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191-1012-50-000
Wisconsin Department of Commerce Safety and PRIVATE SEWAGE SYSTEM Buildings Division County INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. 370298 Permit Holder's Name: ElCity ❑ Village 0 1 own of: tate Plan ID No.: Heins,Joe Village of Wilson (Q - 2 Z 32 D 1 J CST BM Elev.:- Insp.BM Elev.: BM Description: rcel Tax No.: ) coo .0' ( ao.o' `T_atI ova h 191-1012-50-000 TANK INFORMATION ELEVATION DATA 2.. 0 bake A--p Q-4 TYPE MANUFACTURER CAPACITY STATION BS HI FS CPLEV. i Septic . 0.k-k. t2� 0. 24 Benchmark 106 - Dosing C:7630 S. Alt. BM 0,p r ip(o,--p 1 Aeration �� ""� Bldg.Sewer �p $� Holding �~ St/Ht Inlet c'._5-9 9-q-.12' TANK SETBACK INFORMATION St/Ht Outlet ---- TANK TO P/L WELL BLDG. Aventir toIntake ROAD Dt Inlet — Septic 7(op ` 03_ T"U ' NA Dt Bottom t 3-701 q3.0 I Dosing /vp " ram_ ' NA Header/Man. 103. Aeration NA Dist. Pipe 2_'1j— 3-0 '03It Holding Bot.System 3./0�3-ti-,5-- 103,0$' PUMP/SIPHON INFORMATION Final Grade Manufacturer S v c f 04.- emand St cover Model Number `(1'( GPM Gil ,0. c TDH Lift p Frictiona 31 IS--yeadm2•s- TDH \5.°6\Ft /�Forcemain Length (00' Dia. Z Dist.TowellA NP SOIL ABSORPTION SYSTEM J iFiTRENCH Width , Length i No.Qf s PIT No. its Inside Dia. Liquid Depth ENSIGNS g 6 3 IQ.) ` S DIMENSIONS SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING anufacturer: SETBACK CHAMBER INFORMATION Type Of .,,,,_,1 lcD t \ OR U odel Num . System: , f DISTRIBUTION SYSTEM el Wfper24-1 Cock-LecQy( rMo - ) Header/Manifold ,/ Distribution PiipeO , , x Hole Size I x Hole Spacing I Vent To Air Intake Length .5.0 ' Dia. 3.0 I Length (00 IC Dia a Spacing 5-,0 �iy-u 36 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over I xx Depth Of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil 0 Yes 0 No ❑ Yes 0 No COMMENTS: (Include code discrepancies,persons present,etc.) (-)(ibl. )-fl) Inspection#1: 10 /°S/1n° Ins ecti / / Location: , (SE 1/4 SEJO 27 T29N R15W)-21.29.15.99 1.) Alt BM Description= � � � ) 2.) Bldg sewer length= 4' -amou t of cover= 3.) contour= )OZ,0' }` �- )dro r�� cO 5 4A44 Plan revision required? ❑ Yes U No ME ( s Zro I Use other de for a�,dditi9 al information. Lt ` n SSB� r_a- W�l e lea 12 ) eClY2( 1020� 11 +90Q- i' l.9 e�,Q vv� �� ,'me ,wt r . /Mcx°SS 1`35 ve• Safety and Buildings Division ��sc°aDnsin SANITARYRMIT 201 W.Washinngt ton Avenu2� �i ,, P Department of Commerce In accord with Comm 83 Wis A'dm.Code • Madison,WI 53707-7162 • Attach complete plans(to the county copy only)for the sys/erfi,o notASS • my / than 8 1/2 x 11 inches in size. y._--•` :Sanitary Permit Number • See reverse side for instructions for completing this apphcs�t�on ��r� -_��� Z _- I Personal information you provide may be used for secondary purposes �c' , g L • eck if revision to previous application [Privacy Law,S. 15.04(1)(m)]. t. e Plan Review Transaction Number APPLICATIONI. INFORMATION - PLEASE PRINT ALL F" IU.MA1 _ t /� 3�3Z.© Property Owner Nagle `',' '�,�iAp �ds$ $n �r- CJrrP i� {!4_ "�� 1/4,S �� T®2�,NrR� t(01 Property O s Mailing Address Lot Number Block Number ��� tp, cj1CPJZ J`i .,....._ - ,„_____. C�t.�,,State Zip od Phone Nu ber Subdivision Name or CSM Number !lam v i�� � . il 3 K.s�) �1 4f, ,.-------- II. TYPE OFBUI DING: (check one) 0 State Owned �-/� 0 c;i�a e / Nearest Roaddf,`� ❑ Public or 2 Family Dwelling-No.of bedrooms / n OF C.c/i /..Sg, ! 7thi. �% III. BUILDI E: (If building type is public,check all that apply) Parcel Tax Numbers) GUS a7. a 9. /5 99 1 D Apartment/Condo /CIL— ,It`J L— J0 — 06t 2 0 Assembly Hall 6 0 Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 0 Campground 7 ❑ Merchandise: Sales/Repairs 11 0 Restaurant/Bar/Dining 4 0 Church/School 8 0 Mobile Home Park 12 0 Service Station/Car Wash 5 0 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) _, r(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 0 Seepage Bed - ound 0 Specify Type 41 ❑Holding Tank 12❑Seepage Trench 22 0 In-Ground Pressure / r \ 42❑Pit Privy 13 0 Seepage Pit / L7 x 63 ` 43❑Vault Privy 14❑System-In-Fill (spy �,,�-� 102. 80 ) VIA' � VI. ABSORPTION S TEM INFORMATION: 1. Gallons Per Day 2. Absorp.Area 3. Absorp.Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Re fired(sq.ft.) Proposed(sq.ft.) (Gals/day/sq.ft.) (Min./inch) Elevation ç }/ Rc�ef, 4p ,i. /2 'Y Feet /66' % Feet VII. TANK Capacity Site in gallons Total #of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper, INFORMATION Gallons Tanks Concrete glass APP New Existing strutted Tanks Tanks Septic Tank or Holding Tank /2 re 4 ./.2 El El El El El Lift Pump Tank/Siphon Chamber,. '- eix Ea ❑ ❑ 0 El El 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 s%ature:( mps) MP/MPRSW No.: Business Phone Number: .../ &0?, 1/V _ak 7/5";—'92 V‘-tts-/‘ Plumber's Addreesss(S et,City.Stj e`ZipCode- /eA J le 1 �' ` 61 IX. COUNTY/DEPARTMENT USE ONLY 0 Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature(�__(No Stamps) pi Approved ['Owner Given Initials Surcharge Fee) Adverse Determination op b-2b',Z� X. CONDITI NS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(R.12/99) DISTRIBUTION: Original to County,One copy To: Safety&Buildings Division,Owner,Plumber Safety and Buildings 1340 E GREEN BAY ST STE 300 SHAWANO WI 54166 TDD#:(608)264-8777 /sconsln www.commerce.state.wi.us Department of Commerce Tommy G.Thompson,Governor Brenda J.Blanchard,Secretary June 20,2000 CUST ID No.226900 ATTN:POWTS INSPECTOR ZONING OFFICE SHAUN R BIRD ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/20/2002 Identification Numbers Transaction ID No.323201 Site ID No.194289 SITE: Please refer to both identification numbers, Site ID: 194289, JOE HEINS above,in all correspondence with the agency. ST CROIX County,Village of WILSON; 170TH AVE SE1/4, SE1/4, S27,T29N,R15W FOR: Description:MOUND SYSTEM FOR JOE HEINS Object Type: POWT System Regulated Object ID No.: 668691 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner,as defined in chapter 101.01(10),Wisconsin Statutes,is responsible for compliance with all code requirements. --- CAUTION: Wis. Stats. 145.135(2)(b)indicates that the approval of a sanitary permit is based on regulations in force on the date of approval. The effective date of COMM 83 revisions is expected to be July 1,2000. Thus depending on the type of system and your design,this plan approval may not be eligible for sanitary permit approval if submitted to the issuing agency on or after July 1,2000. ` Note:There is a potential for a lawsuit that may delay the effective date of the code so this status may or may not change. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department,which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below,or at the address on this letterhead. Sincerely, 0� DATE RECEIVED 06/12/2000 \�� - ' �� FEE REQUIRED$ 180.00 FEE RECEIVED$ 180.00 KEI A WILKINSON,POWTS PLAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (715)524-3630, FAX: (715)524-3633 ,M-F 7 AM-3:45 PM KWILKINSON@COMMERCE.STATE.WI.US WiSMART code: 7633 cc: JOE HEINS , PLOT PLAN PitOJEC ' Joe Heins _ ADDRESS 965 W. Sherren St. Roseville Mn 55113 SE 1/4 SE 1/4S 27 IT 29 it 15 W Village Wilson COUNTY ST. CROIX MPRS Shaun Bird 226900 �� DATE6/9/00 BEDROOM 4 CONVENTIONAL IN-GROU RESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1250 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 500 Bed Size 8'X 63' BENCHMARK V.R.P. Top of Nail in Tree ASSUME ELEVATION 100' ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION `0 3 g * B.M. k Alt. B.M. 170th Ave 300' Scale 1 /4" = 10' Conditionally - rr'Ap - \ DEPARTMENT OF COMMERCE DIVISION OF SAFETY AND BUILDINGS 4N -TL. k - 1 (49 SEE CORRESPONDENCE ��\L:� `� • 323Zo1 �.