HomeMy WebLinkAbout161-1093-30-000 `COMMERCIAL TESTING LABORATORY, INC.
514 Main Street, P.O. Box 526
Colfax, Wisconsin 54730
715- 962 -3121
800 - 962 - 8378 (WI)
800 - 962 - 5227
ST. CROIX ZONING REPORT NO,* 32123/01 PAGE 1
ST. CROIX COUNTY REPORT DATE, 8/03/89
COLJRTHOIISE DATE RECEIVED' 8/01/89
HtlDSON, WI 54016
ATTNS THOMAS C. NELSON
A ./ cf 7-
j 3 0�, 73
OWNERS Merrill Lynch (formerly Atoucher)
LOCATIONS 212 Station CircLe N, St. Croix Station
Hudson, WI LOT—? 2
COLLECTORS Mary Jenkins - St. Croix County Courthouse
SOURCE OF SAMPLES Kitchen Faucet
COLIFORMS 0 /100 ml
INTERPRETATION: BacteriologicaLLy SAFE
NITRATE -NS 4 ppm
Under 10 ppm is safe for human consumption.
COLIFORM + NITRATE
r�
LAB TECHNICIANS Pam bane
WI Approved Lab Not 19
yOF. \NDEPENpFN • r 3 �''
C�
j V
Means "LESS THAN" Detectable LeveL Approved byi
�� ® PROFESSIONAL LABORATORY SERVICES SINCE 1952
ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
ST. CROIX COUNTY COURTHOUSE
911 FOURTH STREET • HUDSON, WI 54016
(715) 386 -4680
August 1, 1989
Merrill Lynch (Ploucher)
212 Station Circle N
Hudson, WI 54016
Dear Joann,
An inspection of the septic system on the Ploucher property
located in the Town of Hudson was conducted.
At the time of the inspection, the sanitary system appeared to be
functioning properly. The inspection of this sewage disposal
system was based upon a surface inspection of said system, and
did not involve any excavating or chemical analysis.
Accordingly, there is the possibility of hidden defects in the
system not discoverable by this inspection. This does not in any
way warrant or guarantee the continued proper functioning or
operation of this system. It is recommended that the system
should be pumped once every three years. Therefore, the
prolonged life of this system is totally dependent upon proper
maintenance of the system.
Should you have any questions regarding this subject, please feel
free to contact this office.
Sincerely,
Thomas C. Nelson
Zoning Administrator
TCN•sa
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ST. CROIX COUNTY ZONING OFFICE
St. Croix County Courthouse
GJ 911 4th Street
son, WI 540
CI�C Telephone (715)386 -4680
The St. Croix County Zoning Office offers the service of septic
and water inspections to Lending Institutions, Realty Firms, and
private individuals.
Completion of this form is essential so that the property can be
located
Please provide the following information, enclose appropriate
fee made payable to St. Croix County Zoning Office, and mail,
along with form to the above address. Testing will be done as
soon as possible after fee and form are received.
WATER TESTING------------ --------- - - - --- -FEE: $ 25.00
'
. k;
(For nitrates and coliform bacteria)
WATER TESTING FEE: $175.00
(For VOC'S) l
SEPTIC SYSTEM INSPECTION---------- - - - - -- -FEE: $25.00
(Determines if system is properly functioning at time of
inspection)
Property owner's name Ae r r, 11
Property owner's address
Legal Description 1/4 of the 1/4 of Section , T N -R
Town of lllorl i Lot Number Subdivision Name 7
SGr� /ct 7
FIRE NUMBER LOCK BOX NUMBER
Color of house --T� _ Realty sign by house? If so, list firm:
PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP,i.e,COPY OF PLAT BOOK,
WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET.
Testing of residential water requires a sample that is fresh. If
the home is vacant, and has been so for some time, the water line
must be purged by running the water for several hours before the
test can be conducted.
WINTER TESTING: Many times water lines are turned off, or sill
cocks are turned off, making access to the home necessary. If
this is the case, please make proper arrangements with this
office to ensure time when entry may be gained.
Firm or individual requestin services: ?:►� 'Y�
Telephone Number 3� ? 1
REPORT TO BE SENT TO: �-
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Closing
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9 date
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Signature �
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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
515104 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 X Village Township Parcel Tax No:
Harper, Robert & Nanc t I Village of North Hudson 161- 1093 -30 -000
CST BM Elev: Insp. BM Elev: Description Section/Town /Range /Map No:
/ 00- 0 BM /(}� 13.29.20.737A
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
g �.R ���L -�) t' °Z_ Alt. BM �
Aeration Bldi� r
Holding � St/Ht Inlet �
TANK SETBACK INFORMATION t/ utlet d f 6 �
TANK TO P/L WE BLDG. Vent to Air Intake ROAD Dt I
JbsAA • g 7.
