Loading...
HomeMy WebLinkAbout028-1035-20-050 Parcel #: 028 - 1035 -20 -050 03/12/2007 04:42 PM PAGE 1 OF 1 Alt. Parcel #: 26.28.17.216B 028 - TOWN OF RUSH RIVER 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 - HURTGEN, PAUL J PAUL JHURTGEN 151ACTYRDY BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 0231 BALDWIN- WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 10.980 Plat: N/A -NOT AVAILABLE SEC 26 T28N R1 7W PT SE NW COM 402.45 FT Block/Condo Bldg: S& 412.5 FT E OF NW COR SE 1/4 NW 1/4 TH E 903.7 FT TO E LN SD FORTY TH S ON E Tract(s): (Sec- Twn -Rng 40 114 160 1/4) LN TO A PT 528 FT N OF SE COR SD FORTY 26- 28N -17W SE NW TH W 907.5 FT -POB NKA PARC A INC PARC B; COM 412.5FT E OF SW COR SD SE NW TH N = more Notes: Parcel History: Date Doc # Vol /Page Type 11/08/2002 697766 2041/047 QC 03/22/2000 619971 1497/104 WD 06/29/1998 581966 1335/495 AFF 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 09/02/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 35,000 218,200 253,200 NO UNDEVELOPED G5 7.980 14,000 0 14,000 NO Totals for 2007: General Property 10.980 49,000 218,200 267,200 Woodland 0.000 0 0 Totals for 2006: General Property 10.980 49,000 218,200 267,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 567 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM y- Safety and Buildings Division County- Croix INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary,Prp(tNo.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. S LL 11 b6 Permit Holder's Name: ❑ City ❑ Vil age Town f: State Plan ID No.: Hurtgen, Paul lush %ver �ownship 31 0 = i M•6. CST BM Elev.:- Insp. BM Elev.: BM Description: Parcel T o p3• O lv31T w4 a. � - 1035 -20 -000 TANK INFORMATION ELEVATION DATA at, • z9. 17, a /60 TYPE MANUFACTURER CAPACITY STATION BS HI I FS ELEV. Septic p Benchmark C 1 '�, y pg 20 3�� Dosing �7 t. 2- g� �4 Aeration Bldg. Sewer q•Z 4 Si 3�j Holding St /Ht Inlet . +(4 9tf. 4 0 TANK SETBACK INFORMATION St/ Ht Outlet -r TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet ---- -- Air Intake Septic �vU 201 r NA Dt Bottom Dosing } /,,�' c1 3') NA Header/ Man. S o2.29 Aeration NA Dist. Pipe 10 2,Z(o Holding Bot. System 1O ' I O ( -(a PUMP / IPHON INFORMATION Final Grad --:p ;((� (g+ -- �) Manufacturer '2z o Demand St cover Model Number 140 4 GPM 9 y „ c -.It 2 , / S' Loa BS) 3 ma TDH Lift t�.o Friction j1 4 Systema S TDH;LS•t'Ft L oss Head Forcemain Length ZGa Dia. Z u I Dist. To well SOIL ABSORPTION SYSTEM REN Width . C / Len th N . f T PIT No. Of Pi Inside Dia. Liquid Depth DIMENSIONS T 2 'Sa DIMENSION SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEAC� nu acturer: SETBACK MBER INFORMATION Type Of Moe Num System: Y > SD tiL 3 OR UNIT DISTRIBUTION SYSTEM L:�4' Header/Manifold u Distribution Pipe(s) e& H x Hole Size x Hole Spacing Vent To Air Intake Length Dia. 2 LengthQ S ' Dia. � Spacing Ytf Ir �{o v �_ 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 El Yes El No ❑ Yes [] No C j I du de o di r ies p e � I nspect ion i nspect ion , - 13 r� tioun�y Roa �Wa�d � �f4 NW 4 26 T28N R17W) - 26.28.17.216B Location: 1.) Alt BM Description= tea w» �itk[� 2 ' tc •6 2.) Bldg sewer length= °! • O 3 •°Le, N -- ,► - amount of cover = ? `� � S f ,� 08 •Lo 3.) contour= � � e0 • (o � �e�e�c�✓ �4y� � � - SS � ` 1 3 13 s Plan revision required? ❑ Yes M No Use other side for additional information. 0& SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. _ I ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: { ° t s s } a ^^¢ h ° ... ._.. ...... . SCALE s 3 } 3 F t ; 5 ..,__ - Safety and Buildings Division SANITARY PERMIT APPL ON 201 W. Washington Avenue Wisconsin q P O Box 7302 Department of Commerce In accord with Comm 83, 5, , A1�A ko , 0 / Madison, WI 53707 -7302 AP • Attach complete plans (to the county copy only) for the sy emn a , o e�no ess `� my l / than 8 v2 x 11 inches in size. � • See reverse side for instructions for completing this appy kion tat Sa ary Permit Number i q U 2000 Personal information you provide may be used for secondary purposes h k if revision to previous application tp C -r,C� lPrivacy Law, s. 15.04 (1) (m)). i UUNTY Atatj Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT A L' UNY F RAfA�I"`Ir# 3 1 _�- 0 PrpQ wn r Nam ' S 1/4e a T '� 2, N, R) E (or W Pro ertyOwne SXail" Address Lot Nambal: ,_ Block Nu mber M 1� (re %ty, State Zi Code Phone Number Subdivision Name or CSM Number T YPEOF BUILDING: (check one) ❑ State Owned Prot Nearest Roa Public 1 or 2 Family Dwelling - No. of bedrooms o Io w a n OF �B5h Kt V -ev l c: - ,. III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) L Z �. 0-20 1 ❑ Apartment/ Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 F1 Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining oZP - (* po 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/ Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. 'Jig New 2. ❑ Replacement 3. ❑ Replacement of 4 ❑ Reconnection of 5. ❑ Repair of an System ..... System __ ___ _ ___ __ __Tank Only ____ _______ Existing System ____ -___ Existin System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 Mound 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 In- Ground Pres ure o� l X �� s� 42 ❑ Pit Privy 13 ❑Seepage Pit , T 43 ❑ Vault Privy 14 ❑ System -In -Fill (� , (� rec VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Rewired (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Mi /inch) Elevation 5 0C) . p'� ���. Feet I Feet Cap acit y VII. TANK in Ca g Total # of r Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existin strutted Ta nks Tank S tit 0 0 ❑ ❑ ❑ ❑ L Pump Tank. ber $da / L9 1 ❑ ❑ 1 ❑ VI PONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plum is Signatu ( ( Stamps) MP /MPRSW No.: Business Phone Number: Ile, S Plumber's Address Stre City, 514te, Zip Code 50�, W1. LX - Uuodut LL-a 5 q IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate ssue Issui Agent ignature (No Stamps) IPf`Approved ❑ Surcharge Fee) Owner Given Initial �-�— j� Adverse Determination 3 2� 0v `;d o� elk X , :!� . CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: 1 4111.1 /) � � / q / /r /'u� c✓wy is _ � / v S Cr G < 3 to �6, 4e A" r 'r 5 vt O � - c Z ��� S, _ r u to ¢s � .^oct� ,►.• � s f o h, l �. Y -6398 -6398 - ( S (R. 4/99) DISTRIBUTION: Original to County, One copy To: Saf y &Buildings Di ' ' n, Owner, Plumper INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained: The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608 - 266 -3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 112 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. Safety and Buildings 4003 N KINNEY COULEE RD LACROSSE WI 54601 -1831 TDD #: 608 264 -8777 I sconsI www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary May 19, 2000 i CUST ID No.691727 ATTN. POWTS INSPECTOR ARTHUR L. WEGERER ZONING OFFICE 421 N MAIN ST ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/19/2002 Identification Numbers Transaction ID No. 317046 Site ID No. 192328 SITE: Please refer to both identification numbers, Site ID: 192328, Paul & Mindy Hurtgen Proposed Residence above, in all correspondence with the agency. St. Croix County, Town of Rush River SE1/4, NWIA, S26, T28N, R17W FOR: