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HomeMy WebLinkAbout040-1186-40-100 (2)St. Croix County Planning and Zoning Friday, August 03, 2007n18:41:44 AM Detail Sanitary Information Page 1 of I Computer #: 040-1186-40-100 Sub/Plat: Oak Ridge Acres Section: 36 Parcel #: 36.28.19.780 Lot: 27 TNIRNG: T28N R19W Municipality: Troy, Town of CSM: 114 114: NW 114 NW 114 Owner: Olson, Oliver & Pearl 92 W. Woodridge Drive River Falls, WI 54022 State Permit: 186552 Issued: 01/29/1993 POWTS Dispersal: Non -Pressurized In -ground Permit: New County Permit: 0 Installed: 04/16/1993 POINTS Detail: Trench - Seepage Bedrooms: 2 WI Fund: POWTS Pretreatment: NA Notes Issuer/Inspector As Built Plumber Other Re uirements Additional Notes Money Owed Tom Nelson Yes Timm, Roger found a copy of a 1992 soil report - file with permit $0.00 Mary Jenkins �fuC: ff: Yes in archives Maintenance Scheduled Pum Date Pumped 1 st Notification 2nd Notification 3rd Notification 4/16/1996 11/6/2003 04/20/2006 11/6/2006 51112 007 5/1/2010 Parcel #: 040-1186-40-100 03/01/2005 04:59 PM PAGE 1 OF 1 Alt. Parcel #: 36.28.19.780 040 - TOWN OF TROY Current X ST. CROIX COUNTY, WISCONSIN Crdation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): Current Owner OLSON, OLIVER L & PEARL E OLIVER L & PEARL E OLSON 92 W WOODRIDGE DR RIVER FALLS W1 54022-8207 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 92 W WOODRIDGE DR SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 0.000 Plat: 2237-OAK RIDGE ACRES SEC 36 T28N R1 9W LOT 27 OAK RIDGE ACRES Block/Condo Bldg: LOT 27 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 36-28N-1 9W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 990/623 WD 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 27575 2021700 Valuations: Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 341200 168,900 203,100 NO Totals for 2004: General Property 0.000 34,200 168,900 203,100 Woodland 0.000 0 0 Totals for 2003: General Property 0.000 25,300 156,600 181,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 313 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ,consin Department of Industry, abor and Human Rations Division of Safety & Buildings Page — of SOIL AND SITE EVALUATION REPORT in accord with ILHR 83.05, Wis. Adm. Code Attach completo site plah on paper not less than 8 1/2 x 11 inches in size. Plan must include, but riot limited to vertical and horizontal reference point (13M), direction and % of slope, scale or dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION COUNTY PARCEL I.D. # REVIEWED BY St Croix PROPERTY OWNER - PROPERTY LOCATION I Richard Fox GOVT. LOT NW 1/4 NW 1/40s, 36 T 28 N,R 19 I PROPERTY OWNER"S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR GSM # 84 Woodridg Drive 27 Oak Ridge Acres CITY, STATE ZIP CODE PHONE NUMBER M TOWN NEAREST ROAD River Falls, WI 54022 (715)425-2100 Troy East Woodridge Dr i E New Construction Use [yj Residential 1 Number of bedrooms 3 Addition to existing building Replacement [ I Public or commercial describe Code derived dailly flow 450 _ gpd Recommended design loading rate .4 _bed, gpd/ft2 5 trench, gpd/ft2 Absorption area required 1125 bed, ft27 900 trench, ft2 Maximum design loading rate bed, gpd,/ft2 trench, gpd)tt2 Recommended infiltration surface elevation(s) ft (as leeferred to site plan benchmark) Additional design site considerations Sign,if igant Mre KQ gk. Pz is regai:red to