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HomeMy WebLinkAbout040-1134-80-000 SL Croix County Planning and Zonin . N O N O _ _ - M N co cz E U N N 2~p O O OL = > U d V- a a~ O c m p = c M rn o co 'o m .p U 0 O 7 O N O c E !E y 0 3 ai wr a O LO N > N O OO > x O LL O C V N c Y D O m c !~I N E a .m.. 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O CO F (n N O - N O N F- Z Cn O m + w (D M (L EL L: 4) L: 4) IL w (L i~j ~ E u c 3 c 0-4 A U a~ O v~ c°~ 0 U) i c p E°9 I ti 0., o I ~ I 0 0 N N d I a ~ I A ~ I M ~ h p z N c li o - I Q I I OZE- 0 X 00 w c`n+> FN- Z o o z v m Z c Z m f- E .p ~ M .j y c • c O p Q 2 z z Z c E O7 eN} p p I CD d H d N J O N O O d a r r r Z M> 3 3 3 3 ° w o z c • r LL aaa a ~ > I a rn rn fA J V U C) C) Z C C~ O O O CD rn 0 N N ° ° 7 'D p M r ° 00 (D a I ~ ~ cn Q rn y m c~ rn ¢ Z p c o w w C C 04 tO a) Q O 2 M E CO U') p C a V a 0 0 rn C ~ 01 H1 U L rS F- 06 0) .p ~ O N y M d N H C CD co • O M H 0 cc fn N O Z Cl) ='dt a ~a • a d .2 a `m E c ~ i+ C C Y t 0 o a2 O~AU t A U z , o 9 -12 pC~R0W QED 1 NO V) 2 9 1995 ► JAN - 3 1996 KATHLEEN H. WALSH St. Cro X C,0"W~ 5681 c SURVEYOR'S RECORD CERTIFIED SURVEY MAP LORIN AND JUNE SATHER Part of the Northeast 1/4 of the Southeast 114 of Section 3, Township 28 North, Range 19 West, Town of Troy, St. Croix County, Wisconsin. FENCE UNPLA TTED LANDS ROAD SETBACK LINE S 89. 50' /O 498.63' ar / ' s s' 42 33' 33'I ~ Q I Z Kd I O LOT 3 - v l o Z ~ I Q~ 2 Q O 2.637 ACRES O 113, 728 SO, FT. TIN SHED TO B£ REMOVED I Q o 'a o N M S 89. 50' f0 11 E 275.00' N Q I I I Q 2 tAi ~I N P /.OIO ACRES I Q \ LOT 4 44,000 50. F7. I 3 ~1 • 2 I I m QI W 3 x Q, Q, I o " JI O ? m SEPTIC OW L11.1 G I I O " JI = ~ o ~ ~ o o W O O WELL b . I J b ® O DRIVEWAY O ` I 2 ~I . 224.67' 2 275.00' N 89.50'/0"W 499.67' R /WEST 501. /O', 50/.70'1 £ 114 CDR. SEC. 35, T281Y, 52' O R /9 W, (COUNTY SURVEYOR'S 3 O MON.) L O T C. S. M., VOL. 6, m h e oo. a m PAGE 1645 M p 2 O ~ N This instrument drafted by Laurence W. !Murphy w ALL BEARINGS REF. TO THE EAST LINE OF THE SE114 h S LINO NE114 SE 114 5 O OF SEC. 35, T28N, R/9 W, ASSUMED NOO-00'00"E O O O Indicates 1" x 24" iron pipe weiShing 1.13 0 S 89' 57'15 "W 810, 22' O lbs./lin. ft. set. 2 Indicates 1" iron pipe found. R/N89.53'49"W 813.0) P Owner's Address W 36 °ins RidSe Terrace m p h Rivar Falls, WI q W Z SCALE //00' ;407? J O 25'50' /00' 150' 200' 300 SE COR. SEC. 35, r 28 N, R /9 W, I COUNTY SURVEYOR'S MON.) Dated: Seotember 25. 1995 STC 104 AS BUILT SANITARY SYSTEM REPORT p SY CROIX c\~ , COUNTY OWNER . ZCxNINGOFPtcE ~AV ADDRESS !T i A)G i 1 f-36,:7 /t1L~ 46.5 SUBDIVISION / CSM# 4~lo&1g d6Z ~r oC LOT # SECTION T,-,2g N-R/2 W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYT ING WITHIN 100 FEET OF SYSTEM I LZL Id o ~iZ i c G C~ 4-f- d I (yo ~~s O I ~~UnJ~ ~zX71 INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: 7- O ALTERNATE BM: l 7 y r4~cmc~r 7.- SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: f~cr,J /e4 ~ .)Liquid Capacity- C-- Setback \ S r from: Well fi'House A0 1-11t2 Other f ~ Pump: Manufacturer Model#-26_ Size Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: Length. Number of trenches Distance & Direction to nearest prop. line: oZ-,--~ y Setback from: well : N~k House Other c ~S Z L p2rpG, ELEVATIONS Building Sewer 6 ire) ST Inlet:/ 3~ ST outlet: PC inlet PC bottom Pump Off 7 Header/Manifold Bottom of system 61,90, d 9910 Existing Grade 8 Final grade /Q ?.Z a Af. DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: .Jfrr~ ~f~j~~sD,U 3/93:jt Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: kabor andHuman Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division (ATTACH TO PERMIT) sanitare6rrliL►~Lp.: GENERAL INFORMATION 2iE~3 / ' Permit Holder's Name: City Village Town of: State Plan ID No.: SATHER, LORIN gRO_n Y CST BM Elev.: , Insp. BM Elev.: 7BM Description: Parcel Tax No.. TANK INFORMATION ELEVATION DATA A9600326 X710 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV_ Septic ~ ~ r C~ 2cli~-ul'' Benchmark 3 vg~ a4~ S~f/Q~ /Gl~,: Dosing i / d /d~.5~ Aeratio Bldg. Sewer Holding St IX Inlet s d~,3 T K SETBACK INFORMATION St/ Outlet os dam? S' TANKTO P/L WELL BLDG. VVe Intake ROAD Dt Inlet ;j i 1U,53` 9(p Air Septic '27 1;~o' NA Dt Bottom 5 7 /~3,3f1 Dosing 1> 15D LJ /C /G ~ NA #5gber/Man. d 40.53 Aeration NA Dist. Pipe Holding Bot. System % d> PUMP/ SIPHON INFORMATION Final Grade Manufacturer Z¢r 14'a nd' k- (o, c1p" g~, 51 101 r Model Number nj s 7- oss ction/,,,,, System TDH ~3 Ft TDH Lift U Flo' Fri Forcemain Length ~ 7' Dia. H Dist. To Well O SOIL ABSORPTION SYSTEM BED /TRENCH Width Len t L r No. Of Trenches p No. Of Pits Inside Dia. Liquid Depth DIMENSIONS l DFMEN I SYSTEM TO P / L BLDG WELL LAKE/STREAM LEAC urer: SETBACK CH ER INFORMATION Type O Mo a Nu System: r,.,-)c( 2d/(d, ~~U 3 R UNIT DISTRIBUTION SYSTEM AgjAW Manifold Distribution Pii~p//e(sr x Hole Size y x Hole Spacing Vent To Air Intake ~b Length ~ Dia. ~ Length Y~~ Dia. Spacing +!00 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 E] Yes E] No E] Yes E] No COMMENTS: (Inclu code discrepancies, perso s present, etc.) /20'1{ YI/t c~---c~_ fit G ~QN q?