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HomeMy WebLinkAbout026-1117-10-000 ST. CROIX COUNTY ZONING DEPARTME Y �P 'A AS BUILT SANITARY REPORT _; 1.<:/0; 4,;r Owner ell s e Addressl .nS° City /State Legal Description: Lot Q9 Block Subdivision/CSM # WXQ,,.,,� e- '/, Ao '/1 5G y Sec. �, T .30 N -R /d W, Town of jQ PIN # QQ6- A)7 -/D SEPTIC TANK — DOSE CHAMBER — HOLDING TANK INFORMATION: Tank manufacturer ULL -0.0 -- Size ST/PC IaW Setback from: House Well VIA P/L 7 a / Pump manufacture_ r 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: - Aaj Width /a Length 7a Number of Trenches Setback from: House .Q 11 Well P/L ..7, Vent to fresh air intake ELEVATIONS Description of benchmark S 06tnLa.-, f Elevation Description of alternate benchmark Elevation Building Sewer Of 7A ST/HT Inlet 9 9. ST Outlet-- 5 13, 74 PC Inlet '-- PC Bottom Header/Manifold Top of ST/PC Manhole Cover / 3 Distribution Lines( 9 &, O ( ) Bottom of System( ) '37, 5 ( ) ( ) Final Grade ( ) / d /, ( ) ( ) Date of installation 7 A /9 e - Permit number D State plan number Plumber's i nature License numbef a D 5 3 ] Date //L/ Inspector —o/d fr, complete plot plan a i 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 A �tf7� INDICATE NORTH ARROW ,,, WjFconsin Department of Commerce PRIVATE SEWAGE SYSTEM Y Safety Buildings Division Count ST. CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitarxi Personal information you provice may be used for secondary purposes [Privacy L , s.15.04 (1)(m)]. � frt Tftbf K1M JOINT VENTURE [ JT�, 8"e Town of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Ta2r� :1117-10-000 L 6Z7 1 L o"t S fad TANK INFORMATION ELEVATION DATA A9800295 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Se tic tV ( t Z Ben! r (�. too Dosing A Aera n Bldg. Sewer 4 7. - L 4 77 , Holding 6p* Inlet ?Z A TANK SETBACK INFORMATION 4 Outlet TANKTO P/L WELL BLDG. Airintake ROAD Dt Inlet eptir r �, ' NA Dt Bottom Dosing NA Header /Man. tp16, '_7B.� Aeration NA Dist. Pipe Holding Bot. System �� ,3 , ef? ,.5�1 PUMP/ SIPHON INFORMATION Final Grade 1 79.5 ­ /00,9 Manufacturer emand p . Model Numb GPM TDH Lift Friction stem TDH ' Ft Qs ead Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM RENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. , Liquid th DIMENSIONS �2 77, 1 DIMENSION SYSTEM TO P/L BLDG WELL LAKE /STREAM CHA LEACHI anufadure SETBACK ER INFORMATION Type 2U f f � ff OR UNIT - del Number: Syste : ✓ X / DISTRIBUTION SYSTEM Header/ Mani f old Distribution Pipe(s) „ y x Hole Size x Hole Spacing Vent To Air Intak5 Length (G Dia. Length T C Dia. "r Spacing � A C_ t+ 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: RICHMOND 01.30.18.681,NE,SW 1755 144TH STREET A - C - E A f - Z,,46 ,K � s �`�' a�oo v , e, `3 Stz.,, O r i(1 � Plan revision required. ❑ Yes ef I Use other side for additional information. SBD -6710 (R.3/97) Date Inspect&. Si Nature Safety and Buildings Division *SANITARY PERMIT APPLICATION 201 E. Washington Ave. 6cons 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. • See reverse side for instructions for completing this application State sanitary Permit Number The information you provide maybe used by other government agenc programs GhecK if revision to previous application [Privacy Law s. 15.04 (1) (m)J. 1755 NW ono j� /�Q � ' v , ` State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION Property wner Nam Property Location c % ¢ �Q h11�1/4 c., W 1/4, S T 3Q , N, R [ ) W Prop s Owner' aiIIn g Address Lot Number Block Number l z� P c.s �i AA J4 Cit , State Zip Code Phone Number Subdivisio Name or CS Number RC 11. TYPE OF BUILDING: (check one) ❑ State Owned E] lt� Neares Road Public 1 or 2 Family Dwelling - No. of bedrooms N Town OF 111. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 E] Apartment/Condo /, 9 0 • / v • IP9 l (o 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 OrNew 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 7��? Date Issued �L$ p8 V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 E] E] eepage 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. 17 . Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation todo ?$ E: �G it 0 /7,.5 Feet X41 Feet Capacit VII. TANK in gall xper. Total # of Prefab - Site Fiber- E INFORMATION g Gallons Tanks Manufacturers Name concrete con- steel glass Plastic App New Existin structed Tanks Tanks Septic Tank or Holding Tank ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ED ❑ El 11 El VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Na int) PI ber's Sig : (No tamps) MP /MPRSW No.: Business Phone Number: QC &A,I s S t 5 S Plum per's Address (Street, City, State, Zip C de): 5`� %J� C) IX. COUNTY / DEPARTMENT USE ONLY [:]Disapproved Sanitary Permit Fee (Includes Groundwater ate I ssued Issui g Agent Signature (No Stamps) Y Approved ltn Surcharge Fee) ❑Owner Given Initial mi Adverse Determination X . CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: D1157R16UTIOM: Original to County. One copy To: Safety & auildings Division, Owner, Plumber 6 I I - Ldi #-Ae r, - 1 ax 7 r 7. I i 7- i I i r i I i i I i I I I ! I I a _ I 31 a° �Q}I Or'� p� rl IJrI� S p�r_'n -� I (v F V S S V T3o u P/ h F(es.A AIr Inlets. And Obtervallon Plp• Ts C A ----- Appro.'md Venl Cap • n Ml�lmwn 12 ADare Finol O r a de , 20- 42' AEo.a Pipe — 4' Carl Iron To final O1ede Venl Pipe s.lor.n Hoy Or SrAt 41k Co..riny win 2' Ayyreaala . 0141 Pipe DIe1111; lion Pipe •� 0 0 0 Tee s 6 AaylaOale �! Beneath Pipe ° Perlo/oled Ply• below o — Co.pllno Te.nlnaling Al Gollom Or SF►lem P �Dpo5eD Pit ne.I S %clt SOIL FILL DISTRMUTIOM PIPE ., A PPROVED S4)JVETIC COVCp, 2" OF 1�GGRI;GATE MATf- RIM- OR 9" OF STRAW OR MARSH NAy 0F.2 -24 AGGREGATE v^ �� R z � �L E V. o f 7. S� EJE e DISTRIBUTIOM PIPE TU BE AT LEAST .Z IIJCHES BELOW ORIGIFJAL, GRADE AQU AT LEAST LO IIJCHEL BUT MO MORC THAI) 41 IIJCHES OELOW FIMAL GRADE MXIM Mr OF E FROM OKI CWAL 6�1\K WILL BE ' Q S� _ Iu C HE S T11 ilmum pEF r•N OF EACAVATION r-R 0� 116IVJAL GRAPE WILL 6E —_-_CZ INCHC S SIGIJED: LIGCtJSC I ans3� DATE. —` 7' /' " 1 - - -- -• • -.__.. I to _ Wisconsin Department of Industry SOIL AND SITE EVALUATION Labor and Human Relations Page / of 3 Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Attach complete site plan on paper not less than 81/2 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. # APPLICANT INFORMATION - Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy taw, s. 15.04 (1) (m)). Property Owner Property Location [ P ropert-y- �� P Govt. Lot N-e 114SW 1 /4,S Q' T �� ,N,R �� Wr) W w ner's Mailing Address Lot # rBl Subd. Name or CSM# s os S �P�a 9 VCL I'Ao o m City State Zip Code Phone Number Nearest Road N �� El city ❑Villa To w GG, New Construction Use: Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow ( gpd Recommended design loading rate • 7 bed, gpd/IF trench, gpd/ft Absorption area required 959 bed, ft ft Maximum design loading rate bed, gpd/ft e— trench, gpd/ft Recommended infiltration