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HomeMy WebLinkAbout020-1353-20-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 488228 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: 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 Parcel Tax No: Corson, Ryan Hudson, Town of 020 - 1353 -20 -000 CST BM Elev: Insp. BM Elev: BM Description: n Section/Town /Range /Map No: / GCS f AA 1 GS ( 36.29.19.2020 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. 1 i.tiler Septic , J � g / z OO Benchmark 3 . i J•3 /IL) ,� 1 m341 9es;n � t " Alt. BM,...., Coo I • L I / ✓O/ . 7 Aeration i Bldg. Sewer H olding St/Ht Inlet 5 /, St/Ht Outlet ,/ TANK SETBACK INFORMATION -� q 7 4 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 1 ' N ^ / 7 26 . _ Dt Bottom 4.-_, h � - Header /Man. ID: $. f `' • 7 Dosing ,-- "7. L .75 .9 Aeration Dist. Pipe �o.'f 9co . 7 Holding \-----_____-_ Bot. System 9 e r as Final Grade PUMP /SIPHON INFORMATION Tl 14 . I$ .9 Manufacturer Demand St Cover � " GPM . ->,{/-- , I 10 / 7 Model N •er It 7 5 95 ,(e. tt. TDH Lift Friction Loss System H- TDH Ft Forcemain Leng Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width ; Length / No. Of Trenches PIT DIp(IENSIONS No. Of. its Inside4La. Liquid IQpth DIMENSIONS 75 96 Z l c'e.,.c.L2 , SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: //�� INFORMATION CHAMBER OR t'J . O�Js�� Type Of System: 1 ; UNI Mod el Number: C0"4. aa. v ✓�c. ib A- rL, 3lv DISTRIBUTION SYSTEM / (3 4- ITC 3(n -+b-C Header/Manifold rd Distribution x Hole Size x Hole Spacing Vent to A Int 7 L, Pipe(s) ~ \ N 3f ru v Length / Dia T Length Dia Spacing \ °e. SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over 1 Depth Over xx Depth of xx Seeded /S do d xx Mulched Bed/Trench Center 3, 3 Bed/Trench Edges Topsoil \ Yes j ] No Yes j No 3 COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 660 Hillary Farm Road Hudson, WI 54016 (NW 1/4 NW 1/4 36 T29N R19W) Cottonwood Ridge Lot 20 Parcel No: 36.29.19.2020 1.) Alt BM Description = C-` e.... vv 5 1-0<-1C. 6 O.•■ 2.) Bldg sewer length = 1 k - amount of cover = a „J S b r e._"J 'S Z • II , Plan revision Required? 'es i I No 7 , 3 75 " Use other side for additional information. Date Insepct 's Signa Cert. No. SBD -6710 (R.3/97) Usconsin Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 J 4 0 ) • Madison, WI 53707 – 7162 Sanitary Permit Number (to be filled in by Co.) (608) 266 -3151 Department of Commerce 1 2Zg State Plan I.D. Number Sanitary Permit Applicatio i Nom_ In accord with Comm 83.21, Wis. A Code, personal infonnatio ,. • .r. rr .. may be used for secondary purposes Privacy Law, s15.04(1 Project Address (if different than mailing address) I. Application Information – Please Print All Information ' ', p c V E t0 d ii 714,n r Q S Property Owner's Name R�CEi Parcel # ` � a Block # Property Owner's Mailin; Address �� 1 Property Locatio (�_ �-G'l_ �i-- ' T - r rROIX GO jt4 � %a, /y.i�c A, Section k City, State Zip Code 14he Number 1 7 � I ) + J 4/ 0 / 1. 1 / i • Z 6Z13 T II. Type of Building (check all that apply) p (,; n� I �/ G ! Subdivision Name CSM Number r 2 Family Dwelling – Number of Bedrooms kA.? /..0' Vire. )n f•t' / D1 a,r g c/ c�irr.!/ -s 1' ❑ Public /Commercial – Describe Use r (', D ❑ State Owned – Describe Use 2 I t66- ,,\ 4,.// /1 i- u'�S .....wl,aef's ❑City_❑Villag Tow nship of t_, _ j �/ III. Type of Permit: (Check only one box on line A. Complete line B if applicable) 6 2..h 5' /3 3 2.6 �"� — A. _ System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System ~ List Previous Permit Number and Date Issued B. ❑ Permit Renewal ermit Revision ❑ Change of ❑ Permit Transfer to New Before Expiration —_—_ Plumber Owner F IV. Ty a of POWTS System: (Check all that apply) ji A'� trt1 ■ • ` r ' QSf A - Ilfc.