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HomeMy WebLinkAbout038-1115-70-110 o p °q a y 0 h O O ~ O N (D o" m N ~ y ~C I ~ I I > I 3 m ~ I 0 z° LL O N 3 o Q rn a I 0 0000 E Z Z o z m I Q, w a m N~-z I c I 0 o z c in 1Z c z c 7 Cl) N O 7 m I cn ~ c •IV d g 0 (D z 0 z co z N 00 't I E N N Lo H ~ Y ° CL ° Y d c N_ Q, L c O CD a 13 CL -0 c a O Z N> 3 3 3 U o z •►V a a a N IL in > N J V 0) rn ~i N rn rn E L o 0 d co C N TFOL zQ o I O co 0N y " C 0 't LO O o n H Y _ a rn o l r n~ ti ~ c rn o v -O N C CL E ai v rn rn 0-0 • M 0) w N v O c O U O N fn 2 O Z Z m to ftS m da 3 ~ IL • as a d O) r`~i E c c _1 A 0(L2 1 0U)u Form- S T C - 104 AS BUILT SANITARY SYSTEM REPORT T ~N-R_W OWNER TOWNSHIP SEC.,-- ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT_ LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I•LHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM I I i I 1~u~E W r ,y, I DICAT NO~TH ARROW BENCHMARK: Describe the vertical reference point used 7~~ Elevation of vertical reference point: 1(jrj Q J Proposed slope at site: .2 101all SEPTIC TANK: Manufacturer: S Liquid Capacity: /~QQ Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front,Q Side , Rear, O 1D feet i From nearest property line ° Front,OSide,ORear,~ feet Number of feet from: well, building:. / (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE ~ R PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer:. Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear, 0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: X Trench: Width: /111) Length: `1Q Number of Lines:- Area Built Fill depth to top of pipe: /J s Number of feet from nearest property line: Front, O Side, Rear,O Vt.-io_ Number of feet from well: Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK i Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, 0Ft. Number of feet from well: Number of feet from building: from neares-t __rpad : Alarm Manufacturer: Inspector: Dated: Plumber on Job• License Number: 3/84:mj .Sag WisconsirrDepartment ofIndustry, PRIVATE SEWAGE SYSTEM County: Labor an4+,NumanRelations INSPECTION REPORT St. Croix Safety and Buildings Division (ATTACH TO PERMIT) Lot 2 Sanitary Permit No.: GENERAL INFORMATION NE'- NW'- Sec. 29,T31 -R18 Nighthawk Dr. 149184 Permit Holder's Name: ❑ City ❑ Village [k Town of: State Plan ID No.: Mike Hartman Star Prairie CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 00,0 S GST SC 4 1)4781-10-2107500 TANK INFORMATION ELEVATION DATA Q'/ 0 7 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic /dD O Benchmark SL 10 5-,q( 160,o Dosing Aeration J Bldg. Sewer Holding St/ Ht Inlet 1,70 99, a TANK SETBACK INFORMATION St/ Ht Outlet 7 50 9 TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic NA Dt Bottom Dosing NA Header / Man. 1,75 97, - / Aeration NA Dist. Pipe 7. 