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Home My WebLink About020-1327-70-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and BuRding Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 'ermit Holder's Name: City Village X Township Bodick, Kevin Hudson, Town of :ST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic t 1 ROAD Dosing Friction Loss 25 Aeration Forcemain 77 Holding Dist. to Well TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Friction Loss 25 TDH Ft Forcemain 77 Dosing Dist. to Well Bldg. Sewer Aeration SYSTEM TO St/Ht Inlet BLDG IWEL L ,LQ / Z Holding Manufacturer: St/Ht Outlet PUMP /SIPHON INFORMATION Manufacturer BS Demand GPM Model Number ELEV. TDH Lift Friction Loss System Head TDH Ft Forcemain 77 Dia. Dist. to Well SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: 135 State Plan ID No: Parcel Tax No: 020 - 1327 -70 -000 Section/Town /Range /Map No: 29.29.19.1706 STATION BS HI FS ELEV. PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS A B y e � nchmark Y (a�2 Length Dia Spacing Bldg. Sewer SETBACK SYSTEM TO St/Ht Inlet BLDG IWEL L ,LQ / Z K Manufacturer: St/Ht Outlet Dt Inlet CHAMBER OR UNIT Type Of System: Dt Bottom Model Number: Header /Man. Dist. Pipe Bot. System � Final Grade St Co r i/ L &6 ' 71 3 BED /TRENCH Width Length No. Of Trenches Vent to Air Intake PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS Length Dia Length Dia Spacing SETBACK SYSTEM TO P/L BLDG IWEL L LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR UNIT Type Of System: Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Bed /Trench Center Pipe(s) Topsoil E Yes 0 No 0 Yes Ej No Length Dia Length Dia Spacing SOIL COVER x Pressure Svstems Only xx Mound Or At -Grade Svstems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed/Trench Edges Topsoil E Yes 0 No 0 Yes Ej No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Location: 723 Crosby Drive Hudson, WI 54016 ( E 1/4 SE 1/4 29 T29N R19W) St. Croix Estates 2nd Add Lot 35 1.) Alt BM Description = L + r, -N�►e_ ( r4: LP� 2.) Bldg sewer length = - amount of cover �D 3o T v$ j I 4'sS Plan revision Required? El Yes No Use other side for additional information. Date Insepc SBD - 6710 (R.3/97) Inspection #2: / /_ Parcel No: 29.29.19.1706 Gait nec,� Cart. No. � tiy County Sanitary Permit Application ST. CROIX COUNTY WISCONSIN co In accord with Chapert 12 St. Croix County Sanitary nc ANNING & ZONING DEPARTMENT sp Personal information you provide may be used for secon Law. S. 15.04(1)(m)] ROIX COUNTY GOVERNMENT CENTER $► [Privacy 1101 Carmichael Road Hudson, WI 54016 -7710 (715)386 -4680 Fax (715)386 -4686 Attach complete plans for the system on paper not less than 8 -1/2 x 11 inches in size. County Sanitary Permit # El Check if revision to previous a tion d I. Application Information - Please Print all Infor n Location: Property r Owner Name �+ a oLr { 1 14 i Sec Z N4 T 9 E (o W Property Owner's Mailing Address i l i Ntl C� Lot Number Block Number S -T CROIX 7 2 - 3 L/�DS 8 R • ZONI,jC OFFICE 3 S City, State Zip Code one Numer Subdivision Name or CSM Number ASOV, W I S`10 Galt c,,*: K, €std" 2 4 II Type of Building: (check one) n " 1 or 2 Family Dwelling - No. of Bedrooms: JQ� D`r�q - .a.J— ❑City ❑ Village own of ❑ Public /Commercial (describe use): 1 J ❑ State -owned ,�►,�„� earest Road r b D �f + ✓ �-� II. Type of Permit: (Check only box line A. Check box line B if one on on applicable) Parcel Tax Numb (s�2q � 7.Y, j Q • � 7 0 L� 1. pair 2 4. ❑ Rejuvenation A) Sanitation tv - 3 2 7-- - 000 B) Permit Number State Sanitary Permit was previously issued 31, 3 0 Date Issued D _ ( " Z o00 IV. Type of POWT System: (Check all that apply) a 3 7S T�Q�/i/ �/{ e�S / 2 - ifAcm.69w s iF 6"t, N - Zy X Non - p ressurized In- ground ❑ Mound ? 