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HomeMy WebLinkAbout020-1404-09-000ST. CROIX COUNTY ZONING DEPARTMENT No7"� AS BUILT SANITA Owner W A/j l/.4 S �',i Cit }'i,State _�GvOSD.v G�9 /• s `�f>/ � EIVED s (Jz( Ix u( r; ZONU,' OFFICE / &je /r//W— / 0 6WZ - Legal Description: G9C�tJ Lot �_ Block Subdivision/C"Sf** �� 4v 0 S '/� '/� 514) Sec. 2 , T_�tN -R_�9 W, Town of # VPSOAJ PIN # 0 - • 10 F3 •30• �� Tank manufacturer Pump manufacturer Alarm location ,AU1ktTAyL` A ° i1VLL11\ V 1 L11 \ 11. 1111' V1i 16 75o 5'e.2 Size ST/PC / Setback froth: House Model IA 11V1r (p ;/i� L _ Well P/L (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Meter location Alarm location New � . M� ZwAv X GD.N 57 - ;o vr,77a v Water Line SOIL ABSORU TION S M: rA Type of system: Width 3 Length 76 Number of Trenches Setback from: House 7d Well A)/, P/L _/2 Vent to fresh air intake } 50 ELEVATIONS CsTs Description of benchmark 1 7` Description of alternate benchmark �_� TuN 0 5� �,vGlnO 13 M # - ra or 69o#•e Building Sewer _ G ! STAIT Inlet PC Bottom Distribution Lines ( Bottom of System( ) Final Grade ( ) 0 30 3 f' i l Elevation /CTZ� •� Elevation I?•. /T / oD, yd/ PC Inlet y� Y ss Date of installation / / Permit number State plan number Plumber's signature License number 2'2� 3 7 Inspector X:?/V/ y I q/14— Date / / tioU• 3-,)vv Z complete plot plan « Zvi e l31oh/{rvsi�e 4�,Z5 -- ST Outlet Manifold Top of ST/PC Man Ulbricht & Associates Private Sewage Consultants 655 O'Neil Rd. Hudson, Wis. 54016 WO • 74 c0T/G , � I O Z: Zt/..„ \ NS \ V) IV , ...„, ... Hi; pl N A`�, ti ,, . ,.,_ ,,, N, ,. 7 w , a. QQ 1 \ i , I,i \ 1 N ), xc _ -k • Q --{ O 1 `ram -" .ram \ \--.1 / J - 4-7 ...--\ lb\ .._ ,_ , ‘C ,---"A - ' [ Oq ...-' .."" cr IQ Q , lA , _ _ - — 3 - [ __ r-s-- -<-10115 -v-1 \----4 k$3 1 0 W 0 VI N 013 &I t # V NCO .Ci I � xm Hil1/4 $8 (2) ) 00 x Z�, • , , vt. „, , mco E.r_D ) k i Z: - ) r: Z 1/41) tn) r) \ 0_1? ____ ___ _ _, c\-, t. L______„=„ 0 . _ z .0 1 tai ,..„, o ,,,- „, ,, r Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division P INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village x Township Midwest Construction Hudson Townshi CST BM Elev: Insp. BM Elev: BM Description: D System Head Aeration TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic f ROAD Septic W b t S 6 1 V_' System Head Aeration Forcemain Length Holding �r TANK S ETBACK INFO RMATION -!j S v zbF . * 3) TANK TO P/L WELL 0 G. Vent to Air Wa e ROAD Septic ?� r System Head TD Ft Forcemain Length Dosing �r Bldg. Sewer �al•ST Aeration St/Ht Inlet Holding St/Ht Outlet PUMBA80PHON INFORMATION Manu acturer BS Demand PM Model Num ELEV. TDH Lift ction Loss System Head TD Ft Forcemain Length Dist. to Well SOIL ORPTION SYSTEM RENC Width a I D S -� (� SETBACK SYSTEM TO INFORMATION Type Of System: DISTRIBUTION SYVEM ELEVATION DATA County: St. Croix Sanitary Permit No: 420455 0 State Plan ID No: Parcel Tax No: 020 - 1404 -09 -000 STATION BS HI FS ELEV. Benchmark o.yv Top To soil I Yes No i *0 � r Alt. BM L Ia pacing Bldg. Sewer �al•ST St/Ht Inlet St/Ht Outlet Dt Bottot Header /Man. Dist. Pipe Bot. System Final Gra e 9, q t 89.6 �- St Cover 4 �y g�- Ts' I No. Of Trenches