HomeMy WebLinkAbout030-1098-20-000 r I f
Parcel #: 030-1098-20-000 02/23/2005 04:25 PM
PAGE 1 OF 1
Alt. Parcel#: 32.30.19.3551 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): *=Current Owner
*
PATRICK J DOYLE DOYLE, PATRICK J
1208 52ND ST
HUDSON WI 54016
Districts: SC=School SP=Special Property Address(es): *=Primary
Type Dist# Description * 1208 52ND ST
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 7.170 Plat: N/A-NOT AVAILABLE
SEC 32 T30N R19W SE SE LOT 3 OF CSM 1/97 Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
32-30N-19W
Notes: Parcel History:
Date Doc# Vol/Page Type
05/17/2002 679270 1892/571 QC
07/23/1997 1106/135
07/23/1997 774/505
2004 SUMMARY Bill#: Fair Market Value: Assessed with:
5638 470,700
Valuations: Last Changed: 07/08/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 7.170 109,400 353,700 463,100 NO
Totals for 2004:
General Property 7.170 109,400 353,700 463,100
Woodland 0.000 0 0
Totals for 2003:
General Property 7.170 64,300 238,900 303,200
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch#: 157
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
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PUMP CHAMBER
Ma facturer: Liquid Capacity:
Pump Model: Pump/Siphon Manufacturer: Pump Size
Elevation of inlet: Bottom of tank el ion:
Pump off switch elevation: Gal s per cycle:
Alarm Manufacturer: Alarm Switch Type:
Number of feet from nearest perty line: F , O Side, O Rear,0 Ft.
Numbe f feet from well:
N er of feet from building:
(Inc a distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed: Trench:
Width: Length: Number of Lines: Z Area Built:-
Fill depth to top of pipe:
Number of feet from nearest property line: Front, O Side, O Rear,0 Pt .a,�_!
Number of feet from well: 7`- hl , ,] .cW / /-
Number of feet from building: /& Ae4
(Include distances on plot plan).
SEEPAGE PIT
e: Number of pits: Diameter:
Liquid the Bottom of seepage pit elevation:
Area Built:
Has either a drop box distribution box O been used on any of he above soil
absorbtion sytems? (Check one).
HOLDING TANK
Manufacturer: apacity•
Number of rings used: Elevation o ttom of tank:
Elevation of inlet:
Number of feet from nearest pro ty line: Front, ide, O Rear, OFt.
Number o eet from well:
Number feet from building:
Number f feet from nearest road:
Alarm Man acturer:
Inspector:
Dated: 7 Plumber on job:
License Number:
3/84:mj
t, Form - STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER /P7 TOWNSHIP )ps PP SEC. 31- TN-R W
ADDRESS / ST. CROIX COUNTY, WISCONSIN
syes Z
SUBDIVISION �� LOT'- LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of 11HR 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
DAVE Ft OMM PL U M81NG
LiMftd Perk Teeter d Plumber
fo�032y Hee 032ft
Rf�1EFtTS, 448 M51N V02a
74#M34AM
i
3
INDICATE NORTH ARROW
rr
BENCHMARK: Describe the vertical reference point used m e 3w � [, &?,r
Elevation of vertical reference point: Q,D Proposed slope at site:
SEPTIC TANK: Manufacturer: �j,�' ',� Liquid Capacity: / Q-Q
T �T
Number of rings used: �_ Tank manhole cover elevation: //0 jly
Tank Inlet Elevation:. Tank Outlet Elevation: _ l�37,
Number of feet from nearest Road: Front,9 Side,O Rear, A feet
From nearest property line Front 10 Side,0 Rear,0 /pQ feet
Number of feet from: well eOL XW, building: 2,7
(Include this information of the above plot plan)( 2 reference dimensions to septic tan'
SEE REVERSE SIDE
[,x-PARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS
LABOR&14UMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P.O.ROX 7969 BUREAU OF PLUMBING
MADISON,WI 53707 RI
CONVENTIONAL S32,T30N-R19W RICONVENTIONAL ❑ALTERNATIVE State Plan I.D.Number:
(if assigned)
Town of St. Joseph E3 Holding Tank ❑In-Ground Pressure El Mound
52nd Street
NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE:
Pat Doyle Route 1, Box 12, St. Joseph, WI 54082 6-19 -g
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:
Dave Fogerty i3289 St. Croix 92484
SEPTIC TANK/HOLDING TANK:
MANUFACTURER: LIOUID C PACITV TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER
I�] PROVIDED: PROVIDED
J IJS / �0�, ES ❑NO ❑YES AN0
BEDDING: VENT DIA.: VENT MAT HIGH WATER NUMBER OF D: :PROPERTY WELL JBUILFNG: VENT TO FRESH
ALARM: FEET FROM '� LINE: r 27 A)F►IyLET.
