HomeMy WebLinkAbout030-1074-50-200
Parcel 030-1074-50-200 03/30/2005 11:52 AM
PAGE 1 OF 1
Alt. Parcel 26.30.19.257B-20 030 - TOWN OF SAINT JOSEPH
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
* FOLKERTH, RICHARD R & JUDITH E
RICHARD R & JUDITH E FOLKERTH
1365 AWATUKEE TR
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 1365 AWATUKEE TR
SC 5432 SCH D OF SOMERSET
SP 1700 WITC
Legal Description: Acres: 5.030 Plat: N/A-NOT AVAILABLE
SEC 26 T30N R19W PT SW NW BEING LOT 2 OF Block/Condo Bldg:
CSM 8/2368 5.03 ACRES
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
26-30N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
12/11/1997 569755 1282/138 WD
07/23/1997 1107/112 WD
07/23/1997 950/158
2004 SUMMARY Bill Fair Market Value: Assessed with:
5363 291,800
Valuations: Last Changed: 07/08/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.030 103,500 183,600 287,100 NO
Totals for 2004:
General Property 5.030 103,500 183,600 287,1000
Woodland 0.000 0
Totals for 2003:
General Property 5.030 60,700 140,400 201,1000
Woodland 0.000 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 133
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
(JAkfers ILES Ork
JUN I ~
n d i li 1 X71 ? ' 0
a CONN
` 4(VlGrJ~lC t'~J * Ofpwgll
P%~3~.~ obc Co,, M
CIO v Unplatted Lands
West line of the NW} of Section 26
A S0004~215311W S0004215311W
-7
1304.601 1304 60,
• O 17
O "1 Pr A
7 7 O
~p O 7
N ~ 7 7
~ N
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so
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ti H. .7 T
IW IN OO G A N 0
0 CJ
0~ 0
V / M <
1 fi N S~ ~
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11' 5090051
1 0111N 4 N
97.051 0
10.
APPROVED 1 - --platted Lands N
1.0 ;
- 0,
I
M
JUN 1 1 1991 a o
ST. CW X COUWY it ; I z
NP(~EliEN61~ PARKS PLAMVINa I - a o x x
AWZONNGCOM MiEE 661 OO " T rt rn CA T O F'
a ~
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r,. 2 r
i j 10 C
e
Bearings are referenced to the west line of the NW}
of Section 26, assumed to bear S000421531111.
CD
This instrument drafted by Fran Bleskacek, Job No. 78-52-190
Vol. 8 Page 2368
f ,
FORM - STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP S~. ~►OSF
SECTION ZCfl T 30 N-R-Luw
ADDRESS 3 3 W. Q4c mck'j II ST. CROIX COUNTY, WISCONSIN
~;l.~e. ~r6cr2.. LOT~LOT SIZE
SUBDIVISION
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
P~
oe''
Coy
gv
4s' ~
41
B.,
INDICATE NORTH ARROW
BENCHMARK: Elevat o and description: 5E ,Loaf- STake,
Alternate benchmark
SEPTIC TANK: Manufacturer: Ltd Liquid Cap.166
Rings used:-Lmanhole cover ele - 11 a~ ade el_
Tank inlet elev.: ~Pt(n outle elev.:
No. of feet from nearest road:Front_&, Side , Rear Ft.
'74
From nearest prop. line:FrontL, Side , Rear Ft. 106
No. of feet from: Wellq',~o&Mn+ ?o , Building:
(Include this information in the above plot plan)
(2 reference #mensions to septic tank)
SEE REVERSE SIDE
PUMP CHAMBER
Manufactu: U) Liquid Capacity:
Pump Model: S -a Pump/Siphon Manufact.: Pump Size V/a
Elevation of inlet: Bottom of tank elevation
Pump on elev.: Pump off elev.: Gallons/cycle: 550
Alarm: Man.: $c teem S~*cSwitch Type: ttit+t'CCw Location
Distance from nearest prop. line: Front, Side_, Rear_Ft.
