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HomeMy WebLinkAbout030-1099-95-000 o N O m v 0 CJ _1 C 7 C1 3 9 i 4t N 3 ~ I • • sv cn ~ z m z ° cno cn w o . m O o o• o m m ;7 co o CD a (D CD o o rl 77 V) N c p = m m co C O o r ? w m 0 0 n M m o CO O(77 ~O1 °N C (D CL O = O Q ° 3 co :E (n o O N N fl- ~1 (n D (D d N W a 0 CD N N 3 N _ N O OD 00 Q. N p C j 0 w G x a) U) U G a a "ANA o o o R a n b x E °10 - N N o a Z 1,7;j r-I (D U7 K, . C17 N W = (D cn M 00 Q n w 3 m co N n Lil N tz) z 0 - D D o b CL !r 0 D CD 00 4- ~ n i I m c 00 I w m N p v n m N r~ I H H CA 0 _ p Z (D W O W CrJ 4- ID Z v a z L~7 + w w ~O C/] rrn co rr n 3 C I ! C ' Z O N O ::I Z w m O a Iii a (D w w 'b `b . W I I >v o n 5-- CL `11 1 m o o T 0 m c ° z a c _ = v ( O (on 0 C:) 00 f S O O a 7 N 0p A 'U., O ti w ° `L O yb 6 O CL ti Parcel 030-1099-95-000 01/05/2006 05:05 PM PAGE 1 OF 1 Alt. Parcel 33.30.19.359B 030 - TOWN OF SAINT JOSEPH Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - SIMPSON, MARK L & CYNTHIA K MARK L & CYNTHIA K SIMPSON 1266 60TH ST HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 1266 60TH ST SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.019 Plat: N/A-NOT AVAILABLE SEC 33 T30N R19W SE NE LOT 1 OF CSM Block/Condo Bldg: 4/929 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 33-30N-19W Notes: Parcel History: Date Doc # Vol/Page Type 01/16/2004 751917 2493/102 WD 01/16/2004 751916 2493/100 AGREE 01/16/2004 04/02/2003 715566 2191/347 more I. 2005 SUMMARY Bill Fair Market Value: Assessed with: 84051 281,300 Valuations: Last Changed: 07/08/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.020 75,500 180,300 255,800 NO Totals for 2005: General Property 3.020 75,500 180,300 255,800 Woodland 0.000 0 Totals for 2004: General Property 3.020 75,500 180,300 255,800 Woodland 0.000 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 204 Specials: User Special Code Category Amount Special Assessments Special Charges 00 Delinquent Charges 00 Total 0.00 DES F1JR-l MENT OF INDUSTRY, LABOR & HUMAN RELATIONS INSPECTION REPORT FOR P.O. BOX 7969 PRIVATE SEWAGE SYSTEMS SAFETY & BUILDINGS MADISON, WI 53707 DIVISION El BUREAU OF PLUMBING CONVENTIONAL~'~'ALTERNATIVE ❑ Holding Tank state Plan I.D. Number: ❑ In-Ground Pressure MMound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: -L Leonard Skalick wsPECnoN DATE Y RR#2,Box 340A,132nd Ave.,Hudson, WI BENCH MARK (Permanent re terence point) DESCRIBE IF L~ DIFFERENT FROM PLAN SE-'4 NE-4, Section 33, T30N-R19W, Lot#1, Town of St. Joseph REF. PT. ELEV. csrREEPr.ELEv Name of Plurnner MP/MPRSW N... County Gary Zappa 3300 San,ta,y Pe,mit Number St. Croix 58915 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY: TANK INLET ELEV.. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: BEDDING: VENT DIA.: DYES ❑NO VENT MATL. HIGH WATER DYES ❑NQ ALARM NUMBER OF ROAD: PROPERTY WELL DYES ❑NO FEET FROM LINE BUILDING 1AE LET ESH DYES DNO NEAREST AIR INLET DOSING CHAMBER: MANUFACTURER. BEDDING. LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER YES LINO PROVIDED PROVIDED GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL DYES ❑NO DYES ❑NO (DIFFERENCE BETWEEN NUMBER OF PROPERTY WELL PUMP ON AND OFF) LINE BUILDING I AVENT IR INLET FRESH FROM DYES ONO FEAREST AR SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing NEAREST or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE DIAMETER MATERIAL AND MARKING; the soil is dry enough to continue.) CONVENTIONAL SYSTEM: MAIN BED/TRENCH WIDTH. LENGTH NO. OF DISTR. PIPE SPACING COVER DIMENSIONS TRENCHES MATERIAL: INSIDE DIA -PITS PIT uoulD GRAVEL DEPTH DEPTH: BELOW PIPES FILL DEPTH DISTH. PIPE DISTR. PIPE DISTR. PIPE MATERIAL. ABOVE COVER ELEV INLET ELEV. END NO. DISTR NUMBER OF PROPERTY PIPES. WELL. BUILDING: VENT 70 FRESH FEET FROM L'"F' AIR INLET MOUND SYSTEM: NEAREST--~ Mound site plowed perpendicular to slope upslope: and furrows thrown Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- DYES ONO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER rexruRE PERMANENT MARKERS. OBSERVATION WELLS DEPTH OVER TRENCH/BED DEPTH OVER TRENCH; BED DYES ❑NO DYES CENTER EDGES. DEPTH OF TOPSOIL SODDED DNO SEEDED MULCHED DYES ONO DYES ❑NO DYES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH TRNC LATERAL SPACING. GRAVEL DEPTH BELOW PIPE DIMENSIONS TRENCHES FILL DEPTH ABOVE COVER MANIFOLD PUMP MANIFOLD ELEV. ELEV.. DISTR. PIPE MANIFOLD MATERIAL. NO. DISTR DISTR. PIPE ELEVATION AND DIA ELEV. DISTRIBUTION PIPE MATERIAL & MARKING PIPES DIA DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL. VERTICAL LIFT CORRESPONDS TO APPROVED ❑ YES PLANS. COMMENTS: PERMANENT MARKERS: ❑NO DYES ❑NO OBSERVATION WELLS: NUMBER OF PROPERTY WELL BUILDING ❑ YES ❑ NQ FEET FROM LINE: DYES ❑NO NEAREST Sketch System on Reverse Side. Retain in county file for audit. SIGNATURE. TITLE. DILHR SBD 6710 (R. 01/82) in APPLICATION FOR SANITARY PERMIT COUNTY (PLB 67) UNIFORM SAN ITARY PERMIT # ILHR 5- V,LRSOR 6 HUMRn RELRTIons Q J 5F /_5 -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 G-,vr y / PROPERTY LOCATION PIE ~3 ,TN, R PE (o W TO~Wt OF: LOT DUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, L" ^ninnnnCi! STATE PLAN I.D. NUMBER TYPE OF BUILDING OR USE SERVED 1 or 2 Family Number of Bedrooms. 3 ❑ Public (Specify): THIS PERMIT IS FOR A: Newer ❑ Tank Replacement ❑ Repair Replacement Soil Absorption System ❑ Revision ❑ Privy Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total # of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer: IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: X / A Mound ❑ In Ground Pressure Total # of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Li*t-Q mp/Siphon Chamber C' Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): 'i~:3 -3-75 ! 7 Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumbp-r rin Signature: J*W/MPRSW No.: Phone Number: 33co 1()15 Plumber's ddress: Name of Designer: COUNTY/ DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved ~J 7 ❑ Owner Given Initial ~.~t%f~` 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. wisconsin APPLICATION FOR SANITARY PERMIT 1-5 - COUNTY 'Z~DILHR (PLB 67) UNIFORM SANITARY PERMIT # OEPRRTTEnT OF f ///~~~yyy• ' - InOUSTRV,LRBOR&HUMRn RELRTIOnS , .G 4 _P; -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'hx 11 inches in size. L---i -See reverse side for instructions for completing this application. PLEASE PRINT PROPER OWNER /J o MAILING ADDRE y~ PR TY LOCATION ci~Fy°' 1- 1/4A~C 1/4, S ~3 TJjN, R , q ) W TOOVVN o : G LOT NUMBER BLO CK NUMBER SUBDIVISIO NAME NEAREST ROAD, LAKEjqA LAND RK ST TE PLAN I.D. NUMBER Z ~/Iv/~/'1~ % ' n e TYPE OF BUILDING OR USE SERVED A1 or 2 Family Number of Bedrooms. ❑ Public (Specify): THIS PERMIT IS FOR A: New-Systt-M ❑ Tank Replacement ❑ Repair ❑r~ Replacement Soil Absorption System ❑ Revision ❑ Privy lol Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. ❑ Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank ❑ System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer: 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 0 Lift Pump/Siphon Chamber ) Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): ❑ Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Na 6:~,e Plumber (Print l: Signature: MP/MPRSW No.: Phone Number: p (7,>-) t7,FZ Plumber's Address: Name De ner: COUNTY/ DEPARTMENT USE ONLY Signat e of Issui g Agent: Fee: Date: ❑ Disapproved Owner Given Initial .GL,~ Approved Adverse Determination eason 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; & 