— . CAL7 n – Pressurized In- Ground ❑ Mound > 24 in. of suitable soil 0 Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ i ---- - ------, Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Fillet thing Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area ormation r 75* ( 4 , 3 , Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dis ersal Area Proposed (sf) System Elevatio C VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing (�' G �t ( i ) Tanks Tanks l i Septic or Holding Tank �/ /� / 'L CL ( i `/ Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the undersigne • / a-, e responsibility for installation of the POWTS shown on the attached plans. Plumbe Name (Print) Plumber' •re MP /MPRS Number Business Phone Numb c � . 5 f'� rr /--t M )7`t { 5 t + � r.V �` 7 2� CJ 9 J r � fJ ~ ` ( 4 Plumber's Address Street, City, S te�Ztp C.� _ ) Z,r.) .. VIII. County Department Use Only ""C {� f � Sanitary Permit Fee (includes Groundwater Date Issued Issu Agent Signature 'r o Stam; ) pproved ❑ Di pwxe Surcharge Fee) t C ❑ Owri en Reas fo? Denial J IX. Conditions of Approval/Reasons for Disapproval SYSTEM OWNER: 1. Septic tank, eff filter and dispersal call must all ba selvrces I maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable cad. / ordinances. Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) I • Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code t County ,.. S.1( . C r 0 Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. i Please print all information. Reviewed' Date Personal information you provide may be used for secondary purposes ivacy Law, s. 15.04 (1) (m)). - 1 7 /516 Co Property Owner Property Location , ,/ n t ye k.--- e.--0 r Govt. Lot 4/f LJ 1/44/V 4 S - - p? N R r / E (o W Property Owner's Mailing dress Lot # Blocubd. Name or CSM# 1 '2-- / / f- 5-f _ k # S C V or-- . i -c-J ,v cit State Zip Code one Num. .,,,, City Village o wn Ne re t Road , J . It f) 7i 5� ()/ ,, R�EGE /74,<_e I/71/ /ar• / .ti /e lew Construction U Residential 1' of i�tt f bedr�ppoos` t e derived design flow rate G- GPD ❑ Replacement ❑ Public or co , eraai __ ___ Parent material _ - ' c / _ )r"� - „\` Flood lain elevation if applicable /V/ 11 ft. General comments 5 and recommendations: ` T 3 - t'. let) ? r C L, ' ` System Type J Li t�Gi°- :!�� ^ System Elevation 9 V . 7 � / 0 Boring # Boring /� g fir `' pit Ground surface elev , ft. Depth to limiting factor 0 i n. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 1 Q - /! J 3/ - - S / �m t r'I f" c;2.1_,--' /0-3n - y e_ 1 a� f Z /7-)/�,-- / / 3 6...4- 2 /-(- - 9" 3 3 r 4 W‘ .� X41, ❑ Boring -, Y g . j _ ../.) Z # Pit Ground surface eley ft. Depth to limiting factor /2 J in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 1 - I/ / n o�rV/ ,, � (1 _ — h 1. Z 1/ - / ,- .-J /c,C <Li ,�i/14.1 / ✓KiL �. /,(J / t • Effluent #1 = BCD, > 30 < 220 mg/L and TSS >30 < 150 mg/L ' ffluent #2 = BCD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 — 7__ --/ / -- 0 715- 246 -4516 • Property Owner Parcel ID # Page of Boring # ,❑(Boring 3 1 Z R.1 pit Ground surface elev, rJ ft. Depth to limiting factor 0 in Soil Application Rate • Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 *Eff#2 I 0- y a , ;/v I 19,,1A 0V rn,;� L' r him-. -.6 / 2— y 1 11 �/ 1, — 5 � ! % 1 �-��- �1 / - 7 1, , � q6. 4 q x. Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure ` Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon lepth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mglL • Effluent #2 = BOO, < 30 mg/L and TSS < 30 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. SBD -8330 (8.6/00) 1 f S a fety an gBuildings Division County n I W. Washin om, ` on Ave., P.O. Box 7162 c i Madison WI 53707 — 7162 Sanitary P . it Number (to be filled in by Co.) (608) 266 -3151 �� RAF T Of Co merce 1 State Plan I.D. Number Sa itary Permit Application JUN 1 2n 70 , ; with Co 83.21, Wis. Adm. Code, personal information you provide may be • ed for secondary purposes Privacy Law, s15.04(1)(m) Project d dress (if different than mailing address 6 Lo, i 1-2 - D o a0a0) ISA.Fik oQation Please Print All Information Property Owner's Name Parcel # "- •t# BIocK# Property Owner's ' ing ddress ' Property L. lion /i�G l 't �.i .�_, . , "/,% / <, Section ,..3 Z City, State j ` Zip Code /� Phone umber //-1(....,.1/1, l J/ G7 L 61 Z— 3 4 -77 1 7 N; x/tEc. IT. Type of Building (check all at apply) / Subdivision Name CSM Nu r iv% • 2 Family Dwelling — Number of drooms Otit C. .C: C� ❑ Public /Commercial — Describe Use 4 „e c�i�r,V) i Villa a wnshi.. .. ❑ State Owned — Describe Use ❑Cty ❑ g `� III. Type of Permit: (Check only one box ol.Iine A. Complete line B if applic: . e) A. w System ❑ Replacement System ❑ Treatment/Holding Tank: ' eplacement Only ❑ Other Modification to Existing System List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ■ hange of r Permit Transfer to New Before Expiration Plum. - r Owner IV. T pe of POWTS System: (Check all that apply) C(2 3' qO -f re 4.CJ1 taS) --- 3c. Arc_ % c4 _ / -_ c _ . i on — Pressurized In- Ground ❑ Mound > 24 in. of suitable soil P. ound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- , • d ❑ Holding Tan, ❑ • ..t Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ / Recirculating Synthetic Media Filte A: --_ •thing Chamber 111 e rip Line N Gravel -less Pipe ❑ Other (explain) - ra , • V. Dispersal/Treatment Are nformation: � Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Requ - d (A) Dis ersal Area Proposed (sf) ,/System Elevati n 6 � z� 7 <Y� y yon? 90.7 7.0. VI. Tank Info Capacity in Total ' Number Manufact . -r � � Prefab Site eel Fiber Plastic Gallons Gallons, ' of Units W )r�_ i ii Concrete Constructed Glass New Existing / DQ Tanks Tanks , Septic or Holding Tank __ M��.itai .r�.w7F�� Aerobic Treatment Unit F / 1 Dosing Chamber VII. Responsibility Statemen 4 • unders :' , assume responsibility for installation of the POWTS - . own on the attached plans. Plumber' Name (Print) i Plum . Signature MP/MPRS Number Business Phone Number Plumber's Address (Street, City tat - i> . +e) //, '3 / • . % 12- //je--.(-) ', w1 D( 7 VIII. County/Depart . • nt Use Only Sanitary Permit Fee (' ludes Groundwater Date Issued Issu ■ : ; gent Signet Stamps) Approved ❑ D .a.. Surcharge Fee) / /� _ `Z 'OK ❑ • ,,,, - t - n Reaso for Denial ` (J 31avt2 i > r " IX. Conditions o pprov: - ' SYSTE i r ” ER: 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) . oil Test and System PLOT PLAN PROJECT Rvan Corson ADDRE 212 11th St. Hudson Wi 54016 NW 1/4 NW 1 /4S 36 /T 2i R 19 TOWN Hudson COUNTY ST.CROIX MPRS Shaun Bird 226900 ! .4 DATE 7/14/06 BEDROOM 4 CONVENTIONAL XXX IN- GKO" D PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 900 # of chambers 36 BENCHMARK V.R.P. Top of Walkout foundation ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE O WELL *H.R. Same as Benchmark SYSTEM ELEVATION 94.8/94.0 4' below grade Plans Designed Using Conventional Powts Well is to meet all Property Line Manual Version 2.0 setbacks required by moVent WDNR >6" Standard Biodiffuser of Cover Leaching Chamber with 25.0 ft2 of Area 5' Long 34" Grade at System Elevation B -1 90' B -2 Vents 10 +0 4 B -3 40' 20' 2 -3' X 90' Cells with >3' Spacing 70' 10 ► \ B.M.