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020-1361-01-000
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I ~ ~ N aov m~G' _° a ~ ~ Z ~ w (A ~ co y Z I ~ A A I a a o I d c I o'aa I ~ y I I I ~`" I ~~ ti I N p w I o :A ~ N ~ V I ~ 2 ~ ti ti QI,. ~'~e~v.~ Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 'ermit Holder's Name: City Village X Township Strand, Glenn Hudson Townshi ;ST BM Elev: Insp. BM Elev: BM Description: 1 to I In I ~?~ 1~ FF --gam .~~ = CS'~ ~S a~-. 8 in•. SANK INFORMATION ELEVATION DATA w TYPE MANUFACTURER CAPACITY Septic nn 1' ~ ~~ Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ^ ~s t ~~` J `S I Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer and GP Model Nu ber TDH Lift Friction Loss System Head TD Ft For ain Length Dia. ~s . o ell SOIL ABSORPTION SYSTEM ENCH Width r Length DIME S 3 43.7 SETBACK SYSTEM TO INFORMATION Type Of System: DISTRIBUTION SYSTEM ~ 2 P/L BLDG WELL STATION B Benchmark ~,Q~ 12•x$ t Alt. BM (~ 3•~ ~o .2~ Bldg. Sewer LJi 5 •30 ~ OG . ~~Cr SUHt Inlet 6•~O oS.~($r SUHt Outlet 6.9`f ~ os.t~ Dt Inlet Dt Bottom Header/Man. S• ~ o 9~ 1 3 Dist. Pipe o • a l to . 8S ,!o . ~3 ~ Bo.~em~` n~ -~+~ ll-3S t 2.30 9.33' ~ • 38' Final Grade St Cover ./STREAM LEACHING Manuf CHAMBER OR ,~y -~-~ UNIT Model u Header/Manifold + Length Dia Distribution Pip (s) Len cin x Hole Size x Hole Spacing Vent to Air Intake SOIL COVER x Pressure Svstem~/~ xx Moun~'lOr At-Grade Systems Onlv Depth Over Depth Over ~)~,- h of , xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench E es ~~ opsoil ~ Yes [] No g' Yes [_'~ No ~ v ,,, - COMMENTS: (Include code discrepencies, ons present, etc.) Inspection #1: f~ / ~ / ~ 1 Location: 803 Crimson Valley Road Hudso , WI 54016 (S1E-_1,/,4- S_W 1/4 2 T29N R19W) Crimson Valley Lot 1 1.) Alt BM Description = `'(~oP o~ ~ J°~'1~ \\ 2.) Bldg sewer length = ~~J ' - ~ n ~\ - amqunt of covgr = o /l" /~ r~ ~ s~, („ _ s,e~t,,,n,~ -~ti b~ .~, ~ 't~a~OOX J G ,,1_ ~ ~~~ •lT tteti'~ l{!,- ~-_-.. ~`~1 `~" '~N e~., s.s.Q.-~ re~~~~ Plan revision Required? Y Use other side for additi 1 inf ation. ~ L J LY_ _____ _ _____- __-__..-___.______-_-_ Inspection #2: TT-- Parcel No: 2 .19.2131 ~~S = Iz. ts' p-l.•~-R+ti. ~ ~Z•a~ county: St. Croix Sanitary Permit No: 384187 0 State Plan ID No: Parcel Tax No: 020-1361-01-000 Section/Town/Range/Map No: 23.29.19.2131 S HI FS ELEV. l ' ~ ~p J.Q~-,, I ctors Signat Cert. o. • SBD-6710 (R.3/97) t'~ "^` .~:~ .J~• y` l :~ tiY;~cn,-~tsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings '~ in accordance with Comm 85, Wis. Adm. Code County ST ' Attach complete site plan on paper not I~ss than 8 1/2 x 11 inches in size. Plan must inGude, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. please print all information. Reviewed by Personal infomration you provide may be used for secondary purposes (Privacy law, s. 15.04 (1) (m)). Page ` of 3 Date ~~~ L~~ S~~C_Y~Jh.I~ Gev~,-het. S G 1/4 SW1/4 S Z•3T Z.~ N R L~ E (o W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# ~ Z~ S . 6 `rH- ST , ~ C2t. -'LS 0 ~ V f'~Ll_.1~~-/' City State Zip Code Phone Number ^ City ^ Village ~ Town Nearest Road ~W~Z ~r1.LS l~ S~I~ZZ (7LS) 4°Z~_3Z6`v 'c~~S 0)v c R ~ oiv ~PrD ® New Construction Use:,® Residential / Number of bedrooms _~ Code derived design flow rate ~ t1C1 GPD ^ Replacement ^ Public or commercial -Describe: Parent material Lh~~ OUL~'it. 5~~1./p ~( pV`T'~,,`~(~-9 ~ Flood Plain elevation if applipbie ~ A ft. General comments and recommendations: 3 CQ„~ ~.~ 3 r X bZ. 5 , Lcyv G" In.1L`Tl.-} ~p V1vLn pl= L`i-'L GH C1AP p~cL'M S t. ~~1 t ~ ~R L~~e1.1- C~fr'I''1.13 ~2S l' ~1Z C.~t.(._, - ~3 ~`~p`N1 of ~-~t(S ~ ~ w) t ~i - 5 0~ ~~ , ~N P 01=- C.~l~'l~RS ~ ~3 ~ ^ Boring rt w'r~ • ~ ' ~~~.OW Flr\J L311'L~ G R-~fl E. Boring # ® pit Ground surface elev. 1 ~- 3 fL Depth to limiting factor ~ q 6 in. Soil Appliption Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftZ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 p_t0 zo~t,rz3lz - sit z~sbk ~~r es l~ _S :`~ Z to it io~t~z3Lro s~ ~ Z. sbk m~- c'~., - . S , ~ 3 Zl-3Z ~-SYi2jL - 1S US9 wi~ ~S ~ ,~ ~Z z -q 6 Z.S YrL~L - S O S g vn I - . ~ ~. z. a Boring # ^ Boring ® pit Ground surface elev. ~ DD ~ ~ fL Depth to limiting factor ~ `31 in. Soli Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 - I o-i~ ~ow~.3 !.Z - -- sil Z-`~sbk ~n~ GS 1~ •S •~~ z l0-~.3 1~`~R- 3Z6 ~ s; ~ Zwzsbk m~ ~ ~~ - , S _, ti 3 L~3-6o Z.S`2R31~ ~ 1S O S9 m ~ c~S - •"~ ~• ~ ~ bD q~ '1.S`~23j ~ S O s m I ~- - .~ ~. ~ C~ 1 S - .. ~-:-_ . S - 18 _o ' Effluen t #1 = BOD_ > 30 < 220 ma/L and TSS >30 < 1 50 ma/L 'Effluent dY1 . Rnr) a 3n mnn ~nrl TCC a 3n mnn CST Name (Please Print) - ignatu O, _ a ? • CST Number Arthur L. Wegerer '~%~h%~~ -! J 220254 Address 4~ e g e r e r S o i l Testing & Design S e r v i c e Date Evaluation Conducted Telephone Number 421 i1, Fiain St. River calls, WI 54022 5-1~-0~ 715-425-0165 ~. ~ ~ , , .~ Property Owner _ S~Z~~J~ Parcel ID # a Boring # ^ Boring Pit Ground surface elev. ~O~`- S ft. Denth to limitinn factnr 1 ~ ZCl t.. Page ~' of 3 Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ft2 in. Munsell Qu. Sz. Cont. Coior Gr. Sz. Sh. •Eff#1 'Eff#2 1 Z ~-~~ 10-2y lb`tfL3lZ 10`2 316 ~ S1 1 Si 1 Z`~sb-~ Z`F s 6k N'1`FI- In'fl- e Cw ~~' - •S ~ S . ~ - E! 3 Z~ 3 6 ~. S'-i2 31 y ~ ~ S a S -vl S ~ ~ 1 ~- Z 6_~zo ~.s~~.sly S cy s9 ~, 1 _ . ~ ~. ~ ^ Boring # ^ Boring ^ pit Ground surface elev. ft. DPnth to limirir,n r~..~n~ ~.. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Appligtion Rate GPD/ft2 in. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Boring # (J Boring pit Ground surface elev. ft. Depth to limiting factor tn_ Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Applicatlon Rate GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 • Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 - a _ mglL and TSS < 30 mg/L 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. S80.ti3D0 (R.6/00) ~* ~ . • w Pave 3 of 3 PLOT PLAid Scale 1' = 30' v1 O Q 0 N 7 0 v y 7 J 3 0 N, a.~1o4 3 S2 5 ~~~~. 3' 3 ~ S 103 ~, 3. `_a.~1o0 ~` ~ 2,s ~#`~' X7%-_!03 o g.'3 ~~.$° ~~ ~'C~ a~u~wt~r-r PfF~X _ LOT L.lhl~.- V ~1z.11=y ~~~ °w1J S't~.c, c~ ~ - -~II"afS~~7 =~'':L~=L6l~E~_31~°=I~1~-P_VC---~-F5~~17_ _ - __ _,.__ _ y.. _. ~. Y'1._AT-~`~=LIPcC..= ~I?=Q~ ~3L~T:-~Tce.~9~1!~-T~~.U-~-3- - ~-- - _~V~~=~'e-7=`_OF-'T_~~?=UP~Sl~-S`is-~~~-°.i i~~3'A-T~~:fl~C~T~ 8C .__~1`_~to_U_tD_~? 12L01Z_:_?Ll _: 5.~13f~'~-1._ .7 ~uS7~Ar~Ip 1V;-~_ S-1D-OI 715-425-0165 220254 p~_q3 CST Signature Date Telephone Igo. CST A1o. Job PiO. ,~-e ; ~ ~ 3 ~ yr Wisconsin Department of Commerce SOIL EVALUATION REPORT Page ~ of 3 Division of Safety and Buildings• in accordance with Comm 85, Wis Adm. Code ~~ County ST . ~ X Attach complete site plan on paper not less than 8 1/2 x 11 inch i r ~ Plafi,tnue include, but not limited to: vertical and horizontal reference poi ~ ,direction an'd ` :.:`~; parcel LD. percent slope, scale or dimensions, north arrow, and locatiofl d dipstan~-to n crest road. P%ease print all inform~t' ~~ , i~~~~~~.