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CROIX COUNTY ZONING DEPARTMEN - -' AS BUILT SANITARY REPORT �� �' o''a Owner Property Address f ,.t City /State �, Legal Description: �X Lot Block — Subdivision/CSM # ✓ f/' /a, �l/4, Sec. , T&N -RZ4W, Town of < G PIN # SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer f�r/� �� Size ST/PC Setback from: House Well 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: ^ ,- G / Width Length �5 S' Number of Trenches vK Setback from: House Well P/L Vent to fresh air intake ELEVATIONS Description of benchmark / �,�®u Flu �o over I Elevation Description of alternate benchmark %,moo lr 4.�!> x �f /� Elevation 1�a Building Sewer p ST/HT Inlet - ST Outlet PC Inlet PC Bottom Header/Manifold Top of ST/PC Manhole Cover O Distribution Lines) ? U . 5 , Bottom of System (�) 5 � Final Grade Date of installation // /� ermit number State plan number Plumber's signature License number ski 0 z 7 Date AU Inspector r � �� lete plot plan � �K- % kA 1 �` r 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 aim f -i INDICATE NORTH ARROW Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM County: INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No -: ST . eROrX Personal information you provice may be used for secondary purposes [Privacy L , s.15.04 (1)(m)]. 338977 Per I me: ❑ Cit Villa e Town of: State Plan ID No.: �', MICHAEL S�RR F� RIE --- CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: �1 D � 038- 1101 -85 -100 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. r r Septic �� Benchmark C- 3.1yo- wo Dosing A-14 a 431. 9 S0 r Aeratio , Bldg. Sewer �. l00 9f 2 Holding St/ Ht Inlet 4.0 gp,g6 TANK SETBACK INFORMATION St/ Ht Outlet (o • 3`F 9psZ' TANK TO P/ L WELL BLDG. Air I to ntake ROAD 17 111112t Air Septic p - 0-3 NA Dosing NA Header / Man. •72 0. f. ! Aeratio NA Dist. Pipe D. Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade 5, 20 I t G� M a n u fpauxe r I Demand �,t �i7- 33 92.fo , Model Number GPM TDH Lift Lriction stem TDH Ft For ain Length Dia. Dist .Towe SOIL ABSORPTION SYSTEM REN Width / Length _ No. f T enches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSION 2 S csZ. DIMENSION SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manu Y ty�r - INFORMATION Type of CHAMBER Mo el Nu ber: - + System: :2 �' OR UNIT - (_ u DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. pace 7 3a � 4- 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.) LOCATION: STAR P p��' R E 2 31.18.427C 1953 TY D CC — LOT 2 tt4 ®CO Plan revision required? ❑ Yes ®No Use other side for additional information. ley I t Z �o 1c , SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. SANITARY PERMIT APPLICATION Safety and Builgt n Avenue Division Vi s�onsin 201 W. Washin P 0 Box 7302 r with LH i . m. Department of Commerce In accord th 1 R 83 05, W s Ad 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. y .p • See reverse side for instructions for completing this application State Sanitary Permit Number Pe Personal information you provide may be used for secondary purposes ❑ Check if revisi "n� r�vi6us a Ication [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATI N Property Owner Na Pr pert cation 101 � /4 /4, S — T , N, R E it/ d �� Property Owner's Mailing Address / Lot Number Block Number r G f / City to t / Zi Code one Number Subdivision Name or CSM Number IL P OF B ILDI G: (check one) ❑State Owned v la a �� Q l 1 Nearer // t Road El Public or 2 Family Dwelling - No. of bedrooms own ol� !