Description: Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 664042 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. I CAUTION: Wis.stats 145.135(2)(b) indicates that the approval of a sanitary permit is based on regulations in force on the date of approval. The effective date of COMM 83 revisions is expected to be July 1, 2000. Thus depending on the type of system and your design, this plan approval may not be eligible for sanitary permit approval if submitted to the issuing agency on or after July 1, 2000. Note: There is a otR ential for a law suit that may delay the effective date of the code so this status may or may not change. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation /operation. i ARTHUR L. WEGERER Page 2 5/19/00 Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, ^ DATE RECEIVED 05/15/2000 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 Gerard M. Swim BALANCE DUE $ 0.00 POWTS Plan Reviewer - Integrated Services (608)- 785 -9348, Mon. - Fri. 7:15 AM to 4:00 PM jswim @commerce.state.wi.us WiSMART'code: 7633 I Page y of b 1 MOUND SYSTEM FOR A BEDROOM RESIDENCE LOCATED IN THE S E 1/4 OF THE NW 1/4 OF SECTION Zb , T Zt N, R 17 W, TOWN OF '�Z-vSIA- \Z LUL1Z , ST CtZU UC COUNTY, WISCONSIN. INDEX PAGE 1 'of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW -CROSS SECTION PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT .PAGE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR L n+ '1 7 o goo o o�y f PREPARED BY WEG FEE FcEFt E3 C3 I L TEST 2 NG DES 3[ GN �SEF2V I CE � scows/ P.O. BOX 74 421 N. MAIN ST. ., ;•' �+� RIVFF. FALLS. MI 54022 w EH nc c D -B15 P 715 4C.r41bJ Hls4VORTH. V.T.S. - w;. a® • Y.• • a d. . 1 ... o �rlitiona Y P TR OV E D CE ARTMFNT OF COMMERCE 0 D DIVISION F ET GOE�RES ENCE SEE . JOB NO. C)o lZ,s• MAY -19 -00 FRI 01:39,PM NELSEN WEBER SURVEYING,M 1 715 425 6864 P.03 c.r.NNY" ''v n,,,. h, ?rl 20x6 — ' • . Ka.« - aaoUeRw uNe P W 1p n �u C C L t A o. u+ avnirZ f� r- P 0 ` r K 1 M F 7 A N ryj M • (w r i W x 0Ho� A ow �JW � pp o N ?a m n Marva a� S y ' •� it I ^� a p w o v r- J SaM �» n 4'9 n na vii i n W n p � 1 TS � � •'y 9f A O 10 CIO 4 n -r d pr + y 8 •• 7 WGN d o v aw- nj v ti '' d �N a 91 g a r MAY -19 -00 FRI 01:39 PM NELSEN WEBER SURVEYING.M 1 715 425 6864 P.04 Page >Of Approved Synthetic Covering Distribution Pipe Medium Sand Topsoil - .' G 3 E ; P u % Slope Force Main Plowed Trench of 2 z" From Pump Lo er Y (undisturbed Aggregate D Ft. Soil E - Ft. Cross Section Of A Mound System Using F o -5 Ft. I Trench For The Absorption Area G N•a Ft. A 1 4 Ft. H i- S Ft. B 'b -2 -5 Ft. I Z% Ft. Linear Loading Rate= y -8 GPD /LN FT J Ft. Design Loading Rate 0 ZGPD /SQ FT K l0 Ft. L BSI Ft. W 31 Ft. of iD Z /may. PtGG�GR'f� . s4 or Z . �Z.S nc 2� � vC F. +� • t� DAP Vvc p B"Al 7CJ pto�s tr 6 � O'gS�V�4►� P1p� ��1C - Mound Using 2 Trenches For Absorption Area MAY -19 -00 FRI 01 :40 PM MELSEM WEBER SIIRVEYIMG.M 1 715 425 6864 P.05 Page Of Perioroted Pipe Oetolt 0 End Vi.x Pe►lorofed End GaR o A PVC Pips U✓ Q' 1 ,''1►�l�1cC�FL Q t Q 4.• "'FOFLC� M q f N WC %.^TIERAL5 Q "QL*-4 LOQATM - OW BOT"M d° + _P_tl�.L t�D �tZk t�vpLLY 5P►.C.e7D . �• t Q IQ . FRAH [ill M V `lEx7 Zb ZkZ CAP astribution Pipe Layou P Ft, X 3b Inches Y 3 Inches Hole Diameter 11 Y Inch Lateral 1 1 1 1 Inch(es) Force Main Z Inches # o•f holes /pipe Io Invert Elevation of Laterals Ft. �ux1• \1 W x Z. -y 6o'' � - � - '� .