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030-2103-60-000
c n+ 3 T 0 d �1 C O W N O W D �, � U7 W h N N O 7 ca y � 7 C: co a '' � W° rte+ r m N 7 `� CD V ) - O O O N O a 0 j CD O O O O O C 1 ? V V CD A3 > � N S W n'S N N N O- 7 CD ry O 0 0 7 y n w o ' R 0 0) N C O 00 `� O d N N 0 p 0 � C � O r� ID O CD iS � O O N p O � pp O �y J W a r I � cD m r N ID I m w n N to lD N � C o a OD 3 Nl O O O Z �! o D 4 rn c 3 3 ... j u o � N Z I m .. m i m t�+i O 4 ° A :E Ro .7 y r CD N m �+4 CL o o °' N z ', o 0 D � 0 ! 7 — 9 . O v v cn o 0 a h to O r V C (Q N S (p W N O <. C 'P n .a CL � z O 4 C 3 O. 7 � C/) W C W A p Z O c � r: (n 3 m � N z CD w Q W O O 7 T O N C CO S Z p O 00 O N Z N Cn N 7 CL y W w N A T ' I • r ,a I N O I O V I A 0 W � b m o C I o a I Parcel #: 030- 2103-60-000 05/15/2007 03:38 PM PAGE 1OF1 Alt. Parcel #: 25.36.30.19.838 030 - TOWN OF SAINT JOSEPH 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 - ANDERSON, WAYNE D & PRUDENCE E WAYNE D & PRUDENCE E ANDERSON 1310 89TH ST NEW RICHMOND WI 54017 -6958 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1310 89TH ST SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 3.880 Plat: 1914 - DURNING & LEWIS ADDITION SEC 25 T30N R19W SE SE LOT 6 DURNING & Block/Condo Bldg: LOT 06 LEWIS ADDN 3.88AC Tract(s): (Sec- Twn -Rng 401/4 1601/4) 25- 30N -19W SE SE Notes: Parcel History: Date Doc # Vol /Page Type 04/23/1999 601918 1421/314 WD 10/28/1998 590033 1370/180 LC 07/23/1997 1129/143 QC 07/23/1997 1124/141 QC more... 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 04/16/2007 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.880 160,100 311,300 471,400 NO Totals for 2007: General Property 3.880 160,100 311,300 471,400 Woodland 0.000 0 0 Totals for 2006: General Property 3.880 160,100 302,100 462,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 10/13/2005 Batch #: 05 -31 Specials: User Special Code Category Amount i Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wiscons?h Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of _ i Labor and Human Relations Division of Safety 8 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. — (' G APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION " James Durning GOVT. LOT SE 114 SE 114,S 25 T 29 N,R 19 g(or) W PROPERTY OWNER':$ MAILING ADDRESS % (� LOT # BLOCK # SURE). NAME OR CSM # 7217 Courtly Rd. 6 q na I Durnina & Lewis Addn. CITY, STATE ZIP CODE PHONE NUMBER [ (]VILLAGE KFOWN NEAREST ROAD Woodbury, MN. 55125 (612 739 -5208 St. Joseph Cty. Rd. " A " [ ij New Construction Use [x] Residential/ Number of bedrooms I [ ] Addition to existing building I I Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate .7 bed, gpd /ft trench, gpd /ft Absorption area required 643 bed, ft 563 trench, ft Maximum design loading rate .7 bed, gpd /ft .8 trench, gpd /ft Recommended infiltration surface elevation(s) 97.98 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material stream terrace Flood plain elevation, if applicable na ft rUl unis table for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK uitable fors stem ®S ❑ U ®S ❑ U ®S ❑ U ®S ❑ U ® S ❑ U El (�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 Trench ................. 1 0 -12 10 3 2 1 12-27 7.5yr4/4 none sl 2csbk mvfr crw if .5 .6 Ground 3 1 27- 84 7 .5 r4 6 non elev. 101 ft. Depth to limiting factor +84 Remarks: Boring # S1 9mgr, 2 2 8 -18 5 r4 4 none sl 2m r mvfr if .5 '.6 ................ Ground 3 18 -80 7.5 r4/6 none ms _ oSg ml na na .7 .8 elev. 101 ft. Depth to limiting ' F RECE1 factor + M AY 2 Mil - `"�, ST_ C�� Remarks: " CST Name: -- Please Print Gary L. Steel Phone: 715 Address: 1554 200t . ve. New Ric and WI 54017 Signature: Date: CS um er: -02298 5 -14 -97 PROPERTY OWNER James Durning SOIL DESCRIPTION REPORT Page - ,of _ -3r _ 1, PARCEL I.D. # 03 0 - 1067 -40 k Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench - 2 8 -20 7.5 r4/4 none s1 2mgr mvfr gw if .5 .6 Ground 3 20 -82 7.5 r4 6 none ms osq ml na na .7 .8 elev. 10 Depth to limiting factor +8 Remarks: Boring # 1 0 -1 s r mfr im .5 s.6 