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004-1051-80-000
� 7 / 2 R % u 2 � _ . 5 i 0 $ ƒ � 0 S z / ƒ z �. ƒ \ / � � k \ § § _ � ƒ ) . a a E { ƒ § z . % § t 2 . E . ( z :!t \ « z ® } . 2 7 E 2 ; m . � } � •� 2 � � . Q )zz j � .. } $ ) \ O tt i i L ■ F ■ . E m E § a c a = G Z }% k E _ -� k} a 2 a CL ] § \ 2 2 G : 2 » r D E 0 :k in ° i o I £ ° _ 0 E�c� 2$\ ¥ a G a£ 8 E B\§ k ® k f § 7// ■ co _/ : OD (A \ / 2 2 \ ®� - . ® s' -_� $ q g/ g o z $)) A � ■ � l 2EL {� E$ f I k J a 2 0 & J t V ���11111 1111 /l� //i � /�C Wisconsin Department of Transportation 11111111 TRANSPORTATION DISTRICT 6 718 West Clairemont Avenue Eau Claire, WI 54701 -5108 September 21, 1999 Telephone (715) 836 -2891 FAX (715) 836 -2807 BEVE LY TIMM 289 ST 128 WILSO WI 54027 BJECT: Variance to Trans 233.05 Driveway Permit 5��� a STH 128, St. Croix County ,- - - File Ref: 0608- 15 -00 -4 Dear Ms. Timm: Attached is a permit for your existing access driveway to STH 128 from your property in the town of Cady. It is necessary that you sign both copies and return the copy stamped "WISDOT COPY PLEASE RETURN" to this office in the enclosed self - addressed envelope. Your existing access is hereby granted a variance from Trans 233.05. However, the access is limited to agricultural / residential use to serve only lot 1. Please note carefully the Permit Requirements listed on the reverse side of the permit. Sincerely, Ray Drake District Transportation Planner cc: Steve Fisher, Director, St. Croix County Zoning Office Attachment DT82 People who care, creating quality transportation - today and tomorrow w APPLICATION /PERMIT TO CONSTRUCT DRIVEWAY Wisconsin Department of Transportation DT1504 398 (Replaces EM404) s.86.07(2) Wis. Stats. & Ch. Trans 231 Wis. Adm. Code Please fill out the required information on BOTH SIDES of this form and submit to the District Office per the attached instructions. PLEASE PRINT OR TYPE. DRIVEWAY LOCATION INFORMATION 1. Applicant Name 5. Area Code - Telephone Number 6. Highway Number 7. County BEVERLY TIMM (715) 772 -4421 STH 128 1 ST CROIX 2. Applicant Mailing Address 6. ® Town ❑ Village ❑ City 289 STH 128 Of: CADY WILSON WI 54027 9. What Type of Driveway (check one) ❑ New Driveway 3. Property Owner Name, If Not Applicant ❑ Improve Existing Driveway ❑ Relocate Existing Driveway 4. If Not Property Owner, Reason For Application? 10. Driveway Within The: NW Quarter of the NW Quarter Section 22 Township 28 North, Range 15W East/West Log Mile or Reference Point: (filled in by WisDOT) 11. Completion Date: 12. What type of use will the driveway serve? (check one) ❑ Rural - Commercial /Industrial ❑ Urban - Commercial /industrial ® Rural - Residential ❑ Urban - Residential ' C Rural - Agricultural This application is not an application for a 13. Approximately how many times will vehicles use this driveway daily? (check one) right or easement of access for property go-100 ❑ 101 - 500 ❑ Over 500 that abuts a Controlled Access Highway or for a property whose access rights were 14. What side of the highway is the proposed driveway located? (check one) previously purchased. ❑ North ❑ South ® East ❑ West 15. Is the proposed driveway less than 500 feet from another driveway on the same highway? ❑ Yes ® No 16. What is the name of the nearest side road from the proposed driveway? 30 AVENUE 17. Approximately, how far is the proposed driveway from the side road listed in 16 875 FEET (distance can be measured in feet or miles) and in what direction is the proposed driveway from the side road? South * If the driveway is not completed by the "Completion Date" specified, a time extension must be obtained from the Department or this permit is null and void and the driveway shall not be constructed unless authorized through a subsequent permit. The construction and maintenance of the driveway shall be the responsibility of the applicant. It is understood and agreed that approval is subject to the applicant's full compliance with the pertinent Statutes, as well as any codes, rules, regulations, and permit requirements of other jurisdictional agencies. The applicant shall also comply with all permit provisions, superimposed notes, and detail drawings, which may be added by the Department. Any alteration of this form by the applicant is prohibited and may be cause to revoke this permit. X (Property Owner / Authorized Representative Signature) (Date) PERMIT Approved by Division of Transportation Districts Permit Number ! J j 55 -13 -1999 X li �_T�r%�__ f'—a1 _1�9 (District Dire r Approved epresentative) (Date) - 1 18. Does this parcel of land abut or border alongside another public road? ® Yes ❑ No. If yes, please indicate road's name. 19. Please provide a copy of documentation from the jurisdictional zoning authority to prove how the property is zoned. If no zoning has been assigned to the property, include a statement from the jurisdictional zoning authority to the effect that the land is unzoned. 20. If this parcel is unzoned as indicated in 19, please explain how the land is currently being used. AGRICULTURAL / RESIDENTIAL 21. Are you aware of any future plans to change the zoning or land use for this parcel? ❑ Yes ® No ❑ Don't Know. If yes, please explain. 22. Are there any plans to divide the property into smaller lots? ❑ Yes ® No If yes, please explain? 23. How many existing driveways does this property currently have? 1 24. Are there any access restrictions limiting the number of driveways to this property, i.e.: subdivision plat, certified survey map, deed, access covenant (recorded or unrecorded)? ® Yes ❑ No (If yes, please submit a copy of the access restriction agreement with the permit application.) 25. Are there any access easements across the property (recorded or unrecorded)? ❑ Yes ® No (If yes, please submit a copy of the access easement agreement with the permit application.) APPLICANT SHALL PLACE A FLAG OR MARKER IN THE HIGHWAY DITCH VISIBLE FROM THE HIGHWAY AT THE LOCATION OF PROPOSED DRIVEWAY. Additional permit provisions are listed below (to be added by WisDOT): REQUIRED DRAINAGE STRUCTURE: 1. WISDOT RESERVES THE RIGHT TO REVOKE THIS PERMIT AT SUCH TIME THAT ALTERNATIVE ACCESS BECOMES AVAILABLE (PUBLIC OR PRIVATE)OR RELOCATION IS DEEMED NECESSARY BY WISDOT. 