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HomeMy WebLinkAbout020-1441-69-000 UfU fp co � E. go* 3 3 4 * w Fi Fi a ▪ 0 E m ai O o co 2 w o m N ? <. 'p "* o cn a IV Q MCI a .+ 7 N N Cn o CO .b. D • am w o 0 3 --I K.) • `I \ 1 Q c m c � 1 con o A qZ 3 7 . p I .� o Q ▪ (� C d 0 _ _ C m CD cn z > a 50' ' m co D'° a x N 3 0 "` �00 • O v V Z N N= n r N O ° w C a 3 Cr N• CA I Z CT 000 O * o n o a Q 10 v v, o 7 77 W,' '° rn II cu , N I N * 3 co .Z1 I - '� a Q m F. 1 (0 0 3 a c cn o cn I m O = a m Q m m U, 1 I fD K C N w �' m a a 3 0 D z a — d, y a c n a •• 0 3 o cn - 1w m co a) z p O x) r : Z 9 P. Z I * a I Q I a O I 01 c I o a co il I O m o 0 o I 1 ti I 1 ti I ° o A I k K I O Oq W I < c0 to O ti LA,, 1 o on. v ' ti ST. CROIX COUNTY WISCONSIN m, • ZONING OFFICE b 11 n r r n ■ n • — YID& ST. CROIX COUNTY GOVERNMENT CENTER . e = 1 � „I;.:� _ 1101 Carmichael Road , � - -''�- Hudson, WI 54016 -7710 (715) 386 -4680 FAX (715) 386 -4686 Monday, January 10, 2005 Kernon Bast 838 Wilcoxson Drive Hudson, WI 54016 Regarding septic inspection for Kernon Bast. Location of Property in St. Croix County: Municipality: Hudson, Town of Subdivision or Plat: Cottonwood Ridge 1st Certified Survey Map: Lot: 69 Address: 838 Wilcoxson Drive Dear Applicant: A septic inspection of the above reference property was conducted on December 17,2003. This property is located in the SE 1/4 NW 1/4 of Section 36, T29N R19W, Cottonwood Ridge 1st (Lot 69 ), Hudson, inspection, Town of, St. Croix County, Wisconsin. At the time of the in sp this septic s y stem was found to be code compliant for a 4 bedroom home. If you have any questions regarding this, please contact our office at 715.386.4680. Sincerely, i evin Grabau jai "qy,` Zoning Staff cc: file . Wr LC0)(Se , ✓ Pe-. Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division - INSPECTION REPORT Sanitary Permit No: 430450 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: Bast, Kernon Hudson Township �/'�j�� "�` i �,I- CST BM Elev: Insp. BM Elev: BM Description: Section/To �1�=n /Map No: 1 r—' (60 ,7 (trta .a 1 ef j Qj r 36.29.19. TANK INF RMATION ( ELEVATION DATA TYPE MANUFACTURER. CAPACITY STATION BS HI FS ELEV. Septic ) Benchmark LL) ,` (S &Q. 1 2 Sag 0 L o (10(.6) 1 w- r, Dosing 0 Alt. BM Aeration Bldg. Sewer S. 3t r /Z -63 Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet 9. 35 it `s' TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic > / \ 2 2 r �■ Dt Bottom //�—f Dosing J Header /Man. C 1;) Aeration Dist. Pipe / L � 'S 1 0. � �- 0 • s / Holding Bot. Sy m (\ n I , 11.15-- g s ; �( 12 �� I I z o &b Final Grade , Avkil, - PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM 3.3 ° Model Number TDH 'Lift action Loss stem Head TDH Ft Forcema n Length Dia. Dist. • ell SOIL ABSORPTION 4) RENCH idth 'Length r No.f Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIM 3 1 I eT.S< i (2 / SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Magy�fac� l rgr:l _ 54S INFORMATION CHAMBER OR ,ti 4 T Type f Systy ' S (4-- Iii I 6() _ UNIT Model Number: (2 rC , . D SYSTEM -(o Lengt ?IL) (I;�/ Di Pipe Distri bution x Hole Size x Hole Spacing Vent to Air Intake �� ` ,0,-- � Length � Dia Length Dia Spacing ' 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 Ci Yes 0 No H Yes r I No CO MME TS' ncl�u a c di persons pres etc.) Inspection #1: pea . (14 '247 Inspection #2: L 8 ilcoxson Drive HudN 1' 54016 (SE 1/4 NW 1/4 36 T29N R19W) Cottonwood Ridge 1st Lot 69 Parcel No 36.29.19. 1.) Alt BM Description = 1:1—. 