9 1 9 -7, Sy Holding Bot. System , a- PUMP / SIPHON INFORMATION Final Grade y 76 Manufacturer Demand Model Number GPM Friction System TDH Ft TDH Lift Loss Head I Forcemain Length Dia. Dist. To well SOIL ABSORPTION SYSTEM BED/TRENCH Wi Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS dthoff- -70 DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE /STREAM LEACHING manufacturer: SETBACK INFORMATION Type O l7VCV/ Moe Number: System: 38 .410 CHAMBER 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 o ' Bed /Trench Edges Topsoil ❑ Yes No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Plan revision required? ❑ Yes O/No Use other side for additional information. a SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ' r DILH SANITARY PERMIT APPLICATION - L-► R In accord with ILHR 83.05, Wis. Adm. Code couN STATE SANITARY /Qom` -Attach complete plans (to the county copy only) for the system, on paper not less than / ``~r~i}} C1 6 8% x 11 inches in size. ❑ Aeck f 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. PROPER ER PROPERTY LOCATION 'Y4 t/4,S T ,N,R E(or PR ER OWNER'S MA LING ADDRESS LOT # BLOCK # 2 CITY, STATE ZIP CO E PHONE NUMBER SUBDIVISION-NAMEE R GSM NUMBER C 7~_ (Check one) ❑ VLL NEAREST RD II. TYPE OF BUILDING: State Owned CITY ❑ Public R 1 or 2 Fam. Dwelling of bedrooms PA EL Nu B R( ) 111. BUILDING USE: (If building type is public, check all that 1 ❑ Apt/Condo / v 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 40 Church/School 80 Mobile Home Park 120 Service Station/Car Wash 50 Hotel/Motel 9 ❑ Office/Factory 130 Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. M New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5-E] 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 12E] 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/ q. ft.) (Min./Inch) ELEVATION / Feet 00.7 Feet VII. TANK CAPACITY Site INFORMATION in allons Total #of Manufacturer's Prefab. Fiber- Exper. New iin Gallons Tanks Name Concrete Con- Steel glass Plastic App- Tanks Tanks structed it Septic Tank or Holding Tank - S Lift Pump Tank/Si hon Chamber n n I FFF F1 VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installat n of the onsite sewage syst m shown on the attached plans. Plu be s Nam (Prin • N Plumber's S netur (No S4m!~) MP/MPRSW No.: Business Phone Number: &~2 S- yiS" g-.12s' P m ddress tree , City, State, Zip Code)'. IX COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent SignLie( Stamps) Surcharge Fee) Approved ❑ Owner Given Initial / G? / / Adverse D ermination d 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 ' k v I INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 4 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 Ibe 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, 608-266-3815. 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. 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 13% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 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. Owner of property Location of property_Aj~.:1/4 A~JZ_114, Section, T~N-R-yW Township Mailing address Address of site IJ Subdivision name Lot no. Other homes on property? yes No Previous owner of property a&-d~,pp Total size of parcel Date parcel was created ~y~97j Are all corners and lot lines identifiable? ~Y _Yes No Is this property being developed for (spec house)? Yes No Volume226 and Page Number /y/s- 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 the office of the County Register of Deeds as Document No.