HomeMy WebLinkAbout002-1056-20-040Department of Commerce PRIVATE SEWAGE SYSTEM
3uilding Division
INSPE~TIOIV`I'tEPORT
uENERAL INFORMATION (ATTACH TO PERMIT)
Personal information you provide may be used for secondary purposes fPrivacv Law, s.15.04 (1)(m)l.
Permit Holder's Name: City Village X Township
Strobush, Gerald Baldwin Townshi
CST BM Elev: Insp. BM Elev: BM Description:
_ ~~ /~ (3 /-~ ~ CST
•~ANK INFORMATION
' ELEVATION DATA
TYPE MANUFACTURER CAPACITY
Septic
~~
Dosing d
Aeration
Holding
TANK SETBACK INFORMATION
TANK TO P~~ WELL BLDG. Vent to Air Intake ROAD
Septic ~
~~
~/
Dosing , ~,
Aeration
Holding
PUMP/SIPHON INFORMATION Ua~G.c~.~t ~l
A9anufacturer Demand
GPM
Model Number ~~ C
J ~ ~~-
~'
TDH Lift ~, Frictio+
o s System Head TDH
~
Forcemain Lepgt~ t Dia. ~~ Dist. to Wel
~
~~ ~ /
SOIL ABSORPTION SYSTEM
County: St. CrOiX
Sanitary Permit No:
453194 0
State Plan ID No:
Parc I Tax Noa ' ~
~~Z , b
Section/Town/ ange/Map No:
23.29.16.
l.!'T_ Z
STATION BS HI FS E ; ~
Benchmark
Alt. BM
Bldg. Sewer
~ •t~
~. 7~
SUHt Inlet ~ ~ ,2 ~~
J
SUHt Outlet _.----~
Dt Inlet _~
Dt Bottom
at3.~
~1.7`i
Header/Ma_ n. ~ ., ~ r a 2•
Dist. Pipe , ~ ,~ •~
~o2-s
Bot. System
''
1 H `,~ D ~ ~
Fin~J -.rade ~ s~ ~ ~~ 3~~
St Cover
~•Z'
~~.
~ r z ~~ i~
BED/TRENCH
DIMENSIONS Width Length
~ ~ No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
SETBACK
INFORMATdON SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING
CHAMBER OR Manufacturer:
T
f S
t t
ype
ys
em: ~-~ ~
~a UNIT Model Number:
DISTRIBUTION SYSTEM ~j~~y,~ ,pn,,,~ s
Header/Manifdld Distribution ~3 x Hole Size x Hole Spacing Vent to Air Inta
~ QQ ~ ~ ~
Length ~ Dia 2 ~t Length 0 Q ~ ~ Dia ~+5~ A Spacing ~ ~ ~' t
SOIL COVER x Pressure Systems Only xx Mnund Or At-Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched
Bed/Trench Center Bed/Trench Edges Topsoil ', Yes No Yes No
COMMENTS: (Include code discre encies, persons present, etc.)
~~q~~~
Lacatio~ 2518 80th Ave ~~ndC-n ~(SW 1/4 SW 1/4 23 T29N R16W) NA Lot 6
1.) Alt BM Description = ~7
2.) Bldg sewer length = ~ ~~
- amount of cover = / ~ ~
3.) Contour =~Qp~ O
- - --• -
Plan revision Required? Yes i ' o ~f~'
Use other side for additional information. _~0 ~~ " -t
\ D-6710 (R.3/97) Date
Inspection #1: ~y / ~Z/ ~4 Inspection #2: ~ 0 / Z?7 U
~V Parcel No:A2~.29.1_6. ~~
Cti.. -seQ. P /"
1 ~ Qi~LaK~Y
~1 C l~ 1
~~~ lit ~ ~"
Insepctor's Sign tune ~~~~ Cert. No
Jessie N ~~/~I V
ye
Subject: Stang, Strobush, 453194 (final)
Location: 2518 80th Ave., Baldwin
Start: Fri 10/22/2004 1:00 PM
End: Fri 10/22/2004 2:00 PM
Recurrence: (none)
Ryan did plow in arn. -leaving paperwork at the site
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Safety and Buildings Division County L
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5
` 201 W. Washir.,,ton Aye.,,P. 7162 L .
k
iseonsin Madison, Wl 5370 - 7162 Sanitary Permit Number (to be filled in by Co.)