7 - ""'14frte• ceud'r • if � `�pp 2.) Bldg sewer length = 22 Ste( Go- r - amount of cover = ?. a+ I 0 A , l ��� s `t 11:34 Plan revision Required? L] Yes No II Use other side for additional informatron. r... ` q 70 I 14-1i2.4) SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No. Safety and Buildings Division _,. County 201 W. Washin•to _ le: t 7162 ` i• S C irc7 i r X ISCOnS s n Mad son, VIVO Sanitary PerttNu ber (to be lied in by Co.) Department of Commerce (608)'2Z6 3 � ) 71 Sanitary Permit Appli i . tiq c 6 t ' State Plan I.D. Number J In accord with Cornm 83.21, Wis. Adm. Code, - personal in +rmation you provide - may be used for secondary purposes Privacy Law, 15.04 -�(ttpROG pC `)F]CEY Project Address (if different than mailing address) I. Application Information - Please Print All Information `--- " ?3 p 73 0 J -.0 Sew, D2 Property Owner's Na me / 6 t # er Property Owner's M ailing Address perry Location City, State Zip Code Phone Number 't ��'� Section 36' �� 4 2 J KG,/ < (circle one) II. Type of Building (check all that apply) /,- S � T :?� N; R/Q E or� ev n� Subdivision Name CSM Number or 2 Family Dwelling - Number of Bedrooms _ a } \ (y(i1s, Li Public /Commercial - Describe Use c",0 6,v Del , j /s 7'4,11 ❑ State Owned - Describe Use CZ) 3 ' X FT -SD C CESS - ❑City ❑Village J township of /-tead_cd.A✓ III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. 1 y New System y ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only 0 Other Modification to Existing System B. ❑ Permit Ren al Permit Revision ❑ Change of [I List Previous Permit Number and Date Issued g [0 Permit Transfer to New Before Expirati Plumber Owner 4/ S 0 q / 0 l 7 /0 3 r IV. Ty • e of POWTS System: (Check all that apply) ,Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At- Grade ❑ Single Pass Sand Filter El Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter El Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter , Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) _ F V. Dispersal /Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdst) Dispersal Area Required (sf) Dispersal Are'. • i ..sed ( - ystetn Elevation 6d i - IS? '1 ," ° 'K ' dD VI. Tank Info Capacity in Total Number Manufacturer 'r Site Steel Fiber 1 Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank x /Z SD Aerobic Treatment Unit _ i ., • 1 1 Dosing Chamber t4' y x l rJ, 'e 5e VII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POINTS shown on the attached plans. Plumber's Na me (Print) Plumber's Si gnature 'c'MPRS Number j Business Phone Number L,,A1C,:tr lot < IC/ � r oig'? 9Ye, 1 7 S - 3 PC -3e'21 Plumber's Addre ss (Street, City, State, Zip Code) / 67a c e 2'/Cd /a. eiso.,u 42.' SA/ °/s VIII. County /Department Use Only f / _ Approved 1 ❑ Disapproved Sanitary Permit Fee (i eludes Groundwater Date Issued Is.uing ' lent Signatur (No Stamps) Surcharge Fee) ` I 1 ❑ Owner Given Reason for Denial . 1 3 ' t f IX. Conditions of Approval /Reasons for Disapproval � ��" '� 1 SYSTEM OWNER: 3) 6e S �(2...) i e� 1 Septic tank, effluent filter and - „�,,Q; �„∎ o ��_ ` n - dispersal cell must all be serviced i maintained �tL `1' _ u � l' °n9�s"' as per management plan provided by plumber. c D� C i'� 45 2. All setback requirements must be maintained , as per applicable code /ordinances• G 2 3o9) i • • j Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size 1 l ii SBD -6398 (R. 01/03) I , k 9 _ a 4 .4.3. M \ ..\i \ ` s Ty '4-r 4 <.47 A's - r i 's m\ J i + 't \0 ti ■iN a i c \ . .. c \ ----------------'".. \ ) f \ A 1 0 C O ‘S \-A '..A.,._., . X o k \aec>1\41,\6. -.I \AS:1'°"3 i 0 \ ' a v k r t It D % \ .."( 5 ? � area s 'L.." XX - r J d _ ' \ '1 -i:7Y:n \ . K .,.,„.,.. ..:••C'S. : _ Ita ■ A Ne 111QV \ L ii.