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HomeMy WebLinkAbout004-1053-90-100St. Croix County Planning and Zoning Monday, February 29, 2006 at 4:24:11 PM Detail Sanitary Information Page 1 of l Computer #: 004-1053-90-100 Sub/Plat: NA Section: 23 Parcel #: 23.28.15.361 B Lot: 1 TN/RNG: T28N R15W Municipality: Cady, Town of CSM: Vol. 10 Pg. 2814 1/41(4: SW 1/4 NW 1/4 Owner: Wegener, Chad 251 310th Street Wilson, WI 54027 State Permit: 218955 Issued: 09/28/1994 POWTS Dispersal: Mound Permit: New County Permit: 0 Installed: 09/28/1994 POWTS Detail: NA Bedrooms: 3 WI Fund: POWTS Pretreatment: NA Notes Issuer/Inspector As Built Plumber Other Reauirements Additional Notes Monev Owed Not determined Yes Timm, Roger data from notecard -file this permit with more $0.00 Jim Thompson Signed Off: No recent reconnection Maintenance Scheduled Pump Date Pumped 1st Notification 2nd Notification 3rd Notification 10/30/1998 10/30/2001 6/27/2002 04/02/2004 6/27/2005 Owner: Wegener, Chad 251 310th Street Wilson, WI 54027 State Permit: Issued: 06/13/2001 POWTS Dispersal: Mound Permit: Reconnection County Permit: 16 Installed: 06/13/2001 POWTS Detail: NA Bedrooms: 3 WI Fund: POWTS Pretreatment: NA Notes Issuer/Inspector As Built Plumber Other Requirements Additional Notes Monev Owed Kevin Grabau No Timm, Roger need to file original permit with reconnection for $0.00 None Signed Off: No records assume tank pumped as part of reconnection Maintenance Scheduled Pump Date Pumped 1st Notification 2nd Notification 3rd Notification 6/13/2004 /* 1Rsin :Department of Commerce . Safety and Buildings Division GENERAL INFORMATION PRIVATE SEWAGE SYSTEM INSPECTION REPORT (ATTACH TO PERMIT) Personal information you ptovice may be used for secondary purposes [Privacy w• x.15.04 (lxmjj. egene"ro •saNdame: City ~a~y~oQmstlip CST 8M Elev.:- C! Insp. BM Elev.: BM Description: TANK IN FORMATION TYPE MANUFACTURER CAPACITY Septic Oosi ng Aeration Holding TANK SETBACK INFORMATION TANK TO P / L WELL BLDG. vent to Air Intake ROAD Septic NA posing NA Aeration NA Holding PUMP /SIPHON INFORMATION -. Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft Forcemain Length Dia. Fi Dist. To Well SOIL ABSORPTION SYSTEM ELEVATION DATA STATION Benchmark It. BM Bldg. Sewer St/Ht Inlet St/ Ht Outlet Dt inlet Ot Bottom Header /Man. Dist. Pipe Bot. System Final Grade ~'ft'ICroix Sap~ary Permit No.: St''llate Plan 10 No.: Parce Tax No.: 004-1053-90-100 BS I HI I FS I ELEV. BED /TRENCH Width Length No. Of Trenches PIT No.Of Pits Inside Dia. Liquid Depth 1 N 1 N DIME I N LEACHING Manu adurer: SYSTEM TO P / L BLDG WELL LAKE /STREAM SETBACK CHAMBER er: N INFORMATION Type O OR UNIT um M e System: DISTRIBUTION SYSTEM x x length Dia I Length Dia. Spacing I I I 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, ~~peC ton 1: / / Inspection #2: / Location: 251 310th Street, Wilson, WI 54027 (SW 1/4 NW 1/4 23 T28N R15W) - 232815361 B -Lot 1 1.) Alt BM Description = 2.) Bldg sewer length = -amount of cover = 3.) contour = Plan revision required? ^ Yes ^ No Use other side for additional information. SBO-6710 (R.3/97) Oate Inspector s Signature Cert No. r~rl7 q -~ 41-1 U County Sanitary Permit Application ST. CROIX COUNTY WISCONSIN • ~ Gpv In accord with 15.04 St. Croix County Sanitary Ordinance ZONING OFFICE Personal information you provide may be used for secondary purposes ST. CROIX COUNTY GOVERNMENT CENTER [Privacy Law. S. 15.04(1)(m)) 1101 Carmichael Road ~t'~ -"' Hudson, WI 54016-7710 ~'' „~---- -~•.,~` (715)386-4680 Fax (715)386-4686 Attach complete plans for the st;°- ' 11 paper not less t n 8-1/2 x 11 inches in size. visi~.to previous placation County Sanitary Permit # ~ ck if ~ ~ o ,~ ,~ ~ 1. Application information -Please Print all information Location: Property O~ ner Name ~ ~ ~ ~~~~ r s~ 1/4 ~f 1/4, Sec Z ==~: ST C G RUIX i %y T Z N, ~ 5 R (or) Property Owner's Mailing Addre ZONMWGOFFIGE \ ~'' ~ Lot Number Block Number d ~/ 3 rb tti S ~ ~`~'~ l /V ~ City, State Zip Code Ph er Subdivision Name or CSM Number ~„~ syaz~ 7~5 77a - 3z(z Cs~t z~ ~ /ot ~o , ~ - II Type of Building: (check one) J ~ amity ^ Village LjdTown of ~ '~ 1 or 2 Family Dwelling - No. of Bedrooms: 3 ~~ ~ • P ^ Public/Commercial (describe use): C ^ State-owned Nearest Road ' Check box on line B if applicable) e of Permit: (Check only one box on line A II T h'~~ ~6 ~ . . yp Parcel Tax Number(s) /dom. 3!o t' 8 8 ~ ~ 1.^ Repair 2.~ Reconnection 3.