PIT DIMENSIONS No. Of Pits iS r P/L IBLDT IWELL LAKE /STREAM I LEACH CHAMBER OR T eoi 0 f j UNIT Model NumbeV /•,,, r/ Depth Header /M�a d Distribution x Hole Size x Hole Spacing Vent to Air Intake �• 1 1-ength ipes ) Top To soil I Yes No i *0 � r v Dia L Ia pacing 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 I Bed/Trench Ed es g I Top To soil I Yes No i Yes [] No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: 31, / Z$` Z" Inspection #2: - t - --- Location: 429 Jack Pine Drive Hudson, WI 54016 (NE 1/4 SW 1/4 29 T29N R19W) Walden Woods L oL9 1.) Alt BM Description = 2.) Bldg sewer length amount of cover 4 R'red e ? Plan rev sl Yes XNo r ! Use other side for additional Information. _____ a Insepctor's Signature SBD -6710 (R.3/97) �Ysf -t, 4 irJh►Srf -� � � -- '1`o-•. (A) CBS k,-- Cert. No. —p-me paN ve me uoeery owly for me ryftefn an paper net less man ern 111 taeaea IN th SBD -639$ (R. 05101) Safety and Buildings Division cry 57 Cieo� N visc , onsin 201 W. Washington Ave., P.O. Box 7162 Madison, WI '53707 - 7162 Site Add De artment of Commerce o - 7 -4 Z: 3 �pOo9 7 Pfd t>� San Permit Application Sanitary Permit Number L Lo �� In accord with Comm 83.21, Wis. Adm. Code, persorwl Information you vide E C' E B �teck I Revision Lay be used for second purposes Privac Law, sI5. I m 1. Application Information - Please Print All Information 17 . � State Plan I.D. Number ;/ 'A /T Property Owner's Name M101,v�5 T Covs77��t�T"��� % ry �, 4wivel Nu ber cF <oix c �j 7 Property Owne Mailing Address � � r A Q . /-� 0 X- y � 2 � �Eo erty lion e d yvfG ,7 � y L7 / ! Si :; S T N. R B City, State Zip Code Phone Number 6 Lot Number 9 Block Number r V►D (0� 4W. S' (�/D // ws7 . 76 Q • Sub division Name CSM Number CvA - /DES tc900D S II. Type of Building (check all that apply) 4 IL r 'tr 5 wry DCity I or 2 Family Dwelling - Number of Bedrooms []Village U Public /Commercial - Describe Use W- ownship V SO p ❑ State Owned �S )n,, (sex r,1 n D Nearest Road /� n 7A CK III. Type of Permit: ( eck only one box line A (numbering scheme for Internal use). Complete line B if applicable) A. 1 New 2 0 Replacement System 3 11 Re of 6 I Addition to For Ceunly rue System Tank Or 14thig System B • 0 Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that opply)(numbering scheme is for Internal use) dD 44 Non - Pressurized In- Ground 2111 Mound 47 0 Sand Filter 50 0 Constructed Welland . 22 0 Pressurized In- Ground 41 Itolding Tahk 48 0 Single Pass 510 Drip Lim 45 1J At -Grade 46 0 Aerobic Treatment Unit 49 0 Recirculating 30 0 Other V. Dix ersal /Treatment Area Information: Design now (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(GalsdDaysistITI.) (Min./Inch) Elevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass wles& -- R - New Existing Tanks Tanks I Of Septic or Holding Tank J � I r� e J 7 / ,` • Dosing Chamber VII. Responsibillty Statement- 1, the undersigned, asstmie responsibility for Installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Sltnalre - ktP/MPRS Number 2- 3 �S Business Phone Number w 7 /S• ?kw /o Plumber's Address (Street, C Code) �U�SD� �/• S 7 �� �i . VIII. Count /De artment Use Onl Y4 Approved 0 