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HomeMy WebLinkAbout020-1142-60-000 o i m o I 03 N C j O a 0 ti � I h °o I II N i I � I I I I I a� I z I j LL 0 � I a Cl) � I Z H c IN- z OO m o o z v v 0 z ° o I -Zo E N C m N • D y 0 N Q z m z N z w� d �i v 10 E s N Q CO .. t0 U d N a M c 3 rear` EY m � 0 3 3 3 a = Z o co co pip N �y to J U 0 rn rn } tf�i -o M CD a \ M w O N N C7 ° c 3 '0 _ m y C a m Q U) to -y N w O 0 co 3 °i3 C U d C:) p r 9 c E O -p N N V w 7 0 � � � nNl L: 0) N N N .NO Z C N rn 'p - - d V v d m j € a .. = n ` IL • (m O. d .v N E ° w r A vat °� s 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, O Rear,Q Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan) . R-em),tp - spar— �.90 %-73 SOIL ABSORBTION SYSTEM 10_0_0 o lob",U �N p - 4(0.�3 : toy. 90. 35. 81 Bed: Trench: 13.05 GHOrn (3e� Width: ) Length:�Q Number of Lines: Area Built: p Fill depth to top of pipe: Number of feet from nearest property line: Front, Side, Rear,Ft .- 11, Number of feet from well: I'1 Number of feet from building: 7Cp1 (Include uistanee5 on piOt pi.Iu). 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, O Ft. - Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: Plumber on job: l ' License Number: 3/84:mj Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER 11ry d �'� I I I j TOWNSHIP aw V�_ SEC. J TN-R�© A. ADDRESS ST. CROIX COUNTY, WISCONSIN 0LOT SIZE 1 V SUBDIVISION �('WARS _LOT UR PLAN VIEW Distances and dimensions to meet requirements of H 63 SHOW EVERYTHING WITHIN 10O.FEET OF SYSTEM 3 Be J wa rat Syr, 33- I I 'o INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: I '� .J . ,/ Proposed slope at site: -- — SEPTIC TANK: Manufacturer: �� Liquid Capacity: Num��r of r .ngs used:I ; ' - Tank manhole cover elevation: (O J. 3� p Tank',Inlet :levation:-99 Qg Tank Outlet .Elevation: Numbt;r of foet from nearest Road: Front,O Side,O Rear,, ,0 ( � feet From siearest property line Front 10Side,0 Rear,0 feet Numbtr of feet from: well ,5 building: �3 (Include this information of the .11)Ove plot plan) ( 2 reference dimensions to septic tank) SEE REVERSE SIDE FV DEPARTME#JT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS L jBOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O!BOX 7969 BUREAU OF PLUMBING MA,DISON,%kI 53707 .ppI NW�,SW�,S34,T29N-R19W UCONVENTIONAL ❑ALTERNATIVE Sifaeigned)D.Number: i Uf assigned) Town of Hudson ❑Holding Tank ❑In-Ground Pressure ❑Mound Stewarts Addition NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Jim & Shelley Hallen 1620 Vine, Hudson, WI 54016 t�) • 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: Richard Hopkins 1059 St. Croix 92524 SEPTIC TANK/HOLDING TANK: MANUFACTURER LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LAB L LOCKING COVER i QQ PROVIDED: PROVIDED. 4 �� ,'� � ��•�U YES ❑NO ❑YES NO PROPERTY WE BUILDING. IVENTTO FRESH BEDDING: VENT I .: V L.: JHIGHWATER NUMBER OF ROAD: LINE��✓ t AIR INLET AL"RM FEET FROM \J❑YES o ❑YES NO NEAREST DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL. PUMP/SIPHON MANUF ACTL ER. WARNING LABEL LO ROV IDEO OVER PROVIDED: DYES FIND DYES ❑NO ❑YES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NU E F PR OPERTV WELL BUILDING. VENT IR INLET FE F M LINE (DIFFERENCE BETWEEN ❑ PUMP ON AND OFF) YES ONO N AREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing FORCE LENGTH 1111AME11H MATERIAL AND MARKING or excavation, (lf soil can be rolled into a wire,construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: LIQUID BED/TRENCH WIDTH: LENGTH NO.OF DISTR.PIPE SPACING COVER JINSIDE DIA 1t PITS DEPTH 3 J TRENCHES 1 I M ERIAL: PIT DIMENSIONS 1 l'rn GRAVEL DEPTH FILL DEPTH DISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL. NO.DI NUMBER OF PROPERTY WELL BUILDING: V NT TO FRESH BELOW PIPE I t ABOVE COVER. ELEV.INLET EL v.END: PIPES FEET FROM LI 3 S !