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HomeMy WebLinkAbout002-1023-20-100St. Croix County Planning and Zoning Monday, March 26, 2007 at 10:21:39 AM Detail Sanitary Information Page 1 ojl Computer #: 002-1023-20-100 Sub/Plat: NA Section: 11 Parcel #: 11.29.16.162A10 Lot: 1 TN/RNG: T29N R16W Municipality: Baldwin, Town of CSM: Vol. 15 Pg. 4109 114 1/4: SW 1/4 SW 1/4 Owner: Lee, Betty 2516 County Road E Woodville, WI 54028 State Permit: 399577 Issued: 11/13/2001 POWTS Dispersal: Mound Permit: New County Permit: 0 Installed: 09/13/2002 POWTS Detail: NA Bedrooms: 3 WI Fund: POWTS Pretreatment: NA Notes Issuer/Insaector As Bui1i Plumber Other Reuuirements Not determined NA Schumaker, William Pam Quinn `ius~e~ C)ff; Yes M ; rsanec Scheduled Pump Date Pumped 1st Notification 2nd Notification 9/13/2005 10/18/2006 04/20/2006 10/18/2009 3rd Notification Additional Notes Monev Owed $0.00 Parcel #: 002-1023-20-100 03/26/2007 10:20 AM PAGE 1 OF 1 Alt. Parcel #: 11.29.16.162A-10 002 -TOWN OF BALDWIN Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O -LEE, KENNETH G KENNETH G LEE 2516CTYRDE WOODVILLE WI 54028 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description " 2516 CTY RD E SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 4.000 Plat: 4109-CSM 15/4109 002/01 SEC 11 T29N R16W PT SW SW BEING CSM Block/Condo Bldg: LOT 1 15/4109 LOT 1 4.000AC Tract(s): (Sec-Twn-Rng 401/4 1601/4) 11-29N-16W SW SW Notes: Parcel History: Date Doc # Vol/Page Type 11/12/2003 746404 2454/508 WD 08/28/2001 654974 1707/589 WD 06/22/2001 649130 1666/369 W D 08/24/2000 628764 1537/286 (~C mo .. 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/27/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.000 32,700 173,700 206,400 NO Totals for 2007: General Property 4.000 32,700 173,700 206,400 Woodland 0.000 0 0 Totals for 2006: General Property 4.000 32,700 173,700 206,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Department oflndustry, SOIL AND SITE EVALUATION REPORT labor and Human FRelations - Division of Safety & Buildings ~~ __~ ._.:.~ ~~ ~ ~r, ~ ~ ..,:_ w~.Y ~._~_ Page _ of „_ ~-~.~ ...,..........~.., ..,.,..,.,, .... .. ................. r' COUNTY ~`~" ~' Attach complete site plan on pa `r ~ an Plan must include but 'nches in size not limited to vertical and hori a fere ce point (B dimensioned, north arrow, a lion ar1~ i~}~ce ton . , ction and % of slope, scale or road. PARCEL LD. # ;- APPLICANT INFORMAT PLE~~~~RIN,Ta~I f NATION VIE D T 6 ~l3 ~ PROPERTY9W#ER- ~ -c'~r ; ,~',~ ~`~ ~~~~~'~ PROPERTY LOCATION ' R I ( E (or W I S j I T ~ q N GOVT LOT ~ ( () 1/4 S~ 1/4 ,n ~,~, ~ , , . , , PROPERTY OWNER':S MAILIN D~i~SS ~ ~,t~ ~ ' ~~ ~ ~~• LOT # B~~~# SUBD. NAME OR CS~M,# ~ ~ C, f~11-- CI STAT 0 E; "P}~IONIa BER ^CI ^VI LAGE N NEAREST ROAD [ ew Construction Use [ Residential / Number of bedrooms ,t/~ (J Addition to existing building j ]Replacement [ J Public or commercial describe Code derived daily flow ~_ gpd Recommended design loading ra bed, gpd/ft2~trench, gpd/ft2 Absorption area required ~~ bed, ft2 trench, Maximum esign loading rate r bed, gpd/ft2 .f~~/~,-,trench, gpd/ft2 Recommended infiltration surface elevation(s) t ft (as referred site plan benchmark) Additional design /site considerations Parent material S , ~~~ e~ Flood,plain elevation, if applicable ~ ~ ft S =Suitable for system U =Unsuitable for s stem CONVENTION ^ S M U"'^ i IN-GR _ RE.SSURE AT-GRADE SYSTEM IN FILL '-' " `-' ~ ~ ~~ HOLDING TANK ^ S B~ Boring # 4~ ~ ~~:<g ku ~ :;:.: }~<r~:<::<;< Ground elev. Depth to limiting fa r~ Horizon Depth in. Dominant Color Munsell ~". ~ 3 a 8-a~ 10 3 -3 ~ Qy ~" ' /'~?u-of Qrau e Sf~ rn~ -.Q~ eur,4cr~u ~ ~ ~ ~f¢itafca>: -~ l y~ ~D ,. ~OL/~ Remarks: . Boring # K4Et:: is };•••}:.:;:fi}: .r ~} a F 4ti•nl~v Ground elev. ft. Depth to limiting fact ~1 ~ i ~ s ~ ~c ~n~ i ~~-~-' ~u , F - - .