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HomeMy WebLinkAbout020-1343-18-000Wisconsin Department of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)j. Permit Holder's Name: City Village X Township Jas erson, Richard Hudson, Town of CST BM Elev: I Insp. BM Elev: BM Description: ~~•O l~rt`~~ GST~~~~ ~JL TANK INF[1RMATIf1N E _FVATION DATA TYPE MANUFACTURER CAPACITY Septic 1F5~- 12.$0 Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ ~ r ~ 3 f ._,_.~ Dosing Aeration Holding PUINP/SIPHON INFORMATION Manufacturer Demand GPM Model Num r TDH Lift 'ction Loss System Hea TDH Ft Forcemai Length Dia. Dist. to Well county: St. Croix Sanitary Permit No: 479357 0 State Plan ID No: Parcel Tax No: 020-1343-18-000 SectionlTown/Range/Map No: 24.29.19.1846 STATION BS HI FS ELEV. Benchmark ~' ©~ ~, /•O `-f ~I ~ f Alt. BM Bldg. Sewer ~r5~ ( ~3~5 St/Ht Inlet / / ` S ` (' ~'~ f St/Ht Outlet ~ a [ 6 r ' Dt Inlet Dt Bottom Header/Man. p ~ ~ ~ 1 Dist. Pipe , Bot. System ~~ ~ o, ~ ~.p, ~*~ (0 ~ ~ . 30 / Final Grade . ~a _ 3 g-- St Cover _ 3.o r~ e-• 3•S c~SErS ~... r1,.le~ - ~ ~,r SAIL ABSORPTION SYSTEM Lff„~ ~ ~A Z3 ~ nor-~nr e.jn r o ~~ _ RENC DI SIO Width ~ t Length t ~ Z. Qy~. No. Of Trenches Z J IT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER OR M c INFORMATION Type Of S~~++ystem: i ~ UNIT Model tuber: 1'11CTRIRI ITIr1N CYCTFM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing Cnll R/1\/FR ., o.,.~~...e c..~~e..,~ n.,r.. vv IUlnnnrl (1r Af_r,`rada Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ~~ Yes ~ ; ~i No ,f ~ Yes (~ No E TS: (Inclu a dis re s, ersons present, etc.) Inspection #1:~~IP L~1 /~~ Inspection #2: '~~ ~iA- ~~ ~~~~~ cation: 890 Young Road Hudson, 15401 (SE 1/4 NE 1/4 24 T29N R19W) Wyldwood III Lot 18 Pa cel No: 24.29.19.1846 1.) Alt BM Description = 1 ) ~ 2.) Bldg sewer length = ~Z i- a~' „ ~ „ L~~ ~"~ t n` "^ ~' 'Tgfl~/ T I -amount of cover = .(^.^^d,~l l ,,,~~, .~ S~.X t1ae,. ,~ ~ ~DU~~ ~ W2 `~B~~!..qd~ 3 `~) Q~xr~-y C ~~n~rc ~`nD ~ ~s/ \~ :~ "-T' i't , ~- -_ ~ Plan revision Required? I ]Yes o ~ Use other side for additional information. 1-Z~r ~~i~ - Date SBD-6710 (R.3/97) „racya..yy a v~y,~q•u,v l//~'_ /y~l~~~~~j_rijVljfWJ~ `rrl 'f' ~~ Safety and Buildin i ' ~ ~' Co ty ~ ~ 201 W. Washington A CrOiX ~scons n Madison, 3 ~ Sanit Permit Number (to be filled in by Co.) Department of Commerce 1 (~Og ~_ ~ ~~' ~'~~ 35 ~' Sanitary Permit Applicatio J ` 1 ,~yate P n I.D. Number ~ ~ ~---~ F In accord with Comm 83.21, Wis. Adm. Code, personal information u provide ~0~ c ~ may be used for secondary purposes Privacy Law, s15.04(1 x ) 5 Z~~,~~C~4.~ oject Address (if different than mailing address) / I. Application Information -Please Print All Information (Young Road :~ ~ ~ D ) \\ / Property Owner's Name # Parcel # t # Block Richard & Lynn Jasperson S~o.~ 18 Property Owner's Mailing Address Property Location 713 Penny Lane SE ,~ NE y, Section 24 City, State Zip Code Phone Number ~ Hudson, WI 54016 29 ~ circle one) T N; R r IL Type of Building (check all that apply) a R r $ ~~ / ~ ~ ~ yf~~ ``~ ~- 1 or 2 Family Dwelling -Number of Bedrooms 4 .~r`e^;-d.