Loading...
HomeMy WebLinkAbout042-1020-10-110 Q) 7\ °® \ } e , \ ) ƒ 0 k � �\\ })t L ear �_ c E ■ �2f \ \/% » � = z t \ 0 z e . _ / z a ■ . g q ; 0 z t 2 \ k k 7 ) 2 / ) V 3§ } .� k& § E EL § o Q z z . ., } � a } f . � / I k ^ . (L co & k a ® E / < _ 0 R U) U) \ 2 \ k § § z a a a ; � . U) -i § \ k G \ « 2 \ « S § = E 2 2 < ƒ / \ £ # z = 2 § o o % e ■ E \ { § c § 0 U') . 0 k k r ~ b k \ % a / & 8 \ ; -� k § ) ) \ ■ k « k J � E) E k a § k u a 2 U) 2 Parcel #: 042 - 1020 -10 -110 07/11/2005 05:10 PM PAGE 1 OF 1 Alt. Parcel #: 08.29.18.113A -10 042 - TOWN OF WARREN Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * GEORGE &NANCY STUTTER STUTTER, GEORGE & NANCY 1083 110TH ST ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1083 110TH AVE SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 10.160 Plat: 0395 -CSM 08/2382 SEC 8 T29N R1 8W PT NE NE BEING LOT 1 OF Block/Condo Bldg: LOT 1 CSM 8/2382 10.16AC EZ -U- 1201/243 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 08- 29N -18W NE NE Notes: Parcel History: Date Doc # Vol /Page Type 08/05/2002 686014 1941/102 EZ 01/08/2002 667520 1809/165 WD 06/12/2000 624717 1518/506 QC 07/23/1997 913/80& 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/22/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 10.160 64,000 231,400 295,400 NO Totals for 2005: General Property 10.160 64,000 231,400 295,400 Woodland 0.000 0 0 Totals for 2004: General Property 10.160 64,000 220,900 284,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 557 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY &BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISON WI 796 HUMAN RELATIONS (ILHR 83.09(1) &Chapter 145) LOCATION: SECTION: T0WNSHIP /MV1qTCTPAttT-Y: OT NO.:BLK. NO.: SUBDIVISION NAME: /T 29 N/R & E (o ► w A � � E� SUBDIVISION PaN :D % k) c,-- COUNTY: MAI U WT ADDRESS: 'ST cZo(x ANNE ST ` R06115 e T S S . USE DATES OBSERVATIONS MADE rryye� N0. B DR .: COMMERCIAL DESCRIPTION: I \ _ S: iAlResidence 3 pR �- /(f , PdNew Replace L�L)LI t V? t J cxY l : 3'0LtI/ i Icl RATING: S= Site suitable for system U- Site unsuitable for system • ONVENTIONAL: MOUND: IN- GROUND - PRESSURE: S STEM -IN -FILL OLDING TANK: RECOMMENDED SYSTEM: (optional) r ES 011 ES ❑u ES ❑u ❑ s ©u a s au �EN� s a� �y— w; l Dpop I dx 1'S T uT i o,v Vun rcolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the s. ILHR 83.09(5)Ib), indicate: GL�'S `S 41=7 Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS IN TOTAL DEPTHTOGROU NDWATER- INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGP ET TO BEDROCK IF OBSERVED (SEE ABBRV. O BACK.) 0 -f - /o ye 3/2 s pr o�nco B - 12-0 9'5 .1 2- tieo > ( 2d ef,r�rx s �'re 41l. s, /,W9e, /o Y4 ('Z5" f oC s A t G r o - - /,, y e 317- 5/ P /0 .0 &D ' = /4" /o %P 9/g s' 2f / ,sl, ��� 7 I • Z 7 12-0 ecv 2 F QcrJ i / `/ "- 5'O " iD oe �9 /G iS, B- 2 yeYI - /7- /o ,e s/y s , o o s - D - QQ" /Oy/? .3/2 10i1M C'cc, Sbt (PA 1 V'l= 12co'r TQ� s' i2 "- i2 • /OyR S/4 S! 2 S(ok �n. �i B-3 l o� �� 8 Z > 10(:? a z ~- yz " /cs Y X ¢ s/ ��, q ie ,wt U F o� s /4 idy - s ,e, Age /o y /Q elir ., B _ s J-) O y Z o►fM p O to 3& / D YR 4/1 Si B - � l Ig 8 7, 2 2LO > l 1 � Sak, ,A R 3� I " �o y R s /��Ir�F /�o�o.s'� r , o- f- /o ye s/z )o,�h t proweo� 9 �� " /o yR B -5 (Q 0 Lf - � 40 > (/D /A„ 6A ) -AS ' 36' 1/0' /o yk m/ S' A - x ae l ;I - RtRC E(E Wk T iOAI3 S PERCOLATION TESTS TEST DEPTH . WATER IN HOL TEST TIME DR 1 WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLI INTERVAL -MIN. p RIOD 1 PER 2 PER OD3 PER INCH P _ ) y Z Y)o :?S. d 2 - 3 P _ 2 o < 2 0 X3 P_ PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings a and percent of land slope. �{� �I 5 / /� e SYSTEM ELEVATION. _ _ _ _. _. _. _ _. ? -� E 7 Co 1 , I • . i i -- , I , —4 - I -ti - I _. i 1, the undersigned, hereby certify that the soil tests reported on this -form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print : ITESTS WERE COMPLETED ON p HOMESITE SEPTIC PLUMBING CO. (� L 3 1 6 1 J .. 655 O'NEIL RD., HU DSON, WIS. 5410 l ADDRESS: ROBERT ULBRIGHT CERTIFICATION NUMBER: PHONf NUMBER (optional): 41S. MASTER PLUMBER LIC, NO. 3307 M.P.R.S. 1 3 r6 " 4 ?