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HomeMy WebLinkAbout004-1011-40-000 3 03:43 PM Parcel 004-1011-40-000 01/30/201P AGE E 1 1 OF 1 F 1 P Alt. Parcel 05.28.15.76A 004 - TOWN OF CADY Current [X] 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 - BAKER, LESLIE & MARY M BAKER TR LESLIE & MARY M BAKER TR BAKER 2848 50TH AVE WILSON WI 54027 Districts: SC = School SP = Special Property Address(es): = Primary Type Dist # Description ` 2848 50TH AVE SC 0231 SCH D BALDWIN-WDVILLE SP 1700 WITC Legal Description: Acres: 33.000 Plat: N/A-NOT AVAILABLE SEC 5 T28N R15W SE SW S OF INTERSTATE Block/Condo Bldg: HWY Tract(s): (Sec-Twn-Rng 401/4 1601/4) 05-28N-15W Notes: Parcel History: Date Doc # Vol/Page Type 09/21/2011 941791 QC 09/21/2011 941789 TD 09/26/2005 807532 2896/059 0C 09/01/2005 805220 2879/631 TI more... 2012 SUMMARY Bill M Fair Market Value: Assessed with: 172830 Use Value Assessment Valuations: Last Changed: 04/23/2012 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 28,500 310,700 339,200 NO AGRICULTURAL G4 22.250 4,400 0 4,400 NO 05 UNDEVELOPED G5 1.750 1,500 0 1,500 NO AGRICULTURAL FOREST G5M 7.000 11,600 0 11,600 NO Totals for 2012: General Property 33.000 46,000 310,700 356,7000 Woodland 0.000 0 Totals for 2011: General Property 33.000 45,800 310,700 356,5000 Woodland 0.000 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch 511 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 7 AS BUILT SANITARY SYSTEM REPORT OWNER ve5/e~~ Y-~►~ TOWNSHIP SECTION-T N-R--4-!~-W ADDRESS y S /m,~ Se ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM e Q S G e ~e `il 5 e t~'~~ ZC o t~ I c~1 V i u Lk_) 4(? r~0_ 0 -C_ cL 1 INDICATE NORTH ARROW BENCHMARK: Elevation and description: - Alternate benchmark iL w . SEPTIC TANK:Manufacturer: Liquid Cap. r~~O Rings used:-k-Manhole cover elev: O Final grade elev: Tank inlet elev.: Tank outlet elev.: No. of feet from nearest road:Front ;/Side , Rear Ft.'f3 -O ,prop. line:Front , Rear Ft. From nearest Side C No. of feet from: Well 0 Building: e2 (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE a PUMP CHAMBER Manufacturer: ~0'ccas'r Liquid Capacity: /G ?y Pump Model :U)Cy5-14 Pump/Siphon Manufact.: o'-/i Pump Size Elevation of inlet: S-) -9Y Bottom of tank elevation TT+ -3-y-- Pump on elev. Pump off elev.: 'Gallons/cycle: d ~c .rv ,,~JelK'{v Alarm: Man.: S- E Switch Type:~/o. 4 Location Distance from nearest prop. line: Front , Side` , Rear_Ft.!I'~ Distance from: Well 'VoBuilding 1 L/ ~ SOIL ABSORPTION SYSTEM Bed: Trench: Seepage Pit: Width: r' - Length Number of Lines:_ Area Built Exist. Grade Elev. 1~D-S Proposed Final Grade Elev. Fill depth to top of pipe: 0C.- No. feet from nearest prop. line:Front , Side -~F_Rear Ft.7) No. feet from well: No. feet from building ~a 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: ~t- lve ~ ~ y eyl t% ~ INSPECTOR: Al a,Y-~----=~ V DATE : - PLUMBER ON JOB : LICENSE NUMBER: 6/90:cj OWNER: LESLEY BAKER ( ✓ 43 s g, . To.