~ Subdivision Name CSM Number Public/Commercial-Describe Use W11dWOOd 111 ~---~ ^ State Owned -Describe Use QCity ^Village Township of Hudson IIL Type of Permit: (Check only one box on line A. Complete line B if applicable) O2p - 3 _ f -ODD ~ ~(p A' 0 New System ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System B• ^ Petmit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. T of POWTS S stem: Check all that a ~ Z Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constmcted Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter Leaching Chamber ^ Drip Line ®Gravel-less Pipe ^ Other (explain) V. Dis ersal/freatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation 600 0.7 857.14 871.1 94.00' VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units - '~l~ f1'1~E Concrete Constructed Glass New Existing /'^~ ~.} l~'~, Tacks Tanks Septic or Holding Tank 1250 1250 1 Wieser x Aerobic Treatment Unit Dosing Cbamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Mike Nelson MP 225053 715-273-5000 Plumber's Address (Street, City, State, Zip Code) 278 East Summit Avenue Ellsworth, WI 54011 VIII. Coun /De artment Use Onl Approved ^ .-- Sanitary Permit Fee (includes Groundwater Date Issued Issuing gent Signature (No Stamps) - Surcharge Fee) ,. 'van Reason r Denial "- , 0 ZIIU Ix. Conditions Approv al n ~,.ts7Ca7_ ~~ ~ ~~j ,~- ~~- 3) ~M ~-61a 0 SYSTEM OWNER; 1 Septic tank, effluent filter and `~"^'~-~ ~ ~e~-- ~,,~ dispersal cell must all bra serviced /maintained '--- as per management plan provided by plumber. ~ S~~ , c~,~--SY ' 2. All setback requirements must be maintained _ ~ - ~~~ ~ t~. as per applicable code/ordinances. Attach complete plsm (to tlK County ody) for the system on paper not leas than 812 a 11 inches in size ,.~ s ~~ SBD-6398 (R. 01/03) chard & Lynn Jasperson 713 Penny Lane Hudson, WI 54016 SE %,NE%, S24,T29N,RI9W ~ N, Wildwaod III Lot # 18 Hudson Township Sx Croix County Scale 1 " = 4D' We' 1250 tank 100.00~top of 12" tall PVC pipe by B2 #2- 97.33' top of Spike in tree 2.10' above ground em EL 94. 0' "' 45 Quick 4 chambers ~----,._„_~r, ;, ~~ ~~~4ne -~`~~ ® UJE~_ J"l, ~,~~ Nt/so-~ ~''~ f 2 z. S'o~ S' 3 G~'% ~Dtan~ OQoaO Page 6 of 8 Septic system plans For Richard & Lynn Jasperson SE 1/4, NE 1/4, 524, T29N, R19W Hudson Township St. Croix County Wisconsin Prepared by Mike Nelson Plumbing 278 E. Summit Ave. Ellsworth, WI 54011 273-5000 MP# 225053 Page 1 Title sheet Page 2-4 Soil evaluation report Page 5 System sizing Page 6 Plot plan Page 7 Management plan Page 8 Quick 4 Cross section Page 1 of 8 ' Jun' 22 05 08: 12a atuner 7154264827 Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings p.1 Page I of 3 in aeooroarxz; wnn Lomm eso, vvrs. wam. ~.we ~N 5T. CROIX t Attach eompiete site plan on paper not less loan 8 l/2 x 11 inches in size- Plan mus include, twt not tlmited to: vertical and horizontal reference point (8M), direction and lyaroel I.D. 020 - 1343 - l $ - 000 scale or dimensions. north arrow, and location and distance to nearest road. percent slope , Please print ap information. Reviewed hY Date Personal inrofmaiion You provide Tay be used Ibr 9etondary Purposes (Privacy Law, s. 15.04 (1) (ml). properly Owner ProPertY Location ^ RICHARD & LYNN JASPERSOTI Grnrt. Lot ---- 56 1~ NE 1(4 5 24 T 24 N R 19 E (or) w Property Ownefs Mailing Address Lot # Block # Subd. Name or t"..'SRlktr 713 Penny Lane IS -- WYLDWOOD III City State Zrp Code Phone Number try Village Town Nearest Road Hudson, WI 54016 ( } 1VIC Voung Road O New Cor-struction Ust~ Residential t Ntxntler of tredrooms 4 Code derived design flaw rate 600 GPO Repiaoemerd ~ Public or commercial - Describe: Parent material outwash flood Plain elevation if applipble rv e___ ft. Gent O°~~~ Convcntiona! In-ground trenches -- 0.7 loading rate -- to be designed by installer, Mike Nelson and recommendations: Address: 890 Young Road - j , Boring # L{ Boring 7 V' 'z' .