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030-2010-40-000
p N y y M a O y N N N N y y f4 a N 70a m y o E coi e x o -0:2 E 0 y N N E I 3 C N I Y N > -ZB V O c Z w O N z a) -0 C Ri ~~E c me 9) 0 I ~ ~f6m aci N~ a ~ E Q aXi I U N M N rn W j ~ ~ r M Cl) Lu a m I' I l o 0 z .4 c 76 01 z~ I 2 c o fn F- m N z c -o 0 CD N a) rn M .1 CL 1 :3 (D N U) 0) 2 C O O z H w O z to = c E r y N L l0 O IL o CL M M c o m C a a r- m m m a 0 r I h~ zv> i~000 a~ z ~^N cIL IL CL IL N (n J U iI = rn rn } ;73 "a O a 00 co 01 m a. c O N a V d~ Q~ cA m I ~ Y 0 O C5N - N C ,w E O 0 W 0 N co I- - u a oo o n V C, a U O C C N a 0 Lo V) -0 l=xj ry~~ o r N *4 O M N 'M L - O C5 2 O C O N .O o t U) M N o z C co 4 Y U I Y t d €a ~t a L: a r A U a 2 0 N V I • CERTIFIED SURVEY MAP ~l Located in the SE 1 /4 of the SE 1/4 of Section '34, T 30N,. R 19W Town of St. Joseph FILED Surveyed for: Gerald Line F AUQ81984 CENTERLINE Rt. #2 1AM O' CONMU Y. TRUNK HIGHWAY ,tI.1 _ Hudson, WI botdr of 38ods LEGEND 511 C1VN C,3nh, ~ N0°19'21"W 328.0 ' ,1 u ~IIOOQ:'1 _262.03' m 1 _ 11 " - COUNTY SECTION CORNER MONUMENT 9 328.0210, 1 a • 1/4"STEEL REINFORCING ROD FOUND la :1 30 O IN24" IRON PIPE WEIGHING 1.68LBS./LIN. FT. SET m ~01j166' w FENCE .o b-~~- SHORELINE N0°(021"W - SCALE IN FEET Q"=15d1 i~ A LOT 3 50 150 300 450 z zz BEARINGS REFERENCED TO THE MONUMENTED EAST P~E7e ro LINE OF THE SE 1/4, ASSUMED NO°13'06"E DESCRIPTION W A parcel of land located in the SE 1 /4 of the SE 1 /4 1_ t+oMe of Section 34, T30N, R19W, Town of St. Joseph, St. Croix County, Wisconsin, described as follows: v, 10 o ' z Commencing at the SE corner of said Section 34; co o1z thence N0013'06"E (assumed bearing referenced to - N 1D the Certified Survey Map recorded in Volume 2, page 236.89 w 1 512, St. Croix County Register of Deeds) 982.56' C+ I~ OOL P" S 0 19 21 E N Im along the East line of said Section 34: to P.O.B: ;thence IM - z m jO S89016138"W 1328.001; thence NOo19121"W 328.03' N OD LOT 4- !D along the West line of said SE 1 /4 of the SE 1 /4; 13 m _ 0) iz thence N89017132"E 1331.091 along the North line 0 Iv °o c„ P~ 7 F U'icon of said SE1/4 of the SE1/4; thence SOo13'06"W 327.72' 40 °D- 4D along the monumented East line of said SE 1 /4 to the -4 1 rsi o 42 `N 6%% point of beginning, containing 435,925 square feet or o 6 `30 55 5 10.01 acres, more or less, including County* Trunk j--3r'. Highway "I" right-of-way and lakebed of Furger Se,o u lake (5.9 acres, more or less excluding said right- 32j4" ° of-way and excluding said lakebed. a) I, James E. Rusch, registered Wisconsin Land Sur- 1.4 % veyor, hereby certify that I have surveyed and mapped fD 22' the above described property; that such plat is a true \ \N and correct representation of the exterior boundaries CD of the land surveyed; and that I have fully complied C with the. provisions of Chapter 236.34 of the Wiscon- m sin Statutes, the St. Croix County Subdivision Ordi- r, - 4 nance, and the Town of St. Joseph Subdivision Ordi- o nance to the best of my professional knowledge, X r standing a elief. m mes E. Rusch ~~~lt aEd aamZoA 0£6'Z i£9LZi 95Z'9 IZSZLZ Z££69 iZ8SLZ 090'£ 96Z££i SL£'£ E00011 SL9'£ fi0i091 £ saaoy laaj aaen g saaoy ;aaj axen g saaoy 3aaj aa-en g • ~N X0-1 paga~pe7 pule Tenn-jo eM-jo-4Lt ig -4qSi a 2uipnj6xa easy Suipnjoxa 'eaay ea~~ je~oy sleaay ;oZ jo ajgiey CHRISTOPHER C. BABBITT & PEGGY L. AUDLEY 1221 COUNTY RD I HUDSON, WI 54016 715-549-5404 2-21-00 e. St. Croix County Zoning Office Attn: Mary J. Jenkins 1101 Carmichael Rd. Hudson, WI 54016 ~ i Dear Mary: Thank you for your information and assistance on our propossed project at our present home. Per our recent conversation I believe we areaddressing the concerns to be examined with the information we have gathered. Enclosed please find a diagram outlining the requested measurements of our septic manhole to the house as it presently exists, and where the addition will be built. Also, we've included where the well cap is located although our proposed additions do not include the north end of the house. We will be taking down a bedroom wall to open up the area to the existing family room and taking out the small window in another bedroom to make it a walk-in closet. This bedroom will then be an interior, no outside access room so will no longer be usable as a bedroom, (it also appears to be plumbed for a kitchen in the closet). The addition will then replace these two bedrooms downstairs and above them will extend the existing living/dining area. Off the front entrance we will be including a four season porch type of room. In all, the added square footage would be 1168 sq. ft., making the total sq. footage for the house at 3408. The updated septic system was installed in September 1997 by Ulbricht & Associates. As I looked over the papers from Ulbricht it was indicated on the information that this house was set for three bedrooms and a 1000 gallon tank system. We bought this house as a four bedroom home which you will see on the enclosed