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HomeMy WebLinkAbout030-2048-70-000 c d o o ~ CD o 2 0 M -5, qt a M CD W CD s~ K) 0 O N O N O Oo D v W O• O A - W MCI A CD. O N v n FD' 0 U) O N co( n N a O ? J C A 7 O NO 0 O e•4 :3 C~ CD cQ a m m N C d D - I ~ 3 o co 9 3 a0 = A N I' 00 ~ N i, Z CC) 0 r, 0) O CO ~ C A M C 00 0 0 3 0 ca ca a D t" yrl 0 F, 0) M. OD o ICD N CL M Z o O D co CD _O A .0 N N G N N I G, ~ a Z m (6 -I N U) c j s CL a o G) C Z 3 3 r O N N y z I ~ w I -o a ~ 310 Q No S m v c d N Z p n O O fi 3 m y CL ;:L a -ti o o N A ~ 0 fi C ~ ,4 f~D < 0c N ('D O O o (O C O b O N O I c ~ ~ a ti Parcel 030-2048-70-000 02/18/2005 12:29 PM PAGE IOF1 Alt. Parcel M 27.30.20.510S 030 - TOWN OF SAINT JOSEPH Current I X- ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): Current Owner VIELLIEU, ALLEN & KAREN ALLEN & KAREN VIELLIEU 1384 HILLTOP DR HOULTON WI 54082 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 1384 HILLTOP DR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 1.280 Plat: N/A-NOT AVAILABLE SEC 27 T30N R20W 1.28 AC IN GL 2 LOT 3 Block/Condo Bldg: OF CSM IN VOL I PAGE 144 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 27-30N-20W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 763/328 2004 SUMMARY Bill Fair Market Value: Assessed with: 6125 236,800 Valuations: Last Changed: 07/09/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.280 54,700 178,300 233,000 NO Totals for 2004: General Property 1.280 54,700 178,300 233,000 Woodland 0.000 0 0 Totals for 2003: General Property 1.280 32,000 132,700 164,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 114 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Form- S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP Ss~p~ SEC. 2 T ~v N-R ~UW ~}~vy 35 1/'1141Sf P~ ADDRESS l ST. CROIX COUNTY, WISCONSIN s"f- JOSt~~ W I S_ ~ SUBDIVISION LOT 3 LOT SIZE Z~~ S PLAN VIEW Distances and dimensions to meet requirements of ILHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM o 011 =30 \ YS Na , r'A f0f vast ~D ~o of 5o%"D 1 S , yy o h tV 7o/ ~,vTEV C~° ~ ~ ~ ~ y~a H Pr. oaf- of I I SO- 10T 61,3E INDICATE NORTH ARROW ~fp~ ai '5"'V1 47_A vx 4.0t BENCHMARK: Describe the vertical reference point used S /07- Elevation of vertical reference point: Proposed slope at site: 'j O SEPTIC TANK: Manufacturer: Liquid Capacity: ~;Oro c3 A" 8y Number of rings used:/U49AY_ Tank manhole cover elevation: /0 2. Tank Inlet Elevation:/®/S0 Tank Outlet Elevation: ~ / / 3Z ~~S T Number of feet from nearest Road: Front,O Side,O Rear, O 4~ U25~ ~d0 feet 10Rsr as From nearest property line Front,OSide,©Rear, O feet i Number of feet from: well building: 2 J (Include this information of the above plot plan)( 2 reference dimensions to septic tank) PUMP CHAMBER • i" Manufacturer: Li Capacity: Pump Model: Pump/S on Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elev ion: Gallons per cycle: Alarm Manufactur r: Alarm Switch Type: Number of fe from nearest property line: Front, O Side, O Rear, 0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: N I Qt~ N3 Width: ~Z Length: 5 7 Number of Lines: Area Built: Fill depth to top of pipe: 319 to, A ~/z so 0 Number of feet from nearest property line: Front, O Side, O Rear,0 Pt. Number of feet from well: 13 Number of feet from building: 0 f (Include distances on plot plan). SEEPAGE PIT Size: Number of ts: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box been n any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings ed: Elevation of bottom of