4 2 if .7 8 Ground 3 20 -80 7.5 r4 6 none ms oscf ml na na .7 .8 elev. 1 Depth to limiting factor +80 Remarks: Boring # 1 0 -10 10 r3 3 none s1 2m r mfr gy 1m .5 `:.6 2 10 -24 7.5 r4 4 none s1 2m r mvfr 9w if .5 .6 ................. Ground 3 24 -82 7.5 r4 4 none ms 0sq m1 na na .7 .8 elev. 1 Depth to limiting factor +82 Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: i SBD- 8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel ,Tames Darning 1554 200th Ave. CSTM2298 S SE %SE% 2 5 - T2NR19W 9 - New Richmond Wf 54017 4 4 MPRSW 3254 town of St. Joseph (715) 246 -6200 lot #6- Durning & Lewis Addn. N 1 =40' BM.= top of12" pvc pipe@ el. 100' Alt. BM.= nail in Pine tree @ el. 101.85' a �� fo 5 0 ) 1P ib( 6 `o -` 1� Gary L. Steel 5 -14 -97 Parcel #: 030 - 2103 -60 -000 05/10/2007 04:02 PM PAGE 1 OF 1 Alt. Parcel #: 25.36.30.19.838 030 - TOWN OF SAINT JOSEPH 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 - ANDERSON, WAYNE D & PRUDENCE E WAYNE D & PRUDENCE E ANDERSON 1310 89TH ST NEW RICHMOND WI 54017 -6958 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description * 1310 89TH ST SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 3.880 Plat: 1914 - DURNING & LEWIS ADDITION SEC 25 T30N R19W SE SE LOT 6 DURNING & Block/Condo Bldg: LOT 06 LEWIS ADDN 3.88AC Tract(s): (Sec- Twn -Rng 401/4 1601/4) 25- 30N -19W SE SE Notes: Parcel History: Date Doc # Vol /Page Type 04/23/1999 601918 14211314 WD 10/28/1998 590033 1370/180 LC 07/23/1997 1129/143 QC 07/23/1997 1124/141 QC more... 2007 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 04/16/2007 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.880 160,100 311,300 471,400 NO Totals for 2007: General Property 3.880 160,100 311,300 471,400 Woodland 0.000 0 0 Totals for 2006: General Property 3.880 160,100 302,100 462,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 10/13/2005 Batch #: 05 -31 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ST. CROIX COUNTY ZONING DEPART AS BUILT SANITARY REPORT J„ Owner (Jn, eu ✓,lel °sue Property Address f 3/0 6'� ti sf S E P Q l 199 City /State 4t4,, &� -1 e ,—J 4d( 55 7 � s-T Cpoy, Zo�a�n►ao�� Legal Description: Lot _� Block — Subdivision/CSM # t /a /a, Sec., T N -R W, Town of PIN SEPTIC TANK — DOSE CHAMBER — HOLDING TANK INFORMATION: Tank manufacturer <� Size �P C '1d - . � Setback from: Hous �3 Well PAL, 6o fir. � - 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: Width r Length '7 Number of Trenches Setback from: House /!y Well /° PAL It" Vent to fresh air intake /oo ELEVATIONS Description of benchmark Elevation Description of alternate be nchmark ?ate ve Ce o CZ=-- Elevation Building Sewer ST/HT Inlet 1< , 2 ST Outlet D o 57 PC Inlet PC Bottom Header/Manifold 4P Top of ST/PC Manhole Cover Z Distribution Lines (1' 98. 4o - 7 ( 9,8 • ( - 7 ( ) Bottom of System ( ) 9 38 () 1-7 3j6 ( ) Final Grade O w/ • O /y /° d� ( ) Date of installation 199 Permit number 3 3c99/8 State plan number Plumber's signature / u -- License number 2 Z4 1 ; 2y Date Inspector \ (� e�..� Complete plot plan Q A 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 Cali r� I ` 1 r Ib � o X10 9 V - 0 . T 11 V INDICATE NORTH ARROW ST. CROIX COUNTY ZONING DEPART 9 AS BUILT SANITARY REPORT � ► \LCC��9 LO r\ Owner _ Property Addres �3/� d'�t ti s f SEP 0 �, 1999 N City /State /I/ &• 5 ST GROX S' C;Ou wy G� Z04 oFFl �, Legal Description: � Z Lot 6_ Block — Subdivision/CSM # �✓� - 6 ,� 1 /4 ' /a, Sec. �, T N -R W, Town of �" �e h PIN L/� 3 _ 0 SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer lC 6�Size OPC 1'1 A- ' ' Setback from: House �� � Well 9"-3 P/I, 66' 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: '7 e'e Width 3 Length ' Number of Trenches 2 Setback from: House Div Well /° y P/L I " Vent to fresh air intake /oo '�— ELEVATIONS Description of benchmark Elevation /a Description of alternate benchmark i Elevation , Building Sewer ST/HT Inlet , Z ST Outlet D o PC Inlet PC Bottom Header/Manifold 4v*7 Top of ST/PC Manhole Cover OS, 2 Distribution Lines (rD 98• 40-7 ( �/ • �� ( ) Bottom of System () 9 1 3j6 ( ) Final Grade Date of installation Q l 1 Permit number State plan number Plumber's signature License number Date Inspector \ (�� Complete plot plan � ` JOB (NCc.l7GI ��LaLC�S�'►1 TIMM EXCAVATING SHEET NO. OF z- Route 1 Box 192 G '� WILSON, WISCONSIN 54027 CALCULATED BY A ` � \ DATE 7 (715) 772.3214 (715) 386.5443 MPRS #3224 WI MPCA #696 MN CHECKED BY DATE SCALE /� �U 1, �/U L.J E✓'r ! ................... .... .... T ............... <...