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HomeMy WebLinkAbout022-1095-10-100 C I N p oGoq~ v 0. ° o c o N o Q X O N U N O v C ti N y. N Y c I _N U U 'NO 6 U N C Z N N 7 6 N U. C (6 C O CD 4= a O 0 3 co z y CO z E o azo III m~ z l a m o E 6 ~ 5 o z c o N _ z tt o z m co co ~V N 0 ~ 04 ry~ N (n C • 2 U O LO ~ c Q U o Q N ~ZNZ uS z U.) m y c° I lL E N O N N r 2 co d w N _ C co C. •lC CL O N N (D i a) 0 E 0 O G G a C 76 N Q o owcn~ ~ ~~yy Z v > , I- f- I- d - o 0 0 0 o • ir„~ > a a a (n a c g N N ID - rn } (n J V E 0) O AV O p z U O a 0) 0 cc) z 0 0 E OO M m a O N I • N U O O ~r 0 0 0 3 E H c 0 0 ® N CO F- 2 O M U W c C 0- O O y ~ N N Lo 2L 12 i2 - V Lo C C C C C -2 V w 0) Y N N ~ ~ m~ O 00 U rn I (D (D rN N N C "~O Z' Z' , C_ • y~,i' O CO Y Q N O y U) O ~ ~ T •E ~ I •E II °i #6 Q_ d a Iri a m a+ a - +r E L c c A a 0 O m STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER J rom R. Patricia Anderson ADDRESS___ Lot # 4 Emerson Valle Drive RIVPY Falls, WI 54022 SUBDIVISION / CSM# Co„ Page 2463 ntryside Hills/CSM 513A-10 Vol 9 LOT # 4 SECTION 33 T__2~LN-R 18 W, Town of Kinnickinnic ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Scale~~=bO~ BM lw , /00, 0 yot r INDICATE NORTH ARROW Provide setback and elevation informat'on on reverse of this form. Provide 2 dimensions to center of sep is tank manhole cover. V BENCHMARK: 5" High 3/4" Dia PVC Pipe with Lath Flo f• 100.01 ALTERNATE BM: 8" High T-2th SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: Wieser Liquid Capacity: 1000 Setback from: Well 9c/~ _House ~ Other Pump: Manufacturer_ Myers Modell ME40 Size Float seperation Gallons/cycle: Alarm Location :SOIL ABSORPTION SYSTEM Width: Length_ /06 Number of trenches Distance & Direction to nearest prop. line: Setback from: well: ,2410 House Other ELEVATIONS Building Sewer ST Inlet. ST outlet PC inlet PC bottom Pump Off Header/Manifold Bottom of system Existing Grade Final grade DATE OF INSTALLATION: SP ltp~ PLUMBER ON JOB: -Paul L Steiner LICENSE NUMBER: 6780 INSPECTOR: 3/93:jt WisconSin Department of Industry, PRIVATE SEWAGE SYSTEM County:n Labor and hNKjjn Relations INSPECTION REPORT ST. CROIX Safety and Buu ,r,,~pivision Y (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION Permit Holder's Name: ❑ City ❑ Village Town o : State Plan o.: ANDERSON, JEROME & PATRICIA 1k CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: SDD d ?Jtl.-r72~ -A ,J TANK INFORMATION LEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark /0a-r2 /00 Dosing Aeration Bldg. Sewer ar 8S. Holding St/ Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet ` Vent TANK TO P / L WELL BLDG. Airito ntake ROAD Dt Inlet Ar Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe 2r,.2 61 q -3.7 Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft Len Dia. Fi Dist. Towel Forcemain 1 1 L SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSION S" /o0 DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE /STREAM LEACHING manufacturer: SETBACK CHAMBER INFORMATION Type O Moe Number: System: i,&& 