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HomeMy WebLinkAbout042-1020-60-100 .. O F 3 n o O C O N A n A '6 K m 3 " �+ S W D) C p O V M v N N e� S CD A ro `.0 = N CD 7 PO O 3 N O CP -04 CD n .Z7 j � iO to to 0 O p 0 CA CD ro CD W (D y `ni W - O O o '' V N N S > ` A CD CO w O N O C W 00 CCJD .. Q y o OOO ry� n D * 2r w Z y N N D cu ro 3 M C O N O K CD ID N W N . CD m w N A A ` �I O Z a Z z O o N w O D om' N j ? c A Lj cn cn ro (D c ) CD w m I o. 3 m � Z (D Cfl 1 N `p Z O u c 0 o cn -i m w M m N) M z o g O Z 00 H Z CD A w � c I 0.. CL o' — I v c z CL p .. CD U) I I I a w h O I ry N I o i O I A I o CD o O 0 ° tv w CD 0- �� r' c 3 0) G d r C = 8 3 a a , :a C C: o � o N N O p v N II I d a°o Cl:• ! W C M L n N C f�D G C L , o CD � Q= CD ( D 0) 9 o V 3 o' D a p �p ! W CD cn m N C N CD CL W CD p O p O N N S CD (� o A A f co co n r N CD co cr 01 . Z 000, 0 C w z o n' cc N N N p D N a) CD _ fp CL N Z w �` A o z 1 z l D 0. > > N � 0 n i O CD ? • A 7 CD C Z1 (D (D 7. C Lo N d z CD cc 7 a A Z n N C �_ .► v CL A 7 0 3 Cn 'i OD a W m co z O z E2 C Z M OD ! w z CD A a a S v c o a N rl I � I I ! I 't I I ~ ti o tA I a 0 A CD 4 0 b O O ~ * b ° o i a, -0 r Parcel # : 042 - 1 020 -60 -1 00 07/11/2005 04:23 PM PAGE 1 OF 1 Alt. Parcel #: 08.29.18.116B 042 - TOWN OF WARREN Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): " = Current Owner * ROBERT J WEHAUSEN WEHAUSEN, ROBERT J 1072 110TH ST ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): T rimary Type Dist # Description " 1072 110TH ST SC 2422 ST CROIX CENTRAL �i SP 1700 WITC e�� Legal Description: Acres: 11.211 Plat: 0577 -CSM 12/3344 SEC 8 T29N R18W NE NE SE NE BEING LOT 3 Block/Condo Bldg: LOT 3 CSM 12/3344 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 08- 29N -18W Notes: Parcel History: Date Doc # Vol /Page Type 11/03/1997 567893 1274/292 WD 07/23/1997 1050/610 WD 07/23/1997 862/203 07/23/1997 816/158 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 37937 Use Value Assessment Valuations Last Changed: 07/11/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 42,500 192,700 235,200 NO AGRICULTURAL G4 8.210 1,200 0 1,200 NO Totals for 2004: General Property 11.210 43,700 192,700 236,400 Woodland 0.000 0 0 Totals for 2003: General Property 11.210 43,700 192,700 236,400 Woodland 0.000 0 0 Lottery Credit Claim Count: 1 Certification Date: Batch #: 314 Specials: User Special Code Category Amount 018 - RECYCLING SPECIAL ASSESSMENT 15.00 Special Assessments Special Charges Delinquent Charges Total 15.00 0.00 0.00 ST. CROIX COUNTY ZONING DEPARTMr AS BUILT SANITARY REPORT r . O wner Il w� /YiS�G�Sff,�'� cF Address City /State oe 1 a �N �x���� Legal Description: Lot R Block — Subdivision/CSM # V4 Sec n Tow of PIN # SEPTIC TANK -- DOSE CHAMBER -- BOLDING TANK INFORMATION: `L Tank manufacturer _ �.r.c�s —_ Size ST/PC � Setback from: House 30 Well PAL D Pump manufacturer 4ga / - Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fres intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM:. Type of system: ZZff c Width # Setback from: Hous p/I, t t � Number