Disapproved ' Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) 0 Owner Given Initial Adverse Surcharge Fee) Determination �— U. Condittonis of ApprovaVR�r Disapproval —p-me paN ve me uoeery owly for me ryftefn an paper net less man ern 111 taeaea IN th SBD -639$ (R. 05101) , , , . . r , ,or 4E7 ? k4I SYSTEM SHALL \ THIS POWT PER CHAL \ INCORPORATE POPER ZABEL \ FILTER 44( )c MODEL# f'�M -' Aro j ,j O nd s1'9 we 4 = <o v 6v/e 4' -e 0 r re • 1 o ie ,, , /ce,,5 yd , , l'5 p , , 1 id i65i t- o Cvi4- -, Nt 5T Q 5 YST � _oec, . / , . 27._ _______La...„_________ _______. , J o _ _ _ _ _ _ _ _ ice 4 __ le' _ 9yo y° � f- - - - - - - - -1- 3'X 7.3 �11,0 , ` ' 7,o P� & �I4cMEN� A aD��I y £.,- 8 5 /30re5 - 76.0 ' .t-i SV lc- : \IN . . C S 7(C ,b1 .0_ )m I$\* r? of 5T e_ f :Alc re 5 7— h x !(t". 1. ' LL3T-IICI-11- & ASSOCIATES CO. 655 �J'Neil, Road • F IudsOn, WI 54016 Peg..Designers of Engineering Systems 715 366-a 165 Private Sewage Consultants PROJECT INDEX ,l97' PLAN ID if /V �� ' DATE 7D • OWNER "'PVt 5 T 40A, S TrIC'('C T/6-J PHONE 7/5 • es p 2. 7, ADDRESS A a• dor 132_ !T(,z2So ) /• syo/(! LEGAL DESCRIPTION �f �4/��'v '�ooPS NI 02.0 • /OJ3 .30• o" , See, sec. 1-f. T.2.y' iP /y &c I • TOWN OF #0D.So� 5 • `Z6(•}. COUNTY CSTM '". T aAffsD 4' - 360 Z LOCAL AUTHORITY/ SUPERVISION 57. G/D/x �j`t , �U.4",.;v PROJECT DESCRIPTION! M� cD,J svpacr/0� — f/� 4- / /9O y /7 Af . S � z.z�3� S. MPS ai r 2i/b 1 C i r Ulbricht& Associates Private Sewage Consultants 655 O'Msil Rd. Hudson,Wis. 54016 G * e- — /f1 -2(1 401' iVE/�S/e V y� S s� �-1�(_ -" S� � T-140,/ /I�.�I.S . l�d / 'l�9Tc GGl S . M Pg. l INFILTRATOR SIZING WORKSHEET Pg . 2 SYSTEM PLOT PLAN Pg. 3 CROSS SECTION OF SYSTEM, WITH ELEVATIONS. P g. 4 " 11 II Pg. 5 OWNER MANAGEMENT PLANS & ZABEL FILTER SPECS Pg. 6 (OPTIONAL) CROSS SECTION AND SPECS FOR DOSING TANK. PG. 7 (OPTIONAL) PUMP PERFORMANCE SPECS. The attached plans and specifications are based on "In-Ground Absorption Component Manual For Private Onsite Wastewater Treatment Systems . " (Version 2 . 0) SBD-1075-P(N01/O1 . \\ -1`) i .-k-1 o Gam :)‘1 I z�roe ° zox I la ‘.1) \ en m o N \ kij -.11/4,c) . 0 iv `y1 1; 7 k, ,. ULI C N i � c - \ w � Ni ..%\. VI x % oo t -A \-----N ct‘ "--• \--a -1\--k 3 _\ J \ CY_ . \ - ,- - -- � � li �1 k - - . , Ic, �� --o w o -- c - 2 oil s OO .- '15, --''' \S=.1 77 . "..• — ---k ...?') -- *N 1/4-A i \ L../ .. 0C3 \ kA) ?‘ -6 -63 -° m _ � o O, r- D m ?� c -v ca, D V u1h -�, 7 1 mom og C) (>2-1 (N l4 .)...4 '', vj c t. Crl -I N..sllh o w o i k c. K.> V1 Q y � 14Q `I N1 N oi s!/) - rt /0 Ni ) t C o \ c.. V w (xi• 1,) / ) - ---1 C z I . . . . , , ,.0r4r W� G jE-4) V0005 l'...- THIS POWT SYSTEM SHALL PER N COMM INCORPORATEA PROPER ZABEL. FILTER MODEL# M 4- /� ee 5C41/k-; / 30 ieo paste 0 well-) ' = f3Acx- e pt i S 4 = 41,c) 66,/e zi:u-e 0 r '' /41 -4 r e , i o /'' ,0 /c6,5 yd . i 115 p , , 1 s„.) N i 65 it) 0 \ . ,id - s- SO r/c r, Ni .k 6111 e° . 0 t --.....„...„.........:,. , ,,, .---, IN. .' W‘) -e-7-__€ ee , ?,D� 9/,o r za' 5 - k. ,or ii, 1 , 0c( , / , . k. 1; #.1-_, .,----c__,_-_-_-_-1 ___'_ _ ___-,-T-7_, , 6 ,_ L__. . b ° - - -- T-47 - ---4° • -------- 4 '74'"° /- i-v -- - - - ---G�- -�`b gyp -a- -Ti_- -- -- -LI a- - _ Q ' ` 3(X73 ' y) y2.0 i 790 z- APP aem/ P RE /4C k1FN7— 0 PO, ec.4-- 85 fie re 5 ray Y E . 