^Non-plumbing 4. ^ Rejuvenation a) ' oZ / • • Sanitation cso y_ /0 53 -' ~o -/cam Permit Number B) Date Issued State Sanitary Permit was previously issued o2f ~•J ~~j 9- zg - 9 IV. Type of POWT System: (Check all that apply) • ^ Constructed Wetland ^ Non-pressurized In-ground ~ Mound ^ Sand Filter ^ Pressurized In-ground ^ Holding Tank ^ Single Pass ^ Drip Line ^ At-grade ^ Aerobic Treatment Unit ^ Recirculating ^ Other . DispersallTreatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application Rate 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed (Gals./day/sq.ft.) (Min.linch) Elevation -~~ ~3~ ,~3 , sy ,~ .2 ,a~,. ~- I. Tank Information Capaicty in Gallons Total # of Manufacturer Prefab Site Con- Steel Fiber- l Plastic New Existing Gallons Tanks Concrete structed ass g Tanks Tanks /c»o /cam ~ ct/ C P, ^ ^ ^ ^ • 6o~i oa ~ ^ ^ ^ ^ . Respo ability Statement 1, the undersigned, assume responsibility for repair/reconnenction/rejuvenation installation of non-plumbing for the POWTS shown on the attached plans. A license is not required for ten-alift repair or the installation of non-plumbing sanitation system, Plum rs Name (print ~ Plumbe Signature (no stam ): MP/MPR Business Phone Number ~/y' 77Z - 3z/ t Plumbe s Add ~ s (Street, City, ~~te, Zip o J L Z L ,~ d III. County Use Only Disapproved Sanitary Permit Fee Date Issued Issui Agent Signa re (No stamps) Approved Owner Given Initial Adverse ~ ~ ~ ~'~ W~ ~~ Determination • - IX. Conditions of Approval/Reasons for Disapproval: ~ ~ ~ JOB TIMM EXCAVATING ' Route 1 BOX 192 SHEET NO. OF WILSON, WISCONSIN 54027 CALCULATED BY '~ DATE ~ Z I^GI (715) 772-3214 (715) 386-5443 MPRS #3224 WI MPCA #696 MN CHECKED BY DATE Pfi00lICT 20f1 ~ Inc., Groton, Mass. 07171. To OrOer PHONE TOEI FREE t-BOo-715b380 JOB TIMM EXCAVATING Route 1 Box 192 WILSON, WISCONSIN 54027 (715) 772-3214 (715) 386-5443 MPRS #3224 WI MPCA #696 MN SHEET NO. OF CALCULATED BY DATE ~ Z ~~ d CHECKED BY DATE SCALE PRODUCT 205-1 ~ Inc., Graton,Mass.01d7L TO0rder PHONETOLL FflEE 1-BrJD~225~G780 ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the ~ ~~ ~p~ei2~,r residence located at : S-c.1 1/,, ~%, Sec . ~, T 2$ N, R r~W, Town of C~~ St . Croix County, Wisconsin. 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 6 -acs ,:L rt 5 ~~- ~ rota) 'ac~vr-~J 7` 5~~. •rn~c~c- ~ ~~r' Did flow back occur from absorption system? Yes No~ (if no, skip next line. Approximate volume or length of time: gallons minutes Capacity: /~ ~ Construction: refab Concrete X Steel Other Manufacturer ( i f known) : 4J pro r C, P. Age of Tank ( if known) : /~ q~ /sue /'ti (Sig tore) (Name Please Print (Title) (License Number) ~,- xi- 01 (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 Signature MP/MPRS ~2~,5 ~S/ -~ ~ °`~ (,~-~ ~ n5~ec.r~iu~ DOCUMENT No. ;j STATE BAR OF WISCONSIN FORM 1-1982 WARRANTY DEED .. -., ~. !; 521.6`78 von ~a~9f~~~`~~~~. - ~{ Dean Timm of kf a Dean R This Deed, made between .....................:._-_ ......._.-._.__...-__~...._-. I Timm-.and,.Sue..Timm,.-husband--and.-wife--and--_each--in--_their--------- I~ own.. x'ight,_......._...... ------- -------- ----- -- ----•---------- Grantor, I~ and __...Chad..D~...Wegener._ .................................................................... ~~ _.........- - ------...._, Grantee, ~'' ~7~11t17eSSeth, That the said Grantor, for a valuable consideration...... i, i' conve}'s to Grantee the following described real estate in ..S.t...CrQ7.X........- •-- County, State of Wisconsin: THIS SPACE RESERVED FOR RECORDING DATA ST. CR01X Cr., 't'-fi ' R9C'd f:,`t N~~~rd ~ S EP 2 3 1994 '~~~ 9:30 A. ~~~ ~~-~'~` ~:_^_.•'.:. :tip!:^Y~.'...d0.~.. •. ~ . RETURN TO L......_-...__...... -_~._..___..._~_.._._____~ A parcel of. land located in the SW} of the NWT of ~ ~_ IO~J" ~r r/(~ Section 23, Town 28 North, Range 15 West, St. Croix Tax Parcel No :. . .............................. County, Wisconsin, more fully described as follows: Beginning at the W 1/4 corner of said Section 23; Thence North along the West line of the NWT a distance of 225.00'; Thence S 89°36'09"E 297.00; thence South 225.00' to a point on the East-West Quarter Section Line of Section 23; Thence N89°36'09"W along said line 297.00' to the point of beginning. Contains 1.53 acres subject to 310 Street right-of-way over the westerly 33' thereof. Also subject to any and all additional easements, rights-of-way or conveyances of record. w~~%._...... ~. , ~,).l~-` This ...is..not.......... homestead property. (is) (is notj i Together with all and singular the hereditaments and appurtenances thereunto belonging; and... --.....Gr.ant.Q-r-$ ............... ........... ................- --..............-----.....------.......------- -----............... warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except and will ~vari•ar~t'and efend the same. Cti Dated this .........................--........... /~ ~ Dean Timm .... day of ....... ...~eptelnbex :..............••----....----.........---~ 19... 9.4.. ........ (SEAL) . `... .. ....... .. ..... 1.:T.LJ..... .-... (SEAL) ................................_-----------.......----•---.. (SEAL) „ Sue Timm .................................................................. (SEAL) Ii AUTHENTICATION ACKNOWLEDGMENT ,, ii of Dean Timm and/ Sue Timm STATE OF WISCONSIN ~ Signature(s) ...-•-•---• ..............................••------•-•---._... ss. ,~... ~ ....._..-• ............................County. 