HomeMy WebLinkAbout010-1031-95-000 DEPARTMENT OF +'-REPORT ON SOIL BORING SAFETY & BUILDINGS
INDUSTRY,
S, DIVISION
LABOR AND PERCOLATION TESTS X15 P.O. Box 7969
HUMAN RELATIONS
MADISON, WI 53707
(H63.090) & Chapter 145.045)
LOCATION: O ' c TOWNSHIP/MUNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME:
NE DE ~%4 13 /T30 NA6 k (or) W Emerald n/a n /a n /a
COUNTY: OWN R'S NAME: MAILING ADDR SS:
St. Croix Farm Credit Services Hy. 35 N. River Falls Wi. 54022
USE DATES OBSERVATIONS MADE
NO. BEDRMS,: COMMERCIAL DES RI ❑
PTION: ROFILE NS: PERCOLATION TESTS:
(Residence 3 n/a New Replace 9-24-87 9-25-87
I
RATING: S- Site suitable for system U- Site unsuitable for system
ONV.ENTIONnNAL: MOUND: IN-GROUND ESSURE: S STEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional)
❑ S K] U Z S [;]U ❑ S)2U 1xOU .1.
❑ S ❑ " Mound
If Percolation'Tests are 146T' required DESIGN RATE.'- if any portion of the tested area is in the
under s.H63.09(5)(b), Indicate• n/a Floodplain, indicate Floodplain elevation: n/a
PabFICttfESCRIPTTC!V _
decimal= '19 Or? R
BORING TPTH T GR UNDWATER•INCHES CHARACTER OF SOIL W HICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DE". ELEVATION BSERV T. HIGHE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B-1 4.83 102.74 none 9.50 .67bl.1. 1.83bn.s.1. 2.33 bn.mot.s.l.
8.2 6.33 10?.76 > ne 3.08 .75bl.1. 2.33bn.s.1. 3.25bn.mot.s.1.
B_3 6:16 96 5.41 ` 4.66 .58bl.1. 1.83bn.s.1. 3.00bn.mot.s.1. .75water
B-
B_
`
B-
decimal' PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTE,
NUMBER XDMM C AFTERSWELLING INTERVAL-MIN. PERIOD E I D PERIOD PER INCH
P_1 2.00 none 30 11 1 1 30
P_ none 30 2 13/4 13/4 17
P_ none 30 1 7 8 7/8 34
4- v P_
P-
P-
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope.
SYSTEM ELEVATION 103.76
t ~ I I I
t if q- 1
. V)
I
1 "
41
f
L ' l { ~i u
f l r I I
I f1t7 j
-
b
110
I
L
I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin
Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
j NAME (print : TESTS WERE COMPLETED ON:
Gary L. Steel 9-25-87
ADDRESS: CERTIFICATION NUMBER: PHONE NUMB, ER(optional):
988 N. Shore Dr. New Richmond Wi. 54017 2298 1715-246-6200 j
CST SIGN RE.
dl
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. 1{
1711.Hf'l•$D13:0395 Q. 02/82) OVER
~ o a~ o
o~
a a
b
o
0
N
b
o I
t
d
tl Q
~ O
CL
N
N ~
O C
a Z
= U
7 CO
N
U. r-
•O C
E Q Z
R
M
CL
d 2)
aD ~ o
0
Z d d
M C', z a m
0
o z ~ v I
m w
y I
aU o
i Z c z
cn F- .p
M
~ II
0
•WA L O
O Z Z
N E z
d
c N
M
M m
N ~
w N
R d
~a d fl. O
co T N i
0 o a co U) (n u
Z N > ~ F- F- F- N w
3 3 3 ° z z
a
• ~aa N
IL R
•
U) -j E rn o
w ~ z
Q ai tr_ CD
~1 Q `o° E
LOO m c. a
a y
Q o co
•a ~ ¢ z in co
I
m ~
m ~ Y ~ I
N N N
w O C N N 6 N =
m Cp
L6 E
(0 m N
M N r ~ ~ N
R; O ,n C7 Z v C
o O U)
• o - w C) Z F- ZO zmR cnU
O
O ~ A-
CIS 01 R l d
CL L: CL
• a m d Y c
w E c c
~w o `o 3 - o
_1 A a. 2 0 (1)
Parcel 010-1031-95-000 02/06/2006 09:27 AM
PAGE 1 OF 1
Alt. Parcel 13.30.16.197B 010 - TOWN OF EMERALD
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 - ALBRECHT, ALLEN
ALLEN ALBRECHT
2661 155TH AVE
EMERALD WI 54013
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description " 2661 155TH AVE
SC 2198 GLENWOOD CITY
SP 1700 WITC
Legal Description: Acres: 5.000 Plat: N/A-NOT AVAILABLE
SEC 13 T30N R16W PT NW SE & NE SE Block/Condo Bldg:
FORMERLY PT LOT 1 CSM 7/1879 NKA LOT 2
CSM 11/3230 5.OOAC Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
13-30N-16W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1117/353 LC
07/23/1997 840/560
07/23/1997 782/426
07/23/1997 419/108
