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HomeMy WebLinkAbout040-1190-40-000 ! . 0 c 7 Ln g K ( a ) & T . 2 _ \ s o � $ E / £ & E / 2 k j Z E + e k B\ g ' [ E 10' q@ @ f % �\gg q Edo /t Q 0 E E B o z E ; CD / § ± ¢ \ _ _ _ - § � k -4 � CD � s o o § E ca 2 E E . 7 o o o § " < 0 ƒ ■ U) a) -: E k / J E V \ < CD m » % CD £ ■ k CD I cc � lo t \ o }� \ / 0 �- i � I o k c § ; f CL & a / _ / \ a k k � _ § § + ) / w T / # # 0 § k \ § CA) . M \ � ok ) 0 E � a Ak`oi S § /§/ ( CL -n k\k\ / {[ /A $ =k)0) $ [ //% ; :E w a ■ ©)tee t CD S2- - -__ . #/0 k 0 \ . | � CD CL ` , y / 12/14/20 Parcel #: 040- 1190 -40 -000 05 04:57 PM PAGE 1 OF 1 Alt. Parcel #: 4.28.19.842 040 - TOWN OF TROY Current _X! ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co - Owner WILLIAM D &LAURA USIAK DEWITT O - DEWITT, WILLIAM D & LAURA USIAK 537 MARSON DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description ` 537 MARSON DR SC 2611 SCH D OF HUDSON SP 1700 WITC )/jij Legal Description: Acres: 0.500 Plat: 2569- VALLEY VIEW HEIGHTS SEC 4 T28N R19W P NE SE LOT 3 VALLEY Block/Condo Bldg: LOT 03 VIES r Tract(s): (Sec- Twn -Rng 401/4 1601!4) 04- 28N -19W Notes: Parcel History: Date Doc # § fr � Type 07/23/1997 WD 07/23/1997 c� 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 103530 233,500 Valuations Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.500 53,200 171,500 224,700 NO Totals for 2005: General Property 0.500 53,200 171,500 224,700 Woodland 0.000 0 0 Totals for 2004: General Property 0.500 53,200 171,500 224,700 Woodland 0.000 0 0 Lottery Credit Claim Count: 1 Certification Date: Batch #: 137 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 r Wisconsin Department of Ccmmerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division - , INSPECTION REPORT Sanitary Permit No: 463132 0 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: DeWitt, William D. Troy Township 040 - 1190 -40 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 1 0 , C' C` C s T '3' -"- Z 04.28.19.842 TANK INFORMATION ELEVATION DATA 3y is TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark c% v 93 BC) 3. Dosing Alt. BM Aeration Bldg. Sewer Holding (2 P St/Ht Inlet _ TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet \ Septic � � � � °�� � Dt Bottom r Dosing _ Header4Man.n 5 r Aeration c`f_ �' g -- c he t.n Aye S S5 8 - 7 ,3 Holding - - - - - -- Bot. System �- s . 2 . Final Grade PUMP /SIPHON INFORMATION Manufa rer Demand St Cover �3 J7 / GPM I' &t Y`,,� S Model Number Q 5: TDH Lift Frictio s System Head T DH t Forcemain Length Dia. Well SOIL A ORPTION SYSTEM 1 `3, v'E� - 7. BEDITRENCH Width 3 Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid D epth DIMENSIONS 1 6& - ( SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturey , • 1 INFORMATION CHAMBER OR 1 T Type Of System: /) = / /� v UNIT Model Number: �vnt}zr+�1c>.�c`�� C� 7U /c +fa / .�:r�`_ 'I DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing TVenl to A ir Intake F, Plpe(s) t*o Length Dia_ Length Dia Spacing SOIL COVE C---V 4L° G z Pyres a ms 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 r Yes [] No 6i C. t (G COMMENTS: (Include code discrepenci4s, persons present, etc.) Inspection #1: r' / 7 / v Inspection #2: /"tw Location: 537 Marson Drive Hudson, WI 54016 (NE 1/4 SE 1/4 4 T28N R1 9W) Valley View Heights Lot 3 Parcel No: 04.28.19.842 1.) Alt BM Description = �'7 -t 2.) Bldg sewer length - amount of cover Plan revision Required? Yes Ik " 7 T J Use other side for additional informatiok L_____ __ Date I sepctor's Signature Cert. No. SBD -6710 (R.3/97) Safety and Buildings Division County 201 Washington Ave., P.O. Box 7162 ST. CROIX COn . S,n O dison, WI 53707 - 7162 Sanitary Permi umber (to