(608) 266-3 D ~ q~
/
De artment of Commerce J
Sanitary Permit Application ~ Sp ,~ State Plan 1.D. Number
In accord with Comm 83.21, Wis. Adm. Code, personal information you provit~ 1 ~ - ~~~ - ~'
maybe used for secondary purposes Privacy Law, s15.04(Ixm) _ ~~ oject Address (if different than mailing ad ess)
1. Application Information -Please Print All Info atio , :__~~ ~~./~ ~--6<~
//~. -
Property Owner's Name (o ~ /~/ S/7O9 Block #
Parcel OZ
l~Gr~ ~ ~'~ tc,.S ~iAY 1f 6 2004 ~~
..
d,- i OD2-/oSIQ ~-ctX~
Property Owner's Mailing Address
i,vl:Vl~. A,UiJI~~ ,
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.. tion
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CONING OFFICE
~(~ Sl.J y, SeJ y,
Section .~
City, State Zip C Phone N
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7~.~ (07CJ -.2~~0~ ~ (cincleone)
T ~} N; R ~(, ~QLW
Il. T of Building (check all that apply) 2) S
~ ~`~ 9~ CSM Number
. vW ny
1 or 2 Family Dwelling -Number of Bedrooms , 7Z
' ~ ~~~~3
w
^ PubadCornntercial-Describe se 1 -- r t
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of Permit: (Check only one box on line A. Complete line B if applicable)
`~' ~~
~~
I~New System ^ Replacement System ^ TreatmenUHolding Tank Replacement Only ^ Other Modification to Existing System
B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New l,lst Previous Permit Number and Date lssued
Before Expiration Plumber Owner
IV. T of POW'I'S S stem: Check all that a 1
^ Non -Pressurized ln-Ground ^ Mound >_ 24 in. of suitable soil Mound < 24 in. of suitable soi ^ At-Grade ^ Single Pass Sand Filter ^
Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^
Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain)
V. Dis rsal/Treatment Area Information:
Design Flow (gpd) Design Soil Applies qn Rat( pd
1 ~ Dispersal Area Required (s~ Dispersal Area Proposed (sf)
0 System Elevation
'
LSD , N. O.SO
~ sf' S~S~ SSG. ~1 5
5.,~ /0%8
3
Vl. Tank n o Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units w / ~ ~ `/~ Concrete Constructed Glass
Ncw Existing ( /',
Tanks Tanks 'Y~
Scp[ic or Holding Tank (%~ ,~. / .mn
(/~V ~i e~~ /i _ _C ~ ~®
lGA't ~C.~ ~~
Aerobic Treatment Unit n ~ ~
1~I1 ~i /~~1 ~Y/
Doping Chamber
gGiJ
S
5~ ~ c ~' ~~
l
VII. Responsibility Statement- I, the under igned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) PI 's Si t MP/ir41'it6 Number Business Phone Number
a~e z3 y?S pis ~ G9~'- si~,c
Plumber's Address (Street ,State, od
~3 u~J~ l .e ~Ji, s~oyp
VIII. Coup / e artment Use Onl
Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date lssued su' Agent Signature o Stamps)
^ Owner Given Reason for Denial Surcharge Fee)
~~ ~-
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1X. Conditions Approv
SYSTEM OWNER:
1 Septic tank, effluent filter and
dispersal cell must ali be serviced / maintilrined
er management plan provided by plumber.
s
a
p
2. All setback requirements must be maintained
as per applicable code/ordinances.
Attach complete plans (to the County only) for the system oo paper not less than 81/2 x 11 inches io size
SBD-6398 (R. 01/03)
~~)
;<-~ I~'(°k,-,mod u~,Z~.Y7x //1.95'
,'' x 90' d: s~OCrsa/ c.~//. Two (Z) _
Ecra.LS Qf /y '~r 88.SS'w/ %p'°
c i~'~: e.es space d a-f 1.53:
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I SCI!/G • ~ - f/O
Proposed w; ~Ser Cu~+c.rc,~e
~,'/ fix.-a.~ S.T; owt lc,~
_ ~'~Sc.l.. ~o~ t/.C.
bu-i Id; -,~ Sewcr,
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JOE STANG : -
Page 2 4/20/04
• Comm 83.22(7) 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
Owner Responsibilities:
• Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and
maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s.
