Loading...
HomeMy WebLinkAbout020-1346-00-000 o ? to 0 k $ � 3_ / » e g z E z \ 9 = a° Q �• o a o © - � ® - 91 ~� k/ + 4 0 C k / [, o E 2 E to a) ° 6 w� §]] a 0\ 0 2 / / 2 ; § \ \ E / g v E 0\ & E E Q 22q ■ Z ® -< 1 > E a m R I /r \ c co 9 0 S§a \ CD ® \ j k k k ) k E / -0 m . I I 2 2 2 m \ � § \ CA to 0 » 0 S 7 T 0 7 j & £gam [ � \ k ® ) r I % & 20 { 2 z � § ■ > 2 g & 0 @ 5 § & 0 7 ( § • GR; , I 7 \ [ 0 k 2 \ / w » / C ¥ ƒ E I q & @� I " \ ) 0 § $ {_ z C % ® I I > OL 0 § G a z % I a z � ° $ � \ � [ I a I \ I ƒ / I � \ I CD \ / _o �2 I \ \ 7 Wisconsin department of Commerce PRIVATE SEWAGE SYSTEM County Safety and Buildings Division ST. CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitaryl2wi7l Personal information you provice may be used for secondary purposes [Privacy Lap(, s.15.04 (1)(m)]. j gijl}g lgr'sgl +: EjM 2)SjAIage ❑ Town of: State Plan ID No.: CST BM Elev.: ! Insp. BM Elev.: r BM Description: Parcel Tfy�P}- 1346-00 -000 TANK INFORMATION ELEVATION DATA A9900039 310s1 'q TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic C(��'SL1 l 6 Benchmark / eo_ &' Dosing D Ii r , Al. / 7 f " Aeration - -� Bldg. Sewer Holding - St/ Inlet TANK SETBACK INFORMATION St/ I Outlet 92' 112, 36 TANKTO P/L WELL BLDG. Airl to ntake ROAD Dt Inlet ir Septic NA Dt Bottom I Dosing A Hader ' e ' g � 2 Olo .Sb Aeration NA Dist. Pipe Holding Bot. System 2 30 PUMP/ SIPHON INFORMATION Final Grade Manufa r Demand Model Number GPM TDH Lift riction gym. Ft L COSS e Forcemai Length Dia. Dist. To well SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length, No. Of Trenches P No. Of Pits Ins a. Liquid Depth DIMENSIONS J DIMEN' _ SYSTEM TO P/ L BLDG WELL LAKE/STREAM `LEAC- Manufacturer. SETBACK "`°- ""°"°"" " "_ INFORMATION Type O //a_v C' u: ✓ � OR UNBT R Model Number: ti 2 1 �- System:-Cr.,- O l DISTRIBUTION SYSTEM Header / UADAo + - Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length _4 Dia- f Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil E] Yes El No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: HUDSON 11.29.19,SW,SW 712 PACKER DRIVE – HOMESTEAD LOT 10 Plan r ision requi red? ❑ Yes Eg o / Use other side for additional information_ �o— SBD -6710 (R.3/97) Date Inspector's Signatu a Cert No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ....... . _. . W d _ _. , _ � .., a m a E E € E P , e ..<....«. f pm...e a... _:e.,- .... .i... .. 5, ...,,., v e t } 4 F 3 r F 'e E E s i 3 1 1, . _ __..m.�.. i .. m em. .. -- t e t $ a � s ' i .... .., mm ,.,m_._:�. mmms._- .�.. .. . m } �_..m ,..... _..v � ;. ....�- ,�,... am e. �,,, ... ..,�.....�.. ,. _ -.... ..... ..<...«....,� ........... ... y ..- e. .., e - . . .„.. ':.� =,- mm...4 �. (, e e E _ ..« s e a P, m m .«...„1 mm1 � „�.. 3 j a E a j '� d � ',• t 7 i E .... _ m s r � F f i c t E ®m eem -® 4 . - e w a.m. F .a Waa F ' J ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner _ 1614514.,.... Property Address 7/ Z_ - ?A E k of /4 - Q Y City/State,/- U D -So A/ W/ C �G Legal Description: Lot / 6 Block Subdivision/CSM # J 1 14!44 � '/4, Sec. LL, T Town of All C A/ PIN SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer Size ST/PC Setback from: House 4 Well- S - P/L LIZ Pump manufacturer Model -- 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: ��I�Cl� �k��� Width -�' Length Z; Number of Trenches Setback from: House P / 7 Well 19 i P/L b ` Vent to fresh air intake ELEVATIONS Description of benchmark 1 Lc� f' /,� G�,.