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HomeMy WebLinkAbout030-2071-20-000 Q o o c 0. 0 C, O O ti ~ O 7 ~ p I Q 06 ~ i N U I N .p Z O O O c m E LL O O a ~ V ~ M I Z C) E N = O O z O d N (D ce) Z a m c o I o Z ,1 c v a Z d' c o N h l N z c E -a 7 C N Cl-I i.. O 1 CL :s I O m Q O w O N Zmz z• ~ E N z IL CL (a d d i N O C o a 6 z~>°(nU)~ = m w u O O O N z • rv m a a a N I''' o 0 co J U rn rn z N~ = M M O N N N M o o _ x E M d S 'C n a') . » ao d Q u m L O 04 y N 0 O C N C r.+ O 3 E ° o co c C E (O Q 0 0 CL C:) O CL c E E m m l O N y N c+7 L L GY N '2 (n r~ N OM lil W N H H C N O .2 C~ N E E m U • 9a ~ co R Ili O N Cn L. O M in a c CQ O w ~i ~ w fir/ d m y a at a w `IV at a d .2 m a ~~ww E air c `1 A 0 a O in ci r Parcel 030-2071-20-000 02/09/2007 05:03 PM PAGE I OF 1 Alt. Parcel 36.30.20.619A 030 - TOWN OF SAINT JOSEPH 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 - BLINKMAN, TRENT L & LAURA J TRENT L & LAURA J BLINKMAN 1238 HWY 35 HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 1238 HWY 35 SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 4.460 Plat: N/A-NOT AVAILABLE SEC 36 T30N R20W NW SW LOT 1 CSM 4/1117 Block/Condo Bldg: TOGETHER WITH AN EASEMENT AS DESC IN VOL 886/298 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 36-30N-20W Notes: Parcel History: Date Doc # Vol/Page Type 01/12/2005 784847 2730/291 WD 11/13/2000 633525 1559/07 QC 06/02/1999 604200 1431/13 WD 06/02/1999 604199 1431/10 WD more... 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/09/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.460 114,200 300,700 414,900 NO Totals for 2007: General Property 4.460 114,200 300,700 414,900 Woodland 0.000 0 0 Totals for 2006: General Property 4.460 114,200 300,700 414,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 11/07/2005 Batch 05-49 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 r , FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER A_cx-4RQ--' TOWNSHIP- -!S-T N SECTION-3(e, -T-SO N-R-'?o W ADDRESS 2Q2"TE ST. CROIX COUNTY, WISCONSIN Aw-A TOti SUBDIVISION IVA LOT___LOT SIZE A/4 PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM / ~ 3S /Q S o 'S6vric Til-rl,C ,✓co,.AY W.Trf S~.f y~ 0✓c At ~NLST ('~TLdT PR0005~A Aof 7-i TE OA LA F (,JCsT wru p r.E pp j ~ ; ~x~s~~ sT g034 pi/c S 20 f ' 7 L'~'~ ~ GtSrT,Csv ~Gvr ill ~ ^ li~~ Qiol ptl SouTN ~°o~`s ~iNc ~nE~. /wI DICAT TH AR W 07 Sc.4~ BENCHMARK: Elevation and description: /"~~P~:y~aE /w' Alternate benchmark ^JA SEPTIC TANK: Manufacturer: wise' Liquid Cap. Rings used:_ J_Manhole cover elev: o.33 Final grade elev: /off. 7-T' Tank inlet elev.:_~74.(,• Tank outlet elev.: yG.3/ No. of feet from nearest road:Front , Side Rear From nearest prop. line:Front , Side,----, Rear Ft. G/" No. of feet from: Well /off , Building: 30' (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE . • r . 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 : &'Az-y. 9S/" Trench: Seepage Pit: Width: /,ir' Length Number of Lines: 3 Area Built Exist. Grade Elev. ~SProposed Final Grade Elev.-99-e1-5- Fill depth to top of pipe: No. feet from nearest prop. line:Front , Side Rear Ft.'