HomeMy WebLinkAbout022-1055-80-000
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~.1,. CROIX COUNTY ZONING DEI'ARTMEN
AS BUILT SANI'T'ARY REPOR'T'
Owner ~►1 'Y~ 4,1 ~Y~ ~ ~~a ~,~n~ ~.u ry~c~~~, ~ = ~ ,
Address 5 a-~,,< o r
City/State I a no- (p 8
Legal Description:
Lot Block 4A Subdivision/CSM 1/ ZZ4 el-
a~
o
` '/45, Sec. , T&N-R19 W, Town of 'nn;e-141 i PIN It Nja 105S S O
SEPTIC TANK - DOSE CHAMBER - HOLDING. TANK INFORMATION:
Tank manufacturer Size ST/PC lactback from: House j~L Well ' P/L
Pump manufacturer ~'yLL/L r? Model /h SQ
Alarm location dt4e~ e A St--
(HOLDING TANKS ONLY)
Setbacks: Service road AA Vent to fresh air intake AA Water Line A )A
Meter location ►'V
Alarm location
SOIL ABSORPTION SYSTEM:
Type of system: zoz~ Width Length Number of Trenches
Setback from: House ;7&0 Well ~Zoa P/L, Vent to fresh air intake 7
ELEVATIONS:
Description of benchmark G~ 4- 944 / /~D S E PR8? • eoA11J&n Elevation
Description of alternate benchmark C S~ r3 M p pN Lo-~ Z-1 -v E Elevation W3,3
Building Sewer 59 ST/HT Inlet q69, ST OutletATd , PC Inlet 7 U
PC PB Al> m N , Z.SHeader/Manifold '1195, qS Top of ST/PC Manhole Cover ~Distribution Lines ( ) --2ZR,
T Z ( ) ( )
Bottom of System ( ) q/ ( ) )
Final Grade ( ) Zt~, 0 ( ) ( )
Date of installation /Z/ ermit number a9909c)2, State plan number 9 ~a6~ aa,
Plumber's signature Yom--- License number Date 121
Inspector
('amPICIC plot plan K
r
NOTICE: Please provide the following:
• A plan view sketch showing everything within 100 feel of the system.
• Two horizontal reference points to center of septic tank manhole cover.
• Show alternate benchmark, if applicable.
PLAN VIEW
I r
B
t~ ~ z +v l.L
_ ro
INDICATE NORTH ARROW
Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County:
'Labor and Human Relations' INSPECTION REPORT ST. CROIX
Safety and Buildings Division Sanitary Permit No.:
(ATTACH TO PERMIT) 299092
GENERAL INFORMATION
Permit Holder's Name: ❑ City ❑ Village Town o : State Plan ID No.:
ANDERSON, NEIL/RAYMOND, EDWARD KINNICKINNIC ~O
CST B EI v Insp. EI BM Description: Parcel Tax No.:
".sc!4~3 ty;3 liro~ !a G`l 022-1055-80-000
TANK INFORMATION ELEVATION DATA _FA22
TYPE CAPACITY STATION BS HI r
MANUFACTURER S ELEV.
c w/ ~e .inv,
Benchmark U g ng ~I!► )Do(°) A 4 .OZ 21,3 Bldg. Sewer ~l9
FAeration
Holding/ Inlet
TANK SETBACK INFORMATION / Outlet o7
JI-le
vent
TANK TO P / L W LL BLDG. Air Ito ntake ROAD Dt inlet 7' 6
Air _
i~ U~ NA Dt Bottom 2
eptic
NA Header / Man. S97 9 g
osi n Sb+ U QI~I • Z •
Aeration NA Dist. Pipe vq 7Z-
Holding Bot.System 3• &1 41/7.7/
PUMP/ SIPHON INFORMATION VA", SS Final Grade
Manufacturer Demand py,(d IMA
Model Number qC-60GPM
TLoss System S TDH34, Ft
. Hr} f Dist. To Well
th3 3 S Dia
SOIL ABSORPTION SYSTEM
/TRENCH h ' Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
IMEN 1 DIMEN I N
LEACHING Manu a SETBACK STEM TO P / L BLDG WELL LAKE /STREAM CHAMBER
INFORMAO ~ + MoNum e rf~ OR UNIT
m: ~,A'•Y`OU
DISTRIBUTION SYSTEM
Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length Dia Length ,2_ "l Dia. / Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth OT_ 7 xx seeded / Sodded xx Mulched
o
1Z- ~Qi Z s 01
Bed/ Trench Center Bed / Trench Edges Topsoil Yes ❑No Ye I
3Z ~
COMMENTS: (Include code discrepancies, persons present, etc.) 6 I7 7 Xyr
LOCATION: KINNICKINNIC 19.28.18.304E,SE,SE 1006 QUARRY ROAD LOT 4
L4 S(nl
v~e C's sue.
Plan revision required? ❑ Yes No PER -T75
Use other side for additional information. I &I _U]
Date Inspector' ignature Cert. No.