Distance from: Well Building
SOIL ABSORPTION SYSTEM
Bed: Trench: Seepage Pit:
+lidths 5 Length Number of Lines: Z Area Built95Z -it.
Xist. Grade Elev. 10 t.~ Proposed Final Grade Elev. I(Y1.3
Fill depth to top of p*pe: s"'e
t
Now, feet from nearest prop. line:Front k , Side , Rear Ft.Z3
No. feet from well: ~S6 No. '?"'t from building >2S~
HOLDING TANK
Manufacturer: Capacity:
No. of rings used: Elevation of bottom tank:
Elevation of inlet:
No. feet from nearest prop. line:Front , Side Rear Ft.
No. feet from: Well , building , nearest road
Alarm Manufacturer:
INSPECTOR:
DATE: PLUMBER ON JOB:
LICENSE NUMBER:
6/90:cj
'r
i
LQeATIO~i: 2~.0.19.ST. JOSEPH SW NW LOT 2 AWATITKEE TR ATT.
WOscons Rgartmento Industry, PRIVAYE SWAGE SYSTEM County:
Labor.and Human Relations INSPECTION REPORT
Safely and Buy'dings Division LI G
(ATTACH TO PERMIT) Sanitary Permit No-:
GENERAL INFORMATION 171471
Permit Holder's Name: ❑ City ❑ Village E*Town of: State Plan ID No.:
LACASSE, RICHARD ST. JOSEPH
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
f d CST / 15Z x~1
TANK INFORMATION ELEVATION DATA A9200236
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark I~3, S 3,S0 /00,0
Dosing
Aeration Bldg. Sewer
Holding St/ Ht Inlet ~a, b,./
TANK SETBACK INFORMATION St/ Ht Outlet
TANK TO P/ L WELL BLDG. AirI to ntake ROAD Dt Inlet
Air I
Septic >,/60" :af NA Dt Bottom )S (o-7
Dosing NA Header/ Man. Aeration NA Dist. Pipe ~ia gg, 3
Holding Bot. System p TI, S
PUMP/ SIPHON INFORMATION Final Grade /p
Manufacturer S Demand STr7-rte; 3,09 /OO ,yam
Model Number L~ GPM
TDH Lift Friction System TDH Ft
Forcemain Length Dia. Fi Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS DIMEN I N
SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACHING Manufacturer:
SETBACK CHAMBER
INFORMATION Type O Mode 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 j
I ,
Qrti ~ ; '
a
11i
Plan revision required? ❑ Yes No
Use other side for additional information.
LIAZ
SBD-6710 (R 05191) Date°` Inspector's Signature Cert. No.
1
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
{
-dn SANITARY PERMIT APPLICATION
®ILHR °°UNTM
In accord with ILHR 83.05, Wis. Adm. Code ~
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than -/(471
8% x 11 inches in size. F1611kfr'revision to previous application
-See reverse side for instructions for completing this application. STATE PLAN I.O. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PRO RTY WNER PROPERTY LOCATION
Ca~cse~ Y. K, S Zb T310, N, R 1 E (or (W
MA LING ADDRE ` LOT # BLOCK # - rO*
PROPERTY OWNER'S
,V
W, Q r 2J 1
AME OR CSM NUMBER f J `
CI STATE ZIP CODEZ PHONE NUMBER SUED
k&0" e-1
IG~
` usa,r SO` cZ X30- ~I,Q.- Avy AL ,
II. TYPE OF BUILDING: (Check one CITY NEAREST ROAD
1:1 State Owned ❑ VILLAGE ~SV, I
❑ Public Uahj 1 or 2 Fam. Dwelling-# of bedrooms PA LTAX NUMB W
Ill. BUILDING USE: (If building type is public, check all that apply) C $ Z3
1 ❑ Apt/Condo
20 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. W 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 22 ❑ In-Ground 42 ❑ Pit Privy
13 Seepage Pit Pressure 43 ❑ Vault Privy
14 ❑ System-In-Fill IJ
VI. ABSORPTION SYSTEM INFORMATION:
1. GALLONS PER DAY 12. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE
REQUIRED (sq. ft.) PF1POSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) q uE1LEVATION
4~O 7 T S J D 14-7 ~ 9 ? Feet f4/0, 3 Feet
VII. TANK CAPACITY Site
in gallons Total # of Prefab. Fiber- Exper.
