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HomeMy WebLinkAbout038-1083-40-100 . § � e _ § r w / , � } � k fcc % Co C § CU : p \] � mn C ƒ c \ t $E \ � a � t � W . o }) E z . $z8 c » ƒ {2 20 LL ($ /k« ��}kk � . ¥ . � 8 2 & § z 2 $ / S 0 k z : c § \ \ (D } � \ / L \7 N _ U) ' \ c _ \ § 2 \ z = _ /z co CD . 2 m k ■ � £ LO / 2 \ § k a / 3 % z / k k k k CL o k t 2 2 2 114 't IL ° \ k k \ ° G z g j \ \ \ E cl § / co . \ 2 G 2 <» e a �§ £ I § 6 § / �~ © § co G � a o o � 40. \ - o = c �\ �0 - §\ �la / §! -� _ — = a . c o § \ f\ / o k f } ) \ « � I CL a) / J a 2 !o$ J � Parcel #: 038- 1083 -40 -100 02/15/2005 08:55 AM PAGE 1 OF 1 Alt. Parcel #: 20.31.18.349B 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 * TIMOTHY G CLOUTIER CLOUTIER, TIMOTHY G 2022 CTY RD C SOMERSET WI 54025 Districts: SC = School SP = Special Property Address es * = Primary P P Y : ( ) Type Dist # Description SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 5.259 Plat: 0870 -CSM 13/3666 SEC 20 T31 R1 8W NE SW BEING LOT 1 CSM Block/Condo Bldg: LOT 1 13/3666 INCLUDES THAT PT OF OUTLOT 1 LOCATED IN THE NE SW Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 20 -31 N-1 8W Notes: Parcel History: Date Doc # Vol /Page Type 06/28/1999 605817 1437/515 QC 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 30246 207,200 Valuations: Last Changed: 10/14/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.259 48,300 168,100 216,400 NO Totals for 2004: General Property 5.259 48,300 168,100 216,400 Woodland 0.000 0 0 Totals for 2003: General Property 5.259 24,000 113,200 137,200 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 Wisconsln-DepartmentofCommerce PRIVATE SEWAGE SYSTEM County: Safety and Buildings Division INSPECTION REPORT Sanitary Permit No.: IX GENERAL INFORMATIO N (ATTACH TO PERMIT) 344603 Personal information you provice may be used for secondary purposes [[Privacy Law s.15.04 (1) (m)]. Perm6ttfQl fffkge: TIM E] City STA la � I wn of: State Plan ID No.: CST BMLLEVIev. EE Insp. BM Elev.: BM Description: Parcel Tax No.: 038 - 1083 -40 -100 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Aeration Bldg. Sewer Holding St /Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P / L WELL BLDG. Air I ntake ROAD Dt Inlet ir Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft L oss m ead Forcemain Length Dia. Dist. To well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth D IMENSIONS DIMEN I N SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manu a ct urer: SETBACK CHAMBER INFORMATION Type Of mod Number: System: OR UNIT DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length 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 F Yes ❑ No ❑Yes ❑ No COMMENTS (Include code discrepancies, persons present, etc.) LOCATION: STAR PRAIRIE 20.31.18.349B,NW,SW 2022 CTY ROAD C — LOT 1 Plan revision required? ❑ Yes ❑ No Use other side for additional information. CRn -A'" n /R 11/071 Date Inspector's Signature Cert. No W v 'rrs- Saf ety and Buildings Division `0115%11 SANITARY PERMIT APPLICATION 201 B. Washington Avenue Department of Commerce In accord with ILHR 83.05, Wi Adrn.t t -3 Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not $S County than 81/2 x 11 inches in size. °. ST • See reverse side for instructions for completing this application ` '" I '/'D S to Sanitary Permit Number .� 3 Personal information you provide may be used for seco dary purposes heck it revision to previous application (Privacy Law, s. 15.04 (1) (m)]. A I t to Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INFORM ION " Prop Owner Na a L y 1JI/ , V p T , N, R /rE (or&N Propel Owner's Mail ng ddress Lot r r Block Number City, Stat Zip Code Phone Number Subdivisio Name or CSM Number d 1. T YPE F BUILDING: (check one) ❑ State Owned V 0 Cit © Ne 'est Roa Public 1 or 2 Family Dwelling - No. of bedrooms g Tow OF %0.