‘,, 4 VVV V 4, : Y A i V 1 KtGt1VtU - DEC 1 6 2003 Wisconsin Department of Com rce ST. CROIX COUNT OI EVALUATION REPORT Pagel. of 3 Division of Safety and Building 20NING OFFICE in accordance with Comm 85, Wis. Adm. Code n County _S ( M t. 4 Attach complete site plan on paper not less than 81/2 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. Please print all information. - evi " by 11 Date Personal informatiion rovide may be used for You P Y secondary purposes (Privacy Law, s. 15.04 -_ )). Abh. ■ . _ - !I, _ ., _ EL _ k K • 1 b i ae0-3 Property Owner - • • erty Location , i-• . Lot ^A'' 14 2 � q N R /9 � � ' ►��'%� t I�►�7: /Q . y 66 /V S .7'JT 2 / W 'roperty s Address —411111 11111114 41 " 7 7 1 „. .0, ock : _ _ - - City State Zip Code Phone Number M City ❑ Village R Town Nearest Road ( ) Ida 0 1 till New Construction Use: F. - - , • +P: ' • .. . - s Code derived design flow rate 4/52:5 /o C3 a GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Ott RS IN Flood Plain elevation if applicable „Al 1 V+ ft. General comments C' y s l'✓∎ $ ► G d , 93 Q 0 and recommendations: f ! • Ong Q Boring Ground surface elev. 747 C d ft. Depth to limiting factor 1 36) 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 1 011 loyr3/Z . Jnt,sbi •t c CS I v.I , - Z 1Z - !o r y Y — $v -f ZrnSA 'Y �' G '`7! 6 Y S - . 3 3&L o — - - r y/� s as m l -7-- z Y a . •o l Icr010 .2--1 10 g t tAS -4 # ❑ Boring e t Boring ® Pit Ground surface elev. 79:0 ft. Depth to limiting factor ' rt in. Sal 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 ay3 la y r -VZ 1 Sr( _ a 94isbt vv 4- e S 1 v .<s - i< /3-3f /0 y CY /y — . / AltSiat. WV( 6 c-S – i y •, 3 3&+-1s( hyt-Wo ,_ C — 49- ?-2�08 I�,.�� jf • Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BCD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) - / CST Number a `w. . € __ � ' c"�353y Address Date Evaluation Conducted Telephone Number )//3 , " 5 z f–o,3 7 ..5 =7 oz A r Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 2, of. Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not Tess 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. Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law. s. 15.04 (1) (m)). I Property Owner Property Location 4 4 4- >` V, Govt. Lot 1/4 1/4 S T N R E (or) W Property Owner's i ing Address Lot # Block # Subd. Name or CSM# City State Zp Code Phone Number ❑ City ❑ Village ❑ Town Nearest Road I I I( ) I ❑ New Construction Use: ❑ Residential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: _ _ ________ Parent material Flood Plain elevation if applicable ft. General comments and recommendations: 31 Boring # 0 pit Ground surface elev. ! re/ 6 ft. Depth to limiting factor / r d in. Solt Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz Sh. •Eff #1 •Eff#2 S O - 'Z / /Z = si L�.>,,..c6t Pi f..- 6,S 1 u ( S $ 6 iZ 3V /6v / S;G( Z.mcJ, /( 4' c 5 1 ' 4' 3 3y -/yl' ia j i9 /4 5 o-si 441 I . 7 /, Z 7 Z/r 0 1. 2 - Boring # ❑ BOf ng ❑ Pit Ground surface elev. Of ft. Depth to limiting factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft 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 CST Name (Please Print) Signature CST Number Address Date Evaluation Conducted Telephone Number 3 a 3 N.( BvP fox I er rI n gt .Q016904 4 0e4- 1o4.- 5 c.(4) . Pd , ..Sys-k " - e-(e'. 73. o &A p p0 -g0,i =MO. Safety and Buildings Division 1 County —1 201 W. Washington Ave., P.O. Box 7162 �- --- ` 2 ( Wis' eonsIn Madison, WI 53707 - 7162 Sanitary Permit Number (to be filed in by Co.) Department of Commerce , (608) 266 - 1 1 3 0 V Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide �A may be used for secondary purposes Privacy Law, s15.04(1)(m) Project Address (if different than mailing ad ress) I. Application Information - Please Print All Information ('t 1 7 3 W /L b'e Property Owner's Na me 1 `/ OCT P. _ Z-t Lot # Block # r E ' c � JC Property Owner's M ailing Address ocatio ✓ 151 " 73 ' . 