24 in. suitable soil ❑ Mound <_ 24 in. suitable soil ❑ Mound A +0 1;N ji" ❑ Sand Filter 13 Constructed Wetland ❑Peat Filter ❑Drip Line p ac' �A G ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Other ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating . Dispersal/Treatment Area Information: / 11. . Design Flow (gpd) 2. Dispersal Area Required 3. Dispersal Area Proposed 4. Soil Application Rate (Gals. /day /sq.ft.) / 5. Percolation Rate (Min.finch) 6. System evation r 7. Final Grade Elev i i IT i 5 It- Tank Information Capaicty in Gallons Total # of Manufacturer Prefab Site Con- Steel Fiber- Plastic Gallons Tanks Concrete structed glass New Existing Tanks Tanks 120 0 ❑ ❑ El f3l E 11 11 0 1 El Vll. Responsibility Statement I, the undersigned, assume responsibility for repair / reconnenction /rejuvenation/installation of non - plumbing for the POWTS shown on the attached plans. A license is not required for terralift repair or the installation of non - plumbing sanitation system. Plumber's Name (print) Plumber's Signature (no stam MP /MPRS No. Business Phone Number Plumber's Address (Street, Cit State, Zip Code) (D d v n'f ' l� � u Xra o S / VIII. Count Use Only Sanitary Permit Fee Date Iss d Sign re Approved Owner Gi Initi verse -7 dtj L/ d I Lnt 4 tamps ) Deter ation X. Conditions of Approval /Reasons for Disapproval: SYSTEM OWNER:�� 1. Septic tank, effluent filter and dispersal cell must all be services / maintained as management plan by plumber. per provided 2. All seftwk- requirements must be maintained /t as per applic" code / ordinances. i J: VOAO �j z1 7Z 3A � r 1 1scon6in Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)I. Permit Holder's Name: Bodick, Kevin MANUFACTURER ❑ City ❑ Villag E] Town of: Hudson Township CST BM Elev.:- Insp. BM Elev.: BM Description: r tad � 1 JC_ TANK INFORMATION ELEVATION DATA County - St. Croix Sanitar State Plan ID No.: Parcel Tax No.: 020 - 1327 -70 -000 TYPE MANUFACTURER CAPACITY Septic Ventto Air Intake I Z0 D d . Z 9 Liquid Depth Aeration Alt. BM NA Holdin DIMENSION TANK SETBACK INFORMATION TANK TO P/ L WELL BLDG. Ventto Air Intake ROAD Septic d . Z 9 Liquid Depth 0 v Alt. BM NA D DIMENSION Bldg. Sewer A E e ration SYSTEM TO (D/ Ht Inlet BLDG WELL N HO ding Ht Outlet SETBACK INFORMATION 1-3 PUMP/ SIPHON INFORMATION nufacturer Model Number TDH Lift Friction S stet L oss d Forcemain Length Dia. SOIL AQS�ORPTION SYSTEM TDH Ft To Well STATION BS HI FS ELEV. Benchmark Z d . Z 9 Liquid Depth 0 v Alt. BM S 2_ DIMENSION Bldg. Sewer 1 2 SYSTEM TO (D/ Ht Inlet BLDG WELL ) - _1 Ht Outlet SETBACK INFORMATION 1-3 CRAM UNIT f Type O J Z `' Mo el N m er: System: C�J I 3 Header / Man. h ac, Dist. Pipe 2 /.G Z G Bot. System 4. /L' DL , 2- Final Grade G' ovp i f A, 91P St cover - BED / REM Width Length No. Of Trenches Vent To Air Intake PI No. Of Pits Inside Dia. Liquid Depth DIM 3 S 2_ DIMENSION SYSTEM TO P / L BLDG WELL LAKE/STREAM,-LE G Ma of cturer: SETBACK INFORMATION CRAM UNIT f Type O J Z `' Mo el N m er: System: C�J I 3 h ac, DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length G -// Dia. Length S Dia. Spacing N 4 ❑ Yes ❑ No ❑ Yes ❑ No SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded 1 xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1l /AP/OUInspection #2: Location: 723 Crosby Drive, Hudson, WI 54016 (NE 1/4 SE 1/4 9 T29N R19W) - 29.29.19.1706 St. Croix Estates -�ot 35 1.) Alt BM Description= +? o/° h t*_ h P o 5 a 2.) Bldg sewer length = y e Sd, J bori45, S O - amount of cover co/ 40 a, Plan revision required! Lff Use other side for additi nal i SBD -6710 (R.3/97) / /c 7 � on. Date a- t--d / &W e --e�/ Inspector's Signature Cert. No. Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and quildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). Permit Holder's Name: ❑ City ❑ Villa e [] own o lodick, Kevin Hudson Township CST BM Elev.:- Insp. BM Elev.: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ;� ROAD v � [`p ❑ Yes ❑ No Aeration NA Ing DI Bldg. Sewer TANK SETBACK INFORMATION TANK TO P / L WELL BLDG. Ve Air Air I ntake ROAD Septic � [`p ❑ Yes ❑ No Alt. BM NA DI Bldg. Sewer NA Aerat' f / Ht Inlet BLDG WELL N Holding t Ht Outlet; SETBACK PUMP/ SIPHON INFORMATION urer Model _ N ! er Lift Friction S s Forcemain Length Dia. SO4k AB$,Q. " TION SYSTEM Q Demand TDH ELEVATION DATA Count t' Croix Sanit1659M No.: State Plan IDN N o.: Parcel Ta o 02��1327 -70 -000 STATION BS HI FS ELEV. Benchmark �, Z Inside Dia. Liquid Depth ❑ Yes ❑ No Alt. BM DI Bldg. Sewer l� SYSTEM TO / Ht Inlet BLDG WELL LAKE/STREAM t Ht Outlet; SETBACK ;LEAC BER Type O l I W Model INFORMATION System: ( Header / Man. �_! UNIT Dist. Pipe r — Bot. System c /0 ' ° 412- Final Grade St cover / RENO Width Length No. Of Trenches Vent To Air Inta / ke PIT No. Of Pits Inside Dia. Liquid Depth ❑ Yes ❑ No DI SYSTEM TO P / L BLDG WELL LAKE/STREAM anufacturer: SETBACK ;LEAC BER Type O l I W Model INFORMATION System: ( (i �_! UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipes) x Hole Size x Hole Spacing Vent To Air Inta / ke Length Dia- _� Length Dia. A Spacing Topsoil ❑ Yes ❑ No ❑ Yes ❑ No 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.) Inspection #1: � /� /0Ulnspecuon F/-: / / Location: 723 Crosby Drive, Hudson, WI 54016 (NE 1/4 SE 1/4 29 T29N R19W) - 29.29.19.1706 St. Croix Estates -Lot 35 1.) Alt BM Description= 2.) Bldg sewer length = W - amount of cover = C ,� Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert No. X23 CwsB IA, �VisconS %n SANITARY PERMIT APPUCA ION . �. Qepartmen&f commerce In accord with Comm 83 -0e 1(Yib. Adm. Code • Attach complete plans (to the county copy only) for the stem, one, o less_, than 81/2 x 11 inches in size. F,r; • See reverse side for instructions for completing this ap Ucation q � Personal information you provide may be used for secondary purposes [Privacy Law, s. 15.04 (1) (m)). \ 3 UN� r _ Safety and Buildings Division 201 W. Washington Avenue P O Box 7302 Madison, WI 53707 -7302 u my e Ste Sanitary Permit Number �6 38o9 heck if revision to previous application . S ate Plan I.D. Number I. APPLICA INFORMATION -PLEASE PRINT AM INF R TION ` Property rName PropgrtL c n r l ei ti4t /4, S T , N, R E (or� Property Owner's Mailln dress L er Block Number City, St a Zi Code Phone Number Subdivision Name or CSM Numb r ( ) 11. TYPE 0 F B 1LDING: (check one) ❑ State Owned It E] village Neares ood Public 1 or 2 Family Dwelling - No. of bedrooms Town of , III BUILDING USE (if building type is public, check all that apply) Parcel Tax Numbers) ( 21. 2A. t 77.04 1 ❑ Apartment/ Condo 0 — 1 3 a? - — 74 — 0ZrD 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/ Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/ Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1.0 New 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 Pressurized Distribution Experimental Other 11)0 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 1 1 n 43 ❑ Vault Privy 1-7 14 ❑ System -In -Fill a u �� cX 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 (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft_) (Min. in Elevation 8 Feet Feet VII. TANK Capacity INFORMATION in gallo s Total