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Home My WebLink About018-1081-20-000 A Croix County Planning and Zoning Detail Sanitary Information Monday, February 03, 2014 at 9:30:54 AM Computer 018-1061.20-000 Page I of I Parcel 36.29.17.5608 Sub/Plat: metes & bounds Section: 36 MunicipalityHammond, Town of Lot: TNIRNG: T29N R17W CSM: 114114: NE 114 SE 114 Owner: Lee, Kenneth G. 624 Hwy 63 Baldwin, WI 54002 _ _ State Permit Issued; 01/01/1970 POWTS Dispersal: Non-Pressurized in round County Permit: 0 Installed: 01/01/1970 POWTS Detail: NA Permit; New Bedrooms: 0 WI Fund: POWTS Pretreatment: NA Notes Issuerlssuer/lsoeetor As Built Plumber Not determined NA OtherOther R Additional Notes Unknown Mone_ v Owed Not determined Signed 08: No See Permit #79157 for Kenneth Lee in 1986 - he $0.00 had 2 houses next door to eachother and only one POWTS permit on record. Might be one house existed prior to 1986 construction. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - LEi KENNETH (KIP) SE SE, Section 36 Rt. 1 ~2oZi~ G3 T29N-R17W, ,Baldwinn, WI 54002 ToT,an'af Hammond San.Permit#79157 5-21-86 D. Hudson Conventional, New Parcel 018-1081-20-000 02/03/2014 09:26 AM PAGE 1 OF 1 Alt. Parcel 36.29.17.5608 018 - TOWN OF HAMMOND Current D ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner KIDZ PLAZA III LLC 0 - KIDZ PLAZA III LLC 624 HIGHWAY 63 BALDWIN WI 54002 Property Address(es): * = Primary Districts: SC = School SP = Special * 624 HWY 63 Type Dist # Description SC 0231 SCH D BALDWIN-WDVILLE SP 1700 WITC Notes: Legal Description: Acres: 5.000 SEC 36 T29N R1 7W 5 ACRES S1/8TH OF NE SE Parcel History: Date Doc # Vol/Page Type 12/30/2013 990848 PRD 05/05/2009 894819 QC 08/11/2006 831999 WD 04/16/2001 642860 1618/510 TD more... Plat: * = Primary Tract: (S-T-R 40% 160%) Block/Condo Bldg: * N/A-NOT AVAILABLE 36-29N-17W NE SE 2013 SUMMARY Bill Fair Market Value: Assessed with: 226764 103,300 Valuations: Last Changed: 11/04/2008 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.000 75,000 53,200 128,200 NO Totals for 2013: General Property 5.000 75,000 53,200 128,200 Woodland 0.000 0 0 Totals for 2012: General Property 5.000 75,000 53,200 128,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount 010-GARBAGE SPECIAL CHARGE 60.00 Total Special Assessments Special Ch r es Delinquent Charg0e0 0.00 0 Form - S T C - 104 k ~ AS BUILT SANITARY SYSTEM REPORT OWNER /J~~~/j TOWNSHIP SEC.G T 29N-R~W ADDRESS ST. CROIX COUNTY, WISCONSIN ~O~G~GU/ 17 SUBDIVISION _ LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of IIHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM EA 4- ~ ~u cl- ire 5 _)3 U r G C~, All$ c >1 P, 1 1 l INDICATE NORTH ARROW A10. BENCHMARK: Describe the ver'trical reference point used o,~7 Elevation of vertical reference point: Proposed slope at site: /Q SEPTIC TANK: Manufacturer: Liquid Capacity: Number of rings used: 1 Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: 99.9 ~ Number of feet from nearest Road: Front, Side,O Rear, O feet • From nearest-property line Front, OSide,0Rear, 0 feet Number of feet from: wellQ building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER i ~ Manufacturer: Liquid Capacity: Pump Model: Pump/Siph,n Manufacturer: Pump Size 1 Elevation of inlet: Bo m of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: / I Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear, Q Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Y.E'- Trench: i / CJ Width: Lenjth: 3 Number of Lines: G~10 Area