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HomeMy WebLinkAbout020-1356-28-000Q c ~ ° ~ ° ~ r.. .~ ~ °~ ~ °~ ~ ~; h ~ c c ~: Q, --~ ~ ~ ... ~ ~., ~ n o •o- c ry ~ ~ N ~ M Y ~ ~ ~ N dl ~ ~ L O -0 O N U •- C: ~ C 2 i ~ I ~ L N~ C `C U I ~ p ~ y !', •O U i Y N C Ew ~ ~ ~ ~ ~ to ~ cn ~ ~ O Z N as 3 r ~ 0 2 ~ ~ 0 Z ~_ ~ ~ N ~ ~ m ~ ~ - N LL O _ a N ~ LL O ~ m~ ~ "' O E Q ~ ~ Q N U , i I I , Y O r O °' a m a m w ~ Z c U ~ io .a io o . z ~ d' r c ~ c ~ U e} ~ U N ~ ~U u7 c ~ ~ c ~ ~ N O ~ N O ~ _~1/ ~ ~ N (V 1~ '. y ~ ~ ~ y ~ C ~ q O 0 •~ C ~ '~ O d N ~ ~ O d N ~ 'C 0 tis N N ~ U . C '"' ~ ~ C mo w' ~.'_- p •o Z c Z Z ~ Z ca Z O N Q .. °~' `0 ~ ~ R E '~ C1 O y ~ ~ ~ ~ y - ~ ~ i !mil !ri ~ o ~ .. a O a~ m (~ N > N N H ~~ L ~~ > H H H ~ ~ N ' aa a aaa • a ~ = ~ = I *~ •~ i ~ Si ~ o N ~' > o o ~ ~ ? ~ rn rn ~' i M J U, j Q O O N _ z Q O O } ~\V V N M (`') N N U Z ~ L E M N N O ~ ~ O N ~ i 0] ~ O I O m O O I ~ O M O ~ ~ + n ~ i ~ d m ~,~ o ~ ~ y , . d o ~ Q: Z ! C! _" M C m y :°. i ~ _ R N N i ~ O Q ~ i N V N C ~ N C ++ O Q o O c w O ~ w O ~ O7 ~s N ao I O r Tr N O N O '. > N ~ > U N C O N U~ 0 ~ '6 N 0 N ` V O ~ ~ i ~ ', fn ~ ~ ~ ~ ~ C c _ c ~ ~ W ~ c ~ ~ °~' _ ~ ~ a ~ 1 ~ v w~° ~ ~°' ~I y~ r"ti O' N -p I ~,' X M ~ E C X ~ ~ N O C t6 U i3 L? R ' ~i . v C ~ ~ .. .. w E E « ~ ~ E f _ ~. ~ ~ a d da d da • " ~ ~;Q +~+ ^• ~ d L _ .V G N C N C d C ~ C ~ , ~,~ rr ~ "'1 Q U a ~ O in U O iA U ounty rntary ermtt Appllcat' sT. cROix courm wlscoNSIN In accord with Chapert 12 St. Croix County Sanftary ce PLANNING & ZONING DEPARTMENT Personal information you provide may be used for da s ST. CROIX COUNTY GOVERNMENT CENTER ~~ [Privacy Law. S. 15.04(i)(m)] 1101 Carmichael Road ~~ Hudson, W 154016-7710 (715)386-4680 Fax 715366-4686 Attach tom ate ans for the system on r not less than /2 x es in size. County Sanitary Permit # ^ Check if revision to previous appli n G_~ k~tlon Information -Please Prim all Information ion: Property Owner Name ~E 1/4 (~1/4, Sec / o C T 2 2 Zoo 7 ~ C e z,y N R cJ w . ~ h , P Owner's Mani Address ~rtY n9 ST CROIX COUNTY Lot Number Block Number n State T.ip Code Phone Numer ubdivision Name or CSM Number vo» LJ/. SS~v/G 7/5 3~(- Z8'~ ra ss '=` i~i u ng: ( one ~ .~(~S ~.n ~ - No of Bedrooms: DweNin 1 or 2 Famil qty ^ Village own of g y . ~~~ ^ PubliGCommerciai (describe use): ~ ^ State~wned ty~arest Ro~j / Check box on line B if applicable) one box on line A Check onl f P rmit T ~J ,17u.'~• . y . ype o e : ( arcsl Tax Number(s) ~/ ~ 1.I~ Repair . ^ Reconnection .^Non-plumbing . ^Rejuvenation 20 - /,3 Sro ~ ~' lJ~ D Sanitation . Permit Number ,~/' B) State Sanitary Pemtft was previously issued •3 ~~ 5'`(0 Date Issued f~~ /~ ~" Z`~ ype of POWTSystem: (Check all that apply) ~ tyy;~- Z~Ii ~2 ' GJ / ~,,.