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� Parcel #: 020-1053-60-300
09/18/2006 10:45 AM
PAGE 1OF1
Alt. Parcel#: 20.29.19.197N 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): O=Current Owner, C=Current Co-Owner
O-CHURCH OF THE HOLY CROSS
CHURCH OF THE HOLY CROSS
498 JACOBS LA
HUDSON WI 54016
Districts: SC=School SP=Special Property Address(es): *=Primary
Type Dist# Description '498 JACOBS LN
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 7.300 Plat: N/A-NOT AVAILABLE
SEC 20 T29N R19W SE SE LOT 4 OF C.S.M. Block/Condo Bldg:
6/1525 CHURCH BUILDING
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
20-29N-19W
Notes: Parcel History:
Date Doc# Vol/Page Type
07/23/1997 736/246
2006 SUMMARY Bill#: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 08/24/1995
Description Class Acres Land Improve Total State Reason
OTHER X4 7.300 0 0 0 NO
Totals for 2006:
General Property 0.000 0 0 0
Woodland 0.000 0 0
Totals for 2005:
General Property 0.000 0 0 0
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch M
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
107- A,
1
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS
LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P.O.BOX 1969 BUREAU OF PLUMBING
MADISON,WI 53707
SE, ISON,W ,53707 19W CONVENTIONAL ❑ALTERNATIVE State Plan I.D.Number:
(If assigned)
Town of Hudson El Holding Tank El In-Ground Pressure ❑Mound
NAME OF PERMIT HOLDER: RESS OF PERMIT HOLDER: INSPECTION DATE:
Church of the Holy Cross 522 2nd Street, Hudson, WI 54016 `7 g7 ��
ADD
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:
Gary Steel 3254 St. Croix 92470
SEPTIC TANK/HOLDING TANK:
MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
DYES ❑NO DYES ONO
BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH
ALARM: FEET FROM LINE: AIR INLET
OYES ONO ❑YES 1:1 NO NEAREST
DOSING CHAMBER:
MANUFACTURER. BEDDING: LIQUID CAPACITY. PUMP MODEL: PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
❑YES ONO OYES ONO ❑YES ONO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL- BUILDING. VENT TO FRESH
(DIFFERENCE BETWEEN FEET FROM LINE AIR INLET
PUMP ON AND OFF) ❑YES ONO NEAREST
SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKING
or excavation. (If soil can be rolled into a wire,construction shall cease until FORCE
the soil is dry enough to continue.) MAIN
CONVENTIONAL SYSTEM: COVER
BED/TRENCH WIDTH: LENGTH: T CHES DISTR.PIPE SPACING MATERIAL: =NSIDE
CIA *PITS LIQUID
DIMENSIONS
GRAVEL DEPTH FILL DEPTH JOISTR PIPE DISTR.PIPE DISTR.PIPE MATERIAL. NO.DISTR. NUMBER OF PROPERTY WELL BUILDING: VENT TO FRESH
BELOW PIPES. ABOVE COVER ELEV.INLET-ELEV.END: PIPES. FEET FROM LINE: AIR INLET.
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.
OYES ONO
SOIL COVER ITEXTURE PERMANENT MARKERS JOBSIRVATION WELLS
DYES ❑NO OYES ONO
DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL: SODDED SEEDED MULCHED
CENTER. EDGES.
❑YES ❑NO ❑YES ❑NO DYES ❑NO
]
PRESSURIZED DISTRIBUTION SYSTEM:
WIDTH: LENGTH: NO.OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER
BED/TRENCH TRENCHES:
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL. NO.DISTR DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING
ELEVATION AND ELEV.: ELEV.: DIA.. ELEV.. PIPES DIA.:
DISTRIBUTION
INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED
DYES ONO DYES ❑NO
COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING:
FEET FROM LINE:
❑YES ❑NO ❑YES ❑NO NEAREST
Sketch System on Retain in county file for audit.
Reverse Side.
SIGNATURE: TITLE.
DILHR SBD 6710(R.01/82) Zoning Administrator
Thomas C. Nelson
r
INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT ,
APPLICATION '
TO THE APPLICANT:
4 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, 608-266-3815.
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;
11. 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;
ill. 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,
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 81/2 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 Ground Ater
included the creation of surcharges (fees) for a number of regulated practices which Wisco in`S
can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buriedreas4fe
is used it your building is returned to the groundwater through your soil absorption u
system or the disposal site used by your holding tank pumper.
