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HomeMy WebLinkAbout030-1073-95-000 ` n N O' n N O 3 n d 1l go 0 � CD d o o v o p W S m d o o o W rn ° w • CL CD - _ - m rt cn CD _ o N O a 7 O j y 0 C 0) N a 7 y C S N u'S C N C co ' fD O C CD D m O O N O D O m O CL 0 63 a. to 1 y W fA co W lr o m° a C O o v N O m D ,� o v U> Z D ,� a s � A y a W I co � D y a W y I 0 CD W y l CD y m o rn CD N V� CL y 0 0 a ( 0 C CO CO CT CT 3 :'! tS CL CL C Ci 9 O000 z 000 0 , l�l• o Z v 7 Z< D A A o G o G O O 0 F 3 N co) N � � 3 N N N O N N �_ y CD O D _ O O O (� CD w N o CD y O W so V < w < w V N , m °� N 3 °1 cn CD m O Z .. _Z N ° zcoz °— z�z 0 o D Q - D v 3 o O �i O CD � m r' // CD m y ( ►► [�� 11 cn T7 C CD CD y G �f G_ CD G N I (D a W W CD CD Q 3 3 o 3 m ca Z CD Z CD N Z y C y O C r w y a f a A z 0 0 O w 0) ( W � o Z c c r°r. CO co U) Z a m m I I f I v c� °. o a v ty a Cc, °O d - j C-p• a CD CD n = i m o: CL :3 O O ?t D �' m c v` CD c c� Z n a � o 0 a _ � � o CD cn En =r a 0 CD I N - � d - d O CD O C d M ►1 CD CD x � a r N a3 n� m o �' p a N m A 0 I I CT T CD y h. O O N CD CD O O y O s q 0 o b w CD < C wo 69 w ° O I o '` v 0 o m o m b I o Parcel #: 030 - 1073 -95 -000 05/15/2006 03:50 PM PAGE 1 OF 1 Alt. Parcel #: 26.30.19.257A1 030 - TOWN OF SAINT JOSEPH 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 DARRELL C BURMAN O - BURMAN, DARRELL C 1304 BASS LAKE RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description ` 1304 BASS LAKE RD SC 2611 SCH D OF HUDSON SP 8040 BASS LAKE REHAB DIST SP 1700 WITC Legal Description: Acres: 12.640 Plat: N/A -NOT AVAILABLE SEC 26 T30N R19W GL 8 LOT 1 OF CSM IN Block/Condo Bldg: 3/759 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 26- 30N -19W Notes: Parcel History: Date Doc # Vol /Page Type 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 12.640 177,200 175,300 352,500 NO Totals for 2006: General Property 12.640 177,200 175,300 352,500 Woodland 0.000 0 0 Totals for 2005: General Property 12.640 177,200 175,300 352,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 209 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 epartrneht of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix wilding Division INSPECTION REPORT Sanitary Permit No: 479353 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m) Permit Holder's Name: City Village X Township Parcel Tax No: Burman, Darrell I St. Joseph, Town of 030- 1073 -95 -000 I CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: o o. 0 (� C 26.30.19.257A1 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS FS ELEV. Septic Benchmark i000 441 iOb�U Dosing Alt. BM Aeration Bldg. Se r d,,, — a Holding SUHt Inlet SU t Outlet TANK SETBACK INFORMATION TANK TO WELL BLDG. Vent to Air Intake ROAD Dt Inlet l i Septic , r I i ( 21 Dt Bottom 7 2 " D Dosing S , Pf - Bader /M �,p� / 6 3 ��• b Aeration Dist. Pi / 'S �g � /�-fS /�• b 3 �� Holding Bot. System F inal Gr ade PUMP /SIPHON INFORMATION I syr-4 emox 3 Manufacturer Demand St Cover GPM D5 - Model Number Z t TDH Lift Friction L ystem Head TDH Ft Forcemain th Dia. Dist. to SOI ABSORPTION SYSTEM 'f BED/TRENCH Width Length No. Of Trenches PIT DIMEN S No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM L CHI Manufr: Rai INFORMATION Ty Of System: CHAM OR �1'!