'I , i au h~ntiFated t ...d~of. e-p~t~mber ---, 19.94_ Personally came before me this ................day of ~, .~ ,i j- ............. ~' ~- ./ - L-'L--~_ ..__......., 19__.___-_ the above named ----- '',', Robert R. Gavic !j TITLE: 11IEbiBER STATE BAR OF WISCONSIN ~' (If not j~ authori2ed by § ?06.06, Wis. Stats.) to me known to be the person ........-... who executed the foregoing instrument and acknowledge the same. ,, THIS INSTRUMENT WAS DRAFTED BY ~ ROBERT R. GAVIC '~ ,,~ ....Attt~raay--at--Law-• .........................•------•--------• ,~ „ ................County, Wis. ~'' ..Spring..Valley,_--W~--------------------•-----._....._._...... Notary Public _.-----•-•------..._...... ~' (Si~~natures tnay he authenticated or acknowledged. Both My Commission is permanent. (if not, state expiration are not necessary.) date : ......................................................... 19.........) 'Names of persons signing in any capacity should be typed or printed below their signatures. ~~ i i---------_...----__...._._. ~iwcmra- FORM No. i - 1982 Stock No. 13001 ~..~. 52098 WI/4 CORNER OF SECTION 23 ( I '~ I~RON'PIPE FOUNDI. CE RT l FI ED SURVEY MAP ~~ ~'u'~ LOCATED IN THE SW4 OF THE NW4 OF SECTION 23, T28N, R15W, TOWN OF CADY, ST.CROIX COUNTY, WISCONSIN. Prepared for: Elaine and Dean Timm NW CORNER OF SECTION 23. ' "~ '~~~~~~~ ~~ (1 ~' IRON PIPE FOUND.1, a N~ O: Q: J~ `W: !~' F". a• J' a' z~ ~~ Z ~^ ~ UNPLATTED LANDS ~N I a F. ~ ~ 3 0 ~° N07E: BEARINGS ARE REFERENCED .N TO THE WEST LINE OF THE NWI/4, '° ( RECORD BEARING), W 2 " ~ I S89°3609"E o w 33.00 I ! 2 ~ z J H ~ SETBACK LIN E W 3 33' 33 ' _O i I 0 0 ~; 0 0 ~; o N NI ~ 0 T H o: O Z M. 297. 00' ~r~ 0 F~'94 ~OtX !:UUtVTY 'o;ein0 and ~.;.-~ s Ccmrnittee ' >1Jt fCCOr(~E'C~ ~~.~~nir+ 30 Drays of ~t~.~roval date i;.iynri~lc~t' Sf18if b0 ~,;aE• ~• v raid y /. U U E•W QUARTER LINE I UNPLATTED ~ANOS ~~~~® \ ~.._..: )_ 1994 ri- lc JAMES O'CONNELL Register of Deeds ,, sc croa co., wl O 0 ~. a: J. N of N ^~ ~~ _ ~ W' o _ w • H N _ ~• U W W 4 1- Q • V1 ~ J• LL a o cn a• ' °_ 0 Z W ¢ ~, z z' o a U N v x ~ _ 4966.02' ... _.Q~,.._ .. W .. . N89°36'09"W 4,~~~ 609rnT yY?!y+ly~ a°~ ~ '~ O= SET I "% 24 "IRON PIPE WEIGHING e+ ~ JAh1fS JtR. ~j 1.13 LBS. PER LINEAR F007. 4 Vyr-.3c?~ SCALE I " = 60 ' VOLUME 10 0 30' 60 120 ' S • 1704 SPRIPJG VALLEY 1 ~ WIS. l ~ .• .,,.~.. e PAGE 2814 ~°~~~ $ ~ R~ `, ~~ ~9~,08~©vGO~-~~ JAMES M. WEBER S -1804 •NELSEN - WEBER LAND SURVEYING GATED a..,~.~ z-.°\,-~~tT SHEET IOF2 94.100 THIS INSTRUMENT DRAFTED 8Y JIM WEBER ~.~x1 c w lu~Tw nv IelenaalT A DD1 lit _ATIiA111 ~. vr+^tt• ^ ~^ a ^ ^ r.^ u~^^ ^ r.. -' ~' ~- - - - - - - ~'~~~~- In accord with ILHR'83.05, Wis. Adm. Code COUNTY r.. ~- ~ .., . ` ~ ~ ~ STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than ~ i ;~? . f~ ~. °~ ^ 8tf1 x 11 inches in size. Check it revision~revious application -See reVer3e Slde for IfiStrUCt10t1S for Completing thlS appllCatlOn. PLAN I.D. NUMBER STATE 1. APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION. _ ti' ~ fr iI '~ cx!'S PROPER'TYtOWNER PROPERTY LOCATION PROPERTY OWNER'S MAILING DRESS _ LOT # ~ BLOCK # ~~' ~ , ~ ~~ /U sr _,~ CITY, STATE .. ZIP CODE I PHONE NUMB n ~ SUBDIVISION NAME OR CSM N,U~,M(`BER J ~ j ti ~l ~ / f ~) -~' ~C~' l -7" l ~ L<.l! SC- ~ r ~LJ_.i._ J ~ C.1 e` 7 / ~.~ r ~ );11I.. i :./CJ v::~ h. TYPE OF BUILDING: (Check one CITY ~ NEAREST ROAD ) ^ State Owned ^ VILLAGE ; •- ~ ~w ^Public l~llor2Fam.Dwelling-#ofbedrooms -~ AR EL TAX NUMBER( )~ UI. BUILDING USE: (If building type is public, check all that apply) ~~ fU ~ ~ ~ ~~ ~ ~~~ 1 ^ ApUCondo 2 ^ Assembly Hall 6 ^ Medical facility/Nursing Home 10 ^ Outdoor Recreational Facility 3 ^ Campground 7 ^ Merchandise: SaleslRepairs ~ 11 ^ Restaurant/Bar/Dining 4 ^ Church/School 8 ^ Mobile Home Park 12 ^ Service StatioMCar Wash 5 ^ Hotel/Motel 9 ^ Office/Factory. 13 ^ Other: Specify OF PERMR: (Check only one in line A. Check line B if applicable) PE N. TY ~~ 11 A) 1. !xJ New 2. ^ Replacement 3. ^ Replacement of 4. ^ Reconnection of 5. ^ Repair of an System System Tank Only Existing System Existing System B) ^ A Sanitary Permit was previously issued. Permit # 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 42 ^ Pit Privy 13 ^ Seepage Pit Pressure 43 ^ Vault Privy 14 ^ System-In-Fill VL 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 ) (Min./inch) -, ELEVATION - ft /sq (Gals/da ft PROPOSED . . y J (sq. REQUIRED (sq. ft.) '/ ,f ,;: t% • L- Feet i/J i . ~ Feet ~t~- ' ~ ~ ` ~ ~ b VIi. TANK CAPACITY in allons Total # of Manufacturer's Name Prefab. Site Con- Steel Fiber- Plastic Exper. A INFORMATION New istin Gallons Tanks ncret d t t glass pp Tanks Tanks rut e s Se tic Tank or Holdin Tank ds:: ~ ` u ~ Lift Pum Tank/Si hon Chamber ~ ,l.3 ! r'-• - r Vill. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumberjs Name (Print): Plumber's Signature: (No Stamps) MP/MPRSW No.: Business Phone Number. Plumber's ddress (Street, City, State, Zip Cod,;e)): ~ , - Il(. COUNTY/DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee pncwdes Groundwater a e ssu Isswng ygentSignatu~a~No Stamps) _ Surcharge Fee) ., ,-- ~ _... • ~ Approved ^ Owner Given Initial ~` ,. ~ ~~^ ~,_,...~~ r Adverse Determination ?~~ X. CONDITIONS OF APPROVAUREASONS FOR DISAPPROVAL: ~ ' SBD.6398(R,Og/g3) DISTRIBUTION: Original to County, One Copy To: Safety 8 Buildings Division, Owner, Plumber 1 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER C~ ~ /~ t r ADDRESS af/ _ ~/a ~Q~ //, ~~yl o~/Fi.s $slo ~ 7 SUBDIVISION / CSM#_ Sav95P U, ~<-~ fq a~/'~ LOT # SECTION o~ 3 T o~-~ N-R /5 W, Town of ~~.~~, ST. CROIX COUNTY, WISCONSIN PLAN VIER SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ~ O ~~~ we 1, I Dis~~c ~ra-.7.. ~ ~ we f ( fa i ~~~~ ~,... k. 98. . SyS~La~ _'~fPI1CK / 3 J C~.~9e • ~/ h/!~ ~° L/J~C. ~~ / ~ Y ~~~ '\ ~ - sue. ~ o ~ ~ ._. _.._•-. _ ~2 n ~ ~,.,_.w __.._. O 1h 0 '~'~ INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. ~. BENCHMARR : _~ ~~ ~ ~~-¢- ~ 1/l~~ ~,e. ~ 3"~l e ~ S~ .~ o~, .S'c~, ~~.~i~ ALTERNATE BM• SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION f Manufacturer: ~/P.P.Pr ~'~ P Liquid Capacity: ~~~ 6CY~ fJjr~~j Setback from: Well~_ House 56~~ Other Pump: Manufacturer ZO~~r Model# 5~3 Size Float seperation ~: ~~ N Gallons/cycle: is ~ Alarm Location C..•-~- ~''~~ ~' 1`~a~ SOIL ABSORPTION SYSTEM Width: S 7~ Number of trenches Distance & Direction to nearest prop. line: Setback from: well: %~ Length .rte--~~ / 5' House ,~ Other ELEVATIONS Building Sewer PC inlet Header/Manifold Existing Grade ST Inlet: ST outlet. PC bottom Pump Off Bottom of system Final grade DATE OF INSTALLATION: ~A - ~ - ~~ ~-- PLUMBER ON JOB: CJIj ct2 r ~~~+..,.- LICENSE NUMBER: /f?~.Q-~ .~Z2~/ INSPECTOR: 3/93:jt Wisconsin Department of Industry, Labor`and Human Relations Safety and Buildings Division ,' GENERAL INFORMATION PRIVATE SEWAGE SYSTEM INSPECTION REPORT (ATTACH TO PERMIT) Permit Holder's Name: ^ City ^ Village Town of: WEGENER, CHAD CST BM Elev.: ~ ~~C /~~1 Insp. BM Elev.: ~ ~~ JOd BM Description: ~ ~'f~~ ~ . , ~ ~ ~.s TANK'INFORMATION TYPE MANUFACTURER CAPACITY Septic ~- ~ . t. ~ c„ ~t 'r (~ Dosing ~om~i~~?~ Ga-i C;I a.f Aeratio Hol ~'~ TANK SETBACK INFORMATION TANK TO P/ L WELL BLDG. vent to Air Intake ROAD Septic ~~~ ~> ~~. NA Dosing (' /~ /' ~ NA Aeratio NA Ing PUMP / SFNFORMATION M~n~v~nliv, Manufacturer ~Q~ Demand Model Number ~~ GPM TDH Lift `riction Syste ~I TDH Ft Forcemain Length g~ ` Dia..2 " Dist. To weu SOIL ABSORPTION SYSTEM ELEVATION DATA County: ST. CROIX Sanitary Permit No.: State Plan o.: F ~7 j _ Parcel Tax o. dJl rCJ STATION BS HI FS ELEV. Benchmark 3%/~. ~ `3 ~~ 41~.~ ~ :~~~ ~, n1. 3 ~~., dd,~s ° Bldg. Sewer St/F~Inlet ;Z" ~p~° St/,~P Outlet Dt Inlet Dt Bottom ~ 3j~ q~ ~ /M n - . a A Dist. Pipe ~' ~,~~ /a~ Q~ ~ Bot. System 3 3~ '° Od, Final Grade BED /TRENCH Width ,, Length 9 No. Of Trenches PIT No.O is Inside Dia. Liquid Depth DIMEN I N S 5 IMEN I N SETBACK SYSTEM TO P/ L BLDG WELL LAKE /STREAM LEACHING HA r' INFORMATION T~pe 0 new ~ S ~ ( ~~ C R UNIT Mode Number. S stem: ~ a1h-~ ~o ~, DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe(s) t/ ~~ x Hole Size ~ °I x Hole Spacing ' , Vent To~Airj~take Length Di Length ~ Dia. ~/~ Spacing ~ ~(~ ~J 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.) ~~"'I~bCATION: CADY.23.2&.15W,SW,NW,LOT 1,310TH STREET ~ ~- yam. -~ ;_i; ~~ , -, .-~ a 4.GE~' ~ Ci/ ~Oycr ~ itr~ ,~~ ~/ ,. 5J `~v~~f ~~ + ~rr/P~"~ ~r?'-~u`~', ~~G~1 <:,~ !d-~` Lc.~zP •' -•~ f~~.~ ~ ~ n ~j f ~ /~ ,/a' , Plan revision required? ^ Ye '~ o Use other side for additional information. /~ SBD-6710 (R 05/9J~ r ,~ C~ ~ j ~ ~r Date ~ r ~' ~P / ~~ . ~n .' Inspector's Signature -Q~ Cert. No. SONITORY PERMIT OPPLICATI~N ~.. ...~ . ~'~~~ In accord with ILHR 83.05, Wis. Adm. Code cO~j . ~,CO `x J TT .• SANITARY PERMIT # ST AT E -Attach complete plans (to the county copy only) for the system, on paper not less than 11 inches in 8r~ i e a ~ ~9SS ^ x s z . ~ Check if revision to previous application wee reverse Slde fOr InStfUCtIOr1S fof COmpleting thlS appllCatlOn. PLAN LD. NUMBER STATE I. APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION. O S 7 ~ ~'` o~Q t!p 3 PROPERTY WNER ~~~~ e~tx..v PROPERTY LOCATION S Glf '/aw/' ~ '/a, S a13 Td~ , N, R ~~ (or) PROPERTY OWNER'S MAILING DRESS LOT # / BLOCK # 1~~' 02 r /~ S CITY, ~T/~TE l<J~/~ ~a ZIP CODE ~~~ 7 PHONE NUMBE ~ SUBDIVISION NAME OR CSM NUMBER ~ li'? v~ 4~ l/o ~ l0 lp ~8 ~ 11. TYPE OF BUILDING: (Check one) CITY ~ NEAREST ROAD State Owned VILLAGE : ~~~ ,/`'h~ ^ Public ~1 or 2 Fam. Dwelling-# of bedrooms -3 ARCELTAX NUMBERO III. BUILDING USE: (If building type is public, check all that apply) ~~ j®~ 3 ~ X00 y J~ 7 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 E OF PERMIT: (Check only one in line A. Check line B if applicable) IV. TY P t ~ A) 1. !