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HomeMy WebLinkAbout020-1353-07-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM county: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 569560 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Fox, Earl &Carol Hudson, Town of 020-1353-07-000 CST BM Elev: linsp.BM Elev: BM Description: Section/Town/Range/Map No:0Z I 36.29.19.2007 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark , OG /aYo6 /oo., o Dosing �—� Alt. BM Aeration S L Bldg.Sewer V S77,, S Holding S Ht Inlet S tMt Outlet q Gp TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 2(p 2 �--- Septic > i Dt Bottom ' S /s ✓t1 Dosing 4v N Heade Man. 'S O( t Aeration Dist.Pie I J� 9 s'U 6o _4 1 LT Holding Bot. m / sr ® 13 Final Grade ` /OO- O PUMP/SIPHON INFORMATION U Yw� t33 � Manufacturer Demand St Cov GPM h ��h k Z• /D/ Model Number /_ ` TDH Lift Friction Loss s Head TDH Ft Forcemain Length ia. Dist.to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width �) Length No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS �-� SETBACK SYSTEM TO JP/LL, BLDG WELL LAKE/STREAM LEACHI Mar actu er:. INFORMATION CHAMBER O J_ h T e Of System: f UNIT Model Number: S y_�c_ x D IBUTION SYSTEM 66WZ � 1 YLi,(rr1R, Q Header anifold ution x Hole Size x Hole Spacing Vent t Air Intake. Cj r ) /' W Length D D �0 Di a Spacing W SOIL VER x Pressure Systems Only xx Mound Or At-Grade Systems Only D th ver / Depth Over xx Depth of xx Seeded/Sodded T ulched d/Trenc enter 5 (/w Bed/Trench Edges Topsoil Yes 0 No [� Yes No COMMENTS: (In u e code discr encies,persons present,etc.) Inspection#1: / / D Inspection#2: Location: 852 Wilcoxson rive Hudson,WI 54016(NW 1/4 SW 1/4 36 T29N R19W) Cottonwood Ridge Lot 7 1 (%x) Parcel No: 36.29.19.2007 1.)Alt BM Description= r 2.)Bldg sewer length I_(-(/ -amount of cover W�V u-�-e- � �-YC�s �"'�� � V'�"�S'�K/►'� � �1 Plan revision Required? ❑ Yes o 4 , 13 Use other side for additional information. Date Insepctor's Signal re Cert.No. SBD-6710(R.3/97) • • : - � II1111111111111fIIIIIiINlllfll �� 8 Tx442018185 0 DOCUMENT NO... EASEMENT 999126 BETH PA13ST REGISTER.OF DEEDS ST. CROIX CO., WI THIS EASEMENT,made tiy' Earl K.Fox.: Carol A.Fox.as Trustees of the RECEIVED FOR RECORD Earl K.Fox and Carol A Fox Revocable Trust' 07/24/2014 12:22 PM EXEMPT #:> m described X grantors)convey an easement below to Frederick G i Eisen a n n I II as Trustee of the Frederick. G.Eisenmann III REG FEE: 30. 0, 0 T rust d at e May 13 2 00 5 PAGES: 1 • , grantees)for.the sum of $1.00 and other valuable consideration for the purpose of septic system Other persons having an interest of record in the property: ' None Return To: Loberg Law Office 359 West Main St. Ellsworth,WI 54011 Tax Parcel No:020-1353-07-000 An easement for septic system over part of Lot 7,Cottonwood Ridge,described as follows:Commencing at the Southeasterly.comer of said Lot 7,Cottonwood Ridge,thence N13°18'25"E along the lot line between Lots 7 and 8 of Cottonwood Ridge a distance of 316.70 feet to the Northwesterly comer of Lot 8 of Cottonwood Ridge,thence. N71006'57'W 15.00 feet,thence S13°18'25"W parallel with the.Easterly line of said Lot 7 to the Southerly line of said- .thence Southeasterly'along the Southerly line of said Lot 7 t the point of beginning. St. Croix County, Wisconsin. This easement shall terminate upon failure of the existing septic system. (Signature) (Signatur ) Earl-K.Fox Truste (Print Name) ( rint N e) I (Signature) -(Sign e) Carol A. Fox.Trustee (Print Name), (Print Name) yy Subsc d w to re me this j;', - ' atur of Public) (Print or Type Na e, Notary Public. (0ate Commission Expires) THIS INSTRUMENT DRAFTED BY:.' �`'� G �'�, LOBERG LAW OFFICE ��Q� . j... Jens H.Loberg u o _ _ o DQ vn St.Croix County 999126 Page 1 of'1 �4 C 1701 (3/tl 63 cc_4�e x 63 slob / KNUDTSON PLUMBING& �-• CONTRACTING,LLC r 927150TH Sr.648447MPRS VA 64M-8M CELL 651.470.1737 �-- ; County Safety and Buildings Division P 201 W.Washington Ave., P.O. Box 7162 Sanitary Permit Number(to be filled in by Co.) Madison,WI 53707-7162 �rs5/ >y `7 'raS(t(RZ�ti .. State Transaction Number Sanitary Permit Application NP In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to thepriate governmental unit is required prior to obtaining a sanitary permit. Note:Application forms for state-o WTS are submitted to Project Address(if different g address) the Department of Safety and Professional Servies. Personal information you provide used for secondary purposes in accordance with the Privacy Law,s. 15.04(1 m,Stats. / r e D I. Application Information-Please Print All Inform o parcel# (/C/ Property Owner's Name � C�O� 9�Q Property Owner's Mailing Address OG Property Location Z��\ _7 � L L F�O�j�- Govt.Lot C� J City,State Zip Code Phone Numb 4( /, sS c-�'/., Section _ ,/` cucle one) SQL r T N; R EorW II.Type of Building(check all that apply) L Subdivision Name E1 or 2 Family Dwelling-Number of Bedrooms Ok � - B ❑Public/Commercial-Describe Use ❑ City of CSM Number ❑Village of ❑State Owned-Describe Use i Town of )'711.e 3 6� L ,4 f.J ZZt-ZZ Glna„ r III.Type of Permit: (Check onit one box on line A. Complete line B if applicable) Z A. New System ❑Replacement System ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System(explain) List Previous Permit Number and Date Issued B. 11 Permit Renewal ❑Permit Revision El Change of Plumber 11 Permit Transfer to New ``-- Before Expiration Owner IV.Type T e of POWTS S stem/Com onent/Device: Check all that apply) N'Non-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grade ❑Mound>24 in.of suitable soil ❑ ound<24 in.of suitable soil ❑Holding Tank ❑Other Dispersal Component(explain) ❑Pretreatment Device(explain) V.Dis ersal/Trea ent Area Information: Design Flow(gpd) Design Soil Application Rate(gp 0 Dispersal Area Required(sf) Dispersal Area Proposed System Elevation 6a ?X6 ��'� VL Tank Info Capacity in Total #of Manufacturer / F o Gallons Gallons Units U „ New Tanks Existing Tanks / a U Septic or Holding Tank Dosing Chamber VII.Responsibility Statement- I,the undersigned,assn le ijAsponsibility for instal 'o f the POWTS shown on the attached plans. Plumber's Name(Print) Pl be' ature MP/MPRS Number Business Phone Number Plumber's Address(Street,City,State,ZAip Code) �f II.Coun Department Use Only Per t /e Date�ule Issuing Age ignature Approved ❑ isa a y f ❑ iven Reaso for Denial 5 IX.Condvmr40"o-Reasons for Disapproval 3> 4 ',,C4- C 1 'vii >? ptiG'tank,efuent filter and r J ,,dispersal cell must all ie I' rAW,ned e b at per managemort oro by plumber. / 2 ;A'ksetbackrequirements muskli as per aWiceble code Attach to complete plans for the system and submit to t e County only on paper not less than 8 12 x 11 in hes in size SBD-6398(R. 11/11) CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Earl Fox sewer Owner's Name: Earl&Carol Fox Owner's Address: 1818 Hunter Hill Rd. Hudson Wi. Legal Description: NW 1/4 SW 1/4 S 36 T 29N R 19 W Township: Hudson County: St Croix Subdivision Name: Cotton Wood Ridge Lot Number. 