(J(�tJ zoo / I Model Number: PISTR� BUTION SYSTEM Header/ nifolq Distribution x Hole Size x Hole Spacing Vent to Air Int Q 4 Pipe(s) T'f � „ � L gth Dia Length V Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only ` S th Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched ed/Trench nter f BedlTrench Edges Topsoil •� [7] Yes L] No Yes F] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:�/ Inspection #2: Location: 1304 Bass Lake Rd. Hudson, WI 54016 (Gov't Lot 8 26 T30N R1 9W) NA Lot 1 Parcel No: 26.30.19.257A1 1.) Alt BM Description =P of 2.) Bldg sewer length = 2 v— 41- Well f - amount of cover = J > Plan revision Required? ❑ Yes r No 0 Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor' Signature Cart. No. Al Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 t V sevnsin VCodn Sanitary Permit Number (to be fill in by Co.) Department of Commerce 8) MirIVED 7°� 35 Sanitary P`erion State Plan I.D. Number In accord with Comm 83.21, Wis. Adtion"d*ov c,3 x,005 may be used for secondary p 4(l xm) Project Address (if different than mailing address) 1. Application Information — Please print A ZONING OFFICE P, rgperry Owner's Name r,Jl � Paa�rcel # Lot # Block # N Q Property // Owner's Mailm ddress Property Location , Ci State 6 7/ / V , ' w '/ 1 . � Zip C e Phone Number Section Ason W� s 1 b '7 S &7 t ircl T N; R _aE o W II. Type of Building (check all that apply) K 1 or 2 Family Dwelling— Number of Bedrooms CSM Nu g El 3S PubliclCommercial — Describe Use c ❑ State Owned — Describe. Use ❑City ❑Village Township of P III. Type of Permit: (Check only one box on line A. omp to line B if applicable) A. ❑ New S ystem Replacement System ❑ Treatment/Holding Tank Replacement Only El Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. T ofPOWPS System: Check all that a pply) Non — Pressurized In- Ground ❑ Mound ?24 in. of suitable soil ❑ Mound <24 in. of suitable soil ❑ At -Grade []Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter El Leaching Chamber ❑ Drip Line Gravel -{ s Pipe ❑ Other (expla V. DispersaVrreatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation S - 7 010 VI. V auk Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units P�t,Yt_o k PLS Concrete Constructed Glass New Existing I 1 Tanks Tanks Sept r Holding Tank 1 000 Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the aadetsig , assnrne ponsibitity tort t the NOWTS shown on the attached plans. P tier's Name (Print) Pl tier's 'gnature RS tuber Business Phone Number ` e 5 1 _7L5 o1q 6 SIBS Plumber's Address (Street, City, State, Zip Code) I C t to C1 sId, N .� s VIII. Coun /De artment Use On Approved ❑ Di Sanitary Permit Fee includes Groundwater Date Issued Issuing Agent Signature (No Stamps) C Surcharge Fee) , ❑ Owner -- Su Given Reason Denial 00 ^ O3 IX. Conditions o pprov l SYSTEM OWNER: 1 Septic tank, effluent filter and psi dispersal cell must all be serviced / maintained as per management plan provided by plumber. rr -- 2. All setback requirements must be maintained ) s� fS �t° as per applicable code /ordinances. to o Attach c wm le plans (to the County only) tar the system on paper not tess than 812 x 1 t inelmlln size SBD -6398 (R. 01/03) 1000 OJ Q S ec an , 3 , i r , f , , : E , , -a G _ , , - , b i , l 13o4, 'joss �Ca_ 1�0� �.�os S _ C ro;X _. Q j � - CC 1000 'c t A u Nam . Q F- n l�.fi 1 1 a G 1 i b f , lw l 63 Mw d'� SOIL EVALUATION REPORT Pop a r+ MM"I" -0 OOMM ft Vft Adk. Cods aorpydr sw, p Coves < on p"w tidudo. butaati�i/1ac %mloo 4" 1d tip k" a tQ: t t owfe sly PIS► w W ors 0� tBlq. �Ilae and �O��Ra�ardwnwsiais„ ��� .wdbca�awddMAOn�sbwMwwlao�ad. Pfau pr" 4w mftmwaa d by Chft 61nR id S 4 SAM Sarp T 3 a w R W '�1a? &A o two ! d. Nwnaaresw $��< °- �s s o I 7aMn Ra M..�rMapb.rdbas ftwaft V54D aPn Ropl.oamonc P+ubSctaraona�_ �,.�,� ar.ww Q �.� �Cc►.,s {L naodwa>aalaarfonitappicoiJl� � �iaaaoiaan.n,ee } , ��� ❑� �yz dni2� onar��a P* em"wNaoadov. • — & 6, ? t>rpw a rarrO wl�o�or �Z� �„� wssasc..ap� Toga ,, Sew 0 M imft n PAW va. OL am caar OLSL ML vw 6 - S; pm S G� q tr s I c� - ,5 1 fD r 1 •7 ,.� 5s 9/• Z- U • d aswron � �t� . prdoR a.000plsn �. Sbrrdrw �. woos OIL i�lanoo6 m. SL Caut Color Or. SL SR 1 M S M g(o•3D 1M s * SO j mm W40& aad TSS 3-U 760 no& 1 30 U40L arm 7w 130 wqL • Q CWWw w 7 Add�as t1MtEliMia�� 74s -a Y6 S 13 ® V ■ , WIR m ����� V\ R oar Pa- h ! 