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018-1004-60-050
C) Cl) p 0 N O 0 to p 3 v C) r� c° m c °: 0 °' f r 4/ 0 a �1 N C 3 A N C 0 A 'B K v n v v n Zi c ro `�° M `t 0 ` Z `n z w O A � = N O 1 � • h 3 = O c'°3, W N C O CD 0' N N cr W 03 CD N ,� ID Cn C 7 @ A a d N V+ D. Q ry N N Q 7 N A C < No a j D ? j y o ° ?@ y ° W - ro = @ - - o o o @ cQ cc @ o m B m -i 0 n � N � (w O 7 = O O O CO O O _ m O C) k N N 7 N N j 7 N N j O O. o N y = O y c O y c D D Q u Z D m a m _� a I m a m N Z7 C cn a c Q i c 0 p � o 0 N I 0 . N Q O@ j N O O SD @ Z O@ CD CL CL m O O 2 CD O O 2 CD O O S 1 n r N (� or y W CO 0 0 N N m m 3 3 3 3. 3 U O O O °- O O O PL Q O O O Q I o N N y o N tq N 0 3 N N N 'I D T G 0 A T y O IN .'�. A N O CD N K ai y O W M D1 - M N - PY d y C1 W M ip 3 3 m 3 °' 3 °-' n m m CD w o Z . z z N A °_ D D o D D o D D o CSS fy. Q 7 Id 7 N N 7 Q ? Q CL 1x11 o o o n m m m m O =3 .,±. C(U N ( N cn S C N ',. C p C ill � I 7 7 @ N @ N @ N cn I� w m d v {`, Z O ss Q C7 O a CD CD c cn N N (n N N W N W N m Q Z 0 0 0 3 A T1 cn 3 3 3 .' c rn Z @ @ @ A 0 ip �= D D m y' n m m a a C 0 0 0' o N CO O 7'I p T @ = A -n -� tll c SU c N @ Z C. z C. O Z O. 3 0 0 0 N 3 � ro C� c. C) 00 °�° cr rn @ 0 a o l Cl) � - v � CD F a 0 N N V 3 N lv � 3 ° @ O � v I I � V 0 0 O �, @ @ @ 1q J fA O EA O Efl 0 + N O CD Safety and Buildings Division County N p 11V 201 W. Washington Ave., P.O. Box 7162 cons�n Madison, WI 53707 — 7162 Sanita Pe it Number (to be filled in by Co.) Department of Commerce (608) 266 -3151 00 C) 7L� Sanitary Permit Application State Plan ' I.D. Number / In accord with Comm 83.21, Wis. Adm. Code, personal information you provide /- may be used for secondary purposes Privacy Law, s15.04(1)(m) Project Address (if different than mailing address) 1. Application Information - Please Print All Information # ///d 't 712— J Property O er's Name / Parcel # Lot Block # C)M -- 106 1q,_ D Property Owner's Maiiing Address Property Location City , Stat Zip Code Phone Number �' - �'' Section ' _Circle grtpj N; R E o II. Type of Building (check all that apply) Subdivision Name CSM Number A or 2 Family Dwelling - Number of Bedrooms ❑ Public/Commercial - Describe Use ❑ State Owned - Describe Use ❑City_ V [age ATownship of III. Type of Permit: (Check only one box on line A. Oomplete line B if applicable) A. ❑ New System ❑ Replacement System tment/Holdin Tank Re lacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiratfon Plumber Owner N _W. Type of POWTS System: Check all that appl ❑ Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) Dis ersaUTreatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (st) Dispersal Area Proposed (sf) System Elevation V1. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank [ Aerobic Treatment Unit Dosing Chamber VII. Resp nsibility Statem t- I, the undersigned, ass a responsibility for installation of the POWTS shown on the attached plans. Zul Nam Pr Plumbe s Sign MP /MPRS Number Business Phone Number J � dar e (Stree City, Sta a ode) VIII. unt /De art nt Use Onl pproved 11 Disa proved sanitary Permit Fee (includes Groundwater Date Issu d lssuin gent Signat a Stam Surcharge Fee) 4 ' �► _ Z 1 a El Owner Reason for D ial IX. Conditions oZp roval /Reasons for Disapproval t?( � l.Jcv1 L cr�v� � 'f C�© j �� C't7 9t'� lctir� � �Cc ! — z-4 rte,. -L C Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix i Safety and Building Division r INSPECTION REPORT Sanitary Permit No: - 98 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). Permit Holders Name: City Village x Township Parcel Tax No: Penfield, Allen Hammond, Town of 018 - 1004 -60 -050 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 2.29.17.27B -10 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic "Rchmark Dosing � � Alt. BM J t, Aeration IF B dg. Sewer Ju Holding t /Ht nlet S t /Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WEL BLDG. V ent o Air IntaKe ROAD 7757 S ept ic B ottom t osing i ea er an. 7 50 5 Z 24C) j era ion D ist . Pine o ing Elot. em PUMP /SIPHON INFO 10 is rae manufacturer eman over Iv 54a' ( GPM o e um er 45G Co 50 3 7. Z$ I UN IL ITt r lc ion oss yS em ea 1'l•� , Zf 2, 5� 19.1 or emaln I Lengi n � , l „ 5E. EV VVU11 5 � ZDTI 5Y5 I t:M - UT r11S 111bluu wid. T Ulu Depin DIMENSIONS F IvidiluldUtul r l INFORMATION 5 CHAMBER OR UNIT 140111bul. nucluW11vidliffuld butiall A rJute SIZE: JA nuM to All 11 Itat" Pipes) Length Dia Length Dia Spacing x Pressure Systems Only xx Mound Or At - Grade Systems Only Bed /Trench Center Bed/Trench Edges To Yes F No Yes No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1110 192nd Street Hammond, WI 54015 (SW 1/4 SW 1/4 2 T29N R17W) NA Lot 3 Parcel No: 2.29.17.278 -10 1.) Alt BM Description = eZ Co')e,t.� 2.) Bldg sewer length = I �j>� - amount of cover = Plan revision Required. ;'J Yes No c Use other side for additional information. SBD -6710 (R.3/97) Coun r Pe it Applic ion T. c IX COUNTY WISCONSIN G p In accord with Chapert 12 '"9wq�,�ounty Sanitary i ance PLANNI & ZONING DEPARTMENT Personal information you provide may be used for seco ary puE &R (' e S709POIX UNTY GOVERNMENT CENTER �� [Privacy Law. S. 15.04(1)(m)] 101 Carmichael Road $`.".1�'' dson, WI 54016-7710 ST. CROIX UNT)(7 6 -4680 Fax (715)386 -4686 Attach complete plans for the system on paper not h5b s in size. County Sanitary Permit # ❑ Check if revision to previous application 00 C � $ I. Application Information - Please Print all Information Location: Property Owney Name / 114 1/4, Sec N, R E (or Property Owner's Mailing Address Lot Number Block NN ber City, St at Zip Code Phone Numer Subdivision Name or CSM Number 11 Type of Building: (check one) 03ity ❑ iilage JSTown of 1 or 2 Family Dwelling - No. of Bedrooms: ❑ Public /Commercial (describe use): p ❑ State -owned Nearest R ad -` 11. Type of Permit: (Check only one box on line A. Check box on line B if applicable) Parcel Tax Number(s) A) 1 Repair 1 2. ❑ Reconnection []Non- plumbing 4. []Rejuvenation Sanitation 0 — B) Permit Number Date Issued State Sanitary Permit was previously issued - IV. Type of POWT System: (Check all that apply) ❑ Non - pressurized in- ground ❑ Mound ? 