2. THIS PERMIT SHALL SERVE ONLY THAT PARTICULAR LAND USE WHICH EXISTED AT THE DATE OF ISSUANCE(SEE LINE 12). A MORE INTENSIVE USE WILL REQUIRE A REEVALUATION BY WISDOT. 3. NO ADDITIONAL ACCESSES PUBLIC OR PRIVATE ARE PERMITTED WITHOUT WISDOT APPROVAL. 4. THIS ACCESS SHALL BE TEMPORARY UNTIL SUCH TIME THAT THE PROPERTY IS FURTHER SUBDIVIDED, LAND USE CHANGES, AND OR REDEVELOPMENT OF THE PROPERTY OCCURS. 5. THIS ACCESS SHALL SERVE LOT ONLY, EASEMENTS FROM THIS ACCESS IS PROHIBITED. CONDITIONS OF ISSUANCE 1. The permittee, indicated on the reverse side, represents all parties in interest, and that any driveway or approach constructed by or for him /her is for the purpose of providing access to property, and not for the purpose of parking or servicing vehicles, or for advertising, storage, or merchandising of goods on the highway right -of -way. 2. Except in cases where the indicated driveway access may be constructed by forces acting on behalf of the State in relation to a highway construction or reconstruction project, the permittee shall furnish all materials, do all work, and pay all costs in connection with the construction of the driveway and its appurtenances on the highway right -of -way. In every instance, the subsequent maintenance of the driveway and of its appurtenances within the limits of the highway right-of-way shall be the responsibility of the permittee, who shall be obligated to pay all costs and accomplish all works necessary in relation to the said maintenance of the driveway facility. Materials used and the type and character of the work shall be suitable and appropriate for the intended purpose. The nature of construction shall be as designated and subject to approval of the District Director. The driveway installation shall be made without jeopardy to or interference with traffic using the highway. Highway surfaces, shoulders, ditches, and vegetation which are disturbed by the driveway installation shall be restored to at least the pre - existing conditions by the driveway constructor. Any such facilities disturbed by operations relating to the subsequent maintenance of the driveway shall be restored by the permittee to the satisfaction of the District Director. 3. No revisions or additions shall be made to the driveway or its appurtenances on the right-of-way without the written permission of the District Director. 4. The Department reserves the right to make such changes, additions, repairs and relocations within statutory limits to the driveway or its appurtenances on the fight-of-way as may at any time be considered necessary to facilitate the relocation, reconstruction, widening, and maintaining of the highway, or to provide proper protection to life and property on or adjacent to the highway. 5. The permittee, successors or assigns agree to hold harmless the State of Wisconsin and its duly appointed agents and employees against any action for personal injury or property damage sustained by reason of the exercise of this permit. 6. The Department does not assume any responsibility for the removal or clearance of snow, ice or sleet, or the opening of windrows of such material, upon any portion of any driveway or entrance along any state highway, even though snow, ice or sleet is deposited or windrowed on said driveway or entrance by its authorized representative engaged in normal winter maintenance operations. 7. Wisconsin Administrative Rule Trans 401 requires the permittee of commercial driveways to assure that proper erosion control and storm water management measures be implemented at all times during work operations. The permittee shall also be responsible for providing erosion control and storm water management measures to protect all restored areas upon completion of the driveway until the replacement vegetation achieves sustained growth. 8. ROCK, BITUMINOUS, CONCRETE, TIMBER OR OTHER EMBANKMENT RETENTION OR DRIVEWAY MARKING TREATMENTS ARE PRPOHIBITED. O � V APPROVET ST. CROIX COU1 a ; Planning Zoning and I". ' ' • � ', 7 1999 C� 2 1 nr;T 2 7 1999 If not recorded wui 'O . approval date approval shr: .. null nwl CERTIFIED SURVEY MAP NO. 3754 VOLUME 13 PAGE 3754 BEING A PART OF THE NW 1/4 OF THE NW 1/4 AND THE NE 1/4 OF THE NW 1/4, ALL IN SECTION 22, T.28N.,R.15W., TOWN OF CADY, ST. CROIX COUNTY, WISCONSIN. CONTAINS 3,361,249 SQUARE FEET (77.16 ACRES) OVERALL CONTAINS 3,280,190 SQUARE FEET (75.30 ACRES) LESS RIGHT OF WAY ►... BASIS OF BEARINGS IS WISCONSIN STATE LEGEND z w PLANE COORDINATE SYSTEM w � _ _ _ • FOUND 5/8 REBAR i 33' 0 SET 3/4 "x24" IRON REBAR WEIGHING 1.502 LBS. /FT. 0 Z / / I DETAIL FOUND GOVERNMENT CORNER AS NOTED �- - 0• FOUND CAST ALUMINUM MONUMENT (18" BELOW GRADE) O a (\ se c. R/ W . SEPTIC VENT ao w CL Lo b / j� LOT 1 ** CAUTION: HIGHWAY SETBACK N z w U 31.33 _ _ f RESTRICTIONS PROHIBIT N ° 0 a � v — — — IMPROVEMENTS. SEE SHEET 2 N En 149.11' UNPLATTED' LANDS i ` ° z S88'09'42 "E - 2613.25' — — — — — — — ° z M 3 o S88 — 2464.14' o 0 -I Z 614.62 - - 30TH ----- 589.26' - -- ��• - -- 589.26'- -N.UNE NW1 /4 -- 671.00' - -- -- Z ``- - -t in - -- j 88'40T3 0 9'42 8" 630.4b' S88'"E- 5 8 9. E 09'42 "E- 589.00' S88'09'42 "E- 671.49' m `c� I N28`06'32 E_ 154.22 f� O 1 - - 33.00' ----- - -- - -- 33.00'--- - -- 33.00' -- - O O I m O.T. SETBACK LINE 00' ________ � I 1 AS PER D.O.T. TRANS S88'09'42 "- 1849.50' u 04 U) I t ETBACK LINE FROM - _ ►- h 233.08(2)(0)) �R ST. CROIX CO.z I} 1 110' FROM CL OR 50' FROM A w TER O T ' LOT 4 O 3 IS G TE TER. (S SEE N r LOT 2 I I ~ I T 1 771,952 SQ.FT. = I 772 SQ.FT. 900,597 SQ.FT. 