-~~c- , 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. , Signatur f applicant Co-applicant Date of Signature Date of Signature a ()(`CUMI NT NO WARRANTY DEED r « n ,~•.,wo 6sl,i: .s'. 3TATti: PAR OF WiSt'UN51N F(►1C41 -19x2 ACA12S ; rocILW REGISTER'S OFFICE „ ST. CROix CO., WI f Orville J. Rivard and Jeanette A. Rivard, Recd for Re-ord husband and wife, individually, and each in (~0V1 5 their own right , a/k/a _Jeannette A. Rivard ( 8:30;~ A A~ Michael J. Hartman and Q1 C'~^C ' Rebecca A. Hartman, husband and wife as ~O~M►ai0r~ marital survivorship property Huah H. Owin 430 Second St. - Fi.icison, WI 54016 Vie fo!1o%,ng de<cr:bed real e-oate in St. Croix <urto . - w1s.,onsin New T-;x ' ,r-e! 038-1115-70-110 r - Part of the NE's of the '.14k., and hart of the NW of the NF.'-. of Section 29, Townshir) 31 `'orth, Rance 18 West, St. Croix County, Wisconsin descri'>ed as `-)llows: Lot 2 of a Certified " Survey Mao dated July 3, 1900 and filet? Jul%, 26, 11990 in Vol. 8 of Certified Sur-ev Mars, at Pace 2248, As Document !cumber 460815. ;A is not r 13tr, - ertrbc'_ 90 Orvi' le Rivar.' r Jeanette A. Pivard a.~ A t' T It i .'0 ^ i' T. 0 N nr .•i Ile T ni` r' . Jeanette A. Vivard , Ir ;innr t t, ;1. t iii dry?. bf • r 1 nr , Atty. Hunh H. twin, r' l 1 t r i 4 3'1 cocnnr? St. -ire N l',i AYtf D.1RU ~A t•Y K't'+r'(`V -'.V a . SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER ADDRESS: FIRE NO: LOCATION: 1/4, A/,A)_1/4, SEC. TOWN OF: ST. CROIX COUNTY ~C SUBDIVISION: LOT NO. Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system: St. Croix County residents may be eligible to receive a grant to help with the cost of the replacement of a failing system, which was in operation prior to July 1, 1978. St Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to the St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certification from will be sent approximately 30 days prior to three year expiration. I/WE, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification form must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: DATE : q' ~ y~ St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 t~~t~UEr`~a OC` FOIL 130idi,'GS MD T ..R 'rill 1` ! .i',', i) HU"JAN RrE(LATIONS MADISON, V Ixc +109 1H63.090) & Chapter 145.045) LOCAT ION SECTION: TOWNSHIP 'Y: LOT NO.: BLK. NO.: SUBDIVISION NAME: NE Nti~4 29 /T31 N~PL8xk (or) Star 'Prarie 2 n/a n/a COUNTY: OWNER'S 'S NAME: MAILING ADDRESS: St. Croix Orville & Jeanette Rivard 1980 Nighthawk Dr., Somerset, Wi. 54025 USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMM R AL DESCRIPTION: PROF TONS: ATION TESTS: Residence 3 nab CJew DReplace I 7_17_90 7_17_90 RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) IaS DU ®S DU LAS DU D S HU D S RU I conventional 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/a ( Floodplain, indicate Floodplain elevation: n/a decimal' PROFILE DESCRIPTIONS page 19 BrB BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEMI-MM. OBSERVED EST. HIGHES TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B-1 7.58 100.55 none >7.58 1.08bl.1. 