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HomeMy WebLinkAbout030-1019-70-200 Q o ~ I o: ao ~ I N ~ c o ~ ~ I 1 I I ~ I C' r~ I N o z c i` m m I LL c . I Q 3 r> a y Z N O z ~ y m I U) U) a m o I O z d' c N aVi U) F- r c ~ v 2 m ` N 7 [~1 N R//1 0) co cu CL of N CO O O O N Q w N Z m z o N co z d ° F~ co \T m I, ~ u~i ~ N I d I d o a N_ '0) m c C O o C C a` E m m o Z (o > F- I- F- c U N 0 0 0 z 0 • ►v in a a a a I -a S~ N 7 0 y a) a) O N O 0) 0) N O O -:-5 = N c y a m (D ' N 'C N N .V..s~ N 06 I, ~ m I a - Q m _ d - 0 0O 3 ~ a c 14 O Tp oWF-I' N a- 00 V C 00 C N E N ap L 4. ai Ql o) (max'! O p -C N tp N L 'O O N E pOj 15 to • 7, O E U O (n U) Q N O y Z: fn w wb O. d w 0 CL -6 2 `IV E c c 3 A ciao 0 mv Parcel 030-1019-70-200 05i08i2007 10:29 AM PAGE 1 OF 1 Alt. Parcel 05.29.19.81 E 030 - TOWN OF SAINT JOSEPH Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - BLAUKAMP, SCOTT A & TERA M SCOTT A & TERA M BLAUKAMP 500 IRON MINE LN HEDGESVILLE WV 25427 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 1169 42ND ST SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 3.120 Plat: 3108-CSM 11/3108 SEC 5 T29N R19W PT SE NW BEING LOT 6 CSM Block/Condo Bldg: 11/3108 3.119 AC Tract(s): (Sec-Twn-Rng 401/4 1601/4) 05-29N-19W SE NW Notes: Parcel History: Date Doc # Vol/Page Type 02/28/2006 819475 WD 07/23/1997 1208/275 WD 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/07/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.120 93,500 162,700 256,200 NO Totals for 2007: General Property 3.120 93,500 162,700 256,200 Woodland 0.000 0 0 Totals for 2006: General Property 3.120 93,500 162,700 256,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 210 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 WisconsRnDepartmentofIndustry, SOIL AND SITE EVALUATION REPORT 'O el of 3 [abagai,ig,Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code CMt + . 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 L I.D. # dimensioned, north arrow, and location and distance to nearest road. d APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION WED B DAT ST CROIx PROPERTY OWNER: PROPERTY LOCATION 20 COON "F E Hank Fogelberg GOVT. LOT SE 1/4 NW 1/4, , g ~,R or) W E an - V1 PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NA 275 192nd. St. 1 na na csm e CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE MOWN ST ROAD Star Prarie, WI. 54026 (715) 248-3003 St. Jose h 42Nd. St. [xJ New Construction Use [J Residential / Number of bedrooms 3 ( ] Addition to existing building Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate • 7 bed, gpd/ft2 •8 trench, gpd/ft2 Absorption area required 643 bed, ft2 563 trench, ft2 Maximum design loading rate • 7 bed, gpd/ft2 .8 trench, gpd/ft2 Recommended infiltration surface elevation(s) 96.40 ft (as referred to site plan benchmark) Additional design/ site considerations alt site trenches @ 96.00 & 93.20, 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 13S El U [3S El U LAS El U ®S El U ® S ❑ U ❑ S ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles . Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0-9 10yr3/3 none 1 2msbk mfi gw 2f .5 .6 2 9-21 10yr4/4 none sit 2msbk mfr gw if .5 .6 3 21-40 7.5yr4/4 none sl lmsbk mfr gw na .4 .5 I- Ground 106~ey' ft. 4 40-84 7.5yr4/6 none s Osg ml na na .7 8 Depth to limiting factor +84" Remarks: Boring # 1 0-8 10yr3/3 none 1 lm sbk rrki gw 2f 1.5 .6 .....2..t` 2 18-23 10yr4/4 none sicl 2msbk mfr gw if .4 .5 3 23-40 7.5yr4/4 none sl lmsbk mfr gw na .4 '.5 Ground elev. 4 0-84 7.5yr4/6 none co s Osg ml na na .7 `.8 100.00 ft. Depth to limiting factor +84" Remarks: CST Name:-Please Print Gary L. Steel Phone: 715-246-6200 Address- 1554 th. Ave., w Richmond, WI. 5401 Signature: i Date: CST Number: 2-21-96 cstm 02298 PROPERTY OWNER Hank Fogelberg SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL I.D. # Pending a. r Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft # in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0-4 10yr3/3 none 1 2msbk mfi 2f .5 .6 g. 3 fi.........:: 2 4-20 7.5yr4/4 none sicl 2msbk mfr gw if .4 .5 Ground 3 20-84 7.5yr4/6 none co S Osg ml na na .7 .8 elev. 99.4 ft. Depth to limiting factor +84" Remarks: Boring # 1 -6 10yr4/3 none 1 2msbk mfr gw 2f .5 .6 2 -22 10yr4/4 none scl 2msbk mfr 9w if .4 .5 3 2-52 7.5yr4/4 none sl 2msbk mfr 9w na .5 .6 Ground elev. 4 2-92 7.5yr4/6 none is Osg mvfr na na .7 .8 97.7 ft. Depth to limiting factor +92" Remarks: Boring # 1 -8 10yr3/3 none 1 2msbk mfi gw 2f .5 .6 5 2 -22 10yr5/4 none sicl lmsbk mfr gw if .2 .3 3 2-40 7.5yr4/4 none sl 2msbk mfr gw na .5 .6 Ground elev. 4 0-84 7.5yr4/6 none co s Osg ml na na .7 .8 97.2ft. Depth to limiting factor +84" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) Y STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Hank Fogelberg SE4NW4 S5-T29N-R19W New Richmond, WI 54017 MPRSW 3254 town of St. Joseph (715) 246-6200 I- lot #1-csm N 1"=40' BM.= nail in tree C el. 100' ItA ono ~nJc w ~~o2s ~ off` GaarY' L. Steel 2-21-96 MAY 2 9 1996 0, 1996 KAT HLEEN H. WALSH Q 1 r 8 F KSURVEYORN ILED g Register of Deeds St. Croix Co., WI . CROIOUNTY 544383 RECORD CEP T I FI ED SUP VE Y IWA P Located in the Southeast quarter of the Northwest quarter of Section 5, Township 29 North, Range 19 West, Town of St.Joseph, St.Croix County,. Wisconsin. Owned by: Hank Fogelberg 400 South Second St. Hudson, Wi. 54016 UN_P_L 4T T_ED_ L_AN_D_S_ (SO0020'08"w 588.26') sh S09,9021 05"W S 00' 02' 05"W 588.30' ,F• SOO.02'05"W v -4 4 1307.8/' EAST LINE OF THE SE l/4 ~ 3347.30' N1/4 Corner OF THE NW 114. S1/4 Cor. Section 5 (ni Section 5 cy .7, LEGEND Z, coo __Ji N LOT 4 Section corner - . I monument, Berntse w 463,007 Sq. Ft. (10.629 Ac) (01 N 1 ~~aP • w Including' right'-of -way. NI 1"X241 Iron pipe 461,846 Sq„Ft. (10.603 A)) 1 1 weighing 1.68 lbs/ w ;e Excluding right-of-way. CSI ti 1 lin. foot set. 0 ~I O t R f Previously recorded. w 2 i J information. m ~ - Fence. (V 2 0J O 1 '1 N ~lI -...-Proposed drive- cr) way - must Wi vi Z j1 ROVED maintain 200 1.