2005 SUMMARY Bill Fair Market Value: Assessed with:
80157 209,900
Valuations: Last Changed: 10/19/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.000 20,000 173,000 193,000 NO
Totals for 2005:
General Property 5.000 20,000 173,000 193,000
Woodland 0.000 0 0
Totals for 2004:
General Property 5.000 20,000 173,000 193,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 131
Specials:
User Special Code Category Amount
010-GARBAGE SPECIAL ASSESSMENT 30.00
Special Assessments Special Charges Delinquent Charges
Total 30.00 0.00 0.00
SANITARY PERMIT APPLICATION
1ZD1LHR COUNTY
In accord with ILHR 83.05,-Wis. Adm. Code
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than ❑ 9519
8% x 11 inches in size. Check if revision to previous application
-See reverse side for instructions for completing this application. STATE PLAN I.ttD/..N,UMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. gQ- ~Jl
PROP =OWNER PROPERTY LOCATION
Y4 SE % S T~pJ , N, R E (or
PRO RTY OWNER'S MAILING ADDR LOf #114 BLOCK # 1114-
CI STATE ~y~ ZIP CODE P UMBER SUBDIVISION NAME~R sj6M NUMBER
Biz/ - / `
U/. ,S-y /
II. TYPE OF BUILDING: (Check one CITY ~ NEAREST ROAD
❑ State Owned LLAGE : C4112
S
❑ Public 1 or 2 Fam. Dwelling4 of bedrooms a_ PARCEL TAX NU BE g t
III. BUILDING USE: (If building type is public, check all that apply) f ~.Q~ f DdJ,~/
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: (Checkk o y one in line A. Check line B if applicable)
A) 1.0 New 2. R 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 Pressuriz d 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 Y 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) EL ATION
-YS?1 1uDA 3 y 33 r D37 Feet P17 Feet
VII. TANK CAP 1.11 Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete struct Con- Steel glass Plastic App
Tanks Tanks A
Septic Tank or Holdin Tank /~00
Lift Pump Tank/M onn Chamber
VIII. RESPfSNSIBILITY 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) lkkP_/MPRSW No., Business Phone Number:
lumber's Address (Street, Ci ,State, Zip Code):
17
IX. COUNTY/DEPARTMEN SE ONLY
❑ Disapproved s itary Permit Fee (includes Groundwater ate s ue Issuing Agent Signature (No Stamps)
rcharge Fee _
Approved ❑ Owner Given Initial Rdo ~ o?S !S D~ a/ ~9
Adverse Determination S~
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new
criteria in the Wisconsin Administrative Code will be. applicable.
3. All revisions to this permit must be approved by the permit issuing authority.
4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be
submitted to the county prior to installation.
5. Onsite sewage systems must be properly maintaineb. 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.
Ill. 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.
Vlll. 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; dose volume; elevation differences; friction loss; pump
performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if
required by the county; E) soil test data on a 115 form; and F) all sizing information.
GROUNDWATER SURCHARGE
1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of
regulated practices which can effect groundwater.
The monies collected through these surcharges are used for monitoring groundwater, ground-
water contamination investigations and establishment of standards.
,.may
SBD-6398 (R.11/88)
Form - S T C 100
Owner of Property yQyyles Dtt ~S e 44re Uk
Location of Property , Section l 3 ,T ?ON R//„W
Township5;~7mQzy(d
Mailing Address ~~Olp~ l Ste'
Subdivision Name
Lot Number
Previous Owner of Property zz-e.
