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HomeMy WebLinkAbout032-2038-50-000 / 0 ) E § j k § U o 0 \ k= /f ) o \ Ems ■ � ( C; \ k [ �:2 ƒ k > \ () 0 co 0 0 ) z_ E§m ( LOL �d w 3 �§20 8 \ J ) E-0 Cl) i § E a / k CL co q \ § :!t } k D k k z 7 7 � 5 � � ) � ,� c � _ ) g Q \ z z j .. z k 4 _E c \ 0 2 . . CL 0 G a \ m 2 k J ) ( I CD U) k \ 3 a 0 - \ \ a a a § g n U) I u 0 } § z k y / � r a / 2 0 0 \ 0 k § g k \ m - - # = E . � O § B / \ [ ¥ $ o 2 § c § _ B $ a © r § a CN 2 B § E z 2 2 7 7 E f / \ - k § $ / / o z / z / ) $ cj % y � : ) g ( § I E ' IL C » % 2 § t k k ) k k ) Parcel #: 032-2038-50-000 02/01/2006 12:23 PM PAGE 1 OF 1 Alt.Parcel#: 10.30.19.620C 032-TOWN OF SOMERSET 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 CHARLES M&LILIANN T BRYSE O-BRYSE, CHARLES M&LILIANN T 1658 CTY RD I SOMERSET WI 54025 Districts: SC=School SP=Special Property Address(es): '=Primary Type Dist# Description " 1658 CTY RD I SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 11.250 Plat: N/A-NOT AVAILABLE SEC 10 T30N R1 9W 11.25A IN SW NW COM Block/Condo Bldg: 923'S OF NE COR SW NW,TH W TO A PT 374'N OF SW COR, S 374'TH E TO SE COR, Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) N 364.9'TO POB 10-30N-19W Notes: Parcel History: Date Doc# Vol/Page 5eJ� Type 09/14/1998 586961 21 WD 07/23/1997 792/881 2005 SUMMARY Bill#: Fair Market Value: Assessed with: tq � 77807 381,200 �� Valuations: Last Changed: o7/23/2 o63 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 11.250 89,200 217,600 306,800 NO Totals for 2005: General Property 11.250 89,200 217,600 306,800 Woodland 0.000 0 0 Totals for 2004: General Property 11.250 89,200 217,600 306,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 114 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 • w PUMP CHAMBER Manufacturer: ,i 21 S 1t r` Liquid Capacity: O88 ho �.i Pump Model: 105w-/'Os Pump/Siphon Manufacturer: toll` ize Elevation of inlet: f� . ]g Bottom of tank elevation: na Pump gwitch elevation: ///, ?I Gallons per cycle: � 7 '_' ? C1 " �r!!t 'a r Alarm Switch T e: Al Alarm+ �. jacCurer: 2 YP Number of feet from nearest property line: Front, Side, Rear,0 Ft.�4 Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM 11V,04,,d,0 Bed: >� Trench: InR4WA 0U1X'-"4- w8 Width: Lenjth: " Number of Lines _ Area Built: Fill depth to top of pipe: S i Number of feet from nearest property line: Fro t, O Side, O Rear,®Ft .� _ Number of feet from well: Number of feet from building: �� � (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, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector• Dated: O 4Zj Plumber on job: lltIU14 License Number: /-S 3/84:mj Form - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP Sa,,�ry✓� S! SEC. /C) T N-R, W ADDRESS Y� SpY,� .�, ST. CROIX COUNTY, WISCONSIN s (Z SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I•T.HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM r b IY 60 � r � !03 s r ♦ \ t e a8 IIDICATE NORTH ARROW S / '/ yo BENCHMARK: Describe the vertical reference poJfnt used Nod Lh -'A" S (t'• Elevation of vertical reference point: /441> Proposed slop,. at site: SEPTIC TANK: Manufacturer: .7-L.-P �4�.