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HomeMy WebLinkAbout020-1361-05-000~onsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division ~ M' INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village x Township Jennin s, Jamice Hudson Townshi CST BM Elev: Insp. BM Elev: BM Description: 00 ~ loo` Nr LoT Lt~~ - ~sr ~M~ I TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ ,.-~` ~ (~ Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Int a ROAD Septic ~ , ~ ~ ~ ~ Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer ,_--- _" Demand /~ ~ GPM / ., Model Number TDH Lift ~ ricti oss System Head TDH Ft Forcemain Length Dia. SOIL ABSORPTION SYSTEM BED/TRENCH Width w t Length ) No. Of Trenches DIMENSIONS °Jl SETBACK SYSTEM TO P/L BLDG WELL D INFORMATION Typ Of System: ~/ ,{- ~ DISTRIBUTION SYSTEM „ ~ ~ . „ t t _ . tr-J ( ~n n --- t- - r-17~rn. P fL G( Header/Manifold / ~ ist i i 1 ~. r _ / x Hole Size/ x Hole Spacing Vent to r Intake/ ~ ~/ - Pip s) `~ ~n tPT 3 / / - / l Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Svstems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched BedlTrench Center ~ Bed/Trench Edges Topsoil i Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~0 / 25~ / 01-~ Inspection #2: / / location: 814 CrimsonTValley Road Hudson, WI 54016 (SE 1/4 SW 1/4 23 T29N R19W) Crimson Valley Lot 5 Parcel No: 23.29.19.2135 1.) Alt BM Description = IOP~`~4~~• ~« above $,s. ~ ~~-uC~.~ 5-~-p DOl,cln.) , pxn- US~p (~I ST. 8~(, ^~ .Si~,f ~ 2.) Bldg sewer length = 30 / F~~ ~~ Ly ~a~~ -~ 'f14E/~ • -amount of cover = ,~ .5 , ~ t SY S?L~)'-'l Nt~~U Plan revision Required? Yes [ _ No ~ ~ ._ ~ ', Use other side for additional information. 2i _ ~ SBD-6710 (R.3/97) Date Insepctor's S gnature Cert. No. ELEVATION DATA county: St. Croix Sanitary Permit No: 405076 0 State Plan ID No: Parcel Tax No: 020-1361-05-000 STATION BS HI FS ELEV. Benchmark n M ~ f ~ ~ ~ ~DO ' Alt. BM Q 3 7. - Bldg. ewer t~ r! a I b D2•?`~ St/ t Inlet ~, c•7 SbHt Outlet // __ ~l~ ~Q~. Dt Inlet ~.. ~- Dt Bottom ~ Heade an. Dis ipe^n o ~ L L 0.0 . ~•~1 B t. ystem („ Final Grade ~. ~ °19.5 St Cover ~ 7i (J 2 Depth LAKE/STREA LEACHING CHAMBER OR / UNIT r Safety and Buildings Division County ~ ~ 201 W. Washington Ave., P.O. Box 7162 cS~T Q ) ,~CO~S jn Madison, WI 53707 - 7162 ' ' Site Address , a/~ ~` E~d v ~~`~ ~ "' Department of Commerce "a 5 =D ~ D//S~ ' - / ' ~msd.~ + Sanitary Permit Application Sanitary Permit Number ~sd }~ In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ^ Check if Revision ma be used for secon ses Privac Law, s15. 1 (m) I. Application Information -Please Print All Information .