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HomeMy WebLinkAbout024-1003-40-000 ` ST. CROIX COUNTY ZONING DEPARTME�r�� -' AS BUILT SANITARY REPORT Owner �_ s 0/, Address s City /State _ Alo,vr r, �� : c CR01 /8 eov Legal Description: Lot .42"1 Block Subdivision/CSM # 65;i 1a ,12,ey d '/. '/, U Sec. , T ?ft -R l- W, Town of T A-Ile �e PIN # eW4 /ADS C -6b Nk� SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer A7, Size ST/PC /&v / Gsa Setback from: House .?D'' Well .-ate PAL 52� V- Pump manufacturer Model Fp o y /� Alarm location mac w , r (HOLDING TANKS ONLY) Setbacks: Service road Je*;ri lirintake e Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: Aa &,yot Width Z — Length Number of Trenches Setback from: House SGT Well P/L 45" Vent to fresh air intake SW ELEVATIONS Description of benchmark Sk p -, e a6 / ' - r Elevation Description of alternate benchmark Elevation Building Sewer ST/HT Inlet l ST Outlet PC Inlet PC Bottom M S2 Header/Manifold 11 Top of ST/PC Manhole Cover d`11* 3 Distribution Lines 7 � () ( ) Bottom of System Final Grade ( ) ( ) ( ) Date of installation 7 / / Permit number State plan number Plumber's signature i License number 2� 79 �G Date /mil y� r Inspector Complete plot plan Or f NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW Q h v r� vw I �ND ICATE NORTH ARROW Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count Safety arld Buildings Division INSPECTION REPORT S y . Cray 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)]. J0 Permit Holde' 6Z : ❑ ity El Village ® Town of: State Plan ID No.: 0 �I e" a1� li'll CST BM Elev.: sp. BM Elev.: BM Description: Parcel Tax No.: (Z In o-3-4 - /003 -q -,6 TANK INFORMATION ELEVATION DATA A 98, l ow 52 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic VM0 + 1000 Benchm r 1`75"' 1 46 - W /Od Dosing CW1 13 ® (o S &1 4. 3 ICXo - Aeration Bldg. Sewer 2 1 Holding 1 Inlet 9 10 1 - `45 TANK SETBACK INFORMATION D/ Outlet TANKTO P/L WELL BLDG. Air to ir I ntake ROAD Dt Inlet A Septic 90+ - 7c; O` Ia NA Dt Bottom 17-22 '17 5 Dosing L S NA Header/ Man. 4910 1014 7 Aeration NA Dist. Pipe 4b 1 04 .78 Holding Bot. System j (o I PUMP/ SIPHON INFORMATION 43 iy , - Final Grade Manufacturer &O ICA S Demand � 4, Model Number E_Pv4 72-GPM TDH I Lift-7.y Friction) System.Z TDHII.11 Ft Forcemain Length "12' Dia. Fia t" Dist. To Well SOIL ABSORPTION SYSTEM TRENCH Width o Length t No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIM N I N ``� DIMENSION SETBACK SYSTEM TO P / L C BLDG WELL LAKE / STREAM LE CHING Ma u acturer: INFORMATION Type Of CHA ER ModelyLer: System:mpVA [�� �8 140 OR UNIT DISTRIBUTION SYSTEM Header / Distribution Pipe(s) 1 x Hole Size x Hole Spacing Vent To Air Intake Length 1 Dia. _� Length __W Dia. t ) u Spacing r I y SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over - xx Depth Of r _„ " xx Seeded/ Sodded xx Mulched Bed /Trench Center i B Bed /Trench Edges +1 ' Topsoil G "12 XYes ❑ No ❑ Yes ❑ No COMMENTS: (include code discrepancies, persons present, etc.) o lf (P O'% AVC #7 ue iQ. pLA. M _ T cr F c - pied od bac K �c�,✓u y� clmr: 3 U�c-C' S Su.►�c� � �a.!^C Dv>✓� +I�,� hor 1 end al •1� mo4�v1 U l�hfa��' M ov ed 15� . fro kti _ S O.Ak dirt � -wIr✓ ins, fM 4 Ae, Zle c•#1/'i l- 1 i he �� +vv&k 4kAiz 1'n Wt15 f Ian revision required? ❑ Yes t No ` Use other side for additional information. SBD -6710 (R.3197) Date Inspecto ' ignature ert. No. ` * �/! SANITARY PERMIT APPLICATION 01 E. W shngtongs ve'sion sconsin , r W; m. P.O. Box 7969 Department of Commerce n accord with ILHR 83 05, s. Ad 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. • See reverse side for instructions for completing this application State Sanitary Permit Number 30 - 7443 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)]. 