+��riS sz �� 10#,,% Liquid Capacity: Number of rings used: � Tank manhole cover elevation: _ jj_�2 a Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front g)Side,O Rear, O O feet ;From nearest property line Front-C Side,®Rear,O feet Number of feet fr m: well vV , building: (0-3(Include t1is information oft above plot plan)( 2 reference dime sions to septic t;lnk) h"`_« SEE REV ESE STPF DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX 7969 BUREAU OF PLUMBING MADISON,WI 53707 SW'-4,NW-'4,S10,T30N-R19W ❑CONVENTIONAL )MALTERNATIVE State Plan I.D.Number: Town of Somerset ❑Holding Tank El In-Ground Pressure UMound g7-07570 County Road "I" NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER: INSPEC 10 DA Wayne Schmit Route 4, New Richmond, WI 54017 BENCH MARK(Permanent reference pomtl DESCRIBE IF DIFFERENT FROM PLAN. REF.PT.ELEV.: 77 LEV.. Name of Plumber MP/MPRSW No.: County: Sanitary Permit Number: Calvin Powers Jr. I1563 St. Croix 102808 SEPTIC TANK/HOLDING TANK: MANUFACTURER LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV_ WARNING LABEL LOCKING COVER PROVIDED. PROVIDED. DYES ONO DYES ❑NO BEDDING. VENT DIA.. VENT MATE.. HIGH WATER NUMBER OF ROAD: PROPERTY WELL. BUILDING. IVINTTOIRESH ALARM FEET FROM LINE: AIR INLET ❑YES ❑NO DYES ONO NEAREST DOSING CHAMBER: MANUFACTURER JBIDDING ILIOUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED. PROVIDED: DYES ON O DYES ONO DYES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PR OPERTV WELL BUILDING VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE Al.INLET PUMP ON AND OFF) ❑YES ONO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKING or excavation. (if soil can be rolled into a wire,construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH-. LIENGT NO.OF DISTR.PIPE SPACING. COVER INSIDE DIA =PITS LIQUID BED/TRENCH TRENCHES MATERIAL: PIT Devn DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR PIPF DISTR.PIPE DISTR.PIPE MATERIAL: NO.DISTR. NUMBER OF PR OPERTV WELL BUILDING. V NT TO FRESH BELOW PIPES ABOVE COVER ELEV.INLET ELEV.END. PIPES FEET FROM LINE AIR INLET j I NEAREST-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- ❑YES ❑ meets the criteria for medium sand. TIONS MEASURED. NO SOIL COVER ITEXTURE PERMANENT MARKERS TBSIHVATION WELLS DYES -]NO DYES ONO [DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED ENTER. EDGES [:]YES ONO DYES ON DYES [_1 NO PRESSURIZED DISTRIBUTION SYSTEM: WI DTH. LENGTH NO.OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES. DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MO DISTR DIS TR.PIPE DISTRIBUTION PIPE MATERIAL.&MARKING ELEV ELEV.. DIA.. ELEV.. IPES DIA ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY RIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS DYES ONO 1:1 YES ❑NO COMMENTS: PERMANENT MARKERS: JOBSERVATION WELLS: NUMBER OF PROPERTY WELL BUILDING. NEARESFEET FROM LINE: DYES ONO DYES ONO T Sketch System on Retain in county file for audit. Reverse Side, SIGNATURE TITLE DI LHR SBD 6710(R.01/82) Zoning Administrator I 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: 1. Property owner`s name and mailing address. Provide the legal description where the system is to be installed; Il. 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 Gi-oun d Aal4tbpe r '— included the creation of surcharges (fees) for a number of regulated practices which Wisco tl't'S can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried reasul' 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 groundwater contamination investigations and establishment of standards. Groundwater, ;. s vvor �- protecting. BG-ci39� ?3.03%86) DIF� SANITARY PERMIT APPLICATION COUNTY LH (3 D In accord with ILHR 83.05,Wis.Adm. Code STATE SANITARY PERMIT# /oa go OL' —Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER 8%z x 11 inches in size. ,, S,4) —See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES ® NO PROPS TY OWNER PROPERTY LOCATION PROP OWNER'S MAILING ADDRESS LOT NU ER BLOCK MBER SUBDIVISI NAME CIT ,STATF ZIP CODE PHONE NUMBER CI Y NEAREST R AD, OR LANDMARK ❑ VILLAGE: II. TYPE OF BUILDING OR USE SERVED: 120,4c". Ad• (� -off � '5-0-(30 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. V New b. El Replacement c. ❑ Replacement of d. El 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. ❑Conventional b. X Alternative C. ❑ Experimental 2. a. ❑System- b. ❑ Holding c.