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Parcel 018-1000-20-110 01/05/2006 08:24 AM
PAGE 1 OF 1
Alt. Parcel 01.29.17.2A-10 018 - TOWN OF HAMMOND
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O - MORTON, THOMAS G & THERESA CHERI
THOMAS G & THERESA CHERI MORTON
1183 205TH ST
BALDWIN WI 54002
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 1183 205TH ST
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
Legal Description: Acres: 11.320 Plat: N/A-NOT AVAILABLE
SEC 1 T29N R17W PT NW1/4 NE1/4 LOT 1 CSM Block/Condo Bldg:
8/2241 11.32 AC & EXC NSP ROW
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
01-29N-17W NW NE
Notes: Parcel History:
Date Doc # Vol/Page Type
04/23/2004 760453 2555/281 QC
07/23/1997 972/10
07/23/1997 887/565
128215 149/477 WD
2005 SUMMARY Bill M Fair Market Value: Assessed with:
89938 209,700
Valuations: Last Changed: 07/13/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 26,000 138,700 164,700 NO
UNDEVELOPED G5 9.320 8,600 0 8,600 NO
I,
Totals for 2005: II
General Property 11.320 34,600 138,700 173,300
Woodland 0.000 0 0
Totals for 2004:
General Property 11.320 34,600 138,700 173,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M 111
j Specials:
User Special Code Category Amount
010-GARBAGE SPECIAL ASSESSMENT 60.00
Special Assessments Special Charges Delinquent Charges
Total 60.00 0.00 0.00
4605(;IL
CERTIFIED SURVEY MAP ~r
r.., f
LOCATED IN PART OF THE NWJ OF THE NE'4 OF SECTION 1, T29N, R17W,
TOWN OF HAMMOND ST. CROIX COUNTY, WISCONSIN.
LEGEND Fti;;z.'?)
St. Croix County section corner monument-aluminum cap in concrete JUL 17 1990b.
• 111 iron pipe found FS`O'CONNELL 3
va~ SL Croix t o`ds
O 1" x 2411 iron pipe weighing 1.68 LDS per linear foot, set. wt'' Q
OWNER
Richard Smith
Box 704
Baldwin, Wi. 54'N2 J:
NJ corner
section 1-29-17 unplatted-lands LINE DATA TABLE
a 40 S8905113311W 576.001 LINE BEARING DISTANCE
~
b '•c 549.94' a-b S0000913411E 49.521
T b-c N8905113311E 26.061
I c-d S0104515711E 175.971
493,088 sq. Ft.) d-e S0004113611W 546.061
11.32 acres )INCLUDING R/W a-f S0001711911E 178".101
0
o d f-g S8905113311W 23.271,
rt 469,256 5q. ft. )EXCLUDING R/W o
o I 10.77 acres ) o
IS I Io+
I ~ ~ Irt
111 I rn I rr
i n rl-• I = 1 N
LOT 1
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~ 1~ - I ❑ M j a Vrl'y ~.rp. x`21
f:•'. ',.~•w,
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existing house E hn out buildings lJ
~41) So :,I,
iisE,L~d:4tiil•~'•
1?✓,W~~~ nm~~ jJ~£(
G
661 ~o`oti
f 327.731 A b' 'f.;~~+~~; F.)
9 N89°51' 3311E 1s
351; 001 J Y ~J V 19(]
E unplatted lands •Cil. CROIX clOUNI Y
.~~lD ZOMNc:; CCIlvlnnl n+~ .
oe CQVI e I Bearings are referenced to the
r, north E south one-quarter line
assumed to bear S0000913411E.
SCALE IN FEET N
MM Mai
200 100 0 200
Sj corner
section 1-29-17
VOLUME 8 PAGE 2241
Parcel 018-1000-20-200 01/10/2008 10:48 AM
PAGE 1 OF 1
Alt. Parcel 01.29.17.2A-100 018 - TOWN OF HAMMOND
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
11/17/2006 00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O - AULT, KAREN S
KAREN S AULT
1965 15TH AVE NW
ST PAUL MN 55112
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 2050 117TH AVE
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
gal Description: Acres: 4.120 Plat: 5311-CSM 22-5311 018-06
EC 01 T29N R1 7W PT SW/NE & GOV LOTS 2., Block/Condo Bldg: LOT 01
3 & INC CSM VOL 2/445 FKA CSM 16/4328
LOT 1 24.342AC BEING CSM 22-5311 LOT 1 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
(4.12 AC) 01-29N-17W NW NE
~,A
Notes. Parcel History:
- t Date Doc # Vol/Page Type
11/22/2006 839345 WD
11/17/2006 838992 22/5311 CSM
04/23/2004 760451 2555/259 WD
04/23/2004 760450 2555/258 QC
more...
