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HomeMy WebLinkAbout032-1058-95-000 f ~ C 3 d 0 eD _1 3 3 A 0 ~ 1 34 O n d 0 N 0 o ° c0 0)i 0 N W 'c O C?D 3 O c F'D N N 3 w ~ d Z O. C Q) O= CD lA\ co ET - N CL O y y m fD N 90 C 1 c cc) CD co co CD CD al 0 3 > 6 CD 0 N C N! o O o.. 1D v O ~ fD y D. d ° (D W O f0 c a c ° = i Z co 0 o co 00 o n or v (D N ¢ (D y Z O O O lr• FJ- m (D v0' O c ~ 0)~ w 1f 0 w w (D m 3 CO) to to cn cn rt n ~i = o• V O O c m ro ° m a m 03 c: 93 C~ N t~D = y (D O rt m Z a I y' Z CD Z O t-( O D a b rt v CD y • 0 m c I~ F+ O D N N to (D w o a NA OIQ ao n G,` a 3 3 (D gl H H cn o o A Z Cl) . O W Ci7 .1 y C M M `Z 0 F+ :E: i o V H O Pd 0 M H V7 G] ~ ( r D Q' A M W N O O n rt/ o A (D 0 (D rt CA) I a D v a ~ I m a ~ o I 3 ~ c o Z 0 c. 0 i c ~ v FL I A Q a p O V N a °o a, ti 4OPMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715-962-3121 800 - 962 - 5227 I ST. CROIX ZONING REPORT N00 20726/41 PAGE i i ST. CROIX COUNTY REPORT DATE. 4/09/92 COURTHOUSE DATE RECEIVED; 4/08/92 HUDSON, WI 54016 ATTN2 THOMAS C. NELSON OWNERt E ene 6 Angela Baratto v LOCATION: 527-205th ve., omerse+ COLLECTOR*# M. Jenkins DATE COLLECTED: 4-06-92 TIME COLLECTED! 2S00pm SOURCE OF SAMPLE: Kitchen faucet DATE ANALYZED444-08-92 TIME ANALYZED'*2100pm COLIFORM: 0 /104 ml INTERPRETATION: Bacteriologically SAFE NITRATE-N. 2 ppe Above 10 ppm exceeds the recommended Public Drinking (dater Standard. Coliform Bacteria/100 ml Nitrate-Nitrogen► mg/L n c' tflj ~ ~ N . LAB TECHNICIAN: Pam Gane ~y 6 ptyO~,NDEVENA._l ICI Approved Lab No. 19 < Means "LESS THAN" Detectable Level Approved by! ~f ® PROFESSIONAL LABORATORY SERVICES SINCE 1952 ST. CROIX COUNTY ZONING OFFICE l St. Croix County Courthouse ✓ 911 4th Street ` Hudson, WI 54016 Telephone - (715)386-4680 Y~ Th St. Croix County Zoning Office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals. Completion _Qf this form J& essential 5-Q t= tag property can be located. Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning Office, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received. WATER TESTING------ ----------FEE: $ 35.00 xxx (For nitrates and coliform bacteria) WATER TESTING FEE: $185.00 (For VOC'S) SEPTIC SYSTEM INSPECTION FEE:. $25,.00 XXX (Determines if system is properly functioning at,-time of inspection) PROPERTY OWNERS NAME: Eugene L and Angela M Baratto PROP. ADDRESS: 527 - 205th Avenue CITY Somerset Legal Description NE 1/4 of the SW 1/4 of Section 22 , T 31 N-R 19 Town of Lot Number Subdivi??s'lion : 5 d 2,7 FIRE NUMBER 527 LOCK DQ$ NUMBER ~70`- g Color of house Realty sign by house? If so, list PLEASE CALL ANGELA FOR AN APPOINTMENT AT HOME - 715-247-3580 PLEASE INCLUDE, IF AT ALL POSSIBLE, A NAP j.e,COPY OF PLAT BOOR, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER .TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual requesting services: Bank of Somerset Telephone Number 715-247-3348 REPORT TO BE SENT TO: Bank of Somerset - ATTN: Kristen Dixon, P.O. Box 220, 110 Spring Street Somerset, WI 54025 CLOSING DATE: ASAP Signature i/G~'1 PAeT"SOMERSET T.31N-R.I9W 51 RO. 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BL k~ /e Ve17 h?y Ca/n/ e e b S7 R.WI r '4D F U Rr/ene 3 ge/sk Cec7/e a~~ RJ _ N 35 l b k39~ 'B f~~4~0 c bbro~, 3 F f T tl )a Ph Jrf ur 6 0 ° 00 P HY hpf 74 .s ~o l/ar ov~ ~Q S4 C~ AxCLTSase% Sanerset. rya : 'C o 7,e5 ~ Q i W S 4494 CEN ifM Js ,0.?:... q` 6I Qockfo d. / 4ayoPub/s,In~~ SEE PAGE 53 a~ 1 roi+ Gain Wns. 300 400 500 wo 700 800 i j i. I BANK OF SOMERSET LHNDRY j Save With Us - LONDSCOPING Help Build Your Community Black Dirt - Crushed Gravel MEMBER FDIC Driveways - Landscaping SOMERSET, WISCONSIN Phone: 247-3480 Phone: 247-3348 soMexsET ST. CROIX COUNTY WISCONSIN '"p~. ZONING OFFICE 3 