HomeMy WebLinkAbout030-1017-80-300
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Wisconsin Qepartme aooIndustry, SOIL AND SITE EVALUATION REPORT Page 1 of 3
Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but St. Croix
not limited to vertical and horizontal reference point (BM), direction and % 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
Donald Nestrud GOVT. LOT 1411 1/4 NE 1/4,S 5 T 2 ,R or) III
PROPERTY OWNER':S MAILING ADDRESS LOT # BL K # SUERR. NAME OR CSM
1194 42nd.. St 1 na n/a
CITY STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE MOWN flina EST RO
HiAosn, WI. 54016 (715l 549-659f3 Hills TrJ_
Ro!
[XkNew Construction Use Residential / Number of bedrooms 3 [ J Addition to existing building
(J Replacement Public or commercial desaibe
Code derived daily now 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 • trench, gpolft2
Recommended infiltration surface elevation(s) 106.40 ft (as referred to site plan benchmark)
Additional design / site considerations n/a
Parent material outwash plsin Flood plain elevation, if appricable n/a ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem US ❑ U as ❑ U ❑ U EaS ❑ U ❑ S 5311 ❑ S E111
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft ...mow......
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed rertctt
l 1 0-7 1 r3/3 none L. 1/f/ P1 mfr /w 2/f .0 3
13 2 7-24 10yr5/4 none sicl 2/m/gr mfr g/w 1/f .4 .5
Ground 3 24-36 10yr4/4 none sl. 2/m/sbk mfr g/w 1/f .5 .6
elev.
107.0 ft. 4 36-80 10yr4/4 none ls. 0/sg ml n/a n/a .7 €.R
Depth to
limiting
factor
>80"
Remarks:
Boring #
1 0-6 10yr3/3 none L. 2/m/gr mfr g/w 2/f .5 .6
2 2 6-21 7.5yr4/4 none Is. n/sg ml g/w 1/f .7 €.8
3 21-£ 10yr4/4 none Co. S. 0/sg ml na/ na/ .7 .8
Ground
elev.
110,_QQ_ fL
Depth to
limiting
factor
>82"
Remarks:
CST Name:-Please Print Cary L. Steel 715-246-6200 Phone:
Address: 1554 200th. Ay ew Richmond, WI. 54017
Signature: Date: CST Number:
8-11-93 cstm 2298
PARCEL I.D. #t Donald Nes trud - • •
Page 2 of 3
Boring # Horizon Depth Dominant Color in. Mottles
Texture Structure
s• Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Consistence BardarY Roots G P D/ft
3 1 0-7 1 r3/3 none Bed Trends
2 7-16 10yr4/4 none ~i •5 .6
cl 2/m/gr mfr /w 1/f .4
Ground 3 16-82 10yr4/4 5
elev. none co.s. 0/sg
109.40 ft n/a na/ •7 8
Depth to
limiting
factor
>82"
Remarks:
Boring #
nht: 1 0-10 10yr3/3 none
F L• 2/m/sbl;
4 mfr
2 10-18 10yr3/4 /w 2/f .5 .6
n none sil. 2/m/sbk mfr
/w 1/f .5
Ground 3 18-31 10yr4/4 none scl 1.6
1/f/sbk mfr g/w 1/f .2
elev. 4 31-88 1 3
.
110.5(t}. X414 none co.s. 0/s
Ml n/a n/a •7 ,g
Depth to
limiting
facto
>88"
Remarks:
Boring #
1 0-12 10yr3/3 none L. 2/m/ r Mfr w f
Ej- 2 12-19 5 i 6
10yr4/3 none 2/m/sbk
mfr /w .
Ground 3 19-36 10yr4/4 none f 5 6
scl 1/f/sbk mfr
lef?,r• 4 36-80 10yr4/4 g/w If 2 3
ft none co.s. 0/sg Ml n/a na/ .7 8
Depth to
limiting
facto
Remarks:
.Boring #
13~
Ground
elev.
ft 9
Depth to
limiting
factor
Remarks:
38D-8330(R.05/92)
k
STEEL'S SOIL SERVICE
1-554 ~-zcwzn--zvc.