�.s° C< B-2 o Area 25' below system is to remain ---- M v.._ undisturbed 9% 1 B-3 Slope ❑ WI System is to be F t)r c.t installed along the 7 Well is to 102.8 Contour Line meet all Huffcutt setbacks Combo found in B- 1 Tank Comm 83 Tank is to be properly Pro 4 bedded and provided with Bedroom approved warning labels, House dose tank is to have a lockdown cover Designera ____-- ` _ Dat Non-Woven Filter Fabric 4" Observation Pipe Perforated ,,Distribution Pipe Below Filter Fabric f AS= C-33 Sand-`--,,, a " TapLoll b _....•00.11'..0.111111009111P1*-01 laraiirmovitAirly .q 7. S;opc Bed Of li- 2 %2 N. LForct Main \�Piowed Drain Rock From Pump Layer / 'D i Tr Cross Section Of A Mound System Using F ,85. A Bed For The Absorption Area G r A J7 Ft. h ./'S E �_ Ft. I 1 ,4 rt. 36. gFt. K ,,LL.3 Ft. L ,?5. 4Ft. w 30. 7 Ft. _,—Iv tObser vat ion Pipe--.\ E K r... ...... MieNoll.0.1111.0.OINIMM. ••••••• Onsmwr 1••••••• +me elmml•..dema •••••• ellimor OWN.maiMMID 4111••••11.104 , a. A i ___ �_ ._____ Forte Main W (o L '-- . ` 1t1,. Pump ® Distribution Bed Ot %2�— 2 pipe Drain Rock I � ►� Observation Pips Permanent Marker Pipe or Rods Plan View Of Mound Using A Bed For The Absorption Area PAGE OF Pe,Porated PI* Oetoii r+a Yte. (pettoralta .✓ End Gao ,,. ,.�• PvC PAt Woos taegted 0n Moran. Are Cowell, sYpoete +�I PVC rorCt main f tRS4 „two. Its seatut'd•' ?YC ,i411444,4111monifoio PipeFSfe i7i91 trout+aR tam Mole Should Be Nair To End Cap Eno Cap -) a:slrioutWn Pipe Layout R . Fl, X Inches Y . Inches 1. Signed: Hole Diameter Inch License Number: �,, j U Lateral Inch(es) Date: �-- f ��, manifold Inches Force Ma i n p e;7-- Inches # of holesrpipeo?l invert Elevation of Laterals251t, • • £R CROSS SECTION ANU SPECIFgCA'�'IO�1S • SEPTIC TANK F� ttJM? C�iAT'iR ETH 4" CI VENT PIPE 12" KIN. ABOVE GRADE JUNCTIONPBOXF APPROVED ?' 25 ' FROM DOOR , WINDOW WITH CONDUIT MANHOLE COVER FRESH AIR INTAKE W J PAALOCK v t+ CI R r SER � WARNING LABEL FINISHED GRADE6" MIN . -----*"� LI i AB4vE ,G ADELit___ 38" IN. 6" MAX. i� "XII. INLET .0., --- : , M, 0. I WATER TIGHT SEALS �j}sip GAS- i k __ A SEAL it t APPROVED BAFFLE i BALM JOINTS W/ 4" APPROVED B 9 , ON ' APPROVED PIPE 3' PIPE } SOLID3SOIL �— f P1 '1 UNTO SOLID SOIL PUMP OFF ELEV . T FT . �-�--; . —I--- R/d kr;:OFF ** RISER EXIT I D PERMITTED ONLY L t \ 1 IF TANK MANUFACTURER HAS APPROVAL 3iP APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS 17 fa„(covc+ per } n a-- SEPTIC / DOSE TANK MANUFACTURER : A-444A NUMBER DOSES PER DAY : y TANK SIZES : SEPTIC .4250 GAL. DOSE VOLUME INCLUDING DOSE ?so_.... AL. FLOWBACK: S GAL. (7`08. ALARM MANUFACTURER: CAPACITIES: A = o'er-CINCHES Z9" AL. MODEL NUMBER: L. �,/ 33 SWITCH TYPE: 1 4, B = 2 INCHES 3 J GAL. PUMP MANUFACTURER; ce)", C = / - INCHES = S`(9-9- 2GAL MODEL NUMBER : a SlicF Yv /o p SWITCH TYPE: D = INCHES S - GAL. REQUIRED DISCHARGE RATE ,'j //GPM PUMP € ALARM WIRING AS PER ILHR 16 . 23 WAC. VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE . . 12 FEET * MINIMUM NETWORK SUPPLY PRESSURE '-. . . . S FEET + so FEET FORCEMAIN X 3',/$ f TI130 FT. FRICTION FACTOR . . �,�� FEET TOTAL DYNAMIC HEAD = ` .3� FEET INTERNAL DIMENSIONS() OF PUMP TANK: LENGTH 7-, ; WIDTH !` 3 ; DIAMETER ) / LIQUID DEPTH r �� SIGNED: � LICENSE NtJMSEP • 0 g/aa DATE:1 6:le—06 1111111111111111111. r j 0�44.,„. 13'4 j I - , Engineering Details - SHEF40 1 1 Performance Data 40 " : ,111-1Z--riiANAIllimimum Pun' . Characteristics �� �,,.. 1111111111111 /hlaror ifailiii11111M _1'''di r. I Mooing Monet% 911140M1 StliF44 012 Auturoet«MuJels > SNEF40A1 SltEf40A2 v • Spe 0 i •—•--.--^'--'i Horse d .� Full Load Am s • 0 r b�l JO ! 10 20 30GPM I �� is�a 10 ) 18 r 3Q ! 35 1 ""_mot total Hand ( I` 10 /7 21 d g,5... _......_ .__ Ydtage x30 fleet) {� l � 8.8 � {0.7� 4.3.F._5.2 , 4.1�I~ . Mil 6. (r"t 3.0 .210 _ _ _J SO 40 30I !0 � 0 1 Owe 120°i Max.Feld Um.. GPM(US GPM) 74 �_ "],9T^- NEW Das' o A ( en 3.8 � 2 2S 3 .03 , 1 ImuDist atinx Dischar , Siu 11111.11M � Dimensional Data Solids Handy . 6&rr1;'i068.a?t--, 1, AN dimensions in incites.Nitric far 3•Tte'""Ir international use). r (98.42) r(12'�-- Power Card t i113►511W,20'std t 2.Component dimensions may ts�'optional) 3-ire° ' ,,,,. vary t 1!9 inch. (� Materials of Constructioni . Not for cansm►c+> pram VHS' ��� ��� �.wscH��aE unless certified. ! . �) „ weights are '._FLOAT 4, Dimensions c ens and 4 Motafu approximate. Patwt Castaa CU1 S.apW reserve the right la mane t- .. " --r---i'; revisions to ath prodhtt and their i S!.ct+nelcal S FAct t edess Steel ll _____f- revis irotions ur pr+)notice. Nit seal `al °r d'leed Sfo� 5 Stainless Stoat t •r he,. riti ..r-- Bwrle• PI : ..r a c i ;r ens; s !sce) Fasteners -'.;.` �...r— �.�._ Legs n his RoiervMei__�.^ t t 199e hiydromuflc"?ct,Nps, Ashto,xl, o 9 Yo r Avthrnzed fecal�istTiiaulor I 11$ HYDROMATIC" Zia-' , \ 67 00 PENTAIR PUMP GROUP ^~ .- ----I chlotli Ohio 44805 iel'41089.3042 fax:419.281-40E7 sr�w, �� 1 "� Web 5118'NYIWV�r1Af pump MT' 7R �Lr llli.i��� , fICES IN :MAJOR CITIES AND COUNTRIES `,o v4u,cs vv,,piu'ne 44 r;'ory M , Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code Page of Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include,but not limited to: vertical and horizontal reference point(BM),direction and c�� ere, ;vt, percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# APPLICANT INFORMATION- Please print all information. Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). viewed by Date Property Owner i 1 g—�,�0 Property Location J J / ; Govt. Lot ,S 1/4$$$ 1/4,S 7 T j f N R /$ E(or& Property Owners Mailing Address / Lot# Block# Subd. Name or �ICSSSM# City State Zip Code Phone Number /S 4)M/� I/474C-x/73 i (K5/ )�f7 9 f ❑ City `Village ❑ Town Nearest Road 4p- JVew Construction Use: residential/Number of bedrooms �`J Addition to existing building ❑ Replacement / El Public or commercial Describe: Code derived daily flow< � gpd Recommended design loading rate /'/ bed,gpd/ft2 /' 2trench,gpd/ft2 Absorption area required-- bed,ft2--�1''69 trench,ft2 Maximum design loading rate/% bed,gpd/ft2 /• Z trench,gpd/ft2 Recommended infiltration surface elevation(s) /v 9. ft(as referred to site plan benchmark) Additional design/site considerations Parent material Flood plain elevation,if applicable A",/.42 ft S = Suitable for system ElP Conventional MouInd In-Ground Pressure AT-Grade System in Fill Holding Tank. U = Unsuitable for system S ]_U ❑ ElS ❑ U 'u S '� El S.�S1 ElSOIL DESCRIPTION REPORT // Boring# Horizon Depth Dominant Color Mottles Structure Texture Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed , Trench &-y /ma >Y/z A ? 4/If - <a / 1�/ �3 /Ground j / / �i J S� e//lev// 3 Fes!�- /i.'., 5/Z C/C%*..,7.:� -5e--"/ -/7'7 ..0 7v./ Ai9A- 114.(<')v,,A /aft. Depth to limiting acctor Remarks: Boring # 1 l9 / -'0. / yr 3/z ,/��'s-h.2� . /�- �,,.,�� ' ''' G':3' y`' - S go y/�,�c y�,s �-� se/ Ground l l�y�/�� �'/ ,fyl, i /1/J /t/ii9 ,�/iP N, elev. /dL!/ft. Depth to limiting fin. Remarks: CST Name,(Please Print) nature e..) /� i f . ''� Telephone No. Address�t c �`"/� /6/: � � � � 1 Date CSTNumber/- 6 . 9� i - (,, kee,i .l6zf: 5/o/ ? - �o� 69aa SOIL DESCRIPTION REPORT PROPERTY OWNER Page j of• PARCEL I.D.# Boren # Horizon Depth Dominant Color Mottles Structure G D/ft2 g Texture Consistence Boundary Roots P in. Munsell Qu.Sz.Co�n/t.Color Gr.Sz.Sh. Bed Trench 2 yo Z /�/ O , A--1. /� ,4, -02 / ,/. ,-. 7- ._mac'/, ,s- %;1,›.; /z, )Y ,elf f���o Ground 3 �/�y/ /r/J�i/ e 7,7 / /�i ..5.�r// './7!„— ; ,?