�S '7(/ Algy�Ler� 27 2 NEAREST- !�O 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 El NO MES T MARKERS. OBSERVATION WELLS SOIL COVER TEXTURE. ONO DYES ONO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL- SODDED SEEDED MULCHED CENTER: EDGES: ❑YES ❑NO D Y ES ONO 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. DIS7 R.PIPE DISTRIBUTION PIPE MATERIAL-MARKING ELEV.. ELEV.. DIA.: ELEV.: PIPES DIA_: ELEVATION AND DISTRIBUTION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT ORI I TO APPROVED INFORMATION PLANS ❑YES ❑NO EYES ENO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING. FEET FROM LINE: DYES ONO EYES El NO NEAREST 0V V Sketch System on RLinn ounty file for audit. Reverse Side. SIGNATURE. TITLE. Zonin AdminDILHR SBD 6710(R.01/82) INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION TO THE APPLICANT: 1. This sanitary permit is valid for two (2) years; 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable; 3. All revisions to this permit must be approved by the permit issuing authority. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms,-etc.), depth of system, or type of system; 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be } submitted to the county prior to installation; 5. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a. Licensed pumper whenever necessary, usually every 2 to 3 years; 6. If you have questions concerning your private sewage system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 608-266-3815. 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 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 8'/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; dosing or pumping chambers; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E),soil test data on a 115 form. . -------------------------------------------------------------------------------------------------------------------------------------------------=---------- GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was.the result of over 2 years of steady negotiation and public debate. The groundwater bill Ground at [.�-. included the creation of surcharges (fees) for a number of regulated practices which Wisco ill. can effect groundwater The surcharge took effect on July 1, 1984. All of the water that burred aSUrs a is used in your building is returned t, the groundwater through your soil absorption o , system or the disposal site used by your holding tank pumper. i a The monies c.oiiec,ted through these surcharges are cred ted to the groundwater fund adminis- ieren by the Department of Natural Resource;. These funds are used for monitoring ground- t 01ate� , grourrdwaler contamination investigations and establishment of standards. Groundwater, _ s vrorth protecting. 