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HomeMy WebLinkAbout004-1025-70-000 ST. CROIX COUNTY ZONING DEPART lk ` AS BUILT SANITARY REPORT Owner J 6 % �c r Property Address 2 S . , City /State �/L� � Sys Legal Description: Lot Block Subdivision/CSM # ' /4 � �4, Sec. �, T?fN -RAW, Town of c�� PIN # GY�S�- /a�� 70 //, Z 8s 1S► 1 7S - SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer _ �� p � -p Size ST/PC 12-�;ol - 7:!�o Setback from: House Sy• Well /,9f 1 P/L As2-? Pump manufacturer tai / d Model �7 120 Alarm location ��.y�•� (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: ; Width j Length 1 1, 9 0 Number of Trenches / Setback from: House 95"_ Well &' PAL /co f Vent to fresh air intake ELEVATIONS Description of benchmark V r Il L,) c Iq Elevation /b t) Description of alternate benchmark A, oA 51, 5 &.-tyr Elevation Lbo, fie I?r Xc. AA4 .- Building Sewer 66 ST/HT Inlet / 77 ST Outlet PC Inlet PC Bottom %o, �z-7 Header/Manifold Top of ST/PC Manhole Cover 97 Distribution Lines () 9y 5�, () ( ) Bottom of System Final Grade () () ( ) Date of installation Permit number �y State plan number Z 3 i > Z 3i Plumber's signature -- License number zZhs z,� Date ,2 /Z4 vo Inspector 4111 i Complete plot plan e Y NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW 8M .ill S aip lV INDICATE NORTH ARROW Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM County: INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permi IX 3446 4 Personal information you provice may be used for secondary purposes [Privacy La s.15.04 (1)(m)]. Perrpii C Nam OE El City El of: State Plan ID No.: N , All 4P 2302 ;7_ = r" r�. CST BM Elev.:. Insp. BM Elev.: BM Description: _ ' Parcel Tax No.: 004 - 1025 -70 -000 I OD TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION 3.64 BS HI I FS ELEV. M Septic Q � �2S,D Benchmark s ly t o 3, 1 � D , r Dosing r Sk+ 10' s Leo . 83� Y Aeratio Bldg. Sewer Holding St/ Ht Inlet 3` 2.4 `t`t�•'��' TANK SETBACK INFORMATION TANK TO P/ L WELL BLDG. Ventto ROAD I 9•* . Q Air Intake k Septic �.� ' 5D NA Dt Bottom 12 `�� t 12.E 9 `1'Q• o�-�' Dosing t " 5'� / NA Header / Man. Aeration NA Dist. Pipe b 3• (o Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade 3 Manufacturer 0A1_ Demand 5-1 5 p S. D� V l S Model Number aj GPM TDH Lift 0� L oss riction ,9�� Systern, TDH �k•�lFt Forcemain Length r Dia. FFiit " Dist. To Well r SOIL ABSORPTION SYSTEM TRENCH Width ► Length 1 No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMEN DO DIMENSION SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACHING Manufacturer: SETBACK CHAMBER INFORMATION Type Of > /fi 1 �_ mod Number: System: S OR UNIT DISTRIBUTION SYSTEM Header / Manif d n Distribution Pipe(s) [! x Hole Size x Hole Spacing Vent To Air Intake G� f a / @r Length ia. 2 Length �L Dia. 2 Spacing f v D — SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil E] Yes E] No El Yes El No COMMENTS: (Include code discrepancies, persons present, etc.) 3 3 14 p � /� n LOCATION. CADY 11.28.15.175,NE,NE 482 320TH STREET ©C ca q , Z 22 ka + Plan revision required? ❑ Yes -PNo Use other side for additional information. 02 ZZ oo �(S SBD -6710 (R.3/97) yDRS , (� — �,e, Inspector's Signature Cert. No. a ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: p ... .w .. W + E a i t E e s E s e e + 8 ,. m - -_. .. ...!_.... ... ... a e _ E , ,.. ,,....,. mas ,e..... ......,e ..e .�e .. .. .... __ ...�. .._ .md _ ee i a i + � 3 � + S } 3 e 4 i + J i 3 t + e � 3 vem erm ...�,.. ,...�.e .. £ E e.. x y 9 e C _ + .tea. N ee t e.. .. ryW .,�.