'as I� t3 916,427 SQ.FT. 0 17,72 ACRES w 17. I 'r (21.04 ACRES) M '` ( ) 73 ACRES) ) M (20.67 ACRES) I 1 � 752,512 SQ.FT. p N 752,832 SQ.FT. oD N -- SQ.FT. i• N I 1 0 896,400 SQ.FT. ao N 10 oo "� N o 4 Z ' (20.58 ACRES o "n (17'27 ACRES) M (17.28 ACRES) M (20.17 ACRES) N LESS R/W LESS R/W Co LESS R/W 0 LESS R/W I N 1 N I N 1 • - =- ® NOTE: THE SETBACK w w w Z ` 1 I I\ ETWEEN PTS. 2 AND 0 P. - Q I i 5 IS 110' FROM CL ww \\ `a 3 J W 1 I ®EDRIVE G Vv I `/ iv w 0 l Z I NOTE: THE FOUND ALUMINUM MONUMENT O , O p Z JI I AT PT. "3' IS S485Y12'E - 0.32' Z `'N\ / / Z Q of 1 AWAY FROM COMPUTED AND RECORDED \v� I �v/ N 'Pos1 J 11 W SETBACK FROM R/W \ � \ Z i 701.44' PER ST. CROIX CO. 579.02' I 579.02' 690.77' jl 1 SOUTH LINE N 1/2 - 'NW 1/4 00 - 01 1 N88'06'24" I — 2550.25' � -m �t • I I LANDS ACQUIRED BY W.D.O. T. (FEE TITLE) 00 N PER VOL. 641 PG. 264, ST. CROIX CO., R.O.D. SE CORNER OF THE 1 rn I LINE TABLE UNPLATTED LANDS NE1 /4 -NW1 /4 I M 1 I UNE # BEARI DISTANCE * "AS OWNER I HEREBY RESTRICT ALL LOTS AND BLOCKS SO THAT NO OWNER, 1 -2 N01'18'25 "E 384.43' POSSESSOR, USER, LICENSEE OR OTHER PERSON MAY HAVE ANY RIGHT OF ' 3 2-3 N10'42'22"W 71.43' DIRECT VEHICULAR INGRESS FROM OR EGRESS TO ANY HIGHWAY LYING WITHIN ' z 3 4 N01 °27'40 'E 130.00' THE RIGHT OF WAY OF S.T.H. 128, AS SHOWN ON THE LAND DIVISION MAP; w IT 1S EXPRESSLY INTENDED THAT THIS RESTRICTION CONSTITUTE A RESTRICTION w 4 - N09 °59'31 "E 101.12' FOR THE BENEFIT OF THE PUBLIC AS PROVIDED IN s.236.293, WISCONSIN STATUTES ' S 6 N04 °19'25 "E 300.38' AND SHALL BE ENFORCEABLE BY THE DEPARTMENT OR ITS ASSIGNS." d 3 6 1 N01 '27'40"E 197.95' ACCESS IS GRANTED, PER D.O.T. VARIANCE APPROVAL, FOR RESIDENTIAL USE 7 1 N28 °06'32 "E 119.28' ACROSS THE EXISTING DRIVEWAY (LOT 1) AS DEPICTED ON THE FACE OF THIS MAP. z 12 8 -9 N28 °06'32 'E 34.94' (ACCESS RIGHT FOR A PORTION OF THE FRONTAGE TO S.T.H. 128 WERE PURCHASED 00 1 PREVIOUSLY BY THE DEPARTMENT OF TRANSPORTATION.) w I All 4 CD STEPHENJ. /9 N KOCH VER= 1 I`a SOUTH 1/4 22 -28 -15 I 0 0 I (Al S -2257 =a FD. 1" IRON PIPE WEST 1/4 22 -28 -15 MENOMONIE, FD. BERNTSEN SURVEY NAIL WI Q` PREPARED FOR: OF RECORD. 9y� HANSEN AND YOUNG AS AGENTS suR� FOR BEVERLY TIMM N W. D.O.T. TRANS 233 APPROVAL # 55 -128- 2945 -19 99 SCALE. >" =400' PREPARED BY.' THIS INSTRUMENT DRAFTED BY �, KOCHAVER LAND SURVEYING ' STEPHEN J. KOCHAVER , E5772 490TH AVE. JOB # 99031 0 200 400 800 SHEET 1 OF 2 MENOMONIE, WI 54751 Vol. 13 Page 3754 ST. CROIX COUNTY ZONING DE 7� p,,'� AS BUILT SANITARY REPO P-4 Owner A el a►1►.v. Property Address City /State I,� �d� t,U �"y ©� � s r ctiov. COUNTY • • ZOMNG; OFF(GE Legal Description: �, , :,, . Lot •— Block — Subdivision/CSM # jjj� '/4 ALU)'/4, Sec. 2� , T 2� N- R,[.�i W, Town of JD SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer 49 rte.._ Size ST/PC /�/ GAetback from: House Well ;'e PAL Pump manufacturer Model -1 Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: Width _ Length . ..7-5 — Number of Trenches 47—L Setback from: House & `Well &,o_l' PAL Vent to fresh air intake ELEVATIONS Description of benchmark +- a Elevation /, 0 d Description of alternate benchmark o a �S Elevation / =� � Building Sewer ST/HT Inlet ST Outlet 9 PC Inlet . Sd PC Bottom Header/Manifold 3 7 Top of ST/PC Manhole Cover Distribution Lines Bottom of System Final Grade Date of installation 1' / c /gg Permit number State plan number Plumber's signature icense number Date 2 y Inspector 4 Complete plot plan �+ ■ 5a I Q6 ser✓o.� on /�.� NOT E: Please provide the following: / • plan view sketch showing everything within 100 feet of the w • wo horizontal reference points to center of septic tank manhol ver. • how alternate benchmark, if applicable. 83 � g PLAN VIEW P,�p� 7s0.P 82 wb� `�PrucQ ACC W;ti�roiJ P `""`p cjwr,4c r' 0 C) 0 C)OC \ �t [)e n h Mark: 86t601" o- ffsrrn 3oss/P.�c. S�dt . ASS ned elc%` = /UC�� Propoud6 a{'�'lucnf I;KC --� ,4irm 303 �` �cs�derce gam¢ corn Crib Pet< S ec� y�3S =` �. � ca�i• g ¢ � Tr . r � l...o-t, / o•F�o%oo Sect �+t , o Cedes &Iclwin, tJ1, c( Ils KATE NORTH ) LRRO W Sf�� -Z .S� • C+"a X C� �� 701 s�s/ Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count y 'Safety and Buildings Division INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). 353158 Permit Holder's Name: ❑ City ❑ Village ® Town of: State Plan ID No.: Timm, -Bev I Town of Cady CST BM Elev.( Insp. BM Elev.: BM Description: Parcel Tax No.: .10 l + eIsA= 9`(• { ,BOA Lqj g j1RN 1 004- 1051 -80 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration ! C. es�¢ Bldg. Sewer 3, q 5t /Ht Inlet -13 TANK SETBACK INFORMATION St/ Ht Outlet S 10 4 1' 4 , 3 Z TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet O Air Intake D , q Z 9 ,0.6 - D Septic > I" 3Z � NA Dt Bottom IZ 4 4. �l Dosing yz ap ti �IZ� f<Ib .,, I� f NA Header /Mar Aeration NA Dist. Pipe 3.Z(� 73- 7 - 5 -- Holding Bot. System C ;q3 q 3,0 PUMP/ SIPHON INFORMATION Final Grade g ou S� Manufacturer itsni Demand St cover � Model Number C q I 1�IP TDH Lift 5.fib Friction °1 System TDH $I(Ft oss e Forcemain Length Dia. it Dist. To Well SOIL ABSORPTION SYSTEM iW,94j8 width r Le r Ao. PIT No. Of Pits Inside Dia. Liquid Depth — DIMENSIONS T 7 oZ DIMENSION SETBACK SYSTEM TO P/L BLDG I WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION Type Of CHAMBER Model Number: System: 2 . > 13 OR UNIT DISTRIBUTIO SYST Header / Manifold u Distribution Pipe i t p x Hole Size x Hole Spacing Vent To Air Intake � ii t/ L 't Length �� Dia- �� Length 3 t Dia. I Z Spacing "— T h SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only T.1 Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed/ Trench Edges Topsoil P ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) In petition 41 1 AO Inspection #2: Location: 289 Highway 128, Wilson, WI (NWI /4, NWIA, Section 22 T28N -R15W) - 22.28.15.344A WC 6 1 2 Plan vision require No � Z Use other side for additional information. atiq QQ SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: d ; m _} K+ i a e R i _....... ,. __ x .�, ......._ �_ .... .� _ ., �_...... _.. ... _.._, _ _.. ...,.»_...— .�...� E �e v F a e I j : s e 1 E £ . m. E s a , z ry e. .... ._T,�a ._ �..,,��... _..v . ., ..... _. # T — I __ __ ....,.., ........ _ . , ...__. .. _ .._ _ . , .... — . m � S e `: !44— £ e..a..... LA s _ .e. 3 .