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HomeMy WebLinkAbout020-1359-26-000 n to O ~ m f ~ ~ tOp ~ 'D ;? ', ~ ~ i 3 i ~ O ~ y O i S O < ~ O V O d I n C7 ? ~. O fD O < m O C ~ ~ ~ fl_ ~ O N R't CO N O O. Oa N O ~ Ub W N -+ C j G7 ~ A O ro ~ O ~ N (D O N N N N ^. N Q n N O- ~ Q 0 0 0 'p 7 N !D C O -p £7 N N O O C n N ~ _ =44 C C1 ~ O ~O ~ ~ O 7 N d N ~ ~ :> v y ~ a ~ z D (D ? cn G ~ N i~~:,,. O cn ~ V ~ s ~ ~ ~ (C W ~~ N N ~ i ~ r« ~ ~ W ~ C_ ~ ~ ~ ` ~} O _ Q1 ~ L .. -< p ~ . K Z i m ~ o o ~ l o ~ ~ ~ I c N a I ~ O O O c O ~ N N N ~ '~ `~ ~ ~ o~ ~ ~ ~ d v ~ v, o - m i n ~ ~ N d 01 ~ ~' ~ . . I ~ ~ p o o Z ~ Z ~ ~' O _ _ N L°i N Yll O ~- ~ ~ ~ ~ N N ~ O 3 n 2 O co C . ~ ~. O ro n a _ w ~ ~ m ~ ~ _ N ~_ -' o _ ~ ~ ~ ~ ~ n W ~ ~ c I ' -+ I I o 0 3 N Z O ~ C.J m ~n o~~~a l~ m ~~ ~ m a c . n ~~ C N D j 00 ~ T ~ C 7 O O ~ n z a , .~ v z O m ~ ~ O ~ ~ ~ ~ ~ N (D O O d...7~ j ~ y ~ ' ~ O C > j' (] NO ~ ~ C ~ N O N NO ~ -. n ~ 3 j 3 O ~ ~ O ~ ~ N ~ O ~ 7 ~ ~ 7 O 3 o _ r. i I ~ I ~ to O I <» O o ~ o g I °o Q. °o Q- o m ~ c ~ o ~ ~ d •• tD A ~ ~ ~ 3 ~ ~ i j ~ , = o y '~, O ' 41 N O O N i N ~ N ~ ~ j Ut O O N O A - + N I S N O i O O I N O N 7 N ~ O I N N = ~ '. d m o (D fl' A ' a w O ~< ~!I A A O I ' N N N ', ' D o a i n r to N N C I ~ 3 ~ ~. I a , : 'l .. ~ _ °' O O O - ' ~ ~ ~ ~ y N N O O ~ ~ O O A o ~ ~ - ~ ~ m • = ~ ~ I N I I m 3 ° ' ~ I ~ N O. 3 ' : ! ~ N Z ~ Z 'I D => N "~ O N I N = O f0 N S (D n ~ v ~ ~ ~ ~ ~ N ~ n A Z ~ rn _ O .. .. rn W ~ ~ ~ a ~ 3 ' ~ a z c ~ i o " c n o C ' N ~ (D (~ ' A A O 7 7 (D ~ ~ I T C ~- i Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Lisowe, Nick Hudson Townshi CST BM Elev: Insp. BM Elev: BM Description: INFORMATION CAPACITY TANK SETBACK INFORMATION PUMP/SIPHON INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to well NATION DATA county: St. Croix Sanitary Permit No: 41 State Plan ID No: Parcel Tax No: 020-1359-26-000 STATION BS HI FS ELEV. Benchmark Aft. BM Bldg. Sewer SUHt Inlet SUHt Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot. System Final Grade St Cover SOIL ABSORPTION SYSTEM BEDRRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 943 Daily Road Hudson, WI 54016 (NW 1/4 SW 1/4 16 T29N R19W) Parkwood Meadows Lot 26 Parcel No: 16.29.19.2122 1.) Alt BM Description = 2.) Bldg sewer length = ~ - amount of cover = I Q i_ l No ' i iI ~ ~ s de fo uadditional Informatlon. Use other _._ __.... _~ l_ - _ I Date Insepctor's Signature Cert. No. SBD-6710 (R.3l97) Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes L~ No [j Yes I ] No ry ounty Sanitary ermit pp ication sr. CROIX COUNTY WISGt7NS1N lr accorc! witn t5,D4 St. Croix County Sani~ary Grdinance ZONING OFFICE PQrsonal information, you provide may be used tar secondary purposes ST. CkG1X CGUNTY GOVERNMENT CENTEF [Privacy Law. S. 15.