~-~'/~~ IV T ~ / ues Non-pressurized In-ground ^ Mound 2 24 in. suitable soil ^ Mound s 24 in. suitable soil ^ mound A+0 ~ ~~ ^ Sand Flier ^ Constructed Wetland ^ Peat Ffter ^ Drip Line ~~~ ^ Pressurized In-ground ^ Holding Tank ^ Single Pass ^ Other ^ At-grade ^ Aerobic Treatment Unft ^ Recirculating reatmeM Area Information: ~ t 2t1 dLtS ~SSu N'm, ~ "~ Or 1 Design Fbw (gpd) 2. Dispersal Area 3. Dispersal Area .Soil Application Rate 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed (Gals./day/sq.ft.) O o (Min.~nch) ~ Elevation ~ ~ 9 7 9/ ' ' o . p .fit 7103, Z Ca GD .d. 7 S o%~ ~ 1. Tank Infornation Gapaicty in Ilons Total f Manufacturer Prefab Site Con- ell Fiber- Plastic New Existing Ga-lons Tanks Concrete strutted glass Tanks Tanks / ," n IIiY" ^ ^ ^ ^ ^ ^ ^ ^ ^ 1. Responsibility Statement f, the undersigned, assume responsibility f nnenctioNrejuvenationInstallation of non-plumbing for the POWTS shown on the attached pians. A is not r fired for terralift re 'r the installat n of non- umbi sanitation system. Plumber's Name (pri ~' PI bar's Sig lure (nos ~.._ MP/MPRS No. 3 ~z/ B Sine Phone Number his ~,yd_ ~?(7 ~ 3 Plumber's Ad ss {Street, C' ,State, Zi e) s~zm Ds cJ/ 3 ceo . .~ IL Coun Use OM Disapproved Sanit Permit Fee Q"d ~ Da Issued sluing Age Signature stamps) Approved Owner Given Initial Adverse Z~' / ~Z 3 Determination . Conditions of ApprovaUReasons for Disapproval: ~ / Q % ~ `nL Q~~-~12 ~~ c~ a SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be ~rviced /maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as r a /~O ~~ Rev:8/05 ~' / - tic C.~ /~b/e 6u: b~;.~ rS~ j ~h V Y V SEedc ~x~~~~ /of .7d s~/'6~a ss,Pa.~e 2 ="fWn'; Sec, ~S~ T. ~c~dSirr, Sf,. CrbIKQ,;i Pa/.~otp-i3SG -?8~ O y ~ ~ ~ c `1 G ~/ ,r. ~ c~~E ~eS~denc~ 11 ~% ~i v m Te.~o ~ix~es at 3 x rS,' Crx~~fi ~, ~co ~. ~~•~ ~~ 0 0 ~~ z~ ~_ m n~ O zy Cn 0 C %17 C7 O --i z zz r 0 0 m D ~7 Z D r m O D z m r D z m z 0 O r 0 ---~ Z ° c~ z ~ o IT ^m ~~ D m 3 Z 0 m z r •~~ c~ ~- W O. N a~ m m m n ~ a3i n3i ° m~ a v ~° •°~ _~ 7 m m w v w m o 7 c Q `D p ~ ~ m o m 7 o m~ 7 o~ '* o~ m 7 0 ~ ~ 7 N y C ? w N ~ .o y ~ ~ ~ j fl. ~ ?_ w • O ~ O 1 ~ O N `~ N .o ~ N ~, ~ (D N m N ~" O~ ~ ~ N fD • y 3 y cD ~ ~ ~ ~ O ~ ~1 c~ C t/J N O~ r: L1 ~ n m o o 3 co ~ ~ o 7 ~~~ =~ m ~- m f X X N ^' ~ fn w ~ tii t0 o 7 W n N O~ p) n '~ ~ n N~ 7 -Oa. 7 7 ~ 7 ~ ~ D ? (D 7 O ? o fl. N Q w `~ O7 ~ 7 `Z `~ ~ N ~ f ~ ~ ~ a ~ ~. ~ ~ N ~ ~ ~ ~ ° ~ ~ m ~- w 3 ~ ~ ~ ~ ~ c _ ~ "O N N~ 7 y N ~ O N ~ N ~ ~ ~ ~ 3 °' °• ~ v o °' ~' ~ ~ m ~ ~ ~ ~ o ~, ~ ~ ~ ~ 7 ~ m •- ~ ~ - .D C w ~ j O ~ m ~ ~ ~ ~ -o O ~ ~p fl- ~ cn ~ y 7 a 7 0 w ~ n N W 7 _ w° w m m ° ~ ~' ~p (D 7 N `z N 7 ~ N ff 7 v m~ -o ~ m vi ~ a m 3 m .°-' ° n ~ ~' °-' w ° 7 0 N ? N 7 W d ~ A 0 ? 7 (D ~ .