~ j~-A.~►,~ ~ i LOCATION: TROY-35.28.19W, NE SE, PT_hE RIDGE TERRACE~ 0-5-6'_ air Plan revision required? ❑ Yes No Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: SANITARY PERMIT APPLICATION BureaSafetyu o off Buiuiildii nWater Systems gWater ~ 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 • Attach complete plans (to the county copy only)-for the system, on paper not less County than 8 112 x 11 inches in size. s7 eo / 7r • See reverse side for instructions for completing this application State Sanitary Permit Number The information you provide may be used by other government agency programs Pais it revision ~ previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORM TION 5 .2 o--A 3 Property wner Name perty L fation c~/ is S C- 1/4, 53 T ZV r N, R E (oQ~p Property Owner's Mailing A`ddress Lot Number Block Number Cit gate Zip Code Phone Number Subdivision Name or CSM Num er ~Q tee: L!J S ( > ~bd Of • 11. TYPE F BUILDING: (check one) ❑ State Owned E] City rest Road ❑ Village Public 1 or 2 Family Dwelling - No. of bedrooms Town OF -7';&)41 - c 111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church / School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel / Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank OnlyExisting 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 KMound 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. Sys a 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/da sq. ft.) (Min./inch) Elevation f1 L~ v Feet QZ Z. Feet VII. TANK Capacity in gallons Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existin strutted Tanks Tanks Septic Tank or Holding Tank vo r p~ 3 ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber 75Z -r X v g- ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY S ATE-MENT I, the undersigned, assume responsibility for installation of the onsite s ge system shown on the attached plans. Plu ber's ame: (Print) Plum r'sSi ature: ( o, Stain s) M PRSW No.: Business Phone Number: / 3 2 5-7-0 P um a 's Address (Street, City, tate, Zip o e ~r c Gc ^ LL t~ } IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sa itary Permit Fee (Includes Groundwater ate Issued Issuing gent Signature o S mps) Approved ❑ Owner Given Initial Surcharge Fee) Q/a9 Adverse Determination CXJ / - X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SOD-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. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement- Installing plumber into 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. HEAD/CAPACITY CURVE EFFLUENT and DEWATERING WARNING: Model 18514185 should not be subjected to less than 30 feet TDH. TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE 1n cr sus w 17, SERIES 43 41 $1-" w 177.139 16014160 16114161 16314163 1659163 1159165 II6N1w 14441w 1wNtp 191 FT. M. GM. L6a7. Gal. :LLS. Gal. 2! Gal UM Gal. Lin Gal. Lrs Gal. Lis Gal. Lim Gal. Lft Gal. Lft& U. um C.I. Lks. Gal. LIM. GAL : Lts 1 4 S 112 16.5 Q 21 166 ' Q 10 72 m 97 152 fr 356 106 601 61 211 N 271 w 220 155 $0 155 567 45 II6 42 10 2A6 131 $0 21 - 91 34 121 61 .214. 79 200 M 111 100 376 61 771 61 211 w 220 141 6e0 151 672 45 '.170 13 1s 1. 1.1 15 19 4$ 110 : N 43 U 11 60 7 60 1 56 142 7 145 IS n 20 6.10 2.5 1 3 11 25 95 36 134 73 276 62 110 59 223 W 221 56 220 156 515. 140 $30 45 II/ 40 1 3 2S 7b2 1 30. 63 236 74 Ito 57 211 59 223 54 no 126 4Lt 137 '$01 : 45 .:170 70 1.14 53 Mf 65 2µ ss 205 58 226 90 ]14 . 720 121 4p 127 d61 : 45 110 40 1LI$ 30 114 46 111 44 172 55 296 75 267 so 220. 105 317 114 431 IS 170 38 -12 50 1124 21 60 33 its 51 191 54 211 56 220 w 141 100 110 45 170 w 1629 1s $1 43 141 36 136 st In 71 M 15 32 45 119 120- 70 2134 30 111 10 L 52 117 ' 51 167 70 I24545 170 36 1 9 1 w x.76 14 53 45 176 26 toe 54 .204 45 .'.470 115- 90 2163 32 121 2 1 37 140 45 '.111 IN w.4t - u sa. 21 ,79 40 `111. 34 110 zoo 7 26 1 20 70 .114 110 120 3616 w n +w 39 u 32 105 10 1s Lod vaM: 21.C 21, +925 27 25 65 w' w it 77 115 91• 112' 13r 100 30 95- 28 t08 186, 26 4186 165, 24 4165 5 75- 22-- 70- S2 J x 20--- 65 0 18 60 163, 4163 189 55 4189 0 16 50 14 45 12 40 140, 188, 35 4140 44 4188 10 30 137, 185, 8 25 139 4185 6 20 Zzz 15 4 T D.n! 2 5 43 48 53,55 [57,59 98 161, 0 4161 U.S. GALLONS 10 20 30 40 50 6 70 80 90 100 110 120 0 140 150 160 LITERS 80 160 40 320 400 480 560 640 0 FLOW PER MINUTE 009922 Note: For Head Capacity on Mo el 112, industrial column-explosion prooof pump, see FM0219. &6 *G,/' 'vl, . p rn o O C ♦ N a a n vi li ? M p w...