Comm 83.54(1).
• 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 be considered a human health hazard.
• Comm 83.55 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.
All permits required by the state or the local municipality shall be obtained prior to commencement of
construction/instal lation/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
on this letterhead.
The above left addressee shall provide a copy of this letter to the owner and any others who are responsible
for the installation, operation or maintenance of the POWTS.
Sincerely,
Charles L Bratz
POWTS Reviewer II ,Integrated Services
(608)789-7893 , 7:45 am - 4:30 pm Monday -Friday
c bratz@commerce. state.wi. us
Fee Required $ 175.00
Fee Received $ 175.00
Balance Due $ 0.00
WiSMART code: 7633
cc: James K Thompson , A.C.E. Soil and Site Evaluations
Leroy G Jansky, Wastewater Specialist, (715) 726-2544
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MOUND AND PRESSURE DISTRIBUTION COMPONENT DE ~_ 'Q,j ~~/~
9~' J' .2 'V
INDEX AND TITLE PAGE ~~` ~Q~Q
°~s
Project Name: REVISION -Gerald Strobush 3 bedroom residential mound O,~
Owner's Name: Gerald Strobush
Owner's Address: 2545 80th Ave.
Woodville, MN 54028
Pcl. Add.: Pending
Legal Description: SW1/4SW1/4, Sec. 23, T.29N., R.16W.
Township: Baldwin
County: St. Croix
Subdivision Name: Pending CSM Vol. XX)CX, Pg. YYYY
Lot Number: 1
Block Number: NA
Parcel I.D. Number: Pending from 002-1056-20-000
Plan Transaction No.: 980274
Page 1 Index and title
Page 2 Data entry
Page 3 Mound drawings
Page 4 Lateral and dose tank ~~~~fY
Page 5 System maintenance specifications ~ ~
~' +
Page 6 Management and contingency plan ,~
Page 7 Pump curve and specifications ,~ COM14fE~rE
Page 8 Site Plan `
~OtNG
~
Page 9 Soil Evaluation Report S~
~; ~~c
' O~D~N
Designer: Joe Stang License Number:
Date: 04/07/04 Phone Number:
Signature: ~t _~
~'
223475
715-684-5166
Designed Pursuant to the
Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and
SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81)
Version 3.0 (03/01/01) Page 1 of 9
` ~ Mound System ,lVlar~agement Plan
' ~ pursuant to Comm 83.54, Wis. Adm. Code
General
This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component
manuals [SBD-10691-P (N.01101) and SSWMP Publication 9.6 (01 /81)J and local or state rules pertaining to system maintenance and
maintenance reporting.
No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death.
Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as
POWTS components.
Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings
used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject
to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to
prevent accidental or unauthorized entry into a tank or component.
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank
shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at
least once ev e b ins
outlet fitter hall be cleaned as necessary to ensure proper operation. The fitter cartridge should not be removed unless provisions are
made to retain so ids in the tank that may slough off the fitter when removed from its enclosure. If the filter is equipped with an alarm, the filter
shall be serviced if the alarm is activated continuously. Intermittent fitter alarms may indicate surge flows or an impending continuous alarm.
The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If
the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next
service needs to be.pertormed to maintain less than maximum scum and sludge accumulation in the tank.
The addition of biological or chemical addttives to enhance septic tank performance is generally not required. However, if such products are
used they shall be approved for septic tank use by the Department of Commerce.
Puma Tank
The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper
operation. If an effluent filter is installed within the tank it shall lie inspected and serviced as necessary.
Mound and Pressure Distribution System
No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall
be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative
maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow
compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched
as protection from freezing.
Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or
30 mg/L GODS, 30 mg/L TSS, 10 mg/L FOG, and 10° cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow
specified in the permit for this installation.
The pressure distribution system is provided wtth a flushing point at the end of each lateral, and it is recommended that each lateral be flushed
of accumulated solids at least once every 18 months. When a pressure test is performed tt should be compared to the inttial test when the
system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the
dispersal cell.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels
above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring.
Contingency Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system
in proper operating condition.
If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately
repaired or replaced with a component of the same or equal pertormance.
If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in
its' present location by increasing basal area if tce leakage occurs or by removing biologically clogged absorption and dispersal media, and related
piping, and replacing said components as deemed necessary to bring the system into proper operating condition.