~q No. feet from well: 160' No feet from building HOLDING TANK Manufacturer: Capacity: No. of rings used: Elevation of bottom tank: Elevation of inlet: No. feet from nearest prop. line:Front , Side , Rear Ft. No. feet from: Well , building , nearest road Alarm Manufacturer: INSPECTOR: I DATE: 110).70 PLUMBER ON JOB: LICENSE NUMBER: 3395 6/90:cj LCW DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING DIVISION ''LABOR & HUMAN RELATIONS P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION ? ec 707. 36 State Plan I.D. Number: DIS WI (If assigned) ii -R20 N ~ of ' Aing CONVENTIONAL El ALTERATIVE St. Jo'sT30ephT „ t Town ~ Hw 35 H Tank El In-Ground Pressure ❑ Mound N ME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: William Plourde Rt.1 Box 84 Houlton WI v-/") -~~j c) v° BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.' y' / ~ /db O' Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Zap pa Brothers In 3395 St. Croix 128823 SEPTIC TANK/ .2S ke ✓e = 122 LOCKING COV 1(~ MANUFACTURER: LIQUID CAPACITY: TANK INLE TANK OUTLET ELEV.: WARNING LABEL PROVIDED. PROVDED: i, / r SC~~ 5~? 91.95 Co•Lt7 YES ❑NO ❑YES NO OPY WELL: BUILDING: VENT TO FRESH E NUMBER OF ROAD: PR BEDDING: v"111 DIA.: PENT M;7HIG C , , FEET FROM LINE: AIR IN E❑YES 21 NO O NEAREST----* ING MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: pROVID DLABEL pROVIDED:OVER ❑ YES ❑ YES ❑ NO ❑ YES ❑ NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF LINEPERTY WELL: BUILDING: VENT TO FRESH FEET FROM AIR INLET: (DIFFERENCE BETWEEN PUMP ON AND OFF) NFAR 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 SYSTE S sE~ Ctu/ = 93.85 WIDTH: L O. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: PITS: LIQUID BED/TRENCH r TRENCHES: / MATERIAL, P DIMENSIONS GRAVEL DEPTH FILL DEPT ISTR. PIPE DISTR. IPE D TR. PIP MATERIAL: N . D STR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH : AIR INLET: BELOW PIPES: ABOVE CO ELEV. INLET: ELEV. END: ~'f PIPES: LINE FEET FROM / j NEAREST 7.2 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 DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑ YES [__1 NO ❑ YES ❑ NO ❑ YES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH: TRENCHES: LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.: ELEVATION AND DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑ YES ❑ NO ❑ YES ❑ NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: ❑ FEET FROM LINE: YES [:1 NO ❑YES El NO INEAREST '.~yrt ~ A~"'~f 'i ~.,.Y:.i 'V T ~ . ~i6~^1 L~.~✓~~`i ~.Y - ~ ~ r' P `'`P L r ~ QA°'Y'~~'`..r^,, s G etain in county file for audit. Sketch System on Reverse Side. 2SIGNA TITLE: r SBD-6710 (R. 06/88) SANITARY PERMIT APPLICATION .70, LHR In accord with ILHR 83.05, Wis. Adm. Code couN STATE SANITA Y PERMIT -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ 8% x 11 inches in size. c ec Wel, Fon Rorevious 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 L~ ~/f JOl, c9 u AlLJY,, Sc A., S S T N, R a0 E (Or PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # e- /3d I CITY, S ATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER Ali,tTD,Q GJ, SSo~ S 38~- 2A49 II. TYPE OF BUILDING: (Check one) VITM NEAREST ROA ❑ V 3S f~I ❑ State Owned TOWN ILLAGE QC: _5T _)CrsEi" Sr*7- c ,~}y ❑ Public ®1 or 2 Fam. Dwelling-# of bedrooms ! PARCEL TAX NUMB ( O 2~ ` _~-Q~ J~ Ill. BUILDING USE: (If building