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HomeMy WebLinkAbout002-1044-10-000 01/30/20 PM 3 0128 Parcel 002-1044-10-000 P PAGE E 1 1 OF 1 Alt. Parcel 19.29.16.281 002 - TOWN OF BALDWIN Current 0 ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner 0 - WEBB, THOMAS W THOMAS W WEBB PO BOX 250 LAKE DELTON WI 53940 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 865-867 HWY 63 SC 0231 SCH D BALDWIN-WDVILLE SP 1700 WITC Legal Description: Acres: 41.000 Plat: N/A-NOT AVAILABLE SEC 19 T29N R16W S 1/2 OF NW FRL 1/4 Block/Condo Bldg: TOWN BALDWIN Tract(s): (Sec-Twn-Rng 401/4 1601/4) 19-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 05/28/1986 412553 741/289 WD 04/03/1986 410561 736/80 WD 2012 SUMMARY Bill Fair Market Value: Assessed with: 173988 Use Value Assessment Valuations: Last Changed: 04/10/2009 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 37.000 7,500 0 7,500 NO UNDEVELOPED G5 1.000 100 0 100 NO OTHER G7 3.000 12,000 73,100 85,100 NO Totals for 2012: General Property 41.000 19,600 73,100 92,700 Woodland 0.000 0 0 Totals for 2011: General Property 41.000 19,600 73,100 92,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 04/17/2001 Batch PRGRM Specials: User Special Code Category Amount 010-GARBAGE SPECIAL CHARGE 60.00 Special Assessments Special Charges Delinquent Charges Total 0.00 60.00 0.00 f 4~ FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER 1(? TOWNSHIP SECTION ~ T j N-R__,~~_W i ADDRESS" ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT r`- LOT SIZE/ ~Cfs PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM V 1 G C ~CL.~ ~116V1 ( ~Clb1 6 d G l G 'f' ~ it INDICATE NORTH ARROW _ r BENCHMARK: Elevation and description:. a " Alternate benchmark SEPTIC TANK: Manufacturer: 5 1-1t 7= Liquid Cap. Z, t Rings used:_LManhole cover elev: Final grade elev: Tank inlet elev.: Tank outlet elev.: No. of feet from nearest road:Front Side Rear Ft./G~; G' From nearest prop. line:Front Side , Rear Ft. 7j G No. of feet from: Well rICG> Building: le (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE N.0 PUMP CHAMBER Manufacturer: P,( Liquid Capacity: Pump Model:,,,,-./- ' %Pump/Siphon Manufact.: Pump Size Elevation of inlet: Bottom of tank elevation Pump on elev.: Pump off elev.: Gallons/cycle: Alarm: Man.: Switch Type: Location Distance from nearest prop. line: Front-L "Side_, Rear-Ft. Distance from: Well Building SOIL ABSORPTION SYSTEM Bed: Trench: Seepage Pit: Width: Length Number of Lines: Area Built Exist. Grade Elev. Proposed Final Grade Elev. Fill depth to top of pipe: ~r No. feet from nearest prop. line:Front ~fA, Side Rear Ft. No. feet from well: ~L No. feet from building 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 " ST. CROIX COUNTY WISCONSIN x "y ^S r~ k~ i. F. ZONING OFFICE s:. ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 !W Aug. 20, 1991 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An on site investigation of the Tom Webb property, located in the SW 1/4 of the NW 1/4 of Sec. 19, T29N-R16W, Town of Baldwin, St. Croix County, revealed 16" of suitable soil which requires 20" of sand fill beneath the replacement mound. This site should be suitable for a mound. Should you have any questions, please feel free to contact this office. Sinc , Janes K. Thompson, d Assistant Zoning Administrator js COP BALDWIN T29N-R.16W DD SEE AGE 47 .ech i; 3 a He o°'s Edward • Ro 9 .ssa DD .