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HomeMy WebLinkAbout022-1057-20-000 r CD oC; o a v zi I 0 I' y I 4, o Z � p z C LL O a I ' I Z y .0 c z r y a °' w a m N I z O O z d c G 2 '. O` C O O N Z c M ^J N CL 7 N N c N C • N u L O O Z 1� Z N z c � E N V) d Z N N O. M O O (n (n U N N d l N V O 0 p (6 M N N }� ^ M 0 fn V) d) V) w 0 0 0 z O C o •�w ;� MI)aa(L L g LL (ry 7 O to `y O) O) y W J U Q 0 O ) 0 ) } Cl) LO �V ( O N O O O O N N N W p p r r 1z L m a rn 0 N O M 7 w p Q O C 04 a O O C C O R O r F-- '?� � N 7 as j N (n o0 d "+ O U m N C N U O_ 0 0 0 0 r y� . Cl? 'C p E E 'D N N N N V Q a p C O 67 pp f� 4.r O Y L O C q) N 0 0 N C6 cc r C N O CY v) O N Fa U • ►V L' 0 Y m M o Z z Y to d m £ a 3 # a L: a • Cl CL d .V (D .O+ C L `�1 A v at Oin t - r - . . Parcel #: 022 - 1057 -20 -000 04/13/2007 09:08 Ann PA 1 O F 1 Alt. Parcel #: 20.28.18.314 022 - TOWN OF KINNICKINNIC 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 - BREDAHL, DARWIN R & MARGARET A DARWIN R & MARGARET A BREDAHL 233 HWY 65 RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description t esc Yp p SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 38.000 Plat: N/A -NOT AVAILABLE SEC 20 T28N R18W NW SW ALSO NE SW EXC Block/Condo Bldg: CSM 6/1601 CSM 10/2944 & CSM 11/2980 (THIS IS A SM TRI PARCEL LEFT IN THE SW Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) COR NE SW) EZ- UT- 1450/176 20- 28N -18W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 2001/198 WD 07/23/1997 1198/399 WD 2007 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 08/10/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.000 80,000 286,500 366,500 NO AGRICULTURAL G4 33.000 4,900 0 4,900 NO Totals for 2007: General Property 38.000 84,900 286,500 371,400 Woodland 0.000 0 0 Totals for 2006: General Property 38.000 84,900 286,500 371,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 516 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 lb S7 oop ` ST. CROIX COUNTY ZONING ,REPARTMENT AS BUILT SANITARYAPORT Owner ! /nrWt (3 r A , Property Address N w G.� ►� City /State lZky Legal Description: Lot Block Subdivision/CSM # V V E' /a 0' /a, Sec. 20 ,TOON -R II Town of K��,w� et, � - }_ # 022 ►b�7 -2a SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer P rec-;' Size ST/PC iiou / 9oa Setback from: House �_ Well >75' P/L 72� Pump manufacturer ('rbN its Model Alarm location s T (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: i re ncl e s Width _ Length 7 5 ' Number of Trenches 2 Setback from: House 6 22 , Well >io o " P/L _ Vent to fresh air intake 12 5' ELEVATIONS Description of benchmark ► o p �� -o w L) oT C o i ne, Elevation ► oo, o a Description of alternate benchmark 'ry o l l K yi ,e %da tl Elevation , Building Sewer � ? j S ST/HT Inlet 91, 84 ST Outlet Co. 6 o - b- k PC Inlet PC Bottom 8 8, 15 Header/Manifold Top of ST/PC Manhole Cover S c 99,-3 a, 9. o Z Distribution Lines (I) 95,0 ( q4 - 19 ( ) Bottom of System (1) 9 '3 , -7-4 a 3.-7 0 ( ) Final Grade 0 4 a 7 (z) 17, 9 7 O Date of installation l� o9 /19 Permit number 3 3 911 0 State plan number (� Plumber's signature 1 ~' t y. License number '2 - ?0 - 5 -5 - 1 Date -1 13010 � Inspector k e u %^, fy r 6� Complete plot plan w' 1 1 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 o Lt- 72 o n � n o INDICATE NORTH ARROW r --a" Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count y INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) S N o... IX Personal information you provice may be used for secondary purposes [Privacy Law s.15.04 (1)(m)]. 