3u t; 96 ,R.03'861 SANITARY PERMIT APPLICATION COUNTY 3 ©ILHR In accord with ILHR 83.05,Wis.Adm.Code �) Z om..,....,�.mu STATE 4?ITARYPERMIT# —Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NU/'MBBER 8%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 NO PROPERT OWNER PROPERTY LOCATION�, ' �Ij '/a5lt�' '/4, � T� , N, R E (or I T4 PROPERTY OWNER'SRAILING AD L T AVIBER BLI MBER SUBDIVISION NA CIT ,ST E t ZIPP E PHONE NUMBER 1111 iCITY { NE EST OAD,LA E OR MARK • A VILLAGE: V ' / II. TYPE OF BUILDING OR USE SERVED: Ciao �fyo?' Number of Bedrooms if 1 or 2 Family �� OR ❑ Public(Specify): V.Ir k/ wivil; III. PURPOSE OF APPLICATION: (Check only one in#1. Check#2,3 or 4,if applicable) 1. a. 6N 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: (Check only one in#1 and only one in#2) 1. a. Xonventional b. ❑Alternative c. ❑ 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. X Seepage Bed b. ❑seepage Trench c. ❑ seeDacle Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: mutes per inch): REQUIRED(S uare Feet): PROPO ED quare Feet): CAPACITY 1 Feet Aprivate ❑Joint ❑ Public VI. TANK Site in allons Total #of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks 1/�� structed Septic Tank or Holding Tank d®V Lift Pump Tank/Siphon Chamber ❑ ❑ ❑ ❑ VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans. Plumber' Name( int): Plum s Signature:(No Stamps) * MP/MPRSW No.: Business Phone Number: P ex's A d ess eet,Ci at@,Zi Co—de-)-0 Na of Des'gner. e M Pa H ov k i Ns VIII. SOIL TEST INFORMATION Certified Soil T ster(CST)Name `� CST#�(0,� tC CST's ADDR ESS(SCity,State,Zip C ) Phone Number: �?G �+ U1.0ky (J) S*1 I Y01 L (I )MILIP311 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) Approved ❑ Owner Given Initial '/o V`` charge Fee r Adverse Determination •� , ( / X. COMMENTS/REASONS FOR DISAPPROVAL: • �j -Av m as SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber 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 �o me 2 r e S\e_ Location of Property ) = �_- , Section T-.�2—N-R W Township JA.,.,ASp n Mailing Address Address of Site 1�P')u 1 Lax 45'1 & l Subdivision Name " Uicc f- AAA L L C)T_ . Lot Number Previous Owner of Property GC, In(,A La j nq S„s prn�j a,r;,A 4 -1 (-,-i5�-- Total Size of Parcel �: 7S A Date Parcel Was Created jc Q ;rye N '191 `] Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes x No Volume and Page Number r �o 6 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 1 (We) centti.6y that att statements on thin 6onm ahe true to the but o6 my (oun) knowledge; that 1 (we) am (are) the owneA(s) o6 the p toper ty des cA i bed in thiA in6onmaxi,on 6otm, by vi tue o6 a wahAanty deed teco&ded in the 066ice o6 the County RegisteA o6 Deeds as Document No. 7 ; and that I (We) phesentfy own the proposed .bite bon the sewage di�spos Sys em (on I (we) have obtained an easement, to nun with the above described phopeh ty, bon the constnuc ti.on o6 said ayatem, and the same has been duty neconded to the 066tce o6 the County Reg.isten o6 Veeda, a,a Document No. ) . GNSI ATURE 01 OWNER SIGNATURE 0 CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED T THM.n as anosom FORK 1—�F DOCUMENT NO. STATE 11" OF WIBOONM WARRAM DM 8r. Clio N Me W% •424127 scox 774 wv-i 166 ibed. Z. Ii day V April 87 !i This Deed, me& between L*W...of f';-IR§-1...... _AA 11 P ..................................... ......... .............................................. ................. ................... ......Grantor. _James O'Connell ............... W. ....................................................... L and..... ,14M9.0...