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HomeMy WebLinkAbout018-1025-50-100 Q c N Co h O 0 0. c I c~ I O o I o; I ~ I O I w Q ~ I N s c Cl. ~N " o 0 V) ° C I Z v~' = I L z c LL c o. a LL oi ° m° Y n v - E E N Q I O Z ~ _ c E o z a co N FN- ~ I O O 2 d c V D p v N Z d C O N F N o E z M g ~~ww m co `~+U III' ~ o I H N c • d U O C C O U 0 o m Q N C> 0 O z d p I N N c C. w c L r o m a~ r o C, co O a a N Z w H H H w o a = 0 m 0 0 0 o •r~v 0 a a a IL g r r o (n U) J U o } O rn rn ~i U C 0 N O a pN O O O N m _ o C o U O O C O N c O CQ O W. 7 N C C U p O Op r m N N_ V 0. N r C C O O c a1 l_O O (p - D M_ C%j a; E (3) 0 CD .6 =3 ca 0-0 N E ° Z t r `n _ w • O _ N O z N Z g Sn EL L; O ~ G~ a W .V a7 a E 7 rr~~ L 1 A 0 a m o in Q r Parcel 018-1025-50-100 04/09/2007 09:37 AM PAGE 10F1 Alt. Parcel 12.29.17.188A 018 - TOWN OF HAMMOND 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 - BALDWIN DAIRY INC BALDWIN DAIRY INC 2487 CTY RD G EMERALD WI 54013 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 2046 CTY RD E SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 11.454 Plat: 3214-CSM 11/3214 SEC 12 T29N R1 7W PT SE SW BEING LOT 1 Block/Condo Bldg: LOT 1 CSM 11/3214 11.454AC Tract(s): (Sec-Twn-Rng 401/4 1601/4) 12-29N-17W Notes: Parcel History: Date Doc # Vol/Page Type 02/15/2005 787612 2751/086 QC 02/15/2005 787611 2751/084 QC 02/11/2002 670685 1833/67 WD 05/29/1997 1241/608 WD 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/06/2006 Description Class Acres Land Improve Total State Reason OTHER G7 11.454 41,200 1,023,800 1,065,000 NO Totals for 2007: General Property 11.454 41,200 1,023,800 1,065,000 Woodland 0.000 0 0 Totals for 2006: General Property 11.454 41,200 1,023,800 1,065,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Department of Industry, SOIL AND SITE EVALUATION 'Labor and N,pman Relations Page 1 of 4 Division of Safety and Buildings ith s. ILHR 83.09, Wis. Adm. Code Y C(Mpt 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 St. Croix percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. # 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 Baldwin Dairy Govt. Lot SE 1/4 SW 1/4,S 12 T 29 N,R 17 ) W Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 2036 CTHW E City State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road Baldwin, WI 5 002 (715 ) 672-5941 Hammond CTHW E New Construction Use: ❑ Residential / Number of bedrooms Addition to existing building Replacement >]Public orcommercial -Describe: Milking Par1nr w/ Z CTC (no floor drains or catch basins) Code derived daily flow An gpd Recommended design loading rate 0.2 bed, gpd/ft2 0.3 trench, gpd1ft2 Absorption area required 86 bed, tt2 75 trench, ft2 Maximum design loading rate 0.7 bed, gpd/ft2 0.8 trench, gpd/ft2 Recommended infiltration surface elevation(s) 88.5 it (as referred to site plan benchmark) Additional design/site considerations install 5' x 55' trench area B-1/B-6/B-4, maximum area for conventional system Parent material sandy/loamy outwash Flood plain elevation, if applicable _ NA ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system ® S ❑ U 9@ S ❑ U Ea S ❑ U 9@ S ❑ U ❑ S )EU ❑ S X© U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 1 1 0-13 10YR 3/3 - sl 2 f-m sbk mvfr cs 1f/m .5 .6 2 13-3 10YR 4/4 - sl 1 c sbk mvfr cw 1 74 .5 39 Ground 4 37-61 10YR 4/6 - s 0 sg ml cs •7 ,.8 elev. w/ occasional gr , 9-L5-ft. 5 61-6 7.5YR 4/4 - is 0 sg m cs - , Depth to limiting 6 67-7 7.5YR 4/4 - sl 0 m mfi cs - .3 ; .4 factor ~ in, 7 73-9 10YR 4/6 - s 0 sg ml 7 •8 90 Remarks: Boring # 1 0-12 10YR 3/3 - sl 2 f-m sbk mvfr gs 1f/m .5 .6 2 12-5 10YR 4/4 - sl 3 m sbk mvfr cw 1m .5 ;.6 2 3 56-5 7.5YR 4/4 - mcos 0 sg ml aw - •7 ;.8 4 59-6 10YR 6/4 c2p 10YR 6/2 si 0 m mfi cs - NP ..2 Ground elev. 5 • .6 5 69-7 10YR 5/8 - fs/lfs 0 sg ml . ; -n w/ stratified 7.5YR 3/4 lfs weakly cement bands ® 71-73 Depth to This area chnically suit ble for below grou d system; not recommended duet massive silt n, J fine. limiting factor sands/loamy sands at depth w/ poor permeability & likelihood of perching effluent _a_in. Remarks: CST Name (Please Print) Sig lure Telephone No. Henry F. Grote 715-665-2681 Address Date CST Number PO Box 57, Knapp, WI 54749-0057 1/297 3065 PROPERTY OWNER Baldwin Dairy SOIL DESCRIPTION REPORT Pa 2 of 4 9e PARCEL I.1014 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots