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Home My WebLink About016-1031-70-000 A to 0 3 -0 A r_ 0 :E r fu 0 3 o w x V+ z N cD I 0 p ^Z 0 a O) N 0 O N W O _ rn w N 0 7 S Oa CCD D N O O o n c to r h o o fD w 00o0 0 m m (.n ►-h fD O N p of r v, H H ~l [1 m of 2 D F a o~ C7 f7 N R (7 O rn O. V m fD H• O H nNi ` a c 1 a rt x r o 11 v N) PQ 00 x N N H C cO CO O n r CD o o Cl) 0 ccr w 00 H 3 ti (D In 0 c n W ~~yyN,,,~~ ~ T vy ~ w ~ 3 to to to - U, I-' c a v v cQ N q <o 3 m .''c7 W ~ iD N 0 3 - R. -0 C o N N rT A pj N 7 A u, (`b p z = N , zz z z~ o a O H• ~ N N I oQ ' -I N 70 9i 'zi` r"M4 I ~ c ol z z m .a o p z A o a c z 0 3 A 3 `n N Z O A W S G z c- 1 D O $ 7 j 3 a (D - ID (D c0 U Ru O T 7 y c O 2 ~ ~ ~ Z Q C O ~ ~ 7 = n n 3 x.tn O w < p y O _ ~ N 7c ' Z SQa illQ A r T O O p C a Q M 09 :r 0~<y Qn ~ ev 0' :3 x o a o r, O CD o O ° a ~ v 0 N -a n d 7 .C7 1 O 3 ~ # d O O 0 O (J is T y ~ o N~ c° rn a ~ p r o ~ N 7 (D co 7 ? W N 3 , Q N V CL p U n OD CD (.r Cb c.~ 5 ° o o • 3 N 0 N N Ul p %IWA ~ d m N y rn C D m n t N 0 c' = N a C X C: 0 CD (D N 3 c x Q UP a ^ ti N Z co 00 71 n a O _ O O 3 '9 lv z O O O v n : c N N N w `ice 0 Q v v v t y o ~ m ~ m N o 0 7 CD A N 2 Z N D D 0 O C n n ci ryl~~i c~~jc 0 co c x ~ m L 78 m -j fn y of X ;i ~ A Z O G' ~ CD N _ W A t ~O CL 1 J Z 3 ~ o cn 3 m Z N ~ A N {v n CD G 2 L D 3 1 $ S y CD CD CD S~ CS - CD 0 2 i~ N f2o O C C C 3 n y z 4 c U p N ~ O (1 ~ S U CO 0 • D C < _=r 7 ? ~ j a N O O O F . y CD n CL a) np ,n0 0 CD cD 0 y O Q~o~,o 0 a m 0 g<° r~ ? ~ n1 ~ Q0 o a a 0 CD 7 70',1 N ~ ~ w HI[. Parcel 4: 14.3u. i o.ts5 v i u - I vvviv or- OLtN Vv UUv 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 O,.vner, C = Current Co-Owner O - HOFFMAN, DAVID W & THERESA M DAVID W & THERESA M HOFFMAN 1505 CTY RD X GLENWOOD CITY WI 54013 Districts: SC = School SP = Special Property Address(es): = Primary Type Dist # Description ` 1505 CTY RD X SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 39.000 Plat: N;A-NOT AVAILABLE SEC 14 T30N R15W SW SE 429 PAGE 228 EXC BlocklCondo Bldg: PT TO CO. HWY AS IN 640!218 Tract(s): (Sec-Twn-Rng 401;4 1601;4) 14-30N-15W Notes: Parcel History: Date Doc # Vol/Page Type ,07!23/1997 11951133 WD 2006 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07x26!2006 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 34.000 3,400 0 3,400 NO UNDEVELOPED G5 2.000 200 0 200 NO OTHER G7 3.000 13,500 131,300 144,800 NO Totals for 2006: General Property 39.000 17,100 131,300 148,400 Woodland 0.000 0 0 Totals for 2005: General Property 39.000 17,800 131,300 149,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 150 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 016-1076-10-000 101'0212006 03:20 PM PAGE 1 OF 1 Alt. Parcel 35.30.15.522A 016 - TOWN OF GLENWOOD 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 - HOFFMAN. DAVID W & THERESA M DAVID W & THERESA M HOFFMAN 1505 CTY RD X GLENWOOD CITY WI 54013 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 1505 CTY RD X SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres. 27.570 Plat: N!A-NOT AVAILABLE SEC 35 T30N R15W NE NE EXC P522B AS DESC Block/Condo Bldg: 8091121 AND EXC PT LYING N & S 130TH AVE DESC IN 834;334 & IN WD-1120!315 130TH Tract(s): (Sec-Twn-Rng 40 114 160 1/4) AVE EXC PT TO CSM 1012964 35-30N-15W Notes: Parcel History: Date Doc # Vol/Page Type 12!02;2002 700423 2064i581 QC 07!2311997 1120i315 WD 07!23(1997 834, 334 07!23;1997 809,121 mom... 2006 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/2712006 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 26.570 2,600 0 2,600 NO OTHER G7 1.000 4,500 25,000 29,500 NO Totals for 2006: General Property 27.570 7,100 25,000 32,100 Woodland 0.000 0 0 Totals for 2005: General Property 27.570 7,800 20,000 