24 in. suitable soil /4 Mound :5 24 in. suitable soil ❑ Mound A +0 ❑ Sand Filter ❑ Constructed Wetland ❑ Peat Filter ❑ Drip Line ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Other ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application Rate 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed (Gals. /day /sq.ft.) (Min. /inch) Elevation VI. Tank Information Capaicty in Gallons Total # of Manufacturer Prefab Site Con- Steel Fiber- Plastic New Existing Gallons . Tanks Concrete structed glass Tanks Tanks ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ II. Responsibility Statement I, the undersi ned, assume responsibility for repair /reconnencti /rejuvenation/installation of non plumbing for the POWTS shown on the attached plans. A license is t required for terralift repair or the install ion of - plumbing nit tion system. Plu is Na ( Plumber's S' re MP /MPRS No. Business Phone Num � lu ber's Address (Street, ity, State p Code) i VIII. Cou Use Only =Owner Sanitary Permit Fee D to Issued Issuing t Signat Approved in dverse Z, Z 3 �� IX. Conditions of Approval /Reasons for Disapproval: r 0 0 0 W W O 2 O Ob $ S a W h V � , m M W Z L5c Z CL Z W m c a r O c o m E a 0 � 519 s c �m �m W W r o tO m p eo v a z a W $ Q a ui CL y Q a NL E 10 a_ oN 0 o m$ E 7 a N r C N V N r O m Z L U m VVV = . 0 q r N M {A e Im Z e X /� • I O /C w H M V V W Q M CO a Q ac•E C H m 3 W 3 6 W W m o o m m c I 7 a m N to m m 9 O w �� W °� -E E g� so . a W O� Z W Z Z LL 1 0 ZQ U ` z o0 L -1 !- > W D U) o CO w �F- C m SQ J 0� Z W Z Q Z w 0 w 0 O W z WU U F— F- ►_— = Z � N - ~- Q o m � o F _ Y � o 0o U Q LL O N V 11� o °° O m o • w > CO U � �M o O •. F- 0 W U o� 2 W oc 0 O 0 fro 0 z z Q $w v — CL -j 0 *. yl* o a Safety and Buildings Division ,�s S ANITARY PERMIT APP PC ATION 2 01 W. Washington Avenue ,partmentof Commerce In accord with ILHR 83.0 C� e, P O Box 7302 Madison, WI 53707 -7302 Attach complete plans (to the county copy only) for the SOe , on pyplrA* le "� ounty than 8 112 x 11 inches in size. c► +� ® � See reverse side for instructions for completing this ap tiort'p St to Sanitary ermit Num r Personal information you provide may be used for secondary purposes �j S (Privacy Law, s. 15.04 (1) (m)), / rP O r 0 heck,ewsio pr evious application / �/0 S to Plan I.D. Number 1 PP I ATI N INFORM I N- PLEA E PR I N .f oZ Prope ner Name P Pro ca t4, 5 T 0 , N. R E (orav or ProVe#13j Owner's Mailing Address d✓ Block Number City ate Zip Code Phone Number Subdivision Name or CSM Number • TYPE OF B L N (check one) ❑ State Owned ❑ Ity rest Road Public 1 or 2 Family Dwelling - No. of bedrooms ❑ Village own OF Ill. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) a`�. pr oZ. - to 1 ❑ Apartment/ Condo Ole- /&9'6`/- lod — aS0. 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 Q Service Station/ Car Wash 5 ❑ Hotel / Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box online A. Check box on line B, if applicable) A) 1. IS New 2. ❑ Replacement 3 Replacement of S stem 5 stem ❑ p 4� [:1 Reconnection of 5 ❑ Repair of an ---- _- _________ ___y-_ - Tank Only ---------- -_ Existing System Exist S stem B) F] A Sanitary Permit was previously issued. Permit Number 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 Pressure 13 42 ❑Pit Privy Seepage Pit 43 E] Vault Privy. 14 ❑ System - -Fill A. ABSORPTION SYSTEM INFORMATION: L � 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc Rate [6 Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft -) (Gals/day /sq. ft -) (Min. nch) Elevation /I1. TANK Capacity �7� / Feet Feet INFORMATION in gallons Total # of Prefab. Site Fiber- Ex p er. New Existin Gallons Tanks Manufacturer's Name Concrete CO " - Steel glass Plastic App Tanks Tanks / strutted aptic Tank or mg Tan oma `� ❑ ❑ ❑ ❑ !, ft Pump Tank /SiPh er I ❑ ❑ ❑ ❑ ❑ ''ill. RESPONSIBILITY STATEMENT 1, the Vndeirsigned, assume responsibility for inst ation of a onsite sewage system'shown on the attached plans. lum ame (Pr' Plumbe ' atur ps MP/MPRSW No.: Business Phone Number: t lumber's - Address (StrQet, Ci y, State, Z' ode): ��" J ^o, C COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate I ssued Issuing � nt ature (No Stamps) ❑ Owner Given Initial f,d - surcharge �� ,�; � ]Approv ed � -S 9e Fee) `� Adverse Determination z :. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: ;DT 6398 (R.11197) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber 0 ' y a m i w NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW Iii., fi'�o�isk ac INDICATE NORTH ARROW COMPOSITE CURVE STA- -RITE' ■ 0 ■ A CAPACITY LITRES PER MINUTE 0 50 100 150 200 250 300 350 400 450 500 550 1 � Fy�'� 26 80 24 22 70 F 20 � 60 18 FC uj W 50 U. 14 ? c c � 1 40 12 A yp 30 F 8 C? 6 � F C3 r o 4 yr��ti tip 10 2 yp 0 I 0 25 50 75 100 125 150 I CAPACITY GALLONS PER MINUTE ST. CROIX COUNTY ZONING DEPAR AS BUILT SANITARY REPORT r f � Owner l` Property Addres 2 - City/State Amd ,n J r 'vIN Legal Description: Lot _sue Block Subdivision/CSM # , IL !/4 ' /a, Sec. N -RAW, Town of PIN # le90 05 SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION y Tank manufacturer Size ST/PC /sic Setback from: House _j,r_ Well P/L Pump manufacturer Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: ,jua".d o Width �_ Length Number of Trenches Setback from: House g Well P2 f_S� Vent to fresh air intake s', ELEVATIONS Description of benchmark 3? v Elevation 1,5 ,e, e Description of alternate benchmark m s Elevation Building Sewer 2,2,o7 ST/HT Inlet %/.- ST Outlet /_�- /�_ PC Inlet 9- 77 PC Bottom 97,,14 Header/Manifold ,/ �_� Top of ST/PC Manhole Cover Distribution Lines Bottom of System O /41, 7 O ( ) Final Grade Date of installation/ / / P mit number �_ State plan number ,�o9 Plumber's signature License number •:� Date Inspector _��� Complete plot plan � NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW 6 3_ 41Z INDICATE NORTH ARROW Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM County: INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)1. 353114 Permit Holder's Name: ❑ City ❑ Village [R Town of: State Plan ID No.: PJ d t Town of Hammond C T BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: w d 3 18- 1004 -60 -050 TANK INFORMATION LEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic l`� Benchmarks ;�� Dosing ©C7 Alt. BM o .0 A tion Bldg. Sewer 1b Z , Hold t Ht Inlet 4 TANK SETBACK INFORMATION S&/ Ht Outlet [ S Q TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet # IAN Air Intake Q, Septic 7 56 (p / NA Dt Bottom Dosing )" AJ4 > /Sf NA Header /Man, 3. 3 ?o Z- Z A Dist. Pipe 3,3 /o Z .