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HomeMy WebLinkAbout020-1111-06-200 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 592194 GENERAL INFORMATION State Plan ID No: /t ) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. / Permit Holder's Name: City Village Township Parcel Tax No: Howard Wilson TOWN OF HUDSON 020-1111-06-200 CST BM Elev: r;P. BM Elev: BM Descr tion: f Section/Town/Range/Map No: ) y~ 12.29.20.450H 7 .5~7~1 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER. CAPACITY STATION BS HI FS ELEV. Septic / IN Benchmark ' ( Alt. BM AerdTion Bldg. Sewer y St/Ht LA r >1 inlet 7 TANK SETBACK INFORMATION / U outlet TANK TO y P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic a _F Dt Bottom Dosing Header/ an. Do Aeration Dist. Pipe /L7)L9 (Q Holding.,, Bot. System ~l PUMP/SIPHON INFORMATION Final Grade A,6 Manufacturer Demand St Cover / L ~ Q r~ ~y 6 Mpdel Number 1 DH Lift Friction Loss System Head TDH Ft rcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM Gi y l f J BED/TRENCH Width Length ,J No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Dept DIMENSIONS SETBACK SYSTEM TO P/ BLDG WELL LAKE/STREAM LEACHING Manufacturer:, INFORMATION Ty e Of System : CHAMBER OR a J - 5,. LIUNIT Model Number: - ~1 6k L /Q , NBUTION SYSTEM 4Length_] ader/Manifold Distribution x Hole Size x Hole Spacng Vent to Air Intake s~®, ^ ' Pipe(s) - m.._ - _ fv~' Dia Length jaSpacing 91, SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Dept Ov n Depth Over ' xx Depth of xx Seeded/Sodded xx Mulched Be Tr ncly'Center Bed/Trench Edges Topsoil COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection # Location: 287 EDGEWOOD DR y J j~ ry~ tjP 1.) Alt BM Description 2.) Bldg sewer length = - amount of cover = E~ J N Plan revision Required? d p[] Yes 1 No Use other side for additional informati n' SBD-671 0 (R.3/97) Date Insepc is Signature Ce . No. ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the following residence: (Street address) 287 Edgewood Drive located at: SE '/a, NE '/4, Section 12 , Town 29 N, Range 20 W, Town of Hudson , St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of SPS. 384.25, and it (they) appear(s) to be functioning properly. Most recent date of inspection or service Did flow back occur from absorption system? Yes No (if no, skip next line.) Approximate volume or length of time: gallons minutes Tank Capacity: 1000 Construction: Prefab Concrete X Steel Other Manufacturer (if known): Powers Cement Products Age of Tank (if known): 31 years Permit number (if known) 69652 i~ John Schmitt (Lip used Plumber Signature) (Print Name) MPRS 223760 (Title) (License Number) MP/MPRS (Date) Form to be completed by licensed plumber (Dept of Safety and Professional Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 2/2012 Page 10 County, St. Croix 1 t 7Co.) Industry Services Divl 1400 E Wasl e-tary Permit Number (to be filled in a S P I°~ ~(1b P.O. B( S Nw Madison, WI 531u, 011, ct uUN ` r ST. OR ENT porn anitary Permit Application State Tran actin cumber in accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for seconda 287 Edgewood Drive purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. 1. Application Information - e Print All Information Property Owner's Name Parcel # Howard Wilson & Laurie Plante 020-1111-06-200 ~1 1 e f of - A y . 4 Prop rty Location Pro erty Owner's Mailing Address 28fEdgewood Drive Govt. Lot City, State Zip Code Phone Number SE 1/4, NE 1/4, Section 12 Hudson, WI 54016 (circle one) T29N ; R20Eo ~V II. Type of Building (check all that apply) ~ Lot# ® I or 2 Family Dwelling - Number of Bedroo 2 Subdivision Name ❑ Public/Commercial- Describe Use 'Al~~ Block # ❑ City of ❑ State Owned - Describe Use ❑ Village of C Number Town of Hudson III. Type of Permit: (Check only on box on line A. Complete line B i licable) D At., A. F1 New System ® Replacement System El Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued B. Plumber Owner 69652 9/4/1985 Before Expiration IV. Type of POWTS System/Component/Device: (Check all that apply) 1 ® Non Pressurized In-Ground ❑ Pressurized in-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil F-1 Holding Tank El Other Dispersal Component (explain) El Pretreatment Device (explain) 43 V. Dis ersal/Trea ent Area Information: Design Flow (gpd Design Soil Application Dispersal Area Requ' d (sf) Dispersal Area Pr osed (st) System Elev 450 Rate(gpdsf) 643 675 99.60' 8. 