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Home My WebLink About038-1038-20-000 n CO) o \ ■ ) c \ \ m \ \ k i - - � » « z = ƒ z > 2 S ° ".*A. 6 » ° & / m & \ e e/\ m 7\ = 2 f\ « § [53 \ i } i { % ) § f 2 \ { * 0 / \ ; ¥ E U) = : \ @ U) 2 ID = 2 0 ; 2 / F y -4 \ \ ° 2 \ D 0 § § z . g E / % � � a, � V _0 -0 0 0 0 % E -4 \ d 3 _ § m 7 = o q / 2 � . E . ` / �\° ` , CL _ . j 0 ( / { } \CD CD 0 i N CD \ CD \ _ , ) k Z \ . $ z E » 02 w 2 { ) ° 0 \ { \ % m C4 \ \ . =zw> » ao== 0 . \ % . ) % . ; \de/ \ /no CD \IL \ CD . rl) . V 7 %E \ 7 \\ . \ ){\ \ h ~ 7 7 \ . ) / < ) \ o . . \ \ 2 \ Wiisoonsin,oepartment of Commerce PRIVATE SEWAGE SYSTEM county: 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)). 12 Permit Holder's Name: Q City ❑ Village 15 Town o : State Plan ID No.: brahamson, John Star Prairie Townshi CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 038 - 1038 -20 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION 85 HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St /Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANKTO P/L WELL BLDG. ventto ROAD Dt Inlet Air Intake Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe — f7 Holding act System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand over Model Number GPM TDH Lift Friction System TOH Ft Loss Forcemain Length Dia. Fi Dist.Towell SOIL ABSORPTION SYSTEM BED / TRENCH width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth - D IMENSIONS D IMENSION LEACHING Manu adorer: SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM CHAMBER model Number: INFORMATION TypeOf OR UNIT System: DISTRIBUTION SYSTEM Header / Manifold Distri ution 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 reed pth Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes (3 No COMMENTS: (Include code discrepancies, persons present, ection #1: / / Inspection #2: / Location: 1067 Co. Rd. H, New Richmond, WI 54017 (NW 1/4 NE 1/4 9 T31N R18W) - 093118161A 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision required? ❑ Yes ❑ No Use other side for additional information. I I HF Cert N o LLL� Date Inspectors Signature Cert . SBD -6710 (R.3/97) County Sanitary Permit Application ST. CROIX COUNTY WISCONSIN In accord with 15.04 St. Croix County Sanitary Ordinance ZONING OFFICE Personal information you provide may be used for secondary purposes ST. CROIX COUNTY GOVERNMENT CENTER [Privacy Law. S. 15.04(1)(m)] 1101 Carmichael Road Hudson, WI 54016 -7710 ♦ (715)38&4680 Fax (715)3864686 Attach complete plans for the system o ,piper not less th n 8- 'F /2'x 1 inches in size. County Sanita Permit # 13 Check r (evjsion to �ica2iop" I. Application Information - Please Print all Information 1 7 A r E cation: Property Owner Name ST f of W 1/4 fV 1/4, Sec J � / '"�n7TV l ' Gh � A a m_so�-1 !� 3 1 N, R E (or Property Owner's Mailing Address �� Lot Number Block Number a6) 06 s� ity, State LV Zip Code Phone Numer Subdivision Name or CSM Number 11 Type of Building: (check one) amity ❑Village Town of 54 1 or 2 Family Dwelling - No. of Bedrooms: �, u l I ❑ Public/Commercial (describe use): d ❑ State -owned Nearest Road 11. Type of Permit: (Check only one box on line A. Check box on line B if applicable) J Parcel Tax Number(s) A) 1 1.