998 47,ka 4 / T �`` /f i City, State' w . _ ' �� I Zip Code Phone Number k, ,Section (circle o II. Type of Buildtn ' eck all that apply) • Tag N; R Y E or 1 or 2 Family Dwelling umber of Bedrooms _ Y ' '' / / � Subdivision Name CSM Number {-3 Public/Commercial - Descri. se "icr . /- i � ! ❑ State Owned - Describe Use � ��_ �'. / � '' i r ❑Ci �ry ❑Vil}age�Townsh of ����,� 4 � / �_ / • III. Type of Permit: (Check only o • box o ne • . ' omplete line B if applic ' •) I I r A. ______. Ne w System ❑ Replaceme stem ❑ Treatment/Holding Tank Rey ement Only ❑ Other Modification to Existi ystem ' B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of {] Pe'it Transfer to New List Previous Permit Number and Issued Before Expiration Plumber O IV. Type of POWTS System: (Check all that ap f V Itir Non - Pressurized In- Ground ❑ Mound > 24 in. of su .le soil J ound 4 in. of - e soil ❑ At -Grade S Pass Sand Filter U Constructed Wetland ❑ Pressurized In - Ground El Hob t Tank / Li Peat Filter 1 erobic Treatment UUjt Li Re ulating Sa • ter ❑ Recirculating Synthetic Media Filter Leaching Chamber Line ❑ Grav-1 -l= _ Z ! o ther (e ai V. Dis . ersal /Treatment Area Information: j� '',* • - r i/� i , ♦ / Design Fl ow rL����/ � �I" - g (g pd) Design Soil Application Rate(gpdst) Dispe ea Required (st) Di .f) / a:16 ,7 y � l/ �. r ~a� Syste• o. e VI. Tank Info Capacity in Total Number , nufact urer � \ ' 17 ab pir /r. reel ` Fiber Plastic Gallons -_ Gallons of Uni . . z 7.0-0 � Crete Glass New Existing / Tanks Tanks r - Septic or Holding Tank as' � � - 1111i � ! .C.S,� v a. Aerobic Treatment Unit Dosing Chamber , '%72'r 1Z g oo r ose v villirliP v Ariliiiiiiii f VII. Responsibility Statement I, the undersign; , assume responsibility for `• llation of the ' TS shown o the at' hed plans. Plum / tier's Na me (Print) Plumber's • gna re PRS Number Busing Phone Number 4:421 ,CX4 nL - / �- Plumber's Addre ss (Street, City, State, Zip C• • -- VII County /Department Use Onl i V Sanitary Permit *VIS.. proved ❑Disapproved y Fee (includes Groundwater Dat Issued ig . 'tamps) Surcharge Fee) 4 - C b ❑ Owner Given Reas for Denial _ (....zit IX. Conditions of A proval /R" . • s for Disapproval SYSTEM OWNER: 3 s s `,a �L 1 Septic tank, effluent floe : neovt,,, Rs-7_ bill p dispersal cell must all + - serviced / maintained as per management plan provided by plumber — r. - .S/ 's ; 2. All setback requirements must be maintained "� / as per applicable code /ordinances. lit �yLUC! ,c�G r�, - li�i i „...-,-,' S' Al Attach complete plans (to the County onty) for the system on paper not tees Ues t slzeG� -K / / � SBD -6398 (R. 01/03) �''' � v ' "`'"�� ' /�G� ■ V • 1 ,` • .., s. 1, sz_ e . , or e 0 \ c I sL ic12), . / r' ., ,,,„ Q i J V C A .(, of ... . \sr ,/ o v . ' h e� I U o 1 w Nit I , i vo Ni. r N i r 4. y w ti \ 1 ..:• N A V Q k ZZ\ NI CJ O , I'l , g— . )1. 13 N , , I ;'' -k. 4" CI. VENT PIPE 12" MIN. ABOVE GRADE 6 a 25' FROM DOOR, WINDOW OR i4EAT�! RPROO FRESH. AIR INTAKE'. ' JUNCTION BOX APPROVED �`�'""� WITH CONDUIT WHOLE COVER F:NISHED GRADE �! W/ PADLOCK 5 " CI RISER —1 1 WARNING LABEL " 4" MIN. I�," Intl. 6" M X. j , � " I. , 17 , 0 _______ _ ____ » .,.�; * * :NLET ,,...._.., i j r ..H .....1 .t .L.,, t, WATER TIG j SEALS �; CAS# ; ; ' �••.... : ::..,... f TIGHT, ", "'"" I A SEAL ' . � d ' V PPROVED APRflY�3 ,, ,�_, JOINTS WITH i E L V ' 1 8 r PALM I APPROVED PIPE )NTO S� ?.IQ 4- �F ' "' ' ' pN 3 ,ONTO ;p;{, C ; 1 SOID. SOIL, PUMP OFF ELEV . F T, ,.� C I it* I. -- .-�... I - '�"- ►�"Or RISER EXIT T ' j } 11111114 PERMI?TED ONLY Li ali IF TAMS MANUFACT*JRER 3" APPROVED BEDDING UNDER TANK HAS APPROVAL CONCRETE PAD SPECIFICATIONS ;EPTIC / DOSE ANK MANUFACTURER: 4', rge NUMBER DOSES PER DAY: .. „ :ANY. SIZES: SEPTIC /;t 4 GAL. LOST VCLUME INCUUDING DOSE 6'0 GAL. FLOWBACX: 159 — GAL. ,LAR MANUFACTURER: ,.r1.,440/4..,6.J , CAPACITIES: A `°� INCHES MODEL NUMBER: � „ ''�' L. SWITCH TYPE: �� � ...,. eij: r, 5 a 2 INCHES s ..1,2 GAL. 11 MANU CTURER : 4: C * INCHES = !C8 GAL. MODEL A MJM$ER : - SWITCH TYPE: " ..,,.. D z .. INCHES s _Lt ......._.GAL EQUIRED DISCHARGE RAT p GPM PUMP S ALARM WIRING AS PER ILHR 16.23 WAC ERTICA1. DIFFERENCE BE. ^■ `- - OFT AND DISTRIBUTION PIPE . , /2 FEET MINIMUM NETWORK SUPPLY PRESSURE . -- as FEET ‘p FEET FORCEMAIN X tc0 FT /100 'T , FRIC ?ION FACTOR . . FEET /lfj TOTAL DYNAMIC HEAD x ►F E;,: NTERNAL DIMENSIONS CF PUMP TANK: LENGTH ----` WIDTH R ; Ij R .