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HomeMy WebLinkAbout002-1047-20-000 \ o \ 2 $ i ) � 2 ° 0 § c 22 70 m 7 (D ¢ 7E / \ 0o � ,/ � $ $k a= � . \ f ) � a §§ 2 � \ « E Li § \ . K i ? § @ % m § � § z :!t \ U) � \ { £ � D } \ \ z z \ .. z 2 § ) i § / � M § § g 2 0 o a § / o o � 0 k k k L \ \ . n 0 0 0 k CD C IL � � § 'D j \ \ k o \ k 2 k k § a R =0 E 2 § o o / 0 0 ; < 02 a J z m ■ § % � E ) E ° _ q , g o § m ; § § \ ; _ ¥ c J o 0 0 = § \ 5 / \ k \ k § N 9 / \ � n . \ z z f 2 » / § - ) § j / \ o } $ / k ) \ . ■ 2 f : § 2 " a » ) ' k c o & j 0. o 2 Parcel #: 002-1047-20-000 02/01/2006 11:05 AM PAGE 1 OF 1 Alt.Parcel#: 20.29.16.298B 002-TOWN OF BALDWIN Current X ST.CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): 0=Current Owner, C=Current Co-Owner 0-RING, RALPH&KATHLEEN M RALPH&KATHLEEN M RING 2208 80TH AVE BALDWIN WI 54002 Districts: SC=School SP=Special Property Address(es): "=Primary Type Dist# Description "2208 80TH AVE SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 2.000 Plat: N/A-NOT AVAILABLE SEC 20 T29N R16W 2 A IN SW SW E ON S LN Block/Condo Bldg: SEC 20 200 FT TO POB TH E ON S LN SEC 20 296 FT TH N 294.25 FT TH W 296 FT TH S Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) TO POB TOWN BALDWIN 20-29N-16W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 765/240 07/23/1997 693/94 07/23/1997 624/311 2005 SUMMARY Bill M Fair Market Value: Assessed with: 86990 230,300 Valuations: Last Changed: 11/02/1999 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 9,000 138,900 147,900 NO Totals for 2005: General Property 2.000 9,000 138,900 147,9000 Woodland 0.000 0 Totals for 2004: General Property 2.000 9,000 138,900 147,9000 Woodland 0.000 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch#: 510 Specials: User Special Code Category Amount 010-GARBAGE SPECIAL ASSESSMENT 45.00 Special Assessments Special Charges Delinquent Charges Total 45.00 0.00 0.00 DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR..&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION BUREAU OF PLUMBING P.O.BOX 7969 MADISON,WI 53707 SW , SWIG, S20,T29N-R16W 'CONVENTIONAL ❑ALTERNATIVE (If. lan Number: (If as n I.D.'Z. Town of Baldwin El Holding Tank ❑In-Ground Pressure ❑Mound CJ 80th Avenue 7NSzP 414 A E: NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: rRalph Ring Route 1, Baldwin, WI 54002 —/ U 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: Dale E. Hudson 6629 St. Croix 95983 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: ROVIDEDLAB L PROVIDED OVER OYES ONO ❑YES DNO NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH IHIGH BEDDING: VENT DIA.: VENT MATL.: ALARM WATER LINE: AIR INLET: FEET FROM DYES ONO ❑YES ❑NO NEAREST DOSING CHAMBER: MANUFACTURER: BEDDING: 77ECOYN—P MODEL. PUMP/SIPHON MANUFACTURER ACTUR ER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: OYES ONO ❑YES ONO ❑YES ONO GALLONS PER CYCLE: TROLS OPERATIONAL: NUM BER OF PROPERTY WELL- BUILDING. AIR NLET RESH FEET FROM LINE(DIFFERENCE BETWEEN ES ❑NO NEAREST PUMP ON AND OFF) LENGTH. DIAMETER MATERIAL AND MARKING SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing FORCE or excavation. (If soil.can be rolled into a wire,construction shall cease until MAIN the soil is dry enough to Continue.) CONVENTIONAL SYSTEM: LIQUID BED/TRENCH WIDTH: LENGTH NO.OF DISTR.PIPE SPACING: MATERIAL PIT NSIDE DIA SPITS DEPTH TRENCHES. DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR.PIPF DISTR.PIPE DISTR.PIPE MATERIAL: NO.DISTR. NUMBER OF PROPERTY WELL. BUILDING. V NI LE FRESH BE LOW PIPES ABOVE COVER: ELEV.INLET ELEV.ENO: PIPES. LINE: AIR INLET: FEET FROM NEAREST MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. ❑YES El NO PERMANENT MARKERS. O WELLS OIL COVER TEXTURE. ❑YES ❑NO ❑NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. SODDED SEEDED MULCHED CENTER: EDGES. El YES El NO DYES El NO El YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: FILL DEPTH ABOVE COVER WIDTH: LENGTH: NO.OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPF. BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL. NO DISTR DISTR.PIPE OISTHIBUTION PIPE MATERIAL&MARKING ELEV.. ELEV.. DIA.. ELEV.: PIPES DIA_: ELEVATION AND DISTRIBUTION VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL: PLANS ❑YES ❑NO El YES ❑NO COMMENTS: IFtHMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: TUILDING: FEET FROM LINE. ❑YES ❑NO ❑YES El NO NEAREST Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE: TITLE. Zoning DILHR SBD 6710(R.01/82) Admini DILHR SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05,Wis.Adm. Code 5- ' .-D,"X .o.:� ,.dam.... . STATE SANITARY PERMIT# /1? -Attach complete plans(to the county copy only)for the system,on paper not less than STA PLAN I.D.NUMBER 8%x 11 inches in size. ���� 9$/ —See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES X NO PROPERTY OWNER! PROPERTY LOCATION Yt> %_'5 ) '/4, S 0 T.Z 9, N, R //0 11 (or) PROPERTY OWNER'S MAILING AD RESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME CITY,J q�7 n �� ZIP��aO PHONE N Env 97r� O 7n CITY VILLAGE : �}Q �� NEAREST ROAD,LAKE OR LANDMARK II. TYPE OF BUILDING OR USE SERVED: b 7 L 4�O /�J-", Number of Bedrooms if 1 or 2 Family OR ❑ Public(Specify): III. PURPOSE OF APPLICATION: (Check only one in##1. Check##2,3 or 4,if applicable) 1. a. ❑ New b.A"'Ril Replacement c. ❑ Replacement of d.❑ Reconnection of e.❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit## Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in##1 and only one in##2) 1. a. ❑Conventional b. P?Alternative c. ❑ Experimental 2. a. ❑System- b. ❑ Holding c.❑ Pit Privy d. ❑ Vault Privy e.,X Mound f. ❑ IGP In-Fill Tan k V. ABSORPTION SYSTEM INFORMATION: Check one 1. a. ® seepage Bed b. ❑Seepage Trench c. ❑See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED(S quare Feet): -s 7,5 J,74 S /00'0 Feet ja Private ❑Joint ❑ Public VI. TANK CAPACITY Site in allons Total ##of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank Qo /OOp �.L�i°t° ❑ 0 Lift Pump Tank/Siphon Chamber o0 UD Me e- ❑ ❑ VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name(Print): Plumber's Signature:(No Stamps) MP/MPRSW No.: Business Phone Number: n/e. hueso//_7 ADa —, z e,"� �Z 71,5� 6&I337F Plumber's Address(Street,City,State,Zip Code): , Name of Designer: VIII. SOIL TEST INFORMATION Certified Soil Tester(CST)Name CST#�,> CST's ADDRESS(Street,City,State,Zip Code) Phone Number: A _ 7/3� aJI-.3 06 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater Date Issuing Agent Signature(No Stamps) Approved ❑ Owner Given Initial ��] Sujgha�ge Fe Adverse Determination L�j,oc) JQ/ ra1►-r�^ -���� X. COMMENTSfj1fASONS FOR DISAPPROVAL: SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION TO THE APPLICANT: 1. This 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. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 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. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed pumper whenever necessary, usually,every,2 to 3 years; 6. If you have questions concerning your private sewage system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 608-266-381:5. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description where the system is to be installed; Il. Type of building or use served: If public is checked, indicate type of use (i.e. 10 un t apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, r number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. 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. Fill in designer name if applicable; Vlll. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8'/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; dosing or pumping chambers; 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. ------•------------------------------------------------------------------------------------------------------------------------------------------------------ GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was the result of over 2 years of steady negotiation and public debate. The groundwater bill Groun0#0er included the creation, of surcharges (fees) for a number of regulated practices which Wisconts['r3'S can effect groundwater. The surcharvg took effect on July 1, 1984. All of the water that buriedeclstlf E3 is used in your building is returned t.. the groundwater through your soil absorption system or the disposal site used by your holding tank pumper. The monies collected through these surcharges are.credi!ed to the groundwater fund adminis ° to e, by the Department of Natural Resources. These funds are used for monitoring g � water, groundwater contamination investigations and establishment of standards Groundwater, it's worth protecting. SBD-6398 'Li.03/86) 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 p/ �i F EF Location of Property, >�16, Section /v , T �� N - R 1� W Townships U i7 ' Mailing Address a7' Subdivision Name Lot Number Previous Owner of Property F IE p 6&1 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 and Page Number as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: . ' Warranty Deed 3. Land Contract •�. 3. • Other recordings filed with the Register of Deeds Office 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 the Certified Survey Map shall also be required. - - — — - — — — --- — — -- - — — — — — — — — - — — PROPERTV OWNER CERTIFICATION I (We) eeati.6y that att a.tatemen A on xhi-6 6oAm cute tAu.e to the beat o6 my (OuA) knowt.e.dge; that I (we) am (ate) the ownen.(4) o6 the pnopenty d"cAibed in #hiA in6oAmat ion JoAm, by virtue o6 a watunty deed neconded in the 066.ice 06 the County Reg c a#eJC o 6 Deeda as Document No. : and that 1 (we) ) 'p4aently own the pnopoaed bite"bon the aewage poa a yatem (on 1 (we) have obtained art eiueirient, o %:un uLi. , the above deov'uf;ed F3'toPrv�-ty, 6o't conAtkUCti.on o6 ea.id 6yatem, and the same has been duty %ecoAded in the 066.iee of the County Reg-iateA o6 Desch, as Document No. ) . ,"j;:w c� SIGNATURE OF OWNS SIGNA U OF CO-0 (IF APPLICABLE) '37 DATE SIGNED - DATE SIGNED MEN DEPARTMENT OF REPORT OM SOIL BORINGS AND SAFETY & BUILDINGS DIVISION INDUSTRY, LABOR AND PERCOLATION TESTS (115) MADISON WI 3707 HUMAN RELATIONS (H63.090)&Chapter 145.045) LOCATION:S SECTION: TOWNSHIP/M NICIPALITY: LOT NO.:BLK.NO.: SUBDIVISIO�NA S /4a 4 2o IT29N/R/41( /4w,r �c/ �I✓r4' /G�i COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: Q/ 2 ✓ �� USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE DES IPT ONS: O ATION TESTS: Residence 2 ❑New Replace T—97 RATING:S=Site suitable for system U=Site unsuitable for system ICONVENTIONAL: MOUND: IN-GROUND-PRESSURE: tEM-IN-FILL HOLDING TANK:RECOMMENDED SYSTEM:(optional) as ®u ®s ❑u os u s ®u osTu If Percolation Tests-are NOT required DESIGN RATE: IFloodplain,If any portion of the tested area is in the under s.H63.09(5)(b),indicate: 14 indicate Floodplain elevation: A PROFILE DESCRIPTIONS BORING TOTAL D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- ('og 97��� //0,96 c�1` •, o�'G'/s� ° SG .Z '/Z 13- 216,25 96,0 MAI so 13 Rhro /o / i i /�'/.►2 rl me ., �D 1 . .. B-.3 ����' 95..1'7 oriel a t 32" /''ls's�'/- (� sc ° 5"'' l• Z s�id B- B- B- PERCOLATION TESTS TEST I DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER FPl$F+E9 AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 -RE R OD 3 PER INCH P_ 2.0 30 P_ Z Z-o' A46,1 30 P-B I ZIP, P-_ P- P- PLOT PLAN- Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate sc o i e at 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 /oo-off t 1 _ ! Jf � IN �. - - �-- G j -- 1 �.. 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. NAME(print): TESTS WERE COMPLETED ON: We uals n -5--7-?