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HomeMy WebLinkAbout038-1017-50-000-7 'A vt-- Countya I ary Permitpp ca Ion ST. CROIX COUNTY WISCONSIN In accord with. t r 12 St. Croix County Sanitary Ordinance COMMUNITY DEVELOPMENT DEPARTMENT t ST. CRO� ��n?*'W_ u provide may be used for secondary ores ST. CROIX COUNTY GOVERNMENT CENTER - y Law. S. 15. (m) 1101 Carmichael Road n Hudson, WI 54016-7710 2�2 19L (715)386-4680 Fax (715)245 4250 plete lansfpr the system ess t n 8-112 x 11• inches in size. JCounty�"*ROOWMt*� ❑ Check if revision to previous application I. Application Information - Please Print all Information Location: Property Owner Name N� J 1/4 1/4, Sec j T N, R E (or) j' _ Property Owners Mailing Add ess Lot Number Block Number S _� City, State Zip Code Phone Number Subdivision Name or CSM Number � ,I /vl < a�-� M rk II Type o uilding: check one ❑Ci ❑ Village ®-Town of P( 1 or 2 Family Dwelling - No. of Bedrooms: ❑ Public/Commercial (describe use): AeIIOL ❑ State-owned Nearest Roa II. Type of Permit: (Check only one box online A. Check box online B if applicable) Parcel Tax Number(s) 30 Non -plumbing 4.❑ Rejuvenation A) 1LI Repair [�� Sanitation B) Permit Number Date Issued ElState Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) ❑ Non -pressurized In -ground ❑ Mound >_ 24 in. suitable soil ❑ Mound <_ 24 in. suitable soil ❑ Mound A+0 ❑ Sand Filter ❑ Constructed Wetland ❑ Peat Filter ❑ Drip Line ❑ Pressurized In -ground Holding Tank ❑ Single Pass ❑ Other ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application Rate 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed (Gals. /day/sq_ft.) (Min./inch) Elevation VI. Tank Information Capacity in Gallons Total # of Manufacturer Prefab Site Con Steel Fiber- Plastic Gallons Tanks Concrete structed glass New Existing Tanks Tanks �j,' ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ VII. Responsibility Statement I, the undersigned, assume responsibility for repair/reconnection/rejuvenation/installation of non -plumbing for the POWTS shown on the attached plans. A license is not required for terralift repair or the installatio of non -plumbing sanitation system. Plum s Na a ript Plumber atur (n MP/MPRS No. Business Phone Number c 7 Plumbers Address (Street, Ci State, Zip Code) VIII. County Use Only Disapproved Sanitary Permit Fee Date Issued Issuing Agent Signature (No stamps) ❑ Approved Owner Given Initial Adverse Determination IX. Conditions of Approval/Reasons for Disapproval: ©� r i SYSTEM OWNER: 1 l�`0�-� h 1. Septic tank, effluent filter and dispersal cell Pec e vek" must be serviced / maintained as per fl"lrAl S management plan provided by plumber. �� SD�.�ti�(� `I 2. All setback requirements must be maintained f� Rev: 3 f �S (A� ` UuP 2-0Z3 . 06 s "J Z I 2 o w` CFpgR C E%ISTIN� �� 'P' qkf FIOODPLAIN /ELEV=921.00 APPROXIMATE OHW M ELEVATION 918.5 ' LAKEELEVATLON X TREE ON 819122=918.0 OFF TO BE_ REMOVED> EX CONCRETE STAIRS 8 WALKWAY TO REMAIN'?' _i \ CENTERLINE OFC.T.H. "H" R,W ASS DETERMINED BY ST. CROIX COUNTY \ �O \ yr CENTERLINE OF C.T.H."H"- \� AS TRAVELED \ IESER wieserconcrete.com Innovation, Quality and Service Since 1965 1101RETE /5 r v RECEIVED FE B 17 2023 $T. 