27,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 016-1051-30-000 10!02;2006 03:20 PM PAGE 1 OF 1 Alt. Parcel 23.30.15.363A 016 - TOWN OF GLENWOOD 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 - HOFFMAN, DAVID W & THERESA M DAVID W & THERESA M HOFFMAN 1505 CTY RD X GLENWOOD CITY WI 54013 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 1505 CTY RD X SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 38.000 Plat: NiA-NOT AVAILABLE SEC 23 T30N R1 5W SW NE EXC P363B 522,434 Block/Condo Bldg: EXC PT TO CO HWY AS IN 640/218 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 23-30N-15W Notes: Parcel History: Date Doc # Vol/Page Type 07i23!1 997 1195/133 WD 07i2311997 522.434 2006 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/26/2006 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 37.000 3,000 0 3.000 NO OTHER G7 1.000 1,000 500 1.500 NO Totals for 2006: General Property 38.000 4,000 500 4.500 Woodland 0.000 0 0 Totals for 2005: General Property 38.000 4,700 500 5,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 p ' 'GLENWOOD T.30N.-R.15W 49 1 _ S SCE P4 G£ 00 rec rr; jl DUNK r COJ.V TYAVC. ~t ~`.j ~•r.. YL- t7 n -~/2B~ /t•~~ ,r~~~ A' i~.l :~:•a ~ _ o a-,. . ..-y .rs•r rL ~ ar.h• ,~ii~y r " .f n r.a/h . s'e-erg EMERAL STA. • Arc, • _ J ` r 1 s~<rs d l ri l P~ 7 E• i H ) 1 H . ~ • v :`y,~ ~r.r,r v ra, . L/Z•B SHY O 000-T !70TH mwf fj :V f I _l irlr•.~ ~ , _ .f'C, G" ~ ~ :.<7 C. 1 L OTC/ L. • F Sr.~~. i - i/.•.y :l " I ,~~<,~C.: V,' _ ~ ~ ~ t63TN _ ~'J • n~ ^e SF rh. U m . l4 J 10 I • 4 ' ~ AVF 'Al t. t; 1E` J ERALD, t v y 7~. / Sv:Sn n 6 _ CR` i sera FIB 5 r G w s 'eh sN _ J C J .•n. t Cr r/ s c: ` s 1 P+~ Z ~y 3 r r qr 4 ^xr, z.r.)c, I u / t.n-~~' t ~1 Jy 1 r;~ v, . •'1 r e. 7.0 - • 5 G~ sorh c._ s . • _ A i 1 VS anc~.c ; r./ro T • • ! r : r u. i,~~ ~ • - • a 2 l ~ ~ Trzir F I' v N/•~~`/ t ) -v ! '4^rr:, is SCr.e,r - ca :l.yc/; fr' ~y. q 1 •I E / i •j L - AYL d ~1 i'.~ .i - r. y- v i T 1 r t 7 ` 2 j170 a AVF ~ • -~L U FOR ! 17 • f✓ j/ G L E OD C1 ~-1-- ~ Y iL F ,rr 1 ~ rn f ~ ~S7L ~Y I V I C] IIIr~ a V ~h<` f t - F • P ly 1~~ ! L.. 31 z.> = " 33 ,314 36 1 D a I • -c 'We t ¢ wO.Re, _ .r t PAGF 37 GLENWOOD CITY CO-OP SERVICES b GLFNVVOOD CITY; WISCONSIN 5401.?~ Glenwood City EX-PRO 0 Ford Phone: 265-4224 FARM SUPPLY Mill: 265-4827 Fertilizer Plant: 265-7212 _Y,s-cm E.endec Prc :eirl Sales & Service Cnnputcr 3aianced Rat,--is Phone: (715) 265-4877 GAS * FUEL OILS * LUKE OILS * TIRES Cus-cm Fxt u:i<'i Soynea'i; LP GAS ACCESSORIES * SEED * AG CHEtvflCALS c 1 Glemvrnd City, Wi c~nsin 54012 FERTILIZER * ANIhhAL HEALTH * FLED; BAG Kr BULK 265-4239 Oi IN_SPLCI- ION - INDIVIVUAL SfWAG( SVSTFM 3: a` Sant tarry Vv m.< t~~2 S to tc Sep,t"c Cnocx County catto16 --Sectiun Lot p-- Subd~v.ib.iort Ai'TIC TANK S.r -e------ gat-fold's Numbe.7- oA cu►npa-itments facie r i ~om: GletY_ 6u,(, 'd~ rig -_--12 $ 5 t upe - NtigItwa-teh PIN CIiAM-6FR ya~1'ort-5 Pump ',1 ccvtu{jctc.tuheh-- Mudvx' Nurnbeh ?LDIN t TANK c ~ak~on6 Numbeh o6 Cum-p itmeet.te c q At'ahm Syt%.tern tar:c {h. m: We4'k 1iuA.Ld,i r►e o H.~9irwa.ren h e d------ Th e Yl t. 11 {ar~cc rjnc,►n: (Ue~k - _ 8u~.?d<rtg_--- i2$ oZope. H.~yhwa.te-a :':OkPTION SITE VIMLNSIONS ~ i► t r i l~.r t~teF1cel ane-u- { eaer► -cne_-- - t De.pti► oA hoeiz beFow t[.xe n Vcpth a fj lock ovi"h (0'v__ t.rl r, r..i' ►',,i,:ilh [:n inee - - 5t Depth u(j Lcf'v bvt'mv y'radc ~.n i?s tat!!-' bvtwei'ri x.inen - A# Skopv o f th.encrr_----- <rr. r.:rn 100 6t c: ut,~o"t.N.tc(;rr tlheu-- ---o.t 1yr-,e u6 Cuvet: Vapv,r 01 6 haw I i VIMFN5ioNS ~'urnbv.ti p-<-tn (;havt'f' Lt n(Pund 1) c' yee r!1) iut# i(iv d-cClineten - ---St vcpth beemo celeL't (y.t Lutai' ab5[ih-ptiun atPa - _~►t Area h.equ~.2e.d _S,t PFCTE 0 BY OVEll OATS----~~~--~~-~_ 19rs i DATL 19n ~,`;(?N (t'h' RL-11 CTI(",N ~ State and County State Permit 3 .p Lg 6 ~ 7 Permit Application County Permit for Private Domestic Sewage Systems County ~C~C jL 'DENOTES STATE APPROVAL REQUIRED _ cJ.