0
The monies collected through these surcharges are credited to the groundwater fund adminis- °
4ered by the Department of Natural Resources. These funds are used for monitoring ground- t
~eater, groundwater contamination investigations and establishment of standards. Groundwater,
it's worth protecting.
SBD-6398(R.03/86)
SANITARY PERMIT APPLICATION COUNTY
� DILHR
��� In accord with ILHR 83.05,Wis.Adm.Code STAT SANITARYPERM{T#
a y y6
—Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER
8%x 11 inches in size.
. 87-00180-
—See reverse side for instructions for completing this application. PETITION
1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES H]NO
PROPERTY OWNER PROPERTY LOCATION
Church of the Holy Cross SE X4 SE %4, S20 T2 , N, R 19 rX(or)W
PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER IBLOCKNUMBER SUBDIVISION NAME
522 2nd. St.
CITY,STATE ZIP CODE PHONE NUMBER CITY NEAREST ROAD,LAKE OR LANDMARK
Hudson. ❑ VILLAGE Ili TOWN OF* T-hielczn-n Tningm
II. TYPE OF BUILDING OR USE SERVED:
Number of Bedrooms if 1 or 2 Family OR ® Public(Specify): church
III. PURPOSE OF APPLICATION: (Check only one in#1. Check#2,3 or 4,if applicable)
1. a. 9 New b.❑ 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: (Chec7rpnly one in#1 and only one in#2)
1. Via.0 Conventional . �� b. 1:1 Alternative C. 1:1 Experimental
2. a. ❑System-.--- b. ❑ Holding c.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP
In-Fill Tank
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(Square Feet):99.31,99.51,10
<3 2915 3000 a Prvate ❑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 A
Tanks Tanks
strutted pp'
Septic Tank or Holdinq Tank X 3000 1 Midwestern ❑
Lift Pump Tank/Siphon Chamber X 2800 1 1 Midweste Ll I ❑ I Ej ❑
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' gnature:(No am [__/MP11SW No.: Business Phone Number:
Gary L. Steel 715 246-6200
Plumber's Address(Street,City,State,Zip Co Name of Designer:
988 N. Shore Dr. New Richmond, Wi. 5 407
VIII. SOIL TEST INFORMATION
Certified Soil Tester(CST)Name EeN
Gary L. Steel
CST's ADDRESS(Street,City,State,Zip Code) r:
IX. COUN TY/DEPARTMENT USE ONLY
❑ Disapproved S nitary Permit Fee Groundwater ar a Fee
g ate Issuing Agent Signature(No Stamps)
�1 S ch F
Approved El Owner Given Initial AD C) v C)
Adverse Determination v
X. COMMENTS/REASONS FOR DISAPPROVAL:
SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber
ro
VF
\ �g►1 tr t VI i%
ot
b.
y
#3034 from db to trenc s- ,
1"-40' distributiori -
'. or. ass box ---.A � � distribution
dimensioned SO- box
` bm- top of 1" steel pipes -- 2 pwc Pt.tt
with marker pipes
#1=100' ----2800 gal. pump a
#2-93.80' ei �
--7-- `
` ti
25 ?NT
I
i---4 r1 3o0p�E
elevations of trenches Uib`;:% 'a ' &, E!`,"A, s `
#1=38.31
#2=99.51
#3=100.21 ----3000 gal . septic tank
#4=101.21 I Ws approve{does cot irc!!Ca plats for the general
#5=102.166 plumhirc systems Pr sestet piplrg to the s2;;ir!ho{diag
#6=102.98 {� t^nk that is •re. rcd `,or ;,i proint. Thas£ plans
60'-�-�-4 3034
a n,w+ ,r ahr.�!t. vil approve�J ���u,a cclsti ction
s elevation of distribution boxes $re�sE�-rr►�e'" ►lfrs � -w ����� �
box #1 higher than 104 . 50 r Soo k-4
#2 higher than 104. 25
#3 higher than 101 . 71' ,��, „b ��00 !►i��
�'o ation on distribution �/ I�/ pprN�at Ise 4:119 s
of Yeb. ,23 , 1987
►^,'"►bi
ell chureh ,�rC
EI yEp
A� ,; 9s
plot plan - plan view
' KAf E O/�MMCwAw w�NN
now-
�R PRIVATE SEWAGE SYSTEMS ennaeNaeilP�tr�rtotNafi
� 9L
4"a rwMStNO
'g'°�"'a•"'-"""• PLAN APPROVAL APPLICATION r ai«tw t �a+w�.Mn�m►ei
faN./N.tnif
��78MUCTIONS: Please fill in all applicable data and submit this form with plans. Plans will not be reviewed u W all lees are received. The
bsck`side of this torn describes required plan information. 114wWaIng codes can be purchased from the Department of Admh*8V&ti0n.
