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Home My WebLink About030-2093-70-000 C G 0 N O r M 0 _1 3 ' CD a e 7 , M d CD A Cn L z N O CO fn N O el • f7 O O in Ca (n CD co W 3 C L W O _N C1 Cn (D �_ OD N 0 O ro 7 W �p -O cD W C 1 N N N CD 3 N O O O 0 � J O - G O � W O O O O O C N O C5 7 O O 3 o a i 3 N L: . c o O CD C W _ co C o p 3 C, �'�' O f0 CD -"1 O N S �y N CL CA N N � � Ch 0 (D G ° a o c. C) S c N N y o � v v v O 0 0 �• S lei � O N < N y C ' N z �. I =� D D 0 O v O CL CD v 4 CD c W Im n 3 _ z p 2 m O N CD J 0 Ij .. O O m W CD W CD O CD C 1 z 0 3 a 0 r: (n 3 � (0 !n z W (D A m D =r Q o C c_ ? O T CD z C O 3 CD z I N m 0 S a S 0 v I � b CD m E» O N ° o CL Wisv7nsinD�partmentofIndustry, SOIL AND SITE EVALUATION REPORT Page of_ Labor and Human Relations D[visr- , �raafety 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 ' 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. APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROP77 OWNER: PROPERTY LOCATION n C h S I C O GOVT. LOT 56 1/4 _F G� 1/4,S2 °� T 3 p N,R � -(or) W PPtRk9TY OWNER':S MAILING ADDRE LOT # BLOCK # SUBD. N E OR CSM # /// O, CITY, ST TE ZIP CODE PHONE NUMBER 13CITY VILLAGE Zi WN NEAREST ROAD �#L V/5)38 .- ada S '-New Construction Use Residential / Number of bedrooms 3 [ ] Addition to existing building ] Replacement [ ] Public or commercial describe Code derived daily flow _ '16 - 0 gpd Recommended design loading rate bed, gpd/ft to trench, gpd/ft Absorption area required 75 bed, ft 75 trench, ft Maximum design loading rate 5 bed, gpd /ft t'o trench, gpolft Recommended infiltration surface elevation(s) /D ft (as referred to site plan benchmark) Additional design / site considerations ..-tiln Parent material 5 / ", 41 6 0 , — Flood plain elevation, if applicable 1,444 It S = Suitable for system CONVENTIONAL I MO ND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem 13 S au ❑ U E3 S ❑ S f� ❑ S � ❑ S •E�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 Ground - Z 7 5 /2 c? m5'r' elev I � l sdi m �/�- NFL • 5 , Cv 0 � Depth to limiting factor o ft( Remarks: Boring # d ^ O f2 3 o7rv/S/�/'f f'yI •L C a �� • (/ Z <` Z �/ - Ground it <. el co ( Depth to ,, limiting s factor Remarks: CST Name _ Please Print n Phone: Address: a µ� S tai 7 Signature: Date: CST Number: C'S Z Z i PROPERTYOWN ns, o SOIL DESCRIPTION REPORT Page ''' ,,o1--�P— PARCEL I.D. # Boring # Horizon Depth I Dominant Color I Mottles Texture I Structure Consistence Baxtdary Roots GPD /ft in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed ITrench Z O- zo /U i2 4/ --si S' , 5 . i Ground elev� A z O t o ft. • s 2 o S a rn Depth to limiting factor Remarks: Boring # NEW Ground elev. ft. Depth to limiting factor Remarks: Boring # ?L ..:4. 'CiitiG:O:•: Ground elev. Depth to limiting factor Remarks: Boring # Ground elev. ft Depth to limiting factor Remarks: can -aaanra nrrom STEEL'S SOIL SERVICE Gary L. Steel iv Brive C.S.T. 2298 �n /t f_ �f.✓� S 1 C o New Richmond, WI 54017 MPRSW -3254 (715) 246 -6200 5[✓Y4 Su} ( sf - S `j �'3vit7. 2 )� W \C \ -- P q o 3 35 , A— 0 rY> 7 Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 2 Labor and Human Relations f VIS;4n of Safety &Buildings in accord with ILHR 83.05, Wis. Adm. Code revised 2/25/94 (Sub, T & R) COUNTY St. Croix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but 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. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION part SW -SW & JoAnn Persico GOVT. LOT SE 1/4 SW 1/4,S 29 T_ 30 N,R 19 'W PROPERTY OWNER':S MAILING ADDRESS LOT # I BLOCK # SUBD. NAME OR CSM # 700 Second St. 7 - Hi hland.Hills CITY, STATE ZIP CODE PHONE NUMBER ❑CITY []VILLAGE MOWN NEAREST ROAD Hudson, WI 54016 ( ) t. Joseph I CTHW " E " [ j New Construction Use [ X ] Residential / Number of bedrooms 3 [ j Addition to existing building [ j Replacement [ j Public or commercial describe Code derived daily flow 45n gpd Recommended design loading rate bed, gpd /ft trench, gpd /ft Absorption area required bed, ft 2 trench, ft 2 Maximum design loading rate bed, gpd /ft trench, gpd /ft Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations lot is not developable under current code Parent material ti Flood plain elevation, if applicable NA It S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ❑ S Q U ❑ S] U ❑ S CCU ❑ S Q U ❑ S C U ❑ S [ U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trends 1 0 Sl 2 15 dense till, resistant to penet ation, e fective BR Ground elev. ft. Depth to limiting factor Remarks: Boring # 1 0 -18 sl 2 18- dense till resistant to Qenet e fective BR Ground elev. ft. Depth to limiting factor t o co z r , m Remarks: w CST Name: — Please Print - Rhone: a. 1 rn LO Henry F. Grote Address: PO Box 57 Knago, WI 54749- Signature: "" CST Number: 3 3065 �. a A s e P S l.Y C _ _.. i Wisco sin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 2 7i Vtiot %nd`Human Relations vsion of Safety & Buildings in a ccord with ILHR 83.05, Wis. Adm. Code COUNTY revised 2/25/94 (Sub, T & R) \4-F St. Croix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but 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. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION part SW -SW & JoAnn Persico GOVT. LOT SE 1/4 SW 1/4,S 29 T 30 N,R . 19 W PROPERTY OWNER':S MAILING ADDRESS LOT # I BLOCK # SUBD. NAME OR CSM # 700 Second St. 7 - Highland 'Hills CITY, STATE ZIP CODE PHONE NUMBER v Hudson, WI 54016 ❑CITY ❑VILLAGE MOWN NEAREST ROAD ( ) t. Joseph CTHW " E " [ New Construction Use [ X ] Residential / Number of bedrooms 3 [ ] Addition to existing building ( ] Replacement [ ] Public or commercial describe Code derived daily flow 45n gpd Recommended design loading rate bed, gpd /ft trench, gpd /ft Absorption area required bed, ft trench, ft Maximum design loading rate bed, gpd /ft trench, gpd/ft Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations lot is not developable under current code Parent material till Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL I MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ❑ S 1XI U I EIS Q U ❑ S CC EIS Q U ❑ S Q U EIS Q 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 Trend& 1 0 sl 2 15 dense till, resistant to penet ation, effective BR Ground elev. ft. Depth to limiting factor Remarks: Boring # 1 0 -18 sl 2 18- dense till resistant to enet ation e fective BR Ground elev. Depth to limiting factor �. Remarks: CST Name: — Please Print J e: Henry E. Grote 15 - Address: , PO Box 57 Knapp, WI 54749-005 Signature: Date: L , CST Number: y 3065 I r PROPERTY OWNER SOIL DESCRIPTION REPORT Page_ #�# PARCEL I.D. # ' Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourbary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trend 4v: Ground elev. ft. Depth to limiting factor Remarks: Boring # OCv. Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(R.05/92) r 0 _ ,T. _ L4 0 � .. . ._ . . . . . . . . . . Ll J �' Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count y 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)]. 353183 Permit Holder's Name: ❑ City ❑ Village [ITown of: State Plan ID No.: T it Town of St. Joseph v.: Insp. BM Elev.: BM Description: Parcel Tax No.: 00 O d r 030 - 2093 -70 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic S Z p0 B e n c h m a A , 1 Z 0 Dosing C (�.� Alt. BM �• A Bldg. Sewer 0 Holding S / Ht Inlet TANK SETBACK INFORMATION psi Outlet 2 �� TANKTO P/L WELL BLDG. Aenttake ROAD Dt Inlet ` /2. Septic 4 -7S N/- 51 NA Dt Bottom - 3 Z Z Dosing _� - + jy N l �'� NA Header / Man. p 3 A Dist. Pipe Holding Bot. System 5' Ib . ^- PUMP / SIPHON INFORMATION Final Grade Manufacturer �� ✓ /' Demand St cover �. Do Model Number 1 3 �j 31 dPM TDH Lift �� Friction System2 TDH 7Ft Forcemain Length s/ Dia. Z Dist. To Well S IL ABSORPTION SYSTEM E RENCH Width Le nth No. Of Tre th PIT No. Of Pits Inside Dia. Li DIMENSIONS 2. Z e e DIM N I SYSTEM TO P/L BLDG WELL LAKE /STREAM G SETBACK Manua er: CHAMBER INFORMATION Type O System: k -f ] Q + qV S OR UNIT DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) / x Hole Size x Hole Spacing Vent To Air Intake r �� 3 Length Z ✓ Dia. Z Length �/ O u Dia. Z 