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HomeMy WebLinkAbout030-1004-70-100 \ . e \ } 0 2 � � ¢ � � \ � § } w _ f k k c k \ ! � 7 E U. 7 - � k / � \ ) \ E ƒ $ B R z § z 4 2 {� z' � � z' 8 � k � / k : a m \ $ o # e E / / E e r e = 9 E � CD 2f / ) Q ! } coz j kcok .. 'D ! .. 7 $ R L C _ $ \ � _ ) \ CL ' _ Q CL f ° 1 o a k ¢ o 0 a / < _ 5 . © co w ■ _§ % \ � a ■ _t § \ ® t � \ & % % ® ( - " a a a � - a a a 2 :3 U) 0 � 0 ■ U ; c 0) 2 � 2 CO k Lu � LU � 0 _ 2 @ � � 2 < \ 2 R % a < z m § IS ; � � g ■ 2 cc,, % � - 2 S � o � '0 ) . § c = k 2 § 6 ° ; • o c v a E % i = o \ § � ) _ @ k k k k § � ) r 2 i 0) § i e n . s z z a = 8 . D 0 - k § 2 S Co a § E E 2 ± $ m a k § g § ; ) a o 2 / 2 $ o ° o z / I k J 2 % � 2 COL © uCLZ, I � � » I ® E ] k § k 0a2 o20 U) 0 r 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,© Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Z Trench: Width: M, Lenth: Number of Lines: Built; . Fill depth to top of pipe: i Number of feet from nearest property line: Front, O Side, O Rear,Ft .�� i Number of feet from well: Number of feet from building: l_ (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 O 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: i Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: - (� Plumber on job: )4/i�./ License Number: z4az 3/84:mj Form - STC - 104 AS BUILT SANITARY SYSTEM REPORT ER QIS�;cI TOWNSHIP SEC. -�— T2? N-R W DRESS �� ST. CROIX COUNTY, WISCONSIN SUBDIVISION (/� LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of IIHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM y 4b �o I� E _ INDICATE N RTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: /aa-0__-_-- Proposed slope at site: SEPTIC TANK: Manufacturer: - iquid Capacity: Number of rings used: ./ Tank manhole cover elevation: L77 5� Tank Inlet Elevation: -�� Tank Outlet Elevation: Number of feet from nearest Road: Front,O Side o Rear, feet From nearest- property line Front,O Side,n Rear,O feet Number of feet from: well _ building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS a LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS BUREAU OF PLUMBI P.O.BOX 7969 NG MADISON,WI 53707 NW-4,NWI� Ip�• , S2,T29N—R19W KICONVENTIONAL El ALTERNATIVE State Plan l.D.Number: I l f assigned Town of St. Joseph ❑Holding Tank ❑In-Ground Pressure ❑Mound CITY Road F NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: J� Richard Olsen Jr. Route 2, Hudson, WI 54016 11-.07 BENCH MARK(Permanent reference paint)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF.PT.ELEV.. Name of Plumber: MP/MPR SW No.: Cou 102831 SEPTIC Croix Sanitary Permit Number: Calvin Powers Jr. 1563 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIOUID CAPACITY. TAN INL T ELEV TANK OUTLET ELEV.. WARNING LABEL ILOCKING COVER 0 0 x/to ' I 70 PROV DES: PROVIDED. (� � qy�• / YES ❑NO DYES !ONO BEDDING'. VENT DIA.. VENT MATL. HIGH WATER NUMBER OF ROAD PROPERTY JWELL: 11111EDING. VENT TO FRESH C1 ALARM FEET FROM 0 0 LIN O S S 3 Z AIR 1=LET DYES O ❑YES NO NEAREST DOSING CHAMBER: MANUFACTURER BEDDING. LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED: PROVIDED. ❑YES ❑NO OYES ONO ❑YES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM uNE AIR INLET PUMP ON AND OFF) —]YES NO NEAREST SO IL ABSORPTION SYSTEM.Check thesoil moisture at the depth of p'Ow ing 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: WIDTH LENGTH. NO.OF DISTR.PIPE SPACING COVER JINSIDE CIA -PITS LIQUID BED/TRENCH 1 a "'}? TRENCHES ! r MATERIAL PIT DEPTH DIMENSIONS l ( � l/O GRAVEL DEPTH FILL DEPTH DISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO—I R. NUMBER OF PROPERTY WELL. BUILDING VENT TO FRESH BELOW PIPES ABOVE COVER E V IN LE ELE V.END'. c; PIPES LINE A15 INLET / ` 72 / FEET FROM 2 I 5(0 13 2 1 3 2 (ptt 28 133 : NEAREST—i I MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain'that it ON REVERSE SIDE.SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. ❑YES NO SOIL COVER TEXTURE PERMANENT MARKERS ` OHSEH VATION WELLS DYES EINO ❑YES ONO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED SEEDEI ,L] MULCHED CENTER EDGES. OYES ONO Y ES ONO DYES El NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LENGTH. NO.OF LATERAL SPACING GRAVEL DEPTH BELOW PIPF. FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE IMANIFOIDMA TIRI AL NO DISTR DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MAHKIN6 ELEV.. ELEV.. DIA. ELEV.' PIPES DIA.. ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL PLANS VERTICAL LIFT CORRESPONDS TO APPROVED DYES ONO OYES ONO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS. NUMBER 01 PROPERTY WELL: BUILDING: FEET FROM LINE DYES ❑N YES ❑NO NEAREST L Sketch System on unty file for audit. Reverse Side. V SIG NAT ITLE. Zoning Administrator DILHR 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; Itl. 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% 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 included the creation of surcharges (fees) for a number of regulated practices which Wisco ii 1'S can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried reAsure is used in your building is returned to the groundwater through your soil absorption system or the disposal site used by your holding tank pumper. The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- t water, 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 STATESANI'/?(-)/ , —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. —See reverse side for instructions for completing this application. ' PETITION [5K II APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES ILu NO PROP RTY OWNER PROPERTY LOCATION '/4 '/4, S , N, R E (or) PROP TY WNER'S MAILING ADDRESS LOT NU ER BLK BER SUBDIV ON NAME i - CITY STATE ZIP CODE PHONE NUMBER EJ CITY NEAREST ROAD,LAKE OR LANDMARK El VILLAGE : 171 TOWN OF: II. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family. OR ❑ Public(Specify): 111. PURPOSE OF APPLICATION: (Check only one in#1. Check#2,3 or 4,if applicable) 1. a. 4 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# d°�y Q 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. XConventional 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. ❑See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: inutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): ❑Private ❑Joint El Feet VI. TANK CAPACITY r Site in allons Total #of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank Lift Pump Tank/Siphon Chamber ❑ ❑ ❑ ❑ VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation ivate sewage system shown on the attached plans. Plumber' Name(Print): PI ber's Sign ure• o to s) MP/MPRSW No.: Business Phone Number: um er's Address treet,Ci State,Zip Co Name of Designer: Vlll. SOIL TEST INFORMATION Certif' d SO it Tester ST)Name CST# C I DDRESS Preet,Cit 9tal e,Zip Code) Phone Number: 3 A& - IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved S nitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) rcharge Fee NQ Approved ❑ Owner Give nInitial '�^, Adverse Determination lJU d 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 INSTRUCTIONS FOR COMPLETING FORM 115 - S6 3 - 6395 To he a complete and accurate sail test,your report must include: 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 3. MAXIMUM number of bedrooms or eomrraereial use planned; . Is this a new or replacement system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6 PLEASE use the abbreviations shown here for writing profile descriptions and completing the pleat plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A separate sheet may be used if desired; £3. Make sUre your benchmark and vertical elevation reference point:are clearly shown,and are permanent; S_ Complete all appropriate hoaxes as to dates, names,addresses, flood plain data, percolation test exemp- tion, if appropriate; 10 ff the information {such ras flood plain, elevation}does riot apply, place N,A,in the appropriate box; 11, Sign the form and t,lace your current address and your certification number; 13. Make logible copies and distribute, as re<luired. ALL SOIL TESTS MUST BE FILED WITH THE 1_C)CAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS So"ss Separates and Textures Other Symbols s Stone (over 10") BR Bedrock coin -- CFobbie (3- 13") SS -- Sandstone gt, — Gravy=,I (tinder 3") LS Limestone s Sand HGW — Nigh Groorndwatei CS f curse Sastcf Perc - Percolation Raton mw"Cl - Medium Sand Vi l - I_oarny Sand _. Greater Than sl _ Sandy Loam < Less Than ,! .._ Loam Bn Brown i! _._ Sil* Loan B1 --_ 13iaa k si Sill Gy -- Gray mac;( - ti lay° L.oar a Y _ Yello?vv s<I .