2007 SUMMARY Bill Fair Market Value: Assessed with:
223805 43,200
Valuations: Last Changed: 07/19/2007
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 4.120 32,400 0 32,400 NO 05
Totals for 2007:
General Property 4.120 32,400 0 32,400
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
U ~ 682988
VOL 16 PAGE 4328
AUG 14 2002
KATHLEEN H. WALSH
REGISTER OF DEEDS
ST. CROIX COUNTY ST. CROIX CO., WI
RECEIVED FOR RECORD
NOTE: THIS CERTIFIED SURVEY MAP WAS PREPARED TO CONSOLIDATE THOSE
PARCELS DEEDED TO MICHAEL BLUHM IN VOLUME 1164, PAGE 505 AND VOLUME 06-28-2002 3:00 PM
1683, PAGE 425. CERTIFIED SURVEY MAP
205th ST. REP FEE: 13.00
COPY FEE:
PAGES:
S00°17'31 "W 5268.50'
NORTH-SOUTH QUARTER LINE
S00°17'31 "W 549.50'
3767.48' 949.52' m z
00°09'46"W 516.26'(K)
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SHEET 1 OF 2 SHEETS °o o
Vol. 16 Page 4328
DEPARTMENT°OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING
LABOR & HUMAN RELATIONS DIVISION
P.6. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION
0 DIS1VtSQ~ 1N , ec . 1,-T29-R17 State Plan I.D. Number:
4 9 4
j y El CONVENTIONAL El ALTERATIVE (If assigned)
Town of Hammond
Twn. Rd. 205 ❑ Holding Tank ❑ In-Ground Pressure Mound
NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPEC~TI~ON IDA
Richard Smith Box 704,Baldwin, WI 3
BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: f p R . P V.~f SK REF. P EV.:.,
0 0
01
/0~/ .s rcD,d'
Name of Plumber: MPRSW No.: County: Sani ermit Number:
Wm. Schumaker MP/6382 St. CtOix 128843
SEPTIC TANK/ K:
MANUFACTURER: LIQUID CAPACITY: TANK IN ET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
❑ YES NO ❑ YES NO
14
BEDDING: VENT Dl kg VENT MATL.: HIGH WATER NU ER F ROAD: PROPERTY WELL: BUILDING. VENT T FRESH
t ALARM: FEET FROM LINE: AIR INL
❑ YES NO `J G E NO NEAREST ~10 > z
DOSING CHAMBER: J R T" ` r `I l
MANUFACTURER: BEDDING: LIQ ID CA PUMP MODEL: PUMP/SFpF16(fMANUFACTURE WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
.~Gvt2 ❑ YES 0 1 4_7 O Q E,~ ❑ NO C;l f j NO
GALLONS PER CYCLE: /J PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH
(DIFFERENCE BETWEEN / FEET FROM LINE: / , AIR INLET:
PUMP ON AND OFF ESE:] NO NEAREST }
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 Z~ z f "yt~_C(j
the soil is dry enough to continue.)
CONVENTIONAL SYSTEM:
WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: PITS: LIQUID
BED/TRENCH MATERIAL: PIT DEPTH:
DIMEN c
AVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR.11 NUM PROPERTY WELL: BUILDING: VENT TO FRESH
BELOW PIPES ABOVE COVER: ELEV. INLET ELEV. END: PIPES FEET FROM AIR INLET:
~ NEAREST~~
MOUND SYSTEM: f % font, 9? k = oc f il R~/~ 3 cc
Mound site pl wed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM
slope and f;2~0 own unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW
NO meets the criteria for medium sand. ELEVATIONS MEASURED.
SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS;
~2), ( 64_-Q '5 Ct.. M,*E9_E1 NO ZLY-E NO
DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED:
CENTER: EDGES: M of
❑YE ❑NO R;-) r❑NO
PRESSURIZED DISTRIBUTION SYSTE
BED/TRENCH WIDTH: t LENGTH: / O LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER:
DIMENSIONS RENCH S: 0 -0,
MAEENyIIFOLD PUMP MANI LD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION IPE MAT RIAL & MARKING:
ELEVATION AND . f ELEV~47 / DI ELE aid(/ ~ ~,L,-` A,yr PIPES: DIA.: ~ pk //T
DISTRIBUTION HO((LE IZEHOOOOOL'/E SPACING: DRILLED CORRE TLY: COVER MATERWIL: VERTICAL LIFT CORRE P DDSSTTpa,
C s /7
INFORMATION QPLANAo
yS~ 1/U liJ_1 S E NO / xG--- YES ❑ NO
PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING:
COMMENTS: FEET FROM LINE: f >
[9b El NO E] NO NEAREST A 7.
~ X71✓%c,c4.> .tae C~2~?~ v7 Q i~ G
a, it Ara ~~M
Sketch System on R Ain in county file for a dit.
Reverse Side. SIGNATU TITLE:
SBD-6710 (R. 06/88)
~ SANITARY PERMIT APPLICATION
OILHR In accord with ILHR 83.05, Wis. Adm. Code COUNTY
..,...a....,..,. .
.d
EZ
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than 1:1 evis; 8% X 11 inches in size. Chec if on to revious application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER Q~
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. Q - ~a S I
PROPERTY OWNER PROPERTY LOCATION
A2 le~
/"A 41A) '/4 '/a, S T.2,?, N, R E (or
Idle'd S" PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
0O
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
II. TYPE OF BUILDING: (Check one) 1:1 State Owned VILLLL.AGE : NEAREST ROAD
A-!1!/yl~~+OC- o
=N OF:
❑ Public 1 or 2 Fam. Dwelling-#of bedrooms PARCEL TAX NUMBER(S)
Ill. BUILDING USE: (If building type is public, check all that apply) O t 0 _ / o C? - e7A
1 ❑ Apt/Condo L
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 8 ❑ Mobile Home Park 120 Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1.'~New 2. ~ Replacement 3. ❑ Replacement of 4.0 Reconnection of 5.0 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 A Mound 30 El Specify Type 41 ❑ Holding Tank
12 El 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
L / REQUIRED (sq. ft.) PROPOSED (s q. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION
"7 Sd ` ~ , ~ ® '??r 7S Feet 01e$' Feet
VII. TANK CAPACITY Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION New isttn Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
Septic Tank or Holding Tank /G
Lift Pump Tank/Si hon Chamber
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system show on the attached plans.