£ _ .,....,.. t .:,............, «yam m m l Y £ � ' Z $jQ � v k ]( ....,., ;'.... .,._.., a.- ....._,_, m.-. «4 .. ...., Kt i $ E i a. ._ .a...,... r ...a -Y_.. «._, eem� ........,,e..,_ m.�w..- ..,. .... ,�.. «.. ,... #.m:.... f c � i a i 3 � � !41- S. # [ A 0-61 ._ _ w. . __, t _.�.. . ..... k . ... . Ad 1_4 1 A Ell _2 4 1_1_1 A t i m.... ,. � € 4 e a .. ....... .:... ..s...,... .,, _,.. ,, ,.., _...�.. ._..w 3 k 3a v ,.. a I S i e �fl a 1n £ a �. Safety and Buildings Division S Visconsin SANITARY PERMI APPLI N� 201 W. Washington Avenue In accord with ILHR 83.05, W &4e ( P 0 Box 7302 Department of Commerce t d_ / Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the Sys pa 14t less`= ty than 8 112 x 11 inches in size. co / I�Y cFf `�S ROIX • See reverse side for instructions for completing this appli n Strata• nitary Permit N umbe r c%' n 3E3 0 9 Personal informati you provide may be used for secondary purposes Ln i ST OgO `' (] Ch k if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. couNry S'tat Ian I.D. Num berS lTE ID 181480 I. APPLICATION INFORMATION -PLEASE PRINT ALL i�� r ns ID 249392 Property Owner Name Property L, a #iqn' BEV TIMM ,ii4 r ',1r4 22 T 28 r N, R 15AW) W Property Owner's Mailing Address Lot Block Number 420 CEDAR STREET N/A N/A City, State Zip Code Phone Number Subdivisi n Name or CSM Number BALDWIN WI 54002 1 (715)684-5559 nga II. TYPE F B ILDING: (check one) ❑State Owned Cit Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms _3_ ° ro w a n OF CADY S.T.H. "128" III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 004- 1051 -80 -000 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. ® Replacement 3_ ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an S stem -- - - - - -- System ------- - - - - -- Tank Only -------- - - - - -- Exis Iran Ks i -- - - - - -- Exist)nQ 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 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure s I ..) 42 ❑ Pit Privy 13 ❑ Seepage Pit 1C � k 43 ❑ Vault Privy 14 ❑ System -In -Fill q 2 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 450 375 375 1.2 93 06 Feet 93.259 Feet VII. TANK in Capacit Total # of r Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturers Name Concrete Con Steel glass Plastic App New Existing structed Tanks Tanks Septic Tank or Holding Tank 1000.. 1000 1 MIDWESTERN PRECAST® ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber 750 1 750 1 1 MIDWESTERN PRECAST ❑ ❑ ❑ 1 ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Ptu 's Signature: No �sMPIMPRSW No.: Business Phone Number: BENNIE HELGESON 0292 71$ -772 -3278 Plumber's Address (Street, City, State, Zip Code W1229 770TH AVENUE SPRING VALLEY WI 54767 IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved S itary Permit Fee (includes Groundwater Surcharge Fee) D ate I ssued Is sui g Agent Sign re (No Stamps) �pproved ❑Owner Given Initial .�� Adverse Determination Sa �9 X. CON F APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11/97) 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 by the 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 3 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. i 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. Ili. Building use. If building type is public, check all appropriate boxes that apply. IV. T e of ermit. Check only one on line A. Co line B if permit is for tank replacement, reconnection or repair. P p Yp p Y p p 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 isto 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 81/2 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 mains/water 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. • Safety and Buildings 2226 ROSE ST LACROSSE WI 54603 -1905 TDD #: (608) 264 -8777 Isconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary September 29, 1999 CUST ID No.268093 ATTN.• Rod Eslinger ZONING OFFICE HELGESON EXCAVATION INC ST CROIX COUNTY W1229 770TH AVE 1101 CARMICHAEL RD SPRING VALLEY WI 54767 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 09/29/2001 Identification Numbers Transaction ID No. 249392 Site ID No. 181480 SITE: Please refer to both identification numbers, Site ID: 181480 above, in all correspondence with the agency St Croix County, Town of Cady NW1 /4, NWIA, S22, T28N, R15W Facility: Bev Timm residence FOR: Description: Repl. 3BR Mound Object Type: POWT System Regulated Object ID No.: 493032 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. Adm. Code. • 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(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 09/22/1999 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 Dennis R. Sorenson BALANCE DUE $ 0.00 Wastewater Specialist (608) 785 -9336 dsorenson @commerce.state.wi.us WiS i� MOUND SYSTEM DESIGN Residential Application S Fp INDEX AND TITLE SHEET 719 Fly► 9s Project Bruce Miller three bedroom residential mound �s Owner Bev Timm Address 289 Hwy. 128 (site address) Wilson, WI. 54027 Legal Description NW1 /4NW1 /4, Sec.22, T.28N., R.15W. Township Cady County St. Croix Subdivision Name Proposed CSM Lot No. 1 Parcel ID Number 004- 1051 - 80-000 Plan Transaction Number Index and title sheet Page 1 Mound calculations Page 2 Mound drawings Page 3 Pres. dist. caics. and laterals Page 4 TDH and pump tank drawing Page 5 Pump performance curve Page 6 Site plan Page 7 Attached soil evaluation report Page 8 Designer Bennie Helgeson License Number 220292 Signature Phone No. 715 -772 -3278 Date ,U'849— Notice Tampering with this file by unauthorized persons is prohibited. Deliberate modification will result in disciplinary action under s. 145.10, Wis. Stats. Personal information you provide may be used for secondary purposes (Privacy law, s.15.04 (1)(m)]. SBO- 10462 -E (R.05198) Page 1 of 8 I MOUND SYSTEM DESIGN Complete red boxes as necessary. 