~ '`~. Reviewed by Date ~,>_. . Personal information you provide may be used for. seconds p ses (Priva law, s. 1504 (mp. , ~ , Property Owner r ~ Pro ocati6n, Y'~~117 ST ; j~ 1/4 SW1/4 S ZIT Z~ N R 1°~ E (0 1 Property Owner's Mailing Address ;:~''~:, $toc,~ # Subd. Name or CSM# ~Z-1 S . 6 ~- ST . _.. ~, ; ~~~ ~ e~~ t-tSOr~ V f'rlu`-~ City State Zip Code Phone Number ,~ ^ Village ~ Town Nearest Road ~lU~z ~-+~ttS 1~ S~oZZ (~~S) 4°t~-3Z6 ~~ S off, ~ R ~ o~v ~.c,Pr-c ® New Construction Use:,® Residential / Number of bedrooms ,~_ Code derived design flow rate 6 (1l~ GPD ^ Replacement ^ Public or commercial -Describe: Parent material L.O~T~S~ OVA Si'~1./p ~ pV`(~PH9!`~ Flood Plain elevation if applicable !J q ft, General comments and recommendations: 3 Ct~g ~~,~ '3 r X bZ. S r Lt~-v G• I.vL`n,~. (~ U~~-~-~ ~l_ ~ ~ C-~P'°ccll`-t Sl~~l~.llr~~ L.N~~4- C~V°r~+,•143~LS 1~C~tZ ~°-L'Z-L, ~3 o`t-tpy,~ U~ C.t=LtS 7"D ~, IF-'1 t iV • 5 ok ~~ , ~ P 01= ~~j fl}^1t~S ~'0 l3 ~ ^ Boring ~- ~ ~-r7- • LS ' ~~ Wti\] FZ ~! i.St1'~ Ci -zf'CD E, Boring # Pit Ground surface elev. ~ 0~l- 3 ft. Depth to limiting factor ~ R 6 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 0-10 zpw2 31z: - si l Z sbk ~'l`Fi-, e S l~' - S • `~ Z to-~..t ~o~t23L6 - s~ 1 Z S k h2'Fi- e;N - . S , ~ 3 Zl-3Z ~-S `~~-j! -- lS U S9 m ~ ~ S - ,~ ~ Z Z-Ot 6 ~.S YfLj~ - S G ~g VvI ~ - .~ l- 2. Boring # ~ Bonng Z ®pit Ground surface elev. 1 ~ ~ ~0 ft. Depth to limiting factor ~ `~ 7 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Textun: Structure Consistence Boundary Roots GPD/ft2 in. Munsell- Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 - i ~ ti0`1~R3 Li --, s i ~ Z~'-sbk ~n`~-'' cS 1~ • S '~ Z )o -y,3 1~K 2 j l 6 - S i, Zwt s bFr »1'Ft- ~ ~ w - . S , ti 3 t_~3-bD ~-SY231y .~ l S O S9 m ~ ~S - •Z ~• z 4 bD q~ ~.S`~~31 S O s m I - - .-t t. z - t=muent tFi = taws > 30 < zzo mg/L and T55 >30 _< 150 mg/L ' Effluent #Z = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) ~ ig~natu~r CST Number Arthur L. idegerer ~~1~/~'~•~~ O1_g 3 220254 Address W e g e r e r Soil Testing & Design S e r v i c e Date Evaluation Conducted Telephone Number 421 :1, Bain St. River calls, FJI 54022 S-~D-O~ 715-425-0165 Property Owner 5~~~ B ~ ^ Boring Parcel 1D # Page Z of ~ a o ng # pit Ground surface elev. `O~~• S ft, Depth to limiting factor > 1 z-O in Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 1 c7-~~ lo7rz3LZ ~ si 1 z~sbK w-`~~ e ~~ .S , ~ -Z 10-Z~/ 10`t2 316 _ Si 1 Z.`~'s~k in`~- CW - , S - ~ 3 Z~,( 3 6 ~, S ~t 2 3 l y ~ i s O S -yl ~ S 1 ~ ~- Z 6_~ZD 1.S`i23ly - S d s9 -'>7 ~ . 7 l• 2. ^ Boring # ^ Boring ^ Pit GfOUnd surface elev. - __ ft. Depth to Iimitinn f~ernr :.. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ft~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to IimiGng factor __ in. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 `Effluent #1 = BODs > 30 < 220 mg/L and TSS >30 < 150 mglL • Effluent #2 = BODa < 30 mg/L and TSS < 30 mg/L 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-67J0 (R.N00) s PLOT PLAPd Scale 1' = 30' Z-o"1o an~-I e d N 7 0 v y J 3 0 N Page 3 of 3 a.~~o4 3 ~ 62.5 ,~~~ , 3 ~ 3 ~ c7 ~~3 ~, s , 1_@.Z~po `` ~ 2,s ~y~2 1? o-_~ 10 3 B ~~~ D.J. u ~wt~f - F1PCW K . L.oT l.l-~I~T - V ~z.l ~'`f ~~~ caew+~ sTic, c~ ~ ---13~`1~'-~-----.~~1S6~p`-~N ~`~E-}L61~, 31~___L~C)~~:_P-_VC:_P11~~--Wl-C7~ t e q --~~-~- `14_3.E.__R'T._._LL'"ft`JT-. 50~ [~1Z,t)f"1 .~-~-~---~!'`~---~T-~-~-~-- _._Z S ~ _~~=Uut Soh 1Z L' 1~~c _ ---------- T~ - :-- 'h'~_~'r~~..LiPzl._~Sz-~-.'1 -~~l.~i:::-~U9V~1~_t1ll-'3--$~l_~~_ 3b :DV~2. r~_~ `Tlf'k.:~??-D a ~ S1~ __ s `s~1- -~?-~A__ _~iti-D-- L~`i`O 8C -2L31`-L~ U_~D : ~ 2L O ~ :7U : S-'-L~~"L . _ 1 ~ST_'R-c1-R-71 Q 1V _ --- _._ ~_-D-OI 715-425-0165 220254 p1_°13 CST Signature Date Telephone Ito. CST P1o. Job PTO. Wrsconsin Department of Commerce SOIL EVALUATION REPORT Page \ of 3 Divislon of Safety and Buildings ' in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not I7''ss than 8 1/2 x 11 inches in size. Pian must a,.~w~~y S l ~ J~ i include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location ~'~V ~ \~ S~-~}~l~ Gevt,-l et. S ~ 1/4 SW 1/4 S z 3T ~-°1 N R 1~ E (o W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# lZ~ S . 6 ~ ST . 1 <..~.1 I'1-S0~ V RL~.I~-~-/' City State Zip Code Phone Number ^ City ^ Village ~ Town Nearest Road TZ-~U~z ~tCS l~ S~UZZ (7LSi4°t~_3Z.6~ e,~tr~t u~v ~~S01'v ~L lZ.dt'rD ® New Construction Use:,® Residential / Number of bedrooms ~- Code derived design flow rate ~ t1tJ GPD ^ Replacement ^ Pubiic or commercial -Describe: Parent material Lh~S~ OV~2., S~'1~1p `-[ pV~"l~~Ar-g h~ Flood Plain elevation if applicable ~ A ft. General comments and recommendations: 3 CEZ,Lg ~~~} 3 r X bz. S r t_t~v G' w~`Tl,-} LO Vlvl'(~ pi= L`fi''L 6~1 cep ~-tM S ~ k~1~11r~ts~ L~~ et.l~ arts ~ ~lZ e.~u, _ ~3 o"C"Tbir~ of c~.(S 7 p ~, wf 1 ti • 5 OY ~~ , ~-p P 01= ~~I~RS ~ 8 £ -~ n .. _ _. - 1M. K'rX • $ ' '~~L.t)W f=1 w f ~ S4tL~ !, t2_Pct1 tr Boring # u ""~"~a 1 lit ~.....a _..j.._ _~_ - I\c. ~ ~. > 9 G, Soil Appliption Rate Horizon Depth Dominant CoIQr Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 0-~o iowR3L - sit z~s6~ ~`~~^ es 1-f ~S ,.~. Z to-Z.l ~o-~~z3L6 - s1 S Z s k m~Fi- c~u`, - , S , g 3 ZL-3Z ~.5~~~` - is ~s9 m) ~s ~ ,~ ~Z Z-a 6 ~.s YR~~ _ s a sg vn 1 - .~ ~. z. a Boring # ^ Boring Z ®p(t Ground surface elev. ~ ~ ~ D fL pepth to limiting factor ~ R 7 in. Soil Appliption Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 - I o - « tio~-.R3 ZZ ~ -- s i ~ z-`Fsbk m.-F--- ~S 1~ . s : ~3 Z )o-y3 1~K1Z 316 -~ s;1 ZwtSbk rr1'~t-' ~tv _ , S . ~ 3 t.~3-bo ~.S'.2R3 i~ ~ l S O 39 m ~ c~S - .--~ ~. ~- 4 ~D q~ ~.S'~2.31 S O S in I •• - . ~ ~. ~ 'Effluent #1 = BOD. > 30 < 220 ma/L and TSS >30 < 1 50 ma/L ' Effluent #2 = BOD_ < 30 ma/L and TSS < 30 ma/L CST Name (Please Print) - ignatu CST Number Arthur L.~ Wegerer ~~~1 ~~'~~ 220254 Address Wegerer S o i l Testing & b e s i g n S e r v i c e Date Evaluation Conducted Telephone Number 421 i1, Fiain St. River calls, WI 54022 5-lD _0~ 715-425-0165 i Property Owner S~Z,~'(~~ B # ^ Boring Parcel ID # Page ~' of 3 onng _ ~ pu Ground surface elev. 10~~- S $_ I7pnth to limifinn f~nfnr 1 1 7 t~ t.. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ft~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 c7-10 ibKrz3~Z ~ si J z`-FsbK m`~1- ~ )~' .S . ~ Z 10-2y 10`t2 316 - Si l Z`F's bk In`~- CW - . S - fi 3 Z~ 3 6 ~, S ~tfL 3! y ~ `S a S -,~ ~ g - -1 t- Z 6_~zD -l.s~~3~v - S c~ s9 ~) ~ . ~ ~. Z ^ Boring # ^ Boring ^ pjt GfOUnd SUrfaCe @IeV. ft. Depth t[t limltinn farttnr t.. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ft= in. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 Boring ~ Boring # ^ Pd Ground surface elev. ft. Depth to limiting factor _ in. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 • Effluent #1 =BODE > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. .. ,' PLOT PLAit Scale 1' = 30' z2.a "! o ~~~1 a Q d 7 a v y 7 J 3 0 N Pave 3 of 3 a.~io9 3 '~,_ 6 2.5 ,,~~~ , a' a - __ 5 i~ 3 ~ ~ 3 , '? 100 `~ ~ 2,S ~~2 17%`~-103 o g.'3 ~~$~ ~~ r'CO ~~z,~.u~~t~-f PrP~t1X . t,OT l.lh)~.- V~z.1.~-y Q~~ ~~ S1~t, c~ ~ ~3~'~C =~~~66:~t5`_~~~'_':I-Y161~~_31~t,,.~~=P_vC__~r'~~_TIr_ - p_~_ I~ -------- ~~-~0~3-E=at-T ~T_-5.0`::[=~zci~_~~~~ =~~D ~~ 8C ---~1`_~l:o_U_t''D=S? tZL0:1Z--~j ---5-'~~1'"L---~ ~S2L~-L-~1101~1:~-~- ~-IO-OI 715-425-0165 220254 Ol-°13 CST Signature Date Telephone PIo. CST I~1o. Job Pt0. y~r ~ ~~~ .oN.~~ a,nieu6Ks,JO~adsul a3ep "ter, ~ Ito S~r~~„n~. ~ Q ~ . .fin ;u! 1 -l!ppe ~o; apc!s ~~.K~ }~ oN D sax D tPa~!nba~ uoKUw~ ue~ '$4 z~ ` ~ 4 ~S ~ \~~ '~~ ~'~'-~" ~~ ~ _ ~ano~ ~o ;unowe- ~~ • z1 =- /•+~"'~~5~ V V 1 ~~~ -'y;6ua~ ~annas Bpl9 ('Z - ~£~Z6~6Z£Z - (M61.21 N6Z1 £Z til6 MS ti/i~ 3S) 91.0>~ IM `uospnH `peon ~(a~~en uosua~a~ £pg :uoi~eoo~ -1---,f-- ~Z# uoi;oa sub o/ge/~0 ~ ~# uoi;~a sub (-~~a'~uasa~d suos~ad'sa!weda~x~p apo~ apnpul) :S1N3 W WOE oN ^ sax p oN ^ saJl ^ ~rosdol sa6P3 4x-a~l / pa8 ~alua~ ~pua~l / Pa8 pay~~nW xx PaPPoS / PaPaaS xx ;O 43dap xx ~anp y1da0 ~anp 41da0 ~lup swa~S ape~g-fit/ a0 punoW xx nlup swa}sns a~nssald x 213A071105 6uned yi6ua~ ~.:e~a ~.a yi6uil ale;u~ ~~b of luaq 6uaed$ off x ars a H x s)ad}duoiu-quic~Q ,_ t~ eve / ~~~. ?'-'7 -1`~1 rr~1.~n~ nvw ~sna.i.~w llNn 210 -- -~ ~'Z` ~. :wa S :~ wnH a ~~ NOLL 2139Wt/H~ ~ 813S 9NIFgV3l 2l15 / 3~Ibr1 113M 9018 l / d Ol W31SAS Wise eeyy _ 'sue ~ 43dao pmb!l 'e!0 aP!wl u!d;O'Wd 1W . ~ saywa~ oN .~,.e , 16ua~ ~ ~ 43W.M / -~`-I 1 ape~91~!~ .£.~ wa3sl~S -;08 58 'v l ° , ,., ad!d 'ls!0 S Q~' Lo J -UeyV / ~apeaH wouo8 i0 3a1u1 ZQ wh1'°-oi ~b~9 a~np3H/35 ~~'t° v£'~c ~ ~annaS'6p18 ~$2'bo( ~~ ~ W8 '~Ib~ / o • J o 1 •Z.1 ~,ewywa8 ~'~ 'A313 S~ IH S8 NOIlV1S :•oN xel »Qd :'oN OI ~ aitl 18~ti8£ :•oN 3!wiad ~t~wes xioa0 '~S :~luno - ~ v - ~ _,,; ~yi~ws nvuaw~av n na .o -e!0 i136ua1 u! 3 HOl wa S uor~u~ HQ.L ~ ~Iw IaPoW puewa0 ~a~n~e ' NOIl~IW210~N1 NOHdiS / dWfld 6u~p1oH b-N uoria~ay t/N 6uKOp Ot1021 a'I~~'"'r oii~aA '9018 113M l / d O1 ~INb1 N0111~W210~N1 ~1~~/8135~INti/1 ' : Cw!ppH ' uor~e~ 6uKOa ~ codas JI.Ll~ddb7 2l321f117t/~f1N~-IN 3dJLL ~Il~lO NOIl~/A313 NOllf/W210d N1 ~INVl ~ :ualdu~sap W8 3 W8'~W iysunnol uospnH o wrw a6a ~A ~ :aweN s [(wXl) ti0'4L's'Ma'~ fYlOdN1d ~p1100es bl p9se o9 ADtU ~~ nOJ•,110~81WOM1~ (.UW213d O1 HJdllb) NOLLHWaO~NI l laOd321 NOLL73dSN1 W31SJlS ~9~IAA3S ~lt/Ai21d "0~O ~ to / ~ R o 3 (` ~.1 w~.StiV USE `~ l2Q ' ~ ~ ~ Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. ®~SLconsin See reverse side for instructions for complet is application P n l i f ti id ed f b c -1 ~ PO Box 7302 Madison, WI 53707-7302 Department of Commerce you prov ersona n orma o e may or se e us on u oses [Privacy Law, s. 15.04(1)(m) '-P rP ] (Submit completed form to county if not ,' ~ state owned.) Attach complete plans (to the county copy only) r'the syste ,per not less than 8 -1/2 x 11 inches in size. County ~ S State Sanitary~ermit Number Lek if ~ri~®q previous applicatitn " ~'~~~ State Plan I. D. Number ~~ V ` p'~ I. Application Information -Please Print all Information -- ry ~~ Location: Property Owner Name `°; ~ ;~ GQ, ~ FF ..~ `' ~ ~ ~ G Property Location ~ Gp l, ~ -~, cA .. ,.~ ~ 5~ 1/4S(.ill/4, sa3T I,N, R (o Property Owner's Mailing Address ~ ~>,~ ` Lot Number Block Number City State Zip Code Phone Subdivision Name or CSM Number II. Type of Building: (check one) ^ City ~. 1 or 2 Family Dwelling - No. of Bedrooms :~ ^ Village ' ^ Public/Commercial (describe use):_ ~d Town of ^ State-Owned ~ ~(,,tt!~"' `^_ Nearest Road I ~ 3a ~~,~ 3, ~- Sr 2 3 Pare ax Numbe ) III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) - - Q~j p A) 1. New 2. ^ Replacement 3. ^ Replacement of 4. 5. 6. ^ Addition to System System Tank Only Existing System $) Permit Number ate Issued ^ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) Non-pressurized In-ground ^ Mound ^ Sand Filter ^ Constructed Wetland ^ Pressurized In-ground ^ Holding Tank ^ Single Pass ^ Drip Line ^ At-grade ^ Aer bic Treatme~}t%~ Recirculatipg ^ Oth T V. Dispersal/Treatment Area Information: - QQ 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals./day/sq. R.) (Min./inch) Elevation ~~o sic ~- i o.~ y~, ~ VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing Crete structed Tanks Tanks T is a -- ia~~ ~ ~~=~- ~ ^ ^ ^ ^ ^ ^ ^ ^ ^ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (print) uT~~~ /~~ Piumbe ' Signa re (no RS No. Business Phone Number ~ ~ ~ ~ - a ~ 3s ~ y 7~s ~~ - Plumber's Address (Street, City, State, Zip Coe ~ /' , ~ ~ IX. County/Department Use Only ^ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) Approved ^ Owner Given Initial Adverse Determination Surch a Fee) 2..2s ~ Nibn,t~ ~(p Zt9p ~ X. Conditions of Approval /Reasons for Disapp~r~ Rv~ale ~ C~~sS ~`g~h~ ~ ~ r10~2p `~ Lowe... ~ ~• ~.5 tt Sr~,a--- ~ au~ aa ~~ ~:~$a uu e ' ,~ n h ~ ~~~ ~ - - o~ 'C~o ~ ~- OC~Cc~ueeBJ So.t ~ ~'i ~uS . ~ar~ i ~St~X~ vc7to o- ~ ~ ~~ ~ -- ' ~ , ~ p~~ ~. ~~;ks~d~..~ ~ . p~t,l ~ rte- ~.- -. t~ . L . X96 .~s ao ~ e~ .~" ~ Y ~ _ S v,na,`~.-4~-txed~ ao p.~,. w~. - r~e.ee,M.wt SBD-6398 (R. 07/00) - /~Ilyj P '~~~ /~ /~ ~~ O~ ~~ a ~~~- a N~ ,, O- ~i ~ a ~ '~ ° ~ ~ ~ ~ sy . ~l vi ~I~ ~~ P .a' 9 9S- ~~ :/~ o ~~-~ ST~ ~_____ ~3~ua+~.~s ~ ,.~ . ~~3- 3 ~~- y~, 1\ I~-;~ ,~~ aao3s~ s~ . y~. ~ ~~ ~,~„ - ~~ a ~-,~a~ s ~~ \I vl ~~ ~< p 1~~ . ~~ ~~ ~~ y~` ~ \~ G~~ aa~3s~ s ~~~ ~ ~~ Wisconsin Department oflndustry, SOIL AND SITE EVALUATION REPORT Pa e ~ 3 LaF or and Human RelaCOre g _ Of _ Division of $afety.& Buil~ngs • in arrnrd with II NR A~ n~ Wic nrir„ r nrlo i COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but' ST. C1~.O },~ not {invited to vertical and horizontal reference point (BM), direction and % of slope scale or PARCEL I.D. # , dimensioned, north arrow, and location and distance to near d. ~ ozo - - 0 63 - ~ ~ _ ~ { ~• • APPLICANT INFORMATION-PLEASE PRIN REVIEWED BY DATE a PROP ERTYOWNER: 6t_~?Jt~ 8.'S~-t '~ ERN LOCATION I1 ~ C/ O ~A D S`~1Z r4 ivD _ S E 1/4 S I.V 1/4,S Z 3 T Z q ,N,R l q E (or~ W P `Z~ OWS o~~ ING`DD~ . S ~ ~/(// L ~ BLOCK # SUED. NAME OR CSM rt ! C.-2.