surface elevation(s) 9 7i ft (as referred to site plan benchmark) Additional design /site considerations Parent material O 4 %.4 CL-. h Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system [As E) U ❑ S U 7S ❑ U I ❑ S V U I [gS ❑ U ❑ S CZ U 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 l D -fl /a r 3 L �.rnsbk n• S Z.Z / S/ CQ I. I r , S Ground 3 :3 S f mi elev. /eft• y 6.9 o r — s os m l — -- � � , � Depth to limiting factor Remarks: Boring # _ro 3a 6 k to, Ant i •� p r 1 Ground `l /o r '1. elev. /w f ft . Depth to limiting fa �in. Remarks: CST Name (Please Print) ig ture Telephone No. C,ci r 7- /y -9f1 1 - Address Date CST Number \10� ` �o�r ©� OIL DE REPORT PROPERTY OWNER n V .Q � _, , Page � of PARCEL I.D.# ;(p -- I t l 7 ) 0 Borin g # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 64 lb r Z o 2 len S W a S S' / 6 0 r - Af J r q v Ground elev. '7 ff Dept to limiting f ctor Remarks: Boring # x: I Ground elev. ft. Depth to limiting J factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # Ground elev. ft. Depth to limiting factor ' Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBDW -8330 (R. 08195) • _I oll I 1 o h c,�Jk`e . - — - - -- - — -- I I _ i � �5 I I I f I I I I I I O I - - - -- - I . f , i I I I I i I i A) "V I i I t I i I i i i I � I ' 3 9- 17 1 1 Gad' •Wisconsih Department of Commerce PRIVATE SEWAGE SYSTEM Count y: Safety "and Buildings Division INSPECTION REPORT ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitar Permit No.: Personal information you provice may be used for secondary purposes [Privacy L , s.15.04 (1)(m)]. 307697 fff LiIL�yWerik ft JOINT VENTURE I E Vf � Off EJ Town of: State Plan ID No CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax .: 76- 1117-10-000 TANK INFO ATION ELEVATION DATA A9800086 TYPE MANUFACTURER CAPACITY STATION B HI FS ELEV. Septic Benchmark Dosing Aeration Bldg. Sewer Holding St/ Ht 1/t TANK SETBACK INFORM A ON St/ H j ro uti et Vent to TANK TO P/ L WELL BL G. Air Intake ROAD D nlet Septic NA t Bottom Dosing NA Header /Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer a nd Model Number G TDH Lift Friction System TDH Ft oss —" ead Forcemain Length E Dia. Fi t. To well SOIL ABSORPTION SYSTEM BED/TRENCH Width Lengt No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIME I N SYSTEM TO P/ L BLDG WELL LAKE/ S EAM LEACHING Manufacturer: SETBACK CHAMBER INFORMATION Type O Mode Number: System: OR UNIT DISTRIBUTION SYSTEM Header / Manifold tribution Pipe(s) x Hole Si x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade S terns Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil El ❑ No ❑ Yes El No COMMENTS: nclude code discrepancies, persons present, etc.) LOCATION: RICHMOND 01.30.18.681,NE,SW 1755 144TH STREET Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert No. SANITARY PERMIT APPLICATION 201E Washingt a nd A s 1*6consin P.O. Box 7969 Department of Commerce In accord with ILHR 83.05, Wis. Ad m . Code Madison, WI 53707 - 7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 1/2 x 11 inches in size. ` • See reverse side for instructions for completing this application State Sanitary Permit Number 302 �I 2 The information you provide may be used by other government agency programs ❑ Check if revision to previous appl ►ion [Privacy Law, s. 15.04 (1) (m)). State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION Propprty Owner e ( Property location V �JO n nJE 1 /ash va, S I T, N, R j fir) W Property Owner's Mailing Addres O Lot Nurrilher Block Nu mb er City, StataL Zip Code Phone Number SubdivTn Name o SM Number 77 v © l O ( ) -e r S II. TYPE OF B ILDIN : (check one) ❑ State Owned ity Nearest Road G - Village ff ' Public 1 or 2 Family Dwelling - No. of bedrooms own of d. N w III. BUILDING USE (If building type is public, check all that apply) arcel Tax Number(s) 1 ❑ Apartment/ Condo a (0 — l 11 — ID 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.'