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HomeMy WebLinkAbout020-1370-41-000t- ,/* ~ i 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)). Permit Holder's Name: LaCasse Homes, Inc., ^ City ^ Village ^ wn of: , Hudson Township CST BM Elev.:. q. ~ Insp. BM Elev.: R ~. ~ BM Description: ~.a° 1 ~ o ~F~< < TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic .~ ~ w ~ ~ZQo / 2 d'O~ Dosing ~00 Holdi TANK SETBACK INFORMATION TANK TO P / L WELL BLDG. vent to Airlntake ROAD Septic ~ 3o i ~ ~ ~s~c c NA Dosing > 3~ ~ 'zj •ZZ ~ NA NA Holdin PUMP /SIPHON INFORMATION Manufacturer Q6 5 Demand Model Number ~ ~ Y GPM TDH Lift S Z Lriction System TDH Ft Forcemain Length Dia. Fi Dist. To well ELEVATION DATA Count ~t. Croix Sanitary~P39rrli1 No.: State Plan ID66No.: Parcel Tax No.: 020-1370-41-000 STATION BS HI FS ELEV. Benchmark ~ .Z Alt. BM 2.~ /o .S ~ Bldg. Sewer to ~ ~ St/Ht Inlet ~. S ~, 5 St / Ht Outl Dt Bottom 1(. 3 . ~S Header /Man. Dist. Pipe Tl S, ~ • ~S- Bot. System (`~ ~f ~' zs 9 3- ~ Q ~., o Final Grade St cover a o/, Z ~ SOIL ABSORPTION SYSTEM /~ ~s ~ BED / ENC DIMEN width ~ 3 Lengt ~ ~ y No. Of Trenches ~ PIT DIMEN 1 N No. Of Pits Inside Dia. Liquid Depth SYSTEM TO P/L BLDG WELL LAKEISTREAM L Manufacturer: SETBACK INFORMATION Type O ~ ~ 3 CHA BER Mode Num er: ' System: GOwJ ~3~ ~ Z(1 0 T ~ ~ DISTRIBUTION SYSTEM Header 1 Manifold i i~ Distribution Pipe(s) i x Hole Size x Hole Spacing Vent To Air Intake Length L- Il Dia. ~ Length ~ Dia. ~f,~ Spacing N 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 Bed /Trench Center Bed /Trench Edges Topsoil ^ Yes ^ No ^ Yes ^ No r~ COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1• ~ / 1 /va Inspection #2• / I Location: ~9 £S Parkview Lane, Hudson, WI 54016 (NW 1/4 NW 1/4 16 T29N R19W) - 1629192207 Parkwood Meadows - Lot 41 \ 1.) Alt BM Description = }"~D o~ f~u~vl~%M Q6•u~ ~~d~ SPw~~ y J ~'"'~'S~ < <'` s/°`c~``~ ~'~t 5 ~^- 2.) Bldg sewer length = /y ~ .6.0'~ ~~,~5 ~ Gv9r~ lv~yt~;i' /~~ -amount oflcov/q~er = >(~" ~ ~rh ~/ ,, // 3~ hd Wl~~ au' t.'~a~ S~SVS~cw.f~u,St Ir(G~"a.~'iw. L~.j~ - t1 t t.6~ Ot.S ~6k i ~i~ Plan revision required? ^ Yes ~' No Use other side for additional information. ~ j 0 SBD-6710 (R.3/97) Da Inspector's nature Cert. No. ~ J.c~, P.4.te_lc,,t~_t~r- l~ ~ I ~ , r1A , lq . 27~ ~1 °f ~ Sanitary Permit Application Safety & Buildings Divisior ~ In accord with Comm 83.21. R'is. Adm. Code 201 W. Washington Ave ~ ~ `~ See reverse side for instructions for completing this application PO Box 730: seonsin personal information you provide may be used for secondary purposes Madison. WI 53707-730" Department of Commerce [Privacy Lati•. s. 15.04(1)(m) _----~ (Submit completed form to county if r state owner. Attach com lete tans (to the county co only) for the sv b t`less t 8-1/2 x 11 inches in size. Coun State Sanitary Permit Number ^ Check vi n to prev~is applicati;~h , State Plan I. D. Number I. A lication Information -Please Print all Information ~ ~ cation: ~ ` Property Owner Name ~ i 1 ~ 1 ~ Z~~~ ~ -P perty Location , ) ~"YI~-~~ `'V ~-'; 114 /U~I4. S ~J T~ >N. R/ or Vb Property Owner's Mailing Address C(7Uty! v ~ ~ ~ t Number Block Number City, State Zip Code Phone ~ p, ~ Subdivision Name or CSl`1 Number 1/~- -~ .. II Type of Building: (check one) ^ City {d' 1 or 2 Family Dwelling - No. of Bedrooms:~ ^ Village Town of ^ Public/Commercial (describe use): ^ State-owned III Type of Permit: Check only one bex on line A. Check box on line I3 if applicable) Ne est oad - p) I. ~1 New System 2. ^ Replacement 3. ^ Replacement of 4. ^ Addition to Parcel Tax Number(s) S stem TankOnly Existin S stem C?o2G' - - - O B) Permit Number Date Issued ^ A Sanita Permit was reviousl issued IV. Type of POWT System: (Check all that apply) f,B.Non-pressurized In-ground ^ Mound ^ Sand Filter ^ Constructed Wetland ^ Pressurized In-ground/3 ~D ^ Holding Tank ^ Single Pass ^ Drip Line C ^ At-grade ~ c t~ D Aerobic Treatment Unit ^ Recirculating ^ Other: -lt^ ~S V Dis ersaUTreatment Area Information: 3~ /o 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade G ~o Required Proposed Rate (Gals./day/sq. ft.) (Min./inch) ` ~ ~~: qD Elevation mob ~/y •i . ~ - z - VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing Crete structed S Tanks Tanks .