Loading...
HomeMy WebLinkAbout020-1027-80-000 7 0 2 7 . 0 & \ ) o w 0 / � I ƒ � . 5 � � \ � i ■ � § $ § ) } 7 U. .0 § ■\ o < _ � � . ■ Cl) ± ) ; ., o \ �) � f a, i m . / § k 2 § U) k k \ E 2 7 e % � � ) E j -� § / o k / z / } (0 % k t . CL Lo � & k q \ k k k CO Z I ; = 0 0 0 z U) ` § ) \ k ° c — — = g G \ \ ® ° o Cl / § § % \ E / 2 2 CD as § < ƒ f ) ■ . § , Ln - • o E _ Q \ § (L § % E / D ) k ) 2 §2 \ \ o E E 2 f 5 g 2 ) E o 2 $ / / ■ m a � � f � , % k a I — � a CL a E k§ a § & 0 0 & 0 C, r Parc I #: 020-1027-80-000 07/1012006 11:32 AM PAGE 1 OF 1 Alt. Par rel#: 16.29.19.123B 020-TOWN OF HUDSON Curre t EX-1 ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Adi Iress: Owner(s): O=Current Owner, C=Current Co-Owner O-KRAUSE, MARK E MARK KRAUSE 598 M UTCHEON RD HUDS N WI 54016 District : SC=School SP=Special Property Address(es): *=Primary Type Dist# Description *598 MCCUTCHEON RD SC 2611 SCH D OF HUDSON SP 700 WITC Legal escription: Acres: 2.515 Plat: N/A-NOT AVAILABLE SEC 16 T29N R19W NE NE LOT 1 CSM 3/851 Block/Condo Bldg: REPLACED BY CSM 4/997 REPLACED BY CSM 7/1882 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 16-29N-19W Notes: Parcel History: Date Doc# Vol/Page Type 01/07/2005 784502 2827/223 QC 01/07/2005 784498 2728/219 QC 07/23/1997 1117/237 WD 07/23/1997 925/527 more 2006 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/25/2005 Descril ition Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.515 71,100 189,900 261,000 NO Total I for 2006: General Property 2.515 71,100 189,900 261,000 Woodland 0.000 0 0 Totali for 2005: General Property 2.515 71,100 189,900 261,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 202 Spec als: User S ecial Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size , Elevation of inlet: --"--- Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, Rear, p Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width: ,$' ' Length: Number of Lines:—_,2 _ Area Built: Fill depth to top of pipe: �6 " Number of feet from nearest property line: Front OSide, O Rear,OFt .—/0' Number of feet from well: v Number of feet from building: (Include distances on plot plan). SEEPAGE PIT * Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box 0 or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, Ft. O Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: Plumber on job: License Number: 3/84:mj Form - S T C - 104 �► "° AS BUILT SANITARY SYSTEM REPORT OWNER Teter Heilmann TOWNSHIP Hudson SEC. 16 T 29 N-R 19 W ADDRESS 205 Country Road TT ST. CROIX COUNTY, WISCONSIN Roberts, WI 54023 SUBDIVISION N/A LOT 1 LOT SIZE N/A PLAN VIEW Distances and dimensions to meet requirements of I•T.HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 10-d IV 1 1 l� w 1\ M r e IX sf' A i I INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: Proposed slope at site: SEPTIC TANK: Manufacturer: 14,x; ✓ Liquid Capacity: Ntmber of rings used: / Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front 10 Side 0 Rear, O feet From nearest- property line - Front 10 Side,O Rear,0 l/a ` feet Nimber of feet from: well �, building: (InclILde this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE fRY, INSPECTION REPORT FOR SAFETY&BUILDINGS DEPARTMENT of iR7ATIONS PRIVATE SEWAGE SYSTEMS BUREAU OF PLUMBING LABOR&HUM 5370 P.O.