Dooutnent Sales,202 South Thornton Ave.,P.O.Box 7840,Madison,Wisconsin$,1707,Telephone(WW8)288,9350.
1. PROJECT INFORMATION(Type or pried dowly) Nam a plan Number.`✓ i r
Name of ubmi ng any( lans returnee to same) Name
Cnrg T. qt-pal urch of the Holy Cross
Street a No.or Aural Route Prgect Location-street t No.or Legal 0 eeer10148
E' S20 T
city or village state ci leowNy
OF: Hudson St. Croix
Vow Pirhmrina Wi. - 54017
Telephone No,(Incwee aria 00001
715-246-6200 Church Pres .
Oesigner Telephone No.(Include&M 0001 Name Temoleft NL(1f U"area owe)
Same
Wet•NO.
527 Spnon St
or Village state ZIP CAY or Village ZIP
Z PPLiCATION FOR: New Mound System(3a) Groundwater Monitorinig(7)
x Conventional System-Public Building(1) Replacement Mound(4a) Hold"Tolk(2)
Replacement Pressurized System(4b) System in Fill(1) Petition For Variants(8)
New Pressurized System(3b) System in Flo l-Fringe(1) Other Alternatives(5)
..:FEE COMPUTATIONS(Include existing tanks) 4. FEE St)OMITTED FOR OFFICE use
MAKE ALL CHECKS PAYABLE TO DiLHR
3a. 750- 1,500 gallon septic tank - $0.00 4a.
3b, 1,501- 2.500 gallon septic tank - 80.00 4b.
3c 2.501• 5.000 gallon septic tank - 80.00 4c. Q n n n
3d. 5.001- 8.000 gallon septic tank -100.00 441.
3e. 9,001-15,000 gallon septic tank -150.00 4e.
3f. Over 15,000 gallon septic tank -250.00 41.
39. 500- 1,000 gallon dose chamber - 30.00 4g.
36.. 1,001- 2,000 gallon dose chamber - 50.00 4h.
2.001- 4,000 gallon dose chamber - 70.00 41.
31. 4,001 - 8,000 gallon dose chamber - 90.00 41.
3k. 8.001- 12.000 gallon dose chamber -110.00 4k.
31. Over 12.000 gallon dose chamber -150.00 41.
ft4rn. 500. 5,000 gallon holding tank - 30.00 4m.
Vin. 5.001-10,000 gallon holding tank - 55.00 4n.
Over 10.000 gallon holding tank -100.W 4o.
3p. Revision* - 20.00 4p.
3q. Groundwater Monitoring Per Lot - 32.00 4q.
(other than a proposed subdivision) Sublotal Sri om, _
3r.` Priority plan review:walk through 4r.
Submittal of plans in person,
by appointment.with double fee
s: Petition for variance
•. . ; Setback - 25.00 4s.
Site evaluation - 50.00 1 50.00
Tr
Total Fee
NOTM Pace preraal to wed."ft cede.ct"War rid.as
- 'aN�rM M nfaa
a>N M @k*w attow eae0tlaNtr
P!b. N 60
1�r8 PROJECT DETAIL DATA SHEET
NAME OE(PUS I NESS
LEGAL DESCRIPTION. SE � SEk Stn T29 R1 g W Towns
OWNER Church of The Holy Cross MAILING ADDRESS R R Hudson' Wi .
ZIP �i.n1
ARCHITECT, ENGINEER, ADDRESS o--,�- • jhor A nr-
PLWSE.R OR DESIGNER
N;.;3 Richmond ZIP 54017
TELEPHONE NUMBER 715-246-6200,
„
1. Check appropriate building usage(s) and fill in 20 information requestedo0Posite
•:;each usage listed. Please consult Section H 62.
