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Home My WebLink About018-1015-10-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count y: Safety and Buildings Division INSPECTION REPORT S- Crest,c GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 31 IS Permit Holder's Name: ❑ City ❑ Village IN Town of: State Plan ID No.: Ke h h e4h L i wd J-) 14aw11 w.o CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: Igo toc> l o of ?l c3 f'r%tt h0YIG d�a — /D1 —/O — mop TANK INFORMATION ELEVATION DATA A 7800 3 TYPE MANUFACTURER CAPACITY STATION BS HI I FS ELEV. Septic lAlce_ It-S lo Bench c 2 162.2?- Dosing Aeratio Bldg. Sewer Holding St/ Ht Inlet TANK SETBACK INFORMATION (fSt_,�Ht Outlet 3,2 78.9s! TANK TO P / L WELL BLDG. Air I ntake ROAD Dt Inlet Air Septic NA Dt Bottom Dosing NA Header/ Man. Y 97.52, Aeration NA Dist. Pipe yep q7. y2 Holding Bot. System 57 7,1 1(. PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH I Lift Friction System TDH Ft H ead Forcemain Length Dia. f Dist. To wen SOIL ABSORPTION SYSTEM BED / TRENCH Width •� Length No. Of Trenches PIT Inside Dia. Liquid Depth DIME J �O 2 71 DIMEN ION SETBACK SYSTEM TO P/ L BLDG WELL LAKE /STREAM ACHING Manu r: INFORMATION Type ?/ ' I�� CH Mode Numb Sys ,,v�1� 4 09' DISTRIBUTION SYSTEM 410 �t Header /Manifold Distribution Pipe(s) �• x Hole Size Hole Spacing Vent To Air Intake Length al� � Dia. Length - jg ' Dia. Spacing A":�rN\ S x W Z7�f 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 , YI Bed/ Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) b ( ( Q p -M, c �. - f CL6 2—� �lP.vwh�►'t C;• W fTZ, ovfu, -tz� �( & u fL� lt°a�p c Wl:yt • (� �� t1/tG- fi�,s' Cibll P� j"11� '%''�2� Plan revision required? [:]Yes 0 No Use other side for additional information. I ( SBD -6710 (R.3/97) Date Inspector's Signat a ert. No V iscons in Safety and Buildings Division SANITARY PERMIT APPLICATION 201 E. Washington Ave. P.O. Box 7969 Department of Commerce In accord with ILHR 83. 05, Wis. Adm. Code 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. ST CROIX • See reverse side for instructions for completing this application State Sanitary Permit Number 311 �7!5 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 1. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION Property Owner Name Property Location KENNETH LINDUS NE 1/4 SE 1/4, S 7 T 29 , N, R 17 M61 Property Owner's Mailing ddress Lot Number Block Number 1034 160TH STREET 2 City, State Zip Code Phone Number Subdivision Name or CSM Number HAMMOND WI 54015 ( > 344176 II. TYPE F BUILDING: (check one) [] State Owned El It Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms _3 ° Tow o f Village HAMMOND 160TH STREET 111. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 018- 1015 -10 1 ❑ Apartment/ Condo 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 _____ Sysstem ________ System_____________ Tank Only______________ Existing System - --------- Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 []Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 M Seepage Trench 22 ❑ In- Ground Pressure / 42 E] Pit Privy 13 [] Seepage Pit 3 — x 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPT 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) Elevation 450 900 900 .5 N/A 96.5 Feet 99 Feet VI Cap TANK in g allon s _ allots Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Exist structed Tanks Tanks Septic Ta Ing Tank 1000 1000 1 UNKNOWN ® 1:1 1:1 El E] ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ I ❑ I ❑ I ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plum be ' ignature: (No St m MP /MPRSW No.: Business Phone Number: BENNIE HELGESON 220292 715/772 -3278 Plumber's Address (Street, City, State, Zip Code): W1229 770TH AVENUE, SPRING VALLEY WI 54767 IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater D ate Issued Ifssu ing ,, t S ture (No Stamps) approved ❑Owner Given Initial ,/, 00 Surcharge I,) Adverse Determination �� D &L' X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: f wl - X12 0 - t1_k rn.