< a s ue....... .... .., ,.. e ....... .s.... ... ...... . _ �.. .._ .. e. .... .,ee wee. - s °e I ! ECE�VE� Safety and Buildings Division R 4 C S ARY PERMIT APPLICATION 201 W. Washington Avenue Mlisco accord with ILHR 83.05, Wis. Adm. Code P O Box 7302 Department of commerce �?,M 1 3 1999 Madison, WI 53707 -7302 • Attach comolety planIPFFICE ounty only) for the system, on paper not less County than 8 vi x \11nc,he26 �, 5 1 • ` • See reverse sifcm 1tructions r o pleting this application state sanitary Permit Number h Personal information you pro ' e or secondary purposes ❑ ch ck if revislo�o brevious application [Privacy Law, s. 15.04 (1) (m)). i�Z 3 � G f. 7 State Plan I.D. Number I. APPLICAT INFORMATI -PLEASE P INT ALL INF RMATION Z 3 Z3Z Property Name ro ty Lo O �a t /vim " e 4 L)V / 1/4, S , T Z(tj r Nr R /7 `�(or)© Property Own is Mailing Address Lot Number Block N r City, to Zip Code Phone umber Subdivision N me or CSM Number I. TYPLVOF BUILDING: (check one) E] State Owned ill N ear est Road Public 1 or 2 Family Dwelling - No. of bedrooms To of III. BUILDING SE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 1 00 – /U 7-5 70 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel / Motel 9 ❑ Office/ Factory 13 ❑ Other: specify IV. TYPE OF PERMIT (Check only one box on line A. Check box on line B, if applicable) A) 1. ❑ New 2. ;g Replacement 3_ ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System _____ ^ ______ Tank Only______________ Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 Mound 30 E] Specify Type 41 ❑ Holding Tank 12 E] Seepage Trench 22 In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate, 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation p Obt3 �oo� �8 ' Feet l!)/ 3 Feet r' Capacity Site VII. TANK in ga llons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper_ INFORMATION New Existin Gallons Tanks Concrete strutted glass App. Tanks Tanks Septic Tank Jaa /�Sc7 j r C.�' 11 ❑ ❑ ❑ ❑ Pump Tank r 7- f ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plu er's Name: (Print Plumb 's Signature: (No amps) MP /MPRSW No.: Business Phone Number: ,z4,5� 77 Z -3'z Plumb 's Address (Street, City, State, Zip Code): � � IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate Issued Issuing Agent Signature (No Stamps) P[ Approved F1 Owner Fee) Qwner Given Initial 7 el Adverse Determination 4" 3 Z.S- 00 ! X. NDITIONS OF APPR / REASONS FOR DISAPPPR A �� s Sr rte"` � Gc GLCal�vrcn tea✓ e � C.�� I a 'f N� C 1 W /_fat 1'" I P �;'�l �7��"i (a u� k/ . lr..) r.�� r J SBD- 6398 (R.11197) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved bythe permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to years_ 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608- 266 -3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mainstwater service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. I . Safety and Buildings 2226 ROSE ST LACROSSE WI 54603 -1905 - TDD #: (608) 264 -8777 Visconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda I Blanchard, Secretary July 20, 1999 CUST ID No.226524 ATT - POWTS INSPECTOR ZONING OFFICE ROGER L TIMM ST CROIX COUNTY SPIA 3128 20TH AVE 1101 CARMICHAEL RD WILSON WI 54027 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 07/20/2001 Identification Numbers Transaction ID No. 236232 Site ID No. 176833 SITE: Please refer to both identification numbers, , Site ID: 176833 above, in all correspondence with-the agency St. Croix County, Town of Cady NEIA, NEIA, S11, T28N, R1 5W Facility: Joe Menter Residence FOR: Description: Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 480413 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, DATE RECEIVED 07/12/1999 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 &erardM. Swim BALANCE DUE $ 0.00 POWTS Plan Reviewer - Integrated Services (608)785-9348, Mon - Fri, 7:15 AM - 4:00 PM jswim @commerce.state.wi.us Wig MAR 00 . de: 7633 Joe Menter - Mound Transaction # Location: NE 1/4 of NE 1/4, Sec. 11, T 28 N, R 15 W Town: Cady County: St. Croix Date: July 1, 1999 b "7 Owner: - Joe Menter S ✓i�� C �� 4A Address : 469 315t St . �✓� 6 Knapp, WI 54749 4&Cv Plumber: Roger Timm Signature: ' License # MPRS 226524 Attachments: 6748 -Plan Review Application SBD 8330 page 1: cover F �tpl� 2: calculations�t" 3: plot lan M p 4: system cross section 5: plan view, lateral detail o�FR'RS A� o ��,s 6: pump tank exit detail �N G G 7: pump curve CO —k SP page 1 of 7 II System Calculations One family residence 4 " bedrooms Loading rate L9.7 gallons /sq ft per day Depth to ground water T ' 3 in Depth to bedrock �' b in Cross slope g •S - ►V "� % Force main length 3� ft of Z in Manifold /header length of in Drainback �`- gallons Lateral length ' I @ a `O ft 9 f Z in Lateral elevation q -A- ft (bottom of pipe) Lateral hole size " in @ ( ' O ' O in ( S'O ft) spacing ° holes /lateral, �`� holes total Lateral volume � gallons Total lateral.discharge rate �3- gpm @ 2 ' i ft head Elevation difference ft Friction loss o ft @ 25 gpm 1� -0 Total dynamic head ft r � Pump /skpbon gpm @ ft of head Manufacturer ° "`` �S 3 } � Model # Dose volume gallons Lift /si�on tank �'" °'�" �za-a' ���D CO `�` � _ gallons Septic tank , �Z �`t� gallons Measurement pump on & off ,O `� in Height alarm from tank bottom in Reserve capacity 4' Z gallons talcs page Z of v � N to r0 -� � o c cr 0 6 c r bo s 3 d Q r � � d d ,► a �— fj o r C► r IJ • J S tf.+M � �ror 4 L ' � �, e. �t ova AAt �I 1 p� 10w Zu V. tQ ..r vr.t: � b s , .l ce:1 S wv�a� /; A ( C� '}mil �'� /IL•1�� e � S �h► ) 0.49 - v� � 1 s. d r x : '� L" 5 } � t a. \..�r Cc's v °� •.: v ., 1. i.a, � �,�. � �► oa..� aa,, CX.�.: V a., �j is •..� .�•! Vi Q 4�� P%JC. f+Q `k 10 4c-- o roc, k c t Qt S or`�. t � o � z � � e �• L � �t�v o r... Y o c.�c. 4s.,C S•o' ( So� � I S' l S'�� • it � l� of o •� , ..t a► , �-�► G. `01 � o •.► : » � � o. �» 5'• o ' J 10 �. o � a-S �o �•St ' MAIN • WE1►TIIERPROOF " JUNCTION LOCKING COVER GIICK WRta�r�GT� 4" C.T. lNtrtii,1►oN�M T T I. PIPG. 3' ro U0 Uft o L. Z 4" 5.10. Vi1�1T Tarr N1q�lllOf� � � fi MIN. 91q .Q APrPitorltR A C.Z. P1r IMT ODrir'J BAFFLES AL 3' oWTO . PI/i - Q V, urQCT10Mi i � — ,� � GRDY�IO LCD+, OLF g�•z� PWAP p b „ . torvcreEr� . LWV- 6�oC•C SEPTIC S PE C I F fCATI OU S U aosE TAWK MMJUFACTURCR: WUMOER OF DOSES: 3 S PER DAu TANK SIZE: 45� 606LLOIJS DOSE VOLUME , (.9 Le ARM MAmumcTNII,[R: S � 'O IMCLUD104CP OACKFLOW: &ALLOWS MODCL IJUMl►ER: ° ~�' CAPACITIES: A= 29 .q WCAE5 Olt � Z GALLONS SWITCN Tvpa : d c �` WCHES oA 1 Z¢ GALLOIJS PUMP 1AAWUFACTURCR: ° "`' _ C 1 iULHE5 OR ( Ls.) 2 GA MODEL AIUMOCR'. $ }, 0 1µ�;HES OR 4 � • - + L GALLOW6 SWITCN T%jPE: y " 4 '�'�'` �'��'�° MOTE:: PUMP AWD ALARM ARE TO bE MIWIMUMI DISCMAlt" KATC Z G►M INSTALLED OW 5EPARATE CIRCUITS VERTICAL DIFFEXEWA OETWE[y PUMP OFF AM DISTRIOUTION PIPE.. ' FEET ► + MIAIIMUM NETWORK SUP►Ly PREitURC ........... ^ ?•5 _ FCCT '3Z 1►\ F T,/ 0.N) ZJ + F O F rORCC MAIN X -- . 00VtFRICTIOIJ FACTOR..,__ FEET 14 TOTAL DyA AAIC. MEAD 1 r ' `� FEET k" ILITERWAL. DIMCWi101Ji OFr TANKS LEM&TN `Z � ;WIDTH � 4 �;LIQUID DEPTH �A�+ -1 �` of MO MO i Vertical • Pump P '1 Su bmersib le GOU LDS f °= r r� i I T— Pump Specifications . 1 I. HP METERS FEET to 40 GPM Up 10 MODEL 3871 Discharge size 1 NPT 6 30 Solids:'b" maximum Motor 35 Single phase: 115V 6 20 Materials of Construction 5 Brass/thermoplastic 15 EPOS Features and Benefits *Top suction eliminates _ impeller clogging. 