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HomeMy WebLinkAbout012-1046-00-000 0 to 0 "a 0 o ro) 0 T 7! T con co z 6 z 0 0 0 o o o M =r = u cn to § (D C 0 M CD X CD CO) 0) ■ CD w a 5. 2 o 1 0 CD c 4 M N) a) CD m 6 3 (a CL 0) 0 0-0 - 4 (D (a CD 0 0 co CD C I a c 3 0 0 0 0 CD 0 ;o co CD co 0 o r ca Co z CD * w CD CD Z 0 0 ;o 3 CD 0 0 9 ■ CL 0 0 0 CD CA Q 0 -4 0 / { 0 1:3 CA CD C: =r 3 z CD 0 =3 0. rl: z m M i: z 0 0 1:3 z --I V M 03 0 CL Z a j ;o m [ 7N± CD a:3 0 C7_ 0 CD 0) :3 0 F 0 m z 0 lz 3 CD E 0 0 =r 3 CD CD 2) CL 0 ;T CD kj o 0 < 0 0 Parcel #: 012 - 1046 -00 -000 09/07/2006 03:55 PM PAGE 1 OF 1 Alt. Parcel M 20.30.17.305 012 - TOWN OF ERIN PRAIRIE Current ,Xj 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 DONALD &MARGUERITE MALONEY O - MALONEY, DONALD & MARGUERITE 1637 CTY RD G NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description * 1637 CTY RD G SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 39.000 Plat: N/A -NOT AVAILABLE SEC 20 T30N R1 7W NE NW 39 AC Block/Condo Bldg: Tract(s): (Sec- Twn -Rng 401/4 1601/4) 20- 30N -17W Notes: Parcel History: Date Doc # Vol /Page Type 2006 SUMMARY Bill M Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 05/31/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.000 53,000 158,500 211,500 NO AGRICULTURAL G4 20.000 2,900 0 2,900 NO 00 UNDEVELOPED G5 1.000 100 0 100 NO ENTERED BEFORE 2005OPE W7 13.000 20,800 0 20,800 NO Totals for 2006: General Property 26.000 56,000 158,500 214,500 Woodland 13.000 20,800 20,800 Totals for 2005: General Property 26.000 55,900 158,500 214,400 Woodland 13.000 20,800 20,800 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 311 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 . 0 c o , R n ■ . % ; c ' . 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CROIX , COUNTY ZONING DEPART. ,® AS BUILT SANITARY REPORT ., RECEIVEQ Owner Q- 0. � k I~' 9a 9 L Property Address 'T 0 City /State ` l 00UNT�P ZON INGOFFICE Legal Description: Lot Block Subdivision/CSM # t /4 & Lo 1 /4, Seq,La, TAN -RjaW, Town of PIN # CO Q - ICS S/(n -0 SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer Size ST/PC 1 d50/ Setback from: House /(a Well 76 } P/L Sd ' Pump manufacturer Model � -jAZ , Alarm location L11 r (HOLDING TANKS O \ Y) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM n S rcc'ars Type of system: Width J Length 7 Number of Trenches Setback from: House 3 /6 'Well �" P/L s W) Vent to fresh air intake -99U ELEVATIONS Description of benchmark a erg— 5rw- , SId /ri q 0-A e S Elevation f Do Description of alternate benchmark ✓5 a S -d Elevation 9 Building Sewer ST/HT Inlet 1 r ST Outlet PC Inlet 7 to PC Bottom ? Header/Munifold ��' S- Top of ST/PC Manhole Cover 21 Distribution Lines ( /) 9 '' S (� `�' .s, Bottom of System (/) 9 �` Z (�) 9 �� L ( ) Final Grade ( h 9 �' � 04 Date of installation I 1 //0/ w P 't number 3S3J State plan number Plumber's signature License number S. 37 Date / /0/ 4 Inspector ,�,., _ Complete plot plan � 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. C) r P AN W 3# tasa a � 0 q •� ok 7 So � INDICATE NORTH ARROW 1 I Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: 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)]. 