-.. ~ 7 - v 7 m n ~~ ~y n y O ~ ~ ~C ~b y °~ ~~ ~tij~ J N ~W m ~ m ~ n m z r z - ~ C D ~ I ~ - - I 'D Z z ~ z D A Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice may be used for secondary purposes [Privacy w, s.15.04 (1)(m)]. Permit Holder's Name: ^ Cityy ^ Villa e Town of: RIXEN, STEVE HUDSONN CST BM Elev.: Insp. BM Elev.: BM Description: ~- i TANK INF RMATION °I° - Z - s 9 ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic c ~~~ ~~ Dosi Aeration Hol TANK SETBACK INFORMATION ;,~ ~ ~,.~if TANK TO P/ L WELL BLDG. VAen to ROAD e Septic I -LZ [ ~~ NA D Aera ~ NA Holding PUMP /SIPHON INFORMATION Manufacturer Model Num TDH Lift Lrl Force in Length Dia. r ~a BED / RENC Width Length , No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIME ~ 3 S Z DIMENSI N SYSTEM TO P / L BLDG WELL LAKE /STREAM LEACHING Manuf ct /rery SETBACK INFORMATION Type O ~ ] ~~ °~~ CHAMBER NIT O Mo a Number: System: ~/ ~ Z 7 R U County: Sanitary Permit No.: 344646 State Plan ID No.: Parcel Tax No.: 020-1356-28-000 STATION BS HI FS ELEV. Benchmark ~ ~~~, ~. ~' d~ ~ /5 S Bldg. Sewer ~ d ~ 0 t Ht Inlet ~"~r ()V4 ~/ Ht Outlet 7 (Od~. ~ m Header /Man. "~, 9 / ~ Dist. Pipe ~ T 9 ~ '~. Bot. System Q */ ~ ~ Z Final Grade jQ~~' S ~- ~v TOIL ABSORPTION SYSTEM ~ Demand ~~ TDH DISTRIBUTION SYSTEM ~ ~ Header /Manifold h Length ~ Dia- /~ Distribution Pipe(s) ( ' Length ~ Dia. ~~ Spacing ~ x Hole Size N/~ x Hole Spacing ,V ~ Ve1nt~To Air Intake /~1" 7 (~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched eed /Trench Center Bed /Trench Edges Topsoil ^ Yes ^ No ^ Yes ^ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: HUDSON 14.29.19.2098 729 PAUL BURGH DRIVE Z 2 ' or ~~1 s®wu'' ~ ~~~~ D`~ C(~1/~PP/ Plan revision regwred. ^ Yes No Use other side for additional infor ation. Z Z ~ ~ ,I SBD-6710 (R.3/97) Date Inspecto ' Signature Cert. No Safety and Buildings Division ~•ISCO/1S%11 SANITARY PERMIT APPLICATION zPOO B w302ngton Avenge Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707-7302 • Attach complete plans (to the county copy only) for the t SS County r than 8 in x 11 inches in size. ^ ~ ~~J ,5 • See reverse side for instructions for completing this ation ~~~ ~ \ -r State Sanitary Permit Number ~f,,~ F~UF t" 3 ~ b'~ ~ Personal information you provide may be used for secondary~urpos ; ^x'~ ~ ~ ;-~ ~ Check if revision to previous application ~., _ .a n " ""-'' --"" "~ ' "'" ' `'' `'"'"" ~, _,_ /~ State Plan I.D. Number I. APPLI ATION INF RMATI N -PLEASE PRIN ALL N Propert Owner Name ~ .s ~ Property~.4cati n I(d~i is : '. a, S l ~ T o7 ~ , N, R ! ~ ,l?~or Property Owner's Mailing Address \ : ,' Lot Nrrtil r Block Number !. ~- ~ , -. Cit , Sta a Zip Code Phone Number Subdivision Name or CS Number YPE F B LDIN : (check one) ^ State Owned ~ Icy Nearest Road Public 1 or 2 Famil Dwellin - No. of bedrooms ~ town of 111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) ' 1„(. ~ - I G, w •~~ 1 ^ Apartment /Condo J`^lo ` 2 ^ Assembly Hall 6 ^ Medical Facility/ Nursing Home 10 ^ Outdoor Recreational Facility 3 ^ Campground 