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HomeMy WebLinkAbout020-1161-00-000 (2) n cn O 3 v n rl o 0) m f to 3 (D O 3 O v m n (D = A~ 1 d A 0 0 M N Z O (O O = O) N • zr tv S v c O9 A m n N o ~~C 111 Q Z Q y W N y0 "r7 O N N j (T O O O W O ? (D O N N N N N N a O O N (D O (O'~ .z 0 V O 0 0 0 0 0 0 0 7 N O O m A 0 Oo O N 3 Ln = 00 l~ w (Ji, ° O y O C 0 Q fD O (D N V (\1 (cn m O N G 7 -10 CD CD O N N A 3 a C7 N N N N N Q CD CD CD N CJ7 O O O O pj !~I W V (n W 8 (D ~1 (cn do O A A O !V y Q c 3 Q O :2 ~I O 00 C * * * A N Z 3 cn to ~ O 0 u- =r Q) m M w - C ^ry o y (D M m 3 N rzr (D r O N :4- vi 7z7 y W o 4:1 ~l TJ Q a s 44 "*A 44 CD CD C _ (D a rYA 14 CD (D H (D a 3 E (D (n 1 to y o A z 81 rn cl A 3 I CL -I Z -i f n 0 A r W Q Q IV :F~ 3 z I y z O A C: ~ ~ ~ (o ~ D `4~ ~ ~ n N Q C • ~ = T n r-j. N C c'+ N SM oz a Cn CD o` (D N a ti O o ft N O A O O CD dQ O Cn ~ N Eli Q v V O NCI Ly a O I Form - S `1 C - 104 AS BUILT SANITARY SYSTEM REPORT q OWNER `TOWNSHIP / SEC. T N-R / W ~ v L U c1~~~J /~Ji'bS . CD.u s 7- • ADDRESS / 7/5 ST. CROIX COUNTY, WISCONSIN 0 /f v1'.Io,v Gc,/S • S~/Q i ~ SUBDIVISION LOT 2-6 LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H 63 L)t10W EVERYInim, wliil iv "'n FEET OF SYSTMI•: W ~~QaC~ NoRb'~ ~o~ r~~ t YO 3y - - - - - - - - - - - - - - - Eoj ,ems. ~p ry v y. ap INDICATE NORTH ARROW TOP Cued-- PA-D 8,4s6- oIC64eE~ BENCHMARK: Describe the vertical reference point used llig'k (ID~T /?OA Fj . Elevation of vertical reference point: O ' 0 Proposed slope at site: SEPTIC TANK: Manufacturer: lNE~r~S Liquid Capacity: l~ Number of rings used: PTank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front,(%/Side,o Rear, O feet from nearest property ling: Front,Q,)Side,0Rear, 0 feet Number of feet from: well t building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REM61,; 511)1? A PUMP CHAMBER cturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of to elevation: Pump off switch elevation: Ions per cycle: Alarm Manufacturer: Alarm Switc e: Number of feet fro Barest property line: Front, C Side, ar, 0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: X Trench: Width: Length: 3, Number of Lines: Area Built: Fill depth to top of pipe: 1-'11 XTM 0--1 7-/- XI, Number of feet from nearest property line:'U Front, 0Side, O Rear, O Ft Number of feet from well: Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: r of pits: Diameter: Liquid depth: Botto seep- elevation: Area Built: Has either rop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capac' Number of rings used: E ation of bottom k: Elevation of inlet: Number of t from nearest property line: Front, O Side, O Rear, d Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: Plumber on job: HOMESITE SEPTIC PLUMBING CO. License Number: RT. 3 O'NEIL RD., HUD WIS. MASTER PLUMBER L IC. No. 3307 M.P.RS. MINN. INSTALLER & DESIGNER LIC. No. 00663 3/84:mj G-PARTfviiENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING III. ISON, WI 53707 [WONVENTIONAL ❑ALTER NATIVE state Plan LD. Number (lf assigned) ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER'. ADDRESS OF PERMIT HOLDER'. INSPECTION DATE' TeAAy Lonenz 603 Funt St., Hud6 i W1 - S - e yc 3 0 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN REF. PT. ELEV.'