-7 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): CST SIGNATURE: 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 - SBD - 6395 To he'l ? ):Ylpletc 1. C011,00tU &Scl ipt imi, 2. The use section must clearly indicate whet!ier lids is a re",!cle'rine w commercial project; 3, MAXIMUM number of bedrooms or cotnmeicii�l use plarineci; 4. Is this a new or rej-)Iacement systeiri; 5. 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; 6. PLEASE use the abbreviations shovvr, how for c—,;ng pr(Jile df�scril)!Jons and comolelinq the plot plan: 7. MAKE A LEGIBLE diagram F,(;curatoiy !ocall-i Yuur tic-alions. Diavviny to scalc is preferred. A separate sheet may be used if desired: 8. 'Make stllu your hencnniark anti v,-; pomlalwnl, 9. Complete all appropriate boxes as to dates, e-ssPs, t!ood plain data, percolation test exemp- tion, if appropriate; 10. If the ifilormatlon (sud-, as floor. �ek vaJorl) Ooot no am', ,/, rIoclr N,A, in the ipptopnato box; 11. Sign the fotr-n and pkicf' your CUM'!It W'0 tWnlber; 12 Make logible copics <;ncl distiihuw '11� '\Ll- SOIL TESTS MUST OF FILLED 1NITH -1714-7 LOCAL AUTHORITY VVITHIN 30 DAYS()l' DOCUMENT No.- WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA STATE BAR OF WISCONSIN FORM 2-1982 421040 boos 105 PAGE �® AfCA5W$ZS OfFiCE ST. CROIX 00., WIS- ..................Elf r-i•e.da---Er_i-ck-son,---- n---unmarr i.ed---woman-_.-._ Rec°d. or Rewrd this 2nd .............................................• --_--- -------- --- ------ ---- •Icy of d_an_A 19 d7 I__------------------ i �+ 10:30 ------------------------------------------------------- ---------------------------------_------------------- conveys and warrants to ------------ E x1g-t husband---aEa-_xi-f e-,----nat. i-a ..t-enant-s...in---- tip,°^ems of Deod� common--but-__as__�ont_-.tenants---wi-th...r_i-ghts______________ 9f...$Ur_V.].-3L 0_r"5j aiP------------------------------------- ------------------- -------- __________________________ RETURN TO 9 -------------------------- --- _--_ the following described real estate in ......-S-t_.___C_ o1_X--------------------County, II State of Wisconsin: Tax Parcel No- ------------------------------ Part of Southwest Quarter of Southwest Quarter ( SW4 of SA ) of !' i Section Twenty ( 20) , Township Twenty-nine North (T29N) , Range Sixteen West (R16W) described as follows : Commencing at the Southwest (SW) corner of Section Twenty ( 20) , Township Twenty-nine North (T29N) , Range Sixteen West (R16W) , and thence East on the South line of said Section Twenty ( 20) for a distance of Two Hundred ( 200') feet to point of beginning; thence continuing East I on the above mentioned South line of Section Twenty ( 20) for a i distance of Two Hundred Ninety-six ( 2961 ) feet; thence North a distance of Two Hundred Ninety-four and one-quarter ( 294. 25 ' ) feet; thence West a distance of Two Hundred Ninety-six ( 2961 ) feet thence South a distance of Two Hundred Ninety-four and one- quarter ( 294. 251 ) feet to point of beginning. This deed is given in fulfillment of a certain land contract between the above parties , dated January 22 , 1981 , and recorded January 23 , I 1981 in the office of the Register of Deeds for St . Croix County, Wisconsin in Volume 624 of Records at image 311 , as Document No. 368989 . This ----iS_--Ilot.......... homestead property. 7tW (is not) t� 61 4 I. Exception to warranties: easments and restrictions of recordL' i FT Q �UL ` Dated this !!