65, a5 ' </vi ,U 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: KIN.NICKI.NNIC_33.28._18W. NE, NE, EMERSON VALLEY DRIVE r ~`/`SQL U 3/'' Plan revision required? ❑ Yes No Use other side for additional information. (o I J SBD-6710 (R 05/91) Date In ector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH ° SANITARY PERMIT NUMBER: ' SANITARY PERMIT APPLICATION ' e-~I`IlrZllln In accord with ILHR 83.05, Wis. Adm. Code COUNTY St Croix STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ 6 L? i qi-1 , 8% X 11 inches in size. Check If revision to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION Jerome & RXDdKrX Anderson Patricia NE % NE S 33 T 28 , N, R 18 )eq"W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # 741 South n n 4 CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER 1521 Coun side Hills/CSM 513A-10 Vol. 9 Page 2463 II. TYPE OF BUILDING: (Check one) ❑ State Owned NEAREST ROAD e ❑ Public ®1 or 2 Fam. Dwelling~# of bedrooms 3 ' Emerson Valle PAR EL TAX NUM ER(S) III. BUILDING USE: (If building type is public, check all that apply) 0 9 - - l Q 1 ❑ Apt/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 in line A. Check line B if applicable) A) 1. 9 New 2. ❑ Replacement 3. ❑ Replacement of 4.0 Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 300 Specify Type 41 ❑ Holding Tank 12 H Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-ln-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) QYy.O' EVXATION 450 1,125 1,125 .4 .2.0- q'3.a Feet , D Feet VII. TANK CAPACITY Site in allons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New istin Gallons Tanks oncrete structed glass App. Tanks Tanks _TT F1 Septic Tank or*WkfiavTw*y J 000 1000 1 Weeks VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): P ber Signs r : (No Stamps) MP/S[FBM No.: Business Phone Number: Paul C.J. Steiner r 6780 42S-5544 Plumber's Address (Street, City, State, Zip e): N8230 945th Street; River Falls WI 54022 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sa Permit Fee (Includes Groundwater ate Issued Iss 'ng Agent Si ature (No Stamp ) Approved ❑ Owner Given Initial surcharge Fee) Lei v Adverse Determinationi 2-94 on-WA X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(R.08/93) 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 the 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 & Buildings Division, 6013-266-3815. 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 in 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 in ##1-7. VII. Tank information. Fill in the capacity of every new and/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 DIL'HR. 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'/Z 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, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) i pjof Plan- 4 16. IN E~v gj-,y' F/cup , /oo.o a h /Dao~,a Sppi~c Toss ~ c y9a~ Goth Q Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page I of Y_ Labor and Human Relations Divis" re of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code " COUNTY 5-r- CRm Lx Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION LUCK ok-1 E t= 1")11-t. S 0 IV GOvT. LOT t-1 1/4 NET' 1/4,S 3 3T zH .,N,R lib E (ore PROPERTY OWNER`-.S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 6~ E?'1C12.St~►v U_ i~l.,l..