type is public, check all that apply) 611219' 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ 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. El Replacement 3. El Replacement of 4.0 Reconnection of 5. El Repair of an ystem System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) / I ELEVATION ©O g,?0 f~ g .7-21 S ~y Feet ~O4 SFeet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank ia50 ,,,R so I El E3__ Lift Pump Tank/Si hon Chamber Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber' Signature: (No Stamps) MP/MPRSW No.: Business Phone Number: ,p r ~~o?S 33 yS ('g/ ,S- 3S& -j?<eSv ~~i¢ f~og.TNc. ~4 Plumber's Ad W e -W -5-r A/ dress (Street, City, State, Zip Code): A/wsaj IX. COUNTY/DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee (Includes Groundwater La ssue Approved ❑ Owner Given Initial Surcharge Fee) , Ad a rmi i n X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-8398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 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 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; (lose 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) . APPLICATION FOR SANITARY PERMIT 9TC-100 This application Eorm. is to be colapleted In full and signed by the' ovnet(s) of the property being developed. Any Inadequacies will only result In delays of the permit Issuance. -Should this development be intended lot resale' by owner/contract 0z,(spec houce), than 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 J( I i A V-" Pi 0 u V Location of property A) LIU ) 1/4 1/4, Section -ter T.2...~01141-D-Y Township Mailing address Address of alto Subdivision name C S ri1 . Lot number Previous owner of property Total also of parcel ~ i y (0, Date parcel was created ©e' Ace all cornets and lot lines Identifiable? as o Is this property being developed for resale (spec houses?as Yolums and Page Number Be tecorded with the Register of Deeds. l INCLUDE WITH THIS APPLICATION TIIE FOLLOWiNCt A WARRANTY DYED which Includes a DOCUMENT NUMBRR, VOLums AmD PAQS NUMStR, and the BEAL OF THE R2018TER Op DEEDS. In addition, a cettifled survey, It avallable, would be helpful so as to avoid delays of the reviewing process. it the deed description references to a Ceitlfled Survey Map, the Cattlfied survey Map shall also be required. PROPERTY OWNER CERTIFICATION I(ve) cattily that all statements on this form are true to the best of my lout) knovledgej that t (we) am (are) the owner(s) of the property described In this Infotmatlon iotm, by virtue of a warranty deed recorded In the office of the County Register of Deeds as Document No. , !~A Ski' ) and that I (We) Presently own the proposed alto for the sewage disposal system lot I (we) have obtained an easement, to tun with the above described property, tot the construction of said system, and the same has been dui recorded in the Office of the County Register of Deeds, as Document No. ly5';~ & 57, 1. signature of owner Signature of Co•ownec (It Applicable) Data of signature Date of Signature DOCUMENT NO. WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA 'SSTATE BAR OF WISCONSIN FORM 2-1982 II PAre 266 452656 O 'k* REGISTER'S OFFICE WILEMAR W. STUDTMAN and DENISE M. STUDTMAN, ST. CROIX CO. WI _ Recd for Record l husband. and-wife.,---Grantors OC 181989 at 1 11:15 A. M conveys an-d narrants to _._._WILL1AH..D_...PLOURDE_._and...... -CAROL.