The URL can be used to link to this page

Home My WebLink About042-1052-60-400 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: � INSPECTION REPORT 488142 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: Mortel, Dan Warren, Town of 042 - 1052 - 60-400 CST BM Elev: / Insp. BM Elevi BM Description: Sectionlrown /Range /Map No: 1 60 , 0 06 .O +vo-v^ TANK INFORMATION ELEVATION DATA TYPE MA UFACTURER CAPACITY STATION CBS 4 HI FS ELEV. FL S Septic Benchmark / W t56Q LSD -.So •lS .��' ac.o Dosing I t Alt. BM Aeration Bldg. Sewer izww t Holding St /Ht Inlet / St/H Outlet f TANK SETBACK INFORMATION / TANK TO P/L WELL . Vent to Air Intake ROAD Dt I nlet / ep ic y ^/ =eader/M�in. ,Ta A / O µ �. �r Ib d VS Tf osing tLt,J u 2 t J 1 A eration J T Is • HIP o o Ing o . ys em ("Y74 Z 3! • 3 �� 4• r inal Gracle P /SIPHON INFORMATION •a / t an urer eman over rk t u GP . um er lima .� 6K a ia. a )N SYSTEM 8 D21,3701 31 70 CeQ. 4 ( INFORMATION CHAMBER OR �J - 4aeW�� I b -I-,b UNIT Qgrrtu2 . V. d.� 6 S — (o Pipes) �_ Length ength Dia Spacing I x Pressure Systems Only xx Mound Or At - Grade Systems Only Bed /Trench Center Bed/Trench Edges Topsoil Yes No Yes No CO MENTS: (Include code dis%epencies, persons present, etc.) Inspection #1: ' ��_ Inspection !e _ _ -0 $U1/ 1/4NW 1/419I29N R181IU} -AIA l.o 3 \ 1 1.) Alt BM Description = 1 5. - r. VA6,^�A14 -5�4 �`• �� Cis u� yd�: 2.) Bldg sewer length = "`• so �' tJ `� :� 9k 6 "" v� j LL*" / amount of cover = 7 f n �.� Plan revision Required? Ej Yes XNo Use other side for additional information. SBD -6710 (R.3/97) Safety and B P uildi vision County ` 201 W. Washington A e., . Z.J 62 �p , pisconsin Madison, WI 707 - Sanitary Permit Number (to be filled in by Co.) (608) 2 6 -3151 �� `� , / / Department of Commerce 0 `1 �� y Z- Sanitary Pe i plieati n j State P n I.D. Number In accord with Comm 83.2 1, Wis. Adm Code,' ers al informa on yoto7o do ' �(' may be used for secondary pulp es P I-aw, s 15. 1 (m) RQ /X L � Proje t Address (if different than mailing address) 1. Application Information - Please Print All Inf matlo 0 7 V 7 ( Property Owner's Name arecl # Lot # 3 Block # 0$ r� 2- U -Yvo Property Owner's Mailing Address / Property Location G `C� p /[_P f'✓Z Gi7 �vZt � ) Wr /., ' • Li l l, Section 7� City, State / Zip Code Phone Numberr ,�j q [ ? w Z' 3 // - f ! 1- U% y' T N; R �CJ (c ' 0 c (.2 1J II. Type of Building (check all that apply) p /c 4 subM,'P A I or 2 Family Dwelling - Number of Bedrooms V 0/ems Subdivision Name CSM Number ❑ Public /Commercial - Describe Use (Ac- oo I ( � � bQSewtC � VIZ- 53- ❑ State Owned - Describe Use 2 Q S4 - 1, C- ❑City_ ❑Village UTownship of tjcq iV �'EH III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. „New S ystem ❑ Replacement System g p y g y ❑ Treatment/Holding Tank Replacement Onl ❑Other Modification to Existin S B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: Check all that appl ,Non - Pres surized I n- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Saad, F 1 1) Recirculating Synthetic Media Filter JKLeaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) cAg V. Dispersal/Treatment Area Information: c� `31 � rti Design Flow (gpd) Design Soil Application Ratc(gpdsf) Dispersal Arca Required (sf) Dispersal Arca Proposed (sf) Systc levation� VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units n Concrete Constructed Glass New Existing Tanks Tanks P Septic or Holding Tank Aerobic Treatment Unit X l.. �c� v Dosing Chamber VII. Resp onsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plat 's Name (Pri t) Plumber's Signature f I MP/MPRS Number Business Phone Number '1/N C�Lrrsr -- 11 Z �j S z Plum 's Address (Street, City, State, Zip Code) 3 l' 2 Gv � `✓ � z - 7 VIII Coun /De artmen a Onl Sanitary Permit Fee (includes Groundwater Datc Issue Issui Agent Si tur o Sta s) Approved isapproved Surcharge Fee) ) q ❑ O rven Reason for Denial IX. Conditions