1000 gpd maximum design flow. Inch - pounds Metric Residential or commercial? r (r or c) (y or n) Replacement system? Creviced bedrock site? n (y or n) Slope 6 % Wastewater flow rate 450 gpd 1703 Lpd Depth to limiting factor 14 in 35.6 cm In situ soil infiltration rate 0.6 gPd/fe 24.4 Lpd /m` Contour line elevation 91.2 It 27.80 m Use standard fill depths? I x OR Design depth? in cm Place X in box to use standard depths (24 and A +4 inclusive) OR specify design fill depth. Center or end manifold C (c or e) Hole diameter 1 0.25 in 0.125, 0.156, 0.188, 0.219, 0.25, 0.281. or 0.313 inch only. Lateral spacing 0.00 ft Use 0 lateral spacing for trenches. Estimated hole space 3.50 ft Not a final calculation. Number of laterals Pump tank elevation 88 ft Outside bottom of tank. Forcemain length 40.0 ft Forcemain diameter 2.0 in 1.5, 2 3 or 4 inch only. 2.067 in Actual I.D. HOLE DIAMETER CONVERSIONS 118 = 0.125 1/4 = 0.250 SYSTEM SOLUTIONS Inch-pounds Metric 5/32=0.156 9/32=0.281 Estimated daily flow 450 Igpd 1703 Lpd 3116=0.186 5/16=0.313 7/32 = 0.219 Absorption cell Design load rate & area 1.2 gpcw 375.0 ft 34.84 m` Linear loading rate (LLR) 6.00 gpd/ft 74.4 Lpd /m Design width (A) 5.00 ft 1.52 m Cell length (B) 75.0 ft 22.86 m Depth of cell (F) 9.5 in 24.1 cm Sand filter Upslape fill depth (D) 22.0 in 55.9. crxt. � ; „ �' , `LM Downslope fill depth (E) 25.6 in 65.0 cm Basal area required (gpdAnfiltration rate) 750.0 ft 69.68 m,' iL Supporting components Topsoil depth 6.0 in 15.1$ " Subsoil depth at center 12.0 in 30' q LJ � , Subsoil depth at cell wall 6.0 in OF SAFETY AND BUILDINGS End slope toe length (K) 12.83 ft 9 Up slope toe length (J) 9.20 ft 2 0 m Down slope toe length (1) 14.40 ft Total mound length (L) 100.66 ft 30.68 CORRESPONDENCE Total mound width (W) 28.60 ft 8.72 m Project: Bruce Miller three bedroom residential mound Transaction Number: Page 2 of 8 MOUND PLAN VIEW observation pipes (typical) �J I 28.6 ft A= 5.00 ft 1.52 m 8.72 m • .•....• : ::::.::::::.:•..:.::: B = 75.0 ft 22.86 m W -- B J= 9.20 ft 2.80 m I K I= 14.40 ft 4.39 m K = 12.83 ft 3.91 m L L _ 100.66 ft f 30.68 m typ. obs. pipe (anchored securely) I = down slope dimension = absorption cell (A)B J = up slope dimension �� = plowed area (LxW) K = end slope dimension 6" (152 mm) T MOUND CROSS SECTION D = 22.0 in 55.9 cm lateral topsoil G H subsoil cap E = 25.6 in 65.0 cm invert 93.53 ft F= 9.5 in 24.1 cm elev. 28.51 m F G - 12.0 in 30.5 cm T ASTM C33 l H = 18.0 in 45.7 cm D Sand Fill E Sys. 93.03 ft W elev. 28.36 m 91.20 ft contour 27.80 m elev. 6 % ---� slope D = upslope fill depth plowed layer E = downslope fill depth Note: Absorption cell media will consist F = absorption cell depth of aggregate and pipe with laterals G = subsoil + topsoil depth at cell wall centered across AxB media. The cell H = subsoil + topsoil depth at cell center media is covered with geotextile fabric. Designer notes: Final gr ading plan should include placement of fill on upper side of mound and grading of area now carving overflow to divert surface water away from the mound site. kGE SYSTE Project: Bruce Miller three bedroom residential mound Transaction Number: 4 of 8 L x_i`1'(F PRESSURE DISTRIBUTION CALCULATIONS Absorption cell Inch-pounds Metric Width (A) 5 ft 1.52 m Length (B) 75.0 ft 22.86 m Lateral specifications Number laterals 2 Holes/lateral 10 holes Lateral length (P) 35.63 ft 10.86 m Hole diameter 0.250 in 6.35 mm Lat. dis. rate 11.65 Igpm 0.73 Us Sys, dis. rate 23.30 Igpm 1.47 Us Hole spacing (X) 45 Jin 1cm Lateral diameter Pipe diameter Design options Design choice Designer must 1 in (25 mm) I Place X in red X' one choice 1 114 in (32 mm) x box of chosen from the options 1 1/2 in (40 mm) x x diameter. provided. 2 in (50 mm) x 3 in (75 mm) x Manifold diameter Pipe diameter Design options Design choice Designer must 1 in (25 mm) X' one choice 1 1/4 in (32 mm) None required. from the options 1 1/2 in (40 mm) No choice necessary. provided. 2 in (50 mm) 3 in (75 mm) 4 in (100 mm) Distribution system contains: 2 Lateral(s) LATERAL DIAGRAM - CENTER CONNECTION Place correct lateral diagram by clicking in one of the drawings at right and dragging the diagram into this area. I P end cap (E }e: x12 I x124` Laterals & force main of PVC Sch 40 Last hole drilled next to end cap (per COMM Table 84.30 -5) Hales drilled on the bottom of the lateral. = permanent end marker equally spaced Inch-pounds Metric Lateral length (P) 35.63 ft 10. ali i I Lateral spacing (S) 0.00 ft 01W ✓ Hole spacing (X) 45 in i 4. Manifold length 0 ft i 4r Hole diameter 0.250 in m °' Lateral diameter 1.50 in a SAF1 Y AN8 BUILDINGS Forcemain diameter 2.00 in 50 mmr� Project: Bruce Miller three bedroom residential mound SEE CORRESPONDENCE Transaction Number: Page 4 of 8 TDH and Pump Tank Drawing Total Dynamic Head Operational head 2.50 ft 0.76 m Vertical lift 4.23 ft 1.29 m Are laterals the highest point in the Friction loss 0.39 ft 0.12 m system? Yes 'x' here. x „ Total dynamic head 7.12 ft 2.17 m If no, what is the highest elevation Dose Volume downstream of pump? Dose is > 10 times lateral volume Forcemain drain Lateral void volume 7.5 gal 28.4 L back to tank? ('x' one) Minimum dose 112.5 gal 425.9 L x Yes Drain back 7.0 gal 26.5 L No Dose volume 1E 119.5 11gal 452.4 L Typical Pump Chamber Layout In combination with state approved treatment tank. Tank construction as per Comm 83.20(3) WAC. approved manhole cover with weather proof warning label and locking device grade levels junction box - disconnect grade levels alternate 4" vent pipe electric as per NEC 300 and x 4 outlet Comm 16.28 WAC location 19'(46 cm) min. wall of pump k' approved chamber or outlet joint combination tank A Provide 1/4" weep hole or anti - alarm on siphon device as necessary pump on B Grade levels pump 89.3 ft C - pump tank manhole = 4!'(10 cm) off elev. 27.2 m minimum above finished grade D - vent =12" (30.5 cm) minimum above finished grade 88.0 ft Pump tank elevation 3 " (75 mm) of bedding under tank 26.8 m bottom of tank Tank manufacturer Midwestern Precast 750 gal. Pump tank capacity 19.5 gal/in Pump tank volume 750.75 gal Pump manufacturer JGoulds Inches Gallons Pump model number 3871 EPO4 o A 18.4 358.3 W B _;, 2 39.0 Alarm manufacturer LevelArm f C 6.1 119.5 Alarm model number DLV 12 234.0 J, Project: Bruce Miller three bedroom i?