~ - ,oy. s ~~~ ~~ ~bk ~, ~' d~~ ~~ - - ~ w~ 3 V ~ _ - G~ Remarks: CST Name:-Please Print ~ ~ ' Phone: Address: c~ 1 S i^ i vt C)~ ( ~ L.l.,~, 5 ~~ 76 Signature: ~ ~ ~ „~ Date: , , _ CST Number: _ iG PROPERTY9WNERpY /~''~ ~ her~sa,.--SOIL DESCRIPTION REPORT PARCEL I.D. ~ Boring # tic :`.: ~:: •:;? ;;~~.' k.., ~vak~C iis} k; • .•=•~~ i Ground elev. ft. Depth to limiting factor ,, Boring # .. , .. >:~ Ground elev. ft. Depth to limiting fact c~ Boring # ~K •ti\ `Y ~: ~~•h ~i$4. ..: is ~s.4~W+t?ti i. Ground elev. ft. Page _ of r Depth Dominant Color Mottles T t Structure i tence n C r>de Ba Roots GPD/ft Horizon in. Munsell Qu. Sz. Cont. Color ure ex Gr. Sz. Sh. o s s . y Bed Trench 5 i ~ S ir-ti i c:~ ~ ~ J. - .~ -- ~ ~ ~ ~~ lZ ~' ~`,~ a ~ ~ ~ sb ~ h ~- 1 ~, J RPmarks~ ~-~ r~ r~ - s ~~ ~ ~~ u~ r ~ ~- -/ l o y R '~ vK ~ ~ .S ~ --- ~ ,b vim. ~ ~ +..~; 1 `' ~ -- Remarks: Depth to limiting fac~;, Fs~ ~,~`~ Boring # ~ti1 10 ~}~ ,,. Ground elev. ft. Depth to limiting ~f~ctor Remarks: (.,C,lct-f-P~.- ~ ~f- ~~ !• ~ `~ t~~~ f~ e .~ . S 1c-~ ~ ` S I .2 ~ V r ~ tv~ 4 0-~ ~~y~ ~ s~~l ~~~ ~~ ~~ ~ ~~~ - w..~ v.. y ~~ ~' ~'~ Remarks: SBD-8330(8.05/92) ~-- // ~~ - _ _- ~ _-- -- _ --- r _ U ~ ~ J r0 C _ .. (=-t-- C~_-~ 'S ~ c, ~,~- ~E s r,: r 4~ ~ J~ i6 (~~ 1 "' ~G Cj r~ r ~7 ~1 7 !' ~J .k n R. r I ~ Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Labor and Human Relations Divisior~of Safety & Buildings 'n It~l 83 05 WIS Adm Code Page _ of COUNTY lete site lan on er not less t Attach com a but ~8~/2 x 1 inch`s in ? n must include J~ p p p p , ~ D # PARCEL I not limited to vertical and horizontal referen and pe, scale or nt (BM), . . dimensioned, north arrow, and location an nce .nea~d: u~ r ~ ~ "'" APPLICANT INFORMATION-PLEAS ~ ~~' INT A~L`IJOF/~OFjMATIOIV ,~... V I~~ti ti t REVIEWED BY DATE PROPERTY9WfNER- <~r : ~ ~~ , ~, ~. "'~~~)~ , "~~~~~~ ~;" ~ .~~ ~P OPERTY LOCATION ~ OVT. LOT ~ ~ 1/4 ~~ 1/4,S ~ ~ T ~ `~ ,N,R ~ (~ E (or W~ PROS ~ ~WNER':S MAILING ADD)=iESS ~ ~ LOT B~~I~ # - SUBD. NAME OR CS ~` t f} CI STAT (( ~~ KZI~P/ CODE PHO / ^CI ^VI LAGE WN NEAREST~,R(OAD [ ew Construction Use [ Residential / Number of ttedrooms ~t/f~ [ ]Addition to existing building (]Replacement [ ] Public or commercial describe Code derived daily flow /1/,F[ gpd Recommended design loading rate ti,~ bed, gpd/ft2~trench, gpd/ft2 Absorption area required ~ bed, ft2 _ trench, ft2 Maximum design loading rate ~_bed, gpd/ft2 A~trench, gpd/ft2 Recommended infiltration surface elevation(s) /l//~ ft (as referred to site plan benchmark) Additional design /site considerations Parent material S , ~ ~` Q~-~ Q v- ~~ ~ Flood plain elevation, if applicable ~ ~ ft S =Suitable for system l f CONVENTION ^ S MOUND ~ ^ S IQ S UND PR URE A^T- S DE ~ S M IN~FIL~. H^0 S NG TANK ors stem e U =Unsuitab SOIL DESCRIPTION REPORT Boring # Ground elev. ft. Depth to limiting fa r~ Boring # Ground elev. ft. Depth Dominant Color Mottles T t Structure Consistence Bounda Roots GPD/ft Horizon in. Munsell Qu. Sz. Cont. Color ex ure Gr. Sz. Sh. ry Bed Trer'id't .~ ~ -3~ ~ ~~ ~ . S y ~ ~ ~- S ~ I S ~ k ,~ ~',~ Remarks: (' ~ v V++ 3 p Depth to limiting fact CST Name:-Please Print ~ ~ Phone: Address: ) ~ ~ j S r i ~ 1.14 ~ e~ ~.v; ~ y 76 Signature: .~. ~l Date: CST Number: PROPERTYpr /~''~~-c ~ey~~a,.-SOIL DESCRIPTION REPORT PARCEL I.D. Boring # '4\ ~~ ~ vi ':\ ..._ v ••• Ground elev. ft. Depth to limiting factor ,, ~- ~6~ ~,fs W Boring # :nw::.::::: M1.... ..::>::: ~> ~:~~~`. Ground elev. ft. Depth to limiting fact c~ Boring # ,.., ... ~~~~ ~- Ground elev. ft. Page _ of Depth Dominant Color Mottles Texture Structure Consistence Baxxiar Roots GPD/ft Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. y Bed Trench Remarks: ~- (~ (Z '~ _ ~ ~• r~ ~ w.