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HomeMy WebLinkAbout020-1102-00-300 o a i o 00 ~ ~ c O O H w a ry p c E D z c .F N aN N N E O p N O CU N C O z N O {i 7z- 0.0 I O O ~ =o E O _0 I N Q F- N M V~ N Z N Z : G Z am d d v N W I a m M H Z O E co O Z c _ ~ o H r DI Z c E -2 N Cl) N f6 a U) N fA .N. c L L 0 L O C C Y O U Z w O Z ~ C N C "O U y E , N a d co a L m ` o a r E CD m § , 16 cn d LL - c 0 0 0 Z paaa cn a Wail -m.) 0 0 to J U ~ ~ rn p Z p Y _ -0 O co co co O 43 N N m Q o o 4) -M ^i O O m N C E O R1 Mo 3 06 m a o 0 CS 0 TT N N F- 0 1 O' co R v O_ O_ C to O N N W d O Z C N l0 l0 • 04 'q 7 O O c p O O Yr O M 2 Q' O Z - H U) C ~ # r v~ d 'moo € a a L: a • a y .2 1 d r/► O m c 3 3 A U a 0 co V _1 7 Parcel 020-1102-00-300 01/24/2005 07:50 A PAGE I OF 1 Alt. Parcel 34.29.19.406E 020 - TOWN OF HUDSON Current I X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * MARSKE, FRANK & JANICE FRANK & JANICE MARSKE 702 BAKER LA HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 702 BAKER LN SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.220 Plat: 2501-STAHLECKER ACRES SEC 34 T29N R19W NE NW LOT 1 OF PLAT Block/Condo Bldg: LOT 1 STAHLECKER ACRES TOWN OF HUDSON INCS 1/3 INT IN RD BEING OL 1 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 34-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/16/2002 684307 1928/195 WD 01/07/1998 570881 1286/479 WD 07/23/1997 985/210 WD 07/23/1997 859/57 2004 SUMMARY Bill Fair Market Value: Assessed with: 48432 223,900 Valuations: Last Changed: 10/29/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.220 48,200 125,000 173,200 NO Totals for 2004: General Property 3.220 48,200 125,000 173,200 Woodland 0.000 0 0 Totals for 2003: General Property 3.220 48,200 125,000 173,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 134 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER • 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 July 20 1994 Ms. Andrea Kary Century 21 706 19th Street Hudson, Wisconsin 54016 RE: Water Results for Residence Located at 700 Baker Lane, Hudson, Wisconsin Dear Ms. Kary: Enclosed is the original test results from Commercial Testing Laboratory, Inc. for water inspection of the above property. If you have any questions regarding these results, please do not hesitate in contacting our office. Sincerely, Mary J. J kins Assistant Zoning Administrator mz Enclosure r .9 FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP SECTION Y T f N-R l9 W ADDRESS ©_l~a• ST. CROIX COUNTY, WISCONSIN SUBDIVISION '7 LOT LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM rkG zr k x b M t - 14 -4 s.`~t yc • w ~ N W ~ °O / ~rtat/'rr 9 8. $74 f T, 711 fit/d Qv,D {r-elc~~' tmo,3 ~cct'fY ~ ~ooi 7 'CrtL~ a ~OL'•> Fi'elc~ : qv"o ~o INDICATE NORTH ARROW BENCIDIARK: Elevation and description:- 'ora, e Alternate benchmark SEPTIC TANK: Hanufacturer:_ &Iee,4 ~ife Liquid Cap. 4 ,~?©p Rings used: Q Manhole cover elev: L~ inal grade elev: Tank inlet elev.: Tank outlet elev.: ~~tf No. of feet from nearest road:Front' Side Rear V Ft. > /DO From nearest prop. line:Front , Side , Rear Ft.--,- loo tto. of feet from: Well- f* WC`/ , Building: (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufact.: Pump Size Elevation of inlet: Bottom of tank elevation Pump on elev.: Pump off elev.: Gallons/cycle: Alarm: Man.: Switch Type: Location Distance from nearest prop. line: Front_, Side_, Rear-Ft. Distance from: Well Building SOIL ABSORPTION SYSTEM Bed: Trench: Seepage Pit: Width:- Length Number of Lines: 3 Area Builtq.?