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HomeMy WebLinkAbout032-2077-30-000 M ~ O CD m c a 0 � I I o I N b O � I tl W C Z LL c O .O Q z H o w N O FM- Z a m O O Z � r O O d Z a C CD M CD I c • c 0 Q 2 Z Z N z Lo N ! a > 1 10 O1 - ° (D ' O n N ❑ ❑ o. -a - Z N > ,n d a o Z aIaa y CL IL g o 3 O N 7 0 N J U O Z M CD Q E r o 0 a 6 d ¢ Z 0 m rn d co = ( c O O M O Q y = co M O H N c C V d 0 C o W y c co Li N O L N N Z C N a M O O O rn p 0 .� U C) (n 2 0 Z �' H Z d fn Or.+ 4. .w V it Y = € � � d at a ! c a a a v '�c °' c r A U a O u) U Parcel #: 032-2077-30-000 02/06/2006 01:17 PM PAGE 1 OF 1 Alt. Parcel#: 14.30.20.793E 032-TOWN OF SOMERSET 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 ROY E&JUDITH E HOLMQUIST O-HOLMQUIST, ROY E&JUDITH E 1539 MAPLE HILL RD HOULTON WI 54082 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description * 1539 156TH AVE SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 5.030 Plat: N/A-NOT AVAILABLE SEC 14 T30N R20W 5.03A IN NW SE PARCEL Block/Condo Bldg: REFERRED TO AS#2 ON SURVEY&DESC IN VOL 505/595 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 14-30N-20W Notes: Parcel History: Date Doc# Vol/Page Type 08/31/1999 609592 1453/233 QC 07/23/1997 809/430 2005 SUMMARY Bill#: Fair Market Value: Assessed with: 78143 209,200 Valuations: Last Changed: 07/24/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.030 58,100 110,300 168,400 NO Totals for 2005: General Property 5.030 58,100 110,300 168,400 Woodland 0.000 0 0 Totals for 2004: General Property 5.030 58,100 110,300 168,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 308 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 DEPA,RITMENT 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 NW�SE � 14� 3 0 , 2 OW State Plan I.D.Number: ❑ CONVENTIONAL ❑ ALTERATIVE If assigned) Town of Somerset x 1 ❑ Holding Tank ❑ In-Ground Pressure Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Roy Holmquist 16724 Ashwood Rd Apt . 307 Woodbury BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: MD4 5 12J REF.PT.ELEV.: CST REF.PT.ELEV.: Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Calvin Powers 1563 St. Croix 119542 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ❑NO ❑YES ❑NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM. FEET FROM I LINE: AIR INLET: ❑YES ❑NO ❑YES ❑NO NEAREST----00-1 DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: 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---100- 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: 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 DISTR.PIPE DISTR.PIPE MATERIAL: NO.DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV.IN 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 7DEPTH 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: ELEVATION AND ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.: DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑YES ❑NO ❑YES ❑NO COMMENTS' PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE: \ 2 ❑YES ❑NO ❑YES ❑NO NEAREST----* `e `J Sketch System on / Retain in county file for audit. Reverse Side. / SIGNATURE: TITLE: SBD-6710(R.06/88) lZoningAdministrntnr Thomas C. Nelson SANITARY PERMIT APPLICATION LHR In accord with ILHR 83.05,Wis.Adm.Code COUN TY STATE SANITA Y PERMIT# -Attach complete plans(to the county copy only)for the system,on paper not less than //, 