~ o~ i Pow ~ t-~~«v~ As S ham, /~}c rc~ 3 r J~~ s fi t OWNER: LESLEY BAKER Perforated Plpe Detail 0 End Vlew )Perforated End Cop) l° PVC Pipe 1 ob~t s Permanent End Markers s Holes Located on Bottom are Equally Spaced e PVC Force Main y From Pump PVC El~p Manifold Pipe P, INC Distribution,.. Pipe Last Hole Should Ce Next To End Cap Distribution Pipe Layout P 3/ R S .3 x 36, Y may„ Signed: Hole Diameter _ Inch License Number: Lateral " / Inch (es) Date: Manifold " Inches Force Main Inches S~Jkr~ C~Q~f. 10 OWNER:; LESLEY BAKER • Page Of Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe Medium Sand Cle Topsoil ---H- ~G _ 3 E " D b , % Slope. Bed Of '2-"-2 % Force Main Plowed Aggregate From Pump Layer D C: Ft . Cross Section Of A Mound System Using E f. 3 Ft. A Bed For The Absorption Area F - • Ft. G Ft. A L Ft. H f, S Ft. Signed: i3 ~03 Ft. License Number: K 0,~ Ft. 'Date:' L g- Ft. J Ft. Alternate Pos i ti on T Ft. of Force Main W PLy L Observation Pipe--.,,,, B K --------------------1--------------------- W o T -----------J Force Main Distribution Bed Of 2 2 2 Pipe Aggregate Observation Pipe Permanent Markers Plan View Of Mound Using A Br' i-:-7r ; 1- Absorption Area OWNER: LESLEY BAKER • PAGE OF PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS -VENT CAP 'i"C. I. VENT PIPE ' WEATHER PROOF APPROVED LOCKING JUNCTION BOX MAWHILE COVER, 25' FRCM DOOR, 12 MIN. LJ /1 WINDOW OR FRESH t~lavnlw~ ~a-acI " AIR INTAKE GRADE I I y" MIIJ. L _ - I8"MIN. COLIDUIT 11~ fNLET PROVIDE AIRTIGHT SEAL I I I APPROVED JOINT A I III APPROVED JOINT: W/C.2. PIPE I III W/C.Z. PIPE EXTENDING 3' I II ALARM EXTENDING 3' OVITO SOLID SOIL B I 11 ONTO SOLID SOIL 1 ON I PUMP r. OFF D LJ -E ku -7 3 CONCRETE BLOCK RISER, EXIT PERMITTED ONLY IF TANK MANUFACTJRER HAS SUCH APPROVAL SPECIFICATIOMS EPTIC AND J / OSE TANKS MANUFACTURER:-~6,I)LI0t¢t ~~(t.l C. WMBER OF DOSES: C/ PER DA-4 TAAIK GIZE : GALLONS D1QS~F VOLUME: ~ ~l GALLOt~1S ~v .4N Ik lh,SS ~iuC I"Iuw ALARM MANUFACTURER: \7). C L J CAPACITNES: A= /i•i INCHES OR 0 GALLOUS MODEL IJUMBER: ,L - B= l INCHES OR 1 GALLONS SWITCH TYPE: le- k- e C./1-1 C= /L1' rD INCHES OR .2 7 9 GALLONS PLIMP MANUFAC_TLIRE: R: (~r- - l D= INCHES OR r,_O GALLOU5 MODEL NUMBER: F C)57 NOTE: PUMP AND ALARM ARE TO BE SWITCH TYPE' f K <INSTALLED ON SEPARATE CIRCUITS PUMP DISCHARGE RATE zel -2 GPM ~ ~ VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE..Q I FEET + MINIMUM • NETWORK SUPPLY PRESSURE . . . , . . . . 2.5 FEET + _~3SC FEET OF FORCE MAIN X _ ti7 F31/0OFT.FRICTION FAcrrOR..°l'-L_ FEET TOTAL DIJUAMIC. HEAD = FEET IMTERNAL DIMEMSIONS OF TANK: LENGTH /0 _;WIDTH -;LIQUID DEPTH SIGMED: LICENSE DUMBER: DATE: OWNER: LESLEY BAKER Performance Submersible Effluent Curves Pumps METERS FEET 90 25 MODEL 3885 80 WE15H SIZE 3/4' Solids 70 J , 20 WE10H F 60 WE07H +4~- i 15 50 E05 40 i 10 WE03M 30 20 WE03L 5 T- INQ 10 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM t ~ I 0 10 20 30 m'/h CAPACITY III MGOULDSS PUMPS, INC. 1'OPK 13148 i SBNECA FALLS NEW METERS FEET 120 MODEL 3885 35 110 WE15HH SIZE 3/4" Solids 30 100 i 90 I 25 80 70 Z 20 60 1 O I 15 50 WEOSHH 40 4- 11 N 1 0 30 20 5 10 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM i 0 10 20 30 ml/h 01985 Goulds Pumps, Inc. CAPACITY 't Effective July, 1985 A q~ 00 0-SP7 DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING LAE,OR & HUMAN RELATIONS DIVISION P.O. BOX 7969 TAT ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION ,.1,p,4DIS~A1.; I ?'07 2 15 `'Y State Plan I.D. Number: OC ft l CONVENTIONAL ❑ ALTERATIVE (If assigned) Town of Cady El T Rd. Holding Tank ❑ In-Ground Pressure Mound Norsman of NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: esle Baker 2457 Sim son Roseville MN 55113 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. EL (o / '0CU-/to., Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Dale E. Hudson 6629 St. Croix 149027 SEPTIC TANK/HOLDING TANK: ~Z 13 j°/,40& 7-2 MANUFACTURER: ±ATER CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER J/ p / PROVIDE PROVIDED: ~/\S ~GY7 C ' l~I ~ 0) p. 73I f. f~ ES ❑ NO ❑ YES BEDDING: VEN DIA.: V£f "ATL.: NUMBER OF ROAD PROPERTY WELL: BUILDING: VENT TO FRESH LTO(' AFEET FROM LINE: qs l ~i AIR IN T' NO :NO NEAREST~► DOSING CHAMBER: 7 6-10 MANUFACTURER: BEDDING: 4-40UID CAPACITY: PUMP MODEL: PUMP/9"%W6 "ANUFA WARNING LABEL LOCKING COVER Goad ~ PROVIDE PROVID Fst S ❑ NO ES ❑ NO [EfIES ❑ NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN + FEET FROM LINE: ♦ tisct G AIR INLET, PUMP ON AND OFF) 44 1-1 I© YES ❑ NO NEAREST /0 ✓J ZZ >ZS SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: / DIAMETER: MATERIAL AND MARKING: or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN q the soil is dry enough to continue.) CONVENTI WIDTH: LENGTH: N0. O IPE SPACING: COVER INSIDE DIA.: # PITS: DEPTID B BENCH TRENCHES: MATERIAL: PIT ENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR. N PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV. INLET: ELEV. END: PIPES: FEET FRO LINE: AIR INLET: NEAREST MOUND SYSTEM: Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ❑ YES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ES ❑ NO Q~fES 111 NO DEPTH OVER T46NGH/BED DEPTH OVER ZRENft/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ~D ❑ YES [P-~:-- L~1`E3` ❑ NO E~YE$ ❑ NO PRESSURIZED DISTRIBUTION SYSTE ' 1`-< / JG ~a 3 WIDTH: LENGTH: NO. OF - LATERAL SPAqWI$: GRAVE DEPTH BELOW P E. FILL DEPTH ABOVE COVER: BED/TRENCH TRENCHES: / l1(/ / / e, / Q re DIMENSIONS [j cP MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEVATION AND ELEV.: / ELEV.: ` DIA.: ELEV.:.,O PIPES: DIA.: . r 169 DISTRIBUTION HOLE SIZE:/ HOLE SPACIN DRILLED CORRECTLY: A COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION t 11 f1 APPROVED PLANS D YES 2 NO "7 c,~ D YES 8180 PERMANENT MARKERS: OBSERVATION WELLS: fNUMBER OF PROPERTY WELL: BUILDING: COMMENTS: T FROM LINE: / ES ❑ NO YES ❑ :7~ REST-► - 70 3~ 1_4 C1111 A A ~f.T~. -'ice 6-i~ 7f~~. , io ¢o(~ccr-/o/S~- JAI /)7- .,O Re;?in county file for audit. Sketch System on Reverse Side. SIGNATU TITLE: Zoning Administrator SBD-6710 (R. 06/88) t DILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY , STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ 8% x 11 inches in size. ec 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. q - PROPERTY OWNER PROPERTY LOCATION _e Y" 1-7 % S TZ , N, R IN (or) W PROPERTY OWNER'S MA LING ADDRESS LOT # BLOCK # ,,`f~C ~ i~ .5-Ori Al CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER II. TYPE OF BUILDING: (Check one) El State Owned 0 VILLAGE : NEAREST ROAD /,v/O r' S'MQ n ❑ Public [2,311 or 2 Fam. Dwelling-# of bedrooms Z PARCEL TAX NUMBER(S) III. BUILDING USE: (if building type is public, check all that apply) 1 ❑ Apt/Condo 2 ❑ Assembly llall 60 Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 40 Church/School 8 ❑ Mobile Home Park 120 Service Station/Car Wash 50 Hotel/Motel 9 ❑ Off ice/Factory 130 Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1.,~ New 2. El Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. El 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 120 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 SFeet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name oncret Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank loco 10 C7D e , S Lift Pump Tank/Si hon Chamber clo 00 VIII. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) MP/MPRSW No.: Business Phone Number: Y2 1 e7 It.- En Z Plumber's Address (Street, City, State, Zip Code): 0 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved 15 itary Permit Fee (includes Groundwater Date Issued issuing gent Signature No a Surcharge Fee) / Approved ❑ Owner Given Initial Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber ti INSTRUCTIONS r 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. 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. Ill. 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 forth; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Pict 410 included the creation of surcharges for (fees) 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) a s APPLICATION FOR SANITARY PERMIT TC-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. w - Owner of property 4%.i / y r Location of property S] 1/9 1/4, Section , T Z N-RW Township Mailing address l' 7 ~.:~,eSn,~J Address of site Subdivision name Lot number A Previous owner of property Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house)? Yes No Volume ~'9X and Page Number 7 as recorded with the Register of Deeds. ---------s--------------------------------------------------------------------- INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER, and the SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays or 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. f0592 ; 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 recorided in the Office of the 9jounty Register of Deeds, as Document No. j I It J gnature of Owner Signature of Co-Owner (If Applicable) bate of Signature Date of Signature f 5 4 YOl COMO" &W wa►ratttb to Ztvr-j; ~ np er , pETW1N TO the following described 1`481 estate in Si - CJn f x County. State of Wisconsin: j Tax Pare! .sec, S T~dw K ISw' SE Su/ s d /~iT .STET r A0 3.3 •CX~o i9c~-es , } R -This 15 ma t homestead property. (is) (is not) Exception to. Warranties: E Dated day of (SEAL) ~3 - OkKeY` (SEAL) ( AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN St. Croix County.. aud+enticsted this day of 19 Personally came before me April g 9f i - - Rak)rwnd J;. ;Baker ' TtTLE: MEMBER STATE 8AA Of WISCONSIN 'a 'At not ` authorized tome known to be the perlon .y S 706.06. Wis. State. for Instrument a d 5 y T STRUMfNT T aHaEitltfl~p~iorY„~{ EYt k a+. a . S \ 7r~r.