Septic i+5 Dt Bottom
y13 9tr. -7-
sing > , v y �/ Head /Man. f 6 .0
Aeration D ist. Pi pe Ulr6 S /
+ � � V G �•GS 9 9
Holding Bot. System G
7.6 93• I5
` Final Grade pp
PUMP /SIPHON INFORMATION 3.10 �0 • d
Manufacturer Demand St Cover
P • 2
Model Number
TDH Lift Friction j Sysi6rnQ ead T Ft 11 7I
Forcemain I LV6th Dia. Dist. to well
SOIL ABSORPTION SYSTEM Zl C im
BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS ( �j
SETBACK SYSTEM TO I P/L 5 BLDG WE LAK /STREAM EACHING Manufactur
INFORMATION CHAMBER es J L
O V
Ty Of System: / 7 D
Model Number:
ti LL, DIS IBUT ( 25 1 (p �✓' �4
Bader/ anifc d Distribution r C�S x Hole S ze x Hole S Vent to Air Intak6
Pipe(s)
Length L Dia Length D Dia Spacin n
SOIL COVER x Pressure System Only xx Mound Or At -Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded /Sodded Mulched
Bed/Trench Center � Bed/Trench Edges Topsoil
0 xx Yes � No El Yes � No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: // 0 1 Inspection #2:
Location: 212 Station Circle North Hudson, WI 54,01166 (SE 1/4 1/4 13 T29N R29W) St. Cmix Station Lot 13 Parcel No: 13.29.20.737A
1.) Alt BM Description
2.) Bldg sewer length =
- amount of cover =
Plan revision Required? ❑Yes No - --
Use other side for additional information.
Date Ins ctor's Signature Cert. No.
SBD -6710 (R.3/97)
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PAID
COmmerCe.Wi.gov Safety and Buildings Division Count y
201 W. Washington Ave., P.O. Box 7162 ✓ ��o
i seo n s i n Madison, WI 5 3 707 -7 1 62 Sanitary Permit Number (to be X
filled in by Co.)
Department of Commerce • S� I S
Sanitary Permit Application State Transaction Number
In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental [V
unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS are Project Address (if d' ferentthanmailingaddress)
submitted to the Department of Commerce. Personal information you provide may be used for s ondary
u oses in accordance with the Privacy Law, s. 15.04(1 )(m), Stats.
L Application Information - Please Print All Information
Property 0 er's N e �\\ Parcel #
V, 6 6 ` Y� I V ANG p� i� JUL 2 9 2009 /40/ - 1' c�93 _30 — �J
Property Owner's Mailing Address Property Location
ST CROIX COUNTY , e `7 z
1 � S - P l 0 N C� L 1 PLANNING & ZONING OFFICE Govt. Lot C
City, State Zip Code Phone Number // 1
e ' /., Section
40b 0� �� 2 "1 111 %(,r D�� ' V� T N, R a �(circlEoo,W
11. Type of Building (check all that apply) r Lot #
or 2 Family Dwelling - Number of Bedrooms t' Li(` ) +fi l3 Subdivision Name
_ Block # 5A , Ci-O►X S l, i oN
❑ Public /Commercial - Describe Use
—- El city of ,�-\ \t
11 State Owned - Describe Use _
CSM Number ®.Village of Wtl h 1"V nS o e
❑ Town of
Ill. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A.
❑ New System Replacement System ❑ Treatment/Holding Tank Replacement Only El Other Modification to Existing System (explain)
13. ❑Permit Renewal El Permit Revision ❑ List Previous Permit Number and Date Issued Change of Plumber ❑Permit Transfer to New O
Before Expiration Owner / Z I r�
IV. Type of POWTS S stem /Com onent/Device: Check all that apply) �.
&Non- Pressurized In- Ground ❑ Pressurized In- Ground ❑ At Grade ❑ Mqund > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil
i Ell
t
E) Holding Tank 11 Other Dispersal Component (explain) �' `L '+� i_ ` t � ry / � p � t t L ?� ; l t1,
_ .__ 3 `" y L '`(� Pretreatment J evi�e (expT� Y
V. Dis ersal/1'reatment Area Information:
Design Flow (gpd) Design Soil Application Rate(gpdst) Dispersal Area Required (st) Dispersal Area Pro sed (so Syste Elevation 7 ' i '
c0 o () . �% <a S� ?) k�i. 4 �'�I .ov
Vl. Tank Info Capacity in Total # of Manufacturer y
Gallons Gallons Units ;? U A
New Tanks Existing Tan
Septic or Holding Tank
Dosing Chamber If 7
V11. Responsibility Statement- t, the undersigned, assume re sponsibility for installation oft POWTS shown on the attached plans.
Plumber's Name (Print) m r s MP /MPRS Number Business Phone Number
S 1L � 9 � t S� - 3�j�,_
r t ` OJA Mk
Plumber's Address (Street, City, State, Zip Code) r -
�� Un W� C- `
VIII ount / epartment Use Onl
Approved El Disapproved Permit Fee Date Issued Issuing Agent ign tore
El Owner Given Reason for Denial $
[�C WcQ)VW &Rroval/Reasons for Disapproval 7
1 Septic tank, effluent filter and
dispersal cell must all be serviced ! maintaine
. / �/ �� /I - 7: /
as per management plan provided by p ��� y rZ
s must be maintained
2. All setback requirement `L L (L J/
rorle /ordinances.