„,`� A"-lit' /t / ' �1' t. /SL// /fj Depth to — - limiting *act Remarks: Boring# Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed , Trench Boring # I Ground elev. ft. Depth to - limiting factor in. Remarks: Boring# Ground elev. ft. Depth to - limiting , factor in. Remarks: SBD-8330(R.9/98) MIIIIIIIIIMIIIIIIIIIII".""'"..------. Soil Test Plot Plan 7. r Project Name Joe l Heins Sha ,$ W Address 965 W. Sherren St. Roseville Mn 55113 TM #226900 -____-- Date 6/9/00 Lot s— Subdivision SE 1/4 Wilson SE 1/4S 27 T 29 N/R15 W Village of — — Well PL Property Line y ST. CROIX 0 Boring Q TopCount of Nail in Tree BM or VRP Assume Elevation 100 ft. System Elevation rk Alt. BMTop 103.8 *HRP Same as Benchma of Nail in Tree @ 101.2' / * , B.M. , Alt. B.M. 170th Ave 300' / Scale = 1/4" = 10' B-2 0 9% B-3 Slope _ 0 0 B- 1 Pro 4 Bedroom House • ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND • OWNERSHIP CERTIFICATION FORM Owner/Buyer Jece_. Mailing Address r� r�✓� .4 ,`rot--- v ig. /y',�1i f/3 0 .J > t Property Address -t �o `w cTT (Verification required from Planning Department for new construction) City/State /,..,I, Parcel Identification Number g LEGAL DESCRIPTION/. /� N-R � %� 1 � '< ��-%, �, /�f�i�..5�✓ Property Location .5t , , Sec. Lot #r---- • Subdivision /� Pa e # Certified Survey Map # , Volume g Warranty Deed # l ? ‘, V y , Volume �j .r----- Page # Spec house 0 7no Lot lines identifiab/ es 0 no • SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintethe nance tem consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. at youput 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 journeyman plumber, plumber or a licensed pumper verifying that(1)the on-site wastewater disposal system master plumber,j Y�nP ,restricted � (if necessary),the septic tank is less than 1/3 full of sludge. is in proper operating condition and/or(2)after inspection and pumping Uwe,the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth,herein,as set by the Department of Commerce and the Department of Natural Resources,State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 da f the three yea ex ' • n date. / c/u, —1/ DATE SIG A - OF AP LI ANT OWNER CERTIFICATION y (our) knowledge. I (we) am(are)the owner(s) of I (we) certify that all statements on this deed are s ecordede to e best of m Register of Deeds Office. the operty described ove • e ofwarranty /F/a6 -�- � DATE SIGN T OF APPLICA ****** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Depaitruent. ****** ** Include with this application: a stamped warranty deed from the Register r of s Deedsma ofe in the warranty deed a copy of the certified survey map yni.146SPAGE 5(14 61264'3 • STATE BAR OF WISCONSIN FORM 2-1998 KATHLEEN H. WALSH 7]oeuD,on�N,,mhrr WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Robert O. McGrane and Lois H. RECEIVED FOR RECORD McGrane,husband and wife, 10-25-1999 11:30 All WARRANTY DEED Grantor,conveys and warrants to EXENPT Trish Heins and Joseph N.Heins,wife and husband, CERT COPY FEE: COPY FEE: TRANSFER FEE: 171.00 RECORDING FEE: 10.00 ,Grantee. PAGES: 1 Grantor,for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin(The"Property"): Recording Area Name and Returid Ir1'T0: Edina Realty Title 400 South 2nd Street Suite#115 Hudson, WI 54016 191-1012-50-000 Parcel Identification Number(PIN) This is not homestead property. The Southeast Quarter of the Southeast Quarter(SEI/4 of SE1/4)of Section 27,Township 29 North,Range 15 West, St. Croix County,Wisconsin. Exceptions towarranties:Easements,restrictions and rights-of-way of record,if any Dated this / / day of O(.+ .t) 091 + bert McGrane Lois H.McGrane AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) )ss. authenticated this_day of 4-)k.(Xb1L County ) Personally came before me this q day of A.-4root.rdVithe above named Robert O.McGrane and Lois H.McGrane,husband and wife, TITLE:MEMBER STATE BAR OF WISCONSIN(I to me known to be the person(s)who au thorized by§706.06,W is.Stats.)not, executed the foregoing instrument and acknowledge the same. au THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Ogland Hudson,WI 54016 Notary Public,State of W consin pt. (If not,state expiration date: (Signatures may be authenticated or acknowledged.Both are not RE E^� s .) ��I necessary.) NOTA Y PUBLIC /0/0 /OJT STATE OF WISCONSIN `Names of persons signing in any capacity should be typed or printed below their signatures WARRANTY DEED STATE BAR OF WISCONSIN FORM No.1-1.9911 INFORMATION PROFESSIONALS COMPANY FOND DU INC.WI 800-63S-2021 Safety and Buildings 2226 ROSE ST LA CROSSE WI 54603-1905 TDD#:(608)264-8777 � www.commerce.state.wi.us isconsinTommy G.Thompson,Governor Department of Commerce Brenda J. Blanchard,Secretary September 28, 1999 CUST ID No.283360 ATTN:POWTS INSPECTOR ZONING OFFICE BOLDT'S PLUMBING&HEATING ST CROIX COUNTY SPIA 820 MAIN ST 1101 CARMICHAEL RD BALDWIN WI 54002 HUDSON WI 54016 RE: CONDITIONAL APPROVAL Identification Numbers APPROVAL EXPIRES:09/28/2001 Transaction ID No.249056 Site ID No.181313 Please refer to both identification numbers, SITE: above,in all correspondence with the agency. Site ID: 181313 St.Croix County,Town of Springfield SE1/4, SE1/4, S27,T29N,R15W Facility:Robert McGrane Proposed Residence FOR: Description:Four Bedroom Mound System Object Type:POWT System Regulated Object ID No.:492703 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19,Wis. Stats. • Inspection of the private sewage system installation is required.Arrangements fjinspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20 2 d ,Wis. Stats. A copy of the approved plans,specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department,which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below,or at the address on this letterhead. DATE RECEIVED 09/20/1999 Sincerely, FEE REQUIRED$ 180.00 (sw—� FEE RECEIVED$ 180.00 BALANCE DUE $ 0.00 erard M.Swim POWTS Plan Reviewer-Integrated Services (608)-785-9348, Mon.-Fri.7:15 AM to 4:00 PM WiSMART code: 7633 jswim@commerce.state.wi.us REC DESIGN �' • MOUND SYSTEM D SEP , Residential Application INDEX AND TITLE SHEET 7 ,99 Project Robert McGrane Four Bedroom Residentail Mound 49 Div Owner Robert McGrane Address 3068 70th Ave. Wilson,\NI 54027 15W. 1$. Legal Description SE114SE114, Sec.27,T•29N., R. • itionally County St. Croix Tn. Of S 'in �, EO Township Villa e of Wilson, Lot No. riP COMMERCE FARTMENT of o B PINGS �` FE Subdivision Name WOO ID Number 191-1012-50-000 EE CORRESPO NCE Plan Transaction Number Page 1 Index and title sheet Page 2 Mound calculations page 3 Mound drawings Page 4 Pres. dist. calcs. and laterals Page 5 TDH and pump tank drawing Page 6 Pum rformance curve page 7 Site plan Page 8 Attached soil evaluation eor[ License Number 220853 Designer Dale Hudson ,/� Phone No. 715-6 -3378 S? tt� �A`r,� Signature Date 8126199 persons is prohibited. with this file by unauthorized 145ohi to Stats. Notice: Tampering disciplinary action under S. de may be used for secondary purges[Privacy Law,s.15.04(1)(m)1 Deliberate modification will result in discip 8 Personal information you proms Page 1 of SBD-1p462-E(R-05198) MOUND SYSTEM DESIGN Complete red boxes as necessary. 1000 gpd maximum design flow. Inch-pounds Metric Residential or commercial? r (r or c) (y or n) I y I Replacement system? Creviced bedrock site? n (y or n) Slope 11 % Wastewater flow rate 600 gpd 2271 Lpd Depth to limiting factor 16 in 40.6 cm L In situ soil infiltration rate 0.6 gpd/ft2 24.4 Lpd/m Contour line elevation 100.7 ft 30.69 m Use standard fill depths? x OR Design depth? I Iin I Icm Place X in box to use standard depths(24 and A+4 inclusive)OR specify design fill depth. 