~za • K°n>e veGn~ndaa ~$'/etterz Eo'w°rd ` Ron ,p f • e. PINE \ tQ 7s 7s ~W- 67 Wi%/ a n Ke xdy, JG snne rz a nrn>on \ h'oytr'n/~ /g9 e/ux E.schenbac FCi/ori~ Bp ~ atux Q G roo/Ln_ eB c door - ~1b2 • ~ ~ U•UA,Z G7g h ,:s i9 o Etc e F /ss ,zo ,ss Lc £ e 0 •,v. ! 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(r trsnVJ~1 f Kue:/cR vOT. i/, 7 s~.Y 2~ g av~n ~tl ~Q o~ Fernrd Robcee S • 2-v-o ~o Bo ' yC • • tO 3.Q • Bo PoBOr • s7C. .9m`hony y. io ~7artmann, ~ 0 • ~ dwar •W • • V ry % .Yo etux 0 d U h l is Aber ~eu~ki11 n,E ti` F ` 78 David 9 • C `y • 4 f OO,, .vz. s V d % % ,Be rz,ee U nFQ W/' .E o)~C R/VER CCU 9o 0A/ a/ 2i7•G Ment nh dpe '4oh0 sTh i~ .0 j4 Ra do3e/ 0 a a rr Bo Q J y' Whitmanth V tln aq°~ /gs • .Pobert N a wr t 1 a.Es r {rya ne s /60 4o Larr ~J ~r~ 9/°n.E o/ A47-9 arse /,:s,E Koo'emr y ~Fa, • Sa cs• Bo 479 W go 6e "oig q/vin s a !/eenened~. Few -so ra/- T w l n Fame/c[ • Da v a f Dor,' CD' ~ N • dei>e r' n Petcraon l a BO okkcr /s C so .[ti/- .s uyr b QNy~~ E ne.- z,o /an ~un9e a R 7i.2B c.<. ro O~ •19z door 0In I N~-nos .~r.[. iBarb zsg- Q;Q .B u~ ~a~0 00 'I)0 U: ( O W • .2obert fBett . • eO ~~n- ? s y ~V~ v~C erja ® t7 W Hi ens f • car/ . • 4J~ S y y /o ,°au/ P !'sera /d,ne U .9en een~ 41 n a C• Q• • • Q C C Loe.fe C • ° ~a K U'~Q~ ~C tTerry ,e C• N. 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S>av Q 4, J /2 N N Ho/o PGACrgan O Myers E/nine • G/ayd V s Q,gy~( 6 i ton \ 0 /io r /oo ,y/ r s /9S F Ilarv,ir d ~ ~ U b Luc .Ewa/dt ~~j aC P- H< is/s e /4! C'0 JU ~ teYO7 4 77 a. 0 \ l 117 Gacoi. cE tl U ` nth U~ /,B er ° J d.'/ ~i V C .9 d- C fo ..1 r p0~x'v E- V ROS s Oil !9h ~1v K. G Son - \ a l Ca o/ n ob - N y qe to 0!•• u ro etai b y :g tl o~ ef~ • C R ~ p V 1' .x 's tl.C V Inc. o ~'.C C ,a / b . ro oy G a. J • b•d p@ • 7e a N At a 4 so ~Csan ~ rml- 9c C~, C d. d.U • He9/ Ci/enn J n gs ;p: Roy ltl~~ Ey an • ~V HHuls- 62 • Bison V4C t c.r:r noc.Ye"6 v c~5y H .Cao o sM z6 r w~ 79 Bo \1(0 OKee a Ne/son ;t:;Efk"iii[?EEEE:i[iEEEEt:F t[:Ei°Et;::ail. H//- ry, T iE 0 s ♦ f p 4l Joh s.Pa a/ia 'i i€Ci;.,:,::....;,.::::::::::::::s:::::i:t:: stead James s ,e s ~ ~ ~ 77 ~ u • H/e/SS.Y E mii/li G/oy < Caro/e T lia~debe y C . . 3 ~ O/se /zo Z ~ zo 6 i::::ii•tti=i: /b c. . ys n 968 Roc.E • 6O (1.~j LA. ,Brenne ~a/ous ¢ H~%aM 7 ° d /oPub/SInSrev /979 7g Q eo :E............. SEE PAGE 2/ •so asPer cStCroix Caun py~ FitE~'S PUMA SERVICE Woodville ALUMINUM CASTINGS Dental ALUMINUM FLAG POLES PUMP REPAIR AND Center All Sizes NEW INSTALLATION RIEHM We Sell TRW -Redo Frank W. Keeler Submersible Pumps D.D.S. FOUNDRY Woodville, Wisconsin 698-2410 Phone: 698-2959 54028 WOODVILLE, WISCONSIN 54028 698-2915 Woodville, Wisconsin Parcel 002-1044-10-000 01/30/2006 08:58 AM PAGE 1 OF 1 Alt. Parcel 19.29.16.281 002 - TOWN OF BALDWIN 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 THOMAS W WEBB O - WEBB, THOMAS W PO BOX 250 LAKE DELTON WI 53940 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 41.000 Plat: N/A-NOT AVAILABLE SEC 19 T29N R16W S 1/2 OF NW FRL 1/4 Block/Condo Bldg: TOWN BALDWIN Tract(s): (Sec-Twn-Rng 401/4 1601/4) 19-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 