338 9 9 10 Permit Holder's Name: ❑ Cit pp Villa e Town of: State Plan ID No.: BREDAHL, DARWIN y KINNI 9 CI NNIC CST BM Elev.: Insp. BM Elev.: BM Description: Arkr Parcel Tax No.: 022- 1057 -20 -000 TANK INFORMATION ELEVATION DATA ozo,a8, 18, 31�( TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 3--2- /a 3 -Z l� Dosing Aeration Bldg. Sewer Holding Q F#1r- M+ei; �f 3 L y' , TANK SETBACK INFORMATION t I+t- �er+et• TANKTO P/L WELL BLDG. ventto ROAD ^mot - inlet = Air Intake Septic 7z t ! NA Dt Bottom Dosing 7Z t 6 NA Header / Man. t9 Aeration NA Dist. Pipe Holding Bot. System PUM / SIPHON INFORMATION Final Grade fjiir Manufacturer Demand �~ f r r r't l, y�, t.� r, /l - L fr . 2 L Q . Number 3 © GPM9 8, TDH Lift G. ,( 7 Friction : 1 � SYeterr- L DH( Ft ad oss Forcemain Length 3q' Dia. H a Dist. To Well SOIL ABSORPTION SYSTEM Z ;, X 7 5-' BED/TRENCH Width :3 1 Length No. Of renches PIT No. Of Pis Inside Dia. Liquid Depth DIMENSIONS DIMENSION SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Ma n u c rer SETBACK CHAMBER ~�� Srr INFORMATION Type O �(i� ���,, _ / �• - ► M e Number: System: (pit , J. o X200 OR UNIT DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent -. To // Air Intake Length Dia. Length Dia. Spaang > T" . 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 I ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) R�', ' 1 4 LOCATION: NINNIC I�20.28.18.314 NE, SW 233 HIGHWAY 65 �` //.w © *- $wt = 'imp ®rte" jw Plan revision required? ❑Yeso _� 1 Use other side for additional infor tlon. SBD 6710 (R.3/97) 015(ft 6 O a 4% CC s g�tyr�e _ Q 6 . 1 Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: : e ,. ,._.. .. ..... <.., a F_. .. ........ _.. .. .... ... ...... ....... ... ... .. ,. ...... ... _ e 1 ...... e, e e r ee t I 3 3 e y � .e. .,.,.... .... .......... .... .. v . „.,. .eve veeee .. ...,...... _ � _. ,... r e 3 t 3 a � e a :.. ... 3 e � s B c 1 e° s .,mfle ` M 4 .... S e � e i i E E i t e— f S f 3 m F 3, i 3 3 E a I e ` s m v E i ce. �W 7 3 feeme . .e. .. _: i- ......e —. e. .. �..,.b .ems t ..P .....«..... 3 .. ee.e.. —.,. — .._ { .... ;..... «... e ,.3....,.... «. .e.,. Y ,., ...... .� �.. ...�..�.. _ .. .» .�..__ ..._........ .. . _. R „k t semmm. .e. ee ee e:ee ............ .. .m.ee w... ° ee.. m. ,.m.. em �. a ,,.. ... e a .e em a ,. 4 2 H ..�. e mew ... .., �... .. ,... r ? e .. 3 m e e s j w � n e m e pee.... ......._ .. «�... ,...,..✓ ae. ..seam ....,.m, e i i ..- se...... .a. .m. a ..,.� .e.�....... S ..m ....:..... .... .ee..q { t B � 3 s a mem.m .e .� e..� S w 9 e 3 i t y P �... .. Ae .. e.....a A_m _.....e.eL... ...... _. ...,.,, ».,,.,,- z.........., e, m.e, e..... .,,.....5 .. .,e�.e.. ..... «..,... Z ` 3 ..,. w . .,,. ....,i € .... w . .m. w.... .., e.e.�.. .tee. —�_ ., e ..... ...................z Safety and Buildings Division V iscons i n SANITARY PERMIT APPLICATION 201 E. Washington Ave. In accord with ILHR 83.05 Wis. Adm. Code P.O. Box 7969 Department of Commerce Madison, WI 53707 -7969 • 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. S! y • See reverse side for instructions for completing this application State Sanitary Permit ibriber 2 2 3g The information you provide may be used by other government agency programs ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATION Property Owner Name Property Location ar w Q rt #tak AIE1 /4 S W 1/4, S 2 O T N, R) g "for) W Property Owner's Mailing Address Lot Number Block Number 4� y Qd