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HomeMy WebLinkAbout034-1033-20-325 LEGAL ST, CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF SPRINGFIELD COMPUTER NUMBER 034 - 1033 -20 -325 Parcel Number 15.29.15.228F -40 OWNER NAME: First JOSEPH P & JAYNE I Last DONAHUE PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment 3081 96TH AVE SECTION 15 TOWN 29N RANGE 15W 1 /4160 NE 1 /440 SE Line Description Line Description TOTAL ACREAGE 4.000 PLAT CSM 17 -4513 034 -03 LOT09 BLK 01 SEC 15 T29N R15W PT SE NE 15 02 CSM 1714513 LOT 9 16 03 (4 AC) 17 04 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division 0 INSPECTION REPORT Sanitary Permit No: 430534 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: Donahue, Joe I Springfield Townshi 03 - /633' x'3 2 -� CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: ZZ )� /06 o r?, kc i .z n 15.29.15. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark �., S .wY c r� ci g n2 t3 t 6.7 1 i UCl 11 Dosing Alt. BM Aeration — / O O Bldg. Sewer 301 '97, Holding St/Ht Inlet � TANK SETBAC INFORMATION St/Ht Outlet TANK TO PiL WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 3 ,� Dt Bottom 9 3 7 ?, j Dosing ..r _. Header /Man. Aeration _ Dist. Pipe W 1 • - 7 5 i 7 - _ 01 _ 7 - 7 q G 1 1 Bot. System ow 3 � F- � PUMP /SIP ON INFORMATION Final Grade Manufacturer Demand St Cover �<<��� GPM � Model Number j v TDH Lift Friction Loss System Head rD Ft 'D, /. — ?__ U Forcemain Length tfyc Dia w Dist. to Well J\ a SOIL ABSORPTION SYSTEM BED/TRENCH Width Length t No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS t 1 SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufactu INFORMATION CHAMBER OR Type Of System: -7 UNIT Model Numbe DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing S Vent to Air Intake i �' Pipe(s) i f Length_ Dia Length �� 5 Dia lZ Spacing 3 /� v�&' �� �`'�— SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded ,. xx Mulched Bed/Trench Center v Bed/Trench Edges . Topsoil Yes [] No Yes f No COMME TS: (Include code discrepencies, persons present, etc.) Inspection #1: 1 f / /4 /3 Inspection #2: It / d3 'Ar Accc),c:l`; .- 40 pt &A �.�.� Y-*.. Y-*.. Pa , f , + < < <:. a 7 7 't „ (mil .. Location: 3081 96th Avenue Wilson, W1 a027 027 (SE 1/4 NE 1/4 15 T29N R15W) NA Lot 9 ParcO No:: Z 15 9915. t3s 1.) Alt BM Description = 3) ,-, rt S��s 78 � 3L � ' u .15. 2 '7 2.) Bldg sewer length t4. S; w� 4 A e S wk cr� S t k• t t - amount of cover T cs ti G✓[LO Yvt,z L✓a Gv.sz �'`� �f" V LJLJ t Plan revision Required? i ;1 Yes J No Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No. Safety and Buildings Division County ` 201 W. Washingto}6� -. s 1,[ �� �seonsin Madison, 537 � Vi' Sa itary Permit Number (to be f[II� in by Co.) Department of Commerce (608) 266 -3151 •20 ,- Sanitary Permit Applieati n NOV ? 2003 S to Plan D. Number In accord with Comm 83.21, Wis. Adm. Code, personal inform yoN�r�v IX COUNTY �5 Y 1 may be used for secondary purposes Privacy Law, s15. (1)(m C jeer re)s (if different than mailing ad r ss) ZONING OFFICE f� a (L t (f I. Application Information - Please Print All Information��� Property Owner's Na me Parcel N L t N q �#MT 3 _/�3 7 Property Ow I nvrrs M ailing Address ( Property Location , -3 ' l J 9 /v-1 �� SC ��, G /,,Section = C ity, State Zip Code Phone Number (circle TN; R �II�. Type of Building (check all that apply) � �j w. o — L^ 1 or 2 Family Dwelling - NumZeref Bedrooms A p ubdivision Name CSM Nuntbcr � L-! Puhlic /Commercial - Describe °It'o • 3 iJ 1 — ��q Li State Owned - Describe Use x 0 DCity_�JVillage L4rownS Ip of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) _ I New System D Replacement System D Treatmend Hold irig Tank Replacement Only Other Modification to Existing System List Previous Permit Number and Date Issued B �� Permit Renrwal I �_ Permit Revision ❑Change of D Permit Transfer to Nesv Before Expiration Plumber Owner IV. Type of POWTS Sy stem: (Check all that apply) lion - Pressurized In- Ground Ll Mound > 24 in, of suitable soi{ Mound < 24 in, of suitable soi A[ -Grade Ll Single Pass Sand Filter Constructed �` cdand Pressurized Irt- Ground L I Holding Tank D Peat Filter U Aerobic Treatment Unit 1 Recirculating Sand Filter '._ Re circulating Synthetic Media Filter D Leaching Chamber LJ Drip Line Ll Gravel -less Pipe D Other (explain) V. Disp ersal/Treatment Area Information: f Design Fluw (gpd) Design Soil Application Raie(gpdsf) T Dispersal Area Required (sf) Dispersal Area Proposed (s System Elevation — VI. Tank Info r Capacity in Total j Number Manufacturer Prefab Site Steel Fiber PI as c F _ Gallons Gallons y of Units Concrete Constructed GI ass � ,dew Existing I ', _ Tanks Tanks Septic or Ho Wine "Dank , //�� �_ ��•� ;Aerobic Treatment Unit I Dori to Chamber VI1. Resp onsibili ty Statement- I, the und ersigned, assume responsibility for • Stallati of the POW 'TS shown on the attached plans. Pfn.thcr's Na rile (Print) Plu ber's Si gna re M /MPRS Number Business Phone Number Plu a re ss (Str el, City, State, P i C e) �- - -`'- Cr L 4-C VIII. C_ ounty /Department Use Only _ � �l Sanitary Permit Fee "includes Groundwater Date Issued Iss in gent S arge ignature ( Stamps) Approved Disapproved I�� Surch Fee) ��""..�� D Owner Given Reason for Denial ��� C�CK1 IX. CApjjji & /Reasons for Disapproval MOL— C 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. I Attach complete plans (to the County only) for the system on paper not less than 8112 x 11 inches in size SBD -6398 (R. 01/03) k�i�ST�o GR i SL�f'fNE` /4 S(5 - T2,gV R15�.! ST, C,z b , k Cou t-� y SPRiN(,FlEL) Taw Mskin 'APPROX. /ooa' I • l�R.vve56n � �y ��, � , ►`�-�c E r�s ®wow s ao , 2240I \ (b0 r. 5 3 'Nc lo o py LIIV& • $CtalE 90' Tot' of /i 0RAN'66 uIT Tot' ot= ' /i•��v8�c�auiT Safety and Buildings PO BOX 7162 MADISON WI 53707 -7162 i = TDD #: (608) 264 -8777 A www.commerce wisc ns / Department of Commerce www.wisconsin.g Jim Doyle, Governor Cory L. Nettles, Secretary November 04, 2003 CUST ID No.224617 ATTIC- POWTS Inspector LYLE J MYERS ZONING OFFICE NORTHLAND PLUMBING INC ST CROIX COUNTY SPIA E1556 STATE ROAD 64 1101 CARMICHAEL RD BOYCEVILLE WI 54725 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/04/2005 Identification Numbers Transaction ID No. 938563 SITE: Site ID No. 667843 Joe Donahue Please refer to both identification numbers, Rustic Rd 3 above, in all correspondence with the agency. Town of Springfield, 54013 Co p!: i St Croix County SE1 /4, NE1 /4, 515, T29N, R15W FOR: f � Object Type: POWT System Regulated Object ID No.: 929124 DEPA M' DIVISiO F Ar MOUND / DWELLING 450 GPD The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes SEE CORI and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Robert Kanter POWTS Plan Reviewer, Integrated Services WiSMART code: 7633 (608)261-7735, Monday -friday 8:OOAM - 4:45PM rkanter@conimerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 Mound System Cover Page Pg 1 of tt MIENEN emEff � Project Name: Donahue -Mound Owner's Name Joe Donahue Owners Address 443 Fifteenth Avenue Baldwin, WI 54002 SE ♦ + NE W • Legal Description l., �� /. Sec 15 T 29 N, R 15 Township Springfield County Saint Croix Subdivision c f i iJ t `'"� Lot# " 4' j ft Parcel ID# Table of Contents �PCNDENCE pg- 1 Cover page 2 Mound