353211 Permit Holder's Name: ❑ City ❑ Village JC] Town of: State Plan ID No.: Donald To wn of Erin Prairie CST BM Elev.: Insp. BM Elev.: BM Descri tion: Parcel Tax No.: Q�. Ift- 9e I e 012- 1046 -00 -000 TANk INFORMATION r6VATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Pr/ IBS v Benchmark z„ D Z� Are k'U Dosing �r —v Alt. BM * 3 0 Bldg. Sewer ding / Ht Inlet `p TANK SETBACK INFORMATION TANK TO P/ L WELL BLDG. A� ° ROAD Septic " U� >$-6 � / r ?,D/ NA Dt Bottom � / � 4. 7 Dosing '�' r 7 ` b' NA Header / Man. frQ �- Dist. Pipe SWO o ding Bot. System �� v 'f3,& 6 PUMP / SIPHON INFORMATION ��6 Final Grade Manufacturer J Demand St cover 'p , s v „Q a pmk Model Number �� GPM 2 Z TDH Lift 0 Friction System TDH 71.2/Ft oss mead Forcemain Length Dia. 3 r � Dist. To Well SOIL ABSORPTION SYSTEM (Z BED E Width Len th If No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIM N L DIMENSION SYSTEM TO P / L BLDG WELL LAKE/STREAM LE G Man urer: SETBACK CHAMBE INFORM ATION Type O o m r: System: fIOU 7 /Q�J 7If!(J IT ' DISTRIBUTION SYSTEM Header /Manifold LJa Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length -Lo— Dia. 7 Length �e Dia. A Spacing N 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 ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #l: j( //( /Inspection #2: Location: 1637 County Road G, New Richmond, WI (NE1 /4, NW1 /4 Section 20 T30N- R17\V) - 20.30.17.305 1.) Alt BM Description= b�l 0? �o% 64a Sim <� �5 � �,, ���,� dad - amount of cover = -7 ' Jl 2.) Bldg sewer length = 2 / y' Plan revision required? ❑ Yes ❑ No Use other side for additional information. I r SBD -6710 (R.3/97) Da (e nspector's Sign Wr e Cert. No ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: qQ3 k V v ... � o Safety and Buildings Division SANITARY PERMIT APPLICATION 201 W. Washington Avenue Vi consin " P O Box 7302 Department of Commerce In accord with Comm 83.05, Wis. Ad � a Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, er n lew, Co t . than 8112 x 11 inches in size. r 1 (2 • See reverse side for instructions for completing this applicatio t , ate SarrrCa y PermTN 6m be? Personal information you provide may be used for secondary purposes f heck it reirision to previous application [Privacy Law, s. 15.04 (1) (m)]. X State Plan la. Number 2 I. APPLICATION INFORMATION - PLEASE PRINT ALL INF Propert ner Nam r rty Locate AqA .1 Lnt T 30 N R ( 9') W Property wner's Mailin dress f Lot Nu Block Number JDA City, State Z2 Code Phone Number Subdivision Name or CSM Number ( `7l9 o IV IN II. TYPE 4 F B ILDING: (check one) ❑ State Owneb 0 Cit Neare t Road W llage El Public 1 or 2 Family Dwelling - No. of bedrooms []- village Town OF Z-1 t 111 BUILDING USE (If building type is public, check all that apply) arcel Tax Num v 1 ❑ Apartment/ Condo la 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Aecreational 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 System - _______System_____ ______ __Tank Only______________ Exist 119 -- -- 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 ❑ Specify Type 41 ❑ Holding Tank 12 XSeepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit I 43 ❑ Vault Privy 14 ❑ System -In -Fill Q 3 = 2 4 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 (s ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation (Qoa — M O . $ T4 • ok Feet Q $. 