� /,2Cc� -C /4� III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) z r 1 ❑ Apartment/ Condo lv ? 3 J yd — too [ (� 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. fS New 2_ Q Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an ______System __ _____System _ _ - Tank Only_ ____ ___ _ _____ Existing System __ - - - - -_ Exlsting 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 EI Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit x 2 43 ❑ Vault Privy 14 ❑ System -In -Fill 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.) Pro (sq. ft.) (Gals/da /sq. ft.) (Min. /inch) Elevatio �7� D Feet / � Feet i VII. TANK Capacity in gallons Total # of xper. Prefab. Site Fiber- E INFORMATION Gallons Tanks Manufacturer's Name Concrete st Con ed Steel glass Plastic App New Exist* Tanks Tanks Septic Tank r Holding Tank 2_ 9 11 1:1 n Lift Pump Tank /Siphon Chamber I El I El n 1 11 1 11 E VIII. RESPONSIBILITY STATEMENT i I, the undersigned, assume responsibility for installation of the onsite sewaKin! em shown on the attached plans. Plumber's Name: (Print) PI Br's Signatur o Stamps) I M PRSW o.: Business Phone Number: Iii - ,?6� =6�3 Plumber's Address (Street, $ y, State, Zip Co e): _ IX. COUNTY / DEPARTMENT USE O LY ❑ Disapproved S nitary Permit Fee (Includes Groundwater Dat � I ssued Issuin gen ignature (No Stamps) roved Surcharge Fee) i pp ❑ Owner Given Initial ` 6D 1 o� Adverse Determin d' X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11 M71 DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber i 07/20/1999 09:49 715 - 268 -6637 GILLE TRK & EXCAVAT PAGE 02 S T CROIX COVNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FO Owner/Buyer F /Z Mailing Address = Property Address Gl'aC�,Vl a (Verification required from Planning Department for new constructs n) City /State SbLYI & 2ZSC Parcel Identification Number 3 LEGAL DESCMTXON Property Location LL- V., Sly '/., Sea. D . T,3j—dN R -Zff-W, To of SJA A A /Rlk Subdivision Lot # Certified Survey Map # 1�,� , Volume 4S Page # Warranty Deed # S 2 . Volume Page # Spec house 0 Cl no Lot lines identifiable es ❑ no SYSTEM MA UENANCE Improper use and maintenance of your septic system could result M its premature ure to bamdle wastes_ proper maintenance consists of pnmping out the septic tank every three years or sooner, if needed by a license pumper. What you put into the system can affect the ftmetion of the septic tank as a treatment stage in the waste disposal s The property owner agrees to submit to St. Croix Zoning Department a certifiea "on form, signed by the owner and by a master plumber, joumcymanplumber, restrictedplumber or a licensedpumperverifying that 1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the s eptic tank is less than 1/3 full of sludge. Uwe, the unden:igned have read tbA above requirements and agree to maintain the private rA wage disposal system with the standards set forth, herein, as set by. the Department of Commerce and the Department of Natural Res uroM State of Wisconsin. Certif raltian stating that your septic system has been maintained must be completed and returned to the S t. Croix County Zoning Office within 30 days of the exp' tion date. SIGMA OF AN ICANT DATE OWNER CERTjICA77ON I (we certify that all statements'on this form are true to the best of my (our) kno ledge. I (we) am (are) the owner(s) of the property "bed abov y virtue of a, wanaaty deed recorded in Register of Deeds Office. �. d/ 1 SI A P AI"1? ANX' DATE Amy information that is mis- represented may result in the sanitary permit being r ked by the Zoning Department.' �"•"' *a Include with this application: - a'stamped warranty deed from the