Sizing Calculations F ' u 3 Pressure Distribution Layout and Dynamics 0 0 1 2 7 2003 4 Dose Tank 5 Management and Contingency Plan SAFETY & BLUbS. DI V. 6 Plot Map total # of pages: 6 Designer Name: Lyle J. Myers MP /License #: 224617 Date: 10115/03 Ph. #: 715 -643 -2520 Signature: Mound System Design Methods Used per "Mound component Manual For Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD- 10691 -P (N.01/01) per" Pressure Distribution Component manual for Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD - 10706 -P (N 01/01) Spreadsheet provided by: 3bAdvisement N12486 720th St, Boyctft, WI 54725 Ph: 715 - 6435068 email: 3ba @3badvisement.com Mound System Page 2 of s Mound Sizing Calculations Project Name: Donahue -Mound Site Conditions Design of Entire Fill Project Type: — ,or 2 Family Dwelling Cell depth at upslope edge (D): 15.0 in. % Slope: 3 Cell depth at downslope edge (E): 16.8 in. # of Bedrooms: 3 Distribution cell depth (F): 9.5 in. Depth to limiting factor: 21 in. Cover thickness over edge (G): 6 in. Absorbtion rate of fill material: 1 gal/ft /day Cover thickness over center (H): 12 in. Absorbtion rate of in -situ soil: 0.4 galift /day End slope width (K): 9.4 ft. Effluent quality Fill length (L): 108.8 ft. Max BOD effluent value: 220 mg/I Upslope width (J): 7.0 ft. Max TSS effluent value: 150 mg/l Downslope width (Toe) (1): 8.9 ft. Fill Width (W): 20.9 ft. Design of the Distribution Cell Basal Area System Design Flow: 450.0 gal /day Basal area required: 1125 ft Distribution cell width (A): 5.00 ft Basal area available: 1251 ft Distribution cell length (B): 90.0 ft Area of Distribution Cell: 450.0 ft Observation Pipes Contour Elevation of Mound: F 96.30 ft Location from end of cell (Z): 15 ft System Elevation of Mound: 97.55 ft Final Grade of Mound: 99.34 ft Mound Plan View Observation Pipes WA B w , , k--K I Tilled AreatFill Material L ' Mound Cross Section Final Grad Observatti n Pipe Synthetic Fabric Distribution Cell dr System Elevations . a F_ m 1 Cover Matenal F Inveit ill Material Tilled Area -� -Slope �Forcemain System Contour Notes: Fill material to consist of ASTM C33 Sand Distribution cell aggregate to comply with Comm 84.30(6)(1) synthetic Fabric covering on cell per Comm 84.30(6)(8) Distribution Cell to have minimum 6" aggregate below lateral and 7' above. Mound System P w 3 °' e Pressure Distribution Calculations Project Name: Donahue -Mound Lateral Layout Lateral /Manifold Design Lateral elevation: 98.1 ft Lateral diameter. 1'h In. Rows of Laterals: 2 Lateral spacing (S): ft Manifold type: center • Lateral to cell edge: 1 ft Orifice diameter: o.i2s In. Lateral discharge rate: 7.83 gpm # of Laterals: 4 System discharge rate: 31.31 gpm Distal Pressure: 5 ft Manifold diameter: 2 In. Lateral Length: 44.,5 ft Manifold length: 3 ft Orifice Spacing /Distribution Forcemain Friction Loss Orifice spacing (X): 28.86 Inches Forcemain length: RIn. ft Orifices per lateral: 19 Forcemain diameter. Avg. ft 10rffice: 5.92 ft Friction loss in forcemain: 3.146 ft Lateral Side View Manifold Lateral \Lateral x x x x x x x f x x 7r x x x 2 2 Lateral Length F Lateral Length Lateral Plan View Lateral Length Turn-up w/ball valve or cleanout plug ° ° Orifices on bottom of lateral equally spaced PVC laterals and forcemain to comply with specifications per Comm 84.30[21(e) Forcemain connection via tee or cross to manifold at any point Clean Out Detail Observation Pipes Glean -out plug Final Grade or ball valve -rv— Water tight cap or plug Lawn Sprinkler Box lot Nate: Closet Colar 6" Minimu may be used in Long Sweep 90 P of 318" bat or two 45`s 3/8" Bar Lateral Mound System