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HomeMy WebLinkAbout030-1072-70-000 c d f !' r 0 o 14 O 0 C> C7 G G > > 0" 3 h. 3 o m o m ''� � A� � • v d m w o O O G (C co CD G �. C N L W ►r CD < N C G7 �1 O co co .Z7 N - v O N 30 v fJ N rn O S N N R O 0 3 O O O ^; C y D 7 y y y G l G D o cn < D m a c� D vi v , oa •�M co r W n = o o v c °° - o o r ' 3 C c\, co cn o v fD O N N CD 00 00 CD CD 0 r cn N a O O O n O O O 'i Z� o * * * -o T * * * aQ w c ccnn o N N N o o D ! N N ID y y N N m y cn '., p) m - d fD — f0 fu CA cn D W z D 0 0 Q. o m � m � m N �• ID CD w o N N — N C C CD cD — "O (D (D Q cu n m _ 3 3 m CD = N -i N O ? z m (n o T c c — ; _ 0 CL f a A 3 I I (n -1 N M Wo M a m a `D z o 3 0 3 z 0 0 Z cn 3 3 � I g y N y CD W ? n CD C O N n O n C 7 CC cn G N< N O T D) C '0 CD a o o y a C 'a E; 5. co m cn CD N 3 3 O o ! O y (Q O F =. c �. m n N O 3 ' p v CO O o `1D 3 0 m m I ,.. I o m o, I I 0 0 m w CD ac a o p o p 110 °`° `° CL a- a Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 488268 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal informati3n you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)J. Permit Holder's Name: City Village X Township Parcel Tax No: Smith, Roger I St. Joseph, Town of 030- 1072 -70 -000 CST BM Elev: Insp. BM Elev: IBM Descriptio Section/Town /Range /Map No: ��d -o � ^ 26.30.19.254G TANK INFO MATION 6 ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark I Dosing V Alt. BM Aeration Bldg. Se wer pbL 9� ioz r H olding St /Ht Inlet TAN SETBACK INFORMATION t t utet - ,54 &V V ent o Air Intake ROAD Dt In ep Ic � > too I � � /- Bottom osmg Header/Man. )o.4 era lon Dist. Pipe H oldin g o . System F 75 - 5713 ra e i i PUMP /SIPHON INFORMATION 2- Lf M anufacturer Vqmana Stuover GP' o e u er ?.Z7 v' 7 J L ITt is ion oss ys em ea L engfff n I.) bL. Lo vven rt n^ ' v DIMENSIONS � r � 3 , INFORMATION /� r C R ype 04 SyStel 11. (!,&W t S i Z3 3 ' (Dl� ��I UNIT [CiVt�E DISTKIBUTIUN SYSTEM LL u Pipe(s) r Length �7 Dia Length Dia g 5 � x Pressure Systems Only xx Mound Or At -Grade Systems Only Bed/Trench Center /J Bed/Trench Edges Topsoil Yes No Yes No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: 4 #2: Location: 713A Terrier Lane Somerset, WI 54025 (NW 1/4 NW 1/4 26 T30N R19W) NA Lot 1, Par No: 23019.254GG}/p_� 1.) Alt BM Description = �P ���° 1 °r`�j11" 2.) Bldg sewer length 9 ,q - amount of cover = 7 �!� 10 A3 (0 I � �� Ct " • (�O Plan revision Required? i ! Yes 1 1 1 No 1 Use other side for additional information. �jW Bert No. In y � - pat nsep or`s Sig re- SBD -6710 (R.3/97) Safety and Buildings Division Coun (1 201 W. Washington Ave., P.O. Box 7162 PLO 1 Madison, WI 53707 — 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce ��a� ��� ztar Sanitary Permit Application static Plan LD. Nn In accord with Cotton 83.21, Wis. Adm. Code, personal information you provide Inuy be used for secondary pturpases i nvacy law, si �.i►a(i j(mj emject Address (it'di@ than mailing ) L Application Information — Please Print A A..; 4 r•roperty UPWS Name JUL 0 7 2006 Parcel a lot # Bloa # iv kr-)o Ile C- 1530- /07Z » Property admgAddras ST. CROIX COUNTY PM won j� %, �-%%, Section �'o City, State Phone Number C / A j - f ` (circ� . Z 7 � l 7 It. Type of Building (check all that apply) t T � nt, R�F Subdivision Name CSM Number V i or2 Family Dwelling - Number ofBedroom ❑ PubiicXomnmtial - Describe Use U State Owned -- � _ , tY Rage l ip E 4 LJCi LJVi , • owash' of � J\C'_ r III. Type of Permit: (Check only one box on line A. C e B if applicable) A I n w. C veh m QI aw.mro..,a..r ewMm fl r ... •e Lnr��a;... r n . a .. _ .., i . t"t B• ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Daft issued Before Expiration Plumber owner IV. of POWTS Systerx Check all that a pply) P f N -Pressurized h awnd ❑ Mound 2:24 in. of suitable soil ❑ Mound <24 in. ofsuitable soil ❑ At -Grads ❑ Single Pass Saud Filter ❑ r o- rt."t'd wetlsn t 1 1 r>rweaeoL�nA lnJ`.nns,..rl n irnl.r;.... -r rl P...., C ;1 - t •..,.I.i.. T.............. fi.:, rl n.,..:` «_,. n....� r.:.. r . ___"___ _ _._ —... _.__.._ .... __..._...p ._.... .�_....... ... .w........ ., w ......... ....... u.wrawau.u.g ✓Ww.ua.w 1..1 Recirculating Media Fiber ❑ Leaching Chanter ❑ Drip Line craveldess Pipe ❑ other ( tacpisin) V. D reatlacat Area Information: Des' Flow (gpd) / Design Soil Applimtion Ratr(gpdst) Dispersal Area Ri WhW (sl) Dispersal Area Proposed (s�, Systdn Se / VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Sted Fiber Plastic Gallons Gallons of Units I concrete site Glass Talcs TwJm '/P" Tao'` X .Y ✓ - f Aerobic Treau alt Uait "Oft Caftum m VII. Responsibility Statement 4 the nodersiSaM mspoasibaity for f the POWYS shown on the attached plans. P Nana (Ptin Plumber' S40- PRS mbar Busmcss Phone Number Plumber's Address (Street City, Statc. p Code) vm - counq 4 L ela rtinerrt Use onl Approved ❑ Sanitary Permit Fee (includes Groundwater Da Issu" t signs tamps Surcharge Fee) rs\ -21114o (P ❑ Rtasou for (.(� iii. Conditions ova_uiceasoas for ivisaptim"i SYBTlIIO O oiApppr ER: .3� -�; C S r w._. 1. sole tank, eMtta t star and L dispersal cell must all he servit:ett / mahttaktad ��� e GD d/� Q as per mattagement plan provided by pluMtw. 2. AN selbaok ret*ements must be mainta wl ass per' appic" Coda / ordimr;as. attach conWileft n►.a: (As tae Ceswiy.ay) for the :rates an paw astrm it" svz x 11 inches in she SBD -6398 (R. 01/03) t� a 0131AWO M3TZYQ y Fig l91!tfl In-A 114 Ant! x1ge2 . t t9cim .. ; • r . � ��� ;r .n�ssr� .� >c - -� -z = y� !4 v ._..sue 4 qir 1; s 1 4e - ��t �� . mod G Ho I 4 j X a SID � � fi +3 e� �o� rs � 5 �di •z.� �% icy . � / X 9 i 4? o _ � p,,bard�• h I e 01 i Of SOIL EVALUATION REPORT Bd*V4 pop at -� ndfps a a000�rs rft Omm W Vft Adot Caft a.t..r�.na co mw 5 -r. C . o x Ini�r'nw Mtom s lax 111 1 1 I E ales. Pion cwt W�ev�aaE�ed rr.�..no.pow4i ,a WA p LD .....10a.. Pimsee D v by "�'r"iw'wr'a°"*w�w�►a"' � iawt�lN�it. 7 // D L J�JL 1'rl (� /� l4kat tat S vs n� «» s - T N R E LNE S tags 1 02*8 arf d Nmwor LS&M t` � W _5 o a5 7/ S 7i�9- 5� n S rra..al A..e ".w um. Rer+w"lible"Obar„.a. c�ea.a w.aw4nw.►�.i. .