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M. 0 N Q m m� m Z ° m m� m F , y v c m m 0 0 3 m m m 0 0 3 m _ a <3 �m>> ° =a <3 0 ID ° a amv o co co y m ao_o_ �,v co co m c o o � a— m co 3cn W . o Sao m cL � 3 w cL od0_ Wco m mm0 WCo m °m a `2 c o o� cn� o� c � 3.�3 m m :7 aCDi EF v �_ a O O C `G O N 0 C c 7 =f c 7 Z. U) CD 0 W O= fD co C = N O N W o 7 p m Qo 7 p N 9. I ti Q Q O O O V O 0 0 O 0 0 n+ 0 `2 CD O O C- O O C- N �' Parcel #: 038- 1118 -70 -000 03/3112005 10:45 AM PAGE 1 OF 1 Alt. Parcel #: 29.31.18.490H 038 - TOWN OF STAR PRAIRIE Current XI ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * THOMAS G & ALICE C CONOVER CONOVER, THOMAS G & ALICE C 1961 93RD ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1961 93RD ST SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 1.100 Plat: N/A -NOT AVAILABLE SEC 29 T31 N R1 8W PT SE NW COM NW COR SE Block/Condo Bldg: NW S 214.5'TH N 88 DEG E 173.9'TO POB S 10 DEG E25' N 88 DEG E 123' TH S 9 DEG Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) E 163.3' TH S 88 DEG W 295.3' TH N 29- 31N -18W SE NW 186.3'N 88 DEG E 140.9' TO POB Notes: Parcel History: Date Doc # Vol /Page Type 04/09/2001 642366 1615/212 WD 07/23/1997 1111/142 WD 07/23/1997 1027/32 WD 07/23/1997 669/292 2004 SUMMARY Bill M Fair Market Value: Assessed with: 30614 338,100 Valuations: Last Changed: 10/15/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.100 75,200 277,800 353,000 NO Totals for 2004: General Property 1.100 75,200 277,800 353,000 Woodland 0.000 0 0 Totals for 2003: General Property 1.100 37,700 172,500 210,200 Woodland 0.000 0 0 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 � r Wisconsin Department of Industry, SOIL AND SITE E REPORT Page of -� Labor and Human Relations Division of Safety & Buildings in accord withF,�}S. 1 de COUNTY C Attach P complete site Ian on paper not less than 8 1/2 x 11 ' in ' e PI a inclu P not limited to vertical and horizontal reference point (B silo �� M), d nand Ad,gt le o PARCEL I.D. # dimensioned, north arrow, and location and distance to no oad. 03 b) jam APPLICANT INFORMATION PLEASE PRINT ALL I REVIE DBY JDATE PROPERTY gM. PROPERTY ON �fI L /,-v . X E �/ - r 0 1/4 /tl(.C�I /4,S Lq T 3 1 ,N,R le E (to W PROPERTY OWNER':S MAILING ADDRESS OCK # SUBD. NAME OR CSM # CITY, STATE ZIP CODE PHONE NUMBER {]CITY QVILLAGE BMWN NEAREST ROAD 2— New ( New Construction Use ( Residential I Number of b6drooms 3 [) Addition to existing building j ] Replacement [ ) Public or commercial describe Code derived dairy flow y gpd Recommended design loading rate . 7 bed, gpdM trench, gpw Absorption area required bed, ft &0 3 trench, 11 Maximum design loading rate ' bed, gpd/ft ' d trench, gpd/ft Recommended infiltration surface elevations) -sue 9 • ft (as referred to site plan benchmark) Additional design / site considerations Parent material 11 S Flood plain elevation, if applicable �v ft S = Suitable for system CON YENTIO UL MOUN IN-GROUND PRESSURE A -G E SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem [L7�$5 0 U 19-8 0 U E3 O U 0.8 U ❑ S C�H� SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Tiw6 D -.3 /0 Ve3 /i � s /,W � � is 1� - Ground 3 16 51 - elev. ft. Depth to limiting factor , Remarks: Boring # 0 - 1 io ygo 3/Z ti .. z �,_ 75 y /s /,Ao, mss s — 7 1 4 2 Ground elev. 3 ' y �, S y y . S D. S �ip — — ? 1 ' � �i Depth to limiting 1 > factor Remarks: CST Name: - Please Print P o Q E R T N, L Q P 1 I4T Phone: 7/S ; 3,6; Aje C — Address: �5 y� j C'STiy 2 Signature: Ulbricht & Assoc cites Date: CST Number: Private Sewage COnSultst'" fhll_ 55 O'Neil Rd. I`- (7 4, 6 ud Wis. 54016 OR I GINA L r • 1 13o y&;e : 4i2L 1w P �4 yE/l PROPERTY OWNER SOIL DESCRIPTION REPORT Page of -3 PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bax by Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed rends Ground 3 S �1 , S, �ic� �� 17 ' elev. /o f !s8 ft. - �o " 7 : Depth to limiting factor Remarks: Boring # � •� Y"e 0 Sq Ground elev� ®� G D S 1 '- Depth to fimiting factor Remarks: Boring # S L o- Yo 75 Me y ___-- , s D S4 WV es Ground 3 elev, /oo L ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. 