print out describing the house. So, in our minds we will be eliminating two bedrooms and adding two rooms which could be used as bedrooms. Yet, according to the septic information this is only a three bedroom home and in essence we will be adding a fourth bedroom. If the latter is true, then we will be penalized for the false sale of this home as four bedrooms when in actuality it is a three bedroom home. So, any light you can shed on this will be helpful and the directions we must take to proceed with our addition/remodeling plan. Thank you again for your assistance in this matter. Sincerely, G.Al S a N- LAND SURVEYING HUDSON , WISCONSIN 54016 715) 386-P-007 First Federal of La Crosse 201 South Second St. Hudson, WI 54016'. Part 66 SE4 of SE4 of Section 34-30-19 described as follows: Lot 4 of Certified Survey Map filed in Vol. "5", page 1455; St. Croix County, Wisconsin. Christopher C. Rabbit and Peggy L. Audley z&' PLAT DRAWI Thiel is not a complete Land Survey 9 „ Ga lP !1 ter,....,... 4' 5ep74~ cq' - zlcek- p N89°17. '3. 2"_E ..1._3..3_1.09' 28' garage N N Pip! " 89°17 2"E 536.50' rn V -i r~ w 0o v f ' ~o house FURGER LAKE N o N ~J Ol O O _ ~ . H N9901613811E 782.83' L@W1 REAL ESTATE 1201 MAYER ROAD • HUDSON, WI N IN 540.16 • X715) 386-3363 or (612) 436.2034 MAIN FLOOR MASTER/BATH - CLOTHES CHUTE ISLAND IN HUGE KITCHEN W/EATING AREA- TWO PANTRIES $5000 SATELLITE SYSTEM NEW COLEMAN HI-EFF. FURNACE/CENTRAL AIR l.. GREENHOUSE WINDOWS IN HI-EFF. ANDERSEN WINDOWS COZYHEAT FIREPLACE IN FAMILY ROOM ,I WET BAR OFF FAMILY ROOM WALKOUT FAMILY ROOM/DECKS OVER 300-350 FT. OF LAKE FRONTAGE GREAT FISHING - NORTHERN, CRAPPIES, BASS Addr 1221 Ct Rd. I Daa Hu son Fre 11221 w i4l SE % SW 4 T C St . Croi ' ~t~ j")"! Ettl Cedar Yr ON 1985 Ht LP F A $ Ramble, Al sw SMR TFF Tax Yr 199 2 Acres 1120 2240 $ 2406.49 L C 0 jAwox Rm Site 2 Baths L Y] Hudson i. :LR M Y Y 17.9X15.5 MB Y 88 PAR S St Pt's DR M Y Y 12.5X12.4 Dwshr D Mt Bal. N/A 300 FT. FRONTAGE 21 ACRES ON FURGER'S Kd V B 24.5X15.1 Rek' R60 Mt N/A POND-SPRINGFED LAKE - HUDSON SCHOOL- FR Y Y 12 X 18' jyj WS N R 0 Av HI $475 A RARE FIND MB M Y Y 17.1X11' N C. Wtr IN IC Swr, Avg Ud $50/mo This newer 4 b.r. energy efficient OR L Y Y 16'X11" Y Wei Y Ii POSS Date Neg. walkout rambler has it all! Totally OR L y Y116' X 11' ELFqkS Y C. At 851111 Full W/O finished 2240 sq. ft., family room w/fireplace, wet bar, great kitchen, BR L Y Y 9.6X15' Gil GW j Dock ( J P satellite system-Great views from Rec RR1 Ldr UFFI Y N every room - Central air, decks 21 acres - super fishing & decks g! ffd 300 ft. of lake frontage on Furger's Pond- Rare find won't last long! Exc, hunting & fishing (bass,northern,crappies) Great view Hi-E Andersen windows-Super Eff. Huge kitchen- Satt 2.8 USW Sandee Lowr P11 51 386-3.i PRICE: $139,900. Lowry Real Estate 650 436-2 DIRECTIONS: Take I-94 to Willow River Park exit-left past J.R. Ranch & on past Norlake crossing railroad tracks) on A continue toward Willow River Park through Burkhardt across Willow River Bridge -left on I - straight on I to E. Cross E (staying on I)--3rd mailbo O ~ ~06~~ ~ on right. Fired 1221 Information is considered accurate but we accept no liability error. Listing may be changed or withdrawn without notice. STC 104 AS BUILT SANITARY SYSTEM REPORT OWNER 170 ADDRESS 7Y• A _ -,L x 57 ' S~ l .j~ 1171VSCIJ ltd! 1. Sq a ( (v s ` . l ~fS s SUBDIVISION / CSM 315-?? 3 LOT SECTION3LT 30 N-R / f W, Town of 'sr ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 4n~~ N Ez ous AOAPL41~ 14Iso F J a INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. p Provide 2 dimensions to center of septic tank manhole cover. W ~~G 0 7~p OF leaT•TOf3 tubop D pi-~Cr- AT- BENCHMARK: C1J/l~N - e'5'tX o • ` ~O d - O ALTERNAtE BM-: 9~(rs TIN (r- SEPTIC TANK / PUMP BER / HOLDIN R INFORMATION Manufacturer: ~j~' Liquid Capacity: ~CT s• Setback from: Well >5eD r 1Q House Other Pump: Manufacturer Modell Size Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: Length s Number of trenches Distance & Direction to nearest prop- line: r Setback from: well:House' Other - ELEVATIONS Building Sewer ST' Inlet: 2 x'7.2-0 , ST outlet: PC inlet' PC bottom Pump Off Header/Manifold Bottom of system . ' s 7-IC r Existing Grade Final grade. Cfvj 9.002. DATE OF INSTALLATION: Sol-,. n1 lq ` PLUMBER ON JOB: "Po LICENSE NUMBER: MrP,-S 330 INSPECTOR: ~I~ j~lit1 S 3/93:jt S uttT ~~GG O Pldr PIAA) ,z r~r or j U~ oN ~c~ tl /Q00,~2 O 3 4~w~~ v// MAIM- of o.