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HomeMy WebLinkAbout016-1032-50-000 S'I'. CROIX COUNTY ZONING DEI'AIZ'I'M , 8 AS BUILT SANI I ARY REI'OR 'I' Owner / t Address c. City /State G tt � sn .?"y0 ,��? a S X xr UN7y Legal Description: �! F`.. c°FFrcc Lot `-- Block Subdivision/CSM # ,Sec. , T .3a N -R 43"W, Town of G/ e 4,� Q O 0t P1N SEPTIC TANK — DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer I PN 1 �a l0'� �0 e /P Size ST/PC / Setback from: House 4" Well Pump manufacturer 6 �© c/ /_ al Model 25 / Alarm location _ 91V t V h/ 4 e R /l o y to (HOLDING TANKS ONLY) Setbacks: Service r ' Vent to fres Meter location Alarm to SOIL ABSORPTION SYSTEM: Type of system: L'ON 0-ek- t&A LWidth Len /p 4 f Setback from: House � Number of Trenches // Well _!,Z` P/L 'Vent to fresh air intake `— ELEVATIONS: Description of benchmark _ tD J° p �" ,�,(e fjo� C /Q�, Description of alternate benchmark p p , Elevation �d Elevation Buil ing ewe "f91$' ST/HT Inlet ST Outlet /r PC Inlet 7.2. PC Bottom b Header/Manifold 6�Ot`�� '6, Jf" - 3 Top of ST/PC Manhole Cover 5, .2 9 Distribution Lines O d� O y �O L17/, 78 �� Bottom of System( ) _qj; ( ) 93 Final Grade ( ) 9 U, 0,3 Date of installation t /�// Permit number Q a J oT d State plan number Plumber's signature a A — g 6A / � M�i License number �Date Inspector complcic plot plan NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW W L t eh X) �—° Gk� puMI P IA M ` nJo� 8 r6 me Pe ke ct� He �• ��(1577 N jV&kL O�I k1 INDICATE NORTH ARROW Wiscorf>in Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division CountbT . CROIX INSPECTION REPORT -GENERAL INFORMATION (ATTACH TO PERMIT) SanitaWPZecrr�iLl�o.: Personal information you provice may be used for secondary purposes [Privacy LOW, s.15.04 (1) (m)]. Permit Holder's Name: ❑City [] Town of: State Plan ID No.: ODES, HAROLD G ENW O U CST BM Elev.: � Insp. BM Elev.: BM Description: Parcel Tax No.: Do / 00 TANK INFORMATION ELEVATION DATA A9800403 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV- e (� a 10C> a Bench rk 2.33 !o2•Zi3 / O a sin I ocao 1 I.lg 5 /del/ F6. 22 Aeration Bldg. Seweh� FS�. i g1L Y2 1A. Holding St/ Rt Inlet �5,� '; S� -7 if Z•9 TANK SETBACK INFORMATION St/ Ht Outlet '° 85%c6 �,� -7 TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Intake t 8 11 -56 7 2 7 Z ,, u e , of 12- � NA Dt Bottom X5'.08 �(o.tZ �o$•9G Ing -72 '18/ NA Header / Man. 1 al 3 3 5 Sd 1 7( 0 .573 Aeration NA Dist. Pip �i a•Mi a 9� C9 P I P . .8J e.6S /. Holdi Bot. System i /� 33 w.Z� c o6 PUMP/ SIPHON INFORMATION a Final Grader 102.1 - zs Manufacturer v Demand 9 Oro - 7 a • to Model Number C) I s GPM TDH Lifta'? ,57f Friction • � Systems TDHA.11 He Forcemain Length I&e Dia. a." I Dist. To well SOIL ABSORPTION SYSTEM BED/TRENCH Width / / Length No. O Trenches PIT No, Of Pits Inside Dia. Liquid Depth DIMENSIONS ✓ /off DIMEN I N SETBACK SYSTEM TO P/L I BLDG WELL LAKE /STREAM LEACH G Manufacturer: INFORMATION Type II,1 Flo ! er: Syst r,; CHAMBE X t ''11 I $�j OR UNIT DISTRIBUTION SYSTEM Header /Manifold tt � Distribution Pipe(s) x Hole Size I x Hole Spacing Vent To Air Intake Length ��' Dia T I Length �O Dia. Spacing I j A°>TM � {I I7-72q 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.) 