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ST CRUX COUIqTy
September 21, 2009
John Walter
1294 89 Street
New Richmond, WI 54017
RE: Filling and grading in Willow River Shoreland District
Parcel #36.30.19.836 Lot 4 Durning & Lewis Subdivision
Code Administration Dear Mr. Walter,
715- 386 -4680
Your contractor, Ken Ronsberg, brought plans into our office for staff review of a proposed
Land Information in- ground swimming pool project. This will require filling and grading within 300 feet of the
Planning Willow River, which is subject to Shoreland overlay district requirements. The pool is
715-386-4674 considered an accessory structure and is a permitted use pursuant to Section 17.35
Real Property Recreational residential district.
715- 386 -4677 1 have determined that your project to construct an in- ground pool as shown on the plans
Recycling submitted to this department on September 17, 2009 will not require a land use permit. The
715- 386 -4675 project will not disturb greater than 2000 sq. ft. on slopes less than 12% measured over a
horizontal distance of fifty feet (50'), which is allowed without a permit pursuant to Section
17.29(2) of the Shoreland Ordinance.
Please keep in mind, the closest part of excavation for the pool must meet the 75 foot (75')
minimum setback requirement for structures from the ordinary high water mark (OHWM) of
the Willow River. The 75' setback is shown on the plat map for Lot 4 and the plans indicate
the pool will be just east of that line. Please measure carefully, since no excavation for this
structure is permitted to be closer than 75' of the OHWM without a variance. Even though
a permit is not required, please take precautions to prevent erosion and sediment from
being washed into the river. Use of straw wattles or sediment logs between the excavated
soil and the river, combined with undisturbed vegetative buffer, should be adequate to
protect water quality until the disturbed areas have been covered by seed and mulch or
otherwise stabilized.
In addition to Shoreland ordinance requirements, this project must comply with Dept. of
Commerce setbacks contained in DComm 83.43. The pool must be a minimum of 15 feet
from the dispersal component (drainfield).
Please proceed to the Town of St. Joseph to obtain the required building permit.
If you have any questions or concerns, please contact me.
S'
Pam Quinn, oning Specialist
Cc: Town of St. Joseph
ST. CRO /X COUNTY GOVERNMENT CENTER
I 10 1 CARMICHAEL ROAD, HUDSON, Wt 54076 715- 386 -4686 FAX
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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.
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ST. CROIX COUNTY ZONING DEPART = q
J AS BUILT SANITARY REPORT f tF IVEDECD o
* Owner
Property Addre s
>,
.�` �r ST GPOA
City /State �v / „� n coo i7 couNn
ZOM1iCaC;FFICi *,
Legal Description:
1 {
Lot �_ Block — Subdivision/CSM # 4 rn L . • A
'/a 1 ` /a, Sec. 3 , Two N -RAW, Town of �SQd� ti PIN
SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION
Tank manufacturer Size (OPC tody/ Setback from: House / I � Vell 4- P/L ~ r`'
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: � r c Width 3 Length �_ Number of Trenches Z
Setback from: House 3o Well P/L �2 ” Vent to fresh air intake
ELEVATIONS
Description of benchmark Iy V Thu Z Elevation y6 -
Description of alternate benchmark 1 a s Or, r �&JddrK.cr Elevatio
Building Sewer ST/HT Inlet ST Outlet Z , Z PC Inlet
PC Bottom Header/Manifold Top of ST/PC Manhole Cover gel, q 3
1,
Distribution Lines (Tr) Fez)
Bottom of System (1
Final Grade O ( ) ( )
Date of installation) / / Permit numb ? State plan number
Plumber's si nature uA License number
Inspector
Complete plot plan a
4 4 , r s
JOB /
TIMM EXCAVATING SHEET NO. 1 OF
Route 1 Box 192 f� Q
WILSON, WISCONSIN 54027 CALCULATED BY '" DATE
(715) 772.3214 (715) 386 -5443
MPRS #3224 WI MPCA #696 MN CHECKED BY DATE
SCALE
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PRODUCT 205 -1 Inc., Groton, Mass. 01471, To Order PHONE TOLL FREE I -B00- 225-6380
� ' = ST. CROIX COUNTY ZONING DEPARTAIWO
AS BUILT SANITARY REPORT �►
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' 4 Owner
ri
Property Addres 3T RO .
¢� '��,� 1
City /State We j *wrt d- 4 ! 5/o /) cOUN Y
` ZM9NC CFFIC,t
Legal Description:
Lot _� Block Subdivision/CSM #
%4 �/C- t /4, Sea � T_o N -RAW, Town of PIN # - at /3 - /U
SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION:
Tank manufacturer It . e—t r. f Size(j�)pC lode/ Setback from: House /I � Vell P/L
Pump manufacturer Model
Alarm location
(HOLDING TANKS ONLY)
Setbacks: Service road _ Vent to fresh air intake Water Line
Meter location
Alarm location
SOIL ABSORPTION SYSTEM
Type of system: f re.- -e A Width 3 Length -!� I_ Number of Trenches z
Setback from: House -- 3o Well P/L �2 "" Vent to fresh air intake 5d'
ELEVATIONS
Description of benchmark /yam u° f?.ir Ti's Z Elevation yG-
Description of alternate benchmark - i 1 151 t 0ca e- eor+ticr Elevation
Building Sewer ST/HT Inlet ST Outlet Z , 71 PC Inlet
PC Bottom Header/Manifold Top of ST/PC Manhole Cover gel, q S
Cow {�
Distribution Lines (T)
Bottom of System (�) r � (�'� !U J3 ( )
Final Grade
Date of installation ! / / Permit number X44 State plan number "-"--
Plumber's si nature License number '� (o 2-� Date /2,-/ 2 /
Inspector
Complete plot plan �
y—
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.