of Trenches Z fresh air intake x'.200 � ELEVATIONS Description of benchmark _ Ellee vatio i Description of alternate benchm E a d /DD.D Elevation — Building Sewer STMT Inle ST Odtlet / ®D: PC Inlet PC Bottom ' Co L —Z - __���__ Header/Manifold� Top of ST/PC Manhole Z� O Distribution Lines 2 Z Bottom of System Final Grade O O O Date of installation L� / 9VPermit number State plan number Plumber's signature License number e CJ Date Z� Inspector Complete plot plan Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM v' Safety and Buildings Division Count ST . CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) SanitarlitT.: Personal information you provice may be used for secondary purposes [Privacy L s.15.04 (1)(m)]. Permit Holder's Name: �� illage Town of: State Plan ID No.: WEHAUSEN, ROBERT CST BM Elev.: / Insp. BM Elev.: FM Description: Parcel TYO�1020-10-100 TANK INFORMATION ELEVATION DATA A9800107 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic a Benchmark m Dosing Aeration Bldg. Sewer Holding St /Ht Inlet C, TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. Air l to ntake ROAD Dt Inlet q /.r ir Septic NA Dt Bottom (3.6L Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft oss H ead Forcemain Length Dia. Dist. To well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type O eJ_4_, CHAMBER Mo Number: Systems Y , r 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 I Bed /Trench Edges I— I Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: WARREN 8.29.18,SE,NE 1072 110TH STREET {� . o 'till _ 0 LkA' L, Plan revision required? ❑ Yes ❑ No Use other side for additional information. ? SBD -6710 (R.3/97) Date �,ypector's Signature Cert. No Vi sconsin Safety and Buildings Division SANITARY PERMIT APPLICATION 2 01 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Department of Commerce Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8112 x 11 inches in size. C • See reverse side for instructions for completing this application State Sanitary Permit Number 3(D The information you provide may be used by other government agency programs E] Check if revision to previous appliation [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATI N Property Owner Name Property Location O T £'ff u E 1/4 tl a 1 i4, S T , N, R E (or WD Property Owner's Mailing Address Lot Number Block Number City, State Zip Code Phone Number Subdivision Name or CSM Number II. TYPE B ILDING: (check one) ❑ State Owned ❑ !t Nearest Road 2 ❑Village Public 1 or 2 Famil Dwellin - No. of bedrooms `� Town OF lit// S III. BUILDING USE (If building type is public, check an that apply) arcel Tax Number(s) 1 ❑ Apartment/ Condo 2' 6 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_ ❑ 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 Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 (?Seepage Trench 22 ❑ In Ground Pressure r 42 ❑ Pit Privy 13 ❑ Seepage Pit XS(p 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 Eley. 7. Final Grade Required (sq. ft.) Proposed (sq. ft,) (Gals/day /sq: ft.) (Min. /inch) !,�/ QT. S