0�. Feet VII. TANK Capacit gall Total # of Prefab. Site Fiber- Exper. INFORMATION New Existing Gallons Tanks Manufacturers Name Concrete st acted Steel glass Plastic App Tanks Tanks Septic Tank `psi rS ❑ El El 11 11 Lift Pump Tan r 5 ❑ i ❑ 1 ❑ 1 ❑ I ❑ I ❑ Vill STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. PI u tier's Name: (Prin Plu tier's Sig at e: ( Stam s MP /MPRSW No.: Business Phone Number: t 11 a t & 7 1 1 Dan S3 7� S! PI III er s Address (Street, City, State, ip Code): J�' f L 1 � / V 1 IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved SS nitar Fee (Includes Groundwater ate Issued Issuing gent Signature (No Stamps) Approved ❑ Owner Given Initial Surcharge fee) Adverse Determination CONDITIONS Q�APP VA RFASQ FOR J�ISgQP�2gVAL� ��u���s ►�t� � ���'(yta��� � uaY SBD -6398 (R. 4199) 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 "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: 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. -- ' 11. 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 ` ecifications not smaller thari 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 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 drequired 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. ah /t}a 3 � .sue 60 oAk 7y l] 6 r) n� _ J l vn g/ 90, y It �5dr duo 537_._ XZSC�/7Sb �A M46 W I en r Pb� o JaanuJ c E 0 U c�-e � E O m u c� � rm x cfl �, ` C U p �. Ir+ 9 N ' cu L N N a m U M T cu co CO cn3� Oc 0 05 O ai ='C� L � E G U O co O ~� ,� N y O O U 'O Z� - 0 co LL O�U�� 0) x D O) O Q.2) 2 N CO U j Q J J OM U) U iA LL • • • • � W N s.j y ^ R N V O N ® Z . O rrnn 3. V H � 9 L M Z C p m �� $ m a. W LL co U co o N rn Z-r cc $. i ; N m „ a � m �. J H� co �a S EPTIC TANK S" PUMP CAMBER CROS SE AND SPECIFICATIONS ,Do o e , 4 CI VENT PIPE 12 MIEN. ABOA GRADE S WEATHER PROOF ?:25 FROM.DOOR, WINDOW- OR JUNCTION BOX APPROVED FRESH AIR INTAKE.— WITH CONDUIT MANHOLE COVER FINISHED GRADE 4" Cl RISER �• W/ PADLOCK & WARNING LABEL 6 MIN. ABOVE G ADE --�— 4" MIN. 1Q" IN. 6" MAX. I14LET WATER TIGHT SEALS GAS- TIGHT 1 L ' APPROVED 4 �� BAFFLE SEAL I ; ALM JOINTS W/ CI CI PIPE ' PIPE 3' ONTO 3' ONTO ON SOLID SOIL SOIL PUM P OFF ELEV. Vio kT. Y OfF Al RISER EXIT PERMITTED ONLY IF.TANK . MANUFACTURER HAS APPROVAL 3 APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE TANK MANUFACTURER: �,�} (St asp- NUMBER 'DOSES PER DAY: TAN SIZES SEPTIC I2 5`Z) GAL. DOSE VOLUME INCLUDING DOSE GAL. FLOWBACK: GAL. ALARM MANUFACTURER: / 'y_5_t"llAPACITIES: A INCHES = VOL GAL. MODEL NUMBER: 161 N SWITC H TYPE: B = 2 INCHES = 29,q GAL. r - -1ov� PUMP MANUFACTURER: �' \�S C = INCHES = IJO GAL. MODEL NUMBER: W � p alb j� y 3 y� SWITCH TYPE: � D = INCHES = L GAL. REQUIRED DISCHARGE RATE GPM PUMP ALARM WIRING AS PER ILHR 16.23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE 1� PEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . % 2.5, FEET + � FEET FORCEMAIN X e FT /100 FT. FACOR , 5 7 FEET T.OTAL DYNAMIC HEAD Jd FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH -1 ; WIDTH rY.A ; DIAMETER LIQUID DEPTH �J � .� /3),1> n SIGNED: LICENSE NUMBER: a20537 DATE: �!9 Goulds Submersible Qof)G�A n``aAc, I l0 3 7 01,1 R L Effluent Pump W%(>r151_V t7 3885 APPLICATIONS • Overload protection must smooth operation. Silicon can be operated continuously Specifically designed for the • be provided in starter unit. bronze impeller available as without damage. following uses: Shaft: threaded, 400 series an option. = 1111111 Bearings: Upper and •Homes stainless steel. ■ Casing: Cast iron volute lower heavy duty ball bearing • Bearings: ball bearings type for maximum efficiency. construction. • Farms upper and lower. PP 2 NPT discharge adaptable • Trailer courts s ■ Power