741/289 07/23/1997 736/80 2005 SUMMARY Bill Fair Market Value: Assessed with: 86956 Use Value Assessment Valuations: Last Changed: 06/28/2004 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 38.000 4,000 0 4,000 NO UNDEVELOPED G5 1.000 100 0 100 NO OTHER G7 2.000 4,000 52,000 56,000 NO Totals for 2005: General Property 41.000 8,100 52,000 60,100 Woodland 0.000 0 0 Totals for 2004: General Property 41.000 8,100 52,000 60,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 04/17/2001 Batch PRGRM Specials: User Special Code Category Amount 010-GARBAGE SPECIAL ASSESSMENT 45.00 Special Assessments Special Charges Delinquent Charges Total 45.00 0.00 0.00 Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations • INSPECTION REPORT St. Croix Safety and Buildings Division SW NW ~ 19 , 2 9 ,160kTTACH TO PERMIT) sanitary Permit No.: GENERAL INFORMATlON Hwy 63 149211 Permit Holder's Name: ❑ City ❑ Village [IrTown of: State Plan ID No.: Tom Webb Baldwin 91-02160 CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: f 9 00 j R Lr ~A~ 270-002- ) 0000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark /QSd (DD , Dosing -7 J_V Aeration Bldg. Sewer Holding St/Ht Inlet j0 /L,3 TANK SETBACK INFORMATION St/ Ht Outlet g11, 3~ TANK TO P/ L WELL BLDG_ Ventto ROAD Dt Inlet Air Intake Septic /06) /SO' 7j~"a NA Dt Bottom l/al 83.97 Dosing u-v y~~~l ~~5' 77 a NA Header/Man. )0,36 Aeration NA Dist. Pipe 3, z3 97,o7 Holding Bot. System 1,00 PUMP/ SIPHON INFORMATION Final Grade Manufacturer =6-) JV Demand .k a ~y 0 3. J Model Number 0-j L. I~j E gj~;JGPM TDH LiftIp,` ~ Friction System TDH,q,,< Ft Forcemain Length 1))Dia. Dist. To Well O' SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS I` DIMENSIONS LEACHING Manufacturer: SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM INFORMATION TypeO CHAMBER Mode Number: System: rVldt},U,Rb "/60 NIa OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s~ x Hole Size x Hole Spacing Vent To Air Intake 3i{/ Length Dia. Length "Y Dia. 211 Spacing 1 i -4 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over qq Depth Over aI w xx Depth Of k xx See ed / Sodded- xx Mulc ed Bed /Trench Center l? Bed /Trench Edges I Topsoil' - EKYes ❑ No es ❑ No COMMENTS: (Include code discrepapc1Ois, persons present, etc.) 00 r r Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R 05/91) Date l~ Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH ' SANITARY PERMIT NUMBER: { E a ` =Z:70Q SANITARY PERMIT APPLICATION LHR In accord with ILHR 83.05, Wis. Adm. Code co STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than /'Yg?a, I 8% x 11 inches in size. ❑ Check if revision to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. A - Oaf (p PROPERTY OWNER PROPERTY LOCATION k rt? '/a G1 '/a, S Cf T c~h, N, R Ai E (or) W PROPERTY OWNER'S MAILING ADDRESS LOT # IBLOCK#~ g CITY STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER bo 1 3 -7aX1 LI&P 11. TYPE OF BUILDING: (Check one) ❑ State Owned O VILLLLAGE NEAREST ROAQ ❑ Public [S~ 1 or 2 Fam. Dwelling-# of bedrooms PAR NUM ) III. BUILDING USE: (if building type, is public, check all that apply) O a 1 ~Ov 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 30 Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 