3 0 ass C�ad. -JQ)E-. le Q l S C_M i X C al 6YA Y Ali vi ch+q �h 1 4 � ' r a� EZ1203H vvvea ��• � ves vvvsvv �•' , ir :• vvsa ovv 4 t t vve svav O4a s t ..,.. f.: s�. °NN4Nav 24 tt vov i < , {��w ow 121► L vvv vvv 4.625 N vvv J vv sve vov vvv vvv ovs� 1 tt 0 o I12 Cut . = 18.84" vTv ovN ° Ne0044 ° T ovvv seo °v °t °°° VW VVI vov °O° ovovs v ovvsvoevssosor eovev° °o ° ° °ov °vvvTVv 24 Bottom 36 Vold 1 2 -1/2 DIA. (tyP•) Void Coefficient -in Aggtepte give, at 57.44•, oil Interface A_ r _ea 12. IQ EL Cg l?t O.D. of 4" pipe - 4.625 inches Sidewall (2 Sidewalls) 2 * 18.84in — Void volume per linear ft. = 3.14. 2.3125iu • 12th — 3.14 ( 12i. /ft /, Ift =0.117 ft, lR Bottom 0.D, ofcentercylinder -T2.5 inches 2.00 Total Soil Interface Area Void volume in aggregate of center cylinder= 3.14+ fi.25in _ 5.14 SQ.FT (( t 12in —J - 3 14 • t JI25ia 12intfl Y) • .574 = .422 f1' ll O.D. ofoutside eylindetsg 12 inches Void volume in outside cylinders r Projected Trench Area Y dens = 2 •3.l4( bin l \12in/1,f 901 _••574 =. ft' AA Sidewall Height = 12 in. "2 = 2.00 Sq.Ft. Void volume at bottom between cylinders - ( 24th Bottom = l bin bin }) 12in /ft • 12iniR�' (3. 14( 3b in. = 3.00 $q.Ft. {. J = 0.215 ft' 12 nn /1, l )J Projected Trench Area = Void volume at outside bottom corn 5.00 Sq.Ft. cor ners (1/2 of void volume between cylinders) 0,21512 = 0.108 fN 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 >rallont n r linear tt t! EPS /A ggregate Trench System EZ1203H Rin U flow 65 9In ustrial s park Rd. Oakland, TM 18060 SCALE FILE NAW& ¢1203H -vst SHEET: 1 of 1 11 -27 -01 t Pa POWTS OWNER'S MANUAL & MANAGEMENT PLAN _1 of �ldi: MaOf�MATtON SYSTB i SKZCRCATtONB owner Tank Marwfactuaer � •eS -2 ❑ NA Permit # �? seati� ©Dose ❑Molding Vol. gal Tank Manufacturer 0 NA tlESifif! PARAMETEtRS of Bedrooms O NA 0 Septic 0 se Do 0 Holding Vol. g al Nurnber Number of Public Facility Units Effluent Fitter Manufacturer 0 ❑ NA Estimated leverage) flow Effluent ROW Modal Design #Peak) flow - (Est x 1.5) PurnP IlManufacttrer DN(Est Sot Application Rate ! MW /fta P ump Morel Standard IrMurent/Efftui nt Quality Monthly raga' ave Pratnsatment Unit [3 NA Fats, OR & Grease (FOG) 530 mgiL ❑ Sand/Gravel Filter ❑ Peat Filter Biort aI Oxygen Demand (BOW 5220 mg& 0 NA 0 Mechanical Aeration O Wetland Total Suspended Sonde (TSM St So mg/L 0 Disinfection ❑ Other: Pretreated Effluent Quality Monthly average manufacturer Biochemical Oxygen Demand (BODj 530 mg& Dispersal CONS) DNA Total Suspended Solids (TSS) 530 mg/L 0 NA in'Grouxf (f�ty) 0 I► Ground (pressurized) Fedai Conform (geometric mean) :51W cfu/10C)rrd 0 At Grande ❑ Mound Maximum Effluent Particle Size Y in dia. ❑ NA 0 Drip 0 ❑ NA Other: 0 NA •Values typical for domestic wastewater and septic tank effluent. other. 0 NA 11Apt tAP E SCHEDULE Service Event Service icy month(s) imaxii tan 3 years) 0 NA Inspect condition of tank(s) At Mast once every: s When combined sldge and scu+n equals one -third (%) of tank volume u ❑ NA Pump out contents of tanks} Whan the high wa alarm is activated D month(8) (Mw& um 3 yea rs) 0 NA Inspect dispersal caltls) At least once every: s} rug mo+tth(s) ❑ NA Clean effluetni filter At Mast once every: (s1 rrrorrftn #s) 0 NA Inspect pump, pump controls & alarm At least once every: 0 ) p rnornth(s) 0 NA Flush laterals and pressure test At Mast once every: 0 yew Other: ❑ month(s) 0 NA At Maas once every: 0 s) Othor. 