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. PLAN APPROVAL Safety and Buildings Division D I L H Bureau of Plumbing P.O Box 7%9 ❑ General Plumbing Plans Madison, WI 53707 ❑ Private Sewage Plans Telephone: (608)266-3815 OFFICE USE ONLY Plan Ider,~jfi~agion No,j Gallons Per Dray ' ©~Fy/yC 98~ PRIORITY PLAN REVIEW ONLY Plan Review Petition For Modification Project Name Project Location - Street No. or Legal Description Co El city 11 Village El Town of: The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped "conditionally approved". This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. ❑ FOR GENERAL PLUMBING PLANS: This approval will expire two years from the date approved below. If construction has not commenced before the expiration date, new plan approval must be obtained. ❑ FOR PRIVATE SEWAGE PLANS: This approval will expire two years from the date approved below or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. Comments: By: James Sargent Bureau Director If Questions Plans Approved By: Date Approved: Contact cc: ❑ OWS ❑ DPS ❑ H&R & Rec. San. Section ❑ County ❑ Local PI ❑ Facilities Need Analysis Section ❑ UW-SSWMP ❑ Plumber ❑ Department of Agriculture DILHR-SBD-6099 (R. 01/84) ❑ Owner ❑ Other H S T C - 105 r r a SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County ° 0 a OWNER/BUYER_ Leonard V Skalicky ROUTE/BOX NUMBER Route 2 Box 40A, 1'32nd Ava Fire Number'057 CITY/STATE Hudson, Wisconsin LIP x.016 PROPERTY LOCATION: SE 4E ~4, Section '13_, `1' 30 N, R ] W, Town of St. Joseph St. Croix County, Subdivision- ;'done Lot number 1 Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July a, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County 'honing a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. 0 I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x the standards set forth, herein, as set by the Wisconsin Depart- o ment of Natural Resources. Certification form must be completed and returned to.the St. Croix County Zoning Office w thin 30 days of the three year expiration date. w SIGNED DATE No em be J R R4 _ 1Q St. Croix County Zoning Office P. 0. Box 98 Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. O N r m m ono m ? w 5t2 ^33 0 c u,w~ m 0m nnm~ L o, * ~ n H o_- QO cc 0~~ ~ os~ I n amm~o? c ~ 7' 3 ccoI o N "I c cD w cD 0 8 1 u o g mg~o 0 CD ' CD (D I q r 0 5C=Do=moo CD " o a nCD CD y' o 3 a . o m cowo-co 3: O_ CD _ w =r 3 O 0 .c c- c h w w w Cn w CD o o d o O CD co o c '0 o <mv, T Q N ° Co . o Dc = m n o n 0 _ °c O cD O Q cl) 11) CD ~CL oN~ ~.0 w=N C N y 0 N 0 m w cn Z a w 1m m m ci~~m' 0) CD mg m aoc~ 3~a,CDina D n NE ~ oEr -,o~ m ~=a Mw =ono QN~ ( D fin>>M mv~~a(a N v;w° ac0 m C 171 N =r 3CDO voo~=~ 0 = o OL CA n S a co ~ ~ CD (D _ 00a cCp~OVi ~ :3 0 CL 03 0 cc aw o m w w Cu -'M m (n M 0.0 co a a ~ L =CA Q Q c~~ cDm, °3 pno m n c 0 (a d 0 N' ~D O to o S-. 7 a o 7 o co c" -I N c O OO a j 0 a = C =r ¢1 = o 40 n.c3 0 ~m003 a o m 0 0 V~ 3 c w 3' a o < - # m co o Z i o 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/contractor,("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 Leonard V Sks.licky Pnd Angels H. Skslicky Location of Property 5- 14E Section T 3 N _ R 19 W Township St. JoseT)h Mailing Address Hudson, Wisconsin; K1!016 Subdivision Name None Lot Number 1 (one) Previous Owner of Property Steven W. Senrick and Jan Senrick Total Size of Parcel -'3-102 Acres Date Parcel was Created _.May '0 19 80 Are all corners and lot lines identifiable? X Yes No Is this property being developed for resale (spec house) ? Yes ,X No Volume __70() and Page Number 326 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. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -C-~(- - - - - - - - - - - - PROPERTY OWNER CERTIFICATID~[ X (We) eeAti 6 y that aP~ statements on this 6onm ane ~tA e o 'chef beet o j d9C ( outs ) knowledge; that ]X (we) ( arse) the owns ( s ) o g the p)LQi aA,ty dens eA.tbed in this in6onmati,on 4okm, by v.vctue ob a waAA.anty deed seconded .En the 066ice of the County Regis-teA oA Deeds as Document No. R and that X (we) pne~sent- y own the proposed bite 4o.,L the sewage poea2 ~ ystem (oA N (we) have obtained an easement, to nun with the above de~seAibed pnopeA,ty, 4oA the eonstAue ti on o6 bai.d ~5 y,5 tem, and the same h.as been duty Aeeorcded in the O~6iee o6 -the County .i~,,ten o4 Deeds, as Document No. ) . SIGNATURE OF OWNER S TURE OF CO-OWNER (IF K-P ABLE) November 10,_19FL November 19, 19K, DATE SIGNED DATE SIGNED FORM NO. 98S•A CERTIFIED SURVEY MAP SCALE IN FEET N F CORNER SECTION 33 -LEGEND 0 130 200 300 COUNTY MONUMENT BERNTSEN CAP ,ATTEQ L.ANOS UNP \ 6 6 p 3/411 x 24" ROUND. STEEL REINFORCING 890 34' 6" 9;)Q Q4 to ROD WEIGHING 1.502 LBS./LINEAL o FOOT SET. opt u►, \ I--.r--K EXISTING FENCE N o o MONUMENT ca • I IRON PIPE FOUND TO RIGHT- OF- WAY. r) o 0.56 U6 r (n co 01 P1 1 tol, 3.019 ACRES N~ N:,i ec Previous recorded bt:aring 'H d = IG ° 46' 06" N1 :)n E. line of NE--, was assumed R = 900.00' ONE w due South, but no E4 corner locrrti( i.l a1 zI I was established, therefore thitt Tj 1 _ bearing and description are not ca `D'(( t a I considered for purposes of this ~i •u m 1710 36' 50" ; description. v, .c I W CAS. O O z w z C !y I J <1 zo I rq J J I fail a w I ~1 113. 6A' w N 870 07 24 W 3 U_' I Z I . i E o I y l 'J I i .t ~ r! O to DI WI fi. ,n QI I I- i 01 1,-1 ZI ^4 _ ACRES I ~1 h of e: 1" iron p 1 pt: found o s •,C described to monument road riE~ht- GII of-way, set by J. Murphy. The w I description therewith of the sectic t ~1 ~i 01 line does not fit previous surveys H-1 location for the E;; corner of Section 33• y 3 0 I I o^ W W:CMNING 44. _ - .._..,.r__ _ S f39° IUy56 W 308.65, I s I INI '=t E I/4 CORNEFI SECTION 33 Z T30N) R19W THIS INSTRUMENT DRAFTED BY JOHN D. 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SOL{M RTaagsaM aAl:auoo aA.tno sn?1)e.1 ,00' 1.913 uu uO aUl l RT.1.)gsaM E,'les BUO-[e ,SL't~Z R113ggnos ;,ol,agl ::;ouil pies duolc ,ol'T-I :IIITSI~r{o1.TS aouar{q :auTT ReM-Jo-grl%)Ta /:).r;agsaM p{I:s oq ( ;IN 11 J pips Jo au?l gq~oM ayq 3o y'~ncS s[ yaTyM) »u.,; ~lu)gsix:, I.le ducle JI V 1` t (C`' [119£ 1 h o68S aouagq c • 1 eL' Yj06 M„ Z 190()ON aJU:?Tlq , S9' g0£ N:.. 'IOTr,69S ' 19•~ ;3ulnu'{guca aouclq•+ 1duTUUT9aq Jo quiod ayq Pue Ph • oU umoJ, r)uTqsTxa i.., 30 au[ . ` duO RI:M-,;o-:It{;l!z Rl.I;vgsm aq'l Oq 1~{6'h+t M.,,SSIUTc,6aS aouat{q !c~i![ gsrg pies lr: .PP' O1: (5TIILTIU:,oON duT.Te lq TITr:s Jo null qsr g ayq ca paouaaaj;i.: 2upuoq yq qe d1lTautlwujOo [..)wnssr: j ~I LT IOZo0l1 a: tlq uc'?qo,,g piss Jo 13u.TCO g 'I :,umol lo.l s13 P3gT t• T `uTsucos?M `R111noo x?c.IO •qS 'r{dasor .,4c, JO uMO.L `NOE,L uO?q Jc gN aqq 3o St; atiq ul page:;o[ pUer j(,, lao.ied V NoIJi J IH0S14Q IOAM NO. 9ASA CERTIFIED SURVEY MAP SCALE IN FEET N E CORNER SECTION 33 -LEGEND 0 180 2,00 300 UNPIATTTQ IrVY S 6' \ + COUNTY MONUMENT 13ERNTSEN CAP S-890 e" 220-64', a O 3/4"X 24" ROUND STEEL REINFORCING a ROD WEIGHING 1.502 LBS. / LINEAL o \ FOOT SET. & EXTSTING FENCE w `O ° \ • I" IRON PIPE FOUND TO MONUMENT RIGHT- OF- WAY. o \ o z 38 d6 4.) m to 1 .d -4 ~ ~ ro of 1 W 1] N d OI 1 Q) -dz p w~ M I ~1 N 43 m 3.019 ACRES ro~ Note- Previous recorded bearing 6= 16° 48' OB" NI :)n E. line of ■ i N&was assumed p q - R 900.00' ON A w due South, but no E~, corner local' d ; ti j I was established, therefore that w do r I bearing and description are not h a, a, 3 I considered for purposes of this N 4~ [ y 171° 36' 68" 6+ 1 description. A, ° 0 I W O Z "3e' 1 w v>I O~, = z Nate: A joint driveway