0.125,0.156 0.188,0.219,0.25, Center or end manifold c (core) Hole diameter I 0.25 Iin 0 281 or.0.313, inch only. Lateral spacing 0.00 ft Use 0 lateral spacing for trenches. Estimated hole space 3.50 ft Not a final calculation. Number of laterals 2 Pump tank elevation 86 ft Outside bottom of tank. Forcemain length 210.0 ft Forcemain diameter 2.0 in 1.5,2,3 or 4 inch only. 2.067 in Actual I.D. HOLE DIAMETER CONVERSIONS 1/8 =0.125 1/4=0.250 SYSTEM SOLUTIONS Inch-pounds Metric 5/32=0.156 9/32=0.281 3/16=0.188 5/16=0.313 Estimated daily flow I 600 Igpd 2271 (Lpd 7/32=0.219 Absorption cell 1 Design load rate& area I 1.2 I9p�2 500.0 ft` 46.45 m Linear loading rate (LLR) 6.00 gpd/ft 74.4 Lpd/m Design width (A) 5.00 ft 1.52 m Cell length (B) 100.0 ft 30.48 m Depth of cell (F) 9.5 in 24.1 cm Sand filter Upslope fill depth (D) 20.0 in 50.8 cm Downslope fill depth (E) 26.6 in 67.6 cm Basal area required (gpd/infiltration rate) 1000.0 ft2 92.90 m2 Supporting components Topsoil depth 6.0 in 15.2 cm Subsoil depth at center 12.0 in 30.5 cm Subsoil depth at cell wall 6.0 in 15.2 cm End slope toe length (K) 12.70 ft 3.87 m Up slope toe length (J) 7.80 ft 2.38 m Down slope toe length (I) 17.90 ft 5.46 m Total mound length (L) 125.40 ft 38.22 m Total mound width (W) 30.70 ft 9.36 m Project: Robert McGrane Four Bedroom Residentail Mound Page 2 of 8 Transaction Number: MOUND PLAN VIEW observation pipes(typical) I _tJ _ 30.7 ft :::::::::::::` ::::::::::: :••: A I, A= 5.00 ft 1.52 m 9.36I m ::::::::::::::::::.. y B = 100.0 ft 30.48 m J = 7.80ft 2.38 m W I� B K I = 17.90ft 5.46 m K= 12.70 ft 3.87 m r L_ 125.401ft I 38.22 m typ. obs. pipe (anchored securely) 1 = down slope dimension 1 = absorption cell (AxB) J = up slope dimension CD = plowed area(LxW) "�' K= end slope dimension 6 (152 mm) MOUND CROSS SECTION T D E 20.0 in 50.8 cm H subsoil cap lateral topsoil E 26.6 in 67.6 cm 9.5 in 24.1 cm invert 102.87 ft :::::i G = 12.0 in 30.5 cm T ASTM C33 elev. 31.35 m ^F H = 18.0 in 45.7 cm ySand Fill sys. 102.37 ft elev. 31.20 m 100.70 ft contour \/ 30.69 m elev. 11 % --> slope D= upslope fill depth plowed layer E= downslope fill depth Note: Absorption cell media will consist F = absorption cell depth of aggregate and pipe with laterals G = subsoil + topsoil depth at cell wall centered across AxB media. The cell H = subsoil + topsoil depth at cell center media is covered with geotextile fabric. Designer notes: Additional 1.5" of sand fill required at center of mound to compensate for"dip" in contour line. Project: Robert McGrane Four Bedroom Residentail Mound Page 3 of 8 Transaction Number: • PRESSURE DISTRIBUTION CALCULATIONS • Metric Inch-�ounds m Absorption cell ft 30.48 m • Width (B) 100.0 ft Length (B) Lateral specifications Number laterals 10111111 holes m Holes/lateral 48.38 ft ® mm Lateral mete(P) 0.250 in .33 Us Holet diameter 16.31 gpm 1.0 Us Sy dis. ratera 32.62 gpm 2.06.2 cm Sys. dis. rate ;n Hole spacing(X) Design options choice in red Pipe diameter' _Place X Lateral diameter box of chosen Designer must '_-diameter. froone choice 1 1/2 in(40 mm) from the options 2 in(50 mm) _ provided. MIIIIIMIIIIIIII Manifold diameter pipe diameter Design options_Design choice __None required. from the options 1 112 in(40 mm) 11111111111 Designer must _ �x° one choice _No choice necessary. __ provided. 2 in(50 mm)ECBCM__ 4 in(100 mm) _� C Distribution system contains. 2 Lateral(s) LATERAL DIAGRAM CENTER CONNECTION M sat right and dragging the diagram into this area. Place correct lateral diagram by clicking in one of the drawing end cap ,J I I Laterals&force main of PVC Soh 40 -CIE xv'2 I xr2 3I (Per GO(+INI Table 84.30-51 Last hale dulled next to end cap Moles drilled on the bottom of the lateral. equally spaced • =permanent end marker Metric Inch-•ounds 14 75 m 48.38 ft 4.70.0 m Lateral length(P) 8 3 ft 109.2 cm Lateral spacing (S) in 0.00 m Hole spacing(X) 0 ft 6.4 mm Manifold length 0,250 m .4 mm Hole al diameter diameter 1.50 in 4050 mm Lateral diameter 2 00 in Forcemain diameter Project: Robert McGrane Four Bedroom Residerdail Mound Page 4 of 8 Transaction Number • TDH and Pump Tank Drawing Total Dynamic Head Operational head 2.50 ft 0.76 m Vertical lift 15.87 ft 4.84 m Are laterals the highest point in the Friction loss 3.80 ft 1.16 m system?Yes"X"here. X Total dynamic head 22.17 ft 1 6.76 m If no,what is the highest elevation Dose Volume downstream of pump? Dose is > 10 times lateral volume Forcemain drain Lateral void volume 10.2 gal 38.6 L back to tank?(''x"one) Minimum dose 150.0 gal 567.8 L x Yes Drain back 36.6 gal 138.5 L No Dose volume 186.6 gal I 706.4 L Typical Pump Chamber Layout In combination with state approved treatment tank. Tank construction as per Comm 83.20(3) WAC. _ approved manhole cover with 7-I 1 weather proof warning label and locking device grade levels junction box disconnect grade levels alternate 4"vent pipe .`� electric as per NEC 300 and \ n 0 1-1 ::: E- outlet Comm 16.28 WAC location 18"(46 cm)min. wall of pump 1 k------ approved chamber or I Q outlet joint combination tank A A Provide 1/4"weep hole or anti- alarm on v el siphon device as necessary pump on B (� C Grade levels pump 87.0 ft ^ d r -pump tank manhole=4"(10 cm) off elev. 26.5 m minimum above finished grade D -vent=12"(30.5 cm)minimum / N.> above finished grade v _ 86.0 ft Pump tank elevation 3"(75 mm)of bedding under tank 26.2 m bottom of tank Tank manufacturer Wieser 1250/750 gallon concrete combination Pump tank capacity 16.12 gal/in Pump tank volume 757 gal Pump manufacturer Zoeller Inches Gallons Pump model number 140 o A 24.9 401.2 'o B 2 32.2 Alarm manufacturer LevelArm a) C 11.6 186.6 Alarm model number DLV a D 8.5 137.0 Project: Robert McGrane Four Bedroom Residentail Mound Transaction Number: Page 5 of 8 HEADICAPACITY CURVE EFFLUENT and DEWA dE less than 30 feet TM. WARNING: Model 18514185 should TTAot be L DYNAMIC HEAD1CAPACITY PER MINUTE IeSN165 teLu111 ®® 11®MI S}S9 �� 1,°4'U 1NNie1® G,I. Un.®®�l� ey aSO Gd,ltr,® Se 21G laJ r SERIES 12113 e1 271 61 271 1al Ill cd. ltt Gd. Le7 u 716 i ® se 229 cirsFT. M. G,i.11n. WI.IL,� /] 112 R 2TS p 7s2 � el 27t 5e 11e N! 7 1i- y 1.Sx I: e2 11 tee �, 79 300 N 129 VIM" e0 i7 W 17 se 2Ie Ue StS MIMI ESCI �� 1 4• ■ 10 7AS 17] S1 lu l 39 uy /e 111 ow 17 - ® se 22e 116 �® 42 IS 1. t.1 S7 211 s9 217 tI1 10 10 15 e Q 271 se 121 90 7ue ®� 13 ss 2e1 ■ :s t.ei � s7 tet 7� se � 40 13� )0 U4 � 77 125 11 ?A9 Ira �� 40 1t19 . 11 7 ® 76 171 sl x2e 7° 76s II ilu 1° 11 s2 192 S1 197 yo 1SIu __ 10 ui 176 54 x°/ 38 12 sl le un n teo WI, 71 12t111101 1f11 1 I11 u36 191 11 roe w.0 _iiiói 110 17�79.62 105 32 Eay v,wr. 00 ,,30 95 ■ ` 111 lirall011101101111 ■ ■■■■28 90 ■ 186. 11111111111111101111111111111111111111 26 5 WM 1, ■■■■■■ 8 1654101111101111111011111111111111111 ,■ '■■ ■■■■ 80 4165 , , ■■■■■■ 24 , �■75trealli0 22 111011110111111111111111101111111111 ct 20 65 ` li ■■■ 60 16163, III4189 1111111111111111 0 18 4 ' ■, �a 55 1140111 IrMINOMMINI,111112 1 4 45_pi 50 Willati 40 a'"411 11011r1 I ,■■,,■■ 12 1 40, •, `' 4140 �,` ■ a OIRMS1015: M011 30 ■ t4185 ■ 1 37. 9■',1 1,' " "7 20 _=`,' 11 , ■■\, 4 10 SP li 161111111rildlillirli pia 5 � e gal 4161 1111111F59 0 140 150 160 111110111111 60 70 80 90 100 110 120640 0 30 40 50 480 560 10 20320 400 009922 U.S. GALLONS B0 160 240 LITERS FLOW PER MINUTE see FM0219. 0 ,vj. i►►Fn�meAm �" Gc;rea�SCpP/yr a>�e pr000f pump, Po•19 o t 3Z4a2 P Note: For Head Capacity on Model 112�ndustrial column-explosion -e ' X X X X /324 .* x x X x r ■ .5e:( ry :on N 5m4e /"-VC' 33 A 6e,c6 iff e 'ia.,e... 36 to S 70'(-44'e. ?S''' rv;Csor), cv/. , c9 Sie0�7 vn //^- / / / LoCa .ri // v 6 30- s r 4e5t'`y See. ?7 T. 29/T., / c,, / : .. ..