~f 1~.. >~tu~ - - ~ ~Pos~ c,s•wi . CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE [WOWN NEAREST ROAD Rlv~2 a=rtUs WI S4ozZ (-)Is) qZS. sSL/b ~.tf'lxj letctkN IC lelM_-scvv Uk"'W b d N New Construction Use [JQ Residential / Number of bedrooms 3 [ J Additign to existing building [ ] Replacement [ ] Public or commercial describe Code derived daily flow qSO gpd Recommended design loading rate O- S bed, gpd/ft2 0' 6 trench, gpd/ft2 Absorption area required c M0 bed, ft2 1 S o trench, ft2 Mabmum design loading rate o - S bed, gpd/ft2 0- b trench, gpddt2 Recommended infiltration surface elevation(s) S~ P Acc e y ft (as referred t0 site plan benchmark) Additional design / site considerations 5 E W 0'eS oQ P n 6 e 11 Fa R Ll t8 b12~r S f Z I A J G Parent material S AAlt y ouTw RS H Flood plain elevation, if applicable 9y • R • It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for system ® S ❑ U EaS ❑ U T ®S ❑ U ®S ❑ U IDS ❑ U ❑ S D?U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Botaxlary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed tench o- vz~ -t 3 l z ~S o s '1'j as Zu cw 0.8 Z y-~ 5 ~t ytL itA - s o ~9 h1 - v. S o• I. Ground elev. ft Depth to limiting factor M S Remarks: - Boring # 'I S 10`12 3lz _ 1s vgg wl~ as Z~~ o~ _ u s' 0.6 Z _ o s Y►~I Z S ~3 to Lt Z_ V 'l I6 ~g 9 Ground elev. 01-Ls ft i 1 Depth to limiting r 3s;J fyto~3r, Remarks: T Name:-Please Print Phone: << Arthur L. We erer 5 egerer Soil Testing & Design Service-P.O. Box 74 River h ~S 2 Signature: 93 c (q [ 3 Date: - T Number: 0 0576 L PROPERTY OWNER 1-W1EAISW SOIL DESCRIPTION REPORT Page?- of PARCEL I.D. # t ` Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench oL z 6 -LB LoLf TZ_ 31b S C~ sg m I ~s - • s Ground 3 1 [bL1 P- VA, ss v s _ 0 3 0 elev. ft. Depth to S L IUVT lj S ~Z S S limiting factor So" Remarks: Boring # ,w:rw~; 1 t7-S l~`~2 3~z - 1S o s9 m' N_S Zv~ 0.7 O•d Jti ~L~ ` Z S 13 Lto L2Y/~ _ 'Fs oSg ~1 - o.So.6 z : Ground elev. a~ ft. Depth to : limiting factor 7 -7 3 ~ Remarks: Boring # Ltd -C t2- 3 l Z _ S o 3 wt 1 e-S Z u 0 1 o, S 5 Z S 76 M `'l olio - g 99 w1 , - o . S o, L Ground elev. Rq • S ft. Depth to limiting factor ~ 6 Remarks: Boring # S v `'t tZ Z. j Z l S S `t) (1-3 Z U L) U Z S -lb ~O`-ItL 31~ ``FS \b~ r1v F~ co 5 0.5 0.6 t 3 16-13 wC-t ►z Ul6 S v w► - o` S o,6 Ground elev. 3 ft. Depth to limiting factor y Remarks: SBD-8330(8.05/92) PROPERTY OWNER EME ZSDIJ SOIL DESCRIPTION REPORT Page - of PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Baxxfary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench - k Z s-~6 w~2~lld `Fs o s wt 1 - o•s o.L Ground elev. q0 . ft. Depth to limiting factor ? Remarks: Boring # Ground elev. ft. , Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) PLOT PLAN Page of SCALE 