❑ Pit Privy d. ❑ Vault Privy e. PC Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. ❑ 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(Square Feet): PROPOSED(Square Feet): s1cG b Feet ®Private ❑Joint ❑ Public VI. TANK CAPACITY Site in gallons 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 i e Lift Pump Tank/Siphon Chamber ❑ ❑ ❑ VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation oft a private sewage system shown on the attached plans. Plumber' Name(P ' t): PlFr's nat ur :( Stamps) MP/MPRSW No.: Business Phone Number: umb is Address(S eet,Cit State,Zip Code) Name of Desi er: 7 Vlll. SOIL TEST INFORMATION Certif' d S it Tester T)Name CST# 00 IALes CST's ADDRESS(S eet,City,S Zip Code) Phone Number: IX. COUNTY/DEPARTMENT USE ONLY 3 Nd ❑ Disapproved itary Permit Fee Groundwater Date Issuing Agent Signature(No Stamps) Approved ❑ Owner Given Initial �!.! $yrch,S Fee Adverse Determination V' X. COMMENTS/REASONS FOR DISAPPROVAL: SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber 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/contractpr,, ("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 /ly�E�CL�Mrt.� r Location of Property �w Section T 190 N W - R I9 Township -50 f-4 2Z Mailing Address Subdivision Name �A Lot Number Previous Owner of Property Total Size of Parcel Z Date Parcel was Created Are all corners and lot lines identifiable? X Yes No Is this property being developed for resale (spec house) ? Yes x No Volume snd Page Number as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed I 2. Land Contract 3. • Other recordings filed with the Register of Deeds Office In addition, a certified survey, if available, would be helpful so as to. avoid delays of the reviewing process. If the deed description references to a Certified Survey" Map, the the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTV OWNER CERTIFICATION I (We) eenti.6y that att 6.tatemen.t6 on thin Sown ane th.ue to the bed-t os my (oun) knowLe.dge; that 1 (we) am (ane) the owneA ja) 06 the pnopenty deecA bed in t UA in6oAmati.on Sonm, by v Atue os a wauanty deed necoaded in the 066.ice o6 the County Reg"teA os Deede ae Document No. 43o c-:,-z- 1 ; and that I (we) pheaentey own the paopoeed 44te Son the eewage dZ&po,6at eya.tem (on 1 (we) have obtained an memen.t, to Aun with the above debehi.bed pn.oway, bon the eonetnuction os ea,i.d aya.tem, and the name has been duty teco4ded in the Ossim o S the County Reg.i.b.teA o S Deede, ae Document No. SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) /C) - `� i-- g DATE SIGNED DATE SIGNED ;cam ^' ,, '• ,s �! _ m ,;�. :-�- - t!lIGUMOiT t+10. Y NR NlA1<OIt "N'UN PORK I—fat ew awe aeriawaa Mt * �• � 430 eon 79� 9s This Deed, .r.de h.ewaeM ThYl-li$-.Breault .and... ST.C XX CO.,WIC. .-brleau7.t,.. we and aas'i br Record d&24th t; wife d husband _ ._.. Sept. ., NOW .. . G of Sept. rantor. a ad.-Ma ne.Y....Schmit..and Charlotte..M_. .Schmit., . 8:00 .-buaband.