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HomeMy WebLinkAbout026-1015-80-000 a o ass °o I ~ oo I ~r Q 6°a p ~ ~i ap N CD N 0. 0 _ o E °o ~ a I I N y c ao I I a aD rn °E I I ^o x m aEi w BD ° V1 U T y y cc = n _ m :t2 z v 3 U N M OOi U') m ¢ z aa) iz~ = zCD zU) CD r- I. C co LL C y _ o + o I o I - 3 ~5 OE v o 0 Qom: E QN a m m E E co O Y O O O z E 9 d m d (D ce) uj a m a co I o I o Z a c I c ~ I m ~ > 0 o o o O Z c c rn rn Z 0 I- CD (D c o v 2 CO o a~ o aD S N o. y a a~ N y I m o N wall C_ 0 z°mz zomz co o m v LO c Lo 16 E L E N 4. CL d N N C y d 2 N L ' 0 0 No o c o a m Y E G G CL o to N I z~ j L N U) N 0 tv) mm ~v ~ v r DI 2 o r r d co 3 3 3 z } o Oo Oo N a a s N d Z Z r 2 Q ¢ co co N V n N p 0) OOi U) J U m CD M o I o) 't E c, 'ooo m o U~ m o U p (n N rn O 9 ai o~ d QI ~ iA I ~ 'ri d Q} in m I O C C O O „Cd~ p 0 N N v N N N V d O O roU~ C -2 -2 N N O O c N N N C OD C y ` m co r C C c O o o E E co d o 0 2 ctOO w w rn N V L N O 0 N W 70) O 0 0 U T ~S O O F- t~ Z N 2 2 Q N O Z 2 O 4 a~ r~ of = E E m y a • o `m a d c d = m r- r~ Parcel 026-1015-80-000 10/11/2006 02:32 PAGE 1 OF 1 F 1 Alt. Parcel M 04.30.18.54C 026 - TOWN OF RICHMOND Current XI ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner O - AURORA RESIDENTIAL, ALTERNATIVES INC ALTERNATIVES INC AURORA RESIDENTIAL PO BOX 68 MENOMONIE WI 54751 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 1710 CTY RD A SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 2.000 Plat: N/A-NOT AVAILABLE SEC 4 T30N R1 8W 2A IN SE SE BEG 440' N & Block/Condo Bldg: 55'W OF SE COR SEC 4 TH W 208.8' N 208.8'E 208.8' TH S 208.8' TO POB Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 578/89 BEING CSM VOL 2/598 04-30N-18W Notes: Parcel History: Date Doc # Vol/Page Type 11/14/1997 568561 1277/051 QC 07123/1997 991/449 WD 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/19/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 40,500 127,600 168,100 NO Totals for 2006: General Property 2.000 40,500 127,600 168,100 Woodland 0.000 0 0 Totals for 2005: General Property 2.000 40,500 127,600 168,100 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 s AS BUILT SANITARY SYSTEM REPORT OWNER (k)\56 l_~ro i S~I~C' TOWNSHIP i~10-i~vyvj-vj6 SEC./ T,~611, RJFW P.O. ADDRESS , a_ ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW 7( - I cal S - &b p OL7p Distances & dimensions to meet requirements of H62.20 `~c~; SHOW EVERYTHING WITHIN 100FEET OF SYSTEM go V-S A © goo, . V Y7d ' ,~L7~~~ 5L ~ ~ d SEPTIC- TANK(S) MFGR./&9 f~S c`i' ne"' CONCRETE Z/ STEEL NO. of rings on cover Depth ? DRY WELL TRENCHES No. of width length area BED no. o lines widt~i leng !Z P/ /Z _ dept t(),, top of pipe-,- AGGREGATE 3/ -~v s h,,-, C! PERK RATE 5 AREA REQUIRED i 3 AREA AS BUILT /ilea ~ DISCLAIMER: The inspection of this system by St, Croix County does not imply complete compliance with State Administrative Codes_ There are other areas that it is not possible to inspect at this point of construction. St. Croix County assumes no liability for system operation. However, if failure is noted the County will make every effort to dete ne cause of u GREASES AND OILS SHOULD NOT BE DISPOSED THROUGH TH YSTE . INSPECTOR .DATED PLUMS ER ON JOB LICENSE _3 REPORT or. ills PEC ION--I IDIJIDUAL SEWAGE DISPOSAL SYSTEM Sanitary Permit r State Septic L~C G'C?~ TOt•RJ S H I P ~L . • t. Croix County SEPTIC TA'111 Size gallons. `umber of Compartments • Distance From: !