- Al �'" C e tf N �'�- �'� ��- Elevation Description of alternate benchmark P a t �� I L) c r l 01 ' +1 !e# '1 - � - Elevation Building Sewer ST/HT Inlet 1 4 y' 3 ' ST Outlet y' J ,3 PC Inlet PC Bottom Header/Manifold 1 = _ op of ST/PC Manhole Cover Distribution Lines 10 b Bottom of System ( ) � t� I�? �1 ( ) 1 3,3 � ( ) Final Grade Date of installation 3 1Y / Permit number : ? Z , 4/ 7 77 State plan number 11 f ` ' Date Plumber's signature License number p �aDa Z I Z .2 SO 3 Inspector Complete plot plan Q f 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 F uF -- VE- w A 4. Ho�E, INDICATE NORTH ARROW -,a w�. Safety and Buildings Division SANITARY PERMIT APPLICATION 201 W. Washington Avenue VL P O Box 7302 t f In accord with ILHR 83.05, Wis. Adm. Code Department o Commerce Madison, P WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 1/2 x 11 inches in size. • o % X • See reverse side for instructions for completing this application State Sanitar Permit Number 32q ?? Personal information you provide may be used for secondary purposes ❑ Check it revision to previous akplication [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Num I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION Prop Owner Name J Property Location cc lt3 / y r / /L L I��... Ir11 /a S U,) 1/4, S T Z r N, R E ("(i:.;,:..' Property Owner's Mailing Address Lot Number Block Number ar_ / � / 1 — City, State Zip Code Phone Number Subdivision Name or CSM Number v S o N s/a/ 40 ( oME s A I. TYPE F B ILDING: (check one) ❑ State Owned 0 C It(a Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms E] Town OF uD SOIN I III. BUILDIN USE: (If building type is public, check all that apply) Parcel Tax Number(s) t! 1 1. 29 Q 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 New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5_ ❑ Repair of an System ________System ______ _____ __Tank Only______________ Existing System ____- ___- Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 []Seepage Bed N - ,z 1 ❑ Mound 30 Specify Type 41 E] Holding Tank 12 Seepage Trench LfA c >� 22 E] In Pressure 42 E] Pit Privy 13❑ Seepage Pit W. 14 FtI.TXArrd Z Z 3X SG Z 5 43 ❑ Vault Privy 14 ❑ System -In -Fill '31 Sd rr SIDE W IN PE R. t+ C g. / T 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 yl Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation, l J -0 5_4. 3► S 7 L. , $ � l�,' r OD Feet / 09.0 Feet VII. TANK Cap acit y gallons Total # Of r Prefab. Site Fiber- Exper. INFORMATION New Existing Gallons Tanks Manufacturers Name Concrete st noted Steel glass Plastic App T nks Tanks Septic Tank Q400 WE 45,04L ❑ ❑ ❑ 1 ❑ ❑ Li Pump Tank /Siphon Chamber ❑ 1 ❑ I ❑ I ❑ ❑ 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) Plumber'2 Signature: ( tam DO MP /MPRSW No.: Business Phone Number: E t 2Z�o3� 7/S -3 -Fh Z_ In er's Address (Street, City, State, Zip Code T. 070 H U175 S Y40 <o IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuin gent Signature (No Stamps) ® ❑Owner Given Initial Approved surcharge Fee) / /� pq � Adverse Determ / IBC X. CONDITIONS OF 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, usual) ever 2 to 3 ears. y y y y 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 bQromplete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling_ III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and. holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 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. HOME :;T4eib /-CT� / s - o s El.z V I IN, � �.� N L7 r*ri A T ---------- F) 17 tiL ATo AL S jcoo r -0 e6 PR 6, 14 T o I'rAte J t7 2d e6 AG a ti ZO E -o a ca x �, �,.. 60 S ` y \ cu N Q)j Q c0 C. V! • V ' IT N C7 C r O O o ca V U C 0 C c0 p L4 O v X 9- i = i� N ca '� O Q. EiE r Q) a) _ �.. t�► E c 5 0 CO y A CU N> O O a O J co Ll O S U U F15 -C U� a 0 3 .. I Q) ti w N ca N k � 1 _ ' — 3'r y 4- .' E Ln h w 1 p E s to cra z N (nap X � w 3O i ( rn N e Z , C m 0 r to U O O rn W m Q. 3 N a; Q m ) co e v ap :6 rl3 J Ahsconsin Department of Commerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code Envir BY Design Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix percent slope, scale or dimensions, north arrow, and location and distance ton -arest road. Ratrai LQ# APPLICANT INFORMATION - Please print all information.� Personal information you provide may be used for secondary purposes (Privacy law, s. 15.44 (1) (m)). y Date Property Owner Property Location 7 Miller, Sam Govt. Lot SW 1/4 SW 1/4 S l t T 29 N,R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# Truutbrook Road 10 I I Homestead City State Zip Code PhoneNumber E] City [] Village ®Town Nearest Road Hudson «n 54016 Hudson i Labarge New Construction Use: I M Residential / Number of bedrooms 3 —] Additi on to existing building Replacement Q Public or commercial describe Code Derived daily flow 450 gpd Recommended design loading rate - bed, gpolf!? 8 trench, gpd& Absorption area required 643 bed, ftz 563 trench, ftz Maximum design loading rate •7 bed, gpdff .8 tr ench, gpolfF Recommended infiltration surface elevation(s) Primairy 105 ... Alternate 112' ft (as referred to site plan benchmar Additional design / site consideration P rimaity site boring 1, 2 & 5 .... Replacement mound t Parent aterial Loess O ver Glacial Outwash Flood lain elevation, if liable Na ft le for system I Conventional I Mound I In -Ground Pressure AT -Grade I System in Fill I Holding Tank table for system ® s❑ u ® s❑ u j ❑ s ®u I❑ s® u ❑ S ®u j ❑ S N u SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/fF Baring# Horizon I in. I Munseil I Qu. Sz. Cont Color I Texture I Gr. Sz. Sh. Co nsisten I Boundary I Roots I ;Trench 1 0 -11 10yr3 /2 I - I sil 2msbk 1 mfr cw I 2f .5 .6 y 2 11 -22 10yr4 /4 - sil 2msbk mfr cw If 5 6 Groun elev 3 22 -35 10y /6 - s1 lfsbk mvfr - .5 .6 j 109.3 ft 4 1 35 -92 ! 10yr6 /8 I - I s I Osg ! m} `', . 0U .7 8 Depth to limiting i factor X92 Remarks. 2 1 ! 0 -7 ! 1Oyr3 /2 ! - ! sil ! 2msbk I mfr ! cw ! 