�cr4� aPo l�rtY - .D y��e°���� c j, �Dwai.c PiatPrMtiliM.ioaMsp�u�lr Aj ZA A tit e1WAd 92 ,► D A it oow..raartbar a ttoiltdp °°.irM Ae/uirmen%" T"m SWAftb AetAr Out C*lr 0" v � lmsbk � .� m 5 <3 7 S s s 5 hk t� �• Z l , sow iMoAnta �p ft ti .d#�r1.o.+M. _ 1 % , R t ttiiwl.rAer - tteelepes bed per ` 1a. tirnai ML St c at Oe1er ' D r 3 � ,�-- 5d a m r cA; I yr\ i 1 ti n / ctirn -a3 -o( 71 P#Npmv )wa.r + n • a of !O' � crow4 d.aftwobv. rt oapik a r+�wrs . `° EH owr ao.+mrc w.ae�o�.oi� <�a t�rtte�.. M.ac cw. ft cat CAW 6rr, s=. sue. D —Ff a oL — d $ h/1 r —Nx m s 7 J, ►r a 0 D we Gwwdwwftmarar. X oapth 0 a twor im t ea oap* o wbb" nr"DOMM M TOWA s r. I fl °"°. D �' p pa 0" aa1 air. +L oap*bt dW*ftd r W w� ! Oa�iw�!' ararro..a�r.. T+.rlrr. SM�Ir�s �loaai�irio. tisos W mar QAL or- Qmt. ft yr. OL Sk ' • EMmo 81 000, > 301220 mpt add TSS 3 s 16o nqL. • Errant 02 s BCO 30 nolL and TSS 1 30 rrvL 7La Dap.eome� a�'E3oatrweeee is m a4aa1 oppocamiry ser+rioa prarvWar asd �P�+'. if raa meal aa!Ir�oe to aaoass a«< and =a%*I I at m aMmmft fmrart, pkm conm A die dqmtmom at 608- 26W151 air TTY 1608- 2644rr?7. maaasw,«wr own ■ f ` ". .: 7,Q ��- S , t^ s E- V� ,� �; Y S acs Ts o ry R 1 U.) _7 1 � �t � rte', •e �� �e S� . J� �, S . 1p Q U A BM ° 1Tow. o� S:d v� �l boo' 4 g ko. \�. cz i 0) q 9 _ s i l l 3 � 6, ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Bu yer e �(' S n(1 '�A Mailing Address - �� So d Property Addres CA1'Y\.2 (Verification required from Planning & Zoning Department for new construction.) City /State Parcel Identification Number 0 — /6 - 76 Cad LEGAL DESCRIPTION Property Location C,3 ' /4 , NU) '/4 , Sec. �, T �N R�W, Town of �T . �1US i� S ubdivisio n , Lot # Certified Survey Map # �j 5��j , Volume , Page # I S S Warranty Deed # 1� a - ,Volume T / , Page # � 5 Spec house yes Lot lines identifiabl 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 (i€ necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my /our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number bedrooms NA OF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. REV. 08/05 I� STATE BAR OF WISCONSIN FORM 3 - 1998 6 Z g92 9 QUIT CLAIM DEED K f)THLE:f_N H. WALSH r/ /� QA RFe OF DEEDS Dum 6r ent Number / L'�tV / PR';' r. CRt I X oc CO., till' ti � REr,GIVED FOR RECORD li This Deed, made between A c 7 -�Qf 02 -28 -2000 9:30 AM _ QUIT Cl_AIM DEED Grantor. EXEMPT # 8M - — CERT COPY FEE: and C , o ►^ r+,. 7� I _ cl.r�l 0� -1 _ 1�/1Qri_- ._ COPY FEE: �� F A !� IC�Ii [i o Y �' T 1��rs�i r "' ------ - -- -.. ... _.._- -- - - -- T RANSFER FEE: REC.ORDING FEE: 10.00 PAGES: 1 Grantee. , is Grantor quit claims to Grantee the following described real estate to If o_I County. State of Wisconsin: t.] (•1� , .:t rill e; 1 • if �f a J TBY• t �°�Y-t^• LLCM a Name and Return Address 7 I �� / 3 • f' f &9-1 46 L/. 72 1 30 N � 19 W /�T G'L .� `ll 3 Te Y e L o+ D erf s e- WL 5VO.;z S -b'91 3 low .own o S Lot f C 5M �sS�F Prlso -file !l% �l o f Lafs 8 9 -Z�2- ? - 00<1 Parcel Identification Number (PIN) gas K� So � P jQ� L � This Is JjW homestead property. (is) (is not) Together with all appurtenant rights, title and interests. Dated this '2 9 day of ' 4C.39Y14 4 y v (1__,_ -_. (SEAL) — -- -- ..._.- - (SEAL) r (SEAL) — - - . -._ (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, lI 1 ss. County J authenticated this day of Y Personal] came before me this .28 -r— day of ! Gla ru a' 07 9 O , the above named "m itt. 5m� / �a � /�tnO�a a/U ma.ry TITLE: MEMBER STATE BAR OF WISCONSIN to (If not, �' tune, known to be the person who executed the foregoing authorized by §706.06, Wis. Stats.) �Y�,. Yristrument and acknowledge the samee..Q� THIS INSTRUMENT WAS DRAFTED BY = •- 'tea ' - - - �"—" Keg l ee" I,iJ als �l - k Ncttat*„Public. State of Wisconsin 1 t► yj " y jSMmission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not JINj a�• ` ,�t1Z I $ r)�) ) necessary.) • Names of persons signing In any capacity must be typed or printed below their signature. STATE BAR OF WISCONSIN Wisconsin Legal Slank Co.. Inc. QUIT CLAIM DEED FORM No. 3 - 1998 Milwaukee. Wis. c� T EZ1203H e0aev �i ..,• +•.. ♦. ':. ^�•` •T •• ": OOOea Oa evo vo � •• w OOVO Ov .s'• •r• t !. • I:� OvvOV Va vev •• ••�. •',a , • •• •• e000 vOV ivv vev 12 11 2411 0 ' 4.625t vee vvv ov vvv vvv vav ovv s vov v v 1 11 1/2 Circ. = 18,84" v VV- ov vva ove T vv W ev a vaOe90 -00 vvvev e° •vvvvovvvvve vvvV 0 oveovvo sveovovvevveva voveavv ovvvooa vv ves vvvvvvoovvvvavev v - 24 11 0 Bottom 36f Void Vo lume 12 -1/2 DIA. (typ.) Soil In fa Area S IQ F Void Coefficient is Aggregate given at 57.4°A. Sidewall (1 Sidewalis) * 18.84in O.D. of 4 "pipe = 4.625 inches = 3.14 Void volume per linear ft. = 3.14 • ( 2.7125°' )2 2m • tft = 0.117 ft' Bottom i 2i l t2in/ft J 2.00 O.D. of centercylinder- T2.5 inches Total Sofi Interface Area 5.14 SQ.FT Void volume in aggregate of center cylinder - 3.14 • ( 6.25in 3.14 + 2.3125in l l 12in'/ ft) ( 12in /ft ), Jf '574 -.422 fta O.D. of outside cylinders - 12 inches Projected Trench Area Void volume in outside cylinders - 2.3.141 lzui i ft) • 574-.901 ft. Sidewall Height = 12 in. '2 - 2.00 Sq.Ft. l = Void volume at bottom between cylinders — r( 24ni 6m bin 11 t2in /ft 12in /ft)_( ) 1 '0.215 ft- Bottom 36 in. = 3.00 Sq.Ft. Projected Trench Area a 5.00 Sq.Ft. 12in / ft JJ Void volume outside bottom corners (112 orvoid volume between cylinders) 0.215 /2 -0.108 ft' Total void volume - 0.117 + 0.422 + 0.901 + 0.215 + 0.108 = 1.763 cubic ft/ ft Gallons per ft - 1.763 X 7.48 - 13.2 eallons ner linear ft ErPS Aggregate Trench System EZ1203H Rin :.; g Industrial Group 65 Industrial Park Rd. Oakland, 1W -18060 SCALE FltF NAA2: IZ1203H -m1 SHEET: 1 of 1 11 -27 -01 I ,r ' POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page — L FILE t�llf0 TION of SYSTEM SlEC�ATIONS Owner i�', Septic Tank Capecity E3 NA Permit a l Septic Tank Ma nufaccWrer Y �, 13 NA ARM �'ARAL% - nm EffhAnt Fitter Manufactures ❑ NA N Bedrooms O 13 NA Effluent Filter Mode! 4 � ❑ NA ]EEEE its t3 NA Pump Tank Capacity O NA �� Pump Tank Manufacturer DNA alida ; Design flow (peak), (Estimated x 1.5) `J al/d Pump Manufacturer ❑ NA Soil Application Rate c ai/d Pump Model Standard !n#tuentlfffluent Quality Month O NA I y