INFORMATION New xistin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
Septic Tank or Holding Tank d
Lift Pump Tank/Si hon Chamber 6 ~ CC N
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on t attached plans.
Plumber's Name (Print): Plu is Signature: (No Stamps) /MPRSW Business Phone Number:
z '715)5
Plum s Address (Stre City, State, Zip Code):
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved San' ary Permit Fee (Includes Groundwater ate Issued LissuingAg7 t Signature o Stamps)
Surcharge Fee)
El Owner Given Initial Advee 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
t -
1. A_sanitary permit is valid for two (2) years.
2. Your satnitafy 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 (SBE) 6399) to be
submitted to the county prior to installation.
5. Onsite sewage systems must be properlimaintaiced. The septic tank(s) must be pumped by a licehsed K
pumper whenever necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code administrator or the
State',of Wisconsin, Safety & Buildings Division, 608-266-3815__-
To b8 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.
Il. 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 replacernent, 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. Complete for all
septic, pump/siphon and holding tanks for this systern. 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.
i
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 absorp°ion system if.
required by the county; E) soil test data on a 115 form; and F) all sizing information.
- - - - - - - - - - - -
GROUNDWATER SURdHARGE
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)
S T C - 100
This application form is to be completed in full and signed by
the owner(s) of the property being developed. Any inadequacies
will only result in delays of the permit issuance. Should this
development be intended for resale by owner/contractor,(spec
house), then a second form should be retained and completed when
the property` is sold and submitted to this office with the
appropriate deed recording.
---------II-------'---------------------------------
Owner of property ~i J A,1 L~ o, C-e -r S;Z2
Location of property W 1/4 __AW114, Section _*:)6, TrZQ N-R~ W
Township
Mailing address 3/3 W ctid-Cl ~(A
C
Address of site c.~~•p \//rbi~ Gt, /wl. S L )O
Subdivision name (n~2nre~ Lot no.
other homes on property? ~ yes No
Previous owner of property ,~`CI - ,
Total size of parcel GLG~~
Date parcel-was created p 1
j
Are all corners and lot lines identifiable. Yes No
Is this property being developed for (spec house)? VYes No
Volume 8 and Page Number ZA 18 as 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 n the o fice of the County Register of
Deeds as Document No.~®Z4 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. '0 L.) ~Y_j applicant Co-applicant
Date of Signature Date of Signature
4
aicmrd el- Abu.a•
..d tar. pa 2 a
aM~aN6adIMM aura
1rrPa=~_ r 1:36
hnmband and rifer,
"I"Aw To
~ 7NMOH0a0 raM atllMa M _ sr _ e i sr Cor~Yr -
win: Located in Town of St. Joseph, Sect. 26, ? N,
fully described as: Lot 2 of CSN filed June llrexPw ntw; '
991, in Vol. 8, page 2368, as Doc. 470294.
111 and sub ect iva a road
ingress and egress , page 236
Document #470292, ecorded in Vol. 6, page 152 and CNN
recorded in Vol. 3, page o Deeds. St.
Croix County.
The roadway easement shown on the face of this map is a private.
roadway easement. Any maintenance costs of the private rosdMT
shall be shared pro-rata by the adjoining property owners. Thy
lot is subject to assessments for maintenance, repairs andjoW•
plowing should unpaid real estate taxes on the outlot (aacess ei
shown on the CSN result in St. Croix co. acquiring a tax dis" for
the outlot.