[] Repair 12. ❑ Reconnection 3. ❑Non- plumbing 4�ejuvena ion _ Sanitation AerltA ��r j�o u 4 Q3g — 10 B) tc: 7e Del, !N �kr r r 1rW k� �"�C'V Date Issued r l �t ❑ State Sanitary Petit was previously issued et,64 ►J 6e O� IV. Type of POWT System: (Check all that apply) 5r Non- pressurized In -ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At rade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Are 4. Soil Application Rate 5. Percolation Rate 6. System Elevation 7. Final Grade Required e A als. /day /sq.ft.) (Min.Mch) Elevation VI. Tank Information Capaicty in Gallons Total # of Manufacturer Prefab Site Con- Steel Fiber- Plastic New Existing Gallons Tanks Concrete strutted glass Tanks Tanks d 00 I jCnac,,h El El ❑ ❑ ❑ ❑ ❑ ❑ 1 ❑ j ❑ II. Responsibility Statement I, the undersigned, assume responsibility for repair /reconnencUon /rejuvenation /installation of non - plumbing for the POWTS shown on the attached plans. A license is not required for terralift repair or the ' stallation of non - plumbing sanitation system. nature (no stamps): MPfMPR9-Ne- Business Phone Number 4 L ]no sa�l� plu�d� U � S • &� Plumber's Address (Street, City, State, Zip Code) P " 70 el .4-5p v , III. County Use Only Disapproved Sanitary Permit Fee ate Is ued Issuing Agent Signature (No stamps) Approved Owner Given Initial Adverse v 31 Vl Lal�d_ Determination r�%St ons of Approval /Reasons for Disapproval: Z s�ac s 1 �v i?�o( u� e ycAlrs 'Cel gr 4-A MRY 31 2001 12:36PM HP LRSERJET 3200 P.1 POWERS LIQIIID WASTE MANAGEMENT, INC 346 GREATON RD NEW RICMKM, WI 54017 (715)246 -5738 FAX (715) 246 -7762 FAX TRANSMITTAL FROM: TAMMY POWERS TO: ROD ® ST CROIX COUNTY ZONING OFFICE (FAX #715- 386 -4686) DATE: 5 -31 -01 NUMBER OF PAGES INCLUDING COVER: 1 SUBJECT: SEPTIC REPORT FOR JOHN ABRAHAMSON RESIDENCE ® 1067 COUNTY RD H, NEW RICHMOND, WI 54017. -THE BAFFLES ARE IN PLACE -THE SEPTIC TANK STUCTURE IS O.K.(NO SIGNS OF LEAKAGE) Wisconsin Department of Comnikrda ' SblL EVALUATION REPORT Page of Division of Safety and Building�'`,1 V f� - / i tlrEl nce with Oq ypl 85, Wis. Adm. Code i County Attach complete site plan o gaper not less t ar- 11 1 inchas in size. Plan must `-� include, but not limited to: Ftical an�11 1�(zo tal reference point (BM), direction and Parcel LD. percent slope, scale or dim gsivns, nbtth a rti42i 'location and distance to nearest road. 639 I D3 — a� — o o o Pleaseprint a�ly�Aion. ,! Re ' e b D Personal information you provide mpo"sed for secondary purposgs (privacy Law, s. 15.04 (1) (m)). 1 Property Owner �. ' Property Location Vv 0 Goff. I Govt. Lot 1)1/4 Nf,1 /4 S T,3 N R' I E (o W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# I o L7 Co. k City ,, R pp State Zip Code Phone Number ❑ City ❑ Village %7own Nearest Road ! ' e►x> di S yo 1 ( 715)41 3 «Z � 4. V' Pf-rk V ` k � C_ 'R ❑ New Construction Use: [$ Residential / Number of bedrooms � Code derived design flow rate L o h GPD ❑ Replacement or commercial - Describe: Parent material e- Flood Plain elevation if applicable ft. General comments ;5 bot-`k �� 1 f and recommendations: d1'4. &,00%f— '�o �` /' GJ V V G r�4_T 1 D i>^ 'f S� t L- A we- ; v F ► r- IS - . Sys4evw se-+ 4-+.� -t�.a y � rn. A3 " abalu U1 Boring # ❑ Boring // /� 95 Pit Ground surface elev. b. _ ft. Depth to limiting factor � in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 a- 1 E 5(- ------- s VA-460 - 7.5199� b F-1 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 &Yio Ale a.n u e e. * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L CST Name (Please Print) Signature CST Number a P% n 14 J. 6+a r k. 22, Address � Date Evaluation Conducted Telephon umber f SBD -8330 (R07 /00) Property Owner Parcel ID # Page of 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 1ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 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 I ❑ Boring # F1 Boring El 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 * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 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. SBD -8330 (R.07 /00) / 1u fY ±c .. �' T311► - kIS e 1 r1 V1 iq- � k Al C S 1 -"'i A a• t - 1Y6 lot i s I i ar,$,r , W S ; I O Vl* AD �, 'I o •S't' ; roe , h �, 1 t� �,�.. 