average • Pretreatment unit ❑ NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (SOD,) 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS! 1 51 so mg /L 0 Disinfection ❑ Other: Laximum fluent l O Quality Monthty average D a 6eNTe) Biochemical © NA Ox ygen Demand (BOD �0 mg /L In -Ground (gravity) D In-Ground (pressurized} tal Suspended Solids (TSS} �0 m ❑ NA L7 At -Grate ❑ Mound :if orm (geometric mean) 510` cfu /100mt O Drip -Line p Other: lt Particle Size )a in dia. Q NA Other DNA NA Other ❑ NA "Values typical for domestic wastewater and septic tank effluent, Other: ❑ NA MAIN7 ENANCE SCHEDULIE Service Event Serge Frequen Inspect condition of tank( At least once every: ) (Maxiinum 3 Yaws) O NA mon{tl (s! Pump out contents of tank(s) When combined sludge and scum equals one -third (Y.) of tank volume ❑ NA Inspect dispersal celt(s) At least once everyi O month(s) year(s) tMaxinwm 3l/earsi DNA Clean effluent fitter At least once every: r� ❑ month(s) ❑ NA ea0s) Inspect pump, pump controls & alarm At least once months) every; ❑ year(s) ❑ NA Flush laterals and pressure Pest At least once every: ❑ mont Q year {s Q NA Ot At least once every: a mtuttFr(s} Other: o rear($) r►' 17 NA MAINTENANCE INSTRUCTIONS i nspection$ of tanks and dispersal cads shall be made by an individual carrying one of the following licenses or certifications: Master Plumber: Master Plumber Restricted Sewer; POWTS inspector; POWTS Maintainer, Septage Servicing Operator. Tank inspections must include a visual inspection of the tanks) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground: surface. dispersal effluen che condition and requires shall be visually inspected to check the effluent levels in the observation pipes and to check for any ground surface. The ponding of effluent on the ground surface may indicate a failin q ces t immediate notification of the local r uires the regulatory authority. When the combined accumulation of sludge and scum in any tank equals one - third %) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in, accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. START Up AND OPERATION Page f For new construction, prim- to use of the POWTS deck treatment tank(s) for the presence of painting products or other chemi that may impede the treatment process and /or damage the dispersal ce*sj. if high concentrations are detected have the corntents Of the tanks) removed by a septage servicing operator pri to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal ceq(s) in one age dose, overloading the ceti(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil. absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation dram (sump pump) water; fruit and vegetable peelings; gasoline ;. grease; herbicides;. meat scraps; medications all; Painting products; pesticides; sanitery napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following . steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septege Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and shod not 'be infringed upon - by required setbacks from existing and proposed structure, lot Ones and wells. Failure to protect the replacement area will result in the need for a new soft and site evaluation to establish a suitable replacement urea. Replacement systems must comply _with the rules in effect at that time. ❑ A suitable replacement area Is not available due to setback and/or soil !'imitation. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace *9 failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARiNWG> > S FM- PUMP AND- OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RE SULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS MISTALLER POW f$ E>AI AVER Name U ; 1 -c Narne Phone Phone SR"iAIM SRBtV G OPERATOR (PU MPEBN LOCAL REGULATORY AUTHORITY Name Name c —� -- cep Phone phone . E This document was drafted in cxangAance with chapter Comm 83.2242) (btll itdi &If) and 83.54(l f 2j & 13). Wisconsin Administrative Code. r START UP AND OPERATION Page _,2-of For new prior to use of the POWTS check treatment tank(s) for the presence of may ampede'the treatment process and /or d the dispersal cegis). If high concentrations are Painting products or have th ha c ont e is Of the ta clng operator prior to use. nk1s) removed by a septage SwW detected e contents System start up shall not occur when sop conditions are frozen at the infiltrative surface. During power outages pump tanks may fM above normal water levels. discharged to the d' � When power is restored the exeess.wastewater will be epersal cep in one large dose, overloading the cell(sl and may result in the backup or surface discharge of e"umt- To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring Power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the - pump con is to restore normal levels within the pomp tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or d` n park over, or otherwise disturb or compact, the area within IS feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss, diapers; disinfectants; fat, foundation dram (sump pump) water; fruit and vegetable peernngs, gasoline ;. grease; herbicides; meat scraps, medicaticros: oil; paurting products; pesticides; sanitary napkins; tampon; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following, steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • AN piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil. gravel or another inert solid material. CONTMit#NCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a repl soil absorption system. The replacement area should be protected from disturbance and compaction and should notte M* igW upon-by required setbacks from existing and proposed "structure, lot lines and wells. Failure to protect the boement area will result in the need for a new sop and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect st that time_ ❑ A suitable replacement area is not avallable due to setback and /or soil limitations. Bening advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to - locate a suitable replacement area. if no replacement area is available a holding tank may be installed as a last resort .to replace *e failed POWTS. ❑ Mound and at -grade sail absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNNW> > , PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL BASSES AND/OR INSUFRCIENT OXYGEN. DO NOT ENIM A SEPTIC. PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE .NWFEV40R OF A TANK MAY BE DIFFICULT OR iMpOSSWLE. ADDITIONAL COMMENTS POWiS NySTALLi9t POILYTS MAINTAINER Name Naas Phone Phone SAGE SERVICING OPERATOR PER) LOCAL REGULATORY AUTHORITY S Name Name O Fl ` y1. Phone Phone This document was drafted in compliance with chapter Comm 83.22(2)ib)(1 l(d) &ifl and 83.84111. (2) & 131. Wisconsin Administrative Code. 403488 CERTIFIED SURVEY MAP VERNON ORF !Fart of Government Lot 5 of Section 26 Township 30 North, Range 19 West, Town of St. Joseph, St. Croix County, Wisconsin. ;, a `'`���\SCONS/ 5`' .