Attach to complete planes for the system and submit to the County only on papgr / not less than g ttt x I 1 inches in size
� L� "ri r ��it Yh.,�ti'v ,7"(.�E�e`'�tf t�'(;'�P1 = LLZ'�e -` ✓! )C� C,f'1/` �J, � �!,�,�
SBD -6398 (R. 01/07) Valid thru 01/09
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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3
Division of Safety and Buildings i nce with Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations
County
Attach complete site plan on paper no It ess than 8'/: x 11 inches in size. PI C e �C D St. Croix
include, but not limited to: vertical and horizontal reference point (BM), dire 3F Gam+ G 8 G
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D.
161- 1093 -30 -000
Please print all information JUL 0 2 2009 Review �"By D ate
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). / Zy � J
Property Owner 1 FILE f 3
Robert M. & Nancy M. Harper PLAN Govt. Lot 4 19 19S 12 T 29 N R 20 W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
212 Station Circle N. 13 1 1 St. Croix Station
City State Zip Code Phone Number _j City e Village I Town Nearest Road
Hudson WI 54016 1 (715)386 - 1267 North Hudson Station Circle North
J New Construction Use: 0 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
T a Replaceme _f Public or commercial - Describe:
WT material Glacial OutwaSh Flood plain elevation, if applicable Na
General comments
and recommendations: it a for conventional POWTS using 0.7 gpd /s . loading rate. Proposed system elev ion =
94.00'.
Boring # I Boring
1A Pit Ground Surface elev. 97.94 ft. Depth to limiting factor >1 10" in. Soil 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
1 0 -7 1Oyr3/2 none sil 2fsbk nvfr as 2fl,c 0.6 0.8
2 7 -21 1 Oyr3 /3 none sl 2fsbk dsh cw 1 fmc 0.6 0.8
3 21 -32 1Oyr3/6 none gr Is Osg dl gw 1fm 0.7 1.6
4 32 -64 7.5yr4/6 none gr Is Osg dl gw 1fm 0.7 1.6
5 64 -110 1 Oyr4 /6 11 } none gr s; Osg dl - 1fm 0.7 1.6
Horizons #3, 4 & 5 contain appr x. 50% gravel & cobbles.
Boring # -I Boring
1/ Pit Ground Surface elev. 98.20 ft. Depth to limiting factor >1 15" in. Soil 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 I *Eff#2
1 0 -13 1Oyr3/2 none sil 2fsbk nvfr as 2fl,c 0.6 0.8
2 13 -26 1Oyr3/3 none gr sl 2fsbk dsh cw lfmc 0.6 0.8
3 26 -36 1Oyr3/3 none gr Is Osg dl gw 1fm 0.7 1.6
4 36 -62 7.5yr4/6 none gr Is Osg dl gw 1fm q 0.7 1.6
5 62 -115 1Oyr4/6 none gr s; Osg dl - lfm 0.7 1.6
Hori ns #3, 4 & 5 contain approx. 50% gravel & cobbles.
* Effluent #1 = BOD? 30 < 220 mg/ and TSS 4< 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L
CST Name (Please Print) Si ature: CST Number
James K. Thompson •- 5--- 3602
Address A.C.E. Soil & Site Evaluation Date Evaluation Conducted Telephone Number
340 Paulson Lake Lane WI 54020 6/22/2009 715 - 248 -7767
Property Owner Robert M. & Nancy M. Harper Parcel ID # 161 - 1093 -30 -000 Page 2 of 3
3] Boring # Boring
tI Pit Ground Surface elev. 98.07 ft. Depth to limiting factor >112" in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2
1 0 -11 10yr3/2 none sil 2fsbk nvfr as 2f1,c 0.6 0.8
2 11 -23 10yr3/3 none sl 2fsbk dsh cw 1fmc 0.6 0.8
3 23 -32 10yr3/6 none gr Is Osg dl gw 1fm 0.7 1.6
4 32 -60 7.5yr4/6 none gr Is Osg dl gw 1fm 0.7 1.6
5 60 -112 10yr4/6 none gr s Osg dl - 1fm 0.7 1.6
Horizons #3, 4 & 5 contain approx. 50% gravel & cobbles.
