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HomeMy WebLinkAbout016-1020-90-100 _ ST. CROIX COUNTY ZONING DEPARTMENT s AS BUILT SANITARY REPORT Owner •� Property ddress p to G , ! , 3 :c{n� � / City /State t.J 'T� I Legal Description: Lot Block Subdivision/CSM # t /a 40 ' /a, Sec. -P—, Tf0_N -R45 W, Town of PIN # ep I(a —1O ;)o —2s y' 62 /(P - iC4:�;o - 90 SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: I� Tank manufacturer _ Size ST/PC etback from: House Well P/I, Pump manufacturer Model 1 Alarm location `� 4 v (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: 4 Width Length Number of Trenches l Setback from: House ell /L Vent to fresh air intake ELEVATIONS Description of benchmark ElevationSd Description of alternate benc ~ ark NA Elevation --3 Building Sewer (0 ST/HT Inlet _�� l ST Outlet PC Inlet ff PC Bottom j t 1J Header/Manifolc' d Top of ST/PC Manhole Cover Distribution Lines O 9.-11 O O Bottom of System () `l 1 () ( ) Final Grade O O ( ) Date of installation b /�L Permit numberS3 State plan number Plumber's signature c icense number Datee& / Inspector c:� Complete plot plan p � J 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 A 11 c� PA PA INDICATE NORTH ARROW Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: IX y ou rovice may be used for p urp oses [ Privacy La s.15.04 (1)( 38864 Personal information Y P Y secon P P [ Y PerrpitlLQ i'16 N & LANA E] CitY Town of: State Plan 1D No.: CST BM Elev.:- U Insp. BM Elev -: BM Description: L WV Parcel Tax No.: OV a r 016 - 1020 -90 -100 100 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic �fiJ� rr Q da Benchmark — rc / C o Dosin co g P s v B s lC l Aeratio Bldg. Sewer a .� st t Inlet /3.0 'Fe, 7 TANK SETBACK INFORMATION utlet TANKTO P/L WELL BLDG. Ventto ROAD D t T Air Intake 0 tD ptic .� Jr t i ZL' NA Dt Bottom Sf osing �) f /i!� 1` 1ZL� NA Header/ Man. rat ion NA Dist. Pipe 79 r Holdin Bot. System 9 >- PUMP / SIPHON INFORMATION Final Grade Manufacturer � � Demand T 7_ S Model Number Gt/Z� �� GPM TDH Lift d Friction ✓� System2,� TD (� Ft Loss 0 Forcemain Length S Dia. Z ' Dist. To well T _T SOIL ABSORPTION SYSTEM BE /TRENCH Widt Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth EN I N ''J 1 1 1 DIMENSION SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type Of , A CHAMBER Model Number: System: 0Ok /b Z �l � " �F! OR UNIT DISTRIBUTION SYSTEM Header/ Manifold Distribution Pipe(s) Ir x Hole Size x Hole Spacing Vent To it Intake Length Dia Z� Length y Dia. ( ice_ Spacing p �� # �� ' V 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 resent, etc.) P P P r- LOCATION: GLENWOOD 10.30.15.163B,SE,NW,1671 HIGHWAY 128 — LOT q�, t' p ti.��l'�X I �'� J L 's •- �l �' ' t��yt. 1 t C ( A Vklt3 rN a J'fSi� c�d h991 .�' %. �:.',, t '.u/i�'1`Ed Y o t� ✓� ; , �., uc Gl v`/ Lt,�� G 04, ; z r .� ' jv :- Z - fig' �i (AM IWr /��/ l D, f t ! roo"Pr r,', 0 11 glo �Q�1"�* oav�atl�v+1 /r 1 y ba�iF .f was Ver;�, f tJ f a / e� sated V CleaN 6,J 4\�WIA l r4aw. 1 � l✓ 'Mad ''. r�e�T� �rbwi a U Plan revisiofr' r&1 &Pes ❑ No Use other side for additional information. lv S SBD -6710 (R.3/97) Date Inspector's ignature y ADDITIONAL COMMENTS AND SKETCH . SANITARY PERMIT NUMBER: , # , , r # s < S 4 f p .. .... .... ... ... E, n .. - _ a. .. .aw e r t € E y .P�... ... ,.. rE .,..n... _m. ... ..... t , e .... ..m .ate. �. w e .. e. t � [ € . , f m e 9 s a } c a 1 e 3 L E L 7 . , i k .. , E 3 i r 2 f Y i . .e .......a .,m _. .... ...... p. .