~ Exist. Grade Elev. Proposed Final Grade Elev. Fill depth to top of pipe; Z5' / 74 5/ No. feet from nearest prop. line:Front , Side_jt::~', Rear Ft.L2L1 No. feet from well:-.;- 01 No. feet from building Y54 HOLDING TANK Manufacturer: Capacity: No. of rings used: Elevation of bottom tank: Elevation of inlet: No. feet from nearest prop. line:Front , Side , Rear Ft. No. feet from: Well , building , nearest road Alarm Manufacturer: INSPECTOR: DATE:-// 1 PLUMBER ON JOB: LICENSE NUMBER: 6/90:cj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING LABOR & HUMAN RELATIONS DIVISION P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION UgS`i N A'411 , ec.34,T29-R19 State Plan I.D. Number: Lot] 1❑ CONVENTIONAL ❑ ALTERATIVE (If assigned) Town of of Rd. Hudson LLJ Holding Tank ❑ In-Ground Pressure El Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Pat & Beth Ro ers P.O. Box 92, Hudson WI BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.: Name of Plumber: MP/MPRSW No.: County: - Sanitary Permit Number: David Fogerty 3289 St. Croix 19(8846 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKNG COVER PROVIDED: PROVIDED: ❑ YES ❑ NO ❑ YES ❑ NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM: FEET FROM LINE: AIR INLET: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVDED: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL, BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF ❑ YES ❑ NO NEAREST 1110- 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 the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID BED/TRENCH « TRENCHES: MATERIAL: PIT DEPTH: DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV. INLET: ELEV. END: PIPES: FEET FROM 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; ❑ YES ❑ NO ❑ YES ❑ NO FIEPTH R TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: EDGES: ❑ Y ES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH: NO. OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEV.: ELEV.: DIA.: ELEV.: PIPES: DA.: ELEVATION AND DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS 11-1 ❑ YES ❑ NO ❑ YES ❑ NO PERMANE FR R : OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: I]II COMME TS: FEET FROM LINE: ❑ YES ❑ NEAREST YES ❑ N 1 Q ] 0 s o-\ l r~-y► S Retain in county file for audit. Sketch System on Reverse Side. SIGNATURE: TITLE: SBD-6710 (R. 06/88) SANITARY PERMIT APPLICATION ILL f ILHR In accord with ILHR 83.05, Wis. Adm. Code couN mmmmumom ❑TIT Ii -PER -Attach complete plans (to the county copy only) for the system, on paper not less than /~I 8% x 11 inches in size. Check if evasion ytop evious application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION Pat & Beth Roger* E %NW S34 T29 19 E (or PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # B.O. Box 92 1 CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER Hudson WI 154016 1(549 Vol. 2- n. 373 11. TYPE OF BUILDING: (Check one) 11 State Owned ❑ VILLLLAGE : NEAREST ROAD .M 420 A Rtidoom Baker Rd. TAX NUM R( ) ❑ Public b 11 or 2 Fam. Dwelling-#of bedrooms PARCEL Ill. BUILDING USE: (If building type is public, check all that apply) I„ 1 ❑ Apt/Condo Y 2 ❑ Assembly Hall 60 Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 70 Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ 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.E] 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 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ® Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ASSORP. 