7 ^ Merchandise:sales/Repairs 11 ^ Restaurant/Bar/Dining 4 ^ Church /School 8 ^ Mobile Home Park 12 ^ Service Station /Car Wash 5 ^ Hotel /Motel 9 ^ Office /Factory 13 ^ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box online B, if applicable) A) 1. New 2. ^ Replacement 3. ^ Replacement of 4. ^ Reconnection of 5_ ^ Repair of an _______ystem ________System -_ Tank Only______________ Existing System _________Exist)ng5ystem B) ^ A Sanitary Permit was previously issued. Permit Number -Date Issued V. TYPE OF SYSTEM: (check only one) ~ Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ^ Seepage Bed 21 ^ Mound 30 ^ Specify Type 41 ^ Holding Tank 12 ^ Seepage Trench 22 ^ In-Ground Pressure 42 ^ Pit Privy 13 ^ Seepage Pit r / 43 ^ Vault Privy 14^System-In-Fill K ~ ~~ ~ ~. X7(03.2 VI. ABSORPTION SYST M INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Pert. Rate 6. System Elev. 7. Final Grade Q~ Required©. ft.) Proposed (sq. f~ (Gals/da,X~sq. ft.) (Min./inch) r Elevation ~ 7 Feet i ~~ Feet ~ tiS VII. TANK Capaat INFORMATION in gallo s Total # of Manufacturer's Name Prefab. site con- l Fiber- plastic Exper. N E i ti Gallons Tanks Concrete stee glass App. ew x n s strutted Tanks Tanks Septic or'Meltliwg~jJL. .~ f ~ ~ ^ ^ ^ ^ ^ Lift Pump Tank/Siphon Chamber ^ ^ ^ ^ ^ ^ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite s wage system shown on the attached plans. Plumb 's ame: (Print) Plumber' ignat re: (No a s) MPRSW No.: Business Phone Number: aao ~ a~~ -~ ~ ~s- Plum ~r7slAddress (Street, City, State, ~ Code): IX. COUNTY /DEPARTMENT USE ONLY ~ ^ Disapproved Sanitary Permit Fee (Includes Groundwater TurchargeFee) ate ssue Issuin ent i nature (No Stamps) [ pproved ^ Owner Given Initial ~ d /G O Z3 - Adverse Determination ~~ ` f 1 1C. C.V DI I INNS Vt APPKVVAL/ KtASVNS FOR DISAPPRVVAL: .. ~; .,a~.•._sY~. w.0. 8 i~ ~.. .--~~, SBD- 6398 (R.11/97) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a 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. 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. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin; Safety and Buildings Division, 608-266-3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. 11. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on tine A. Complete line 8 if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tan~C material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. 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. IX: County /Department Use Only: X. County /Department Use Only. Complete plans and specificatians not smaller than 81/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; 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; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. Jul 08 99 02:08p Sandra Rixen 'Ilb-:iEib-~~:~5 p.4 ., , ~, - - S~~ I~J~"` .