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Parcel #: 038 - 1133 -20 -200 04/2612010 04:04 PM PAGE 1 OF 1
Alt. Parcel M 32.31.18.542H 038 - TOWN OF STAR PRAIRIE
Current OX ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner
O - FLANDRICK, MICHAEL D
MICHAEL D FLANDRICK
1817 FLANDRICK RD
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): " = Primary
Type Dist # Description 1817 FLANDRICK RD
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 2.003 Plat: 3837 -CSM 14 -3837 038 -2000
SEC 32 T31 N R1 8W SW SW SE SW BEING LOT 7 Block/Condo Bldg: LOT 7
CSM 14/3837
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
32-31N-18W SW
Notes: Parcel History:
Date Doc # Vol /Page Type
03/03/2009 890029 DOM LTTR
02/18/2009 888985 PR
02118/2009 888984 PR
2010 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/15/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.003 32,000 126,800 158,800 NO
Totals for 2010:
General Property 2.003 32,000 126,800 158,800
Woodland 0.000 0 0
Totals for 2009:
General Property 2.003 32,000 126,800 158,800
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel #: 038 - 1131 -20 -200 04/26/2010 03:56 PM
PAGE 1 OF 1
Alt. Parcel #: 32.31.18.532A -10 038 - 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): O = Current Owner, C = Current Co -Owner
MICHAEL D FLANDRICK O - FLANDRICK, MICHAEL D
1823 WINDING RD
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): = Primary
Type Dist # Description 1823 FLANDRICK RD
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 141.888 Plat: N/A -NOT AVAILABLE
SEC 32 T31 RI 8W NW NE,SW NE SE NW,NW Block/Condo Bldg:
SW,NE SW,SE SW & SW SW DESC AS BEG N1/4
COR SEC 32; TH S 89 DEG E 1314.33';TH S Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4)
00 DEG E 2027.79';TH N 88 DEG W 32- 31N -18W
1815.39';TH S 36 DEG W 784.46';TH S 00
DEG W 1340.69 ;TH S 89 DEG W 471.92';TH
more
Notes: Parcel History:
Date Doc # Vol /Page Type
10/09/2009 905147 ALC
10/09/2009 905146 PR
02/27/2008 869590 ALC
10/01/2001 657909 1729/54 LC
more...
2010 SUMMARY Bill M Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 06/15/2009
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 138.665 16,300 0 16,300 NO
OTHER G7 3.223 31,100 122,300 153,400 NO
Totals for 2010:
General Property 141.888 47,400 122,300 169,700
Woodland 0.000 0 0
Totals for 2009:
General Property 141.888 47,400 122,300 169,700
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 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 Coun
Safety and Buildings Division INSPECTION REPORTt. Croix
GENERAL INFORMATION (ATTACH TO PERMIT) SanitUNA, No.:
Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)l.
Permit Holder's Name: ❑ City ❑ Village ❑ .own of: State Plan ID No.:
landrick, Russell Star Prairie Township
CST BM Elev -:- Insp. BM Elev.: BM Description: Parcel Tax No.:
U (7 (] 0 r o
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic � Be�glhrBlc
7� aZ. Z fop
D i G� s L z Z
Aeratio Bldg. Sewer
Holding S Ht Inlet
TANK SETBACK INFORMATION Ht Outlet '7�
TANK TO P/ L WELL BLDG. Ventto ROAD Dt i nlet
Air Intake
Septic Sl A NA
NA Header/ Man.
_ 7 11 y 3.
Aeration N Dist. Pipe 147L
Holding Bot. System T1 9'
CC S, 7 G L d
PUMP / SIPHON INFORMATION Fir9Q ;WVe r „
anufacturer __. _...._ .� - -.._. Demand
_ oar .Z
Model Numb . GPM
TDH Lift Lrictio System TDH t
oss Forcemain Length Dia. H st. To well
SOIL ABSORPTION SYSTEM
r
BED / EN Width. / Len th No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DI MEN 3 .z Z DIMENSION
SETBACK
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
INFORMATION Type of I A14- 3 A B 2moel um er:
System:
DISTRIBUTION SYSTEM
Header/Manifold t Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length __j Dia. ( Length Z S Dia. N& Spacing A 7 ZS
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched
Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include ode discr ies, per onsp� esent, etc.)