96.0 1, ' AI/ ..----- --m \ cQ/H r c 2 k r? ©r S re z fE�/c 0/o S T_ h 57f7 I x 1 -,• LMICI-IT & ASSOCIATES CO. 655 O'Neil, Road • Hudson, WI 54016 Deg Designers of Engineering Systems 715 386-81 a5 rrivale Sewage Consultants PROJECT INDEX r 3 a -- PLAN ID # /WA DATE 1 Z--- OWNER Alf"A y r Go.49 s 7',E'vc T/5-J PHONE '/6 e' O . 7, ADDRESS ALP doe 13a //I vs /di• 590/4, LEGAL DESCRIPTION zOf y �'9/DZ''v �oaPs' Ns) a 2.0 • /D,3 .3o • o"-a N E, Sty, Sec. i�. ,p if 6(1 • TOWN OF #opsOA> Sri• 4i•}_ COUNTY C S TrI •? D-4-ff5 2-(-1 if 36,0 Z LOCAL AUTHORITY/ SUPERVISION 57• G'/x PROJECT DESCRIPTION: ,BEV) co/0 S772JC71O,0 — 2 4- /0"-e,O S� y /144't • 1-*vt•e_ /WY ROB grr- Ulbricht& Associates te Consultants 655Priva O'M9Sewageil Rd. 70 Hudson,Wis. 5�d016 �- S0 i4 .�T_/fv y 4 IS . o �I S M Pg. l INFILTRATOR SIZING WORKSHEET Pg. 2 SYSTEM PLOT PLAN Pg. 3 CROSS SECTION OF SYSTEM, WITH ELEVATIONS. Pg. 4 " Pg. 5 OWNER MANAGEMENT PLANS & ZABEL FILTER SPECS Pg. 6 (OPTIONAL) CROSS SECTION AND SPECS FOR DOSING TANK. PG. 7 (OPTIONAL) PUMP PERFORMANCE SPECS. The attached plans and specifications are based on " In-Ground Absorption Component Manual For Private Onsite Wastewater Treatment Systems . " (Version 2 . 0) SBD-1075-P(NO1/Ol . • Ni 'o -- j) V , ''\ I r . o W' 1. .' filrfri I 1.\ N IRBIL- I k\, Min O ` l' NA, 1 [ , V 1111111 1 k (ii f • . IA fi iit--I! ,zN /t mull _ a MIA— 1 o e --1-- "Tv __ 1 0 Mu] n - \ a) flhIDL- itfihlU 11), 1 A ' - a 1 ). (,,, L . -`/ C. 7''' nrrnn� n mr-„,,,,T, z.\ .......I i.4.4 ss:. 16 'ri >6 ( . • -4, Ne-1 w, •N A .,,i . ,1 k, N Z k 0 -1 , , '2 ti- \a' N\n 41 , . T ), o i ,/_ , _., <y O \ .) ,, , I ) . tic( 7t, N r r . , , . . , o T 4 � 04 G'EV VODD5 1[ THIS POWT SYSTEM SHALL INCORPORATE PER COMM. N B3.44(2)c q PROPER ZABEL FILTER MODEL# N,� ' �0-0 -- 4 = 4a v 6v/P zi;uz 5 0 r , p tA e . I / 6 -0. ° / --,. /: g C 5 5 r� P .os \ / �'P Cvi'eSe1' IO,,ceeKe 9�i 5 i 9 — if t, sly/ ', 4 A c��/ 6 "y C � i o I-� -- -- - -- 1G- -"O gyp • �_ 1— — — -- — - -- — _- -'- Q 3(x--73 ( 2,0 , IP y a 90,o s vs T • k to? orSre- z f :,41c leOSI X 0 1)ATt-i0A) , /9 /51`yNE t'c ° u C0�' VO O . p1AP q i,P,o,� of C-e a nokI 0 iv 1 , .v ANyootp VEo 7- CA/0 1 i ,v ,,vs'/EC T/o v //1, AIM!. :a , iff J 1/// ► 1 - yc Ito / . 01 I -. _ir-r., ',.:5__IFjib - ' 1 • t, I/ z v'il Rai�(' D 7-/t6 E,W4 ,-z, S y S T1 A4 , ei/v, 7. .o OM 5S S E cT/OA) OF T43E4)C S 11$/f 6- . -rj L 7 '/t-r-- 5 .O R /3/ O Pi f f UsEl S ; hip. 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'' z_ v 6- Gv id it 3/- / s Ql Fr To T4 L /)4L S C Tic'•v ii ' --2-- ,v ,Ns/Ec T/o,cJ //-+e. ,►",,v. ,2 M /V, 11 1/G7x4Ta ',I 5a 4. ia --2_____ ,;(11,41:5 4//: ,5:.0 . --lac -I-- r - - ------- . ,.,--- -# , /1< /, MtiiAi; i ''� ,' z k Wi- /P'1 D Tile S S '4 TE y eiv, / O pi 5" All' i9 151 A-'cE d C pim - D 1 t 0� . .--- q --.. ,' ream of crele SP g� y�� ..�(f 0 `� -- TJi,) f , 4Pp tp v0T c,'/' , p P i , 'V ,,)s,EC T/o,) /V e ,Ain/. /1- ' iff I v// , l -�z, F,N/S 1/ED , 1 5C'. 10 yyo c N 9�'�4f�L: n 1 - THE Ca 12, 1 4 ,-,-_-,:_ -- 1,:.#.: 7-ff g r- „ ,/ ti9• , .9--, 10744 -. . 