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HomeMy WebLinkAbout042-1046-50-150 (3)a ST. CROIX COUNTY ZONING DEPARTME s AS BUILT SANITARY REPORT 1~~Owner D~ r a~w>e a.v e? Property Address oo S a o ~rco/~41City/State W E 5l o Legal Description:0 ZLotBlockSubdivision/CSM # NO V4 A10 '/a, Sec. 1, TAN-R ! L W, Town of LZa-,t~PIN # 04-Z I v So _ 0 0 SEPTIC TANK DOSE CHAMBER HOLDING TANK INFORMATION: Tank manufacturer`w?~~~ P Size PC/200//0ooSetback from: House ~E- Well Yr P/L Pump manufacturer ';g4 Q,Pt...,Model -Al /40 -0 Alarm location E - iPne-P-,~ t o Sti.,enc ~.~'~w~ o n o rRcs..• ~2~HOLDING TANKS ONLY) 0-4, Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM: Type of system: 'j2ja-•v-Q Width Length Number of Trenches Setback from: Houser Weller PA[, 30 Vent to fresh air intake X- P m we k~...a~+O-a ~i%Y., ELEVATIONS: Description of benchmark 6t 3 Elevation Description of alternate benchmark e1Lzc e Elevation 7Y. q9 GI u2 0 5' P l o~ v+. s... AA4d .o n.,-°-~ f$ 4.3 9 Building Sewer 87 • co X ST/HT Inlet 88 < 5'7 ST Outlet B 8 , 3 5, PC Inlet 8 6• PC Bottom S 4, 41 Header/Manifold i 03, 19 Top of ST/]W Manhole Cover 9 L • 41 Distribution Lines a 3 R C7 O Bottom of System 9;Z . 65~ Final Grade Date of installation S /00l 4 Permit number VLq b'7,A- State plan number Plumber's si t e 0 License number A;L -7 -7 10 Date 6' /gyp/ Inspector kvja~M~Z4 Complete plot plan It 3 : ,i o iii Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County Safety and Buildings Division INSPECTION REPORT ST . CROIX GENERAL INFORMATION ATTACH TO PERMIT)Sanitars2e~rpitjV~.: Personal information you provice may be used for secondary purposes [Privacy L s.15.04 (1)(m)). Permit Holder's Name:flitvsl illage Town of:State Plan ID No.: HAMANN, DANIEL VIAK~jK~g A CST BM Elev.:Insp. BM Elev.:BM Description:Parcel 34LO 1046-50-100 10 'too, TANK INFORMATION ELEVATION DATA A9800563 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic h I Be chi II~,~ N • 2q IL2~1 1 D t7otuxe~z.,, T,,7, Dosing N o lm 16 It-Z til. Aeration Bldg. Sewer I D5 161 b-bff Holdin OF* Inlet ps, 17.13 Fl Y. S7 TANK SETBACK INFORMATION S ~llt Outlet jps,7 17•8~ 3 Vent TANKTO P/L WELL BLDG. AirItontake ROAD Dt Inlet A Septic Vlj4- qo'NA Dt Bottom OS• 3 YV• y Dosing NA Header / Man.Bbl • Z o D3 r 4 Aeration NA Dist. Pipe 3-03 105 l Holding Bot. System Z g•70 p PUMP/ SIPHON INFORMATION Final Grade Manufacturer 70e 11,t Demand S I,10 oS•'1~ate Model Number JJ v qD GPM g W Ioj.~ i 3•p5 TDH Lift ~.g, Frictions S System2•S TpFQG75Ft P-9bS-'To `(v1~j/ 51q. Head k b ' Id•B'S ZForcemainLengthZ(Z' Dia. Z " Dist. To Well 5;4, L44 jOS. -7 SOIL ABS PTION SYSTEM A14, 6 K I los. AZ BED / ENC Width Length 1 No. Of Trenches PIT No. Of Pits Inside Dia.Liquid Depth DIME DIMENSIONS r~ LEACHING Manufacturer: SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM INFORMATION TypeO CHAMBER Moe Number: System:.&OR UNIT DISTRIBUTION SYSTEM Header / M~nj old t Distribution Pipe(s)r r x Hole Size x Hole Spac ing Vent To Air Intake 1y Spacing - f 11 SLengthl/!0 Dia.Length Dia. r SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed/ Trench Edges Topsoil Yes No Yes No COMMENTS: (Include code discrepancies, persons present, etc.) to-'77 gf~y jZ LOCATION: WARREN 17~.1_2~9/.18,NW,NW 1005 00TH AVENUE L PT 1 Plow[ Vi e'S '~'"`T 10.7 -7 10 p, C,- 40 W~ a..,( Mr(w bv+ l d 11 C-ay rwob11 e Uov-a.