~ w-1 SU~i V Alr~~1 CITY, STATE ZIP CODE HONE NLI~@ R1U~1Z 1=Y~t~S, ~l1 S~I~tZ tS ~,y 6a ^VILLAGE ®fOWN 1-~ ' S NEAREST ROAD PRUPD S tiD C v p 0 N 21w1SptJ V>~ Z.D jxj New Construction Use [~ Residential ! bedrooms [ J Addition to existing building j J Replacement (J Public or commer ' i ~ ~ Code derived dairy flow 6 0 o gpd Recommended design loading rate • ~ bed, gpd/ft2 • ~ trench, gpd/ft2 Absorption area required 8 S ~ bed, ft2 ~ SO trench, ft2 Maximum design loading rate • ~ bed, gpd/ft2 • $ trench, gpd/ft2 Recommended infiltration surface elevation(s) S ~ N OTC ~'U ft (as referred to site plan benchmark) Additionaldesignlsiteconsiderations ttiSTR-I..LL-~ p>V to~GL 3 Parent material Lo ~ S ~ y ;'n Si~y ov~P~SN Flood plain elevation, if applicable ' ry~ ft S =Suitable for system U =Unsuitable fors stem CONVENTIONAL ®S ^ U MWND ®S ^ U IN-GROUND PRESSURE AT GRADE ®S ^ U ( ®.S ^ U SYSTEM IN FlLL ^ S ®U HOLDING TANK ^ S ® U SOIL DESCRIPTION REPORT Boring # ~~ I =: _~ `J:C {:4~ £a:.,wN..rra.M. Ground elev. ~t6 •-t fL Depth to limiting f 8, Boring # 7 K s~~^"w I ,~:. r ~:, Z .:.., ::~ Ground elev. qs•z fL Depth to limiting factor ~~ ?81 Horizon Depth in Dominant Color Muns ll Mottles Q S C Texture Structure ~~ . e u. z. ont Color Gr. Sz. Sh. g~ rerxft I o_~ to~~~1z - sil Z`~sb1z ~ CS - .s •b z $-~0 1~~~~« - s~, Z~Sb~ asp, ~S - . S .~ 3 30$8 ~. S `1231y S Q, 6r• O S9 c~ 1 ,1 .~ G:t" ~ (oho J o 2 cte...~.i,~. o -9 1 opt, R ~) ~. _ S t 1 Z'~s~k ~~• CS - . s ~ ~ z g 3g. I.o~r{~ 316 _ Si 1 2'ns1~k >n~~ ~S - . s I_~, 3 3$-s -~.s ~{z3~y - 1 s v s9 wt l e s - --, • ~ ~ so -~, ~ . S `~ 2 31 y - S c~ s9 ~ 1 --- . -, . g •2~ ~---- Remarks: CST Name:-Please Print Arthui ~ergerer Soil Testin Signature: ~~~ w~: ~~ L. We~erer Phone: 715-425-0165 ' & Design Service-P.O. Box 74 River.Falls,WI. 54022 ~' Date: CST Number: . ~~-~ q~-yl- 1 ~~_~~ -49 220254 tstence Boundary Roots P Dlft ~S ~S . ~- .S . ~• .~ PROPERTY OWNER ~ 1~-dl~Vy SOIL DESCRIPTION REPORT PAACELI.D.~ ~ ~ , lOV~-!0. I IU Boring # Ground elev. troy -7 It. Depth to limiting (actor > 411 " Boring # ,., y . _~< Ground elev. \ ob.4, tt. Depth to limiting lactor ?g(," Boring # ;:: ~{ S i'~': Ground elev. lit •0 It. Depth to limiting I> `i O" Boring # <<~;:< ~`~i Ground elev. tt. Depth to limiting factor 'r • z: Page ?- of -~ Horizon Depth in. o - 9' Dominant Color Munsell ~ Mottles Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ft Bed Trends - . b~ \Z 31 Z - s t I z~Fs~,1-c ~,. s ~ s ~ . s . (, ~ q_3s lb`1lz~l(e - s,l Z`E's~~, ~ ~h cw - - S -6 3 3S ~o ~--S`tR y/C - ~S O S~ y,.l ~ eS _ .~ .~ ~oA'7 ~-S~r-~31 _ S ~ ~ ~ 1 _ ., .~ I i I I-lemarKS: Z b-~Z l o`~cz.. 3/6 - s ~) Z~sb~, cQ s1~ L° S - • s ! • ~ 3 L'Z-Z.$ ~ •S 7 R Sly ~ Gr I.S ~ ~~, o~ ~ Z°.w ~ ~ ,1 ~ •~ - r ~ 's ryemarKS: I o 9 ~o~.~ 31z. - si) z~ob~ r~ s1~ cS _ •S •~ Z 9 30 l Ll `i iL- 31 ~ - S t ~ Z `~ S~1~. vvt f l- ~ ,~ - . S I .6 3 30 90 --.5 yR 3L y - S ~. Gl. ~ s9 ~ 1 - ,~ ~ . `~ I i . i I . Remarks: i o,,,.,.,.i,... . r, •~ oo•~nir, ..r ., ., I Q ~1J f~ G . PLOT P L~`~ Page 3 of 3 'SCALE 1"= t4.0 ' ~~ of N n L11. a S Z ~: ! ~ ~/ s ~ ~Tre~ ~.~ A'~1~$A ~t ~U2 w 11'~ R-~.. IP~.7 Iv ~- ~ 5.5 ~~ ~ 19~~8. ~ _- 0 4 Mme) ~ L'Ll~l°- t.1,~u 8 B.~-- ~`~-loy,~ 6- +fi~ 8~ t~-z- 6 ~, t~o.o' o~ S~11rcfi, ~S"FFBov~, G2uUfvD iN S~~t~A ~;.,~ , ~. Bhp - ~z,.. 1tv.o ~ ~o~ .• ,~ 4'' ~~ K ,C , , r ~ s`tYn.l. Z 11Zp~V C4t1~ ~C1~ 3'x '1 S ` ~o~ ~ >~~ !-}-16H C~t~:l7y S 1 D E W 1jvDe2 t Ct~t~ >3 ~ s . T~H~+C!{'~S 1'0 $ c _ -~T ~ ~-- D~'P ~'T `S1;r~ ~OUwrU SwPE ~'D ~E_ _. _ _. -- ~~~-RM ~-J E ~'12~'~/CN ~~V A~fIUkJS 1"rfi' 'h~l`-1E OF C~~STIZU ~~_~ . ~ u c~c~ ~~ StL~e,l1 '~s ~Y~~'(~'-ti D S ~'~,v'R-tj ~ =Ban ' 49-y1-) ~` z'~`~-~ (715 ) 425-111 h5 CST Signature Date Signed Telephone No. CST # ~~~h*~.~5 2AgD Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWYS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- Table 1: System Design Specifications Sanitary Permit Number Number of Bedrooms Design Flow -Peak (gpd) C7i7 Estimated Flow -Average (gpd) i~ Septic Tank Capacity ( al) 1 - Soil Absorption Component Size (ft~) - ~ ~ Type of Wastewater Domestic Table 2: Soil Absorption Component -Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow -Peak (gpd) Z-as Maximum Influent Particle Size (in) 1/8 Maximum BODS (mg/L) 220 Maximum TSS (mg/L) 150 ~~ Tab le 3: Maintenance Schedule Septic Tank Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the se tic tank and outlet filter shall be assessed at least once every 3 years by inspection. Th outlet filter shall be cleaned as necessary to ensure groper operation. The filter cartridge shou not be removed unless provisions are made to retai Ion to isn 'ds in the tank that may slough off the filter when removed from its enclosure. If the ' ~ Mahagement Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank maybe difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 ' ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP C~:RTIFICATION FORM OwnerBuyer `,rl,~il~l ~ _.lr~-1L~+1N ~-i~.1~1Jp Mailing Address f Z,'1 ~ jo ~-EE.T'. ~tV~~.~l~~ W 1 ~~02~ Property Address (Verification required from Planning Department for new City/State Q`~bf~.1 {~-~ 1 Parcel Identification Number ~?7, Z~ , (~ .~Z~~~ LEGAL DESCRIPTION Property Location ~J~ %., sl'`~/., Sec. ~, T~N-R~W, Town of 1~1,'P~~ sal . Subdivision ~~'~`'~~ t`5 ~.~.1,'~-`~ Lot # Certified Survey Map # ,Volume .Page # Warranty Deed # ~y~~ ~ ~ ,Volume 373 Page # ~ a Spec house yes ^ no Lot lines identifiable (~s ^ no 1C,~ 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 masterplumber, journeymanplumber, restrictedplumberor a licensedpumperverifying that(I)the on-site wastewaterdisposal 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 days of the thre ear expiration date. /~ b SI NATURE F ANT 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 property described above, by virtue of a warranty deed recorded in Register of Deeds Office. S A' 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 ` ,. • . ~~ ~~ •- .u~- ..wwr NZ Z~ o `~ y~ ! ' O >; ~~ ~I ~ V ql ~ ~ ~{ W ~ ~ ~~ ~ FC ~~! C a ri v .a o ~; I w ~ a~ ~ Z ~y i 0 U1 ~ ~ ~ ~ F~ U o0 ~~ e~ a :a w U~ u V ~ '. i ~ / a' ice, ~ "~ / •: Q, U N y Z O [`., F 5~•~1 y ~risN7ais7a - sr o7,vos sawn wttru7n 7M1 ~/l M1Mf - x1Y0N7 7 aAil u a~booir i~ ~a f~---i ~ ~ I R 1 ~ ~ ~ ~~~ ~ ~~ ~ ~~[ I I ~~ ~ ~ a~ ~ ti~~i ~ ti ~ I I I i~ g! ~~~ N ~ ~~~^ I F 6 I ~I !r --------- -~ ---- I == $ iI ~i ~I 7YJ1N701S9tl - 9Y Q9NOi s~ ~ I ~ I I ~ I ~4 1 I ~ ,4 I ~ ~ ~~ + ,~ I ~ I ~I ~a 1 1 (.74'9177,.W.77AfWJ q~C I I YY 2 .ra•a7 ' I ~ °cJ ,y ~ i ~ I `, \ w ; pe j \ ~~ ~ ?\ ~ Mr h ZF. i i; I hSS.t I ~ .` / \` /~.~. i i i I ?~ I N .,` ~` ., ". _._ _.._~_ ___..J ~ Si ~~. \ .... • ................_....... I --. _..-.._. _ L.._.. fi. ......... "~ i ;~ I I ....- Y i I ...... I ~~ ' I ~ . ~ '~ ~.. .....: I ~:'UC L..__~ 'ii I I ~ CO,: cti a ! ~i l I o O 10 _ i I I pp 41 ` I.. _._.---~a I f. UU~ ~ I py eQ! ~i ~~ w q w~ I I as N .: i ~i ~ ~ I~-.-.ml I I a C, ~ m I I,. .u'u~ ~ ~ ,Ica 4 , I h„iisr.arJ '~ ~ 'ur sxt io 7Mn tr7~ ~~~ (" I I I S m 7Y/.LN90lS9Y - 9Y QiNOY ~ i ~~$ ~ (I I I W ~I ~ of I I g~ I ~ a e ~ ~~ O N t I ~i tg ~ SS ~~ Y~ @~ k ~ ~~ ~ I _ 4co 2~ qq ~ ~ ~ ~ ~ ~ i ~~ ~k ~~ II R I~ ~ b R 4~ ~Z Y ~ ~ ~ K ~ ~~ ~ ~ ~ ~ ~ %R ~y~~ ~i b b @ ~ ~ I ~ I 9 I < ~ 1 ~ I III Z ~~ ,( e 0. II ~ ~ 0 ~ • i ! ~ n \ ;~ ~ ~ 22141f 1 I 1 I I i ` E a i _ ,~ x c,; '~ . - t .. ~` ,,590633 ~' ; DOCUM~NTNO ~o~ X3.73 PacE~~i '~° `~'~ STATE BA4 OF WISCONSiN FORM 2 - 19A2 WARRANl'Y DEED '' Susan K..Huhta and i.