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HomeMy WebLinkAbout026-1066-95-200 I n m o su 0 c ��7 . k ± ƒ\ o r 0 f% G / E e m ƒ wƒ w e , _ 3 P \}( m °\ PL w o2G CL ° ® I m { \ E . F c # > % OD \ D co \ . § 0� > § 2 . CL \ $ 7 ƒ CD k §CD 2Er cr rr \ o o o 3 § C \ \ M v v \ � , � ® _ § § 0 . 0 \ o § { k » : — _ , k - � ■ _ OL 9 \ � 2 § CL i k q § q 7 , CD CD ^ � 2 - , \ k / . � \ ) � ƒ 4 . qb tA : % 2 / § // %i k CD i Parcel #: 026 - 1066 -95 -200 03/31/2005 02:45 PM PAGE 1 OF 1 Alt. Parcel #: 22.30.18.342D 026 - TOWN OF RICHMOND Current 1, X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * DAVID E & LAUREL A LORFELD LORFELD, DAVID E & LAUREL A 1258 140TH AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1258 140TH AVE SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 3.522 Plat: 0646 -CSM 12/3421 SEC 22 T30 R18W PT SW SE BEING LOT 3 CSM Block/Condo Bldg: LOT 3 12/3421 3.522AC Tract(s): (Sec- Twn -Rng 401/4 1601/4) 22- 30N -18W Notes: Parcel History: Date Doc # Vol /Page Type 11/02/2000 632886 1555/604 WD 07/08/1999 606483 1440/360 WD 07/23/1997 861/346 07/23/1997 787/128 2004 SUMMARY Bill M Fair Market Value: Assessed with: 20120 320,000 Valuations: Last Changed: 06/30/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.520 47,300 243,100 290,400 NO Totals for 2004: General Property 3.520 47,300 243,100 290,400 Woodland 0.000 0 0 Totals for 2003: General Property 3.520 47,300 121,900 169,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 A Wisconsin Department of Industry SOIL AND SITE EVALUATION Page / of 2 Labor and Human Relations .. and Build in accordance with s. ILHR 83.09, Wis. Division of Safety g oZ 3 O • oma Attach complete site plan on paper not less than S 1/2 x 11 Inches in size. Plan must County S CiP0r y Include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # O2 0_/0&&-70 •/a 02 APPLICANT INFORMATION - Please print all Information Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ( , —) - 1 q ' Property Owner C C / O M M Property Location ,L ,�Zflo `� K Govt. Lot -4a) 5£ a) 1/4 1/4,S T ,N,R E (or Wo Property Owner's Mailing Address Lot # Block# ubd. Name or CSM# CSM I0i3 ST G,E'o /X ST• 3 / 007 of - e - *ht:5 . Cityy State Zip Code / Phone Number // Nearest Road �7U�SON W�. Syo�� � )JO (0 T -I 7 E ] city I, Village Town / O �t/ u� New Construction Use: Residential / Number of bedrooms 3 _ y Addition to existing building ❑ Replacement ysa - El Public or commercial - Describe: Code derived daily flow &6 gpd Recommended design loading rate bed, gpdJti trench, gpd /f1 Absorption area required _ bed, ft 7 trench, ft 2 Maximum design loading rate bed, gpd/ft gpd /ft? Recommended Infiltration surface elevation(s) SL-� P ea • 3 ft (as referred to site plan benchmark) Additional design /site considerations 1M1 -f" rE 4 7,CS i eC40 /APS /M o,8 , ¢T' syr Parent material SGs 3 (0 - 104 A4 S /IE.vTS - f 4 JJ 9 Flood plain elevation, if applicable N ft S = Suitable for system Conventional Mound In-Ground Pressu AT-Gra a System In Fill Holding Tank U = Unsuitable for system ❑ S 9 �❑ U El S '—' U 3 ❑ U ❑ S ❑ S SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft Texture Consistence Boundary Roots In. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Ground 3 2 '� /o Y/e Y / f� 1 7 f e elev. 3 /oo e ft. • y /dy,,e 5 /ee �— — Depth to S o 7SY�P LvJCS S.e S — — .S' - <; limiting factor > g Remarks: Boring # s• ,� -F- , S o lo Ye 1314 ioYR Y` - sc- 2fis�� 1$4v 3 /o Y �S �f y� d,C - • s ' Ground D /O t Sl�� / rf�d G's — • S ' �o elev. S Y6 I Ho 7 L U�-C l S _ � S . G s IX Ye ft. voe s Yee y6 Depth to limiting factor 50 _In. Remarks: CST Name (Please Print) � L d�G�T Signature Telephon �o. /C rC7 (/zf 7 /S- 386 •3 8 Address Dale CST Numb a -�•y� csr- �,- y�Z Private Sewage Consultant$ WS O'Neil Rd. Hudson, Wis. 64018 —; �� a t ORIGIN ST CRGik ZONING OF 4clr- r - R S�ti y SOIL DESCRIPTION REPORT 2 f 3 PR OWNER P o PARCEL I.D.11 .4 r - 3 Boris # Horizon Depth Dominant Color Mottles Structure 2 9 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench rr 3 _ 1 0.5 �� yR 3l sL /fsle CS z` ' ' s 2 •30 s n Yl Ls" i� y,� v� 4 .s Ground /Q /0 2 elev. f 7• s y Y F w' f /`t'0 *5 5 L // r /I rl T • .5 io YX 4�_/z Depth to limiting factor Y e _ Remarks: Boring # SL / {s`J/e� /Hn'Fre S 7� q : D /o ye 3/ 3 Pc, /° W l 6 S osq Ground .. D 7 7 's Vl f HO�"f 5L f ie �1a1 �� • •S elev. /D 2 _ s vie,, s� Depth to limiting factor � In. — Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /f in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # ; Ground elev. ft. Depth to limiting t factor In. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBDW -8330 (R. 08/95) 1 , `N I 1 � � •I z k 63 U3 r T r �c rn n � 0 y r - � o� c 7 0 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 420385 0 GENERAL INFORMATION 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: I City Village X Township Parcel Tax No: Lorfeld, David E. Richmond Township 026- 1066 -95 -200 CST P.M Elev: Insp. BM Elev: BM Description: DD .- D / o v rg - -Ai,/ TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic < Benchmark `O 6 ©Dy Dosing Alt. BM Aeration Bldg, Sewer L i!2 j /ate i Holding St/Ht Inlet S � OUl TANK SETBACK INFORMATION St/Ht Outlet TANK TO ��� B Vent to take ROAD Dt Inlet Septic O l - j � � �� Dt Bo om Dosing l Yl Header /Man. C1 `o L Aeration Dist. Pipe 9'7.3 Holding Bot. Syste � q 2, 6 / ,� - / PUMP /SIPHON INFORMATION Final Grade 5, /0 t) ✓ Manufacturer Demand St P over GPM Model Num r TDH Lift Friction Loss System Head TDH Ft Forcemain ength ia. �Jisto Well i SOIL ABSORPTION SYSTEM q l3 BED/TRENCH Width ' Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 SETBACK SYSTEM TO b l P/L BLDG IWELL LAKE/ STREA LEACHING Manufacturer: INFORMATION CHAMBER OR Typ g Of SysVm: - 36 i UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spaci Vent to Air Intake ! !r Pipe(s) reT Length Dia Length 4 Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Syst s my (,�� vujir ,- Depth Over Depth Over xx Depth of xx Seeded /Sodded xx I ed Bed/Trench Center /� /„ Bed/Trench Edges Topsoil ' Yes No L ] Yes j jj] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:1 / Inspection #2: Location: 1258 140th Ave New Richmond, WI 54017 (SW 1/4 SE 1/4 22 T30N R18W) NA Lot 3 `� Parcel No: 22.30.18.342D 201 W. WOMWVMM Ave.. P.O. Banc 7163 . wl s3am - 9162 sit Adisft _ Twv Department of co nmerce 019 _ NwAbdr Sam Permit Application �-Z o S TS is swami wo ckwo UM. Ms. AML cods6 seesaw bOwu dm yet ram 0 Cbuk it Revision >te tits Ar Low, gM "M M MWAM L A atina L1leratedsa - Z� Pad As h*W trt --, I tbf.e Preod ttember — t0 S 0 a (� 6 In � --moo o� ST 'ASt--,A T30 R! if chr som coat r:� "°d ` )vidon Nla csm No dw X01 G 5 II, st Dr�iiii� (eiYeelc sit S ""` DCigr «2 Pmft D wdNn - xem d 8edfoona Uvi�e 1 U . 