~' ~ ^ ^ ^ ^ ~ ~~~c~ r `5O I V VII Responsi City Statement I, the undersi mod, assume res onsibilit fer installation of the POWTS sho n the attached ]ans. Plumbe 's Name ( int) Plumb 's Signature (no M PRS No. Business Phone Number /~ r Plumber's Address (SVeet, C'ty State, Zip Code) VIII County/Department Use Only O Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued D Issuing Agent Signature (No stamps) ~pproved ^ Owner Given Initial Adverse $°,~ u ) - 7 ' ~ ~ Determination P aas ~ T Z ~7~ IX. Conditions of Approval/Reasons for Disap roval• a~S s~. ,~-{-I~ae-- ~-- o.~ r~- .~.Q~-.d-e~-e~C-s ~~a~e, .e~l.e~l.v.~t,~ - ~ ~- SBD-6398 (R. 07/00) ~ ~Z ,~l:ew*~ 1 S ~ ~ 2R . f ~ 3a ~~,~ d ~ 'f ~ /~.~n~ . 1 ~~ ~ ~T c ~ ~,/~C-'~-- f ~ /a,~c /TSC T~-~-~ ~,~ G sy ~~ ~as~ /~ ~ , _ ,~, ~ ~~ ~ ~ g,1 ~ '~ J ~ x ~~fi ~~ ~~ ~~ ~~~ ,~- /~{v~-- e~ pr(o6/3c5A ~` l~aa~.3s~ .i _~~ ~~evsa ti Wisconsin Department of Commerce nip,,,, ~ Gatww and l3uildinas ~/~ir~yS ~ o r~~`l2 `~ ~, ~ ~,~~~~- ~ SOiL EV i REPORT Page ~ of .3 -------- -- -----, - in accordance with C t}~,1Wis. qdm. ~eQe / \~ ~~ Attach complete site plan on paper not less than 8112 x 17 i ~fn inducts, tsar rat limited to: vertical and horizontal reference r M), di „ ..P I.D. Cs, ~G ~ ©^ /O Z and Iocati n distance to nearest road. north arrow dimensions o t ~,.~ © CJ , , e r percent scope, sta Please. pant all infonrtati .' l ~ t ! +- ~ '{ Zu~L~ by Date rivacy Law 1 ).(m})• Personal intormelron you provide may ba used for secondarypu ~f Q•i~ ~ Prop_erty~r \~~~ Z L~~ Govk Lot ~~~/4 (,~ 1!4 S T z~J N R `iSCw? W O~ ~F S~ Pn Owner's Mailing Add ss ~ .Name or CSM11 15 ~ws~' ~a~~ ~~ ~~' c-_ ~ iR C State Zip Code Phone Number ^ City ^ Pillage ~i Town Nearest cad d~ o u~~ s4-o c 5~~8 f -5~`a5 ,~. New Construction Use: ^ Resideatlal t Number of tredrooms ~_ Code derived design flow rate ~00 GPD ^ Repfaoerrrent ^ Public or corrrrrrercial - Desrxibe: Parent matestial /~ t.G~ "1 ~~~ Flood Plain elevation if applicable ~ General correrrerrts and recommendations: ~~ I] Bonne ~~ ^F1'7n I ~ r ~n~ ~ ~ Pit Ground surface elev.1~ / ft. Depth to limiting fas~or ' r `^ " rn. ~I Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP *Eff#1 O 'Eff#2 in. Mansell Qu. Sz. Conk Color Gr. Sz Sh. ~ O- Lf Q 23/,3 / S YV1~ ~ u~ ~ 5 . 8 .3 ~ z D ~i~ ~?d "7 . S l~ ~ ~s ~ ~ . 5 , ~ Z - Zo ~ ~ S 5 r4- ~ ~ • ~ btioo " ~•F ss•Z tf , z boring # ~ -f ~ z ~ -Pit Ground surface elev. ~ d ~ ' 9 ft. Depth to limiting factor in. Scp icetion Rata Notizon Depth Dominant Color Redox Descxiptian Texture Stnrcture Consistence Boundary Roots OPD/fF in. MunseN Qu. Sz. Conk Color Gr. Sz. Sh. ~E~1 ~ j Q_ O ~ 22/~ ~ , ~ 8 ~, _ 2 ~i S, I s m ~7 / , 5 - S _,3 5/ zd ,S 5/ c°S ,~ ~- ~ S ~ z5 9' ~ s 'O s I J. ~•$ t3o.8 • EfthreM#1 = BOD > 30 _<?20 mgiL and TSS >30 < 1 50 mglL Eftluerd #2 = < 30 mgli-and TSS < ~ mglL CST Name (Please Prim Signature / CST Number ©zz. yB Address Date E Conducted Telephone Number ~~- -tr ~ ~ ~ S-Oct 7 S - 2~~ - (o zo 0 Property Owner C-~C~~ Parcel 4D # ~7D ' ~~ ~ ~ J 6 Page ~ a Boring ~- Pit Ground surface elev. /~ 1~.5 tt. Depth to limiting factor Z D ~• Soil ication Rate ~ ~°~~ Horizon Depth Dominant Color Redox Desc~ption Texture Stnx.~ture Consistence- Boundary Roots. GPDItF in. Munseb Qu. Sz Cone Color Gr. Sz Sh. `E1f#1 'Etf#2 Z ~Z Cs a .S ,~ 2-,~ ~~ ~ :SJ ~ `~ I S p., a z S/ S l ro Z~ ~,5 ~ ~ S ~' _s Z Z ^ ~~ # U Boring ^ Pit Ground surface elev. ft. Depth to rrmiting factor in. Sail ~ Rate tion ri d D R Texture Structure Consistence Boundary Roots GPD/FE Horizon Depth in. Dominant Color MunseA p esc ox a Qu. Sz. Coat Color Gr. Sz Sh. `Etf#1 •Eif#2 ~ ~ri~ ^ Pit Ground strriace elev. ft. -Depth to Itmidng factor in. ~! icatlon Rate Horizon Depth Dominant Cotor Redox Desaiption Texture Stntdure Consistence Bowrdary Roots GPD1tF in. MunseN Qu. Sz. Cont Color Gr. Sz Sh. 'Ef!#1 `EYt#2 ` E8luent #1 =BODE > 30 _< 220 mglL and TSS >30 < 150 mglL. ` Effluent #2 = BODE <_ 30 mglL and TSS _< 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R6A0) t ~ ~° STEEL'S SOIL SERVICE Gary L. Steel l / 1554 200th Ave. CSTM2298 ,G,q- ~~sSG-" ~..c.ss~o ~r ~~~~C New Richmond, WI 54017 MPRSW-3254 ~ ~)/,~ ~ ~ y~ f S /(~ --~`z~ ~ ~ OZ ~~ ~ (715) 246-6200 ~D u~ ~ ~ ~l~ o ~ ~ "~ ~~ ~~-~/ ~~- v~ ~~ ~ Wisconsin Department of Industry, SOIL A N J SITE EVALUATION R E P O R T Labor and Fl+~man Relations - LDivision of Safety & Buildings .~ . '"` ..a4. ~~ uo en nr ~A/te. A.