�1 �v�its ��1 Inspection #1: �/ �IGd Inspection #2: I /
Location: , Star Prairie, WI 54026 (SW 1/4 SW 1/4 32 T31N R18W) - -Lot 7
1.) Alt BM Description `= 64v a-c,, �O. s f� S s4._ e �e a& k ,,. 4/% t g S l/
2.) Bldg sewer length= � (L
- amount of cover = 7I
j pj,0,11 / I L I
twR!(�Zt �D r�QleC.�t�xSr f/ow./�
Plan revision required. ❑ Yes No
Use other side for additional information.
SBD -6710 (R.3/97) Da a spector's 5,dnature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
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Safety and Buildings Division
Vi sconsin SANITARY PER T APPLI 201 W. Washington Avenue
,1► r P O Box 7162
Department of Commerce In accord with Comm 83.05, Wis. `� Madison, WI 53707 -7162
• Attach complete plans (to the county copy only) for the system on. aper �Q��� co ,
than 8 1/2 x 11 inches in size. ` &Vie
• _ See reverse side for instructions for completing this a licati rid State anit ry Perm Number
p g pP , tF 3b3
I
Personal information you provide may be used for secondary purposes 't ST GI`40X q9 Ch9q1 vision to previous application
[Privacy Law, s. 15.04 (1) (m)]. NTY State eview Transaction Number
I. APPLICATION INFORMATION - PLEASE PRINT ALL INF
Property Owner Name Pf ` oc
T ,N,R� E( (r)W
Property Owner's Mailing Address Lot Numbe Block Number
City, State Zip Code Phone Number Subdivision Name or CSM Number V.
. TYPE OF BUILDING: (check one) C] State Owned o !t� Vi
Nearest t oad
Public or 2 Family Dwelling - No. of bedrooms ❑ Town OF �.Tm -� r�"-��
111 BUILDIN USE: (If building type is public, check all that apply) Parcel Tax Numbers)
1 ❑ Apartment/ Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Ho 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash
5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify
IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable)
A) �rNew 2 E] Replacement 3, E] Replacement of 4_ E] Reconnection of 5. ❑ Repair of an
%"_'_ System Tank Only System - -------- - Existing System
B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non - Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy
3 ❑ Seepage Pit ` / 4 C] Vault Privy
14 E] System-In-Fill 2 �j (�
VI. ABSORPTION SYSTEM INFORMATION:
1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 15. Perc. Rate 16. System Elev. 1 7. Final Grade
Re uired (sq. ft.) Pro osed (sq. ft.) (Gals/da /sq. ft.) (Min. /inch) / Ele tion
7 Z , / /et . r� Feet
Capacit VII TANK in Ca g Total # of Prefab. Site Fiber- plastic Exper.
INFORMATION New Existing Gallons Tanks Manufacturer's Name Concrete st Con cted Steel glass App.
T anks l Tanks
Septic Tank or Holding Tank ❑ ❑ ❑ ❑ 1 ❑
Lift Pump Tank /Siphon Chamber ❑ ❑ I Cl Cl I ❑ I ❑
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for i s lation of the onsite sewage system shown on the attached plans.
Plumber's Name: (Print) Plumber's 2�.: AS (No t ps) M No : Business Phone Number:
Plumber's Address (Street, 'ty, Sta e ' C d C � f
IX. COUNTY/ DEPARTMENT USE ONLY J
❑ Disapproved Sapitary Permit Fee ll Surcha s eFee) Groundwater ate Issued Issuing Agent Signature (No Stamps)
Approved [:]Owner Given Initial �,i/^ Surcharge Fee)
Adverse DeterminationS� ZD�
X. CONDITION OF APPROV L / REASO .O DISAPPROVAL:
SBD -6398 (R.12/99) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the
Wisconsin Administrative Code will be applicable.
3. All revisions to this permit must be approved by the permit issuing authority.
4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD -6399) to be submitted to the
county prior to installation
5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever
necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of
Wisconsin, Safety and Buildings Division, 608 - 266 -3151.