See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider.
Project: REVISION -Gerald Strobush 3 bedroom residential mound Page 6 of 9
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Pump Specifications
'3hP
Up to 40 GPM
Discharge size 1'/a~' NPT
Sollds.3EB maxlmDm
Motor
Single phase: 115V
Materials of Construction
Brass;thermop{astic
Features and Benefits
Top suction eliminates
i?~pe~ller clogging.
Corrosion resistant
coas?ruction
• Float actuated sr^~itch.
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MODEL DVP03
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~, _ - 10 t5 20 25 30 35 JO US.CPM
i ~ 2 4 6 8 10 m3Ehr
CAPACITY
IVIE IEHS EEE7
10
9 30
8
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Pump Specifications
'/lo and'/~ HP
Up to GO GPM
IVlaximum head to 32
Discharge size 1',,1. NPT
Solids: ~'i'a` maximum
Motor
All motors feature ball
bearing construction.
Single phase: 115V
Materials of Construction
Cast iron
Thermoplastic
Stainless steel
MODEL: 3871
EP05
EPU4
a~ ~ ,> „r.
a 10 ~'z-h-~
Features and Benefits
• EP04 impeller- semi-open uesign
with pump out vanes to pro~ec~
mechanical seal.
• EP05 impeller - enciosea aesign
for improved performa!~cu.
•Ruggen glass-filled thern~oplastlc~
casing and base design provides
superior strength an~i conosloh:
reSlStanCe.
•Cast Iron m0i0f hOUSlllg fGr
efficient heat transfer. strength.
and durability.
• Corrosion resistant threar~e~i
stainless steel shaft,
•Available for auto~»,~~ie ~;;ri
manual operation.
• CSA Ilsted models av<<i~abie.
All Models are designed for continuous operation and feature stainless steel hardware.
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P,-aPos~ 11'(ou,r,cl a~,Zlo.y7x //1.95'
.w/ S' x 90' d~ s,ocrsa/ ce/% Two (Z) _
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Proposed u~;~ser Cu~+c.rt,~e
~lcmolSao-nq2 C'D,~-~l~~-tc~~TWe
~~'1 {acra~ S.r. owt lc,~
5~'~Sc.1.. ~o ~ t~..C.
(~~-~-i !d; by Sewcr.
P-'aposed
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Bench a~ ~ Top o/~/i4r/.c./p,~e.
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Wisconsin Department of Commerce SOIL EVALUATION REPORT
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code
County
Attach complete site plan on paper not less than 8Y: x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D.
Please print atl information.
Reviewed By
Personal informatron you prnade may be used for secondary rposes~i~ ~~~n,)).
Property Owner Property Loca on
1633
Page 1 of 3
A.C.E. Soil $ Site Evaluations
St. Croix
002-1056-20-000
Date
Tim & Charlotte Bazille SW 1/4 SW 1/4 S 23 T 29 N R 16 W
Property Owners Mailing Address L B k # Subd. Name or CSM#
2558 80th Ave. - na Proposed CSM
City State Zip Code Pho a Numt~NING FFI~ City ~Ilage /J Town Nearest Road
Woodville ~ WI 54028 715-698-2328 Baldwin 80Th Ave.