~i 0 1^. a f Nq U r~ O h A' b 1N0 • h N w A O ~ to a g o vwi N A 0 gg A In 0 m V ° n W w~ M r ,p Z N L O Ot h g ~ N eo w a ~ g' a ^ W 'Z wAi e3 w c, n J , n ILZ 9~~gl~ ° o ~w° n N IL v Q Q N q eOy N Iqqn~ t! ^ q O O O Q W ao P 1 p1 tV w O N OQy::J"f N r a N OI ~i N q ~ w ~O 1~'f O pN f. pp p p Cp O F"' ='W^ a off e'1 N ~ ~ O O d o V A • C, O A N w a N II A N Z W b J ♦ h N N O o ~i o cr ~ a N M Z fy/1 Q J r M r in < Q Q W d N q N o N N O C', > 0 OD W n J h r N a O j U N 4 N w O O N N Q1 O MI O y N O N UU H N - n O~ O F w 70 N~ ~ J J a / 1 Q gi ~O N A. N Z V N ~ C N YNi O h O r r N N n O. r Q. O _ W vi i ¢pi w of pci pr p q N Y e a O a 0000 _ao ~ O q O 00 Q y 4) 1~L 1p N ln`I t0'f O N 10 n J N n Q O O O^ W Q w Q = O W N y N r O ^ j o J r Z C) Lj n rn a N N O as $ 8 Z N 3 Q I1J O V U Q m to N N c N O n l0 i LLJ n co E Q V N O LLJ O o O N N oa - m cm N ~ a ~ e E d E L rn0 N r c 7 N U N O a Ul) V O d) Na a 0 co -V CA G_I U N N O vJ O.«.••- O N O iii (y ow=c> 'moo `l ° to N.C ° Q `l - 'o mo0 poiL Lik YE I -r- ,5 cn E=Uy p o O.+ C O O L 1333 n O ° N e M N N ° ~A Z LL w O m v.10 n sa313H N N N N m ~O O N O ED ~D < V O .2 R '00 a, =v °"i w 4) 2 nv OV3H OIMNAO 1V101 j j IY ♦00.Myp SAFETY & BUILDINGS DIVISION ' 201 E. Washington Avenue jr P.O. Box 7969 Madison, Wisconsin 53707 State of Wisconsin July 12, 1996 201 East Washington Avenue P. 0. Box 7969 Madison WI 53707 GUSTUM PLUMBING N13450 937 ST NEW AUBURN WI 54757 RE: PLAN 596-02543 FEE RECEIVED: 60.00 REVISION TO PLAN S96-02023 SATHER, LORIN NW,SE,35,28,19W TOWN OF TROY COUNTY OF ST CROIX MOUND SYSTEM The Department has reviewed the above-referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based on chapter 145, Wisconsin Statutes, and chapters ILHR 83 and 84, Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter ILHR 82 or in chapters ILHR 50-64, Wisconsin Administrative Code. This plan submittal approval will expire two years from the approval date, or if a sanitary permit is obtained, plan approval will expire on the day the initial sanitary permit expires. The licensed plumber responsible for this installation shall keep one set of plans with the Department's stamp of approval at the construction site. The installer shall notify the appropriate inspector when inspections can be made. All permits required by the city, village, township or county shall be obtained prior to installation. Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Sincerely, n eth Stiemke Plan Reviewer Section of Private Sewage (608) 266-8230 7:00 to 3:45 Mon. thu Fri 6414R/ 1 SBD-5524 (R. 09/88) l - - - - I _ l_ 1-1-11 I- - l- - - - - - - 1. T I i i t t I i I ! I i I - - All , r~-w - - - - - - ~tf '9' ~n S &L 3 I ' I I ; , i ~ I T TIT } - - - is -~-d---L-_-. f t T 01 I C. - i I I SPA _ _ _ - - - SPA Di~G i v -70 /Pa ^ I 7 } - - - - -ter zX a 3 acs Qa- o ;T M, q$ o ' r t-\\. el ~or~ovr a O o ~►,e `'a O u VN~~ c~ Q o Page 2 Of ' Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe Medium Sand H G 6" Topsoil F 3 E p 3 Y % Slope Bed Of = 2 %2 Force Moin Plowed Aggregate Layer (6" Below Pipe) D / Ft. Cross Section Of A Mound System Using E /,45~ Ft. A Bed For The Absorption Area F .8 Ft. G / Ft. .Zt~o A Ft. H _S- Ft. Signed: B -~rO_ Ft. License Number: A/ZOI K /6,W-Ft. Ft. Date: K1319c L 7012 7. Ft. I Ft. W Ft. L - pvc, d Observation Pipe d - t A • I Force Main r 'r ~-.Di-stribu-fion----7\B9d Of z - 2 iZ Pipe Aggregate i i i lbservation Pipe Permanent Markers I Plan View Of Mound Using A Bed For The Absorption Area 1'IV 1 C. 1'OOi SIC ~lIIliYilll lV •~Ir. /'WAN. vwv~ v~~~yw~ ~r~ n~ v.... v.......wv........-..a.. ~le~ '1 ~ Oe1N1 t"e cer '•rr«.f•~ " vi ' pvc pipe MeN• Leeeae ow e.fr.~, tewMr sreeee ted Ch f OUf~I • ~ arllM ~i~ ~ X00 i ~ItIr10Y~lq~ p~ a Le eul PI..• Nwe ~AwN ea fva► MMN.fI Force fAN~,.f r•~ po". P 74- '?i: S t x ~a Y 1 3b., I Hole Diumte y Inch Wil Lateral " '°T" . Inch(es Manifold N / ~ Inches Force Main « a inches " „ # Of holes/pi 12 Invert Elevation of ~ Lateral U6, Ft. 20 6 20 10 10 20 20 •0 00 00 70 . am. S 70 60 •0 100 110 120 rEeER 101 ri7 271 pdg~ 30 ~ ~ my I C: rues are pur2iuarlt tv rrls. PWII1. a.we, VIImptul It.nr% c, of Pi ate auuftna to uslanye anrluan . • I'Af;I ~ ~,;F PUtAP CHAMBER CR6S5 SECTIOU AUri SPECIFIC4•r10h!S VCWT CAP M"C.I. %,E!LIT PIPE WEATHERPROOF APPROVED LOCKIAIG T JUNCTIOM BOX MAMHOLE COVER 25' FRO-^1 DOOR, IZ•MIU. it/~ btlA,cA)inj 1.4641 WINDOW OR FRESH AIR INTAKE I GRADE I y• MIN. I I B" Ir11 M. CONDUIT le•MIIJ. - . PROVIDE I IMLET AIRTIGHT $CAL I III T A I ( ( APPROVED JOIWTS APPROVED JOIIJ I I I W/C.I. PIPE W/C.I. PIPE I I I ( ALARM EXTEUDIUG 3' EXTENDING 3 ONTO SOLID $OIL OUTO SOLID SOIL B I I I 1 I I ON . 