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�' >t Safety and Buildings Division
SANITARY PERMIT APPLICATION
n 201 W. Washington Avenue
In accord with ILHR 83.05, Wis. Adm- -o-e. C
P O Box 7302
Department of Commerce '^ .
Madison WI 53707 -7302
•~ Attach complete plans (to the county copy only) for the systerj('On papfr not less - Coonty ^
than 8112 x 11 inches in size.
State Sanitary Permit Number
• See reverse side for instructions for completing this appllc � y
Personal information you provide may be used for secondary purposes
c �. fitic if revl$IOn to previous application
[Privacy Law, s. 15.04 (1) (m)l. _ 1ti� ° > '` �, Crime to S an I.D. Number
1. APPLICATION INFORMATION -PLEASE PRINT ALL f RMAT f
Propert OwgerName Pr y atl C/ ��;^�
/4-rf� 5 �� T Z1 r Nr R ��j k(or)
Property Owner's Mailing Address Nr Block Number
City,,State Zip Code Phone Number Subdivision Name or CSM N mber,,
( ) N we �e - 2 mss' A. 2
IL Y E BUILDING: NG: (check one) ❑ State Owned It� age �,� Nearest Road
LT il
Public 1 or 2 Family Dwelling - No. of bedrooms _ own of Sj�
I11. BUILDING USE (If building type is public, check all that apply) Parcel Tax Num (s)
1 ❑ Apartment/ Condo t 4536 z613 > a
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. ❑ Replacement 3, ❑ Replacement of 4. ❑ Reconnection of S. ❑ Repair of an
System ________System __TankOnl�r______________ Existing System ________ Ex)stingSystem
B) A Sanitary Permit was previously issued. Permit Number 3 41 ye a Date Issued 9 J ,y_ 7f
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
1214 Seepage Trench 22 ❑ In- Ground Pressure 42 [] Pit Privy
13 []Seepage Pit 1 - 2 3 X S4 • Z15 43 ❑ Vault Privy�,�
14 [] System-In-Fill 18
VI. ABSORPTION SYSTEM INFORMATION:
1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. Systemtle . C f. Final Grade
Required ft.) Proposed
7 •
d (s . ft.) (Gals/day/q. ft.) (Min. /inch) c� Eleva ion
• 81, 3 Feet 9 Feet
Cap acit y
VII TANK in Ca gallo Total # Of Prefab. Site Fiber- Exper.
INFORMATION Gallons Tanks Manufacturers Name Concrete Con steel glass Plastic App
New Existing strutted
Tanks Tanks I ,v
Septic Tank or Ing Tank `� " s' �G S C G3 ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber ❑ ❑ 1 ❑ 1 ❑ ❑ ❑
Vill. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plum 's Name: (Print) Plum is Signature: (No amps) MP /W BBSW No.: Business Phone Number:
Plum er's f ddress (Street Cit State, Zip Code): � % �� 6 � /� � 2
IX. COUNT DEPARTMENT USE ONLY !!/
E] Disapproved Sanitary Permit Fee (includes Groundwater ate I ssued Issuing Agent Signature (No Stamps)
1dA roved Surcharge Fee)
Adverse Determination
pp ❑Owner Given Initial ��
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SBD- 6398 (R.11197) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber
i -
INSTRUCTIONS j
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 of where the
P y 9 9 p p (s )
system is tote installed.
i k only n and complete of bedrooms if 1 or 2 Family Dwelling.
I1 . Type of building being served. Chec o y o e p # y . g
III. Buildin g 9 type use. If buildin t e 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. -
VI11. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.),
address and phone number. Plumber must sign application form.
IX. County/ Department Use Only.
X. County / Department Use Only.
Complete plans and specifications not smaller than 81/2 x 11 inches must be submitted to the county. The plans must
include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic
tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon
tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served;
B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume;
elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section
of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information.
----------------------------------------------------------------------------------------------------
GROUNDWATER SURCHARGE
1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can
effect groundwater.
The monies collected through these surcharges are used for monitoring groundwater contamination investigations
and establishment of standards.
r
JOB
TIMM EXCAVATING SHEET NO. Of
Route 1 Box 192
WILSON, WISCONSIN 54027 CALCULATED BY DATE
(715) 772.3214 (715) 386 -5443
MPRS #3224 WI MPCA #696 MN CHECKED BY DATE
SCALE
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PRODUCT 205-1 ®Inc„ Groton, Mass. 010. To OrCar PHONE TOLL FREE 1-800 - 2255300 -
i SANITARY PERMIT APPLICATION S afety and Buildi Division
201 W. Washington Avenue
.�i�30tA.SIR P O Box 7302
Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code
Madison, WI 53707 -7302
Attach complete plans (to the county copy only) for the system, on paper not less County
than 81/2 x 11 inches in size.