~t(t)(m)J 1141 Carmichael Road 5~,~ - ~ZS~-OZ_ ~ Hudson, Wt 54(16-7710 (715j3BB-4680 Fax 715 86.4686 Attach complete plans for the System on pa er not less than $-112 x 11 inches in size. County Sanitary Permit ~ ^ Check If revision to previous application QQ t. A llcation fnformatlon - Pleaee Prlni alt intormatlon Location: Property Owner Name ~t/lt/ 1,a U a sec f , JUN 1 8 2002 a~ T ,? N, R / ~ (or Property Owner's Melling Address ST. CROIX COUNTY Lot Number Block Number ~ J ZONING OFFICE ~ ~ ~ /~ ~ / < CL v City, State Zip Code Phone Numer Name or CSM Number Sutxflvision tY~ ..,/ ~ ~ ~ S f C ~ - 30 ~' ~-~~~ ~Q ~'~ E ype o is 1 ng: chea one Cx+ty QVlllage own of ^ 1 ar 2 Family Dwelling - No. of Bedrooms: ^ Pub11c1Commorclai (describe usel: ^ State-owned """-" "`•"-"'-'~ Nearest Road , Check box on line if applicable) one box on line A ck onl f teermtt: (Ch tf T y . e , ype o arcet ax um r s /~•2 j~''/~-Z/2Z A} 1.^ Repair 2~Recannection 3.^Non-plumbing 4. QRejuvenatian _ ~ 4 2(0 ~G' G% ~ ' ~ ~ ~ (~ Sanitation Permit Number Date issued 6) ^ State Sanitary Permit was proviousfy issued lV. Type of POWT System: Check alt that apply} Non-pressurised in-ground p Mound ^ Sand Filter ^ Constructed WetSand ^ pressurized fn-ground O Holding Tank O Single Pass ^ Drip Line ^ At-grade ^ Aerobic Treatment Unit ^ Recirculating ^ Other . S+Sie 1Rreatment Area information: 1. Design Flow tgpd) 2. Dispersal Area 3,1~isparsal Area 4. Soli Application Rate 5. Percolation Rste 6. System Elevation 7. Final Grade Required Proposed (Gals.ddayteq.ft.) - (Min,/inch} lal ~.~ Elevation ~d~ ~~ 7~ ~ ~ t. Tank 1n rmat an apaicty in a ns otaf o Manu acture- re ab rte on- tae 1 er- last c New Existing Gattons Tanks Concrete strutted glass Tanks Tanks © ^ ^ U ~r ^ Q ^ {, Responsibility Statement t, the undersigned, assume responsibility for repatrlrecannenctionlrejuvenationlinstaitation of nan•piumbing for the POVaTS shown on the attached plans. A icense Is not required for terralift re air yr the installation of non- lumbing sanitation s stem. Plumber's Name (prin!) P'lumber's Sign t re (no stamps}: P MPRS No. Business Phone Number ~~i ~`~nc S icrn.~llc;/ !.~ ~ d'~ Y -38G 311 Plumbers Address (Street, City, State, Zip Code} za~d ~ ~ 6~ tit. Gaun Use Qnl Disapproved Sanitary Permit Fee i}atB Issued issui q Agent Signature {No stamps Approved Owner Given Initial Adverse ~ ' zS- -~- Z 2co2 peterminatlan .X. Condtlone of ApprovallReasons for Disapproval: 5 ~ r ,~ yam: cl~ .C ,sd cite. 9Y3 ~~, /~ h~ d ~~o~s~a.rl t! , _ ~ '' G. a - -f' .5".t Y v c c~ .d ~ Y cult -~ l.J, ' t/ G ~ ~. J U ~ ~~d,~o~ u. ,~-v~ G ate. S< a ~ c. l „_ 5,4 ~ ~ fix, s7'~'.u ~ S~r7"~ ~-- A ,Os- o ~ ors o.t .~ . 79~ ~ ~ • ~~ a~7~p4 ~/~~o~z ~ ~ c~ ~ .sue W~ 9Y3 1~~ • `/,r /~ d ~-r`~a[se.cl ~ , ` • ~y '' c. e . s S.~ ~e u c c~ ,~-c y Goolz -~ _ !J, t! G ' ~~ U c ,~/° ~ u- ~.L G c yds. $<a~ ~. ` '~- y~ ~ s ®~k.~'~i~tiq- S~r7'`e ,~, A.OYo .