Cit State Zip Code Phone Number Subdivision Name or CSM Number >Vv j=am ids w 1 I 54*7,-L (71 4;2s - -;?51, 1 II. TYPE OF BUILDING: (check one) ❑ State Owned E] lt �/�- t c Kt Nearest Road �w W w►µ t Public 1 or 2 Family Dwelling ❑ Village - No. of bedrooms Town o f ST. 1�w III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) Q, I 9 YP P PP Y _ 2-a. �i 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. jK 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 21 ❑ Mound 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 -Fill 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 6 00 1 763 0 q 3 8 to Feet Feet VII Capacit TANK in gallo Total # Of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturer s Name Concrete Con Steel glass Plastic App New Existin structed T nks Tanks Septic Tank or Holding Tank I Zap 12-60 (1 M X r f 1 ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber 8 I'J0 D ' ® ❑ 1 ❑ I ❑ 1 ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No Stamps) MP/ R o.: Business Phone Number: ar Q Gt 'c aos:5 4 171 s -, 42S 2175' Plumber's Address (Street, City, State, Zip Code): 5. 1042 t 11 W IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater D ate Issued Issu ng Agent Signature (No Stamps) Approved E] Owner Given Initial Surcharge Fee) Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-6M (R.11/96) DISTRUkrFlOR: ori9naf to County, One copy To: Safety 8 Buildings Division, Owner, Plumber I 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. 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. V1. Absorption system information. Provide all information requested for numbers 1 through 7. Vll. 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. Vlll. 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 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. r PLOT PLA N DARWIN BIZEDAHL ScaIQ / = 40 h D� o { i 2 pr Je w► �l om , Awes' cv P, TA )dK t ! Av et . ( 0 0 k 4 o r? a ,. (3q i r, Brn i �� tron Ya,p�. y2oy I(7Lo) ntr 1TL.I0o,oa NOTE: SYS TO IACLII 2 TK AICPF_5 of IZ rA NIGH CAPACSTY J'AIFIL CRAM BkfZS SYS�FN� !*1 , g3,t3b 9 I � M, �j � •�• , f l y Y - i s V , , UC i .... 3871 APPLICATIONS Motor: FEATURES • Single phase: 0.4 HP, 115 Impeller: Thermoplastic Specifically designed for the or 230 V, 60 Hz, 1550 RPM, Se,1,i- Vortex design wily following uses: built in overload Willi i )u,l,p out vanes for mechani- • Effluent systems automatic reset, cal seal protection. • Homes • Power cord: 10 toot Casing and Base: Rugged • Farms standard length, 16/3 SJTf) • Heavy duty sump with three prong grounding thermoplastic design provides • Water transfer superior strength and • plug. Optional 20 foot corrosion resistance. Dewatering length, 16/3 SJTW with three prong grounding plug. Motor Housing: Cast iron SPECIFICATIONS • Fully submerged in High for efficient heat transfer. Pump: grade turbine oil for strength, and durability. • Solids handling caliatlility: lubrication and efficient Motor Cover: Thermoplastic 3 /4 " maximum, heat transfer. cover with integral handle and • Capacities: up to 55 GPM. Available for automatic and float switch attachment points. • Total heads: LIP to 24 feet. manual operation. Automatic Power Cable: Severe duty • Discharge size: 1 1 /2 - NPT. rated oil and water resistant, Mechanic c arbo • al seal: carbon- models include Mercury Mechanical seal: Float Switch assembled and 0 -ring: Provides positive reset at the facto sealing. No gaskets to replace BUNA -N elastomers. p factory. during maintenance. • Temperature: Stainless steel fasteners. 