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Home My WebLink About020-1013-40-000 • t ~ } a o to p n c_n p 3 m n C Lo_1 (D Z v n •2 v' ik y CD m v (D CD l 3 3 z C) p 0 ° CO AN O z ° CO CD C N H• 3 C,) O O N CM O O N (b O j C C- 0 o o ~n 3 I 3 D 0 CD CD 6 N r I 7 N~ 7 N N I 00 ~ N N O N N O I !1 y^ Cn m o cn ~ D a Cl) O < D m a { e (p' N G CD N a 07 N W 7 N a Imo' C) CD CL ° 0 CD O Al< O °J °r' Fp N) CD c,D CD 00 -r CD 03 N A N c A A c N N• N Q 1 0 0 0 0 0 0 K ter( c -p 1 -4 _ F, Vii can ai Ln 3 N Cl) CA ai A D ° 0- vvv°_Q vvv0 (D CD rm' fD y m CD d CD m c~D (D - c co z c co z p j a 7 p ? a 7 3 O 5 O D 7 (D ((D 7 N l7 N (n CD C (D Si (D C CD 'i CD a N a 3 S 3 E (D _ (6 - 1 U) p z (D CL a A j z ca M W (No m (D (D CL c. z 0 3 0 3 a 3 3 U) 0 m N N z D (D A W p~ ~W CD °gmmoao°CL 5- 0 ~~Q CD N(N O0:1a:E _~n CD ch (D Nom o' m 60 0. 0. -m CSC 4tCC Cr ~CD :3 am NfD 3 T -~w`< n m-O 0-0 (D T CD o P, CL a) C= 'D D CD 0? o in c ` Z a N C N (y N 3 Z a CD C) NO ° N a m (D ° 0 3' O p 2 - C) CD c CD o N O W IV d (D (n N N N z 0 O n. N CD a cn a m Cn CD m rn' :3 7 - CD =r WOO cCn n y O 7 a 0 CA N C CD 0 (fl a N' ~ 3 n< Cap 7 N Cj M. CD N? O N D (D = d n_ (q A O •O N N a A C, 2. 6-0 0) cn PQ CD cn M 7 1 0 CD , 41 O CD (D 07 CD CD CD (D C) r o N a0 ZI mEn m N'o vcc~ 3 a ~ v a CL -(Da ~ mcv ~O~ aCD 0- M. CD n ='01 7 o co oca:E woom 03 a~ c 3 Na a 0) S O N O •p O cu C - CD CD . Cl) 0= 0 7 C CD X•q N n~.at0m. NO aS N (D _ CD 'O N CD F) 0) O CJ SN 1 N ID W O N a 7. O o < :3 CD c 3 7 d v 1 z a CD :E C/) a O j a ~ mm ° ° rn a N O p ti b CCDD (D D O ° CD O CD +l O i O a r t 3 ~ -n w ~i \o ~t J M n Z H uo H ti J ~fl ~ 7 C LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF HUDSON COMPUTER NUMBER 020-1013-40-000 Parcel Number 11.29.19.58A OWNER NAME: First CELESTE M Last BENNETT PROPERTY ADDRESS: Hse # 1/2 PD --Street Name-- Type SD Apartment 1050 TANNEY LA SECTION 11 TOWN 29N RANGE 19W '/4160 1/440 Line Description Line Description TOTAL ACREAGE 11.250 PLAT LOT BLK 01 SEC 11 T29N R1 9W PT NW SE 15 . 02 BEG NE COR NW SE-TH S 400'-W 16 ~D 03 485'-N 75'-W 835'-TO W LN 17 04 SE1/4-TH N TO CEN SEC 11 E 18 05 POB & PT ROW QC-1299/343 19 06 2 r~ v r jl 07 21 1 08 22 i J 09 23 / 10 24 11 25 12 26 13 27 14 28 F1-General, F4-Prev. Parcel, F5-Next Parcel, F7-Valuations, F8-History, F10-Exit LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF HUDSON COMPUTER NUMBER 020-1012-00-000 Parcel Number 11.29.19.53A OWNER NAME: First CELESTE M Last BENNETT PROPERTY ADDRESS: Hse # 1/2 PD --Street Name-- Type SD Apartment SECTION 11 TOWN 29N RANGE 19W '/4160 '/440 Line Description Line Description TOTAL ACREAGE 18.000 PLAT LOT BLK 01 SEC 11 T29N R19W PT NE SW 15 02 N 613 FT OF NE SW 583/4 16 03 17 04 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1-General, 174-Prev. Parcel, F5-Next Parcel, F7-Valuations, F8-History, F10-Exit AT T 29 N • R-19 -W z~ a.~~u~ %r~~.~iu• See Page 112 For Additional Names. 014 ST. JOSEPH 'E' PAGE 46 900 MOUND DR SOUTH 800 600 700 - - - - - tr tT clalrce Richard & TANNEY oE~ Edna Pahle Philippine Daniel Hntng A HDPkLns Beer tr Beer Club x a 80 28 Inc 67 26 ,yti K& 29-50 40 D Bast Celete 29 L&D a r AlWght Bennett r C ~ n Q W Fain` f n Q° Y 19 38g I i m t,L, & 20 4 W tr m O 52 ~ tl o. ~ 'I EXuAe9 m K 1- 1A B R&B 21 ~eN~& QZad S s yryxl A&M W b Bast F- J 1 21 A&M 34 2 H&L I 40 D &L^ 7 CH & K 10 g 40 - @Sfrtrb - C&D b _ L &1 s& 5 MOON- _ z sar ester 20 ~r S&C iC BEAM 1i sfsu - 510 tr 6I RD ^oJ~ 1 3Lir Bask zN tr;; RM 7 tr CS s Q, N o o R St Croix a I.A,,,- 2 f tl . d Ronald & Er ''t:.