• State Plan I.D. Number Property Owner's Name ~ /~~ ~~r ,~ -E! /I rJ i ~ 7 S ~ Parcel Number ~0-~36--oS-ooo iling Addr ss Ma e Property Owner's Property Location /^ ~ ~ f ^ ~f /'I (3 LG! E-~ A Y ~../~ S C' >4 SW ik; S ~3 T aZ9 N. R ~ 11 City, State Zip Code Phone Number Lot Number Block Number ~ ~ ~3 ~ O ' `~ ber CSM N (,( I~ S a ~ ~-J ~ Sy0 I ~ um Subdivision Name ' ~ C X2.1 /y1 S d x UItc~E Y II. Type of Building (check all that apply) S~ ^Ciry 1 or 2 Fanrily Dwelling -Number of Bedrooms n ^Village ^ PubliclCommercial - Descri be Use r Township N(,[ Q p ~ ^ State Owned I/2~ 3 X' 0 * ~ ~ Nearest Road ~ ¢ ~ ~l1~iN ca P /A/FiLT2~T~/~ r~(~iri,9oF~ . Y 1 crZrr~Sd~J tl~~ III. Type of Permit: (Check only one box on line A (num use). Complete line B if applicable) A' 1 ~ New 2 ^ Replacement System 3 ^ Replacement of 6 ^ Addition to For County use S stem Tank Onl Existin S stem B. ^ Check if Sanitary Permit Previously Issued Permit Number Date Issued l:V. Type of Permit: (Check all that apply)(numbering scheme is for internal use) t` 44 ~ Non -Pressurized In-Ground 21^ Mound 47 ^ Sand Filter 50 ^ Constructed Wetland Sew 22 ^ Pressurized In-Ground 41 ^ Holding Tank 48 ^ Single Pass 51 ^ Drip Line 45 ^ At-Grade 46 ^ Aerobic Treatment Unit 49 ^ Recirculating 30 ^ Other V. Dis ersal/Treatment Area Informati on: Design Fiow (gpd) Dispersal Area Dispers Area ~ Soil Application Percolation Rate System Ele loaf Grade Required Propo ed~ p„l, Rate(Gals.lDays/Sq.Ft.) (Min./Inch) b Elevation 10~~ ~'~~ (~ ~JOf ~ . ~ ©. ~ ~ . .s VI. Tank Info Capacity in Total Number Manufacturer Prefab feel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Sep[ic or Holding Tank _ w' £ ~. X Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Si cute MP/MPRS Number Business Phone Number W1LLIAW~, a.6 lv~~~ 0• ~339og ''1~S ~a 533 Plumber's Address (Street, City, State, Zip Code) 6'SGOI7' lt>>. SNo~! E PQ ' ~~ . ~4V (,vl~ St7 ~oR5 VIII. Count /De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) ~ ^ Owner Given Initial Adverse ~ ~S .- Determination IX. Contlit~io~nps)of ApprovaUReasons for Disapp-rova_l ~-- L ,, ' ~--~ ~ ~ /~ ,~ _ ~,,,./- n - ., I~ J~^~` "~ ~MtluM+~'atiw,u~ cs~ per.. C~-~ C,6O'~/ ~OC~'~"~''~~ . ~ ~~ . spa-c. -~ ~' I f ~ ~ e u` Attact- cogtptete p~anv (w [~ nr~ol[pcy omy) [or u[e sys[em on ap pe-r/no~s cola-n o.~~ a ..~ww y~ sic;, _ ~ _ , SK, 's- ~~~ ~.AS ~•CtM.~ Q~f .IJL~~ Tv w'~2,Qii {~t ~ `7't".~ SBD-6398 ~5/O1) - j ~ , 5~ ~~~'~C~ 1 '~"~ ~- -' ~fl S~ 02 d32.ttL~ ~ os t 11~lbSo~ W1 • s~o~ 6 Gtr- 701^ y7~0 C E L(,../ :c,ovJ oa-t61N~'- G~~~ ,E ~•o(L Q~Ef',~~G~M E~ 1 y.~ wo P~ C, ,•e I~ _ 1,,~, T .. ,~, ., -- .. ~ r ~ l 1 ~- tr~P y~,~T y --- , ~'- , f 5 P~ - C~ c Ri mso~ ~,M-~E Y o L ~~~ ~ OF {-~u~so~ 9? c-~ ~ x ~7 ~ ~S ~y o~~ PJ~ P. P~ ~~ _~~ ~~ a 3rn r ~ 6c- ~'•~,~ L ~ aa. v 1 (7l5) 262.5336 y~~ j N S ~ ~`~ ~ EARLY PLUMBING & HEATING w~-~# ~3390°l Nb~ ~ BILL EARLY W1pRESCOTT, W~ 5454021 i c+t 3~ ~ ~~ •5 c SYSTEM T© ~'E ~ TR~.~~+,~5 ~ ~--w~~i~ c~t.c-S 3 r S~cPA ~ l~o i11 ~ l C~1P 51D~G»,wD~EfL I t4 ururTS H ~ ~~~ T D ~ ~ `'~' ~ Att~f~ NOR.~t t-E 6F' S Y5~ ~ 1~ Su lT E PT ~ ~- -fqN !~ w~ts~2 ~~SV S Z~~3 ~'~. A- l o d r~ LT F ~-- ~~ G 5u !!.PAGE E L ~ . 5 ~Q~, 4 ~~ 7Q~N~-~*~ a ~ < <c svST Et. X5.5 t~,~-~o~ P~a~ ~RFac~ ~` coo• t5 Ara T' ~`^~ `~ -~Q~,NG1.1 ~ t ~~~ t ,, .r W,ES~R. a~~ ~~ ~r~ t~~r ttttl' 5~?gym sc. 9 6 . a ,, ~ . a5 (715) 262 _ Jn~ s ; ac,c.