~ J New 2. ^ Replacement 3. ^ Replacement of 4. ^ Reconnection of 5. ^ Repair of an .System System Tank Only Existing System Existing System B) ^ A Sanitary Permit was previously issued. Permit # 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 42 ^ Pit Privy 13 ^ Seepage Pit Pressure 43 ^ Vault Privy 14 ^ System-tn-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.) PROOPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION ~ Z ~ ~ /~~ r ~ r Feet Feet 1 O ~ . VII. TANK CAPACITY in allons Total # of ' N M f t Prefab. Site C Steel Fiber- Plastic Exper. INFORMATION New istin Gallons Tanks urer ame anu ac s Concrete on- strutted glass App Tanks Tanks Se tic Tank or Holdin Tank /~~ Lift Pum TanWSi hon Chamber (A~ / VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached, plans. Plumbe Name (Print):. Plumber's Signature: (No mps) MP/M PRS~fjp.: Business Phone Number 2 ? Plumber's ddress (Street, City State, Zip Co e : ,, ~' ~~ ~ ~~ ~ ~ ~~~~'~ l ~ ~ ~ ~ s~ IX. COUNTY/DEPARTMENT USE ONLY ~y~' YV Approved '- ^ Disapproved. ^ Owner Given Initial Sanitary Permit Fee pncludes Groundwater C~/ ~~J\ Surcharge Fee) t ate ssue Issuin i o~ps) Q ~, ~~ \ Adverse Determination ~ (~ X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-ti398(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, 608-266-38.15. 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 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 al/ 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'f~ 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) n.,~~a~~ ~~ ~ t j. O 1 w6~ b C y, }i 0 ~ i ~ i ! ~ ~ o~ i i ~' ~-- ~~ ~ . ~ ; ~- 1 ~ i ~~ C~, ' ~ i i . ~ ~ i C44.a ~ ~~ ~~~ ~ W : mow. ~~-Loo i ~ i ~ On~ i 11'~ ~ ~EIATI(~N`~ J.~ 8()R & H~~~'td i ~~ ; 4llS~RY ~ p~6D g11iL0 q~GS l/~'- ~, ~'' ~7.4t" ~.aS10~., .Q.t L ~~ l.~~swcsp;l ~ f ~ 1 1...~-o.. ;.Q S~;'' ~`` ~sy.'+vw ~ J ~~ ~ u '~ /~ S ,...2 ~ ,~f ~~3 i ~ e~, i `,~ 4LIL ~ I ~ i i i ~ i 1 i i ~ i I. (('~~ I I (~ 1 +, o ~~ D3~~V~ LRT ~~4\t ~vt~b~II~~ O~-M. ~~(~1 ~ ~VCI wy~t t S 3 ~~ ~~ ~~ "~ ~ ~ f ~ ~ ' ~ / Z o ~ O i 639 Chad Wegener - Mound 594-20639 Location: SW 1/4, NW 1/4, Sec. 23, T 28 N, R 15 W Town: Cady County: St. Croix Date: August 1, 1994 Owner: Chad Wegener Address: E 1035 WSHW 29 Spring Valley, WI 54767 Plumber: Roger Timm Signature: License # MPRS 224 Attachments: page 1. 2: 3: 4: 5: 6: 7: 6748-Plan Approval Application 115 r~ -.. ._ ~~~~ pRiVAS~' orc~i~iona ~-T tA~ ~p BIjiLD14i6S ~, flp iND~S ~~ $~ OlYtS1tZN cover ~~#~lCi~~~~ calculations ~'~ ~ ~ plot plan system cross section plan view, lateral detail pump tank exit detail pump curve page 1 of 7 ~°,~ 594-2.0639 Y 6ystem Calculations ~ One family residence Loading rate ~'~ Depth to ground water ~~ Zb Depth to bedrock ~ 34 Cross slope Z Force main length ~ S Manifold/header length ~`~'~ Drainback ~ 3-`Z ¢ Lateral length ~ @ ~'i°•~ Lateral elevation ~~•~ Lateral hole size ~~~- in @ ~jO'° >>~ holes/lateral, ~Si ~O•~~ Lateral volume Total lateral discharge rate ~ }'~S~ Elevation difference ~~0. ~~ Friction loss ~''~ 3 Total dynamic head ~ °'`~~ Pump/si~on ~ ° gpm @ ~ t Manufacturer ~O Q'll~"' Dose volume ~ Z ~ Lift/si~l'ion tank ~"~' ";°"' ~ "'~''° - ~~ ~•-~ h • Septic tank • • , Measurement pump on & off ~''Sg Height alarm from tank bottom ~ ~'L ~ Reserve capacity 3~Z-{ calcs bedrooms gallons/sq ft per day in in ft of 2 in ft of ~ in gallons ft of ~~~z in ft (bottom of pipe) in ( S•° ft) spacing holes total gallons 9Pm @ 2 . ~~ ft ft @ 18 ft ft of head Mode 1 # ~ ? ft head gpm gallons ~c~ gallons ~ `~"~ gallons in in gallons page Z of ~ 594-20639 .. 3 1 1roe.~ ~at-d( ~ 0. OOrt b pt ~~~t (s,' ~JS1ow~ Z ..~...«1^j a.,,.,,,..5~ , ~ ~ Ct9.~3 ada~ a. o ~.~p av <o•. ~...ru., 1 1 ~C~.v. ~ 1 ~,~ +o,pt~~, 1~ 2 ( ,,,,~.~ ~ b s..~co:, ` ~.~~ z wv<r... gR.Z ~. ~ ~ N o~~: ~ e~~ ~..5~. ~~" o. ~ 3' ~~~` p~~~~-~~ ~~ ,~ ~on~~t~n~~ ><F~. i ,'.. ~ j, 1871~11~5~ ~ ~~ ~~tS1$.11i4+9G~ Ot; n ~F $P~ OE1!!Sl~~tJ ~ ~ ,~ -~ . ~ { . ,-^~ , ~~4- 2t~63 9 4 0~ ~ ~ 2~' --, PIPG. 3' o~DISSUR6ED .. SOIL. 24" 2.U. 4 G.L. Eww• M4Nti0LE - ~ YE ~ I ~iwt!.~r • ~~ WLCD ~ r+o:t QPPROVtD L-T 3bAtT.'! A ~., ~FFLES ~ ~ ~~ . ~~r ~" - ~ ~,. ~ .~ C.t PIPC _ T ~ - ~y ~ ~Rt,,,a~XlY6~ AL 3' owro ~ gMO1S~t~RlEC EL IONS ~ ,,, (3RDaJND ~ ~6`~ e~ , ~ <~ ~ ' ~ tt t~ ~gla ~q~'s.~~ IQt~ ~ ~~ ~~ ~lP D P I ~ ~ ~ ~ f I ~ CorvcaeEnE ; Fv , ~ L•c~ .4•. 6coCK . ... v sEPrlc E SPEGIFI~GATIOI~IS 005E ~?yf' 'y TAIJKS MAWUFACTURER: " IJUM6 ER OF DOSES: PER DAy TAA1K SIZE : ~ ~'~ ~ ~'~ GALLOAIS DOSE VOLUME ALARM MAUUFACTURf R: ST ~G ~aa.~-.p IMCLUpIA)G 6ACKiLOW: (Z ~ GALLONS MODEL AlUMBER: ~ ° ~ ~ "`~ CAPACITIES: A = ZOi~Z IIJCHES OR 34t•Z GALLOAIS SWITCH TyP¢: `"'O"' ~ ~ i B = INCHES OR 33'~Z GALLOAIS ` PUMP MAIJUFACTURCR: ~°t:`lar 1Z} C= }'Sg IA 5 lLHES OR GALLOWS MODEL AIUMBER: - 3 D e ~ INCHES OR I ~ ~S~~GALLOWS SWITCH TYPE: r"~'d""' ~"'`~ WOTE: PUMP A1JD ALARM ARE TO DE MIIJIMUM DISCHARGE RATE «"`~S~ GPM • INS7ALLE0 OIJ SEPARATE CIRCUITS ; VERTICAL DIFFEREAICE DETWCCW PUMP OFF AA10 OISTRI~UTIOAJ PIPE.. ~"q)~ FEET 1~.