Loading...
HomeMy WebLinkAbout026-1077-70-400 \ , & C) A ¥ c & K 0 2 Q$ \ U)D § /) � CIO) k $ k {k � . $ k \ ƒ / ) ƒ\ V } — -a U. 7 kCD o =n . « ° /L E )ƒ4$ § � � CL 2 K oo $ Z' & / k . K / $ : § B ) :!t 2 / . � , , k k k k \ ) .� � ƒ f ) b Q k)k } ;_ E % � . / k § § ) c f 0 2 o § o a = _ C'4 ) 00 $i § y j \ \ } t G a a a « CL k ] § § k k / 2 / = 0 Eg �§ co § « _ � 7 S R } k k 2 7 2 3 )_= E Q § \/ § f z a J/\ o c c c— B - 0 ° ( k / k 2 f) § § \ 04 / o z f k k ) A ■ � �2 .. CL E ) k a § k J a 2 0 U) J RECEIVED 7 910222 VOL 19 PAGE 4949 KATRE= H. REGISTER OF DEEDS �1 ST. CROIX CO. MI �i RECEIVED FOR kECORD 03/22/2005 03t15PM CERTIFIED SURVEY MAP W. MD( lavele 's D SURVEY M ARAO FEE: 3.00 GESt 2 Located in part of the Southeast Quarter of the Southeast Quarter of Section 26, Township 30 North, Range 18 West, Town of Richmond. St. Croix County, Wisconsin, being Lot 7 of a Certified Survey Map recorded in Volume 13 page 3712 Document No. 609354 at the St. Croix County Register of Deeds Office. OWNER/PREPARED FOR: Michael and Colleen Beauvais East 1/4 Corner 1394 130th Avenue Sec. 26 -30 -18 New Richmond, WI 54017 (Found Bemsten Survey Nail) Drafted By. Jason M. Gustafson c c y , \��SCONS+ / � �y co I n u 9 =$ JASON M. '• I GUSTAFSON * a o c _HAMMOND,; o" N V 'f(��� Lot 6 K •$ _Certified Survex Maw_ ` IN Volume 13 Page 3620 IN o E o c` S 89'40'38' E 675.01' 3 3 N a l I 0 643.90 31.11 -� 3 y..� 3: E A 1 ti o E T r'l �I�I "S*�� Lot 10 134Co ' 9 E, �� — °I M a= �--I to I I �e o ® g) M ''.' o o I E ;_os 4)1 � ®43.61' 31.091- H AZ I o O) r v L 89'40'36" E 474.70' c h� o ail —o) c o W n M y a. I �1 R^ of o � Lot 9 Lot 8 3 ' rn o LO ( M I a 5 C1- N ° i\- N o v t w® ® w am c (�0 N silo ;:.: `nj o Z� gd� g °- �� =`� Centerline � had ° ( I o Orivewo L"A vl W o Ouse NW 2650 00 c0) Well. 1 3 A.- I - �e S 89'52' . � `\ / S 89'37 51"A E 193735 ER. W. Centerline of 130th Avenue - 1 3 -N 89'37'51" W 2606.56 - - 130 A v e n ue L South 1/4 Comer South line of the Southeast Quarter of Southeast Come Sec. 26 -30 -18 of Section 26 -30 -18 Sec. 26 -30 -18 (Found Bemsten _n (Found 3/4" Iron Rod) Plot Of Sunset H OIIOW Survey Nail) -_-- - - - - -- Lot Areas: l Lot 8 Lot 9 Total Area: 225.243 Sq.Ft. /5.17 Acres Total Area: 115,110 Sq.Ft. /2.64 Acres ExcludingR Sq.Ft. /4.52 Acres Excluding ROW: 109,226 Sq.Ft. /2.51 Acres Lot 10 Total Area: 115,450 Sq.Ft. /2.65 Acres Leaend• Excluding ROW 5 .Ft. 2.51 Acres 4jp� Section Comer Monument 200 0 200 ' Job X1040004 O Set 1 "x24" Iron Pipe weighing —� Prepared By. a minimum of 1.13 pounds per GRAPHIC SCALE Gustafson Geomotics, LLC linear foot. SCALE IN FEET: 1 Inch-10 feet ammm P.O. Box 274 • Found 1" iron Pipe Hammond, WI 54015 ® Soil Test Location Bearings ore referenced to the South line of the Phone: 715- 796 -5775 _ -- Proposed Driveway Southeast Quarter of Section 26, Township 30 Sheet 1 of 2 . Building Setback Line North, Range 18 West which is assumed to bear 100' From ROW N 89'37'51" W. Vol.19 Page 4949 I 600 os CERTIFIED SURVEY M A,...n P Located in part