ST. CROIX COUNTY COURTHOUSE - 911 FOURTH STREET 0 HUDSON, WI 54016 (715) 386-4680 April 6, 1992 Kristen Dixon Bank of Somerset 110 Spring St. Somerset, WI 54025 Dear Ms. Dixon: An inspection of the septic system on the property of Eugene and Angela Baratto, located at 527 - 205th St., Somerset, WI was conducted on Apr. 6, 1992. At the same time a water sample was obtained for testing. The results of that testing will be sent to you as soon as we receive them back from the laboratory. At the time of inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. Si ceAantZoninag M s Assis Administrator cj Form- S T C - 104 a AS BUILT SANITARY SYSTEM REPORT OWNER E UGS n tl TOWNSHIP _~WkyN~ S SEC. T I N-R I W ADDRESS 5 `Tlo7~a~~n - ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of 11HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM A"/' 9 11!'/c C14 ~v 1 f k m INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: /4*P0 Proposed slope at site: ©rZi SEPTIC TANK: Manufacturer: Liquid Capacity: Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: jp--- Tank Outlet Elevation: Number of feet from nearest Road: Front,n Side o Rear, O feet From nearest property line Front ,O Side,0 Rear, O feet Number of feet from: well , building: (Include this information of the`-above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: pct(i/15 Liquid Capacity: CZ;;F © Pump Model: 3/f Pump/Siphon Manufacturer: Pump Size/ Elevation of inlet: Bottom of tank elevation: Pump off switch elevation:- Gallons per cycle: 7 Alarm Manufacturer: 'I Alarm Switch Type: Number of feet from nearest. property line: Front, OSide, Rear Ft ,r Number of feet from well: N1 Number of feet from building: 4F (Include distances on plot plan). w SOIL ABSORPTION SYSTEM Bed: Trench. Z•~ Width: Len the g , Number of Lines: Z Area Built. -V Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, RRear'oirt Number of feet from well: Number of feet from building : (Include distances on plot plan). SEEPAGE PIT Size: N er of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area B t: Has e' er a drop box O or distribution box O been used on any of the above soil ab rbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings ed: Elevation of bottom of tank: Elevation o inlet: Number feet from nearest property line: Front, O Side, O Rear, OFt. Number of feet from well: Number of feet from building: Number of-feet from nearest road: Alarm Manufacturer: Inspector. Dated: Plumber on job: License Number: 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION MADWBOXON, W WI N~ 63707 BUREAU OF PLUMBING o ICON V E NT I ONA L ALTERNATIVE Stata Plan I.D. Numfter ® Holding Tank ® In-Ground Pressure D Mound (It seal®nad) NAME OF PERMIT HOLDERS ADDRESS OF PERMIT HOLDER. INSPECTION ATE Eugene Baratto 5967 Hobe Lane, White Bear Lake, MN BENCH MARK (Permanent reference Paint) DESCRIBE IF DIFFERENT FROM PLAN.: REF. PT. ELEV., CST REF. PT, ELEV. E SW, Section 22, T31N-R19W, Town of Somerset Name of Plumber: MP/MPRSIN Nn.. Cnu ntv. Sanitary Permit Number: Gary Steel 3254 St. Croix 79220 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV WARNING LABEL LOCKING COVER PROVIDED: PROVIDED : YES ONO OYES ERNO BEDDING: VENT DIA.: VENT MATI HIGH WATER NUMBER OF ROAD: PROPERTY WELL- BUILDING: JVENTTOFRESH IAIARM FEET FROM LINE / AIR INLET DYES NO 4 `f OYES O NEAREST / 7-f ~aC S f j 7 DOSING CHAMBER: MANUFACTURER. JBEDDING- LIQUID CAPACITY PUMP MODEL PUMPS IPHON MANUE ACTURER WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: DYES ONO OYES ONO OYES ONO GALLONS PER CYCLE: PUMP AND CONTHOLS OPERATIONAL. NUMBER OF PHOPERTV WELL BUILDING (DIFFERENCE BETWEEN FEET FROM L'"E JVENTTOFRESH AIR INLET PUMP ON AND OFF) OYES ONO NEAREST--)► SO I L ABSO RPT I