�. .�..... .., .m....e .....e e< ... _.. . ... .. g, ... ..< .m ,. . i 1 S � # ? ......,. e : ... ... f E b � } aE 9 # a # 2 a e E e ° e� `a # # I Safety and Buildings Division SANITARY PERMIT APPLICATION B ureau of Building Water Systems 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. S+ ,Cr • See reverse side for instructions for completing this application StateSanitaryyPjerrmit�Number The information you provide may be used by other government agency programs El Check if revision to p nevi a lication [Privacy Law, s. 15.04 (1) (m)1. State Plan LD. Num I. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Property Owner Name Property Location .}. /,"� 1t 1/4, 5 0 T ;70 , N, R E (or6) Pro erty Owner's allin Address Lot Number Block Number 10 1 Ss City, State a Zip Code Phone Number Subdivision Name CSM Num e . TYPE OF BUILDING: (check one) ❑ State Owned 0 v ilag s Nearer oa Public 1 or 2 Family Dwelling - No. of bedrooms _J_ ALT( Town DF � 1 t�n� I11. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 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 po New 2_ ❑ Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5_ ❑ Repair of an System System Tank ank Only stem ______________ 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 PffMound 30 ❑ Specify Type 41 []Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System- In -FiII 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 / s� ? ,, 0 Feet 1 99,1 Feet Capacit VII TANK in Ca gallo s Total # of N Prefab. Site Fiber Exper. INFORMATION Gallons Tanks Manufacturer s Name Concrete Con- Steel glass Plastic App New Existing strutted Tanks Tanks ptic Tan ❑ ❑ ❑ 1 El 1:1 ft P er , v I 6 7 El El El ❑ I ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber' am,e: (Print) Plumb r'S5ignature: Stamps) MP /MPRSW No Business Phone Number: 40-� Plumber's Address (street, Ci y, State, Zip ode): � IX. COUNTY a / USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater D ate Issue Issuing t Signature (NO Stamps) ['Approved C] Owner Given initial oO Surcharge fee) Adverse Determination 3 /�Cb X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: tf cCi . - Lo v. 1 k SOD -6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To: Safety 8 Buildings Division, Owner, Plumber ` v, 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 ary 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- 3815. To be complete and accurate this sanitary permit application must include: 1. 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. 111. 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 into 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 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 r 2226 ROSE ST LA CROSSE WI 54603 -1905 TDD #: 608 264 -8777 Nvisconsin ` www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary April 13, 1999 CUST ID No.5176 ATTN: POWTS INSPECTOR ZONING OFFICE RED CEDAR PLUMBING & HEATING ST CROIX COUNTY SPIA 4792 STATE RD 25 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 04/13/2001 IdgntifacatauNubrs Transaction ID No. 218769 Site ID No. 169607 SITE: Please refer to both identification numbers, Site ID: 169607 above} in all correspondence with -the agency. St. Croix County, Town of Glenwood SE1 /4, NW1 /4, S10, T30N, R15W Facility: Dan Bonte FOR: Description: Mound Object Type: POWT System Regulated Object ID No.: 459807 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 user • 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 04/01/1999 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 *erar2sf BALANCE DUE $ 0.00 POWTS Plan Reviewer - Integrated Services (608)785-9348, Mon - Fri, 7:15 AM - 4:00 PM jswim @commerce.state.wi.usI c�*. 