~1/i'S o.l~l 79P, ~ ~ ~~ a~7Yp4 6ll~a-z r 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 Law, s.15.04 (1)(m)1. Permit Holder's Name: ^ City ^ Village ^ la4wn of: la Casse Custom Homes, Hudson Township CST BMElev.:- Insp. BM Elev.: BM Description: ( 3 . L l~3. a-~ ~ ,. TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ i P 5 t U %~ 2 oa Dosing c e ~ f ~~ ~ Hol ing TANK SETBACK INFORMATION TANK TO PJL WELL BLDG. vent to Airlntake ROAD Septic ~ Z I 3 -3 ~ ' 3 ~ / NA Dosing ~ ~ j ( 3 `/t7 ` ~~/ f ` NA Ion A Holdixlg- PUMP /SIPHON INFORMATION ..API, Manufacturer G ,- Demand Model Number Z~ GPM TDH Lift Z Lriction System TDH ~' Ft Forcemain Length -3 ~ r Dia. z !( Dist. To well ELEVATION DATA County: St. Croix Sanitary Permit No.: 370291 State Plan ID No.: Parcel Tax No.: 020-1359-26-000 STATION BS HI FS ELEV. Benchmark Alt. BM 3 ~~ Bldg. Sewer ~ _~ ~/ Ht Inlet ~ 3~ O utlet Dt Bottom '~, y 9 Header /Man. Dist. Pipe (C -I- ~.L 9'. Z ~ . ~ e 2 . / 0 2 . ~' Bot. System l kl r- L is . /, Z /a/. i. Final Grade x ~. Z+b a ~ ~ St cover c~U p ~/, C-f / >l I~ a~ ~~~ Z . a 7 . ~ SOIL ABSORPTION SYSTEM / Z „~,_ /_.. ~ aA„/_ BED / T Width ( Len th ~ No. Of Trenches ., PIT No. Of Pits Inside Dia. Liquid Depth DIME ~ DI EN 1 SYSTEM TO P / L BLDG WELL LAKE 1 STREAM LEACHING Manu ~ctur r: ` SETBACK ~ INFORMATION Type O r / ~ ~ 3 ~- A BE OR NIT o e Num er: System: Cbr.V Q (~ DISTRIBUTION SYSTEM Header / Man old Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. I _~[__ ' ~ Length ~ Dia. Spacing ~ ~9 ~ N ti 7 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only yp Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed !Trench Center Bed !Trench Edges Topsoil ^ Yes ^ No ^ Yes ^ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: ~? lCl l~0 Inspection #2: / / Location: 943 Daily Road, Hudson, WI 54016 (NW 1/4 SW 1/4 16 T29N R19W) - 16.29.19.2122 Parkwood Meadows -Lot 1.) Alt BM Description = ~, 6 -~' ~~ c~ 3~ I"O '""~ cif ~ ~s ~l~ dal 2.) Bldg sewer length = 3(r `/-) L~ vt~- lo~~ 6 ~i a J -amount of cover = ~ ~ r Plan revision required? ^ Yes g No Use other side for additional inform tion. ~ Z SBD-6710 (R.3f97) Dat nspedor's Si ture Cert. No. `•/sconsin SANITARY PERMIT APPLICATION Department of Commerce fn accord with Comm 83.05, Wis. Adm. Code • Attach complete plans (to the county copy only) for the system, on paper not less than 8 v2 x 11 inches in size. ~• See reverse side for instructions for completing this application Personal information you provide may be used for secondary purposes [Privacy Law, s. 15.04 (1 } (m)]. Safety and Buildings Division 201 W. Washington Avenue P O Box 7162 Madison, WI 53707-7162 County , 61 State Sanitary Permit Number 3 X2.9/ ^ Gheck if revision to.previous application - State Plan Review Transaction Number 9. APPLI ATION INFORMATI N -PLEA E PRINT ALL INF RMATI N ~ i Property Owner Name Property Location ~. E ~ v4 SLR t /4, S 1 T , N, R ~ E (o W ' Property Owner s Mailing Address Lot Number Block Number ' 'T City, State Zip Code Phone Number Subdivision ame or CSM Number l.