Gallons # of Tanks Manufacturers Name Prefab. Concrete Site con Steel Fiber- glass Plastic Exper. App New Existing structed Tanks Tanks Septic Tank or Holding Tank -- ❑ El 1:1 1:1 Lift Pump Tank /Siphon Chamber I ❑ ❑ ❑ 1 ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for in ation of the on site sewage system shown on the attached plans. Plumber's me: (P i t Plumb 's Si ur Sta ) MP /MPRSW No.: Business Phone Number: PI m er's A dress ( rget, City, ate, Zip C ): IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate Issued Issuing Agent Signature (No Stamps) .Approved F1 Owner Given Initial Surcharge Fee) I 4, AA- Adverse Determination ,� Ll LZAID IAA A. LUNDI I IUNS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6398 (R. 4199) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRucTONS 9 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Adminr , Five Code will be applicable. 3. All revisions to this permit must be approved by the permit: issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly mZiintained: The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and B- uddings Division,:80&26643151. - To be complete accurate this sa tary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system isto be installed. Il. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information_ Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following'. A) plot plan, drawn to scale oY wiith complete dTrhensions, locatidn'of holding tank(s), septic' tank(s) or other treatment tanks; building sewers; wells; water mains /water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; Q complete specifications for pumps and controls; dose volume; elevation differences; friction boss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; Q soil test data on 115 form; and F) -all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) fora number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishmnof standards. ` r 1 ftsc.orisin Department of Industry SOIL AND SITE EVALUATION REPORT ,abor and Human Relations Pivkifl: r_f Safety & Buildinas __ 11 1 — n — %At :- AJ— / -.J- Page 1 of 3 111 ........1....1.11 1 �I 11 ........... ..1�. , ...11 ....,.... COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but oix ,ARCEt D'*-'. not limited -o vertical and horizontal reference point (BM), direction and % of slope, scale or dimensilll ?red, north arrow, and location and distance to nearest road. pe. =VVifl) ;B z DATE 5A- APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION Bed Trer& PROPERTY OWNER: PROPERTY LOCATI Bridgeland Dev. Company GOVT. LOT NE /4 w SE 1/4,S 29T 29� N,It_4 (or) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # NAME OR,,C ,§M, #' 11736 117th. St. 35 I na and Addn. CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE NEAR D Lakeland, MN. 55044 (6121 985 -5000 r„ Hudson /,`F osby Rd. 9w if .2 [ T- New Construction Use [x] Residential / Number of bedrooms 3 [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate .7 bed, gpd /ft .8 trench, gpd/ft Absorption area required 643 bed, ft2 563 trench, ft Maximum design loading rate • 7 bed, gpd /ft .8 trench, gpd/ft Recommended infiltration surface elevation(s) 94.55 ft (as referred to site plan benchmark) Additional design /site considerations alt. site system el.