10 . CV C LOCATION: GLENWOOD 15.30.15,SW,NE 3047 155TH AVENUE - LOT 1tooe" , ��J� I l / 00a S1 � 1 /►�'W''r�l. ( 1217 ctaoxo�'(' qo{- `-� [ eam � /I.Zcvt,.t �/ . • top r f �y � 1 v°v flG Ir Plan revision reci Ired? Yes In No Use other side for additional information. Q l 1 � 98 71 y $BD -6710 (R.3/97) Date Ins ector's Signature �f SANITARY PERMIT APPLICATION S afety Washington lAveision Vi sconsin In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Department of Commerce Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Permit Number ?2 21 The information you provide may be used by other government agency programs ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION D Prope y Owner Name Property Location f7 14 N B U 4�0 y 5 kl 1/4 h� 1/4, 5 T ..; �?O , N, R /f ilia # W Property Owner's Mailing Address Lot Number / Block Number 7 .4 A v L City, State Zip Code Phone Number Subdivision Name or CSM Nu b r uro (.4 1`' ( 7-41 d -7.s/f ---E o/ A X3 9 II. TYPE F B ILDIN (check one) ❑ State Owned ❑ ity Nearest Roa ❑ Village Public 1 or 2 Family Dwelling - No. of bedroom Town OF G­ III. BUILDING USE (if building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo I 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, Cg Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an System System Tank Only______________ Existing System ExlstingSystem 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 QSeepage 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: 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) �,9 ElevatI n I y /SOO - r 9J .� Feet 7,9- P `Feet Capacit VII. TANK in Ca allon Total # of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturers Name Concrete Con Steel glass Plastic App New Existing structed Tanks Tanks Septic Tank or Holding Tank X /Dam e e, ,S ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ow l e >✓ K S ® ❑ ❑ ❑ ❑ 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 Signature: (No Stamps) MPAVNMW No.: Business Phone Number: 7 1 - 1-- Plumber's Ac dress Street, City, State, Zip Code): w / tr,L e d C - 0 /3 IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No Stamps) t�A roved Surcharge Fee) r pp ❑Owner Given Initial. Adverse Determination X. CONDITIONS OF APPROVAL] REASO S FOR DISAPPROVAL: SBD -6398 (R.11196) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber Safety and Buildings 15837 USH 63 HAYWARD Wl 54843 -8107 , sc0ns n Tommy G. Thompson, Governor Department of Commerce Wi lliam J McCoshen, Secretary July 23, 1998 CUST ID No.640767 ROBERT J TUTTLE 316 E WALNUT ST GLENWOOD CITY WI 54013 RE: CONDITIONAL APPROVAL I�ler►tiiaatinNlux APPROVAL EXPIRES: 07/23/2000 Viers "' Transaction ID No. 118400 Site ID No. 16135 SITE: Please refer both tdetttaxtioxx nur , Site ID: 16135 abpve, in 11 corresPdndence wtYh'the agency. ST CROIX County, Town of GLENWOOD SWl /4, NEIA, S15, T30N, R15W HAROLD RHODES SEPTIC SYSTEM FOR: Description: CONVENTIONAL SYSTEM, 750 GPD Object Type: POWT System Regulated Object ID No.: 35691 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in P. chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. C'ondi The following conditions shall be met during construction or installation and prior to occupancy or use: APP 1. This plan action is subject to designer comments on the plan. DEPARTN1EN D ", t 2. This approval does not include plans for the general plumbing systems or sewer piping leading to the septic/holding tank that may be required for this project. See section COMM 82.20, Wis. Adm. Code, to determine if plan submittal and approval is required. S! _E CORR 3. Maintain well and waterline set backs per COMM 83.10(1) and 83.14(4)(a). 