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FT - �7 W (D (7 O ' v Z m O N Q O A Z 0 .G C T7 •• Z O y a A O O. O M N (D W m CL 3 a z O �: z 3 .. 00 N z CD a F O N 3 X N 7 C jy D n N 0 0 O o " CD y m ° '�.ci TO C7 < o O S O 11 cn O y F N N C w c 3 w 9- ' 0 . 3 v > •• N �__? n N M E : 0 3 p d O N O O N co fa (D 5.0 N 0 0 0 -p W co N ? 0 3 N W CO d O �) O O cn O ( fD Cn'O N N CL N O a, m m 0 a 7 X - �A 0 ` o o ay �_ ft w CL o a C- o rn Sp O c A N O O O O Cb O L I LEGAL S OIX COUNTY, WISCONSIN REAL ESTAT TOWN OF STAR PRAIRIE COMPUT NUMBER 038 - 1118 -70 -000 Parcel Number 29.31.18.490H OWNE AME: First THOMAS G Last CONOVER PROPE TY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment 1961 93RD ST SECTION 29 31 N RANGE 18W '/4160 NW 1 /440 SE Line Descn . Line Description TOTAL ACREAGE 1.100 PLAT 01 SEC 29 T31 N R1 8W PT SE NW 15 02 COM NW COR SE NW S 214.5' TH 16 03 N 88 DEG E 173.9' TO POB S 17 04 10 DEG E25'N 88 DEG E 123' 18 05 TH S 9 DEG E 1633 TH S 88 19 06 DEG W 2953 TH N 1863N 20 07 88 DEG E 140.9' TO POB 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 I ORDINARY HIGH WATERMARK DESCRIPTION CHECKLIST Form 350046 Rev. 2-83 z�•�i.ta.`f�aJ Observer ,� 7 Waterway Property Owner L OCATION i/a a Section L2 Town I 3/. N Range W Town o f County of � DATE Day 2 Month Year Hour WEATHER I Wind Speed Wmd Direction I 1 Temperature LL—L� PHYSICAL SETTING L L � J ° Wave eg I I Ft. Bank: Height Height Ft. Slope � 1 L 7 � I ., � � Distance From Ft. Beach Width I Ft. Slope L OHWM To Water's Edge 0 Assumed u , 8 N� 8(-1 . 3 O _ 0 M.S.L.D. (Describe references r =♦ c 1 C .. S ' Z� 0 I.G.L.D. on back of form) S t o Water Level dk ••/'fit C S G -Other ,r � © � V• i • ts' P �. ` �v - F1ew<i� • Assumed • M.S.L.D. (Describe references Field Book Elevation of S� . �j 0 I.G.L.D. on back of form) Number OHWM 0 Other' OHWM DESCRIPTION 'to 04 Ban L. Item Description S � +• �� j -- zs . Bed material adjacent to ; OHWM S +te - mss Factors affecting location of OHWM (e.g., structures, shore ! w1k v4(ar o n protection, shore configuration, �{ -2- -0 1 F ro Indicators and procedures used to determine OHWM &¢ p General vegetation types below < OHWM -�-. r 1,�., ��,•C� General vegetation types above OHWM If photographs taken, how many? What type of photographs? _ Where are they stored? ^ F:p'r ,19 01 11:01a Tom Conover 7635440415 p.3 4� y � . D t �Q L ; 5 U nJ rjz� ae dZ � 5 -r�,p--e :�a a c F Q�l �4 ' Rpr.19 01 11:01a Tom Conover 7635440415 p.2 /Va� N 1,12 SEC. c'S. T3 1N, R /8 W G / TOWN OF STAR PRAIRIE id r ►� ' 1 �. ur U& M QW30 ■:z.or j 1 ` 3 f 46TG , for l + M 487 120 844 s 487130 yes 487 F I !71 R 2 ezzc� 839 W_ I l Z AE 114 - NW X10 z to NW 114 - NE V _ , 1 487 J ( ``��• ss I� 12 8 843 487 H .r.>o 11 487E 487 I Gp N U,- 488 ' 4s LOT los9raso -zz� I 488 1 4rz37 7 � 1 L1 488 LOT B42 841 48 48487 A 24919 487A-10 --- mac � ) ` 4 9 H 9 H f \ i{ �Q l4 485 A F + ++ 490 A 4-NE114 � S W // _ I SE - NW 114 WAVI4 I \ 485 D 490 I 490 G �� \ LOT 2 \ 1 ,yM1L 4900 485 C "90B h" LOT - — 3 fF r„19 01 11:01a Tom Conover 7635440415 p.1 April 19, 2001 St. Croix County 1101 Carmichael Road Hudson, WI 54016 Attn: Rod Eslinger St. Croix Zoning Office Dear Mr. Eslinger, Please schedule a visit by your staff to our lot to determine the ordinary high water mark in order for us to be able to confirm the positioning of a new home we plan to build on the lot_ You mentioned you are running a lead time of about 2 weeks on this type of service. Per our phone call this morning I am faxing you a copy of the following information: • A drawing of the proposed site plan, with directions as to how to get to the site. • A drawing from the county which identifies the site as lot 490H on the map with the heading "N' /2 SEC. 29. T39IN. R18W. If there are any problems with reading this fax, or you have any questions, please call me at 763 540 -0626. Sincerely, Thomas Conover Materials faxed to: 715 386 4686 Zoning office phone number: 715 386 4680. I h. T r� • .. fir• sire "7' � .r" 3 ar cs"rri. Iaet = f • . uar.uwl�✓A «rt�Y ..c r •1. • w 4 GW�e a 1g AD • str ✓ , Y � , f air �+ • , .. ,� ry j K�`S"'""w+" ,ate+,«». �`!�i " \ "� #,.^r' 4 'Lv '�""'""y 'tf +' �' ,.: "�,> ,,a ,� '��,• 1 r s All T ti r #��.