> O Pit Ground surface elev. 97.43 ft. Depth to limiting factor $4 in. got! A lication Rate Horizon Depth DomineM Color Rtjdox Destxtption Texture Structure Corlstalenoe Boundary Roots GP in. MurlseB Qu. Sz_ CoM. Color Gr. Sz. Sh. `Eff#'I 'EtT#2 1 0.5 7.SYR3/3 - is 3fgr mvfr cs 3vf-c:o 0-7 2.6 2 5-15 7.SYR3/3 - !s 2fgr&sbk mvfr cs 2vf-co 0.7 1-6 3 15-23 7.SYR3/4 -- s Osg ml cs 2vf-co 0.7 ! •b 4 23-29 10YR3/6 - s Os dl cs ivf-m 0.7 l.b 5 29-$4 10YR5/4 - s Osg dl - -- 0.7 t.6 Horizons 18r 2 have some gr, hotizoo 3 has 30-35% gr.; few cobbles & stones. - . ,.. 2 ~ Boring 90 ' ~ .i Bourg # 96.93 0 Pit GrourW su~Ce elev. ft. Depth to limiting faQOr ~~ gat ication Rate H i th O Daminarrt Color Redox Descaiption Texture Stnxxure Consistence Bourtdary Roots GPDlfP or zon ep in. Munsep Qu. Sz. Cont. Color Gr. 5z. Sh. 'Eff#1 `Eff#2 1 0-4 10YR2/1 - 1 3fgr mvfr cs 3vf-co 0.6 0.8 Z 4'10 10YR2/I -' 1 2fgr mvfr es 2vf-ca 0.6 0.8 3 1U-27 10YR3l3 - sl 2fsbk mfr cs 2vf-co 0-6 1.0 4 27-~ 7.SYR3/4 - Is Osg ml cs 2vf-m 0.7 1.6 5 44-90 l OYR414 - s Osg m! -- -- 0.7 ! . b aizon 4 has 15-20°~ gr; fer+cobMcs&. stones. ` Eifluer-t #1 = BOO, a 30 < 220 mgJL and TSS >~ _< 15t1 mgrs - trm~rc rrc =Duos _ av n ny~. m... ~ _ , • ~, CST Name (Please PrsA} alone CST Number M Jo Hollister 224832 p,~~ Date Evaluation Condtxx~eed Telephone Number W9875 690th Avenue, River Fails, WI 54022 06 - 15 - OS (715) 42b - 1775 Sizing fora 4 bedroom house Geiser 1250 Septic tank Zabel A 1800 filter System Elevation 94.00' 4 bedrooms x 150 gpd = 600 gpd 600 gpd / 0.7 = 857.14 sq. ft. 2 sets of Quik 4 end caps @ 5.8 = 11.6 sq. ft. 857.14 - 11.6 = 845.54 sq. ft. 845.54 / 19.1 = 44.26 45 Quick 4 Chambers Page 5 of 8 Richard & Lynn Jasperson 713 Penny Ldne Hudson, WI 54016 SE %,NE%, S24,T29N,R19W Wildwood III Lot # 18 Hudson Township S~ Croix County Scale 1 "= 40' Weis 1250 tank 100.00;top of 12" tall PVC pipe by B2 #2- 97.33' top of Spike in tree 2.10' above ground em E~ 940' 45 Quick 4 chambers '~r~ ~T v r J ~~ 0 i h v 3 yDGt n~ dQ oo~ O ~ UJELL ~"~~ 2 Z so~ S' 3 ~ ~~. \N Page 6 of 8 Septic System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equippedwith 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 sludge and scum 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 a triennial 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. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Page I of 7 Distribution System No trees or shrubs should be planted on the septic system. Plantings may be made around the septic system's perimeter, and the septic system shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the septic system is not recommended since soil compaction may hinder aeration of the infiltrative surface within the septic system and snow compaction in the winter will promote frost penetration. Cold weather, installations (October-February) dictate that the