`2- Ho ' Bot. System 91 by �ff PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand St cover Y Model Number GPM kr' - } - f 9 TDH Lift f q , i l Lrictior��� ( System �- TDH q Ft oss Forcemain I Length $� Dia. Z ,1 Dist. To Well SOIL ABSORPTION SYSTEM ( BIED TRENCH Width Len g t hhj� No. Of T enches PIT No. Of Pits Inside Dia. Liquid Depth N 1 N (a > DI SYSTEM TO P / L BLDG WELL LAKE / STREAM ING > p"1 acturer: SETBACK CHAM INFORMATION Type of del Number: System: SO �S � ��� OR IT DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) n r x Hole Size x Hole Spacing Vent To Air Intake Length � Dia. Length � Dia. 1 '(Z Spacing _ I T/ y/ SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges I Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1;/a /(o /99Inspection #2: 1a / 71 0; Location: 1110 192n WI (S 1/4, SW1 /4, Section 2 T29N -R17W) - 2.29.17.27B -10 3 .3 = ©!�, S r SrrS G►� �P Sri �a w, ct; Maui ' // %n � 'h 4 / Z / ✓GWtGn� -F rl/ t 13' d s -� ,rte o,-r' �I��lly ,'7 3' p L Coed/ er6 5'o,r. r r r 1170 cr y Plan revision required? ❑ Yes ❑ No Use other side for additional information. Z a I� SBD -6710 (R.3/97) Date Inspector's Si & ure Cert. No. Safety and Buildings Division Vi PERMIT APP ATION 201 W. Washington Avenue n F1 P 0 Box 7302 In accord with IL r3z o Code Department of commerce Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for thn p� rt less , ounty t han 8 v2 x 11 inches in size. �F • See reverse side for instructions for completing this ap � State Sanitary ermit Num r Personal information you provide may be used for secondary purposes , ❑ check �ew'sionto �ewous application y Law, s. 15.04 (1) (m)l. [Privac / � Rgs, ` State Plan I.D. Number I � I. APPLICATION INFORMATION - PLEA E PRINT ALL WFOkUMMN f oZ nq Prope ner Name c � ` Prop _ CQcatio 1 , 1 14, S T , N, R E (orJV Prooe rfj Owner's mailing Add re Block Number City ate dd✓✓ Zip Code Phone Number Subdivision Name or CSM Number IL TYPE OF BUILDING: (check one) ❑ State Owned ❑ !t( - N crest Road Public 1 or 2 Family Dwelling - No. of bedrooms ° V o wn of III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) a!1' - oZ, - 7/3 — to 1 ❑ Apartment/ Condo c!e— lee l l°a --O - © 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 Nome Park 12 ❑ Service Station/ Car Wash I 5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. IS New 2, ❑ Replacement 3 ❑ Replacement of 4 ❑ Reconnection of 5 ❑ Repair of an System System. Tank Only --------------- Existing System -- - - - - -- Existing Systerrl B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed' 21 J21 Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill ovr ,..,1 ( o_ VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate IS. Pert Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. nch) Elevation / < Feet Feet acct VII. TANK in Cap llo Total # of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturers Name Concrete con- steel glass Plastic App New Existing structed Tanks Tanks Septic Tank or Ing Tan r oma l !c f ❑ ❑ ❑ ❑ 1 ❑ Lift Pump Tank /Sip h er — ❑ ❑ ❑ 10 1 ❑ VIII. RESPONSIBILITY STATEMENT I, the Vndersigned, assume responsibility for inst ation of a onsite sewage system shown on the attached plans. Plumb ame (Pr Plumbe ' atur ps MP /MPRSW No.: Business Phone Number: 3 Plumber's -Address (Stre�et, C1 y, State, Z' ode): -' IX. COUNTY / D PARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate Issued Issuing Agent Signature (No Stamps) Surcharge Fee) [] ❑ Owner Given Initial Q �( g4_ ' Adverse Determination /lfl7 X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: 'elms SBD- 639H (R.11I97) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber 1' INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a 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 and Buildings Division, 608- 266 -3151. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling_ Ill. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on 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 for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /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 81/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. I l Safety and Buildings 3 PO BOX 7162 MADISON WI 53707 -7162 * is cons'in TDD #: (608) 264 -8777 www.commerce.state.wi.us Department Of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary September 08, 1999 CUST ID No.224263 ATTN: POWTS INSPECTOR ZONING OFFICE KIM A O'CONNELL ST CROIX COUNTY SPIA 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 RE: CONDITIONAL APPROVAL Identification Numbers APPROVAL EXPIRES: 09 /08/2001 Transaction ID No. 245209 Site ID No. 180384 SITE: Please refer to both identification numbers, Site ID: 180384 above, in all correspondence with the agency. ST CROIX County, Town of HAMMOND SW 1/4, SW 1/4, S2, T29N, R17W Facility: ALLEN PENFIELD 192ND STREET, HAMMOND 54015 FOR: in o .. ,cr numb Obj_ - Regulated Object ID No.: 490131 MCtUNT f PD _ The submitta T IQG �f2i �(',�/� with applicable Wisconsin Administrative Codes and Wtsconsi ��� Y APPROVED. The owner, as defined in chapter 101.( L ace with all code requirements. The followin lation and prior to occupancy or use: • A copy ill be on -site during construction and open to inspecti( hich may include local inspectors. All permits requires d prior to commencement of construe � f Inquiries co � HoP r i cS to telephone number listed below, or at the address on this lettei A REP Sin rely, q -7- 3b q DATE RECEIVED 09/03/1999 D1VtSt FEE REQUIRED S 180.00 FEE RECEIVED S 180.00 SEE 1 ES -B QUINL'AN , POWTS PLAN REVIEWER _ BALANCE DUE S 0.00 Integrated Services (608)266 -3937, JQUINLAN @COMMERCE.STATE.WI.US WiSMART code: 7633 cc: ALLEN PENFIELD IR Safety and Buildings PO BOX 7162 MADISON WI 53707 -7162 TDD #: (608) 264 -8777 isconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary September 08, 1999 CUST ID No.224263 ATTN. POWTS INSPECTOR ZONING OFFICE KIM A O'CONNELL ST CROIX COUNTY SPIA 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 RE: CONDITIONAL APPROVAL Identification Numbers APPROVAL EXPIRES: 09/08/2001 Transaction ID No. 245209 Site ID No. 180384 SITE: Please refer to both identification numbers, Site ID: 180384 above, in all correspondence with the agency. ST CROIX County, Town of HAMMOND SW1 /4, SW 1/4, S2, T29N, R17W Facility: ALLEN PENFIELD 192ND STREET, HAMMOND 54015 FOR: Object Type: POWT System Regulated Object ID No.: 490131 MOUNT / DWELLING 450 GPD The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner. as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of c onstruction/installation /operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sin rely, DATE RECEIVED 09/03/1999 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 MES B QUINLAN , POWTS PLAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (608)266 -3937, JQUINLAN @COMMERCE.STATE.WI.US WiSMART code: 7633 cc: ALLEN PENFIELD MOUND SYSTEM DESIGN RECEIVED Re„dentiai Appiication SEP 0 119." INDEX AND TITLE SHEET •7 SAFETY &6ta GS. 0!Y Project ALLEN PENFIELD Owner ALLEN PENFIELD Address 232 SOMMERS LANDING N. HUDSON WI 54016 Legal Description SW SW- SEC2- T29N -R17W Township HAMMOND County ST CROIX Subdivision Name Lot No. #### Parcel ID Number Plan Transaction Number Index and title sheet Page 1 Mound calculations Page 2 �`t °.