be filled In by Co.) Department of Commerc n ( 6 08 -3151 3 '� SanitaryTe it Appliea on ((�� State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal infor lion you provll7�r�j�. / A' may be used for secondary purposes Privacy Law, s .04(11(tzt)._ cC� ject Address (if different than mailing address) I. Application Information - Please Print All Information ST 20 4 a Property Owner's Na me AtG OF ()U/V y Parcel Y Lot I B lock DAN I)IJWITT V / u -- -- / Property Owner's M ailing Address Property Location ' / 537 NARSON DR NE - , SE io 4 y 7Z ` k k,Secuon City, State Zip Code Phone Number HUDSON WI 54016 715/3131 -1765 f 28 N: It 19 ( cir cl e r WQ II. Type of Building (check all that apply) t Subdivision Name CSM Number or 2 Family Dwelling - Number of Bedrooms _ 9 ❑ Public/Commercial - Describe Use VALLEY VIEW HEIGHTS i ❑ State Owned - Describe Use 3 5 I e 4 S_4946 OCity_❑Village MTownship of TROY III. Type of Permit: (Ch n line A. Complete line B if applicable) A ' ❑ New System ® Replacement System ) ❑ Treatment/Holding Tawk Replacement Only ❑Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number cud Date Issued Before Expiration Plumber Owner I IV. Type of POWTS System: (Check all that apply) N on - Pre surized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Piss Sand Filter Constructed Wedand Pressurized In- Ground ❑ Holding Tank 0 Peat Filter ❑ Aerobic Treatment Unit O Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter YLeaching Chamber ❑ Drip Line ❑ Gravel-less O Other (cx lain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rwe(gpds4 Dispersal Area Required (sl) Dis •rs. ca Prupu co (s1) S st tit I at — 87 2 J 450 .5 900 90 (o = 8 � 3 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber P Gallons Gallons of Units CUnCfCIC Constructed Glass New Existing Tanks Taus se ptic or Holding Tank 1000 11000 1 WIESER COi'VCRETE X Acrobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the widersigned, assume responsibility for Gutallation of the POW'fS shown on the attached long. Plumber's Na me (Print) Plumber's Si gnature MP /MPRS Number Business Phone Number I BENNIE hELGESON - 210292 715/772 -3278 Plumber's Addre ss (Street, City, State, Zip Code) W1229 770Th AVENUE, SPRING VALLEY, WI 54767 VIII. uric /De artment Use Onl 1 Approved ❑Disapproved Salutary Permit F e (includes Groundwater D Issued I Wu' A i e ) Surcharge Fee) 6f71 1 p O Owner Given Reason for Denial ov6 an Reaso is for Disapproval eptic tank, a uent T iter c� dispersal cell must all be serviced maintained C %�L� as per management plan provided by plumber. ,S 2. All se ac requireme �- j as per applicable code /ordinances. i Attach complete plans (to the County only) for the system ou paper not less than 8112 x 11 inches In size �D11 iG404 /D nT /n�� j l (,�.2n �e � �a� 1✓e Ali c� ��'Ic�w, �tr; �ev� v� ►� e ��PsoK. ��a r �h � \ac � � r 0 a� L re - rpp n 4 - P`P PrCY)CIS -ck I WO w/ a�e1 X4-160 �,` �S ��► 1,4,E ALL 3 3e�4 Homes f IV 1 S C , i 1�IQ�C � �Q�� �✓e LU�� r o� l�7a \ 5ibp.Q 5 1 ► I� f �L 7o 6P IZ �.M- 4o ro Nit ►-��.- �K-P 7"©p o.F a" P rcfos--� WO a�ef 4 -/6G WELL �onne.. �. f IV i 1 A et-, � roSS S�cj"��h a� 3' y Ds wk er 4 b"-s S t , Wisconsin Department of Commerce R UATION REPORT Pagetof Division of Safety and Buildings in a rdanc with C 85, Wis. Acorn. Code County Attach complete site plan on paper not less th n 8 1/91R inches iR 9U4. Plan t 5 7— C X0 W include, but not limited to: vertical and horizon t ifol;, ' reference point (BM), directio and Parcel I.D. percent slope, scale or dimensions, north arro ancggc�fj@p t4p4n ce ton arest road. Q Q —000 Please print all G OFFICE vie , Date //11 Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location