ET./
" TMa f a net P UftO Prove"Y ' y
(b) (is nog b
r' E17owson to Wwlromme.
r, •
Oalad this day of Apr ' 1
(SEAL) OK
ISEAt
' R_ i_inhard 0, c n - Janet P. -Stout
(SEALI (SEAL,)
AUTHENTICATION ACKNOWLEDGMENT
Stpnature(sl
St. Croix Cuunq
authsnt"od this day of 19 Gr•r %ond,+ r• r I Y
r ~..,mbeorM me my , day of
April 19 - 92 th«ebov@nr- ed -
Richard O. Stout and Janet p,. >
St(Jut
TITLE MEMBER STATE BAR OF WISCONSIN ?
Utnot .nuq,, to tie the person n ` t hi
o a"mall 7M
by 4 706 06. W,a Slats o'.~
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atonot,MC/Nary I s Dt►maner(
date I *t
fMSrA d~Msyr^hy s'•AgiRl,'W r2 ♦rxi(,a 'r • v 1Lt •riNOa [r.~trap sgtead.l t $4,4 001 Dp•a.s e. eWt~I.S. .N
CAM _ u fto rEll, O aea tomaa.- ,
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r '3/e~c~tiio~npy~26~, assumed to hear S90°1215311W,
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CERTIFIED SURVEY MAP t ►oi
(OOCATED IN PARTS OF GOVERNMENT LOTS 6 C 7 IN SECTION 26, T30N, R19W, TOWN OF ST. JOSEPH,
ST. CROIX COUNTY, WISCONSIN.
OWNER LEGEND
RICHARD STOUT 11'x 2411 IRON PIPE WEIGHING 1.68 LBS/LIN. FT., SET.
RT. 2 , "BOX 340
HUDSON, WI. 54016 111 IRON PIPE, FOUND.
N APPROVED
BEARINGS REFERENCED TO THE WEST LINE MAY 01 19850 ~y's`e,
OF THE NW 1/4 ASSUMED TO BEAR NOO 42 53 E
ALLEN C.
ST. CROIX COUNTY Y 'yl NYHAGEN g
SCALE 1"= 200' °0" ,we ~~`eoI MNC coOi►Wnte S-1407
200 100 50 0 200 14 HUG.`7N,
6
N~`~
W E
U
S W
NW CORNER CSM vol. 2, page 553
v SECTION 28
\ CO. MON.
W NORTH LINE - GOVERNMENT LOT 6
z ' S89028'48'°E S89°28'48"E
1 a 1600.76' 440.00'
Z v ~`'O \ BA SS
ri o a o. A
a Z °149,659 SO FT \ a J LA KE
W 3.44 A. IN. R/W \O 9E 562
\ 3 0 9
3 ,y 147,362 SO FT. 6T°\9 \ F
41 n C, 3.38A. EX. R/W NZ\ /
a m \31 • j ?
W I/4 CORNER m! 0
ro
SECTION 28 11 a \
CO. MON. 'at = 146, III SO FT. 3 s~ /9 33' `4J
a~i~ 4 bid 3.32 A. IN. R/IM ~ 6°45' " 2os
s9
4j 1 244.73' \ 2d
rtll
00 1 0 133,739 SO FT. /SJ~3J? F
"11 6 g°j b 1b
EX. R/W p.
Q.l _ a g~6 137,017 SO FL - O•~ s
2, 3.15 A. IN. R/W
a9
0
90. 120.00 03 131,013 SOFT.
as Cb ro 3.00 A. EX. R/W F
63. 15570'
d
N89028_4 W 217.50 _ ® ` ~ ~ J~ r 3 33 o
1
66 FOOT PRIVATE ROAD \ \ 50,5063 75.69 o\a
EASEMENT DESCRIBED IN \ . m A° 59 00 0 6 SE •-+`s.
rP~ \O g6 .6 NpJ 4 \m 6 , c
to -
%
VOL. 679, page 524. -11
A ZZ 138,957 SOFT. \aaD
22 1~ 035 3.19 A. IN. R/W y
N21o0 3362 6 N6 130,701 SO FT.
bb N \ 3.00 A. EX. R/W
° 59 ®a$,
56A 33 0\ \ `3 ~ A,5 ' yl aGi
E , a 1 o Al .
