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HomeMy WebLinkAbout020-1341-13-000 I 34) o 0 co d S c �; �°—! ^ O 0 3" C j Z O CO 2 N 0 H Fp* CO 7 p IV Q ICI • CL p (D N OD C p CA O O a Q -0 n c GW O C N C co OD C, I o OD ° N CD a. o D C a c C CD � o v, o, c W CL N °moo CL oODn O z N p O CO C C1 I"' M !mil O t0 00 3 '! C !�I • 7 :2 tN11 z 0 d . o 03 CA� WIs '? g5iV N O. » Z O 7 O1 O 3 CD �\ 7 M H N / o o, w CD N N C (D m to a a p m 3 7 Z M CD (a �_ p ' O A Z n n Oo> > A z O CD \` co N A 0 0 m m eo 0 iz co a ° z 3 m y y Z A I 3°—' o. N 06 ^• 7 Q g d C f V) y Z a 3 ° 2.3 y ? CD 0 z I w O CD a CL fi 3 p a 0'a m o c� o 0 0 a b o o w ° o n ti 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 1 >� � � 7 is �g 1 INDICATE NORTH OW ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner AZ 9 Property Addres City /State 4 r �Z� Legal Description: r Lot 7 Block Subdivision/CSM # Z Sec. , '�N -RjW, Town o PIN # y/- 15--5-M% SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer 5 Size ST/PC / _ Setback from: House/ Well — P/L 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: cL-.�b Width � _ Length Number of Trenches Setback from: House,---'2 Well -- P/L _ Vent to fresh air intake :S 0 ELEVATIONS Description of benchmark Elevation -0, t) Description of alternate benchmark Elevation W P1/ Building Sewer L ST/HT Inlet 7.9/ ST Outlet fi' 7 PC Inlet PC Bottom Header/Manifold 7� /� Top of ST/PC Manhole Cover t s' Distribution Lines Bottom of System Final Grade 1- O ( ) Date of installation / /45 numb r �? r f'�S State plan number Plumber's signat r License number –— S� Date 1// /Cd Inspector Complete plot plan � i ♦ �: i \ 4 �► ISI% y IL 8, `' iscusln Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Pa a of Bureau of Integrated Services In accordance with Comm 83.09, Ws. A Codegl g 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 �S percent slope, scale or dimensions, north arrow, and location and distance to nearest road. d Parcel I.D. # APPLICANT INFORMATION - Please print all information. by / _ Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m))) ,/ A - jt P Pr7 Owner Property ation v v Govt. Lot 114 1l4,S T N,Ror Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# City City Village Town a Zip Code Phone Number Nearest Road ❑ ® 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 1 _�_ bed, gpd/ft — trench, gpd/ft Absorption area required SC? bed, it ,5 trench, it Maximum design loading rate l am bed fl trench, 9P� �— 9Pd/112 Recommended infiltration surface elevation(s) 1 It (as referred to site plan benchmark) Additional design/site con rderations Parent material _ design/site 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 U4 S U Las ❑ u 1 ®s ❑ u 1 ❑ S 0 U ❑ s O U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 Ll in. Munsell Qu. Sz. Con Color Gr. Sz. Sh. Bed Trench Ground 3 A-214 1 LJ (y Depth to – limiting Qf factor > feS jn. Remarks: Boring # 13 za:�e�11_ .r C Ground elev. , Depth to limiting factor ? Remarks: CST �Namease Pri ) Signature Telephone No. _ /I/ Address Date CST Number f SOIL DESCRIPTION REPORT PROPERTY OWNER Page i of 3 PARCEL l.D.ff Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots G M O all / - 0 � y / in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench r Ground 3 elev. U &ft. S i Depth to limiting factor /l5in.� Remarks: Boring # -6 Ground elev. �s — �.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 # 131 Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) I ; I I �9 Ap ZA is , __ - - - -- , ....may -a' - - - - - - - - - ��- _ -• - -- : ,p f I { ' I i • : i I i I ! I I I ' r f : r ! I l i ! I h,.,. 7 _ I T / TAr.A�i`( �01f-� -•�f � ',- -- - -- -- ... - - -- I_ - , I Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: ST . IX P information you provice may be used for secondary purposes [Privacy Law s.15.04 (1)(m)). 