septic system be heavily mulched for frost protection. Influent quality into the septic system may not exceed 220 mg/L 8005, 150 mg/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shalt be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82-84 Wis. Adm.'Code, and shall maintained in accordance with its' component manual [SBD-10705-P(N.01/01)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump 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 a tank or component. Continge cY Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. If the septic system component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area If toe leakage occurs or by removing biologically Dogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions about the operation or maintenance of this system should be directed to: County Zoning Office 715-386-4680 Mike Nelson Plumbing 715-273-5000 Weiser Concrete 800-325-8456 Zabel Filter 800-221-5742 Page 7 of 8 J f V W U~ 3 ~w ° O m - ~ Oa F V w o o N W F J ~ o ~~ ?Z ~ J ~ w = Q F fn W V 2 ~ C (n V n n W ~ p .o ~^e c U y a ~u°_~~ ~ uwi ^ axYNm O o = v -~ ~ ~ "j md id°m°mm h in W Z ~ ~ ~ '^°'y r m oar m Z +~~~ 1 '~ o ~ w 3 ~ O ~ ~/ {L l7 Z ~~ ® W W W = , J -- L1 Q ~ ~ ~'°' ~ a _ U ~ ~ U _ ~ ~ `N W ~!! Z ~ -~••. a ~ ~ ~ ~ ~ J Y ~ U g ~ a ~ M /~ V 3 i w_ `h o '. .~ U W ~ R~CE~VE ~-~-C..~ s P~,-c.eQ . Wisconsin Depart nt o roe S~~j EVA UATION REPORT Page 1 of 3 bivision of Safety and /j ~ ~ `t 2, ~j V m acpowerroe wrtn t.ornrn ao, vrt . rwm. t,a~e UN1Y Cody ST. CROIX Attach complete site plan on rot tha ®Wt ' size an must inducts, but not limited to: vertical ' o 'region and Parnel I.D. 020 - 1343 - 18 -000 percent slope, scale or dimensions, no arrow, nand distance to nearest road. Please print all information. Re ' ` by Date Persaial inrormation you provide may be used for secondary purposes (Privacy Law, s. 7 5,04 (t) (m)). ~~~~ _ (7 Properly Owner Property Location 0 RICHARD & LYNN JASPERSON ~,ti Lot --- SE t/4 NE 1/4 S 24 T 29 N R 19 Properly Owner's Mailing Address Lot # Block # Subd. Name or CSM~ 713 Penny Lane 18 - WYLDWOOD III City State ~ Cade Phone Number ily ~ Viflage own Nearest Road Hudson, WI 54016 ~ ) NK Young Road New Construction Use Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replaoarrrer-t ~ Public or cxunrneraal - Desaibe: Parent material outwash Flood Plain elevation "rf appNcable Are tt General c~ Conventional In-ground trenches -- 0.71oading rate - to be designed by installer, Mike Nelson and ret~mmendations: Address: 890 Young Road 0 ~~# u ~~ 0 pit Ground surface elev. 97.43 ft. Deptli to limiting factor 84 in. Sal ication Rate Horizon Depth Dom~rant Color Redox Descxiption Texture Shucture Corraiatence Boundary Roots in. Munsefl Qu. Sz. Coot Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-5 7.SYR3/3 - is 3fgr mvfr cs 3vf-co 0.7 1.6 2 5-15 7.SYR3/3 - is 2fgr&sbk m"fi' cs 2vf-co 0.7 1.6 3 15-23 7.SYR3l4 - s Osg ml cs 2vf-co 0.7 1.6 4 23_29 10YR3/6 - s Os dl cs lvf-m 0.7 1.6 S 29-84 10YR5/4 -- s Osg dl -- -- 0.7 1.6 Horizons 1 & 2 have some g; horizon 3 has 30-35% gr.; few cobbles & stones. 