of the Southeast Quarter of the Southeast Quarter of Section 26, Township 30 North, Range 18 West, Town of Richmond, St. Croix County, Wisconsin. EAST 114 CORNER Prepared for and at the request of: SEC. 26-30 -1B \ Bridget Bouvale (ALUM. CO. MON.) 1394 130th Avenue 0 New Richmond, WI 54017 1 N' OWNER: Margaret A. Brown LOT 2 1 Drafted by. Kristi A. Ey andt 1 CERT SURVEY MAP LEGEND VOLUME 9 PAGE 2551 to County Section Corner Monument --- - - -_ -- - -- ^I of Record NORTH L /NE OF THE SE I of • Set 1" x 24" Iron Pipe weighing 114 OF THE SE 1 4 0 a minimum of 1.13 pounds per I �. linear foot. _ _ S89'40'15 "E 675.01 9 1999 O Found 1" Iron Pipe 642.01' ��� MAR I ' MTHLEEN H. WALSH Is.er 01 Deeds LOT 4 33.00 -�i \ Reg W< a�i in ��E "• ",.. w � %/1' °,ar � I I I I �.'i� SLG(OIXGO• � a q a ;,� ba 1 o TOTAL AREA: v a I 0 0 ^ry � �� 0 218,025 SQ. FT. I ZZ' : i Co 5.01 ACRES ✓ �ilri C r o > + RON LID F. AREA EXCLUD, R.O.W.: M I W d o , 0 JC[ i 1�7N I . 207,366 SQ. FT. Z 0 0 t 1'. I I � V) v- v APJiF{ry 4.76 ACRES a 0 c�'i V ✓I( t s N89'40'15 "W 675.01' I I I v E �00 s 1 �� S D am �� Q ...•.•'• y0 Q�I \ - - -- - - - -- 642.01' - - - -- o E O SU R �� a0 1 1 \ / %}i I r \ 1 ��0 4B9nfc�p: ^' "�` II � 33.00' i 0 co •� I O I I I j.— I Z L # > p I 1 I wl 0 °?'D 0. N I I I ,so o ° w i Wi i : in I I 3 :: WI I ( �I N i V1• - cam I ll a_ M I �� ICI ZI 5 CO _ °I o 0)1 _� LOT 5 ' 3 00 I �I v)i J� c�U� W W .r I , :per I O I o wl O ` I I I I I QTAL AREA: '� M W f-I c � o u F- 1 D M I I 1 I � I-. o `0 Z a wi O 0 i 1 674,033 SQ. FT. Z; I =i W w, ° �I � z I i� 0 15.47 ACRES =� 3 I I F-I z1 0a��' I I M Y� io�'� I I 0i 2 m .E I I `° °° AREA EXCLUD. R.O.W.: a' i Oi o I I rn i ^N 3= aj 0 >, I I I 620,251 SQ. FT. pt �w; o I a) 14.24 ACRES \ �: 7 Fs. ' ° Q US o.o j BARN m: j I I W 000 I I Z z� .,U S© i I Q SHED :: 1 WELL I I Q 1 d j I I CENTERLINE DRIVEWAY II I 1 1 O V Z ,+ SOUTH 114 CORNER I I r 33 1 � 1 / r� R SEC. 26-30 1 .O. W. 130th \ (FND 1" IRON PIPE) \\ r1 i i i ii Avenue . I • ' i o I 3 _ 00 " W /6 \ i i . N89'4 _ \ —� -- — — — i� S89'37'32" " E 1931.64' _ — — i — - M N89'37'32 "W 675.01' — — — — — — — — — — — — — - -- N89'37 32 W 2606.65'------- -- CENTERLINE 1 3 0 H A V E _ N U E 133 331 1 130th Avenue SOUTH LINE OF THE SE 114 OF SECTION 26 UNPLATTED LANDS JOB #99009 200 0 200 NO TH Prepared by A & E GRAPHIC SCALE I W LAND SURVEYING & CIVIL ENGINEERING SCALE IN FEET: 1 inch = 200 feet Phone No. (715) 246 -4319 BEARINGS ARE REFERENCED TO THE SOUTH LINE OF THE 109 East Third Street, P.O. Box 325 SE 1/4 OF SECTION 26, TOWNSHIP 30 N., RANGE 18 W. New Richmond, WI 54017 WHICH IS ASSUMED TO BEAR N89'37'32 "W. Sheet 1 of 2 VOLUME 13 PAGE 3620 CO FILED $ AUG 2 7 1999 ► 9 KATHLEEN H.WA M G 05354 Z Register of Deeds Co., tlVf, CERTIF $1. Croix VEY MAP Located in part of the Southeast Quarter of' th�'�ao, E st Quarter of Section 26, Township 30 North, Range 18 West, Town of Richmond, St. Croix County, Wisconsibsing Lot 5 of a Certified Survey Mop recorded in Volume 13 page 3620 Document No. 600287 at the ,St '6pix County Register of Deeds Office. Prepared for and at the request of. Fronk He n ,,,.,e ' " EAST 1/4 ner CORNER 450 Hugo Street NE SEC. 26 -30 -18 I �, Fridley, MN 55432 C�5 N,� 5 (ALUM. CO. MON.) 1 OWNER: Margaret A. Brown LO_T_2 � ;;1 i Drafted by. Krteti A. Eyiandt � -- T D _SUR_VEY _M_ � MA- - P LEGEND �� VOLUME — 9 PAGE 2551 Section Corner Monument' =. 