-jell ft 12% or greater slope ft Building' ~ ft. Wetlands f: Iiighwater eft. DISPOSAL SYST A Tile Field or Seepage Pit(s) Mstance From: Well (9 ~ ft. 12% or greater slope* - ft Building; eft. Wetlands f z. FIELD Hifhwater Total length of lines ft. Number of lines ,-F Length of each line ---eft. Distance between lines ft. Width of the 1 reach ft. Total absorption area sq. ft. Depth PO f rock Uelow tile Lin. Depth of rock over tile, in.. Cover .nver.rock., Depth of tile below grade in. Slope of '33 trench in er 100 ft. Depth to Bedrock ft. Depth to ground water PITS Plumber of pits 0 ts'de d' eter ft. Depth below inlet ft. Gravel ar nd pi es, no. Total absorption area sq. ft. .Square feet of seepage tre ch bottom area required :square feet of eepage n' ar a required - ' Inspected by. Title':. , Approved Date 1975. EH ,1,15 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 ' MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS, LOCATION: Section , T~N, RZZ E (or) W, Township or Municipality D h Lot No. , Block No. County - z' Subdivision Name Owner's Name: Mailing Address: TYPE OF OCCUPANCY: Residence No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS fflRCOLATION TESTS - , SOIL MAP SHEET SOIL TYPE PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN jG ~ ~o r ,~Q ~ ~ ~Z 3 ~ ~o ~ S P-1 P-1 3i SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) s a ~ B S7'-S _ 7JZ 5"s- y'~; PLAN VIEW (Locate percolation tests,soi I bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas . Indicate n ber s uare feet of abso rea ILal t '25 /_2 needed for building type and occupancy. d d S/~' or distances. Give horizontal and vertical reference poin ndicate slope. cr/ ~ 3 ~ N f t 1 17 State and County State Permit # PLB67 ' Permit Application County Permit - for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY ;jG Address: B. LOCATION: "Y4 L Y4, S ion T.3,9N, RLff f (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township C. TYPE OF OCCUPANCY: Commercial *Industrial er (specify) *Variance Single family C/ Duplex No. of Bedrooms No. of Persons D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder AXjfFSXN0 # of Bath roo Automatic Washer L---'ES NO Other (specify) E. SEPTIC TANK CAPACITY Total gallons No. of tanks *Holding tank capacity -Total gallons No. of tanks ' New Installation Addition Replacement Prefab Concrete y *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 1_1572) , 5-3) , ! Total Absorb Area / y2 FD sq. ft. New Addition Replacement *Fill System Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches _ Seepage Bed: Length 70 'Width /3 , Depth ? dTile Depth 'Zy No. of Lines 3 Seepage Pit: Inside diameter Liquid Depth Tile Size Percent slope of land :3% - S el',,- Distance from critical slope I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Ce ied Soil Test~f NAME C.S.T. # and other information obtained from (owner/builder). Plumber's Signature MP/MPRSW# 40 e,- Phone y S Plumber's Address -VX! 1 PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). Ci q% / • a ~ State Permit # PLB67 State and County Permit Application County Permit # for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: B. LOtATIONIV _SF Section, Tj~N, R E (or) W ot# City_ Subdivision Name, nearest road, lake or landmark Blk# Village Township /0K I- C. TYPE OF OCCUPANCY: Commercial *Industrial *Other (specify) *Variance Single family Duplex No. of Bedrooms No. of Persons D. TYPE OF APPLIANCES: Dishwasher DES NO Food Waste Grinder YES tom- # of Bathrooms- Automatic Washer C-fl`S NO Other (specify) E. SEPTIC TANK CAPACITY f' e3l ' Total gallons No. of tanks d2n-t *Holding tank capacity Total gallons No. of tanks New Installation Addition Replacement _ Prefab Concrete d-"4-- *Poured in Place Steel Other (specify) F. E F F U NT DISPOSAL SYSTEM: Percolation Rate 1) 5 2), 3) Total Absorb Area A sq. ft. New-X Addition Replacement *Fill System Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches Seepage Bed: Length Width / 4 , • Depth G Tile Depth ;Z V No. of Lines 3 Seepage Pit: Inside diameter Liquid Depth Tile Size ~/D Percent slope of land Distance from critical slope I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the CertifSoill/ Tester, NAME c. !t A e Peg ) kL,`7 C.S.T. # and other information obtained from (owner/builder). 