- ti i ;.� 10 LAURENCE, S m W MURPHY = c o '• S , ,O ° App pyEl� RIVER, A .. Wfe.. �'••.�� LAND S �O s• Sv 02 1985 em ������� t W Laurence W. Murphy e2 8 S1. q • a Registered Land Survey A +1 CO wFj%~ „o re LU [y A 3 W Q aS9 ti b V t R O �z.c�C N P, H IL ° M O CL 4L Ck CNJ ci D r-i .-d 0.6 1 3 A 1 � h w4� VI N ' q i V v 2 q * 1 ' 00 v ,O .,y H R� y 00 . e � I tl 3t• .� ! 0 -Jam V W I N N k V @ � h b �► ! m lu 97 � .� W v v N W M 9 ft 7 Q ! I t S 10•!0. 1 '36 ;0 "6' 9j4.10 3 W a b 3! ~ q q t RCS R Z W k. N N 8 S h Q = m w Q M I jp q f V1 �f �If Ck 9 4 Ob W ^ q t N O f 8 O of c � a b I ✓� a [I -- . FILE D JUL 1519 CV q h Qdi a- Q O O !1•' � � '�I j '10 ^/! 0•!7 , I 0� •46'O�% 'O _ C b Z m Dated: April 11, N 1985 w jj7.7j�� y c OWAY SASE AfEFC IN -b Q Rl SIO'3B ROA At. R 339. pe st. !NC•S' 50 3. OF '` �T'ro'� S Vol. 1551 3 c 'asL�R� X crY M',S — S /o• rP�A p,6A St. County, SN6EY i Of S Parcel #: 030 -1 072 -70 -000 07/11/2006 03:50 PM PAGE IOF1 Alt. Parce( #: 26.30.19.254G 030 - TOWN OF SAINT JOSEPH Current * 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 O - SMITH, ELEANOR K ELEANOR K SMITH C - SMITH ROGER A SMITH ROGER A 713A TERRIER LA SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 713A TERRIER LN SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 4.700 Plat: N/A -NOT AVAILABLE SEC 26 T30N R19W PT GL 5 LOT D OF CSM Block/Condo Bldg: 2/533 NOW KNOWN AS LOT 1 CSM 6/1554 ALSO THE N 9' OF LOTS 8 & 9 PLAT OF BASS LAKE Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) SOUTH 26- 30N -19W Notes: Parcel History: Date Doc # Vol /Page Type 02/28/2000 618929 1492/463 QC 10/02/1998 588273 1380/327 WD 10/02/1998 588273 1362/242 WD 07/23/1997 1022/163 q mor .. 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/08/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.700 119,400 280,400 399,800 NO Totals for 2006: General Property 4.700 119,400 280,400 399,800 Woodland 0.000 0 0 Totals for 2005: General Property 4.700 119,400 280,400 399,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 129 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 C�U)O' 0CA01 cT0 d �1 cn 3 z 5 z o w 0 Cf) ic _ z o 0 rn w `C • Q 3 0 (D N W 3 O O N O G 0 0 n o o a n m y o m co pO N N d 3 O iz Q O ' =r N v R O O jo N j O N -q -4 W O O cr C c O A7 3 W W 3 W E O 3 N D 1 5 y y o p y CO N N cn z D m a m C/) D a o m a o cn o m m n y N a C m rl r m W r co 3 a c o o 3 o o o O 0) Q m l O !° °' m co i. — U � X 00 0 OD CO 0 z 000 �I z 000 A CO) (ft cn Ip o CA u� Cl) r° � D o n m m a o m e• m v o rn =r N N 3 d N 7 Q M - Q A , ` a z co z ° z W CD 0 z O w 0 0 D a' v O D n �°. m o m • CD v c N C C c OD N W o' m' a w a a v 3 5 a 3 5 z CD CD C6 z N I °- 3 ' �' c I ° v z m a v a f' CD .. o y o C a ` z .p o o ° 0 z a N N z < N A W O W 7 t7. 00 yi (7 • d> N ?,7 x O. C w�a`OG 0 . C N <N w . C CD '� d z a I z a 2 Er ;L o m o �l< :o m z EP m j N 77 m O -0 N N 7 N N S a C C n CD CL _ O O O O aT-.3 O o a 7 0 o W �ccnn 3.. =7 -n �, S Cp n ti O 3 N• co 0 C CD OD 7 m . 2 0 O O CD O N �• 0 0 CD m o0 o0 CD (D om • AS BUILT SANITARY SYSTEM REPORT DYER Il iged TOWNSHIP SEC. T�N, R N. 0. AD R SS , ST. CROIX C�, SEC N 17 LOT BDIVISION , LOT / LOT SIZE 3G--1 b7 606) —1— PLAN VIEW -Distances b dimensions to meet requirements of H62.20 'I SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM { d i 9 i I C o . i W �. .t 1 A t X g S Y Indicate 6zthi, Arro' j i • SCALD: ' i i QTIC TANK MFGR. (�rl..�. &ir. � C ONCRETE_�C STEEL NO. of rings on cover j Depth �S DRY WELL ANCHES NO—of width length area a J no. of lines widt lengt are dept -top of pipe �GREGATE � r , :'SIC RATE _ AREA REQUIRED �,/ I AREA AS BUILT 1i&ciaimer: The inspection of this system by St. Croix County does not imply complete ;o;pliance with State Administrative Codes. There are other areas that it is not possible • t i n_pect at this point of construction. St. Croix County assumes no liability for 13tem operation. However, if failure is noted the County will make every effort to iii ermine cause of failure. ,'EASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYST `INSPECTOR DATE PLMMER ON JOB LICENSE NUMBER • REPORT OF INSPECTION — INDIVIDUAL SEWAGE SYSTEM Sani tarry PeAmi t fQ sbo S e S e p.ti c S NAME S4. C.%0 County SEPTIC TANK i Uzeln Q aUon4. Numbers 96 Compa4-tmen.t4m"/ I iµ1 Cd,�ng W e.t�and4 ,_,_�•t. DISPOSAL SYSTEM � a e " • Di.4.tance Fnam: weer �dU �6 # , 12 o n �nea$en 44ope it. We.ttan44 Ft, . H�t�hwa�e�„6.t• FIELD DIMENSIONS: W .dzi� 06' nenah it. Depth o6 40 a 0 e4ow, 44Ire 2--in. , Length 06 eaah .ne,....•,�64. pep-th 06 4o ck o ve,n tine_.