4 µ � d Iron in NOR1N LINE OF THE SE * Sett x 24 t i g � .b a minimum of 1.13 pounds per 1/4 OF THE SE f/4 I - . I ( � f 1:5 Ilnear o t . • I -- - - -- - - -- I 1 Iron Pie —•• —• -- —'— g O Found p I.- �3 �.e.H•ri�.a� I I �� I � OAJ o u N �119IJ I LOT 4 I of C ot I CERTIFIED SURVEY MAP f tl RONALD F . '(X - - -- ,• N > JOHNSON I VOLUME 13 PAGE — _gl ( 1 w 1a; � o' y o AMERY +, C I I t V° U O wis. Z .. o E - ♦ wg o � S89 4015E 675.01 N c o m ° � O S R�IE p 3!!�� - -- - - - -- 642.01' - - - -- 9, o~ t I OT AREA 6 33.00'" I co • c °' I - SOIL I ( N 0 ° a o I M 218,236 SO. FT. 1FST i ''� ''� co �.•.I = m 3: - o. 1 N 5.01 ACRES AR£ NIN I N WI `o ai o `a M AREA EXCLUD. R.O.W.: �33.00'� \l\ Wj Lu o`er 0 o I 207,566 SO. FT. I I � 1 3 �I N� E c o d I 4.77 ACRES FENCE - - -' 1 I �..I ZI H °,cam j 642.01' I ^ 1 S tay tnl rnr o a Q� �I r I �\ S89 '4017 "E 675.01' i aol C of CPU L I 0) I ` I O N h I c -"a8 yl `V I rn LOT 7 w m �I i QI I 1 ( I = �I o ;' o �I �i t` 1 to a TOTAL AREA: a l o, �� :i n- w "� I 455,797 SO. FT. Y °� 31 I ~I zi m o o ► 1 t u) U I OI `m'E o v1 I o� rni 10.46 ACRES < ^i wl w l r I AREA EXCLUD. R.O..: w 3 r .—� 0 3 a� >, 1 1 ;M I I W I V) e o d P: JI o I 412,684 S0. FT. '� L a; U wl �� i j .' 9.47 ACRES (� 9 0 ��� 8 W TIN U V� � o C a X ,h a BARN ~ m N CIL I Z rt 3 0 d I` 22 C) H° LL) j CO SILO I I too O I I O i ( O 1 0; I I SHED 1 + -��..� WELL 1 I W CENTERLINE ( I .. ih .... DRIVEWAY . • . HOUSE Q j I Ci SOU1H 114 CORNER I 1 1 1 33 SEC. 26 -30 -18 1 R. W. 130th b �3 fI (FNO 1 " IRON PIPE) i i� Avnu / o �\ i _ N8 9,4300*W 642.01 _ _ _ � S89'37'32 "E 1931.64' _ 4 t _ _ _ _ _ N89'37'32`W 675.01'_ _ _ -- N89'37'32`W 2606.65'- - - - - -- -- '33 33I 130th Avenue CENTERLINE 13 0TH AVENUE OUTH L/N£ OF THE SE 0 OF SEC RON 26 UNPLATTED LANDS I I JOB #99083 (stol) 200 ° _ NO TH � Prepared by. A & E GRAPHIC SCALE W LAND SURVEYING do CIVIL ENGINEERING SCALE IN FEET: 1 inch = 200 feet Phone No. (715) 246 -4319 BEARINGS ARE REFERENCED TO THE SOUTH LINE OF THE 109 East Third Street, P.O. Box 325 SE 1/4 OF SECTION 26. TOWNSHIP 30 N.. RANGE 18 W. New Richmond, WI 54017 WHICH IS ASSUMED TO BEAR N89'37'32 "W. Sheet 1 of 2 4'1.13 Page 3712 Parcel #: 026- 1077 -70 -400 09/18/2006 09:13 AM PAGE 1 OF 1 Alt. Parcel #: 26.30.18.407C -30 026 - TOWN OF RICHMOND Current [X!, ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 03/24/2006 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner MICHAEL L & COLLEEN E BEAUVAIS O - BEAUVAIS, MICHAEL L & COLLEEN E 1394 130TH AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 5.170 Plat: 4949 -CSM 19 -4949 SEC 26 T30N R18W PT SE SE BEING LOT 5 Block/Condo Bldg: LOT 08 CSM 13/3620 