See reverse side for instructions for completing this application State Sanitary Permit Number
3 yys `7a
Personal information you provide may a used for econdary purposes ❑ Check if revision to previous application
[Privacy Law, s. 15.04 (1) (m)). /��� State Plan I.D. Number
1. APPLICATION INF RM I TION - PLEASE PRINT LL INF RMATI N
Property Owner Nam ��P roperty option
k (�14v- 411 f� 1/4, S �' T , N . R �
Property Owner's Maj4ng A s dr Lot Number E !ck Number
City, State Zip Code Phone Nurrlbr� Subdivi ion Name of CSM Number ,
II. TYPE OF BUILDING: (check one) ❑ State Owned o itlIyy Nearest Road 11
CO]
Public 1 or 2 Fam ily Dwelling - No. of bedrooms _� Iow 7 -T A
I11. BUILDING USE (If building type is public, check all that apply) Parcel Tax Numbers
1 ❑ Apartment/ Condo 9 0 ' m � / -•dd0 p
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, Eg New 2, ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5, ❑ Repair of an
System -- System - Tank Only - -- --- --------- -- - Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non- Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 [:]Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 Seepage Trench 22 Ejln r nd Pressure 42 ❑Pit Privy
13 E] Seepage Pit �8 ! A �, e_ < • /_ 43 ❑ Vault Privy
14 E] System In -Fill J
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
'Sr��p 'ej 72 Q5% 33 Feet 99, Z Feet TANK Capacit
VII• INFORMATION in gallo Total # of Manufacturer's Name Prefab: Con- Steel Fiber- plastic Exper.
New Existin Gallons Tanks Concrete glass App_
Tanks Tanks strutted
an g an j 53 ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑
VIII. RESPONSIBILITY STATEMENT
1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumb r "s Name: (Print) Plumb is Signature: (No amps) MP / MPRSW No .: I Business Phone Number:
Plumber' Address (Street, City, State, Zip Cod
IX. COUNTY / DEPARTMENT USE ON
❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuln Agent Signature (No Stamps)
[Approved []Owner Given Initial �) Surcharge Fee)
Adverse Determination Am>
X. CONDITIONS OF APPROVAL / REASONS F R ISAPPROVAL W T Fjyt�lyd� • e4�1 �rirr
A l \ 5�1r v r Owt IM r
u�,� ��� �K ��ti� 5 .fir' O N6r .t� `( -l�,e k,�r j �oti✓ �11/tr",
SBD- 6398 _(R.11/97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit 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:
1. Property owner's name and ri ailing address. Provide the legal description and parcel tax number(s) of where the
system is to be installed.
11. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling.
111. Building use. If building type is public, check all appropriate boxes that apply.
IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair.
V. Type of system. Check appropriate box depending on system type.
VI. Absorption system information. Provide all information requested for numbers 1 through 7.
VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and
manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and
holding tanks for this system. Check experimental approval only if tanks received experimental product approval from
DILHR.
VIII_ Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.),
address and phone number. Plumber must sign application form.
IX. County/ Department Use Only.
X. County / Department Use Only.
Complete plans and specifications not smaller than 81/2 x 11 inches must be submitted to the county. The plans must
include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic
tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon
tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served;
B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume;
elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section,
of the soil absorption system if required by the county; 'E) soil test data on a 115 form; and F) all sizing information.
---------------------------------------------------------------------------------------------- - - - - -=
GROUNDWATER SURCHARGE
1983 Wisconsin Act 410 included the creation of surcharges (fees) fora number of regulated practices which can
effect groundwater.
The monies collected through these surcharges are used for monitoring groundwater contamination investigations
'r and establishment of standards.
Joe
y ' TI M NI EXCAVATING Z
Route 1 Box 192 SHEET NO. OF
WILSON, WISCONSIN 54027 CALCULATED BY DATE �Z J
(715) 772.3214 (715) 386.5443
MPRS #3224 WI MPCA 0696 MN CHECKED BY DATE
SCALE
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PRODUCT 205 -1(-I Im, Groton, Mass. 01471. To Order PHONE TOLL FREE b870- 215-8380
` JOB
' TIMM EXCAVATING SHEET NO. L OF 2
Route 1 Box 192 - '
WILSON, WISCONSIN 54027 CALCULATED BY DATE A 7 " G
(715) 772 -3214 (715) 386 -5443
MPRS 03224 WI MPCA #696 MN CHECKED BY DATE
SCALE
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PRODUCT 205-1 Inc., Groton, Mass. 01471. To Order PHONE TOLL FREE 1- 8*225 -M
NLsconsi; C;e ardent of Commerce . IL Pa AND SITE EVALUATION e I of 3
; ivisirya of pia ety and Buildings ORIGALw Comm 83.05, Wis. Adm. Code 9
.. Certified Soil Testing
Attach complete site plan on paper not less than 8' fare& -io size. Plan mu,t County
include, but not limited to: vertical and horizont t feteltide Ooint(B'M),,direction and St. Croix
percent slope, scale or dimensions, north a \,ar1d "iodation and distance to nearest road.
Parcel LD.#
APPLICANT INFORMATION - fI ,itme prirjt irfformaltiowl u3u 2ul to
Persona{ information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Rem d Y
Property Owner Property Location
Walter, John Govt. Lot NE 1/4 NE 1/4 S 36 T 30 N R 19 W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
1254 89th St. - ._. 4 Darning -Lewis Xddition
City State Zip Code PhoneNumber '' ❑ City [ Village IXTown Nearest Road
New Richmond W1 54017 St3oseph 8 rh St.