--, IGNED: _ /88 i S 1''nt.a l: ' " r .. 111• I OW ' Submersible 4 Effluent Pump • . tosaminaz < EP O4 EPOS •• ....., ... ,,, ...._................ • • .. A TIONS • Fastens 300 series • Fully submerged In high ■ MOW Null* Cat iron tor Ow " e6e1, grads turbine oil for . for *indent hoot tinder, foliowktg WC • spsble of running iubricadion and talent strength, ehd durability. *Mont systsms thy without dooms to heottransfer. - si Thermoplos- COMMAS, tic oar with intagrsi handle Mils* for Wangle and and !'lo siMtch attld:tnent • Forms Mr manual epaistioa. Adana • Ham/ duty sump • EPO4 S .,, �ttase: 0,4 HP, read* leSil ldellnidal p • *don bandy 113 or "a , 60 Hz, 1550 Float NW mumbled end a Palmy Cable: Severe duty • Ctewlterhrc RPM, built in overload with mot et Os biddy. rm. r oil end water refit automatic react II ; tipper and lower inor r o krum • S le phase: 0.3 HP, FEJITtiR�f bearing Kvn ,.......W WWWII 118 V, Will Hz, 1550 RPM, Pwtip: EPO4 built in overload with s EPO4 impeder: Thermo- • t ad+ornitiie reset. plastic Semi.opar design ABEMOY U$TINa k' mndmum. • Power corti:10 foot with pump out vanes for e— , Cspec l * up to 36 GPM. standard lengtN,1 S/3 SJTC meotw� It seed orotedton. �. cuss wow* ' • 'Coil turtle: up to 24 ter. � three prang Ground!np ■ EPOS DIsoh ozo: vie tor, plug. optim toot ptasPc wined deetgn for (CSA mud m numbers ▪ Mechanical Nat: carbon- hngth, SJTW with end to •F" or AC,) rocyl ry, three prong groundhog plug improved Pallowmance. BUNAN! alutemers. ;standard on EP05), • and llase: Rugged • T : therm� design provides . 1O$ continuous superior st ingtlt and 140•F (NrC) interinittint. corrosion-rotten • Fastens: 300 series Mmeas Rya ,_ _... stainless e1ed. 10 I _ 1 r 1 ► • le ilf running �y, . -- dry without damps to a 80 '. • s Solds *Ong oapablihy: 7 . A maximum. •�••_ —y 7+ • Capacities: up to 60 GPM. `.. I } • Tot halt: 31 fear.. a e �� ' I """'N - _ 1 ut • Meo�iar as a carbon- e 1b 111111111 111,11.11111111116.. 610 81 01 4 7 aistiGIINY moro. 1 1 4 NM , 111111111iiiMirini, • 1 d�� con ti nu G i ! 140".(30V) Intermittent. s 111111` __ t 8 , 1 0) o o. PM A t 40R draft Ran. If10. r 4MaanwlAay, fees i I cc g7 l ' ; 4 t . .1,,,,.,,„,,,, 0 ,. y . i x x �' : � 8.7_4, t m k G • s g ---I r 111111111111 - n rr;i Cr V 0. s. 1' Ca d _ (IIlIt11iI1} �� a 0 mouton CD n j r I Mau 11 gi P7 Z 0 / • CP !!iiIii!iflh1 r i liffr r 0 .' 4 2 i'IIIJ!!J1IIIlI 1 11 ligialr ii 6. I I i h !I!I!1!!!I!I 1I i 1 Q. 1' 1 1! 2 c _ a ibliItiII ca • q P: (F)D - i Ei z 7 Lk , T ar 0 1 r— x 0 -1 cu _ g 11! IN1I11 z o iii i i i; i i iii iu i i iiir Ell 1 m 0 g e ll 1 11!1 — —• E o l 20m 0 0 • CD * < !jiiIiiHiiIIu it r Q , l1 ► Va X .g Si a i o � . t w O �Illllll�l111111 11 r (� r t < Cr G 0 g 9. — Invert 11' --} t • i i • .r` 11 1 k \f , 1 c I L 4 i • • k 6104900 r q iiik V 0 / e.t i , ` � , � . k... k i d i 1.1 \Z • W C „ _ q■ k. 4 r x v k /�iyil ' p vt pe72 : KE/WON /345 f 3 1 5FE /3,+5 T 9 yS l4- 84 &-F RP • h'vvso w/. s Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3 Division of Safety and Buildings • in accordance with Comm 85, Wis. Adm. Code County ST GR of A__ Attach complete site plan on paper not Tess 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. - /3e./6 u, 4— percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all Information. R: rewed by / ��,,i Date Personal Information you provide may be used for secondary purposes (Privacy Law. s. 15.04 (1) (m)). / G�'(/ rk. I f / 11/0 3 Property Owner roperty Location , Of W �L 4151L. Ct11LCo3C.S °N RECEIVED ovt. Lot S � 1 I 1 / 4 4 s369 T.21 N R If 1 (or) W Property Owner's Mailing Address t # B6citr Subd. Name or f,SM# l WP/it1( "'Mr- rite CTY. RAIY. N " .t A N 0 9 2001 Ot m 4 2 /Le 15"1, llcicO. City State Zip - Phone Number ❑ City ❑ Village 14 Town Nearesoad /jvp.SON I ZO /. 