-1 W M foot separtation~- co 3 CL I Qi m N N Q1 INAY 2 4,'c6a • J1 Lo //'*'~S00-10'57"E 524,54' O chi j CL 1 Z1 (U 296.80' 227.74' (V - ~j -i{UfX CCUIVT'V Lot 5 -31 ;v %M 176,315 Sq. Ft. (4.048 A) M ® ® (ytl' ~,ensive Placusiz Including right-of-way. 00 SHED IP SHED m -oning and o o ~I P++s Commttee 170,522 Sq. Ft. (3.915 A) Z U) Excluding right-of-way. v v c~ Lot 6 a) -iot recorded M:. y F m m w io o • .n 30 days of 135,850 Sq. Ft. (3.119 A) w w !LOT 5 rn w LO co pl Including right-of-way. o m co a o ~1al3rovaldata 130,727 Sq. Ft. (3.001 A) ° !n 6 i ~I ~.t•;''oval shall be cNU N N OI & '"';d Excluding right-of-way. ~ ~I m W z -zoo'--+ 250' ~ U~ a tl O p BUILDING SETBACK . GQN,,~~I~ ~ 66. ' t. S0029762 9 N S00229. 4 N LINE `~►_a~~ S/~~~j; -298. -22J' 6~' 'D ZJ - - 11-6 ,l_ 42N N 00-10-57"W 5'2.4,'?' STREET ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner f Address IMI ft/,-07 City/State Legal Description: Lot C_ Block Subdivision/CSM # S . '/.1Utom, 1 Sec. ~5` , T 6 N-R2W, Town of PIN # bib - /a/ 9 - L a60 SEPTIC TANK DOSE CHAMBER HOLDING TANK INFORMATION: Tank manufacturer Size ST/PC /Oao/ Setback from: House / Well Y/P/L Pump manufacturer Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location OIL ABSORPTION SYSTEM: Type of system: Width r Length S-O / Number of Trenches Setback from: House )IA' Well _ /2,T / P/L Vent to fresh air intake ELEVATIONS: Description of benchmark 7` 5 a~ SOD ~ Elevation Description of alternate benchmark Elevation Buildin Sewer ST/HTInlet. 16/ L ST Outlet 7 PC Inlet PC Bottom Header/Manifold -L-03 Top of ST/PC Manhole Cover Distribution Lines 6, /V ( ) i Bottom of System 7.6/ ( ) ( ) Final Grade ( } ( ) ( ) Date of installation /7 /9 Permit number oZ State plan number Plumber's signature License number A/# 7X74 Date / I Inspector Complete plot plan R NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW a T 1(q KATE NORTH ARROW Wisconuin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: 299029 Permit Holder's Name: ❑ City ❑ Villa a Town o : State Plan ID No.: AMUNDSON, JEFFREY & JEANETTE ST. JOSEPH CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: } i 030-1019-70-200 TANK INFORMATION ELEVATION DATA A9700344 916,1~'11`,!~;7 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Aeration Bldg. Sewer 11-31 D [Holding St/IWlnlet TANK SETBACK INFORMATION St/,z Outlet TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake - Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System 7 o,/ PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Num; TDH Lift Fr' on Force Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS - ~ LEACH anu acturer: SYSTEM TO P/ L BLDG WELL LAKE/STREAM SETBACK INFORMATION Type O/ ' 'CHAMBER R r .ht J Mode Number: System: j OR UNIT 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 Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: ST. JOSEPH 5.29.19,SE,NW 1169 42ND STREET LOT 6 21 Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710(R 05/91) Date Inspector's Signature Cert. No ADDITIONAL