~ ~ ~ ° ~ 5 P~~1 ~ ~,~' cRl mso~ v,A~-LE Y wig ~33°to°I i ~ au~N ~' Nuo~an~ s; c.rLa-x cv. NO f~l BILL EAR S Y5TEm To f3 E ~ is '~'y oil Pic- Pi P~ ~` 3m~ I ~m~~ EL t o,D, v - 6L °I~:7 ~ r r ~ ~/ So ro ~~ 5D2~C, 4 ~~ P ~ G _S~ ~.F ~c~ ~N,P6cr, o+~ svs~ Pt~E AIR Tt6u ~ ~ ~, EQ ._ 54 (t fac E ~ SysT$M ~ w~E S~rZ. ORAf' Bob Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings • in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must inGude, but not limited to: vertical and horizontal reference point (BM), direction and P cel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. a iew Personal information you provide may be used for secondary purposes (Privacy Law, s. t5.Q4 (1) (m)). ~ Property Owner Property Location ~2v C~ w1 pST SL. 1/a~?~~ Property Owners Mailing Address Lot # Block # ~ ~ Z 3 i~- . ~3LV ~~-~,~ L~ S - C tz ~ ~. City State Zip Code Phone Number ^ City ^ VAlage ®Town ~='r~S~>v -ti 1 S~1ai 6 (6 ~Z) ~o I _ a1 ~~O ~tv ~ S o r~ Page 1 of 3 sT.e.~tx p-13{x) -OS-boo D Date ~~ ~~ T Z~ Ft R I q E (or~Wl Nearest Road C~c..lv~sw.l UPcI~~! [ZD ,~ New Construction Use: [>~ Residential / Number of bedrooms _~_ Code derived design flow rate OO GPD ^ Replacement ^ Public or commercial -Describe: Parent material Flood Plain elevation if applicable ft. General comments and recommendations: ~~~f"1)"')~D z- ~'~-L S , L Cl 3 ' ' `~ ~ S~.S L~rv6 wt`-}~-{ t y v n,,t~ Q 1= ~. G N C-°tP~a-CLT~( S ttb~-yvl/v~ ~2 LL~el~ eli ~gh-t i3 ~S l~ ~2 ~C-stC..- ~~~N-t d ~- C-~`-2.LS hl t3E Y 8 "~~-P - Boring # ^ Boring Pit Ground surface elev. 1 O 1. ~ ft. Depth to limiting factor 7 a S in., Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 b -$ l b `12 3 C 3 ` S 11 Z 'FS bk ti`/1 `~L- ~~ ~ V ~ • S • ~ `f$ qb ~~ _~ ^ Boring ~-~ Boring # ~- ®Pit Ground surface elev. ~ b ~ ' ~ ft. Depth to limiting factor Z g ~ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 - 'Eff#2 0 -9 1 b`ZtL 313 ^ S t 1 Z`Fs b k ~i- ~v 1 v~ • S - L Z g 3 S ! O Y2 3l r; ~ s L l Z ~r2 s b -~ l+~-`f~- e w - • 5 .~ 3 3 S-~~ -Z -S~t2-~c~C -_ S U S9 wt J eW ~ • ~ ~ . Z - tmuem ~i = ~s~u5 > 30 < zzo mg/L and TS5 >30 _< 150 mg/L ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Si nature CST Number Arthur L. tdegerer ~ OZ-$9 220254 Address [~ e g e r e r S o i l Testing & Design S e r V i C e Date Evaluation Conducted Telephone Number 421 i1. i%ain St. River r'alls, t•1I 54022 ~l-Z.S_OZ '715-425-0165 Property Owner ~ U ST Parcel ID # ~ Z-D ~ 1~~ ~ ~ U S -UU 0 Page Boring # ^ Boring ® pit ~ Ground surface elev. Q ~' •~ ft, Depth to limiting factor ~ g ~' in, f-• ~a€ + .r.. ~- of 3 Horiz •pepth `'rf~A GOlpr /'~'~[~ d D i ti Soil Application Rate In M ll e ox escr p on Texture Structure Consistence Boundary Roots GPD/ft2 . unse Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 ~ ~ -q 10`~!Z-3l3 - S ! 