-PLOURDEhusband - - and---w: -fe as----------------------- _-s-urvyorship_-mariaal._pro.perty .-.Grantees----.- I Register of Deeds I - - RETURN TO I~ ~I - - ' - - the following described real estate in .t_....CirrQix------------ county, ' - - State of Wisconsin: Tax Parcel No- l ' Part of NW-1/4 of SW-1/4 of Section 36-30-20 described as follows: j Lot 1 of Certified Survey Map filed October 5, 1981 in Volume 4, j~ Page 1117, Document No. 373750. I I I MANSE i. $1 - • FETE TOGETHER WITH AND SUBJECT TO reservations, restrictions, rights-of-way, and easements of record, if any. ii This LS_nOt homestead property. 1 (is not) i Exception to warranties: I I Octobe. 19- -8.9. Dated this - - day of < . L) * - ~ILEMAR---- STUDTMAN ...(SEAL) / a-~.. (SEAL) DENISE M. STUDTMAN li it AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN I~ ss. -St . Croix y County. authenticated this day of 19 Personally came before me this day of October 194~~i~~th~bove named * Wi lemar W- S------- L - ;and-------=; i TITLE: MEMBER STATE BAR OF WISCONSIN Denis. Studtrr&r~ O (If not, authorized by § 706.06, Wis. Stats.) to me known to be the persolxjS'•,_____:._: \o ex6 M14 the foregoing instrument and aclfn~.W ledge the sa ; THIS INSTRUMENT WAS DRAFTED BY Attorney Barr C . Lundeen •GIL-BERT- MUDG P-OR'TER__&--L`UNDEEN- 11Q__SecQ~l•-S_treet•,_---Hudson-,__WI----_-_--_ Notary Public _______.St. Croix County, Wis. ii (Signatures may be authenticated or acknowledged. Both My Commission is permanent. j are not necessary.) date: 19--•-----•) ii { 'Names of persons signing in any capacity should be typed or printed below Unit ,igoaturvs. 1 WARRANTY DEED STATE BAP. OF WISCONSIN Wisconsin Legal Blank Cu. Inc. FORM No. 2- 1582 N!:1wi.uk". wis. ® FORM *5-A • ' ' M C Y.,., (.a.,ay c~c,c 3 Co T3 0 Iv - te . a 0 Y V rc,r- sw c~ Uoe41 ~D 00 373750 OCT 981 WttELL I f c,:: Ga.a7. CERTIFIED SURVEY MAP W ~6.4 CC CURVE DATA TABLE G 1~N ' NO. 1 RADIUS CHORD CHORD BRNG. CENTR4L- 1-2 /8/0,08 /2/5.05' 59°53'56"E 39 °13'20 ! II~ 3 /8/0.08 555.88' S49°07'14"E /7°39'56" 3-4 4 107.82 123.29' N74°17'17"E 69°4436" W114 CORNER 4-5 80.00 103.60 N68°4827"E 80°42'16 SECTION 36, 4 80.00' 8754' N75°59 /8'E 66°20'34" T30N, R2OW 2 80.00' 20.00 N35°380E 74-'672-1'42" 6-7 433.0 264.01N10°42'19"E 35°30'00 2 433.00 109.70 N21 °10'39"E 14033 20 433.00 157.40 N3°25'39"E 20°56 40 ' ® J UVJ) Z IN N7°0241,W IN t \ j 159.46 I W I Fey.. 3 °a 1 °o LOT l of 4.46 ACRES \ Il, _I \ Z 4-80197045'' _ ® I \ , _N28°27x9E 20.00 0,1LOT 2 0) \ LOT 3 to°s 3.54 ACRES - 4.41 ACRES \W ti N \ s cV APPRO.<IMATE 385.00, 632.75' - ca HOUSE LOCATION S89°3/ 4 E /0/7.75 3 ~ I W to LOT 4 M , L 14.12 ACRESS rn p s SEE DETAIL ~ N W o Z ON REVERSE p , j o 09 `Qj N 89 °31 40 W 1307.21 SOUTH LINE OF THE NW-SW APPROVED MAY 2 0 1981 o SET I"by24"IRON PIPE WEIGHING Si. CROIX COUP-41Y 1.13 LBS.'PER LINEAL FOOT. COMPAeHeNSwE PARIS PlAWA44;i 0 =IRON PIPE FOUND. SCAL E 1"-200, AND zG141r1C, cc::.:i.[t 0 100 200 400 on oe V02umc L Paru 1117 _ / N • f? SEPTIC TANK MAINTENANCE AGREEtIENT St. Croix County r a FA, 0 OWNER/ BUYER ~ Fire dumber © r 0 ROUTE/BOX NUMBER ZIP ~SO~ 2- CITY/STATE (,,~rS id k, Section T3 N~ R W, PROPERTY LOCATION Town of ~a s°!