Existing building __ New building ,� Addition
Apartments and condominiums Number of bedrooms 1
Assembly hall . Seating capacity
Bar Seating .capacity of meals served
Bowling a11ey Number of lanes ( ) With bar
Campground and camping resorts . . . Number of seweregites
Number of unsewered sites _
Total number of sites
O Camps . . . . , . Day use only Number of persons
Day and night Number of persons
Catchbasin . . . . . . . . . . Number
X; Church . . . . . . . . . . . No tc en Number of persons
With kitchen Number of persons
Dance halt Number of persons
Dining hall Number of meals served daily
Dog kennels . . . . . . . Number of enclosures
Drive=ln restaurant . . . . . . . . Inside seating capacity
Car-service -- Number of car spaces ,
Dump station . . . . Number of dump stations
Employees ( total of all shifts) Number of employees
Hotel ( ) Motel ( ) Cottages . Number of units with
ersons per unit
Number of units with 4 persons per unit
O Medical and dental office bldgs. Number of doctors, nurses, medical staff
Number of office personnel
Number off patients
Mobile home parks Number of sites
Nursing homes, . . Number of beds Toilets Showers
Parks . . : Number of persons! )
Restaurant . . . . . . . . . Seating capacity
Dishwasher an or disposal.
24-Hour service
Retail store . �. . . Total number of customers
Schools Number of classrooms 7(7 Meals . ( )' Showers,
. . . . . . . . .
Self service laundry . Total number of machines
Service station . . . . . Number of cars served daily
Swimming. pool bathhouse Number of persons
OTHER . .. (Specify). . . . . . .
COMPLETE OTHER SIDE
2., Indicate whether the following facllitiel are present.
Floor drain yes x_ no Number of drains _A _
Food waste grinder yes _ no x
Dishwasher yes . x_ no
Automatic clothes washer .yes no Number of clothes washers
3. Septic tank capacity gggs Cgnnnr---
Holding tank capacity
Septic or holding tank manufacturer
4. SEEPAGE TRENCHES: total square feet 2915 width of trenches'
length of trenches 1 nn depth
number of trenches
SEEPAGE BEDS: total square feet width
length of bed depth
SEEPAGE PITS: total square feet outside diameter
depth below inlet
total depth from top to bottom of pit
Signature erson com Teti form: FOR DEPARTMENTAL USE ONLY
Address SAR N Qhnra inr --
NP W Ri rhmnnd Wi Zip SZ111 7�
Telephone Number
Date
r ,
r
''OPTIONAL WORKSHEET
►
IL IN•GROUND PRESSURE%YSTEMCAaa0"r'
L MOUND SYSTEM iR rem maw
�. Wamwtwadlf Laand►Tow DS"hwo ..�... iM. 1111111111111411 04"tool• ••-�-•••w
Use a. iUM 83.15 (3) (c)
Adm.Code aed PROVIDE A DETAILED 11. Total Naawt �~
LIST OF SIZING ON PLANS. S1rf11M iflaald K?
L 0"tkiloMPeUndtMt FMW ...= f. V6t1101 Lift• ^"�/Kf.
/1iCdaa LM• ...r...
4. 01cta0a horn"a Cbambw M
St DkuMla 11 PmmP Sa uam
f. EwvatNO Dl "mm iatr»om P"W wM ft"W at Mrt
pump am Dbw*u*0 S""
L Arlerpllu Ana fltMtt hlmp mo1M1 W d/111111hII110M
Ana Roillow• t11.K
0041 M Tnseb Lot6111B)' I& Dow Velum
EN w TNR*WWdm(A) M' 10 TImW V4W Viltlmo.P
Tnt1d1 Spadq(C)• A' Dbu*v"LkWu '�•"�'
7. Mount MNrmes K DamNfr WwwwaW vWWW
"
FM Dopda(D)• �""�" 4 Deem M 241WL W .... ..r•.
FW Dppo pewnelapo(E)` --��'`111. BaekfMw• .r""�'
•ad.or Tawmdm Mp a IF)` K MM10wmt! b0i Cap Town Dapdm 101• ----- fL � g 0
Cap ammo TOWN DasA IN)• ---- K 14. Dew C
t. MoWW LW4*t
EM Sups(K)! •-""�� K 111. CONVENTIONAL PRIVATE WWACX S" EM
T"M.dnd Loads(L)• h'
MaON WW*t visa a. JIM 83 1 OETAi�. Waaawaw LNmI.Tad 01Np Ibw•(c t..
!. .15 1.Eb NiN.
UF-W--WF-W-C.rnmNn rector. Adm.coals"d PRONIOE
UplePe Wmala W• , "'�"" W' LIST OF SIZING ON PLANT.