Built: ~o-3lm Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, Rear,O It Number of feet from well: 100, Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: _ Liquid depth: Bottom f s page elevation: Area Built: Has either a drop box O or distri ''t on ox en sed on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bo om of tank: Elevation of inlet: t, O Side, O Rear, 0Ft. Number of feet from nearest /tfeefr Vilinlg:: Number of Number of feeNumber of feet fro d: - Alarm Manufacturer:_ Inspector: Dated: - Plumber on job: License Number: 3/84:mj DEPARTAAENT OF INDUSTRY, INSPECTION REPORT FOR LABOR & HUMAN RELATIONS SAFETY & BUILDINGS P.O. BOX 7969 PRIVATE SEWAGE SYSTEMS DIVISION MADISON, WI 53707 BUREAU OF PLUMBING X CONVENTIONAL OALTERNATIVE State Plan I.D. Numbec ❑ Holding Tank ❑ In-Ground Pressure O Mound (lfassignedl NAME OF PERMIT HOLDER JADDRESS OF PERMIT HOLDER Kenneth (Kip) Lee Rt. 1, Baldwin, WI INSPECTION A E: 54002 ` 30 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: SE SE, Section 36, T29N-R17W5 Town of Hammond REF. PT. ELEV.: CST REF. PT. ELEV. Name of Plumber- - MP/MPRSW No.. Cn7 Sanitary Permit Number: Dale E. Hudson 6629 St. Croix 79157 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIOUIDCAPACITV. TANK INLET ELEV. TANK OUTLET ELE V.: WARNING LABEL LOCKING COVER /71/'10 100.1b -O~V(IDED: PROVIDED: BEDDING: VENT DIA.: VENT MATT HIGH WATER J ES ❑NO OYES SNO ALARM NUMBER OF ROAD PROPERTY WELL BUILDING VENT TO FRESH ❑YESO FEET FROM AIR INLET: ❑YES ~Q NEAREST ~O DOSING CHAMBER: MANUFACTURER. BEDDING: LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUF ACTOREH WARNING LABEL LOCKING COVER ❑YES ONO PROVIDED PROVIDED: GALLONS PERCYCLE: PUMP AND CONTROISOPERAnoNAL OYES ❑NO ❑YES ONO (DIFFERENCE BETWEEN NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH PUMP ON AND OFF) FEET FROM LINE AIR INLET YES SOIL ABSORPTION SYSTEM. Check the soil moisture at the❑de pth of plowinONO _ NEAREST or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE D1AMErE{+ A1ATEHIAL ANDMAHKING the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: BED/TRENCH '.VIDTH. LENGTH NO.OF UISTH PIPE SPACING COVER DIMENSIONS 5 THE N_CHES If M INSIDE I)IA aPITS LIQUID P rEHIAL: PIT DEPTH: G A\t_ LLI'1,. FILL DEPTH DISTR. PIPE UISTH PIPE DISTR. PIPE MATERIAL BELOW PIPES ABOVE COVER ELEV. INLE I ELEV. ENU NO I TrT NUMBER OF PROPERTY WELL. BUILDING. VENT TO FRESH G o?Q p -A y PIPES FEET FROM LINE R t~ AIR INLET:` NEAREST--i. V p~/ a5 MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- OYES ❑NO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEXTURE PC ItMANF NT MAHKE HS CHSEH VA rIQN WELLS DEPTH OVER TRENCH BED DEPTH OVER TRENCH HE U OYES ONO ❑YES ONO CENTER EDGES DEPTH OF TOPSOIL SODDED SEE UEODYES ONO MU OLCHED . YES ONO PRESSURIZED DISTRIBUTION SYSTEM: DYES ONO BED/TRENCH WIDTH LENGTH NO.OF LATERAL SPACING GHAVEL DEPTH BELOW PIPE TRENCHES. FILL DEPTH ABOVE COVER DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL NO UISTH DISTR. pIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEVATION AND ELEV. ELEV CIA ELEV PIPES DIA DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECT LV COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS COMMENTS: OYES ONO ❑YES ONO PERMANENT MARKERS: OBSERVATION WELLS NUMBER OF PROPERTY WELL: BUILDING: ❑YES ❑NO FEET FROM LINE: YES ❑NO NEAREST 7 Sketch System on Reverse Side. Retain in county file for audit. SIGNATURE. TITLE: DILHR SBD 6710 (R. 01/82) z0►~~/1~ dM;~j~~r~,~nr' mon. uAscons"I APPLICATION FOR SANITARY PERMIT ILHR OEPfURTMEL TqF (PLB 67) 1101ST `tA.