� � y,l •Y, Gtr, `��'1•itt, Puce ' 1st hole « from tee with succeeding holes at '5(� intervAIS . Last hole to be next to the end cap. MAY-19-00 FRI 01:40 PM NELSEN WEBER SURVEYING.M 1 715 425 6864 P.06 - Combination Sept-ice Tank and PUMP CHAM5CR CRO55 SECTION ARID 5FICIFICATIOUS ' PAGE S OF r -VC►JT CAP WCATHEK PROOF .IUUCr10N QoX ti C.I. VGNT PIPE , APPKDVCD LOCKING ? -10' FROM DOOR, MANNOLE COVER PvIV JINOOW OR FRESH WAANIUG LP.pEl, AIR 0JTAKt E coNputr r ' � I J IiT JAI, y u 11151>cCTIO1a p lDt �l _ PROVIDE I IIUI - a" — AiKrI6MT SEAL. Approved '-A I Approved joint w/• Tank constzuction I joint w/ PVC pipe shall comply with - I ALA,RIK PVC pipe ILH� 7;3.15 and 33.20 e I I { t C)u g,�. 6� I LLCM, fT. PUMP --` ` _J OFF ° couCR£rE lSL�� $].UQ, MOCK x KISEK EXIT PERMITTED OQLy IF TANK MAUUFACTURCK HAS SUCH APPROVAL 3 APP " fit SCPTIG f SPCCIFIGATIOMS DOSC TwUKS MAQUFACTUX. ER: M / l '•I� ` t" PJ'3 PTL( WUMBER OF ()OSCS: pEK DA4 TAUK SIZE: � 1-O Z ) 1 � GALLOXIS DOSE VOLUME t ALARM PIAUUF S'�' �`1R4 SySt .S I11lC OAWLOW; _ GALLONS MODE WUMBER: CkFACITIES: A= t ''1 Q WCNC5OK L � V ��'u GALLONS SWITCH TY PE: _ 1r'1EIZCLJ�Z,�' B =- I IUCWES`oR u 4LLau5 PUMP M MUFACTURER: _ Z��'� -L�'S7 C: a 1UCKE5 OR � r641- S CaAlLoW5 MODEL WUMbm, D� INCHES OR '� GALLONS SW ITCH TYPE; AlOTE: PU HP AWDALARM�ARC T oo.o MiWIM DISCHARGE RATE_ -A. INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEU PUMP OFF AUD..DISTRIbUTIOQ PIPE.. l3. 'I-5 FECT + m' MIMUM NETWORK SUPPI.V P �RESSjSURE, + 1ZS FCET OF FORCE MAIN X, /00f1Fi[1C71ou FACTOR.. 5 '' FEET HCAp �.� FEET As per manufacturer Z 1.OS gal /in. Liquid depth _ MAY -19 -00 FRI 01:41 PM NELSEN WEBER SURVEYING.M 1 715 425 6864 P.07 TOTAIDYNWCNpAO!cAPACITY 3 '/` " /' — HEAD CAPACITY CURVE KRMWM 117 ` MODEL$ •140/4140" - UFLue r AND DEWATER0 �� Ft. Males T CII. Ltn. l 14 s ls2 sl �+• 1/1 • - lie 1p 7,45 6 12 40 0, 20 1.10 W Ts• 14 41 40 TS 1.67 77 TT3 10— 10 614 40 113 0 - 3S IO.q 3a 144 40 12.10 21 79 e 25- v.n a 1• Z . 'z 7 // CP 4 W% VOW 4 F 6 I 'VZ • �/ 16 15� SKIS24A 4 y�• I O t0_ z Double Seal D esign 7 T/e 1 1p 4 3 /0 1 17 0 U.S. CMI ONS 16 20 30 t0 s0 60 70 e0 90 100 ­0 3 7 /1 LITERS e0 160 240 320 400 D FLOW PER MINVTE 010940 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and supplied Mitt an alarm. , • Mechanical afternators, forduplex systems, are available vAthorwithoul _. Alarms. A 7 /16 • Control alarm systems are available for 1 phase pumps used in simplex SK11 :4a system. See FM0732. • Variable level control switches are available for controlling single phase systems_ • Double piggyback variable level float switches are available for variable SELECTION GUIDE level long cycle controls. 1. Single piggyback variable level float switch or double piggyback variable level • Sealed Owik48ox available for outdoor installations. See FM1420. float switch. Refer to FMC447_ • Over 130•F. (54TJ special quotation required. 2. Mechanical alternator M 10 or 10-0075. • Refer to FMO806 for E00' F. applications. 3. See FM0712 for correct model of Electrical Alternator E•Pak. 4. variable level oontrol swiloh 100225 used as scontrol activator, specify duplex (3) or (4) Mat 6ystem. 5. four (4) hole J -Pak, junction box, for watertight connection or wlrad•In simplex 140 Series - 53 lbs. 4140 Series • 73 Ibs- or 2 pump operation, 10-M, 14014140 MODELS control Selection Model model volts -Ph Mpds Amps Slm x Duplex N140 Ntttp 115 t Non 15.0 tort 115 20364 CAUTION 140 440 230 1 Non .5 10< 1 115 2 or 364 All Installation of controls, protection devices And wiring should be done by 14 14 jjL 1 Non 15.0 1&1115 1 2&364 llV40 DE4140 230 1 Non 73 1 & t 11 5 2 & 36 4 a qualified licensed electrician. Ali electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the •^ Dpubk6eWpump9u1mt6pkrAopcgndmoisNnancota6aMFspYl6atorrgtgx +abphlnNFMA1aNEMA4X occupational Safety and Heahh Act (OSHA). i. ooMrd pan4b. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. AWL T0: P.O. BO 18347 � - }� LouisvAe,KY 4 06.0947 Man11/ecnner3d.. i ' ♦ / tiNlP TO: 3649 Cane Run Road ��� �•• �+ l Lolesv10 KY 40211 -196 �wrcir.- P4aues Ss c� PU !O, (5�> 7>BarJ f•1(800)926 -PUMP FAx(S02) 7765624 __ Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page -�— of .A (, Labor and Human Relations Division of safety & Build"+ngs in accord with ILHR 83.05, Wis. Adm. Code r COUNTY ' 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 % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION R�JI DBY ( �A � K PROPERTY OWNER: PROPERTY LOCATION GOVT. LOT5;C 1 14 1 /4,S T ,N,R j 7 1M10r^W PROPERTY OWNER .S MAILI ADD ESS LOT # BLOCK # SUB0. NAME OR CSM # 'tt CITY, STATE ► ZIP CODE PHONE NUMBER (]CITY []VILLAG MOWN NEAREST ROAD orsl i6e New Construction Use K Residential/ Number of bedrooms oR [ J Addition to existing building [ J Replacement R [ Public or commercial describe 3 b8 I I Code derived daily flow m. pd Recommended design loading rate /VP, bed, gpd/ft? A � trench, gpd/ft ��a� faaso) Absorption area required bed, ft ench, ft Maximum design loading rate LP - bed, gpd/ft 2_ trench, gpd/ft Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) lovn , ay N Additional design /site considerations i Parent material S �- ml elm Flood plain elevation, if applicab 6f 4 ft Suit for system coNVENTIONAL MOUND I PRESS URE ATGRADE SYSTEM IN RLL HOLDING TANK S - U nsu Unsu rs stem OS &U !�S 0U S au ❑S JRU ❑S oU cis Q1U U - U tab fo SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Twch Ground 3 /- S 'y110 S I s6 2 S 5 q el ft. - yl �" �� � � { 2 8 sz 1 r17 rih nq xf" iG CS I r s Depth to J f -S 7, S e 1 41 i s limiting factor - 5 y� C. 0? /W A f' P A te_ Remarks: 1 rzl ICYN :3 tk Boring # 9� r Ground elev. Depth to limiting Q 8 } factor 1 Remarks: CST Name: — Please Print,, / Phone: A ddress: If If - �/�1' Al Signature` Date: /J CST Nu w <(_ /P PROPERTYOWNER t%j 4 fAtnk 9-At, h SOIL DESCRIPTION REPORT Page of ` PARCELI.D.# Boring # Horizon Depth Dominant Color Mottles - -Texture Structure Consistence Boandary Roots GPD /ft . in. Munsell Qu. Sz. Cont, Color Gr. Sz. Sh. Bed rerxh . Ground 3 0— SLY, M pp, C-5 1 „s e(e 7.5 2 8 grio � /Y Depth to limiting factor Remarks: I' Boring # I Ground elev. ft Depth to limiting factor Remarks: Boring # xx l 1 10 31 / 56lk 172 fie CS 3 h l ,, s. Ground 3 - 3a p III s I 3 sbk M FE A-5 I - elev. S Sl S . 7 '• /O ft l° I © , Depth to ?a limiting factor el- 9'1.'� Remarks: Boring # Ground elev. _ ft . Depth to limiting factor Remarks: SSD- 8330 (R.05 /92) `! `� t1f � ri 33 VI ce I I f� ' \� i mI � OQ o r 00 b �\,.i U If ol v ! l to 0 o � o N (� i VII �o v► cr - co 14 O N K O ' o- Qj l + l (D o N \ I rn u, O - Z L' C. TH. Y 864.$0 DO'9 I r � � N � w a W 'oo cc W ( J s W N J U -P S Z ,OZ'6_ , �� �i ,OZ '96� 00 N 9 I v co CA � ° CA o rn 1 j II W ` W Pct 00' lO6 ." CA 14 co I j Ln im . I:LU rn '9 ■ ��N fl C N o �� v co J V ` N . I y rn O rn w .� ID I ^ � N 1 00 -P to �► 1 N N � .� w w _ I � c I I � r lids 1 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer v a'Li PLLr 4 qe n Mailing Address 114 30 (Q ClUt r� Property Address A 0-? � (Verification required froth Planning Department for new constmetion) City /State Parcel Identification Number LEGAL DESCRIPT10h j� Q Property Location � ` /., NW v., See. TALN -R�W, Town of (u5k T � Subdivision Lot # Certified Survey Map # . Volume . Page # Warranty Deed it W I q C� ? Volume f y , Page Spec house ❑ yes R no Lot lines identifiable P9 yes ❑ no SYSTEM NLAj LM"CE improper use