SBD-6710 (R 05/91)
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
.,o. Safety and Buildings Division
SANITARY PERMIT APPLICATION Bureau of Building Water Systems
l-7L■7R 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 (Z- O (,k
• See reverse side for instructions for completing this application State Sanitary Permit Number
a99o9A
The information you provide maybe used by other government agent programs ❑ Check I( revision to previous application
[Privacy Law, s. 15.04 (1) (m)]. /00& ( ~1 I a )~C/. State Plan I.D. Number
1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION :7 Q ~c.0 Z-
Property Own ame pw~ Property Location Q
ND 4, v 14 SAC 1/4, S T oZ 0 N, R E (or~g
Property Owner's Mailing Address r , Lot Number / Block Number
2 A J'~ V Ly!
Cit tate I Cod Phone Number Subdivision Name r CSM Number
. TYPE OF BUILDING: (check one) ❑ State Owned 0 it~r Nearest Road
❑ VII age
E] Public 1 or 2 Family Dwelling - No. of bedrooms Town of h1,Ve f^1NI rL P
III. BUILDING USE: (If building type is public, check all that apply) Parcel IaxNumber(s)
I9.9S.1$.304E 0ZZ 10557 8 a
1 ❑ Apartment/ Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility
3 Q Campground 7 Q Merchandise: Sales/ Repairs 11 Q Restaurant/ Bar/ Dining
4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash
5 Q Hotel / Motel 9 ❑ Office/Factory 13 Q Other: specify
IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable)
A) 1- New 2. ❑ Replacement 3. Q Replacement of 4. Q Reconnection of 5. ❑ Repair of an
ystem System Tank Only____ Existing -ystem _____Ext-----yytem
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 ]SWound 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 2 ❑ In-Ground Pressure 42 ❑ Pit Privy
13 ❑ Seepage Pit 43 ❑ Vault Privy
14 Q 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
Requ§Oftft.) Prop (s . ft.) (Gal` day/sq. ft.) (Min./inch) / Elevation
((~J / gi0 Feet Feet
VII. TANK Capacity Site
INFORMATION in gallons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper-
New Existing Gallons Tanks Concrete strutted glass App.
Tanks Tanks
Septic Tank or Holding Tank 75-0 I Z!~ 1/1' Lin ❑ ❑ ❑ ❑ ❑
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.
Plumber Name: (Print) Plumber' Signature: (N ps) MP/I#M"ffNo.: Business Phone Number:
e 4W71, 73-
Plumber's Address (Street, City, State, Zip Code):
CI Z cJ fn- 4-0 C-1J ( S~eo l
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater nDate e Issuing Agent Signature (No Stamps)
Surcharge Fee) -
%Approved ❑ Owner Given Initial AdverseDetermination
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SHD-6398 (R. 0' 5/94) DISTRIBUTION: Original to Counly, One copy To: Safety & Ruildings Divi>ion, Owner, PlumtKr
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:
1. 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 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 smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must
in 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.
SAFETY AND BUILDINGS DIVISION
ti 2226 Rose Street
scs La Crosse, WI 54603
Department of Commerce Tommy G. Thompson, Governor
03-Oct-97 William J. McCoshen, Secretary
Wegerer Soil Testing & Desig NEIL ANDERSON
421 N Main St
PO Box 74
River Falls WI 54022
ANDERSON, NEIL Plan ID 9720602
SE,SE,19,28,18W
Municipality of KINNICKINNIC Inspector: Leroy G. Jansky
County of St Croix (715) 726-2544
Private Sewage plans including the following element(s):
MOUND 600 GPD
The submittal described above has been reviewed for conformance with applicable Wisconsin
Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY
APPROVED. The owner, as defined in chapter 101.01(2)(e), Wisconsin Statutes, is responsible for
compliance with all code requirements.
This plan action is subject to the conditions listed on the following page(s).
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. All permits required by the state or local
municipality shall be obtained prior to commencement of construction/installation/operation.
This project is under the supervision of a state inspector. As inspection concerns arise feel free to
contact the state inspector at the number listed. The inspector for this project is listed above.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or
at the address on this letterhead. Please refer to Plan ID number listed at the top of this page when
making an inquiry or submitting additional information.
Sincerely
s
Crar~d M. Swim
POWTS Plan Reviewer
(608) 785-9348
SAFETY AND BUILDINGS DIVISION
2226 Rose Street
LaCrosse, Wisconsin 54603
' Vfisconsin
Department of Commerce Tommy G. Thompson, Governor
William J. McCoshen, Secretary
Page 2
'oIl ~f 0 ~
- A Sanitary Permit must be obtained from the County where this project is located in accordance with the
requirements of Sec. 145.135 and 145.19, Wis. Stats, prior to installation.
- Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with
the designated county official in accordance with the provisions of Sec. 145.20(d), Wis. Stats.
I
SBD-5524-E (R.07/96) File Ref:
Page ` of b
MOUND SYSTEM
FOR
A BEDROOM RESIDENCE
LOCATED IN THE 5E 1/4 OF THE SE 1/4 OF SECTION ~0 , T ZS N, R 1S W,
TOWN OF ~c~tyT.1~ClLLUiJIC ST-C,~tol)C COUNTY, WISCONSIN.
INDEX
PAGE 1'of 6 TITLE SHEET
PAGE 2 of 6 PLOT PLAN
PAGE 3 of 6 PLAN VIEW-CROSS SECTION
PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT
.PAGE 5 of 6 PUMPING CHAMBER
PAGE 6 of 6 PUMP PERFORMANCE CURVE P.O,W,T.S.