•�• Mound drawings Page 3 S F r 01 1 (1 a y Pres. dist. calcs. and laterals Page 4 TDH and pump tank drawing Page 5 PUMP CURVES Page 6 ft ENT 0� OT BUiLDlNO PLOT PLAN Page 7 Sp�ETY A A )RRESPON Designer KIM OC NELL License Number 224263 �i Signature - i, Phone No. 715 -755 -3145 Date 8 -13 -99 Notice; Tampering with this file by unauthorized persons is prohibited. Deliberate modification will result in disciplinary action under s. 145.10, Wis. Slats. Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. SBD- 10462 -E (R.05M) Page 1 of I MOUND SYSTEM DESIGN Complete red boxes as necessary. 1000 gpd maximum design flow. Inch u Metric Residential or commercial? R (r or c) (y or n) L..'_._1 Replacement system? Crevic:ed bedrock site? n (y or n) Slope 1.5 % Wastewater flow rate 450 gpd 1703 Lpd Depth to limiting factor 26 in 66.0 cm In situ soil infiltration rate 0.5 gpd4f 20.4 Lpd/m Contour line elevation 100.5 ft 30.63 m Use standard fill depths? x OR Design depth? in cm Pleice X In box to use standard depths (24 and A +4 inclusive) OR specify design fill depth. 0.125. 0.156, 0.188, 0.219, 0.25, Center or end manifold ( e or e� Hole diameter 0.25 ; in 0.261, or 0.313 inch only Lateral spacing 3.00 R t}ae 0 lateral spacing for trenches. Estimated hole space 4.00 ft Not a final calculation. Number of laterals 2 Pump tank elevation 91.5 ft Outside bottom of tank Forcemain length 110.0 ft Forcemain diameter 2.0 in 1.5, 2, s or a inch only. 2.067 in Actual I. D. 1/8 =0.125 1/4 = 0.250 SYSTEM SOLUTIONS Inch-pounds Metric 5✓32 = 0.156 9/32 = 0. 281 Estimated daily flow gpd 1703 Lpd 3116 = 0.188 5416 = 0.313 7132 = 0.219 Absorption cell _ Design load rate & area 1.2 gpcW 1375.0 Jft 34.84 m Linear loading rate (LLR) 1 7.14 Jgpd1ft 88.5 Lpd/m Design width (A) 6.00 ft 1.83 m Cell length (B) 1 63.0 Ift 19.20 m Depth of cell (F) 9.5 in 24.1 cm Sand filter Upslope fill depth (D) 12.0 in 30.5 cm Downslope fill depth (E) 13.1 in 33.3 cm Basal area required (gpd/infiltration rate) 900.0 ft 83.61 m Supporting components Topsoil depth 6.0 in 15.2 cm Subsoil depth at center 12.0 in 30.5 cm Subsoil depth at cell wall 6.0 in 15.2 cm End slope toe length (K) 10.01 ft 3.05 m Up slope toe length (J) 8.00 ft 2.44 m Down slope toe length (1) 9.10 ft 2.77 m Total mound length (L) 83.02 ft 25.30 m Total mound width (W) 23.10 ft 7.04 m Project: ALLEN PENFIELD Transaction Number: Page 2 of 7 MOUND PLAN VIEW observation pipes (typical) J 1 23.1 Ift A= 6.00 ft 1.83 m 7.04 m B - 63.0 ft 19.20 m W r B J= 8.00ft 2.44m I K I= 9.10 ft 2.77 m K = 10.01 ft 1 3.051 m I� L _ 83.02 ft 25.30 m typ. obs. pipe (anchored securely) I = down slope dimension = absorption cell ( Ax B) J = up slope dimension = plowed area (LxW) K = end slope dimension 1W 6" (152 mm) MOUND CROSS SECTION subsoil cap D = 12.0 in 30.5 cm lateral topsoil G H E = 13.1 in 33.3 cm invert 102.00 ft _ _ F= 9.5 in 24.1 cm elev. 31.09 m F G = 12.0 in 30.5 cm ASTM C33 H = 18.0 in 45.7 cm ft W Sand Fill Sys. 101.50 y elev. 30.94 m 100.50 ft contour 30.63 m elev. 1.5 % slope D = upslope fill depth plowed layer E = downslope fill depth Note: Absorption cell media will consist F = absorption cell depth of aggregate and pipe with laterals G = subsoil + topsoil depth at cell wall centered across AxB media. The cell H = subsoil + topsoil depth at cell center media is covered with geotextiie fabric. Designer notes: Project: ALLEN PENFIELD Transaction Number: Page 3 of 7 PRESSURE DISTRIBUTION CALCULATIONS Absorption cell Inch -pounds Metric Width (A) 1 6 Jft 1.83 Im Length (B) 63.0 ft 19.2 m Lateral specifications Number laterals 2 Holes/lateral 16 holes Lateral length (P) 60.00 ft 18.29 m Hole diameter 0.250 in 6.35 mm Lat. dis. rate 18.64 gpm 1.18 Us Sys. dis. rate 37.28 gpm 2.35 Us Hole spacing (X) 48 in 121.9 cm Lateral diameter Pipe diameter Design options Design choice Designer must 1 in (25 mm) _ Place X in red "X one choice 1 1/4 in (32 mm) box of chosen from the options 1 12 in (40 mm) x X diameter. prov ded 2 in (50 mm) x 3 in (75 mm) X Manifold diameter Pipe diameter Design options Design choice Designer must 1 in (25 mm) W one choice 1 1/4 in (32 mm) _ Place X in red from the options 1 12 in (40 mm) x box of chosen provit9d. 2 in (50 mm) x n X diameter 3 in (75 mm) x 4 in (100 mm) x oistribution system contains: 2 Latera(s) LATERAL DIAGRAM - END CONNECTION Place correct lateral diagram by clicking In one of the drawings at right and dragging the diagram into this area. 0ontscod own the A & a difr*nsion Last hole drilled nest to end cap encoap P AM lawals are k"doal I+ x ---*I Holes drilled on the bottom of the lateral equally spaced 3 • 'r'am main oonnoction via the of cross to mani10M at -any point. Laterals & force main of PVC Sch 40 .: permanent end marker (per COMM Table 84.30.5) Inch-pounds Metric Lateral length (P) 60.00 ft 18.29 m Lateral spacing (S) 3.00 ft 0.91 m Hole spacing (X) 48 in 121.9 cm Manifold length 3.00 ft 0.91 m Hole diameter 0.250 in 6.4 mm Lateral diameter 1 1.50 lin 40 mm Forcemain diameter 2.00 in 50 mm Project: ALLEN PENFIELD Transaction Number: Page 4 of 7 TDH and Pump Tank Drawing Total Dynamic Head Operational head 2.50 ft M m Vertical lift 9.60 ft m Are laterals the highest point in the Friction loss 2.55 ft m system? Yes 'W here. L.....�.