7 Parcel ID Number: Page 1 Index and title Page 2 Plot Plan Page 3 System Sizing&Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test&House Plans Designer/Plumber. Keith Knudtson License Number: 648443 Date: 05/04/2014 Phone Number (651)470-1737 Signature N Designed pursuant to the In-Groupd Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P(N.01101). Page 1 x �D�7 40/1 fir Rj a �,,p 8- / KNUDTSON PLUMBING& CONTRACTING,LLC 9271WTH BT.648447MPRS ROSERM WI 540234=6 CELL 851.470-1737 l 3011 Absory4on Svsten_I C_rasa Section 96.50 ft Final Grade V Schedule 40 PVC Vent Pipe 5.00 With Vent Cap Leaching _..j, 91.50 Chamber `-3 5.0 ft System Elevation Soil Abe-RM&n Svstg,Plan View ft 3.00 ft i 5.00 ft � Leaching Trench 1 Vent Or Observation Pipe Chambers 4'Dia. Trench 2 Header Leachina Chamber Soec[flaWons Manufacturer And Model Infiltrator Quick 4 EISA Rating 20.00 sq ft per chamber Soil Application Rate 0.70 gpd/sq ft 600.00 gpd Design Flow+ 0.70 Soil Application Rate + 20 EISA= 43.00 Chambers 2 rows of 22.00 chambers each. Page 3 of 9 Filters._ FFLUENT RLTER FL-525 Fitter is rated for 10,000 GPD (gallons per day) 1/16" Filtration Stots AWM ` it-one of the largest filters --� ift etass. It has 525 linear feet + + > 6" filtration slots. Like the _ AwOMPVC k PLA 22,the Potylok = - has an automatic shut ball installed with every filter. the-fitter is removed for ad ing,the ball will float up and - i ;r>ararity shut off the system so The effluent won't leave the tank s3uRm6' other filter on the market can FWAtenSW `® R ftd frw mw ce'that claim. 1MGM L-525 Maintenance. SM.40 �--- ` The PL-525 Effluent Filter should €operate efficiently for several years rtder normal conditions before mss: _aquifln 9 cleaning.. It is recom- mended that the filter be cleaned every time the tank is pumped or � - - ' at least every three years. If the t �= _kistatted filter contains an optional 4 alarm,the owner will be notified ` by an alarm when the filter needs servicing. Servicing should be i done by a certified septic tank ----a ; pumper or installer. U.S.Patent No#6,015,488 -®BA Um FAw is 1.Locate the outlet of the 5,s71,640 septic tank. `2. Remove tank cover and pump tank if necessary. PL-525 Installation: 3. Glue the filter housing to 3 Do not use plumbing when the 4° or 6° outlet pipe. If filter is removed. Ideal for residential and com- the filter is not centered 4. Pull PL-525 out of the housing. mercial waste flows up to under the access opening 10,000 Gallons Per Day (GPD). use a Polylok Extend & S1. Hose off filter over the septic Lok or piece of pipe to tank. Make sure all solids fall 1. Locate the outlet of the center filter. See page back into septic tank. septic tank. 19-21 for Extend & Lok 6. Insert the filter cartridge back 2- Remove the tank cover and information. into the housing making sure pump tank if necessary. 4. Insert the PL-525 filter _ the filter is property aligned into its housing. and completely inserted. 5. Replace and secure the 7. Replace septic tank cover septic tank cover. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION .FORM OwnerBuyer Earl & Carol Fox Mailing Address 1818 Hunter Hill Rd. Property Address 882 Wilcoxson Dr. (Verification required from Planning&Zoning partment for new construction.) City/State Hudson Wi. Parcel Identification Number 6z — /353— d 7 OCIC� LEGAL DESCRIPTION Property Location NW '/4 , SW '/4, Sec. 36 , T 29 N R 19 W,To-,vn of Hudson Subdivision Plat:Cotton Wood Ridge Lot# 7 Certified Survey Map# / - , Volume , Page# Warranty Deed# (before 2007)Volume Page# Spec house❑yesOno Lot lines identifiable ElyesOno SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner,if needed,by a licensed pumper. What you put into the system can affect the function of the septic tarok as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in§SPS.383.52(l)and in Chapter 12-St.Croix County Sanitary Ordinance. The property owner agrees to submit to St.Croix County Planning&Zoning Department 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/or(2)after inspection and pumping(if necessary),the septic tank is less than 1/3 full of sludge. ]/we,the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth,herein,as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St.Croix County Planning&Zoning Department within 30 days of the three year expiration date. liwe certify that all statements n this form are true to the best of my"our knowledge. 