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HomeMy WebLinkAbout032-1001-90-000 z °o �n p ° m tr c op "` O o` o p aci N . O U) i C O T= (6 _ 3 a aD v' L@ p m U c ~ o N N OO O O c.- C 00 E 4 ' N O (n C' N O - O � � C (cvo °�C) 0 °��"'o V N C p N j N C p O N N C (6 > N - C N 0 -0 � O @ v m U i N p '6 Z > p 'O C Ur p - 3 (6 c"N- c o T t 3 LL c o o U)- 0 Q O a(n U Cc')-o (1) C L N c 0 @ L a c p O U N L o c 0 E d N C C p p U Co CO O N o uj L H Z li a [a O I O Z :!t m U r C N N Z N V) I- N N @ c w N i N � C •� N C O 0 C 2 U - O © Z Z 0 Z C) N Moy CL U O C. .O. V N N i U to N �n 0 O a L N Z > d a • '� E a a a U_ O t!1 Q O to J U 3 rn rn z o CD PI N O m n r3 pJ O O C `1�wii I N d a� d z £ a WA% N O p ''.. W N C ` °0 3 E LO rn d O 0 0 U 0 @ O - M F- - U C C U � 0 0 40. O Z Z p a Lo 0 � E E C O r • ii, O O Cn I C7 O N H (J L a x* a L a > • (� s3 Tv .� d y c u 1v o C c o , (,I� o "M = 3 .2 o i U a 2 0 (A U IIIIII i y-� J l V / I I � 1 or� lU / y 2 � IZ Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 119536 0 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 Holder's Name: City Village X Township Parcel Tax No: Grubbs, William I Somerset, Town of 032-1001-90-000 CST BM Elev. Insp.BM Elev: BM Description: Section/Town/Range/Map No: ltd •0 /09- 0 c ' 01.31.19.13A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION HI FS LEV. a-f�- Septic Benchmark ��7 00.0 Dosin G/"r J Alt. BM Qra osed �y�,cvto 6/0 ? No d esc It qwp, 7.13 Aeration Bldg.Sewer /f ve Holding St/Ht Inlet (•f) TANK SETBACK INFORMATION �w} _ SUH O t1-1 A I p•2Z �'j�� 07 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 112 qq,.So Septic Dt Bottom A 2-7 1 I. ga S3 Dosing Header/Man. Aeration Dist. Pip Z (?K2-' il, 2-1 4 loo.. 77 Holding Bot. Sy Nem PUMP/SIPHON INFORMATION /`/�1 � Final Grade Manufacturer 9 Demand St Cover 1- ?"Z,C_f C. W' n` GPM Model Number � V IC t /� TDH Lift ` Friction Loss System Head TDH Ft �.� Forcemain Length ,Dia. Dist.to Well SOIL ABSORPTION SYSTEMf BED/TRENCH Width Length No.Of Trenches PIT Dt SIONS No.Of s Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type f ystem: UNIT Model Number: DISTRIBUTION SYSTEM :SQL Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing 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 Topsoil El Yes ❑ No [:] Yes 0 No COMMENTS: (Include code discrepencies, persons present,etc.) Inspection#1: , Inspection#2: / / Location: 2348 80th St. New Richmond,WI 54017(NE 1/4 SE 1/4 1 T31 R1 9W) metes&bounds Lot Parcel No: 01.31.19.13A 1.)Alt BM Description= SU �� �f %?�` ;� L 1, up �J 2.)Bldg sewer length = r / -amount of cover= TL Plan revision Required? F1 Yes ❑ No LL Use other side for additional information. SBD-6710(R.3/97) Date Insepctor's Signature Cert.No. DQpARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDING LABOR&HUMAN RELATIONS DIVISION P.O.BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES&APPLICATION MADISON{WI 53707 N:, SL.' , 1, 31, 1 9W (If at signed) Number: NE f Somerset xi2 CONVENTIONAL ❑ ALTERATIVE 8U�tti �treet ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: William Grubbs Route 2 New Richmond, WI 54017 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: Calvin Powers 1563 St . Croix 119536 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TT ELEV.: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: 1EYES ❑NO ❑YES ❑NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM: FEET FROM LINE: AIR INLET: ❑YES ❑NO ❑YES ❑NO I NEAREST­11110i DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: P PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF) ❑YES ❑NO NEAREST-� SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: I 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: BED/TRENCH WIDTH: LENGTH: NO.OF DISTR.PIPE SPACING: COVER INSIDE DIA.: #PITS: LIQUID TRENCHES: MATERIAL: PIT DEPTH: DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR.PIPE I DISTR.PIPE DISTR.PIPE MATERIAL: NO DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV.INLET:I 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 I TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ' ❑YES ❑NO DYES ❑NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑YES ❑NO [--]YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL: NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING: ELEV.: ELEV.: DIA.: ELEV: PIPES: DIA.: ELEVATION AND DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑YES ❑NO ❑YES ❑NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: ❑YES ❑NO ❑YES ❑NO NEAREST did ilwrd -0- rid a a'.1 .r � / M auk 4K -r/A,od o f 7 y ,�Ie- 40er Qn 91??12�0� Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE: TITLE: Zoning Administrator SBD-6710(R.06/88) Thomas C. Nelson SANITARY PERMIT APPLICATION 7DRLLHR ' In accord with ILHR 83.05,Wis.Adm.Code COUNT r :t STATE SANITARY PERMIT -Attach complete plans(to the county copy only)for the system,on paper not less than /19sS 8%x 11 inches in size. El Check if revision to previous application —See reverse side for instructions for completing this application. STATE PLAN I.D.NUMBER I. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION. PROP R OWNER PROPERTY LOCATION Alf 1/4_S/, S T21 , N, R (or P OP TY OWNER'S MAILING ADDRESS LOT# BLOCK# Cif,STATE ZIP CODE PHONE NUMBER SUbd`I-VIS7N NAME OR CSM NUMBER -17 ITY 11. TYPE OF BUILDING: (Check one) El State Owned VILLAGE: e rS T NEAREST ROArD ❑ Public [4 1 or 2 Fam.Dwelling-#of bedrooms 2- ARE AX NUMBER(S ) cif f�' IIL BUILDING USE: (If building type is public,check all that apply) �, 3 f , °� /3A, 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/C Wa 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 L3 Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ❑ New 2. X Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.❑ 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 El Holding Tank 12 ❑ Seepage Trench 22 LJ El In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1.GALLONS PER DAY 2.ABSORP.AREA 3.ABSORP.AREA 4. LOADING RATE 5. PERC.RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED(sq.ft.) PROPOSED(sq.ft.) (Gals/day/sq.ft.) (Min./inch) ELEVATION 13 Feet Feet VII. TANK CAPACITY Site in allons Total #of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed El M I El 71 Septic Tank or Holdina Tank Lift Pump Tank/Siphon Chamber VIII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation th o ite se age system shown on the attached plans. Plum er's Nam e(Pr' t): PI is Signat e:( S ) MP/MPRSW No.:-A Business Phone Number: Plum is Address(St re ,City,StaW Zip Code): 7 d IX. COUNTY/DE ARTMENT USE ONLY ❑ Disapproved S ry Permit Fee(Includes Oroun star Date asue Issuin A nt Signature(No Stamps) Approved ❑ Owner Given Initial surcharge F %�;Advers Determination D — /� X. CONDITIONS OF APPROVALIREASONS FOR DISAPPROVAL: SBD-6398(formerly Plb-87)(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 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: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete##of bedrooms if 1 or 2 Family Dwelling. 