/,? - 5 - kIINN. INSTALLER & DESIGNER LIC. NO, OUM CST SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. nii uR_ctan _Azov iR to /wii _ nvFR _ 1 /4 UC FvIINO. Soi?oeyoR'S P�--oT P`A I" Pv? h Nw G.OT 1C)T co+Ra1ER... EIEU -k 0 v H � J i � - = f��4c�ffo� p,•TS 'r pei:c I ocrtTiaNS HOMESITE SEPTIC PLUMBING CO. 6% O'NEIL RD., HUDSON, WIS. 54016 ROBERT ULBRIGHT c S 7` -I;' 2.y WIS. MASTER PLUMBER LIC. NO-3307 M.P,R.S. MINN. INSTALLER 4 DESIGNER LIC. NO.00663 � is �tEN T �7 to J Q 3 h 'L i Wisconsin Department of Industry SOIL AND SITE EVALUATION Labor and Human Relations Division of safety and Buildings in accordance with s. ILHR 83.og, Wis. Page Of 3 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 Percent slope, scale or dimensions, north arrow, and location and distance to n• a road. S GRO% K Parcel I.D. # APPLICANT INFORMATION - Please print all Information. 0y —16i0 — /0 — //a Personal information you provide may be used for seconds u Reviewed by Date ry p rposes ( Privac y Law, s. 15.04 (1) (m)). � Property Owner 'hy kl�4 Property Location Property Owner's Mailing Address ] /I �` Govt. Lot NE T 2- g ,N,R f 8 E �0 90 �/O /k 411t . Lot # Block# subd. Name or csM# City State Zip Code Phone Number ; ;: D� &, ��s PE.uP/U G" �' S (if Ro/3ERT'S �j, �,r�0i3 (7�S )7f 1- 370& ❑ City ❑ village p Tow, Nearest Road r ry O i¢GA u ew Construction Use: Residential / Number of bedrooms 3 ^ 7 ❑ Replacement Addition to existing building ❑ Public or commerbial - Describe: ^/ .- NpT- — �•vD>�y Code derived dally flow (0 0 g pd Absorption area required " bed, ft2 10`60 2 Recommended design loading rate bed, gpd /ft (ranch trench, ft � trench, gpd/ft2 • ' gpd�2 Recommended Infiltration surface elevations Maximum design loading rate bed g pd /ff • & () sue• 3 (a referred to site plan benchmark) Additional design /site cons ff lions use 1-046- /Il WOW P rent material J ✓� 7� S� rr ,PE U,pjr4 Ait'D .v Flood plain elevation, if applicable S = Suitable for system Conventional Moun , In- Ground ressure AT U Unsuitable for system ❑ U 5 ❑ U System in Fil 7TIding Tank ❑U ❑U � ❑U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles In. Munsell Texture Structure Consistence Bounds R GPD /fie Qu. Sz. Cont. Color Gr. Roots Q' Trench Sz. Sh. Boundary Bed , / ll /aYR 3�z togy 2 ,Msh� 4Sti cs 3f R 3 /t� S/L . z f sdK Ground 2f • S • ( elev. /d SL 9Q. X00 ft. LS ee ' l 7 , , x Depth to �� S V limiting S• factor �d..n In. Remarks: Boring # / 0 -/ 0 10 y e 3/2-. Z mAf Z.wf s b,� sti Cs 3 . s Z 2- o -/ / 3/47 s�� Z s6 sti s 3 1 /0 Ground ^ f 7 � GS �� . � C f ete / 5 -2 Depth to limiting factor 7 11-1-_in. Remarks: CST Name (Please Print) .��� y�- T Signature ���"v'�V -7 Telephony No. Address 7�y'' .381 Date CST Number ggo. a is Private Sewage Consultants 666 O'Nsil Rd. Hudson, Wis, 54016 ORIGINAL J J PROPERTY OWNER SOIL DESCRIPTION REPORT 2 3 Page of PARCEL 1.01 AVE 4 , 1 40 Boring # Horizon Depth Dominant Color Mottles Structure *.. in. Munsell Qu. Sz. Cont. Color Texture Consistence Boundary Roots ' tar. Sz. Sh. 2 Bed ,Trench /o y she 7 e.s 3 s :. 6 Z 11-lo ,o ye 3/ 51L 2 f sk �G cs z . s' •� Ground 3 oY ,y SL / elev. ��.�ft. -� o SCo S. d • s � . � Depth to limiting factor / Remarks: , Boring # -� /o ,P 3/2 4D/ft1 2,V sde dsti os 3 F 3 AY - if she Ground 3 / . O L S L S C5 .— • S elev. /o ( �`� 7 •8 .S •� Depth to limiting factor in. 1 Remarks: Horizon Depth Dominant Color Mottles Structure Texture Consistence Bounds OP /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bound Roots Bed ,Trench Boring # / '/L 10W 31Z Go.w Z,rr, 3f r ✓� z -� /o oe G goy 457 / ,e C3 . Ground /O • . elev. Depth to limiting factor In. Remarks: Boring # Ground elev. ft. Depth to limiting factor In. Remarks: , SBDW -8330 (R. 08/95) W y 0 0 w Z o CL S 1 06 o kA Q O W � O o z o W i * CSC ZI -71 A6 Ile/ ,9 f - 2,3,P2- # / �io• q s Wisconsin Department of Industry, SOIL AND SITE EVALUATION ' Labor and Human Relations Division of safety and Buildings in accordance with s. ILHR 83.Og, Wis. Page / of Attach complete site plan on paper not less than 8 1/2 x 11 inches In size. Plan most County Include, but not limited to: vertical and horizontal reference point (BM), direction percent slope, scale or dimensions, north arrow, and location and distance to r. A road. S � GRO% Parcel LD. # APPLICANT INFORMATION - Please print all information. 