}b + MIA11~h1UM AIETWORK 5UPPLy PRESSURE . ~ ~ ~ ~ J 2.5 FEET ~( ~'^ • ~5 FEET OF FORCE MAIM X •~O=' FT,~ -------/p0-T.FRlCT101J FACTOR.. d• ~' FEET ~ V~ , ~•„~ - TOTAL Dy1JAMIC HEAD = lo'°t8 FEET •` AlTERAlAL, DIME1JSIpIJfi of TAA1K: LEAICaTH X4'4 ;WIDTH ~. ~g ;LIQUID DEPTH ION ~~c~-L _6 nF -~ 594- 2Q~63 ~ a' HEAD/CAPACITY CURVE EFFLUENT and DEWATERING WARNING: Model 185 should not be subjected to less than 30 feet TDH. TOTAL DTNAMN: NFAO/CIIPACRY PEN MINUTE EfiIUENT AMD DEWATEN{N6 77.7! l7-36 06 177.170 161 167 16! 117 IK IM 111 iJ. L0. G.I. ltr1 G11 lU. CY. l1n GIL lh. 011. U• _ 011 laa _ 0.1 L4 _ G.1 Laa 011 Laa 17 167 72 277 101 701 106 101 61 271 61 271 9 220 IS! !11 1!! 307 N 120 61 271 70 700 100 776 61 271 61 271 _ !1 _220 1_K !60 1!1 !72 10 72 IS 170 W 212 H !11 60 227 __ 60 717 --~~~_- >/ 7I0 117 577 f1! 010 23 63 % 1% 62 710 50 227 60 227 >e 220 I% !1! NO S% 6 % 71 200 77 216 _SO 227 -~- ~~ N 220 120__161 177 507 83 1K !!_ I08 _ N 270 710 00 31 220 111 1% 121 K1 K 171 /6 172 !! 306 IS I6J SI 220 10! 707 111 qi 21 60 37 12! S1 101 K 216 >e 220 00 N1 100 770 1! 77 p 161 M 176 % 220 71 260 1! >? % 111 10 % 52 107 fl 107 70 206 u u _ K l7o zt 1a s. 201 >2 121 2 1 77 IK u u 21 78 7 n 6 7e u2s• n• 26• x a• er n 117 n~ tlr z u_ 0 t 0 HEAD/CAPACITY CURVE SEWAGE and DEWATERING WARNING: Model 293 should not be subjected to le:s than 15 feet TDH. TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE SEWAGE AMD DEWATERING aEn~a 2tt zt~ 28T 28i nt to 292 287 ~. m 100 Ff. M. Gal Lb CV Lb Gil Ln Gal Ltra Gal Lb Gd lb Gal In G.I ltr. Gal Lv. Gal ltr. Gal Ltr. S ib2 90 311 128 181 128 181 128 WI 130 192 180 611 110 530 t96 712 725 852 100 1511 J S1. •Ux3- T .,Wisconsin Department of Industry, Labor and Human Relations brrision of Safety & Buildings SOIL AND SITE EVALUATION REPORT Page ~_ of ~_ 111 GIVVVIV ~~Illl ILI 111 VV.V V, •.1V• •.V1. ~. vvb.v COUNTY r ~ er not ssy ~,'.,`~`~+,`21 ' s in size Plan must include but lete site lan on a Attach com St. Croix , . p p p p not limited to vertical and horizontal r fete a point (BM), otT and % of slope, Scale or PARCEL LD. # dimensioned, north arrow, and loc io end ctato neares r APPLICANT INFORMATION- ~~ASEE'~ A'~FO TION REVIEWED BY DATE G;`~,~. ~ PROPERTY OWNER: 1 - r ,-~' ~ ~ ~~~~` -Z G~ PROPERTY LOCATION Chad Wegener ' p, , a- ,-~+j~~~ 4~ w GOVT. LOT SW 1/4 NW 1/4,S23 T 28 ,N,R 15 ~X1;prJ W PROPERTY OWNER':S MAILING ADD "ti~.,p:=^ LOT # BLOCK # SUBD. NAME OR CSM # E 1035 WSHW 29 i ~,, - - - NA CITY, STATE ZIP DJ= : T°PHONE f~UiWB ^CITY ^VILLAGE MOWN NEAREST ROAD S tin Valle WI 54767 ~~."(7~5'~°' -3124 Cad 310th St. ~~} New Construction Use [X] Residential / Number of bedrooms ~ [ ]Addition to existing building [ ]Replacement [ ] Public or commeraal describe Code derived daily flow 45o gpd Recommended design loading rate .5 bed, gpd/ft2J,~trench, gpd/ft2 Absorption area required 90o bed, ft2 75o trench, ft2 Maximum design loading rate _ s bed, gpd/ft2 _ ~ trench, gpd/ft2 Recommended infiltration surface elevation(s) 100.2 ft (as referred to site plan benchmark) Additional design /site considerations install 5' x 75' rock bed on 99.2 as upslope edge w/ 1' sand fill Parent material loess Flood plain elevation, if applicable NA ft S =Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U =Unsuitable for s stem ^ S ®U ~ S ^ U ^ S ~ U ^ S ~ U ^ S C~7 U ^ S fj~7 U SOIL DESCRIPTION REPORT Boring # ~1 f Ground 9~e~~ ft. Depth to limiting factp~r~~ Boring # `':::':' 2 ... ,::: :.:: ,::: •i:\ Ground 9~1e~' ft. Depth to limiting factor 2~ Depth Dominant Color Mottles T re t Structure Consistence Boundar Roots GPD/ft Horizon in. Munsell Qu. Sz. Cont. Color ex u Gr. Sz. Sh. y Bed Trench 1 0-4 10YR 3/2 - sil 3 m sbk mfr cs 2f/m .5 .6 2 4-15 10YR 3/2 - sil 2 f sbk mvfr gs 1m/f .5 .6 3 15-25 10YR 4/4 - sil 2 m sbk mfr as 1m .5 .6 4 25-30 10YR 3/6 - sl 1 m sbk mfr gs 1f .4 .5 w/ f gr 5 30-34 7.5YR 4/6 f2d 10YR 6/2 sl 0 m - - - .3 ~.4 dense, poorly orted till Remarks: 1 0-5 10YR 3/2 - sil 2 f sbk mvfr cs 2f/m .5 .6 2 5-11 10YR 3/2 - sil 3 m sbk mvfr as 1f/m .5 i.6 3 11-22 10YR 4/3 - sil 2 m abk mvfr cs 1f/m .5 .6 4 22-25 10YR 4/6 - sl 1 m sbk mfr as 1f .4 .5 5 25-30 7.5YR 4/6 - sl 0 m - - - .3 .4 dense, poorly sorted till Remarks: ;STName:-Please Print Phone: Henry F. Grote 715-665-2681 address: PO Box 57, Knapp, WI 54749-0057 - >ignature: - Date: 7/ 16/94 CST Number: 3065 PROPERTY OWNER Chad Wegener PARCELLD.# Boring # ryt;.:.:riii}iin~i: w::• ~:i<. 3 Ground elev. 99.4 ft. Depth to limiting factor 26" Boring # vti<~: F•}: Ground elev. ft. Depth to limiting factor Boring # t:: ... Ground elev. ft. Depth to limiting factor Boring # ~;< Ground elev. ft. Depth to limiting factor SOIL DESCRIPTION REPORT Page 2 of.