Cable: Severe duty • Motels Power cord: 20 foot for slide rail systems. rated, oil and water resistant. lengths available). • Schools standard length (optional n Mechanical Seal: SILICON Epoxy seal on motor end Single phase: • Hospitals CARBIDE VS. SILICON provides secondary moisture • Industry '/3 and' /2 HP —16/3 SJTO CARBIDE sealing faces. barrier in case of outer jacket • • Effluent systems Stainless steel metal parts, damage and to prevent oil with 115 V or 230 V three prong plug. BUNA -N elastomers. wicking. SPECIFICATIONS • % -1'/2 HP —14/3 STO with n Shaft: Corrosion - resistant ■ 0 -ring: Assures positive Pump bare leads. stainless steel. Threaded sealing against contaminants • Solids handling capabilities: Three phase: design. Locknut on three and oil leakage. 3 /," maximum. •'/2 -1'/2 HP —14/4 STO phase models to guard • Discharge size: 2" NPT, with bare leads. On CSA against component damage AGENCY LISTINGS • Capacities: up to 128 GPM. listed models — 20 foot on accidental reverse rotation. SP Canadian Standards Association • Total heads: up to 123 feet length SJTW and STW ■ Motor: Fully submerged in — TDH. are standard. high -grade turbine oil for • Mechanical seal: silicon lubrication and efficient heat 111 underwriters Laboratories carbide -rotary seat/silicon FEATURES transfer. carbide - stationary seat, 300 ■ Designed for Continuous series stainless steel metal •Impeller: Cast iron, semi- open, non -clog with pump - Operation: Pump ratings are parts, BUNA -N elastomers. out vanes for mechanical seal within the motor manufacturer's • Temperature: protection. Balanced for recommended working limits, 104 °F (40 °C) continuous 140 °F (60 °C) intermittent. METERS FEET • Fasteners: 300 series 90 stainless steel. SERIES: 3885 SIZE:' /: SOLIDS • Capable of running dry 25 80 RPM: VARIOUS without damage to wE' ......_._L._.... ___.. ....... . _........ - +- – 5 GPM ..... _._._ ... ....- .......... _ _... _._ components. 70 W 5FT i 20 -- --- — I Motor ° eo Single phase: _ -wEO •' /3HP 115V 200 V 230V " 5 0 60 Hz, 1750 RPM; %2 HP, z 115 V, 60 Hz, 3500 RPM; 0 4 EO M '/2 HP —1'/2 HP, 230 V, - - — - 60 Hz, 3500 RPM. ° 10 30 • Built -in overload with 20 vuEO3L automatic reset. 5 • Class B insulation. 1 Three phase: • '/2 H P —1'/2 H P 200/230/ 0 0 460 V, 60 Hz, 3500 RPM. 0 10 20 30 40 50 60 70 80 so 100 110 120 130GPM • Class B insulation. ' 0 10 20 3 3n, m CAPACITY ©1995 Goulds Pumps Effective May, 1995 83885 Wisconsin Department ofCommerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of- Bureau of Integrated Services in accordance with s. ILHR 83.49, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must C my include, but not limited to: vertical and horizontal reference point (BM), direction and 1 C f- r percent slope, scale or dimensions, north arrow, and location and distance to nearest road. `t Parcel I. D. # APPLICANT INFORMATION - Please print all information. y,_, Revie ed by Date Personal information you provide may be used for secondary purposes (Privacy Law sr19 f Property Owner Properf cation,, u l p ��� ;Govt. Lot j 114 M W 1 /4,S AID T .30 ,N,R / Oor) W Property Owner's Mailing Address f LO"-' ._ # Subd. Name or CSM# .3 a G P r N p- tJ R City State I Zip Code Phone Number ❑ City illage Town Nearest Road WI 1 _ of ('tt )a 5 r;r `r`� A* ❑ New Construction Use: %Residential / Number of bedrooms — Addition to existing building [Replacement ❑ Public