~oren W. Nelson ~ _ com•evs and warrants to _ Glenn H Strand and Jerilyn M. _ Strand, husband and wife, as survivorsh'_p marital - rO ~' - •REGiS~'ER~S OFFICF+ ~T. ~ROlX CO., WI .i~S! ra. M•ae NOVA 3 1998 q~ 30 /~~ Rea tK d 6~ '-'---"' ~ TRIS SPACE RESERVED FOP RECORDING DATA v _ NAME ANf~ RETURN ADDRESS ;hr fnllowing descnbrd real estate in St- CSOLY _ County, Aatr .~i Wls:onstn: iwld~r-,@fiCa Bank NOr!h PO Box 149 Ladysmith, W{ 54848 020-1063-10-110 PARCEL ?FNTIFICATION NUMBER The South 988.09 feet of the SE1/4 SWl/4 Sec. 23-T29N-R19W except the East 462.84 feet of the South 660 feet thereof. TRA~lSFER $ 330 °- - FEE This iS not homestead property. X]Q~t iLS not) Exception tD warranurs Easements, restrictions and rights-Of-way of record, if any. Catrd this ~~ day of October -~ ~~~ (SEAL) Susan K. Huhta (SEAL} AUTHENTICATION Signatures} Susan K. Huhta, _ Loren W. Nelson authenticated t i 'day o[ oCt4ber , 19 98 Krishna and TITLE MEMBER STATE TZAR OF WISCONSIN Q(not, authorized by 4706.06, Wis. Stats.) THIS MSTRUMENi WAS GRAFTED RV Attorney Krishna bgiand ___, .: _~-_._ ~_r. CAAI ~ A.D., 19 .98_ ~v w~ (sEAI.} Loren W. Nelson (SEAL} - ACKNOWLEDGMENT State of Wisconsin, 5:. _ County. Personalty came before me this day of _„ 19 ,the above named to me know~rt to be the person __ who executed the foregoing instrument ar,d ackno•~lzdge the same. Notary PabLc, my cortmissi (If __` Crurty, Wis. state expiration date i c v+ o n Si ~ 3 v n Cy r~ 0 0~ o w m ~ eo ~o ~ • ~ ~ ~ n ~~: ~~ ~ ~ a I ~ O ~~ Z~ Z O W f~ Z~ Z o N 2 2 W N ~ ~• I o o m °°' ~~ J~ ~ ~ '~ ~ m~ '~ 1 b I 3 a ~ y o 3 v+ W ° °o p ~ c n d~ n l ~ a ~ a ~ cn Z D ~ ~' v (n Z D ~ O d tan I m co D ~' d y cQ °1 ~ o0 o V I 3 O -~ rn w d p W Ao' d _ N N ~ ~ i ~ ~ ~ ~ ~ ` ~ O O O p O ~~ ~ O C I °, a 3 ~ N = 2 ~ N Z ~ ~ D y~ ~ ~ ~ y ~- X11 • ~'~- o (rl I ° aIQ vvo~ ~~ ~v_v,~ N ~ °' ~ ao ~ d a ~ ~ ~ ~ ~ ~ ~" ! ~ ~ ~ so o ~ ~ m o i ~ ~+ i m a ~~ ~~ - ~ N .. .. it ~~o o O N N l~l O 'fl 7~ N C ~ N N C I Oao ~ ~ ~ N' ~ N. n ~ v ni ~. ~ ~ ~ ~ ~ I ~ . ~ m m ~ m ~ -` -~ N o ~ ~,_ a AZT o ~ ~ a a I A Z O v ~ ~ I = v ~ ~ N ~ I fA --I N ~_ ° ~~ a~ I m o W ~ a 3 ~ ~ ~ ~ I ~ ~ ° :: N °o r: cn I ~. m H N H I~~ ~ .. z .~ .. z o. a ~ ~ o ~ A I sp~v ~ ~ D 7v d > > ~ (D D ~' 7'a~ ay Q o° ?f E 3 y n ~ N ~ m ~m ° ° aauo'~ ° ~ y p~ ~ `~G fD ~ 'O y n ~ C ~ ~] 41 ~ ~ '7„ 03 V 7.4_7 .~ I ~'o m qcq ~~ a7 ~3 ° ;..y fi `,~G ~ fD N` n fD d 7 V O fl. A `° m'-5' 0 3 ~ay~ y~o ~ x ~ ~ F ~ ~ ~ ~ ~ m ~ N ~ y ~ ?m o ~' -0.03 ~v ~ fD 41 ° 1 7. fD I daova 3~dma~ v ° ~Dpo 0 ycom' ° y m o ° 3~ ~ I o~~ 3 om II a 7 ~ ~ m ~ ~, b ~° I ~ O ~ O ~ ~ o f o f I ~ a I °o ~- °o ~ j ., Parcel #: 020-1063-10-110 01/25/2005 10:42 AM PAGE 1 OF 1 Alt. Parcel #: 23.29.19.241A10 020 -TOWN OF HUDSON Current ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * =Current Owner * STRAND, RETIRED RETIRED STRAND Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description * SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 22.362 Plat: N/A-NOT AVAILABLE SEC 23 T29N R19W PT SE SW DESC AS L O ' Block/Condo Bldg: FO L WS: THE S 988.09 OF THE SE1/4 SW1/4 SEC 23 EXC THE EASTERLY 462.84' OF Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4} THE SOUTHERLY 660' &EXC PT TO TOWN 23-29N-19W HUDSON FOR ROAD PURPOSES (DESC 888/352 .638AC) NIG4 PLAT CRIMSON VALLEY Notes: Parcel History: Date Doc # Vol/Page Type 11/03/1998 590633 1373/021 WD 07/23/1997 1102/394 W D 07/23/1997 853/231 LC 2004 SUMMARY This parcel will not get taxed. It exists soley Assessed with: for parcel history tracking purposes. Valuations: Last Changed: 02/02/2000 Description Class Acres Land Improve Total State Reason Totals for 2004: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2003: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 . , Wisconsin Department of Industry, Labor and Human Relations Safety and Buildings Division GENERAL INFORMATION PRIVATE SEWAGE SYSTEM INSPECTION REPORT (ATTACH TO PERMIT) County: ST. CROIX Sanitary Permit No.: State Plan D o.: Parcel Tax No.: Permit Holder's N m HUHTA , S~TSgAN K . ^ City ^ Village Town of: CST BM Elev.: Insp. BM Elev.: BM Description: TANK IN FORMATION TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/ L WELL BLDG. vent to Airlntake ROAD Septic NA Dosing NA Aeration NA Holding PUMP /SIPHON INFORMATION Manufacturer Demand Model Number GPM TDH Lift Lriction S stem TDH Ft Forcemain Length Dia. Dist. To well ELEVATION DATA STATION BS HI FS ELEV. Benchmark Bldg. Sewer St/ Ht Inlet St/ Ht Outlet Dt Inlet Dt Bottom Header /Man. Dist. Pipe Bot. System Final Grade SOIL ABSORPTION SYSTEM BED J TRENCH width length No- Of Trenches PIT. No. Of Pits Inside Dia. Liquid Depth DIMEN I N DIMEN I N SYSTEM TO P / L BLDG WELL LAKE /STREAM LEACHING Manu acturer: SETBACK INFORMATION TypeO CHAMBER Mo el Number: System: OR UNIT DISTRIBUT{ON SYSTEM Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing 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 COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: Hudson.23.29.19W, SE, SW, Badlands Road Plan revision required? ^ Yes ^ No Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. -~ SONITORY PERMIT OPPI ICATIAN ~' O~Lf""~ " - - -- - - - -- ----- - - - - -- -- - - - - - - `.~~~ `~-~ In accord with ILHR 83.05, Wis. Adm. Code ~~ CO STATE SANITARY PERMI T # -Attach complete plans (to the county copy only) for the system, on paper not less than r as a Q 8'r4 X 11 IfiCheS In SIZe. ^ ' ~ Check if revision to p vious applicatbn -See reverse Side for InstrUCtlOfiS fof Completing th13 BppllCatlOn. STATE PLAN I.D. NUMBER I. APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION. PROP OWNER ~ PROPERTY LOCATION t~eS ~ ~'/a (.lS%a, S ,3 ToZ. , N, R E (o W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # 1 ~, O a ~ y / v /~f y / V CI ,STATE ZIP CODE PHONE NUMBE R SUBDIVISION N AME OR CSM NUMBER _, t / ~{~ Jt L /V 11. TYPE OF BUILDING: (Check one) CITY ~ NEAREST ROAD State Owned ^ VILLAGE ~ ~ ~D9e I~G ^ Public ~ 1 or 2 Fam. Dwelling-~# of bedrooms. 111. BUILDING USE: (If building type is public, check all that apply) 4~~-~alo3- c~-lio 1 ^ Apt/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 in line A. Check line B if applicable) A) 1. New 2. ^ Replacement 3. ^ Replacement of 4. ^ Reconnection of 5. ^ Repair of an System System Tank Only Existing System Existing System B) ^ A Sanitary Permit was previously issued. Permit # - 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 42 ^ Pit Privy 13 ^ Seepage Pit Pressure 43 ^ Vault Privy 14 ^ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2, ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/d /sq. ft.) (Min./inch) ELEVATION ~ =~~ ~ ~~ ~ j D .. ~ ~ Feet Feet VII. TANK CAPACITY in allons Total # of ' Prefab. Site Fiber- l i Exper. INFORMATION New istin Gallons Tanks Manufacturer s Name oncret Con- Steel glass P ast c App. Tanks Tanks ~ ~ structed Se tic Tank or Holdin Tank f~o0 (dc1O 6 ~' Lift Pum TanWSi hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) MPRSW No.: Business Phone Number: ss ~' ~ >'~ G z~" Plum is Address ( eet, City, te, Zip C ..