HomeMy WebLinkAbout030-1017-95-112
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Wisconsin bepartment of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3
Labor-arid Human Relations
. Division of Safety & Buildings in accord with ILHR 83.05, Wis. #khtff:;.GDtte-, ^ ,
'e. COUNTY
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. P ra t include, but St. Croix
not limited to vertical and horizontal reference point (BM), direction and % f e, sciilre oc PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road. ndin
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATIOX-1i : WED BY DATE
PROPERTY OWNER: ; OPERT`r OCATION
Jim Dahlby ,0~}1fT 1/4 a1% T 29 N,R XXor) W
PROPERTY OWNER':S MAILING ADDRESS B CK SUBp: R E OR CSM #
399 Brookwood Dr. na- pending
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY•-- _LLA_)' WN NEAREST ROAD
( ) St. Jose h River Rd.
[)q New Construction Use [X] Residential / Number of bedrooms 3 ( ] Addition to existing building
j ] Replacement [ ] Public or commercial describe
Code derived daily flow 450 gpd Recommended design loading rate .7 bed, gpd/ft2 .8 trench, gpd/ft2
Absorption area required 643 bed, ft2 563 trench, ft2 Maximum design loading rate J-bed, gpd/ft2__.$_trench, gpd/ft2
Recommended infiltration surface elevation(s) 99.75 ft (as referred to site plan benchmark)
Additional design i site considerations iia
Parent material outwash Flood plain elevation, if applicable na ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT GRADE SYSTEM IN FILL HOLDING TANK
U=Unsuitable fors stem ®S ❑U ®S ❑U ®S ❑U [2 S ❑U ®S ❑U ❑S ZU
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trer>ch
1 0-17 10 r4 3 none S1 2m r mfr Mi 2f -9 -6
2 17-25 10yr4/4 none sl 2m^r mfr w if .5 .6
Ground 3 25-72 10 r4/4 none is • 7 .8
elev.
102.8 ft.
Depth to
limiting
factor
Remarks:
Boring #
1 0-9 10 r3/3 none s ' 2ms
2 2 9-26 1.0 r4 4 none Scl 2msbk mfr
3 26-76 7.5 r4/4 none lS osg mvfr na na .7 .8
Ground
elev.
102.9ft.
Depth to
limiting
factor
+76"
Remarks:
CST Name:--Please Print Gary L. Steel Phone: 715-246-6200
Address: 1554 200th e. New Richmond WI . 54017
Signature: Date: 9-12-96 CST Number: mO2298
PROPERTY OWNER Jim Dahlby SOIL UtbUKIN I IUN rltrun rdy~ fl u. 3
PARCEL I.D. # pending #6 •
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bolrx~ry Roots GPD/ft
in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed Tmr&
1 0-12 10 r4 3
is 2m r mvfr
none
:rk
2 12-32 10 r4 4 none sscl 2Mgr mfr 9N 1f -4
Ground 3 32-44 7.5vr4/6 none s
elev.
104.1 ft. 4 44-96 7.5 r4 6 none 1,q nsg =xfr n
Depth to
limiting
factor
+96"
Remarks:
Boring #
1. 0-1 3 .5
kkii
` 4 2 12-23 10yr4/4 none 1S 0sa mvfr 9w -7 -A
Ground 3 23- na .4 .5
elev. 4 33-72 7.5 r4/4 none 1s os mvfr na na .7 .8
102.6 ft.
Depth to
limiting
factor
+72"
Remarks:
Boring #
2f .5 .6
2 116-77 7.5 r4 4 none is os mvfr na .7 .8
Ground 3 177-84 7.5 r4 4 none scl 1f r mfr na na .2 .3
16x..4 ft.
Depth to
limiting
factor
+841,
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(8.05/92)
STEEL'S SOIL SERVICE
Gary L. Steel 1554 200th Ave.