8%x 11 inches in size. chec 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. lzo PR170RTY OWN PROPERTY LOCATION tow,5 E'/a, S / T_?r- N, R2, 0 E (0r)W PROPERVIF OWNER'S MAI NG ADD RES LOT# / J BLOCK# 3u N/ CITY,STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER L 0 CITY II. TYPE O BUILDING: (Check One) ❑State Owned ❑ VILLAGE NEAREST AD nn .S ❑ Public I�1 or 2 Fam.Dwelling-#of bedrooms PAR EL Ax NUM ER( ))Q?.r1_�77 c73�'� Ill. BUILDING USE: (If building type is public,check all that apply) � 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. New 2. ❑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 CK'Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1.GALLONS PER DAY 2.ABSORP.AREA 3.ABSORP.AREA 4. LOADING RATE 5. PERC.RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED(sq.ft.) PROPOSED(sq.ft.) (Gals/day/sq.ft.) (Min./inch) ELEVATION 3-7.5 a Pt Li X75 Feet 5W 5 Feet VII. TANK CAPACITY Site INFORMATION in allons Total #of Prefab. Fiber- Exper. New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks strutted Septic Tank or Holdin Tank 10 6 0 Iota 0 W e U nk/SlphonChamber.10061 oo e_r G VIII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name rinty Plumber's Signs e: Stamps) NIP/MPRSW No.: Business Phone Number: C o 7iS XY,4,-5-1 -7 SS PI ber's A d ss(Street,Ci tate ip Code 3 5 �� IX. COUNTY/DEPARTMENT USE ONLY E] ry Disapproved nita Permit Fee(Includes Groundwater a e ssue Issui gent Signature(N Stamps) )tA I pproved ❑ Owner Given Initial Surcharge Fee) Adverse Determination L X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(formerly Plb-67)(R.11/88) DISTRIBUTION: Original to County,One Copy To:Safety 8 Buildings Division,Owner,Plumber i 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 suPmitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and ma�ling 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. Vl. 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. SBD-6398(R.11/88) 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. Owner of property R© o� rn d. Location of property _&.w1_1/4 _ZiC-_1/4, Section 1 , T 30 N-R LBW Township Mailing address 72�f O 7 W � s s ins Address of site Subdivision name Lot number Previous owner of property Total size of parcel Date parcel was created Are all corners and lot lines identifiable? x Yes No Is this p operty being developed for resale (spec house)? Yes - No D Volume d Page Number 9-30 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. f/z & X 7�3 ; 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 the County Register of Deeds, as Document No. ) . Signa re of ownklr Signature of Co-Owner (If Applicable) Date of Signature Date of Signature _7 DOCUMENT NO. I �) THIS SPACE RESERVED FOR RECORDING DATA WARRANTY DEED REGISTER'S OFFICE .• ;I STATE BAR OF WISCONSIN FORM 2-1982 4368' 3 ' BOOK K 809 FA4E43O j ST. CRQlX Co', WI j I I j Recd for Reewd DALE K. _FOOTE AND DOROTHY L. FOOTE, husband and MAY 2 1988 wife •- - �j of 1 :30 P M I� ..................... ........... ................................ -•----•---------•.................. . ....-----•-------------------- •-------------------------• l conveys and warrants to ReplsterofDeeds ROY-_HOLMQUIST j' ....... ..............._....... ...._..------•-•-•• ---•--•. --•---•. ------.. •---•--•-••----•-•••. 