. CST REF. PT. ELE V. SW NE, Sec. 16, T29N-RII Lot#26,Nonthtine Station II, Town i Hud6 n Name of Plumber. MP/MPRSW No M.t. Sanitary Permit NumberRobert UtbAicht 3307 Ctr.oix 49446 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER 1 C I J'R VIDE D'. PROVIDED - i/ G % (f L7 } ES ENO YES NO BEDDING: O I JV . VENT MATL 11-11111 WATER NUMBER OF ROAD'. PROPERTY WELL: BUILDING'. VENT TO FRESH / ALARM ~ FEET FROM ~ LINE /AIR IyLEj~ DYES N DYES NO NEAREST mil/ ~(J DOSING CHAMBER: MANUFACTURER BEDDING. ILIOUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED: PROVIDED'. DYES NO EYES ENO DYES ENO GALLONS PER CYCLE: 77D CONTROLS OPERATIONAL. NUMBER OF PH OPERTV JWELL BUILDING I(DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) DYES NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing f FNGTH 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 IN111 IDISTR PIPE SPACING COVER [INSIDE DIA &PITS LIQUID BED/TRENCH TRENCHES MA IAL PIT DEPTH DIMENSIONS le -3 GRAVEL DFPTH FILL DEPTH JDPITH PIPE DISTR. PIPE DISTR. PIPE MATERIAL'. NO. ISTR NUMBER OF PROPERTY WELL BUILDING: VENT TO FRESH REI OW PIPES ABOVE COVER I INLET E EV. END PIPES FEET i LINE AIR INLET i a FROM 4. f I 1• O 4~ I Z- 7 2 ~i 3 NEAREST--t► a C7 S G S~v f 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- D meets the criteria for medium sand. TIONS MEASURED. YES NO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS EYES ENO DYES NO DEPTH OVER TRENCH BED DEPTH OVER TRENCH: BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES DYES ENO DYES ENO DYES ENO 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 NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MAT4RIAL & MARKING EL EV.. ELEV. DIA. ELEV.. PIPES DIA.'. ELEVATION AND DISTRIBU710N INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS DYES ENO DYES ENO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: :TILDING: FEET FROM LINE: DYES ENO DYES ENO NEAREST Ins Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE: ITITLE DILHR SBD 6710 (R. 01/82) s_ wisconsin APPLICATION FOR SANITARY PERMIT (Cr COUNTY (PLB 67) moeacaRrmousrav, enr Laeoova 6 Human aeLanons UNIFORM SANITARY PERMIT # h~9 y y~ -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 MAILING ADDRESS PROPERTY LOCATION l+, 1 /4 k'C 1 /4, S TAI N, R I C' E (or W~ TowrvoZl !%S"~. ~=1 LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER TYPE OF BUILDING OR USE SERVED A 1 or 2 Family Number of Bedrooms. ❑ Public (Specify): THIS PERMIT IS FOR A: X New System ❑ Tank Replacement ❑ Repair ❑ Replacement Soil Absorption System ❑ Revision ❑ Privy Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. X1 Seepage Bed ❑ Seepage Trench U Seepage Pit ❑ Holding Tank ELI System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued - El An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total #of Prefab. Site Gallons Tanks Concrete Constructed Steel Fiberglass Plastic Septic Tank Capacity ~(1J Lift Pump Tank/Siphon Chamber t Holding Tank capacity TVA- Manufacturer: Lvlo'3t~ ~dV~Llt Y 6 nfd~t~~_ ~'o /6k,rS 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 (Square Feet): Private L-1 Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber (Print): Signature: MP/MPRSW No.: Phone N[umber: ,fin EX T V/6~' / ~ T_ C~ Cz 133 o 7 (71) ) 3~'6-. Plumber's Address: Name of Designer: COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved lei I / ❑ 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. APPLICATION FOR SANITARY PERMIT S T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractaz,("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property Id" ~Ikwlt Location of Property L` 4 4, Section T N - R ~W Township Mailing Address 7 Subdivision Name Lot Number 2 Previous Owner of Property Total Size of Parcel -3-7 r r, Date Parcel was Created Are all corners and lot lines identifiable? y Yes No I5 this property being developed for resale (spec house) ? Yes d/ No vr- /Z~,-Vs Volume and Page Number 67 as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract 3. Other recordings filed with the Register of Deeds Office In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the the Certified Survey Map shall also be required. PROPbRTy OWNER CERTIFICATION 1 (We) eett 6y that a.(X statements on this 6onm aAe V ue to the best o6 my (ouA) knowledge; AaJt 1 (we) am (anez) the owneA(e) o{ the pnopenty dacAeibed in this in6onwia ion ,6onm, by viAtue o~ a waAanty deed neeo~Lded in the 066ice o6 the County Regiiten o~ Deeds as Document No. 36T V1 and that I (we) pne,sent.ey oun the pnopoised site ion the sewage posa~system (on I (we) have obtained an easement, to nun with the above dauLibed paopeA.ty, 4oA the const&ucti.or ob said system, and the same has been duty neconded in the 066ice of the Coun4 y Reg-i~sten o4 Deeds, as Document No. ) . 2W,4j, e rx&tg~~ Ll mjo!7, SIG ATUR fF OWNER SIGNATURE OF CO-OW (IF APPLICABLE) DATE SIGNED DATE SIGNED i It1~'f'''^f",•1f~'~ +1A r '~i3" ~.x• w r i,y 1. ~t,~l, ~4t! 1 t- `-rS. j} ~Y"'.~• - , p r^~~ I Ir1 ~~I•' I I~6 I I I i ~ x'~''. ?y+ \ -r` ~^'Y K~xt'f. 1B iI Stn p { \ I rc a1 r _ _ „ YS p IJj 1T I I l ' .J~ ui AT>;j r D/c/ - J `Jlf i\ - J; 1-.i',1"L•r-, R.. i0'1". 4"l x~ c N p ~c oo~ViV IJ , Gy 40.0 N ♦ ^ ~ I;.:,n a ~ = o ° I t y r, ~ N'. 8 o, mh ~ °~d~ 4 j m r o uj OD CC. 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A+~.'►: t1..:.••~.1s:;s:;"..1.a. ~cs+c...~ ,=>vt,•iG ~n1 i DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 HUMAN RELATIONS MADISON, WI 53707 (H63.09(1) & Chapter 145.045) ~ nl P LOCATION: / ' SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: 4 4 T= N/R E (or) W'-- 2( COUNTY: OWNER'S/BUYERS NAME: MAILING ADDRESS: USE DATES OBSERVATIONS MADE r5* BEDRMS.: CSCR IPTION: PROFILEDESCRIPTIONS: PERCOLATION TESTS: LL~ Residence - ]New ❑Replace RATING: S= Site suitable for system U= Site unsuitable for system ~'f~( 1 h/~~~~/f✓J/ r CONVE: ODNILLHOLDING TANK: RECOMMENDED SYSTEM:(optional) 5 ❑MS ❑u ❑S DU ❑S LDU If Percolation Tests are NOT required DESIGN RATE: ~ / ~ portion of the tested area is in the under s.H63.09(5)(b), indicate: j, oodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-IN r'% CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B L i7 'L7 13 10 a,-, ST s ; i off', /5 . C oP 0,(J S (71//Ozz < 4. ;~r 9/ T- op-cy /,-"~fs 7 7' B- r 4 i i ~R C l~ d f S (p- . 