CSTM2298 JIm Dahlby
44 S5-T29N-R19w New Richmond, WI 54017
MPRSW 3254 town of St. Josph (715) 246-6200
1 lot #6-csm
N
1"=40'
BM.= top of 1" pvc pipe C el. 100'
Alt. BM.= top of wooden post C el. 103.6'
p f 101o
6' Z(h 2"PIV. .3
r~Z5,\ tiOr
3`10
0 :,10
Gary L. Steel
9-12-96
s 9 p C~ 0 d I~
FILED `
OCT 0 2 1996 0, 10 DEC L 1 1996 a,
KATHLEEN H. WALSH
Registerot Deeds -TT. CROM COUNTY
St.CrolxCo.,WI 1y SURVEYOR'S RECORD
5502".f0
CERTIFIED SURVEY MAP
Located in part of the SWj of the NEJ of section 5, T29N, R19W,
Town of st. Joseph, St. Croix County, Wisconsin.
N Le end
Aluminum County Section Monument Found
OWNER • 111 Iron Pipe Found
s
4J c 3 Jim Dahlby o 1"x24" Iron Pipe set, weighing 1.13lbs
0.0= 399 Brookwood Drive per linear foot
+1.• I.
10 Q ^ fl, Hudson, WI 54016 100' Roadway Setback Line
c`O 0 ~f - o Existing Fenceline
L- o a00
y Z ( ) Previously recorded bearing and/or distance
UNPLA_T_T_ED LANDS I LCT I
L- ,,it o NORTH LINE OF THE SW 1/4 OF THE NE 1/4 V9,2678 1- S.M. I N
39' 18"E 782.14'
S89°
*----3-
+4 0 I" IRON PIPE FOUND 91 .7391 •07'
1o vi NSS'SO'13"W3620' v
co 4) to FROM COMPUTED
POSITION.
LOT 6 4 UNPL,ITTEL'
LOT 5
r- LANDS
6.01 Acres Ln 8.81 Acres
261,966 Sq. Ft. v; 383,765 Sq, Ft.
v~ -APPROVED
LC T ? o o ti
N o LOT I NI
5. M. IN M ~ OCT 0 2 161 w m ST. CROIX COUNTY/
„ -
E
J_o m N om ahensive FiarFUw cse9 sTe"E-
- N P'^ N89°45'19"W
a 1] Zoning 1
0 0 1 Parl(f,.QtS~eraddtea 3 91 • 27 <<
S89045118-1E 306: 7
N x 240.471 s oo' - C14 LOT 2-
2.0' f not recorded c~
LCT 2 vMhin 30 days of 0`00 0
= LOT 7 approval data 0
W - Cn
w O 'PProval shah be cal
ti A UI
~04 6
1489045 8'W 380.13'
;0
1° IRON PIPE FOUND
co 1-
0
'n _r W y { W -T N02001'33"W, 0.92'
to LA 1~
u1 11 M LOT I ( FROM COMPUTED POSITION.
o
Q-5-LA. iNi LOT 4
J -
y M .N V 2, PG. 580 ~t~~~irtcas*slraa~a
IUj'
u~i may`;t`~~!
STC - 10 4 of,^
AS BUILT SANITARY SYSTEM REPORT
OWNER 1-eU ,41 t1
pNIryGOF
ADDRESS A'OZ
SUBDIVISION / CSMJ G yyJ LOT
SECTION T N-R W, Town of
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
G
tb
h
Q
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK: Soo~v& -e .5'
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: «,7`t-y-,,/ Liquid Capacity: 1,7dd
Setback from: Well House ll~
Other
Pump: Manufacturer Modell Size
Float seperation Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
Width: Length Number of trenches
Distance & Direction to nearest prop. line: 2Q 25 7--
W P 7- aed
Setback from: well: _ House Other
ELEVATIONS
Building Sewer ST Inlet: ST outlet:
PC inlet PC bottom Pump Off
Header/Manifold Bottom of system
Existing Grade Final grade
i
DATE OF INSTALLATION:
PLUMBER ON JOB: ~.~2
LICENSE NUMBER:
INSPECTOR: -
3/93:jt
ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
ST. CROIX COUNTY GOVERNMENT CENTER
~aaaan~n.