Elevation l�Sp L +2- ?7, * Feet 100.0 Feet Capacit VII. TANK in g allons Total # of r Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks manufacturer Name Concrete Con- Steel glass Plastic App New Exist in st�ucted Tanks T nks Septic Ta 121 ❑ ❑ ❑ ❑ 1:1 Lift umpTank pheN.GHamber X ❑ ❑ I F11 El ❑ VMF - RESR ONSIBILITY STATEMENT e!voW,=/ 7 I, the undersigned, assume responsibility for installatio f the onsite sewage system shown on the attached plans. AAE(MPRSW No.: Business Phone Number: Plumber's Name: (Print) Plumber's Signature: (N amps) zii 7 Plu ber's Address (Street, City, Stat , Zip Code): IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved I Sanitary Permit Fee (Includes Groundwater ] No ssue Issuin ent Signature ( Stamps) «harge Fee) Approved ❑Owner Given Initial �rti coo J � L j I J - W �i �,�, natprmin ation O X. CONDITIONS OF APPROYAP REASON$ FOR DISAPPROVA cj out" s hovicA b-e. vl 5 l (fu:51 or ' -4he- ka (1 v %/& j �o { ►� ' o-�- -��. SOD -6398 (R 11/96) DISTRIMMON: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber 6M �� y- g 7 k � X 1 A ,s rzY e cs7 rf � 0 Dave Fogerty Plumbin �3 �A P S M1 �^ �` R ae'� s SEWER SYSTEMS & PERK TESTING '" w FOGERTY HEIGHTS ROAD ROBERTS, WISCONSIN 54023 �y.ciw ° Epp _ (715) 749- 3656 a u , >.- �'� "�` 'r S s s,, -.• �",1�': ,- `yg r Ott ii "7 t {. s r�yy4w" 4 ^� 2— e le,, Ca ��-It tf I PAG F GF a PUtfkP CHAMFER CROSS SEC IOIJ —ki 0 SPECIF►CarIOu5 VENT CAP 4 "C.Z. VENT PIPE WEATHERPROOF APPROVED LOCKIAIG Z5' %RO•^1 DOOR. JUAJCTIO►J BOX MAIJHOLE COVER rs WINDOW OR FRESH IZ "MIU. AIR INTAKE GRADE I I y" MIAJ. I CONDUIT 18" h11M. � -- 18"MfAI. ---- - - - - -- 11� INLET PROVIDE I - -_ —_ -- AIRTIGHT SEAL * A I I I I I ALARM B I II ( i c *APPROVED I I o1J JOINTS WITH I I ELEV. FT. APPROVED PIPE 3' ONTO PUMP g OFF D SOLID SOIL COMCKETE BLOCK RISER EXIT PERMITTED OQLy IF TANK MAMUFACTURE.R HAS SUCH APPROVAL SEPTIC E DOSE SPECIFI'CATIOUS TANKS MA UU FACT LIRE R: 44//– le/z IJUMBER OF DOSES: Z PER DAB TANK SIZE: V/106 GALLONS DOSE VOLUME ALARM MAMUFACTURER: S, INCLUDING 5ACKFLOW: 27-5- GALLONS MODEL 1.lUMBER: l�l —'V — Ti4iVK 9< E j CAPACITIES: A= — .L_IAICHES OR GALLONS SWITCH T AV4,ER Ceofm 7 y /��LD/1T IIJCHES OR _ ?/ GALLONS PUMP MAMUFACTURER C : , Leei)s C= 23 INCHES OR 2 9'1 s GALLOWS SWITCH TYPE: MODEL A►UMBER: ��•!� Z/ p ­ .3 IMC14ES OR 5 26 GALLONS 1� ,� rytf•�/Y�9 MOTE: PUMP AMD ALARM ARE TO BE MINIMUM DISCHARGE RATE S'S ' GPM INSTALLED OU SEPARATE CIRCUITS 1p VERTICAL DIFFERENCE BETWEEM PUMP OFF AND DISTRIBUTION PIPE... 2— FEET C /O•S I xrjnc�t> + MINIMUM NETWORK SUPPLY PRESSURE . . -$�- • FEET FEET OF FORCE MAIN X F� l00 FL FRICTION FACTOR.. _Q FEET TOTAL 091JAMIC. HEAD = • FEET IMTERNAL DIMEWSIONC OF TANK: LENGTH 6(S ;WIDTH ;LIQUID DEPTH 4-7 SIG NJED: LICENSE NUMBER. 3 9 ne�-c• Performance Submersible Effluent Curves Pumps METERS FEET 30 100 SERIES: 3885 SIZE: 3/," SOLIDS 1 ........ ........ ...... ...... GPM % . ...... --A RPM: VARIES 80 5 ..... . ....... . . ... .. .. . . . ...... . . ... ....... ...... Uj 20 lip 15- 60 Z 0 40 ly 10 . . ......... . 