Conditionally
PREPARED FOR pipROVED
ENS of COMMERCE
OEPXfa E7 NGS
o1vls~0%0
i~l t I L A ~~L-R-S O N
iV~Oo 5 °l15 'Tlt ST'. _ E CORRES DENCE
TZ.\V ~ ~l.L$,Z.11 Sy.OZZ
PREPARED BY
WEGEE;t ER 13 C3 I L TEST I htC3
nES = GhiNDSEE~~1 I CE ~\5 Shy
F.U. BUI 74 421 K. KAIK ST. AMNURL
MGERER
RIVEII FALLS. VI 54022 D-915r
H.LSWORTN,
715-i~.,-0165 W
J I G l; JOB NO. ~7-Z3
.
. I
V:IO+T, CST RV- MK7
•_~~RT ~iL~ 3-30 -4~.
LOT LIKJg r`
dx D
4
r Q
i
A
~1
elevations unless otherwise noted.
each lateral. ( 11 required)
proved caps. ( Z required)
-?acity manufactured by
1D $l~ ~OUO Glrl. W~~Fi2_ ~1PkJN•r.,
So3.13' Ler LI^Je prevent .ponding at the. uphill side.
Page 3 OfJ 6
I
Approved Synthetic Covering
I-rs-rm c 33 Distribution Pipe
Medium Sand
Topsoil H G
F Elev.. qt8~
3 E D
b
Z % Slope
Bed Of 2-2, (Force Main Plowed
Aggregate From Pump Layer
D 0 Ft .
E 1.16 Ft.
Cross Section Of A Mound System Using
A Bed For The Absorption Area F Y, Ft.
G 1-o Ft.
A 8 Ft. H 1.5 Ft.
Linear Loading Rate= q • S GPD/LN FT B 63 Ft.
Design Loading Rate= 0•Y .GPD/SQ FT j 1 ~o Ft.
J a Ft.
K EO Ft.
A! te L 83 Ft.
-Fere W 3 Z Ft.
L
bservation Pipe
$ JK
-
A I - -
o
W -----~1 Force Main
~D t
~Distribution \,-B ed O,f 2M-2-2
Pipe Aggregate
1
Observation Pipe Permanent Markers
(Anchor securely)
Plan View Of Mound Using A Bed For The Absorption Area
Page Of
Perforated Pipe Detail
0
End View
)Perforated
End Cap1 e PVC Pipe Install permanent marker
• f . b~~
at end of each lateral
r Holes Located on Bottom,
Are Equally Spaced
S i
PVC Force Main
P
PVC
Monifold Pipe
. 4
Distn ution
Piee
Last Hole Should Be
Next To End Cap
End Cop
P Z8 S Ft.
Distribution Pipe Layout S
~ Ft.
X 36 Inches
Y 36 Inches
Hole Diameter HIV In5h
Lateral l "Y Inches,
Manifold Z Inches
Force Main Z Inches
# of holes/pipe 10
Invert Elevation of Laterals 91S.-SR.
~oxt.11_ %t.lY-4= gG.80 6PM
Place lst hole tbu from center of manifold with succeeding holes
at 736' intervals. Last hole to be next to the end cap.
' PUMP CHAMBER CROSS SECTION ARID -SPECIFICATIONS' PAGE 5 OF b
VELIT CAP
4'C.L VENT PIPE
WEATHER PROOF APPROVED LOCKING MANHOLE
10' FROM DOOR, JUIJCTION BOX L COVER WITH WARNING LABEL
w1wDOW OR FRESH 12•14IU.
AIR INTAKE i
I -
GRADE.
j2. oI t6 1 y'AIM.
CONDUIT
18'fKIAI.
PROVIDE I
IIJLET ~ AIRTIGHT SEAL I I i I ~
II v
APPROVED JOINT/ A Tank construction shall comply 1 ICI APPROVED JOINTS
with ILHR 83.15 and ILHR 83.20 1 III
I I I ALARM
b I I lit> ON
C
- - - 9oS.oo I
CLCV. FT. PUMP-~
~ OFF
- 0
LT1 qiD O CONCRETE BLOCK
3" ApPRoven
RISER EXIT PERMITTED OULy IF TANK MAIJUFACTURER HAS SUCH APPROVAL. 6E00IN6
SPECIFICATIOMS
005E
TANK MANUFACTURER:~1e Z- CO►~Iejz~'1~ NUMBER OF DOSES: 3 46 PER DAy
TANK 51ZL: 1000 GALLOWS DOSE VOLUME I
DL O 5`1S~1~r1 S _O GALLONS
ALARM MAUUFACTURLR: S.T. INCLUDING, OACKFLOW:
_ U
MODEL IJUMBER: 1 O1 H Lv CAPACITIES: A 1 l WCHES OR yb L 01 GALLONS
SWITCH TUPE: - FBI C()>t2'~-( 8= Z INCHES OR Sl4 G(LLOIJ5
PUMP MAIJUFACTURCR: fly LAS C= g 1lZINCHES OR ZAy.O CALLOUS
MODEL NUMBER: M~1 E SO D- \Z- INCHES OR 114 q. S GALLONS
wlcv~z~ 7-0 - I O 4~.g
SWITCH TYPE: - NOTE: PUMP AND ALARM ARE TO OE
MIIJIMUM D15CHARGE RATE 'I 6-SD GPM IN5TALLED ON SEPARATE CIRCUITS
VERTICAL DIFFERENCE BETWEEIJ PUMP OFF AUD_0I5TRIBUTIOU PIPE.. ~3' SO FEET
+ MIIJIMUM NETWORK SUPPLY _ PRESSURE 2-50 FEET
+ 430 FEET OF FORCE MIN X y'I F~pFEFRICTiou FACTOR. 1'1'80 FEET
TOTAL DyNAMIG HEAD = 33-80 FEET
DIAMETER
t
INTERLIAL DIMLWSIOLIP OF TAWK: LEAIGTH - ;WIDTH ;LIQUID DEPTH 1~.