* • 40' B.M. * \ Pro 4 Bedroom House 180' r 25' B -5 0' 70' 1 20' 1 Replacement area B 1 Nail in 12" poplar @ A 100.0' 41 1,0 50' B -3 B.M. #2 20' 10' 25' • • 90 ∎ ❑ e l B -4 B -2 4% Slop 30' Cotton Wood Trail PLOT PLAN PROJECT Ryan Corson ) DRES 212 11th St. Hudson Wi 54016 NW '114 NW 1 /4S 36 /T 29 / 1 = TOWN Hudson COUNTY ST. CROIX MPRS Shaun Bird 226900 % ► � DATE6 /10/06 BEDROOM 4 CONVENTIONAL )00( IN- GROUND / SSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 900 # of chambers 36 BENCHMARK V.R.P. Top of Nail in poplar tree ASSUME ELEVATION 100' Filter B T Filter ❑ BOREHOLE O WELL *H. . p Same as Benchmark � SYSTEM ELEVATION 90.7/90.0 5' below • rade • Plans Designed .ing Conventional Powt e 11 is to meet all Property Line Manual Version 2.0 setbacks required by moVent WDNR Ai t. 6" S S. d : odiffuser i D c- o over chi : : mber > % 41 ekc,^›'T ith .0 ft2 of Area > 11" � �g Grade 34 " ade at System Elevation Pr: 4 Bedroom House * =�_ 20' \ ' ST O 25' 20' - 0' v 70' r Nail in 12" 20' B -1 poplar @ • 1/00•0' - - - 50' I B.M. #2 20' 2 -3' X 90' ! Is with >3' Spacing Pq GO \ ■S Oft 2S B-4 90' B -2 30 4% Slope. ----- Mr2 /4..4, a PLOT PLAN PROJECT Ryan Corson DRES 212 11th St. Hudson Wi 54016 NW 1/4 NW 1 /4s 36 /T 29 41 : TOWN Hudson COUNTY ST. CROIX rf MPRS Shaun Bird 226900 ' 1 ►' ��2 DATE 6/10/06 BEDROOM 4 CONVENTIONAL XXX IN- GROUND ' ItSSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 900 # of chambers 36 ■ BENCHMARK V.R.P. Top of Nail in poplar tree ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 90.7/90.0 5' below grade A Plans Designed Using Cony tional Powts Well is to meet all Property Line Manua ersion 2.0 setbacks required by inoVent WDNR >6 „ S '. d : odiffuser OS A of Cover - achi • : mber 36 .0 G „.3 '' with .0 ft2 of Area 1 Long Grade at System Elevation Nrr 'ro 4 Bedroom House \ 20' ST O 25' 20' B -1 Nail in 12" 20' poplar C 0 50' B -3 B.M. #2 20' 2 -3' X 90' eei['s wit >3' Spacing A , 25' 90' • B-4 B -2 ,---- 4% Slop - 3 0' - • • , Wiscolhsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings — Page ± of Bureau of Integrated Services in accordance )wit'6 s, 'ILHR 8p Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inch iri Size. PI, L t>4 `county • 7•.(2— include, but not limited to: vertical and horizontal reference poirtt (BM), directibh arid Tr) 1 C Yn f v percent slope, scale or dimensions, north arrow, and location and e tto nearest r od . 'Et,1rcel I.D. # c, - ' t 72 0I3s 3 2 o -oo0 APPLICANT INFORMATION - Please print all in orination. CR0l :. 14viewed by Date Personal information you provide may be used for secondary purposes (Pjvacylaw 4 {��4ii)) '' t / /5 ■ Property Owner .;. ' Proo Locatiar / r ' Govt, Lot . ' 1/4 1/4,S T N,R E or Property Owner's Mailing Address `" tot #"`" Block# Subd. Name or CSM# \ 3 JJ 1t_+`_3, -- k�C f r C'c . 20 - 1-Vim . o 'K k L ❑ City Village � Nearest Roa Town City State Zip Code Phone Number � d — � 1 LkA\ I yc(le I (115 ) I� - (c ?31 1 - I.tl1 0/> I 004+Orr,Jvod -. Fr. L -. ew Construction Use: Residential / Number of bedrooms 3 - - I Addition to existing building ❑ Replacement Public or commercial - Describe: (. Code derived daily flow (DN.) gpd Recommended design loading rate • Z bed, gpd /ft • S' trench, gpd /ft Absorption area required c. k bed, ft I50.) trench, ft 2 Maximum design loading rate - 7 bed, gpd /ft • 8 trench, gpd /ft O Recommended infiltration surface elevation(s) 9.70 ft (as referred to site plan benchmark) Additional design /site considerations 41-'71, 41-'71, �i n /, 7 Z . Z0 • Parent material C1 I C>,CI Ct,i OU_ I Flood plain elevation, if applicable Ai/Ail- ? 