`7.t day of -------------•-----------•----------•--- a, !. ----- ---------(SEAL) - ----- -----------(SEAL) '1 f r-i-ed-a--- r-1-ck_sQn------- (SEAL) ------ - ------- ------------ -------- ---------------------------(SEAL) - - - * ---•------- -•-------------------------- I AUTHENTICATION ACKNOWLEDGMENT Signature(s) -------- --------------------------------------------------- STATE OF WISCONSIN ss. i ------------------------------------------------------------------------------- St . Croix County. ---- ------------•--------- -- authenticated this ________day of___________________________ 19------ Personally came before me this _ ___________day of �r4! Ja_J ______________________ 19________ the above named -------------------------------------------------------------------------------- E l f r i e d a Erickson m -•---------------------------------------------------------------------------- ---------- TITLE: MEMBER STATE BAR OF WISCONSIN ----------------•--------- -------------------- n i� (If not- ------------------------------------------- ---------------- ----------------------------------------------------------- v--.� authorized by § 706.06, Wis. Stats.) p '• H z W H r S T C ­ 105 �~ a . H SEPTIC TANK MAINTENANCE AGREEMENT Ho St . Croix County z d OWNER/BUYER ROUTE/BOX NUMBERf> / Fire Number CITY/STATE S/<�l.(Jr� /�(/� � LIP S�M7i PROPERTY LOCATION:S&)�f-, 2 Section T Z9 N , R lel, _W, Town of �p/<i�Gl�.' St . Croix County , Subdivision Lot number Improper use and maintenance of your septic system could result in its premature failure to handle wastes . Proper maintenance con- sists 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 treat- ment stage in the waste disposal system. St . Croix. County residents may be eligible to receive a grant for a maximum of 60% 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 veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary) , the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to H three year expiration. o E z I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with H the standards set forth, herein , as set by the Wisconsin Depart- 'b ment 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 J5 -P-�S7 St . Croix County Zoning Office P . O. Box 98- Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign , date and return to above address . ae L 'gyp 3 g Qj �o l t.> . , \.1 p � b 4jey C40 V V v Page I Of Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe Medium Sand G Topsoil =-- - F E I� D 3 n b i1•l tArRllR NG % Slope Co / fir log Bed Of 2N— 2 2 Force Main Plowed rug', Aggregate From Pump Layer `. , ��'- r, �; ED �+, its'�T{ON5 D /-D Ft. DEPARTMENT OF 110',U ;i3 I. . � DE?A r C ;1? 'z r' 'i, 1i�ii BUI�Ditiu� E 11 Ji.-�- ��� �' Cross Section Of A Mound System Using ed For The Absorption Area F _ Ft. =r. Cslii :,r JNE3BNCE G Ft. pp �� Signed: B - Ft. License Number: ��a K �%�Ftv. \Date: S= —�7 E Ft. J _F Ft. Alternate Position T / Ft. of Force Main W Ft. 094 Observation Pipe AI.---------------------- ---------------------+I I•----- --------- ----------------------•I Force Main Distribution Bed Of % — 2 2 2 Pipe Aggregate I Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area Page _ Of 5 'I t r+ :Y Perforated Pipe Detail 5: End View Perforated End Cop) PVC Pipe i .. -4 �o�c Holes Located On Bottom, S Are Equally Spaced r \ is X S P PVC Force Main * t From Pump i P/ .7 PVC Manifold Pipe Distribution �"'�� �� Alternate Position Of Pipe y Force Main From Pump Last Hole Should Be Next To End Cap End Cap Distribution Pipe Layout P ` - - ------ ---- - R 5 330 309 - s 32 X 30,, Y ,� Signed: / � ��, }�����,�-- � Hole Diameter 1Y Inch qyLicense Number: /Y1i����� Lateral ;/� Inch Date: S 7 -F:Z Manifold Inches3 PLUM13ING Force Main ,3 Inches CJ aIhl;f,[ yA' olona by DEPARTWIENl ;IF 3��:C.�S'h�, . :;R A`,;') REII,AT!ONS 1)1v!Swj 0' F SAFE711 tiu RIJILDih"5 _l_l Q%P h PAGE J OFL PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS --VENT CAP `i"C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING � 25' FROM DGOR, JUNCTION BOX MANHOLE COVER WINDOW OR FRESH I2°Mill. AIR INTAKE GRADE 411 'i"MIN. CONDUIT INLET PROVIDE I --__- UMBI'NGAIRTIGHT SEAL APPROVED JOINT A C01zditiof'lCxa.L( I I I APPROVED JGIr W/C. C. PIPE. I III WIC,=. PIPE EXTENDING 3' I I I OXTOUS ONTO SOLID S SOLID Sol C I L ALARM o PARTh,,;:T .� , ,,.;,, f,,: �;_ . , r_'!A710NS i ` ` I I oN t iw 'Jj;�, .i.