15.470AC FKA LOT 7 CSM 13/3712 NKA LOT 8 CSM 19 -4949 Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 26- 30N -18W Notes: Parcel History: Date Doc # Vol /Page Type 03/22/2005 790222 19/4949 CSM 10/20/2004 777586 2679/579 WD 07/23/1997 1030/27 TI 07/23/1997 777/261 2006 SUMMARY Bill #: Fair Market Value Assessed with: 0 Valuations: Last Changed: 06/22/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.170 32,700 84,800 117,500 NO 00 Totals for 2006: General Property 5.170 32,700 84,800 117,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 600 Parcel #: 026- 1077 -70 -300 09/18/2006 09:13 AM PAGE 1 OF 1 Alt. Parcel #: 26.30.18.407C -20 026 - TOWN OF RICHMOND Current _Xj ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 03/24/2006 00 5 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner RETIRED BEAUVAIS O - BEAUVAIS, RETIRED Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 10.460 Plat: 3712 -CSM 13/3712 SEC 26 T30N R18W PT SE SE BEING LOT 5 Block/Condo Bldg: LOT 7 CSM 13/3620 15.470AC NKA LOT 7 CSM 13/371210.46AC Tract(s): (Sec- Twn -Rng 401/4 1601/4) 26- 30N -18W Notes: Parcel History: Date Doc # Vol /Page Type 10/20/2004 777586 2679/579 WD 07/23/1997 1030/27 TI 07/23/1997 777/261 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 03/24/2006 Description Class Acres Land Improve Total State Reason Totals for 2006: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ST. CROIX COUNTY ZONING DEPARTMENT r n, AS BUILT SANITARY REPORT Owner �' Qr'� �'' RECEIVEO Property Address City /State 1A e•J OC sr j ? 1999 coax COUNTY ; Legal Description ZONINGOFFICE Lot Block Subdivision/CSM # 3 '/4 ' /o, Sec, T�N -R�, Town of fig PIN # SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer e Size ST/P� Setback from: House A g*jjr* - Welly 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 ' , 9 Type of system: Width X -A Lengtb, Number of Trenches Setback from: House, Well to v P/L Vent to fresh air intake ti ida r ELEVATIONS � Description of benchmark�� �� Elevation Description of alternate benchmark Elevation of 1l Building Sewer 95 , e� ­ § T/HT Inlet _ O ST Outlet PC Inlet PC Bottom Header/Manifold Top of ST/PC Manhole Cover L v2 Distribution Lines (n 2 C7 ( ) ( ) Bottom of System Q) P - AV O ( ) Final Grade Date of installatiOMO/ 4 mit number jXV"�f State plan number "' � fez -fi�p Plumber's signature License number , d.5 Date Inspector )G-- Complete plot plan � f � 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 � r 7 ti \ \ ' INDICATE NORTH W G, _ Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count y Safety and Buildings Division INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 344656 Permit Holder's Name: ❑ City ❑ Village [].Town of: State Plan ID No.: Brown I Town of Richmond CST BM 11v Insp. BM Elev.: BM Description: Parcel Tax No.: nU o0 - TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic U Benchmark , 3�5__ osing Alt. BM A n Bldg. Sewer Holding S / Ht Inlet 7 TANK SETBACK INFORMATION n / Ht Outlet ,(� / TANK TO P/ L WELL