/~ New Construction Use: 1~ Residential /Number of bedrooms 3 Code derived design flow rate
Replacement ~ Public or commercial -Describe:
Parent material Glacial Till Flood plain elevation, if applicable
General comments
and recommendations: Install mound system at elev. 101.84' at 22" above 100.00' contour. 450 GPD
na
^ Borin
Boring # -~ g
~/ Pit Ground Surface elev. 100.02 ft [~d~..~A~ oo F~•
,
. Depth to limiting factor 8 ~ in• Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 0-8 10yr3/3 none sil 2fcr mvfr as 2f,1m 0.5 0.8
2 8-18 7.5yr4/6 none sl 2msbk mfr cw 2f,1m 0.5 0.9
3 18-28 7.Syr4/6 c2d 7.5yr5/8 sl 2msbk mfr cw 1f 0.5 0.9
4 28-40 7.5yr4l6 map 7.5yr5/8 scl 1csbk mfi - - 0.2 0.3
Boring # _.I Boring
1/ Pit Ground Surface elev. 100.16 ft. Depth to limiting factor ~~~ in• Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2
1 0-8 10yr3/3 none sil 2fcr mvfr as 2f,1m 0.5 0.8
2 8-17 7.5yr4/6 none sl 2msbk mfr cw 2f,1m 0.5 0.9
3 17-24 7.5yr4/6 c2d 7.5yr5/8 sl 2msbk mfr cw 1f 0.5 0.9
4 24-38 7.5yr4/6 map 7.5yr5/8 scl 1csbk mfi - - 0.2 0.3
' Effluent #1 = BOD ~ 30 < 220 mg/L an TSS >30 < 1 mg/L Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
CST Narne (Please Print) Signatur . CST Number
James K. Thompson _ s~ 3602
Address A,C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number
340 Paulson Lake Lane. Osceola. WI 54020 5/8/2003 715-248-7767
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Property Owner Tim & Charlotte Baxille
Parcel ID # 002-1Ori56-20-000
Page 2 of 3
Boring # ?Boring
/! Pit Ground Surtace elev. 98.60 ft. Depth to limiting factor 14" in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-9 10yr3/3 none sil 2fcr mvfr as 2f,1m 0.5 0.8
2 9-14 7.5yr4/6 none sl 2msbk mfr cw 2f,1m 0.5 0.9
3 14-24 7.5yr4/6 f2d 7.5yr5l8 sl 2msbk mfr cw 1f 0.5 0.9
4 24-42 7.5yr4/6 m2p SyrS/8 scl 1 csbk mfi - - 0.2 0.3
^ Ong # ~ Boring
u.f Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
^ Boring # ~ Boring
~ Pit Ground Surtace elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots /
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2
.~
. cp
' Effluent #1 = BOD ~ 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 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.
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Subdivision: Immanuel Luthern Church Owner/Developer:
Category: Minor Company:
Township: Baldwin Township Engineer:
S 23 T 29 R 16 Company: Do not enter information
Total Acres: 0
08/25/2003 Joel Brandt Jon Sonnenfag
I explained that staff was still waiting for Mr. Bazille to make a decision regarding the rezoning
request. This 40 is kitty corner to another 40 that is zoned Agricultural. The remaining portion
not rezoned must be attached to this other 40, but additional land must be obtained to make them
contiguous. Otherwise they could rezone the remaining portion of the 40 as well. He will have
Mr. Bazille address this issue.
02/17/2004 Jim Thompson Pam Quinn
Verified site conditions and proposed mound site location. House and system area are near the
top of a low ridge, wihere positive drainage can be achieved around and below mound. Identified
SW and NE corners and measured distances to Benchmark and system area. Correction
needed on CSM to 80th Ave., not 97th Ave. Snow cover and frozen soils prevented verification
of reported depth to limiting factors.
02/19/2004 Joel Brandt Jon Sonnentag
~~ A
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer ~o.d/'a~d ~~d ~k~
Mailing Address ~~`'~`S ~ ~~~ •, l.J~~di~~e ~~• ~~o~''
Property Address ~S/~ ~Q~j¢uQ, ,
City/State
LEGAL DESCRIPTIO
Property Location-5~ '/4 , S~ '/4 , Sec..2~3 , T
-2 N R ~6 W, Town of ,~,Ldcv"~
Subdivision ,Lot # ~_.
Certified Survey Map # 7SS,3D~Z. ,Volume / ~ ,Page # ~7"/
Warranty Deed # ,Volume ,Page #
Spec house ^ yes ~ Lot lines identifiable Jr~s ^ no
SYSTEM MAINTENANCE
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into
the system can affect fire function of the septic tank as a treatment stage in the waste disposal system.
The property owner agrees to submit to St. Croix County Zoning Department a certification form, signed by the owner and
by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal
system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of
sludge.
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
Department within 30 days of the three date.
~lz~i~
SIG ATURE OF AP LICANT DATE
OWNER CERTIFICATION
Uwe certify that all statements on this form aze true to the best of my/our knowledge. Uwe am/are the owner(s) of the
property described above, by vii~e ~f a ~a**~nty dee recorded in Register of Deeds Office.
~~, ~ '~~ ~ 3 /a3/~
SIGNA RE OF APPLICANT DATE
****** Any information that is misrepresented may result in the sanitary permit being revoked by the Zoning Department. ******
(Verification required from Planning Department for new construction.) ~~
Parcel Identification Number D-ndin ~ vo'2 -/O0~S6 -~-~
N ~~ ~~ U
Include with this application a stamped warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed.