`R New 2. [] Replacement 3. E] Replacement of 4. E] Reconnection of 5. E] Repair of an ___ //_ - System ________System _____________Tank Only______________ Existing System _________Ex --- - 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 E] Mound 30 [] Specify Type 41 ❑ Holding Tank 12 Seepage Trench 22 ❑ In- Ground Pressure s 42 ❑ Pit Privy 13 ❑ Seepage Pit 2. X �2 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade r ®� Requir d (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation Feet Feet VII. TANK Capacit in g allons Total # Of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con Steel glass Plastic App New Existing structed Tanks Tanks epticTank ot� (� La f^ ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ 1 ❑ 1 ❑ 1 ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for ins a ' n of the onsite sewage system shown on the attached plans. Plu ber's Name: (Print Plu er' Sign ture: S mps) MP /MPRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code): Cf I IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater D ate Is Issuin Agent Signature (No Stamps) li�A pp roved []Owner Given Initial Surcharge Fee) `-�'/ �� � �O 61"J Adverse Determination too X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SB0 IRA 1/96) DISTRIBUTION:" Original to County. One copy To: Safety a loildi gs Division. Owner, Munber I e i , C C 25 6 e s 16�t 57 ell as • - I - I R k At PIN n v _ 3 /3 .31 , PAGE _ OF C r U S'S S �c�Iol� o� 2 V r l'� S y t,v.� F(I1A Alt Wall An0 0b&atvap0A pipe C) s ` w `j 'N.eLWD R � UWmum 12'Above � Approvid Vaal cap fit-al Cede tvi� Yt spy �S I - 20. 12' Above Plpr 4 Ca►1 bon y To flnol Orede Vanl Pipe 1 / SS _ l 7 l � f � ua,sh Ilo 00t t S nlMlk Co�uln u1A 2 pVg,epola C ©t Olal - tip. ` 0 0 0 Taa e V AiYrogele Beneath Pipe ° P41101064d Pipe 1' . go ° r"e""All Twalln°Ilnp Al ! r 6 0110nt Of S7elam P ro poI.e. D Ptne.I 9ri.c-1-C SOIL FILL DISTKIBU7101.1 PIPE 2"0 F&GGRE1GA1F. - -' r • ..`APPROVED +Syl PETIC COVCR !'IAT�KIgI. Olt 9" OF 57R1�W / OR tjAKSN HAy � o raa,3 FE . L. oPr 2 AGGREGATE DISTRI15IUTIOM PIPE To INC AT LEAST — Q _ 0 AuU AT LEAST LO 1lJCHES BUT 1.I0 MORE THA►.l ti2ElIJCNES BELOW I F L CFtAOE M XtMUM DaPrH Of fXCAVATIo0 F40 O 1GIh1 L 6 1'11 oEPn oFExcAVAnaN K rho wl�L BE -iq INCHES pm 1 1 1 gL. G RAvF- WILL BC � INCHES SIGIJEO: LICE►JSC NUMBER: ao�0 53 DATE' " Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Hurhan Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. Croix not limited to vertical and horizontal reference point (BM) direct ion and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nea "t 026 1117 - 10 - REVIEWE BY DATE APPLICANT INFORMATION- PLEASE PRINT ALL - 1NFOR A� �� PROPERTY OWNER: � `� PERTY LOCATION R� Derrick Construction, Inc t � . LOT NE 1/4 SW 1 /4,S01 T 30 N,R 18 X (or) W PROPERTY OWNER':S MAILING ADDRESS BLOCK# SUBD. NAME OR CSM # 1505 Hwy #65 na I Willow River Meadows CITY, STATE ZIP CODE PHONE NU NTY ❑VILLAGE ®TOWN NEAREST ROAD New Richmond, WI. 54017 (715) tCE Richmond Hwy GG New Construction Use