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HomeMy WebLinkAbout030-1096-80-000 I CD o 0 ° p y tt c t o u) E o m cn c c a) N 4) C N V N U O) U CL o >a o� Ec CI- - y Ocl. c.. d� L E y rnym �`° xy 0, oowaci�° m �L Q � � a a�U oo I v10 o v cod a) LO C Y .rn I L (n mx I 3 3 C) N: C:, �_ O y E c -' 4L O CO E > Z O ( O U O) p Z a7 C d(n> a 9 Z O. O)_ U. c - N o U 4) a ! V I O C •c vi o Y L a�H E 4 m'x rn� °) E L) aDr- oOa� 9 o!o 0 rm a ro (D ca o� Q U sty o C E Q w .. co � w M iR v y y Z rn W E E U ° o :: $ E � E z I I °. o a m cc') H z a m � I I o I o zv' rn c m m c Z m H c C a N O N O) o C = a) y N •� N a) O d ` p a) o D. tl .�. m O O N Q o +� Q Z m Z Z Z N _ z d d c a E E > N y c N d 10 w C M 10 A2 Cl) G G a. I C G d O N w fA fA U) j �i fn co U) V o z N >° a U) FF yy a cn c y i Z co •N a a.. a m a m m a = _ N 3 o v i i - - �a cn J U rn rn } CD � } (n ul O c0 .. p cm O c) .. O N - 0 E O Cl) d Q>- CO M d � Q �- U) m O O C . y C -O N C CD C14 co O �L' O m r ' m O N a) a O O F.+ t] c t] O O M M L O N m 'a N N O O a) O o N O N (� G .�- Cl) I 4 o o a) f- a) Z l y 4) c - mo o • ~ O M c O N O )n O cn N O c N U Z h Q M o Z c Y c� I I V - w it a `(L La i • C7 CL d .V 4) d C d y c rr ` w I�t r� E v c c 0 c c — 1 A Ua2 OaiCi I,Oinv Parcel #: 030 - 1096 -80 -000 03/23/2005 05:06 PM PAGE 1 OF 1 Alt. Parcel #: 32.30.19.353D 030 - TOWN OF SAINT JOSEPH Current 1 , X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): ` = Current Owner * VIZENOR, PATRICK N & LEAH D PATRICK N & LEAH D VIZENOR 1237 ROLLING HILLS TRL HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description " 1237 ROLLING HILLS TRL SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.160 Plat: N/A -NOT AVAILABLE SEC 32 T30N R19W NW SE LOT 2 OF CSM Block/Condo Bldg: 2/514 & IN CSM 3/636 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 32- 30N -19W Notes: Parcel History: Date Doc # Vol /Page Type 12/27/2000 635815 1570/01 WD 07/23/1997 1204/218 WD 07/23/1997 978/478 WD 07/23/1997 709/01 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 5624 251,700 Valuations: Last Changed: 07/08/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.160 77,500 170,100 247,600 NO Totals for 2004: General Property 3.160 77,500 170,100 247,600 Woodland 0.000 0 0 Totals for 2003: General Property 3.160 45,300 132,000 177,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 212 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT � nn Owner 1 )AL1 SQn/ Property Address a.3 7 )?oL c1 A!( r z r c T!) City /State ,1L" Q so& 11-k 6 Legal Description: Lot 2 Block ,A& Subdivision/CSM # 3 , 4 A 1 /4 ,$, 1 /4, Sec. 3.2, T,20 N -Rjj W, Town of S 7' s — PIN # 01/9 -/D 94 - 9 40 SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Size ST/PC I Setback from: House Well P/L Pump manufacturer Mo e Alarm location ( M LY ) Setbacks: Service esh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: TW E&C & Width 3 ` Length !;70 ` Number of Trenches 3 Setback from: House 90 ` Well O' P/L Z& ` Vent to fresh air intake /DPI ELEVATIONS Description of benchmark �,rzg r t LE, a d /v )ipam : ac' Ah"LL Elevation & Description of alternate benchmark Tom o /= TRAWS FoJe rzEa Elevation 5 9, 6 — Building Sewer ST/HT Inlet ST Outlet PC Inlet &_ _ 87 y8 PC Bottom Header/Manifold 86, VS Top of ST/PC Manhole Cover JW/ e"f m faOcrc Z- a Distribution Lines () 99. () 8 2_ R - a B A3 Bottom of System O f3 2, ;.i ( ) 4 5 � O 8 S• Final Grade -3 3 () 8 Date of installation % lD f5/p Permit number 3 - i 2 State plan number Plumber's signature License number 24 1 17 V / Date / Inspector Complete plot plan � I" 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 a � EL. fro � o � Brrr srep � � W / 3 # ,( 5 - 0' NF /L�/1i4T ✓ �ivcrf�S 0 3 �2c w�Y 'rep ?QANSfodM�/� ACT fl M FL, 99, G SGAGC INDICATE NORTH ARROW Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count Safety ancrBuildings 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)]. 