'ROL, COUNTY CDC Maiden Rock, WI (800) 325-8456 Fond du Lac, WI (800) 641-5937 Portage, WI (800) 362-7220 Spooner, WI (800) 336-3416 Roxana, IL (618) 251-9210 - STEEL HOLDING TANK DESIGN Single Tank Option INDEX AND TITLE SHEET Project Hanson Family Real Estate Trust Owner Hanson Familv Real Estate Trust Address 5295 Neal Ave N Stillwater MN 55082 Legal Description Township Star Praairie Subdivision Name sec3-T31 N-R18W Parcel ID Number 038-1017-50-000 Plan Transaction ID Number County St Croix Lot No. Index and title sheet Page 1 Holding tank specifications Page 2 Site plan Page 3 Maintenance and contingency plan Page 4 Designer Kim A Oco II Signature License Number 224263 Phone No. 715-381-7917 Date 08/21 /22 Designed pursuant to: Holding Tank Component Manual For POWTS (Version 2.0) SBD-10855-P (N. 03/07, R. 01/12) Version 7.0 (11/12) Pagel of 4 HOLDING TANK SPECIFICATIONS 4 Number of bedrooms Non-residential estimated flow (gpd) 2000.0 Minimum holding tank volume required (gal) 2000.0 Proposed holding tank capacity (gal) TMC Tank manufacturer 2000 steel Tank model number SJE Rhombus Alarm manufacturer HW 101 JAlarm model number Tank Dimensions and Data 38.0 Liquid depth below inlet invert (in) 8.0 Maximum depth of soil cover (ft) 120.0 Length (in) 68.0 Diameter (in) }Outside Dimensions Tank Anchor Calculations 5500 Ibs Weight of tank 1.50 Safety factor 11676 Ibs Weight of anchor required 29.0 in Soil cover req. for anchor, or 2.9 lyd3 Concrete counter weight HOLDING TANK CROSS SECTION finished vent grade cap ,12" min. vent pipe blind plug to seal outlet manhole cover with locking device and junction �— warning label box ;0 1 --T F 23 " min. conduit —�� tether Note: All tank joints, and joints between tank openings and piping are sealed water tight. Pipe and vent materials comply with SPS 384. Manhole and vent locations may be reversed. weight L 12 in service 26.0 in. 4" min. 3 in. bedding under tank. Tank is anchored as necessary to negate buoyancy. Because of this tank's rounded surface, soil cover alone may not be adequate to prevent flotation. 18" min. building sewer inlet Electrical is as per NEC 300 and SPS 316. Project: Hanson Family Real Estate Trust Transaction Number: Page 2 of 4 ' CF Og044k t EXISTW FLEp?pDPLAIN ELEV.s921.00 APPROXIMATE OHWM ELEVATION 918.5 LAKE ELEVATION X. TREE ON"12.2=918.0 OEOK�13 REMOVE EX. TREE w F-` 9 Sp 0 REMAIN aesE22R46 9') r FFFNL\ � t EX. CONCRETE STAIRS & WALKWAY TO REMAIN??? ..r CENTERLINE OF C.T.H. "H" R/W AS� \ ` DETERMINED BY ST. CROIX COUNTY Yr CENTE lo HOLDING TANK MANAGEMENT PLAN This Private Onsite Wastewater Treatment System (POWTS) has been designed, and is to be installed and maintained according to SPS 383, Wis. Admin. Code, the Holding Tank Component Manual (SBD-10855-P N. 03/07, R. 01/12), and the St Croix County Sanitary Ordinance. 1. This POWTS is designed to accommodate a wastewater flow of 80.0 to 400.0 gpd. 2. The owner of this POWTS is responsible for system operation and maintenance, including all provisions in the attached Holding Tank Servicing Contract and Maintenance Agreements. 3. Each time the wastewater in the tank reaches 90% of the tank(s) capacity or a level of 12" below the inlet (at which time the alarm activates), the pumper listed in the current Servicing Contract must be called to empty the tank's contents and dispose of them in accordance with NR 113, Wis. Adm. Code. 4. At each service event, the service provider should visually inspect the condition of the tank, risers and manhole cover(s) and verify that the alarm system functions and manhole locking devices are present. Discrepancies are reported to the owner in a timely manner for corrective action. All corrective actions shall comply with the county sanitary