Register of Deeds of ce a copy of the, certified survey map if reference is made Lu the warranty deed Parcel #: 038 - 1083 -40 -100 01/08/2009 01:57 PM PA GE 1 O F 1 Alt. Parcel #: 20.31.18.349B 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): 0 = Current Owner, C = Current Co -Owner O - CLOUTIER, TIMOTHY G TIMOTHY G CLOUTIER 2022 CTY RD C SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 5432 SOMERSET G SP 1700 WITC L ] 1 eglr'� Legal Description: Acres: 5.259 Plat: 3666 -CSM 13 -3666 SEC 20 T31 R1 8W NE SW BEING LOT 1 CSM Block/Condo Bldg: LOT 1 13/3666 INCLUDES THAT PT OF OUTLOT 1 LOCATED IN THE NE SW Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 20-31N-18W Notes: Parcel History: Date Doc # Vol /Page Type 06/28/1999 605817 1437/515 QC 2008 SUMMARY Bill #: Fair Market Value: Assessed with: 264780 242,000 Valuations Last Changed: 1011412004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.259 48,300 168,100 216,400 NO Totals for 2008: General Property 5.259 48,300 168,100 216,400 Woodland 0.000 0 0 Totals for 2007: General Property 5.259 48,300 168,100 216,400 Woodland 0.000 0 0 Lottery Credit Claim Count: 0 Certification Date: 12104/1998 Batch #: PRGRM 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 Owner T ' Ch c ie 0- o Property Address � Z 2 C T X City /State SomQ� s -e T .;UNTY i Legal Description: A of / Block Subdivision/CSM # ' W 1 /4 '/4, Sec Q _ , T3 / N -R /� W, Town •f S Tar PIN # -/ d SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer Size ST/PC Setback from: House >-� Well 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: Width R Length S Number of Trenches 3 Setback from: House 222 Well 7 P/L �5�� Vent to fresh air intake ELEVATIONS Description of benchmark Elevation /bO Description of alternate benchmark Elevation Y. S Building Sewer ST/HT Inlet � ST Outlet ��� 9 PC Inlet PC Bottom Header/Manifold Top of ST/PC Manhole Cover Distribution Lines ( ) C � 7, () ( ) Bottom of System () 7r © Z - () ( ) Final Grade () () ( ) „S 3 'M o 3 Date of installatio � �9 Permit number ' State plan number Plumber's signature a License number .22/ 4 / 7 / Date Inspector Complete plot plan � 1 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. I PLAN VIEW .S� o i8" P ICATE NORTH ARROW Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count y: 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.15.04 (1)(m)]. 344603 Permit lglst1� i1�9ne: TIM E] C � t `STAR ag P IRIE State Plan ID No.: CST BM Elev.:- E Insp. BM Elev.: BM Description: Parcel Tax No.: 038 - 1083 -40 -100 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI I FS ELEV. i Septic Benchmark , 3 oc.3 Dosing � ©, 1 0i - Aeration Bldg. Sewer OR [ Holding St /Ht inlet tpjo Cq,o6 r TANK SETBACK INFORMATION St/ Ht Outlet 9 TANK TO P/ L WELL BLDG. Air I to ntake ROAD ir Septic 20 NA Dosing NA Header / Man. eration NA Dist. Pipe �• S q�•81� Holding Bot. System g'32- aZ PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction Syestem TDH Ft Forcemai n Length E D i a. FFii Dist. To Well SOIL ABSORPTION SYSTEM E EN H Width f Lenggt / o. Qf rent es PIT No. Of Pits Inside Dia . iqui th DIMENSION SYSTEM TO P/ L BLDG I WELL LAKE/STREAM LEACHIN anufacturer: SETBACK CH ER INFORMATION Typeo } el Number: System: (� OR UNIT DISTRIBUTION SYSTEM 3. 