To be complete and accurate this sanitary permit application must include:
I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the
system is to be installed.
II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling.
III. Building use. If building type is public, check all appropriate boxes that apply.
IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair.
V. Type of system. Check appropriate box depending on system type.
VI. Absorption system information. Provide all information requested for numbers 1 through 7.
VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and
manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and
holding tanks for this system. Check experimental approval only if tanks received experimental product approval from
DILHR.
VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.),
address and phone number. Plumber must sign application form.
IX. County/ Department Use Only.
X. County/ Department Use Only.
Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must
include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic
tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon
tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served;
B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume;
elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section
of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information.
----------------------------------------------------------------------------------------------------
GROUNDWATER SURCHARGE
1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can
effect groundwater.
The monies collected through these surcharges are used for monitoring groundwater contamination investigations
and establishment of standards.
i
I
I
PLOT PLAN
PROJECT Russel Flandrick f/8,W DRESS 1823 Windina Trail Rd. New Richmond Wi 54017
SW 1/4 SW 1/4s 32 /T 31 TOWN Star Prairie COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE 5/2/00 BEDROOM 3
CONVENTIONAL XXX IN -GROUN PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .8 ABSORPTION AREA 572 # of chambers 18
BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100'
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
SYSTEM ELEVATION 93.1/92.1
Property Line M. 160'
Vent
0 '
B -5 » Sidewinder High
30' ,- of Cover Capacity Leaching
T - Vents Chamber with 31.8
30 6' Long 16„
ft ^2 per chamber
J
15% Grade at System Elevation
lope 2 -3' X 56' 3499
B -3 Trenches with 6'
Spacing
30'
15' 20' Pro 3
T Bedroom
B -4 B-1 House
Driveway
•d
F
Wisctjnsin Department of Commerce SOIL AND SITE EVALUATION
Division of Safety and Buildings Page of
Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code
Attach complete site plan on paper not less than S 1/2 x i 1 inches in size. Plan must County /
include, but not limited to: vertical and horizontal reference point (BM), direction and J 7 11 /x
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. #
APPLICANT INFORMATION - Please print all information Reviewed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner Property Location
Gam' Govt. Lot 1 /4�llt /4,S T N,R E (orYV
Property OA&s Mailing Address Lot # Block# Subd. Name or CSM#
r
City St Zip Code RKone Number ❑ City ❑ Village Town Nearest Road
New Construction Use: Residential / Number of bedrooms Addition to existing building J
Replacement ❑ Public or commercial - Describe:
^
r
Code derived daily flow 5 U gpd Recommended design loading rata _,_,2_ gpd /ft ' trench, gpd /ft
Absorption area required / �JT bad, It ! J4trench, ft / 2 Maximum design loading rate - 7 bed, gpd /ft ` trench, gpd /ft
Recommended infiltration surface elevation(s) C��' / 1r- _ __jt (as referred to site plan benchmark)
Additional design /site considerations
Parent material C Flood plain elevation, if applicable D ft
S = Suitable for system Conventional Mound In- Ground Pressure I AT -Grade System in Fill Holding Tank
U = Unsuitable for system S El �S ❑ U � S El �<S El U ❑ S 2 ❑ S B�U
SOIL DESCRIPTION REPORT
Boring Horizon Depth Dominant Color Mottles Structure GPD /ft
g Texture Consistence Boundary Roots
in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
x d
Ground
elev.
�� --eft.
Depth to
limiting
factor
1 Remarks:
Boring #
Ground
elev. B
q ft.
Deptf, to
limiting `
factor y c
y /m in. Remarks:
CST Name (Please Print) Signature lephone No.
Address,'. G Date CST Number
PROPERTY OWNER DESCRIPTION REPORT
of
PARCEL I.D.# Pagdr
Boring # Horizon Depth Dominant Color Mottles Texture Structure 2
in. Munsell Qu. Sz. (' ont. Color Gr. Sz. Sh. Consistence Boundary Roots
/ Bed , Trench
Ground X � /
a
elev. /Gu? r yam• /�
Depth to
limiting
factor
Remarks:
Boring # J
Ground
:.
env
Depth to
limiting
factor
_71 c,
Remarks:
Horizon Depth Dominant Color Mott! )s Structure
in. Munsell Qu. Sz. Co it. Color Texture Consistence Boundary Roots GPD /ft
Boring # Gr. Sz. Sn.