❑YES NO C DYES NO NEAREST yW —1 /(ZV T �fl-1
DOSING CHAMBER:
MANUFACTURER: 171 LIQUID CAPACI7V. PUMP MODEL. PUMP/SIPH N MANUFACTURER: WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
ON . OYES ONO OYES ONO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATION NUMBER OF PROPERTY WELL BUILDING: VENT TO FRESH
(DIFFERENCE BETWEEN FEET FROM LINE AIR INLET
PUMP ON AND OFF) OYES ❑N NEAREST
SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing 1 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 INSIDE DIA. #PITS. LIQUID
BED/TRENCH ) py THE NCHES / M ERIAL: PIT DEPTH
DIMENSIONSVl`
GRAVEL DEPTH FILL DEPTH DISTR.PIPF DISTR.PIPE DISTR.PIPE MATERIAL: NO. R_ NUMBER OF PROPERTY WELL BUILDING. V NT TO FRESH
BELOW PI PES. ABOVE COVER EL V INLET.ELEV.END: PIPES. LlfyJy _ /� AIR INLET.
/ �r I� „ 0 FEET FROM d\��q/
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.
DYES 1:1 NO
SOIL COVER ITEXTURE PERMANENT MARKERS OBSERVATION WELLS
❑YES ❑NO 1OYES ONO
DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL 7SODDED SEEDED MULCHED
CENTER: EDGES.
1:1 YES El NO DYES ONO OYES ONO
PRESSURIZED DISTRIBUTION SYSTEM:
BED/TRENCH WIDTH LENGTH TRENCHES: LATERAL SPACING JGRAVLL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR,PIPE MANIFOLD MATERIAL. NO.DIS7R. 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
PLANS
DYES 1:1 NO 1 1:1 YES El NO
COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: ]NUMBER OF PROPERTY WELL: BUILDING:
FEET FROM LINE:
OYES ONO
—]YES ONO NEAREST
V� 4 4-ID
Sketch System on Re in in county file for audit.
Reverse Side.
SIGNATURE: TITLE.
,� Zoning Administrator
D I L H R S B D 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 flour (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 tarirk(§)should be pumped by a licensed .
pumper whenever necessary, usually every 2 to 3 years;
6. if y(„j have questions concerning yoi�r pr ivat+ sewage syster, 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:
Property owner's name and mailing address. Provide the legal description where the system is to be
installed;
H. Type of building or use served: If pulbdc 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 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 nxains/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 publk; debate. The groundwater, bill Ground
included the creation of surcharges (tees) for a number of regulated practices which Wiscorfsim$
can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that Buried rea.sufe
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.
a ,
The rilonir)s collected through these surcharges are credited to the groundwater fund adminis-
tt:rec, by t)e Department of Natural Resources. These funds are used for mon;torl g ground- t
ater, gr-wr;dwater contamination investigations and establishment of standards. Groundwater*,
s worth protecting.