~ v T [,STS , r Q7. I,> p ei - - N 34e' rp~t Of c lost-sr c ~ 32-0 ropot-.R or 1L~M Zy r ^ s , ?OPlfI t ~2, 22 ( ~ j _ _ _ - _ - _•L SOS' 7201116 e s°' 70 ` SYST OF OA" Wisc6nsin Dep.Irtmentof Industry, PRIVATE SEWAGE SYSTEM County: Labor ~Human Relations S INSPECTION REPORT ST. CROIX Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) SanitarYPermitNo.: 299051 Permit Holder's Name: p City p Villa e Town of: State Plan ID No.: BABBETT, CHRIS/AUDLEY, PEGGY 5T. JCISEgP CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: r J~~, ..e 030-2010-40-000 TANK INFORMATION ELEVATION DATA A9700368 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic - Benchmark l r Dosing Aeration Bldg. Sewer Holding St/Ht Inlet 71 - TANK SETBACK INFORMATION St/ Ht Outlet ' Vent TANKTO P/L WELL BLDG. Airito ntake ROAD Dt Inlet Septic y / >c2 / NA Dt Bottom 07 9 Dosing NA Header / Man. 9,0 ? Aeration NA Dist. Pipe ~~,Y, 01Z Holding Bot. System i65 Q -7 PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM r TDH Lift Fri on System TDH Ft [Forcemain Len Dia. I f Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length j No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Typeo , CHAMBER Moe Number: Systemic Y a✓ 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 34.30.19.387E,SE,SE 1221 CTY RD I LOT 4 Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R 05/91) Date ns a is Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: Visconsin SANITARY PERMIT APPLICATION 2018E w shingtiongAve sion P.O. Box 7969 Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 81/2 x 11 inches in size. 57-. CRO • See reverse side for instructions for completing this application State Sanitary Permit Number ) wos/ The information you provide may be used by other government agency programs ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. SQ,Yj'LQi State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATION IV/ Property Owner Name p 4&v Property Location ! i4 e? T' /"Ej`~,s e-&Y 5~ p1/4 s 1/4, S 3 T 30 , N, R (q E (or Property Owner's Mailing Address Lot Number Block Number 1-22-1 41'. A o - = 'TT City, State Zi Code Phone Number Su vision Name or y? M Number S o,- Gvl . ,~yoi Co -7 1!; )5W Ar Ste? Ud/• S P~. it Nearest Road II. TYPE F BUILD NG: (check one) ❑ State Owned E] City j Public or 2 Famil Dwelling- No. of bedrooms -3 F voan of sr• S 111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 3Y 30. /9.3SriE °30 • zoo . ya 1 ❑ Apartment/ Condo 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. E] 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 25eepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 72, Gk.eS 43 ❑ Vault Privy, 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 90.0 ` `zf '73-20 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) 0 Elevation 7Ife 4¢ Co.s 0 . g 00- 0 Feet 'F2.0 Feet Capacity VIL TANK in gallons Total # of Prefab Site . Fiber- Exper. INFORMATION New Existin Gallons Tanks Manufacturer's Name Concrete stun- Steel glass Plastic App cted Tanks Tanks Septic Tank or Holding Tank - lQjfa ❑ ❑ ❑ ❑ 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) Plu ber's Signature: (No Stamps) /MPRSW No.: Business Phone Numb ?o gt_R-c-- 7AL18Z i c(,,T- 33 0 ~!S • 3 • $C~S Plumbers At dress (Street, ity, ip CodeX: n IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ant Si No am pproved I ❑ Owner Given Initial surcharge Fee) Adverse Determination , X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-6398 (R.11/96) 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 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: I_ 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 cou.nty;.E) soil test data on a 115 form; and F) all sizing information- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creationof surcharges (fees) fora 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. Fresh Air Inlets And Observation Pipe .HIGH TRENCH Approved Vent Cap Minimum 12".Above ct 3.2 O Final Grade FINISHED GRADE 36, " Above Pipe - 4,1 -to Final Grade Vent tPfpe' Synlhetic Covering Min. 2'1 Aggregate Over Pipe Distribution Tee Pipe FO 0 0 0 0 Aggregate o Perfbrated Pipe Below Beneoth Pipe Coupling Terminalin9 At L0o 9 -Li- Bottom Of System SYSTEM ELEVATION CI~%J100A Ws9e conSuhsn% ptW6t Ne % F0. ess *%s Hudson, PER PLUMBING PRODUCT APPROVAL CODES, ALL ABOVE-GROUND PVC PIPING (FROM TANKS b SYSTEM AREAS) MUST BE SCHAD PVC MEETING ASTM D1785 OR 02665 STANDARDS. LOWER TRENCH Fresh Air Inlets And Observation Pipe Approved Vent Cap Minimum 12" Above y, 2 , 0 Final Grade FINISHED GRADE g Above Pipe c' 4 Z c.u °o Q O O ~vES T ~ a T a Z ~ ~ Vv I w 0 w I '"~-I r ~N ~ n Z G ~ ~ o • Wisconsin Department of Industry, SOIL AND SITE EVALUATION / ,3 Labor and Human Relations Page of Division of-Safety and Buildings in accordance with s. ILHR 83.09, Wis. Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County _ D Include, but not limited to: vertical and horizontal reference point (BM), direction and S/ C,\ Or~ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # *//o © 3 O ZO/d ' APPLICANT, INFORMATION - Please print all information. Reviewed by - Date Personal information you provide may be used for secondarypurposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location ew,:5 1310384E"7-7- Govt. Lot f 114 5~ 1/4,S 3Y T 3 0 ,N,R 9 E (or(D Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 31 "e-11 3 City State Zip Code Phone Number Nearest Road 1'- f f (Jf~So~ W Sf/o16 ( 715 ) 3.?,/ /07 ❑ Ci Village l~ Town !7 1 /LOr/ I ❑ New Construction Use: ~sidential / Number of bedrooms 3 Addition to existing building []Replacement ❑ Public or commercial - Describe: NOT )e Code derived daily flow gpd i -I Recommended design loading rate "/)d bed, gpd/f12 ' 7 trench, gpdht2 Absorption area required bed, ft2 J trench, ft2 Maximum design loading ratelyA bed, gpd/f12_-_ff_gp trench, d/ft2 Recommended infiltration surface elevation(s) s-Q e ri • 3 It (as referred to site plan benchmark) Additional design/site considerations ~S 7 40A,,' j A/ f'464 4) 7W f-V 44e S Parent material 5"47- lr'tirP "t- 5,"'7) b "PIV4 r'^ Flood plain elevation, if applicable z ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank Ettr- U = Unsuitable for system ❑ U C s' ❑ U E4~ 1:1 U D-5- U ❑ S E3'u--- ❑ S SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench l 0-7 10)P 3/3 S[. if'4~e ~s~ cs 3-F q ; . S z io y,10 31 y SL /f' cs . S Ground 3 s •3 7-S Yk Y s s WX c.5 ' 7: . 8 elev. R 3 45-ft. /~1Q S/~o S o. s _ _ . 7 Depth to limiting factor } jin. Remarks: Boring # I 0 , o yle 313 S ! L 2,f57bk 6CS L C 5 3-P -7 . G z Z y• is yR 311 - 514- z-F Sbk A-7f2 05 a /o Y)( Y/ 01 SQL Z f 5 b )K.-F t • S • s' . CL 'd Ground /aYe 6- S S d • 7 •0 ~5.. elev. Depth to limiting factor in. Remarks: AIRq y/9 C07L /a "ox 111oAt oFF- .To165011 ea&, 132 • ~ 74- CST Name (Please Print) G Q E R T_ Signature Telephone No. vCA 3$~•gi'g5 Address f ;l Date CST Number G SS D Q• 7. q 7- c 5 7'--, JLq 81~ C. f3,4 (3 t3 SOIL DESCRIPTION REPORT 3 PROPERTY OWNER Page Z of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Structure 2 'Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 3 ► a-/ Hoye 31 S~4- Ifshk 4,5k S If • Z: • 3 Z /S •Z io % 31 S~ 17~Sh • 2 ; •.3 Ground 3 /D jrl L Sh /wl f C - • 2. , • .3 elev. off. Depth to limiting factor -%~in. Remarks: /t~~2QlsI'~P O: CST /.1" ~/Q DR~~ D~ ~~OSaj'G VY Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles structure GPD/ft2 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Boring# Ground elev. tt. ' Depth to M limiting factor in. Remarks: ~ rh ~ O O ~c v ~ N 0 -r CIO o", 1 I r~l ~ ~ O , I i~ f y y ~ r r, '~ti~ n Z C - _r O 1 o rnNA S O 3 95773 CERTIFIED SURVEY MAP Located in the SE 1 /4 of the SE 1 /4 of Section 34, T-30N, R 19W Town of St. Joseph FILED Surveyed for: Gerald Line s AUG23 U4 CENTERLINE Rt. #2 JAM Of OOHM ~ ~TY. TRUNK HIGHWAY "II" Hudson, WI boMw ot Do** LEGEND M► tarok oa•h, c~ NO°19'21' W TO' W4o=lb 262.03' COUNTY SECTION CORNER MONUMENT 32e.02• I/4 STEEL REINFORCING ROD FOUND 30 O 1"X24" IRON PIPE WEIGHING 1.68LBSAIN. FT. SET FENCE SHORELINE N04021W ¢ SCALE IN FEET 1"=15 LOT 3 ; i 1 O 25 50 150 300 450 o z 77 o BEARINGS REFERENCED TO THE MONUMENTED EAST tr1 h LINE OFTHE SEI/4, ASSUMED N0°13'06"E U CRI ON - Re-divisi.Ithe f of 1 of o In I I Certifiedu~rvey in Vol 2 P e l~ a 0 m 0 A parcel of land located in the Sk 1 w SE 1 /4 Im HOME of Section 34, T30N, R19W, Town of St. Joseph, a Im St. Croix County, Wisconsin, described as follows: -0 cn 10 0 ' OD 1~ Commencing at the SE corner of said Section 34; 41 CD 00 a- o 0 zz thence N0013'06"E (assumed bearing referenced to CD m ca rn to I - ID the Certified Survey Map recorded in Volume 2, page r+ 0 N .8' sr 1a ao ° S 0 23621E N I-4 512, St. Croix County Register of Deeds) 982.56' W o Im : e m 1o along the East line of said Section 34;to P.O.B.;thence rn I~ z 1 S89°16'38"W 1328.001; thence N0019'21"W 328.03' FA LOT 4 !r along the West line of said SE 1 /4 of the SE 1 /4; M In co _,~o thence N89°17'32"E 1331.09' along the North line 0 o w 1W of said SE 1 /4 of the SE 1 /4; thence SOo 13'06"W 327.72' - 0 along the monumented East line of said SE 1 /4 to the point of beginning, containing 435,925 square feet or o c55~4 ra p •'(5 10.01 acres, more or less, including County Trunk a N , 13-r- Highway "I" right-of-way and lakebed of Furger s2,o3 G lake (5.9 acres, more or less excluding said right- $ of-way and excluding said lakebed. I, James E. Rusch, registered Wisconsin Land Sur- °D N, veyor, hereby certify that I have surveyed and mapped (D w ( N 22' the above described property; that such plat is a true and correct representation of the exterior boundaries (D of the land surveyed; and that I have fully complied CD _n o C with the provisions of Chapter 236.34 of the Wiscon- m sin Statutes, the St. Croix County Subdivision Ordi- J nance, and the Town of St. Joseph Subdivision Ordi- o nance to the best of my professional knowledge, r standing a elief. . nl -wt Affidavit in '_MPR F._ Rnarh Vol 7)il Pa -P. 1t77 ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK t This is to certify that I have inspected the septic tank presently serving the 15,t,613E-7_ ccresidence locat.:d at: ` e 1/9,--s~ -1/9, Sec. 3 T T36 NI R_/? W S~ 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 Did flow back occur from absorption system? Yes No / (if no, skip Approximate volume or length of time: next line) gallons minutes Capacity: Construction: Prefab Concrete Steel Other Manufacurer (if known): Age of Tank (if known) : N (Signature) (Name) Please Print (Title) private Sewage Consultan a ( L i c e n s e Number) ~dsoonew s- 540'6 1P /~-S 33 6 (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. Adm. Code (except for inspection opening over outlet baffle). Name pog"T" ?,1G0r' Signature /40--2 J4@'/MFRS ~3 O 5/88 r • 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 e0!,5 e• B/~'/~17- AefYV L . /¢1lDL~~y Location of property S 1 S /4 1/4, Section T3 N-R Township ,s ,SEA f~-- Mailing address Address of site Subdivision name CPS.