~ CJ~I,~ l U _ _ ~~ ~ Remarks: ~ `9 t o lZ ~" ~ ~, s b k u~~ ~ at,J -~ ~ ~- ~,.-. a Depth to limiting fac ~~ F ,~° 6'-U Boring # :tii4ti.:`: ...: h: is ~••~~-• :~.v ::........... Ground elev. ft. °' Depth to limiting 7,f~ctor ~~ Remarks: ~lQ'fPl~ ,~'f c~Q r~ ~- 11 [ ~~~ ~ ' ~ 9 l o ~l f2 i , S c'6" ~ ~ S I .2 ~ tr r ~ 1 v - - ~ 19- ~, s ~ ~~~ -~- sy K ~ ~- s ~ l ~ ~ ~,,, ,- -- - - - ~ D-~ I ~y R. ~ s ~ ' ~ ~ ~ ~ ~ A .z v'~- `~ ts~ ~' Remarks: SBD-8330(8.05/92) ('> ~Y%~ ~ 4) ._ .. o~o~sP~ row J ,,,~ J ~+-- ~. 0 ~~ III `6 • ~~. 0 V, b _~ A r j BALDWIN T.29N-R.16 33 I~ ~ ~ W s ~~ `~ ~: N ~.., s erc 6 S E E 47 O F M y r ,5°,n y~" P/NE'i raj Cluam, eta •K ere ~ Ev9v`OndlaE •Dto L w ris •y N" rn Sl es_~ Rom ~ 6 Ro~-P s 6/z.3 D~ Bi~ranf N 7 odor R J~a~.ra • m e z~or..- U ~ s uth r4s Cl¢~kEscherhac N/ar/ene ~ v y i y y eenend¢// iTm~e~s ti Hurt- en L. ~ ~ ~ 7s~ ~ C . //w~z~"'n/ M Bec,ewiifi /zo eis„ ~ .~ i ~ v J • .-mme /44.98 ~ - ~ ~.z z • ~Y v+~ 6 ~¢ sT undo :S7 La,no. ~ /s~s _ ri 0 Q .n. °. s'. 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O h iRS ~ ~ v 4S ~. w ~~e vb~r. ~ ¢ ~ v~0 b v~~`•5°~y "uca,~ Lgod ca/tw ~z L ax - r 72 v q E d~C h• h• W' h a ~ ti yroi /son r7c~ife hof Glenn s .CyC a ~ Q a C.8 ~/e~„ RR °~' j.,,r,< ~ ~ rFly AvE v~~o J ~d He9/¢Lrd fta w M sii r° • <Toe ~T ti k h a,`^ ~~ee' h~S i7 4/ 2e h ~ /30 9chterhof ~ -- • W w ~ ~ sf sr.~°~ • v SMphe ~ ~ h re 49 Nv a BO - --r ~C OKee ~ o rtFMory `A' Y l L.L E L/ yd o e Se/J' . y f Carol . 63 i .•°~e c ~ ~ Dal ri urr .~ = F ea r~ Udin W 4 of e,7 ~ Be~6oN ~ rzo ~ ~ n3e~ sneay E BB roo Gie~n x i3 rb e. gg x • rv sor /i2. r8 Schmrll- ~ o .6rerne w '~ rf ii- 62.67 ~ ¢ 199J rPoc,Ft rc[ r° a 6/s r ~ ` ~' /z6 n /ej/e `sr ~ d ~ ~~ . o ~ 2100 2200 SEE PAGE 2/ a 40 °n •s° q. PAS 2300 O 2400 Est cro;x co~r,ry w,s f m 2500 2600 ' 2700 NELSON'S ~tntutY ~ SUPER VALU South Highway 63 & Cedar Street Baldwin, Wisconsin 54002 HIELKEMA REALTY, INC. ©1s84saperva~ustores,Inc. Phone: 684-3307 990 Hillcrest Street -Baldwin, Wisconsin 54002 YOUR COMPLETE SUPERMARKET Business: (715) 684-2276 Full Line of Groceries, Meat, Produce, Dairy, Each Office Is Independently Owned And Operated. F(OZen ~OOd and In-Store Bakery. ~~,,,,,_; .::,..~.. SOIL AND SITE EVALUATION REPORT ~~ ®~ `~"{ R in accord with ILHR 83.05, Wis. Adm. Code ~~ ~~ ~ d .~,,,-,,,~..,.,......o. Attach complete site plan on paper not less than 8 1!2 x 11 inches in size. Plan must include, but PARCEL ~d~ not limited to vertical and horizontal reterence point (BM), direction and y. of slope, scale or dimensioned, north arrow, and location and distance to nearest road. AEVIEWI APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION I'ROr'ERTYOWNE ~ ^~ PROPERTY LOCATION GOVT. t.OT ~ trt ~'~ ti4,S -~ ~~~ I.OT BLOCK SU80. NAME OR PROPERTY 0 NER: S ~nAI G ADDRESS ~~ ~~ ~~ r _ ~~~ S r e ~e i- CIT'f TAT ZIP CODE PNONE NUMBER OCITY IUAGE ®rOWN G Pace ~ d 3 BY DATE T may' ,N,R / ~M rl _ . l 1 New Construction Use ~ ~ Residential I Number of bedrooms '.~ (~ Addition to existing building Dfi Re (j Public or commercial desaibe i;aie derived dait)i flow _ ~~ gpd Recommended design loading rate N ~ bed, gpdAt2 ~~_tench, 9Pdm2 Absorption area required ~t/A bed, itZ ~ ~ trench, n2 Mald:num design loading rate ~~_bed, gpdm2 A bench, gpdm2 Reoommended infiltration surtaceelevation(s) /i0A K (as reterted >D site plan ber>chmark) Additional design I Site nsiderati ~~ s ~a ~ ~ S /s _ Parent material ~ (~ o ~ a r PS plain elevation, i(appficable /1/ ~ R ~~ $• $lllt3ble tOr SySlem D~~~NU ENO IN'GADINID PRESSURE AT~GRADE SYSTEM IN FILL HOLDING TANK u=UnsuitablerorS Sleet ^S ®U ^S ~U ^S ®U ^S L~U ^S ®U ~S Uu nnn neeno~eTIAU Rl`DART Loring tl ~ . err,. •: t« ~rourld g R 5 tt. Deptr~ to u~ti~ l~,i ttl vv M SVucture 8 ~ ots R GPD/tt Depth Horizon in es o Dominant Color Munsell Ou. Sz. Cart xture Gr. Sz. Sh. Consistence otlx ry o Bed rert<i`t „ ! 