� T otal dynamic head 14.65 If no, what is the highest elevation Dose Volume downstream of pump? Dose is > 10 times lateral volume Forcemain drain Lateral void volume 12.7 gal 48.1 L back to tank? ( ")" one) Minimum dose 127.0 gal 480.7 L 1 x Yes Drain heck 19.2 gal 72.7 L I No Dose volume 146.2 gal 553.4 1 L Typical Pump Chamber Layout In combination with state approved treatment tank. Tank construction as per Comm 83.20(3) WAC. approved manhole cover with weather proof weming label and locking device grade levels Junction box —� grade levels disconnect y alternate 4" went pipe electric as per NEC 300 and F— outlet Comm 16.28 WAC location 18" (46 cm) min. wall of pump Lim approved chamber or outlet joint combination tank A Provide 1!4" weep hole or anti - alarm on siphon device as necessary pump on B Grade levels PUMP 92.4 ft C - pump tank manhole = 4'(10 cm) Off elev. 28.2 I M minimum above finished grade D - vent =12" (30.5 cm) minimum above finished grade 91.5 I ft Pump tank elevation 3 " (75 mm) of bedding under ta 27.9 m bottom of tank Tank manufacturer WEEKS Pump tank city 19.04 galln Pump tank volume 800 gal Pump manufacturer GOULDS Inches Gallons Pump model number WE0311 L o A 24.3 463.4 . as B 2 38.1 Alarm manufacturer S.J.ELECTRO INC E C 7.7 146.2 Alarm model number H.W. 101 i5 D 8 152.3 Project: ALLEN PENFIELD Transaction Number: Page 5 of MEN ■■■■ ■� ■■ :1■ ■N■■■ 'rIllommill ■■ w / / ■� ■��� ■■■ ■■■ MEN ■■■ . FARM ■■■ ■,v ■ . MEN ■■E■■ ■E ENEWIN NEON NE 0 o■ ■. ■ ■■■ ■■■ ■.�■ NEON.■ ■ ■ ■ ■■ �'mm ■■ NONE� ■■N m ■■ ■■ ■■Q ■ ■• ■■■■■■■_► ■ NEON■■■ ■► ■ NEN■■■ �► y� aQ J , --------------------------- e m b Q SOIL.AND SITE EVALUATION R PORT of r and Human Relations Ic Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code J • 'COU Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but ST: LZU!?C not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. n 1 " 0 D (0 0 APPLICANT INFO RMATI N- L A E PRINT A L IN OR ATI N REVIEWED BY DATE PROPERTY OWNER: C 'aQ4 L:m S PROPERTY LOCATION L ! :yt Kt a tJ C3� �R L�v S GOVT. LOT Ski 1/4 SW 1/4,S Z. T Z°t ,N,R 1 - 1 E (ore PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # y o wt A P ST- — — vtzu� cs>� CITY, STATE ZIP CODE PHONE NUMBER []CITY ❑VILLAGE [MOWN NEAREST %OJD Sf'tLOtNI",WI sqoa \ \""vivo I IotZ ST. New Construction Use [>4 Residential / Number of bedrooms 3 [ ] Addi#tQn to existing bu [ ] Replacement [ ] Public or commercial describe Code derived daily flow t•[SO gpd Recommended design loading rate bed, gpd/9 0.32 trench, gpoltt Absorption area required 31 S bed, ft 315 trench, ft Mabmum design loading rate o S bed, gpd/ft ° • L trench, gpoltt Recommended infiltration surface elevation(s) 1 O \ . S It (as referred to site plan benchmark) Additional design / site considerations REC0 M M eN& Ih OujO w/ 2 - W x y 7 `TReev C4QZ - r-) , " . 1 ' of SA;Qb Fr LL . Parent material - Tt LL Flood plain elevation, if applicable r-3- N ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for system I ❑ S ®U ®S ❑ U ❑ S ®U EIS O U [IS O U I [I Il U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bo y Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Tmrch 1 o - \o�tz zlZ — sil Z�S� rnv-F�• as a.S o. h Z 6- \`7 10'-12 V /V V, \j s o• S o. 6 Ground 31y sc W% s bVt M o•z 0.1 elev. w y 27 -SI - ).S 'Ye- 3/y - C�hsl o s5 vh CS o•S io.b Depth to S 51 -5� tort R �/6 # cz �.syQSlg O,,h P ,•Sy2 Me it �.sKQ �slr� '�s limiting fac Remarks: Boring # z.Cz — S1 a,5 Z` �- y- 30 V y/ k 1 — S11 Z� 3 � Mv `F ► - o4s -s 0 -6 3 3 o -33 t o It tz Y IV — s I zw sbk c s o - 0.6 Ground C 1 elev. y q a.� ft. 33 -yo lOy 5 �3- S'tRY /L Std Z msbk w►`Ft- cS Depth to S LIO .V 4 ►•o y 2 V — Gmiting \V\ \ 6tt %I L: I ® s PaW CANT'S a�1 PAS Remarks: TName: Please Print Arthur L. W e e r e r Phone: 715 egerer Soil Testing & Design Service -P.O. Box 74 River Falls,WI 54022 Signature: Date: CST Number: qZ_ 2-13a A � . Z�{, \44z. MOO 576 PROPERTY OWNER ta S SOIL DESCRIPTION REPORT Page ?•of 3 PARCEL I.D. # ' Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench .< . o Z 'F 9t- env ��^ �. S o. 5 0. Z y -zZ vO V — s j Z`FS �rn�'�1- S o� O•L Ground 3 Z Lo , i fZ Y !y sC Z `FS dk 'M F� cs ti • �[ o. S elev. 1Dbgft. 2& - 3Z lo R yl� — Depth to rj �,Z- y Z t '— limiting - 7 •5 `t 2 y/L 1 s � o � ►n u �� — - factor yz. -SZ Remarks: Boring # I ra ;•Y.ti;4:ti Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) PLOT PLAN -Page 3 of 3 SCALE 1"= 30 ' �\Z -P.lilla A G E W �- 2r ? L V q. r 100.0 oral 6 ►tl G1-4 Pv C P I V N W /�Fl CN o1° � Zo % Lv- 50 1 J w+ 3. 6 z41: 7 ( cAK]`fov2 LA-• 10o•S� 101.51 Boti�Or� OF • vuR" Wqt JjI 43•.L M / IfL 0j C! \ -+? -moo IVoT CAw1p�RCT oSZ \sTvR13 `r*ks ^%,LWq w oop � E s.. 0 'D 8iZ PtT LLIAST Z S F12owt Sul., A ti1O `C'14 1�uET', sec t 2y, 19-? Z ( 715 ) 425 - M00576 CST Signature Date Signed Telephone No. CST # SEP -10 -99 03:94 AM BELISLE EXCAVATING 7152473038+ P.01 4.: ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT M , AND OWNERSHIP CERTIFICATION FORS: x Owner /Buyer � �1 _���,�,,,�, 1�Y f Mailing Address v� d ( �t r. o�sa✓� Gt�.� . s ¢6! 6 r ' .Property Address K ' (Verification rcgtnrc,l from Planning, DviNantwri for new constniction) tl " City /State d/Y�►'Y � Parcel Idcntificution Number . LE D ESCRIPTION 1 Property Location J w "A, SU V-, Scc, Z , T Zg N.R� Town o` Q Vi'to Subdivision , Lot Certified Survey Map # S oU , Volume _, Page # Warrant) Deed b _ 1510 Volume 137 , Page # rll Spec house CJ yes o I,ot lines identifiable es ID no Ik SY51EM MAINTENANCE Improper use and maintenanceof your septic system could result in its premature fa,lure to handle wastes. Proper maintenance .`9 consists of pumping out the septic Tank eve ye ars er, �!' r ded b a licenses p umper. What you put into the system , ,... P P g p c s or seen tcc p P y P 1 'J Y 1 J can affect the Nnctipn of the septic tank as a treatme�tt stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by s master plumber, journeyman plumber, restricted nlumber or a ticcnsed pumper verifying that (1) the on-site wastewaterdisposal system "'y.. is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 113 Plrll of sludge, 0.' 1 the undersigned lr;tvc read the ,rbove rev i w vmen t ts and a tree to maintain the private sewage disposal systeri with the standards set (orth, heroin, as sot by the Department of Coinrttcrcc and the Department of Natural Resources, State of Wisconsin. Cen:fcatton sWtirg that your ss m has bocn maintoined roust be corttpleted and returned to the St, Croix County Zoning Off ce within 30 days or the thm car ex anon d tc. AT E -, - -- SiGNATtJRt; 0 � APhL1C lr' f Q)JY ER CERII ATr N I (we) certify that alt s tatements w form are tote to the best of my (our) knowledge, I (we) am (arc) Lhe owncr{s} of the apeny desc Q Love, b virt r a warranty decd recorded in Register of Deeds Office. J NA'fUR F APPt.I A OATE • " "' Any information that is mis-represented may result in the sanitary permit being revoked by the zoning Department. " "•' •• Include with this applicptlon; a stampod warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed VOL '1371. mF 594 590373 J s� STATE BAIL OF WISCONSIN: FORbt 2 — 1982 WARRANTY DEED DOCUMENT NO. REGISTER'S