0.7 W~ VI. Tank Info Capacity in o Gallons Total # of Manuf cturer U Gallons Units L v: New Tanks Existing ranks PO ~DV SZS U .2 E Septic or Holding Tank 1000 1000 2000 2 Powers/ W i ser ® ❑ ❑ ❑ ❑ Dosing Chamber ❑ ❑ ❑ ❑ ❑ VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumb ure MP/MPRS Number Business Phone Number John Schmitt XFxl "IX 223760 715-760-0486 Plumber's Address (Street, City, State, Zip Code) 616 150`1' Ave. Somerset, W154025 VII ount /De artment Ilse Only Approved isapprove Permit FQee~ Date ssued Issuing nt Signature iven Reason for Denial $ IX. Condi$YfiTWReasons for Disapproval le UCI % y, ~~;flc4n: filter t?nd 3' 41AI 11t A. 4isp'0*#i cell must all be - ics ! Lm !n tar ~ n~ as aragemen'. plan pi o-iided by plumber. IG J 2. AA rearP.ments must:be rzaiMriee' as oppkabls wdta / crdinancea. Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x I t inches in size SBD-6398 (R03/14) PLOT PLAN N Project Name: Wilson Replacement Septic System Legal Description: NE114, SE1/4, S18, T30N, R18W P. 1. D: 020-1111-06-200 Subdivision Name: Lot 2 Township: Hudson Parcel Size: 1.34 SCALE: 1" _ County: St. Croix System Elevation: T1= 99.60' Proposed 45.00' EZ Flow Trench Slope: T2= 99.60' Proposed 45.00' EZ Flow Trench A BM1 Elevation: J101.50' Existing Septic tank outlet T3= 99.60' Proposed 45.00' EZ Flow Trench BM2 Elevation: .90' Existing Septic tank Cover Existing Bed 99.60' Existing 12'x54' Rock & pipe bed ■ Backhoe Pits: S1 Existing 1000 gallon Powers Cemment Products S2 New Wieser Concrete WLP1000-MR See CSM or Plat for complete view of parcel Filter POLYLOK 525 4 inch Sch 40 -ASTM D2665 4 inch 3034 - ASTM D3034 EL), C" oc,D 060 CO ~ ti I ~4 r y 1 ~ 3 _ a ltl~ Page 2 CONVENTIONAL COMPONENT DESIGN INDEX AND TITLE PAGE Project Name: Wilson Replacement Septic System Owners Name: Howard Wilson & Laurie Plante Owner's Address 287 Edgewood Drive Hudson, WI 54017 Legal Description: NE1/4, NE1/4, 529, T31N, R19W Township Hudson County: St. Croix Subdivision Name: Lot Number: 2 Block Number Parcel I.D. Number 020-1111-06-200 Plan Transaction No. Page 1 Index and title Page 2 Plot Plan Page 3 Septic Tank Specifications Page 4 Effluent Filter Information Page 5 System Sizing & Cross Section Page 6 EZ Flow Information Page 7 & 8 Management and contingency plan Page 9 Septic Tank Maintenance Agreement Page 10 Existing Tank Certification Page 11 Warranty Deed Page 12 CSM or Plat Attachment 1 Soil Evaluation Report Attachmemt 2 Original Septic System Plans Designer: John Schmitt Licnese Number: MPRS 223760 Date: 11/28/2016 Phone Number: 715-760-0486 a Signature: In-Ground Soil Absorption Component Manual Version 2.0 SBD-10705-P (N. 01/01) Page 1 PLOT PLAN N Project Name: Wilson Replacement Septic System Legal Description: NE1/4, SE1/4, S18, T30N, R18W P.I.D: 020-1111-06-200 Subdivision Name: Lot 2 Township: Hudson Parcel Size: 1.34 SCALE: 1" _ County: St. Croix System Elevation: T1= 99.60' Proposed 45.00' EZ Flow Trench Slope: T2= 99.60' Proposed 45.00' EZ Flow Trench A BM1 Elevation: 101.50' Existing Septic tank outlet T3= 99.60' Proposed 45.00' EZ Flow Trench BM2 Elevation: 103.90' Existing Septic tank Cover Existing Bed 99.60' Existing 12'x54' Rock & pipe bed ■ Backhoe Pits: S1 Existing 1000 gallon Powers Cemment Products S2 New Wieser Concrete WLP1000-MR See CSM or Plat for complete view of parcel Filter POLYLOK 5 4 inch Sch 40 -ASTM D2665 4 inch 3034 - ASTM D3034 V t ~O \ Is ~ - 1'~ 0 u S 1= V~, ~ t t t 3 6 t r 4YELL~ P~ I Page 2 8VOWta :3-11d 95t~8-5Z~-008 ° \ z r- OSLbS IM 'A 08 N301VW OL .IMH sn 9LL2M ivnNVV4 OIld3S 21flOd-1SOd 31VO 00/00/00 31V0 w o 570d-32ld :31V0S d0M A8 NMVa0 313HHOD 13131M 0-00OIdIM \ W w Lki F- J N v H Q J z = J U O C! Z C U Q W N N M: m N N d } Z O p w p ~y pJ ti W 0• (j 6~ V I O, aW H J J V~ Q uw 0 wow U w' -W U Z co 0 uj i= z F~ X0 ^ O LLI D a W~ Q H O p p z O Q~ Opp p Q z t1 a LO F- LU H Z 2 \ 00 M U > V) F-- LUiJ~ OQ QJU J pp N O LO z 3 o> u Q w p O W Q Q W Z w U Q CL U am p vi mcn -jww O 0~ o \ z~ a s M O C] m Q Q W 0 U) 00 J I- z U) C O LL U _oo w I aw(n a- ° Q? 000 z O a ° (nom mww U p 4k- O N_j 0 J Jw> W Q V W Z N N Z N Z z uj (D N ~J....~ZJ.. =OQW Ozw U ZF-J U) WU pW HN (n ..o==~=3p= UY vw a <w¢ o LLJ mF x0 ov Y °QO OaWWpOwaO Z" < Q30 U OOU O Q~ U 0O z Z3m UmJ QOQ Q Y p Y O li LL, F- ~ 0 Z z 00< U J Q W (n I Q U FJ-- „6 p w O d W d :2 p :D a a_ w I ~ ~a r O W U wm II w I w cn I -1 5; I r > 0 I I CD a d „S I „92 w w Cf) w ~I. o ° w w \ ` s ~ / ii ~ III + I W 0 p N of W 77 Z_ (~j uZ~ ~ Z Q „9g 173bjlno la SV „ FS w (Y Q N Y z Q F- Page 3 Filters PL-525 EFFLUENT FILTER ( "AVIV MERCIAL) Polylok, Inc is pleased to add its new commercial filter to its existing line of quality effluent filters.The PL-525 is rated for over 10,000 GPD Alarm h; (gallons per day) making it one of accessibility Accepts PVC the largest commercial filters in its extension handle class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok_ PL-122, the new Polylok PL-525 has an automatic shut off ball installed 