ordinance and SPS 383 and 384 Wis. Adm. Code. 5. All service events or inspections of this POWTS shall be reported to the county within 30 days. 6. The owner may not remove any of the wastes from the holding tank(s), or cause such wastes to be removed by any person not authorized to do so under Ch. 281, Wis. Statutes. The discharge of wastes from this hold- ing tank to the ground surface, including intentional discharges and discharges caused by neglect, consti- tutes a failing POWTS and may result in issuance of correction orders or a citation by the county or state. 7. No one should enter a holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within these tanks may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. 8. In the event that this POWTS fails and cannot be repaired, a code compliant replacement holding tank may be installed in the same location (a new sanitary permit is required for such a replacement). Connection to municipal services would also be considered at this time if they are deemed available to the property. 9. If this POWTS is replaced, or its use discontinued, components no longer in use it shall be abandoned in accordance with SPS 383.33 Wis. Adm. Code. 10. If there is a problem with, or question about this installation, the following persons should be contacted: a. Installer .............................. b. Service Provider ................... c. County Zoning or Health Dept. 11 Kim A Oconnell Phone: 715-381-7917 Phone: St Croix County Zoning _ Phone: 715-386-4680 Project: Hanson Family Real Estate Trust Transaction Number: Page 4 of 4 ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the following residence: (Street address) Z/S-b r rge.D located at: '/a, '/a, Section _�, Town_,Z_LN, Range_/,Y_W, Town of St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of SPS. 384.25, and it (they) appear(s) to be functioning properly. Most recent date of inspection or service Did flow back occur from absorption system? Yes No__,—>,- (if no, skip next line.) Approximate volume or length of time: gallons minutes Tank Capacity: -�% 0.V, 11 Construction: Prefab Concrete `Steel_ Other Manufacturer (if known): Age of Tank (if known): Permit n ber (if known) I ��4�a (Licensed PlumberSignature) (Print Name) (Title) (License Number) MP/MPRS 9 -� (Date) Form to be completed by licensed plumber (Dept of Safety and Professional Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 2/2012 Parcel #: 038-1017-50-000 Valid as of 08/19/2022 09:24 PM Alt. Parcel *: 03.31.18.59 TOWN OF STAR PRAIRIE ST. CROIX COUNTY, WISCONSIN Owner and Mailing Address: Co-Owner(s): HANSON FAMILY REAL ESTATE TRUST 5295 NEAL AVE N Physical Property Address(es): STILLWATER MN 55082 * 1156 CTY RD H Districts: Parcel History: Dist# Description Date Doc # Vol/Page Type 3962 SCH DIST NEW RICHMOND 02/25/2019 / QC 1700 NORTHWOOD TECH 08/24/2015 / EZ-1 8050 CEDAR LAKE/N R 09/15/2014 / WD 10/09/1990 883/254 WD Abbreviated Acres: 0.000 more... Description: SEC 3 T31N R18W PT GL5 COM C HWY 799FT E OF W LN WLY ON C HWY 161FT N TO SHORE CEDAR LAKE SELY ON LK TO PT N OF POB S TO... more... Plat Tract (S-T-R 401A 16" GQ Block/Condo Bldg * N/A -NOT AVAILABLE 03-31N-18W 2022 Valuations: Values Last Changed on 10/21/2019 Class and Description Acres Land Improvement Total GI -RESIDENTIAL 0.000 57,300.00 80,600.00 137,900.00 Totals for 2022 General Property 0.000 57,300.00 80,600.00 137,900.00 Woodland 0.000 0.00 0.00 0.00 Totals for 2021 General Property 