9 c • i I ELEV. FT. PUMP Off D• CONCRETE BLOCK 3EPT1C E 3PECIFI•CLATIOAJS DOSE : /~'1;r1 ~~1/GS4 rn Pr2CAST IJUMBER OF DOSES: PER TANK MArvUFACTURER 12- 75-0 GALLOUS DOSE VOLUME 7s• / AL TANK SIZE: J ms . ~ S ALARM MAUUFACTURER' S1L :T - ~ce,4ec> INCLUDING BACKFLOW: GALLOWS MODEL MUMSCR:. 101 CAPACITIES: A= INCRES OR CALLOUS SWITCH TYPE: Mcr cu 8 = I IMCNES OR _3~9~- GALLONS PUMP MANUFACTURCR: L'A S C- 2 IMCNES OR 17s's" GALLOWS MODEL NUMBER: S-E y// D- '/IMCHES OR 71? GALLONS SWITCH TAPE' Me r[-tsr,/ MOTE: PUMP AUD ALARM ARE TO BE MINIMUM DISCHARGE RATE vl~, 9 GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWE[N PUMP OFF ARID DISTRIBUTIOU PIPE.. FEET + MINIMUM NETWORK SUPPLY PKESSUKE✓.. . . . 2.5 FEET + 20 FEET OF FORCE MAIN X 3, 9 $ F~oo Pt FRICTIOU FACTOR. 2. 78' FEET TOTAL Oy1JAMIC. HEAD FEET IIJTERNAL DIMEMSIOMS OF TANK: LE►UGTH -;WIDTH ;LIQUID DEPTH 51GUE0: LICEMSF DUMBER: O/Z~ DATE: ~ v _ WIsconsiVi Department of Industry, PRIVATE SEWAGE SYSTEM County: L•aborand•HumanRelations INSPECTION REPORT Safety and Buildings Division (ATTACH TO PERMIT) RSa_ r i GENERAL INFORMA TION 1 Permit Holder's Name: City ❑ Village j] Town o : D N . TIl, C BM E ev.: Insp. BM Elev.: BM Description: arceax No.: A9600203 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosi ng Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet Vent irl to ntake ROAD Dt Inlet TANK TO P / L WELL BLDG. A Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. Syst PUMP/ SIPHON INFORMATION Final G ade L Manufacturer Demand Model Number GPM TDH Lift Friction System Loss Head TDH Ft Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK CHAMBER INFORMATION Type O Mode Number: System: 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: TROY.35.28.19W, NE, SE, PINE RIDGE ROAD Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH - SANITARY PERMIT NUMBER: SANITARY PERMIT APPLICATION BuSafetyreau o oand ff BuilBuilddinng Water S sterr Sy tem: 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 /1 than 8 112 x 11 inches in size- 6~ - C --O k • See reverse side for instructions for completing this application State Sanitary Permit Number a&.2-3 q The information you provide may be used by other government agency programs ❑ Check if revision to previ us application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATION Property O ner Name Pfr y Location SC 1/4, S N, R E (or PropertOwner's Mailing Ad ess Lot Number Block Number 736 - r t L I Cit fate Zip Code Phone Number Subdivision Name or CSM Number jl~ is d xz~ ( > 11. TYPE F BUILDING: (check one) ❑ State Owned E] City Ne st Roa 13,Village Public 1 or 2 Family Dwelling - No. of bedrooms 3 PS-Town of `-f`& / 111. BUILDING USE: (If building type is public, check al that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo EJ - 3 y _ gej 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. )?f New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 0 Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (!5. ft.) (Gals/da /sq. ft.) (Min./inch) Elevation 2K f t Feet Feet VII. TANK Cag in gallons Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existing structed Tanks Tanks Septic Tank or Holding Tank A r ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber A)G ❑ ❑ ❑ ❑ ❑ VIIL RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite se age system shown on the attached plans. Plumber's Na e- e(Print) PI b 's Signa re: (No Stamps MPRSW No.: Business Phone Number: Plumber Address (Street, City, t te, Zip Co / tc 'I S ~4b G ! g J Z IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Agen o Stamps) roved Surcharge Fee) pp ❑ Owner Given initial 0? as Adverse Determination . CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: SBD-6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To:. Safety & Buildings Division, Owner, Plumber INSTRUCTIONS y 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3_ All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number'with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans mutt include the following: A) plot plan, drawn to scale o.