1.17bn.sil. 5.33bn.c.s.&gr. B 2 7.17 100.50 none >7.17 1.17bl.1. .75bn.sil. 5.25bn.c.s.&gr. B 3 6.92 100.77 none >6.92 .92bl.1. 1.00bn.sil;. 5.00bn.c..s.&gr. 4 7.25 100.30 none >7.25 .92bl.1. .75bn.sil. 5.58bn.c.s.&gr. B-5 16.83 100.70 none >6.83 .75bl.1. 1.08bn.sil. 5.00bn.c.s.&gr. - J - decimal' PERCOLATION TESTS 1 LS1 DEP I H WA I ER IN HOLE TEST T IME DROP IN WAT ER LEVEL INCITES RAZ E ~1IN111 F NU'1BER KK9CIK AFTERSWELLING INTERVAL-MIN. PERIOD_t__ PERIOD2 FTZS_ PER INC11__ P.1 3.45_ none 3 -6 3 p -3.85 none----- - - 13-~ 3. none - - - -Z3-- i P _ _ ' PLOT I'L,,% Ir,,-a;ions of n^rcC:at{nn t~~st~, t:,mincs 2^-i +he iinxr c~~,ns of suitable soil areas. Indicate wake or I-srr,t r'n,,^linn rE'Irrr•nce ~.~!^is and sh;.w In-?!i^.n nn th~• I,Irtt plan. Show the surface elevation a' 21~ !,„ir,~c. and the ci.. . r. "c ! ~_i:i [_LEVA i ION 96.85 IC [ r✓'11~'.t~~2 S. e• c .-t ~l C~ . , 3 tT / 1 t -3' iYz ~,1r i . ~ t „5 .prm R.a'1c h,' ~.r.- : _ ,.,.:..nth t~P , , I'. t`.2, t^ S',il teStS re, ^+ted on 1 ~ - - . C-.;,? ! t`3t the data recorded and the tocat.nn of the tests are correct to the b'st of m•; l no.Ylr:+, ~n h i ~1 ' ~TESTS':ERS Ctr"F%L E'FI) C'. r L Stee1_ 7-17-9~ 1 I i t"❑Fl: 1 1 ;}T Ave., 1~ew RTchn->nd, Wi. 5401 / I nT~~l(Ttll _ 1 c-~4~' i i ./9 ,5~,,~✓,~ XIS Sr s,~~~, O ~I 'C. ~~G/a95iZ j f JUf tfd' 6z` t jB9 ~ /l lot a~J E A0 ti PAGE OF CrUSS J ~C~1 Vll Q T /q Vicl~ ~~S IC!4n frdNl Ali Inlal• And OOtdrvallon Pipe i~~Appsovid Volts Cap "Wmunt 12' Above final Clods 20• 42' Above Plpp 4' Coal Iron To find Glad• Venl Pipe uo.ln flat Of Srnlnalk Co•adlna Mug 2' Aypeapale O•w Plpa OIaulCullon . Pips 0 0 0 Tad = Agplapala Banealn Pipe ° Parlaaled Pipe baler o ~Coypllnll Twallnellne AS Gallant 01 Sfliaal P/`u ~o c D 1 ~r,%cl< f1©~ - c1~ L 'l(la- / •T-I'L o j ion SOIL FILL DISTRIBUTIOI.I PIPE APPROVED S4)JTRETIC COVCR - °~'/IATl:R11~t- OF, 9" OF STRAW 2"OFhGGRE6Ali E-~ ORtjARsw HAy F L"OP~rZ-2l/2 AGGRCGATE, LEY. O !~FEET-r ' r DIST1115UTIOIJ PIPE -TO BE AT LEAST _ INCHES BELOW ORIGINAL GRADE A►JU AT LEAST LO INCHES BUT LIO MORC THAN 42. ILICNES BELOW FINAL GRADE MAXIMUM DEPTH OF EXCAVATIOP FKOM OR16V AL (59ADF_ WILL BE INCHES MINIMUM OEPT"li OF EXCAVATION fAOM 0~16INAL CRAVE WILL BC INCHES SIGNCD: LIC C LJ SC LJUMBE 11: _ OATS: .-16f t t o _ NF~TM OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUDUSTRY, , DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX 76 N WI 3707 HUMAN RELATIONS (H63.090) & Chapter 145.045) LOCATION: SECTION: TOWNS H I PM6Q00MZ9=Y: LOT NO.:BLK. NO.: SUBDIVISION NAME: 'I NE 1/4 NA 29 /T31 N/Pd8xk (or) W Star Prarie 2 n/a n/a COUNTY: OWNER'S S NAME: MAILING ADDRESS: St. Croix Orville & Jeanette Rivard 11980 Nighthawk Dr., Somerset, Wi. 54025 USE DATES OBSERVATIONS MADE NO. BEDRMS,: 1COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: yMResidence 3 na/ Mdew ❑Replace I ]-17-90 7-17-90 RATING: S= Site suitable for system U= Site unsuitable for system ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: S STEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) ❑ s ❑U ®S ❑U S ❑U ❑ S ®U ❑ S ®U conventional If Percolation Tests are NOT requifT IGNRATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: n/a I Floodplain, indicate Floodplain elevation: n/a decimal' PROFILE DESCRIPTIONS page 19 BrB BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTHXX. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B-1 7.58 100.55 none >7.58 1.08bl.1. 1.17bn.sil. 5.33bn.c.s.&gr. B 2 7.17 100.50 none >7.17 1.17bl.1. .75bn.sil. 5.25bn.c.s.&gr. B 3 6.92 100.77 none >6.92 .92bl.1. 1.OObn.sil' 5.00bn.c..s.&gr. 4 7.25 100.30 none >7.25 .92bl.1. .75bn.sil. 5.58bn.c.s.&gr. B- B-5 6.83 100.70 none >6.83 .75bl.1. 1.08bn.sil. 5.00bn.c.s.&gr. B- decimal' PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER ) AFTERSWELLING INTERVAL-MIN. PERIOD I PERIOD 2 P R PER INCH P_ 1 3.45 none 3 6 <3 P none P_ none 3 6 6 6 <3 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 96.85 Y , x ~ j 3 ~ I 6 t 3 ~Z n 1= f r I E E l~ ILI i , E , 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: Gary L. Steel 7-17-90 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): 1554 200th. Ave., New Richmond, Wi. 54017 2298,1 715-246-6200 CST SIGN RE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - INSTRUCTIONS FOR COMPLETING FORM 115 - SD - 6395 To be a mplete and accurate soil test, your report must include: 1. Co -.1 description; 2. n must Ilea ' whether is is a residence or cornm r project, tuber of k C, mmerr planned; placai d. suiabilit:y A SITE I ° ITBLE FOR A HOLDING TANK ONLY IF ALL OTHE -S Ar C +.1T BASED f ONDITIONS; 6. P' ' i i here for wri ~,le descriptions and completing the plot plan; 'y Iocatinr t locations. [ ig to scale is pre" ~d. A ovation i point are cdc y rt, vnt; 9. -s, names, flood pla 3~- 10, s flood p-oi, elevation) n_ )ply, plr,,., a~;~,t~r,tr t irux; 91. our current address and yr fication M. I ;tribute as required. IL TES _-'E FILED VVITH THE )CAL A- .;f t, 1 ITHIN 30 DAYS OF COW 'N. ~JIATIONS FOR CERTIFIED SOIL 6 !-EFTS T Other Syr ~tds L 10") F I,+ ~dr (3 - 10"; a - Sand qr ,.S F~ 'i .s '.indwatei Cs - 1.9 Rage med s id fs ld Is - I Sand - C''' er Man sl - Loam - L `;s -1 Bn - Br(, `sil B1 Black St - C1y - GI.;r cl- Y SCI Learn R - Sic) - Loam plot SC W~ sic - = fff fi fit C rc -c pt - rnm n~ - d - distil p - {?r otaI MAIL F gh >vel, r Six r^n's '"'(lures Sul aer for Iii .11 i T aosal B m B t. VRP - 0! I nce Porn Y 2~ /lELG2L1/ C\j ILF-D JUL 2 619900- JAMES n-rnvNELL _ pegisxl of L ce-s 46®8 ,5 SL Croix Co.,WI CERTIFIED SURVEY MAP ' ( LOCATED IN PART OF THE NEI OF THE NW} AND IN PART OF THE NW} OF THE NEJ ALL IN SECTION 29; T33N, RIOW., TOWN OF STAR PRAIRIE , ST. CROIX COUNTY, WISCONSIN. OWNERS LEGEND Orville E Jeanette Rivard St. Croix County Section Corner Monument - Al,uminum Cap-se t 1980 Nighthawk Drive ® in concrete found. Somerset, Wi. 54025 1 • 211 iron pipe found. ` {,I - Denotes drainage course. , • 111 iron pipe found. 