tank: Elevatio inlet: Number of feet from nearest property line: Front, O Side, O Rear, Q Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: f 7 Inspector: Af t,7- 7 4d Dated: Plumber on job: License Number: HOMESITE SEPTIC PLUMBIMG CO. RT. 3 O'NEIL RD.: HUDSON, WIS. 54016 ROBERT ULBRICHT 3J$4 : m . WIS. MASTER PLUMBER LIC. NO. 3307 M.P.R& 'AINN. INKALLER & DESIGNER LIC. NO. 00663 Form- STC-104 AS BUILT SANITARY SYSTEM REPORT OWNER U~~//EX TOWNSHIP s ~-;e 7 USEp~. SEC. 2 T SC) N-R Z~W ADDRESS ""~l 3S///S~ . CROIX COUNTY, WISCONSIN $-F J'Os t`p j, W 1' .S I SUBDIVISION e'sq ~ 21(6J LOT 3 LOT SIZE 2 I/Of r r~. M4 PLAN VIEW Distances and dimensions to meet requirements of I•LHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM i/ -3 0 S~ ti5 NP Aviv 60 JA"T 4 ~ sr pTr ~ SyS7E'`1 501, 119 E~~fiT '~D ~ ~ v ys IV ~v C~°ss~ ti 1 X16 X5.3 Pr. 1 oaf. gLo f SO- 410T 61.0E INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used S E 1o7-3z,y~o Elevation of vertical reference point: Proposed slope at site: Cr~/ 4i5-S64 C SEPTIC TANK: Manufacturer: Liquid Capacity: /0-.010 4y Number of rings used: Tank manhole cover elevation: /0 2. 8/ Tank Inlet Elevation:/O/' SD ' Tank Outlet Elevation: 10/. 3,~, , Number.of feet from nearest Road: Front,O Side Rear,f~ Vie Ado feet 4017 40 From nearest property line Front ,OSide,QRear,O 110° feet Z Number of feet from: well building: 7 ' (Include this information of the above plot plan)(2 reference dimensions to septic tank). PUMP CHAMBER Manufacturer: Li Capacity: • Pump Model: Pump/S on Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switcZelev : Gall ons per cycle: Alarm ManufactAlarm Switch Type: Number of fe from nearest property line: Front , Side, O Rear, Q Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width: ~Z Length: 7 Number of Lines: Area Built: 36 72- Fill depth to top of pipe: ' Number of feet from nearest property line: Front, O Side, O Rear,0 It. Number of feet from well: 13 Number of feet from building: &0 j (Include distances on plot plan). SEEPAGE PIT Size: Number of ts: Diameter: I Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box been sea-csri any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings ed: Elevation of bottom of tank: Elevati inlet: Number of feet from nearest property line: Front, O Side, 0 Rear, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: f ;4 Inspector: Dated: Plumber on job: License Number: HOMESITE SEPTIC PLUMBING C(L RT. 3 OWEIL RD., HUDSON, NAS. 5400 ROBERT UT 3/ 84 :m j WIS. MASTER PLUMBER IULBRIC. Na 3307 M.P.U MINN. INSTALLER i DESIGNER UC. NO. OM SAFETY & BUILDINGS DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR DIVISION LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS BUREAU OF PLUMBING P.O. I#OX 7969 ❑ALTERNATIVE State Planl.D. Number: MADISON, WI 53707 $CONVENTIONAL (lfassignedl ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound INSPEC ION DATE: NAME OF PERMIT HOLDER: A2DDRESS OF PERMIT HOLDER: AA E ('T omerset, 8 cioutig.D~402 " 8 (JX Uy REF. PT. ELEV.: CST EF.PT.ELEV.. Allen- Karen 7point) eu 50 BENCH MARK (Permanent refce SCRIBE IF DIFFERENT FROM PLGGA N: o.: Cou14 i~,.t SEA- NW% S ec 0N R20W Town O 1 Sanitary Permit Number MPIMPRSW ntryName of Plumber: 3307 St Croix Robert UlbriSEPTIC TANK/HOLDING TANK: WAR LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: PROVID DL ABEL PROVIDED OV MANUFACTURER: ❑YES ❑NO ❑YES ❑NO ROAD: PROPERTY WELL: BUILDING: VENT LINE: AIR INLEFRESH LET. HIGH LARMATER NUMBER OF FEET FROM BEDDING: VENT DIA.: VENT MATL.: A ❑YES ❑NO ❑YES ❑NO NEAREST DOSING CHAMBER: PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER MANUFACTURER BEDDING: iI CAPACITY: PUMP MODEL. PROVIDED: PROVIDED: ❑YES ❑NO ❑YES FIND ❑YES ❑NO PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL BUILDING: AVENT IR INLET RESH GALLONS PER CYCLE: FEET FROM LINE (DIFFERENCE BETWEEN PUMP ON AND OFF) ❑YES ❑NO NEAREST LENGTH DIAMETER MATERIAL AND MARKING SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE or excavation. (if soil can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: INSIDE DIA SPITS LIQUID WIDTH: LENGTH. NO. OF DISTR. PIPE SPACING: COVER DEPTH BED/TRENCH TRENCHES MATERIAL: PIT DIMENSIONS PROPERTY WELL: BUILDING: VENT TO FRESH GRAVEL DEPTH FILL DEPTH DISTR. PIPf DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR. NUMBER OF LINE. AIR INLET. PIPES' FEET FROM BELOW PIPES ABOVE COVER: ELEV. INLET ELEV. END. NEAREST MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. ❑YES L_jNO PERMANENT MARKERS OBSERVATION WELLS SOIL COVER TEXTURE ❑YES ❑NO ❑YES ❑NO SEEDED MULCHED DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL: SODDED ICENTER: EDGES. YES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: FILL DEPTH ABOVE covFR WIDTH'. LENGTH: TRENCHES LATERALSPACING. GRAVEL DEPTH BELOWPIPF. BED/TRENCH DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL'. P OEDISTR. DD1SAT R. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEV.. ELEV.: DIA.. ELEV.. , ELEVATION AND DISTRIBUTION COVER MATERIAL'. VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION HOLE SIZE HOLE SPACING' DRILLED CORRECTLY PLANS ❑YES ❑NO ❑YES ❑NO NUMBER OF PROPERTY WELL: BUILDING'. COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: LINE: FEET FROM ❑YES ❑NO ❑YES ❑NO NEAREST Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE TITLE' DILHR SBD 6710 (R. 01/82) SANITARY PERMIT APPLICATION CouNTM ~ DILHR In accord with ILHR 83.05, Wis. Adm. Code 5~` STATE SA TARY PERMIT # -Attach complete plans (to the county copy only) for the system, on not less than paper STATE PLAN I.D. NUMBER 8% x 11 inches in size. -See reverse side for instructions for completing this application. PETITION -09 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑ YES NO PROPERTY OWNER L PROPERTY LOCATION Alt,EN ° AWA1 111'*E11 a-x_ 5E '/a AW 1/a, s Z? T ~D N, R 20 E (or ow PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME 2.0 s cl-oor/k-;- i2o. Av r 9 3 rr 3 x-76 3 uo/- / P6, CITY, STATE ZIP CODE PHONE NUMBER ❑ L_j CITY VILLAGE : S NEAREST ROAD, L K SoM~es~ s o ~s ~7 9.3_Z 3 r 'cs # 11,11 C,.e& s r- II. TYPE OF BUILDING OR USE SERVED: fatt, X1j . OX - odd -70-0 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. Q New b. Fl 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. ❑ Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) t 1 X S L 1. a. Seepage Bed b. ❑ See a e Trench c. ❑ See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 14. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSLE~D (Square Feet): y ~1~ e., 2- / " '5* Feet Private ❑Joint ❑ Public VI. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks strutted Septic Tank or k f ❑ ❑ ❑ ❑ 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 Signature: (No Stamps) fV P/MPRSW No.: Business Phone Number: RoQei r 2(L(3QiC~ 3,307 7/S 3~Plo~~~6~s' Plumber's Address (Street, City, State, Zip Code): Name of Designer: VIII. SOIL TEST INFORMATION Certified Soil Tester (CST) Name PLUMBING CO. CST # RT. 3 TNEIL RD.; HUDSON; WIS. 54016 CST's ADDRESS (Street, City, State, Zip Code) yy►g; MASTER PLROBERT UILBRICHT UMBER LtC. NO. 3307 M.P.R.S. Phone Number: MINN. 1NffALLER & DESIGNER LIC. NO. IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater Date Issuing Age Signature (No Stamps) Approved ❑ Owner Given Initial 9,0 Surcharg Feb Adverse Determination P~ S X. COMMENTS/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber 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 every 2 to 3 years; 6. If you have questions concerning your private sewa e systeE<), c:ontac:t your local code administrator or the State of Wisconsin, Bureau of Plumbing, 608-266-3815. To be complete and accurate this sanitary permit application muss, include, 1. Property owner's narne and mailing address. Provide the legal description where the system is to be installed; Il. 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; III. 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 8th 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 115 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-pajblit: debate. The groundwater bill Oroundlwater included the creation of surcharges (fees) for a number of regulated practices which Wiscorfsbn's t can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried Ilreasure 0 is used in your building is returned to the groundwater through your soil absorption ~ t system or the disposal site used by your holding tank pumper. A_ The monies collected through there ,urcl;arges are r s; to the groundwater fund adminis_. wk Alf tered by the Department -if Natural Resources. These funds are used for monitoring ground- t .rater, groundwater contamination ir:.~ stigati ins and establishment of standards. Giround°wate- ~ is's worth protecting. SBD-6398 (R.03i86) HUtwESITE SEP11C PLUMBING CO. RT. 3 O'NEIL RD., HUDSON, WIS. 54016 APPLICATION FOR SANITARY PERMIT ROBERT Hd WIS. MASTER PLUMBER LiC LiC. NO, 3307 M.P.R.S. MINN. IN3•TALLER & 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 inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, ("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property ~ Location of Property Section , T ,?0 N-R 20 W Township ,CTSEj . Mailing Address 2-0 C L6 U r I &-A /f ;v I' d 5 OAJ Ej12S€ T G~~ S S Address of Site .0r Subdivision Name Z / Ce Lot Number Previous Owner of Property )~IvLVp !Total Size of Parcel d `114? s Date Parcel was `Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes X No Volume and Page Number as recorded with the Register of Deeds. 713 3~~ INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and pa&e number, and the Seal of the Register of Deeds. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPFRTV OWNER CERTIFICATION I (We) ceAti 6y that att ~6tatement6 on this 4oAm ate tAue to the best ob my (ouA) knowledge; that 1 (we) am (ate) the owneA (.a) o j the pupen ty des cA-i.bed in thiz -i.n6mmation 6okm, by viAtue of a waAAa.nty deed Aeconded in the 04gice o6 the County RegisteA oS Deed6a6 Document No. 1/'ZDyl f ; and that I (We) ptesent y own the pto po.d ed .site 4o t the b ewage digs pod .6yy6em (on 1 (we) have obtained an ea,sement, to nun with the above de~schibed pnopehty, 4on the conStAucti.on o6 .6a1,d syAtem, and the dame has been duty teconded in the 04jice o6 the County Regi6teA ob Deeds, " Document No. J, SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED z H a ST C- 105 r' r . a SEPTIC TANK MAINTENANCE AGREEMENT • o St. Croix County z OWNER/BUYER H ROUTE/BOX NUMBER R741 Fire Number .CITY/STATE 7 yU`~ ZIP J 70 PROPERTY LOCATION:5.