9� Dan Bonte - Mound ,p;P Transaction # O +� Location: SE 1/4, NW 1/4, Sec. 10, T 30 N, R 15 W Town: Glenwood County: St. Croix Date: March 26, 1999 Owner: Dan Bonte Address: 910 First St.; # 10 Glenwood City, WI 54013 Plumber: Kevin Lannon Signature: License # MP 224229 Attachments: 6748 -Plan Review Application SBD 8330 C0120 W011'al page 1: cover A p� F ,, ()Nf . t 2 : calculations ' of corr�M�RC� p�PARi � g INGS s 3: r plot plan A 4: system cross section 5: plan view, lateral detail Ea COR- -�LSP0 NCE 6: pump tank exit detail 7: pump curve page 1 of 7 System Calculations One family residence I bedrooms Loading rate �'� gallons /sq ft per day Depth to ground water ? 3 Z in Depth to bedrock 7 in Cross slope 1 � � For(.:e main length 2 " ° ft of in Manifold /header length � � ft of in Drainback 3 ' Z g gallons Lateral length @ } O ' J ft pf \" z. in Lateral elevation ft (bottom of pipe) Lateral hole size k A ' in @ �"' in ( S ' 0 ft) spacing holes /lateral, »/ holes total Lateral volume 4 gallons i 1 Total lateral.discharge rate �' S gpm @ Z.S ft head Elevation difference S/ ft Friction loss �' tZ ft @ gpm Total dynamic head \Q.\ ft Pump /si'*on I' q gpm @ Z ft of head Manufacturer ��orw �• ��, Model # S w z- 'I Dose voluTe ��� gallons Lift /siphon tank `""��' �'� , yal lons Septic tank , gallons Measurement pump on & off "`� in Height alarm from tank bottom � in Reserve capacity gallons calcs page �- of 1 CA 11 - Y � � t�R'©• �!$� Wr►�as 4 a ` >� 'a, ., a' Oi+ u mfr Get. � ► Y 30 4-o of w« ti / , 1 o dp O�.k«. ► � �c�c l.o ��c 13 -3 `a S $S N SEA Sat� TC5'i" r4 PAN ADbi�i ©�iAc.- S17'� 1Ml�o �- U r "' c - • J S�i.w► C v-ot S at w. vt 4A t Rte, ct q. w . Rte 1 1 1•d� i,�'�.�i � n w.. ` � b i•.�co:1 1 s••a Aver.. 1 S 9 1 � a C �� 1.L v ; a..,,,. 14 3' ct OL ( QA. �.11 �+ .�. 1tw•t o �n :., a..•. � �:. Jl ZS p; QV.0 u.xor� ob ta.bv.�'F�a •..a.`�L �oo... of b•c \� b � l p n py.aJ � o.i Yar• r,c }fir w.L S, , S r o ... 0%6 � o Y Q_ tie 0 i I t'-e. O •. .. a~ V( Go... T on. o�� «- C�`��� �1�1 „�� =. \�., S� ... �o�.Q dC.:iea►.w �a 2.S �� ' WEATHERPROOF JUNCTION LDCKIi✓G COvRR 8o�t 1vA�N AM4 1,4W44. "ICK a�calwarr --� �� 4 C.Z. IN lbPWJU r *V"VKb _ T w 4 ♦ � t�ml7 P1PG 3 fT0 Qwj>IbTufkaD SO L. T4" Z.D. YEWT P.A" LE s MIN. A%sr ppoPitOVLQ A G.Z. ew �KC:T 7d�R� �0►JFFLE5 �AL 3' owt 'I. Pam 4 2" � 1lwo�szvoe. ON KN .CTIOMi �^ Gfi0Y�l0 L Lew , G�+F �a•�s' Pur4p D • by to�vt�tEr'E . T• . SEPTIC ` SPECIFfCATI DO S E �•►� '3 ' 1 v�c.y TAWA MAAJUFACTURER. WMBER OF DOSES: PER DAy T^WK SIZE: ` `� ' 4° es O G^L.LOIJS DOSE YOLUME ALA" MALIUFACTUILER: S 2 �� `° I01CLUDIM& OAGKFLOW: 1 `� GALLOWS MODEL WUM*R: , of ~ `°� CAPACITIES: A= Vs IWCHCS Oft 394 ¢ WALLOWS SWITCH Tyf> . �'""' Q g o INCHES OR 34 CALLOUS PUMP MAMUFACTURCR: �""v�"' P"O"` C a 6,19 I&Jf mE5 OR 116 GALLOWS MODEL AIUMOER: S W 2 D• INLHES OR ko -L GALLOWS SWITCH TUPC: y J QJ L MOTE: PUMP AND ALARM ARE TO OL MINIM DISCKAR" ItArko. L$ G►/A INSTALLED ON 5EPARATE CIRCUITS VERTICAL DIFFEREAICC bETWLgU PUAP OFF A4J0 013TRIOUTIOJJ PIPE.. � FEET + MINIMUM NETWORK SUPPLY PRE66UILC .... ..... .. 