meet state code and system el. i Parent material Flood plain elevation, if applicable ft S -Suitable fors stem CONVENTIONAL [A S El U MOUND NS ®U[3 IN -GROUND PRESSURE S El U AT -GRADE 91 S El U SYSTEM IN FILL Ej S 0 U HQLD1-',0 4r, T A' EIS N- U U = Unsuitable fory ,system SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Munsell Moues Qu. Sz. Cont. Color Structure Gr. Sz. Sh. Consistence Bourbaq R o o ts G - PD/ft,�- Bed T+i :-n in. VWAN� 1 0-12 10YR 3/1 None sil 2 f sbk mvfr as 2m 5 6 ................. 2 12-26 1 OYIR. 4 4 None sil 2 m sbk mfr as if e5 a6 Ground 3 26-45 10YR 5Z6 None scl 1 m sbk Mfi as if elev. 98. 60 ft. 4 45-I0J 10YR 6/6 None is cab 0 m mvfr .5 Depth to limiting factor Remarks: Boring # 67 1 0-14 1 OYR 3/1 None sil 2 f sbk mvf r as 2m e5 2:-,.*" 2 14-31 1 OYR 4/4 None s i l 2 m sbk m fr 1 f as .5 e6 3 31-43 1 OYR 5/6 None scl I m sbk mf i cW 1 f ---,-2 Ground eiev. 4 43-50 1 OYR None if s 1 m sbk mvf i CW -- 5 .6 9-9- *­0 ft. 5 50-1022 10YR 6/6 None scab 0 M mf r -- -- _ 4__. 5 Depth to limiting factor Remarks: 4311 5011 Layer-- 1.9 ynery ery--f ine syst to be bel r)w t-.h is ]-;-:i er. ;T Name---Plaase Print Paul C.J. St dress- N8230 HicrhwZ 65 South; River Fa 22 Phone: (715) 425-55 Dater CST Number: *W'm tiol PROPERTY OWNER Richard Fox SOIL DESCRIPTION REPORT PARCEL I.D. Page Boring # 3 Ground elev. 1 00, 61 ft Depth to limiting factor Boring # 4 Ground elev. 101 , 07 ft. Depth to limiting factor Boring # 5 Ground (] [] elev. 99r87 ft. Depth to limiting factor Boring # Ground elev. ft. Depth to limiting factor H o r�zo n Depth in. Dominant Color M u nse! I Mottles Chu. Sz. Cant Color Texture Structure G r. Sz. 5h . Consistence Rants :. G P [D /11L ...._ ._......-_ ____ 0 -16 10YR 3/ 1 one s i t 2 f sbk mvf r as 2m6_ _,-._ 2 16-36 10 414 Nme 1 -f 1-91ak M fr A. _q I f 3 36-46 10YR 5/6 None is 1 m sbk mfr as 1 f *4 .5 4 46-64 1OYR 4/4 None scl 1 m sbk mfi as -- ,2 ,3 5 64-121 10YR 5/6 None is qr .0 m s mvfi -- -- 4r _ 5 Remarks: 46�� - 64" layer very hard. Tb of layer v wets stem below this laye 1 0-11 10YR 3 1 None r'_2 ' f sbk r - .a.6. .-.. 2 1-33 10YR 4/4 None sil 1 f sbk m fr as if , 5 ., 6 3 3--42 10YR 5/6 None limestome 1 f sbk mf 4 2-57 10YR 4 6 None scl 1 f sbk mfi -- , 4 - , 5 5 7-69 10YR 4/4 None is 0 m S9 mvfr as 6 9-112 10YR 5 6 N 1S 0 M Eg MMfr Remarks: 42" - 57" very, very--fina.. Svsten belQw this layer_ 1 0-12 10YR 3 1 None ' 1 2 f sbk as 2m 2 2-28 10YR 4/4 None sil 1 f sbk mfr as 1 3 8-36 10YR 5 6 None sl 1 f sbk._...._._5-_._. 4 6-58 10YR 4 6 None is o m sg mvf Remarks: 0TE n h 'at rock will have to be used 'n 'n 42" pipe And meet system elevation f i Remarks: SBD-8330(a_05192) ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET 0 HUDSON, WI 54016 (715) 386-4680 January 16, 1993 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An onsite soil investigation of the Richard Fox property, located in the NW1/4 of the NW1/4, sec .36, T28N, R19W, Town of Troy, St. Croix County, WI., has been conducted with the assistance ofPaul Steiner, CST# 3074* This onsite revealed suitable soil for onsite sewage disposal to a depth of 10611 while meeting the requirements of the A + 411 rule. This site should be suitable for new construction utilizing a conventional septic system. Should you have any questions, please feel free to contact me at this office. Sinter ly, n er mes K. Thompson Assistant Zoning Administrator cc: file AS BUILT SANITARY SYSTEM REPORT OWNER- ee, e rn TOWNSHIP SECTION T N - RAW ADDRESS ST. CROIX COUNTY, WISCONSIN iv y' �" -/% � (.5 SUBDIVISION /C 19ce e 5- -LOT -27LOT SIZE ��Zoq-e,"e PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 7) A Q �"_ a o INDICATE NORTH ARROW BENCHMARK:Elevation and description: C Alternate benchmark SEPTIC TANK: Manuf acturer : 4 -, Z - E4 - , k.85 ( " /,'C7 Liquid Cap. Rings used:-"'- Manhole cover elev: Final grade elev: Tank inlet elev.: Tank outlet elev.9. No. of feet from nearest road*.Front , Side-1 Rear K Ft. From nearest prop. line:Front—, Side I Rear Ft._2.� No. of feet from: Well Building: (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER `/ Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufact.: Pump Size Elevation of inlet: Bottom of tank elevation Pump on elev.: Pump off elev.: Gallons/cycle: Alarm: Man.: Switch Type: Location Distance from nearest prop. line: Front Side_, Rear Ft. Distance from: Well Building SOIL ABSORPTION SYSTEM Bed: Trench: Seepage Pit: Width: Length Number of Linese. Area Built -4(.-11CC-* Exist. Grade Elev. Proposed Final Grade Elev. Fill depth to top of pipe: No. feet from nearest prop. line:Front Side_, Rear Ft. L— No. feet from well: No. feet from building `'7 HOLDING TANK 0 14, Manufacturer* Capacity:AL No. of rings used: Elevation of bottom tank: Elevation of 'inlet: No. feet from nearest prop. line:Front . Side _ , Rear Ft. No. feet from: Well , building , nearest road Alarm Manufacturer: INSPECTOR: DATE: PLUMBER ON JOB: LICENSE NUMBER: 6/90:cj Harm- Acres Lot 27 TJ r� Ye� t AP�Y �l Ind ir�, Z 0 a -L'-;7 * k / :7 PRIVATE !Qk' SEWAdt SYSTEM tabor cfnd Humah Relations INSPECTION REPORT Sa-d'ety and guildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Permit Holder's Name: ❑ City 0 Village [Town of: U T -r-3 Troy CST BM Elev.: Insp. BM Elev.: BM Description: f P VAN K INFORMA I 1UN TYPE MANUFACTURER CAPACITY Septi c Dosi ng Aeration Holding TANK SETBACK INFORMATION TAN KTO P / L WELL BLDG. Ventto Air Intake ROAD MNEEENNW� Septic 7,� NA Dosi ng, NA Aeration NA I Holding PUMP SIPHON INFORMATION Manufacturer Demand Model Number GPM, TDH Lift Friction Head System TDH Ft I I Forcemain Length Dia. I Dist. To Well IN FVATION DATA County: ST. CROIX Sanitary Permit No.: L" 8 6 52 2 State Plan ID No.: Parcel Tax No.: 040-1186-40-000 ow- .,ov,5.+v STATION BS HI FS ELEV. Benchmark Bldg. Sewer St / Ht Inlet �(X. 0 St / Ht Outlet Dt Inlet Dt Bottom Header / Man. Dist- Pipe 41 e? V 4, Bat- System ,©, q:? Final Grade SOIL ABSORPTION SYSTEM BED/TRENCH Width Len No. No. Of T.`.ench PIT No. Of Pits Inside Dia. Liquid Depth -DIMENSIONS DIMENSIONS Manufacturer: SETBACK SYSTEM TO P L BLDG WELL LAKE STREAM LEACHING INFORMATION TypeOf rLjXJ CHAMBER model Number: OR UNIT System: k�L -I- I DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe x Hole Size x Hole Spacing Vent To Air Intake Length Dia Length Dia. Spacing L t- I SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of a xx Seeded/ Sodded xx Mulched 4 � ❑ Bed Trench Center Be'd /Trench Edges 1�, Topsoil Yes [_ Nc❑Yesit No (Include code discrepancies, persons present, etc.) COMMENTS: r% 9.ae 1 10 , j -LE.4 es 'Lot 27 "77911,78 & NWIWW Oak Rid e Acr LOCATION: TROY 3 6 2 8 O�t 711. 