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HomeMy WebLinkAbout020-1063-90-000 l 0 d C d 0 r1 3 n 3 (D "0 M 1 V1 (ID cn g -i z o a r = N C) H O W O N O W N C W N t 7 3 0) a d N O j(D 0 O N (JD _ Z n O O ^ " m ° -i co co ° \ 1 N) CL 0 cu 0 O n 0 (D = A O O O C (p (n 0 (17 3 m N r N) O o (A (A 4 m (0 (D (n a a a T m co 3 O C 3 0 o 0 (D O N -4 < O L M O o r cn !i CD co (n w w W a v v v v v Z O O O +y 0 c -1 -1 -q c~' a fn V1 cn c: x ~ O O N O < 0 0 N N 0 d V (D ' (n 3 d N CL o z 0) 0 C co Z 7 (D O 0 O ? 77 d 7 I > > N N O C C N (D w d a 3 5 z CD 1 to O O A Z n c ~j R d ? C 7 0 cn ~ N W -0 M ro w d a z 0 C/) 3 m z CD w ~ N Q x O C cn Y N j ,n 0- N C a Z p p (D 0 II ~ I A N ti I ~ N O ~ d ~ A O (D O O CA a O (D Z7 0 CL 'r } LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF HUDSON COMPUTER NUMBER 020-1063-90-000 Parcel Number 23.29.19.245E OWNER NAME: First CHARLES & ELIZABETH Last LADD PROPERTY ADDRESS: Hse # 1/2 PD --Street Name-- Type SD Apartment 827 WILL BRADLEY DR SECTION 23 TOWN 29N RANGE 19W 1/4160 1/440 Line Description Line Description TOTAL ACREAGE 4.179 PLAT LOT BLK 01 SEC 23 T29N R19W 15 02 SE SE 16 03 LOT 4 CERT SURVEY MAP IN VOL 17 04 II PAGE 541 ORD 18 05 EXC PT TO TOWN OF HUDSON FOR 19 06 ROAD PURPOSES (DESC 888/350 20 07 .021 AC) 21 08 22 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 AS BUILT SANITARY SYSTEM REPORT s OWNER_ TOWNSHIP cry _S~Z SEC a1 %-R~W 7% 4, ADDRESS. -S 1'. CROIX COUNTY, WISCONSIN. SUBDIVISION,/ LOT - L OT S IL. E PLAN VIEW Distances and dimensions to meet requirements of H63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM K !b G~'~ LL •l 17 0 fi U J TR t~ L3 ~ 1, m j,, y_ c VIA 1 14 r c~ ' K J J n rY) 4. i I di at N r h rr w u rU (A 11~ o r e BENCHMARK: (Permanent reference_ Point) Describe: Cr1r Sr - j" .~'4)- , wt jl-av~ ~c~ k•`~ I-,' t~ . ~ ~ J'r~ rI i ~ ~ ~ orY~v ,J > ~ - -t ~ Elevation of vertical reference point: Slope at site: 77, SEP'T'IC TANK: Manuf-acturer:,~~-~°..5~1- _ Liquid Capacity: Number of rings on cover Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: PUMP CHAMBER Manufacturer; i'___ Number of gallons Number of gal pump set for a cycle gallons; Total capacity of distribution lines gallon: size of pump head; gallon per minute horsepower ;brand name of pump and model number ; Type of warning device HOLDING 'T'ANK: Manufacturer Number of gallons Elevation of manhole cover ; Type of warning device SEEPAGE PIT SIZE;_ -Number of pits feet diameter feet liquid depth seepage pit inlet pipe-elevation bottom of seepage pit elevation feet. SEEPAGE. BED SIZE: number of lines width length the depth SEEPAGE 'T'RENCH: width le th PERCOLATION RATE f AREA REQUIRED AREA AS BUILT ✓ INSPECTOR v aZ2 - DATE D PLUMBER ON JOB.e~ LICENSE NUMBER 7:~ 0,1 4i > 7 0 1 j'Lur- 4- a /I DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BO; 79F,fl BUREAU OF PLUMBING MADISON, WI 531"07 C CONVENTIONAL ❑ALTERNATIVE StatePlandL)D.Nurnk- ❑ Holding Tank El In-Ground Pressure ❑ Mound Ilf assigne NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER: INSPECTION DATE. Charles Ladd 1781 Warbler Lane,St. Paul, Mn I1,-7.