2 . 5 MET 2D c�,1 l� ♦ � FEET' OF FOR MAIf X O'koZFT FLiRICTIOId FACTOR. FEET TOTAL OtAWA IC. HEAD 1O 1 � FEET ' 1 v � h IIJTEK)JAL. DIMEIJ4106JS Of TANK: LEN&TH I t ;WIDTH � .;LIQUID DCPTN l 6 nom ^ Y - F fir a ;� MCC Performance Data Pump Characteristics Pump/Motor Unit Submersible Manual Models SW25M1 SW33M1 24 Automatic Models NMI SW33A1 1/3 HP I T Horsepower 1/4 1/3 1s Fall Load Amps 8.0 10.0 1/4 HP � Motor Type Shaded Pak R pole) a R.P.M. 1550 o a A I I IT 1 1 *1 N Phase 0 1 Voltage 11 S Hertz 60 0 0 10 20 30 40 so 60 CAPACITY -U.S. G.P.M. Operation Intermittent Temperature 120OF Ambient Total Head (feet) 4 6 8 10 12 14 16 18 20 22 24 NEMA Design A 9;� 44 41 36 33 29 26 23 18 12 6 0 Insulation Class A GPM 47 45 43 40 37 34 30 26 22 16 10 Disdlarge Sue 11-1 NPT � - SeIas Haring 1/r Dimensional Data Unit weight 30 IbL 1. Au dmeosiom in kw Power Cord 18/3, SJTW, 10' std. 3-1/2 s-a/a 1 d wwoesa9 (20' Optional) 4 _1/2 ray t I/t ndt 3. Not for camtru[Oar papose 1 -1r2 NPT Unless (a" � � 3-1/2 DISCHARGE � DimensionsadswphKae Materials of Construction awaaim le S. W level 04"W Handle Steel 6. We resave On not b 3 -1/2 make rerrsiern b as Lubrkat Oil Dielectric 09 prodwb W4 tlw Motor Housing Cast Iron s , w Oka Pump casin cost ken Sha ft Steel Mechanical Seal Faces: Carbon /Ceramic Shah Seal Seal Body: Anodized Steel Spring: Stainless Steel 11 - 1i6 Bellows: Bmm -N PUMP I 10 -1/8 ON 9 -1/2 tic Upper Bearing Bronze Sleety hming DISCHARGE HEIGHT Lower Bowing Skiak Row Bd T __T Strainer /Base Plastic 3 3 -1/2 PUMP OFF Fasteners Stainless Steel AURORA /HYDROMATIC Pumps, Inc. �- 1840 Baney Road, Ashland, Ohio 44805 (419) 289 -3042 Soil Test Plot Plan ject Name DAN BONTE Byron Bird Jr. r Address 910 1 ST ST. NO #10 GLENWOOD CITY, WI 54013 CS I ' M #3479 Lot Subdivision -- Date 5/5/9 S E 1 /4 1/4S T 3 0 N/R 1 5 W Township G LENWOOD • [] Boring Q Well PL Property Line County ST. CRO IX IL BM or VRP Assume Elevation 100 ft TOP OF WHITE STAKE System Elevation 95.8 * H R P SW Corner Alternate Benchmark Top of White Stake ioo L. v B -2 0 0 30' Alt. 70' B.M. v� 60, 50' 10% slope r 10' B.M <<5 B - 3 s - 1 P�• N 30' 0 v� PL 300' 660' Wisconsin Department of Commerce SOIL AND SITE EVALUATION l ,Dividion of Safety and Buildings Page of Bureau of Integrated Services in accordance with S. ILHR 83.09, Wis. Adm. Code I Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # �J/l G e /'I G�'1 o �!�-e 0 +' /DSO ` 0O a APPLICANT INFORMATION - Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).� q Property Owner Property Location ;6_ f� Govt. Lot � 1/41;1V14,S`Q T D,N,R Property Owner's Mailing Address Lot # Block# tSubd. Name or CSM# City 1 State Zip Code Phone Number ❑ City �., Village To n Nearest Road f en ' 1 D 5d 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 bed, gpd/ft trench, gpd /ft Absorption area required _ bed, ft - ft Maximum design loading rate __ j _ ,::;_ bed, gpd /W , , trench, gpd/ft Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design /site considerations Parent material 61 1 / ; ei / 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 El [9 U XS 0 U El ,®U ❑ S O U ❑ S 1 U ❑ S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 / in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. / Bed , Trench Ground eiev. O�eZ / // ✓`/ �ft• ' Depth to limiting factor AP' in. Remarks: Boring # /o i0 cf i2 .3 3 &_ 2 S l l a s h rn C 5 1 - to 0. 