- 7U Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: B. LOCATION: 5'4- Section. I T-Ll N, R / E (or) W Lot# City Suhdivision Name, nearest road, lake or landmark Blk# Village__ REPORT ON INSPECTION OF SANITARY PERMIT # y.j. (1) Name and Address of Permit Holder Person/Persons at Site (2 )Date of Inspection Time of Inspection ame, res , olcense No' o ns a ng Plumber 3r Ir" INSTALLATI N CONSISTS OF: ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber ❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System B N ermanent reference Point) Describe: Elevation of vertical reference point: Slope at site: (5)MATERIAL AND DEPTH OF SEWER: (6)SEPTIC TANK: Manufacturer:----- Liquid Capacity:_ Tank Inlet Elevation: Tank Outlet Elev: # ft to lot or property line: # ft to well: (7)DOSING TANK: Manufacturer: # of gallons: # of gallon pump set for a cycle gallons; total capactiy of distribution lines gallon; size of pump head; gallon per minute horsepower brand name of pump and model number Is the warning device installed? ❑ YES ❑ NO Wired? ❑YES ❑ NO ; 8 HOLDING TANK: Manufacturer o gallons construction ; depth to the cover ft; If septic tank is being used are baffles removed? ❑ YES ❑ NO; ft from residence; ft from well; ft from property line. Type of warning device is the warning device installed? ❑ YES ❑ NO; Wired? ❑YES ❑ NO; Locking device on cover? ❑ YES ❑ NO; Diameter of vent and material Distance from building to vent (9) SEEPAGE PIT SIZE: W. of pits; _ _ ft diameter; ft liquid depth; ft to residence; ft to well; ft to property line; ft to ordinary high water mark of lake or stream; `ft to edge of slopes greater than seepage pit inlet pipe-elevation ft; bottom of seepage pit elevation ft. (10) SEEPAGE BED SIZE: ft width; ft length; tile depth; li.neal feet tile; ft to residence; ft to well; ft to lot or property line; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes, water courses or drainage ditches Elevation of tank discharge line entering bed ft. 11 SEEPAGE Total length of seepage trench ft; width ft; tile depth ft; ft to well; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes, water courses or drainage ditches; elevation of tank discharge line entering seepage trench ft. (12) Has system been installed in area indicated on EH 115? ❑ YES ❑ NO (13) Has system been installed in floodway? ❑ YES ❑ NO Floodplain? ❑ YES ❑ NO DILHR-SBD-6095 N.05/80 Signature of Inspector: 2. state (pink copy) 4. Plumber (canary copy) I Revised Date 6/1/76 EH 115 Rev. 9/78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION:~Jt,L Ya, 5i coon ,TEL N,Ra E (o, Township or Municipality Lot No. , Block No. County- , 1 - iVi ion Name Owner's/Buyers Name: r Mailing Address: TYPE OF OCCUPANCY: Residence //No. of Bedrooms COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW jZ REPLA EMENT ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS ZiP /3 //yt-1 SOIL MAP SHEET yD NAME OF SOIL MAP UNITQX&1_ - • -46-151-22! PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P 5cilyo:re- O P F-.2- G~ 1 P- 3 r~• O a P- P- i-CL P- SOIL BORING TESTS TEST I U I AL UEPI H 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 7C 10 B- A ' c C? 13 2:5 I .I B- 7c -5 ?-5 B- !c' Ir it ,S 39 14 PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. 