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/Tr nch Center Bed / Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No discrep ancies, persons resent, etc.) �° ; a COMMENTS: (Include code discre p p Inspection #1:�/ / / �Dlnspechon #2: Location: 469 Hi hland View, Houlton, WI (SE1 /4, SW1 /4, Section 29 TION -RPW) - 29.30.19.781 av f� �� - /✓ � <; �<�� - g,14 y /v z � G of G Sewer X gerc 401 t,44 // cyo,oeA- 71'' tv er So ti . t rna,& I S� Plan revision required? ❑ Yes No Use other side for additional information. I 4 )'Ad SBD -6710 (R.3197) Da Inspector' S na ure Cert- No. 7 ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: w 3 i 1 s t te n.:. ..... .......a. f T 999 "i i a '� y .� ...................e... ..««..... �_ ,�_.�,......�... — .�__._m. E E E s E I "�°° j 3 n f e � s . p ! a 3 r .,,m. ..... Safety and Buildings Division Visconsin SANITARY PERMIT APPLICATION 201 s Department of Commerce In accord with Comm 83.05, Wis. Adm, ¢vQ yy' Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, n er not less County than 8 1/2 x 11 inches in size. • See reverse side for instructions for completing this applicati r�., j ` / ? State Sanitary Permit Number 3s3�g� Personal information you provide may be used for secondary purposes f t , F p F Check it 'revision to previous application (Privacy Law, s. 15.04 (1) (m)1. [ f / ! tate Plan I. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL 1 Opertkowner Nam Prop 9 s. s'. 1(4 1 /4, S, ' T3o , N, R E (or)V Propert Owner's Mailing Address Lbohkj u71b I t Block Number .� s� Q — Pox Ay9 City, S to Zip Code Phone Number Subdivision Name or CSM Number f •�4 (.ui` S O ( 7 /S> .Zf' f�i' s1<t�eiv v tz II. TYPE BUILDING: (check one) ❑ State Owned ❑ C it y Nearest Road ❑ Village Public 1 or 2 Family Dwelling - No. of bedrooms Town OF , asp / /G0L�D /GLs 10 Ill. BUILDING USE: (If building type is public, check all that apply) Q Parcel Tax Number(s) 1 ❑ Apartment/ Condo 0 3o a 9 3 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. g New 2_ ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an ------ Sytem ........ 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 RMound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit t 43 ❑ Vault Privy 14 ❑ System -In -Fill �D U�, 10 2 �o VI. A BSORPT ION 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 60 w O , O. C 6 Feet J V 7. 1 Feet VII TANK in Capacit g all o ns Total # of Prefab. Site Fiber- Exper INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Exist in structed Tanks Tanks Septic Tank (Jo oo ❑ ❑ ❑ 1 ❑ ❑ Lift Pump Tank amber 8d® oQ lg� ❑ ❑ 1 ❑ 1 ❑ ❑ Vill. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plu is Signature: (No mp M Business Phone Number: Plumber's Address (Street, City, State, Zip Code): 6 ZZ.41, E!Z IX. OUNTY /DEPARTMENT USE ONLY ❑ Disap Sanitary Permit Fee (Includes Groundwater ate Issued ssuing ent Si ture (No Stamps) Pp y Approved []Owner Given Initial 2 urcharge Fee) , Adverse Determination J c X. ONp TIONS OF APPRO Al_ / REASONS FOR DISAPPROVAL: SBD -6398 (R 4199) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit invalid 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 Aclministr•a`tive Code will be applicable. 3. All revisions to this permit must be approved by the permit.issuing authority_ , 4. Changes in ownership,or•p6umber 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 maintainedl The septic tank(s) must be pumped by a licensec7pumper wfierieJer necessary, usually every 2 to 3 years. 6. If you have questicns concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Bi4i+dings 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. Ill. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. . X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: 'A) plot plan, drawn to scare or with complete dimensions, location of holding tank(sj, 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 Joss; pump performance curve; pump model and pump manufacturer; D) crosssection of the soil absorption system if required by the coonly; E) soil test data ors a 115 form; and F) all sizing inforimation. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the'6eatiori 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. f Safety and Buildings 2226 ROSE ST LACROSSE WI 54603 -1905 - TDD #: (608) 264 - 8777 Vhsconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary October 19, 1999 CUST ID No.221741 ATTN: POWTS INSPECTOR ZONING OFFICE DONAVIN L SCHMITT ST CROIX COUNTY SPIA 586 VALLEY VIEW TRL 1101 CARMICHAEL RD SOMERSET WI 54025 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 10/19/2001 Identification Numbers Transaction ID No. 251852 Site ID No. 182421 SITE• Please refer to bbili- idendfication nu nbers, Site ID: 182421 above, in all correspondencezw,* the agency: St. Croix County, Town of Saint Joseph SETA, SW1 /4, S29, T30N, R19W Facility: Jack & Liz Webster Proposed Residence FOR: Description: Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 495962 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. A copy pp P P of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, DATE RECEIVED 10/08/1999 t FEE REQUIRED $ 180.00 rP FEE RECEIVED $ 180.00 Gerard M. Swan BALANCE DUE $ 0.00 i c� , POWTS Plan Reviewer - Integrated S rvipes rl r h P pr, , �� (608)- 785 -9348, Mon. - Fri. 7:15 A tQ 4:00'PMC t jswim@commerce.state.wi.us ��', , C.ROkk Wi814�. 76�' COUNTY •, ZONiNGOFF I Safety and Buildings 2226 ROSE ST LACROSSE WI 54603 -1905 TDD #: (608) 264 -8777 Visconsin www.commerce.statemims Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary October 19, 1999 CUST ID No.221741 ATTN: POWTS INSPECTOR ZONING OFFICE DONAVIN L SCHMITT ST CROIX COUNTY SPIA 586 VALLEY VIEW TRL 1101 CARMICHAEL RD SOMERSET WI 54025 HUDSON WI 54016 RE: CONDITIONAL APPROVAL Iden0ficafionNunkexs APPROVAL EXPIRES: 10/19/2001 Transaction ID No. 251852 Site ID No. 1824 SITE• Please refer to both identification numbers,; Site ID: 182421 above, in all correspondence with the agency. St. Croix County, Town of Saint Joseph SETA, SWIA, S29, T30N, R19W Facility: Jack & Liz Webster Proposed Residence FOR: Description: Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 495962 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system instiillation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required b the state or the local municipality shall be obtained prior to commencement of q Y P h' P construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, DATE RECEIVED 10/08/1999 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 #erard M. Swim BALANCE DUE $ 0.00 POWTS Plan Reviewer - Integrated Services (608)- 785 -9348, Mon. - Fri. 7:15 AM to 4:00 PM jswim @commerce.state.wi.us MOUND SYSI LM for Jack & Liz Webster SEE /4 SW 1/4 S29'130 R19W kl. ,lurrl►l► '1 owuMUil► � t�l. l 'rnix l 'uunly Page 1 to 3 Soil Evaluation Page 4 Work Sheet Page 5 Plot Plan Page 6 System Cross Section Page 7 Pipe Lateral Layout Page 8 Dosing Chamber Page 9 Pump Curve by A onavin L. ►Sch it -= A - ) Valley iew 'frail Somerset, W154025 715 -549 -6651 MPKSW 221741 September 24, 1999 pp NATE SIEyAGE SYS M Conditionally AP PROV, " RECEIVED SAF Aa aC � 0 7 1999 "w F ' SAFETY & BLDGS DIV. SEE Le171�f1Ll C R3Ll I Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations Division of safety &'Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less th -8 ,�C �f es in size. Plan must include, but St. Croix not limited to vertical and horizontal ral re (�oio l9Nit ir�ytl nd �o of slope, scale or PARCEL I.D. N dimensioned, north arrow, and location n tsfancep nears 030- 2093 -70 '" REVIEWED BY DATE N —PL P �1i� APPLICANT INFORMATI , 0 RI�T PROPERTY OWNER: - t, .t r' PROPERTY LOCATION l,UEl�ZEP C, GOVT. LOT SE 1/4 SW 1/4,S 29 T 30 N,R 19 fx(or) W 3 PftO ftEfTIY O1t1NE 8 irIAIUNLt A C " L0(' N BLOCK N 6U61). NAME OR CSM N 400 S. second st. 4P 7 na Highland Hills hase 1 CITY, STATE ZIP NE UhllB OCITY OVILLAGE E]rOWN NEAREST ROAD Hudson, WI. 54016 ) 38i St. Joseph Co. Rd. #E New Construction Use ( Residential / Number of bedrooms 3 [ j Addition to existing building Replacement [ j Public or commercial describe Code derived daily flow 450 