40 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 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 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION S00 ZZO Feet 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 Holdin Tank r Ives d k Lift Pump Tank/Si hon Chamber X t k Fj F] F] I F1 VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plum ' Signature: (No S mps) MP R Business Phone Number: 72~4 *14 s ~ it 12&, 32 3 Plumber's Addre (Street, City, State, Zip Code): % l/ ff~ r~ IX. COUNTY/DEPARTMENT USE ONLY ~9 g Agent Signat re (No Stamps) ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued L Approved El Owner Given Initial ~ ys dG Surcharge Fee) . ;7 _ (/`J ~j y1 Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed 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, (308-266-3815. r To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank 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 foam; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which cap effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards.' a 5 BD-6398 (R.11/88) 6S - o • APPLICATION FOR SANITARY PERMIT STC-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. Ownec of property T G-~ J n ~3 Location of property a_,L-l/4 /4, Section , T c" N-R~Y Township ka A" J 1/4 Mailing address 6Ox- SU /-/,a IF Lzi w L" 5.`35~0 Address of site ( L)!n Subdivision name Lot number Previous owner of property Total size of parcel it r P S Date parcel was created Are all corners and lot lines identifiable? ~ Yes No Is this property being developed for resale (spec house)? Yes X No Volume and Page Number as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PACE NUMBER, and 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. ; and that I (We) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the same has been duly recorded in the Office of A-he County Register of Deeds, as Document No. 1 ~ Signature of Owner Signature of Co-Owner (If Applicable) 9 Date of ign Lure Date of Signature Y~ ,~•r - 1 ~ ~ ..61+1w~ .~~~=:f« ~ •rla.o.,w.eYy"-?.wM1~•M"~•. +N'.~F"T.-^' a, ~ fir" 3 z:: ~ ` •,~2f ~:~I Hilo ° r !!!Iqi ft-204 ~ Y'. 4 tom, ~ ~ ~•T~ ~ ~r~~ A*IM 1 AVn law aiM .C fl North, oil' and tN lf6"0 . 'i,n . P 0 '`1 POP* 1. - . thi=s of record, and mm 1116911 wa ads" ft March .y sK r - ....irobA.: : ....a -•--...(SFAL) -1` An-EXUA IVATiON ACKNOVI s~►s e STATS OF WIM ` r. - MUN " 5t. c eQ I'.!`__.......... Wr ....*w d_...«.... 19...... P.r.oa~Ib ea.» l *M w.t i11 AQ t N , lf.. Ills TIITAI x2MM STATE BAR OF WISCONSIN ~(athIM*l etlMd by ! ?0.96• a R~i..gtata.~ i THIS INWr*WMKNT WAS ONA/TTD By i~i~r1 7.$R .._G .Qlu3..Ra..QJ~A................... A 1-x-vx _ . . .....r t ~ .:C 1t CS • is ~ >rIR► taipwAum ny be ~ or adcewladihi. val[I past. K , -x~NDmry Rt1iC - are •oR mom"mal.) UL ~hUrr ~Lir +~r~w'' N SEPTIC TANK MAINTENANCE AGREEMENT ~ ba S Croix County OWNS BUYER o ROUTE /BOX NUMBER Fire Number o • ' ~ /''9'~C ~ d CITY/STATE ~Q '2 (J~1B111~- ZIP M PROPERTY LOCATION:'.. .1 k, Section 'T N. R IZW, Town of /51) fA.J.l.a 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 con- sists 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 a ect t e unct on of zne septic tank as a treat- ment stage in the waste