1101 Carmichael Road
r Hudson, WI 54016-7710
- (715) 386-4680
December 30, 1997
River Valley Abstract
Attn: Roger Beavers
206 2nd Street
Hudson, WI 54016
RE: Septic Inspection for Kevin Leines located at 456 River Road,
Town of St. Joseph, St. Croix County, Wisconsin
Dear Mr. Beavers:
A septic inspection of the above referenced property was conducted
on August 29, 1997. This property is located in the SWl/, of the NEl/
of Section 5, T29N-R19W, Lot 6, Town of St. Joseph, St. Croix
County, Wisconsin. At the time of the inspection, this septic
system was found to be code compliant for a four (4) bedroom home.
If you have any questions regarding this, please contact our office
at (715) 386-4680.
Sincerely,
lames K. Thompson
Zoning Specialist
/sm
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County:
Safety and Buildings Division ST. CROIX
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT) SanitarY99491
Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. G ti
L(ETM"er'sPMN 4; 9,ty 46 ff l Town of: State Plan ID No.:
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel TMV-4017-95-112
c
l/!~. l/~i fG'l~, i C.~ yr'. ~ J`'(- /`jam
TANK INFORMATION ELEVATION DATA A9700306
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark 7'j'
Dosi n
Aeration Bldg. Sewer
Holding St/#( Inlet IS
TANK SETBACK INFORMATION St/#f Outlet / 37
TANK TO P/ L WELL BLDG. AirI to ntake ROAD Dt Inlet
rl
Septic NA Dt Bottom
Dosing NA Headers ^ oo,
Aeration NA Dist. Pipe
Holdin Bot. System
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand
Model Number GPM
TDH Friction Sys e _ Ft
Forcemain Length Dia. H Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width / Length No. Of Trenches PIT No. Of Pits Inside Di d Depth
DIMENSIONS ENSIOM_
I
SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHIN
SETBACK
INFORMATION Type Of rew-c; nl A NIT R Moe Number:
System: v-, O r ' 7 fit' D'~
DISTRIBUTION SYSTEM
Header/Manifold Distribution Pipe(s) x Hole Size x Hole S g Vent r Intake
Length Dia. Length Dia. ~f Spacing "
SOIL COVER x Pressure Systems Only xx Mound Or At-Gra Systems
Depth Over Depth Over xx Depth O~ xx Seeded/ Sodded xx Mulched
Bed /Trench Center Bed /Trench Edges Tgpsoit" ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: ST. JOSEPH 05.29.~9,SW,NE 456 RIVER ROAD LOT 6 f
1 y f ✓J
Plan revision required? ❑ Yes ❑ No
Use other side for additional information.
SBD-6710 (R.3/97) Date Inspector's Signature Cert. No
ADDITIONAL COMMENTS AND SKETCH 5
SANITARY PERMIT NUMBER:
SANITARY PERMIT APPLICATION 201BE. Washington and Ave sion
NVisconsin In accord with ILHR 83.05 Wis. Adm. Code P.O. Box 7969
Department of Commerce 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. C P-, 4, X
• See reverse side for instructions for completing this application State Sanitary Permit Number
v2V4W.
The information you provide may be used by other government agency programs ❑ Check it revision to previous application
[Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number
1. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATION
Property Owner Name Property Location
.5W114 ~ F 1/4, S :5- T a , N, Rl~ E (or)
Property Owner's Mailing Address Lot Number Block Number
City, State Zip Code Phone Number Subdivision Name or CSM Number
(G /2) s = C ! 31c, 7
II. TYPE F BUILDING: (chec one) ❑ State Owned ❑ city Nearest Road
E3 Village
Public 1 or 2 Family Dwelling - No. of bedrooms Town OF S7'7 0;5 ' lev 02
III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s)
1 ❑ Apartment/ Condo 4 9 G ' l!J/ I
2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 Q Merchandise: Sales/ Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/ School 8 ❑ Mobile Home Park 12 Q 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. p. New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ 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) Elevation
~O rOd d O0 /(f l Feet ley, Feet VII. TANK Capacity In gallons Total # Of Prefab. Site Fiber- Exper.