4. Provide 3 approved bedding material under tank(s) per COMM 83.15(4)(c). 5. The replacement area shall not be disturbed per COMM 83.09(1)(c). 6. Insulate building sewer per COMM 82.30(11)(c). 7. Install dose pump per manufacturer recommendation (Re: "D" dimension — 4 inches). 8. There shall be at least 36" below the system elevation to the limiting factor. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. • ROBERT J TUTTLE Page 2 7/23/98 Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, DATE RECEIVED 07/13/1998 -^ FEE REQUIRED $ 190.00 PATRICIA SHANDORF , POWTS PL REVIEWER FEE RECEIVED $ 190.00 Integrated Services BALANCE DUE $ 0.00 (715)634 -7810 , M -F 7:45 AM - 4:30 PM PSHANDORF@COMMERCE.STATE. WI.US XeAll- Q PQA in tq sEro-r �j - - -- - - - - I - i� I `'1 '� '�- - - �- - - 73'\ Fi ga I il I 4b t3 V* --41 f1 j IMS, Vol, i ,- e 4 y t l- X -�� - I i I i I I I I i t f I I I i gl 5 -6� I — - -- - - -- d �-- Wr J � • - PAGE . or-*- PUMP CHAMBER CROSS SECTION AAID SPECIFICATIOfJS ' VEIJT CAP 4 "C.I. VENT PIPC ' WEATHER PROOF APPROVED LOCKIILIG zS� FROM DOOR, JUTAICTIOU BOX MAMHOLE COVER • WINDOW OR FRESH Iet4IU. ' AIR IIUTAKE � 3 GRADE I COAIDUIT 18 "MIDI. 111L_ET PROVIDE AIRTIGHT SEAL I I I I AFFROVED JOINT A I I APPR�vEC __ J' C.T. F :FE I III W /c.I. F L EXTEND :MG 3' EXTEND''. .' CNTO SO'_ID SOIL. ALARM R I I I UNTO )i I C i � o tiJ �/�_� I CLEV I FT.._...._ _ __1 PUMF -� .— OFF D CONCRETE BLOCK // ''SA RISER EXIT FEPMIT CIJLLJ IF T"A1JK MAIJUFACTIJRE.R HAS Sc'CH APPROVAL �ed aN�eR r,, NIr SEPTIC f SPEGIFICATIOK15 COSE /! TANKS MAWUFACTURER: - „ S IJUMBER OF DOSES: PER Q +y TAILIK SIZE : _ %64D GALLOWS, DOSE VOLUME �/� ALARM MAMU FACT URER: S`T a e I D IMCLUDI BACKFLOW: - GALL0? S MODEL 1JUMM: - /C / H pi CAPACITIES: A= • -IIJCHES OR 4�GALLOAI; SWITCH TYPE: _ m es R c N /T V 8=- -� INCHES OR .,,Z� PUMP 1AAMUFACTURER: • - 0 G y� d C-0 - ... IMCHES OR a Zg: r , GALL0k:3 MODEL IJUMBER: - i N DuINCHES OR I GALLOIKIS SWITCH T%IPE: _ ' Tele ) VOTE: PUMP AIJDALARM ARE TO BE MIWIMUM DISCHARCiE RATE - ----E GPM INSTALLED OU SEPARATE CIRCUITS VERTICAL DIFFEREWCE BETWCttJ PUMP OFF AtJO OISTRIBUTIOMIlPE.. FEET + 1AIAM _MUM NETWORK SUPPL9. PRESSURE ,� I MET + l Qom_. FEET OF FORCC MAItl X - .. F4Y011. _ . 7 FEET TOTAL 09MAMIC. HEAD >� a0, 7 FEET 1UTERNAL DIMEIJSIONL Of TAIJK: LENGTH ......... ._,_ $WIDTH LIQUID DEPTH .._ SIGAIEp ,._„ LICEMSE DUMBER• ° �. _ DATE: 'Rev �l �a lei WESTBURNE SUPPLY INC. 1 0, 0ve - 12 DUSTRIAL RD. Goulds 0N, WI 54016 Submersible Effluent Pump 3871 EPO4 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- • Homes components. tic cover with integral handle •Farms Motor: Available for automatic and and float switch attachment • Heavy duty sump • EPO4 Single phase: 0.4 HP, manual operation. Automatic models include Mechanical points. • Water transfer RPM, 230 V, 60 Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, built in overload with automatic reset. preset at the factory. rated oil and water resistant. SPECIFICATIONS • EP05 Single phase: 0.5 HP. ■ Bearings: Upper and lower 115 V, 60 Hz, 1550 RPM, FEATURES heavy duty ball bearing Pump: EPO4 built in overload with ■ EPO4 Impeller: Thermo- construction. • Solids handling capability: automatic reset. 