~Irr. ;.f`nH.i Page 1 of 3 ~". ,: _., _ COUNTY fs~t f'ar1•rsrust incl~?de lan on a er not less than 8 1/2 x 11 inches in size P Attach com lete site , p p / p p not limited to vertical and horizontal reference point (BM), direction and % of •alope scale br ' ~~ ' PAR EL LD. # dimensioned, north arrow, and location and distance to nearest road. _ ` ' 020-1028-90 ~ ~ ~~~~ APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION' .V REVIEWED BY DATE PROPERTY OWNER: ay0 PROP LaCasse Custom Homes, In¢~,! ~ 'GOVT. LOT 1~~~rpE>1 ~ 1ia,S 16 T 29 ,N,R 19 ~ (or) W PROPERTY OWNER':S MAILING ADDRESS L T:# ' BLOCK #: ,St~Bp: ,Nf•CME OR CSM # 521 Mct:`utcheon Rd. 41~ -_na '-Packwood Meadows First Addn. CITY, STATE ZIP CODE PHONE NUMBER ^CITY ^VILCAG~ [MOWN NEAREST ROAD Hudson, WI. 54016 (715j 381-5405 Hudson McCutcheon Rd. [x] New Construction Use (x] Residential I Number of bedrooms 4 (]Addition to existing building j ]Replacement ( ] Public or commercial describe 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, gpolft2 •8 trench, gpolft2 Recommended infiltration surface elevation(s) 97.9/97.3/96.10' ft (as referred to site plan benchmark) Additional design /site considerations system installed to code depth or surface area cut to code. Parent material outwash Flood plain elevation, if applicable na ft S =Suitable for system CONVENTIONAL ~] S ^ U MOUND ~l S ^ U IN-GROUND PRESSURE ^ S ®U AT-GRADE ^ S ®U SYSTEM IN FILL ®S ^ U HOLDING TANK ^ S L~9 U U =Unsuitable fors stem SOIL DESCRIPTION REPORT Boring # .................. ................. 1 Ground elev. 102.4ft. Depth to limiting factor Boring # 2 ................. Ground elev. 103. ©. Depth to limiting factor +100" Depth Dominant Color Mottles re Text Structure Consistence Bounda Roots GPD/ft Horizon in. Munsell Qu. Sz. Cont. Color u Gr. Sz. Sh. ry Bed Trer>ch 1 0-10 10yr3/3 none 1 2msbk dsh gw 2f .5 ~.6 2 10-36 10yr4/4 none sil 2msbk dsh gw if .5 .6 3 36-46 10yr4/4 d 7.5yr5/6 sil 2csbk dsh gw if .5 .6 4 46-10 7.5yr4/6 none cos Osg ml na na .7 '•. .8 r ~ 4,90 ~ 9b _ 90 s~/q o ~,___ ~ ,r Remarks: 1 0-10 10yr3/3 none 1 2msbk dsh gw 2f .5 .6 2 10-29 10yr4/4 none sil 2msbk dsh ~w if .5 .6 3 29-39 10yr5/4 2d7.5yr5/6 sil 2csbk dsh gw if .5 i .6 4 39-10 7.5yr4/6 none cos Osg ml na na .7 ~ .8 4.1.2 4~•L d(-4G•9o ~'i.'Z I~t,Z~ Remarks: CST Name:--Please Print Ga L. Steel Phone: 715-246-6200 Address: 1554 20 ve. New ichmo WI 54017 Signature: Date: -30-99 CST Number: m02298 PROPERTY OWNER LaCAsse Custom HomesSm~bl.cDESCRIPTION REPORT , Page? of 3 PARCEL LD. # 020-1028-90 ~ Boring # .................. ................. .................. ................. .................. ................. Ground elev. 7n~_~#t. Depth to limiting factor +i nn~~ Boring # .. 4 ~<~. Ground elev. 101.5t. Depth to limiting factor + ~~ Boring # 5 . Ground elev. 101.1 ft. Depth to limiting factor +100~f Boring # Ground elev. ft. Depth to limiting factor Horizon Depth Dominant Color Mottles Texture Structure Consistence Borxx~ry Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0-14 10yr3/3 none 1 2msbk dsh gw 2f .5 .6 2 14-32 10yr4/4 none sil 2msbk dsh gw if .5 .6 3 32-43 10yr4/4 c2d 7.5yr5/6 sil 2msbk dsh gw if .5 .6 4 43-10 7.5yr4/6 none cos Osg ml na na .7 .8 4G,~o~ 46.90 , ~~•Y o. b~P•e/too.e Remarks: 1 0-14 10yr3/3 none 1 2msbk dsh gw 2m .5 .6 2 14-32 10yr5/4 none sit 2csbk dsh gw lm .5 .6 3 32-10 7.5yr4/6 none cos Osg ml na na .7 .8 Remarks: 1 0-17 10yr3/3 none 1 2msbk dsh gw 2f .5 i .6 2 17-40 10yr4/4 none sil 2csbk dsh gw 2f .5 .6 3 40-50 10yr5/4 c2d 7.5yr5/6 sil 2csbk dsh gw if .5 .6 4 50-10 7.5yr4/6 none cos Osg ml na na .7 `.8 Remarks: Remarks: SBD-8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel LaCAsse Custom Homes, Inca 1554 200th Ave. CSTM2298 NWgNw4 S16-T29N-Rl9w New Richmond, WI 54017 MPRSW-3254 town of Hudson. (715) 246-6200 lot #41-Parkwood Meadows First 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 may or may not be as shown as permanent lot lines were not established at the time the test was conducted.. N 1"=40' BM.= top ofl" pvc pipe C el. 100.00' Alt. BM.= nail in Boxelder tree C el. 99.80' 4 nn~ lv G~ Gary L. Steel ($' 30-99 Sep-O1-99 10:30A • --•~ ~:..+~~a~.rc tyKOSS SECTION AND SPEC?FIGTIONS 4" CI VENT PIPE I?" MiN. ABOVE GRADE E VCATyER PR00F ~ 25' PROM DOOR, idINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MANHOLE ~ FINISHED GRADE 4• CI RISER W/ pA0L0~ 6" MIN. HARNING l A80V E G AD E -~.._ -~_ w ~~ M I 1 18" IN. 6" MAX. _. ;: ~ • INLET ~f"-' ~~ / ~ ' „ WATER TIGHT SEALS GAg_ ~ • 4 / ~ TIGHT. CI PIPE BAFFLE ,-/ ~_ SEAL ~ APPROYeD 3. ONTO B ~ LM JOINTS W/ SOLID -T- ' ON PZPE 3' 0 S0I L C ' SOLID SO! PUMP OFF ELLU . __E'T• ~ ~ ~ OFF +• RISER ~ PERMITTCD IF TANK MANUFACTU] 3" APPROVED BEDDING UNDER TANK HAS APPRO' SPECIFICATIONS CONCRETE PAp EPTIC t DOSE ~ •- - ~ •-- -------- -- -........ _ ........ . TANK MANUFACTURER: NUMBER DOSES PER DAY: ____ • 'TANK SIZCg; SEPTIC ~o~SIJ GAL. DOSE VOLUME INCLUDING DOSE ~ GA L , F LOWBACK : 13, ,,~ GAL . htARM MANUFACTNRER: GPACITIES: A : MODEL NUMBER : G~, ~ INCHES = ~-J y ~ ~ SWITCH TYPE: "'~"~- B = _~ INCHES = ~3Z G t'UMP MANUFACTURER: ltODtL NUMBER : C ~ `~%2 INCHES = ~,~ SWITCH TYPE: D ° --L.... INCHES -` KEOUIRED `~ DISC HARGE RATE ~ GPM PUMP E ALARM WIRING AS PER ILHR 16.23 VERTICAL DIFFERENCE BETWEEN pUhp OFF AND DISTRIBUTION PIpE . • MINNIMUM NETWORK SUPPLY PRESSURE /G ~ FEET • ~¢..,,~_ FEET FORCEtlAIN X /, 7 FT/ 200 •FZ'. •FRICTION FACTOR ~ . FEET TOTAL DYNAMIC yGp __ FEET INTERNAL OIHENSIONS OF PUMP TANK: LENGTH / ,3 FEET WIDTH ; DIAMETER LIQUID DEPTH ,j~~~ _ . . IGNED LICENSE MJNeER ~~' as d ~s ~ .. -.~... ST CROIX COUNTY SEPTIC 'T'ANK MAIN'T'ENANCE AGREEML~NT AND OWNERSHIP CERTIrICATION rORM Owner/I3uyer ~.~4- C~ 5 SR. ~~a //}~(~ Mailing Address Z- Property Address _ ``"~`~~?Rrl'c ~/r -~_ > ~ ns~~ ~'lA d S a-yc (Verification required from Planning Department for new construe City/State ~~ ~ f,-~.v G}.i• Parcel Identification Number Q r~ G' -- 1 ~ 3 7 L> ~ ~f~-U LS~~Z LEGAL DESCRIPTION Properly Location 1~'1l'W '/,, ~j~. '/,, Sec. ~_, 'I'~N-R~~,W, Town of ~t,~~ 5~h~ . Subdivision ~Arkt~o~~ YT'1 _~ ~ n`~„LS ~ s~' a~ Lot ## ~. ie S y ~~a,C ,Volume Page # Warranty Deed # l a (/ f S/ ,Volume /So~S ,Page ## ~s~ Spec house ^ yes no Lot lines identifiable ~es ^ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result iu 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 systecn. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by We owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after i~upeclion and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwc, 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 tl~e St. Croix County Zoning Office within 30 da fire Q>ree ea xpiration date. ~7 / 1091 ~~ SIGNATURE O PLICANT DATE OWNER CERTIrICATION I (we) certify Uiat all statements on this form are true to the best of my (our) knowledge. I (we) am (are) We owner(s) of Qre pro erty des 'b above by virtue of a warranty deed recorded iu Register of Deeds Office. _ ~/w/off SIGNATURE APPLICANT DATE ****** Any inforniation that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ****** ** Include willr this application: a stamped warranty deed from tiic 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 I~ „~ WARRANTY DEED DOCUMENT NO. ~~ VOl_ .~525PAGE 258 ~~ Howard LaVenture, three-fifths This Deed, made between (3/5) interest in and Arlene LaVenture, two-fifths (2/S) interest in, as tenants in common. ,Grantor, and LaCasse Custom Homes Inc. Grantee, Witnesseth, That the said Gtantor, for a valuable considetadott ~~ conveys to Grantee the following described real estate in St . Croix County, State of Wisconsin: LOT 41 OF PARKMEADOWS, 1st ADDITION, TOWN OF HUDSON, ST. CROIX COUNTY, WISCONSIN 626 1 S 1 i:ATHLEEN H. WALSH REGISTEk OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 07-10-2000 3:~0 PM WARRANTY DEED CERTPCOPY FEE: 17 COPY FEE: TRANSFER FEE: RECORDING FEE: 10.00 PAGES: 1 THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN A~D`DRESS C.A~u~se Ct,c-~ s ~ (~ 5 Z l (U~eCoi~Chedr~ 2-c~ ~~~~ W ~ X01 ~ d20-13~0-y1-ooa PARCEL IDENTIFICATION NUMBER This deed is given in partial satisfaction of certain land contract dated February 19, 19S and recorded in Volume 1404 , Page hlh as Document Number which was subsequen 1 assigned by assignment dated May 28, 1999 and recorded i~n-Volume 1~7~ , Page ~5~ as Document Number -w~3Z~-• ;~ This is not homestead property. X (is not) Together with all and singular the hereditaments and appurtenances thereunto belAtging; ~ And Grantor warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except ;', all liens, covenants and restrictions of record, ~! encumberances created by act or default of the Grantees '; and will warrant and defend the same. if any and any liens or if "~ Dated this 10th day of JULY ~ 2000 ' (SEAL) ~a' ~ (SEAL) • Howard LaVent~u/r`~e (SEAL) ~[,!/~t.~..~d.