0.000 57,300.00 80,600.00 137,900.00 Woodland 0.000 0.00 0.00 0.00 2022 Taxes Taxes have not yet been calculated. Key * - Primary P�IIIVIIII9'IIIIIII IIIIIII Quit Claim Deed Document Number This Deed, made between Richard Gilbert Hanson and Teri Ann Hanson, husband and wife ("Grantor", whether one or more), and Richard G. Hanson and Teri A. Hanson. Trustees or their successors in Trust, under the Hanson Family Real Estate Trust date 1$nd any amendments thereto, ("Grantee", wheth one or more). Grantor quit claims to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property"): See attached Exhibit A for legal description P Authentication Signature(s) Title: Member State Bar of Wisconsin (If not, by Wis. Stat. §706.06) This Instrument Drafted By: Attorney Dallas E. Klemmer authenticated on authorized 1078170 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI 02/25/2019 12:01 PM EXEMPT#: 16 REC FEE 30.00 PAGES: 2 Recording Area Return to: Attorney Dallas E. Klemmer PO Box 26 Keaau, HI 96749 038-1017-50000 Parcel Identification Number(s) This is not homestead property. *Teri Ann Hanson Acknowledgment Statg of Minnesota ) fho County )SS. � qq Personally came before me on a"°`''"7 '�r de/the above - named Richard Gilbert Hanson and Teri Ann Hanson to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. * a� T I^'Ist �e►rs Notary Public, State of tA rnn e My Commission expires: ! — 3 [ — a-1 E , Vs I.r r:J' f,iA?� HE4yS `10, Fry PLI ,^.. MINNESOTA St. Croix County 1078170 Page 1 of 2 Exhibit A Part of Government Lot Five (5), Section Three (3), Township Thirty-one (31) North, Range Eighteen (18) West, Town of Star Prairie, St. Croix County, Wisconsin, described as follows: Commencing at a point in the center of highway, as now located, running East and West through the West Half of Lot 6 in Section 3, Township 31 North, Range 18 West, said point being the Southwestern corner of that certain piece of land deeded to James Thompson in Volume 177, Page 599; running thence Westerly along the center of said highway for a distance of 102 feet; thence Northerly to the shore of Cedar Lake; thence Easterly along the shore of Cedar Lake to a point directly North of the place of beginning; thence Southerly to the place of beginning. EXCEPT the East 55 feet as measured along the highway. Subject to County Highway "H" right of way. Tax Parcel Number: 038-1017-50-000 St. Croix County 1078170 Page 2 of 2 File #: ST. CRo` :NTY. SANITARY SYSTEM Office Use ````"'� OWNERSHIP/ADDRESS FORM Created 2/202T Community Development Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources. Once approved, this completed form and educational information will be sent to you by email. OWNER/BUYER INFQ1tMATlON Certified Survey Map # , Volume , Page # Warranty Deed # _(before 2006)Volume , Page # Number of bedrooms 1 Spec house 17 yes A no Lot lines identifiable X yes 13 no New Property Address (Staff Initials) (Verification of new address required from Community Development Department for new construction.) (Date) This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New System: Include with this form a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. Community Development Department — Land Use Division 715-386-4680 St. Croix County Government Center 715-245-4250 Fax cdd@sccwi.gov 1101 Carmichael Road, Hudson, WI 54016 www.sccwi.gov N O N E °o 19 m 3 R L UponCopyp y for these draf— d- ro owned by lam's Dra .. Room, � Upon payment of all fees due