BOTTOM AREA - 231 GAL/INCH
AS PER MANUFACTURER = Z8'-lI GAL/INCH
ME Series
1/3 through 14/2 HP
Effluent Pumps
Performance Curve
r CAPACITY LITERS PER MINUTE
O 50 100 150 200 250 300 350 400 450
100
90 28
BO 24 Co
~So W
70 w
w/pO 20
U- 60 Z
z o
Q 50 M~~S 16
W J
Q
40 F`SO 12 O
O 33 8n
H
30
y6. 0 8
20 MF33
• 4
10
0 0
0 10 20 30 40 50 60 70 80 90 100 110 120 130
CAPACITY GALLONS PER MINUTE
• 1101 Myers Parkway, Ashland, Ohio 44805-1923
M"zW
419/289-1144 FAX 419/289-6658 Telex 98-7443
K3327 8/92 Printed in U.S.A.
5t//�� / 1 Doh LD P vsc,G�.--
• Wisconsin Department of Industry, SOIL AND SIT - , , L T I O N g
REPORT Page/of 3
' Labor and Human Relations
Division of Safety&Buildings in accord wi ••R 8�, ,�y�` S. Adm. Code.
i���'t COUNTY
Cn �io bi -' S.-r. C R CM(
Attach complete site plan on paper not less than 8 1/2 x 11 i chats in si$A?.?I 'n ffiuStinclude,but,
not limited to vertical and horizontal reference point(BM),dir• tide ancd-b%of slope,scale or PARCEL I.D.#
dimensioned, north arrow,and location and distance to nearest:road. '
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION. REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
Jt'/VA Z)/Du c t< ( (3 0 yEe) GOVT:LOT SE 1/4 5E 1/4,S 11 T ig ,N,R 1e E(or)W
PROPERTY OWNER':S MAILING ADDRESS LOT# BLOCK# SUBD.NAME OR CSM#
7/V7 2MPERr',4t. At)E. So . 4-- cs,q PE41*o (-
CITY,STATE ZIP CODE PHONE NUMBER ❑CITY OVILLAGE DRIWN NEAREST ROAD
COTr/4(6E- GPO OE, MN. 9561Co(V/z.) K5<-!/7d' NNicki,v,vrL QoARRY T .p.
[0/New Construction Use[frrResidential/Number of bedrooms Y : [ ] Addition to existing building
[ ] Replacement [ ] Public or commercial describe ,
Code derived daily flow (900 gpd Recommended design loading rate - bed,gpd/ft2 • trench,gpd/ft2
Absorption area required SO° bed,ft2 S 0 o trench,ft2 imum design loading rate . -S- bed,gpd/ft2 ' 6" trench,gpd/ft2
Recommended infiltration surface elevation(s) S-ag- r% • 3 //8•.3-) ft (as referred to site plan benchmark)
Additional design/site con ' rations 5/'7E- -co/7- /3/E ,2.. Al0 ti-/P
Parent material 5C5 3 6-4 't'�aw - s7REAm T>;RRAC5 Flood plain elevation,if applicable 9/3.s"o ft
7Yp(c CHAP t) 4 PER o
S=Suitable for system CONVENTIONAL MMOUyD IN-GROUND PRESSURE A❑T-S DE _ SYSTEM IN FIB LoLDING T
U=Unsuitable for system ❑S ETU LA'S ❑U ❑S [ t7 [�]' (_•
SOIL DESCRIPTION REPORT
Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence BaLrntary Roots GPD/ft2
in. Munsell Qu.Sz.Cont.Color Gr. Sz. Sh. Bed Trench
r.11.>::>«:I:i]Il:: o/0 to Yp. 2/2- , Si 2 -F S'b Ali irf R T s
g],,::>::<t::::: Bit /D'/e /0 y1 3/ - s/ 2• F rib, n,,N-c le cs Z-F . s . 6,
Ground 2-C-f /Q• 3y' /D yRP s/ .s O c, sc1 , ,L .5.
-- • 7 . p
I 17.elev.2- ft. 2C 39 6- /D YR 5/i S,eE Gb75 - d NASC�r n�,�- — —
Depth to 2.5 � S/g
limiting 5 YR 4/F
factor „
3 -f hi 6k. 5/47 d G44r cD'7"E> 'T-- S4-7r4u E-4>v PROS, /Jlo•-v 6- /00,f0 $
SOS Zo,v4--- or /-//vv.if-j-roAJ -
Remarks. s-}-✓DS -54-7 ,/,1-TFD 47— ' ''.
Boring#
6 F O. 7 /a y,e 2-/2-- s/ 2,f, Si& µ,v-iie q s 3-F • 5 .
L:ii
ti:j
Iii 2 § Q 2.f- 7-if 7•s ye / ------ /5 (.9,c 55 e q.,s . 7 *P
Ground 2C I /I-z, /0 fie `'/ / S 0 It 5. .. n^,► ;t? GS . 5 .6
elev. Z.C 2, 21.Gv /p y,C 5/6, C.9vDD 5 O,,wt. 5. /Iv► ,C. A S• . 7 ' •
a•76, ft.
d'
7sy�e 5/y y 4- o of y
. e /01 7e/e et s — . s . 6
L.Depth to , 3 r
limiting 2.5" y2 5/Q d
factor r, S VA 4/?
