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HomeMy WebLinkAbout036-1079-20-000 STC - 104 / AS BUILT SANITARY SYSTEM REPORTr" RECEAD 7 T-97 OWNER aM/J ST CROIX ADDRESS COUNTY' ZON FI:ICE IN(30 K"(~ 1\ l C h'rr 4 W 52e 647 - 0~ t /C DO d~. L2 LOT SECTION-_3/_T~/ N-R__~Q W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM pl~~ L) h !COQ. S L r 04 N I va a, rlQ• INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. I IIENCFiMARK : 4), ;E 'Q h e Tr / ALTERNATE BM- PTIC TAN / / Manufacturer: Liquid Capacity: no lSetback from: Well House , Other Pump: Manufacturer Model# - Size Float seperation 1A Gallons/cycle: Alarm Location > 4 SOIL ABSORPTION SYSTEM Width: /oZ Length Number of trenches - Distance & Direction to nearest prop, line: 1,[ 0~ t~Ja.a Setback from: well:__ALI,_ House YOi Other ELEVATIONS • R Building Sewer s, ST Iniet-, ST outlet: PC inlet PC bottom Pump Off Header/Manifold-13,, Bottom of system Existing Grade Final grade ~5c 7 DATE OF INSTALLATION: PLUMBER' ON JOB: LICENSE NUMBER: /$(o INSPECTOR: 7/ 57.3 3/93:jt Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor andHuman Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary 299088 Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.: HRISTENSEN, HANS STANTON CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 10-0' 1 CGi 036-1079-20-000 TANK INFORMATION ELEVATION DATA A9700407 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic w~ loco Bench mar ~ ,I 3 r{7 103•g1 / o Dosing Aeration Bldg. Sewer ni✓ Holding Inlet ~L/ TANK SETBACK INFO MATION (DJV Outlet ~,2 Cj~ Zz7 TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic 15d' A d` ±3 ( , ' NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe q.8o /o' ;(,7 43 ~7 Holding Bot.System 1C~-% Gj2 S! PUMP/ SIPHON INFORMATION Final Grade -7,D C1 to •'17 Manufacturer Demand r~},y►~uN aolc q qq, 9Fl 48 Model Number GPM TDH Lift Friction System TDH Ft oss Head Forcemain Length Zia. Dist. To Well SOI ABSORPTION SYSTEM ED / RENCH Width Length , o. re c ies PIT No. Of Pits Inside Dia. Liquid Depth D EN I N 12 -1 DIMENSIONS SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACHING Manufa urer: SETBACK INFORMATION ypem CHAMBER ^ qD/ -7 1n8 OR UNIT Mo Number: System orM►,nt~aao DISTRIBUTION SYSTEM ST'rkl%2 Header /Manifold rr Distribution Pipe(s) x Hole Si x Hole Spacing Vent To Air Intake Length T Dia. Length 9 Dia. y n Spacing (O 725"' SOIL COVER x Pressure Systems Only xx M 91 nd Or At-Grade Systems Only Depth Over Depth Over xx ;~pth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges To oil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: STANTON 31.31.17.488,NE,SE 1833 OAK RIDGE TRAIL LOT 1 jyb1. ;ro GAG ~aM~ . Plan revision required? ❑ Yes N0 Use other side for additional infor at n. It le q SBD-6710 (R 05/91) Date Inspector's Si nature Cert No. I ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ' • Safety and Buildings Division ~•■~r■r,. SANITARY PERMIT APPLICATION Bureau of Building Water Systems 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County C than 8 112 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Permit Number g7C168 The information you provide may be used by other government agency programs E] Check f revision to previous application [Privacy Law, s. 15.04 (1) (m)]. 