Loading...
HomeMy WebLinkAbout034-1050-70-000 n y O n cn O E 0 C7 r_ F c o o m o M :I Z v c (D3 d m N r - 2 Z O V (n N O O• 0 (0 031 C CD CO d C C CL N? 00 3 (0 0 0 m o iv cl tz c- Z d N N V S CD p ,C:~ L co =lCD 6 Co CD 3 N n fll N N 0 N O v CD M CD CD n :3 n N N 'O O CD o 3 O O CL :E O ff" 7 N w N N C.D+ D O O (1) 0 N C co y c N ~ !r (D CD - F CD (a CD N a 0, (0 7 N M O 7 N W S CD 7 W O a0 D ~O o rn rn o' CD j m rn p s "Nft* i ~ 3 CD to OZ CO CO ON , O C N CD (fl O O CP ' C . a' * .:6 Z * IV 'D UT : ET J'E fn N fn < p ID Vl fA V1 N (D CD tT m v g J CND 1, p CAD ; .fir N O A N O CD L N) U) CD N W - y 2) D N CD A 7 rr fl. `v O I Z Z Z Z 2 2 D D o O O Q O~ m D D !mil :3 5r :3 0 CD ~ m o c w m m ~ z CD CD -1 C/) o :3 A Z o A O Z Cv G7 7 M N N W CD W CD M OD CL a z 0 3 o cn o m o CC N z CD U1 A < N ~ w O7 CD o -o am D = D 3 o ° ci m n CD Q o a cmt o -n m c -I m c m v Z d z ~c N O O O CU ~ m V CD N CD N D- 0 1 CD 3 p0 CD CD m s cn m 3 O S v o- a o cn CD ti n 3 ti o- ~ m o o a =r A ti 0 o 0 b CCDD N All v 00 va O 4 O p0 i. °o a a 'd N ~ N' 4- O, O U) ` 41 +41 `n W x p~ O rn r4 N O E-i H 00 ~ I 0 I Q O W 1 ra I ,0 41 6 U H cn U F..~ r r` N N O CO R"+ q i - ifl W G H i 4-3 ro o 3 E-a PM on ' N r4 6 ; - O Pa v aj 0 w~' 3 00'0 00'0 00'0 le)ol soBjeya )uenbullea soBaeya leloadg s)uawssessV leloadg )unowV AJOBa)ea epoa leloadg jasn :sleiaadS ZO£ 43)ee :a)ea uoneo!;lpaa L :)unoa wlela :IIpaao AJallol 0 0 000'0 pUelpooM O9E'Z£L 009'L LL 09L'17L 000'017 A:podoJd IeUauaD :SOOZ Jo; sle)ol 0 0 000'0 pUelpooM OSL`LEL 009'LLL 09614 000'017 Apadoad leJauaE) :9002 ao; sle)ol ON 09 L'LZ L 009`L L L 099'6 OOO"Z LO H3H10 ON OM 0 OOL 0007 99 a3dOl3A3aNn ON 009'17 0 009`17 000'9£ 17O l"niinoiHov u0sea21 a)e)g le)ol anoidwl PUB-1 saaoy ssela uoI)dliosea 9002/17L/170 :pa6ueya )se-1 :suOljenleA )uawssessy enleA ash :y)lnn possessv :enlBA WPM Jle=l 11M Abdwwns 900z 96E/LOL L66 L/EZ/LO am L L L/8£Z L L66 L/EZ/LO OO Z L L/8£Z L L66 L/EZ/LO odAl 86ed/10A # ooa 0)ea :tio}slH Iaoaed :sa)oN M9 L-N6Z-ZZ (17/L 09L 17/L 017 bud]-unnl-oaS) :(s);oeal :Bple opuoapioola EB/17EE L-in-Z3 3S 3S 4017MS LH N6Z1 ZZ 03S 31OV11 dA`d lON-V/N :)eld 000'017 :s0ioy :uol)dl.iosea le6a-i XIM OOL L dS I.11O GOOMN3-19 96[Z OS 3AV H108 880E uol)dla3sa0 #;sla 0dAl tiewud :(se)sseippy A;jadoJd leioedS = dS IooUoS = OS :s;owsla LZ0179 IM NOS11M 3Ad H108 890E 1d 13 aH`dMOH `lH`dallJi - O 1Hda11>1 lb' 13 aRJvMOH jaumo-oo;uaiino = 0 'jaumo luajjno = p :(s)iaumo :ssaippv xel 0 00 odAl;lwJad #;IwJad # uoI)eollddV eeiV soleg # deW 0480 leolJo)sIH a)e(3 u0I)eaJ3 NISNOOSIM '.llNnoo XI02iO '1S X )uenna a13130NlHdS 30 NMOl -17£0 Z9E'2V6Z'ZZ 103Jed -41V 6 d0 L 39Vd Ad 09: 900Z/ZZ/60 000-01-050VVC0 laaaed 1 ornO' oa>O.I 3 n CD 0 of c ~ :e 0 fD,• (D CD M 1 39 m m 1 ~ 3 1 ~ 3 3 0 n v m Vyi O m d O O o Z m co a a s H m c- H ? 20 con r~., I CD oWi u00i N 3 1 co m o f CL C4 CL 0 a" a' CD CD 0 N O RO1 O O r CD CD CDn.. N y N Oo$ O K 3 3 N Cal O O m CD J O O Q 'NyY A ~ d a v O `r3 to N ID ° co m w a o m N co a O y o00 CD I~ S m co 0 rn rn o O < o 5D D co co 0 r. CA CD CO CD, m m o l y rn co N c 3 M O O O O O O o 01 CD.. o 0 3 Co~C~I c 3 ~vi~ j v Q o CD p p 1 p T v o o m m y ? CD-4 i N CL CD 3 z z= z z= N a D D o D D a 0 a o• O h • cc CD CD m CD I CD ~ I CD ~ c E I w ~ I m CL 3 z CD -4 W O = in A Z CD m A O 0 I ~ 1 CL c. z c B a fv o m 0 N z ;o CD D N ~ ~ N I I m T O a Q C j C0 N Q CD . O CC O C x CA al, o S f~ O G 7> (D CL (D O G .O-. O O O C N O N N N 7 CD - w m z a z a CL m a) ? -4 m --4 N F5 CO N CD S 0 CA y d N 'O S m 3 o o m fD '~7 CD C CD 3 cno ~a v A O) C) CD 3. 