1P - ues�e c11ea ` UL Tjpe et pa (CbKk ask as bw hu aw Co"Oe iss s itaplinW) A t Naw 2 ❑ RrpMaworot sgatee 9 0 Rgb=NM d 6 0 Addidon fo Far � see Tanis Drs Im ofd a. 0 chock if so ids? Neoie Rcsvim* tiered pkerioit Nls■Sar IY d pw (Cb a n lba I - _ t - I I I ig admwe b far Wand 990 p io tiio®d 210 Honed 47 0 sand Now so 0 Cooenoomd wedmd 22 F l- : 1 m-afow 410 - 1 IN 9 il'aeir 48 0 Sw& Pats sl 0 Drip Lisa 43 0 Aa4ltade 46 0 Aefofia SaMM thox 419 Ifts 30 0 tamer V. MkjqMnpMg amt Ames sasootffioo RM si Ek Plod Grade P Grade ti dp i raw (00 Am Ara RRm APL) p6 r} 1Ra+rciaa i� ��� 1 �i I 11 Vt �ta.t IN" ca Told rf�ae sift std Pear Plafic t nom tutu Of Tuft Ceasfaa Coestrsaed 131sss tf.. tlarrts 1 Tom lWds NdfeslieeE ` Zu C7eeier / VII.IsIMnt1` L Yn lrr - atom fCM1S aNwa ea lire atiried : s Bofiness alone 14amber pMnnlee a Add o s Obest. Cigr. SfMn. coda} Vm. un Cwh SNOWY 0 tea (inaladee ONIUMIrrntr Damao Lstied t foils sl w=m (No s maw) 0 Owm Gives Mold Adveoa ZZS- -� J , Ib A ML condblo s of ApPcwpd,>R.....: ffor s sue. C&L y ��•- .� j zx--,- /M AMA 0=00 AM se4wC�wb)trr ■. Pwmr f.. r.. sirs a ll s ri.lsie aRr"gQst m ni/ni ) I I i , I I I 1 � • I XL eaZ I i i I i 1 I i I � ,( y I ! � `• � y � n�!� `� 4f� ! i I 1 i T -� L { _ I 1i I - - - - -- --; - i- �-- !---�- 1 - - — �- i _ I I I I i I i l l I � I 1 i i l f i � i � •_ -; � � �- i I I I _ N t S ,, 3o wl- d S 1 n'1 a N Doti iv, N C, .l o LL . E'1 L �{p Wisconsin Department of Industry SOIL AND SITE E V A L U AT 1(!-D1- U O R T Page 1 of 3 Labor and Human Relations , Divigion of Safety & Buildings in accord with ILHR 83.05 s )Adr . God2'', COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size Plan must melds but, St. Croix not limited to vertical and horizontal reference point (BM), direction ands% of slope, scale or •.,jf P ` 026-1066-95-200 I.D. # dimensioned, north arrow, and location and distance to nearest road. 066 APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION ;,; tRE VIEWED BY DATE PROPERTY OWNER: ; PA ATION Tim G ' ov i t G�4VT LOT alt 114 $ 1/4,S 22 T 30 N,R 18 fir) W PROPERTY OWNER':S MAILING ADDRESS ;' #` `S NAME OR CSM # 175 144th. St. 3 csm CITY, STATE ZIP CODE PHONE NUMBER [ ❑VILLAGE [ZOWN NEAREST ROAD New Richmond, WI. 54017 (715 246 -4347 Ri I 140th. Ave. [x] New Construction Use [ 21 Residential / Number of bedrooms 4 [) Addition to existing building I ] Replacement ( I Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate .5 bed, gpd /ft - 6 trench, gpd /ft Absorption area required 900 bed, ft 750 trench, ft Maximum design loading rate .5 bed, gpd /ft .6 trench, gpd /ft Recommended infiltration surface elevation(s) 96.40 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK _7 U= Unsuitable fors stem ® S ❑ U Rl S❑ U R1 S 1:1 U N S El U N S ❑ U 1:1 S ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft .................. in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench <....1..,.' 1 0 -13 10yr4 /3 none sl 2csbk mfr gw 2f .4 .5 2 13 -26 10yr4/4 none sl lcsbk mfr' gw if .4 .5 Ground 3 26 -84 7.5yr4/6 none is Osg mvfr na na .7 .8 elev. 10 ft. Depth to limiting factor +84" Remarks: Boring # 1 0 -12 10yr4/4 none sl 2mgr mvfr gw 2F .5 .6 €.