must be °1• ~I _j constructed'to service lots 1 an, m I 2 along the extension of their I common lot line. W a _ W I 1~-I 118.68' ~ Q~ N 87007'24" W 3 Z1 I of APPROVED SE-NE I I g' MAR 18 1980 n p N CSI I of and 4) 'n Q01 I I KI ST. CROIX COUNTY 2 ti I COMPAENINNVE ?AM$ NAMIM 0 I JI AND ZONING COAIAWIN O M O O ZI z O 3.0018 ACRES Note: 1" iron pipe found as I described to monument road right- of-way, set by J. Murphy. The 13:1 description therewith of the sect: OI line does not fit revi.ous survey r- F-i location for the E;, corner of Section 33. O °POINT OF ai• p, BEGINNING 21.1 0 44. f S 89° 10' 58" W 308.88' m 61 o '0 UNP~ATTED ~ANQLS, a ~ = E 1/4 CORNER SECTION 33 T 30 N, R 19 W THIS INSTRUMENT DRAFTED BY JOHN D. NICKLEBY ,AOioadsui LPOOI .AOloadsui .AauM xj.,A a Lq isuodsad ,AO Aagwn Ld , It se aed-u 6U L wn s i o a.Anj-eu6 LS (Z8/OT'2I) Z6T9-QgS-xH'Ila _Is L d ~'a , a •payoeliy aaS( Ily a.An'ieUBLqi LM assnos 6ZLV9 IM `slle~ emaddit4o 77 41 -V ? z ) 57 T ),n nit r -A m - 4, 7 71 Y\4 is - I c3 W I s T -1 3 _ s 79d N 5 N, _ oD ~L (yl h (V i Q - 1 , B9 N 1s«I F~-__ g{, 3n3IS ssa.A ,AauM ~I-IVA ~Z1W s'NW ssa.A=a~hP rfatno( rOT, ~d J-t~~~ To" ssa~lppv !s9 awe w.Ai .Aa wn .Aa se .kI~~~•~S 1yqJI (V(1`r. =`r-c.~ q ~w.Aa RJPI Peg V4 uno Vd` *ON Wl ue a e sas iwa.A o a'we _ 6u Lgwn Ld jo nea.Ang uoisLnLQ s6uipBnq I alaieS ANA N0I10ldSNI T-Od suoLIeLad uewnH ~ Aogel X.Alsnpui jo quawl.Aedaq uLsuooSLM k r. ST. CROI X COUNTY z .rt~=SK "may WI SC O N S I N 7 ZONING OFFICE 796-2239 (HAMMOND) 425-8363 (RIVER FALLS) HAMMOND, WI 54015 November 5, 1984 Division of Safety and Building Bureau of Plumbing P. 0. Box 7969 Madison, WI 53707 Dear Sir: An on-site investigation for the Len Skalicky property located at the SEA of the NEk of Section 33, T30N-R19W, Town of St. Joseph, St. Croix County, revealed suitable soils at a depth of 2.67 feet, below which seasonable high ground water was noted. This site should be suitable for a mound system. Should you have any questions, please feel free to contact this office. Sincere Thomas C. Nelson Assistant Zoning Administrator T CN:mj STATE OF WISCONSIN-DEPARTMENT OF INDUSTRY, LABOR & HUMAN RELATIONS DIVISION OF SAFETY & BUILDINGS - BUREAU OF PLUMBING P.O. BOX 7969 - MADISON, WI, 53707 APPLICATION FOR THE USE OF AN ALTERNATIVE SYSTEM Location: Township ANVOWOUXLY, SE Z NE 14 S 33 T 30 N/R 19 )EtCM) W St. Joseph St. Croix Street Address: Subdivision: County: Landowners Name: Mailing Address: Len Skalicky R. R. 1, Boardman Rd.,New Richmond, WI 54017 I (We), the undersigned, hereby make application for an alternative system on the above-described premises. I recognize that the above premises are not suited for a conventional private sewage system. If approval is granted, I agree to have the system installed in conformance with the Bureau's approval of plans and specifications. I further understand that an alternative system is more complex in nature than a conventional private sewage system and as such will require detailed inspection during construction and monitoring after the system is put into use. I agree to permit both county officials charged with administering county sanitary ordinances and Bureau employes or other authorized persons to have access to the above described premises at any reasonable time for the purpose of inspection the construction of or monitoring of the system. I further agree to either personally or by my agent contact the proper county official to arrange the time and date to begin construction of the system. I understand that this application does not permit me (the applicant) or my agent (the contractor) to begin installation. If the system is approved, the Bureau will send the applicant a letter of approval which authorizes construction of