Plumber's Name (Print):/ Plumber's Signature: (No Stamps) MPRSWQ~Noo..: 71Business Phone Number:
~f/ r /N t G' ~7 k I!► A/~L t'd/ ` f~ a a( /5- Y3 E15 -2/;Z/
Plumber's Address (Street, City, State, Zip Code):
IX. COUNTY/DEPARTMENT USE ONLY
sue ssung gent Signature (No Stamps)
e s
❑ Disapproved Sanitary Permit Fee (Includes Groundwater lil
Approved ❑ Owner Given Initial Surcharge Fee)
q5__
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
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 Saritary 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, 6108-266-3815.
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.
Il. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling.
III. Building use. It 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%z 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
I
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)
APPLICATION FOR SANITARY PERMIT
9TC-100
This applicatlon form In to be completed In full and Blgned by the owner(s) of
the property being developed. Any Inadequacies will only result In delays of
the pzrmIt Issuance. -Should this development be intended for resale by
owner/contractocf(spec house), then a second form should be retained and
completed when the property Is sold and submitted to this office vlth the
appropriate deed recording.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Oxn=r 'at property d S ~iZ /_N
Location of property ,&~'L-1/4 1/4e Section - / Ta0k1-R1? Y
Tovnshlp ayi maw.
Mailing address TYDU ~
Address of alto d, G✓e* 0-7-
Subdivision name
Lot numbec
Ptevious owner of property __%41211 Total size of parcel _ ~'D~ o~- ","-e X-
Date parcel was created _ >rf o Y
Are all cornets and lot lines Identifiable? o
Is this property being developed for resale tapec house)?- an 0
Volume O;and Page Humbsc /~2-?F an recorded with the Register of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWINCI
A WARRANTY DEED which Includes a DOCUMENT HUMBER, VOLUME AND PAGE NUMBER, and
the BYAL OF THE R8018TBR OF DEEDS. In addition, a certified survey, It
available, would be helpful so as to avoid delays of the reviewing process. It
the deed description references to a Csitllled Survey Hap, the Certified Survey
Hap shall also be required.
PROPERTY OWNER CERTIFICATION
I(ve) certify that all statements on this forth are true to the best of my (our)
Rnowledgel that I (we) am (ace) the owner(s) of the property described in
this Informatlon form, by virtue of a warranty deed recorded In the office of
the county Register of Deeds as Document No. _!!q-57 ey a+2 f and that I (We)
Presently own the proposed alto for the sewage disposal system (cc I (vol have
obtained an easement, to tun with the above described property, for the
construction of sold system, and the same has basin duly recotded In the office
e he C ynt Rogistec of Deeds, as Document No. 1.
(.J
a 9nature of ovnec Slgnatuto of Co-ovnec (11 Applicable)
Date of Ignatuce Data of Signature
J)
ft
SEPTIC TANK MAINTENANCE AGREEMENT C
St, Croix County
0
OWNER/BUYER
ROUTE/BOX NUMBER 'ozC 70 Fire Number :J
rt
CITY/STATE_ ey e* ZIP `t
_Section T= • R,17
PROPERTY LOCATION:
Town of c1a ; St. Croix County,
Subdivision , Lot number
and maintenance of your septic system could result in
Improper use
its premature failure to handle wastes.- Prover maintenance con-
sists of pumping out the septic tank every three years or sooner,
if needed, by a licensed' 's'e" t'ic tank pumper. What you put into
the system can a ect the unction of the-septic tank as a treat-
ment-stage in the waste disposal system.
St. Croix Count residents-may_ be el.igible to ofrecieve aggrantefor
a maximum of 607. of the cost.of rep]
whLC was in operation prior to-July 1, 1978. St. Croix County
this program in August of 1980, with the requirement
accepted that
owners of all new sys't'ems agree to keep their system properly
maintained.
Count
The ro erty owner agrees to submit to St. Croix Y Zoning a
I
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
t ation.
hree Year 'exPit y I/WE, the a agree o
undersigned have read the above requirements and
to maintain the private sewage disposal system in accordance with
the standards set forth, herein, as set by the Wisconsin Depart- •:r
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.-.
SIGNE1Y
DATE
St. Croix County Zoning Office
911 4th St.
Hudson, WI 54016
386-4680
Sign, date and return to the above address.
I
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, DIVISION
LABOR AND PERCOLATION TESTS (115) MADISP.O. BOX ON WI 7969
HUMAN RELATIONS
(ILHR 83.09(1) & Chapter 145)
LOCATION: SECTION: TOWNSHIP/per : LOT NO.:BLK. NO.: SUBDIVISION NAME:
1/4 NE 1/4 1 /T 29 N/R 17& or) W Hammond n/a n/a n/a
COUNTY: OWNER'S Qbtfgy=AME: MAILING ADDRESS:
St. Croix Richard R. Smith Box 704, Baldwin, Wi. 54002
USE ZS DATES OBSERVATIONS MADE
NO. BED 1COMMERCIAL DESCRIPTION: IPROFILE DESCRIPTIONS: 1PERCOLATION TESTS:
esidence 3 n/a ❑New GaReplace Il 8-28-90 8-29-90
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUNDPRESSURE: j 0
S STEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional)
S ®U [~],S ❑U ❑ S ®U S f]U [~S [U mound with variance
If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the n/a
under s. ILHR 83.09(5)(b), indicate: n/a Floodplain, indicate Floodplain elevation:
decimal' PROFILE DESCRIPTIONS page 54 AuA
BORING TOTA DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH ELEVATION OBSERVED EST. IGHE T TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B- 1 3.92 97.75 none 1.00 .67bl.1. .34bn.sil. .92bn.mot. sil. 1.99bn.mot. s
13- 2 4.00 97.75 none 1.08 .67b1.1. .42bn.sil. .92bn. mot. sil. 2.25bn.mot.s
e 3 3.50 96.83 none 1.00 .58bl.1. .42bn.sil. .50bn.mot. sil. 2.00bn.mot. S.
