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HomeMy WebLinkAbout038-1098-50-000 n to) o'■ -� o -0 7! \ i § a z � 0 m co } O m k m co - / E E \ 0 \ J k § ± § § - @ » \ \ �o2Q E L ° ^'0 70\ E c � » ■ � o �F�@ ' \ / _ 2 \ a � a § § @ Q @ e e 2 § k 7 , z 0 0 0 \ Oro / § / < M 7 ~ k 2 7 . A § & & { .. Sh §J0 r = ? 0 0 \ k § CD f ( CD / 3 % 5 � 2 6 -f CO) M ; M � 0 § % ƒ T $) k CD CL 12 7 § F / OD �D � � # / ± ) 0 § � ( � 0 % ; � @ � $ ƒ � $ kQ � 2 . 0 % CD A % . 69 % k � § � �7 Parcel #: 038- 1099 - -000 G� / 10/25/2004 10:45 AM 0 �a �© PAGE OF Alt. Parcel #: 24.31.18.417A 038 - TOWN OF STAR PRAIRIE Current ❑X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): ` = Current Owner * MATTHYS, JONNA M JONNA M MATTHYS PO BOX 141 STAR PRAIRIE WI 54026 � 6 to Districts: SC = School SP = Special L*2060 pe es): * = Primary Type Dist # Description HWY SC 3962 NEW RICHMOND SP 1700 W ITC s ' Legal Description: Acres: 42.960 Plat: N/A -NOT AVAILABLE SEC 24 T31 N R1 8W PT OF N1/2 NE1 /4 & NW Block/Condo Bldg: SE DESC AS COM E1/4 COR SEC 24 POB; TH S 0 DEG E 717.38'; TH S 89 DEG W TO W LN Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) NW1 /4 O N1/2 SE1 /4 TO POW EXC P ,TO E ALG 24- 31N -18W STATE EXC PT /HWY PROJ 8936 -06 -21 more... Notes: Parcel History: Date Doc # Vol /Page Type 10/10/2000 631499 1549/523 QC 10/10/2000 631498 1549/522 WD 07/23/1997 2000/392 LC 07/23/1997 1150/552 LC more 2004 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations Last Changed: 10/14/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.000 25,000 16,500 41,500 NO AGRICULTURAL G4 36.960 7,200 0 7,200 NO UNDEVELOPED G5 5.000 12,500 0 12,500 NO Totals for 2004: General Property 42.960 44,700 16,500 61,200 Woodland 0.000 0 0 All 42.960 44,700 16,500 61,200 Totals for 2003: General Property 42.960 25,000 14,500 39,500 Woodland 0.000 0 0 Total 42.960 25,000 14,500 39,500 Lottery Credit Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 399494 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: Olson, Gerald I Star Prairie Township 038 - 1098 - 50-000 CST BM Elev: ' Insp. BM Elev: BM Description: TANK INFORMATION LEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic s Z (' / l Benchmark Dosing Alt. BM if Aeration Bldg. Sewer ✓` �r Holding S t Inlet � TANK SETBACK INFORMATION SU t Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic � / > j , / v r � J Dt Bottom Header /Man. ` Aeration ��` Dist. Pipe / �• p i Ho Bot. System L k- 3 PUMP /SIPHON INFORMATION Final Grade X Manufacturer errand St Cover � G Model Number TDH Lift 'Friction Loss System d TDH Ft Force n Length Dia. Dist. to Well OIL ABSORPTION SYSTEM J r BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS r L SETBACK SYSTEM TO P/L IBLDG IWELL LAKE/STREAM 6EIG Mannufactu er: INFORMATION ( A OR Type Of System: r IT Model Number: 'S® DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake i .r Pipe(s) i / / Length f Dia Lengt Dia � Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Sy terns Only Depth Over Depth Over xx Depth of xx Se ded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes [W No ❑ Yes [1 No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1:/ ? / Inspection #2: Location: 2066 St. Hwy. 65 New Richmond, WI 54017 (SE 114 NE 1e//4 24 T31 N R18W) NA Lot 2 Parcel No: 24.31.118/.408A2_ '�/ 1.) Alt BM Description = j 0 y -j 6r�s�r. — jVWX dk "ZW Avvel DG�biG1001'�'"� 2.) Bldg sewer length = �' Is / - amount of cover = 5—</ rrt z G tr 4�'' G Plan revision Required? ❑Yes o / Use other side for additional informati . 