ON SYSTEM. Check the so I I mo ist u re at the dept h of pl ow I ng TAMFTEH ]MATERIAL ANDh9ARKmG or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: BED/TRENCH WIDTH. LENGTH NO OF UISTH PIPE SPACI N(, COVER INSIDE DIA zPITS LIQUID S THEHES h1ATEHIA PIT DEPTH DIMENSIONS GEIAVFL DCPII1 FILL DEPTH UISTH PIPF UISTH PIPE DISTR PIPE MATERIAL NO JISTR NUMBER OF PROPERTY WELL. 7;D VENT TO FRESH BELOW PIPES ABOVE COVER EI EV. INOE f ELEVENgv PIPES FEET FROM LINEAIR INLET All) 2 y 2- 7 2 NEAREST► /7,3 17.51 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 O NO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEXTURE PtHMANF NT MARKERS OBSERVATION WELLS _ DYES ONO DYES ONO DEPTH OVER TRENCH BED DEPTH OVER TRENCH BEU DEPTH OF TOPSOIL BODGED JEEDID MULCHED CENTER EDGES DYES. ONO OYES ENO OYES ONO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH NO OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER TRENCHES. DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATE"IAL NO UISTH DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEV.. ELEV. CIA ELEV. PIPES DIA ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING GRILLED COHHE TLV COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS OYES NO OYES ONO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS. 7FFO UMBER OF PROPERTY :BUILDING: EET FROM LINE: 3 r OYES ONO OYES ONEAREST Z Sketch System on 0". '/0 Retain in county file for audit. Reverse Side. oS SIGNATURES. TITLE DILHR SBD 6710 (R. 01/82) - DILHR SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05, Wis. Adm. Code STATE SANITARY PERMIT # ZD A w -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 PROPERTY LOCATION E u- a,n -12_~ 1-,a a 0-0 e-'/450 S -?a T3 N, R / (or) W PROPERTY OWNER'S M LING ADDRESS LOT NUMBER BLOCK N MBER SUBDIVISI N AME S9 G (,C& .nn. N A. CITY, ST TE ZIP CODE PHONE NUMBER CITY NEAREST ROAD, LA E OR LANDMARK VILLAGE : f Ip/1r .J Z9 ❑ SZ TOWN OR II. TYPE OF BUILDING OR USE SERVED: '05d CtJ C01 -~0'~~ Number of Bedrooms if 1 or 2 Family OR ❑ Public (Specify): 111. PURPOSE OF APPLICATION: (Check only one in ##1. Check 2,3 or 4, if applicable) 1. a. XNew b. ❑ Replacement c. ❑ Replacement of d1_1 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) 1. a. ❑ Seepage Bed b. ee a e Trench c. ❑ Seepage Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): Sd 1?41 /9 Feet Private ❑Joint ❑ Public VI. TANK CAPACITY Site in gallons Total of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank ❑ ❑ ❑ ❑ Lift Pump Tank/Si hon Chamber r,/' ~p ❑ ❑ ❑ ❑ ❑ 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' ignature: (No Stamp PofPEMPRSW No.: Business Phone Number: ` ,c ( 3~ S 5' Z 4~6'loZaa p ber's ddress (Street, City, State, Zip C e): AA Name of Designer: 1~ _ca VIII. SOIL TEST INFORMATION Certified iI Tester (CST) Name CST # , - L. &~C, / 2Z~ CST' ADDRESS ( eet, City, State, Zip Code) Phone Number: A AJ, A LOY 19 L (71.3' Zq-4v -4~4100 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuin gent Signature (No Stam S) AA roved Surcharge Fee ~j pp ❑ Owner Given Initial 5 / fdf Adverse Determination / P PaICIC 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 cc„cernin your private sewage''syste n, contact your local code administra'or ol- f:h 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 1c; be installed; li. Type of building or use served: I public is checked, indicate type of use (i.e. 10 unit apartment, 3g seaf 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'/z 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 public debate. The groundwater bill Groundwater included the creation of surcharges (fees) for a number of regulated practices which Wiscor~:n's a can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried treasure 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 r& areas are credited to the groundwater fund adminis- tered by the Department of Natural R}sources. These funds are used for monitoring ground- f water, groundwater contamination in,:estigations and establishment of standards. Groundwate-, it's worth protecting. SBD-6398 (R.03/86) r ~3 APPLICATION FOR SANITARY PERMIT ST C- 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 -11,I 6s'1 .471`D Location of Property 42 14 S~ 1L, Section .7a7 , T / N - R 9 W Township Mailing Address Subdivision Name Lot Number Previous Owner of Property _ d W762 r Total Size of Parcel r,~?S•~ ✓i,NMAI Date Parcel was Created f-2-(6s Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes J No Volume 716_ and Page Number as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 01 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) cati.6y that att statement A on thiA 6onm are tAue to the belt o6 my (our) knoweedge; that 1 (we) am (ane) the owner (a) o6 the pro pen t y dea eh ibed in .th i a injonmati.on 6onm, by viAtue o6 a wavunty deed neeonded in the 066ice of the County RegiA teh o j Deedb " Document No. ~ o ; and that I (we) ptuentty own the pnopoaed a.cte jon the aewage diApo.6at ayatem (on 1 (we) have obtained an eabement, to nun with the above de cAibed pnopeh ty, bon the conatnucti.on of aai,d 6y6tem, and -the acme has been duty recorded in the 066ice o6 the County Reg"ten o6 Deeda, a6 Document No. ) SIGNA RE OF OWNER SIGNATURE CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED H z • H a r STC - 105 r a H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z cy OWNER/BUYER = ((qen e_ Angt l~ 4&1 ra-f-f ® M ROUTE/BOX NUMBER c~ ~0 X y y7 Fire Number, .CITY/STATE '5' 0Mek-S T /.[_)L ZIP yD'z7 ~-W, PROPERTY LOCATION:.~c_;41 SrJ ~4, Section , T31 N, R_L Town of jWerSe , St. Croix County, Subdivision 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 pdt 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 I/WE, the undersigned, have read the above requirements and agree cn to maintain the private sewage disposal system in accordance with x H the standards set forth, herein, as set by the Wisconsin Depart- ro ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Offkce within 30 days of the three year expiration date. SIGNED DATE /7 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. DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY,, 1 DIVISION P.O. BOX 76 LABOR 4ND PERCOLATION TESTS (115) MADISON WI 3707 HUMAN RELATIONS (H63.090) & Chapter 145.045) LOCATION: SECTION: WNSHIP/I%HftCTrXLITY LOT O.: BL O.SUBDIVI ION NAME: or) ]TO Su7r ,`y /4 3 N/R fm COUNTY- I WNER'S UYER-S NAM • MAILING ADDRESS: 147i -,n c -6_26, USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: 1 eplace 86 Residence ? ) ~FJew ❑~R RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: MIS TEM-IN-FILLOLDING TANK: RECOMMENDED SYSTEM:(optional) fAS DU 1-S Ou ❑U SaU IHEIS ISU If Percolation Tests are NOT required DESIGN TE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: Floodplain, cate Floodplain elevation: / PROFILE DESCRIPTIONS C BORING TOTAL D PTH TO GROUNDWATER-INCHES CHARACTER OF OIL W H THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DWg++P4. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- l c0 93 ! g 311 '9'."K B- z U O l~ l~ rl cs~ 1 1dr1.~ , oC n. N.~ d n.S.,L n.G~ B- ,3 00 4 No ,tlOPIJs 1-1 All B- I19 N } 17 /,1. .L;1. 17 V B- j- qqV A)6,& E ;q 1. 