13 t3 , ~44 e.l L n vy, J-4-. ice I 4-i p _ N SO 51 is I] 1 =J d i 4 F p4 i • 7 I, 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. c Name (print). k1c ) Q(. C. Certification No. Address ' fVame OT Insianer IT KnOwn CST Signatur Copy A - Local Authority ❑ 1 l _ r IINI cf) 1e- c,~ -~J t L 13 1 I I I 1 I, 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 %oles are correct to the best of my knowledge and belief. Name (print) Certification No. & Address Name of installer if known Copy A - Local Authority CST Signature N Ov 171980 PLUMOINd SECTIC't Otis Qt' 1W~ .F t~~ , Stpc~ v cwt` / ~ ~ ~ ~ ~ i I _ I _ - YL~-y-- i - ~ ~ - . ~ I i ~ J i ~ ,J ~ ~ I ~ - - - - _ - x i , v - j~ /,t - . I ST. CROI X COUNTY WI SC0 N S I N .rte . 1 s III:v~ t.u• -2239 Nj ZONI NG OFFICE 196 rPost 0666ice Box 227 Hammond, WI 54015 O W N E R P U M P E R A G R E E M E N T PLEASE BE ADVISED, That un.t.i.t you axe again no.t.i6.ied, I w.i.t.t 1 ~ 1 C. contAact with WiAcons.in, (Pumpex), bon the puxpose o6 nemov.ing a.tl waate 6nom the ban.i.tany system to be .tocated on the pnopexty and 6utuxe home site Located in St. Cno.ix County, Wisconsin, Township o6 being in the ~ W4 o6 the 4 o6 Sec. 7. N. - R. Z W. (Ox more 6ut.Ly descn.ibed as 6o.t.tows: ) Dated this I ~ day o A 19 ~ 'e T (OWNER) State o6 W.is co ns i-n ) A-6 County o6 St. Cnoi.x ) Pexeonnaetyappeaned be6o4e me this day o6 19Ci. the above named , to me known to be khe pexson who execute the onego.cng .cns.tnument and acknow.tedged the same. o any u cc, st. C)io- lx- rounty, My Comm. (.is penman.t) (Exp•ines I I. 1c~ ~4-4hexeinbe6one ne6enned to as Pumpers, jo.cn .cn the-above agneemen.t .to -t e extent that I have a con.tnac.t with Owners as above stated. r-~ ( cl ~1c Lf - (PUMPER ) AGREEMEN^ This AGREEMENT, made and entered into on the 15th day of November, 1980, by and between William Hoffman, owner, and the Township of Glenwood, St. Croix Count'v, ,',isconsin. WHEREAS, An application has been made 't-or a sanitation system on the following described real property: The Southwest 4- of the Southeast 1; in Section 14, T30N, R15W. WHEREAS, Septic tank drainage does not meet the- JTjij_jiMUM standards of the ordinances of St. Croix County and state codes. WHEREAS, Owner agrees to install a holding tank for septic tank purposes. NOW THEREFORE: For and in consideration of the permission to install said holdinq tank, the owner agrees that the use of said tank shall not extend beyond the 15th day of November, 1984. This agreement shall be bindinq on the owner, his heirs and assigns. IN WITNESS WHEREOF, the parties have hereunto set their hands and seals the day and year first above written. Township of Glenwood, by Owner STATE OF ,'ISCO?: 'l~: ) J ti . COUNTY OF ST. CROIX ) S sc ibed nd s rn to before ire this 15th day of November, 1980. Notary '~Iublic Perrianant Commission This agreement, made and entered on this day of," by and between the Township P. ddresa'~ VEEREp S: 1-n application has been made for a sanitation system on the following described property: ViEEREAS: Septic tank drainage does not meet the minimum standards of the ordinance of St. Croix County and state codes. V.FiLREAS: The owner agrees to install a holding tank for septic tank purposes purposes. NCV,, THEREFQRE: 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 %%rill 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 IT IS UNDEESTOOD that this agreement shall be binding on the owners, their heirs and assigns. IN Vt ITNE SES WKERLOF, the parties have hereunto set their hands and seals the day and year first above written. Township of Developer , or owner L,,i STATE OF V,15-CONSIN) SS: _ COUNTY CF ST. CRCix) Subscribed and sworn to before me this day of 19, ; C % C i- Notary Public, St. Croix County IJ C] tl I ~ j r / O CY lJ N W W n W O Ul V W Q :2 Lj Q o co v 4 ul } V c Li a O W W a a w, s O a w a F ii a C O a U n d 4 1 _ - R? \ - ~ h7 Q OC Li 1.: Jl O Z ~5 (1 L a Q 1,{ ~s (Y O } <1A a aH 71 O 0 cY 1 > c; W O w 1\ I W _ CY i J R C~ u s I- g 16 V) O L 2 1 Jw LAJ J _ -j Z,O C~ 4 ~ T J J~ P V cn ' -L o , YS- d v w H y W W > o CAP T cc~ w 1 Z ~ toiyl 7. CO S O 5 .1 N Q ~ kJ U' -A - o a O. Y r ~ J J d Q, 0. O 1 J J i O A Q ? 