Qep/0 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 1 0-24 10YR 3/3 - sl 2 m sbk mvfr cs if .5 .6 2 24-4 10YR 2/1 - sil 1 m sbk mvfr cs 1m .2 .3 Ground 3 42-5 10YR 3/3 - sil 1 m sbk mvfr cs - .2 .3 elev. 90.8ft 4 50-6 10YR 5/1 c2d 7.5YR 4/6 sicl 0 m mfi - - NP .2 Depth to limiting Horiz n 1 appears to be eroded fill fro higher g ound factor in Tech ically suitable for shallow in-gr nd press re; weak st ucture an massive ilty c ay loam argues against using this area Remarks: Boring # 1 0-14 10YR 3/3 - sl 2 f sbk mvfr cs 1f/m .5 .6 4 2 14-3 10YR 4/4 - sl 1 c sbk mvfr cs if .4 .5 3 30-3 7.5YR 4/4 - lcos 1 m sbk mvfr cw 1m .7 .8 Ground 4 36-8 10YR 4/6 - s 0 sg ml .7 .8 elev. 91 .6 ft• ' Depth to limiting factor '80 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 # 1 0-27 10YR 2/1 - sil 1 m abk mvfr gs if/m .2 .3 5 2 27-3 10YR 3/3 - sl 1 c sbk mfr cs if .4 .5 3 33-4 10YR 5/4 - sl 2 m sbk mvfr gs if .5 .6 Ground 4 43-5 10YR 4/4 - sl 2 m sbk mvfr cs if .5 .6 elev. 5 53-6 10YR 4/4 f2d 7.5YR 4/6 sl 1 c sbk mvfr 4f1.9 ft. - - 4 .5 Depth to limiting factor 53`- in. Remarks: Technically OK for in-ground pressure Boring # 1 0-12 10YR 3/3 - sl 2 m sbk mvfr cs 1f/m .5 .6 6 2 12-4 10YR 4/4 - sl 1 c sbk mvfr cs if .4 .5 3 40-6 7.5YR 4/4 - lcos 0 sg ml cs - .7 .8 w occasiona gr around ~11e9 n 4 64-8 10YR 4/4,4/6 - s 0 sg ml .7 .8 )epth to imiting actor 38 in. Remarks: 3BDW-8330 (R. 08/95) Baldwin Dairy SOIL DESCRIPTION REPORT Page 3 of 4 PRO10ERTY OWNER PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure 2 g Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench n 1 0-1 10YR 3/3 - sl 2 f-m sbk mvfr cs 1f/m .5 , .6 2 13-32 7.5YR 4/4 - sl 2 m sbk mvfr gs if .5 .6 Ground 332-44 7.5YR 4/4 sl 1 c abk mvfr cs - .4 ; .5 elev. _ 94.3n. 4 44-63 10YR 4/4 - lmcos 1 m sbk mvfr as .7 , .8 5 60- 10YR 6/4 c2d 7.5YR 4/6 si 0 m mfi - - NP .2 Depth to limiting factor rn n. Remarks: Boring # 1 0-11 10YR 3/3 - sl 2 f-m sbk mvfr cs 1f/m .5 .6 2 11-2 7.5YR 4/4 - sl 2 m sbk mvfr cs 1m .5 .6 3 29-4 7.5YR 4/4 - sl 1 c abk mvfr cs - .4 .5 Ground 4 42-4 10YR 5/8 - fs 0 s ml cs - .5 .6 elev. 93 A n. 5 46-6 10YR 6/4 c2d 7.5YR 4/6 si 0 m mfi - - NP .2 Depth to limiting factor 46 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 # Ground elev. n. Depth to ; limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor 'n' Remarks: SBDW-8330 (R. 08/95) v r t r \L ~ ~L c ea p C~ 07 r►i N ~ .r ~N v+ t f 5'p C7 v 1 ~ A 5 o -0 zp :r ~ r ^r 'A f ✓j a ~ t ~ 0 v ~ ~ Z p • N ~ vi o ce N f f 44 f s ~ - ~ r ~ ^ nor N T "4a/ l T AILED J~T MAR 1 7 X997 6 FEB 2 5 1997 1► 3 KATHLEEN H. WALSH Register of Deeds ST. CROIX COUNTY 556002 SL Croix Co.,WI SURVEYOR'S RECORD CERTIFIED SURVEY MAP VRIEZE FARMS, INC. Located in the SETA of the SWIA of Section 12, T29N, R17W, Town of Hammond, St. Croix County, Wisconsin. OWNERS ADDRESS : 2036 C. T. H. "E " 8ALDWIN, WI, 54002 N114 COR,, SEC. 12, 7-29N, R17W r IRON PIPE FOUND J Dated: Jan. 15, 1997. ~ "Revised this 25th day of Feb. 1997." h Z UNPL A T T ED LANDS O O W N 89 1'7 39 "E 743.77. ' h P APPROVED yh ~I FEB 2 '97 o T. CRUiK Cul.;W`Y 2 2 QI a Corr1arehanwe Planr;uv I W o Ji c ;t 1 x W ^Lcttiry acid Q ~ o ; 41 " LOT 1 Parks Con?ns toe o ~I1 o lLl 3 498, 23 SQUARE FEET t I1. 454 Ajfndtrecorded pi w : INC UDING RIGHT- OF -WAY within 3©days Of m i N ~I o a 474, 73 SOUARE FEET 110.890 Arpp~ovaldate ~I W Z QI EXC UD,ING RIGHT-OF-WAY approval shall be o ~I o J n null and void n 11 e ~ W ~I o° h J I NORTH- SOUTH 114 O ~I SECT/ON LINE 2 W I^ukl,.,,.., at 111W d' I ~ z o h /00' 8U/LD/NG SETBACK LINE /00' S B9' 2 0 /3 "W 743,9? $ . n1880.08 SB9' 20 /3"W 743.92' S 89' 20 ' /3 " w COUNTY TR NK HIGHWA Y E SW COR. , sec, 12, T29N, R 17W S04V7H LINE OF THE SW// 4 S114 COR, , SEC, 12, T 29 N, R l7 W I COUNTY SURVEYOR'S MON. J //.".IRON PIPE FOUND J r UNPL A T TED L A NDS LI' A HURLBURT, HEATING, PLUMBING & ELECTRIC, INC. ( HEATING - SHEET METAL - PLUMBING - ELECTRIC 1227 E. PROSPECT ST. DURAND, WISCONSIN 54736 n n PHONE 672-8190 FAX 672-5490 0 ~ Q F9~ a ~vro ~ • u II L P m C~ C ~a o t a ~ Cie `4-- a ~ 4, y a a J W 4 v Q M `-4 a w -.O4L 0010 2~z a ' i < • 10 V) 111L w d v cY a. ~ =r Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: ,Safety and Buildings Division ST. CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) SanitarXP~~jtjVR.: Personal information you provice may be used for secondary purposes [Privacy L , s.15.04 (1)(m)]. G yy 33 yy Permit WALDEANr BUILDING PARTNERS Q_~;Yy,❑ N]lage Town of: State Plan ID No.: CST BM Elev./: /t Insp.. BEM E~lleev.: BM Description: Parcel L~i'X f L' 1025-50-100 / ~ / y 1 U1t5 TANK INFORMATION ELEVATION DATA A9700207 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic A i Benchmark Q~ ( fG, Dosing Aeration Bldg. Sewer Holding St/ Ht Inlet if TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic NA Dt Bottom Dosing NA Header / Man. 13.s , SS Aeration NA Dist. Pipe ? 