INFORMATION Gallons Tanks Manufacturers Name Concrete con- steel glass Plastic App
New Existin strutted
Tanks Tanks
Septic Tank or Holding Tank [tJl5s7 ❑ ❑ ❑ ❑ ❑
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's Name: (Print) Plumber's Signatur : (No Stamps) MP PRSW No.: Business Phone Number:
Ll Yn C ~ L1 / ~ l
Plumber's A( dress (Street, City, State, Zip Code):
e S° -
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing A ent Sig ture (No S p
proved Surcharge Fee)
p❑ Owner Given Initial p j cb, r
Al I 97
Adverse Determination U
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SBD-6398 (R.11/96) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber
,1
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, 608-266-3151.
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
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.
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Wisdonsiq Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3
Labor and Human Relations
Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
St. Croix
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but
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. 030-1017-95-112
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
GOVT. LOT SW 1/4 NE 1/4,S 5 T 29 ,N,R 19 g(or) W
Kevin Teines PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
5969 Lynwood Blvd. 6 na csm vo1.11- 2116'7
CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE MOWN NEAREST ROAD
Mound NIN. 55364 1612) 635-1265 St. Joese h River Rd.
New Construction Use [xj Residential / Number of bedrooms 4 [ ] Addition to existing building
Replacement [ ] Public or commercial describe
Code derived daily flow 600 gpd Recommended design loading rate .5 bed, gpd/ft2-.-6 -trench, gpd/ft2
Absorption area required 1200 bed, ft2 1000 trench, ft2 Maximum design loading rate .5 bed, gpd/ft2_ . _L__trench, gpd/ft2
Recommended infiltration surface elevation(s) 101 .10 ft (as referred to site plan benchmark)
Additional design / site considerations na
Parent material pitted glacial dirft Flood plain elevation, if applicable na ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U=Unsuitable fors stem ®S ❑U ®S ❑U ®S ❑U ®S ❑U I S ❑U ❑S [ U
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure Consistence Bounchry Roots GPD/ft
Boring # Horizon in. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
.5 .6
1 -13 10yr3/3 none 1 2msbk mfr 2f
2 13-38 7.5yr4/4 none scl lcsbk mfr 9w if .2 .3
Ground 3 8-56 7.5yr4/4 none 1 fs Osg mvfr 9w if .5 .6
elev.
105.1 ft. 4 6-90 7.5yr4/6 none co Osg mvfr na na .7 .8
Depth to
limiting
factor
+90"
Remarks:
Boring #
1 -13 10yr3/3 none sl 2mgr mvfr 9W 2f .5 .6
7 2 3-20 7.5yr4/4 none is Osg mvfr 9w if .7 .8
8
3 0-80 7.5yr4/4 none ms Osg ml na .7
Ground
elev. 191,
r
104.1 ft.
Depth to
limiting
factor
1~ $9 1
+8011
Remarks: J ob
CST Name:--Please Print Gary L. Steel Phone: 715-246)-6)200
Address: 1554 200t ve. New Rich nd WI 54017
Signature: ( Date: 7-1-97 CST Number: m02298
PROPERTY OWNER Kevin Leines SOIL DESCRIPTION REPORT Page 2 of 13
PARCEL I.D. #
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourcky Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
1 0-10 10 r2 2 none sil 2msbk mfr w 2f .5 .6
'2 10-17 10yr4/4 none sil lfgr mfr gw if .2 .3
Ground 3 17-29 7.5yr4/4 none is Osg mvfr gw na .7 .8
elev.