g pd Recommended design loading rate -5 bed, gpd/ft . trench, gpd/tt Abx orption area required 375 bed, n2 375 trench, ft Maximum design loading rate -5 bed, gpd/ft •6 trench, gpdm Recommended infiltration surface elevation(s) 103.66 ft (as referred to site plan benchmark) Additional design/ site considerations system el. based on contour line of el 102.66 Parent material pitted glacial drift Flood plain elevation, if applicable na R F U • Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT•GRADE SYSTEM IN FILL HOLDING TMs(( P Unsuitable I O S ® U KI S O U O S ® U O S g] for stem U 0S U U 0S ® U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon in. Munsell Qu, Sz. Cont Color Texture Gr. Sz. Sh. co nsistence Elour>dary Roots Bed ferldi r 1 1 —13 10 r4/3 none sl 2mgr mfr gw 2f .5 .6 2 13 -23 10yr4/4 none sl 2msbk mfr 9w if .5 .6 Ground 3 23 -33 7.5yr4/4 none scl lmsbk mfr gw na .2 .3 elev. . yr 10 3.76 n 4 33 -50 7.5yr4/4 c2p2.5yr5/6 scl lmsbk mfr na na .2 1.3 ' Depth to limiting factor 33" r Remarks: Boring # 1 0 -12 10 r3/3 none sl 2mgr mfr gw 2f .5.6 2 2 12 -21 10yr4 /4 none sl 2msbk mfr gw if .5.6 E 3 21 -32 7.5yr4/4 none scl lmsbk mfr gw if .21.3 Ground , 103 n 4 32 -40 7.5yr4/4 csp2.5yr5 /6 scl lmsbk mfr na na .2 .3 ( Depth to i limiting i' factor s F 32" Remarks: CST Name: — Please Print Phone: Gar L. Ste 715- 246 -6200 Addre 1554 200th Ave. New Ric and 1. 54017 9 -20 -9 CSTMO2298 n: -- - -. n...... r`CT kh -1 .- PROPERTY OWNER J. Fersico SOIL DESCRIPTION REPORT Page_ of 3 PAMEL I .D. 8 030- 2093 -70 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell 13u. Sz. Cont. Color Gr. Sz. Sh. Bed ITrendi 1 0 - 10 r4 3 none sl 2m r mfr Ow 2f .5 .6 L"3 6 2 12 -21 10 r4/4 none s1 2msbk mfr gw if .51.6 Owund 3 21 -30 7.5y_r4/4 none scl _ lmsbk mfr gw -- na .2 .3 p� 2.5y r5 /2 .2:!.3 10 4 30 -50 7.5 r4 4 c2 2.5 r5 6 scl lmsbk mfr na na Depth 10 f Nrragng 30" Remarks: Boring # C1 GraJnd elev, ' ft. to I faclOt I i Remarks: Boring # j Ground elev. ft. I j 11tt to - -- - --- - Remarks: } Boring # Lj G roin 'r It. Uwq I to I Remarks: S8D4=(R.05/92)' STEEL'S SOIL SERVICE Gary L. Steel Joanne Persico 1554 200th Ave. CSTM2298 SEhSWk S29- T30N -R19W New Richmond, Wi 54017 MPRSW 3254 town of St Joseph (715) 246 -6200 lot #7- Highland Hills phase 1 1 N 1" =40' EM-= top of NE lot stake C el. 100' r - 7- 5 � d Gc �i� is 3v ..� / N oru�d�.,� j �3 Gary L. Steel 9 -20 -95 J Page 4 0f OPTIONAL 19ORKSHEET i. MOUND ,SYSILAi / Ii. IN•Gkot;:.:)PRI.',',UR(.SYSTLM•Contmued- 1. Waste wiles Ltl+d. Iol+l Daily Flow■ (Ur - t +l• IU. 1 one �t.us ? - 7 Use so ILII'R f33. 1S (3) (C) in. ALmmum 0os.nit Rate al „flf i- open. Code and PROVIDE A DETAILED �� LIS I Of SIZING ON PLANS. � 11. 101.1; O,n.ITIL Head: tvs:enl IIeaA a 2.5 (1. 1. Depth to LinliUng Factor = (t' ��r�trcat Lilt = - •- 1.�' -- (1• 3. Landslope r. -f x 62 it. 4, 014lsnce from note Chamber to ' Friction Loss = Iiltullllltll/n Nyilaln a /• to, 11)11- h. S. Elevation ll0Ie1e11cs Nat West$ �' spin and Distribution System ■ (t• Pump will discharge at least d tpl 6. Absorption Area Siting: at , 7� / ft. total dynamic head. 1 Area Required ■ sq.1t. Pump model and manufacturer: 20L�LL E2 Bed or Trench Length (B) -ft. J Bed or Trench Wid ) ■ ft. 13. Dose Volume: • ft. 10 Times Void Volume of go, q 7. Mound Height: Distribution Lines ■ . - rLLfGLL fat• . Fill Depth (0) ■ ft. Daily Wastewater Volume + Fill Depth Downslope (E) ■ ft. 4 Doses In 24 hrs. ■ gal• Bed or Trench Depth (F) ■ 11. Btck(low = gal. Cap and Topsoll Depth (G) ■ ft. Minimum Dose = gal. Cap and Topsoil Depth (H) ■ R. 14. Doa Chamber: 4. Mound Length: Volume = &0 gal• End Slope (K) ■ ft. Total Mound Length (L) ■ ft. III. NVENTIONAL PRIVATE SEWAGE SYSTEM I 9. Mound Width: 1,. Wastewater Load. Total Dally Flew ■ 1 • Upslops ' se s. , Wis. Upelope Width (1) ■ it. dm Correction Factor ■ ILHR 83.15 (3) (c) . Code and PROVIDE DETAILED Oownelope Correction factor ■ 3rs7 c .2 L T OF SIZING ON PLANS. Oownslope Width (1) ■ it. f' 2. Requlr Septic Tank Capacity ■ gal. Total Mound Width (W) ■ ft 3. Parcolatio Rats ■ .._� Min./in. 10. Basal Ana: 4. Absorption a Si:int: ! InflitratWe Capacity of Refer to able 2 in c ILHR 83 , Natural Soil = � SaLlsq•It•/day and PROVID A DETAILED 1ST OF Basal Area Required ■ _ � 94. ft. SIZING ON PL S. Basal Ana Available ■ sq. ft. Required Area = ' eq. ft. 11. If Standard Tables from Chapter ILHR 83 Length = f are used, Indicate Table $ Width = ft . 