B-
B-
B-
decimal' PERCOLATION TESTS
TEST WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER AFTERSWELLING INTERVAL-MIN. PERIOD 1 RI D2 PERIOD PER INCH
P_ 1 2.00 none 30 z 2 60
P-2 2.00 none 30 5/8 9/16 9116 53
P-3 2.00 none 30 3/4 570) 518 48
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 99.75
3
_ w .
f N
A `)p
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:
Gary L. Steel 8-29-90
ADDRESS: CERTIFICATIOWNU BER: PHONE NUMBER (optional):
1554 200th. Ave., New Richmond, Wi. 54017 2298 715-2 -6200
CST SIGNAT
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 10/83) - OVER -
h laal s
- t~LITEO STATES DEPARTMENT OF AGRICULTURE
yv FANNERS NOW ADMINISTRATION
QUITCLAIM f~EEC
T1 : UNITED STATES OF AMERICA, acting through the Administrator
wars Me" Administration, United States Department of
tt~re9 CONVEYS and QUITCLAIMS to RICHARD R. SMITH, Grantee, for
$TIfTY TW USAW THREE HUNDRED AND NO/100 DOLLARS
4.00) all interest in the following described real estate
In the County of St. Croix, State of Wisconsin, to wit:
ehmsnt A.
S OFFICE
p Coot CO.,
j
M~~ Rroo~d EXL1~ • •
- _ ~60819i~9
y 0:45 tom'
~►af0eir
z
Mar.
fftoo 1118s A" authsrt ty 64t ! ~
S>•tt +A.
S `Ills?IILM T MAiS OWAFM BY THE UNITED STATUS 00ART1 NT OR
Alq.1"tN1Ec
No member of Confrese shall be admitted to any phare or part of
this dead or to any bwmflt that may arlso therefrom.
Dated, July 210 191111.
I ED Cr IIMICA (fam
M
•
W. C;AU.W X 9 , tat• ireotor
Farmers Home Administration
United States Department of Agriculture
In the preieno• of:
17 -
Frawo i s E. Kuh 1 s
GPI
athy 8loskey
ACKNOWLEOCMENT
STATE OF WISCONSIN )
) SS
COLEM OF PORTAGE )
I, Susan E. Kohnen, a Notary Public in and for said County and State,
do hereby certify that on this 21st day of July 1989, before ae
appeared Ronald W. Caldwell, State Director, personally known to me
to be the person and officer of the Farmers Home Administration,
United States Department of Agriculture, described in and who exeouted
the foregoing instrument, and being by me duly sworn, he/she
acknowledged to me that as t,is/.,her free and voluntary act and deed,
he/she executed said i no e'en *;tor the uses and purposes therein sat
forth. ~"f
r l
Susan E. Kohnen, Notary.i cQ
My Commission Expires: A~ i.d....'!y 1991
+t A•
A
L
vmunson:
Part of Wi 1/8 of section 1-+~lrtfi 1~ ~I
C iet at the v 1 /6 so an or
South 19.326 to the point o!nd
degrees 24 minute 00 seconds ist
line of sestion 1 923.26' tb@MW
minutes 45 seeonds Mast 214.56'
02 minutes 10 seconds Best 416.' _
• degree 36 minutes 39 seoouds Best 11 t,
Worth 89 degrees 30 minutes 10 senor'
s
tbssoe month 6 degrees 26 Minot" Of
theme soots 0 degrees 84 mimes M
246.G09; thence South # degrees 40 singles'
Nest 480.909; then South 31 degrees 06 ~d
r0~.
seconds Nest 269.201; thence south 15
00 seconds Yost •58.17• to the 3owtb Labe at
of Section 1; thence South 89 degrees 36
seconds Vest along said south Line 11 .13R'1L0.
Line of the`-NZ 1/4; thence Worth along said
2611.39"to the point of beginning.
rt
_V
w
z
r - -
I.L.H.R. 83.08(2)
P R O J E C T INDEX SHEET
O w n e r : Address:
30 x 70 ~/GT>Gv/tip ~j;S"/00 Z
Site Location:
'0"v 1 5.eC7- / 7a Al I-P17 G" TDw/.v O,
10 ~r D.v,L7
Project Description: ST ciPa~X Gpv.vTy
~i✓ ~~iSTiy /3EDrt'oaM ~17~~ ESTi~ 7 /
Glii}sTe-10,tp oyc ySv 14,~ s
Sys rE4r
-gy GDU-v1` ~~v S, T,~
y
/P eve* - g a 7-
J~~~`.r0~~1"//
y
ov)
Page 1. PLOT PLAN VIEWS
Page 2. 'MOUND CROSS SECTION & SYSTEM PLAN VIEWS
Page 3. PIPE LATERAL LAYOUT
Page 4. DOSING CHAMBER CROSS SECTION
Page 5. PUMP PERFROMANCE SPECS
r. 11..TR
PLUMBER: ~iry -<e&'1of
DATE: SITE EVALUATER/ DESIGNER
SIGNATURE
x 6
- QQ
~ L oT pL~~
~sr~N~ cve~~
0
3 BAH
Naw~ ourceT E/~v.trn,✓
~ uS E
~YisriNG- pRt~asr ,
~ yEpr~c T~wK . / > yD
~ >U ,SE Gv,TPEcT~D 3 5G ~ /E
N ' co royal of
ctiez,~ep cone cooE 2 303'1 Pv~ SDiL rEsr
j'A'
c o~+io Gi c si ye , ~0 0 0 ~ f..P • y 1~ 9t,~/foG~ TS
! cUND/T~o~ OjG I34fFlesi AWL)
ivwST R>vPat~ Ct~ +wc1~~F~w lF' ~ z B,ri:fTi.~G..