COMMENTS AND SKETCH ~ SANITARY PERMIT NUMBER: I SANITARY PERMIT APPLICATION Bureasafetyu o oand ff BuiluildiinWater Systems gWater 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. • See reverse side for instructions for completing this application State Sanitary Permit Number The information you provide may be used b other government agency Y Y Y programs, ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION Property Owner Name c Property Location lp S 5 T 2 , N, R q (Or Property Own is Mailing Address Lot Number Block Number City, State Zi ode Phone Number Subdivision Name or CSM Number II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ Cit Nearest Road E] o age Vil Public 1 or 2 Family Dwelling - No. of bedrooms To Twn OF ill. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) p 1 ❑ Apartment /Condo ~o,30 /a`/ l - 70 - oo?oQ 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. ❑ 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 (h Seepage Bed )~'X 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 L-1 `5 C' q o c; 90C o 1 0a, LjFeet Feet Ca acit VII. TANK in gallo s Total # Of Prefab. Site Fiber- Plastic Exper. INFORMATION New Existing Gallons Tanks Manufacturer's Name Concrete Con- Steel glass App. strutted Tanks Tanks Septic Tank or Holding Tank -/ODO l Con ~ (21A-711 ® ❑ ❑ ❑ ❑ ❑ 4 14 Loft Pump Tank /Siphon Chamber I 411~ ❑ ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumb 's Signat re: ( o S p M SVV No.: Business Phone Number: Zi vu PI mber's A ess (Str ' City, State Zip Code): IX. C UNTY / DEPARTMENT US NLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater ate Issue Issuing A nt Signature (No S s) Surcharge Fee) Approved ❑ Owner Given Initial l~~~j/~/S 7 Adverse Determination u X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-6398 (R. OS/94) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Divn_ion, Owner, Plumber _ INSTRUCTIONS F 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 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. 160 7cy ter, Y Pc~ ~O ~ 3°`3Y i L 5 70 y Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of Labor and Human Relations Divislon of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code p 11 NTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must' u 1 ut 1 St. Croix not limited to vertical and horizontal reference point (BM), direction and % of slope, r PAS # dimensioned, north arrow, and location and distance to nearest road. pending APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION co i EVIEWM-BA DATE a r, lv! PROPERTY OWNER: PRO LOCATJQN Hank Fogelberg GO SE AlW 1/4,S 5 29 N,R 19 $(or) W PROPERTY OWNERS MAILING ADDRESS LOT # 66f1) INME< # 400 S. second St. 6 csm CITY, STATE ZIP CODE PHONE NUMBER ❑CITY E1 NEAREST ROAD Hudson, WI. 54016(71 386-0222 St. 42nd. st/ ~W~ -4 Pc] 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 • 5 bed, gpd/ft2 - 6 trench, gpd/ft2 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) 102.54 ft (as referred to site plan benchmark) Additional design / site considerations alt. site trenches C 100.29 & 105.04' Parent material pitted glacial drift 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 CAS ❑ U 12S ❑ U 12S ❑ U ® S ❑ U ❑ S ®U ❑ S Lou SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 -10 10yr4/3 none sl 2mgr mfr gw 2f 1 .5 .6 >k<>>-><<.