14 .1 Plumber's Signature MP/MPRSW# _~-Phone # Plumber's Address PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). rr n 1 v 1 $ l 9 STC - 104 AS BUILT SANITARY SYSTEM REPOR ~0 RE~ n d e ~vE • 4 OWNER ,GL`O NOV 1997 ST CFKXX MOW ADDRESS --5 ZONINQCE SUBDIVISION / CSM# LOT SECTIONf T~ N-R_/g W, Town of ST. CROIX COUNTY, WISCONSIN X /srl J~ ~ V '$W SHOW EVERYTHING WI 9j100 FEET M i ~ y \ y oCN INDIC E NORTH ARR W Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: 30X CTERNATE 0 ! (vs~ BM: X00 D.~r ~~.w a d ®~-E" ! ~ • EPTIC T / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: n Liquid .Capacity: o~ _ I 0 6 Setback from: Well House 5 Other Pump: Manufacturer Modell Size Float seperation - Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: Length d Number of trenches / Distance & Direction to nearest prop. line: < i Setback from: well: c-7?0 Ll- House_(Z,1~_ Other ELEVATIONS Building Sewer -r(IZI ' ST Inlet: Chi ST outlet: q-7-57 PC inlet PC bottom Pump Off Header/Manifold--,L? 61- Bottom of system Z3 ~Y12n'~i Existing Grade Final grade DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: p2 INSPECTOR: /e /7) 3/93:jt Wisconsih Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Buildings Division INSPECTION REPORT ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitarltrgi ft: Personal information you provice may be used for secondary purposes [Privacy Lag, s.15.04 (1)(m)). pegt erk DENTIAL ❑ Town of: State Plan ID No.: CST BM Eleva.:~r Insp. BM Elev.: / BM Descri tion: A xy Parcel TUN-;,015-80-000 100 TANK INFORMATION ELEVATION DATA A9700480 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Benchm rk,., Septic p coo Dosing Aeration Bldg. Sewer Holding St/ Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet 7 57 ' TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic 7 f 25 j p` NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe g•c/~ ~3 . ~b Holding Bot. System .S/' `12. 2* PUMP/ SIPHON INFOR ATION Final Grade 6c{r 7. 2-:(" Manufacturer Demand A141 QM -9;;J a, 00 •W Model Number GPM TDH Lift Friction System TDH Ft Head Forcemain Length ia. Dist. To Well 5 L ABSORPTION SYS ,EM &0' BE / TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth EN I N 21 `NCO DIMENSIONS LEACHING Manufac rer: SETBACK SYSTEM TO P / L BLDG WELL LAKE /STREAM INFORMATION TypeO CHAMBER Moe lumber: System: ~C"'/t.o nom' r 90 + Itip OR UNIT DISTRIBUTION SYSTEM &e;l M 7 7 21 ,Header/ Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Ai Intake Length Dia. Length 5? Dia. Spacing - - 7 2 5- 1 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over A xx D th Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed/ Trench Edges Top it ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, u.) LOCATION: RICHMOND 4.30.18.,54C E, S~ 1710 CTY RD A 81 sc4/?-3o3y y d~ 4- 1 ~o tR rG i~•9-7 PlaF1evtston required? ❑ Yes ❑ No I Use other side for additional information. 