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HomeMy WebLinkAbout038-1189-40-000 /y \\ . § / 0 c c§S . k § / § \ oe ®E m k §/% � ~ §�\ R k£§® % . S /E 2 ., E 2 75o, k. {22 \%§ . c f CD & ® a LL `.E -0 \©RQ- e¥ »L7+ /$2/£: r « z Li / \ § k � /fl . Q § 7 © % _ \ E \ §f { z w_ _ , z . cu \ \ r f k § ƒ c k& \ § 0 ) Q z z z � c \ / _ . _ G CD / �� § k 2 6 } k o � / m = 7 2 \ z� o E a 0 - " \ a m 2 7 � 'a (3) 0) 0) / m u f f ) ƒ ( \ 'C k 6 2 \ / E $ '0 & 2 J }/ s § ° c U, 0 2 c ( o c » f7\ 2 \ k \\� & 6 [ \ - \ 7 / ) g 7 \ 0-0 co � Cl Co - / 0 z / } \ � ® . � k «k L , _ _ . E 2 ' § a § / L) a. 2 A& 3 Document Number Document Title St. Croix County Occupancy Affidavit Name — (Owner) Typed or printed being duly sworn, states, under oath, that: 1. He/she is the owner /part owner of the following p arcel of land located in St. Croix County, Wisconsin, recorded in Volume 2&(Iq Page Document Number 77 S SO ,f St. Croix County Register of Deeds Office: Recordinq Area / A parcel of land located in the !JW V. of the C V4 of Section Name and Return Address ? 3 , T 31 N—R IV W,Townof PoeAtRJE , St Croix County, Wisconsin, being duly described as follows (include lot no. and subdivision/CSM or detailed legal description): 03 9 - // 1-6-f / /Vp,p 17� SUL3b . Parcel Identification Number (PIN) As owner of the above described prope , 1 acknowledge that the septic system serving this residence is sized for a ,- bedroom home, or a design flow of 1 /5Q gpd. The design flow is calculated by assuming 150 gpd for 2 Individuals per bedroom. There are currently --�( occupants living in this residence; f& occupants are permitted based on the design flow. Therefore the septic system serving this residence is code compliant. However, I understand that if there are intentions to exceed the number of permitted occupants, the system will need to be modified to aceomodate any increased wastewater flows and /or contaminant loads. I also acknowledge that I will make this information available to any future parties interested in purchasing this property. Dated this day of AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) )ss• authenticated this day of St. Croix County. ) Personally came before me this day of the above named TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Slats.) instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY Notary Public, State of Wisconsin (Signatures may be authenticated or acknowledged. Both are not My Commission is permanent. If not, state expiration date: necessary.) Da te: "THIS PAGE IS PART OF THIS LEGAL DOCUMENT — DO NOT REMOVE" This kotirmadon must be completed by suhm fitter. name a /etum address. and PLC (if required). other M/amation such as the gramakrg anuses. leaget descdpuon. etc. may be placed on this fist page of the docememt or may be placed on additional pages of the document. &gW Use of this cover page adds one page to your document and 1200 to the M22029 fee. Wisomsin Statutes, 59.517. 1 I --ff� ro �N va O g ST. CROIX COUNTY ZONING DEPARTME • �o AS BUILT SANITARY REPORT��( Owner �/� �� e 2 6 1999 Property Address / ' ST caax P 13 '� � � � 1�r� COUNT( City /State - __ &A-t ,� tic >° �', ZONINGOff " Legal Description: Lot / 7 Block -- Subdivision/CSM # c9 ,sue %4 r.E '/ Sec. /_ T _2N -R_�XW, Town of PIN # .5J- 9 SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION Z � Tank manufacturer _Size ST/PC Setback from: House Well P/L Pump manufacturer Model Alarm location E (HOLDING TANKS ONLY) Setbacks: Service road V s