1 Z. B- i PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER iNCMS AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH P_ 3 ® 3 S' y sy <3 _4 5 P- 3 - 00 3 % .fit P- 0 3 YA el P- P- P- PLOT T 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. SYSTEM ELEVATION ' 6 F 3 3 E e E i , F3~ t E E , E L, pr r F ~P 7 w_ r (JM'' E r V E I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods c11ri sin 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: ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): 998A). Sha-rte ~v G z 2_$ Z6 :C- Zetk-4e4D CST SIG A E: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - i r INSTRUCTIONS FOR OMPL-IN FORM 115 - SIBD - E_ To 7pl_ to an(.! accurate soil test, yo _t include: 1. Jescription; 2. T' ly indica e -e or commercial project; S. l V `rns c r e it system; :ing boxes. A ,SITE IS SUIT/ LDING TAC""' ONLY IF ALL I - ULED OUT EASED O S( L Eons shown here it is and coi alp tF a plot elan; 7. ately Ic ':i cations. Drawing to sc is preferred, A i-,ire clearly show. - PE 9. C :es as to god plain data, per t 1C 7} t n the appropriate box; l e ~ 'on r, E_= FILED WITH THE x.L Y';' r 4~ s- r ABBREVIATIONS FOR CERTIFIED SOIL TESTERS xtures 3") L s' - r L sr~ - sic Pt H ytr L - * t f T1 T' N rr ! t st Submersible Effluent Performance Curves Pumps METERS "AT MODEL 3885 25- eo SIZE /a' Solids 70 20 WEIGH wEO7H 15 50 WEOW- 40 10 30 2Q _!~~36 0 5 rLL~~ 0 0 0 10 20 30 40 50 80 70 80 90 100 110 120 GPM 0 10 20 30 nPn, CAPACITY C GOULDS PUMPS, INC. se*u► tires PeW WW MM ~TERlf FEET 120 MODEL 3885 35 SIZE 3/4" Solids ,1o rWEsHH NJ I- 100 30 . 90 2S 80 70 20 ,eo 15 50 -T- I 40 10 30 20 5 10 0 0- 0 10 20 30 40 50 80 70 80 90 100 110 120 GPM 0 10 20 30 WO/h CAPACITY *lm Qwjw Pumps. MO. EA~ctlw Juyr low PAGE CF PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS VEMT CAP 4'C.Z. VENT PIPE WEATHER PROOF APPROVED LOCKING . _T JUUCTION BOX MANHOLE COVER 25' FROM DOOR, 12"MIU. WIWDOW OR FRESH AIR IMTAKE. I GRADE ( y" MIU, I , 18" /SKIN. COIJDUIT-- INLET PROVIDE I - AIRTIGHT SEAL i i I I V i (I I APPROVED JOINTS APPROVED JOINT W/G.I. PIPE ( III W/ C.2% PIPE EXTENDING, 3' I II ALARM EXTENDING 3 ONTO SOLID SOIL I I ONTO SOLID SOIL B I 1 t I oN ELEV. FT PUMP OFF D CONCRETE BLOCK RISER EXIT PERMITTED OIJLy IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E SPECIFItATIOUS DOSE. ' TANKS MANUFACTURER: kIUMBER OF DOSES: -PER DAH TAWK SIZE: IQ= GALLOKIS DOSE VOLUME ALARM MMJUFACTUR£R: v1 K ~4I 6 INCLUDING BACKFLOW: GALLONS MODEL MUMBER: [-A CAPACITIES: A= eINCHES OR cc~ cc GALLONS SWITCH TYPE: B=~INCWES OR 9 GALLONS PUMP MANUFACTURER: O c9-w I C =INCHES OR L GALLONS MODEL NUMBER: _.(,~C03 L D- ZA INCHES OR Q?i) GALLONS SWITCH TYPE' NOTE: PUMP AND ALARM ARE TO BE MIIJI MUM DISCHARGE RAIL GPM INSTALLED ON SEPARATE CIRCUITS p VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE..FEET + MIKIIMUM METWORK SUPPLY PRESSURE FCET ♦ FEET OF FORCE MAIN X UaZ oo,,FRICTIOU FACTOR. FEET TOTAL OyWAMIC. 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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 - BARATTO, EUGENE L & ANGELA M EUGENE L & ANGELA M BARATTO 527 205TH AVE SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 527 205TH AVE SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 39.320 Plat: N/A-NOT AVAILABLE SEC 22 T31 N RI 9W NE SW EXC PARCEL 292B Block/Condo Bldg: ASM'T INCLUDES 032-1059-40 295A Tract(s): (Sec-Twn-Rng 401/4 1601/4) 22-31 N-1 9W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 716/94 07/23/1997 715/299 07/23/1997 705/427 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/14/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 60,000 430,100 490,100 NO UNDEVELOPED G5 31.320 62,700 0 62,700 NO PRODUCTIVE FORST LANDS G6 5.000 20,000 0 20,000 NO Totals for 2007: General Property 39.320 142,700 430,100 572,800 Woodland 0.000 0 0 Totals for 2006: General Property 39.320 142,700 430,100 572,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 125 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00