-,f 4.) s ' pe. Ba . sl ~ 1. $ B_ O So'~G 7 9 . S 1 )41 Q,a . SY 3. c r o S I IaN /rv~-~.~C 51 - B- 12.5 ?2p Q &3 -YY. S/ ' /.o '-Sy. z, a ` /9 E' Qa ati . S 2- S ate, s 90 7y~G , 90 soo, Nscs s B- ~~2C ~lalTrOUs PERCOLATION TESTS TEST DEPTH . WATER IN HOLE TEST TIME DROP WATER LEVEL-INCHES RATE MINUTES NUMBER MN/"!6S AFTERSWELLING INTERVAL-MIN. PERIOD 1 P RIQQ2 PERIOD PER INCH 1511 r P_ /0 P_ S. 9,0. 72. G ` 3 CP 0 ` Cr S 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. ~Li~EST ~~•v c(ti = ~ S. O SYSTEM ELEVATION. - 1 cCi- /U 7;6 ~ 7 This test site APPRO►'aD _ _ ^ for a conventlonal septic systeat. i__ Rs TN 5'7~e ra,Pj57_ 15 NOT 4 1f /N S'1t L ~~t T r'o~ w ~'/l Q v ,e? s~ 'T~ ~'9 G ~`>~7P r~Tic~.J y (Sy ~i.vG- off= ~~P.~oX o t~ TOP S.0 i L 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. CLIMBING CO_ _ NAME (print): 6NO'NEIL RD., HUDSON, WIS. 54016 TESTS WERE COMPLETED ON: ROBERT ULBRIGHT S - l7 / 7 f d ADDRESS: LICJ1O7-330TM.PA$. - CERTIFICATION NUMBER: PHONE NUMBER (optional): I'AINN. INSTALLER & DESIGNER LIC. NO 00663 Z~ry Z CST SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. PS C~/- ~ p ~G~ S DILHR-SBO-6395 (R. 10/83) - OVER - I OF h. ~ M D ~ o ZZ :c tu 4~ al al tn V „ ~1 i 1 ` O ~un ri = / k /c7! 00 A r2 C6-, x • 9 C> o s I >r. C7 !p(j 0-t O O J 1 ly . v r