3 to S X, S O (OD S 0 Cc U) U) M CD CO O S =r CD p'-°vo O dC ?3 CD A T O y CD CD to =r M CD E o Co CD o Vv C, CD CD x' O p X 3 N r. 7 O I CD O 01 Cc tr S h A O o 0 b 0 I C CD CD o lV ti 69 O ~o En O I o o b po CD CD a o ti ~n a !O~ n p3j N N vNi z N 7'i Cl) 'N `C f:• y girl CD o o w co co~ cow N CL 3 O d y a W Q ISM; D_ ~NCID CID o O Ln 3 0 to w :3 °o p y (D co o cn C D a N cnn ur d p CD W s 3 a y r. CL o CAI m to co o N I 3 tr Oz O -C`O1 O o, t~Ql CD 4~ 0 ca (A ca 10 R~ :3 ~c? -4 w V v o C) ;3 (D Q (D I o I D D o O CD cc • v OIQ I ~ w a 3 I ° m ~ I A Z n A z o Y~ (n -1 N W T M N N ID ID z d C C m o y z C N O O C1 D _ o. a O a a v 3 o °i m c y' v. Z CI o a w CD = N L CD i O a ~X m 7 O (a 7 C ~ N 4t o x 7 cn N O 0 I ~ a A 3 w CD 40 W CD O N CD o Parcel 034-1050-70-000 09/15/2006 05:09 PM PAGE 1 OF 1 Alt. Parcel 22.29.15.352 034 - TOWN OF SPRINGFIELD Current ,X,' 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 - KILDAHL, HOWARD ET AL HOWARD ET AL KILDAHL 3088 80TH AVE WILSON WI 54027 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description 3088 80TH AVE SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 22 T29N R1 5W 40A SE SE EZ-UT-1334/33 Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 22-29N-15W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1238/112 QC 07/23/1997 1238/111 WD 07/23/1997 707/398 2006 SUMMARY Bill M Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 04/14/2006 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 36.000 4,500 0 4,500 NO UNDEVELOPED G5 2.000 100 0 100 NO OTHER G7 2.000 9,550 117,600 127,150 NO Totals for 2006: General Property 40.000 14,150 117,600 131,750 Woodland 0.000 0 0 Totals for 2005: General Property 40.000 14,750 117,600 132,350 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 302 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ti z ' REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM San.i.tany Penm.~~ 2L State Septic 1,2_ f--4 NAME zz -row nahip , S~. Cno.ix County Locat.iox Section SEPTIC TANK Sizega.2.ionb. Numbers o5 Compantment.b 7 t. 12$ on gneazeA 6 tope bt ViAtance FAOm: WetL ? Bu.ied.ing it. Wet.Landb Sat. I H.ighwazeA it. DISPOSAL SYSTEM D.iaxance FAom: Wett i#. 12$ o% lgneateA 6tope 6.t. Bu.i.Ld.ing i td.s Ft. Highwait. FIELD DIMENSIONS: Width o6 tten ch it. Depth o j Ao ck b etow t.i.ie in. Length o6 each Zine it. Depth o6 Aock oveA Cite in. NumbeA- o6 tines Depth o6 t.ite below grade in. Tota.L .Eeng.th o6 tines _6t. Stope of txench in pen 100 it. D.i.aatance between .2.ine.6_J.t. Depth to bed-!cock it. To.tat aba oAbt.ion area 6t2 Depth to gxoundwateA ~ . Requ.iAed aAea it2 Type o6 CoveA: Paper oA Straw PIT DIMENSIONS: i NumbeA o6 p.it.b GAavet around pits yes no OutA ide d.iameteA it. Depth below .inlet It. 2 Totat abaonbt.ion area it A AAea equkAed it2 rn ITLE INSPECTED By N Z4_c"T r , (,~,41,- T , APPROVED DATE % 19 7 REJECTED DATE 197 r I i State and County