7,4A) U fat C'S PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER IN AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH P- -7 P_ I , . c P_ ~v % t ',0 127 t 0 P_ 7 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, - ,f SYSTEM ELEVATION e l I I 1 PLo T Pl-~ f i E 3 ' I tpr ©nyeSt Site APp~ enion QV'ED _ ai se _A ic system.; - 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): TESTS WERE COMPLETED ON: STATE APPROVED SITE EVALUATIONS (PERC TEST` , 7hN,16 ADDRESS: MINNESO NO. 3 CERTIFICATION NUMBER: PHONE ER (optional): WISCONSIN LICENSE NO. 55-02482 ~5 C ? Z/Ir 2 3 - • 3s 0701L X SUN Wi M016 CST SIGN ATUF3E: t DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) -OVER v e se ? on tom, r ,lv 3"! sr-~~?;rR of a[. u ak /tee P: P s ~ 3=g;r tic??"4 , rC ~~cHir`o III', ..Try E diagran acco1 a$t'a'?f 1cr~.~~a'9 ti/i"ur test r. It txdea~~F.,~~FraFrCi,pCHMT 5 o"v11, l'Htx= 3z3?E <$t' f? 1 , icsL::' .t);;r,r i. to ..t,.:, .,mw" _tI ~'1 data, ~"(:€'~kitioY1 L o k. t'ne wopI g'i(l:'t rf? , 'j 0' - 3 ' f A nv _ t. - - - a ns `f)r mfi€ lip 'Ile, 3 y PLB (07 a - - - - PLOT a,n8 CR O55 M1~ ST,®N PJANS Y. i ft 1 J Y/ / " 30 "fit ` ~ 27 ~ C l6 3 ' 61 AST . % 1 yj )9,e Ft iA. r Fresh Air Inlets And Observation Pipe -SOIL TE5'170.Ny ay HOMESITE TES-,-.;Ns r:o. Approved Vent Cap RTJ, t,'uacii. RO-,`) ,.,tt~yt Minim-urn 12" Above Final Grade 3 3 31 Above Pipe 4 Cast Iron yL To Final Grade Vent Pipe Marsh Nay Or Synthetic Covering y t),4 1,16 Min. 2" Aggregate Over Pipe s or Distribution y - ----Tee Pipe 0 0 0 0 0 j~v~r / as ! .o Aggregate 0 Perforated Pipe Below Gj t,- S ~S Beneath Pipe 0 Coupling Terminating At J 1-07 Bottom Of System L~ COMMERCIAL TESTING LABORATORY, INC. 514,main Street, P.O. Box 526 Geax, Wisconsin 54730 16 ~4j 715-962-3121 800 - 962 - 5227 REPORT DATE" 11091 `K- . Ci,OIX COUNTY OURTHOUSE DATE RECEIVEM 1/07l 43I)SON, WI C' 4 zt Ile ~:OLLECTEi~: 1-flb-9:: COLLECTED: 2.15pm 'CE OF SAWLE: Kitchen faucet ,,F ANALYZED. NTEBPRETATIOW Bacteriologically SAFE af+ 9 ppm ?ve 10 ppm exceeds the recommended Publ ±-inking Water Standard. I G!!:' 'DFA DEPE&De, 02 4p WI Approved Lab Nou 19 A Means "LESS THAI" Detectable Level Approved hy. d,~ ~'r 4 PROFESSIONAL LABORATORY SERVICES SINCE 1952 ST. CROIX COUNTY ZONING OFFICE i~ St. Croix County Courthouse 911 4th Street Hudson, WI 54016 Telephone - (715)386-4680 The St. Croix County Zoning office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals. Completion of this form is essential so that the property can be located. Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning Office, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received. WATER TESTING----------------------------FEE: $ 25.00 (For nitrates and coliform bacteria) WATER TESTING FEE: $127.00 (For VOC'S) SEPTIC SYSTEM INSPECTION-----------------FEE: $25.00 (Determines if system is properly functioning at time of inspection) Property owner's name"'L k'J< y ~f1;~`~-l Property owner's address Legal Description 1/4 of the 1/4 of Section , T N-R Town of Lot Number L' Subdivision Name,-.,-,,+f, f FIRE NUMBER LOCK BOX NUMBER Color of house-, f-, Realty sign by house? f' I f so, list firm: PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual requesting services: L_jOn Telephone Number__ (Ze { J Y V G' 16 REPORT TO BE SENT TO: Closing date - r Signature T:: ST. CROIX COUNTY WISCONSIN i .4 ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 14 z U, 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 Jan. 6, 1992 Peg Starke First National Bank/Hudson 307 2nd St. Hudson, WI 54016 Dear Ms. Starke: An inspection of the septic system on the property of Mr. Wotruba, located at 1331 27th St., Hudson, WI, was conducted on Jan. 6, 1992. At the same time a water sample was obtained for testing. The results of that test will be sent to you as soon as we receive them back from the laboratory. At the time of inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. 