0 Yj. - Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) Reviewed by Date Property Owner s p y Property Location 14 11 ,a �/ Property Owner's Mailing Address Govt. Lot NE 1 /4iUE 1/4,S 8 T 29 ,N,R l8 E (or)(0 /0 //O A U-e !,;D4;,O� Block# MOM Name or CSM# City / State Zip Code Phone Number OF 40 , f WS PEN Oi_A_) 6-- CS,k;f ROl3ERT5 I IVY. 1 .Syo2-3 I (7 / S )7!l- 3,0( El ❑Village [B Tee Nearest Road U clew Construction Use: Residential / Number of bedrooms 3 ❑ Replacement . Addition to existing building ❑ Public or commerbial - Describe: Code derived dally flow g pd `'�� Recommended design loading rate ! .L� bed, gpd/f1 6 /f12 Recommended infiltration surface elevation(s) Absorption area required bed, ft2 trench, ft2 trench, g� Maximum design loading rate/VZ _bed, gpd/ft • (P trench, gpd/ft -s�� P Ct , ,3 Additional design /site cons t /v�jPO4� ft (as referred to site plan benchmark) Ions 2l Love— 7i�.F,rr GG�.If P rent material J R S¢ 77 APIG " ' /7 v p rlt i940 T , N/ .v Flood plain elevation, if applicable ff ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade U = Unsuitable for system , Q g El U ❑ U Holding Tank S L✓JS ❑U L"JS ❑U L✓1S ❑U ❑ SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Qu. Sz. Cont. Color In. Munsell Texture Structure Consistence Boundary Roots GPD /ft Gr. Sz. Sh. 3 YR 313 Bed , Trench io y,P 3/y o /f s!A �s c Z-F ' / Ground 3 /O SL 4 S . �q ' .5 /00 : 54 - 3 J 4 U� • T S Depth to 3 ✓` s . T' Q limiting /�- l i- S . 4 factor 7 I Remarks: Boring # -21 y ,o L s cs .s.� Ground - �� / __, ev. s , , f2 • 'ft. Depth to limiting factor > f4:L —ln. Remarks: CST Name (Please Print) RO ,W7 - AY48�PiG47- Signature Telephone No, Address 39Vo 8 /�s Date CST Number ssoc a es sZ 9� CST- sib Private sewage Consultants 665 O'Neil Rd. Hudson, Wis. 54018 �' _ ORIGINAL 4-- e iNl PROPERTY OWNER _ � ' / SOIL DESCRIPTION REPORT Page 2 ' of PARCEL I.D.ft Boring # Horizon Depth Dominant Color Mottles Structure p In. Munsell Ou. Sz. Cont. Color Texture Consistence Boundary Roots dr. Sz. Sh. Bed , Trench 3 : is Ground _, C elev. �+ o LS /1N �J G 7 ' . ft. a — Depth to limiting factor In Remarks: Boring # / No /a 3l -- SL /�'sb� Asti c s Z - f . y' . s -• IMMA a -/ o 3/ �L 170'-541, c o 3 ,a o � Ground , D elev. `. n. Depth to limiting factor , in. 1 7 Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounds Q In. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Boundary Roots Boring # Bed , Trench / -iz �o y/2 31 SL /fs G - � �s�. J �F GG i .,s •4 7. qZ ev. N. Depth to limiting factor 7 f-0- _In' Remarks: Boring # Ground elev. ft. Depth to limiting factor In. Remarks: ' SBDW -8330 (R. 08195) t. M 31 A ' r , NOTE Ulbilcht & AS SOCiStes Private Sewage Consultants 855 O'Neil Rd. Hudson, Wis. 54018 I � So/ ` TE5 7 i �� /Od . 57 I I -- I , /32 N I I 13 3 o /-3f � If /3 � 1 0 TO o f y 1 , 0 r ' l0 r �� /00 1glo 1 ti Sv E3'r�p �� S yS T 614-4: 770,V5 �3 9 3.0 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix Safety and Building Divisiory INSPECTION REPORT Sanitary Permit No: • + 405100 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: Stutter, George Warren Townshi p 042 - 1020 -10 -110 CST BM Elev: Insp. BM Elev: BM cription: ^� 100 (� ' Y1n0'tw-� S4g4 �( T TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI I FS ELEV. Septic B hmark t��. I Ott D 0aa,c- 0 1 - 1 12. ►I 2. ?J Dosing Alt. B /. Aeration Bldg. Sewer 2 Holding t/Ht Inlet �i 0 6o. TANK SETBACK INFORMATION St/Ht outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ` r 1 f Dt Bottom J ✓� Dosing Header/Man. / C1 -12 Aeration Dist. P_i 7 i / / �V 2 - 7 & Holding Bot. System *, I ! `• Final Grade dov PUMP /SIPHON INFORMATION Manufacturer Demand t over GPM o f r Le- I 8 3 Model Num TDH