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HomeMy WebLinkAbout040-1007-60-275 § j ( � » \ % 2 . / \ ; ƒ c § 0 ƒ 0 2 / L 2 7 u "0 \ 3 \ § J£ ± z j \ z ^ . § ' p z < § k IL m 0 2 0 § k , � k 7 k \ \ . \ / [ � 8 e . 7 § I & @ -� % § _r_ G 0 .0 k \ \ � ^ I ts f ■ k E £� CL � a • a e a 9 % , < >. ■■ _z \ Z » > '\ § § § F k -Wob % a a a IL . . } 2 § ƒ � = d_ G £ 2 0 d = / E @ 2 \ 5 < 2 2 o t _ §R U Ew to � k \�(./ \ � \k� 2 /f� ;ate {6 § - \. - ` ` ` . \ 7 / } \ 0 2 / } 2 \ � � / 4 M { a , _ _ " I » \ E $ j k a § Q J a 2 �0 2 0 / ¥ 2 § , \ ¥ @ ' 2 � � > E � § & L 2 0 $ } \ LL. �_ — 0 . � n / \ § k z 2 ca . . - \ J % c } ( ® § c g c 0 3 \ Q ke) , } co i " ± ) � \ B o a k / \ m § 5 \ 00 \ ) - $ a a m m IL / \ §f / ƒ a '= 2 3 e 2 0 { ] _ \ E 0 . m D \ k ƒ \ �) ■a ° � _ -- 2 / § '2 2 3 & = E /� / \/ B o o . % a 3 ® / \ f 2 $$ 0 2 f k) A f $ « \ ( C � A %i (0 1 / J 00'0 00'0 00'0 lelol sa6Je40;uenbu!laa sa6ae43 leloadg s;uawssassV leloadg ;unowV tio6a;e3 apo3 leloadg jasn :sleloadS 4 40188 :a ;ea uol ;eollupeo 0 :;unoa wIBID q pwo /jal;o 0 0 000'0 PUeIPooM 005`09 0 009`09 09517 A:pedoJd leJauaE) :900Z AN sle;ol ON 005`09 0 005'09 095'7 60 IVI1N301S3b uoseau a ;e ;g le;ol anoidwl puel saaoV ssela uol;dljosea 90OZ /90/60 :pa6ue43 4se-1 :suoijunlBA 006'Z9 79020 6 :411nn passassV :enleA;a)lJeW sled :# II!8 Abdwwns 5002 VVSO 7957 /L6 L986ZL £OOZ /66/LO n - Z3 £Z9/ 689Z 076LLL 7002 /SZ /0 6 WSO 8L8716 6 6996LL 7002/ 6 6/ 6 6 adAl abed /1 # ooa a ;ea :tio;s!H laoJed :sa;oN MN MN M66 MN 3N M66 - £0 (t 09 6 7/ 6 O7 bu� umi -oaS) :(s) peal (OV 95'7) (:: S]1018L87 -66 WSO 0NI38 ( 09L'O6) 6 101 50101 : opuoaplool8 7957 O 667 N8Zl £ 03S 70 8L87 - 66 WS0 :3e1d 09517 :saaoV :uol ;dlaosea Owl OilM OOL 6 dS N0sanH d0 0 HOS 6 69Z OS Ml - W38110 885. uopol-josaa #;sla edAl f,ew!Jd = * :(se)ssaappV A:pedad le!oadS = dS I = 08 :s;o!a ;sla 96075 IM N0sanH Ml 12138110 765 "aNVS V W A. JH dl '0NVA3A - O ONVA3A V2lGNVS 1 9 W Ik8bV1 jaumo oo;uenno _ o 'jaumo juaiino = 0 :(s).iaumo :ssajppv xel 0 00 700Z/ 6 V 6 6 edAl ;lwaad #;lw- # uol;eollddV eaiV sales # deW a ;ea leolao;slH a ;ea uol;eaja NISNOOSIM `.l1Nnoo XIO2i0 '1S j X I wenna AObl -AO NMOl - 070 09 0L£'66'8Z'£0 :# laoJed I IV 6 d0 L 3JVd Nd £5.£0 90OZ /£Z /ZO 51Z V0V0 :# I a0ae d Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: 5t. Croix Safety and Buildaig Division s INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 463202 0 GENERAL INFORMATION 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: Vevan , Larry Troy Townshi CST BM Elev: f Insp. BM Elev: BM Description: Section ( rown /Range /Map No: bb • C) 6p • O 3 i�f PV = CS INS 28.19. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark { Dosing - -_� Alt. BM Aeration Bldg. Sewer n\ �- J Holding l St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL qBLDG Ve nt to Air Intake ROAD Dt Inlet Septic ( Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bct. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand S Cover A) 3�- rC� 13� GPM o r Model Number ICY 5 Io l gb f TDH Lift fiction Loss System Head T Ft 1 n, Forcemain Length Dist. to ells J , Z SOIL ABSORPTION SYSTEM 3 BED /TRENCH Width � Length I No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 �s eA.. 3) SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEACHING Manufac rer. INFORMATION CHAMBER OR p �LLS Type Of System: /I N/ 3 � /� UNIT Model Number. DISTRIBUTIO S vvD�l�.ua� Header /Manifo� It Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) (0 / Length ' Dia 1 1-en 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 E Yes [] No El Yes Ff I, No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 71 rt #2 Location: 588 Gilbert Road Hudson WI 54016 1/ NE 4 N W 1/ T L of rc s ( 4 5 28N R19W N I � 1.) Alt BM Description = 5 v I • c /4 • /LI t 2.) Bldg sewer length =() ~+ q�1 amount of cover = > ZV u5 &`$ f T I So 1 4 r✓) .: �g' t o Plan revision Required? Yes No I Use other side for additional information. SBD -671 (R.3197) Date In tor's Signature Cart. No. Y) C- ��� Buildin Division Safety and County gs C" ( k 201 W. Washington Ave.. P Box 7162 viamonsin Madison. WI 53707 — 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 266 G1( 3 Z 02 State Plan I.D. Number Sanitary Permit Appli in accord with Comm 8321, Wis. Adm. Code. pexsona provide may be used for secondary proposes Fri la 1, n > 1 Q Prof Address (if different than mailing address) 1. Application Information — Please Print All I o St CRO uo Lo Parcel 0 tt Block ! Property Owner's Name LCI e u a a d O -� Property owner's Mailing Address - Property Location ,A "" y,, 4 _ _%, Section ` City, State Zip Code Phone Number ire e EO t ) T �D TN: REo V IL II. Ty r of 2 Building (check all that apply) o Family Dwel ling — Number of Bedrooms ❑ Publier-otntttercial — Describe Use ❑Chy ❑-Village ownship of ❑ State Owned — Describe Use III. Type of Pe It: (Check only one box on line A. Cotaplete line B If applicable) A ' System ❑ Replacement System ❑ Treatmertt/Holding Tank Replacement Only ❑ other Modification to Existing System Permit Transfer to N List Previous B. ❑ Permit Renewal C3 Permit Revision 13 Change of ❑ ew Permit Number and Date issued Before Expiration Plumber Owner N. T of POWTS S em: Check all that a Non — Pressurized In -Ground ❑ Mound >_ 24 in. of suitable soil ❑ Mound <24 in. of suitable soil ❑ Un Grade ❑Single Pass Sand ❑ Constructed Wettand 13 Pressurized In- Ground ❑ Holding Tank ❑ Peat Fitter ❑ Aerobic Treatrnmt Unit ❑ Recirculating Sand Filter ❑ Recir %itating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑Gravel tpe ❑ Other ( lain) 1 V. Dispersal/Treatment Area Information: s exn Elevation Design Flow (gpd) Design Soil Applicatio f) Dispersal � sal A9 fired (sf) Dispersal Area ropos tQa VI. Tank Info Capacity in Number M ufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units ' C Concrete Constructed Glass Existing t* ) Tanks Tanks _ Septic cc Holding. Tank s / 426 ` ZG d a cow, - Aaabk Treatment Unit /� Dwing Chamber VII. Responsibility Statement- t, the andersigned, assume rexponsibillty for installation