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Parcel 020-1033-50-000 03/23/2006 01:11 PM
PAGE 1 OF 1
Alt. Parcel 17.29.19.146J 020 - TOWN OF HUDSON
Current rX 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 - FRANZ, EDWARD R
EDWARD R FRANZ
964 TROUT BROOK RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 964 TROUT BROOK RD
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 0.220 Plat: N/A-NOT AVAILABLE
SEC 17 T29N R1 9W PT SW NW COM 884.3'N Block/Condo Bldg:
OF SW COR SW NW TH E 110 FT MOL TO TN RD
TH NLY ALG CEN LN TO CEN S BRANCH OF Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
WILLOW RIVER WLY ALG RIV TO W LN S TO 17-29N-19W
POB
Notes: Parcel History:
Date Doc # Vol/Page Type
2005 SUMMARY Bill Fair Market Value: Assessed with:
91628 108,500
Valuations: Last Changed: 10/25/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.220 37,400 73,300 110,700 NO 05
Totals for 2005:
General Property 0.220 37,400 73,300 110,700
Woodland 0.000 0 0
Totals for 2004:
General Property 0.220 19,400 63,200 82,600
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 111
Specials:
User Special Code Category Amount
018-RECYCLING SPECIAL ASSESSMENT 27.00
Special Assessments Special Charges Delinquent Charges
Total 27.00 0.00 0.00
DEPARtMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING
.LABIOR & HUMAN RELATIONS DIVISION
P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION
MADISON, WI 53707
State Plan I.D. Number:
SWkiMV-,,Sec.17,T29-19W ❑ CONVENTION L ❑ ALTERATIVE (If assigned)
Towel of Hudson ❑ Holding Tank n-Ground Pressure El mound
PE R: ADDRESS OF PERMIT HOLDER: INSPECTION DATE:
i
Ed Franz 964 Trout Brook Rd.
BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.:
Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number:
Robert Ulbricht 3307 St. Croix 135350
SEPTIC TANK/HOLDING TANK:
MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
YES ❑ NO ❑ YES CYNO
BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: [BUILDING: VENT TO FRESH
ALARM: FEET FROM 1 LI 12 0 AIR INLET:
❑ YES [__1 NO L/ C c ❑ YES ❑ NO NEAREST z
DOSING CHAMBER:
MANUFACTURER: BEDDING: LIQUID CAPACITY" PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
ES ❑ NO 5~-o 9 7 Zo ---t YES ❑ NO OYES ❑ NO
GALLONS PER CY LE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH
(DIFFERENCE BETWEEN FEET FROM LINE yf AIR INLE
PUMP ON AND OFF ❑ YES ❑ NO NEAREST
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: MATERIAL AND MARKING:
or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN
the soil is dry enough to continue.)
CONVENTIONAL SYSTEM:
WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUI
BED/TRENCH D
TRENCHES: MATERIAL: PIT DEPTH:
DIMENSIONS
GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH
BELOW PIPES: ABOVE COVER: ELEV. INLET: ELEV. END: PIPES: FEET FROM LINE: AIR INLET:
NEAREST ~
MOUND SYSTEM:
Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM
slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW
❑ YES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED.
SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS;
❑ YES ❑ NO ❑ YES ❑ NO
DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: 7SODDED SEEDED: MULCHED:
CENTER: EDGES:
ES El NO ❑ YES ❑ NO ❑ YES ❑ NO
PRESSURIZED DISTRIBUTION SYSTEM:
BED/TRENCH WIDTH: LENGTH: NO. OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER:
TRENCHES: (/p
DIMENSIONS G
MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING:
ELEV.: ELEV.: DIA.:e EI~,V(7. 3 ,o J PIPES: DI%
ELEVATION AND
DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO
INFORMATION / APPROVED PLANS
j(,0 Ft YES ❑ NO AYES ❑ NO
PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING:
COMMENTS: FEET FROM LI^j
RYES ❑ NO l YES ❑ NO NEAREST °r_ _V . ~ 2S f _j
Sketch System on etain in county file for audit.