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) 98.0' ELEVATION 450 900 900 .5 40 100.5' Feet 102.0' Feet VII. TANK CAPACITY Site in gallons Total #of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name oncrete Con- Steel glass Plastic App Tanks Tanks structed Se tic Tank or Holdin Tank Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumbs ' Signature: Stam MP/MPRSW No.: Business Phone Number: David B. Fogerty 3289 (749-3456 Plumber's Address (Street, City, State, Zip Code): Fogerty A ts. Rd. Roberts WI 54023 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater ate Issued Issuing Agent Signature (No mps) pproved El Owner Given Initial Surcharge Fee) ~ p7a Adverse D terminati n X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: I SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber 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, irnstallation., 5. Onsite sewage sYstems•must be 'properly maintained. The septic tanks must be pumped by ya licensed # puMper,m heneypr necessary, usually ev?ry 2 to 3 years. . r. 6' If you ~hiA gbestions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815yr, To be complete and apct~rate this sanitary pgrmit application must include: 79 I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8'h 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 b~ftei county; E) soil Wst data on a 115.form; and F) all si&MO information. - - - - - - - - - - GRaU#11R#1'TEI 516HARt`aE , 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The moNes~.collgrted through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards: SBD-6398 (R.11/88) 9 T G This # ~ + IuTTm Is to be eem eted in full arid signed by the;a r(s) of thr belm d 'M , ped~ Any lnadequacle3 Vill only s Ott Peril $ I € 511rv«1Should tip development bt iAtended lot 14sah bz o ec, ~ , a ief. hrtute), then a ttconq torn ohould bw kitothed 40 41 , r fi y to told and submItI.e+d to tbit offlct With !h• AA& 114# Stat' on ~R.,)q.V , •xrow svrrr,xR.warurwa:r+au.WWiM'• Y\rEYr- ``wZf..r.rrw . 9'~ 4 . d^' i:, f rxx v. wine u. w , ro.. r>Y to c . f 7$,. is I'1: +Ne / „u,,.. .,ern . •w,.:nr..a.xx,rwm.rsn.u+mrcwwuuw•rnn.wrtumllfYwAtwYrbM04"yp"•i•"• _ ( z c ~"r C,c S T q ~d 1~ N + s h .r > . ' fit ~ .t ~ r ,r, ~ v ~ ,......-v...... n,... .,..r•. , _ . w»,,.., „1-;, k..n„ ~~ma.au,.¢~wremawem•~uurwcww...rnr=.• ,a-, N Wh kti u tdno6 ? 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If P 191 of D ~°q ti t Opt s: soTvey, R € etfso"ir 0 r' .~TI°+gg°N~ ~1d1 ±'i ~Ite~y~af ~y ii ■ ii J., I € ~1'a>> t vtFu *8 to as CitKt Rfu ~'t Yt yattl.Eltd a7, y - PRIMRT F O'W ZR ~a.1ti Pr..A a a` N+'...1 t 4'~r C v:.r ~i 1"A t 1 Y 0 i ky idut :.tr .'w°Zr aft zasO the *w-tr0l. of t PrvPetty detcclbtd In et awl, rs I,~r r b 'vlvt. v, of a wAt1AAtY r3tat ~ r ~~ded In tht 011$ce of t At Z~/ and that x (Vt) t iws) hive C ' pc+~ eaat Own, eOwn, the alto tt a:-°we Sewage d1spwsa~l_ Aytirem (*,,c O Slat an eJ, t.;a TUn v1 thfi dbovo 41c!is c,tIbi~d propu t7r tax !ha c f, u f,4 0 Nei ~..0tis n , and tha same hall rgeecAcd In the afflot C+r tia itnh DSO. -.•,b„r. v,~®1+ grit .a~jiater' r;I Uieedtt AS 8I9natusa of Co-Owfttt (11 Applicable SUJ 4%U .h I .3yY✓ ~~u~ r~w~ ~y t ~ r y. rig ~~V~:. ~.••~~..3 ^ Y``'r ';M.F 'ti~. 7 L +k- HS - r ~ T' ~ ~ t TSB. . AN of .l/ p 4T tl y' "f r~. Neu", P" t PE;ULT C4 J r r t B ...:.2s k f W wh, P: r , ~oJ 1 SANK PUM'pg a M1.. YLAA 2, mum pr or Ths pr n + a~ y' # ~I P M, a. , , r. ~ f1 e VR. :i .r _ .t.. .f. ate. x7 WEE ~~e t the 4 } s.