1"= 30 ' .o 3 S t 4) cl Sli \ B A 1~t3 \.;z A'►~rA ~ F-vi 'k- Ts et, -NB'e'tA" p~Zip 2y 1 I 4`~T z,ow+js ` 1 ups / ~ J y Ise, ~ zy~'>LSO' Fuzz (4 9bjr-M lb g.l~ -O'1 \8 kSU FRA- 3 filb" / e.RZy IfL giY l 1 •,S Ck 31y~'D1A. PUc PIPE 6J /c,A7)f ' S u \TPC13l E M?Z\ ~Z-ehj Cti LZ S uky etg9 _ ~q 3 AT• Z", FoR 39~RM (-T 6~' Fd~2 y ~DR~I 36'l DeqP kT QPSwPtr bbl 8M - • to°'D S \'4'1614 3Jy DIA PuC 01 Pe WA" " Z'~a So' < < rrvS u 1v D iw~ s~s~2~-1 ~~v~fiu,~s p~2~~,~ S1v-uc770A 93- 141 B -43 (715 ) 425-01 65 M00576 CST Signature Date Signed Telephone No. CST # W=onsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page I of Labor and Human Relations DFeidion of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code ' . COUNTY S_T_r ClZ4 LX Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION. EUG OQ E t F 1 l1Z. S01- GOVT. LOT tit 1/4 Nff 1/4,S 3 IT .,N,R L'a . E (or W~ PROPERTY OWNER .S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # CITY, STATE _ ZIP CODE PHONE NUMBER []CITY []VILLAGE [&rOWN NEAREST ROAD ?1 1113 E12 ~l}W I S4r~ Z-Z. QIS) qLS. 5Sy6 `t'~-.irvtil01t1!Nh1 lC k3leWuhj UkEAkVy DR, pQ New Construction Use [JQ Residential ! Number of bedrooms 3 [ J Aden to existing building [ ] Replacement [ ] Public or commercial describe Cade derived daily flow qS0 gpd Rewmmended design loading rate 0- S 'bed, gpN2 0.6 trends, Absorption area required CM 0 bed, ft2 ISO trench, ft2 Maximlml design loading rate -0-S bed, gpcW o, 6 trench, l Recommended infiltration surface elevatiort(s) s pAEC. L- y It (as referred to site plan benchmark) Additional design / sha oonsiderations S eE w zyf5 eu P " r` u F:42- t{ tab" 5 I Z I A J G Parent material 5 aoja OulwkS H Flood plain elevation, if applicable . f-3. A . ft lerp CONVENTIONAL MOINID INaMl) PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK S = Suitable for sys [U=11JInsuitoblemrsystem 0S ❑ U ~-S ❑ U ®S ❑ U 0S ❑ U IRS ❑ U ❑ S [V U SOIL DESCRIPTION REPORT ; Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell tau. Sz. Cont Color Gr. Sz. Sh. Bed trench Z y--) S Lo y>z ~/6 - s o 9~ /n - o. s o t Ground elev. c1Z_~ ft Depth to limiting law N 7wS Remarks: - Boring # v- S 10`12 31 Z _ S v g' vn C5 z' i o o Z Z. 7 10'1 Q ~l ~6 -S g °J ~'t - o .S 0. 6 Ground elev. gI•Sft Depth to limiting bCtDr ti Remarks: TNane:-Please Print Phone: Arthur L. We erer 715-425•-0165 egerer Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022 Signature: g3 c l 4 L Date: _ Z 3 ~3 CST Number: M0057-6 PROPERTY OWNER ~1~~1ZSUN SOIL DESCRIPTION REPORT Page ~of~ PARCEL I.D. # , Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/e in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench o- b lu `t[Z 31 Z - 1 S o S v 1 c S z v o, 8 3 Z 6 -v8 tuLf R alb s G Sq ( cs - u. S o C s - o • 3 , Ground 3 )j-5-0 ! 0`L R Vl(. 5S Cb V%1% elev. °IL, I ft. Depth to l l~ ll7T l~ S ~Z S S Ariz- L-IZA imiting l factor SD Remarks: Boring # -S lok2 3!Z - ~S o Sg m c°_S u 7 'o d Z S -13 l t3 `Z (Z Y A 'F s O Ground elev. a ft. Depth to limiting factor '7 Remarks: Boring # ; 1 0-5 I.b`tiCZ3lZ _ 1S o s~ w~1 ~S Zv'~ 0.1o•g S Z S -7b ~v Ll 2 Yl~ `F g o 9°~ wl - o, S o. 6 Ground elev. Rg S ft. Depth to limiting factor Remarks: Boring # z!Z \S u SS eS. ZU f o.1 u.