&Oy"", T 9N-R19W CONVENTIONAL ❑ALTERNATIVE Sfassiganl.D.Number. "MA['r.4f > (If assigned) .1 of Hudso ❑Holding Tank El In-Ground Pressure Mound igcCutcheon Road NAME OF PERMIT HOLDER JADDRESS OF PERMIT HOLDER INSPECTION DATE: Peter Heilmana 205 County Road TT Apt. 5, Roberts, WI 4023 4—a(p BENCH MARK(Permanent re erence point)DESCRIBE IF DIFFERENT FROM PLAN. REF.PT.ELEV.: CST REF.PT.ELEV.: Name of Plumber: MP/MPRSW No.. County Sanitary Permit Number: pack A. Bowma 5875 St. Croix 99096 SEPTIC TAN K/HOLD ING TANK: MANUFACTURER. LIQUID CAPACITY TANK INLET ELEV.. TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER �f� PROVIDED: PROVIDED: !VL/� Rn 1 O ( G8 1�rJ YES ❑NO ❑YES LY1N0 BEDDING: NT DIA.: VENT MATL. HIGH WATER NUMBIr"'R ROAD: PROPERTY W BUILDING: VENT TO FRESH ^ �— ALARM: LINE: AIR INLET: ❑YES_S]NO FEET FROM 4 1,��.J� ❑YES �NO NEAREST � �U DOSING CHAMBER: MANUFACTURER. B DDING: LIQUID CAPACITY PUMP MODEL. PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED PROVIDED: YES ONO YE ❑NO OYES ONO GALLONS PER CYC_E: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROP TV WE BUILDING VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET. PUMP ON AND OFF ❑YES ONO NEAREST SOIL ABSORPTION YSTEM.Check the soil moisture at the depth of plowing LENGTH DIAMETER ERIAL ND MARKING or excavation. (If soi can be rolled into a wire,construction shall cease until FORCE MAIN the soil is dry enough o continue.) CONVENTIONAL SV STEM: IDTH: LENGTH. NO.OF DISTR.PIPE SPACING. COVER DIA.-. #PITSLIQUID #3EDfTREI0 TRENCHES MATERIAL: DEPTH: # �NSI*N$ GRAVEL DEPTH F LL DEPTH DISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: nDR UMBER CIF PRO PERTY WELL: BUILDING. VENT TO FRESH BELOW PIPES F L D CTHER. ELEV.INLE7 ELEV END. LINE: AIR INLET195 q51 t FROM �- o �0 0 51 + MOUND SYSTEM: Mound site plo ed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA- ❑ meets the criteria for medium sand. TIONS MEASURED. YE ❑NO SOIL COVER ITEXTUF E PERMANENT MARKERS OBSERVATION WELLS ❑YES ONO ❑YES El NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL: SODDED. SEEDED. MULCHED. CENTER. EDGES. El YES ONO I OYES ONO OYES 1:1 NO PRESSURIZED DISTRIBUTION SYSTEM: DTH_ LENGTH. NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER: e; e'`1CGCH TRENCHES: NIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL. NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING: g E EV.: ELEV.: DIA.. ELEV. PIPES: ,I.�i 1lATIflN ANU °�BTIBUTI CIN H LE SIZE HOLE SPACING. DRILLED CORRECTLY. COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO APPROVED INFCiRMAT#ON PLANS: ❑YES ❑NO OYES ONO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: 7BUILDING: FEET FROM LINE: 3 3 S ❑YES ❑NO ❑YES ❑NO NEAREST a 4.1 J / "1 Sketch System on / Retain in county file for audit. Reverse Side. I TITLE: Zoning Administrator DILHR SBD 6710 (R 01/82) INFORMATION & INSTRUCTIONS FOIL'COMPLETING A SANITARY APPLICATION MhT ti 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 airy 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 wastewaterAow (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 4 State of Wisconsin, Bureau of Plumbing, 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 where the system is to be installed; II. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit 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 tahk 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, 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; VIII. 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� 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 e° the building served B) horizontal and vertical elevatior reference points; C) complete specifications for Pumps and controls; dose volume; elevation differences friction loss; pump performance curve, pump model and pump manufacturer; Di cross section of the soil absorption system if required by the courty, E) soil test data on a 115 form. On A1iiiV result o, '` fifer i.; Tn nc > SANITARY PERMIT APPLICATION COUNTY ow In accord with ILHR 83.05,Wis.Adm.Code St. Croix D STI�jE�A��Y PERMIT# r C7/' complete laps(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER ,z x 11 inches in size. -See