___ in. 1 Numb g4 , 0 .I A0 02 Depth o6 , t4c be.tow .6 gnadk n. p - Toxat 4 en9 44 06 "Af it. Szope 0 Uench `� U- pen 1 ka it. S O,i.4 anae be w ean 4ne4,_�_4t. Pe to:'be.4!40 C 6t. To,tat ab4o ,bUQa a4ea,,,�` Pjt Depth t 94oundwate4 bt. Requ4,4cd gus; „�, � t Type 04 Coven; P pen PIT DIMENSIONS+ Numbers 06 p4tA Ga'ave.t m ound p iu e4 no Ouzo. de d amet t, pepxh be4ow '444et�6.t. To�a� ab4onb�i.an a�e.a 2 6� • z �nea .9 6$ m INSPECTED BS/ 14 Ag o, ITLE APPROVED R DATE t �0 • REJECTED . r RA T E 19 7,�,,,,• __Um Mal I LB State and County State Permit # a q8� Permit Application County Permit # 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: iL ;r2N1-,a1 a/:, &A e &uxs d� r B. LOCATION: Y4 ' /a, Section _ , T jo N, R (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# V' ge wnship T C. TYPE OF OCCUPANCY: Commercial *Industrial *Other (specify) Variance Single family _ Duplex No. of Bedrooms .3 No. of Persons D. SEPTIC TANK CAPACITY j0Q0 Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concret Poured -in -Place Steel Fiberglass Other (specify) New Installation x Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured -in -Place Other (Specify) ` E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate Total Absorb Area sq. ft. New — Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top -- No. of Trenches Seepage Bed: —,X Length , -5 Width — _ Depth _ Tile depth (top No. of Line Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land R Distance from critical slope S�D WATER SUPPLY: Private Ig Joint ❑ Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than p owner: 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 Certified Soil Tester, NAME L (�.S,es:, ^� .�. C.S.T. # S;S - - /S - /9 and other information obtained from (owner /builder). // Plumber's Signature MP/ PRSW# �'� -� Phone #J4� Plumber's Address 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. , , Nj i e i i l , _a 7A n.... - , 3 1 f i C , C E , cr , — �. W € f� Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application rU Af 46 Fees Paid: State /S'< °= C ZU Date O Permit Issued /Rejected (date) ^/rr-4f o Issuing Agent Nam Inspection Ye ✓ No State Valid# Date Recd 1. county (white copy) 3. owner, (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary cop - _ Revised Date 7/1/78 E ll 1 15 Re x.9/78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION ' / <, `em /a, Section '- ,T2Q_N,Rap (or)(IVTownship or Municipality Lot No. AO , Block No. — ,) 4#r f oF' CrIy 0) 1 County S f' Q 01 k u Ivision Name Owner's /Buyers Name: �ea -_&Q tt 01- F Mailing Address: TYPE OF OCCUPANCY: Residence_ '- No. of Bedrooms Z.- COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW K _REPLACEMENT ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS �6`�a PERCOLATION TESTS _a kf f eC3 SOIL MAP SHEET 7 eZ NAME OF SOIL MAP UNIT ( 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 AFTE INTERVAL MIN /IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- Q Bv�-e D y o 3 a' 2 Z Z P - Z " S-c e ore- A /�— 3 P - 3 0" See- dr2 AA 6— ' q y P- P- P- SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, MOTTLING AND DEPTH TO BEDROCK NUMBER INCHES OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES B— H e " /,3.17~55 A/ 6w.1 B _ 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 @2 0 4 0 0 ' 0 ' .Indicate scale or distances. Give horizontal and vertical refe� points. Indicate slope. / S& 1 A-eo4r peel, fires T rt I t to Mora, • A ... _ _. ¢ory E E E E r E m q f ,0, � n ..¢ � — t f oe 9 43 : 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) AWAI,.V J0 Certification No. Address fVAt cot S • U .Name of installer if known Copy A —Local Authority CST Signature r i ' D_ - - _ J f �• L i �• STATE OF WISCONSIN Department of Industry, Labor and Human Relations Safety and Buildings Division, Madison, Wisconsin 53707 Z JOB NAME: DESIGNER: LOCATION: ZONE • DATE INSTRUCTIONS: This worksheet is recommended for determining conform- ance with the Uniform Dwelling Code's Energy Conservation Standards. Dwellings may be evaluated by the System Design Method or the Accept- able Practice Method. Heat loss thru basement walls and floors where insulation is not required by code may be included in furnace sizing calculations at the option of the designer. System Design heat losses not exceeding the losses determined thru the code requirements by more than 1 are considered acceptable. 0 area calcu GROSS WALL AREA: FOUNDATION WALL ABOVE GRADE: 710 sq. ft • /s/ sq. ft . WINDOW <,AREA:Uglass size (3unit size FOUNDATION WALL BELOW GRADE: Z -0335 3 C. ll 3 c 14 LI Z Z- AV &I 1 157. sq. ft, 44Z aq. f DOOR AREA: FLOORS OVER UNHEATED AREAS: 0 4Z sq. ft. sq. ft. CEILING AREA: NET (OPAQUE)WALL AREA OTHER OTHER: I sq. ft. 5s2 sq. ft. sq. ft. sq. ft. , Form No. SBD -5518 page i ' U " V Luzz INSTRUCTIONS: Calculate R and U values using TABLE A -4 in Dwelling Code Book. Separate calculations for systems having the same insul- ation but different interior or exterior finishes is not necessary provided the system with the lowest R value is used in the System Design or Accepted Practice calculation. type typ 2 type 1 type 2 wa ll cav sol cav sot roof cav sol cav sol exterior film .17 .1 7 .17 .17 exter film .17 .17 .17 .17 siding _ ,81 ,81 ext. finish I.I.Z. J.LL sheathing 2.6(. Z.0` insulation 30.00 insulation 19.00 xxxx d.68 framing xxxx 137,§ xxxx framing xx 4.38 xxx insulation in finish .45 . int. finish ,q5 • interior film .68 .68 .68 interior film .61 .61 .61 .61 TOTAL R ZS.17 8• TOTAL R 32.9 /G.2o I V Y = 1 /R 1 .047. 11 4 1 nU+t = 1/R .03 .061 above rade walls othe fdtn cav sol cav sol cav sol cav sol exterior film .17 .17 .17 .17 exterior film ext. finish ext. finish masonry l ,y$ I.Z$ wood .8 insulation int. finish A . .q 5 interior film .68 .68 .6R .68 int. finish Insulation 8/b interior film TOTAL R 11.3` 0 TOTAL R "U" = 1/R .08$ . Zt3 U = 1/R baze=ent� 1st thru 3rd foot 4th foot below grade below grade to basement floor no insulation .288 .o94 walls R 5 rigid board .113 .o63 R 11 fiberglass .072 .048 w/ 2 x 4 framing floors no insulation .025 .025 * includes air film, wall,,insulation & soil page 'STBTZ CONSTRUCTION HEAT LASS I)ZSZGN eat loss i AREA " U " TD TU per hou tyre cay. 7 x 5 .043 Z 2l..3 1 Sol. 7Zo x 08 . I` 7 alls Z 12.SZ type cav . ( x ---- -� ) 2 sol.( x % ) type cay. 800 x 90 O •030 7L 1 Sol.(/860 x / tyn - cay. ( x 180 ) roof � —� ) 2 s 01. ( X _1 ° o ) WNW 1 above grade walls •Od$ Z �3•Z 2 below grade(3 feet) Z 2 se Z2 T dt n 3 1 windows S7• Z •� O IlIass 2 patio doors 3 1 t• 3—° .4 3 2.17 doors 2 1 oth er 2 T=kL 3 - 7 4 CODE COMPARISON ADJUSTMENT FACTORS Fv NT AREA CODE FOR WOOD F ING U TD BTUH LOSS RAM cc studs joists ov f dtn 7Za 7 �(�, 12" 20 1/ ove grade 16" 1 10% ve _ g_rade _ /.s� . 25 �Z • 7 24" 10% 7% grad 4 ow grade(3� .20 S2" ling / 800 .029 7Z 52.2 ALLOWABLE HEAT LOSS J � COMPONENT AREA "U" TD BTUH LOSS b as e � walls more than 3 feet . 