of Approval/Reasons for Disapproval SYSTEM OWNER: 1. Septic tank, effluent titter and dispersal cell must all be, as per management plan provided by plumber. Z. AN setback Mgldre M"ft must be fralintainad a$ per appk0a bade / erd finances. Attach complete plans (to the County only) for the system on paper not less than 8It2 x It inches in size SBD -6398 (R. 01/03) JOB TIMM EXCAVATING Route 1 BO 192 SHEET NO. OF WILSON, WISCONSIN 54027 CALCULATED BY DATE = -ab f MPRS 2 *3224W1 MPCA 3 #696 MN / r' CHECKED BY DATE /1SA l^ Z ! SCALE -'/ Yp� v ! i i .........a ................._ ................................... i..........:..........: ......... ..........:.................. .... .... ........6.... ..... ...i................. .... .... ....... i ..:............................ ;..................... i ! i -i i ! ! ry ! i ... .. .... .... .... .... ............................... ....... .... - ...... .1,p -..,............:.. .........:- .................... a......... ............................... ..... ..1........... a.. .... ....... �................ ... .... ................. ......:...........i......,..... .... ! i ! : ! ...............i......... .... .... .... ..... .... .... .... .... ..... ..... .... .... .... ... i �3 ,...... ..........::........ .... .... ..... T .......... ........... > ........ ..... ....... e.. . ....................e.......... .... ....... ..........i .... .. {......................i.. .........1,..........o.......... .............. ..... ..... ..... .... .... .... .... .... .... .. .... .... .... ...................... ..... .... ... i .........:...........c.. .......i .......... e .................................. i,........ .... .... .... .... .... ..... ..... ..... .... .... ...................... . ..... .... .... .... 1 i i i i i i i e ..... .. ..... .... .... .... .... ........... .............. j...('. l .,. i... ........:- .........e..........F .... ..... ... ..... .... .... .... .... ...,. ..... .... ........... .... ..... .......... .... .......... .... ... .� i ` ? .... .... . ... ..... .... .... .... .... ... ......... s ........... .>..........a�j.....e.......... o .......... .......... i...........1,.... .... .... .... .... ... ..... .... .... .... .... i i J'� x e i _ j . (. .... ..._ ..... ..... ..... l Q i !P Y: A S J e / i i i �a ' . � .......... ... ... ��` .. >... \N r ... .. .. ... ... .. ................. .. .. .. ... .. i.. ...... ... .... ... ... .. �. C rC /,� ! aka.... .. ... ........ ........ ':...... .' .......... ,� �:i . .... ... 7 . .. . .. . ................. ... .......... .. 1a3 • if A��f '� �. _.;. .. . _..... f ........ - li ........ ...:... .. ...... . PRODUCT 205-1 Inc, Groton, Mau. 01471, To Order PHONE TOLL FREE 1- M225 -M JOB TIMM EXCAV SHEET NO. OF Route 1 Box 192 WILSON, WISCONSIN 54027 CALCULATED BY DATE (715) 772 -3214 (715) 386 -5443 P'/ MPRS #3224 WI MPCA #696 MN CHECKED BY DATE �' ;L �� i 1 / l Z f SCALE C�. )r p .... .... . ......:... i E a 5 ............................ ... ... .... I i 1 S �ta- W , ....... i.... ....................< ............................... ............................... .... ..... ..... ..... ..... .... .... .... .... ... .... .. .... .... .... .... ..... ........... .... ... ... ...... i... ...;... .... Ci ............... ; ...... ... .... .. ... ..... cd ? ................ :................. ;.. ... .... ..... ..... .... .... .... ... .. ..... .. .... ... ..... t ... d r . ........ :... �\ X .. ... .... .. ......... t: .. ....... / � �... ....... 6G� lG t,, c /` �; .._.. 7e �t2sb� .... _ ... f�bUSe ... . :S�' ._ _ . ................. ............ - ---------- ----------- ---------- ........... Jai �3 z., 5 .......:..: ....... PRODUCT 205 -1 Ina, Groton. Mau. 01471. To Order PHONE TOLL FREE 1-800- 225 -6980 ORIGMAL V isconsin SOIL EVALUATION REPORT #2430 Department of Commerce , in accordance with Comm 85, Wis. Adm. Code Page 1 of 2 Division of Safety and B 'Idings Certified Soil Testing, LLC County Attach complete site plan on pap�northrarrow, 11 inches in size. Plan must include, but not limited to: verticence point (BM), direction and — percent slope, scale or dimensioocation and distance to neare st road. Parcel I. . 42- 1052 -60 -400 Please print all information. Revie d By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). y( /$ Property Owner Property Location Mortel, Dan Govt. Lot SW1 /4, Nil /4, 19, T29N, R18W Property Owner's Mailing Address Lot # Block # Subd. Name or CSMO 106 French Court 3 1 Woodhill Land CSM, V 16, P 4376 City State Zip Code Phone Number L_ City ❑ Village U Town Nearest Road Roberts WI 1 54023 1 715 - 749 - 0194 1 Young Road /92Nd Ave. New Construction Use: Z Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement 11 Public or commercial - Describe: Parent material loess over outwash Flood plain vation, if applicable NA ft. General comments install "conventional" in- ground trench system @ system elevati 3.5' b low surface contours / 0.7 and recommendations: gpd /sq ft loading; supplement to 5/8/02 Gustum report Boring # Boring X Pit Ground surface elev. 103.3 ft. Depth to limiting factor > 84 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistenc Boundary Roots GPD /ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 •Eff #2 1 0 -8 10YR 2/1 - sl 1 f -m sbk mvfr gs 1m .4 .7 2 8 -16 7.5YR 3/3 - sl 1 m sbk mvfr gs lm .4 .7 3 16 -24 10YR 4/4 - Is 0 sg ml gs lm .7 1.6 4 24 -84 10YR 4/4 - s 0 sg ml - .7 1.6 � r Pit dug to extend available ngth from Gustum report for Humbird Land Corporation ` Effluent #1 = BOD > 30 < 220 mg /L and Tf S >30 < 150 mg /L " E t #2 = BOD < 30 mg /L and TSS < 30 mg /L CST Name (Please Print) 'gn ture: CST Number Henry F. Grote 222774 Address Certified Soil Testing, LLC Date Evaluation Conducted Telephone Number E. 4366 353rd Ave. Menomonie, WI 54751 4/3/2006 715- 233 -0398 SBD•8330 (R.07 /00) ioun 4wku4 1 � I � T � f Ir 1 �e d m j ` t r t{ s % 1 I r 1 1 CD ^ I I 1 I 1 1 ' j r 1 1 1 I I I 1 1 r one � i I I a 1 I I 9 m m `, I I own 4odwd - I � d Sa .so s J t s d1 I , ' I 1 I T I C14 I i W' f �J 1 w 11 11 Il c 4W 1 '�` � 1 1 1 I i i i 1 1 � sl°� It I jl I 1 � I d 3 I 1 1 i � •j� 1 1 1, 1 Q � _ U 1 m Q RECEIVED 1567 Wisconsin Department of Commerce SOIL EVALUAT14 IN R FMRT o 7002 Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Ad n. Code Gustum Septic Service LS Z(Attach complete site plan on paper not less than 8' %x 11 inches in size. Plan must NING OFFICE Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. arce . D. _ in Please print all information. Y1e ,,, e gy Date Personal information you provide may be used for secondary girposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Z Humbird Land Corporation Govt. LqL n/a SW 114 NW 1/4 S 19 T 29 N R 18 W Property Owner's Mailing Address Lot Block # Subd. Name or CSM# 332 Minnesota Street, East 1404 3 n/a Vgl Pending CSM y3 7 City State Zip Code Phone Number ity J Village Town Nearest Road Saint Paul MN 1 55101 1 651 - 222 -5555 Warren I Young Road / 92ND Ave. jo New Construction use: 1+! Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe: Parent material outwash plains Flood plain elevation, if applicable n/a General comments and recommendations: Part of 3.29 acres. BM #1= 100.0'. BM #2 = 104.6'. 