air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: /�`���� Width S � Length Number of Trenches Setback from: House 2S- Weller P/L Vent to fresh air intake ELEVATIONS Description of benchmark / Elevation' Description of alternate benchmark Elevation lol /77" ST/HT Inlet �' � ST Outlet/ PC Inlet Building Sewer - � D PC Bottom Header/Manifold 4 To r of ST/PC Manhole Cover l 49 Distribution Lines Bottom of System( Final Grade Date of installationl �/ Perin' umber 1T Z State plan number Plumber's si ature License number/ ewe Date/ Inspector Complete plot plan I 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 � ` q Qu �o INDICATE NORTH ARROW 4 ' PLOT PLAN PROJECT Shawn Farlow ADDRESS P.O. Box 383 Hudson Wi 54016 NW 1/4 SE 1/4S 13 /T 31 N/ w Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 ATE 9 /5/99 BEDROOM 3 CONVENTIONAL XXX IN -GROU PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 Gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .8 ABSORPTION AREA 572 # of chambers 18 BENCHMARK V.R.P. Top of 1" Pipe ASSUME ELEVATION 100' ❑ BOREHOLE O WELL "H. R. P. Same as Benchmark J Vent SYSTEM ELEVATION Sidewinder High Capacity Leaching Chamber with 31.8 ft ^2 per chamber " 34" Grade at System Elevation B.M. - Property Line 40' 60' 20' 12' 12' B -2 52' -1 53' � -3 3' 2- 3' X 56' Trenches with 6' Spacing Vent B -5 �B -4 20' a T a. 10' ° rn Pro 3 Bedroom ` House 214th Ave Parcel #: 038 - 1189 -40 -000 04/07/2005 04:04 PM PAGE 1 OF 1 Alt. Parcel M 13.31.18.966 038 - TOWN OF STAR PRAIRIE 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 * KING, SAMUEL E & KAYE L SAMUEL E & KAYE L KING 1346 214TH AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1346 214TH AVE SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 1.322 Plat: 2225 - NORTHGATE SEC 13 T31 R1 8W NW SE LOT 17 NORTHGATE Block/Condo Bldg: LOT 17 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 13 -31 N-1 8W Notes: Parcel History: Date Doc # Vol /Page Type 09/28/2004 775508 2664/274 WD 02/17/2000 618448 1490/466 QC 08/20/1999 608969 1450/366 WD 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 31157 189,100 Valuations: Last Changed: 10/12/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.322 27,300 170,200 197,500 NO Totals for 2004: General Property 1.322 27,300 170,200 197,500 Woodland 0.000 0 0 Totals for 2003: General Property 1.322 14,900 119,400 134,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 12/04/1998 Batch #: PRGRM Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 I Wisconsin bepartment Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count y INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: Personal information you provice may be used for secondary purposes (Privacy Law, s.15.04 (1)(mg 344696 Permit Holder's Name: ❑ City ❑ Village ❑ of: State Plan ID No.: Town of Star Prairie CST BM E ev.; Insp. BM Elev.: BM Description: Parcel Tax No.: 6 K n _ 11 — D • o' 60 0 - - 3 • Q4� TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic (� U� Benchmark 1 Dosing Alt. BM 3•n /o . Z`F Aeration Bldg. Sewer (� ,DZ W. q( r Holding St/ Ht Inlet 6, 4 T? /e TANK SETBACK INFORMATION St/ Ht Outlet o 16,99 TANK TO P/ L WELL BLDG. Air I ntake ROAD ir Septic r I �--- NA . a , Dosing NA Header/ Man. Aeration NA Dist. Pipe 9 Holding Bot. System r, L3 2 ,t PUMP/ SIPHON INFORMATION Final Grade Sob 11?FIT Manufa urer Demand St cover 40 Qg - 5 Model Number GPM TDH Lift L oss e ad TDH Ft For In Length Dia. H Dist. To Well SOIL , A PTION SYSTEM ' Width / Length No. f T enches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 