� <r/ <:::o III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment / Condo 61 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 online B, if applicable) A) 1. New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an ystem ________ System____ _________TankOnly_------------- Existing System ________ Ex(stln�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 120Seepage Trench 22 ❑ In- Ground Pressure , 42 C] Pit Privy 13" ❑Seepage Pit % /, el N 3 43 ❑ Vault Privy 14E] System-in-Fill 1 g VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate S. Perc. Rate 6. Syst Elev. 7. Final Grade L Requited (sq. ft.) Proposed (sq. ft.) (GaIs/da / q. ft.) (Min. /inch) Z I' Elevatio `7 © .4 Feet Feet Capacit VII. TANK in gallo Total # of Site INFORMATION Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. New Existing Gallons Tanks Concrete strutted glass App. Tank - Tanks Septic Tank 9LWa1diacf-Fank' -b �,Q. ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ 1 ❑ 1 ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plum Name: (Print) ( Plum ' ignature: (NO St ps) MP /MPRSW No.: Business Phone Number: Plum is Address (Street, City, Sta e, Zip ode): IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater D ate Issued Issuing Agent Signature (No Stamps) Approved []Owner Fee) Owner Given Initial �� Adverse Determination / X. CONDITIONS OF APPROVAL / REASONS FOR DI APPROVAL: 'Ott / 5 • Y/ V��f� S i �VV TT • / (Iff / 'V f/� 1�� VY SBD- 6398 (R.11197) �^1 DISTRIBUTION to County, One copy To: Safety & Buildings Division, Owner, Plumber PROJECT i �1 �.� 6— DRESS /��?me cl/� S� ©Bv , 1/4 /4 /S / N/R/ W •'TOWN COUNTY MPRS Byron Bird Jr. 3318 DATE - � BEDROOM CLASS PERC _ CONVENTIONALkN -GRO D PRESSURE CONVENTIONAL LIFT MOUND HOLDING TANK SEPTIC TANK SIZE ��— LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ABSORPTION AREA J :�7.Z— PERC RATE _. _BED SIZE d'?— T 5 t 1► Benchmark V.R.P. Assume Elev on X00' Location of Benchmark * H.R.P. ' C7 Borehole Q Well Scale = Feet — 0 Per H ole System Elevation g n � 5 1 C/e al / - 7��r er Grad L y� *17 L 3 f' U v �.�a Wisconsin department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of Byreau 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 County include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. If APPLICANT INFORMATION - Please print all information. Re wed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). / /� Property Owner 1 Property Location O / /Gt fct Z4 GOVt. Lot 114V14,1 �T N,R E (o6W_, Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# l 1 - City S to Zip Code Phone Number City ❑ ❑ Ci Vill Town Nearest Road C�//lZG'N ,�ir1 ! ' , O/� ��/ �6 ` !% �• cr hi 2 1 GG �lew Construction Use: Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow gpd Recommended design loading rate = . bed, gpde _ — trench, gpd /ft Absorption area required A _ bed, ft trench, ft2 Maximum design loading rate s bed, gpd /fl S trench, gpd /ft Recommended infiltration surface elevation(s) V - 6 , �j It (as referred to site plan benchmark) Additional design /site considerations— c� -�'" Parent material `rG iu �ly�z Flood plain elevation, if applicable It S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = unsuitable for system S ❑ U �S ❑ U J� ❑ U . J ❑ U ❑ S au ❑ S IR 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 Ground F. -3v. 94- Depth to limiting factor Remarks: Boring # Ground fo ' Depth to limiting n• factor„ �in. Remarks: CST Name Please Print)ignature t �blephoQe b. Addre Date Number r �C/G� f OIL DESCRIPTION REPORT Pa a of PROPERTY OWNER 9 PARCEL I.D.