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HomeMy WebLinkAbout034-1061-50-000 d g ° y 0 o O d c m F c ° c 3 m m M 3 ID �1 ID � v z O W n c_ 0 � \' 0 z O O w v N 7 w w O N (� Cn N O e� �• _ : a a c O v c � ° w a o m C', (D m m m rn m 0) � r. O N C N N O� pj 03 r O 'r3 N N N O N O. 4 7 ( > > 3 N 7 CD 01 O A IO , E O. A 0 0 0 0 0 O 7 q (D ° N CJ7 D Oo V O Cn N C O N O n 7 A O A7 O 7 O O O fD 0 O y N V Eft N -cn .4 7 O !'\i m A m iD C Q 2 o CD - O cnn I co N ID I co =r N Oo Q> A O (� �M O O (p 0 C) O O O O I(D .,1 j N j 0 0 O O O C) (D "7 � O w r j Ut A co N -< 8 W _.., N CD CC c U) cO co c C y A A 3 O O O O O O �' !�• 3 E ��� A m e N t% ti A o N I3 N N co) O (o o C7 y o C7 O N n O .�i N V cl i D1 ? Ot v In K - N co CD d 3 _ CD (� A O O CD N 0 o'z M. N N z z D D o Q D D c O N v O p N h • m 0 O O 'Mill m CD Vq m 3 CD CD z m N a � A z O C 3 ao u m NJ M Q a m z o 3 " O °o z M cn N ; N CD A A 7 A N O N y D CD - D 3 ci m Q m c- m ? O =. j S g (D �. IO T N Q' O C D) T _ _ C L o z n 0 a cn o m _0 3 3 4 CD a o CD n 4 O � A c ti W � O `J T w vD O w o o Q C) ° ° o IQ ST. CROIX COUNTY ZONING DEPARTM AS BUILT SANITARY REPORT r` ' RECEIVED Owner 1 I � �T ytvt T P Property Address �S� ( b+w� I Z� R �r c City/State In) i I S rn w NTv Legal Description: -; Lot Block Subdivision/CSM # _ Sf '/4 N ' /a, Sec. 24 , T N -RAW, Town of PIN # 6 o6 I SEPTIC TANK -- DOSE CHAMBER -- HOLIMNG TANK INFORMATION Tank manufacturer M D iva Ltieo Size ST/PC IZW/ — Setback from: House 1/. Well too PAL <i� Pump manufacturer Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: Width Length Number of Trenches Setback from: House Well P/L Vent to fresh air intake ELEVATIONS Description of benchmark Elevation Description of alternate benchmark Elevation Building Sewer ST/HT Inlet ST Outlet PC Inlet PC Bottom Header/Manifold Top of ST/PC Manhole Cover Distribution Lines () () ( ) Bottom of System ( ) ( ) ( ) Final Grade ( ) ( ) ( ) Date of installation / S Permit number " "4 State plan number !Sfl It Plumber's signature d n License number 1 M v Date Inspector Complete plot plan e 09/21/98 MON 10:22 FAX 715 386 4686 ST CRX CO ZONING 0 006 a 1 � 1 S ` ' 7 �b r A OF �w 4 !i ' Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count Safety and Buildings Division INSPECTION REPORT Count . CROIX 'GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary 320 Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: ❑ Cit ❑ Villa a Town of: State Plan ID No.: CHRISTIAN, DANIEL SPINGFIE CST BM Elev.: T Insp_ BM Elev.: BM Description: /+ Parcel Tax No.: 034- 1061 -50 -000 (,6v� TANK INFORMATION ELEVATION DATA A9800476 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic f P t? - / Be q Dosing -- Aeration _ Bldg. Sewer Holding St/ ' Inlet TANK SETBACK INFORMATION St wt Outlet 5 73 C 7 4 -5 ; TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake 27/ NA Dt Bottom Dosing Header/ Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade �^ Manufacturer Demand ;�, We4 {ccrU %'S Model Number GPM TDH Lift Friction System TDH Ft oss H Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED / TRENCH Width Le Trenches PIT No. Of Tre PIT No. Of Pits Inside Dia. Liquid Depth DIM N I N DIMENSION SYSTEM TO P/ L BLDG I WELL LAKE /STREAM STREAM LEACHING Manufacturer: SETBACK CHAMBER INFORMATION TypeO Model Number: System: OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing 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 E] Yes E] No ❑ Yes E] No COMMENTS: (Include code discrepancies, persons present, etc.) cIS LOCATION: SPRINGFIELD 28.29.15.424,SE,NE 754 HIGHWAY 128 5 f fieW Nil Plan revision required? ❑ Yes ❑ No Use other side for additional information. Z 1 SBD -6710 (R.3/97) Date Inspector's Si ature Cert. N Safety and Buildings Division onsin SANITARY PERMIT APPLICATION 2 1 B Washington Avenue 'Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less Count than 81/2 x 11 inches in size. r ex • See reverse side for instructions for completing this application State Sanitary Permit Number -32-02&4;2 ❑Check if Personal information you provide may be used for secondary purposes (f revision to previous application [Privacy Law, s. 15.04 (1) (m)J. A //t�� State Plan I.D. Number I. APPLICATION INF RMATI N- PLEAE RMATI N`�� 64' Property O er Name Proper L cation / L 5� /a / 1 /a, S T , N, R /�E (or)&V Property Own ' ailing Addr s / 112 Lot Numbe Block Numb Cit ,a e Zip so e Ph ne umber Subdivision Name or CSM Number 1 Y OF BUILDING: (check one) ❑ State Owned it Nea est Road Public 1 or 2 Family Dwelling - No. of bedrooms ° Tow III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑Apartment/ Condo a g ' a9 . 