5 •2 DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Many a urer• INFORMATION Type 07_ a OR UNIT CHAMBE Model Number:. System: DISTRIBUTION SYSTEM Header! Manifold L r� Distribution Pipe(s) I x Hole Size I x Hole Spacing Vent To Air Intake Length Dia. 1 Le Dia. Spacing li SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only �s 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: 1 Inspection #2: Location: 1346 214th Avenue, New Richmond, WI (NW 1/4, SE 1/4, Section 13 T31N -R18W) - 13.31.18.966 I 6`(� I 5 + Plan revision required? ❑ Yes E4 No ID 26 — l e t Use other side for additional information. ( U� Z- Y SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. ST. CROIX COUNTY ZONING DEPART /0 AS BUILT SANITARY REPORT Owner . Property Address �3 'f C .?/ 2 h�ri-� tti ..C)uNTV /.w : City /State A � lLc,. r 2� c.y° Zoe ;NGCrFIGE p . Legal Description:` �` e Lot /? Block -- Subdivision/CSM # /V&/-// G �2 — j. '/4 .S� '/4, Sec. /, TN -R_�XW, Town of SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION r � Tank manufacturer � Size ST/PC� Setback from: House Weller, p P/L Pump manufacturer � Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road V s air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM r Type of system: /4 eAN Width S� Length Number of Trenche Setback from: House 2 S" Well 4A PAL Vent to fresh air intake a2X� ELEVATIONS Description of benchmark 7 / Elevation' Description of alternate benchmark Elevation /o/ Building Sewer �/ ST/HT Inlet ST Outlet 0, yf PC Inlet PC Bottom Header/Manifold Top of ST/PC Manhole Cover / 0' Distribution Lines r ` Bottom of System ( ) ��� O ✓� ( ) Final Grade O O ( ) Date of installation/ Permit Lmber 4 State plan number Plumber's si ature License numbey �'" / _ Date,2 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 r'� P0 4- I �o INDICATE NORTH ARROW i PLOT PLAN PROJECT Shawn Farlow ADDRESS P.O. Box 383 Hudson Wi 54016 NW 1/4 SE 1 /4S 13 /T 31 N W Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE9 /5/99 BEDROOM 3 CONVENTIONAL )= IN -GROU PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 Gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .8 ABSORPTION AREA 572 # of chambers 18 BENCHMARK V.R.P. Top of 1" Pipe ASSUME ELEVATION 100' ❑ BOREHOLE (D WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION Lent X12" idewinder High of Cover apacity Leaching hamber with 31.8 6' Lon t ^2 per chamber Grade at System Elevation 34" B.M. Property Line 40' 60' 20' 12' 12' B -2 52' -1 53' � -3 3' 2- 3' X 56' Trenches with 6' Spacing Vent B -5 -4 20' a T a 10' 0 rn Pro 3 Bedroom ` House 214th Ave 7 ' Safety and Buildings Division SANITARY PERMIT APPLICATION 201 W. Washington Avenue ti sconsin 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 sys a I b (fit ley County than 8 1/2 x 11 inches in size. �-�. e ro i x • See reverse side for instructions for completing this app c on r �, s to Sanitary P rf9it NjLmber Personal information ou p rovide may be used for sec da 4 °; ``� T ` y p y pq ry purposes i�heck if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. 4� " ,, ('3% 21 �T A ve- � ST f� �} i State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT MM i6fAb*0 W I Property0 a Name ` , 6 ertyLoc v /�, 3 T '3/ , N, R E (or) Prope Owner's Mailing Addre �` r Block Number , 3 � r � ' — . City, Stat Zode / Phone Number Subdivision Name or CSN]glu er ( I yr T YPE BUILDING: (check one) ❑ State Owned V 0 it� Nearest Road A vil age Public 1 or 2 Family Dwelling - No. of bedrooms own OF III. BUILDIN USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ 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 -16Alew 2. ❑ Replacement 3. E] Replacement of 4 E] Reconnection of 5_ ❑ Repair of an ______S ten ________ System Tank Only 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;Kseepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit , 3 E] Vault Privy 14 [] System-In-Fill 2.