OFFICE _ C h arles R. Pace and Re J. Pace. h usband and ST. CROIX Co wl _ w f L - - - - - -- -- — �ie,r :.e •�,•o.d 1 - OCT 3 0 1998 conveys and warrants to _ P. Penfield and S -.nd J_ _,3 0 _P enfield, husk d and wif as survivorsh marital Q�, +�'� —P roperty, -- ��, -- - -- - -- Ra tsisr THIS SPACE RESERVED FOR RECORDING DATA _ NAME ANC AE 4UORESS the following descn' real estate in St. Croix County, t 4" Ew /pzhv/ /E-, D a State of Wisconsin: /A�� R1�p20 R vc s Wro 20 144 d so V v� l � � yv h e 0 18- 1004 -60 -050 PARCFL IDENTIFICATION NUMBER y, 7 f that certain Certified Survey Map filed at the Register of Deeds office for St. Croix County, Wisconsin on October 14, 1998 in Volumel3,.Page =533, as Document Number 588977, together with a 66 foot easement for ingress and egress over the North part of Lot 4 as shown on said Certified Survey Map. J TRANSFER i �� FEE This is not ___ homestead property. r (is) (Ls not) Exception to warrznues Subje--t to easeme::ts, reservations and restrictions of record. s Dated this ' day of C)ctoh, ,A.D., 19-.9A. ��'�:' •' ` (SEAL) l!s d!� (SEAL) CHARLES R. PACE Q� — _ - - -- (SEAL) " �.�, . t�Q C�� (SEAL) REBECCA J. PACE AUTHEN>t iCAT10N ACKNOWLEDGMENT Signature(s) State of Wisconsin, ss St. Croix County authenticated this day of .19 PersonAly came before me this _ SO day of October —, 19 98 , the above named Charles R. Pace a nd Re becc a J. Pace - - -- - - -- Tl"-E: MEMBER STATE BAR OF WISCONSIN _. -_ - - -- — (If not, authorized by §706.06, Wis. Stars.) to :ne known to be the erson s who executed the foregoing instru. e nd acknow � • l he same. j THIS INSTRUMENT WAS DRAFTED BY STEP J. D UNLAP — — �. — — H Wi scon sin _ _ Notary Fub6c, St. Croix Co y, %Vis. (Signal -,es may be authenticated or cknowledgfd B,,,h are not '!y commission Is rmanent. (1f not, state expirauoa date- W y 588977 CERTIFIED SURVEYMAP Located in the SW 1 /4 of the SW 1 /4 of Section 2, T29N, RI 7W, Town of Hammond, St. Croix County, Wisconsin; being Lot 2 of that Certified Survey Map filed in Volume 9, Page 2611 of the St. Croix County Register of Deeds. Bearings referenced to the South line of OWNER /SUBDIVIDER the SW 1 /4 of Section 2, assumed to be and CHUCK & BECKY PACE previously recorded as S89 E. 991 190' Street LET 9 OF CERTIFIED SURVEY MAP Hammond, WL 54015 ( R S89P32'37 "E 552.50') VO 9, _PAGE 2611 S 89 31' 17" E 552.49 - - — Cp 380.95 171.54 EJ, (R171.55') � i F /LE'ri 231,595 square feet (5.317 acres) — 8 8 d O TM 1 H 1998 6. a W I 1 A di a pp �i W� °. z N _ East line of the SW1 /4 of tJ14 I _ °�° R S8"Z37 "E 505.73' ) g l y� ^ 268.4 S 89 3 ' 17" E 552.41 S 89 3T 25" E 505.67 33 0i � , 486.40 ?oo.00' W i mi 04 _ - 24.00 472.67 ( R 47273' ) i o> s N 65 access easement for Lot 3 : Q. ° V . ' 04 N 89° 3T 25" W 538.50 & Easement 438,957 square feet 10.077 acres PJ 8 ;� I WI� Z �1 Z � LOT4 g � : � a o. 509,288 square 1.692 acres) w M I (I W W W i .. � _ _ including R.O.W. M _ { eoccludinq R.O.W. & Easement Q $ �I a ) M � N TOE 1 "ron pipe found S78'33'48 "Ei ,4i8 �-10t7 setback from R.O.W. — ?1v5 m r \ o:Z ��8a: from computed Peron• ...... . R N88gpO'00 "E 196.93') N " N 87 _ { o 64 ' 2 6 " I ~ I S89 32'37"E uJ _ S �9° 40' 00"00" E 827.00 — 19.9 E S89 32'37 "E 247.50 — — — — — —�-- — 1304.32' — 110TH AVENUE — — oL SW corner of Section 2� N 89° 32' 37" W 1,056.82 — — S1 14 comer of Section 2 County nail found. UNPLATTED LANDS South line of the SW 1/4 County nad found. NOTE: Each parcel shown on this map is subject to State, County and Township laws, rules and SCALE IN FEET 1" = 200' regulations ( i.e., wetlands, minimum lot size, access to parcel, etc. ). Before purchasing or 0' 100' 200' 400' " 600' developiiig'liny parcel contact the St. Croix County Zoning Office and the appropriate Town Board for advice. This instrument drafted by. Joseph W. Granberg LEGEND 1 Standard Erosion Control Plan for 1 & 2 Family Dwelling Construction Sites -t ording t0 tiapters II. 2i7 & I f the Vi(` cousin �aifortu velliiig Code, 414 sion ao4ntrol plan heeds to bexubmitted and approved prior <ta the ssuanve of bildin permits for 1 2 family dwelling units m those >�rtsdiCx4isvvhere the �r�tlras�on contro.pr4vtstons of tote In>fcratwelltng bode are enforced. Standar�:�c�tston Conirol Plan`�5`provided to assist. In mttag ;this xequirement. Buildutg ins rs< ave autlionty to r nest erasion control xueasares<u t s iectficaYly required by Cod...... i. ire AM]deemed tieeessary to meet the Code's <dve#a1t rforntance standaitd of keeping soil oit slte. :........::,:. nt< hat.:fistur<inorcthan 5 ConstrtYCtian ra ecis that disturb m t ;:than S acresa or are part pf a. tlevelapme i .. ::<:�..... . >it� >�� ��.: utred ;t� Obtain a �onstruetion.. stte statttt ;- watet�:: �disc�ar a Ctnt frog:: =�t� �VisCO.gsin 3 :ariuient:fatucal Resources , . Applicant: �T mCV►� T� E r 5 ' Z�� �3 '� Name Daytime telephone number i Ab � �Q�� fit �'ad �;4 -0 P. Street address, city, zip code Landowner. P fA-1 - C dJ - _ ,`7�� �S,7— Name Daytime telephone number -1 vIb Street address, tity, zip code Location of the building site (complete as appropriate): _ quarter of Section • Town le-1 N., Range Lot Block Street address Instructions: 1. Complete this plan by filling in requested information, marking (.0 appropriate boxes, and completing the site diagram. 2. In completing the site diagram, give consideration to potential erosion that may occur before, during, and after grading. Water runoff patterns can change significantly as a site is reshaped. 3. Chapters ILHR 20 & 21 of the Wisconsin Uniform Dwelling Code, the DNR Wisconsin Construction Site Best Management Handbook, and UW - Extension publication Erosion Control for Home Builders can be referred to for assistance in completing this plan. The Wisconsin Uniform Dwelling Code and the Wisconsin Construction Site Best Management Handbook are available through State of Wisconsin Document Sales, 608/266 -3358. Erosion Control for Home Builders (GW0001) can be ordered through Cooperative Extension Publications, 608/262 -3346. 4. Submit this plan at the time of building permit application. P Chock (,/) appropriate boxes below, and complete the site diagram with necessary information: CP� ova Site Characteristics North arrow, scale, and site boundary. Indicate and name adjacent streets or roadways. 