5 ' a 9' �`37�' 1661 _ J�0 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 E] Replacement 3. ❑ Replacement of 4 �( Reconnection of 5. ❑ Repair of an ___ --- System System Tank Only A - Existing System - - - - - -- Existinq System B) A Sanitary Permit was previously issued. Permit Number /) /I ( Date Issued Q V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21AMound 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. Gall s 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 ' h) t Elevation � 00 12.06 I?,� . te r' I. Feet 4 15* eet VII. TANK Capacity in gallons Total # of er. Prefab. Con- Steel glass Site Fiber- Ex INFORMATION New Existing Gallons Tanks Manufacturer's Name concrete Plastic A p p structed T nks Tanks eptic Tank k l i�vw zpp fvif/ ❑ ❑ ❑ ❑ ❑ ift /Siphon Chamber �� 1W �,� � ft C & f R ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, th ersigned, assume responsibility f r installa ' f the onsite sewage system shown on the attached plans. Plu er's Name: (Pri Plum r Si ( Stamps) MP/ PRSW No.: Busi ss Pho a Number: Arr G 2 1111z,- �3�- 2.6 Plumber's dress (Street, tat� Co Ip e)� �T 77 IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater ate ssue Issuing Agent Signature (No Stamps) PgApproved ❑Owner Given initial / 0a surcharge Fee) f Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11197) DISTRIBUTION! Original to County. One copy To: Safety & Buildings Division, Owner, Plumber �J�"'_'r"""" � .�.,'kttyffi�h+r c ir.FS�»•N�wttsbuct.w xrry��,Far �r..;..: �:n,< .. , .ri. +' -.. - .sk.:y,� -. "�A" y 'w! L C Y r z � a A l VJ :2 a IV A � N 4 a y �.. ;Zk rA h N i OL C-) C31 ,0 0 O r \. `' JKIHOZ 03 RpYO. ZS 999b 99C 211 YV3 ZZ:OT MOR 86 /TZ /60 STC -105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER DANIEL CHRISTIAN MAILING ADDRESS 13S 4 E H Y/K ,v l tt AVE ST. PaL. , m IV J S I t g PROPERTY ADDRESS - 75 T T ii W y ( ag (location of septic system) Please obtain from the Planning Dept. CITY /STATE W IL90AN W i s9oaa PROPERTY LOCATION SE 1/4, NE 1/4, Section 28 T 29 N -R. 15 W TOWN OF SPRINGFIELD ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAP , VOLUME , PAGE , LOT NUMBER 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 licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS 7 S vn SUBDIVISION / CSM # LOT # SECTION a:9 T j N -R_ W. Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM INDICATE Id Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. -�� BENCHMARK: ALTERNATE BM: Tp� R. 14 (7 j 1 e i�G ` ,5/1 16P (,A2 SEPTIC TANK / PUMP CHAMBER / OLDING TANK INFORMATION Manufacturer: �� Pl Liquid capacity: �/,;?(0 a Setback from: Wel House Other Pump: Manufacturer 71 Size Float se eration P g� Gallons /cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: Length_ Number of trenches Distance & Direction to nearest prop. line: �U S Setback from: well: - House �.�..� Other t ELEVATIONS Building Sewer f, ST Inlet. ST outlet PC inlet g i PC bottom Pump Off Header /Manifold -. ' Bottom of system /, , Existing Grade (> Co Final grade DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: 3/93 3/93:jt Wisconsin Dr artmela Relations of Industry, Labor and PRIVATE SEWAGE SYSTEM ounty: • f,,:rnan Rela ST . CROIX Safc, }r:cBuildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Permit Holder's Name: CHRISTIAN, DANIEL 7C ❑ City ❑ Village 9 Town of: State Plan ID No.: CST BM Elev.: Insp. BM El BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic i �[� u G * /� , Benchmark X00 U D, O b Dosing J S 75 Aa. Aeration Bldg. Sewer Holding St /Ht Inlet 13 13 TANK SETBACK INFORMATION St/ Ht Outlet ? N TANK TO P/ L WELL BLDG. vent to ROAD Dt Inlet Air Intake /L 7. G Septic >�? S' 9Z a / y . <—� NA Dt Bottom Dosing >d 5 ' 98 � . >-O , NA Header/Man. Aeration NA Dist. Pipe i 3.3 9a. - 4's Holding Bot. System r- PUMP / SIPHON INFORMATION Final Grade Manufacturer Demand "'J0" X3. F X77 G7,V Model Number p %, � ?l GPM TDH Lift t:I� Friction < System �� TDH Ft H Forcemain Length Q Dia. rr DistJTOweu1� SOIL ABSORPTION SYSTEM BED / TRENCH Width Length / F renches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ` / 1 DIMEN I N SETBACK SYSTEM,TO P/L WELL LAKE /STREAM LEACHING Manufacturer.. INFORMATION Type0 _ CHAMBER System: /f," ,v 1 / a S /�/�� OR UNIT Mo a Num er: DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake �I Length Dia. a Length Dia. I �/ Spacing r �; k r7 > c, c SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over I Depth Over xx Depth Of + xx Seeded /Soddeff xx Mulched Bed /Trench Center l� Bed / Trench Edges Topsoil {Yes ❑ No (s El No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: Springfield.28.29.15W, SE, NE, Highway 128 ct-� 9 ,L,9 5 _ c, 3. Plan revision required? ❑ Yes ❑ No Use other side for additional information. c� `' SBD -6710 (R 05/9 t) Date Inspector's Signature ` Cert No e ' SANITARY PERMIT APPLICATION � In accord with ILHR 83.05, Wis. Adm. Code COUNTY ST CROIX STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than of TA/ 834 x 11 inches in size. ❑ Check If revision to previous application - reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER I. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION S94 -40687 PROPERTY OWNER PROPERTY LOCATION DANIEL CHRISTIAN SE % NE %, S 28 T 29, N, R 15 06 W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # 1854 HYACINTH AVE N/A N/A CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER ST PAUL MN 55119 612 778 -132 N/A II. TYPE OF BUILDING (Check one) CITY NEAREST ROAD State Owned ❑ VILLAGE : SPRINGFIELD I HWY 128 ❑ Public M 1 or 2 Fam. Dwelling-## of bedrooms 4 PARCEL TAX NUMBER(S) 111. BUILDING USE: (If building type is public, check all that apply) 034 - 1061 -50 1 ❑ Apt/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 in line A. Check line B if applicable) A) 1. ❑ New 2. ❑X Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit## 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 ❑ Seepage Trench 22 ❑ In- Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 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 600 REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals /day /sq. ft.) (Min. /inch) ELEVATION 1200 1200 .5 N/A 91.75 Feet .75 VII. TANK CAPACITY Site in allons Total # Of Manufacturer's N Prefab. Con Steel Fiber plastic Exper. INFORMATION New istin anuact Name Gallons Tanks Concrete stCon- glass App. Tanks Tanks Septic Tank or Holdina Tank lz uu 1 MIDWESTERN PRECAS Lift Pump Tank/Siphon Chamber 750 750 1 MIDWESTERN PRECAS X 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 Sta ps) MP /MPRSW No.: Business Phone Number: BENNIE HELGESON MPRS 3215 715 772 -3278 Plumber's Address (Street, City, State, Zip Code W1229 770TH AVENUE, SPRING VALLEY, WI 54767 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sa ary Permit Fee (includes Groundwater Date Issued Issuing A nt Si tamps) Approved ❑Owner Given Initial Surcharge Fee) Adverse Determination �/ ' X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: SBD- 6398(R.08/93) DISTRIBUTION: Original to County, One Copy To: Safety 8 Buildings Division, Owner, Plumber .ra O m o ft o S is 1 r \� I 3 �N a � ° p Gi Q xc a cn e1 i N /,y G � S 0 I V A F (46 Mp S T r P a V A f s l Page _ Of Straw, Marsh Hay, Or Synthetic Covering AS IIQ lt.NIC E'3 ,Z3�3��V1 Distribution Pipe Medium Sand Iz. L5 Topsoil =_ N 4 - =- c 'E/cam. `�3 —J F - 7 S 3 E N D PRIVATE SEWAG b • % Slope. Conditional- p ya.o Bed Of 2 2 2 Force Main Plowed E Aggregate From Pump Layer A t0P R () V jj UIA �A RE pf It1DUfTaI. � g NGs D t f, 7.S R. Dt:�r• avlstDN of tiill�Y s Sec 'on Of A Mound System Using E 16S Ft. S 0 DEHGE A Bed For The Absorption Area F .80 Ft. SEE C G I Ft. A (o Ft. H 1-9 Ft. Signed: ,�� �•,�— B Ft. License Number: if K 'Ft. Date:' 7 -7 -1 b / 09� Ft. J Alternate Position 1 13.0 Ft. of Force Main W ZZ_1 S - Ft L Observation Pipe (°---------------- - - - - -- --------------------- A __ '_ - - - , Force Main W o - - T --------- - - - - -- ------------------ - - --. Distribution Bed Of Pipe Aggregate I Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area tj C Ala 1� S94-40687 Perforated Plpe Oetoll End View ) POfforcled End Cop b y' PVC Pipe �o�i' o CI Permanent End Markers �s Holes Located on Bottom are Equally S Spa • � Q S�V� ASE s * PVC Force titain + at y From Pump co ` n a $ ENO PVC M on AR p- 9A3 \OM Monllold Pipe � CAP UgpR 8 6 �4111G j \NOUSO Oislrlbutlon..• Pipe Lost Hole Should Oe - Next To End Cop E GO R Sp SS Distribution Pipe Layout P R S 3� x Y .3 Signed: J_ Bole Diameter Inch � License Number: 1 !/J�'�S �r /� Lateral " Inch (es) Date: rj —_ - -j Y Manifold " o � Inches Force Main " _� Inches (7 a _L �s , t1�a ���.,� c ►14 < +Iu S 94- 4 0687 IWO -- PUP %P CHAMBER CROSS SEC AMC) SPECIF ICA VE UT CAP y' C.I. VENT PIPE WEATHERPROOF APPROVED LOCK:!jG > r RO! ' A DOOR, JUMCTIOAI BOX MANHOLE COVEF. WINDOW OR FRESH I2 "MIN. AIR IAITAKE GRADE i 4" MIN. ` -- 18 "MIIJ. COIJDUIT ________ 18 "MIN. ---- - - - - -- \ -- ILET P1�9v °;�.TI= SEWAGE SY N \ 11� PROVIDE - - - -- - - - -- Conditi0ft ffi ✓ SEAL APPROVED JOINT A I I I APPROVED JOINTS W/C.I. PIPE I III W /C.I. PIPE EXTENDING 3' App I I ALARM EXTEWDIAIG 3' � HUMAN OUTO SOLID SOIL TIONS B � N BOLA ONTO SOLID SOIL DEPT. Of INDUS O f, 0 �l}llfllllfiS I I. C DI SI i I ow I- LEV. flJ• FT. -� . SEE R SPONi)" ° ` - �uMP � - -� OFF 0 COUCRETE BLOCK RISER EXIT PERMITTED OIJLy IF TAUK MANUFACTURER HAS SUCH APPROVAL i _ Ga.i SEPTIC E SPEC,IFI DOSE (� I TANKS MANU FACT URER: Ib D.X.C-aS 4, - (DUMBER OF DOSES: PER DAB TA WK SIZE : 7 11 GALLLOIJS DOSE VO LUME b► a,r QOC-k ALARM MANUFACTURER: _� � • Ej,C'1V0 Sc i .) PAS IMCLUDING BACKFLOW: 15�; • Z- GALLONS MODEL AIUMBER: L L UJ CAPACITIES: A= al X 5/O ,1 LLOUS O UICNES OR � ._ �A SWITCH TYPE: /� r►— 5 = INCHES OR 37 S GALLONS PUMP MANUFACTURER: v C = 2_ IAICHES OR 5-t 3 7 GALLOU5 MODEL NUMBER: -zy D = - 8 INCHES OR /S'b GALLONS SWITCH TYPE: b Li -p-, MfrC i- � W MOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE y2. / )GPM INSTALLED OfJ SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE,. 7,3 / FEET + MINIMUM METWORK SUPPLY PRESSURL� ✓✓. . . . . .. . . . 2.5 FEET + 0 FEET OF FORCE MAIN X �C /00rrFRICTIOU FACTOR.. 