�ibv� 6 - 6-vi �C(5 � .st-v -CG K �( wn J S> fA-t t/96) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plu vdw I' (�Cyl/1eh 4-" L (n 111�.v�nY �ChV�1 11UC, PSPt�— L4 a9b X E� To B MM E-L . l oo. o off' s� �rbs 4 6 k f X- -- rB ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the k -ellne `i f U 1 "A r residence located at: Section : 2 TN, R / , � W, Town of Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced: ��, -2 Did flow back occur from absorption system? Yes i/ No (If no, skip next line) Approximate volume or length of time: gallons minutes Capacity: Construction: Prefab Concrete Steel Other Manufacturer: (If known) : Age of Tank (If known): /97 z I Lk (Signature) V (Name) Please print/ / 1 � 7 (Title) (License Number) Date Form to be completed by licensed plumber (s.145.06, Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements of ILHR 83, Wis. Adm. Code (except for inspection opening over outlet baffle). Name 61e n. ri t e - C l c, S ignature P/ PRS�� Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of 3 Labot and Human Relations Division of,Safety & Buildrgs in accord with ILFiR 83.05, Vvs: Adm. Code ' COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but Ste• �� not limited to vertical and horizontal reference point (13M), diFection and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and dista mn ark roa' . . B APPLICANT INFORMATION- PLEASE I,f�'T�7(LL ,.._ INFORMATIO R I DATE / 8 f o wa PROPERTY OWNER: P OPERTY LOCATION �c 3 ( GPYF 4BT IJE 1/4 SIS 1/4,S 1 T Z9 N,R E PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # �o 1 1 ,113 `T1t sT. �� rn _ �s �'1 vow Z r Llgq CITY, STATE ZIP CO Ei , P fill „ CITY ❑VILLAGE [MOWN NEAREST ROAD �khmm(oKjb wl S OI ' 'x ll 9 ,z6y i 1b0 `'Cll S New Construction Use [)q Residential / r' r 91 (]Addition to existing building QQ Replacement [ J Public or commerc Code derived daily flow \A SO gpd Recommended design loading rate bed, gpd/ft 5 trench, gp d/ft 2 Absorption area required 11 L S bed, ft °1 y trench, ft Manamum design loading rate bed, gpdffl S trench, gPdtft Recommended infiltration surface elevation(s) o f b • S It (as referred to site plan benchmark) Additional design / site considerations LrCtt S , X 60' LUx/G Parent material S - T - x Flood plain elevation, if applicable N fl It S = Suitable for system CONVENTIONAL MOUND IN. GROUND PRESSURE AT -GRADE SYSTEM IN RLL HOLDING TANK U = Unsuitable fors stem EQ S El ® S 11 U ®S ❑ U 91 S El U ❑ S QU ❑ S [2 U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed m_nch ��s Z lb Z-fl 1 p`4 R- 3 L � — Gr s 1 S Z wi SVbc m�� cs _ • S • � Ground 1 y tf elev. s 1 s vvt v � C � 9 7 ft t41 �•S btR3l — SI C�`M wn`�� cS — •3 .� Depth to 5 6Z -gD S R /!, — \S o limiting facto Remarks: Boring # o - S tio-t�_ z-Lz � Z 1S 30 � o `t R 3 1 G — 6►- S � ( Zm s�k yrt'�� — _ s • b '`I 'S Ground w elev. �$ �.S `tR VA � sl ow, 1�t `FH — �� •y ob -S ft Depth to limiting facto > be Remarks: TName:— Please Print Phone: Arthur L. We e r e r 715-425-0165 eserer Soil Testing & Design Service -P.O. Box 74 River Falls,WI 54022 Signature: L f j / °I; $- I S 9 N Date: -- ` i` g s CST Num c 0 5 6 PROPERTY OWNER SOIL DESCRIPTION REPORT Page Z of 3 PARCEL I.D.