-Al 3f S* 773 a4l-s Lot no. Other homes on property? Yes No Previous owner of property 6&W"FLO Total size of property Total size of parcel Date parcel was created 2 2 - Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house) ? Yes Volume P6oi and Page Number SyT as recorded with the Regist-No er 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 office of the County Register of Deeds as Document No. ys Z Z- 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 of the County Register of Deeds as Document No. Signat of Applicant Co-Apple t Date of Signature Date of Signa ure STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County UDLEy OWNER/I R CA "S C' /SIM131'7- ' EJ~✓!~ Z. MAILING ADDRESS / 2 2 l G T Y. •Uo~Sov .s' ybl~ PROPERTY ADDRESS SGT, (location of septic system) Please obtain from the Planning Dept. CITY/STATE L~ PROPERTY LOCATION c ~ 1/4, `s~ 1/4, Section `3/ T 3 4~9 N-R 11q W TOWN OF ST • CrS P ST. CROIX COUNTY, WI SUBDIVISION CS14 3 S ? 3 LOT NUMBER CERTIFIED SURVEY MAP _,VOLUME 5 , PAGE y ss, 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. 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 exp' tion date. SIGNED: t_ DATE: -tea-Q 7 St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 JF DOCUMENT NO WARRAMY 0 THIS NA'[ on agra"VINO DATA STATE BAR OF WISCONUM FORM 2-18l3 y 45823 ;I,,t %P, REGISTER'S OFFICE ST. CROIX CO., WI Gerald G. Line and Katherine L. Lire, ~s his wife Recd for Record and in her own.r.ight......- - . n ~r••,Y V 31J90 - . - 10:55 A. conveys and warrants to -_.Chri5togber_C-,_.B46@.it- and--P(-ggy __L.__ 0 Aud1QY a~ oant_~enanc_s . ~*Wxsp ►dp~ - - . . RCTURN TO . the following described real estate in St-e__CCOiz County, State of Wisconsin: Tax Parcel No: -030=291.0-40..... Part of SE14SE14, Sec. 34-T30F-119W described as follows: Lot 4 of Certified Survey !dap filed August 23, 1984 in Volume "5", page 1455 '1')- : AD 'Ors a 1 This is homestead property. (is) 04") Exceptwn `.o warranties: Existing high.:ays• easements and rights of way of record. Dated this day of -~'s..,...._ 90 (SEAL► - (SEAL) Gerald G. Line - --(SEAL) SEAL) Ka.therlnP L._Line AUTHENTICATION ACHNOWLSDOMBNT Signature (a-) STATE OF WISCONSIN ss. .t,... KQix.. County. 'r N authenticated this day of 19 ersonally came before me this ..•~!!----.---day of Q• 1999.... the above named - - Gerald•G.-_Li•ne-_and_-Katherine•L•--Line... • - - husband-and-wife TITLE: MEMBER STATE BAR OF WISCONSIN (If Dot . authorized by j 706.06. Wis. State.) to me known to be the person 5-......... who executed the fore 9iw~strunient and acknogledge the same. CERTIFIED SURVEY MAP Located in the SE 1 /4 of the SE 1/4 of Section 34, T 30N, R 19W Town of St. Joseph Surveyed for: Gerald Line CENTERLINE Rt. #2 TRUNK HIGHWAY "I" _ Hudson, WI LEGEND _ 11 NO°19'21°W /2' "1 a ERMONUMENT _ _262.03°' COUNTY SECTION CORN 3z30- + • 1/4"STEEL REINFORCING ROD FOUND O 1`X24" IRON PIPE WEIGHING 1.68LBS./LIN. FT. SET M FENCE SHORELINE SCALE IN FEET 0"=154 LOT 150 300 450 2 77 ~ BEARINGS REFERENCED TO THE MONUMENTED EAST LINE OF THE SEI/4, ASSUMED NO°1306„E DESCRIPTION W A parcel of land located in the SE 1 /4 of the SE 1 /4 M Im 0) NOME of Section 34, T30N, R 19W , Town of St. Joseph, _Z1 St. Croix County, Wisconsin, described as follows: 11 a) Commencing at the SE corner of said Section 34; 0Iz thence N0013'06"E (assumed bearing referenced to ° jr° the Certified Survey Map recorded in Volume 2, pag Ic LW N S 0 236..89E w I-i 512, St. Croix County Register of Deeds) 982.56' I< ° e ' N Im along the East line of said Section 34;to P.O.B.;thenc z m IO S89016138"W 1328.001; thence N0019121"W 328.03' co LOT 4 If- along the West line of said SE 1 /4 of the SE 1 /4; Ic ,000 _ 4i in thence N89°17'32"E 1331.09' along the North line Iv r1j o 1N of said SE 1 /4 of the SE 1 /4; thence SOO 13'06"W 327. 