~2 h~~ 514-T29N-RL9W tawn of Hudson lot ~k28-0rnaa Range Second Addn. ~l~iie soil ervaluatian ~oae ccaiducted to satisfy a moving requirement, it may or may act be suitable for your use. The location of the test mayor spay not be as•shoen as pnncanent lot lines were ~crot established at the tie the teat wan co~txiuctQd. N 1"=40' BM.= tap of mid lot survey stake ~ ei. 100' Alt. Hl~I.=nail in wooden post @ el. 99.00' ~~ ~ ~ n~ 7 w% N ~ `~" ~ ~ ~~ a - is ~~,.,~-~ r ay x .~~ S = 7~ 3~ as /~'`~ ~ao3s~ Wscnsin` Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 ~ Labor and Human Relations n..; n of C~icw A. R~~ilrlinnc A J. /~~J~ - I11 QI.l.V1U WIUI ILI 111 UJ.VJ, •11J• /~a~ii~. vvuv ^0' I~ V l/ but n must include i Pl 11 i h i th 8 1/2 l St. , ze. a nc es n s ess an x Attach complete site plan on paper not not limited to vertical and horizontal reference int irection and % of slo e, scale or p ~ ~~~'~ PARCEL I.D. # "'~ Kest'rgad. dimensioned, north arrow, and location and di c8 to nea 020-1020-90 . APPLICANT INFORMATION-PLEA r~.~IT ALL N~ORIIIL' ION . , REV ~~"~- DATE ~~~ /o/~/9s , , PROPERTY OWNER: ---_~~ ` JVED ! PROPERTY LOCATION '~' Kernon Bast ~ `~' ° ._._ GOVT. LOT NE 1/4 NW 1i4,S 14 T 29 ,N,R 19 ~C (or) W PROPERTY OWNER':S MAILING ADDRE -- `' r ,~ 1 ~ LOT # BLOCK# SUBD. NAME OR CSM # 98 ' 948 LaBArge Rd. -~~ sr -• 28 na Grass Ran a Second Addn. ,P ER ;,,, ' CITY, STATE ZIP ~~ - ^CITY ^VILLAGE [x]TOWN NEAREST ROAD ~~ 2 Hudson, WI.. 54016 ~ ;,, `("9~fa~Al~ ~.'°` Hudson LaBAr e d. ~, .. [xJ New Construction Use [ ~ Resident) h~f(lu~-fi rbo 4 [ J Addition to existing building j J Replacement [ J Public or commerc rlbe Code derived daily flow 600 gpd Recommended design loading rate . 7 bed, gpd/ft2 .8 trench, gpd/ft2 Absorption area required 858 bed, ft2 750 trench, ft2 Maximum design loading rate . 7 bed, gpd/ft2 .8 trench, gpd/ft2 Recommended infiltration surface elevation(s) 97.97 ft (as referred to site plan benchmark) Additional design /site considerations none Parent material outwash Flood plain elevation, if applicable na ft S =Suitable for system CONVENTIONAL ~7 S ^ U MOUND CAS ^ U IN-GROUND PRESSURE CAS ^ U AT-GRADE ^ S ®U SYSTEM IN FILL f~7 S ^ U HOLDING TANK ^ S ~C1 U U =Unsuitable for s stem SOIL DESCRIPTION REPORT Boring # 1> Ground elev. 102.5ft. Depth to limiting factor t90 ~~ Boring # 2 Ground elev. 102.3 ft. Depth Dominant Color Mottles T Structure n i tence C Bounda Roots GPD/ft Horizon in. Munsell Qu. Sz. Cont. Color exture Gr. Sz. Sh. s s o ry Bed Trerxh 1 0-16 10yr2/2 none 1 2fp1 mfr 2f n .3 2 16-41 10yr5/4 none sil lcsbk mfr gw if .2 .3 3 41-90 7.5yr4/4 none ms Osg ml na na .7 .8 ~ `' 0 . Remarks: 1 0-11 10yr2/2 none 1 2msbk mfr gw 2f .5 .6 2 11-28 10yr4/4 none sil lcsbk mfr gw if .2 ~ .3 3 28-52 10yr5/4 none sil lcsbk mfr gw na .2 .3 4 52-88 7.5yr4/6 none ms Osg ml na na .7 ~ .8 ~~ Depth to limiting factor +88" Remarks: PROPERTY OWNER Kernon Bast SOIL DESCRIPTION REPORT PARCEL I.D. ~ 020-1020-90 Boring # 'vii: i4i .... 