and maintenaneeof your septic system could result in its premature failure to handlewastes. Propermaintenance consists of pumping out the septic tank every throe 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 wstetn. The property owner agrees to submit to St. Croix Zoning Department a certification form, sighed by the owner and by a mastcrplumrber, lou veymanPlumbtr. restrictedplumber or a licensed pumper verifying that (1) the o, - Site wastewatcrdisposal system is in proper operating condition andtor (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. 11we, the undersigned have read the above requi mments 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 Natual Resources, State of Wisconsin. Certt cation stating that your Sep 'c em has been maintained must be completed and returned to the St. Croix County Zoning Office within 34 o the r x lea. date. SI NA O LIC DATE OWNER CERTII�+1 CATI0W i (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of th erty seri ve, Virtue of a warranty deed recorded in Register of Deeds Office. Np OF LIC DATE Any information that is axis- represented may result in the sanitary permit being revoked by the Zoning Department. Include with this Wli¢ation: a stamped warranty deed from the fe� e a in the warranty decd a copy of the certified survey trap I I vo1 1497 fm 104 KATHLEEN H. WALSH REGISTER OF DEEDS WARRANTY DEED 5T. CROIX CO., WI RECEIVED FOR RECORD Clinton W. Hurtgen and Judith R. Hurtgen, a /k/a Judith Hurtgen, 03- 22--2000 9:30 AN husband and wife conveys and warrants to Paul J. Hurtgen and VHDtW" DEED Melinda Hurtgen, husband and wife, holding as survivorship EXEMPT I marital property the following described real estate in St. Croix CERT CORY FEE: COPY FEE: County, State of Wisconsin: TOWER FEE: 15.00 RECORDING FEE: 12.00 PAGES: 2 Part of the Southeast Quarter (SE 'b) of the Northwest Quarter (NW 1 /4) of Section 26, Township Twenty -eight (T28N) North, Range Seventeen Recordin Area (R17W) West, described as follows: Name and Return Address Thomas A. McCormack 1, Commencing 402.45' South and 412.5' East of the Northwest comer 1020 Avenue of said Southeast Quarter of the Northwest Quarter (SE' /. of NW %), P.O. Box 2120 thence East 9037 more or less to the East line of said forty, thence Baldwin, WI 54002 South on the East line of said forty to a point 528.0' North of the Southeast corner of said forty, thence West 907.5% thence North to the point of beginning; o2a. 1035.40, - 2. Beginning at a point 412.5 feet East of the Southwest corner of said (Parcel Identification Number) Southeast Quarter of the Northwest Quarter (SE Y. of NW 1 /4) of Section Twenty -six (26); thence North parallel with the West line of said Southeast Quarter of the Northwest Quarter (SE % of NW '/.) 528.0 feet, thence East parallel with the South line of said Southeast Quarter of the Northwest Quarter (SE '/. of NW %) 907.5 feet; thence South along the East line of said Southeast Quarter of the Northwest Quarter (SE '/4 of NW 'h) 528.0 feet; thence West along said South line 907.5 feet to the point of beginning; EXCEPT Lot One (1) of Certified Survey Maps filed June 29, 1998, in Volume 12 of Certified Survey Maps, at page 3477, as Document No. 581965, AND FURTHER EXCEPTING the property described on Exhibit A attached hereto and made a part hereof. Exception to warranties: all easements and restrictions of record. This is not homestead property. Dated this ,f day of _6W J 2000. 