tiD- 398;F.03/86)
Ez SANITARY PERMIT APPLICATION CODUN-TY 01LHR In accord with ILHR 83.05,Wis.Adm.Code v ;/ 0
'°""""°� STATE SANITARY PERMIT#
9a L1S
—Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN F.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 9 NO
PROPERTY OWNER PROPERTY LOCATION
Pat Doyle S '/4 SE %4, S 32 T , N, R E(or)W
PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER B SUBDIVISION NAME
Rt. Box 12
CITY,STATE ZIP CODE PHONE NUMBER 77-CITY.. NEAREST ROAD,
O VILLAGE: St JoseDh 52nd st
II. TYPE OF BUILDING OR USE SERVED: 630-1091--;?o
Number of Bedrooms if 1 or 2 Family 3 OR ❑ Public(Specify):
Ill. PURPOSE OF APPLICATION: (Check only one in#1. Check#2,3 or 4,if applicable)
1. a. ® 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. Eiconventionai 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. RrSee a e Bed b. ❑Seepage Trench c. ❑ See a e Pit
2. PERCOLATION RATE 3. ABSORPTION AREA 14. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY:
(Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet):
Z ,' Feet Private ❑Joint ❑ Public
VI. TANK CAPACITY Site
in gallons Total #of Manufacturer's Name Prefab. Con- Steel Fiber- plastic Exper.
INFORMATION New xisting Gallons Tanks Concrete structed glass App.
Tanks Tanks
Septic Tank or Holding Tank ❑
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 Name(Print): Plumber's Signature:(No Stamps) MP/MPRSW No.: Business Phone Number:
Daye Fogerty 3Z 749 3656
Plumber's Address Stree,City,State,Zip Code): Name of Designer:
VIII. SOIL TEST INFORMATION
Certified Soil Tester(CST)Name CST#
CST's ADDRESS(STreet, ity,State,Zip Code) Phone Number:
IX. COUNTYIDEPARTM ENT USE ONLY
❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps)
®Approved ❑ Owner Given Initial charge Fee
` /vU.va .va 3-g7 DMc�o C'. AZt1 i /'n-��
Adverse Determination
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
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 V- � t
S w fw
Location of Property S _' - .--k• Section„T2 , T �o N-R_ZJ - W
Township
Mailing Address
Address of Site
Subdivision Name
. Lot Number
Previous Owner of Property
Total Size of Parcel
Date Parcel Was Created_
Are all corners and lot lines identifiable? t/ Yes No .
Is this property being developed for resale (spec house) ? Yes ,/ No
Volume _�_ and Page Number �_ 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) ee ti6y that aU statements on this 6onm ane ticue to the best o6 my (owc)
hnowtedge; that 1 (we) am (ahe) e pnopenty desc&i.bed in this
n 6ovna ti on 6o4m, by v ih tue o6 a r n�eonded in the 0 6 6ice o6 the
County Register o6 Deedsas Document NAposat-Ty—sTe—m,x ; and that I (we) pnedentCy
own the proposed site bon the sewage (on 1 (we) have obtained an
easement, to nun with the above de6ox bed pnopelrty, bon the cons.tAucti.on o 6 said
system, and the same has been duty recorded in the 066iee o6 the County Reg-c.s#en o6
Deeds, ab Document No ) ,
S1616ATURE 09 OWM' SIGNATURE OF CO-OWNER (IF APPLICABLE)
DATE SIGNED DATE SIGNED
A'
L
DOCUMENT NO. STATE BAR OF WISCONSIN FORM 2-1982 THIS SPACE RESERVED FOR RECORDING DATA
WARRANTY DEED
James H. Burtis and Carol G. Burtis, husband and
�i
wife
conveys and warrants to Patrick J. Doyle and Christine A.
i
Doyle, husband and wife
i!
ii
RETURN TO
'I
II the following described real estate In St. Croix County,
State of Wisconsin:
Tax Parcel No:
I I
;
Part of the SEA of the SE14 of Section 32, Township 30 North, Range 19 West,
Town of St. Joseph, St. Croix County, Wisconsin, described as follows:
I, Lot 3, Certified Survey Map, dated March 25, 1975, recorded March 26, 1975,
in Vol. 1, page 97, as Doc. No' . 326101.
I�
i�
i,
is
�I
i
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�t
i
This is not homestead property.
(is) (is not)
I� Exception to Warranties:
Easements of record
Dated this 31st day of March 9_87
(SEAL) "� - (SEAL)
me H. Burtis
(SEAL) w��l 1 J (SEAL)
. Carol G. Burtis
AUTHENTICATION ACKNOWLEDGMENT
i
II Signature(s) STATE OF WISCONSIN
i Ss.