Gary L. Steel
C.S.T. 2298 Donald Nestrtid New Richmond, WI 54017
MPRSW-3254 1 1 (715) 246-6200
N[dw D1F S5-T29N-R19t~
town of St. Joseph
lot #1
0-
,6 m=4-t~-12
44- 100'
I kid t7-
~ • ~ may,,
5c~~
Gary L. Steel
8-11-Q3
Parcel 030-1017-80-000 05/08/2007 10:52 AM
PAGE 1 OF 1
Alt. Parcel 05.29.19.75A 030 - TOWN OF SAINT JOSEPH
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
03/22/2004 00 4
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O - BRUSHY MOUND PARTNERS, RETIRED
RETIRED BRUSHY MOUND PARTNERS
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 30.940 Plat: N/A-NOT AVAILABLE
SEC 5 T29N R19W FRL NW NE EXC N 83 FT & Block/Condo Bldg:
EXC PT TO CSM 9/2676 ASM'T INC
030-1018-50-100 (78A-10) NKA PT BLUEBIRD Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
BLUFFS '04 05-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
03/22/2004 757255 10/01 PLAT
12/02/2002 700547 2065/474 WD
07/23/1997 1095/410 QC
2007 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 03/02/2005
Description Class Acres Land Improve Total State Reason
Totals for 2007:
General Property 0.000 0 0 0
Woodland 0.000 0 0
Totals for 2006:
General Property 0.000 0 0 0
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
T
T \
STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER FMORl,. C~R1S~6~ ~ P14)N
ADDRESS i~~ l) Iv c`.' 1 11 121
SUBDIVISION / CSM# LOT
SECTION-IS T a9 N-R 19 W, Town of ~)A
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
I ~ORuUM
)J or^s.
4
1
ac~
N~t~ s
as ~~IP~N~'1
I$kb1 fin
R-8
0
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK:
ALTERNATE BM:
SEPTIC TANK II/ PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: W ~eS Liquid Capacity: I a 0 5~
Setback from: Well No"1' N House a(. Other 3 al
Pump: Manufacturer Modelf Size
Float seperation Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
Width: S Length (D--? Number of trenches
Distance & Direction to nearest prop. line: g
Setback from: well: N of ~N Houseoyen IW Other
ELEVATIONS
Building Sewer ST Inlet: ST outlet:
PC inlet PC bottom Pump Off
Header/Manifold Bottom of system
Existing Grade 103,`() Final grade
DATE OF INSTALLATION:
PLUMBER ON JOB:
LICENSE NUMBER: 31U\~
INSPECTOR:
3/93:jt
Wisconsin,Department of Industry, PRIVATE SEWAGE SYSTEM County:
Labor and Human Relations INSPECTION REPORT ST. CROIX
Safety and Buildings Division
(ATTACH TO PERMIT) Sanitary Permit No.:
GENERAL INFORMATION 284251
Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.:
MURRAY MARY & MEDIN CHRISTOPHE ST JOSEPH
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
030-1017-80-200
TANK INFORMATION ELEVATION DATA A9700015
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark r /a /00 1
Dosing
Aeration Bldg. Sewer
Holding St/ Ht Inlet
TANK SETBACK INFORMATION St/ Ht Outlet 9,r
TANKTO P/L WELL BLDG. ventto ROAD Dt Inlet
Air intake
Septic > ! NA Dt Bottom
Dosing NA Header / Man. ? 5,
Aeration NA Dist. Pipe s;9S 9y,v~
Holding Bot. System 49,~z
PUMP/ SIPHON INFORMATION Final Grade
T!
Manufacturer emend
Model Number GPM
TDH Lift Lric ' n System TDH Ft
Head
Forcemain Le th Dia. Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length I No. Of Tr riches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS DIMENSIONS
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
SETBACK
INFORMATION Type of CHAMBER Model Number:
J OR UNIT
System: 'y
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 j r Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: ST JOSEPH.NW.NE.5.29.19W 184 ROLLING HILLS
X12 _ .U 1~y, .T,..•. .t~ - _ _ -
U / C
f.e j
Plan revision required? ❑ Yes W/N o r
Use other side for additional information. f" 9 .r•;t ej 21,61
SBD-6710(R 05/91) Date 'Ins ectdr'sSignature Cert.No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER: '
SANITARY PERMIT APPLICATION Bureau o oand ff Buil Safety BuildiinWater System!