51 Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length 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.) Q LOCATION: STARP RA NW, SW 2022 CTY ROAD C — LOT 1 Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. Safety and Buildings Division Nvisconsin SANITARY PERMIT APPLICATION 201 Box Washington Avenue Department of Commerce In accord with ILHR 83.05, WAdfrr_'Crrde ,`^ Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper nohe County than 8 112 x 11 inches in size. • See reverse side for instructions for completing this application Slla Sanitary P ermit N umber Personal information you provide may be used for secoLiclary purposes p heck if revision to previous application (Privacy Law, s. 15.04 (1) (m)). ��� I. APPLI ATION INFORM i to Plan LD. Number ATI N - PLEASE PRINT A L INS I Prop Owner Na e � y L U 1 fn r4 1_ , S,;Z T3/ , N, R /rE (or l&V Property Owner's Mail ng ddress Lot N r Block Number r City, Stat Zip Code Phone Number Subdivisio Name or CSM Number "'� • �. /D Z l/f� / /.� ` � II. TYPE F BUILDING: (check one) ❑ State Owned V [3 it Ne "est Roa 7 ❑ Village Public 1 or 2 Family Dwelling No. of bedrooms v Town OF Ic�.� I:2��� III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 2 .0, I • r 3 L./ q [ i2 1 ❑ Apartment / Condo /0 ? 3 �d — too _6 / 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. In New 2. I] Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an System ________ System_____________ Tank Only______________ Existing System _- ______ Exi sting 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 a Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit X S�U 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 1 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/da /sq. ft.) (Min. /inch) Elevatio X00 700 0 d Feet / Feet Capacit VII. TANK in Ca gallo s Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturer s Name Concrete Con- Steel glass Plastic App New Existing structed Tanks Tanks Septic TankjDr Holding Tank /Opp 'rte ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ 1 ❑ 1 ❑ 1 ❑ I ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage stem shown on the attached plans. joan Plumber's Name: (Print) Pi er's Signatur : o Stamps) M PRSW o.: Business Phone Number: Plumber's Address (Street, Cft, State, Zip Co e): /40 s ice° lv_t S� IX. COUNTY/ DEPARTMENT USE O LY ❑ Disapproved S nitary Permit Fee (Includes Groundwater at4 ssue Issuin gen ignature (No Stamps) Surcharge Fee) � f i F[�r7 - Approved E] Owner Given Initial r 6D Q p, C, o� Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11/97) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber , 22/Y7/ Z f'I 1 p /GEC .z le) O - z l a �y `Z W t le "12 1 J 4 • PAGE OF C, rvSS Sec�lon o� � tJeO S y s t�cr� i Fresh Ak Inlets And Observotlon Pips C +---- Approved Vent Cap Mtnlmurn 12' Above Final Credo 20- 42' Above Pipe 4' Cost iron To Final Grado r Vent "a moreh "by Or Synthelk Covering . Mtn 2' Aparepate Ovor Pipe Olftrlbut— Pipe --' o e e ^ Tea 6' Aspresota Perforated Pipe @Now (leMS/A Ply Cospinp Terminating At Bottom Or System P rup oSeD �inal 9r�c�c JJ � I t 01A SOIL T ILL DISTRIBUTIOF.I PIPE APPROVED S4MPETIC COVER 2 "OF AGOR EWE -� c � OR M RSSM HA`j t1 OF STRAW LEY, aF FEET DIS'T RIF3UT10W PIPE To BE AT LEAST IUCHES BELOW ORIGIAJAt_ G R ADE AJU AT LEASTQO lA3C)4ES BUT UO MORE TRAM 142 IUCHES BELOW FIMAL GRADE ?W MA M r►i OF F-%e-AVATiou FKoM oR &woAL 6i(AvF WILL BE D tuCHES 1'11 AMUM AE rtf of EACAVATION FROM 0 6RADE WILL BE l"cNEs 1 LICEMSE UUMBER: DATE: 3 Wisconsin Department of Commerce SO E EVALUATION e Pa / of Division of Safety and Buildings j„ g Bureau of Integrated Services in a p s.' 1LHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/ inches must County include, but not limited to: vertical and horizontal re int (BM), dir 6t and 5 7; � percent slope, scale or dimensions, north arrow, an _ tior kfi nce to nearest road Parcel I.D. # APPLICANT INFORMATION - Please prr Ir�>N Reviewed b Dat Personal information you provide may be used for secondary p Pri I Property Qwner :'� -, ; r rty Location C fc, kP i £ ovt. Lot A1161 1 /4.Sk,/1 /4,S T 3 j ,N,R 17 E (or )(9, Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# /s1V'e 411,11 ,Y( City