F-1 Boring # - Boring
_J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2
❑ Boring # - Boring
_J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "Eff#2
Effluent #1 = BOD 5 > 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD -S.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 (R.07 /00) A.C.E. Soil & Site Evaluations
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Parcel #: 161- 1093 -30 -000 07/07/2009 04:03 PM
PAGE 1 OF 1
Alt. Parcel #: 13.29.20.737A 161 - VILLAGE OF NORTH HUDSON
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner
O - HARPER, ROBERT M & NANCY M
ROBERT M & NANCY M HARPER
212 STATION CIR N
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): ` = Primary
Type Dist # Description * 212 STATION CIR N
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 0.000 Plat: 04- 038 -ST CROIX STATION 1977
ST CROIX STATION LOT 13 EXC STRIP IN NW Block/Condo Bldg:
CORNER DESC IN VOL 607/181 VIL NH
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
13- 29N -20W
Notes: Parcel History:
Date Doc # Vol /Page Type
07/23/1997 848/521
07/23/1997 777/329
07/23/1997 713/83
01/14/1980 362312 607/181 WD
2009 SUMMARY Bill #: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 06/22/2006
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.000 328,800 665,200 994,000 NO
Totals for 2009:
General Property 0.000 328,800 665,200 994,000
Woodland 0.000 0 0
Totals for 2008:
General Property 0.000 328,800 665,200 994,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch #: 208
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF AN EXISTING SEPTIC TANK.
This is to certify that I have inspected the septic tank presently serving
the � A.. + N P N �� �b4 residence located at:
Sec. 01 T _ R -gip 0
i nn v ) 0 4 ti bSd� J , St. Croix
County, Wisconsin. Upon inspection, I certify that I have found the tank and
baffles to be in good cond and it appears to be functioning properly.
Last time serviced
Did flow back occur from absorption system? Yes C7cN/
(if no, skip next
Approximate volume or length of time:
Ca gallons
Capacity: 9 minu tes
}� it : --
y ..L' S 0 _ 1 -
Construction: Prefab Concrete Steel
Manufacturer (if known): - e1SRrt — other
Age of Tank (if known): _ -)
(Sign
(Name) Please Print
(Title) (License Number)
(Date)
Form to be completed by licensed plumber (s. 145.06 W isconsin �sconsin St
ose atutP
P r (NR 113 Wisconsin Administrative Code) s) or
licensed disposer
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Plumber a 1 i
( pP Y n for sanitary anitary permit) Certification:
In accepting the above statement regarding existing septic tank condition, I
certify that the tank, to the best of my knowledge, will conform to the
requirements of ILHR 83, Wis. Adm. Code (except for inspection opening over
outlet baffle).
Name ZJ I m Signature
--
MP /MPRS _ a, (� --
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer
Mailing Address
Property Address
(Verification required from Planning & Zoning Department for new construction.)
City /State , (,�(,� a,(j / Parcel Identification Number 00�_
LE_ D ESCRIP TION
Property Location '/, , 1 /, , Sec. /0, T _ R_-W_W, Town of
Subdivision -�'
c� InAj , Lot #
Certified Survey Map # , Volume , Page #
Warranty Deed # � '5 '�rp/- , Volume 19 / , Page #
Spec house yes no Lot lines identifiable yes no
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 ti F ' *" $ nts and a to maintain the private sewage qi[��e 8 p g dispo�l system with the
standards set forth, herein, as set by the fi agree erce and the Department of Natural Resources, State of Wisconsin.
Certification stating that your septic system has ined must be completed and returned to the St. Croix County Planning &
Zoning`Department within 30 days of the
y three on date.
Uwe certify that all statements on thi9 fo , ttcttie to the best of m /our knowledge. I/we am/are the own s virtue of a warran ' Y g ) of the
property described above, b
Y ty raoorded in Register of Deeds Office.
Number of bedrooms
1277
SIONAOURE OF APPLICANTS) DATE
** *Any information that is misrepresented mayWe sanitary permit being revoked by the Planning ,& Department. * **
;
Include with this application a recorded warranty dad the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed. ,
(REV. 08/05)
Private Onsite Wastewater Treatment System Management Plan
Septic Tank And Gravity In- Ground Soil Absorption Component
Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment
System (POWTS) shall include information and procedures for maintaining the system within
the parameters of Comm 83 and 84, and the conditions of approval by the department, agent,
or governmental unit. The approved plans and permits for system are on file at the county
zoning or health department.
This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground
Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD-
10567-P (R.6/99).
Table 1: System Design Specifications
Sanitary Permit Number S
Number of Bedrooms
Design Flow - Peak (gpd)
Estimated Flow - Average (gpd) p
Septic Tank Capacity (gal)
Soil Absorption Component Size (ft')
Type of Wastewater Domestic
Table 2: Soil Absorption Component - Limits of Reliable Operation
Septic Tank Component Soil•Absorption Component
Design Flow =Peak (god) av OU
Maximum Influent Particle Size (in) 1/8
Maximum BOD (mg /L) 220
Maximum TSS (mg /L) 150
Table 3: Maintenance Schedule
Septic Tank Inspect and /or service once every 3 years
Outlet Filter Inspect once a year and clean at least once every 3 years
Soil Absorption Component Inspect once every 3 years
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks
under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with
NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease
Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable
Restrooms).