7 aD 0 along the monumented East line of said SE 1 /4 to the 1Q~,,w point of beginning, containing 435,925 square feet of N,3i55~3615 " 10.01 acres, more or less, including County Trunk Highway "I" right-of-way and lakebed of Furger lake (5.9 acres, more or less excluding said right- of-way and excluding said lakebed. I, James E. Rusch, registered Wisconsin Land Sur- veyor, hereby certify that I have surveyed and mapy 22, the above described property; that such plat is a tru and correct representation of the exterior boundarie of the land surveyed; and that I have fully complied C with the provisions of Chapter 236.34 of the Wiscon 0 N sin Statutes, the St. Croix County Subdivision Ordi- 4 nance, and the Town of St. Joseph Subdivision Ordi- nance to the best of my professional knowledge, D rstanding a elief. m rn E. Rusch isconsin Land Surveyor 51376 t~ d~ to -Z ueugoZ •g a.,.ooS j~q pa4jvap ssm quauma4$uz sjq punoj adzd uoat „Z +O punoi adzd uoai „T • ~y Mod S'tS 01149 lDore I 1 Off, ~~i1 auzT aapuS LAOIS A~~ `~v Nvaw ION N1471no `M/Nh~ ~oN/WS►Nl~p 1 Q~3Qa auZT uoz~.oas t~/T ao uoz~.oag SM. l va a ddV A1SN3H~8d 'qas 400,E TvauTT/*SqT Zo5'T DuTgDTam x xagGu1vTp A/T `poa DuzoaoJuTaa Taals punoa 9# 0 MAQaW dvo uas4uaag - '.uaumuolq j~qunoZ) (,O : ,.1) Q~IgOgI ,OOZ ,001 1001 ,OOZ 1334 NI 31V0S M618'N021 V2 N01103S 83N800 3S H3N800 MS ,68't,LZS 3„t5,21068 N 3S-3S SONn G311V-1dNn z 9b'8Z M.,61 09 ON Z 9NINN1938 d0 1NIOd ' ' o LoLOti ID p ,9Z'869 3 ,It,,60o68 N o ,06',2£1 M„£b,91o68S ,Zb'S99 8b 809 b0'Lb M IZ 61 0 N 9 3 m kmoos ~i'£r3~ o ,1~o z b/1 3S- - N - Z/1 S) N N rri~ C, l I OD o0e9~\ m N) -4 O N O N % S380V 9'9 W w 0.Zo o EJN10f110M £916 z o rn ~d `3AV1 9 AVM-d0-1H918 OV08 9NIOf110N1 S380V 86.6 I o m tO m _ I- LI'9b9 Q ;96'£8 61'6ZZ ,80'61, 109 1Z C Z D _ -I (n 0 Z Ch a Z ,00'8Z£1 3 .,82,91 o68 N m mm c (b/1 3S-b/1 as-Z/1N-Z/1 N) W im w 0 N W 'Z of m kA b 7, ca -4 rn~ N \L ( J0 1~ Z ` N 1= G) 0 3~V1 19 S380V Z'9 In i m o MomOX3 £9'6 Zorn a~ 3NV1 18 AVM-d0 -1H91H OVO8 JNI(In10N1 S380V 10101 1;~+ ~N - Z 8,'9£9 19'bb9 0g ~I 60'1££1 3„Z£,LIo68N 4,ZI rn -i ZZ ,0£ S'9 o .0 6,g 96% SdNb=~ a311~dNf1 CCL 1SOd 30N3A 1V ONnOz1 q~~~110► MIIdS POE 83A0 / ,~~o iN01 bZ `2dVe N02i1 b/£ 13S tpcoQ 1 I lot +~iq>'N 83N80O t/1 3 ~ieNsoo i• $Mt Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT i • OWNER TOWNSHIP SEC. , tV T 36) N-R W ADDRESS J1 ( ST. CROIX COUNTY, WISCONSIN 3 11~ii (~f.~ SUBDIVISION C~ p LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of II-HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM a ~ L p~ Gr+~ LV t L v 3 ii~iir (t t-1T R Y 00-1 ~i INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used j j AL41 1 jL SO,O,,& PUMP CHAMBER • y Ma cturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons cycle: Alarm Manufacturer: A Switch Type: Number of feet from est property line: Front, ide, O Rear, Q Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed:_ Trench: Width: Length: Number of Lines:~ Area Built: Fill depth to top of pipe: A~r,~/►,¢6-Z Number of feet from nearest property line: Front, O Side, Rear,O Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). EPAGE PIT ze: Number of pits: Diameter: Liquid pth: Bottom of seepage pit elevation: Area Built: Has either a drop box distribution box O been used on any of th above soil absorbtion sytems? (Check one). HOLDING TANK i Manufacturer: Ca city: Number of rings used: Elevation of tto f tank: Elevation of inlet: Number of :e et from nearest pro ty line: Front, O Side, ear, CyFt. Number feet from well: N er of feet from building: .r r,.,.« r ,....a . DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS P.O. BOX 7969 PRIVATE SEWAGE SYSTEMS DIVISION MADISOAI„ WI 53707 BUREAU OF PLUMBING ` ®CONVENTIONAL -1 ALTERNATIVE fate Plan l,.D. Number: Holding Tank ❑ In-Ground Pressure ❑ Mound assigned NAME OF PERMIT HOLDER: =Route OLDER: INSPECTION DATE Gerald Line Hudson W1 5401 40 •'30 BENCH MARK (Permanent reference point, DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.: SE4 SE4f Section 34, T30N-R19W, Town of St. Joseph Name of Plumber: T"P/MPRSW No.. County: Sanitary Permit Number: Donavin Schmitt 3205 St. Croix 69609 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: T K OUTLET ELEV.: WARNING LABEL LOCKING COVER . PROVIDED: PROVIDED: BEDDING: VENTDIA.: VENTMATL.: HIGH WATER DYES ONO OYES ONO ALARM. NUMBER OF ROAPROPERTY WELL: BUILDING: VENT FRESH FEET FROM LINE: LAIR INLET: OYES ONO s IDYES ONO JNEAREST rI DOSING CHAMBER: MANUFACTURER. BEDDING: LIQUID CAPACITY. PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: OYES ONO OYES ONO DYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET ' PUMP ON AND OFF) OYES ❑N0 NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing H DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: BED/TRENCH WIDTH LENGTH NO. OF DISTR. PIPE SPACING COVER INSIDE CIA #PITS LIQUID DIMENSIONS TRENCHES / _ MATFATAL PIT DEPTH: GRAVEL DEPTH FILL DEPTH DISTR. PIPF DISTR. PIPE DISTR. PIPE MATERIAL' NO. ISTR. PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES. 4 ABOVE.COV~FI. ELEV. INLET ELEV. END: PIP S NUMBER OF CC{{ ? FEET FROM LI E: AIR INLET: NEAREST 1.4) MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- D YES ONO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEXTURE: PERMANENT MARKERS. OBSERVATION WELLS. DYES ONO DYES ONO DEPTH OVER TRENCH/BED 1"t" TH OVER THENCH/BED DEPTH OF TOPSOIL. SODDED SEEDED. MULCHED. CENTER. EDGES. DYES ONO DYES ONO OYES ONO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH NO OF 7GRAVEL RAL SPACING: DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEV.. ELEV.: DIA.: ELEV.: PIPES. DIA.: ELEVATION AND DISTRIBUTION - INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO APPROVED PLANS: DYES ONO DYES ONO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE: 1 S DYES ONO DYES ONO NEAREST 7 b , 2 I 0j ytr S° 1 v ~`L Sketch System on Retain in county file for audit. Reverse Side. SIGNAT I TITLE DILHR SBD 6710 (R. 01/82) r... 17:L consln APPLICATION FOR SANITARY PERMIT DILHR 1-he a_~ COUNTY (PLB 67) UNIF ~M SANITARY PERMIT USTR0,URBOR&HUMRnRELRTIOns -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'hx 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNER MAILING ADDRESS PROPERTY LOCATION CITY: a 1/4; 54 1/4, S -7, T 3 N, R / E (o k'@ TOWN OF J G LOT NUMBER JBLOCK NUMBER SUBDIVISION NAME NIT-WREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER + Cv f 7 16 TYPE OF BUILDING OR USE SERVED 1 or 2 Family Number of Bedrooms: IEJ Public (Specify): THIS PERMIT IS FOR A: X New System ❑ Tank Replacement ❑ Repair ❑ Replacement Soil Absorption System ❑ Revision ❑ Privy ❑ Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. D4, , Seepage Bed ❑ Seepage Trench Cl Seepage Pit ❑ Holding Tank System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued ❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer: - IS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressur Total #of Prefab. Steel Fiberglass Plastic ons Tanks a constructed Septic Tank Capacity Lift Pump/Siphon nu acturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): I > Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. lei Name of Plumber (Print): Signatur 11\4MPRSW No Phone Number: Do,y,4L;,/_A( Sc 7-:r IL;W- ZZO-5- (21L 57~2-4*65,1 Plumber's Address: Name of Designer: r COUNTY/ DEPARTMENT USE ONLY Signatur of Issuing Agent: Fe /e: [ Date: ❑ Disapproved 6, ! ~J•~ ❑ Owner Given Initial Approved Adverse Determination eason for Disapproval: Alternate course(s) of Action Available: DILHR-SBO-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398 To be complete and accurate the permit application must include: 1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in a city, village or town); 2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.); 3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks. 4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of square feet to be installed; 5. Complete the section on water supply; 6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi- fication, place your license number in the space provided and sign the permit in the signature block; 7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the permit; 8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation. Failure to comply will void the sanitary permit. 9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable. 10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system, depth of the system, type of system. 11. All revisions to this permit must be approved by the permit issuing authority. 12. A complete plan including a plot plan, drawn to scale or with complete dimensions. 13. Horizontal and vertical elevation reference points that are permanent and clearly shown. 14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s) to system, building sewer and vent observation pipe(s). 15. The permit issuing agent may require a cross section drawing of the effluent disposal system. TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning your system, contact your local code administrator or the Bureau of Plumbing, DILHR, State of Wisconsin. -000~ APPLICATION FOR SANITARY PERMIT 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 =AeA-10 L /-/,6:- Location of Property Section, T ~O_ N - R~ W Township rl " Mailing Address RT V10/'45 Subdivision Name Lot Number Previous Owner of Property 2jMA(,Z2 ~l~ilE al- C&APoi- Z SYrIA/ Total Size of Parcel s3.,Z_'4Ci~F5 Date Parcel was Created 122 7 Are all corners and lot lines identifiable?_ Yes No Is this property being developed for resale (spec house) ? Yes X No Volume and Page Number 6A-? as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract 3. Other recordings filed with the Register of Deeds Office 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 the Certified Survey Map shall also be required. PROPFRTV OWNER CERTIFICATION I (We) ce4ti6y that a.?.Q statements on th.vs boAm ane true to the beat o6 my (ouA) k.now.tedge; that 1 (we) am ( cute) the owneA (a) o6 the pAopeAt y dens cA bed in th" in6onmat%on {ohm, by vi tue o6 a waAAanty deed %eco&ded in the 066ice o6 the County RegizteA o6 Deeds as Document No. _3 9 ' and that 1 (we) wt,umtN i NU. I STATE HAIL OF WISCONSIN—FORM 3 i QUIT CLAIM DEED ~ .j C~9 ~9 VO' 565 Pnln:f1627 THIS SPACE RESERVED FOR RECORDING DATA , BY•Trlts nia:u, Gerald G. Line__and-Carol. Haskin REGISTERS OFFICE ST. CROIX CO., WIS. - - r--- Grantor _s- , Recd. for Record this 8th l u , , l a i m s t o Gerald Q, Line- c 1ath -r i ne L` T,i no husband- _ ! and wife as joint tenants, ` day