• .,i?F;: : rSI�L ��i�_il;i'a'_ vt;:l� c;C i Sr-iC:ir%Ui'1i3EP�CL'- i� __J PUMP—, OFF D CONCRETE BLOCK RISER EXIT PERMI'TT'ED GNLJ IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC AND SPECIFICATIOUS 87030" ® 30" DOSE TANKS MANUFACTURER: L.���°P KS NUMBER OF DOSES:_ ------PER DAy TANK :,IZE : —_ 6 GALLONS DOSE VO : ��7GALLOt�ly�3/ ALARM MANUFACTURER: SSA 11 _- � �►- � CAPACITIES: A- INCHE OR GALLOr`J MODEL LIUMBER: _ ?d�Q I B= INCHES OR _S' ' GALLGUS SWITCH TYPE: �iJ C= --I`INCHES OR _2<Z GAtLL�_L, PL.1MP MANUFACTURER: p. INCHES OR GAL MODEL NUMBER: �� l =�� f NOTE: PUMP AND ALARM ARE TO BE SWITCH TYPE: __ r'/`CL1Y-�/ INSTALLED ON SEPARATE CIRCUITS PUMP DISCHARGE RATE _Z0 GPM VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. 7 FEET + MINIMUM NETWORK SUPPLY PRESSURE . . , • • _ 2.5 FEET + / FEET OF FORCE MAIN X /,OL? Fy 100 Fr.FRICTION FACTOR.. '�-? FEET TOTAL DJMAMIC. HEAD = FEET INTERNAL. DIMENSIONS OF TANK: LENGTH-2L ;WIDTH ; LIQUID DEPTH SIGNED: LICENSE UUM6ER: �� ���� DATE:-f: l r� /r7 Performance Submersible Effluen , Curves s METERS FEET 90 MODEL 3885 25 60 SIZE 3/4" Solids 70 '---1 o WE151 = 20 WE10H J H 60 WE07H 15 50 WE05H 40 10 30 WE036 20 WE03L 5 1 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM I I i 0 10 20 30 m'/h CAPACITY [qGOULDSS PU�MNPS,IINC. METERS FEET SBNECA 120 MODEL 3885 35 110 WE151 SIZE 3/4" Solids 30 100 90 9094 25 80 70 Z 20 a F- 60 O 50 WE05HH 15 40 10 30 20 5 10 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM 0 10 20 30 m°/h CAPACITY 01985 Goulds Pumps,Inc. Effective July,u y,1985 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS (H63.090) & Chapter 145.045) LOCATION:S SECTION: TOWNSHIP//MUNICIPALITY: LOT N/OJ.:BLK..NO.: SUBDIVISION NAME:All /f COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: USE DATtS OBSERVATIONS MADE WR esidence NO.BEDRMS : COMMER IAL DESCR Il( PROFILEDESCRIPTIONS: R ATION TESTS:❑New Replace 7 5- 7-�� RATING:S=Site suitable for system U=Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE:SYSTEM-IN-FILL HOLDING TANK:RECOMMENDED SYSTEM:(optional) ❑S ®U ®S DU � FIS U ❑S ®U ❑S CCU /Iry ezor_,� If Percolation Tests-are NOT required DESIGN RATE: If any portion of the tested area is in the �� under s.H63.09(5)(b),indicate: Floodplain,indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH s NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) O i /tam d Mot B- G• g 9�-fly mane, at 6-19151 ZZ 1,7 - y s,/Z B-2 1,,z5 9G i� any of so', 13 1o'' • 17 '5-/0� , o /mac% lo,was B-,� 66,09" z Q6 95,,7" e / , A1[r //�S�S//° o SG ° J ry 7 't l• Z , S' �G 1 B--- B- B- PERCOLATION TESTS TEST DEPTH. WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER i?d6+E-& AFTERSWELLING INTERVAL-MIN. PERIOD t PERI Dz PER INCH P. 2-0 a 30 ,, S P ,p' e, 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 /oo-of r I - — s i _C a I I TN �... s t 1 3 , 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. TAME print - TESTS WERE COMPLETED ON:: )DR ES /e s�U�s .S / —F r CERTIFICATION NUMBER: PHONE NUMBER(optional): CST SIG—NATUUht- RIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. 3-SBD-6395 (R.02/82) —OVER — nq f ^� � N 3 1 rI y � j Apt, ``•'`� ` � Sn `k; \\, Sl- iq� Na Lei r# _f3i � QS k ST. CROIX COUNTY 401 =:N WISCONSIN _ . �` ZONING OFFICE r - ,x 796-2239 (HAMMOND) 425-8383 (RIVER FALLS) HAMMOND, WI 54015 May 11, 1987 Division of Safety and Buildings Bureau of Plumbing P. 0. Box 7969 Madison, WI 53707 Dear Sir : An on site investigation for the Ralph Ring property located in the SW 1/4 of the SW 1/4 of Section 20, T29N-R16W, Town of Baldwin, St . Croix County, revealed suitable soils at a depth of 30 inches, below which seasonable high ground water 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 rc WISCONSIN DEPARTMENT OF INDUSTRY, LABOR AND HUMAN RELATIONS DIVISION OF SAFETY & BUILDINGS, BUREAU OF PLUMBING P.O. BOX 7969, MADISON, WISCONSIN 53707 Verification of Exception Status for an Alternative Private Sewage System In the County of St. Croix