ngWater201 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 1/2 x 11 inches in size. 5 V
0 See reverse side for instructions for completing this application State SanitaryP rmitNur'
The information you provide maybe used by other government a ency programs ❑ Check if revision to previous application
[Privacy Law, s. 15.04 (1) (m)]. wkq( S State Plan I.D. Number
1. APPLICATION INFORMATION `-PLEASE PRINT ALL INFORMATION
P operty Owner Name Propert Location
e N 1 1i4 ti4, S 5 T Dj , N, R 1q E (or) W
Pr rt ner ailii g Al
to- ; Lot Numbe Block Number
Cit , Sta Zip Code. Phone umber Subdivision Nam r C Number
oUd N ~JI t uA CA
( r~ N 9 a 7~
II. TYPE F BUILDING: (check one) ❑ State Owned 'tyy r N are oad t1
Public 1 or 2 Family Dwelling - No. of bedrooms o Iowan OF S 8Seo~IN N llt
III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s)
1 ❑ Apartment/ Condo 4 s a 9. 19, / 57A IL-e:10 -
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. 1~rNew 2. Replacement 3. Replacement of 4. ❑ Reconnection of 5. E] Repair of an
System System Tank OnlyExisting 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 ❑ 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./inch) i Elevation
U 1(1 0 0 _ 5 •1 0 Feet ®3• O Feet
VII. TANK Capacity
INFORMATION in gallons Total # of Manufacturer's Name Prefab. Site
Fiber- Plastic Exper.
New Existing Gallons Tanks Concrete Con- Steel glass App.
structed
Tanks Tanks
Septic Tank or Holding Tank I 0 0 W ❑ ❑
Lift Pump Tank /Siphon Chamber El ❑ ~ 1:1 D
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name: (Print) Plumber's Signature: (No Stam s) r/MPRSWNo.: Business Ph one Number.
I M 6V M4, T rk A,_ ov
g~- T 0-) U
Plumb is Address ( treet, City, Stike, Zip C de):
1 ® w 3 A e
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Sary (include sGroundwater Date Issued Issuing A ent Signat No St ps)
A roved surcharge Fee)
pp ❑ Owner Given Initial /I
Adverse Determination
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SOD-6398 (R. 05/94) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS .
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit maybe 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.
11. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling.
111. 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
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.
• " P.B. L.. - _6 r _ P_ LOTA 1-111 (1 1 U t0
P 0 J E C p L OPIU,
N AMC oF-_u •G ► d e_ . NWA~ J, rn 6l
P.' L O, A 1-1 C N S E 3Y
''L•-- ~ Iwo n .fi a I" 4 7
co I
N orz7,l 1 IJQ N E Lnfi
t~
QbgNek
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AP-Q ~P+c~~l~ ~Qp I I 1
• (~pu 100 it- ffto' ~'vi;' I I I .
yfrv%
/.?ob ~o' slu
NSF,- Well 1 ~ • ~ ~ R
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& vj c n
TOp Of fled
P. Al O *v 100.0
t
FRCSII AI1: 't„L[:'l':i AND ODSEIIVA'fl(}t,PIPE
CI1035 SECTION
Approved Vent Cap
Minimum 12" Above I IV3
Final G
4" Cast Iron
Above Pipe Venl pipe
To rinal Gracie- 1-
!Ytsrans; * uDapa rnertment of Industry, SOIL AND SITE EVALUATION REPORT p e 1 3
Labor an~i Human Relations ag _ Of
Division of Safety & Builclings 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 St. Croix
not limited to vertical and horizontal reference point (BM), direction and % 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
Donald P,Testrud GOVT. LOT P'ta 1/4p,E 1/05 T29 ,N,R19 Ml(or) W
PROPERTY OWNER':S MAILING ADDRESS LqqT # BLOCK # SUBD. NAME OR CSM #
1191+ 42,nd / St. 2. n/a n/a
CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE B[OWN NEAREST ROAD
Hudson, tell. 54016 (715)549-6598 west part St. Joseph Polling Hills Trl.