&.1...411-0n- PIs ....go I .husband .and... ............... . :a t: U , ... marltal...pr.gpe.r ty.. .. . .... ........ .. .... ...................... . ........, Grantee, Deputy Witnesseth. That the said Grantor, for S valuable consideration...... .. I I. ....... .. ..... . I . 19TURN TO conve ys t o Gr antee the following described real esta t e i n ......St...&rvi County, State of Wisconsin: Lot Thirteen (13)9 Stewart' s Tax Parcel.No: ................................... Addition to the Town of Hudson, located in the NA of the SA of Section 34, Township 29 North, Range 19 West. This —is..n,ot...... homestead property. (is) .A ftersunto belonging, --bf it r0a.-Trust ... ....... ri . . ...... .............. .... .......... .. . warrants that t.he..title..is..good,..indefeasible..I.n..fee aim.pie..and. . free and clear of encumbrances except easetrents and rights of way of record and will warrant and defend the same. 31st Marc.h... 87 . Dated this day of GAYLDRD �,W OFFICES S.C. lkgrr SHARIM TRUST By .. ....(SEAL) C.(SEAL) ... A'.-�,-i�L. - L.G 1 d Trustee . .. ... ..... (SEAL) By ............... .......(SEAL) • Sandra Price,..Trustee .... ...... .... . AUTRZNTICATION ACKNOWLZDGMZNT Signature(s) ............................................................ STATE OF WISCONSIN ML ................................................................................ ...1)1.L .....................County. authenticated this ........day of........................... 19...... Personally came before M 06 this ... ...Mamb. .. 193.7. ................................................................................ Q.0...Its....gay.19.rd...411d. Siva.14v. % Trus.te.ca...Qf... • .?.Ay1Qia...It6i 'CA6.. ..... .......................I........ ...... TITLE: MEMBER STATE BAR OF WISCONSIN ...P.r. (If not. ............................. .............................. .....................................I............... ........... authorized by 1 706.06. Wis. State.) to me known to be the person Oi......... who-oxeculed the focago �g instrument and ack Clre THIS INSTRUMENT WAS DRAFTED BY C. L. GayLo�ro.p...Att.qrney........ .... ...... ........ ... ... River Falls WI 54022 .. ......Kar.ea..Eng.e I.......... ........... .. .... .. . ........ ... . .,.. . .I.... . . , ................ Notary Public .... ...._...Pierce .... ......county, Wis. (Signatures may he authenticated or acknowledged. Both My Commission is permanent.(If not, state expiration are not necessary.) date: .. .... July. 9............... •Nsasse of persoeu, signing in any C&Iwity should he typed or print.)Wow their signatures. STATZ NAB OF WISCONS111101 FORM Ne. 11-191131 Stock No. 13001 X °4, jy v U1, 1 IV IN ' .•:�'at- ,e: �r •.1(� ��.. � ......:3 ...aY'-. .. ." - LOCATED IN•THE„NW IA OF;THE SW 1/4 OF SECTION 349T29No ' R19W , TOWN OF HUDSON M, ST.. CROIX. COUNTY. !WISCONSIN. _ WEST 1/4 CORNER I ECTIOM 3a NORTH MINE OF SW IJ4 K4 . 29N.a 12W - �j _ NE CORIiA OF 6O N 8f'56�40•E k'RUa Oi BIRIA.00'O 494 94 ¢� 661C0 9p 31000' O W) p POINT of 40000 89a a - _ - L 3 ,• R•!0' ,., s 1A 5, t • p ,, 'y°,+ w N•n' A=111.16'14' •e w J a•BEOINNIMO - r' �� hw TEM►ORART TURN • I _ O r �y ;• '-'. RADIUS• rn ORi f AROUND TO of AUTO• t '; „r `• >r :.` a 8000_ •b 616' oe� MATICALLT VACATED UPON - - ✓ 8 A 1 i 1614• - M STREET EXTENSION '- al a �. 2 22 ACRES. _ �`z o no' Yr 170*54 33 188105'27'. p _ 2.TS ACRES ;fir it= is - r1r • •8?