Reverse Side. SIGNATURE: - TITLE:
SBD-6710 (R. 06/88)
DL' HR SANITARY PERMIT APPLICATION
In accord with ILHR 83.05, Wis. Adm. Code COUNTY
57~'
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than ❑ ~353~
8% X 11 inches in size. eck If revision to previous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER& 0
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. 5 0 1-16) 3 d d
PROPERTY OWNER PROPERTY LOCATION Q
Z' 540 Y. AJwy4, S ? T - N, R 1 ( E (or) W
PROPERTY OWNER' MAILING ADDRESS, ~ d~ n LOT # BLOCK #
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
II. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD
❑ State Owned s VILLAGE : UR,SQA.,~ UT- ~R64OC- AX ,
run =N QF:
1 or 2 Fam. Dwelling- # of bedrooms PARCEL TAX NUMBER(S)
❑ Public
III. BUILDING USE: (If building type is public, check all that apply)
1 ❑ Apt/Condo L I
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
❑
4 El Church/School 8 El 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) 1.0 New 2.~] Replacement 3. El Replacement of 4. El Reconnection of 5.0 Repair of an
System / System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit # - Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 ❑,Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 In-Ground 420 Pit Privy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
14 ❑ System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. GALLONS PER DAY 12. 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) 702 So r ELEVATION
d a Feet 70 S• 3 Feet
VII. TANK CAPACITY Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION Manufacturer's Name Con- Steel Plastic
New istin Gallons Tanks Gd-n /3 0 _ oncrete structed glass App.
Tanks Tanks
Septic Tank or nk ~t
Lift Pump Tank/ er 'v
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Print): Plumber's Signet re: (No Stamps) #P/MPRSW No.: Business Phone Number.
TOOT 7,lL6R164L7_ 13307 pis 3 -~~~5
Plumber's S Address (Street, jL ,StatTj~ e, Zip Code): qs d~ W15-
IX. N
COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issui Agent Signature (No Stamps)
Approved ❑ Owner Given Initial <-1' Surcharge Fee) 0-17- li
Adverse Determination ` `-P 6 0
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 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-?66-3815.
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; 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.
SBD-6398 (R.11/88)
w/~~QW AL~ /EVE
S89~ 4U.3s8
any / \
us&S FIDOD VEVArtoo / 1
ESr^t3LiS HEG 13y legiSTEREV
60 RUEyDk A.C. My HRbE~1 1
• lev~-noaTor of _,I ~ IEUknoa of 12i uER
g- -14g~( Co`l7, r
co'-X-tf . STEP - 702-.70
,sI
rL.wtrl Flood N"+/,V
El~urroa = -70yo~
~oµ E Zoat-3 6- 'J E Pr.
14+
ZO I 5I ~ L`It uAlriotil
'Bomom EOO-E- Dr- SiD►alr - 703, IS
t:xistia&- /
~1~y. SewEQ '70I, 0
9RivEW4y v1n 54EEI SEPTi t- T'hak '1.O RE h8A4JVav&D PAA.
p3.o3 • (1-)
pEw /ooo~.
•~Pn~~Sba d ~Q~S 5 , ~
~ •C . Go ~ B O ?.9,u~ , ~
- Foe►tF' /~i,V ' ;
1 G
43
C 33~ \1
t
C
-r•Roor BRook ~2p nQloft-
ONSITE SEW4 E SYSTI".-M
~ ,,r ~1 •w 7J~ l
gar, +~v + r.+G HUMAN RELATIONS ~
DE~'ARTiME"I'l Oi ,~T AND Q ING9 1
I~ Cia CE L~.
SEE COKii-ES- wCENCE - - -
ZO /
HOMESITE SEPTIC PLUMBING CO. SCALE
655 O'NEIL RD., HUDSON, WIS. 54016
ROBEAT ULBRIGHT CS ~NpZ • = J3~►GKHa~-130 ~'%vrTS
WIS. MASTER PLUMBER LIC. N0.3307 M.P.R.S.
PAINN. INSTALLER A DESIGNER LIC. NO. 00663
~~.~ofsP~S.