8cvnc State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATI N OZ Property Owner Name Property Location d µ 14 114, S T� D , N, R E (or& Property Owner's Mailing Address Lot Number Block Number A6 51 ev e- � City, State Zip Code (hon C �C M Number Vo a . Z . .sue d S • II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ it y Nearest oad ? ❑ village Public 1 or 2 Family Dwelling - No. of bedrooms y Town OF �2 v i 1yv� 111. BUILDING USE (If building type is public, check all that apply)) Parcel Ta 1 C] Apartment/ Condo A 8. /7. 18A �/ ° y ! 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 S ❑ 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. X New 2. ❑ Replacement 3_ ❑ Replacement of 4 ❑ Reconnection of 5. ❑ Repair of an ________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 En 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) Elevation Z/1610 _5_ 37r. r CC Feet 0.4. c/ Feet VII. TANK Capacity allo s Total # of Prefab. Site Fiber- Exper- INFORMATION New Existin Gallons Tanks Manufacturers Name Concrete st acted Steel glass Plastic App Tanks Tanks / .� Septic Tank a Ptultli�+ Wewk� 0 f E] 13 11 1:1 00 A yA Lift Pump TankA*1 a @hen ✓ �Or w�J r�V'� 1 0 1 ❑ 1 ❑ ❑ 10 10 VI11. 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) , P AA PRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code): 7,4 ge v e't�) �4l IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate Issued Issuin Agent Signature (No Stamps) �[ A roved pp []Owner Given Initial ap Surcharge Fee) �'1) Adverse Determination Z 80 /40 X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6398 (R. 11/96) DISTRIBUTION: Original to County. One copy To: Safety 8 Buildings Division, Owner, Plumber SAFETY AND BUILDINGS DIVISION 2226 Rose Street Nvisconsin La Crosse, WI 54603 Department of Commerce CON Tommy G. Thompson, Governor 03- Mar -98 William J. McCoshen, Secretary Wegerer Soil Testing & Desig BRUCE MOLL 421 N Main St PO Box 74 River Falls WI 54022 MOLL, BRUCE Plan ID 9820273 NW,NE,5,28,17W Municipality of PLEASANT VALLEY Inspector: Leroy G. Jansky County of St Croix (715) 726 -2544 Private Sewage plans including the following element(s): MOUND 450 GPD 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 chapter 101.01(2)(e), Wisconsin Statutes, is responsible for compliance with all code requirements. This plan action is subject to the conditions listed on the following page(s). 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. All permits required by the state or local municipality shall be obtained prior to commencement of construction /installation /operation. This project is under the supervision of a state inspector. As inspection concerns arise feel free to contact the state inspector at the number listed. The inspector for this project is listed above. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Please refer to Plan ID number listed at the top of this page when making an inquiry or submitting additional information. Sincerely, 6 erard M. Swim POWTS Plan Reviewer (608) 785 -9348 I , SAFETY AND BUILDINGS DIVISION 2226 Rose Street C� LaCrosse, Wisconsin 54603 hsconsin Tommy G. Thompson, Governor Department of Commerce William J. McCoshen, Secretary Page 2 98 202 3 - A Sanitary Permit must be obtained from the County where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats, prior to installation. - Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(d), Wis. Stats. SBD- 5524 -E (R. 2/98) File Ref: H: \STANDARD PARAGRAPHS APPROVAL LETTER.DOC Page of 6 MOUND SYSTEM i1 - 2 7 3 FOR A 3 BEDROOM RESIDENCE LOCATED IN THE MW 1 /4 OF THE N 1/4 OF SECTION S ,T N, R 1 7 W, TOWN OF COUNTY, WISCONSIN. R F INDEg PAGE 1 6 TITLE SHEET 1998 PAGE 2 of 6 PLOT PLAN ``��S. 0/1� PAGE 3 of 6 PLAN VIEW -CROSS SECTION PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT .PAGE 5 of 6 PUMPING CHAMBER ' PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR Btz v c. ri v L_ L_ 16s1 o `ny 0v PREPARED BY WEGEF;tER SO I L TEST I NG a�144a4w AND �Q► �gCONS� P.O. BOX 74 421 K. VAIM ST. ART L. • wErERER RIVED. FALLS. YI 54022 = 0.P eus P.O.W.T.S. 715- {25-0165 /� w C onditionally C A PPROVED OF DEPARTMENT ( 5EE SION F TY A COM B 4DIN `S CORRES DENCE JOB NO. ��` PLOT PLAN • Page of 6 Scale 1"= L1O' r !, - 60 `m RV E. /Z m ` Tb Q :T �Z o � � �0 IS y J l/ u9.75 104 � I' l'•� In 3,IS r � C tz-O ,udT / � Q • 1 1 y 83 � a (� • �301�� t o �� —� WELL TO '3F PSI' Le "T S 0 ' PLUM 2.s' TPrvlzs . NOTES •1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. ( Z required) 3. Install 4" observation pipes with approved caps. ( Z required) 4. tank to be Nrin IhSri gallon capacity manufactured by Yv� bw lzaT Qjt. PRLRtAj r t NJ a . 5. Bench Mark Z.Rv ►oo•o' otir 4TLF?_ idfrL '%Orse 6. Divert surface water around system to prevent.ponding at the uphill side. Page Of 6 Approved Synthetic Covering 19s�t� c 33 Distribution Pipe Medium Sand _ H Topsoil G. F Elev. 3 D b 2. °!o Slope - , (Force Main Plowed - Trench of z " -2 2" From Pump Layer Aggregate Undisturbed D 1.O Ft. Soil E ♦ •OS Ft. j Cross Section Of A Mound System Using F o.$ Ft. 1 Trench For The Absorption Area G p Ft. A_ Ft. H t• S Ft. B — Ft. I I Z Ft. Linear Loading Rate= 4 �gGPD /LN FT J 8 Ft. Design Loading Rate= o- 3GPD /SQ FT K O Ft. L ♦ VA Ft. A Position of Force Main Z --�� W �_ Ft. B K AL -- r — — — --- — — — w %� Distribution \, Trench Of 2 - 2 2 Pipe Aggregate I Observation Permanent J Markers Pipes (anchor securely) I Mound Using I Trench For Absorption Area j Page Of 6 Perforated Pipe Detail 0 End View Perforated End Cop � PVC Pipe Install permanent at end-of each lateral Holes Located On Bottom, Are Equally Spored Q End Cop * PVC Force Main Distribution Pipe Last Hole Should Be Next To End Cop Dist P i p e Layou P y 6 Ft. X Inches Y Inches Hole Diameter — )/y Inch Lateral 1 IA/ Inch(es) Manifold — Inches Force Main Inches #of holes /pipe V3 Invert Elevation of Laterals lb y. Ft. Place 1st hole Z-Z N from tee with succeeding holes at LL 11 intervals. Last hole to be next to the end cap. Combination Sep"c;Tank and PUMP CHAMBER CROSS S ECTIOM A RI D SP ' PAGE S OF VEAJT CAP WEATHER PROOF JUWCTIOU 80X - i'C.I. VEKIT PIPC APPROVED LOCKING 110' FROM DOOR, MANHOLE COVER wlTll •dINDOW OR FRE5N w ARlJIAIG L.PttjEl.. AJR INTAKE coraCulr s I �I rj b MfrY 18' Mild, y�lusl��c�o►.� PIPE PROVIDE { --- -- W LE T � AIRTIGHT SEAL I I I APPROVED JOINT A I I i APPROVED JOIW I III W /C.I. PIPE-�KPVc W(C.I. PIPE aR Tank construction I II shall comply with ALARM P Y I 11 ILHH (83.15 and 33.20 a I I I i ow C I I °► U.