• �' #e/5-t a; l///Q9.e©� (A3(5�, C1 r` flat iel G gee 1 A51, ‹z )X (A) ' / �J' / C 'o efe e..4.55u ,,e_ / 4� Z // .o I 133 AL8.4 :,7 poilft / Qc° / ,004: E/e o a 98.5-7 4 A - . az /5b'O.f.2.Sc1 V0 / P 14e.,(orce MQJn / / /3S posed,2s6/7socf Cornbinct.-E:cM S.T.'/IBC, N .4"54.4.go Rd•C. Proposed i 00.25—4-6 Fratie. Law-WTI, 5aocr. 95.45_ 0. 4 64elrcorn trade. �'esidevice 0 peapos.4 &ea, /4 >< /326 7o41Avice. 133' 70�'8 Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings in accord with Comm 83.05,Wis.Adm.Code A.C.E.Soil&Site Evaluations Mach complete site plan on paper not less than 8%x 11 inches in size. Plan must County include,but not limited to:vertical and horizontal reference point(BM),direction and St.Croix percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# 191-1012-50-000 APPLICANT INFORMATION - Please print all information. Reviewed By Date Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). Property Owner Property Location Robert McGrane Govt.Lot SE 1/4 SE 1/4 S 27 T 29 N,R 15 W Property Owners Mailing Address Lot# Block# Subd.Name or 3068 70th Ave. City State Zip Code PhoneNumber City ®Village ElTown Nearest Road t_ Wilson WI 54027 715-772-4778 Wilson I 10Th Ave.&310Th St. I New Construction Residential I Number of bedrooms 3 ]Addition to existing building Use: i j Replacement Public or commercial describe Code Derived daily flow 450 gpd Recommended design loading rate 0 bed,gpd/ft2 .3 trench,gpd/ft2 Basal area required bed,ft2 1500 trench,ft2 Maximum design loading rate 0 bed,gpolft2 .3 trench,gpd/ft2 Recommended infiltration surface elevation(s) 102.34'at 20"above 100.67'contour ft(as referred to site plan benchmark) Additional design I site considerations Site suitable for A+4"mound to replace proposed privy. Mound would require 20"of ASTM-C33 beneath system. Parent material Glacial till. Flood plain elevation,if applicable NA ft S=Suitable for system Conventional I Mound I In-Ground Pressure AT-Grade System in Fill Holding Tank U=Unsuitable for system ❑S Hu [7x] S Hi U 11 S N U [- S .. U 1 ❑ S z U 1 ❑ S [>> U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Consistence Boundary Roots Structure GPDIft2 Texture Boring# Horizon in Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed Trench 1 1 0-6 10yr4/3 None sil 2fcr mvfr as 2f 0.5 0.6 2 6-11 10yr4/3 None sil 2fsbk mvfr as 2f 0.5 0.6 Ground 3 11-14 10yr5/4 None sil 2fsbk mvfr cs if 0.5 0.6 elev 99.11'ft 4 14-18 10yr5/4 None sil 2msbk mfr cs if 0.5 0.6 Depth to 5 18-24 10yr5/4 None sl 2msbk mfi cw 0.5 0.6 limiting factor 6 24-38 7.5yr4/6 m2d5yr5/6 scl lcsbk mfi - - 0.2 0.3 24" Remarks: 1 0-9 10yr4/3 None 1 sil 2fcr mvfr as 2f 0.5 0.6 2 2 9-24 10yr5/4 None sil 2msbk mfr as 2f 0.5 0.6 Ground 3 24-32 10yr4/6 None sl 2msbk mfr cs if 0.5 0.6 elev 99.04'ft 4 32-50 7.5yr4/6 None s Osg ml if 0.7 0.8 Depth to 5 50-58 7.5yr4/6 m2d5yr5/6 Sc Om mfi - NP NP limiting factor _ 50" Remarks: CST Name(Please Print) Signat e: Telephone No. James K.Thompson 715-248-7767 -- - _ Address A.C.E.Soil&Site Evaluations Date CST Number Ref# 340 Paulson Lake Lane,Osceola, 54020 8/2/99 3602 1087 Page � of _ SOIL AND SITE EVALUATION in accord with Comm 83.05,W Adm. Code A.C.E.Soil&Site Evaluations Wisconsin Department of Commerce County St. -- -. must ---- of Safety and BuildingsDivision net.Tess than SY=x 11 inches in s'�•Plan in completenot site plan:vical ttoriza reference d'�ta nearest Parcel I.D.# 19 S 1 5 Croix - Date Dude,t limited or dirrtemsions,north arrow,and Reviewed By percent Ste' print all information. --- —_— _ i_ -000 TION- Please p information. Law,s 15.04(1)(m)) Pe Ofl information aT on u provide ro INFORMATION used for secondary purposes27 T 29 N,R 15 W u rovidemay PropertyLogtton SE 1/4 SE 1/4 S p Property onal information y° P Govp Lot Property Owner _ Lot# Block# Subd.Name or CSM# Robert McGrane -_--- Nearest Road Owner'sMailing Address —Village r]T°wn IOTh Ave.&310Th St. Property _ �CityWilson FA 3068 70th Ave._------ -State Zip Code PhoneNum 778 City WI 54027 715-772 � pddilion to existing building Wilson ____3—_ 3 trench,gpolftZ • � Residential I Number of bedrooms—3— L bed,9Pd�2--- 2 New Construction Use. public or commercial describe rate__ — 3 trench,9Pd Replacement Recommended design loading bed,gpolit2 0 450 9Pddesign loading rate plan benchmark) Code Derived daily flow Maximum ft(as referred to site �33 beneath system. bed,ftZ 1500 trench,ff2 wire 20"of ASTM Basal area required_—— 1p2.34'at 20"above 100.67'contour Mound would require lace Proposed privy. S'�suitable for A+4"mound to rep Flood slain elevation,if a., cable N�— Recommended infiltration surface elevation(s) Holding AT Grade System in Fill \ OS U Additional design I site considerationsS U Parent material Glacial till. I Mound In Ground Pressure \ S ® U Conventional S 0 U ft Tank � � S �U U Suitable for system S , u REPORT I GPDIft2 — UUnsuitable for system ❑ SOIL DESCRIPTION \Consisten•-I Boundary I Roots I--Bed Trench Structure I Dominant Color I Mottles Texture Gr.Sz.Sh. � 0.5 0.6 Depth \ Qu.Sz.Cont.Color \ 2f Horizon in. I Munseil 2fcr mvfr as 0.5 0.6 Boring# None sil IS 0-6 10 yr4/ 1111 2fsbk mvfr 0 5 0.6 _ 1 None ' �. 6-11 10yr413 2fsbk mvfr ® 0.5 _ 0.6 -_ 2 ® -- _ None sil 10yr5l4 mfr cs a Ground 3 sil 2msbk ®® 0.5 ; 0.6 - Dev 1E1 10yr5/4 None --- 4 10yr514 None sl 2msbk IIMIIIINIIIII 0.2 .6 5 18-24 scl lcsbk -- factoepth to m2d5yr5l6 - limiting 6 24-38 7.Syr4/6 11111 - .3 tactor 24' ® 0.5 0.6 Remarks: -- ® 2fcr mvfr None 111111115111111 0.5 0.6 0-9 10yr4l3 lei 2msbk ® 0.5 ; 0.6 2 10yr5/4 None mfi cs 9-24 — 2msbk 11131 0.7 0.8 10yr4/6 � None ml cs , NP Groundlen 4! None s Osg mfi cw _ NP elev 7.5Yr Om - --- 32-50 -- r5l6 sc - - _ - — m2d5y — T — 7_Syr416 -- 50-58 — Depth to all limiting ---- ------ _----------- factor 50- NI - ——' Telephone No. Remarks: --- / 715-248-776 �, __ m Ref# $gne. e: CST Number 1087 CST Name(Please Print) �� - Date 3602 1 Thompson 8/2/99 lames K.A.C.E.uoil&Site Evaluations 54020 Address 340 Paulson Lake Lane,COS i - ___________ • ,sG 6 ) v ev.,/-0-2_,”0 [ / / / z5 / ■ / v / fi 2S86� n�/� �70M) g / iy aj•coI z- �a'1 a // �o/c bi457_1 C fo?6'b//4 'ems/ *' ro •n r / 4�6Z1 2 .c7� > 7 / 7 S,j_ s -010 s o�0-7 1 II �� G�o2SS ) (5)( -�)7' ,0Z /3,2 of :_fa-Ucr,Q ,D/s=„/ . cc' N i:Ci t -aI!, aa..„._ awy2,910 ):cc- ■ t`�C ':d y, orr/ ) X x X a �( Q /! , v :o "Tree Ike_ P; N sill ='4' w er': 33, 3010 79 -�v,e, or, c0,7,6ni, 01 sfKoz7 Bi ,Locate-, . a // s f. �_, ys�SC�y S2L'. / 3(O .2? T29 1. / 66. Sr , /6-GO, v//ayc of cA;C50r1, / Ylq;l ivt Greece i4S/, s6. Cr()iX eI; I. / Erie.,4ss-c—,e�( 5/ate / e f-ev- =icb.60' / q / ,3 3 T10a1``� / re.6a : Etc U-- 98.574 / / A / az III // / / / Aroorayfota- 6 at-ZrY,-.1 97S if /326 114 7011,f( e. 33' County: PRIVATE SEWAGE SYSTEM St. Croix INSPECTION REPORT Sanitary Permit No Wisconsin Department pilings Division mmerce Safety (ATTACH TO PERMIT) 353109 INFORMATION [Privacy Law,s.15.04(1)(m)]. State Plan ID No.: GENERAL INFORM be used for secondary purposes Viacy w Town°f' rovice may ❑ City D Personal information you p Villa of Wilson Parcel Tax No.: Permit Holder's Name: 191 1012-50-000 .