1 59 I ( ) nfr irt? //V S° ,t) ( ' ' ° y . // OFFICC ' Construction Use: (Xi Residential / Number of bedrooms 3 Code .derived design flow rate '9 — C' an GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material LQESS 40 eX -571449/ OUT 4J,} ,t, Flood Plain elevation if applicable 41 ./ ft. r °rata rec« dons: • 4-X e T Es r&—p /5 So/r4/3 /-2 gore 4*' i v,,Pov -4.. ‹ ,tiv��r /ov 4-z. P. O. w • r. S. `/3i640 AFvS&.--,e me's 5- - Pc. / Boring ® p rime Ground surface elev. ` ` ° ft. Depth to factor in 9 Soe Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPO/If M. Munsel Qu. Sz. ConL Color ,Gr. Sz. Sh. •Eff#1 'Eff#2 0- /o / /3 — L //sd/e' 444 ee C5 - I-- • 9 • 4 2. /! .iy /o y / ? Y / 5 / G / f S h & ^V► { /e c ' /p- . z. . 3 .1r • y, --- .2 fr$4 A 4•11 i .5 . ? �r - . / 11) t -- Q- 4 9 • 5 ©,s 1,1 7 1.Z. C to 6r g (0 I Z I Boling 1 � # Pit Ground surface elev. � � ft. Depth to limiting factor > yo in. Soli Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff M. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 d --! ,'o %/f 3/ L / fsd - ,s. ),,P etc) 3-F . y .16, )- vim /o y/ 5/6 /7C54(' 4.0ee cw / ..Z • 3 3 /D ' / 5/6 2 444 h 4447 q. s " .5 . a Mi /o ' / G.S ;,4-1, ,' ' C5 -- • 7 i. Z 5 Mil l d 5 , /11%-Pri • S 6, S' o tt i Z - - . 0 ■ • Effluent Print) = BOD > 30 < 220 mg1L and TSS >30 < 150 mg&L • Effluent #2 = BO; < 30 mglL and TSS < 30 mgt CST Name /C o /JER zi/bA'/ Ch 7- - S ignature / 2 2 - , M 7 S, _ Address Date Evaluation Conducted Telephone Number Ulbricht ti, AssocIsles - Y"c • /D - 2D4 z. 71S • 3 ,PG . P /S'S (355 O'Neil Rd. Hudson, Wis. 54018 P!V 5 �1 /V or s to 0 a 6 • yoy•VO • Ozr , • • sE or Nov o / /o9. ao•cup • i . 4. .y L L << . / y L evvet 13 / 1 ' ST 5tP1 aide / o2.0.//0 y . y° . oua • Property Owner ,1 Pf L a d ` e o soN Parcel ID # ° ). o • / 9 • 2O • Page 2-- 3 Boring # Q 0 � 7 > q of 3 I _.pit Ground surface elev. ft. Depth to limiting factor in. Horizon Soil Application Rate Depth I Dominant Color Redox Desaiption Texture Structure Consistence Boundary Roots GPDiff in. Munsef Qu. Sz. Cont. Color _ Gr. SL Sh. 'Etf#t 'Eif#2 0 - /65 R 3 `Y L /f - 4 fp ci, 3 7C / . 6 z /h� ioW �l� - -5 /74,W � i 2 c4J . � f- Z • 3 5 / 3/ is'yl� 5/4 Z tu-t sf 6' s . / • s • c y 3 /yy ion rte. — /S e5 Z yyIi /oY2 s/ — z s . D . �� - 7 Doting ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots [ GPD/ff in. Munsel Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor In. Sod Application Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDAf In. MunseN Qu. Sz, Cont Color Gr. Sz. Sh. •Eff#1 'EIf#2 " t l I Boring # Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description. Texture. Structure Consistence Boundary Roots GPD/If in. MunseN — Qu. Sz. Cont Color � Gr. Sz. Sh. 'Eff#t 'Eff#2 Effluent #1 = BOD. > 30 < 220 mg/_ and TSS >30 < 150 mg&L • Effluent #2 = BOD < 30 mgt- and TSS < 30 nglL 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. saw»o (R.6000) • . 6 ,3---. k , :..... --, _,,,,, ).. .,; /NI ,,, , ■ , ...., __ NNi \_ t " �,� _ 0 • 1 t O ',1 t w 0 r ,. , ,.. 1 b v S 92 73 2 'n W O Q ...IP • y o 0 r p Ov 0 ■ li , i 1 ,%_`,\ t , . , . 1 a . i p (.. A D 0 Ob • : 0 I 0 0 O -4 ttl Z \ Z O • T FROM : Schumaker Plumbing FAX NO. : 7153863121 Sep. 26 2002 11:36AM t e r ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address oft •ilA• ■ 01 • Wi(6o1G' 4 p p ' Property Address 69 C 6r,wood R e 1 sfi (Verification required from Planning Department for new construction) City /State HUl c s , (01 Parcel Identification Number _____ LECFALMSEIgEEM Property Location 5 E 1/4, N co r /,, sea. 3{c , T a N -R 19 W, Town of 14A- Subdivision , Co f'a»GU©a4 I i 5f Na i i (o') -, _ , Lot # (""" ! mss) Certified Survey Map # , Volume , Page # . Warranty Deed # - 7 0 $6 gO , volume (3 /35 , page # 355 Spec house ► yes ❑ no Lot lines identifiable* yes ❑ no might MAINTENANC,F Improper use and mainbananceof your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal *stein. The property owner agrees to submit to St. Croix Zoning Depamuent a certification form, signed by the owner and by a ,masterplumber, jotuneyntanplumber, restrictedphmdber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition atndWoi (2) alter inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set - as set by the Department of COMIC= and the Department of Naomi Resources, State of Wisconsin. Certification t • •, septic system has barn. •• . -/ Croix • be completed and returned to the St. County Zoning Office within 30 days of the ear expirati / 4 � ,Ir'' a �� � , "C23 SION 'LURE OF APP DATE r we) certft that all statements on this form are true to the best of my (our) knowledge. I (we) am (arc) the owners) of the . , • • w • • - • above, )g of a A l .. , deed recorded in Register of Deeds Office. lb, fry g° , Q3 SI ATOM OP .. DATE " Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. "" *** •e include with rids application: s stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pape ( ot 2 FILE INPORMATION SYSTEM SPECIFICATIONS Owner �,` r 4 lbw i, 3 . �\ / CL Septic Tank Capacity l� .$ ga l 0 NA Lmit# ,/ --- Li`3,4CL Septic Tank Manufacturer ki lt ' c�Sar 0 NA DESIGN PARAMETERS Effluent Filter Manufacturer z 01 A Z 4 2 0 NA Number of Bedrooms 4 -/ 0 NA Effluent Filter Mod& /41/4c©• 0 NA Number of Public Facility Unite EI NA Pump Tank Capacity zod' gal 0 NA Estimated flow (average) 6 (ID aa} /day Pump Tank Manufacturer Ld r e , 0 NA Design flow (peak), (Estimated x 1.5) l � o gal /day Pump Manufacturer 410-44 /et/ 0 NA Sod Application Rate D - gal /day/ftt Pump Modsi O NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit $cNA Fats, Oil & Grease (FOG) S30 mg /L 0 Sand/Gravel Filter 0 Peat Filter Biochemical Oxygen Demand (BOW 5220 mg /L 0 NA 1 0 Mechanical Aeration 0 Wetland Total Suspended Solids ITSSI 5160 mg /L 0 Disinfection 0 Other: Pretreated Effluent Quality Monthly average Dispersal Cents) 0 NA Biochemical Oxygen Demand (BOD 530 mg /L )in- Ground (gravity) 0 In- Ground (pressurized) Total Suspended Solids ITSSI 530 mg /L t NA 0 At -Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /100m1 0 Drip -Line 0 Other: Maximum Effluent Particle Size Yi in dia. 0 NA Other: 0 NA Other: 0 NA Other: 0 NA *Values typical for domestic wastewater and septic tank effluent. Other: NA MAINTENANCE SCHEDULE Service Event Service Frequency At least once every: 3 oar(s) s (Maxhtuint 3 years) ❑ NA Pump out contents of tanks) When combined skidge and scum equals one -third (4) of tank volume 0 NA inspect dispersal collie) At least once every: 3 •A (a) (Mexlmum 3 years) 0 NA 1=1111 At least once every: / moilthie) CI NA • . earls) inspect pum(/, pump controls & alarm At least once every: o a — a month(s) ) O NA ) Flush Laterals and pressure test At least once every: • (non (1) 0 NA O ear(a) Other: At least once every: month(s) 0 NA O ads) • her: 0 NA MAINTENANCE INSTRUCTIONS inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licensee or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(a) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal *alga) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y31 or more ot the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter Nil 113, Wisconsin Administrative Code. 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JsMOd UeLIAA 'signal Je *8M4614 10 01100 0A0g9 4111 Aew sluel dwnd se5elno JsMod Bw.np •00e;Jn9 a /41 944 le maw; ale su0111pu03 l!0O Ua4M in000 tOU (legs do uels wO1sAS •esn 01 J0IJd Jote.1edo Bunnies sands, a Aq penowaJ (1)llue; •43 ;o swewoo 943 aAa4 paloeiep ea suollenueouoo 4 ;l 19)1190 lesiedslp 041 a6ewep Jo/pue ss000Jd wewle0J4 wit apedw! Mw ley* sle)lwega J0glo 40 SlonpOJd 6upuled ;0 e0Ues0Jd 841 40; (1}11031 1UOw1eeJ1 )1 S..MOd 941 40 esn 01 NO lb o SU0 an JliV1S ,.