3 /4 " maximum. • Power cord. 10 foot plastic Semi open design AGENCY LISTING with pump out vanes for • Capacities: up to 55 GPM. standard Ic igth, 16/3 SJTO mechanical seal protection. SP • Total heads: up to 24 feet. with three piong grounding Canadian standards Association . ■ EP05 Im ell r: Th —n - plastic enclosed design for I P e e o • Discharge size: 1 ,', "NPT. pug. Optional 20 foot end i n listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with improved performance. end i "F" or "AC ".) rotary/ceramic - stationary, three prong grounding plug BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104" F (40 "C) continuous superior strength and 1401(60 °C) intermittent, corrosion resistance. • Fasteners: 300 series METERS FEET, stainless steel. 10 • Capable of running + n + -1- -5 GPM .. - - - - dry without damage to s 4p components. i Pump: EP05 $ I t-2.5 FT • Solids handling capability: 0 7 /4 maximum. a I I ! UJI • Capacities: up to 60 GPM. s zo • Total heads: up to 31 feet. __ -- • Discharge size: l' /z' NPT. z 5 i • Mechanical seal: carbon- c 15 _ _ .. _: ___ . ___ _ ! _____, - -. - -_! rotary/ceramic- stationary, -- BUNA -N elastomers. 4 ! I EPO$ • Temperature: ° 1041(40 °C) continuous I 1401(60 °C) intermittent. 2 EPO4 s s t I j 0 0— t0 .1 20 30 40 50 GPM L L 0 2 4 6 8 10 12 W/h CAPACITY 191995 Goulds Pumps. Inc. EBective May, 1995 133871 Wisconsin Department of Commerce SOIL AND SITE EVALUATION Divisiori of Safety and Buildings r rposei - ' Page of Bureau of Integrated Services �i kis ;ILHR 83.09, Wis. Adm. Code �r.., ;l "=- Attach complete site plan on paper not less th in es il�asii� Plan `mu3t County include, but not limited to: vertical and horizon p ion and percent slope, scale or dimensions, north arrotn and distance to neakest',road. Parcel I.D. # APPLICANT INFORMATION - Pleas infgr pn f evie ed by Date Personal information you provide may be used for secs aks. 15.04 Prope Owner �, , ' . Or4erty Location .Govt. Lot 1574 1/4 1/4,S T p ,N,R 1j-1y W Property Owner's Mailing Address \ Lot # I Block# Subd. Name or CSM# City State Zip Code Phone Number ❑ City ❑ Village LE Town Nearest Road e o E i o/ 2& )A(3'' /8 I Gl- elv eiv I ! v,� ❑ New Construction Use: ® Residential / Number of bedrooms Addition to existing building 0 Replacement ❑ Public or commercial - Describe: Rof s 4+7 Z 6 -1 r� !! 3 Gtou�G . Code derived daily flow 7J70 gpd Recommended design loading rate bed, gpd/ft ---if- 7 trench, gpd/ft Absorption area required bed, ft �J 4 trench, ft Maximum design loading rate _bed, gpd/ft ._ r trench, gpd/ft Q Recommended infiltration surface elevation(s) �.