~,F`` .1`t IMP H H - a S T C- 105 r" r a SEPTIC TANK MAINTENANCE AGREEMENT rH-+ St. Croix County z c7 a OWNER/BUYER X V Lam` n V_ ROUTE/BOX NUMBER ZSX Fire Number CITY/STATE _ 12 ZIP PROPERTY LOCATION: SLr 1, z, Section -r T2," N, R-/-5' W, Town of C?y St. Croix County, Subdivision Lot number /GI 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 affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their 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 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 to maintain._the.private sewage disposal system in accordance with x the standards set forth, herein, as set by the Wisconsin Depart- a 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 / 'p26 -9/ St. Croix County Zoning Office P.O. Box, 98- Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign,.date and return to above address. D6AVTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY,, cc DIVISION BOX HUMAN RELATIONS PERCOLATION TESTS (11J) MADISON WI 53707 (1-163.090) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/MU ICIPALITY: LOT NO.: BLK. N SUBDIVISION N ME: 'r Y4 0/4 5 IT201111514 C-0 COUNTY: OWNER'S BUYER'S NAME: M ILING ADDRESS: USE DATES OBS RVATIONS MADE NO. BEDRMS.: CPROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence ONew ❑Replace RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: IMOUND: ~`IN-GROUND-PRESSURE: S STEAM-IN-FILLHOLDI~N`G TA'NfK: RECOMMEND.EDD S`YSTEM:(optio al) ~S RU rV J ~U [:]S [2u EIS U EIS Y 1 If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: /f IFloodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH Md. ELEVATION OBSERVED EST. HIGH-EST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) i-n~f ~-7 s "/-Ln r~s; -3Y2Lff~r~s`• •~7 B- ~ 3176 W49 3.76 •l 7W%,"1 •~7 ei 57,'1 ° ,2,y~ LPL s - B- B- B- rf PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER M4Q-GF. AFTERSWELLING INTERVAL-MIN. PERIOD1 PERIOD2 PERIOD PERINCH P_ t 10 / 2~ r z 1- P- .Z O P 10 3 " 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 i + . " j ' I : i t i 3 ~ I ~ ~ I I t N _L I 6 i 1 t I E t ! ~ f 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 (print : TESTS WERE COMPLETED ON: ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(option 1): CST SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - L i + Ou3ne r .C,s/q So K e r az 2 ll57 S,'rrl~so✓1 ora 4Z 30 Rose /le, lrh. 5'5'//3 - 4 ~e P,-oPosco~ B.M. > 30 ~o /Y?auh d ~lQ I3ercA more iS 7oP o P' )C 93,5 ~ $3 P, o /Az PVC P, e, a~ P THE Ap_C4, 25 Ft. BE"W TOE Dewwuotl TOE. of -THE MOOWL2 L ~ MAST i~E1,r~AiN l~tilU~S'~UQP~E-p. B' M . /00.0 L3 / - 9960' B2 - 99.68 i. 13 3 - DF, Q ; Deoote-5 f3enCA 17'?arK Dcoofe's Bore o _ De»o/eS P61v-c flee p~ S 3 Fo.ce /Y~CI,✓1 8 9 Site P. C. /000 S ~ y S~~ Se pt; c. ° , ~ z0 1. ~ 8 N R I tJ zo p Noose tc,~/l J 33,1cre f a~ce~ zz~ l~a.