525 linear feet with every filter. When the filter is of 1/16" removed for cleaning, the ball will filtration slots, Rated for over float up and temporarily shut off. $ 10,000 GPD the system so the effluent won't Ieave the tank. No other filter on the market can make that claim! Accepts 4" & 6" SCHD. 40 Pipe ~ The PL-525 Effluent Filter should operate efficiently for several years under normal conditions before 4-1 requiring cleaning. It is recom- mended that the filter be cleaned 4-1 every time the tank is pumped or 1-1 at least every three years. If the installed filter contains an optional alarm, the owner will be notified by an alarm when the filter needs servicing. Servicing should be Gas deflector done by a certified septic tank Automatic shut-off pumper or installer. ball when filter 1. Locate the outlet of the U.S. Patent No# 6,015,488 is removed septic tank. 5,871,640 2. Remove tank cover and pump tank if necessary. 1. Locate the outlet of the 3. Do not use plumbing when septic tank. filter is removed. Ideal for residential and com- 2. Remove the tank cover and 4. Pull PL-525 out of the housing. mercial waste flows up to pump tank if necessary. 5. Hose off filter over the septic 10,000 Gallons Per Day (GPD). 3. Glue the filter housing to the 4 or 6 outlet pipe. If the tank. Make sure all solids fall filter is not centered under the back into septic tank. access opening use a Polylok 6. Insert the filter cartridge back Extend & Lok or piece of pipe into the housing making sure to center filter. the filter is properly aligned and 4. Insert the PL-525 filter into completely inserted. its housing. 7. Replace septic tank cover. 5. Replace the septic tank cover. S . Page 4 SOIL ABSORPTION SYSTEM DETAIL / GRAVELLESS LEACHING UNIT Project Name: Wilson Replacement Septic System Gravelless Leaching Unit Specifications Manufacturer Model Laying Length EISA Rating Infiltrator EZ1203H-5ft 5.0' 25.0 EZ1203H-10ft 10.0' 50.0 System Sizing EISA Rating per Foot of EZ Flow 5 ft2 Soil Application Rate 0.7 gpd/ftz 450.0 gpd Design Flow + 0.7 Soil Application Rate + ~ EISA = 128.6 Feet of EZ Flow F3-]trenches 45 feet long each 3 No. of Cells 4.5 Per Cell 3 ft Cell Width 13.5 Total No of 1203H 45 ft Cell Length 225 sq ft EISA Per Cell 3 ft Cell Spacing 675 sq ft Total EISA Typical Cross Section Finished Grade 103 ft Observation Pipe with ~{~II approved cap or vent I I r---Soil Backfill r ■ 36 Inch : Geotextile Fabric ■ ■ 12 inch I~ O I) O I Slotted and Anchored Vent/Observation Pipe with Cap 99.60 ft Infiltrative Surface >36 inch 95.60 ft Limiting Factor Plumber/Designer Signature: License MPRS 223760 Date: November 25, 2016 Page 5 Installation Instructions for EZTM EZflow Systems in Wisconsin flFILTRwTOR Wisconsin Department of Commerce, Safety and Buildings 5. The Absorption area (SF) necessary for a given site shall Division, has reviewed the specifications and/or plans for this be sized based on maximum daily sewage flow (GPD) and product and determined it to be in compliance with chapters ; the Permeability for the site. If certain criteria is met, the Comm 82 through 84, Wisconsin Admin. Code, and Chapters EISA sizing can be used in Wisconsin, resulting in a 40% 145 and 160, Wisconsin Statutes. All sites must meet the Site smaller drainfield. & Soil Conditions & Locations & Isolation distances as noted in local regulations. 6. Place EZflow bundle(s) in the EZflow configuration ap- proved by system design permit specified for the particu- The approved products are 1203H (3-12" bundles with pipe in lar site. The top or center-most bundles containing pipe center bundle in 5' or 10' lengths) and 1203HP (3-12" bundles are joined end to end with an internal pipe coupler. Any with pipe in each bundle in 5' or 10' lengths. ; additional aggregate only bundles that may be required, • should be butted against the other aggregate-only bun- A single pipe bundle contains a four inch perforated pipe sur- • dies and do not require any type of connection. rounded by EPS aggregate and is held together with poly- ehtylene netting. A single aggregate bundle contains aggregate 7. The top of each GEO cylinder contains a filter fabric pre- only and is held together with polyethylene netting. manufactured in between the netting and aggregate, The fabric is inserted to prevent soil intrusion. The installer Materials and Equipment Needed shall make sure the the GEO is positioned upward and is • EZflow Bundles : in contact with the fabric contained in the adjacent cylin- • EZflow Geotextile Fabric der before backfilling. • EZflow Internal Pipe Couplers • Pipe for Header and Inlet 8. The EZflow Drainfield Systems should be installed in a • Backhoe/Excavator level trench in all