Lift frfic I oss System Head TDH Ft For ain Length Dia. o Well SOIL ABSORPTION SYSTEM BEDITRENCH Width ) Length No. Of Trenches P{T DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 ) _ �/ J SETBACK SYSTEM TO VJ P/L W JBLDG WELL LAKE /STREAM EACHING Man ct rer INFORMATION 6� CHAMBER Type Of System: ` � � i (� / '�/� � Model Number: DISTRIBUTION SYSTEM l ('- 0 — -* (p jzt n,(z / ( (•� d ,, 'H — �asP�/ Header /Maniffld Distribution / x Hole Size x Hole Spacing Ve take cv Pipe(s) P _T4n Z9 I 1 1-ength – o Dia length Dia I Spacing — 7 / 4® SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only iJwt. Depth Over ! Depth Over xx Depth of xx Seeded /Sodded 1 xx Mulched Bed/Trench Center S Bed/Trench Edges Topsoil 1 , ;a Yes j;� No 1, Yes Lei No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: _/ / Inspection #2: Location: 1083 110th Ave Roberts, WI 54023 (NE 1/4 NE 1/4 8 T29N R18W) NA Lot 1 Parcel No: 18.29.18.113A10 , l3� 1. � utti9" � �_ c6r► urr�.: r"•or'�E'`,t( b.t.�- �s /,I�I:ir 1.) Alt BM Description = U l _ - /J 2.) Bldg sewer length = j ��l iy/ lt�.� S ( C .� Q.��A4 - amount of cover LYwXlX, dK Plan Use other for nl Yes No formation. !_ 7 —3 � � _ ��i(/1/LY► _ (O f J SBD -6710 (R.3/97) Date Insepctor's S nature Cert. No. Safety and Buildings Division County as 201 W, Washington Ave., P.O. Box 7162 r i CZ'Oe /sc0ns jn Madison, WI 53707 -- 7162 4 Site Address De artment of Commerce 5 ,0�� S # 0 $ 3 Sanitary Permit A lication 5 ` P b5- her In accord with Comm 83.21, Wis. Adm. Code, personal infonnation you provide ❑ Cbeck if Revision may be used for secondary purposes Privacy Law s15. 1 m 1. Application Information - Please Print All Information State Plan I.D. Number Property Owner's Name D Parcel Number Q _� Propeny r is Mang Address r 2002 Property Locatio 08.29. IB . I(3/� - / 0 a �el�C LST.CR �/4 't ;5 Ta AF City, State Zip Code 1 hug Lot Number / Block Number Subdivision Name CSM Number II. Typo of Building (check atl that aPp e< s pv s► �° 's ❑City ❑ 1 or 2 Family Dwelling - Number of Bedrooms ❑Village Q Public/Commercial - Describe Use kownship y ,,J ❑ State Owned Nearest Road 2 3 `x U- �` -� im,& a&s D 7/r ve III. Type of Permit: (Check only one box on line A (numbering scheme f or internal use). Complete line B if applicable) A. For County use 1,(New 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑ Addition to S stem I I Tank Only Exismw system B. ❑ Check if Sanitary Permit Previously issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) 1 A f c* . 44 Non - Pressurized In- Ground 210 Mound 47 0 Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recircula ' 30 ❑Other V. Dis tanent Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate ystent Elevation Final Grade Required Proposed`Jf.Zo Rate(Gals./Days /Sq.Ft.) (Min./Inclt) F qtr � y /oU . 74 VI, Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Es sdq Tanks Tanks Septic or holding Tank �/ MA Dosing Chamber VII, Responsibft Statement- 1, the undersigned, assume responsibility far n of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature Number Business Phone Number 21S- 386 Plumber's Address (Street, City, States. Zip Code) VIII. Count !De artment Use Onl Approved ❑Disapproved Sanitary Permit Fee (include=Gyroundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) ❑ Owner Given Initial Adverse �r-- / Determination J l 1X. Conditions o Approval/Reasons far Disa p} ov 6e Attach complete plans (w the County Daly) for the s** paper net lea Ilan 81/2 x 11 laehea In she SBD -6398 (R. 05/01) Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 - r 5 lNOZk Madison, WI 53707 - 7162 Site Address I V " i�sc�nsin Department of Commerce * 0 3 Number Sanitary Permit Application S ' nr "�*S-I co in a=rd with Comm 83.21, Wis. Adm. Cade, personal infora &Wu you provide ❑ Cbeek if Revision may be used for ELva M Lnw. s1S. 1 m I. Application Information - please Print All Information State Plan I.D. Number Property Owner's Name D Parcel Number _.eQr S U el' property is MaiBng Address 2002 Property I ocatio 08.29. 18 . 