'Cl �W. en rtg •J h R. Hurtgen AUTHENTICATION ACKNOWLEDGMENT Signatures) STATE OF WISCONSIN ST. CROIX COUNTY Personpily came before me this day of 2000 the above named Clinton W. authenticated this day of Hurtgen and Judith R. Hurtgen to m r-Yo be the person(s) who executed the fore mg ' i t�um nt!:and acknowledge the pme . signature i — 3 type or print name signature , type or print name 1t.t Ot f " TITLE: MEMBER STATE BAR OF WISCONSIN t•,, a T R (If not, Notary Public St, Croix County, Wisc authorized by §706.06, Wis. Scats.) My commission is permanent. (if not, 7ti a expiration date: THIS INSTRUMENT WAS DRAFTED BY Thomas A. McCormack 'Names of persons signing in any capacity should be typed or Baldwin, WI 54002 printed below their signatures. IMarmetim ProreBaia sCon+pery FondM L- ,W —nsin 900165&2021 VAI. 1497PAGE 105 EXHIBIT A PARCEL A A parcel of land located in port of the SE1 /4 of the NW1 /4 of Section 26. T28N. R17W. Town of Rush River, St. Croix County. Wisconsin; further described as follows. Commencing at the West 1/4 corner of said Section 26; thence S89'59'29 "E, along the cost — west 1/4 line of said section, 1729.95 feet to the point of beginning also being the east lime of o porcel of land recorded in Volume 425. Page 324 at the St. Croix County Register of Deeds Office; thence continuing along sold 1/4 tine S89'59'29 "E 98.26 fact to the west line of Lot 1 of Certified Survey Map recorded in Volume 12, Page 3477 at above said office; thence N00'15'57 "W, along said west line, 89.03 feet to the south line of an access easement recorded in Volume 1332, Page 474 at above said office; thence S89'47'45 "W, along said south line, 98.05 feet to said west line; thence SOO'08'00 "E, along said line, 88.66 feet to the point of beginning. Above described parcel contains 0.200 acres or (8.720 Sq. Ft.) and is subject to all easements, restrictions and covenants of record. PARCEL 8 A parcel of land located in port of the SE1/4 of the NWt /4 of Section 26, T28N, R17W. Town of Rush River, St. Croix County, Wisconsin; further described as follows; Commencing at the Wt /4 corner of said Section 26; thence 589'59'29 "E, along the east — west 1/4 line of said Section, 1828.21 feet to the west line of Lot 1 of Certified Survey Map recorded in Volume 12. Page 3477; thence N0015'57 "W, along said west line, 324.00 feet to the point of beginning; being the NW corner of said Lot 1; thence continuing N0015'57 "W, along the northerly extension of said west tine, 162.00 feet; thence S89'59'29 "E 806.69 feet to the north — south 1/4 line of said Section; thence 500'15'57 "E, along said 1/4 line. 162.00 feet to the north line of said Lot 1; thence N89'59'29 "W, along said north line, 806.69 feet to the point of beginning. Above described parcel contains 3.00 acres or (130,680 Sq. Ft.) and Is subject to oil easements, restrictions and covenants of record. The parcels shown on this document is being added to the parcel shown on the document recorded in Volume 1336. Page 90, Document No. 582039. descrbed as Lot 1 of Certified Survey Map recorded in Volume 12. Page 3477, to create one porcel, and this transaction is thereby exempt from Chapter 18 of the St. Croix County Land Use Regulations pursuant to Section 18.05 (A) (3). i, �I VQL 1498PAGE 135 6240189 KATHLEEN H. WALSH rent Number Q UIT CLAIM DEED REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD --- Clinton W. Hurtgen and Judith R. Hurtgen, a / k/ a Judith 03 -27 -2000 10;30 AM Hurtgen, husband and wife, uit- claims to q Kory A. Kerr and QUIT CLAIM Jolene R. Kerr, hu sband and wife, holding s g su►vivorshi EXEMPT # marital property, the following described real estate in St CERT COPY FEE Croix County, State of Wisconsin: Ijl �d COPY FEE: TRANSFER FEE: RECORDING FEE: 2 2.00 PAGES: Recording Area Name and Retum Address Thomas A. McCormack 102010'" Ave. Baldwin, WI 54002 028- 1035 -40 (Parcel Identification Number) Parcel A and Parcel B as described on Exhibit A attached hereto and made a part hereof. This is not homestead property. Dated this L,S� ` day of Aa►'6 2000. r *Cli W. Hurtgen *JudiKR. Hurtgen AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ST. CROIX COUNTY 8q.. Q Personally came before me this Ir day of authenticated this day of ' 19 2000, the above named Clinton W. Hurtgen-and Judith R. Hurtgen, a/k/a Judith Hurtgen to me own o be the person(s) who exec ad the fore ng instr ment and signature acknowledge the type or print name signature TITLE: MEMBER STATE BAR OF WISCONSIN type or print name (lfnot, authorized by § 706.06, Wis. Stats.) Notary Public St. Croix County, Wisconsin. My commission is permanent. (if not, state expiration date: THIS INSTRUMENT WAS DRAFTED BY 119 ) Thomas A. McCormack *Names of persons signing in any capacity should be typed or Baldwin, WI 54002 printed below their signatures. Information Professionals Company Fond du Lac. Wisconsin 800.855• C voi..1498PAGE136 EXHIBIT A PARCEL A A parcel of land located in part of the SE1 /4 of the NW1 /4 of Section 26, T28N, R17W, Town of Rush River, St. Croix County, Wisconsin; further described as follows: Commencing at the West 1/4 corner of said Section 26; thence S89'59'29 "E, along the east — west 1/4 line of said section, 1729.95 feet to the point of beginning also being the east line of a parcel of land recorded in Volume 425, Page 324 at the St. Croix County Register of Deeds Office; thence continuing along said 1/4 line S89'59'29 "E 98.26 feet to the west line of Lot 1 of Certified Survey Mop recorded in Volume 12, Page 3477 at above said office; thence N00'15'57 "W, along said west line, 89.03 feet to the south line of on access easement recorded in Volume 1332, Page 474 at above said office; thence S89'47'45 "W, along said south line, 98.05 feet to said west line; thence S00'08'00 "E, along said line, 88.66 feet to the point of beginning. Above described parcel contains 0.200 acres or (8,720 Sq. Ft.) and is subject to oil easements, restrictions and covenants of record. PARCEL 8 A parcel of land located in port of the SE1 /4 of the NW1 /4 of Section 26, T28N, R17W, .Town of Rush River, St. Croix County, Wisconsin; further described as follows: Commencing at the Wt /4 corner of said Section 26; thence S89'59'29 "E. along the east — west 1/4 line of said Section, 1828.21 feet to the west line of Lot 1 of Certified Survey Mop recorded in Volume 12, Page 3477; thence N00'15'57 "W, along said west line, 324.00 feet to the point of beginning; being the NW corner of said Lot 1; thence continuing N00'15'57 "W, along the northerly extension of said west line, 162.00 feet; thence S89'59'29 "E 806.69 feet to the north — south 1/4 line of said Section; thence S00'15'57 "E, along said 1/4 line, 162.00 feet to the north line of said Lot 1; thence N89'59'29 "W, along said north line, 806.69 feet to the point of beginning. Above described parcel contains 3.00 acres or (130,680 Sq. Ft.) and is subject to oil easements, restrictions and covenants of record. The parcels shown on this document is being added to the parcel shown on the document recorded in Volume 1336, Page 90, Document No. 582039. described as Lot 1 of Certified Survey Mop recorded in Volume 12, Page 3477. to create one parcel, and this transaction is thereby exempt from Chapter 18 of the St. Croix County Land Use Regulations pursuant to Sv4.tion 18.05 (A) (3). A t + i