X i`dew Construction Use: Residential / Number of bedrooms 3 , jAddition to existing building
replacement [ Public or commercial describe
Code:: Derived daily flow 450 gpd Recommended design loading rate • bed, gpd /ft2 .8 trench, gpd /ft
Abso rption area required 643 bed, ft2 562 trench, f: Maximum design loading rate • bed, gpd /ft2 .8 t rench, gpd /ft
Recwimended infiltration surface elevation(s) 893 ft (as referred to site plan benchmar
Addit;anal design
install 2 - 2.7x 56.25' Sidewinder, Hi capacity "turtle sheli" trenches
Parent material /si consideration sandy/loamy outwash F lood l ain elevation, if applicable
J N p ` ft
I S= Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank
&LInsuitable for system U X SFlu N S Cl U N S! 1 U S U S U
Boring# Horizon
Depth Domin unse Qu. SMCont Color Texture structure Consistence Boundary Roots Bed Trench
1 1 0 -11 10YR 3/2 - sl 2 m gr mvfr I cs 1 f/m .5 .6
2 11 -18 7.5YR 3/4 - Is 1 f sbk mvfr i cs l f .7 .8
-- - - -- - -' - -- - - --- -- ------------ - - -- -- --- -_.---- --- -------
Ground 3 18 -28 7.5YR 3/4 - 1s 0 sg ml cs If .7 .8
elev - - 7. - - - - - - - - - _
96.2 ft 4 28 -39 .SR 3/4 -- - _s_/ m_
j 0 sg ml cs if .7 .8
Depth to 5 39 -66 10YR 4/4 - mcos 0 sg ml cs - .7 .8
-
factorg 6 166 -120 lOYR 4/4 - s 0 sg ml 7
8
_ _120" '4
Remarks: occasional gr below 8"
2 l 0 -10 1OYR 3/2 - A 2 m gr mvfr cs 1 Um 5 .6
2 10 -20 10YR4 /3 - sl 1 msbk mvfr cs lm .4 .5
Ground 3 20 -27 7.5YR 3/4 - Is I f sbk 1 mvfr cs 1 m .7 .8
elev-. - - -- - - -- -- - -- - - - - -- -- -- _ _
95.6 It 4 27 -37 7.5YR 3/4 - s /mcos 0 sg j ml cs - 7 8
- - -- - -
- - - mcos - 0' S _ I
p 5 37 -53 10YR 4/4 -
6 53 -62 - 10YR 3/4 — - - - -- -- mcos - -__O s ____
Depth to g ml cs .7 .8
limitin -- - - - -- j - -.-.- - - - -- g I -
factor cs .7 .8
MI
> 120" 7 162 -120 l OYR 4/4 5, j s 0 sg dl - - 7 8
Remarks: occasional gr below
CST Name (Please Print) Signature:
A� C
Telephone No.
Henry F. Grote 715- 665 -2681
- - mortified- SoiT�tin - -- -_ - - - - -- - - - - - -- - -- - -- -
Address g Date CST Number Ref #
P.O. Box 57, Knapp, WI.54749 816/1999 222774 1244
PROPERTY OWNER: Walter, John SOIL DESCRIPTION REPORT] page ., of- -3
PARCEL LD.# _030- 2013 -10 _ -- _ Certified Solt Testing
- - --
Depth Do Munse Qu. S Mottles
Color Gr. Sh. ! Boundary Roots ! GPGlft2
rY
Bed Trench
Horizon Texture onsistence
3 1 0 -17 10YR 3/3 - sl 2 m gr ds cs 1 f/m 5 6
2 17 -28 10YR 3/2 - sl 1 m sbk ds cs IM .4 .5
elev Ground 3 28 -55 10YR 3/4 - s1 2 m sbk dh cs - S ` 6
94.9 ft_ 4 55 -63 7.5YR 3/4 - Is I m sbk dh cs - j .7 .8
Depth to 5 63 -70 7.SYR 4/4 - mcos 0 sg dl cs - 7 .8
limiting
factor
> 120" 6 70 -120 IOYR 4/4 - s 0 sg ml - - .7 .8
I
Remarks: - - -- - - -- - -- - - - -- - - - - - - -- - - — — -- --
Ground
elev
I
Depth to
limiting
factor
Remarks: _ - --
i
Ground
elev
Depth to
limiting -- -- -- —
factor — - - - -- - -- - - _ -
i
Remarks:
- - - - - - - -- - - - - -- . --
Ground - --
elev
w " i
Depth to '
limiting
factor
Remarks:
� j l
k-t�Wfi 3a�. � v.r..:r. S�1 `�'® �•.r►: Sig. J �s�.�O�
c� �
S c �►QQ �" * 3 a� CiK� }� C. a,¢ S� e� rtpw'c
344S a-o
(4 S, 6�
b -z-
Wale.. dt :vw
�G 2 •ft''S
tk SA
�o V IAC
WSconsin 4ep&tment of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3
Labo. 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 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. 030- 2013 -10
APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
James Durning GOVT. LOT NE 1/4 NE 114 36 T 30 , N,R 19 :R (or) W
PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
7217 Cmirfjy Rd. 4 na
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY []VILLAGE [MOWN NEAREST ROAD
Woodbury, MN. 55125 (612) 739 -5208 1 St. Joseph Cty. Rd. " A "
[x} New Construction Use [ Residential / Number of bedrooms 3 [ } Addition to existing building
[ J Replacement [ J Public or commercial describe
Code derived daily flow 450 gpd Recommended design loading rate .7 bed, gpd /ft .8 trench, gpd /ft
Absorption area required 643 bed, ft 563 trench, ft Maximum design loading rate .7 bed, gpd /ft gpd /ft
Recommended infiltration surface elevation(s) 95.33 ft (as referred to site plan benchmark)
Additional design/ site considerations alt site system el.= 93.90
Parent material stream terrace Flood plain elevation, if applicable ft
S = Suitable for system CONVENTIONAL I MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK
U= Unsuitable fors stem I :K] El as 0 KI ❑U I ®S ❑U RIS ❑U ❑S ®U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence BoLlrldary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trerch
1 0 - 10 r3 2 none ail 2c!sbk mfr cm lm
-- 2 12 -30 10 r4/4 none sicl lcsbk mfr if .2 .3
Ground 3 130-84 7.5 r4/6 none ms 0scl mvfr na na .7 .8
elev.