113k -1D 14 U /,, 7 : e , 'ecJ Care 7 %L - �r/G 'A A T a 4N. R City. State Zip Code it hog 6 Lot Number Block Number Subdivision Name CSM Number o d b ter/ I s S �' - 3 C.Sh2 Osl as P2 U. Type of Boll (check all that apply) � sPv s w ( "S• flay ❑ 1 or 2 Family Dwelling - Number of Bedrooms ❑village ❑ Public/Commercial - Describe Use kownshi .,J ❑ State Owed + /n� ^/) Nearest Road 2 ` K U 1S 4 .� e�S d T/ e III. Type of Permit: (Chwk only one box an line A (numbering scheme for internal use). Complete line B if applicable) A. 1 New 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑ Addition to For County use stem I I Tank O stem B. ❑ Cbeck if Sanitary Permit Previously leaned Permit Number Date issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal tree) 1 44X Non - Ptnssnri.d Ira.Gtamd 210 Mound 47 ❑ Sand Filter So ❑ Constructed Wetland 22 [] Presmized 1n -Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatnutu Unit 49 ❑ Recircul 30 ❑ Other V. tmettt Area Informstiou: Design Flow (gpd} Dispersal Area Dispersal Area Soil Application Percolation Rate /System Elevation Final Grade Required Proposed `e f . Zo Rate(Gais./Days/Sq.Ft.) (�► -�) 9G�y lad. 76 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New t Taroks Teaks Septic or Holding Task �/ - 140v I A L-es ey 1)osio6 f�am�ber VII, Resppnsib Statement 1, the undersigned, assume Wty for tion of the POWTS shows on the attached plans. plumber's Name (Print) Plumber's Signature Number 7!1 iness Phone Number �779a? /S-3SG-3 /a Plumber's Address (Street. City. State. Zip Code) z - .5 1 27` /�� �.�a,t_I VIII. Coon /De artment Use onl Approved (3 Disapproved Sanitary Permit Fee (includes Groundwater Date Issued issuing Agent Signature (No Stamps) Surcharge Fee) ❑ Owner Given Initial Adverse �c-- Deteratimdom tb IX. Condi o ApprovoSeasous for Dina p} t a.L>& Ces�'tskiGt..tb+/Pt1' . Attach eempiete *0 (to IM County ooh) ter the � paper net ten flan 8112 lathes la $he SBD -6398 (R. OS/Ol) 7 = �) 5jy/V9 % S �'T� /Ql �'GJ TuJ•t/ D /.��I�.re�r/ rX lc IN 0 1" a ti e �3 , teS / O O i e9�u y �/ %y�li may' S Ta 9 A IDC� NZA �3 2 c- a 6- 4 r d �. 6 �- r ORIGINAL J 1469 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Certified Soil Testing Attach complete site plan on paper not less than 8'/2 x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. Please print all information. R iewed By 042 Date Personal information you provide may be used for secondary purposes (Privacy law, s, 15.04 (1) (m)). 0 Property Owner Property Location Stutter, George & Nancy Govt. Lot NE 1/4 NE 1/4 S 8 T 29 N R 18 W Property Owner's Mailing Address Lot # Block # Subd, Name or CSM# 1078 Bonnie View Circle 1 8/2382 City State Zip Code Phone Number City - ,j Village lid Town Nearest Road Woodbury MN 1 55125 1 651 - 436 -3526 Warren 1 110Th Ave. New Construction Use: 16 Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement A Public or commercial - Describe: Parent material outwash O Flood, "plain elevation plicable NA General comments and recommendations: install 2 - 2.7 x 68.75' stipulation 1099 chamber tree, syst�9rin�1'eyatipn of. 6. for 3 br (2 - 2J' x 93.75' trenches for 4 br ) Boring # Boring `Ivy f Pit Ground Surface elev. 96.6 ft. l' i Dept t4 h'krliting fa � X 90 }��. �i Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structur C ay is GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz Sh �� y " *Eff #1 *Eff #2 1 0 -8 7.5YR 3/2 - sl 2 f sbk `m4�r'i if /m .5 .9 2 8 -14 7.5YR 3/2 - sl 2 m sbk mvfr cs 1m .5 g 3 14 -21 7.5YR 3/4 - sl 1 m sbk mvfr cs if .4 g 4 21 -90 7.5YR 4/6 - s 0 sg ml - 1m .7 1.2 Boring # Boring Pit Ground Surface elev. 97.3 ft. Depth to limiting factor > 9 0 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff #1 *Eff #2 1 0 -6 7.5YR 2.5/1 - sl 2 m gr mvfr gs if /m .5 .9 2 6 -18 7.5YR 2.5/1 - sl 2 f -m sbk mvfr cs 1m .5 .9 3 18 -32 7.5YR 3/4 - sl 2 m sbk mvfr cs if .5 9 4 1 32 -46 7.5YR 4/6 - s 0 sg ml cs 1m ,7 1.2 5 46 -90 10YR 4/6 - s 0s9 ml - - ,7 1.2 Effluent #1 = BOD 30 < 220 m L and TSS >30 < 1 ' Effluent #2 = BOD < 30 mg /L and TSS < 30 