= 94.2' Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system U = Unsuitable fors stem CONVENTIONAL ®S ❑ U MOUND ® S El IN- GROUND PRESSURE ® S ❑ U AT -GRADE f S ❑ U SYSTEM IN FILL ®S ❑ U HOLDING TANK ❑ S au SOIL DESCRIPTION REPORT Boring # 1 Ground elev. 98.55 ft. Depth to limiting factor +84" Boring # 2 Ground elev. 99.0 ft. Depth to limiting facto 81 Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Baxxlary Roots GPD /ft Bed Trer& 1 0 -10 10 r2 2 none 1 2c 1 mfr cs if n .2 2 10 - 26 10yr4 /4 none sil icsbk mfr 9w if .2 .3 3 26 -29 7.5 r4 4 none is osq mvfr qw na .7 .8 4 29 -84 7.5 r4 6 none ms oSQ mvfr na na .7 €.8 Ulf l 9Y•� �8 Remarks: 1 0 -13 10° r2 2 none 1 2msbk mfr CS if .5 .6 2 13 -38 10yr4 /4 none sil lcsbk mfr 9w if .2 .3 3 38 -88 7.5 r4 6 none ms oSQ ml na na 1 .7 .8 Ulf l Remarks: ;ST Name:— Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 ;400th. Signature: Date: CST Number: 8 -20 -96 PROPERTYOWNER Rri gel and Dev. Co. PARCEL I.D. # pendinq Boring # Li Ground elev. 98.2 ft. Depth to limiting factory +84 11 Boring # :4::;:s::: SOIL DESCRIPTION REPORT Lot #35 Page 9 pf_ 3__ Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Bound3y Roots Bed jTMn6h 1 0-10 1 2 none 1 2msbk mfr cs if .5. .6 2 10 -22 10yr4 /4 none sil m na 9w if np .2 3 122-84 7.5 r4 6 none ms osq ml na na .7 .8 Romarkc- Ground elev. 97.9ft. Depth to limiting factor +84" Boring # S Ground elev. 97.1 ft. Depth to i miting factor +82" Boring # Ground elev. ft. Depth to limiting factor Remarks: l► 1 10-12 10yr22 none 1 2msbk mfr Cs if .5 .6 2 12- 10 r4 4 none sil m na 9w nap ` 2 3 3082 7.5 r4/6 none ms osg ml na na .7 .8 a Ground elev. 97.9ft. Depth to limiting factor +84" Boring # S Ground elev. 97.1 ft. Depth to i miting factor +82" Boring # Ground elev. ft. Depth to limiting factor Remarks: l► 1 10-12 10yr22 none 1 2msbk mfr Cs if .5 .6 2 12- 10 r4 4 none sil m na 9w nap ` 2 3 3082 7.5 r4/6 none ms osg ml na na .7 .8 Remarks: Remarks: SBD- 8330(R.05/92) STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Bridgeland Dev. Co. gSEg S29 T29N - R19w New Richmond WI 54017 MPRSW 3254 town of Hudson (715) 246 L�- lot #35 -St. Croix Estates Second Addn. ✓BM.- top of 1" pvc pipe C el. 100' *Ga. Steel 8 -20 -96 STEEL'S SOIL. SERVICE F . reef CSTM2298 MPRSW-3254 To whom it may concern; 9854 200th Ave. New Richmond, Wi 54017 (795) 246-6200 This soil evaluation was conducted to Satisfy a zoning requirement, it may or may not be satisfactory for your use. The location of the system may or May not be as shown, as permanent lot lines had not been established at the time of the test. Gary L. Steel ST CROIX COUNTY SEPTIC "TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer / �L Mailing Address A /ci Z Property Address — 7 oZ (Verification required from Planning Department for new construction) City /State Parcel Identification Number (}ad — /3a — LE GAL DESCRIPTION -2 29, t q . 1 Property Location N- R_,�LW, Town of Subdivision .��, ✓, ,�_�;� s Lot # Certified Survey Map # , Volume , Page Warranty Deed # ��ZD,Z�,� , Volume 3 ,Page # Spec house O ycsx no Lot lines idcntifiableC� yes O 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 disposaI system is in proper operating condition and. or (?) after mspcctton and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I /we, 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 days of the three year expiration Mic. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION 1 (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 ro erty described above, b vir re of a ��irranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * « «ss« •* Include with this application: a staniped warranty deed from the Register of Deeds office a cop of tl;c certified survey map if reference is made in the warranty deed h r ` 582025 DOCUMENT NO. VOL 1 .316 PQ01 STATE BAR OF WISCONSIN FORM 2 -1982 WARRANTY DEED convcvs and warrants to Keven K• Bodick andl) I. Bodick husbind and wife T �SFER the following described real estate in