~tECESS~R~ ~ SCR crwt~oRi~tarJCE wl CN ~ h Sv~PP~cE
L~.kF~t (6 73
vJ.~..C 6~F1/~¢Tio.us
A ti h
o
o. ~
93.9a ` iNC~f , 2-y
~ ItvM~o"v O ~
7so~. P~.Nvo cH~r•,-QF~P
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OF
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pp«
p tic at~
Oc ~~;1 ? t
z iic z PkR U-Q-
l
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J33 -PASTUQe LAa 1~$
S90 - 4 0 5
. \ eta
alb Ge~u
IO
~ y\oQ
.
~ I ' S3
IIS/ ~yi
\ ~~vuD, SOiL T~ST~iPS '3. M. ToP of SU~u£y0~'S ~'~i ~ ~ y,~°,/U,GQ
.FT S w PRo~Err)/ copvER F/evRT~o.J = /Op. O
x
Page Z Of .5
Synthetic Covering
Distribution Pipe
Medium Sand
s y S7eM
Topsoil
3 I
-1 i E p y_ 9
3 A ¢ % Slope
Bed Of Force Main Plowed
Aggregate Layer
D 2 Ft.
.3
Cross Section Of A Mound System Using E 2-3 Ft.
T Y-7 .7
, n F Ft.
~A Bed For The Absorption Area
1T /
NS G Ft.
® E. A Ft. H IS •s• Ft.
R
B ~y Ft.
z
_n
Ar 4.~
`t1~LAl1QN~ K ~ Ft. K - 13.2 i"-t .
,IYi , a ~O.
G L Ft. L - F
i`A4ZT~ U3*E Ft.
Ft.
W 33 Ft.
Force Main
L
Observation Pipe
g K
A 'o 01
-
w 7
M
Distribution Bed Of I
Pipe Aggregate
I
Observation Pipe Permanent Markers
y pvc c~,opED sfE~~ ,Foos
( (r , r
Plan View Of Mound Using A Bed For The Absorption Area
I
Page 3 Of -
V010 11A 1VM E OR 3 PD FT o~' ~ 1'vc ~oRCF
Y/0,6 /~sr /IU~E Perforated Pipe Detail
zv&6Ar Foe mCvhE
VA C V.4 7
End View
)Perforated
End Cop) c,y~ PVC Pipe
~o~~oo once
0~4 Holes Located On Bottom,
u~~ Are Equally Spaced
R
P
PVC Force Main N CELL
M,r~,vi `o
• , ~EV,~;O.~ Top
Q PVC '6
Manifold Pipe 'of A/t ^ /00, Yo
Alternate Position Of
Dt~rt~ Force Main
' osOre-°U65d Be
Next 'TO E aop
~b~•s End Cop Distr'ut Pipe Layout
P 30 Ft.
» :1 d S
y- ~ f.1`~~ Iii • ~ -
t Pfa~tcvli X Inches
Y s"r 3 Y Inches y
Signed: Hole Diameter Inch
Lateral Inch(es)
License Number: Manifold 2 Inches
Date: Force Main " Z Inches
# of hol es/pi pe 8
~o o, z S
Invert Elevation of Laterals Ft.
R/57 -A1'13u?"/OA.) laisc/~~'yE P~9TE Fdk E~}~!ti 147,0 Al 9.3(0 ~ZAm
S90- 4059
'To T4 l !7/fTRi/3UTio,j ai'SCk AR 4,6F- ;017-6- foR iUC~IvD~PIC 37 f/ 0,11111111- /i1'KGvt
l~~~p
t 1 r
1
PAGE OF ,
PUMP CHAMBER CRO55 SECTION AMD SPECIFICATIONS
VENT CAP
4"C.I. VENT PIPE APPROVED LOCKING
WEATHER PROOF
JUNCTION BOX MANHOLE COVER
-2" 25' FROM DOOR, Gll (vV,1Jlp(/1f1/sEI
WIMDOW OR FRESH 12"MILL.
AIR INTAKE
II14 Ve WFT&I GRADE a
MIN.