9< lJP Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft oss Head Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED / TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Liquid Depth '6 S / DIMENSIONS S S' DIMENSION SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Typeo CHAMBER model Number: I U/ SO OR UNIT System: '/Q DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound 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 E] No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: HAMMOND 12.29.17,SE,SW 2046 CTY RD E q Plan revision required? ❑ Yes 814o Use other side for additional information. 1A da 1 ~J 61 ~p SBD-6710 (R.3/97) Date sp 's Signature Cert No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: . r Safety and Buildings Division SANITARY PERMIT APPLICATION Bureau of Building Water Systems 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. C • See reverse side for instructions for completing this application State Sanit ry Permit Number 99 39 A The information you provide may be used by other government agency programs ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION S 97 " 6 Property Ow er Name / Property Location (NQ n1 8(A ium hTri~Cr4 SC_1/4 SW 1/4, S L T 2 , N, R ~7 ) W Property Owner's Mailing Address Lot Number Block Number 9k Z3 City, State ~ Zip Code Phone oNumber Subdivision Name or CSM Number 11 / 2' / cwt tgad wL "u y II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ City Nearer Road Village ❑ Public 1 or 2 Family Dwelling - No. of bedrooms Town OF eT~ ?C III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 E] Apartment/ Condo (D /,9 - /O 2-5- /00 I 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station y/~~ Wash 5 ❑ Hotel /Motel . 9 ❑ Office/Factory 13 &Other: specify /nl'1+~-v1 4441 IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. New 2. ❑ Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an ystem 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 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12,134,eepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade ~ Required ft.) Proposed (sq. ft.) (Gals/day/sq. ft_) (Min./inch) Elevation 27S , 2-L- Feet /6~ GO jZ-:~Feet TANK Cap cit VII. INFORMATION in allons Total # of Manufacturer's Name Prefab. - Fiber- plastic Exper. New Existing Gallons Tanks Concrete Construtted Steel glass App. Tanks Tanks S tic Tank r k MOO 000 t p 0- El El El 1:1 El Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plum be 's Jame: (Print) Plu ber's ature: Sta s) rP/MPR No.: Business Phone Number: z 81 pd K - V 6-'67 lot li M&4- 1 n Plumber's Address (Street, Cit State, Zip Code): Zz7 a to ~ aej& raxro0, L4.zT 6473 ~ IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued issuing A o Stamps) pproved E] Owner Given Initial l8J Surcharge fee) Adverse Determination . CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SRD-6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To: Safety & Ruildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before.the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address- Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested `or numbe-s through 7. Vli. Tank information. Fill in the capacity of every new/or existing tank, list the tota' gallons, number of tanks and manufacturer's name, indicate prefab or s ,E constructed and tank material Cc--,plete for all s pti:, purnp/siphon and holding tanks for this system. Check experimental approval only if tanks received experimentr:l product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not sma'ler than 8 112 x 11 inches must be subrni'lec' to ' he c ,unty. The plans must include the following: A) plot plan, drawn to scale or \vith complete dimension location o` Holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service, streams (lakes; oump or siphon tanks; distribution boxes; soil absorption systems; replacementsystem areas; arid the iocation of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; f, elevation di fferences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county, E) soil test data on a ? I5 form; and ) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. V The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. T . J SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Commerce June 10, 1997 2226 Rose Street La Crosse WI 54603 HURLBURT PLUMBING 1227 E PROSPECT ST DURAND WI 54736 RE: PLAN S97-40677 FEE RECEIVED: 110.00 BALDWIN DAIRY SE,SW,12,29,17W TOWN OF HAMMOND COUNTY OF ST CROIX NON-PRESSURIZED IN-GROUND SYSTEM The Department has reviewed the above-referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based on chapter 145, Wisconsin Statutes, and chapters Comm 83 and 84, Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter Comm 82 or in chapters ILHR 50-64, Wisconsin Administrative Code. This plan submittal approval will expire two years from the approval date, or if a sanitary permit is obtained, plan approval will expire on the day the initial sanitary permit expires. The licensed plumber responsible for this installation shall keep one set of plans with the Department's stamp of approval at the construction site. The installer shall notify the appropriate inspector when inspections can be made. All permits required by the city, village, township or county shall be obtained prior to installation. Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Sincerely, Lennis Sorenson Wastewater Specialist Section of Private Sewage (608) 785-9336 SBO-7997 (R.11/96) 1 HURLBURT HEATING, PLUMBING & ELECTRIC, INC. HEATING - SHEET METAL - PLUMBING - ELECTRIC 1227 E. PROSPECT ST. DURAND, WISCONSIN 54736 PHONE 672-8190 FAX 672-5490 09 TABLE OF CONTENTS TITLE PAGE (1 PAGE) CALCULATIONS (1 PAGE) PLOT PLAN (1 PAGE) DETAILS (1 PAGE) SOIL TEST (3 PAGES) REGeiv E~ wN _ g 1ggi SPFE Y HURLBURT HEATING, PLUMJ3ING & ELECTRIC, INC. HEATING - SHEET METAL - PLUMBING - ELECTRIC 1227 E. PROSPECT ST. DURAND, WISCONSIN 54736 PHONE 672-8190 FAX 672-5490 4 CONVENTIONAL SYSTEM ; LOCATION U 1/4, SJL 1/4, SEC._12. T21 N, R,-LN TOWN: HAMMOND COUNTY: ST. CROIX DATE: 6/5/97 OWNER: BALDWIN DAIRY '2036 CTH ADDRESS: BALDWIN, WI 54002 DESIGNER: MATTtlFW. URLBURT SIGNATURE:' LICENSE # 224850 ATTACHMENTS ; f I ; HURLBURT HEATING, PLUMBING & ELECTRIC, INC. HEATING - SHEET METAL - PLUMBING - ELECTRIC 1227 E. PROSPECT ST. DURAND, WISCONSIN 54736 PHONE 672-8190 FAX 672-5490 CALCULATIONS MILKING PARLOR WITH THREE FULL TIME EMPLOYEES. THREE EMPLOYEES X 20 GALLONS/EMPLOYEE = 60 GALLONS/DAY. RECOMMENDED DESIGN LAODING RATE _ .3 GPD/SQUARE FOOT. 60 .30 = 200 SQUARE FEET TRENCH USING 275 SQUARE FEET OF TRENCH. r HURLBURT HEATING, PLUMBING & ELECTRIC, INC. u HEATING - SHEET METAL - PLUMBING - ELECTRIC 1227 E. PROSPECT ST. DURAND, WISCONSIN 54736 PHONE 672-8190 FAX 672-5490 n a ou y _u o v 3 Q o ~ Q t*o p a N "W z e _ dl D W 0 W o~ a~ +w 3 v £ 4 d J d t U ~ 1 u rl cll ~ Qlv7L 10/.v Z4-- 17w HURLBURT HEATING, PLUMBING & ELECTRIC, INC. HEATING - SHEET METAL - PLUMBING - ELECTRIC 1227 E PROSPECT ST. DURAND, WISCONSIN 54736 Air` PHONE 672-8190 FAX 672-5490 P-rp P+pe. z„ 2 5'- 3&'~ 2-' 2/i- a~8r~~o~c Gi, ILO c b0 c o: L S 25 - ~Pp F''tCiVrii"E SEWAGE SY3T~~~ Conditionally Elcu = 88-~ _ I~- APPROVED NVIRON of wm me "mm SEE CORRESppNDENCE Wisconsin Departm6nt of Industry, SOIL AND SITE EVALUATION Labor anti Human Relations Page 1 of 4 Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Adm. Code D County Attach complete site plan on paper not less tha l Li' Int'In si Plan must include, but not limited to: vertical and horizontal reference poiBM), I action and St. Croix percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel 1. D. # 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 Baldwin Dairy Govt. Lot SE 1/4 SW 1/4,S 12 T 29 N,R 17 ) w Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 2036 CTHW E City State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road Baldwin, WI 5 002 (715 ) 672-5941 Hammond CTHW E New Construction Use: ❑ Residential / Number of bedrooms Addition to existing building Replacement ]Publicorcommercial - Describe: Milking Parlnr w/ 3 FTE (nn floor drains or catch