€€ 2 0-26 10yr4/4 none scl 2msbk mfr gw if .4 .5 Ground 3 6-37 7.5yr4/4 none sl 2mgr mvfr gw na .5 .6 elev. 103.3 ft. 4 7-80 7.5yr4/4 none is Osg mvfr na na .7 .8 Depth to limiting facto Remarks: Boring # 1 -9 10yr3/3 none 1 2mgr mfr gw 2f .5 .6 2< 2 -17 7.5yr4/4 none sit 2msbk mfr gw 1f .5 6 3 17-34 7.5yr4/4 none scl 2msbk mfr 9W if .4 .5 Ground elev. 4 4-86 7.5yr4/4 none sl 2mgr mvfr na na .5 `.6 104.2 ft. Depth to limiting factor 86 Remarks: CST Name:-Please Print Gary L. Steel Phone: 715-246-6200 Address: 1554 20 Ave. , Neliir::Rc nd, WI. 54017 Signature: Date: CST Number: 5-22-96 cstm 02298 Af3_• PROPERTY OWNER H. Fogelberg SOIL DESCRIPTION REPORT Page PARCEL I.D. # Pending Bed Tre Boring # Horizon Depth Dominant Color Mottles Texture GrStru Sz. cture ShConsistence Boundary Roots Bed Trench in. Munsell Qu. Sz. Cont. Color . . -9 10yr3 3 none 1 ms m r gw . 5 .6 M ON- 1iK,11 ; 2 -18 10yr5/4 none sil lfsbk mfr gw if .2 Ground 3 11 8-36 7.5yr4/4 none scl 2msbk mfr gw na .4 .5 elev. 105.5 ft. 4 k6-90 7.5yr4/4 none sl 2msbk mfr na na .5 .6 Depth to limiting factor +90" Remarks: Boring # 1 -12 10yr3/3 none sl 2mgr mvfr gw 2f .5 .6 4ti M 4::x g 1. 2 112-33 10yr4/4 none sl 2mgr mvfr gw if .5 .6 3 33-84 7.5yr4/4 none sl 2mgr mvfr na na .5 .6 Ground elev. 105.4 h, Depth to limiting factor +84" Remarks: Boring # 1 0-12 10yr3/3 none sil 2mgr mfr gw 2f .5 .6 5€:<: 2 12-26 10yr4/4 none sil_ 2mgr mfr gw if .5 .6 .v.i.:i{::fin{:..i.::• 3 126-37 7.5ry4/6 none is Osg mvfr gw na .7 .8 Ground elev. 4 137-88 7.5yr4/4 none sl 2mgr mvfr na na .5 .6 106.7 ft. Depth to limiting factor +88" Remarks: Boring # r Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) s STEEL'S SOIL SERVICE Gary L. Steel Hank Fogelberg 1554 200th Ave. CSTM2298 SE4NW4 S5-T29N-R19W New Richmond, WI 54017 MPRSW 3254 town of St. Joseph (715) 246-6200 lot #6-csm N 1"=40' BM.= top of SE lot stake C el. 100' N zoo ~oA l~ kC 4,39 -Z& eT 3C n ~Gary L. Steel 1~~X460 5-22-96 t FILED L MAY 2 9 1996 10, 1 KATHLEEN H. WALSH Register of Deeds 9 SL Croix Co., WI 5,14383 w C EP T I E T ED S UP V E Y MAP Located in the Southeast quarter of the Northwest quarter of Section 5, Township 29 North, Range 19 West, Town of St.Joseph, St.Croix County, Wisconsin. Owned by: Hank Fogelberg 400 South Second St. Hudson, W i . 