~ h~~~o _ 0" Sc o /,e 1-'?P 66 Z-? cs7' 34/3 50 eve . i Page Of Straw, Marsh Hay, Or Synthetic Covering c/ Distribution Pipe Medium Sond Topsoil - . ~ _ c SITE SEWA E Y a E D ON bed Of Z~- 2 %Z Foe c,o Moin Plowed RELA wag.ate Front? Pump Layer APF F IRDOS►Ry. LABOR GS Ot PARTME VIst D NCE Cross Section Of A Mound System using E SEE CoRRE F o 7s A Bed For The Absorption Area G /•f7 A l Ft. H Signed.✓ Ft. License Number: J' %/,0 I 1291 ; d Ft Date ,2 Ft. K "e2- _ Ft'. Alternate Position L mss'-Ft.. of Force Main W`r oG Ft'.. L ObSefy0tl0n Plpe-,.~ T B K W ~Q --T----- . Force Main - From P u m p Distribution Bed 0f % - 2 a z Pipe Aggregvte' Observation Pipe Permanent Mprkers , Plan View Qf Mound Using A Bed For The Absorpti4P area 5 1 J 4. i t I N I M 1 , t F1 t r r,~,'1 „ I. 4 r/P 11tt 11AI Of !r+ Ir ~ tk 111 - tilt: perforated Pipe Detoil J f4 r En Mew t " ~ Per(oroted. ; Enq Gop M PVc P,i be ~~L , . ' y / NP14s1 ~l~IFQ}ed ~pn BRitprn. {j.F , r t ~ ~ tl~r - x qr} ~;~y~atly $paC~d'7 , y I. it •I n ( lIIK~ - PVC'Forc4 Molrn FJrI} y e r ~ 1 ri t I , PVC ► i{YS" ~ynifold Pipe z E`t } J ~0{sirtpu(lon ` ,R All [naPQ611Ion Pipe Forp~ IriQthf r, Nast Fq 'np Cqp , v IJ c Eri~ Cpp D{,crrib yfion.Plge;I;oyQU1. t t>~ `~,I . P , per R TII, :X, 3 77 H91eimt~r Inch ne Numb~r~ Sara Inch(es) I'1 tfi ONSITE a►~ifQ ;,h finches 4 ~.hes ' r. # oP holS33~Ripe F ROV r yt1 n U AP " 4 N'RELATIONS, 4R AN x (~1iP RT ~F. g1 RY, .A13 ANT INGS': f . PAGE OF. lit ' PUMP CHAMBER CROSS SECTION AKID SPECIFICATIOMS' - VENT CAP ~ - Il~~/ 4" C.I. VENT PIPC jl WEATHER PROOF APPROVED LOCKING JUAJCTIOIJ BOX MANHOLE COVER 25' FROM DOOR. " WINDOW OR FRESH 12 Mlu. Alit INTAKE I GRADE I , 'iI `1 MIIJ. COWDUIT--"-- ~T~SE~dA PKOVIOL I _-_-_--t IA1l_C T ON5 / , iKTIGHI SEAL . ~ ~ • • pq,APPROVED JOIMT A co I I APPROVED JOINT W/C.I. PIPE R~~~►ONS I I (I W/C.L'jPIPE ExT[NQlub 3' N~ NU N,` I ~I ALARM EXTEIJfING 3' ONTO 50L10 SOIL B INOUS~RY. 080" A ,~,5 ^ i i I ONTO 34LID r.011 p. p,RTMENpN I I oN~.. ND'~NCE ~ I ~I~ LLEV. Ft SEA ~ PUMP-~ OFF 0 CONCRETE BLOCK ~ R15ER EXIT PERMITTED GIJLy IF TANK MAKIWACTURCR HAS SUCH APPROVAL '3" APPRa l igEp01NE SEPTIC f )PFC-IFICATiOP.IS - -1------- DOSE TANK MANUFACTURER: !NUMBER OF DOSES: PER DAB TANK LIZE: Z(20 GALLONS DOSE VOLUME ALARM MAUUFACTURER: ScJ /G~r°r "rl> INCLUDING BACKFLO". C1►lLONS MODEL WUMBCR: CAPACITIES: AINCHES OR3~~'~T .,I f(~lLOAIs SWITCH TyPC: ~E'✓'C:C./y''~z B z INCHES OK-3Z/10Y 4" LLOAIS PUMP MAMUFACTURCR: ('OLI/- C= I N C H E 5 0R1 ~ ZCJ1LL0AJ5 MODEL NUMBER: 122 U J D INCHES OR?..2f' Y qIll, ALLON6 SWITCH TYPE: DOTE: PUMP AND ALARM ARE TO BE ~'l MINIMUM DISCHARGE RATE GPI INSTALLED ON SEPARATE CIRCUITS VORTICAL DIFFERENCE 15ETWEEW PUMP-64Au O'15" 010►JINK- ~ FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . 2.5 FEET + 25d FEET OF FORCE MAIN X •gI F uotT.FKICTION FACTOR.. ZU FEET j TOTAL OtIMAMIC HLAD = FEET IMTERLIAL. DIMLWSIOW~ OF TANK: LE-KIGTH 7 ;WIDTH 7_.,;LIQUID DEPTH l T 5IGh1E0: loa t GGI':a8~ L ICEIJSE IUMOER: ell DATE. Y Performance SEffluent Curves Pumps S2. -'40 METERS FEET s ; 90 MODEL 3885 25SIZE 3/4' Solids WE 15H W 70 _ 20- WE10H 6Q t' WEOTH a 15 50 y WE05H 40 10 30 WE03M WE03L 20 5 10 0 0 i4-H 0 10 20 30 40 '50 60 70 80 90 100 110 120 GPM; L I I 1 0 10 20 30 m3/h'? CAPACITY [qGOULDS PUMPS.INC. SD• FALLS NEW NM 13148 METERS FEET 120 MODEL 3885 r 35 SIZE 3/4" Solids 110 WE15HH ii 30 100 90 25• 80 g 70 Z 20 J Fa . 