New Construction Use [yk Residential / Number of bedrooms 3 1 ) Addition to existing building
j) Replacement Public or commercial describe
Code derived dairy now 450 gpd Recommended design loading rate • 5 bed, gpd'"2 • F' trench, gpd/ft`
Absorption area required 900 bed, ft2 750 trench, ft2 Maximum design loading rate • 5 bed, gpd/ft2 .6 trench, gpd/ft2
Recommended infiltration surface elevation(s) 99.10 It (as referred to site plan benchmark)
Additional design / site considerations n/a
Parent material oiztwash plain Flood plain elevation, if applicable n/a ft
S = Suitable for system CONVENTIONAL MOUND 7 IN-GROUND PRESSURE AT-GRADE SYSTEM IN A HOLDING TANK
U = Unsuitable fors stem U S ❑ U Cis ❑ U )m ❑ U t3S ❑ U ❑ S 13U ❑ S 1RU
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourxl3y Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed rertctt
1 0-6 10yr3/3 none L. 1/f/pl_ mfr c/s 2/f .0 .3
~l
2 6-18 10yr4/4 none sicl 2/ra/gr mfr g/w 1/f .4 .5
Ground 3 18-68 10yr4/4 none ls. 0/sg ml g/w na/ .7 .8
elev.
102.75 It 4 68-83 7.5yr4/4 none sl. 2/m/shy; mfr na/ a/ 1-5 i.6
Depth to
limiting
factor
>83"
Remarks:
Boring # 1 0-6 10vr4 / 3 none L . 2 /m/ sblc mfr o .5 's .6
tr, r
ti t 2 6-17 10vr4/6 none sicl_ 1/f/gr mf g/wn 1/f .3
Q tit'
3 7-52 10yr4/4 none Is. 0/sg 8
a
Ground
e I., i `
elev. 4 152-84 7.5yr4/4 none sl. 2/m/sbv m
n `.5. .6
103.45 It
Depth to
limiting 8 t~..
factor r r
>84"
Remarks:
CST Name: Please Print
Gar L. Steel P-11-9P one:
~
Address: 1554 0th. AXTe , ew Richmond, WI. 54017
Signature: Date: CST Number:
8-11-93 cstm, 2208
PARCEL I.D.,t Donald Nes trud - Pa e
2 of 3
Boring # Horizon Depth Dominant Color Mottles
Texture Structure
r in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ~~~~nce Bourifty Roots GPD/ft
0-8 1 r3/3 none Bed Trends
2 8-22 10yr4/6 none ~ • 3
scl 2/m/gr mfr
Ground 3 22-30 10yr4/4 none g/w 1/f .4 •5
elev. sl. 2/m/sbk mfr /w 1/f .5 .6
104_inft 4 30-68 10yr4/4 none
co.s. 0/s ml /w na/ .7
Depth to 5 68-R2 7.53,r4/4 none 8
~ ting s)_. 2/m/sbk mfr na/ na/ .5 6
Remarks:
Boring #
1 0-10 10yr3/3 none L. 2/m/sbk mfr
r 2 10-80 10yr4/4 g/w 2/f .5 .6
<.A none S. 0/
sg
n/a na/ .7 .8
Ground
elev.
102-R)
Depth to
limiting
factor
>80"
Remarks:
Boring #
1 0-9 10yr4/3 none
L• 1/c/pl mfr c/s 2/f .0 .3
2
E'el- A-27 10yr4/4 none
sicl 2/m/sbr- mfr
Ground 3 27-80 10yr4/4 none /w 1/f .4 .5
Is.
elev./sg rLt n/a n/a .7 4
102,1_ ft.
s
Depth to
limiting
factor
>8
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
3BD-8330(R.05/92)
STEEL'S SOIL SERVICE
1554 200th. Ave.
Gary L. Steel RKDOM
C.S.T. 2298 Doanld Nestrud New Richmond, WI 54017
MPRSW-3254 ITW'-;NE% S5-T29N-R.19W (715) 246-6200
town of St. Joseph
lot #2
k
DD's l5~ j~' 1zS' E, ~a
5 ~wvl"1~42
6-3
J
Gary L. Steel
5-11-93
504644
CERTIFIED SURVEY MAP
Located in part of the NW4 of the NEa of Section 5, T29N, R19W,
Town of St. Joseph, St. Croix County, Wisconsin.
N67 L
° NE Corner of
d
Section 5
o
4' AREA
Lot 1
3.15 Acres including R/W
-a Lr; 137,422 Sq. Ft. including R/W
0 3.00 Acres Excluding R/W F3°1
L. +j 130,697 Sq. Ft. Excuding R/W \ ~.',tl 7
d V ~
o c Lot 2
W ~;ar• cw
C- 3;
o 3.14 Acres Including R/W wy4~~.
z N 136,958 Sq. Ft. Including R/W +aQ
ro 4j 0 3.00 Acres Excluding R/W
o N 130,697 Sq. Ft. Excluding R/W
FILED
AUG 3 019938-
61 W I JAMES O'CONNELL Q
161 Ul)
L I Se9ister of Deeds
01 ~ Croix Co.,WI
UNPL AI TED' LANDS I
co
1 0
Ul)
° N
2 I ^M ~ !
° S8903911811E 655.111 N a
Coil 626.221 N
E 01 28.89
o I_GT o
lA N - O
10 I
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LEGEND
Aluminum County Section
S T C - 100
This application form is to be completed 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.