1 Z~s b~ »~~1- C_.LV ~ V ~' , S ~ Y~ ~ - - y 3 6 1-SY~ 3 /~ - S v s w) I ~° ~ - • ~ 1. Z 36-~~ ~.S~a- ~/6 S U sg. wl 1 - ,~ 1.2 ^ Boring # ^ Boring n Pit Ground surface elev. rr no„--, ~..::.,,:.:..,. ~..,...._ a -`_--~ •~ •~ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Horizon Depth in Dominant Color M ll Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ft~ . unse Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 • Effluent #1 = BODs > 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 = BODa < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-6330 (R.6/00) PLOT PLAPd ' /Scale 1' =40 • LC1T LI k 1~. Page '~ of 3 48 Z1~I~ 8 3~8 `~$ ~~ ~-~ ~Z 1 ~0~ S~ `~~8~ ~ ~ Fo ~ q ~o ~~ 8 Z • S -~i L O I ~ L~r1ZYv q-1Z: ~rzlS. ~- J J I- 9 ?~~ ~'y~ ~ ~ G • ~~~,~" ~~ ./ 3~ t~--L -_ Lst . L O U • 0 ~ o iv . ~3-"'1~fSL~-, 3 ~ c~ D _ P U C~ ('' e P~ w l ~-/Y~-E - _ -- -- ---_ G L .~ .i _ ... _ . _ __--_.----- ~~ Lp 1' L ! ~ ~. ~i ~ ~ ~ u o~ ~ GJ N U y Z.S-U 2715-425-0165 220254 O2 _g CST Signature Date Telephone T1o. CST Tdo. Job PTO. :c ~- i~ ~; ~"- ,` :r YV ~~ Zy :N a. ~ .y X~ ~L i= ~` ~Y ~r f. ~rL _!! i ~6 r~ !~ ~_ aqq ~ Y~ s ~~ ~r I~ M N ~} S e i i • t Y A 5 a c N ~ ~. m ~' yq X W ~ d .~ m ~ N p ~x • ~ pyT Q % R ~m ~c og~ V r d F 0 w K 7 m n mm ~~ a ~ u ~ ~ ~ i ~z ~n 3 0 a 0 N e 3 N _1 W J ~y G. ~ ~ ~ - • • Q m cc~' o ~ ~ ~ _ rs0~'r c~ ~ ~ ~ ~^` C c rT ~ _ ~ ~ ` ' Y ; ,V ` ~~ ~~ J I~ ~ ~ ~ y h i ~ k , ~. Q ~ ~ C J ~• '11 'a ,~' 3 ,~ a c _ ~ . - ~~a o ~ a O c , .p ~ c o C, cn, ~~ cn Q to _ Q' ~i ~ m 0 ~ -- c ; ,; ~ nco _ ; o .~ t~w~ ' ~ ~ a .° o o ~ < s ~ ~ A . m ~ 7 Vi f C W ~ W X C) ~ ti CJ ~ a ~ N ~ Q fD i~ ~ ~" Q ~ ~ ~•~ . W ?( ~ ~ ~ C ~ .~' • ~, C O ~ ?~ N ~ ~. ~. Al C ~ ~ p ~ ~ ~. a Q ~• V CTt (G v \/ G. 2 S~ `, ~;,I /~ ~t{~~ ~+~ ~ ~I~ ~ man ~, ~,~ ~~Il ~ i~ ~n ~~~ t"Mp(11 ~1I ate ~T 1 ~-- Invert 11'-- Apr 11 OZ 10:34a Bruce W. Most L. Q ~ 5, p l~ -~ a -~ ?J/ n/ ~ ~83.Sy~ o~ ~ ar , d ~ 17151 381-6531 p.l C,.. r;w,So.r Va l~~• y1 ~1 ~~~~~oh S7. C~'a~..r' ~~k~~y~ ~~. ? y8.3 ~ I "= So ..~Y57r~t4,ttllN~tl~t~t~;rT ~ edge: . ~. ~~.. i.~'•ti~lni. i7• ': 1 ,_ u ntdtl~hce of Ehid tiystet~~ig ctitiral to iEs pkoper ("!15)262-5336 ~~.^ svity. ltd dystptit..bt~tter MUSt bt3 ptdviddd with d . f tt~s including the m~nbgemetit 9hCtidtl, { Y_PLUMBING & HEATING cENExAL ,~ " i-t rrhy tTpe oP an-sit-e aastp dispobal syster, is ~uttt of center entet'ing the 5p3tem and the quality wet the volume of aster attd the lover the level `N1PRESCOrr ws5aozi mote ef.£iciettt ahd longer ldsti~iig, the system BILL EARLY - y~9Lem tbmpditents include d septic •tarzk •to settle out •and break dd~Jh t3tllldg~ dd e~fllteitt filter gt the g9ptic tank bUtlet to iiltuk dllt ~taall particlei3, g primp tghk vit11 art effluent .pump attd cdtttroid tlttd ~ti abdorptinii ce.11 Eo ~i9prige' bf thti Mater in a manner t~hicli ~tiii pkdtect the. grouhdwuter and pubiie }tealth, IZ~COMlI.~NI~A~.iON3 1: xhdttiii mater saving devicds vtidti and vhdr~ possible. ~' kbpaik dti~ ~at~t leaks des sddn ag pbesibla; 3• bd niiE .pant gt.~gses, oi1n, r}tpmidaln such ng paint or paint tlt.ittn~rd iritd the apdtb;~t. 4, I~ ~bli hd.rr~ a gdtbd$d dispodnl, use i.t npdringlq . 