1. FEET TOTAL DyJAMIC. HEAD = /L FEET IMTERUAL DIMEWSIOUrb OF TA1JK: LE�,i TH ;WIDTH �" 9 ;LIQUID DEPTH — 51GIJED: ` -E' LICENSF UUMBI- R: 6�� � - � - � 7 _ q —_ UATE: L— L • ��( n �J ( J ) 1'P La ` / ; - 4 f C1 L/S / It h i S 9 4 m i o 6 V 7 Submersible Arc. , Cy MODEL: 3871 SIZE: 3/4" SOLIDS Effluent Pump RPM: 1550 HP: 0.4 METERS FEET 8 1 25 7 Q w 6 20 a 5 Z 15 4 ��- -- 3 10 , 5 —1 1 0 00 10 20 30 40 50 GPM 0 2 4 6 8 10 12 m /h CAPACITY �GOULDS PUMPS. INC. SBNL{A FAILS NE `IDW 13148 0 1988 Goulds Pumps. Ir% QDV^Mrs "nrao •nC Effective October, 198E Wwonsi- .Department of Industry SOIL AND SITE EVALUATION REPORT Page — of Ls.+f arw. - iuman Relations Division of Safety a Buildings in accord with . ILHR 83.05, Wis. Adm. Code �, COUNTY /'" ,� Attach complete site plan on paper not less than % Ian must include, but 7- `- ,I not limited to vertical and horizontal reference M), din coon a lope, scale or PARCEL I.D. # dimensioned, north arrow, and location and a to.�ari rod. 63 - 1 ,64-1 - tw APPLICANT INFORMATION -PLEAS DINT ALLO'R'MATIO REVIEWED BY DATE PROP OWNER + r' r_ - PERTY LOCATION 0.hie� C r LSrlo�� �.- �i LOT �� 1/4 N 1 /4,S�gT, q N,R 1$ E(c PROPERTY OWNER':S MAILING ADDRESS ' ' T BLOCK # SUBD. NAME OR CSM # 195'q 1 C. N a�,:� f� 4� ONINGOFFICE CITY, STATE ZIP CODE M0 ❑CITY [VILLAGE N NEAREST ROAD C'uJ thh / (c / nth e1 uJ 1-0 [ J New Construction Use [y— Resi ! Number of bedrooms Y [ ] Addition to existing building jq'Replacement [ ] Public or commercial describe Code derived daily flo gpd Recommended design loading rate 5' bed, gpd/ft trench, gpd/ft Absorption area required � 90 bed, ft -- trench, ft B Y , mu mcesign loading rate �5_ - bed, gpd/ft _, trench, gpd/ft Recommended infiltration surface elevation(s) %/, '7i5 ft (as referred to site plan benchmark) . 5, eD o a Be-k— Additional design / site considerations " uv. e e r e.di 8 4 x e ea Parent material _S j no e�- Flood plain elevation, if applicable IV,4 ft S = Suitable for system CONVENTI I WD IN- GROUND P AT -GRADE SYSTEM IN RLL t OL TANK U = Unsuitable for system C1 S ETU �S ❑ U ❑ S E a ❑ S ®'G ❑ S Pif Ees ❑ 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 f / -7 U A- Lj i >r . -1 0 ; - 4 W, 5 b L.J 1 t� 57 . Ground - S c Sb : y elev. ft. Depth to limiting factor Remarks: &ok-,vA Wck_ e�- oA 3� Boring # 3 s Ground i s - -4c c- c, stk — elev. Depth to limiting factor f5" Remarks: < B T Name : - Please Print { Phone: a 7 ress: L -f q t4 w to , S h,� -o. I Signature: ` Date: � � <L/ CST Number: PROPERTYOWNER LJC"r\J-e-L ',-f WMI I UIL UESURIP I ION INEFUM I Page of PARCEL I.D. # 0421 - 156 Boring # Horizon Depth Dominant Color Modes Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Tmr& a kxj %v 19 IC�VE 51 �, w, Ivw Ground - 7, LS '1 4- ' elev. Mft. Depth to limiting factor r-5.+ Remarks: L-Ur Boring # - 3- knA, aw .5 .6 0 4 Ground .5 Yk , s a i L I elev. Depth to limiting factor A rr 2 es Remarks: Boring # Jo)�iz 1 3 t- 'KIN IN U) rs 3. L - 7- I VS N ta q Ground elev. It. Depth to limiting factor 1 Remarks: lqhQILI� Boring # Ground elev. Depth to limiting factor Remarks: SBD-8330(8.05/92) x eb l E p d Lo d p 3 a ct U r � C S 6 S �n/y V� t0 — d V d Ll cj� �'� Zr ter. `X Cc 515461 ,.. ��"�" APR 1 5 1994 ;ft 2: 15 P 3 l Certificate of Sale By virtue of and pursuant to a writ of execution issued out of' the Circuit Court of St. Croix County, Wisconsin, the following described real property was sold by the below signed sheriff on April 12, 1994; and the bid price for each distinct lot or parcel and the purchasers were as follows: The East One - half (E 1/2) Purchaser Bid Price of the Northeast Quarter Daniel Dale Christian $ 58,100.00 (NE 1/4), Section Twenty - Eight (28), Township Twenty -Nine (29) North, Range Fifteen (15) West, subject to all reservations, easements, mineral rights, highways and privileges of record. The whole consideration money paid for the above real estate was: $ 6,000.00 The sale will become absolute and the purchaser(s) will be entitled to a conveyance of the real property pursuant to law on: July 12, 1995. Dated this 13th day of April 1994. Sherif of St. Croix County, Wisconsin STATE OF WISCONSIN ) ss COUNTY OF St. Croix ) Personally came before me this 1-ith_ day of April , 1994, the above named _Ralph E. Bader Sheriff of S County, Wisconsin, to me known to be the person and of Vc e 4, described in and who executed the above certificate as such 6ff4c� t � and acknowledged the same. -J K Q O� Notary blic, State of--Wisconsin My Co ission: Exu. 2 - - 96 This instrument was drafted by: 1 5322 VOL 1134 PAGE 386 STATE OF WISCONSIN CIRCUIT COUNTY ST. CROIX COUNTY TERRI OSTERTAG and �gEgIFFI3 DEED MICHAEL OSTERTAG, Plaintiffs, S o v vs. Case No. 93- CV -2184 BARNEY D. GWrZ, INTENTIONAL TORT: 30106 Defendant. This indenture made this 20th day of July, 1995, between Paul Burch, Sheriff of St. Croix County, Wisconsin, party of the first part and Daniel Dale Christian of St. Paul, Minnesota, as