6�� la Or M Am Boring # , J Boring Pit Ground Surface elev. 101.5 ft Depth to limiting factor >80 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 -E 1 0-12 10y2/2 none sil 2msbk mvfr as 3f, 1m 0.5 0.8 2 12 -25 7.5yr4/4 none sil 2msbk mvfr cw if 0.5 0.8 3 25-38 7.5yr4/6 none sl 2msbk mvfr cw - 0.5 0.9 4 38-80 10yr5/6 none s 1 gr. s 0 sg ml - - 0.7 1.2 ti U Boring # Boring V1 Pit Ground Surface elev. 103.1 ft. Depth to limiting factor >80 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Q PD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 •Eff#2 1 0 -11 10y2/2 none sil 2msbk mvfr as 2f, 1m 0.5 0.8 2 11 -27 7.5yr4/4 none sil 2msbk mvfr cw if 0.5 0.8 3 27 -35 7.5yr4/6 none gr. sl 2msbk mvfr cw - 0.5 0.9 4 35 -80 10yr5/6 none 1 gr. s 0 sg ml - - 0.7 1.2 7 " 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 CST Name (Please Print) Signature: CST Number Tom Gustum 227618 Address Gustum Septic Service Date Evaluation Conducted Telephone Number N13450 937th St., New Auburn, WI 54757 5/8/02 715 - 658 -1344 r y Pro erty Owner Humbird Land Corporation Parcel ID # _pending Page 2 of # J Boring 16 Pit Ground Surface elev. 102.7 ft Depth to limiting factor >80 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-1.1 10y2/2 none sit 2msbk mvfr as 21, 1M 0.5 0.8 2 11 -22 7.5yr3/4 none sil 2msbk mvfr cw if 0.5 0,8 3 22 -36 7.5yr4/6 none gr. sl 2msbk mvfr cw - 0.5 0.9 4 36-56 7.5yr5/6 none gr. Is 1msbk mvfr cw - 0.7 1.2 5 56-80 10yr5/6 none s / gr. s 0 sg ml - - 0.7 1.2 F-1 Boring # -j Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Sal 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 F j Boring # _j Boring Pit Ground Surface elev. ft Depth to limiting factor in Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPDAF 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. Property Owner Humbird Land Corporation ' paroel1D # ring Page 2 ofd_ a Boring # Boring Pit Ground Surface elev. 102,7 ft Depth to limiting factor >80 in. Sal Application bate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munson Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 IOy2/2 none sil 2msbk mvfr as A 1m 0.5 0.8 2 11 -22 7.5yr3/4 none _ _ sii 2msbk mvfr cw If 0.5 0.8 3 22 -36 7.5yr4/6 none gr. sl 2msbk mvfr Cw 0.5 0.9 4 36-156 7.5yr5/6 none gr. Is 1msbk mvfr ow - 0.7 1.2 5 56-80 1 Oyrs /6 none s / gr. s 0 sg ml - - 0.7 1.2 F Boring # 21 Boring Pit Ground Surface elev. ft Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munson Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 " Eff#2 F-1 Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Apples Rate Horizon Depth Dominant Color Redox Descr pion Texture Stricture Consistence Boundary Roots in. Munson 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 S.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. 1 1 D w 1 n v / 1 ao 1 / 1 c 1 1 I 1 1 1 I I t O p� i i 1 I V , 1 1 Gullctwd I i 1 N 1 1 I c I 1 1 G � � N 1 1 I L 1 1 1 1 1 I I 1 ` C 0 1 1 1 0 N 1 1 1 N � y -' ; �■'� N ■ � , 11 II II � W r r ' o - r o 1 W � � 1 o m v m I w n g cn m Ctl c� o> o S Z 1 C g. `0 1 1= r m 1 m 1 T. or I 0 � l ro 1 1 w 1 C. 4 i N m- a�ccomm r C S 3 zz on — l i p w 8 W 0 -► w n iQ Property Line D w v '1- APPROVED 6 9 1 2 5 ST. CROIX COUNTY VOL _ 7 6 PAGE 43 76 Plannina Zon :4 r4 PvAS Committee KATHLEEN H. b/ALSH SEP 1 7 2002 REGISTER OF DEEDS ST. CROIX CO., MI 11 not rsax ��I RECEIVED FOR RECORD .ppfOV.l ds� d�� F 1 E D SURVEY MAP 09 -20 -2002 11:00 A �� ""Wb%'rED IN PART OF THE SW1 /4 OF THE NW-1/4 CERTIFIED SURVEY MAP OF SECTION 19, T29N, RI 8W. TOWN OF WARREN, REC FEE: 15.00 ST. CROIX COUNTY, WISCONSIN. COPY FEE: 4.00 SURVEYOR S & N LAND SURVEYING NW CORNER EN OWNER DOUGLAS E J. STREET STREET & SECTION 1 9 WOODHILL LAND, LLC HUDSON, W W I $4016 Z E1404 FIRST NATIONAL BANK BUILDING HUD r 0 332 MINNESOTA STREET W c ST. PAUL, MN 55101 W ! P3 1 ------- -- -------- --------------- - - - - -- NORTH LINE OF THE A N89 1'55 "E 487.38 SW 1A OF THE NW1 /4 PA 2 , 1.80' 215.5e' N4 c m q r- LLJ i � � i z uj LOT 2 o ;� U a p 2.39 ACRES ° A C77 104,200 SO FT m w � LOT 7 N u� rn Z� 3.16 ACRES CA CO W = 137.608 SO FT O S cr N —�` o ------- - - - - -- - e 0Z$ g6 � w ♦ 1,04- '16 b S86*2 9'os"Yv_ - 0 ' °� o► - _ . es.00' 92nd AVENUE; -diAts- ME 238: i - 156.47' - 3.6T • - C N88 "E 30.14 — -- ��e 4 �� m LOT LOT E g 1 3 `117 ACRES m 0 r 89.366 SO FT " Q B O EACH PARCEL SHOWN ON THIS = FR A I W MAP IS BOTH WITHIN AND a ' ADJACENT TO SPECIAL DEEP CASING PIPE DEPTH