-v ddt~r 10 01 rc te,QNLAs -P-, W'd i wsf: 4MIA&2 v ctl~ M.Ofi t~'4 TkPJ 5111 ~ 4q Plan revi on required? Yes P-16 Use other side for additional information.1,47 SBD-6710 (R.3197) Date Inspector's Si tur Cert. No. WaterPro Supplies Corporation 15801 W. 78th Street N 9661894WaterProEdenPrairieMN55344 Telephone: 612-9377-9666 WATS: 800-752-8112 Fax: 612-937-8065D~14 J 710 PROJECT DATE 7 N 1 1/ 7 X ~S N o VI I 70 q O 4 ~ O r l cd co 3 yc{zoq J teP 6 S0 y v1i~FiR SANITARY PERMIT APPLICATION Bureasafetyu ooandf BuiluildinWater SystemsngWater 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. See reverse side for instructions for completing this application State Sanitary Permit Number El 3~pre: } -The information you provide may be used by other government agency programs Check if revision to prewou application Privacy Law, s. 15.04 (1) (m)].State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION 8 U19 Property Owner Name Property Location fl/k) 1/4 A) 1/4,S/-7 T N, 15 E (or W Prope y Owners Mailin Ad ress ft~ Lot Number Block Number jg~,n :Z h~A;11 City, S to Zip Code Phone Number Subdivision Name or CSM Number x.86- 7885 iZ ll. -TYPE F BUIL G: (check one) State Owned t Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms ow9 of tJa-~-H 00 A,44.9_ III. BUILDING USE: (If building type is public, check all that apply)Parcel Tax Number(s) 1 Apartment/ Condo A/ 0-Y2 _ /Q ti6-' SG - J 2 Assembly Hall 6 Medical Facility/ Nursing Home 10 Outdoor Recreational Facility 3 Campground 7 Merchandise: Sales/ Repairs 11 Restaurant/ Bar/ Dining 4 Church/ School 8 Mobile Home Park 12 Service Station/ Cat Wash 5 Hotel/ Motel 9 Office / Factory 13 Other: specify IV. TYPWOFPERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1.evii 2. Replacement 3. Replacement of 4_ Reconnection of 5. Repair of an System System Tank Only Existing System Existing System B) A Sanitary Permit was previously issued- Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressuriz d Distribution Experimental Other 11 Seepage Bed 21 found 30 Specify Type 41 Holding Tank 12 Seepage Trench 22 In-Ground Pressure 42 Pit Privy 13 Seepage Pit 43 Vault Privy 14 System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (s . ft.) Proposed (sq. ft.) Gals/d sq. ft.) Min./inch)Elevation Q00 Is- O Q;, o5-2f eet Q eet VII. TANK Ca in gallons Total of Prefab. Site Fiber-ExperINFORMATIONGallonsTanksManufacturer's Name Concrete Con- Steel glass Plastic AppNewExistinstrutted Tanks Tanks t Septic Tank e1d+r9 +0 ik co Lift Pump Tank ip 4-1 eQ-t7 CI VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print)Plumber's Signature: (NoStamps)MP/MPRSWNo.:Business Phone Number:17/S7- zy y-- 33 -2-2 Pumber'sAd res treet Ity,State- Zip Code): Cv 5~h~S a~'~D ~3 IX. COUNTY / DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee (includes Groundwater Date Issue Issuing en Si ature (No Stamps) A roved Surcharge Fee) pp OwnerGivenInitial J U,Adverse Determination J ee~ "Dal( X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: SBD-6398 (R. 05/94)DISTRIBUTION: Original to