party of the second part; WITNESSETH, that a judgment having been taken in the Circuit Court of St. Croix County, Wisconsin on November 1, 1993 by and between Terri Ostertag and Michael Ostertag, Plaintiff and Barney D. Gatz, Defendant in the amount of $176,530.14, and a Writ of Execution issued by the Clerk of Court of St. Croix County, Wisconsin to the sheriff of St. Croix County, Wisconsin to execute against such (personal and) real property of the defendant(s) located within St. Croix County, Wisconsin, as would satisfy said judgment; and the sheriff having found real estate cf the defendant(s) located in St. Croix County, Wisconsin, and executed upon said property. The Sheriff gave public notice and notice by publication of the time and place of such sale in the manner provided by law, that the sheriff upon compliance by the purchaser(s) with the terms of such sale did execute and deliver to the purchaser(s) and Register 1 t, AL 1134PAA87 of Deeds St. Croix County, duplicate certificates of sale containing: a par`icular descripUon of the premises sold, the bid price for each distinct lot or parcel, the whole consideration money paid, and a time when the sale will be absolute and the purchaser will be entitled to a conveyance pursuant to law. AND WHEREAS, the sheriff pursuant to the Writ of Execution did on April 12, 1994 sell at public auction at St. Croix County Courthouse at the hour of 10:00 o'clock a.m., on that date, all the premises mentionod in said notice and at which sale the premises hereinafter described were struck off and sold to Daniel Dale Christian, St. Paul, Minnesota being the highest bidder(s) therefore, for the suss of $59,100.00 in addition to and subject to such existing liens and encumbrances allowed by law, and the time for redemption having expired= NOW, THIS INDENWRE WITNESSETH that the Sheriff by virtue of the Writ of Execution and of the statutes and law in such case made and provided and in consideration of the total sun of stoney so bid as aforesaid being first duly paid by the said party of the second part, the receipt whereof is hereby acknowledged, has granted, bargained, sold, aliened, and conveyed and by these presents does grant, bargain, sell, alien and convey unto the said party of the second part and to its successors and assigns forever all of the following described land situated in the County of St. Croix, State of Wisconsin, to -wit: The East One -half (E 1/2) of the northeast Quarter (HE 1/4), Section Twenty -Eight (28), Township Twenty -Nine (29) North, Range Fifteen (15) West, subject to all 2 i 1136m 388 1 t f.. st""ot.Ims, easements, mineral Frights, highwaa Privileges of record. -. TO have and to hold a ll and singular the pre aisalt "Ationnd and described and hereby can4yed or intended 94 to i" unt't Slid party of the second part its successors and assign F' to proper , use benefit and behold far~. ► w Y td1erefore, Paul Vii, shi riff o8 ft. C µ lits�: aorsaid ajpQeated sQ aft his harms` and seal m "Ru"Ot above Writtes . t r eal , Sher or 8t Croix County Wisconsin witnoaSeth ; ��' �I S'PA'P WOiI11 ) 9: A. COURTT OF or CROA 4 Personally case before to this .2 day of July, 1995, the abwMo Ae d Paul Burch, Sheriff of St.. crois county, Wisconsin, to sie known to be the person and officer described in and who executed the OOVO COAveyance as such officer and acknowledge the sate. v$► s s t10? 7 tY 1C, STA or WI s KY s*ion F .2- - Dratted By: Gherty i Ghe 3 JUL- 9 -98 THU 14:48 HERITAGE BUILDERS 17152357914 P.01 HERITAGE BUILDERS PROFESSIONAL HA ND YMA N SER WCE N6164 370' Street Phone (715)235 -7910 Menomonie, Wl 54751 Fax (715)135 -7914 FAX TRANSMITTAL Date: ° J 196 No. of pages Z (Including cover) To: 2, x ; Attn.: J � so �. From: � r � . . Subject L ff C Message _ 14 c I & a C & i Q�k �o vii K O .b� YJ0.d.c ti.T s -vi .1,0d AC � wt.P� • .� V-0 v � Signature ' JUL- 9 -98 THU 14:48 HERITAGE BUILDERS 17152357914 P.02 • Professional TEL: (715) 235 -7910 FAX: (715) 235 -7914 Handyman Services N6164 370th Street • Menomonie, WI 54751 7 / 19 1 L rv.re�.' V I dLC or MA �- A V � ` � $moo °% � jcoauu, � o h � O vxe, Fr,.�. OY Vol pta#'% T Flee d/ gndl 0 $sd ) 2oa. � I, P I �,� • o0 Y ao 2 4, Fs 4 w , - 5 > Excellence in Craftsmanship and Service STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS 7S Z. 5 , r SUBDIVISION / CSM # LOT # SECTION �2 f T N -R_/ W Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM INDICATE I40' &'H Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. Wisconsin Dr- artmentof Industry PRIVATE SEWAGE SYSTEM County: LaWran6f Aan Relations INSPECTION REPORT ST CROIX - S3fctfu —^ Buildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION No.: PeCHRISTI Name: : DANIEL ❑ City [I an I Village Town of: State PlD CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: i TANK INFORMATION ` ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI I FS ELEV. Septic � : L ,•� Benchmark /D� ) 1 1 6 0, 6b Dosing �S, 71 Aeration Bldg. Sewer 9x1(11? _ Holding St/ Ht Inlet q TANK SETBACK INFORMATION St/ Ht Outlet 9.x9 q/ j t Ventto TANK TO P/ L WELL BLDG. Ai Intake ROAD Dt Inlet . Septic > S' 9 / a i �'"� NA Dt Bottom ` S- g Dosing >a S ' 9g l .