< 2 ....... 2 12 -31 7.5yr4/4 none scl lcsbk mfr gw if .2 .3 3 31 -54 7.5yr4/6 none co s Osg ml gw na .7 .8 Ground elev. 4 54 -84 7.5yr5/4 none fs Osg mvfr na na .5 .6 1 00.Of t. Depth to limiting factor +84" Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. Ayegjqew RichmonA W1 54U7 Signature: Date: 4 -18 -99 CST Number: m02298 PROPERTY OWNER Tim Gjovik SOIL DESCRIPTION REPORT Page of _ PARCEL I.D. # 026- 1066 -95 -200 Depth Dominant Color Mottles Structure GPD /ft Texture Boring # Horizon Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed jTrench 1 0 -12 10yr3 /3 none sl lcsbk mfr GW 2f .4 .5 ........3.... "`' 2 12 -26 7.5yr4/4 none S1 lcsbk mfr gw if .4 .5 Ground 3 26 -84 7.5yr4/6 none fs Osg mvfr na na .7 .8 elev. 1 00. l ft. Depth to limiting factor +84" �, Y Remarks: Boring # 1 0 -13 10yr3 /3 none s1 lcsbk mfr gw 2f .4 .5 4 ' 2 13 -30 7.5yr4/4 none sl lcsbk mfr gw 1f A .5 3 30 -80 7.5yr4/6 none fs Osg mvfr na na .5 .6 Ground elev. 100.Oft. — Depth to - limiting factor +80" Z . Z Remarks: Boring # 1 0 -15 10yr3 /3 none sl lcsbk mfr gw 2f .4 .5 5 2 15 -34 10yr4 /4 none s1 lcsbk mfr gw 1f .4 .5 3 34 -82 7.5yr4/6 none is Osg my fr na na .7 .8 Ground elev. 9 9.7 ft. Depth to limiting 3� factor ` +82" L I Remarks: Boring # Ground elev. j ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) STEELS SOIL SERVICE Gary L. Steel Tim Gj ovitc 1554 200th Ave. CSTM2298 Sw %4 4 SE% S22- T30N -R18W New Richmond, WI 54017 MPRSW -3254 town of Richmond (715) 246 -6200 lot #3 -csm t N 1 =40' BM.= top of NW lot stake C el. 100.00' Alt. BM.= nail in Pine tree @ el. 100.30 r i Gary L. STeel 4 -18 -99 l, Oelfter Y• � r f X � s = 76r OPen Z w •a> one bft mftkims CW * f k 30 SidU, tae ♦ j� a nd e +fie z �° FQrIiorr,� r mw knkft 7de �ea► 3f pm . svr�e n /ectiveis to ve lead., s "m ant ce. t 8n mashed side wall a open bo is desi }Atllary acts° w all to allow effluent ttO p� and —'""-- hieved b co mbin ing n11 direction uelhis° flow via SPFCI A �„ -- n om with eri the tra* Ibis has been oftb C ) O ft : °.� ant inside to al, open ..........76. Low ProAta t/ es of uve E along the the ch amber flows rs alon the sides. W"'c�.... _ t.e►�gth . fuU l to un -- - -34 r .. ..76. design ' h of eac coy"pact Heght ... ........ " Wad 34" °Factea b allow efflue r tde. T}l,� l ouvers I ......... _ _�.. H eight_........ - acicfill Pass i Invert . i 1 �8 into the,ch wh il e preventing ttfr the 8 ��ff�ktso m ft ......... °m 4 tg- b ev a size, whe or �'� `f h J ?". Wfthstand _ > b eatdref!►. H t Q _ �ve f. factOrg r POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pew I Qf FM. 11111111`0111111111AMN &V$TW s'e( c�►TIONs Permit © Septic Tank Capacity �(� al 0 NA Sep d a Tank M� c r---� D NA D II Iy1RIFl)i6TERS Efflnnt Filter Mwwftctww D NA Nurr&w of Bedrooms l7 NA nt Efflue Felt r Madsl C f� 0 NA Number of PkMc Facility Units © NA pump Tsnk Capacity d 0 NA Estimated flow (average) fl Pump Tank Manufacturer 0 N DWAM flow Ipsak). (Estimated x 1.5) p PUMP Manufacturer D NA Std Application Rats pump Modal ❑ NA Standard *dhientlEfrluant Quality • Month dy a vamps Pustretin —nt unit D NA Fete. Oil & Grasse (FO(31 530 mall. D Sand/Gravel falter D Peat Filter &0ch6 ical Oxygen Demand (BOD 6220 mg/l