1 ?33 0~, /d jZ r`-, State Plan I.D. Number 1. APPLICATION INFORMATION v-PLEASE PRINT ALL INFORMATION Property ner Name Propert Location 11/4 rt 1/4,5 T , N, R j fir) W -E 31 IT C>-Y\ 1~.~' l~ `1~•"~ Y~ PropertOwner's Mail,,, Add s Lot Number Block Number t_ ri City, State Zip Code PTt9 one Number Subdivision Name or CSM Number N.x,,D42'~ArixoA -5v ®l C S II. TYPE OF BUILDING: (check one) ❑ State Owned o Cityage Nearest Road p F] Public Z1 or 2 Family Dwelling - No. of bedrooms Vll Town OF Y7 III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) ~j --LL e G p 1 ❑ Apartment/ Condo 63L / v 7 c,? -_,-.Z D -/00 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. Q Replacement 3. Q Replacement of 4. E] 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 -7--, Z/ Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation y Feet 1 Feet qj, 5"_ / - VII. TANK Capacity aclts Total # of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Existing strutted Tanks 'Tanks Septic Tank or Holding Tank r: U"V (o i .QS c-~ ❑ ❑ ❑ ❑ ❑ 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. Plu tier's Name: (Print Plu tier's Sign ure: (N Stamps) rPRSW No.: Business Phone Number: ~Q vS 7 , Sta , Zip Code). Plumber's Address (Street, Cit Z rpk IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issue Issuing Agent Signature (No Stamps) Approved ❑ Owner Given Initial Surcharge Fee) '1 n Adverse Determination 0 o~ "7 X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: SBD-6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To: Safety & Ruildings 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, 608-266-3815. „ . , 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. IL 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. N Eli S5 Y, Sec. 3 17-:3 1 M R~7w 5 0~ 7 193 3 a-mK 5= k 9 ~I~ -s f~ I rw~` 40 < DA 302 i o 9~ _ - - - . _ _ ~ _ , I! i ~i~ l _ - - - i _ _ _ ~ ~ _ I _ i-_ Wisconsin Department of Industry, SOIL AN V A L U AT I O N REPORT Page ot3 ,Labor and Human Relations Division of Safety & Buildings 8 C ` kH R 83.05, Wis. Adm. Code COUNTY _ C Srt Crotk Attach complete site plan on paper not less 1/2 . La in size. PI must include, but not limited to vertical and horizontal refere int (BA ~irection and % of s pe, scale or PARCEL I.D. # dimensioned, north arrow, and location an ' ance to Barest rc~ 2 " a REVIEWED BY DATE APPLICANT INFORMATION-PLEAS cP INT~ 4IIATION 7-f PROPERTY OWNER: r ZoN;aOFF► f PROPERTY LOCATION C h h I S r- C 'GOVT. LOT V 1/4 5,* 114,S~V T 31 N,R /,7 Vor) W PROPERTY NER':S MAILI ADD E S j` LOT # BLOCK # SUBD. NAME OR CSM # 4,11A . A CITY, ST PTE ZIP CODE PHONE NUMBER CITY []VILLAGE J TOWN NEAREST ROAD 4,A A'7 (ice aA6 New Construction Use [ ] Residential / Number of bedrooms [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow !!k5D gpd Recommended design loading rate bed, gpd/ft2 , S trench, gpd/ft2 Absorption area required IZQ-S bed, ft2 qo'b trench, ft2 Maximum design loading rate ,gybed, gpd/ft2 trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations Parent m rial orj „ Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING, ~T4NK U= Unsuitable fors stem S❑ U [9 S ❑ U ZS ❑ U MS ❑ U ❑ S R L ❑ S -P I SOIL DESCRIPTION REPORT OM C 2 f o'er 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 0-16 v R / lU OrUL 1 C IS ~S /o s N s/ K m~~ c.