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. 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'f 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) State of Wisconsin \ Department of Industry, Labor and Human Relations SAFETY&BUILDINGS DIVISION April 21 , 1989 201 E. 7969 ington Avenue Madison,Wisconsin 53707 William Grubbs Route 2 New Richmond, WI 54017 Petition No. S89-00450-P Dear Mr. Grubbs: Re: William Grubbs - Residence Onsite Sewage System NE,SE,1 ,31 ,19W Somerset, St. Croix County, WI Section 145.24 (1 ), Wisconsin Statutes, and s. ILHR 83.09 (2) (b), Wiltgpnsin Administrative Code, allow the owner to petition the department for a varnce to the installation for a onsite sewage system to replace an existif6g ons e sewage system at a site which is not in full compliance with the siting standards in the administrative rule. The system design proposed should protect the waters of the state from contamination. If this system becomes a • failing system or contaminates the waters of the state, this variance shall be rescinded. The petition for a variance requested to s. ILHR 83.23 (1 ) (d) of the Wis. Adm. Code was considered on April 17, 1989. The petition has been approved. The rule requires a mound system site to have a minimum of 24 inches of suitable natural soil . The variance requested was to install a replacement mound system on a site with 19 inches of suitable natural soil . All of the data and statements submitted on behalf of the petitioner were considered. This variance is specific to the subject petition and cannot be used for any additional modifications. Si erely, G Richa4Mer, rchitect Director, Offic of Divi ion Codes and Appl ' ation (608) 266-3080 • RM:KS:3690e cc: Ler y Jansky, Private Sewage Consultant - District 6, Chippewa Falls as Nelson, Zoning Administrator - St. Croix County SBO-6928(R.10/87) s State of Wisconsin ` Department of Industry, Labor and Human Relations SAFETY&BUILDINGS DIVISION I i SBD-6423(R.08/88) 171 IV jp i cl I � r r r , . ,r�'� a 3� ' 3% ob I E qf , I i , w 1 y, , , � O _ 1 1 i . r t 1 I S I r V 77� ��� _..,-#« 1`« 1 r , I , , f 1 f , I i I r f i I ' y . f / LLs W Page \0 Of G +J traw, Marsh Hay, or Synthetic Covering Distribution Pipe yR t } ; { Medium Sand G r-rssaa+s.=a---- saas F Tops it 1 E D 3 ,r Trench of "-2S" Force Main Plowed Layer f1% of Slope Aggregate ndisturbed Soil Cross Section Of A Mound System Using 2 Trenches For The Absorption Area � D Ft. A Ft. E 2.O Ft. B Ft. F 3 Ft, C 19. Ft. G Ft. ' KFt. H 1. , Ft. L Rq,Ll Ft. Ft. Signed: Ca'--Q'� I 13, - Ft. W y Ft. " "' > License #: / 6 Date: Alternate Position of....,��� Force Main L J B ►�.F— K..,--► ==— — —.___.--_. A i!- --- ---- - -- - - -- �---- 1 ' Force/ : Observation I Main W Pipes Permanent Markers `' � Distribution +Trench of Y'"2 ' x x Pipe Aggregate ' a Mound Using 3 Trenches For Absorp 1 Are S a► c� h � lz r _ 41 Rt yrr �.. _) P4 ..rrrrr rr r� ..rr Ic`. C o 4! Q7 :. r 44 Id O U y04 O la 0 (a V_ IA w � t 7 L WOtt C 4j AYoic �n.4 y J !> Page p? s Y FWfOrOled +" C PVC PIpq �.r+C x S Are E"any Skced PVC Fort* mww AIX PVCr , "tad`Pips ' astrip Nif�ll Altornoi• P01iwoA Of 3 , pipe (ores MainE. 