)G/
05 Remarks: 544-T t', 4-r e--P' Silzip5 4-7 6 D
CST Name:-Please Print vo G u t '2,Lpp p,t•ck-r— Phone: 7/5-_3 p _vs,...5--
Address: (vSS O'Net`L. tz D. -o1So,0 col • S'fb t le 3-30 - ?,/ es/r� 2 -
W)-
Signature: Date: CST Number:
1
ORIGINAL
PROPERTY OWNER A�5 SOIL DESCRIPTION REPORT Page 2 of 3
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LOCATED IN THE SEj OF THE SSE' I OF SEC S O 19 YT 8N,P R18W, TOWNSHIP OF
KINNICKINNIC, ST.CROIX COUNTY, WISCONSIN.
PREPARED FOR:
Donald and Margaret Pausch E 1/4 CORNER SEC.
19,(000NTY MON-
UMENT FOUND).
NOTE BEARINGS ARE REFERENCED TO W
lTH-~E-AST LINE OF THE SEI/4 ( RECORD j,
BEARING. iN
• N:p
CERTIFIED SURVEY MAP .0
(D n y
V O L•. PG.... I I
N 86° 31 0 15@'E T3 . 58 ~ ~ •I
708.65' , 28.931
}
BOIL ING SET- I Cr..
BACK LINE ~ y
Z ti C9~ (4:
Q: I p.
J ; M o ,Q Z'
o ,n Q.
N
i If0 ~ J.
3 LID T 4
W. 0 9.83 ACRES ; 013 w p:
F-' N ( 4 28, 3 14 S O. FT) 1 ip i• w W.
p, N
0 S. 80AC. EXC. EASE ENTS I W
J. c ( 383,633SO.F .1 i N
0L . z 1 to a I o J;
OI w
°o
I ti
1 a
~ a
R= E 4 S T A 8.3 I 33' 33I' W
1
N88°40 J5 S88°4O'O5"E 366.'31 Q
W 28$ I2
R = _ EAST p
EXISTING' EASEMENT. (0 q1
366.04 W'po '
1u w ; 8 N88°40 U5 "W 399.04 'I I
CERTIFIED SURVEY MAP ic1 O. R+WEST 1
W)
p M I '
O
M Od• I -I
VOL. PG. 00111 UNPLATTED LANDS ti
ti
z p I
VOL.472,PG.593 NII
"A" : Found 1"iron pipe S6010'25"E 4.31' from recorded position.
"B" : Found 1" iron pipe S4006'48"E 4.36' from recorded position.
"C" : Found 1" iron pipe N26057'17"W 0.40' fram recorded position.
DBSC3:?- I PT I OIV
A parcel of land located in the SE 1/4 of the SE 1/4 of Section 19,
T28N, R18W, Township of Kinnickinnic, St.Croix County, Wisconsin, more
fully described as follows:
Commencing at the E 1/4 corner of said Section 19: Thence SOo00'27"E
along the East line of the SE 1/4 of said Section 19 a distance of
1766.28' to the POINT OF BEGINNING:
Thence continuing SOo00'27"E along said line 664.50';
Thence N88040'05"W (recorded as WEST) 399.04.';
Thence N0006'50"E (recorded as S1013'05"E) 74.35';
Thence N88040'05"W (recorded as EAST) 288.12';
Thence N5020'20"W 531.73';
Thence N86031'15"E 737.58' to the POINT OF BEGINNING.
Contains 9.83 acres subject to Quarry Road right-of-way and to an
existing easement over the southerly 66' as shown. Also subject to any
and all additional easements, right-of-ways or conveyances of record.
SURVEYOR'S CERTIFICATE
I, James M. Weber, registered land surveyor, hereby certify: That in
full compliance with the provisions of Chapter 236.34 of the Wisconsin
Statutes and the provisions of the St.Croix County and Township of
Kinnickinnic Subdivision Ordinances and under the direction of Donald
and Margaret Pausch, owners, I have surveyed and mapped the'above
described parcel of land and that this map is a correct representation
of the boundary thereof.
Dated this day of 1994.
GO,
e
James M. Weber S-1804 ARIES M.
NELSEN-WEBER LAND SURVEYING SE_`ER
RIVER FALLS OFFICE (715)425-0164 SPRS. VALLEY I S
MENCMGNIE OFFICE (715)235-6641 Wis. a
o°e0®®eS U i®®e
LAJ
OCT-03-97 FRI 03:13 PM NELSEN WEBER SURVEYING,M 1 715 1425 6864 P.02
B 'Y (.i 1 v7 4
Thic application form is to be cgmpleted in full and signed by the
owner(s) of the property being developed. Any inadequaaieg will
only result in delays of the pezzit issuance. Should this
development be intended for resale by owner/contractor, (spec
hovob), than a second foam sbnul.d be retained and compl.Oted when
the property is Bold and submitted to this office with the
appropriate deed recording. ---W
.+--------------r---------------r_...r-------+.,--`r,,....-
ownerofpropertYr. DU42)> 4wb,jLC4>Je f -VA7JA)n
1',,ocation of property1/45_1/4 , Section ) y IT -Z, N-R )a W
Towtiship 41pw l.Co /1 wic = Mailing address -Ilo ,p Z--, --(Alp 7*.