o !Ja I-L D W t Govt. Lot A,if' 1/4-S E 1/4 S Y T O R N R I E (or W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# LL S M ArS Oh fi / V a l( O f 'e"i ''�e l tLi TS City State Zip Code Phone Numb r City ❑ Village EMwn Nearest Road l - ► (,5 TROY I Ma rSopi, ❑ New Construction Use: esidential / Number of bedrooms 3 Code derived design flow rate ys0 GPD Replacement 0 Public or commercial - Describe: A Parent material ,o, a A, o e S,( e) e v - _ tj Flood Plain elevation if applicable ff General comments c� J and recommendations: u E- v �"� PD / 9 0 0 ��^^ e a Boring # Boring 99 a 5- ft De g �" Ground surface elev. De to limitin factor In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Etf#2 CWT f l -30 o `i tt S c L b� W 11 < < ' ( F-) S S 15 Boring # El Boring Pit Ground surface elev. �/. a D ft. Depth to limiting factor g in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#i I 'Eff#2 -�1 I OA r cr w . s bk c ,5 k ► I i rvk , ' 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 N. (Please Print) ) Ignature CST Number PA Address , Da valuation Conducted Telephone Number 776 SIP r14 �e CO l q-3oy i f s Property Owner T), Parcel ID # Page :;�) of 3 Boring # ❑ Boring it Ground surface elev. �� ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 -D p S( , S b K W 1 cv w o to 5 i tM /v E2 ��, S d Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Applicatio n Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff 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. S13D -8330 (R.07 /00) qo, a r ti 8 A, (� a�-Soo, , ' "q ° r C o0 Fed<< ,V VU P 00 At (SELL NT G araSe-� Co- j ►' - yo) Page 3 of 4 POWTS OWNER'S MANUAL & MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS Owner DAN OEENZTT Septic Tank Capacity 1000 gal ❑ NA Permit # ' Septic Tank Manufacturer WIESER CONCRETE ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ZABEL O NA Number of Bedrooms 3 ❑ NA Effluent Filter Model A -100 12" x 2011 ❑ NA Number of Public Facility Units 12 NA Pump Tank Capacity a l 13 NA Estimated flow (average) 300 al /da Y Pump Tank Manufacturer 1p NA Design flow (peak), (Estimated x 1.5) 450 gal /day Pump Manufacturer [A NA Soil Application Rate 0,5 gal/day/ft' Pump Model NA Standard Influent /Effluent Quality Monthly average" Pretreatment Unit NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L IN NA O Mechanical Aeration O Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection O Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L II In- Ground (gravity) O In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L a NA ❑ At -Grade O Mound Fecal Coliform (geometric mean) 510 cfu /100ml O Drip -Line [3 Other: Maximum Effluent Particle Size Y. in dia. O NA Other: ❑ NA Other: ❑ NA Other: ❑ NA "Values typical for domestic wastewater and septic tank effluent. Other: O NA MAINTENANCE SCHEDULE Service Event Service Frequency ❑ month(s) (Maximum 3 years) ❑ NA Inspect condition of tank(s) At least once every: 2 LA year(s) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume 13 NA 2 ❑ month(s) (Maximum 3 years) ❑ NA Inspect dispersal cell(s) At least once every: year(s) month(s) ❑ NA Clean effluent filter At least once every: 13 ❑ year(s) ❑ month(s) 0 NA Inspect pump, pump controls & alarm At least once every: ❑ year(s) ❑ month(s) ❑ NA Flush laterals and pressure test At least once every: 3 ® year(s) ❑ month(s) ❑ NA Other: At least once every: ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4 /01) I I OWNER: DAN DEWITT Pape l of START UP AND OPERATION, For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may Impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal call(s) in one. large dose, overloading the ceii(s) and may result In the backup