~~4~ (SEAL) Arlene LaVenture AUTHENTICATION Signature(s) _ a ;~ authenticated TITLE: 1 ~~~ ACKNOWLEDGMENT State of Wisconsin, ss. County. Personally came before me this day of 19 ,the above named QI zl ~ QI ~ ~ of O ~- I ~ QI 0 ~I Q O ~~ N ~ H ~' W M 't W 0 Z Q Z i, ~~ i °6~ ,SZ~ a ,OS' 1.6 l ,00'SZ L 125 ~ ~, i+ O O IQ' CD ~- `t0 a,: t ~. ~~ N .~ ~ ~ ~ ~: • •..:29.~~Z 3W3 •• ~ ~'_... Sy3 o ,• 'ZL' ~~ l ~ g ; . ;~ 3 "~s ~~~` Z , °• b ,8 ;~ ~ c~ tiib 0 •'• W ~co3 ~ z~ ~ '6f;~Z o S• ~ z ,00'OOZ ,~5'~ ~ ••'•'~ OJ z N h }'~j ,00'0 L ,00'0 I. ` ~ NI ~ ~ ~~ ~ ~ ~~ 1 I `~i 1 i ~ i ~ ~ ~ 1 o ~ '/ / ~ '~ /~a . ~~ ~ i ~, 2 ~ v o ~ r-M , C1~~5 ~ ~ ~ ~ ti6 %°i ~~ \~ ~_ - O N ~ ~ O cD UN ~ ~ ~Q ~ ~~ ~ ~ I °p iD N '- o .G1~ C15 ,1~~s ~ °; a~ ~ I 3 W ap ~ M ~I~ ~ 0~ ~ ~ N O O ~ c ~~ ~ f- m ~ N ~ ~w ZI vWia I ,99 w v=i L A, ~( ~O`° "~/ ~ '~~ ,~ ~. O co w ~ F~° 9~ ~ ~Q~ O~S M ~ O o ~i ~ c~ w z M ~ ~~ ~~ ° ~ rn N ,~! •'s~~s ,ZE'9ll ~ 3 „6F ,6~°00 S ~ _~' ,00'0 l Z ~' ,~1~'9Z£ l rn rn N M 0 o°, o 0 ~ ~I ~I ~I N01114a`d 1S~11= ~ ~ •. /* .. 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 ^ T n of: LaCasse Custom Homes, Inc., Hudson Township CST BMElev.:- Insp. BM Elev.: BM Description: 6v ~OU ~ U TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic << p r o w Z oU Dosing ,.~ ~S f ~GIJ Holdi TANK SETBACK INFORMATION. TANK TO P/L WELL BLDG. vent to Airlntake ROAD Septic 7~ -~ 3 ~~~ ,~5pr ~ NA Dosing 7 3 3 ~' r ~3 ' NA NA Holding 111\In / ['InIJ A\1 1\IrAn\I ATIA\1 (; r VI~Ir / JIf 1IV1~ 111 VI\1~1/111V1~ l Manufacturer ~ ~,''~ Demand Model Number ~ ~ y 'Z ~ GPM TDH Li ft ~ ~ Lrictior~ (~ / System TDHr U Ft Forcemain Length S dCC Dia. HZ ~' Dist. To Welf County: St. Croix Sanitary Permit No.: 370242 State Plan ID No.: Parcel Tax No.: 020-1029-30-000 STATION BS HI FS ELEV. Benchmark fa, p}~ b .0 6 O Alt. BM y- Z ~ Bldg. Sewer ~ 3 Ht Inlet . ~- 3 Dt Bottom Header /Man. Dist. Pipe ~~-- ~~~ ~2 Z • d lsY Bot. System ~) T/ L to - f /~ . G Final Grade ~', 9b St cover /U. Z SOIL ABSORPTION SYSTEM i, i'/ / _ ®A../ BED / REN Width ~ Len th ~ No.O Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIME S DIMEN I N SYSTEM TO P/ L BLDG WELL LAKE /STREAM L Manu u er: ~ SETBACK r CHA B m N INFORMATION TypeO ~/ ~ S 7 C ~ `" O UNIT er: u o e System: C J l J DISTRIBUTION SYSTEM Header /Manifold ~~ Length ~ Dia. ~ Distribution Pipe(s) Length ~~ Dia. ~ Spacing ~/ x Hole Size x Hole Spacing N~ Vent To Air Intake ~ ~ sr 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 Bed /Trench Center Bed /Trench Edges Topsoil ^ Y S ^ No ^ Yes ^ No -1 G) COMMENTS: (Include code discrepancies, persons present etc.) mspecuvn rr~: ~ ~ / ~ /~~ ii,~~,~~uv1/ rr~. , Location: 940 Meadowood Lane, Hudson, WI 54016 ~ 1/4 SW 1/4 16 T29N R19W) - 16.2~r9``.1~/9.21/28 Parkwo/od Meadows -Lot 32 4a~ ~/// ~ ~~ r~ Gf(ST'icrO~Or ~OSf 1.) Alt BM Description = ~ p a~ d ~ Gk ~ ~ ~~ s S y~ 2.) Bldg sewer length = 30 ~ ~~--; ~;~G,O ~ sY5 ~~" C~W' Gva '' -amount of cover= >yi ~Z-~y'~< 6~~~, Sir/ ~t~~,o,...lV~yy drSF~,~ 3') y16 w l ~~ ~ /-r r~. ~ GJ A rt i j~U .f/~, .S //cO ~! ~-OY//~ .S. Q S -,~ ~ r~ Qir ~et ~2r•. inC o~~~ Plan revision required? ^ Yes ~ No Use other side for additional information. Z 0 ~,,~, SBD-6710 (R.3/97) Da Inspector's Si ature Cert. No. `~SC011SII1 SANITARY PERMIT APPLICATION Department of Commerce In accord with Comm 83 o i Adr"1-.;~C e ~~ 1 E_ ,. , • -Attach complete plans (to the county copy only) forth sys fn, on pa,~er n~ s than 8 v2 x 11 inches in size. ,,~ ',F~ K r~ , ~ • See reverse side for instructions for completing this ~ppttcatign . ~'~~ Personal information you provide may be used for secondary purposes e ~ ~~ ~~-~ ~~~ [Privacy Law, s. 15.04 (1) (m)]. ST ~~. .- ,, Safety and Buildings Division 201 W. Washington Avenue POBox7162 Madison, WI 53707-7162 I County State Sanitary Permit Number 3 ~o z~ Check if revision to previous application State Plan Review Transaction Number _ L APPLI ATION INFORMATION -PLEA E PRIN~~~r E.I ~ O ~%°" "- Property Ow er Name ~ % _ ~'~/G~, ..: ;. r E 0 on G .u ;' yia, S ~p T ,~ ~ • N, R ~ ! ~(or~ Property Owner's Mailing Address "" r_ lCt# Nutyl~es' ~ ~ Block Number Cit , St to r c Zip Code ~ Phone Number (~ > ~ Subdivi " n Na a or CSM N ber c,(, _ - a I. PE F B ILDING: (check one) ^ State Owned ~ Ity Nearest Road Public 1 or 2 Famil Dwellin - No. of bedrooms ~ Town OF III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) ~l__ ~9. ~9, ?~?