•' � ••�� BM Elev.: BM Description: �� Insp. DATA ®® STATION BS - TANK INFORMATION CAPACITY -- 1111M TYPE MANUFACTURER NM Benchmark - Septic Alt.BM -- 11111111 Ae -- Dosing Bldg.Sewer -Aeration liii Holding St/Ht Outlet TANK SETBACK INFORMATION - Vent to ROAD Dt Inlet P/L BLDG. Air IntakeTANKTO - NA Dt Bottom -- Septic 11116...11111 NA Header I Man. 111M -- Dist.Pipe a'- Dosing - NA Bot.SystemAeration 'nal Grade Holding -- Final SIPHON INFORMATION PUMP/ DemandOIINIIIIIIIIIIIIIIIIIIIIIII iiiiiimalmmimo COMGPM Model Number TDH Ft ® Friction WOW TDH L• Dia. Dist.To Well Length Liquid Depth Forcemain Inside D�a_ IMINIII No.Of Pits SOIL ABSORPTION SYSTEM ength No.Of Trenches PIT No. •NS Width LEACHING BED/TRENCH Oil LAKE/STREAM SETBACK Iiiii DIMEN P/L BLDG CHAMBER Model Number: SYSTEM TO -- OR UNIT 11111111111111111111111111 INFORMATION Type 0 x Hole Spacing Vent To Air Intake x Hole Size DISTRIBUTION SYSTEM Distribution Pipe(s) Spacing H Length h/Manifold Length Dia. Systems Only Dia xx Mound Or At-Grade xx Mulched SOIL Only x Pressure SystemsDepth Of xx Seeded lSodded ❑ Yes ❑ No Deth COVER xx ❑ Yes 0 No Depth Over Topsoil Depth Over / Inspection#2: Bed I Trench Edges Bed/Trench Center discrepancies,persons present,etc.) Inspection#1:27.29.15.99 COMMENTS: (Include code discrep SE1/4, SE1/4, Section 27 T29N-R15W)- 1,ocation: 3068 70th Avenue,Wilson,WI � No Cert No. Plan revision required? ❑ Yes ❑ Inspector's Signature Use other side for additional information. Date \Ms'.�O SANITARY --� — Department of Commerce PERM�7`;4PPL_ . 1 ON Safety and Buildings Division In accord with Comm 83.05, •Wis.pdm Code O 201 W.Washington Avenue • Attach complete plans(to the count copyP 0 Box 7302 than 8 1/2 x 1 1 inches in size. y only)fol �' Madison,WI 53707-7302 t �:Syster Iyr not ltsss County • See reverse side for instructions for completing thi If lit , } �-. e Personal information you provide may be used for secondary purpose 1999 �0r _ ��> State Sanitary Permit Number(Privacy Law,S. 15.04 1 �\ $j COUNTYr I. INFORMATIONZiafy ( t •`•` ./ D check if revision to previous application I. APPLICATIONy Owner • - PLEASE PRINT • State/ Plan I.D.Number E1 F�RMATI• Property Owner's Mailing Address/ L��'' �' , " Pr°pe Location c- -- , r 1/4,S27 T City, 706 L? 7) / ,C • Lot Number �9 'N' R ! (or)C� tat Block Number s'�J "/�,?i Zip Code Phone Number II. TYPE •F B 'L 8 ' de (7/5 )77� c>7_ Subdivision Name or CSM Number ING: (check one) 11 Public iZ 1 or 2 Fa mil D one)ellin• _ 0 State Owned ❑ ityy III. BUILDING No. of bedrooms f,a6vil n � Nearest Road USE: (If building types public,check all that apply) • Town OF ber($) Sn yam, _ Pp y) �,,�,� Parcel Tax Numbers) /UAr �`�/t")�S�: ❑ Apartment/Condo 2 Ai. a-�)„ 15• 41 /9/-/o/❑ Assembly Hall l -3�� -000 23 0 6 ❑ Medical Facility/Nursing Home 4 0 Church Campgroundndo) 7 0 Merchandise: Sales/Repairs 11 0 ❑ Outdurant/Bar/Dining Facility 5 0 Hotel/Motel 8 0 Mobile Home Park >> ❑ Restaurant Restaurant/Bar/Dining IV. TYPE OF PERMIT: 9 ❑ Office/Factory 12 ❑ Service Station/Car Wash (Check only one box on line A. 13 ❑ Other: specify A) 1. New Check box on line B,if applicable) _System 2. 0 Replacement 3. 0 Replacement of B) _ _ ____________System___-____---_ Tank Only- 4. ❑ Reconnection of 0 A Sanitary Permit was previously issued. Permit Number --- Existing System 5. ❑ Repair of an V. TYPE OF SYSTEM: --- - -------------Existing System (Check only one) Date Issued Non Pressurized Distribution Pressurized Distribution Experimental 12❑Seepage Trench 21 ❑Mound 30❑Specify Type 41 ❑Holding Tank Other 1 1 ❑Seepage Bed 13❑Seepage Pit 22❑In Ground Pressure 14❑System-In-Fill 42❑P VI. ABSORPTION SYSTEM INFORMATION: aul1vy 1- Gallons Per Day 2. Absorp.Area 3. Absorp.Area 4. LoadingRate _5� Required(sq. ft.) Proposed(sq. 5. Perc. Rate 6. ft.) (Gals/day/sq. ft.) (Min./inch) System Elev. 7. Final Grade III. TANK Capacity Elevation INFORMATION in gallons Total #of Feet Feet New n. Gallons Tanks Manufacturer's Name Prefab. Site ank • TanksTv Concrete Con- Fiber- Plastic Exper. � *t3ti7lttg ianK strutted glass App h Pump Tank/Siphon Chamber__ III. RESPONSIBILITY STATEMENT 0 [] I,the undersigned,assume responsibility for installation of the � 0 Cl ❑ ember's Name:(Print) onsite sewage system shown on the attached plans. 0/ Plumber's Signature:(No Stamps) /)v / /r�riy/�r/7),^� at MP/MPRSWNo.: amber's Address(Street,City,State,Zip Code): Business Phone Number: COUNTY/DEPARTMENT USE ONLY Y� leJ ��� 0 Disapproved Approved ['Owner Sanitary Permit Fee (Includes Groundwater Given Initial Surcharge Fee) gate slue. Adverse Determination Iss ing •g•nt Signature(No Stamps) CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL•• f / / Dl� •t�h GSS -pvv>� ` l pir. ./ 1ti.�s'f lu- �„ �)��`�` w o �S6ti.-„ �pea, r'5' v/0 b�1l, ' I , , 398(R.4/99) � e�1 f�C cc? _ _/ .- 60 y� W 1i(. �.f t7t 1iki i 4 p v /- _ DISTRIBUTION. Original to County,One co• . , 444, ,P C5.4t�er n �4sti�� S y✓ copy To: Safety&Building/Division`Owner,Plumber SO DISTRIBUTION: "�— X X X ,C. a..za X X >c Tree Itl 33, D w n e( : Abe.-% /1(�(,'�a.�� 30ee, 70€`-4(-e ?� w; _60)-), to(. c� Sfeoz7 v \�/ 131 / /ocQ m • • f/ 310- • cfrf5L 1 se2. .2Z T. z9rl., // L• ..• K.: /s(.J; //yy,of�;(saY7, /n,,ai l i _ h G re¢r�A-61, Cto � W/. �1 .b // Clet."Wu—,L / / . / • B3 ,A -84 sTpcFyu/ / nc.ba.- Etc a?8S 7 4 / A • / az PropoS nere,4e dQ pn y. A tap coy 1,ti(a cadil 6,-e.4_ 75- �f /326 LOOP-SLOPES i' {ROTH SIDC Of BUILOING)---� / GRAB BARS (4) b" fY_P WALL w�. s 8 5- r WOMEN MEN I" 30" I IO '.6"'(>OOR _ _ O O 36"DOOR 9"YI — I PER PIPE .r I PCR SIDE I e-DC,CR 34-DOOR I" 1 20"OR 8"DIA. MANHO.E OPENING ' O —" ---------____— _ ZBO. AND CC/ER These buildings are handicap accessable and can meet DNR specifications. With no wood floors or walls to rot, this building is a maintainence mans dreams. If cleaning is required, the building can be hosed down with water or disinfectant. The buildings are very resistant to vandalism. The stools are made of durable plastic and will not dent. The door and frame are constructed of steel. After completion the building is painted inside and outside. = N. f ` v ' ' ,1 o- tom- (u - s.. ' 4. • The roof is set and then the • The inside of the building is • This unit can be done as a bug screens are installed. finished off which includes in- -two-seat-or one seat unit. A Ventilators draw air from both stallation of grab bars, stools, concrete roof c b added pits. and stalls. also. When looking at the long-term maintainence cost of this building, you can see what a value it would be. We can also manufacture a secure utility/storage structure. This building would be ideal for storage of flamable or hazardous liquids and materials. For more information contact: �`oNAI PgFc ? , 1p HUFFCUTT CONCRETE o IC 0 737 Herbert Street zo � Chippewa Falls, Wisconsin 54729 BETE Assoc'c' (715) 723-7446 Huffcutt Concrete is a member of the National Precast Concrete Association and Wisconsin Precast Concrete Association. Steve Olson, President 1)— 1.` 54PA' 429 6.239$ 9 KATHLEEN H. WALSH REGISTER OF DEEDS Document Number Document ntle ST. CROIX CO.. , WI RECEIVED FOR RECORD p i�`/ 5-L(,( t; A. r-e em-¢-rie 09-03-1999 4:00 PM AGREEMENT EXEMPT N CERT COPY FEE: COPY FEE: TRANSFER FEE: RECORDING FEE: 12.00 PAGES: 2 Recording Area Name and Return Address Gi M�S a m10So+'? . 3 /o AZ.tdSi r- (tee OSCeo(q cAD/• syozo /9/-/O/Z- Parcel Identification Number(PIN) • "THIS PAGE IS PART OF THIS LEGAL DOCUMENT - DO NOT REMOVE" This information must be completed by eubrnitter:document title,name Sc return address,and PIN(f required). Other.infonnation such as the grunting clauses,legal description,etc.may be placed on this first page of the document or may be placed on additional pages of the docruunt. Note:Use of this cover page adds one page to your document and,F2.00 to the recorrEnt fee. Wisconsin Sran.r,s,59.517. WRDA 2196 Wisconsin Department of Commerce Q 'Division of Safety and Buildings SOIL AND SITE •. '+ j 1Q in accord with Comm 8 is.q Page 1 of 3 Attach complete site plan onss s. (' Cade ` ,��, include,but not limited to:on and horizontal reference point(BM)direct'. :.. I�E�+'-"�U A.C.E.Soil&Site Evaluations percent slope,scale or dimemsions,north arrow,and location and distance to lia APPLICANT INFORMATION- t r0� St. Croix Personal information Please print all information. iiip# you provide may be used for secondary purposes(Privacy Law,S. r3T GROW' 91-1012-50-000 Property Owner )> to Re = e, e Robert McGrane • ' �� _ Date ' Property Owner's Mailing AddressGovt , SE Kt` : 1/4 S 27 T 29 N,R 15 W 3 068 70th Ave. Lot# -..,« a'.';Name or CSM# City State Wilson Zip Code PhoneNumber WI 54027 715-772-4778 City [Drown Nearest Road Wilson 10Th Ave.