3 1 o & ri rv, i G S tJ A ,,, P.3 (o � rn _ _,),qe 10 11 A /L S C_ n ^ 1 A IJ A N A- , V) -! ; l Ground elev. r n �r 6 sl.t - Depth to limiting factor COU 1 `� NTY - sakin. Remarks: Name (Please Print) Signature -'; ? ,.. T ephone No. t4 Q,0 �� r dL� r Address Date CST Nu �ber 7d' 10 PROPERTY OWNER Q N +�- SOIL DESCRIPTION REPORT P4ge 9.f - - PARCEL I.D.# Boren # Horizon Depth Dominant Color Mottles Structure 2 Boring in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed ,Trench •3 b - /o /O 3 13 "5' / , 5 - elev -`I� 44 o Co 02 /a1 l� 1 /�) /� hj A elev. Depth to limiting factor Remarks: Boring # 13 Ground elev. tt. 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 ' Remarks: Boring # Ground elev. Depth to limiting factor ' Remarks: SBD -8330 (R. 07/96) ' r F - Soil Test Plot Plan Project Name DAN BONTE Byron Bird Jr. . Z7 Address 910 1 ST ST. NO #10 GL ENW OO D CITY, WI 54013 CS M #3479 Lot - ----- Subd ---- -- ----- Date 5/5/98 SE 1 /4 NW 1 /4S 10 T 3 0 N/R 15 W Township GLENWOOD R Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 1t.TOP OF WHITE STAKE System Elevation 9 * H R P SW Corner Alternate Benchmark Top of White Stake o B -2 c � o 30' Alt. CAJ 70 ' B . M. 60' 50' 10% slope 10' B M B -3 50 B -1 �L. 70' 30' 0 v� i u Poo PL 300' 660' " ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer U oLY\— p LP Mailing Address 0%Dq 1 % 6 (4 PUS Property Address 1 (DrI ( RLx; LA tc 0 Ginu-)(� O d- E4C 5 (Verification required rom Planning Department for new construc City/State Parcel Identification Number b 1(n - y 210 95 4- b t (o - 4 bao -- 90 LEGAL DESCRIPTION , ` Property Location 5G '/4, WW Ya, Sec. , T -R15 W, Town of C r nkk-y� . �- Subdivision , Lot # Certified Survey Map # S�J ____ , Volume O , Page # Warranty Deed # 6S9 , Volume �3to`1 , Page # 6 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 master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and ligree 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 of the three y r expiration date. raou I 1 9 / /�/ gy "-e G1jATURE 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 pr perty describe above, by virtue of a warranty deed recorded in Register of Deeds Office. 4e24 � !< q,q TURE 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 I t� n 5 949'7 - 4 �� 9" Dwunw.tNwnber WARRANTY DEED This Deed, made between Kenneth Mae* and Mary Ann Maes. husband and wife and each in their own right, Grantor, and Darnel M. Sonte and Lana K. Sonte, husband and wife as survivorship marital q S property, Grantee. Witnesseth, That the said Grantor, for a valuable consideration .t conveys to Grantee the following described real estate in St. Croix County, - .. �.''�._ _te State of Wisconsh Lot One (1) of Certified Survey Map, filed in the Office of the Register of D'seds for St. Croix County on August 26, 1998, as Document 0585875, Reccordft Are being part of the Southeast Quarter of the Northwest Quarter (SE % of Name and Return Address NW % ) and part of the Southwest Quarter of the Northwest Quarter (SW 4 /, of NW %) of Section Ten (10), Township Thirty (30) North, Range Richardson taw Omu Fifteen (15) West, o F C C � t. �', c j StJ► r � e P Box 399 / 1/ ✓` C S Spring Valley, WI 54767 �b�w,� tZ 1�,c 3Svy Part or 016 - 1020.9:. E Pan o(016-1020-90 (Parcel Ideriblication Nmibw) TRANSFER $ 3C°° FE i This is not homestead property. Together with all