or commercial - Describe: Code derived daily flow � _ gpd Recommended design loading rate —,L )—bed, gpd /fi r S trench, gpd /ft Absorption area required $A7 ft - -qo_trench, ft2 Maximum design loading rate y 7 bed, gpd /ft S trench, gpd /ft Recommended infiltration sChace elevation(s) t -e q +A ft (as referred to site plan benchmark) Additional design /site considerations A /i4 . AV A, material Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system S❑ U I S❑ U [ s U EIS W U EIS W U EIS JO U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench / a_b A• 2 I S m r 0, 61 In -51 m sak Lo m s Ground 3 0 Al O m S 0 1 1 - 3 elev. Iwo 36A Depth to limiting' factor Remarks: Boring # 8 fD A R Z rn,4 r 0 - 5 a s 1 m f` c is r►^ 5 : •(, Ground elev. Z Depth to limiting fact (?r in. Remarks: CST Name (Please Print) Signat a Telephone No. p Address ate CST Number Jg t W T `` S S 'car OS l i OIL DESCRIPTION REPORT ' PROPERTY OWNER � �'`�� 1 � � -iM 4 � Page of3— PARCEL I.D.# Boren # Horizon Depth Dominant Color Mottles Structure 2 9 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench J o - ) 0 hN4 r c . 5 �. Ground b•$© j S n1� �� `� elev. 5D 21g Depth to limiting factor �in. Remarks: Boring # Ground elev. ft. , Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # ........................... Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft , Depth to -t--4 limiting factor in. Remarks: SBD -8330 (R. 07/96) IL 19 3 7 `hr (L G V 0 . �_ r � _ .�3 D S ar 1 3 ' r m eil Do, 4 m 11 $, �1� 'B� Sidi �� v1( 'rtZ p 53 r _ 0 L I SYSTEM ELEVATION AND SIZING CALCULATIONS Below Grade Chamber Soil Absorption Systems Permit Number 11/8/99 Date x °x. Gravity Distribution only 1 Pressure Distribution 3 ft Suitable Soil , Note 1: Bury depth as per manufacturer 18 in Chamber Height 2 8 ft Maximum Bury Depth 3 600 gpd Estimated Daily Peak Flow 0.80 gpd /ft Wastewater Infiltration Rate 750.0 ft Code SAS Size 40 % Down Sizing Credit 300.0 ft Reduction ( -) 450.0 ft Min. SAS Size 94.20 ft Proposed SAS Elevation Soil Surface Acceptable Finished Grade EL 4 (ft) Boring Grade Limitation SAS Elevation (ft) System Minimum Maximum Number Elevation (ft) Depth (in) Lowest Highest Elevation? 97.20 103.70 1 98.20 86 94.03 96.03 Yes 2 1 97.30 84 93.30 95.13 1 Yes 3 98.50 90 94.00 96.33 Yes 1. Depth of suitable soil required below the infiltrative surface for treatment. 2. Total height of chamber in inches. 3. Maximum bury depth as per manufacturer's recommendations. 4. Based on chosen system elevation, and chamber height. Top of chamber is equivalent to top of aggregate. The addition of fill for cover or the reduction of finished grade may be required to meet minimum or maximum code standards. SBD- 10553 -E (R.05/98) ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer } g � : c m�tn sYo Mailing Address 3? e� �� (v � -ec,,� � � c� Property Address �'Sa v�,.p (Verification required from Planning Department for new construction) City /State C� Parcel Identification Number L`� �- 0 V60 ©� LEGAL DESCRIPTION Property Location NY-- ' /4, !ti '/4, Sec. p�Q, T 3 N -R W, Town of rl �� 0, ol d Subdivision 1 S Lot # N Certified Survey Map # Volume , Page # Warranty Deed # 3 0`°7 `�-� , Volume S 3 , Page # Spec house ❑ yes 4 no Lot lines identifiable F 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 master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating'that your