-EON °a< No Q ~ loretta Vly Gr 1 J m D J&M ~ m; d Bo Scts Inc I C1 13 U m J s y io v&B SADIE [1: 'S Steven BGs ° ,1 s & LN Renee LLI l n 35 r `e+ a. r, & Caye Y sG s IO ' Spott t. FM v R^ Bakken 80 G s S9 < u SH O c& L 104 2$0 Z Q u i s' a m BAKKEN elchrt 1a - i ca y X o °u R D 2 G&L H N iA~ 0 3o en« Thompson K a Barbara u Ss N & ae a e& MXussa oral Fran CH Richardson a~ g 'I s~ Herauf 3o ST/^ 14 o azb 159 _s (o-' 16. ~ 27 JJ_~ 31 PF2 _ - - _ _ - - V -T& Bradley 27 7 22 MuBlnax $ i N= " 47 o` BB a 5 & 5 le LI Larson Lahr Inc 1 N 2 pp'^ 1r G J N Blank 7 D& B 19 I `rR U y tT Martlneau ' ~ ' TfiB CsstY IX St Cra4 M&R 49 1T a S 2 x.: tr Gale a r l R & c aN & Isabel __.,h.~ y shunon ~ Qt1a115 62 etr,~ ~ . R&570' ~ r~ . 1 87 CH 24 ~ D - - M&) F PGb &La 19 Larue,,z + Y~t4I : 1 cobson LgcA x; 11- - -n35 & Don- I & $ T8 J G & S 2 27 + 37 5 li 17 u M b. B n wn to 7ett er a.9 ~ c W'iIIas aw Bast e~ 3 W ~ & Hour D&L 9 DaWd ; o a KobBka ;:.C G f w ]0 G I - 'fi 1~ C .....,i.,.~ A& Elira_ KeBY,,~ ]2 y b p R1 rust m t m .B C&K N {AI . -t-103 < j`yza chi''.?K. s zoo B 11 Q~~ N r. 2B &1 °"t..kE. CRIMS I 2 K s yt _ Rabe' (r A At' v VALLEY R o D x S&1 5 1`1A Marian ^ ~ RD ,9 a' • G V DR Trust Florence s a ns erf ° as 40 p Polen Pale Margaret _ g C L L - - HWs l>izil LPnney n m a ^ s ~ 160 1 r xno 243 t r I1SA j & ¢ _ Lx _LL tir W> Fish. & t 4 c zo cy ! BLUE JAY + LN ~ - ' tr ~ Waldlife 3 r.. _ 110 2 sad= u 3 $ 6 Robert & O o Gregory & 94 2 ZV_ r~ o lH 61 Christine Waxen Q Samantha ~ 1 U v&v WON 132 o L7 Kanne R I 3 - 4 a T , o tr- o u w 5P 10 72 N N Z supnen K 13 ti + + BAKER I e Z & pameh Neil & C7 Lalle- I tr in ao~~ RD Y moot zB Mary r] I c ~b9't D&A ~ W11COR- J Richard R& 1 I z 3 son RD & I { r Barbara zz X. & Jean SE 5 33 1 O . tr 8 Pearson ' Garbe ~ g++ v x R; Micha~l _ G Is nor w CMERRV I ~e U & Joann StJrlq r 4. ,z-oE x ~^io RILLLN 234 I 279 oit40 fit- 177 Larson39 33 dt26 53 l}_~ trJ- - - - - - - BRUM MEL RD - - p -GILBERT RD I TROVE' PAGE 16 A 1 r I M r - as ,'..__t~'_<..,_.c .tee ..,a++.. w ,*_w~ ....v.+:.. _ 1 - . rr., SON T29N:-R.19 _ SEE PAGE 41 .Qo a~ /a,E s ty f• R chard 40 untie C/u6, Inc. A : 6 1 % o~-0w/C die 7~3 Plllida// 67 ~j /91AJ Ne d2 0 /o/ sb o d d sf/~41~ ~ v o l /60 ; KLB C \ f3. 39 L/ ou/eCtu 14X02 o• ~6 w ii e i/ a Q~ i G • sz.si f ..a 9B J • T Ru/h L r RO. 4E/eano/e a Katrc~ O/owr~ i~ 0 nr • • it s h • • • v° k • o Ly/c a • 6 e ;rq : ° o Ci/~/ ouf Counc// /3a e/' ~ • /7x41 Q r/ ?nF : o v f ~S • Croix • /o. °s o o l~Q//ey ilk /Sd /••f f ~Qt •1`IZ:4CT5 Ken f e 270 ~s .9Q,E,~cen .2icfiard ~ c - CS/oo tt s. 80 £Dr~°S /o¢ ~ ~ R '~S Chas-/e s dCo .Barba /so p~C/eno~c= 4iB 2`rqC17al,eSOn R. a' o r~~es ' ` 3 ' ~5 ALL.\ • /R6 ~ 00 vora a ::~:~..9 0 zo Inc' C• g % .1?~cTS ~ • ~ z.B ~s a Ct/-1i- N /do.6 Charm/es ~ .Bcss~ra/e '¢d ~ Kenneth l~ Ke ~Iuab siis 'Se'.,oy -nn ash 1 zo /5375 W ~fi/, efux /97 /86 ~•i/b ei-f' J~ ~ °9 .y RD ~f /`7a/y iP%chey ~ e wi s • • /t/a/s 0 4 5178 a\ 2/9 9 ~6 e Z OLANDS ~R 9 David ~s • ison, K¢the~ine ~ n/e/s era/ >~e~y i9e~~a~d c o Mar ~ Krone /°o/en, cfux iNGL 1y7 Kii~nay 4~ o "ooi'G //o n 3/3. / W 11 /L3B MY /6 0 1¢O P 7 ~ /°Qt~~cna K y wax V,7 wig /sh e 90./ 2 . /80 tTa1/yq P ~ QQII ~2{c~iard M. O VN7ps 6396 /74 0 s ''A ciQ /sSS9 94 ~a/it/e.y~~ s ~CO~~r- ch S/es~ N/axo~ 0~/LZ9b/t2 •zxnc r . • / 3z./B A ro/fei ef4/ +ol - af/i / 5 44- /n 3 6 • va~ ~u: ' ~ y.B¢.Er~ .Qo6e~f m i ~ ~ Ri 2 •FO 339 rl`01 r;~ Q~~1 G 9_• J o Sf%Fw~R Ctl ~ Ma9N GH /o v ~sf t Cs., nc,Rav/979 SEE PAGE /5 e ._'i` ~ ~•1 i ~•n:~sLUV~~e:e`~ti..yei~itcr-~1e.