>,570, NA Header / Man. 3 - 3 Aeration NA Dist. Pipe 3 Holding Bot. System s PUMP/ SIPHON INFORMATION Final Grade q_ 7 g Manufacturer Demand �?77 q7,q ' Model Number 1 3 IV / p GPM S Friction �. stem TDH Lift ���5 L �,� H TDH �I� Ft Forcemain Length Ch Dia. N Dist. ro weu 1 SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. renches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SYSTE TO P / L BLDG WELL LAKE / STREAM LEACHING Manufacturer: SETBACK _ CHAMBER INFORMATION Type O Moe Number: System: OR UNIT DISTRIBUTION SYSTEM Header / Manifold y' Distribution Pipe(s)� x Hole Size x Hole Spacing Vent To Air Intake 9 9 l � Spacing � �� �� j >' Length Dia. a Length Dia. SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over t1 Depth Over / xx Depth Of( , f xx Seeded /Sed�dgd xx Mulched Bed /Trench Center '� Bed/ Trench Edges 1� Topsoil `O U'Yes ❑ No 'es ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: Springfield.28.29.15W, SE, NE, Highway 12$ x:5'1 sr -T 3. C -3, ?7 Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD -6710 (R 05/91) Date 1 peitor's Signature Cert. No. SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COU NTY T ST CROIX STATE SANITARY PERMIT # —Attach complete plans (to the county copy only) for the system, on paper not less than Q ' 4 ( 8% x 11 inches in size. ❑ Check if revision to previous application —See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER I. APPLICANT INFORMATION — PLEASE PRINT ALL INFORMATION S94 -40687 PROPERTY OWNER PROPERTY LOCATION DANIEL CHRISTIAN SE t/4 NE t / S 28 T 29, N, R 15 g/(6 f) W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # N/A 1854 HYACINTH AVE N/A CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER ST PAUL MN 55119 612 778 -132 N/A 1. TYPE OF BUILDING Check one CITY NEAREST ROAD I ( ) 1 State Owned ❑ VILLAGE ; SPRINGFIELD HWy 128 ❑ Public ❑ 1 or 2 Fam. Dwelling —# of bedrooms 4 PARCE LTAXNI BERS) 111. BUILDING USE: (If building type is public, check all that apply) 034 1061 - 50 1 ❑ Apt/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 in line A. Check line B if applicable) A) 1. ❑ New 2. ❑X Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit # Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 M Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 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 600 REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals /day /sq. ft.) (Min. /inch) ELEVATION 1200 1200 .5 N/A 91.75 Feet .75 VII. TANK CAPACITY Site Fib in allons Total # of Prefab. Fiber- Exper. INFORMATION New Existing Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdina Tank 1/ 1 MIDWESTERN PRECAS Lift Pump Tank/Siphon Chamber 75 750 1 MIDWESTERN PRECAST X 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 Sta ps) MP /MPRSW No.: Business Phone Number: BENNIE HELGESON MPRS 3215 715 772 -3278 Plumber's Address (Street, City, State, Zip Code W1229 770TH AVENUE, SPRING VALLEY, WI 54767 IX. CO TY /DEPARTMENT USE ONLY ❑ Disapproved Sary Permit Fee (Includes Groundwater ate s ue Issuing A nt Si N tamps) Surcharge Fee) Approved ❑Owner Given Initial rJ Q�j �/� Adverse Determination o�(�f / ' X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(R.08/93) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber .+, cy, Q e; 3 a d1 q � � a v � �n C,G d �Q lu d lT t L O co 0 N S -:1068 7 Page _ Of Straw, Marsh Hay, Or Synthetic Covering E3.13(3)(ib) Distribution Pipe Medium Sand 5Z: 2-5 Topsoil - :. - -H- _ - o 1 7 S E l� D 3 E SE\NAG p���N CJCJ % Slope. � Condition Bed Of 2 "- 2 2 Force Main Plowed w Aggregate From Pump Layer PR t� 11uM 1 FI kT1a NS of 111OUS'My' AND 6 to s D 1, �� Fi . aEP t. nlvlstol+ E 2.6S Ft . s Sec 'on Of A Mound System Using S p t3 A Bed For The Absorption Area F �$O Ft. SEE C G I Ft. _ A � Ft. H !. S Ft. Signed: �� �- B Ft. License Number':' ,. K ( Ft. 4, 'Dater 7-7 -g(l L /?XI'.? Ft. j 3a Ft. Alternate Position y /3.6-� of Force Main W A2 . `I S "�t . Observation Pipe B K i �.. - - -- - ------------------ - - --•I Force Main W o T - - -- ----- - - - - - Distribution Bed Of 2- 2 % Pipe Aggregate I Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area Perforated Pipe Detoll 0 End View -End Cap) Perforoled 1 y PVC Pipe �c• Permanent End Markers s Holes Located on Bottom are Equally Spar ►„1 ''` ���x 1 PVC Force -Main � r Z X , From Pump .. PVC 4 CAP '� Manifold Pipe �scR�• a Pv� cap �o f s Oiilribullon..• �E:t�•� 10N 0 Pipe Lost Hole Should Hey N'•' Next To End Cap GQ , 5�E Distribution Pipe Layout P R S 3� X Y 3 Signed: � Hole Diameter Inch License Number: �',�`S ? /,� Lateral " Inch (es) Date: 7 —'7 - �j SF Manifold " o � Inches Force Main " Inches e f �. PUP%P CHAMBER CROSS SECTIO..; AIJG SPECIFICATIG�J.c• VE UT CAP y' C.I. VIkIlT PIPE WEATHERPROOF APPROVED LOCKiAJG > ?