0 Wit se, a 1ToAd � k End GOP PIRti a y ^1 a R .CR.. X .2-Y_ Inchpli 1 Y S Signed: Hole `-, Diameter Inch LicePse Humber: ! S Lateral p ,.. /,Z. Inch(es) Date: Manifold " . ._.. Inches :. �-/ �'-85 Force Mein " Inches # of hales/pipe.., do Invert Elevation of laterals&j,d Ft. " PAGE __L O F PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS frTVENT CAP WEATHER PROOF _T'i"C.I. VENT PIPC APPROVED LOCKING JUNCTION BOX AWHOLE COVERL ,5" 2S, FROM DOOR 04 w►1lnipt WINDOW OR FRESH 12"MIN. AIR INTAKE GRACIE w. COIJDWT le^MIN. ___——— - UJh.EI' PROVIDE ------ AIRTIG .. CAL I �, i r7 .. i * MOROVCD JOINT A APPROVED JONTS Jf C.Z. PIPT. I I(I W/C.Z. F.IPE �. � ►JK CChtllAf f., ' ::" ;; I ALARM EXTEI�DIU4 3' 501.10 sc!'. ; A ( 0_NTO SOLID SOIL 1 N C h r r"Yp nir I I y y DOFF BLOCK RISER EXIT PE I OWL IF TANK MAWLIFACTURCR HAS SUCH APPROVAL SPECIFICATIMJS 5 SCPIIIC AND ,amK� MALIUFACTURER: PO4+eFS l� "T1���,� IJUMBER OF (DOSES: PER I)A!d TAAJK SIZE : GALLOUS DOSE VOLUME A4J1RJh MAAIUFACTURCR' E'I ! GALLONS MODEL WUMBER: -- 16 1 CAPACITIES: A=_ 2Q A=_2 IyCHE5 OR lo GALLOUg SWITCH TYPE: 14 41 L B=l INCHES OR C. Y GALLONS PUMP MANUFACTURER'.—( y C= INCHES OR 20 1, GALLOWS MODEL WUMSER: '4k°70 l�r p 17ti� S ++ D w---5 INCHES OR L 0 GALLONS J SWITCH TYPE:- , �'�- MOTE:' PUMP AMD ALARM ARE TO bE PUMP DISCHAR4,E KATE 2L GPM �INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFEKEIJCE B5IWGCU PUMP OFF AND DISTRIBUTIOW PIPE.. s2_L_ FEET ��MIA�J,�IMUM NETWORK SUPPLY PRESSURTT,E��. . , , . , , . , 2.5 FEET . IO FEET OF FORCE MAIN X �FYjoor FRICTIOM FACTOR.. FEET ilk lit TOTAL OyJQAMIC. HEAD !MEET r,,q.Te.r 6u t/ JUTERMAL DIME1J51GWC OF TAAJK: FI-- ap(18fi►# ._ LIQUID DEPTH 51GKIED: LICEMSE 'NUMBER: � �� � DATE:_- �y-P s —117- Wk, 70� ubnrsib�e Effluent Pumps e11 I art ( ,� t t CA,►'i-, 14 il' v J S 4s°7F SVot7 120 Z. tiy�s 100 yA Aw +fi f � f • � Hwy r K � � 80 Ito W r ea} +1 h � k :t Y � WPM03,th H. 20 WP03. h H.P. _ t) 130 � 8p 1(]0 120 CapwClty—EiMom ► , i WAW H P 01dn qo vow PIMM PPM dP - r WPO311E _ tT5 9,4 WPM0311E 1750 : } v' WP0312E 230 10 41 WPMO'11?F T _ WIL WPH0512E... = s 0 Ak ;#a wPHOS32EP3 30 3• V :*`. WPH0534E 4ao ""171 wPHA712E 230 / 90 tr WPH�� 30 S r+ WPZ?34E 21 ?. WPHt 12E 230 id 11 d 3450 i Wp;Z 20M230 44 _. t4PH103rE tNPHt512E tp_ 13.3 WPH1532E 20b/Z30 3. 92 WPI11534E 4W I.3 WPHH1S12E 230 13.3 WPHH1$32E 2OW230 3d 92 WPHH1534E CT TO CIFICATIONS ARE SU9,►£GT TO CHANGE WI MOUE N OTWW . � I i!!li!i ii��....I,11 iil�ilili illi!I!I!I sill i!!I L, 4 2 8 1 3 904281 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI CERTIFIED SURVEY MAP RECEIVED FOR RECORD LOCATED IN PART OF THE NE1/4 OF THE SE1/4 09/24/2009 08:20AM CERTIFIED SURVEY MAP OF SECTION 1, T31 N, R1 OW, TOWN OF VOL: 24 PAGE: 5657 SOMERSET, ST. CROIX COUNTY, WISCONSIN. REC FEE: 15.00 COPY FEE: 4.00 PAGES: 3 W x BEARINGS ARE REFERENCED TO THE EAST z U' LINE OF THE SE1/4 OF SECTION 1,BEARING Q m SOO°07'37'1N. (ST.CROIX COUNTY GRID) �OODdQGID �t]ClaDO � A 0 _ — 0 NOO°12'53"E 661.02 t, 0 34.23 208.59 209.10 209.10' ca W WEST LINE OF THE x p ZO my m� O a NE1/4 OF THESE1/4 I �''m W C z I �Ox [[Dn��� _ Z I cnNC Zm�m gx mm0 O m O -�my� =S I 01 m Z w D cNi+ o Da n am rva r ® x '� W pO �,U) s�-4 ® gam® ' d I� o Q- I Z c2mi,z �n �nN �� v p, � I In o c'x I ZX z I[� �� �a�,so :=n� � zl m �?