78 y Plan revision required? Ej Yes ❑ No Use other side for additional information. U'/� SBD-6710(R 05/91) Date ell iks/,p" ector's Signature Cert No SANITARY PERMIT APPLICATION �i'��:HR COUNTY IMMENNEEL" In accord with ILHR 83.05,, Wis. Adm. Code 60( STATE SAKI PERMIT # Attach complete plans (to the county copy only) for the system, on paper not less than 8% x 11 inches in size. ❑ —See reverse side for instructions for completing this application. C if revision5to previous application STATE PLAN I.D. NUMBER I. APPLICANT INFORMATION — PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY L�C TION IV 'Jo)Y4 I y 7Y4,S 3 iV T N9 R q fo r) W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK 7 414 CITY, STATE ZIP CODIE PHONE NUMBER J"'-40 Y .L 1., � a II. TYPE OF BUILDING: (Check one) El State Owned 0 Public X 1 or 2 Fam. Dwelling—# of bedrooms BUILDING USE: (if building type is public, check all that apply) 1 El Apt/Condo SUBDIVISION NAME OR CSM NUMBER El CITY NEAREST ROAD E3 VILLAGE E9_ MN OF: PARCEL TAX NUMBER() - a 2 U Assembly Hall 6 ❑Medical Facility/Nursing Home 30 Campground 70 Merchandise: Sales/Repairs 4 ❑Church/School 8 ❑Mobile Home Park 5 ❑Hotel/Motel 9 ❑Office/Factory 10 ❑Outdoor Recreational Facility 11 El Restaurant/Bar/Dining 12 ❑Service Station/Car Wash 130 Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. New 2. ❑1:1 Replacement 3. El Replacement of 4. 0 Reconnection of System System Tank Only Existing System 13) E]A Sanitary Permit was previously issued. Permit Date Issued V. TYPE OF SYSTEM: (Check only one) Non -Pressurized Distribution Pressurized Distribution 11 ❑Seepage Bed 21 ❑Mound 12 Seepage Trench 22 El In -Ground 13 ❑Seepage Pit Pressure 14 ❑System -In -Fill Experimental 30 1:1 Specify Type 5. El Repair of an Existing System Other 41 ❑Holding Tank 420 Pit Privy 43 ❑Vault Privy VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION Feet Feet VII. TANK INFORMATION CAPACITY gallons Total Gallons # of Tanks Manufacturer's Name Prefab Concrete Site Con- Steel Fiber- Plastic Exper. App. New xisting Tanks T Tanks r strutted glass Septic Tank or Holding Tank /0&6 e4 E 0 Lift PumeTankJSiphon Chamber, Lj U Vill. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No S ps) MPAAPRS � Business Phone Number: Ifew 42 r' 00% 1 3 ) -7 7 -Z Z/ Plumber' Address (Street, City, State, Zip Code): A tle IX. COUNTYIDEPARTMENT USE ONLY [] Disapproved S itary Permit Fee (includes Groundwater Date Issued issuing Agent S' ps) Approved W-� El Owner Given Initial Surcharge Fee) IL I Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A -saajtar ermit is valid for two ears. YP.� � �Y 2. Your 1sanitarry`lpermit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submMed to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your Iocai' code administrator'or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to `tp:. instil ied. , ll. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. lil. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's -name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. Vill. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tanks), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; so!] absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of l ' regulated practices which can effect ---groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. " SB D-6398 (R.11 /88) APPLICATION FOR SANITARY PERMIT S T C - 100 This application form Js 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,("spuc 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 61 to-tv, L Location of Property &4 KV4,� '-4, Section T N R W Township S'4 el Mailing Address Subdivision Name Lot Number Previous Owner of Property Total. Size of Parcel 04:0 e Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) Yes No Vn I time and Page Number as recorded with the Register of Deeds JV— INCLUDE WITH THTS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract 3. Other recordings filed with the Register of Deeds Office In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (We) cei-t-iKy that at statements on th" Koim cfte tAue to the be,6t o1 my ( out ) knowf,edge; that I (Rfe) am (aAe) the owneA(z) o6 the pTopn-ty desnibed ' 'ki tlliz 4- ,.nKo,qmat,ion Ko.�fm, by v.iAtue ot a waAAanty deed A-ecotded in the 066ice 0� tile County Registers o6 Deeds as Document No. -Y 9V .. j-, ; and tha-t I (tije) ptLe,sentey own the puposed site 4ot the sewage di-s pos -aT—,s Iy Stem ((onI (we) have obtained an easement, to nun w-cth the above described p.kopekty, dot the con,6.aucti-on o6 said system, and the same has been ditty 'keconded 'C'n tite 04�ice 06 tite County Reqi,,6tn oK Deeds, a5 Document No. r 6 �SIGNATURE OF OWNER DATE STGNED SIGNATURE OF CO-OWNER (TF APPLICABLE) DATE SIGNED - DOCUMENT NO. STATE BAR OF WISCONSIN FORM 2-1982 WARRANTY DEED 4943,30 f01 q.q � r z• ji 62 Rolling Hills Development, Inc._,a Wisconsin -corporation conveys and warrants to Oliver L. Olson and Pearl . Olson, husband and wife, as survivorship marital ro pert the following described real estate in S t . Croix_ _ County, State of Wisconsin: Lot Twenty -Seven (27), Oak Ridge Acres to the Town of Troy. This is not homestead property. THIS SPACE RESERVED FOR RECORDING DATA 1 REGISTER'S OFFICE ! ST CROIX CO., WI � 'd for Record Rec J AN 2 5 1993 tat 11:35 PM r �. Register of Deus RETURN TO 11 Tax Parcel No: Exception to Warrantles: easements, restrictions, and rights -of -way of record, if any. Dated this day of DC t q 9 2 0 ��I S DEVEL N , INC. (SEAL)7L (SEAL) AUTHENTICATION Signature(s) authenticated this day of , 19 TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY C. L. Gaylord Attorney , River Falls WI 54022 (Signatures may be authenticated or acknowledged. Both are not necessary.) -Richard N. Fox, President Cj E f -� / ---- (SEAL) *Frances J. Fox, Secretary ACKNOWLEDGMENT STATE OF WISCONSIN ss. P rc P County. iA Personally came before me this `Q6 day of October , 19 2 the above named Richard N. Fox and Frances J. Fox to me known to be the person S ,Wrexected t'h4 •v f re i g instrument d ack?o�dge tie %e. Qr Karen M. Engel Pierce e r s - f • lit � \ w � ' Ve*yjj�ak4r ..;,�', ,. Notary Public �xy,,. M Commission is permanent. (If not, 'S yJul 4 9�`''''1� ��`'`'` date: Names of persons signing in any capacily should be typed or printed below their Signatures SB2 NTF 0021-- WARRANTY DEED STATE BAR OF WISCONSIN Nelco Tax Forms, P.O. Box 10208, Green Bay, WI 54307-0208 Form No 2 — 1982 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER ROUTE/BOX NUMBER Fire Number - Felt, zip v CITY/STATE R Section 3t.,, '� 'W PROPERTY LOCATION:' Town of St. Croix County Lot number.4 Subdivision. Pat,& I eptic system could result in Improper use and maintenance of vour s its premature failure to handle wastes*- Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licen'sed—septic, tank P er, What you Put into the system can affe--6-t-the fun n of the'septic tank as a treat ment-stage in the waste disposal system,* St. Croix County residents ma be eligible to recieve a grant for a maximum of 60% of the cost.of replacement of a failing system, •operation prior to July 1, 1978. St. Croix County which was in accepted this program in August of 1980, with the requ3.