-$3 J".w BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELEV. SE SE, Section 23, T29N-R19W, Town of Hudson Narne of Plumber. MP/MPRSW No. Cou nry. Sanitary Permit Number: Paul Cudd 2739 St. Croix 43697 SEPTIC TANK/HOLDING TANK: MANUFACTURER LIQUID CAPACITY TANK INLET ELEV.. TANK OUTLET ELEV.. WARNING LABEL i L OCKING CO R/ r 1 / ~~J II "7 rf „ PR VI ED: P' D ES ONO YES ONO BEDDING: VENT tr1A VENT MATL. HIGH WATER NUMBER OF ROAD: PROPERTY WELL. BUILDING. VENT TO FRESH ALARM / FEET FROM LINE. JAIR INLET: DYES O DYES NO NEAREST DOSING HAMBER: MANUFACTURER BEDDING. LIOUID CAPACITY PUMP MODEL JPUMP/SIPHON MANUFACTURER WARNING LABEL JLOCKING COVER PROVIDED. PROVIDED: DYES NO DYES ONO DYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PROPERTY WELL BUILDING. JVER NTTOFRESH (DIFFERENCE BETWEEN FEET FROM uNE AINLET PUMP ON AND OFF) OYES NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGTH 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: BED/TRENCH WIDTH LENGTH NO OF IDIST11 PIPE SPACING COVER JINSIDE DIA -PITS LIQUID TRENCHES. M TLRI L' DEPTH. DIMENSIONS; i PIT GRAVEL DEPTH FILL DEPTH JDPIPF DISTRPIPE DISNUMBER OF PROPERTY BIDINGVENT TO FRESH BELOW IPES ABOVE COVER EEV.INLE1 ELEV. END n ! PIPES rr FEET FROM LI"~E,:;~ A(~l IP INLET.. P I f G~ ~.~r~ d 2- N EAREST--.- 1 9 7 MOU D 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- • DYES NO meets the criteria for medium sand. TIONS MEASURED. O SOIL COVER TEXTURE PERMANENT MARKERS JOBSERVATION WELLS DYES ONO DYES ONO DEPTH OVER TRENCH 'BED DEPTH OVER TRENCHBED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES EYES ONO DYES 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 MANIFOLD PMATERIAL O ELEVATIONAND DISTRDISTRPIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEV.ELEVDIAELEV, IPESDIADISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY RIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS DYES NO DYES NO COMMENTS: PERMANENT MARKERS: JOBSERVATION WELLS: NUMBER OF PROPE RTV WELL. BUILDING. FEET FROM LINE. ❑ YES ❑ NO ❑ YES ❑ NO NEAREST 1 ~t r 1 Ci'GL .~4 LC-I~ ~ 1 1 cam-. Sketch System on Retain in c unty file for audit. Reverse Side. SIGNATURE. TITLE. DILHR SBD 6710 (R. 01/82) 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 8'/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 _ Pr perty Location: City, Vill ge wnshCounty: P~ '/a "/aS ~T NCR 1 E (or) - Lot Number: ~ Blk No.: Subdivision Nayne: Ne pest Road, Lake or Landmark: State Plan I.. Number: (lf assigned) TYPE OF BUILDING _ Number of ❑ P blic* ❑ Variance* ❑ Other (specify)* Bedrooms: ❑ 1 r 2 Family *State Approval Required. TOTAL NUMBER PREFAB POURED-IN NEW REPLACE"OTHER GALLONS OF TANKS CONCRETE PLACE STEEL FIBERGLASS INSTALLATION MENT (Specify) SEPTIC