°►~sic~':C.js;n.'wa:~.:.;~~'+-•'s'a.'..r.'wwtC~ta"..v'~:L s.:a:~:r`~aL ~..:-i. _ _ _ _ )SON T 29 N7-R. 19 W. _ SEE 1 GE I/_ Da/- /e lEE Pine amc Un/. n;fcd ■ ibo ymP/e 6if' oha Hi~f n C/~ 6, Inc . • ~a' ow .Bee; 67 / • /Po y ? , ~ 3210. / a.~ A /S /70~O~T //7 S- Pa/ P~fh ~Qy E/ea~a a+f~e~- .s -B~ow~ D 97 its s :v ° .--..,._.2 • ~ • S'7`'Go/x ~ • ti h r l• r ~'.~/cScoy fs f or ~~ys / •sle~soo~ g ss Val Bader Q4y C. ' s iio tae I /off ~i'~4 s s / R.R. s L 7. f ~GLU/ • CK.fK- ° C. & . W c Ci/ass Gso 93 /R 7203 T c • ~Z Tvf u ■ • 19 • 5 I abe// Buoy N 630--//s 6/S /Ye~ne~h tee/ ~z ~z 6 17? 9s 4 • ~o/i / lay 2~s ~~Q y y a 9 J ~ lV • s.•g `s~`~o/4 /Ye/y •,8e~-~Q.-d /moo i97 ~ 40 /3B 393•/ 2 • fig//en 4 197-7'ivc/cz • k ke 11 7 ILUAZAMntia/ /74 per/ Ufin R € ~iSSS9 S ESta.1e5, InG cTo ~QeiS d„ U Leoncz 94 ,Ba,/re^ ■///axon ■ iy3. s esf isz.ig d////4~n N • a ~ a C'/4~°/° 0 E/mB~ C. W~ ~ ~ /St/ loS N l~yyo Vy/✓~S/e ~ x l~ ~ l ,BQ /r-ei. ~ a li 339 /60 So ,Qiuc e z ¢o 'y Wrn. ■ N 70.74 os. fie 471, d14 %6/s hc• SEE PAGE /S ~Sf ~ioi Co~~/ y, /mss. 'DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABdR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 - BUREAU OF PLUMBING MADISON, WI 53707 CONVENTIONAL ❑ALTERNATIVE State Plan I.D. Number El Holding Tank ❑ In-Ground Pressure 1:1 Mound [If assigned) NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER: INSPECTION f ATE: Jim L tiko 621 Vine St. Hudson, W1 BEN~C~H ~j 9r ,Section point) DESCRIBE IF DIFFERENT FROM PLAN REF. PT. ELEV.'. CST REF PT. ELE V. ~VV'Section 11, T29N-R19W, Town o6 Hudson Name of Plumber. MP/MPRSW No.. County. Sanitary Permi[ Nu Robe,tt Utb tick t 3307 S Cnoix 4941 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. JTANK INLET ELEV. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER PR~OY}DED. PROVIDED. CJYES ONO OYES nNO BEDDING VENT 6IA.'. VENT MAIL. HIGH WATER NUMBER O : PROPERTY IWELL,IBUILDING: JVENT TO FRESH ALARM. FEET FROM LINE= AIR INLET. OYES ONO OYES ^❑NO NEAREST DOSING CHAMBER: MANUFACTURER 7ING LI QUID CAPACITY PUMP MODEL JPUMP/SIPHON MA,NUFACTLIERWARNING LABEL LOCKING COVER PROVIDEDPROVIDEDS ONO OYES ONO OYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL i RUMBER OF PROPERTY WELL BUILDING (VENT TO FRESH (DIFFERENCE BETWEEN t L INE AIR INLET .FEET FROM PUMP ON AND OFF) OYES NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LFN(,TH DIAMETER MATERIAL 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: WIDTH LENGTH NO. OF DISTR. PIPE SPACING. COVEF INSIUE DIA #PITS LIQUID BED/TRENCH -'1 TRENCHES. MATERIAL, PIT DEPTH. DIMENSIONS _ l GRAVEL DEPTH FILL•DE TH J DISTR PIPE DISTR PIPE DISTR. PIPE MATERIAL. NO. DISTR NUMBER OF PROPER TV WELL. BUILDING. VENT TO FRESH BELOW PIPES ABO/VE OVER E V INLEr. ELEV. END, t f PIPE16 FEET FROM ,LINE!,. . yr t , AI R.INLET. , Y l1 i. NEAR EST--► MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- O meets the criteria for medium sand. TIONS MEASURED. YES ONO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS OYES ONO DYES ONO DEPTH OVER TRENCH BED DEPTH OVER TRENCH; BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES DYES ONO OYES ONO DYES ONO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH LENGTH NO.OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. IN0 