2f .5 .6 2 1 7 -12 f 10yr4 /4 1 - I sil I 2msbk I mfr I cw L if I 5 b Ground 3 12 -21 1Oyr4/4 - Ifs lfsbk mvfr cw - .5 .6 elev 107.33 ft 4 121 -34 I 7.5yr4/6 ( - I s I Osg I ml cw I - .7 .8 Depth to 5 134 -53 I 7.5 4/6 I i I I I I Dep yr - gs Osg mI cw - .7 .8 limiting factor 6 1 53 -981 7.5yr7/6 I _ I s 1 Osg I rnl 1 - I - .7 .8 >98 Remarks: CST Nance (Please Print) Signature: Telephone No. Thomas C. Nelson ^— 715 -246 -2454 Address Enviromuciital B Design Date CST Number Ref # 1432 120th Street, New Richmond, W1 54017 2/16/99 227387 203 PRUPERTY &kNER: Miller, Sam SOIL DESCRIPTION REPORT a Page 2 of 3 PARCEL I.D.# Environmental B Desi Depth I Dominant Color Mottles I Structure ! 1 I I GPD/ft Horizon in Qu. Sz. Cont Color I Texture Gr. Sz. Sh. �COnsistence Boundary Roots I Bed ; Trench 3 1 0 -8 I I0yr3 /2 - sil 2msbk I mfr cw Zf 5 i 6 2 8 -26 10yr4 /4 - A 2msbk mfr cw if .5 .6 Ground I. I I I elev 3 26 -94 7.5yr4/4 * Osg Osg ml - - .7* .8* 110.31 ft t I I I I I I Depth to t;mifing I I I I 1 I I I I factor 26 Remarks: * A large inclusion in this hole restricts it as there is the following: sil 10yr4/4 that has mottleing of c2d5yr5 /8 1 0 -8 I 10yr3 /2 I - I sit I 2msbk 1 mfr 1 cw ! 2f 5 5 2 1 8 -24 1 10yr4 /4 1 - 1 A 1 2msbk I mfr 1 cw I if 1 .5 i .6 Ground elev 3 24 -96 I 7.5yr4/4 * I Osl Osg I ml I - .7* .8* 110.88 ft Depth to limiting factor I I I I I I I I 24 I I I I I I I I I Remarks: * A large inclusion in this hole restricts it as there is the following: sil IOyr4 /4 that has mottleing of c2d5yr6 /8 r 1 0 -19 10yt2 /1 - sit 2msbk mfr cw 2f .5 .6 I. I. I 2 19 -35 1Oyr4/4 - lfs ltsbk mvfr cw if .5 .6 Ground eley $ 3 1 35 -96 1 10yr5 /8 1 - I s 1 Osg 1 u�l - I - I .7 8 108.40 ft Depth to limiting factor Remarks: I I I I I I I I I I I I I I I I Ground elev 0W. h to limiting factor I 1 I I I I I I Remarks: [KV1 Y 0[516N 1432120 STREET NEW RICHMOND, WISCONSIN (715) 246 -2454 HOME STEAD — Lot SW' /4 SW '/4, SECTION 11 T 29 N, R 19 W Hudson Township, St. Croix County, Wisconsin Page 3 afi 4� � � 0 � Z Z°(o �QS L y 4 a 5 sfc►� Q� y S 1" =40 Thomas C. Nelson BM 1. Top of lot corner pipe ELEV 100' Certified Soil Tester #227387 BM 2. Base of white pine tree with yellow ribbon ELEV 113.65 Wisconsin bepartmentofCommerce SOIL AND SITE EVALUATION Page 1 of Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code En seress s sestsl By Drsign 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 horizo int (BM), direction and St. Croix percent slope, scale or dimensions, no d l n distance to nearest road. � ParceII.D.# APPLICANT INFORMATIO e^ ^ 1R]�ase putt all ation. 9 r-% I , �".Z Personal information you provide may used for F (P 15.04 (1) (m)). Reviewed By Date Property Owner �! _ Property Location MILLER, SAM -- ! t= n Y ! Govt. Lot SW 1/4 SW 1/4 S 11 T 29 N,R 19 W Property Owner's Mailing Addre .1 ST CROX Lot # Block # Subd. Name or CSM# TROUTBROOK RD s �, C:?JNTY �` 10 Homestead City ate :Zi @'�#l�heitrrr ❑ City ❑ Village ®Town Nearest Road Hudson 386 - Hudson LaBarge New Construction Use: lstetiala Afllmber of bedrooms ❑Addition to existing building Replacement ❑ Public or commercial describe Code Derived daily flow '/ 0 gpd Recommended design loading rate 7- bed, gpdff trench, gpdff Absorption area required 64-j— bed, tP Itrench, ff Maximum design loading rate f 2 bed, gpd/ffz tr ench, gpd/f 2 Recommended infiltration surface elevation(s) 