TANK CAPACITY y~- HOLDING TANK CAPACITY LIFT PUMP TANK/SIPHON CHAMBER MANUFACTURER: EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): New ❑ Replacement ❑ Experimental Seepage Bed ❑ Seepage Pit G ❑ Alternative (specify) ❑ Seepage Trench Wa* Supply: O a as Listed on Soil Test Report (If other than present owner): Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Narpe f Plumber: _ jSiigna~ture--~ A4P/MPRSW No.: Phone Number: Plumber's d ess: ` Name of De~ign~er:~ o{ t COUNTY/DEPARTMENT USE ONLY Signat re of Issuing Ag nt: Fee: Date: Sanitary Permit Number: /7 _ _p APPROVED CIh~U ' (1 - /.7 ❑ DISAPPROVED y 9~ Reason for Disapproval: 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) 1'o ruI - S 1' C 100 Owner of Pro trt Location of Prope rty_~E_-~ SE Section_2_ IOW Township ~nN Ma111n6 Address I-(q~~ r~I~ Subdivision Name O)C AI-Lz--,z Lot Number Previous Owner of Property 4 )orvAL ) LLr~IM Total Size of Parcel Z ~CYLES Date Parcel Wad Created m I~ -7 Are all corners identlflable? X Yes No Include with this application one of the Following: - I .Certitied Survey Ntap Deed .Land Contract, or .Other Legal Document which describes the property PROPERTY OWNER CERTIFICATION I (We) certity that all statements on this form are true to the best of my (4r) knowledge; that I il~A am (ii the owner(,4 of the property described in this information form, by virtue of a warranty deed recorded in the Office of the County Register of Deeds as Document No. -$I e) q !J ; and that I (v4) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, 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 Register of Deeds, as Document No. SIGNATURE OF DWNER SIGNATURE OF COOwNER (IF APPLICABLE) Z4 - 7 p UATE bIONEO DATE SIGNED - SAFETY & BUILDINGS DEPARTMENT OF REPORT ON SOIL BORINGS INDUSTRY," DIVISION LABOR AND P.O. BOX 7969 HUMAN RE:-~LTIONS PERCOLATION TESTS (15~ ~r ` (H63.09(1) & Chapter 145.045) MADISON, WI 53707 LOCATION: SECTION: C~ ` TOWNSHIP/MUNICIPALITY: L l NO §K. f~Q,I,!RJBDIVI,1310N NAME: _ / /4 Z3 /T'- N/R/[ ~ L (or y VpJ o!L/ t COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: , 3~ a iX tOIN 'S, ,y~psr v yov USE DATES NS MADE NO. BEDRNIS,: COMMERCIAL DESCRIPTION~ PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence I New ❑Replace e RATING: S= Site suitable for system U= Site unsuitable for system -CONVENTIONAL D: ING_ROUND PRESSURT--t TEM-IN-LDING TANK: RECOMMENDED SYSTEM:(optional) X M S Du ] S ~®S u S as au C~ +1uF~rt/c~,~R/ ~c (,/_~-se2 If Percolation Tests are NOT required DESIGN RATE: t/~C L~O If any portion of the tested area is in the ~r under s.H63.09(5)(b), indicate: 1:265-.5,Q. , to W, P Floodplain, indicate Floodplain elevation: (v/f•iqf~r 3 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 tIF OBSERVED (SEE ABBRV. ON BACK.) p ov, Za CLZGt S ~0 B z a y7c, B- 2 lo,~ Q6 , go Z,s, > /0-0 lz wee mss, ~a'~ Q Qe L C57 B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE. MINUTES I NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD 3 PER INCH J P- P_ 1162 . 