disposal system. St. Croix County residents-may .be eligible to recieve a grant for a maximum of 60% of the cost.of replacement of a failing system, whit 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 'sysVt'ems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or..a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and •(2).after inspection and pumping (if nec- essary), 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. y 0 I/WE, the undersigned have read the above requirements and agree 0 to maintain the private sewage disposal system in accordance with the standards set forth, herein, as.set by the Wisconsin Depart- ment 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. SIGNED- ~DATE St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 386-4680 Sign, date and return to the above address. II~ bEPA WENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS DIVISION INDUSTRY, 1 P.O. BOX 7969 LABOR AND PERCOLATION TESTS (115) MADISON, WI 53707 HUMAN RELATIONS (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: TOWNSHIP/IXITY: 57 0--. BLK. NO.7SU DI ISION NAME: SW 1/4 NW 1/4 19 /T29 N/R1.6xk (or) W Baldwin n/a n/a /a COUNTY: OWNER'S/ ' AME: MAILING ADDRESS: St. Croix Tom Webb Box 250, Lake Delton, Wi. 53940 USE DATES OBSERVATIONS MADE (ESCRIPTIONS: PER OLATION TESTS: NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFI LE D Residence 4 n/a ❑New Replace 4-25-91 4-26-91 RATING: S= Site suitable for system U= Site unsuitable for system r ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL 1111 LDING TANK: RECOMMENDED SYSTEM: (optional) ❑S LAu Lev ❑ U ❑ S g U ❑ S ®U ❑ S H U mound DESl RATE: If an If Percolation Tests are NOT required any portion of the tested area is in the n/a under s. ILHR 83.09(5)(b), indicate: /a Fl oodplain indicate Floodplain elevation: decimal' PROFILE DESCRIPTIONS Da Re 62 JeA BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTMM. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B-1 5.67 95.58 5.00 3.00 1.00bl.l. .92bn.sil. 1.08bn.s.l. 2.67bn.mot.s.1. B-2 6.50 95.58 4.50 2.25 1.08bl.1. 1.17bn.sil. 4.25bn.mot. s.l. B-3 5.00 94.58 3.50 1.33 .83bl.1. .50bn.sil. 3.67bn.mot. s.l. B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOL) J_ PER INCH P-1 2.00 none 30 3/4 5/8 5/8 48 P-2 2.00 none 30 7/8 3/4 3/4 44 P_ none 30 5 z a 60 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. d SYSTEM ELEVATION 96.58 3 rJ T3- 4e) ~r ~I E , 0 / N 3 10 49 ( 3 s. .ham- ~-'P I, the u ndersigned, hereby certify that the soil tests reported on this form we the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests cafect te best o wledge and belief. NAME (print): TES RE COMPLETED ON: Gary L. Steel 4~ 91 ADDRESS: CER F1 ATION NUMBER: PHONE NUMBER (optional): 175-246-6200 1554 200th. Ave., New Richmond, Wi. 54017 DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil '146ter.i.,...-.-JN" DILHR-SBD-6395 (R. 10/83) - OVER - A DENNIS PERck a, TIO N BRANDT TEST, IKV 608-5u.