�� goys' M •� i ,� r-` �':� �• � + •!W.,*r'�'"A'�+ �•M>ae� v � ' �` f1A� *� +.,V .� J° �+ x � lr r ' wMn �d' � � M d"A • ► �,y� ,� r '� ' �y� } t � y� "i*w..�il' A s ? � �r �+. a'F 4 ? awr y � r �'. i• Y. u: A ri f ^' * I ; � � /µ o`i m� r; '�'"'W'hx. ,'a �,rM,,' '•'!' „� k � + �� . w rr .:` 4� ..w�l/Je� .,.yn.,oi. ._ r; , � .,, .. � • � f'" .�" .+,rte- .� �. w , w � � .� - .,r a f}s -6 CA - (f z''- 31.1 q?oJ 2 4 90 PLOT PLAN o38 —�I ( $ - PROJECT Tom Conover ESS 1 93rd st Somerset Wi. 54025 .� SE 1/4 NW 1145 29 /T 31 N/R 18 W TOWN StarPrairie COUNTY ST. CROIX 8 -16 -01 BEDROOM 4 MPRS Byron Bird Jr. 2205 DATE CONVENTIONAL XXX -Grade 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. topof Steil 2 pipe ASSUME ELEVATION 100' ❑ �"�� 12 BOREHOLE WELL * H.A.P. same as BM k699 SYSTEM ELEVATION T- 1= 91.8T -2= 91.77 -3 =91.5 (� > 12" E idewinder High Cove apacity Leaching = ' �► x t , ��1Q� � hamber with 17.2 t ^2 per chamber - s Grade at Systern 70t**01 Long 34" Elevation BM PL 100' 120' 11' 68.75= 11 cells 4' AppleRiver 7 , 56.25 =9 cells st 93r I st garage Driveway 4 bed house Wisconsin Department of Commerc 47 r - - PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Buil�'rfy ;j++:isian u ' INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 383985 0 C,ENbRAL INFORMATION State Plan ID No: I ersonal 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: ! L n NW Conover, Tom Star Prairie Township (N 1118 -90 -0 00 CST BM Elev: I Insp. BM Elev: BM Description: moo. .a C.(,k = csr g>M - a9,90J" TANK INFORMATION V I I ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic W 4- LIS I ZOO Benchmark O •�3 co �'3 �� o r Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet t TANK SETBACK INFORMATION St/Ht Outlet 2 3' TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic f ' SD I 26 t Dt Bottom Dosing Header /Man. Aeration a der JA- �(91,c3 Holding Bot. Systerh Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover PM Model Num r TDH Lift riction loss System Head TDH F Forc ain Length Dist. to well SOIL BSORPTION SYSTEM " ONS RENCH idth i Length No. Of Trenches No. Of Pits Inside Dia. Liquid Depth D► 3 5a- u�.�*- SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Man �cyurer ^ L A n Ar INFORMATION CHAMBER OR l4 WO4wwd Type Of ystem: t 1 UNIT . + 7 p "P ( O — Model Num er: DISTRIBUTION SYSTEM 7 � Header /ManifqW, 4 Distribution x Hole Size x Hole Spacing Vent to Air Intake Lengt Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded T ulched Bed/Trench Center Bed/Trench Ed es To soil g p Yes �F N[E Yes � No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1:�/�/ d / Inspection #2: Location: 1961 93rd Avenue Star Prairie, WI4Q26 ( SE 1//; NW 1/4 29 T29 , N �t18W) NA Lot P No: 29.31.18.490J 1.) Alt BM Description = h Sd+•� y_, `� n �(,� 2.) Bldg sewer length = 3� " C +e $:�} s �(. g(, amount of cover = 1I,o So z I u%- " ti r n Ill'J �,, It 3 . 'f 3� �+ g.Q s 3�- YwI�d�Ew.SQ.Q� 'Q s"'�• f = B.RD x 9r. e3 Pla evision Fqu d� �(S Use er std or d�itiona for n. _ SBD•6710 (R.3/97) Dat Insepctor•s Signature Cart. No. .. r i �SDo�'t -:-i- _/► _ .., __ ��,��.�.a.J , ��I.. 1 y '`` ' f ,r �: (��� S �� �� R�� � y r - # 12 773 V Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. 1* 6 ' consin See reverse side for instructions for completing this application PO Box 7302 Madison, WI 53707 -7302 Department of commerce Personal information you provide m ondary purposes [Privacy (Submit completed form to county if not ' state owned.) Attach complete plans (to the county copy 2 fty. r the s paler no1jess than 8 -1/2 x 11 inches in size. County , — 3 �Sanit it Number p Che o previdus application State Plan I. D. Number f r 11 I. Application Informa - Please Print all Inform afill 2001 Location: Property Owner Name jCn Property Location S � GB gx e Q v'' GptItVN 1!4 !4, T ,N, I�dE Property OiA ner's Mailing Address � Lot Number Block Number City, State Zip Code Subdivision Name or CSM Number )S 0AI II. Type of wilding: (check one) ( ❑ City 1 or 2 Family Dwelling - No. of Bedrooms: �� P �Gtn SOU ❑ Village ❑ Public /Commercial (describe use):_ Town of ❑State -Owned Nearest Road y � � r c.C. t'r. ��'pd Parcel Tax Numbe s III. Type of Permit: (Check only one box on line A. Check box on line B if applicab Q, 31, 19. Y G A) 1. New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. - Ti ❑ Addition To System System Tank Only D 3$ + 1 l ! 