11 --!r4---r. , C , - y CA70 SS 5 E c TioA) of: 7-4364)C (s 2/$i ) 6- To,F'S .oR /3iOD(*ffUsEiP5 4. ///)A CPI/i40I y '5-i,J �v/.ive xo •/ ,y ODEL. , . 3 ')Y 6 'a ,' L ' - Gv q2, 3/, / SG?, Fr: TO 74 L p-A- s c 7 (1 ,.� ANVO rtP VEti 7- c,4/' -� ,v ,WS/EC T/D ,) / , • "AL /2 '' iff 1 I;/, sci. 40 9iP/99L= N 1 h- t j 4.m3sverw . 4 :,..-74-,:uhi y_ _—_,41 r— ,...—.7----- ass .. _►' -ice= 147,-_-LA ;ii-iii.,:.. 4«��7- /e4VtD T/eC , s ys r7A OOWNER ' s MAINTAINCE OF SEPTIC SYSTEM POWTS (landowner ) is reponsible for proper operation and maintenance of this system. Regular periodic inspections and servicing is necessary for the safe healthy operation of. this system. The owner is required by code to submit all necessary maintenance/inspection reports to the controlling ,authorities. SPECIFIC CONTACT AGENTS 57. G/'D/X • C77' 2d �iV�r'— * Governmental authority/ inspectors : �O 36 y� J. * Licensed installer , responsible for providing an operation/ maintenance "Users" manual : 7/s• 3 �G • PiP5 f�. 2c���i r �"r�s .746 zzte3 —7S * Licensed servthce / inspection agent other than installer : / -4 ��v NoR6A! 3 t ( /3 0 * Electrician, for pump, electric controls , wiring units : N/ A— IMPORTANT OWNER MAINTENANCE RE UIREMENTS 1 . Winter. traffic (sledding, shoveling; etc. ) across the area shall not be permitted, or frost can/will penetrate into the cell , freezing up the system. Discontinuos use in the winter (a vacaction trip, resulting in no water use) can also lead to freeze ups . 2 . Water conservation needs to be exercised ! Or system can be hydrol. i.cally overloaded and destroyed . This syslrem was designed for a maximum wastewater flow of 7 5-6) gals . daily. 3 . POWTS are not designed to accomodate wastes from a garbage • • disposal unit , or any other unnatural sources of waste . Any introduction of such waste materials will overload and destroy this system. 1 . If a power outage occurs , or a pump' fails, it may : result in a temporary overload of effluent being pumped into the cell , which may adversely impact the cell (leakage ) . It is recommended that a licensed pumper empty the dosing tank, allowing the pump to return to dosing the correct amounts . consult your installer immediately for advice. 5 . Neglect of the vegetative cover on & erosion preventive ) can lead to' failureelcompactionlsior heav traffic also can destroy t he system. It IS NECESSARY TO y REGULARLY WATER TUE VEGETATION OVER A SYSTEM! ! Effluent in the system beneath IS NOT sufficient alone t0 maintains a grass cover. 6. Periodic inspections by the owner , necessary. Inspection pipes and ports have abeen8incorporated into the system: on the mound basal area level inspection pipes ) , cleanout terminals on thefluent pressurized. laterals , at each tip - for flushing and cleaning the laterals out . The filter system in the tanks (via a locked above ground cover/manho.le person cover/ be ) • Only a licensed properly quali6ied performing this work which involves health & severe safety risks . Evidence of effluent ponding system 's treatment cell shall also be regularly inspected. /D-9 Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference pant (BM), direction and - percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. 