-and..wife,- as aurvivorship _ .......Marital-.property. - _ .. Graatoe, W1tneeeetk That the said Granter, for a valuable cooaideratioe. ... t eoasoys to Grant«the fdlowing described real Mstate in . . St. Croix-- •`•"••�Te t ;a. County. Mate of Whiesown: Taz Paned me:.._.... .... hrt of the Southwest quarter of the Northwest quarter (SW 1/4 of NW 1/4) of ' Section Ten (10). Township Thirty (30) North, Range Nineteen (19) Nest described as fowws: Commencing at the Southeast corner of said Southwest k` Northwest ( / quarter id quarter SN 1 1 of NW 1/4); thence West on the South line of said a Southwest quarter of Northwest quarter (SW 1/4 of NW 1/4) to Southwest corner y; thereof; thence North on the West line of said Southwest quarter of Northwest v s quarter (SW 1/4 of NW 1/4) 374.0 feet; thence Easterly to a point on the East line of said Southwest quarter of Northwest quarter (SW 1/4 of NW 1/4) 364.9 feet North of the Southeast corner thereof; thence South on said East line 364.9 feet to the place of beginning. �e a 'hi. ....is._aot.....-... benwaa d p,.pert,. a _ tis) (fe Met) Together with all Mad angular, the heeeditameate and appurtenances ppurtenances thereunto belonging; warranto that tha title Lis ge0.. . _ uiahraaces, good. indeteaaible in fee simple . ple and free and clear of ear mnft z� and will warrant and defend the same. Dated this 25th. , der of September Qo � (SEAL) :I • P llis Breault SEAL) Thomas Breault (SEAL) . .. .. ', �' AO!=)thtlICAlIOIt ACKX0WLSD01t2NI? =a SiSaeilnrals)Breaault uit i'bos�an, ......_ STATE OF WISCONSIN , -- w this ..... et.....S.e.LyP.!14 .r. ls.1.7 aa, J cMare heforo ato thin the ahasg ..:....--- tad - �R..La._ D. -- • .............. .................. r ...... .... _ TITLE: ItRKBZNt SrA TN:BAR RISCOIrSIN4 �„ � to nie kaiawtr 4 lla.tba freses>_.. .... .�IMs► � , , l SC H tIACER, - i ..A&V-Richmond....1a. 54017. _ .. . fSizastury \eta-r Public : ' err not n•be sutheaticrted or Mekwowlydf& Bah My. Comet' is peroaneat if not. sfaM r date: If $ �7wM d Mwr.46640 fa 6"aoaelp iu!d 1, WAMMAMT sun two we WM&A ta► •i 1ail"yy ws - N ' H 9 STC - 105 rr- * 9 H SEPTIC TANK MAINTENANCE AGREEMENT ►-� 0 St . Croix County z v OWNER/BUYER \dVAV[VE SCJAVtotI'T rn ROUTE/BOX NUMBER Z Fire Number CITY/STATE `jOMIELZ T W l ZIP G4p2�, PROPERTY LOCATION :5W k, VALJ 14, Section 10 , T 30 N , R t9 W, Town of Sopked-54-M-r , St . Croix County , Subdivision 'tA jl-, Lot number Vk 'A: Improper use and maintenance of your septic system could result in I 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 E I/WE, the undersigned , have read the above requirements and agree to maintain the private sewage disposal system in accordance with x 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 . S I G N E D D A'r E St . Croix County Zoning Office P.O. Box 96 Hammond , WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address . State of Wisconsin ` Department of Industry, Labor and Human Relations PRIVATE SEWAGE PLAN APPROVAL SAFETY&BUILDINGS DIVISION Office of Division Codes and Application 201 East Washington Avenue P.O. Box 7969 Madison, Wisconsin 53707 CALVIN W. POWERS JR. Owner: WAYNE SCHMIDT R.R. 3, BOX 249 R.R. 4 NEW RICHMOND WI 54017 NEW RICHMOND WI 54017 RE: Plan Number: 87-07570-S Date Approved: October 19, 1987 Gallons Per Day: 600 Date Received: October 16, 1987 Project Name: SCHMIDT, WAYNE Location: SW,NW,SEC. 10,30, 19W Town of SOMERSET County: ST CROIX Fees Received (Priority Review) : 160.00 'The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped 'conditionally approved' . This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department' s approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. This approval will expire two years from the date approved or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires . The Section of Private Sewage has reviewed these plans for private sewage system code requirements only. These plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the Wisconsin Administrative code. This approval is for the following components only: - NEW MOUND Inquiries concerning this approval may be made by calling (608) 266-3937. Sincerely, Q os!CiCv AMES QUINL..AN Section of Private Sewage Division of Safety and Buildings PPP012/0009n/ 5 cc: WAYNE SCHMIDT -Private Sewage Consultant --County —. UW-SSWMP Plumbing Consultant -Owner Plumber Environmental Health DI LH R-SBD-6423 (N.04/81) I Date: cj�o__- i Division of Safety and Buildings Office of Division Codes and Application 201 E. Washington Ave. , Rm. 141 P.O. Box 7969 Madison, WI 53707 CL Lam•. c,._� �_ In Person Mail In / KLo RIP A,.-cv�A� G_� Telephone No. 9 RE: Priority Plan Review Appointment - Private Sewage Project or Owners Name: i City, Village or To ,y�,�:, lQ Q � I County: ,Cy , Type of plan: Conventional Petition included with plans _ Mound Petition only In Ground Pressure Other Holding Tank T An appointment has been made for you to have your plan(s) reviewed on t / .Z2 &-7 at I, _-3 A.M./P.M. by If you must cancel or reschedule please call (608) 266-9375. Please review the back of this notification for those items that are required for plan review submittal . Thank you RECEIVED OCT 1 G 1987 ti OFFICE OF DIVISION CODES AND APPLICATION SBD-7778(R. 6/87) 0306v 1 P e f '* iv Eft .71, V r Oc ��oqer I $ 30pnN g'7 -' 075 ?0 J ; m QL�► n �ah rg RECEIVED OCT 16 1987 �/ OFFICE OF DIVISION � CODES AND APPLICATION � • fV���1 ,%�"f/,�7-�i:v!_J (�•��` : >4'�-'�� f dlF�t �l�.vr,c�aC:S,E'7 1,000 U (,�,)I,e!►t c ASS' ' YE Se +1 o ` `" _ k SEE �.;UF��:il'! `��.��s ����.�►� .. `r 7a I _ f 7 PO t�' ON SOIL BORINGS AND SAFETY&BUILDINGS DEPARTMENT OF 11 + IND!J5 f Rlt, �"� T LABOR ,_AND n FtRCOLATIO N TES S HUMAN RELATIONS -11-163.090)&Chaptist 146.14k TOW I VIPIM ITY: LOT :BLK. O.: SUBDI ISION NAME: A'1 ; '/� SEC ION_ „� 7�10r � nnf�1 / OWNER'/!S//BUY R A MAIL'N ADD S COUNTY f ,.` r - C DATES OBSERVATIONS M ES : USE L DESCRIPTION: PR FIL D O NO,B gRMS.: COMME New ❑leplace A .Residence RATING:S=Site suitable for system U.Site unsuitable for system l ONVENTIONAL: MOUND: IN-GROUND PRESSURE: SYST IN-FILLHOLDING TANK:RECO ENDE YSTEM:(optional) as �u �s ❑u MS [:]U ❑ � 1 os u If Percolation Tests are NOT require r DESIGN RATE: If any portion of the tested area is in the Floodplain,indicate Floodplain elevation: under s.H63.0915►Ib►,indicate: PROFILE DESCRIPTIONS P H T GR UND ATER-1 HES CHARACTER OF SOIL W17H THICKNESS,COLOR,TEXTURE, AND DEPTH BORING AL TO HEDROCK IF OBSERVED SEE ABBRV.ON BACK.) NUMBER DEPTH M. ELEVATION T-_OBSERV _ _ B- B PERCOLATION TESTS I) P I WA'Ci I.FV I INGIIEv� _ CTA E MINUT&S DEP"l ll WATER IN IIULE AF TERSWELI Tl i;l' CiMC PEF� IN .H r NUMBER lfdPhlf'S ING INTT�CiVAL_MIN. E�L2D i �/ p �,� r L lL� 41,4„ '►��s P. P- r., P- P- P P�PLOT PLAN: Show locations of percolation tests, soil borings and the dime plots plan. Show the surface elleationcat all bosingseand the rdirection andherne,i aontal and vertical elevation reference points and show their location P of land slope. SYSTEM ELEVATION __” '6"A46W YS,U t t N Psfi� ere r _.. 1 1 �/ .rte., .-......:__ -1 '••'1'�� ^ I,the undersigned, hereby certify that the soil tests reported eion of is for is are or ecit me he bestcof mytknowl d9e and belief.methods specified in the'UVisconsin Adr-Kinistrative Code,and that the data recorded and th TESTS WERE'COMPLf7ED ON: NAM int)' _ _ __t____— --------- CER FICATION UMBER: PHONE NUM ERIopNo P AD CST N RE: DISTC'CIBUTION• O- (pnal and one COPY o Local Ali thor1ty,11;opertV Ownei and Soil Toster.