~ 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) fora number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. SAFETY & BUILDINGS DIVISION 0 201 E. Washington Avenue P.O. Box 7969 Madison, Wisconsin 53707 State of Wisconsin June 17, 1996 201 East Washington Avenue P. 0. Box 7969 Madison WI 53707 GUSTUM PLUMBING N13450 937 ST NEW AUBURN WI 54757 RE: PLAN 596-02023 FEE RECEIVED: 180.00 SATHER, LORIN NW,SE,35,28,19W TOWN OF TROY COUNTY OF ST CROIX MOUND SYSTEM The Department has reviewed the above-referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based on chapter 145, Wisconsin Statutes, and chapters ILHR 83 and 84, Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter ILHR 82 or in chapters ILHR 50-64, Wisconsin Administrative Code. This plan submittal approval will expire two years from the approval date, or if a sanitary permit is obtained, plan approval will expire on the day the initial sanitary permit expires. The licensed plumber responsible for this installation shall keep one set of plans with the Department's stamp of approval at the construction site. The installer shall notify the appropriate inspector when inspections can be made. All permits required by the city, village, township or county shall be obtained prior to installation. Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Sincerely, i en eth Stiemke Plan Reviewer Section of Private Sewage (608) 266-8230 7:00 to 3:45 Mon. thu Fri 5813R/ 1 SUD-55U (R. OWN) Private Sewage System Plan Index/Checklist All plan sets should be legible and permanent copies, organized into sets, bound with staples and covered by an index sheet such as this sample. No other pages need be signed as long as the index sheet for each set is signed. Your cooperation expedites your plan review and shortens plan entry time. Plan ID # Owner's Name 5cl / aa0~,3 Zarin - 4~ Legal Description Address r ~y ParfcF lFk~►J►Ji/ oFSfl- ,Ssc36-f-.2F R/4 ' P,'ne IQ 7Lirr 04 c~e_ CityNillage ow County n Contents Comments/Special Instructions Page # Included Two copies needed for all plans 1 Plot Plan 2 Plan View/Lateral ® Return by Mail 3 1srr'!Dol`ien1 e- 4 Tank & Pump/ Q Fax Letter to (County) (Submitter) Information Circle One and Provide Fax 5 System Sizing (Public) 6 Call for Pick-Up: ( ) 7 0 Other I, the undersigned, hereby certify that the aI~EA plans and specifications submitted herewith were prepared under my ~Q direction and control. M ; N Plumber/Designer er License/Registration # 0 M 12116 Address city 0 rState a3 E AJ13 yso 3 7 tb St Ncw f~✓d~~n wl /GIN Signature PRIVA19mce Use Only `Attachments: SWAGE SYSTEM Application Soil & site evaluation Conditionally Fee Needed for Holding Tank Submittal: One copy of notarized holding tank APPROVED agreement. (Originals to County) EPT. INDUS2NDENCE DIVISION NR AN RfiLATION~, Needed for At-Grade Submittal: ILOINGS Original signed and notarized Application for "Use of an At- Grade" SEE CCounty on-site One additional set of plans - SBD-10268 (N.01/96) s J6- 0►2023 /Py 7U~ o a°_ ~ r 3 ~to~lo o ~ ~ ~ £ o vj v 43 43 ~ q Nl,o~ q fry U` ~1, s G~T~ovr lag. J o ~ O O , u. P~c9c l,q l • Page 2 Of Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe Medium Sand H g 6" Topsoil F 3 E D 1 Y % Slope Bed Of '10-2 %2 Force Main Plowed Aggregate Layer (6" Below Pipe) D ~ Ft. E /S~ Ft. Cross Section Of A Mound System Using A Bed For The Absorption Area F , 8 Ft. G Ft. A 7,5' Ft. H Ft. Signed: B jrO Ft. License Number: ,0 /zv I K ID,W_ Ft. Date: 613/9c L 70, 5 Ft. j I. Ft. I 10 Ft. W ~S-,' Ft. L a„ PVL~ Observation Pipe 6 L-- K i.--------------------- - , A !p I -Force Main W Distribution Bed Of Pipe Aggregate lbservation Pipe Permanent Markers i . Pion View Of Mound Using A Bed For The Absorption Area , too CN I!L-V42 ►orhroioo PVC Pipe 0 MSNe Loeoted On asllei", Mo t"GNr Spaced 1s ~f 0S MV-6490S t ted COP f Distribution n Distribution PIPS Lo ouI I WO pad. sAwN /a O two. A KMMdd ~a 30'' X T ~ N _ d _ a S_ I Y1 3601 sa iO - HOle Diameter o 0 0 0 0, T 1' Inch Lateral " t _ Inches) yy f Manifold " Inches Force Main " Inches / of holes/pi Invert Elevation of Lateral) Ud, I v • 0 gorq g Page ~Of~ SEPTIC TANK &PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS 4" CI VENT PIPE 12" MIN. ABOVE GRADE & WEATHERPROOF 25' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MANHOLE COVER W/ PADLOCK ~ FINISHED GRADE 4" CI RISER WARNING LABEL 4" MIN. 18" IN. 6" MAX. INLET WATER TIGHT SEALS GAS- , TIGH T \/APPROVED IA SEAL JOINTS WITH APPROVED ALM APPROVED PIPE PIPE 3' SOIL ONTO SOLID C i ON S31 OLID RISER EXI7 I SOIL PUMP OFF ELEV. 7~'YFT. OFF D PERMITTED ONI IF TANK MANUFACTURER HAS APPROVAL 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE TANK MANUFACTURER: Mid wesfern Pr, (,s NUMBER DOSES PER DAY : / . Sr~o~b<<k TANK SIZES: SEPTIC /Doo GAL. DOSE VOLUME INCLUDING 112.. DOSE 6So GAL. FLOWBACK: 123.1y GAL. ALARM MANUFACTURER: S ~~rv CAPACITIES: A = 'tC( INCHES = yob GAL MODEL NUMBER: A,I SWITCH TYPE: Merv-Curs/ B = 2 INCHES = .3y GAL PUMP MANUFACTURER: ~6 e C = INCHES = 134, GAL MODEL NUMBER : 11 Sf "S SWITCH TYPE: M.ere:yrY D = INCHES = 1,69 GAL REQUIRED DISCHARGE RATE GPM PUMP & ALARM WIRING AS PER ILHR 16.23 WA, VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE . _r FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . . . 2.5 FEET + ?U FEET FORCEMAIN X 3,99 FT/100 FT. FRICTION FACTOR . 