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HomeMy WebLinkAbout042-1085-90-000 Q c U ° y g o o ~ N ~ I\ O J t t v C N N c N N Z O o N 0 c rn C Z (9 ~ m LL CO ~F 0 T3 - 7 a d cn LL 3 ° Z y Z 00 (D 4) _ m w j a co M F- Z O O Z ~r U a, w tt ✓ O i <n ►Z?Iv z o E ° m z M N C • ~l p .,t cn Lo d J O Q Q f w EL Z Z o N Z (n V- C '0 0 7 O C N - 0 O N y it N - c O O ( c o a .a ? ° L H F- f" O Q) Cj 3 3 0 • a a a rnl O N N N fn J U L rn rn O Z Lo in ~V = N E p p 9 (L 1 0 N Q lava N d Q Z' Q O O O N C C? CO O C Q U O N ::s O O o 0 3 ° E S i E 0) 't c C V O coo co ~ E (D LO ~o -T O N N LO 11 (OD 0) "O CO ~ 0. O w N p°p N O O ~ U V ~ ~ al EL L: a. C~ a• d U d ..a E i C C rI~ O to O 3 O i ~1 A L) a O U) 0 L , o ~ o I 3 0 O bq 0o S.c ° N 0.0. c O U O N ~ IT y ~ Oq N Q ~ N C I N y C _N .a. C O N 0 O N N c z C7 LL m o O 3 Ez 2 E o a au)LL 3 0 v ° z E z 0° II L z w a m M H Z c 0 c O o Z a N v o !n H c z ° E 'R 2 M ' m `~+lJ 5 ° M N C (DI III O 7 L 1111~111~~~ U) 0 O U O d z z o N y z N y C c .0 E O N :3 0 O a N W C d C N _ N _ CO 06 ° Q M Y _N % d ~ O O N Q a a .a N 76 N U) E N N fA w o L H H F O O N FL 0 • a a a a rn T C,4 N 0) m 7 O O fA J V rn rn z O O O O DQ m a a a dl ¢ Z N N d l0 O N N N O 0 '0 '0 (0 ° 00 o ° y c c a m F° N m - 8) E d ~ y ° ° °7 v N N p p? ° v C L • ?a V >1 N 00 O N O O U o Cl) > o Z z z (n t 1 w 4 41 v xt M y a w • a d ~ y c `Iv 'c c .Yr 0 1 2 0 tN 00 Parcel 042-1085-90-000 08i22i2007 04:27 PAGE 1 OF 1 F 1 Alt. Parcel 31.29.18.480B 042 - TOWN OF WARREN Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - STATE OF WISCONSIN, D O T D O T STATE OF WISCONSIN 718 W CLAIREMONT AVE EAU CLAIRE WI 54701 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 3.760 Plat: N/A-NOT AVAILABLE SEC 31 T29N R1 8W 3.76A PRT NE NW S OF Block/Condo Bldg: HWY Tract(s): (Sec-Twn-Rng 401/4 1601/4) 31-29N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 895/503 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 05/03/1994 Description Class Acres Land Improve Total State Reason STATE X2 3.760 0 0 0 NO Totals for 2007: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2006: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 I DILHR SANITARY PERMIT APPLICATION C OLIN rr In accord with ILHR 83.05,'Nis . Adm Code St- Croix _ STATE Attacn complete plans (to the county copy only) for the system, on paper not less than 8',1 x 11 inches in size. tm C j C vision to oro~w,s -See reverse side for instructions for completing this applicati S , 1 ' 9 STATE PLAN i 0 NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. State Proj. #1020-09-7 PROPERTY OWNER PROPERTY LOCATION WI Department - (N-ntral NE NW-'/-. S 31 T 29 , N, R18 5txm W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK k _ 4802 Shebo a .1 R N/A N/A CITY. STATE ZIP COOE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER -Madison, WI 53707 (608 11266-R669 ParrPI description a~tached II. TYPE OF BUILDING: (Check one) ❑ X State Owned V CITYLLAGE Warren NEAREST ROAD _ ❑ Public ❑ 1 or 2 Fam. Dwelling-# of bedrooms - A L AX NUM III. BUILDING USE: (if building type is public, check all that apply) N/A i 1 ❑ Apt/Condo 2 Assembly Hall 6 0 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 