~~i .3" m q s1~ ~n uI~.1.{ fULT~I * 30 day ro r 4 . ti ! aM" ] D n fi T~ e V On i County 1 St. 911. 4th street (715) 386-4680 Sign, Date, and ReLurfj to above address f , ~ -AO CPARTMENT OF ~ OR O '+7 OIL BORIW AN V 5AF TY & BUILDINGS DIVISION stir, PERCOLATION TEST-. 1151) ~ Po:,Gox 7969 -UMa,ra F5 f. aTi~-j tiS [mr,11 537;77 (ILHR 93.09(1) & Chapter 145}..x. ,"51. ,3 q Ul f 4f AD 4<J I ' F a A J I4ry,. r ION 'f s.. v r ~ C ~ -«k I ~ L A,. ~ i w;,,,_ + ~ t ~ . r ' ~ i ~5~~ ~ 4F ~ • t ~ TESTS: ~ S 1A N I~J. Ga & Y 1f~fY' ryb kY tV3R8fY1 ~ .Y aC Y'~~ '1, x t1d t~ rp w r ~ y 'Rail p., r ttri+ J. e S , L m.. i s 7, ~+J r } j _ A.7,.~~...ir•.~X..,a.T.~Sc'LYS~~~~ f Y^4't4dS ' y~ 'ice ~ ~ d F,-, ! 3( F t 8 1, 9~ a G'd $ ~ Tip G C C 'S' g tl f' rn ova s ,7 3: x( '1 1 s r s a k u f `111 t X 1' ~t1~ 2,33 ~f 4~ s iffy/ i I rr♦ ryI~/~ 1 I I ? P `V i 1,,, , . ,1 T, ~ ~ ~ w~"~S 4y.1~ d+I. ✓ ~ . " f m ~ . a t . ' A0 e°, 1 if f*r,'ofu ~3a. 4 nice r ' j ~ _ ".•4 ` { tyR( 1 tit „t ~ rl .Si i~ L f f ' tt ` r a F ' aRM r t, a r Vi' r -•i ;;rr~ iNGH , 17, f r s _ P t _ , . • , . ,,n , e'!a^ st y'e~ ~'~at L±J? h f v _t i; Si p4 S r' ,t a yd €.,z!9 ?S dt . iniL! a:,„ ue the horn Ind percent rcent y a i { I ti < E F ' , r ' ~ 1 1 L-L € o Jr,dersigned, h:tretly tr,at t ;.t n.t . • f ara, a b; a in occ y ,r a Groceuurei ■nd methods $paeffied In the Wlteontin \dmi.1i$trat{',r4 Cede, a~~s t'.ct tho data : ee®t• ..~,vn aI vv :,its rracs to tho best of,j)y knowledge a€ d belief. •:A^ tar+m ; _ TEuTS w MPLET~ON; HOMESITE SEPTIC PLUMUING CO sE-Pr, asxl: NEII-AL}r1{~LLSG~,WlS 5hR98 _ ! d ROURT ULBAIGHT CERTIFICA ION NLtMBER: HgNI? NUMBER o canal AS MASIER PLUMES LL.. MINN. INSTALLER 8 CESIGNE-A 1--T- NO, 00683 CST l NA U ' TRIBUTION. Originat and one copy to Local Authority, Property Owner and Soit Tester. HR•SB0,3S95 fA. t0/~2L_ _ f 4 . • DAVE FOGERTY PLUMBING / Licensed03233Perk Plumber Fogerty Heights Road > So, ROBERT S, ~l S49.36 N 54023 Ved 3 qS' ~y 0 V i ~o :e-7 /,f = 6o r~ i Surrc.~ s r4rkc ~lw~- / - 9~•0' i /co• S o = wr// o 113 a N M V go: ° C4 . y C h eaU5 a 06-0 % L& 1W~ OD , M L ~LIN i o LI1 l O 1 ~ lr r H r ~ } COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715-962-3121 800 - 962 - 5227 FAX-715-962-4030 ST. CROIX COUNTY ZONING OFFICE REPORT NO.S 66338/01 PAGE 1. ST.CROIX CTY GOV.CTR REPORT DATE! 7/18/94 1101 CARMICHAEL ROAD DATE RECEIVED. 7/14/94 HUDSON, WI 54016 ATTNS THOMAS C. NELSON r OWNERS Jon StahLecker LOCATIONS 700 Raker Lane, Hudson COLLECTORS M. Jenkins 1Z DATE COLLECTED! 7-12-94 TIME COLLECTED: 12S00pm I' SOURCE OF SAMPLES Outside faucet o j r,,,-`~~ - DATE ANALYZED S 7-14-94 ST C O f~\9 , TIME ANALYZEDt11:1 Sam 2 ~ ~o~~. 49 ~y COLIFORM,iCC. 0 /100 ml ~R xc,) t 9 INTERPRETATIONS Bacteriologically SAFE j I NITRATE-NS 7 ppm Above 10 ppm exceeds the recommended Public Drinking Water Standard. 41 j i I I CoLiform Bacteria/100 ml. 1 Nitrate-Nitrogen, mg/L i I I; LAB TECHNICIAN' Pam Game oF.