-..~ `7~ ~ ~ s IX. CO NTY/DEPARTMENT USE ONLY Disapproved Sa ry Per ~~e (Includes Groundwater Surcharge Fee) a e ssue Issuing Ag t Sign No S Approved ^ Owner Given Initial ~ ~~ a7 Adverse D erminati n L/ X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly PIb~7) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety 8 Buildings Division, Owner, Plumber INSTRUCTEONS _~! , 1. ' A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any,new _ criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 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 licen"sed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsi4e sewage system, contact your local code administrator or the State of Wisconsin, Safety 8~ Buildings Division, 608-266-3815. 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. , 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 in 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 in #1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of , tanks and manufacturer's name. Indicate prefabor 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'f~ 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 §urcharges are used for monitoring groundwater, ground- ~ - water contamination investigations end establishmentof standards. ~ _ ' SBO-6398 (R.11/88) ~~ ~"rC. ~~- Q 5, 7 ~t S r ,~ ~- Y ~ ~PEr~ ~ ~~o ~J 5 E '~y S uJ '~~~ 5,23 T. ~ 9 /~ rL i `1 Gt~ - _ -ivy ~J~~ c € mot/ s ~~/ y2 5~ ~~~~~ ~~ -~-- S'7 ~t 8~/ y ~' ` ,~/~ r ~N~ i i o' 19 __ i ~~ p pSC~' t.J ~-`' ty Nt- ~~~~ ~e3, .~ /~ ~~ ~, ~ ~ ~_s 9 ~ y~ ~ T"` ~ C3, Z 3 ~1 C nc~3 ~' SG-r moo'. ~ ~~ ~ j ~2,t1~ _ ~ ~ QJ,1Z. ~z ~ ,o ~ /TO u S c"' G 6 L i ~ $' 1 ~ °O' ~ ~ ~ y` ~~.f P~ Pc` - /t -z 1,~ G.~.~L-x. q' ~ s'x Sys ~.5+-~ ~~, -~~ r w~sconsin department of Industry, SOIL AND SITE EVALUATION R E P O R T labor and Human Relations Division of.Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code Attach complete site plan on paper not less t, ens in size. Plan must include, but not limited to vertical and horizontal refere. e i i 'and % of slope, scale or dimensioned, north arrow, and location,.airi° , ance to nears r~ APPLICANT INFORMATION-PL~AS.t~ PRI~~ INFO ION Page ~ of ~_ St. Croix PARCEL 1.D. # PROPERTY OWNER: ~~ 0°~'"" ~ ~~' PROPERTY LOCATION ,.wo ~ .:;.,j,• GOVT. LOT SE t/4 ~ 1/4,S 23T 29~N~R 19 1 W PROPERTY OWNER':S MA!i_ING ADDR ;<~, .J ~a~ ~:~s,'~= ~t LOT # BLOCK # SUBD. NAME OR CSM # 310 S. 7th. St. ~~.~ ~~ ~/ CITY, STATE ZIP PH MB ~, , QCITY QVILLAGE MOWN NEAREST ROAD ~ New Construction Use (x~ Residential ! Number of bedrooms ~ [ ]Addition to existing building ]Replacement [ ] Public or Commeraal desaibe Code derived daily flow 450 gpd Recommended design loading rate . 7 bed, gpolft2 .8 trench, gpd/ft2 Absorption area required fi4~ bed, ft2 SFi~ trench, it2 Maximum design loading rate _1~bed, gpd/ft'~_trench, gpd,"t2 Recommended infiltration surface elevation(s) 95.88 ft (as referred ro site plan benchmark) Additional design /site considerations na Parent material outwash Flood plain elevation, if applicable na ft S =Suitable for system CONVENTIONAL MOUND IN•GROUNO PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U =unsuitable for svstem f~S ^ U ~ ^ u ~ ^ U ~ D U O S ®U ( ^ S ~1 SOIL DESCRIPTION REPORT Boring # 1 Ground elev. 99.~R ft. Depth ro limiting facror +83" Boring # `?<•`.:, •~`::::> 2 ~~~•~~ Ground elev. 99.38- ft• Depth to limiting facror + ~~ Horizon Depth Dominant Color Mottles Texture Structure Consistence Botr>dary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trends 1 0-9 10 r3 3 none 1 2msbk mfr 2f .5 .6 2 -24 10yr4/4 none sil 2msbk mfr gw if .5 .6 3 24-32 7.5yr4/6 none is Osg mvfr gw na .7 .8 4 2-83 10yr4/4 none cos Osg ml na na .7 `: .8 Remarks: 1 0-12 10yr3/3 none 1 2msbk mfr 2f .5 .6 2 12-21 10 yr 4,14 none sil 2msbk mfr if .5 .6 3 21-32 7.5yr4/4 none is Osg mvfr gw na .7 €.8 4 32-82 10yr4/4 none cos Osg ml na na .7 •.8 Remarks: Name:-Please Print Phone: Date: (i51 Numb 5-2-94 cstm 2298 PROPERTY OWNER Susan K. Huhta SOIL DESCRIPTION REPORT PARCEL I.D.# 020-1063-10-110 Boring # ;::.u .:~.:.<:<::: •::G:i~ 3 Ground elev. Depth to limiting factor + ~~ Boring # r~~ 4 Ground elev. 94.9_ ft. Depth to IimiUng factor +8 " Boring # ,:~. ....<x.::<: ~~:... 5 Ground elev. 95.38 ft. Depth to limiting factor + ~~ Boring # Ground elev. ft. Depth to limiting factor Page ? ~ of 3 Horizon Depth in. Dominant Color Munsell Mottles Du. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Baxxiary Roots GPD/ft Bed iTrerx~ i sl 2m r mvfr 2f .5 ~.6 2 18-35 10yr3/2 none sl 2mgr mvfr gw if .5 .6 3 35-82 10 r4/4 none cos Os ml na na .7 .8 I Remarks: 1 0- 7 1 r3 3 none 2msbk 2f .5 ~.6 2 7-18 10yr3/4 none sl 2mgr mfr if .5 .6 Remarks: 1 0-9 10 r3/3 none sl 2msbk mfr if .5 ~.6 4 21-80 10 r3 6 none cos Os ml na na .7 .8 Remarks: 1 Remarks: SBD-6330(R.05/92) r• STEEL'S SOIL SERVICE Gary L. Steel CSTM2298 Susan K. Huhta MPRSW 3254 SEQSW4 523-T29N-R19w town of Hudson N 1"=40' ', BM= top of 1" steel pipe at el. 100' alt. BM ~__ _r _._,____~ _.. .., o, o., 1554 200th Ave. New Richmond, WI 54017 -' (715) 246-6200 r~. ~ei ~y~E Gary L. Steel 5-2-94 ~; ,~ f?i/ /I~Eflsc~ r~rr1 ~,~s ~ e-~ ~ ~ ;tJ a d I r~rcd s ~ d . STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Crniz County _ UVVNER/BUYER ~„F,., MAILIl~IG ADDRESS ~ 1 Z'~ ~~ PROPERTY ADDRESS ~ ~y „C~~9~ L~~~:~x /~„~ (location of septic system) Please obtain from the Planning Dept. it CTTY/STATE PROPERTY LOCATION S L 1/4, ~~ ll4, Section o2.61 , T~N-R~W y TOWN OF ~~ ~ ~r~,J ! . ST. CROIX COUNTY, WI I SUBDIVISION ! ! LOT, NUMBER '~_ ~C CERTIFIED SURVEY MAP , VO ~ UME~3, PAGE ,Z3 LOT NUMBER Improper use and maintenance of your is system could; result in its premature failure ~ handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, needed by l~censed septic tank pumper. What you put~into the system can affect the function of the sec tank as a tnratnnent stage 2n the waste disposal system. r - ;- I ! St. Croix County. residents inay be eligible to receive a grant for a maximum `of 60% of the cost of replacement of a failing system; which was in operation prior to -July 1, 198. St. Croix County accepted this program in August of 1980, with the requirement t>aat owners of all; new systems;agree to keep their system properly maintained. I The property owner agrees to submit to St. Croix Zoning a oeatification fo ,signed by the owner .....and by a mater plumber, journeyman plumber, restricted plumber Qra~lice~sed purpper verifying that (1) the n-site wastewater disposal system is in proper operating condition and (2 ~ after inspection -and pum~iing (if necessary), the septic tank is less than 1/3 full of slu a iar-d scum. ! 