# Borin # Horizon Depth Dominant Color Mottles Structure 2 g Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Ground 3 Depth to limiting factor 4� I -s � JJ Remarks: o�Fing # 1 � 1 A j G Ground elev Depth to limiting factor 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 Depth to limiting facto min. Remarks: ,::,2 .y-' Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) oil Test Plot Plan Project Name �, �a ��� ��` By Bird Jr. Address / erg Ci � oo� ', : ✓ �/� TM 502' Lot -- - --- Subdivision ----- ------ Date - ,32 1 /4 &,f /4SaL1' N W Township S � 4'41 E] Boring ()Well PL Property Line County ` jf Zroix k BM or VRP Assume Elevation 100 ft. �° B. �t { � f� 7, N � Gown en PI GLUE (�rh System Elevation HRP as B � o L b V f I p� ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer �'/� /C�� �Cr"�� C_ Mailing Address C_ Property Address (Verification required from Planning Department for new construction) City /State ,� %�� I �� "�� Parcel Identification Number LE GAL DESCRIPTION Property Location �Z./ ' /4, ' /,, Sec. 5 , T__ZZN -R /�- ; Town of Subdivision `` , Lot # Certified Survey Map # / ��� , Volume %,7 Page # Warranty Deed # .3� 7 , Volume , Page # 67 Spec house ❑ yes ❑ no Lot lines identifiable ❑ yes ❑ 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, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days af t thre yea x 'ratio ate. I ff, f SIGNATURE OF LICANT 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 ro erty 7,/d Vyvirtu a warranty deed recorded in Register of Deeds Office. S NATURE OF PP 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 UOCUNII =N f NO. 01 A J C, 11AA Or' W ls(;UNSIN k'ugm 1 -- 1964{ TNre ar—c M166AY 660 r'o,t RCGO oAT4 WARRANTY DEED 43; %111% D"� 811 �a.. Daniel J. Casey .......... ...... REGISTER'S OFFICE This Deed. made between .... ...... . . .............. ST CROI CO., W1 . Reed for Record _ .. _ ............... and Michael J. MAY `' 0 (app .. . ...... Grantor, ....... ........, M A G �JOV Ge . ra .. .... ghty and Linda . L. Geraghty, husband and wife, as at 8:30 AM survivorship marital property Grantee, Witnesseth That the said Grantor, for a valuable consideration. . � One dollar and other valuable consideration .... come; ;s to Grantee the following described real estate in _. St • .. C . r . Otx RETURN TO Century 2 1, Itidianhead County, State of Wisconsin: New Richmond, WI 54017 Tax Parcel No: ............ ..................... The South 890 feet of the West 1,030 feet of the NWk of Section 25- 31 -18. FELL This is a correction deed only. This warranty deed # ---3 -- corrects the spelling of the Grantees last name in EXEMPT the warranty deed recorded in Volume 807, page 237. This is no,t_ . homestead property. (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And Daniel J. Casey.._.._......._ _ . ........ .._ warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except no exceptions and will warrant and defend the same. Dated this 1 (,l day of May _ 19 (SEAL) (SEAL) Daniel Case Y _ (SEAL) (SEAL) • AUTHENTICATION ACKNOWLEDGMENT Signature(s) ..... ......... .......... ..........._................... STATE OF WISCONSIN ............. .......... 33. ...........t•....Croix .Count•. /p authenticated this ........day of......__..- ._....._.... , 19...... Personally came before me this . -L.. day of ...... May._ .................. . 19..8.8. the above namcv: ......... _ ................... - - - -- ... ..--- ..._......_......... ..._ .......Dani.eZ.- .J- ..._C,asey _. TITLE: MENIBER STATE BAR OF WISCONSIN (If not, _ .._ _. ..... authorized by ; 70R.0v',, Wis. Stats.) to me known to he the person ._ won executed the foregoin nt and anknowlcdge THI <. INSTRUMENT WAS CRAFTED AY Eric J. Lundell, Box 157 _ D. Walsh .