8o I~t CONDUIT -
VIDE
INLET HT SEAL
3' APPROVED JOINT ti A~,~C., c~~,V 1 I I ( APPROVED JOINTS
C.I. PIPE W/C.I. PIPE
W1
EXTENDIM6 3' g 0 I I I ALARM EXTENDIMCP 3
ONTO SOLID SOIL B 1a I ~~10a i i ( ONTO SOLID SOIL
f Ow
ELEV. FT. PUMP __J
' y OFF
JJK D I CIS COLICRETE BLOCK
1
i ~~/~v>~fIoIJ
7 1~~ RISER EXIT PERMITTED OWL4 IF TAIJK MAMUFACTURER HAS SUCH APPROVAL
SEPTIC E SPEC.IFI•CATIOUS
DOSE M~~ wEST,E,P,,.~ 3
TANKS MALIUFACTURER: -1Poee-cfS7- G& - WMBER OF DOSES: PER DAU
TANK SIZE: /S GALLOWS DOSE VOLUME 45--'7 2/2„
ALARM MANUFACTURER; L~7JEL rf1~-k 9 GQ- INCLUDING BACKFLOW: GALLONS
!o Z
MODEL WUMBER: U' L ' CAPACITIES: A= INCHES OR 3G~ GALLONS
SWITCH TYPE' DER,-L A4 Fl o,47 ' B 3 INCHES OR 3o GALLOWS
PUMP MANUFACTURER: ~DEI~i/e CasINCHEVOR L Z GALLONS
MODEL NUMBER: 4~3 Y2,- D=INCHES OR 2-00 GALLOMS
SWITCH TYPE: IN 8il ~~~/U~Y 610'lrf MOTE: PUMP AMD ALARM ARE TO BE
MINIMUM DISCHARGE RATE GPM INSTALLED ON SEPARATE CIRCUITS"
VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. ' FEET 'rAak STfGS
+ MILIIMUM NETWORK SUPPLY PRESSURE . . . . . . . . .Q2.5 FEET EACtly I' O{" -,D;E Pitt,
+ 300 FEET OF FORCE MAIN X 1=2- FYoiLFKICTION FACYOR.-FEET ~P 75
TOTAL DYNAMIC. HEAD = L FEET
INTERNAL DIMLWSIONS OF TAWK: LENGTH ~;WIDTH /----;LIQUID DEPTH
SIGNED: LICENSE DUMBER: DATE: i
3< 6 -AA
0~2 c~ ~l~i-L> •
P4 a~ 5
616
HEADI
,15
CAP'. CITY 34
32 10S
100 -
CURVE 30 95
90
25
EFFLUENT 24 s0
MODEL
and Q 75 MODEL 189
DEWATERING = 70 ,65
20
Q
Y ,8
G 55 _
J
Q 18 MODEL
H 50
O 14 163 MODEL
45 189
12 40
35
10 MODEL % It= 30 =MODEL
137 139
185
8
SEWAGE and 25
DEWATERING 6 20 MODEL
MODEL 161
4
10
b~i MODEL
iiCuu LL 2 5 53, 55,
M 57, 59 F
0 1
GALLONS 10 20 30 40 50 80 70 80 80 100 110
24
75 LITERS 0 80 160 240 320 400
22
FLOW PER MINUTE I
70
- IN
20
is MODEL-
W 55 295
Z Is
V 50
Q 14 4S MODEL:
z 294
12 -40~
J MODEL
Q 35 293
0 10 MODEL ;
8 284
MODEL
8 20- 282
15
4 z
10 MODEL
OELLE/P O.
2
5 267, 268
0 3280 OW Mules Lane
GALLONS 10 20 30 40 50 60 70 Bo 90 100 110 120 '130 140 1150 160 170 180 160 P.O. Box 16347 1
LoulsvNe, Kentucky 40216
LITERS 0 80 160 240 320 400 480 560 640 720 502) 778-2731
FLOW PER MINUTE Sq (I ~
. 1
« ri " t4ri K *ri u K
167 - y - 16.5 185!!-fi188"- 189" SOdes
(%2 HP) (%2 HP) (1 HP) (1 HP) (1%2 HP) (2 HP)
ks • Automatic or Non-Automatic.
1EINE{ 1{I IN Nf 1{f /N /N
• 112 H.P., 115V, 230V, 200-208V,1 Ph. or 3 Ph., 460V, aT M GM L1,. GI 1.111 G.1 L11. GM L6. a.1 L6. " Lill
6 152 01 81 271 61 231 N 322
/ , ' 3 Ph. 10 705 :10013 7{ {I 271 U 271 N 327
fernn~ 1 • 1 H.P., 11/2 H.P., 2 H.P., 230V, 200-208V, 1 Ph. or 3 15_ _!sj. .91 ]44 N 277 N 221 N 322
20 6 10 N 310 69 223 N 227 N 322
ZS 7N 14 NO 57 216 N 773 N 722
Ph. 460V, 3 Ph.
V 614 65 TK 55' 706 N 7T0 N 7N N 322
Sc 1225 41 Passes 3/4" solids (sphere). .0 ,216 46 174 K 171 65 706 IS 7N N ]37 N 314
60 16
• 11/2" NPT discharge standard. W 24 71 N 17 125 51 161 S{ 219 73 27. 1626 15 S7 17 161 % 136 1% 37 216 M
16 67 757
is Float operated, submersible (NEMA 6) mech- 70 2134 30 114 N % 37 146 51 216
N 2436 14 N 13 K 41 115
anical switch. 90 2743 %
100 0 ]ON 21 N
• Automatic reset thermal overload protection, 1 V4 t 73 65 11o 56 1
` Ph. only.
°iANnOCi°"nS1pi0Q0f
• Durable cast iron construction. Appro64
q +UL listed .
Non-Automatic • 2" or 3" flange available. '6"1b1
Model Pictured is 20 it, UL listed neoprene cord and plug. NOTE! No UL listing for 200-208WI Ph. pumps.
Mercury float switches are avapabls for non-automalk modals.
PETITION FOR VARIANCE WISCONSIN DEPARTMENT OF OFFICE USE ONLY
OF A RULE IN THE INDUSTRY, LABOR AND HUMAN RELATIONS Petition No.
WISCONSIN ADMINISTRATIVE CODE DIVISION OF SAFETY & BUILDINGS E- umber
P.O. BOX 7969, MADISON, WI 53707
Name of Owner Building Occupancy or Use Agent, Architect or Engineering Firm
%GrI si~li• /rUcx.,
Company Tenant Name, if any Street & No.
HOMESITE SEPTIC PLUMBING CO.
Street & No. Building Location, Street & No. City ROBERT ULBRIG"te & Zip
1361 ''7011 'NIS. MASTER PLUMBER LIC. NO. 3307 M.P.R.S.