NgAo 35 22 o O og2 , ' g6\ S~ia~
N2~ AA
57' r m
N13°4854" W / 1.57' N 13°48' 54"E
N 76011'06 " W
.00'/
9e'84..
66 FOOT PRIVATE ROAD
Vol. 6 Page 1523 DESCRIBED ON C.S.M. VOL. 3, page 738.
STC - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER UYER uleW4
ROUTE/BOX NUMBERI~(j W ~G1 ► FIRE NO.
CITY/STATE ~i f4tuP etf"' 6 '"`ZIP 5-5043
PROPERTY LOCATION: 5*~ 1/4 J 1/4, Section ?Uo, T -s6 N, R_& W,
Town of s: , St. Croix County,
Subdivision Lot No. rZ'
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
$3000 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
systems properly maintained.
The property owner agrees to submit to 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 form 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 Department of Natural Resources. Certification
form must be completed and returned to the St.Croix County Zoning Office within
30 days of the three year expiration date. v
SIGNED ` W
DATE
St. Croix County Zoning Office
St. Croix County Courthouse
911 4th Street
Hudson, WI 54016
(715) 386-4680
Sign, Date, and Return to above address
L
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, 1 DIVISION
LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX N WI 53707
HUMAN RELATIONS
(ILHR 83.09(1) & Chapter 145)
LOCATION: SECTION: TOWNSHIP/M{1;GUMDUUTY: LOT NO.: BLK. NO.: SUBDIVISION NAME:
S41
14 IN 1/4 26 /T30 H/R193kor) W St. Joseph 2 n/a Pine Grove
COUNTY: OWNER'S BYNAME; MAILING ADDRESS;
St. Croix Richard Stout 1353 Awatulcee Trl., Hudson, Wi. 54016
U_SE DATES OBSERVATIONS MADE
1N0. BEDRMS..'COMMERC AL DESCRIPTION: PR FI DESCRIPTIONS: ER LATI
Residence I 3 I n/a New ❑Replace L 9-18-91 19-19-91 7 =
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional)
®S ❑U ®S ❑U liiS ❑U ❑ S ®U ❑ S conventioanl
If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the
under s. ILHR 83.09(5)(bl, indicate: n/a Floodplain, indicate Floodplain elevation: n/a
decimal' PROFILE DESCRIPTIONS page 42 OnC2
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH?[17t, ELEVATION OBSERVED EST. IGH TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B-1 7.58 101.71 none >7.58 .75bl.1. 1.58bn.sil. .525bn.s.l.
B 2 7,22 100.84 none >7.22 .08bl.1. 1.92bn.sil. 4.33bn.s.l.
B 3 6,83 101.16 none >6.83 .83bl.1. 2.08bn.sil. 3.92bn.s.1.
B 4 7.08 99.91 none >7.08 .83bl.1. 1.50bn.sil. 4.75bn.s.l.
B_5 7.00 101.16 none >7.00 1.00bl.l. 2.00bn.sil. 4.00bn.s.l.
B-
deciaml' PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER XOMIES AFTERSWELLING INTERVAL-MIN. PERIOD 1 P R PER INCH
P.1 none 30 12 1% 24
P_ none 30 2 1 1 30
P- 3 -3757- none 30 2 4 14 2
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 97.59
o
C.Or
i _
1~ I
13 r~S F
dot SAO E ff+ EK • ion !
\1 1
a \1A\~\11(\\\ 4 {
d
f
#z~ E
,
r' ~ I I I ,~O 1 ~a t ( ' (per
/a,,
Tj7
2
I, the undersigned, hereby c rjj(R that th~;soil&a ?s reported o th form were made by me in accord with the procedures and methods specified in the Wisconsin
Administrative Code, and the the,dgLi rd r6, and (91,;~Pcati f, he tests are correct to the best of my knowledge and belief.