1/we am."are the owner(s)of the property described above,by virtue of warranty deed recorded in Register of Deeds Office. Number of bedrooms 4 SIG ATU E F PPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning&Zoning Department. *** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV.04/12) POWTS OW'NER'S MANUAL & MANAGEMENT PLAN 1`11911 FILE W-OFIVATIDN SYSTEM SPEC11FICATIONS Ov ner Septic Tank Capacity ged ❑ NA Perrrirt Septic-Tank Manufacturer :�e(�+ ❑ NA DESIGN PARAME7EFIS Effluent flier Manufacturer a ❑ NA Number of Bedrooms 'T' ❑ NA Effluent flier Model 5Z ❑ NA- Number of Public Facility Units Nj::gA Pump Tank Capacity go, *11A Estimated flow(average) 1�� day Pump Tank Manufacturer Design flow (peal), (Estimated x 1.5) " Purrp Manufacturer Sal Application Rate �j.7 9WArtlfi2 Pinup Mode( Standard Influent/Effluent Quality Monthly average' Prstvatraent Unit XIA Fats,Oil&Grease (FOG). 530 mg/L ❑ Sand/Gravel Fitter ❑Peat Filter Biochemical Oxygen Demand (BODJ 5220 mg/L ❑NA ❑Mechanical Aeration ❑Wetland Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection [3 Other. Pretreated Effluent Duality Monthly average D' Cen(s) 'Si.j,'( -Ic u_ Q xck— ❑ NA Mori emical Oxygen Demand (BODJ 530 mg/L �-Grouc►)h d (gravity) ❑ In-Ground (pressured) Total Suspended Solids (TSS) 530 mg/L ❑ NA ❑At-Grade E3 Mound Fecal Co6form (geometric mean) 510"afn/i OOnd ❑Drip-L�e ❑ Other: Maximum Effluent Particle Size in dm2 ❑ NA "'` ❑ NA Other. ❑NA Otfaer: ❑ NA `Values typical for domestic wastewater and septic tank st luerut. Other' ❑ NA MA NTENANCE SCHEDULE Service Event Service Frequency '3 ❑Yes(s) (Mw&==3)rears) 0 NA Inspect condition of tanks} At(east once every: Pump out contents of tank(s) When combined sludge and scm equals one-third %) of tank volume ❑ NA Inspect dispersal c eli(s) At)east once every: ❑Yeer(s(s) (MaAmm 3 Years) ❑NA Clown effluent filter At)east once every j3jrwithts) ❑ NA yearts} ❑ month(s) Inspect purnp, pump controls&alarm At feast once every, ❑year(s) Rush laterals and pressure test At least once every. ❑ month(s) NA ❑ ear(s) At least once every E3 month(s) ❑ ear(s) ❑ NA Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an indivudual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS inspector; POWTS Maintainer, Septage Servicing Operator. Tank inspections must,include a visual inspection of the tank(s)to identify any missing or broken hardware, identify any-cracks or leaks, measure the volumne of combined sludge and sccxrn and to check for any back up or ponding of effluent an the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to checkkfor any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a faulting condition ipd requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Ysl or rnore of the tank volume, the entire contents of the tarok shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent fitters,mechanical or pressurized coff"nerits, wetreatmeint units, and any servicing at intervals of 512 months,shall be performod by a certified POWTS Maintakw. A service report shall be provided to the Iotad regulatory authority within 10 days of completion of any service event. paw ?i START UP AND OPERATION for new construction, prior to use of the POWTS check treatrnent tarktsl for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cen(s). If High concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil ins are frozen at the infiltrative surface. During power outages pump tanks may fill above normal hir¢nwater levels. When power is restored