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Parcel #: 038 - 1007 -60 -000 09/14/2005 03:08 PM
PAGE 1 OF 1
Alt. Parcel #: 2.31.18.22C 038 - TOWN OF STAR PRAIRIE
Current LX' ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner
HAROLD D & SANDRA J FLOM O - FLOM, HAROLD D & SANDRA J
1232 S CEDAR DR
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): * = p P Y Primary
Type Dist # Description * 1232 S CEDAR DR
SC 3962 NEW RICHMOND
SP 1700 WITC
SP 8055 CEDAR LAKE /N R
Legal Description: Acres: 2.000 Plat: N/A -NOT AVAILABLE
SEC 2 T31 N RI 8W PT NE SW LOT 2 OF CSM Block/Condo Bldg:
5/1235 & PARCEL S OF LOT 2 CSM 5/1235 &
N OF CTY TK H Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4)
02-31N-18W
Notes: Parcel History:
Date Doc # Vol /Page Type
07/23/1997 1115/063 PR
07/23/1997 871/48
07/23/1997 669/592
07/23/1997 654/432
2005 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/12/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 177,200 121,500 298,700 NO
Totals for 2005:
General Property 2.000 177,200 121,500 298,700
Woodland 0.000 0 0
Totals for 2004:
General Property 2.000 177,200 121,500 298,700
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch #: 110
Specials:
User Special Code Category Amount
Special Charges Delinquent Charges
ecial Assessments S q 9
P P 9
Total 0.00 0.00 0.00
Parcel #: 038 - 1007 -60 -000 09/14/2005 02:41 PM
PAGE 1 OF 1
Alt. Parcel #: 2.31.18.22C 038 - TOWN OF STAR PRAIRIE
Current X1 ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner
HAROLD D & SANDRA J FLOM O - FLOM, HAROLD D & SANDRA J
1232 S CEDAR DR
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 1232 S CEDAR DR
SC 3962 NEW RICHMOND
SP 1700 WITC
SP 8055 CEDAR LAKE /N R
Legal Description: Acres: 2.000 Plat: N/A -NOT AVAILABLE
SEC 2 T31 N R1 8W PT NE SW LOT 2 OF CSM Block/Condo Bldg:
5/1235 & PARCEL S OF LOT 2 CSM 5/1235 &
N OF CTY TK H Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4)
02-31N-18W
Notes: Parcel History:
Date Doc # Vol /Page Type
07/23/1997 1115/063 PR
07/23/1997 871/48
07/23/1997 669/592
07/23/1997 654/432
2005 SUMMARY Bill #: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/12/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 177,200 121,500 298,700 NO
Totals for 2005:
General Property 2.000 177,200 121,500 298,700
Woodland 0.000 0 0
Totals for 2004:
General Property 2.000 177,200 121,500 298,700
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch #: 110
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Wisconsin Department Commerce PRIVATE SEWAGE SYSTEM
Safety and Buildings Division
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: IX
Personal information you provice may be used for secondary purposes [Privacy Law, s.15.o4 (1)(m)]. 338805
Permit Holder's Name: ❑ City ❑ Village IN Town of: State Plan ID No.:
FLOM, DOUG STAR PRAIRIE
CST BM Elev.:- Insp. BM Elev.: BM Description: Parcel Tax No.:
/.0
t S ILe . -fir 038- 1007 -60 -000
TANK INFORMATION ELEVATION DATA A99 UU68
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic C_ ! act Bench ofct .03 100 U3 too
Dosing VOL 144K _ - 7 SZ>
Aeration e c eh c
Holding (9/Wlnlet ° 1,2� qO "17
TANK SETBACK INFORMATION _ 9* _
*t Outlet . &5 w. 0
TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet CI (o j / 0 t�
Air Intake
Septic �S� /_v� 1✓ NA Dt Bottom 4
Dosing �b/ �. l (�p 5 p NA Header / Man. "7$
Aeration Dist. Pipe r ►• 4 Z I L
• 3
Holding Bot. System 9 y
PUMP/ SIPHON INFORMATION Final Grade r 2 , i.ti 3 f
Manufacturer Demand Pvw, a /� 7 `a T2 i`
Model Number S 4 CF 7 -2 3 S GPM C
TDH Lift f .01? Friction cp Syste TD t
Forcemain Length q5 ' j Dia. Dist. To well
SOIL ABSORPTION SYSTEM
BED width r Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 2 DIMENSION S
SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manacturer.