State Permit # PLB 67 • Permit Application County Per ' # for Private Domestic Sewage Systems County 2 *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # / s A. OWNER OF PROPERTY Mailing Address: R P, -f / ~ u j Pt / W", /u B. LOCATION: E Y4 Section T V, R_ZS{--{ate W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family X Duplex No. of Bedrooms No. of Persons_ ~Q- g i SEPTIC TANK CAPACITY Total gallons No. of tanks HOLDING TANK CAPACITY X.S© `9 Total gallons No. of tanks Prefab concrete Poured-in-Place Steel Fiberglass Other (specify) New Installation Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate Total Absorb Area sq. ft. New Replacement_TAlternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed: Length Width Depth Tile depth (top) No. of Lines Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land Distance from critical slope WATER SUPPLY: Private b91 Joint ❑ Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than present owner: I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Certified Soil Tster NAME R © .h V j 8 rec~~ C.S.T. # and other information obtained from (owner/builder). Plumber's Signature MP/ ~~r9~~ Phone Plumber's Address 4 a-s~ zu c eryyclr~s ' PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca- tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors property. If well has not been drilled please indicate. 15oa Lalln.u 'HA.1K ' a E t'STi ji r Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application Fees Paid: State County,/-,-)4, Dat Permit Issued/$z#z;wd (Ate) l Issuing Agent Na Inspection YesNo State Valid# Date Recd 1. county (whi a copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 4. plumber (canary copy) Revised Date 7/1/78 EH 115 Rev. 9/78 AccE,sS Nor- REPORT ON SOIL BORINGS AND PERCOLATION TESTS /,v 1,4 7- 806 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES L^N/p AQQE'S /+S PA BOX 309, MADISON, WISCONSIN 53701 B' KEf/FE Awl i LOCATION: ~E%, Section 22 T '?N,R.6_E (or) W, Township or Municipality S S Poe IN 6-Ft eL D Lot No. , Block No. & 0 tlhGaEf County X Owner's/Buyers Name:- CAW & L/N~Jiv Subdivision Name County x Mailing Address:_Tr'u,/lso/y &vls• S'/01.7 TYPE OF OCCUPANCY: Residence X No. of Bedrooms Z COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW x REPLACEMENT ALTERNATE SYSTEM OTHER DATES OBSERVATI MADE: SOIL BORINGS SE/~T /G I~ 21 PERCOLATION TESTS NOT 4?V1!11F1'4c,4> SOIL MAP SHEET NAME OF SOIL MAP UNIT AM / ` Z PERCOLATION TESTS Amen y- CA0014 we// TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTE INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- 0 r 2%k 6 '60er D E remrA ED 0 is / &,f ivl- SU P- S/l IaW to,v a L tAT v i D P- (VoiTEOle occ~ i 10' AC PA E M. P- - V to Svi lAff o P_ SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES B- / S NONE I Qy " Av-& . 41- 0 7 ' xE>,jj iP. S/ B- O AJAME 2.G " i/ /0"SC / w f. f. 