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C.C'oSS SE cr~o,J - TK) 6-~0UND P',C%SS0 r2~ QED
S~AIt : ~ 30,
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gR,tDE F/ui5 t~ fefA--
7o Y• 3 ' 70 S. 3 0
~ 2'~ •t ~o i Tio,u,} I I c o u ~2
y~o $!o/j~- a EF~Sn~~ F,/~ Co~tre (st~v3 Is) -
APpRo~Ea A542=c~rE uNaeR IrrTERnls°3 slope,
ooc-,~ e"efrc co al
o~~ gook . I / y `
SYSTeM3 •SOI ~ IeV-4T~Oa
r
70 -Z So
466r -er l rE 7o Re- Guts oED 3/q T-ock
• eLL-V*Ttoo of ►,DueP-T- of I„ 1A•tek#dS 703,0' - - - -
s Et-EU#RTto. , To ~ 01 1 RreR4(S 70 3. 0 g r Sv4TUt;~4Tro
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• ~LevhTioJ 2" 11 hv~ F~l L7 703. 12 (51 Ev,4 rioJ
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otZ Aa 3ua.r ry` ~L~~E~,rfl►J
UEPARTMBIT O i`!-'5,1 AND HUMAN RELATIONS
sEE
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889-40388
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ONSITE SEWAGE SYSTEM
(fonlitionallvt
I
GEPr^~'if~" 1'= l tfsf~ AND HUMAN RELATION.
a w N L (DINGS
_ 1J as A
SEPTIC TANK &*PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS
C I E v4T t o j p F U E-0 T= "1 v S. p ~/Fo mp,.) of CoUttf
4" CI VENT .PIPE 12" MIN. ABOVE GRADE & !'WEATHER PROOF ~oS.D
25~ FROM DOOR, WINDOW OR JUNCTION BOX APPROVED
FRESH AIR INTAKE. WITH CONDUIT MANHOLE COVER
FINI$I~FD GRADE 4" CI RISER v W1 PADLOCK
7v ?L . ` 6" MIN . WARNING LABEL
AB OV E G AD E 4" MIN.
18" IN. 6" MAX.
ooooooooo,.,ooooooool~~~~~
S
INLET LIEU ` 70
000,
WATER TIGHT SEALS GAS-
-TIGHT i
11
4 BAFFLE A SEAL APPROVED
CI PIPE , B , ALM JOINTS W/ CI
3 ONTO B 15 1 v4 ON PIPE 3' ONTO
SOLID 5 ( 1 , 'SOLID SOIL
SOIL PUMP OFF ELEV. FT. OFF RISER EXIT
BOT'rO.A D PERMITTED ONLY
1461PE Elev. (p4CD•2S IF TANK
MANUFACTURER
6-vtcA )A-"pod APPROVED BEDDING UNDER TANK HAS APPROVAL '
c/cOAT''°A) a CONCRETE PAD
~~C~• SPECIFICATIONS
Gtr/ESEi2 ~O-~ y~ a v D/}J/
SEPTIC / DOSE c61/, -
TANK MANUFACTURER: -CO- NUMBER DOSES PER DAY: /
TANK SIZES: SEPTIC Id-0-0 GAL. DOSE VOLUME INCLUDING ,
: DOSE p0 GAL. 15~j FLOWBACK: GAL.
ALARM MANUFACTURER: GFVEL 9Gr~;PM CAPACITIES: A= y INCHES GAL.
MODEL NUMBER: , V, I- .
,.-;,SWITCH TYPE: Mt Gv rT B = 2 INCHES = GAL.
s
PUMP. 'f MANUFACTURER: 7-00(E z C = ~ S INCHES = GAL.
MODEL NUMBER : k 2- ff
SWITCH TYPE: P(66YBAM KEUuity F/oArS D = INCHES = ~_GAL.
REQUIRED DISCHARGE RATE GPM PUMP & ALARM WIRING AS PER ILHR'16.23 WAC
VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE 6p' 33 FEET
+ MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . 2.5 FEET
+ _ 40 FEET FORCEMAIN X •/C, FT/100 FT. FRICTION FACTOR'. FEET
0V&L- 5 HIA6Fp TOTAL DYNAMIC HEAD = FEET
INTERNAL DIMENSIONS OF PUMP TANK: LENGTH /10"-; WIDTH DIAMETER
^ LIQUID DEPTH 57
I .