-5' FROM DOOR, JUNCTION BOX MANHOLE COVEF. - WINDOW OR FRESH 12 "MIU. AIR INTAKE GRADE J i Y" MIU. ` -- IB "h11AJ. COIJDUIT 18 "MIN,v ---- - - -- -- �- ]r �q� PROVIDE I - - - -- ol�EditioA Y�.Fi SEAL APPROVED JOIMT A rm t I I APPROVED JOIWTS W/C.I. PIPE $y� '�� I II W/C.I. PIPE EXTENDING 3' 3 ' OUTO SOLID SOIL B I j I ALARM EXTEIJDIIJG t„ `` T ONTO SOLID SOIL iDic:r.�:k I i dl IN 1) OF , uBD HD �,,, .. ( I ON , ELEV. 22.nDFT I PUMP --j $EE �'' —� OFF 0 COIJCRETE BLOCK �I RISER EXIT PERMITTED OIJLy IF TAIJK MAMUFACTURER HAS SUCH APPROVAL i �co �SEPTIG E SPECIFItATIQKJS DOSE / TAIJKS MAAIUFACTURER: 9 1h, fleraC UMBER OF DOSES: PER DAB TANK SIZE: � cc �d GALLLOWS DOSE VO LUME � � "ash �- ALARM MA%JUFACTURER: - �1 �1 • rz 1pc o . JC/ � � INCLUDING BACKFLOW: � 2 - — GALLONS MODEL NUMBER: W CAPACITIES: A= �I a IAICNES OR y0 ,/�GALLOAIS SWITCH TS P[: /� G- B _ INCHES OR ..L.= GALLOAJS PUMP MAN v C= 2- INCHES OR /s9'3 7 GALLOUS MODEL NUMBER: D- _ INCHES OR iso GALLOUS SWITCH TYPE: -_L)C L! A-+ MfIrC i -c, 5 Y MOTE: PUMP AMD ALARM ARE TO BE MINIMUM DISCHARGE RATES�:S GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFEKEIJ BETWEEN PUMP OFF AAJD DISTRIBUTIOIJ PIPE;,, 7 - FEET + MINIMUM NETWORK SUPPLY PRESSURE . 2.5 FEET + FEET OF FORCE MAIN X � FAC FEET TOTAL DyIJAMIC. HEAD = / 1� ? FEET IMTERNAI- DIMEWSIONS OF TANK: LE,..iGTH ;WIDTH 9 ;LIQUID DEPTH Y_ 51GrJED: , LICE.IJSF NUMBER: s!� ��-b•+ '7 ��--77_� __ UATE:�4 I� Submersible Arc , �� MODEL: 3871 SIZE: 3/4" SOLIDS Effluent Pump RPM: 1550 HP: 0.4 METERS FEET 25 7 � I a 6 20 = I Z 15 } 4 g 10 2 I 5 1 0 00 10 20 30 40 50 GPM 0 2 4 6 8 10 12 M3 /h CAPACITY (� GOU LDS PUMPS. INC. SeC-CA FALLS WW ram 0 148 Effective October, 198E 0 1988 Goulds Pumps, Inc. SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE PRINTED IN U.S.A w sconsV .Department of Industry, SOIL AND SITE EVALUATION REPORT Page _ of r , Lm*AanQqumsn Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than A ./� Ian must include, but 7 not limited to vertical and horizontal reference,poifBM), dir, ction a lope, scale or PARCEL I.D. # dimensioned, north arrow, and location and'Aaride to pear rRad. " r = ' '` Y' t I - REVIEWED BY DATE APPLICANT INFORMATION- PLEAS�r1�YNT ALL'°iTlFOR1111ATIO �; PROPT OWNE i a PERTY LOCATION 0.h�t -� FLS�Io�v` LOT 114N 1 /4,S .)$T�y N,R 1s E(o ) PROPERTY OWNER':S MAILING ADDRESS v" T BLOCK # SUBD. NAME OR CSM # I Q J E. Q G / t t^ fi U ' 1fmi4C � CITY, STATE ZIP CODE O�E;NU []CITY [VILLAGE N NEAREST ROAD F Gu� tom 1i (�ol"�'�5l r1h :-e� u) leg [ J New Construction Use [Residential / Number of bedrooms Y [ J Addition to existing building iq Replacement [ J Public or commercial describe Code derived daily flow 4 6 00 gpd � « Recommended design loading rate a 5� bed, gpd/ft trench, gpd/ft Absorption area required 1 ) bed, ft trench, ft �I ao imum design loading rate - bed, gpd /ft trench, gpdtft Recommended infiltration surface elevation(s) 1/, '2 67 '2o,V B-.Q It (as referred to site plan benchmark) 5 -- Additional design /site considerations A e er ca $ 4 x e� Parent material S i ( ©oer ±JA Flood plain elevation, if applicable It S = Suitable for system CONVENTI W IN- GROUND P AT -GRADE SYSTEM IN FILL HOL NG TANK U = Unsuitable fors stem El L�7U ® S ❑ U ❑ S DO ❑ S P ❑ S C ❑ 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 / 0-7 1 o • 4 c. 1 LJ I S Ground j57_ S y, 3 c I t k y . S elev. ft. Depth to limiting factor Remarks: Boring # , v Ground �' cJ /b �' C_ L S�Ic elev. ft• Depth to limiting fac tor 5 " Remarks: Y � �e 8 T Name:— Please Print Phone: ! 7 t A ddress: L Ll q t W 1_ 8 S ` 12 6 7 Signature: Date: p? CST f merry \ � 3 S P T y \ V J f � P A '0 Ot V P A r � a r ' CO �c rl P ' \ by F ?Qm N y am T S rA ID h t a 'b lb W c n _ - -- o b i 7T ` I s. I- Z � `� y 0 16 Q CO APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner /contractor, ( "spec house "), then a second form should be'retained and completed when the property is sold and submitted to this office with the appropriate deed recording. .Owner of.. Property DANIEL CHRISTIAN :Location. of Property sE 3 4, Section 28 , T- N -R _ W Township SPRINGFIELD Mailing Address 1 ASS R HYArTNTT4 AVFNTIR - S.T PAUL MN 55119 Address of Site Hwy 1�8 W LSOA) W% Subdivision Name. Lot.Number Previous Owner .of Property Total Size of Parcel go Date Parcel was`Created 'ire all corners and lot lines identifiable? _ Yes No Is this property being developed for resale (spec house) ? _ Yes __x — No Volume', ja 7 0 and Page Number s as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING A Warranty Deed which includes a Document number volume and page number and the Seal of the Register of Deeds In,addition, a certified survey, if available, would be helpful so.as to avoid delays of the reviewing process. If the deed description refer - ences.to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATIO 1 (We) eenti.6y that att dta-tement6 on Chia bonm aAe tk to the beat o6 my (oun k.nowZedge; that 1 (we) am (ante) the- ownen(Z) o6 the pnopMty desni.bed in this .i.n6onmation �onm, by viAtue o6 a warvc.anty deed neconded in the 04�iee ob the County Reg.iaten of Deedaas Document No. 6 t ; and that I (We) pnesentZy own the pnopoded .6 to bon the aewdge dibpos aydtem (on I (we) have obtained an easement. to nun•w.ith. the above de6wr_ bed paopenty, bon the con.6tnuction_o6 aa.id oa��� c still y �9+ a~ . 