60 O Y ; 50 WEOSHH 15 40 ~ 1 s-cr• 10 30 . 20 10 t _ a , are; Ck': 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM a J a t 1 1 1 ' 0 10 r, 20 30 m3/h CAPACITY 01985 Goulds Pumps. Inc. Effective July. 1985 REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS DEPARTMENT OF DIVISION INDUS Y, ' P.O. BOX 7969 LABOR AND . PERCOLATION TESTS (115) MADISON, WI 53707 HUMAN RELATIONS (H63.09(1) & Chapter 145.045) LOCAT4 TOWNSHIP/MU ICIPALITY: OT NO.:BLK.`O: SUBDIVISION NAME: ON 4 s " '/S / /T28,0151 co COUNTY: OWNE BU ER'S NAME: M ILIN ADDRESS: 9 5' C , lens t;' Z~i~rl Sirl SoYI Tl oSr_ e USE DATES OBSERVATIONS MADE NO.BEDRMS.: r OMM R PTIO : IPR NS: A TS: Residence ONew ❑Replace RATING: S- Site suitable for system U- Site unsuitable.for system ONVENTI NAL: MOUND: IN-GROUND•PRESSUR.: S TE -FILL OLDING TANK: RECOMMENDED SYSTEM:(optio al) Ds RU SEA EIS [2U as u as u r If Percolation Tests are NOT required DESIGN RATE: if any portion of the tested area is in the under s.H63.09(5) (b), indicate: N Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH K ELEVATION OBSERVED ES I HE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) r i i B- f 5-~71o q9•~ lv~ir~of3'S °e7 nI ns:/.3, `i'7 CT6'n5 • -~7 z% S_ B• 7j 3f >2,7Z , •G / 7O 2' / Z"& R,- ' B- 13,93 CIS-/// ~{7 >3-?S 75 1315,'1, r B- B- PERCOLATION TESTS T DEPTH. WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER lAICWrrv AFTERSWELLING INTERVAL-MIN. PERIOD I PERIOD 7 PER INCH Z Z- P. /'S' t'. 10 z -2 P. 7- 1 Z • P~ f ) 3 3 -s S• P_ n 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 /oz -WSJ _ _ k ST. CROIX COUNTY WISCONSIN r~ F ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 _ (715) 386-4680 Mar. 13, 1991 Jerry Swim Division of Safety and Building AMENDED Bureau of Plumbing for State No. S91-40057 P.O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation of the Lester Baker property, located at the SE 1/4 of the SW 1/4 of Section 5, T28N-Rl5W, Town of Cady, St. Croix County, revealed suitable soils at a depth of 28 inches below which seasonable high ground water was noted, requiring 12 inches of sand fill beneath the system. This site should be suitable for a mound. Should you have any questions, please feel free to contact this office. Sincerely, James K. Thomp Assistant Zoning Administrator cj a ST. CROIX COUNTY 1 -VWISCONSIN 1 r _ j} ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET HUDSON, WI 54016 x.. (715) 386-4680 Mar. 4, 1991 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the Lester Baker property, located at the SE 1/4 of the SW 1/4 of Section 5, T28N-R15W, Town of Eau Galle, St. Croix county, revealed suitable soils at a depth of 28 inches below which seasonable high ground water was noted, requiring 12 inches of sand fill beneath the system. This site should be suitable for a mound. Should you have any questions, please feel free to contact this office. Sinc'grely, mes K. Thompson Assistant Zoning Administrator cj