-..............-.............. ............. >.......... <...........<.........-.;............. .......................... ......... ........... s.......... .... .... .... ...;.... ...i. .... ..... ..... ..... .. ..... ...................... ......... ............ . ..... .... .. .. ... .... .. ......... < ............... ....... . ........ ... ... ...... ..........; . ... .. tl. f .................� • ........... .. ... ........ ' ........ ... .. ... .... .... ..... ........ ��.� /Z �'�-� . ...... ... i ....... . .. I° _ ....... ..... b �� y .. . e l l i 3 Q... / d . �. .. frez .... �Sr�g 7` ?, gyp... _... . i .:; .. .... .... .._. .............. ............. I ..... ............ ........... ............ ........... .......... ......... ............. .......... .......... ........... ........... PRODUCT 205a�lnc, Groton, Mass. 01471, To Order PHONE TOLL FREE I- W25-MW I JOB /,W- TIMM EXCAVATING SHEET NO.– OF Route 1 Box 192 • WILSON, WISCONSIN 54027 CALCULATED BY DATE wr (715) 772-3214 (715) 386-5443 MPRS #3224 W1 MPCA #696 MN CHECKED BY DATE SCALE .......... ........... ........... ........... .......... ................ ...................................... ............ ....... ......... ........... ........... ........... ................. ...................... .. ........... . ...... ........... ........... ....................... ........... ........... ........... .......... ........... ........... ............. ........... .......... .......... ........... .......... ........... ........... ........... .......... .. .......... .......... .......... ................... .......... ........... >........... .... ..... ..... ...... ...... ...... .... .... .... ..... ..... ....... ...... ....... ...... ...... ........... ........... .......... 1 .. ......... ............ ................ ................. .......... ........... ........... ... ....... ........... ........... .......... ............. ........... ........... .................. ........... ........... . ..... ........................... .......... ......... .... ........... ........... ........... ................ .............. ........... .......... ........... ........... .................. ........... ...................... ........... ........... ........... ........... ...................... ................... .... ........... ........... .......... ........... .......... ....................... .......... ........... ........... – .......... ........... ....... – ...... ........... .............. ........... ........... ........... .......... ........... ........... .......... ...................... ........... ........... .......... ........... ........... ........... ........... .......... .......... ............. ............ ........... ........... ................... ........... .... — ........................... ........... ........... ........... ........... .......... ....... .... .. ... ...... ...... .......... ........... .................... ........... .......... .......... ........................................... ........... ........... ........... ............ ........... ........... ........... .......... ........... .......... ........... .......... . ........ ........... ....................... .......... . ...... ..................... ........... .................. ........... ........... ........... ................................... .......... .......... ........... .......... .......... ----------- .......... .......... ........... ........... ........... ........... ---------- ....................... ........... .......... ........... ........... ................... ............... ........... .......... .......... ....................... ........... ........... .......... .......... .......... .......... ........... ........... .......... .......... ..... ...... .... ...... ........... ........... ........... ........... ...................... ........... ........... ........... ........ ........... .......... ........... ....................... ........... .......... ......... .......... .......... ........... .......... ........... ........... ........... ........... ........... ...................... ........... ........... ........... ........... ................... ........... .................... .......... ...... ................... .. ........... ........... ---------- ..................... ........... ........... ............................... ..... . ...................... .. ........ ........... ............ ..................... ........... ............................... .......... ........... ........... ........... ........... ........................... ........... ...... ............. ........................ ... ....... ........... ........... ........................ ................. ........... ...................... ...................... .......... ...................... ............ .................. . .............. ----------- ........... ............ ........... ................. . ................... ................... .......... ....................... ........... ........... ........... ........... .......... ........... "Z 2 ........... .......... ........... . .............. ......... ........... ........... ----------- .......... ............. .......... ................. ... ............... ............. ....................... .................. ............ .......... ................................. ............... ........... .......... . .......... . .................................... .. ......... .............. - ............... ................................ .......... ........... ............. ............ .......... ....... --- ........... .......... .............. .......... -------------------- ----------------------- ...................... ................. ................... ........... .................. ............... ............ ...... .. . ......... ............. ................ ........... ---------- ............ .......... .......... .......... .............. .......... ........... .......... ........... ----------- .................. ................................. ............... ............ ----------------------- ........... ........... ........... ---------------------------- ------ PRODUCT 205-1 Inc., Groton, Man. 01471 To Order PHONE TOLL FREE 1,BW225-M a Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count y INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: IX y ou rovice may be used for second p urposes [ Privacy La s.15.04 (1)( 3 3 8 918 Personal information r��� �p �,r p��p� Y P Y rY P P [ Y Per ANll K�U1V ; WAYNE [] CitbY Village P Tgw CST BM Elev.:- Insp. BM Elev.: BM Description: I� �1U n of: State Plan ID No.: tl Parcel Tax No too eo 030- 2103 -60 -000 i� P TANK INFORMATION q . ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic e Z C)b Benchmark Z 07 y X)a Dos A I/ • Aera ' Bldg. Sewer , Holding 9/ Ht Inlet '� , Z,r TANK SETBACK INF K ' �A ' / Ht outlet z, 3 3 /6 ; D TANK TO P/ L WELL BLDG. V n ke ROAD I Septic NA D D Header / Man. }- LT Z , Aeration NA Dist. Pipe L 7l / D Hold' Bot. System z PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Mode ber 6 S 4 q TDH L ction System TDH F 7P Forcemain Length Dia. Fi SOIL ABSORPTION SYSTEM a ��„� � BED IXRENAellf Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMOKIONS T 75 I DIMENSION SYSTEM TO P / L BLDG WELL LAKE/STREAM LE G M an c rer: SETBACK AMB r d INFORMATION Type O Mode Number: System: J �U� �� o O O C . DISTRIBUTION SYSTEM Header /Man i ifold Distribution Pipe(s) I x Hole Size x Hole Spacing Vent To Air Intake Length Dia Length —2c-1 Dia. d1_4 Spacing 'V SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only D Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: ST. JOSEPH 25.30.19,SE,SE 1311 89TH ST DURNING & LEWIS LOT 6 A'0 Ca/ 'ee'14 'd L / Ol Cever _ .