reverse sidE for instructions for completing this application. PETITION 1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES Lbw NO PROPERTY OWNER PROPERTY LOCATION Peter Heil nn NE '/a NE '/a,S 16 T 29 , N, R 193)W PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME 205 County Road TT Apt # 5 1 N/A N/A CITY,STATE ZIP CODE 1PHONENUMBER CITY NEAREST ROAD,LAKE OR LANDMARK VILLAGE: Hudson Mc utc eon Road Roberts WI 54023 715 749-3779 II. TYPE OF BUIL ING OR USE SERVED: Number of Bedrooms if 1 or 2 Family 3 OR ❑ Public(Specify): Ill. PURPOSE OF APPLICATION: (Check only one in#1. Check#2,3 or 4,if applicable) 1. a. n Nevy b.❑ Replacement c. ❑ Replacement of d.❑ Reconnection of e.❑ Repair of an Syst am System Septic Tank Only an Existing System Existing System 2. ❑ A Sanit iry Permit was previously issued. Permit## Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The Sy tem is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYS EM: (Check only one in#1 and only one in#2) 1. a. Con entional b. ❑Alternative C. ❑ Experimental 2. a. ❑System- b. ❑ Holding C.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In-Fi.I Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a.X See a e Bed b. ❑Seepage Trench c. ❑Seepage-Pit 2. PERCOLATI RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes pe inch): REQUIRED(Square Feet): PROPOSED(Square Feet): 17/ 5s s ��O Feet 2Private ❑Joint ❑ Public VI. TANK CAPACITY Site in allons Total #of Prefab. Fiber- Exper. INFORMATION New xistin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Se tic Tank or Holdin 3 Tank /aoc, K Lift Pump Tank/Si h i Chamber ❑ VII. RESPONSIB LITY STATEMENT I,the undersigned assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name(Pri t): Plumber's S' ature:(No mps) MP/MPRSW No.: Business Phone Number: Jack A. Bo n � 5875 715 235-3650 Plumber's Address( treet,City,State,Zip Co Name of Designer: 2819 Knapp S reet Men onie, WI 54751 VIII. SOIL TEST 1 IFORMATION Certified Soil Tester ST)Name CST# 2538 Jack A. Bowmin CST's ADDRESS(Str et,City,State,Zip Code) Phone Number:- 2819 Knapp Street Menomonie, WI 54751 715 235-3650 IX. COUNTYIDEI 1ARTM ENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) S rcharge Fee Approved ❑ wner Given Initial ( *�� w l s,o U a '1 I_ � OI + Adverse Determination (�l of "Cy I X COMMENTS/1REASONS FOR DISAPPROVAL: rj SBD-6398(formerly P -67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber APPLICATION FOR SANITARY PERMIT ST C - 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 s bmitted to this office with the appropriate deed recording. Owner of Property peter J & Debra M Heilmann Location of Property NE ;x NE 4, Section 1_ 6 , T 29 N - R 19 W Township Town of Hudson Mailing Ad ress 205 County Road TT Roberts WV 54023 Subdivision Name Lot Numbe Previous Owner of Property Gordon L & LaVonne Bradley Total Size of Parcel An Date Parcel was Created &-Dlbh,-L � J& �9�7 Are all corners and lot lines identifiable? ,/ Yes No Is this property being developed for resale (spec house) ? Yes ,.- No Volume 3 and Page Number 851 as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. 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) a '6y that aU 6.ta.tement6 on thiA 6onm ane true to the best 06 my (oun) knowtedg ; that I (we) am (ane) the owneA(s) o4 the pnopeh ty du cA bed in this irn6onm 'on 6onm, by viktue o6 a wahAa the 066ice 06 the County R giAten o6 Deeds as Document 1 a d that I (we) pneaa own the pnopoaed bite bon th tem (on 1 (we) have obtained an eu ement, to nun with the above de6ex bed pnopenty, bon the comtuction o6 said system, and the same has been duty neeonded in the 066ice o e County Reg"—t-en o6 Deeds, a6 Document No. 1 . SIGNATORE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SI GNED DATE SIGNED o ,Meru HO. STATE BAs OF WHOWNSIN 7031K 1-3sM *"�+rrw awran. snags i WAFAAKff 01M A37 NO 8 Cho - -- --- Gordon L. Bradley and' _. W, 'Zwd n ..... .. ........... ... . ........ ► LaV nne ra ear, ..-uaband and wife twa fW to A � .................Peter . He ilsann and De Lisa H. fle ilaaan. husband 1:00 ! .> (irattoe, r .......... ......................... .........t................... and we as survivorship marital Property, '' .. ..... . .. ... ................................................ .......... ................••......, Gsantea, 1 Witnesseth, That the said Grantor, for a valuable consideration..--.. F .•. --•- - ............ .. --••........ --- - --------------fit-. -Croix asrua«ro , cone s to Grantee the following described real estate in ... ................. ............ Count , State of Wisconsin Pari of the Northeast Quarter of the the Northeast Quarter of Section 16, Township 29 North, Range 19 West, a; Tax Pared No::...-..._-_...... J,. described as Lot 1 of a Certified Survey Map filed in ' the office of the Register of Deeds for St. Croix County, Wisconsin In Volume 7, Page 1882, as Document Number 430173, on September 15, 1957. Tog they with a non-exclusive easement for ingress and egress over a 66' vide st of land shown on said Certified Survey Map as 'Townhall drive". Sub ect to easements, covenants and restrictions of record, including an easement granted to Ruth L. Katner, of which grantees are aware. 4 sS • � � r�F ' Ft xr x {' is not homestead property. Together with all and singular the hereditaments and appurtenances thersuato belonging: s And.....Gordon L. Bradle and 4yonne Bradley ; .....--•--...... ..Y........... ........... ---- . .-Y _._ .. - ._.q......,> warm its that the title is good, indefeasible in fee simple and free and clear of encumbrances swept ' !9 9 and w 11 warrant and defend the same. 4 Dated this .....................e�...... ......... day of . . .... September . 1187.._: f .. . ... .... .. ... .. ............................ r: ......... ..... ...... ---......_......... ...... (SEAL) • ...... ........................................... • Gordon L. Bradley................ 1 - - •-- ........ .............................................. ............(SEAL) d- - .........................(u") LaVonne Bradley ...... ........................................................ .. ..... ... •-- ._.. ...... .... ............._--•-•--- AUTH1elgTICATION ACKNOWLEDOKNNT S (s) ....Gar.69A.le--1.1r4-a y..a!d.-•-•---•-•-• STATE OF WISCONSIN LaV nne Bradley !, ............................................................_...� ....................... ............_.County w au ticated day 'beg 1s 87 Pill came before at County. . ...... fL / .=� ........ ........................................... 1s_..... fire alws a iflr suel,,R: Cari..._.. ._:...._ .......3 . TI s I[jSDER STATE BAR OF WISCONSIN .... .._ Y �E ( Nick•..... ......................-•-...--•----•-....... ...._. E 3 by; 706.06,Wis. State.) to me known to be the person ............w1o''asap foregoing instrument and aeitnowledge the name. MIS IT46MUMENT WAS ORAMED BY D, CART 6 MURRAY ......-_. ........ ............. ................ rPry Notary : ... --•- -•-- ............. -... ..�..°- . tom be autbenticated or acknowledged.Beth My Commission is permanent (If tot, sonar � •) date: , yisalee hb-my mpeeft sibmild-Im used at eriaU4 b.— their.rsJ t�craw. . �. arasa awt err .