REQUIREMENT AREAS ESTABLISHED BY THE 250,04' 260.04' WISCONSIN DEPARTMENT OF NATURAL RESOURCES AREA. O 789 °25'43 ' W 510.08' GROUNDWATER IN THIS AREA W � HAS BEEN AFFECTED BY (iS Uft�lPLA7 ED L ARaS LEGEND VOLATILE ORGANIC AA COMPOUNDS. OWNERS AND & ALUMINUM COUNTY SECTION CORNER OCCUPANTS OF EACH PARCEL MONUMENT FOUND SHOULD CONTACT THE DNR FOR 0 1 5/16 DIAMETER IRON PIPE FOUND INSTRUCTIONS REGARDING WELL W1 CORNER Q 1 DIAMETER X 18' IRON PIPE SET INSTALLATION AND S e TION 19 MAINTENANCE, AND WATER — — — — — — — — — — WEIGHING 1.13 LBS. PER LINEAR FOOT 100' ROADWAY SETBACK LINE SAMPLING. • 2 3/B" OUTSIDE DIAMETER IRON PIPE FOUND SCALE IN FEET 1 = 15O' X CENTER OF W RADIUS CUL- DE-SAC 150 O 150 300 (XXXXXXXXXX)Q PREVIOUSLY RECORDED MEASUREMENTS -4-- PROPOSED DRIVE LOCATION SHEET 1 OF 3 12 UTILITY EASEMENT Vol. 16 Page 4376 ST. CROIX COUNTY SE PTIC TANK MAINTENANCE AGREEMENT AND '',, OWNERSHIP CERTIFICATION FORM Owner/Buyer .06—o K t kl t Mailing Address le6 /'r oc,A Cote' Property Address 90 7 �7 v (Verification required from Planning & Zoning Department for new constru ion.) City /State k,i. t Is Ljr Parcel Identification Number T Z - w 5 2 - w - c7Cj LEGAL DESCRIPTION Property Location 1 /4 , fV IJ '/4 , Sec. d T 2 N R�W, Town of �Ja_t f Subdivision , Lot # 5 Certified Survey Map # �g ! Z S `J , Volume Page # /7 � 7 L —• Warranty Deed # 7 7( 3 6 , Volume <. & 7/ , Page # 6;5 't' Spec house yes o Lot lines identifiable es no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. 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. Number of bedrooms - 9 gel z PA J_ SIGN URE'OF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) S2 U, 77 C63 t, 2 6 7 1 P 0 3 9 KATHLEEN H. WALSH STATE BAR OF WISCONSIN FORM 1 - 1998 REGISTER OF DEEDS WARRANTY DEED ST. CROIR CO.. MI RECEIVED FOR RECORD Document Number 10/06/2004 01 :40PH This Deed, made between Nielsen Enterprises. Inc.. a Wisconsin Corporation, Grantor, and Daniel J Mortel and Jennifer L Mortel WARRANTY DEED EXEMPT R husband and wife Grantee. Grantor, for a valuable consideration conveys to Grantee the following REC FEE: 11. 60 described real estate in St. Croix County State of TRANS FEE: 285.00 Wisconsin (the "Property "): CCPFEE: PAGES: L Recordi Area Name and Retum Address , l NJ. ,_mct Title >O France Ave. S- T'; rst Fluor „ vN 55435 42 1052 60 400 Parcel Identification Number (PIN) This is homestead property. (is) (is not) Lot 3 of Certified Survey Map recorded September 20, 2002, in Volume 16, page 4376, as document number 691255, St. Croix County, Wisconsin. Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Properties good, indefeasible in simple fee and free and clear of encumbrances except Dated this day of September 2004 (SEAL) (SEAL) Thomas K. Nielsen, Pr ide Nielsen Enterprises, Inc., a isconsin Corporation (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, WENDY SWATZINA ) as. NOTARY PUBLIC St. Croix County -� authentica�4 As f �� Personally came before me this day of September 2004 the above named Thomas K. Nielsen. as President of Nielsen Enterprises. I nc. a Wisco In Cornoration to me known to be TITLE: MEMBER STATE BAR OF WISCONSIN the person who a ecuted the foregoing instrument (if not, apd acknRv.4edge the sam �` authorized by §706.06, Wis. Slats) THIS INSTRUMENT WAS DRAFTED BY V f2L Coldwell Banker Burnet Notary Public, State of Wisconsin 1301 Coulee Road Hudson, WI 54016 My commission is a anent. (if not, state expiration date: 4 -48405 � 0 b" ) (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. 1 ✓ Q T I r o -. • MniH WEATNERPa00F JUNCTION LACKING COVER �t 4�iI�N � 4w,cv. 4" C.I. Iw` ft0%pM*p6N1M6 CG- C.I. PIRG 3' 4T0 NDI.STuRBED SOIL. 241, LD. VENT ' BILLOW tAANUOLE 4 � N ,LY, MIN. NO.t pp►�itOVtD A - f_. Z . vu- ,sbmT 30wr6 WFLES ALUXC 3' o•r�o .L PJIL 4 ON wcC�stuic>S_ �KN ECTI O" (I RDU1�0 C.. N l.Cv Ow pvAp Go�6r'F SEPTIC t SPEGIFI V DOSE TAWKS NMA►JU FACT UILER: WLIMBER OF DOSES: g PER DA4 TAAJK SIZE: Z - GALLOUS DOS[ VOLUME ALARM MAAUUFACTUK&R: S� F �a � o IIJCLUOIIJlo 5ACKFLOW: 1 GALLOWS MODEL NUMbEK: I ° `' CAPACITIES: A= 2 7 ,72 IMCNE5 OR w /� GA LLOIJS SWITCH Ty /E: — v..a�.a...