2.7y FEET TOTAL DYNAMIC HEAD = 7o,2g FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH d S ; WIDTH 7 8 ; DIAMETER I VA LIQUID DEPTH 39 SIGNED: ✓ LICENSE NUMBER: QIZol DATE: `13194 1/88 Wkw-gnsinDeportment of Industry, SOIL AND SITE EVALUATION REPORT Page of 3 Labor and Human Relations Divisidn of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than •x 1 iiiq ' size. Plan must include, but i Y ,I not limited to vertical and horizontal referenc t' t dir orb n % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location an ata+c`e to nearest ro` O~Q 1131 - 90 _ APPLICANT INFORMATION-PLEA VllNT ALL INFORMA REVIEWED BY DATE PROPERTY OWNER: ROPERTY LOCATION Lry'l r jcL-} her r 04 LOT N Q 1/4 SE 1/4,S 35 T 28 N,R 19 W PROPER OWNER':S MAILING ADDRESS ; LOT # BLOCK # SUBD. NAME OR CSM # Inc qic~e_ CITY, STATE ZIP CODE :PH, ER ❑CITY ❑VILLAGE ErOWN NEAREST ROAD iy~X Its WI 51022 F~!)z T ~t►e Rid .Tcxracc ~Q New Construction Use (ICJ Residential / Number of bedrooms 3 [ J Addition to existing building ] Replacement [ ] Public or commercial describe Code derived daily flow ~ 6D gpd Recommended design loading rate 0,L bed, gpd$ o•S trench, gpd/ft2 Absorption area required P12 S bed, ft2 900 trench, 112 Maximum design loading rate 0.5 bed, gpd/ft2 0, trench, gpd/ft2 ,15e.1.ammenved i tiler atlon surface elevation(s) -jo bo ~.f_I-tYYYI~n`f.cl ft (as referred to site plan benchmark) Additional design / site considerations Parent material gl %lCt a t +,11 Flood plain elevation, if applicable k)It It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for s stem ❑ S ELI Ns ❑ U ❑ S j9 U ❑ S S U ❑ S ,o U ❑ S XU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 0-16 lo* t stl mfr- s C-Z i >.;f 2 ) , 33 10 rh~r .5 [ O.5 0 . Ground 3 33-yg 10 112 5 yi< ;4 +5 a CS I elev. f Id J, 9v.5 ft. 93- 10 Y P, 3 y 7.5 y ~T `S ~ m 1 - A) K ' iJ Depth to limiting factor Remarks: h'0ri7,an .3 ayOA-1 Boring # ► 0-Iq Io R -211 5t I 1 ~~bK n-.F s Z 0.5 0•~ h; h:. Sr I 2- fh t~bK -fir s 1 0.5 0. 2 19-2,8 0 ye 2/z 3 -40 10 3l 61 I 2 rn s b m-F t C 5 b-5 Wo Ground elev. v0-y/O to 14 10 1 5 st I s ~i CIS R Or - 611? J. ft. Depth to y6-b 10 f2 5 t7 nrrn) - - ADS- limiting factor 1011 t a~ 49" Remarks: 6+*vzon,3 r v 1 or S Ila5 dt-fts-e- I" CST ame:-Plea a Pr• t Phone: _ar O X01 (`ts~er (7iS ZbY-~(9~5 Ate s: qe. Amer tJY, 5o01 10013, Signature Date: CST Number: 6 7 _07_ S 'PROPERT1f OWNER SoAK'e-r, SOIL DESCRIPTION REPORT Page?- of -3 PARCEL I.D. #+_0yn 1) 3y - ?D • Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bound3y Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tu-id xk 3 10 21 1 s as 2 0-,5- o ,io o IL z z s11 Z 5,b K ~ e s o, 5 0 ,1,,, Ground 3 _3(0 10 12 3/H -i6K - i rnft eS 0.5 D, l,- elev. 102 ft. 4 -4 t7 ) 0 is 3l I b Sf -51 --V Y TY' C5 1U 12 t - ,D Depth to 6 _ S +0 Y R y ~O S yy) limiting factor Remarks: r' S cle . e r r; 2-o r\ S er\ 1 3/ Boring # c~ <:<><;,~j;: sj ! 0-15 1C cam, l ► .C'. Y M.4"r Lk rs C.,? Q. -510 2 is-2 s) rnJ~r s 0, 5 to ::A............................. <>>:< Ground 2 3 o l d 5 :51 1 2 F I< rn Fr Cs N R elev. 1 - ft. 10 R y - s O Yy,, Depth to limiting factor 21.1 r, Remarks: h or + io r' 4 husoo cKeb of ktnsen es s _ Boring # Ground. elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) Page 3 of 3 PLOT PLAN Property Owner 5oc+h-cr, Lor % r\ Legend: I ~~-140 ~~ccep} wk~rQ hold Legal Description 3( pj4pf'+ken)LA BM = 9SIO -4 suer-t cX a{ yx14posh- af he Ss `1(.EI, Str, 1'2 em o,~SU.r+ti~ea ~~•o' - ~ R19 W 514,--'1r\- grass -Town p; Troy S4. Cr6v Cpv.m+jj WIWOnb, n v = soil boring w/backhoe ~J +rtas ®0~+1 m`u'd' sir dace a-'~ 4x14 ps• 100,0 FL 4Q•5 113) i 'C '~D C763~ 135 ' Jk~ ~L l02.5~ C7p,4 in 9L q7. S' <Z~o slope.. ;~a I~ I• EL 49. I' Signed CST c 6Mo37a7 V L-) Date ju-kj 7. 1 ggS Cz FILED 1z NOV 2 9 KATHLEEN H. WALgH 1 Registerotbeos , 5a360L)S SL Croix Co., WI ' c~ W CERTIFIED SURVEY MAP LORIN AND JUNE SATHER Part of the Northeast 1/4 of the 'Southeast 114 of Section 35, Township 28 North, Range 19 West, Town of Troy, St. Croix County, Wisconsin. FENCE UNPLA TIED LANDS ROAD SETBACK LINE S 69 • 30' /O "E 4 98.63' 66' ` ~42 33' 33' ti y I W p) : L 0r 3 o V p z b Q~ I ~1 Q O 2,617 ACRES JJ O 111, 728 SO. Fr. r/N SHED TO aE REMOVED I O 1 I JI O I p a 1 c ~ h W S 89•301IO"E 271.00' 1 h O ILUI I ~I % a t /.DID ACRES I Ql o LOT 4 - 44, 000 SO. Fr. I 3 I ~I o ;t K I t o h J I I Z C SEPT/C OW LL/ G O >J h ~n I I al WEL L 1 b O O ® ` ~ I b DRIVEWAY O , I O 2 ~I • 224.67' 2 271.00' N 89.10'/0"W 499.67' R /WEST 301. /0'; 10/.70'1 C114 COR. SEC. 31, r28N, R /9 W, ICOUNrY SURVEYOR'S r L O T 1, C. O MON.) S. M., VOL. 60 ~ h b a i ~ a PAGE 1645 "o k a m ~ O q h This instrument drafted by Laurence W. °O M a IMurph ~ ~ a W ALL 84FARINCS REF. r0 THE