-' h St. Croix County, Subdivision Lot number Improper use and maintenance handle wastese~tPronerta►aintenancescon-in its premature failure to sists of pumping out the septic tank every three years ur sooner, if needed, by a l`ic'en's'ed' 's'e t'ic tank um er. What you p into the system can a ect t e' function o, t ha septic.tank as a treat- ment•stage in the waste disposal system. St. Croix County residents-ma►'be eligible to recieve a grant for a maximum of 607. of the cost.of replacement of a failing system, wh c was in operation prior to-July 1, 1978. St. Croix County accepted this program August to keep,thair systemgproperly that owners of all hew ~stiems agree maintained. The property owner agrees to submit to St.. Croix County Zoning a certification form, signed by the owner and by a mater plumber, veri- Journeyman plumber, restricted plumber or..a licensed pump fying that (1) the on-site wastewater disposal system is in proper nec- operating condition and -M-after inspection and pumping essary), the septic-.ill kbessentsapproximately130fdayadpriordtoc~• Certification form w 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 Depart- b ment of Natural Resources. Certification form must be and returned to the St. Croix County Zoning Office within 30 days of the three year expiration.date. ~~;;pp S IGNED~,r~cti DATE / 6 - 5 0 St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 386-4680 Sign, date and return to the above address. DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS i~ INDU,StRY, DIVISION LABOR AND' PERCOLATION TESTS (115) MADISOP.O. BOX N W 5739069 HUMAN RELATIONS (ILHR 83.0911) & Chapter 145) LOCATION: SECTION: TOWNSHI UNICIPALITY: OT NO.: BILK NO.: SUBDIVISION NAME: t=sr~ NW1/ sw 1/ 3( /T~ N/Rzo E to 1L I COUNTY: MAILIN ADDRESS: ST:12*41)C Lvk l t ~-rm pV~vC~ v~ w ssa 2 USE DATES OBSERVATIONS MADE I&esidence NO. B DR : COMMERCIAL DESCRIPTION: L4 N•New ❑Replace RATING: S= Site suitable for system U= Site unsuita'b_lee for system O CONVENTI NAL: MOUND: IN-GROUND-PRESSURE: SY EM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM: (optional) ZS au OS au COS au OS ou o S Eu If Percolation Tests are NOT required DESIGN RATE:: If any portion of the tested area is in the A ` under s. ILHR 83.09(5)(b), indicate: N • Floodplain, indicate Floodplain elevation: N• PROFILE DESCRIPTIONS BORING TOTAL IDWATER-IN L4 CHARACTER IL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION 08 IF EST, RIFOL T B K IF OBSERVED SEE ABBRV. ON BACK.) B- 1 g$ 01n.8 1,z-WQ , > 8 S s'- C:,. k a is Z 0 >r 7- B- z. 8b q&.4 > a B- > qO k B- loZ- 1ut.3 > lOZ B- S lob 4a.-7 > )rz B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME WATER DROP IN LEVEL-INCHES RATE MINUTES f NUMBER INCHES' AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD PER INCH P_ \ 1,Z) Z 8 Z We. Z 3/a P. Z 3 S - to Z3/8 z<< Z cl P_ 3 68 Z Z S P- H CC-)eTt 1 ~+=S P• S~ o ! Svc ! GL~ . 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. INL'>,pt~, t# hLTER~,hTS 7p~G~ ~.~4,(ri~1~f1 ~1.)1'16l') SYSTEM ELEVATION y • o' OV t tP J Zv' 1 50 1 Jr 8 SP'S ~ I i - I I.jid.rt u~I S c I I 41 w- + - - t t Pr - s~~;rtE~t~ S3~ ; et T101M W_ S aftt.