54016 UNPLAT_T_E_D _LANDS (S00°20'08"W 588.26') S09*021 051. W _ S 00' 02' 05"W 588.30' SOO"02'05"w 1307.81 EAST LINE OF THE SE 114 334730' N1/4 Corner OF THE NW 114. S1/4 Cor. Section 5 (0i Section 5 i LEGEND Zi -_.f lL®7T- 4 Section corner monument, Berntse w 463,007 Sq.. Ft.,. (10.629 Ac) ~I I cap. Including right'-of-way'. N~ N • 1 'X24' Iron pipe 3: a 461,846 Sq,,Ft... (10.603 A)in • I weighing 1.68 lbs/ ~ Excluding right-of=way.. M UI ~I lin. foot set. o w d l q I R' Previously recordecL w z r I .LI information. N fj tL O ~I x -x- Fence. a I J --Proposed drive- `i a OI m z m >I wa-,v - must LLUi I "ROVED maintain 200 I-i W rn ^I foot separtationQ~ LD N QI r,~), 2 916-1 Ij _II to S 00'10'57"F- 524.54' 01 - ~I (U 296.80' 227.74' (V ZI MOIX COUNTY Lot 5 >_I a+ ;yenstve Piatutii 176,315 Sq. Ft. (4.048 A) 0 ® ® to r;a r 00 SHED SHED co >I -cnin9 and Including right-of-way. ao Ct: I Anf*s comrritteo 170, 522 Sq. Ft. (3.915 A) Z o fi U) Z) I Excluding right-of-way. V CY) _ L71 "not recorded Lot 6 u~ Co 1.0 to o X ~'FIM 30 days of 135, 850 Sq. Ft. (3. 119 A) w w LLD T- 5 m w to (0 ~apreval data . .1 a; wi N M - krovpl shay be Including right-of -way. M ~ 130,727 Sq. Ft. (3.001 A) N w 1• (L(a)T 6 to Itl Excluding right-of-way. o a cNV u~i [_~_I O I I 3 JI co m co W Z 250' Z -zoo'--r I{ _..I..._ :.I... 1 e° BUILDING SETBACK N SOO°47'2~"E N SOO°47'216"E O N LINE 66.0296 79 229 4 • - - e - sa 41 -29t3.80 "229'. J 80T£ a$Ed TT 'ToA • QOTAp-e aoj pa-eoq utAoi aj-eTadoadd-e ail; pu-e aOTjjp 2uTuoZ A4unoo xioaD•IS agi joe4uoo Taoat:d .Cue BuidoJOAap a0. 5uTe-e1qOxnd aaojag (•o4a 'jaoa-ed o3 ssaoo,e 'azTs IOT uInUl utul 'spu'eTIGA& ~ • a •T) suoT4vTnBax pu-e sajna I stALeT drgsx4Moj pule 'A4urI03 'a;-eis o} 43afgns sT d-etzr sTgi uo utAogs Taoxed g3-eZ 1;aLON ~ n a n s ~i// `vo ~p ~~...-..,.,•hO,yb/pry t it NS/M 6B °nH • 9I0f5 uTSUOOSTM 'uospnH NOSB~ ~S glaoN aATaa mop-eaw 91 Z •I~NHOr •Ouj 'BuiAaAxnS uosugor 6681-S uosui.l AQA"eH 01. JZ /Iy~It11N~~ / ! - ~ •jaTTaq pu-e 2uTpu-e4saapun 'a$pajenotiiq j. uoTssajoxd Aw jo isaq aui 03 aOUleuTpap ISCISTATpgnS gdesor' •`3S jo•unnoy atlj pule 'aOUIeuTpap UOTSTATpgnS diunoo xToxD•IS ag; 'sapITBIS uTStLOOSTM agi jo 9£Z UOT43aS jo suoTSanoad agi giteA paTTduzoo ATTnj'aAeq I 1,egj pule :paAanans puieT agi jo saTa-epunoq XOTX04XQ agl jo uoE;-eiuasaxdax paxxoo pine ana} U ST I-eTd gOns 3vgi :dixadoad pagTxOsap anoqe at~3 padd~euz pule paAanans aA1Eg I 'aautAo 12aagTa9oj Diu-eH jo uoT;Oaa'p aapun,3egi A T4aao Agaaatl 'aoAananS puErj uTSUOOSTM paaQisTSax 'uosulOf •.o A6AIVH 'I •paoOax jo s4u-eUOAOD pine SU014OT24SOX '94uatzz -asL-a TT-e o; 4oafgns 2uTaq pine 'ssal ao aaotu (saxO-e 961.'LI) 49aj axenbs I L I 'SL L OuTupejuoo ' SuTuuTSag jo ;uTOd gq4 04 QUIT gixom Pyes 2UOT-e 309j £Z'pI£I jsiea spuoOas £5 soinuTuz ZZ s9912ap 68 IRIO l aOuag; !uoTloas aaia-enb pies jo auTT gjaojl agi o3 auTT IsoM plus 'uOT'e IGOJ Z;P Z65 389M spuODas L5 sainuruz 0i saax2ap 00 g3aoN aouagl Ixa4xlenb Is9eng4xoM ago jo aaia,enb is-eaginoS agi jo QuTj;saM ag; 01;99; T,0'7T£T 4SOM spuoOas 7n S T C - loo 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 t✓ 2 ~,f~ A[ T 0-5'0/1'/ Location of property SE 2/4_Alv4_1 jq, Section ~T _N-R-19-W Township, t+ Mailing address Ave A-1 M01 Address of site z~ 9 .v S A /Z_ Subdivision name 0 .A Lot no. Other homes on property.?? Yes No Previous owner of property DUX- 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 - 16 7 and Page Number 12- 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 voice of the County Register of Deeds as Document No. own the proposed site _,57~ and for the sewage f disposaltsystem) oprr I (entey obtained an easement, to run the above des ribed property, for the construction of said system, and the same has been duly recorded in the office of the County Register of Deeds as Document No. ala't;~ie of Applicant Co-Applicant STC - 105 SEPTIC TANK MAINTENANCE AGREEMEN"F St. Croix County/ OWNER/BUYER MAILING ADDRESS v~~S 7S~AL,~L / /W 537 I PROPERTY ADDRESS (location of septic system) Please obtain from the Planning Dept. CITY/STATE PROPERTY LOCATION 1/4, 1/4, Section T_ N-R-/Y_"r TOWN OF Spp~ ST. CROIX COUNTY, wl SUBDMSION Lr,l Catltstrt,~ LOT NUNII3ER CERTIFIED SURVEY MAP , VOLUME, PAGE oe-40 , LOT 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 UWe, the undersigned have read the above requirements and agree to maintain the private sc%vagc disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNf. Certification stating that your septic has been maintained must be completed and returnee{ to the St Croi.~ County Zoning Officer within 30 days of the three year expiration date SIGNED: X92_._-- DATES St. Croix County Zoning Office a--Iow~ Governnient Center 1 101 Carnlrchael Road Hudson, W l 5401() 1 1 q; ~ G oolf't'~ 552008 i State Bar of Wisconsin form 2 - 19W I; WARRANTY DEED DOCUMENT NO. Whe CUO R=C 6TEn CFRCE - $tCRWM,W1 H-ink Fogelberg, a/k/a Hank D. Fo elber,: a sin le person. NOV, IV 1998 ; 10:30 A?, conveys and warrants to Jeffrey C Amundson and ..7mL.•. `1t 4)Af► Jeanette M. Amundson, husband and wife, P xafOadf I i THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS V 3a ~i Eoul?y 717 ~S9 coov .0 the following described real estate in St- Croix 4Q(; -T E (,UT SERVE i County, State of Wisconsin: i~ '-J(f U•S~jy, `l ~/SEDO6 D $TREer- (Parcel Identifiatien Number) Lot 6 of Certified Survey Map, recorded in the office of the Register of Deeds in Vol. 11 of Certified Survey baps, page 3108, as Document No. 544383 and being a part of the Southeast Quarter of the Northwest Quarter of Secti(m 5, T29N, R19W,Town of St. Joseph, St. Croix County, Wisconsin. is $T 8 SFER 'I !i This is not homestead property. ji (is not) j! Exception to warranties: Easements, restrictions- and rights-of-way of record, if any. ,i Dated this 28th d" at June 19 96• (SEA1) (SEAL) •_EI,3I)k_EQgelbpr a/k/a Hank n_ Fogelberg (SEA-) (SEAL) I Il it ! AUTHENTICATION ACKNOWLEDGMENT STATE OF d'iSCONSI": Signature., SS• it St. Cro' Count . y L authenticated this . day of 19_- Personally came before me this 28t0h day of 1! June I & above named II Han oge r, a a Han F D. _ ~I Fogelberg, a single person, I TITLE: MEMBER STATE BAR OF WISCONSIN - (I (if not, _ authorized by §706.06, Wis. Stats.) Diane M_ BaWsct;1 tome known to be theperson who executed the I~ Notary P foregoing instrument and acknowledge the same. TWIT INSTRtIMFNT WAR DaAFTFD BY Qttl+A n(! YY~rC il_ T