6 A 2 0 - VIE )3 . . . .. ....... OL 00 20 40 60 80 100 120 140 160 U.S. GPM 10 to 3 . 0 m FLOW RATE [qGOULDS PUMPS. INC. WATER TECHNOLOGIES GROUP SENECA FALLS NEW YORK L3148 METERS FEET 120 SERIES: 3885 SIZE: 1 /4' SOLIDS 35- RPM: 3450 110 5 - GP M 100 5% 30- -- 90 w 25 80, i. 70 20- Z 60:7 � -j 50 ... . ..... ..... . .. 0 40 ........... I . . ........... ............ ........... .. .... .. .... 10 1 30 ..... ....... ........... ........ . ........... ..... . .... . .... . ..... .. ........ . ......... . 20 5 - . ...... .......... ........... ........... . . ........ 10 ...... .... ............ ......... . ! ........... . ..... ..... .. .... ........... 4. ... . . ... . ..... .. ...... . .. ........ ....... . .. ....... OL 00 1 0 20 30 40 50 60 70 80 90 100 110 120 U.S. GPM 0 10 20 30 M CAPACITY Effedive July. IM 1993 G0uIdS Pumps, Inc. SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. PHIN I E 1) IN U 5 A. W, S, C38853.150 VJ!isconsiq )��. trrwnt or Industry S 01 L AND SITE EVALUATION REP 0 R T Page I of 3 Labor and H3rrian net Division of Safety 8 Ruild;rxjs in accord with ILHR 83.05, Wis. Adrn. Code COUNTY ST, CrC.o t X CO , Attach complete site plan on paper not less than 8 1/2 x es► Plan must include, but I � PARCEL I.D. x L a not limited to vertical and horizontal reference point ) �ir�i� af�*� *I, slope, scale or dimensioned, north arrow, and location and dista ar ©st load ` 0 L (c APPLICANT INFORMATION- PLEASE PR LL�i10N ,- Rr= VIEW DBY DATE PROPERTY OWNER: I NI P RTY LOCATION NE VoGazr WEH AtkS e-M NGV 7 6- 1997 T 5e 1/4/�A' 1/4,S $ T o"? N,R 18 W PROPERTY OWNER':S MAILING ADDRESS S x t I BLOCK # UBD. NAME OR CSM # SOS COULE PZ.� APTT, 11 � CouNTY E G5M VOL.12 PG. CITY, STATE ZIP CODE ITY [ MOWN NEAREST ROAD N U w Dsbtj z SH O I to W R "EM I/ 8` ST �(J New Construction Use p(j Residential / Number of bedrooms —3 ( J Addition to existing building j J Replacement ( i Public or commercial describe Code derived daily flow (45 gpd Recommended design loading rate 0, bed, gpd/ft 0.8 trench, gpd/ft Absorption area required /043 bed, ft - trench, f1 Maximum design loading rate D.-7 bed, gpd /ft 0.8 trench, gpd/ft Recommended infiltration surface elevations) Tp_P -k— RM RY (as referred to site plan benchmark) y Additional design/ site considerations 1,r,� -,�„ q .�r• `1 � _�? �' S - E led APr 1 I`+` Parent material - AAX)LTMA) E — _ Flood plain elevation, if applicable Nit' ft S = Suitable for sysle NTIONAL MOUND IN GROUND PRESSURE AT GRADE SYSTEM IN FILL HOLDING TANK U =Unsuitable fors em S❑ U 21 S C7 U Jo S ❑ U S❑ U El U ❑ S U SOIL DESCRIPTION REPORT Depth Donnnant Color Mottles Slructurct VND iII` Boring # Horizon Toxturo Corlsstonce Bwxkry Roots - in. Munsell OU, Sz. Cont. Color Gr. Sz. Sh. Bed jTrench 2- 1d-?.? _ ► o Y," . -- - - -- -- C- 1"1d2 -K -- C Ground 3 - -Z' .J` C' elev. q 2L .32 ro vKyl� -- -- - - -- D _ ►_h 1 c s D .g too 5'' - - � — Depth to limiting factor X. Remarks: l4D.gl- t+AS p�►uti�, -- -- — Boring # I 0 - 1Z lov�z /Z ctb 2 z 1z �l S�___...�oYR_3)y _ .