SETBACK I AD/'
INFORMATION Type / CHAMBER �dgl Number:
Syste3'.M �d �' -� OR UNIT C
DISTRIBUTION SYSTEM
Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent T it Intake
Length / S r Dia. Length 3 4Bia. '� Spacing �Ir 4 Gtnw�._ S '� �O b
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 El El No E] Yes [] No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: STAR PRAIRIE 2.31.18.22C,NE,SW 1232 SOUTH CEDAR DRIVE
1, q' " -� eelfz i cOAA
Plan revision required? ❑ Yes E�No`'
Use other side for additional information. G � f
SBD -6710 (R.3/97) Date Inspector's ignature Cert No.
1
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ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NU BE :
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Safety and Buildings Division
SANITARY PERMIT APPLICATION 201 W. Washington Avenue
Visconsin In accord with ILHR 83.05, Wis. Adm. Code P O Box 7302
Department of Commerce Madison, WI 53707 -7302
• Attach complete plans (to the county copy only) for the system, on paper not less Count �L
than 8 1/2 x 11 inches in size. c� &-'
• See reverse side for instructions for completing this application State Sanitary Pgrmit Number
Personal information you provide may be used for secondary purposes ❑ Check it revis to previ application
(Privacy Law, s. 15.04 (1) (m)].
State Plan I.D. Number
I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION
P p rty Owner NaRe Property Location
1 i4 Tk 1 /4, S Z T , N, R & E (or)
Property ner' Mail In Addre s Lot Number Block Number
Cit ,State Zip Code Phone Number Subdivision Name or CSM Number
czl5' > 2 —38
IL - T YPE OF BUILDING: (check one) ❑ State Owned City Nearest Road
Public 1 or 2 Family Dwelling - No. of bedrooms _ 'Town OF
III. BUILDING SE: (If building type is public, check all that apply) Parcel Tax Number(s) �Q t
1 Apartment/ Condo /• �� � w �
❑
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 [g Replacement 3 ❑ Replacement of 4_ ❑ Reconnection of 5_ ❑ Repair of an
System
-_____ ________ System _____________ Tank Onl�r______________ 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 ❑ In- Ground Pressure 42 ❑ Pit Privy
13 Seepage Pit 43 ❑ Vault Privy
14 ❑ System -In -Fill
VI. ABSORPTION SYSTEM INFORMATION: AZI
1. Gallons Per Day 2. Absorp. Area 13. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade
Required (s ) Prop sed (sq. ft.) (Gals/d y /sq. ft.) (MinJivrch) % q Q4, Elevation
ol. ? . 7 . ! q Feet 9I.q —T5 Feet
VII. TANK Cap aclt in gallon Total # of Prefab. Site Fiber- Exper.
INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks
New Existin strutted
Septic Tank or Holding Tank � ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber $� El ❑ El El ❑
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Print) ber's Signature: (No Stamps) MP/MPRSW No.: Business Phone Number:
a. i �' /L L) 2�
Plumber Plumber Address (StreeXstat , Z- / -r
l'!5 1 � vC c7 `t �
IX. UNTY / DEPARTMENT USE ONLY
❑ Disapproved Sanit ry Permit Fee (Includes Groundwater ate I ssue Issuing A ent Si ps)
Approved []Owner Given Initial /� Fee) 3// A
Adverse Determination v
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SBD- 6398 (R.11197) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber
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PUMP CHAMBER CROSS SECTION Am SPECIFICATIONS
VC►.JT CA►
4'C.Z. VENT PIPE WEATHER PROOF APPROVCD LOCKING
JUNCTIOU BOX MAmmLc COVER
L5' FROM DOOR, Ij•M11J.
wINDOw OR FRESH I
AIR INTAKE I
GRADE I `I'PUN.
I
IB' MI►t.