Sept* system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 day , f the thr ar expirati date. p : I NATURE PLI A 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 =GNAOF)*ffLIC ab - ve, b irtue 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 DOCUMENT NO. STATE BAR or n BODNSM -Ffta } WOMAN" DEED 3 u " »� � y o` 5 2 '��E 165 THIS SPACE RESERVED f011 RECORDING DATA 8V John W. Peterson a sin man MEGI STERS OFFICE THIS DEED, made between ♦ sin ST. CRotx CO„ W11L Recd for Re=d thts_2 Granter ft Ofd AD. 191$ and Wri ald'_ oney an rguerfI:e I - 15 bus= t � ban a i3fe`is ') n— t t enan t s, Grantee, Witneeseth. That the said Grantor for a valuable consideration 124 g hty-six ! — T2souaand -- (.$4$, Dollars I conveys to Grantee the following described feel estate in_„ St `( zoi,x,.,- ^Count Y. rHE NDRIX To State of Wisconsin. W. VAN DYX I The South Half of the Northeast Quarter (Sh of NE(t) Section Twenty (20); The East Tax Key e Half of the Northwest Quarter (E� of NW's) This is homestead property. Section Twenty (20); All in Township + j Thirty (30)North, Range Seventeen (17) West I E IRAN FER ` Together with all and singular the hereditaments and appurtenances thereunto belonging or in any wise appertaining; Ana ___Jahn w- �- tP�nn a single man gy warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except l I and will warrant and defend the sank. �! Executed at New Rir -- hriln Wiscons this day of camber 19-7,S-. ' SIGNED AND SEALED IN PRESENCE OF (SEAL) John W . Peterson (SEAL) (SEAL) -- -- - - -- -- - (SEAL) Signatures ot_j4Dhnsr -..1 "e ter Son,. authenticated this 2211Ej day of .. __- Uleoce r 19 Z / A L Hendr1k -WT Van -$yk Title. Member State Bar of Wisconsin or Other Party Aut%orized under Sec. 706.06 via. j STATE OF WISCONSIN _ County. s a. j t Personally came before me, this __ -_ _.__ _.___ day of I9 the above named. - - - to me known to be the person- who executed the foregoing instrument and acknowledged the same. t t i j This instrument was drafted by Van Dyk Law Office - _New_Richmmnd,_1dLi4W ___._ -__ Notary Public County, Wis. 3 +r The use of witnesses is optional. My Commission (Expires) (Is)- Names of persons signing in any capacity should be typed or printed below their signatures. welar..c«e.y� WARRANTY DEED -STATE BAR OF WISCONSIN. FORM NO. I — 1971 Parcel #: 012 - 1046 -00 -000 09/28/2005 09:59 AM PAGE 1 OF 1 Alt. Parcel #: 20.30.17.305 012 - TOWN OF ERIN PRAIRIE Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-owner O - MALONEY, DONALD & MARGUERITE DONALD & MARGUERITE MALONEY 1637 CTY RD G NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1637 CTY RD G SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 39.000 Plat: N/A -NOT AVAILABLE SEC 20 T30N R1 7W NE NW 39 AC Block/Condo Bldg: Tract(s): (Sec- Twn -Rng 401/4 1601/4) 20- 30N -17W Notes: Parcel History: Date Doc # Vol /Page Type 2005 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 06/15/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.000 11,000 103,800 114,800 NO AGRICULTURAL G4 20.000 1,900 0 1,900 NO UNDEVELOPED G5 1.000 100 0 100 NO ENTERED BEFORE 2005 OI W7 13.000 14,300 0 14,300 NO Totals for 2005: General Property 26.000 13,000 103,800 116,800 Woodland 13.000 14,300 14,300 Totals for 2004: General Property 26.000 13,000 103,800 116,800 Woodland 13.000 14,300 14,300 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 311 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00