�► ®�!' j' ':p Plan revision required? ❑ Yes ❑ No Use other side for additional information. d all SBD -6710 (R.3/97) Date Inspector's Si ure Cert. No. f �1 I ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: - F .a E _ f t » i F b e , " 3 3 t 0 t k i t a n n ! i F r } � d 3 i } E F F r r e r S � y F d e i E ' f o t x g .F.. -, � W G 1 � 9 i 4 F t E ... € e ' t t s e ? k r t : r } i n e F i $ _ 1 i 1 s 5 ildings V� s t' f m#i SANITARY PERMIT APPLICATION 201 Saf W and as n Avenuen In accord with ILHR 83.05, Wis. Adm. Code P 0 Box 7302 Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County ^ than 8112 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Permit Number - 3gq 1`2 Personal information you provide may be used for secondary purposes ❑ Check it revision to previous application (Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATI N Property wner Name Property Location 4t-4 t 1/a J 1/4 S Z$ T 3 p . N, R ly lijo Property r�lylailin dr ss�,� Lot Number Block Number U City, State ,// o �� •,� Zip Code Phone Nu Subdivision Name or CSM Number C(.V .C�trc, Jf. �j 0 / ( ) '" P ig �.lrc✓iS' !� �t..ril II. F ILDIN : (check one) ❑ State Owned ity Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms r Town of C7 III BUILDING USE (If building type is public, check all that apply) Parcel Tax Numbers) 2.5 ibis. 1 1 ❑ Apartment/ Condo d 36 — - /D 3 ` $32 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. rg New 2_ ❑ Replacement 3_ ❑ Replacement of 4, ❑ Reconnection of 5. ❑ Repair of an ______System ________ _____________ ____ System Tank Only ^_________ Exi sting ________ Existing System B) E] 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 ve'y *- — , 10" 15 3 113 2 . 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 &40 754 3 - R 97. Feet ` 64 # Feet VII. TANK in Capacity llo Total # of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturer Name Concrete Con Steel glass Plastic App New Exist]n structed Tanks Tanks Septic Tank or Holding Tank I Z 6 I zJ;6 LS ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑ Vill. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plu er's Name: (Print) Plumber' ignature: (No St ps) MP /MPRSW No- Business Phone Number: uR- / /,00V^ Zz S fy�=l - 7 Plum rs j l .zg ress (Street, City, State, Zip Code): kk o IX. COUNTY / DEPARTMENT USE ON ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate Issued Iss ing Agent Signature (No Stamps) Approved E] Owner Given Initial — Surcharge Fee) Adverse Determination C X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: )` l2os SBD- 6398 (R.11/97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber f INSTRUCTIONS ' r 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. 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 OnJy. 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. `Nisoansin Department of Commerce SOIL AND SITE EVALUATION Page . of 3 .Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code Certified Soil Testing 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. C roix percent slope, scale or dimensions, north arrow, and location and distance to nearest road. - - - -- -- - -- - Parcell.D.# 030 - 2103 -60 APPLICANT INFORMATION - Please print all information. - - - --- - Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1 (m )1. Reviewed By -- - — Date Property Owner Property Location Anderson, Wayne Gov Lot SE 1/4 SE 1/4 S 25 T 30 N R 19 W Properly Owner's Mailing Address Lot # Block # Subd. Name or CSM# 4583 148t Co urt 6 l Lewis & Durning Addition ----- - - - - -- - - -- - - - - -- - _ - - -- City Apple Valley State Z Code PhoneNumber ❑ City ( J Village XTow Nearest Road MN 55124 612- 423 -1648 St.loseph CTHW A New Construction Use: Z Residential / Number of bedrooms 4 [ to existing building Replacement ❑ Public or commercial describe Code Derived daily flow 600 g pd