City State & Zip City County -l "ANB AL ER & DESIGNER /~lv/,✓ 4yS. SyooZ
Phone/ - ( ~O d~ IF Plan KNOWN Number(s) Name of Contact Person 21
a o$~ 241,16 R I
~G 83.2,3 (1 ?-)tRule he Wisconsin Adminstrative code cannot be entirely satisfied because:
s oiL ~O,Piv~S _ -CST ~t~lFi~v-13~ ss~'•
~0~1 • t • ~D,t, rJO-.t)1_ _ ~PPVe-1 L _ Sup/S f~Ctp.S'S /~°£~G~/C-C
.fe.4SD.41,flly . S,f-M,&j&-D /f T- /z
~X/ 7;-,V'6- - 4W "ekf~`o ~ 16 S!/ S Te`^ /'S i42 G--- .
2. In lieu of complying exactly with the rule, the following alternative is proposed as a means of providing an equivalent
degree of safety:
iNIAl U
~tov up S ST-M -G~~ -
3. Supporting arguments are:
+,PP17j0V0t6 .514A/19
A~a
rj,e07'1fEA7r -1-'S ~ ~~•v j0F 4-f1CJ vEw 11D sf-TiS-f~ _ ~ _ /,vfE'"u
VERIFICATION BY OWNER . PETITION IS VALID ONLY IF NOTARIZED
For Fee Information See ILHR 69.15 or Contact The Department at (608)-267.7843
NOTE: Petitioner must be building owner. Tenants, agents, designers, contractors, attorneys, etc. may not sign petition unless a Power
of Attorney is submitted with the Petition.
T 1?,~ - - 'fi being duly sworn, I state as petitioner; that I have read
-(NAME of PETITIONER Please type/print)
the foregoing petition, that I believe it to be true and I have significant ownership rights in the subject building.
OFFICE USE ONLY
Sienetur. of Owner Date Received Amount Paid Receipt No.
Subscribed and sworn to me this date: /V -
S l i'IV Co " wi N
County, Wfseei tin.
Department Action
e
Wyk5Q Office of The Secretar Y
Date
My commission t> r~~ur c 1R►-C'W N
ti Y
Wisconsin Department of Industry, ONSITE SEWAGE SYSTEMS Office of Division Codes and Application
1 Labor and Human Relations Onsite Sewage Section
Safety and Buildings Division 201 E. Washington Ave., Rm. 141
PLAN APPROVAL APPLICATION P.O. Box 7969, Madison, WI 53707
(608) 266-3815
INSTRUCTIONS: Please fill in all applicable data and submit this form with plans. Plans will not be reviewed until all fees are received. The
reverse side of this form describes most of the required plan information. Further requirements maybe contained in the Wisconsin Plumbing
Code, which can be purchased from the Department of Administration, Document Sales and Distribution, 202 South Thornton Ave., P.O. Box
7840, Madison, WI 53707, Telephone (608) 266-3358.
Plan Number Previously Assigned
1. PROJECT INFORMATION (Type or print clearly)
Name of Submitting ftW0Q +0:1rrFTU% tO, Project Name
f'oA!
655 O'NFL RD. HUDSON. WIS. 54016 RE G}G5;4fe'Vr
Legal Description
Street Address, P.O. Box # ~BHpfR9158RIiGHT Project Address or '7•-Z fN R /'7 W
WAS, MASTER PLUMBER LIC. NO. 3307 M.P.R.S. Alit! Irk NE y S" . l , r
City or Village 1008M Code City ❑ County
--II
. 3JV6 Village ❑ of t gMMO'Q T> $T • Cho!
Telephone No. (include area code) Town 9-
Designer Name of Owner
HOMESITE SEPTIC PLUMBING CO. ee-A h R D S M I '
ArGA10-011 an -
Telephone No. (X6660 d Telephone No. (include area code)
s _
R BERT WRIGHT 30-P
Street Addr Street Address, P.O. Box # or Rural Route
~R LIC. N0.00663 05 - '10 y
City or Village State Zip Code City or Village State Zip Code
9 'If is 54100
2. APPLICATION FOR: ❑ Experimental ❑ Mound System ❑ Holding Tank
❑ New Construction ❑ Large System ❑ Conventional Gravity System ❑ Groundwater Monitoring
Petition For Variance
❑ Replacement At-Grade System in Fill ❑
❑ ❑
❑
❑ Revision Pressurized System ❑ System in Flood Plain (attach SBD-6698) Other Alternatives
❑
3. FEE COMPUTATIONS (include existing tanks) FEE SUBMITTED FOR OFFICE USE
MAKE ALL CHECKS PAYABLE TO SAFETY & BUILDINGS
CCJJ
- 1,500 gallon septic tank /If 50.00
a. 750
b. 1,501 - 2,500 gallon septic tank
c. 2,501 - 5,000 gallon septic tank $ 80.00
d. 5,001 - 9,000 gallon septic tank $100.00
e. 9,001- 15,000 gallon septic tank $150.00
f. Over 15,000 gallon septic tank $250.00
g. 500- 1,000 gallon dose chamber ;30.00
h. 1,001 - 2,000 gallon dose chamber S .00
i. 2,001- 4,000 gallon dose chamber $ 70.00
j. 4,001- 8,000 gallon dose chamber S 90.00
k. 8,001- 12,000 gallon dose chamber $110.00
_L Over 12,000 gallon dose chamber $150.00
M. 500- 5,000 gallon holding tank $ 30.00
n. 5,001- 10,000 gallon holding tank $ 55.00
o. Over 10,000 gallon holding tank $100.00
p. Revisions $ 20.00
q. Groundwater Monitoring - Per Site $ 32.00
(other than a proposed subdivision)
r. Petition For Variance: Setback S 25.00 ^
Site Evaluation $ 50.00
Subtotal:
s. Priority Plan Review: Enter same amount as Subtotal
Total Fee:
SBD-6748 (R. 04188) NOTE:Fees are pursuant to Wis. Adm. Code, Chapter Ind. b9, and OVER
are subject to change annually.