0 NA Inspections of tanks and &mpersal cells shall be made by an individual earryM one of the f licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer; Septage Servhcung Operator (Pumper). Tank inspections must include a visual inspection of the tankis) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and a duck for any back up or ponding of effluent on the ground surface. The dispersal cents small be v=aNy gropected to dieck the effluent levels in the observation pipes and to check for any ponding of effluent on the wmxnd surface. The ponding of effluent on the Wound surface may indicate a failing cor6tion and requires the immediate notification of the local regulatory mdw" - When the combined accumulation of sludge and scurn in any treatment tank equals one-third IYsl 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. Ail other services, including but not limited to the sir cmV of affluent filters, mechanical or pressurized components. pretreatmen units, and any servicing at intervals of 512 months, shall be performed by a certified POWTs Maintainer. A service report $hall be provided to the (Deal regulatory authority within 10 days of completion of any service event. GMW 12/02! START UP AND OPERATION Page of For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other chemicals that may impede the treatment process and/or damage the soil dispersal mil(s). if high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when sod conditions are frozen at the infiltrative surface. During extended power outages pump tanks may fdl above normal highwater levels. When power is restored the excess wastewater will be dischafged to the dispersal colds) in one /sups dose and may overload them resulting in the backup or surface urge 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 disperse! 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 drain (sump pump) discharge; fruit and vegetable paehngs; gasoline; grease; herbicides: meat scraps; medications; oil; Painting products; pesticides; sanitary 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 )nsure that the system is Property and safely abandoned in comrpliance with chapter Comm 83.33, Wisconsin eve 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 property 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. 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 replacernent area should be protected from disturbance end compaction and should not be infringed upon by required setbacks from exis*V and proposed structure, lot lines and weft. Failure to protect the replacement area will result In the need for a new sod and site evaluation to Establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. O A suitable replacement area is not available due to setback and/or soil limitations. 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 arts. Upon failure of the POWTS a soil and site evaluation must be performed to bate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. 13 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. < < WARNING> > SEPTIC, 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 RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFRCULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS h11ISTALLER POWTS MAINTAINER Name % Name Phone j Phone P Ld I j SEPTA43E SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name S C 7—' t\ 1 h Phone Phone This document was drafted by the staffs of the Green Lake. Marquette and Waushsa County Zoning and Sankadon agencies in compliance wfth chapter Comm 83.22(2)(Wf1)(dl &(1) and 83.54(1), (2) & (3). Wisconsin Administrative Code. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer _ ��, trP AA Mailing Address I�� �( BtzSS IZ-0JR00, 8 � � soh (� _ to Ip Property Address V1�Q (Verification required from Planning Department for new construction) City /State Parcel Identification Number — OLTO LEGAL DESCRIPTION Z S7 Property Locatior Sec. , T, -R Town of Subdivision , Lot # ' Certified Survey Map # 3 S Volume 3 , Page # Warranty Deed # 3 S (0 LO 7 Volume S CJ 3 . Page # 3 Spec house ❑ yes'Kno Lot lines identiftable,�fyes ❑ no SYSTEM MAINTENANCE Improper use and maintenauceof 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 tm nt sta a in the waste disposal pu g sposa system. The property owner agrees to submit to St. Croix 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 wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read 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 system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 lays o e y expira ' IGNA 1= APPL DATE D WNE CC, C,RTII" ICATION ce ' .y that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of he p pe escri d e of a warranty deed recorded in Register of Deeds Office. F/Z14 SIG A APPLICANT DATE A information that is mis- represented may result in the sanitary permit being rcvoked by the Zoning Department." " Include svith this gpplication. 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 1 St. Croix County Property Report Page 1 of 1 r AMR LISTING UPDATED ON: 8/3/2005 4:22:00 AM Location Information Tax & Assessment Information 2005 2004 PIN: 030- 1073 -95 -000 Status: Mapping Number: 26.30.19.257A1 Assessed Acreage: 1112.64 12.64 Municipality: TOWN OF SAINT JOSEPH Total Land Value: -� $177,200.00 $177,200.00 Site Address: 1304 BASS LAKE RD Total Improved Value: $175,300.00 $175,300.00 Section: 126 Total Value: $352,500.00 $352,500.00 Township: 130 Fair Market Val 1$0.00 71$358,300.00 Range: 119 Fair Market Rat 10 710.9838 Quarter - Section: Original / Net 1$0.00 $5,005.89 Quarter - Quarter: Special Assess 1$0.00 71$578.77 Plat Block: Special Charge 1$0.00 71$0.00 Lot Number: Delinquent Utilities: 11$0.00 1 1$0.00 School: 2611 -SCH D OF HUDSON Woodland Tax: 11$0.00 $0.00 Managed Forest: 11$0.00 $0.00 Private Forest: $0.00 1 1$0.00 Total Amount Due: $0.00 $5,584.66 Ownership Information Total Lottery C 1$0.00 $85.11 Primary Owner Name: DARRELL C BURMAN 1st Installment: $0.00 $2,996.61 Due: Due: 1 /31/2005 Secondary Owner Name: 2nd Installment: [D$iu 0.00 $2,502.94 e : Due: 7/31/2005 Billing Address: 1304 BASS LAKE RD Total Amount P 1 $0.00 $5,584.66 HUDSON WI 54016 Balance Due: 11$0.00 j $0.00 Document Number: Interest: 11$0.00 1 1$0.00 Volume: 11 Penalty: $0.00 1 1$0.00 Page: Total Due: 11$0.00 $0.00 If you are paying taxes based on this report, please print & attach with your payment. Legal Description SEC 26 T30N R19W GL 8 LOT 1 OF CSM IN 3/759 http: //72.21. 230. 178 /website /pasystem /pro /final_report.asp ?IDValue= 030 - 1073 -95 -000 8/3/2005 DOCUMENT NO. STATE BAR OF TISCONSttf - FhDRM 4' 3566 � ^JW 93 wARRANTY HEED ( � VOL i �^��3r3 TNIf ! ►ALE *ESERVED FOR RECOi10010 DATA Clifford D. Noreen and Luella Noreen, KEGISTERS OFFICE -- Ff7i — w i f a ST. CROIX CO., WIS. Rec'd.. for Retort this 7UL convoys and warrants to Darrell C. Burman, a- single man ,day of .lay A.D. 1919 at 1 00 A IVY /pb a/ wit ulm To the foifowing described real estate in St. Croix County, State of Wisconsin: — part of Government Lot "8" of Section 26,, Township 30 North, Range 19 West ae bed as follows: t 1 of Certified Survey map filed January Tax Key No. 31, 979 in V olume "3 ", p age 759 as �io�ument X354822 EXCEPT -the area South of 'the fence (being 48 feet wide - north and south - on the East , ' side and approximately 47 feet wide on the West side and being_713..06 feet East tnd West-.) TOGETHER WITH a permanent non - exclusive easement over that part of Government Lot "8" lying East of Town .Road (including that portion lying East of the Town Road within Lot 2 of this certified survey map) as a means of access to Bass Lake. This easement is appurtenant to Lot 1, but applies only to one family residing on such lot. TRANSFER fo od FEE This is homestead property. (is) (is not) Exception "to warranties: easements of record, if any Dated this _ 4th dap of Ma y .19 79 I (SEAL) _ .