�s tl Transaction Number: D Page 5 of 8 DIVISION O S AFETY AND BUILDINGS SEE CORRESPONDENCE I M OD EL 1 1 M OD EL Vertical P0' P0 • • Su bmersible Effluent • F�1 YN dx r; GOULDC i k- X 12(1 5irr L .. I L I Pump Specifications METERS FEET 113 H P 10 Up to 40 GPM MODEL: 3s» Discharge size 1 NPT 9 3 0' Solids: 3 /8" maximum ° Motor 7 25 -. _._..,. Single phase: 115V C3 5 20 _:__I Materials of Construction U Q 5 Brass /thermoplastic 5 I __C i__. ' E 0 Z�4 Features and Benefits W4 i , Top suction eliminates - impeller clogging. 5 , r • Corrosion resistant construction. d ' �` Y 0- 0 0 10 .. 20 3 - - U 40 50 US. G°M -Float actuated switch. 0 2 4 c �fti ^ , 12 . METERS FEET 25 Pump Specifications Features and Benefits MODEL DVP03 4 /t0 and 112 HP •EPO4 impeller- semi -open design G 20 with um out vanes to p rotect 5 Up to 60 GPM mechanical seal. p 15 - Maximum head to 32' Z 4 I Discharge size 172" NPT • EP05 impeller - enclosed design 0 3 10 Solids: 3 /1 ' maximum for improved pertormance. 2 Motor • Rugged glass - filled thermoplastic 5 All motors feature ball casing and base design provides 0 , ° bearing onstruction. superior strength and corrosion 0 5 10 15 20 25 30 35 40 U.S.GPM resistance. Single p ase: 115V U 2 CAPACITY 6 8 10FRIAir Materi s of Construction 'Cast iron motor housing for it n efficient heat transfer, strength, Cast Cast plastic and durability. Ther Stain ess steel • Corrosion resistant threaded stainless steel shaft. -Available for automatic and manual operation. • CSA lister) models available. All Models are designed for continuous operation and feature stainless steel Hardware. / PV Sa / Qbs�✓a�(i on At A /QI�QOr �E�E l�nee sl 0 a pGE SYSTEM • / r P EW 83 vndtti ® nay I - - -- i PP ED v z -a� AND BUIL MNGS a: a p 1S10N OF SAFER 1 .$ o v 1 u � � 1 ONDENCE Profo3ed 7so�P SEE CORRESP 2 5 Prue2 ee w rout pt wtpc•l%a,r I er O ' s 1 M C 1 4enCllYV(ar(C: 86660m sT rn 303 /. ✓.C. Srd� .Assumed elegy =iuu� Pr Prop {a4 ' e4'F'lucnf l;Ke 6� - Asrrti3o3y ♦ 91/.67 I P.rC. 7 ri � SeP6Lbl"*( I wa ouerriow P:pt ¢,X,3E"�q OI L ° dtvdlutrts - to grade 3 bdrnt. SS' � /. �eS�deree �,� gora�Q C,r�b Po ({ s �.ed : aa6Lom oP M� y8S �t Owner: ,LQCa.�ion: B ev - mm Gof / oi�orvosed esrt , I zo 6&jae S-/- Ba /dw:n, o/, /,�e 70%�/�' r - , .1 Wisconsin Department of Commerce SOIL AND SITE EVALUATION P 1- of .. Division of Safety and Buildings in accord with Comm 83.05, W is. Adm. Code A.C.E. Soil &Site Evaluations * Attach complete site plan on paper not less than 8'/2 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, or dimemsions, north arrow, and location and distance to nearest road. — pe ope, Parcel LD.# 004 - 10 -80 -000 APPLICANT INFORMATION - Please print all information. - -- - — - - -- -- - - - -- - -- _ - - -- - - -- Personal information you provide may be used for seconds ur ses ( Privacy Law, S. 15.04 1 m Reviewed By Date Property Owner Property Location Bev Timm Govt. Lot NW 1/4 NW 1/4 S 22 T 28 N,R 15 W Property Owner's Mailing Address Lot # 1 1 Block # Subd. Name or CSM# Pro osed CSM 420 Cedar Street #55 City State Zip Code PhoneNumber _] City [J Village [;]Town Nearest Road Baldwin W1 54002 Cady S.T.x" 128" LJ New Construction Use: [y.] Residential I Number of bedrooms 3 LLAddition to existing building C Replacement L Public or commercial describe Code Derived daily flow 450 gpd Recommended design loading rate •5 bed, gpolft' .6 trench, gpd /ft' Basal area required 900 bed, ft' 750 trench, ft' Maximum design loading rate •5 bed, gpd /ft' .6 trench, gpd /ft' Recommended infiltration surface elevation(s) 93.08' at 22" above 91.24 contour ft (as referred to site plan benchmark) Additional design I site considerations Site suitable for A + 4 mound requiring 22" of sand lift. Parent material Glacial till. Flood plai n 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 ❑ S O U F1 S D u [� S 1 U ❑ S U C7 S U ❑ S® U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPDIft' Horizon Texture Consistence Boundary Roots - -- -- - -- — Boring# in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0 - 5 10yr3 /1 None sl 2fcr mvfr cs 217 0.5 0.6 2 5 -9 10yr3 /2 None sl 2fsbk mfr cs - 2f 0.5 0.6 Ground 3 9 -14 1Oyr4 12 None sl 2msbk dsh cs if 0.5 _ O - elev 89.68'ft 4 14 -22 1Oyr5/3 f1dIOyr /8 sil 2msbk dsh cw if 0. 0.6 Depth to 5 22 -38 1 Oyr5 /2 m2p7.5yr5/8 SO Om dh - - NP 0 .2 limiting factor - -- - - -- 14" Remarks: - - - -- - - -- _ -- — — - -- 2 1 0 -6 10yr3 /1 None sl 2fcr mvfr cs 2 f 0.5 0.6 2 6 -10 1Oyr3/2 None sl 2fsbk mfr cs 217 0.5 0.6 Ground 3 1 0- 16 1Oyr4 /2 None sl 2msbk dsh cs if 0.5 0._6 elev - - - - - - - -- - -- - -- - - -- 91.89' It 4 16 -24 1 Oyr5 /3 None sil 2msbk dsh cw if 0.5 0.6 Depth to 5 24 -28 1 Oyr5 /2 f2p7 5yr5/8 SO 2msbk dh gw - 0.4 0.5 limiting factor 6 28 -38 10yr5/2 m2p7.5yr5 /8 scl Om dh _ _ NP 0.2 24" Remarks: — - - -- -- - -- -- - -- CST Name (Please Print) Signatur Telephone No. James K. Tho 715- 248 -7767 Address A.C.E. Soil & Site Evaluations Date CST Number Ref # 340 Paulson Lake Lane, Osceola, WI 54020 7/20/99 3602 1084 'PROPERV OWNER: B Tim m_ SOIL DESCRIPTION REPORT toga Page _ 2 of 3 PARCEL LD.# 004- 1 051 -80 -000 A.C.E. Soil & Site Evaluations Depth Dominant Color Mottles Texture Structure sistence Boundary Roots GPDJft2 Horizon in. Munsell Qu. Sz. Conn Color Gr. Sz. Sh. Bed Trench 3 _ 1 0 -5 10yr3 /1 , None SI 2fcr _ mvfr cs 2f 0.5 0.6 2 5 -8 10yr3 /2 None sl 2fsbk mfr cs 2f 0. 0.6 Ground - -- -- - - - - -- -- - - — elev 3 8 -13 10yr4/2 None SI 2msbk dsh cs if 0.5 0.6_ - -- - - - - - - - -- -- 89.85'ft 4 13 -20 — 10yr5/3 None sit 2 msbk dsh cw if 0.5 0. 