$ cc~ 1 ^ Apartment /Condo ~ '- ~ 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 on line B, if applicable) q) 1 _ New 2. ^ Replacement 3. ^ Replacement of 4_ ^ Reconnection of 5. ^ Repair of an stem S stem Tank Onl __ Existing System ____ Existin~System - -------y-------------y------------------------y------------ ---------- - B) ^ A Sanitary Permit was previously issued. Permit Number Date Issued V. -TYPE OF SYSTEM: (Check only one) Non-Pressurized 6stribution Pressurized Distribution Experimental Other 11 ^ Seepage Bed 21 ^ Mound 3 Specify Type 41 ^ Holding Tank 42 ^ Pit Priv 12 T f S h ~' ~ ~ 22 I d P G ' y ~ eepage renc ,~ n- roun ressure / -~ 13 ^ Seepage Pit S ~ l9~" (2- C~ 43 ^ Vault Privy 14 ^ System-In-Fill _ _ (, g ~ 7~p3~ VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorpp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade ~ El ti Mi /i h l ft eva on nc ) ~' ,r~ n. .) ( Required (sq. ft.) Pro sed (sq. ft.) (Ga s/day/ q. ~ ~ 6 ~ z © j -- rJ/ -feet Feet VII. TANK INFORMATION Capaat in all0 S g Total # Of , Manufacturer s Name Prefab. Site Con- l St Fiber- Plastic Exper. N E i i Gallons Tanks Concrete ee glass App ew x n st strutted T nk Tank Septic Tank or Holding Tank ~ -~ p-O ' ^ ^ ^ ^ ^ Lift Pump Tank/Siphon Chamber '-"' Of3 ~ ^ ^ ^ ^ ^ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plum r' (P "nt) Plumber' gnatu : (No MPRSW No.: Business Phone Number: Plumber's ¢~ss(Streewt,C/yty,Sta ipCo )~ L%~~ S ~~ UU IX. COUN TY / DEEPARTMENT USE ONLY ^ Disapproved saggq~~ytary Permit Fee (Includes Groundwater ate ssue Issuing Agent Signa ure (No Stamps) Approved ^ Owner Given Initial Surcharge Fee) ~~` ~ -~ `~~ C Adverse Determination 1 X. CONDITIONS OF APPROVAL / R A50 5 FOR DISAPPROVAL: SBD-6398 (R.12I99) 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 toinstallation - , , - 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 sanitafy 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 Qe 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 online 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. ' IX. 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; 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. ~N r /ll( ~D ~, v.. ~ a-~~ TT C1~ .~~tJ L ~~ ~ a ~ ,` ~~ ~ D ~~ ~~~ X ~ k a~ ~ ~,~ N~ "' ~ - is ~~ T-~-~~ s~ ~ . 95~, yo ~ `"I ~~~ n~ ~-- ~' -{,~ ~~ ~ ,~~aa ;~ v.=~...~ ~ ..- - - - --. . . ~~~ - - -••• ~.~n.~a~.K LfiOSS SFC'1'ION AND SPECIFICATIONS 4" CI VENT PIPE 12" MiN. A80YE GRADC ~ 25' FROM DOOR, WINDOW OR E YCATHFR PROQF FRESH AIR INTAKE JUNCTION BOX APPROVED WITH CONDUIT MANHOLE c FINISHED GRADE 4' CI RISER W/ PAD LO( 6" MIN. - -~NARNING 1 ----. A80V E G AD E --- ~.__ v •• M I t 28" IN. 6" MAX. INLET ~ • ~ ;. • ~ ~ ~ . WATER TIGHT SEALS GAS_ ~ --~- TIGHT ~ •, v BAFFLE CI PIPE A ~ SEAL ~ ~ ~ ~ A PPROYED 3' ONTO _ 9 ~ LM JOINTS V/ SOLID ";'- ~ ON PIPE 3' 0 SOIL C ~ SOLID SO! PUMP OFF ELLV . FT. -- ~'~' ~ OFF •'~ RISER D PERMITTtD IF TANK MANUPACTUI 3" APPROVED BEDDING UNDER TANK HAS APPRO'_ CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE TANK MANUFACTURER: •rnNK S2ZZS: SEPTIC DOSE nU1RH MANUFACTURER: MODEL NUMBER SWI?CH TYPE: ~'UMP MANUFACTURER : MODEL NUMBER SWITCH TYPE: ~ GAL. ~ GAL . ~.~ ~-~--- D REQUIRED DISCHARGE RATE ~~ GpH NUMBER DOSES PER DAY: . DOSE VOLUME INCWDING . F LOiiiBACK : a o2 GAL , GPACITIES: A : ~y~CHES = ~/3 ~ e = _ ?_ INCHES = ~~G C = ~~NCNES = --~~_L__r O = S INCHES = /DQ G PUMP E ALAR!! WIRING AS PER ILHR 16.23 VERTICAL DIFFERENCE BET6IEEN PUliP OFF AND DISTRIBUTION Plpf . • MiNIMUH NETWORK SUPPLY PRESSURE . • J~ FEET FORCQIAIN X /. 7 FT/ 200 AFT. ~FRtCTION FACTOR ~ . TOTAL DYNAMIC HEAD _ r NTERNAL OIHENSi ONS OF PUMP TANK : LEJJGTH `_; WIOTN 1 ~ LIQUID DEPTH :IGNED: LZCFId3E MUMeER: ~C~ ap7Q,'~~....... FEET ~3`:~r FEET -_L.Ser1l FEET FEET DIAMETER Motor Single`phase:115V Materials of Construction Brass/thermoplastic Features and Benefits 'Top suction eliminates impeller clogging. 'Corrosion resistant , construction. • Float actuated switch. 44 ~ METERS FEET ' ~ MODEL DVP03 c 6 p = 5 v 15 a a c 3 10 2 5 0 00 5 70 15 20 25 30 35 40 U.S.GPM 0 2 4 6 8 10 m~Au CAPACITY All Models are designed for continuous of E METERS FEE T '0 MODEL: 3871 9 30 8 25 6 20 v 5 - z a 15 EP05 ~ 3 2 X04 5 °o i o 20 , o s o usGPM 0 2 4 6 8 10 12 m~M caPaclTY Pump Specifications Features and Benefits 'h° and'/Z HP • EP04 impeller- semi-open design Up to 60 GPM with pump out vanes to protect Maximum head to 32' mechanical seal. Discharge size 1'/2" NPT • EP05 impeller -enclosed design Solids:'/." maximum for improved performance. • Rugged glass-filled thermoplastic Motor All motors feature ball casing and base design provides bearing construction. superior strength and corrosion resistance. Single phase:115V 'Cast iron motor housing for Materials of Construction efficient heat transfer, strength, Cast iron and durability. Thermoplastic Stainless steel 'Corrosion resistant threaded stainless steel shaft. 