# Old— IONS — tl� Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Clu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends 13 0 -10 Z /Z Z do Z7 to`-1. iZ - �,/z L Zwi sb�t wi aw .S ._ Ground `), U cz-j elev. ° 19.3 ft. 61 - - ) 5 I 0 `9 iZ Y/ fo — �'►'1 U . Depth to limiting factor TES`` Remarks: Boring # E3 Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # 13. Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) PLOT PLAN Page 3 of 3 SCALE 1" y,p ' o r; / r \'Li -N f S • 5' i o J f n�. k sQPTic el , 100 •� CfJ - Tb OF 3 41yj ':R p� �Yy - L - , l off. o J►J `�P U?^ 3 b" .tt� � h( > l0 0' \A T of `rn"1 -J ( 715 ) 42.5 -01 14 00576 CST Signature Date Signed Telephone No. CST # Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of 3 Labor and Human Relations Division of Safety & Buiktings in accord with ILHR 83.05, Wis: Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but Ste• �� 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. CNLa lo15 �0 APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION IE!'rm GOW. LOT ►JE 1/4 SET 1 /4,S —) T Z9 ,N,R �-) E PROPERTY OWNER':S MAILING ADDRESS LOT It I BLOCK # SUBD. NAME OR CSM # 1034 ) b 0 `M ST . Z: — c— S 1 "'t. Vq\.. Z, CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE jQrOWN I NEAREST ROAD �khmmo►j� w) S '4ot s c)t3 -zGg9 0 1bo `rti s . (] New Construction Use [ Residential /Number of bedrooms 3 [) AdditiQrt to existing building QQ Replacement [) Public or commercial describe Code derived daily flow \A Si3 gpd Recommended design loading rate `( bed, gpd/ft S trench, gpd/ft Absorption area required NNZ S bed, ft � O k3 trench, ft Maximum design loading rate • 4 bed, gpd/ft • trench, gpd/ft Recommended infiltration surface elevation(s) ( : ) l 6 • S ft (as referred to site plan benchmark) Additional design /site considerations 3'Y-c tt t- - k MC 'ft 5 �X b LUxl6 Parent material Flood plain elevation, if applicable N fl It S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem E� S ❑ U I ®S ❑ U I ®S ❑ U ®S ❑ U ❑ S Q U EIS IZ U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. g� rertdt nm :V;.::. � 1 o-16 fog R z [ z Z Ground 3 Z� -4I - 1.S 4R Y!u w _ ,\4 -S elev. 9 - ft. yl -LIZ R-,) Jy C* 1v1`F1 CS Depth to 5 6i - gD S R Y/( — lS o gig limiting factor Remarks: Boring # 0-IS V)4%z zLZ ' - � .> Z �S 3o b o � R 3 1 � — Gr- S i I Zw s�k �rt��- � — . s • � Ground Y/y — S I 1 �s�k wl v'f�- CL'j • �[ -S elev. �, $ S `t R Yl b — S I ors lit `FH • y Depth to limiting factor > Remarks: CST Name: — Please Print Arthur L. W e e r e r Phone- 715-425-0165 egerer Soil Testing & Design Service -P.O. Box 74 River Falls,WI 54022 Signature: A Date: —7 — — CST umb 0 0576 PRbPERTYOWNER SOIL DESCRIPTION REPORT Pag2? of 3 PARCEL I.D. # Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr, Sz. Sh. Consistence Boundary Roots Bed Trench o o — La o Z lz Z 10 z o�-1 tZ '�/2 Ground IZ V/ 1 CS �k m U ) S elev. ft. i,Z �s 10 `7 tZ .5 Depth to limiting factor Remarks: Boring # s Ground elev. s ft. Depth to limiting factor Remarks: B4.cing # E3 G,iqund etev: ft. Depth to limiting factor Remarks: Boring # { Ground elev. ft. Depth to limiting factor Remarks: SBD,8330(R.05/92) of PLOT PLAN Pa 3 3 SCALE 1 "= yp ' 0 0° t-'� D I' �Z \SLCt1 `�. ' -01 -D I �i'8\2�µ \ I ` �6'� � J •�• Q I 1 - -kq3 t I B -3 0 S o + � 3 13ti Rx1 i � i i — -- 3 d S oF > v3 --1—g� - (715 � _ 14 00576 CST Signature Date Signed Telephone No. CST # ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer KENNETH LINDUS