Pc ] Residential / Number 6(bedWtr Q N , 4 [ ] Addition to existing building (] Replacement [ ] Public or commercial Code derived daily flow 600 gpd Recommended design loading rate ' bed, gpd /ft ' 8 trench, gpd /ft Absorption area required 858 bed, ft 750 trench, ft Maximum design loading rate • 7 bed, gpd /ft • trench, gpd/ft Recommended infiltration surface elevation(s) 102.30 ft (as referred to site plan benchmark) Additional design / site considerations trenches spaced to code 3/50 below surface grade Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL I MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING &K NK U = Unsuitable fors stem ®S ❑ U El O U ®S ❑ U El [2FU ® S [3 U [I S U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Y Roots GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tre & ................. .................. ................. :.:.1_:., 1 0 -9 10yr 3/3 none 1 2msbk mfr gw 2f .5 .6 2 9 -23 10 r 4/4 none sicl lcsbk mfr 9w if .2 .3 Ground 3 23 -33 7.5 r 4/4 none sl 2m r mfr CIV na .5 .6 elev. 1 01.4 ft. 4 33 -80 7.5 r 4/6 none MS osg ml na na .7 .8 Depth to limiting factor +80" Remarks: Boring # 1 0 -10 10 r 4/3 none 1 2m r mfr gw 2f .5 .6 2 <' 2 10 -26 7.5yr 4/4 none sl 2mgr mvfr gw if .5 .6 Ground 3 26 -80 7.5 r 4/6 none Ms oSg ml na na .7: .8 elev. 101. 4t• Depth to limiting factor +Fin Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200 ve. New Rich nd WI 54017 Signature: Date: 11 -21 -97 CST Number: m02298 , 2LL:U� PROPERTY OWNER Derrick Constructi DESCRIPTION REPORT Page 2.' of 3 PARCEL I.D. # 026- 1117 -10 - Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounday Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3 1 0 -13 10 r 3/2 none 1 2msbk Mfr r1q 2f -9 .6 2 13 -24 10yr 4/4 none sici lcsbk mfr qw if .2 .3 Ground 3 24 -38 7.5yr 4/4 none sl lcsbk mvfr 9w na .4 .5 elev. 9 9.3 ft. 4 38 -82 7.5yr 4/6 none ms osg ml na na .7 .8 Depth to limiting factor +82" Remarks: Boring # 1 -14 10 r 3/2 none 1 2msbk mf 2 14 -22 10 r 4/4 none sici 2msbk mfr qw if .4 .5 3 2 -35 7.5yr 4/4 none is oscf mvfr qw na .7 .8 Ground elev. 4 5 -80 7.5yr 4/6 none ms oscl ml na na . 7 ; .8 9 6.5 ft. Depth to limiting factor + 80" Remarks: Boring # 1 -11 10 r 3/3 none 1 2mcir mfr qw 2f .5 ` .6 5 2 1 -22 10yr 4/4 none sici lcsbk mfr gw if .2 .3 Ground 3 2 -80 7.5yr 4/4 none ms osg ml na na .7 .8 elev. 1 05.8 ft. Depth to limiting factor +80 Remarks: Boring # 1 -6 10 r 3/3 none 1 2msbk mfr qw 2f .5 6 2 6 -14 10yr 4/4 none sici lcsbk mfr cfw if .21 .3 Ground 3 14 -42 7.5yr 4/4 none sl 2mar M r Crw na� elev. 10 ft. 4 42 -80 7.5yr 4/6 none ms os m i, I Depth to limiting factor Remarks: SBD- 8330(8.05/92) STEEL SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Derrick Cosntruction, Inc. New Richmond, WI 54017 MPRSW 3254 NEaSWa S1- T30N -R18W (715) 246 -6200 town of Richmond lot #29- Willow River Meadows N IL 1 " =40' 6C BM.= top of SE lot stake @ el. 100' �IJ Alt. BM.= top surv of Mid -lot stake C el. 90.20' Y ti k h a� t 1 A .,35' 3 t' iff a� I 2V' 8� off. Gary L. Steel 11 -21 -97 I ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerMuyer \ wVw w V'1-144 r - \Afft4 4d- M LC*44,EL- SMVc If Mailing Address PO (?�O X 4 V--L M y N c , W T S4e0 1 . 1 Property Address 1 S S 1 44.1 - E-t- Cyr 1Q, (Verification required from Planning Department for new construction) City/State w P4(-N M4 N0 Parcel Identification W p Number O'Lb - 111 - 1-tO —0 00 LEGAL DESCRIPTION Property Location b4E '/4, 5W % a, Sec. , T 3 N -R 19 W, Town of Pt C.HKA Subdivision \04%%A 4W [?.v. M.