the alternative system after all necessary permits have been obtained. I agree to give notice to any subsequent buyer that an application for an alternative system has been made and if installed, that the premises are served by an alternative system and further agree to give the buyer a copy of this application. The Bureau accepts this application subject to this understanding and subject to all the conditions and obligations set out in this application. Signature of Applicant Date STATE OF WISCONSIN Subscribed and sworn to before me SS. COUNTY OF This day of 19 Notary Public, State of Wisconsin DILHR-SBD-6413 (N. 05/81) My Commission Expires: WISCONSIN DEPARTMENT OF INDUSTRY, LABOR AND HUMAN RELATIONS DIVISION OF SAFETY & BUILDINGS, BUREAU OF PLUMBING P.O. BOX 7969, MADISON, WISCONSIN 53707 Verification of Exception Status for an Alternative Private Sewage System In the County of St. Croix Location SE 1/4, NE 1/4, Sec. 33 T 30 N, R 19 P W Town *X X r St. Joseph Street Address Lot No. Block , Subdivision Landowner's Name: Mr. & Mrs. Len Skalicky The application for this site is for: 0 new construction use. ❑ replacement system use. If this is NEW CONSTRUCTION USE, the alternative private sewage system is: 1 --Ito have one of the first five approvals guaranteed for this year. This is number - - of those applications. (Use one of the first five quota num ers-issue~to you.) ~X]one of the applications needing a quota number. The quota number assigned to this application is 59 - 11 - 5 D for one additional homesite on a farm to be occupied by a parent, child, grandchild, sibling, niece, nephew, or first cousin. [_.]for an individual lot for which a sanitary permit was issued but was later ruled unsuitable due to new or changed soil criteria established by the department. for an application on file prior to February 1, 1980. LI for a lot that meets the criteria for a conventional private sewage system. If this is a REPLACEMENT SYSTEM USE, the alternative private sewage system is replacing: ❑ a failing conventional soil absorption system. ❑ a holding tank that was installed and in use prior to February 1, 1980. ❑ a privy that was installed and in use prior to February 1, 1980. If this is a REPLACEMENT SYSTEM USE and the A of meets the criteria for a conventional private sewage system, check here. ❑ I certify that the above information is true and accurate to the best of my knowledge. Name Thomas C. Nelson Si ure` County Official Title Assistant Zoning Administrator Date November 5, 1984 DILHR-SBD-6158 (R 12/82) 13 vy" : Al. jli,eS. Z" 5~&4z- ',~y P,gGE / ~F - i°, d6eS . DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY,, DIVISION LAB-OR AN P.O. BOX 76 HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 3707 (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP /t~tFr#t} LOT NO.: BLK. NO.: SUBDIVISION NAME: S6 1/ 1/ -33 /T3°N/R/9 E (o 577 ost,o / ~s C7NTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: 5 1 2 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTIQN: PROFILE DESCRIPTIONS: PERCO TION_TESTS Residence 3 2407A_ ~//,/y,~GQ New ❑Replace 4U , 7 72S SC'S Yj- sffdwS 143; s~Nt i4~o/ Ati fi~-or ~ yl-eciC • ,k RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IfV-GRTiME URE: SY STEM-IN-FILLHOLDING TANRECOMMENDED SYSTEM:(optional) ❑s©u ~s❑u s®u ❑sa u ~oU~o S~s~-- If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) ri t ell 6!1-41v. S, / G yW-4,,r- -/2N s; as ci\ B- l So /C~y7y -)10,- 32- &V s// 'j, a-f' ff~ /-'o y-1iFS I) B p,-6 /3,v. Envy S w fNi` i`+O fs C h 23", 9 PAJ B L y o ? 