~ ( ) 11. P B ILDING: (check one) ^ State Owned ° ~t~ 9 ° vu Nearest Road, ~ , Public 1 or 2 Famil Dwellin - No. of bedrooms .~ W of CAI III. BUILDING USE: (If building type is public, check all that apply) -~ r l' tier(s) I ~ . ,~ ~ 1 ~ ~ Z~ 22 h~'1 \ ' ., . , , 1 ^ Apartment/Condo 2 ^ Assembly Halt 6 ^ Medical Facility /; ~ ing H '^ Outdoor Retreational Facility 3 ^ Campground 7 ^ Merchandise: S Repairs ~ 1 Q Restaurant! Bar/Dining I I?' ~~ n n 4 ^ Church /School 8 ^ Mobile Home P c~-; ~„ , ,~ ~~D~ Service Station./ Car Wash 5 ^ Hotel !Motel 9 ^ Office /Factory '= S}- Clli01X ^ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A.t.Ch~ck b 'f a tile) A) 1 _ ~ New 2, ^ Replacement 3. ^ Re~(ac~rtaenfof econnection of 5_ ^ Repair of an ` ~-~_~~ _ _ ExistingSystem ________ Exlstln~System - -_____System ________System ____!________ Tanh_fln# _ 'y Date Issued B) ^ A Sanitary Permit was previously issued. Permit Nil ;~ V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other f 11 ^ Seepage Bed ~ 21 ^ Mound 30 ^ Specify Type 41 ^ Holding Tank 12 Seepage Trench{} 1 ~ Sr 13Et.Jii~$^ In-Ground Pressure 42 ^ Pit Privy 13 Seepage Pit 43 ^ Vault Privy 14 ^ System-In-Fill oZ i a c G ~ !~ . $ s 7~ 3, Z V1. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate. S. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gafs/day/sq. ft.) (Min./inch) ,~S Elevation `tLOt~ "7(03. ~ ~~i "-' ~ ~ r Feet Feet VII. TANK INFORMATION Capacit in allon5 Total # Of r Manufacturer s Name Prefab. Site l Fiber- Plastic Exper. N i E i Gallons Tanks Concrete u~t stee glass App ew x n st ~ ed Tanks Tank Septic Tank or Holding Tank f ~~ - t2AO (Y1 i Qrv ~ ^ ^ ^ ^ ^ Lift Pump Tank /Siphon Chamber ~ "r BCX;~ Lpt'-'l1g ^ ^ ^ ^ ^ ^ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plum r Sign ure: (N MP/MPRSW No.: Business Phone Number: a ~ ~a~3 X15- ~~-I~~s Plumber's Address (Street, City, State, Zip Code): IX. COUNTY 1 DEPARTMENT USE ONLY ^ Disapproved Sa ary Permit Fee (Includes Groundwater ate ssue Issuing Agent Signature (No Stamps) Approved ^ Owner Given Initial Surcharge Pee) 7~ ~ ~ ' Z6" ` Adverse Determination 0 S . X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: SBD-639H (R.12/99) DIS1ntBUTION: 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 maybe 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 onsitet;ewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Divisipn, ,608266-3151. 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 t+o oe installed. ` II. 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 line A. Complete line B 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 tank 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. - !X. County /Department Use Only. X. County /Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 1 1 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; F) soil test data on a 1 15 form; and F) all sizing information. GROUNDWATCR.