~ l tt ~ ~{br L~at'pT f1S S f}OwN S~2 3L 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 date recorded and the location of the tests are correct to the best of my knowledge and belief, WEGERER SOIL TESTING NAM print : AND EST WERE COMPLETED ON: - DESIGN SERVICE AZ)- L 9-4 0 008 S : CERTIFICATION NUMBER: PHONE NUMBER optionel P.O, BOX 74 421 N. MAIN 8T, 0-37 o0o S76 7't S- ~lZS-O! 6S RIVER FALLS, WI 64022 S SIGNATURE: 715-425-0165 RIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. L or-- Z. •SBD-6395 lR. 10/83) - OVER - SOIL DESCRIPTION FORM (At to S I Prot i lo a a On o Su arate Shoe GL G RATE; rJ 3 ~b .cJ L S 2 3 Yom" I S LOPE • ViJ I'n pt L Pf.~'A PURPOSE S .,F31 nESr.RL10N BY C T?rna QIZ- L WE IE6 ~ ASPECT. R LAND USE; 1:: S l 1990 CLI COUNTY/STATE ST CZ O LK Cou. TL1 Gv) VEGETATIVE COVER- GgkS S- W o E0 5 - F moQ "T1Z-EL S LOT DESCRIPTION:'- PT O~ icy SKS-Z6 Ta R20kftA NAGS CLASS: VJ Lf -L-- 't)~Z lNCft LOCATION I`-1 O SL) S GALLONS' PER $0• FT. PER OAYt PARENT MATERIAL(W SOIL SERIESt ~)rCT ! L h~{ PTA..►'n co - HORIZON DEPIII MATRIX COLORS MOTTLES TEXTURE STRUCTURE CONSISTENCE CLAYSKINS/ PORES ROOTS Pil -BOUNDARY REMARKS n. moist C St. COATINGS 130 dL.! G 0-01 It VV- 31Z - s i 1. 3~k Y-t vih 9s si I l~s~k m~►- cs Z cy -3Z 3 3Z_g IrJ~cz_Y/6 S o S9 m l. G Z 1 0-5 vw-t R. 3 1 Z - 5-i Z s bh Ht v 4~- c s 3 23_33 lb~ttZ Y! - s I Zm 9~h ~'I't•'F►- ~S 13 -%I. 1oLt9- YA. - S P s m 1 u~ G 3 z 5-2,5 tb-tR / - s 5ek Tn4\, ~S 1 3 Zs _90 L(.~,l C~L Y/6 S o s In Aar.~ 0-8 lu`fR 3 1 i S i 1 S tik Yln v ~v- Z lb 4R. Y/ - si) l'~Sdk ki:~ ~s 3 2V-lb lb (Z, Y/` - S O $012.1 uG S - 1 p lb`'IR. 3 ! - s.1 ~ Z S ~lrr; Tn U`'FF; Q,S Z v! - s i I 1 `FS Ok mph cS 10 l u`1 R Y& S S h1 OTHER SITE FEATURES/NOTES: 1O_)C~_gd rto 000 5 74, LIMITING FACIORS/DEPTH: Signature Date CST 0 p~<y PLO 87 PLOT & CROSS SECTION PLANS ~n?rr+ ZAPPA BROS. EXCAVATING INC \•1 PLUMBING UNIT 4 "v` PROJECT /,)SV C-.4, SLPT IC T/1NK JVlw ~odEVrlbuAc s4'S 7s GtJTl1 /O C.~• /~T a ✓LtT otA7,itr DUR/~E \ ~.ce.Lv c~uT/S.v SnL~notJ 'yikldlcr G✓ ~N i~TiT~ r1H 6 LJ 35~ Q 157-, C~OSEA~ Sc.cR a~sLo ao soy 36 K tf'U ~,/v r L. /N E S I ~LS~/~LNC6 ~ ~R~posco CC ~r.,1 BL L, L XS tN A Aeo as ,v' A N DR°O~ry ~ ~S T Jfr ~ "~.P", n/~P,vE Q3 CALE S0,,-rw P,Wcwri/ 4,&,,c FRESH AIR INLET AND OBSERVATION PIP APPROVED VENT CAP MAXIMUM 12' ABOVE FINAL GRADE 4' CAST IRON VENT PIPE MAXIMUM OF 42' ABOVE PIPE TO FINAL GRADE SIGNED: //6~ MARSH HAY OR SYNTHETIC COVERING LICENSE: ~/lS ~3 gS MINIMUM 2' AGGREGATE DATE: /0 OVER PIPE DISTRIBUTION PIPE i ~ TEE SOIL TESTING BY: C ELEVATION BED 6• AGGREGATE • BOTTOM PER SOIL BENEATH PIPE PERFORATED PIPE BELOW TEST IS COUPLING TERMINATING q5/' FT, AT BOTTOM OF SYSTEM ST. CROIX COUNTY { s WISCONSIN r II~~~ ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 IW May 26, 1993 LeeSchultz 1238 Hwy. 35 No. Hudson, WI 54016 RE: TOWNSHIP BUILDING PERMIT Dear Mr. Schultz I have reviewed the information which we have on file regarding the septic system which serves your existing three bedroom home. The septic was designed and installed to treat and dispose of the waste generated from a 4 bedroom home. It is my understanding that you wish to obtain a building permit for