10- NW corner {v! 0 1" x 24" iron pipe weighing 1.68 LBS per linear foot set. Sec. 29-31-18 ` ` N} corner 66 ` north l unplatted-lands 810.08' Sec. 29-31-18,-. ) I line of the NW D N89014159" 799.241 A 1842.361 i PRIVATE zo C B; < F ~G ROAD 4- I I~ - I 1 Z m 221± I N N w T N8901415911W S w J 4 456.30' z I F n C) C N ~ `-J A ola ro a ' F I ° CD o 2 j r o -cn 1:r A' I; I rt tD fD t D ~ . I 17: I rt I CD - I IV 1,91 Q- z ~ U N8901415911W co 1 1 456.301 ! I m o~ 'r 1 L I ~a rr I m 221+ a v Ln rt ! v to s I rt un to I 610•• 119- r• I I~ .M 0 ~'I' I C I ° I s 1 O ~ 1 ~ I 1 rtI ro ~ O I ~ Z h ❑ k House []o 66' N ❑ Outbuildings LI± 681.58! P N8905411911E 914.73' Q - 211 iron pipe and-1 ~ I I unplatted-lands 111 iron pipe ; found. LINE BEARING DISTANCE LINE BEARING DISTANCE I A-B N8901415911W 10.84' north line of the NE'J N-0 N89054119"E 129.01' 1 A-C " 456.30' 0-P 11 104.14' B-C " 445.46' Q•-R N0004911511W 400.00' C-0 285.681 R-S It 238.75' C-E " 3.53.781 S-A 11 " D-E " 68.10' U-T It " G-F it, „ T-C n " E-F S1303013211E 50.001 recorded as S12°O1 0911E Si corner D-G " II It it n Sec. 29 F-H S2902212011E 126.721 recorded as S2715215711E SCALE IN FEET H-I S3701912111W 129.48' recorded as S3804814411W I„-J N8901415911W 78.501 neaorded as N8704513611W 200 200 J,-K S0400412011W 176.44' K-L S6405111511E 190..141 A1 k S70°35!25"W 226_,_51' L -M L-U. N82050`' 2211E. 286.40' .2 L <.."1 1 M-N S.0..8°381 3211E 222,.88 f;..y 7f~rO I v A-E N89°14' 5911W 810.081 '.,`1,y~,`~LIEt?1). ~;:..I,~!•,1~,, SU~l, 14. VOLUME 8 PAGE 2248 ~.,yrv.r-at'r ~+{,K five -44 ST. CROIX COUNTY WISCONSIN - ZONING OFFICE M e a " _ _ ~ ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 _ (715) 386-4680 March 16, 1994 Mr. Dave Bracht 7 I _ j b RE/MAX TEAM 1 REALTY ~T 103 Main Street Somerset, Wisconsin 54025 ~j RE: Water Inspection for Mike Hartman Address: 1988 Nighthawk Drive, Somerset, Wisconsin Dear Mr. Bracht: Enclosed is the original test results from Commercial Testing Laboratory, Inc. for water inspection of the above property. If you have any questions with regard to said report, please let me know. Si rely, James K. Thompson Assistant Zoning Administrator mz Enclosure COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715-962-3121 800 - 962 - 5227 FAX - 715 - 962 - 4030 G ST. CROIX COUNTY ZONING OFFICE REPORT NO.S 58472/01 PAGE i. ST.CROIX CTY GOV.CTR REPORT DATE: 3/11/94 1101 CARMTCHAEL ROAD DATE RECEIVEDS 3/09/94 HUM, WI 54016 ATTNS THOMAS Co NELSON j OWNERS Mike Hartman 1 I LOCATIONS 1988 Night Hawk Dr., Somerset COLLECTOR. Jim Thompson ` DATE COLLECTED' 3-08-94 TIME COLLECTED' 12S15poi SOURCE OF SAMPLES Kitchen faucet DATE ANALYZEDS3-09-94 TIME ANALYZEDS21#00pm COLIFORM,MFCC4 0 /100 ml INTERPRETAIIONt Bacteriologically SAFE NITRATE--NS 4 1 ppm ~i Above 10 ppm exceeds the recommended Public Drinking Water Standard. Coliform Bacteria/100 mt Nitrate-Nitrogen, mg/L C,; { y+ co SCpU TY LAB TECHNICIANS Pam Gaye ZONINGOWCE It\ ~.WDEVINOpNr, I.