County, One copy To: Safety & Buildings Divi.ion, Owner, Plumber Safety and Buildings 15837 USH 63 HAYWARD WI 54843-8107 iscons~n Tommy G. Thompson, Governor Philip Edw. Albert, Acting Secretary Department of Commerce October 21, 1998 CUST ID No.259518 ATTIC- POWTS INSPECTOR ZONING OFFICE ULBRICHT & ASSOCIATES ST CROIX COUNTY 655 O'NEIL RD 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 10/21/2000 Identification Numbers Transaction ID No. 182612 Site ID No. 162217 SITE:Please refer to both identification numbers, Site ID: 162217 above, in all correspondence with the agency. ST CROIX County, Town of WARREN NW1/4, NW1/4, S17, T29N, R18W DAN HAMANN RESIDENCE SEPTIC SYSTEM FOR: Description: MOUND SYSTEM, 600 GPD Object Type: POWT System Regulated Object ID No.: 431220 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: 1. This plan action is subject to designer comments on the plan. 2. The orientation of the mound system must be such that the mound's longest dimension is perpendicular to the direction of maximum slope. 3. The area 25' below the downslope edge of the mound must remain undisturbed. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation.P.O.W.T Conditro Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead.FIX pEPARTMENj of Sincerely,i N ()f SAFF- DATE RECEIVED 10/13/1998 DI, C-G'FEE REQUIRED $ 180.00 SEE CORRr PATRICIA SR , POWT LAN REVIEWER FEE RECEIVED $ 180.00 Integrated Services BALANCE DUE $ 0.00 715)634-7810, FAX: (715)634-5150, M-F 7:45 AM - 4:30 PM P SHAND ORF@COMMERCE. STATE. W I.US ULBRICHT & ASSOCIATES CO. 655 O'Neil Road • Hudson, WI 54016 Reg. Designers of Engineering Systems 715-386-8185 azoelVea Private Sewage Consultants v Oct Z 1998PROJECTINDAft-ty,&,q1DgS. D111 DILHR Plan I.D. #Date owner 41,v Phone 715 3 g 78 e s Address 1607 ASAFv f~ip f(/~~d.~/ L(J~S• S~OLC.r Legal Description ~p f CSC! G sZ SS, UO/ /2-33P/ail t1.1• 1O Y6 • So -idv 10 i 7, r.2 %-Av Town of County 5 r. GR0CY, C.S.T. `~ol3E~I' 2{Ll3(Zi °~T- iZ43~S Installer Local Authority/ Supervision s T : cRD JC GT y. z o A3 I' Al PROJECT DESCRIPTION I3e",q- 5/7- ED h t, -P • OD ~~-~S, 9jf %G L(Ji¢ST F~Ozc1 3 4"So r G Re-STie r7 1'5 P o%--tr.AC Cv i'dZi, 02, y" S ~•vv 7c~ ll s S~l~ NEE Com E i INGS ICON PONDENCE 0,~.••,,.....„„ r yPg.l PLOT PLAN VIEWS ItouffW. ULINUaff Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS r gRODOilq Pg. 3 PIPE LATERAL LAYOUT d 4. S I G CZ Pg.4 DOSING CHAMBER CROSS SECTION Pg.5 PUMP PERFORMANCE SPECS N cnl ~d U1 0 L4 ZQ I a I I b 1 I C I1 I o w I I I E3 C° 11 c II~ I a 11 C I ~o I 3.I i1 a fall- I I o r E I~I tj I I ll I U£ R o F I ,4 T~ R A I S 1 03. 0 1 Z Df 5^ Top aF i ATe R ~ ~ 5 TO P Of R Or k lo 3, 3 s /sriM E11uuArt oN X02 •.~Z Straw, Marsh Hay, Or Synthetic Covering Medium Sand Distribution Pipe f Topsoil H -_-. e saassr7 G i vu~EORNlQ % Slope Trench Of 2"- 2 i Force Main Plowed Aggregate Layer Undisturbed D 2'0 Ft. Soil E 2• J/' Ft. Cross Section Of A Mound System Using L F Ft. SATE- Trenches For The Absorption Area G Ft. A Ft.H s Ft. B 63 Ft. C t K 3 Ft. L Ft. Ft. Position of Force Main I z/ Ft. W-3Y Ft. L J rB B K W Observation Pipe s p ~o. PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS PAYE of JC VEfJT CAP 4"C.I. VEMT PIPE WEATHER PROOF APPROVED LOCKIMG JU"CTIOM BOX MANHOLE COVER 25' FROM DOOR, 12"MIU.l,%dlA)&- IA13EI WINDOW OR FRESH AIR IMTAKE rJ/ IADgr 1,^1-10N GRADE I 4" MIIJ.19" MIIJ.97 Ja COIJDUIT--lob it / 15 V4 N r' PROVIDE I INLET AIRTIGHT SEAL I III 1`APPROVEO JOINT A 5,1(~ K I III APPROVED JOINTS C. I. PIPE lvM Dy 3 I III E' ATEM PIPE 1JEXTENDING 3'0,a I II ALARM XTEWOING 3 OVJTO SOLID SOIL B Q!f I II ONTO SOLID SOIL 3. 