8 D - a Existing System B) Permit Number ��� Date Issu d ❑ A Sanitary Permit was previously issued' ((S S < IV. Type of POWT System: (Check all that apply) PNon- 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: 3d 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area . Soil Applic on 5. Percolation Rate 6 System Elevp Lion 7. Final Grade Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch)_. / �/• ( ✓ Elevation VII. Tank Capacity in Total # of Manufacturer Prefab Site S Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks �- ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigne assume responsibility for installa 'on of the POWTS shown on the attached plans. Plum s Name (print) I Plumber's S' attire no stamps): 1 MP/MPRS No. Business Phone Number Plu Address (Street, City, State, Zip Code) IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) 1 Approved ❑ Owner Given Initial Adverse Surcharge Fe / e � / Determination �fi 2? - X. Conditions of Approval /Reasons for Disapproval: l / � �1 � � �il�rJrG�° ��1�ai��cr:n���r �a�u t�L7�li�rv's ✓NGorr�nlew�a�;oxS. (. Se�d� clt s tie / / w`i i U s C� y�,� V V e P1 2- 4 P13 hOkse (0(i0--11"" ( / y (0 ' S C' Gf 2 � h1 iL�a �eCUE Mir % wt kw� S��p far -W 0- [[ Iva S ea -S.' e a "' ka�' 6 Serves oo'x' oo � a,' Co4 w Carrel S1Y15 (R'07 %OOj ham! dvo w- (d ueel� �P survey {ov d! �Cto �Pq� ,it �•.,. aJ�it��c, ,'t dPSr'v e4! �• PLOT PLAN PRUJEC"i' Aey 0 (f`" ADDRESS 1/4s � /11, w I'owN / CU UNI'1`� 1VIPRS Byron Bird Jr. 220527— DATE r Z BEDROOM r CONVENTIONAL IUNAL )00( IN GROUN RCSSURE CONVENTIONAL LIFT HOLDING TANK -IOuND SEPTIC 'TANK SIZE LII'I' TANK SIZE DOSE 'TANK SIZE HOLDING TANK SIZE LOAD RATE / ; � 7 AIISORPTION AREAJ # of chambers 14 BENCH:\IARK 11.11.P• .LASSUAI ELl "WATION 100' l ❑ BURILHULL O WELL "H.R.P. Vent SYSTEM ELEVATION 12" Sidewinder High of Cover Capacity Leaching Chamber with 31.8 ftA2 per chamber Lone 16" 34 „ Grade at System Elevation 7 — — , Q �\ � ra # 3 r /3D I � 4— 1-5 a7 _ II` VtliscoA i Deparn Relations ting dndustry, SOIL AND SITE EVALUATION REPORT Page —/—of 2 F Yabor aixt Hu ma Civision of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code ' COUNTY 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 reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION R WED Y DATE Z U PROP Ty OWNER: PROPERTY LOCATION GOVT. LOT 114 7 1l4,1 T 3 1 N,R E (or) W PROPERTY OWNER':S MAILING ADDRESS LOT If BLOC # SUBD. NAME OR CSM # tf! CITY STATE 1 ZIP CODE PHONE NUMBER ❑CITY . IL GE ®TOWN NEAREST ROAD �j New Construction Use [uJ Residential / Number of bedrooms Addition to existing building (j Replacement [ ] Public or commercial describe Code derived daily flow gpd Recommended design loading rate __ bed, gpd /ft _ l z_ trench, gpd /ft Absorption area required /_ �� bed, ft2 _.S13 trench, ft Maximum design loading rate 7 bed, gpd /ft trench, gpd /ft Recommended infiltration surface elevation(s) d ft (as referred to site plan benchmark) Additional design / site considerations z Parent material ' Flood plain elevation, if applicable Z R /), n ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem 7I S ❑ U (Z S ❑ U 1 14 S ❑ U ®S ❑ U ❑ S Cad U EIS ® U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft ►ray Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots 5BedTrench We Ground ,( elev. ft. 3 - - Depth to limiting fact Ct 1. Y Remarks: Boring # A1114 [SA?L— A 4 � Ground I elev. , ft. _ Depth to limiting I f c r Remarks: CST Name:—Please Print Phone: r- Address: Signature: Date: CST Number: � _ PROPERTY OWNER SOIL DESCRIPTION REPORT . Pagef� PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boar Roots GPD /ft we (P in. Munsell Qu. Sz. 22nt. Color Gr. Sz. Sh. Bed Trench Code n / Ground ?9-9 /Oye — elev. ft. Depth to limiting fact Remarks: Boring # Ground ft. i Depth to limiting factor CT - 1 0 a Remarks: Boring # vZ .