Weiqh Sta. IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) i A) 1. LJ New 2.E] Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System e) ❑ 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 D 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ® In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill 2 11IN 12 VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 12. ABSORP. AREA 3. ABSORP. AREA 4. LOAOING RATEt I$- SYSTEM ELEV. 17. FINAL GP REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/-_4.*) (Min./inch) ELEVAT?C 1696 2120 2,208 0.77 9 1023.74Feet 1028.0 VII. TANK CAPACITY I I in altons Total #of I Prefab. Site 1 Fiber- j -X INFORMATION New istl Gallons Tanks Manufacturers Name Con- Steel Plastic ` ~Concret strutted I I glass 1 a ` Tanks Tanks II ' Septic Tank or Holding Tank 2500 1 1 I I I Lift Pump Tank/Si hon Chamber 274 1274 1 I I X! VIII. RESPONSIBILITY STATt.*AENT I, the undersigned. assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print):: Plumber's Signature: (No Sts ) MP/MPRSW No.: Business Phone Number im R SL 6' Y 7~ Sld` i / 3 Plumber's Address (Street. City, State, Zi Code): - IX. COUNTY/DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee (Includes Groundwater ate issued Issuing Agent Signature tNo Stamps) Surcharge Feel XApproved [3 Owner Given Initial © (0- J Adverse trmintin - X. CONDITIONS OF APPROVAUREASONS FOR DISAPPROVAL: 1 C7is) b,aSLj SBO-0398 Iformerly Plb-67) (R. 11 188) 01STRIBUTION Onginai to county. One Coov 7o Safety 8 ew dings Civ,siOn Owner = „"per LLJ d C C Y C d w N or) c « m 3 `y c m OE E C JJ O O V ? O. « W` Q • O O W a Q, W T G Q W N 0 W E y d ~ a - Cc E O Q~ L W O •2 ? O F- m EWN o m O• ° W « C W W C c Co ° a HW a Z Q C H W V T W y Z I Q y Q r > Q - C ~ - T O! HW d d Vf ~ Z 2 E Nnu W U U ~W a O y E E E L d Q. a= ? ~,aL L C j Y OI 0.7 A W N Ln W C >Op C N > W M " = 0 4) C- 'U C V OC 'o .2 z ° W,E~ O W o~ = a~~~ aE oU Q CL y. >o L. W J Q ay m of m~ do -cEtd ~o cc W U aW OWL -0 ct, w E d~ N'~ o,v m T O; N~ W C W N ~p .Y C d L > , N LU i ` t y L t W; C L d L O. O W W W W - W D 4 V N £ W y =°n ao uod z w z z Z 9 U) F- 0 O U O o w z U doc U c) 0 -1 cr Q > ? U- Ir D ° O z0 co < U) N z cr U W Ir 0 W C'3 U Q j z C) U Q F- pC 2c J cr co LL W • i w w m U) ~ > CL X W O ~ U- J 2 or w O CC w co w m z O 0- Z j 3: o CU/1) O z = CL COOD O C H Q All H 0 ✓E?1R-fvicNTOF REPORT ON SOIL BORINGS-AND SAFETY & BUILDINGS INDUSTRY, C DIVISION LABOR AND P.O. BOX 76 HUMAN RELATIONS PERCOLATION TESTS (115) MADISON WI 5370-7 (ILHR 83.09(1) & Chapter 145) LOCATION. I 1 TOWNSHIPIMUNICIPALITY: OT NO. BILK NO.: SUBDIVISION NAME 4 Pwv4 31 /T z9N/R 18 or) W ToR/v of 144fEAI COUNTY: sr, Po/ X IMAIIINGADDIll SHESOY6A~tJ /q(/~~(JvE ClJ / S o'o s/,v 'Po T Av / so.c~ Zzl i5'Co~vs~.U USE DATES OBSERVATI NS MADE NO. MS: OMM L DESCRIPTION:1 l PROFILE DESCAlFTTZSIV aLATTOTVTE3T5 OResidence _ rA6Z/C,e New ❑Replap RATING: S- Site suitable for system U- Silo unsuitable for system N I NAL: MOUND: IN ROUN M-IN-FILL OLDING TANK: RECOMMENDED SYSTEM:foptionall XONVS ❑U ❑ S zu l CKS ❑U ❑ S NU ❑ S EU_ C eAla-=,v wq L 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: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH T R UNO ATER-INCHES H A R IL WITH THICKNESS. COLOR. TEXTURE, ANO NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE AB8RV.ON BACK.) L DEPTH Bn d B h B /00 /,0 29' , a OVE OZA59 /00 0-9 9- 3 3 -/oo B- 7- loo 10-7&02 110AAL- OU6)e /oo o -/S 1S-3z 32 -/oo e- 3 /00 /0zBr3 t10AJ6 ovE 00 0 - / z 1Z -33 33 -/o U e 4 /00 1,028.73 0/t1.97 441E4 100 o-/3 /3-3Z 32 -/oo /00 /0 ZT, 07 A10A/-t5 "Pa'" /00 0-13 /3 - z8 Z8 /oe IB- 6 100 / 0zs r 5 lleA"lc 00,54 10010-16 8 -1 PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP 1 WATER LEVEL-INCHES RATE MINUTES PC NUMBER INCHES AFTERSWELLING INTERVAL•MIN. t PERINCH P. Z Z7 A. 4y/6 P. 3 56 .0dVE o z;jib 2% Z S P. O 01OU49 D IZZ i P- 19 q- I Alg~ A.1 E O /6 g//& 4 ~V1G 7 P- IV /0 / / S /b PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate sale or distances. Describe what are the ho, tontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and perce^ of land slope. SYSTEM ELEVATION 71e0t iy,eY 5' s~co•wi/r°Y LV, /O z3, 7 - - L y- W'j__--- 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 Wiscons, Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (prin0: ,9/-4 /.P "c-r SA~tI K v TESTS WERE COMPLETED ON: SO/L 5 /4414P 6.l/ 1"e 41Av S,E0 A/C - ADDRESS: //0z 5r ' x:a1'4de r S j'i(°,EE J- ERTIFI ATION NUMBER: PHONE NUMBER Ioptionall b / v.v Ni/S~ ws~,v 93713 6(g 2 Z 74 - 76oO CST SIGNATURE: DISTRIBUTION: Or,ginei and one copy to Locei Autho,ay Pfopery Owner ano Son Test- DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & SU;LDIN';S INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.O. 30X 76 N WI 53707 HUMAN RELATIONS (ILHR 83.0911) & Chapter 1451 LO A I SECTION : TOWNSHIP/MUNICIPALITY: OT NO. LICNO.:SUBOIVISIONNAME y, uw 1/ 3I /T o? 19b4l W Toaiv of w ,APB COUNTY: MAILING ADDRESS Sr, C,Pa l!J/SL'0A1.5.1(1 Z1,1 7- Av ov !v/s~o.c~r,L/ USE DATES OBSERVA ONS MADE NO. B : O M A ION: 1PROFILE yy DESCRIPTIONS- IPERCOLATION TESTS: 1 ❑Residence rte C/d K ~dE/B-/! Y"New ❑Replau 27 - ~V s r _e, RATING: S~ Site suitable for system U- Site unsuitable for system ONVEN I NAL: MOUND: -1 FILL OLDINGTANK:RECOMMENDEDSYSTEM:loptionall ~1S ❑U ❑S ~U OS ❑U ❑S "'U ❑S J;OU Co,u!/=~•vr/oAvs L If Percolation Tests are NOT required DESIGN RATE: H 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 T GROUNDWATER-INCHES HARACTER F S IL WITH THICKNESS. COLOR , TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED TO BEDROCK IF OBSERVED (SEE ASBRV. ON BACK.) B/ s/ Bn C/ Bn /r sr B- 7 I00 1028,4] A4DV 041E4 00 0 _ e 8 - z 9- Z ~ - /oo B-$ 100 1OZSf7 ,UD~f7 otr/E loo o - l Z IZ - 3o ~o - /oo B-'?/00 1OZ6,' i✓e <9pjF7e oa o - 9 9-33 33 -/oo B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DR IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. q P PERINCH P- 7 6 oNE d /6 P_ 3 460 P- oN U ' 57 P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or disunion. 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 p~P/H.~1~Y 9- SE COivpi9'PY 66v~ /O Z3. 74 T - - -i -1- - - - - - - -L O C ~_T'/O/y f - - - - - - - 5 ;i~_ sff 7- 011= 3 - - - - - - - - - N - - - - t - - - I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (prim): oL A/ 0 ~r Sl~~P,C CJ TESTS WERE COMPLETED ON: Soil S NO E 6 !A-' 3746,f -rlW //-27- 9v ADDRESS'. //02- STC- 6l//JQ r rryPEE r CERTIFICATION NUMBER: PHONE NUMB EAloptional): ~1A v / ,v .!