���• �"�mcz 'C — II mX o z x O I '+ N00°OT37"E 490.71' ro I �X I ' s?,oG Ix x m - o z co D m "' SHED 7S j p O M'j r D Z C m O m Imo .+ S T �p m Z M� Z z m c0 m ?Z v I a Imp T> z r O 23 K I� CD m g Z o 7C T� Z Z M NZ gmi a o Tm �0° INm � m z0 ci o-n Im = m 33 33 0 0 en = x°1n #or m M" Z $m :m0 ms �m� V o.. ...... m ° n C � c) z Oz mQ. O, '! �n � � z I <�m I z O m�R ° "''z �O O n°� r3ng m !Im O--I 111 - �_ ' oww ' Im ` m °+ °WN(rn w i - - I I I V S00°OT37"W S00°0915"W 1.05' i r o S(:; 07T37"W 659.49' 104.05' m i°v CIO m 64.98' i —S00°OT37"W N 594,61' , _ I D 98' 1981.59 A 594.50' Q, F ro EAST LINE OF THE SEV. 66.03' m cn m ' 80TH "T 300°07'37"W SS0.53' m. m A nO ---- — — na C70 D �O SHEET 1 OF 3 SHEETS 70 1 of 3 Vol. 24 Page 5657 INDEPARTMENT US , OF REPORT ON SOIL BORINGS AND. SAFETY& BUILDINGS INDUSTRY, � DIVISION LABOR ,AND PERCOLATION TESTS (115 P° BOX 7969 HUMAN RELATIONS 1 � MADISON,WI 53707 (H63.09(1) & Chapter 145.045) L PUN 7 SE TON: OWNS HIP/ : LOT NO.:BLK.NO.`. SUBDIVI ION NAME:Wd /T.J N/R 1741. �r C Y: O N R'S B11Y S DIA MOD MA IN6 AD S: ( 2- &2CV-17E n v J `(0I USE DATES 69SERVATIONS MADE _ NO.B DAOMMER IAL DESCRIPTION: OF L DESCRIPTION 10 TESTS: MS : C Residence n I/� ❑New Replace I RATING:S-Site suitable for system U=Site unsuitable for system l �f IC QN-VIE-N DS MU'_[MO IXS•E]UNGaS 1%U S S� M-1ELHQSG lj0 .REC �DSYSTEM`.(optional) if Percolation Tests are NOT required DESIGN RATE Al 9 f If any portion of the tested area is in the <. under s.H63.09151(bl,indicate: � n1��� J I Floodplain, indicate Floodplain elevation: 114 PR FI DESCRIPTIONS C' lNG TOTAL ) P H T R U DWATER , CHARACTER OF' SOI WITH THICKNESS,COLOR, T XTURE, AND DEPTH a NUMBER D'�H&fj. ELEVATION OBSERVED EST. IGHES TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) 0-2— "t, b 783 W 6 rul �� ' o " 7 61 , t/ G Tian 0"-os ru _ Cd J B R PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLINC., INTERVALM_IN._ jQp,t—_� rpkglglj PERINCH oN O iF j No N- o P- t� AJ 10 N _ a 3 h- 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 mo-14_ ­1 1yo 0611- -IVA+C t rl pule t I t� »1 Svt� (�orin5) ' area /, 3c>5' I,the undersigned, hereby certify that the soil tests reported oh 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: At­1 •1` Ll r AD ES CERTIFICA—TLIO—N NUMBER: PHONE NUMBER(optional): Ll/ o 1 ! — CST 1 ATUR : 7Z DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) OVER — Tr- A ST. CROIX COUNTY ^ " t :... WISCONSIN 'T ZONING OFFICE ST.CROIX COUNTY COURTHOUSE M J� : 911 FOURTH STREET • HUDSON,WI 54016 (715) 386-4680 March 15, 1989 Division of Safety and Buildings Bureau of Plumbing P. O. Box 7969 Madison, WI 53707 ' Dear Sir: An on site investigation of the William A. Grubbs property located in the NE 1/4 of the SE 1/4 of Section 1, T31N-R19W, Town of Somerset, St. Croix County, revealed suitable soils at a depth of 1.6 feet, below which high groundwater was noted. This site should be suitable for a mound system. Should you have any questions regarding this subject, please feel free to contact this office. sincerely, Thomas C. Nelson Zoning Administrator TCN:rms DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY_ & BUILDINGS INDUSTRY,' c DIVISION BOX 76 HUMAN RELATIONS PERCOLATION TESTS (115) MADISON WI 537907 9 53707 (1-163.090)&Chapter 145.045) LOCATION: SECTION: OWNSHIP/Mb"tetRA-b ': LOT NO.:BLK,NO.: SUBDIVI ION NAME: '/a 1/ !T3 N/R 174(o �r COUNTY: O NER'S B R�S-�14AA� IMA)+ING ADDRESS: T- t (�-' 2 