338985 Permit Holder's Name: ❑ Cit pp Villa ye Town of: State Plan ID No.: PLANSKY, DAVID DSO CST BM Elev.; Insp. BM Elev.: BM Description: Parcel Tax No.: I ot a r h �� � r �'�'(' ((�rVf 020- 1341 -13 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark �� f I mp I Dosing l • 3 90.5b r Aeration Bldg. Sewer 3 33 g'�,SI Holding St /Ht Inlet /,7"93 It r TANK SETBACK INFORMATION St/ Ht Outlet /(Z( 87 .63 TANK TO P/ L WELL BLDG. Air i to ntake ROAD Dt Inlet ir Septic S f n 3r NA Dt Bottom - ---�- Dosing NA Header/ Man. , Aeration NA Dist. Pipe / ''7Z g (Z� Holding Bot. System /5-1,605 &./? , /Q , PUMP/ SIPHON INFORMATION Final Grade (Z -aD . qy ' Manufacturer Demand lZ' $q 2-s" Model Number GPM TDH Lift Friction Syestem TDH Ft Forcemain Length Dia. FFii Dist. To well SOIL ABSORPTION SYSTEM ED ;r Width f Len th t No Of PIT No. Of Pits Inside Dia. Liquid Depth EN t N DIMENSION SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type Of � f �� f � CHAMBER Model Number: System: , OR UNIT DISTRIBUTION SYSTEM Header/ nifold + �j� Distribution Pipe(s) , p x Hole Size x Hole Spacing Vent To Air Intake Length Dia. "! Length Dia. Spacing I / SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil E] Yes E] No E] Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: HU SON 22 _29.19,SE,NE 878 YOUNG ROAD — WYLDWOOD II LOT 13 A.4, 41 IJ 41ou yi L, s _IA n � fan revision required? n d No; ©� /g/ U I r 5 Z Use other side for additions If nr SBD 6710 R.3/97 L �` Date Insp�ecor' i natur8 V4P ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: . , a ! y e e w e t t s e E x e c.P e�qm o c e �s t .. a b. .., ., .., ..a.ma vm., . ._ . ._ ...1... .. .mm c E i Q x € i E s e e 5 3 _ 3 i _._, ..... m�. , ,emA. m�...:,... .... „._. .. .... .. ..... e E 1 Safety and Buildings Division SANITARY PERMIT APPLICATION 201 W. Washin Avenue 84wonsin In accord with ILHR 83.05, Wis. Adm. Code P O Box 7302 Department of Commerce Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 81 x 11 inches in size. • See reverse side for instructions for completing this application State sanitary Permit Number 3 SC7 la� Personal information you provide may be used for secondary purposes ❑ Check if revision to previous application. [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLI ATI N INFORMATION -PLEASE .PRINT ALL INF RMATI N Property Owner Na Property Location 1 & 1 /4, 5 T , N, R 4orko Property Owner's M fling A dr Lot Number Block Number -7 City, to Zip Code Phone Number Subdivision a or{SM Number ( ) PE F B IL IN : (check one) ❑ State Owned It� Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms 0 Town Tax Nu OF Parcel mbers) III. BUILDING USE (If building type is public, check all that apply) l / 3 — BBD 1 ❑ Apartment/Condo ©� r 9, . 1 q 1 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 5a New 2, ❑ Replacement 3_ ❑ Replacement of 4_ ❑ Reconnection of 5, ❑ Repair of an System System____ _________TankOnly______________ Existing ________ 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 ❑ Seepage Trench 22 ❑ In- Ground Pressure ' / 42 E] Pit Privy 13 E] Seepage Pit 43 ❑ Vault Privy 1 /2 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absor . rea 1 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /' ch) Elevation Feet Feet VII. TANK in allo Capaclt y s Total # Of r Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturers Name Concrete Con Steel glass Plastic App New Existin Tanks Tanks is Ta r H ❑ El k[ 1:1 1:1 1- um Pp Tank /Siphon Chamber ❑ 11 ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for i stallation of the onsite sewage system shown on the attached plans. Plumb r' Na e: (P nt Plumber's Si6na re: (No ps) MP /MPRSW No.: Business Phone Number: r PI ber's Address (Street, ty' State. Zip Code) t7 , IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwat ate I ssued Issuing nt 'gnature (No Stamps) 1�A roved Surcharge Fee) pp ❑Ownes D al a� t�/o ��� Adverse Determination b I X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 IRA 1/97) 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. 