'I? M^ "S/ B- 3 MOVE to 3°/QN. L "6 5 " AR / W CoM. (2 . MO +S ,90 B- SO NONE 19 B-.f o E /O Au /-,17"6Y. C Wig, MAN ROM. No+S 3T' R• S/ . e- (0 60 1 /DAVE Z 3? VI "AV c j/ G 51'4 7-4 w -d Mott) 1" ~P s PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the I tion an square feet of suitable areas Indicate number of square feet of absorption area needed for building type and occupancy ;00641:~ )011 Indicate scale or distances.r Give horizontal and vertical reference points. Indicate slope. T 7~d Sc~1/E. v/SriWcES /1'GG v/P09T'E. P/ r, /0 = /,f - o /oiAUECo o S/opE NR A 40 a 13- E ~~r~ri~ ~~s r of L iivpSTiP _ _.r vi,p t ~4 AARM tee qr- e E E e e 1, the undersigend, 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 location of test holes are correct to the best of my knowledge and belief. Name (print) k bEnr ?114 c hT / Certification No. S3 * 02.yf'2" Address O W &A. l0.So N W iS Name of installer if known v CEO /Q LM • OE V7,4 MOWIA-IeE Copy A -Local Authority CST Signature Z,ceAf 66, - AGREENIEIN 1' This agreement, made and entered on this 22 '1~'( day of 19by W; Loa. and between the Township of f 1;% L P. ddress ELV: hEREF S: E n application has been made for a sanitation system on the following described property: Vw EREAS: Septic tank drainage does not meet the minimum standards of the ordinance of St. Croix County and state codes. SlaEREAS: The owner agrees to install a holding tank for septic tank purposes purposes. NC.V::, THEREFORE: For and in consideration of the issuance by the Town- ship of of a permit for the above premises, the parties do hereby agree and bind themselves as follows: 1. Owner agrees that they will conform to all the rules and regulations pertaining to a holding tank system. They agree that anytime said township deems it necessary to pump out said tank, the owners shall have same pumped out in 24 hours, or township will have said work doneand charged to owners and place same on their tax bill as a special charge. 2. The Township reserves the right to assess a bond if they desire to cover any possible pumping charge in the sum of $a6. IT IS UNDERSTOOD that this agreement shall be binding on the owners, their heirs and assigns. IN VITNESS WEEREOF, the parties have hereunto set their hands and seals the day and year first above written. Township of,/ cy%~ by Developer or owner_ STATE OF, v,ISCONS N) SS: COUNTY CF ST. CROX) t~ Subscribed and sworn to before me this day of Qr" 1~ 19~. . 79' 0 536 St. Cro' County 1 _ C~+ _n u Ado 4o jc.# ' eqj Ali y+ao} la 1- SUO!4!puOa 04 s G;AOUddq Ida© A- -t U01 G40-d ~r~~ t li, 1,,upoda® A 9] q;IDSH 10 maino }o uol;gas aq~ Ra ua has Pua ,Nil f. t ;.,7_.~..,._. _ w 111 ~ { f \V/ K i `1 7905361 ST. CR01' COUNTY f 796-2239 I #t~ Co.3:t. 046 j ice Sox 22.7 s = Hammond, WI 54U15 0 w N E R P U M P E R A G R E E M E N T PLEASE BE ADVISED, rha:t' unt.it you axe aga.iff noti4Ued I w.itZ conxac wtrc - 4 Wi,6c0n-6kn, (Pumpex), Got the purpose o6 %emoving a.Lk'wa.6te Jn-orr, the .6anita,ky .6y.6tem to be .located on the property and jutuxe home .6 ite vCC located in St. C,%oix County, Wi.6 conz in, Town.6h.ip of s° „ t F be-.ng in the ,7L % on the of Sec.,~, T-~~N•-R.~w. (0n mo Ice 6utZy ded cntibed as S otZow.6 : ) Dated th.i•b_ day ol,zt 197 I (OWNER) f State of Wizcon-6in1 County of St. Cxo.ixl_ Pex.6onnattyappeaxe e~oxe xh,is day of ' . 19 7 the above named ~ru~ co~ to me d.nown to b.e tke pex4on who execute the oxegoing instnument and acknowZedged the 6a.me. otaxy u .cc, oun y, My Comm. (.i.6 pexmari4.t) (Expired) ~neinbe jone xe e -red to as Pumpex, fo.in in the bove ag ee,ient to the extent that I have a contnact with Ownex a.6 above scat d. (it d 9 10 ~~f s REcElV off ~lbee1%)Se n 4 E o.