%i Jr coA,-' s i.u 63 / 3 / 4( 2 Z 7#- - 76 0 0 CST SIGNATURE. OISTRIBUTION: 0ri9,nat and one cony to Local Authority. Property Owner ano Sod Tail- 46- SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations September 26, 1991 201 East Washington Avenue P.O. Box 7969 Madison, Wisconsin 53707 MEAD & HUNT, INC. Owner: WI DEPT OF TRANSPORTATION 6501 WATTS ROAD SUITE 101 4802 SHEBOYGAN RM 651 P 0 BOX 7916 MADISON WI 53719 MADISON WI 53707 RE: Plan Number S91-02619 Project: WI - DOT - I-94 WEIGH STATION ounty: ST CROIX Location: NE,NW,32,29,18W Fee Receive-d------125.00 Date Received: 9/17/91 WARREN This letter is to acknowledge receipt of the Petition and Plans which you submitted to the Office of Division Codes and Application, Section of Private Sewage. We cannot however, process your submittal until we receive: - An onsite report signed by the Private Sewage Consultant verifying the soil. Private Sewage Consultant, Leroy Jansky, can be reached at (715) 726-2544 to arrange for an appointment. - Revise drawing to show how 4" header pipe will be drained to prevent freeze up. - The dosing tank is required to have a one day storage capacity above the alarm in accordance with s. ILHR 83.15 (5)(b). - Complete calculations for total dynamic head. - Complete calculations for total gallons pumped per cycle. - It is recommended that a longer and narrower designed system is used for this site. The geometry of this system (46 X 48 feet) means that a linear loading of 35 gallons per linear foot is being used. Based on past practices and design of using a square bed, this may lead to early failure of this system. - Plans which are properly signed. If a cover sheet is used, it must be signed, dated and clearly identify all of the sheets comprising the bound volume. Plans not properly signed will be returned. Additional information requested shall be properly signed as per Section ILHR 83.08•(2) (a). Unless otherwise specifically noted, please submit two copies of all requested information. Please retain one copy of this letter for reference and return the other-witkr the materials requested. SHD &1831 H. 01/811 f SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations MEAD & HUNT, INC. Page 2 September 26, 1991 Your Petition and Plans will be processed within 30 working days fallowing receipt of the requested items. Petitions or plans submitted to this office which require additional information will be held 90 working days for receipt of the information. If, after 90 days, response to this letter has not been received, your plans will be returned. If you find it necessary to contact us regarding your submittal, please call us at (608) 266-3937 and refer to the plan number as shown above. Sin rely, J MES QUINLAN Section of Private Sewage Division of Safety and Buildings PPP012/000In/ 3 COMP: 1 15 ELEM: 12 cc: WI DEPT OF TRANSPORTATION tC County Plumbing Consultant Local PI _Plumber _Environmental Health Facilities Need Analysis Section _UW-SSWMP ~Qept of Agriculture -3Z -Private Sewage Consultant SIM 6423 lit. 01/911