SIGNED: LICENSE NUMBER: DATE:
1/88'
ONSITE SEWAGE SYSTI`ri
SPCc(f onji . nafs
~uM P
A P DEPART`IEDN'f 01 AND fiiiNIAN RELATIONS
w`!SlPJ Of c iTY AND DlN
SL2
Ir
W ~
HEADI
115 ~
CAPACITY 34 110
32 105
00 _
CURVE 30 95 I
90
28
EFFLUENT 24 --so-
MODEL
and Q 75 MODEL 109
22
70 185
DEWATER/NG :
Y is 80
55
18 so MODEL
C 103 MODEL
1- 14 100
12 40
35
10
197G
30 MODEL
zs
SEWAGE and 15
DEWATER/NG ° 20 MODEL
1S MODEL 181
4 7
10
2 MODEL
{ 5 53, 55,
i 57,59
0
GALLONS 10 2,01 30 40 50 80 70 80 90 100 110
24
75 LITERS 0 80 180 240 320 400
22 FLOW PER MINUTE
7o I
20
1• 00_ MODEL
44 . 295
W 55
= 10 I t;.
v 50
a 11 MODEL
~ 12 40- 294 ~ ~ ~ - -
MODEL
35
29
10 3
MODEL
284
e
25 - MODEL
282
8 20-
15
10 MODEL
OELLE/P O.
2 5 287, 214
_ 171t
0 3280 Ok/ MXws Lww
GALLONS
10 20 30 40 50 80 70 80. 90 100 110 120 130 140 '10 1°0 170 180 190 P.O. BOX 16317 i
L _4
` Loulavi r Kentucky.10216
LITERS 0 so 100 240 320 400 480 550 840 720 (502) 776 2MI '
FLOW PER MINUTE
.i
"97 CeSt Ifun Sods HEAD CAPACITY
UNITS/MIN
Feet Meters Gal. las.
• Automatic or Non-Automatic.
~ 5 1.52 57 216
• 'h H.P., 1 Ph., 115V or 230V. 10 3.05 51 193
• Non-clogging vortex impeller design. 15 4.57 43 153.
• Passes 1h" solids (sphere). 20 8.10 27 104
• 1112" NPT discharge. Lock valve: 24.5'
• Float operated submersible (Nema 6) mech- i
apical switch. 97 Serbs
• Automatic reset thermal overload protection. V~ listed SC-2225
• Stainless steel screws, guard, handle and arm and
seal assembly.
• Watertight neoprene' ring between motor and
pump housing. ,We`
Vail "
I N97, non-automatic, available packaged with a piggyback marcury
3 float switch.
S89-40388
I.L.H.R. 83.08(2) j
PROJECT INDEX SHEET
Owner : Xl f AA-)Z IS - 3c4o!~- 3 55~' j
Address: 1z' ~f -p"O i 13 T'oolt
• j
Site Location:
sc.~ % Nw' SEQ. 17 T Z ,v 1 y Taw, of
I
Project Description:
L A) 6-- 61D
ti G-
Soi~ ~o~i-~lrS 4ti D,v_s,'7--
`i - t TAO l9- S U I' T? G Si 7.
2-104,101,10 6- ~4Piv! o Cit . r i
s G~~s s r
L TE' .
Sit / 3 ~cD kM IAv ' Gi oVU vD P,P~SSviP~'
l
4U TSiO~' OG (/t/,~0(J~) ~ ~PE%~D.E' TEl~ rcGV 60
Z-D,,r~. S~ E-- i l s F l o o D E 16 v-*rl 0,J A- TTA e-Gt-,-16.N7~5
Page 1. PLOT PLAN VIEWS
Page 2, CROSS SECTION & SYSTEM PLAN VIEWS
Page 3. PIPE LATERAL LAYOUT
Page 4. DOSING CHAMBER CROSS SECTION
Page 5. PUMP PERFROMANCE SPECS
i
' i
I'^ '•`SITE SEPTIC PLUMBING CO.
PLUMBER: 605 O'NEIL RD., HUDSON, WIS. 54016
ROBERTULBRIGHT OCT - .1989
'AIIS. MASTER PLUMBER LIC. NO. 3307 M.P.R.S.