7/. C ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ® S ❑ u © S ❑ U FJ S ❑ U VI s U ❑ S [,O U ❑ S © U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 1 6-1z I(� Yr 3(L L. 1 nicibk r . .C' t _ (_ ) f . 4 -_(.. 5 .. 2 IZ -N3 loirLI /i L S c Ground 3 %-id,p I n .r `I I tp — I n ; oc r ( c S . -- - 8 elev. 9ZZOft. Depth to - ' limiting cd RO .30 factor 1 , I I , L� in. ' Remarks: Boring # I ® -(P (L3 '4 t- 3)2 51_ 1 rr�c i / -C - ` 2 2 - ( 0 - 3 In r `-III S i t 2 ss-- 01--C( r S Iv(, • 5 3 -)Z'f IC1yr U Ito 015 C?5i n1 (5 . --) . . Ground elev. ' 7 ft. Depth to c9 , limiting a Z factor IL`/ in. Remarks: CST Name (Please Print) Signature Telephone No. • c .m 4 L.A. er LA. — (1 l S) Zy 7• CO& Address Date CST Number Le-0 b C. ed e ✓' 54. `/ Some► - s - I - , 4 ) t --- &-I0 zs `-i -15 -`19 2533:5 SOIL DESCRIPTION REPORT PROPERTY OWNER `j Page of PARCEL I.D.# • Boren # Horizon Depth Dominant Color Mottles Structure G D /ft 2 g in. Munsel! Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots P Bed Trench I 0-13 0 M- Cr c 5 ( C `{ . 5 2- 13 -2o cU1/4/(- ici L fm5� fm� c3 Ground 3 2a-u /0 - 0- 3 659 IYI c3 elev. qi '/.Uoft. Depth to limiting egi-90 factor 11LI in. 51 ' la 03° Remarks: Boring # ( 3 -(p r 6 yr 31Z `5L Ynabk m - S 1 . ; - S� `-� Z E() -1. lb yr LI I 5. 2 r thic_ zs Ivc 5 16.4rg1(o MS d`)c m( s — ; . g Ground elev. 9 3Zat. Depth to limiting 41/ 1`a� factor / Z( in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring# 0_12... 13yr3iZ S L 1 mab- rye -(- C S \ • 5 2 )2 -Zlo to (-IN I- S L m sy m I c-5 lv c – 1 .• 8 3 ?i, -124 lb ...ix ho � m s a 5) 1 1-) < < s — Ground elev. - 0: Taft. lat ?o•?C — Depth to 40/94. , limiting factor (Z' in ' Remarks: Boring # Ground elev. ft. Depth to limiting factor in " Remarks: SBD -8330 (R. 07/96) r Vole_ 3 4.3 4 2- 4-0 ÷ cr & f°feAcJo-c -1—r —L.:�. _. .. � scc,l'e.. I 1 too ' 1 / X no 1 ,- n I Lf " �I pp ,k '; / - —+ - r 3 U r law, , - e�.c..0 • (�ro, a yl YY gd ytat'l ) IZ "e �(p f' jt( NI , , a VIAC sv5 /' -e-i-e-c. g ) 4-/. e(-eo. `?Z.Z v � 7� 5 L �. X1. C w u k 130) 1 • ' gC A.V�• 131 • • 1 33 • • �ib4 VAD'r -1 6• Brnt 1 0 i r ' Parcel #: 020- 1353 -20 -000 02/09/2005 04:41 PM PAGE 1 OF 1 Alt. parcel #: 36.29.19.2020 020 - TOWN OF HUDSON Current X ' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner RYAN G & RENEE L CORSON * CORSON, RYAN G & RENEE L 768 WALL ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 660 A &B HILLARY FARM RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.007 Plat: 0194 - COTTONWOOD RIDGE '99 SEC 36 T29N R19W PT NW NE COTTONWOOD Block/Condo Bldg: LOT 20 RIDGE LOT 20 3.007AC TWIN HOME Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 36- 29N -19W NW NE Notes: Parcel History: Date Doc # Vol /Page Type 06/08/2001 647747 1656/377 WD 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 49928 47,200 Valuations: Last Changed: 10/30/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.007 36,500 0 36,500 NO Totals for 2004: General Property 3.007 36,500 0 36,500 Woodland 0.000 0 0 Totals for 2003: General Property 3.007 36,500 0 36,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 12/04/1998 Batch #: PRGRM Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 C Plan Optioystem fails, determine cause of failure, use alternate area and install new system in