directions (both across and along the trench bottom) and should follow the contour of the ground Installation Instructions surface elevation (uniform depth), with all continuous The instructions for installation of EZflow products are given ; adjoining 10-foot cylindrical bundles placed end to end, below. This product must be installed in accordance with state with central bundle distribution pipe interconnected, rules defined in chapters Comm 82 through 84, Wisconsin Ad- without any dams, stepdowns or other water stops. ministrative Code, and Chapters 145 and 160, Wisconsin Stat- utes, as well as the local health department's current design 9. The trench top shall be graded such that water will not manual. pond. Backfill should be seeded or sodded immediately after completion to reduce erosion. 1. After the local health department has determined sizing, configuration, and layout for the EZflow systems, stake 10. EZflow EPS bundles are flexible and can fit in curved or mark with paint the location of trenches and lines. Be trenches as may be necessary to avoid trees, boulders, or careful to set correct tank, invert pipe, header line or dis- other obstacles. tribution box and trench bottom elevations before instal- : lation of pipe bundles. 11. EPS aggregate is lighter than water, therefore, it might : be expected that natural buoyancy forces would tend to 2. Remove plastic EZflow shipping bags prior to placing cause EZflow assemblies to float out of ground when bundles in the trench(es). Remove any plastic bags in the ponding occurs. Field experience has shown, however, trench before system is covered. that this is not a problem when systems have a minimum of 6" of soil cover as recommended by manufacturer. 3. This product must have geotextile fabric that meets re- quirements of s. Comm 84.30 (6) (g), Wis. Adm. Code, installed directly on top of the product and extending 1203H-GEO down along the sides of the product to a point at least six inches from the bottom of product. Geotextile roe 9090, Barrier Material 4. When installed in a trench, the trench should be dug to o~ r~.........._ a width of 36 inches" - ° ° . This not only saves labor in excava- 12 tion, but also provides better load-bearing capacity after ooo~ backfilling is complete. : - 36" Page6 POWTS OWNER'S MANUAL & MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS Owner: Howard Wilson & Laurie Plante Tank Manufacturer: Powers C. P. ❑ NA Permit # 0 Septic ❑ Dose ❑Holding Volume: 1000 gal DESIGN PARAMETERS Tank Manufacturer: Wieser Concrete ❑ NA Number of Bedrooms: 3 ❑ NA 0 Septic ❑ Dose El-folding Volume: 1000 gal Number of Public Facility Units: NA Vertical Distance Tank Bottom(s) to Service Pad: ft Estimated (average) Flow: 300 gal/day Horizontal Distance Tank(s) to Serivice Pad: ft Design Flow = estimated x 1.5: 450 gal/day Specific servicing mechanics must be provide if vertical is>15 feet or if In Situ Soil Application Rate: 0.7 gal/day/ft2 horizontal is > 150 feet. Specific instructions to be provided on back. Standard Domestic Influent/Effluent Monthly average Effluent Filter Manufacturer: Polylok ❑ NA Fats, Oils & Grease (FOG) s30 mg/L Effluent Filter Model: 525 Biochemical Oxygen Demand (BOD5) 5220nrl ❑ NA Pump Manufacturer: Total Suspended Solids (TSS) 5150mg/L Pump Model: High Strength Influent/Effluent Monthly average Petreatment Unit L NA Fats, Oils & Grease (FOG) 530 mg/L Manufacturer: Biochemical Oxygen Demand (BOD5) 5220mg/L 0 NA ❑ Mechanical Aeration ❑ Peat Filter Total Suspended Solids (TSS) 5150mg/L ❑ Disinfection ❑ Wetland Petreated Effluent Monthly average ❑ Sand/Gravel Filter ❑ Other. Biochemical Oxygen Demand (BOD5) 530mg/L of sor~t,lon ystem Total Suspended Solids (TSS) 530mg/L 0 NA L~ In-Ground (gravity) El In-Ground (pressure) Fecal Coliform (geometric mean 5104cfu/100m1 ) ❑ At-Grade ❑ Mound Maximum Effluent Particle Size: % in dia. L-INA ❑ Drip-une ❑ Other: Other: Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency When combined with sludge and scum equals one-third of tank volume Pump out contents of tank(s) When the high water alarm is activated At least once every: 3 month(s) Maximun 3 Years ❑ NA Inspect condition of tank(s) ryears At least once every: 1.5 month(s) Inspect dispersal cell(s) ❑ (Maximun 3 Years) ❑ NA year(s) At least once every: 1.5 month(s) ❑ NA Clean effluent filter ryear s Inspect pump, pump controls & alarm At least once every: month(s) NA ear s Rest existing bed for 5 years At least 5 Ld month(s) El NA ear s Alternate between new an old systems Annually 1 month(s) ❑ NA annually or as indicated by inspection year(s) MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer, POWTS Insepector; POWTS Maintainer; Septage Servicing