3 S/ w -f f--F - OR 6 ndff B ! N 0 B- 3 /01 y 37 9„,~ f5o s, , . B oafs 4T 3,7 ,gS VIA iE PERCOLATION TESTS Z TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH P_ 30 2- P P- 2- W P- P . O 2_,0 / R1 C 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\Q of land slope, p0Ck - S,4 ND INt~f.9CE = /0 J!," / FT f~ N SYSTEM ELEVATION /Nvrei of D/sTR;,IvT-,o,~ pal _ 1.6. _ - _ T , 3 , E _ • NOT APPROVED F ~e 'This test , for a convenfiional septic system. sae explanation. a Z,. S~sovF~Ly -s%9 T vr~rtTv so~'~ t N .Soil s 441F_ SF~9So r ~?~G~ / S,g?Gr t c~ N , E.- - _ , „ i , i r 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: To&ERT 7?yG/3RichT' SED~' Z5 /~7~ ADDRESS: CE TIFICATION NUMBER: PHONE NUMBER (optional): 9-63 0/() Ei L RP UPSa.J //I'S. S Lp 3,f CST SIGNATURE- I DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. :HR-SBD-6395 (R. 02/82) -OVER r 7" MI, (NIUM nu,nber of b£d . E r ~,v _rt corr,t,~.aaarii 4, Is €.;s anew £3i laie,ln; DT ER Y st ' 5 r RE " Y 01.) T ' ,S a € ,"'a _,C)IL C N D T I',D S: W ,s._ W the r,bbi v'arlorry Shun "s het , r£,, xv, ;ape MAN Sao Qmns wvi f.'C2£Y pkiin£a the IMP p1£={3; %,,IAKE:: A 1_` GH Q Cil;7W m ac£;.#,,,.Wy k ,r.r wq tgm" t., ,.a=T,;yons. ),laii-ving to SUc;,r is t3-£3f+, irai- . , r . Showt oily ,p , HIM ps n c", , . .,3r e h .,'nm k t.., - , n . ,t 1E lk, ,t fp nce r}L nc are clow1v Ivw-i an p ".e^ e ;'3'}r' 6 190p, QtQ W c .c r ow ,p'43d e your =wt adcf£ and }°mn r E n`i e:, . , in e , - , Oval :~z r. it RR - ;5 ,C:i,-. 3 fW Gabon t t ri`Ie`? {tBF Ar T") LS i m., t: -r € . -Y r'1 H'i f rt3rr - ~ r1,~ C, r£t, com- £ ._.t".,155 Raid f[ ? a As ,N FWU a 3 3 5 Qwu x t My Lo n, Y - H a;-,r ~e - P v i_ era l; r'. ;ta ; - PAC! le, STV c WaKii A rr ,pt, Ugh :r- / !net, ,N!m an! r p4e t! 1 a, 3£- rh :=gyp S PI, w urb , . Fztrkrc. _ t 3£ Vol E, ; We i-x r=.,'°'_ ;lent may r ..,c£est at 50, s r r 1"! in Q, ht-0 ;-)Pxs in _ , ,i P.rw A s;-'`t;k i am of prwy for the pow n 3 4; j :c 0, lyn-I 1 E - 4 6~6- Z o70 f- REPORT ON SOIL. 130RINGS ll' PERCOLATION TESTS IISw Poor PLAN PRo3-Ec i r. D. I-E.v DA rE Lo f / CS,q Ss y tiE'/y s33 7- ,y HONIES1TE TESTING E~~IN~ Co. Sv • 70 sEjVjf- IPly 40 "T. 3, O'NEIZ ROAD BOB 3~1, VNIS..._ 54016 C57- 02 yfZ PROPOSED MoVSE Mosr LIE 2.;, Fr. 04 Mo,PE F,POM qL~ TEST f3,PEgS, PRO POSE 0 We u M Vsr LIE 50 FT a,e /'lDiQE FiQDH ALL TEST /i,PEgs, ~ = t3,4f.('fjroE /~iT's O =EXIST/.U LC~ELL X = PEG IDC~¢T/O~Uf ~ = yqu~ ~}v9E,PE0 o,Q S~OdEL ~jp,~ES • ` Yoeiz . S M ~PEFERever P A)7- / % P~pr sir o,v ~oR /OJ" /iuFANo ,UaR~G. lof Gi•~F /~~R/S /V9 6000p -40 Cl LEGEND /EV~~oN o~ var. ~E~ PT /60. v f ooONE~ v9 p0Sr NoRHk /of Li Jg 11 d. G Cc9DOD ~oRNER O Posr-y NW 407- COAV~r,f , q 30lv 133 ' 3 70 V 6R f tip `C Zy 41 ► y ► 34 ~o d 9C y`~ o v ! OR (4- ot p, 110 00 IL o ca T, k ►V Q v (~j~ lu 40 Uf w. v 2 2 p o~ ~ 1 k o 'K - STATE OF WISCONSIN DILHR DILHR PRIVATE SEWAGE SYSTEMS BUREAUNOFFPLUMBING BUILDINGS 201 E. Washington Avenue, Rm 141 W PLAN APPROVAL APPLICATION P.O. Box 7969, Madison, Wl 53707 608-266-3815 INSTRUCTIONS: Please fill in all applicable data and submit this form with plans. Plans will not be reviewed until all fees are received. The back side of this form describes required plan information. Plumbing codes can be purchased from the Department of Administration, Document Sales, 202 South Thornton Ave., Madison, Wisconsin 53703, Telephone (608) 266-3358. 1. PROJECT INFORMATION (Type or print clearly) Revision To Plan Number: Name of Submitting Party (Plans returned to same) Project 51"41w C// 11 Street & No. or Rural Route HOMESITE SEPTIC PLUMI Project Location - Street & No. or Legal Description f f RT. 3 O'NEIL RD., HUDSON. WIS. 54016 Lo f /CSC 36 3 513 $ 3 3 , T3 3N, /Pi City or Village Stat WIS. MASTER PLUMBER LIC. N0. 