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HomeMy WebLinkAbout020-1088-70-000 0 CO) O 3 v n 0 CD G CD so M m O O m 0 O O W C N N `C• 3 p C eo 7 C N p H CD a z a to a° N O m O CC) N CD 3 ~p W (b CD go (n p ` 1\ N a O N N n n O CD O O ' v N E ~ O1 cn C A O CD 7 p ,ft in y O O C) C 13 O W N 3 3 ' J r"S Cl. D N C GJ !~i (rD P-d O N CD (a CD N a° m p (D -p CD F 3 -4 O 0D ID rt H CD rn o N Cp a a! n r N vZ o CA 0) c 3 " Q can 'a Oo O O O• WI 0 Ch Ch ccnn Oro c,; m n CS T v v o CD to p 00 eo - d V N 3 E D. 00 a y ON z N tv O O N O a, y a CD 0 o a° H H rn 7~ =r Z z O C a) c CD a) p ~,fd C1Y c to N I-h F- k, CL x Si' (D aC a O fn z 3 CD A 2 CD G n 9C! CL rt ° N ; J n A z 0 f~I' N A A < CNO N Q a zz °O z I y m ~ z O A 0 d O. c N C CD CD a O rl- II n N O N CT ~ I 0 w CD Q Q a A ti EA O . V O CL Form- S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER W AMA' L TOWNSHIP SEC. Z' T 1/ N-R 2 n p D ',mIL ADDRESS IZtJ~ ST. CROIX COUNTY, WISCONSIN Hopl°'`i (.01- S - SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of ILHR, 83 N L 64 ` SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ✓ / =30 133' ,J T i N yy 37 / 65 , U. 9 yon s~' ~~3~ IWO S CA'~ T r ~ r~2 113.3z ice. a / R6 ( K e 1 72 tIfRT INDICATE NORTH ARROW r 7v/ y., Cu 00D i ce rO6 ?e- BENCHMARK: Describe the vertical reference point used OAJ4 iN L%A)F lee -A ~c1 } Elevation of vertical reference point: Proposed slope at site: c7 ~6 SEPTIC TANK: Manufacturer: CAl,'* Netc! ~ ~ f~ .+o•J D CJ%S Liquid Capacity: Number of rings used: q' Tank manhole cover elevation: sO / Tank Inlet Elevation: / 3' l~ Tank Outlet Elevation: ✓7-do , Number of feet from Barest Road: Front,@ Side, Rear, O feet N014- j From nearest property line Front, 0Side 0Rear, 0 feet Number of feet from: well l9 9 , building: 2,5-- (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Liqu' apacity: Pump Model: Pump/Si n Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch ele tion: Gallons per cycle: Alarm Manufac er: Alarm Switch Type: Number o 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 l X ~J Bed: Trench: 2 3 ~ r Lf ~ Width: Length: J + Number of Lines:, / Area Built: Fill depth to top of pipe: L'e SS y~ v~~ 3 " , ArO Number of feet from nearest property line: Front, O Side, O X Rear, O Ft. Q Fr, Number of feet from well: co S ' Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area >adrop : Has eit box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elev n of bottom of tank: Elevation of inlet: Number of feet fro earest property line: Front, O Side, O Rear, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: L 2 I 7 Inspector Dated: Plumber on job: License Number: RT. 3 o'NEIL RA., HONOW Wit 64016 ROQERT ULSRICK WIS. MASTER PLUMBER U0. NO. 3307 Oft MINN INSTALLER & DESIGNER LIC: NO 00610 3/84:mj (it -4 APARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HIbMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISONw WI 53707 RXCONVENTIONAL ❑ ALTERNATIVE State Plan 1,D. Number • Ilt assigned) ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER. INSPECTION 7RE~ Mile Kranz 327 River SLtreet, Hudson, WI 54016 Y-;? BENCH MARK (Permanent re ference point) DESCRIBE IF DIFFERENT FROM PLANREF. PT. ELESW NE, Section 32, T29N-R19W, Town of Hudson, Lot#3 Name of Plumtter. JMPIMPRSW No.. Cou my Sanitary Permit Number. Robert Ulbricht 3307 St. Croix 83798 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID APACI TV. TANK INLET ELEV. TANK OUTLET ELEV. WARNING LABEL LOCKNG COVER LPROVIDED PROVIDED Cf lJ I 7 9YES ENO EYES ~ O BEDDING. VENT CIA. VENT MATL. HIGH WATER NUMBER CJrF ROAD. PROPERTY WELL BUILDING VENTNTO FRESH ALARM FEET FROM / O LINE _ 6 A ~AIR ILET EYES NO r, EYES O NEAREST (j DOSING CHAMBER: MANUFACTURER JBEDDING. JLIQUID CAPACITY PUMP MODE I. PUMP: SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED. PROVIDED. OYES ENO EYES ENO EYES ENO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPFHTV WILL BUILDING