NAME (print): TESTS WERE COMPLETED ON:
Gary L. Steel '%~r 9-19-91
ADDRESS: / CERTIFICATION NUMBER: PHONE NUMBER (optional):
1554 200th. Ave., New Richmond Wi. 54017 2298 /1410 715-246-6200
CST SIGNAT
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 10/83) - OVER -
o . ~;CtvrA Lc~, Cas se,, 3 keA u4 JA aUA_ -
.1~e-E-. 716 / Cg (A.)
r
464 Sf. ja s ~ S-1. C4v of
az,57-19 Z-
Q
2-
-LEG A 06 f ~ ~f~ ~ ld ad ~ ~'G
A z P Slug,
~~ael _ a. loo `a c ~ -lest • /d ~ S~ ~ a,~Q.~r~}"
Ci? 9-7. 5-9 _-;f
mss Se~"io~ o~
~w
eA
CS~ ` lJ ~T< A SEA ztr0/CT ~ f~ ~ ~ ~ PAGE OF
PUMP CHAMBER. CROSS SCCTION ARID SPECIFICATIONS '
Ls.~`7`` 'tea` c,. CAS of
t ' VEWT CAP
4"C. I.. VENT PIPE WEATHER PROOF APPROVED LOCKING
'
'JUNCTION BOX MAWHOLE COVER
25' FROM DOOR, •12"MIU.
!.WINDOW OR FRESH f
AIR' 4MTAKE'
GRADE I y" MIN.
• ~ ~ 18" MIW.
CONDUIT--
19"MI1d. \
• - 111
PROVIDE
INLET AIRTIGHT SEAL I I i I
' ~ I II v
APPROVED JOINT A I III APPROVED JOINTS
W
w/C.Z. PIPE I III /C.I. PIPE
EXTENDING 3' I II ALARM ONTO OIG
S
01JTO SOLID SOIL ( I I AISOLID SOIL
s I I
« I i
ow
- -
C
ELEV. FT. PUMP--~_
OFF
r
D '
CONCRETE BLOCK
3" APPROVED
- RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER' HAS SUCH APPROVAL BEIDDINQ
t
SEPTIC E /000 SPEC.IFICATIOUS
005E Q
TANKS MANUFACTURER: ~ NUMBER OF DOSES: PER DAy
TANK SIZE: GALLOAIS DOSE VOLUME
INCLUDING BACKFLOW: /ZS GALLONS
ALARM MAMUFACTURER: tta ";::Is,
MODEL NUMBER: ~d f CAPACITIES: A=_I ~IWCHES OR ZZO GALLONS
SWITCH TYPE' "&Q tQ&=aMr! ach&::: g = INCHES OR GALLONS
PUMP MANUFACTURER: C =INCHES OR 1.~ GALLONS
MODEL NUMBER: D= INCHES OR 33g GALLONS
SWITCH TYPE: WOTE: PUMP AMD ALARM ARE TO BE
MINIMUM DISCHARGE RATE GPM //INSTALLED ON SEPARATE CIRCUITS
VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. ~ FEET
+ MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . a~/~~FE.ET
♦ FEET OF FORCE MAIN X F~0FT.FRICTION FACTOR..- FEET
TOTAL DJAIAMIC. HEAD = FEET
IIJTERNAL DIMEIJSIONS of TANK: LENGTH ;WIDTH (34 ;LIQUID DEPTH
- p
SIGNED: W~61 LICE1~lSE NUMBER: m` rs- .X-ft
EFFLUEN'T''PkIUMPS
• • • Performance
OSP33
1/3 HP - MAX. SOLIDS 5/8" SPHERE -1750 RPM
• Available in automatic or
24 manual.
• Completely submersible.
• Non-clog bronze impeller.
20 - • No suction screens to clean.
• Oil-filled, double ball bearing
W1e 3yA motor with built-in overload
protection.
'12 Reliable diaphragm switch with
piggyback plug-in.