3)I I ON 1q. 3°c y ELEV. FT.PUMP OFF 014-0lloAtE eF DDI, J !s N K BLOCK S/lrvl>ItvA rio d f3~ v (r n~ RIStR EXIT PERMITTED OUL9 IF TANK MAUUFACTURER HAS SUCH APPROVAL SEPTIC E S P E C I F I•CAT 10M S DosE Pw s7ewN DiLClw- 40 '3 TANKS MAMUFACTURER:IJUMBER OF DOSES:PER DAH TAUK SIZE* 0'0-0GALLOUS DOSE VOLUME. 26 ALARM MAMUFACTURER: G'0y44*,l D 'INCLUDING BACKFLOW:GALLONS MODEL HUMBER:D•U'LCAPACITIES: A=~GINCNESOR 00 GALLONS SWITCH TYPE: 1qERway 13 = Z INCHES OR 50 GALLONS PUMP MANUFACTURER:C= f• Z INCHES OR 2.30GALLONS MODEL NUMBER:I D= 12. 8INCHES OR 320 GALLONS SWITCH TYPE: 617`CY''4"_`_ If'r'A * Fle'+7- NOTE: PUMP AMD ALARM ARE TO BE MIUIMUM DISCHARGE RATE yo `GPM MSTALL: EO ON SEPARATE CIRCUITS 0: 27 •VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE..FEET fiANFL S~~C S IU) UM NETWORK SUPPLY PRESSURE . . . . . 2.5FETE! EACtl.FEET OF FORCE MAIN X 2'GZF joF1FRICTIbN FACTOR..F 7'F)E~t7_g0AI S 2"loA ls.7. 01Fr.TOTAL DyIJAMIC. HEAD EET~'or j IIJTEItRIAL bIME1JSI0US OF TAUK: LEIJGYH WIDTH LIQUID DEPTH r A HEAD/CAPACITY CURVE p' HEAD CAPACITY CURVE p EFFLUENT MODELS i43,55,1-0 tb 1 1 f 3, t65, 185, 1 ti6 88140-1, 189 91MODEL424898134257594140 _ 416 4163 4165 4185 4186 4188 4189 135 FT. M. GAL. LTRS. GAL LTRS. GAL. LTRS. GAL. LTRS: GAL GAI LTRS GAL. LTRS. GAL. LTRS. GAL. QTRS. CAL. LTRS. CAL. LTRS. GAL. LTRS. CAL. LTPS. CAI.. L 5 751.52 15 57 32 121 a3 163 72 2/} y3 1 91 544 100 379 61 231 61 231 50 220 145 Sag 145 549 45 1 130 10 3.05 11 42 25 94 34 129 61 231 79 J 84 315 --93 352 61 229 61 231 58 220 740 530 140 530 45 170 38 125 15 4.57 6 23 15 57 19 72 45 170 6 2 761298 85 322 60 227 61 231 58 220 134 507 135 511 45 170 20 6.10 25 95 36 8 257 79 299 59 223 60 227 58 220 128 484 131 196 45 170 120 25 7.62 8 t 59 223 IC 255 57 216 59 223----58 220 122 462 125 473 45 170 I 36 191 30 9.14 49 8S 62 23 51 206 58 220 85 322 58 220 116 439 120 454 45 170 115 F 40 12.19 Iy 21 19 45 1170 46 172 55 206 70 265 58 220 104 394 109 413 45 170 34 110 50 15.24 I 70.. 76 33 12 50 189 51 193 58 220 90 341 97 36, 15 170 60 18.29 111 1-- - ,`I 19 148 12 121 58 220 71 269 85 327 45 170 32 105 70 21.34 r 23 87 9 34 52 197 51 193 69 261 45 170 80 24.38 I~-_ 10 i 38 45 170 28 106 51 193 45 170 100 I -Jfl 90 27.43 31 117 2 6 34 129 45 170 95 100 10.48 I -Ifi 60 17 64 40 151 28 110 32.00--- 4 15 30 114 90 120 36.58 20 76 186. 26 . 85 4185 130 39.62 10 38 LOCK VALVE: 19' 19' 19.25' 2J'46 S6 66__ 86.5' 73' 114'110' 137' 24 165, 75 416 22 70 20 65 78 60- Y 14163 89 69 o CAUTION Model 185/4185 should not be subjected to 16 less than 30 feet TDH. so 14 45 NOTE: For Head Capacity on Model 112, Industrial column-explosion proof pump, see FM0219. 