3rJ / SBD -6710 (R.3/97) Date Insepctor's Si ature Cert. No. k 2`�f Z`�� d /o Z � I 5 rS Sanitary Permit Application Safety & uildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 `wi sconsin Personal information you provide may be used for second purposes Madison, WI 53707 -7302 Department of Commerce (Submit completed form to county if not [Privacy Law, s. 15.04(1)(m)] state owned.) Attach complete plans (to the county copy only) for the system, on piper not less than 8 -1/2 x 11 inches in size. County ` State Sani MerrrAM ❑ Check if revisi� v' pf application State Plan I. D. Number I. Application Information - Please Print all Information Location: Property Owner Name Property Location ST CFOX 14 l 1411, S. T ,N,RjE(o Property Owner's Mailing Address I �C�NNf3C1FF►Gfw Lot Number Block Number City, Sta Zip Code Phon a O` Subdivision Name or CSM N her II. Type of Building: (check one) ❑ City 1 or 2 Family Dwelling - No. of Bedrooms : ❑ illage ❑ Public /Commercial (describe use):_ own of ❑ State -Owned Nearest Road — ✓ Parcel Tax Number(s �p s III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) ( , A) 1. ❑ New 2. MQZeplacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only q ,?j� 1 0 � 4- Existing System $) 11 Permit Number Date Issued A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) PQ'lon- 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 Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) �—� _ �� ' Elevation 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. P m Plumber ae (print) / Plumbe ' ignature (no stamps): MP/MPRS No. Business Phone Number PlumlSees Address (Street City, State, Zip C&-&O' IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) fi(Approved ❑ Owner Given Initial Adverse Surch a Fee) ap Determination 22.5 2s ?m X. Conditions of Approval /Reasons for Disapprqval: A4 IeE4. --- so.n ,,l� �Ie- W-V' SBD -6398 (R. 07/00) 1 PLOT PLAN P[,o►JECT Geald Olsen ADDRESS 2066 St.Hv. 65 NewRichmond WL 54017 SE 1/4 NE 1/4s 24 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX 10 -25 -01 BEDROOM 4 MFRS Byron Bird Jr. 2205 DATE CONVENTIONAL XXX I CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE 0 LOAD RATE 1.2 ABSORPTION AREA 500 # of chambers 30 BENCHMARK V.R.P. base of sideing ASSUME ELEVATION 100' ❑ BOREHOLE O WELL *H.R.P same as BM Vent SYSTEM ELEVATION T -1 =89.8 T-2 =89.7 >12" Sidewinder High Of Capacity Leaching Cov Chamber with 17.2 °' t ^2 per chamber Grade at Sydern Long 3,V FJevation Drive way 4 bed house lie 20' 36' 36' 30, d Ex Se tic tank 20' �' ob pipe under house 4.5 13 ' State Hy 65 B2 50' 9 Well S , cn, PLOT PLAN PL. - AJECT Geald Olsen ADDRESS 2066 St.Hv. 65 NewRichmond Wi. 54017 SE 1/4 NE 1/4S 24 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX 10 -25 -01 BEDROOM 4 MPRS Byron Bird Jr. 2205 DATE CONVENTIONAL XXX rade CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE 0 LOAD RATE 1.2 ABSORPTION AREA 500 # of chambers 30 IL BENCHMARK V.R.P. base of sideing ASSUME ELEVATION 100' ❑ BOREHOLE O WELL *H.R.P. same as BM Vent SYSTEM ELEVATION T-1 =89.8 T -2 =89.7 f Sidewinder High Of Capacity Leaching Cove Chamber with 17.2 6" t ^2 per chamber n 34„ Elevation Drive way 4 bed house B 20' 36' 36' 30' d Ex Se tic tank 20' 60' ob pipe under house 4.5 4 13 ' State Hy 65 B2 50' (iD 95 Well 94' Ll1, Wiscohsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Gro � Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must / 5 f X, include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.O. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ( — ' Please print all information. iewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Locati n Cwt / �r-.� Govt. Lot` 1/4/ 1/4 S�;;2 7 T 3/ N R E ( Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# o C>e y� City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road ❑ New Construction Use: V Residential / Number of bedrooms Code derived design flow rate (�� GPD Replacement ❑ Public or commercial - Describe: Parent material e_,. k� 5� Flood Plain elevation if applicable ft. General comments and recommendations: OZ Boring # ❑I Boring Lf_� Imo} pit Ground surface elev. ft. Depth to limiting factor —�/c-O 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 D ZV, � Ffl Boring # r ❑� Boring Ia Pit Ground surface elev. ft. Depth to limiting factor P �Adf� 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 CST Name (Ple Print) Signature CST Number Address Date Evaluation Conducted Telephone Number SBD -8330 (R07 /00) 1 Property Owner CT "�D( _�� Parcel ID # Page of Boring # IE ❑ Boring Ul"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 --/ 6e 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 a Boring # ❑ Boring Ground surface elev. ft. Depth to limiting factor in. El Pit So ii 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 Soil Test Plot Plan Project Name Gerald Olsen Byron Bijrd Jr. Address 2066 St. Hy 65 NewRichmond Wi. 54017 CSI` #220527 Lot Subdivision csm 4/992 Date 10 12412001 County CROIX S E 1/4 NE 1/4S 2 4 T 3 1 N /R 1 8 W Townshi Star Pr ❑ Boring Q Well PL Property Line# Alt. BM ,BM or VRP Assume Elevation 100 ft.base of sideing System Elv. T -1 =89.8 T -2 =89.7 H.R.P. same as BM Drive way 4 bed house B3 20' 36' 36' d - Se tic taAnk under house 60' ' State Hy 65 B2 50' B3 95 / . Well 94' 60' 95' PL 150' >150' to PL POWTS OWNER'S MANUAL eZ MANAGEMEN PLAN rage or FiLE INFORMATION SYSTEM SPECIFICATIONS Owner �-n /L �� Septic Tank Capacity �o-� gal ❑ NA Permli # Septic Tank Manufacturer ut�.�fr ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ��e54 ❑ NA ❑ A. Effluent Filter Model /� ❑ NA N Number of Bedrooms gal ANA Number of Commercial Units NA Pump Tank Capacity Estimated flow (average) gal/day Pump Tank Manufacturer ANA Design flow (peak), (Estimated X 1.5) gal /day pump Manufacturer )LNA Soil Application Rate A 02 gal/day/ft' Pump Model ®NA Monthly average* Pretreatment Unit NA Influent/Effluent Quality ❑ Sand /Gravel Filter ❑ Peat Filter Fats, Oil at Grease (FOG) 530 mg/L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BODs) 5220 mg /L ❑ Disinfection ❑ Other: Total Suspended Solids ( TSS) 5150 mg /L Manufacturer Pretreated Effluent Quality ' ❑ NA Monthly average* * Dispersal Cell(s) din-ground (gravity) ❑ !n- ground (pressurized) Biochemical Oxygen Demand (BODs) 530 mg/L ❑ At-grade ❑Mound Total Suspended Solids (TSS) 530 mg/L [3 Other: Fecal Coliform (geometric mean) 510 cfu /100m( E3 Drip-line Maximum Effluent Particle Size -A inch diameter * Values typical for domestic (non - commercial) wastewater and septic tank effluent. * * Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every ❑ month syear(s) (Maximo Pump out contents of tank(s) When combined sludge and scum equals one -third (Ys) of tank volum Inspect dispersal ceps) At least once every j ❑ months t5j�year(s) (Maximum 3 yrs.) Clean effluent filter At least once every 'j ❑ months �year(s) ❑months ❑ year(s) i�NA inspect pump, pump controls 8t:2larm At least once every Flush laterals and pressure test At least once every ❑months ❑ year(s) I�LNA Other: At least once every 11 months [I year(s) t$�NA Other: At least once every ❑ months ❑ year(s) IWNA MAINTENANCE INSTRUCTiONS fications: Mast Inspections of tanks and dispersal cells shall be made by an indivpuaas aintainer; Septage Servicing ing Operatorrt inspection Plumber, Master Plumber Restricted Sewer; POWTS Inspector; POWTS measure must indude a visual inspection of the tank(s) to identify any missing or tlon the ground surfacee dispersal i o volume of combined sludge and scum and to check for any back p p onding of effluent cell(s) shall be visuafly inspected to check the effluent levels In the observation indicate a g and r any requires immediate the ground surface. The ponding of effluent on the gr ound surface may nodflcadon of the local regulatory authority. the entire When the combined accumulation of sludge e n t ds cum t l and disp one osed of in accordan e th with ch. 113, Wiscon: contents of the tank shall be removed by p a g e Servicing Operaor Administrative Code. and The servicing of effluent filters, mechanical or pressurized POWTS be performed by a certified POWTS Main�tainer.ny ocher maintenance or monitoring at Intervals of 12 months p A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION • For new construction, prior to use of the POWTS check treatment tank(s) for hi concentrations are detected have the con e a that may impede the treatment process and /ordemfQe the � dis� I cell(s) g Ar the rwas9 mmawd by tenw servici � ng p 6 2.13-9A 9� u y u W*2y. . ...... 2l9 awtl.1 AinfoRinv AbOlY11M9b mom ndw5j) bolysiao ONDIAXIS 37YLd'3S DUOU NOW aWN 1l3NIV1NIVW SLMOd. *1311ViSNl W%Od S.LN3WWo3 aciv .1 IIIISSVd W l bo i�n�l��ta ;t>i A1lW �Ntit v �o aot ll3lNl 3?ll l�I N os 213d Y d 3 ' 1 �nsab AVW Hlv3a 'snNylswnSvp ANY 113aNn xNYl Lmam i mmio vo awnd 'Dwis Y nim iON Oa •NIDAXO 1N36minsm X10 /aNV s3sSV9 wmal Nlv1N0D AYW smNVI LN31.1Y3d1 b3N10 aNV allnd 'o11d35 < <7NINNVM> > •awp letp It »aJJa u1 saln.I syI 41M+► �ldwoo'Isnw swalsts yons)o suolvMSUOOab •aorlans anptnlyul atp It Iewolq atp Jo leAOUaaa 2UlAOp0J aDeld ul pron=ooaa aq stew nuals4s uopdaosge ilos apeA&Ie put puny p 'SIMOd Palle) ayI a>eldaa oI vow isrl t se pallmul aq stew 4uei 3u!plOq t algtgtnt 4 tax luawa .)eldai