&310Th St. ; xNew Construction Use: Residential/Number of bedrooms 3 Replacement Public or commercial describe 11 Addition to existing building Code Relived daily flow 450 Basal area requirede gpd Recommended design loading rate 0 bed bed,ft 1500 trench,ft2gpd/ft2 .3 trench,gpdt2 Recommended infiltration surface elevation(s) 102.34'at 20"abov p0 Maximum'design loading rate 0 bed,gpe/pl .3 trench,gpd/ft2 Additional design/site considerations sate suitable for A+4^mound to replace proposed privy. ft(as referred to site plan benchmark) Parent material Glacial till. P Y Mound would require 20"of ASTM-C33 beneath system. S=Suitable system Conventional — `, _ , - ei. Flood 'lain elevation,if a..licable N A ft S=Suitable foro for systema Mound S ; s u In-Ground�� Pressure I AT-Grade System in Fill Holding Tank }' U H S � ; u ! ; � s � u SOIL DESCRIPTION REPORT Boring# Horizon Depth Dominant Color Mottles in. Munsell Qu.Sz.Cont.Color Texture Structure Consistence Bounda GPD/ft2 Gr.Sz.Sh. ; ry Roots 1 1 0_6 10yr4/3 None sil ' Bed : Trench 2fcr my 2 _ j fr as 611 2f 0.5 ' 0.6 10yr4/3 None sil - 2fsbk1E11elev Ground 3 I 1-14 I 10yr5/4 mvfr 2f 0.5 0.6 None sil 2fsbk MIMI ' ____ 99.11'ft i mvfr 4 14-18 0.5 0.6 10yr5/4 None sil I 2msbk --- Depth to 5 18-24 10 5/4 mfrMIMI 0.5 None MEN11111 0.6 limiting s1 ; 2msbk - -- factor 6 24-38 7.5yr4/6 m2d5yr5/61E11 0 5 j 0.6 24" i I csbk a 0.2 0.3 Remarks:- - 2 0-9 10yr4/3 None 1E111 2fcr i mvfr 9-24 10 r5/4 2f 0.5 ' 0.6 None 11311 GroundIMI 2msbk mfr as 2f elev 10yr4/6 0.5 0.6 Nonein ---- - --- - 2msbk 99.04'ft mfr cS I f 32-50 7.5yr4/6 1111 _-_- 0.5 0.68 None --- --- Osg ml Depth to -- p 50-58 7.5yr4/6 m2d5yr5/6 cs 1 f limitingYill 0.7 0.8 Om mfi cw a factor NP NP Remarks: 1 111111111...... Ilimail 1111111 aim CST Name(Please Print) _Amp'Sgn. , e: isimom--- _ James K.Thompson ., Telephone No. Address A.C.E.Soil&Site Evaluations L��'1p.� 340 Paulson Lake Lane,Osceola, 715-248-Number 54020 Date767 — CST Ref# 8/2/99 3602 1087 'PROPERTY OWNER: Robert McGrane PARCEL LD.# _i 91-1012-5 r Opp SOIL DESCRIPTION REPORT u>8-r P 2 of 3 Horizon Depth Dominant Color Mottles A.C.E.Soil&Site Evaluation in. Munsell i Qu.Sz.Cont.Color Structure Gr.Sz.Sh. insistence Boundary Roots GPD/R� 3 0-8 1 oyr4/3 Bed : Trench None sil 11111EM 8-16 yt mvfr lain 0.5 Ground 10 5/4 None 1111 2msbk 0.6 elev 16-18 IOyrS/4 ®a® 0.5 � 0.6 _ f2d7.5yr5/8 ® 2msbk 101.08 ft mfr MIMI © 18-36 l 0yr4/6 m2d7.5yr5/8 0 5 I 0.6 Depth to - lcsbk limiting © 36-55 7.5yr4/6 m2d5yr5/6MI NMI= 0.4 0.5 factor Om mfi 16' 111111111 - ®a NP , NP Remarks: ; Ground elev mimmillillonalli Depth to - ri INIIIIIIIIIIIMMIIIIIIIIIIIIIIIIIIIIIIIII limitingIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII -- factor �lIIIM11lIl.Ei11ll1Il1 MIN Re marks: iillili I li I li I In in -Ground I h alelev - Depth to IIIIIIIIIIIIIIIIMMIIIIIIIIMIIIIIIIIIIIII fact factor IIII Remarks: -- Ground 1111111111mMinimmemin III 11111111111111111111111111111111111111 elev Depth ing to liii- factor � 1111111111111111111111111111111111111111111111111 Re marks: i31a '* P.30f3 • nD%( Chseraz&o Twee /ke p; N eke. ,'c4 ' W 33, /006.er6 6c e: 3a 62 r 70 s -4v,e. �,( w,"t6cm, w/. � 60.2-�' t\ cI S V \�/ a / ,Lo eQ // S�y�s�`y see. .27 T. 29/r., / ,,J '. f 3(0� Sf. / i /Su). c///aye off'cJ,Cs / ' '�' C.!'6!X Co; c.J/. a7 n0..1 iv) G reQ,i,451, -` t.b / &cc.ASSUm� /ate // e l-e0- _/Gb.c29' ,-, q / � M / .8. T/0o/4 / rdoQ,, Elf -9B.s7 4 / A / • $2 // / / / A100rtJ)(;,vca ,6,-ems I 97.5 / ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer /c>L e a":71- 727G 6-'1,,4 j/G Mailing Address 3 O G 17� Xve, > la/O j^ ', - i.Z7 i S 1 I aj- Property Address -Si-r>E (Verification required from Planning Department for new construction) City/State Zit,Jr,..y u/j ; Parcel Identification Number /7 -/O/Zd 50-ood LEGAL DESCRIPTION N" ` r,r� V° "'�`� Property Location 5 t/,, S2_' y, Sec. 2 7 T79 N-R/J W, Town of S70(-).7-1; Id. Subdivision , Lot # Certified Survey Map # , Volume _, Page # - Warranty Deed # ...5)/0 g17,3 , Volume /f4/ , Page # -57?0 . Spec house 0 yes [ no Lot lines identifiable i3"yes ❑ no SYSTEM MAINTENANCE Improper use and ma intrnancc of your septic system could result in its premature-failure to handle wastes.Proper ma inttsrancc consists of pumping out the septic tank every three years or sooner,if needed by a licensed can affect the function of the septic tank as apumper. What you put into the system treatment stage in the waste disposal system. The property owner agrees to submit to St Croix 7nning Department a certification form, signed by the owner and by a masterplamber,jorim.epianplumber,1c tric tcdplumberor a licensedpamperverifying 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.42,4-,-1-- _ . OF APPLICANT DA / TE OWNER.CERuTIh7CATION I(we)certify that all statements on this form are true to the best of my(our) knowledge. I (we) am(arc) the owner(s) of the property described above,by virtue of a warranty deed recorded in Register of Deeds Office. 1 IGNATURE,e7 OF APPLICANT �` CI / // ciR DATE sw«««R Any information that is mis-represented may result in the sanit ary 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 madc in t c warranty deed ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND • // OWNERSHIP CERTIFICATION FORM b Owner/Buyer /�C> P r' / 7)?G �'�•4�G Mailing Address 3a �1�74717 7vc Property Address e- (Verification required from Planning Department for new construction) City/State l✓i 'a 1y l Parcel Identification Number / /--//Z-- 5 —()n0 LEGAL DESCRIPTION N" " 1' — — ‘16 Property Location ,f %,, Sl y, Sec. l 7 TZ. N-R/J W, Town of -j71)K-%.r�_�-�,.e- /C . Subdivision / , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # -'/O`/t7 3 , Volume / 1 Page # . Spec house ❑ yes Lino Lot lines identifiable III yes ❑ no SYSTEM MAINTENANCE Improper use and ma inter,anrrof your septic system could taint in its premature failure to handle wastes.Proper maintenance e 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.systcur. The property owner agrees to submit to St. Croix Toning Department a certification form, signed by the owner and by a nrasterphrmba;jo ynanpIu:mber,witdctedplumbcroralicensedpumpervaifyingthat(1)theon-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 ed 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, stating that your septic urccs,State of Wisconsin Certification system has born maintained mint completed and returned to the St.Croix County Zoning Office within 30 days of the three year expiration date. GNATURE OF APPLICANT DATE OWNER CERTIFICATION I(we)certify that all statements on this form arc true to the best of my(our) knowledge. I (we)am(arc) the owner(s)of the property described above,by virtue of a warranty deed recorded in Register of Deeds Office. /;/ CT lei/ rSIGNATURE OF APPLICANT DATE s*«««« 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. },� 4 I SOU big- -;"'; :° WARRANTY DEED ff { �, . K sawn:O ‘V ISCONstN—foRNt I 1 i' r. AJ THIS SPACE RESERVED FOR RECORDING DATA 1 THIS INDENTURE, Made this 25th (lay of April REGISTEiiS UFF I:::1= A. D., 19 72 ,between A, A, Willink and Dorothy Willink, ST. CROIX CO., WIS. his wife Rec'd for Record this-391th_ day of__slay_----- A.D.1912 part ies of the first part and at__ __8:3D____A, M. Robert 0. McGrane and Lois H, McGrane, husband and wife I/► / �ter of Zi',�C/ I ReR .n•ic ! part lea of the second part, _ — --- 11 W i t n e s s e t h, 'That the said part 1es of the first part, for and in consideration RETURN TO II of the sum of : :Forty Five Thousand Dol lass • I II to them in hand paid by the said part ies of the second part, the receipt whereof is hereby II confessed and acknowledged,ha given,granted.bargained,sold,remised,released,aliened,conveyed and confirmed,and by these presents do......