COWOUIT �"— ;_ -- — - - --
'PROVIDE --
IMLET AIRTIGHT SEAL. I I
I IC
APPROVED JOINT A I I ` APPROYEO JOINTS
I I I w /C.I. PIPE
W /C.Z. PIPE' I II EXTENDING 3'
CXTENDING 3' ALARM ONTO SOLID WIL
OWTO SOLID & OIL
lcin
• l I ON
E.LEV. F? PUMP —� —�
` OFF
D
CONCRETE BLOCK
3" APPRM
RI5CR EXIT PERMITTED O WLy IF TAWK MANUFACTURER HAS SUCH APPROVAL, . 8E00IM6
SEPTIC
SPECIFICATIOMS
E (� -
f DOSE IQ
TANK MANUFACTURER: • =Y.•►� NUMBER OF DOSES: P6R OI►y
TAAJK SIZE: GALLONS DOSE VOLUME
Ct*9 css'f 70 1�
INCLUDING OACKFLOW: GALLONS
AL_ ARM IAAtJUFACTURGR:
MODEL NUMBER: fIg CAPACITIES: A= Z>1 INCHES OR GALLONS
SWITCH TYPE: 6 = _ INCHES OR GALLO
PUMP ^ANUFACTURCR: C =/� INCHES OR GALLONS
MODEL NUMBER: 53 Do INCHES OR 2 GALLONS
SWITCH TYPE: MOTE: PUMP AND ALARM ARE TO BE
INSTALLED ON SEPARATE CIRCUITS
MINIMUM DISCHARGE RA E
VERTICAL D1FfCRCNCE BETWEEN PUMP OFF AWD QISTR►BUTIOW PIPE.. ___L�? -- FEET
+ MIUINUM NETWORK SUPPLY PRESSURE . . . . . .. . . . . ` FLET
+ _ FEET OF FORCE MAIN X 2jj: F y OF xFRICTIOW FACTOR. FEET
TOTAL O'JWAMIC. HEAD = 100 Z— FEET
IMTERUAL. D IMLIJSIOWS Of TAiJK: LEIIC?TK- _;WIDTH - ;LIQUID DEPTH
Z
SIGIJE 0: LICEWSE NUMBER: 3 �I� Z DATE:��
_
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Typical Application' Sump /Effluent pump 7Typkal ati on' High Heod Effluent and Dewatering Capacities to 44 GPM (2.8 IN odlies to 33 GPM (2.1 IA)
Heads to 24 h (13 m) Heads to 37 h (11.3 m)
Electrical 115V, le, B.OF1A, 60Hz Electrical 115V, Ia,10.8F1A, 60Hz
Motor 1/4 HP shaded pole w /thermal overload 13011, 1 e, 5.5FIA, 6011z
1550 RPM Motor 1/3 HP shaded pole w /thermal overload
Minimum Recommended Simplex =18" (457mm) protection,] 550 RPM
Sump Diameter Duplex = 30" (762mm) Minimum Recommended Simplex =18" (457mm)
Automatic Operation Wide angle float switch Sump Diameter Duplex = 30" (762mm)
Materials of Construction (lass 30 cast iron and engineered thermoplastic Automatic Operation Wide -angle float switch (manual available)
Impeller Thermoplastic vortex Materials of construction Class 30 cast iron
Discharge Size 1 -1/2" NPf(38.lmm) Impeller Thermoplastic vortex
Solids handling 3/4" (19.1 mm) Discharge Size 1 - 1/2" (38.1mm)
Power cord 20', SJTW Solids handling 3/4" (19.1 mm)
Superior Features • Carbon /Ceramic mechanical seal Power cord 10' , SJTW, (30' optional)
• Oil filled motor w /automatic reset thermal overload Superior Features • Carbon /Ceramic mechanical seal
• Uses single row ball bearing construction • Oil filled motor w /automatic reset thermal
• Piggy -back plug available for easy maintenance overload for maximum protection
and replacement • Ball bearing construction
• Piggy -back plug available for easy maintenance
and replacement
• Patented inlet design for better solids handling
121 40
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/1 SHEF33
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� 6 . '2 20
CD SHEF25
3 10
0 0
Capacity -U.S. G.P.M. 10 2 30 50
Liters/Second 0 1 5 3
Refer to your authorized local HydromaticT"' Distributor, Representative or the factory for other applications.
Wisconsin Department of Commerce SOIL AND SITE EVALUATION
Division of Safety and Buildings Page of
Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must Coun
include, but not limited to: vertical and horizontal reference point (BM), direction and 5
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. #
APPLICANT INFORMATION - Please print all information. Reviewed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
P rty Owner Property Location
Govt. Lot 1/4 .Jt� 1/4,S t , T 3 N,R Q E (ore
Prop rty O er s Mailing Add ess Lot # Block# Subd. Name or CSM#
City State Zip Code Phone Number City ❑ village [A Town Nearest Road
k. L � -i "-L i A6 (71�7) 2 ys - A?$ I Alt, AU�Q_ I
❑ New Construction Use: r / Number of bedrooms Addition to existing building
Replacement Public or commercial - Describe:
Code derived daily flow 460 gpd Recommended design loading rate • 5 bed, gpd /fe i trench, gpd /ft
Absorption area require bed, ft 15nrench, ft2 Maximu design loading rate o_ bed, gpd /ft • 6 trench, gpd /ft
Recommended infiltration surface eleva 'on(s) ! u- W w q ws ft (as referred to site plan benchmark)
Additional design /site considerations
Parent material f Flood plain elevation, if applicable N ft
S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank
U = Unsuitable for system [A S E] U ❑ S [X U �S ❑ U ( S ❑ U El S U ❑ 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
rz
Ground 7 ti _ ' "
n elev.