-Usk c a.t-.ups FILED SEP161987 to -Anp a cowdu cam. of News"4 CERTIFIED SURVEY MAP ocated in the NE 1 /4 of the NE 1 /4 of Section 16 , T29N, R 19W , Town udson , R . Croix. County , Wisconsin, Being Lots 1 & 2 of that Certified Survey Map recorded in Volume 4, Page 997 . Owned by: Gordon Bradley Rt 5, ivlcCutcheon Road I�Pr ROVED Hiadsori, 'JWisconsin 54016 NE CORNER SECTION IB \ \ T29N, R19W PARKS I'LANN#V ���{yN \0 H ZON NG COMMITTH q`1­1 � �O z y b \ 63b•/s , FW (V 9, 1, y rf O O 'BO �� Ww ti 12'UTILI'TY \ W ? EASEMENT 0z < LOT 2 M 1-2 id J� \ -I 128, 788 SO. FT. W >Iq F2 .95 1AF.) q \ \ U W" y 't Li W° v al 0 '�'�' w V I z N89 034'01"W PREVIO S LOT LINE , ` i W za "1 37.38' L 0 T 1 v - a1 109, 350 50. FT. z='a al01 w F 2.515 .AC. ) W a ~O WI I {O i(V I s I S CD 0 z= ul- o Cert if ed m Surve Map I m N °J �� z 0 v of 3 Pie-51 o �I POINT OF BEGINNING o z l - - - 205.00• _399.00 33' 33'� - - N 89° 54 01 W 604.00 " _MC_ CUTCHEON— ROAD NORTHLINE STATION 3T VOL. 5 PG.6 h GALE ')N FEET 1" n 150' --„� LEGEND n 3 E 1 /4 C OR. 0 ' 75 150' 300' SECTION CORNER MONUMENT N O I"X 24" ROUND IRON PIPE WEIGHING Oj 1.68.LBS./LIN. FT. SET. Z I" ROUND IRON PIPE FOUND L Radius Central Arc Chord Chord Tangents Nc Angle Length Length. Bearing 1 185 . 001 65°26' 12" 2l 1 .28' 199 . 99' S32`55155"E' S65*39101"E S0012149' E NOTE: Proposed roadway centered on section line 33' east of Lot 1 . A 33' easement will be granted from Katner to Bradley adjacent, ca st of'' and parallel with said section line , also, a 33' easement will be granted from Bradley to Katner adjacent, west of, and parallel with said section line . Cne;4 h s m ap is a realignment of lot lines. No b lots have been created. St. Croix o my Zoning approval is not required , pe St. Croix County Zoning Ordinance HARVEY Q, 18.02 (4)(b)3 ---,� JOHNI N HO Vol. 7 Page 1882 ''�N�111N!M� 487.1275 SA. 11 from- ' H - z H a ST C - 105 r a y SEPTIC TANK MAINTENANCE AGREEMENT o St . Croix County z t7 a OWNER/ UYER GT9k- "OLPA00 ROUTE/ BOX NUMBER P,015 (' S Fire Number CITY/S ATE l,Oc�Fk f ZIP 5`�OZ3 PROPER Y LOCATION : 1J� �, t�E _14, Section_, T Z4 N , R 141 W, Town of tA Vo'tpOo-f , St . Croix County , Subdivision OqVUNE !%"W4 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 . C oix . 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 ownerE of all new systems agree to keep their systems properly maint ined . The p operty owner agrees to submit to St . Croix County Zoning a certi ication form, signed by the owner and by a master plumber , journ yman plumber , restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper opera ling condition and (2) after inspection and pumping (if nec- essar ) , the septic 'tank is less than 1/3 full of sludge and scum. Certi ication form will be sent approximately 30 days prior to three year expiration . y 0 E I/WE, the undersigned , have read the above requirements and agree to ma ntain the private sewage disposal system in accordance with H the s andards set forth, herein , as set by the Wisconsin Depart- b ment tf Natural Resources . Certification form must be completed and r turned to the St . Croix County Zoni Office within 30 days of th three year expiration date . S I G N E DATE St . Croix County Zoning Office P .O . 3ox 98- Hammo d, WI 54015 715-7 )6-2239 or 715-425-8363 Sign, date and return to above address . r INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 • To be a complete and accurate sail test:,your report rust include: 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 3, MAXIMUM nu€nber of bedroorns or comma€=,rcial use planned; 4. Is this a new or replecenaent syst:ena; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLD NG TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED CAN SOIL CONDITIONS; 6. PLEASE use the abbreviations shower 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 sheer may be used if desired; 8. Make sure your b€fnchna ark and vertical elevation reference point are clearly shown,and are permanent; 9. Complete all appropriate boxes as to dates, names,addresses,flood plain data,percolation test:exerp- tiott,if appropriate; 10. if the information (such as flood plain,elevation)does not apply, place N.A.in-the appropriate box; 11. Sign the form and place your current address and your certification number; 12. Matte legible copies and distribute as required. 