(SEAL) C LIFi D. NOREEN (SEAL) (SEAL) LUELLA H. NOREEN i - 354822 CERTIFIED SURVEY MAP %r N GOV 'T. LOT 8 T- 30 - N R - 19 - W SECTION 2 6 BEARINGS ASSUMED S89 4e -03 W ALONG THE SOUTH LINE OF THE SW 1/4 JNP`ptyE��.pN�S 5 �` P �t C � - o CENTERLINE S 24 - 01' -39 BOAROMAN RD. 1 `2. 44 �� 15.01' _ S 89 22" E _ 1305.22' .40 - - - - - -= - - - 491.77= _ _ _ �\ �- 11-7 .43 226.5 310 S51 °- 35` -58'W SB9 °- 51;27"4. ' g . 484.44 47.24' 83 \ ice' j 78.47' p S89� 51 =27 "E S _ °-2'5'-30••4 -1 o; s� 3 17.20' y z ro A I tl S70 52 =19" W,. 123.47' 'O N o w I S06 34' -30 "W. 143.37' LOT 3 A 1 LOT 2 4.23 A. S02 2T- 10r'E.76.04' �= 4. 8 6' A. � cry U 1 4 m ' EXISTING o � BASS HOME LAKE \ io D A O w �IW z LOT 4 �-� N. - ��-' ` 1 S09 od -59 "E. 293.87' 14.72 A. WEST 3 48' 0_30 - 261.60 69.88. �- /,• N g ?2 66_A9 33.42 ` , S15°- 03`- 11"E.60.21' cm 107.01' q a h 523 ° - Od-15 "E, 5728' cx / 1 _ APPROVAL O 15 MINOR SUBDIVIS N 64.24' S33 47 -47 44.87' w DOES NO MEAN APPROVAL o OR / Q \ S50 45 =1r► E in BUILDING E OR SEPTIC SY;TEM, 55.52' A ItEEGIt T 62.20. - POND / 5z dC!' _ST4 =4G -34'4 �`O� - _41.65' b ROVED z 44.91 4' CENTER - tE _ LINE vp ST. CR COUNTY ., / LOT 1 `PNp9 COMPAEHEN TARKS P1ANNiNB' BASS RO AND LO co4wtT€€ 13.48 A. m BI L it w� Q EO Sbo I / 779. 22' 3.4.40' � /� � 272.52' 1 261.88' 134 578.27' L. �`«S1 /4 CO R. S 89 ° - 45'- 03" W s� 1315.62' i ; SEC. SOUTH Ll NE- SW 1/4 CO- MOO N. LEGEND Z•�► yc ros INSTRUMENT WAS \P THIS INS o— — — P.K. NAIL SET DRAFTED BY G.C.S. o— — — I "X 24" IRON PIPE SET, 78 -75 GENE C. WT. 1.68 LBS. /LIN. FT. SHAFFER S -1325 S -1328 t?— - - I "X 30" IRON PIPE SET, IOd O 100 200 300 HUDSON \� WT. 1.68 LBS,/LIN. FT. Q O NOTE= SCALE IN FEET < ' 9 Su ALL ROADS SHOWN ARE M � G6' TOWN ROADS REVISED THIS 177N. DAY VOL. 3 PAGE 759 CERTIFIED SURVEY MAPS of Nov., 1978. ST. CROIX COUNTY, l— e o 3 d 0 C7 ° c C D > > 3 CD d CD W 0 Q) O W N B. 3 fD O L W Mme( CL Z n y N N y O O M N Q p 0 T N CO \ j O (O n 7 V Y, 3 cn N (D m F D o0 ? N o O v cn f D a co m n cD CL � m C a W y 3 O j - r i c rn C J J CC) co CL N g � O .�► • ° c CO) o D o CD G . y N 7 3 61 CJl C O Q .► 1 Z o Z a7 Z O O D a 0 CD N (D N y C N N Z (D C j C j T v a j' G o. CD M o c rn CL Z c r: .° 3 w CO CO m W f o a C: m o c a o a I � N I � _x I ° I N � A X N ba CD �. CL N O A ti o CD CD O CD a ° o � Parcel #: 030 - 1073 -95 -000 04/01/2005 11:04 AM PA 1 OF 1 Alt. Parcel #: 26.30.19.257A1 030 - TOWN OF SAINT JOSEPH Current I X', ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * DARRELL C BURMAN BURMAN, DARRELL C 1304 BASS LAKE RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1304 BASS LAKE RD SC 2611 SCH D OF HUDSON SP 8040 BASS LAKE REHAB DIST SP 1700 WITC Legal Description: Acres: 12.640 Plat: N/A -NOT AVAILABLE SEC 26 T30N R19W GL 8 LOT 1 OF CSM IN Block/Condo Bldg: 3/759 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 26- 30N -19W Notes: Parcel History: Date Doc # Vol /Page Type 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 5357 358,300 Valuations: Last Changed: 07/08/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 12.640 177,200 175,300 352,500 NO Totals for 2004: General Property 12.640 177,200 175,300 352,500 Woodland 0.000 0 0 Totals for 2003: General Property 12.640 109,600 147,400 257,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 209 Specials: User Special Code Category Amount 040 -OTHER ASSM'T SPECIAL ASSESSMENT 578.77 Special Assessments Special Charges Delinquent Charges Total 578.77 0.00 0.00 i I } Parcel #: 030 - 1073 -95 -000 03/02/2005 04:50 PM PAGE 1 OF 1 Alt. Parcel #: 26.30.19.257A1 030 - TOWN OF SAINT JOSEPH Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * DARRELL C BURMAN BURMAN, DARRELL C 1304 BASS LAKE RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description " 1304 BASS