~ 19 Ground 3 3 S o S ortf2- S s V / , elev. 99.,5 ft. 7~S /S lm S MLA r. Depth to -_'3 So- /0 S o rh V § r. 7 $ limiting factor Remarks: Boring # '•titi AWtJ e 5 p m r C ti. 7 ,1~5 Ground elev. 50X65 7,S NOv~n- ~S m S m~ t- r ~S / S Dm s ~5.. 1 Depth to limiting factor .Z~ Remarks: CST Name:-Please Print Phone: 715' -a316 n Address: Signature: n! ' Date: -5-7-71-7 CST NumbeS3/ PROPERTY OWNER d,w ~f+4,, SQrSOIL DESCRIPTION REPORT Page ` ofd . PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounday Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Ground 0-0 .131 /D S 0 m S v Cc p /M 1 elev. CLZ Y ,S -S ft. 7, NONA6 Depth to S ~k-7 p o~ a rn s m r C limiting factor = /s 16 -4 s Remarks: Boring # 16~e -V12 Z 4 J< L3 ;30 o S/ a s~lr M L.ti<.. c,a /r,.~ -3 30.53 104 S N ~S s YA Ground elev. " ~Z ft. 4, 4 S Ow. S ra U V. Depth to - limiting factor / Remarks: Boring # NOW- 7:10 /0 a SIk, Vft7ir 04 Ground a R 5 elev ft 3sr-7.2 /D S Dh, Clsr i i 7 i S Depth to limiting factor , Remarks: Boring # Fi Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) IR-t , ~ ~ I I i I I I I I ~ I ~ ~ i I i , i 'Cil C7 I Yd~7~ TY I -715-_~lll ! ! - i 1 r ~ t I -17 - oc L'~' I t 1--.--- +~-~i-2hr~`' ~_-h! I I - _ I I I ' ~ I 1 I I I ; ! I j I I I I I , t t ~ I I I _ 1 I , I ~ I I ~ I r I ~ ~ 1 1 I I t ~ I ! : f ~ ~ i i I I I I I j I ~ ! I i I I r- ~ I _ \a I I I sr`y I - I I \KNI i , i I I I ~ I ~ ~ ~ I ~ i I i I I I i r I I I ~ I j I + I ~ ~ ~ ~ I J ~ I I ~ ' I I I i i I L . - - - - I - i - ' - - I t - ~ I 7 1 I I I 'r i i i } I I i ~ ~ i l t Jl- : I , 1 I I I ` i l 1 f I i I I I I ~ i ~ I I I ~ I ~ - I . I i I I ~ ~ I I ' I ! ~i i I I I ~ I I I I I i I 11. F I 7 I t I t I I 1 I . I i I i I I I i I I 1 _ : : I , r I t i 1 t I f I r , _II _ i ~ I ~ I ~ ~ I ~ I I F f I i I i ! I I I ~ I I I I 1 I i I ' i ~ : ~ 1 ~ I ~ I I i i I 1 i I i t i 1°y/ 4411j L nn PAGE - OF • . CrvSS S~c~lol, ~l ~r1~ S, S~en • F141A Alf IAIfIb And Ob6olvollon Plp• "Wm°m 12'Apora ~Approrid Van1 C,,, • flnol Crooa 20•~2'AOora Pip.. 4. Cool bon To final Otado Vonl Pipe stwo~ Ita Oo S ntMtk Co.., ern 2' Aggeoyolo 0161180r1198 Oral pipe tips ° ° o Tao ' s AiY~apala i 6oaaolll Pipe ° Palaolod Plpa 0.010 or ° "Coup11n1 Tarminollny Al v Bollom 01 Syslam i PruP05e p f Ina1 gri.cl< SOIL FILL DISTRIBU710k1 PIPE 2"OFAGGREWE APPROVED SIJJ7NETIC COVER `*`14ATfR1A1- OR io OF S-rAAW OR MARSM HAy 1:LEV, of FEAT (",01 lit `Zl-a AGGREGATE I t. ~ I DIS'1•R15UTI(JN PIPE T(j BE AT LEAST a>IU AT LEAS740 1AICHES BUT 1.10 MOR THAQ y2EuCNES 9 `OW GIWAL GRADE FINAL. GRADE • I !'I~cIMUM WrN OF F-)ce • V /1 ATIoI.D Fi~DI'1 0({IGYJAL b~hpl: WILL BE 1NNIMVh1 pEPrtt of EXCAvj1TImN "100 0916INAL GRAVE WILL eE - IIJCHes INCHES SIGIJED: LICr_IJ5C DUMBER: DATE: • 110 . _ _ ' /Y l r. z A ro o ~r✓ Q AT v E : v _ mac, o.wm Ev°10=> cv K c ~ U cv~i p ~ X v' 0 M =n Q. UmN c 560046 'a 0 0 a 3 CERTIFIED SURVEY MAP Located in part of the North ost Quarter of the Southeast Quarter of Section 1, Township 31 North, Range 17 West, Town of Sta on, St. Croix County, Wisconsin. Prepared for and at the request of: NOTE: This parcel Is created pursuant to Section 17.14 (1) (b), St. OWNER: Croix County zoning ordinance, and may not be reconveyed by Harvey B. and Linda M. Christensen Initial grantee except In compliance with sold section. 