1 v J W I Plb 160a 12178 "OWL * 3etach And Return Upper Jtrite of Widconsin Portion Of This Form With DIVISON OF HEALTH SECTION OF PLUMBING Any Return Correspondence AND FIRE PROTECTION SYSTEMS MAIL ADDRESS: P.O, BOX 309 MADISON, WISCONSIN 63701 DATE: I I D 608.266-3816 : PROJECT: aSC«t~ SSA V U c PLAN ID. # DETACH HERE ,~OJECT NAME _4P PLAN ID. 0C S 76 -tis is to acknowledge receipt of your plans and specifications for the above-indicated project. liminary review indicates the plan review fee required is $ ~l_lZ ❑ Plan accepted for review. Fee received is $ [ 7 Fee is bung returned because of ❑ Overpayment ❑ Underpayment. Providing one of the two catagories above is rho-I-', ,at;I lee on one payment. No fee has been remitted. Plans submitted with no fees will be held in abeyance. 7 Plans being returned. Additional information required. SEE BELOW. Plan Submission Additional information shall be submitted in triplicate unless specifically noted. ] Plans not clear, legible or permanent. All information submitted shall be signed, sealed or stamped in accord with Section H 62.25(2) (a) Wisconsin Administrative Code. J Affidavit enclosed. Alternate sewage Disposal Systems (Mound Systems) ❑ PLB 108 (Application for use of an alternate system). JCounty onsite required (1 copy). -J Design calculations for pressurized distribution Cross section of mound. Cl Pipe lateral layout. Plan view of alternate. Private Sewage Dispos,,l Systems J Ground slope with 2' contours in entire area of soil absorption system extending 25' on all sides. I Elevdtion of permanent reference point (benchmark). Location of area suitable for replacement system provide soil test data. I Plot plan showing lot size and all lateral distances from sewage disposal system or holding tank to bldgs, lot lines, well, watercourse, etc. Construction detail of septic, holding or lift pump tank if site constructed or tank manufacturer if precast. C1 Construction detail and cross-section of soil absorption system. IJ Soil boring and percolation test on EH 115 completed by certifiedsoll tester (1 copy). L~ Complete data relative to anticipated use of bldg. J 3 copies of PLB 60 enclosed. Deed restriction required (1 copy), Holding Tanks Profile of holding tank. I Holding tank agreement signed by owner and local unit of government (sample enclosed). Reason for installing holding tank soil test or statement from county 0 copy). ift Pump Calculations for total lift pump discharge, head and gallons pumped per cycle. Size, length & depth of force main. Detail & model of pump or automatic siphons i icluding size, pump curves, drawdown and average flow rate GPM. 1 Cross section of lift hump tank showing pump(;) or siphon(s), 't-ms In F ;l (Fill must he placed prior to p,drl suLmission) 'Total a:ea filled (fill to extend 20' beyono edge of trench before ;Ide slope heginJ. DPIVII ar,d type of tlli. Copy of on iwe relror by count; or dishier plumbing supervisor. t L,:nyth 01 I,me fill has hi-- ih „I,,.o Department of Industry, Labor & Hurtlan Relations Division of Safety & Bldgs. state 01 WiG010n5ttn Bureau of Plumbing Platting & Fire Protection P.Q. Box 1969 r r► Madison WI. 53707 608-266-3815 J +r J bV ALL CORRESPONDENCE REFFH TO PLAN IDENTIFICATION NO. NAME OF PROJECT / ) ^ T'rP[ X APPRJVAL II LL sIHFFT AND vo , S-W CITY OR TOWN COU Y STATE 515 1 OWNER ~.fJt LLB ~ t.ln ~,1 Ff`- ~vla ~l - Gentlemen: Examination of plumbing plans and specifications for the above-mentioned project has been completed. In accord with Chapter 145, bVdisconsJn