Total Size of Parcel 7
Date Parcel Was Created
Are all corners identifiable? Yes No
Include with this application one of the following:
.Certified Survey Map
.Deed
.Land Contract, or
.Other I:egal Document which describes the property
PROPERTY OWNER CERTIFICATION
1 (We) certify that all statements on this form are true to the best of my (our)
knowledge; that I (we) am (are) the owner(s) of the property described in this
information form, by vl a of a warranty de c in the Office of the
County Register of bas^9ocument No. ; and that I (we)
presently own the proposed site for the sewage disposal system (or 1 (we) have
obtained an easement, to run with the above described property, for the g'Ya ~J s-G~
construction of said system, and the some has been duly recorded in the Office /
of the County Register bf Deeds, as Document No.
i `
SIG TORE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE)
A
DAT GNED OAT IGNED - 1-
• STC - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER JAe~~i
ROUTE/BOX NUMBER ~ D o FIRE NO. p~(Ol0 /
CITY/STATE ZIP 'Wo
PROPERTY LOCATION: V_Ll/~_ 1/4, Section T_20 N, R_J_(~ W,
Town of St. Croix County,
Subdivision , Lot No.
Improper use and maintenance of your septic system could result in its premature
failure to handle wastes. Proper maintenance consists of pumping out the septic
tank every three years or sooner, if needed, by a LICENSED SEPTIC TANK PUMPER.
What you put into the system can affect the function of the septic tank as a
treatment stage in the waste disposal system.
St. Croix County Residents MAY be eligible to receive a grant for a MAXIMUM of
$3000 of the cost of replacement of a failing system, which was in operation
prior to July, 1978. St. Croix County accepted this program in August of
1980, with the requirement that owners of ALL NEW SYSTEMS agree to keep their
systems properly maintained.
The property owner agrees to submit to St. Croix County Zoning a certification
form, signed by the owner and by a master plumber, journeyman plumber,
restricted plumber or a licensed pumper verifying that (1) the on-site
wastewater disposal system is in proper operating condition and (2) after
inspection and pumping (if necessary), the septic tank is less than 1/3 full of
sludge and scum. Certification form will be sent approximately 30 days prior to
three year expiration.
I/-WE, the undersigned, have read the above requirements and agree to maintain
the private sewage disposal system in accordance with the standards set forth,
herein, as set by the Wisconsin Department of Natural Resources. Certification
form must be completed and returned to the St.Croix County Zoning Office within
30 days of the three year expiration date.
SIGNED
DATE
St. Croix County Zoning Office
P.O. Box 98
Hammond, WI 54015
(715) 796-2239 or (715) 425-8363
Sign, Date, and Return to above address
a f
r" s ~ N M~ .may r ~ 1' S x`
cr .yjj ~ fi} '
n
r
a AIt;INE i 14r~ i~et~uAff "m to Worl" iri.rir'o,;.M
► pc t.r..rmma a►swpo*w.N boko h rk,
tiC ~ ~ #it ~~►'~tlli~ M~ ~ wr~~ wit
All I
marr
The or 1!reft ~R
Ai~
t° ;
# t d J ~ t :i~. ~ ly
'1'~. 84 T S rt~,~ ~L + `1( , -fit ii. ,,xdt~ L • ~ 1 ~ 4.
b ` a -j e
J -
Trl
w L fiYe ~ ~
, t
b ~ Y
s.
k
4pww a°a tr:: COW
1
` &S" W.