` D g c Z INCITES OR Z 2- CALLOUS PUMP MAIJUFAC.TUIt[R: C 6 ' INCITES OR / GALLOUS MODEL WUMpCR: 'C Q Oc I I) D L' INCHESOR Q 6 -" 7 GALLOQS SWITCH TSIPE: - � ►Sw. MOTE: PUMP AMD ALARM ARE TO BE MINIMUM OISCNAft" $LATE_.d_G ►M1 ✓ INSTALLED ON SEPARATE CIRCUITS VERTICAL DI /FER[IJCf OETWEEU PUIhP OFF AUO OISTRI&UTIolJ PIPC.. 1.oS FEET I + MIAJIMUM NETWORK SUPPLY PKESSUR .... ..... .. � Q FLET + � FEET OF FORCE MAIIJ X I ' 1 F /portFKICT101J FACTOR —QuAL FEET g ,�i3 TOTAL Oy1JAMIC HEAD — FEET v" IIJTERAJAL. DIMEU6106JG OF TAIJK: LENCrTH �'� ;WIDTH C� ;LIQUID DEPTH �$ Goulds Submersible Effluent Pump 38 71 EPO4 EP05 PU LIONS fasteners: 300 series • Fudy submerged in high ■ Motor Housing: Cast iron ., 1tc Inless steel.' grade turbine oil for for efficient heat transfer, 4 igned for the lubrication and efficient stren th, and durabili �d11oW1 Capable of running 9 ty• dry without damage to heat transfer. ■ Motor Cover. Thermoplas- ems components. tic cover with integral handle • Ho AvaPable for automatic and 9 '. Motor and float switch attachment manual operation. Automatic ' °. • Hea' sump • EPO4 Single phase: 0. 550 models include Mechanical Points. 115 or 230 , 60 Hz, ■ Power Cable: Severe du Water,transfer FloaL. Switch assembled and ty Dewaterir - -RPM, built in overload with rated oil and water resistant. 9 preset at the factory. Bearings: Upper and lower automatc reset. SPECIFIdATIONS • EP05 Single phase: 0.5 HP, pEAYURES heavy duty ball bearing 115 V, 60 Hz, 1550 RPM, TO ■ EPO4 Impeller: Thermo- mp' Ems; built in overload with construction. • Solids (laiidling capability: automatic reset. plastc Semi -open design .; rflaximurn. • Power cord: 10 foot with pump out vanes for AGENCY LISTING ?.0. standard len gth, 16/3 SJTO ::u to 55 GPM. 9t , P a up to 24 feet. with three prong grounding mec'tanfcal seal protection. C Canadian Standards Association -To , m EP05 Impeller: Thermo - jD size: 1 /2' NPT. plug. Optional 20 foot P g (CSA listed model numbers ' seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in 7" or "AC ".) jury` remic- stationary, three prong grounding plug improved performance. BUNA- elastomers. (standard on EP05). ■ Casing and Base: Rugged •';Tempewii: thermoplastic design provides 40°C) continuous superior strength and L.140`50C) intermittent. corrosion resistance. Fastener's: 300 series METERS FEET stainless steel. 10- dry damage to s 30 runnin 5 GPM components. Pump: EP05 8 -- 2.5 FT • Solids handling capability: 25 l _ '/, maximum. -- - - • Capacities: up to 60 GPM. = s 20 • Total j ids: up to 31 feet. ;Discharge size: l'fr' NPT. •`Mech s — - -- - -- - — _ - -- - e ani cal seal: carbon - 'rotary'�dfamic- stations ° 15 - ry, ` a ,,BU eiastomers. . NA: � • Temperature: 3 10 104 °� 40 °C) continuous ; 140°F 60 intermittent. 2 __ -_ -- *.. i 1 .0 00 10 7 311/ 20 30 r0 50 GPM C 2 1 6 8 r 10 12 m CAPACITY t. s y ®1895 Gpuk� Pumps, Inc. Effective May. 1995' ent S System Management Y g Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, Timm Excavating, 715- 772 -3214, or the St. Croix County Zoning Office, 715- 386 -4680, should be contacted for assistance. General Proper functioning of an on -site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or compartment to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. 1 f the septic tank is installed prior to sheet -rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. Install water- saving appliances whenever and wherever possible. 3 Repair even small water leaks as soon as possible. 4 Never pour grease orbil down any drain or stool. Garbage disposals are not recommended; if you must have one, use it sparingly. 