the excess wastewater will be discharged to the dispersal cells) in one large dose, overloading the oafs) and may result in the backup or surface discharge of effluent. To avoid this situation have the ©omtents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in msawafY oparafmg the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or adwwwise disturb or compact, the area wWm 15 feet down slope of any mtorsnd-or at-grade soil absorption area. Reduction or eLmkwtion of the following from the wastewater stream may irmprove the performance and prolong the ffe of the POWTS: antibiotics: baby wipes: cigarette butts: condoms; cotton swabs; degreasers; dental floss. draper's; dsrrrbctilrnts; fat, foundation, drain (sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products: pesticides: sanitary napkins:tampons: and watr softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shalt be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33,Wisconsin Administrative Code, • AN piping to tanks and pits shall be disconnected and the abandoned pipe openings seated. • The contents of of tanks and pits shag be removed and property disposed of by a Septage Servicing Operator• • After pumping, all tanks and pits sham be excavated and removed or thek covers removed and the void space fuled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS falls and camat be repaired the following measures have been, or.must be taken, to provide a code compliant replaom rent system: O A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system_ The replacement area should be protected from disturbance and compaction and should root be infringed upon by required setbacks frorn existing and proposed structure, lot lines and weft. Failure to protect the replacement area wM result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement system must comply with the rules in effect at that time. - 0 A suitable replacement area is not available due to setback and/or sof limitations.' Barring advances in POWTS technology a holding tank may be instated as a last resort to replace the failed POWTS. . ?RN418 rl9Z�► ¢'DIE:WiW Ct,IVS-r/zUnn on Mound and at-grade sort absorption systems may be reconstructed in place following rernoval of the biomat at the infUtrative surface. Reconstructions of such systems must comply with the rules in effect at that tine. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR MtWMC:IENT OXYAEM. DO MOT ENTER A SEPTIC,PUMP OR OTHER TREAT14EWT TANK UNDER ANY CU=MSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DI<FICUL.T OR IMPOSSIBLE. ADDITIOKAL COMMENTS i POWTS INSTALLER POWTS MAINTAINER Name te.-A— Name Phone 1,951-- +76— Phone SH'TAGE SSWICING OPERATOR(PUMPER) LOCAL RE6UtATORY AUTHORITY Name Pei &'j-ems sci, ` a Name- s-� Ckp[ U 2wlk Phone �_ - Phone —71 S- 3�iG— 41(a C7 Ties domirr>ent was drafted in corrrpbarrce with chapter Gomm 83.22(2)(b)(1)1d)td1l)and 83.5411 1,(2) &13I,win A&ninis�e Cods. I I I I I I I I I I I I I I I I IIIIIIIII � Till DocUMENTNO. STATE BAR OF WISCONSIN FORM 16-1982 8 2 1 0 3 0 7 TX:4173437 TRUSTEE'S DEED 992366 BETH PABST Frederick G.Eisenmann III,as Trustee of the Frederick G.Eisenmann III REGISTER OF DEEDS Trust,dated May 13,2005,for a valuable consideration coveys to Earl K.Fox ST. CROIX CO., WI and Carol A.Fox Revocable Trust,Grantee,the following describe tate 02/06/2014 2:21 PM in ST CROIX County,State of Wisconsin: / EXEMPT#: N/A Lot 7,Plat of Cottonwood Ridge in the Town of Hudson,St.Croix County, / REC FEE: 30.00 Wisconsin. ✓ TRANS FEE: 216.00 PAGES: 1 RETURN TO St.Croix County Abstract&Title Co.,Inc. 219 S.Knowles Avenue New Richmond WI 54017 Tax Parcel No: 020-1353-07-000 Dated this 30th day of January,2014. "O j rt C,( c c (SEAL) (SEAL) * Frederick