MINN. INSTALLER & DESIGNER LIC. N0.00663 SAFET'y & FBI D03. DIV.
DATE: SITE EVALUATER/ DESIGNER
SIGNATURE - vonESITE SEPTIC PLUMBING CO.
6b6 O'NEIL RD., HUDSON, WIS. 64016 i
ROBERT ULBRIGHT
WIS. MASTER PLUMBER LIC. NO. 3307 M.P.R.S.
MINN. INSTALLER & DESIGNER LIC. N0.00663
i
S & N Land Surveying
108 WALNUT STREET
HUDSON, WISCONSIN 54016
(715) 386-2007
September 5, 1989
s
Edward Frantz
964 Trout Brook Road
Hudson, Wisconsin 54016
Dear Mr. Frantz,
I established elevation 702.70 on SE corner of bottom step on
South side of house at 964 Trout Brook Road.
Bench mark was taken from Rusch Surveying which was done for
North Hudson Aerial Contour Map. (USGS).
Thank you.
Sincerely, ~J
Allen C. Nyhagen, R.L.S.
S & N Land Surveying
ACN:ln
cc: Bob Ulbricht
1
j
State of Wisconsin ` Department of Industry, Labor and Human Relations
PRIVATE SEWAGE PLAN APPROVAL SAFETY & BUILDINGS DIVISION
Office of Division Codes and Application
201 East Washington Avenue
P.O. Box 7969
Madison, Wisconsin 53707
ROBERT ULBRICHT Owner: EDWARD FRANTZ
655 O'NEIL ROAD 964 TROUT BROOK ROAD
HUDSON, WI 54016 HUDSON, WI 54016
i
RE: Plan Number: S89-40388 Date Approved: October 2, 1989
Gallons Per Day: 150 Date Received: October 2, 1989
Project Name: FRANTZ, EDWARD - RESIDENCE Location: SW,NW,17,29,19W
Town of HUDSON County: ST CROIX
i
The plumbing plans and specifications for this project have been reviewed for
compliance with applicable code requirements. This approval is based on Chapter
145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are
j stamped 'conditionally approved'. This approval is contingent upon compliance with
any stipulations shown on the plans. All items that are noted must be corrected.
F All permits required by the city, village, township or county shall be obtained
prior to construction. The licensed plumber responsible for this installation
shall keep one set of plans with the department's approval stamp at the
construction site. The installer shall notify the appropriate inspector when
inspections can be made.
This approval will expire two years from the date approved or if a sanitary
permit is obtained, it will expire the day the initial sanitary permit expires.
The Section of Private Sewage has reviewed these plans for private sewage system code
requirements only. These plans have not been reviewed for the code requirements
set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the
Wisconsin Administrative code.
This approval is for the following components only:
- REPLACEMENT IN-GROUND PRESSURE SYSTEM
Inquiries concerning this approval may be made by calling (608) 266-6952.
Sincerely,
6;e~ *r -
cgt)_Irl~
GERARD M. SWIM
Section of Private Sewage
Division of Safety and Buildings
cc: EDWARD FRANTZ X Private Sewage Consultant
SBD-6423 (R. 08/88)
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, c DIVISION
LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX 7969
N WI 3707
HUMAN RELATIONS
(ILHR 83.0911) & Chapter 145)
TOWNSHIPl~: OT NO.: BLK. NO.;SUBDIVISION NAME:
w '/,vim 17 %TzrN/R1~ E to ►W HuPsoa
S NAME: MA N ADDR ESS:
COUNTY: NER'
sfcQo%k eD FRgAJZ 9G/ -7,F'D07- ooh 12D, vDSo,J 4-)IS-540140
USE - 55- jr DATES OBSERVATIONS MADE
No. DR COMMERCIAL DESCRIPTION: STS:
IAResidence C1 New X Replace I - Z;. w A i ue
RATING: S- Site suitable for system U- Site unsuitable for system C-5 8 ~m m E 2T' 1 S
ONVENT NAL: MOUND: 1N-GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK: RECOMMEN ED SYSTEM:(optional) .