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. Il. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. Ill. 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. .D,��,',� �/ �Js� �.5,�� • ,�� sae 7�?�i1� � �� � ,V Q A S 6 � 16��✓ ,2/P Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of Bureau of Inti3grated Services in accordance with Comm 83.09, Wis. Adm. Code 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 S percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # APPLICANT INFORMATION - Please print all information. Rev wed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). (� Prope Owner Property Location Z VVVVVV Govt. Lot 1/4 1 /4,S L N,Ror V1 Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# City 8 f a e Zip Code Phone Number ❑ City P Village ®T Nearest Road d - ( ) 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 gpd/ft Absorption area required 9,T bed, ft Z S'O trench, ft Maximum design loading rate bed, d/ft g g �� gpd/ft2 ___g _ trench, gpd/ft Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design /site con iderations Parent material at 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 [Z S U Ids ❑ u [Z S❑ u ❑ S 0 U ❑ s 0 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 .,, h;., .....,.. ?= f 3 Grounder elev. Depth to limiting Q� factor > /dS in. Remarks: Boring # r ° Ground elev. Depth to limiting ° kI factor Remarks: CST A;m6 ase Pd ) Signature Telephone No. Address Date CST Number SOIL DESCRIPTION REPORT PROPERTY OWNER Page - L2 of PARCEL I.D.# L12C2_G��/ / -��? - Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed . Trench Ground 3 elev. d o Depth to limiting factor q� //5 in. Remarks: Boring # 13 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 # ; 13 Ground elev. ft. Depth to limiting factor in. Remarks: Boring # MUM Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) 3 AV la 7p �s I t�3 ago Wiscrosin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations Division of Safety &Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. Croix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. 020 - 1329 -90 APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION R IEWED BY ATE PROPERTY OWNER: PROPERTY LOCATION Greenwood Enterprises, Inc. GOVT. LOT SE 1/4 NE 1/4,S 24 T 29 N,R 19 : k (or) W PROPERTY OWNERS MAILING ADDRESS LOT # I BLOCK # SUBD. NAME OR CSM # 1416 Third S 13 na Wy1dwood phase 2 CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE MOWN NEAREST ROAD Hudson, WI. 54016 (715 386 -3674 Hudson, Vr)iincy 'Rd. (x] New Construction Use (x) Residential / Number of bedrooms 4 [ ] Addition to existing building j ] Replacement ( Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .7 bed, gpd /ft .8 trench, gpd /ft Absorption area required 858 bed, ft 750 trench, ft Maximum design loading rate .7 bed, gpd /ft = trench, gpd /ft Recommended infiltration surface elevation(s) 98.50 alt. area =96.90 It (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL I HOLDING TANK U = Unsuitable fors stem KI S ❑ U KI S ❑ U K7 S ❑ U ® S ❑ U ® S ❑ U ❑ S ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft .................. in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Twich ................. .................. ................. 