3307 M.P.R.S. Zip City 0/' I 7- IF MINN. INSTALLER & DESIGNER LIC. NO. 00663 Towne O OF: s71- TO 5-E~ S{. n D/ X Town Telephone No. (Include area code) 71L_ 3'P6 _ P11'S Designer Telephone No. (Include area code) BwnersName Telephone No. (Include area code) GE.VD.E' D Street & No. Street & No. City or Village State Zip City or Village State Zip C)-ti?;'~ S'/"it 2. APPLICATION FOR: New Mound System (3a) ❑ Groundwater Monitoring (7) ❑ Conventional System - Public Building (1) ❑ Replacement Mound (4a) ❑ Holding Tank (2) ❑ Replacement Pressurized System (4b) ❑ System in Fill (1) ❑ Petition For Modification (6) ❑ New Pressurized System (3b) ❑ System in Flood Fringe (1) ❑ Other Alternatives (5) 3. FEE COMPUTATIONS (Include existing tanks) 4. FEE SUBMITTED FOR OFFICE USE MAKE ALL CHECKS PAYABLE TO DILHR ~D bz2 3a. 750- 1,500 gallon septic tank - 50.00 4a. 3b. 1,501 - 2,500 gallon septic tank - 60.00 4b. 3c. 2,501 5,000 gallon septic tank - 80.00 4c. 3d. 5,001 9,000 gallon septic tank - 100.00 4d. 3e. 9,001 15,000 gallon septic tank - 150.00 4e. 3f. Over 15,000 gallon septic tank -250.00 4f. I 3g. 500- 1,000 gallon dose chamber - 30.00 4g. J 3h. 1,001 - 2,000 gallon dose chamber - 50.00 4h. 3i. 2,001 4,000 gallon dose chamber - 70.00 4i. 3j. 4,001 8,000 gallon dose chamber - 90.00 4j. 3k. 8,001 12,000 gallon dose chamber - 110.00 4k. 31. Over 12, 000 gallon dose chamber - 150.00 41. 3m. 500 - 5,000 gallon holding tank - 30.00 4m. 3n. 5,001 - 10,000 gallon holding tank - 55.00 4n. 3o. Over 10,000 gallon holding tank - 100.00 4o. 3p. Revisions - 20.00 4p. 3q. Groundwater Monitoring Per Lot - 32.00 4q. (other than a proposed subdivision) Subtotal 3r. Priority plan review: walk through) 4r. Submittal of plans in person, by appointment, with double fee 3s. Petition for Variance Setback - 25.00 4s. .151 Site evaluation - 50.00 Total Fee Note: Fees pursuant to Wis. Adm. Code, Chapter Ind. 69 j may be subject to change annually } DILHR-SBD-6748 (R. 03/84) Effective July 1, 1984 -OVER s c . H•,P, ~3 . o~/~J PROJECT IND*P,,X SHEET OWNER: /avyE,e : LE'No~P1D 'ckyJ 6rt,~E- ~/Ew~P.~~otiD S~ /~iP STfU SE/V~'i'G,~ /i Z ~vf~ yv- SDt , ec2/-1. SyOi~ SITE: LGf y C-5'11 363S23 doz. y sEiyNEy S 33 %30/✓ R/yam • `11~ s~• ~bSE~oh'` T6wtisl~~ $y GLU%X C><y PROJECT DESCRIPTION: o /,I Mo U~vD s~S~ ~ f°~2 ~/E-w 161wil o s-x~ e-dN SIW UGf/'O v 3 12ee,zf. ~~l yllE~if(~ S7~i y 7~ '2 ft PAG 1. PLOT PLAN VII ;^/S PAG 71 2. MOUND CROSS SECTION & SYSTEI'4 PT-,AN VT.EV1-)' PAGE 3. PIP? T ATERA-C, T,AYOUT PAG? 4. DOSING OR SIPHON CHAMBER CROSS S-Y TIONS PAGE; 5. PUP'P PERFORMANCI~ SPECS OR SIPTl()N >P'?CS PLUMB'.' R : S T TE EVAT.,UAT?'R or DESIGNER G~~y Z~~p M~~s 7Y' 3 300 Hwy 3s" HOMESITE SEPTIC PLUMBING CO. ~/O~ y!/DSo~ Cv/s , S yG/ ~i RT. 3 O'NEIL RD., HUDSON, WIS. 54016 715 - 3~G - ~2- F57o WIS. MASTER PLOUMBER LIBC. NO. 3307 M.P.R.S. MINN. INSTALLER & DESIGNER LIC. NO. 00663 DAT'i' 1-7 SIGNITUR- ( lv . Lot c vii' c> E/Q) Vj CORN E~ ~V.~. Gaf asf wood E,e /~o5f' Nd~ /ot LivF Cv000 co,~N 2 /I c o,P.v 22 ' f I I ~ f y~ f O 7L r ' 30 ~o frr rrl.~ M r v , r o r /r may, r r J r ~ - r r / I o Z i /00'707",f/ i A/34U~ ~ S' Ti}Tt' ~/J~iPOUF/~ 7y ,U~ ev G Gfz a~ 5'a' L T 3(~/s 1 1 I I ! s~~TE ~/J~jPGYIEO ~ G~9S7" r I _ ~o,v~C ~-e /ate 7XV, F .)t)6a 76a i v 'R OAA. 5arf G 3Oq a ~ ~ .i 1 furl cv~s T FD~c 0~= soy-r~~s~T ~Po . . /S. 74-- SET 13 y C 5'. T C/cU~T~o(U /00. FT Page - 0f _ Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe Medium Sand LG Topsoil F ~i p 3 E it b % Slope Bed Of ZM- 2 %2 Force Main Plowed Aggregate Layer D Ft. Cross Section Of A Mound System Using E A Ft. F • 7S Ft. A Bed For The Absorption Area G / Ft. A Ft. H S Ft. Signed: B y7 Ft. License Number: K Ft. L Ft. Date: Ft. t /S^ Ft. W 30 Ft. L d Observation Pipe F- A I.--------------------- - _ ~I Force Main Distribution Bed Of z - 2 %2 Pipe Aggregate I Observation Pipe Permanent Markers S FEEL /WS ` Plan View Of Mound Using A Bed For The Absorption Area