of the POWTS shown all the at Business ismess plans Plumber's Name (Print) Plumber's Signature: M P umber Phone Number A Plumber's Address (Street, City, State, Zip e VrjI. Count y /De artment Use Oal Approved oved Sanitary Permit Fee (includes Groundwater Date Issued I suin Age;t Signet to o Stamps Surcharge Fee) Z � fl en or Denial _ IX. Conditions Approv SYSTEM OWNER: t9•r 33� �)q�x dal 1 Septic tank, effluent filter and , dispersal cell must all be serviced / maintained as per management plan provided by plumber. / 2. All setback requirements must be maintained as per applicable code /ordinances. Attach comptete plans (to the a aunty aaDy) for the systm► es► paper not less than aln :1 Dacha is size 1kk L-V ` \ 398 R. 01/03 � � dv 9 19 46r-3 ($,75' tiae�. �- 7,. /Yl ZA L C op Is, 3 r-- f,1 fri _ r � t � • - 19/� B�rcA /yt a� X99, ro I W7 Tod i� �Pkc ya c ,�-yoz3 0 7 1 9 V too 90 ' W9' 3 7 1 4 / m ZA L e�e�' ' 11Y� 3L vM II ' f � Ae. 9 1 i ndul .MOO 01 p.Tenn.TOJ 31001 am •uoilu.zapisuoo pue MQTADJ .MOX .TOJ nOX xuetH, . •luouz:� BuiuoZ aql louluoo aseald `saoueuTpzo pasodo.Td jo saTdoo alaldwoo axt Inom io suoTlson Xum ant,q noXjI - am suTuoZ all of s uego kmivaw3ldwoo pu `suoiswpgns Tz�TSa uoTleAJasuoo .TOE apiAwd pue smilod alupdn of auumpio uoTSTATQ pue? 01 suotstAW zofu `sapoD 2uigwnld alelS agi glrnn XlduTOa of aatTelT Tp Xnllut,S pasiAw Xlalal Euoo u apnlaui slua pu uoum pasodo.Td aqZ •saoueulp.Tp as fl puu-I XjunoD posodozd aql o goea loj X.TuTuums a put oTlou 2uixeal aTlgn aql axe pagoelld •aoueu!p.Tp 2 OZ alp of sa2uego Ascluo Iduioo pue `uoisTAT eZ `f reliuuS :saoueujpiO f4uno3 xioiD •lS 2u. ollo3 ail of sluauTpuau e s osip of `puouzgotg ;)N `0231100 leolugoaZ peaquutpul uisuoosTAk le aluaO aouQJ;DJuoa ut,uTgs agl to uT d L le OOZ `1�Z o f `Xupsmgl uo 2uureaq oilgnd a pIoq II, aalitu moo 2uiuoZ p uTuuuld 4unoD o D 'IS aq.L s ua ua a u as uu uo 2u a o n : aaf n l �P � T .PLO Il P 'I . H T .Iq d ; .a S aal}TMMOD SumOz p uumuld ;` :uuo.l3 sO!Uud paIsazalul :OJL ti00Z 1 0I aun f :ale( Lvna�or��rnl 989ti-99£ (91L) X8- • 089V-98£ (9 LL) OLLL IM `uospnH - pe% Ieeyoiwieo LOLL --- H31N301N3WNH3AOJ AiNnoo XIOHo ■..0 rrrrrnrr NISNOOSIM A1Nno3 XIOa3 '1S 1480 Wisconsin Department of Commerce SOIL EVALUATION REPORT p age 1 of 3 Division of Safety nd Buildi is. Adm. Code Steel's Soil Service, Inc. Y 9 in accordance with Comm 85, W ' Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Pending Please print all information, viewed Date q Personal information you provid m� be �± : ij4w s (Pdv4 Law, s. 15.04 (1) (m)). Property Owner ` Property Location Vevang, Larry # Govt. Lot na NE 1!4 NW 111 S 3 T 28 N R 19 W Property Owner's Mailing Addrels I ` ''' `! Lot # Block # S bd. Name or CSM# 594 Gilbert Rd j na Z City Plate 'zip Cade Phone, Number rty I Village 01 Town Nearest Road Hudson ' "� Tf'S= 386 - To235 Troy Gilbert Rd New Construction Use: 01 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD I Replacement J Public or commercial - Describe: Parent material outwash plains, stream terraces and areas of pitted Flood plain elevation, if applicable na General comments and recommendations: Conventional System, system eleyAi 00. 