3 ~ S% m i ~ ~t_ ~ o~S O~lo 3 -, rr ~,sy~ 3~. - . y ,~ 6 s ~ M sb/~ in - ~ ~~ ~~ ~`- ~, ~ ~- ~ . 3oring tJ ~. Grotuxl elw. It. I)eplh ro Frruting iac4~ ~~ r+emancs: l v -i~`' lv Yi2 3 a- :,~ s~ l arns,bl< ~ s 3~' .s ~-~ a ~`=~" ~ ~ y~ ~ ~ ~-~ sil a a s a~' tip ~.a 10 ~ c Fi '~' '~' C T^. ,. cA . -° ;~ Remarks: T Name:-Please Pr~ ~~ A S ~. ~a ~ SgnaNre:~ ~~ 4 . _ .. ,. _ -58- Phone: ` ~ / ~/ 7i J ,' ,Sz/7S / /U - d fi -~ PROrERTYOWNER~~- SOIL DESCRIPTION REPORT PAC EL I.D.1 Boring # ~ , <:~>:~:Y::r Ground elev. 9~ n. Deplh to Grating fa4tori Boring # ~. Ground elev. fti Page, of Horizon Depth in. Dominant Color Munsell Moffies tDu. Sz. Cont. Cola Texture Structure Gr. Sz. Sh. ~ gam Roots GPDIft Bed rortth 01 ~- ~ " /p R 3 a -~ S'`l ~ r7 m ~~~ ~ s a~ NP 4 a 3 , fs`' ~ ~ ~/ ~. sy2-1"/~ ~n3 ~ay,2 ~ ~ s~ I a ~ I ~ 1~' p nJ~P Remarks: ~m uniting factor Boring # r-emaras: r---~- Ground elev. ft Depth to uniting facbr Boring # Ground elev. fL Depth to uniting tacta Remarks: e -59- r i l i r Tv N^'/~ T~7 iiT I i~ i~ i ~r r r~ F ~' 1 ~ I i ~ ~ f i ~~ T I i i _. ' ' ~ ~ % ' ~ I I ~ I I ~ ~ i ~ i i I ~ j ~ ~ i i ~ i I t j ~ "iy I~~I ~QV i Y , 1 + Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safet)~'~Y~I ~trildir~ Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Lee, Bett Unknown CST BM Elev: ~ ~ v ` Insp. BM Elev: /off ~ BM Description: ~ ~~/ ,V~a~.p ~ ~ 8 TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic /l~~ Dosing nn (~6~Yh'~U~ G/ Aeration Holding ~ ~" TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic /~~ ~ ~ ! > lO f > O f Dosing ~ r ~~l Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Z Model Number ~~ Q ~ •~ 3l1 TDH Li ~• Z3 Friction Loss 2 • ~{ a System Head 2S TDH Ft 13 •~ Forcemain Len ~ Dia. ~~ Dist. to Well ~~ ~ SOIL ABSORPTION SYSTEM `L ~ SGtn,.c( -{-i 1 I ELEVATION DATA County: $t. CrOIX Sanitary Permit No: 399577 0 State Plan ID No: Parcel Tax No: 002-1023-20-100 ~jY1 ~ % ^ , b qa . ~ t coo. Alt. M rjt,drZ )t9f` • f dg. Sewer SUHt Inlet p . ~a- SUHt Outle ' / ~" Dt Inlet ~ ~_ Dt Bottom Header/M n. (' 01' 1 2 • ~ ~~ • ~~ Dist. Pipe ~i - 2 .~ 9!0 •9 Bot. S stem "'t~ ~ • ~' ~- 3 . ~ 3.1 pG • 3 / Final Gra a ~~ ~, 98.~i / St Cove ~ ~ `s /oi.. 3. l ~ . 20 ~~~. S.r `~`f- 3 BED/TRENCH DIMENSIONS Width / Length ~ No. Of Trerlche;, ~ / PIT D ONS No. Of Pits Inside Dia. Liquid Depth ~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STR M LEACHING Manufacturer. INFORMATION Type Of ystem: a'~ 510 ~ > ~~a C MB OR IT Model Number. DISTRIBUT ION SYSTEM ~e_ O t In _ / ~e n __ !'fe-fit' ~ n A , __ 1. ~.. ~iAL Or ~ 1,/11111 // . tea/ Header/Manifold M Distribution ~ ~ h , x Hole Siz x Hole Spacing ~ Ven ntake ^~ ) /J Pipe(s) ,~/ ~'7 3 / ~ I ' ~ 3~/ ~/ ~~ Length Dia u Dia Length~ Spacing SOIL COVER Y PraesurP Svctnme Anly rY Mnund Or At-Grade Systems Only Depth Over ~ Depth Over xx Depth of xx Seeded/Sodded xx Mulched BedlTrench Center s Bed/Trench Edges Topsoil ~ Yes [~ No ~ Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ / ~ S / Q ~' Inspection #2: ~ / ~ / ~ G Location: 2516 County Highway E Baldwin, WI 54002 (SW 1/4 SW 1/4 11 T29N R16VI~INA~dt 1 " " Parcel No: 11.2 .19 6.•T62A10 1.) Alt BM Description = `ST ~ Y~~ /~~ ~~ ~~~~ 2.) Bldg sewer length = ~ Q ~ s~,b~ ~ ~'~~ Cr~,r,.2G~IU~^- - ~~~NLtq~ UJ ~y""`~`." - amount of cover = > ~~ 3.) Contour = ~', (l~ C,/ .3 ~ - Plan revision Required? !~] Yes No ~ ~ ~I ~ 3 D u~~ln.