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HomeMy WebLinkAbout020-1328-00-000 ST. CROIX COUNTY ZONING DEPARTMENL~) AS BUILT SANITARY REPORT Owner io, Address City/State 4 Legal Description: Lot 3S Block Subdivision/CSM # T--t Town of PIN # t/4 )Z9 '/4, Sect, N SEPTIC TANK DOSE CHAMBER HOLDING TANK INFORMATION: Tank manufacturer Size ST/PC,Q~ / Setback from: House Well -2- 2 P/L L Pump manufacturer _ Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM: Type of system: Width Z-2- Length -75-_ Number of Trenches Setback from: House _g~Z Well 12Y . P/L z42_ Vent to fresh air intake -,z ELEVATIONS: Description of benchmark Elevation 40 ,,1 Description of alternate benchmark dgwg Elevation 1J, /,q Building Sewer : ST/HT Inlet ' Qua Z ST Outlet PC Inlet PC Bottom Header/Manifold ~ Top of ST/PC Manhole Cover D Z Distribution Lines O _ O ( ) Bottom of System ( ) % ( ) ( ) Final Grade ( ) _9 /~3 f~_/ ( ) ( ) Date of installation /x/? P mit numb ~ /A/ State plan number Plumber's signature - License number Date / Inspector Complete plot plan ~ NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW yo e NO i 0 fJ ~~~cE ~uSir i A2 )s i3m A D INDICATE NORTH ARROW Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety apd Buildings Division INSPECTION REPORT 54. arc (A GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit NNoo..: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). C~-~-I 1Oro Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.: ` J Q04011f,,O hirn"Vi 4u4 S" CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: ov i±DV o OFV Pv(_ ; 07-0- I3z$-Ov-oda TANK INFORMATION ELEVATION DATA A47oo(1z.b TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. eptic wr_cxs ~ ~ Benchmar 5(S lpg# Dosing 446 v& l / ,3 !Op Aeration Bldg. Sewer 6'01 101-:551 Holding St/Ht Inlet ,5.2$ 1Cq-07 TANK SETBACK INFORMATION St/ Ht Outlet 9,.Vf /O~ TANK TO P/ L WELL BLDG. Airke ROAD Dt Inlet Sep Ic ILI, 100:I 3 NA Dt Bottom Dosing NA Header / Man. PAT q?ar 917• 2 Aerate NA Dist. Pipe 9tj/ 9~.pt{ Holding Bot. System gyp, 9$','L PUMP/ SIPHON INFORMATION Final Grade X03 •D~ 3 7~ j/D• Manufacturer Demand ST'• mankol"(Wge Model Num GPM /t,,6AA 1/y3 .ZS TDH 6fL Friction Fiystem TDH ead Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM E TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. iquid Depth DIMENSION I L 7S DIMENSIONS SYSTEM TO P / L BLDG WELL LAKE/STREAM LE CHING M=~~ SETBACK INFORMATION Type O CH E 5~~ cJo~ ~~Of CH UNIT a Number: System DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) t/ x Hole Size Hole Spacing Vent To Air Intake Length Dia. Length 7C ` Dia. Spacing x0 Z72C 70 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over ep ver xx ep xx ee -&//Sodded xx Mulched Bed /Trench Center Deu, opsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) 7~S 4 -906h~ ~r'. Lod 3 M. Q*'l - & "v 4"4V1 ct-,4D~ Gttt~ 2 4(V~ rvsG ~ .ij ~~/jl~ 44$ q--,j4( f heal . Vo Plan revision regZ; dP ❑ Yes ® No Use other side for additional information. 7 SBD-6710 (R.3/97) Date Inspector's Signature ert. N ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: Safety and Buildings Division 146consin SANITARY PERMIT APPLICATION Po ~Wa Washington Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8.1/2 x 11 inches in size. _S7/ L~~ L'OK • See reverse side for instructions for completing this application State Sanitary Permit Number i9g91o4 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 INF RMATI N Property ner Name Property Location 1/4, S 120/ , N, R 4ork9 Property Owner's Ma ing Address Lot Number Block Number City, t to r Zip Code Phone Number Subdivision Na e r M Number 4 sai;~ I ) sL ( > o' II. TYPE BUILDING: (check one) ❑ State Owned !ty Nearest Road ❑ Vtl age Public 1 or 2 Family Dwelling - No. of bedrooms Town OF 111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 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/ Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. IZ New 2_ ❑ Replacement 3, ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 n Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage 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 (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./i ch) Elevation Feet Feet VII. TANK Capacity gallons Total # of r Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existing structed Tanks Tanks Septic Tank or Holding Tank l ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑ Vill. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for inst lation of the onsite sewage system shown on the attached plans. Plumber' Nam : (Print) Plumb sSi t o• PS) MP/MPRSW No.: Business Phone Number: Plu tier's Ac dress (Stree , City, State ip Code): IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Age ature o Stam Surcharge Fee) JKA'pproved ❑ Owner Given Initial/ jj~G~/ Adverse Determination GPI X. C NDITIONS gf APPROVAL / REASONS FOR DISAPPROVAL: SBD-6399 (R.11/96) - DI I ON: Original to Co nty. One copy To: Safety & Buildings Division, Owner. Plumber - INSTRUCTIONS t ; 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, 608-266-3151. 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 for numbers 1 through 7. VII. Tank information- Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR_ VIII. Responsibility statement. Installing plumber isto fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County / Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. 0 - Sel r L Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 +11 i chQS T"Ize. Plan must include, but St. Croix not limited to vertical and horizontal reference rmt'($~A~, aiteCtton and`% of slope, scale or dimensioned, north arrow, and location and to"~c' to nest road. 020-1328-00 APPLICANT INFORMATION-PLEAS P.f#INT A"JNF©FMATIONREVIEWED BY DATE PROPERTY OWNER: t, r r. KPPOO RTY LOCATION Bridgeland Dev. Co. LOT NE 1i4 SE 1/4,S 29 T 29 N,R 19 iE(or) W PROPERTY OWNER':S MAILING ADDRESS BLOCK SUBD. NAME OR CSM # X1736 117th. St. na StCrix Estates Sec. Addn. CITY, STATE ZIP CODE PHONE NUMBER ❑VILLAGE ®i OWN NEAREST ROAD Lakeville, MN. 55044 (61 985-~5f~00 ` Hudson Crosby Dr. _7 7. [x] New Construction Use[ ] Residential/ Number of bedrooms 4 [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate • 7 bed, gpd/ft2 •8 trench, gpd/ft2 Absorption area required 858 bed, ft2 750 trench, ft2 Maximum design loading rate _.1_7 bed, gpd/ft2 .8 trench, gpd/ft2 Recommended infiltration surface elevation(s) area A=98.2' -B=99.2' ft (as referred to site plan benchmark) Additional design / site considerations none Parent material 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 fors stem nS ❑ U EIS ❑ U :K1 S ❑ U KIS ❑ U KI S ❑ U ❑ S DM I SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0-15 10yr3/2 none 1 2msbk mfr 9w lm .5 .6 1 2 15-25 10yr4/4 none sil lcsbk mfr gw if .4 .5 Ground 3 25-36 10yr4/6 none scil lcsbk mfr gw if .2 .3 elev. 4 36-44 7.5yr4/6 none is Osg mvfr 9w na .7 :.8 102.2 ft. Depth to 5 144-84 7.5yr4/6 none ms Osg ml na na .7 .8 limiting factor + " Remarks: Boring # 1 0-15 10yr3/2 none 1 2msbk mfr gw 2f .5 .6 2 115-23 10yr4/4 none sil lcsbk mfr 9w if .4 .5 3 23-30 10yr4/4 none sicl lcsbk mfr gw if .2 .3 Ground elev. 4 130-80 7.5yr4/6 none ms Osg ml na na .7 .8 101.2ft. Depth to limiting factor +80" Remarks: CST Name:--Please Print Gary L. Steel Phone: 715-246-6200 Address: 1554 200th v New Rich nd WI 54017 Signature: Date: 9-4-97 CST Number: m02298 PROPERTYOWNER Bridgeland Dev. Co. SOIL DESCRIPTION REPORT Page2 of 3 PARCEL I.D4 020-1328-00 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 'ti`....`....`.. 1 -12 lyr3/2 none 1 2msbk mfr gw 2f .5 .6 2 12-27 10yr4/4 none sil lcsbk mfr 9w if .4 .5 Ground 3 27-31 10yr4/4 none sicl lcsbk mfr 9w if .2 .3 elev. 102.2 ft. 4 31-84 7.5yr4/6 none ms Osg ml na na .7 .8 Depth to limiting factor +84" Remarks: Boring # 1 -9 10yr3/2 none 1 2msbk mfr gw 2f .5 .6 4 2 -20 10yr4/4 none sil lcsbk mfr gw if .4 .5 3 0-30 10yr4/4 none sicl lcsbk mfr gw if .2 .3 Ground elev. 4 0-84 7.5yr4/6 none ms Osg ml na na .7 .8 103.0 ft. Depth to limiting factor +84" Remarks: Boring # 1 -12 10yr3/2 none 1 2msbk mfr gw 2f .5 1.6 2 12-27 7.5yr4 /4 none sl 2mgr mvf r gw If .5 ~ .6 3 7-80 7.5yr4/6 none ms Osg ml na na .7 .8 Ground elev. 102.0 ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel Bridgeland Dev. Co. 1554 200th Ave. CSTM2298 NE4SE4 S29-T29N-R19W New Richmond, WI 54017 MPRSW 3254 town of Hudson (715) 246-6200 1 lot #38-St. croix Estates Sec. addn. N 1"=40' BM.