5ft. renches spaced and depth to code 3.75ft below grade. � R - 7.)S'aA - �► Boring # I Boring 16 Pit Ground Surface elev. 100.90 ft. Depth to limiting factor 115 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fta in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 - 10yr3/1 none I 2msbk dfr cs 1f .6 .8 2 7 -24 10yr416 none sicl 2msbk dfr gw na .4 .6 3 24-35 10yr4/4 none sicl 2msbk mfr gw na .4 .6 4 35 -115 7.5yr4/4 none Is osg ml na na .7 1.6 Boring # I Boring Vol Pit Ground Surface elev. 100.90 ft. Depth to limiting factor 115 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -2 10 Y r3/2 none sl 2msbk dfr cs 1 c .6 1.0 2 2 -115 7.5yr4/6 none sl s 2msbk mfr na na .6 1.0 * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L Effluent #2 = BOD <30 mg /L and TSS < 30 mg /L 5 CST Name (Please Print) Si nature: CST Number David J. Steel 248956 Address Steel's Soil Service, Inc. V Date Evaluation Conducted Telephone Number 994 200th St., Baldwin, WI 54002 8/18/2004 715 -684 -5680 Property Owner Vevang, Larry Parcel ID # Pending Page 2 of 3 a Boring # I Boring IM Pit Ground Surface elev. 104.70 ft. Depth to limiting factor 115 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-7 10yr3/1 none sil 2msbk mfr cs 1f .6 .8 2 7 -18 10yr4/4 none sicl 2msbk mfr gw na .4 .6 3 18 -115 7.5yr4/6 none Is osg ml na na .7 1.6 a ° 1 `F q ❑ Boring # J Boring _J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh, i'Eff#1 *Eff#2 Boring # J Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Sat Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Rood P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD 5> 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. • Page 3 of 3 STEEL'S SOIL SERVICE INC. David J. Steel 994 200 th St CST -POWTS Larry Vevang Baldwin, WI 54002 Lic. #248956 NEl /4,NW1 /4,S3,T28N,R19W Bus .(715) 684- 5680 Town of Troy St Croix Co. Fax (715) 684 -3449 CSM Lot, 4 Legend 1 " =40' ♦ =Benchmark Etc. 100.00ft Top of 3/4" PVC Pipe • = Alt Benchmark Ele. 99.60ft Top of 3/4" PVCPipe �^ ❑ = Borings �lr Boring Elevations BI = 100.90ft B2 = 100.90ft B3 = 104.70ft B4 = 00.00ft y � 3' 7 � G 6 2,76` mmm0pyc`nm (V - _ m cA r 77 O x z =G 0 Q z j N3 _ D M O o'= 0C m O < b C2 �- x Z /� .+v u�i c v t iv j D Z Z Oc O O �aD mC YI Ovz0m0 Cccno� O i A �o � a) rn W In � r O O ° v� �� tit MW_9 C c on C D .c, o 0) a o o co r O m m < Z yo tO 00 'Z �OiZ Or < !" G M m m m – m l w m v O Oz rZ CG �x� n C Zm� Z C3 0 m Z v z m m z S `LMD m –{ m .a 0 b m �J> �� tnZ MG) S Q ° z a Z m Tt „cco Tim A xK Q °o G Z w W cn cn N cn M 0 � {{ m 0 0 0 O C O on t _+ w m cn cn M� w w 0 w N 0 c z 9 1oa Nro D �o Z 8 pt C9 Q cn C D o ° m D Z � � m 4C3 CT, c)`O Q s z Oy m m z c� nm Q I� m A - w mC =� a of o re &Z, 70 m / BEARINGS ARE REFERENCED TO THE (f) M m cn / NORTH -SOUTH 1/4 LINE OF SECTION 3. �"I m n a / ASSUMED TO BEAR S00°0236"W. z Q 2 .i c; cn cjnrw �OZ�� Osh