5, bb htlt dispose bi tlti ' ti ter spdtehi~ ~ p i products other than tissue into the Gr 7th td nvtiid eitCessive 'tlpl,~d tic trat~t iit sltott periods of tilae, Spket~d3hg:trlothps vadhiiig t}irougltout the peek is recom-nendecl, y, CoHll:l~fGENCIES Holiito>:iti~ b:~ the +~blume dttd ~Efiuent qudlit~ may liecr;mr. h if ptabl~nts dtiupiap, Hohitbiring must •b~ sane dg~ par rite redilirptiients bf ~aliH g~`54t~~r pu>itipl'hg slid digpbedl b.£. wddtdwdtpr by d llcetiaed l~ttbi~iek ~d~ b~ tldceaadrj+ bliila iinaly'did and rejttilyd std mndd, i r ~'stiad !dtl!!Hd dydtt~rud mti~ rdquird i~dMbvgi •atid didpdaal di`.` the uifist_'fh1~ ~~btid ;Fill bnd replacirt~s it ~a~itlt new sand ne inscdllittg sh ~urabie ~td~ttdgtbent (!tilt td ru facet: bad`t td~y bt!_ }~t'plleht, deice or eliminate tidy clogging ~~ #H-~tfyitHd ~di2 tt dOtpticih d gf:omg tlC st^gr~idt? epgtpind bap require t:he irt~EgiigEiett tli• an gerd~it pr~~trdat;mctit unit tl't Elt~ ~irstew. Additibnai site. «nd stli.i c~WniUat,idhgrtNdYpdppdmtot be done add rldditibttiil plriaa uidy need td be ,pi;ppbred end gppidit~d b~ the 5d.tdt~r find ~uildiHgtt bivisidu oi:, the yehdYtment- di• ~~oteta~rr'~, ` xhe septic tank should be inspdctad Uq a licensed U thted ydtlrd dt; less ahd pumpt'd if necessary to kpmovepsolidsr~ gnd drum, ~` filet, e lunrtt tiltet must by cl~sdhed eriodicall t' ncr:Uiuula . m ve an d e:t~t 3hou a i~rdslte tick into the septic dd t itttt;rvdls or as pet tha mitttufd~t_urer.~ ti racofnMendation: d' ka.E.itidi~ itygpectiotis at the bbse,CVgtlbh p~.pes should be made by Eltu bt-HOI~ to detdkmine if any pdnding is taking place ih the sbdtlrhEioii tell, Alsd cheek .tor etiy aatipdge td Ehe Ero>lnd sut.tace: t~ doH~.l.gtphf: pbnding dt $pt?p£tgp ie ttdted, ti litph9pd plumber sheuid b~ ~`btltdt tad 4` `.this s~taw,t:dritsind an aldkm vhiClt ~ttlet b~ indtdlldd do d >;eparate tnii~ciiit ~>Ed~ thN liu~p., l~ thh alarm iiGtivt;tes, ntialtialze vakat Use ti-id t+ttHttldt g lt~~ttsed plumber im~~iddiatel tldINTEHAN~E ~ ' ,~7Ti4C,~ ! D C ~ nI J PF.~ ~''~' ~ ~ P~'. May 08 02 07:i3p Bruce W. Most 715.381.6531 p-1 S'Y' CRfl7X CflUWTY SCPTIC TANK MAfNTENANCC AGRFEMEN'}• AND OWNCR(SHIN CL'K~'Ii'ICA'fiUN FORM C~wncrlF3uycr ~1ti.r-.t i c,~ ~R..r ..r ?.+at _- .... ,•-~ ~° ~/ MatlilsR Address ._ .. ~~~ lS~..+~ ~ ~., _ .c, c_~ l~ct.C..• , CJ~ S'~•i O~.~Y $ . Prupt;rty Addrtsa ~_~ri.t•..~a.+ ya t~,_~o4d .. _ (yenficuson reQuired frosts Pi•tsroog Depammnt for sseti constructtan} _. •__•. __________ City/Statt: ~,,,~•dS o,.l Parcei ldcntifcatton Number 020 - 131 -ns -ooo I1vCAL DESCRiYT10N Property l_otafiun __._.._ ~., ~,,,., '/,, See. --- , /T "' TF-R,•..,,'"-.W, ~T~uwtl of ... ~~,.,~,lt•... tiuFxltviaiUrt _. r' .~~_...._a/ c. ~ ~,r~t.. Lt31 u .s.. . Ccrtsfied Survey Mup N ,volume ,.,_._, _.,_,_, Page h Wtsrrantr Dtxd # __ `~ l 5 (rg __~, volume ,.,~~.~.'?-_...__... 