basins) Code derived daily flow 6n gpd Recommended design loading rate 0.2_bed, gpd/ft 33.trench, gpd/112 Absorption area required 86 bed, It2 75 trench, ft2 Maximum design loading rate 0' 7 bed, gpd/fl2 0' trench, gpd/f12 Recommended Infiltration surface elevation(s) 88.5 ft (as referred to site plan benchmark) Additional design/site considerations install 5' x 55' trench area B-1/1]1-6/B-4, maximum area for conventional system Parent material sandy/loamy outwash Flood plain elevation, if applicable NA ft S = Suitable for system ventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system L04 ❑ U ES ❑ U E3 S❑ U Q S ❑ U ❑ S )EI U ❑ S X© U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/I12 g In. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed , Trencf. 1 0-13 10YR 3/3 - sl 2 f-m sbk mvfr cs if/m .5 •.6 2 13-3 10YR 4/4 - sl 1 c sbk mvfr cw 1 .4 ;.5 mu - Ground 4 37-61 10YR 4/6 - s 0 sg ml cs - .7 .8 elev. w/ occasion 1 gr 5 61-6 7.5YR 4/4 - s 0 sg mI cs - Depth to limiting 6 67-7 7.5YR 4/4 - sl 0 in ntfi cs - .3 ; •4 factor 90 In. 7 73-9 10YR 4/6 - s 0 sg ml - - - 7 •8 Remarks: Boring # 1 0-12 10YR 3/3 - sl 2 f-m sbk mvfr gs if/m .5 .6 2 12-5 10YR 4/4 - sl 3 in sbk mvfr Cw lm .5 •.6 2 3 56-55 7.5YR 4/4 - mcos 0 sg ml aw - .7 :.8 4 59-6 10YR 6/4 c2p 10YR 6/2 si 0 in mfi Cs - NP ..2 Ground R-h ilev. 5 69-7 10YR 5/8 - fs/lfs 0 sg ml - - .5 •.6 ; ;h w/ stratified 7.5YR 3/4 lfs weakly cement bands ® 71-73 Depth to This area chnically suit ble for below grow d system; not recomm ded duet massive sit an el. imiling actor sands/loamy sands at depth w/ poor permeability & likelihood of perching f n 5g_ln. Remarks: CST Name (Please Print) Sig ture Telephone No. Henry F. Grote 7)5-665-2681 Address 1/2ate CST0 Number PO Box 57, Knapp, WI 54749-•0057 Baldwin Dairy SOIL DESCRIPTION REPORT page 2 01 4 PRORHRTY OWNKR • j PARCEL LO./ Flortzon Depth Dominant Color Mottles Structure 2 aY Texture consistence Boundary Roots In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ;Trench 3 1 0-24 tOYR 3/3 - sl 2 m sbk mvfr cs if .5 .6 2 24-4 IOYR 2/1 - sil 1 in sbk mvfr cs 1m .2 .3 hound 3 42-5 IOYR 3/3 - sil 1 m sbk mvfr cs - •2 •3 lev. NP .2 ~0.8ft. 4 50-6 IOYR 5/1 c2d 7.5YR 4/6 sicl 0 m mfi )epth to miting Horiz n 1 appears to be eroded fill fro higher g ound ,ctor Tech ically suitable for shallow in-gr ind press re; weak st ucture an massive ilty c ay loam in. argues against using this area Remarks: 3oring # 1 0-14 10YR 3/3 - sl 2 f sbk mvfr cs if/m .5 ; .6 2 14-3 10YR 4/4 - sl 1 c sbk mvfr cs tf .4 .5 4 3 30-3 7.5YR 4/4 - lcos 1 m sbk mvfr cw lm .7 .8 ~F`~•-~ 4 36-8 10YR 4/6 - s 0 sg ml - - •7 •8 ground lev. , q I..6_ft. repth to miting rctor Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ; Trench 3oring # 1 0-27 IOYR 2/1 - sil 1 m abk mvfr gs if/m .2 .3 2 27-3 IOYR 3/3 - sl 1 c sbk mfr cs if .4 .5 5 3 33-4 10YR 5/4 - sl 2 rn sbk mvfr gs if .5 .6 around 4 43-5 10YR 4/4 - sl 2 m sbk_ mvfr _ cs if _ .5 .6 ;lev• 5 53-6 10YR 4/4 f2d 7.5YR 4/6 sl 1 c sbk ^mvfr - - .4 .5 fl_4 it. depth to imiting actor 53-rn' Remarks: Technically OK for in-ground pressure wing # 1 0-12 IOYR 3/3 - sl 2 m sbk rnv cs f •6 2 12-4 10YR 4/4 - sl 1 c sbk mvfr cs if .4 .5 6 .3 40-6 7.5YR 4/4 - lcos 0 sg ml cs - .7 •8 w occasions. gr sound Lev. 4 64-8 10YR 4/4,4/6 - s 0 sg ml - - •7 •8 11,9 R. ; .pth to siting ctor 8 in. Remarks: ;BDW-8330 (R. 08/95) r PP.Of;ERTI( OWNER Baldwin Dairy SOIL DESCRIPTION REPORT Page 3 of 4 PARCEL I.D.# Borin # Horizon Depth Dominant Color Mottles Structure 2 9 Texture Consistence Boundary Roots Gepjt In. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. Bed . Trench 7 1 0-1 10YR 313 - sl 2 f-m sbk mvfr cs 1f/m .5 . .6 2 13- 7.5YR 4/4 - sl 2 m sbk mvfr gs if .5 .6 Ground 3 i 7.5YR 4/4 - sl 1 c abk mvfr cs - .4 : .5 elev. 94.38, 4 44-60 10YR 4/4 - lmcos 1 m sbk mvfr as - .7 . .8 5 60-65 10YR 6/4 c2d 7.5YR 4/6 si 0 m mfi - - NP .2 Depth to limiting factor An n. Remarks: Boring # 1 0-11 10YR 313 - sl 2 f-m sbk mvfr cs if/m .5 .6 8 2 11-2 7.5YR 4/4 - sl 2 m sbk mvfr cs lm .5 .6 3 29-4 7.5YR 4/4 - sl 1 c abk mvfr cs - .4 .5 Ground 4 42-4 10YR 5/8 - fs 0 s ml cs - .5 .6 elev. Q3.4 ft. 5 46-6 10YR 6/4 c2d 7.5YR 4/6 si 0 m mfi - - NP .2 Depth to limiting factor 46 in. Remarks: Horizon Depth Dominant Color Mottles Structure GPD/ft2 Texture Consistence Boundary Roots