A M m 171 r r ' r�Q� n IV On w � l c xx m to co O VI % /1 o r� O m �� . vU �st'� m D cn Z M 10 r � W `'3 2 w W `, l OP . -, 0 > l , C I I° M Fs 3, I 1q I ssv,`�SF oT ate` co, ! a, "(9 VI d cNn ut / ulJ Qj c SvS / iTi M y�' •�i Iit`I// � °�i,V(J A� .p •VVVJJ /� i rn cn C7 C�1J ; ° cb o m M o ' %� �zcn D c 1 o -- _ � D 0 D c v 1 I 1 L 7 =7 / D V 0 N I 1 1 ' 0� CD Z — S00 °02'36W 1045,45' A i � �-- � `lo I Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component p Y p p 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 plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number 02 Number of Bedrooms Design Flow - Peak (gpd) 'qV Estimated Flow - Average (gpd) 600 Septic Tank Capacity (gal) -p Soil Absorption Component Size (W), Type of Wastewater Domestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) 7 wu Maximum Influent Particle Size (in) 1/8 Maximum BOD (m /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 maintained 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 an "bec s hall be assessed at lea st o nce eVPy insaecti The outlet filter sed 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 Management Plan for a Septic Tank and Soil Absorption Component ' filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 l Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep- rooted trees and shrubs directly over or within ten feet of the component should b voided since root intrusio to the comp ent may obstruct tewate flow. U P c o _ e � � - _ 0 ©�s~ 3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM �'uyer a H'�' y Let' Mailing Address 4�5 i / 41012 ' Property Address (Verification required from Planning Department for new constriction) City/State �LcA Parcel Identification Number 4 7 ^!d 0 LEGAL DESCRIPTION f- Property Location � Y., N V1 Sec. , T__N- R4..4� Town of OF Subdivision . Lot # Certified Survey Map # 7 2 22 9 7 . Volume _. — , _ Page # Warmitty Deed # S 4 5 5 - . Volume Page # 13 Spec house ❑ yes l!1 no Lot lines identifiable 0 yes ❑ no SISTEM 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 masWplumber, journeyman plumber, restrictedplumber 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 o the three year exp tion date. lD� / SIGNA OF UCANT 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 property described above by virtue of a warranty deed recorded in Register of Deeds Office. SIGNAT OF AP ICA'NNTT� DATE « « « « «« A 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 r - - -- - 36' -0"" — 14' -0 " - 1X-7 6' -0" x 6'-8" 2' -0" x 3' -0" x 3" 3'-0" x 5' ry n v w C',n v cV 04 02 C 5'-4 4 -2" 0 2 -8" x 5' o M i 4 k i) o co rn o, 0 0 ' 8 -0 "x 5" 4' -0 "x 3 -0" =moil \ I ��� 18' -0" 18' -0" 505967 'VOL MNPAP -34 SHERIFF'S C. RE: CITY COUNTY FEDERAL ;t jc'a for Report3 VS. EDWARD E. JOHNSON, et al S EP 2 2 1993 Case No. 92 -CV -518 at 3:00 - P,�,,� s � , RMS,ar of Ofteft Pursuant to a judgment of foreclosure entered in this matter, the subject premises was sold at auction to the highest and best bidder, Larry M. Vevang. Therefore, the