020 -1( Please print all informa _ tion. R eHred By Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). T 1474 Page 1 of 4 A.C.E. Soil & Site Ev aluations Croix ID #29.29.19.334C Date OrA-, A Midwest Const. & Development Of Hudson„ INC. Govt. Lot NE 1/4 SW 1/4 S 29 T 29 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# P.O. Box 932 9 Plat Of Walden Woods City State Zip Code Phone Number . j City j Village 01 Town Nearest Road Hudson WI 1 54016 1 715 - 760 -114 ' - 1 dson Glenna Drive W New Construction Use: it Residential / Number of moms 14 � design flow rate 600 GPD Replacement Public or commercial ribs �V - Parent material Glacial outwash F and lain elevation, if applicable na General comments (� and recommendations: Install 2 trenches using 29 hig cityQif�t�t �i f et below grade at elev. = 92.0' & 91.0' on 96.0'& 95.0' contours. D��ff''�f,�o 6 Property Owner Property Location C M Bones # im � _ � �I Application Rate + Pit Ground Surface elev. 96. /' ,� iting factor >98 in. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIft *Eff#1 *Eff#2 1 0 -18 1Oyr3/2 none sl 2fsbk ds as 2f,1mc 0.5 0.9 2 18 -34 1Oyr4 /4 none Is 1msbk ds a 2fm,1c 0.7 1.2 3 34-66 1Oyr5 /4 none s 0 sg dl cs if 0.7 1.2 4 66 -98 1Oyr6/4 none s Osg dl - - 0.7 1.2 0.7 1.2 17- -D Ss • Z lij 01 Boring # Lj Boring Pit Ground Surface elev. 96.28 ft. Deoth to limiting factor > 95 11 in. Sal Application Rate orizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD 1ft *Eff#1 *Eff#2 1 0 -16 1Oyr3 /2 none Is 1fsbk ds as 2fm 0.7 1.2 2 16 -30 1Oyr4 /4 none Is lmsbk ds cs 1fm 0.7 1.2 3 30 -44 1Oyr5/4 none s 0 sg dl cs if 0.7 1.2 4 44 -95 1Oyr6/4 none s Osg dl - - 0.7 1.2 Effluent #1 = BOD 5> 30 < 220 mg1L and TSS >30 50 mglL #2 = BOD < mg/L and TSS <30 rrg1L ;ST Name (Please Print) Signatu / CST Number 3602 James K. Thompson _ s kddress A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 5402 9/15/01 715- 248 -7767 property owner. Midwest Const. & Development Pared ID # 020 - 1083 -30 -000, ID# Page 2 of 4 3 Ong # Pit Ground Surface elev. 92.64 ft. Depth to limiting factor — > 94 " - - in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 1 0 -29 1 Oyr3 /2 none Is 1 fsbk ds as 2fm 0.7 1.2 2 29 -52 1 Oyr4 /4 none Is 1 msbk ds cs 2f,1 m 0.7 1.2 3 52 -79 1Oyr5/4 none s 0 sg dl cs if 0.7 1.2 4 79 -94 1Oyr6 /4 none s Osg dl - - 0.7 1.2 1.2 9 0 ? .3 j�lct � ,33(o Horizon #2 contains approximately 30 s . - 5(, Gs/ 67-6 �l /►o . Sz s F4 Boring # ig Pit Ground Surface elev. 91.87 ft. Depth to limiting factor >90" in. Sal Applcaton Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP_Dtlt? *Eff#1 *Eff#2 1 0 -30 1Oyr3 /2 none Is 1fsbk ds as 2fm,1c 0.7 1.2 2 30-43 1 Oyr4 /4 none Is 1 msbk ds cs 2fm,1 c 0.7 1.2 3 43 1Oyr5 /4 none s 0 sg dl es if 0.7 1.2 4 60 - 90 1Oyr6/4 none s Osg dl - - 0.7 1.2 ? .3 j�lct � ,33(o Horizon #2 contains approximately 30 s . F- s Boring # Boring Pit Ground Surface elev. _ 91. ft. Depth to limiting factor >89" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP_Dtlt? --- *Eff#1 *Eff#2 1 0 -23 1 Oyr3 /2 none Is 1 fsbk ds as 2fm,1 c 0.7 1.2 2 213 -32 1 Oyr4 /4 none