2 ^ Boring # ~ ~ BO""g 96.93 90 Pit Ground surFace elev. ft. Depth to limiting factor in. SoA ication Rate Horizon Depth Dominant Caor Redox Description Texture Stnxture Consistence Boundary Roots GPD/fF in. MunseN Qu. Sz. Coot Color Gr. Sz. Sh. "Eff#1 'Eff#2 1 0-4 IOYR2/1 -- 1 3fgr mvfr cs 3vf-co 0.6 0.8 2 4-10 10YR2/1 - 1 2fgr mvfr as 2vf=~ 0.6 0.8 3 10-27 10YR3l3 - sl 2fsbk mfr cs 2vf~o 0.6 1.0 4 27-~ 7.SYR3/4 - Is Osg ~ cs 2vf-m 0.7 1.6 5 44-90 10YR4/4 - s Osg ml -- -- 0.7 1.6 Horizon 4 has is-20°/. Sr: few cobbles & stones. * Effluent #t = B~ > 30 < 220 mglL and TSS >30 < 150 mglL ' Effluent #K2 = BODS < 30 mglL and TSS < 30 mglL CST Name (Please Print) CST Number M Jo Hollister 224832 Address Date Evaluation Cow Telephone Number W9875 690th Avenue, River Falls, WI 54022 06 - I S - OS (71 S) 426 -1775 Property Owner Jasperson+ Richard & Lynn Parcel ID ~ 020 - 1343 - 18 - 000 Page 2 of 3 ~~ ~ 0 pi~n9 Ground surface elev. 103.33 ft. Depth to Gmi4ng fador ~ in. Soil ication Rate Horizon Depth Dominant Color Redox Descriptice Texture Struchire Consistence Boundary Roots GP D/fP in. MunseB Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-4 10YR2/1 -- 1 3fS~' mvfr cs 3vf-co 0.6 0.8 2 4-17 7 SYR3/3 __ sl 2fsbk mvfr cs 2vf-co 0.6 1.0 3 17-24 l0Ylt3/4 - sl 2fsbk mvfr cs 2vf-co 0.6 1.0 4 24-72 l0Ylt3/6 - s Osg tnl cb 2vf-m 0.7 1.6 5 72-96 10YR5/3 - s Osg ml -- -- 0.7 1.6 Horizons 3 & 4 have some gr; few cobbles & stones. Bonng # ~ ~~ pit Ground surface elev. ft. Depth to lirr~ting fador in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Stnxffure Coruistence Boundary Roots GPD/fP in. Mur-seN Qu. Sz. Cont. Color Gr. Sz. Sh. "`Eft#1 *Etf~2 ^ ~~ ~ ~ Bonng Ground surface elev. ff. Depth to Nmiting fador in. Pit Soi bon Rate Horizon Depth Dominant Redox Description Texture Strudun: Cora;istence Boundary Roots GP D/fF in. MunseN Qu. Sz. Coat Cator Gr. Sz. Sh. *Eff#1 *Eff#2 * EtAueM #1 = BOD$ > 30 < 220 ntglL and TSS >30 < 150 mg/L * Effluent ~2 = BODS < 30 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. SBD-8330Tost (8.07/00) i R bl r~r' #~1 Ad l i Vv r r ~~~v rem /-S~~~ro Hsu , `lrvcra~es~ Z. t gg Ac,~~s Y L J (Y ~ ~ lll a tom,. fl ~ 3 ~W~~ 103.33 \ ~O 300 . ~Q\ ion ~`~. 9q ~ ' a0 ~ 9SC~ i r N~ ~ ~, z4 07/19/2005 09:3 F9X ST CROIX COUNTY OwzteztBuyez - C Mailing Address Property Address (VeriCcation requ led from Ptanning Department for new r~ooi City/State ~~ ~~~,,,~ _ .__ Pazcel Identification Numbez®~-13 Y3 ~/ --~40 Ilg~f~) I,EGA~, DESCRZPTXOI'~t Property Location ,~ '/<, ~ '/~, Sec. ~, T,~I~T-R % 9 W, Town of ~~ Subdivision '~/ ~ Certified Survey Map # SEPTIC TA,'~K IVLAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Loi # Volume _ ~/-:Z _ _.- - ,Page # _1~___ Warranty Deed # ,'~ ~ , (nCo5r5 g~ . Volume Y !2 ~ ~, Page # ~~ Spec house D yes ~ no Lot lines identifiable yes O nu SYSTEM MAINTENANCE Improper use and maintcnanceof your septic system could result in its premature failure to handle wastes. Proper niainttnancc consists of pumping out the septic tank every Ihrcc years or sooner, if needed by a licensedpumper. What you put znto tE:e systetu can affect the function of the septic tardc as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning DeparOment a certification form, signed by tE,e owner and by a mastcrplumber, journeymanplumbcx, restrictedplumber or a liceusedpumper verifying that (1) the on-site wastcwaterdisposal system is iu proper operating coz~ditiorx and/or (2) after inspection and pumping (if necessary}, the septic tank is less than I!3 full of sludge. IIwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system wita ttie standards set forth, hereir~ as set by the Depat~tnaent of Commerce and the bepartment of Natural Resources, Stag: of Wisconsin. Certifieatit+a stating that your septic system has been maintained rrtust be completed and returned to the St. Croix County Zonurg Oflicc within 30 da s the three year expiration date. ~;; S ~ ~ !