Pop 4 or s Septic, Pump and Dose Tank Project: Donahue -Mound Tank Information Dosage Volume Pump tank manufacturer: W ieser Con crete Forcemain drains back to tank? Q yes O No Pump tank size /model: W1000 /650 -MR Lateral void volume: 18.8 gal Pump tank gal /inch: 17 Dosage to absorbtion Cell: 90.0 gal Actual Pump Tank Volume: _646 gal Forcemain volume: 26.1 gal Tank bottom elevation (inside): 861ft Total dosage: 116.1 gal Septic tank size /model: w1000 /650 -MR —� Pump and Filter Total Dynamic Head Pump Manufacturer. Little Giant Are laterals highest point? y Pump Model: 9EH if not, enter highest elevation: 0 ft Effluent Filter. Zabel A100 System head (distal x 1.3) 6.50 ft Vertical Lift ( "D" to lateral) 11.55 ft Note: Access opening of sufficient size to be provided to allow removal of filter. Opening to terminate at or above grade. Friction loss in forcemain: 3.15 ft Pressure loss from filter. �O ft Total dynamic head (TDH): 21.20 ft Pump Tank Diagram Dose Tank Levels -- WatertightLockingCover In. Gal q Inch With Warning Label Minimum inished A Reserve 23.2 393.9 _ 7 Grade g Pump off to Alarm 2.0 34.0 Alternate C Total Dosage 6.8 116.1 Outlet Location Elect. per Comm D Effluent depth for pump 6.0 102.0 and NEC EC 300 Total Capacity: 38.0 646.0 Weep Hole A or Anti- Siphon B Device FLOW- LITERS/F OUR C 0 1000 2000 3000 D 30 10 N W 7.9 � 20 a 5 Pump must be capable of: 31.3 GPM to and head pressure of 21.2 Feet 25 0 0 l 111 11 111 0 20 40 60 so Little Giant FLOV- GALLONS/MINUTE 9EH PUMP PERFORMANCE CURVE 113V 60HZ I • Mound System Management Plan pursuant to comm 83.54 W.A. C. page 5 of 6 Owner's Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make periodic inspections of the components, checking for surface discharge, treated effluent levels, etc. The owner or owner's agent is required to submit necessary maintenance reports to the appropriate jurisdiction and /or the department. Septic Tank: Septic tank(s) are to be inspected routinely and maintained by department approved individuals when necessary in accordance with their approvals. The use of chemical /biological "treatments" is not required or recommended. If such additives are used, make sure they are approved by Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & cleaned as necessary, with provisions to keep solids from passing the septic during removal. No more than 1/3 of the usable tank volume may be occupied by sludge /scum. 3 year inspection: If tank has greater than 1/3 volume sludge, tank contents must be emptied and disposed of in accordance with NR 113 Wisconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank, then the owner must be notified of when pumping should be done as to not exceed 1/3 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. Pump /Dose Tank If an effluent filter has been installed in the pump /dose tank, it must be removed & cleaned as necessary, with provisions to keep solids from passing to the mound component during removal. The pump, float switches and alarms must be inspected at least every three years for proper operation. Pump /dose tank should be routinely inspected to be watertight and of good repair. Mound and Lateral System The mound system component must remain free of ponded surface water prior to pump operation. If 4 inches or more water level is detected in the observation pipes, the owner must be notified of possible problems /failure. The designed daily flow capabilities of the component should never be exceeded. Trees and any other deep rooted vegetation should never be planted, or allowed to grow anywhere on the component. Activities OTHER than mowing /maintenance (i.e. excessive walking, pets, vehicles, etc...) could compress the component and reduce it's absorbtion capabilities and /or possibly cause it to freeze in winter conditions. Lateral distribution pipes should be flushed out/tested every 18 months using the cleanout points at each end of the component to remove scum that may clog orifices. Performance Monitoring: Performance monitoring must be done at least once every three years following the installation or at the time of a problem, complaint, or failure. Contingency Plan: If the septic tank, pump tank or any of their components therein (including floats, alarms, pumps, etc) become defective, the defective tank or component must be replaced immediately to ensure that the system can operate as designed. If the mound component cannot accept wastewater or ponds wastewater to the surface, the component must be repaired or replaced in it's current location by either: extending basal toe to provide added absorbtion area; or by removing the clogged bacterial mat,aggregate cell, and distribution piping within the mound and replacing said components in order to return system to proper working order as required. t'1JST <<' �OKtI r I C 7 w � GR J oE L-) SE Sly - T Zq�l ST. Ctz b t k CCU a SPR(N(,RC-Lb Taw- �jstfa> AoiR� • /aoo' FEZ �a vvo56n ® - � , "E RJS sao onE tbOC�() n i 0 i APPKek. �`� )moo ���2T� LINE Toe' o2Ari (rE Co . Ak. -tt 2 = 98.84' Tot' of c cf-l6uIT r Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings In accordance with Comm 85, Wis. Adm. Code County O Attach complete site plan on paper not less than 8 1/2 x 11 Inches In size. Plan must include, but not limited to: vertical and horizontal refer BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow ti �i' nee to nearest road. Please print a d on. awed by Date Personal inrorrnation you provide may be use ndary Privacy'Law, s. 15.04 (t) (m)). , Property Owner p arty Location L(! e SGr l L r Lots ,A' 1/4IVF1/4 S 14 T N R /�Jr W Property Owner's Mailing Addre ss ` S7 CRax LW Block # Subd. Name or CSM# City State Zip Code "r, , City ❑ Village 0 Town Nearest Road 50 New Construction User( Residential / Number ,� Code derived design flow rate T. �a GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material ,( �j a J ' A L. tLZ Flood Plain elevation if applicable / / General comments and recommendations: 17 1 Boring # ❑ Boring QQ ❑ pit Ground surface elev. / Depth to limiting factor e2 in. Soil Application Rate Horizon Depth Domtnant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 S' /- 6 G S ! V r P4,4 v F S t ,96 rS Boring # ❑ Boring /. Pit Ground surface elev. v ft. Depth to limiting factor -in Sofa Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 A4SJ N /=�l S 2M (? /o C :2 M Ahk M F I G S 1 U r L 6 6 /o IV C , S e s Effluent #1 = BOD > 30 1 220 mg/L and TSS >30 1 150 mg/L • Effluent #2 = BOD 1 30 mg/L and TSS < 30 mg/L CST Na / me (Please Print) Signature r, CST Number F- Address L Date Evaluation Conducted Telephone Num �{ry Property Owner AY /�te .Se i1 / /N�' Parcel ID # /Q 33 — /10 1 Page of FY Ong # Cy Boring / 7 47 Of C] pit Ground surface elev. 9 , / 7 ft. Depth to limiting factor Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF In, Munsell Qu. Sz. Cont Color Gr. Sz. Sh. •Eff#1 •Eff#2 J o� /v l0 R3 L a M54 S t t3 r0- se 5 �A I 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/fF in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. •Eff#1 •Eff#2 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Sal ication Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. •Eff#1 •Eff#2 Effluent #1 = BOD, > 30 < 220 nVL and TSS >30 < 150 