*rement that owners of all news sterns agree to keep their system properly maintained'. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a water plumber,, journeyman plumber, restricted plumber or a licensed pumper verL- fying that (1) the on -site wastewater disposal system is in proper operating condition and .(2) - after inspection and pumping (if nec- essary), the septic',tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year -expiration. I/WE, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with 0 the standards set forth, herein, as set by the Wisconsin Depart- 'fication form must be completed went of Natural Resources. •Cert1 Zoning office within 30 days and returned to the St. Croix County of the three year expiration date* 41 SIGNED DATE -- .� St. Croix County Zoning off ice 911 4th St. Hudson, WI 54016 386-4680 Sign, date and return to the above address* EVALUATION REPUM I Irii��pnsin Nipar"rit 01 Industry, SOIL ►AND SITE tod Human Ralations ILHR 83.054 Wis. Adm. Code Divisiol; of-safisty & BuddiNs M accord WILh COUNTY lop St Croix Plan must includa, but a sate plan on paper not less than B 1/2 x 11 inches in size PARCEL I.D. g Attach complat I OU N AR Ty riot limitod lo'verkai and horizontal ratur#inca point (6M), difuc�on and % of 510PO, scale Of CEL location and distanc4 to naarast road. REV W1 OAT E dimarisioned, north arrow, and REVIEWED BY APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION .,.�` PROPERTY OWNER. PROPERTY LOCATION S 36 T 28 NR 19 GOVT. LOT NW V4 NW 1144 , Richard Fox LOT BLOCK SUB 0. NAME OR GSM 9 PROPERTY OWNER':S NWLING ADDRESS 2Oak Ridge Acres 7 84 I Woodr 1 yM_ OWN N EARE S T ZiP CODE PHONE NUNGER - East W00 idg--Drie QTY, STATE To _. - v%-I rA n ) ) (715)425-2100 1 Giound elev. 98, 60 fL Depth to kiil0g factor Boring Ground 99._Q1L Depth to 1111111ing SOIL DESCRIPTION REPORT FA= ,A KOH ati I 1 '10 la n s +� o2b' Y I ,, r © �k �i U �r r� IL, , a qq,i Eicc,. SaU+� k.of�►r-� TDB Q S G�oc�'rkc� r Dr 7 k P'L,4c-,,,e A ccr,•l D,ck, ro1 �" ,- TIMM EXCAVATING Route 1 Box 192 WILSON, WISCONSIN 54027 (715) 772-3214 (715) 386-5443 MPRS #3224 WI MPCA #696 MINI JOB SHEET NO. OF CALCULATED BY- DATE CHECKED BY DATE Of% A I C PRODUCT205-1�Rs� Inc,, Grow, Mass. 01471, To Order PHONE TOLL FREE 1-800-225-6380 1"71- 0 (t 1J 110 0 ul al 4 (D I rt TI) 0 1 cf) Ow ft I I W 0 P 10 W P)j P. 411 %10 i F�3 V1 H- 1 0 L A) 20 41 F-1- (1 0 1 rt W H- 0 C) P- k r-: 0 C) 1 0 co l--I C) R V-1 rr III 0 H, ct F,--j V-1 C) V,1 0 41 on so 0 H (I M I IIi N) 0 V1 I (C}) F�3 4), 1 H 0 C) H C) F�3 >1 111 M WN (t J) CO P:-- 0 0 I Ftj i o �aw rj) 0) 00 U) III 171 (t 0 :31m, V1 1 0 ul I HWA4 0 Ill 0 0 z C) II 10-00 Z �3 1% LA) 0 II t7i > I F-i 00 0) F--1 H 20 t7" I 0 M 0 0 000 m N) III C L-Ij C) I M. I --A H <044 0 h Vj.1 :--jr'i 1- -1 I F-III "0 (1 a)I C) tc) ;.Ph. III CD V1 (t I 0 C) I 0 Oil H. 11 0 W (t 0 C) z 0 > CO (D III F�3 0 00 11 H (') (t 11 0 0 III z C-11 0 Zo 0 111 �20 1 4 -1 11 F� 4 3 <14 B 0 H'- Z '17 j j 1 I I 0 jMFM I"- (t 0 0 0 0 0 C) V1 (r) CD 0 0 0 40 a 4 9 ED 00 V) 11 0 I I �j oil tz) III 4=� !2p,4 0 t7l c-4, C) V1 ft C) (D C)! II! tQ �j V1 11 Cr 11 M3