or surface discharge of effluent To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Malntalner to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may Improve the performance and prolon9 the We the POWTS: antibiotics; baby wipes: cigarette butts: condoms; cotton swabs; degreasers; dental Aoss;'dlapertr; disinfectants; fat; foundation drain (sump pump) water, fruit and vegetable peelings; gasoline; grease;• herblddes; meat scraps; medications; oil; painting products;' pesticides; sanitary napkins; tampons; and water softener brine. ABANDONOMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned In compliance with ch. Comm 83:33, Wisconsin'Admintstradve Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall' be removed and properly disposed of by a Septaga Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another Inert solid material. CONTINGENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: O A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compadlon,and should not be infringed upon by required setbacks from existing and proposed structure, lot Imes and wells. Failure to protect the replacement area will result In the need for a new soil and site evaluation to establish a sultable replacement area. Replacement systems must comply with the rules In effect at that time. O A suitable replacement area Is not available due to setback and/or soil limitations. Barring advances In POWTS technology a holding tank may be Installed as a last resort to replace the failed POWTS. ® he to as not be valuated t tif a s b replace r�t-ar Uoo Ufa of the POWTS a soil and site e u on m t be rfo d to to a suitabi a ment area. If no rgpiaCe heat is available e holdin tan be installe as a last resort to replace the failed POWTS. Mound and at -grade soil absorption systems may be reconstructed In place "following removes we the blomat at the infiltrative surface. Reconstructions of such systems must comply with the rules In effect at that time. < SEPTIC, G SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAYBE DIFFICULT OR IMPOSSIBLE ADDITIONAL C M POWTS INSTALLER POWTS MAINTAINER Name HELGESON EXCAVATION Name JOHNSON SANITATION Phone 715/772 -3278 Phone 715/273 -5811 SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY Name JOHNSON SANITATION Agency ST CROIX COUNTY ZONING Phone 715/273 -5611 Phone 715/386 -4680 This document was drafted by the staffs of the Green Lake, Marquette and Waushara County Zoning and Sanitation egencl i& Thla dowmsr4 wmW the minimum requirements of ch. Comm 83.22(2)(b)(1)(d) &(Q and 83.54(1), (2) & (3), Wisconsin Administrative Code. Use Of thin document dos aot guarantee the performance of the POWTS. "M(2p1) Parcel #: 040 -11 50-40 -000 10/20/2004 08:33 AM PAGE 1 OF 1 Alt. Parcel M 4.28.19.842 040 - TOWN OF TROY Current 1XI 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 * WILLIAM D &LAURA USIAK- DEWITT DEWITT, WILLIAM D & LAURA USIAK- 537 MARSON DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 537 MARSON DR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 0.500 Plat: 2569- VALLEY VIEW HEIGHTS SEC 4 T28N R19W PT NE SE LOT 3 VALLEY Block/Condo Bldg: LOT 03 VIEW HEIGHTS Tract(s): (Sec- Twn -Rng 401/4 1601/4) 04- 28N -19W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 982/453 WD 07/23/1997 501/632 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 215,000 Valuations: Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.500 53,200 171,500 224,700 NO Totals for 2004: General Property 0.500 53,200 171,500 224,700 Woodland 0.000 0 0 All 0.500 53,200 171,500 224,700 Totals for 2003: General Property 0.500 48,400 158,500 206,900 Woodland 0.000 0 0 Total 0.500 48,400 158,500 206,900 Lottery Credit: Claim Count: 