~e- 'f /1W' Section T -?o N, R ZO W, Town of Sr 70-rje, St. Croix County, eSA 3,2? Core 3 Subdivision 1/I(• A Lot number I~ Improper use and maintenance of your septic system could result in v 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. H 0 I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x thestandards set forth, herein, as set by the Wisconsin Depart- ro ment of Natural Resources. Certification form must be completed U1 and returned to the St. Croix County Zoning Office within 30 days y of the three year expiration date. SIGNED ~e~el- DATE 1Z St. Croix County Zoning Office H4MESITESEPTIC PLUMBING CO. P.O. Box 98, RT. 3O'NI:IL RD., HUDSON, WIS. 54016 ROBERT ULBRICH4 Hammond, WI 54 015 WIS. MASTER PLUMBER LiC. NO, 3307 M.P.R.S. 715-796-2239 or 715-425-8363 AHNN. INMALLER & DESIGNER LIC. NO. 0066'i Sign, date and return to above address. The fine homes you are about to see bring you the Your Contemp r finer things in housing - things like style, beauty and-thanks to modern technology-homes you Designed Ho s can live with on a budget. Each and every idea that went into these homes was selected to give you bonus features that you always associate with Good Invest nt... more costly custom homes. You'll find homes with a flair-a home that is distinctively you and your y family. J; E~;~;Bnt As you study the plans, you'll note the entrance foyers, the room arrangements that eliminate un- wanted traffic through major rooms.. . more than • Great ROOM adequate bathroom space and ample storage. If you've been home shopping recently you'll recog- COncepts nize these features as belonging to more costly ~t homes. ~Solar Today's homes are in the process of startling and "ry' ~eS%g~s fresh changes, not only in designs but also in func- tion. Modern families are increasingly relying on The designs in this book have been chosen from the home to provide multi-functional centers for j many designed by nationally recognized architect, increased family use and enjoyment. These few John D. Bloodgood A.I.A. National Plan Service ideas illustrate how your home can provide privacy takes pride in presenting them to you. and study centers your own "room concepts" can be developed for the plan you choose. ~A house designed by an architect gives you the benefit of his many talents good layout, Study the designs carefully, select one you be- esthetics, and good dollar value. lieve will fill your needs. 4 ji Our Cover Design design 3 JB-7833 I I ~J - Y/ ` 24x 24 sitting ar 2 Br a Family? 9x 11 12x12 10-6x14 _16x16-6 ^w Lo - K pining 10x21; 14 -6ix13-6 M ~tl dn PMT u r W ri Entry 22x15-6 - - Garage 25x 22 SECOND FLOOR fl FIRST FLOOR Living Area 2,620 Sq. Ft. National Plan Service, Inc., Elmhurst, 111. 60126-Printed in U.S.A. F• ~/o FiPO ST WI. WX_ TES r- 40007,",r 300 OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY! c DIVISION LABOR AN 0. BOX 76 HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 ' (H63.09(1) & Chapter 145.045) .3t7GG3 LOCATIO SECTION: TOWNSHIPt~~Y: LOT NO.:BLK. NO.: SUBDIVISION NAME: SF 1/ 1/ 27 /T30N/RzoE(o sr Tas~p 3 ly COUNTY: OWNER'S BJ*Ef 's NAME: MAILING ADDRESS: 5T• eAW X lf6&AA- P 64 Ut vTVi2E P3 - / w 3 S S1 ' 36.f 1/ 5S6pZ USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PER O ATION TESTS: Residence 3 New ❑ Replace 12 Z"4 . RATING: S= Site suitable for system U= Site unsuitable for system 5O C-5 y, CONVENTIONAL: MOUND: IN-GROUND PRESSURE: SYSTEM-IN-11LLHOLDING TALNK: RELCOMMEND/E'D SYSTEM: (optional) Qs ❑U ®s E QS Du IDS CCU 0 s E1U co vpirw e-t4- If Percolation Tests are NOT required DESIGNLRATE: I If any portion of the tested area is in the ~j under s.H63.09(5)(b), indicat( : GG~I SS Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS a BORING TOTAL DEPTH TO GROUNDWATER-IN& CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH W ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) p e.. ~e- 1~a. es B- 2 6 .3 r 99 s3 ' Q • .2. /S) /,D ' 040 EKG S " acs &U -2 IC4- R jk I? N . cs o ' • 5,,, 0,0. -16-. G-,e p > ?0 C s, .2, 6 o.-190. • s dW . 3N CS os 7 1 B- PERCOLATION TESTS EUE DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD PER INCH ~v ~v N l iT v le L_ n__AA2AS' P-- 6 M r-- ri S is I-S I _'t At r" F-I 11 Hire - OR- 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 borings and the direction and percent of land slope. 9yS0 = 8° SYSTEM ELEATION ' Fill, ( l i _ 30 m 1 -l i 3 IN E t ~ [ € % ~ ? i I Lip r ; ''•I , F = E ~ E I 4 J/C IV. 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 COMPLETEDRN/ HOMESITE SEPTIC PLUMBING CO. ~QG 3 - / 7 dr Y ADDRESS: CERTIFICATION NUMBER: PHONE NU ~%(optional): ROBERT ULBRICI~i /7lOb Z 3 Q®f/O 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 - m . - M 13 - 6395 . s ALL 7. 10 THE i s Tl Description: . From the northeast corner of Gov. Lot 29 Section 27, T 30 No R 20 W, St. Croix County, Wisconsin go 1247.83 feet west and 827.02 feet south to point of bgginning for parcel *.to. be herein de- scribed; trienoe S 85 140 E a distance of 33.00 feet; thence N 260 56' E a distance of 90.30 feet to the south side of a road easement; thence with sane S 880 09' E a distance of 524.30 feet to the west r&ght-of-way line of S.T.H. V. u•. 64; thonce with same S 32, 56' W a distance of 684.00 feet to thg south line of Gov. Lot 2; thence with r o same N 86 54' W a distance of 545.30 feet; thence p N 46° 25' E a distance of 257.10 feet; thence m N 490 25' E a distance of 9o.00 feet; thence b N 240 37' E a distance of 127.00 feet; thence, ~ N 40 461E a distance of 133.00 foot to b M LOT / o the point cf beginning , 2. /S A. °o Pf of oe inrliri9 82702 Soufy 44 /d47 a3' ~C34,v;ONF Gorr7tr 7. - ~ 't's•.3, of Gov. Lof Z., Scc..2T, T30N, .Tr)CIi•Ga4e s iron f'i Pe ~~`-'z--° W. I .5*ake, 2,q S @S•/y'E dt4mefer ,,f• /O -y.~ 33.00 I -ro 0 y, L OT 12 S. Li~7e Gov. Lai ,2 c 4' 0 LOT 4 N I 41 s0 d 0 I Certification: LOT 3 h I hereby certify 22 • - s / 8 A h W that I have surveyed and divided the lands shown hereon; that the above do- r 1. scrition is ~ true and correct 6 % qt "I o p e description or said lands; and '7P, .o • o N that r have complied with all the pro- %t`* o PC visions of Wis. Chap. 236.34 of Wisconsin Statutes in surveying, dividing, and mapping said lands. ./'dames R. Grubb Rei Land atedtFeb. 2 9 1Surveyor S-722 Surveyed for Howard LsVenture D Fab., 1975 9?5 nty Vol 1 Page 1!~!a Mt! R: miGRUBB Certified urvev R" " f 3 ~ ~eoPas~v WC/1 • • /ouo ~,l / 1g o RA's ' 5e991--ec, 7- V I r ~ ~ o~;v~w y. ~ of 101 ~I 1` I ~ I I • v I ~ 0 w I ~ I I i I ~3 ~a: IAc~a`Nr ' I w--► , 55,x30 Top O ~ sE ' ~Ij nor ~o A 150 ' Fresh Air Inlets And Observation Pipe O 0. 11 Approved Vent Cap 000 Minimum 12 Above RE Final Grade f,'viS/46 f~i! ~;A4UA" O l~~ 4" C a st I r on 40 " Above Pipe Vent Pipe -fo Final Grade Synthetic Covering min. 2" Aggregate Over Pipe Distribution Tee pipe _ 700- 0 0 0 , M 6 r o " Aggregate Beneath Pipe 0 Perforated Pipe Below ~~/Z SYS7~ ~~o Coupling Terminating At ~dN Bottom Of System t A qq- L