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. . , ,,,; 1 `r -- `~ ~ _~ _ app e ~~T~ 8~ ~ 103, ~b t z~~o C ~~ a~ P ~~- laoo/g©o .~- ~ ~-~ l~~ o?ao35? ~. 5~~ ,.~. to/~ 7.~ Wisconsin Department of Industry, SOIL AND SITE EVALUATION R E P O R T Lal~pr and Human Relations r)iviaion of Safaty R Ruildinas _-~ ...:.~ n 1 1h .,., ..~ 1.1:_ w.a..,, n_.a_ Page 1 of 3 111 G1VVVIV ..1111 141111 VV.V V, •.1v. r 1~.. ,. vv~v ~ COUNTY but Plan must include 81/2 x 11 inches in size e n a t l Att h t it l th l St. , . an on p p r o ess an ac comp e s e e p not limited to vertical and horizontal reference point (BM}, direction and % of slope, scale or PARCEL I.D. # ~., dimensioned, north arrow, and location and distance to 020-1029-3- 1 i I APPLICANT INFORMATION-PLEASE PRI ,~L~-F#f0`R'MATIO'N, E IEWEDB DATE , ~. 3- I}- PROPERTYOWNER: r~ ~ ~ ~ ~ PROPERTY LOCATION "lI~~CJ LaCasse Custon Homes Inc. ~--.~ -GOVT. LOT IVW tl4 SW 1/4,S 16 T 29 ,N,R 19 f(or) W PROPERTY OWNER':S MAILING ADDRESS ~ f ~, ~ ,17~ # BLOCK # SUED. NAME OR CSM # 521 McCutcheon Rd. '' - na Parkwood Meadows CITY, STATE ZIP CODE ~- -RHONE !k TY VILLAGE {]TOWN , NEAREST ROAD Hudson WI. 54016 '1; •~-~ N 405 ~ Hudson i'Keadowood Ln. [ ~} New Construction Use ~ ] Residential / I~rimGer.~# t~edr t [ ]Addition to existing building (]Replacement [ J Public or commerce Code derived daily flow 600 gpd Recommended design loading rate .7 bed, gpolft2 .8 trench, gpolft2 Absorption area required 858 bed, ft2 750 trench, ft2 Maximum design loading rate . 7 bed, gpolft2 .8 trench, gpd/ft2 Recommended infiltration surface elevation(s) 101.75 ft (as referred to site plan benchmark} Additional design /site considerations na Parent material outwash Flood plain elevation, if applicable na ft S =Suitable for system CONVENTIONAL ®S ^ U MOUND ®S ^ U IN-GROUND PRESSURE ®S ^ U AT-GRADE ®S ^ U SYSTEM IN FILL ®S ^ U HOLDING TANK ^ S C$U U =Unsuitable fors stem SOIL DESCRIPTION REPORT Boring # .................. ................. 1 .> Ground elev. 105.5 ft. Depth to limiting factor +84.' Boring # a Ground elev. 105.5 ft. Depth to limiting factor +8 11 Depth Dominant Color Mottles T t Structure Consistence Bounda Roots GPDlft Horizon in. Munsell Qu. Sz. Cont. Color ex ure Gr. Sz. Sh. ry Bed Trench 1 -13 10 r 3 3 n 2 13-28 10 r 4 3 none sicl 2msbk mfr 2f .4 .5 3 28-36 10 r 4 4 2 7 r n f n 4 .2 4 36-84 7. 4 s ~l' Remarks: 1 0-12 10 r 2 2 none 1 2msbk mfr 2f .5 ~.6 2 12-30 10 r 4 4 none sicl 2msbk mfr if .4 '.5 3 30-88 7.5 r 4j6 none cos Os ml na na .7 `: .8 i ~~ 81 Remarks: CST Name:--Please Print Gary L. Steel Phone: 715-246-6200 Address: 1554 200th. Ave ew Rich and I 54017 Signature: Date: 7_10-99 CST Number: m02298 i PROPERTY OWNER LaCasse Custom Homes, SlQtil. DESCRIPTION REPORT Page 2of~ ~ PARCEL I.D. # 020-1029-30 i Boring # 3 , ................. Ground elev. 105. ~. Depth to limiting facto+90 Boring # 4 Ground lUl~v.7ft. Depth to limiting factor +84" Boring # <" 5 Ground elev. 106.p Depth to limiting factor +90" Boring # .................. ................. Ground elev. ft. Depth to limiting factor Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/~t in. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. Bed Trends 2 8-25 10 r 4 4 none sicl mfr 3 25-35 10 r 5 s' cos Os 1 na na .8 ~.b `(,~, Remarks: 1 0-9 10 r 2 2 none 2 9-23 10 r 4 4 none i 1 ,5 3 3- 10 r 5 4 c2 7.5 r 5 8 sil M na if n .2 4 Remarks: 1 0-12 10 r 2 2 none 1 2msbk mfr 2f .5 i .6 2 12-30 l r 4 4 e r 2f .4 .5 3 30-90 7.5 r 4 4 none cos Os ml na na .7 .8 Remarks: Remarks: SBD-8330(8.05/92) f STEEL'S SOIL SERVICE Gary L. Steel LaCasse Custom Homes, Inc. 1554 200th Ave. CSTM2298 ~4~4 s16-T29N-x19w New Richmond, WI 54017 MPRSW-3254 town of Hudson (715) 246-6200 lot #26-Packwood Meadows This soil evaluation was conducted to satisfy a zaninq requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test-was conducted. "=40' ~?= top of SW lot stake C el. 100.00' ~t. BM.= top of NW lot stake ~ el. 103.60' ~ ~ Gary L. Steel 7-10-99 -...:.r ....~ _- ------- . _~ - _ •~• _.;_.~~ar.a tt1tOSS SECTION AND SPECIFICATIONS 4n CI VENT PIPE 12" MiN. A80VE GRADC E W~Ty~ pR00F 25' FROM DOOR, WINDOW OR JUKCTION BOX APPROVED FRESH AIR INTAKE MITN CONDUIT MANHOLE t FINISHED GRADE 4• CI RISER W/ PADLOC 6" !lIN. MARKING ! ----.. A80V E~ GAD ~_ ~ _ -~~ v N it I 1 18 IN. 6" HAX. t - _'~ INLET •• - ~ ~ ~ . WATER TIGHT SEALS ~S_ ~ TIGHTS v ~* CI PIPE SEAL ~ BAFFLE ~ APPROVED 3' ONTO - 8 ~ LM JOINTS V! 5 D ~ ON PIPE 3' 0 ~ j i C ' S01,ID SO! PUHP OFF ELLV . ~-FT. -~-- ~ OFF '~• RISER D PERMITTCD IF TAyK MANUFACTUI 3" APPROVED BEDDING UNDER TANK HAS APPRO' CONCRETE PAp SPECIFICATIONS SEPTIC / DOSE ~ - -- -- ----------• -- --. _...--- - ...... . TANK MANUFACTURER: NUMBER DOSES PER DAY: `J ~rANK S2Zt5: SEPTIC /o7G2~ GAL. ~~ _.__ DOSE DOSE VOLUME INCLUDING _,~~~ GAL . FLOWBACK • a~~ ALARM MANUFACTURER: -- HODEL NUMBER: SWITCH TYPE: PUMP HANUFACTURER: MODEL NUMBER S1~iITCH TYPE: REQUIRED DISCHARGE RA p~ . ____.__, GAL . CAPACITIES: A = 33 INCHES = y~ ~ C B = _?,,, INCHES = G Q ~ C = ~ INCHES = _~~ D = ~ INCHES = SD G TE -_ GPM PUKP E ALARM WIRING AS PER ILHR ~ 16. 23 VERTICAL DIFF'ERCNCE 8E'1~lEFN PUlsP OFF AND DZ5TRIBUTIOIV PIPE ~~ • MINIKU~ NETWORK SUPPLY PRESSURE _ FEET • - ~~ FEET FORCQNAIN X ~FT/ 100 ~ FT. FRICTION FACTOR ~ . ~ ~~fr FFEZ' TOTAL DYNAMIC HEAD . ~ -~L~ FEET INTERNAL OIHENSIONS OF PUMP TANK: (,ENG~ ~_ FEET WIDTH ; DIAMETER LIQUID DEPTH ~Q /~ ---_.,. IGNEO : _ LZCENgg IRJMeE7t ll~oZ 0.3.E?....