EAST LINE OF THE SE114 h S L/NE NE//4 SE//4 / O OF SEC. 35, T28N, R/9 W, ASSUMED NOOO 00100 -F O O O'Indicates 1" x 24" iron pipe weighin- 1.13 0 15s./lin. ft. set. S89.17'i1"W 810.22' O R1N89.15'48"W 813.07 2 • Indicates 1" iron pipe found. Owner's Address 3S Pine RidSe Terrace m W Rivar Falls, WI ♦ W A 2 54022 SCALE 100' O 21' 50' /001 150, 200' ' 300 1 W SE COR. 9EC. 31, T28N, R /9 W, ,-1 1 COUNTY SURVEYOR'S NON.) 536868 CERTIFIED SURVEY MAP r LORIN AND-DUNE SATHER Part of the Northeast 114 of the Southeast 114 of Section 35, Township 28 North, Range 19 West, Town of Troy, St. Croix County, Wisconsin. Description: That certain parcel of land located in the Northeast 114 of the Southeast 114 of Section 35, Township 28 North, Range 19 West, Town of Troy, St. Croix County, Wisconsin, more fully described as follows; Commencing at the Southeast corner of said Section 35, thence N 00000100"E (assumed bearing on the Easto line of the-Southeast 114 of said Section 35) a distance of 1319.431; thence S 89 57`15"W 810.22' (recorded as N 89 55'48" W 813.01) on then South line of the Northeast 1/4 of the Southeast 114 of said Section 35; thence N 00 05'581}W 512.09' (recorded as North-510.00"); t'o' the-POINT- OF BEGINNING, tof-the- pahcsl 'to be- harem- described-,:thence hN 89 501101114 499.67' (recorded as West 501.101 and 501.701); thence 'N 0000511211E 320.00' (recorded as North) on the West line of the Northeast 114 of the Southeast 114 of said Section 35; thence S 8905011011E 498.63; thence S 0000515811E 320.001 (recorded as South) to the POINT OF BEGINNING, containing 3.667 acres, being subject to easements of record. This instrument drafted by Laurence W. Murphy Dated: September 25, 1995 "Revised this 29th Day of November, 1995." Note: The parcel shown on this map is subject to State, County and Township laws, f-ules and regulations (i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County 7..oning Office and the appropriate Town Board for advice. State of Wisconsin) County of Pierce) I, Laurence W. Murphy, Registered Land Surveyor, do hereby certify that by direction of the Owners, Lorin and June Sather, I have surveyed and divided the lands shown hereon in accordance with official records, Chapter 236.34 of the Wisconsin Statutes and the Ordinances of St. Croix County and that this map and description are a true and correct representation thereof. ```ottalls CITY _06 `RI'FFALLS . • LA EN • APpa^oved• b y. r W U~ rn Cr o 1 13 Hit?et 44J N FALLS,,: J STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER -4 SA,74 E `Z MAILING ADDRESS 2 /Z A-t '7- r ! (c J ~ L C ~ w 1 PROPERTY ADDRESS Y , rJ fit (D G ~ t n n Ac f Z_ 3 CS l~f ~O C (location of septic system) Please obtain from the Planning Dept. 3 ,q CITY/STATE c c ~(N ( 3-t J Z Z , PROPERTY LOCATION 1/4, S 1/4, Section 3 T ZR_/ 2-W TOWN OF~ ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER -3 CERTIFIED SURVEY MAP , VOLUME N ( , PAGE 3 G 11, LOT NUMBER 3 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 (Y) 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: /.'O~ v DATE: Z. U t, 97 St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 1 • S T C - loo This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of property G- Ott ` r) Y,.+ 7- yZ Location of property ~JF 1/4 S E 1/4, Section 3.5- ,T 2g N-R__L _W Township '7--a y' Mailing address 3 V E X (96 £ ►n1Jf-r LAS j W1 3~f 2L Address of site subdivision name Lot no. other homes on property? Yes X No Previous owner of property Total size of property 2, GAS 7 Total size of parcel 2 : L 5` 7 A- Date parcel was created N o j Z'91 1/r Are all corners and lot lines identifiable? A Yes No Is this property being developed for (spec house)? Yes No Volume H and Page Number 3(olcf 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. S3 6 g 68 , 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. .536 8&13 Signature of Applicant Co-Applicant 2 sV ~ Date of Signature Date of Signature • • DOCUMENT NO. WARRANTY DEED jam'- 5--1, RESERVED FOR RECORDING DAB. STATE BAR OF WISCONSIN FORM 1-1982 4g~5G5 _ _ VOL 940 13) REGISTERS OFFICE ST. coo+x co., w+ Kenneth D. Martin and Carol J. Martin, husband and TCR for Record wife-as joint tenants MAf21 C. i..-' _ _ . 11:15 A. M conveys and warrants to Lorin D.. Sather,-and,-June- A. Sather, V husband and wife as .survivorship- marita1-property....... $*LReq rof Deeds . R'_"T r_i`V ~7 the io!lowtnr described real estate to - - _ St-.