$ 6 € Z s b ~O`-(2 316 - 1`FS ~b`2 Yvty FY s o.s 0.6 kvi 3 16-13 10~ ►Z Yl6 `~s u w, \ - o. S o, b Ground elev. - 3 ft. Depth to limiting factor y Remarks: SBD-8330(R.05/92) PROPERTY OWNER E) -Sbfj SOIL DESCRIPTION REPORT Page 3 of PARCEL I.D. # Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont Color Texture Gr. Sz. Sh. Consistence BOwdary Roots Bed Trey r{w Z s-~6 ~v~(~ 4~l6 O s 1 - o.S o:L Ground elev. qD~ ft. - Depth to limiting facto y Remarks: Boring # E3 Ground elev. I'L _ _ _ . . . Depth to limiting factor Remarks: Boring # Ground elev, ft. Depth to limiting factor Remarks: Boring # Ground elev. ft Depth to Nmiting factor Remarks: S6D-8330(8.05192) PLOT PLAN Page of • SCALE 1"= 30' r=te CLs 44 At o ~3Srt lb syr LE~ ~ Lit 4o \ dL 91 so' B • "1 I 9.Z Sv 1TKQ l.E. PYR~`q / tT0 Qe, f \ 14 tsbTf-M X8' x Su 1=0~ 3 bb" eL, R ~ ~ qY ~tS'1~~G L-TL ate- . ~i5.y' Oki e"ltlc1l CY -1 A. PV c P ►PF w /t hTl}, - Ft TL 'M E;xj ti e S 10~~ :.s etg9 s 1q~~O 3 Ar So' FoR 39tRM `r 3 rrT F~~2 q gby--M 36" DTeP hT UPSLtspe L'D6B L-L l00.O' oN S bF1614 3/y"DIH puC PIPE W/LA-y/ 'N~"Cls.: ~avsE TO 8~ 1°r'r l..~sT Z.S~ ~M SHS~r~ fltt~S wt~.t It 4 So' << tiSTh'L-~ - lU ~ L1y~w~ SLSl2'7I L2eLOv7)Wvs \jv z cwzs)2.uc72W-J, 93- N1 B. I--?Iz -3 (715 1 42S-0165 M00576 CST Signature Date Signed Telephone No. CST # II.CcU~r.,r~~l , 5045'4 CERTIFIED SURVEY MAP LOCATED IN THE NE 1/4 OFTHE NE 1/4 OF SECTION 33, T28N, R18W, TOWN OF K INNICKINNIC , ST. CROIX CO., WI. PREPARED FOR: c~ O EUGENECEMERSON NOTE: BEARINGS AREREFERENCED TO /7 I~ r 1, THE NORTH LINE OF THENE 1/4. ff(/6t~L .41~ ~ ( RECORD BEARING). Lfd 5 JAMES O'CONNIELL Reglster C; o0ees St. C; 01A Co.. WI Yl N 1/4 CORNER SEC. 33 UNPLATTED L A N D S N NER SEC. 33. ( 2" IRON PIPE FOUND) ( COUNTY MONUMENT NORTH LINE OF THE NE 1/4 FOUND). N88°19'34"E N88019 '34"E 676.94' QH Se 8119'3 4" W 1317.58 231.15' 64' I IJ pl O° (R= 640.93') / EXISTING 16.5' WIDE v /EASEMENT. a / - In I I w L OT 4 1 5.07 ACRE S o 1 2 20, 76 5 SO. FT.) a N S88°19'34"Wn340.91' 4. 82 AC. EXC. EASEMENT N R p ( 210, 174 SO. FT. I y 21 2.35' VI It. 64' Q, N 16.92' > c: O 1 1 I,J V Z 513 A_ ' - ^ a 11 0 N n D ~ ~l 0 3 ,5"l3 ~-Zo w o w: 1 u') • O b / / N W V- F-; O co I ko _ Q, o (6 © • e O m' w. J' w N m s o in IT v: N a. a \ L 0T\\5\ N c cp CD Z w SETBACK a o in 2 \ \ \ LINE h P PR C?V 5. 9 6 A C R E S ( 259, 659 SO, FT.) LL 5. 62 AC. EXC. EASEMEN T 08 00. 0 ( 244, 787 SO.FT.) 1 i AuG 2 7 911 I I ~ J 340. 03 A I I© \ ' I M r-q3jx COUNTY N 88oo21 53 "W ass, 65 nr 4)%nsiwQ P 3 708.68 Zoning and I I3 rao~; Conu'nitt** ~l F UNPLATTED LANDS o~ M ~ I li 1%6t jecoided r. v aA-Lbin 30 days 0 ' EMERSON. I of C dO Z 133HS £8-£6 9L9Z aSed 6 'TOA NOtftltt~ n I~~I C) A. 