~ N S NATURE OF APP~.ICANT .. OWNFR CERTI)czCATYON 1 (we) certify that all statements on tlus form are tree to the best of my (our) knowledge. 1 (we) am (art j the owner(s) of pro described ab ve, by virrire oi' a warranty decd recorded in Register of Deeds pffice. S `[ ~ °' SIG ATZTR,E OF Li AN7' " "' *****` Any information that is rnis-represeutc;dmay result in the sanitary penult being revoked by the Zoning Departmment. **•*r^~ ** Include with this application: a stamped warranty deed from the Register of Deeds affce a copy of the certified survey map if reference is za~ade in the warrar:ty deed v~sconeinDepartmentoflndustry, SOIL AND SITE EVALUATION REPORT ~ Labor and Human Relations Ilivi~inn nF C~fufv R Ruilrlirnc r ur._ w ~.- n_..I,. Page 1 of 3 - III QIiLiVILJ 1I1IIL11 ILI 11 l VJ.VJ, •.IJ. /~VI1~• vvvv . ~(~/ COUIY I 1 but Plan must include 11 inch in size 8 1/2 t l th it l h l A St. Croix , . x es an on paper no ess an e p ttac comp ete s not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or qq PARCEL I.D. # -- ~ 3~f3' ~ 0` dimensioned, north arrow, and location and distance to nearest road. 020 9 APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION R IE ED BY D E / ~ ~~i' PROPERTY OWNER:. PROPERTY LOCATION ~„.: ~j 'Z erpri s, pfi ~ T SE va ~ 1/a,S 24 29 ,N,R 19 or) W PROPERTY OWNER':S MAILING ADDRESS ~~ OT # BLOCK # SUBD. NAME OR CSM # 1416 Third St. 18 na Wyldwood pha CITY, STATE ZIP CODE PHONE NUMBER CI ^VILLAGE ~]IOWN NEAREST ROAD ~ Hudson WI. 54016 h15)386-3674 Hudson Young Rd. ,Sj~.Q. ~ New Construction Use [x~C Residential / Number of bedrooms 3 [ ]Addition to existing building (]Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate . 7 bed, gpd/ft2 .8 trench, gpd/ft2 Absorption area required 858 bed, ft2 750 trench, ft2 Maximum design loading rate • 7 bed, gpd/ft2 •8 trench, gpd/ft2 Recommended infiltration surface elevation(s) 94.10 ft (as referred to site plan benchmark) Additional design /site considerations alt. area= trenches C 94, 40' & 93.10' Parent material outwash Flood plain elevation, if applicable na ft S =Suitable for system CONVENTIONAL ®S ^ U MOUND ^ S CCU IN-GROUND PRESSURE ®S ^ U AT-GRADE ^ S ~] U SYSTEM IN FILL ®S ^ U HOLDING TANK ^ S C$U U =Unsuitable fors stem SOIL DESCRIPTION REPORT Boring # 1 Ground elev. 97.0 ft. Depth to limiting factor +RR'I Boring # 2 '» Ground elev. g~ ft. Depth to limiting factor +84" Depth Dominant Color Mottles T t Structure nsistence C Bounda Roots GPD/ft Horizon in. Munsell Qu. Sz. Cont. Color ure ex Gr. Sz. Sh. o ry 1 0-12 10yr3/2 none sl 2mgr mvfr cs 2c .5 .6 2 12-21 10yr4/4 none sl 2mgr mvfr gw if .6 3 21-88 7.5yr4/4 none ms Osg ml na na .7 .8 Remarks: °~ ~ ~~a-~ ~~~~A/j2 ~ o~~~ 1 0-10 10yr3/2 none sl 2mgr mvfr cs 2c .5 ~ .6 2 10-48 7.5yr4/4 none sl 2mgr mfr gw lm .5 .6 3 48-84 7.5yr4/4 none cos Osg ml na .7 .8 .~ .., L 3 ~_~.~ lLJ_.1 `"' ..