gr. Ifs 1 msbk ds cs 2fm,1 c 0.7 1.2 3 32-64 1Oyr5/4 none s 0 sg dl es if 0.7 1.2 4 64-89 1Oyr6/4 none s Osg dl - - 0.7 1.2 ? .3 j�lct � ,33(o Horizon #2 contains approximately 30 s . * Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS <_�0 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608- 264 -8777. Property owner Midwest Const. & Development Parcel ID # 020 - 1083 -30 -000, ID# Page 3 of 4 G rig # Boring Pit Ground Surface elev. 95.33 ft. Depth to limiting factor >94" _ in. Soil Application Rate H orizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW 'Eff#1 *Eff#2 1 0 -20 10yr3/2 none Is 1fsbk ds as 2f,1mc 0.7 1.2 2 20 -30 10yr3/3 none Is 0 sg ds cs 2f,1 m 0.7 1.2 3 30 -55 10yr6/4 none s 0 sg dl gs 2f 0.7 1.2 4 55 -94 10yr5/4 no s & gr. Osg dl - - 0.7 1.2 9•�o & Horizon #4 contains appro imately 20% cobbles. F Boring # JBoring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP *Eff#1 "Eff#2 F-1 t Boring Boring # ft. Depth to limiting factor in. ;�� Pit Ground Surface elan. _ __ � Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff42 * Effluent #1= BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD -i mg/L and TSS <30 ntg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 - 264 -8777. ce n � Ste;! ¢ ✓a /c�w e- of'; z /dw� Lc�tx Sec, 29, i rr. 0 ,-(Sc 5 £. c, -o; x (� > cj i . 'ggl " mzwe: I?a,' / ii /'a; /roa..d 6'e e nce post. ss a me c! I r e& = i 00.x . �z ■ X ■ 5 keJ�_� Q � Q �a 'Ali B Top o{'Siee/ then c e�DoSt . Cie r/. • - 9 7,17 c,,� co dcd q 6. o co.fbvc�i moo 5 I i I ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM �— E r/g /� Owner/Buyer ✓� (4 GrrEST r����✓� T 1 �- Mailing Address Property Address 0. X0 L © 7 ;f- y -- S v (Verification required from Planning Department for new construction) - v 9' J O—C k 'Pi rl 'e r City/State 46 SO •v ; (Ali s�o /( Parcel Identification Number 0� o - /483 - 3e - cp) o 0 1 0 #- 511 '�' /9, 3 3 I/C LEGAL DESCRIPTION Property Location _X IC - %., 1 /., Sec. 2 L T_2 -� N -R__4W, Town of &'; -S'6AJ Subdivision _ e-J D E1/ W 003 . Lot # c _. Certified Survey Map # 005 -0 , Volume . .Page # Warranty Deed # 7 a T Volume _ 7 0 s , Page # .S` �l Spec house 14 yes ❑ no Lot lines identifiable F3 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 mastcrplumber, journeyman plumber, restrictedplumber or a licensedpumper verifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection 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 year ex ' tion date. / a / SIGNATURE 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 p descri above, by v'rtue of a warranty deed recorded in Register of Deeds Office. AE 0 SIGNATURE OF APPLIC DATE « « « « «« Any information that is mis- represented may 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 1 STATE B4 lua r " - 1998 Document Number I WARRANTYIIEED This Deed, trade between JoAnn E Neubarth and Betty M. E•ien Grantor, and Midwest Construction and Development of Hudson Inc. a Wisconsin Corporation, Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (the "Property "): 654704 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 08-24 -2001 12:30 PM WARRANTY DEED EXEMPT I CERT COPY FEE: COPY FEE: TRANSFER