44 V41 0 • J / 7 r .
Address of site 1 0,,,? dY Ro,4r--:, R) Vek. i-:H -LS', ~Ao ,r 51q 2,.L
Subdivisi ch name MIA Lot no .
other homes on property? YesNm c. paue~►+, t_.}+.-:iYUG
Pro-v3 otlg owner of property r>,aE jEll',uelc.s ,4,srs )u Ctihtvkad
14
Total x1te of property 5,2.y i~tf-'
Total size of parcel .z*4 Jac s
Date parcQ1 was created 190605T, /9 , I ?el
- - w
Are all Corners and lot, lines identifiable? . Yes 110
Is this property being developed for (spec houso) ? , . Yea _ v~~ Na
volume 413- and page Number vZo.~ as recorded with the Register
Of Deed.
------------------.r------^.-------------------.-... n.iw.IWOLDDE WITH THIS AFPLICATIOX TEX VOLLOWING:
A WAPMANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE
NUMH'RR AND THE SEAx., OF WHE REGISTEn or DEVD3. In addition, a
certified survey, if available, would be helpful so as to avoid
delays of tho reviewing process. If true deed description
references to a Certified Survey Map, the Certified Survey Map
shah, aloo ba r&quired.
PROPERTY OWNER CERTIFXCATION
X (ve) certify t1lat, 411 statements an this form are true to the
best of lay (our) knowledge that 1 (we) am (are) the owner(s) of the
proVcrty described in this information form, by virtue of a
Warranty deed :recorded in the office of the County Register of
Deedbi art Document No. 3-7g'LPi4_Q- aDd that I (we) presently
own the proposed site for the sewage disposal system or I (we)
obtained On easement, to run the above described property, for the
conutructi,on of said system, and the same has been duly recorded in
the offiv*j cf the County Register of Deeds as Do No..
signature of Applican Co-Appl.icant c -
Date of S3,gnat xe Date of Signatx e
OCT-03-97 FRI 03:14 PM NELSEN WEBER SURVEYING,M 1 715 425,61864-, P.03
01/FlH11 qy5 12-14 7157737753 NELSON 1'LUt. 44C PAGE E2
t
STC-145
SEPTIC TANK MAINTENANCE AGREEINfENT
St. Croix County
ovn4M BUVF9 HDW 42 7 1.. L 1-* o,i1 p y ' , ~l~, i owl
MAILING AMMS lr? - I--'®1V 90j1-- F-0004*1w kf / R.t
A;2- Asz~-6s
(location of septic system) Please ob n from the P[w.ming D pt, C 1717Y/STATE _ /?-I V 1!Q2. #FA't.,s A
PROPF,R,'ITY LOCATION 1/4, _ 1/4, Section 1 1 N-R ~,S'V
TOWN OF 1 C s1-~ s I U N t c~-
ST. cRarx COUNTY, wri
SUBDMSJON LOT N TMER
f
C ER I'TYMI) SURVEY MA,P VOLUME PAGE LGT NUMBER
Improper use and maintenance ofyour septic system could result in its premature failure to handle
wsrtes. Proper maintonancc 001lsists of pumping out the septic tank every three years or sooner, if needed
by licensed septic tank pumper. What you put into tho system can affect the function of the septic tank
as a trauWent 3UV W th9 waste disposal system.
St. Croix County residents may be eligible to receive a grant for a maximum of 60% ot'the cost
of replamnent of a failing system, which waS iti operation prior to July 1, 1978, St, Croix County
accepted this program in August of 1980, with the requirement that owners of all new systems agree to
keep their system properly maintained,
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 pumpoi verifying that (1)
the on-site wastewater disposal systeM is in proper operating:,cotndition attd (2) after inspection and
pumping (if necessary), the septio tank is less thali 1/3 fail of sludge and scum.
I/Wa, the undersigned have read the 4bove requirements and agree to maintain the private sewage
disposal system in accordance with the standards set forth, herein, eS set by the Wiw.orlsin E)NR.
Certification stating that your septic has bccn nnatutal ned trust be oompieted and returned to the St. Croix
County Zoning Officer within 30 days of the three y Diration e.
SIGNED,
DA'Z'E:
St. Croix County Zoning OiIIC@ Lv f 6/~~7
C3uverMairtCilt Center
t 101 CarmichiLel Road
Hudson, W1 54016 Conch iy~9 f fco
/vo~ 11/93
r
68 mr,101? S,
EASEMENT
sr
This Easement is dated this day of C ,
1997 by and between James M. Zyduck and Debra K. Zyduck, husband
and wife, ("Grantors") and Neil Q. Anderson and Judy L. Anderson,
("Andersons"), husband and wife, as survivorship marital
property, and Edward L. Raymond and Ileane I. Raymond,
("Raymonds"), husband and wife, as survivorship marital property,
("Grantees").
RECITALS
A. Grantors own the real property described at Exhibit A
to this Easement.
B. Raymonds are the owners of the real property described
at Exhibit B to this agreement.
C. Raymonds have entered into an agreement with Andersons
for the sale by the Raymonds to the Andersons of the real
property described at Exhibit B.
D. Andersons plan to install a mound septic system on the
real property described at Exhibit A; the said mound septic
system will serve a home to be constructed on the real property
described at Exhibit B.
E. The property described at Exhibit A also will be the
subject of an ingress and egress easement from Quarry Road to the
real property described at Exhibit B.
THEREFORE, in consideration of the mutual covenants
contained herein,
1
1. Grantors do hereby grant to Grantees a permanent
easement for ingress and egress and for a mound septic system on
and over the real property described at Exhibit A to this
agreement.