ou jl •Naar; )uawaoridaj olgnlns a ale>ol of pauuopad aq Isnw uopenlena alts put not t sL%od ao Jo a ot) uodn 'teat Iuawmlda.I al AA$ a gpuapt oI Palenitna uaaq IOU sey alts 041 6 S1MOd Ale) ap aoeldai of 31mm Isti a sr pantlsul aq Am IIun SUIP1 e ,taolou4�al SIMOd ul WI Nnpt 3ul,utg •suopnlwll lls jo7pue.)ppgsas of anp algtlleAe Iou 4 Bair suawaoeldaa algnlns V p •awp It41 It IoaJJa ul salw 042 tplM Aldwoo tcnu, ttualsAs Iuawaoeldab 'ean wawa5tldaj 414ellns a ysllgnsa oI uoptnleAa ales put llos Mau r. aoJ paau ayI ui Ilnsaa 11pA cage Iuatu»tldaj mp u4loid oI aanlltd 'sllom put-oull Iol'unt)Ms pasodoad put 3upslxa woaJ g)egias paalneaa Aq uodn paaul�)ul aq jou pinoys put uop edwoo put aluegarnslp w ao oa) pomoad aq pinoys Bair wsweldej aq.L walsAs uopdjosge llos IuawaMdas a )o uopMl atp )o) patllpn aq stew put palenlena uaaq se4 taae Iuawaoeldw algellns y q :wmAs Iuowaoeldaa Iutlldwo) #poi a aplAoid oI 'uorin aq Isnw JO 'Uw%" aAt4 saanstaw suVAollol atp paaledaa aq Iouue) put slleJ SJ.MOd a4l A NV1d AaN30HIINO:) •Ielaalptu pllos Iaaul aa41oue )0 laneaa 'llos 4t1M pally coeds plop ato put paAOUJW saanoo a164% ao panotuaa put pa3tntoxa aq 11t4s slld put q uel lle 'auldwnJ ,ally • •aoteaad0 aulopuaS aaeldaS t Aq )o posodrlp Alladoad put panowaa aq lleys n1d pue qun lle jo swaluoo a4y a •paleas ssuluado odld pouoputge a41 put paloauuomip 0q 11p4s nid put qun oI auldld Ilv • :apoo sApenslulwpy ulsuoAM '££•£8 wwo:) '40 41IM kwelldujoo ul pauopuege Ala)es Put Al,ado,d sl walsAs #tll let" amsul of ualn oq llegt sdals sulmollo) ayI aolAaas Jo Ino ualel Alwauetwad sl ao/pur slleJ S,LtAOd 0 4 1 ua4M LN3W3NOQNVBV •aulaq aauagos nom put :suoawel n1jaeu Aaellues :sapl31Is10 :rlonpold bullultd :llo :suonrolpaw :sde�K Ieaw !sopplgaay tastaj2 :augost3 lsaullsod olgnaam pup Ilrny :�aleM (dwnd dwnsl u(eaP uollepuno) .Ie) , nuwp)ulgp (s odtlp :srog lewap !s madap :sgtMs wnoo :swopuoo :s11nq a�Iaarald ssxilM ,tgeq :sopolgllue *-SIMOd ayI )o a)ll stp suoloald put aoutwao,Iaad atp snot dwl Arw wtwU aoleA I SWA All woa) SUIM011o) 041 Jo uopeulwlla ao uoponpaV •talc uopolosgt qos ape13•Ie jo punotu Aue Jo adols u M op IaN S 1 ul411A'► race ayI 'IOedtuoy jo cl,MgP a4tnJa4110 JO'aano naed ao aApp IOU oa 'sllao lesaadslp pue Opel aiAO s11p140 Ted ao anlap IOU 04 •xum dwnd a41 MIN slanal letwou aaOlsaa rn clonuoo dwnd ayI 3upel0do Allenuew ul Islsse of aaultlUltW SIMOd ao Jagwnld a wiuoo ao dwnd Iuangja ayI oI a mod aulaoisaj oI ;topd•ioieiadp 3upWaS a3ndaS t A4 panowaa lun dwnd ayI Jo nualuoo ayI 4Ae4 uonenlls s14 plonr. of 'IUanllla to aaJV4.)Slp ax)ms,w dn)ptq ayI ul Wnsaj Atw put (s)pso ayI 3ulptolaaA0 'MOP All aUO ul (s)pao lesaadslp 6 4 1 01 paaar43V aq il�M aaltMalStM ss»Xa ayI pamisaa s1 aaMod ua4M •slaAat .pltM4al4 leuuou aAOge llll stew oluel dwnd saaelno aamod aulma .aoe),Ins aAptnt{)ul atll I t uatoj) ait suoalpuoo cps uayM amoo IOU Ile4s do vets wats�s f r ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 6=f ham /' / " Mailing Address 42 49 4 G Property Address (Verification required from Planning Department for new construction) City /State Parcel Identification Number LEGAL DESCRIPTION Property Location �V4, '/4, Sec. , T LW , Town of Z:5fr�i'tci,i°� �? Subdivision GS ��5,� . Lot # a Certified Survey Map # O 3 ` , Volume /� _. Page # � ' �d �- 6 Warranty Deed # 3 9 m o 7 s , Volume ., _ Page # � a - Spec house ❑ yes )S no Lot lines identifiable g yes ❑ no SYSTEM 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 mastorplumber, 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 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. 