~ Pre to NoY a r ~p f` ~y rYl aL Ti`vS s..x " ~J ~A ~w oNCi P 6 e D,i ev e c e 'r - -Z:7 ~ l w r 9 , ` es-~ jj sT.a64- hi h r yV ~ { 2j ~r % c y~ KI h v~d epl -v -17 OC*44 197,9 `til `a sit 4 Attrrs a J W1 IWO W1, Vol? 'Pion 14"o #14at to" *0 79-05361 Rr t ~ 1L~ Al ~ 1 „~f0 ~r1 l~s . _ " tot 11**"*- Tral lssr" 1 / _ U hlp ,qf s i laIft+atd,; St, Gr*lx-_ !r+t1P. VlsMh$io nestan Gif p1 1oo plans and "Osl fteatt for r4wrapm,10"d aooplo=od. J_ws, l r~1 It1+: Chapter _MsVlseoavisla St44"g snd ~ap~rr it 62 illa fa, , t31r fid ds, pla*l pig #~d_ acpa+al #1+ Otl s' ar+s s"ro " s ue t" . *aw; wm* rfth tht bt l pt[pU14061". t.: ur ratrlswar of th• holdia tomk puo b"rot, 4111io~ awtI'mat ii !br st t tt , ab t1 ~h►~ 1T Mar i f, t` t 011riitrtts y0 . WOOS. t4 k- 6411 ho g4to 11~ ~ 4"spooi likio, 44 *alsr '"t tow M is. lb ~1 soa to strul w hods. 7116 4001141 test. , r0i"10i# ,440to"'r r ~t~ 1 r, Ow"r or St r ad, sartraat,o~ sAalt "i p opt the anrat#tlrsttQ sttAi a" "t of papm b" i#4 the *taw of spMrews l of 04 dbooiaiw;. 1n the 'ovmt tno tstiotIan of tht 04*1 t tip or s""O ha, not ssd with In two T o rs fine We , ~ t~_ aPp r~l ~►l 1 hoops and -norr app11 sa# 1 an soa11 A64 +~le r 4 rN~s p 1ne~s bsOM 1 _ s t J t A i 4v; F {.'1 l~ b S,l ~ { ~ j,l~r " s~ t~'Yd ~r~~i~ ~fF~~ ~R?~ ~ vk'~F ~ ~ e•• K :n asm .eta .4`; "IG ~J .'~„~j4~~S~' i~ ( ~~4~~1 `f~ r~r fat 110 W-11 13 oa ifo pi, ti*IT rkn I y 4 ' ~ f. k 2''s "fi4tCJ a . , e # itw:~~r Sd ~n lo an i yin i ciset da ~,4t i sty n i ark :z # fi ~a~ r,'~ 1ar~b: t~ Z ea t ..ilk i ` ~ 't 4 k#.3 tt~ it« b'k G~: s k l '>t 20 ,ai'rIr,t~ ,tea" ;w+r;t3iniui+► -Oo I ~W i ter &f 3 + °n n I b i usfl J,O' WD i - t # ~~v~ ~z~ ~ttr~a ~t►~ ~t~~s ~n~ ~ i~'~as~~ ~i~s~ *3~ ~f #~sa~u~~ ~ ~ ~ 14 a .acs b z i ~ ~ b i ~r~ik4as € firta 4xa:o ~ Ibb; 'Mao tip.~ef~~~~[ti 1:7a! ir~z~-[~ osET ...F ? foa ood 6.1 a 'ffi~;.gn . I T'O & 3ar~ ti °i o n i derv i savtq.; oft ao'r$ p ill `s3aya n 4 . T tm..:) a'e' 't Iocf4 t vi q~r Irk . ~ ry a i At I' Z- t~-av t`wl o1 -13 1 u s s oa -ton 0-1,01ew i :air, ~a # s'.' 4 1 jtt,7i2~kG ^~cr abmpt !54 11 -tit 1.1f,3;Iqcjz a t r. - Fh - • _ 46 ~~a~trtie! ` OCtab+rrvE6 ? #A. srir t#+ 'Rtes , r+ rt ; the at, it, +►f' mftl"% `mss nab 1w14 E,beTf f liEs sr aeyr Safi is ij pk&n J►e► 40 E#i is s 1~m e~rt~r to . s eEE aat f' wears #l~ t r ~ s t~rwc i on or any 4OM90 that ftyr -result iii o #r `MCta t is tion + tests r+n is ; ta, ordiltr ° . err s~dt l slI d i# ttaas airEsa amt fir, tt+ s, slit#~r P 1 Is ba"if ',ad Ga* i : It shrE ba r ream tt +ascessairy toe in ful`#11 I 411i per t ~q # f'-..of the a E tyt,~ ~rti i hays,- -tawnsh E~ air rte Epr- -4 ~ is _ #oa rl IaR~aa s` to be rt d. I {urrr►`, +*ta#o- lased ptr l s wE ? I amt i"t ty Vol it o wwp taxeos. -rat _ r IEE~rE~+tn ~t i"th , r. Sol" M16f: iratafriof a3 ~i~t~ta~tfe+t .gyr~tama ~ a ~ tiaa~ort - ~ d #orsnsar►, : Oigt - Ol s# r a t - U c rams vur-, #srnE d C, 1&6 *r. Zon l #AWfj E at ►tor, x rAimatyr . r } -?ere ~ rt < i3t✓"3191•,~fy~;t4 . # Eta. roe :ray! 4Yso1a OIL $i5 no # #*44 R i1 , Orr, iri-Sxc, '.~c~1~3i~~,~`-,~ ~';t~~~+:.-~~s~~:~~,~.