99.2 ft.
Depth to
limiting
factor
+84
Remarks:
Boring #
1 1 0-6 1 3 2
2 6 -86 7.5 r4 6 none ms os mvfr na na .7 i.8
Ground
elev, ' t` A-
9 9.5 ft. ! RED
Depth to
limiting �° MAY 1997 Phi
factor
+86 f�
Remarks:
CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200
Address: 1554 200thAY6., New R'ch WI 017
Signature: Date: 5 -14 -97 CST Number: m02299
PROPERTY OWNER James Durning SOIL DESCRIPTION REPORT Pagg ,2 of --
PARCEL I.D. # 030 - 2013 -10
Depth Dominant Color Mottles Structure GPD /ft
Boring # Horizon Texture Consistence Bounday Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
3 1 0 -9 10 r3 2 none
2 9 -30 10 r4 4 none sl 2csbk mvfr
Ground 3 30 -84 7.5yr4/4 non ms osg ml na na .7 .8
elev.
97 ft.
Depth to
limiting
factor 10
Remarks:
Boring #
1 0 -12 10 r3 2 none sit 2msbk mfr .5 '.6
4 _ 2 12 -32 10 r4 4 none sicl lcsbk mfr if .2 .3
Ground 32 5yr4/6 nnne Is OSQ mvfr na .7 .8
elev. 4 40 -80 7.5 r4 6 none ms OSQ ml na na .7 .8
9 6.4 ft.
Depth to
limiting
factor
+80
Remarks:
Boring #
1 0 -12 1 r3 2 mfr lm .5 ' .6
5 " 2 112-27 10 r4 4 none scl lcsbk mfr if .2 i .3
Ground 3 27 -80 7.5 r4 4 none cos 0scr mvfr Crw na .7 ' .8
elev.
96.3 ft.
Depth to
limiting
factor
+80
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD- 8330(R.05/92)
STEEL'S SOIL SERVICE
Gary L. Steel James Durning 1554 200th Ave.
CSTM2298 NE4NE4 S36- T30N -R19W New Richmond, W154017
MPRSW 3254 town of St. Joseph (715) 246 -6200
lot #4- Durning & Lewis Addn.
N
1 =40'
BM.= top of 12" pvc pipe C el. 100'
Alt. BM.= nail in White Pine tree C el. 96.70'
At
2
,
Gary L. Steel
5 -14 -97
- ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer
Mailing Address
Property Address IJK9 f5
(Verification required from Planning Department for new construction)
City /State 1 Pw &,1 yvte-� Parcel Identification Number. ao 13 - /O
LEGAL DESCRIPTION
tvf (�_._
Property Location ' /,, r 1 /4, Sec. S , T 3 o N -RRVV, Town of -�
Subdivision _ ew + A - t7 u,r rt , 04 c <Z ��1 , Lot #
Certified Survey Map # , Volume , Page #
Warranty Deed # J�e O /6 Q . Volume / 3aZ,(� Page # OZ 26
Spec house 0 yes 5 no Lot lines identifiable 51 yes 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
master plumber, journeyman plumber, restrictedplumberor a licensed pumper verifying that (1) the on -site wastewater disposal system
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge.
I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards
set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification
stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30
days of the three year expiration date.
6 7
SITOf1m 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 - de ribed above, by virtue of a warranty deed recorded in Register of Deeds Office.
SIG ATURE 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
VOL
STATE BAR OF WISCON�'N FORM t l - :982
?` i LAN17 C{�1 I RACT
1nliridual :;r. Cci poret
(To HF. Uif 0 FOR {Lt - 1 R.Ath-Ai J:'P Nitf RE CIVIR
DOCUFt LENT Nn. S2i_hk h Fl *rAtiCtD A'.R iN i�iFitR ^.•��- CU'ISLAiFR
ACT tvat, ' <lit)4ii
J Ai`{ J. DUK vINI " and lS p '•ti3 }� 1 t»` `�♦' f �'..+
T r at •�
COiltla t, by and betwe " ��'? t �
SANDKA. J. DL121'rING `x
_C e n'or ",
wt. (.,_r oc;e or mvt_) and JOHN C WALTER and MELISSA A. WAL
her band and wife as joint ten tats
_. - - - - -- - - - -- 9:30 A
—_ - -- _ -_ ('Pt r ha er" wt ither one or tnor0.
t o
Vendor :.ells and agrees to convey to Punha,'r, upon dic prompt and full pc.fo „ " 7 ! [3mada
of ihts caitrsct by Purchaser, the folltoving piopen), together with the rents, profits,
fixtur._s and other appumn,nt interests (all called the "properly '), in
St. Croix ____�- CDUnty, State of Wisconsin:
THIS SPACE RESERVED ✓=OR r,�_COR.JING DATA
NAME ANr RE rUPN ADDRESS
Barry C. Lundeen
MUDGE, PORTER, LUNDEEN & SEGUIN, S.'