'Available for automatic and manual operation. • CS;A listed models available. aeration and feature stainless steel hardware. - ~~ aaO 3s7 Wisconsin Department of Industry, Labor and Human Relations Division of Safety & 8uildines SOIL AND SITE EVALUATION REPORT ...J :iL 11 1IA n \.I:~ AJ.w /~..J~ Page 1 of ~ 111 GVVV~V •.~\~~ ~~~ ~~ \ VV.V V, ••~v. ..v~••• vvvv COUNTY Plan must include but a er not less than 8 1/2 x 11 inches in size Attach com lete site lan on , p . p p p not limited to vertical and horizontal reference point ~ etia~n and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and dist c~'t4 e~r>ast rbad: •., 020-1029-30 APPLICANT INFORMATION-PLEASE „F#1I~i'~ALL INF~RMATIdJV •y IEWEDBY DATE~~ PROPERTY OWNER: '~~ % ~° j/~^'n PROPERTY LOCATION ~ LaCasse Cu Homes I i:- ,' './!rs U ifiOVT. LOT 1,}W 1/4 ~ 1/4,S 16 T 29 ,N,R lg f(or) W P RESS ST ~`~ ~ N R~ O ~ # , BLnaK # SP r)~a C Cut heon Rd 521 mc , 9~ 32 ood Meadows CITY, STATE ZIP CO E:~ R ~. ~ CITY VILLAGE ~]I'OWN NEAREST ROAD .% 71 0 -5495~~1 Hudson, WI. 54016 ' Hudson Meadowood Ln. New Con~#tuction Use [X] Residential / ` r~o~;bedliod~'~ 4 [ ]Addition to existing building .(]Replacement [ ] Public or commercial describe 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) ~ 95.40 ft (as referred to site plan benchmark) Additional design /site considerations ~=-->3a~w~. Parent material outwash Flood plain elevation, if applicable na ft S =Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL ^ HOLDING TANK ^ ~ U =Unsuitable for s stem ®S ^ U ®S ^ U ®S ^ U C~ S ^ U U C~ S U S SOIL DESCRIPTION REPORT Boring # .................. ................. 1 Ground elev. 99.3ft. Depth to limiting ~~ +a90r Boring # 2 Ground elev. 99.1 ft. Depth to limiting factor +90" Depth Dominant Color Mottles Texture Structure Consistence Bourtcia Roots GPDlft Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. y Bed Trench 0-12 10 r 2 2 none 1 2msbk mfr 2f .51 .6 2 12-24 10 r 3/3 none sicl 2msbk mfr gw 2f .4 .5 3 24-35 10 r 4 4 none sil 2msbk mfr gw if .5 .6 4 35-90 7.5 r 4 6 none ms os ml na na .7 .8 ~- 6.8/ g Remarks: 1 0-11 10 r 2/2 none 1 2msbk mfr gw 2f .5 .6 2 11-25 10 r 3/3 none sicl 2msbk mfr gw 2f .4 .5 3 25-40 10 r 4 4 none sil 2msbk mfr gw if .5 .6 4 40-90 7.5 r 4 6 none ms os ml na na .7 .8 . ~( Remarks: CST Name:--Please Print Gary L. Steel Phone: 715-246-6200 Address: 1554 200th. A .New Richmond I 54017 Signature: Date: CST Number: m02298 _ 7-9-99 P' ROPERTYOWNER SOIf_ DESCRIPTION REPORT Pa e T_.a aG~ C_i~ctom Hc~mPG g ~,of ~_ PARCEL LD. # 020-1029-30 Boring # 3 Ground elev. 99.3 ft. Depth to limiting factor +90" Boring # .'' 4 .. Ground elev. 9~,~ ft. Depth to limiting factor +90" Boring # 5 ,<~~' Ground elev. 99 . R. Depth to limiting factor +9 " Boring # Ground elev. ft. Depth to limiting factor Horizon Depth Dominant Color Mottles Texture Structure Consistence Bour>~y Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trerxh 3 25-36 4 36-90 7.5 r 4 6 none ms ml na na .7 Flo ~S . ~ Remarks: 1 0-10 10 r 2 2 none 1 2ms k mf 2f .5 .6 2 10-20 10 r 3 3 none sicl 2msbk mfr 2f .4! .5 3 20-32 l0yr 4/4 none sil 2msbk mfr gw if .5 .6 4 32-90 7.5yr 4/6 none ms osg ml na na .7 .8 5``{ ~ Remarks: 1 0-12 10 r 2/2 none 1 2msbk mfr 2f .5 .6 2 12-20 l0yr 3/3 none sicl 2msbk mfr gw 2f .4' .5 3 20-30 10 r 4 4 none sil 2msbk mfr if .5 .6 4 30-90 7.5 r 4 6 none ms os ml na na .7` .8 si,b $~•G Remarks: Remarks: SBD-8330(8.05/92) f STEEL'S SOIL SERVICE Gary L. Steel LaCasse Custom Homes, Inca 1554 200th Ave. CSTM2298 ivw4sw4 sib-T29N-Ri9w New Richmond, WI 54017 MPRSW-3254 town of Hudson (715) 246-6200 lot #32-Parkwood Meadows 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 may or may not be as shown as permanent lot lines were not established at the time the test was conducted. "=40' = top $. BM.= f W 3 c~ v 7~ Gary L. Steel 7-9-99 ~~ ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ~,,4 ~~ 55~ ~,~t~ m ~ 4 ,~G . Mailing Address '~ ~ ~_ rn c~ t,c ~~ ~ p ~ ~r~ 1-d Lt ~ 5 r_rn~ - ~ ,~ ~ `~~ ~ ~ Property Address (Verification required from Planning Department for new City/State ~ .5 m ,,~~ ~ Parcel Identification Number r~ ~ 6 ~ ~~ oZ ~ _3 ~ LEGAL DESCRIPTION .N~„/ Properly Location '/,, sic~~ . '/,, Sec. TN-R c W, Town of if ,t rt ~,c.