4� SIGNATURE 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 owners) of the aperty described above, by virtue of a warranty deed recorded in Register of Deeds Office. kL B A ,I, SIGNATURE 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 reference is made in the warranty deed i i DOCUMENT NO _ STATE OAR OF W1sC0151N - - FORM 1 _ _. i „ , • WARRANTY DEED r 11 1 � �� � h.�a n,:i sr•A• E rrc •;tnvtn r'n =a •:ngn oAr• 3900'75 i This Deed made between . F= rst American Bank _ Axry,a Wisconsin -- corporation, 104 - West �Iaple . Street A.. -- AM4eCy,--Wlsconsin - 540.1 .... ___ _ _ --- - -. - -- F' 21st ............ .. ... ..... ..... _.... .... Grantor II _ and.... 'erald .0. .Olsen... . - --. . .............. .. _ - II ds .f 8 3UDec 8.3 .. ..... __.........._ .....- _... CI_ A i . _... _ .G ra - - ntee, , -- e ! James O'Connell ... .�,,;, 1 Witnesseth That the said Grantor, for a valuable consideration..... , Thirty -two thousand and no/ 100--------- - - - - -- ($32,000..00 conveys to Grantee the following described real estate in St _ . _ ._ - RETURN To First American Bank of Amer/' County, State of Wisconsin: 104 West `,aple Street j _A.aer u I.Ti -_ �nng =, 4Il 0L__ Tax Key No ... . .... . .... ..__.......... t A parcel of land in the Southeast Quarter of the Northeast Quarter (SE:, of NE4) I of Section Twenty -four (24), Township Thirty -one (31) foorth, Range Eighteen (18) West of the 4th principal -ieridian, located in and forming a part of the Tow,. of Star Prairie, more particularly described as fellows: Beginning at the East quarter (E4) corner of Section Twenty -four (24), .ownship Thirty -ore (31) CIorth, Range Eighteen (18) `rest, Town of S,;ar Prairie; thence ;forth along the Section line 357.4 feet to the point of be-Tirning; thence :forth 88 57' West a distance of 345 feet; thence North parallel rc the Section line a distance of 275 feet; thence South 38 57 Eas` a distance of 200 feet; thence 'north parallel to the Section line a distance of 35 feet; thence South 88 57 East a distance of 145 feet; thence South along- the Section line a distance of 310 feet to the point of beginn' -ng. The East 33 feet being reserved for hi.nway purposes. All beat based upon an assured bearing of 'forth for the East line of the :;crtheast Quarter (ZdE4) of Section Twenty -four (24). - I Iq This .......... j ?. _.... - ho.nestead property. (is) (is not) Together with all and singular the hereditainents and appurtenances thereunto belonging; And EZr3t A : :.erican tank of tl •.ery warrunts that the title is good, wI fcasli :e ul fee simple and free and cica: of encumbramc :i except :;one. and will warrant and defend the same. Dated this . 1 t day of 'iovember 19 33- SST A,,ERICA,K. � - OF AVERY (SEAL) /L C c� .`_'� :_ .�-C ��- .- _.__..�.�....(SEAL) _ . ..... ..arc 1; Fr.. e resident.. C v� t� - -- (SF.aLi �{.