+-u ,'//0 / Licenser Since 1975 • CST 0753 C Fo 3 lye L C a~ ~eSC21 L ro M t r ~ 1 1V. w S i g T~ 1 H R 1 C w IJ« f~(w,~. D o T S Y S,~ © N -r& R5 a O 01 a T RIOL v~ l Q q L°. - r-1 ) PCA9 e- 13 0~ V-0 CC Ale C, Ira e o << 1- I Pa o C^ Pa C d 4e Kii r \1Z ~ a n opproc)a ~ a PP h c- IL: 14 its C- aue-i y Ot, S~Z c Not-anZttL F'orts OhtIL-. OtrA i'cDoa L torn v LAJ 1 " a e LL nn( r t2.. Valley Soils Service ® RoyAn, :enter, W1 5~F£~1 (~Czl -t o ~ L PLOT PLAN Name C 3,M_ _ ("1 r jr G° Size of parcel ~~.:6 {s Address d o~.Depth of limiting factor City, State & Zlp o, c- 3 ~zj~C,j_ Lift on pump I 1 Legal Description s l.~ N w S 19 I '1 t I? 1 G ~ o ength force main 3 a r • ~t Required absorption area Recommended K KS, absorption area Signature . N Legend A Benchmark; valued at 100' X Backhoe pit XA auger boring c; O Percolation hole x,F Fenceline~ well SGRi19 1' W1~ r' .r - CST* 175S ~tr+ '1 l) , ~L T `t r s i 1 r _ I: t r 1 i 0 SAP 1 et OF ONOF (!i ~ p0 C T ~ S ,r d o s v v. y r p a,.' V ~ ~ l d ,d O v a d t.!) c s u ~ d t Q ~,'71 . oV 4c y r lid s f. v lt- UJ tJ~ X I ° y Ct) c a t o • v . f. a .r t A za, i i CJ ` V' ` J O a- IJ ~ ~ C r ~ o c d ~ n C/I L-4, a ~ b ~ c r Q a3 i AN I •,1 _.5~.. PUMP CHAIAPER CROSS SECTIOU AAJG SPECI FICA rIOtiS VENT CAP CC.Z. VENT PIPC WEATHER PROOF APPROVED LOCKING 25• FROM DOOR. JUNCTION BOX MANHOLE COVER WINDOW OR FRESH 12"MIU. AIR INTAKE 1 GRADE I H" MIN. r 10 • cououlT Ie'MIIJ.~ IIULET PROVIDE AIRTIGHT.. I III ~ .,r.r, I I v APPROVED JOINT A 'r I I I APPROVED JOIWT W/C.Z. PIPE s~ I III W/C.I. PIPE EXTENDILIG 3• p(~F► I II ALARM EXTEUDIUCe 3 OUTO SOLID SOIL. d $ I I ONTO SOLID SOil 10100 ELEV. gG.7S FT. PNO~V~P _ J . orr _ .~~F~NNOFS BLOCK Viso= to- RISER EXIT +g 4 IF TAWX MANUFACTURER HAS SUCH APPROVA4. _ SEPTIC f 5PCCIF!•CAT10KJS • DOSE TANKS MANUFACTURER: W117 P1 1C~cr1 -•~exo root WMBER OF DOSES' PER DAN TANK SIZE: - ~~C7 GALLOWS DOSE VOLUME ALARM MAUUFACTUII,ER: s V r i-Tr o IMCLUDIAIG OACKFLOW: GALLOMS MODEL WUMBER: I O I I~~ CAPACITIES: An a3y INCHES OR O~• s GALLOtJS SWITCH T!JPC: f i d INCHCs OR 32-44 GALLONS PUMP MANUFACTURER: I' 1 C.. INCHES OR 1911 GALLONS MODEL IJUABER: ~ 0• IMCHES OR 10318' ' GALLONS j SWITCH TyPC: XV AJOTE: PUMP AND ALARM ARE TO BE i C• INSTALLED OfJ SEPARATE CIRCUITS MMIMUP015CHAtCE RATE GPM VERTICAL DIFFE&ENC9 DETWECU PLIIAP OFF AIM 013TRIbUTIOU PIPC.. 10'2S" FEET 17. ♦ MINIMUM NETWORK SUPPLY PRESSURE " . . . . 2-5 FACET ♦ __2!_ FEET OF FORC[ MAIM X s3 r AoanzFRICTIOk1 FACTOR. I' I FEET p, . TOTAL 04 AMIC. HEAD = FEET r 1 ~ 11 IuTERAIAL CIMCIJSIOMSj Or TAUK: LEAIGTH - ;WIDTH .;LIQUID DEPTH . , SIGIJEO' LICEA.ISE NUMBER: DATE: Submersible Effluent Performance • Currie Pumnc~ G -k METERS FEET i MODEL 3835 80 25 „a SIZE 3/4"Solids I.o..._ WE15H y~ 70 Z 20 llv WE10H i 4 60 FF WE07H 1s ~t so wE0W ; 40 10 `30 WE03M 20 WE03L 5 10 0 OFF-i L- 71 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM i i i 0 10 20 30 IWA CAPACITY GOUMS PUMPS, INC. l 5> urAU5NEWV=8" - METERS FEET ?'~P 120 MODEL 3885 35 SIZE 3/4" Solids 110 I 15HH 100 30 90 25 80 - ~ 70- 2D M►EWHH 1`r 1s so 1 ~ ' n y, ~ ~ 40 ti 10 -14 30 20 _ 5 - 0 0 0 10 2D 2D Q 50 iD 70 i0 i0 100 110 12D GPM 0 10 20 20 wbA CAPACRY ~l ~ ~ Vk* ,ft 9W AL SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue P.O. Bog 7969 Madison, Wisconsin 53707 State of Wisconsin Department of Industry, Labor and Human Relations September 27, 1991 TOM WEBB SOX 250 LAKE DELTON WI 53940 Plan I.D. No. S91-02160-P Dear Mr. Webb: Re: Tom Webb Private Sewage System SW,NW,19,29,16W Town of Baldwin, St. Croix County, WI