- Use other side for additional information. I__ SBD-6710 (R.3l97) Date Insepctor's ignature ~~ Cert. No. .--~-- Saftry ued ~dui,dir,~s ;~C;sSn 7162 •z-L= ~'~-'~ 2Qi vi . W~shlaritaci Ave• Y x s ~` Wlt. Ald+ Ctid~, +~ ~ Y04 r#ttpv' ~'+ Cbio~c it ~~or- ~'~~~~Wy .,~-~, .. /l. 2 9. lG . l~ z d~ -/a ~ _ .,~~ ~~ . ppz-lUZ3~ZU 1 , 1 ~ - ~T Cfi01X s' S!~/ ~$' l ~~ O ~ r,~f./ ~`/~ Gtr i NWOfl~t 1 t ~ iNGOFFlGE +~r, ,St1a1 C8M I~ritmbu i ~,r/c~lrl~` dJ ~~ `~Y4D'2 tt tY. "1"yw ~ii Ot 3 ° 3'~IIMMt ex! ~1dec~4is~ 0 n~~ n ~ ~ °.~...-~-- i Q P~sbi ~i>r .~ r .~ ' ~~ ~ s~uo cwt •---~ yr~?, ~ id applla~Wt? t ,~~ i ~ ~ au fax aoQ A ~+ i'az ~! ~ to t ~. G1 t1c ~' ' P~~Y 1'w~ _--'i ~ ta~sotl w~l ! (~ ~h ~ S ~ 14 Q ilia{ F~lt~t 14Q Co~usaki W~sisnd µ Q ~1Y1 ~ IsMti~ !4 ~ Ds~+Lis» 3 31 G' 'mod tai 4i !lolf~'T~k It !~ ita~tM 8ts~ ~ ~ ~ ~v ,~ A Z~aD s ~ G v4 f iAti Grwit i ~~ ; ~3tvacoa ,I ~ttw+,ray-irsa,~s~a j d-~ ~ - ~ ~~~d~ ~9~~~ i j~llsmblt ~tpit~r COM'n` ~~ QS1ii d`uod c!'hela + ' ~ ldo ~ !~; es e ~ ...... ~~D l W; e, e v , _,....-.....--.-~i t !~e ~~ ~ .usa tr ~ ` as ~ 9 d f~~3 =.~~~ - 3fa l ,' ~ a ~Z .~L~iG~ mac' ~•*,~~'_ r ~ ~ ~ ~~ Jr-L jdl~ ~aT~ s~ a~ opt ~~~ ~' ~tWtLLt~ 1,~r0 ~~D~i 4 ~ ! / ~ // / ~ i ~ ~ '.~~rrwr. lAIl1~ Ir!! Al/A4t'. Scale 1"= gyp' ~ ;~ r • ~0 1J~T CV~"1PA~ff' OtZ o1gTV2a Tli-Ls HAS .~35 ~-~---- ~ ! ~Si I~S• ~ i q i ~~ B.1 -- woo~~ q 5' ~ F 1 Page 3 of ~ 935 Neeccir~s~r ~o1r ~!-J L"i 801~Ow- 01- °~- 9S 3B! o ~~- $+'I~F-1 9~y~2 o ~~ ~N ~S'OE 4'~P~C r 3 3~~-''9 G c~-R ~Mt I > ~So' NOT Tfl SCfit~) O . I M ~ 1'p Z so_r~ sT'. _ _ ~ - ~M1~'1 -:@Z.10O.~-~ --OdJ NPtlL:: U~ _°1 `' gOJC ~Z- ~~_~ _ __- _ . -- __ - -13r~~2. -~Z:11)U-0 .. -- . NOTES : ~~-~ .~-S ? So'-~o~ -w! ova- ~-~.~ ~ Zs' ~-rwwl "1~1h.S , - -~-- 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be 1oo0~6sy gallon capacity manufactured by W ~ ~~12 C(~v e\Z~ -~ / ~ _ 1~' 0 0 Z'Ptt3 ~'t Fl ~ T' ~''R 4. $ench marks •. S~ ., fi~t3oV~ , 5. Divert surface water around system to prevent ponding at the uphill side. ,. . . j ~ r ~;° ~ ~ ~scons-n .Department of Commerce October 08, 2001 CUST ID No.691727 ARTHUR L WEGERER WEGERER SOIL TESTING & DESIGN SERVICE PO BOX 74 RIVER FALLS WI 54022 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/08%Z003 SITE: BETTY LEE RESIDENCE CTH E TOWN OF BALDWIN ST CROIX COUNTY SWI/4, SWl/4, Sl 1, T29N, R16W FOR: Safety and Buildings ,~'.•'~ 4003 N KINNEY COULEE RD ' LACROSSE WI 54601-1831 ;r ; TDD #: (808) 264-8777 ,. www.commercestate.wi.us/sb p ~~~~~ www.wisconsin.gov \~~' ~ ~~01 ~ Scott McCallum, Governor 't ~ ~, Philip Edw. Albert, Acting Secretary s ~.: `~' ,fit ai' r ~~. c~. ~, ZONING OFFICE ST CROIX COUNTY 1101 CARMICHAEL HUDSON WI 54016 ~', R \~ ~ 1~ c' 6~ Identification Nuc~i ber's-~"`" Transaction ID No. 678062 Site ID No. 636811 Please refer to both identification numbers, above. in all correspondence with the aQencv. DESCRIPTION: THREE BEDROOM MOUND SYSTEM OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 814376 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. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.O1/O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10706-P (N.O1/O1). [n the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the Mound manual, and section VI of the pressure distribution component manual are complied with. A copy of this letter including instructions and information relating to proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. • Access to the filter for cleaning must be provided per Comm 8~t product approval conditions. Maintenance intbimation must be given to the owner of the tank explaining that periodic cleaning of the filter is required • Limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • ARTHUR L WEGERER Page 2 1018101 • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintertarice of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). In addition, the owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall bd:considered a human health hazard. • Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. • 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 for inspection 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. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address nn this letterhead. Sincer/ely, / ~ Charles L Bratz POWTS Plan reviewer II- Integrated Services (608) 789-7893, Mon.-Fri. 7:45 AM to 4:30 PM cbratz@commerce.state.wi. us cc: BETTY LEE , C/0 LEE CONSTRUCTION -Dp 1.J~T CO~p A-eT OR v1 sTu2.a lZ+i s RtZ~ .~35 •'~S, fggS i z; ;--= = ~_ ~8. oar ~100'~'~7 I ~ qS~ ~>_ znpu@ F.+~+. FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 WiSMART code: 7633 q~s .s ~I-JF t-t ~ , co~~~R- ~ . °t 4.3 e.- ~. qb.3, ~~r- 9 S 3°! o ~-~_ ~-~V~-1 ~'1~Z ~S~pE 4~cp~c 3 B~~-"~ j G +~tZ ~Mt > ~So' ~NpT To SCfi-L~) D • l M ~ TO z s o 7-I} sT,, o ~? STN ~ ~~ _ ~~~ ~ E _ ~M'~-l - eZ>_ao.Q_~__-oe~ 1~~1=: tr.~ -q `~ aoxt~z-~~__ _:--~ -- _ _ __ -- .~ H Z ~ _ __..___ w ____ .. ._ . NOTES: ~v~LCIS_~_So,_FR-oIy widvNta 1~1~-~D 7 ZS~.~Ra~h•~~::~Y~Jh.S -_-_---. 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be tioo0~6st, gallon capacity manufactured by W ~ ~.3L't12 C:.C~v e~Z~ -~ / (~_ 1~' 0 0 Z P~3 ~. Fl ~ r~~t 4. $ench marks •. SN .~, ~3oV~ , ~. Divert surface water around system to prevent ponding at the uphill side. _~ ~ boll Ey/i,~W-TICN REST ~ o~~ I~dYM~~ ~~ M~ 1~~~ ~ ~Y~1M r AMr ~. HAM ~M ,AHZ r ~~~ ~yw, - ~wM MI rq. tMM/ ~Illlw~~ •~~ M M - - r,,,,,,~,,,a„r, ~ r t i arMn+.~w~M t y i f+•H . ~. ~. ~ r... ......~~.~Mlr~a A.nL. ~ ~,I sv. Iy.~e ~ ~ ~ Nrr ~~ ~, sgr•~ p d. ~n ~~ ~.ea' t iC t00z t0 ' ~ :o z•d iBIE-i99-SLL-t •~r: ~t: OAII S?101IHIMISIQ h10Sa3tIWd ~~~-- «3 . ~+~ Nd9i ~ 6 ~ OOZ O,E •1fIC .. Wisr,~nsi-) Deparhnent of Commerce SOIL EVALUATION REPORT Page ~ of ~ Division of Sa1~ty and Buildings " in accordance with Gomm s5, vvrs. p-am. was / County S-f • ~' iTj ~ ` Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must indude, but not limited to: vertical and horizontal reference pant (BM), direction and Parcel I,D. north arrow, and location and distance to nearest road. scale or dimensions ercent slope , , p Please print all i-rformattion. Reviewed by ~~ Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location E (or~ N R/ J O B ~/ r~ C Z t Govt Lot s w (~ 1/4 S w 1 /4 S ~/ T Zq Property Owner's Mailing Address Lot # Block # Subd. Nam or CSM# q8~ Zoo ~`' S //P~c/`•" City State ~ Code Phone Number ^ City ^ Yllage ®Town Barest Road ~a~~Qw i r~ WI S`r'~Z (7rS) Co y-,~93 ~~~Wi/` _ ~'' ® New Construdion Use: ® Residential I Number of bedrooms design flow rate y.S~ /~ 40 GPD .. Replacement ^ Public or commercial - Desar~e: -- Parent material ~' ~ ( Q _ pFloes'lain elevattrfq if applicable ti /~ #• General comments S y Sfe -'vt ~-1 a v. Q!o • o o ~~ I ~~~L~~J~Q ~ i and recommendat ons: (lo n i~-o r GI e v< 4 y Q ~ Q 7~ 1'16-! f 1 tf ~nn~ !~~/ , ..,, sr crux curveNCi OFFICE ' .'~ Boring - Bon ~ # ©Pit Ground surface elev. 9y ~ d ~ j ~ -. Depth,taNE~i factor l ~ in. ~_.__;_~ ~ Sal ication Rabe Horizon Depth Dominant Color Redox Description Te re Consistence Boundary Roots GPD/it? in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 •Eff#2 ~ O-~ l0 r3/I - 5 ; ( zn-labk Yr'~ ~r~ C S .~.. / Z ~ Q-/S /oYr - S.' ( Z-~.u b v-1~' r C S _ . ~ ~ $ ~ 3 • ~s-3o /0 3 to c Z , s' r /~ S L Z Y-•. !o n1 ~ -- _ . S q~ Boring # ^ Boring f y d ®Pit Ground surface elev. 9y `/O ft Depth to limiting factor ~_ in. soft ~~ Rate Horizon De th Dominant Colo Redox Description Texture Structure Consistence Boundary Roots GP Dift? p in. Munself Qu. Sz. Cont Cobr Gr. Sz. Sh. 