�ws Lot # 2 9 Certified Survey Map # , Volume . Page # Warranty Deed # _ 4 5't- e , Volume It C. + , Page # 4S 9 Spec house )<yes ❑ no Lot lines identifiableXyes ❑ 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 t your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days thathree ea r p' 'o te. GNATURE OF APPLIC 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 pro rty descri bed bo � y virtue of a warranty deed recorded in Register of Deeds Office. GNATURE OF APPLI ANT 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 452767 GUARDIAN'S DEED REGISTER'S OFFICE ThisDeed, made between .......................................................... ST. CROIX CO., WI Gertrude E. Schmit by Recd for Record ..................................................... .. ...... .................................................................................................. , Grantor, ............... ......... OU11221989 ........................................................................................ and ..... Michael R. Stevens, William . H. Derrick, 8 A M ...................................................................................................... ........... W i.1.1. i. a.m.. M.... _Pe r.r. i c.k ..... E. Derrick and . .... . .... .. ....................................... .......... RgnAA ... L. t... P.e. K r.i. q.k..?.us .. t.e.jRAAt;$ ... in .. P.Q.Mwn ............. I Reg hterofDeeds ................................................................................................... Grantee, Witnesseth, That the said Grantor, for a valuable consideration ... E.....S.qhm.i.t..by B.................... conveys to G rantee the following described real estate in County, State of Wisconsin: Southeast Quarter of Northwest Quarter and Northeast Quarter of Southwest Quarter of Tax Parcel No: ................................... Section 1, Township 30 North, Range 18 West. This deed is given pursuant to the Order to Sell, dated October 16, 1989, and the Confirmation of Agreement and Order, dated October 19, 1989, both duly authorized by order of the Court and whereas the undersigned, Beverly Buckner, is authorized to sell the same by Letters of Guardianship certified on October 22, 1989. vS. FEB X I-P 2 i'M This ........ i Sn o t ...... homestead property. .... .... .. (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And ..... Ge-r.tr-ude .. E-....S.chmit ... by ... Be.ver.ly.. Buckner ........................ ......... ............................ warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and rights-of-way of record, if any. and will warrant and defend the same. Dated this ............... g 0 e /L� day of ......... October .... ............................... .. .... . .... . ............................................ -7 ........... (SEAL) ............. ..................................... Gertrude` E. Schmit by Beverly .................................................................. ------ * ...... ..................................................................... (SEAL) .................................................................... (SEAL) .................................................................. .................................................................. AUTHENTICATION ACKNOWLEDGMENT Signature (a) ....... .................................................... STATE OF WISCONSIN Beverly Buckner as. ................................................................................ ...................................... county. 'I .­j4/' October 89 authentic ted this-..... day of ........................... 19...... Personally came before me this ................ of cl(e t A , 4_ 7-7e"e — ------------------------------------------ P 19.... - -•• the above named ............ Kristina 0gland Lundeen ­ ..... ­' ................................................................................ .............................................................................. ......... TITLE: MEMBER STATE BAR OF WISCONSIN ................................................................................ (If not . ................................................... : ........ ...................................................................... * ......... authorized by § 706.06, Wis. Stats.) to me known to be the person ............ who executed the foregoing instrument and acknowledge the same. K n ................................................................................ ..... At t.o.r n.e-y ... at..Lax ....................................... ....................................................... ................ ................................................................................ Notnry Public ...................• ..... ................ County, Wis. (Signatures may he authenticated or acknowledged. Both -Aly Commission is permanent. (If not, state expiration are not necessary.) date: ..............................................• ......... 19.._...... -Names of persons signing in any eapncity should be typed or printed helt)w their sismatur". i r 1 1 , 1 1 N G. 1 c N,ou G 1� kl i LVAJ 'r N C c i TL I✓1 n 1. � :e check Payable to: WILLOW RIVER i Real Estate STATE OF WISCONSIN 199? Sequence No. Bill No . MARY M KELLY PROPERTY TAX BILL FOR TREASURER TOWN OF RICHMOND Correspondence should refer it 1156 CTY RD G ST. CRO I X COUNTY s« reverse tilde for Important I NEW RICHMOND WI 54017 Computer # 026 - 1117 715- 246 -4129 PAR #01.30.18.6 1 ,essed Valu 1 6 , 200 1 b Ased. Value Impmetnents Total Assessed value, A ve. Merril. Ratio 85.10% Est. Fair end. land Est. Fair end. IaptowrtrMs Total Est. Fair MW. A st 19,000 19,000 D Net Property Tax Est. State Aids East. State Aids 1996 1997 %Tax Taxing Jurisdiction Allocated Tax Dist. Allocated Tax Dist. Net Tax Net Tax Change ATE 3.10 3.71 19.7% ?JNTY 55808 57419 74.13 84.61 14.2% 'WN OF RICHMOND 125866 130227 26.23 36.20 38.0% :W RICHMOND 1559093 1716180 148.19 155.23 4.8% PER WILLOW REHAB 0.00 VOCATIONAL SCH00 29298 29706 25.18 28.59 13.5% 1770065.00 1933532.00 276.83 308.34 11.4X TOTAL Total Lottery Credit • FOR FULI Net Pr Tax 7 ' 70.83 _ -�- �� PAY BY JANUARY 31 r 1 1 ;hool taxes reduced by Net Assessed Value Rate 23 t , iool levy tax credt 38 loan NOT ren.a Ids«y crew► ' $ 'ORTANT: Be sure this description covers your property. This 0 . 0 19033281 81 Warning: If not paid by due dates, crlPtlon Is for property tax bill only and ma not be a fug legal description. H ILL NO. 20845 lost and total tax is delinquerd subji 026 - 1117 -10 -000 applicable, penalty. (See — 30N -18W 2 WILLOW RIVER JT VENTURE Or Pay tat Installment And Pay 2nd u 1 T30N R18W SE NW $ $ 83.34 $ 15 SW LOT 29 OF WILLOW RIVER : JANUARY 31 1998 B Jul ADOWS 2.32AC 1505 HWY 65 PO BOAC A NEW RICHMOND WI Spec I Ch arge 54017 -0000 ecial a Tax Paid Spttcial Total Amount Assessment Paid Paid Trop Balance Due Paid by Rec'd by