-...give,grant, bargain,sell,remise,release,alien,convey and confirm unto the said part.ieS...of the second partxbeiZeirs and assigns ! 1 forever, the following described real estate situated in the County of.....-tr.....Cer.Pi and State of Wisconsin, to-wit: ! The East One Half of the Southwest quarter (E' of SWI) and the West One i I; P Half of the Southeast quarter (W1 of SEA.) and the Southeast Quarter of the Southeast I '! Quarter (SE'2 of SE'k), all in Section II Twenty Seven (27), Township Twenty Nine (29) !' North, Range Fifteen (15) West. i, II i' I' 1' i) r T .. _ . ., ii ,i f li „ (IF NECESSARY, CONTINUE DESCRIPTION ON REVERSE SIDE) I h Together with all and singular the hcreditamcnts and appurtenances thereunto belonging or in any wise appertaining;and all the estate i`I Ili right,title,interest,claim or demand whatsoever,of the said part....ie£f�f the first part,either in law or equity,either in possession or expectancy ' I of, in and to the above bargained premises,and their hcreditamcnts and appurtenances. I' To HMV and To Hold the said premises as above described with the herejitaments and appurtenances, unto the said part._ie.s.of the ;l ii second part,and to...their...heirs and assigns FOREVER. '' I! And the said A....A-...--Wil-lick...and...D.orothy...Wlilli.nk.,...-hi.s.-.xtife 1j (I i; for t.hewselves.,...t.hear heirs, executors and administrators, do . covenant, grant, bargain, and agree to and I II with the said parties_.of the second part, their heirs and assigns,that at the time of the ensealing well seized of the premises above described,as of a good, sure, g'1Od indefeasible delivery estateof ofth inheritance presents it in the law. in fee simple,and that the same are free and clear from all incumbrances whateverabsolute and of l and that the above bargained premises in the quiet and peaceable possession of the said part.ia/L.0f the second part X.henteirs and assigns, it 1 against all and every person or persons lawfully claimingthe whole or any part thereof, will forever IYArtRAN'(\D DEFEND. ii In Witness Whereof, the said part..ies..of the first part ha...v.e...hereunto set...the' ...handI day of April _.and Ali .25. II �- , A. U., 19.-7..2 SIFNED AND SEALED IN PRESENCE OF II ���� (SEAL) I Il 'Lr � � � ,I ! e'= • , G. E�,j-1 , I_-�/ • A, A. Willink /- x e-t e`Iz_.I/ (? e "t L Il (SEAL) 11 �Sifirley A. Rademakfr 'I / Dorothy Willink �1 (/ �. -_ Il l �� •Z tL (SEAL) I - lI DaleW. Fern I! 04L-V-) IL i, SPATE OF WISCONSIN, it St. Croix SS II County-i. II Personally came before me, this 25th day of April ii the above named- .A-.-..A. Wi11.i.n.k..-allid._.Dorothy-..Willink !i A. 1) 19...72-.- II t- I I qt.- .DOCUMENT NO. . • i . i 9neK 464 C.I .' " Id WARRANTY DEED 0111. r I i, ,, . ... . • • '. 1..0‘...,-,..' ,---, - !, STATE OF WISCONSIN-FORNI f 1 ' 'THIS SPACE RESERVED FOR RECORDING DATA t ,1 ;.,,.' )).• ;:. ‘o '',, I c. ... , ,-4-: .-r - ! ----— i • — • • THIS INDENTURE, Made this 25th (1)0.of April REGISTE:iiS 01- A. D., 19 7h2ishetwe;n' A, A, Willink and Dorothy WillilIk, ST. CROIX CO.. VVISwie . Rec'd for Record this...30..th_ 1 . 1: ... • li II day of May A.D.19:12 lir par(ies ()I the first part and 14 Robert 0. McGrane and Lois H, McGranej husband and at__ ..../2:11.1__.A1 M. .alett.s...../zit‘xe/ ir I, i ! wife part.4..§. of the second part, ___ ,... ,,,................... .. . . . Regtst,tr of ))0.is .1 1, • J RETURN TO Witnesseth, "fhat the said part..1.e...of the first part, for and in consideration ;II of the sum or..::Forty Five Thousand Dollags ,...„„..„...„....„___ II , i. w them in hand paid by the said part/es of the second part, the receipt whereof is hereby II confess«1 and acknowledged.ha. ... .. given,granted,bargain;d.sold,remised,released,aliened,conveyed and confirmed,and by these presents li li:' do ,ive,grant,bargain,Fell,remise,release,alien,t onxey and confirm unto the said part..ieS..of the second partJtheilleirs and assigns ; forever, I he following described real estate situated in the County of....S.t.,...Cr.PiX and State of Wisconsin, to-wit: ll li The East One Half of the Southwest Quarter (E.. of SW ) and the West One Half of the Southeast Quarter (W1/2 of SE ) and the Southeast Quarter of the Southeast j. !1 Quarter (S4 of SE.), all in Section Twenty Seven (27), Township Twenty Nine (29) • North, ange Fifteen (15) West, • 1 . Ti:::,.: . • • •- ., t,1i! • . li OF NECESSARY, CONTINUE DESCRIPTION ON REVERSE SIDE) - Together with AI and singular tin heredimments and appurtenances t hereunto belonging or in any Avise appertaining:and all the-i(4.1ate !I I: right,title,inkiest,claim or demand whatsoever,of the said part....iCaSif the first part,either in law m"co idly,either in possession or expectancy I! III, in and to the above bargaint•d premises,and their herditaments and appurtenances. ,•. -.. • • To!rave and To{fold the said preii i. is above described with t he here,litaments and appurtenances, unto the said part.i.e.Sof the i second part,:ind to...tbe.ir...heirs and assigns FOR I! . And the said A...A......Willink..and.Dorot.hy...Willink.,...his...laif.e , ii•., .,--\. li ; . .'. for themselves4....their heirs, executors and administrators, do coevmult grant bargain, and agree to and il .. II with the said parties...NI'the second part,. _their heirs and assigns,that at the time of the ensealing and delivery of these presents i l' .........they were.....well seized of the premises above described,as of a good, sure. perfect,absolute and indefeasible!estate of inheritance .1 ; I in the law, in fee simple,and that the same are free and clear front all incumbrances Whatever '••• i ti ti ti it --.."•..— • - - • and that the above bargained premises in the quiet and peaceable possession of the said part.i.E.S..of the second Parttheibeirs and'itssigns. !I 1 ij .;; against all and every person or persons lawfully claiming the whole or any part thereof, will forever WARRANT AN!) DEFEND. !I ti ;i In Witness Whereof, the said part..ie.a.of the first part ha...v.e.Lbereuato set...tite4t............„5,.....hand ....-.and ills .......this _2,5 1 II day of.....Ap.ril 1. sliNED AND SEALED IN PRESENCE OF ----.,.."-e-----7--...--- ------1.-.;.--77.7 .,‘ (SEAL) i• ' .1 , ',A. A. Willink i 1 , ,.‘ , l • •.,• . 'i .• 0"- i .4 • . ' 4 V.:"Ce -",fr I 4,• ',---t•—•"' • / il .•i rit 1 I k (SEAL 1 -.../ 0 filey A. Rademaker D6rothy Willink 4 , '' (SEAL) ;I Dale W. Fern ' ----4 ;. • .,1 , ,i • STATE OF WISCONSIN, il . .. : 2St. Croix ss. ,.cowIty. Per..;rinally came before me,this 25th day of April A. D., 19-72.- •! tlwAovemimed..._AA7A. Williniumd_Ddrothy_Williak .,• ....-•- •. ......- 44, , ' — .f: \ •• -........,..4.- -,-7;',,,-..-- ;:• ,.,.....:,,....-.4.--,.:,..:zi...... -_ - - . . .