DS ❑U ❑S DU S DU ❑S DU ❑S DU =-G • $~Fssv R~
DESIGN RATE:
If Percolation Tests are NOT required If any portion of the tested area is in the C C
under s. ILHR 83.0915)(b), indicate: (:L~$ S = Floodplain, indicate Floodplain elevation: 70 V V J J
IrJ u$(fs FEET PROFILE DESCRIPTIONS ?AI _bECb4*L -FsET-
BORING TOTAL 75- H T GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN. ELEVATION SERVED EST. HIGWE_-S TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
j B- $ 70y33 p S o s~ , o' So. • S-1 S. S ' ? cs'
' 0 ' pit. &.3 CaURSE ? p ' Tit) M
2- 5 70 ~s , 5 5,5 S. 3, T '
'BN covresF S) S S-. 3, o lfv
j B-3 rte. S 7ay!o7 5, o s,o o d 6-
B-
B- 11010 ,Jr R. Ali, . EvEL /f SS T~S T IW C f- = Co l`"9, o ' A/°P gee x.
.
I
B-
I
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP I WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. D PERIOD 3
PER INCH
I P.
P- M V Li D L 1 ~Tt 1 20 a~ 7r
P- A.) I C E jArr ( S
STIA-4 5' - l
P-
P- l
1Z CIA N't
i PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale of 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
I of land slope. i
SYSTEM ELEVATION a"
I.
r
I
_
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:
HOMESITE SEPTIC PLUMBING CO. 5e P -r. ( - i 9 8
, 669 0- ADDRESS: ROBERT ULBRIGHT CERTIFIC TION NUMBER: PHO E NUMB (optional):
Zy-2- 13,P6 - 4N'_5
MINN. INSTALLER & DESIGNER LIC. NO. 0060 CST SIGNATURE:
i
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHRSBD-6395 (R. 10/83) - OVER -
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Is
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EI e UArfoa = 70 y. 0
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'PLOY PL-Ar '
SCALE 20
HOMESITE SEPTIC PLUMBING CO. S -
655 O'NEIL RD., HUDSON, WIS. 54016
ROBERT ULBRIGHT oSf-#' ZyPa I = T3,4ct( vE...&,e/.J&S
WIS. MASTER PLUMBER LIC. NO. 3307 M-P.R.S.
MINN. IIJSTALLER & DESIGNER LIC. NO. 00663
STC - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER 6,)9 f~"f
ROUTE/BOX NUMBER FIRE NO.
CITY/STATE #DsD - / w l T • ZIP _f y~l
PROPERTY LOCATION: 514-11/9 ~61 1/4, Section ? , T L~ N, R W,
Town of Dfib"- , St. Croix County,
Subdivision -Lot No.
Improper use and maintenance of your septic system could result in its premature
fail6re 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 1, 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 / 9 Q
St. Croix County Zoning Office
St. Croix County Courthouse
911 4th Street
Hudson, WI 54016
(715) 386-4680
Sign, Date, and Return to above address
APPLICATION FOR SANITARY PERMIT
STC-100
This application form is to be completed in full and signed by the owner(s) of'
the property being developed. Any inadequacies will only result in delays o_f
the permit issuance. Should this development be intended for resale by
owner/contractor,(spec house), then 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 e:p- 2-
Location of property ' 1/4 1/4, Section W
Township ff VpyD
Mailing address ~4 T~
~vD S'o Cy ~ S ~S" tea! ~
Address of site ~G
Subdivision name
Lot number
Previous owner of property Total size of parcel
Date parcel was created t ~~O
Are all corners and lot lines identifiable? Yes No
Is this property being developed for resale (spec house)? Yes ~No
Volume and Page Number -5 S~qas recorded with the Register of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER, and
the SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if
available would be helpful o
so as to avoid delays o
of the reviewing process. If
the deed description references to a Certified Survey Map, the Certified.Surve
y
Map shall also be required.