In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # 3 Ground _ elev. ft. - Depth to - limiting factor in. Remarks: Boring # Ground _ elev. ft. Depth to limiting factor in. Remarks: SBDW•8330 (R. 08/95) t P 04 4- f V d ~ f ~ f a 01 t r, ' F ell Gip 0 f VJ~ Ap' ~ p w 1 r G- x ~ 0 6 CtIj ) ifj / 1. Wisconsin Depaftment of Industry, SOIL AND SITE EVALUATION Labor and Human Relations Page 1 of 4 Division of Safety and Buildings ah with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x i 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. # 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 Baldwin Dairy Govt. Lot SE 1/4 SW 1/4,S 12 T 29 N,R 17 t) ) W Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 2036 CTHW E City State Zip Code Phone Number City ❑ Village Zj Town Nearest Road ❑ Baldwin, WI 5 002 (715 ) 672-5941 Hammond CTHW E New Construction Use: ❑ Residential / Number of bedrooms Addition to existing building LJ Replacement X;~ Publicorcommercial-Describe: Milking Parlnr w/ 3 FTE (no floor drains or catch basins) Code derived daily flow 60 gpd Recommended design loading rate 0.2 bed, gpd/ft2 0.3 trench, gpd/ft2 Absorption area required 86 bed, ft2 75 trench, ft2 Maximum design loading rate 0.7 bed, gpd/ft2 0.8 trench, gpd/ft2 Recommended infiltration surface elevation(s) 88.5 ft (as referred to site plan benchmark) Additional design/site considerations install 5' x 55' trench area B-1/B-6/B-4, maximum area for conventional system Parent material - sandy/loamy outwash Flood plain elevation, if applicable NA ft S = Suitable for system Conventional Mound In-Ground Pressure TAT-Grade System in Fill Holding Tank U = Unsuitable for system E] S❑ U Es ❑ u Q S El U 9@ S ❑ U ❑ S )M U ❑ S X© U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2 9 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 1 0-13 10YR 3/3 - sl 2 f-m sbk mvfr cs 1f/m .5 .6 2 13-3 10YR 4/4 - sl 1 c sbk mvfr cw 1f .4 .5 Ground 4 37-61 10YR 4/6 - s 0 sg ml cs - .7 .8 elev. w/ occasional gr 9Z.5-ft- 5 61-6 7.5YR 4/4 - is 0 sg ml cs - 7 Depth to limiting 6 67-7 7.5YR 4/4 - sl 0 m mfi cs - 3 ; .4 factor 90 in. 7 73-9 10YR 4/6 - s 0 sg ml - - .7 .8 Remarks: Boring # 1 0-12 10YR 3/3 - sl 2 f-m sbk mvfr gs if/m .5 .6 2 12-5 10YR 4/4 - sl 3 m sbk mvfr cw 1m .5 -.6 3 56-5 7.5YR 4/4 - mcos 0 sg ml aw - .7 8 4 59-6 10YR 6/4 c2p 10YR 6/2 si O m mfi cs - NP ,.2 Ground elev. 4/6 5 69-7 10YR 5/8 - fs/lfs 0 sg ml - - .5 !.6 9_~. ftw/ stratified 7.5YR 3/4 lfs weakly cement Ed bands @ 71-73 Depth to This area chnically suitable for below grou d system; not recommended duet massive silt an! J fine limiting factor sands/loamy sands at depth w/ poor permeability & likelihood of perching effluent _5~1_in. Remarks: CST Name (Please Print) Sig ture Telephone No. Henry F. Grote 715-665-2681 t Address PO Box 57, Knapp, WI 54749-0057 1/20t~ /97 CST Number o-- h 1 v PROPERTY OWNER Baldwin Dairy SOIL DESCRIPTION REPORT 2 4 Page of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GVp/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench I 1 0-24 10YR 3/3 - sl 2 m sbk mvfr cs if .5 .6 2 24-4 10YR 2/1 - sil 1 m sbk mvfr cs 1m .2 .3 Ground 3 42-5 10YR 313 - sil 1 m sbk mvfr cs .2 .3 elev. 90.8ft 4 50-6 10YR 5/1 c2d 7.5YR 4/6 sicl 0 m mfi - - NP .2 Depth to limiting Horiz n 1 appears to be eroded fill fro higher ground factor 5n in r-1 Tech ically suitabl for shallow in-gr nd press re; weak st ucture an massive ilty c ay loim argues against using this area Remarks: Boring # 1 0-14 10YR 313 - sl 2 f sbk mvfr cs 1f/m .5 ; .6 2 14-3 10YR 4/4 - sl 1 c sbk mvfr cs if .4 .5 3 30-3 7.5YR 4/4 - lcos 1 m sbk mvfr cw 1m .7 .8 Ground 4 36-8 10YR 4/6 - s 0 sg ml - - .7 .8 elev. 91 .6 n. ' Depth to limiting factor > 80 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 # 1 0-27 10YR 2/1 - sil 1 m abk mvfr gs 1f/m .2 .3 5 2 27-3 10YR 3/3 - sl 1 c sbk mfr cs if 4 .5 3 33-4 10YR 5/4 - sl 2 m sbk mvfr gs if .5 .6 Ground 4 43-5 10YR 4/4 - sl 2 m sbk mvfr cs if .5 .6 elev. 5 53-6 10YR 4/4 f2d 7.5YR 4/6 sl 1 c sbk mvfr - - 4 5 9II.9 ft. Depth to limiting factor 53 in. Remarks: Technically OK for in-ground pressure Boring # 1 0-12 10YR 313 - sl 2 m sbk mvfr cs 1f/m .5 .6 6 2 12-4 10YR 4/4 - sl 1 c sbk mvfr cs if .4 .5 .3 40-6 7.5YR 4/4 - loos 0 sg ml cs - .7 .8 w occasiona gr Ground elev. 4 64-8 10YR 4/4,4/6 - s 0 sg ml - - .7 .8 9.1-9 ft. Depth to limiting