I(DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) EYES ENO NEAREST-illim 11 SO I L ABSORPTION SYSTEM. Check the soi I moistu re at the depth of plowi ng LENGTH IDIANIFTER IIIATIHIAFANDMARKIN(. or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: _ WIDTH LENGTH NO. OF DISTR. PIPE SPACING COVER INSIDE DIA =P1 TS LIQUID BED/TRENCH THE NUu' ~s M tIAL: PIT DEP111 DIMENSIONS G- ~j f w (IHAVFL DEPTH FILL DEPTH 111111111111 DISTR. PIPE DISTR. PIPE MATERIAL NO. DIS NUMBER OF PROPERTY WELL BUILDING VENT TO FHF SH BF LOW PIPES ABOVE VEH FIFV I I ELE V.ENU - ~ PIPES iLINE/< AT 1r Jr ((T FEET FROM / N ! ~5 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- meets the criteria for medium sand. TIONS MEASURED. EYES NO SOIL COVER TEXTURE [11110ANI NT MARKI RS 1185[ HVA111I11 WI I I5 EYES ENO EYES LINO DEPTH OVER THE NCI( BED DEPTH OVER TRENCH. BED OF TOPSOIL S(DFD SEEDED MCHCENTER EDGES :1TH EYES ENO EYES ENO EYES NO PRESSURIZED DISTRIBUTION SYSTEM: _ WIDTH LENGTH NO. OF LATERAL SPACING GRAVEL OE PTH BI LOW PIPE GILL DEPTH ABOVE COVEH BED/TRENCH TRENCHES DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE IMANIIIILI)MATEIIIAL NO DISTH DISTH PIPE OISTIOBII I ION PIP[ MATIRIAL &MARKIN(i ELEV. ELEV. DIA. ELEV. PIPES UTA ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECT I_V COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPRUV[ 0 PLANS _ EYES ENO DYES ENO COMMENTS: PERMANENT MARKERS. OBSERVATION WELLS: NUMBER OF PROPERTY WELL. BUILDING FEET LINE EYES ENO I C,1 YES ENO INEARESTOM 53 0.77 Sketch System on Retain in county file for audit. Reverse Side. S D ILHR SBD 6710 (R. 01/82) ac - SANITARY PERMIT APPLICATION COON ILHR W.~~~~ x In accord with ILHR 83.05, Wis. Adm. Code STATE SANITARY PERMIT # Ems S'3 ~ 919, -Attach complete plans (to the county copy only) for the system, on paper not less than STATE PLAN I.D. NUMBER 8% x 11 inches in size. -See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑ YES ® NO PROPERTY OWNER ~j PROPERTY LOCATION Q / ifiei- &A,,1V Z w % NE /a, S 3L T If , N, R / E (O W PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER IB,,LOC/KNUMBER SUBDIVISION NAME 3~7 iv,~ ST 3 :,uvf ~h CITY, STATE ZIP CODE PHONE NUMBER CITY NEAREST ROAD, L# v i✓ S 1!S d (O P ~3 VILLAGE C r/V E%L II. TYPE OF BUILDING OR USE SERVED: 1"t4--,064- ONO - /O30-06 Number of Bedrooms if 1 or 2 Family OR ❑ Public (Specify): III. PURPOSE OF APPLICATION: (Check only one in #1. Check # 2,3 or 4, if applicable) 1. a. New b. E1 Replacement c. ❑ Replacement of d. ❑ Reconnection of e. ❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in #1 and only one in #2) 1. a. Conventional b. ❑ Alternative C. ❑ Experimental 2. a. ❑ System- b. ❑ Holding c. ❑ Pit Privy d. ❑ Vault Privy e. E1 Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. ❑ seepage Bed b. Seepage Trench c. ❑ See a e Pit 2. PERCOLATION RATE 3. ABS RPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): t, Y 370 0 D Feet Private ❑ Joint ❑ Public VI. TANK CAPACITY Site in gallons Total #of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New Existing Gallons Tanks Concrete stCon glass App. Tanks Tanks Septic Tank or Holding Tank ❑ ❑ ❑ ❑ Lift Pump Tank/Si hon Chamber ❑ ❑ ❑ ❑ ❑ ❑ VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Si t m s /MPRSW No.: Business Phone Number: RT. 33 O'NEIL RD., HUMN WIS. 5WI& ~30 7 -71S )3X _Q PI mber's Ad ess (Street, City, State, Zip Code): Name of Designer: WIS. MASTER PLUMBER LIC. NO. 3307 MARS. Vlll. SOIL TEST INFORMATION Certified Soil Tester (CST) Name CST # e RT. 30'NEIL RD., HUD60N, WIS. SWIA 2, ROBERT UhBRI CST's ADDRESS (Street, City, State, Zip Code) WIS. MASTER PLUMBER LIC. GH NO. 3307 T M,RR,~ Phone Number: 2 - D p MINN. INSTALLER DE61ONER I:& NO, OM ,7 ~°lG S IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater Date Issuing Agent Signature (No Stamps) Approved ❑ Owner Given Initial /D Surcharge Fee ) ~J L j Adverse Determination X. COMMENTS/REASONS FOR DISAPPROVAL: IV r/ V SBD-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber t INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT , APPLICATION TO THE APPLICANT: 1. This 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. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 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. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed pumper whenever necessary, usually 4very •2 to 3--years; 6. If ya a have questions concerning your private sewacg`e syster;i, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide- the legal description where the system is to be installed; II. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; Ill. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. 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. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8'/i 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; dosing or pumping chambers; 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 1.15 form. GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly 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 Groundwater - included the creation of surcharges (fees) for a number of regulated practices which WiscoriSin's can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried treasury is used in your building is returned to the groundwater through your soil absorption o 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 ,lye Oepartment of Natural Resources. These funds are used !or monitoring ground- t ate , g ourdwater contamination investigations and establishm ::it c standards. Groundwater, it's word: protecting. SBD-6398 (R.03i86) HOMESITE SEPTIC PLUMBING CO. RT. 3 VNEIL RD,, HUDSON. WIS. 54016 ROBERT UIBRICHT • WIS. MASTER PLUMIER LIC. N0.3307 MARA APPLICATION FOR SANITARY PERMIT MINN. INSIALLER & DESIGNER LIC. NO 00663 STC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequaoies 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 Location of Property Section 3L , T Z/ N - R W Township Mailing Address 3 Z~ /~/v ff Subdivision Name Lot Number Previous Owner of Property / _mx/-V e-- •U ~L~~ . Total Size of Parcel Date Parcel was Created 9 ' Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume and Page Number as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract .~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. PROPERTY OWNER CERTIFICATION I (We) cvLU6y that a t atatementa on thin 6onrn aAe tnu.e to the beat o6 my (oun) knowledge; that I (we) am (one) the owneA (a) o S the phopen ty dea eh ibed in thiA in6o4mation 6onm, by viAtue o6 a wauanty deed 4W4ded in the 066ice o6 the County Reg.ie.ten o j Deeda as Document No. ~ L ; and that I (we) pheaentty own the pnopoaed bite bon the sewage poa ayatem (on 1 (we) have obtained an easement, to hun with the above de,6cAi.bed pnopenty, bon the conatn.uction o6 aai.d ayAtem, and the same has been duty teco4ded in the 066ice o6 the County Reg.caten o6 Deeds, as Document No. r loo, SIGNA RE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) T D E SI ED DATE SIGNED ' r1 z H Y S T C - 105 H4MESITE SEPTIC PLUMBING CO., r ' RE 3 Q'NEIL RU., HUDSON, WIS 54016 a ROOFERT ULBRICHT y SEPTIC TANK MAINTENANCE AGREENWOUSTERPtUMgfRUC.NO.3307M.P.Rg 00 St. Croix County MINN INSTALLER 8 DESIGNER LIC. NO 006Fi3 z d OWNER/ Aff_/( e_ ROUTE/BOX NUMBER ✓ 2'` A-4y -r/ . Fire Number CITY/STATE 12f~~ ZIP PROPERTY LOCATION:s :41 14, Section 3L , T / N, R W, \ Town of-,~✓D~ , St. Croix County, Subdivision , Lot number .3 'j 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- p© 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. y 0 E I/WE, the undersigned, have read the above requirements and agree vzi to maintain the private sewage disposal system in accordance with x the standards set forth, herein, as set by the Wisconsin Depart- b ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Off'_ce within 30 days of the three year expiration date. d SIGNE __N DATE 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. 