3'stgc N 33~. s~ notlt;~ o ya ~ ~ t>o lol lines idenirliable U yes L no SY~~M 1N.I~1N'Y'E +~l~IC~ Impmlrer u.c aad rna;ntennpet:ofynur sephe systetnCOUldtssult ~n its prtanattue f~~2ure w hrrtdlr ~. asses I':~~txi rnauue~urue cOpSisl! of purapittg out the sepnc tank eery tdree yeast Ot tO04tt, it needed by . hccascd pumper wt,at .ou put rna ~l:c :ys~em tsn sIt'cct the hwctfea of the repot tstlk as • treamneat stage as tLc •vaste dilposst systersr The ptoperry owner agrees m subruir W St. Croix Zoaiaa Department . eerttfieatton forrq, stGttcd Ay the n~.nct .net t•i . master pltanDeC, jOUrac yrrran yltmtber, restricted plrunbe+ a a licensed putnptr verifyitag that (I } ibe oa-s rte waste +atc r dt r posa: sy sa n: is io proper opcratiag coaditiote and/or (2) .Rer i/ssyeenon aad purttpiag (if aecetcs•ry}, We septic: tang ss kss than t. + :ul! a'.' sludge L'we. 46c uaden~gned .r tesd th< •bo~e rcgt-itsments •ad •grcc ro m•intatu the prtrate:ex~a~e dispUSal system wtrl: t!ie stutda~.ts aer forth, beresn, as by a Depetoosent of Cttmsnerce and the Y?cparQrKtrt of Nahtral Rcsottrces, State of W rsconsrn Ceruficancm t1pR that your a tic ryr+ has been tnstittamcd must be completed sod rettsrned to tbte St. C;tvix CWlt11Y Gotursg (1fiK< ~',dt~tt i u rS Of tliC Wrte u !xDl h0o d•te. ~ n ~+111R1: AF nPPI~I~ANI' ' f ( e) ct:rtify t~,ptopcr described SIG3VA1 of '•""~ nay inlor •tt t )q' t. r all ~tatemeets on this tone ue true l0 tae beet of mr (o~u) knn+NlcdRc 1 {wr) 71n~ tair) lhr iiwnen sl n( fvr., b • >,u t+f warranty deed *ecwded in Izc`uter of Occds Qlrie- .~~!.~L~°dz _~nrr v~ t ttnat is nsis prssentt:d rtt•y result io dte saaiary permit !sting revokcA ny theLunrng f -~patNnrnt • •"• `~ '• Include rrtth this •ppllcatl.w a •tatnped warr•nry deed horn the Reguler of Deeds office s copy of the cerribed aur.ey trop if relereoee a made ~n the wan•attty Jcc4 I0' d b666 SZb S t L ~X3 ~12ltiW-?J3H Wd t T'= LB Q3M - W ~o-. ,1612 PA~~ 336 STATE BAR OF WISCONSIN FORM I - 1998 WARRANTY DEED Document Number This Deed, made between Glenn H . Strand and__. Jerilyn M. Strand, husband and wife Grantor, and Jamice Jennings, a single person Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of W' sin (the "Property"): Lot 5, Plat of Crimson Valley, Town of Hudson. ~. c~. ~~n * Glenn H. Strand , ~~ *J rilyn M. Strand Area Name and Return Address RETURN TO: TITLE ONE 70619TH STREET SOUTH HUDSON, WI 54016 020-1361-05-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Roadways, Easements, and Restrictions of Record. Dated this --1~ day of , ~~ Signature(s) AUTHENTICATION authenticated this day of ~~-1965 KATH~EE'bl H. wALSH kEG.TSTER aF DEEDS sT. c~azx ca., wz RECEIVED FOR RECORD 44-43-c401 9;45 AM WARRAN?1' DEED EXEMPT # CERT COPY FEE: COPY FEE: TRANSFER FEE: 195.04 REG4kD?NG FEE: 10.04 PAGES.::- 1 ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. St. Croix County. ) Personally came before me this day of --~~~~' , ~C~j/ the above named Glenn H. Str nd and Jerilyn M Strand Lot 5, Plat of Crimson Valley, sown oz tiuason. Area Together with all appurtenant rights, title and interests. Name and Return Address RETURN TO: TITLE ONE 70619TH STREET SOUTH HUDSON, WI 54016 020-1361-05-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and. free and clear of encumbrances except Roadways, Easements, and Restrictions of Record. Dated this - J~;p~~- day of ~ , ~~ * __ * AUTHENTICATION Signature(s) authenticated this day of , * TITLE: MEMBER STATE BAR OF WISCONSIN (If not, _ ,~.,..e_ ~...