~,
U 2559P Z1?
STATE BAR OF WISCONSQ~1 FORM 1- 2000
R'ARRANTY DEED
Document Ntlmbcr
This Deed, made between Timothv A. and Charlotte H. Bazillc. a
married coupe resi ' is the State of Wisconsin. Grantor, and Gerald H. and
Judv A. Sttobuah, a tnaaied couple residing in the State of Wisconsin. Grantee.
Gtan~r, for a valuable consideration, conveys to Grantee the following
described real estate in St Cmix County, State of Wisconsin (the "Property's (if
rnorc space is seeded, Please attach addettdnm):
See Attached Exlnbit A
7E+~926
KATHLEEN H. MALSH
REGISTER OF DEEDS
ST. CRQIX CO. , MI
RECEIVED FOR RECORD
09/2x/2009 10:45AH
MARRANTY DEED
El(EMPT #
REC FEE: 13.00
TRANS FEE: 21.00
COPY FEE:
CC FEE:
PAGES: 2
Name and Rehm Address
Gerald H. and Judy A. Strobush
2545 80th Avenue
Woodville. WI 54028
Phone: 715.698.2761
Together with all appurtenant rights, title and interests. ~,~~~~CXJ°2' - !D S( -,;~j ~ l.)"0"(~
Parcel Identificatia- Nutnher (PfN)
This i~ homestead property.
Grantor warlasts that the title to the Property is good, indefeasible in fee side and free and clear of encumbrances except
Dated this day of-(~~'_'_"` ~iJ ~~
Signature(s) authenticated this day of ,
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, authorized by § 706.06, Wis. Slats.)
THIS INSTRUMENT WAS DRAFTED BY
James M. Susag
Wisconsin Bar #1038x21
(Sigwturea may be authenticated or aclotowledged. Hoth am not necessary.)
~t~ld H. Strobush
~ ~ ~~~
•J S ush
ACKNOWLEDGMENT
STATE OF WISCONSIN )
ss.
oix County )
Personally came before me this~3°`I day of A~r~' , 2004.
the above named Timothy A~.~.It7.~L4, Charlotte H. Bazille.
d H. S ttsh and 3ud . Strob ~~ own to be the
person ~ who executed the fore aclatowledged
same. `~~` O~. • ' ' • G''R.
•
• • r
y~ • •~.,
Notary Public, State of Wiscaonsiri * •
My Commission is permasetiy, (It'uot,~ate expyatioa daL~
•Namts of persons signing in any capacity must be typed a printed below their signature.
WARRANTY DEED STATE BAR OF WISCONSIN
•.~~~~,./~
11aR~
1111 tll~` ~ FORM Na l -2000
~3.,
AUTHENTICATION
a ~~ K
U 2559P 218
EXHIBIT A
LEGAL DESCRIPTION
A parcel of land being a part of the Southwest 1/4 of Section 23, Township 29 North, itange 16
West, Town of Baldwin, St. Croix County, Wisconsin, and more particularly described as
follows:
Commencing at the Southwest corner of said Section 23;
Thence 587°26'08"E, a distance of 593.91 feet to the point of beginning;
Thence N00°26'23"E, a distance of 400.00 feet;
Thence 587°26'08"E, a distance of 219.00 feet;
Thence 500°26'23"W, a distance of 400.00 feet;
Thence N87°Z6'O8"W, a distance of 219.00 feet to the point of beginning.
Said parcel contains 87,540 square feet (approximately 2.0 aces).
930188.1
CORM t:Ci. 98~ A
~~ ~~crr_,-,~~,~
~'1~.1~/Qler
.., E...,....-...
Stock No. 26273
CERTIFIED SURVEY MAP NO.
VOLUME PAGE
PART OF THE SOUTHWEST QUARTER OF THE SOUTHWEST
QUARTER, AND PART OF THE SOUTHEAST QUARTER OF
THE SOUTHWEST QUARTER.
SECTION 23, TOWNSHIP 29 NORTH, RANGE 16 WEST,
BEING PART OF LOT 3 OF CERTIFIED
SURVEY MAP,VOLUME 12, PAGE 3290.