I� St. Croix
County.
authenticated this day of , 19 Personally came before me this 31st day of
+ March 19 87 the above named
James H. Burtis and Carol G. Burtis
�! TITLE: MEMBER STATE BAR OF WISCONSIN
i�
(If not, t e no be the person s who executed the
r••
j authorized by§706.06,Wis.State.) 8 �dpe.the
THIS INSTRUMENT WAS DRAFTED BY
ACORN REALTY, INC.
245 Main Street Dennis Fleischauer
Somerset, WI 54025 Notary Public St Croix County,Wis.
(Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration
f are not necessary.) date: September 30 19 90 )
I
'Names of persons signing In any capacity should be typed or printed below their signatures. NTF 2280
STATE BAR OF WISCONSIN
WARRANTY DEED Nelco Forma,P.O.Box 10208,Green Bay,WI 54307-0208
Form No.2—1982
32610;
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L
32G I U_11
I, Arthur L. Wegerer, registered land surveyor, hereby
certify: That in full compliance with the provisions of
Chapter 236.34 of the Wisconsin Statutes and under the
direction of Rex Myers, owner of said land, I have surveyed,
divided and mapped said parcel of land, that such plat
correctly represents all exterior boundaries and the
subdividion of the land surveyed; and that this land iT
located in the SEA of the SEA of Section 32 and the SW� of
the SW71; of Section 33, all in T 30 N. R 19 W. Town of
St,.Joseph. St.Croix County, Wisconsin, to-wit:
Beginning at the Southeast corner of Section 32; thence
West alon the Section Line 57.611 ; thence North 62$.971 ;
thence N 57°55100" E 120.151 ; thence. S 89 00515$" E 1220.031 ;
thence S 0°14145" E 614.241 ; thence West 1285.00' to the
point of beginning.
Also: Commencing at the SoUtheast corner of Section
32; thence West along the Section Line 410.611 to the
point of beginning; thence continuing West 418.001 ; thence
North 534.$6' ; thence Northwesterly along the are of a 125.00'ra(
curve which is concave Southerly and whose long chord bears
S 73 017145" W 166.46' ; thence S 31 033100" W 111.481 ; thence
North 927.281 ; thence S 89°44140" E 668.7$' ; thence South
700.141 ; thence Southwesterly along the arc of a 320.001
radius curve which is concave Southeasterly and whose long
chord bears S 80°03'25" W 33. 511 ; thence South 610.391 to
the point of beginning.
The above described parcels being subject to Town Road
Right-Of-Way.
d this 2 th day of March, 197 5.
Date 5 Y Arthur L. We rer
R.L.S. No. S-963
,\\1\1111lift%
SC 0 A/
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ARTHUR L.
C WE-,-4ER
- � S-963
ELLSWORTH
WIS. J
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SEPTIC TANK MAINTENANCE AGREEMENT C
St . Croix County x
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ROUTS/BOX NUMBER Fire Number
.CITY/STATE Sy4f2 ZIP
S JV 3 3
PROPERTY LOCATION: Set Section_, T To N , R I W,
Town of '54 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
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. «�
0
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I/WE, the undersigned , have read the above requirements and agree z
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to maintain the private sewage disposal system in accordance with x
the standards set forth , herein, as set by the Wisconsin Depart- v
ment of Natural Resources . Certification form must be completed
and returned to the St . Croix County Zg Offkre wi in 30 days
of the three year expiration date. :7
SIGNED::::
DATE
St . Croix County Zoning Office
P.O. Box 98,
Hammond, WI 54015
715-796-2231 or 715-425-8363
Sign, date and return to above address ,
INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395
To be a complete and accurate soil 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 commercial use planned;
4. Is this anew 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;
S, PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan;
7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A
separate sheet may be used if desired;
S, tMlike sure your benchmark and vertical elevation reference point are clearly shown,and are permanent;
9, Complete all appropriate boxes as to dates, names,addresses, flood plain data, percolation test exemp-
tion, if appropriate;
13. If !hi?, information (such as flood plain,elevation) does riot apply, place N_A.in the appropriate box;
13 Sigti the form and place, your curierlt address and your certification number;
12. MllaI e leciihic, copies and dismibulo, as required. ALL SOIL TESTS MUST BE FILED WITH THE
LOCAL AUTHORITY VVITHIN 30 DAYS OF COMPLETION.