__.. — -( _._l_m�hK_._ _ �vf� S 3 3 -5 T ~ p s _ ml r D ,$ Ground elev . - -- lg- —lo Yf3_ / ��_ ___... _____.. _ - _-- ___ - -__ -- —� . 14 — �c, -4o 0 Y1V - __ f S — — m 1 _ _ C' - 2'lslt. -- -- - - -- 9q. - j7' Depthto --- - - - - -- __ __.. - -- - - - - - -- - limiting f acto r -- -- - - -- -- Romarks' C T Name:- Pleaso Print A&YAD Naut �-- - - - -- (71,5 zq7 - 17 5 Address: 220 AvE. l2_l V&&� LLs N , _..>51D? _------ - - - - -- -- Sig at�� / �� Date CST Number -" - - -- -_ _ Al ICJ, 1997 M&3707 PROPEMYOWNER_Wk — SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL I.D.# 'b 42 QZOALD`I 0 _— Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon Texture Consistence Barbary Roots in. Munsell Chu. Sz. Cont. Color Gr. Sz. Sh. Bed 1Trurxii 0 —7 10 Y 3 1 3 — sl 5 – 0 - 1 >> Z 7 -f7 toy - - - - -- -- s D _ D 0•$ Ground elev. q�15Z Depth to limiting - f actLo�'' — --- - - - - -- Remarks: - - - -- - - - - -- - - -- -- - - - -- - Boring # _ 1 0A I o YX 5 *i 1 2 m m qVC Q5 y Z 3 -- — S -- - - - - ml CS - o�? -off Ground_ __ - --- - - - - -- - - - -- -- - - -- elev. Depth to limiting factor - -- - - -- - - - -- - ._... _ -- - -- - - - -- -- - - - -- - - -- Remarks:R - Boring # 1 0 -1Z_ 10Yr'ZjZ - � �►71�b1s_ �� 0.S D.S p.6 5 3 Zy-9 Ground - - - - -- - - -- - - - - -- _ _. - - -- elev. l 99 IT" Depth to — - - - - -- - - -- - - -- - -- - - -... -. -- - - - - -- limiting ffaacttoor� - - -- -- - - - -- _ _ _- __.. -- -- - - -- - - - - -- - - -- L_N Remarks:K! Ns4 - SoMar GRAt ✓F�t -- -- - - - - -- -- - -- Boring # i Ground - -- - - -- - -- I - - - - - -- - - — -- - -- elev. Depthto — — - - - - -- - _ - -- - — — -- - - - -- limiting factor - - -- - - - -- Page of ' PLOT PLAN Property Owner j?Q6ERrVjS4jAVSSAJ Legend: VOTet. Legal Descriptiori y OL, 1 2 - flM C ROlLN D 6u.fL»L kT F�NC1= PAST- / I OO.p� �ro .334y d .p t�, t+tS NE s1✓% D F 9 j#7-- 6RouN0 SUKF A-T TOE N6 % sue, $,T2q*j, RIxW - ia vj) pF pEw PoST - 15.37" WAR.f SrWV CO. �LJ\Se0 MS IA) ❑ = soil boring w /backh( i l • 21 RCfZEs 5rT E W A L FIB ►-FA N O GoM M 43 b BT �g K,� do *2 -DD N OT WSTUAS K X9 x ^ A x ,, v :— x —�►t .ic F ace t_rN� -- VoRr►+ PR0Pr i TY LmE El Sq EL e 8' yyy °17:3 APPkoXI/\A (000' TO 110 ST. >7 If EL 9 — a . q4'7 7 M I- FL- NCe 5 T vi] WaovqA L- A r+4 Ib NaT 'p r S T tKR 2 Signed CST � S .t10 370'7 Date NOVEMBt—�R 14, 199'1 Wisconsin Department of Indus SOIL AND SITE E V A L U r; T I O N REPORT Page / of z labor and Numan Relations Division of Sa'my & Buildings in accord with ILHR 83.05, Wis. Adm. Code r COUNTY SA Attach complete site plan on paper not less than B 1/2 x 11 inches in size. Plan must include, but D q not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. 6 �q — 1020 — (V d — / 00 APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION N We . 