-.. Sand,/ C;l<ry Loam R _ Red sicl -- Silly Clay Loam 11-�ot — Mottles ;;, Sal!dy clay v,' witl, tic -- `iilty Clay fff f,vv, fine,faint Y +^ C; ._... illy cc — conlman,coarse Ill Peat min ._ Many, niediUM nF — Mrlck d - distinct p prominent HWL — 1-figh ev,ater level, Six general soil textures surface water for liquid waste 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 rout e.St verification of this soil test in the field prior to permit issuance, A complete sat of plans for the private sowage systetr and a permit application must be subrilitted to the appropriate local authority irr order to obtain a pf,-"nnit. file sanitary permit must be obtained and posted prior to the start of any construction. DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 HUMAN RELATIONS MADISON,WI 53707 } (H63.09(1)&Chapter 145.045) LOCATION: SECTION: T N IP/M NICI ALITY: LOT O.:BLK.NO.: SUBDIV ION NAME: / N/R E (or '. ` ' COUNTY: N R'S BUYER'S NAME: MAITLING ADDRESS: USE DATES OBSERVATIONS MADE NO.BED MS.:ICOMMERC AL DESCRIPTION: (PROFILE DESCRIPTIONS:1PERCOLATION TESTS: OResidence ! 56New ❑Replace RATING:S=Site suitable for system U=Site unsuitable for system s J CONVEccNTION'AIIL: MOUNT IN-GROUNND-PRESSURE: SYSTEccM-IN-FI LHOLDIlcN`G ANK:RECOMMENDED1SYSTEM•(optional) ®J oV Z! �� NS E1U EIS ZU EIS LAU I f If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b),indicate: S Floodplain,indicate Floodplain elevation: PROFILE DESCRIPTIONS T BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH NUMBER DEPTH t1q. ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- - 3- B B- a / , ,l B- , B-,3 2141fdw Is PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PER1003 PER INCH P- P_ b P- 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 a Rer?,nt of land slope. �` -e) ��� IL SYSTEM ELEVATION e, 9 _TT- _. ",Ii&o ✓� 1, i - ( - 9G! - _ � _ u _ '�N ' E ' € € € 1 �Q... - i _ ...,.-i �_._ _..m.... .�.._.,... + � c i � G S 1__.AL,._ _ _ tI,the undersigned, hereby certify that the soil tests reporte on this form were made by a in accord with the procedures and methods spec fied in the Wisconsin Administrative Code,and that the data recorded and the loc ion of the tests are correct to the best of my knowledge and belief. NAME rint) TESTS WERE COMPLETED ON: - y AD CER (CATION NUMBER: PHONE NUMBER(optional): CST AT R DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) —OVER — yO �� v G Srie 7 �v�Srd erg / 411"'1 40 ///,P/Sto /sals �P39 �9s9 76 ,3e` h%us� PAGE OF I Cr o Sy 1 n-) l/ Fresh Air Inlels And Observation Pipe — j Approved Vent Cap I q �_/�-f� Minimum 12'Above Final Grade 20-42"Above Pipe _4"Cost Iron To Final Grods Vent Pipe Mash May Or Synlhelle Covering rain 2"Aggregate • Over Plp• Dlsulbutlon —Tse Pipe 0 0 0 0 0 Be neath Pipe Aggregate o Perforated Pipe Below Beneath —Covoing Terminating At Bottom Of System SOIL FILL DISTRIBUTIOVI PIPE APPROVED SsjIJPETIC COVER ATE 14- OR 9" OF STRAW ZN OF gGGREGAIE -�� c o 4R MARSH HAy p� to OP 12-zl/2 AGGREGATE T.LEV. OF FEET, r / DISTR19UTIOQ PIPE TO BE AT LEAST c-2 INCHES BELOW ORIGIMAL. GRADE AAIU AT LEASTZO INCHES BUT KIO MORE THAI) H2 IMCNES BELOW FILIAL GRADE MAXIMUM DEPTH OF EXCAVATiop FROM OWMAL 6KAK WILL BE - - INCHES MNIMUM W" of EXCAVATION FROM 01�14IWAL GR49E WILL BE _ INCHES SIGUED: C44 LICENSE. DUMBER: i DATE : _Zz7"1 -1597 I 110 j LLJ d C C L O_ C N i N M O O 'E 'N� N N y O C N N C d C GO o ° m.� > a o f 0 0 0 „ a a a > M > a 0 -° ° cQ ° °'E E A W r U N C Q N Q C E O ° L O•� > O _ �� N = y N �o ` LN Z >O , m a c Q a wZ v E N a 3 m Ea a o.—°� a v w � Eo cr _H ° O E E E • d� O aN > 'O•wL `yt c 7 a 7 n 7 m N m In .0 'C > OO C O " Z L.. > N /t\ w C N .a.D w \V\ ui �"� d « ; y E 3 c. " u c m 01 " E c m m c y m E � d d N 3 O OC w o - ° ` E m ° c a ° Q w ° N a� �� � w 2 E U E �•n� 7c �0 H �? w d o� ov :° T,- ° � � ° E :°'a 30 a a �w w N O ~ U C O U r m ~9 - Q W _ _ z V N Ol C s W cl z w m z O U z � z � LAJ O o J p C) C) LAJ > z z 9 LJ Cr 4:9 E35 Q D O D Z ` U) cr_ 41-- LLI o w i b Q ? _ O o m LL w J U' m w w = � Ir > x w o , rm= I w O m w w m z O z p CUD m D z = CL O C Q E-- i ST. CROIX COUNTY y ,: . k � WISCONSIN ti �sr , ZONING OFFICE .. 4 XSwSy�,� F. Yx c�_,,rX1 796-2239 (HAMMOND) i 425-8363 (RIVER FALLS) HAMMOND, WI 54015 December 2, 1987 Ms. Vickie Smith Sanitary Permit Program Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 Dear Vickie: Permit No. 102831 replaces permit No. 102800. The reason for the new permit is that the septic system needed to be moved to a different location. If you should have any questions regarding this matter, please feel free to give me a call. Sincerely, J Roxann Croes Administrative Secretary DEPARTIyENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS DIVISION LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS BUREAU OF PLUMBING P.O.BOX 7969 MADISON,WI 53707 