Bed ,Trench
Ground
elev.
Depth to
limiting
factor
Remarks:
orr #
Ground
elev.
ft.
Depth to
limiting
factor
in.
Remarks:
i
SBD -8330 (R. 9/98)
I
Soil Test Plot Plan
Project Name � � � ` Byro ird Jr,
Address
1-712 cem
Lot --- Subdlvlslon -- Date
�1 /4 l4 ST N /R,W Township
I3orin� O Well PL Property 1.,ine County
131 or vRP As ElevatLon 100 ft
/
System Elevation *HRP�
m 30 a
a�
v
Leo
1 ;4
vi ;, f
9; z
Scale 114" = 10 ft. When Dimensions aren't stated �� ;
Wisconsin Department of Commerce
SOIL AND SITE EVALUATION �� � page of
DINIsidn of Safety and Buildings t9 { —
Bureau ofjntegrated Services in accordance with Comm 83.09, Wis. Adm. Code /J
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County
include, but not limited to: vertical and horizontal reference point (BM), direction and j G ✓
rQ /_X
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. #
APPLICANT INFORMATION - Please print all information. Revi wed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). G il—
Property Owner Property Location
G f Govt. Lot 114 0/4,S T N,R f E (or
Property O s Mailin 9 Address Lot # Block# Subd. Name or CSM#
P .�
.� d /,� ,,-, r C • -
City St Zip Code DKone Number ❑ City ❑ Village Town Nearest Road
New Construction Use: Residential / Number of bedrooms Addition to existing building
Replacement ❑ Public or commercial - Describe:
Code derived daily flow ygpd Recommended design loading rate ,2 bed, gpd /ft trench, gpd /11
Absorption area required / _ bed, ft trench, ft 2 �-�--_ Maximum design loading rate - / bed, gpd /ft trench, gpd /ft
Recommended infiltration surface elevation(s) -�� /�^. ft (as referred to site plan benchmark)
Additional design /site considerations -
Parent material �� G �r /�' ecru % Flood plain elevation, if applicable
S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank
U = Unsuitable for system 5dS ❑ U Q`S ❑ U [Z] S ❑ U O� ❑ U ❑ S EQ ❑ S �U
SOIL DESCRIPTION REPORT
Boris # Horizon Depth Dominant Color Mottles Structure GPD /ft
Boring Texture Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
K
Ground
� ev. -- = ,
�ft.
Depth to
limiting 3 ,
factor
J Remarks:
r
Boring #
ON
Ground
elev.
D eptt`to
limiting
factor
j ,�in. Remarks:
CST Name (Please Print) Signature Telephone No.
5�
� � Date CST Number
I
PROPERTY OWNER ' �� �i� � DESCRIPTION REPORT
PARCEL
Page of
LD.# _
Boring # Horizon Depth Dominant Color Mottles
in. Munseli Texture
t,ont. Color exture Structure Consistence Boundary Roots 2
Qu. S Gr. Sz. Sh.
Bed , Trench
Ground
el I le �<
ft Depth to
limiting
factor Z
'7
Remarks:
Boring #
7
Ground .
' �e�vft. _
Depth to
limiting
factor
Remarks:
3 Horizon Depth Dominant Color Mottles
in. Munsell Texture Structure Consistence Boundary Roots GPD /ft
Qu. Sz. Cont. Color Gr. Sz. Boring # D � � Bed i Trench
Ground
elev.�
Depth to
limiting
Pctor
J ? Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
in.