D.wmlW Corned"Eaeta Z. R"uhd Soptk To*COO"• M8 2
DowMbPe WW*(1) L (Marlon Raw•
Total Mound Wwth(W) 4. AbasfPtfeta Ana Slaf>ra
IL B Ana* Aalar to Table T in alt. Z= $3
asal
lotlluadw CAPa►c1 Y Of PROVIDE A 09TAIL90 L151 OF
Nawnl S.N K SIZING ON PLANE.
•aW Ana R440*041 0 Roqvkod AM
acal •
•R Ana AvAabw• �.. tf'fl Loath•
11, If Swam Tables from CMaPW I= I 3 Wldd►•
aiev fused, Itadicata Table ::f Numbor of TnnMm•
1'!. is the Dbt►Ibmmew0 Pletw.rlt.UM Numbon f•14 M Soa41u 11. Tma k 510"I f<
S. Dkulbudoaa S9awaaat
L IN-GROUND PuSSURE-3YSTEM, Latonl Loaatda•
1. DNtla t4 LMmltfAt FKar• 0' NuOmM/K Lawata•
L LanddePo w W R^ Latoral SPS"`
L Fwadatle0 ` top"*
Raw DiataOa from fIMwN
4. Pr.P.fed SYWW Elaratkn` ---- SYS"Elovadeta•' See d e t
S. Nhowwaw Load T.�tdd O P M-�- shee t
use a. 83.15 (3) (a) , IV. :1fsTEMaNflll
Am Carlo and PROVIDE A DETAILED /NI M AN IwnM from 566"111
LIST OF SIZING ON•PLANS.
Ro4wred swtk Took CaPKW V. SEPTIC TANK 3
L A►arPtlm Am SkNO I. cap"W o� n4 ale s t .Pr e c a s
porgolad"Raw■ �.�....� mM,IM. m mawrodu
Ana ROI uJ d` ~' _L Show$No CetmauttslN TaN►ONaMa o1m plea
Sys"m Loadth■ ham.
System WWII• VI. DOSING TANK
7. Dbtf vd"PIP Sb bmtt � 1. CyKlt1►•
Now SI:a• _. Mane SOWSrt
Bolo Spm t fft* f. Pump ManufxWtW
Wool Loath• 4. Pmtamp Itmmmloh
tAW d tine • ��.- Mm. 12
l. .OMnttmA INm1/• .
L.Neral gpacMmlt —f%*Raw
ULarmmco from W&WAN imm Pyme 7. Show SIN C"Woo1!d Tuim OotaN/M Mw
L Dhlrlbuth m PW DkJ&NW RAM
"';. Nmmmmber of I immlee tear PIp►• VIL IIW.W NG.tANK"• ►rte,+_
I low Per Pipe: .�.� steer.. 1. Capedw•
il: Man"SuMM: Mamufeclwoft
TYPe(cooler Of 00411- — "'Show .a Plana
lotaWa• - 1:• SIN NtTa1>tm Da�eaMa
Dlamew M1.
INP'OR"TION I'
ALL PA "
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�nd . e
GO
14 2'
9 291
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o�l 115 - 1
v5' 103 �� r` 0 ,9 1987
PLUMBINB BUR
Am!! be accompa
dimstributien to the two disst-mLptitien lo.
JLJL= water 'j.
-eaeh side into 4" 3034, LI-Aim to un-tcr--
Eq�
�v ws(-O. bv;L o n �p
�4vnvavP�
B?
rn-r✓.r2 s U). 3as�
-----4" C.T. vent w/ approced cap
18-26" fill
over cover
----30_'--------- -----30= ----
--approved synthetic
cover material
4" perf.. pi
-rock 12" zto 2h" aggregate
` r 6" below pipe, 2" above
elevations + _-_- ----- I
trench 461=98 . 31 --------------5
462=99 . 51 all trenches to be 100' in length
463=100 . 21 7 0 01 90
#4=101 .21 .
465=102 . 16
166=102 .98 �± .5• llc�+
4,
•3.0.3 ��. ��
J Lo� i
_Pt UMONG
�iona Ai4
AP6�7 f7;
DEPAFT"A jN( Or,' NO-"".)
N
i ti V[.Ids`,E
cross section trench system
pipe detail
'. PACsf: Or —�
z'^ PUMP CRAM6ER CROSS SECTIOU AUD SPECIf1CATIOWS
VEIJT CAP
w•C.Z. VEUT ►IPC WCATNEI4 ►ROOT A►PROVCO LOCKIU&
JUIJCTIOIJ BOX
MAIJMOLE COVER
>_ L.5 rRarA 000 it, .