~ v Depth Dominant Color Mottles Texture Structure Consistence Bourxlary Roots GPD/ft Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trerxh 1 0-7 10YR 3/2 - sil 3 f sbk mvfr cs 2f/m .5 .6 2 7-15 10YR 3/2 - sil 2 f sbk mvfr cs 1m .5 .6 3 15-26 10YR 4/3 - sil 2 m abk mvfr as 1m/c .5 .6 4 26-31 7.5YR 4/4 f2d 10YR 6/2 sl 2 m sbk mfr gs - .5 .6 5 31-35 7.5YR 4/6 - sl 0 m - - - .3 ~.4 dense, poorl sorted till Remarks: Remarks: Remarks: Remarks: SBD-8330(8.05/92) ; i i i i I f I ~ i i 1 ,__~ _._.. _.._ I ___ _ _ _ . -- _ '_ ~ ~ ~.._ 1 i_ I i _. j j i i I _fI ,. . ~~ __ _ - - - i ~ ~ ~ ~ i ~ i a ., I , ~ ; I j ..I ' ~ I 4 -- .. _ ,.. __ __ --- -_ I ~ ~ ! - -- -- ~ I `---- I- ` i j I -- ,. ~ _ j j ~ ~ ~ - - - i -- _ .~. _ _ _ _. ---- -- --- -- ~ _ - --- - -- -- ---- - i --_ I __ ~ i ~ _ _ ~ ~ _- _ _ .~_ ~_..~ i ! j ~ ' ~ I I I ~ I ; i ~ , __ __ . _ } ~ - -- - - I ~ z ~ + ~* ~ ~ ~ f I ~ _ _ I I _ _.. ~_ . __. ... ._._ ---_ __. _ __ .-- -- t ___ I I - -- - - I ~ ( l I I ,, ... ., I ~, I I _ ~' -. i I I _ __ j ._ j ~ t ~ _- --_ __. _._. _ ._' .. _ ... ~ _~ ' ~ ~ _ I i ~ i ; ~ _ .. _ .. (('~~~~ .- -- • - -- - ~ ~ 1 r ~~i ~ 1 I ~ ~ ~ I I ~ ~ ~ ! i i _ II 1 11 I ; ,, ~ , ~ , ~, i ~~~ 3~~t~1 ~M~T ~°• ~<. ~ ~jub~r~i- o~r-.~/t - >;1uo~ i I I { .. j J ii ~ 1 ~~ I I ~ ~ i c ~ I j I ~_ _ ~_ -~ ~ - i I I j I 1 ~ I ~ i ' ~ I I ; f ._ STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNE]R/BUYER MAILING ADDRESS ~~ /03 5 S~ ~~~. 07 l ~~ri~ L~~~ 4~,y" v~l~7~~ PROPERTY ADDRESS ~~ f ~ ~ d 5 ~ c~ 1 ~ SoY~ C~ (location of septic system) Please obtain from the Planning Dept. CITY/STATE ~ ll~j /~yJ ~~ o'~J ~~ a`7 PROPERTY LOCATION S uJ 1/4, ry eJ 1/4, Section a 3 T a~ N-R~W TOWN OF ~-4.-~vj ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAP ~Z ~$ VOLUME /~, PAGE 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:}jou 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 rep cement f a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted gram in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. UWe, the undersigned have read the above requirements and agree to maintain the private 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 a iration date. SIGNED: DATE: ~~ ~ ~ .` ~ ~~ St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 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 ~i'ia.o~ Location of property S tcJ 1/4 Township /035' ,~, h1 w 1/4 , Section ~3 , T ~8 N-R~W Mailing address ~r i.r.~ f fi1,~,~w ~ " ~S17~ 7 Address of site c~ S 1 ~ ,~ f0 ~~~- Lc~ ~ ~5®v~ j~ ~; Subdivision name Lot no. Other homes on property? Yes k No Previous owner of property ,l2cc~,.._ ~ ~ /„~-j,...~ Total size of property ~ . 5 ~ Total size of parcel _ j . _3C® Date parcel was created ~ - / - Are all corners and lot lines identifiable? ~_Yes No Is this property being developed for (spec house) ? Yes ~_No Volume /d and Page Number oZ~/ as recorded with the Register of Deeds. ------------------------------------------------------------------- INCLIIDE 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. J~a/(~7~ 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 o Applicant J- ~- ~ ~ 9~ Date of Signature Co-Applicant Date of Signature ~~ TE BAR OF WISCONSIN FORM 1-1882 WARRANTY DEED 5216'78 ; ~ von ~~g~~~lr~~~.~ This Deed, made between ..-Dean--Timm=__a,k/a__Dean_R,_______ Timm--and--Sue--Timm=--husband--and- wife--and__each in their-________ own..rght., .- - - - - -- - -- - - - -- - -- -------- -- ------- -- ---- ---------------------- ---------•, Grantor, and_ - Chad_Dr-_Wegenez-- -- -- ------ - ------------------------------------------------- --- - --- - - ....- --- -- -- Grantee Witnesseth, That the said Grantor, for a valuable consideration...._. conveS~s to Grantee the following described real estate in ..St....Cr.Oix........._..- County, State of Wisconsin: __ ..__ _ ..._ .-- 'DOCUMENT NO. County, Wisconsin, more fully described as follows: Beginning at the W 1/4 corner of said Section 23; Thence North along the West line of the NWT a distance of 225.00'; Thence S 89°36'09"E 297.00; thence South 225.00' to a point on the East-West Quarter Section Line of Section 23; Thence N89°36'09"W along said line , 297.00' to the point of beginning. --• ~ ~~- Contains 1.53 acres subject to 310 Street right-of-way over the ^~~ Q _, :>:,~ --- westerly 33' thereof. Also subject to any and all additional _T., I~,a.~ easements, rights-of-way or conveyances of record. THIS SPACE RESERVED FOR RECORDINQ DATA ST. Ci3fliX CJ., t"~~i Rac'd ~r l?~~~-d SEP 2 3 1994 '~ 9:30 A. /. ~..w AJ ~9~St~E, ^t' ~ V RETURN TO A parcel of. land located in the SW~ of the NWT of ~/ Section 23, Town 28 North, Range 15 West, St. Croix Tas Parcel No: _~_`_~- 6oS3 This ....-.is..not.--....... homestead property. (is) (is not) Together with all and singular the hereditamenta and appurtenances thereunto belonging; And_ --- -.Gr.~.nC-4.X.S---------- -- -----------...-----------•--- -- --- - --- -- -- ---------------- --------------- -•---•-••---•-•--- wal•rants that the title is good, indefeasible in fee simple and free and clear of encumbrances except ..._ and will warrar~t'and efend the same. ,- ., Cy Dated this .._------ - ---- - --- --------- ----- -- day of --------~-September.....