mgL CST Name (Please Print) Sig e: CST Number Henry F. Grote L 222774 Address Certified Soil Testing Date Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, I 4751 12/11/2001 715- 233 -0398 Property Owner Stutter, George & Nancy Parcel ID # 042- 1020 -10 -110 Page 2 of 3 7 Boring # _j Boring ej Pit Ground Surface elev. 100.3 ft. Depth to limiting factor > 90 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots QPDW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -6 7.5YR 3/2 - sl 2 m gr mvfr Cs if /m .5 .9 2 6 -16 7.5YR 3/2 - S1 2 f sbk mvfr CS lm .5 .9 3 16 -30 7.5YR 3/4 - Is 0 sg ml Cs 1m .7 1.2 4 30 -90 7.5YR 4/6 - s 0 sg ml - lm .7 1.2 4] Boring # I Boring Pit Ground Surface elev. 100.3 ft. Depth to limiting factor > 90 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 -6 7.5YR 3/2 - sl 2 m gr mvfr Cs 1f /m .5 .9 2 6 -13 7.5YR 3/2 - S1 2 f sbk mvfr Cs lm .5 .9 3 13 -19 7.5YR 4/4 - sl 1 m sbk mvfr Cs if .4 .6 4 19 -30 7.5YR 3/4 - Is 1 m sbk mvfr Cs if .7 1.2 5 30 -90 7.5YR 4/6 - s 0 sg ml - - .7 1.2 ❑ Boring # _ 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 ' _ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 ' Effluent #1 = BOD 30 < 220 mg /L and TS >30 < 150 mg /L ' Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. SBD -8330 (R.07 /00) Certified Soil Testing Y Q- I V w h a. �l T y A•�r• -- 1 O 1� 1 a.....� L t> �- !� e O 1 •� � -� I ,.see min ►� b�l�L,,,� U L L ff ( R Ol U U i _c t J° i Ipt1llli Am • o(111�i MIMI, MIMI i �'tl,ll IIIfflfflt1�11i #fl 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 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 UO Number of Bedrooms Design Flow - Peak (gpd) Estimated Flow - Average ( pd) O z, Septic Tank Capacity (gal) c�tso Soil Absorption Component Size (ft �C ; Type of Wastewater Domestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) 6 SY, Maximum Influent Particle Size (in) 1/8 Maximum BOD (mg /L) 220 Maximum TSS (m /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter In spect once a yea 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 and outlet filter shall be assessed at least once every 3 years by inspection. Th u let filt shall be cleaned as necessary to ensure proper operation. The filter cartridges not be removed unless provisions are made To retan so ids in1he tank that may slough off the filter when removed from its enclosure. If the Management Plan for a Septic Tar* aria So ,Aosorptlon Component filter le equipped with an alarm, the filter snail b® serviced if the alarm is activated continuousiy, intsrrrrittasnt filter 111M May Indicate sure flows or an Impending contistuous 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 tenet. If the contents of the tank are mat removed at the time of an assessment, maIntenano perlorirrel s#lali advise the owner of when the next service needs to be perfOffn d to maintain less then maximum scum and sludge accumulation In the tank. Manhole risers, access risers and covers should be inspected for water tightness aand soundrteaas, Access openings used for service and assessment shall be sealed watertight upon the smmpletlon of service. Any opening doomed unsound, datlfedva, or subject to failure must be replaced. , Exposed arrca" ops mIngs greater than 8.1richas In diameter sholl be secured by an effective IooWng device to prevent aocidrrntol or unasuthorlxed entry Into the tank. No one shwid at er a so#ic or other treatment or holding teak for any reason without being In full oasmponave with 06HA shhndords for rate ng► it ,cw0hod iapo& The 8&nOsp wv wlthln the #so* car other fmlrftwt of hat#1sI6a t tank easy acontoin tat N Pm #Ad re rous of a Aa►eeon ftm ithae Inferior of the Wk may be VOWN or ImpOsslb#e. Tank abandonment shall be In accordance with Coma $3033, %U. Adm, Code whar+ the tank is no longer used as a PC1 Vra component Aw l The soil absorption component serving this structure Is designed to accept domestic wastewater from a residentIIal fae6lity. The limits of operation of this component are showr, In Table 2, The lort evi of a soll absorption