104 °F (40 °C) continuous 140 °F (60 °C) intermittent. • Fasteners: 300 series stainless steel. METERS FEET i • Capable of running I dry without damage to B i 1 ___ - 2.,m components. 25 --- - - -- ___. _.__ �,. .� -5GPSA a 7 i. j z 20 a t Z I Y I 2 I 0 0�_._- 1__ -.___ ___.._ ._...t _... _... ._._..._...L_._w .... _. ... .. ...- i -..... i. ..._ ....... _._ 0 10 26 40 50 GPM j 0 2 4 G !3 10 12 111 CAPACITY rnective May, 1994 > 1994 Goulds Rumps, Ire ct B3871 2, '5 SEPTIC TANK & 'PUMP C HAMBE R CRO SECTION AND SPECIFICATIONS >. w 4" CI' VENT PIPE 12" MIN. ABOVE GRADE E WEATHhR PROOF '' y 25' FROM DOOR, WINDOW OR "`` ` FRESH AIR INTAKE JUNCTION BOX APPROVED WITH CONDUIT MANHOLE "' bVI FINISHED GRADE 4" CI RISER Yt, PADLOCK. 6 MIN. WARNING` 7.ABI Y ABOVE GRADE 4 ":'MIN 18" IN. 6 MAX. s4 u: INLET "E WATER TIGHT SEALS GAS- f TIGHT s, 4 11 _/ _A SEAL BAFFLE APPROVE v +its `. D, ; i CI PIPE , ALM JOINTS C3 3' ONTO B ON PIPE 3' °ONT( SOLID , ° SOLID S SOIL C PUMP OFF ELEV . 27"5 FT. — OFF '`'` RISER EX) D PERMITTED`' - 401• LL .IF: ;TANK . s MANUFACTUREF 3" APPROVED BEDDING UNDER TANK HAS APPROVAI CONCRETE PAD 4 SPECIFICATIONS N: SEPTIC / DOSE. TANK MANUFACTURER: rn;,�u, +n �rrc NUMBER DOSES PER DAY: TAN SIZES SEPTIC 1 GAL. DOSE VOLUME INCLUDING 1 DOSE 00 GAL. FLOWBACK: 151 GAL.} ALARM MANUFACTURER: _ ...- ►� Ec�a � CAPACITIES: A MODEL NUMBER: INCHES _ SWITCH TYPE: B = 2 INCHES = _.._ GAL PUMP MANUFACTURER: C = 7.9 INCHES = I 5.S GAI. MODEL NUMBER; SWITCH TYPE: D – INCHES = 12 GAL REQUIRED DISCHARGE RATE 3_ GPM PUMP ALARM WIRING AS PER ILHR 16.23W VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE 36. FEET t + MINIMUM NETWORK SUPPLY PRESSURE FEET, + 25 FEET FORCEMAIN X • 9 S FT 1100 , FT. FRICTION FACTOR . . 25 FEEZ T.OTAL DYNAMIC HEAD = /� _/e I FEET . INTERNAL DIMENSIONS OF' PUMP TANK: LENGTH ; WIDTH DIAMETER LIQUID DEPTH 21 V , ,,� rsr; F S IGNED: LICENSE NUMBER : y> S5 DATE: 1/88 Wisconsin DeRartment of Commerce SOIL AND SITE EVALUATION - Z Division of Safety and Buildings Page of Bureau of Integrated Services in accordance with s. ILHR 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 C , T Lvot percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # 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)). Property Owner Property Location V w V eJ. Govt. Lot NU_ 1/4 w 1 /4,S 2-0 T Zg ,N,R 18 ,$(or) W Property Owner's Mailing Address Lot # I Block# I Subd. Name or CSM# 42 ev 0 Its rA City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road R Wtv kfl, 1 (71S ) 925-2562 K m W . i _. ,.r. 5T ® New Construction Use: ® Residential / Number of bedrooms `� Addition to existing building v\l 14 ❑ Replacement ❑ Public or commercial - Describe: hr A Code derived daily flow 0 0 gpd Recommended design loading rate 6.7 bed, gpd/ft O . A trench, gpd/ft Absorption area required R5 9, bed, ft 7 SD trench, ft Maximum design loading rate 0.7 bed, gpd/6 0� trench, gpdfft Recommended infiltration surface elevation(s) q3 . $ ft (as referred to site plan benchmark) Additional design /site considerations 2 T e -q (. e s 1'-9- 4,u 1, C u�...�. i Tn {, I T r a7i a r c'L , M b4 \ e tic Parent material o u7t w rls � Flood plain elevation, if applicable 9/6 , 3 ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Z*U] U = Unsuitable for system t4 S El U 21 S El U � S El U 9 S ❑ U ❑ S ®U El S SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD/ft g in. Munsell ou. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed , Trench i o -q 7 5Yf 3/ S j 2 9 - 7,5'(2 `" 5; 2 4 rh V CS L)4 oj OS Ground 3 6 2e 7. 5 2 6 yve v 7 r C S 6 v+ Q � 0, S elev. 44.7Gft 4 28-91 7, 5 Y C - CJ . Depth to limiting factor in. Remarks: Boring # o -m2 7,5 C 3) 1 _ 2 r C 2� A 5. S'0. jo 2 2- )2 -29 7,5 Y 2 51 4 _ c 2 -4 , , A 4.31 '7.s Y2 3 2. Ground q 1- lk $ 7. 5 Y 5 "i v rn ( C , , elev. rK 02 Depth to limiting factor El jo in. Remarks: CST Name (Please Print) Signaturel Telephone No. COY !� �� e 71 42S _Z175 Address Date CST Number )042 rA Sy, gwe. Fk iis W; 5 402+ 5X0'9 a S s <. PROPERTY OWNER �� w i� Q �J�h ( SOIL DESCRIPTION REPORT Page —�-_ of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots G in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench [ 1 0 -L ?,SY2 3-.- — ( 2 + rn u4 p Z Ii 7 <5 `! 5 4 5;C,I Zfsbj( r), L' G l,4 GA ,O,.S Ground 3 3 -34 7,5 f Yhv7v C lv+ b. D.S elev. a l - cot . 4 34 -48 7.S Depth to 5 4 8- 9G 7, S Y fL limiting , factor ZULin. Remarks: Boring # Vw3 0 24 �, 5 ` s" I -f 0 A S' 3 24 -?t 7. 5 (' R 4 ; ry fa Yj 1 0, Ground elev. 99.a ft. Depth to limiting factor Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # r I 4 -'L? 7.5 Y2 5'cl 2 C C),9 0,s" 22 Y P 5 1 2 1 s l/ r;Zt' ,0. Ground -g 5 6 5 4 n, 5 rn) u 0.7 ' 0, elev. 4G•86 7 7.S & mei5 D A a Depth to limiting factor V in. Remarks: Boring # Ground elev. ft. ; Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) (3 RFVAP PL"T iPLA N sc"Ie 4o i L 7 p P CJ 132 T4 4/ 9i G N of Q i 65 0 L B3 To O" em Tv�Trvr VIP 204 L-U7 Cprntr E�•l a0.06 !l.tiu ria ST CROIY COUNTY SEPTIC 'TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer _ ��►_,j MARL ARr_` - 1� N L Mailing Address y R,j L,t f • , 25'y 6 Property Address (Verification re aired f Plannin De partment for new 9 g 1 r construction) City /State R',j p,. , VjAa I Z tom, Parcel Identification Number LEGAL DESCRIPTION O LZ — 1 G S �� O Property Location _IVW '/q, 5 w '/4, S , 'T N R Town of Subdivision T , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # _� 9 7� 3� � _ , Volume 0? 46 � , Page # /9�( Spec House ❑ yes hirno 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. I /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of�my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNA'IURG OF APPLICANT DATE * * * * ** Any information that is this- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Inctnde with this application: a stamped warranty deed from the Register of Deeds office a copy of the ceitifted survey map if reference is made in the warranty deed DocvMHa?T No. WARRANTY DM RECORDING INFORMATION 549'7+62 = ft2MIlAdDS ( Tma DEED, Lade between Mid central Reeds, Inc., Grantor, and G E �E Darwin R. Eredahl and Margaret A. Bredshl, husband and wife as survivorship as ital property, Grantee, � M+•r" RITNESSETE, That the said Grant +r, :or a valuable consideration ��� conveys to Grantee the following described real estate in St. Croix County, State of Wisconrtnt S E f 0 1996 The NWW of the SW of Section 20, Township 28 Tiorth, Range 18 Kest, 10:30 A M except that portion which is part of Lot 3 of CSM, in Vol. 11 of CS", `� k ccaveyed page 2980 as purposes t of Nisconsin dK - s r of (iJ for highway purpo �imter of t1e4;:s 421, page 224 as Doc. No. 283528. plus a parcel of land located in the NEW of the SWA of Section 20, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin, m fully described as follcws: Commencing at the S 1/4 corner of said Section 20t _ . , , , , . . . . . Thence