G.Eisenmann III Trustee Trustee AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN authenticated this day of 120 COUNTY OF ST.CROIX ss. TITLE:MEMBER STATE BAR OF WISCONSIN Personally came before me this 30th day of January,2014,the (If not, above named Frederick G.Eisenmann III,as Trustee of the authorized by§ 706.06,Wis.Stats.) Frederick G.Eisenmann III Trust,dated May 13,2005 to me known to be the person(s)who executed the foregoing instrument and acknowledge the Wme. THIS INSTRUMENT WAS DRAFTED BY t\� Robert L.Loberg/Loberg Law Office * �IG(/CSI r (/f✓,t�Dir f-�� 1417173/asc Notary_ Public 57�- C> County,Wis. My Commission is permanent. (Signatures may be authenticated or acknowledged. Both are If not,state expiration date: not necessary.) *Names of persons signing in any capacity should be typed or printed below their signatures. '�� .•••.......kip, 0,. StMr'R- o'unEtyD992366 Page 1 of 1 FORM NO.16-1982 COTTONWOOD RM LOCATED IN PART OF THE NWf14 OF MR Nat 14, IN PART 01 THE Na1 14, SE1 14 OF THE NN1 14, NW1 14 OF THE Sa114 AM OF SECTION 96, T29N, R/9 TOWN OF HUDSON, ST.CROI% COG _- N69'S647'V 795.92 - 1711 \�` � � "C 39164' -• /4 CORMER C11QN 36 �a 14 ! \ �feQom. i 6 ,p 7 ti , 54 9 j _ 1039 ACRES i 2.230 ACRES 2.019 ACRES ! 87.970 S . 88,810 SOFT Y7,154 SO FT.2.006 ACRES / I y 67,367 SOFT. % 1 r ? C % a 3100 , _' -_ 1 R 1 " a 2.025 ACRES 2.281 ACRES ` 88.213 SQ.FT. i 98,510 SO FT. \126 B6 y ...�. `,.,\ S Jas �. C �1 6 Q ' TEMPORARY CUL-DE-SAC EASEMENT 3 ! 56Jy, \ \ E. N CUL-DE-SAC TO K REM WD ," 2.855 ACRES \ UPON ROAD E%TENSON a• '�; zss 115.840 SO. FT. 2.034 ACRES \ ! ' �o•a5 v 9T't 4 H.W.L 992.0 �! 88,824 SOFT. NB9./4'S9_'E 416 66 1 .S7g J � l /r 57 , .ti 4 2.690 ACRES 177,157 SO. FT. w r 2.023 ACRES It i'Af�o 88,107 SQ.FT. 20'DRAINAGE Q = •---r °fi' EASEMENT H WL 1036.0 ''� I5• TIP ♦' /0_'E_58212 pp �. O 5" TIP -� N69 x954 E X4000 10' S Tvp 51 TIP 58 ,..._ 10' TYP .4 Q x 2.360 ACRES °n 102.812 S0. FT. ;N 2.001 ACRES N 87,185 SQ.FT. -- - 63 N64/9 59 E 39E1 oa w. 4.320 ACRES - — - 188.182 S0. FT. - - m 59 u n'U i'p 62 CENTERLINE 2.034 ACRES a pl ' 'z .- 88,604 SO..FT. 2193.ACRES 4C DR1IMAOE 95.508 SO. FT. EA5f1D17 ;N 2.001 ACRES r r n aso yw N 87.165 SQ.FT. J L PROPERTY OWNER Sr/DU+ SOIL DESCRIPTION REPORT I_ f 4 Page of PARCEL I.D.# Boring# Horizon Depth Dominant Color Mottles Texture tructure 2 in. Munsell Qu.Sz.Cont.Color e Gr.Sz.Sh. Consistence Boundary Roots Bed Trench 3 t d-10 1014t- 3 3 2 X0-51 to ,- LI — Si I 2 mabK ,, L5 Ground 3 7-13b 1 O r`f U I r15 v 59 r71 elev. Depth to limiting factor in. lP Remarks: Boring # t -14 10w-3 -3 –' Si I 2 mcabk rnfr (_S l lv y Z 14-qq t0 r (4/j r-n-Cr — • 5 .Co 3 y9-1 r y to rn S CAS t C.5 Ground elev. Depth to limiting factor 2fo in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed Trench Boring # D-N 10 3 1.5 — Sit zm a b K C,5 1 5 •14:) 5 2 4-40 l0�r Si( Z tmabk mfr C,5 3 0-52 tD r 3 to LS m m i C S Ground I 2-!Iq ��Vf Lk (D IY1S CS-) r` ) C s ._7 FS elev. Depth to limiting kp0 factor 119 m. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD-8330(R.07/96) vltsconsin Department of Commerce SOIL AND SITE EVALUATION Page of Division of Safety and duifdings "- Bureau of Integrated Services in accordance�n[i#I(s; ILHR 63.®g;•1Nis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inche in size. Pilamrifust bounty * j include,but not limited to: vertical and horizontal reference poin f(.W),directi4ri and . i _ -I percent slope,scale or dimensions,north arrow,and location a cl distance to nearest road pa cel I.D.# APPLICANT INFORMATION - Please print all information -A ie ed by Date Personal information you provide may be used for secondary purposes(Prillacy Laws Property Owner Property Locatieri K 'I' 1+�c1 Govt.; ` 1/4_5kj 1/4,S 34 Tpq ,N,R ICI E(or)® )�. Property Owner's Mailing Address Block# Subd.Name or CSM# -I r. i 4-16 r- w o-o cQ 2 d 2 City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road tw � S C:I �, fl.