NW%,NW,4,S2,T29N—R19W CONVENTIONAL ❑ALTERNATIVE state Planl.D.Number: 11f assiflnedl Town of St. Joseph ❑Holding Tank ❑In-Ground Pressure ❑Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Richard Olsen Jr. Route BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN'. REF.PT.ELEV.: CST REF ELEV. .PT. . Name of Plumber: /MPR SW No.: County Sanitary Permit Nu r.mbe Calvin Powers MP 1563 St. Croix 102800 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV._ ROVID DLAB L pROVIDEDOVER []YES ❑NO DYES ONO BEDDING: VENT DIA.. VENT MATL. HIGH WATER ROAD: PROPERTY WELL'. BUILDING. VENT T E FRESH. NUMBER OF LINE. (AIR INLET JALARM FEET FROM OYES ❑NO OYES ONO NEAREST DOSING CHAMBER: MANUFACTURER BEDDING. LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER PROVID DLABEL PROVIDED OVER OYES ONO ❑YES ❑NO DYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PROPERTY WELL BUILDING VENT LE FRESH LINE AIR INLET (DIFFERENCE BETWEEN FEET FROM PUMP ON AND OFF) 1:1 YES 0 N NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH uiAMETEH 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: WIDTH'. LENGTH. NO.OF DISTR.PIPE SPACING. COVER INSIDE DIA ii PITS LIQUID BED/TRENCH TRENCHES MATERIAL! PIT DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH JUISTN PIPF DISTR.PIPE DISTR.PIPE MATERIAL: NO.DISTR NUMBER OF PROPERTY WELL BUILDING' V NT TO RESH BELOW PIPES ABOVE COVER. ELEV INLE7 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 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. OYES El NO SOIL COVER ITEXTURE PERMANENT MARKERS OfiSEN NATION WELLS ❑YES 7NO E YES ENO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL S MULCHED CENTER. EDGES. ❑YES ❑NO ❑YES C�NO YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH LENGTH NO.OF LATERAL SPACING GRAVEL DEPTH BELOW PIPF. FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL NO DISTR DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MAIIN6 ELEV.. ELEV.. CIA. ELEV.. PIPES CIA.. ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING GRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS ❑YES ❑NO El YES El NO COMMENTS: PERMANENT MARKERS: OBSEHVA I ION WELLS: NUMBER OF LRNE ERTV WELL: BUILDING. FEET FROM [11 YES El NO OYES 1:1 NO NEAREST Sketch System on Retain in county file for audit. Reverse Side. TITLE SIGNATURE. i Zoning Administrator I DILHR 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; 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; 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 included the creation of surcharges (fees) for a number of regulated practices which Wisco iK1t;"i' a can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried reasure is used in your building is returned to the groundwater through your soil absorption o system or the disposal site used by your holding tank pumper. The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- t water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398(R.03/86) � �ILHR SANITARY PERMIT APPLICATION Cou ��o In accord with ILHR 83.05,Wis.Adm.Code STATE SANITARY PERMIT# /Qa —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. —See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES ICJ NO PROP I OWNER PROPERTY LOCATION IqZ , N, R E (or PROPE�VJER'S MAILING AD RESS LOT NUM ER BLOC NUS BER SUBDI�ISIO! NAME CITY,STATE ZIP CODE PHONE NUMBER 7n CITY NEAREST ROAD,LAKE OR LANDMARK �tfcSG f- o/ ` VILLAGE :TOWN OF7 II. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family OR ❑ Public(Specify): III. PURPOSE OF APPLICATION: (Check only one in#1. Check#2,3 or 4,if applicable) 1. a. 1W 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. 19 Conventional 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. m Seepage Bed b. ❑seepage Trench c. ❑ seepage Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6.-WATER SUPPLY: (Minutes per inch): REQUIRED(Sure Feet): PROPOSED(Square Feet): Feet ®Private ❑Joint ❑ Public VI. TANK CAPACITY Site in allonti Total #of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic per. INFORMATION New xis A sting Gallons Tanks Concrete strutted glass App. Tanks Tanks Septic Tank or Holding Tank A?Sll" La ❑ El Lift Pump Tank/Siphon Chamber 1 ❑ ❑ ❑ ❑ VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's qfime(Print) Plu tier's Signatur :( Stamp MP/MPRSW No.: Business Phone Number: P umb is Addre ( treet,City tate,Zip Code): Name of Designe VI 1. SOIL TEST INFORMATION Certified S ester(CST)Nam Q CST# CST's ADD E ( et,Cit , ate,Zip Code) Phone Number: IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved S nitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) Approved ❑ Owner Given Initial r L1 rch�a�rgg Fee Adverse Determination �� "-'� C7U+ X. CO ENTS/REASONS FOR DISAPPR VA : SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,OwnertiPlumber r APPLICATION FOR SANITARY PERMIT STC - 100 his application form is to be completed in full and signed by the owner(s) of the roperty 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 --�{ 10-d&4�^��`.