/ M- ♦ _ t �• I i 1 r t po 28 A I 2.61 ACRES t J, _ .. _ .9 1TO•sa'73 T/r�I 1Ivos'2T N = r 400.00' 2.OS ACRES 8 6 ► o° . Ri8f'56'40't • •nom _ _. 688.02. - " 3S4 27' • Er in a J i 12 "' •' ^ A 2 43 ACRES _ 10 2 " _ (R 6 6 1h. •�~ =�-SOAO ` 2.0! ACRES -•Op • ! •• •'� O O~• 1'1: ry^' C C,:op __•21•S OG I ; c se'w c • 6 'o .1 1 � ���--•_•- .- `\ .. O. .. �0 3.95 ACRES 6Et4.N0 •\ S S4 BSia 84'3••18l7Gi�•�E •-- `'` w'•, di Ss�1 ~� � `1�-L .. ••�-� __ .-r� . . +'r•r - ~+I�f '_- �P• 6 4.• '+= J•, t i zzC %. I t .a w G _ 0 1 u ~ �.' a a ..,• 07 2 02 ACRES OJ J c •O�♦ '- v 1 e BNEC7 '...._ 17 f•lTf7\J I �a JO• • 6 u 'LO♦ �- r N 89.36 a0 E _ .. - 1 63 ►woa[D ' • K••7•LS• ":.' f f r�•. lei.DS Qe+" �wATS•%TOR•OL T4RR X• - .. '� RUNT-osRrAr ullt 1.51 ACRES1 O/�•` `1 �� / • tea F_!�FO r e .a s • e _y' aI 1 • 'l.'... a +` O • + I t a. •, •nls 2 65 ACRES I NRUUItiv `!. a o1 O o r > >- f � • � t � :F 10 ye y �:.-w 1 EJ.SEMC•T f• 1. .� 4' TS~• '-t•a. ,e..�7 .s ±; - r :ti•i A Ti'•i.[ii[••rwt ,..+...�i:S a 9•SSaTM �Q s \ s ��aa ,+► +c Y aS�E :r-, t. o ad c s.AC -'! 3 8 0 1 t'l z s , •2 \� N• 74•7,,-e • w , o 1. L ' ■'«a r �ye` a a► 2' Slka �Ir to •, '. ;t 4 ,r.a� -,s .attic 1C saS oo a ..r, .• �j ACRES 'ii Qi rr'.."x- ,,.�� F �.�rty "t- w "� r �• �i}.rri 8 v ?� � —'• r= �~� Tw,, ol4a R •• w �$sa. 1.ri` t j .� Cag .i r r� • • � f +' � � Ebe• .++•a�'SCALE'_5i- IN 5 FEET •ti t 177.77 7!L e:''� C+ '°p' _ '^�4 3._wr3,.- i?q;" , Z� o .11+`"� cr r - • 2.S!ACRES 100 0 `•- _ 3 1.70 ACRES 00' wp . C , _ r 2 100 2 '_ • ° - - LEGEND - -` _�. ' ti /yf o "~w• d COUNTY SECTION CORNER MONUMENT FOUND.SERNTSEM CAP-1 !✓ t 0 4 - - b • -. .�- �� •_ I IRON ►1►EwEIGNING r.67rJlINEAI FT. FOUND _"`---•� ,' 4 i QD" p... 2 X 30 IRON PIPE WEIGHING S ts+•/LINEAL i T. SET O ALL OTHER LOT CORNERS STARED w1TN 1,X24,uoN PIPE • WEIGHING Li7•►JUNEAL FL .0 A• r� 1 X 24'IRON PIPE wEIGNiMO L6lO/LINEAL FT SET ON LINE s • ° NW-SW �� ■ • FENCE = - - ` ._ SW- 0 r ..� r77•Ara 1t, u r N( E. A Kft DING SETBA.^I.I of TOP FROM THE CDITER-M OP ILLL ♦ I - A t ei PUBLIC ROAD*IS ESTABLISHED FOR ALL LOT6 IN I"6U7DIVISION. _ s �` .. Lot• 1, 2, 3, 4 by Cart [1N Survey _- ♦ ♦ - N• �` , Jy!'o, e� rSBs'32w ATTED.� cn .-a , y ST C - 105 r Y SEPTIC 'TANK MAINTENANCE AGREEMENT r' 0 St . Croix County d Y OWNER/BUYER TQjy-\2'6 C;C_VXe A2 ROUTE/BOX NUMBER oar �) , f1t 7A Fire Number CITY/STATE— tJT ---Z 11, f 1 ---- PROPERTY LOCATION :'-4 , SLJ !4 , Section —, '1'aC N , R-1°!�_W , Town of �1�s� ? '�� -- _-_—, St . Croix County , Subdivision _�k ,J,fy,Lot number 13 I Improper use and maintenance of your septic system could result in its premature failure to handle wastes . Proper maintenance cun- sists of pumping out the septic tank every Lhree years or sooner , if needed , by a licensed sejLtic tank jtumLer . What. you put into the system can affect the function of Lhe Sul)Lic tank as a treat- ment stage in the waste disposal system . SL . Croix County residents mcy be eligible Lo receive a granL fur a maximum of 60% of the coast of replacement of a failing system, which was in operation prior to July 1 , L978 . St . Croix County accepted this prugram in August of 1980 , wiLh the requirement Lilac owners of all now systems agree to keep their systems properly maintained . -- -..