The operating condition of the septic tank and outlet filter shall be assessed at least
once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure
proper operation. The filter cartridge should not be removed unless provisions are made to
retain solids in the tank that may slough off the filter when removed from its enclosure. If the
Management Plan for a Septic Tank and Soil Absorption Component
filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously.
Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The
septic tank shall have its contents removed when the volume of scum and sludge in the tank
exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at -the
time of an assessment, maintenance personnel shall advise the owner of when the next service
needs to be performed to maintain less than maximum scum and sludge accumulation in the
tank.
Manhole risers, access risers and covers should be inspected for water tightness and
soundness. Access openings used for service and assessment shall be sealed watertight upon
the completion of service. Any opening deemed unsound, defective, or subject to failure must
be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by
an effective locking device to prevent accidental or unauthorized entry into the tank.
No one should enter a septic or other treatment or holding tank for
any reason without being in full compliance with OSHA standards for
entering a confined space. The atmosphere within the septic or other
treatment of holding tank may contain lethal gases, and rescue of a
person from the interior of the tank may be difficult or impossible.
Tank abandonment shall be in accordance with.Comm 83.33 Wis. Adm. Code when the
tank is no longer used as a POWTS component.
Soil Absorption- Component '
The soil absorption component serving this structure is designed to accept domestic
wastewater from a residential facility. The limits of operation of this component are sh®wn in
Table 2.
The longevity of a soil absorption component depends greatly on proper and timely
maintenance, and system use within or below the limits of reliable operation. Good water
conservation practices by all occupants and the installation of water conserving plumbing
fixtures are key factors in extending the useful life of this component.
The soil absorption component's operation must be assessed by inspection at least
once every three years. The inspection shall include recording the levels of ponding, if any in
the observation pipes, and a visual inspection for any evidence of surface seepage or discharge
from the component. On steeply sloping sites, areas of erosion should be identified and
reported to the owner for repair. The surface discharge of domestic wastewater or sewage
from the system is prohibited and considered a human health hazard.
Traffic around or over the soil absorption component should be avoided particularly
om
during winter months. The compaction or removal of snow cover over the component may lead
to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or
impossible to repair until weather -conditions improve. In general, soil compaction over this
component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to
more intense, and earlier, organic clogging of the soil.
Plantings of deep- rooted trees and shrubs directly over or within ten feet of the
component should be avoided since root intrusion into the component may obstruct wastewater
flow.
9
1NSTALLF,R'S NOTES:
RECYCLE GREASE! Do not pour grease down the drain. Your septic tank and filter
will not handle it.
NO BLEACHES! Do not introduce bleaches into your system. The bacteria in.-your septic
tank is what makes your system work. Bleach kills the bacteria. When that happens, your
septic tank will no longer function correctly. This will cause premature failure of your
system.
WATER SOFTENER! Do not run the brine solution into your septic tank. This solution
has a high concentration of lime (that's what makes your water hard). The lime tends not
to settle out in the septic tank but goes directly to the drain field. Lime is an excellent
sealing agent, and yes, it does the same thing in your drain field.
Think of your sewer system as you would your car. Treat the attached information as
you would your car manual. Remember, also, that your car requires regular maintenance.
'hare must be exercised as to what you put into it. And like your car, your system
eventually will wear out. The question is - how quickly. If you have any questions, please
call: o u r - '-� w'rS" o rr Cm 4z ca- �OGc�TS "Z✓�S� r
4 CoUh —(7 6 b -
r
I have read the attached information regarding the construction and maintenance of my
sewer system.
Owner's Name Date
r •
^ Mound System Management Plan
ShAti_ c Tank
The septic tank shall be maintained by an individual certified to service septic tanks under,s. 281.48, Slats. The contents of the
septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and
outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to
ensure proper operation The filter cartridge should not be removed unless provisions are made to retain solids in the lank that
may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm. The filler shall be serviced if
the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The
septic tank shall have its contents removed when the volume of sludge and scum in the lank exceeds 1/3 the liquid volume of
the tank. If the contents of the lank are not removed at the time of a triennial assessment, maintenance personNel shall advise
the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in
the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required.
However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and
Buildings Division.
Pump Tank
The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to
verity proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary.
Mo und and Pressure Distributio System
No trees or shrubs should be planted on th mound. Plantings may be made around the mound's perimeter, and the mound
shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic
(other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder of the
infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather
installations (October - February) dictate that the mound be heavily mulched for frost protection.
Influent quality into the mound system may not exceed 220 mg /L BOD5, 150 mg /L TSS, and 30 mg /L FOG. Influent flow may
not exceed maximum design flow specified in the permit for this installation.
The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each
lateral be flushed of accumulatdsolids
s set lea
was lo j de ermine if nfi a clogging has•occuured and if f ce cleaning is
c compared to the initial test whS r t Y
required to maintain equal distribution within the dispersal cell.