component depends greatly and timel C Y maintenance, arld s ystorn U114 within o .e nt r below the llMRS of railable oP on eratlpn QaOd water COnservation pcactiCes by 68 Owuponts and the installation of water canserving plumbing fixtures are key factors in extending the useful life of this component, The soli absorption components operation must be as"m od by Inspection at least once every three years. The Inspection shell Include recording the levels of ponding, If any, in the observation pipes, and a visual lnsperction for any evidence of surface seepage or discharge from ft component. On steeply sloping sites, oreas of erosion should be Identified and reprarted to ttte owner for repair. The surface discharge of domestic wastewater or sewage from the system to prohibited and comildered a human heai:h hazard 'I"ralflc around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the comp"M may lead to hydraulic failure by freezing. This type of failure is usually temporary, Wit difficult or Impassible to repair until weather coridittons Improve, In general, salt crompactlon over this :component will reduce diffusion of oxygen Into the soil end dl eperest trace, which may lease to more intense, sand earlier, organic clogong of the soil, 2 Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep - rooted trees and shrubs directly over of within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. Contingency Plan In the event of system failure, a new system could be Installed in an alternate area. With the installation of a diverter valve, the existing system could also be reused after a period of three to four years. It is the property owners responsibility to maintain the alternate area free from any planting of trees, shrubs, etc, In case of failure of the original system, the alternate area will be needed. If any trees, shrubs, etc, have been planted on the alternate area, they will have to be removed at property owners expense. If alternate area is destroyed, there are other alternative systems that can be used, in which, could result in added expense to the property owner. Any tank abandonment shall be done in accordance with Wisc. Code 63.33. Any questions regarding this code, please contact your local Zoning Office or contact the installing plumber. V. rim tv 3 `b b - 3 1 z 1 i 05/02/2002 08:22 7152354669 STORK BUILT HOMES PAGE 01 uv/ aui ul 1;9: FAA .. ID 002 ST CROIX COUNTY SEP= TANK MAINTENANCE AGREMAENT AND OWNERSHIP CERT'IP'MCATION FORM Owner/Buyer �Cu off. t - N o g EL` Mailusg Addrm 1"o 7 $ 6-t j o — .Yj', 0 , e L" t rt - Property Ad**" D ?3 ) j b PA r (VMficatioa jogUbed fnm PlawinS bopartxment for new coastntction) ,. 6J-A.lJ -tN fOwNS�j p City�Statt: „ , If a2 i Parcel Identification Number LLQ "' =CliIP" 2& Propaty I.ocatjot .`lam %., 'I•, t Ile „VJ, Town of Subdivision , Lot # 1 s'J ,C oi l7oe.Np. +C'extl � Survey xup '7 f J ...,, V Page # Z-3SL x Warranty Decd # - -L L Volurne .18�? j PsS0 # 1.4S Spec house D yes 29 110 Lot lines i dentifiable 'Er yes © no SXSTEM N=EDj unpropsr use and mairamanca of Yom septic system Itauld result in its prema lure failure to handle wastes. Proper msintenmce donsists of pumping oast tbse septic tank @very+ three yeems or sooner, if aocded.by a licamod pumper. What you put into the system tea amot the t'ltttotiou of the soptic tank " a t wwnent stage in the waste dtaprreal system n" property 9 %vote to spbmit to St Croix Zon* Dcparle=La cordfication form, signed by the owner and by a masterphumtber, jownoytnanplumbar, reetriotedplumber or a liaen"dpunververitAq (1) the on -bits wastavmter disposal system is in proper aperWat coixu ion and/or (a) Afiter inspection and pumping (if necessary), the septic tart$ is less d=1 /3 tell of @Midge. Vwe, the undarsi and have read the above requirements and agree to maintsin the private savage dire of system wi* the stiadards set forth, Units, as set by the Dt partmnt of Cmamtrce and the Dsyamaat of Natu"I Resources, State of wisco=lg. Certification sUdng due your septic systeaa has been cuintai od must be completed cad romped to the gk Croix County wing Oftf ce within 34 dayss off the three year api date. V 77 SyGthTA ..."" ..._.r ��. 