factor >88 in. Remarks: SBDW-8330 (R. 08/95) I ,I PROPERTY OWNER Baldwin Dairy SOIL DESCRIPTION REPORT Page 3 of 4 PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 1 0-1 10YR 313 - sl 2 f-m sbk mvfr cs 1f/m .5 .6 2 13-32 7.5YR 4/4 - sl 2 m sbk mvfr gs if .5 .6 Ground 3 32-44 7.5YR 4/4 sl 1 c abk mvfr cs .4 ' .5 elev. 94.3ft 4 44- 10YR 4/4 - lmcos 1 m sbk mvfr as - .7 .8 5 60-66 10YR 6/4 c2d 7.5YR 4/6 si 0 m mfi - - NP .2 Depth to limiting ; factor min. Remarks: Boring # 1 0-11 10YR 3/3 - sl 2 f-m sbk mvfr cs 1f/m .5 .6 F 2 11-2 7.5YR 4/4 - sl 2 m sbk mvfr cs 1m .5 .6 3 29-4 7.5YR 4/4 - sl 1 c abk mvfr cs - .4 .5 Ground 4 42-4 10YR 5/8 - fs 0 s ml cs - .5 .6 elev. 93.4 ft. 5 46-6 10YR 6/4 c2d 7.5YR 4/6 si 0 m mfi - - NP .2 Depth to limiting factor 46 in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ff2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # ; Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBDW-8330 (R. 08/95) Wisconsin Department of Industry, SOIL AND SITE EVALUATION y Labor and Human Relations Page of Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Adm. Code ~ 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 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # 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 Govt. Lot 1/4 1/4,S T N,R E (or) W Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# City State Zip Code Phone Number ❑ City ❑ Village ❑ Town Nearest Road ❑ New Construction Use: ❑ Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow gpd Recommended design loading rate bed, gpd/ft2 trench, gpd/ft2 Absorption area required bed, ft2 trench, ft2 Maximum design loading rate bed, gpd/ft2 trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design/site considerations Parent material Flood plain elevation,r if applicable ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system ❑ S ❑ U ❑ S ❑ U ❑ S ❑ U ❑ S ❑ U ❑ S ❑ U ❑ S ❑ U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2 Texture Consistence Boundary Roots in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Ground elev. ft. , Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in, Remarks: CST Name (Please Print) Signature Telephone No. Address Date CST Number r 0 Cl Q d s > Cl cr o _ J+► 0 d a 9"t r t -_P cat -ol Sw -9 9 so f Ch r 14 A Cl ,j cl I r. 0- ci o f 1. . Cl r r .e J CoP6 Ll ~ Z UU xq j a f C d i 04 I r-~" l.~ I REC&IVEW 06f09 10:50 1997 AT 715-672-8886 FROM 715 672 5490 PAGE 2 (PRINTED PAGE 2) ) .06/09/97 11:54 FAX 715 672 5490 HURLBLTRT HEATING Q002 11/13/96 15:07 $ COIIM CLERK Q002/003 6 T O - ld0 This application farm is to be completed in gull &nd signed by t%e awner(s) of, the property being develOPCd- Any inadequacies vili only result in delay, of the permit issuarrce. should - 't.bla eLave3.opmant be intended for resale by owner/cony-raCtOr, CSpeC house) , then a second form should be retained and comglkted when the property is sold and submitted to this office with the late deed recording Owner 1 of property a jz~~ a / v , ~J T,Dcatioln of proPerty 1/+I .f 'll~ , Secti ri Tk?N--R W T ship ding address 70: J 4 Ltd M D n ZLI Address of Site 0'/6 Subdivision na>m Lot no • - - Oi--her homes on property? -Ye-s-- No Previous owner of property 42 e Z, r Total size of property 4 C Total size of parcel e/cf Q` C Date parcel was created 41~ CJ Are all corners and lot lines identifiable? ~ Yes No Is this property he-Ing daveloped for (spat house-)? Yes NO volume and Pane Number as recorded with the Regiater of Deeds. _ rr i INCLUDE WITH THIS "PLICATION THE FOLLOWT-WG: A WARRAN'i')f DEED which includes a D0CAMENT NUMBER, VOLMW AND PAGE NUMBE'R AND Tim sz?,L OF THE REGxsTER of DEEDS. Ift addition, a certified survey, if available, would be helpful- so as to avoid delays of the reviowiny process. If the deed description references tQ a Cartified survey map, tha 'Certified Survey Map shall also be required. PROPERTY 0W2MR CERTIFICATION T (we) certify that all statements an this form are true to the best of my (our) knowledge that -T (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County RegiSter Of Deeds a.s Document go. r and that I (we) presently own the proposed site for the 'sewage disposal system or I (we) obtained an easement, to run the above described property, for "the constructlon of said system, and the same has been duly recorded in ffice