-: - / Z 9 1 Ground elev. ft. Depth to limiting RY u factor Remarks: 7(' Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(R.05/92) I r - -- -C= - I _I _ i y Y r i r I - 1 + I I - -- - - - -- - -� -- -- - - - } - - - -- - -- r - -{ - - -; �- - - L - - - I I I I - _ I i I I/ I a� r 1 I I I ___j I - } --- '�---- i--- -Y - -T-�T --------- 1 I I I I : i T, - ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND f � OWNERSHIP CERTIFICATION FORM Owner/Buyer 12 -2 C/ e yn Mailing Address 73.-7 1-, /f�� ���•Q� �� � �5 � �7 Property Address 93 (Verification required from Planning Department for new construction) City /State Parcel Identification Number _ O $� 1 11.J e 2, - Q0O LE GAL DESCRIPTION Proper Location � /4 /4 Sec. P Y S� ' , TLN -R ! W, Town of Subdivision , Lot #_. Certified Survey Map # , Volume , Page # Warranty Deed # — , Volume 16 / 7 , Page # +�+7 Spec house ❑ yes [)Kno Lot lines identifiable % 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 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 1/3 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 oft three year expiration date. SIGNATURE OF APPLI ANT 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 erty described above, by virtue of a warranty deed recorded in Register of Deeds Office. 4 C 1 / lS,/ O SIGNATURE OF APPL CANT DATE * * * * ** 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 it VOL 1615��fJ= 212 STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH Document Number WARRANTY DEED REUSTER OF DEEDS ST. CROIX CO -, WI This Deed, made between Arlin A. Axell and Jeanne M. Houle, RECEIVED FOR RECORD both single persons, 04 -09 -2001 10:50 AM YAMIIY DEED EXEMPT # Grantor, and Thomas G. Conover CERI COPY FEE: COPY FEE: TRANSFER FEE: 177.00 RECORDING FEE: 12.00 {�IGESr .»ti 2 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area (See Attached Exhibit "A ") Name and Return Address 7� \-b"_ X8Y 038 - 1118 -70 Parcel Identification Number (PIN) This is not homestead property. CK) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of April 2001 x'� = ,c + Arlin A. Axell y� , * + Je a M. Houle AUTHENTICATION ACKNOWLEDGMENT Signature(s) Arlin A. Axell and Jeanne M. Houle, both single STATE OF WISCONSIN ) ) ss. persons, County ) authenticated this day of April 2001 Personally came before me this day of the above named s Kristina Ogland TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY • Attorney Kristina Ogland Notary Public, State of Wisconsin Hudson, WI 54016 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ) " Names of persons signing in any capacity must be typed or printed below their signature. womwion Professionals company, Fond a, Lac, W1 STATE BAR OF WISCONSIN eoo ess 2o2t WARRANTY nvFn r t615PAGE213 EXHIBIT "A" That certain parcel of real estate located in the SE% of Ni3; of Section 29, rownship 31 North, Range is West, St. Croix county, Wisconsin described as f011ows: From the NW corner of said SrA of NWT go South a distance of 214.5 feet; thence N88 °56 a distance of 173.9 feet along the North line of the abandoned town road; thence S10 along the East line of said torn road a iistance of 25.0 feet to the point of beginning of the ce1 to be conveyed 2erein; thence N88 °56 a distance of 123 feet to an n i stake on the 'pore of the Apple River; thence on a meander along said s ore S9 a "tance of 163.3 feet; thence S88 a distance of 295.3 feet to the East Line of the North /South town road; thence N0 along the Rast line of the forth /South town road a distance of 161.3 feet; thence NBSO56 approximately 140.9 feet to the point of beginning, including all land lying 3etveen the meander line of the above described parcel and the Apple River and including all of the abandoned Town Road to the Town of Star prairie =ntained in the above described parcel. tv-p P. y . 488 K } 1 1 '. M50 4 LOT 3 G: LOT 2 W0 : I I— 487 I 30 }88'K 2 a: t { rl / IV rl 487 F 1 N G .M " / s 7�ZO5, f NE //4 NW / 438KI g 487 J S9 ssr LOT I a.' , 286.E JO's 2 ej - NW //4 �" W . 487 H 488 H G I 487E t \,;•. 