105.1 ft. 4 29-84 7.5yr4/4 none ms Osg ml na na .7 ;.8
Depth to
limiting
factor
+8411
Remarks:
Boring #
1 0-9 10yr3/3 none sl 2mgr mfr gw 2f .5 .6
g' 2 9-18 10yr4/4 none lfs Osg mvfr gw If .5 ::.6
3 18-80 7.5yr4/4 none lfs Osg mvfr na na .5 .6
Ground
elev.
104.3 ft.
Depth to
limiting
factor
+801,
Remarks:
Boring #
1 0-6 10yr3/2 none 1 2msbk mfr gw 2f .5 .6
2 6-30 10yr4/4 none sicl lcsbk mfr gw if .2 .3
3 30-78 7.5yr4/4 none lfs Osg mvfr na na .5 .6
Ground
elev.
104.81•
Depth to
limiting
factor
+78"
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(8.05/92)
STEEL'S SOIL SERVICE
Gary L. Steel 1554 200th Ave.
CSTM2298 1 Nevin -T29N-R19w New Richmond WI 54017
MPRSW 3254 SW4NE4 s5T29N 715 246-6200
town of St. Joseph
lot #6-csm-vol.8-pg.2297
N
1"=40'
BM.= top of SW lot survey stake C el. 100'
Alt. BM.=top of steel fence post C el. 109.30'
for alt. site see attached copy of soil evaluation dated 9-12-96
3 ~Q
A,k
0
~o
~V
~Al
0
-yj(
Gary L. Steel
7-1-97
j
s 9 'Cake Highway 35 North 1.5 miles to
FILED Cty Rd V, right on V 1/4 mile, stay to
OCT 0 2 1996 ► 10 the right which is River Rd., continue
KA1lILF.EN H.WALSH
sl~cr rofDa on River Rd 1.5 miles to property on
5502 ;40 left side (north side) of road.
CERTIFIED SURVEY MAP-
Located in part of the-SW} of the NE} of section 5, T29N, R19W,
Town of st. Joseph, St. Croix County, Wisconsin.
N Le end
19 Aluminum County Section Monument_Found
ui OWNER a 1" Iron Pipe Found
0 0 Jim Dahlby 0 1"x24" Iron Pipe set, weighing 1.131bs
y•_ 399 Brookwood Drive per linear foot
u u M21 Hudson, WI 54016 1001 Roadway Setback Line
C O
e -I Existing Fenceline
v e = ( 1. Previously recorded bearing and/or distance
q uN1?~,-9T.TCe l,~~O LOT I
f.'.r I C.S.M. IN
IPII11 If 1 PIF 111 IIW IIIHIW 1/4 I°• IIIP IW 1/4
r it ' '
~ 1' 1 1 n V ~l 26/l
i4 r~ 1ll I11 IY 11~17,~4t- t_1
T I f "VMProPwu-/'1 +51.0l• f 391.uJ' •1 r
;q SLt~nii w Nos- is"W, a.a2''+ a.o' +t i~
'E FROM Compulau (Colov. perc)
POlIIIOIr.
'f{ ~s
COST OF UTILITIES: LOT 6 LOT 5 N ~1ral~~,arT
Natural Gas-1st 100'
free, then $1.06 ft. LANDS
Electric-$1.00 ft. 2610,966rSs. Ft. 8.31 Acres
+ q 383,765 S q, first 500', then ~q'
$4.00 after. Phone-
no charge ^ In N -%PPROVED o
N
oI
C~I
C. S. M IN a LOT I Al
OCT 0 2.'%-.]
e,
ST: CItO1XC01114TY 1, Ell. 256
v ;
o v omprehensive Piatuw isa! I
r,1 Zoning and N89°45' 19"W
00 ° S89045118"E 306.47' Parks Connndttee+ 91.27'
GAS CO. Midwest Gas W ,
247-5279 - °z 240.471 ss.ao'- Ll?T c .
U not recorded .