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 — Stone (over 10") BR Bedrock cob — Cobble (3- 10") SS — Sandstone gr - Gravel (under 3") LS — Limestone "s __ Sand HGW High Groundwater cs Coarse Salad Perc Percolation Rate reed s - Medium Sand W Well I's F nE Salad Blelcl — Buildin€I is .._- Loamy Sand > - Greater Than sl — Sandy Loarn ` Less Than 'l Loam rasa — Brown Isil — Silt Loarn BI Black s€ Silt Gy _... Gray Xcl — Clay Loam Y — Yellow scl — Sandy Cray Loarn R -- Red sicl Silty Clay Loam mot — Mottles sc - sandy Clay tn:` - with sic - Silty Clay fff few,fine,faint *c — Clay cc — common, coarse p.t ..... Peat rm .... Many,medium n) — Muck d — distinct: p -.. prominent. HWL High water level, Six general sail textrares � surface water for liquid vvaste disposal BM — Bench Mark VRP Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department may request verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a permit. The sanitary permit must be obtained and posted prior to the start of any construction. i I r DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTRY, DIVISION LABOR AN R`Ep PERCOLATION TESTS (115) MADISON WI 3707 HCIMAN LATIO S (ILHR 83.0911)& Chapter 145) LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: NE �4 NE 1/4 16 /T 29 N/R 19r)W Hudson 1 N/A N/A COUNTY: O NER'S BUYER'S NAME: MAILING ADDRESS: St. Croix Peter Heilmann 205 County Road TT Apt # 5 Roberts WI USE DATES OBSERVATIONS MADE 140.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PER 0LATION TESTS: ®Residence 3 N/A New ❑Replace I August 1, 1987 August 2, 1987 RATING:S=Site suitable for system U=Site unsuitable for system CONVENTIONAL: U ND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDINGTANK: RECOMMENDED SYSTEM:(optional) ®S ❑U IMI S ❑U ®S DU ®S ❑U 0S ®U If Percolation Tests are OT required DESIGN RATE: If any portion of the tested area is in the under s. ILHR 83.09(5)(b),indicate: Floodplain,indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH 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- 1 80 V7.5 None ) 80 4" BL ts, 8" BN sil,68" BN sand & gravel B- 2 1 75 97.8 1 None ) 75 6" BL ts, 9" BN sil, 60" BN sand & Gravel B_ 3 72 93.0 None ) 72 8" BL ts, 10" BN sil, 54" BN sand & gravel B- 4 75 12.5 None ) 75 8" BL ts, 12" BN sil 55" BN sand & gravel B- 5 75 None ) 75 6" BL ts, 10" BN sil, 59" BN sand & Gravel IB- 6 1 75 97.4 None ) 75 4" BL ts, 11" BN sil, 60" BN sand & Gravel PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH P_ 1 30 None 10 6-2 6 6 Class 1 P- 30 None 10 7 6�4 6 Perc P- 6 30 None 10 6 54 5 Rate 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. - G--�7 -/ Sf� SYSTEM ELEVATION t` k fly L 'T s7u/let _ Q.. E A,-r_ -7?'.m e F.t/ - 3 I E I,the undersigned, hereb 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: Jack A. Bowen n d/b/a BOWMAN PLUMBING August 2, 1987 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): 2819 Knapp S reet Menomonie W 1 54751 2538 1715-235-3650 CST SIGNA R DISTRIBUTION: Origin I and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395(R. 10 83) —OVER — Bowman's plumbing Jack Bowman - Proprietor _ilmann Master Plumber No. 5875 .,ounty Road T _oberts, WI 540D 2819 Knapp Street Menomonie, WI ' St. Croix County 34 Town of Hudson 715 235-46 � ; jack A. Bowman CST��4�52538 NE14NE%S16T29N/T 9W o` 6 i f.r' n �I o e � , 0 Woof , / oo A/, n2*�A'I' t\ i