° Rugged cast iron construction.
6 Completely field serviceable.
PULL LOAD V 1 1/2" NPT discharge.
AMPS AT AT Id ttl, 115. •
4 64 AT 23M.. 3,6
I -J
° 0 10 20 30 40 50 60
U.S. GALLONS PER MINUTE
SPD50H/SPD 100H -
1/2 and 1 HP - MAX. SOLIDS 3/4" SPHERE - 3450 RPM
ED Available in manual or
automatic.
50 • Dual seals standard. Seal
SPD1 AH ~i
FULL LD D
AMPS Pi failure sensor capability
a 2 I tiA LLLDAD available (to be wired to an
PS AT .
A FULL ~ OA alarm device) on manual pumps.
• Open two-vane sewage type
1 impeller.
14 SPDWAH • Pump shaft and all fasteners are
20 :°.`PS ADTA1. I'M
2.23. AT 2XV. 6,125 stainless steel.
• 1/2 HP (SPD50H) and 1 HP
10 (SPD 100H) motors. Ball bearing
construction and oil-filled.
0 0 20 40 6D 80 100 120 140 • 2" NPT discharge (3" flange
U.S. GALLONS PER MINUTE optional).
SKHD 150
1%HP-MAX. SOLIDS 3/4" SPHERE- 3450 RPM
180 Semi-open thermoplastic
impeller.
W ,20 1 1/2 HP, oil-filled motor.
Z Pump shaft and all fasteners are
g stainless steel.
_ FLU OAD • 1 1/2" NPT discharge.
PS AT 11,
10 2'° IAT Spring loaded mechanical seal
O ~MLL LOAD
40 2.v. 2:B•
°~""with carbon and ceramic faces.
• Pump-out vanes on rear shroud
of impeller
°a o 20 30 ao 50 so 70 .
• Dual seals. Seal failure sensor
U.S. GALLONS PER MINUTE capability available (to be wired
to an alarm device).
5'
REPT131 ST. JOSEPH ST. CROIX COUNTY ZONING PAGE 1
09/01/92'15;03 REQUESTS FOR INSPECTION WORK SHEETS FOR: 9/ 2/92 AREA: MJ
Activity: A9200236 9/ 2/92 Type: CONVSEPT Status: PENDING Constr:
VAddress: 26.30.19.ST. JOSEPH,SW,NW, LOT 2, AWATUKEE TRAIL
Parcel: - - - Occ: Use:
Description: 171471
Applicant: LACASSE, RICHARD Phone:
Owner: LACASSE, RICHARD Phone:
Contractor: SYKORA, JOHN Phone: 568-4948
Inspection Request Information.....
Requestor: SYKORA, JOHN Phone:
Req Time: 10:09 Comments:
Items requested to be Inspected... Action Comments Time Exp
00012 FINAL INSPECTION
Inspection History.....
Item: 00012 FINAL INSPECTION
D&PARTMFMT OF' REPORT ON SOIL BORINGS AND SAFETY & BU
INDUSTRY, - DI
P.O. BO
LABOR AND PERCOLATION TESTS (115) MADIS
ON WI
HUMAN RELATIONS
(ILHR 83.09(1) & Chapter 145)
LOCATION: SECTION: TOWNSHIP/W~ Y: LOT NO.: BLK. NO.: SUBDIVISION NAME:
SW 1/4 1,114 1/4 26 /T30 N/R].9)&(or)W St. Joseph 2 n/a Pine Grove
COUNTY: OWNER'S/B> 33=NAME: MAILING ADDRESS:
St. Croix Richard Stout 1353 Awatukee Trl., Hudson, Wi. 54016
USE DATES OBSERVATIONS MADE
NO. BEDRMS.: COMMERCIAL DESCRIPTION: a PROFILE DESCRIPTIONS: 1PERCOLATION TESTS:
I Resider ce 3 n/a New ❑ Replace I 19-18-91 9-19-91
RATING: S= Site suitable for system U= Site unsuitable for system
ICRJS ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional)
❑ U E,S ❑ U li-~ ❑ U ❑ S ®U ❑ S conventioanl
If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the n/a
under s. I LHR 83.09(5)(b), indicate: n/a Floodplain, indicate Floodplain elevation:
decimal' PROFILE DESCRIPTIONS page 42 OnC2
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTFNX ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B-1 7.58 101.71 none >7.58 .75bl.1. 1.58bn.sil. .525bn.s.1.