Post Office Box 469
H:(,'son, Wisconsin 54016
030- 1067 -
03 0. 2013 -10
PARr'tt !i.EN?:r "� ariCN NU ?R�eR
Lot `+, Durning & Le °•pis Addition to the Town of St. Jo:_epb, St, Croix Co=:nty, Wiscop-sIn.
TR A
�
This - - - not homeste i property E
not)
Port haFi agrees .> u chart the Property and to pay to Ven !or at 721 7 Courtly Rr '. t- jd ury , Mi. lr so : 3 55125
p _._.
the suns or 5 0 -- -- -- _
73, 000. ____._ m the following manner: (a) g1.,00Q,Q -- at or_prio to
to gether with interest from date
�u5e execution of this Contract, and (b) the balance of g �Q .� . -- __- �- __ _ _ $
hereof Cin the bah^.;ce ourta,:ding from tine to time at the r +ate of _— Ill.t3c.__- ____ ___— 1k L ,:rr a.,,,.:ru utiul paid :,: full, as allos”:
1. $5,000.00 principal paymont together with all accru ^d intereft due and payable on or
befor4 June 1, 1999.
2. $10,00f. principal payme-t':. together with all accrued i ref =: -st dot and payable of 1,r
before June 1,2000.
3. Balance of all of the then re,aaining principal and int- . Is due and payable in
full on or before June 1, 2001.
e4 _
Foflcrw rig ar default in payment, interest shaft ac r =_ ;u the rate of 12 % per arim. ; of th - • ire of -_.uw in dera» ,
ine'., e, without limitat.. %n, delinquent interesr arid, ulaxT or maturity, the entire psi o_i( ba- t,aei
Purchaser, unless excused by Vendor, agrees to pay monthly to Ven.'o" arriouns sufhcters to r a y e ably anticinat rd annual taxes, sPCRI
a ssments, fire and reri -tired insuranee premiums when due. Tc, •h.• cxt-(it ircei >t_i by V nd=ir, Veo,lo. agrees to - ,pply r,:rments to these
oh ors when due. Such amounts received b; the Vendor for pa met:, of taxes, assess,ncrl,s and fns:. •; _e will Ix d = -T o_'aed it :o an -_Croy
fund or trustee account, but shall not bear interest unless otherwise required by law-
_• - F- •$- �.:- ie;�- aF±sM�-a�iie�l� first'? W- rrr' zrTrvt •Z�rz- t?°:r•mrrfst�T-}r�axzz • sot -rhr °rs:�sfrcrfrc'F-t?rr*<tYrgs �: Pret3- �r� ^:�*."'t"Fe'T'vr"tT�#
may be no prepayment of princip •i
t p.,;,;;sion of Vendor,'
I
In the cvent of any orepaymr ,i(, this conuact shall n z be tTea7 ?d j, it, default w'.th respect to r.1ya _,:t se, !. ,, the unpaid b<'_'nce cf
principal, and inremst (Znd in such _ accruing u' -rest r•o. month to niowh mall be it: aced as snpaid is -,ban the amo that
said :ads:. -:dnc b would i.avc bee ha.' h- monthly tern made is first specified a aye; pm ,r ", a tbit mot�i`il) stall be
a , 4 t i 1 f, ,h_r
co:.''.rued in the event of crewt of ary prtxee r f r.;itrancY or c. , u,r.zr,, ti, th coot enuied pre nines _, g t.,er - r esdnd� c,e :
fuid,a: r states that 1 -haler tS Ssfie'i 'AiTh t1w title shnK : by the title evi2 su'j,,w1ed to Pur,hrxr r examtt,at except,:
1 t 1 g .cs to ffy t`.> -st or Iut ,. 41 xe if tut_ .'Terre is i:� the fo nil i• tt ,1 ` e seta:: zd by Venu,, a ^.a
the fn?I o; :c hale p<we is l
P t �t. k hz;l _f rnCtt� it tci ta' _ }n sses. , or ahe "-,pe"ty L C lo:= , t
slam 1�i :i; =1,; "t. )'�i -: Wes :.� 1•i -. a, .'o
t l`•.; CCU i�.kt-T ... t .t.. _.t, .'. - -� [.,, �-� •c.t z; F:.:c .., _. i, ._ }9R' M z 1.._
4 k r -c
a � .. � rS,,.so-. -.s .`R.,,. <i_;ra} .,,, ,l sY •r _ , .m .w. — w .. .._. .. _. ......- �. _. ...
est in it and to deliver to Vendor
P. r_haser promises to pay whet, due ail taxes and ass(-=srr,eh. levied on the Property or upt,:n Ve.;dc:t= inter
on dern,s, d receipts showing such pay me a s � pe
Purchaser shall keep de imp, •pots or.