Obsery ation pipes within es i conside considered as an impending hydraulic failure requiring levels shall
more f owner,
req ent onitor ng .j
and any levels above
General
This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its
component manual [SBD- 10572 -P (R. 6199)] and local or state rules pertaining to system maintenance and maintenance
reporting.
No one should ever enter
shall ti in pump accordance s wifh Comm 83 33 gases
Wis. Ad Code when the tanks are not longer use d
d as
pum tank abandonment
POWTS components.
Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access
openings used for service and
ct o s failure must replaced. Exposed access openings e grreatter than 8- inche opening n diameter shall
unsound, defective, or subfe
be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component.
Contingency Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep t he
system in proper operating condition.
If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall ;be
immediately repaired or replaced with a component of the same or equal performance.
If the mound component fails to accept w aste water
area f toe leakage occurs or by removing to bring the system into proper
ng biologically clogged adsorption
or replaced in its' present location by increasing basal deemed
and dispersal media, and related piping, and replacing said components as necessary
operating condition. -
Questions on the operation or maintenance of this system should be directed to your county zoning or health inspector.
s � II 4 FI w iFJl6aRCaaRV>Qi rvw RI:C�:.CL"B�T=
poCUtweNr No. STATE BAR OF WISCONSIN ]CORM 1
1 1 WARRANTY DEED
45 ' eac�
- -- - — — f -- ` REGIS'TER'S OFFICE
!._
--- - = - - --
This Deed, made between ---.....- °--- --- � RO
�IX C04" W1
_- -- -- - ---
HIiSEiA� BD1LL W 'E -------------------------------------- -- Grantor, `AUG 5
and ----- -- --• 11- A. M
ROBERT M HIISRPER AND NALJC'Y M HARP7,
A
AND WIFE AS SURVIVDFi.STiIP
HUSBAND „ IO�tbr Deeds
-----• Grantee, of i
Wit21eSSe That the said Gr fo � r � , � va l uable couAideration - - -. --
.. r__ A41 -. gQQy... ��. SrfWvZiF __X.[twWYT_'r4}ed:lES__.. RETURN TO j
conveys to Grantee the following described real estate in .... S'1',. - -C MIX--- _- -. -. -- ( !
County, State of Wisconsin: �1 I
l '
Tax Parcel No- ------------------------------------
IrC'r 13, ST, C'f�I.`. STATILJLV, V=AGF, OF NORTH HUDSM, ST. CROMYL 00
WISCCNSIN,_ EXC EWT THE FC7I.LC7P ING DESCRIBED PARC�:I Q� iF�3C NG AT THE I�
'W 'COMER czr' SruL, ,� � .�,•'"•• -c _- c.-�.� nw-_RE ES 11' E (TRM BEARING) ,
.,
AIDIY G THE Nly IAT LANE, 108 00 FEET: T'rWN= S54 ' 0GR]Kb ' to o� , •, ;!
AT.IDNG THE NE1y IDr IZNE 55.92 FFor; THEIR= N75 DEGREE 3-1'w, 160.22
Fr&V M THE Wly IM LINE. THENCE N14 DECD 49'E, AZT `SAID Wly LOT
LINE, 20.00. P' r TO THE P01M OF BEGINNI`s1G.
- 1
Subject to restrictions Of reoord, Conditions,- reservations aria
easements, zoning o if any, and general taxes and II
assessn not yet due and payable. 11
q
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This ... ..... S • -- hoc -stead property.
. .......... �
- (is: not)
�'- Together with all and singular the hereditaments and appurtensncav thereunto belonging;
And. DAVID. N� -- BLOCS AND- Nfr r� .R._.BF.I ......... ............................... I
f l
warrants that the title is good
, indefeasible in Yee simple and "free and clear of encumbrances except
and will warrant and defend the same.
I i
i Dated thiisl l-- q-- -- .....J.......... -G�-...:1. day of y _. ..._._._.
II X !!'. _Y� !� /t� C "" °_.!'._ _.__,.' ..........(SEAL)' n .�-� "' . (SEAL)
' DAVID- W.••PI�CX71iJ -_--- - -.-- -•--- -- -••---- :: u r � c , HF , T r.E A. 1.I.O..... ....
--' . ------C I
�i (SEAL) it
-- - - -- (SEAL) .._ _-
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II AUTHENTICATION Cl N WBNT II
rca.o{ u i
Signature(s) STATE OF �RFFS6A#6�N
--- ----- •---- --- ..._.•-- --- --- - -- J( (
ss.
1 ' ----- •- ----- --------- ° -------- -- -- -- - -- -------- - County.
{ authenticated this ........ day of ---------- 19_ -_ -_- Pe � alflrll_y came before me this ....P...