MNNDow AR rKca►+ I= M��• t with warning labs
IR INTAKE. t
ORADC 1 Y•MIM.
' t
i le•/'tIIJ.
COWDUIT t_..
4
` ►ROVI09
11�lLET AIRTI6NT SCA i II t►leGQ�.
APrROvco JaaT A tip' iM
PIPE
l�T UDIU& s' A1.AItK ONtb �Ot.10
o+.nco soLlo ;DI L.
0y�
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COWC V R[Ti �L06K ` O Q
RIscIR EXIT PERMITED OUL.11- IF TALxt MA11 p#cTURCR NA= SUCH AFMOVM1.
SEPTIC #
3PECIrI'GA7`IOAJS
';OOSL• . Midwest PrPes�at .Tr►�'_ I�NYMdER OF OOSEiS�.. � PLR,OA11
N►AMUFACTURLR..
TAIJK 51Zt �Rrin `A"OUS DOSE VOLUME 525'
tank alert IIi1CLU01W6 SAtKrL.OM/1
M/14WFACTURER:_ 46.3 2095
MODCL. IJUMeER: n/a CAPACITIESI A s•�,.�.w=s OR
SWITCH T>iPE: mercury a._ 2.0*Xwcs OR .0.-b111-
PU�► /."FACTURCR:.. Gould C� IIJLMEi DR—�L'�►L
IAODCL. UUMBER.. wE,0 5 H D .�..INCiIEi OR ..�.�;bALL
OWiTCM Ty►c. m gar r,I U!?Tc: PUmp AMD ALARM ARY TO &L
N11W11gUp% DI=CHA1t6C RAIL +1L.r .6PM
INSTALL90 OU !►tPARATE CIRCYITi
.L1..1Z f[Gr
VERTICAL OIIfCRE= sETWECU PUMP OFF AitfD Dif'1'kIWT101J MPE.. '
} MIUIMUM UETWORK SUPPLY PRCSSURC • . • • . • iCCT
• FEET Or rORCE MAIM X •3.• %nowtCT1O1J •'"�'*'�S FEET
TOTIU. 0l�1JAMIG`,Nf Ap _ LCT
12 Z71r
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rUTLRWAL. OIALUSIO1JS of TAUK' L.EAI6TM,._,1,43.,.•WIOTH ........
k•` . AIt 0= L.IC[S1l,L taUMSLRs 3Z-54p 5-8
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Conventional trench system
for
Church fo the Holy Cross
sek sek S20 T29N R19W
Hudson township, St . Croix, Co.
pages
#1= plan approval application
X62= plb #60 project detail data sheet
#3= plb #60 project detail data sheet #2
#4= worksheet
X65= 115
#6= plot plan-plan view
X67= system cross section-pipe detail
#8= pump chamber
#9= pump curve
0180
Gary L. Steel
988 N. Shore Dr .
New Richmond, Wi . 54017
MPRSW 3254-. ...-..
1-5-87
z
K'
State of Wisconsin ` Department of Industry, Labor and Human Relations
SAFETY&BUILDINGS DIVISION
February 11, 1987
`r r , Bureau of Plumbing
201 East Washington Avenue
P.O. Box 7969
Madison, Wisconsin 53707
GARY STEEL
'e �. y`ner: CHURCH OF THE HOLY CROSS
988 NORTH SHORE DRIVE ''- "� 522 SECOND STREET
NEW RICHMOND WI 54017 HUDSON WI 54016
RE: Plan Number 87--00180-S I--- -
Project: CHURCH OF THE HOLY CROSS County: ' ST CROIX
Location: SE,SE,20,29, 19W Fee Rec 150.00
HUDSON Date Received: 2109187
This letter is to acknowledge receipt of the Plumbing Plans which you submitted
to the Safety and Buildings Division, Bureau of Plumbing. We cannot however,
process your submittal until we receive:
Equal distribution can not be provided thru a Y patern fitting.See enclosed
drawings for additional information.Provide elevations.
Additional information requested shall be properly signed as per
Section -ILHR 83.08 (2) (a).
All information requested shall be submitted in duplicate unless
otherwise specifically noted.
Please retain one co of this letter for reference and return the other with
the materials requested.
Your Plans will be processed within 15 days by the Bureau of Plumbing
following receipt of the requested items.
Petitions or plans submitted to this office which require additional information
will be held 90 working days for receipt of the information. If, after 90 days,
response to this letter has not been received, your plans will be returned.