'SIM ? ATI- VA `JNlddS vU8l S = U393M 'w S31NVf ,r r ;000.f I( ,9£'L6Z 3„£S,ZOo88S d-d (,fi0'OZI 3„9£,90oLS=21) ,£I'OZI 3,,90,170oLS d-O 09'881 3„5757,LZoZ17S=d) ,957'061 3„157,6ZoZ17S O-N Al„fii, I57o0IS=d) ,017 •£17 1 Al„£I,O57oOIS N-W (,£57'OLI 3„9Z,I9o17IS=d) ,817 'OLI 3„9£,Z9o17IS W-}I (3„9Z,157o17IS=2I) fig-101 3„9£,ZSo17IS W-'T (3„9Z,,I57o17IS=d) ,179"89 3„9£,Z570fiIS -[-N (A1,17£, 1901IS=21) ,Zfi'57ZI Al„£I, Igo I IS ?I-C (,fi9'Z£17 AX,6lo88S=d) ,96'Z£fi Al„ZZ,6Io88S r-I (,£57'571M=21) ,6L'571717 3„fi£,6Io88N H-O (,11£'Z171 3„fi£,1570TIN=21) ,LE 'Z171 3„61,I57ollN O-d (,89'OLI AX, 15ofilN=d) ,£9'OLI Al„LZ,Z9o17IN d-4 (A1„9Z,ISo17IN=d) ,89'89 Al,ZZ,ZSo+7IN d-3 (AX, I57o17IN=N) ,96' 101 Al„LZ,Z9o17IN 3-0 (3„fl I,I57oOIN=d ,16'071 3„££,ISoOIN CI-O (,Z9'I6I M„5757,LZoZfiN=2I) ,69'£61 Al,ZZ,0£oZ17N O-9 (,89'8ZI A1„9£,90oLN=21) ,ZL'8Z1 M„17fi,ZOoLN 8-V 3'T9b.L 392Um 3„Ofi,O£oZLS =Z W Al„8Z,LOo88S =I Td :SBur,r-eaq jua2u2Z 3„017,8Io17ZS ,SZ'61I ,09'17£1 ,00,lZo96 ,00'08 9 }o-I Al„17Z,000957s ,LO'578 ,69'68 „80,tlot9 100'08 fi 10-1 m„17Z,817oLS ZL*Lgl ,6Z'17ZZ „80,8£0091 .00'nR 7-T E:)aSCR I PT I OIV A parcel of land located in the NE 1/4 of the NE 1/4 of Section 33, T28N, R18W, Township of Kinnickinnic, St.Croix County, Wisconsin, more fully described as follows: Commencing at the N 1/4 corner of said Section 33: Thence N88019'34"E along the North line of the NE 1/4 a distance of 1317.58' to the NW corner of the NE 1/4 of the NE 1/4 of said Section 33, said point also being the POINT OF BEGINNING: Thence continuing N88019'34"E along said line 676.94'to an iron pipe at the NW corner of Lot 1 of the Certified Survey Map recorded in Volume 5 of Certified Survey Maps, Page 1485; Thence S2006'25"E along the westerly line of said Lot 1 a distance of 571.49' (recorded as S2002'11"E 570.00'): Thence southwesterly, southerly and southeasterly 224.29' along the arc of a 80.00' radius curve concave easterly whose long chord bears S7048'24"W 157.72'; Thence S76030'59"E 58.24'; Thence S0027'30"W 4.69'; Thence N88002'53"W 708.68' to a point on the West line of the NE 1/4 of the NE 1/4 of said Section 33; Thence N2000'17"W along said line 702.15' to the point of beginning. Contains 11.03 acres subject to an existing 16.5' wide roadway easement reserved for building, replacement and maintenance of septic systems as described on the Certified Survey Map recorded in Volume 5 of Certified Survey Maps, Page 1485. Also subject to any and all additional easements, right-of-ways or conveyances of record. SURVEYOR'S CERTIFICATE I, James M. Weber, registered land surveyor, hereby certify: That in full compliance with the provisions of Chapter 236.34 of the Wisconsin Statutes and the provisions of the St.Croix County Subdivision Ordinance and under the direction of Eugene Emerson, owner, I have surveyed, divided and mapped the above described parcel of land and that this map is a correct representation of the boundary thereof. Dated this z day of ~r01N9""►rh ZS ~3 OVED 0IVs'".. James M. Weber S-1804 . `o NELSEN-WEBER LAND SURVEYING AUG 2 7 1 rSPFRING ES M. % = EBER = 1804 VALLEY S O . CROIX COUNTY IC NE COR. 1 v SEC. 33. C 0 N 33 405.93' 36:691, t D4 LOT 1 4 t 1 x-ag~J3° 200.00 t ► Li 513A."