6 - - - -- -- -- - - - -- — Depth to 5 20 -27 10yr5/2 f2p7.5yr5/8 scl 2msbk dh gw - 0.4 --- 0.5 limiting __ ___ __ __ _ _____ _ - - - - - -- — - -- - - -- - -- factor 6 27 -3 5 10yr5/2 m2p7.5yr5/8 scl Om dh - - N 0.2 20" - -- - - - - -- - - - - - -- - - - - -- - — - - Remarks: - -- - -- - -- - -- -- -- - -- ------------ - - - - -- - - -- Ground — - -- -- - - - - -- -- -- - - -- --- - - - - -- elev Depth to limiting - - - -- - - - -- -- - factor Remarks: -- - - - Ground _ -- - -- - elev Depth to limiting -- — - -- -- -- - - -- factor Remarks: — - - -- - -- - - - - - - -- - — -- — Ground - elev - - - - - -- - - - -- - - - - -- — — — Depth to limiting -- - - - - -- - . - - - -- - --- - - - - -- -- factor - - - - -- - -- ------ - - - - -- Remarks: -- ■ 50 106ser✓aon P,i • rle✓at -Y'7*" ��ee 0 w 83 I "1,Z8 OC= 000 Bz�I Wip;(y 5 Pruc� �r�c W ryn�r o�.J ( o I M I aenr-6 WafK : 86660M of S�dr��. Assumed elc�` = /Qa� 7 I 6 Q,r S I distl a !s - tp arada 3 fi • ss' res�derce gam¢ �n Cr; b Po ( c a OrSp` ® .6. co Y , � v � NG� d► gp�N�� yes ,t G � Owne g� B a v- Tr n„� ,C.ot / oF csrt, f/,2o Cedar' S�. "ss 4 l �y, sec. Qa�dwTn, �.J /, g T. o� Wady, Sfr�,2 &. ero; y de., 9 m . Ii e � -7/ 7 i v ►�`.sconsinDepartment ofCommerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code A.C.E. Soil &Site Evaluations Attach complete site plan on paper not less than 8%i 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 dimernsions, north arrow, and location and distance to nearest road. - 1 5 arcel -Parcel I.D.# 004- 1051 -80 -000 APPLICANT INFORMATION - p/ l nf�hog,ion. . _; , vie r By Date Personal information you provide may be used for ! purpo (Pacer Laws. 15.04 (1) (m)). _ t Property Owner 1 , Property Location EE Bev Timm "' ! /� ovt. Lot NW 1/4 NW 1/4 S 22 T 28 N,R 15 W Property Owner's Mailing Address 1 pt # Block # Subd. Name or CSM# 420 Cedar Street, #55 > �I �' '-! 1999 i 1 Proposed CSM City State i Code P*h r ri1 City E] Village MTown Nearest Road Baldwin Wl 5 2 Cady S.T.H. "128" ❑ New Construction Use: z edrtiaij Nu y0(1 s 3 ❑Addition to existing building Z Replacement Pub cor�lnlel�i I ribs Code Derived daily flow 450 gpd Recommended design loading rate •5 bed, gpd/ft' .6 trench, gpd& Basal area required 900 bed, It' 750 trench, 11 Maximum design loading rate .5 bed, gpdff .6 trench, gpd/ft Recommended infiltration surface elevation(s) 93.08' at 22" above 91.24' contour ft (as referred to site plan benchmark) Additional design / site Considerations Site suitable for A+ 4" mound requiring 22" of sand lift. t Par u entmateria l Glacial till. Flood lain elevation, K a icable NA ft ble for system Conventional Mound In Ground Pressure AT - Grade System in Fill Holding Tank itable for system ❑ S ® u ® S ❑ u ❑ S ®u Li s ®u ❑ s ®u ❑ S ® u SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPDff Boring# Horizon In Munsell Qu. Sz. Cont. Color Texture Gr. Sz Sh Consisien Boundary Roots Be ,Trench 1 1 0 -5 10yr3 /1 None sl 2fcr mvfr cs 2f 0.5 0.6 2 5 -9 IOyr3 /2 None sl 2fsb mfr cs 2f 0.5 0.6 Ground 3 9 -14 10yr4 /2 None sl 2msbk dish cs if 0.5 0.6 elev 89.88'ft 4 14 -22 10yr5 /3 fldl0yr5 /8 sil 2msbk dsh cW if 0.5 0.6 Depth to 5 22 -38 10yr5/2 m2p7.5yr5/8 scl Om dh - - NP 0.2 limiting factor 14' 7 77 1 2 1 0 -6 1Oyr3 /1 None sl 2fcr mvfr cs 2f 0.5 0.6 2 6 -10 10yr3 /2 None sl 2fsbk mfr cs 2f 0.5 0.6 Ground 3 10 -16 10yr4 /2 None sl 2msbk dsh cs If 0.5 0.6 elev 91.89'ft 4 16 -24 10yr5 /3 None sil 2msbk dsh cW 1f 0.5 0.6 Depth to 5 24 -28 1 Oyr5 /2 f2p7.5yr5/8 scl 2msbk dh gw - 0.4 0.5 limiting factor 6 28 -38 1Oyr5/2 m2p7.5yr5/8 scl Om dh - - NP 0.2 24" Remarks: CST Name (Please Print) Signatu Telephone No. James K. Thompson 715- 248 -7767 Address A.C.E. Soil & Site Evaluations Date CST Number Ref # 340 Paulson Lake Lane, Osceola, WI 54020 7/20/99 3602 1084 49iPERiYdw�: >�T� SOIL DESCRIPTION REPORT �oea Page 2 of 3 PARCEL. t D.e. ooa �os� -so-0oo A-CX. SO & sae Evaluations Depth Dominant Color Mottles Structure GPD/fF Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz Sh sistence Boundary Roots Bed Trench 3 1 0 -5 10yr3 /1 None sl 2fcr mvfr cs 2f 0.5 0.6 2 5 -8 10yr3/2 None s1 2fsbk mfr cs 2f 0.5 0.6 Ground elev 3 8 -13 10yr4 /2 None sl 2msbk dsh cs If 0.5 0.6 89.85' ft 4 13 -20 10yr5 /3 None sil 2msbk dsh cw if 0.5 0.6 Depth to 5 20 -27 10yr5/2 f2p7.5yr5/8 scl 2msbk dh gw - 0.4 0.5 limiting factor 6 27 -35 10yr5 /2 m2p7.5yr5/8 scl Om dh - - NP 0.2 20" Remarks: k Ground elev Depth to limiting factor Remarks: Ground elev i Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: I .r .�t• �, 3d�'3 5a / Qbse�-✓o on At ♦ E1,eA-6 .Pin ee 0 �I cI V a g3 l 5 r1 �, 5 P�uc2 -Ei�cc w;�tr cw I O OC)C)000 M 4 &nck Yrvtafk: 8 6660m of � 5;d.��. Assumed e1e�` =jq�eb � ar �A dtrjrrlA"3 pe 8, a.de ('CSid¢ree Qor►1 g`� crib c( P� shed S�d�v�. Ele%= 9s!sG. k Be TI m r, �C of / aF�orgoa�d esrt, y Cedar' S4 A'sS /I j *,lt�y, Sec.;M,T. 189. /O . line �12 • I ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address Sao :f ! ZA4� 2 ,, 40; 6 - 4ke 2 i Property Address (Verification required from Planning Department for new construction) City /State Gi) 7 Parcel Identification Number I LEGAL DESCRIPTION Property Location A)W ' /4, A/W '/,,Sec. L2- T N -R Town of d c. Subdivision 1A , Lot # . i Certified Survey Map # X)/t , Volume , Page # Warranty Deed # 1,,6 W 94 , Volume /c 6/ , Page # Spec house ❑ yes ® no Lot lines identifiable ® 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, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days jsoof the three year expiration date. SIG ATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. 9'lao�9.� S NATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed STATE OF WISCONSIN, CIRCUIT COURT, ST. CROIX COUNTY IN THE MATTER OF THE ESTATE OF MARVIN W TIMM &L DOMICILIARY LETTERS MARVIN TI M File No. 99 PR 0 9 ✓ To: Beverly A. Timm Name(s) The above named person died, domiciled in St. Croix County, Wisconsin, on July 1. 1998 Date You have been appointed personal representative and have fully qualified. THEREFORE, these Letters are issued to you, and you are required to administer this estate according to law. BY THE COURT: Seal Probate Registrar Ed ka Nelson Date "1149 Of Wisconsin of ::t. Croix I t : ; .•r l.fy i. , ;it this document bar, hsen nc^ ahat if is a PuII� tr;fa„ and ��.. ' r- ;- nn f •� ?::'.: of r•� -: .. �" �::) t:`131 it i_; ..!