Operator (pumper). Tank inspections must include a visual inspeciton of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicated a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumualtion of sludge and scum in any treatment tank equals one-third or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Admininistrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, petreatment units, and any servicing at intervals of 5512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 30 days of completion of any service event. Page 7 START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other chemicals or sediment that may impede the treatment process and/or damage the soil dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During extended power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose and may overload them resulting in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) discharge; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks, pits and other soil absorption systems shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide the opportunity to obtain a sanitary permit for a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at the time of their permit issuance. ❑ A suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption system cannot be rehabilitated and barring advances in POWTS technology, a holding tank may be installed as a last resort. [~f The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. WARNING: TREATMENT TANKS AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES AND LACK SUFFICIENT 1 OXYGEN TO SUPPORT LIFE. NEVER ENTER A TREATMENT TANK OR HOLDING TANK UNDER ANY 1 CIRCUMSTANCE. DEATH MAY RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK IS VERY DIFFICULT. ADDITIONAL INFORMATION: POWTS INSTALLER POWTS MAINTAINER Name: John Schmitt Name: John Schmitt Phone: 715-760-0486 Phone: 715-760-0486 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name: Marko Septic Name: St. Croix County Zoning Phone: 715-749-3404 Phone: 715-386-4680 This document is intended to meet minimum requirements of Ch. Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. Use of this document does not guarantee the performance of the POWTS. (Rev. 2/05) Page 8 ~I ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Howard Wilson & Laurie Plante Mailing Address 287 Edgewood Drive Property Address 287 Edgewood Drive (Verification required from Planning & Zoning Department for new construction.) City/State Hudson, WI Parcel Identification Number 020-1111-06-200 LEGAL DESCRIPTION Property Location SE r~4 NE r4 Sec. 2 , T 29 NR 20 W, Town of Hudson Subdivision Plat: , Lot # 2 Certified Survey Map # Volume , Page # Warranty Deed # (before 2007)Volume , Page # Spec house (]yes[Dro Lot lines identifiable Byes[]no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (l) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on is form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a w rranty deed recorded in Register of Deeds Office. Numbe of bedrooms 3 '44 l1 /Zz.l 14 SIGN URE OF APPLI ANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 04/12) Page 9 NDUSTTRY Y OF REPORT ON SOIL BORINGS AND BL "s INDUS DIVISION AB09 P.O. BOX 7969 HU,'VIAN F~ELATIONS PERCOLATION TESTS (115) MADISON, WI 53707 IH63.09(1) & Chapter 145.045) - L CATION SECTION S " '/'/4 r 04VNSH1cIf R/:W4H~nti/ +@fPXCLTT'Y"------~LrJT NQ. HLK NO: S~UH~OrIV1 ISION NAME: ITxyN/Rce(o /AA, W,i- rTL - - COUNTY OWNER'S(BUVER'S NAME- MAI ING AgDRESS: k,~~lFF'~ / DATES OBSERVATIONS MADE y~ v 2_ NO. BEDRMS COMMEI~IAL DESCRIPTION - PROFIT E DESCPIPTIONS 'T-FIRH,OL ATION TESTS ycxtt esrdence Neu !Re lace -3 4 `f 11 eh C •Z- RATING S= Site suitable forsystem _ U- Site unsuitable fors stem CONVENTIONAL MOUND. IN GHOUNDPFIESSURETYSTEM IN-INL HOLD-NGcT~•^•NK. RECOMMENDED SYSTEM cphon,lb . ~S CCUS CJU xS ElU EIS k.~ I I L'o~scet. r~tc.+,~/ F3 1fdC~,c It Perlilation Tests are NOT required DESIGN RATE If an portion of the tested area is in the under s H63.09(5)(h) indicate' _ Floodplain, indicate Floodplai elevation. ~ PR FI E DESCRIPTIONS BORING TOTAL' EPTH TO GROUNDWATER CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH,iIQ, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK) i r 7 B _ . S / C C 6c -t --1, _ 1 B ~~'Sr ~v.7.t.ut~-- 7 a~~• ~ ( d, 6.'v ~5/~~L` n C S-5( S B- _ N 5 e 3. I ~~L[ do 1'i ! r t lc n C - _S _li r C S B- - - - - - - - - - - 1~ PERCOLATION TESTS TEST DEPTH' WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES HATE MINUT FS NUMBER IiWt4l E5 AFTER SWEL. LING INTERVAL-MIN, PE R10D 1___--- PE Mob22 PERI PER INCH P _S~--- - _ _ - - - 4-3 3 -i--- - L 3 I t~ PLOT PLAN: Show location, of pr c. I rtion tests, soil horings and the dirnerns(ats. of suitalTW°'so indi e scale, or distances. Describe what are the non zontel and vertical elevation reference points and show their location on the ploi~tpfan. 