of the county lzegister of Deeds as Document No- S 4 A App icant Co- plicant Date of Signature Date of signature 11/13/96 15:06 TX/RX NO-7452 P.002 ( RECEIVE6'06109 10:50 1997 AT 715-672-8886 FROM 715 672 5490 PAGE 3 (PRINTED PAGE 3) 1 •06/09/97 11:54 FAX 715 672 5490 HURLBURT HEATING 1@003 ~ 11113198 15:07 it COUNTY CLERK ~ 003/003 STC-105 SEIc'TIC TANK NV-H WKNANM AGREEMtNT St. Croix County a ~h C1 S AILLIl~TC AODRE53 ~a2 M FROPE ICY ADD]Et~SS 4~ l_' l cam- ~ l/~ S^ Uv -9- i0i on of septic systrAn) Please obtain the planning Dept C]!'x.'Y/ST,►TE PROPERTY LO _A 301% s r _ V4, S~rr~ 4, Sec ion ^-~N A ( / W TOVM OF /7l 0 ~t G ST_ atom CQti w,, W, S(j 3DrMION LOT NUMBER C7WR'l jF= SURVEY NLAF ~ IfOL»l~ _ PAGE _ J LOT NtMIBER Impropcr use and maintcnmic a of your Scoo system could result in its pmroatm+e "me to handle wastes. Proper vajum aaw consists of pumping out the septic teak every three years or sooner, if nettled by licensed septic Mk pumper. what you put iljo ft system cau affect the fiut,C0On of the septic tank as a t-mment stage in the waste disposal system. St. Croix County residents M&Y be eligible to meive a grant for a maadrtrmm of 6096 of the cast of rcplacemcat of a failing system, which was in operation prior m July 1. 1975. St. Croix County accepted this program in August of 1980, with the yegttirement that owners of all new systems agree to keep t!Ar system properly maintained. The propettyr owner agrees to submit to St Croix Zoning a certifiration form. signed by the owner ± and by a mater plumber Journeyman plumber, restricted plumber or a licensed pumper vmying that (1) the on-site wastewater di%mrnfl system is in proper operating condition and (2) after inspection and pumping (if rimessary), tho septic tank is less than 1/3 fbil of sludge and scum- VW,e, the undersigned have read the above requirements and ugree to maintain the private sewage disposal system in artardaace with the mrdands set forth, herein, as set by the. Wisoonsin D3NIL Cerdfication stating that your septic has been maintained must be completed and returned to ffie St. Croix County Zoning Officer within 30 days of the three year expiration date. SIC3N~. , vl- LA, OATG: .l St. Croix County Zoning Office Govetnment Ceprer 1101 Carmichael Road 11193 Hudson. W1 54016 i 11/13/96 15:06 TX/RX NQ-7452 P.003 [ RECF„1VER-06Y23 06:47 1997 AT 715-672-8886 FROM 715 246 3876 PAGE 2 (PRINTED PAGE 2) 1 . 06-23-1997 07:51AM FROM GUINN SWIGGUM & GILLS TO 17006728886 P.02 7401 VOL I PAAM 1%0032 WAUANrY DEED 001~WEHT NO. 1 yr iese Farms, Inc., a Wisconsin - ST. rAm' w3.11k i imcYaa'71a,M 1 corporation MAY.?. 8 0W ~Ddwerryr+~ w-Waldoan Build ng-Ya-r narst~~ rdt 8.45 ,SIN '~xt•r 4t W.7k f " - 'Wit tFwA RC3EIWEIki ~t11 al!dJROtNG 9Aln - - NAM'r AND AVON A0011t:S,1 . . [hc !oU deae+sbtd tul e6tRt In S Croix Coua a~viad (Y Fax= Credit Services S[.GCOI iacw•a ia; lei County Fpad River Falla, 1f1 54022 i i PlliC0. pyN F~RICA+YKTN Nl7N6FA Fart of the Southeast Quarter of the Southwest Quarter (SE} Of SA) of Section Irwelve (12), Township Tva3nty-"nine (29) North. Range Seventeen (17) West, Town of Hammond, st. Croix County, Wi,sgonsin, more particniariy descrlboa as Lot One (t) of certified Survey MAPS filed February 25, 1997, in Volame ii of certified Survey Naps, at Page 1214, es ooGU[nent No. 558002, o£Eico of the Register of Deefl9 for 3t. Croix County, Wisconsin- i N$RER I h a _ is na k homae~d ~rapcrty ~ 7tAd7[ fa ro~ E>rsj,6enrevrot~nttiec; EaS .xe9nts an$ res$tip't:.~,oYis of a 3 97 ❑a[ed [his S f d.y of _ "!7r c A b.. 14 VR F MS, C"" (SeaU b = (SEAL) K. vrieze,_PreaidBnt , - - ~rxaL3 MAU i AUTUENTICATION ACKNOWLEDGMENT S w,eSsJ.~__ Stare of Wf;consin, Atilllit'IUGAkd 17145 day o[ 19~_ Pasw[aCty esme 6e cree [hts _ . ~5 f d■y of - _ t~ , ~ 4 , [I1! Bbuvt 17711Y[@d - ij. Vriese. Pr~slidtnnt of m'mg; MEmtx $TAIT BAP. OF V7kSCONSW Cf not. *u')h6r=tA by 97(16.96, Ws. inn and ilclmewlrc e' i TK8 INSYRUk"T WAS t1RAF[[(J 6Y c= _Thomas A. McCormack; rv BalCdv$inr WT 54002 ~trrr P,~ Ilnlaly yad,7SC. $ " Croix rdwuk WlS. CS:gnaturn "W he a Lhmir*cd of Kk nn. Wged &rlh eat .1 My eanmrs i [ Pe (7I eel, stale c Rrimuo4 date: ! Iulx S N r - HA.It3 Vt W00A! Ajraflj, Ire ],1!'r~packp ltxld hY ir( dIX PrM4Sa bSkvw dl[ft S~1ulU [f. WARkANTt 01-LD 5SATP. SAL(" WIK'ONSIN NA~ppop+y.pe &sM Lb.. Inc [-err N4,2 - n61 TOTAL P.02 low