If you find it necessary to contact us regarding your submittal, please call us at
(608) 266-3937 and refer to the plan number as shown above.
01LHR-.,sn.-r,e-„
State of Wisconsin ` Department of Industry, Labor and Human Relations
SAFETY&BUILDINGS DIVISION
GARY STEEL
Page 2
February 11, 1987
Sincerely,
JAMES QUINLAN
Bureau of Plumbing
Safety and Buildings Division
PPP012/0001w/ 6 COMP: 10
ELEM: 10
cc: CHURCH OF THE HOLY CROSS
County �lumbing Consultant Local PI
_Plumber- _Environmental Health Facilities Need Analysis. Section
.UW-SSMMP Dept of Agriculture &o'Private Sewage Consultant
t
DEPARTMENT of REPORT ON SOIL BORINGS AND SAFETY `BUILDINGS'I .
INDUSTRY,
LABOR AND PERCOLATION 'TESTS X115) MAOiso°i w �oi
HUMAN RELATIONS (H63A90)&'Ch MW 145.045)
LOCATION: ON: f:
W
z9 N/R 9,L )W A*t%�/ Id
CO /BUYER'S NAMZ:, imAIIJAIGA00"Ifta
,%r.'0A lei ' J_1 "sa
DATES 0WRVATION11 MADE
N0.BeDFlM%:rOMMEKClAl LIESCRIPTION: FILE OR I
CIRoidana 4 ❑Replace '..
RATING i l-Ske sukable for system U-lilt uneakable far syatans 01
r cgs OEO a
U. a u 7i t
H Percolation Tan are NOT required It any portion of the soeta(am Is M tln
under s.1,163.09(6)(b).indicate: Q .4 floodplain,indkate Itloodplain Nwvation:
M11� PROFIi.t .lRIPTION=
BNUNR6ER IN. ELEVATION •. P 4
7 rr
a 33
B,, ac h e "PA
B- ," a bQ, m o le i > `'�- ��, 1`� , . ova s, t a a
B- B N �' /T ' _'! t'
PERCOLATION TESTS
NUMBER NCHES AFTERSWELLIN INTERVAL-MIN. P RI
P. '
P
P.
PLOT PLAN: Show locations of percolation tests, soil borings and the dhrlanslons of suitable soil area.Indicate scale or distances.Describe what are the hors-
rontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and pa►asnt
tit
of land slope. 4-rf-it riVr ,� 31 21 �X4
SYSTEM ELEVATION /= 9g` '2=99 -fjr aaax x ` 10
0
1 ' I t '
&I oil
40
II ,
1,the undersigned,hereby certify that the soil tests reported on this form wart nodo by no in accord with the procedures a bnNtodtepeolfNd'ln tM Wiscenfin
Administrative Code,and that the data recorded and the location of the soft we;cor"to.the bast of my knowledge and ballef.
NAME(prX4: WERE
A f CERTIFICATION E I , , oil
1*10
S 2 Via-
DISTRIBUTION:Original and one copy to-Local Authority,Property Owner orlr ftil Tatar.
DILMR45041398(R.02/82) —OV
� H
z
C
. H
a
STC - 105 r
r
• a
' H
SEPTIC TANK MAINTENANCE AGREEMENT o
St . Croix County x
a
a
OWN ER/ Church of the Holy Cross
ROUTE/BOX NUMBERR.R. , Hudson Fire Number
.CITY/STATE Hudson, Wi. ZIP 54016
PROPERTY LOCATION:SE 14, SE ;41 Section 20 T 29 N , R 19 W,
Town of Hudson St . Croix County ,
Subdivision n/a Lot number 4
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 pdt 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-aite 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
three year expiration. «�
0
• E
I/WE, the undersigned , have read the above requirements and agree C
to maintain the private sewage disposal system in accordance with x
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 Zo ng OffL:e within 30 days
of the three year expiration date.
, ,�'r4�_
SIGNED
,
DL
L
DATE
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.
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 (hil-rc of rha Hal g,,C c�
Location of Property SE 14 SE ' , Section 20 , T 29 N-R 19 W
Township Hudson
Hailing Address 522 2nd. St.
Hudson, Wi.
Address of Site R.R. , Hudson, Wi.