1492 County Road "K" NOTE: The parcel shown on this mu is subject to State, County and Townshl New Richmond, WI 54017 p p laws, rules and regulations ( Le. wetlands, minimum lot size, access to parcel, Drafted by. Kristi A. E&ndt etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office and the appropriate Town Board for advice. WEST 114 CORNER EAST 114 CORNER SEC. 31-31-17 SEC. 31-31-17 (ALUM. CO. AfON.) EAST-WEST QUARTER LINE OF SECTION 31-31-17 (ALUM. CO. MON.) R = S 89'4620" W ,__1--- ---------M N 89'43'41" E 5468.55'--------- - 4148.93' -S 89'43'41" W 1319.62'- EAST LINE OF OAK N lr RIDGE ES TA TES FIRST S ADDITION (SEE DETAIL rc) k LA O~ 2 SHEET 2 OF 3) •I~ c°n FILED I UNPLATTED LANDS OF OWNER 6 MAY Z 8 1997 A o H.WIiLSH 0 0 K `O stet d Deeds { $LC( W WEST LINE OF THE NE $ 1 a 114 OF THE SE 114 (SEE DETAIL SHEET 2 OF 3) T 1 F ~m a i N 89'55'40" E 660.00' Ic y 1Z iD aI Z N I S I PLAT OF OAK-RIDGE L 0 T 1 1D ESTATES FIRST-ADDITION AREA: j0 DOC.-N0.-331198 217,780 SQ. FT. m rERL WA tiE'WA IYNE 5.00 ACRES 10 VOLUME-4 PAGE 15 ORIIVE ID P p I 00 $ Irn / BUILDING SETBACK LINE j• , --------f-- -T % / / S 89'55'40" W 680.00' Mi NORTH LINE woj Co 00I OF LOT 1 01 NI 1 / / SOUTH LINE OF THE NE 114 OF THE SE 114 22 . of 0i / LOT 1 < .1 a_I / - - - UNPLATTED LANDS OF OWNER o: 0 r)j EAST LINE OF OAK ~~wa 1 f °I wl RIDGE ES TA TES ~ O N IA, Ql ~i of 2 (SEE DETAIL OF 3) 1 SHL 1 2 g S "Y J! ~i ~WEST LINE OF THE SE AA-- I - - - - 114 OF THE SE 114 RONALD F. wi £E DETAIL SHT. 2) LOT 3 JOHNSON I I s-tteg AMERY. County Section Corner Monument I WIB. n of Rennrrl .d<-_~•'` CERTIFIED SURVEY MAP Located in part of the Northeast Quarter of the Southeast Quarter of Section 31, Township 31 North, Range 17 West, Town of Stanton, St. Croix County, Wisconsin. Prepared for and at the request of: OWNER: Harvey B. and Linda M. Christensen 1492 County Road "K„ DETAIL New Richmond, WI 54017 • Drafted by. Kristi A. Eylandl NOT TO SCALE I ( LOT 3$ ~ 1 I j-S 89V8'55" W 2.67 WEST LINE OF THE NE 1/4 OF THE SE 1/4 EAST LINE OF OAK RIDGE -•-j't ESTATES FIRST ADDITION 1 t •i~ = RONALD F. i . JOHNSON l~ Iq~. I AMERY. into WIS. a I I~i~,r•~0~ r Q~T-OF A~ y A I 133 -Q.69 ##eoht saa o RIDGE ESTATES I pm o l s FIRST ADDITION FN- - 1000 I I • Set 1" x 24" Iron Pipe weighing I tlo! LOT 1 a minimum of 1.13 pounds per linear foot. 1 a 0 Found 2" Iron Pipe r l i G Found 1-1/2" Iron Pipe I -.