0� Z Z2•?$ M1 below grade S floors /8d0 ZS Z gs.0 *TD = inside temp. minus 20 degrees HEAT LOSS (7• **From table on page 2 page CCZPTZD F AACTZCZ INSTRUCTIONS: for completion of acceptable practise method, please refer to Uniform Dwelling Code, Chapter Ind 22, Energy Conservation Standards, Appendix Tables A -1,2,& 3. WINDOW GLAZING:HSingle w /storm DOORS: nsulated SIDING Qwood(R .77) WALLS ABOVE Insulated glass Solid wood alum(R1.82) FOUNDATION [Triple pane ninsul w /storm WALL ;i INSULATION TYPE: WINDOW AND DOOR AREA PERMITTED % GROSS WALL AREA(from worksheet, page 1) = square feet. GLASS /DOOR AREA(from worksheet. page 1) = square feet. PERCENT WINDOW /DOOR AREA = glass /door area PERCENT WINDOW /DOOR AREA = glass /door area + gross wall area X INSULATION TYPE: R VALUE (per inch) CEILING SQUIRED THICl2IESS(per table A -3): " in cavity "over framing FOUNDATION WINDOW GLAZING: single C1single w/ storm Qinsulated(double) WALL INSULATION TYPE: _ R VALUE EXPOSED FOUNDATION AREA(from worksheet, page 1) = square feet. (walls must TOTAL FOUNDATION AREA(includes above & below grade)= square feet. be insulated PERCEIIT EXPOSED = Exposed foundation - total fdtn square feet. to be in con- PERCENT WINDOW AREA PERMITTED(see Table A -2) _ _ %) formance.) PERCENT WINDOW A'RM(Window area t exposed area) = p ercent(') :tqr:LT3t i r TZON VOLUME CALCULATIONS: LEVEL VOLUME CON. TD A /C* BTUH HEAT LOSS Basement .018 Level 1 .018 'f Level 2 _ .018 Level 3 .018 *AIR CHANGES. Recommended changes between .25 and 1.00 INFILTPATION `€ depending on type construction, number of openings, I HEAT LOSS weatherstripping, caulking etc. +j ruz%2c cz azzz ALLOWABLE HEAT LOSS(from page 3) TOTAL DWELLING LOSS INFILTRATION LOSS(from above) x 1.15 BASEMENT HEAT LOSS (fro page 3) MAXIMUM FURNACE SIZE TOTAL DWELLING HEAT LOSS: S PECIFIED * Furnace output 4 . 0 0 14 w o R ; ■ ° y■ z I z e @ \ k < \ 0 / k ` _ ° % : s -4 « G �0 _ 21 ��� -4°G) 6 E CD a © CD e 0m A & o m $\ 0 $$�� ¢ C ® $ $ E z co ca ° 00 � ) F. � k :2 \ \ k $ � : ■ ■ ■ q / § 0 7% Q o a� o =r W k ■ k z _ § 2 ( \ g E / (D CD 0) [ . � { CD E � / 2 § ; 2 z $ \ E . z ¥ ( f § c \ c # ! C o -0o > a kk)0 G c . kCD k/ ( Ecr o §a§ � c cn � \ 0 \ q CD a . a � ■ n \ \ ' f \ \ % 8(D ! �\ � Parcel #: 030 - 1072 -70 -000 02/10/2005 10:38 AM PAGE 1 OF 1 Alt. Parcel M 26.30.19.254G 030 - TOWN OF SAINT JOSEPH Current �k ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * SMITH, ELEANOR K ELEANOR K SMITH SMITH ROGER A SMITH ROGER A 713A TERRIER LA SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 713A TERRIER LN SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 4.700 Plat: N/A -NOT AVAILABLE SEC 26 T30N R19W PT GL 5 LOT D OF CSM Block/Condo Bldg: 2/533 NOW KNOWN AS LOT 1 CSM 6/1554 ALSO THE N 9' OF LOTS 8 & 9 PLAT OF BASS LAKE Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) SOUTH 26- 30N -19W Notes: Parcel History: Date Doc # Vol /Page Type 02/28/2000 618929 1492/463 QC 10/02/1998 588273 1380/327 WD 10/02/1998 588273 1362/242 WD 07/23/1997 1022/163 .0969 2004 SUMMARY Bill M Fair Market Value: Assessed with: 5342 406,400 Valuations Last Changed: 07/08/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.700 119,400 280,400 399,800 NO Totals for 2004: General Property 4.700 119,400 280,400 399,800 Woodland 0.000 0 0 Totals for 2003: General Property 4.700 80,400 189,900 270,300 Woodland 0.000 0 0 Lottery Credit Claim Count: 1 Certification Date: Batch M 129 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 I Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count Safety and Buildings Division INSPECTION REPORT ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy Law s.15.04 (1)(m)j. 315860 Permit Holder's Name: ❑ Cit ❑ village Town of: State Plan ID No.: ORF , VERNON SF. JOSEPH Q CST BM Elev.:- Insp. BM Elev.: BM Description: Parcel T'd b-- 1072 -70 -000 TANK INFORMATION ELEVATION DATA A9800248 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosi ng Aeration Bldg. Sewer Holding St/ Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. Air I to ntake ROAD Dt Inlet Air Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe F olding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction Syestem TDH Ft Forcemain Length Dia. FFii Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS — DIMENSION S SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: SETBACK INFORMATION Type Of CHAMBER Model Number: System: OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes E] No E] Yes ❑ No COMMENTS (Include code discrepancies, persons present, etc.) LOCATION: ST. JOSEPH 26.30.19.254G,NW,NW 713 —A TERRIER LANE Plan revision required? ❑ Yes ❑ No (� Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. v ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: e ; E , r E e , e „ a t ,pee._», 3 � t S t e e { ; ; 3 t y ye n M a t ri I ; ; i r 3 a 3 i ; F e } T ; ; Safety and Buildings Division N%f j.SC0nSjn SANITARY PERMIT APPLICATION 2 01 W. Washington Avenue In accord with ILHR 83.05, Wis. Adm. Code P O Box 7302 Department of Commerce Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County f than 81/2 x 11 inches in size. S • See reverse side for instructions for completing this application State sanitary Permit Number Personal information you provide may be used for sec�ogdary purposes ❑ Check if revision to previous application [Privacy Law, s. 15.04( (m)]. tS &?' State Plan I.D. Number I. APPLICATION INFOR - PLEASE PRINT ALL INF RMATI N Prop rt Owner Name Property Location �,� �,i is N w 1 i4, S ( T N, R / E (or)� Property Owner's Mailing Address Lot N ber i3lock Number I — A f(.t� - City State Zip Code Phone NumAer Subdivision N me or CSM Number (_)r< ) Sy 11. TYPE OF BUILDI N (check one) ❑ State Owned D C IT r Nearest Road VII age Public 1 or 2 Tamil Dwelling - No. of bedrooms sa_ Town OF lrfl✓ � )Dh III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo Z — 13O' 1 9 ' a ( q )67 - 7 d 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 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) .GrrG4— A) 1. ❑ New 2. ❑ Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5 Repair of an System ________System_____________ Tank