11 REALTY WORLD PAULEY $ JOHNSO �I 1940 SOUTH GREELEY ST. •----------------------------------------------------------------------------•-----------------------••----••-•-. I STILLWATER, MN 55082 ' . -------------------------------------•-------•--------------••-------•-•------- ------ .---•--. -----•• -- -. ... ... .._- --------- --------------------------•-------••------••--......---•- .................................... RETURN TO �i .... ...........................................................................................- i the following described real estate in St C ._�...•-•- roix--•--------------•--•---••--•--....._County, State of Wisconsin: it Tax Parcel No: ........ Q Part of NWJ of SEJ of Section 14-30-20 described as follows: Commencing at the S � corner of said Section 14; thence N0001 'W (true bearing) 1319.39 feet along W line of said SEi ; thence N 89°33140" E 1323.43 feet along the S line of said NWT of SEA; thence N0002'50" W 290.00 feet along the E line of said NWj of SEJ to the Point. of Beginning; thence N 0002'50" W 681.65 feet along the E line of said NWj of SEJ; I; thence S 73017100" W 530. 10 feet; thence S 16043' ' l; 126.00 feet along the Ely right of way line Of town road; thence S 350421E 1' 131. 11 feet along the NEly right of way line of said town j road; thence Sly 90.34 feet along the Ely right of way line of said town road on an 80 foot radius curve concave Wly whose j chord bears S 3020'40" E 85.62 feet; thence S 60059120" E 446.55 feet to the Point of Beginning. +fir This ..1S not.......................... homestead property. 11 NX) (is not) • Exception to warranties: i i !' Dated this 13 .................. day of ....April. ....-------- ---... ......... .....---•-----.....--_, oo . ....... K ........ ........ ...•-•�----••--••---•--•-•-----...----.....(SEAL) .Dale � .��Foo t. ..... ........---• ..........(SEAL) e it : 1' It i ----•---..._..(SEAL) '' th ------••---•-------------•------...(SEAL) �I Doro L. Foote ii ----------------------•---------------------...-•----•.._......•- AUTHENTICATION ACKNOWLEDGMENT Signature(s) --------••-•-•••••• ........................................ STATE OF N Minneso a SS. ton ... .. h illy� ' ......................................County. authenticated this ........day of........................... 19...... Personally came before me this .....13-------day of ......April..........................I 19_$&... the above named I` Dale . . . _I'oo. and Do•rQthy ---- -••-•--- husband and_wife TITLE: MEMBER STATE BAR OF WISCONSIN ----------------------------------------------•--- ............................. 1 (If not................................................................ --•-••----•••- authorized by § 706.06, Wis. Stats.) to me known to be the person _S......... who executed the f egoing instrument and acknowledge the e. 1 THIS INSTRUMENT WAS DRAFTED BY 0- 1' 1/, (` W'••,- - t gKney'_s _Title_of__Stiliwater_______________ r r L 1835 Northwester A nue ' ---------------------•-------•--•-••••-•-......._...... .•--------•--..----- ........ 50�__ _ Washin ton y II Notary Public .__.... g ..........._Count W'iXt MN i! (Signatures may be authenticated or acknowledged. Both My Commission is permanent.