-&HUfnRnPE.ATmons UNIFORM SANITARY PERMIT / {/S7 -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than $1/7 x 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT ' [PROPERTY 4WN R MAILING ADDRESS R PE TY LOCATIO < 5 11457/4. S T 9N, R / a (or W TOWN OF: y' LOT NUMBER BLOCfC NUMBER SUgQIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER TYPE OF BUILDING OR USeSERVED Aax at" /Q 60 1 or 2 Family Number of Bedrooms: ❑ Public (Specify): THIS PERMIT IS FOR A: X New System ❑ Tank Replacement ❑ Repair Replacement Soil Absorption System ❑ Revision ❑ Privy i i Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. Seepage Bed F-1 Seepage Trench ❑ Seepage Pit, ❑ Holding Tank System-In-Fill ❑ In-Ground Pressure ❑ Val,Tlt Privy ❑ Pit Privy L~ Existing, For Which A Previous.Permit Is On File, Permit # issued ❑ An Existing System That Has Been Inspected And Is Compliant As Far AS Soil Conditions. Total #of Prefab. Site Gallons Tanks Concrete constructed Steal iiberglass Plastic .Septic Tank Capacity Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer: S IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground` Pressure Total *of Pr ab Sim Gallons Tanks Cr `e C t cted Steel Fiberglass Plastic Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer. PERCOLATIOWFIATE ASSO PTION AREA ABSORPTION AREA (Minutes per inch): REQUIRED (Square Feetr: PROPOSED ((S/Square Feet): WATER SUPPLY: `~~.3 4a j1 Private ❑ Joint ❑ Public 1, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber (Print):.- Signat MP>MPRSW No.: Phone Number: ( a Plumber's Address: t7i5 3 Name of Designer: COUNTY/DEPARTMENT USE ONLY ;eason :for Issuing Agent: Fee: Date: ❑ Disapproved a ~ 114 93, 6 ❑ Owner Given Initial Disa pprovalApproved Adverse Determination Alternate course(s) of Acton Available: DILHR SBD-8398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber Alehow ~S, -f29AI R/74) f5y A BM l_'~ao •3' 82 - S3 C3 13 3 _ 141, eo'` 190 13 ° - Lena eOrBn/rS a D e no'e s Pe, r c Alofes 63 (~3 C3 r De m No r 1'-5 -417 0 ",PVC (Wh, 4) a+ -90-5d 0-~ ps,fic tree, AW. n fo 2.Z Cover 4~9 -Y 1-7 17 Perk, Drawl) ~y Aar IV _ 30.. A/i°'Y DEPARTMENT OF REPORT ON SDI BORINGS INDUSTRY, RE AND SAFETY & BUILDINGS LABOR AND ' PERCOLATION TESTS (115 DIVISION HUMAN.RE'LATIONS , ) MADISON, WI 3707 (H63.09(1) & Chapter 145.045) , WI 53707 A N. TOWNSHIPlMUNICIPALIT OT NO.: SILK. NO.: SUBDIVISION NAME: 'f COUNTY /T,21/R i (o : OWNER'S BUYS 'S AM MAILING-AI)OR 5S: USE ' r l ~ NIQL e !aD B CO A DES RI TIO DATE OBSERVATIONS MADE ' Residence 2 P S: A E TS: New ❑Replace. '.c~C7 "`~1~`.. RATING: S- Site suitable for system U= Site unsuitable for system NV TIONAC•; MOUND• IN-GFiOU S TANK: RECOMMENDED SYSTEM:fo tional) L.S ❑U I1S CJU QS ❑U DUE- If DSU Percolation Tests are NOT requi DESIGN RATE: under s.H63.09(5)(b), indicate: If any portion of the tested area is in the Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TAL NUMBER DEPTHfi, ELEVATION P H R UNDWATER-INCHES CHARACTER O S IL WI H THICKNES COLOR, EXTURE, AND DEPTH OB V D E HST TO BEDROCK IF OBSERVEp (SEE ggBRV. ON BACK.) B- G 0" e 0' f 1110 747 A0 100 -no ff PERCOLATION TESTS NUMBER DEPTH , WATER IN HOLE T ST TIME +►+LS AFTER SWELLING INTERVAL-MIN. D I N W- A TER L V 1 H AT MINUTES / P I P- i PER INCH P_ All ,•d/ P P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all bori of land slope. ngs and the direction and percent SYSTEM ELEVATION 97 tt I.. J i . E ' ,..p._ I j y r ' t + IN i l_ • f T__~7 r, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. .