of Dec. A.D. 19_77 i at 8:30 n , M ~,rautec• for a Valuable consideration R0961W of Deard ..w.c, r,< nbud real estate in - -_S.t-_ CMiX_-_- County, Slate of Wisconsin: Ir~t 1 s shown on the Certified Survey Map filed and RETURN To r ded in the Office of the Register.of Deeds for -r St. Croix County,Wisconsin, on November 25, 1977, in Vol. 2, Certified Survey Maps, page 512, Doc. 344993. Tax hey k This is_L1tp-X7--homestead property. This deed is given in connection with a partition of land formerly owned Gerald G. Line and Carol Haskin, as tenants in common. It is 'relieved to be ex empt from the Wisconsin Real Estate Transfer fee under Section 77.25 (5) and (8). FEF il EXEMPT I i 'i F, I II Hudson, Wis. and DePere, Wis.t}11S 29th as of November f~ and Dt.c,ember 2, 1977. - - - y I9~Z , I~ - _ _ 2 SIGNED AND SEALED IN PRESENCE OF (SEAL) ~ ~ J II (SEAL) li CARMBASKIN-- (SEAL) ) (SEAL) l ~i Signatures of -Ierald G. Line _ II auth< n[icated this- day of - NOV rnhPr 97Z- JOHN D. Hhk-'YWOOD - Title: Member State Bar of Wisconsin AKXVQ ii Authorized under Sec. 706.06 viz. OF WISCONSIN Pm- 1 _ _ i H z H 9 STC - 105 r r a H SEPTIC TANK MAINTENANCE AGREEMENT H 0 St. Croix County z d 9 OWNER/BUYER GEQALD L!/V6- ROUTE/BOX NUMBER ~Ti 2 s Fire Number CITY/STATE A-4(a k2k ZIP -6 PROPERTY LOCATION: JE 4, s~ 1, Sectionc3ly , T 30 N, R~W, Town of S;r' CTbS~~f/ $ t. Croix County, Subdivision Lot number. Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect.,the function of the septic tank as a treat- ment 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 systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. 0 E I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x H the standards set forth, herein, as set by the Wisconsin Depart- It ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Offic within 30 ys of the three year expiration date. SIGNED DATE St. Croix County Zoning Office P.O. Box 98- Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. m<2< > O U C ~ _ fq .r yr s: 13 tv 'a pac) to V y m N A C p)L O V m y C c° c p O y O 3-- 0-0 Lil o emo v •c C c• m 0 -0 C9 3 oZ 3 E cc cc 0 m c~ w o v) O O 0 V N w C l0 0 N CD to N m y C W H e c..v ccv ~ cn ~0 E a 0 (D -p c v al V) ~ Q ~ m rn3£ o m o N • N w 3 Erma ~E cimm y z r to 0U) m~c to - cv M .C C m of 0 3 O 30aa)ow 0 0) b.. Lt =v - o Co c ` M C) 0 C'3 C) C.) O cu a v•-.- ~Q m o ~o v) m Q aa0a~o cv mcr c c 13 0 o a) O 3 C .a .C c0 m U •O O E O O rn Z .C ~'Ccu E c _ 0 0 V O c C t R1 O co 0 0 0 C CO m m p U 2 T~ m E U w CO) U) CD 0 (D (D a cv Nd C.) Cyr- R! O L: V0-0... m etc\ Qv H O 'y m~ fl ( m om O #13 >,.x v) L- L- :3 E L- C O C m w O a p C M M O O OC O) ` 0 ? 1 .C t' a O L.: O 0 ~ o f O t C c i) (a to O A ~J N m m w cc C ac 01 = N c LS R "In, Wl~~ 111F +a,$ REPORT ON SOIL BORINGS AND PERCOLATION TESTS r.w j r WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES f . MP,O BOX 309" ISON, WISCONSIN 53701 ,tea y { LOCATION rSectlon ,'I'',XRI W, Township eF~r v0~ aQ7.. r Lot No , ~IockNo .t."* i r" t y cs y I?x ~t Ali, County Cie, of k ! f x~ Ivlsloame " O ~csf uyers 5'~2 ++e rL ~€~!i a i tom. in /s 1 Mailing Address i TYPE OF OCCUPANCY RResadence No. of Bedrooms COMMERCIAL Y EFFLUENT DISPOSAL SYSTEM. 'NEW x , REPLACEMENT ALTERNATE SYSTEM OTHER J DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS !SO MAP.~SHE -4 } b1`"' NAME OF SOIL MAP UNITL H ~K ~+C lriMi~1.,-'r•" b_c E.i"~ +G ~qq•'^4 - - 1 PERCOLATION TESTS HOURS, WATER IN TEST TIMEDROP IN WATER,LEVEL, INCHES DEPTH k ACLEF So -4 RATE - SINCE14OLE HOLE AFTE INTERVAL BER INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN 3 3'/8 A A' - p- f L,`.. CJ A✓ t1 arlE -u r ~ r ~ a ,t 4~ - BORING TESTS" .'TEST' `T07AL plrpTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, 1 `NUMBER" w TEXTURE, MOTTLING AND DEPTH TO BEDROCK OBSERVED ESTIMATED HIGHEST p~ 55 e7. t Q[ IF OBSERVED IN INCHES - _ h B-.t 7• L . ' ? it. 77 i • G T s - L° ~a S M 5 8 ~,rA a r .a+ll ? 1. mil} i /N S i L •)5m - ?,e s. 6= Mn ~a';+ t lok-f Z. !a f~ n 5~~ 4y~ v~ f~a~ s ~ { B.",! s+~,r"~+ 4~r3 .;:~6/V E" "f i7~ 'rs fjlL. !S M G~7~ ~J S.✓~ Yf.~S ~ 7'~' B_ y~~ :r> rafil , S,~ 4' ns~ }3w►SC~t S'/~+±(`v4~ tfC~,e z3 1 .V.IEW (L ,k ation,.tests, soil bore holes and suitable soil areas.) indicate on the plan the location and square feet of.suitable areas. cqwolcol Indicate number,,gf Square feet of absorption area needed fob building type and occupancy Indicate scale or distances. { 're izg+~te4 r rence points Indicaate slope `4'C _ 0 9 a 40 a ` y~ ` ~t o ! g 6► 1 S4 ty ti S,µ ice. > i e 3 lp, V tl' Z5 f `r t--. "k v D i ~N i 77~ -1 77_ r Q~K pX ~ y"dRs~ 1'e~ Vol • r JeN D d %ypA-P- co~re2 o ',Qkof!iw ROLE s ys?~rf EL. 99, 7~ ~ ~ pf,~ ,',eivcc NO& /VdRrit piPopaRTy 11WA7 .3,2 ~4cRES P~~F ~sr gol IM~► /01 /oo ' j ~ r se ac r~NK i ~ 10 's sysrr~ e~ a~, 8 i8 x a LT, _ s~Ep G-l~ pets{ . - ay 03 B2 ~~~r~N JJk~K Cc ~dOr as 1 d .5p1/C,6 /AK c Lu~IP ole 6 ~o~l.~R T/1~ES L • 7 :2.3'8 DRr4WIA(4- 13y ~Q~Fcul~v~ f og Cry- L~ oo►ma-.M-,- o~ e kE rl