DISTR. JDISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEV.. ELEV.. DIA. ELEV. PIPES DIA.: ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY 77 MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS OYES NO OYES NO COMMENTS: PERMANENT MARKERS: JOBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING. FEET FROM LINE f A EYES ❑ NO ❑ YES D NO NEAREST--~► ~I Sketch System on _",,Retain in county file for audit. Reverse Side. SIG E. TI I DILHR SBD 6710 (R. 01/82) ,^e. i__ ~i~..,~ ~ ~,i w W L1 ~ t 3'~ + z ,S r3 i , •y i.. ~ ) 1 i„-i Y4 ~ ~ ~ ~I ~ i ~ IAI Z, Z-7- / r/ ~ -2 ~l 5 s µ i/~ ~~Y..'. " ` rA' / ice. L i • I`1 ! y / j i N uu O~ s HiOMESITE TESTING CO. R-1. 3, VNEIL ROAD BOB sUl ~il ~rL'ia. . rW1 SON, WiS...._. 5401 Cs7r SS as y~z PROP05ED tiwsE most LIE 2, ~r• o~ MOB ' ~~PdM .glt TEST ,g,#~E~~. Q POSE WELL M uS- Li 50 r FXd,--l 444 TEsr " s - C3A+r Whr PfT"S Q 'ISIlr41,(r- LC~~ LL { s ` f/ot►i~ ( rRri Al- &ArRiAleL - Poi)T of= ~.Pcc-~ X, ST106 , ,(E" 11jJE" /~!o Lc~,J 13 0 X - /S2 BED GE NI,~r~ Pat r f ~r' /o 0.O o~ ~ ss rn t V1 ~jti, p - N Z ~ t 'V w ~ tAZ ~ t c G pK i m ~ O 04 a ~ 4 fU % R J ~J r ~Jrr~ ey l v e 00 ol ~f poll r/~~~T~6,J Fr C) 1117 /vas - N a. y 7-3,o Ti r7- Romps TTE Stl'nC r7gG NEE -IATT JI.IJ ~J 'l l lY! A: 7 2 L ~.~i.i _ N'TNNES7TAINSTALLERS .UL .D1-~ ES' ,G~ N~E."; 3307 NIPR.S RT. 3, OWEIL RD, s Lrc - $ NO. 00563 HUDSON, IVI 54016 AS BUILT SAN I'FARY SY S'TE'M REPOR'i' U W N 1,11 ~ %5T~1C 1 VOWN:;ll11' SLC W '1'•'/ N - k ' W ` J~_ ADDRESS Co2/ S'1'. CROIX COUN'T'Y, WtSCONSiN. /71 SD c) C~11 S SUBDIVISION LOT LOT SIZE Distances and dimL:nSionS to meet requireuientb of H63 SHOW EVERY'111NG W.14111N 100 FE,E'T OF 5YS`i'EM --TT I nn ,j it dic at' N r h rrc w BENCHMARK: (Permanent referencc Polnt) Describe: '00, DST ~~~G Elevation of vertical referuLicc point Slope at site: SEPTIC 'T'ANK: Mii nulacturer: Liquid Capacity. - Number of ringki ou coven j Tank manhole cover elevation: 7• 'l'ank line.- 1 levatlon Tank Outlet Elevation: ~3.2,p, 1 PUMP C1iAMBER~ Ma nuiacturer: Number, of gallons Number of bal. hump set for a cycle gallons; 'total capacity o distribution I I n e 6 gaI Loa; size of pump head; gallon per minute _ horsepower_ ;brand name of pump and model number Type of warning device v lk~' HOLDING TANK: Manufacturer _ Number of gallons Elevation of manhole cover --J--------- 'Type of warning device SEEPAGE PIT SI/.E; L'4- _,--Number of pits feet diameter feet liquid dept Seepage pit inlet pipe-elevation bottom of Seepage I.,it elevation feet. SEEPAGL~ BED SIZE: number of lines Z width ~1length 5 ` the dept SLEPAGI 'I'RENC1i: widtl Length-- - PE1tCOLA'TiON I,A1'E AREA 1tLQulltcD t.~ ,O-j? AREA AS HuLLT~ ~i / IN SPEC'I'Dk DA'r1'D PLUMBER ON JOB I --C Azz/ - LICENSE NUMBER- 2An ,(4 C HOMESITE 5P1?C ENGINEERING Co. & EXCAVATING ASSOCIATES ROBERT ULDRiCIIT MINNESOTA INSSTA MINNESOTA TA 't PLUMBER LICENSE NO. 3307 MPRS MINNESOTA LLERS & DESIGNERS LICENSE NO. 00663 RT. 3, O'NEIL RD., HUDSON, WI 54016 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, /'1 DIVISION LABOR AND 6 PERCOLATION TESTS (115 1 P.O. BOX 7969 HUMAN RELATIONS ( / MADISON, WI 53707 • ~ ~ 4 (H63.0911) & Chapter 145.045) LOCATIO SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME: /a '/a /TN/R' ` E (orl W ~-:*T df~ 4 24- 000NTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS:, PERCOLATION TESTS: Residence ; It t "IV New ❑ Replace - RATING: S= Site suitable for system U= Site unsuitable for systemi j CONVENTIONAL: MOUND: IN GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM:(optpnal) l~l S ❑ U 0. $ ❑ U Q $ ❑ U ❑ $ ❑ U ❑ $ ❑ U [un:ders.H63.09(5)(b) ercolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the , in dicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS c .