-ME print : ' TESTS WERE MPLETED ON: %DDR S f J CERTIFICATION NUMBER: PHONE NU ER(optiona, CS SIGN TUBE: ISTR16UTION: Original and one copy to Local Authority, Property Owner and Soil Tester. ILHR-SBD-6395 (R. 02182) -OVER- • ' APPLICATION FOR SANITARY PERMIT STC - 100 'his 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 fora should be retained and completed when the property is scud and submitted to this office with the appropriate deed recording. Owner of `Property Location of Property _C Section 3~ , T .29 N -R 17 w Township Mailing Address f- 31a L6111V ~2 Subdivision Name Lot Number Previous Owner of Property Co G~r~ S~5~~ Total Size of Parcel Date Parcel was Created ,29 40 Are all corners and lot lines identifiable? Yes No - Is this property being developed for resale (spec house).? yes No Volume and Page Dumber as recorded with.the Register of Deeds i INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land. Contract let. 3.. Other recordings filed with the Register of Deeds Office In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the the Certified Survey Map shall also be required. . _-_T_.------- - PR0PERT O N!T CERTI FTCATION I (We) coti.6y that W atatementa on tJUA 6onm ane true to the beat 06 my (ouA) knowledge; that I (we) am (ane) the owneA.ta) o6 the 6 pnopehty deachibed in th.i,a injoAma4on 6oAm, by v Atue o6 a wa4Aan~ty deed neconded in the 066.ice o6 the County Reg-i. teh 06 Deeds as Document No. _Z/0 2- ; and that I (we) pnea entt y own the pno poa ed a.i to box the b ewage po6 a yatem (on I (we) have obtained an ea,6 emen t, to nun with the above, des cn.i.bed paopeh ty, 6o& the conatAuction o j aai.d aya.tem, and the name has been duty necoadpd in the 066.i.ee a6 the County Regi.a.tex o6 beedb, ab Document No. SIGNATURE OF OWNER..... L~ ~ l y SIGN ZU ~ OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE S GNED , Y- , H H ' a S T C- 105 r" r • a y SEPTIC TANK MAINTENANCE AGREEMENT H St. Croix County z d ~ a OWNER/BUYER 7~, ROUTE/BOX NUMBER. Fire Number CITY/STATE 117 ZIP ~S/QQZ PROPERTY LOCATION: Section ?4~; T Z4 N, R /7 W, Town of St. Croix County, Subdivision 41,4 Lot number. Improper use'and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.-County residents may 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, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. 0 E I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x the standards set forth, herein, asset by the Wisconsin Depart- d ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNED DATE C b St. Croix County Zoning Office P.O. Box 98- .Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. Unscor"Un SANITARY PERMIT ounty TDILHR C ~ wmusTwoL,m,&~nan GROUNDWATER SURCHARGE / X Sanitary Permit No. . On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more com- monly known as the groundwater protection law. This change in statutes was the result of over 2 years of steady negotiation and public debate. The groundwater bill included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that is used in your building is returned to the groundwater through your soil absorption system or the disposal site used by your holding tank pumper. The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. Ground SI re of Issuinn Agent: Groundwater Fee: Date: WISco R"S li r DILHR SBD•7289 (N. 05184) .J ~ p6 burled trenutlb A f Y `CC9 3 CIS Gib .v 1 a TJ O i ~~S a ~ ~ .