\NDEPENOftir WI Approved Lab No. 19 A C Means "LESS THANE" Detec+abte Level Approved byt Hwy. OO PROFESSIONAL LABORATORY SERVICES SINCE 1952 ST. CROIX COUNTY WISCONSIN 't ZONING OFFICE I r x w N x x u r = .,,,,r, ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 _ (715) 386-4680 July 12, 1994 Ms. Andrea Kary Century 21 706 19th Street Hudson, Wisconsin 54016 RE: Septic Inspection for Residence located at 700 Baker Lane, Hudson, Wisconsin Dear Ms. Kary: i An inspection of the septic system of the Jon Stahlecker property located at 700 Baker Lane, Hudson, Wisconsin, was conducted today, July 12, 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, water samples were taken. Once we receive the results we will forward the same on to you. Should you have any questions in the meantime, please do not hesitate in contacting this office. Sincerely, Tariy Jenkins Assistant Zoning Administrator mz (COO Fly ST. CROIX COUNTY WISCONSIN ZONLNG OFFICE infix psi ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road ' - Hudson, WI 540 1 6-771 0 (715) 386-4680 !^6 SEPTIC INSPECTION / WATER TEST REQUEST FORM 'II Please 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 arrangements with this office to insure that entry can be gained. ❑ Water (VOC's) $185.00 ~4 Septic $50.00 +Water (Nitrate & Bacteria) 45.00 ❑ Nitrate & Bacteria retest $15.00 Owner: :rpm :5-rA* ccILFf--- Requested by: AN40g.EA k.Ag-V e-ew x Z/ Address: lbo &ftK.rRL ENE Address: 70 (o 19f4- ST. WT ZIP 1;1101(a I OD60") GUT- ZIP 5 0!6 r J4rjnN Telephone N4: ( ) 38l, - 5 2g 2 Telephone N9: ( ) 75gl,- R 20 Property address (Fire N° & Street) : 700 6AK -p- LANE Location: N[ NWSec._c_, T~_N, Rj_I_W., Town of I4VASn&j Realty firm: ;11 Lock Box Combo: LAM Closing Date: 7- Zg- TO BE COMPLETED BY PROPERTY OWNER *PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORM' Water sample tap location: 5 Is the dwelling currently ccupied? IA Yes ❑ No If vacant, date last occu ied Age of septic system: C- i Septic tank last pumped by: i ate: Previous Owner's Name(s): L Have any of the following been observed? ❑Y ell-- Slow drainage from house. ❑Y KW-Sewage Back-up into dwelling. ❑Y ERT' Sewage discharge to ground surface or road ditch. ❑Y PN--Foul odors. Other comments relative to system operation: .77. ?t >n.;t 717 fI~certify that the above-information-is complet"e ~ --v rue "to the best ,,o f ;.my k n ow l e d g e OWNERS SIGNATURE 1/94 R: '7 177' -7 OWNERS.DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION IN t•r l TO BE COMPLETED BY INSPECTION AGENCY System design &/or`permit on file? ❑Yes PKo, Soil series per SCS Soil Survey: sheet # Type of soil absorption system: C3$'elow grd []At-Grd ❑Mound j. Approx. size 'X ❑Gravity ❑Dose OPressurized Ft.' OBed ❑Trench ODry -Well ❑Holding Tank OOutfall pipe OBSERVED DEFICIENCIES ❑Other OUnknown Septic tank ' Setbacks: OHouse L OWel l ❑Prop . line 00ther Dose tank Setbacks: ❑Ho Well ❑Prop. line ❑Other OLocking co er ❑W n labe ❑Pump/Floats OAlarm OElec. wiring .Soil Absorpti n System Setbacks: ❑House / OWell ❑Prop. line OOther OPonding: ❑Discharge:~yJ General comments: INSPECTORS SKETCH OF SYSTEM LOCATION Inspecto y4CJ~~4~i Title N.• N. a D.~ °u ..6 2 O O9 ~ ~ ,w.. 1Ns99 ,~-g - t 2014.24 -ter- - hub .bb 0 ) _ / O O J. f * r / 14 I \ ~"Q l)/ w c~ - ~ ~ ~v ~C7 ~Cv ~ or tio~' ~ w U o i \v I N N I /n N N Q~ `\O• I IN / / D N ~ 0 /n F a'V ~ 1'1 1 \ o I ~ / r* n' o / z / i/o 0 0 I 1 ° N <N J \ ,'p I O n O 1 to Q O n 3 27. 12' W .C C) \ m 0 io I- 'm V G _ ,•,4',o ~ to i ?p~ 14.6 pp,~/~ m II I ~/r O W 1 m m ° N N u -'II IC to O~ 1LD ?n 0 I - D w L.I m - / cn 1 I IN C y w II 111 A r a j - t I NOD W W r W O I I~ - N Z U T+ N O A w 1, O p ~ W 11 o .A I 1 .V C'1 O O C) -4 I 1 I i IGv.4B' - S 89° 571 25T.00~ „ 357• 481 W GII.f 9' 1 . 89 ° 58 39 E 1 sa . N e9° 5e oo r MAP CER1FIED_- SURVEY - til - PAGE.-373 V01-•. 2- I i I .I ,I Cf v ..t fl I S V