State of Wisconsin ` Department of Industry, Labor and Human Relations
SAFETY & BUILDINGS DIVISION
201 E. Washington Avenue
P.O. Box 7969
r? Madison, Wisconsin 53707
i
hits awjval i- >r1-,n JG • 1i13 1 'rit ii(.1si 1. 6 t 1' t "47i:3tit}'1a
13
b't
V 11s :ii I :i( I I'll_':' t I'V 1 S
/ f
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ST. CROIX COUNTY
WISCONSIN
.nr., ZONING OFFICE
ST. CROIX COUNTY COURTHOUSE
"Y911 FOURTH STREET • HUDSON, WI 54016
(715) 386-4680
Oct. 10, 1990
Division of Safety and Building
Bureau of Plumbing
P.O. Box 7969
Madison, WI 53707
Dear Sir:
An on site investigation for the Richard Smith property
located at the NW 1/4 of the NE 1/4 of Section 1, T29N-R17W,
Town of Hammond, St. Croix County revealed suitable soils at a
depth of 12" with an A horizon of 8" and 4" to motteling. This
site will require 24" of fill beneath the mound.
Should you have any questions, please feel free to contact this
office.
/ Sincerely,
J es K. Thompson
ssistant Zoning Administrator
cj
COMMERCIAL TESTING LABORATORY, INC.
514 Main Street, P.O. Box 526
V Colfaix, Wisconsin 54730
715-962-3121
800 - 962 - 5227
ST. CROIX ZONING REPORT NO.; 29369/01 PAGE 1
ST. CROIX COUNTY REPORT DATE: 9/18/92
COURTHOUSE DATE RECEIVED: 9/16/92
HUDSON, WI 54016
ATTN: THOMAS C. NELSON
116 l~
OWNEfit Rill & Marge Abernathy
LOCATION; 1183-205th St., Baldwin
COLLECTOR: M. Jenkins
DATE COLLECTED: 9-15-92
TIME COLLECTED. 3200pm
SOURCE OF SAMPLE: Outside faucet
DATE ANALYZED.9-16-92
TIME ANALYZED 42IOOpm
COLIFORMt 0 /100 ml
INTERPRETATION. Bacteriologically SAFE
NITRATE-N: S 1 ppm
Above 10 ppm exceeds the recommended Public
Drinking Water Standard.
Coliform Bacteria/100 ml
Nitrate-Nitrogen, mg/L
LAB TECHNICIAN: Pam Gane
WI Approved Lab No. 19
< Means "LESS THAN" Detectable Level Approved by:
ST. CROIX COUNTY ZONING OFFI
St. Croix County Courthouse
911 4th Street
i` Hudson, WI 54016
Telephone - (715)386-4680
The St. Croix County Zoning office offers the service of septic
and water inspections to Lending Institutions, Realty Firms, and
private individuals.
Completion`of this form is essential so that the property can be
located.
Please provide the following information, enclose appropriate
fee made payable to St. Croix County Zoning Office, and mail,
along with form to the above address. Testing will be done as
soon as possible after fee and form are received.
WATER TESTING----------------------------FEE: $ 25.00 J~
(For nitrates and coliform bacteria)
WATER TESTING FEE: $127.00
(For VOC'S)
SEPTIC SYSTEM INSPECTION------------- --FEE: $25.00 J
(Determines if system is proper functioning at time of
inspection)
11 _44- Vj CL~
Property owner's name m
2 0S' ~~►7 W) S~OOZ
Property owner's address 119
Legal Description 1/4 of th 1 4 of Section I T 29. N-R[Z
Town of qCerA L t Number Subdivision Name
U- I CS Vn v a- p~ -z-T-4 ~
FIRE NUMBER LOCK BOX NUMBER alY-/ 6~0- -AO 11 274-76
Color of house Realty sign by house? ??If so, list firm.
PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP,i.e,COPY OF PLAT BOOK,
WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET.
Testing of residential water requires a sample that is fresh. If
the home is vacant, and has been so for some time, the water line
must be purged by running the water for several hours before the
test can be conducted.
WINTER TESTING: Many times water lines are turned off, or sill
cocks are turned off, making access to the home necessary. If
this is the case, please make proper arrangements with this
office to ensure time when entry may be gained. ``rk
Firm or individual requesting services: V~ 4e.
Telephone Number
REPORT TO BE SENT TO: ( 5 l RLu~LLf.._
30-1 S e c. e~,.ti %Ifi.
Closing date+ 14-
Signature
10
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A~D
ST. CROIX COUNTY
~ WISCONSIN
ZONING OFFICE
k. ST. CROIX COUNTY COURTHOUSE
911 FOURTH STREET • HUDSON, WI 54016
- (715) 386-4680
Sept. 18, 1992
Doreen White
First National Bank/Hudson
307 - 2nd St.
Hudson, WI 54016
Dear Ms. White:
An inspection of the septic system on the Bill & Marge Abernathy
property located at 1183 - 250th St., Baldwin, WI was conducted on
Sept. 15, 1992. At the same time a water sample was obtained for
testing. The results of that testing will be sent to you as soon
as we receive them from the laboratory.
At the time of inspection the septic system did not appear to be
failing by surface discharge. Upon investigation of the soil
survey however, it is noted that there are the possibilities of
hydraulic failure of the system. The inspection was based upon a
surface inspection, and did not involve any excavating or chemical
analysis. Accordingly, there is the possibility of hidden defects
not discovered by this inspection. This does not in any way
warrant or guarantee the continued proper functioning or operation
of this system.
Should you have any questions Please contact this office.
Si cerely,
Mary J. Jenkins
Assistant Zoning Administrator
cj