Recommended design loading rate -7 bed, gpd/ft - trench, gpd/ft Absorption area required 857 bed, ft 750 trench, ft Maximum design loading rate -7 bed, gpd /ft - tr ench, gpd/ft Recommended infiltration surface elevations) 97 ft (as referred to site plan benchmar Additional design !site considerations install 2 - 2.7 x 72' Sidewinder, Hi capacity "turtleshell" trenches Parent material sandy /loamy outwash Flood plain elevation, if ap licable NA ft S= Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U= Unsuitable for system X E] U X S❑ U X S❑ U X S U ❑ S X U ❑ S X U Depth Dominant Color Mottles Structure GPD /ft Boring# Horizon in Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Boundary Roots Bed - Trench 1 1 0 -4 1 OYR 3/3 - sl 1 m gs I f/m gr mvfr .4 .5 -- I T - 2 4 -26 7.5YR 4/4 - cos/f gr 0 sg ml gs 1 f .7 .8 Ground 3 26 -82 l OYR 4/4,3/4 - cos 0 sg dl as - .7 .8 1 01.4 ft 4 82 -100 10YR 5/4 - s 0 s - t - - i 7 8 elev g dl Depth to - - -- - - -- -« i j _ limiting -- - -- � � factor -- - -- - - - - -- - --� - --- - - + - -- -- -- - - > 100" Remarks some gr below 26" — - g 1 0 -6 l OYR 2/2 - sl 2 m - r mvfr cs I f/m .5 i .6 2 2 6 -16 lOYR 2/2 sl 2 m sbk mvfr 1 g s 1 m .5 .6 Ground 3 16 -34 10YR 3/4 - sl 2 m sbk mfr gs If .5 .6 elev - -- - - -- -- -- - 97.5 It 4 34-49 l OYR 4/4 - sl 0 m m 11 cw I m .3 .4 Depth to 5 49 -86 l OYR 4/4,3/4 - cos 0 sg dl cs - 7 8 limiting 6 86-1001 lOYR 8/1 - s 0 sg ml r - .7 ! .8 factor _ -- some gr 34 -86 "; occasional gr, cob, st below 16 "; horiz 5 dips @ about 30 degrees to east w/ sand about 18" deep @ west end of Remarks: pit; this pro i e rea�Teast pit d — - -- -- _ _ - - -- - CST Name (Please Print) Signature: Telephone No. Henry F. Grote - 715 -665 -2681 - - �erti tf ed SoiCTestm - -- Address g Dat CST Number Ref # P.O. Box 57, Knapp, Wt 54749 5 222774 1138 MAY-10-99 MON 11:19 AM HENRY F GROTE 715 665 2681 P.01 TY OWNM:A!d! WOTnt SOIL DESCRIPTION REPORT P 2 o f 3 cirdaw 9-o T%sting Depth Dominant Color Mottles structure GPD/ft' zon in, Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. . "istencell Boundary Roots Bed TrerlG 1 0-111 10YR 3/3 $1 2 m gr I mvfr CS I Vni .5 .6 2 11-20 f 10YR 3/4 A 2 m sbk mvfr Cw In) •5 Ground 1 3 7 ew 20-32 1 0YR 4/4 sl 2 m sbk mvfr cw IM 'S 6 4 32-44 1 OYR 4/4 Is I msbk nxvfr Cw I ni .7 8 Depth to 5 444.5324 IOYR 4/6 WOO 6 mcos 0 Sg Ml CS 3 .8 factor .96 1 �52-96 1 OYR 4/4,3/4 cos 0 sg M I .7 .9 Remarks: r & BE NIP INTO% -A* 7 . 1 OYP, 3/2 0 2 m gr j mvfr CS I 0M .5 .6 2 7-22 5YR.4/6 mcos 0 sg ~ dl cs I M .7 .8 Ground elev 3 22-26 7.SYP, 4/4 sl I m sbk m as I f A 5 10 1 s 0 s ml as Im .7 .8 101.4 ft 4 26-29 Depth to Imiting 5 28-40 1 OYR 4/6 S 0 sg ml cs l .7 .8 Cdr 6 40 -6 1 OYR 4/4 S 0 S& dl cs IM .7 .8 7 i 63-110 10YR 4/4,3/4 cos 0 s 7 .8 Remarks: some 9r, MprValkily oclow bs 0- 6 I IOYR3/2 2 m gt mvfr Cs Ifini .5 6 2 6- 16 7.5YR 4/4 51 1 rn sbk mvfr cs If A .5 Ground elev 3 16-30 7.5yR 4/4 mcos 0 M I gs Im .7 .8 30 -96 cos 0 sg ---. MI .7 .9 Depth to krruling € _ ' factor > 9r, C=0 alk mlow 10- Ground Post-it" Fax Note 7671 oat$ 1 51,4 v Wev J ---'F Depth to Phone # P hone loon FaX M Fax 4 ornarks: • V t a rA v (� 4 of FA M f t A { > 3 4 N �, 4 CA t M r1i 4 r t � Ca 1 0 s d a � 0 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer -;/ /I ._ Mailing Address Property Address v �y (Verification required from Planning Department for new construction) City /State *U / � cuff Parcel Identification Number LEGAL DESCRIPTION Property Location 5 C '/4, : F ' /4, Sec. -,915' TlN -R / % W, Town of Subdivision L Otis d&'oe' 1 A1.41' " Lot # Certified Survey Map # . Volume . Page # Warranty Deed # , Volume , Page # Spec house ❑ yes-1 no Lot lines identifiable 1Z yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and 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 X the three year piration date. SIGN TURE 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 pperty describe a e, by irtue of a warranty deed recorded in Register of Deeds Office. SIGNATbRE 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 1 — 