�. �d } 9 q�s 7 ft (as referred to site plan benchmark) Additional design /site considerations Parent material 6;.4 A G / A Flood plain elevation, if applicable S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system I QK S❑ U ® S ❑ U WS ❑ U I W S ❑ U I [- ®U ❑ S [M U SOIL DESCRIPTION REPORT Boren # Horizon Depth Dominant Color Mottles Structure GPD /ft Boring in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench F o -/O D A45 0-0 6 Ar M rnt 6 S ! irk Ground 6 e,l,ev,,^ 9_111f a Va t Depth to limiting factor ? in. Remarks: Boring # S n7d J ? S•6 r Ground elev. Depth to limiting factor ?7Ain. Remarks: CST Name (Please Print) Signature r Telephone No. &' - k e M/'r,4 & Address Date CST Number PROPERTY OWNER MY R�Jd� SOIL DESCRIPTION REPORT Page -1 of PARCEL LD.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench 3 B A s .._. 1i- es Ground elev. Depth to limiting factor Z3—in. Remarks: Boring # A6 Ground elev. f I T— Depth to limiting factor din. 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 # _ t o o 6 ,� F Zt, 02 Ufa Ground elev 7�Q Depth to limiting Z� fact in. Remarks: Boring # Ground elev. ft. ' Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) s �� I N 144 - -------- AN ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owners y DI o Mailing Address Property Address (Verification required from Planning Department for new construction) XL City /State 6,�4eN4,v o oal /fly/ Parcel Identification Number LEGAL DESCRIPTION Property Location .5�a %. , s, Sec. T,N -R W, Town.� Subdivision Certified Survey Map # D Volume o2 P Warranty Deed # 5 3 . ey Volume v� Page ft Spec house ❑ yes ❑ no Lot lines identifiable ❑ yes 0- no ��IAIl��NANCE - lmpunp rusesndnuhd aamoeofyoaruptiaryst= couldrcsItisits tohan dlewastmProperaain6caanct cood-sts pumping oat the septic tank evay am years or Sooner if needed b d : What yon pat. into the system can affect .the fm cfion of &C septic tank a trrabnueat st:$e is rho wsstedcsposai_systCnL TIM. property- owner agrees to srrbmif to St. Croix ?cuing Depart a oatificxtioa form, signed by fire -owns' sod by a P 7 y�aPlumbcr,= < idadpiumbaorahocmdpumperverWfttbat (l)thcoa-sitav�divwdsysbem is is PmPct op�ag condition and/or (2) after boa and pm�p*.(if neo*ary), the septic tanlcis less tlraa m full of sludge. Vwc. the undcm4 pod have read dw abm requkements and agree to maintain true private sewage disposal system with tine standaz+ds k forth, h=in.'as set by true Department of Comma oe and the Department of Natural Resources-. State of Wisconsin.. Certification $U&9 69 your septic gstcm has beea maintained muust be completed and returned to the St. Croix.Courdy Zoning Ofliee within 30 days- of the three year expiration date. Ot SIGNATURE OF APPLICANT / / DATE OWNER, CERTTII C MON I ( ere) ratify that all statements on this foam are true to the best of my (oar) knowledge. I (we) am (are) the owner(s) of the p6paty dmnibcd above. y virtue of a waaaaty deod reoorded in Register of Deeds Office. SIGNATURE OF APPLICANT / / DATE «« «* «« Any information that is znk4 presentodmay result in the sanitary permit being revoked by the Zoning Department. «•' "` Imcfade with this application: a stampod wuranty deed fi+om the Register of Deeds offi a Copy of the certified survey map if reference is made in the warranty deed °Bar of Wisconsin Form 2 — 1982 _ 53546U ii WARRANTY DEED � DOCUMENT NO. P, 116Pa fiEG1STER'S OFFICE _ 10 I' ST. CROIX CO., WI Rac'd for Record Gerald Mitch, a /k /a Gerald F. Mitch, OCT 2 7 1996 and D orothy Mi c F. Mitch, us an anti fe ; as joint tenants %..t 9:15 A. M