1 b S ° ft (as referred to site plan benchmar Additional design / site nsideration Parent material C W A5 Flood plain elevation, if applicable ft S= Suitable for system Conventional unkt in Gr r:nd Pressure P,TGrade System in FIN Tank U= Unsuitable for system S ®u S ®u S ®u I ❑ S ®U EIS ®u ❑ S ® U SOIL QE'CR! TION REPORT Depth Dominant Color Mottles Structure GPD/ftz Horizon Texture Consistenc Boundary Roots in. Munse ;Tr Bonng# ff tau. az. Cont Color Gr. Sz. Sh. 1 1 0 -11 10yr3/2 - sir 2msbk mfr cw 2f .5 -6 2 11 -22 10yr4 /4 - sil 2msbk mfr cw if .5 .6 Ground 3 22 -35 10yr6 /6 - sl lfsbk mvfr cw - 5 6 elev / 4 135 -92 ` 10yr6/8 I - s I Osg I ml - I - I .7 .8 Depth to limiting factor Remarks: 2 1 0 -7 10yr3 /2 - sil 2msbk mfr cw 2f .5 .6 2 7 -12 10yr4/4 - sil 2msbk mfr cw if .5 .6 Ground 3 12 -21 1Oyr4/4 - IS ifsbk mvfr cw - 5 6 elev 4 21 -34 7.Syr4/6 - s Osg ml cw - 7 8 T Depth to 5 34 -53 7.5yr4/6 I - I gs Osg ml cw - I .7 ! .8 limiting 6 53 -98 7.5 yr7 /6 s Os ml - - .7 .8 factor ,. Y - g Remarks: CST Name (Please Print) Signature: / Telephone No. Thomas C. Nelson' (— 715- 246 -2454 Address Environmental By Design Date CST Number Ref # 1432 120th Street, New Richmond, Wl 54017 8/18/98 227387 69 PROPERTY OWNER: MILLER, SAM SOIL DESCRIPTION REPORT ® Page 2 of PARCEL I.D.# Environmental By Desi Horizon I Depth Dominant Color Mottles Texture Structure I Roots GPD/fts in. Munsell Qu. Sz. Cont. Color xure Consistence Boundary Gr. Sz. Sh. Bed ! Trench 1 0 -8 10yr3/2 - sil 2msbk mfr cw 2f .5 ! 6 2 8 -26 1Oyr4/4 - A 2msbk mfr cw if .5 .6 Ground elev 3 26DI4 7.5yr4/4 * s Osg ml DeW to limiting factor Remark ' !) A laze inclusion in this hole restricts it as there is mottlein the whole ftth of the inclusion 4 1 0 -8 10yr3/2 - sil 2msbk mfr cw 2f .5 .6 2 8 -24 10yr4/4 - sit 2msbk mfr cw If .5 .6 eley n 3 24-6 7.5yr4/4 * s Ibsg ml * e* ) L-0 Depth to limiting facto Remarks: 5 1 0 -19 10yr2 /1 - sil 2msbk mfr cw 2f .5 .6 2 19-35 10yr4/4 - is l fsbk mvfr cw if " ji ! $, 6 Ground elev 3 35 -96 1Oyr5 /8 - s Osg n - - 7 8 Depth to limiting I factor Remarks: Ground elev Depth to limiting ' factor I i I I I I I Remarks: I 0 OL BY DE51G � � � 1432 120th STREET, NEW RICHMOND, WISCONSIN 715- 246 -2454 PROJECT NAME HOMESTEAD I PAGE 3 DESCRIPTION SW % SW %, SECTION 11 T 29 N, R 19 W TOWNSHIP Hudson COUNTY St. Croix I� 9 Ll lv G � �o fl r g) 3 a '5 5 c c( j ' Sj6�� cal L X33 CI �� �.. A Sri 0 SCALE I"= Tom Nelson BM 1. L u I lei 6Ln e r �� Q J 1 C5TMO 2605 BM 2. Li 'r) O D O r) 1 1 3 t-5 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer _ _54// I Mailing Address R®X .S Property Address (Verification required from Planning Department for new construction) City/State ZL Q .S o , "'V 4 6 , '/ Parcel Identification Number Q L�o LEGAL DESCRIPTION Property Location -!S '/4, s U- '/4, Sec. _/�_, T Z`? N -R/ W, Town of subdivision Z&O /Y1F S7, , Lot # Certified Survey Map # 3 , Volume 7 Page # -3D Warranty Deed # w Z 31 . Volume /A Page # Z 9 Spec house 6 yes ❑ 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 masterplumber, 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 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 St. Croix County Zoning Office within 30 da s of the three year expiration date. ATURE dF APPL ANT DATE -: WNER CERTIFICATION �.: 1'(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 propbCey &scribed above, by virtue of a warranty deed recorded in Register of Deeds Office. ATURE 6F APPL 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 111.64' 31 n141 N.61' 07.8r 151 64"41'64'1 r .... 