- ---------•-----------•----•-----, ls...94.. ~"'__" -------------- (SEAL) - - - _..-~^c?rv-""~ - --- --- - - ----- -(SEAL) ./ - - - - -- -• - -•• -- ----- !.'.~-1 Dean Timm Sue Timm --- --- ---- ----- - --- -----------•------•-----(SEAL) ---------•----------------------------------------•--------------. (SEAL) I~ AUTHENTICATION ACSNOWLEDGMENT ~' of Dean Timm and Sue Timm__ STATE OF WISCONSIN Signature(s) -----•--•---------•-••---...------•------••-•----- I ss. _ .. ' ---- --• .. ~; ---- -._~..-•------------•-••-•-•------•----------------•-• --County. ~ j ---------•--------------•-•--------- au h nti~ated t ....da of. e~t_mber _ lg 94 personally came before me this ________________day of - f YJ" 1::.. ) •• L-~L--~_._ ------------------------•------••---------~ 19-•------ the above named ,- ~ . Robert R. Gavic i ----------------------------------------------------------------------------- jj TITLE: MEivIBER STATE BAR OF WISCONSIN I (If not- ------ -- ---------•---- ---- ----• --- I authorized by § 706.06, Wis. Stats.) ~•--•----•----•---•----•---• ..................•---•--.....----•--•--••---•------ to me known to be the person -.-....-.-_- who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED 6Y \ ROBERT R. GAVIC "~ ------------------ -------------------------------------------------------- ---Attorney--at--Law-•-----....-•-•---------••------------------ * ,~ ,~ ;; Spring--Valley,.. WI--------------------------------------•--• Notary Public ......._.__...----••----.. y, Wis. ----------------Count (Signatures may he authenticated or acknowledged. Both My Commission is permanent. (if not, state expiration ~' are not necessary.) date: ----------•--------•------••--------------------------•, 19.........) ~ i "Names of Persons signing in any capaci*,y should be typed or printed below their signatures. Hc. R111Wr E BAR OF WISCONSIN FORM No. 1 - 1982 Stock No. 13001 S~ I ~ 5~09~8 ~~~~® c, ".,~ ~ ~:._.. ; ]_ 1994 ~•- 1~ JAMES O'CONNELL Register of Deeds ,, St Croix Co., WI CE RT I Fl ED SURVEY MAP '~~ ~ I~''~ LOCATED IN THE SW4 OF THE NW4 OF SECTION 23, T28N, R15W, TOWN OF CADY, ST.CROIX COUNTY, WISCONSIN. Prepared for: Elaine and Dean Timm N~ ~: Q: Q ' W; ~' f... Q' J' Z• ~• N W CORNER OF SECTION 23 . ` (I~' IRON PIPE FOUND.). la .o N x a ti ~ ~ 3 Z y W x 4 o •` w z J w 3 33' O C) N N 0 Z ~! ~, NOTE: BEARINGS ARE REFERENCED TO THE WEST LINE OF THE NWI/4. ( RECORD BEARING). UNPLATTED LANDS S89°36'09~~E 297. 00~ 33.00' I 264. 00' SETBACK LIN E 33 ' loo'~y. -ol~ o NI L 0 T I N I. 53 ACRES x (66, 823 SO.FT.) ~ 1.36 AC. EXCLUDING ROAD R/W 2 of ( 59, 399 SO.FT.) z APPROX. ~}, CAUY CREEK - 33.00 ~ 264.00 ' ,~ N 89 36 0.9 W 297.00 ~F~ 1 ~~'9~.a _-..;re~2nsive Frlaruiir "c;zin~ and '~ l~?t iC'COideC~ ~w.~'.~in 30 days of c3~,iovai`date <;.rbrr+val sfia61 bo <,;~4E• Nr• u I~+d WI/4 CORNER OF SF_C710N 23. E-W QUARTER LINE ( I "~ I~RON'PIPE FOUND). I UNPLATTED LANDS• 0= SET I~~X 24"IRON PIPE WEIGHING 1.13 LBS. PER LINEAR F007. SS C I " = 6 0 ' VOLUME 10 PAGE 0~• 30~ 60' 120 SHEET IOF2 94-100 THIS INSTRUMENT DRAFTED BY JIM WEBER O O N N H O to ; O. J~ ~• W' F- • ~. Q• J• Z' 4966.02' N89°36~W ~.p~8649fr.'~8}s~.y~+~ ~ ~ JAh~ES int. X`f g 4 ~'" VdE~cN ~ S • 1804 ~, SPRRVG VALLEY ~ WIS. ~ ~' 28 ~ 4 ~~~d98,5 ~ i ~~ ~~~'~~' emu. JAMES M. WEBER S -1804 -NELSEN -WEBER LAND SURVEYING S N 2 O W ~ N V ,y, W a a ,~ a o z ~ o W ~_ 2 ([ o a V N a x ~_ .~ ~:... i D~ SCR. I PT I O1V A parcel of land located in the SW 1/4 of the NW 1/4.of Section 23, T28N, R15W, Town of Cady, St.Croix County, Wisconsin, more fully described as follows: Beginning at the W 1/4 corner of said Section 23: Thence NORTH along the West line of the NW 1/4 a distance of 225.00'; Thence S89°36'09"E 297.00'; Thence SOUTH 225.00' to a point on the East-West Quarter Section Line of said Section 23; Thence N89o36'09"W along said line 297.00' to the point of beginning. Contains 1.53 acres subject to 310th Street right-of-way over the westerly 33' thereof. Also subject to any and all additional easements, right-of-ways or conveyances of record. NOTE: The parcel shown on this map is subject to State, County and Town laws, rules and regulations. (i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St.Croix County Zoning Office and the appropriate Town Board for auvice. SLJRV I=.YOFt ' S CBRT I F I CAT)E 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 Elaine and Dean Timn, owners, I have surveyed and mapped the above described parcel of land and that this map is a correct representation of the boundary thereof. ~~ Dated thisZR~day of J~~~ , 1994. ~c~1~'~~ James M. Weber 5-1804 ~jr ~ ~,, `+~ NELSEN-WEBER LAND SURVEYING ~ 1~ Jk~LtES AI. ~ ~ w~r3e~ S - 1 t3U4 SPf~ING VALLEY ~ WIS. ~ ~ e`~ je' ~ ~ R e ~t~v SHEET 2 OF 2 94-100 This instrument drafted by Jim Weber f , ~~~ VOLUME 10 PAGE 2814