LAKE RD SC 2611 SCH D OF HUDSON SP 8040 BASS LAKE REHAB DIST SP 1700 WITC f Legal Description: Acres: 12.640 Plat: N/A -NOT AVAILABLE SEC 26 T30N R19W GL 8 LOT 1 OF CSM IN Block/Condo Bldg: 3/759 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 26- 30N -19W Notes: Parcel History: Date Doc # Vol /Page Type 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 5357 358,300 Valuations: Last Changed: 07/08/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 12.640 177,200 175,300 352,500 NO Totals for 2004: General Property 12.640 177,200 175,300 352,500 Woodland 0.000 0 0 Totals for 2003: General Property 12.640 109,600 147,400 257,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 209 Specials: User Special Code Category Amount 040 -OTHER ASSM'T SPECIAL ASSESSMENT 578.77 Special Assessments Special Charges Delinquent Charges Total 578.77 0.00 0.00 Fill S I 1 'Ci'�d -' R 54822 suRV�v���m��� CERTIFIED SURVEY MAP 9 N GOV T. LOT 8, T-30-N R -19 - W r~ Fit ED SECTION 2 6 SAN 81 1979 J'>f3 0. roELL BEARINGS ASSUMED 84 DOOdir;..` S890- 45'!-03 "W ALONG THE SOUTH LINE OF THE SW 1/4 CENTERLINE S 24 - 01� -39 "E E 1 305.2 S 89 0 -52'- 22 CBOARDMAN RD. - 15.01 2 172.4 \ - - s�. -- 310.4 f - 0- - - - - - - - 4�91.T7= = - 0d -- = -o� - - `�5. - -- m R/W S89 °- 51 =27"E, 1 .43' 226.5 �\ 1ga '�S51 -35 -5d'W ,00 �R/IN 484.44 47.24 6 T8.4T A S89 51 -2 E �. S 83° x -30 "E - �� o . �� s 317.2 I S70 -52 -19 W,_123.47 0 N 0 N AN I �! 1 0 C6 ° o � z°I P S06 ° - 34�- 30 143.37 % LOT 3 A o OT 2 m� a! 4.23 A. Q� S02 27 =t0 'E, T6.04' EXiSTI G � t� BASS HO"'Itr ` �. LAKE � w = LOT 4 o w ►I�,` O , N- AA 1 S09 ° -06 -59 E, 293.87 o 14.T2 A. / W WEST 364..48 I 261.60 69.88 S-(2? 6a Ab 3&4e o S15 03 -1I' E, 60.21 o! / t 07.01 ' $ N �' S 23 -015 -15 "E, 5 r 2-8 APPROVAL O HIS MINOR SUBDIVIS ON / `-' DOES NO MEAN APPROVAL 64.24 —`► i 333° 4T =47't, 4`4.57' �m BUILDING E OR SEPTIC SYSTEM. OR / Q` S50 45L14 "E � ' REFER TO 62.20. .� P 0 N D 5258 s749-4d-34'E W -- • - - - - -- / �� _41.65 N 44 I ` ROVED o .91 co N• _ � ( flf '$ ,, EID / ®- c ( �° C ENTER - aP L 0 T 1 LINE ' ST. CR COUNTY ' -�ANOS CAMP PARKS PIANNtNo 0 / N4 BASS Alf D ZO CpMANfTf€ / 13.48 A. 0 LANCE U R DQ ` o. m I \ a. p 1 `lbo o 11'9 / �� LI VN NOS tl 5 3.4.40' 779.22 134.79 16 272.52' i I 261.88 �'. 578.27- �S.I /4 CO R. IN . S 89 45 03" W 1313.62 i SEC. O SOUTH LINE-SW 1/4 CO. MON. LEGEND o THIS INSTRUMENT WAS NOg �'� o- - - P. K. NAIL SET DRAFTED BY G.C.S. �P 0- - - i "X 24" IRON PIPE SET, T8—T5 7 GENE C. WT. 1.68 LBS. /LIN. F7 SHAFFER S -1325 - - I "X 30" IRON PIPE SET, IOd 0 100 20d 300 HUDSON WT. 1.68 LBS,/LI N. FT. w 4 NOTE SCALE IN FEET �<qk ALL ROADS SHOWN ARE 3(3R 66' TOWN ROADS q�> ) L. 3 PAGE 759 REVISED THIS ITTH. DAY W MFIED SURVEY MAPS of NOV., 1978. CROIX COUNTY, WI. I �C1 • AS BUILT SANITARY SYSTEM REPORT qtER , TOWNSHI SEC _ Z , R Y 9 W .0. ADDRESS , ST. CROIX COUNTY, WISCONSIN. -�' :3DIVISION , LOT LOT SIZE PLAN VIEW -Distances S dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM F i r i n i . w 1 1 1 1 _ 7 j I di�cate i orthl Arrov + j SCALD J 1 7-4 'tP TIC TANK(S) MFGR. ,,,�,,,(,� - ^� ^: •, CONCRETE, TEEL E NO. of rings on cove Depth , DRY WELL INCHES NO. of width length area , no. of lines _ 2 width length ',L are ' GRE6ATE ,,depth to top of pipe • — •'AK RATE AREA REQUIRED AREA - AS BUILT liStiaimer: The inspection of this system by St. Croix County does not imply complete iogliance with State Administrative Codes. There are other areas that it is not possible ` , inspect 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 etermine cause of failure. AEASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. `'INSPECTOR DATED �-� — /f 7 — ,� �) PLUMBER ON JOB LICENSE NUMBER 9EPORT OF INSPECTION SEWAGE SYSTEM San.itany Permit 4 State Septic Z7 NAME rownah.ip Cno.ix County • Locatiox S� -ti See / SEPTIC TANK ga.t.tone. Number o6 Compantmenta i ViAtance Fnom: We.t.t 12$ on greaten a•tope Bu.i•td.ing yl it. W bt. Highwaten it. R DISPOSAL SYSTEM . .