Statutes and Wiscunsin Administrative Code, the plumhing plans and specifications are approved contingent upon com- phance with the stipulations indicated on the plans. Please review your code for the requirements of each code section noted. the architect, professional engineer, reyistered designer, owner or plumbing contractor shall keep at the construction site one set of plan, bearuut the stamp of approval of the department. In the event nstallation of the plumbing improvements or system has not commenced within two years from this dale, this approval shall become void and new application shall be made for approval of these plans before work may commence. In granting this approval, the Division of Safety and Buildinys does not hold itself liable for any defects in plans or specifications, plan omissions, examination and reserves the right to orlder changes or additions should conditions arise making this necessary. This approval is based oil Wisconsin Administrative Code requirements. It shall he necessary to obtain and fulfill the permit require- ments of the city, village, township or county in which this installation is to be constructed. Failure to obtain local permits will auto- matically void this acceptance. Sincerely, James Sargent-Bureau rertor DATE: PLANS REVIEWED BY. YI-4.4 z/ I L4 '2 cc DP -olds OA'ner OII HR L I Plu ber H & R (2) oust Mfg. Rep. Bur. of Health Fac. & Services Di irn .,OD-6099 (N. O6iHO) Rec. & Env. Services • Department of Industry, Labor & Human Relations Division of Safety & Bldgs. State of Wisconsin 1 Bureau of Plumbing Platting & Fire Protection 1-1=1 P.O. Box7969 GOO Kai ` Madison bVl. 53707 q Tel. 608-266-3815 1 i ~D' 2 9 1NALL CORRESPONDENCE r' ~f j r _ r S REFER TO PLAN j IDENTIFICATION NO. NAME OF PROJECT "YPE OF APPROVAL 7f~, - ~L t-l, i l -/00 C) STREET AND NO. CITY OR TOWN ~ COl1R~fY STATE LIP vVQi i, o','J N F R i Gentle^nen: Examination of plumbing plans and specifications for the above-mentioned project has been completed. In accord with Chapter 145, bVisconsin Statutes and Wisconsin Administrative Code, the plumbing plans and specifications are approved contingent upon com- pliance with the stipulations indicated on the plans. Please review your code for the requirements Of each code section noted. The architect, professional engineer, registered designer, owner or plumbing contractor shall keep at the construction site one set of plans bearing the stamp of approval of the department. In the event installation of the plumbing improvements or system has not commenced within two years from this date, this approval shall become void and new application shall be made for approval of these plans before work may commence. In granting this approval, the Division of Safety and Buildings does not hold itself liable for any defects in plans or specifications, plan omissions, examination and reserves the right to order changes or additions should conditions arise making this necessary. This approval is based on Wisconsin Administrative Code requirements. It shall be necessary to obtain and fulfill the permit require- ments of the city, village, township or county in which this installation is to be constructed. Failure to obtain local permits will auto- matically vuid this acceptance. Sincerely, James Sargent-Bureau Director PLANS REVIEWED BY: DATE: -I r f CC: DPS'OWS Owner DILHR a1 PI Plumber H & R (2) R~unty Mfg. Rep. Bur. of Health Fac. & Services D I I HR sRD 6099 (N. 06!80) Rec- & Env. Services I Plb 100a 12r78 Detach And Return Upper - State o iseonsm DIVISON OF HEALTH Portion Of This Form With SECTION OF PLUMBING •!(y, AND FIRE PROTECTION SYSTEMS Any Return Correspondence MAIL ADDRESS: P.O. BOX 309 MADISON, WISCONSIN U3701 608-266-3815 DATE: PROJECT: 1 17r S E f, SI B T.