Depth to
limiting
factor
in.
Remarks: 4v LI
Boring # 3�� S
I lk
X 0-% q libK J_�� '
Ground
elev.
Depth to
limiting
factor
230— in. Remarks: X C43
CST Name (Please Print) Signature Telephone No.
L e �� 716 g5`3s'r "-
Address j Date CST Number
AM
SOIL DESCRIPTION REPORT
PROPERTY OWNER Page of
PARCEL I.D.#
Boring Horizon Depth Dominant Color Mottles Structure 2
g in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots
Bed ,Trench
3 AOM 3 5 - A4:;., - a liv JLbk ihar
'I
2 Z-Gr ltltl a 7 1 ?
Ground
elev. ,
ff. '
Depth to
limiting
factor
T n.
Remarks:
Boring #
...........................
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)
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ST. CROIX COUNTY CERTIFIED SURVEY MAP LOCATED IN PART
OF THE NE 1/4 OF THE SW 1/4 OF SECTION 2, T 31 N, R 18 W, TOWN OF STAR
PRAIRIE, ST. CROIX COUNTY, WISCONSIN.
', UNPLATTED LANDS_ 1
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215.85
N 7o O2' 38.. W• 54.56' 1
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VOLUME 5 , PAG
CERTIFIED SURVEY M.
this instrument was drafted by ken hodkiewicz. _J08 N 82 -29 ST. CROIX COUNTY, N
• VOL 1134 PAGE 322
DOCMENT NO. THIS SPACE RESERVED FOR
WARRUM DRXD RECORDING DATA
STATE BAR OF WISCONSIN FORK 2 -1982
Return to: �
S � 1 j . ,�� u l \ F L
AUG 81,995
Et 11 :15
Tax Parcel No.038 - 1007 -60 Xx -:A. _
I
�,- , LG
Georgia 8iru1, single conveys and warrants to Harold D. plan, and Sandra
J. plan, husband and Wife
the folloMinq described real estate in St. Croix County,
State of Wisconsin:
Attached "EXHIBIT A" hereto made a part thereof.
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This is homestead property
Exceptions to warranties:
Dated: August 7th, 1995
Georgia Z rul
ACKNOWLBDaE1iSI T
STATE OF
COQIM OF S _ Ooew x )Ss.
Personally came before me on August 7th, 1995, the above named "rgia Sirul,
to me known to be the person(s) who executed the foregoing instrument and
ac owl dge the same.
o ary public ••
� l7_ �'• v ` NOTARY SEAL
This instrument a by:
Attorney's Tit ter
1835 Northwest
Stillwater, r11d
VOL 1134PA,E323
Lot 2 of St. Croix County Certified Survey Nap recorded in Vol. "S",< page
1235, certified survey Naps, St. Croix County, Wisconsin located in part of
NE% of SW; and part of Government Lot 2 of Section 2, Township 31 North,
Range 18 West, Town of Star Prairie, St. Croix County, Wisconsin.
A parcel of land located in part of NEh of SW% of Section 2, Township 31
North, Range 18 West, Town of Star Prairie, St. Croix County, Wisconsin
further described as follows: Commencing at the center of section of said
Section 2; thence N89 0 14 1 06 "W, 400.00 feet; thence S62 "W, 585.46 loot
to SEly corner of Lot 2 as recorded in Certified Survey Nap, Vol. "Se,
1235, said SEly corner of Lot 2 is also point of beginnin¢
description; thence continuing S62.31 "W, 166.40 feet; thence ti *#rSi"
339.45 feet - c Nly right -of -way line of County Trunk Highway "H" and a point
on a curve which is concaved SWly and having a central angle of 5.21 and
a radius of 1670.16 feet; thence SEly 156.02 feet along the are of the
curve, the chord of which bears 574.20'14.5 "E, 155.98 feet, said arc also
being the aforesaid Nly right -of -way line of County Trunk Highway "H";
thence N1 °09 "W, 458.34 feet along West line of Lot 3 of Certified Survey
Nap, Vol. 0 4 0 , Page 1130 to point of beginning. Above described parcel is
subject to a 20 foot private road easement along the Nly boundary line.
TOGETHER WITH and SUBJECT TO the right of ingress and egress over the 20
toot private road easement connecting with County Trunk Highway "H".
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