2- 5 • Corrosion resistant 1 construction. ° 0 10 2 0 00 40 w us OY • Float actuated switch. 0 2 , 6 6 10 1 eA. C Pac�rr METERS FEET 26 MODEL DVPO3 Pump Specifications Features and Benefits '/1. and'/: HP • EPO4 impeller- semi -open design 20 Up to 60 GPM with pump out vanes to protect 5 15 Maximum head to 32' mechanical seal. 6 Discharge size 1 NPT • EP05 impeller - enclosed design C 3 10 Solids: 3 /4" maximum for improved performance. 0 2 6 Motor • Rugged glass - filled thermoplastic 1 All motors feature ball casing and base design provides 0 o L bearing construction. superior strength and corrosion 0 s 10 is zo 26 30 3• 40 U. S." resistance. 0 i : 6 e 10-W Single phase: 115V . Cast iron motor housing for cnrncm Materials of Construction efficient heat transfer, strength, Cast iron and durability. Thermoplastic *Corrosion resistant threaded Stainless steel stainless steel shaft. • Available for automatic and manual operation. • CSA listed models available. All Models are designed for continuous ration and feature stainless steel hardware. Aliscor4sin'Department of Commerce SOIL AND SITE EVALUATION Page.. _ 1- of 3 ,,9W ion of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code Certified Soil Testing Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix percent slope, scale or dimensions, north arrow, -md distance to nearest road. - Parcel I.D # L 004- 1025 -70 APPLICANT INFORMATION - P/ If alj informa>ton. -- - - - Personal information you provide may be used �dary urpp&s (Privacy Law, s. 15.04 (1) (m)). R By Dale Property Owner UL I " Property Location Menter, Joe f €- ivt. Lot NE 114 NE 1/4 S 11 T 28 N,R 15 W Pro Owner's Mailing Address "�g9 r t # j Block # Subd. Name or CSM# 469 315th St. >� ' - AOix 1 City State \Z Cod d ` City �_] Village XTown Nearest Road a - Cady 320Th St. New Construction Use: Res' 6 /W r edrooms 4 [Addition to existing building Replacement Public or commercial describe Code Derived daily flow 600 gpd Recommended design loading rate • bed, gpd /ft2 •6 trench, gpd /ft' Absorption area required 1200 bed, ft 1000 trench, ft' Maximum design loading rate - bed, gpd /ft2 .6 tr ench, gpd /ft Recommended infiltration surface elevation(s) 98.9 ft (as referred to site plan benchmar Additional design / site consideration install 5' x 100' rock bed mound on 97.9 as upslope edge of rock w/ t' sand fill Parent material sandstone Flood plain elevation, if applicable NA ft S= Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U= Unsuitable for system ❑® U M S❑ U ❑ S® U F] S M U S U S X U UttiUKIPTION 1111-M3111111 Depth Dominant Color Mottles Structure Roots GPD /ft' Boring# Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. ! Boundary Bed Trench 1 1 0-5 1OYR 4/4 - sl 2 m gr mvfr cs 2fl m .5 .6 - t f; 2 5 -20 l OYR 4/4 - sl 2 m sbk I mvfr cw 1 m .5 .6 Ground 3 20 -27 1 OYR 4/6 - Is 1 m sbk mvfr cw Inn .7 .8 elev - - -- -- — - -- . - - - _ 96.4 ft 4 27 - 33 l OYR 79) 5/6 - fs 0 sg ml cs 1 f 5 6 g - - -� - limiting -- 5 _ 336 +6 1 SSBR 6 t2f lOYR 6/2 fs 0 s � m1 Depth to - - - -� . C5_ 5 6 factor 33" Remarks SSBR is weakly cemented, monolithic - 2 1 0 -8 10YR 3/3 - sl 2 m gr mvfr cs 2flm .5 .6 � �„ 2 8 -16 lOYR 4/4 - sl 2 f sbk mfr cs 6 round 3 16 -39 1 7.5YR 3/2 - sl 2 f sbk mvfr c 5 elev 97..9 ft 4 39 -44 I OYR 7/6,6/6 f2f l OYR 6/2 scl 0 m I mvfr Depth to limiting - r 9 factor - 39" -- - -- - -- - - - - -- - - -- �— -- v7 � `, I Remarks: considerable SS gr 16 -39" / `, 7 ` ' ,,.,\r C CST Name (Please Print) Signature: Telephone No. Henry F. Grote "-' 715- 665 -2681 - - Certi i�ied — _ a -__ -- Address P.O. Box 57, Knapp, WI.54749 � 2277qumber Ref PROPS JY OWNER:- Menter, Joe _ _ — SOIL DESCRIPTION REPORT Page 2 df 3 PARCH.. LD.