......d
_ ay o£
7 .... 1 P the nhova nar,�ed
- ------- ------ -- -- ---- --- -- •--- • -------• --- - --- ---- - -- -- -- -- -- ------ -- - DAVID .Y^7_•_PLOi R _AA - - - - --- --- • -- • --- -- - --- -
* r� CNFTTS.F _A.. -PIER. -------------------------------------
TITLE: MEMBER STATE BAR OF WISCONSIN _'apm -T F...-------- ----------------------------------
(If not, - - -- --------•-- - - -- .. ...... ---------------------------------- -
:v -: -•: •• to ..r 4nnwn to be the person --------- who executed the
foregoing instrument and nckn-wledge tnc s.. - -._.
THIS INSTRUMENT WAS DRAFTED BY
� .� ...............
James C. Sie ex 1550 N_ NOrUhvVeSt HW'J. . �" ;
.............. _.._------- ---._..:.. i= .cam- ... .....
cm —L:',
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tea.... _„ ma hs• anthenticateii � r '
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I ... :r cs.S1LCSy
Sire not neCOSSRr,Y.j r ��•"�•• s 0 .... -
datC: .- .. lU,il Jinn n.. -. .. ............. y , .- _. .)
Ii6YA0v" PUBLIC • MINNESOTA
*Names of persons sixninw in any capacity nh,mld he typerl nr i,rintod bat.; th.:r eez ^ev ++� - 7,,w YKi t�rl^S L__ _� • ��
WARRANTY DsED ATATF DAR OR WISCONSIN VNV y VVVV N~AAN&%-V•MRtI•�!N�I'N'LCCSY B1a nk Ca. lne.
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Parcel #: 161- 1093 -30 -000 02/16/2006 04:40 PM
PAGE 1 OF 1
Alt. Parcel #: 13.29.20.737A 161 - VILLAGE OF NORTH HUDSON
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner
0 - HARPER, ROBERT M & NANCY M
ROBERT M & NANCY M HARPER
212 STATION CIR N
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): ' = Primary
Type Dist # Description ` 212 STATION CIR N
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 0.000 Plat: 04/38 -ST CROIX STATION 1977
ST CROIX STATION LOT 13 EXC STRIP IN NW Block/Condo Bldg:
CORNER DESC IN VOL 607/181 VIL NH
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
13- 29N -20W
Notes: Parcel History:
Date Doc # Vol /Page Type
07/23/1997 848/521
07/23/1997 777/329
07/23/1997 713/83
2005 SUMMARY Bill M Fair Market Value: Assessed with:
108570 820,300
Valuations: Last Changed: 05/20/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.000 328,800 473,900 802,700 NO
Totals for 2005:
General Property 0.000 328,800 473,900 802,700
Woodland 0.000 0 0
Totals for 2004:
General Property 0.000 177,800 299,600 477,400
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch #: 208
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
AS BUILT SANITARY SYSTEM REPORT
T6P �E C . N , R o 20 W
SS
IBDIVI ST. CROIX COUNTY WISCONSIN.
C'r�i s� LOT 1-3 LOT SIZE
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
T v
I
D i
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i
P 'C I t
hi Arrow
SEPTIC TANK(S) /'J�v MFGR. CONCRETE X STEEL
NO o rings on cover O Depth
PUMPING CHAMBER SIZE PUMP MFGR. MODEL NO.
GALLONS Per Cycle
TRENCHES NO. of width length_ area
BED NO. of line width o 7 length u rea
depth to top of pipe ao "
NUMBER OF SEEPAGE PITS Outsi e iameter total pit area
AGGREGATE / /y //
PERK RATE 4,5 S AREA REQUIRED AREA AS BUILT
Disclaimer: The inspection of this system by St. Croix County does not imply
complete compliance with State Administrative Codes. There are other areas that
it is not possible to inspect at this point of construction. St. Croix County
assumes no liability for system operation. However, if failure is noted the
County will make every effort to determine cause of failure.
GREASES AND OILS SHOULD NOT BE DISPOSED THROUGH THI
l } INSPECT _
DATED ,7 $ 0 PLUMBER ON JOB
LICENSE NUMBE 3aa
1
inn ,
EQ.
it MET
1:
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REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
San,ixaxy Penm 't 3�
State S Q p.t.i.c — Sl
�-a �u
NAME ,f/ townah.ip � St. Cxo.ix County
Laces .iore�� -- 6J SectiOn - 1.. - 2--
SEPTIC TANK
Si 1 5a ga.l.l Numbex o6 Compantmenxa I
Vi.atance Fnom: Well _it. 12$ on g elope 01 .4 6t
Bu.i tding it. Wettandb 6t.
H.ighwa - it. R
DISPOSAL SYSTEM
Vii Lance Fhom: Well _� 12$ on gxeatex a.lope Z 6 6t.
Bu.i.ld.ing it. W e.tt and.a `— Ft.
• Highwatex St.
FIELD DIMENSIONS: --
Width o6 tnench it. Depth o6 no below ti..le in.
Length of each .Line 3 St. Depth o6 nock oven .ti..le 2 i n.
Numbex, o6 Zi.nea `f Depth o6 ti.le below gnade in.
To#at, teng,th of Zinea 0 ix. Slope o f .tnench — in pen 100 ix.