(If not, state expiration I; are not necessary.) date: ........,AAAAn^n� .._.,A9......... ) • TERRY C. McCONALIGHEY "Names of persons signing in any capacity should be typed or printed below their signatures. S NOTARY PUBLIC-MINNESOTA 2 " r . WASHINGTI COUNTY �� _ k1y'Camnt:-�iplres=JUlt6.1.7,.1991 _. ._ Kr-millerCompargiry7l STATE BAR OF WISCONSIN Y vvvvvvvvvvvvVVVVVVVWVV�I�/Yyy�yyv � �kTr��'T1 FORM No. 2— 1982 JioCK Co 13002 D�UMENT NO. I WARRANTY DEED THIS SPACE RESEn VED ►OR RECORDING DATA ' i STATE BAR OF WISCONSIN FORM 2-1982 I DALE K. rOOTE AND DOROTHY L. rOOTG, husband and . .......................................................................I..........__....._...._.... wife i ..................................................................... ............................._..........._......_............_...._..........._.,_.,...,,....,_,._._.. .......... .................................... convcya and warrants to ......RQX--HQ�QUIST.......................... II j REALTY WORLD PAULEY & JOHNSO 1940 SOUTH GREELEY ST., ......... ....... ..-•---•----......................__....._...._..._. STILLWATER, MN 55082 Ili .............._..........______..............--•--._....._...._......._..._.........._....._.._......._• I ................................._.........._......_........ ... RETURN TO ......... ........................................................ ................................................................................................................. -....._...... .. _...... .. .. .. ..___ the following described real estate in ..5�.� Croix ...•_County, State of Wisconsin: Tax Parcel No: ........03�307.7.30.... Part of NW} of SE} of Section 14-30-20 described as fo Commencing at the S flows: N0001 'W (true bearing)co1319.39 feet alongoW lineto�fnsaid j Sl;t ; thence N 89°33'40" I: 1323.43 feet along the S line of said NW} of SI:f; thence NO°02'50" W 290.00 feet along the E line of said NW} of SE} to the Point Of. Beginning; thence i N 0°02'50" W 681.65 feet along the I's line of said NWJ of SE}; thence S 73°17'00" W 530. 10 feet; thence S 16°43'E 126.00 feet along the Ely right Of way line of town road; thence S 35°42'E 131 . 1.1 feet along the NE.ly right of way line of said town road; thence Sly 90.34 feet along the Ely right of way line of said town road on r�in 80 foot radius curve concave Wly whose chord bears S 3020140" E 85,62 feet; thence S 60°59'20" E 446.55 feet to the Point of Beginning. This .-is not ., homestead property. Kit) (is not) Exception to warranties: i i i Datedthis ....................13......................._ day of ....n1?41........................................................ I9. 8.... 1 I ...........................(SEAL) .........................................(SEAL) Date K. Foote f � ' I ......................(SEAL) .... . .. ..... ..._ ............................ ........(SEAL) Dorothy L. roote j' AUTHENTICATION ACKNOWLEDGMENT II �� Signaturo(s) STATE OF VGlt�t}4�1's4V Minneso a r i �' sa. �j .........................•-....-•-•.......- Washington ...............................County. authenticated this ....._._day of............. ........1 19...... Personally canto before me this .....11.......day of j _..._.lh?�:l........................... 19.0.11._. the above named ! ..........................................•----......._................._._..... Dale K. Foote•-and._p4.lot1?Y...II....FOaL�......_. .... •--• husband and wife ...................................... TITLE: MEMBER STATE BAR OF WISCONSIN (If not. ............................................................ ..._._.........................................................._........._.... authorized by § 706.06, Wis. Stats.) ! to me known to he the person .._......... who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BV hll'S No .thwest:erp y nue •..............................................................I............... SI:JLJ.�.Mld�kx._..�7N....,?:?�31�...... ._..... Notary Public .........Washin.gt4n.............CountyMX MN i� I (Signatures may be authenticated or acknowledged. Both My Commission is permanent.(If not, state expiration II are not necessary.) ! date: ......................................................... 19.._......) I� •Names of persons dRninE in any capacity should be typed or Printed below their einnature.s. � I) KCMillerConpsrry� STATOR M No. 2 19 2SfN Stock No. 13002 9 htof` dustrt ' ON ITE SEWAGE SYSTEMS off+ceii�M IllibnCodesandappiI(aclor� '. rtlteh irons Onsets Sewage Section. a gs lsion A 201 f:WaiIiihingtaR��r R 1 i41 ' PLAN APPROVAL APPLICATION P'O.Box 7"9,filla�isan W1 l i7�iT �? (0)21616=38 IS fRT10N Please fill in al[applicable data and submit this form with plans. Plans will not be reviewed until all fees are received. The Lever We of this form describes most of the required plan information. Further requirements maybe contained in the Wisconsin Plumbing ry „ K Yre de, 00 kh On be purchased from the Department of Administration,Document Sales and Distribution,202 South Thornton Ave.,P O:Box ald40o�'WI 53707,Telephone(608}.266-3358. E Plan Number previously Assigned PR ?1EC1`"INFORMATION(Type or print clearly) >, g R u in y'(Plans returned[p same) Prof ame w debt f 5s, .Ct.Box or Rural Route Project Adcfress or Legal DescriFtion lr Ofaqu . a S 'ty a Q - State Zip Code City ❑ Cou y or Vil p e r` It Gyvy1,' (tiJ Village ❑ of x rwT4JeP No.#include area Code}. f/ Town "'"1 s" i$rJ Na gt o f Owner V 4leph6Nte:No'(inc! de area code) Tele ne No:(include area code) 0,00t dress P.O.Box#or Rural Route Street Address,P.O.Box#or Rural Route O -q q cA ity or yo age, State Zip Code City of Village $ ate Zip Code F 1' (J �, 5l �,,2 A 101 FOR: p Experimental Mound System ❑ bolding Tank hlesarinstruction ❑ Large System ❑ Conventional Gravity System ❑C,rOUndvwaterMonrWrnq - Q Replae rent [] At-Grade Cl System in Fill;` ❑ Petition For Variance , r• ,ttpa►isit [ Pressurized System ❑ System in Flood Plain(attach$BD b698) ❑Other Alter"tives. rf,: Cef(IPUTATIIDNS (include AXIS1t1ng tanks) FEE SUBMITTED FoR'L?I!F10E MAIf£IwI1 CME CIi:S PAYABLE TO SAFY d.BUILDINGS DFVISIOM. ° a. '750- 1,500 gallon septic tank $ 50.04 s; b 1.,501- 2,500 gallon septic tank $ 60.00 CS. 2,601- 5,000 gallon septic Unk $ MOO 5;601- 9,000 gallon septic tank $100.00 15,000 gallon septic tank S 150.00 ` f "ti r 15,000 gallon septic tank $250.00 ; 500• i.000 gallon dose chamber $ 3(11.00 �" h 1,001 2,000 gallon dose chamber $ 50110 — 211- 4,000 gallon dose chamber $ 70,00 -- y, 01- 8,000 gallon dose cumber $ 9g.00 k 801- 12,000 gallon dose chamber $110,00 '. 