to la�n'e Drawrg Room, a 6mkecl ko rw a granted to use these Flare to build one stnzture. lain's D—rg Room reserves all rghts. These plare may not be re -used for any additarul stnwtures, may not be assgned © or coped, and may not be modified or used m ary redcs t .U- the poor wntten consent of lnrh Draxmq Room 8:I2 FRONT ELEVATION 114" = I'-O" 4'-O' POURED CONC. FOUNDATION 9'- I 1/8" CEILING Q MAIN LEVEL 8'-1 1/8" CEILING @ UPPER LEVEL FOR BIDDING ONLY NOT FOR CONSTRUCTION a� L o IMBIBE LEFT ELEVATION 1/4" = 1'-0" #21-144 Lm Gfalll 6-9-211 0 3 c O E s U cy 3 o z `` a 0 v ]= 00 .L W x l0� t o U 'O nRO1rCTjQ rr MAW 929 tDVrR aw TOTAL lim JW-ET: 1 or 5,12 ■ 14:12 — REAR ELEVATION 114" = P-O" N O CV E 0 O� 3 m L p Corr,#* for these drawags a o-.d by 1.01 D,." Roam, Upon payment of all fees due to Ian's Dra" Rv . a Minded Ma ,s g,tm to use these plain to build one stnrcture. hays D—.g Room romp all nght, These plans may not be re-uxd for any add t—W stnAa.-, may not be ass,grrd ©or coped, and may rot be modfied ar used m ary redesign wrthout the pnor wntten consent of lases Draanr 9 Room FOR BIDDING ONLY NOT FOR CONSTRUCTION 4 3 a h c :OlUPT 6-4-21 wjjm 6-9-21 ND RM1 &17-21 MW 1_17-22 4�/� 0 Ln I- �_ ` • I _ _ • • II■I■I111■I■I■I�I� ICI■I■I �I■I■I�II�JI11�1■I f� F2,�r RIGHT ELEVATION 1 /4" = 1 '-O" #21-144 om FOR BIDDING ONLY NOT FOR CONSTRUCTION o CRAWL SPACE o I '3' CONC. BOOR i I ieca+- ;� I move CRAWL5FACE b '3' LONC. R.00R is A _ — MECHANICAL CRAWL 5FACE '3' CONC. rLDOR '3' LONC. MOOR 0 E pO oC 3 CAPY^9M for these draw ings is owned by tarawin xis Dg om Ro. me Upon payrit of all fees due to lam's Drawing Roorn, a hmRed h-- a granted to -c these playa to build one str-t— lam'rawr s Dg Room reserves all rghts. These plans r y not N be —sad for any additwrW sV-t—, mry not be assgned ©or copied, and mry not be modified or used m any rcdesgn without the pnor wntten consent of I]xM D—q Room FOUNDATION PLAN 1/4" = I'-O" 4'-0" POURED CONC. FOUNDATION #21-144 E a log "CoficzpT m PWX EDE JKLT: V111 I -5 1 FOR BIDDING ONLY NOT FOR CONSTRUCTION P.C. TRU95E5�� 2 DEC], MATCH n(15TH 15 SHAPE • 4-5WON f7 c - ? •LVP b a — m F$ •VN*T® I'Q i 1 O-3• EurD301 IX R Y TOP ®T- I ESCA2650-2 E55PDG080-%O N Dw _ KITCHEN "VP 333iiii 14'Q K 13'-6• GREAT •°C u I T-3'lVP " 13'�' ci u m - m - 4 I b• _g � F , — — — PULL HEIGHT 6111LTJ1J� p Y 2'O I a, N I J22� FOYER $ - 'CAW 5 /', -, 1 I'-G•a It ` � z�• BATH I o •�vT® F; _ SrACR waD � $ Z-& 3'-0' N O N E 0 m C 3 p Copyngflt for thcx drawings oowned by laxfs Drawly Rnpn. Upon payment of all fees due to lam's Drawing Room, a hilted hcenx 1s granted to ux thex plain to build one sGucGlre. C Izm'5 D—ng Room r r,— all rght5. Thoe plans may not @ be re--d for any adddrol w5tnxb-5, may not be anlgned ©or coped, and may not be modified or —d in any red—y without the prior written corset of 1a,r05 Drawalq Room MAIN LEVEL PLAN 1 /4" = 1 '-O" 9'- I 1 /8" CEILING @ MAIN LEVEL C.OtKZ-Fr 6d-21 vlallt 6-421 BID PLAA 617-21 C 0 v a �L IMW 9M' 1DOER am JMUT: #21-144 m 4 or FOR BIDDING ONLY NOT FOR CONSTRUCTION LOFT BEDROOM /2 —i § ia yq6y(T - r-0• H z'-0• — w T o BEDROOM #4 - BEDROOM #3 T� b o- y a® - ° BATH #2 N O N E O 6r 3 rn � Gopynglrt for these wis owned by IarAs DrawRoan.Upon R. Upon payment of all fees due to lams Drawnr3 Roan, a limited license rs granted to use these plans to build — stn�. l.. s w Dranq Roan reserves all rq ts. These plans,may not e Le rused for any add�bonal stmd res, may not be assigned ©or