~o f ; ` PLAN ID. # vE 1 ACH HERE PROJECT NAME PLAN ID. # This is to acknowledge receipt of your plans and specifications for the above-indicated project. Preliminary review indicates the plan review fee required is $ ❑ Plan accepted for review. Fee received is $ Fee is being returned because of ❑ Overpayment ❑ Underpayment. Providing one of the two catagories above is checked, remit correct fee in one payment. ❑ No fee has been remitted. Plans submitted with no fees will be held in abeyance. ❑ Plans being returned- El Additional information required. SEE BELOW. 1. Plan Submission Additional information shall be submitted in triplicate unless specifically noted. U Plans not clear, legible or permanent. ❑ All information submitted shall be signed, sealed or stamped in accord vvith Section H 62.25(2)(a) Wisconsin Administrative Code. F-1 Affidavit enclosed. ll. Alternate sewage Disposal Systems (Mound Systems) ❑ PLB 108 (Application for use of an alternate system). I County onsite required (1 copy). I Design calculations for pressurized distribution ❑ Cross section of mound. ~ Pipe lateral layout. U Plan view of alternate. I II. Private Sewage Disposal Systems ❑ Ground slope with 2' contours in entire area of soil absorption system extending 25' on all sides. F-1 Elevation of permanent reference point (benchmark). L-1 Location of area suitable for replacement system provide soil test data. L7 Plot plan showing lot size and all lateral distances from sewage disposal system or holding tank to bldgs, lot lines, well, watercourse, etc. ❑ Construction detail of septic, holding or lift pump tank if site constructed or tank manufacturer if precast. ❑ Construction detail and cross-section of soil absorption system. ❑Soil boring and percolation test on EH 115 completed by certifiedsoil tester (1 copy). U Complete data relative to anticipated use of bldg. 3 copies of PLB 60 enclosed. U Deed restriction required (1 copy). IV. Holding Tanks ❑ Profile of holding tank f1 Holding tank agreement signed by owner and local unit of government (sample enclosed). D Reason for installing holding tank soil test or statement from county (1 copy). V. Lift Pump II Calculations for total lift pump discharge, head and gallons pumped per cycle. LJ Size, length & depth of force main, ❑ Detail & model Of PUMP Or automatic siphons including size, pump curves, drawdown and average flow rate GPM. n Cross section of lift pump tank showing pump(s) or siphon(s). V1. Systems In Fill (Fill must be placed prior to plan submission) ❑ Total area filled (fill to extend 20' beyond edge at trench before side slope beam). F -I Depth and type of till. I Uopy or onsire report uy county or aC:! r piurnr. Supe n~,o . ❑ Length of time fill has been in place. I Lhhh, { ST. CROI X COUNTY r : s r 11I I JG U N I M ZONING OFFICE 796-2239 HAMMOND, WI 54015 November 25, 1980 Robert Cassellius R.R. 1 Glenwood City, WI 54013 Dear Sir: Enclosed, please find the pumping report sheets which include all the information needed by this office. .These reports should be sent to us once a month through the first four months, as to get an idea of the usage, and thereafter on a quarterly basis. Thereafter, the township should also receive a copy of these reports. Then on a yearly basis, the state should receive the past year's pumping report informa- tion. Should you fail to submit this information, we will request, of the owner, to contract with a new pumper. In additioLi, pCL luu_~ Lnspections ey the county and state will be made to determine the success of the holding tank system. Should-you have any questions, please feel free to con- tact this office. Yours_ truly, Thomas C. Nelson TCN:sl cc: William Hoffman HOLDING