�4 D. ia#ance b etween tinea i t. Depth to bednock Total abaoxbtion axes 6 2 Depth to gnoundwatex it.
Requ.ined anew i # 2 Type of Coven: Pap on Straw
PIT DIMENSIONS:
Hum bex o p.i Gxavet a pit.6 yea no
OutA ide di t it. Depth b e.low .in.let St.
2
Toza.l ab nb a it A
Axea xe ned it2 rM
�z INSPECTED B TITL _
APPROVE _ ,DATE s 1971ti.
REJ . TED , DATE 197
h s�.-�
YLO cons -c. doh
s -
`i
E H 1 15 Rev. 9/78
w y REPORT ON SOIL BORINGS AND PERCOLATION TESTS
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
Y P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATION: � ' / <; Y. Sectio /Z jT N,R Z� (or) W, Towns or Municipality
Lot No. 13 ,Block No. �'� n c �ES s�' ��f'O/ 5 14 /oN County sy" Cleo/)(
TER,V - t /�E� u ivision Name
Owner's /Buy ers Name: 1
Mailing Address: C �U �1��+ E�PS/ �Z /W. $7 0.4
TYPE OF OCCUPANCY: Residence —No. of Bedrooms 3 COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MA U • SOIL BORINGS 2- F / i p 7 1 PERCOLATION TESTS / 21 If -) f
SOIL MAP SHEET SC S 7 NAME OF SOIL MAP UNIT Me /' Vbb-AXO 40/26 ee-
PERCOLATION TESTS
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTEF INTERVAL MIN /IN
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
P I 36 IPEA;7je, t - to g E ,PE z ^O - /D /r 2 a
0* 46Z
P_ z3oeE-
P—
P- 3 3& /Of 1 &44 -
P— 0 3
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,
TEXTURE, MOTTLING AND DEPTH TO BEDROCK
NUMBER INCHES
p OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES
B I D IMOV E �� S "D s 12 'AN. /S / "kE s W !D S I(o "C 5 "eS
B— 0/11 > / . Ae A), 1 5 Y " 6 AJ Is 0 30 'CS a - , car 2J" OS
B- 3 ez M OVE - P ` "P4'S'V . r i 'a) /S. 2,S''cs w , 3 406- / s "es "cs
B- P ND,vt } 15 "D,f'B.v. /s " B,v. /s !�O cs L, �G- j R .
B- /V D.VE ? 8 "1�f' IQJ f. "B,v. S "LS w Af 8 "cf 2.7 - o f w
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas.
Indicate number of square feet of absorption area needed for building type and occupancy �Za �/P AED Indicate scale or distances.
Give horizontal and vertical reference points. Indicate slope. /
I /
r _ . ro f '1 '' E �� /E� i7i� "ex r S Ulf U�Y' MO,v. �..
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1, the undersigend, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods
specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my
knowledge and belief.
Name (print) Certification No.
Address AIL 3 ill e/L eA 2r W S . O/
Name of installer if known Copy A — Local Authority CST Signature & /
ry
• State and County State Permit
` Permit Application County Per #
for Private Domestic Sewage Systems County
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
o /Son <- �I 5'y40
B. LOCATION: 5 c '/4, Section _&2, T_IL N, R 2,0 tL (or) & Lot# j City
Subdivision Name, nearest road, lake or landmark Blk# Villa b}' /tio, a
Township
C. TYPE OF OCCUPANCY: Commercial *Industrial *Other (specify) *Variance
Single family �< Duplex No. of Bedrooms S� No. of Persons .�
D• SEPTIC TANK CAPACITY - _ otaI gallons No. of tanks
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete X Poured -in -Place Steel Fiberglass Other (specify)
New Installation Replacement
Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured -in -Place Other (Specify)
E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate ��sS Total Absorb Area sq. ft. /tcur�c{,
New X Replacement Alternate (Specify) 1 0.2.
Seepage Trench: N Line Ft. Width Depth Tile depth (top) No. of Trenches
Seepage Bed: Y Len§ Width� Depth �Tile depth (top a No. of Line
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land AI'me Distance from critical slope
WATER SUPPLY: Private ® Joint ❑ Community ❑ Municipal ❑
Owners name as Iisted on EH 115 if other than present o wner:
I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH -115 prepared
by the C ified S it Tester,
NAME 1 , C.S.T. # .i5�- 0�5/�� and other information
obtained from C ,- e. (owner/build e ).
Plumber's Signature P /MPRSW# - a Phone # 3 y6 — (( y
Plumber's Address e on L%J1 10
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca-
tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors
property. If well has not been drilled please indicate.
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Do Not Write in Spac Below FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application — Fees Paid: Stat Count D e Date
Permit Issued3 (date) — Issuing Agent Na
Inspection Yes State Valid# Date Recd
1. county (whit copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (pink copy) 4. plumber (canary copy)
Revised Date 7/11/78