'f ❑ Location of existing drainageways, streams, rivers, lakes, wetlands or wells. ❑ Location of storm sewer inlets. The gradient and direction of slopes before grading operations. The gradient and direction of slopes after final grading operations. f� Location of existing and proposed buildings and paved areas. ❑ / Overland runoff (sheet flow) coming onto the site from adjacent areas. Erosion Control Practices ❑ Location of temporary soil storage piles. Note. Although not specifically required by Code, it is recommended that soil storage piles be placed behind a sediment fence or more than 25 feet from any downslope road or drainageway. Location of gravet access drive(s). Note. Recommended gravel drive design is 2 to 3 inch aggregate stone laid at least 7 feet wide and 6 inches thick Drives should extend from the roadway 50 feet or to the house foundation (which ever is less). �L C3 Location of sediment fences (filter fabric fence, straw bale fence) or vegetative strips that will prevent eroded / soil from leaving the site. ❑ Location of sediment barriers around on -site storm sewer inlets. ❑ Location of diversions. Note: Although not specifically required by Code, it is recommended that concentrated flow ( drainageways) be diverted (re- directed) around disturbed areas. Overland runoff (sheet flow) from adjacent areas greater than 10,000 sq. ft. should also be diverted around disturbed areas. ❑ "I — Location of practices that will be applied to control erosion on steep slopes (greater than 12% grade). Note. Such practices include maintaining existing vegetation, placement of additional sediment fences, diversions, and re- vegetation by sodding or by seeding with use of erosion control mats. ❑ Location of practices that will control erosion in areas of concentrated runoff flow. Note. Unstabilized drainageways, ditches, diversions, and inlets should be protected from erosion through use of such practices as in- channel fabric or straw bale barriers, erosion control mats, staked sod and rock rip -rap. When used a given in- channel barrier should not receive drainage from more than two acres of unpaved area, or one acre of paved area. In- channel practices should not be installed in perennial streams. ❑ Location of other planned practices not already noted. ■■■■■■■■■■■■■■■■■■■■■■■■ PROPERTY Site Diagram Legend DRAINAGE LINE FENCE EXISTING SALES T TEMPORARY GRAVEL DIVERSION FINISHED ., TREE TOPSOIL DRAINAGE -PRESERVATION LIMITS OF STOCKPILED GRADING VEGETATION AREA �- o 1 •• `-' / � �/ � ` 4 � � �� � � .� � � �sL Z �u � hc[ �� �, � �°�'� Jai � '. �', .c � � � � � I � �� _ _ =�` � � ' � � ®� � w � as � ����� � �H i ` � � � � � � �� � � � � a i� � ��� � � " i 1 � � ,� -� �� � � v 1� `e J � � � M �4 � � � � I '`l � �� , .� 4 ` 4 1 � � �� � �� � � '� ` Indicate management strategy by checking (.f7 the appropriate box: 44l Management Strategies ❑ (,� Temporary stabilization of disturbed areas. Note: Although not specifically required by Cok it is recommended that disturbed areas and soil piles left inactive for extended periods of time be stabilized by seeding (between April 1st and September 15th), or by other cover, such as tarping or mulching. Permanent stabilization of site by re- vegetation or other means as soon as possible. `Y ❑ Use of downspout and/or sump pump outlet extensions. Note: Although not specifically required by Code, it is recommended that flow from downspouts and sump pump outlets be routed to stable areas such as established sod or pavement. ❑ �9— Trapping sediment during dewatering operations. Note: Although not specifically required by Code, it is recommended that sediment -laden discharge water from pumping operations be ponded behind a sediment barrier until most of the sediment settles out Proper disposal of building material waste so that pollutants and debris are not carried off -site. Maintenance of erosion control practices. • Sediment will be removed from behind sediment fences and barriers before it reaches a depth that is equal to half the barrier's height. • Breaks and gaps in sediment fences and barriers will be repaired immediately. Decomposing straw bales will be replaced (typical bale life is three months). • All sediment that moves ofd site due to construction activity will be cleaned up before the end of the same workday. • All sediment that moves off -site due to storm events will be cleaned up before the end of the next workday. • Gravel access drives will be maintained throughout construction. • All installed erosion control practices will be maintained until the disturbed areas they protect are stabilized. hereby certify that I understand the construction site erosion control provisions of the:Wiscorisin Uriforui r: Dweliing Code, and that i accept responsibility for carrying out the above.ers>sion rontrot;plan as approsied by' the codt: erifo ocempti t authority. p Srgnaiure of applicant D f A publication of the University of Wisconsin- Extension, Ron Struss, UWEX Water Quality Education Specialist (12192). This publication may be freely duplicated Additional copies are available through the UWF.X Environmental Resources Center, 216 Ag Hall, 1450 Linden Drive, Madison, ", 53706 6081262 -3652 EROSION CONTROL FOR HOME BUILDERS Preventing Erosion Is Easy Erosion control is important even for home sites of an acre or less. The materials needed are easy to find and relatively inexpensive straw bales or silt fence, stakes, gravel, plastic tubes, and grass seed. Putting these materials to use is a straightforward pro - 3;' cess. Only a few controls are needed on most sites: • Preserving existing trees and grass where possible to pre- vent erosion; �' : • Silt fence or straw bales to trap sediment on the down - slope sides of the lot; By controlling erosion, home builders keep our streets • Soil piles located away from any roads or waterways; and waterways clean. • Gravel drive used by all vehicles to limit tracking of mud onto streets; Erosion Is a Costly Problem • Cleanup of sediment carried off -site by vehicles or Eroding construction sites are a leading cause of water storms quality problems in Wisconsin. For ev ery acre under con- storms; struction, about a dump truck and a half of soil washes • Downspout extenders to prevent erosion from roof into a nearby lake or stream. Problems caused by this sedi - runoff; and ment include: • Revegetating the site as soon as possible. Local taxes — Cleaning up sediment in streets, sewers and ditches adds extra costs to local government budgets. Dredging —The expense of dredging sediment from lakes, + ' harbors and navigation channels is a heavy burden for - taxpayers. Lower property values — Neighboring property values are damaged when a lake or stream fills with sediment. Shallow areas encourage weed growth and create boat- b t�s a ee ing hazards. Poor fishing —Muddy water drives away fish like north- 0 ern pike that rely on sight to feed. As it settles, sediment � smothers gravel beds where fish like smallmouth bass find t; food and lay their eggs. Nuisance owth of weeds and gr algae — Sediment carries fer- tilizers that fuel algae and weed growth. '' Erosion Con For Hoy STRAW BALE or SILT FENCE • Put up before any other work is done. • Install on downslope sides of site parallel to contour of land. • Extend ends upslope enough to allow water to pond behind fence. SAMPLE EROSION \ • Bury 8 inches of fabric in trench (see back page) CONTROL PLAN I \ \ \ • Stake (2 stakes per bale) FOR 1 OR 2 ®\ • Leave no gaps. Stuff straw between bales or overlap sec- FAMILY D WELLINGS tions of silt fence. \ • Inspect and repair once a week and after every %z inch i rain. Remove sediment if deposits reach half the fence \ height. Replace bales after 3 months. I \ \ • Maintain until a lawn is established. \ r SOIL PILES TD • Locate away from any downslope street, driveway, \� stream, lake, wetland, ditch or drainageway. Aee AREA TO BE T MULCHE D, • Temporary seed such as annual rye or winter wheat is SEEDED AND MULCHED recommended for topsoil piles BY OWNER AT THE HOUSE COMPLETION OF ( GARAGE CONSTRUCTION ITU Tr GRAVEL DRIVE • Install a single access drive using to 3 inch aggregate. g • Lay stone 6 inches deep and at least 7 feet wide from \ \ the foundation to the street (or 50 feet if less). TD • Use to prevent tracking mud onto the road by all vehicles.` R/W LINE • Maintain throughout construction., 1 ' SEDIMENT CLEANUP S OIL TYPE: SILTY CLAY STREET NAME • By the end of each work day, sweep or scrape up soil SLOPE: 3% tracked onto the road. • By the end of the next work day after a storm, clean up the soil washed off -site. SEWER INLET PROTECTION g� • Protect on -site sewer inlets with straw bales, silt fences o e or equivalent measures (see back page). eam • Inspect, repair and remove sediment deposits after every storm. s u r o - m DOWNSPOUT EXTENDERS aye an` • Not required, but highly recommended. o • Install as soon as gutters and downspouts are completed o o to prevent erosion from,roof runoff. 1 e Route water to a grassed .or paved'. area. F • Maintain`tintil a lawn is established. v �1 '4t .fir "741} ' ` � ` ��ry S � V . ht Y y y t,f oI Pract e Sites PRESERVING EXISTING VEGETATION • Wherever possible, preserve existing trees, shrubs, and other vegetation. EROSION • To prevent root damage, do not grade, place soil piles, CONTROL PLAN or park vehicles near trees marked for preservation. LEGEND • Place plastic mesh or snow fence barriers around trees PROPERTY to protect the area below their branches. LINE I _ _ EXISTING -- TOPSOIL DRAINAGE REVEGETATION -+ TD TEMPORARY DIVERSION Seed, sod or mulch bare soil as soon as possible. _ DRAINAGE FINISHED SWALE —' DRAINAGE LIMITS OF SEEDING AND MULCHING r - — GRADING • Spread 4 to 6 inches of topsoil. S IT FENCE • Fertilize and lime if needed according to soil test (or apply 10 lb./1000 sq. ft. of 10 -10-10 fertilizer). STRAW BALES . Sal with an appropriate mix for the site (see table). GRAVEL • Rake lightly to cover seed with 1 /4 " of soil. Roll lightly. VEGETATION a Mulch 00 l with straw (70-90 lb. or one bale per 10 CONSTRUCTION SPECIFICATION SQ. ENTRANCE/EXIT AREA •Anchor mulch by punching into the soil, watering or TREE by using netting or other measures on steep slopes. PRESERVATION . Water gently every day or two to keep soil moist. Less STOCKPILED watering is needed once grass is 2 inches tall. SOIL SCALE -401 SODDING . PROJECT LOCATION: EXISTING CURB PROPERTY OWNER: * Spread 4 to 6 inches of topsoil. AND GUTTER ANTICIPATED STARTING DATE: • Fertilize and lime if needed according to soil test (or CONTRACTOR: ANTICIPATED COMPLETION DATE: ap 1 10lb./1000 sq. ft. of 10 -10 -10 fertilizer). PREPARED BY: DATE: • Lightly water the soil. • Lay sod. Tamp or roll lightly. • On slopes, lay sod starting at the bottom and work toward the top, overlapping like shingles on a roof. Peg each piece down in several places. • Initial watering should wet soil 6 inches deep (or until r water stands 1 inch deep in a straight -sided container). Then water lightly every day or two to keep soil moist _ but not saturated for 2 weeks. o o If construction is completed after September 15, final seeding or sodding may be delayed. Temporary seed (such as rye or winter wheat) may be planted until October 15. ; Mulch or matting may be applied after. October 15, if . weather permits. Straw bale or silt fences must be main - tained until final seeding or sodding is completed in spring ;. (by June 1). We - R -'!- - I Ni'; I mv � , "� S "I, Straw Bale Figure 2 —How to Install a Straw Bale Fence Fences 1. Excavate a 4" deep trench. 2. Place bales in trench with bind- ings around sides away from the ground. Leave no gaps between Figure 1 —Cross Section „ IW bales. of Straw Bale Installation ,tl • '" 4" r.. . a Bale ' I• Width Staked and Entrenched � �^- '' 4' Straw Bale Binding wire Compacted Soil to 3. Anchor bales using two steel re- or Twine Prevent Piping bars or 2" x 2" wood stakes per - Fiftered I II j iI!�' Sediment Laden bale. Drive stakes into the ground 4. Backfill and compact the Runoff ll`III t I Runoff at least 8 ". excavated soil. • �. - x. �qy, rp Source: Michigan Soil Erosion and Sedimentation Control Guidebook 1975. Silt Fences Figure 4 —How to Install a Silt Fence 1. Excavate a 4" x 4" trench along 2. Stake the silt fence on downslope Figure 3 —Cross Sections the contour. side of trench. Extend 8" of fabric into the trench. of Trenches for Silt Fences / Filter Fabric a" Flow is llll% 4 " ' Flow r ul , , I III Jri _ 1111L 3. When joints are necessary, over trench 11— lap ends for the distance between 4. Backfill and compact the two stakes. excavated soil. Fitter Fabric —► ' �I 111 " � =' 5111 Source: North Carolina Erosion and Sediment Control Planning and Design Flow Flow I ow Manual, 1988. ! Gravel Entrance 1. Install as soon as possible after Figure 5 —How to Install a Gravel Entrance start of grading. 2. Use 2 to 3 inch aggregate stone. Hard surface road 3. Drive must be at least 7 feet wide so' or distance to foundation and 50 feet long or the distance to the foundation, whichever is less. 6" minimum 4. Replace as needed to maintain depth 6 inch depth. s