Remarks:
SBD -8330 (R.9/98)
'W4,�onsin 3:epartment of Commerce SOIL AND SITE EVALUATION
Division''' Safety and Buildings Page of
Buree,u of Integrated services in accordance with Comm 83.09, Wis. Ad . Code
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. PI 4r14s 9 County
include, but not limited to: vertical and horizontal reference point (BM), dir
percent slope, scale or dimensions, north arrow, and location an distan ares oad& Parcel, D. #
"20 CMG ' ` LL t t —//
/mo
APPLICANT INFORMATION - Please print all inform „ � •� Reviewed y n Date
Personal information you provide may be used for secondary purposes (Privacy li", s. 15.04 (1)
.t
Property Owner 01 .
�i Prop UN n ,'
,AV l G/1 a�N1bpQ 1J4 �1/4,S T N,R E (or�l
Property OwTieles Mailing Address Lot # Block# Stu . Name o CSM#
City r S Zip Code Kone Number [] City ❑ Village To Nearest Road
r� ` c
New Construction Use: ,Residential / Number of bedrooms Addition to existing building
Replacement ❑ Public or commercial - Describe:
Code derived daily flow 5�gpd z Recommended design loading rate - ,7 bed, gpd /ft I — trench, gpd/ft
Absorption area required bed, ft h � trench, ft2 -� - Maximum design loading rate - 7 bed, gpd /fi — '5 trench, gpd/ft
Recommended infiltration surface elevation(s) , � /i - �0 ft (as referred to site plan benchmark)
Additional design/site considerations / T
Parent material art u Flood plain elevation, if applicable ft
S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank
U = Unsuitable for system s ❑ U J �ys ❑ U �9 S ❑ U 1 aa ❑ U I ❑ S 2 ❑ S B�'U
SOIL DESCRIPTION REPORT
Boring Horizon Depth Dominant Color Mottles Structure GPD/ft
g Texture Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
G _G
Ground
-elev. ;
��ft.
Depth to R 3
limiting 5 1 4 Al
factor
� 5f in.
J` 3 Remarks:
Boring # i
e0z
Ground
elev.
q�ft. 3
�. 51.E
Deptffto
limiting
factor
/ in. Remarks:
CST Nam (Please Print) Signature Telephone No.
Addr / �.�� Date CST Number
fJ ��U � pZ
Xn �/� � OIL DESCRIPTION REPORT
PROPERTY OWNER �� / Page of
PARCEL I.D.#
Boring # Horizon Depth Dominant Color Mottles Structure 2
in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots
Bed ,Trench
Ground
q�ft. ;
Depth to *;t— 9Z ' 1 I
limitin 316
factor
y T Remarks:
Boring # l
-
is ° -sx
Ground
elev.
Depth to
limiting
factor
Remarks:
3, Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda ry Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench
Boring #
Ground
elev.
Depth to
limiting ;
�� factor
in. Remarks:
or 4g #
f :
Ground
elev.
ft.
Depth to
limiting
factor
in. Remarks:
SBD -8330 (R.9/98)
T
Soil Test Plot Plan
Project Name ra4 �� / - �— Byro ird Jr,
Address I- �
Lot Subdivision -- Date
�1 /4 � 1 /4 S T N/R W
Township
Iloring O Well PL' Property Line County
}�
Dm or vRP Assume Elevat on 100 ft; j?--e/
System Elevation ' �
y HRP
S
10 o
I
�fl �
4
VI
I
c
Scale 1/4" = 101~t, When Dimensions uen't stated
I
Soil Test Plot Plan
Proiecl Name �`f / Byro ird Jr, `
Address
�l - 1�� U s C M C ZZ 2 0
Lot Subdivision — Date
1 /4` 1 /4 S�T N /RW -,- Township
Boring O Well PL' Property Line County
I3m or VRP Assume ElevatJon 100 ,ft -, y e-`� 2
System Elevation *HRP� Gd�-n Cr oJ:
3
�U
� I
VI
�/ Scale 1/4" = 10 Ft. 1Vlien Dimensions aren't stated
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer
Mailing Addresv z
Property Address
(Verification required from Planning Department for new construction)
City /State Parcel Identification Number, l ¢
I
LEGAL DESCRIPTION
1 c� l
Property Location Sea�S , TZI N -R L.0 W, Town of
Subdivision C-'-6w , Lot #.
Certified Survey Map # e45 Volume P/ , Page # 7
Warranty Deed Volume _ Page #
Spec house ❑ y
aa Lot lines identifiabl 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, of the three year expiration date.