`vlep BORING TOTAL DEPTH TO GROUNDWATER-IN r CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTUR AND DEPTH NUMBER DEPTH ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) L 13, Ij B- ~y B y, / r '7 -7 B iAJ 7 PERCOLATION TESTS TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER IN AFTERSWELLING INTERVAL-MIN. PERIOD1 PERIOD2 PERIOD3 PERINCH P- ".Q. P_ 604 7 P_ V, 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 ~3 l w ,PTicy/ ' ~ = 7 . _ t Am T This test sits Pit OVE® fora ~ _ ~ ; oven 'on se t s fl 5~~Z - E I , Ile, r. Lowy _ GA,t1,t1k /N f i4 ~P' '14 1 6 13 E T ~D LUG' t.a 4 /t11 ` _ S4I G E F• I 41 . d" 14.4 I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): 110MESTTE'T r.5 T-1 1NT1 C; C-0. TESTS WERE COMPLETED ON: 'STATE APPROVED SITE EVAT,LT ad ('ERC TEST ~j~ f~,f'~(I = ADDRESS: MINNESOTA LICT' e~E CERTIFICATION NUMBER: PHO E NUMBER(optional): WISCONSIN LICENSE NO J3-0243"2 t T. 3, O°NEIL RD.; CST SIGNATTE: r 1 , 7TRIBLITION: Original and one copy to Local Authority, Property Owner and Soil Tester. HR-SBD-6395 (R, 02/82) OVER of SK _A U 0 ro (.[tae= and c MAX TH AM ntrrmw of hurt, a , or € tgni n , e d was {i mun €O 1.zeW t? r,. abbby way ! xes- ~`s SETA It SiJI d ABL,'_ _ PLEASE use [£'j?' `,v itin ` i5r, .d . _c , , and Cn%11;54' ing tho idot e,ia,t . j"01,,'lKF j-'k LFC +1s,. t t.:lijnin."tw ..._i:N homing vm"Im! W itm. Drawing (E ;cog a ,{.:mprod. sty. t i S it . d are > , e Wr;tW and vr a! . sitar, .{.tore,€ce r.o.,n c . l ix`} all c3,}i::a; 1t, ,<,u' I C3,a:,9 t.. w +,r3,PS, nameq admen,. Nod or ul ;M€ , E'. . k m .r .t lime qw_" r , r amonh .0 yca..t+ .,..t, c. Al ma i `i BR - W. Y - Lirmsu~ ChdWI - Wd H V - 6't qh fix,; - E. Se Sa : - - pof- W&W 4i 4. Sow jai ay B w x3 P L t, f Y Sao! UN L own R why Coy WOT! o'n"'0 r , Ron; + 'zit t Y' A r v'-s f Kph t C}`Q . ~1C_i ,~.eCGr cr i] i, <s', ri iseF ° g _`a. .-r .,np in 5mmir`.r ? ot. v i,=smt_. h op r t tho ~s . ,n e he 1 # ,sv ra d i tear the 3 i ivaio DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 ' BUREAU OF PLUMBING M,4DISOId, WI 53707 11}CONVENTIONAL ❑ALTERNATIVE IState,Plan ID Numberlf asigned) ❑ Holding Tank ❑ In-Ground Pressure F-1 Mound I NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE'. Jim ei6tko 621 Vine ST., Hudson, W1 RK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELEV. Section 11, T29N-R19G1, Town o6 Hudson Name of PI- mber_ MP/MPRSW N.. Cou nty. S y Per t N b N11 Robetrt U.~btfi.cht 3307 St. cuix 49466 GE-~ SEPTIC TANK/HOLDING TANK: MANUFACTURER LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.. IWARNING LABEL LOCKING V R PROVIDED'. PROVIDED. OYES ONO OYES ONO BEDDING. VENT DIA.. VENT MATL. HIGH WATER FNU_~,l BER O F ROAD: PROPERTY WELLBUILDINGJVENTTOFRESH ALARM ET FROM LINEAIR INLETOYES ONO OYES ONO AREST DOSING CHAMBER: MANUFACTURER BEDDING. LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANU FACTUREH WARNING LABEL LOCKING COVER PROVIDED'. PROVIDED OYES ONO OYES ONO OYES ONO GALLONS PER CYCLE: PUMP AND CON TROLS OPERATIONAL NUMBER OF PROPERTY WELL BUILDING (VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM NE AIR INLET PUMP ON AND OFF) OYES ONO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing jLEN(,TiI DAND 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: WIDTH'. LENGTH JENOOIH DISTR PIPE SPACING COVER INSIDE IA &PITS LIQUID BED/TRENCH CES MATERIAL PIT DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH ) ISTH. PIPE DISTR. PIPE DISTR. PIPE MATERIAL. NO. DISTR NUMBER OF PROPERTY WELL. BUILDING: VENT TO FRESH BF LOW PIPES ABOVE COVER ELEV. INLE T ELEV. END. PIPES. FEET FROM LINE. AIR INLET. 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- O meets the criteria for medium sand. TIONS MEASURED. YES NO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS OYES ONO OYES ONO DEPTH OVER TRENCH BED DEPTH OVER TRENCH; BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED. CENTER EDGES DYES ONO OYES ONO OYES ONO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH LENGTH NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES. DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE JMANIFOLD MATERIAL. JN.DISTR IDISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING. ELEV.. ELEV. DIA. ELEV.. PIPE S. DIA.: ELEVATION AND DISTRIBUT ION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS OYES ONO OYES NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE ❑ YES ❑ NO ❑ YES ❑ NO NEAREST ~ qil, ~ Sketch System on Retain in county file for audit. Reverse Side. DILHR SBD 6710 (R. 01/82) [IGNATURE LLJ~SCOns~n APPLICATION FOR SANITARY PERMIT 6~" DILHR COUNTY I.L UNIFORM SANITARY PERMIT # OEPRRTTT1ErlTOF (PLB 67) I n0U5TPV, LRBOR 6 HUTRfI RELRTIOfIS Np^ -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 PROPERTY OWNER f MAILING ADDRESS l1t 1 l 7 f C"l~ /iV f~ 1 °,~z Cd C+!,~.' PROPERTY LO ION V+~t-AGE'.= ~1 i F rC7 ~ ~ 1/ X1/4, S 11 , T ' ~N, R E (or W TOWN OF: 1 TATE PU7BE BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK S PLAN I.D. NUMBER 2- 7 'A TYPED F BUILDING OR USE SERVED 1 or 2 Family Number of Bedrooms. ❑ Public (Specify): THIS PERMIT IS FOR A: Sy S7~'' ~1 ~►f 1 c. f t' 7 A New System ❑ Tank Replacement 1 ❑ Repair 7 f-,`.JZ h' L_j Replacement Soil Absorption System X Revision El Privy 7_e2 Elc ❑ Alternate System ❑ Reconnection ❑ Petition for Modification e ' IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. '4E190''j Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tan kdjP System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ;)e ❑ 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 Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity / O Lift Pump Tank/Siphon Chamber a J Holding Tank capacity Manufacturer: C) i_z Al, IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure Total # of 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 ISqu e Feet): Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for insta lation of the private sewage system shown on the attached plans. Name of Plumber (Print): Signature: f PAf /MPRSW No.: Phone Number c /'Lf l _ v it, . r r c.