1982 Es01918 WARRANTY DEED KATHLEEN H. WALSH REGISTER OF DEEDS DOCUMENT NO. ST CROIX CO., WI RECEIVED FOR RECORD � This Deed, made between JAMES J. DURNTNG and 04 -R3 -1999 11:30 AM SANDRA J. DURNING, husband and wife - WARRANTY DEED EXEWT M 17 Grantor, CERT COPY FEE: and WAYNE D. ANDERSON and PRUDENCE E. ANDERSON COPY FEE: husband and wife as - joint tenants TRANSFER FEE: RECORDING FEE: 10.00 PAGES: 1 Grantee, Witnesseth That the said Grantor, for a valuable consideratio conveys to Grantee the following described real estate in St. Croix THIS SPACE RESERVED FOR RECORDING DATA County State of Wisconsin: NAME AND RETURN ADDRESS Wayne D. Anderson Prudence E. Anderson 4583 148th Court Apple Valley, Minnesota 55124 1 030 -2-1o3 - 6 G 0 i �V 3 V � ZlTl7 .t7^ PARCEL IDENTIFICATION NUMBER Lot 6, Durning & Lewis Addition to the Town of St. Joseph, St. Croix County, Wisconsin. This Deed is given in satisfaction of that certain Land Contract between the parties dated October 26, 1998 and recorded October 28, 1998 in Volume 1370, Page 180 as Document Number 5900'33 in the St. Croix County Register of Deeds Office. This is not homestead property. (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And James J. d Sandra i D ,rn; ng warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except — none and will warrant and defend the same. Dated this 23rd day of April ,lq 99 (SEAL) (SEAL) * AM J . DURNING (SEAL) (SEAL) * * SANDRA J. DURNING AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, ss. St. Croix County. authenticated this day of 19 Personally came before me this —mod day f April y 19. 99 ,the above named * James J. Durning and Sandra J Durnin TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by §706.06, Wis. Stats.) to me known to be the person who executed the foregoing tru ent and acknowledge the me. THIS INSTRUMENT WAS DRAFTED BY i rr L ndeen MUDGE, ORTER • , LUNDE N & P Y eissler 110 Second Street Hudson Wisconsin t 7' 54016 Notar Public, St. Croix County, Wis. (Signatures may be authenticated or acknowledged. Both are not My commission is permanent. (If not, state expiration date: necessary) November 10 2 ) Names of persons signing in any capacity should by typed or printed below their signatures. PEGGY J. GEISSLER f+lOtary pUbIIC WARRANTY DFF.D STATE BAR OF WISCONSIN State of Wilfterltsitp lank Co., Inc. Form No. 1 — 1982 lwaukee, Wis. / i 0 x r- m r t0 z o 0 m o WillP'_.A T T ED LA�JDS o _ QI 6Y O T HEFcS m m WEST LINE OF THE SEI /4 OF THE SEI /4— m m S00 ° E 349.50' v )42'i w m -Cl) m -A V n N �+1l O ff` N.4 N A CU CD Ow cn� O m m M „ .. 313. N N M •."� ) . 6 4' t+ -S05 °22 03 143.54' p p x Q m 170.00' a°D o i o F v N 20 � A W N N 3 3 y m CD OD 9. W m m 0' (p OD C A to O W n O D W ° .'v 0 v 0 OD Q X A N W O 0� 3 3 0� w � - n ° 0 M m ! � — cn N It it .� o 4D w 0 06 �, a►. m -t v O I 0 t , dj & � do o CD ~ - w / T O _ g0 - STREET w 01, .4Z � Im t0 r 3 /go � p a X, Z A Dg > o`"iA xZ.4c mm D z 0'` r s _ M O N A O N 0 t p t0 n O n + 1 i EROSION CONTROL PLAN CHECKLIST C ? ` �� Check (./) appropriate boxes below, and complete the site diagram with necessary information. Q Q �oF Site Characteristics North arrow, scale, and site boundary. Indicate and name adjacent streets or roadways. i ❑ Location of existing drainageways, streams, rivers, lakes, wetlands or wells. ❑ [j Location of storm sewer inlets. P O Location of existing and proposed buildings and paved areas. ,! The disturbed area on the lot. Approximate gradient and direction of slopes before grading operations. Approximate gradient and direction of slopes after final grading operations. j ❑ Overland runoff (sheet flow) coming onto the site from adjacent areas. Erosion Control Practices ❑ Location of temporary soil storage piles. Note: Soil storage piles should be placed behind a sediment fence, a 10 foot wide vegetative strip, or should be covered with a tarp or more than 25 feet from any downslope road or drainageway. ,k Location of access drive(s). Note: Access drive should have 2 to 3 inch aggregate stone laid at least 7 feet