-CENTERLINE M= Measured As I DRIVEWAY R= Recorded As I EAST LINE OF OAK RIDGE 1 i S 89'08'55" W ESTATES FIRST ADDITION/ I , 1.02' -------7Z-- --T-- NORTH LINE OF LOT 1 Ir 01 PL.AT-4F 9.6 C" RIDGE ESTATES LOT 1 IWNI WEST LINE OF THE SE EAST LINE OF OAK I14 OF THE SE 114 w. RIDGE ES TA TES 0 1 V11 JOB #97030 L L- - _ - - San: Prepared by. 80 A & E - - - - IN Ni _q RQ*nR'S5" w CERTIFIED SURVEY MAP Located in part of the Northeast Quarter of the Southeast Quarter of Section 31, Township 31 North, Range 17 West, Town of Stanton, St. Croix County, Wisconsin. SURVEYOR'S CERTIFICATE I, Ronald F. Johnson, a Registered Wisconsin Land Surveyor, hereby certify that by the direction of Harvey B. and Linda M. Christensen, I have surveyed, divided and mapped a part of the Northeast Quarter of the Southeast Quarter of Section 31, Township 31 North, Range 17 West, Town of Stanton, St. Croix County, Wisconsin, described as follows: Commencing at the East Quarter Corner of said section 31; thence, on a bearing, referenced to the St. Croix County Global Positioning System Network, along the east/west Quarter line of said Section 31, South 89 degrees 43 minutes 41 seconds West a distance of 1319.62 feet to the west line of the Northeast Quarter of the Southeast Quarter of said Section 31; thence, along last said west line, South 00 degrees 51 minutes 05 seconds East a distance of 994.13 feet to the point of beginning of the parcel to be described; thence North 89 degrees 55 minutes 40 seconds East a distance of 660.00 feet; thence South 00 degrees 51 minutes 05 seconds East a distance of 330.00 feet to the south line of the said Northeast Quarter of the Southeast Quarter; thence, along last said south line, South 89 degrees 55 minutes 40 seconds West a distance of 660.00 feet to the last said west line; thence, along last said west line, North 00 degrees 51 minutes 05 seconds West a distance of 330.00 feet to the point of beginning. Containing 217,780 square feet (5.00 acres). Subject to all easements, restrictions and covenants of record. I also certify that this Certified Survey Map is a correct representation to scale of the exterior boundaries surveyed and described; that I have complied with the provisions of Chapter 236.34 of the Wisconsin Statutes and the Subdivision Ordinance of the County of St. Croix and the Town of Stanton in surveying and mapping the same. Ro ald F. J nson Reg. No. 1186 Date- X997 A & E Land Surveying Telephone # (715) 246-4319 P. O. Box 325 New Richmond, WI 54017 SURVEYOR'S REPORT: State Statute 59.62 was complied with in subdividing Section 31, Township 31 North, Range 17 West. The west line of the East Half of the Southeast quarter of said Section 31 (East Half per Government section breakdown) lies east of the East lines of the Plat of Oak Ridge Estates and Oak Ridge Estates First Addition, as shown on the Survey. Said Plats do no call the east lines of the Plats as being the east line of the West Half of the Gnn1-hnaat- n„nrl-nr „F -;A 11 fw~..4 U-1 F ~...,,...........4 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. OwnerofpropertyanC CllI,L,~L --Q- w Location of propertyl/4 1/4, Section ,T__fLN-R__Z ~W Township - o Mailin address /1/yd !~A m le. 01 Address of site Q ` Subdivision name _ CS (Yu /.)