� 12$ on greaten a.tope Distance Fnom: We.t.t N�` #. Bu.i•td.ing 3 1 it. W ettand.a F . H.ighwaten it. FIELD DIMENSIONS: Width o6 trench it. Depth o6 tac b e:tow ti in. Length o6 each .t.ine it. Depth o6 rock oven ti..te � i n. Numbers - o6 tines 1 ' Depth of t.ite be.tow grade � i.n. Total .length o .Linea � St. S.tope o trench in pen 100 it. Distance between tinea Depth to bedrock fit. Tota.t abs onbt.ion area �.:,� `�� 6 t2 Depth to groundwate -- Requ.i.ned area : �� 6t 2. Type o6 Coven: t Papen'`ox Straw PIT DIMENSIONS: n Gnave.t around .ita yea no Numb e a pits P Out-side d.iameten ! ' Depth below .in.tet 5t. 2 Total abaorbti,on area it A Area nequed it i. r rn INSPECTED -BY --'_ TITLE, '' ,r APPROVED L/ DATE X 19 7 %. REJECTED ,DATE 197 —. EH 115 4. WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH ' P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS / LOCATION: �t' /a, L"/a, Section Tt!N, R L12 E (or) VOTownship or Municipality 5_7_ Lot No. , Block No. _, Count S T CJ� OlX ����� Subdivision Nam Owner's Name: ' y� q Mailing Address: i" 2_.3-3' S £ 10 � - 5`S /F, / TYPE OF OCCUPANCY: Residence 1 4 No. of Bedrooms — 3 Other EFFLUENT DISPOSAL SYSTEM: NEW z� ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS l Z 75' PERCOLATION TESTS SOIL MAP SHEET Z SOIL TYPE On ;k 0 11 )4m la PERCOLATION TESTS TEST I DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL 1ST BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- ( Z� D P- 3 SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) 0 O 9 0-175 — - S a — 0 c" 3 �a ? v s PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suit ble reas. Indicate number of square feet of absorption area needed for building type and occupancy. l Indicate scale r or distances. Give horizontal a d vertigal reference points. In to slope. I� 1 `O S t N A A l i I s � cot- t c.o�nry rt-�o E 'tify that the soil tests reported on this form were made by me in accord with the procedures 'isconsin Administrative Code, and that the data recorded and location of test holes are correct ' belief. w " Certification No. `5 r CST Signature # PL_967 .State and County State Permit 7 # Permit Application County Per # for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Addresa: O P 4 r r s , ou'p -'• s /o B. LOCATION: Y s %, Section 7,6, T I, R_a E (or) Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township I. 0,7'.5e .0L C. TYPE OF OCCUPANCY: Commercial *Industrial *Other (specify) Variance Single family x Duplex No. of Bedrooms 7? No. of Person D. SEPTIC TANK CAPACITY r 40 00 Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concret Poured -in -Place Steel Fiberglass Other (specify) New Installation _A 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: S Z Width I Z� Depth �� Tile depth (top `"� No. of Line Z- Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land Distance from critical slope S'C1 WATER SUPPLY: Private ;K 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 Test NAME � 14L V `I y1 d %. ' _e ✓_ s C.S.T. # and other information obtained fro m K wne builder). Plumber's Signature MP PRS^ Phone # '2yE 5 3 S Plumber's Address G•�t 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. 5 G 1+,L „ _ v ei a a V _- 4 I E 3 ....v .....e.,.. ..® --._.� T � E f .... aw v. i A j e L _ � a E n 4 E E e m i s� s t 3 < Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application 1 — �� Fees p Paid: State /� Count _-.J 5 00 D e Permit Issued/Pe ssstod (date) Issuing Agent Naat Inspection YNo 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 copy) Revised Date 7/1/78