4 1. _ Exer 12,000 gallon dose chamber $150,00 a; h m 500, 5,000 gallon holding tank $ 30.00 n. %001 10,000 gallon holding tank $ 55.00 o.' Over 10,000 gallon holding tank $10000 .fig.. }. k p. Revisions $ 20,00 ; Groundwater Monitoring-Per Site $ 32.40 x` q (char than a proposed subdivision) r., Petition For Variance: 'Setback $ 15.00 # Site Evaluation $ 50400' c A t 7�° Subtool. �_ d Priority Plan Review: Enter same amount as Subtotal Total I": 0. -1 SOD-6248(R.04/88) NOTE:Fees are pursuant to Wis Adm.Code,Chapter Ind 69,and OVER+ are subject to change annually. ST. CROIX COUNTY WISCONSIN ZONING OFFICE `} .f ST.CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON,W154016 -- •.,_ _ (715)386-4680 April 4 1989 + c , m ,. Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the Roy Holmquist property, lcoated in the Wk of the SE 4 of Section 14, T30N-R20W, Town of Somerset, St. Croix County, revealed suitable soils at a depth of 3.7 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 AdTdnistrator TCN:rms x � Ui x� RQ A11 l k �` Alt 1 gnu "` � � : y w«� ry. -" �:ft��'_`Ii,�,W J11, t, i�'� l titt 1 i. �4, lti5!#�ET !NOUN[? SYSTEM UESIGN �. H ,� "�`0. ,' i s �`� A "v ,% ;� 7 `{ � R ;.a,,„�. > 3 n. q' �,k• . �I R y 4 Ai.4 ,E , S �.. d Design a mound system far a �c Qofr► ,he s,lte characters sti, s are Va'Ae, 4a , i n 11 i pth to grrovndv�ater or bedrock __.�.,.. 11 +. 4,u k�, �, , , 4 l iendslape �,' I*" * ,k, + ' Q,.' Perrcat�tlon rate .,b win''��p. �� y ' a s � ' S ft. I it `� . Distance from dose chamber tp disti~ibutlon system c' ' ,..,..� A"'k,r �. " I.,x I~le�ratlfln differet+c�e bett�reen bump and distribution► systear � 1 fi<. �� "I r r �t wASTaTa • rs�� ( an == ,. +� . x I 'I lil,4"4[a g� 1 a P 3 SIZE THE ABS?b2ATI0t1 AttE,A '� >; r i ,L f �-+^11 A �� A ArS regtul red . &1/qr Z' y ' J.5 .� 4► "i,� 4 11'' a } � i - :, 1 14 Y B) Bled or tro-nch length (B) I t � f t♦ . x ,: ;�` n C) Bed or tr inch width (A) ...,. it � �°11�, z 4 ti :,' �1. . � a � � �" a 11 �11 f :` ) Trw�nch spicing (C) r �: 11 ik: ri ;a. a`° 4' ��d �; Waste *ewr load .24 c�sl/fC2/day - • t. i YA' �y^h - ��y �, �, h ,y z 11 , ��; ►t+ep'ry MOUIO NE IGN V , 1. A} Fitl depth (Q) f t' * . ,. B) Fill depth (E) D + slope (A !fi _I,,�5 ft. "" i.# c= '3 S o�!i y 3 'fit. tAq , C) Bed or trench depth (F 1Fr+.•••_ 7�,z � D Cep and topsoil depth (G) 'ft 'j L ` ��_ 1,,. "'. � '=a az 11, � � E) Cap and topsoil depth (t ) t• � ', r � � I ,: ].J�I • . -- 1, I _ ,111,1 , ,� #'. . +; ,1 Ci'U , 'A' I. .- --' 1: .1. "_rte � � . . ; ;K 4 a . __ , / J .- T;v+ .'J ri.+�'"3 ": • r* s NF 11 w " r ' �� �. nth�li+c Ccwerinq i� r0stributfort �} � . a ` Mediums Sand-�.� �� `. *1 I o �. ---*���r r �` 6 � � r 4 Topsoil~'— s t 11 + f L.t ` ..T........ ` ..1 I [/�� �(+y -1111..i C'nj©N8�E SEWAG �y IT"i" ` fed Of 4- a � Fort»e Moira i"I o, . `, " }q�p A p rs qss wlt (;1 a . I' . fit i�v r""404, , , ) . D ,� . M t NT`0F;)NDU�TRY. LABOR 'AND �-vjhAAN LA t l',,I. ( L Fir� `< ,w. 11'* D1U�SlQI� OF SAFE AND BU ' c �; ►t A Mooed System Ung x" tl Irp 't"inb Absorpt#CIh tAriea ` Ft� �. < dr y a .;,, ry,11 1P x SEE C(�FtIE �d1NtCF } r .11� " " �• : . ir:s '. i' s ,1 , „ "j,"- do-'°'..11 I C � wl.��I�t `�, il, ,�.` 1 °..wry'}.. *S"� y I+ , S { 5'�,vo 4 '� t .'y) Y 6 ���, `�Ft0 , iF } ` aav' I _11 1x ,v ;. a a Alteroa:t+e 'pb tion ,Y Ft•. ' `-P It 1z q;11 F ee W Ft. C. • . 3�'" y ��yy Y . 4u' o^ k;11 i 4 � 1 >7 �', ,1. °. I, :�r �'.. ser,�t+dtIon pipe 1f, 11 I 4 � �•.. �; 11�,� . fir— -- - — — — ��� �� %z� q ray" �a . dry ; : .. _ _ _ ( I ��,� Y+t - , `r Distribution. Bed Ot — 2 z �` r , 1. Pipe t AggreQ+'ttsa r � r 1)` A Yv � ,. , 1111 , + La''C, , a 11—, , : Qbservdti4n Pipe Permanent Mtarkers ;r ;4 + 1 j,: y _ g�` ,- . 