�i ill i icka S. Naison I in Probate g $AQUARV LETTERS (INF. ADM.) ss. 865.08, Wisconsin Statutes `+ Information Professionals Company Fond du Lac, Wi 800.65 •j- �l i WARRANTY DEED THIS INDENTURE, Made by John Feldh'ahn, a single man, William Feldhahn, a single man, Herman Feldhahn, a single man, Frank Feldhahn and Anna Feldhahn, his wife, Joseph Feldhahn, a single man, Helen Haglund, and Louise Rasmussen, grantors, hereby conveys and warrants to Marvin Timm, grantee, of St. Croix County, Wisconsin, for the sum of Three Thousand One Hundred Dollars ($3100.00) the following tract of land in St. Croix•County, State of Wisoonsin: The South Half of the North Half of the Northwest Quarter (2+ of NJ of NWT) of Section number Twen- ty -two (22), Township number Twenty- eight.(29) North of Range number Fifteen (15') West, St. Croix County, Wisconsin subdect to an easement to the St. Croix County Electric Cooperative, a cooperative association, dated.November 9, 1939 and reoorded in Volume 256, ° a - 16 in the fice of the Register of Deeds for St. Croix County; of is'consin. ` I • II �i j The the second part ag rees to P ay all real estate taxes for the year 1946. I That there is excepted from this conveyance that certain . garage building,:looated on said real estate of the dim - ens of-fourteen feet by eighteen feet . (14' x 19' - and that the title to the same" is to rest in the owner or owners - thereof and the said garage is not being as- signed or transferred to the said party of the second part, and that the owner or owners thereof to have to M 3, 1947 to remove the same from and that the said garage may remain on without,charge to said date; that all of the personal property of :said parties of the first part shall be re- moved from said real estate on or before the time poss- ession of said real estate is given to the party of the second part. l; 4; j .I 1A 51PA� 3M 649194 PETITION AND CERTIFICATE KATHLEEN H. WALSH REGISTER OF DEEDS TERMINATING JOINT TENANCY ST. CROIX CO., WI RECEIVED FOR RECORD oa«,�„cM Clamber pocumeflt 7Stle 08 -25 -1999 9:30 AM CERT. OF TERMINATION 0 EXEMPT N CERT COPY FEE: COPY FEE: TRANSFER FEE: RECORDING FEE: 14.00 PAGES: 3 Recording Arc& Name and Rcaua Address Ci RICHARDSON LAW OFFICE S233 McKay Ave. , Box 399 Spring Valley, WI 54767 Y 004- 1051 -60 - 000; 004- 1051 - 80 - 000 004 - 1051 - 40 Parcel Identification Nambcr (PIM THIS COVER SHEET IS PART OF THE ATTACHED DOCUMENT - DO NOT REMOVE This infotmarioa awn be compldcd by abcuiau dome ^am, & rcrurn oddreis, mend FIN (f rcq�dred). Onc�r infom�aaon ++�h ar du sr d^r ela�uer, te lal derenpdon, ere. ^.ay be placed on d ar fvrr pale of Ac docwntw or —Y 6 - 1 placed on adduawial pager of 14-- N Use of OLU COV r pal, addr one pal, to yo"r doc+oncnt mid �2 00 ro rkc rccordint lcc. Wucwuin S ^- • -• , 19.5I7. WRD.( 2/96 V(,1 1 P c STATE OF WISCONSIN, CIRCUIT COURT, ST. CROIX COUNTY IN THE MATTER OF THE ESTATE OF PETITION AND CERTIFICATE • TERMINATING JOINT TENANCY MARVIN W. TIMM a /k /a MARVIN M T I MM rixtm 9X Soc. Sec. #468 -20 -5863 n File No. 6 7 1-- Pr 9`3 Under oath, I state that: 1. The above person died on July 1, 1998 domiciled in St. Croix County, Wisconsin, whose post office address was 289 Highway 128, Wilson WI 54027 2. At the time of death the decedent had the following interest(s): • Describe property (including recording data, if any). • Designate type of property Interest (Joint Tenancy, LIf EGkdaK DciivCDtShip%k>'d&WAopeCty). • Give name of surviving owner(s). See Appendix " attached hereto and made a part hereof. ® See attached. I ask that a Certificate of Termination issued. Subscribed and sworn to before me ) ,� ° Au s 9, 1999 2 12 Signature of Petitioner _BeYerly A. Timm Robert J . R chardsori'ota<y isconsin Name Typed My co issiorAk; MX is permanent __Au 9, 1999 Date R obert J. Richardson Attorney at Law Name of Att orney CERTIFICATE R ichardson Law Office Based on the petition, the court certifies the date of death and P. 0. Box 399 Address ownership interests of the decedent, and terminates/vests that S rin Valley, WI 54767 interest. The Department of Revenue's Certificate Determin- �s ing Inheritance Tax, if required, is on file with the court. County of St. Croix I har^ -y cf riifj that this document is a fult BY THE COURT: ^C'r'ct copy of the or ginal on file ar'! ;i ':`^ )rt? `.'1 Z °yeffice and has hs?n comp_rej 6y rilO.' G� Judge Attest `r}'' •. ' � t5 rcutt ,�.. C A. Ric ards • r " y..' ,�: -- -- ... — Name Typed 8/16/99 bate /J y +/� u 1 Re9i��'r to PR -fa26. 460 - (PR.1:67, 43A,44A) PETITION AND CERTIFICATE TERMINATING JOINT TENANCY/ s. 867.04 and 667.046, Wisconsin Statutes TERMINATING LIFE ESTATE/VESTING SURVIVORSHIP MARITAL PROPERTY Stock No. 25464 �KC, �lL 14 5 IPAGi 386 Attachment to Petition & Certificate Terminating Joint Tenancy - Estate of Marvin W. Timm APPENDIX "A' Real estate held jointly between Marvin W. Timm & Beverly A. Timm as shown by Warranty Deed dated February 15, 1966, recorded February 24, 1966 in Volume 421 of Deed on pages 157 & 158 as Document No. 283487 described as follows: The North Half of the North Half of the Northwest Quarter (N 1 /2 of N '/2 of NW '/4) of Section Twenty -two (22), Township Twenty -eight (28), North, Range Fifteen (15) West, St. Croix County, Wi. Estimated FMV determined by sale price = $ 59,000.00 Vendor's interest in Land contract by & between Marvin W. Timm and Beverly A. Timm, vendors and John R. Lamb &Cheryl K. Lamb, husband & wife as joint tenants, purchasers, dated March 19, 1985, recorded April 2, 1985 in Volume 708, Pages 573 -574 as Document #400771; Addendum to Land Contract dated January 28, 1993, recorded February 1, 1993 in Volume 991, Page 527 as Document #494575 to the following described parcel: The Southeast Quarter of the Northeast Quarter (SE '/4 of NE ' /a) of Section Twenty -two (22), Township Twenty -eight (28) North, Range Fifteen (15) West, except the North 447 feet of the East 315 feet, St. Croix County, WI. Remaining Balance = $ 4,167.50 Parcel ID #s: 004 - 1051 -60 -000 004 - 1051 -80 -000 004 - 1051 -40