St. Croix County, State of Wisconsin I_ p �CtiWZet, Lo D _, St. Croix Estates Second Addition in the Town of Hudson, St. Croix County, Wisconsin. This is ntM homestead property (u) Ox not) Exceptions to Warranties: Dated this 12th day of ma , 19 98 . r (SEAL) _ r r AUTHENTICATION Signatures authenticated this day of — -• 19 TITLE: MEMBER STATE BAR OF WISCONSIN (if not, authorized by 706.06, Wis. Stats.) This instrument vias drafted by BridY Dcyelonnwni Company 20141 Icenic Tr. Suite B Lakeville MN 55044 (Signatures may be authenticated or acknowledged. Both are not necessary.) /C�3 �04. REGISTER'S OF E CE ST. CROIX Co., W, s 4" 4 Air itef" JUN 3 0 1998 9:15 A M Rry+•+. of tlrr is ACKNOWLEDGMENT STATE OF MINNESOTA Dakota County Personally came before me, this j2lh .day of May 1998 the above named Neal Krzyzanilk to me known to be the person who executed the foregoinnginstrument and acknowledged the same. *Darla J Bauer Notary Public DakQt . County, MN My commission expires January 1, 2000. .,288• DARLA J. BAUER MIARY PUBLIC - MINNESOTA DAKOTA COUNTY + My Commission Exp'ras Jan 31, 2000 r r } V x' R r r r i C ' I` I 11j Ini 10 -6 jc p ,00'681 C 4 A e r 10 =8 O fn = a (7i �m O 0 W r z m 8 m � z 8 cn 'n M 3 v O m U) m N n N U O g U) OD l0 1P W -P E g 3 2g �r- Ij> 12 tics I L7 W N co W O N OD — N D N f7 �m o m N r o 6oZ- I I 1 � ® I I N i'o F ~ 00 W 1 obi n ) O S 1 Nm O W O ~� n W � O r N N O N D (7i N m 0 �o p o m � N cn 'n W 3 v .k �O i CD N W� r W O D � W F �s 90w 4.00s / / (7) W _ gy GJ N O � " ,et 96£ M „b£,9£ I I I I a � z r o N OD !� W ro N W W W O D ,61'OLZ 3 „b£,9£ ? N r n n W � �. 1 °�1 �m Nm � 1 � 1 \ 90w 4.00s / / (7) W _ gy GJ N O � " ,et 96£ M „b£,9£ I I I I a � z r o N OD !� W ro N W W W O D ,61'OLZ 3 „b£,9£ ? N r n onsin Department of Industry SOIL AND SITE EVALUATION REPORT and Human Relations rf Safetv & Buildings l Horizon Depth in. Dominant Color Munsell Mottles Clu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD /ft Bed Trench 1 0 -10 10 r2 2 none 1 2c 1 mfr cs if n .2 2 10 -26 10yr4 /4 none sil lcsbk mfr 9w if .2 .3 3 26 -29 7.5 r4 4 none is OS9 mvfr qw na .7 .8 4 29 -84 7.5 r4 6 none ms 0SQ mvfr na na .7 .8 r � SOIL DESCRIPTION REPORT Remarks: Boring # r7 � f B {: u f � t :�`•':ba:w Ground elev. 98.55 ft. Depth to limiting factor +84 Boring # Ground elev. 99.0 ft. Depth to limiting factor +88'1 1 0 -13 10 r2 2 none 1 2msbk mfr cs if .5 .6 2 13 - 38 10yr4 /4 none sil lcsbk mfr 9w if .2 i 3 38 7.5 r 6 none ms 0scr ml I na na .7 .8 [ T- New Construction Use [x] Residential / Number of bedrooms 3 [ ] Addition to existing building ] Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate .7 bed, gpd/ft •8 trench, gpd/ft Absorption area required 643 bed, ft 563 trench, ft Maximum design loading rate • 7 bed, gpd1ft .8 trench, gpd/ft Recommended infiltration surface elevation(s) 94.55 ft (as referred to site plan benchmark) Additional design / site considerations alt. site system el.= 94.2 Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system U = Unsuitable fors stem CONVENTIONAL ®S ❑ U MOUND ®S ❑ U IN- GROUND PRESSURE ®S ❑ U AT -GRADE [2 S ❑ U SYSTEM IN FILL ®S ❑ U HOLDING TANK ❑ S [�U Remarks: CST Name: — Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. Ave. Signature: Date: CST Number: 8 -20 -96 Page 1 of 3 111 "VVVIV ••I \II 1"1 11 l VN.V�q •.IJ. / IU111. VVVv COUNTY ,H -c: nplete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but r ;- • oix 'P CELAD. #�-4 j gy p`' o vertical and horizontal reference point (BM), direction and % of slope, scale or ;', alV ,,QP �`ad, north arrow, and location and distance to nearest road. % : -' '' a., pe APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION REV,EVVp ?6r s DATE PROPERTY OWNER: PROPERTY LOCATI Tor- Bridgeland Dev. Company GOVT. LOT NE cE 1/4, S .29T 29 ,N, (or) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # NAME pla;C§ #' 11736 117th. St. 35 I na k'djx %i; to and Addn. CITY, STATE ZIP CODE PHONE NUMBER []CITY ❑VILLAGE r . _ ` % NEAR NOAD " osby Lakeland, MN. 55044 (612) 985 -5000 Hudson ; e ; -. ,, Rd. [ T- New Construction Use [x] Residential / Number of bedrooms 3 [ ] Addition to existing building ] Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate .7 bed, gpd/ft •8 trench, gpd/ft Absorption area required 643 bed, ft 563 trench, ft Maximum design loading rate • 7 bed, gpd1ft .8 trench, gpd/ft Recommended infiltration surface elevation(s) 94.55 ft (as referred to site plan benchmark) Additional design / site considerations alt. site system el.= 94.2 Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system U = Unsuitable fors stem CONVENTIONAL ®S ❑ U MOUND ®S ❑ U IN- GROUND PRESSURE ®S ❑ U AT -GRADE [2 S ❑ U SYSTEM IN FILL ®S ❑ U HOLDING TANK ❑ S [�U PARCEL I.D. # pending Lot #35 Boring # 3 >t SIN Ground elev. ►8.2 ft. Depth to limiting factor +84 Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots G' Bf , r6 1 - 10 r4 4 none 1 2msbk mfr Cs if np .2 .6 2 10 - 22 10yr4 /4 none sil m na gw if np .2 3 122 7.5 r4 6 none ms Osq ml na na .7 .8 Remarks: Boring # rw,'. Ground elev. 97.9ft. Depth to limiting factor Boring # Ground elev. 97.1 ft. Depth to i miting factor +82" Boring # ik •ta:, •; 3cE :i Ground elev. ft. Depth to Nmiting factor 1 0 -10 10 r2 2 none 1 2msbk mfr cs if .5 .6 2 10 -29 10 r4 4 none sil m na gw if np .2 3 29- 7.5 r4 6 none cos OSq ml na na .7 .8 k Remarks- 1 none 1 2msbk mfr Cs if .5 .6 2 12 -30 10 r4/4 none sil m na gw na :,pp .,.2 3 30 -82 7.5 r4/6 none ms osg ml na na .7 .8 Remarks: �w- aNNIMPINIFEW 'A. W OOA OO 0 ". Remarks: SBD- 8330(R.05/92) rnurcnirvvvvov o-L-LuWt---L PARCEL I.D. # Pending Lot #35 Boring # Ground elev. ►8.2 ft, Depth to limiting factor +84 Boring # r Ground elev. 97.9ft. Depth to firwong factor +84 Boring # 0 Ground elev. 97.1 It. Depth to limiting factor +8211 Boring # C- I Ground elev. Depth to limiting faft Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont Color Texture Structure Gr. Sz. Sh. Consistence Bourrivy Roots A G B( F, 0-10 10yr2/2 none 1 2msbk mfr CS if np:: .2 2 10-22 10yr4/4 none sil M na na if n 3 122-84 7.5yr4/6 none Ms OSq Mi - 9w na na .7 .8 P Mamnkle- 1 10-10 10 none 1 2msbk mfr CS if .5 .6 2 110-29 10 r4/4 none sil M na gw if np:: .2 3 29-�M' 7.5vr4/6 none cos I OSq 4 na na .7: .8 SRI MP,,A a- —41A P Remarks: Remarks: Remarks: SBD-8330(R.05/92) �M- SRI MP,,A a- —41A P Remarks: SBD-8330(R.05/92) 1 PF STEEL'S SOIL SERVICE Gary L. Steel Bridgeland Dev. Co. MPRSW 3254 NE4SE4 S29- T29N -R19W town of Hudson I lot #35 -St. Croix Estates Second Addn. N 1 "= 40 ' BM.= top of 1 pvc pipe C el. 100' 1554 200th Ave. New Richmond, WI 54017 (715) 246 -6200 N GaL. Steel 8 -20 -96 X All� Aa OF 9'1 OA J�y�.C�q�C� (r3 �i.55.� fd r '41 7, A � 1 I I, Mike McDonell, inspected the septic system and leaching trenches at 723 Crosby Drive. I found the tank and leaching system to be working properly. All baffles and trenches were up to standards for fullest waste water flow for a 4 bedroom home and meets all set - backs. I connected a 3034 "TY" and 25 feet of sewer line to the temporary trailer house and will disconnect when called. The homeowner has agreed to insulate the above ground pipe for frost protection. I Mike McDonell, MPRS #223056 1070 Hunter Ridge Hudson, WI 54016 1- 612 -865 -1927 (Cell) 1- 715 -386 -8692 (Home)