mg& • Effluent #2 = BOD < 30 rrg/L and TSS 130 mg/L 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 -264 -8777. sao-uw (resroo) I� 1 I I _ I a i - -- t -! - - - -- -� -- i VL -- I - - -- - - -� - -- i- i D d 1 I i i 1 I I i i i i I , _ ! J r t — i I f I r — I T I ` a i - I I ' © 8 z N BV-3 iy\ x 41 oil t II I I II N m oLU-9 "- ---� - ---- -- :1 1 O o o r ELF 2 t i1 `` A ll w < s --- - - - --- v s"rl'°°"""""Cr" o Z v W O m N to U t ��'� � t 0 t = J j' � t o 4 V� 3 `./ Q uonoaurajao 1 o N 0-4 b > N Xe 1dID O m O a1 ca cr m O m w 1 g M W Q J _ r w N o m fl. _ ms , I Q� x a i ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND / OWNERSHIP CERTIFICATION FORM Owner/Buyer �1 owe.cfNdrJ� Mailing Address r 5' i3�--D wi N �,� 5 �{o z - -f-" �� ✓ Property Address (Verification required fro Planning Department for new construction) �� City /State 0�r��r7 Pv - r - Q / Parcel Identification Number 3� e LEGAL DESCRIPTION Property Location '/., '/., Sec. , T N -R W, Town of Subdivision _ , Lot #. Certified Survey Map # 7 Z' L � 2 , Volume /Z , Page # / Warranty Deed # ? Vq llZ , Volume Page # Spec house ❑ yes ❑ no Lot lines identifiable ❑ yes ❑ no S YSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, 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 (if necessary), the septic tank is less than 113 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days o the three year iration date. SIGNA OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the pr perty des" e bove, by virtue of a warranty deed recorded in Register of Deeds Office. s ` X Dc 1 19/03 SAWE OF APPLICANT DATE * * * *** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** this application: a stamped warranty deed from the Register of Deeds office Include with pp pe ty g a copy of the certified survey map if reference is made in the warranty deed AIL u 2y q P n}4 744112 1 STATE BAR ?F W1S�ONSIN FORD I `'2000 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX Co., WI This Deed, made between Wayne E . Schilling and Teresa RECEIVED FOR RECORD D. Schilling, husaband and wife 10/17/2003 01:00PH Grantor, WARRANTY DEED and Jostaph D. Donahue and Jay ige I . Donahue E % , husban EXEMPT and wife as survivorship marl arty - ' REC FEE: 11.00 TRANS FEE: 109.50 G COPY FEE: Grantee. CC FEE: Grantor, for a valuable consideration, conveys to Grantee the following PAGES: 1 described real estate in St. Croix County, State of 5 n i s n (the "Property") (if more space is needed, please attach addendum): Lot of Certified Survey Map recorded in Volume s 17� page 451_3 as Document No. 720507 being a part of Lot 8 of Certifie Survey Map recorded in Volume 16 Recording Area on page 4289 as Document No. 677931, and being a Name and Return Address part of the Southeast Quarter of the Northeast Title One Premier Group li Quarter (SE'i of NE Section 15, Township 29 North, 706 19th Street South Range 15 West, Town of Springfield. Hudson, WI 54016 RE: TOPG $ 6398S Pat 034-103377 Parcel Identification Number (PIN) Together with all appurtenant rights, title and interests. This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee pimple and free and clear of encumbrances except Roadways, Easements, and Restrictions of Record Dated this 16th day pf October , 2003 . �✓ � t to, ' * Wayne E. Schilling *Teresa D. Schillin * * AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) SP PU Q ) ss. St. Croix County. ) authenticated this day offf. f Personally came before me this 16th day of PAIdVI. October 2003 the above named Wayne E. Schilling and * � TITLE: MEMBER STATE BAR OF h► W Teresa D. Schilling z (If not, , to me known to be the person a who