-, C---r-ol-x- County, State of Wisconsin: Tax Par-,el No: The South Half (S 1/2) of that part of the Northeast Quarter of the Southeast Quarter (NE 1/4 of SE 1/0 of Section Thirty-five (35), Township Twenty-eight (28) North, Range Nineteen (19) West, described as follows: Commencing on the West line of said NE 1/4 of SE 1/4 990.0 feet North of the Southwest corner thereof; thence East parallel with the South line of said NE 1/4 of SE 1/4 499.3 feet; thence South 320.0 feet; thence West parallel with said South line 500.5 feet; thence North on said West line 320.0 feet to the place of beginning. b Q 0 1!,; is not on,:., ;ni Ilr y r.; c4K) is nut) Kxv, i&on tI• %carrantic;: easements, restrictions and rights of way of record, if any. ~ Itu:cd th< da% March 92 ! L ri-:.A1_ .Kenneth D. Martin .Carol J. Martin AUTHENTICATION ACKNOW LEDGMENT Signature(s) `TATE OF WISCONSIN ) 1 F~nn~th D. Ma rtin TrfLi:: )!F MI F:R.-:TV1F. k.\I:I Ir 1\i:I II`= C.irol Martin I. t I, _ . .}I.: % • !I DOCUMENT NO. WAIIIIANTY IMED THIS araCS RasaltvaO FOR MCCONOINa DATA STATE OF WISCONSI6N-FORM 2 soox 82 PA, -NO This indenture, made thi---_.»-2Qth-------- day of........October REGISTER'S OFFICE A. D., 19_-$5., between [2i~13A~1I2 .Ft [ZE13.AIK._SA.YIN S..sk..LAN...A.5500.A ON ST. CROIX Co., Wl - . a Corporation duly organized and existing under and by F Recd for Record virtue of the laws of the State of Wisconsin, located at..~Q$..T.rII.C_44..A.Y.~Ll4~~...~.~.Sto.LZUt d Wisconsin, party of the first part; and ~.RC.II[LQ~...s10Jd ~4An~.A._~~lth€r,--Fi4sb~n~ ~ CC T 1 3 11988 s~osdYl~te„S~1t~ClY4~shj~Marital Pro ~erty__~w 2:00 PM _ » c &,,,Q party of the second part. ~ of D006 Witnesseth, That the said party of the first part, for and in considerationof the sum of--forty Thousand Dollars and not 1G0„('540;000) to it paid by the said part.._..ie..-__ of the second part, the receipt whereof is hereby confessed and RETURN TO acknowledged, has given, granted, bargained, sold, remised, released, aliened, conveyed and con- iI firmed, and by these presents does give, grant, bargain, sell, remise, alien, convey and cnrfrm unto 1 the said pact-_ 1eS of the second part ,...__their heirs and assigns forever, the following described real estate, situated in f the County of....... St. CrolX State of Wisconsin, to-wit: A parcel of 1.8 acres located in the NEL of SEa of Section 35-28-19, further described as follows: From the SE corner of said NEJ- of SEo of Section 35, go W on the S line of said NE; of SE$ a distance of 813.0 feet, thence N at a right angle a distance of 510.0 feet to point of beginning for parcel to be conveyed herein; thence continue N a distance of 160.0 feet, thence W parallel with said S line a distance of 500.5 feet, thence S on the W line of said NEa of SE- a distance of 160.0 feet, thence E a distance of 501.1 feet to the point of beginning. s , 00 FEB (IT NECESSARY CONTINUE DESCRIPTION ON REVERSE SIDE) Together with all and singular the hereditaments and appurtenances thereunto belonging or in any wise appertaining; and all the estate, right, title, interest, claim or demand whatsoever, of the said party of the first part, either is raw or equity, either in possession or expectancy of, in and to the above bargained premises, and their hereditaments and appurtenances. To have and to hold the said premises as above described with the hereditaments and appurtenances, unto the said pars ies of the second part, and to_._._.their heirs and assigns FOREVER. And the said Durand Federal Savin s do Loan Association _ Party of the first part, for itself and its successors, does covenant, grant, bargain and agree to and with the said part. 1es _ of the second part, heirs and assigns, that at the time of the :gsealing and de;.very of these presents it is well seized of the premises above described, as of a good, sure, perfect, absolute and indefeasible estate of inheritance in rile law, in fee simple. and that the same are free and clear from all encumbrances whatever,.excepting easements and restriction of record. ~w....... and that the above bargained premises in the quiet and peaceable possession of the said of the second part, -iheir_.»... heirs, and assigns, against all and every person or persons lawfully claiming the whole or any part thereof, it will forever WARRANT and DEFEND. In Witness Whereof, the said ____...._.Durand_Fedtir -1•.-Saving;.. 1..4an..fl sQSiat on--....... ~ party of the first part, has caused these presents to be signed by Nael..EE..Minbcr_k...... its President, and countersigned by..... o~Y.a-_J. Hansen its Secretary. at »„-308-_Third Avenue Westa -Durand . Wisconsin, and its corporate seal to be hereunto affixed, this day, af...._._ October A. D.. t9..gg... BIONED ANI>'SEALED IN I!JtESENCE OF DUR FEDERAL VIN S do LOANASS_O_CIA ION Corporate Name Presldent Noel F. Holinbeck --t-E~ 4 Ct~UNT RSICNIdD: 1 J . J G .174"), . . Son J. Hansen Seer"tar' STATE OF WISCONSIN j } ss. ---•»P.e-pin.---.•.----..... County, 111 Personally came before me- thi.