~ r' P e ( 7/S) J~ t I r yf 41) Plumber's Address: '1 t } ~ ~ Name of Designer: t. COUNTY/ DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved f~ 41F ~i ~_L~ ❑ Owner Given Initial / Approved Adverse Determination Reason for Disapproval: Alternate course(s) of Action Available: DILHR-SBD-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber 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. ST. CROI X COUNTY f~ r Via, WI SCO N S I N ~r ZONING OFFICE It 4' #r lfl 796-2239 (HAMMOND) -`y- 425-8363 (RIVER FALLS) HAMMOND, WI 54015 May 3, 1984 , State of Wisconsin, DILHR Bureau of Plumbing P. 0. Box 7969 Madison, WI 53707 Attn: Carolyn Haag Dear Carolyn: Sanitary permit #49418 has been rescinded as the system had to be put in at a deeper elevation. A new sanitary permit was issued to the same land owner, Jim Leistiko, that number being 49466. Should you have any questions regarding this, please feel free to contact me. Sincerely, Mary at~4kt nkins Secretary Attachment: Rescinded Permit Void PLB 67 I DEPARTMENT OF APPLICATION ~ SAFETY & BUILDINGS INDUSTRY, FOR SANITARY DIVISION LABOR AND PERMIT P.O. BOX 7969 HUMAN RELATIONS (PLB 67) MADISON, WI 53707 Attach plans for the system on paper not less than 81/2 x 11 inches in size. Include a plot plan that is dimensioned or drawn to scale. Horizontal and vertical elevation reference points must be shown. All appropriate separating distances and physical characteristics as specified in chapter H-63, Wis. Adm. Code, must be shown. An index page or each page must be signed, sealed and dated by the designer. If designed by a Master Plumber, the date, signature and license number must be shown. A legible reproduction of the soil test report or the owner's copy must be included. Property Owner: Mailing Address: 1/m LE/s T'14C-, 6Z j jNZ:- 5 f'. DS0A/ Property Locatio City, Village or Township: County: 4 14S /T 29 N/R /9 E (orO f{UD.S'oA) Mf Blk No.: Subdivision Name: Nearest Road, Lake or Landmark: State Plan I.D. Number: 11 - 1 f1~ipE c"11~ / HIVE Y GN. (If assigned) / A TYPE OF BUILDING Number of ❑ Public* ❑ Variance* ❑ Other (specify)* Bedrooms: 7 1 or 2 Family *State Approval Required. 3 TOTAL NUMBER VffNAB O ED-IN NEW REPLACE- OTHER GALLONS OF TANKS C NC ETE P ACE S L FIBERGLASS INSTALLATION MENT (Specify) SEPTIC TANK CAPACITY 10-17Z) HOLDING TANK CAPACITY f1 LIFT PUMP TANK/SIPHON CHAMBER MANUFACTURER: W11-A-5 rC~NC~7 Tr ,PT. / rr ul /GG~~(UVG~ C!~ EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square fe tNe ❑ Replacement Experimental ,1 Seepage Bed ❑ Seepage Pit 1/3 ❑ Alter ivg (specify) . ❑ Seepage Trench Watery Supply: Owner's ame as Lis on Soil T st epor If other than present owner): Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibi r Ntallation of the pri to sewage system shown on the attached plans. Name of Plumber: Sign tur : W/MPRSW No.: Phone Number: Plumber's Address: Name of Designer: R/-). A) 6ov_'"~/rat COUNTY/ DEPARTMENT USE ONLY Number: Signat re of Issuing Agent: ee: Date: APPROVED Sanitary Permit 41 0-~n DISAPPROVED Alf IV Reason for Disapproval: epe Alternate course(s) of Action Available: Change of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to in- stallation. Failure to comply will void the sanitary permit. DISTRIBUTION: White-County, Canary-Bureau of Plumbing, Pink-Owner, Goldenrod-Plumber DILHR-SBD-6398 (R.07/81) O C002 00 v z rn ~ CC) m O r- Tt -17 d _ O 1 / ~ ~ ai • CC) ~ O r C) O rn 1 - o ~ n 00 4 m Z O` Z D cf) ~ n Q ~ x C DD Z _ C-)_ zo C r-P ° p C~ o~ z O ZZ m :1) C m D 3 f z d < j:) 3 = C l .3 _ O p o< 30 3o T W T' i i 3 c~, a a p 7 3 j2~ m rao :10 O~ ID D _ 0 < ...t m y c a o c~ d ? v cn -/7 T z_ 3 = to ~ 0 M< D c y ~yxy 1 am < Joy N Jo Z _ z D v Na M 20 a o~ D 10 o < O s m d 3 o " m o 7 3 N C m y U s 3 3~ m t~ o - < c 3 y m V) D ° s ca a J 3 o D n v d ° N 3 O o ~ rn sJ~ - s oo ~ + I Fu rm - `S T C 100 Uwner of PrupCrty LC~57 LOCatluu of Property iwl Sr Z, SectiOU 1' N R~W TOwnahip Mailing Address Subdivision Name Nj /V Lot Number Previous Owner of Property r..