1 I/We, the undersigned have read the above requirements and agrce to maintain the private sewage disposal .system in accordance with the standards set forth, herein, as set by `the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiation date. ~ SIGNED: DATE: ~j- ~ '" `7'~ St. Croix County Zoning Office Government Center 1101 Canmichael Road Hudson, WI 54016 11/93 Attach complete site pla T A on paper not less than 81/2 x i 1 inches in size: P{an must ir~luLio fiut ''~° yv yv.. St • Croix not limited to vertical an , horizontal reference point (BMy, direction and~% of sbpe, gcais 0E' ?_," ~" _ ~ dimensioned, north arro ,and location and distance to neatest road ~ °`~~ 02 -10 3-10-110 APPLICANT-INFORM TION-PLEASE PRINT ALL INFORMATION ` ~ VIE - / E /-C~~ PROPERTY OWNER: PRQP CATION ~, .g,,n4 ?. LOT SE va,s 23T 2 .N,A 1 g V PAOPEATY OWNER':S ~_ING ADDRESS ~ J , D. NAM OR CSM 1'-'! ` 3I0 S. 7th. St ~ A7 j CITY, STATE tIP CODE PHONE NUMBER f CITY QVILLAGE ~fOW NEAREST ROAD i ~ New Construction Use [x$ Residential ! Number of bedrooms ~ (]Addition ffl existing buikintg 1) Replacement (] Public or commercial describe Code derived dailyr flaw gpd Recommended design loading rate . 7 bed, gpd+ht2 .8 trer-dt, gpoltt2 Absorption area required bed, K2 5h~ trentri,112 Maximum design loading rate . 7 bed. gpd/ft2_,~$_trenCft, gpoltt2 Recommended infiltration surface elevation(s) 95.8 n (as referred to site plan benctxrtark} Additional design i site ce 'derations _ n~ Parent material outwash Flood plain elevation, if applic~le na ft S = Suitable br system ~ ~YEM'~~. MOUND !N•GROUND PRESSURE AT•GRAt)E SYS7EM IN F1L NOt.OWG TM U =Unsuitable for stem' l~sS ^ U ~ ^ U ~ ^ U ~tS ^ U ^ S ®iJ ^ S ~4J SOIL DESCRIPTION REPORT Boring # .itax?: 1 is <z•,ar~,xc~~:K Ground elev. 99.38_ fi. Depth to limiting factor +83" Boring # i ~~~~.'~ i'+t:ii~M~t ~~ .4ii~4; iii ,.~,.,;.;.,.a7 yz5~::k~nRr:~ Ground elev. 9'~ ..3t3._ ft. Depth to limiting factor Horizon Depth Dominant Cotor Mottles Texture Structure ~ ~.~ Roots GPO/ti in. Munseil tOu. Sz. Cont. Color Gr. Sz. Sh. Bed Tie 1 0-9 10 r3 3 none 1 2msbk mfr 2f .5 .E 2 -24 10yr4/4 none sil 2msbk mfr gw if .5 .E 3 24-32 7.5yr4/6 none is Osg mvfr gw na .7 .E 4 2-83 10 r4/4 none cos Osg ml na na .7 ~ .>; Remarks: , 1. 0-1 10 r3/3 none 1 2msbk mfr 2f .5 2 12-~1 10 yr 4,14 none sil 2msbk mfr if .5 ~.6 3 21-32 7.5yr4/4 none is Osg mvfr gw na .7 .8 4 32-82 10yr4/4 none cos Osg ml na na .7 •.8 Remarks: Name:-Please Print Phone: ~ ---_--- . G~h~~ Date. GSTIYtmIGOr~ 5-Z-94 cstm 2298 PFtOPtcRTYOWNEA Sty an K.; i-ii~rta SOIL DESCRIPTION REPORT Page? ~Of 3 PARCEL I.D. ~ 20 0-1 Q~3-10-110 i ~ , . Boring # s i : b ~' 3 <~,., :: Ground elev. 97.83- ~~ Depth to limiting factor ~ ~~ Boring # ,4 Ground elev. i~ , ~_ ft. Depth to Gmitfng factor +8 ~~ Boring # :..;;> 5 `: Ground elev. 95.38 ft. Depth to limiting factor ~. „ Horizon Depth Dominant Cofor 1 Mottles Texture Structure ~~~~ ~~ Roots GPO/ft in. Munsell i Qu. Sz. Cont. Color Gr. Sz. Sh. g~ Rte, s 2 r 2 .5 ~.6 2 18-35 10yr3/2 none s1 2mgr mvfr gw if .5 .6 3 35-82 10 r4/4 none cos Os ml na na .7 .8 I t Remarks: 1 0- 7 n 2 7-18 10 r3/4 none sl 2m r mfr if .5 .6 i Remarks: 1 0-9 10 r3/3 none sl Zmsbk mfr if .5 ~.6 4 21-80 10 r3 6 none cos 0 n na .7 .8 I Remarks: w r r ,'' . ~ STEEL'S SOIL SERVICE ~r Gary L. Steel 1554 200th Ave. CSTM2298 Susan K. Huhta New Richmond WI 54017 MPRSW-3254 SEaSW4 S23-T29N-R19W _ ' ~{, town of Hudson (715) 246-6200 I N ' =40 ' ~I= top of 1" steel pipe at el. 100' lt. BM_ ~.-.,.. ..c ,-,,,,...~...a. tea. .., a~ Qn S „~. r ~v r t ~?~~ /l~6~~sce r'/n~~~S ~r,e-n-- ~ ~j ,~3r~d I ~r~d S 1~ d-. ~~~" L. Steel 5-2-94 APPLICATION FOR SANITARY PERMIT STC-100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, ("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of Property y~ ~u Location of Property ~~ '~ ~~ --'~, Section ~~ , T „~~, N-R~~ W Township Mailing Address ~ / © ~j ~ "~ ~ S-~~~---~--- ~it.t~S e ,c~~s 1 c ~~ D,L ~ Address of Site Subdivision Name '-'~- Lot Number Previous Owner of Property{-~ ~i~~~~` 7'S/~oZ ~°uC~,eE~,(, ,~,~, (,(,,~DBu~t.~ I~A~ - ~~~~,}~ Total Size of Parcel ~'3 AC°rt-G5 I~DX Yi4LEY ~~ ~ ~ae-H~tti(_~~iRtC~ ~~3d ~ICC,F Date Parcel was Created ~ ~ a6 ~ _ ~ ~ 00 J- lam. J"f. 'p~gtcl.~ ~ ss') ) Are all corners and lot lines identifiable? Yes Is this property being developed for resale (spec house) ? No Yes ~_ No s Volume ~~3 and Page Number as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and page number, and the Seal of the Register of Deeds. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. PROPFRTy OtVNFR CFRTIFICATION I (G!e) ce~.ti.by ~ha~ a.?,e a~a~emen~s on ~h-i,b banm cute ~lcue ~a the bead ab my (oun) fznow.2edge; ~h.ctt 1 (we) am (cute) the awnen(d) ob the pnapenty deachi.bed .~n zhia ~.nbonna#,i,on banm, by v-chtue ab a wa~vcav~ty deed necanded ~.n the Vbb~.ce ob the Counxy Reg.cb~elc o ~ Deecf~ a3 Documev~t No . '~ p and .that T (Gle ) pne6 ent,~y awn the pnopoeed ~atite bon ~h.e deivage d~pa.a eyb em (on 1 (we) have ab~ai.ned an easement, ~a nun w.~th the above deacnibed pnopenty, bon the eons~cuc.#,i.on ab aald bysxem, and ~h.e .same has been du,2y neeonded ~.n ~h.e Obb~,ee ab zhe Caur~ty Reg-i.~~en ob - - - -- - - ' ,' 4~22~3 LAND CUNTR ACT-:V ltEout In~uran~~e ~'I:,use siy ~.~. ~53Px~~~ STATE OF WI~COI~IIV YOHM No. 16 tt'Iarondn L,~c~~l IItank Com nanr M ll.vnukcc, tV 1.., vi'his Article of Agreement, /. Made and concluded this ..__-~...~' 1C __..day of---- ~tyber-------------------------•----._. A. D., 19 89....._., by and between... Norman . C t.. Mears. and Frank •LaPlantt.,•-••_ tenants---~n__cpnmoll~..~{l~-.~aGla ................_ ------.~1'_ .hid--own_-right-- ------•-- - ...-•---- -- - --- ---•--•-----• - - •---.... ..... ---- •• -•----P~-ies----.. of the first part, and ._..~ usan K. Huhta as to-=3n _~--intert~st,--_ar?3- Loren_ W._ Nelson,__as to an interest ......................_......parties_.of the second part. Witness, First, Tha*. the said part 1.~~-.- of the second part hereby agree.__._ and bind________________________~__ ...._-..._.legal representatives, to pay, or cause to be paid, to the said part--1e~.of the first part,ies•--_--..heirs or assigns, the sum of.Thzz>Ky. '1",~~u~3ne~ FiZ-:~.-Nun~lr~'d ar>.d No% 10U---------:-----_ ----- Dollars, in the manner following:..k'ou~--~'hQusand-_~r~d--No,'l OQ----..---_------- .------ _-- _--- _------ Dollars, at the ensealing and delivery hereof :._. --.