ez, u kJ USE DATES bBSERVATIONS MADE NO.BEDRMS.:ICOMMERCIAL DESCRIPTION: PROFfI'LE,DESCRIPTIONS: A ON TESTS Residence 3 n 1:1 New /N1 Replace _ : t _ RATING:S=Site suitable for system U=Site unsuitable for system a CON�VENTI®AL: MOUND:❑U IN-GROUND : SY❑STEM-IN-FILL O❑LDING�NK:RECOMMENDED SYSTEM:(optional) If Percolation Tests are NOT required DESIGN RAT I If any portion of the tested area is in the A/ under s.H63.09(5)(b),indicate: L Floodplain,indicate Floodplain elevation: /v/14 Y% Y I PR F1 U.DESCRIPTIONS I G Sa -h 1 BORING TOTAL DEPTH TO GROU NDWATER- CHARACTER OF SOIV WITH THICKNESS,COLOR,TEXTURE, AND DEPTH NUMBER DEP`FM-0 ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B_ I lq. y 7 B-2 q. (0 O- — .(o 6fist z.(e —L/ J B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PE R PER INCH P- 1 O N O 3 g (3 p- Z 0 N 0IU 6 3 O 68's— P- 2 0 - a 3 3 el 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 ,►�o�n�- 10 I _ � E , , 1 7S t 1 j tN f � 1 . . � s� 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: l a -IV- IDESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): �.+ CST ATUR DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) —OVER — INSTRUCTIONS FOR COMPLETING FORM 115 - S D - 6395 To be a complete and accurate soil test,your report mu,,t include: 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 1 MAXIMUM rlUmber of bedrooms or corn nercia; use planned; 4. Is this a nevv or replacement system; S. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING-TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; d. PLEASE use the abbreviations shown here for writing Profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A separate sheet may be used if desired; 8$ Make sure your benchmark and vertical elevation reference point are clearly shown,and are permanent; _ Complete all appropriate boxes as to(fates, names,addresses, flood Main data, percolation test:exemp- tion, if approprrate; ?f}, if the information (such as flood plain,elevation)does riot apply, place N.A.in the appropriate box; 11. Sign the form and place your current address and your certification number; 12. Make legible copies and distribute as regrrired. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION, ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols St -- Stoma foyer 18,:) BR Bedrock Cob tau lJle {3- 10") SS Sandstone gr Caravel (under 3") LW — imestom-, sand FICA"4t — Nigh Grom,,d;vater _ ( ,arsra Sa?O derc P.rc:oiatron Rale W V';oll =s Fine. St3 a Bldg _. r3 u i Idinip_ Loamy &-fli l > ._. C .3t€ar Tharf I _ r dy i oao – Z E ii )n ,ara F._ S Ia- Lo,'n L31 ;k M >, sit �y ._ ti,r<�'�: Y L(rta€Yt S,iady Clay Loam R Red t ;;c� `;-rty Clay Loam otttr:=s _ _. ;:.d" Cloy Iy pl d;stia�c'1. } o - ps.1!-;J,riir{.rat: H i�tr L _.. l E I Six qe!w r., ,oil textrcres soirlace ioi li i d rv�istr disposal 13M - B";n n Vliark, VRP V P0cai i fi;rer c° Poia.t TO THE OWNER: This soil test report is the first steps in secoling a sanitary permit, The county orthe Depayrnicrrt may rectuest vetificatiora of this soil test in the ficid prior to permit issuance. A complete set of plans for the private _rvv:agu systern anct a permit rnus't be submitted to the appropwoe local authority In order to oik)t,in a p,e, mit, The sanitary rrn'it mlw Eas_, ohtame(J and posted prior to the start of any construction, 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 of 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. ---------------------)--,-------------------------------------------------------- wner of o L� rte. bS 0 property � P P Y � � � 10.