353162 Permit Holder's Name: ❑ City ❑ Village Q Town of: State Plan ID No.: David Town of St. Joseph CST BM Elev.:. Insp. BM Elev.: BM Description: ArL} Parcel Tax No.: q`l. (a 0 ' 0 -4 - R"`& 030 - 1096 -80 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic . Benchma Dosi ng Alt. BM Aeration Bldg. Sewer Holding St /Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet ( o .o q o. ($ TANK TO P/ L WELL BLDG. Ventto ROAD _Q4 01 Air Intake Septic > 5'0 531' NA Dosing Header/ Man. ,2. a g .9 Aerati n NA Dist. Pipe ic - =s 7' Holding Bot. System 7 -'19 q6 PUMP/ SIPHON INFORMATION Final Grade Ma u a Dem St cover 1 �. I q3.o} Model Number GPM .33.E TDH Lift Fri Syste DH Ft For n Length Dia. He Dist. To well SOIL ABSORPTION SYSTEM, RENCH width Length No. Of renches PIT No. Of Pits Inside Dia. uid Depth DIME $�� 3 DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACHING Ma�uf ctur r. ` CHAMBER de , 1 INFORMATION T o C l r r ~" Model Numb r: System: 0 O OR UNIT ' -C r✓� DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia- Leng g 9 O z SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over a a Depth Over xx Depth Of xx Seede / Sodded xx Mulched Bed /Trench Center 2� Zs Bed /Trench Edges Topsoil ❑ Ye []No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection # 1 0 / fs759 Inspection #2: Location: 1237 Rolling Hills Trail, Hudson, WI (NW1 /4, SE1/ Section 32 T30 -Rl W) - 3 3 .19.353D ID -t!9'- Jq Plan revision required? ❑ Yes K No Use other side for additional information. 7� 1 ( Z- SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: E € � m m e� s } 1 x a i a s m ^_p k 4 6 � t < t t is s , q # t d 4 3 € , s e x e. g � s . I � � 3 i i ( � € I_ , .. .«. �.s3 mu € s 9 7 a }. t j K I 1 t w.W t l x j � € f � x € E a E € 3 E aR 3� s i k Safety and Buildings Division Vi scons i n SANITARY PERMIT APP ON 2 01 W. Washington Avenue P O Box 7302 s. dht Department of Commerce In accord with Comm 83.05, � 44,B -" / Madison, WI 53707 -7302 '1 , • Attach complete plans (to the county copy only) for the sy on Raptn lest M my than 8 112 x 11 inches in size. a� I`ECOVt 1 , c rc • See reverse side for instructions for completing this appl 4 Ifon 'ttatk Sanitary Permit Nufti you provide may be used for seconds i u C T 0 9 1999 .-� Personal information Y P Y secondary purposes _ GROix 6 eck if revision to previous application [Privacy Law, s. 15.04 (1) (m)). � t (;Ob93TY a e Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL 1 Property Owner Name y> __ Propert c ti Q _ 1 ,5�� T ,N,R E(or Property wner's Mailing Address Lo Block Number /X 2 GZ Cl y , State Zip Code Phone Number Subdivision Name or CSM Number o s 6 ( -) y II. TYPE OF BUILDING: (check one) ❑ State Owned 0 I Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms Village Town OF i r III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) $ 2 - 1 ❑ Apartment/ Condo O — 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. ❑ New 2.,K Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an _Sy tem ........ System - - - __ - -_ Tank Only Existing System Existing System -- ----- - -- - - -- g y ________ B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental _ Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 fgJ Seepage Trench 22 ❑ In- Ground Pressur \ 42 ❑ Pit Privy 13 ❑ Seepage Pit �� �, k �"O�?_ 43 [] Vault Privy 14 ❑ System -In -Fill Z -+ VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area I.Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade R uired (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) Min. /inch) F2,,!;' ✓ Elevation Feet Feet VII TANK in Capacit g Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete con- steel glass Plastic App New Existin _ structed _ Tanks Tanks eptic Tank`pertk 0 ❑ ❑ ❑ ❑ ❑ ❑ 1 ❑ 1 ❑ 1 ❑ 1 ❑ ❑ VI11. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage s stem shown on the attached plans. PI ber's Name: (Print) Plu a 's Signature: (No S ps /MPRSW Business Phone Number: I j Plumber's Address (Street, City, State, Zip Code): /ACF Gam` .�Yo IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate I ssued Issuing Agent Signature (No Stamps) Approved E] Owner fee) Owner Given Initial _ Adverse Determination '�' 7_ z - � /c, X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: // t // a V 1 < � '�`/ fo (tJ { vcv.Zh P(e l1"k C��- �� t{+''�7;o, ; � i[(,1 fO C. rc � !jraJe SBD -6.398 (R. 4/99) 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 pi operly maintained.' The septic tank(s) must be pumped - by a licensed pumper NWhenever 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-BuildiAgs- DWision, 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 ins ,1alled 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 isto 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(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 complete specifications for pumps and controls; dose volume; elevation differences; frictiond_oss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by theZ6Uhty ;'E)' soil test data iii a 11511 rm; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation'of surcharges (fees)' fora number of'reguIated practices which can - effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. I - I i i t I I — 1 1 [T -- � c i i `4 rat I i I • f i Y. Q!"! ths�cse : I j 3 , i : f ' i AV rU GPJ /¢ -- , i : r d ' I � , • } � i : I , j i 1 VV � r 4 i 6 � s r , 1 I ` F t r � f , 7 l jf f E ' ' 1 i �— i j , j x , 1 1 t � f r � f 1 i L f i 1 t � . 1 t I ' f � I i I i I 9 t i 1 i 1 1 t — . i p f t d j 1 i I i _� i Wisconsin Department of Commerce SOIL AND SI UATION Division Uf Safety and Buildings r Page / of Bureau of Integrated Services in accordance wi K ,I �bpNyis. Adm. Code lb 4 Attach complete site plan on paper not less than 8 1/2 x 11 inches i i Ian n Cou n ty include, but not limited to: vertical and horizontal reference point (B rection dr# aa{�.� percent slope, scale or dimensions, north arrow, and location and Eta ce to nearest road l Parcel J.D. # t ! ` 1 030 - 169I -I'd APPLICANT INFORMATION - Please print all ini forl i` n. RoU x Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy A �, 11r1Jdl'rc FCE j Prope Owner �{ " a, i/► U Cam h , pt : Gbh wt 114s� 114,S �? T ,30 ,N,R Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# /a - 7 PC f a / ? COM 3 Gab City State f Zip Code Phone Number Nearest Road � �-y- ❑City El Village LP Town // 1 �Z sy©/� (7>.S' ) S`y�f ,S"a?5"„1 4) / r ❑ New Construction Use: KResidential / Number of bedrooms 1 9 , Addition to existing building ER Replacement ❑ Public or commercial - Describe: Code derived daily flow _462a_ gpd Recommended design loading rate — _bed, gpd /f? & 9 trench, gpd /ft Absorption area required _ bed, ft 25 trench, ft Maximum design loading rate e � bed, gpd /ft gpd /ft Recommended infiltration surface elevation(s) e ) - �e e s ft (as referred to site plan benchmark) s) Additional design /site considerations / 12e Zt5e C-r ,� /�f Parent material �Lc GJu 5 4 t1ti h Flood plain elevation, if applicable / 1 14 ft S = Suitable for system Conventional Mound In- Ground Pressure AT Grade System in Fill Holding Tank U = Unsuitable for system a s ❑ U KS El S❑ U 1 5 6 ❑ U ❑ S XU ❑ S ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench U A, Vd-,i?4 IOve V1, s i Ic Ground °�'� �^-/ � �s B� e L ev py�/ t/ Kn it. 7 f' Depth to _ limiting factor Remarks: Boring # Ground / y� �� 6 S4 4� �S Y' "-ft. -weft• 4 Depth to limiting fa or A�Eln. Remarks: CST Name (Please Print) Signature Telephone No. Address Date CST Number PROPERTY OWNER ItulBr Sty SOIL DESCRIPTION REPORT Page f 9 - ,? of ..� PARCEL I.D.# Boris # Horizon Depth Dominant Color Mottles Structure 2 g Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench ,2 34k 9 m eb F;- c 1✓ Ground - 7, S 2 G "'""_'� S� 2-,s ik l�r{� t„j . S� elev. V S3 D 2 S » S` 3-J D 5 t s P l Q, + Depth to limiting (r v i I ���,5�.� t a ai c ,a` e �) ? i" *;,.�. y t '":.1 (C factor Remarks: ��` ,ca •,� LG�l�iz�'. :S �ltr►a�s df/�o?�S6'� S�. Lc��G�iv,r /Z�,e. / Boring # /� "1151 Ta /e{ /�o� -- �-1,e �l�rw►,' (ji li � r r, 'cfi s Crrc Qd ]�'hesc. Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # ......................... Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. ' Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) ' I I I I I I I I ! I j ; I 66 Alexi ji I I I �V i I i I I II I , I I I I - - -- IL I - TY I � i 1 - -- _ 1073 k ll sw'� s 7ri�r ; I -- I i i I I j I I j- j ;,� f,_ �_ �: ; t ,___ _ };: ', _ - -- _ , __ i ! - , - - _: _ _ _ _. - - , -- �_ _ -- '� -- ' � - _, . , � , , , ` — _. ,_ _ , , , ; � __. � , i ___ i � ; �. . ,. i - I i i a _'� ' � ', � �, i j ', �, �I I i �; � ' �.. - �.� �. { �_. t .. ... �� ,i - � � r � �, " � i �� i � � I i ,. _ ,. _— — I i � � l �, i � � i '. i � — — -- _ � a I_ _r — � — ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOP (ITT1.17ATTnN OF AN 1:XISTIN(. SM"1 TANK This is to certify that I have inspected the septic tank presently serving the L sksaly residence located at: GU 1/4, 1/4, Sec. ,3� T N, R _Zy W, Town of T u on inspection, I certify that I have found � ! ! Y the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced C(N/r/I�OCV I Did flow back occur from absorption system? Yes No (i£ no, skip next line) Approximate volume or length of time: gallons minutes Capacity: /0200 Construction: Prefab Concrete X_ Steel Other Manufacurer ( if known) : UNrAfO AN Ag f Tank (if known): IVPROX /S Y A5 (Signature) (Name) Please Print pR15 .2 (Title) (License Number) ' -2- - 7 _ (Date) Form to be completed by licensed plumber (s.145.06, Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements of ILHR -83, Wis. Adm. Code (except for inspection opening over outlet baffle . Name �pNAUi.tl JChW /TT Signature - - MPAIlEii2 21/7V1 5/88 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM 'Buyer `- 1 -i5" , } Mailing Address /a �; 7 -f o/1 t,• /7,///i; jr. s: � Property Address / 7 lF ! /, fills %r•�.