511 1„ dice 1124 ion at all borings and the direction and Iw cen, of land slope. SYSTEM ELEVATION 6' C', t-~~-sRc C, e- • tN oPI o a IL b(fit. 116 , L~ PcrcS fi f = tfcn~ 1~J1 3 ?c -5, S. cf I, the t rs,gnerl, hereby certify that the soil tests reported on this form were rnarle. by roe io accord smith the hrti lad.uas mid methods specthea tj:r „ . A.<Lmnlstrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. "`IE (pn t) TESTS WERE COMPLETED ON r f~ J "r ' / 'CERTIFICATION NUMBER FH )NE NUMBER (oot-,, A e. Gf F - - rr• wlsconsu-1 APPLICATION FOR SANITARY PERMIT HH D 1 L H R (PLB 67) , e COUNTY Ut.4~HFil fTll-i IT OF UNIFORM SANITARY PERMIT # ~ - 11't01J"T- L"L UP 1. HUM-1RE1 F t1Ur15 ~ 44 -Artach complete plans in accord with S. H 63.05, Wis. Adm. Code for the system, on paper riot less than 81! x 11 inches in size. -See reverse side for instructions for completiny this application. PLEASE PRINT PROPE TY OWNER MAILING ADDRESS PROPERTY LOCATION CITY: 1/4 1/4 S T,, ! N R VILLAGE: (or) W TOWN OF: LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST RQAQ, LAKE OR LANDMARK STATE PLAN I.D. NUMBER ~.l TYPE OF BUILDING OR USE SERVED 1 or 2 Family Number of Bedrooms. _i Public (Specify): " 1 THIS PERMIT IS FOR A: ;_/j New System Tank Replacement L___ Repair Replacement Soil Absorption System Revision Privy Alternate System Reconnection Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. L ICI Fa Seepage Trench go Bed Seepage Pit Holding Tank , _J System In-Fill In-Ground Pressure r Vault Privy Pit Privy L_J Existing, For Which A Previous Permit Is On File, Permit # issueu 1 An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total # of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity ~nrlr, / Lift Pump Tank/Siphon Chpifnber Holding Tank capacity Manufacturer: l t y /s~ v IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: _.j Mound _ In Ground Pressure Total # o f Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): Private i Joint Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Narcx of Plumber (Piipt): Signature: MP/MPRSW No.. Phone Number; Plumber's Address: Namr, of Designer: COUNTY/ DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: r 1 ~ -_1 Disapproved Owner Given Initial It- Approved Adverse Determination Reason for Disapproval. Alternate course(s) of Action Available: DILHRSBD 6398 (R. 5; ;2) DISTRIBUTION: Orighlai to County, One Copy To; Bureau of Plumbinq. Owner, Plumtlei fre►A Alt In1ti1► And Obtsivation PIPS AVPr ur~o VOW Gap ►W++- 12 Abur• f Ina+ - .0. 4" 1.uU Irun 42° Abu.* PIP• - - Vont Plp► lu Howl ura41• Mast, 11419 Ur mMtn. 1,11r.+Iny r+n 2° AVVr.yujjj] 0ru PIP► Pip► - o u u u b" A49,09al• Pinola i♦a Vlp• B►lor b►n. alb P1p• -Lowing T, minut Ing At bottom of S9at.m t'('V )U5~ O rtnc.l x'11^c~C< - ti i 1e.~ .ors \`i/\\\\~\\ SO!L FILL LI C)f. P, pt- APPP'.IVED S wTNETIr C.Wr MATER14 ° F PAS/ VOF IAGGRFGAIE - ( , ,V r i - - - 4 I i- t: j, ,f, I'll"E P'r 4-i i ~A`"1 11JLHE' HELO~n,' rt J"AL CjPADE r 9r rNA~{ `1 ~ ~t.li.'NE ~ l i,',N t 1f,lAt r,P AOE /'MUMUM M-PrN Of E:XCAOTld)0 FKOM OK161NqL OKADF- P> `+iFJt=NES MINIMUM ©f r" OF FXCOATI,00 FKOM 1 14'MgL (3RADL W(LL ~E 1 1 O j N "I" 1 tR• 1 / A ii t 0 l ~ X I 1 i~ a Form - S T C - 104 . AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP 1 SEC. T_.W ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of IL11R 83 SHOW EV RYTHING WITHIN 100 FEET OF SYSTEM '3j, i ,sy ~y A-e L~ i INDICATE NORTH ARROW ' r~ i H% ~piT n BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: Proposed slope at site: SEPTIC TANK: Manufacturer: ~fly~.-Liquid Capacity: T_i z Number of rings used: Tank manhole cover elevation: 4T Tank Inlet Elevation: 161;7 _ Tank Outlet Elevation: 141s-- Number of feet from nearest Road: Front 10 Side , Rear, O feet From nearest property line Front,O Side,O Rear,@ feet Number of feet from: well A/~, building: __2_(L (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE 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, Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: i Width: Length: Number of Lines: ~ Area Built: Fill depth to top of pipe: Number of feet from nearest property line: Fro rt, O Sid., Rear, O pt 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: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: Plumber on job: License Number:"/ E 3/84:mj DEPARTMENT of INDt/srRY, INSPECTION REPORT FOR LAPOR & HUMAN RELATIONS bAFETY & BUILDINGS ?.C*BO;: _/9t9 PRIVATE SEWAGE SYSTEMS DIVISION ,IADISON, WI 53707 XX BUREAU OF PLUMBING CONVENTIONAL L__ALTERNATIVE S7 vI~„ oo N.,t„nv Holding Tank [_-I In-Ground Pressure Mound NAME Or PE NNIj It)LDER AIiD=7 ESS 11F PEHMII 11171ER INSPE( i!ON PA 'F John Windolff I R R. 1 Box 195, Hudson WI 54016 BENCH MARK Iv )DLSf,NIP_ tftt.,N' REF Pr. ELEV. r . SE NE, Section 12, T29N-R20W, Town of HUdSOn,LOt#2,M. A. Windolff Su in Powers, Jr. 1563 St Croix 69652 SEPTIC TANK/HOLDING TANK: IVANUr AITDREn -7. I!1 1 y .!