3L 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 ~a1)~d percent of land slope. ~0I-j'p/tj QiG 13E,'~ 7''a GiE `,Yi4G / Lt . FT• ~jp t/0_ZU-` r%(A! r Y~~ SYSTEM ELEVATION PO 1k) pt r' r a r cam' &-v,4r/o - . y 3 Y 14 fi E C G Pe R3 ' f Q~ r { ) - ! ~ r - ReP ;.'TZZL 10E-lalle,.l~~.v 56,1vk - - - - - E hFV IVa fi6U vim` . U EXT"o /P-~~ - - ' - 1245-r- (hlbe . y _ .s i - - pl- .2G ' 0 - 77K /4v ~T /(lo,P 4d TZ . i Sir J/~ -or 3 N. -ate l,.P©,~a~1~ /v -~'7` /s ~Pc ~c},~.~►~.f}-p ,'1` P1,,4 C4 V 10,'41-> 6,1r 134~v 7-o AAppo,~. 3~ly' QaAJ /Oha~1~ Wcoo Rxr a"dt, ea- An 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: ~PQh" 7" GAT /Rel.c - -~QC_--7- 3 V P2, ADDRESS: 1111141 Cyr ill! CERTIFICATION NUMBER: PHONE NUMBER(option,il): C sl ,NArl.l HUDSON, 111S. D!S .u. V O'; .,nrl ^ni?1 l0 -/?i P-33 3,95 K, o 41-7444/ytT~ 9 -9 C `-ES LAl~ U ~~„,ner s n,ln,~. t 1) low Location, of building ~crVLd Septic tank Vertical Ieicrcr,ce Dint ltuildiny sewer L -A Horizo n tal .c.1,~1~•nCu lx>int I f i luent system L✓J well I-i o _ l ty l.i„c-s whin ~Q' of _ystem L }teplacc,uunt syste,n urea I , ~P-XCLIPT hS J1iu`~rJ Di si ributiiun boxes 1 ~1 `kale = \ L -I N hump and can Lrol s: Mir, L N,ocrel No. Vertical •Li1 t Size b'orcC A:ain - - - - FXiCtion Loss I'. L. H. Vol. Dist. Pipe v Gal. per Min. Gal. per Cycle place checy mark in appropriate box, indicating item is shown or) plot plan below: l ~~`l1E L-A C..n\l urn 4 "cr • ~ _ _ ~ \ l Opp ~j f\~- . ~u s ~ w ~ ~ S t='~Z S~ C GC- i~ S TIC 1(r,.~ wE2v Wc. ~Y LL.._~. ~ ZDO 1 of Sol t. -l~'TC~ ~t~l~U1t~~ `Ri E T•i~ .ty~, PVG ~ZEti • lv E E C-t-. , 99. sus ` 1- 8~ wh1 1» Tn cL . y~ , $ ~ S. EL `~-1•`d~ -V- "t-f- L.t'rST lop. ~ Q 1v~~ L$l 1/~1~T(\~ ~lU ITT 6L. JO) -oc> , l~ x 3 S' LYE . A wt ut 'd E- iAJ STrnc~ t!S\ opt rS~tu wT,~ c t P~YiU SLVPt Mhfcfil V r_.r o hJA 1-iorc~ sl ue . v~ti v)EWGri d4 ti L . y~ = ~ a, m \ ti M r~ t3 \-t P tL[-V. 100 O orJ ~s~ "1~1- uF C7~T by the granting or apps ovii,y of the above plan, or uLr-)r, the cvcnt of a subsequent permit being issued, s~-cv_w)k Cow,ty a„d t},e sr. Ko,x Count)' Zonirny 3,d,ninistrator, does not assume or hold itself liable for any deiects in plans or specifications, plan omission, exautination oversight, col,-t-ruction, or any damage t1,at may result in or after insta]lation. ~ _ VJ .v t't[. s IJ h C _ CKO SS SECT 101.1 OF A BELL S-'JSTLM t Grz~~_- ~L~L. lOS- S a- SdiL FILL 2 OF HGGREGATC G[ h1~E EL 1o3.0 DISTRIbUTIO►U PIPE-- Sy►JTHLTIC COVE o ";o-- T~ MhTEK1AL DR 9" OF STKA j OK MAKSH F{! J !o OF%Z-21joAGGRCGATE JCHES BCL0I-.1 DRIGWAL GKADC of DISTRIdU7101J PIPE TU fjC AT LEAST 1► uP A,UD AT LCAST20 IIJCHCS BUT 11U MOKC THh%J `i2 IIJCHES BELOW FI►JAL GKADC WC-HES MAXIMUN ULP-I H (,F kXCAVA71o1J FKOM OKIGI►JAL GKADL WILL 6L _ MINIMUM DEPTH OF EXCAVATIOIJ FROM ORIGIIJAL GRADE WILL BC -INCHES