� S FT I CLEY. PUMP —� - -� .. OFF 0 CONCRETE BLOCK 3" APPROvet, RISER EXIT PERMITKI) OAILy IF TA MANUFACTURER HAS SUCH APPROVAL g SPECIFICATIC)US SEPTIC f DOSE TANK MAIJU FACT URGR: \'O"S)h 4 LII WT A4 \- 3T WUMbER OF DOSES: 3 'b 9 PER DA4 TAIJK .,IZC ti � GALLOUS DOSE VOLUME I ALARM MAIJUFACTURCiZ: IAICLUDING SACKI'LOW: S 3 GALLOMS MODEL IJUMBER: `b` �w CAPACITIES: A= l $ WC14E50R 3 oE' GALLOI,I5 swITCH TYPE: _ 'Y B = � IN 3 G{I CHES`OR � LLOUS PUMP /"IAWUFACTURER: ` �S C 9 101 OR �S 3 GA L L OU5 MODEL MUMDER: 3 �1 I D- IMCHES OR \ GALLOMS SWITCH TYPE: Y�� — QCU1L MOTE: PUMP AMD ALARM _ RAE TO OE MI DISCKARGE RATE 3o '� Z GPM INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFEREWCE DETWECU PUMP OFF AIJO..DISTRIBUTIOIJ PIPE.. 10` \S FEET t mimmUM METWORK SUPPLY PRESSURE , .. 2 54 FEET + y $ FEET OF FORCE MAIM X L 46 - 1 F Xo f EFRICTIOLI FALTOR -. �'� y FEET .= TOTAL OyUAMIC HEAD = � " FEET Pump chamber DIAMETER 3$, INTERAIAL DIMLWSIOM� OF TAUK : LENGTH ;WIDTH _.-- ;LIQUID DEPTH BOTTOM AREA — - 231= GAL /INCH ac DT; T7 MAI�TTTI:AC'TiTRP'R = ,� GAL /INCH Goulds V-T� Lr 6 or- 6 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. Available for automatic and tic cover with integral handle Motor: and float switch attachment • Farms manual operation. Automatic • Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical points. • Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, built in overload with preset at the factory. rated oil and water resistant. automatic reset. ■ Bearings: Upper and lower SPECIFICATIONS • EPOS Single phase: 0.5 HP, FEATURES heavy duty ball bearing 115 V, 60 Hz, 1550 RPM, Pump: EPO4 built in overload with ■ EPO4 Impeller: Thermo- construction. • Solids handling capability: automatic reset. plastic Semi -open design 1 /4" maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING • up t to 24 feet. standard l ength, p ong grounding ng mechanical seal protection. 0- Canadian Standards Association Total heads • Discharge size: 1 NPT, plug. Optional 20 foot ■ EP05 Impeller: Thermo- (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in " F" or "AC.) rotary/ceramic - stationary, three prong grounding plug improved performance. BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 • Capable of running — dry without damage to s 30 y s1 components. Pump: EPO5 s - -__ -- 25 • Solids handling capability: ° ; I 1 /4 maximum. a W _ -L--- • Capacities: up to 60 GPM. s 20 i • Total heads: up to 31 feet. i • Discharge size: 1 NPT. z 5 -- -- - — • Mechanical seal: carbon- 0 15 rotary/ceramic - stationary, 4 i3.�lg BUNA -N elastomers. - • Temperature: 3 10 104 °F (40 °C) continuous 113.41 14OOF (6O intermittent. 2 5 1 0 00 10 20 30 40 50 GPM L -L L 0 2 4 6 8 10 12 m -/h CAPACITY 01995 Goulds Pumps, Inc. Effective May, 1995 83871 Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations Division'of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code P � Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but ` - ' ., S , Cr 7f not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or ICEL LD. dimensioned, north arrow, and location and distance to nearest road. ( ceding t cst. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION ! V Y , T El 1F 21A0 1 4ff& 4 `� PROPERTY OWNER: PROPERTY LOCATION Bruce Moll GOVT. LOT N[rJ 1/4 4,8,5 . N, k4or) W PROPERTY OWNER':S MAILING ADDRESS LOT # I BLOCK # SUBD. NAME R 1651 60th. Ave. 2 na CSM $ CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE MOWN NSMrST ROAD Hammond, WI. 54015 715)796 -5491 Pleasant 60th. Ave. : ] New Construction Use [Y4 Residential /Number of bedrooms 3 [ J Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate • 2 bed, gpd /fta- • 3 trench, gpd /ft Absorption area required np_ bed, ft 375 trench, ft Maximum design loading rate .2 bed, gpd /ft .3 trench, gpd /ft Recommended infiltration surface elevation(s) 104.57 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material pitted glacial drift Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL I MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem I EIS KI U as ❑ U ❑ S FLI U ❑ S ®U ❑ S p U ❑ S ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench t'... 1 0 -10 10 r2/2 none 1 2msbk mfr cfw if .5 .6 IR 1 2 10 -26 10 r4/4 none sicl 2msbk mfr Ground 3 26 -36 10 r4 4 none scl 2msbk mfr 4 elev. 103. ft. 4 1 36-70 10 r5 4 c2 7.5 r5 8 scl m na Depth to limiting factor 36" Remarks: Boring # 1 0 -10 10 r3 2 none if .5 .6 ................. .:.._.. 2 10 -23 10 r3/4 none sicl lfsbk mfr 9W if .2 .3 Ground 3 23 -32 7.5 r4 4 none scl lfcfr mfr cfw na 1 .2 .3 103 l ft 4 32 -42 7.5yr4/6 2d7.5yr5/6 scl 2mgr mvfr na na .4 .5 Depth to limiting factor 32" Remarks: CST Name: Please Print Phone: Gary L. Steel 715 - 246 - 6200 A ddress: 554 200th Avg., New Ricb mond, WI. 54017 m02298 Signature: fQ 6 - - Date: CST Number: �( PROPERTYOWNER Bruce Moll SOIL DESCRIPTION REPORT Page? of 3 PARCEL I.D. # Pending Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench 3 ., 1 0 -8 10 r3/3 none 1 2msbk mfr cs if .5 .6 kg : :: 2 8 -25 10yr4 /4 no scl lcsbk mfr qw I if .2 .3 Ground 3 25 -34 1 r5 /4 none scl lcsbk mfr aw na elev. 10 4 34 -50 10 r5 6 2 7.5 r5 8 scl lcsbk my Depth to limiting factor 34" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel Bruce Moll 1554 200th Ave. CSTM2298 NW4NE4 S5- T28N -R17W New Richmond, WI 54017 MPRSW 3254 town of Pleasant Valley (715) 246 -6200 lot #2 -CSM N 1 =40' BM= top of electrical transformer base @ el. 100' 6 I o x �0 , V Gary L. Steel 6 -4 -96 7 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/B C uyer � f 6 Mailing Address 1 60 - '� - -H LIC N a. (,� J 1,, Prop Address 60 1 ` P Y � wP (Verification required from Planning Department for new construction) City/State 1 hn M 0lA d Parcel Identification Number l9 T� LEGAL DESCRIPTION Property Location ' /4, IV L %., Sec. T L 6 P N -R�W, Town of PI�ee S e,,t, Subdivision , Lot # Certified Survey Map # S? (Ml 7 _____ , Volume 12— , Page # .33 Warranty Deed # el (o l 7 �5 , Volume Page # Spec house Oyes ❑ no Lot lines identifiable 2"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 da ys 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 F ILE D 1 2 1998 go ! _ k'.FHLLeN H. tVRtSH S. Croix co.. I CERT FIED SURVEY MAP LOCATED IN THE NW 1,14 OF THE NE I AND IN THE SW 1/4 OF THE NE 1 /4, ALLAN SECTION 5, T28N, RIM TOWN OF PLEASANT VALLE , ST. CROI X COUNTY, WISCONSIN. N 1P CORNER of UNPLATTED LANDS SECT I ON 5. NORTH L 1 NE OF THE NE 114 (ALUMINUM 33 .0 N 89 '10 ° E 66.039 _w 3 89 °45' 10 - W MONUWNT FOUNp) '' 4 .......... ....... ... . o . O `� ....$.. w.. SECT 1 CN 5 E .. ..... o SET CK• �; ��' L I NE a (2" IRON PIPE FOUND). ° w LOT 2 o, .84 ACRXS ^' 5.00 ACRES " o PREPARED FOR NOTE BEARINGS ARE Z (�� W 7 �+ �* co - , REFERENCED - IQ THE N -S - �� to o, v� BRir E .dl�tt OUARTER LINE. ( ASSUMED) o - a TE C CENTERLINE OF °. b X 1 NG DRIVE 15 APPROX. �+ 393.9 396. 70' S' EAST OF WEST PROPERTY L INE. 4 S 89 10 °W S 89 °45' 10 "W 7 z v I �lp,� LOT Q � 14.13 ACRES AREAS Z. Q w f 815, 636 SA. FT.) v O m l4. 