>'i~ ~ Subdivision ~~~~'< <~Y~~ ; ~ n'ju~~;~ f_~7 .~ .Lot # ,~~. Certified Survey Map # ,Volume Page # Warranty Deed # ~v o2 ~ ~ ~ ~ .Volume ~~ Page # Spec house ^ yes t~ no Lot lines identifiable ~ yes ^ 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 wastewaterdisposalaystem 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 ha been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expire 'on te. 4 SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify th all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the pro ert~r desc ' abov , by vi e o a warranty deed recorded in Register of Deeds Office. / / ~'~ SIGNATURE OF 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 II STATE BAR OF WISCONSIN FORM 1 - 1982 WCA~R1RCA~NTY DEED DOCUMENT NO. j '~~JL .~UIVPAGE ~~O ~~ Howard LaVenture, three-fifths This Deed, made between ~ (3/5) interest in and Arlene LaVenture, two-fifths !~ (2/5) interest in, as tenants in common. ,Grantor, :' and L~SSf Ls1~-i.n ,.~o~, r`~- Grantee, Witnesseth, That the said Grantor, for a valuable consideration conveys to Grantee the following described real estate in County, Stale of Wisconsin: St. Croix LOT 32 OF PLAT OF PARKWOOD MEADOWS, 1ST ADDITION, TOWN OF Hu~c~p~- ST. CROIX COUNTY, WISCONSIN 624 1 34 N.ATHLEEM H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 06-0~-000 10:30 AM YARRANTY DEED CERTPCOPY FEE: 17 COPY FEE: TRANSFER FEE: RECORDING FEE: 10.40 PAGES: 1 THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS ~e~~ p ~~~ ~~ ~ ~~ ~ ~ meC,,t~c1n•e.~n '~ ~1son ~ l~l ~(-~bl ~o Sao-1~5q -'~~.-ooo PARCEL IDENTIFI ATION NUMBER This deed is given in partial satisfaction of certain land contract dated February 19, acid recorded in Volume ~_, Page ~~ as Document Number which was subsequently assigned by assignment dated May 28, 1999 and recorded n o ume 1431 , Page 352 as Document Number 604323 This is not _ homestead property. (is) (is not) Together wi[h all and singular the hereditaments and appurtenances thereunto belonging; And Grantor warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except all liens, covenants and restrictions of record, if any and any liens or encumberances created by act or default of the Grantees and will warrant and defend the same. Dated this ~~ ~ ~ • + day of ~~~~ ~~~ (SEAL) (SEAL) • Howard LaVentu~rOen (SEAL) _~ ~~ ~~~qs~ (SEAL) + Arlene LaVenture AUTHENTICATION Signature(s) authenticated this ~~~ 4-` , ~9a~~• r TITLE: MEMBER OF WISCONSIN i~ I ACKNOWLEDGMENT ~~ State of Wisconsin, ss. County. ~~ Personally came before. me this day of ~~ 19 ,the above named i ~ a-----~--------------- ---- 9~-~J 00°14' 29" W 2623.31' DAILY ROAD I nnu v onnn ---- 2~6T'" ~ :Z~ 115.1 0 249.15' :~ O ° . tp °- ~ 616' _ • ° ~'~ o I °° DRAINAGE o 33' 33 'O ~ .4' 29' . w. ° EASEMENT -=:~' P 66.73' ... N I-= 50 :~ ~ 1 ~°~, (Z I m " NI 00° 4029"~ •W c°n ~ , W ( OD ~ I O O ;~cn ~ rn Cn ~W N ~ N ~ I ON O~ I ~ W 1 ~I ; I = ~ _' ~ N ~ ~~ =1m nNi v>D~ ~ n ~ cn 50' t° ° ?' cmi~ r, p I _. 1 ~ N I 1 J~ .. .. v I . ~QQ' . -J .............. _ . ~oo-0br- . `39.15' T Z --~ N ~ O W NON W WD~ N (n ~ ~ ~m .fib'. o ~~ -r N001429 W _ c ~ N O W ~ cO N N N W oD N (n ~ co ;i m to N I00°18` 32" W 1314. _f 250.00' ~~0. x.53 i I 1 ~~I I 1 ~o I ° I o' tO ~ ~ N 1 ~ 1 O~ Z ~ Z o' W~ ~ ~r. Wcp OW `~ I ~`' OV W ~ N ~ N ~?' Cn D ~ ~ ~ ~ Cn ~' OD f - ' C7 N W N W O c0 <Jv /~~. \ '~~j I~TI V N N ~ !;v v N N D _~ cD c0 C7 '• \ ?I I ~ \ ~ OD '~ I \ o~ ~ - - - - i m ~+) ~ . 98.93' ° 265.00' 265.00' - ~' ~ ~~; wa, MEADOWOOD LANE N oo°1s~ n5 ~9 < W~ _ i.9e ~ ~ \ \ ~'' S 00° 18 61;~1~°O'~ ~ ` C8 ~ 156.29' - ~ o- ~ 27500' _ _ _ ,~ I N 00° 18' 32" W o Z N I ~~{t ~- - ,,fi ~IOQ Iv C~,a -~ V N W ~ N Oo -+ N ~y ''^^ W o ~~ N emu' ~ ~ ~~ 7r> ~ W C,A ~ N N ~ tp (n [O (NIA ~~ ~ (J~ tD CNII -~ 5 'N*I N I '~v~v w D ~ 25' ~ ' ~ ~ ~ ~ °o N V ~ ~ I ~ (n ~ Z - UI N ~ ~ V! l7 ~ ~' ~m ~w ~m = ~m r\~X ~ I ~ ~o. ~ o .op ~ ~ I °'O N N ~6, w 0. i=i O '' ~ ` I `°_ : °- , ..... 25~.. N, X10° 18' 32" uY 440.00'.........., 374.50' g cn S 00° 18' 32" E 1471.22' ~ 174.99' 349.50' 5.00' °- 75.00' 275.OQ \ \ ~-149.64' \ I \ \`. o I \° 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 ~~~A1A~Af)nnnc7(~C')t7C) O~ ~ VO(l~~F+WN-~OtOODVrnCn~WN~ m T