49 t 1 4871 143.8? u 4 a 8 LOT DI / � 488 914.73' . • 488 f v tOT 2\ l 5 486 487 C ��` `� o e (/��� 487 A CERT I FI ED SURVEY MAP VO 488 B: ici 24:8:57' PG. -- 192.10 812.19' / Ha� � — xt ' c 90 q 1419 r ro CJ4 of � 4 - / ��� J a .g . I 9 ^I ���, \g2�� • g A �,, I r � � � Y ikR OT I i. — ��� , y 2 — - c am• t' 1 L 489 I 95 119.7 LOT 2 -. �,� to33 SE NW //4 9C� I ��q78 38 33 \ \ 490 J �- — 4 NW //4 o va � 490 F �( 9� �. - - -- - -- -•- - -- 8�b, O C.S.I1�I. VOL 2, $ _ _ _ _ _ PG. 533 � � 490 a l o z — / 08 / / �� �/ Ii 1yZ 9lG 430 V � ,p /yjB 1l l0315'?" 490 G \\ 489 A r�� r�� _; LOT Z �P it t 2 TDy a 487 G i 48 Lor 1 LO► a G•� y 488 K it I 488 M �/ / 488 K y / 4 • a: t r 487 F , 48X30 7=48Kr- �, r MR /4q Q i�p lOT 1 f { '1C 1 N /({ r 487 J 488 N a 488 H / 487 H / 1 1 487E � t aaiswy 488 �LOr,�, I M 4871 488 L r i y i .1 2i t 1 1 , 1 N6 04F'F - 8 I 4870 5 xr 488 8 ' i < < 487 A 489 B wE z48 1 �T F gQ �€Y 'r t ,�l�i r srx -W �490C 90E� y O� S. 48 . 9 H — w ` t 9 H i 4891 I I \ � 489p LOT : 4c LOT 3 8 SE I \ NW 4,q 489 C t 489 G 4 89A I ,� x r 1 LOT p w la0oft- f sac 2e _ 4900 LOT g 491 l — a Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management complies ent Ian lies with Comm 83.54, Wis. Adm. Code, and the In- Ground p Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567 -P (R.6/99). Tab 1: System Design Specifications Sanitary Permit Number Number of Bedrooms Design Flow - Peak (gpd) Estimated Flow - Average (gpd) Septic Tank Capacity (gal) o Soil Absorption Component Size (ft') Type of Wastewater Do estic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) Maximum Influent Particle Size (in) 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years " Septic Tank The septic tank shall be main coed by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the . 1 Management Plan for a Septic Tank and Soil Absorption Component I ' Plantings of deep- rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. I I 3 i Standard Erosion Control Plan for 1 & 2 Family Dwelling Construction Saes Accb �3 hapters ILHR 20& 21 of the Wisconsin Uniform Dwelling Code, soil erosion control informa- l tion paWs to be included on the plot plan which is submitted and approved prior to the issuance of building permits for- I & .2' family dwelling units in those jurisdictions where the soil erosion control provisions of the t .U`nil rn bwi fi`ng Code are enforced. This Standard Erosion Control Plan is provided to assist in meeting thl� ' irement. j Instructions: f 1. Complete this plan by filling in requested information, completing the site diagram and marking (✓) appropriate boxes on the inside of this form. 2. In completing the site diagram, give consideration to potential erosion that may occur before, during, and after grading. Water runoff patterns can change significantly as a site is reshaped. 3. Submit this plan at the time of building permit application. Site Diagram Scale:- r EROSION j CONTROL PLAN LEGEND PROPERTY LINE EXISTING I4 yy DRAINAGE 11 `� TD TEMPORARY I DIVERSION FINISHED -' DRAINAGE LIMITS OF GRADING SILT I p FENCE STRAW BALES GRAVEL c s + O VEGETATION SPECIFICATION C f TREE •� � PRESERVATION N STOCKPILED SOIL Please indicate north by completing the arrow below. I j I IZZ N — I PROJECT LOCATION A -' {ra r' BUILDER �f -' i�' OWNER a4 ^ i. ✓ r WORKSHEET COMPLETED BY DATE EROSION CONTROL PLAN CHECKLIST Check ( ✓) appropriate boxes below, and complete the site diagram with necessary information. Q C o 0 =� Site Characteristics North arrow, scale, and site boundary. Indicate and name adjacent streets or roadways. i ❑ Location of existing drainageways, streams, rivers, lakes, wetlands or wells. ❑ Location of storm sewer inlets. i Location of existing and proposed buildings and paved areas. The disturbed area on the lot. Approximate gradient and direction of slopes before grading operations. �! Approximate gradient and direction of slopes after final grading operations. ❑ 1) Overland runoff (sheet flow) coming onto the site from adjacent areas. Erosion Control Practices X ❑ Location of temporary soil storage piles. Note: Soil storage piles should be placed behind a sediment fence, a 10 foot wide vegetative strip, or should be covered with a tarp or more than 25 feet from any downslope road or drainageway. Location of access drive(s). Note: Access drive should have 2 to 3 inch aggregate stone laid at least 7 feet wide and 6 inches thick. Drives should extend from the roadway 50 feet