Onl�r-------------- Existing System ________ ExlstingSystem 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 11SSeepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill 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 Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq, ft.) (Min. /inch) Elevation � � / n j f 3 feet 7i Feet VII. TANK in Ca g clt allon Total # of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturers Name Concrete con- Steel glass Plastic App New Existing strutted Tanksl Tanks p c a /�Oo l V� ❑ 11 11 ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ I ❑ I ❑ 1 ❑ 1 ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility f K ins pplatign of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plum r' i ure o Stamps) MP /MPRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code): -* IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitar Permit Fe (includes Groundwater D ate Issued Issuin9g nt S nZture (No Stamps) .)gApp ❑ roved Owner Given Initial / �j � Surcharge Fee) 1/V �� � j� 1 Adverse Determi X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: �uvchw+joh o -� .Q-k� Ski ✓tq S ��wti . J $BD- 6398 (R.11/97) DISTRIBUTION: Original to County. One copy To: Safety Z Buildings Division, owner, PI mber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be 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_ Ill. 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. Vill. 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 1/2 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. `. Wisconsin Department of Commerce rl ID SITE EVALUATION � Division of Safety and Buildings k 31__ . 1 , i, Page -j- of Bureau of Integrated Services �n'at;cordance �iv�i's� ILHR 83.09, Wis. Adm. Code County Attach complete site plan on paper not lest than 8 1/2 x 1 ti ilic�e .id size PIAhi rust include, but not limited to: vertical and hor reference point (BM), direction -ind percent skipg, scale or dimensions, north Arrow, and kJC+tiovh aidce to nearest road. Parcel I.D. # ST CROIX — d APPLICANT INFORMATION - P1e I prig iatiorf.,. % Reviewed by Date E ; Personal information you provide may be used for se46ndwfy urposes (Privacy LaW, s.' .04 (1) (m)). Property Owner j '� ;';,, Property Location V\ m r' `° - -- Govt. Lots OW 1/4 OW114,S L T 3c) ,N,R' 9 E (or Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# '1 \ 3- Pt Te-'r r tr R. C, r 1 I C M IPA5 City State Zip Code Phone Number ❑ City ❑ Village Y Town Neares oad :50W\e Se W� S�4aZ5 (� ► >Sy Y �° K 5o e �c '��r �. ❑ New Construction Use: Residential /Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow 95 O gpd Recommended design loading rate bed, gpd/ft trench, gpd/ft Absorption area required bed, ft trench, ft Maximum design loading rate bed, gpd/ft trench, gpd/ft ppG1 . fl etorrfrttend i ed nfiltration surface elevation(s) q 3 ft (as referred to site plan benchmark) Additional design /site considerations to el J a. b h J o N L ro v- Q o S s .r 6 r , - Parent material Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ® S ❑ U ®S ❑ u 54 S El [54 S El - Is ®U ❑ S U SOIL DESCRIPTION REPORT Boren # Horizon Depth Dominant Color Mottles Structure GPD /ft Boring Texture Consistence Boundary Roots in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench '� S _ , 0_ joy{ n_ Ground elev. 97 - !k 2ft. `{ -14 2 S ` AY 1 y 5 L S b - 3 7 S `�l SL Depth to limiting 9 -70 7.5 `f QS factor 70 in. Remarks: Boring # h� r `+ S H— !a rw-3u Oki Ground elev. ft. , Depth to limiting factor in. Remarks: CST Name (Please Print) Signature Telephone No. 0 C1 e- j!- 7I 5 - aZy $' 3$�� Address Date CST Number V Sy o a 1. SOIL DESCRIPTION REPORT PROPERTY OWNER _ Page of PARCEL LD.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # ........................... Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) OV , lot 5 N W yy tvQY S sc„ G.� T 30rv, R 19 W S►rnews`, 0K V..a, r O t -t sc l c c st w► y I � - 70 a cr e - to +) \ v 3 it. 9a 1 l Po�-e. Stiff •► h l l �o Fa ► as 0 4 f a he—) 4� I �rP.� �c��sV�v►t`P�p 1 rt Ori 13r� 100 re fe eh a c.. 9 7, S to F-C ON Post ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer - Mailing Address Property Address " (Verification required from Planning Department for new construction) City /State Parcel Identification Number 3 d - / z — 2! LEGAL DESCRIPTION Property Location %, , e y� Ste. TN RW, Town of ST Subdivision Lot #_ . Certified Survey Map # 1/U39 Volume re Page # /s`y Warranty Deed # X13( )a3 Volume c Page # Spec house 0 yes [o Lot lines identifiable es ❑. no �l Y SYSTF- I1'I- MAINTENANCE - - QImPr�Op ruseaadmakt=z=ofyour:epticr moould=altmitsp - tohaadlewastes.Prope umktmance P out scptrc task CVW three years or wanet; if wedeiby x licensed pinupm What you put into the system can affect.&C - fimctioa of dw septic twk a treat meat stage in rho waste disposal Vacm MW PiroPertY ow= agmes to submit to SL. Crn� Zoning Dcparta>eat a f�,, by the -ownrx and : - P7�y�aPlua�yr�ictodplumberoraliccasodpamperverifYingtbat( ij$ Leoa�itavvastewatcrdssposaisys0em is is P� condition and /or (2) after iaspcdion and pamping.Cif aoxssazy). gbe ieptie•tank is less draa 1/3 - full of sludge. I/we. the undcmigned. have read the above requirements and agree to maintain the Private sewage disposal system with the standards set ford herein. as set by the Department of Commerce and the De stating that your tic of Natural Resources; State of Wisconsin.. Cetific ad6a �' mtcar has Boca maintained must 6e completed and r>rbumcd to the St. days of tine three year County Zoning Office within 30 Y� troa date. SIGNATURE OF J � DATE OWNER• CERTJ.PTCATTON the , I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owaer(s) of PAY described above, by virtue of a warranty dcod meorded in Register of Deeds Office, SIGNATURE OF AP CANT 6 DAT E « « « « «« Any information that is mis ted ma y result is the sanitary permit being rev by the Zoning Department. «« « « «« «« Include with this application: a stamped warranty deed from the Register of Deeds offic a copy of the certified survey map if reference is made in the warranty deed i ST. CROIX COUNTY ZONING OFFICE i CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving g the residence located at: %, Sec. - , T 2)0 _ N, R – Ic� — W, Town of St. Croix County, Wisconsin. Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced <11 Ig9g Did flow back occur from absorption system? Yes4 No (if no, skip next line. Approximate volume or length of time: 51 gallons minutes Capacity: J000 Construction: Prefab Concrete X Steel Other Manufacturer (if known) : Age of Tank (if known) : ' (Signa re) ` (Name) Pled 6e Print z eo s`s4 (Title) (License Number) (Date) Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) , - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify hat h y the tank, to the best of my know edge, will conform to the requirements of ILHR Q 83, outlet baffle). Wis. Adm. Code (excep f r inspection opening over Name Signatur MP /MPRS l ii1v8ETiT tdS7�. - -- • i WNW vaet 21"Pvzo how 01140406404 DATA U STATE BAS OF WI3CONUM FO R l-- JM � *. put - ST. CR6X Co., WI R*ed tour Resod ...I% gA t.- f+....7{ AQ... jt7 CAi1 .............................. ............................... APR 29 emms and warrants to Vo xr= ... 0r f..& nd ...Mat1y_s ... MI.., .•...__._...__ d 8 :� 0 AM a -- husband--and- a Xjq hts-.-o f_ surV- iVor8hip ........................... ........ ..................... .. w«r+wra�oai 4 ................ ............... ..--- •- ••-- .................... ..... ...-- •..._.. .................. 1ifMw TO ............................................................................... ............................... .....................................................................•....... ............................... r floe following des+ribe3 teal estate in ........4ti.. Croix ....................C State of Wisconsin: Mist Paesd No: ........... _ .... _........... Lot BD' of Certified Survey Map, as recorded in the Officm of the Register of Deeds, St. Croix County, Wisconsin, in Volume R2" of Certified Survey Maps, pap 553, berg a part of Government Lot Five (5) , located in the north Half of the Nwthk g;t Quarter (N} of NW}) of Section Twenty -six (: `►. Township Thirty (30) North, of Range Nineteen (19) West, 8)CUT the folly a+inq described parcels Ccmaeming at the Northwest corner of said Section Twenty-six (26)1 theme due East (assumed bearing) , a distance of 769.13 feet aloW the North line of said Section 261 thence Sou h 10° 38 30 East, a distance of 1007.10 feet to the point of beginning of the parcel to be described= thence oantiming South 10. 38' 30 East, a distance of 324.73 feet= thence due East, a distance of 475.0) feet= ! hence in a Norttaxwterly direction, to a point vAdch is 425.00 feet East of the Paint of Beginning, and 33.00 feet South of the North line of said Lot "DR; thence West to Point of Begbviirtg. St> JWT to easement fac ingress and egress as described in the above described Certified Survey Map; and =m= WITH easements for ingress and egress as also described in the above described Certified- Survey Map. This conveyance is given in full satis- faction of that certain land contract, This ....... ia__.n4t....... homestead property. dated May 18, 1978 and recorded May 19, s (is) (is no 1978 in Vol. 574 of Records, page 260, Doc. No. 348689. i Exception to warranties: (� � y Dated this ............ ....a_7.._..................... day of ............. A ....... 88 .... 19_........ ........................... - - - -- .................. (SEAL) `L "-.�!v /1��LA _1 .. (SEAL) ._Martha B. __Orf_ ..(SEAL) ,Y��(c �Gt4 ......(SEAL) • ..............•-----•...._.... .- •--- •---- •••- ••- ...._.. - -•••• .... • Aargaret...Orf .................................... If AUTHENTICATION ACKNOWLEDGMENT i� j" 8ipstare(s) •_--------------------------------------------------------- STATE OF WISCONSIN ......_...._._..__.........._...----- -•-- --- ------------ --- ---- -- satbaatieated thin .--. ---ds7 a- ----- ----- --- ----- ------ 18 --- --- Persomm eaa.e Imfore me this ._22t l_---day of y t - pr.U. ------- �__-� 19.,3_A.. the above named Max tha__B.__ Qr a __Kargar.et_..0.rf_....... • - --•-• -••••••---- BA OF WISCONSIN • - T -.._.. -- ... TITLE: Y$7iBICB STATIC •----------------- - - - - -- - ----------•-•------------------------------- }� • ---- -- - --- -- - - --- -- ---- --- --- .............................. satbo by ; 706 06, Win. Stab) to me known to be tin I� lwrwn a ......... wft ecnted the g g jr Ins r 7Instr+�eat net wledya+'ttie him! es THIS INSTRUMENT WAS DRAMD BY N •• Ar L Reinstra, Van k &Needham, S.C. .. - ?`. -- ' 201 Sout)t Knowles Avenue J n ...- ; O.-Ruth. A.___ a` . ...,.Oj'__.- ......_�__.. - New °n # etaondy - 141 - - - - - 540.17------- ----------------- Not Public --- St__- Croix . ....... • '_don ty, Wis. (Owwtures may be ent or acknowledged. Both Yy Commissim is teraminent. (w n , piraiion an not date: 12 .I9.........) *XG .f p.no+9 doable is W pp•eft .ha.ta bo typed or priaW below their a4pabire.. ~ STATE SAE O1 WiWoNSM R FOAM Mo. 2 —1982 Sfoe)c No. 13004 403488 CERTIFIED SURVEY MAP VERNON ORF art of Government Lot 5 of Section 26, Township 30 North, , tange 19 West, Town of St. Joseph, St. Croix County, Wisconsin. a co ,`` �sgfttaaaa�a y �� o 4; �S io Z .H . 2 LAURENC ' 0 � h s m • W MURPHY = Z S 41S � 5 0 °0 PP OVE�D .W a p2 1985 Laurence W. Murphy Litt Registered Land Survey Q 55 M LpK It h o W W Q: ro P ? • A :.,NI , - Q U b .1 ku tu o -- vl 4. ~ ° " N o o �I N �j kl8 ib I ss' Z 3A0 8 I y +) +� ,r v+ • _� I I W g 2 cd cd 23 �I Z, i . 0 X00 .� i o 10 Wk HI N % 31 H H i V r. • O -4 VI I I N � f O v R Q; o y 3 I W N tu O n g W h tu cb r y v d ,o M 3Q M M rr 972'70 ') W N 2 p� m 10 , 17'10,3 874. 3 ° 3 q tu <n a R Sj0 2 W to h h $ O q 3 m y -j x N I o q a Q M I u � b q a O q 4� • I b C O � b Q 131 m � W N O R o m o q h ° a ci FILED ° 15198 ° W JUL M to / boom st H Oaudr _ W w Ord% Crrih. q b y W h ' 10 it rrw 167. 46 / I o O Q: N 10' 17 r 30 W Oty P to h Dated: April 11, R1N — 'o 1985 _ R l V A rE 73r) b N � _ _ � r „ 357. V j A pt ENT b P 4 , 1sIO.3e 30 LU RO C.S. M REOF N O r X0 E 3 9 R Vol. 6 Page 1 14 3 2 p oL � 2, CTY M's ` FL A =p_LA i NDS Certified Survey P o N 3 a ° S 7 • cR _ _ . �. �- St. Croix County, Wis. KNEE T / OF 3