13. For the Distribution Network, Use Numbers 5.14 In Section 11. Number of Trench Sl es ■ pacln ■ �� ft• II. IN-GROUND PRESSURE SYSTEM - 5. Distribution S em: 1. Depth to Limiting Factor ■ �- h. Lateral th ■ fl 2. Landslope ■ ` _ % NH1,01-1c: of Laterals ■ 1 J. Percolation Rate ■ min. /in. Lpacing ■ In. 4. Proposed System Elevation ■ ft. from Sidewall to Pipe ■ in. A 3. Wastewater Load. Total Dal Flow: gal• System Elevation ■ fl• Use s. ILHR 83.15 (3) (c) Wis. ' Adm. Code and PROVIDE A DETAILED IV. 3 >ft :r - E •IN- LIST OF SIZING ON-PLANS. FGems from Section 111 Required Sepik Tank Capacity ■ /Ado gal. ,. 6. Absorption Area Sizing* V. SEPTIC TANK Percolation Rau ■ min.Nn. 1. Capacity = gal. Area Required = $4. ft. 2. Manufacturer. System Length ■ 6916 + • ft. 3. Show Site Constructed Tank Details on Plan System Width ■ ft. 7. Distribution Pipe Sitlnt: VI. DOSING TANK . Capacity = , 60 gal. Hots Sti 1 s • � i ^• ^ /("�' CO P�•�T't� Hole Spa,int • _ It. 2, A1.Inufatlurrr. L� � I..tler.tl Lemith 0_ 11. .1, Pump Manulaclurcr: 1 .renal Sbr -LL T in. 1. Pump Muhl• I AMA %Ilttinll _ 3 11, s. Ojv-jimo: 14cid= It. 1100 +11tt' hom %idrw.11l lob 1 30 nl t., 1 Is,% Rate r gWn• A. (1i.udallhtn Pier 01%th.11tr Ralr: 6 Shrw Sltr l Tank Details on Plans Nttlt►Ilrs set 11411r% I've 1'ipr 1 VII. Ill) t. • 1 ANA I hew i'rl 1•rytr 9s,Za Kpra• 1, CaN.rt• ga •• �� q, Manifold Avian. Alrro ..tur� l pr Is rau•r or rnrQ •. Tank Details o (sn 11IL.11•Irt � qL� In • ti110W All. WORM AT ION ON FLANS - 1111 HR A1111 I. li' l 104 n tia n MEMO EEO■■ - IMME ■■■■ ■■■■ ■■ ■� ■w■■■rpo■ ■■ ■lil ■■■ C hums i 7I r; r ON , i M L ■11■■ so" None I 1 11 ■E■ ■� ■ ■ ■■E■■ ■Err ■■ ■■■■■ IEE!�1! % ■ ■■ ■■ ■■ ■ ■E■ I■EM■■■■■■■ r■ EE■■ Imi■■■■■■ ■ ■ r ■■■■■ IOM■■ ■■ ■■■■ IE■■■ _ ■■■ I■ ■■r ■■ 1■■■■■■ _ - E ■■■ I■■■■■ ■■■ ��E�� ` 8■ M I■■■■■ ■■■■ , _ �E�� ■ ■ ■■I■ ■■ MMMEMM 1■■■■ ■E■ � "m i�ii r ►'' *119 ■■ i■■■■■■■■■■:� : ■�E■■■ 1■■■■■■■■■■ E■E■ I■■■■■■■■■ r A ■ I■■■■■■■■■ e 1 _ 1■■■■■■■■■! ■r ■■ 1■ ■E■■■ ■M MEMOS I■■■■ ■EERM ■ ■■ENE■■ I■■■■■■■IUM ■ ■■ ■■■ 1■■■■■■■ ■ ■■F��■ 1■■■■■■ ■E _► ■ 1■■■■■■ ■E I■■■■■■Omni ■ I■■■■■ ■■ M�/ ■■ I■■■■■ ■■ ■11 ■■■■ INMENEMEME I■ ■EEO■■■■■ ■ CEO ■E■■ NPI'vis"M PINES loom ME �MI ES �; r te!` ■ ■■ . .�.� ■E E Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe Medium Snnrl - — -L. • rte' i _ i, ilh 6 Topsoil - w -- _ - - 3 E b %. Slope Bed Of - 2 %2 Force Main Plowed Aggregate Layer (6" Below Pipe) D / Ft. Cross Section Of A Mound System Using E Ft. A Bed For The Absorption Area F ,79 Ft. G / Ft. A S Ft. H . b Ft. Signed: L'a" --�' z 14 B ,,� Ft. License Number: �ZAJ K 0, Ft. Date: p L By, y Ft. J F Ft. I / /.� Ft. W X,, 97 Ft. L Observation Pipe ---,, g K I � - ------- - - - - - - - - - - - - - - --------------- - - - - -- - A W L- - - -- ------------------------------- - - - - -- T 7Force Main Distribution Bed Of 2M— 2 '2 Pipe Aggregate . I Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area 1'uilut f 'it!e t.t Nlul 1 End View (Perforoteo i End Cop ,^ PVC P,pe ,opt e Jo�` Holes Located On Bottom, �s � Are EQuolly Spoced P bistribut-o� - Pipe Lost Hole Should Be Nest To End Cop Distribution Pipe Layout P_ Ft. r-00e "A'N S_ X Inchee Y �$_ Inches Hole Diameter Inch Signed: 2 lateral .b. Inches) License Number: 7 Manifold Inches Date: 9'.Z.