12 40 14 168, 35 41040 a18 j 3 009922a i`•'10- A, 0 30 137, 165, 8 25 4185 15 4 10 41 i2 5 a8 4661 4 57,59 98 O IU.S. GALLONS 10 20 30 40 50 60 70 BO 90 100 110 120 130 140 150 160 LITERS 60 160 240 320 400 480 560 640 0 FLOW PER MINUTE W 4 HEAD CAPACITY CURVE SEWAGE MODELS 24.L . - 75 MOOEI 261 266 161 268 42'0 4281 4284 4291 4293 1291 4295 1 282 2154 2 2 22 fl. MCTERS GAL, liRS. GAL. Lt I" I rLTRS GAL. liRS. G41. LTRS. CAL. LTRS CK. lIRS. CAL. LTRS. W.' LTRS. CALF IiR4.~ L1R5. 70. T27 90 341 128. 481 119 484 129 484 132 500 130 191 180 681 140 SJO 196 71BIG 60 227 89 33 89 331 89 337 101 382 95 160 158 598 121 469 181 685 199 753 2G 6521.5 85 SD IBJ .l _50 199 50 189 11 191 67 139 IJS S 100 409 118 111 165 615 181 696ICI10B. 10 38 10 JB 56 117 JJt,`5 106 91 344 tOB 109 150 S6B 166 636 1110 9 6 Z88 75 181 96 363 136 515 151 SBJ 1 a 60 67 5h 82 310 121 458 140 530 0 18 162 94 356 115 435 58_ 210 89 v/16 13 49 59 223 23 LOCK VALVC: 11121.5 21.5 T 215 ' _ 1 2635' 42' 50 62' 75'14- 45- i -.--i-- 12- 40- 10- i p 35n CAUTION Model 293/4293 81 30 should not be subjected to less than 293. a 25 4293 15 feet TDH.282.4282. 270, 4270 6-20 I...-. 15- 4-1 0266,267.2 68 2 5 26429'2,4, 294, 295,4292 4284 4294 295 0U.S. GALLONS 10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160 170 180 190 200 210 2202' 30 LI S 0 80 160 240 320 400 480 560 640 120 800 880 009904a FLOW PER M E40 Series 4/10 HP Effluent and Drain Water Pumps Performance Curve MODEL ME40 EFFLUENT PUMP CAPACITY LITERS PER MINUTE 0 50 100 150 200 250 300 350 40 12 35 10 N 30 H 25 6 Z 20 6 J 15 Q F-4 0. 10 F11-5 2 0 0 0 10 20 30 40 50 60 70 60 90 100 CAPACITY GALLONS PER MINUTE F.E. Myers, A Pentair Company • 1101 Myers Parkway, Ashland, Ohio 44805-1923 419/289-1144 FAX 419/289-6658 Telex 98-7443 K3326 7/91 0. A im 11 0 e Wisconsin Department of Industry,SOIL AND SITE EVALUATIONLaborandHumanRelations Page of 3 Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Attach complete site plan on paper not less than 6 1/2 x 11 Inches in size. Plan must County Include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road.Parcel I.D. o yAPPLICANTINFORMATION - Please print afl information.Review b 9 p Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).4 S Property Owaer 13 u YC P,Property Location N itA P'I /4NN V10 A-/,00 11,4R4,W Govt. Lot 11W 1/4 N rv;N,R E (or~ Property Owner's Mailing Address Lot # Block# Subd. Name iro, fd Ac,e SO/ f 606%- if V E- -cvf EVP G- - .2 City State Zip Code Phone Number Nearest Road RDI3EI2TS 4)7 /S ) 7 yq - 3g03 El City Villa ET-Town L31 New Construction Use: L'_TResidential / Number of bedrooms 3 -9 Addition to existing building, Replacement Public or commercial - Describe: 3 trench, derived daily flow ~yso and Recommended design loading rate bed, gpd/ft2 3 trench, gpd/ft2 Absorption area required 5Q _bed, ft 2 5~ trench, ft2 Maximum design loading rate bed; gpd/ft2 3 trench, gpd/ft2 Recommended Infiltration surface elevation(s) S 3 O Z S 7-ft (as referred to site plan benchmark) Additional design/site considerations o v 4r ;90~p p lJ-v~ 5,VS7-. Parent material -5G15 37 SAO&AS /IS iP0C&7o v pv Flood plain elevation, if applicable /V/1¢ft S Suitable for system Conventionaall Mound In-Ground Py_Tres/sure AT-Grade System in Fill Holding Tank U Unsuitable for system S io ~ U L~'f S U S L-' u S S 9-15- S SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2 in.Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench 1 0-y /oYA 313 Sim 2-,M5hX dSA e, s 3 f s ; .4 S ioye 30 5/L fshe l6-c 5 6vf . z ' . 3 Ground G !s/L fS~~ /IN CS 2 ; . 3elev. eft.y o zae CL. z,,,, 6 iZ L 3 7.5 yX s/ Depth to QlimitingseD7•S V4 G2 c57/lle le M4 Ak y , -jfactor SYA S/LIle Remarks: _ AA61t- 13ZlN fyi'%~t-C3/~ E~V ~-v c° CIO U,vp S~/S'7`~i y Boring # 0-? lO 51z- 2,ws CS 3f- S z f,/& /o y61 S/G f d i eS Uf z 3 3 z vle ,vlil 14- 411 ho'6e 405 171 Ground G /y s N D N elev. tpo•2y ft. Depth to limiting factor 2--4t-In. Remarks:P~STit'~cTio~ CST Name (Please Print)Signature Telephone No. ToQE~F?r Ib~~'~-~L"~S•3~~ • 885 Addrwcc 71 O E~y o ti PROPO~Ed w~5 T _ O b l` O 0 y ti 5)C c r G I~o IV 1 nT o ti cn SIG r moms ST CROIX COUNTY SEPTIC TANK MAINTENANCE-AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner uyer D n Al a COL Mailing Address 4Z.4-5 LO/?Property Address SUS " 10yl~ Ate.SydZ 3 Verification required from Planning Department for new construction)e~ M~C.rCity/ States)Aef/__S 4c)Parcel Identification Number LEGAL DESCRIPTION Property Location A 1/,, Sec., TN-RTown of I,#i.at~ .Subdivision Lot #Certified Survey Map #Volume 2 Page #3`f 8 Warranty Deed # 5-6 'Volume 1, A' y Page #Spec house yes no Lot lines identifiable 9 yes no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system.The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3full of sludge.Uwe, the undersigned have read the above requirements and agree to maintain the private sewage•disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 s of the thr a year expiration date.1. 11.4SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I ( we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office.@~ rnum~1.96SIGNATURE OF APPLICANT DATE Any information that is mis-representedmay result in the sanitary permit being revoked by the Zoning Department.Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed rK V?'4rAUU7T I SG1809 I STATE BAR OF WISCONSIN r -C" 3 - 199E I I CUR CLAIM DEED IDOCUMENTNO. r_awn n REGISTER'S 'Jr r 1i ST, CROIX CO„ W, r R40 '9r R-1, 4 n Il.+4C 'f~\ quit-clans to OCT 31 1997I 2:30 PM Ra later of O~sda l CC t \j County,F the following described eat estate in State of Wisconsin: i n 0.r o~ -the N VJ %14 L c, cc, cV ; scc_~t0 n. 1-7) `f - 1 1Aj RETURN TO AA`sQ~C C-c) 1\ F ~t9Q1 (C~ ll~i uJ 10G-v,-,R- f l (O t C 1 4~S PF `1 ,c t r C~ T W ca r e. r t 5 C 1 l~su Parcel Identification Number (PIN)IISC 12 pc"te 3 3 Leg I z i EXEMPl it i rY I I 3 15 Q homestead Property. i iThis I I is no 19 3 I L day of t-'C e f i i Dated this SEAL) tSF,i i SEAL) j! I sS1 L_i i i ACKNOWLEDGMENT IIIAUTHENTICATIONISTATEOFWISCONSINtISignature(s) ss.I~ 1j 5 c C t County- m iII3l .5f- day of 19 Personally came : afore this authenticated this day of 19 ce 11 his he above ,-,amen I' TITLE. M[MBER STATE RBAF WISCONSIN wno execu!ed the I a1 to me known be the Per sOn W 11 not.fpregoinc~ s ument and acknowledge the me i( autho ized by § 706.06. Wis. Slats.)i 1-T01 uncNT WAS DRAFTED BY i I I f I s FILED SEP111997 L KATHLEEN H. WALSH 2 Register of Deeds SL Croix Co.. WI CERTIFIED SURVEY MAP Located in part of the NWJ of the NWJ of