and singular hereditaments and appurtenances thereunto belonging; And Grantor warrants that the title is good, indefeasible in fee simple and free and Gear of encumbrances except easements, restrictions and rights of way r' record and will warrant and defend the same. Dated this 1 9 day of October ggg, a *Kenneth Maes •M ry es i AUTHENTICATION ACKNOWLEDGMENT Signature(s) Mary Anu tlaes and STATE OF WISCONSIN COUNTY Kenneth •ia e s Personally came before me this day of 1998 the above named Kenneth Maes and Mary Ann out enticated ) 4 f 0 c t o b e r 19 9 $ Mae&, husband and wife, to me known to be the person(s) J who executed the foregoing instrument and acknowledge the same. si lure Ja es g N. Knave or print name signature type or prim name _ TITLE: MEMBER STATE BAR OF WISCONSIN (If not, _ Notary Public County, Wisconsin authorized by § 706.06, Wis Slats) My commission is permanent (If not, state expiration date THIS INSTRUMENT WAS DRAFTED BY JENNIFER A. RICHARDSON Attorney at Law 'Names of persons signing in any capacity should be typed or Spring Valley, WI 54767 printed telar their signatures. (Sirinatures may be authenticated or aclmowledged. Bah are not necessary.) 1 ..,..,, adess.c+.ats Comoanr forma au Lx 'JVscons.n �'t:.cS4 Y'�! I 5858'75 CERTIFIED SURVEY MAP Located in part of the Southeast Quarter of the Northwest Quarter and part of the Southwest Quarter of the Northwest Quarter of Section 10, Township 30 North, Range 15 West, Town of Glenwood, St. Croix County, Wisconsin. Prepared for and at the request of: OWNER: Kenneth and Mary Ann Maes Glenwood City, Wi 54013 WEST LINE OF THE NW 114 OF SEC770N 10 Drafted by. - --- S03'1 7'53 "W 2624.94' - - -- - _ _ y. Kristi A. Eylandt �' NO3`I7 '53'E - '�- -- _ �� 1312.47' -�-- ` �S03i 7'53 "1312.47' -� L I Z r- > C X 'U — 0 �_ i v y ��gG Oiy�i I �� z °°� � o v cn� f ° Zr z N RONALD i. • I r0 b :°. f a n S i I p JOHNSON o n I� 6D Nay Q =�z m =Cn� 8 -- 11@6 t C co cn c �n 0 (n _ AMErRy. I n C n > - z WIS o . O v, O Iw Z u�i z D 0 ' ° `� m r D�'9 1�� � m 1Z '1 cp C7 n v a o o'n'' SUR J (D 0 ' o- m 0 ° �h4N1RN� v c c o`' a) ZBcn 100 o Cn Z= rt e.° .+ apo �D iN o C u o p 4^3 W 2 N z va_.� y ° w m n o < _. o UNPLATTED LANDS OF OWNER I D= v 'D N �; m a — - -- - - - - - -- — - -- N .Z7 0 O• a- 00 cD 7 p M D r 0 _ 4. ° a y C Ao rn — R.O.W. K - 0* - - q w — — — � g_T_i -3_ "1 28 c D rrn a) 3. � cn .1 UL v, _ � RLINE -e Z p o 5•r. �m - - , Ln D a m c ° N04- 14'33 "W 293.34 FILED t2 r ° 0 3 ° �'� — Ch ' ` - ,66. o R.O W. AUG 2 6 1998 z p : o co 0? �' o o — KATHLEEN H. WALSN a p / - � 41 I K Register of Deeds r m , D t 1 i N c0 , t BUILDING SETBAC 2 SL Croix Co" WI LW rn � rn a z 0 - vrn N N A n a m 0 n D O U: f. m� rn ao N U+ O� ID r � ADZ fi00 0� �� omy ids W in 0 ? C) Z J W LA Da I C7 00 — 4 t ^1 IZ N� rri m >m Cn / mO � N N (A - 1> CA M C �+ Ia IC � Z � ID I0 O � EAST L /NE OF THE SW W • — I D o M Z 1 / 4 OF THE NW 7/4 M 10 m � cICY) - ptna0 —jm X0 no °� — .._.. —. _.. —.. m r p t O CO o �. ;U I D Z Z w ly£ST L /NE OF rHE Sr 0' t z e 114 OF THE NW 114 v 0C �(n Icn m0 r. 3N a 0 I 0c rt �O Fn ti O — o 10 ; p m W� j I °�,°° 0 0 0 - 0 m I� 0 �p a - co O \� o C tp S03'13'57 "W 469.29' ;� JOB #98134 (R14) Prepared by. UNPLATTED LANDS OF OWNER � A & E - - - I LAND SURVEYING do CIVIL ENGINEERING Phone No. (715) 246 -4319 I . 109 East Third Street, P.O. Box 325 New Richmond, WI 54017 i Sheet 1 of 2 Vol .12 Page 3502