D NA © Mechanical Aeration D wads nd Total Suspended Solids tTSS) I 6160 a & D Dishfection D Other. "Wt<ested EfIlklerit Quality Monthly average Dispersal CANS) D NA Biochemical Oxygen D rnarid (80E)j 530 mg& h4round (gravityl D Total Y SnrsMndsd Solids tTSSi 530 n1vt D NA D At -Grads D Mound [t Fecal f 1piormMc mean, 15,4r cW100ml D Drip-Line D O t h er: MaRkman E7"k nt pardcls Size K in din. ANA Othat. D NA �` * Villas tVO* for dmnwtia wastew"er a nk re aaptic ta o"luer t. O"W: 0 NA NA N llervteiu EMertt V k"Pect condition of tw*(s1 At kiss once every: � � (sllardrnuwu $ yeeral D NA Purro out contents of tankis) When combined sludge and scorn equals one -third (V of tank volume D NA Inspect diapersei cs*sl At iesst once every: Q Y (lillaii Wom 3 lresrsl D NA f2estn effluent filtair At least once every. 1 Z �mornth(s) D NA Inspect Pip . pump controls & alarm At isest once every: 0 utnonth D NA Flush laterals and pressure test At least once every: t � s) D NA 0 At least on D mornhisi ce every: D t7 NA 0grsr: D NA M1hi11TEpiAlilChE WSTMN:TIONS IrapscNiorns of tanks and dispersal cells shall be made by an individual carrying one of the f slowing licensee or certifications: Munster Plm*w. Master Plumber Resuictad Sewer: POWYS inspector; POWTS Maintainer; Septege Servicing Operator. Tank , epwhctiorns must include a visual inspection of the tanks) to identify any missing or broken hardware. identify any cracks or heals, measum the volume of combined sludge and score and to check for any back up or pondirg of effluent on the ground surface. The dispersal conlsl shall be visudly inspected to check this efAur nt is" do in the observation pipes and to check for any pofndbv Of effluent on the Wound surface. The p«Weg of effluent on the ground surface may indicate a fading condition and° nwilres the errrnad* to notification of the local regulatory authority. When the ooenbkned accurmiletson of s and scum in any tank equds ors -third 1%) or more of the tank volume. the ant" conwrme of the tank shay be removed by a Septa" Servicing 00wotor and disposed of in aceordancce with chapter NR 113, Wisconsin Administrative Code. Ali other services. kx*AbV but not limited to the servicing of effluent filters. mednanioal or preorwized components. wetrestment unite. and any servicing at intervals of s12 months, shall be performed by a certiNed POWTS Maintainer. A service report shad be provided to the local regulatory authority within 10 days of completion of any service event. GMW f410tt v -= Up OPERATMN now yy� M �� tw � to Chet "MY anPede the pnor to POWT '�ck treatment tankisl for the of of 1211111 twttoyed by a septa the dispemei c oftj. If 1 of psincing P►oduots or otter System start tip shelf not <„actir when to are dOtected have the Canter a�g power outages soil condi tions are frozen at the jnfiitrat ve argad to the +dupe tanks may fill abo" normal high Unlace. To avoid this �� in oAe large does, �°�_ W1°'^ power Is restated the coNsi power to the �+ent Pump have the con tents or an c � ray result in the �� wastewater " t restore normal SapUgs DO not drive Park in the P tw* PkRrnbar a POWTS Maintainer to amt 0 ►es rin withal i 5 feet over tanks and dispersal c controls t over. ps. Do not drive or down stops any e mound or at -grade soil absorption area. park °dish or RWuct' or ration of mowing from compact, the are: the foundation drain y Pes: cigarette butts; wastewater �Y improve the pie condoms; cotton swabs. the We of the and prol products, PealftV A"NDONMENT Pesticides; sanitar napkins to ions; and * Wall", herbicides, ' : medication oil; When the POWTS faits and/or is permanently taken out of service the WVPWV and safely abandoned in oomph with following n steps shag be taken to insure chapte: Comm 83.33, W that the system is • All Piping to ranks grid �noitrative Code; PKS shall be discannacted and the abandoned p� sisaled. • The contents of ap tanks I PI shall be removed and dsd of • After pump. Oil tanks and by a° g Operator. Rita shill xcavated CONTWXMVCV son, gravel or another ine SO N materia and removed or their covers removed and the void space filled with l. PLAN if the POWTS fails and cannot be repaired the following n+eaeeues have been, or must be taken, to mPlace!►nsrit system: A Provide a code compliant bow _�� rs>placement area has ►w ed s�etbac�ks a bO wotected tretm� a moment soil sorption comply rOSuft in the need for a now 4W with rubs effectation otiatabfieh a meltable refit area. t area will O A suitable replecet area is not available sl►stwns must tech actable due to setback and/or sop lirftitations 9Y a holding tank may be installed as a last resort to replaos the tailed POWTS. as in POWTS !] The site has not been O"kiated evaluation must be perforated to suit to locate a �° area. Upon failure of the POWTS a soil repi may be installed as a last area. if no rem sues is av and site fesort to replace the faded POWTS. aulable a holding tank D Mound and at -grade =d abepPtion systems reconstructed in _ infiltrative surface. Reoonxtrui - I of such systrams� f removal of the <WAI> > with the rules i at that time, biomai at the +'�Rt1Ql SorM PUMP OR �AT�T TANK L �� TANKS MAY CONTAM QOM Tl OF A TANK MAY ME DST OR � • DEATH �T, RESCUE OF A 7S phone t Nan" Phone TAGE 1IYT8 Name � w � r� POWTS MArIT/W� MIIO OP@tATOR l.00AI, �A/l Maine T01�1/ AU1 HDMTY 'hone Nana J t locta r.rrt Was drafted in convhan "ft Phan `_Z 1 e chapter Comm 83 . 2212 1(blfutdiAlf) and 83.54{1). (2) h (3). Wheorlsin Adrrrinistrative Coda. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND . OWNERSHIP CERTIFICATION FORM Owner/Buyer C t R I ' CAI /U C A00 Mailing Address �- taJ k-!� L1- c Car 5 qla / 7 Property Address �L I Ave (Verification required from Planning Department for new construction) City /State f`��-- K� " Parcel Identification Number ' ©� ` 9 S! LEGAL DESCRIPTION Property Location : 1 1 , 31 5 C % Sec. Z �'. T 3 N -R `g W, Town of A?, L-44 A-W sJD Subdivision C5 AA Lot # Certified Survey Map # S W �� , Volume ! Z°' . Page # Warranty Deed # _ n� , Volume .`� . Page # b Spec house O yes )<no Lot lines identifiable yes 0 no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and* by a master plumber, journeymanpl*ber, 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. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification . stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three ear lion te. �;O SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the zerty described above, by virtue .a wa ty deed recorded in Register of Deeds Office. Cd � 8' / V / n L SIGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed WCU NEW RICHMOND Fax :715- 246 -2414 r, Jul 8 '02 7 :34 P.02 10t`)t0PAGs UU4 ` STh- -S BAR OF WISCONSIN PORN 2 -1998 KATHLEEN H. WALSH Doctnnent Number WARRAN'T'Y DEED REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Timothy J. Gjovik and Vicki L. Gjovik, RECEIVED FOR RECORD husband and wife, Grantor, and David E. Lorfeld and Laukel A. Lorfeld, 11 AN husband and wife as survivorship marital property, Grantee. WARRANTY DEED Grantor, for a valuable consideration, conveys and warrants to EXEMPT N Grantee the following described real estate in St. Croix County, State of CERT COPY FEE: Wisconsin:' COPY FEE: - TRANSFER FEEe 136.00 RECORDING FEE: 10.00 PAGES: i Recordin Name and Return Address WESTCONSIN CREDIT UNION P.'o. sox 269 NEW RICHMOND, WI. 54017 PIN: 026.1066. 95-200 This is not homestead property. Part of the Southwest Quarter of the Southeast Quarter (SW1 /4 of SE114) and part of the Southeast Quarter of the Southwest Quarter (SE1 14 of SW1 /4) in Section Twenty -two (22), , Township Thirty (30) North, Flange Eighteen (18) West described ,as: (Co of Certified Survey Map recorded in Volume 12 at page 342 as Document No. 57489 Exception to warranties: Municipal and zonidg ordinances, easements and restrictions of record. Dated this 2Othday of October, 2000. R ` TIMO wly OV ' • VICKI L. GJO AUTHEN'T`ICATION ACKNOWL DGMENT Signature(s) STATE OF WISCONSIN ) authenticated this — day of ) gs ST. CROIX COUNTY ) TrrLE: MEMBER STA,TE.BAR OF WISCONSIN Personally came before me this 3A day ur October, 2000. (If not, the above named Timothy J. GJovtk tand�ki 3 L. Gjovik, authori=ai by §705.06, Wis. Slats.) husband and wife, to me known to � p�t(s) who executeA the foregoing insuument q d 6k erne. THIS INSTRUMENT WAS IDRAPrPD BY ' v Judith A. Remington i y , ' REMINGTON LAW OFFICES F.O. Boa 177 Votary Public, tale of Wisconsin. New Richmond, WI 54017 My Commission is permanent. Telephone (713) 146 -3422 (If nut, 5tatc capiration date: �.� (Signatures may be authenticated or aolmowlad g ed. Both are rmt k necemary 'Names of persons signing in any capacity W be ty or printed below their signatures MAR -23- 1998 08:21 FROM ST CROIX STORPOGE TO 92467287 P.02 z n BEARINGS ARE REFERENCED TO THE D SOUTH LINE OF THE SW1 14 OF SECTION f m 22, ASSUMED TO BEAR N89'30'54 o 7 M rl z ~ N� NAC�9� "n to n) 4� A COX ZZ Gn 0 3 UNPLATTED LANDS R A FILED ----------- ----------- Z � m N MAR 1 2,1998 ►. I m Vi KnTMI.EEti H. YYAtSH r c -+ ~ Rep ;steroiD�ds, Ip � o� Stcrauco,wl N00 . 7 g'57 "W 395.04'k p � I Z z Ev o --1 a � r� > r co zz a i Q m m I 9 I� w 4w _ N Z i I r o C w D O PN 4£ ST LINE of THE SE1/ T 0 • Z f . - I i Z m 0'19 "W 402.65' Z =off d ' m 27.09' 375.56' N 0 rn I En ^I C3 (0 c�£m C W 1 A� gy m....... Vi I C Z7. Z cn �n w a to I r Cn \ m �7 I C b o Q Q I .c N Q z Z H YI 3 o m r*i < (n i m [ z D w if's I �N 4 cI N00'19'S7 "W 394.83' Irj a I r vj• H i x N 0 ; 1 3a 372.9 C7 --I f' ` r 26.85' PI i Z z o — i cn I p C-) z. Q o s i z D 0 N C-O (Tl N O O Z MAR 12 '98 m - n .....CatriliY .:�o�•v.5uresW- �'aninn o v � a 26.61 '. 370.41' �xm 0 err: :crniu dhoti S00'19'57 "E 397.02' ° �A It - . wittn�fYy}4bY. :� _ . - iDGlt/R59lrr - y N Z o ; End UNPLATTED LANDS --------------------- Z V N 2 r N rn 1 Vol. 12 Prjge 3421 TOTPL P.02 i