6 No paper products other than tissue should go into the system. - do chemicals should go into the system. 8 A oid surge flows of water; try to spread laundry throughout the week. Maintenance i The septic tank must be inspected every three years by a properly licensed person. I f necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back - washed into the septic tank to remove accumulated material. Periodic observation pipe inspections should be made by the homeowner to examine the state of the in -situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6 The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or ratio days should pass before any necessary repairs can be made. .-avoid compaction such as vehicle traffic within 15' down -slope of the adsorption system. 8 .Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9 Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 0 Surface drainage must be diverted around the system; avoid landscape changes which might send surface run -off into the system area. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitorins ma become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 i?j Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and�or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 Ce9 �Q �y'e ' Dyt ' 0.s'A Go 69 1 255 APPROVED .� ST. CROIX COUNTY ` n' j g. i VOL 6 PAGE 4376 Plannlno Zoninn and Parks Committee � j04 �A9 G KATHLEEN H. _ ---- --,_ -- wALSH �'�- �o Go '�° ZgrO REGISTER OF DEEDS SEP 17 ZOOZ ST. CROIX Co., CO. WI RECEIVED FOR RECORD ppprova da1�Il�� FI ED S U R MAP 09 -20 -2002 11:00 A nu td + G Y krED IN PART OF THE SW1 /4 OF THE NW1 /4 CERTIFIED SURVEY HAP OF SECTION 19, T29N, R1 8W, TOWN OF WARREN, REC FEE: 15.00 ST. CROIX COUNTY, WISCONSIN. COPY FEE: 4.00 SURVEYOR PAGES: 3 S & N LAND SURVEYING NW CORNER OWNER DOUGLAS J. ZAHLER SECTION 19 WOODHILL LAND, LLC 2920 ENLOE STREET E1404 FIRST NATIONAL BANK BUILDING HUDSON, WI 54016 �� 332 MINNESOTA STREET ST. PAUL, MN 55101 is N . . CS r i En § w UNIPL�,ATT ED LANDD S NORTH LINE OF THE N89 °11 ` 55 "E 487.38 SW / OF THE NW1 /4 271.80' 215.58' I I N I I Z 1 F- cn C=q 0 0 O I� Z \ Z lO IO 11 = C • I W - 1I Gl m O O LOT 2 v, w cr w m ° a p 2.39 ACRES LL I O 104,200 SQ FT rn I� $ 0 o LOT 1 m ; z O1 3.16 ACRES (x ;� Z I 137,608 SO FT V 1� g to 1 - Inn 1 / � I \ , $.r _ I 1 i ° 16\ A z ca , , - g7g °Z� Q y � ( �$ 3 °31'04 "E m ° ' 10 k, c 66.00 92nd AVENUE �, - �� _ gpE Z 166.47' - - 3.67' NOW29 S "E 30.14 1 N p V M Z Q 0 --4 LOT 3 c LOT 4 60 3.29 ACRES I� I I Q 0 • Oo ; I 2.05 ACRES 74 SO m , w 89.366 SO FT m O , 1� 1 N Z C W i� 0 EACH PARCEL SHOWN ON THIS N = m MAP IS BOTH WITHIN AND mm ADJACENT TO SPECIAL DEEP CASING PIPE DEPTH REQUIREMENT AREAS ESTABLISHED BY THE 250.04' 260.04' I WISCONSIN DEPARTMENT OF NATURAL RESOURCES CDNRI. O S89 ° 25` 3 r J� 0.��` GROUNDWATER IN THIS AREA �+'� -+ HAS BEEN AFFECTED BY N c8 MUG? _ L� ,G_�,`if�__CD__L�,G_�_1_U��_1D� LEGEND VOLATILE ORGANIC w COMPOUNDS. OWNERS AND A N ALUMINUM COUNTY SECTION CORNER OCCUPANTS OF EACH PARCEL W MONUMENT FOUND SHOULD CONTACT THE DNR FOR 0 1 5/16" OUTSIDE DIAMETER IRON PIPE FOUND INSTRUCTIONS REGARDING WELL W11/4 CORNER Q V OUTSIDE DIAMETER X 18' IRON PIPE SET INSTALLATION AND SECTION 19 WEIGHING 1.13 LBS. PER LINEAR FOOT MAINTENANCE, AND WATER - - - - - - - - - - 100' ROADWAY SETBACK LINE SAMPLING. • 2 3/8' OUTSIDE DIAMETER IRON PIPE FOUND SCALE IN FEET 1 " = 150` x CENTER OF 80' RADIUS CUL -DE -SAC 1 SO O 150 300 PaXXXXXXXXX) PREVIOUSLY RECORDED MEASUREMENTS �-- PROPOSED DRIVE LOCATION SHEET 1 OF 3 12 UTILITY EASEMENT Vol. 16 Page 4376 Parcel #: 042 - 1052 -60 -410 04/18 /2006 04:40 PM PAGE 1 OF 1 Alt. Parcel #: 19.29.18.295D 042 - TOWN OF WARREN Current [xi 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 O - MORTEL, DANIEL J & JENNIFER L DANIEL J & JENNIFER L MORTEL 106 FRENCH CT ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 907 87TH AVE SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 3.290 Plat: 4376 -CSM 16/4376 042/02 SEC 19 T29N R1 8W PT SW NW LOT 3 CSM Block/Condo Bldg: LOT 03 16/4376 EZ- RD- 1990/589 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 19- 29N -18W SW NW Notes: Parcel History: Date Doc # Vol /Page Type 1010612004 776352 2671 /039 WD 10/11/2002 693700 2007/486 WD 09/20/2002 691255 16/4376 CSM 08/26/2002 688137 1958/256 ARE 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/11/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.050 35,000 0 35,000 NO Totals for 2006: General Property 2.050 35,000 0 35,000 Woodland 0.000 0 0 Totals for 2005: General Property 2.050 35,000 0 35,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ��. S �� / \ �v`� 7 Department of Industry SOIL AND SITE EVALUATION / 3 Labor and Human Relations Page of Division of Safety and Buildings in accordanc$ y I r 09, Wis. Attach complete site plan on paper not less than 8 1/2 x 11 inches* ,I( . Plan �st, ;' ounty Sl C/po!•3C Include, but not limited to: vertical and horizontal reference point,�Biul�, directiory ;M percent slope, scale or dimensions, north arrow, and location aMAjoanc�jo neares�t4j ,Pfi cel I.D. # f DyZ - - APPLICANT. INFORMATION - Please print all /nfbrirtwation- J, r c R iewed by Date Personal Information you provide may be used for secondary purposes (P j Property Owner p ,4 UL 13 I t ON Pr LooQU o �j VIA! G N �� bit 1/4 NF1 /4,S t' / T 2 ,N,R A E (or� Property Owner's Mailing Address � / � O lock# Subd. Name or CSM# .33 / •So r sT . y •3 Csm City State Zip Code Phone Number ��/ Nearest Road Sr• P L A A) . SS�o I ( &S/ )2.2.2- • 95Y5 City El village i' Town yOZIA/ 6— RP LE rvew Construction Use: [B esidential I Number of bedrooms Addition to existing building ❑ Replacement 4�1 El Public or commercial - Describe: O •• Code derived daily flow (/Oa gpd Recommended design loading rate � _bed, gpd/f? trench, gpd/f1 Absorption area required _ bed, ft ft Maximum design loading rate bed, gpd /ft trench, gpd/ft Recommended infiltration surface elevations) .]�•� P - I it (as referred to site plan benchmark) Additional design /site considerations et /Pie e? L�� • /eFs �-1 p vu, P Parent material 149E.5 B Uri A. Z P et&Er T/L L• Flood plain elevation, if applicable N ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S ❑ U ❑ S ❑ U ❑ S ❑ U ❑ S ❑ U 1 ❑ S ❑ U ❑ S ❑ U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench / �z is SQL 2' .tbk s! cs 17 , s Ground 10 Hiq U SL Uf Al �-- '� • 7 elev. 7V IF L'I Depth to limiting factor Remarks: Boring # / 0• Y 3/3 51L I fSb e h C S / • S - w 13 • 15 10 -- Sl L 2. f sbk d e w, - • S 3 s. /o y -^ U S ?Coe fi s - -q: - Ground •G 7.5 ,j s. �, — ' 7 elev. cr gg4 Depth to limiting } r f or tn. Remarks: CST Name (Please Print) Signature Telephone No. Ro tieRr ZI�aR �C (4l 7 �s• 3g� • SASS Address Date CST Number g • ��'• t�'�'q zz�3, s UIbrIcht & Associates Private Sewage Consultants 655 O'Neil Rd. Hudson, Wis. 54016 ORIGINAL /��, SOIL DESCRIPTION REPORT PROPERTY OWNER �� 6 3 � � `'C/ Page ' of PARCEL 1.01 p e.vp/o G- GO T 3 CS-Al Boring # Horizon Depth Dominant Color Mottles ure Struct 2 Texture Consistence Boundary Roots In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 3 o •� JO b& d s e s 2. 34 / S/L ZAVII h� v C4i - . Ground USA / xiiii elev. � S yg Depth to limiting factor Remarks: Boring # Ground elev. Depth to limiting factor Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD In. Munsell Qu. Sz. Cont. Color Gr. Sz. ,Sh. Bed , Trench Boring # Ground elev. Depth to limiting , factor in. Remarks: Boring # Ground elev. n. Depth to limiting factor in. Remarks: SBDW -8330 (R. 08/95) r r w (,V F T L o i 4 - o V1 vti 0 0 o � b Z I � 1 Q N - C a � d c ' ' oT it d R W 0 S84 C L j nI 286,52 CD co LOT 3 C c r� � � CD 2.035 A C R co co co NN C � j 88,627 S � FT, o 0 ...................... C) ' V) r -- 261.00' 10 S88 °01'42' W - - - -- 66.00'