wide and 6 inches thick. Drives should extend from the roadway 50 feet or to the house foundation (whichever is less). A ❑ Location of sediment controls (filter fabric fence, straw bale fence or 10 -foot wide vegetative strips) that will pre- vent eroded soil from leaving the site. ❑ g Location of sediment barriers around on -site storm sewer inlets. ❑ 4 Location of diversions. Note: Although not specifically required by code, it is recommended that concentrated flow (drainageways) be diverted (re- directed) around disturbed areas. Overland runoff (sheet flow) from adjacent areas greater than 10,000 sq. ft. should also be diverted around disturbed areas. ❑ Location of practices that will be applied to control erosion on steep slopes (greater than 12% grade). Note: Such practices include maintaining existing vegetation, placement of additional sediment fences, diversions, and re- vegetation by sodding or by seeding with use of erosion control mats. ❑ Location of practices that will control erosion in areas of concentrated runoff flow. Note: Unstabilized drainageways, ditches, diversions, and inlets should be protected from erosion through use of such practices as in- channel fabric or straw bale barriers, erosion control mats, staked sod, and rock rip -rap. When used, a given in- channel barrier should not receive drainage from more than two acres of unpaved area, or one acre of paved area. In- channel practices should not be installed in perennial streams (streams with year -round flow.) ❑ Location of other planned practices not alreadv noted a a �c� Indicate management strategy by checking ( ✓) the appropriate box: C Q ~ � Management Strategies P!(❑ Temporary stabilization of disturbed areas. Note: ft is recommended that disturbed areas and soil piles left inactive for extended periods of time be stabilized by seeding (between April 1st and September 15th), or by other cover, such as Carping or mulching. AV Permanent stabilization of site by re- vegetation or other means as soon as possible (lawn establishment). Indicate re- vegetation method: Seed ❑ Sod' Other ❑ Expected date of permanent re- vegetation: J` %pt 3© Re- vegetation responsibility of: Builder ❑ Owner /Buye, < j Is temporary seeding or mulching planned if site is not seeded by Sept. 15 or sodded by Nov. 15? Yes -0 No ❑ ` ❑ Use of downspout and /or sump pump outlet extensions. Note: ft is recommended that flow from downspouts and sump pump outlets be routed through plastic drainage pipe to stable areas such as established sod or pavement. ❑ Trapping sediment during dewatering.operations. Note: Sediment -laden discharge water from pumping operations should be ponded behind a sediment barrier until most of the sediment settles out. Proper disposal of building material waste so that pollutants and debris are not carried off -site by wind or water. - Maintenance of erosion control practices. • Sediment will be removed from behind sediment fences and barriers before it reaches a depth that is equal to half the barrier's height. • Breaks and gaps in sediment fences and barriers will be repaired immediately. Decomposing straw bales will be replaced (typical bale life is three months). • All sediment that moves off -site due to construction activity will be cleaned up before the end of the same workday. • All sediment that moves off -site due to storm events will be cleaned up before the end of the next workday. • Access drives will be maintained throughout construction. • All installed erosion control practices will be maintained until the disturbed areas they protect are stabilized. For more assistance on plan preparation, refer to Chapters ILHR 20 & 21 of the Wisconsin Uniform Dwelling Code, the DNR Wisconsin Construction Site Best Management Handbook, and UW- Extension publication Erosion Control for Home Builders. The Wisconsin Uniform Dwelling Code and the Wisconsin Construction Site Best Management Handbook are available through State of Wisconsin Document Sales, 608/266 -3558. 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