1 Certification Date: Batch M 137 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 s , ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer r c• ti� `� Mailing Address's Property Address 5 � (Verification required from Planning Department for new construction) City /State Parcel Identification Number LEGAL DE SCRIPTION ) qz) Property Location N E ' /,, V., Sec. _�, T a8 N -R�_ P own of _—Er O Subdivision eel C_� ,Lot # _ • 1 Certified Survey Map # Volume , Page # Warranty Deed # `t q / A q Volume `/ , Page # Spec house O yes m no Lot lines identifiable yes 0 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 aid by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal 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. Cerdfigatioi 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 yeapexpgration date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledg I ( we) am ( are) th c owner(s) of the pro erty scribd ove, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT 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 j DOCUMENT NO. WARRANTY DEED this sv,<.c RESeavco roR arcoao na DATA ! :STATE BAR OF WISCONSIN FORM 2 -19fto 49194 pp 53 _ REGISTER'S OFFICE Thomas PaY ick Mahney " a JkJa Thomas ... Maloney and ST CROIX CO. WI f _.. _. Roca d For Record Mary a /k /a_Mary A. Maloney _ I� I� husband and wt fe, • as Joint tenant s, Nw2 3 1392 conv¢ya and warrants to William jl � 3 Daniel DeWitt and 20 a• llfl I� .. ............................... ...... i' Laura - Usiak- DeWitt husband,.and_ �) as survivorship marital property, .... .... . .. -- .. ..... ... _. ......... ............... ..... _ ..... ....... ............ i ._. ....... I , — —i� i 1 I the following described :.al estate in .St y . Ci - o x ,_.._..____.C State of 'Wisconsin: (� I Tax Parcel No: .......... ... ................ it Lot 3, Valley View Heights, MAIVSFEA Town of Troy, St. Croix County, $��+-� Q I I I Wisconsin, FEB it If f is This ... homestead property. (is) (is not) I Exceptio to warranties: Subject t easements, reservations and restrictions of record. 11 Dated this ... - /... • -- --- --- --- -- - -- day of . - - -- -. November............... . _ -_ w : V A. ._. "_ ........... .:. .......... ... (SEAL) THOMAS PATRICK MALU � I -- --- . ............... ............ .. ........ • ..Thomas. P_- Maloney. ........(SEAL) ) ' - ........................ ........ . ...... ' .Mary A... Maloney y�1W '1 I AUTHBN'D'� - x .•emu . 4 � ; s 4 � , 1. u : ;. , � 4 -♦+. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ------ - - - - -- - _ PUBLIG aTn«.7 - .99.0£6 MNOO.b0.00 S ro ffi a .00•!:62 'i00.0l:Fi ,..»,. �� ~' '$� ; CY , G ® rl.3 T C F;,N • rn M , � 1 100*962 .el•oct n.00OPo.00 s It SOS M1100100600 S •�0's It l•*oz e t 1 ' • j f •OC.81.Z6F O v` 1 w i i V (J1 W N O C � I IA 1 1 1 { co 0) Zk ►r rn ? e Cn Z r- Z • •� gi 1 -4m W A 0O �� `.�- • .YI•SS j rn rn .N .b W N cn cn r ° s, to • oo ^' I : 2 ED cD W v cn r n rn D - OCn00 _o Z C:3 :r- 's• o mo o ' W W v V U) ui . 1 N • . V 1 i to °• tr (0 N .. W«+..... N r- r ` 1 NOOLDN► -•V Cr) Lai R1= t Ln0)F.DCDCD )WNZ. ZO Ww 1 iOO ►-• N O W OD O) _ C: M.00 �t0.00 9 09 002 rn O N V OW O«+ m m, •01�2�.ts1 1 Ce n 0) tG O V D N O) Z C7 D 0) D mN)OD )NW ZCAZFAZZZ Fon D 0 OD OD OD •-• ►-• 0) OD V D v M 08.002 W F.D V 0) O N (,D N W :0 N.00.60.00 S • • • • • • • • % . Q M �. JOWdNNC1t 7 I 1 COMMERCIAL TESTING LABORATORY, INC. '514 Main Street, P.O. Box 526 ..