~... GOUIds ~~- ~ e~6 Submersible - Effluent Pump ~, 3871 EP04 EP05 APPLICATIONS • Fasteners: 300 series • Fu11y submerged in high ^ Motor Housing: Cast iron ' Specifically designed for the stainlesssteel. • Capable of running grade turbine oil for -lutiricatiot and efficient ~ foreffigenfheattransfer, strength, and durability. following uses: ~ dry without damage to fieat transfer ^ Motor~Cover: Thermoplas- • Effluentsystems •Homes ~ components' Available for automatic and be cover with integral handle . • Farms ~-~:= Motor. _ • ~ ~manaal operation. Automatic and float switch attachment ` p . oirrts • Heavy duty sump EP04 Sin le base: 0.4 HP 115 or 230 V, 60 Hz, 1550' models include Mechanical - ~ power Cable: Severe d ~ • Water transfer • Dewatering RPM, built in overload with Float Switch assembled and preset at the factory. rated oil and water resistant automatic reset ~ ^ Bearings: Upper and lower SPECIEICATIOHS •EP05 Single phase: 0.5 HP, 1 i 5 V 60 Hz 1550 RPM EEATIfRES ~ heavy duty ball bearing Pump: EP04 , , , built in overload with ~ EP04 Impeller: Thermo- construction. - • Solids handling capability: automatic reset plastic Semi-open design AGENCY LISTING g/a' maximum. • Power cord: l0 foot ~ pump out vanes for • Capacities: up to 55 GPM. t 24 f • T t ! h d t standard length,l6/3 SJTO with three prong grounding mechanical seal protection. SP- t~adiaastandarQsAssoaatioa ea s: up o ee o s ~ EP05 Impeller: Thermo- • Discharge size:l ~/z"NPT. plug. Optional 20 foot plastic enclosed design for (CSA listed model numbers " ° " " • Mechanical seal: carbon- length,16/3 SJTW with improved performance. or AC .) end in F rotary/ceramic-stationary, three prong grounding plug BONA-N elastomers. (standard on EP05). ^ Gasing and Base: Rugged • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Pump: EP05 • Solids handling capability: ~/' maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet • Discharge size:l%'NPT. • Mechanical seal: carbon- rotarylceramic-stationary, BUNA-N elastomers. • Temperature: '~- 104°F (40°C) continuous 140°F (6Q°C) intermittent ....~-r'~r~. :~. ~.. . ,, - .wt.'•f r~ ~. h A ~O~C r LL. bw.- twn METERS ff FEF~' 10h s a o ~ a' w v 6 z 5 }~ 0 '' 4 0 E- 3 2 thermoplastic design provides superior strength and corrosion resistance. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ~ ~~,~ f~3I Y~~ ~~i Mailing Address ~7rZ / Yh C e' u ~-G ~ dam ~~ ~~~ ~. Property Address L ~CF e G (Verification required from Planning Department for new construction) ~" _ City/State 1'~u ~ Ci--± Parcel Identification Number 0 a ~ - ~ ~ ~`~'- ~~ ~ O ~~ LEGAL DESCRIPTION Property Location S ~ '/,, ~~ '/,, 5 ec. j d . T~_N-R~W, Town of ~,rG d .~t°jz- . Subdivision i'~,4 r rc ~~~rr~ ~p ~ A«,~ ~ .Lot # ~. Certified Survey Map # ~- ,Volume ~~- . Page # Warranty Deed # t,,~ v2 ~ ~ 7 S ,Volume X02 ~ Page # S Spec house ^ yes f~( no Lot lines identifiable ^ yes E~f no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 f the three yea expi 'on date. / /~ SIGNATURE APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the perty describe above, b virtue of a warranty deed recorded in Register of Deeds Office. /~ /© SIGNATURE F APPLICANT DATE ****** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ****** ** Include with 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 • ~~ ~ STATE BAR OF WISCONSIN FORM 1 - 1982 WARRANTY DEED .. DOCUMENT NO : VQL_~~~QPAGE2~~__,_ ~ Howard LaVenture, three-fifths ~ This Deed, trade between (3/5) interest in and Arlene LaVenture, two-fifths _ (2/5) interest in, as tenants in common. ,Grantor, .,,~ (ZGt SSn - LatW~n n.p S r1L Grantee, conveys to Grantee the following described real estate in St . Croix County, State of Wisconsin: 625075 Y.ATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 06-19-2000 x:30 PM WARRANTY DEED EXEMPT # 17 CERT COPY FEE: COPY FEE: 2.00 TRANSFER FEE: RECORDING FEE: 10.00 PAGES: 1 THIS SPACE RESERVED FOR RECORDING DATA NAME ANO RETURN ADDRESS ~aC~ e(~om ~br~ s,1 n~ . ~ S oZ ~ fneCv~rh¢-on CLd aav~~ 3s~~ .a~- ~? PARCEL IDENTIFICATION NUMBER This deed is given in partial satisfaction of certain land contract598116 Fewhichywas~ add recorded in Volume 1404 , Page 6th as Document Number 1431 subsequently assigned by assignment dated May 28, 1999 and recorded in Volume Page 352 as Document Number 604323 This is not homestead property. (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; ,_, Grantor warrants•that the title is good, indefeasible in fee simple and free and clear of encumbrances except i! i~ ~~ I~ 199 I~ all liens, covenants and restrictions of record, if any and any liens or encumberances created by act or default of the Grantees Witnesseth, That the said Grantor, for a valuable consideration LOT 26 OF PARKWOOD MEADOWS, -TQa;J of }~t~1~- S~•~(OiX COUNTX, WISCONSIN. and will warrant and defend the same. Dated this 16 day of AUTHENTICATION Signature(s) June 2000 (SEAL) a~ (SEAL) ~~ Howard LaVe~nQture/~ (SEAL) ~~p ~e,.~-C~1SL '!'" •16~~.~- (SEAL) ~ ,~i * Arlene LaVenture ~j authenticated this r~'of d+~+ t , 1'~~D TITLE: MEMBER STATE BAR OF WISCONSIN ACKNOWLEDGMENT State of Wisconsin, ss County. Personally came before me this day of 19 ,the above named r- - - a ~ 'oo° 14' 2s"_ w 2623.31' DAILY_ R_OA_D ~ - nnn V Annn 5.1~ 0 0 N~~ -~___1_____ 3' i ~N ~~ ;W N •D O I~ IN 5 ,a I o ' I to ~ "'' N Z Z I p0 OD pw ~ aD ~N ~ n W N W oo~ ~ N W p p I ~ \ ~ ~ ~ g •'~ to I \ \ a \ ~ c\ ~ , 98.93' ° 265.00' 265.00' _ \ `~ w ~ MEADQWOOD LANE N o0°18~ ` C~9 ~ w rn - \ \ ~_' S 00°1S ~ Cg 156.29' ~ o ~ 275.00' 1 ~ -~- - -~- - -~ I N 00°18'32" W o Z - oc \ N ~ OU (~ , ~,~• cS O v? ~ S _ ~ Z tN W -~. ~ V -+ N N , W ~ ~ ~ ap O N II ~ ~~ 1 ,~'~ W~ ~ 25' ~: ~ ~D J °o N ~~ ~ i N~ Z ~ ~ N~ fD- ~~ k \ I ~~p.NQ O;'p tp 6~ U m \ i • No:o ~ _ 25 N n0° 18' 32" W 44U 00' \ ~ ....... ... . ......... .... : ......., t . 374.50' ~ ' cn ° o ~ ~~ S 00 18 32 E 147 i 1.22 174.99' 349.50' 5.00 - 75.00' 275.OQ ~-149.64' \ - \~ \~ w~ 0 \p l S 00° 18' 32" E 1314.38' - S 00° 18' 32" E 1464.02' LINE OF THE NW 1/4 OF THE SW 1/4 UNPLATTED LANDS ~n ~ ~lO~Cn;`WN~OcO0D~J0~(n~-WN~ m T