State Zip Code Phone Number ❑ City [l villa 0 Town Nearest Road Gc1(V '))-I' s zY (6j > >3 s - Igi� S7� k" ,cam &New Construction Use: E!fResidential /Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow / 7 / ,� d gpd Recommended design loading rate bed, gpd/ft L L trench, gpd/ft Absorption area required 96 bed, ft C trench, ft Maximum design loading rate i bed, gpd/ft gpd/ft Recommended infiltration surface elevation(s) �f 76 ft (as referred to site plan benchmark) Additional design/site considerations � Parent material Flood plain elevation, if applicable S = Suitable for system Conventional Mound In- Ground Pressure I AT -Grade System in Fill Holding Tank U = Unsuitable for system �-s- ❑ U �& ❑ U 2.s ❑ U El B u ❑ s ®U ❑ s -® U SOIL DESCRIPTION REPORT Boris # Horizon Depth Dominant Color Mottles Structure GPD /ft Boring in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed , Trench Ground elev Depth to limiting factor Remarks: Boring # j/ / 13 Ground C al 6 ft. Depth to limiting fact r in. Remarks: CST Name (Please Print) Signature Telephone No. Address `X' Date CST Number 37 Z 1z10 'q 7 C PROPERTY OWNER 4 i=' 9 % < �c SOIL DESCRIPTION REPORT Page Z of 3 PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 13 in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed . Trench Ae )0 CV? ee- Ground elev. Depth 10 limiting factor Remarks: Boring # —y / 13 2- F -4 11CAKe llnocl? 6 � -S /I I �l 3 C 9`i 7.5V sy4 ,C h, Z- , 5 Ground elev. . Depth to limiting factor Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPDM2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench g Bonn # E3 Ground elev,,- Depth to limiting ; factor Qy in. Remarks: Boring # 13 Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) /VtM S ca T31 iV�t ST r At i e -e_ A,ox To P Pd% .Z To 14 ✓ PST 1 ° i Z, t 7 ` Lai L,a � 7C) Po �Z l � 07/20/1999 09:49 715- 268 -6637 GILLE TRK & EXCAVAT PAGE 02 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FO Owner/Buyer F /Z Mailing Address ZO Property Address Gcau,Vl o (Verification required from Planning Department for new construction) City /State 5C)Y>'l►z' S�� 4 ;/SC .� parcel Identification Nwnber 3 LEGAL DESCRIPTION Property Location V4, - 6J Y,, Sec. , T-3,LdN-R__a W, ToNni of Z: _ 9 1R)5. Subdivision Lot # ` Certified Survey Map # 1� ,�_f�� _ , Volume Page # Warranty Deed # . Volume Page # to 5 Spec, house 0 Cl no Lot lines identifiable es ❑ no SXSTEM MAIlf9NANCE Improper use and maintenance of your septic system could result iu its premature fa' Lure to handle wastes. groper ma intenance consists of pumping but the septic tank every three years or sooner, if needed by a lice ns pumper. What you put into the system can affect the function of the *septic tame as a treatment stage in the waste disposal System The property owner agrees to submit to St. Croix Zoning Department a certifica "on form, signed by the owner and by a master pltymber, journeytnanplumber, restrictedplumberor a licensed pumper verifying that: 1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the eptic tank is less than 1/3 full of sludge. Uwe, the undersigned bave read the above requirements and agree to maintain the private wage disposal system with the standards set forth, herein, as set by the.Departuient of Commerce and the Department of Natural Res wrees, State of Wisconsin, Cerhfifttid stating that your septic system has been maintained roust be completed and returned to the S t. Croix County Zoning Office within 30 days of the fl a exp. tion date. �If�'1GL�lJ 91GNA OF APP111dANT DATE OWNER CERTI�CAT)[4N I (we) certify that all statements'on this form are true to the best of my (our) kno arledge. I (we) am (are) the owner(s) of the property described above y virtue of a warranty deed recorded