TOWN OF 6ALDWIN, ST.CROIX COUNTY,WISCONSIN;
SURVEYOR'S CERTIFICATE
1, Joel A. Brandt, Registered Land Surveyor, hereby certify that I have surveyed, divided, and mapped
part of the Southwest Quarter of the Southwest Quarter, and part of the Southeast Quarter of the
Southwest Quarter, being part of Lot 3 of Certified Survey Map,Volume 12, Page 3290, Section 23,
Township 29, Range 16 West, Town of Baldwin, St. Croix County, Wisconsin, more particularly
described as follows:
Commencing at the Southwest corner of Section 23, Township 29 North, Range 16 West, thence
587°26'08"E, along the south line of the Southwest Quarter of said Section 23, a distance of 593.91
feet to the point of beginning of the parcel herein described
Thence N00°26'23"E, a distance of 400.00 feet;
Thence S87°26'08"E , a distance of 219.00 feet;
Thence N00°26'23"E , a distance of 346.00 feet;
Thence 567°26'08"E, a distance of 526.00 feet to the east line of the Southwest Quarter of said
Southwest Quarter;
Thence 500°26'23"W, along said east line, a distance of 416.00 feet;
Thence 587°27'57"E, a distance of 263.92 feet;
Thence 500°31'51"W, a distance of 82.49 feet;
Thence N87°25'53"W, a distance of 133.91 feet;
Thence 500°26'26"W, a distance of 241.65 feet;
Thence N87°26'08"W, along the south line of said Southwest Quarter, a distance of 874.87 feet to
the point of beginning.
Said parcel contains 533,540 square feet (12.25 acres).
That I have made such survey, land division, and map at the direction of Gerald Strobush, 2545 80th
Avenue, Woodville. Wisconsin, 54028. That such map is a correct representation of the exterior
boundaries of the land surveyed, and the subdivision thereof made. That I fully complied with the
provisions of Chapter 236.34 of the Wisconsin State Statutes and the subdivision regulations of St.
Croix County in surveying, dividing and mapping the same. Said survey is subject to easements of
record and as shown.
Dated this ~~ day of ~EB2.vRR-~/ , 2004.
Joel A. Br ndt, R.L.S. #2603.
Vol 18 Page 4709
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Page 2 of 2
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~RM 'F:G~ 98'SeA
Stock No. 26273 VOL 18 PAGE 4709
CERTIFIED SURVEY MAP NO. az'~~2004 01:25PM
CERTIFIED SURVEY MAP
VOLUME PAGE ~COPYFFEE: 33000
PART OF THE SOUTHWEST QUARTER OF THE SOUTH~E~~~' z
QUARTER, AND PART OF THE SOUTHEAST QUARTER OF
APPROVED THE SOUTHWEST QUARTER.
sr.ctzolxcourtrrSECTION 23, TOWNSHIP 29 NORTH, RANGE 16 WEST,
Ptarudrw zorar~ ana Parks cgl'rlRlltlae B E I N G PART O F LOT 3 0 F C E R T I F I E D
~ EB 2 6 2004 SURVEY MAP,VOLUME 12, PAGE 3290.
T~WN OF gALDWIN, ST.CROIX COUNTY,WISCONSIN;
If not r•oord•tl wittrln 30, ; o
~ N
3 `~~ :` ~w
~ ~ :~ ~ •~ N00'26'23"E 400.00' ~ Z
~ .:
~I?'~ ~ I 366.98' rv
o E.w 1 33.02' I ~ ~ North is referenced to the
W ~ °~° ~, IN 6•-•0~ ~ N~ o_ ~' j South line of the Southwest
:I ri ,o I,o ~ ~~,i .`-' ov, ~ ~ N ~ Quarter of Sec. 23-29-16, which
'~ ~ o to°_ i ~ ;`I i ~~ 1 ~ o o bears 587°26'08"E
a I O~ N I O~ y y W
:• 1 m I ~ y -~ 1 ~ rn ' ~ ~ ~ ~ UNPLATTED LANDS
o. = z 133' 33' I I ~ ---
-'~ fD ° r I I i 366.98' ~ 346.00'
~ { ~ I NOO'26'23"E 400.00' NOO'26 23 'E
°; 1 33.02' OI
a ~. I ~ i 746.00'
N '~ I
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n
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C p ~ N ~ I ^I Lot 3 properly Une
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Vol 18 Page 4709