B-2 7.22 100.84 none >7.22 .08bl.1. 1.92bn.sil. 4.33bn.s.l.
B-3 6.83 101.16 none >6.83 .83bl.1. 2.08bn.sil. 3.92bn.s.l.
B 4 7.08 99.91 none >7.08 .83bl.1. 1.50bn.sil. 4.75bn.s.l.
B-5 7.00 101.16 none >7.00 1.00bl.l. 2.00bn.sil. 4.00bn.s.l.
B-
deciaml' PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER S AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PER D PER INCH
1% 24
P_ 1 4.12 none 30 12 11,
P_ 3.25 none 12 1 1 30
P_ none 30 1 2 4 14 2
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 97.59
i_
3 i
E E
T-7
E
3
E
E
3
.
3
-
`z~_ - ~x
10~ o AtQ (pot .
44 ~
41,
I, the undersigned, hereby c r~ij that thk*oil<te s ze'ported o t form were made by me in accord with the procedures and methods specified in the Wisconsin
Administrative Code, and tha da~ r~rand- Dr9 cati f` he tests are correct to the best of my knowledge and belief.
_'Cl~~ il.
!
NAME (print): TESTS WERE COMPLETED ON:
Gary L. Steel 9-19-91
ADDRESS: l CERTIFICATION NUMBER: PHONE NUMBER (optional):
1554 200th. Ave., New Richmond, Wi. 54017 2298 715-246-6200
CST SIGNAT
0/x 1~
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 10/83) - OVER -
o cs
~01LQ INSTRUCTIONS FOR COMPLETING FORM 115 - SB - 6395
To be a complete acid accurate soil test, your report must include:
1. Cor I gal description;
2. The us st ion roust clearly indicate whether this is a residence or commercial project;
1 MAX"- " number of: bedroorris or- commercial use planned;
4. Is thi! r 3placen-sent systP
.r-z. Compl_:._ _"lability tati_„ SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL
OTHER SY TENI ARE GUT BASED ON SOIL CONDITIONS;
6. PLEASE use the abb v'. rr3wn here for writing profile descrittions and completing the plot plan;
7, MAKE A LEGIBLE c" a{curately locating your i locations. Drawing to scale is preferred. A
separate sheet may b,. u, F -`,sired;
B. Make sure: your benchnt vertical elevat.itan ret ~c it are clearly shown, acid are permanent;
9. Complete ~iopriate I ' o dat"e5, names, add Mood plain data, percolation test exemp-
tion,
1C3. If the -1 , =levation) does not place NA. in the appropriate box;
11. Sign the yo£s° ressandyourcerti. °ionnumber;
12. Make lec e :s : d disci requi;ud. ALL SG-l_ TESTS NAUST BE FILED VVITH THE
LOCAL AUTHORITY WITH) kYS OF COMPLETION,
-.._VIATIONS FOR CERTIFIED SOIL TESTERS
Ti xtures Symbols
io r 16") Bid Bedrock
13 - 10") S San(' 'ne
f Oder 3"5 LS - L
I" GW High f ides -,ter
id Perc - Percol R E pe
n C„and Well
s (I
L
sc` C ' Loarn „
sic: _;l +`f Lc3eSm mot
S= 1 clay
sii y Clay , fine, faint
s. "ninon, coarse '
I
'in
p promir
I1'„' High uv
Si- _r°Efit'rdl soil tex- SUr;a::.
ltdid was : Bench Pdz .
Vertical Refeience 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.