N00 "17.33 along the North -South quarter Section Line 1 ^00.12 NAME AM ADDRESS feet; Thence N89'39'12•W 854.79 feet; Thence S35'31 499.39 feet to the point of Beginning: Rodlt_. Heakar, Soles i Krueger, S.C. Thence continuing S3S "31 256.68 feet t a point on the Mast line 219 North Main of said NHi( of the SWA; Thence N00°08 uong said line 209.82 feet po BBO laps, MI 54022 to a point on the south line of the certified Survey Nap recorded in Volume it of Certified Survey Maps, page 2990; Thence S89 "3:'12 along said line 149.65 feet to the point of beginning. Contains 0.36 acres. Farce Z nt cat on r PIN ..__ This is not homestead property. $49t Together with all and singular the herditaments and appurtenances thereunto belonging; and Grantor warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except: Basements, highways, utility rights and reservations of record, and will warrant and defend the same. Dated this 19th day o =" 1996. r 2 p xAL) (SEAL) Oscar C. Lee, Presi Of ' a5 Q its (t't (SEAL) _,�] L�L� (SEAL) Doris M. Lee, Secretary ADSStir ICATION act Signature (9) STATE OF WISCONSIN as. COUNTY 19 persona ly c before me this authenticated this dal of — 19 ;A1 Kid Cen a Fee Ine - by Oscar Doris Lee, Secretary- to me knowri tp ]be Y Ve executed the foregoing instrumenC *11 ac e , v the same. : !d :• .• ! 0 : t v y TITLE: ME?-2pER STATE BAR OF WISCONSIN authorise 5706.06, W e. Stats.) C1 -- jT;3AA "'God +s. THIS ZNSTitU1BNT W315 DR11lSED BY. Notary Ny c Public ission sent. (I not, exp te- Rodli, Seskar, Boles 4 Krueger, S.C_ � � 1 y River Falls, WI 54022 f ��,iS iS ©N e- Continuation of Abstract No. A6473 From the 28th day of August, 1996, at 7:00 o'clock in the A.M. of the land described as: - 19 - THE NORTHWEST QUARTER OF THE SOUTHWEST QUARTER (NW4 OF SW 4) OF SEC'1'ION TWENTY (20), TOWNSHIP TWENTY EIGHT (28) NORTH, RANGE EIGH`T'EEN (18) WEST EXCEPT that portion which is part of Lot 3 of Certified Survey Map in Volume 11 of Certified Survey a s ocum and EXCEPT those portions conveyed�for AY Purposeseto the num Wisconsin by deed recorded in Volume 421, 283528. page 224, as document number ALSO A PARCEL OF LAND LOCATED IN THE NORTHEAST QUARTER OF THE SOUTHWEST QUARTER (NEB, OF SW,) OF SECTION TWENTY (20), TOWNSHIP TWENTY EIGHT (28) NORTH, RANGE EIGHTEEN (18) WEST, TOWN OF KINNICKINNIC, MORE FULLY DESCRIBED AS FOLLOWS: Commencing at the South Quarter corner of said Section 20; thence N00 0 17 1 33 "W along the North -South Quarter Section line 1900.12 feet; thence N89 0 39 1 12 "W 854.79 feet; thence S35 °31'09 "W 499.39 feet to the Point of beginning; thence continuing S35 0 31'09 "W 256.68 feet to a point on the West line of said'Northeast Quarter of the Southwest Q uar t er ; thence N00 0 08 1 37 "W along said line 2.09.82 feet to a point on the Soth line of the Certified Survey Map recorded in Volume 11 of Certified Survey Maps, page 2980; thence S89 0 39 1 12 11 E along said line 149.65 feet to the point of beginning. Containing 0.36 acres. St. Croix County, Wisconsin. - 20 - Oscar C. Lee, Sr. and Doris WARRANTY DEED M. Lee, husband and wife - to - Dated: August 29, 1996 Recorded: September 4, 1996 Mid Central Feeds Inc. at 9:00 A.M. In Volume 1198, page 399 a Wisconsin Corporation Document Number: 549040 Transfer Fee: $279.00 This is not homestead property. Subject to easements, highways, utility rights and reservations of record. Conveys same land as shown at entry 1.9. I I :fit. Croi Valley Title Services, Inc. X. C.