�.' ".L,L.l _ .(SEAL) David J. Park,_ Vice_ President & Cashier i AUTHENTICATION ACKNOWLEDGMENT Signatures authenticated this - .. . .— day of sTATI: OF WISCONSIN 1 Polk County. Personally came before me, this - day of ;ovember,, 1983 the above named _ !Jarc ,, 1- . Fre..nch, - - - - - -- - - Vice President and David J. Park, Vice TITLE: NIE5IBER STATE BAR OF WISCONSIN President & Cashier (If rot, aut horized by § 706.06, Wis. Stats -) THIS INSTRJMENT WAS ORAFTFD IIy to n•.c known tckb(s•the p_rsnn 9 who executed the , forvgoin;; insfrument and acknowledge ti•c same. ',arcel French for , First American Bank. of Amery Susan - I F2Strus;en Nmz t t pl�(J 1 } folk County, Wis. (Signatures may be nuthe:..icnted or acknowledged, Both \I}' Cnrort�44pn 14 ) 4 knnan `t.. (I[ lint, state ex,lirttion !t' are not necessary.) dale: S AptembPr.'7. 119 86) 1 �= r 1S i +N&m or perwns ■ignins in •r.y cal +ho b- hied nr printeA hel— their i WARRANTY DEED STATA BAR OF WISCONSIN Wi+cnnnn L•unl ft;nnk t'n. !n- FORM No.l — 1977 (J,,1,33223) DOCUMENT NO. WARRANTY DEED THIS arsci R[atRVeo F R[COROINe DATA TATS BAR OF WISCONSIN FORM 2 —UN 460328 v ,. �- c � r " REGISTER'S OFFI sent,_..Inc.. . ................... ............ _ .... ST. Co MIT ......................................................................... .. ............... Reed for Record . ........•-••--• ..................................•----.............. ......- •-- ......•- •- ••..._.._.. . ......... ........................ ....... ••• - -_... � conve_•a and warrants to ........ d.. G,...Ql a�lcl ............. .......::........:....... ...... a , .... .... ................................................................._...... ......••••..-- ................. • a.; . . ................................ .•. --............•-••-............................. ............................... ................................................. ............................... . ... RETURN TO " the following described real estate in ...... .St._ Croix Counts, - -- state of Wisconsin: TaxParcel No: .............................. Part of the Southeast Quarter of the Northeast Quarter (SE 1/4 of HE 1/4) of Section 24, Township 31 North, Range 18 West, described as follows: Lot 1 of Certified Survey flap filed September 25, 1980, in Vol. "4 ", page 992, Document No. 366606. i 1 ♦ �iA f I fi ly � •� II .t 18 not homestead property. { This - -. .... - ` (is)r (is not) .rSxe"O to warranties: AQa' 4.T ,.zoihinq and ordinances, easements and restrictions of record. , V • . N .Dazed th� i.'' ............. .__..._. day of .......... ._. 19.. .Q. ri les ! «.y o --• -- •--- -•- --•- --- - - - - -- --(SEAL) - -- - . .... . ... .... .... .. . .. .. ...........(SEAL) i . �Cfia D'� . ......- •• - -• -- ... ... -- • Y ......... . . . ..�...�.- _ ( AL) -- -.. - - - -- -- _---- ---- -- ------ •- ----- ------ .......... (SEAL) a. Carol Carlson ecre tar y •. -- - -- - - -- - - - - -- ... _ ...... ADTRBNTICA ON ACHNOWLEDOURNT Sitnaturs(s} - --- ----- ----- - --- ------ °--............................ STATE Or `VISCONSIN ................. .......... .............. ..... ....... .. ..... ............ St. Croix as. ......