2. This Easement shall be binding on the Grantors, their
heirs, successors and assigns, as well as the Grantees, their
heirs, successors and assigns.
Dated the day and year first above written.
GRANTORS:
?4PXL-
Ta~es M. Zy uck
0&' k- ~u b ck
Debra K. Zy k
STATE OF WISCONSIN )
) ss.
COUNTY OF )
Personally came before me this day of OJOb-f/ 1997,
the above named James M. Zyduck and Debra K. Zyduck, to me known
to be he persons who executed the foregoing instrument and
ack w dged the same.
~\G`A K.
101 d
o ary Public
Vi GrGL C unty, Wisconsin QP JAOTA~Y to
My Commission <e?re$ 2-4CXP
U®LIG
~'J► P
9>~ OF ~ `SCOT
Drafted by:
Keith Rodli
Rodli, Beskar, Boles & Krueger, S.C.
PO Box 138
River Falls, WI 54022
715-425-7281
2
VOL 1268PAU030
DESCRIPTION
An easement located in the SE 114 of the SE 1/4 of Section 19, 728N9 R18W, being
part of Lot 4 of Certified Survey Map recorded in Volume 10, Page 2752,Town of
Kinnickianic, St. Croix County, Wisconsin, more fully described ns follows:
Commencing at the Southeast Corner of said Section 19;
Thence N00°0012711W along the east line of said SE 1/4, 208.70' to the south line of
Lot 4 of Certified Survey Map recorded in Volume 10, Page 2752;
Thence N8804010511W along said south line, 33.00' to the west right-of-way line of
Quarry Road and the POINT OF BEGINNING;
Thence continuing N88°40'05"W along said south line, 366.04' to the west line of
said Certified Survey Map;
Thence N00°06'50"E along said west line, 74.351;
Thence N60059125"E 177.491;
'T'hence S88°40'05"E 211.63' to the west right-of-way of Quarry Road;
Thence S0002015711W along said west line, 164.02' to the point of beginning.
"HIBIT
+ VOL 12-68PACt039.
J
ODE§CR1PT10N R18W
A parcel of land located in the SE 1/4 of the SE 114 of Section X3; T28N, ,
Town of Kinnickinnic, St.Croia County, Wisconsin, more fully described as follows:
Commencing at the SE corner of said Section 19:
Thence NO0°00'27"W along the East line of the SE 1/4 208.70' to the POINT OF
BEGINNING: -
Thence NW40105"W 399.04' (recorded as WEST);
Thence S00°06'50"W 208.70' (recorded as S01°13'05t'E) to a point on the South line
of the SE 114 of said Section 19;
Thence N88°40'05"W along said line 503.72';
Thence N01*49'55"E 283.011;
Thence SW40'0511E 894.11' to a point on the East line of the SE 1/4 of said Section
19;
Thence S00°00'27"E along said line 74.35' to the point of beginning.
Contains 3.93 acres (171,003 Sq. Ft.) subject to Quarry road right-of-way and any
and all additional ease aeots, right-of-ways or conveyances of record.
lawXH1BIT B
/8va t4,
DOCUM9NT NO:
EASEMENT
REGISTERt' OFFICE
ST. CROIX CQ„ WI
Re;ld for It~nr4
OCT 0 2 1997
1:30 PM
Re stor of Dssds
. . . . . . . . . . . . . . . . . . . . . .
NAME AND RETURN ADDRESS
Rodli, Beskar, Boles & Krueger, S.C.
219 North Main
PO BOX 138
River Falls, WI 54022
Parcel Identification Number (PIN)
"THIS PAGE IS PART OF THIS LEGAL DOCUMENT-DO NOT REMOVE"
I
a
L&L F'AFFTNERSHIF IIi:602488,1936 REF 04'97 21:43 No.002 F.02
• . a Y Stock No. 13001` NC MdIm Gary uryljy~I
DOCUMENT NO, r~ „y s
v~#~' ff STATE BAR OF WISCONSIN-FORM I
-0
y. w
I r l3~ WARRANTY DEED
i 13 Ir 2P'4~ THIS SPACE RESERVED FOR RECORDING DATA
THIS DEED, made between -_Donald-j_ -P auses "Er S ERS OFFICE
1? A.t, s nh T ar~,a~.e_f~_.C--._
u, p-__f~•~ck-and Harriet,
--Mas~E~~rrr_ck,_ 3"1. CROIX Co., WIS.
hra.nsn~g- 9 n r+nmmnn
Ric'd, for Rooord thlq 19th
- f]tant0Is
and Edwa__rdd L,_RaWQp4 agd Ilene I, Ra_ym day of n A.D. i9-ai. ~
on_d husband _ -•-r:.~u.at".
li and f~_._a8_-_ G;I tenanhg at 830 A
Granteag {
Wi t n e s s e t h, That the said Grantor, for a valuable consideration --M1, 00) Rp Dow$ Ji
jl One. Dollar
ansL_Q~hsr-_ v
conveys to GtRntee the following described real estate in URN To
CrD1X
County, State of Wisconsin:
chat certain parcel of land located in the Southeas
of the Southeast k of Section 19, Township 28 Nort
Range 18 West, Town of Kinnickinnic, St. Croix County, Tax Key No.