1 111.14' 61114 ukN' 31 6 4'4.59 14.31' 113.0' 61441'64'e Mlhl'31'1 � 31.11 1 117.64' 11 333.15' 1i 113 51.41' 64.31• kill7we 13460.43.1 ll )1 IA 411.0' U1 1N.N' 4 IU41'31.S'1 mu 1N.4' 111 10664'11'1 t 411.0' 11 111.64' 4 Af 131.4' 143.4' O1 11640'0'1 l /11.64' 15 111.11' WNW# u341'4.Sq 10.14' /64.4' Of i1141444 E 4 111.64' )1 531.16' 11 buou'Sf.St N.N' N.N' 5161 64560'11'1 • ) 0 11 ' 11 731.64' N t6443'N.S U3.34' ucU' 641 1N41'N'1 4 733.11' 1064'4 W41'134 4.64' 4.64' Nf44'0 10fhl'13'1 j 11.31 1 13 3.11' 13 713.10 3141'37' Rfhf'Uq 164.11' 131.13' of W811'11'1 Wil 1 161.11' )1 W.w 41 44 NA3 U1. 161.15 aft 141 31.14 1 331.11' 64 117.164 0h6411' Nf N9.49 6M.64. 641 644 mov'13/ 948 v 4.13' 13.'.3 141 141 � 9 c 1641511 Qf , 2113'1 U9.61 335.31' aft'N'1 ljoiru'1 ,C r L/ 3 V 0 1 'P A-1- 1� o S 164.11' UeN75 ulbrlmew 311.11' 113.21' 131 115 3 161.0' 13 13N11'lSq 131.11' 135.31' 131 '.64457646 UI`1P A TTED ! ANDS POWTN L41K or TN9 evt OF T4K 9"M S89' 35' 5 0'C 2448.54' 010.0 1 I • 11os.e••' - 4� *BAN ern FT. I :34 AMS �, :73 ' ts.SS Ac) I 42.13? s4 .. 1144 11M.10e go. 1rt) ! ® 1 2.23 107.06/ M -1 J• 1114, 3 a S ANOM 2.10 ACM , i� j ' V • ,' ao '. s� w...12 SO. ".. /�o p 4 ' its 13 ' 1.04 mou'T. 984 J lJ �• :.b 6c11n ' to \ �Ml .10 .t. (Owl" 8 e1,as WT. ! 2.ee •won 1l e» / 622 Ary 1 \ $32 It0 sp.1A' 11 I 1✓ I �� w' % � en AcA4a �- ., e ; /, K>1�4 SOIL • Z LS �is AwRt1 I 4 110104 fn R ml /.» O 1 '� ' ! - 1� aye AOId 6417?'► 9a►c � ` �\ � ''�» � � . ��. 8 \� � - - -_ 1 11 ��� / 4• AO, I x �DRIVE� " 41. �/ A9 " 3 A 337 AM . 21e1CAl 3 J< 113.064 S0. R A L \ /\ 150491 �/. Y► "�. /' 1 -40.04 =FT \ Lit 6141. V- 43 I I 507.43' te l u' »' 9Wfw LINK OF T11K SWW4 N89'29 2378.39' UNPLATTED LANDS -- - -- - 1 LOCATION SKETCH F •.: TATt. BAR (IF WISCONSIN FOR51 t— 19e2 � � N: sCN. JN er corto. .o oar♦ iWAIFTit DE � } — -- -. �; This Deed rnrJe between :tons Lc L. t: i l 1 ie and Naomi. R. t.il l ie, husband and 1, ite M AR _ Grau:un 10:30 A.' .,wl Jam C. 'tiller, a single. p.erso.R , Gr•tntee, W itnesseth , Thut the :aid (;raptor, for a valuable constdcrat,on co.IV,•;+ t•, t:r.uttce the fulluwu t ; dcs.nbcd real estate in J.t.. Croix Ill VNA rJ (',unto, State of N'IscLnstn: See attached description. Tait t areal No : ... ............................... . TRANSFER; $M 49 - This is not homeslcad property. (lb) (Is not) Togrther with all and singular the htredaAments and uppurtcu - -ices .f,vreunto bt—tiging; And Ronald L. Willie and Naomi R. t +illie uarrant> th.,t the title is guod, ulJeir .Ili r in :rr sltople ,End frre ,,I.0 C1.:.,! .f encurrtbr:.,u,cs eaC,pt easements, r?strictions, and rights -of -tray of record, :aid wltt ,+art ant and defend ti �;,me. hated tilts d:,y of `larch 19 96 (SEAL) vr%t• �r� L• t t t L�tL (SEAL) . Ronald Willie (SLAL) LCe (SEAL) . Naomi R. Willie AUTHENTI CAT 10N ACKNOWLEDGMENT Signature(s) ... _._ ........ STATE OF 1\ ISCONSIN ........... _ ......... .... ...__......... . ....... S.t•._CrQ1X ....... County. „ authcpticated this ... Jay of 19.... Person:...; came bef,re me this .....day of ....... _. ........... H.a�'Ch., 19 9b.. the above named ... Ro.na ld...L...Mil l.i.e ... akid ................... .... .... ..... ............ ................... TITLE: NIEMgER STATE B.\It r WISCONSIN Elf nut, -. _. _- authorized by S 7W.C4, t1'r;. Star,.) to me known t„ i,e the pers..n .$. .... ahu executad the foregoing instr .went and.41',k9owlcdge the same. THIS N arRUMCNr WAS O, h EU IIV + •.\ C. L. Gay. lord River Falls WI 54022 _ . <� Falls, Notery 1 Ib,fr lt. .k. "S A Cnunt }• , Wis. 1-iv tie autlh,riticat,J �r :.. I, Ir,w lc It,.th %I> l'omtuitikir:n i9r �tnlghi•nt. (If `ndt, state aspiration date: _�!. ;....L.. Q KAlt itA VTI' DGlD +r'.. I.kit 111 N'hr'It]�IN N. �• L• :.I L':....I. 47" ire. L I I'.' ParcE1 of lane located in the Sf -1/4 of the 5V -1/4 and in part cf tfE S" /, of the SV of Section 11, low'r.Ehip 25 !�erth, i,r,ntE 19 bent. Town of Hudson, beirc further descrit << follows: berannint - at the S -1/4 corner of said Section 11; thence N89 29'G3 "1;, along the South line of the S6; -1/4 of said Section 11, 237& 9 feet; thence NO2 21 he Kcrih lire '06"h, 1322.62 feet, to t of the S -1 /l of th e SV-1/ Qf Section 11 ; t!.E' "E o th_,� cam,., said North line, 2446.: fEEt to the North-icuth 1/4 line of Section li; 1325 thence S00 34'16 "i:, along said North -South 1/4 line fE , .6; EL to the point of begincinE. Parc.El contains 73.32 acres (3,19'3,674 Square fEEt) and subject to all ease:-,r of record. Together with and subject to an easement for ingress and egress located in part of the Ei: -1/4 of the SW -1/4 of Section 11 and in part of the SE -1/4 of the SE -1/4 of Section 10, all in Township 29 North, RanpE 19 West, Town of Hudson, being further described as follows: Commencin, at the 5 -1/4 corner of said Section 11; t} ice NE9 29'03 "6;, along the S 4th line of the S4; -1/4 of said Sec::_.. 2316.39 fEFt; thence NO2 26'06 1256.5 feet to the point of bEg.innini; thence continuing NO2 66,06 feet to the North lin� of the S -1/2 of the Si; -1/4 of said Section 11; thence Nb) 3515011w, along the North line of the S -1/2 of the SW -1/4 of said Section 11, 179.28 feet to the NE corner of the SE -1/4 of the SE -1/4 of Section 10; thence NS9 41'39 "v, along the North line of the SE -1/4 of the SE -1/4 of said Section 10, 1318.24 feet to the West line of the SE -1/4 of the SE -1/4 of said Section 10; thence S00 25'39 "h', along said Vest line, 66.00 feet; thence SS90 e thenc "E, on a line being 66 feet distant Southerly a,-,d parallel to the North line of the SE -1/4 of the 51-1/4 of said Section 10, 1116.32 feet to the E line of said SE -1/4 of the SE -1/4; thence S£9 "E; or, a line t,Eing 66 feet distant Southerly and parallel to the North lir.E of the of the Si: -1/4 of said Section 11, 162.54 feet to tf.c �oint of heginnint. Parcel contains 2.27 acres (95,9 6 FEEL Square arl is sut)ect to right for town road (S subject to all eascrEnts of record. cott h.cad) and m _ f ore .. ?ri- ea�c..._. _ .....- f= xclus : t. fi 3 i