515461 �.��� 1D74 pv�f .146 APR 1 1994 at 2: 15 P. Certificate of Sale By virtue of and pursuant to a writ of execution issued out of the Circuit Court of St. Croix County, Wisconsin, the following described real property was sold by the below signed sheriff on April 12, 1994; and the bid price for each distinct lot or parcel and the purchasers were as follows: The East One -half (E 1/2) Purchaser Bid Price of the Northeast Quarter (NE 1/4) , Section Twenty- Daniel Dale Christian $ 58,100.00 Eight (28), Township Twenty -Nine (29) North, Range Fifteen (15) West, subject to all reservations, easements, mineral rights, highways and privileges of record. The whole consideration money paid for the above real estate was: $ 6,000.00 The sale will become absolute and the purchaser(s) will be entitled to a conveyance of the real property pursuant to law on: July 12, 1995. Dated this 13th day of April 1994. Sherif of St. Croix County, Wisconsin STATE OF WISCONSIN ) ss COUNTY OF qt Personally came before me this _13th_ day of A ril 1994, the above named f Ralph E . Bader , Sheriff of St Cr M County, Wisconsin, to me known to be the person and of <-fce described in and who executed the above certificate as such offVc� and acknowledged the same. -J o Q p� G Notary e o - Wisconsin r blic St Y My Co ission: Exp. 2 -4 -96 This instrument was drafted by: 1 k STATE OF WISCONSIN CIRCUIT COUNTY ST. CROIX COUNTY TERRI OSTERTAG and NOTICE AND MOTION FOR CONFIRMATION OF MICHAEL OSTERTAG, SALE OF REAL PROPERT - Plaintiffs, VS. . �� X994 f�v JUN T Cas No. 9 - J J994 A- 2 BARNEY D . GATZ , �C� INTENTIONAL T iG� 1 _706 Defendan �' 0 Q PLEASE TAKE NOTICE, that on Monday, June 13, 1994 at 9:00 a.m. or as soon thereafter as counsel can be heard, at the Courthouse in the City of Hudson, St. Croix County, Wisconsin, the undersigned will bring the following Motion for Confirmation of Sale of Real Property before the Honorable James A. Wendland. Whereas, judgment was rendered on November 1, 1993, in an action before the Circuit Court for St. Croix County, Wisconsin, for Terri and Michael Ostertag, as plaintiffs and against Barney D. Gatz, defendant, for the sum of One Hundred Seventy Six Thousand Five Hundred Thirty and .14/100 Dollars ($176,530.14), including damages and costs, as appears by the judgment roll filed in the office of the Clerk of Court for St. Croix County, Wisconsin. On November 19, 1993, Honorable James A. Wendland signed the Order for Judgment and Judgment. Whereas, an execution for satisfaction of said judgment was signed and then filed by the Clerk of St. Croix County on December 15, 1993 to be made out of the non - exempt personal or real property of the. defendant. On April 12, 1994 a sheriff's sale was held and real property owned by the defendant was sold to Dale Christian for r P1 $58,100. Payment for this property was made to the Clerk of Court's office. The plaintiffs have incurred the following costs related to the execution of sale totalling $187.00: Sheriff's fees $50.00 Filing fee to the Clerk of Court for the Execution: $5.00 Filing fee to the Register of Deeds for the Execution: $12.00 Filing fee to the Register of Deeds for the Certificate of Sale: $10.00 Publication of the Notice of Sale in the Tribune Press Reporter: $110 Further, the Court is advised that $18,000.00 of the amount received will be paid to Mrs. Carol Gatz, as her marital share of the proceeds. Plaintiffs move the Court for an Order confirming the sale of the defendant's property, and the sum in possession of the Clerk of Court be turned over to Gherty and Gherty, S.C. trust acco and Carol Gatz. Dated this 9th day of June, 1994. GHERTY AND GHERTY, .C. Attorneys for Plaintiffs ' i I AR J. GHER Y #10 397 The Constitut on Buildi g 328 Vine Stree P. Box 190 Hudson, WI 5401 - 190 (715) 386 -2332 ORDER Pursuant to the motion of the plaintiff, The Court hereby approves the sale of the property herein. The Court finds that the sum of $58,100.00 is a reasonable sum. The Court finds that the costs of $187.00 are reasonable and necessary. •.' fi t s r- r The Clerk of Court of St. Croix County is hereby ordered to disburse the funds as follows: Carol Gatz $18,000.00 Gherty & Gherty Trust Account Remainder of $40,100.00 plus interest $ �aS 7 2 3 Pursuant to Wisconsin Statute §815.40, the defendant shall have the right to redeem the property. BY THE COURT: G�G H ORABLE JAMES A. WENDLAND I ji i i 2