conveys and warrants to Harold R o e s , a s y Reai t ?r of De- -1s person THIS SPACE RESERVED FOR RECORDING DATA I NAME AND RETUFIN ADDRES 5 the following described real estate in St. Croix County, State of Wisconsin: I - - - -- - i I (Parcel Identification Number) The Northwest Quarter of the Southwest Quarter (NW4 of SW4) EXCEPT that part conveyed to the Town of Glenwood City in Book 164, Page 133 described as follows: Beginning at a point 37k rods West of Southeast corner of Northwest Quarter of Southwest Quarter (NW4 of SW4) of Section Fifteen (15), Township Thirty (30) North, Range Fifteen (15) West, thence North 8 rods, thence West 10 rods, thence South 8 rods, thence East 10 rods to place of beginning. The Southeast Quarter of the Northwest Quarter (SE4 of NW4); and the Of '� West Half of the Southwest Quarter of the Northeast Quarter (W o SW4 of NE4); all in Section Fifteen (15), Township Thirty (30) North, Range Fifteen (15) West, St. Croix County, Wisconsin. fi�zA�s jl "o w l it i s This homestead . ro ert P P Y (is) (i Exception to warranties: Easements and restrictions of record. it I� October , 19 5 Dated this 25th day of ,I (SEAL) (SEAL) Mitch d Mitch Gerald F a/k/a Geral t i (SEAL) (SEAL) Dorothy U F. Mitch a Dorothy Mi tch fl AUTHENTICATION ACKNOWLEDGMENT Signatures) STATE OF WISCONSIN l SS. St. Croix County. j i authenticated this day f , 19 Personally came before me this 25 day of Y October 19 the above named Gerald Mitch, a /k /a Gerald F. Mitch and Dorothy Mitch, a /k /a TITLE: MEMBER STATE BAR OF WISCONSIN D orothy F. Mitch , Husband & Wife _ ,I (If not, authorized by §706.06, Wis. Scats.) to me known to be the person s who executed the II fore ng in rumens and ackn wledg the me. THIS INSTRUMENT WAS DRAFTED BY Thomas A. McCormack ■ ij Baldwin, WI 54002 Nota blic St Croix County, Wis. (Signatures may be authenticated or acknowledged. Both are not My commission is permanent. (If not, state expiration date: necessary.) May 9 19 99 MD _ No *Names of persons signing in any capacity should be typed or printed below their signatur State WARRANTY DEED STATE BAR OF WISCONSIN sconsin Legal Blank Co.. Inc. Milwaukee. Wis. FORM No. 2 — 1982 _ 9a � 10 StP 0 1 19 � XpZtIIEENH• Re0�sloc of D 11 � Rt.CcolxCA^ 5�62�0 ti C ER T I E Z ED S UR V E Y MA R Located in the Southeast quarter of the Northwest quarter of Section 15, Township 30 North, Range 15 West, Town of Glenwood, St. Croix County. Also, located in part of the,Southwe.st quarter of the Northeast quarter of Harvey Rhodes Section 15- 30 -15. 3055 155th Ave. Glenwood City, W i . 54013 L w AVENU f ";:' N8 4 °2901 E 70.57'•, —tZ PROPOSED SEPTIC 0\ ` tp; ; :•�• pia � \�' ,�'� s .. a:n rvd: ix ' OJ� o �• AREA ,l 2 u� k G OUSE •,,. x:xi vc,m P � 2 4— P08 � 1 � LO 1 � ti9,• 64,562 Square feet t (1.48Z acres) �941 East -West , approxi- quarter section ,t� '0 2 0 Q� mate North - line. <.5 0 '((�,'�� South 1/4 �?