~c#-t•`~t~ ~cr,~ r1cx3:~~~Is~~,;~sa~ ~~~'~~.7r, "f -jet aw•i lo, fo(p tlsl Ad 4 f tfi16 cl46 il0 } 3•ig~sY~~ ~s~?~' ~ f i~ iu~. ~,fi~" ~#a; -mod t tc.:rtx 3 i ;,€~a~ #~~r~~t fv { 1 Id ~ IQ f Iw C6 3 x30 ~c# z~ -q' # g +#s~ f♦ i to e # x= ...Et 'I •-ta Iov ~ c i lowuy J:v ~i 'f4;No`S t~~9RtE~~~~vVt3"l~~i"R r *t s0?, t in y {ryra1ff; `iiryitt {-6v, tr t4 c ~'t j Vht ~1 I ao [ l M f 77 ~ ~ W ~ t ` `4 t ~fi3iks:! 47 1, 4 Form-STC- 104 AS BUILT SANITARY SYSTEM REPORT TOWNSHIP r. 111'n T OWNER ? N-R ADDRESS ST. CROIX COUNTY, WISCONSIN W~_ SUBDIVISION 141A ---LOT LOT SIZt PLAN VIEW Distances and dimensions to meet requirements of 11HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM C91 ~~M tYvK OVu"l~ J~~INS Cr%O i Vv 4 INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: Proposed slope at site: SEPTIC TANK: Manufacturer: Liquid Capacity: Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front,O Side,O Rear, O feet -From nearest property line Front,0 Side,O Rear, O feet Number of feet from: well , building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) /1 TTT'T TTr1TT[T [.TTT PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet 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: Width: Lenith: Number of Lines: Area Built: Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, O Rear,O Ft. Number of feet from well: 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 Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: / l1W05r er1r &reh5l Capacity: 3 Q~ _ Number of rings used: Elevation of bottom of tank: cl~_ Elevation of inlet: 29, - g Number of feet from nearest property line: Front, O Side,~Rear, OFt./A Number of feet from well: 7 Number of feet from building: / Number of feet from nearest road: C7 Alarm Manufacturer: F Inspector: 42 Dated: ~So Plumber on job: sv License Number: 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOW& HUMAN RELATIONS P.O.O. . BOX 7969 PRIVATE SEWAGE SYSTEMS DIVISION ' MADISON, WI 53707 BUREAU OF PLUMBING ❑CONVENTIONAL ALTERNATIVE State Plan l,D. Nurnber: (lf assigned) Holding Tank ❑ In-Ground Pressure 5dVound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER INSPECTION D Tedd Kildahl Rt. 1 Box 11, Wilson, WI 54027 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELEV SE SE Section 22, T29N-R15W, Town of Sprin field Name of Plumber: ]MP/VPRSW No Cnunty Sanitary Permit Numher. Bennie Hel eson 3215 St, Croix 79187 SEPTIC TANK/HOLDING TANK: 91 1 s LBEDDIN LIO IID APACITY. ANK INLET ELEV TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER $D~ PROVIDED. ❑ PROVIDED-. (/C YES NO YES ❑NO VENT A.VENT HGH WATER dr NUMBER OF ROAD PROPER TWELL NG VENT FESALARM FEET FROAIR T ETNO YES ❑NO NEAREST DOSING CHAMBER: MANUFACTURER BEDDING. LIOUID CAPACITY PUMP MODEL PUMP;SIPHON MANUF ACTUHEH WARNING LABEL LOCKING COVER PROVIDED. PROVIDED. ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERTY WELL BUILDING I VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM NE AIR'"LET' PUMP ON AND OFF) ❑YES ❑NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing DIAMF TEH %IATE RIAL AND MARKING 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 DISTR PIPE SPACI N('. COER INSIDE DIA -PITS LIQUID DIMENSIONS THE NCHFS MAVTEHIAL PIT DEPTH: GR:CdCL DCP -IH FILL DEPTH DIST It PIPE DISTR PIPE DISTR PIPE MATERIAL NO DISTR NUMBER OF PROPERTY WELL B . UILD ING. VENT TO FRESH BELOW PIPES ABOVE COVER El EV INLF F ELEV. END PIPES LINE AIR INL ET: FEET FROM NEAREST ► 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- ❑ YES ❑ NO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEXTURE PEHMANI NT MAHKEHS OBSERVATION WELLS _ ❑YES ❑NO ❑YES ❑NO DEPTH OVER TRENCH BED DEPTH OVFH TRENCH HEU DEPTH OF TOPSOIL S(1DDFD SEEDED MULCHED CENTER EDGES ❑YES. ❑NO ❑YES DNO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BE WIDTH LENGTH NO OF LATERAL SPACING GRAVEL DEPTH BF LOW PIPE FILL DEPTH ABOVE COVER TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DPIPE MANIFOLD MATEHIAL NO DISTR DISTR. PIPE DISTRIB ELEVATION AND UTION PIPE MATEHIAL MMARKING ELEV.ELEVDIAEV. PIPES DIA." DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS 1 [!]YES ❑NO ❑YES ❑NO COMMENTS: PER MANENT MARKERS: JOBSERVATION WELLS. NUMBER OF PROPERTY WELL. BUILDING: FEET FROM LINE: ❑ YES ❑ NO ❑ YES 1:1 NO NEAREST Sketch System on Retain in c file for audit. Reverse Side. SIG AT R ITLE. DILHR SBD 6710 (R. 01/82) wlsconsln APPLICATION FOR SANITARY PERMIT LB 67) OUNTY 11 ILHRIE (P - MIN rUNIFORM SANITARY PERMIT # InOUSTRV, LRBOR 6 HUMRn RELRTIons I I -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8/2x 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROPER Y OWNER MAILING ADDRESS PROPERTY OCATION CITY: i". ~ -sue ~LLAGE: 1/4~/ /4,S-, Tom, N, R E ( W~ Tow NaF LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER TYPE OF BUILDING OR USE SERVED 1 or 2 Family Number of Bedrooms: ❑ Public (Specify): 14 , ,11 THIS PERMIT IS FOR A:~~r~i~ ❑ New System ❑ Tank Replacement ❑ Repair Replacement ❑ Revision ❑ Privy ❑ Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. ❑ Seepage Bed ❑ Seepage Trench ❑ Seepage Pit )~(Holdiny Tank System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ 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 Steel Fiberglass Plastic Septic Tank Capacity Lift Pump Tank/Siphon Chamber Holding Tank capacity , Id Manufacturer: IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure Total #of Prefab. Site Gallons Tanks Concrete Constructed Steel Fiberglass Plastic Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Mii~njuutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): ' A"'> Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber (Prin Signatu / MP/MPRSW No.: Phone Number: Plum per's Address: Name., Designer: 0 U/J= COUNTY/DEPARTMENT USE ONLY Signature of Issuing A ent: Fee: Date: /j/ p/ ❑ Disapproved /71 . In 10. ft (~OCJ ~d i 6 b ❑ Owner Given Initial Ong v Approved Adverse Determination Reason for D' I: Alternate course(s) of Action Available: DILHR-SBD-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber ~ t INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398 To be complete and accurate the permit application must include: 1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in a city, village or town); 2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.) ; 3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks. 4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of square feet to be installed; 5. Complete the section on water supply; 6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi- fication, place your license number in the space provided and sign the permit in the signature block; 7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the permit; 8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation. Failure to comply will void the sanitary permit. 