�I ���i_�i lr ( �I� )�`-�J-(r��3 I U {`QC`s" l'a�on cva�/ •Gr• New Construction Use: ®Residential/Number of bedrooms 3_4 Addition to existing building ❑ Replacement ❑Public or commercial-Describe: Q Code derived daily flow 00 gpd Recommended design loading rate 7 bed,gpd/fie lJ trench,gpd/f12 Absorption area required q 5 1 bed,ft2—�L-trench,ft Maximum design loading rate 7 bed,gpd/fie . trench,gpd/ft2 Recommended infiltration surface elevation(s) SV s**-, el e r 9�•�o ft(as referred to site plan benchmark) Additional design/site considerations l4�-f 1G�C Ir q/SCE Parent material G I&A&I �UTV�IGS`l Flood plain elevation,if applicable j 3,�y ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system © S El © S ❑ U RI S El ® S El El ® U ❑ S 5� U SOIL DESCRIPTION REPORT Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed Trench D-12 I U r 3 3 S►'I mabk m Pr C S ►5 ' .lp 2 t2ll, I D r L1 14 2l Ground 3 26-4 Ill r 3J& --- l S I ry)-)g m 1 GS elev. 9(�ft. 42-I IL) r y�ln -" S C�S �� CS —• 1 g Depth to limiting factor 0-0 in. Remarks: Boring# 0-13 (tJ r 3 3 Sil 2 CS Z 2 13-45 10 r L4 S 2 rr CS 3 45-12 10 yr ti J(o —' mS 'SC4 j Ground elev. �I 11 l� Depth to Vo a� i „ll limiting UN factor 12.40in. Remarks: CST Name (Please Print) Signature Telephone No. c e 04 - --- G.r--Z 7- D Address Date CST Number PAOPERTYOWNER- S100-I- �+� �.vwv�ur �ww ncrvnl % Page of_3 PAIVEL I.D.# Boring# Horizon Depth Dominant Color Mottles Structure 2 Q _ in. Munsell Qu.Sz.Cont.Color Texture Gr.Sz.Sh. Consistence Boundary Roots Bed ,Trench 3 d-10 t0 r 3 13 L /0-57 l0 r y 51 Z ably (-5 — ..'S ;. Cn Ground 3 1-1 elev. O r- la Depth to limiting factor !min. ILD tP Remarks: Boring# xy t -4 t r3 3 sil 2mobk mfr t Z ►4- 1 t0 r 4 -- 5.l 2 m(iblt ry�r c -5 t Li 5 Og I C15 Ground elev. Depth to limiting factor 24P in. Remarks: Horizon Depth Dominant Color Mottles Structure GPD/ft2 Texture Consistence Boundary Roots in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed ,Trench Boring# I Zm b Tr C.S 1 C 3 3 ,b 5 3 2 4-4o t0� 9 A -- sit Z n-obk m4- CS 1 .•5 3 o-5z ION,, 3 tp -- LS tr ml CS - g Ground '1 Z-111 4Q) —` M5 ry-1 l S .'7 g elev. Depth to limiting bo qb` factor 119 in. Remarks: 3oring# C1 around Aev. )epth to imiting actor in. Remarks: SBD-8330(R.07/96) gale -(0v Double ebev o,c) I-op O-j '7-" Pvr-, P1 Pc 3G �..sv Ar r4' lo3y.o �� 6� Pr;n�IL a z t,.T • d \ pz✓ e Parcel #: 020-1353-07-000 02/09/2005 04:40 PM PAGE 1 OF 1 Alt.Parcel M 36.29.19.2007 020-TOWN OF HUDSON Current X ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): =Current Owner * EISENMANN, FREDERICK G III FREDERICK G III EISENMANN 636 HILLARY FARM RD HUDSON WI 54016 Districts: SC=School SP=Special Property Address(es): '=Primary Type Dist# Description "852 WILCOXSON DR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: es: .039 Plat: 0194-COTTONWOOD RIDGE 199 SEC 36 T29N R1 9W PT SW NE&NW SE Block/Condo Bldg: LOT 07 COTTONWOOD RIDGE 2.039AC LOT 7 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 36-29N-19W SW NE Notes: Parcel History: Date Doc# Vol/Page Type 08/19/2004 772132 2640/618 QC 05/22/2000 623428 1512/427 WD 2004 SUMMARY Bill M Fair Market value: Assessed with: 49915 44,100 Valuations: Last Changed: 10/30/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.039 34,100 0 34,100 NO Totals for 2004: General Property 2.039 34,100 0 34,100 Woodland 0.000 0 0 Totals for 2003: General Property 2.039 34,100 0 34,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 12/04/1998 Batch#: PRGRM Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00