5 r n:I— I' } )y `47 , . jy 1,. I �" ! ` k ,i . �, lr�l z fy FMoI View Qt Mound Using A 1W For The Abs+orptionf Ares �A � try. "i -4 S �jM . A. ,.. : ; I .11 ... .t,. * .- w .q �', W.oo .b0,FXj' tf �' ka"�' IH � , �_.,1.. 11 11 / � i1}" 3 . � � j; , �: ;tea: � ��+ S-- 1 I .I ^.f _. � , ;x � 2. k C' , R Y ,: ".. �' 3 �, - — ! z'T ! }� r _ •R► \ f. �';k �,' �� k TANK 3P IFICAT# . ' i a ��. 11 C". '` . /' _41 ox 11 ` t COVER - 04 RIESAf� �" - +�` `i' a \ TANK - 6 x 6/10 GA. WIFE'Mg1�ld �.r �, / '�" 1,111 .. .R,_ ..." DIMENSIONS: �" _. �� ,r .. WALL: 21/2 LENGTH, 1C�1 V®nTc+ .f El '1"tQM; 2y2r' ILUW INE ;fi1;`. ' ,. - ' i L++rn• COVER: 4„ IAN'I-IQi.Ec ' a ,1 ;, r u MEIG MT: 67" .i 0 I. "VENT: 4,, CAST #� HUI� �a� >�� '�` '' R H II 4 t p+` ih , •r a INLET:4" C #ST'��1Y I 1. QI Ewa spy t ay (/�� ,.11 11 •�« I ISGFBARCE E "'!x`�F yr '^'' M�ER 3A:AUT :lO , �11 t on AVAt1.AS1 E ? :' '�;. 3 70 A#. . ., , , ^ `� ' C(�NCRETEIGMA# LQCKQ a� STEEL LOCKE . ��'' ��� .. QALLQNS'PAR A1E. ` I. r • . . , , f GiALLONS PER 1l+lG*,',,23 BSI � �'� '+� • •..i • 33 n 11,� .� WEIGIHT: 8 P �t�S ,� ` }yFir d k 11 ti Jyl t '� IK A 4 .;:` .�. ga y 3` ,7, �S � N.1I1 ENI ER -1 111 1 .11. FDEL 1NT•1 000 , , . �,��I,,--�;��,1­v�,;';�'',I��t�-,-1�"�1'I­­',1��.1`�,,I­_,,A 1'j,�1�"I-�_",�1",':,,7I,',,",I�-,',"`-�,',,-,,I I I, I, 1000 Gallon Siphon Tank TARN Rt.2(Hy 10)Maiden Rook,W154750�(715)647.231 i. "-"` �� �... 9TC 1.05 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER O Yr`t ROUTE/BOX NUMBER )4�5A W004 I�D a-W- 30 7 FIRE NO. =�•T CITY/STATE W00,R1 ZIP PROPERTY LOCATION: 04J1/4 X1/4, Section / , T 3 o N, R W, Town of , St. Croix County, Subdivision ,/U , Lot No. N 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 $3000 of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of ALL NEW SYSTEMS agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Department of Natural Resources. Certification cation form must be completed and returned to the St.Croix County Zoning Office within 30 days of the three year expiration date. SIGNED DATE St. Croix County Zoning Office St. Croix County Courthouse 911 4th Street Hudson, WI 54016 (715) 386-4680 Sign, Date, and Return to above address b C1 RTM ► SAFETY& {JILDIRI P.O.BOX 7 g r" TION TST (11 ) AlIONS M 10 5 7 # (H63.Q8t#)&Chapter 74$.045) w .� � N; Td NSHI /3tiMkIiHBhPAekt^T'4': OT NO.:BLK.6 SU13DI,r ION NAME: r . TY, E U NAME, AI LN ADDR f DATES 8SERVATIONS MADE - NO.MD MS:: C MER AL DE.SCRIPTION: R F IP S'. A 1 T ST$: esidenca New EIReplace f0 ' Tit RATING:S=Site suitable for system U-Site unsuitable for system• � � � .° C PiVENTI AL: MOUND: IN-GR�OU� _:S T -1N-FILL OL�SG TANK:REGOMMENDE SnYST,EMaoptione SLUS ❑ U GG_1111 DESIGN RAT : If PgrcolatiQn Tests are NOT required /�t/fJ If any portion of the tested area is in the p ' under s.Hf;3a)9{>;t{t7i,indicate: Floodptain,indicate F loo dplain elevation: PROFILE DESCRIPTIONS LEV TI N UN ATE -INCHES CHARAC ER OF SOIL WITM THICKNESS,CO LOR,TEXTURE, AND D6PTH 8t1 Tn I ER 19PIsT1"T fN, Pf T TO BEDR K IF OBSERVED SEE ABBRV.ON BACK.) Sri o" VIA 84 /Q / ./r� l(i A. 3I 7 ' vr7 �/� ./r�S .�'���'�1�J�1- i��(RN!d+L/►SC7'IYr Pn.