Owner of property c
Local ion of prope.rty-,W-01/4 0X1/4, Section T a? N-R__Ly W
Township S, w ok Mailing address
Address of site
Subd i vision name S Lot no.
Other homes on property? Yes ~ No
Previous owner of property 1,e- S
Total size of property
Total size of parcel
Date parcel was created
Are all corners and lot lines identifiable? Yes No
Is this property being developed for (spec house)? Yes No
Volume and Page Number "I e as recorded with the Register
of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A WARRAIVVY 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 office of the County Register of
Deeds as Document No. and.that I (we) presently
own the proposed site for the sewage disposal system or A, (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 ffic_e of the County Register ot. Deeds as Document No.
Signature of Applicant Co-Ap n
P.It<, of i~~n,~f.LI1"e mate of Signature
STC - 105
SEPTIC TANK MAINTE,NANCF, AGREI,.N1FNT
St. Croix Countl•
OWNER/131)YEIZ
MAILING ADDRESS _ 1385 1'`l~ir~ 0`11"r 110() W). e 408;l, PROPER'L'Y ADDRES *01IMn 4-1I)b -
(location of I stJptic system) Please obtain from the Planning Dept.
CITY/STATE. W1.
PROPF,R'ITY LOCATION Ny4 1/4, N 1/4, Section '1' N-R
TOWN Oh S"I'. CROIX COUNTY, \i'I
SUBDIVISION o~~t~<~ t tl LOT NUMBI.,R
~.ro7Cp
CERTIFIEDSURVEY MAI) , VOLUME 4-, PAGE , L01' NUMB(:R
('..~OC • ~641~~-1y
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 scrim
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 he completed and returned to the St Croix
County /.onlng Officer within 10 days of the three year expiration date
I)A f1.
til Croix County lonilig O11irc
( ;over nnrrnl Centcl
1101 l arnrrclrarl I:oad
II/'It
llnd.a1n. \',I ,,1010
• i STATE DAR OF WISCONSIN FORM 2 - 1982
r 547554 II WARRANTY DEED -
_ 119?Pac~49
17,00 WENT NO. VOL II -
FIGSTE1i J C r r
- - i
Charles A. Brickson and Mic ue A. Brick,
- - ti-soan a JULY 1996
coneys and warrants 'o 6th C Merlin and Marl/ J.
Murra Oth si le persons, as joint 1erse-~„~,1. 3h4
IlptasK or 040,4q
THIS SPACE RESERVED FOR RECORDING DATA
NAME AND RETURN ADOPESS
t CrO1X
the following described real estate in S• County. /L', ~il✓
State of Wisconsin: 1, / ' d ! Ct i
030-1017-80-200
PARCEL IDENTIFICATION NUMBER
29 forth, Range 19 West,
Part of NW1/4 of NE1/4 of Section 5, Township
St. Croix County, Wisconsin, described as follows: Lot 2 0of rNo- ttif50e4644•
survey Map filed August 30, 1993, in Vol_ "V, Page 2676,
: n
This 1S nOt _ homcstead property.
70WC fbnot> -of-way of record, if any.
Exceptiortrowarrandes: Easements, restrictions and ri is
26 July A.D., 19
Dated this day of -
a (SEAL)
(SEAL)
Mic a A. Brickson
Charles A. Brickson (SEAL)
(SEAL)
ACKNOWLEDGMENT
AUTHENTICATION
State of Wisconsin,
ss.
Sirature(s)
St. Croix county.
day of
lk,sonally came before me this
l9_
authenticated this day of July 19 % the above named
- rice ~irkcon and Micatie -
TITLE: MEMBER STATE BAR OF WISCONSIN
(lf not, tro a w knrnvn to be the person S who executed the foregoing
authorized by 9706.06. Wis. StatsJ ,u d acknowled the -inc-
THIS INSTRUMENT WAS DRAFTFU one Terkelsen
r
r ~
t