►0 LOT 513E SM_318 a i. 5 3F Ito N P N i i T 1 ; 5138 C.S.M 5,1485 13 .39' % ,/4 93.91 258.58' LOT 285.62 LOT 708.6 , l co co CA C • N ~.S.J~- ~~12Z6.. ' 371.43D \ N 5 13C • ~I LOT - 1 516 A - 20 1046 /221 i c ?q5q 3 ..M W 1 1. 3.1 . wi '#1:j ( V-b I ~ja ~7 MAP 1 01 ~1ERT1FIED SURVEY - G•gg313 w, - - 9, PG• VO- 2463- 0. _ - 56 A-30 > LOT 4 , LI 1/4 SE r STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNERBUYEItF~~~ MAILING ADDRESS 713XI PROPERTY ADDRESS (location of septic system) Please ob ' from the Planning Dept. CITY/STATE PROPERTY LOCATION 1V C 1/4, 1/4, Section w ST. CROIX COUNTY, WI TOWN OF SUBDIVISION LOT NUMBER / a 6'7S CERTIFIED SURVEY MAP VOLUME PAGE 1,'- LOT NUMBER __Y 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: St. Croix County Zoning Office Government Center 1101 Carmichael Road 11/93 Hudson, WI 54016 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 de rol-wz e i--/ ,.;v 2 22110 Location of property ` 1/4/V,6~ 1/4, Section .Z3 ,T ad'' N-RAW Township Mailing address 2Z- Zd, Address of site, O an7 22 Subdivision name l,- 7 Lot no. Other homes on property. Yes No Previous owner of property f~~f y C~/11 ZIA 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 -q e- Volume 9 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. 11-116-711 , 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. D ignature of Applicant Co-Applicant Date of Signature Date of Signature i DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1-1982 THIS SPACE RESERVED FOR RECORDING DATA i WARRANTY DEED 153 n1I~~t;t~ REGISTER'S OFF=ICE S1 CROIX CTY., WI This Deed, made between -.-EugeneG_._.. EmersQn._and-.... Redd for Record Marie-11___A•.-_Emerson.,___husbandwife APR 2 1996 , Grantor, at i1: 307 and..J.ero.me...C --Anders.on..and._Pa_tra..ci.a..L....AnAer.aon, c W ..husband..and.-.wi.fe... as...surv.ivzarship.-mar.i tal k • pr.op.er-ty n Register of Dwft Grantee, . Witnesseth, That the said Grantor, for a valuable consideration-. /6- RETURN TO C. L. Gaylord conveys to Grantee the following described real estate in ....&t.,.._Cl<o.i.X.....-._. Attorney at Law County, State of Wisconsin: P.O. Box 46 River Falls. WI 54022 Lot Four (4) of e ap recorded on 8-27-93, i Volume 9, Page 267 as Doc. O 91 Jo9T-/O No. 504574, loc n e e NE~4 Tax ParcelNo:._. _ . of Section 33, Township 28 North, Range 18 West, Town of Kinnickinnic. TRANSFER This ....1 s...l?O t.._....... homestead property. (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And Eugene E. Emerson a_ nd Mariell A. Emerson - warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions, and rights-of-way of record, and will warrant and defend the same. Dated this A ril 1x.96... --------•---1-St-------------•-------------- day of p.... SEAL (SEAL) Eug.. ne.. !...Emerson- (SEAL) (SEAL) Mariell A. Emerson AUTHENTICATION ACKNOWLEDGMENT Signature.(s) _.)al.9eJalw...C_.....E1RP_r.SQL1... .Xl STATE OF WISCONSIN Mariell A. Emerson-- County. . 1 a t . r~ri - QCi ....__._-n -_.,..-..11.. „.,e +l,ia dAv of