�Wiscon Wisconsin n 54730 7 15 - 962 -3121 800 - 962 - 5227 ` ST, CROIX ZONING REPORT NO.' 31009/O1 ST. CROIX COUNTY REPORT DATE. 10!20/92 HUDSSONON, , W WI PAGE 1 CO DATE RECEIVEM 10/16/92 5401b ATTNS THOMAS C. NELSON SRS Thomas Maloney LOCATIONS 537 Marson Dr., Hudson COLLECTORS M. Jenkins DATE COLLECTED## 10 -14 -92 TIME COLLECTED## 3300pm SOURCE OF SAMPLES Outside faucet DATE ANALYZEDSI0 -16-92 TIME ANALYZEDamoam COLIFORMS 0 /100 at INTERP'R'ETATIONS Bacteriologically SAFE NITRATE -N## 3 pp" a \ Above 10 ppm exceeds the recommended public Drinking Water Standard. s COliform Bacteria /100 at Nitrate - Nitrogen, mg/L g T cfl 0 X91 LP O �. LAB TECHNICIAN: Pam Gane r S 510 r WI Approved Lab No. 19 �£ t Means "LESS T}iAM! Detectable Level Approved by. ST. CROIX COUNTY ZONING OFFICE St. Croix County Courthouse 911 4th Street L Hudson, WI 54016 _ /T�he Telephone - (715)386 -4680 v' s St. Croix County Zoning Office offers the er ice of se t' p is water inspections to Lending Institutions, Realty Firms, and private individuals. Completion of this form is essential ss that the property fan be located Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning Office, and mail, along with form to the above address. Testing will be done as ` soon as possible after fee and form are received. WATER TESTING--------------------- - - - - -- -FEE: $ 35.00 (For nitrates and coliform bacteria) c WATER TESTING FEE: $185.00 ~` For VOC' S SEPTIC SYSTEM INSPECTION---------- - - - - -- -FEE: $25.00 �d (Determines if system is properly functioning at. time of inspection) PROPERTY OWNER'S NAME: " PROP. ADDRESS: �'�� �/� �`L CITY Alp Legal Description A 1 /4 of the - ' 1/4 of Section , T Z,?_ N -R22 Town of ot Number , Subdivision: FIR _ ER J LO CK BOX NUMBER Color of house Realty sign by house? SIf so, list firm: PLEASE INCLUD , IF AT ALL POSSIBLE, A ,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual requ9sting services: Telephone Number REPORT TO B E O: // © / CLOSING DATE: Signature Ile Z�ca EAST �•� O T. 28 N - R.19W 15 PART _ SEE PAGE 27 1 0 Fredervck " � F 4. f G. 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N + w�a Lew- ew- so Sn�rie G. s Hnde � � "sor .to ,n 40 :L� ariss.�a Patrick � �� wer�en O'Malle rf Ju✓,d' nn sK. 6'aard o HIll3 U RLCN � PQU/SOn R Ij..v �a id Y !/ni ✓e S7tL/ m�r a� PAULSON V i ' t3 o Ws ons(n °a 65 Char /es V Car o n Ruth f 2eB az f Donna o c7'h(a/ /y • Nancy f 7R5 N h s jj Onn E ou,n Pearson _ 2ao. s fhnsc,� H // `� Kenne hb /594 3 17o m 'a5l2 z 5 a Dev Snc. umner O C Z Q A C r S69 e+d m a MAI Y�y• O • sm O Mori are '�`' 194 _ • as Q�tl Cernoh S 5; \ 7 ne 5 vsi In . p z d4 C u Cl ere \ W W - 1 Gera /d J : 6 I� � fC /Cla, o u • " ; i �� Cerro - a W - C - ,r n 0 3 /antler' EDIS s• 2 w o` h c � a ? r H✓•de � 13 i Trust- v 5 v Cie 9� /03 Z '�sV1Q e6O6 iv rVe /son Q ��� 3 R I VE R FAL�.S M O /99✓ .?ac for M¢oPub xnc PIE Y PIERCE couNr StC or Cau ty s O 500 600 700 800 900 BALDWIN 54002 Our Sign Will Move You... di ERICKSON Junction 1 -94 & Highway 63 FREEDOM HUDSON For Sale Coulee ee Road HUD SON 54016 Edina Realty Edina Realty HUD"`' 386-8236 219 Second Street fAm x.nn n . aer.wdu.. fi..1611 c.rcw.r.. r.•... >. NEW RICHMOND 54017 Prescott: 2623500 386 8236 455 South Knowles Avenue New Richmond: 246 -5059 St. Croix Falls: 483 -3833 WE WANT TO BE YOUR CONVENIENCE STORE TWIN CITIES LINE: 436 -7072 • 700 -2nd STREET, HUDSON ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, W154016 - (715) 386 -4680 October 15, 1992 Lucy Gearhart Y' ' Centur 21 706 - 19th St. South Hudson, WI 54016 Dear Ms. Gearhart: An inspection of the septic system on the property of Thomas Maloney, located at 537 Marson Dr., Hudson, WI was conducted on Oct. 14, 1992. At the same time a water sample was obtained for testing. The results of that testing will be sent to you as soon as we receive them from the laboratory. At the time of inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. SVncerely, Mary J. Jenkins Assistant Zoning Administrator cj