an addition to the house, which is to include adding a fourth bedroom. As the septic system meets current code requirements for a four bedroom home, the only permit which is needed is a building permit from the township. We have no objections to an addition to your home provided two provisions are met. The first being that an affidavit, which is enclosed, is signed and recorded with this office. The second provision is that the addition must not encroach upon the required setback separations from the septic system. The addition must be at least 5' from the nearest edge of the septic tank, and at least 25' from the nearest edge of the drainfield. Should you have any questions or concerns regarding this matter please feel free to contact me at his office between the hours of 8:00 am - 5:00 pm, Monday - Friday. S incer Ll~ly, mes K. Thompson 1 Assistant Zoning Administrator III ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 1 1 - (715) 386-4680 EXISTING SEPTIC SYSTEM AFFIDAVIT The existing septic system serving the three bedroom dwelling located at 1238 Hwy. 35 No. was designed and installed to accomadate the needs of a four bedroom dwelling as set forth in s. ILHR Chapter 83.10(2) WI. ADM. CODE. St. Croix Co. Zoning office records reveal this to be true and correct to the best of my knowledge. As the existing septic system meets the above minimum requirements, an addition may be added to the dwelling without updating that system. This addition must not, however, encroach upon the required septic em setbacks etforth in s. ILHR Chapter 83.10(1). County Authority: U^- 0 Title: c Gri~^ ^ Date: Property Owner(s) Property Address: Property Legal Description: Lot#CSM/suAadi-vjlo-tp"~ ~1/4,5901/4, Sec. .3(o , T. X N. , R. V W. , Tn. of nstLz' I, as the owner of the above described property, hereby affirm that the proposed addition to this dwelling constitutes a fourth bedroom, and will not result in the existing septic system becoming undersized as per s. ILHR 83.10(1). Notary Public 1 Subscribed and sworn to before me on this date: Signature(s): Date: /Z'~ o /7~7My commissi n expires: FORM N'"'-0~5-A N.GMIII.rGprgNry® 0 CERTIFIED SURVEY MAP CURVE DATA TABLE N0. j'O 71 N RADIUS CHORD CHORD BRNG. CENTRAL 1-2 /8/0.08'12/5.05' 59°53'561'E 390/3'2011 I /8/0.081 6770 S68°43'S4'lE 21033r24" 3 /8/0.08 555.88 S49°07'14/E 17°39156" 3-4 4 107.821 /23.291 N74(117 l7 E 69°4413611 W114 CORNER 4-5 80.0 /03.60 N68°4827"E F680-0'16 °42SECTION 36, 4 80.00' 87.54' N75059 /8 E 2134 T30N, R20W 2 80.001 20.00' N35°38'IO'E /4°2/ 42 6-7 433.0 264.01'N 0°42 /9 E 35°30 00 2 433.00 109.70 N21 °10139"E 140,33 20 - , / 433.00 157.40 N3025'39"E 20°56 40 m o t L ® N7°02'41; j Q I s~ 15 x.46 W xt- 0 0. LOT l 3 1 of 4.46 ACRES cn p / cal 66.020 , `j h\ 197°45'0d1 80 ~ ~ \ W 8c27119'E 's4o 0.00 \ \ LOT 2 LOT 3 Wo W°~g .54 ACRES 4.4/ ACRES \ \ F` ^ wrn I (0 N s N APPROXIMATE, 385.00, 1017. 75 632.75 N 3 \ tp HOUSE LOCATION S89031 4 E ti co ~ z W LOT 4 N 14. l2 ACRE, SEE AIL N W N ON REVERSE -p ? r J ~ I o~0yh .fl00 c~- ~ Q 09 °s 1i,1 N89°3/ 40 W 1307.21 SOUTH LINE OF THE NW-SW o = SET I "by 24"IRON PIPE WEIGHING 1.13 L BS. PER L / NEA L F00 T. • =IRON PIPE FOUND. SCALE O~ 0 100 2000 Ink /pct t ~ . ~✓-~~G , ~ ~'7'' 79-33