in Register of Deeds Office. t0v l SIGIOA V -PP ANT DATE Auy information that is mis- rcpresbutcd may result in the sanitary permit being r Iced by the Zoning Department. sage•.' Include with this applications a starnped warranty deed from the Register of Deeds of ee a copy of the, certified survey map if reference is made h the warranty deed vQi.1437 515 I& oss 1 DOCUMENT NO. QUIT CLAIM DEED KATHLEEN O DEEDS REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 06 -29 -1999 2:00 PM Gerald Cloutier a/k/a Gerald H. Cloutier, a single person, quit claims to Timothy G. Cloutier the following described real estate 1E DEED a St. Croix County, State of Wisconsin: CERT COPY FEE: COPY FEE: TRANSFER FEE: RECORDING FEE: 10.00 PAGES: 1 )t 144" R d • _ Tax Parcel No.: Part of 38- 1083 -40 Part of the Northeast Quarter of the Southwest Quarter (NE1 /4 of SW1 /4) of Section Twenty (20), Township Thirty-One (31) North, Range Eighteen (18) West more fully described as follows: Lot 1 of Certified Survey Map recorded in Volume 13, at page 3666 as Document No. 605102. TOGETHER WITH AN easement for ingress and egress and all utility installation across part of the Southeast Quarter of the Southwest Quarter (SE1 /4 of SW1 /4) and part of the Southwest Quarter of the Southeast Quarter (SW1 /4 of SE1 /4) of Section Twenty (20), Township Thirty-One (31) North, Range Eighteen (18) West, being a part of Lot 7 of that Certified Survey Map recorded in Volume 11, at page 3181 being further described as follows: Outlot 1 of the Certified Survey Map recorded in Volume 13 at page 3666 and Outlot 1 of the Certified Survey Map recorded in Volume 12, at page 3278 as Document No. 560896. This is not homestead property. Dated this ?y lay of June, 1999. (SEAL) GERALD CLOUTIER A/K/A GERALD H. CLOUTIER ACKNOWLEDGMENT STATE OF WISCONSIN ) ) ss. ,,.•+�91l.. ST. CROIX COUNTY ) •s -•4s_� ` o� � June' Personally came before me this s? • y''i• ,-„ 1999, the above -named Gerald Cloutier a/k/a Gerald H:lClottiec„J to me known to be the persons who execute the {?eg'ingq?; THIS DOCUMENT DRAFTED BY: instrument and acknowledge the same. Judith A. Remington REMINGTON LAW OFFICES 126 South Knowles Ave., P.O. Box 177 * dith A. Remington New Richmond, WI 54017 Nbl ary Public, St. Croix County, Wis. Telephone: (715) 246 -3433 My commission is permanent. 9 - N 1 � 1g9 sH CERI VEY MAP ti LOCATED IN PART OF TI C /4 OF THE SW1 14 OF SECTION 20, T31 N, R 18 W, TOWN OF ST. ' R PRAIRIE, ST. CROIX COUNTY, WISC&SIN. N 0 N1 /4 COR. z SEC. 20 OWNER o N � UNPLA TED LA_ NDS - -- D GERALD CLOUTIER ~ o° OWNED ' n w w o - - ly PLATTER - - - - _._._ 165 N. MCKNIGHT RD. v zv o ST. PAUL MN. 5 19 M ,t Q S86'46'; )" w ow E 440.31 w O N O� co' N m o o j Z) 4•I co Wi a z a E , CS T woo O mZN �i �i 0 i OT 1 0; �� q ; o I Wi 5.( 02 ACRES CO �ji �i m qi h 21 ,888 SO. FT. 5 ' VI O,I o c) cD Z a - t N01 W OUTLOT 1 TO BE RETAINED ©, PLATTER z N i ql N AND IS TO P USED AS AN ACCESS .ASEMENT tN IU Li i. i d a- ' Q p� O O col r O) l > m Z C5 k , I w i a OUTLOT 1 AREA w d q 0.257 ACRES J FT 188 S0 11 f- 32 "W 311,77' ,. . w G' � N86'4 N86'46 32 "W 233.21 78.56' 11 i � o UNPLATTED LANDS ���• �° OWNED BY PLATTI' ------- - - - - - -- - -- SOUTH LINE OF THE NE1 /4 OF THE SWt /4 2" IRON PIPE FOUND 2.7 r, ' 1 /- - 504'33'48' E 2.66 FEET 4t f FROM MONUMENTED 7 _ LO T CORNER N86'46'32 "W 3 I PART OF L OT 7 CS. Y. � 120.48' \' C. S.M.VOL._ i1,_ PG._ 31 81 ' LOT 1 SCALE IN FEET 1 100' \ � ----- - - �I \� PC. _ 3278 100 0 100 200 LEGEND \ S1 COR.