�O �•� "•.�, �� New Richmond Wisconsin 54017 �}� QT�•�r+ at ...... . ... Notary Plthlic $ t . C r0 ( I • �t• (Sk,natures may he authentic,iteil or acknowledged. Roth %fY ('nmmiainn is permam•,t Itf nt. -tato exp ritio•n are not necessary. L > date: December 10, i7{ r.M« of pv Vn Mw"inz in •. c•Pnri'Y yD «•1 •,r �• lr F / •N v Y Prntrd T «low th• it .i¢nnr; m� ` , • y L , ' ♦_ 01 '4­ 3- N.G Mrn4, Ca.oarti� STA'ry BAR OF WISCONSIN 4 ����, FORM No. I — 1982 Stocil - n'. 13001 7 G035'73 i CERTIFIED SURVEY MAP Located in part of the Southwest Quarter of the Northwest Quarter, Section 25, Township 31 North, Range 18 West, Town of Star Prairie, St. Croix County, Wisconsin. Prepared for and at the request of: LEGEND OWNER: LOT 2 Aji�- County Section Corner Monument Michael J. and Linda L. Geraghty I N88 "E of Record 1957 C.T.H. CC t-- — — New Richmond,Wl. 54017 �_ ( 58.76 i • Set 1" x 24" Iron Pipe weighing o a _ a minimum of 1.13 pounds per Drafted by. Krieti A. Ey andt "CD 0 o c i linear foot. o � I . 0(6 • • • • • • • •Building Setback Line (100' — NORTHWEST CORNER z I I tO from R.O.W. ) 1 SEC. 25 - 31 - 18 - 41.26' 58.76' TOTAL AREA LOT 2: j (ALUM. CO. MON.) S88'52'01"W 100.02' LOT 3 61,742 SO. FT. / 1.42 ACRES 3 ( AREA EXCLUDING R.O.W.: f I o C, 4ME DMEWAY DETAIL 56,223 SQ. FT. / 1.29 ACRES to I ° NOT TO SCALE I Po IN TOTAL AREA LOT 3: 1 N 61,748 SO. FT. / 1.42 ACRES I I 1 ��41.25' UNPLA LANDS -- AREA EXCLUDING R.O.W. 50%) S89'36'34 "E 1030.01' : �'� 56,230 SO. FT. 1.29 ACRES � 1 � W 5 cV , 988.76' �G W, SHED 7.4Y Z % n 0:620Q v FILED V) d N I I I '� z=� MAY 2 POLE BARN 1 19 \� 1 � I ° =� U � N LOT 1 L KANEEN 9► N 1 1 1 00 c AeDi sterplp ea dt 1 1 I 3: TOTAL AREA: a SLC10Gc CO. V4 M o ; 793,219 SO. FT. w a : 18.21 ACRES V) 0 1 rn (� * SHED o ' Z i ` O I 00 I -�°o / AREA EXCLUDING R.O.W.: z o � °° 1 ( Po i 767,544 SQ. FT. J H I Z w ° ///"••` 17.62 ACRES a Z CENTERLINE DI QI I I O ( _�� DRIVEWAY 3 �� O Q J 1 1 I 10 i HOUSE FENCE, TYPICAL p j co SEPTIC VENT /` P Z I I ° 1Z j I I N8T21'0 ®E 444.29' x N 403.00 .n UI i � Mme- 41.29' LOT 2 ° ° 1 04 M IM 66' JOINT DRIVEWAY a _� : S88'52'01 "W 443.89' 3 EAST 114 CORNER 402.63' o SEC. 25 -31 -18 EAST -WEST 1/4 LINE I . I ci I r'?� �,� o (ALUM. CO MON J U M� 1 d 41.26 LOT .� ,d P OF SECTION 25 I - - - -- 443.79 = -- _ 11 V °, — N89'36'34 "W 1J — 402.54' - -- 586.22' 4278.31' �`�`► -- - - - ---- 988.76'-- - - - - -- �� �� AVE. - - FENCELINE 2.5' SOUTH -- - ------- 1- N89 '36 34 " W 1030.01 -- - -- - -- -- OF PROPERTY�INE'� 50'. 1 ��.�� — I ------ --- N89'36'34 "W 5308.32' - -- 1 41.25 RECORDED AS: S88'21'20 "E 1 50' LOT 1 1 ter QlI T1FI Q SVRVFI MAP I U_N_PL_A_T_TE_DL_AN_D_S GO�Vs I i VOLUME 2 PAGE 387 I - s� f RONALD F. �} \h V i )OHNSON ~N � AMf Y. J S y r WIS. �s • i► r` NOTE: The parcels shown on this map are subject to State, County and �< �0�� Township laws, rules and regulations (i.e. wetlands, minimum lot size, access ♦ �N E 0 • to parcel, etc.). Before purchasing or developing any parcel, contact the St. 1t401 Su Croix County Zoning Office and the appropriate Town Board for advice. ea+esag JOB #99020 (Sta1) 200 0 200 NO TH Prepared by. A & E GRAPHIC SCALE LAND SURVEYING & CIVIL ENGINEERING SCALE IN FEET: 1 inch = 200 feet Phone No. (715) 246 -4319 BEARINGS ARE REFERENCED TO THE WEST LINE OF THE 109 East Third Street, P.O. Box 325 NW 1/4 OF SECTION 25, TOWNSHIP 31 N., RANGE 18 W. New Richmond, WI 54017 WHICH IS ASSUMED TO BEAR NOO'06'04 "E. Sheet 1 of 3 VOLUME 13 PAGE 3645 a r v OL � y �J s or C pl DO M