1 0 -12 10yr3/2 none 1 2msbk mfr gw 2f .5 .6 .......1...: 2 12 -38 10yr4 /4 none sicl lcsbk mfr gw if .2 .3 Ground 3 38 -88 7.5yr4/4 none is Osg mvfr na na .7 .8 elev. 10 ft. Depth to limiting factor Remarks: Boring # 1 0 -10 10yr3 /2 none 1 2msbk mf cs 2f 1 .5 .6 2!__' 2 10 -24 10yr4 /4 none sicl 2msbk mfr gw if .4 .5 3 24 -34 5yr4./4 none sl 2mgr mvfr gw na .5 .6 Ground elev. 4 34 -84 7.5yr4/4 none co s Osg ml � , ta!P..1 rr 1 .8 t 1 02.6 f Depth to limiting fac ( r.• 1 ST HOIX Remarks: ZONINGOFFICE CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. e. New Richmon I 54 17 Signature: Date: CST Number: m02298 4 -9 -98 r PROPERTY OWNER Greenwood Enter. SOIL DESCRIPTION REPORT Page 2 'qf PARCEL I.D. # 020- 1329 -90 Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends 0 -9 10yr3 /2 none 1 2msbk mfr gw 2f .5 .6 2 9 -19 10yr4 /4 none sicl lcsbk mfr gw if .2 .3 Ground 3 19 -29 5yr4/4 none scl 2mgr mvfr gw na .4 .5 elev. 10 4 29 -86 7.5yr4/4 none is Osg mvfr na na .7 .8 Depth to limiting factor +86" Remarks: Boring # 1 0 -12 10yr3 /2 none sl 2mgr mvfr cs 2f .5 .6 2 12 -21 7.5yr4/4 none is Osg mvfr 9w if .7 .8 3 21 -80 10yr4 /4 none cos Osg ml na na .7 .8 Ground elev. 99 ft. Depth to limiting factor + 80 11 Remarks: Boring # 1 0 -12 10yr3 /2 none 1 2msbk mfr cs 2f .5 .6 5 2 12 -24 10yr4 /4 none sici 2msbk mfr gw if .4 .5 3 24 -30 5yr.4/4 none sl lcsbk mfr gw na .4 .5 Ground elev. 4 30 -80 7.5yr4/4 none is Osg mvfr na na .7 .8 9 9.4 ft. Depth to limiting factor +80" Remarks: Boring # Ground elev. ft. Depth to limiting factor LL Remarks: SBD- 8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Greenwood Enterprises, Inc. New Richmond, WI 54017 MPRSW -3254 SE4NEq S24- T29N -R19W (715) 246 -6200 lot #13- Wyldwood -town of Hudson N 1 =40' BM.= nail in Boxelder tree C el. 100' Alt. BM.= nail in Boxelder tree C el. 104.05' This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be satisfactory for your use. The location of the system may or may not be as shown, as permanent lot lines had not been established at the time of test. 5Z 2- 1� Ila' g *2 l o t , `([� xf r 5 ' �O 1 Gary L. Steel 4 -9 -98 ST CROIX COUNTY SEPTIC "TANK MAINTENANCE AGItLALAI :NT AND OWNERSHIP CERTIFICATION FOIZNl Owner/Buyer tz 4 _ ` S "L — ---- - - - - -- 1 1 - 1 1 ve - f , Mailing Address �' rY' z � Property Address -0 �-� /ivy► - yctauz— (Verification required rom Planning Department for new cui;_,inic tton c City /State /1 i Parcel Identification Nutnbci __63 :; _ 41 — L;? 9 LEGAL DESCRIPTION Property Location ' /,, /A, Sec. �4 , "f - -N - R _� - �1 '0 i ow tl r,t SGf7. Subdivision "-J Lot # — 13 Certified Survey Map # 57%C/6 Volun1C Warranty Deed # Spec house 0 yes fd' no Lot lines identiliLlblc ;cs C] do SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result un It," tailun c to liandlc wastes. Proper ilia late nance consists of pumping out the septic tank every three years or sooner, if needed by i ho, ert�,cd puu,l,cr. wliat you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal ,y tern The property owner agrees to submit to St. Croix Zoning Department a ccrtifncatuin form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper \cnlyirij- that ( 1) the on site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the ,cpinc tack is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to mamiain the pn ic.,tc .cwaj;c disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natur::l PC OLLree5, State of' WiSConsill. Certification stating that your septic system has been maintained must be completed and returned to the ;t i 'iui:, ('aunty Zoning Office within 30 da% a of the three year expiration date. SIGNATURE OF APPLIC4XT DATE OWNER CERTIFICATION I (we) certify that all statements on this forru are Luc to the best of nn (�:c) aui (arej the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of I )o•ed. ( tit,, r SIGNATURE OF APP • NT l)A 1 t. MSr * ** Any information that is mis- represented may result in the sanitary pciuut L t r,l 1, iiic• zoning Department. rr Include with this application: a stamped warranty deed from the Register of a copy of the certified survey snap i1 rcfeieucc ii uia,ir u; ihr ,%,iiianty decd J ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGRL -'FN /1 :N '1' AND OWNERSHIP CERTIFICATION FOIZN'I Owner/Buyer ` S — -- - - -- Mailing Address f �" I've 1 Property Address '-0 13 (Verification required rom Planning Department for new c„i;:,uuCtiun __ \ City /State 50/7 i w Parcel Identification Number _ /341 - 12-R. - LEGAL DESCRIPTION Property Location Se /., ' //, Scc. h - N -R iown r,l Subdivision WVlGlGt"d Lot 4 _ Certified Survey Map # 571K/6 _, Voluntc Warranty Deed # 7g talk , Volume _ Spec house ❑ yes ff no Lot lines i�lcritiIi iblc ;�s L 1 no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its prciii.,iiat ta,l:uc tO 11:111dlc wastes. 1•r oiler maintenance consists of pumping out the septic tank every three years or sooner, if needed by ., ii�ensed puiope `What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal Sy:,tem. The property owner agrees to submit to St. Croix Zoning Department a ccitiftcatum form, signed by the owner and by a master plumber, journeyman plumber, restricted Plumber or a licensed pumper V entyin, that t I) the tin Site waste water disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the Scptic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the prig atc Scwaz;c disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natur;,I RC10nR:es, State ol' WISCO"Snl. Certification stating that your septic system has been maintained must be completed and ictumcd ti, tljr : t + c'uunty 7_.onmg Offi e within 30 daj.; of the three year expiration date. 4.4'2' &W�' _ � L SIGNATURE OF APPL.IC U.61 'L- OWNER CERTIFICATION I (we) certify that all statements on this foini are tnic to the best ( d (, ti:c owner(s) of the property described above, by virtue of a warranty deed recorded in Register of I )red, "11 r _ J 44�� ` SIGNATURE OF APP NT UA f1: ••* * ** Any information that is mis represented may result in the sanitary pciuut t i!ic Zoning Depailnient. '• Include with this application: a stamped warranty deed from the Register of I )eedti .t t it copy of the certified survey map it reference i >, uiatir u, jilt- %t.uianty deed 58s25U Vol .:urnant Number _ WARRANTY DEED REGISTER'S OFFICE ST. CROIX CO.. WI This Deed, made between Greenwood Enterprises, Inc., a Itaa•d rw Raro vsconsin corporation, Grantor, ar.; David L. Piansky, a single person OCT 0 L 1998 Grantee. Witnesseth, That the said Grantor, for a valuable consideration 9 p A M ..)f one dollar and other good and �,aluable consideration conveys to Grantee the following described real estate in St. Croix County, hate � RaXhlfef ONda of Wisconsin: Recording Area Name and Return Address_ � q� 020 - 1341 -02 -999 (Parcel Identification Number) Lot 13, of the Plat of Wyldwood 11, filed in the Office of the Register of Deeds for S:. Croix County, Wisconsin, on May 27, 1998, in Volume 7 of Plats, at Page 20, as Document Number 57 $ �SFER FEE This is not homestead property. Together with all and singular hereditaments and appurtenances thereunto belonging; And Greenwood Enterprises, Inc. warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and reservations, if any, of record and will warrant and defend the Dated this; L day of September, 1998. GREENUYOOD ENTERPRISES,, By. -- 'James E. Rusch, its president FiREENW O NTER {� ay: — •Mary R. t1rs sec eta AUTHENTICATION (/ ACKNOWLEDGMENT r y f ; WYLDWOOD II 579&LG RLGIS7 Fit's OFT ICE ST CO.w19. )k Rax+vw 1. Rm d ;h..2L 4.7 d q� A 0.195._ Ar a ' F�F� - M Rw.r.:e7n LOCATED IN )HE SE 1/4 Of THE NE 1/4 OF SECTION 24. T29N• R19V, TOWN 01 HUDSC)N. St. CROIX C i af "74f3 -- p4• o rri{1� rt OWNER'S ACCESS DRIVEWAY RESTRICTION CLAUSE All driveways .h;Ch culvert hereby required to have the appropriate apron endwalt on both ends or such cut., Qeyfo .