TANK PUMPING REPORT • Name o S R ee.idence • A d d t ea a T- 7 C= r Tetephone s ~s } y Legat: % 06 % o6 Section T N-R_W To nahip Date Pumped Amount Pumped Location S head Remanke Pum eh'b S.igna.tune Zoning 06j.iee Uee: Date Inspected Condition-6 Found The above .ingonma.t.ion shah be een.t to the St. Croix County Zoning U{Aice, Pob.t 066.ice Box 221, Hammond, W1 54015, monthly through the first four months, thereafter on a quarterly basis. The township receives a copy o~ these reports quarterly. Yearly a report should be submitted to the state. Periodic inspections will also be made by the St. Croix County Zoning Office to inspect the success of the system at the above location. NIX ca I` C=z n. %V ,consin- Department Of 8005d o d r~us;iy. Labor & Human Helalions ;;:vision of Satety & Buildings This document s a full, true and correct copy RECGI~a''- of the original un file and of record in my AGREI'MFNT 17 office / 9 1tloV -~~rL • 3 I$ tA~'' certified 1 By '2 PLUMBING SECTif: This AGREEMENT.' made and entered into on the 15th day cif Ncwc_;r~?er, 1980, by and between William Hoffman, olv ner, t lac I~~wr.ship of Clen,•.ood, St. Croix County, Wisconsin. t%IJZREAS, An application has been made for a -lani.tati.on Sys t-ent on the, Collowing descr-i hed real pro_; r t :r ",he Southwest ; of the Sout:cc ist in Section 14, T30N, R15W. :lil]:R.I;rS, `,_,,tic tank drainage does not me-L.t. 1. ~,?.girds of the Ordinances of St. Croix County in(-] state cock l:il!;l?l: ~1 , r yrees to install a holding tank. for soot i Pdc)~; THEREFORE: For and in consideriation cf th(, :)ermission tc) --n: tall said holding tank, the owner agrees that the use of said tank shall not extend beyond the 15th day of November, 1984. This agreement shall be binding on the owner, his heirs 'And assigns. Ir,J !dI'M F 1IiERF.Oi i_hr parties have hereunto set their u~nc? s '_inci ac_ 1 s the day and :ar f i r~- t :hover v.,r i t ten . Towns}iip of Glcn,:~ood, by r- STATE: 0F 1,:'ISLO:^7sIrI ) COUNTY OF ST. CROIX ) ss. Si sc ibed nd's .rn to before me this 15th day of November, 1980. Notary Public T'c--r.l.int;nt Corui,.ission This agreement, made and entered on this / day of'"'~. ie 19 by, / -and between the Township of P d d r e s s - /-,'f: <<. e r ---r' TEEREAS: In application has been made for a sanitation system on the It following described property: 8005761 V,HEREAS: Septic tank drainage does not meet the minimum standards of the ordinance of St. Croix County and state codes. %EEREAS: The owner agrees to install a holding tank for septic tank purposes purposes. NCV', THEREF 9• IE: For and in consideration of the issuance by the Town- sf:ip of,,.,C! . of a permit for the above premises, the parties do hereby agree and bind themselves as follows: 1. Owner agree:; 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 snarl have same pumped out in 24 hoer s, or township .frill have said work doneand charEcd to owners and place same on their tax bill as a pecial charge. 2. The Township reserves the right to assess a bond if they desire to cover any possible pumping charge in the sum of IT IS UNDEFSTGOD that this ngreement shall be binding en the o%%ners, their heirs and assigns. IN VJTNESS WEER L0.1, the parties h3ve hereunto set their hands and seals the day and year first above written. Township cf , , bye Developer NO ? 11~. - or Owner P!UMB'.NG SECT[i STATE OF' WISCONSIN) S5: COUNTY CF ST. CROX) - Subscribed and sworn to before me this /--3 day of 19, :Fate of Wisconsin Department of Industry. Labor & Human Relations Division of Safety & Bui!Ongs Notary Fublie, St. CroLY County This document is a full, true and correct Copy of fne origina! on t:{e and of record in my office ' G rer diprf i Z / .J 19 r~ r 1