� section line. S89 94S.91T Bearings referenced to the ' 3349.11' East - West quarter section Ne9 "W 5295.08 line, assumed N89 * 51'43 "W . W 1 /4 Corner E 1 /4 Corner Section 15-30-15 Section 15-30-15 County monument. Ma g section corner Legend nail found. • - denotes 1 "X24" Iron pipe weighing 1.68 pounds per lin, foot set. ot11111111 i0 , a C ON �����i Curve information Radius - 247.00' •� N 2 i Central angle - 41 ° 55 1 20" Jp G Arc length - 180.73' S HNSO1V Chord - N63 ° 31'21 "E L yUps 99 176.72' Z ON fr•� r i o O " � - fit test* S 6 It SCALE IN FEET I'= 80' O 40 80 120 /go 200 This instrument drafted by 4982607 Vol. 12 Page 3509 '•pct of Wick Bui ng Systems, Inc. Production No. 22221 P.0 / Irshfield 54449 - (715) Last Page Attach Printon this Page: 11/27/1996 lb , � O �o 0 iw 0 O ti ° A, V Q� z, ; =::: = 0LQ l.� :.. o=e : `::: 0� 0 0� 01:Z: lb I 1 o� 95�o� v� A -3 ST. CROIX COUNTY �. WISCONSIN "Wo �'� � ZONING OFFICE ` N N ST. CROIX COUNTY GOVERNMENT CENTER +"++ 1101 Carmichael Road Hudson, WI 54016 -7710 " - -�- -' (715) 386 -4680 October 15, 1998 Violation # 98 -V -26 Harold Rhodes LOCATION: SW 1/4 of the NE 1/4, 222 - 330th Street Section 15, T3028N -R15W, Wilson, WI 54027 Town of Glenwood, St. Croix County, Wisconsin Dear Mr. Rhodes: The St. Croix County Zoning Department has determined that the septic system serving the residence at the above described location is a category II failing septic system as defined by Chapter 144.245 of the Wisconsin Statutes. This is evidenced by the discharge of sewage effluent to the surface of the ground. This system is hereby condemned as it constitutes a violation of Section 254.59, Wisconsin Statutes, s. ILHR 83.03 (2) (c) & (e) Wisconsin Administrative Code, and 15.04, St. Croix County Ordinance. Yo per mit for a new ed to obtain a sanitary er ou are hereby order y p replacement septic system within 30 days and that system should be installed and in use within 60 days of this notice. You may be eligible for partial reimbursement of the cost of replacing your septic system through the Wisconsin Fund Program. To qualify for the program, the house which the replacement septic system is to serve must have been constructed and occupied before July 1, 1978, and must be your primary residence (meaning that you personally occupy the house at least 51% of the year.) There is an income limitation for qualifying for the funding of $45,000 total household income for the year 1998. You may check this from your 1998 Wisconsin tax returns. If you filed Form 1, use the total on line 5, and if you use Form 1A, line 7, and Form WI -Z, line 1. Should you wish to apply, please complete the front page of the application completely, making sure to include the tax parcel number (from your property tax statements), and the Register of Deeds Document No. (from your warranty deed). Return the application along with a copy of your 1998 WISCONSIN tax returns, and the application fee of $50 to the Zoning Office. Application may be made as soon as the permit has been issued for your new system, but no later than January 15, 1999. Failure to comply with this order will result in this office seeking enforcement through circuit court as allowed by Chapter 254.59 Wisconsin Statutes, and /or through the issuance of a citation in the amount of $250 per day for each day the violation continues beyond the deadlines given above. This violation is noted as having occurred June 23, 1998. Should you have any questions, please contact me. Sincerely, Mary J. Jenkins Assistant Zoning Administrator CC: Corporation Counsel Clerk, Town of Glenwood File Enclosure