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HomeMy WebLinkAbout032-2143-80-000 0 3 -0 n r1 c ; d 3 d _1 eo n o = 7 O co o O N N • 7 W F� CD ,�,. (n CD y (D � CD 3 � (D n Q. �, o 7 W O Q co m w a m j D W �L 3 ° CD _ OD O 0 L y O O S y CD 3 Z 000m ° ou m co ca �' fl N (a CA c cr 3 3 N n d N CL M z Q 0 =w O � O O M O O ^ V CD = V y �• (D A C ll+ll N C = CD (D d a N o C �_ CL �' o. � c _ t ID C O N CL z ;U O fT Z Z m w O a �• n cc O > > T r N C i OZ O. O N � N A A A A 'z N V N O O A ti O N D O N CD cn 0 CL y ti Parcel #: 032 - 2143 -80 -000 01/27/2005 12:22 PM PAGE 1 OF 1 Alt. Parcel #: 12.30.19.1254 032 - TOWN OF SOMERSET Current IX; ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): " = Current Owner " WILLARD A & CATHERINE M COTE COTE, WILLARD A & CATHERINE M 861 169TH AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description " 861 169TH AVE SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 3.000 Plat: 0113 -BLUE STEM PRAIRIE 01 SEC 12 T30N R19W NW NE LOT 8 BLUE STEM Block/Condo Bldg: LOT 8 PRAIRIE Tract(s): (Sec- Twn -Rng 401/4 1601/4) 12- 30N -19W NW NE Notes: Parcel History: Date Doc # Vol /Page Type 01/29/2003 707420 2123/433 WD 10/17/2001 659302 1740/03 WD 10/17/2001 659301 1740/01 LC 2004 SUMMARY Bill M Fair Market Value: Assessed with: 11647 240,400 Valuations: Last Changed: 07/24/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 51,000 152,800 203,800 NO Totals for 2004: General Property 3.000 51,000 152,800 203,800 Woodland 0.000 0 0 Totals for 2003: General Property 3.000 51,000 152,800 203,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 12/04/1998 Batch #: 565 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Depa;tment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division * INSPECTION REPORT Sanitary Permit No: 399554 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: P.C. Collova Builders, Inc. I Somerset Township 032- 2143 -80 -000 CST BM Elev: Insp. BM Elev: BM De cription: lo6 fed a Z TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark / Do ' Alt. BM p 90 Aeration Bldg. Sewer Holdi ! S ;Ht Inlet 3 � TANK SETBACK INFORMATION t Outlet 30 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ) , 3 �� Dt Botto ma Dosing Header /Man. Aeration Dist. Pipe l .3 Holding Bot. System /0 . � i f Final Grade PUMP /SIPHON INFORMATION 03. anufacturer Demand St Cover /. Z , S' 6 A I GPM l Model Number TDH Lift Friction Loss m Head TDH t For ain Length Dia. Dist. to We SOIL ABSORPTION SYSTEM / s BED/TRENCH Width Length No. Of ranches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 S Z SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM L i Manu ct INFORMATION Type Of System: AM E OR yp y 7 r 7 r M umber. DISTRIBUTION SYSTEM I to Air Intake Header /Manifold Distribution x Hole Size x Hole Spacing Ven / rr Pipe(s) / (} � / i Length — �d Dia _ Length �!