6 � _ .� .� � __. 1 ' � � � I i i � � � ' i i., I .. �. � � I � _ _ _. i �� . I ' '� i �, � � i I I � _ I � ; � � ' � '. '. i -� � i ' � � � i j I I i i I ' i _ _ .', _ _ . III _. �. ' ST CROIX COUNTY SEPTIC TANK NIAINTENANCB AGREEMENT AND OWNERSHIP CERTIFICATION FORM Dvmer/Buyer -- Mailing Address 1062 �� 1 Property Address (Verification required from Planning Department for new construction) City /State 1 V t,�,J- �^^ Patel Identification Number LEGAL DESCRIPTION property Location JW-W_ %•, V SeC- LN-Rj w► Town of { Lot # Subdivision Certified Survey Map # , Volume — . Page # Warranty Deed # y , Volume et q i . Page # �l L Spec house ❑yes ❑ no Lot lines identifiable ❑ yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes consists of pumping out the septic tank every . Proper into the system three years or sooner, if needed by a licensed pumper. What you put can affect the function of the septic tank as a treatment stage in the waste disposal system' The owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by as ter P�rt3' P v that (1) the on -site wastcwa disposal cyst masWplumber, joumeymanplumber, restricted lumber or a licensed pumper enfYing the c tank is less than i/3 fnll of sludge. is in proper operating condition and/or (2) after inspection and pumping (if necessary), septi vate sewage disposal system with the standards Uwe, the undersigned have teed the above requirements and agree to maintain the Mural Resources, State of Wisconsin, Certification D set forth, herein, as set by the Department of Commerce and th e Department of Natural within 30 stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning days of the three year xpiration date. OF APPLICANT DATE OWNER CERTIFICATION the owner(s) of I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) MAW Y descn' bed abo e, by virtue of a warranty deed recorded in Register of Deeds Of DATE OF APPLICANT « « « « «« Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. *« Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if refetwce is made in the w==ty deed VOL i 646 PAGE 342 ts►46►5CNCP KATHLEEN H. WALSH Document Number Document OF DEEDS t Rtle ST. CROIX CO., WI RECEIVED FOR RECORD 05 -25 -2001 10:30 AM AFFIDAVIT EXEMPT D CERT COPY FEE: COPY FEE: TRANSFER FEE: RECORDING FEE: 14.00' PAGES: 3 Rwordisig Meer Name and Rebun Addr w Part Idmti6catioa Nmnber M I "THIS PACE IS PART OF THIS LEGAL DOCUMENT - DO NOT REMOVE" This information must 'be completed by subruluer. doetonent didle. name & return add—,. and PIN af - q�dred). Oder.W- .W such err du gas dwitt kod sf-crfp". eta gray be placed on ddrfl W pale of the doe+" or way be placed on addfdond paces of der docrament, W te• Use dls cover page adds one a so your doesonew atd ,00 to the re-r&n ee Wisconsin RDA 2N6 �s U . of Pat ya �2 r f . sconsin Samwes. $0.51 VOL 1646 PAGE 343 ST: CROIX COUNTY �- WISCONSIN ZONING OFFICE NNN / /IIN�• rorsi ST. CROIX COUNTY GOVERNMENT O ERNME NT CENTER 1101 Carmichael Road — — Hudson, WI 54016 -7710 (715) 386 -4680 AFFIDAVIT OF SYSTEM REJUVENATION Property owner: T 5tin 4 , ah 4 w► shr Address: /6) - & w Day time phone:() 2 qK -312 7 Parcel I.D. # _3�1 Legal Description of property: , k Sec. 0 1 T. 3) N. R. L�W. , Tn. of