Wisconsin, more fully described as follows;
j ?ommencing at the South 4 corner of said Section 19, thence N 90000'00" E
(assumed bearing along the South line of the Southeast
a distance of 1755.22' to the POINT OF BEGINNING of the pIL4 of sid Sion arcelato becherein9)
described; thence N 00030'00" E (recorded as N 0a , „
283,001; thence N 90000'00" E 495.23'; thence S1013'05" E)283.05'; thence
;i
N 90080'00:1 W 503.72' to the POINT OF BEGINNING, containing 3.24 acres,
more or less, incluJing an easement for ingress and egreRp more f!rll.y II
described as follows;
EASEtENT DESCRIPTION:
Com,nencing at the South corner of said Section 19, thence N 9nor; , 00r, E
(assumdEd bearing along the South line of the Southeast
I of said Section 19)
.'his.__I,4-NOT -homestead property. CONTINUED ON ATTACHED SHEET
W') OR not)
Together with all and singular the heredita-m-rits and a
ppurtenances thereunto belonging,
And
-Grantors-_
warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except _ l
T' ~~LT1S~'r~t~ !I
and will warrant and defend thH same.
Dated thus Z3 d day of --Ju-ly
f~ ? d
(SEAL) (SEAL)
I H. nck +_-Donald _ J Pausch
y
(SEAL) (SEAL)
arriet Mae E iynck *__fargaret_._C._Pauaeh--_----_
AUTHENTICATION ACKNOWLEDGMENT
Signatures authenticated this------.. 231dday of S'T'ATE OF WISCONSIN ~
19.81. t ss.
Cnun}v (l
_ T
12
9 r; , '9 1994
51599 JAMES O'CONNELL
flogister of Doed3
St. Croix Co., Wl /
C E RT 1 FI E SURVEY MAP
LOCATED IN THE SE4 OF.THE SE4 OF SECTION 19, T28N,-R18W, TOWNSHIP OF
KINNICKINNIC, ST.CROIX COUNTY, WISCONSIN.
PREPARED FOR:
Donald and Margaret Pausch EI/4 CoRNERSEC.
19:(000NTY MON•
UM ENT FOUND).
NOTE: BEARINGS ARE REFERENCED TO iO
TH~~ ST LINE OF THE SEI/4( RECORD _ ~N
8 ERRING.
0;0
N:0
• ~
X00
C E R 11FIED SURVEY ASAP 0
V O L.:. PG.....?'.3
N 86° 31 1 5" E 58 28.93
708.65' 1 1
1
1 }
BUILDING SET•
84CK LINE -J\~ , I
_109 14
Z
Q•
In ' N v I J,
o. 3 L0 T 4 I 0l0 W
0 9.83 ACRES y 3 H p•
W• N W W•
N ( 428,314 SO,FT.) 1 ~I
- 8.81 AC. EXC. EASEMENTS W x
N ( 383, 633 SO. FT.) I in N 1• I
Q• ° 1 I to N 4 a.
a• z ~ N c~ w a.
Z• A PPROX. 100 YR. 1 ° Z Z•
FLOOD ELEV. LINE/ i ( NI J
(913.5). f
I
1 N
1 Q
' w
I
R = EAST (Dill, 8.54' 33'33I'
-r~ S88°40'05"E 366.31 C
N 88°40 05 W 288, 12 _ R 2 EAST _ ^ _ 0I
O EXISTING EASEMENT. 0 0•
t0 0 co
0
366.04' 033.0 I
UNPLATTED LANDS ;B N88°40 05"W! 399.04 I '
= R= WEST.
0 L0
0 00~ TTED LANDS ~I
PPROVEd
01
VOL 472, PG. 593 , I
APR 2 9'94.1'
SE CORNER SEC. 19
<15
DOCUMENT NO. ! STATE; BAR OF WISMIC&1•~t FoRm 1--1mIl Twin srAca sssew= roe stcoiw" o^vA
7 WARPLANZY DI
IS_
This Deed, made betwesa __DQna-id-__•I~ P~tlxs Wit) Rex.4 a-ft ham.,
Margare_t.-C.._Pausoh,__-husband:__az►d--mkf
Hamlet--.Mae_Ei_ynck__A/kj_a._.Harries.J,__, iyn-_6C, MAY 2 4 1994
-as.._tenants__-in__rammoa_______.__-_______ ciran4or, 8:45 - - A.
and- James .--M-___ Y_dur_iL__etch__Debx.a__14~__~. + i~. t
..husband..and--_wtile_.
proper rX ~aratl9ses+~
- - . Grant*%
Witnessetb, Twat as aaid ?T- . tar a atok i........
x
conveys to Grantee the follo
eriatanerlbad ris2 aata&a is ___SL.>L_S•LS)jX.......... etT""" TO FA00LI
S S
County. State of Wiseoaein: X10 , ~j oot lt~t +~jd
,L+C-r1(
Lot Four (4) of Certified Survey Map, in
Volume 10, Page 2752, as Doc. No. 515993, Tax Pszcei No:._
I Register of Deeds' office, St. Croix County,
Wisconsin, located in the SE} of the SEk of
Section 19, T28N, R18W, Township of Kinnickinnic.
Cy'
FEE
This . ~O hanleateQ proswertY-
(is) (is nom)
Tocether with all and ahwdar the hem sma appurtenances thereunto belonging:
And------ Gx_aJtJrj----
warranta that the title is
SW4 iadefeasibie in fee siae
Yie and free and clear of encumbrances except
easements, restrictions, and rights-of-way of record, if any,
and will warrant and defegd the mme-
'w' of _h • ig-.94--.
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