~ ~~J Gr S -~ih-c ~ 6 `, ~ ~'l 'nil. . q ';`. l.._.. /, ~ 5T CR ~- X ~ ~: ~a....... ,..-. zoNl~uGOF~rcr /..~</ Remarks: ~: ~,' CST Name:--Please Print G L. Steel Phone: 715-246-6200 _ ~ o '• ' Address: 1554 200th. e. New Rich nd WI 54017 -~ - ~~ Signature: A~ ~ l Date: 4_13_98 CST Number: m02298 PROPERTY OWNER Greenwood Enter. PARCEL I.D. # 020-1329-90- Boring # '..3 Ground elev. 98.4 ft. Depth to limifang factor +90" Boring # €.' 4 ~--- Ground elev. 98.1 ft. Depth to limiting factor +88" Boring # 5' Ground elev. g~ ft. Depth to limiting factor ~~ Boring # Y.ti........... ;:::: ;:::< r Ground elev. ft. Depth to limitlng factor SOIL DESCRIPTION REPORT Page ? pf 3 ~~ i H Depth Dominant Color Mottles Texture Structure Consistence Bo~ ~ary Roots GPD/f or zon in. Munsell Du. Sz. Cont. Color . Gr. Sz. Sh. . Bed Trerxh 1 0-12 10yr2/2 none sl 2m r mvfr cs lm .5 .6 2 12-2 10yr4/4 none sl 2mgr mvfr gw lm .5 .6 3 24-90 7.5yr4/4 none ms Osg ml na na .7 .8 Remarks: 1 0-12 10yr3,12 none sl 2mgr mvfr cs lc .5 .6 2 12-2 10yr4/4 none scl 2mgr mfr yw if .4 `: .5 3 28-8 7.5yr4/4 none ms Osg ml na na .7 .8 Remarks: 1 0-12 10yr3,12 none sl' 2mgr mvfr cs 2m .5 .6 2 12-84 7.5yr4/4 none cos Osg ml na na .7 .8 Remarks: Remarks: SBD-8330(8.05/92) rt STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 New Richmond, WI 54017 MPRSW-3254 Greenwood Enterprises, Inc. (715) 246-6200 SE4NE4 S24-T29N-R19W t~ lot #18-Wyldwood phase 2-Hudson, Township IN 1 "'=40' BM.= top of 2" pvc pipe C el. 100' Alt. BM.= nail in Aspen tree C el. 98.10' This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be satisfactory for your use. The location of the system may or may not be as shown, as permanent lot lines hsd not been established at the tome of the test. ~~ ~~ ~~ ~~Jo ~k ~ ~ ~ ~, 5 r ~~~ / ~ ~ ~ ~ ~ ~. i, v~ y ~ o ~ ~,'~ ~ ~ ao ~ lDd' ~ ,. ~-r Gary L. Steel 4-13-98 ~Y y ; ~ Parcel #: 020-1343-18-000 03/24/2005 02:53 PM PAGE 1 OF 1 Alt.•Parcel #: 24.29.19.1846 020 -TOWN OF HUDSON Current X, ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): " =Current Owner RICHARD S & LYNN M JASPERSON * JASPERSON, RICHARD S & LYNN M 713 PENNY LA HUDSON WI 54016 Districts: SC =School SP =Special Property Address(es): " =Primary Type Dist # Description * 890 YOUNG RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.188 Plat: 2647-WYLDWOOD III '98 SEC 24 T29N R19W PT SE NE LOT 18 Block/Condo Bldg: LOT 18 WYLDWOO D III 2.188AC Tract(s): (Sec-Twn-Rng 401/4 1601/4) 24-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 12/18/2001 665581 1793/531 WD 10/25/1999 612647 1465/495 WD 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 49857 53,100 Valuations' Last Changed: 10/30/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.188 41,100 0 41,100 NO Totals for 2004: General Property Woodland Totals for 2003: General Property Woodland 2.188 41,100 0.000 0 2.188 41,100 0.000 0 0 41,100 0 0 41,100 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 Vnl. ~ ~.'