�" �l Force Main Z Inches # of holes /pi pe _,[� Invert Elevation of Laterals Ft. I Page_a SEPTIC TANK & PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS 4 CI VENT PIPE 12" MIN. ABOVE GRADE & WEATHERPROOF >_ 25' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MANHOLE COVER W/ PADLOCK & FINISHED GRADE WARNING LABEL ,4 --L - - - -4" MIN. 18" IN. 6 MAX. INLET � WATER TIGHT SEALS GAS- TIGHT )APPROVED A SEAL JOINTS WITH APPROVED �— ; ALM APPROVED PIPE B 3' ONTO ONTO SOLID ' O N SOLID SOIL SOIL PUMP OFF ELEV . --- 1 OFFS` RISER EXIT D PERMITTED ONL IF TANK MANUFACTURER HAS APPROVAL 3 APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS, SEPTIC / DOSE TANK MANUFACTURER: GU5Ek `.s NUMBER DOSES PER DAY: TANK SIZES SEPTIC Zgoo GAL. DOSE VOLUME INCLUDING DOSE 80' GAL. FLOWBACK: _ 1�6.y GAL. ALARM MANUFACTURER: r ,�LE2T CAPACITIES: A = INCHES = GAL. MODEL NUMBER: SWITCH TYPE: /'7l_G/� B = 2 INCHES = y3, 7 GAL. T PUMP MANUFACTURER: ZOel -Lc/2 C = Q INCHES = 7 , GAL. MODEL NUMBER: 137 SWITCH TYPE: D = �_ INCHES = , y GAL. 32 808, ys REQUIRED DISCHARGE RATE , , yV GPM PUMP & ALARM WIRING AS PER ILHR 16.23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE /g - FEET + MINIMUM NETWORK SUPPLY PRESSURE . . .. . . . . . . . . . 2.5 FEET + /OD FEET FORCEMAIN X j l La FT /100 FT. FRICTION FACTOR g,ct FEET TOTAL DYNAMIC HEAD = /7,/, FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH ; WIDTH ; DIAMETER 5 LIQUID bMTTFT 27 SIGNED: LICENSE NUMBER: �� /7Y/ DATE: p- Al -gT_ 1/88 Total Dynamic Nead /Capoeily SEWAGE/WASTE PUMPS GRINDER PUMPS AGRICULTURE PUMPS 0 ONE ENE ol IN MMMMMMI No own m IN mmm MIMMIN 7 MOWN- 'ails.!► MEN No son IN No �MINE � �_�� MIN Il��Olm�r,.�l� Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page ? of 3 Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less the 8`;112 X_ ! es in size. Plan must include, but St . Croix not limited to vertical and horizontal refers PARCEL I.D. # ktEr{'por�Btvfy dict`ttl9 and % of slope, scale or dimensioned, north arrow, and location h"istance Jo neareiWr 0- 2093 -70 APPLICANT INFORMATION - PL MINT AU INFO ON R D BY DATE PROPERTY OWNER: I - PROPERTY LOCATION Joanne Persico GOVT. LOT SE 1/4 SW 1/4,S 29 T 30 N,R 19 k(or) W PROPERTY OWNERS MAILING ADDIZIMA LOT # BLOCK # SUBD. NAME OR CSM # 400 S. second St. , 7 na Highland Hills phase 1 CITY, STATE ZIP 1HO N NUMB []CITY OVILLAGE EJfOWN NEAREST ROAD Hudson, WI. 54016 o^ 5) 386 St. Joseph Co. Rd. #E New Construction Use [ Residential / Number of bedrooms 3 [ J Addition to existing building Replacement [ j Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate • 5 bed, gpdm • trench, gpolft Ab =rpflor, area reguir°<± 375 berg, rt2 375 tram tr2 Maximum design loading rate • 5 bed, gpd/ft • trench, gpolh Recommended infiltration surface elevation(s) 103.66 ft (as referred to site plan benchmark) Additional design/ site considerations system el- based on contour line of el. 102.66 Parent material pitted glacial drift Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL I MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for system ❑ S ® U E) S cl U 0S ®U ❑ S IKI U D S T: U 0S [NU SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure I GPD /ft Boring # Horizon Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ITmnch 1> 1 0 -13 10 r4/3 none sl 2mgr mfr gw 2f .5 1.6 2 13 -23 10yr4/4 none sl 2msbk mfr gw if .5 1 .6 Ground 3 23 -33 7.5yr4/4 none scl lmsbk mfr gw na .2 .3 103 4 33 -50 7.5yr4/4 c2p2.5yr5/6 scl lmsbk mfr na na .2 i.3 Depth to limiting factor 33" i Remarks: Boring # 1 0 -12 10 r3/3 none sl 2mgr mfr gw 2f .5.6 2` " 2 12 -21 10yr4 /4 none sl 2msbk mfr gw if .5 .6 IX 3 21 -32 7.5yr4/4 none scl lmsbk mfr gw if .2.3 Ground 10 elev. t 4 32 - 40 7.5yr4/4 csp2.5yr5 /6 scl lmsbk mfr na na .21.3 Depth to limiting factor 32" Remarks: CST Name:— Please Print Gary L. Stee1 715- 246 -6200 Address: 1554 200th Ave. New Ric and i. 54017 9-20-95 CSTMO2298 Signature: Date: CST Number: PROPERTY OWNER J. Persico SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL I.D. u 030 - 2093 -70 Boring # Horizon Depth Dominant Color Mottles I I Texture Structure Consistence Bourtlary I Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed iTrerxh 3 1 0 -12 10 r4 3 none sl 2mcfr mfr Cfw 2f .5i.6 2 12 -21 10yr4 /4 none sl 2msbk mfr gw if .51.6 Ground 3 21 -30 7.5 r4/4 none scl lmsbk mfr cry na .2i.3 10 4 1 30-50 7.5 r4/4 c2 2.5 scl lmsbk mfr na na .2�.3 Depth to limiting fac 1, Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. rlenth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(R.05/92) STEEL'S SOIL SERVICE Gary L. Steel Joanne Persico 1554 200th Ave. CSTM2298 SE4SW4 S29- T30N - R19W New Richmond, WI 54017 MPRSW 3254 town of St. Joseph (715) 246 -6200 lot #7- Highland Hills phase 1 T N 1 ,, =40' BM.