= top`of 2" pvc pipe @ el. 100, Alt. BM.= nail in Cherry tree C el. 107.90' 183 961 61 r 30 qo 0o 8 24 ~.2 20. I2r' no v✓1 Lr, ~ ~,A Gary L. Steel 9-4-97 Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of Labor and Human Relations -.1 Division of Safety & Buildings ► in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but ix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PA • y dimensioned, north arrow, and location and distance to nearest road pedin + APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION fil WED B' IFS PROPERTY OWNER: PROPERTY LOCATION Bridgeland Development Company GOVT. LOT NE 1/4 SE.J/4,S29 T,.29- N 9 W PROPERTY OWNER':S MAILING ADDRESS LOT# BLOCK# SUBD.NAME'ORCSM#-:; 11736 117th. St. 38 na St. C>roix;L %t;e;a;,§ecot l ddn. CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE 97OWN % NEAREST, RO D, Lakeville, MN. 55044 (612) 985-5000 Hudson ''r ;C' orb `Ef. * ] New Construction Use [x] Residential /Number of bedrooms 3 [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate • 7 bed, gpd/ft2 •8 trench, gpd/ft2 Absorption area required 643 bed, ft2 563 trench, ft2 Maximum design loading rate • 7 bed, gpd/ft2 - 8 trench, gpd/ft2 Recommended infiltration surface elevation(s) 101.15 ft (as referred to site plan benchmark) Additional design/ site considerations trenches @ 100.4' & 98.5' for alt site system el. Parent material 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 fors stem InS ❑U ®S ❑U ®S ❑U [3S ❑U ®S ❑U ❑S K7U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 -8 10yr3/3 none sl 2mgr mfr cs 2f 7 .6 2 -88 7.5yr4/6 none ms Osg ml na na .7 .8 Ground elev. 105.0 ft. -r c -e- U C 9 6 9 Depth to limiting factor Remarks: Boring # 1 -6 10yr3/3 none 1 2mgr mfr cs if .5 .6 2 2 -30 10yr5/4 none sil lfsbk mfr gw if .2 .3 3 0-88 7.5yr4/6 none ms Osg ml na na .7 .8 Ground elev. 105.0 ft. Depth to limiting factor +88" Remarks: CST Name:-Please Print Phone: Gar L. Steel 715-246-6200 Address: 155 200th. Ave., )Jew Richmond, WI. 54017 Signature: Date: CST Number: 8-21-96 cstm 02298 PROPERTYOWNER Bridgeland Dev. Co. SOIL DESCRIPTION REPORT Page-2- Of -3_ PARCEL I.D. # pending GJP Depth Dominant Color Mottles Texture Structure Consistence Bourcl3y Roots U/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 .6 1 0-8 ib r-3/3 NONE sl 2m r mfr -w if 2 8-19 10yr5/4 none sil lfsbk mfr gw if .2 .3 3 19-84 7.5yr4/6 none ms Osy ml na na .7 .8 Ground elev. 103.9 ft. Depth to limiting factor +84" Remarks: Boring # 1 0-12 10yr3/3 none 1 2msbk mfr gw if .5 .6 4n" 2 12-42 10yr5/4 none sil lfsbk mfr gw if .2 .3 3 2-80 7.5yr4/6 none ms Osg ml na na .7 .8 Ground elev. 102.00 ft. Depth to limiting factor +80" Remarks: Boring # 1 -9 10yr3/3 none sl 2mgr invfr yw if .5 .6 5>< 2 -26 10yr4/4 none sil lfsbk mfr yw if .2 .3 3 26-83 7.5ry4/6 none ms Osg ml n.a na .7 .8 Ground elev. 1.02,2_- ft. Depth to limiting factor +83" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel Bridgeland Dev. Co. 1554 200th Ave. CSTM2298 NE4SE4 S29-T29N-R19W New Richmond, WI 54017 MPRSW 3254 town of Hudson (715) 246-6200 lot #38-St. croix Estates Second Addn. N1"=40' BM.= top of 12" pvc pipe C el. 100' Z A 10-7 lam- ~ Gary L. Steel 8-21-96 placation form is to be completed in full'and signed by the er(s) of the property being developed. An inadeacies my result in delays of the permit issuance. Should will this development be intended for resale by owner/contractor, (spec house), then a second form should be retained and completed w the property is sold and submitted to this office with the. appropriate deed recording. - Owner of property - DO~ -7/444 §t Location of roperty 1/4 1/4, Section Township ~j~ ~-R W Mailing address Address of site 1,©T *43S Jr Subdivision name ST- G c I)( ES7-h 7-6g" Lot no. Other homes on property? Yes V No Previous owner of property Total size of property Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Is this property being developed for (spec hou-se`? Yes No Volume Yes =No and Page Number as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. certified survey, if available, would be helpful so asdtolavoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (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 as Document No. own the proposed site for the sewage_disposaltsystem) orr Ie(we) I and obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of the County Register of Deeds as Document No. Signatur of Applicant Co-Applicant Date of Signature Date of Signature 10. . t f STC-Jos SEPTIC TANK - MAMTENANCE AGREEMENT `St. Croix county OWNER/BUYER MAILING ADDRESS ' 5~-' PROPERTY ADDRESS l•vf '9Sg C~-~►,t (location of septic ° system) Please obtain from the Planning Dept, 11 CTTY/STATE PROPERTY LOCATION l~ 1/4, _ 1/4, Section 21-1 T r~ ~_N•R TOWN OF _L _W qV u- ST. CROIX COUNTY, WI SUBDIVISION C1` ,~rl7! % CERTIFIEDSURVEYMAp LOT NUMBER VOLUME PAGE , LOT NUMBER Improper use and maintenance of your septic system could result in its premature failure wastes. Proper maintenance consists of pumping out the septic tank every to handle licensed septic tank pumper. What you put into the system can affct three funct onr of sooner, if needed as septic stank as a treatment stage in the waste disposal system. the St. Croix County residents may beeligible to receiv of replacement of a failing system, which was in o ° a grant for a maximum of 60% of the cost accepted this program in August of 1980, with the requirement thattowners lof all newt ems County keep their system properly maintained. sY agree to The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that 1 the on-site wastewater disposal system is in proper operating condition and (2) after ins ection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. P I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED; DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 eons VOL 3 .3 PAa T15 ,55 S' C;0A GTY..W1 7yC@ 27r must i DOCUMENT NO. STATE BAR OF WISCONSIN FORM 2-1982 WARRANTY DEED APR 16 Xk! 11:45 A. M Bridaeland n t~ment Lomoanv a 1\AirLn~ta conwration - 1'1tly~StB~ v( 7tl4'...1 con s and warrants to Kim K Harmon and DDo_ngvan W- Harnwn wife and husband the follou ing described real estate in St. Croix County, State of Wisconsin Lot 38 St. Croix Estates Second Addition in the Town of Hudson, St. Croix County. Wisconsin. This _ is not __-homestead property. (is) (is Ism) Exceptions to Warranties: Dated this 25th day of March- 19 97 (SEAL) * Acal r 7ania.. reside - (SEAL) -(SLAL) AUTHENTI ATION ACKNOWLEDGMENT STATE OF MINNESOTA Signatures authenticated this _-__---day of _ I9 Dakota---_- County, personally came before me, this -255th-day of Ng*ck 1997 _the above named TITLE: MEMBER STATE BAR OF WISCONSIN Noc21 Krgzaniak (If not- authorized by 7t,.06, Wis. Sta!'_) - - - This instrument was drafted by r me known to be the person who executed the Brid~cland Devcio meat Comflanv xroa instrument and acknowledxl the same. 20141 Iconic Tr. Suite B. LakeAlk. MN S50A i /'G~/`~' 'ij~r'~7 B,Ltt4r-- - (Signatures may be authenticated or acknowledged- Both are not necessary.) County. h1"d Nccaan Public Dakota commission expir-,s ?anonry 1, 2(xA . J. BMER 7DI LA 'aL Hp~NµESpTA COiNTY NAO J ~ a ~ y ~ ON f f r.• W t y ( n r ~ v'~ w y 3-11 Z" ~~i On ST. CROIX COUNTY WISCONSIN ZONING OFFICE ~n a milli "p ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 - (715) 386-4680 February 20, 1998 Hartman Homes, Inc. Attn: Becky 103 Main Somerset, WI 54025 RE: Septic Inspection for Donovan Harmon located at 715 Crosby Drive, St. Croix Estates, Lot 38, Town of Hudson, St. Croix County, Wisconsin Dear Becky: A septic inspection of the above referenced property was conducted on January 8, 1998. This property is located in the NE'/4 of the SE'/4 of Section 29, T29N-R1 9W, St. Croix Estates, Lot 38, Town of Hudson, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a four (4) bedroom home. If you have any questions regarding this, please contact our office at (715) 386-4680. Sincerely, id V'1~-6r Rod Eslinger Assistant Zoning Administrator /sm FAX ST. CROIX COUNTY ZONING OFFICE 1101 Carmichael Road Hudson, WI 54016 (715) 386-4680 DATE: O - TO: Fax Number: q 0 Name: FROM: Fax Number. 386-4686 Name: Number of Pages Including Cover Sheet IF COMPLETE AND LEGIBLE INFORMATION IF NOT RECEIVED, PLEASE CONTACT: NAME: c / TELEPHONE NUMBER: T