BLDG. Aenttoke ROAD D Septic �y/ / / NA A Header / Man. Aera ' NA Dist. Pipe Holding Bot. System /r -�-( 00 4 PUMP/ SIPHON INFORMATION Final Grade 3 MA , nulacturer Demand St cover 3 Model Num GP TDH Lift ictio S stem TDH Loss e Force n Length Dia. . S L ABSORPTION SYSTEM )II Eby TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth ( DIM ENSIONS ' s 4 DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE / STREAM HI acturer: INFORMATION Type Of i odeI Number: System: ,) 71 T�d y 35 ' OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length _ZL� Dia- � Length AZi 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 I ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 1394 130th Avenue, New Richmond, WI (SE1 /4, SE1/4, Section 26 T30N - R18W) - 26.30.18.407C WA 65 42 SCwtci �•vs✓ i /k gw��ti -- ik driW Plan revision required? ❑ Yes ❑ No Use other side for additional information. <D Z SBD -6710 (R.3/97) Dat Inspecto Signature Cert. No. e� ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: w # E i t mA� 3 j 3 ; t } � e.. e 3 w a E 1 5 m ^fie g# D i 3 ... .... .. i i t 3 3 1 Nm a F { x . ........... ➢ i 3 i a j e E e 7 e w e em b� f i a a a as a `m �.... y . t E } ; e e�a E e , .a € r i s e ee.' # E a ` a e ' ......._ u.A .. ..�....,...�...,. '. � ..a.......�... ._....e..,,.. ,..�e..em...... :a., ,... ...e..wn... .... 5.... .a...€ .....: .....m .� ..... .....Pe. _. ..a _._k .,,,.... _ .mm.. m.._ ,...«.,..A..�te..... ..t.. m. -.... .. „ 1 -1-1111 41— � d 6 6ons in Safety and Buildings Division SANITARY PERMIT APP CC�1 M 2 1 B . WashingtonAvenue Department of Commerce In accord with ILHR 83. Wis. Adm. Code Madison, Wl 53707 -7302 • Attach complete plans (to the county copy only) for the stem, on papet , ss fogn ty than 8112 x 11 inches in size. • See reverse side for instructions for completing this applic,4ion Stat Sanitary Permit Number Personal information you provide may be used for secondary purposes p l✓heck if revisionkf eJ e s application [Privacy Law, s. 15.04 (1) (m)]. yG : Spate Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALLINFOWATI ` Property Owner Name L d� S T ,N,RI� W Property Owner's i g Addr Lot Number Block Number aft /� -�-�- City, to 41, Zip Code Phone N b r Subdivision Name or CSM Number r .— I1. TYPE OF BUILDING : check one) ❑ State Owned i t� a Nearest Road it age Public 1 or 2 Family Dwelling- No. of bedrooms own OF III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo ZG- I Tr. 44 7 r, 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 online B, if applicable) A) 1. ❑ = New 2.)gReplacement 3_ ❑ Replacement of 4. ❑ Reconnection of 5, ❑ Repair of an ______System ________System Tank Only y 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 1 j 'Seepage Bed 21 ❑ Mound 30 []Specify Type 41 ❑ Holding Tank 11 E] Seepage Trench 22 ❑ In- Ground Pressure , 42 ❑ Pit Privy 13 ❑ Seepage Pit l 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSO RPTION SYSTEM INFORMATION: 1. Gallons Per Day . Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. Final Grade Required (sq. ft.) roposed (sq. ft.) (Gals/da /sq. ft.) (Min. /inch) ��� Elevation i ,� f a .2 ,,..� `6g `C! eet �d SO.5 Feet VIVII. Ca acit TANK in gallo Total # of Prefab. Site Fiber- LExper- INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic New Existin structed Tanks Tanks Septic T er- Fleldiwy�.af+k �� 1 la ❑ ❑ ❑ ❑ er ❑ ❑ ❑ El 1:1 VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plum s Name (Print) a Plum Signature: (No mW MPIMPRSW No.: Business Phone Number: D/j l O l Plum is Addr s (Street, City, State, Zip Code): IX. COUNTY / DEPARTME USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwa! ate I ssued Issuing Agent SigLre o S tamps) Surcharge Fee) Approved ❑ Owner Given Initial Adverse Determination � �- �.� ICJ X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: I° 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 maybe 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. 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_ i NLU I LAN PROJECT ADDRESS 4��' - 1/4 /T�o N/F W TOWN CO TY J Byron Bird Jr. 3318 D BEDROOM CLASS PERC �,�'l� CONVENTIONAL IN -GR U PRESSURE CONVENTIONAL LIFT_ MOUND_,., HOLDING TANK SEPTIC TANK SIZE _� LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ABSORPTION AREA -- PERC RATE =— BED SIZE Benchmark V.R.P. Assume Ele do 100 fit ow Location of Benchmark �� o �.�, � d �� k -5 Cl Borehole Q Well Scale = Feet 0 Perc Hole System Elevatio Z7 Uent 12" Grndp TYPAR COVERING 2" 12" 3' 4 s , 4O 3 . 1 6' Sewer Rock 12' $' /c, d 1 0 ti 64 ( 0 -�- �0 Wisconsin Department of Commerce SOIL AND SITE EVALUATION Qivision of- Safety and Buildings - Page of Bureau Integrated Services in accordance w' �. ; , &3 04, Wis. Adm. Code Plan Attach com)X9te site plan on paper not less than 8 1/2 x 11 inche - an f , unty r include, but not limited to: vertical and horizontal reference poin (Brd rectio�rtd�J' percent slope, scale or dimensions, north arrow, and location a ance nearest ro� Par el I.D. # tC APPLICANT INFORMATION - Please print all inf r tion. ):�jtx i Reviews4l by f Date Personal information you provide may be used for secondary purposes (Pri c`y w,�sJ Property Owner r,,_ Property � _ n' /d�/ Ct f e f �' ✓'per , `���o�i1OL t ` ' 1/4 J1 /4,S T ' 7FJ , N , R �`5 E Property Owner's Mailing Add ss Lot'r Block# Subd. Name or CSM# City State Zip Code Phone Number ❑ City ❑ Villagg jjj Tow Nearest Road ❑ New Construction use: Residential / Number of bedrooms Addition to existing building [FQ Replacement Public or commercial - Describe: Code derived daily flow l Apd Recommended design loading rate = bed, gpd /ft .5 trench, gpd /ft Absorption area required gy bed, ft G r 2 •^ tench, ft �G Maximum design loading rate �� bed, gpd /ft .L .S trench, gpd /ft Recommended infiltration surface elevation(s) �f > ft (as referred to site plan benchmark) Additional design /site considerations Parent material <r A. C I k c✓a 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 i.S ❑ u X S ❑ u I 0S ❑ u I D S ❑ u I ❑ S 9 u EIS }Z u SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD /ft g Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench ) ve C) /9 r % .