1 erely, Mary J. Jenkins Assistant Zoning Administrator cj rC•M.-ViRCIAL TESTING LABORATORY, INC. 514 Mail Street, P.O. Box 526 Colfax, Wisconsin 54730 715--962=3121 800 - 962 - 5227 FAX - 715 - 962 - 4030 kt-Kik1 DA t. 11i2711 0"THOWE .7 ' -,17. _-1 sr . !UDSON, W Pi t. \ ' l f l ! ( Kam' COLLECTED*+ 3:30;, E OF SAMPLE: ~e OF.\NOECENgENr -vai Lab Nt~. O A i i s "LESI^3 THAN" wy®~? PROFESSIONAL LABORATORY SERVICES SINCE 1952 . ST. CROIX COUNTY ZONING OFFICE r~ St. Croix County Courthouse 911 4th Street Hudson, WI 54016 Telephone - (715)386-4680 ~O~The St. Croix County Zoning Office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals. Completion of this form is essential so that the property can be located. Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning Office, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received. WATER TESTING----------------------------FEE: $ 35.00 (For nitrates and coliform bacteria) WATER TESTING FEE: $185.00 (For VOC'S) _ SEPTIC SYSTEM INSPECTION-----------------FEE: $25.00 (Determines if system is properly functioning at time of inspection) _ PROPERTY OWNER'S NAME : PROP. ADDRESS: CITY Legal Description of the 1/4 of Section l6 T 4LN-RZ2Z-1 Town of rri'y~L~~ Lot Number Subdivision: 4~'/f`~i11',S~IT FIRE NUMBER` LOCK BOX NUMBER Color of house Realty sign by house? If so, list firm: PLEASE INCL E, IF AT ALL POSSIBLE, A HAP,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual eq est' ng serviges : /ZZ-.Zz Telephone Number -,f REPORT TO BE SEND' TO : ~i ~ lee, CLOSING DATE,- Signature.- -~~dy Z" ~~s EAST HUDSON T29N-R.19W. 27 PART _ SEE PAGE 41 _ ,<„c C/anm Pin e WILLOW h y t C/ Z5, Y-1. 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IM 5M4 LL o ~o17 h k /~o~xr'1f 2 :05 1 /4x.,55 - TRACTS ViLN J/ Ov ~ 5 as J rt _ eQ b 3 a ? Chrlshine W¢ron 35 ,~~ti `Y ,,..L P3zz7 ! 2e2s , v ~ ~ rimer . oR."'r"_' brr~ 'r o O1991 Qoc o dr/a~f f /s,' c SEE PAGE /S StCoix o yw> q 0 500 600 700 800 900 I PREPARE FOR THE RIVER VALLEY ABSTRACT i FUTURE & TITLE, INC. 220 LOCUST STREET _ IN HUDSON, WISCONSIN 54016 I PHONE: (715) 386-7772 ROGER D. BEVERS ABSTRACTS • TITLE INSURANCE • CLOSINGS c~ ST. CROIX COUNTY "L WISCONSIN ZONING OFFICE 4ST. CROIX COUNTY COURTHOUSE . AV R-AILA 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 November 24, 1992 Lucy Gearhart Century 21 Premier Group 706 19th Street South Hudson, WI 54016 Dear Ms. Gearhart: An inspection of the septic system on the property of Terry and Janet Lorenz, located at 575 Spurline Circle, Hudson, WI was conducted on Nov. 24, 1992. At the same time a water sample was obtained for testing. The results of that testing will be sent to you as soon as we receive them back from the laboratory. At the time of inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. S ncerely, V' Mary J. Jenkins Assistant Zoning Administrator js