9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable. 10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system, depth of the system, type of system. 11. All revisions to this permit must be approved by the permit issuing authority. 12. A complete plan including a plot plan, drawn to scale or with complete dimensions. 13. Horizontal and vertical elevation reference points that are permanent and clearly shown. 14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s) to system, building sewer and vent observation pipe(s). 15. The permit issuing agent may require a cross section drawing of the effluent disposal system. TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning your system, contact your local code administrator or the Bureau of Plumbing, DILHR, State of Wisconsin. DEPTrrMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, C DIVISION LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 P.O. BOX 76 HUMAN RELATIONS (H63.090) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP UNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: C NTY: OWNER'S MAILING ADDRESS: C c1a0 / l W/DSO USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: P ROFILE DESCRIPTIONS: PERCOLATION TESTS: [ So Residence ❑New Replace RATING: S= Site suitable for system U= Site unsuitable for system ~Q13 L AMe r d- ~i-Gr O.1 s mu TIONQL: MOUND: %U IN-GR❑OUOUND-PRESSURE:SYSTEM-IN-FILLHOLDING T❑ANK:RECOM ENDED SYSTEM: (optional) CONF-iVEN If Percolation Tests are NOT required DESIGN RATE: LF'loodplain, an y portion of the tested area is in the , under s.H63.09(5)(b), indcate: indicate Floodplain elevation: I PROFILE DESCRIPTIONS BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- If -7,-8/ s; 'fS 1. -1 n S ,w.a ors Gy 47'9; B.% F$ ' ` B-~ C)n e_ 00 B- , , • ~ ' ,B / S:/ 7 $•f S:'/ ~r ic/~ arg ..i►~t ~1' "k.1 gc- L ~B-~ / 7. . 7',61 S d r5 . $h / ~yF'[) 0 . A4at B- to '3.0' or o, .7'81 S;/ 1"s ~7' /fit --Uo" Rd 13b SL e PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD I PERIOD 2 PERIOD PER INCH P- P- 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 borings and the direction and percent of land slope. SYSTEM ELEVATION e _I "ol t . E ~ j E i 3 } E I, the undersigned, hereby certify that the soil tests repor e.10" this ' p re*fn by' in accord with the procedures and methods specified in the Wisconsin Admin ative Code, and th he data recorded and the to r n of r $af~t t&R a best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: lslei-f i I vie /V, cd ti I \"'v ADORE , CERTIFICATION NUMBER:PHONE NUMBER (optional): C/ 7 7 T- CST SIG TUBE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. D I LH R-SB D-6395 (R. 02/82) - OVER - Tc urate sail test, your report mus 2. ra,o whether this is 3, commercial use 4-K ON LY 'LL 5 A r° - 6 - E A 3 3 .1 L 11 7, n Tr% -rug iv y7- R ~ 83 -51b~ .e. Hay ~r • 37 Eyl-3 A~l V R,