-.._ _________ _________ _________ ___________________________ The balance of $26,500 on a Land Contract payable at the interest rate of 10$ per anntur, monthly payments to be $400.00 or more each month including interest from the date of closing. Payments to begin on November 1, i9&9 and a like amount due each month thereafter until and including October 1, 1994 at which time any unpaid balance including interest will be due and payable in full. 4 r The said payments to be mode to the part .ieS.._of the first part, at .-.a_designat„t~__P1;________________________. and the same being intended to apply, when fully completed, as the purchase money for the following tract, piece or parcel of land, situated in the County of.._.St, Croix _ __ .-_ .and State of Wisconsin, to-wit: A tract of land located in the SE 1/4 of the SW 1/4 of Section. 23, T29N, R19W, of the 4th P.~?., 'Poem of Hudscn, County of St. Croix, State of Wisconsi^. descri!~ed as follows: - - _.• _~ ,. t n ! ~ l ~ ~ TRANS ~'~ ` t ~ FE ,, The southern 988.09 fee*_ of the SE~ L~4 of the SW 1%4 of said. Section 23. EXCEP`T' therefrom the easter_1y 462.84 feet of the southerl,~ 660 feet. Subject to a 66 foot wide ~ablic road right-of-way along the southerly line and any other easemenr_s of record or imp Lied. Containing 23.00 acres-store or lc~s. The said part-°_~f the second pars '.crtaer agree-_-.tl:at__~?`.'i"_-__ will pay, when due and payable, all tax~is~trtd assessments which have been assessed or lewd on the above described premises since the 1st day of ~9cA. D., :: 88 ., and also all such as .nay oe hereafter assessed or levied thereon, or upon the interest of said part.l.~~S.of the first part in said premaes; and also all taxes and assessments now or hereafter assessed or levied against any clcrtgage which rna}• e~lst against sairi premises, or agsir,st the note.......or the indebtedness secured by such mortgage, or against the ~r.terest in said l:r~mis~ s of any-party hnldinga inottgage against said premises during ttie term of this r~r,rract, and promi3N any, agree '*.hat the interest of the party..:: of the first part and the inceres* of chi i,.,rt;i~:= c,f rite recur ri par: l: •,<:_ ; ;~~~i es~ate, and the interest of any party holding a mortgage aga:;at sale r: t: es*.a! , ~iur.~:g tii,. -.-.,,..:r ,, ,,.,n;;e:t ~i:all .,e assessed for taxation and taxed together, withnut sepa:at•~ •:.ti~,~~;for a5 unincu~f~ ,~~~~ ~• ~~ .., a,1rl s:~.,tll be paid by the said part of ti:^ seenr.l i_:art, ano° r,:; t.l; ; .-,,r! .. -,! ...,~:•, ,i' ri~rts r.t ~ftscts or ~l.~l~:c- t10ilS Df ~%3LSe ni [hr _.. .!: ~,C ~ - . -. -t: ~ ~. _ -.- _. ~ ~ ., - - .. SA:~I ~.~~i Br !SI C~RPV Shah ~SP . ., ' '~;; 853PA~f ,~`,, ` The pazt_ies..of the second part further agree.._...-.to hold the said premises from the date hereof, as the tenant...... by sufferancz of the said partie~...of ti2e 5rst part, subject to be removed as ..............tenant...... ................holding over, by process under the statute in such case made and provided, whenever default shall be made in the payment of any of the installments of purchase money, interest, taxes or assessments as above spe- cified;and not to do any act whatsoever which tends to depreciate the value of said premises. Second, That the said parties_.of the first part, hereby agree-....and bind.... their ....heirs, executors, and administrators, that, in case the aforesaid sum of._.`1'h~rty..Thousand Five Hur.~3rc-d -•••_-_. Dollars. with the interest and other moneys shall be fully paid sad all the conditions herein provided shall be fully per- , formed at the times and in the manner above anecified,._they._..._..__will, on demand, thereafter cause to be exe- cuted and delivered to the said part. ies .of ;he se-.;nd part, or_.... their heirs or legal representatives, a good and sufficient Warranty Deed> in fee simple , of the premises above described, free and clear of all legal liens and incumbrances, except the taxes and assessments heron agreed to be paid by the part..ies _of the see- - and pazt and except any liens and incumbrances created by the act or default of the part.les._of the second part, heirs, legal representatives or assigns .. ..............- ----------....---•-•-------._...--------------•------.....--------•-•----• ---••--•--•---•--.. Third, It is distinctly agreed and u..^.derstood by and l3et~veen the parties hereto, that, if the said parties. of tre second part shall fail to make any of the payments of purchase money and interest above specified, at the times and in the manner above specified, or fail to pa;~ the taxes and assessments, as above stipulate, or violate any other terms o:' conditions herein contained, this agreement shall, at the option of the said part__ies of the first part, be henceforth utterly void, without any notice whatsoever, and all payments thereon for- feited, subject to be revived and renewed only by the act of the partlO~...of the first part, or the mutual agree- ment of both parties. The said partZ~S ___of the second part, further promise..-.--and agree-.....that ir. case of the eommenctment of an action to foreclose this contract, and also in case of the fore-losure thereof,...... th~_y.__...___.__.will pap, in addition to the taxable costs and expenses incurred, a reasonable sum of money as attorney's fees__________________ In Witn s Whereof, the said parties have hereunto set their hands and seals this___._a~-~2-----------------day 626NfiD AND BEALED IN PRESESCE bF JUS{1,1 A. L1 Uiitd ~ ~J , 1 ~?~ .....s!'S<:7~-~--- ...`Z .:.................. ...~•rt.'Jr-L../..-..................(SEAL.) .........._ ..................••---•--------....._:..._........_._...._..._........_..............._...... ~o v. Nelson /J J," .... --_....G'2'I'~=n....l(1_., ................a:.u'.....---......(SEAL) Norr L. Meters /, 4. _ ,; --- ,. ~ . . - ~ - '~~iic ~ ~ '•. ~ .~ --..~:............ (SEAL) NfIAII~50YA ~ .Frank LaPlarte State of ~gloa~xi~c SS. ..._-- hIDSH~1G'!.C)I!1-----•--•--•-•------County. ~, Personally came before me, this.-....._~~_.~a--.._.__._.__...-day of _..9ctQq~l•.._ ..................... A. D., 19$9..._._ the above named -•---NQr3?!an--C,•-Mearsr-F.zan.i~_.I.~P~~z1t~.--tenants--in--conannn+--anci_::ach-in:_'.Zis--cRart --------x~.ghZ_.-._ans~__Susan_ K.__ Huht~-and-.Loren [ti,_- Nelson, --•----- --------------------•--------•- ----....----------------------.._. to SSx known to be the person.. S_who executed the foreboi Snstrumeni and knowl ged,the s S.. - s...: - -------- LAURA BILDER6hCK ~~" NOTARY PUBLIC - MINNE3oTA Notary Public, ..__._ ~:?~?~______________________County, ~s1lf. ~ GOODHUE COUNTY r My caTMnisdo^ aWrn 7•t3-93 - 1Q, commission expires.-......I::1~.~'_:::7.3.:: ...:..............A. D., 19.93:__ This inatrnment eras dratted by: Jo`'•n ,'. ;a~, , Ins. 782 Burrell I3oule~.•ard, Woodbury , P'Ibl X5125 4 z` o ' I V ~ ; ~ ~ ' I ~ u.' u ~ G ~ O Y o r .. ~ N L V+ Q ~ O .( ~~ ~ N '` Q ~~ O O~~ y ~ ~ .`~ ~ . J G ~ ~ H a. ~ < Z 4 1 _ a ~ ~ ~ ~ i