03MA ZION X (we) occtify drat all sutsraeuts on this foam are true to the vest of my (our) knowledge. 1(we) am (art;) the owwr(s) of the descri b vivo of a wxrrcaip doedromordod in Register of Doeds Oiiics, SION URZ QP AI>IfL.TCANT DA'TS rerr re Any infarction that is atu s-Mrsai mad may result is the unitary permit being revoked by the Zoo ft Department. ++ Isdlu4a with this application: a stamped warranty dud from. the Register of Deeds office a copy of the cestiftrd survey Wrap if refereaae is made is the w arranty, decd 3 1 a3s� ��a� Wl.1 809PAf,E 165 STATE BAR OF WISCONSIN FORM 2 • ]999 ti H ' 52p WALS Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Kimberly E. Abra f /Wa Kimberly RECEIVED FOR RECORD E. Agger 01 - 08 -2002 9:30 AM WARRANTY DEED EXEMPT 11 Grantor, and G Stutte and Nancy Stutter, husband and wife, CERI COPY FEE: —' COPY FEE: - - TRANSFER FEE: 345.00 - - -_ RECORDING FEE: 11.00 PAGES: I 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 That part ofNEI /4 NEI /4 Sec. 8- T29N -29N described as follows Lot I Recording Re address of Certified Survey Map recorded in Vol. 8 of Certified Survey Maps, ge KRISTINA OGLAND 238 2, as Doc. No. 471816, St. Croix County, Wisconsin. `-L— ESTREEN & OGLAND 304 Locust Hudson, WI 54016 042 - 1020 - 10.110 Parcel Identification Number (PIN) This is not homestead property. N) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this Zee day of January 2002 * Kimberly E. (braham, f /Wa Kimberly E. Agger AUTHENTICATION ACKNOWLEDGMENT Signature(s) Ki mberly E. 4braham, f /k/a Kimberly E. Agger STATE OF WISCONSIN ) — - ) ss. n ^• County ) authenticated thi .� day of January 2002 — Personally came before me this day of _. the above named • Kristin Ogland - - - -- TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Sta[s.) — instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY r Attorney Kristin! 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. Inrormarion Profess orris compae Fond du U4 wl STATE BAR OF WISCONSIN aW - 655 - 2021 WARRANTY DEED FORM No. 2.1999 JUL' ^� "''�� �► _LL 47.816 6' SL aol><�., W CEP T I FI ED SUP VE Y MA Located in the NE /4 of the NE /4 of Section 8, T29N, R 18W, Town of Warren, St. Croix County, Wisconsin. Surveyed for: Anne Kurkowski 1020 99th St 1 Roberts, Wi.54023 (715) 749 -3772 q # HARVEY G. C.S.M. C.S.M. = JOHNSON O VOL VOL. 3 HUDSON North line of the N1 /4 Corner PG. 694 PG. 86o W'S NE1 /4 go, � � �o Section 8 (S890I7'3d'W) I (S89 0 17'30 'W) �� ENO SURV� N 88 45 27 r E i������1ta�� ---5 99'08' 40 "E 897.29 _ - 1 LOTH-AV O F33 0 OIL �� �G Se Corner 88'45'27 "E Q O Section 8 \T29N R 18W 301.16' ' •••••••_•-- •••••••••• � ���J I Ea st line of the � (3 2 tS� \ I� NE1 /4 r - i S Approximate -I �' C �I L- �'— perc'd areas '' �- J \ Z n c� S, tfl I- �fi N I aj ILO Y 1 3 442,610 Sq • Ft. u°r o ( I 01 io (101.16 Ac.) 3C `oo 7 w n - I t 0 � Including right - of - way m m, '� 7 \ \ 1 Iq 427,367 Sq. Ft. a �� 01 .81 Ac .) e+ -+. ;' Excluding right -of -way G J a1 Z. LL ®1T 2 \�\ > I _J1 Z ;25'e I Q 1 296,930 Sq. Ft. \ zl (6.82 Ac.) QI, �� to T Inc. right -of -way w s w 261, 366 Sq Ft. Op (r) 01 (6.00 Ac .) in m� Exc . right-of-way ? �+ o I 852.18" 4 o a 'i ( .x..' . i ......... 10� ° rn �O 5 . 18 . . .............397.00' ...: N•. 1 cn N 88'00'41 f W T 885.21' UN PLATTED LANDS 1 j N88 001 it "W LEGEND — — — — — — - I ( ;N00 19 "W Section Corner Monument HOT . OT H 1604.43' ST 0 1 "X24" Iron pipe weighing 1.68 lb s /lin. 5 ft. set.. Q ..............Building setback line.. (distances indicated) E44 4 Corner . yr.� Section 8 ( R) Previously recorded information. r UL 2 4 1091 T2�N, R 18W � st. CI'OIXCC�I- 11<!�Y NOTE: Joint driveway easement approximately 40' square perpendicular to r ead at lot ANDZOr „r.�; �c:�r,:nitirf; corner. SCALE IN FEET 1 200' Bearings referenced to the East line of the NE1 /4, previously recorded as 0 200' 400' S00 19 "E This instrument drafted by 4911897 VOLUME, 8 PAGE 2382