- -•• • •• ...................County. Bud 6w d this _.day o1 ................ .. ........... 19...... Personally came before me this .2=d ........ day of � ?u -•------------- ------ - named . the above ned �f ( ............. «. ....._.._.........-•----•... ............................... ° j ---- --•-- -- --- -•-.... •.. ............ .•............._............... •_..._ . .. ... .................. C harles Pol fus y........... ............................... .._.. .._......._.. ............................................. TITL • MEXBER STATE BAR OF WISCONSIN *� Carol__ Carlson. ............ a --------------- s.Z. ' b7Wis. States I - •--- - - - - -- - _--- _- •- •--------- __----- - - - - -- ........ ............... to me known to be the person ...- s....:' �+ Q foregoin 'nstrumcnt and acknowledge 1b� jFS1 IN U ENNTnA ED BY a , o , Schumacher, •• ..................... 5hirle Nilsen New Richmond, WI 54017 - - - - -- ............................... = i ....-» .......... ° ..................---- -- .... .......................... Notary Public ...... .St..-Croix ..... .. ... . �� ` County R► a vutuu MAY bs authenticated or acknowledged. Both My Commission is permanent. (If nof;.,slat¢ expiration we not necessary.) ............ ••• - -- date 11 -28- 1 993 f - ..... ..... 1 , ' dealag in W aDwft shoaW ..0 tn)ed or printed below their sifnatures. NiA= BAS OF Wn4CONMN FORK go. 'd— 198E Riweonsle Lesal Slunk Cw ter: �hiwweA.c- was. — _ Q 563031 w CERTIFIED SURVEY MAP GERALD G. OLSEN Part of the Southeast 1/4 of the Northeast 114 of Section 24, Township 31 North, Range 18 West, Town of Star Prairie, St. Croix County, Wisconsin, being Lots 1 and 2 of that Certified Survey Map recorded in Vol. 4, Page 992 as Doc. No. 366606, in the St. Croix County Register of Deeds Office. NOTE: This certified survey map is intended to supersede and serve as an affidavit for that certified survey map recorded in Vol. 12, Page 3274, Doc. No. 560525, of St. Croix County Certified Survey Maps. NE COR. SEC-24, T3 /N, O Indicates 1" x 24" iron pipe weighing 1.13 lbs. /lin. ft. set R /8W /P.IC.NAIL Indicates 1" iron pipe found. F O1 --- Indicates fence. R () Indicates recorded data. This instrument drafted by Laurence W. Murphy UN PL A T TE LANDS S 88 "E 671.19' R/SBB•37'E1 � wo �o LO T l o Q o 2 0 0 3 I � • O 4.497 ACRES O h 0 N t 9:5, 910 S0. F 7. ♦ I Q 2 h o i ♦ ' O M STORAGE UN /7S C 2 :k Z �► (/� �. Q 0 N 849* 33 "W 671.77' I ` QI 10. Q -J R N W I Q O Z v/ ✓ L J I N W � / ,. is �� � b c� to M W tu W o Q ? �l BARN I h 'k �I �i.il� OO t........... N o ` Z WELL O O Q W I LOT 2 SEP HOUSE h R Z „ i T /C O Owner's Address 8.189 ACRES 0 �. _' I JO' 10' 2066 Highway "65" 374 129 $O. F7. New Richmond, WI 54017 o►dECL 3 , GAgACE I 49.3 ` I ' I � ' Z IV ' I N 88 • 13'00 "W 723.30' V1I LO T 3, C. S .M. ,_VOL . 4, o SCALE / "z zco' _ PA 992 In ' D 30' 100'130' 200' 300' 400' 300' 600' h M E 114 COR. SEC. 24, 73 /N, DRIVEWAY £AS£MEN7FOR L073, R 18 W. /2 "IRON PIPE C.S.M. , VOL. 4, PAGE 992 AS FOUND/ . ,II `` i % \C j I PER SAID C.S.M. ` w� ll�� �•• 00 Dated: July 24, 1997 LAUR N M P Y • c � dw 713 �• IVER FALLS.,; WISc. • Laurence W. Murphy F Q • • .LANO.SJ•`�•• Registered- Land Surveyor ` -- - Vol.12 Page 3312 -