Your petition for a variance to section ILNR 83,23 (1)(d), Wisconsin Administrative Code, has been reviewed. The rule being petitioned requires a mound system site to have a minimum of 24 inches of suitable natural soil. The variance requested was to install a replacement mound system on a site with 16 inches of suitable natural soil The following comments were made in the petition analysis: 1. In reviewing the petition, it was noted that the request was similar to other petitions accepted by this department under petition numbers S89-03304, S89-03318, and S90-00072. 2. Based on the precedent established by the previous petitions, this petition for variance is being processed as permitted by Wisconsin Statute Section 101.02 (6)(g). Departmental Action: Approval. 9 ftT 1j 13110 6628 A 01/01t 1 f SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue P.O. Bog 7969 Madison, Wisconsin 53707 State of Wisconsin Department of Industry, Labor and Human Relations .TOM WEBB Page 2 September 27, 1991 This approval is granted with the understanding that all of the petitioner's statements and any conditions of approval cited above will be carried out. Prepared by: Kenneth Stiemke Departmental Signature: T AA 1, Date: 91~ Richard U: a er, "h ec Director, Office of Division Codes a~d Application KS:24WPP5 Enc. cc: Leroy Jansky, Private Sewage Consultant - District 6, Chippewa Falls Thomas Nelson, Zoning Administrator - St. Croix County I I i i i 'SBD 69" (R. 011811 j SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations tkt Afi -AWME PLAN APPROVAL Ot f i c e.. (it 01 v i s i ran Codes and Application 201 East Washington Avenue P. r1. Box 7969 Madison, Wisconsin 53707 TOM WANG EXCAVATING Owner: TOM WEBB RR 4 BOX :342B BOX 250 RIVER FALLS W1 54022 LAKE DELION W1 53940 RE: Plan Number: S91-02160 Gate Approved: Uc:tober 1, 1991 Gallons Per Day: 600 date Received: September 18, 1991 Project Name: WEBB, TOM - RESIDENCC Location: SW,NW,19,29,6W Town of BALDWIN County: sT CROIX The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. ThiS approval is based on Chapter 145, Wisconsin Statutes, and the Wisconsin Administrative Code. The plans are stamped 'conditionally approved'. This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed plrjmber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. This approval will expire two years from the date approved or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. The Section of Private Sewage has reviewed these plans for private sewage system code requirements only. These plans have not been reviewed i-or the code requirements set forth in Section ILHR tar for general plumbing or in Chapters 50--64 of the Wisconsin Administrative code. This approval is for the following componr--,nts only: REPLACEMENT PETITION - REPLACEMENT MOUND ~N0-64231 R. 01191) { SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations i TOM WANG EXCAVATING Page 2 Inquiries concerning this approval may be made- by calling (608) 266-0230. Since ely, E NE H STIEMKE: Section of Private Sewage Division of Safety and Buildings PPP016/0009n/ 3 cc: TOM WEBB ----Private Sewage Consultant-" Cuuni:y UW-SSWM1r _ Plumbing Consultant - Owner ---Plumber ~--Environmental Health I QN0.0423{R.01411 { , b