46 G/f 1 j0 A47-4- e r A Clfs s _v- o4.4> 19 7So l'e- 441-V- ° T- NDUST OF AND SAFETY & BUILDINGS INDUSTRY, REPORT ON SOIL BORINGS c DIVISION LABOR AN P.O. BOX 76 HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 (H63.090) & Chapter 145.045) LOCATION: f 4W SECTION: NSHIP/Ib4k~J?d+eFPPeL Y: LOT NO.: BLK. NO.: SUBDIVISION NAME: 1/ '/a 3Z /T.z9 N/R /7 E (or) ir; ups aitJ 3 lyly oKlNt y C.tM COUNTY: OWNER'S BUYER'S NAME: MAILING A RESS: ST 132-7 R uE R .5"t. R uDSa,j tx;IS , S Vol 6v USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence 3 No rof- I 4New ❑ Replace RATING: S= Site suitable for system U= Site unsuitable for system `5C.5- C6&D AA07- ,5_1/- ~ l~s(f b ~►~~~!FL a CONVENTIONAL: MOUND: IN-GROUND-PR -IN•FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) 9~D AP cis ❑u ®s ❑u IRS au a s NU o s ou dom urvrloA T~P~v s If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: t✓ `ss Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEppPTH IN. ELLEVATTIION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) /9 B- O 17;4 / ' yam' S-11 (07 N s, /o u *s es , `/X ' /3/ s,/ 33' A) S, -rhAf AA" CS B,J So' 1~ /y ltd, >,P.0 i o 1 s v I" AJ A r / ZJAI C, r /J, Jf B- , j' Jc~ i I S A /.0 1414 f 167 ' r 6- PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD PER INCH P- / 5- r Z CD S T P- P- Z l L P-_ P- L s P , Si TE. 'X I 1C4 6& L PLAN w*at'i~s of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- ii al anVfiarI jevatio erence points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent and slop.. S V ON 0110 til a - ( a 3 r i F F 3 3 11 X33 E 1 }V I 33 60 _.m _ _ _ E ~ POS Cs -site-APPA --ED 01 S f for a Cdnupnt"ogal- E -ULAWl'CMrs POOP0 Ty . (WOOD f~,uct'~osr.=ioo•o' I, 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. NAME (print): TESTS WERE COMPLETED ON: SEPTIC WOMESITF PLUMBING CO. Tu) o IE I L. 1986 ADDRESS: IT. 3O'NEIL RD:; HUDSON; WIS. 54016 CERTIFICAIIONON NUMBER: PHON NUMBER(optional): ROBERT ULBRICHT Y~ 3 (?6 - WIS. MASTER FLUNWR LIC, NO. 3301 M.F.Ft& MINN. INSTALLER & DESIGNER LIC. NO. 00663 CST SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) -OVER - l c To€tt 4. &Y I ALL 10, THE A IOlmo ~,FI SOIL `L- I 1 i .J 3 9 4` $'~xS s EAST 133 8 v ¢c U D~U tiL /~D . n~ Jo A O ~ G7 Tod MoD fAr,ucc Its- , So. 4o7- Lime" ?iL-ap+ck'r PRop.Pty V Fresh Air Inlets And Observation Pipe ~nvvp h sA~E Ale /F0-/-k 7r. .,vG~2.S 5V4rtxYae's pi ~ L=--- Approved Vent Cap Minimum 12" Above Final Grade 4" Cast Iron y2 " Above Pipe - 'ro Final Grade Vent Pipe Synthetic Covering Min. 2" Aggreje] Over Pipe Distribution Tee Pipe 0 0 0 AggregatPerforated Pipe Below ~/~(/1tj,O~_ 1,2.0 Beneath PipCoupling Terminating At Bottom Of System i L • ' ` Parcel 020-1088-70-000 03/24/2006 03:28 PM PAGE 1 OF 1 Alt. Parcel 32.29.19.371 G 020 - TOWN OF HUDSON Current IX ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - KRANZ, MICHAEL & JULIE MICHAEL & JULIE KRANZ 463 STAGELINE RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 463 STAGELINE RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.600 Plat: N/A-NOT AVAILABLE SEC 32 T29N R19W NW NE COM SE COR N Block/Condo Bldg: 453.4' CL HWY N 56 DEG W 485.8' ALG CL TO POB;S 34 DEG W 437.86'N42 DEG W Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 348.52'N 71 DEG E 109.98'N 42 DEG W 32-29N-19W 512N48DEGE13.42'N21 DEG 37.51' N 34 DEG 225.1' CL HWY "N" S 56 DEG E more... Notes: Parcel History: Date Doc # Vol/Page Type 07/09/1998 582661 1338/580 WD 07/23/1997 1027/64 LC 07123/1997 803/182 07/23/1997 798/271 more... 2005 SUMMARY Bill Fair Market Value: Assessed with: 92110 273,000 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.600 82,800 195,600 278,400 NO 05 Totals for 2005: General Property 2.600 82,800 195,600 278,400 Woodland 0.000 0 0 Totals for 2004: General Property 2.600 47,800 200,200 248,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 145 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00