� ° e @e d J 2 1 3 5 P 3 5 5 708880 KATHLEEN H. WALSH WARRANTY DEED RE OF DEED Neil L. Wilcoxson and Mary J. Wilcoxson, a /k/a RECEIVED FOR RECORD Mary Jo. Wilcoxson, husband and wife, conveys 02/07/2003 02:00PM and warrants to Kernon J. Bast the following EXEMPT # described real estate in St. Croix County, State of REC FE Wisconsin: TRANS E: EE: 288 COPY FEE: CERT COPY FEE: PAGES: 1 Exception to warranties: all easements and restrictions of record. This is not homestead property. Parcel Identification Number(s): 20- 1109 -40 -000; 20- 11 -9 -20 -000; 20- 1109- 10 -000; and 20- 11 -90 -55 -000 Name and R lAW t0: A parcel of land located in part of the Southeast '/4 of the ina Realty Title Northwest 1/4 , part of the Southwest 'h of the Northwest- 400 South 2nd Street 1/4 , part of the Northeast % of the Southwest1/4, and part Suite #115 of the Northwest'/, of the Southwest 1/4, all in Section 36, /� s on, WI 54016 Township 29 North, Range 19 West, Town of Hudson, St. j 7V -l4 Croix County, Wisconsin described as follows: Commencing at the South 1 /4 corner of said Section 36; thence North 00 degrees 10 minutes, 01 seconds West along the north - south % line, 1634.77 feet to the Northeast corner of a parcel of land described in Volume 526, page 259 at the St. Croix County Register of Deeds Office, being the point of beginning; thence continuing North 00 degrees, 10 minutes, 01 seconds West along said North - South ' /a line, 1977.22 feet to the South line of the North 350 feet of said Southeast % of the Northwest 1 /4; thence South 88 degrees, 49 minutes, 51 seconds West, along said South line and the Westerly g es erl extension of said line, 1324.14 feet; thence South 00 degrees, 09 y , minutes, 43 seconds East 2,096.73 feet to the centerline of County Trunk Highway "N" being a point on 1,999.00 foot radius curve, concave southerly, whose central angle measures 03 degrees, 00 minutes, 19 seconds, whose chord bears South 80 degrees, 02 minutes, 21.5 seconds East and measures 104.84 feet; thence Easterly, along the arc of said curve and centerline, 104.85 feet to the point of tangency; thence South 78 degrees, 32 minutes, 12 seconds East along said centerline, 712.54 feet to the West line of said parcel described in Volume 526, Page 259, thence North 00 degrees, 10 minutes, 01 seconds West along said West line 304.75 feet to the North line of said parcel; thence North 89 degrees, 49 minutes, 59 seconds East along said North line 523.00 feet to the point of beginning, all in Section 36, Township 29 North, Range 19 West, St. Croix County, Wisconsin. tk Dated this /� day of .�C•�—rCC , 2003. lie77 'Wilco on ' xs Mary J a i on • v ACKNOWLEDGMENT K ; STATE OF WISCONSIN ) � X P(/e � COUNTY OF ST. CROIX ) J < {� Personally came before me this- day of '7/- 2003, the above • -med Neil L. Wi lco of d Mary . C �f; Wilcoxson to me known to be the persons who executed th fo oing instrume - • acknowledge the mme DEBORAH A. r:. PRESTON Nota Public _ /7 ` '! j My commission expires: � (O " r � This instrument drafted by Robert F. Wall. WilcoxsontoBastWD03 -1 „3 c OF W`S „ c F wlSw- .... _ \s\ `4, \ Qv� ¢� � (U • U14- .-r 0, ¢ U lT vi c in N tD co CI ® • O" 3 -P it') U U W N • 81\s/C • • c� ?' J( • T • a) t(-) � • t coo p �� z • L lT (U ¢ U 0 1 ¢ 4 UI 4- (11 ° O� Cu � CUB . ® In CO i co o in cu o m • • t . I I • -P U14- a, ML Q Q¢ co U CO i M (D ¢¢ N • ¢ ¢ In N ..-1 CU t ^! M CU In O' • • • •• ®• •® . • .9C'£90 i£L'960Z 3nCV 60o00S j , c o a°io S00 °10'01 "E 259.28' r,1 76.15 159.28'— N CV cc •^ 100.00' • M 94.03' In _ . N 0�• m X O� M w 1 t \ N00 °10'01 "Iq/ 259.28' fn - xo I .. x�� 0 • x • o Z ,00'6L£ 3„1.0,01-.00 / . 12 y . 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