-.� s1 n _ Lz _ J c 2JI. -.�-_ l ,, / ,j E Ground l elev. ' Depth to limiting LJi ✓, }� factQr Remarks: Boring # Ground �elev.. i Depth to limiting factor - in. Remarks: CST Name (Please Print ) Signature Telephone No. Addre _ Date CST Number PROPERTY OWNER I GCti %f) SOIL DESCRIPTION REPORT Page ' of PARCEL I.D.# r Boring Horizon Depth Dominant Color Mottles Structure 2 g Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Ground oe elev. / ck Depth to L / limiting (� factor n. Remarks: Boring # / Ground elev. Depth to limiting factor Remarks: �- Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # ........................... Ground elev. ft. Depth to limiting factor in. Remarks: Boring # .......................... Ground elev. ft. Depth to limiting factor ' Remarks: SBD -8330 (R. 07/96) r • Soil Test Plot Plan Project Name �� ,r� ,r�� �.-� Byrop Bird Jr. Address Lot Subdivision Date zz -7, J �I /4 11 /45 , T �� N/R Township E] Boring Q Well PL Property Line County BM or VRP Assume Elevation 100 ft System Elevation Elevation *HRP J V lr , fdnL� T r 1 S � IT j1�••1_ h u Q. - Scale 1/4" = 10 Ft. When Dimensions aren't stated ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer ea, Mailing Address Property Address �-v (Verificat required from Planning Department for new construction) City /State � � Ire Z4 t Parcel Identification Number f o X077 70 --�eo LE GAL DESCRIPTION Property Location` — '/4, � %4, Sec. v T � N -R�W, Town of Subdivision -- , Lot # Certified Survey Map # - - , Volume a ge # Warranty Deed # �� y ��� , Volume ��O ,Page # 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. 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. C �1�3/ 5� SIGN 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. !�31 SIGN URE 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 ` STATE BAR OF WISCONSIN- FORM 2 DOCUMENT NO WARRAN!Y DEED w17n ­143 R L Ignatius D. Brown, Single 13V THIS DEED, ST. cooix Co., WLS t hen Brown and M kret A. Qt Grantoor conveys and warrants to 3rown, husband an wire as joint tenants Grantee for a 6,'Qable c-nsideraition _Qne Dollar ,and other yaluable___._ RETURN T3 he real estate in St. Cr 1X — County, State ofWisconsin: T&s Key The East Half of the Southeast Quarter This is homestead pr�perty. (E� of SEI-4) of Section Twenty-six (26) Tcwnship Thirty (30) North, of Range Eighteen This deed is given in satisfaction of a land contract between the parties dated Mav 3, 1972 and recorded May 5, 1972 in Vol. 483 of Records, oages 550 and 551, arid a replacement land contract 3ated Avril 17, 1975 and recorded April 21, pages 13-6 and 117, )ocument � 326472. MANSFER New Richmond, Wisconsin this__,_ 24th I day of 8 -ED IN PRESENCE OF SIGNED AND SEAT Ignatius D. Brown, Single 2 day of F eb ruary.- f78 Tim W Ward Title: Member State Bar if Wisconsin STA 7E OF WISCONSIN ir P—sonally came before me this ds� Cf ty MY