the Prof, riy ri �rcd again, 1os r dama ,�t,aacned by Errs r$_ c lnsur�le Value
a and ucY other hazards as`�ct dor may qu ,e, wrihout c irsuriiiLe though nsurers appt,•ved by Vend. r m t r ;u ;t o $ ._ _
but Verlor shall not -equine c ne;abe in a an an, tot atone tit a e `r t?r :e ov td antler this Contract. Pu ha7e: ,ha'! pay the insurance pienilutn u
when due. The poll , es sl' al: contain the _c 1nu e1au,, tie m fast t t . ` moor'_ trtere�t ana u 1 s r o �crti.�x a es to writing, the
orgirnal of all policies covering the Property shalt be dep st ed w, h tien,joi, Pur haser shall pronpt'y give norct ?F +c s to nc- ranie companies
and Vendor. Urdu Purchaser -nd Vendor he w'_�� ag ec if" vv :n ms,.;r ce pry ds shall lie apii?ied u resto-anon or re},air of the Property
damawd, provided the Vendor deerr5 e nett anon or repair to be ew,�on i._ally [ea ,e
Purchaser eov -nants not to co.nrt, =.t wjste nor allow wa. -te .o be cninnitt[ed or. the P ,pe �y, to keep the °, pe-ty in g�xd te�artable
eorditicin and repair, to keep the Property free from liens sulxnor to the lien of t,vs CoriuKt, and t comply wuh all laws, ordinances and
regular ons affecting ,he Prupc ty ,
Ve :dor agrees that in ase ih purchase price with in r est , r,i other r v ' Al be fully p t,d an ail cons , iu a c .a i be fu pr: rorme
at the tires and in the manner ahelve sf —ifted Vendor Will on der ind execute an d 'iron to the Pura a r, a' r a r y Deed, in fee simple, of
the P c�pery; free and clear of all liens and enotimbratices, except ar. or ercun :b,a, <e> crcat_d by the "ct or defa.tlt of Nrcba�r, and except:
- - --
ByBg__g�>w;� THA I— TiE3C_.tT��— j�,*��F�tTA iCt DO ANY_BULLDTNL OR EYCAVATIOIv
T. kI .E_.�'R(}E.iALY_I+I.)1�fQFYF -i3 Qt�..- .'$F4M i11Y_W(3R 0N _- 1HF— PROP .ERTY_t?iv_TI L Pc 1YviEYT HAS
k C T . - - -- — - - - - -- --
__
Par hasee age s that. time is of the essence and (a) ,t the went of a default in the pay-me t of any principal or tot rest which continues For
't a perid o of __-3Q ___- days following the specified doe dale or (b) it, the event of a default in perft rnarice of any other obligat I on of Purchaser which
ecntzn >zs for a period of 30 _ days follo-,irg written notice [hereof by Vendor (delivered pe sonally or marled by certified mail), then the entire
oumarndirlg balance under this contract shall become immediately, due and payable in full, at Vendor's .,priors and without notice (which Purchaser
hereby waives). and Vendor shall also have the following ngh� and re nedles (subject to any 1 mtaroas provide' by law) in addition to those
and
provided by law or in equity: (i) Vendor may, at his option rma.
, terne this Contract and Purcha. rs �igl tits and merest in the Property
recover ;he Property buck through strict foreclosure with any equity of redemption to be condi oned up n Pu..has s full payment of the entire
outsta!id with interest thereon from the dat- if �!. f° Ault at the rate in eflrct on a such date aril :: other a mounts due hereunder (in which
event all amounts previously paid by Purchaser shall be rotf_ired as ligvidmed damages fe,r fa:' =e to full :ii th, Cantra and as rental For .'
g Property if Purchaser faits to redeem), or (ii) Vendor ina sue for spe. &tic performn
a:e of this Con m
Contract to copel im : ediate and Full paytnen[ on
the entire outstanding balance, with interest thereon at ii,, rate in effect on the , '.ate of default at,d ot4:er a punts d :e hereunder, in Whicb event
the Property shalt be auctioned at judic',al sale and Purchaser s`iall be liable for soy deft ie' - or (ut) Vendt _ :ay sue at law for the enure unpaid
purchase price or any portion thereof, or (iv) Vetidor m7,y declai. th s &ntract at an end ,.,.d ren cve t t 3ntract as a cloud on title in a quiet -
title acnon if the equitable interest of Purchaser is ins,giahc mi, and (y) Vendor may have Pesch -r !jet d ttorr r ? essinn of the Piop';ty a:nd
have a receiver appointed to collect any rents, Issues or t .rof,ts duor the pend of any acuc , under ), (ii) or (iv) al .,vet Notw,ttitanding
any oral or written statements or actions of Vendor, an elecno- -, of any of the foreg ,rrrr' reined es shall only be hinding ujxrn Vendor if and when
pursred in litigation and all costs a=ad expen_ -s c including ei rot !e n tot: eys fees of _ndor Incu red to eufurce any rem -dy hereunder !whether
abated or not) to the extent not prohibited by law and z s : t %'s o: title eV:denre s::., to added .0 pc :.icipal and paid by Purhaser, a; mcu -red,
and shalt N- included in any judgment.
Up the commer:cement or during the pendency of any action of foreclos. re of this Cn(_Jact, Purchaser consent- to the appointment to
a receiver of the Property, including homes,, °ad interest, to collect he rents issue ,, and profit ` the Pr,)yz r J dune ;o the pendercy of such actioti
and such rents, issues, and profits when so collected shall be held ,,, >d applied as the -•r, shat 'freer
Purchaser shall not transfer, sell or convey any legal or equita>,':e in ere >, in the P - „pee �i� a'_g.nrnent of any of Puu_haxr's rights tinder
this Contract or by option, longterm lease or in any other way) without the pilot w i:ten consent of Vendor unless either h outstandmgbalat'ece
pay able under this Contract is first paid in fill or the interest conveyed is a pledge or assigninene of Purchaser's interest under this Contract solely
as sec city for an indebtedness of Purcha_<er In the event of a: , y such trarrfer, sale or conveya 'e wuhouE Veal .r's w•rinen consent, the entire
Outstanding balance payable under this Contract shall be cme nri at ?ly d e anu payable in 'C!, at Vendor's opuon without notice.