�� 40 1 ZAP A kW PERCOLATION TESTS PAN c r'v �.I WATER IN MOLE TEST TIME -----DROP IN WATER LEVEL-INCHE RAT INU R tC+t ME ,` AFTERS1fVELLING INTERVAL-MIN. RI o __PF_ I e PER INCH YJ T PLABti Show:locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale of distances. Describe vat bm ztxi st end vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the drree#lon'"BncL artaetl 'tt.1Mind slope. STEM ELEVATION , \ a o„ t t: k. f 1 1 Y O►1 i Lam.• � r r �"� . ` ' �� ` { a } r� LI � _ 8r�,alto . , �-- ♦� I� r - .. Ltd d/• r f;[he undprsignedl hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods sped ie m . srn Aciministrafifve Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and heliefi. f ME rint�T TESTS WERE COMPLETED ON: lot' Ru�.,�:c v1s. CERTIFICATION NUMBER: PHONE NUMBERIoptibrel! z. CS G TUR r OTRiBUTIQN:Cir;y.,al ati l one copy . a �.ocal Auth)!itY,P,nperty Owner and Soil`['este . ()'u OILI-IR SBD'3"," `ci3 - f I � � , ( . . I 1 , ti i a el- It{ b 1 j 1 ; , I 1 - f C {.J�YI- i s ` C , i'.__�'-- -t. __.. _ �...-._,.�... _,.._ � —_i-. ._,_. ---!--' -, --I. - - -r - - --� --�-i---•�.-ter-.. , t „3 I I �. try • - - ' �- f � i , 3 , i E, AGE SYSTEM " ' 'ona/11A , ; 1 " OtPA T OF I NDUSTHY.ti, ' ( ►vu 2 �yv G i,F YJ APVID BUILCINGS , ii s... I , '. � - +_ , I ��L Lri)',�� w rn►S,, ---- ._.- ' I — —j--- , , I T­ ;. 1 Op cc hW- o ) W f c w !"1 a Aw J J cr ui W ® W 1 d zap LU mow. 0 w - c y V• s 1 N R ,t-, } r" Z IV or c4l;. ? _ "A (, 1k ,r w CA , wo ST. CROIX COUNTY *-- k WISCONSIN ZONING OFFICE z;e- ST. CROIX COUNTY COURTHOUSE .. Y 911 FOURTH STREET • HUDSON,WI 54016 (715)386-4680 I April 4, 1989 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the Roy Holmquist property, lcoated in the Wlk- of the SE 4 of Section 14, T30N-R20W, Town of Sanerset, St. Croix County, revealed suitable soils at a depth of 3.7 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:rmtis ON SQ BOR� .7 AND SAFETY & lDIVI ION � �^ t Oiy19iQN " F, a 09 145.045 f1)&Chapter �_.. TOWN HIP/ : OT NO.: LK NO.: SUB VFS ON NAME N A M'AT n� bsad ►ur DATES ES BS \lAT1014S MADE 1 ' g R R 10 FI A v >; �yi t4teVV ❑Replace '1 /(�' y'. # . ri i<br em Us$it*or�itable 1166 system swam !: UND: =7GEISIKUEM:(optiona s na s u a i!�arCOfition Tests are NOT required DESIGN RAT If any portion pf the tested area is in the ;? H 3,09(51$bF,indicate: FloodPiain,iri<1iCate FiOOdPia n el[IVation: 51f y PKtQFILE p15CRIPTION6 'r UND ATER INCHES C ER O IL WI H S A.TEX UA AL ELEVAT N TO BEbRd K fF';O SERVE (SES A RV.0 BACK.) S V - 7 .14 PERCOLATION TESTS i DEPTH , WA7EsR IN HO L E 7 T TIM H 5 RAPr E iNCHE AFTER SWELLING INT pVAL-MIN. 1 t # y J L spJAJy; Show locations of percolation tests, soil horings and the dimenslons of suitable soil areas. Indicate sdale or distances.DesCrlbe vu t at9 hod , �,• �l.aqp vertical elevation reference,points and show their location on the plot plan. Show the surface elavatiorr.at all boringsslnd tie dirett41'peT� a f 1��d t►d�e " �rr�' ELEVATION ,. �.. , i l t _ M_ 1 i Jy T r • i tit 11,44 4k t fYI j k i err Mr��:F �YMS "y .. . • W v ` `� gi4Pfiad,�iet�fV`certH`y that-tlie soli tlkta reported on this form were made by me in accord with the procedures and methods spec) e 3 iue Cod>K,�and that the data recorded and the location of the tests are correct to the e beat of my knowledge end belief. ` y r W, t TE S WERE OMPLETED ON: rS Xf CERTIFICATION NUMBER: PHONE NUMBER(optlonai} r CS G TUFT � tY �IK)N rigin`at and one copy-to L6pAf A thor y,Property 3wner 8nd Soil Tester, � 1 SSbo(R,018 -OVER - k s