or to the house foundation (whichever is less). ❑ Location of sediment controls (filter fabric fence, straw bale fence or 10 -foot wide vegetative strips) that will pre - vent eroded soil from leaving the site. ❑l Location of sediment barriers around on -site storm sewer inlets. ❑ Location of diversions. Note: Although not specifically required by code, it is recommended that concentrated flow (drainageways) be diverted (re- directed) around disturbed areas. Overland runoff (sheet flow) from adjacent areas greater than 10,000 sq. ft. should also be diverted around disturbed areas. X ❑ Location of practices that will be applied to control erosion on steep slopes (greater than 12% grade). Note: Such practices include maintaining existing vegetation, placement of additional sediment fences, diversions, and re- vegetation by sodding or by seeding with use of erosion control mats. ❑ Location of practices that will control erosion in areas of concentrated runoff flow. Note: Unstabilized drainageways, ditches, diversions, and inlets should be protected from erosion through use of such practices as in- channel fabric or straw bale barriers, erosion control mats, staked sod, and rock rip -rap. When used, a given in- channel barrier should not receive drainage from more than two acres of unpaved area, or one acre of paved area. In- channel practices should not be installed in perennial streams (streams with year -round flow.) ❑ 7 Location of other planned practices not already noted. e a Indicate management strategy by checking ( ✓) the appropriate box: �a Management Strategies ❑ Temporary stabilization of disturbed areas. Note: It is recommended that disturbed areas and soil piles left inactive for extended periods of time be stabilized by seeding (between April 1st and September 15th), or by other cover, such as tarping or mulching. Permanent stabilization of site by re- vegetation or other means as soon as possible (lawn establishment). Indicate re- vegetation method: Seed Sod ❑ � ❑ Expected date of permanent re- vegetation: Re- vegetation responsibility of: Builder ❑ Owner /Buyer ❑ Is temporary seeding or mulching planned if site is not seeded by Sept. 15 or sodded by Nov. 15? Yes ❑ No ❑ ❑ Use of downspout and /or sump pump outlet extensions. Note: It is recommended that flow from downspouts and sump pump outlets be routed through plastic drainage pipe to stable areas such as established sod or pavement. ❑ r?- Trapping sediment during dewatering operations. Note: Sediment -laden discharge water from pumping operations should be ponded behind a sediment barrier until / most of the sediment settles out. $I Proper disposal of building material waste so that pollutants and debris are not carried off -site by wind or water. I Q Maintenance of erosion control practices. i • Sediment will be removed from behind sediment fences and barriers before it reaches a depth that is equal to half the barrier's height. 4 • Breaks and gaps in sediment fences and barriers will be repaired immediately. Decomposing straw bales will be replaced (typical bale life is three months). k� - All sediment that moves off -site due to construction activity will be cleaned up before the end of the same workday. C • All sediment that moves off -site due to storm events will be cleaned up before the end of the next workday. • Access drives will be maintained throughout construction. • All installed erosion control practices will be maintained until the disturbed areas they protect are stabilized. For more assistance on plan preparation, refer to Chapters ILHR 20 & 21 of the Wisconsin Uniform Dwelling Code, the DNR Wisconsin Construction Site Best Management Handbook, and UW— Extension publication Erosion Control for Home Builders. The Wisconsin Uniform Dwelling Code and the Wisconsin Construction Site Best Management Handbook are available through State of Wisconsin Document Sales, 608/266 -3558. Erosion Control for Home Builders (GWO001) can be ordered through Extension Publications, 608/262 -3346 or the Department of Commerce, 608/267 -4405. EROSION CONTROL REGULATIONS UNIFORM DWELLING CODE (DEPT. OF COMMERCE) PROJECTS AFFECTED • Straw bales, filter fabric