GNATURE 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 pWrty described above, by virtue of a warranty deed recorded in Register of Deeds Office.
SO NATURE OF XPPLICANT DATE
* * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.*
** Include with 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
w
` DOCUMENT N o. WARRANTY DEED Tk.s SPACE ftES9"V90 raft "ECORDINO OAT.
STATE BAR OF WISCONSIN FORM 2— N":1 I�
4 82544 v1' !417PA 3
� i3
REGISTER'S OFFICE j
Sr
Lullabell Flandrick, an anremarried�
widow ( t Reed for Record I
APR 281992
i
ronvvr :, mi-I warrants to Russell L Flandrick a d 8:30 A. M ;
Georgene M. Flandrick, husband and .wife.
$ 119612 of Deeds
RETUIIN TO
the r4mo ;ln.- described real estate in .... St.. Croix ..........County,
State-of Wi;con,in:
Tax Parcel No: ... ............•.... ........ �
Northwest Quarter of Northwest Quarter, South Half of Northwest
Quarter, Northwest Quarter of Southwest Quarter, West Half of Northeast
Quarter of Southwest Quarter, Southeast Quarter of Southwest Quarter
and all land lying Northeasterly of old Highway 64 in the Southwest
Quarter of Southwest Quarter; Northwest Quarter of Southeast Quarter and
West Half of Northeast Quarter, also a strip of land 100 feet wide
lying Westerly in the Southwest Quarter of Southwest Quarter all in
Section 32, Township 31 North, Range 18 West, St. Croix County,
Wisconsin except parcels heretofore deeded.
This deed is given in full satisfaction of that certain land contract
dated November 19, 1969 between the parties hereto recorded in Volume
457 at page 192 as Document No. 298749, as amended by agreement
dated May 21, 1975 and recorded in Volume 523 at page 595 as Document
No. 327201.
r
1�
q Prior tg 121
;';.. is not EXFI
i (, n•',
E t „ municipal and zoning ordinances, easements,
restrictions of record and any lien created by act or omission
of Grantee.
April ; 92
C
l
c
r"
Lullabell Flandrick
AUTHENTICATION ACKNOWLEDGMENT
Si_rnature;s) _
STATE OF WISCONSIN
ST. CROIX ?
i... .::; iU ti•,15 .:a - ,�.' . ;,, ;,.... _ ...i 24th •Lip I'
April 92
Lullabell Flandrick, an
• unremarried woman
ti,E: :.XV,!' �T \TE:
,,, I a . r . c,l 1 .. t\' �tsc ., n [ , .ti t ., c r r �
r i^b••
Judith A. Remington
REMINGTON L_ W OFFICgS Judith A. Remingtbrti cA�.A
New Richmond, WI 54017 . St. Croix
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Wisconsin Department of Commerce County:
PRIVATE SEWAGE SYSTEM
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)]. 363866
Permit Holder's Name: ❑ City ❑ Village ❑xTown of: State Plan ID No.:
Star Prairie Township
CST BM EIO Insp. BM Elev.: BM Description: Parcel Tax No.:
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
TANK TO P/ L WELL BLDG. Ventto Ai Intake ROAD Dt Inlet
Septic NA Dt Bottom
Dosing NA Header /Man.
Aeration NA Dist. Pipe
Holding Bot. System
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand St cover
i
Model Number GPM
TDH Lift Friction System TDH Ft
Forcemain Length Dia. HH Dist. To well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSION DIMENSI N
SETBACK
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type of CHAMBER Model Number:
System: OR UNIT
DISTRIBUTION SYSTEM
Header /Manifold Distribution 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
Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched
Bed /Trench Center Bed / Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: / / Inspection #2:
Location: , Star Prairie, WI 54026 (SW 1/4 SW 1/4 32 T3 IN R18W) - -Lot 7
1.) Alt BM Description=
i 2.) Bldg sewer length=
- amount of cover = .
Plan revision required? ❑ Yes ❑ No
Use other side for additional information. 1 1
SBO -6710 (R.3/97) Date Inspector's Signature Cert No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
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