r
t
r
DEPARTMENT OF REPORT ON SOIL BORINGS4 SAFETY & BUILDINGS
INDUSTRY, DIVISION
LABOR AND PERCOLATION TESTS 3 1 P.O. BOX 7969
HUMAN RELATIONS MADISON, W1 53707
(H63.090) & Chapter 145.045)
LOCATION: q O ' TOWNSHIP/MUNICIPALITY: ]LOT NO.: BLK. NO.: SUBDIVISION NAME:
NE 116E 1 13 ~b !446 E (or) W Emerald n/a n 1a n /a
COUNTY: OWNER 'S AME: MAI I ADDRESS:
St. Croix Fatwreredft 0--- Hy. 35 N. River Falls Wi. 54022
USE E - 1'Sc- L(3 T d DATES OBSERVATIONS MADE
.BEDR : C MM A DESCRIPTION: NS: A 0 TESTS: PROFILE Residence 3 n/a ❑New Replace 79-24-87 9-25-87 5, 2
RATING: S- Site suitable for system U- Site unsuitable for system
ONVENTI NAL: MOUND': IN-GROUND RESSURE: S STEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional)
❑S )FKIu zS ou ❑S3JU ❑SZU ❑SX Mound
If Percolation Tests are N T required DESIGN RATE: If any portion of the tested area is in the
under s,H63.09(5)(b), indicatel * n/a Floodplain, indicate Floodplain elevation: n/a
i - P90FIL)= DESCA1PTr0N
decmal
BORING TOT DEPTH T GR UNDWATER-INCHES CHARACTER OF SOIL W HICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPT. ELEVATION OBSERVED HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B.1 4.83 102.74 none- ;2.50 .67bl.1. 1.83bn.s.1. 2.33 bn.mot.s.l.
8.2 6.33 14.76 49ne 3.08 .75bl.1. 2.33bn.s.1. 3.25bn.mot.s.1.
B-3' 6:16 100.96 5.41 - 4.66 .58bl.1. 1.83bn.s.1. 3.00bn.mot.s.1. .75water
k
B- ,
B-
B-
decimal' PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTE
NUMBER XKMMM AFTERSWELLING INTERVAL-MIN. PERIQQ I D PERIOD PER INCH
P_1 2.00 none 30 1% 1 1 30 j
P_ none 30 2 13/4 13/4 17
p. 3- Z.00 none 30 1 7/8 7/8 34
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-
;ontel and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings aitd the direction and percent
of land slope.
SYSTEM ELEVATION 103.76
0. 541
.
I
{
I !
}3;rn vI 4. (PIP I I ' 1. I `~~f I i
~I
I ;
I ,
01
t ~
1>1
l
4
_ J
l L ' I I ~ I I ~ ~i i ~ i ~ !
1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin
Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
NAME (print : TESTS WERE COMPLETED ON:
Gary L. Steel J
ADDRESS: CERTIFICATION NUMBER: P1HONE NUMBER (optional):
988 N. Shore Dr, New Richmond Wi. 54017 2298 715-246=620
CST SIGN RE: `(1
vk' T
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
rw .DILHFt•.PO-6395_(R 02/821_._ , --OVER
DEPARTMENT OF R + "'REPORT ON SOIL BORING
SAFETY & BUILDINGS 4AND T
LABO N t DIVISION
LABOR AND PERCOLATION TESTS=1 P.O. BOX 7969
HUMAN RELATIONS / MADISON, WI 53707
(1-163.090) & Chapter 145.045)
LOCATION: SqCTIOM,-- TOWNSHIP/MUNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME:
NE 1%E 1%4 13 /T30 1146 IE tor) w Emerald ' n/a n /a n /a
COUNTY: OWNER'59CIWEMN NAME: MAILING ADDRESS:
St. Croix Farm Credit Services H . 35 N. River Falls Wi. 54022
USE DATES OBSERVATIONS MADE
NO. BEDRMS : COMMER A DES RIPTION: PROFILE DESCRIPTIONS: PERCOUAV
N TESTS:
Residence 3 n/a ❑New Replace I 9-24-87 9-25-87
RATING: S= Site suitable for. system U= Site unsuitable for system
ONVENTINAL: MOUND: NGROUND-PRESSURE: S STEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional)
11 S)60 U xnS V ❑ S &-III ❑ Sx®U Mound
ST. CROIX COUNTY
4 WISCONSIN
ZONING OFFICE
ST. CROIX COUNTY COURTHOUSE
911 FOURTH STREET a HUDSON, WI 54016
(715) 386-4680
June 1, 1989
Division of Safety and Building
Bureau of Plumbing
P.O. Box 7969
Madison, WI 53707
Dear Sir:
An onsite investigation for the James and Denise Albracht property,
located in the NE4 of the SE4 of Section 13, T30N-R16W, Town of Emerald,
St. Croix County, revealed suitable soils at a depth of 2,50 feet, below
which seasonable high ground water was noted.
This site should be suitable for a mound system.
Should you have any questions, please feel free to contact this office.
Sincerely,
Thomas C. Nelson
Zoning Administrator
TCN:rms