�/ �L (Verification require (Tfrom Planning Department for new construction) City /State Kc & .r/; cc%.Z^ �r�6t� Parcel Identification Number s • - 30 ' l 9 r � S3 0 0 3 0- 105'e, -80 - oc)a LEGAL DESCRIPTION Property Location .41 L 1 /4, 5hF /s, Sec. 32 T N -R_�W, Town of .ST. �7asc�_ Subdivision , Lot # . Certified Survey Map # Volume b3 , Page # 6 3,6 Warranty Deed # -j;5 Q 9 7 7 , Volume /oZ 0 Lf , Page # 2 Spec house ❑ yes [�Kho Lot lines identifiable Bes ❑ 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 mastcrplumber, 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 of the three year expiration date. tQNATUKE OF APPLICANT VATS OWNER CERTIFICATION 1 (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 , r described above, by virtue of a warranty deed recorded in Register of Deeds Office. ley l si0mA OF APPLICANT DAM 10 * * * * ** 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 5509717 STATE BAR OF iISCONbIN FOI(M 2 – IQ82� WARRANTY DEED DOCUMENT NO. VOL I *.,?- 04 FACE Is Mark L. . L.Ltx and rjplinda_S__Lux, husband and ZT. CROIX CO., V11 wif e, 'bol 18 1.996 conveys and warrants to David 0. _Ande=n_ancL1isA_l._____ at 9:00 A M Anderson, husband and wife -aa--survivorship marital pjpp_erty._________ Desd-, J THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS the following described real estate in St—Cmix County, ei r State of Wisconsin: PARCEL IDENTIFICATION NUMBER Lot 2 of Certified Survey Map filed July 20, 1978, in Vol. 3 of Certified Survey Maps, page 636, St. Croix County, Wisconsin, being a part of the NWI/4 of the SE1/4 of Section 32, 1'30N, R19W. / RANffER This is homestead property. (is) )()(KM Exception to warranties: Easements, restrictions and rights-of-way of record, if any. Dated this 17th day of October — _A.D., 19 96 7W I (SEAL) (SEAL) Mark L. Lux ----- -------- (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, ss. St. Croix county. I authenticated this — day of 1 19— Personally came before Inc this 17th day of Oct-oher , 19__96, the above natned Mark I.- I.= and Melinda -q- Lux, • husband and wifc, TITLE: MEMBER STATE BAR OF WISCONSIN (11 not, authorized by §706.06, Wis. Stats.) 10 ne I qo i to be the person who executed the foregoing : 5d ackn owledge il arne. o THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Ogiland 4t Poulin Hudson, WI 54016 B reg a A - St q. y Croix County, Wis. ol (Signatures may be authenticated or acknowledged. Both are not No (if I sl expiration (1,11c: .is f is 0 State 0 11"Ifi necessary.) 124—, 19 9 6 i` • Names of persons signing in any capacity should vpedor printed l i, iow their signatures. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc WARRANTY DEED Form No. 2 — 1082 Mdwaijkpp, W.q 35025'i CERTIFIED SURVEY MAP X ? N.W. 1/4 - S.E. 1/4- SEC. 32, T30N,R19W RE PLAT OF VOL. 2� PAGE 514 c JU ll w CERTIFIED SURVEY MAPS. ST. CROIX CO. (2 0 �s o• 1 91 ,I, �,�;��., 4 1, 010 1 o c 6 6' i I I S 88- 37 -57 6.53.26' I — 26.58' 626.68' I I ,`900 653.26' °i /1-3 , LOT- 1 ° Ln �; 3.16 ACRES o_ { I BEARING ARE REFERENCED I I S 88- 37 653.85' TO THE WEST LINE OF THE I S.E. 1/4 OF SEC. 32 1 I 28.16 625.69' ( ASSUMED BEARING I I N 01= 36'-15"E ) IZ I O �, _ Q�% p; I i 3.1 ACRES A��'P. I m I S 88 -37 -57 E 654.44' N 1 00 t— - 29.74' 297.48' 327.22 , 327.22' ro LEGEND o – o m 0 = 1" IRON PIPE FOUND cn 1 1 w co 0= I" X 24" IRON PIPE SET, J v N I � I LOT -3 LOT -4 A WT. 1.68 LBS. /LIN. FT. y 1 -4 1 3.54 ACRES 3.64 ACRES { I N53 ° -07 1 0d'E N p 99.75 N7O 20' -00 'E 276.10' 00 WEST LINE . OF i OF O THE S.E. I/4 S 70- 20 -OOW SEC. 32 ` 111.65 i �`,� jME ,`Si•• � - - -_ -__ 49.14 E 62.51' __ '0 -- - -� - X23.81' � N 88 co 40' -22 c - 266.48 co — 