~.)P1it;7E ~J1 f STATE BAR OF WISCONSIN FORM 2 - 1999 Document Number `I WARRANTY DEED This Deed, made between Gregory M- Kpowulu and Suzanne E. Kpowulu, f/k/a Suzanne E. Hansen, husband and wife Grantor, and Richard S. Jasperson and Lynn M. Jasperson, husband and wife Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): L.Q11 Wyldwood II[, in the Town of Hudson, St, Croix County, Wisconsin`-^-' gated this 12 thday of December 2001 * * AUTHENTICATION Signature(s) authenticated this day of , o2o-ISas-ig-ooo Parcel Identification Number (PIN) This is not homestead property. (is) S~$3i4Q Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. • Recording Area 61>j55S 1 :r'1'i a! E~ r~ir9. WALSM •::=t:~I5'i EFi OF DE:'cDS , :. C~~.:z ~~0., WI RECE?VEU FOk RECORD ~~-i9-~40I :1:44 RPl WARRANTY DEED ~x~l7P7 i! CERT COPY FEE: i;OPY FEE: TRANSFER FEE: 252.04 kE~OkDiNO cEE: 11.40 URGES: 1 Name and Return Address Edina Realty TitIE 400 S. 2nd St., #115 Nuc}son, Wi 4016 3~/3 aY] a ®~ M ~~C.. ~ ~ (,ut • Gre Dry M. K owulu * Su a E. Kpowulu, t/Wa Suzsnne E. Hansen ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. St. Croix County ) Personally came before me this 12th day of December 2!101 the above named Gregory 1"I .Kpowulu and Suzanne E. Kpowulu, f/Wa Suzsnoe E. Hsnsen, husband snd wife ,~lr~•••"•~*• to me known to be the person(s) who art anlsa me rorc ; instr nt and ck w d ed t e s _ ~aN O T A R '', r• * 0.ti K R..- a _ Nriary Public, State of Wisconsin My Commission is permanent. (If not, tal~~ny,Qiratio~°.y~~~g~*~ * Names of persons signing in any capacity must be typed or printed below their signature. STATE BAR OF W ISCONSIN WARRANTY DEED FORl1~INo.2-1999 TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristins Ogland Hudson, W[ 54016 (Signatures may be authenticated or acknowledged. Both are not necessary.) Irtormation Prolasslpr,als CdnPlir~,'1•W+6 du Lee. WI eoo~ss-zo2r • 07f22f2@@5 11:32 651-769-8744 OWMER BUILT HOMES PAGE 02 f~C Cli4 * ~ 40CATE0 tN 11E :E ,N ~ rNC NE t/• a tiECT10~1 e•, ttlN. RIyV, TOV*1 Oi 1+110/, ST: C'{0!t COu~1Ttf~ V[SCtlNt1M, ~. n ~~ ,~pl Ai,L aR puTL,prs 2, S. A110 1 OF Tll~ PLAT ~ vYLOWOD :; ~ (NICER'! AECCtf ORIVEVAy RELTsltt:tttlM Ct•AUSG IUi drhrteari vAkA rt0ulr! -culverts a-t •hereby ~ta,Ared to hovt• itN eO~P~rtt •P-or 1rrWratt on desn ends of era+ cw~rrs. . ' ' ME tt>w-HER • .SEC~TIQt1 2~ ' TZ9M, R19Y ~ ~ ' • t~ortt~e,~.lyxt.lwa: ~ U_NP_LATTED_ t.ANDS N~ ~ . pieerh+oe¢Ew.ryti~e~he. North title •Of the^Sta/! OF the NEt/A . ~ . N16 Thud 81rea ~ ~ NE (:o.•nIr of the >iE JI of ihf, ~ Y Hud~ou, aMaanule ilols S 89't5'ST• V '.lDN.22' ~-`` " - yT>aoa ~ ,Igbsr ' ~ . r' . ~~/y IIZ,899 SQ. 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Q L'><~' R~7Nt N1111 PIPE 4EIGNiN6 _li5 t~Rti PER e~T, s[r ' .w ~ C~~ ' ALL OTIEJt t:ORMtAi ARC NOMIM+ENIEB VITN 1'IGt1• AaMB • [RW PIPE IfE1iRR1A Ir60 t.lt PER fQ7T ~ •~ : G " ~~ . ~~ • • ALL ELEv«Tl011l. ARE REFEREttCO TO t1SGi,. 1!t! ApJNtTdENt , • -~~ iRgrDSEi ORiVCVAT IOCAt~ -1CT~l, ORIYEMAf PLACEMENT ~ ~~g . MILL tR OEtERtllhED tT Tti1H1 MMLItNO 1NttPtt:rpR, 0 .• " ~~~ v ~N o'YO' . V) N6EVIQJtLY ~ECDRtEp tATA - . • c : • ~~ILLH16 d! f7RA0fNQ vitWM POI~ltG p=EMtllf MEA - . OM LOT Ii vt1L Ag01gl1E NO NET Lots 01' ftOiIAGE •+. WLA. AN! vILL REOYIIK ARMOV~1. ~' THE TQrM E 1/t CbhILR' er wlotaoN; sT. cnollt couNTr a ApNINt=TRATOR. ~ sECxla+ a•• . 4Np sr, oROI:. taurr t.AN4 cRNlER+rAtuW COIIIIPTrEE ,r~; h9v ~NYRAI, MOT ICE STAtCMCNi. the p•_Kets Mor•- en thls•Otee, w a~~ect to itotr. ~tt- owd Te..+}Aio la~+ti. ruler" enA . - .. .._ ....''- _ _ ~~~~ ~.,.~.~ .• 4.~.w1 •M_1. ~fbN euiMtll•~. ~ ~A«•~^O~•'•y T+~~• ioAWC~