ABBREVIATIONS FOR CERTIFIED SOIL OIL TESTE;
Soil Separates and Textures Other Symbols
t stonf, iclke4r 10") BR Bedrock
_ C v)calm (3 - 10 SS `,andstone,
gi -- &aveal wmisr 3") LS — Lirnestone
s — Sand HGvV — High Gimi;idvvater
Coats(, :j ri Ierc; Ra-.
I Lwair,y Sand O satrar ThE'm
Sandy Loamn
- Loara , .t;rra
;1' -- Sal( i.oam
i Si l' t y
("'lay
//-, I
!..' _. ,�,'t`i13t�Y` lsl l�` ..L1zFEj. E'j _-_ r�"::.ff
._ S r--v Cta,r .>asr ?'out
. .. S rad?r Clay
iy frf
(G
iT;t.'!"ow)
_ r
car ''ct
p -- prot'rltnearlt
H'rtb'L -- fI 7t YLatf lei=c4,
Six tj??nE.E d soil a :t--'s race v"a'tear"
io €EqI I a,vaSte dtisp')Firm l=N1 Bwlch "_lark
VItP. vel tw'41 It"fererrc ° Point
%m0 TI-4E OWN ER:
t
"'h t, �„ z h:ter repoi k. rs the -r['st stor" in ?,t,[chart a simit<ary O,uv nii' Tie county r)r the Department iflay reCIU2st
.t. dtr.. .,,z. lt4`z S€3€t t(-st r.. ht, ft alcl pt for io permit _ssu i.-cc— A dIC?rf pi .je ;,.,i of plans for the private
f; cl)d t3 ,lr?r-nl['_ ariplic'm,-J_a an"UST he sLli l!Wt(?'d tit the appropriate local authority it"a order to
t, f I're oaro.acv rsei ra)it is r,<tt be .'a .i=ae.] zv-rt1 po-,ted I i for to the start of�;ny co nstrucri()rl
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS
INDUSTRY, CC DIVISION
HUMAN REDLATIONS PERCOLATION TESTS (11J) MADISON WI 53707
(H63.090)& Chapter 145.045)
LOCATION: SECTION: TOWNSHIP/Po4di�ttf;tP/ttifiY: LOT NO.:BLK.NO]SUBDIVISION NAME:
SE ��4SE�� 32 �T30 �R lc# (or)W St Jose h 3 — —
COUNTY: OWNER'S BUYER'S NAME: M ILIN ADDRESS:
St. Croix Pat Doyle Rt. 1 Box 12 St. 4oseph, WI 54082
USE DATES OBSERVATIONS MADE
NO.BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE DESCRIPTIONS: PERCOLATION TESTS:
Residence n/a New ❑Replace 3-7-87 13-9-87
RATING:S=Site suitable for system U=Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: S STEM-IN-FILLHOLDING TANK:RECOMMENDED SYSTEM:(optional)
0 S ❑U ®S ❑U ❑x S ❑U x❑S ❑U x❑S 0 gravity 12 x 52 (no lift)
If Percolation Tests are NOT required DESIGN RATE:
4 If any portion of the tested area is in the
under s.H63.09(5)(b),indicate: n/a Floodplain,indicate Floodplain elevation: n/a
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.(
B- 00' C ! / '�h S/ n
B- 3 78 S. `� c/ S/ c / E'� r /, /� n w 8 6n c s s
B- > �'8/�s/ a s - w 2.
B-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PER1003 PER INCH
P 4
P-
P- 7l 3 s
P-_
P-
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope.
SYSTEM ELEVATION
r T E
, ir �t H 'E o_a1dat to 48th_s t. I ) -
_ 52ndt. (east).