-- ---- The pr.operLy owner agrees to submit to St . Croix County Zoning a certification form, signed by the owner and by a master plumber , journeyman plumber, restricted plumber or a -Licensed pumper veri- fying that (1) the on-site wastewater disposal sysLem 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 N to maintain the private sewage disposal system in accordance with x H the standards set forth , herein , as set by the Wisconsin Depart- went- of Natural Resources . Certification form must be completed and returned to the St . Croix County Zoning Office within 30 days of the three year expiration date . S I C N E D A'1 E St . Ctjoix C,runty Zoning Office P . O. Uox 98 Hammond , WI 54015 715-7S6-2239 or 715-425-8363 Sign , date and return to above address . DEPARTMENT OF REPORT ON, BORINGS AND SAFETY& BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION; _ P.O. BOX 7969 HUMPeN RELATIONS TcT� �i� I MADISON,WI 53707 045& Chapterl 5 LOCATION: SECT7)T27 TOWNSH P U" ICIPALITY LOT No.:BLK. : SUBDI ISION NAME: �r r4 i / r W NRq (o )W X45 � / #` � •So=�"' 5�e EVo.n ts %�dc� COUNTY: OWNER'S BUYER'S NAME: MAlLIN ADDRESS: S� C-v; ate- She i�� Ha'�.le�l,,' , Q.,.. ?�fi �e /��c�Svn' t�l5�v1 USE 'DATES OBSERVATIONS MADE NO.BEDRMS.:ICOMMERCIAL DESCRIPTION: PROF PT ONS: I N TESTS: Residence 1A , New ❑Replace / RATING:S=Site suitable for system U=Site unsuitable for system ' CmEsTIau . M .❑� IN-GROUND PRESSURE:S STEM-IN-FILLHOLDING TANK:RECOMMEND D SYSTE ( •onal) S ❑U ❑ U ❑S Co.1/e ' '�t 7 c� If Percolation Tests are NOT required DESIGN R TE ., If any Portion'of the tested area is in the /)1 under s.H63.09(5)(b),indicate: s�j ' Floodplain,indicate Floodplain elevation: /V f ; '''' • , `;PROFILE DESCRIPTIONS BORING TOTAL PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH NUMBER DEPTH ELEVATION OBSERVED EST-HIGHEST TO BEDROCK"IF OBSERVED (SEE ABBRV.ON BACK.) tl .v3'011 , 6��Bn si .S'8n sd yr� 5�. 92'Cfn B- tilt' �, 7 7 j i 7B/�L 2,56 Bn � � A� B- /02.a 3.Y�t y/7i tZ,'s li rlZoa. 4o'P, 1;OV&si I1/ /,31' �Z,/9'�ir 5t/7✓,-Y, G�iS B- /�. 0 0'�:0 7 z o 2,o t�,►s%,•s B.,s �,-, B-S' 7/7 /o1,z� ,, . i ,� •,t ,%� �:; < , � ' '`J,.fa s i Flag,lay- B- �fl �` G�ICor>,+nS a�Ttle sa- ai I-"mx 1 PERCOLATION TESTS 1 TEST D15PTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER AFTEF3SWELLING INTERVAL-MIN: PER INCH P- L ., 31/ >. l P-: 1 P PLOT PLAN: Show locations of percolation tests, soil borings land`the dimensions of suitable"soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION 9 =� T__T v L� � � 'f (tk !(` 3 I p r i 1 d 1 ollw p o 9 + I b"CIF thr) 1,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME(print): TESTS WE[E MPLETED ON: ADDRESS: CERTIFI ATI N NUMBER: PHONE NUMBER(optional): STS I AT DISTRIBUTION: Original and one copy to Local Authority,Property.Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) OVER 6 7 P L OT.. A t�, ��► �. I o S `� C T. .,. . .1��. PROJECT N ;q M E r N — N_A M E `R's; 11_ _ L° o CAT I 0 N_- .t-e.�..�_ s ..._ l_ I C; E N S_ E =f� ..,��59.___. ... P LO .1 MAP W to n ka• , x z y u + I S70 FB _ le 5►t�e N(Z v- N od1eA st i; FRESH AIR INLETS AND 013SERVATI'ON hL.P ► J CROSS SECaTION Approved Vent Cap Minimum 12" Above FINN 9� final yQ 4" Cast Iron p Above Pipe Vent Pipe To Final Grad— _ s 4 Marsh Hay Or Synthetic Cover_ i.nc t Vii ' Min. 2" Aggrcg';:1L �, Over. Pipe Distribution _..l Tee�. Pipe r Aggregate Perforated Pipe Below Vq . Beneath Pipe u < Coupling Terminating At (30 ,•, ____ _ _�__ ��__ Bottom of System