\ / ® ALUMINUM COUNTY `;ECTION COINER SE 20 MONUMENT FOUND \ • 1" IRON PIPE FOUNT' ® 1 1/4" IRON PIPE FfIUND 1" X 24" IRON PIPE SET WEIGHPAG J• L O 1.68 LESS. PER LINE .R F00T / EXISTING FENCELINE `s VOL' ME 13 PAGE 3666 SURVEYOR'S CERTIFICATE I, Douglas J. Zahler, Registered Wisconsin Land Surveycc, here)y certify, that by the direction of Gerald Cloutier, I have su aid mapped a part of the NE1 /4 of the SWl /4 of Section 20, T31.N, rt18W, Toi n of Star Prairie, St. Croix County, Wisconsin; described as Follows: Commencing at the North Quarter corner of said Section 0; -theme S01 "W, along the north - south 1/4 line, 3340.56 fc , 2t to the point of beginning; thence continuing S01 "W, along said north - south 1/4 line, 610.12 feet to the north line of Certified ')urvey Map recorded in Volume 12, Page 3278 at the St. Croix County Register of Deeds Office; thence N86 "W, along said north line, 120.48 feet to the NW corner of said Certified Survey Map; thence N29 "W, along the northwesterly extension of the southwesterly line of said Certified Survey Map, 169.52 feet; thence N86 "W 233.2.1 feet; thence N01 "E 467.61 feet; thence S86 "E 440.31 feet to the point of beginning. Parcel contains 5.259 acres (229,076 sq. ft.). Described parcel is subject to all easements, restrictions and covenants of record. I also certify that this Certified Survey Map is a correct representation to scale of the exterior boundary surveyed and described; that I have fully complied with the provisions of Chapter 236.34 of the Wisconsin Statutes and the Land Subdivision Ordinance of the County of St. Croix and the Town of Star Prairie in sui veying and mapping same. OF W/Sc A� n� Douglas J. Zahler RLS 2145 �Z DHLERJ z S & N Land Surveying S -2145 �(►- 212 Walnut St. HUDSON, Hudson, WI 54016 Wis. c� /2 /I9�L Each parcel shown on this map (plat) is subject to State, County and Township laws, rules and regulations (i.e., wetlands, minimuvi lot size, access to parcel, etc.). Before purchasi.ng or developing any parcel contact the St. Croix County Zoning Office and appropriate Town Board for advice. VOLUME 13 PAGE 36G6 fn XT -+mn G7 C7 'O 7O 1 t7 H S mo <--� -1 •- m �. omm f n X VI � O O X -10 fT O .M O d £ 0 m z� o X, � � mr o �e� H cn z II DOCUMENT NO. QUIT CLAIM DEED Gerald Cloutier a/k/a Gerald H. Cloutier, a single person, quit claims to Timothy G. Cloutier the following described real estate St. Croix County, State of Wisconsin: Tax Parcel No.: Part of 38- 1083 -40 Part of the Northeast Quarter of the Southwest Quarter (NE1 /4 of SW1 /4) of Section Twenty (20), Township Thirty -One (3 1) North, Range Eighteen (18) West more fully described as follows: Lot 1 of Certified e Survey a y p recorded to Volume 13, at page 3666 as Document No. 605102. TOGETHER WITH AN easement for ingress and egress and all utility installation across part of the Southeast Quarter of the Southwest Quarter (SE1 /4 of SW1 /4) and part of the Southwest Quarter of the Southeast Quarter (SWl /4 of.SEI /4) of Section Twenty (20), Township Thirty -One (31) North, Range Eighteen (18) West, being a part of Lot 7 of that Certified Survey Map recorded in Volume 11, at page 3181 being further described as follows: Outlot I of the Certified Survey Map recorded in Volume 13 at page 3666 and Outlot 1 of the Certified Survey Map recorded in Volume 12, at page 3278 as Document No. 560896. This is not homestead property. Dated this ,)V lay of June, 1999. (,- (SEAL) GERALD CLOUTIER A/K/A GERALD H. CLOUTIER ACKNOWLEDGMENT STATE OF WISCONSIN ) ) sS. ST. CROIX COUNTY ) Personally came before me this o? � ' d. ' , -- of June, 1999, the above -named Gerald Cloutier a/k/a Gerald H. Cloutier to me known to be the persons who execute the foregoing THIS DOCUMENT DRAFTED BY: instrument and acknowledge the same. Judith A. Remington. Q - REMINGTON LAW OFFICES 126 South Knowles Ave., P.O. Box 177 * dith A. Remington New Richmond, WI 54017 Wary Public, St. Croix County, Wis. Telephone: (715) 246 -3433 My commission is permanent. J