_ITY ~r 1~ e. l ✓ An, e, - - I- a3.i LOCKIN T PRI.VI L PROVI)E - 1 _ AYES NO YES No IHr~; r^;r F11A i JAE Hti NEE RES O M Bono LCLOI YES Nojv ----1------------YES DOSING CHAMBER: f/-- I- I, M, ",l Nl)FA(,111RE1t =t~YES {it1HEl L01KNt covEH NIV NO Itt wnH ul wYrocES n PROV oED GALLONS PER CYCLE: PUMP "n tunn+,I~s oP[ n [r,NAt NUMBER OF Htw tt, v :.11 .NO eur cl YES evT TO~~r (DIFFERENCE BETWEEN FEET FROM PUMP ON AND OFF) ST YES - _ _ I N~ - NEA RE - I. SOIL ABSORPTION SYSTEM (heck the soil rrtoistu~ at the depth of plowi ng FORCE or excavation. (If soil can he rolled into a wire, constntctlon shall cease until I the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: wIDI , _ BED/TRENCH IEJ LI-- rr )r nl vIP~Nr~..,, Fi ~ - - f DIMENSIONS ~r cI F ;I P], is l 1 I v rtR AL ~ PI _ .IEt-'R (,RA t .11`rr- FI 6 L uN f FI iFI 1 -t far wl'I.'! L)~I a i PF p13rR PIPE MAIFR!AI I )1;•r' PHN ~!POEH11 ~T,_ I E COVFR 11 rs. .1 u.EV fN1, NUMBER OF EtL f ILIJI e,, veNr IF A tS LI AIEd INL 'T FEET FROM I E - 1 ~ NEAREST--► - L-- - i - - - - -1-- - 1 - MOUND SYSTEM: - - Mound site plowed perpendicular to slope and furrows thrown u Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM psiope: mound systems to make Certain that it 1 ON REVERSE SIDE. SHOW ELEVA- rnerts the criteria for medium sand. j TIONS MEASURED. !YES 'NO SOIL COVER rt r ,,,rLf - -L _ of .r sra rtar r..r,l HEIr ut_i I Lr:,, eE:. - YES NO !YES NO (a NI IT x,f - U Prrl T fSt IIL :Efl F , T, 7 - YES NO Y E S ----_-_iN0 i_.YES - NO PRESSURIZED DISTRIBUTION _ SYSTEM: wlnrH Li-. 'V l,l ri NC>()F BED/TRENCH At >vncl aI; ran,>vt L orv13F,wvlpF riFr ,I. ~,vE nr TRENCHES DIMENSIONS I}~ 74A NIF UL!, Pt1AAP f9ANlt ~lL ii DI ISTR CIPE MANIr',LL)1AATff1IAL h 1`;iFt IS F PI'~F - .Nr J I)I t~T •IJ Lit tt -..PIPk 1 tEH4f & ELEVATION ANDFLEV ev Elev PEF; ,la DISTRIBUTION IJ INFORMATION ~I E tittF HnI E ,PACING nT.u L EI, I ,II,Hr~.,, . I'[)V FR 1.14?ERIAL VERTICAL L,/ r (-f {.HE.iP-~:i. 1 .~PPH(,~F YES --NO COMMENTS: PERMANE1,fWA_ ERS~YES L IN O VATIC;NweLLS ~rNUMBER OF FROAEHrv weLL Hult_olNC: FEET FR LINE OM ~IYES _ NO _YES NO (NEAREST-- Sketch System on Retain ire county i Reverse Side. TIi DI LHR SBD 6710 (R. 01 182) C 0 3 m (D CD r as cy) O v'i O p p< I'C N O N• 3 3 9 cn d N (NO `Cp cD O_ (p Z O N N=tz = NO O A N O. O O ° O U O O C) 0 p O) ~1 O C CD _ 7 ? O l~ O O n (n CO m m Cn - N a m (D CD N N co (D C: 0 r_ CL 0 0 a w°oll O 8 8 (<D n r cd (D 00 00 0 r_ U) Ul 1-11 Iz N Z Z O O O ' O * * * ~ G N Z v CD Q T 0 o O N (D (CD .(OD ► N 01 O C' D7 A p II, (D co d 77 N N 3 W co O_ ~ Z O j co z 0: a ° o m ~ ° m ((D Cc c (D N C (D O_ W (D Q. 3 ° -I fq Z O A Z (D O !A C .Z_1 7 p Z O 0 a O 0 :3 cn N W m a 3 4 Z O Z K) N m z O A W N O =r Q C O U) G O O T (A O N O u G) 67 ` v z a n: O 7 O N O ~v S O r A Om O p b O N O s 3 Cl) ((DD O. < (D LIZ ~ 'O p d (D O O. N =3 O ~ W 0 A O a N O oq O N p CD O r V O 0 Parcel 020-1111-06-200 12/14/2004 09:19 AM PAGE 1 OF 1 Alt. Parcel 12.29.20.450H 020 - TOWN OF HUDSON Current Xl, ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * WILSON, HOWARD P HOWARD P WILSON PLANTE LAURIE PLANTE LAURIE 287 EDGEWOOD DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 287 EDGEWOOD DR SC 2611 SCH D OF HUDSON SP 1700 W ITC Legal Description: Acres: 1.340 Plat: N/A-NOT AVAILABLE SEC 12 T29N R20W SE1/4 NEIIA LOT 2 Block/Condo Bldg: C.S.M. 6/1538 (ADD'L HIST 719/293) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 12-29N-20W Notes: Parcel History: Date Doc # Vol/Page Type 04/28/1999 602175 1422/360 WD 07/23/1997 1211/510 QC 07/23/1997 991/471 WD 07/23/1997 832/530 2004 SUMMARY Bill Fair Market Value: Assessed with: 48525 219,000 Valuations: Last Changed: 10/29/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.340 37,400 132,000 169,400 NO Totals for 2004: General Property 1.340 37,400 132,000 169,400 Woodland 0.000 0 0 Totals for 2003: General Property 1.340 37,400 132,000 169,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 501 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 Parcel 020-1111-06-100 12/14/2004 09:21 AM PAGE IOF1 Alt. Parcel 12.29.20.450G 020 - TOWN OF HUDSON Current X! ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): = Current Owner * WILSON, HOWARD P HOWARD P WILSON PLANTE LAURIE PLANTE LAURIE 287 EDGEWOOD DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 1.550 Plat: N/A-NOT AVAILABLE SEC 12 T29N R20W SE NE LOT 1 OF C.S.M. Block/Condo Bldg: 6/1538 (ADD'L HIST 719/293) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 12-29N-20W Notes: Parcel History: Date Doc # Vol/Page Type 04/28/1999 602175 1422/360 WD 07/23/1997 1211/510 QC 07/23/1997 991/470 WD 07/23/1997 834/610 more... 2004 SUMMARY Bill Fair Market Value: Assessed with: 48524 24,200 Valuations: Last Changed: 10/29/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.549 18,700 0 18,700 NO Totals for 2004: General Property 1.549 18,700 0 18,700 Woodland 0.000 0 0 Totals for 2003: General Property 1.549 18,700 0 18,700 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 L 0 to 0 3 T 0 D ~1 C rd+ C O 7 A p' L _ O U) O o c co < = N N O O 7 a O • CD m m CA n rn 0 0- Z n N N O j N T. Q C, N a p c_. ~ .p ^k CD -U :3 0 n S 0 O O O O =3 2 N 7 N N O O N N ~ O ° o m m m u D a s m B C N G N c co m o CL c°o a O m w C) R z m c0 CD N 0 r cn N 00 ~ 2 cn c C: N z O O O N C)' 0 rE to to N < D O A N O ~ < y f N 7 ~ U1 fD W a co z z N Zca Z o D CD o C) O ° m ~ m N• cn -o !mil 0 (D o) C COD N. O w ~ o- a 3 z (D 46 Z O CL A Z r O C ` M N ffl CL Z Z CD C < CD =r CL 27 M A J \ \ N ~°~0 ° \ Qom N ~ \ l i omg y o oc m 4-- a ° o- 4 m < A s r, C ° o k t` J I H N = a) ° O A O O O L ~ EGG z8 \ BEARINGS REFERENCED TO THE EAST LINE OF THE C. o NE 1/4 OF SECTION 12 ASSUMED TO BEAR ° * \ N01°1314711W. C * Z m f D \ D C'7 \ O m O 0 \ T \ S6,10 S 0o, / • y' _ B,SO~~F S'~ \ ,n O ~ w ~ ~ Al loo, H im , ° Ay SFT B9C6' I 6 6, is o r' I / o ru, ul Q rn I n f.. m ~ 4 I r~ (p hp ?O c0 can - . 1 I m ° ' f) N O I ' cm°> i ro o ~ & " 1 f 10 0 a rm w c~ I I ~ cn im z o I N T co cn, a oo I W 17 tp ,~,U` 1 I D TI O 00 r I I N c m rq O n co C~ l) N n X60 ~ZN o -1 rt N O1~OS~ 1 r o m ' a n ~ L7 o m tfj C3 to Im 1 C m 118.011 ' ° Imo- 1~ 155.00' is o C r` icD i-n c ~rn N0505912211E N05 14'04"W r, F Mn Im < O a h 0 -n 00 rn IN n tO Ln Ir \ IN la: H m 10 LG .;0 \ CA C7 'L7 d v ly yC n •--1 L" cu ICJ IF 1~ O ~ Cn O Z O a CA IO 13 Cn Z I v Ia cr E I Iv Z 1--. N c 528.061 -a un C3 u) m NO1 13147"W z w c C-r o m E Z to Z --i \ C C l -1 1-1 Z -4 n N tV -C O ""1 ~"1 O O Z O -•C O m E C3 2-- 3 O r-. 3 Z m ft~ Z N Z O, m C m 2 N 3 G m 3 z m 4 O • o ° 1 - m c rt a o fn- 000 x 1 G7 ° -xc Z x I-I-I co o W .F z o a, N rn Z ? w z iZ7 A 1-4 rev \ -V t= O Z -w x C7, :a •0 1 m z m coil v co o -r1 w~ a y' n YI u' ° ~r Z A v O cn f r1 r r o -n fTl = Z D .o n -I m C N 1 m o 3: 1 cn w A D M C', m W O O r) Z rv t I g z n m = APPROVED .,4 ~4'✓~1~ y~` ;64 AN 0 5 19 Q 5 ST. CR01X 00041 f V O COMPREHENS'VE PARKS PLnIVrr1 JG n m Al`O ZONING COMmITUE 0 N O 3 o CO ET F c o d 3 CD 3 ° 3 (D v w 3 3 O 0 w z O rn C _ O P 0 co N) N) 3f Ey (D -3 rn ~lCll Co Q fp Z n y 2. N a Q N O wr CD I O N j .7 O N O. N O =1Z O OO' 1 cn (D zT C, N O O 3 = = N y y W O O o (D m cn D a o Co' CD W C CD y a (D 3 a (D c ol o ~ a 3 O ` ~l w°oL CD CD CD CD V1 O C) r - y cWn (WJl j N O a' .D CL o o O O n~ ~ ~ ~ N ~ O N Z v ° 3 cn - D Q O O _v A O y (D fD - M O 0) d O m a) cD (D < ~ N N 3 a W Z c* C co Z 0. ~ cl j v O D m CD (D v C (D C CD N' C W N Q - Q 3 Z o Z N in l0 A Z =ti C , ~a 0 v n a z ° 0 3 cn -I ao v m N N M fD _ co a 3 A x O Z N M CD y Z (D A D _ (D ~ y d C Fn, O _S Q (I N N C C ° sm o ° o 0 m m v Z =r O y p s Z3 r- c171 ) o 00C CD O v G a O A O S < k CD a -0 0 CD rn o v o ti 0 v o ~ a O A CD DO H O° i 0 r Parcel 020-1111-06-200 01/07/2005 04:37 PM PAGE 1 OF 1 Alt. Parcel 12.29.20.450H 020 - TOWN OF HUDSON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): Current Owner HOWARD P WILSON * WILSON, HOWARD P PLANTE LAURIE PLANTE LAURIE 287 EDGEWOOD DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 287 EDGEWOOD DR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 1.340 Plat: N/A-NOT AVAILABLE SEC 12 T29N R20W SE1/4 NE1/4 LOT 2 Block/Condo Bldg: C.S.M. 6/1538 (ADD'L HIST 719/293) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 12-29N-20W Notes: Parcel History: Date Doc # Vol/Page Type 04/28/1999 602175 1422/360 WD 07/23/1997 1211/510 QC 07/23/1997 991/471 WD 07/23/1997 832/530 2004 SUMMARY Bill Fair Market Value: Assessed with: 48525 219,000 Valuations: Last Changed: 10/29/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.340 37,400 132,000 169,400 NO Totals for 2004: General Property 1.340 37,400 132,000 169,400 Woodland 0.000 0 0 Totals for 2003: General Property 1.340 37,400 132,000 169,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 501 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Total Special Assessments Special Charges Delinquent Charges 27.00 0.00 0.00 ~oc- ~1c~Z 82 \ BEARINGS REFERENCED TO THE EAST LINE OF THE 0 o NE 1/4 OF SECTION 12 ASSUMED TO BEAR o m \ N01°13'47"W. 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