Subdivision Name n/a
Lot Number 4
Previous Owner of Property Larry Hanson
Total Size of Parcel
Date Parcel was Created 3-17-86
Are all corners and lot lines identifiable? x Yes No
Is this property being developed for resale (spec house) ? Yes x No
Volume 73_6 _ and Page Number 246 as recorded with the Register of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A Warranty Deed which includes a Document number, volume and page number, and the
Seal of the Register of Deeds. In addition, a certified survey, if available, would be
helpful so as to avoid delays of the reviewing process. If the deed description refer-
ences to a Certified Survey Map, the Certified Survey Map shall also be required.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
PROPERTy OWNER CERTIFICATION
I (We) ceAti.6y that att 6tatement6 on this 6oAm ane true to the beat o6 my (oun)
know.tedge; that I (we) am (cue) the ownea(b) 06 the pnopenty dea cA i.bed in th i,a
.in6onmation 6oitm, by vi tue 06 a wa)manaty deed %ecotded in the 066.ice 06 the
County Reg.idten o6 Veed6a6 Document No. 410656 ; and that I (We) phedent.ty
own the pnopos ed 6 to bon the d ewaq e d i 6 po-A d ys em (on I (we) have obtained an
easement, to nun with the above dedcAi,6ed pnopenty, bon the conatnucti.on o6 da.id
system, and the dame has been duty teco&ded in the 066.ice o6 the County Reg.iaten o6
Vas Document No. ) ,
Olt OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE)
'TE SIGNED DATE SIGNED
DOCUMENT NO. WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA
r �I STATE BAR OF WISCONSIN FORM 2-19821i 11—1982:1
,q
- •lam PAGE-246
ASTERS OFFICE
Larry F. Hanson, a sin e
e rson l'. �'ROIX CO., WtS
------------------------------ -------- -- ........................................... ................... * . ._
�'�•'� � •-,�d this 7th
-------------------------- -------------------------------------------- ---------------------------- ay of April A.D. 19 86
-------- --------------- -------------------- ............ -------------•---• ...............................
conveys and warrants to ..Church_of--the.-Holy•_Cross--o '__ Iudso ,-_-- 8:30 A
Wisconsin, Inc---- ....I---------------------------------
---- ------------- ------------ ------------- ................................................. -•----•--._....- (J`
I�r N DMd�
---------------------------------------------------------------------------
...............------------.--------------------------.-------------............................................. �� RETURN TO - ..
------- ---------------------------------------------------------------------•-------.------------- '!
. .......
.............' -------.------------------------------- "ry Y O i_ (j 1
the following described real estate in a... \irolX IF hJ - S DI
..County,
State of Wisconsin:
Tax Parcel No- ------------------------------
`. Lot 4 of Certified Survey Map dated April 26, 1985, filed in the
Office of the Register of Deeds on May 20, 1985 as Document No.
40203 in Volume 6 at page 1525.
b-L-7•lb
FEE
This ------------i-S.-nQt_--- homestead property.
(is) (is not)
Exception to warranties: easements, restrictions, and rights of way of
record.
Dated this .-------------------•-------•------------------ day of ............ ------- 19
March 86
......(SEAL) I � (. .- - j .(SEAL)
----- ry F. Hanson
------------•---------------------•-- -----------------------------(SEAL) ----- --- ------------------- ---------------------------- --_(SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Larry F. Hanson
Signature(s) ---------_------------------------_------------------------- STATE OF WISCONSIN
ss.
----•----•---------------------------County.
authenticated this �tday of
March 1986 personally came before me this ________________day of
/�f!L�i� �2-i.a2: �,�i2 1 z �t c_ C� .✓ ---------------•----------------•---- 19-------- the above named
----------------- f
Kristina Ogland Lundeen
--- ------------------------------------- -
TITLE: MEMBER STATE BAR OF WISCONSIN
-----------•------------------------------------------------------------- ------
(If not- ----------------------•-------------------------------------authorized by § 706.06, Wis. StatsJ
to me known to be the person ............ who executed the
foregoing instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY
Kristin• Ogland Lundeen ----------------------------------- ------------•-------------------------------
........ ................... .........................•---._...............-•--
Attorneyat Law ---------------------- -------------------------------------------------------
-------------------------•---•-----__----------•--------------------- - Notary Public --•--------.-----------•----•----- --...•County Wis.
(Signatures may be authenticated or acknowledged. Both My Commission is permanent.(If not, state expiration
are not necessary.) date;
.Names of persons signing in any capacity should be typed or printed below their signatures.
WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Cu. Inc.
FORM No. 2— 1982 Milwtwkre. Wis.