FEE: 1800.00 RECORDING FEE: 10.00 PAGES: I Recording Area NE 1/4 of SW 1/4 and the North 66 feet of South 495 feet of the NW 114 or SW 1/4, ALL in Section 29, Township 29 North, Range 19 West, St. Croix County, Wisconsin, EXCEPT the South 429 feet of west 203 feet of said NE 1/4 of SW 1/4 and EXCEPT part described in Vol. 461, Page 421, Doc. No. 3006M and EXCEPT part described in Vol. 477, Page 588, Doc. No. 307501. N and Return Address Construction and Development of Inc. 17 Industrial Blvd ��0 %0i2�-V 020- 1083 - 10400 and 020- 1063 - 50-000 Parcel Identification Number (PIN) This is not homestead property. (is; (is not) SUBJECT TO the rights of ingress and egress for an access roadway as described in Vol. 461, Page 421, Doc. No. 3oo625 and In Vol. 477, Page S88, Doc. No. 307501. Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easement and restrictions of record. Dated this 23r day of August 2001. • AUTHENTICATION Signatures) _ IMw MP �� authenticated this _ day of R 1 s. TITLE: MEMBER STATE BAR OF IVAQW. t« , rt (If not, authorized by 1706.06, Wis. Slats.) THIS INSTRUMENT WAS DRAFTED BY William J. Radosevich. Attorney at Law 502 Second Street, Hudson, WI 54016 (Signatures may be authenticated or acknowledged. Both are not nocemary.) "�'JaAnn Neuharth STATE OF WISCONSIN ) ) ss. St. Croix County ) Personally came before me this 23'd day of August , 2001 the above named JoAnn Neuharth and Betty M. Evien to me (mown to be the person(s) who executed the foregoing insttum d t edged the same. f Notary Public, State of Wisconsin My ommigion is pe anmt. (If not, state ti date: 7 OF of persons signing in any capacity must be typed or printed below their siggi<titre. STATE BAR OF WISCOD WARRANTY DEED FORM No. 1 -1999 lotorordon ProRessionds Co., Fond do Lac. W I 9110.6552021 f � LOT 7 2.696 ACRES (117,428 SO. FT.) H.W.L. = 809.0 LOT 8 2.925 ACRES \ (127,401 80. FT.) ,, BAP& - 810 RK: TOP OF V ELEVATION ,HARK: TOP OF 1' MPE, ELEVATION 825.00 )3.01' 9 35.91' 2.509 ACRES (109,293 S0. FT.) : 1Q C5 �.� •. LOT 5 2.433 ACRES O �� (105,990 SO. FT.) / 4r P `i P S Sffmc VENTS do V y co SEp ry LOT 3 H.W.L. • 809.0 2.416 ACRE • \ (105,250 S0. F N84°34'4 5. ENC ` '• `• . �" - u FOOT EACH S DEMOF CENTER LINE ��• \ O� \ \� �- 1 . . . . . . . . . . . . . . . . . • • �. \ Swi &52"E 410.65' JACK PINE D LOT 9 � �• � � • � \ NSW16WW 410.41 , 2.445 ACRES \ / T� 106 524 N.FJJL ft &10 i �y m� 1.84' rm '�• 16.21 — L�� .I . . . . . . . . . . . . . . . . . . HOUSE & I CID GARAGE L 2.0987AC1R S LOT 11 (91,381 SO. FT.) 3.003 ACRES S 3 VENT! ALF-M ■ 610 i (130,791 SO. FT.) 8 7.5.14' 331 I♦. _ : LOT 4 1 2.279 ACRES 2.� (99,283 SO. FT.) (88 . 810 ti 1 I ; s89°16' i o V V / 1 cb' ry LOT 3 H.W.L. • 809.0 2.416 ACRE • \ (105,250 S0. F N84°34'4 5. ENC ` '• `• . �" - u FOOT EACH S DEMOF CENTER LINE ��• \ O� \ \� �- 1 . . . . . . . . . . . . . . . . . • • �. \ Swi &52"E 410.65' JACK PINE D LOT 9 � �• � � • � \ NSW16WW 410.41 , 2.445 ACRES \ / T� 106 524 N.FJJL ft &10 i �y m� 1.84' rm '�• 16.21 — L�� .I . . . . . . . . . . . . . . . . . . HOUSE & I CID GARAGE L 2.0987AC1R S LOT 11 (91,381 SO. FT.) 3.003 ACRES S 3 VENT! ALF-M ■ 610 i (130,791 SO. FT.) 8 7.5.14' 331