Vendor shalt make all payments when due 'rider a .y mortga c : xa.ding agai -,st the Pr,prrty on [he daie of this Contract (except for any
morn a granted by Purchaser) ur under any nu second thrrcby, provided Yur_ha er make t ,e'y F , of the aml;unt then due urdfr this
Contract. Purchaser may make such payments directly to the Mortgage? tf Ve..d falls tr, io nd a' r r rents w made by Purchase shall be
considered payments made on this Contract
Vendor may waive any default without waiving oth - subsequent or prior dera .it of Pu tse
All terms of this Contract shall be binding upon ate. inure to the benefits of the t,e'.r,, h rt pr�Sen[atives susses: ors and assi of Vand,x
and Purchaser (if not an owTi ?r of the property the spE ,;e of Vendor for a valuably Lvnsia Iti j ins herein to release homestead rights in the
suhjeet Property and agrees to loin in the ex?cui on of the deed to be made in fulhllmen±
Dated this - --_ - 1 st -- - -__ —_ day of Jun, ly 98 - --- - - -- - -- - - - -- — _. —.
_ S /
( s
o (S
- --
JAMES J ---(SEAL)
I of *i C. WAL i c i3 — — --
�+ ( . s ! .z.t� Lt —
SA4' R J, DUR*Ilfi {� ME[ CASK i'�t >TER
y
-- - — —
AUTHLNTICATION ACKNOWLEDGMENT
-q Signal. r(s) Jame_ J._Durning, S^rtdra J. Durti: ng State of
_ --
s
-t Jaha C. Walter, Melissa A Walter
•:5 Seated this i_St d _ _ r10 L9_S Personjlly came Y><`- me this ___ dal of
G �
' �}� � - - - -- -- —' — l9_ _ -the ab named
Barry Lundeen
TITLE 6tEVFBF_42 Sf.VTE B 1A CiY VVI CO?ySIN
(If not. - - - - - -- -- -- _ - -- —
> wf etae. -ut; d the foregoin
authorized by 8706 G(5-. 'Xis St� ; : °; } .o m k ,t,v.* .e..,� r`te p� cs:,n - - -- ,- bt. R
nstn m• nt and acknow -dge the szme
Tti :S INSTRtANE.NT WAS DRAM—, BY
Barr”; C Lurideen
__ — — County Vets.
- Sri rt', PLKfbR
t i)
Second CLCe't, 11 o Wisc
_ vot y Pub „c
(Sign 'tares r,. y be iuth_.,t.cat<3 or a ;kr avl. lgr:' &t :'e n at Sly co, - ;m. :on is ik i.n nt cif not, .ate expitauen dat
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Wisconsin Department.of Commerce PRIVATE SEWAGE SYSTEM Count
Safety and Buifdings Division
INSPECTION REPORT St. Croix
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.:
Personal Information you provice maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 344570
Permit Holder's Name: []City ❑ Village ❑ down of: State Plan ID No.:
Walter. John I Town of St. Joseph
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
. 10
b . r0 UAL 030 - 2103 -40 -000
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic lotsp Benchmar� r f 7
(o(>• (� 9(, D
Dosing Alt. BM 'OlY 16.2-3 93:91
Aeration Bldg. Sewer t`A%JtkJ a� }
Holding St /Ht Inlet 7 g - 4.16 1�
TANK SETBACK INFORMATION St/ Ht Outlet I V .'$5 `r2-. 29
TANK TO P/L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic ?50 50.5 � � r NA Dt Bottom
Dosing NA Header / Man.
�rusk: : 9• sl 9a. � o ,
Aeration NA Dist. Pipe 2) 00 q2, i
/ ffl {t 10.42 g4•zz
Holding Bot. System 2) q' */v V. 31 40.93 4P
PUMP/ SIPHON INFORMATION Final Grade �• 9i.0
Manufacturer Demand St cover X3',4 S.31
Model Number GPM
TDH Lift Friction System TDH Ft
Forcemain Length Dia. Ft Dist. To well
SOIL ABSORPTION SYSTEM
TRENCH Width Length i No. f enches PIT No. Of Pits Inside Dia. Liquid Depth
D IME I 3 5� DIMENSION
SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manu ur
SETBACK A- e1: � t
INFORMATION Type Of �5�� r ' �/� r CHAMBER o e Nu m er:
System: Oy 0 - 3 0 5� — C l
DISTRIBUTION SYSTEM CA
Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
u r
Length`S _ Dia. Length Dia. Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched
Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS (Include code discrepancies, persons present, etc.) Inspection #1: I2-/ 2 /g9Inspection #2:
Location: 1294 89th Street, New Richmond, WI 54017 (IJE 1/4 NE 1/4 36 T30N R19W) - 36.30.19.836
l.) Alt BM Description SCI (SUY
2.) Bldg sewer length=
- amount of cover
Plan revision required? ❑ Yes WNo f 12 Z L
Use other side for additional information. /
SBD -6710 (R.3/97) Date Inspector's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH _
SANITARY PERMIT NUMBER:
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