432.01' �'4;• " W G� -44 _ o TOWN w 1 - - -- 655.82 , 'QP• LQ ROAD 0 150' 100' 50' 0 150' M. 0tli /��� G N S 1/4 � i S C ALE IN FEET CO. MON " GENE C. SEC. 32 • SHAFFER THIS INSTRUMENT WAS DRAFTED BY A.C.N S -1325 HUDSON �' JOB NO. 78 -62 S . VOL. 3 PAGE 636 � R'� • C,L RTIFIED SURVEY MAPS ST. CROIX COUNTY, WI. Volume 3 Page 636 I r ►- L LS:U CROIX RECORD 35251 CERTIFIED SURVEY MAP ? N. W. 1/4 - S.E. 1/4- SEC. 32, T30N,R19W REPLAT OF VOL. 2, PAGE 514 ��� � w CERTIFIED SURVEY MAPS ST. CROIX CO.,WI. 0 0 19]8 k% 6� G CON Ott '�``� 5 °• Q`% `' , M { 6 6' I I I S 88t 3i- 57 ' E 6.5 3.26' — 26.58' I' 6 26.68' .� I I `9Oo 653.26' h� LOT- I ` a 1 0 3.16 ACRES o BEARING ARE REFERENCED I 1 S 88= 37'-57'E 653.85' TO THE WEST LINE OF THE I S.E. 1/4 OF SEC. 32 625.69' ( ASSUMED BEARING I N 01=36' -15 ) { Z 1 01 r 7 LOT - 2 3.16 ACRES 1 S 88t 37 57 E 654.44' 1 0 OOD t-i 29.74' 297.48' 327.22' - i 1 327 .22': LEGEND co 00 m • = I" IRON PIPE FOUND I - W _ 0= I" X 24" IRON PIPE SET, N LOT -3 LOT - 4 A WT. 1.68 LBS. /LIN. FT. N 1 3.54 ACRES 3.64ACRES v I N53 -07' Od'E 99. / N 70 '20'- 00 'E�� 276.10' ` / WEST:'LI,NE OF `0 THE S.E. 1/4 S 70- 20 -OOW i EFt�• N� �Q; SEC. 32 111.65 49.14 E 62.51 u' -266.48 , �O - 432.01' - �' `r;• �o• C,�,O Z TOWN N 88 40' -22" W 0. W ,i0 655.82' 7D w ROAD _ ' 150' 100' 50' 0 150' $ A EI S 1 /4►�, "Y� ~� SCALE IN FEET Co MON GENE C. SEC. 32 = S 1325 THIS INSTRUMENT WAS DRAFTED BY A C. S•1325 HUDSON JOB NO. 78- O t VOL. 6J6 CERTIFIED SURVEY MAPS ST. CROIX COUNTY, WI. Volume 3 Page 636 i I tl Y r J p ` j SURVEYOR'S RECORD 345640 345640 CERTIFIED SURVEY MAP 8 s NW 1/4 - SE 1/4 - SEC. 32, T 30N, R 19W n 10 APPROVAL OF THIS MINOR SUBDI PPROVED. m FILED DOES N F, Iv►sI ON r+ NOV 29 NOT MEAN FOR 11977 APPROVAL "U o, CONNELL BUILDING SITE OR SEPTIC SYSTEM; N 2 3 1971 RWWW Or DNd. REFER TO H62.20► o 84 ook coftty, Q v C) ST. CROIX COUNTY COMPREHENSIVE PARKS PLANNING J� v AND ZONING COMMITTEE 6 6' 1 I 1 S88 37'- 57" E 653.26' 1 26.58' 626.68 , 1 , I 1 `��c 2 6' c h� LOT I o I 0' 3.16 ACRES p � ° I o BEARINGS ARE REFERENCED TO THE WEST LINE OF THE I SE 1/4 OF SEC. 32 1 ' S 88 37 -57 "E 653.85 (ASSUMED BEARING I N 01 36'- 15" E ) � 1 ' 6 28.1625.691 00 A O i c r I ' 0 J �Q vP� 1 a ° — i; LOT 2 0 1 3.16 ACRES o p �O 1 p A� J 5 I� 1 S 88 37' -5T"E 654.44' J �Q vP� I rn 1 29.74' 297.48' to 327.22' ' 327.22' ° dp 1 GD i 1 10 , LEGEND I 1 • -1" IRON PIPE FOUND 1 j A ; LOT 3 LOT 4 \ O -I "x 24" IRON PIPE SET, -4 i 3.59 ACRES N 3.59 ACRES WT. 1.68 LBS. /LIN. FT. I 1 1 4 5 V � 1 1 1` p�eo WEST LINE OF THE SE 1/4 ` 0 0 SEC. 32 �� p t> 0 \327.91 3 27.9 1 cirro0 _ _- 266.48 150' 1 00 50' 0 150' o TOWN sa5.82" �: ROAD o N 88°- 40' -22 "W SCALE IN FEET a v p m o p G� Q ` ���fnrni>r� p � y CO. MON. j� THIS INSTRUMENT. WAS DRAFTED BY G. C. S. SEC. 32 JOB NO. 77 -94 GENE C. = SHAFFER N R HUD NO, 27 f WIS. VOL. 2 PAGE 514 ��<q Rq�s��v CERTIFIED SURVEY MAPS 4 ��1�Etltftfs� s` +® ST. CROIX COUNTY, WI. • --7 —�� �•R.� - .aar� ., a u aa:ra au:r vna '-ER TOWNSHIP SEC. T N. R_ /S W . .0. ADDRESS s51��r/A �/v . 121 ? , ST. CROIX COUNTY, WISCONSIN. `.�( Z r� _3DIVISION , LOT LOT SIZE .