Location Sw 1/4, Sw 1/4, Sec. 20 T 29 N, R 16 W Town gnXf%)jg} kk Baldwin Street Address Route 1, Baldwin, WI 54002 Lot No. N/A , Block N/A , Subdivision N/A Landowner's Name: Ralph Ring The application for this site is for: ❑new construction use. 2 replacement system use. If this is NEW CONSTRUCTION USE, the alternative private sewage system is: ❑ to have one of the first five approvals guaranteed for this year. This is number - - of. those applications. (Use one of the first five quota num ersi ssueTto you.) 1 �_ one of the applications needing a quota number. The quota number assigned to this application is - - ❑for one additional homesite on a farm to be occupied by a parent, child, grandchild, sibling, niece, nephew, or first cousin. for an individual lot for which a sanitary permit was issued but was later ruled unsuitable due to new or changed soil criteria established by the department. ❑for an application on file prior to February 1, 1980. ❑for a lot that meets the criteria for a conventional private sewage system. If this is a REPLACEMENT SYSTEM USE, the alternative private sewage system is replacing: ®a failing conventionalAsoil absorption system. ❑ a holding tank that was installed and in use prior to February 1, 1980. ❑ a privy that was installed and in use prior to February 1, 1980. If this is a REPLACEMENT SYSTEM USE and the lot meets the criteria for a conventional private sewage system, check here. I certify that the above information is true and accurate to the b_est jdf my knowledge. Name Thomas C. Nelson Signature County Official Title St. Croix County Zoning Administrator Date May 11 , 1987 DILHR-SBD-6158 (R 12/82) STATE OF WISCONSIN-DEPARTMENT OF INDUSTRY, LABOR & HUMAN RELATIONS DIVISION OF SAFETY & BUILDINGS - BUREAU OF PLUMBING P.O. BOX 7969 - MADISON, WI, 53707 APPLICATION FOR THE USE OF AN ALTERNATIVE SYSTEM Location• Township/Mu-n-i�cipali/ty: �4 1 S IT �?'f N/R g(or W Subdivision:- County: Street Address: Landowners Name: Mailing Address: I (We) , the undersigned , hereby make application for an alternative system on the above-described premises. I recognize that the above premises are not suited for a conventional private sewage system. If approval is granted, I agree to have the system installed in conformance with the Bureau's approval of plans and specifications. I further understand that an alternative system is more complex in nature than a conventional private sewage system and as such will require detailed inspection during construction and monitoring after the system is put into use. I agree to permit both county officials charged with administering county sanitary ordinances and Bureau employes or other authorized persons to have access to the above described premises at any reasonable time for the purpose of inspection the construction of or monitoring of the system. I further agree to either personally or by my agent contact the proper county official to arrange the time and date to begin construction of the system. I understand that this application does not permit me (the applicant) or my agent (the contractor) to begin installation. If the system is approved, the Bureau will send the applicant a letter of approval which authorizes construction of the alternative system after all necessary permits have been obtained. I agree to give notice to any subsequent buyer that an application for an alternative system has been made and if installed, that the premises are served by an alternative system and further agree to give the buyer a copy of this application. The Bureau accepts this application subject to this understanding and subject to all the conditions and obligations set out in this application. "Signature -t5/11/87 Applicant Date STATE OF WISCONSIN nd sworn to be a me SS. COUNTY OF ST. CROIX This 11th day of May 19 87 Notary Public, State of Wisconsin DILHR-SBD-6413 (N. 05/81) My Commission Expires: 1/31/88