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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 WERE COMPLETED ON:
Dave Fogerty -8
ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional):
Fogerty H ts. Rd. Roberts WI 54023 3233 4 -
DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester.
DILHR-SBD-6395 (R.02/82) —OVER —
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ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
^'�� t w'"■ moves ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
Hudson, WI 54016-7710
(715) 386-4680 FAX (715) 386-4684
June 1, 2001
Pat and Lisa Doyle
1208 52nd St.
Hudson, WI 54016
RE: House remodeling,Town of St. Joseph, St. Croix County
Dear Mr. and Mrs. Doyle,
You have requested the Zoning Office to review your remodeling/addition project for compliance with the
state sanitary code (COMM 83). When remodeling or adding onto a dwelling it is required to examine
whether or not the construction involves an increase of wastewater.
It is my understanding that you do plan to add an addition to the existing structure, and also plan on
increasing the size of the original structure. The existing dwelling is constructed as a three bedroom
structure. The septic system was installed by David Fogerty(ID#221180) on June 18, 1987. The septic
system was inspected on May 16, 2001 by Dale Hudson (ID# 220853) and was found to not be visually
failing and no effluent was reported in the observation pipe. Since this project does increase the wastewater
load to the system by an additional bedroom, but the occupancy of the the residence will not exceed 6
persons,this project will be allowed,but it must be disclosed to any future buyer at the time of house sale
that the septic system is undersized for the structure being served, and the maximum occupancy of this
structure is 6 persons.
The property owner has met all the requirements of COMM 83.055 and can proceed to obtain a
building permit for the proposed house addition.
Should you have any questions,please contact this office.
Sincerely,
Kevin Grabau
Zoning technician
e
May 28, 2001 0 �1?.
E
Mqy 2 4
St. Croix County Zoning Commission sT c
CO
11o1 Carmichael Road ,�vx
Hudson WI 54016 c °'�Ice
RE: Building Permit
To Whom It May Concern:
This is a letter to inform you that we, Pat and Lisa Doyle who live at
1208 52nd Street, Hudson WI 54016 are aware that our septic system
is rated for 3 bedrooms. We are adding another bedroom and we had
the septic inspected by a plumber by the name of Dale E. Hudson
with Boldt's Plumbing & Heating on 05-16-o1. Enclosed is a copy of
his findings. Even though we are adding another bedroom the
number of persons residing in the house is remaining at 6 and there
will no more than 6 living here.
Thank you for your time,
Pa & Lisa Dolde
1 ,
Lald:lald
Cc:enc.
1
RBLDT's
LiJ 1
l7tJ`L" 1
PLUMBING&HEATING INC.
"Serving You Over 45 Years"
820 Main Street Baldwin,WI 54002
(715)6843378 Fax(715)684-3144
Date: 05/16/01 sr
To Whom it May Concern;
An on-site investigation of the septic system on the Pat i.Doyle
property, located 1208 - 52nd Street, Hudson, WI
was conducted on 05/16/01
At the time of the inspection, the sanitary system appeared to be functioning properly for the
existing use(See exception*below). The inspection of this sewage disposal system was based
upon a surface inspection of said system and did not involve any excavating or chemical analysis.
Accordingly, there is the possibility of hidden defects in the system not discoverable by this
inspection. Therefore, it is understood and agreed that there remains the possibility ol!hidden
de¢acts in the system which are not d scoverable by a surface inspection and this inspection does
not in any way warrant or guarantee the continued proper functioning or operation of this system. It
is recommended that the system should be pumped once every two to three years. Therefore, the
prolonged life of this system is totally dependent upon proper maintenance of the system and can
very depending on the number of people living In the residence,the age of children,work outside
the home, and use of garbage disposal.
Should you have any questions regarding this subject, please feel free to contact this office.
Sincerely,
Dale E. Hudson
Master Plumber/Certified Soil Tester#220853
*SPECIAL NOTATIONS: Sanitary system consists of a septic tank and
drainfield. Septic tank is at proper operating levels. Observation
pipe on drainfield is dry. Observation pipe is only 2" above ground
level and should be extended to 12" .