1/4 /VE 1/4,S 8 T 29 N,R � �WW PROPERTY OWNER':S MAILING ADDRESS LOT # I BLOCK # SUBD. NAME OR CSM # 9'0.5 Coi �� �p . F�fl T i 3 -- C5M VbL.1 Z P6. CITY, STATE } ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE TOWN NEAREST ROAD H u oso►� WT 64 0 l nls) 391. - I. Int W,q P,kl�j I 10*"- ST, New Construction Use Residential / Number of bedrooms 3 ( ]Addition to existing building ( J Replacement [ J Public or commercial describe Code derived daily flow y 5 0 gpd Recommended design loading rate 6 . ? bed, gpd/ft a 8 trench, gpd/11 Absorption area required bq l bed, ft2 17,G �X �O ft Maximum design Icoadi Q rate 0, 7 bed, gpd /ft 0 trench, gpolft Recommended infiltration surface elevation(s) i ( �z�' tt Ias referred to site plan benchmark) Additional design / site considerations Parent material U An:!iTrw':C Flood plain elevation, if applicable Nor It S = Suitable for system ZONAL. MOUND IN-GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING ANK U- Unsuitable for s st g S El U T-1 S❑ U S❑ U R S ❑ U ❑ S �1 U ❑ S U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft2 Boring H Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Boots JTrench 2 msb rn r 0. Ground 3 23 -80 / Y 2 y f( o _ s 0 s m1 - .' 7 0. elev. -- 9 7.23 ft. Lf FO=RD _._.�_, S Q m 0 r? t_8 Depth to ry/" limiting , fact C ? t r "��.. Remarks: Ir "lJ Boring li F�CF Zt C ) L Ground ► F oK 3' s Q('A RA-rt N elev. I vRrk1b 1 K A r A P Pt t� Ca ft. Depth to v 1 U,11 9 - 7, limiting t t factor Remarks: CST Name: — Please Print P ,onu N1 A K1/ t" 1IN —L-UST Eft Address $ VF4RF A LL-S T V� ' a Date CST Number: APR Mo3"7 0'7 Page Z of Z PLOT PLAN Property Owner LI-1)3T W�ttAwSeN Legend: Y= 1 10 1 C O � Legal Description 3, GSM VDL• BM = -:9-1- G2ekNa SUAPAC,=AT 176 ►oD,p 040 53L4 L- OcAiED 1,1 T+4 E r ►���( ���{ i� 2 - GkOUN O SUAFRcrr Ar pQMCE OF THP, NE' /y� SEC. 9, TZ9--J, re 1 9w - c WA) PAST =. 1L1 -92' o� „��,c,g»u, sT,crzQ�x co,�w��ca�as►N. ❑ = soil boring w /backho" 0 = PfANO AUA.VA ZOAJNS- BoKIAJ&S NOT 0 FrJ2 � -zlo B_ :F eA C= L j e_ Aj o " f PnM)ZTI L 1 A11r 21 A cYLss >(Te i.%1 ALFAt -PA NO Cav-* 93 Slur IP - OLEAX- D�3 C�j`1 �1PPRpKINWt�LY trC10� r L g q ,,S 2 Al Q o r `�, — x .-77' --i _ n � �c 9 �0 0l o y op EL 100- ,r E-L -7L/,77' ®� FEvice post v�l( W-'0orDE.,j STN — Z0 NOT Dk3TU Aa- f� Signed CS T ii& A10 3707 Date APKIL 20, 1998 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 1'?VAeF17 1_/,5 11,4 us4!!�i✓ Mailing Address fBS Co r z xw fed zf o z 'a Property Address le T Z Ile & S� l (Verification required from Planning Department for new construction) City /State _�obrr Tom-. Gtt Parcel Identification Number O.Vi - /020 - /a - -vo LEGAL DESCRIPTION Property Location � A-_ %4, "_ ' /4, Sec. �' . T_�N- R Town of Subdivision , Lot # Certified Survey Map # Volume 12- , Page # 3� Warranty Deed # / 7 ff.7 Volume " 7j/ , Page # �tpZ- Spec house ❑ yes R no Lot lines identifiable dyes ❑ 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 masterplumber, 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. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. f^ SIGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed DOCUMENT NO. WARRANTY DEED M «. .. ..,. .. +� 67593 VOL 1?7-1 c ?9? , THUS DEED, made between John A. Kurkowski and Anne T. I ;,- Kurkowski, husband and wife, Grantor, and Robert I Wehatsen, a tingle r {;j';' L 1991 1 person, Grantee, 11:00 I M M JVITNESSETH, That the said Grantor, for a valuable consideration of A!N one dollar and other valuable consideration conveys to Grantee the following described real estzte in St. Croix County, State of Wisconsin: . ' Lot 3 of Certified Survey Map recorded in Volutme 12 on page 3344 as RECORDIN tr'F00.MATlobi #} Document No. 564787, being a part of the Northeast 1/4 of the Northeast N7 E D RETURN ADDRESS 1/4 and the Southeast 14 of the Northeast 114 of Section 8, Township 29 � r �i+ r � r• North, Range 18 West, Town of Warren. g Norman, S.C. 1 Heritage Drive e Richmond, WI 54017 �kv TRMCFER I o n FEE 042 - 1020 -60 -100 (parcel Identification Number) This is not homestead property.` all and singular the hereditaments and appurtenances thereunto belonging; and Grantor warrants that the title is goal, tf ' Together with a gu indefeasible in fee simple and free and clear of eucumbrances except: Easements, highways, utility rights and reservations of record and will warrant and defend the same. Dated thi day of October , 1997 Jk (SEAL) Z�r (SEAL) Y • • Jobe A Kurkowski +(� (SEAL) (SEAL) w d �_ '-- • Anne T. Kurkowski t AUTHENTICATION ACKNOWLEDGEMENT s , Signature(,) of John A. Kurkowski and Anne T. Kurkowski STATE OF WISCONSIN } } a. + ST_ CROIX COUNTY } authenticated this day of October 19 97 ?enonally came before nse this day of �-_ 19 97 . the above named • Timothy J Scott > r TITLE MEMBER STATE BAR OF WISCONSIN me known to 're t: person a who etz.+u .d the foregoing iry .+tmenl and (if not � t authorized by $ 706.06, Wis. Stets.) acknorl -dged the same. THIS INSTRUMENT WAS DRAFTED BY: Timothy 1. Scow •- BAKKE NORMAN, S.C. Notary Public. County. w iacOnail- NEW RICHMOND, WISCONSIN My C,snmission is permanent. (If ax, s tate expiration date: *Names of persona signing in any capacity should be typed or printed below their 19 —, w, signatures. r- A 104, �•.�.. .. r p •f FILED V C ray £ SEP 0 3 1997 0- 9 5 ( KATHLEEN H.WALSH Register of Deeds 2 SL Croix Co., WI � l � CER T - TF SUP VE Y MA P Located in the Northeast quarter of the Northeast quarter and the Southeast quarter of the Northeast quarter of Section 8, Township 29 North, Range 18 West, Town of Warren, St. Croix County, Wisconsin. Owned by: John & Anne Kurkowski 1 1059 110th • indicates a 1" iron Roberts, Wisconsin 54023 LOT 2 1 pipe found. C_ - - G. LOT VOL. 8 , P 2382 6 6' ?_ S 88'00'41 "E 885.21' 852.17' 3 3.0 41 I Bearings referenced LOT 3 1 I to the East -West 1/4 Section line, 488,363 Sq.ft. (11.211 acres) rl I assumed N89 ° 33'40 ''W Including right -of -way. �I. I 470,567 Sq.ft. (10.803 acres) C_S_M. m Escluding right- of - way. 61 VOL._I PG. _244 L0 "I m W) - LO 0 o' ZI I o Qi S 89'33'40 "E 889.19' i N 856.18 ' ' ,� (� C 33.011 o U') I vl V U 1 U ) U: Q 00 /L ® T 4 893,264 Sq.ft. (20.507 acres) I w o Including right -of -way. NI I , U 860,257 Sq.ft. (19.749 acres) O Excluding right -of -way. ml 1 i U: N cn 1 w z o z : X 1 0 I o -' O �; - LO ZI O m: �,Irn I � , o �j 01 t- i �,, H ARVEY , !. o, ZI I o Q J OHNSO N 1 i S ' F- I Z� L HUps�N -tod �� �I