08 AC. EXC. R"W e ai ro LOT I J; � (613.456 SO. FT.) � . W 1 4.84 ACRES o K-: - (2 I0, 903 SO. FT.) IfJ• 'S 89 °38' 18" W d 6• 4. s5 AC. EXC. R--W V P68. a 1' v .. W �. ( 198, 932 50. FT. ) .. Q: N V! N O i ° 4 Q7" W r '' SHED 169.45 LOT 2 z: m N a. 5.00 ACRES S 89 585. 1 8' e217,928 SO. FT.) ca 4. 70 AC. EXC. R.- [ 204, 749 SO. FT.) w HOUSE 2 ' NOTE HIGHWAY BUIL4/NG SETBACK 19 100' FROM THE t•- RIGHT -OF -WAY LINE OR 133' L OT 4 �I.� 1 ' 98 FROM CENTERLINE, cm Q 20.49 ACRES w F . (892, SO. FT.) g ` ;• ,; ! ; cr 20. 44 AC.. EXC. RiW f 890, SOT 50. FT.) V h z ,;rr,; • 30 :Jpv9 r' _ �HWY, SETBACK u:.•;rnva:;lat�. SP I KE. SET IN RiW POST yg Of - ........ �- — Ch, 4s /y ° � X669. 36, _ R, S•TATE g m oo- , c .aa —CENTER •..'�.4 " ,. EAST BpU /N`�_ ���✓C±tl`Isg�r L .f 0 SET I' x 24• IRON (PC ND LANE WEIGHING 1.I3;L9S PER LINEAR S I!4 CORNER OF SECTION FOOT. 5. (ALUMINUM MONUMENT Y �, 41 FOUND) WEBER S • '1804 SPRING VALLEY ! 300 O 300 600 900 WIS A lp s y � GRAPHIC SCALE — FEET ♦ ° �s�� s 65 x " 0 ' Qa� SHEET I OF 2 JA M. WEBER 5 -- 1804 NELSEN -WEBER LAND SURVEYING 96 -87 THIS INSTRUMENT DRAFTED BY JIM WEBER DATED 0.�•� - tom 'm -� �,'°1� VOLUME 12 PAGE 3420 T /TJ WHVS:TT zow BZ 'hpW S69S962-ST.L : 'ON XUA 011 S3DION3S Ail - 11in SilOW : WO?jj T"" spow-a azaamw Pon asce"Dme "'I'A DOCUMENT HO. WARRAHM STATE MR OF WWOMW FORK I NO VOL Oyu 1`222*26 Rugene F. Neuendorf ce and Joy Weneudorf REGMS Offia ... idd-iff f ii _ C4 .. jawt ... tia 1w . . ... ............... SEOMMM ................................ . ...................................... ................... 6K b=d ....................................... . ......... . ................. . ................................ . ...... . .......... ................. ................... JUL I 81W em'sys "d wumuft to .... Aw3na.-W-tian's M . ..... . ........... ........ ".4olat ... tenants. ............. - - ----------- . 1:30 ...................... 7 ----­------ - - - -------- --­-----­---- &A ........ ............... . .......... . - ..............- ................... . . .................. . . . . ............... . ........... .......... . ................. ............ .............................. . ......... . ... . ... ....................... . . ........ I ....................................................... •................. ................................... .................. ...................... . .................. *A 10nowing an"%" real "tat* to ...... I ...... camly, abate of wieconalm: Tax Pared No: That part of the West Half (W%) of Ifforth6a8t Quarter ( Of sectionk-Five (5), Township TwentyAdght North (T28M),, Rang* Seventeen Went (R17W), lying NoirtbAwlLy of Interstate Highvar 0 1-94"' j , EXCEPT the Bast 400 feet thereof. i s This ........... ... .. ........ ........ .. howuUmd pr 2 0M (is =0 My"0012 to wa"" Basements and e3weptions of record. D" this ..... M . ............... . .......... "Y --- ------- ... . ................... ........................................ ............................ (SEAL) . .. .......... ... . •. ................ ..•.... .......... Bu a -T. u dorf .................................................................. .... .................. .................. . ........ ..................................................................... (SEAL) .. . ..... (SEAL) • ................................ ................................. d .......................... ....N.9mew-orr AUTHRUTICATION ACKNOWL21)GURNT SrATR OF WISCONSIN - - - - ------------------ ST. CROIX aftendad - this -------- dw°f ------ - - - - -- It_- FwwnwL eaiiiiiiI bdwv m this -A ............ a" of -- - - - - - --- - ------ - it-S1. the aba" named ------ --------- - ------- - --------- - - - --- ------- . ..... q ... 1 114 .jjkqp� _qKf --- and --------- --------- -- 0 ---- - -------------- - - ---- - -------- — ----------- . ....... _ffqyqq_.Xquendor.f - - ------------------------------------- TITLE: MENDER STATE BAR OF WISCONSIN ---------------------------------------- (if Bak ----------- – ---- ----- — – ----------------------------------- – ----- ...... ................. autborbW by § 905A6. WhL Stabs.) to iiiiimit erssa --- executed the same. THIS INSTRUMENT WAS 0KArM0 §Y Thomas A. McCormack ...... ..... " ___.....I ................ ........ -- -- - -------- Baldvin, WI 54002 .................... ........... . .... ................... ._.___ –••--- ... .......... County, Wis. (Signatures may be authentinAW or adawwledgeIt. Both crylt not, state expirallon are not necessary.) ................. 1 1 9 ......... *Noma of pwomw skubw in ow eapstft shmid be tnwA or prtsted bdow dwAr alkwooftweL WAIWAN" LxiD STA18 BAR OW gCOSaWf W%corwn Lept 81w* Co.. Inc. V0AN I&L 2— man Milwaukee, Witwnsin _ FIL 1 2 1998 ® fj k JHLEEN H. WALSH 5'7481'7 \� s CroixCo� "wl CERTIFIED SURVEY MAP LOCATED IN THE NW 1/4 OF THE NE 1/4 AND IN THE SW 1/4 OF THE NE 1/4, ALL IN SECTION 5, T28N, RIM TOWN OF PLEASANT VALLEY, ST. CR01 X COUNTY, WISCONSIN. N I14 CORNER OF SECTION 5. CO VrPL TTED LANDS NORTH LINE OF THE NE 1/4 .....: ........ .... - . iS (ALUMINUM _ 33 . ' N 8 9 ° 10 "E 66. — W� $9 ° 45' 10 "W MONUMENT FOUND) • w_ IT15.6 60TH AVE 383 .95' 33.0 ' v, 399.28' T " " " " " " " "' w N 89 °45' lO "E (h "'u► w NE CORNER OF O o w W ..o .... ,......o........... . ............................ ........ SECTION 5. o_ HWY. SETBACK /' L I NE o (2" IRON PIPE FOUND). OT I o N LOT 2 �_ y 84 ACRES ro 5.00 ACRES P' cy NOTE : BEARINGS ARE z m o '^ up o PREPARED FOR REFERENCED TO THE N -S - (m b, BRUCE MOLL QUARTER LINE. (ASSUMED) NOTE_ CENTERL I NE OF Q p v EXISTING DRIVE IS APPROX. ro 6' EAST OF WEST PROPERTY - 383. 396. TO' L INE. S 89 S 89 ° 45' IO "W tx v 2 m LOT 3 cn: w 14.13 ACRES AREAS Q (615 S0. FT. O a <: m 14. 08 AC. EXC. R/W a, o Z: LOT 1 J; (613,456 SO. FT.) °D 4.84 ACRES o �_ • (210, 903 SO. FT.) W S 89 °38' 16 "W W; 4.55 AC. EXC. R/W �' 258.61' _ ( 198,232 SO. FT. Q: N w N 01 ^� H: LOT 2 d p SHED 169. 45' 5.00 ACRES • ° ro z (217,928 SO. FT.) �p S 89 38 16 W 585. 18' 4. 70 AC. EXC. R/W - - - - - - - - ( 204, 749 SO. FT.) W HOUSE - z N OTE : HIGHWAY BUILDING o SETBACK IS 100' FROM THE ti R I GHT -OF -WAY LINE OR 133' W LOT 4 RAI` ° `� X48 FROM CENTERLINE. % cc 20.49 ACRES co L (892,686 SO. FT.) cc 20.44 AC. EXC. R/W (890,507 SO. FT.) i z f -_ HWY. SETBACK ` - _ &,. 1 KE. SET I N R/W POST iu "` n't t+ 3i1i111 Le - - , nui, and void N79° 5 - - __- rn' cn REC, AS N7jo5 , 669. 3 N - TE RS TA TE to _ EAST BB N G - ' •,��S+I O SET I' X 24" IRON PIPE S 1 !4 CORNER OF SECTION D L 0t WE 1 GH LNG I. 13L BS PER LINEAR FOOT. 5 (ALUMINUM MONUAdENT M FOUND) WEBER 8 VA SPRING VALLEY 1 Wis. ,rt Q' r 300 0 300 600 900 < GRAPHIC SCALE FEET S L V r SHEET I OF 2 JAMES M. WEBER S -1804 NELSEN -WEBER LAND SURVEYING 96 THIS INSTRUMENT DRAFTED BY JIM WEBER DATED VOLUME 12 PAGE 3420 v t CERTIFIED SURVEY MAP LOCATED IN THE NW 1/4 OF THE NE 1/4 AND IN THE SW 1/4 OF THE NE 1 /4, ALL IN SECTION 5, T28N, R 17W, TOWN OF PLEASANT VALLEY, ST. CROIX COUNTY, WISCONSIN. N 114 CORNER OF-- SECTION 5 UNPLATTED LANDS NORTH L INE OF THE NE 1,14 (ALUMINUM 33.0 1' N 89 ° 45 10 "E 66.03 9 45 —W� $9 ° 45' 10 "W MONUMENT FOUND) " w _ 1715. 