Mailing Address 1034 160TH STREET, HAMMOND WI 54015 Property Address 1034 160TH STREET, HAMMOND WI 54015 (Verification required from Planning Department for new construction) City/State HAMMOND WI Parcel Identification Number 018- 1015 -10 LEGAL DESCRIPTION Property Location NE ' /a, SE ' /a, Sec. 7 , T 29 N -R 17 W, Town of HAMMOND Subdivision , Lot # 2 Certified Survey Map # a +419 ( , Volume 2 , Page # 499 Warranty Deed # 5 '3 7 , Volume //� , Page # Spec house ❑ yes V' 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 of the three year expiration date. SIGNATURE OF APPLICANT 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 property described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT 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 DOCUMENT NO STATE BAR OF WISCONSIN Fl-a2l v --1982 TH5 SP _E Rt-XR�tD FOR RCCC9GiNG Ow'i S' WT IM DEED Kenneth Lindus t - a /k /a Kenneth L. Lindus an d_ Jean ...... s, a/k/a Jean +( Lindus, husband _ C 7 19 and wife __ �E - - - snit- claims to Kenneth L. _Indus and Jean H. Lindus, %.t 9:30 Af,� husband and wife, holding as survivorship -- -- .._ .. . t marital -- prapert}_.- f ,At ------------------ - - ---- -• - - - -- ------- - - -• -- ..... ..... .. i., . the following described real estate in _ -.$t • - -- CIOiX_ -------------- _ County, State of Wisconsin: eeTCRN To • ?t: r 4 Tar Parcel No: - - ----- -- -----••-•---•----- 1. The Northeast Quarter of Northeast Quarter (NEk of NEk) of Section r 1hrea (3), except the right -of -way to Northern States Power. 2. Part of the Northeast Quarter of the Southeast Quarter (NE's of SEa) s -*r of Section Seven (7) described as Lots One (1) and Tuo (2) of Certified Y' . Survey Maps filed in Volume 2 of Certified Survey Maps, at Page 499, and Certified Survey Map filed in Volume 2 of Certified Sury ^y Maps, b at Page 568. All in Township Twenty -nine (29) North, Range Se :renteen (17) West. S ce1s are further des- in Tax Key Nos. 018- 2015 -00, _4 018- 1015 -10, and 018 - 1005 -20. • Y Y -��. � r s This - . ..- -- - iS. ... . -, --- homestead property. (is) li Dated tl.;s .. - ._. /. z- da ai - J C1.�.��L 19 95 ;,x` . - y _ • .. .... .. ...... (SEAL)_ . _(SEAL) :. _- - - -_ -_ . . Kenneth Kenneth L. Lindus P .-- --- ...... - .... - - - - --- ----------- JSEAL) mow_ fl1.. (SEAT.) V } - -- __ Jean M. Lindus AIITEENTIr; 4TION ACKNOWLEDGIAENT Signature(s) ----------------------•-- ----- -- --- --- --- ------ --- - --- STATE OF WISCONSIN ss. r ............ •-- ---- ------• ------ ----------- -- -------------- - --- --- --- iR ,St.,___C.rQ -i 7C . .......... ..... County. authenticated this -------- day of____ _______ __________ __ __ __ 19 ------ came before me this ................ day of y y ----- -------••-•- -- ......... 1 9--95_ the above named RegneL2i_ Lindus- r_ a. /X- /A,- Kenn ' ____ Lndf�s_ and -- - Jea - ......... Jean Lindus,. ak_�a TITLE: MEMBER STATE BAR OF WISCONSIN Jean M.__ Lindus � s l ' (If not, authorized b .( y § 746.5, Wis. Stats.) to me Ic.0 -a3 to be the person 'f ,e 4' fore -:-c = ir-trument and a j -y THIS INSTRUMENT WAS DRAFTED BY ��- r•. ',►• `*" '� °� +w t �j Thomas A. McCormack - .a - - - - -- . _... -- / �- , ----- . WI 54002 St Croix Y � --- . - • -- --- \ota ro r __.- +. l�} �l is. .$ (S4 natures may he authenticated or acl;nualedt ed. Roth fity Car z_ inn is permanet : :. I If � are not ncces.,ary.) Mate: .�.