fences or other barriers to • All new 1 and 2 family dwellings in Wisconsi started protect on -site sewer inlets on or after December 1, 1992. • Additional controls if needed for steep slopes or other • Additions to dwellings built after June 1, 1980. special conditions MAINTENANCE AND WASTE DISPOSAL APPLICATION PROCESS • Sediment controls must be maintained until the site is • Erosion control measures must be included on the plot stabilized by mulching and seeding, sodding or plan submitted with the building permit application to landscaping the local building inspector in communities where the . All building waste must be properly disposed to pre - dwelling code is enforced vent pollutants and debris from being carried off -site • Plot plan must show: — Location of the dwelling, other buildings, wells, sur- ENFORCEMENT face waters and disposal systems on the site with •Erosion control inspections will be made during other respect to property lines regular inspections (footing and foundation, rough con- struction, final, etc.) — Direction of all slopes on the site • Violations must be corrected within 72 hours — Location and type of erosion control measures •Stop work orders may be issued for noncompliance CONTROLS REQUIRED FOR MORE INFORMATION, CONTACT • Silt fences, straw bales, or other approved perimeter • Local building inspector measures along downslope sides and side slopes • Department of Commerce, Safety and Buildings Divi- sion, P.O. Box 7969, Madison, Wisconsin 53707, • Access drive (608) 266 -2128. STORMWATER PERMIT (DNR) PROJECTS AFFECTED — Proposed erosion and storm water pollution control • Any grading or construction project that disturbs 5 practices during and after construction acres or more and is not covered by a building permit — Documentation that an erosion control and storm • Smaller sites that are part of a planned development water management plan which meets DNR standards involving 5 acres or more of land disturbance has been prepared (plan does not need to be submit- • Effective October 1, 1992 for any new or continuing ted with the application) project —Other information related to site location and per- • Exceptions: Indian tribal lands and work done by local mit holder government staff CONTROLS REQUIRED APPLICATION PROCESS • Erosion control measures specified in the Wisconsin • File a "notice of intent" application (Form #3400 -161) Construction Site Best Management Practice Handbook with the Department of Natural Resources (DNR) 14 • Measures to control storm water after construction days before construction begins FOR MORE INFORMATION, CONTACT • Application must include: • Department of Natural Resources, Storm Water Per- - Timetable for land disturbing activities and installa- mits, P.O. 7921, Madison, W1 53707 -7921, (608) tion of erosion control measures including project 266 -7078 start and completion dates LOCAL ORDINANCES Check with your county, and city, village or town for any local erosion control ordinances including shoreland zoning requirements. Except for new 1 & 2 family dwellings, local ordinances may be more strict than state regulations. They may also require erosion control on construction projects not affected by state or federal regulations. I A publication of the University of Wisconsin— Extension in cooperation with the Wisconsin Department of Natural Resources and Department of Commerce, Ron Struss, Water Quality Educator, UWEX Western Area and Carolyn D. Johnson, Urban Water Quality Educator, UWEX Southeast Area. UW— Extension provides equal opportunities in employment and programming. This publication is available from county UWEX offices or from Extension Publications, 630 W. Mifflin St., Madison, WI 53706, (608) 262 -3346. Copyright 1997 by the Board of Regents of the University of Wisconsin System doing business as Cooperative Extension, University of Wisconsin— Extension. Send inquiries about copyright permission to Director, Cooperative 7 1 Extension Publications, 201 Hiram Smith Hall, 1545 Observatory Drive, Madison, WI 53706. I GW0001 A Standard Erosion Control Plan for 1 & 2 Family Dwelling Construction Sites DNR: WT- 458-96 R -02- 97- 2M -10—S u i