= top of NE lot stake C el. 100' un�,s _ �c2ru`�t?cc,2 D /�--. { -► N t-. 10 z �,� 1�3 Gary L. Steel 9 -20 -95 v - I ` o rb " �, ^x�...,� ""••r,� \ } o 1 AY s i ' z •d tlsLa •btt vT9 93N 17V NO N 66— g0 -1o0 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 9A CC ZFd 5 T E / Mailing Address H&DEL /Acs I SGA-ff'o — y9 Li4/j0%r7a AL Property Address D ' 95 (Verification required from Planning Department for new construction) City/State eiL i o L, ' - Parcel Identification Number a3D - ,I-D 9-3 - 74 LEGAL DESCRIPTION Property Location • S - '/4, 5,W '/4, Sec. 2, f , T R_Z�_W, Town of Si. oigj2A/ Subdivision �/! �'� H�}x /i ,#I'L L S 11-4,r I . Lot # 7 Certified Survey Map # , Volume , Page # Warranty Deed # 7 , Volume _ 13 S ' l , Page # 70 . Spec house ❑ yes Peno Lot lines identifiable Oyes 0 no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal 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 of the three year expiration date. SVIATURE 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 p operty described above, by virtue of a warranty deed recorded in Register of Deeds Office. S NATURE 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 OIL ov .170 State Bar of Wisconsin F.xm t - 1992 WARRANTY DEED DO CUMENT NO. THIS DEED, made between DONNA J. MCKENNA, — -- A SINGLE PERSON REGIS OFFICE ST. C ROIX CO.. W1 SEP 0 3 1998 Grantor, 1/45 A M and JOHN C. WEBSTER AND ELIZABETH L. WEBSTER, HUSBAND AND WIFE, AS SURVIVORSHIP MARITAL PROPERTY Re a +w el 00040 4- f > _ __ T_MS SPACE RESER FOR RECORDING DAT Grantee. NAME AND RETURN ADDRESS: 4 WITNESSETH, That the said Grantor, for a valuable consideratiorr Title One Premier Group, Inc. 706 19th St. So. •: conveys to Grantee the following described real estate in St. Croix Hudson WI 54016 '4 ' County, State of Wisconsin:, a a�� • ' 030- 2093 -70 °'�` PARCEI tt)ENTIFICATION NUMBER t Lot 7, Plat of Highland Hills in Town of St. Joseph, St. Croix County, ' r y !. - Wisconsin. A , TRANSFER E This is not bomestead property. ; 84 (is not) Together with all and singular the hereditaments and a ppurxna®ces thereunto belonging: ' And Grantor warrants that the tide is good, indefeasible in fee simple and free and clear of encumbrances except Easements, roadways and restrict`.jns of record. and will warrant and defend the same. Dated this day of J 19 Q g JJJ " (SEAL) 1 SEAL p . ..._ ...... :........... ' DONNA ..J._MCKEdN1A , .... _ ...... r (SEAL) �. I" ,(SEAL) AUTHENTICATION ACKNOWLEDCMENTr : y Signature(s) _ STATE OF WISCONSIN c •.... •�<!RA County. a s authenticated this day of 19 Personally came before me this day of t # (1ST` 19 the above named I aY nna J. McKenna, a single person k' TITLE: MEMBER STATE BAR OF WISCONSIN i (If not, authorized by Section 706.06, Wisconsin Statu(es) p) me known to be the person who executed the foregoing instrument and ackripwledge the same. THIS INSTRUMENT WAS DRAFTED BY \ ., f MICHAEL H. FORECKI Kathleen R. Videen ' e EAU CLAIRE WISCONSIN Notary Public Polk County. Wis. (Signatures may be authenticated or acknowledged. Bolt are not necessary) My commission is permanent. (If nat, state expiration date: • N;mes of rs��lu si nin in an Opacity should be \ `LLe� 11 !1(4 �. Pe a a Y DA uY ty ped or primed bebw their sitrufure>, V t �[. vE - . 130, 678 SO. FT. W� =J \� 3.00 ACRES � U') f1\ J nat the \ s? 9 9, 2c3 obstruct 2y' 4' Q violation •. N� F1�� y Easements p dies and I � r ��b ty ve the area. b LA 26, ` EL. 945.0 . L 7 s x ,682 SQ. FT. i 3.00 ACRES A k; , a 0 W � O ; 0 , v 2 0 29 ' 13 ' W `-/ / / O � _ _ _ _ _ - _ / � � \ 38.91' �O O to N UNPLATTED v LOT 8 M LANDS _ 147,364 SO. FT. 3.38 ACRES W ti N O 0 N O Z !" 1068.28' 362.24' N89 000'22 "E SI /4 CORNER OF— SECTION 29 ? A E 407 C HUD N, 1 O A qN0 SU RJR REVISED THIS 20TH DAY OF APRIL 1993.