- r— 5 6 '� VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 17. Final Grade C Re uired (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) O� vation J C) (� 3 S Z / O Feet Feet aclt VII. TANK in Ca altos g Total # of r Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glaze Plastic App New Exist in structed T nks Tanks Septic Tank or Holding Tank ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ I ❑ I ❑ 1 ❑ 1 ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Si t o amps) MP /MPRSW No.: Business Phone Number: Plu1n is Address (Street, City, tate, Zip Code): �� OG76 IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Agent Signature (No Stamps) Approved [:]Owner Given Initial SurcAarge Fee) Adverse Determination �5 ' p t X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11/97) DISTRIBUTION: Original to county, One copy To: Safety & Buildings Division, Owner, Plumber I INSTRUCTIONS y 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 Suildinngs.Division, 608- 266.3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. 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) 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. Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code • COUNTY Attach complete site plan on paper not less 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. 038 - 1055 -95 APPLICANT INFORMATION— PLEASE PRINT ALL INFORMATION REVIEWEP BY _ DATE PROPERTY OWNER: PROPERTY LOCATION Greenwood Enterprises, INc. GOVT. LOT NW 1/4 SE 1i4,S 13 T 31 AR 18 J(or) W PROPERTY OWNER':S MAILING ADDRESS LOT # I BLOCK # SUBD. NAME OR CSM # 1416 Third St 17 na NorthGate CITY, STATE ZIP CODE PHONE NUMBER [ (]VILLAGE &ROWN NEAREST ROAD Hudson 54016 ( 214th Ave. New Construction Use (� ] Residential / Number of bedrooms 4 [ ] Addition to existing building j) Replacement [ ) Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate ._ bed, gpd /11 - $_ trench, gpd /ft Absorption area required 858 bed, ft 750 trench, ft Maximum design loading rate .7 bed, gpd /ft .8 trench, gpd /ft Recommended infiltration surface elevation(s) 95.05 It (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ®S ❑ U ® S ❑ U RI S ❑ U [8 S ❑ U 6cl S ❑ U ❑ S (2 U 1 SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ITrench 1 0-12 10yr 2/2 none I 2mgbk mfr 9W if 2 12 -32 10 r 4 4 none sici Icsbk mfr r1w if -9.1 _ Ground 3 32 -84 7.5 r 4/4 no co s os elev. 9 8.7 ft. Depth to limiting factor +84 Remarks: Boring # 1 0 -14 .5 .6 2 14 -33 10 r 4/4 none sicl 2msbk mfr Ground 3 3 -84 7.5 r 4/4 none c �Q 9 elev. 9 8.7 ft. p Depth to limiting _. �/ Vo a factor:_M. +84 (,��1• ST C ` O/y /NG _111 r OFF Remarks: %`�. SCE CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. AvA., New Richnio WI 54017 Signature: Date: CST Number: m02298 PROPERTYOWNER Greenwood Enterpris DESCRIPTION REPORT Ptwge 2 bf 3 ' PARCEL I.D. # 038 - 1055 -95 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench L 3 1 0-10 10 yr 212 none- 1 2msbk mfr Crw 1 f .5 .6 2 10 -23 10yr 4/4 none sici 2msbk mfr gw if .4 .5 Ground 3 23 -84 7.5 r 4 cos 0SQ M1 na n elev. 9 8.7 ft. Depth to limiting factor +24 1, Remarks: Boring # IM9 1 0 -11 10 r 2/2 none 1 2msbk mfr cw if .5:: .6 4 '`` 2 11 -28 10 r 4/4 none sici lcsbk mfr 'w if .2: .3 Ground 3 128-84 .7 elev. 98.7 ft. Depth to 8 , - limiting factor Remarks: Boring # 1 0 -12 10 r 2/2 none 1 2msbk Mf Qw if .5 .6 S 2 12 -32 10 r 4/4 none sici 2msbk mfr QW if .4' .5 ................. Ground 3 32 -84 7.5 r 4/4 none cos 0SQ ml na na .7 .8 elev. AS _ 8 ft. Depth to limiting factor +84" Remarks: Boring # 13 Ground elev. j ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) i STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Greenwood Enterprises, Inc. New Richmond, WI 54017 MPRSW -3254 NW4SE4 s13- T31N - (715) 246 -6200 town of Star Prarie lot #17- NorthGate This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted. N 1 =40' BM.= top of 1" pvc pipe @ el. 100' Alt. BM.= top fo 1" pvc pipe @ el.100' /k � -Y✓1 �D �s Gary L. Steel 10 -29 -98 r ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer r, ly- Mailing Address P ©, , Sme 3 x j L� 61 - e lol Property Address - oZ (Verification required from Planning Department for new construction) City /State Parcel Identification Number I LEGAL DESCRIPTION Property Location &A)/4, ,5 E r /4, Sec., T -R_W, Town of Subdivision 1 r'J-fit,.. (S Lot # Certified Survey Map # (� ®�3 , Volume _ Page # Warranty Deed # (aos 16 q . Volume ) 45- , Page # �6 6 Spec house ❑ yes;- no Lot lines identifiabl�s ❑ 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, journeymanplumber, restrictedplumber or a licensedpumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Itwe, 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 f the three y r expiration date. l S�J SIGNA OF APPLICANT DATE OWNER CERTIFICATION I (we) ce that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the perry descri d ab , b virtue of a warranty deed recorded in Register of Deeds Office. �JJ SIGNATURE OF APPLICANT DATE * * * * * * Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. ** Include with 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 � 60i►969 WATfZ W Of AUCOMN POW I - IM KATHLEEN H. WALSH m 1450m 3W INa�tnstNtstahrr WARRANTY DIM REGISTER Of ban ST. CROIX CO. MI Z'Yir A atrds batateea A IEIE 0 F9 Onow, ad 19san1as. Armator, for a vala"aoasidaaidoty cm. or to so m wiq M-ti -119! 1b/9 M dacubd tend ate. is Couatr, %ft of wiroonsia (Pti. Mm" IEE! OT COPT FEEL COPY FEET MUM FEEL 56.70 P IJN FEEL IL Rsow&va Aran Mm" mW RAMS Addmm £ a 0. �+n W7` s Mol,6 a77 {� P.ac.t ra a dfiedlon NmAbw 0" '[fu kAd homodew parody. Cm moo Lot 17 of the Plat of NerthCiaoe, recorded in the Ofrm of the RegWor of Deeds for St. Quiz County, wi.cotssin OR May 20, 1999 in Volume 7 of Plats, at Page 46 m Document No. 603306. Together with all appurteoan rights, title and interests. (cantor wamraats that the tide to the Property is good, amble in fee simple and five and clam of eacmnbraoces mcwt ommU a6 4 and raarvadons, if any, of rte m Dated this gar of ODD C. s • , s 1L ,its • L AUTHEN77CAIMON AtWIOWLEDGhQ t Sap dU*6) Jam" E. Ruscch, its president STATE OF V#ISWN3]N ) ss. CountY ) y of tfris 1 3 , 1999. came betots me dens L dty r 1!!i dw drove aamod Man IL Ri at Its to me known to be the puson( who executed do s A to. i c WW wkaSe t mm. MEMBER B NS2'1 _. (lt not. u d� � arrthorizod by ;706.06, Wits. Sew.) Z Aibro, State of Wimousin 78D RISTRUMMM WAS DRAFTED BY MY Cammias' is gmanent. (11 not, state ex0mt6a daw. Lois A. Murray, M4 Est eea R Ogled, LLP / Jp0 Z) 364Loaea. 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