�,� Location of Property , Section , Tijl N-R J6, W Township Nailing Address —c f, p E Address of Site t Subdivision Name �r Lot Number 1 Previous Amer of Property Total Size of Parcel ;�• '``�' � � Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes _ No Volume -1_16.2__.. and Page Number , _57 % 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 T (Wel ce-Ati.6y that art Ata.tements on thus 6onm cute .tAue to the but o6 my (oun) hnowtedge; that I (we) am (ahe) .the ownen(,s i o6 the phopehty ducAi.bed in .thiA .in6o4mati.on 6o&m, by viAtue o6 a wa�vcanty deed iceconded in the 066ice o6 the Cocuttyg Reg usteA 06 Veed�sa3 Document No. S -; and that T (We) pne�sentty sun ! e pnoposed s.ete bon the sewage dispo sye em (on I (we) have obtained an ea.a tmEnt, to Run with the above dens cAibed p)topeh ty, bon the eon.6tAuc Lion o6 said ,system, and the same has been duty neeonded in the 066.iee 06 the County Regi,6ten o6 Deed&, ab Vocmen t No. ) SIGNATURE 00 OW66 SIGNATURE OF CO-OWNER (IF APPLICABLE) 41E SIGNED DATE SIGNED DOCY?AENT NO. WARRANTY DEED THIS G►Act RzGz*VSD rog"Ww4womw "TA 9�4 STATE BAR.OF WISCONSIN FORK 2—1M OMC& , ,: 87 ST. C"x Co.* ww Richard L. Beer and Philippine U. Beer, '*C'd- for R*Wd *b 31st July ..__,hj19tbAnd_and_Wif_e...as—ictirit..tenants............................. r4ay 01 ��M jp86 .................................................. ............•....................................•....•. a 8:30 A ........... ..................................................................................................... conveys &4d warrants to ...Ri..ch...a.rd Arnold Olsen, ................... ....... Laurie Jn Olsen., --hq.*b 4AC1... ............. .arital. P Kqqg�FgyA...Wj.t . ra.urvi •i ... ........... ..........I...................................................................................................... ................................................................................................................ ................................................................................................................. RETURN TO ................................................................................................................. ................................................................................................................. ... tbo following described real estate In .......St..-.CXojX............ ... .. u Co, Uty d State of Wiseqnsin'. Tax P"No: ................. Part of the Northwest Quarter of the Northwest Quarter (NA of NA) , Section Two (2) ,, Township Twenty-nine (29) North, Range Nineteen (19) West, described as follows: Lot One (1) of Certified Survey Map filed April 14,, 1986, in Volume "6" of Certified Survey mme, page 1644, as Document No. 410848,, SEMJECT to an irrigation easement over the follmdm parcelt Ccmwmirxj at the Southeast corner of the above described Certified Survey No thence North 890 351 540 West, 150 feet to the Point of Beginning; thence South 89* 35' 54" East, 150.00 feet; thence North 00* 331 43" East, 300.00 feet; thence to the Point of Beginning. This _.1s...nat......... homestead property. (is) (is not) rwomptim to warrantisp: 28th 96 DAtedthis .................... ................... day Of ..........................g141 A y................................lie........ �.........(SEAL) Richard L...........I............ Beer....................................... Rhiliypine,..Ua...Beex.................... . ................................................................... .......................................... ................(SEAL) . .................................................................. ...................................... ........................... AUTHNNTICATION ACKNOWLISDOMBNT STATE OF WISCONSIN Philippine U. Beer .County. ------------"....................•-•..C authen 28 ... ... . ................day Of ted this, ....day of.. July........ 19... Personally aa= before me %_� ..........................................