� PLAN VIEW U, - Distances & d 2 imensions to meet requirements of H62.20 3 SHOW EVERYTHING WITHIN.100 FEET OF SYSTEM "7r' i TIC TANK(S) MFGR. 7 L CONCRETE �TE N0. of rings on cover A" Depth © DRY WELL "NCHES N0. of width length area ] no. of lines 2 width s• length __ area epth to top of pipe :,RELATE 72 :.K RATE AREA REQUIRED �16 tr AREA AS BUILT ova tea' ;claimer: The inspection of this system by St. Croix County does not imply complete % :pliance with State Administrative Codes. There are other areas that it is not possible inspect at this point of construction. St. Croix County assumes no liability for .tem operation. However, if failure is noted the County will make every effort to ,.:ermine cause of failure. '1SES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. • "INSPECTO�� DATED PLUMB,ER�0N JOB LICENSE NUMBER z - REPORT OF INSPECTION SEWAGE SYSTEM San.itax Pexm.Lt 7- y -- State Se ptic D D NAME /yl� �d�{f Township St. Cxo.ix County -. Location , Section _ i SEPTIC TANK j Size G gattons. Number ob Compaxtment.6 j Distance Fxom: Wet 6t. 12% on gxeatex ztope bt Bu.itd.ing 6t. Wettands 6t. Hig hwaten DISPOSAL SYSTEM Distance Fxom: Wett / 12% on g x eatex ztope 6t. Bu.i.ld.ing �' 3 St. Wettande Ft. H.ig hw ate.k FIELD DIMENSIONS: Width o6 txench IL. 6t. Depth p �- xo ck b etow t.ite f in.-- Length os each .Line 6t. Depth o6 xock oven t.ite L .in. Numbers o6 tin Depth o6 tite below grade z - /in. Totat .length o6 tines 6t. Stope o6 trench in pen 100 it. Distance between .Lines 6 t. Depth to bedxock ' - 6t. Total abzoxbt.ion area - 6t 2 Depth to gxoundwatex 6t. 2 T y p e o ; r "Pa e ox Straw . .Requited axea �t yp 4 Coven: PIT DIMENSIONS: Numb ex o6 pits Gxavet axound p.itd ye,6 no Outside d.iametex Depth below .in.let fit. 2 Total abzoxbt. on 'axea 6t z A Axea xequ.ixed 6t r , J INSPECTED BY TITLE APPROVED , DATE a �(� 197 . REJECTED ,DATE 197_ 1 EH 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS / LOCATION: U 5 Section-3?, TAN, R & ir(or) W, Township or Adnfei� Lot No. _/— Block No. Owner's Name: 1 Subdivision Name Count 1 14) r ACC- - S� L Mailing Address: 9 , V - 6 7 c 'f i �f.!/igTl�'�y i m t ✓'> 7� O� 2 TYPE OF OCCUPANCY: Residence '� No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW mi l ` ADDITION REPLACEME�NT / DATES OBSERVATIONS MADE: SOIL BORINGS '`�` _ � � ' 7� PERCOLATION TESTS �` ` 7 �' 7'7 SOIL MAP SHEET 7 Z SOIL TYPE 0. � PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN /IN P- P- Z_ [� * SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) _ z i 0, / 7e 7 6 " C_ . Z i l/ y Z i, ,. C 7 r! / .. "/ __; z „ >7Z a n Z a 7 . a.71 '£nS " ,L . PLAN VIEW (Locate percolation tests,soil bore holes and suitablesoil areas.) Indicate on the plan the location and square feet of suable areas. Ind number of square feet of absorption area C needed for building type and occupancy. Ab - ( 3ov 6 ' �b1,F Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. t o t. 4 f � 1- � d tN I A , I Q 1. I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. Name (print) Certificatio , No. Address �0 , ' Name of installer if known CST Signature COPY A — LOCAL AUTHORITY EH 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION: '/ _tom' /4, Section_;�, tU—N, R/_�i-, (or) W, Township or Municipality Lot No. I+ , Block No County Subdwision Name Owner's Name: Mailing Address: TYPE OF OCCUPANCY: Residence No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW °',-, ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORING 7S PERCOLATION TEST SOI MAP SHEET N SOI L TYPE a 4j PERCOLATION TESTS E HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE IN H CHARACTER OF SOIL THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN /IN Xe P_ cI 3 ,7/ z z 2 SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) r Z , 72- . s Z, , '/ 7 71 Z , N i J l/ b PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy. 646: Q"' Hbl � - Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. -� >r 4 N U � i , Z I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. Name (print) Certification No. ZZ Vy Address Name of installer if known CST Signature -- LOCAL AUTHORITY s State and County State Permit # Count Permit #, ti n Y P o PL rmii A e Ap for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: B. LOCATION: _ ' /4 �j-: '/4, ection , T� N, R (or) W Lot# I tity _ Subdivision Name, nearest road, lake or landmark Blk# Village Township , C. TYPE OF OCCUPANCY: Commercial Industrial *Other (specify) *Variance Single family J Duplex No. of Bedrooms No. of Person D. TYPE OF APPLIANCES: Dishwasher t/ YES NO Food Waste Grinder YES 4 ' IGO # of Bathrooms Automatic Washer 4--­ Y ES NO Other (specify) E. SEPTIC TANK CAPACITY /�/�+�+ Total gallons No. of tanks *Holding tank capacity Total gallons No. of tanks New Installation — Addition - Replacement _ Prefab Concrete *Poured in Place Steel "� Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) i,:5r 2) 3) _ _, Total Absorb Area q. ft. New ✓Addition Replacement *Fill System Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches Seepage Bed: Length. -' Width Depth 3 1 1 Tile Depth No. of Lines —_ Seepage Pit: Inside diameter Liquid Depth Tile Size -� Percent slope of land .5, Distance from critical slope 02 I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH -115 prepared by the Certified Soil Tester, NAME G gar �/ .L, �L� ,(, C.S.T. # Z Z Yd and other information obtained from (owner/builder). Plumber's Sig nature W MP /MPRSW# .10 SL 7 Phone # t'/ � — 5 1%7 Plumber's Addr jeV , 1 d.­, PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). Z. l g µv V'It _ Y � J Do Not Write in Space Below FOR DEPARTMENT USE ONLY Date of Application ` Fes Paid: State i Count Date Permit Issued / (date) Issuing Agent Name C Inspection Yes_)� No Valid# Date Rec'd 1. county (whO copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 6/1/76 i � 0 7 ° 7 . _ . ® ( En E % ƒ� R W S ° e = Q e . \ § } / E ) 8 » k o D ƒ ) 2 Co $ § \ \ \0 E o k@ § § Cl : c 2 2 § 6 ® E E E K § E e ( § ° m m « » E a ® g a $ (n e .. 0 \ 2 = o /® \ $§�� § (D ® $ _» I . � m £ § \� 7 \ 7 E E � o \ 0 0 0 + �- § = § § 2 0 § � k \ \ \ CD 0 §\ w § § § » _ , . � \ � / 2 § \ [ Z f ƒ . CD / \ . { 7 k / e S _ f , § k / ` � p a � { q d " D / t ) � 0 ƒ 0 R 7 ƒ � ) � � ' ) � / % 2 0 * \ f * } E& �7 Parcel #: 030 - 1096 -80 -000 02/25/2005 12:33 PM I PAGE 1 OF 1 Alt. Parcel #: 32.30.19.353D 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): = Current Owner * PATRICK N & LEAH D VIZENOR VIZENOR, PATRICK N & LEAH D 1237 ROLLING HILLS TRL HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1237 ROLLING HILLS TRL SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.160 Plat: N/A -NOT AVAILABLE SEC 32 T30N R19W NW SE LOT 2 OF CSM Block/Condo Bldg: 2/514 & IN CSM 3/636 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 32- 30N -19W Notes: Parcel History: Date Doc # Vol /Page Type 12/27/2000 635815 1570/01 WD 07/23/1997 1204/218 WD 07/23/1997 978/478 WD 07/23/1997 709/01 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 5624 251,700 Valuations: Last Changed: 07/08/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.160 77,500 170,100 247,600 NO Totals for 2004: General Property 3.160 77,500 170,100 247,600 Woodland 0.000 0 0 Totals for 2003: General Property 3.160 45,300 132,000 177,300 p Y Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 212 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00