# 0 - 1025 -70 — Certified'Soil 1 esting a Depth Dominant Color Mottles Structure GPDIftZ C B oundary Roots ' - Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. onslstence y Bed ! Trench 3 1 0 -8 10YR 3/3 - sl 2 m gr mvfr cs HIM .5 .6 2 8 -31 10YR 5/8 - Is 1 f sbk mvfr cs 1m ! .7 .8 el ev d 3 31 -43 10YR 7/6,6/6 f2f IOYR 6/2 scl 0 m i mvf1 - - NP .2 — { - - - - - -- - - -r -- - - - 97 :i ft T � I Depth to limiting factor A Remarks: z Grou id I elev Depth to limiting -- — - -- - - - -- -- -- - -- - - -t _ ..___ } -- }_ factor Remarks Ground elev Depth to limiting factor Remarks: ! Ground - - - - -- — - - -- - ele ± _ Depth to limiting - -- factor �- - - - Remarks: N � rA M/ r o �J 7 � d a i v d d s lb c lb d � a M/ f �� �Q o s r A r C- t l qr Z -� i a � fl 1 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer a Mailing Address �/6y - Property Address (Verification required from Planning Department for new construction) City /State Parcel Identification Number 0 10,;! 7o LEGAL DESCRIPTION Property Location w `_ ' /o, et V4, Sec. % / . T 2 N -R _L W, Town of I Subdivision lxlclle,s Lot # Certified Survey Map # , Volume , Page # Warranty Deed # Volume . Page # Spec house ❑ yes ® no Lot lines identifiable 19 yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeyman plumber, restrictedplumber or a licensedpumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 s of the three year expiration date. p t�lCJ O l � l DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of e property described above, by virtue of a warranty deed recorded in Register of Deeds Office. 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 I I . VOL 1430Pw314 KATHLEEN H. WAL.SH DEED REGISTER OF DEEDS ST. CROIX CO., MI KEIYU Fat K= Lauri.. c. Booton, a/k/a Laurel Bocton. a SkVb person, by 06 -01 -1"9 18:00 All Loren Beduiless, her attomey -in -fact, a kfe estate interest, conveys and warrants to Joseph J. Menter and Audrey L. � No Mentor, husband and wife, holding as survivorship marital CM W FEE: property, the following described real estate in St. Croix C91 FEEs FIEL: 001.60 County, State of Wisconsin: oW INI FM 10.00 Recording Area Name and Reborn Address Joseph Menter 469 315th Street Knapp, WI 54769 004-1024-10,-50; 004- 1025 -70 (Parcel Idenlikation Number) The Northeast, Quarter of the Southeast Quarter (NE % of SE 1 /4) and The Sc?:rtheast Quarter of the Northeast Quarter (SE % of NE 'h) and The Northeast Quarter of the Northeast Quarter (NE % of NE' /• }, All in Section Eleven (11), Township Twenty -eight (28) North, Range Fifteen (15) West, town of Cady, St. Croix County, Wisc,ontrin. Exception to warranties: all easements and restrictions of record. This is homestead property. Dated this 1 day of 'Laurel E. Booton, by Loren Berkness, her attorr sy -fad AUTHENTICATION ACKNOWLEDGMENT Signsture(s) STATE OF WISCONSIN Sr L R4iK COUNTY _ Personally cane before +ass this W day or 1 1999, the above named rel ed la E. Booton, &We LMrei authenticated this _ day of Booton, by Loren Pz- :tesa, her -%ct, and to me k be Itte person exeruW the foregoing' and . -. .ctne. same. sig �L type or print name signature low- type or print name '�„ •. TITLE: MEMBER STATE BA; OF WISCONSIN (Knot. _ Notary Public County, , t A. a authorized by §706.06, �Vrs. Stats.) My commission is permanent. (If CHAS INSTRUMENT WAS DRAFTED BY ) f f Q Themas A MCC rr. so 'Names of per s sgniny in any capacity 64A1Os its I of BaKWn. WI 54002 printed below their signatures_ l Cw . F* du c..c, rYxorw ea:1sr*aox1