-/3 a~ S - Lot no. Other homes on property? Yes ~No Previous owner of property r--~ Total size of property Total size of parcel t Date parcel was created S 7 7 Are all corners and lot lines identifiable? _ Yes No Is this property being developed for ('spec house).?. Yes __X- _No Volume and Page Number 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 office of the County Register of Deeds as Document No. S'/0 6? *.1- , 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. Signature of Applicant / Co-Applicant Date of Signature Date of Signature STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix ii County OWNER/BUYER _a Q V N!& CIN r A'Q VISS _Q Vim, \ MAILING ADDRESS r ~ rcx r PROPERTY ADDRESS 1933 (location of septicc system) Please obtain from the Planning Dept. CITY/STATE 3~ 0 ( PROPERTY LOCATION ofjO~' 1/4, S je 1/4, Section T_3/_N-R__W TOWN OF ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAP , VOLUME PAGE _aQ(40T 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 expiration date. SIGNED: DATE: 7 St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 4 DOCUMENT NO. WARRANTY DEED A1J V 5GO 42 VOL 1244PAci574 Si CP10! c D., N11 a fwc'd kx flw.uti THIS DEED, made between Harvy B. Christensen and Linda M. JUN F 997 Christensen, Grantor, and Hans M. Christensen and Molly K. Christensen, husband and wife, as survivorship marital property, Grantee, 10:50 A M WITNESSETH, That the said Grantor, for a valuable consideration of +F one dollar and other valuable consideration conveys to Grantee the following fibytsaar Of Ubdd,Y described real estate in St. Croix County, State of Wisconsin: Lot 1 of Certified Survey Map recorded on May 28, 1997, in Certified RECORDING INFORMATION Survey Maps in Volume 12, Page 3265, Document No. 560046, located in . • • • • • • . ' ' . ' ' . ' . ' ' ' ' . ' . ' . ' ' part of the Northeast Quarter of the Southeast Quarter (NE 1/4 of SE 1/4) NAME AND RETURN ADDRESS of Section 31, Township 31 North, Runge 17 West, Town of Stanton, St. Croix County, Wisconsin. Bakke Norman, S.C. 1200 Heritage Drive y New Richmond, WI 54017 TRANSFER I , 60 TRANSFER Part of 036-1079-20 FEE- (Parcel Identification Number) This is not homestead property. Together with all and singular the hereditaments and appurtenances thereunto belonging; and Grantor warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except: Easements, highways, utility rights and reservations of record, and will warrant and defend the same. Dated this 3day of IM4, A , 19 97 (SEAL) (SEAL) • * HarvB. Christensen (SEAL) [ aiA . (SEAL) * * Linda M. Christensen AUTHENTICATION ACKNOWLEDGEMENT Signature(s) of STATE OF WISCONSIN } Harvv B. Christensen } as. ST. CROIX COUNTY } authentic a is 30th day of May , 1997 Personally came before me this Y f~ day of June , 19 97 , the above named * Timo v J. Scott LinBa M Christensen TITLE MEMBER STATE BAR OF WISCONSIN (If not, e F _to me known t0 the person who executed the foregoing instrument and ,be authorized by § 706.06, Wis. Stats.) aclcurnvledged ate same, THIS INSTRUMENT WAS DRAFTED BY: Timothy J. Scott BAKKE NORMAN, S.C. NEW RICHMOND, WISCONSIN Notary Pdb1.1c r St. Croix County, Wisconsin *Names of persons signing in any capacity should be typed or printed below their My t6mmission is permanent. (If not, state expiration date: 19---) signatures.