'Etf#1 *Eff#2 I • G - q IO r 3/ ( - <S ~' ~ma bfc w(.~r~ G S v , S ~ 'Effluent #1 = 80D > 30 < 220 mglt. and TSS >30 < 1 50 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mglL CST Name (Please Print) lure _.- CST Number Address Date Evaluation Conduded Telephone Number era ~ s~-,~ .~+ ~~~.~- ~ ~ ,~ ~~~~ ~ - zy-G/ (-1~~)Z~ ~-y~g - 1' property Owner ~ ~' ~ c' $ e _ Parcel lD # ~ Z ~ ~ # U Bonng '~ ~ Pit Ground surface elev. q~ GQ R Deptl~ t~ limiting factor ~ in. ~7 ~ Rate Horizon Depth Dominant Colo Redox Oescxiption Texture Struchxe Come Boundary Roots GPD/t~ in. Munsell L1u. Sz. Coat Cobr Gr. Sz Sh. 'Eif#'1 `Eff#2 ~ Yl'~~r' CS _ , S-'' ~ ^ Boring # U ~ ^ Pit Ground surface elev. R Depth to I~nitutg factor in. Sod. icafion Rate D h t Col r i D Redox Description Texture Structure Consislenoe Boundary Roots GP D/f~ Horizon ept in. o om nan Munsell (lu. Sz. Cont. Color Gr. Sz. Sh. 'Eft#1 'Eff#2 ^ Pit Ground surface elev. ft Depth to 1~nifmg iaclor in. ~~ # ^ ~~ Soil Rate D th ant Cobr i D Redox Description Texture Structure Cansis~rroe Boundary Roots GP D/f~ Horizon ep in. om n Muns~l Du. Sz Cont. Color Gr. 8L Sh. 'Eff#1 'Eif#2 ` Effluent #1 =BODE > 30 _< 220 mg/L aril TSS >30 < 150 mglL ' f-fltuent #2 = GODS _< 30 mg/L and TSS _< 30 mg/l. The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. san-eaw crt-o~roo) ~~ .~ NAME ~ ~ ~ Z e LOT# LEGAL DESCRIPTION SW SCALE: I "= yd BM I ELEVATION ~ a v ' v BM 1 DESCRIPTION ~1ar l i n ~`~ 13oxe Icy a ~' ~l-fcc BM 2 ELEVATION l":J ~ BM 2 DESCRIPTION ha ~ ( ~ ~ - 2 ' ` 3_ o~d?~~c e- SYSTEM ELEVATION q C° ~ /tea ALTERNATE ELEVATION /Ul ~' CONTOUR ELEVATION ~I K •O C~ a~~ N so PAGE~OF,~_ I T 2 ~N.R l ~E or VV Sec-. I( I -l- - i ~G-~vwl I o /- S ha :.x.. $_ s, ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT •-AND OWNERSHIP CERTIFICATION FORM Owner/Buyer ~ ~ ~ Mailing Address ~~~ ~~~ a /d w'%/ ` Property Address :~.~i~ c~ ePd (Verification required from Planning Department for new City/State Pazcel Identification Number LEGAL DESCRIPTION Property Location ~C~._ ~ `/s,.~CJ '/,, Sec. l ~ . T ~ ~N'R~W Town of ~•~/~lw ~'~ Lot # ~ Subdivision Certified Survey Map # Volume _, ,Page # _ Warranty Deed # ~ S `~/ ~ ~ ~ ,Volume / ~~~ ,Page # -5-~ y Spec house ^ yes ^ no Lot tines identifiable ~ yes ^ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wartou gut~into~thet~ in out the se tic tank Query three years or sooner, if needed by a licensed pumper. Wltat y p ~ consists of pump g P can affect the function of the septic tank as a treatment stage in the waste disposal systetu. 'ihe property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owners bem masttxplumbcr, journeyman plumber, restricted plumber or a licensed pumper vonfytn8 that (1) the on site wastewaterdispo yst is in proper operating condition and/or (2) a [ter inspection and pumping (if necessary). the septic tank is less than 1/3 full of sludgy 1/w+e, the undersigned have read the above requirements and agree to maintain the private sewage dispoc f Wts on~sin Cetsttf~'ica~o set forth, Lenin, as set by the Depariment of Conunerce and We Department of Natural Resources, Oflico ~~ 30 stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning days of the three year expiration date. ~ ` ~ ~ 2~ l~ ~za ~O DATE SIGNATURE OF PLICANT OWNER CI•;RTIFICATION I (we) certify that all statements on this form are true to the best o€ my (our) Imowledge. 1(we) am (ar°) tI-e ownet{s) the pr rty d ribed above, by virtue of a warranty deed recorded in Register of Deeds Office. /~ %~ ~ P12~. ld io?