# 19........ the 111ban avow .. ................... HendrikW. Van Dyk ................................................................................ ................. ................................... ..........................................................................e..... id �u �;c TITLE: MEMBER STATE BAR OF WISCONSIN ......................................................... ...................... ——---------- ------------------------•--------__________-____________-____ •-------. ____-___ xQ6h0*"4y_&goo -w3ll.4"616). to me known to be the person ............ who executed the foregoing instrument and acknowledge the same. MENT WAS DRAFTED BY VanDyk & Needham, S.C. .................................................................... ........... at--taw- ---_.----•-•----•-••--*-------------- * Rd.,...Wi5C.QnAinL._...5 U.17 0.127 Notary Public ..........................................County, Wis.autheistluted or acknowledged. Both My Commission is permanent.(If not, state OT141111140110 date: ..... .................................. ............... it........ in Say aeggelfW"ould be typed or printed below their Gisnatur". BTATll! 'R WISCONSIN — IM � Rat /1 C q �wwv ag1986 j�� 111188 CERTII ED SURVEY MAP LOCATED THE NW 1/4 OF THE NW V4 OF SECTION 2, LECEWD T 29N,F ?$,TOWN OF ST.JOSEPH ST.CROIX COUNTY w WISCONSIN �BECRT�t ON ENCOCAP N� r � SURVEYED FOR: RICHARD BEER 0 i"X 24" ROUND IRON FIT. 2 PIPE WEIGHING 1.68 LF NW CORK HUDSON WI. LIN.FT.SET _ SECTION 4 ►-ti /i T29N.R19 00 � r� / SCALE IN FEET (1"2100) a V) 0 100 200 300 r. I W � N�1P 1 1 o °" ��G 1376' HudsA 10- q C.,�w $u Z� in / �•2�' •4 b �tnhoss�A o, O 0 > 0 0 cd �1 4 � � owcd � too w 4.1 a 0 al u ^ . v U :ia) rno � a� a h,6g E-c O M N 44 a '*—POINT f BEGINNING N 44 y 0 O m� 41 V cd cd cd p. Ln old N U N N 00 CM c M to•' rd M Q t /1 o f o V `�-`r , j, z o y J� ) � � M V V / = y _ M W 0 W 1 'LOOT 1 1 z �b M o _ r oo 0 a j 130696 SQ. FT. 't W 0 c��n V 'u 1 3.¢O ACRES 1 E-- '� M M z 0 i r Z( EXCLUDING R O)W. Q( a O 0 O M V O • .. a LY +� V U) o �'� " 00 14$557.S0.'FT. y Z I (� a w 0 in in y` w w N 0 -- m Z (d M O a) O 3.433 ACRES W cd. N 00 H O Z A �� INCLUDING R.O.W A .� O U0 V .O 0 V cd .rj WOE ^ Z - � p cd Z z ON '-' �4 NQ y 4j k z 4� d' O V +r 0 H o •0 U �T N 80 N cd 4• , z .>7 0 V O k m O cd .; cd 0 0 � cd 0 z o� `� 4 OVA `d �H J .-r w 4.+ y w +j - b +~ 0.w 0 0 0 I •M 0 ­1 U) 0 N y`O `G ON 4, W . i m O 04.04 o M.00� w ti >i 44 0 c � ° � K i 35.84 w o o � y.w ^ • V +13 +' cd Oc �1 Q) rn0341 000 NPLATTED _LANDS V M w Zi e� w ' APPROVED 040 0 00 "d � 3 j 0 a °n W I/4 CORM �iPf� 1986 H cad 1 d' 's Z a v �1. : ; I;It Volume 6 Page 1644 ' CUrA{'b't+ILt` it/,'lrHNG u�c zo+lu c� cc,rn,:.orlcc 485-895 I, James E. Rusch, registered Wisco in Land Surveyor, hereby certify to the best of my professional knowledge understanding and belief, that I have surveyed and mapped the above descry: -d property; that such plat is a true and correct representation of the exte -)r boundaries of the land surveyed; and that I have fully complied with the -ovisions of Chapter 236.34 df the Wisconsin Statutes, the St. Croix Cou Subdivision Ordinance and the Town of St, Joseph Subdivision Ordinance. � � `� !'% !% 1115 s idimes E. Rusch S-1376 �. /�usch Surveying, Inc. JAMES E. RUSCH " 407 Second Street :yt S-1376 Hudson, Wisconsin 54016 to Hudson, October 2, 1985 whL �O�.t This map is hereby approved by the Town Board of the Town of St. Joseph Date Carolyn Barrette, Clerk Volume 6 Pa ;e: 1644 C 4 t-r z cn H ST C - 105 r 9 H SEPTIC TANK MAINTENANCE AGREEMENT o St . Croix County z d 9 OWNER/BUYER ROUTE/BOX NUMBER Fire Number CITY/STATE h(UASurX (,t1 z o ZIP -.5- PROPERTY LOCATION : , Afi) Section_, T, ? N , R _W, r Town of � Y,�-:,; � ,/ , St . Croix County , Subdivision , Lot number. Improper use and maintenance of your septic system could result in its premature failure to handle wastes . Proper maintenance con- sists of pumping out the septic tank every three years or sooner , if needed , by a licensed septic tank pumper . What you put into fI the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St . Croix. County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1 , 1978 . St . Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained . The property owner agrees to submit to St . Croix County Zoning a certification form, signed by the owner and by a master plumber , journeyman plumber , restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary) , the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. Ho E I/WE, the undersigned , have read the above requirements and agree Ln to maintain the private sewage disposal system in accordance with x H the standards set forth, herein , as set by the Wisconsin Depart- ro ment of Natural Resources . Certification form must be completed and returned to the St . Croix County Zoning Office within 30 days of the three year expiration date . / SICNED �1 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 . il`W 51 RUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 ' I: ,:ruri.pL it, ,1nil accu1AIII 5U ii 1F�s;t,your 101)011 1nuSt include. i. Coinplete legal description; TII,r use,,;t c:tioi; rru.ist ch!"- ly Indicate whether this is a residence or commercial project; 3. Pf AX.IMUM slumber of hedroorns or coounercial arse planned; �. Is this a new! or replacement system; the suit;rl,,lity Fatima Nixes. A SITE it SUITABLE FOR A HOLDING TANK ONLY IF AL-4. i 1I,I 1� Sr'.`:11 Nis Allf; Rtf) [O t;IUT BASE 1) ON `OIL CONDITIONS; t'. I" [- Sf- F1,i, shuevn here to! vrritinll profile desetiptionsand completing the plot plan; 1 I)i!AKf A I FC ;Rt.F rliarnarn acrtirately locating your test locations. Drawing to scale is preferred. A 1,;:':- 'u,i'y0ty JW4 101 i•lrk 31111 VLl licll gli?Viih!in ich,wncr, point are clearly shown,al'1C1 are permanent; ,all alll'1o1)i iare hov,II. .lti to ri�ur,s, Itsirili:=,, <uidre,sses, flood plain data, percolation test exemp- t ("'W:It �t<. ju.,ICl 111ain,v!evmion;do's rlbi,apply, place N.A. in the approt)rla'te box; I r r i 1'w iwnl �ifid 11; u.,. your Clirrl_'nt I,ulrlr S arA YOM dart iicazion number; iV,11"I" conic-; ;and di;>tribrlts. as recitore(l. ALL SOIL TEST'S MUST BE FILED WITH THE - Y Vvi i I IIN, if) LiJ;'r;i 0I COMM ETION. ABC14F`J AT"IONS FOR CERTIFIED SOIL TESTERS op Other Symbols ;;i ti it BR Iicdrock C"sl�1 10 1 SS Sandstone ai -- 1313'dt.i ii.�ilCidi ") LS -' Liimstune 's Sar)d HGW - High Groundwater Ft^lr _. 111a,colaliorl Bate Bldg 6,111diny _- L.)arla Bn .- Brown si! S lr Loam BI Black si Sill: Uy - t uev `cl Clay Loam Y -- Yellow S'Itiliv Cla, Crum B Rtt d C:ltai, 11,0ottt moi Nlotdes 3 mdy flay vV wrlh Silty Clay flf -- few, fine, faint - is k!y cc - common, coarse pi feat min Many, rnedium 111 A - distinct 1) hrvrninent HWL. - High water level; c qewl ral soil lvxtarw> suriace water !o! litliiid_otaste disposal BM - Bench Mark VRP -- Vertical Reference Point `tT 111`7 t;lI-NN :_F'; A i „ tE,'I.),tf? is the X11 "A,!F1 in t;(wilrflly a Etfflililly [)VIVIlt, IIII! C( LUAU 0, it)(" l)r;l)�1;lint ;:,I.l:_y1i'.0;UR;r .I<„ lif:iC{ Oiltlr ;t7 f)P,q fYiit f°;St.L1tiC f:� .'4 t;(1li11)If Ti. S;:Ii (A I'(.d.y i( S� 'lea s "It'i d t'rxrillt b" ,ilhnlitti:d to thzt %i,11)P.(3i?.li�' i4t181 tj•l -relit iiV i.. I,iiI to i.ift 0,:,i tA ... 1 L At w 0 EPr:S'i'K l-i�ir �s: REPORT N + BORINGS AND ,.�f cr�,' � r3�DIVI NcN UM AN R? w PERCOLATION TESTS (115) MADISON, WI 53707 f-it#r4+I�'>;i�I i;tEL?,7IC`��D�S (1-163.090)&Chapter 145.045) �Cflf A3°(aY� k �TtC1tV} rOWNSH! � 4Ui�1ff{f'FtLf'fY: l7TNO.:BLK.NO.: SUf3f31Vi510Nf+fANi�_ )74�wftrl�4 ! Ni 116, for ; J !^� �pt&;%c &to C- 'S •M r�-VK0T'S7h r I'S NAME:� IAAI iTv fii -W f ) _ DATES OBSERVATIONS MADE ION, New rRepiacs ` EAt. /k, a°S i T�CA"2ii��S lP'58 ES8 —_,___ . ... S ,,J Sol ,a SC `5C'?4:-' �rsR+c►tA�t>`t' RATING:S-Site suitable for system U-Site unsuitable for system '5>)6 S4T_T11Zk (DNV�.t �ltil�,: MC)IJND __..,.w IIiI-UffCCt�A'�tl" ra�E:l4�f-M1d-f�S� i.. CiLfllldtif Tfia7tifC:RECQMMENDED 5Y57EM:(op nail It Petcwr------ Tests ore IdA1 €muu+watt I' SItxN RA t It my portion of the tested area is in the tun to s.if r i alfN,iodimile, + n A r 1°Jiupd mire nciacata Tlr; pia+{�eieva.+=sn. A P R{)F1 [Dr-SCRIPTIONS B—OR ii+i AL N Fi- AC 0 IL'W H TH fCNESS',Cf)LDR,TEXTURE, AND DEPTH NLW Efd ELEVATION TO BEDROCK IF OBSERVED(SEE ABBRV,ON BACK.) G Step a-r�.9` t L c�.g—a. �ivp �/5 IGtah e ! 49,b Aim � 7. L ZA-7.5 ,�.� �,.�. 91.61 t K- '. $•71J foot Ct.46;kC61aC,- 3.3-6 �'i+.td �t�i� t�•2-R.Z. S /66.4`7 Noss i$. a�s> r� �.! "$� L f.l-Z,Q' $e�15�L ealn 7.4-4 7 cS cc�±LO•�� ^ 0-1.0 9LL fe.a'S,L e*4 Sf61z +-1 fah E# PERCOLATION TESTS DEPTH WATER IN PUI. TEST TIME RA-IE MINU,',t ES NL113i3 ref T , tNEL1 iN flit tiVAL fMIN. PER INCti P '' �4 firxrtA t0,° _._..