~ clwpv Total Size Of Parcel /ycle-C c,t i c->5 Date Parcel Was Are all corners identifiable? ✓ Yes No Include with [his application One of rite fOllOWi119: Certified Survey Map .Deed .Land Contract, or Other Legal Document which describes the property f HOPERTY OWNER CERTIFICATION I (Wa) certify that all statements on this form are true to the bust of my (Our) knowledge; that I (wa) am (are) the owner(s) of the property described in this mtormation form, by virtue of a warranty deed recorded in the Office of the County Register of Deeds as Document No.~% and that I (we) presently own the proposed site for the sewage disposal system (or I (we) have Obtained an oasament, to run with the above described property, for the construction of said system, and the same has been duly recorded in the Office of the County Registar of Deeds, as Document No. ..1u rUNE OF OWNER 514NATURE OF CO-0WNER (IF APPLICABLE) -~~7 usc~-c~ ~ ~13DATt SIGNED DATE SIGNED ,mlw7£-e rErT ceA)P,rln 5 s z 3 °7c , ,Uo {.4 , r /,v Soil . v,~) v y. /Vo rtlivtJ . NDU TRY T OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 HUMAN RELATIONS 1 / MADISON, WI 53707 N-6 .1 (H63.090) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOTNO.:BLK.NO.:SUBDIVISIONNAME: '/a ~/a IT Z9N/1119 E (or vl~so',~ /'LO T-` COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: /z5i,71_~' (~z/ l/~vE sf USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence r /VL New ❑Replace JA 5 N { l,~, rifirf~ /r3s ok RATING: S= Site suitable for system U= Site unsuitable for system (p~ • tip / CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) ❑S ❑U ❑S ❑U ❑S ❑U ❑S ❑U ❑S ❑U eovvCNTiov,4/ r. e If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the 1 , under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: /,.,j FT PROFILE DESCRIPTIONS p DT BORING TOTAL DEPTH TO GROUNDWATER-IN CHARACTER OF SOIL W THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) ~q /,17'"6x, 67'04 es~ 7/7'r4V UEljy c~ B 9 d 67'Ae4v 5/ ,1'4V, S/ 117' OP, es, d' ~7' 75 -v B- C-5 , / Zd / S ' 17'Of!BAl . S1 ,03 ' 8.11. L, .S3 ' O//UE CAL W/ K~ f. F 0,6) G B- 3 ais In, 7 ' 1,,V 1/z7.P B- 75,06 , )(0 > ses>~t 7,'N mss, 7 / 7 /7 13'u S/ B- S l~l' sc z w vas; kc-V ~s B / ' / Z0 n~ 3 O ZO' DW . S/, . S'O oo, S/ SO CL w Z9/S Dom- G 1 /rt7~S PERCOLATION TESTS TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER IN AFTERSWELLING INTERVAL-MIN. PERIOD1 PERIOD2 PERIODS PERINCH P- &)A T" PA041A)E T c,- IV < .'•'3 P- ~S A.) 1 /i cJ U y~ S /,v {,q G4, P- f EiP C ,-I - 7-1 /Q. • vZ 1e G 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 pointsshand show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. /.3oTT0.~1 174 1) SYSTEM ELEVATION 7 ~o-'7d EST /C~ E E , E F F t 4 This fora test site APPRO oor~vnt#o VED al septic system, i EE E I, the undersigned, hereby certify that the soil tests reported on this form were made by mein accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of.t,he tests are correct to the best of my knowledge and belief. BOB ULBRICB7 NAME (print): TESTS WERE COMPLETED ON: HOMESITE TESTING CO. 4v-,,. Z5 1q'? DDRESS: RT. It WHIM ROAD C TIFICATION NUMBER: PHONE NUMBER(optionaT. HUDSON, WIS. 5"16 CST SIGNATURE- r IBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. _S BD-6395 (R. 02/82) -OVER