copied, and may not be modified or used in any redes without the pnor —tten consent of 1-6 D—q Room UPPER LEVEL PLAN 114" = 1'-0" 6-1 1!8" CEILING @ UPPER LEVEL #21-144 COAC PT 6-4-21 7R[Ll1 6-9-21 BW 7LAl1 b-17-21 naourJn rr. rtw sxe rora tn� Weer: "' 1 5 a 3 cu Q Copynght for thex drawxgs � owrcd by lairs Draanrg Roan, Upon pay—t of all fees due to Ian§ D—nj Room. a bmded keens- �s granted to use these plans to budd — structure. lanh D-3 Room reserves all rghts. These plain may not @ be re--d for ary addknrel st—tr-, may not be —Tin d ©or =P1ed, and may not be moduse hed or d m re any design WIth—t the pnor —ttan consent of Inn's D—nj Roan ROOF PLAN 114" = 1'-0" FOR BIDDING ONLY NOT FOR CONSTRUCTION I/IG*W INGM INIC EW 1 H[IGM #21-144 COACr2T 6-4-21 PR[LM 6�21 BID PLAN 6-17-21 RZI-V D 1-17-22 r\ O 3 0 E s tR 3 Z a 0 0 C 3 0 V 10 NAN 9IB I�12 ens TOTAL 1.7]) JK[T. [Am6 a ST. C R01X "- UNTY SANITARY SYSTEM File #: Office Use Only OWNERSHIP/ADDRESS FORM Created212027 Community Development Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources. Once approved, this completed form and educational information will be sent to you by email. Owner/Buyer OWNER/BUYER INFORMATION Richard & Teri Hanson Mailing Address City/State/Zip 5295 Neal Ave N Stillwater, MN 55082 Phone Number (required) 651-308-8913 Email Address (required) terihanson13@gmail.com Parcel Identification Number 038-1017-50-000 (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location N 1A , W 1/4 , Sec. 03 , T 31 N R 18 W, T wn of Star Prairie Plat: Sub Ci� � 4 Lot # �� +ems D�-c� Certified Map # ,Volume ,Page # eed # (before 2006)Volume Page # Number of bedrooms Spec house ❑ yes PJ no Lot lines identifiable JIM yes ❑ no OFFICE USE ONLY New Pro rty Address Z 1541 ��I ( � T( (V;'� n of n address required from Community Development Department for new construction.) -0 z3 (Staff Initials) (Date) This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New System: Include with this form a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. Community Development Department — Land Use Division 715-386-4680 St. Croix County Government Center 715-245-4250 Fax cdd@sccwi.aov 1101 Carmichael Road, Hudson, WI 54016 www.sccwi.gov vVIVLRC I rZ / / / . _/ / /' .1), E REMOVED} `,� 920-82 �V4 - J #4e,'e4 8 .9 EX. GAS lk N& .... Vl —11 lb. a EX. TREE 91 TO BE 9 \,REMOVED 920-05)( EX. REE TO BE, REMOVED -_ 919.99 ..METER'./ X20.47 _"'�EX. DECK FOP' , OF WELL, 9 ELLY. =.922.50* REMOVED TO BE ot -EXISTING gy --ow- WELL 21 921.18 c -EX. CONCRETE sx STAIRS & WALKWAY C322 0 9 9 _�4 C %Or SEPTIC 928 TANK W4 fx" 1p 407 924 X923,80 O� ,29.58 91-119 /111 IV/ 925 04. 29.54 -926-- ST, CROIX COUNTY No.��1-1=�Z� SANITARYPERMIT OWNER PLUMBERK:IVAID UWW.Upr LIC. # TOWN OF 4::P" P9PA&eIE SEC LOCATED REPAIR ❑ RECbNNECTION NON -PLUMBING ❑ SANITATION REJUVENATION ❑ purpose of the sanitary permit Is to allow repair, reconnection, m, or installation of non -plumbing sanitation as described in the i for permit. (b) The approval of the santtary permit Is based on regulations In force on Zthe date of Issue. T �N',R 1� AND/OR LOT BLOCK It SUBDIVISION (o) The sanitary permit Is valid for 2 years from original date of issuance and may be renewed for similar periods thereafter. Application for renewal shall be made through the county and shall comply with regulations in effect at the (d) Changed regulations will not Impair the validity of a sanitary permit until the time of renewal. (e) Renewal of the sanitary permit will be based on regulations In force at the time renewal Is sought. Changed regulations may Impede renewal. (f) The sanitary permit Is transferable. A sanitary permit transfer shall be obtained from the St. Croix County Zoning Department. ' If you wish to renew the permit, or transfer ownership of the permit, Tease contact the St. Croix County Zoning Department. 