� �, Location of property 1/9 5 1/4, Section , T 3/'- N-R/W Township Mailing address r , Address of site Subdivision name k'14 Lot number ' Previous owner of propertyr -z,� y. Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house)? Yes No Volume _ -land Page Number as 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 so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey 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) knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the Office of the County Register of Deeds as Document No. 31, yA y/• ; and that I (We) presently own the proposed site for the sewage disposal system (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 he ounty Reglst Deed , as Document No. ) . Signature of Owner Signature of Co-Owner (If Applicable) a, /?IIPY Date of Signature Date of Signature DOCUMENT NO. WARRANTY DEED BOOK '..83 nt-H 4 STATE OF WISCONSIN—FORM 9 ME SPACE USUVID FOR UWRDRIC DATA 0 6 3581 REGISTERS OFF I(77-- THIS INDENTUAE, Kade b GeAnan It. Catuta and June TZ. r___ ts. c Catutat lut,6ba.11,1 anrf it �nt tenan ST. CRI. kl Rec'd for Raw-oi,l this grantor Is 9f St. ctoix County, Wisconsin,hereby conveys and warrants day of A.0, F) 7 2 _G&Ubb,5 at____-, ,-30____A. M. I r grantee RETURN TO of Pat County,Wisconsin,for the sum of Seven Thou-6exnd Tv.'o Hunched ($7 200.00) the following tract of land in _q t- Dto i X County,State of Wisconsin; the I'Vottit Hat(I oS the 14o.%theut QttatteA o� the Southeast QuaAtet (N 1112 o6 NE 114 oA SE 114) o6 section One (1 ), TownShip Thitty One (31 ) Notth, oK Ranae Wbieteen (19) Rles t. deed given in 6n.C,4iMient oA a Lanni Contiact itecovied in Voeume 471 Pctqe 187. EXEMPT IN WITNESS WHEREOF,the said grantor A ha 11V hereunto set PiA hand A and seal A this Ith day of Aptit 72 A. D., 19— SIGNED AND SEALED IN PRESENCE OF �dyllzz (SEAL) BeAnam H. Catma Victotia flendAicks (SEAL) June R. CatuAa U (SEAL) j Wei Mattene A (SEAL) STATE OF WISCONSIN, St- CAQiX COWItY County. Personally came before me, this 7th day of Al iZ A. D., the above named ___Z nam li- Catutia 5 June V Catuka, lhtsb4nd and (040 to me known to be the person who executed the fore iligiinqpment and acknowledged the same. A (0. 0. Btotize It CTO" 16 8 This instrument drafted by ice Public 1! County,Wis. I'VE Inte- R- cabout W My Commission(Expires) (19) (Section 59.51 (1) of the Wisconsin Statutes provides that s%ht§trNUA2ent9 to be recorded shag have plainly printed or typewritten thereon the names of the grantors, grantees, witnesses and notary).4.. WARRANTY DEED—STATE OF WISCONSIN, FORM NO. 9 N.C.MILLER CO..MILW119119 STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER I 0% )1)&-M &L"�> -s ROUTE/BOX NUMBER FIRE NO. CITY/STATE /(tea i ,Ly�Tir �t-rzC� C c��S ZIP PROPERTY LOCATION: ,✓_ 1/4 S� 1/4, Section , T 5> N, R / W, Town of %'cam-rte r� c' �` , St. Croix County, Subdivision , Lot No. Improper use and maintenance of your septic system could result in its premature failGre 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 Co my Zoning Of i within 30 days of the three year expiration date. SIGNED--�--� Q DATES�/�e f Z41 I/ 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