1l 3 SBD-6710 (R.3/97) Date Inspector's ignature Cert . No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: Fw 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 C /J than 8 112 x 11 inches in size. ro • See reverse side for instructions for completing this application State Sanitary Permit Number Z67q/~ The information you provide may be used by other government agency programs ❑ Check it revision to prewdus application (Privacy Law, s. 15.04 (1) (m)]. J a4-ft-e/ - State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Property Owner Nam Property Location ~Td ~cr- x`1/4 1/4, S T p, N, R E (or Property Owner's Mailing Address Lot Number Block Number i r C""its~, State Zi ode Phone Number Subdivision Name or CSM Num r Vle c,c~ J 7 1(11';),0V6- r/d II. TYPE F BUILDING: (check one) ❑ State Owned ❑ city Nearest Road p village Public 1 or 2 Family Dwelling - No. of bedrooms iief OF j` w III. BUILDING U : (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 4` gQ.18- 51ce O c/7- V _ 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. ❑ New 2 eplacement 3. ❑ Replacement of 4. ❑ Reconnection of 5_ ❑ Repair of an System S~jStem 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 1 1' 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/7y/sq. ft.) (Min./inch) Elevation 112- 75,o a , Feet Feet TANK Capacity VII. INFORMATION in gallo Total # of Prefab. Site Fiber- Exper Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Exist in strutted Tanks Tanks Septic Tank or Holding Tank I X, L20 470 0 El ❑ Lift Pump Tank /Siphon Chamber El VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume esponsib or Installation o Ee-onsi a sewage system shown on the attached plans. .Plumber's Name: (Print) Plumber' gnature: (No amps) MP/MPRSW No.: Business Phone Number: Plumber's Address Street, ity, State, Zip Code): "54_41 :5 IX. COUNTY/ DEPARTMENT USE ONLY Disapproved IJOL nitary Permit Fee (includes Groundwater ate Issue Issuing Agent Signature (No Stamps) ~O Surcharge fee) f q Approved ❑ Owner Given Initial 1/. -7 Q Adverse Determint` X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-6398 (R. 05/94) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Divi ion, 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: 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 8 112 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; F) 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. PLOT PLAN PROJECT Aurora Residential ADDRESS 1710 Countv Road A New Richmond Wi 54017 SE 1/4SE 1/4S4 /T 30 N/R 18 TOWN Richmond COUNTY F'(51:1(- 5+, Crp~ x MPRS Shaun Bird 3532 DATE11/10/97 BEDROOM 5 CONVENTIONAL )XX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 2-1000 Gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE.7 ABSORPTION AREA1080 BED SIZE18' X 60' BENCHMARK V.R.P.Top of Fence Post Orange Ribb. ASSUME ELEVATION 100' ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark VENT SYSTEM ELEVATION 92.4 12" GRADE TYPAR COVERING 1 3' 6' Q 3' 3'(1) 3' Existing 5 Bedroom House SEWER R()CK B.MB-2 140' 5' Vent I _1_1 45' I I 80, ( 18'X 60' Bed ST I I I ST 80' 2-1000 Gallon Septic Tanks c~ 1 B-3 25' B-1 6% Slope Failed System Vent 150' County Road A Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of Bureau of Integrated Services in acco/~~ v~gt R 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1 14 si* Plan ~Y ~ include, but not limited to: vertical and horizontal ref point O '5~, C r b ) ! , percent slope, scale or dimensions, north arrow, lion and dista _ Parcel I.D. # L 'go APPLICANT INFORMATION - Please p -,till infdlig ' 97 Reviewed Date Personal information you provide may be used for seconda -Moses 'F- 15.04(l ) • 7.97 64 Property Owner " Location GG,~`Dr ev \ Lot 1/45E 1/4,S T36) N,R / g E (or) W Property Owner's Mailing Address of # Bkx*# Subd. Name or CSM# 20 r lrolC2s9 City Sta Zip Code Phone Number Road ❑ City [I village Town /00 ❑ New Construction Use: Residential / Number of bedrooms Addition to existing building Replacement Public or commercial - Describe: Code derived daily flow J~O gpd Recommended design loading rate ~ / bed, gpolfF_, 3-trench, WW Absorption area required,/ bed, ft2 trench, it2 Maximum design loading rate bed, gpdAt2 _-9 trench, gpd* Recommended infiltration surface elevation(s) / of it (as referred to site plan benchmark) Additional design/site considerations Parent material Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In-Ground Pressu rade System in Fill Holding Tank U = Unsuitable for system s ❑ u ❑ u El u 7R ❑ U ❑ S ,V ❑ s u SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Stricture Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench i / 7: 4 Ground elev. / Depth to limiting factor Remarks: Boring # / D- a. l'S 13 3 a , i Ground Vitt. Depth to limiting factor ,f . in. Remarks: CST Name (Please Print) Signature Telephone No. Address Date CST Number z, 40671 IZ~ C Z2 SOIL DESCRIPTION REPORT PROPERTY OWNER Page of PARCEL I.D.# Boris # Horizon Depth Dominant Color Mottles Structure 2 • g in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed , Trench C V/ 9Ground 3 0 [V Depth to limiting factor l D in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # ; Ground elev. ft. Depth to limiting factor 'n. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD-8330 (R. 07/96) , I Soil Test Plot Plan Project Name Aurora Residential Shaun Bird. Address 1710 County Road A New Richmond Wi 54017 ` C§f4 #3922 Lot Subdivision Date 10/20/97 SE 1/4SE 1/454 T 30 N/R 18 W Township Richmond E] Boring ()Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Fence Post with Orange Ribbon System Elevation 92.4 * H R P Same as Benchmark Existing 5 Bedroom House * B.M. 140' 5' B-2 45' 6% Slope 0, ST ST c 10' 25' B-1 B-3 Failed System Vent r 150' County Road A 348'7'72 8 !s FILED S89°SD'E 90 . 208. $ O ' ~ . MAY 23 1978 ~ 00- D. ti Yj JAMS O'CONNELL An W w.r of Deeds a% Croix swer _ ~i 4 ~,1„' w1. 0008 ACREt 3 C W 3 Z o m `Y3,597 SQ FT. 0 0 \v15 0 VI C ti ~ \NOR Sv V p\. W O h •\e\\S M pee~0 o ~H~ PeeROV No Moo ~QA\C' OP 20A.&O' ae9•so'w S Al 69'S6 'UJ S.O' E o 51t 6.6 'ovoA ROVR T ko" ,APPROVE a I 0 100 zoo MAY 17 1976 I SCALE l" lOD ' X if IS T/n/GX x L~. 3 X -X O = / "MOA/040E 407. Cit0iA GJ11~~t'►` FSN6A-LM 9 1 0 Po.B '4aW,REHENSIVE f947iKffi VUKN~tT't I AAQ ZONIN65 COM"T66" R CERTIFIED SURVEY ( h~ PA RT O F TH E S E /q O F THE SE 1A 3 E 3 SECTION 4 , T 30 N , R 18 W, TOWN OF R►CHMONO , ST. C20IX COUNTY, WISCONSIN. DESCRIPTION Part of the SE4 of the SE!, Section 4, Township 30 North, Range 18 West, Town of Richmond, St. Croix County Wisconsin described as follows: Commencing at the Southeast corner of said Section 4; Thence N 00 10' E. 440.0 feet; Thence N 890 50' W. 55.0 feet and this being the point of beginning of this survey; Thence continuing N 89 50' W 208.80 feet to a goint; Thence N Oo 10' E 208.80 feet to a Boint; Thence S 89 50' E 208.80 feet to a point; Thence S 0 10' W 208.80 feet to the point of beginning. This parcel of land contains 1.0008 acres more or less excluding land released for highway right-of-way purposes. SURVEYOR'S CERTIFICATE I, Richard D. Booth, being a duly qualified surveyor, do hereby certify that by order of and under the direction of Jim Gretz, I have surveyed and mapped the property described. The plat shown on the sheet is a true and correct representation of the exterior hhnurHpriec of the lard qurvPved and that I have complied with the STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County p t (DV FR~UYERcl y c~l'c~ ~G S e 1n_iS~.~ /s~ ~c~Ti c° 1-~►.~ , MAILING ADDRESS P El 6 6 9 I► ) PROPERTY ADDRESS /7/0 AAJ~jj' 11~/o A. e_W _i&A vt (location of septic system) PI obtain from a Planning Dept. CITY/STATE l r) C a~(L~~/~ PROPERTY LOCATION 1/4, 1/4, Section s T-3Z> N-R_& _W TOWN OF 18A r) y` [X ST. CROIX COUNTY, WI SUBDIVISION _ LOT NUMBER CERTIFIED SURVEY MAPS 87 VOLUME PAGE; LOT NUMBER I Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in 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 pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. 