([h•E. ' � r GENERAL NOTICE STATEMENT! The parcels shorn on this plot are subject to State, County and To =nshlp lows, rules and NE CORNEA f regulations (i.e. wetlands, n. nln tot size. access to parcel. etc). Before purchasing or developing an parcel, contact SECTION 24 th St Croix Co Zonin g e . County g Office and the appropriate Town Hoard for advice This statement I put on this plat of the 729N. R19V t direction of the St. Croix County Ptonnirg, Zoning and Parks Committee. - Z o _ UNPLA f Tf.9 LANDS ul -- - - - - - - - - - - - I N u North i-e OF the SEI /4 Of the NE', NW Corner of the SE :1 of the NE x S 89'25'51' W 1328.22' NE Corner of the SE 9 of the 1"' 9 95.00' 322.00' 409.00` 50222' i 13 s O II I ' OUTLOT 2 Z 2.100 ACRES Z Z Z 4.881 ACRES 0 d S o c 91.459 S0. FT. c 14 u u 212,596 SO. FT. 1 Z o w J moo. a °• I O R= 23300' 3.327 ACRES U7 C ARC = 10342' 144.930 SO FT. C o I 61 o CHORD=10257' o 1 N 76' E A =44 : m _ R = -179. I U rt 2.193 ACRES u ARC-179.55' 1 95,514 S0. F T. _ _ . _ _ _ _ _ , o CHORD= 175.1 1 N 89'25'51' E 385.14' ° S 68'29'36' E 1 f- w ; 36 0 a 49 _ _ 3!0.65' - - - - 133.92' °. I Z 60 c b• N 89'25'51' E 474.51 58.377 S0. Ff. \ �' I d • / / T O U T L U T- 3 - \ o =, r r s0 S LA I V) N 89 E 474.64' 1.34 ACRES \ S ARC 12780' _ - 169.64• \ 'a. ��J_ CH =124 71' t DS.OTI 04� 3 OP i - 3 - \ d, I 68 E - e'S• S 14.91' 8 _ A= 44 6 cay. O J. \ N69'44 59 0 CS . N89' S'51'E c? O N 89'25'5 E 10500 R= 167.00' O ff. f \ �• 1 ARC= 128.69' �,p_ .o e V CHORD =125.53' \ o i 3 / /, (, Z A 68 E \ / G= 25'25'51' �- Z \ ° b Y QJN[L H / R= 16700• o I No �� °. G =43 DO' m 7T e ROAD BENCH MAR t� ARC =74.12' I J ' :H o c R =233.00' N89'44'OS'E ° J 1042.23'�ESTAB. CHORD =7352' 15 u = ARC-178.31' ,�dcY 8, 1996 N 76'42'55.5' E � Q? 2.539 ACRES `W° CHORD-173.99 i < S 68'20'29' £ (u m 1 r, C) 11 �l W g 110.607 So. FT. DUTLDT 4 '" Z 2.821 ACRES Q` (AREA C- CLUOINO POND - SO IP ry ' O o a U1 0 `p ' I N o L OR 1.9 t :62.782 SO T. o U- 122.897 S0. F I I I .°, .° OR 1.90 AC _I 3.731 ACRES 0 � +� o (Aa[A E.CLUDINO POaD Esw" ' 162,538 SO, FT. r ^ 56 r) °• 119.715 S0. fl. 0a 2.7(6 ACRESt .1P S69'.2'l :' 105 007 i S y r1 e 6530 S89'25'51'V 534.12' 'D ... N N 69'42'30' E s• o'' tcT m z , Q I 305.00' ' i n N o hA 42332 c.° q c° N 89 E 839.12' (N 89 E 836.9') A ^ ��� o Ai p v u ° 4: �� Q UNPLAT TE D - LANDS Vol. 512, 0 i ° N 2.1891 A CRES X. G. .6 N a L E G E N D ' o• 95,360 S0. FI. I 'd� N - z U SECTION CORNER MGNUMENT FOUND - -ALUMINUM CAP ry (ARCA E.CLUD NG POND ESm'T N 0 62.146 S0. rl_ OR 1686 ACRC S) 40 2' IRON PIPE FOUND 0 ° N 89 E 'A y 0 1' IRON PIPE FOUND i 424.33' �Z -+t-.- EXISTING FENCE O Z - --- UTILITY EASEMENT - -WIDTH SHOWN IF OTHER THAN 12' ° i ry - _ rti - BUILDING SETBACK LINE - 50' OR 100' AS SHOWN ° ut O .11 ° 7 s < % O 2'X30' ROUND IRON PIPE WEIGHING 36 . 5 LOS PER FOOT, SET N 57 2.256 ACRES I 10 E ALL OTHER CORNERS ARE MONUMENTED WITH 1'X24' ROUND t 98,257 SO FT. N IRON PIPE NEIGHING 1.68 LBS PER FOOL BENCH MARK SV Corner of Outlot 1 I ry ALL ELEVATIONS ARE REFERENCED TO USGS. 1929 ADJUSTMENT lu 1014.82. ES TAB. p 8 5'22 . 47• V DO JULY 8, 1996 4 26.98' N 89' '3 ' E A, -�- PROPOSED DRIVEWAY LOCATION - ACTUAL DRIVEWAY PLACEMENT I 6 00' WILL BE DETERMINED BY TOWN BUILDING INSPECTOR. SOUTH LINE OF h C =NO FILLING OR GRADING VITIIN EASEMENT AREAS o OUTLOT I / C7 m (N 0'00' W) PREVIOUSLY RECORDED DATA jD I \� o / w / l O SCALE IN FE ET E 1/4 CORN! U 5 _ SECTION T T29N, R19 0 100 200 300 4100 2 1