1.i;.: 3 :<:: Ground elev. 101.7ft. Depth to limiting factor +84" Boring # 4< Ground elev. 100.8: Depth to limiting factor +80" Boring # 5 Ground elev. lO1.Oft. Page 2 ~ of 3 H i Depth Dominant Color Mottles Texture Structure Consistence Bourrfary Roots GPD/ft or zon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0-12 10yr3/3 none 1 lcsbk mfr gw 2f .2 .3 2 12-33 10yr5/4 none sil lcsbk mfr gw if .2 .3 3 33-84 7.5yr4/6 none ms Osg ml na na .7 .8 `~`.~ ' Remarks: 1 0-12 10yr3/3 none 1 lcsbk mfr gw 2f .2 .3 2 12-28 10yr4/4 none sil lcsbk mfr gw if .2 .3 3 28-80 7.5yr4/6 none ms Osg ml na na .7 ~.8 Remarks: 1 0-12 10yr3/3 none 1 lcsbk mfr gw 2f .2 .3 2 12-27 10yr4/4 none sil lcsbk mfr gw if .2 .3 3 27-36 10yr5/4 c2d 7.5yr5/6 sil lcsbk mfr gw if .2 .3 4 36-80 7.5yr4/4 none ms Osg ml na na .7 .8 Depth to limiting facto+80 ~~ Boring # .................. ................. .................. Ground elev. ft. Depth to limiting factor Remarks: Remarks: SBD-8330(8.05/92) .~ F ,• STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Kernon Bast New Richmond, WI 54017 MPRSW-3254 NE4Nw4 s14-T29N-x19w (715).246-6200 town of Hudson lot #28-Grass Range Second Addn. This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test mayor may not be as shown as permanent lot lines were not established at the time the test was conducted. N 1"=40' BM.= top of mid lot survey stake ~ el. 100' Alt. BM.=nail in wooden post C el. 99.00' 2- ~ ~~ ~~ ~/ (~ Gary L. Steel 8-21-98 ~~ h ST CROtX COUNTY SEPTIC TANS MAINTENANCE AGREEMENT AND OV~'NERSHIP CERTIFICATION FORM C{ +~xterff3tri~; • J h ailing .A'~ ~: t•ess ~ y I'' ~1 ~~ ~~, {Verifecaticut resluired from Planning Department for new t: ° y/Stat;~ ,,,;, . Parcel Identification Number ca ~ ~ ~-i 3 S~ --~ 8 -- p op ~ ~ ~!a-AL C!I~! ,SCRIPTI'ON 1' ~ oFerty E ~~= cation /U/__ =/4, /U ~a, Sec. ,~, T o~ ~N-R ~ ~ W, Town of ~, 5x bdivis++o re ~J'~~. f ,Lot # a8 ~' •>rtifier~~~ ~+a.;rvey MaI- # ,r ~ _ _ ,Volume , Pag;~ # w~ array€~y :i:;~:eed # ~Q ~ ~ ~o~ , Volume ~ yY~., Page # ~_~4 ... ai r~G boats=, 7 yes~no Lat lines identifiable yes ^ no Ix:t}~r~+ ter use and r~~sainten~anc~:of your septic system could result in its premature failure to }aandie wastes: Proper rraintena:tce r~7 utists cti p xti rping out th+s septic tank ::very three years or sooner, if needed by a licensed pamper. What you put int ~ he systertt r.., t affect kis ~ 1~unetion of t'~te septic tank as a treatment stage in the waste disposal system. T~,tr ~°~ •+aperty ownssr agrers to submit to 6t. Croix Zoning Department a certification fotm, signed by the ow~~'r and by a rr .. sterpiuFtt~ ~~:,-,,journeyma;:z plumber, restriyted plumber or a licensed pumper verifying that (I) the on-site wastes~i*aterdi~Yr~sai System is n prop~~ . ~a~':~+~ating cond'tion and/or {2) after inspection and pumping {if necessary), the septic tank is loss t~r.