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: f J ' l U St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 -r~ 4o a This application form is to bescomp--eted in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. --------------------//-----------------------------`----i--------- owner of property Location of property _4 1/4 1/4, Section T_~>N-R_ff _W Township k-"-- WLO&LL Mailing address ov~.t e Lc~.~ S~/7S I Address of site w Subdivision name Lot no. Other homes on property? Yes No Previous owner of property i ✓ Total size of property 45~d 08 2[/`i QA Total size of parcel ✓dy~a v Date parcel was created Z 2 / `2 72 Are all corners and lot lines identifiable? Yes No Is this property being developed .~~~for (spec house)? Yes No Volume and Page Number 7 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. In addition, a certified survey, if available, would be helpful so as to avoid 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 offi e of the County Register of Deeds as Document No. , 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 construction of said system, and the same has been duly recorded in the office f the County Register of Deeds as Document No. S,5 nature of Applicant Co Applicant 7 /47 Date of Signature Date of Signature 010CL0146 t NO- WAWUWVV 000 ,wi..wUM .w w I ar+s Si AT-_ BAR OF wL&70 M FOBS[ I - IM 494MG 449 Is M KCNO MV" IMa'+atorRxo~d . ..........w... . - ~FEB 11993 eauwop ow ww"afs'ti _~'`~Q III.- 111 d11nt~ t1_ IIJ.LII~zu,A ixles 01:00 A. . A M. ♦ «..N First V&&icrjd BMW* f 1~ Se[7ond ft. tM "FtsBo~r( 3loooiboi tMl oob/M A,...CLfaiZ._._.«.....Caant~. So of Tlaeooib: TAM flawt Iii:..........._ Ccwa"cing- g at s point 440.0 feet Worth and 55.0 feet Nest of tbs Southeast corner of said Section pour (4) on the Nest right-Of-way of C.T.H. -A- and this being the point of beginning of this surveti-thence continuing Nest 248.80 feet to a points thence I forth 208.80 foot to a points thence Bast 208.80 foot to a points thanoe South 208.80 feet to a point and the point of beginning of this, survey, also described not Part of Southeast Quarter of Southeast Quarter (Ss1/4 of 891/4), of section Your (4), Township Thirty (30) NOsth, Range Ei3hteen (18) Nest, described as follows: Certified j; Survey Nap is volume ■3", Page 598. !t This Deed is given in exercise of the Option to Purchase between th& Grantor and Grantee bersto. ii TNi 111. e...._ hoameshad go upor1a, ~tW t1o pot} - Ruwtios to va sett,,,: easements, restrictions and rights-of-way of record, It any. v » Jannarg is DoW this dy d 93 r Ni ; owes, Inc. .(81111 by: . (8ZAL) . • .......r .................................................(SIZAL) .(SEAL) AUTUNUTICATION ACKNOWLSDGMZNT (o) :«!►f!lY1!1 L STATS OF WNCOMM s oatia~tod tttlo 1 y o .«iT.ilgl~aXY--... lti-S~ Paioaaft ar befw* a tW day of 19____ the abow nmod wRsistia0 land 1 1', is >A sTAVX 811E OF wiscom8laQ . (U AOL 11 MMM~ hr a mists. wbi. t&i.?" L a.........~.a eh. ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the G~✓ orw sli „ residence located at: S 2 Section T,7 N, R_Zf W, Town of Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced: - 52' 7 Did flow back occur from absorption system? Yes No (If no, skip next line) Approximate volume or length of time: gallons minutes capacity: Construction: Prefab Concrete Steel Other Manufacturer: (If known) Age of Tank (If known): i fir (Signature) (Name) Please print 62't'av'7 0 lS3 Y (Title) (License Number) 3 ~7 Date Form to be completed by licensed plumber (s.145.06, Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements of ILHR 83, Wis. dm. Code (except for inspection opening over outlet baffle). Name S_ Z~C ry✓~^~ Signature P/MPRS ✓