sheriff does hereby grant and convey unto said successful bidder, all of the following d escribed lan located in the County of St. Croix, h. $ i�t�.... o�t.r .. _. Seatlof 7 Terw.ahlp W Nor % Some 19 Mrat. Tarty of Tray dowribod an followar Cannavino at the North aeorrter comer of said Soctlaf 31 then} South a:7 degrees IS. elrwtoa Waft atrrr boarintl SM }sett thence South I dagr" 79 ;matte /eat 376.79 foe* th # enao North 76 dpes rs a:3 rinutoo Y.as 77.35 fee* to tow polif OF 80010 11N61 thence " ft Tat doge"} 25 rifstee Nfat 49%SS fsstt thwraf NortA .71 F y. Z dagrres 13 rinutes Vast 4MIS fast# thsnos Sssth SS ds-1 N < - "� :. rirwtea Vast So-" foot aloft the Soutlsawkwly liver eF.e ter". Cod # Ww"" Seuthfaaterly &lent a "&Go foot radios eww ranoeri - :..;.: Sorthumaterly. cord ban int Sonde Mr ~6e0 77 rriecatw Salt "7.87 LL ` •••w fast aloof sold Seuttsrstarly line of a torn evadf thffoa Sam" i }a door" 79 minutes West 16S.09 fast slay the easterly Iind N'a'tarfr- red to the POINT OF SOSINaiNS, according to the U.S. 77 / Survey thoreef ft. Croix County, Nlsconsif. SHE AYSHERIFF (Strike the inappropriate title) STATE OF WISCONSIN ) )ss COUNTY OF ST. CROIX ) Personally came before me this 7 7e day of M , 1993, the above -named , pers nally known to me as the officer described above, and who executed this document as-the sheriff or on behalf of the sheriff of thf# county. L • i� , Notary A,?4bl4d Drafted by Terry Gray ST 4 wory County, wisco� Yn 600 North Broadway '» Milwaukee, WI 53202 My commission: fi ` 1� 7 2 9 6 6 7 VOL 17 PAGE 4564 KATRGEEA N. ALSK REGISTER OF DEEDS ST. CROIX CO. MI RECEIVED FOR RECORD • O o m 07/11/2003 10:25AM m CERTIFIED SURVEY MAP 8 REC FEE: 13.00 co C: X s m (,� 2 COPY FEE: 3.00 °Z o " °D m Q / !�v �n �� PAGES: 2 M z O ' BEARINGS ARE REFERENCED TO THE D z m ' " �ri \ .: ' �' NORTH -SOUTH 114 LINE OF SECTION 3 M g _ ASSUMED TO BW S00°0738'W. O v v 2 0 Z 8 co 0 -n 111 `► � \ � � '� r '^ O�s7 / �'�,/ z go 0 MCI �' r rSF \tiF i ° v 0 A II moo/ 17 � ® rAL �� •.� \ \ \ � / / �:/v `\ \ ` C11 ^ Q In 0 if Z N P QI'a > O M � Z z I °39'6 r — $ I — 1 ��. �t A NORTH O 1/4 LINE S00 1045. R °02'3 .18' — -� NOTE: � a THE PURPOSE OF THIS CERTIFIED EY MAP OCATE THE lOT LINES BETWEEN PARCELS OW DED IN VOLUME g 474, PAGE 390 AND PA O CE #7 RECORDED IN BOOK 509, PAGE 254 AND VO GE p N o PARCEL CORD 47 E 390 AND PARCEL #7 RECORDE OOK 509 D OL 036. PAGE 134 ARE r S[ OWNED BY T E IN S g CURV D BLE NUMBER C2 C3 C4 z RADIUS 11 60 603.62' 603.6 g C CENTRAL ANGLE 12'36 24'0 53'27' 0 6'01' a T CHORD BEARING 552'26'0 E '32'06'E S 00'06.5'E 01 OT CHORD LENGTH 258.74' 607.27' 543.06' 73.00' Z N Nil = ARC LENGTH 259.26' 636.32' 563.28' 73.05' t6 M TANGENT IN % L58-44-06-E I S58 S 4'06'E S05'16'07'E y TANGENT OUT S4 S05'16'07'E SO1 VOL. 17 PAGE 4564 �` . +1� s s �. Y ! `.yy ! � T �w :ii „!'�'fl � � �� .�,. ,�S�r.. ,) A. �' y • �1 �r�� .'r � ". �. �'"' . 796E_s 1 V L 19 PAGE 4878 K TRLEEA H. ALSH R ISTER OF DEEDS >n= n CROIX CO.. 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