tested replacement area. Option #2. install system at a lower elevation, by removing chambers, removing biomat, and install new system. Option#3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 715 -246 -4516 St. Croix County Zoning 715- 386 -4680 Pumper Tom Mondor 715 - 246 -5148 Shaun Bird #226900 • ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer R / u (S , Mailing Address I a., J/ . S-1 9 1 .S/0/ Property Address (1 (p 6 4a0A,t. f a — (Verification required from Planning & Zo ning Department for new construction.) City /State Parcel Identification Number 0 0 / 3/ 1 ( 2oL0) LEGAL DESCRIPTION ) V4 /' ✓� t Z N R W, AIL..—....,k. l� - Property Location/U-0 /a , /a , Sec. 3 � , T /7 , Town of Subdivision (�, (.Li�4tY, ��`a!' , Lot # Z 12 Certified Survey Map # , Volume /" -- , Page # . Warranty Deed # L/ / *7 , Volume / 6's / , Page # 3 77 Spec house yes no Lot lines identifiable yes n SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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 1/3 full 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 Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my /our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. 6 i't, /6 '6 * X SIG ATURE OF APPLICANT(S) DATE * ** Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) t;.i.1656P*G,t 377 /0 :.� STATE BAR OF WISCONSIN FORM 2 - 1998 16.477 • WARRANTY DEED KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI Document Number RECEIVED FOR RECORD This Deed, made between 06-08 -2001 8:30 AM .RICHARD O. STOUT and JANET P U , WARRANTY DEED - hurband and wifc, — EXEMPT N . Grantor, CERT COPY FEE: and _yan G.Corson and Renee T. Cr vFial _ COPY FEE: TRANSFER FEE: 179.70 RECORDING FEE: 10.00 PAGES: 1 , Grantee. Grantor. for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County. State of Wisconsin: f oc:x 1 ,j A., ..1 Plat of C'.Qtonwoo RidaQ , Town of Name and Return Address Hudson, St. Croix County, Wisconsin and Renee Corson 7 8 Wall Street New Richmond, Wi 54017 - This lot may only be used for a single family residence. 020- 1353 -20 Parcel Identification Number (PIN/ This i S not homestead property. (is) (is not) Exceptions to warranties: rights of ways, easements, and covenants of record. Shared driveway agreement as recorded. Dated this 6th day of _ .Tnn• , 7 00 1 t //�1� '� ` _� y {SEAL) (SEAL) . Richard O. Stout Janet P. Stout (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin. Iss. St. Croix County authenticated this day of Personally came before me this Fit h day of June J�.�. ! 2 00 1 , the above named • Stout • 1 HNUN J. BAST N _ to * TITLE: MEMBER STATE BAR OF WISCONSIN , - Who executed the foregoing (If not. _ me kno - • be the pe g g authorized by §706.06, Wis. Stats.) f • t . • acknowledge the sa e. / ., <!./ THIS INSTRUMENT WAS ORAFTED BY • Janet P. Stout �. 1353 Awatukee Tr_ - • er P r . State of Wisconsin Hudson, WI 5401 6 My commi ion Is permanent. (If not. state expirraattt date: No (Signatures may be authenticated or acknowledged. Both are not 41-( - ' "" .) necessary.) • Names of persons signing in any capacity most be typed or printed below their signature. W iSCOnain Lsgal Biank Co.. inc- STATE BAR OF WISCONSIN l Blank C o. Wic. WARRANTY DEED FORM No. 2 - 1998 I N ' N 1 1 • 1` )- . in i 1 1 r •S9'80S 3,.60.E -_ • ••• __ __ ! , a • I I CU a: 1 w • l. I 1 & W x W • in i' ' I " kci W o " N , ... ...., ,, � ,•. A re 1 •• • • i i 1 `11 1 le I 1 U $ 1 ' r I I 1 F- -% \ !/ t : •I a • I • - i ■ a N_Q4_13'O5 _5.5a7__. -• . -- •-- •-- • - -• -- ' - ! 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