~, ~ ---- -_ __ _ _ __.__. _.. _ authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Michael H. Forecki., Attorney Eau Claire, Wisconsin (Signatures may be authenticated or acknowledged. Both are not necessary.) ~.~ fib. ~~ *Glenn H. Strand ~. ~„~~~ *J rilyn M. Strand ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. St. Croix County. ) Personally came before me this ~_~_ day of ~~,~ _ , a Q'~/ the above named Glenn H. Str d and JerilLrn M. Strand to me known to be the person s who executed the_foree ' g instrument ackl~owl~dged the sar~,p~ __ c~ * Palm Notary Public, State of Wisconsin My Commiss' n is p anent. (If not, state expiration date: Z ~_ •) Notary Public State of Wisconsin 'Names of persons signing in any capacity must be typed or printed below their signature. STATE BAR OF WISCONSIN WARRANTY DEED FORM No. 1-1998 ii Produced with ZipFormTM by Vertisoft Inc. 18025 Fifteen Mile Road, Clinton Township, Michigan 48035, (800) 383-9805 Attorney Michael H Forecki 1830 Brackett Ave, Eau Claire WI 54701-0627 Phone: (715) 835-3029 Fax: (715) 835.4112 06248999.UFD a3~~3 ~ Wisconsin Departrnent of Industry, SOIL AND SITE EVALUATION R E P O R T tabor and Human Rela6or~s Division of Safety 8 Buifdngs ~ In aCCnrd with It HR R3 n5 Wic Aram r:nric Page ~ of 3 COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but ST. G~.p l>C not limited to vertical and horizontal reference point (BM), drection and % of slope scale or PARCEL I.D. # , dimensioned, north arrow, and location and distance t e~ o ~ ~ ~, ~ o~ o - l 0 63 - lp _ t 10' • . APPLICANT INFORMATION-PLEASE PRI jl'f. AtIbN~. REVIEWED BY DATE PROPERTY OWNER: 6 LAN 8 . SE?R. ~ ~~ PROPERTY LOCATION ~ C O ~A D S~1 ~~ F•`Jfl S E 1!4 S 1~ 1/4,S Z 3 T Z q ,N,R l q E( yy PROPERTY OWNER':S MAILING ADDRESS. -- ' - , ! ~ -z.-1 5 o~`nl l~ ~ s ~ ; ,t ~ '9 L T,~ BLOCK ~ SUBD. NAME OA CSM ;R ~ - -' ~_ C.~.~ r-t sD ii V AL~k 1 CITY, STATE ZIP CODE ,.- )-ZONE N !X 1~lU~Z 1•"PsL~S, ~JI S~I~tZ .1Sd 6g, []VILLAGE ®iOWN ' NEAREST ROADPt~iPaS~A ~`" ~1U'1~S0 N C~M'15t~1 VRt .~ ~lj (~ New Construction Use [~ Residential / ~ , r~-~'~~2 [ j Addi#iQn to existing building ~ j j Replacement [ ] Public or commera ' Code derived daily flow 6 0 o gpd Recommended design loading rate •, bed, gpd/ft2 • ~ trench, gpolft2 Absorption area required `~ S ~ bed, ft2 ~ SO trench, ft2 Maximum design loading rate • ~ bed, gpd/ft2 • $ trench, gpd/ft2 Recommended infiltration surtace elevation(s) Ste' ti o~ ~-o ft (as referred to site plan benchmark) Additional design /site considerations 1r~-s'm1,L~iZ cvJ Ps};; ~ 3 Parent material Lo ~ s ~ y ~~ S~ti ~v~..