1 AUTHORIZED ISSUING OFFICER - DATE ' 2 1 THIS PERMIT EXPIRES UNLESS RENEWED BEFORE THAT DATE POST.INrF ISSUANCE VIEW ft?mlo WQAUTI�( RrHEROAOFRo TINGrHELor tMs BAN iss�cS r+R7��8°� r 4 C Q- � - ' �-�Lv REZONING QUESTIONAIRE All rezonings are to be consistent with County land use plans, County ordinances and other applicable local plans. Your application will be reviewed by staff and presented to the County Community Development Committee for consistency with the following ordinances and plans: St. Croix County Zoning Ordinance (Ch. 15), St. Croix County Land Division Ordinance (Ch. 13), St. Croix County Sanitary Ordinance (Ch. 12), St. Croix County Comprehensive Plan, St. Croix County Outdoor Recreation Plan and the St. Croix County Land and Water Natural Resources Management Plan. It is the applicant's responsibility to show that their proposed use is substantially consistent with these ordinances and plans. Each ordinance and plan is available for review by contacting the Community Development Department or on the County website at: www.sccwi.gov. To assist in determining how your proposed use relates to the aforementioned ordinances and plans, please answer the following questions on a separate sheet of paper and include them with your application materials. 1) Explain why you wish to rezone this property. Identify the proposed use if rezoned. 2) Explain the compatibility of your proposed use with uses on existing properties in the vicinity of this site. 3) Explain any interaction that you have had with the Town in which this property resides and elaborate on any concerns they may have with your request. 4) Explain how the proposed use will affect stormwater runoff, wetlands or will impact any shoreland areas. 5) Discuss if the site has any wildlife, scenic or recreational value that should be protected or enhanced. Indicate if you are willing to pursue such efforts as part of your proposed use of the property. 6) If the proposed use is residential development please submit a concept plan of an anticipated lot layout and describe any significant features on the site (wetlands, floodplain, poor soils, steep slopes, etc.) that either support development or are challenging. 7) Discuss any additional issues your feel that supports the consistency of your proposed use with County ordinances and plans as well as any Town ordinances or plans. 8) If proposing to rezone out of the Agriculture Zoning District, explain how your request does or does not comply with the following (Wisconsin State Statute § 91.48): (a) That adequate public facilities to accommodate development either exist or will be provided within a reasonable time. (b) That the provision of public facilities to accommodate development will not place an unreasonable burden on the ability of affected local units of government to provide them. (c) That the land proposed for rezoning is suitable for development and development will not result in undue water or air pollution, cause unreasonable soil erosion or have an unreasonably adverse effect on rare or irreplaceable natural areas. Page 3 of 3