-I3. M,_ f ten w 1C TWA W 5 S► �50tf� -,•e A h4 'LOT PLAN. Show locations of percolation tests, toil borings and the dimensions of suitable soil areas, indicate scale or distances,Describe what are the hori rental anal vertical ttle+rstion rrofetyan o points and show their location on the plot plan. Show the surface elevation at all borings and the direction and 1wrC0111 A lartd stopvl, 300'f 'To 'i of CT14 "E" SYSTEM ELEVATION 94.3x' Ck a 0 i I efi P�t r"► 12 A t✓csrrc,sY j a , .+.i<9 .d'�rrwrr 4 �)' V• E ; t ..� $ �r, R N rsc ;z1 140,.g 'V 1 ^J g !t /st►N Oil ! z 4. !r s+ - .•:-------'tea{ L �JRc ra,b 7R { iA f the undersigne9j.horeby ttertlfy ttw'tfte so letrts reoortttd on this form were made 'y me In accord with the procedures and methods specified in the Wisconsin 1kdmin ttrstive Code,and that the data rot tirded e-4 the location of the tests are corra to the best of my knowledge and belief. _T R COMPLETED ON: Z'2 /' 818 CERTtP CATION NUMBER: PHONE NUMBERloptionai): CST SI URE: r• z Or; iel sad one copy to Local Authority,Property Owner anti Soil Tester. �s rte, I X/ zu ILV r ZZo`!�� IX,1-7 i _ a c 1 Ir PAGE OF CrU SY5S en"} Fresh Air Inlets And Observation Pipe ( APprovsd Vent Cap Minimum 12"Above Final Grade 20-42"Above Pipe _4"Cast Iron To Final Grade Vent Pipe Marsh Noy Or Synlhetle Covering Min 2"Aggregate Over Plpe I Oletrlbullon - Pipe 0 0 0 0 0 —Too 6"Aggrsgole 0 Peftaraled Pipe Below Beneath Pipe o —Coupling Terminating At Bottom Of System _ 1gre,cl< / C?I) SOIL FILL DISTRI13U'T10" PIPE S4jNTu • APPROVED ETIC COVER ° ~—MNTr.RJtj. OR 9'. OF STRAW r OF AGGREGATE —�� OR (MARSH HAy ° le OF Zi/2 AGGREGATE ELEV. OF-5K� FEF-T F C1, DIS-rRIgJTIr-)M PIPE TU BE AT LEAST _ 11JCHES BELOW ORIGIAIAL GRADE AkJL) AT LEASTZO INCHES BUT AIO MORE THAtJ H2 IAICHES BELOW FINAL GRADE MAXIMUM ®EQrH OF F-XCRVATIOM, FROM 0KIGINAL 6KADF- WILL BE INCHES M01MUM ®EPrtt OF EXCAVATION MOM cIKI4INAL GR49E WILL BE INCHES SIGUED: LICEUSE DUMBER: ' DATE : 110 Parcel #: 030-1004-70-100 01/30/2007 11:19 AM A ` PAGE 1 OF 1 Alt.Parcel#: 02.29.19.22D 030-TOWN OF SAINT JOSEPH 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 PATRICK C&LAURIE J TR COLLOVA O-COLLOVA, PATRICK C&LAURIE J TR 715 W SHORE DR SOMERSET WI 54025 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description *705 CTY RD E SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 3.433 Plat: 1644-CSM 06/1644 SEC 2 T29N R19W 3.433AC LOT 1 CSM 6/1644 Block/Condo Bldg: LOT 1 EZ-UT-1531/413 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 02-29N-19W Notes: Parcel History: Date Doc# Vol/Page Type 07/24/2003 731803 2329/137 WD 1201/321 QC 924/76 748/567 2006 SUMMARY Bill#: Fair Market Value: Assessed with: 168505 328,500 Valuations: Last Changed: 07/07/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.430 80,700 204,300 285,000 NO Totals for 2006: General Property 3.430 80,700 204,300 285,000 Woodland 0.000 0 0 Totals for 2005: General Property 3.430 80,700 204,300 285,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch#: 216 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ej G 1 2, 1 .14 x986 GN 10848 a •,° � CERTIFIED SURVEY ' MAP LOCATED IN THE NW 1/4 OF THE NW V4 OF SECTION '.2, LEGEND N T 29N, R19W, TOWN OF ST.JOSEPH ST.CROIX COUNTY WISCONSIN SSERNTON CORNER W N , SURVEYED FOR: RICHARD BEER 0 1"X 24' ROUND IRON W RT. 2 LINE WEIGHING 1.68 LBSi ET 3 NW CORNER HUDSOR.WL, W SECTION 2, ►=-a /I T29N,R19W °o / v u t ( SCALE IN FEET (1"2100) Z n 0 100 200 300 o tgei;ilDltO�. E A S co 0 W O' N : � 1316 c �uNi / 1 1 Hudson, s Q' 0 ML per. ml ZI-N / - �n1.2� •� � � � ttlitt%t I N 9 U0 U � u O 0 r+ 0 O a) 0D w :N .0 - ..14 � G4 0 4) u a 00 -: O v zU on NLc , °• 'ma • M W—, O ,O O N N td O LO E- O cd N +' N 4) 0� ptn_ 4 N� 'Q O 4 � O CO n • / ;,"*-•POINT OF BEGINNING `" b 0 0 M ,, ,� 4 Q 0 cad td U1 O U O �d'O " M td N a) u) N000 A p l � 0 (d M tt1 ,0 0, 4j U1 I W �, v z a 1 o O u "' _j Q) w ,°,,� LOT 1 m z -romoo '" o 1 130696 SO. FT. :r W j O M V) , d a.1 I 3.00 ACRES I H '� M 'd M = �' z O �j O U EXCLUDING R.O.W. cc Q 1 0 0 Z M . 149557 SO, FT. I y a1 U `�� ,U) a) En x'14 o w cd z 3.433 ACRES I W cd 00 O v O O M INCLUDING R.O.W a) to U .0 d WOE O . cad 4 xcn � O C QZ z ON cd 0 QOM � M 0 3 +, X H " . �+ M 'd u W O a) S~ H �O U' a) 0 � O 0 cld F=- U z Q) O W UO� a) p U O 0 - O , � �W r, a• +., 0 3 250.00' „,ti P ..� N 89'35'54'W O o x >,w ^ U „ +, Cd 0W � a J 0 3 .� _ tan U U_NPLATTED LANDS a z o `�, APPPROVED 040 0 a� o „ M 'ct .,4 told�'d o m W 1/4 CORNER APR 11 1986 H a J w '� E0 z ° Q ST Volume 6 Page 1644 COMrkcllrr!sly= MKO 1AAINdING A14D ZONING COMNJTTEE