~f~SN Flood plain elevation, if applicable ~'-~~ ~ ft S =Suitable for system U=Unsuitable fors stem CONVENTIONAL ®S ^U MOUND ®S ^U IN-GROUND PRESSURE ®S ^U AT-GRADE ®.S ^U SYSTEM IN FlLL ^S ®U HOLDING TANK ^S ®U SOIL DESCRIPTION REPORT Boring # >::,~ ~''~ 'ns ~:>< :;5 Ground elev. q-~ .z~ Depth to limiting factor > 1DS`' Boring # Ground elev. Gam- o ft Depth to limiting factor ~ lD6y Horizon Depth in Dominant Color Munsell Mottles Q S C (Texture I Structure Cons'IStence Bourctaryr Roots GPD/ft . u. z. ont Color Gr. Sz. Sh. g~ rer~ °-~ ~o`'trz jfZ - sit Z`~sbK ~~ es - ,S .6 Z g -Z.3 l0`~tz 31 b - 6r s t I 2.'E~sbk ~ sly cS - ~ S 3 Za-u3 ~-S`~23/~ - 1s~sl ~~sb~, dIS~ Cw - ~~ .S ~u 0-4 1u~tZ31Z ~ S11 Z`FSbk ~~ CS _ .S .[, Z Q-~~. 1 ~ti~ 31 l - ~~~ s i ~ Z.'PSbk ~ sly CS ._ . S . ~ 33 -1o b `~. S Y2 3ly~ - S 0 s~ ~ ~ _ ~-~' . ~ Remarks: :STName:-Please Print Phone: Arthur L. Wegerer 715-425-0165 ' ~e`gerer Soil esting & Design Service-P.O. Box 74 River Fa11s,WI 54022 •' . Signature: ~~. ~~~~~ ~, ~ - Ul` S Date: -7 Y ~ 6 ~ CST Numbe 2 2 0 ~ 5 4 PROPERTY OWNER ~~ nzUV SOIL DESCRIPTION REPORT PARCELLD.~ 0 ~ , 1pV~_10. ~ Iy Boring # ::.;k ~ . Ground elev. ~.O lt. Deplh to limiting factor ~, y ~ uq Remarks: ~- Boring # ~ ~`~6 ~-S `'-R 3/y Ground elev. ~oz..3 rt. y Ub_~lp 7_S ~1R 3/y Deplh to limiting factor 711 p" Remark s: Boring # <} cJ Ground elev. ~o~. rt. Depth to limiting factor ?1Qga Boring # 28;.'••' ~':: fF? Ground elev. It. De lh to P limiting factor s i ~ Z~{-'sblz ~~ si l Z`F'sbk cQs~ ~s ~ ~1 ~ >7 Sbh ~ s1~ S o s g p~ ~ Page ? of 3 cS 1 ,S. j,6 ~S - • 5 I. t, cr,J ~ . ~! ~ .S ,~--~ € . o I o -9 t p`-t R. 31 2. ~ s t 1 2`~S b~L ~ ~ C. S - • 5 ! , 1, 3 Z~-~/y 1• S `~ R 3/y - S d,Gi- O Sg {~ O>< 1 C ~ - s •1 } -`d I• j I. .a.~ ~ iu~ no. PLOT PLAN SCALE 1"= L~,~' ~~ out~~ Page ~ of ~' LpT L1~E ~.~,~ /\ ~ e.~ ~- ~ DoT s ~_oT (~ a .z ~... ~ 1N tT~'R~ F}~p I~L`~T`IL~1ty't- / ~~stiv et}~S ~- ~ g-1 , t3-4 ~O a`~ \ ~-l.o Z 3 $*'1~lF-~ i X010 i _S \/ g `'~. ~u 1 4 ~_ J~ _ - a~lt~l - fit, Loop' on., 8"H'16H, 31~`~lA hU~. PIPE w/ L~-j}}_ " bk ~~ ~ ' j ~ti s'TCC~..L z ~~ ~.~s , ~'~-cN ~ ' X ~ s' w~6 w~~ 1`Y~ sN ~~~ StD~witil~~c 1-L``~C~ C1-}fl:~3~-S. T2~w~~3 ~ ~3~~ 60". ~~'P P~- '~~ 1~UwN S~-c~1~C ~'I~GE . ~~-1?Y~'t1hJE. ~lZl~!lCN L`z- Lti t~1 pry S f'~' `'~{ T1 t^, C OF CNU ST~U ~-T~ p,V , ~ u c.P,~o ~ S tt~e.t1 t =moo ' a4-~l l- S ~3~ ,~ l~' , ._.,yl ~ z zo z 5 y 1h~(,~tti2- d 12 ~m~ ~7 ` 1 ~ - ~ ~ (715 ) 4 2.5 - ~ 'I h 5 CST Signature Date Signed Telephone No. CST ## ~Ro~R+.~ s Ctofl,o A CRIMSON VALLEY ~ IN PART OF THE SE>/4 OF THE SA'>/4 OF >9W, TORN OF HUDSON, ST. CROIX COUNTY, y N89.43'44"B 1324.47' UNPLATTED LANDS -------------------------- 103.35 149.87' 31 1.01' 161.14 i~ ~. -, ~ M N °° 5 00 N W 3 2.00 CRES o 87,393 SQ. ~. o o \~ Z z ,• ~ ~ ~ /~ /i'~ © ` / ~ / / N87'33'00"W 242.85' ' __ __ l'0 BEING X / / ' / i ., ~TS TOTAL i~ ~ ~ 99. ~~ ~~/ i' i ~ / / 0 ~ ~ S89'S1 ~ ~ ,~ '~ / ~ 0 100.2