6 60TH AVE. ss . ss'33. oo ' �, �, � _3 ss. 2a ' W � w NE CORNER OF o o SECTION 5. (2" IRON PIPE FOUND). L OT I ° ° LOT 2 c Q ;w 5.26 ACRES ^' N 5.00 ACRES f' a, NOTE : BEARINGS ARE o PREPARED FOR REFERENCED TO THE N -S o, 8URCE MOLL QUARTER LINE. (ASSUMED) co ATE_ CENTERL INE OF p .� EXISTING DRIVE IS APPROX.-- a 6' EAST OF WEST PROPERTY q 416.96' 396. 70' L INE. S 89 ° 45' 10" W S 89 ° 45' 10" W Z O e 2 v ` O N LOT 3 13.72 ACRES A y AREAS Z: O U (597,532 SO. FT.) O p Q; N m 13.67 AC. EXC. RiW ao e Z: LOT I J: (595,353 SQ. FT.) W J 5.26 ACRES (229,035 SQ. FT.) W: S 89 ° 38' 16" W 4.94 AC. EXC. RiW F-: O 0 291, 61" o F-: (215,275 SQ. FT.) <: mw N OI 33' 07 ' W m I-: LOT 2 a: p SHED 106.45' N 5.00 ACRES •°° S 89 ° 38' 16 "W 585. 18' �= (217,928 SO. FT. a`o 4. 70 AC. EXC. RiW - - - - . ( 204, 749 SO. FT.) W HOUSE a NOTE; HIGHWAY BUILDING SETBACK 1S 100' FROM THE 1- RIGH FROM CENTERLINE. OR 133' y LOT 4 cr 20.49 ACRES co L_" (892,658 SQ. FT.) � cr 20.47 AC. EXC. R1W (891,569 SO. FT. ) y I Z SPIKE SET IN R.- POST 2 w o N 79 0 53' p ? . w ss 9. 6 , s` h 3 - -- _ O WEIGHING 1.13LBS PER PLINEAR S 1/4 CORNER of SECTION _ P SG ��/ � FOOT. 5. (AL UMI NUM MONUMENT FOUND) '* 1 300 0 300 600 900 C GRAPHIC SCALE — FEET ti� � t� SHEET I OF 2 JAMES M. WEBER S -1804 NELSEN -WEBER LAND SURVEYING 96 -87 THIS INSTRUMENT DRAFTED BY JIM WEBER DATED y v CURVE DATA NO. CENTRAL ANGLE RADIUS ARC CHORD CH. BEARING 1-2 02 0 27'25" 5914.58' 253.61' 253.59' N81 0 06'44.5 "W TANGENT BEARINGS: AT'1= N79 °53'02 "W AT 2= N82 °20'27 "W DESCRIPTION A parcel of land located in the NW 1/4 of the NE 114 and in the SW 1/4 of the NE 1/4, all in Section 5, T28N, R17W, Town of Pleasant Valley, St.Croix County, Wisconsin, more fully described as follows: Beginning at the N 1/4 corner of said Section 5: Thence N89 ° 45'10 "E along the North line of the NE 1/4 a distance of 915.45'; Thence S01'33'07 "E 2211.65' to a point on the northerly right -of -way line of Interstate Highway "94 "; Thence N79 °53'02 "W along said right -of -way line 669.36'; Thence westerly 253.61' along said right -of -way line, also being the arc of a 5914.58' radius curve concave southerly whose long chord bears N81 °06 "W 253.59' to a point on .the North -South Quarter Section Line of said Section 5; Thence N01 ° 50'21 "W along said line 2051.19' to the point of beginning. Contains 44.47 acres (1;937,153 sq. ft.) subject to 60th Avenue right -of -way and any and all additional easements, right -of -ways or conveyances of record. SURVEYOR'S CERTIFICATE I, James M. Weber, 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 Bruce Moll, I have surveyed, divided and mapped the above described parcel ndoAo that this map is a correct representation of the boundary thei�-of. ,G s� Dated this day of 11996 .z AMEX it YfENkk 3 • � Frl1 .. James M. Weber 5 -1804 SP HIMO VALLEY ! NELSEN -WEBER LAND SURVEYING Les. 0 4D w Note: The parcels shown on this map are subject to State, County anlbty�� rules and regulations. (i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St.Croix County Zoning Office and the appropriate Town Board for advice. SHEET 2.OF 2 96 -87 This instrument drafted by Jim Weber