��- 19�_/ -•) . ��c w f1 QUIT CLAIM DEED ST %TF. UAR OF FORM Vo. 344 -.75 1p 11 ' cb F I � w OCT 2 JAMES O. 719 77 tv R19/rl °� cf ONKf(l C' St. Croi * Oda W/aco c o"', Y, �V Si t? S N 0 E 450.00 19 210.00' 173.99 GG.01 , lb Trn 4 0 0 06 1. I G�, I o. I O ff` ' I 7 1 f ° N I D N Q b f � N f � Cn z p 0 o� I 9 CO CD n W m � N i Z to O U) O fTl � I ° (n T1 -i -N 0 APPROVED < 0 0 i ° W m _ M Z I OD 0 C T 27 1977 w N N Ui O %L7 CA L" . N p ST. CROIX COUNTY O - O_ o L COMPREHENSIVE PARKS PUNNING D Z -O o m C 0 I m AND ZONING COMMITTEE .A.p � I oA A ro \ \ APPROVAL OF IHIS MANOR SUBDi VISION DOES N'I MEAN APPROVAL FOR BIWDING SITS OR SEPTIC REFER T' W� tip ��\ O H62.20. o O o ao o b O Gl 00 O ' Off/ N O :E N m of .,d � \ N WW \OO r� m O \ r *M o1 0 —L co Z m x m -TIM m cn D m D D =z 0 z0az S LIN -n zz � �'�' - ,u O �O m z0 0 - -_ 0 o ZrM �rn -i W" 0 Z -I �1 Z -n M D -N 'Ti x _ '" m (-) cn C , m = DO X 1 M Nmm �I ,'O cx0 �z -ma N A rn U ° mp z p m N O O A � Z �m volume 2 Page 499 er: I, Arthur L. Wegerer, registered land surveyor, hereby certify: That in full compliance with the provisions of Chapter 236.34 of the Wisconsin Statutes and the provisions of the St. Croix County Subdivision Ordinance and under the direction of Louise M. McNellis, owner of said land, I have surveyed, divided, and mapped said parcel of land, that such plat correctly represents all exterior boundaries and the subdivision of the land surveyed; and that this land is located in the NE 4 of the SE 4 of Section 7, T 29 N, R 17 W, Town of Hammond, St. Croix County, Wisconsin, to -wit: Commencing at the East � corner of Section 7; thence S 40 °11 W 672.10 to the point of beginning; thence Southwesterly 1$0.02 along the are of a 350 radius curve which is concave Southeasterly and whose long cord bears S 30 W 17$.04 thence Southerly 261.80 along the arc of a 250 radius curve which is concave Ea6terly and whose long chord bears S 14 °36 E 250.00 thence S 44 0 36 1 44" E 77.31 thence N 88 0 20 1 00 11 W 517.69 thence N 0 0 43 1 30" E 450 .00 1 ; thence S 88 E 483 .97 1 to the point of beginning. Contains 4.389 acres subject to existing Town Road Right -of -Way and subject to the Northerly 66 being reserved for road purposes. Dated this 26th. day of October, 1977. Arthur L. Wegge er Wis. R.L.S. No. S -963 Dittloff Engineering Co. River Falls, Wi . 54022 r ARTHUR L, ; C WEGERER S = v S -9.53 ° ELLSWORTH •. Wis. D 1 0 110 _ 1 I Please prov'dq the following. • A 1 e �s�ctct�tgt? 1i7? 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. � LW"EW > - a.Ia x 1 5 5 � 1 a � vk t �A Mme - -/ � Task M. EI- , bo. a T P o 30 ID O �S I T-el etP o v% e e El-. A Eir 6 " GcJ• i r ST. CROIX COUNTY TONING DEPARTMENT \t' AS BUILT SANITARY REPORT Owner C►� h P- L y1j Lcs 1 Address ! ,4 IL /State - ST CROIX City/State Y 1(A n l_ o n cj (� 1 S 4o I S COUNTY ZONING OFFICE Legal Description: r', Lot Z Block — Subdivision/CSM # CSin kr� P, 4G7 '/• '/, �)E ,Sec. 7 , T z 9 N -R I? W, Town of _ Na,�, PIN # yi 8 -ioiS -io SEPTIC TANK — OSE S H AMBE — HOLDING TANK INFORMATION: z'w S Via--, � �� Tank manufacturer (�; Size ST/Ae G�'/ A b ack P/L /M) L from: House � Well Pump manufacturer _�1 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 S Length GU Number of Trenches 3 Setback from: House loa , Well /� P/L _� Vent to fresh air intake ELEVATIONS Description of benchmark a ® Elevation /i oo Description of alternate benchmark 6 a Elevatio Building Sewer ST/HT Inlet ST Outlet PC Inlet PC Bottom _ Header/Manifold Top of ST/PC Manhole Cover kX- Distribution Lines ( 7. T D Bottom of System (i) S— Final Grade Date of installation fQ2 /Ze Permit number 3/ r97 S - State plan number Plumber's signature ccnse number -2 e�� Date v8 /zo/ 9B Inspector e Complctc plot plan K �b