Section 17, T29N, R18W, Town of Warren, St. Croix County, Wisconsin. Owner Legend N Eldo Hamann Aluminum County Section Monument Found O 111 X 2411 Iron Pipe set, weighing 1.68lbs per linear foot Prepared Fo 100 Foot Roadway Setback Line c r d o_ Dan Hamann- Existing Fenceline L-14-3 N 1607 Aspen Dr.o m Apt. 1 U) Hudson, WI. 54016 a°i o °o Xt U U 4-- 0-0 NW Corner 4-1 y a Section 17 L. o -oireS'00 M0E C N C, DOUGLAS J. 0 o N ZAHt R 2 m r o co 1 m ~ UNPLATTED LANDS 100TH AVENUE I S89°43'20"W 143.10' S89°43'20"W 143.47' t N U C ^ ^ t N Oq eLn-Q J N C N N 01 0 41 M Ol C/~1 LOT 1 G qi M ZI c v Ln ZI M CI JI 2.73 Acres Inc. R/W JI 3 zi) 0 118,908 Sq. ft.ql o kc w LtJ I rn Wi 3 M 2.50 Acres Exc. R/W N I-i 108,993 Sq. ft.M N i o m 0 0 F0 W t.0 C4 j 1 ( ZI Um NNQIV0 JI N O ZI ZI Z I ao 7n 3 3 I N d M_00 N N Ln _r r_ O1C O Y C C M M y.. y )Q lOW 0 1 L O o p C N Ol 01 OD 00 Om F-m fn try C 74j Om 1 SURVRYOR-S CERTIFICATE I, Douglas J. Zahler, registered Wisconsin Land Surveyor, hereby certify that by the direction of Dan Hamann, I have surveyed and mapped a part of the NW1/4 of the NW1/4 of Section 17, T29N, R18W, Town of Warren, St. Croix County, Wisconsin; described as follows: Commencing at the NW Corner of said Section 17; thence 500022128W, along the west. line of the NW1/4 of said section, 580.211 feet to the centerline of 100th Avenue and the point of bedinning; thence continuing S00022128"W, along said west line, 393.00' feet; thence S89037032"E, 300.Q.01 feet; thence N0002212811E, 405.921 feet to said centerline, being the arc of a 130.00 foot radius curve, concave northerly, whose central angle measures 6055138", whose chord bears S8601513111W and;measures 157.32 feet; thence westerly along the arc of said curve and said centerline, 157.42 feet to the point of tangency; thence S89043' 0~W, along said centerline, 143.10 feet to the point of beginning. Described parcel contains 2.73 Acres 118,908 Sq. Ft.). Above described parcel is subject to right-of-way for Town Road Purposes 100th Avenue) and all easements, restrictions and covenents of record. I, also certify that this certified Survey Map is a correct d.representation; to :.scale of the exterior boundary surveyed and described; that'-Z have fully complied with the current provisions of Chapter ;236.34 0 the Wisconsin Statutes and, the Land Subdivision Ordinance of the County of St. Croix in surveying and mapping same. Douglas J. Zahler S & N Land Surveying, Inc. 212• Walnut St.' Hudson, WI 54016 Each parcel shown on this map plat) is subject to State, Counter. alld Township 1Aws, rules and regulations i.e., wetlands, minimum lot;, a-ae, access to parcel, etc.). Before purchasing or developing any 1 contact the, St. Croix C--inty Zoning Office and, appropriate Town a~ for advice. APPROVED SEP 1 1'97 QdAnPWI I'-V*' Ir;nntrig r' Bach parcel shown on this map plat) is subject to State, County ,rules and regulations i.e., wetlandsaccesstoparcel, etc.). Before purchasin minims loi.' taecontactthe, St. Croix O-•~t y g or developing anforadvice: Wit..Zoning office and appropriate gowned c.: PROVED SEP 1197 l..li`LfY t~ ,yet ;:>c»„9ehrJ w;rtm 1ny"A of isrlsVw al :late 4?smuw -Ai'rWi,ne au&Aria "'44' Vol. 12 Page 3348LL+,