~~oi ~ APPLICANT DATE SIGNA De argncnt. **ss*+~ s«*s*s ~y information that is nris-represented may result in the sanitary pcruiit being revoked by the Zoning p ** Include with t4is application: a stamped warranty decd froth the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed ~o~ ~ ~ ~ / i ` /~' o l k' ~- r 1 lc~r ~/' .,~ d ~ ~ /~ p ~ STATE BAR OF WISCONSIN FORM 2.1999 654974 WARRANTY DEED !<A i~HLEEN H. WALSH Document Number kEGIS7Ek OF DEEDS iii. CkUIX CU.~ WI This Deed, made between John Vrieze _RECEIVED FOR RECDRD ~~ "-~ - OA-i?8-2401 9:30 AM -- -_ YARRAHTY DEED Grantor, and Betty Mae Lee, a single person EXEMPT q -- CEki CDPY FEE: " CODY FEE: _~__ _ TRANSFER FEE: 116.70 SECORDiNG FEE: 10.00 PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described rea! estate in St. Croix _ County, State of Wisconsin (if more space is needed, please attach addendum): Part of the Southwest Quarter of the Southwest Quarter (S W 1/4 of S W Rewrding Area 1/4), of Section Eleven (11), Township Twenty-Nine (29) North, Rartge Name and Return Address Sixteen (16) West, Town of Baldwin, St. Croix County, Wisconsin, more Thomas A. McCormack particularly described as One of Certified Survey Maps filed June 8, 102010th Ave. 2001, in Volume 15 of Certified Survey Maps, page 4109, as Document No. iP0 Box 2120 647795, Office of the Register of Deeds for St. Croix County, Wisconsin. Baldwin, WI 54002 002-1023-20 Parcel Identification Number (PIN) This is not homestead property. t6fd (is not) Exceptions to warranties: alt easements and restrictions ofrecord. Dated this ~~ day of ~/ ~ , 2001 , ~`~ . ' • Jo rieze r AUTHENTICATION ACKNOWLEDGMENT Signature(s) ~_- STATE OF WISCONSIN _ ) - ) ss. SL Cra~ht County ) authenticated this day of ~~~ ~, ~Perso ally came before me this .~ day of (~"`fjy/~ _, 2001 the above named John Vrieze -- TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person o tecuted the foregoing i trumettt a d acknowled the sa authorized by q 706.06, Wis. Stats.) ~-~,~ THIS INSTRUMENT WAS DRAFTED BY • _ ~~A j >t . sNLC (O~yytlL , Thomas A. McCormack Notary Public, Statc of Wisconsin Ba dwin, WI 54002 _ My Commission is permanent. 1 not, state exprratro~- (Signatures may be authenticated or acknowledged. Both are not necessary.) _. __ ~ .) • Names of persons signing in any capacity must be typed or printed below their signature. ~'Yarma~ion Froleeaioneb eomwar. Pura a~ tac, VVI STATE BAR OF W ISCONSIN eooBSS•2a'tt WARRANTY DEED FORM No 2 1999 l `~ ~, ~ AREA _ Including R.O.W. 174,249 sq. ft. 4.000 acres Pedestal Excluding R.O.W. 154,859 sq. ft. lated 3.555 acres rt UNPLATTED LANDS S89'04'38"E 484.75' ~ D O N LOT 1 W N °; `° ~° ~ ono -? ~ m CERTIFIED SURVEY MAP Located in the SW 1 /4 of the SW 1 /4 of Section 11, Township 29 North, Range 16 West, Town of Baldwin, St. Croix County, Wisconsin ST. CROiX COUNTY JUN 0 8 2CC1 - - c If Q~ZceccrCe~ w'itii;n 30 days of apFr~•al date apRraval shall be r nu41 anr! vO~d Dj The bearings are referenced to the m South line of the Southwest Quarter ~ of Section 11, assumed to bear S89'04'38"E r IZ 200 100 0 200 ~° ~,, - -~ - ~,,, SCALE: 1 INCH = 200 FEET rn rn 0 0 _ p - _ - 484.75' _ - p Norther R.O.W. of Co. Rd. E _ --: :40.06' ~T `40,06'-~ ~- S89'04'38"E 1580.96' ° -- N89'04'38"W 484.75' • Found South Quarter •B•------------- ~-_ -- °~.- ~ Corner of Section 11 E South line of the SW Quarter of Sec. 11 ~~ 1" Steel Berntsen ~~ Survey Nail --- S89'04'38"E 2637.71' --- ___--~ (Record S87'11'26"E 2637.76') COUNTY TRUNK HIGHWAY E UNPLATTED LANDS ~odwoy feet. ~ south MELCHERT WALKKY tl the landscape architecture 749 HiBhaay 12 E are Civil en ineerin Hudsoa, !-I 64018 B B Phoa~ 716 388-7738 lend surveying Fax (71 ) ~ee-7ea9 ~,ctaaFrr wni,taa s ~. o+ 0 rn a r- 0