PROPERTY OWNER CERTIFICATION
I(We) certify that all statements on this form are true to the best of my (our)
j knowledge; that I (we) am (are) the owner(s) of the property described in
this information form, by virtue of a warranty deed reco ded in the Office of
the County Register of Deeds as Document No. Z -7& ; and that I (We)
presently own the proposed site for the sewage disposal ystem (or I (we) have
obtained an easement, to run with the above described property, for the
construction of said system, and the same has been duly recorded in the Office
of the County Register of Deeds, as Document No.
Signature of Owner Signature Co-Owne Applicable)
Date of Signature Date of Signature
DOCUMENT NO. Wr nIL&NiTY DEMD
soda , ~3"30
. n C~, BTAT6-0R WIBCONBIN-ROAM O
i~ ! 9 THIS $PACK RnRRVRD FOR RRCORDINO DATA
THIS IIVDENTURE, Made by K. B,. Priester and Ethel
Priester,•-his_ wife and Philip D .La... .r_ sen and_ REGISTERS OFriCE
Bernice.. ....Larsen.....his wife............... ST. CROIX CO., Wi5,
. .
grantor.g. of .....St C . ._..ro . .....ix ......................_......_...County, Wisconsin, Rec'd for Record this-12th
.
hereby conveys and warrants to.... Edwaxd...R.....Fxanz day of-.I)8cemr?r -A.D. 19 67
p
s- ---s
at_ ,1 -.00
y^.....grailtee...... of _ _ Re Is r eeds
.............5 t...._C xS2.1.ZG.............................. Coun Wisconsin or th sum o
One Thousand Five Hundred and tyno/100 5~0 00
.............i .........................................................................................».........Ji._.._....:...»... RRTURN TO
Dollrs
the following tract of land in............ St...._Cro ix. _ .............County, - Wisconsin:
A parcel of land located in the southwest quarter of the northwest quart-
er (SWj of NWj) of Section Seventeen (17), Township Twenty-nine (29)
North, Range Nineteen (19) West, St. Croix County, Wisconsin, further
described'as follows:
Beginning at a point on the west line of said
Section Seventeen (17) a distance of 884.3 feet
north of the southwest corner of said southwest
quarter of the northwest quarter; thence due east
110 feet, more or less, to the centerline of the
town road, thence northerly along centerline to
the center of the south branch of Willow River,
thence westerly along said stream centerline to
the west line of said Section Seventeen (17),
thence south along said west line to point of
beginning.
r
(
Ihn Witness Whereof, the said grantor.S.. ha.Ve.... hereunto set.....the it hands... and seals... this
6t- day of.... ...Ileceml]er................... A. D., 19.... 6.7...f'~/
~`r~: rC.J ....(SEAi.)
SIGNED AND SEALED IN PRESENCE OF t
B. Pr.* Ster
.
Dolma Hoag1,rl R+_>> Pri -Gt -r
....................................(SEAL)
Cl ord J ilden Philip D. Larsen
~'7!icccs.l..~f l~d . ................................(SEAL)
-nice C. Larsen
State of Wisconsin,
»Crox____--.Count . Personally came before me, this 6th..... da f.,.......De. eIAQ 9 6.?
the above named .......K.- B. ~ iester~ and Ethel PriestertY~ls wi~e ans PRiiip.
A• ..La.rze>a..AIad...>3e.x-nlce...C......I~axse .,...k?? ..wife.,
to me known to be the persorA... who executed the foregoing rum ent and cknowledged the same.
Clif~ln
................TED $Y;
d fiilden
IS INSTRUMENT WAS DRAFTED
t'h pq.pgy-' Notary Public, St. Croix CountY, Wis.
J: .t
-SEIAL
Hugh F. Gwin _
7L1............
My commission (expires) (iaj.......... January.'... 11,...... 19
(Section 59.51 (1) of the WIS onsip $tattrtea.provide! that all instruments to be recorded shall have plainly printed or typewritten thereon
the names of the *rantors, grsntedj,wkne9ea and notary. Section 59.51; similarly requires that the name of the penoo who, or govern-
mental agency which, drafted such, ihltt)wmrit, shall be printed, t ,pewntten, stamped or written thereon in a legible manner. )
WARRANTY DEED - STATE OFD WISCONSIN wleconuln Legal Blank Company
)
1ronM No. 9 Milwaukee, Win, ( Job 27115