executed authorized by §706.06, Wis. Slats.) the fore ing ins en nowledged the same. THIS INSTRUMENT WAS DRAFTED BY For * Palm Michael H. Forecki, Attorney Notary Public, State of Wisconsin Eau Claire, Wisconsin My Commission is permanent. (If not, state expiration date: I ( Signatures may be authenticated or acknowledged. Both are not necessary.) December 12 2004 . "Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1 -2000 ttorney Michael H Forecki 1830 Brackett Ave, Eau Claire WI 54701 -4627 Phone: (715) 835 -3029 Fax: (715) 835 -4112 Michael H. Forecki T6698395.ZFX Produced with ZlpForm O by RE FormsNet, LLC 19025 Fifteen Mile Road, Cl~ Township, Michigan 48035, (900) 383 -9805 W 72t?JSID 7 VOL 17 PAGE 4513 KATHE= H. WWEW REGISTER OF DEEDS RE C ROI X WI CERTIFIED SURVEY MAP N0, co., CO RECEIVED FOR RECORD 03107121211 12:00PM VOLUME --u--, PAGE 4593 RTIFIED SURVE MAP REC FEE: 13.00 COPY FEE: 3.00 PART OF THE SOUTHEAST QUARTER OF THE NORTHE%!ffl: 2 QUARTER, AND PART OF THE SOUTHWEST QUARTER OF THE NORTHEAST QUARTER. SECTION 15, TOWNSHIP 29 NORTH, RANGE 15 WEST, APPROvtf) 8T ' C ROIX TOWN OF SPRINGFIELD, ST.CROIX COUNTY,WISCONSIN Plannino2onmm�nrf�OUN '. BEING LOT 8 OF CERTIFIED SURVEY MAP, MAY 0 7 20 ,19 3 VOLUME 16, PAGE 4289. If not recoraea wilnfn au UNPLATTED LANDS approvat date approval s .guy, hall be - - - - -- - - -- nullgnrlvnfr� 3/4" iron rod, found 3/4" iron rod, found N89'58'43 "E 660.00 5.58'. S47 °57'23 "E 7.08', S44 °30'45 "E S89`00'18 "E 659.2, ) from set 3/4" rebar �o,�h from set 3/4" rebar �, QQgh� ` PART OF LOT - 5. C 330.00' 330.00' V) o c �a � — o N ,� . , e� VOL. 12 PG. 3375 3 OD V,ro i t o C o - 80.00' LOT 11 � 500'07'25 "E Do '6 m �'I 588`59'04 "E 357 88' ) o n 362.16'— _ — — Z 171ass s.f. r 96th Ave. UNPLATTED - 3,94 ocres - LANDS 0 330.00' 366- 6. 50W / �: co S89'58'43 "W 579' 00 o a5 o C� I N7�� LOT LOT 10 i o (.M_ vaL_ 16 Z 1 PG_ 4289 LOT9 0� 623223 s.f. I o A 0 D 14,31 ocres Z I Z O A 1 0 s.f. ° 0° i N O 4.00 ocres cp N N � W.114 CORNER rrt Section 15 -29 -15 I E. 1/4 CORNER Found Berntsen Noil _ _ — 779.63'- Section 15 -29 -15 0' Found P.K. Nail Q� 871.29 " 40 cor. . 3261.03' i 660.00 119.63 322.50' ' � �, ; „ ------- - - - - -- _ _ 1" iron pipe, found -- 1" iron pipe, found 7.01', N89'58'43 "E S89 1 102.13 0.73', S22'15'49 "W from set 3/4" rebar ( 588 °53'07 "W 1 1094 82' I from set 3/4" rebar in in _ UNP — 589'58'43 "W 5234.45 3 I W UNPLATTED LANDS 1 S88 "; s o1 - W Z I Z 5234 31') LANDS LEGEND I JMA. .........Government Corner (as noted) OWNER /PREPARED FOR: s -seal, o .......... Set 3/4" x 24" iron rebar weighing Wayne & Teresa Schilling OLD w 000 cry, 1.502 lbs. /lineal ft. 958 Rustic Rd 3 Glenwood Cit <, 1 )..........Recorded Dimensioning y, WI 54013 Note: Each parcel on this map is subject to State and County laws, rules and regulations 5 I 3 (i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the ST. Croix County Zoning Office for advice. Note: " Future road extension west of 96th Avenue may not be possible with the creation of this map and may preclude future subdivision of Lot 10. U CURVE DATA TABLE CURVE RADIUS ARC CHORD CHORD CENTRA_ TANGENTIN TANGENT OU US N0. LENGTH LENG BEARING ANGLE BEARING BEARING N 1- 1 80.00' 93.12' 87.95' S33 °28'08 "E 66 0 41'26" S00 °07'25"E S66 0 48'51 "E 2- 3 80.00' 34.44' 34.18' S79 24 °40'08" S66 °48'51"E N88 1- 3 1 80.00' 127.56' 114.47' 1 S45 ° 48'12 "E 1 91 °21'34" S00 ° 07'25"E N88 North is referenced to the SCALE: 1 " = 300' DRAFTED BY: East - West Quarter tine Joel A. Brandt of Sec. 15- 29 -15, which bears S89 °58'43 "W 0' 300' 600' Page 1 of 2 (St. Croix County Grid System) Vol. 17 Page 4513 I