~ WI Approved Lab No. 19 9 A Q Means "LESS THAN" Detectable Levet Approved by'. y PROFESSIONAL LABORATORY SERVICES SINCE 1952 ST. CROIX COUNTY PW "m rle WISCONSIN Z - _ ~ ZONING OFFICE p 9 li ll" s to w r~mitd ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road - Hudson, WI 54016-7710 (715) 386-4680 March 8, 1994 Mr. Dave Bracht RE/MAX TEAM 1 REALTY 103 Main Street Somerset, Wisconsin 54025 RE: Septic Inspection for Mike Hartman Address: 1988 Nighthawk Drive, Somerset, WI Dear Mr. Bracht: An inspection of the septic system on the property of Mike Hartman located at 1988 Nighthawk Drive, Somerset, Wisconsin, was conducted today, March 8, 1994. At the time of inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. Also at the same time, a water sample was taken. Once we receive the results, we will forward the same on to you. Should you have any questions, please contact this office. S' rely, I es K. Thompson Assistant Zoning Administrator mz D ST. CROIX CO Y WISCONSIN --=_`L ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 SEPTIC INSPECTION / WATER TEST REQUEST FORM v lease specify desired test(s) & remit appropriate fee with application. Outside water lines are often turned off during winter months, making access to the home necessary. Please make (U arrangements with this office to insure that entry can be gained. ❑ Water (VOC's) $185.00 ~9 Septic $50.00 Water (Nitrate & Bacteria) 45.00 ❑ Nitrate & Bacteria retest $15.00 Owner: M i kr_ dF}R M1i rV Requested by: yf4v,E i3KltckT _RgfmfI X Address: ~ 98F1 NI,"~l~T/~1~¢wK ~ fZ Address : Ia3,W,4i v s T- SOME2szT wz ZIPSS~oaS ,,wegsj=7T cc,,-z- ZIP-,5'Y,0-9-5 Telephone N4: (pis) ;(c/7 - 394 3 Telephone N4: (7/S) x417- 690a Property address (Fire N2 & Street) : PUP /Vi]2,4T-S4k1k QA Location:_ 1,, A1j41 Sec. A? , TAN, RAW, Town of Realty firm: P_C-jr .4< Lock Box Combo: t~PJE FV Closing Date: TO BE COMPLETED BY PROPERTY OWNER *PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORM* Water sample tap location: 1-44^4a!S /Zc-Vrn Is the dwelling currently occupied? Yes 0 No If vacant, date last occupied: Age of septic system: ~qq[ - Septic tank last pumped by: NEVFE0. 1?6. te :r Previous Owner's Name(s): A// Have any of the following been observed? ❑Y MN Slow drainage from house. ~ ❑Y NN Sewage Back-up into dwelling. ❑Y %N Sewage discharge to ground surface or. rrQad c~itc ❑Y J~N Foul odors. Other comments relative to system operation: N,4~w,Evt I certify that the above information is complet nd r e to the best of my knowledge. OWNERS S IGNATU DATE : Y 1/94 OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION 4 cT~ Ro G _ C e 3 L TO BE COMPLETED BY INSPECTION AGENCY System design &/or permit on file? Yes ❑No Soil series per SCS Soil Survey: sheet # Type of soil absorption system: []Below grd DAt-Grd OMound Approx. size X_'i' []Gravity ODose OPressurized Ft.2 []Bed []Trench []Dry Well OHolding Tank []Outfall pipe OBSERVED DEFICIENCIES OOther []Unknown Septic tank N~o 96' Setbacks: OHousez.7n Dwell ❑Prop. line []Other D e tank backs: OHouse Dwell ❑Prop. line OOther Locking cover ❑Warninglabel []Pump/Floats OAlarm []Elec. wiring Soil Absorption System Setbacks: OHouse( Dwell d__lC;'//_QProp. line C< []Other OPonding: ODis arge. d/iZ General comments: INSPECTORS SKETCH OF SYSTEM LOCATION Inspector Title