� 7 �Dia / Spacin I G 5 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 [W No ® Yes No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1:�Z- 0, / Inspection #2: Location: 861 169th Avenue Somerset, WWII 54025 (NW 1/4 NE 1/412 T30N R19W) Blue Qtem Parcel No: 12.30.19.1254 1.) Alt BM Description = � 0 t 2.) Bldg sewer length = 3 amount of cover �� obsery a�:o„� p, / � lk spa / � �rd ���/�,• � Plan revision � eq red? 1I es No { Use other side for additional informatio n. Date SBD -6710 (R.3/97) Insepctor's Si6nature Cert. N6. �. f I � .i \� / a �� �� '� \� \��' :� _ _ :- ,- Safety and Buildings Division County 201 W. WaWngton Ave., P.O. Box 7162 5 , C V. 1sconsin Media=, WI $3707 - 7162 Site Address Ds artm »t of Commerce � l I6 -g A Sanitary PerWt Application �'`tt N` mb'er ht accord wYb Comm 89.21. Wit, Adm. Code, persoai Imfor uAm you provide / 3 / � s- ' NZ be Pri Law U3. ! M hCheck if Revision L Appllemion Udbrmalleo - Please Print All Warmatlan sue P isa P O�rmc's I+b� ��� � Parcel Nuunber - l� �v C p Z — Prop" Ownet't MWHM Address £ /p' � r � �• � 4, Property Location � � f City, Stag Zfp Code i Noraber ! ,1_ ' N Block Number r Subdivision Name CSM Number o em u. " Tjpe og sdlalep (cam an ghat SP*) Ot-or 2 Pit - Number of Bedroom �. . _ ;� -. _ -, � t ' ❑Village Q PubtisMosm mial - DucrOm Use OrowrAm gun Owned Nearest Road pt-0 Q M. Type of Rrmltt (Cheap a®ly one boar on Hm A (ntmnbe n sehune for lowssal use). Complete line a It "pU=ble) A 2 0 Repfaoemtm Systatn 3 0 Rel"camm of 4 0 Addidaa to For Took Ody I Exis ' m SY ste O a • pK cbwk N&WWY Permit Previously boned Permit Number Dote TWA IV. lyrpe Of Peemkf (Check stli inlet apply)(munbvin= sclu me Is the internal on) ";R "X a psMUrbed 15.0round 210 Mond 47 ID Sand Filter SO I.1 Consmmod WedaW 22 0 hums led Lt- 0tound 410 Holding Tank 48 a Single Pass di a Drip Litz 45 0 46 0 Aerobia Trahnem Unit 49 0 Recirculaft 30 Q Otber V. t Ana Wannadolot Dodge 19eer W Ara Dfipersd Ara. soil Appiton Percolation Rate Sy stsm Siwatioa Y'iaai Grade 2x mo* d Proposed Rate(Gals./Days/Sq.Pt.) Wim/inah) Slevadon Q,6r VL Ttmic Leib C PLOW fm Total Nutnbsr Mtaoufacpues Prafab Site Steel Piber PiaatiC WON Gallons of Taub Concrete Conntucted ohm N ow Moog or HWft Tok .74- w Vb stmeement I tbs undwalzm& ammm ruponsadity for immaatfon of ties POWTt3 shown on the attached phom o Nsmr Ptntnber's MP/MPRS Number Business Pbom Number Plnmbt o Aftm ( Smost, City. , Mp Qft va vt» p0 �� © � Pte Pse (inchwas, Grrnmdwatsr Dst4 Issued ignature Asent s o 8WW) /� ❑ owner Given ir+Waf Adverse. IL �a d0�e /iaD -M ✓a�— 6Q w�a tw�a t..,��✓ a' pro �,dQ,ea+oaces, e�t7� StfS�- C eu- s ai �s o,Q CS7 piers tar C01OWN wV) 1W the .mss on po w am for lama IMS : ,Nee 38D:6398 (R.. OS141) _ I PLOT PLAN PROJECT P.C. Collova Builders Inc. ADDR SS 705 Countv Rd. E Hudson Wi 54016 NW 1/4 NE 1 /4S 12 /T 3P N/ 1 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 11 /12/01 BEDROOM 3 CONVENTIONAL )00( RE CONVENTIONAL LIFT HOLDING TANK 4 Q 1000 II n a o s SIZE MOUND SEPTIC Tt. 9 LIFT TANK SIZE DOSE TA HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 377 # of chambers 22 BENCHMARK V.R.P. Top of 2" Pipe ASSUME ELEVATION loo' Filter Zabel A -100 BOREHOLE O WELL sH Same as Benchmark SYSTEM ELEVATION 102.1/99.2 Pro town road C9 ST CR"x OCUNTY + J 90' 2 -3' X 69' Cells with >3' spacing Alt. BM. Plans Designed Using B.M. Conventional Powts B -2 Manual Version 2.0 Vents 150' Pro 3 Bedroom ' ° House 30' -3 % T 20' 5 Slope 0 ' B -1 Vents Vent > 12" Sidewinder High of Cover Capacity Leaching Chamber 6' Long 16" 34" Grade at System Elevation 491' Property Line Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Count5.t C Attach complete s1to plan on paper not less than 8 1/2 x 11 Inches In size. Plan must r include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.G. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all Information. Reviewed by Hate Personal information you provide may be used for secondary purposes (Privacy Law. s. 15.04 (1) (m)). Properly Owner Property Location IF L '4 . ��� � f���ice�/ Govt. Lot 1/4 �I /A S/ Y� 6 N Rl E (or W Property Owner's Mailing Address Lot # Block # Subd. ame. or CSM# City orate Zip Code Phone Number City [I Village A Town Nearest Road New Construction Use Residential / Number of bedrooms 2 Code derived design flow rate _' GPD Replacement Public or mmercial - Describe: �' Parent material Flood Plain elevation if applicable ft, G e n eral recomme ons: +>G / b2, z NOV 14 -� and recommedi �a� 1 /9 ZO ©' - 1 ST Cpox 0 0MTY ❑ Boring # Boring Ground surface elev. 1 ft. Depth to limiting factor ^L /1 .SL. in. I i plication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft In. M Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff # 'Eff#2 > «-{- to 2,10 ® Boring # ❑ Boring 3,plt Ground surface elev. g ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft= In. // Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 _< 150 mg /L ' Effluent #2 = SOD, < 30 mg /L and TSS < 30 mg/L CST Name (Please Print) a re CST Number Address D e Evaluation Conducted Telephone Number SBD -8330 (1107/00) Property Owner Parcel ID # Page of ®Boring # E] Boring pit Ground surface elev, � ft. Depth to limiting factor y In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Gv 1 s v ,-S ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fN In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Ef #1 *Eff#2 Boring # [] Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in, Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft? In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * 7T- Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L g/L and TSS < 30 mg/!. The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608- 2648777. SOD-8330 (R-07/00) x Sanitary Permit Application Safety & Buildings Division ' * 201 W. Washington Ave. In accord with Comm 83.21, Wis. Adm. Code See reverse side for instructions for completing this application PO Box 7302 Na 1SC0nS1n Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of commerce [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 1 I inches in size. County State Sanituy Permit Number ❑ Check if revision to previous application State Plan I. D. Number 31 I. Applica Information - Please Print all Information Location: Property Owner Name Property Location £� 1.J,33" � � /1�l �/4� /4, S�i� T3�N, R/ (or) Property Owner's Mailing Address ` 3 F f / „ Lot Number Block umbe r? 2 4. r \ City, State Zip Code yfne Nu ��qq,,��• '' //CC ! Subdivision Name or CSM Number I LL'VLD 1I. Type of Building: (check one) u U (' ❑ City I or 2 Family Dwelling - No. of Bedrooms ^—� `�'�'0 1 ❑ Village .-1 ST CROIX n of ❑ Public /Commercial (describe use):_ r ah cou COU 1y �^ Z� ONIfkC or-ICE ❑ State - Owned j` v — � Z ! Nearest Road 1 () 3 ' X �o�- Parcel TaxNumber(s III. Type of rmit: (Chec only one box on line A. Check box on line B if applica A) 1., New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System B) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply)* —IM . n- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required f oposed Rate (Gals. /day /sq. ft.) (Min. /inch) f� Elevation /� ei VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (print) Plumber's S na re (no stamps): MP/MPRS No. Business Phone Number Plumber's Address (Street, City, State, Zip Geox y / IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued 1 Issuing Agent Signature (No stamps) Approved ❑ Owner Given Initial Adverse Surcharge Fee) dD �! Determination 3 ZZS. /s /0/ X. Conditions of Approval /Reasons for Disapproval: (i AM n � W . L . a�►n ae / o b a� �r 'E'�� S .1AW'&1 ab-3 C., \0�� a, ko q4"-14�4 6 y--I-- CAAA�C,,� SBD -6398 (R. 07 /OO '►^ �vviw - . �nnwt, �G -} •�� �!-�r A 0 P-Q. w�p+tk s �d`" °i4S • PLOT PLAN PROJECT P.C. Cbllova Builders Inc. A RESs 705 Countv Rd. E Hudson Wi 54016 NW 1/4 NE 1/4S 12 /T 30 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 10/24/01 BEDROOM 3 CONVENTIONAL XXX IN- GROUND ORESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 377 # of chambers 22 BENCHMARK V.R.P. Top of 2" Pipe ASSUME ELEVATION 100' Filter Zabel A -100 BOREHOLE O WELL *H. R. P. Same as Benchmark SYSTEM ELEVATION 95.0 1 B.M. #1 , Pro town road Plans Designed Using 10 10 _ 35' 35'- Conventional Powts Manual Version 2.0 0 ' 30' B -3 0, B.M. # P L 2 -3' X 69' Cells T with >3' spacing 0 25' Pro 3 ? Bedroom House PLO 0 Vent > 12" Sidewinder High of Cover Capacity Leaching Chamber 6' Long 16" Grade at System Elevation 34" 49 1' Property Line iscorisin Department of Commerce SOIL AND SITE EVALUATION Page ( of D4vist of Safety and Buildings Bureafof Integrated Services in accordance with C 83 'Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in si 'Plan m t County include, but not limited to: vertical and horizontal reference point (BMA' dii @ tion a r ._. r._ "` ° r � �� GQv ' k percent slope, scale or dimensions, north arrow, and location and di�tar►ca to nearest ` parcel l. . # APPLICANT INFORMATION - Please print all informs #ion. G Re "eweld by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) Property Owner Property ocalftin ��/ ` Govt. Lot Aj ` ;�4N� 1 /4,S t 2 T �N,R E (or)© Property Owner's Mailing Address Lot #. BI Subd. Name or CSM# 1 w Pl-\ e e `1 6 7-.AuE::- v---- City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road �\ONtaCN I L�3 v I S1611 I (H5 )Sy'l-67-3 5E k e_e &New Construction Use: [n Residential /Number of bedrooms _ Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: G Code derived daily flow �9 � 0 gpd Recommended design loading rate bed, gpd/ft • 0 trench, gpd/ft Absorption area required bed, ft 2 �7 5� trench, ft Maximum design loading rate ' � bed, gpd/ft2 Y trench, gpd/ft Recommended infiltration surface elevation(s) Q�' �� ft (as referred to site plan benchmark) Additional design /site considerations t4' If+ �✓� /,/1 Parent material nom(, J s K Flood plain elevation, if applicable 4zm ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system S❑ U 4� S ❑ U -] S❑ U fKS ❑ U ❑ S U ❑ S KU SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD/ft g Texture Consistence Boundary Roots I. in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench h�i 13' 4 - rff 0 3 L M tM i C5 Ground 3 6-�b iv 16 L5 c-� s w•�-2 (�S �� elev. Depth to limiting factor m in. Remarks: Boring # KIVlk_, C5 (z -yo re LS Ground g elev. Depth to limiting factor Q-in. Remarks: CST Name (Please Print) S• Telephone No. Address Date -- -CST Number SOIL DESCRIPTION REPORT Q PROPERTY OWNER Page PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 3 t o s to SL K ►v , F 2 6s i e r5 -]5 J .5 Ground *-1K P- 3 6 f--5 vv� V' t — � ,Z „g- elev. Depth to limiting factor Remarks: Boring # 0 - fS to Z t L V e 3 Ground elev. Depth to limiting factor ';;r6 in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD/1`12 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench Boring # 0-6 %o. a '31 1 1 S C ltv K v v�H - L- 6 -5 $ Z -3k to G i 1 3 r ApwV, w` G\ c s _ .S 3 ko Ground C elev. left- Depth to �Jdl limiting , factor � Remarks: Boring # k Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) PAGE 3 OF NAME .S vf- LOT# LEGAL DESCRIPTION ' /alyF' /4 S /ZT �*b N Rl 4' E (or) SCALE: 1 "= zoo BM 1 ELEVATION C) BM 1 DESCRIPTION c "puc,,og4pg_(a.'f BM 2 ELEVATION 9 3 5 Z BM 2 DESCRIPTION 4 " pvc O - ,Q e t SYSTEM ELEVATION ALTERNATE ELEVATION CONTOUR ELEVATION • oa P� 47h ° N �m • a i \ W's 3 SIGNATURE DATE 10/25/01 THU 07:56 FAX 715 386 4667 REGISTER OF DEEDS C�J601 STATE SAR OF WISCONSIN FORM Z -1990 E� 583 2 WARTj(�jlj�Y KA � THLEEN H. DEE tte�arwnNr V7( 11 f� REGISTER OF CO., UI ST. CROIX . WI RECEIVED FOR R1EC4AO This Deed, made betwoem -- 1447 -201 1:70 AM Rt"WAL M A_ AV OM... 0n J a Elr*�CW7`, � 1L7j1aud. anti vifa, �_ IIARR 7Y 6EE� Grantor. ClRl FEES 17 rnT.T.ntra artrT.n*lta jNjt....�, _ C191 CO MP TS ER F�� T ,. RECUIN E:EEs 11.40 �. Graneca Gnuxw, for a valuable corWdoratlon, conveys and warrants to Cantee the foitowlns described rea] owe In _ At, . ..;. rxn+ Y County, Sure of NVIteonNnt Ileerdi.al ra,:a Zpast, Plat of Blue Stem Prairie, Town of ro St. Cax I: aunty, W1lpc ons ial. Namtentlneturnondesa AW This dead is given in partial alltLefaetion of that �� Jv n? f land contrect betwooa Richard 0. Stout and Janet P. Stout and P.C. Collova Builders, Inc., dated October 16, 2001. DOOMIE tT 0 654301 0,_,_,f 2- X044 -2D -300 peyaal Ids.liUM N~.. FIN Tilt ita nn+ homm.cod property. (u) (la not3 Eacepuons III warranties: easements, restri.ctiors, rights -of -way and covenants of r ®cord. naiad ehls 16th dayaf October z°Dt _...... (SEAL) c � (SEAL) Richard O. Staut. + Janlat 17. Stout (SEAL) ..—,.—(SEAL) s AUTHENTICATION ACKNOWLEDGMENT YFU State of Wlsaansln. authenticated thb day of , D aPa+Iy carte for h h13 y �'� • day of R above traded 11TL6. 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LOT ...... ....... .......... ..... . ..... .... .... ....... ..... ............ .......... . ................................... .. ............. . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .............. . NY 3roo 'oikc�" ......... . 4 1 ................. . ..... ....... . 0 . ........ ......... ....... 130,702 6 6' ......... ..... . .. .. . ..... ................ ............. ......... ......... I .......... ..................... . .......... ............... ... . ................ .................. . .. .............. ......................... L ............. ........ .. ............ ........... .... .... ....... ......... .... ......... ....... .. ............. ............. ................ ................. .... ... . ....... 25' 26 ....... .... . .... .... ..... ... ......... ........... . ................ .. ............. I ...... .......... . . ........... .............. ............. 11 ...................................... ................ ...... ........ ....... ........ ........ .................................. I .......................... CENTER OF ..... . ........... ............... .............................. ......... ........ ................. .. .............. ............. I ............................. I ......................... ... . ... ........... ..... * * ....... ... . ... .................................................. ...................... ........ . :.'..7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........... ............ ........... ... ........ ....................................... n .... . . . . . . . . . . . . . . . . ....... ... S89 1319.50 T 66-00 SOUTH LINE OF THE NW1/4 OF THE NE1/4 80 RADIUS TEN GARAGE (S89 I J- EASEMENT TO EXTINGUISHEC EXTENSION. W@[L. UHPLLM @WSH[M) r Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 Contingency Plan 1. If system fails, determine cause of failure, use alternate area and install new system or install system at a lower elevation. 2. Replace any other failing components as needed. Plumber: Shaun Bird 715- 246 -4516 75 � 6 ' 1 � 0 4 7i-� Ml t"' �& J 49 71 Shaun Bird #226900 r u,LLOUA BLLRS, IttiC rhlt_Ptt nu. . r'_5 544 �_ "_i Feb. 02 2001 07:3A p ST CROIX COUNTY ' SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSIiIP CERTIFICATION FORM Owncr(5uyer CV' l3I n 7 � 7 - N`. ?Mailing Address l C� nv . !C' a . r= �a1,�; u •,� f v L 5 �? -v 1(� Property Address ('Jen ication required from Planning Dcpart:aent fcr -cw conz.ncdon) City /Stato — (��'� Parcc! ide:itffcat ;on �iumbcr LEGAL DESC'RII'TION ?rcvery Location &1W Jl� .... /I -Z t'v" cwt 50 6MAS471 Subdivision 1uQ � Lo ='_. v C Sur -icv Man 4 1 >Var7=r De--d ,J vc a: Sce^. 1 . CtIs 4!s ❑ nd _.7C .L'� :'_'•c :iiiiacl Ste: S M liAICEIENANC� !� !=;mpc: ;.:c and m3Iatta .: of your S C c yr : _-. _ Ltd :rriit i. i ZZ Cr :assists of Puatpiag out the septic mzk ever,! tir- -yea : or icener, iu o=i—�' v a Li==d purrs ^_r. ',4 sat you put into 'be s•: st..:.. can affi:w die fuae:ica of the ;epcic :mar as a Yea. rent =ge in the ova. -te d#osal 3yv the prope:ry owner to stria C to St Croix Z.:niog Depa ct : c.- rt0catioa form, :igscd by ta: ow=. and by i Xamrp lucaber yr z icaasednur ^er-e; fyi a, tLt(i} theon -site wlstc�ratcdispw.al:yste.� is in proper cgerati -og cxditlon aMd'oc ti) af:: r ins, ectiea =id 7=p izv (if ace r ; ), tie s =tic ;ark is lew- d= I!3 full cf sludge. Jae, the =dcrsigand have -mad the above - equi=cam and azr-_e to maiatsin ;Lc prir3te sewrgc di =osai system with the standards let forth, hurt n, u set by the of Commere:. sad the rm ,==cat of Narr:i Resources, State of Wiscarsia Certification rating that your septic system has boon maintziacd nust be cetr_plc =1 sad rmxmned to 11 St. Cbi.: County Zanirtg Office within 30 Says o veer s iritioa /0 I SIt RATUFaq OF XPPLIC ki , DATE OWNER CERTIFICATIOy )cer that a1I statc:neats on this form ate true to the bee; of ny !c• r) ksawiedge. 1 (we) ant (sty) the ownet(s) cf the d ve, ' virtue ot• a xst anry drd rccordea in Rr.�is cr of Deals Ofrca. �O il4J o� TUBE OP APPUCA�7 DATZ "'e inGumatiott tha !s =is- moresented ma resuit the sanity x .. c Z oning Dc Any y to tY t rttt being revokc3 by the Z s artment. P •' tnctude with this appliealien: a stamped warranty dccd from the Ragistcr of Deetis omca a -V.y of the cartified survey map if reference is made in the warranty dccd