~ I+'3 fist of stodge. Ii= :c, ttte u,J+ec-+>igned have read the above resluirentents and agree to maintain the private sewage disposal syst,~xrt with kv, standards sc forth, h.t eis ~, as set by t.te DepRtrtrnent of Co~zztrtetce and the Department of Natural Resources, State of Wit#c;otthn t ;:;rtiftcatiou st; teng than: y ru; r .septic systrsm has been maintained must 'be completed and returned to the St. Croix County Zo~iix-tg':O#I~:rt< witbu~ 3 dr; is of this t'it~:~~e year a pi~~ation date. l~t :i ~ :+F APPLICANT DATE. (:~ +~PI~1E1C~w '1:;RTIFIC,~~TIOIV l •-~ t _ ;+~ertify that ail statements on this form are true to cite best of my (our) knowledge. I (we) atn (:are} tha, a.wner(s) of tF-: proper+,~; +,1+"scribed boy ~e, by virtue of a warranty deed recorded in Register of Deeds Office. ;~' iNATL':ll; », '.aF APPLIC +#NT DATA '" ' ~*"* Aaa~ :r+fotirtation ttat is mis-represented may result in the sanitary permit being revoked by the Zoning :~epa+rte;.as:~t. **#"'x" '~"' Include ~ 4, iu:~ h this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed ~v STATE BAR OF WISCONSIN FORM 2 - 1982 ` ~ WARRANTY DEED DOCUMENT NO. ~+ ~~ - _yo~ .1449 PAGE 390 '! This Deed, made between, KERNON J. BAST and DONALDA J. SPEER-BAST, husband and wife ,Gran~o~ ; conveys and warrants to STEVEN C . RIXEN an RIXEN, husband and wife. ,Grantee for a valuably consideration conveys to Grantee, the following described real es[ate in St. Croix County, State of Wisconsin: 608672 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD Oe-16-1999 x:30 PM iN~IWTY DEED EXEMPT N CERT COPY FEE: COPY FEE: 2.00 TRANSFER FEE: 107.70 REC~tDIN6 FEE: 10.00 PAGES: 1 THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS Steven and Sandra Rixen 938 Becky Circle LOT.=28, GRASS RANGE SECOND ADDITION, ST.CROIX Hudson, WI 54016 COUNTY, WISCONSIN oao- /35~-~-moo PARCEL IDENTIFICATION NUMBER This is not homestead propeny. (is) (is not) Exception to warranties: easements, restrictions, and rights-of-way Dated this 16th day of ~, Donalda Speer-Bast AUTHENTICATION ACKNOWLEDGMENT (SEAL) (SEAL) Signature(s) State of Wisconsin, ss. St. Croix County. authenticated this day of , 19 Personally came before me this 16th day of August , 19~.~., the above named OV~1I1 Kennon J_ Bast and Donalda .T_ Yub~l~ Speer-Bast TITI_E~ MEMBER STATE BAR (7F WiSCt7NSiN ~_rv _.,c~Y1 .. Jul 15 9S 05:38p .r ~ • v.,~r,~. •~ J~~9 02~ ~ ~¢ ,~, ~~ ~ y `` ~•, 2 X05 ,. ORES 1(19,113 Q. F T. __~ i 1 i ~ _.. I_. ~~ tG`~ ~ ____ _ ~ 1 :lt' 3 AC.~E. S ,~ ~r~ E t ~:.i ~ " ~` ).~ `~.~ Sandra Rixen ~~ 715-~38G-2239 ~~~ ~~ ~ ~ ~. ~~~ .~ ~ ~ ~ ,~ \ ~~ . \ -~ . !°,~ ~6~;~ LOT 1 f . ~~ ~~ C3~, 2 0. 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