St. Croix County, AI As owner of the above described property, I acknowledge that the septic system serving this residence (is /is not) undersized by current code standards. I understand that the issuance of a sanitary permit to allow the attempted rejuvenation of the septic system does not imply that the system meets current code sizing requirements, nor does it imply that the proposed procedure will be successful. I also acknowledge that I will make this information available to any future parties interested in purchasing this ro ert P P Y• signature: r�L Date. U 5/97 w • I ' ( VOL 1646PAGE344 DOCUMENT NO. W ARRANTY DEED T HI S fFAGt RtftRV[D FOA w[COfOtNO DATA it STATE BAR OF WISCONSIN FORM 2 -1M 1� 4S0990 1LAa4_ I) Norman V. Sullivan, a married person REGISTERS O FFICE ST. CROIX M WI _ ...... Reed for Record .................... ...................... i MAR 2 61992 conveys and warrants to .John -L... Abrahamsptl..and. Gail_.E -_ - . •.._ J of 8 :30 A.. Abrahamson,. "husband..and wife. as _ marital. property- with... C �f►w,a,� rights.of.survivorship fb01W► of Dads .. .. ... .... .... .. ..... ... ... .. .. ...... .. ........ ..... .... REruRN TO . .. ............... .. . .. ..... .. ... .... .... ...... ... .. ....... ... .... .. ..... ... .. ...... . the following described real estate in ....... SC.. • C,Xo1x . . . ....... .... County, State of Wisconsin: Tax Parcel No: .............................. An undivided one -half (1/2) interest in the following described property: The Northwest Quarter of the Northeast Quarter (NW} of NE}) of Section Nine (9), Township Thirty -one (31) North, of Range Eighteen (18) West, EXCEPT the North 241 feet of the West 208 feet thereof, and further EXCEPT the East 99 feet thereof. Subject to recorded.easements, reservations and rights of way. This conveyance is given in satisfaction of Norman V. Sullivan's interest in that certain Land Contract from Norman V. Sullivan and Joan C. Sullivan, as tenants in common, and Grantees, dated September 15, 1982 and recorded September 17, 1982 in Volume "652 ", page 25, as Document No. 379750, which Land Contract was subsequently amended by document dated November 30, 1987 and recorded January 8, 1988 in Volume "800 ", page 538, as Document No. 433595. Exceptions to warranties, any easements, covenants and restric- tions of record and any liens or encumbrances created by act or default of the grantees herein. I Thi: is not !.onto - t.•ad pr, prrt Exception tb• tc::rrantir -: LL E Irntt•,i 11:,.; / 1 dad If March , 19 92 ( . iEA l.) i ,,,cwt l% \��'G �.� D EAL , .Norman V. Sullivan 1SEA1,1 (SEA 1.r AUTHENTICATION ACKNOWLEDGMENT Si;- natun•(s) STATE OF W1 _ St. Croix .vlthcnticated this dad J I'ct' anal!c ,:w:r h,•'•n•• ntc tl.a i� .+ _ ... _.. . ...March ......... !:192 1!c ::h n:,n ••,t Norman V.. Sullivan TITLE: JTENTRER STATF. RAIL OF WISCONSIN 1 1 i not.. authorized b% 706.tlh, Wis. Stag.) • to me r:nnn n to he the prr• -nn tt•P „�tgtY;tttd tFe forrcoi7t:; i+ <tnuu :u:d :u•6natcic•i.;e t.`.4�alnc.'�,�. i 1?1.TRUf.tEWr W45 URAFTEO R� — \\ �.- V •, Reinstra,. Van Dyk & Needham, S.C. 201 South Knowles Avenue, Box 127 Ruth A. Johnson t• . New Richmond, Wl- 54017- - rlIb!ir St. Croix Isivnaturr: tray hr auth— iti,art•d ,,r sckn..wicd ed. C !t: \!.: , '`.nuni «ion n+rtn:t•. I! Wit, rtatc t +irat Q • :err not necrssar)') 12/18/94 • \Am.•. n( p, -rym, e.Rnint in n,.,, •:, h:a + i .t .l I, 1 ..:. ?h . , u WARRANTY DL'ED STA ti: IlAtt OF li e. .,: V:.Iti Wtit• ?nam .•q it yidn. C•i , 't I- 11M No 2— I..• W1wd Uk PS• W..••,.,n