In V.-
vrithln 30 days OC co
ELEC. CO. St. Croix LOT 7 - epprovetdats No
Electric a co 0 Approval sheNbe
684-3336 ^ N82°45 a'W 380.13'.
y. O 1" piON PIPE POUND
' m N In %0
PHONE CO. Ameritech R; in
LET I I FROM COMPUTED POSITION.
800-924-1 000 3 INS.
It! ~~Lk
LOT 4
to -19
V_ 21 L 50
y 1;. o
r
i N89'IS•19"W 305,ia' m a :
N89°37'47"ll I.3'- z44a+7' 66,.00 °y x. I
zi0.4r 66.01 N89°37'4711W~Se Corn 1 /
-306.47123 7.96' Section WCorner APPrroxLwoEJ N89°37'4.7•1114
EAST - f
pgryEWAy -.WEST 1/4 LINE
Section 5 B1VEB gQgp UOSOfd, i
LOCATION'
AREA LOT 7 `~~O~OSGcCI'k:GAo
Scales in Feet 4.00 Acres Inc. R/W
0 50 100 200 300 174.101 Sq. Ft.
3.00 Acres Exc. R/W 6 Road Easement
130,681 Sq. Ft.
This instrument drafted by Michael Erickson Job No. 96-80
Vol. 11`-Page 3167
L
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER ~w'~ t YES
MAILING ADDRESS
PROPERTY ADDRESS lio L7 LJT S-Ya J,6
(location of septic system) Please ob in from the Planning Dept.
Cr449STAT
PROPERTY LOCATION 1/4, Section , T _2c _N-R_Lj_W
TOWN OF I ST. CROIX COUNTY, WI
SUBDIVISION - LOT NUMBER
CERTIFIED SURVEY MAP VOLUME I , PAGE ( 7LOT NUMBER
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 re to the St. Croix
County Zoning Officer within 30 days of the three year expiFation date.
SIGNED:
DATE:
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
8 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 6Vtd 5
Location of pro erty jU~ 1/4 Q~, 1/4, Section TZ~_N-R_
Township Mailing address l3
Address of site lJc'-
j - 9N /o
Subdivision name Lot no. C--:;_
Other homes on property? Yes__ No
Previous owner of property ~Jt W~ ~V~lLi3~
Total size of property 0 C g,-
-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 X No
Volume _kr and Page Number tip 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 ffice of the County Register of
Deeds as Document No. 1--J-0611 , 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 f~~~ of the County Register of Deeds as Document No.
Signature of Applicant Co-Applicant
9-1r17
Date of Signature Date of R; neat-,,,
VOL 1217 PAAN
5590%:6 WARRANTY DEED
Document Number
h. j kA Kama
MAY 7 1997
Return Address W 11:45 A M
-K44-t- 4t L..La
~sOrr F liu~.3y
Parcel I.D. Number: 030-1017-95-110
James E. Dahlby, a single person, conveys and warrants to Kerr B. Leines and Christina B. Leiner.,
husband and wife, as survivorship marital property, the fol o%ing described real estate in St. Croix
County, State of Wisconsin:
Part of the SW 1 /4 of NE I /4 of Section 5, Township 29 North, Range 19 %%7est, St. Croix County, Wisconsin,
described as follows: Lot 6 of Certified Survey Map filed October 2. 1996, in Vol. 11, Page 3167, Doc. No.
550270.
Together with the right of ingress and egress over Private Road Easement as shown on said Certified Survey
Map.
This is not homestead property.
Exception to warranties: Easements, restrictions and rights-of-%%ay of record, if any.
Dated this _ day of April, 1997.
1 Ai' ~`r-'EwR
. b
(SEAL)
f ames E. Dahlby°t
V
AUTHENTICATION
r'
Signature(s) James E. Dahlby, a single person,
authenticated this 36 day of April, 1997.
Kristina Ogland
TITLE: MEMBER STATE BAR OF WISCONSIN
THIS INSTRUMENT WAS DRAFTED BY:
Attorney Kristina Ogland
Hudson, WI 54016