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STC - 104 1b
AS BUILT SANITARY SYSTEM REPORT RE~~rCL°
OWNER 1410 S / EW//V e,L NOV f f 199 r
n ~D ST~~x
ADDRESS N 8d7 Y. 2-q MCOF ti
1 t1.G~ ~mrQJQ, S LtJ' I. S D 2 Z, S
SUBDIVISION / CSM# N! LOT #
SECTION Z~ T 2-9 N-R 2" W, Town of ~Rdvy
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
ORIGNAL
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
M Z
0 OF 3AI 41,04Z 10;14e ~e 70r
WEt4 Blldt t
o o IU.N. e
FAF04 F.3
S~TTj`~TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: Oel%t""S 47.JCa7(C_ 'or-
S Liquid Capacity: ~,p
i
Setback from: Well House Other
Pump: Manufacturer
_ Model# f size rZ ~►I ~~S
Float seperation ~o•,S n Gallons/cycle: 130
Alarm Location 1~51•DC ffD,yF
to 14,, 44 0 U.v9 _
&E19 ) I SOIL ABSORPTION SYSTEM GIN' O/-
w Z li~ 7 `/S
Width: Length Number oft ches /
Distance & Direction to nearest prop, line: 3P /ed lel&2
Setback from: well: House 277 Other
ELEVATIONS NO ~/SA5
Building Sewer. ~ST Inlet.
C qy 3 ST outlet ~y S
PC inlet /yaw PC bottom 7G40*66 Pump Off
Header/Manifold /S ' ,
Bottom of system !FF•S~ ~OT}1 L
'EExx/is /i'~ Grade ~~✓~d _ Final grade /Q/• 70
DATE OF INSTALLATION:
PLUMBER ON JOB: I?o&K r 711he1*eA % /y1~s 330 7
LICENSE NUMBER-
INSPECTOR:
INSPECTOR:
3/93:jt
3 y A u i Lr pi o
y r
PIAN
_fo b o[i s E
Q ~o - owl
l~
3 y ✓ 5~ •40
t3~vRM • e,
New L3 /ooa ,~J QQ .
yoM~ wF Aecfs
y
CALE
i'' = 10
-Fop o F Sill
t Tn?~!- L D~ ,jTj ~ O lam'
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Wisconsin Department oflnt~ustry, PRIVATE SEWAGE SYSTEM County:
Labor and Human Relations INSPECTION REPORT ST- CROIX
Safety and Buildings Division
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.:
Permit Holder's Name: ❑ City ❑ Village Town of: State Plan " a.:
TEWMEL, MORRI R
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
r t
TANK INFORMATION LEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic / % Benchmark 'D /0/,J, 1,ol 16o''
Dosing 07,0 7
r`z
Aeration Bldg. Sewer , 7 f 2 a /
Holding St/Ht Inlet
TANK SETBACK INFORMATION St/ Ht Outlet ! c~,
TANK TO P/ L WELL BLDG. ,Wier Intake ROAD Dt Inlet q q,36'
Septic 331 13- NA Dt Bottom
tar,
Dosing r3 NA Header/ Man. Aeration NA Dist. Pipe ~BS UG` /5
Holding Bot. System q J~7 `
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Al~ Demand 7
Model Number ` -/p'GPM
TDH Lift , FLoss riction Al Systems TDH ~J,~31`t
Forcemain Length -75 1 Dia. Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS ~ e, oZ ~ DIMENSIONS
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
SETBACK
INFORMATION Type O _ CHAMBER Model Number:
System: ~zc ~j X67 r /&//4 OR UNIT
DISTRIBUTION SYSTEM
Header/Manifold „ Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length Dia Length Dia. Spacing 11 W
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth Of xx Seeded/ Seeded-- xx Mulched
Bed/Tr nchCenter ~U Bed /Trench Edges Topsoil L t 0? Yes ❑ No 91*Y'es ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: TROY.26.28N.20>i, SE, NE, GLENMONT RD
Plan revision required? ❑ Yes aNo
Use other side for additional information.
SBD-6710 (R 05/91) Date Inspector's Signature Cert. No.
t
5~~•-~- SANITARY PERMIT APPLICATION COUNTY
DIL" R
` In accord with ILHR 83.05, Wis. Adm. Code C40/-x
~T~~/~~j • • /73 ~/~.T.STATE~SANITARY PERMIT
-Attach complete plans (to the county copy only) for the system, on paper not less than ❑
8% x 11 inches in size. check if . o e Z-Iplplication
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. S Y S' 2
PROPERTY OWNER ~ p PROPERTY LOCATION
/f'10 % S -rC4VI:4! 5.---,1, V %t, S T2P, N, R 20 E (o W
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
N f 074. AV . Z9
CODE PHONE NUMBER f SUBDIVISION NAME OR CSM NUMBER
CITY, STATE ZIP
All 715 q1
II. TYPE OF BUILDING: (Check one CITY NEAREST ROAD
) State Owned ❑ AGE ~ C1
0%
v
lie OWN OF
7
Public L11 or2 Fam. Dwelling-# of bedrooms 3; PARCEL TAXNUMBERR(S)
❑
III. BUILDING USE: (If building type is public, check all that apply) Yo //66 - 3 O
1 ❑ Apt/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
30 Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 80 Mobile Home Park 120 Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 130 Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. ❑ New 2. LJ Replacement 3. El Replacement of 4.E] Reconnection of 5. El 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 El Seepage Bed 21 ~ L'~ Mound 30 ❑ Specify Type 410 Holding Tank
12 ❑ Seepage Trench 22 ❑ In-Ground 420 Pit Privy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
14 ❑ System-In-Fill
2.
VI. ABSORPTION SYSTEM INFORMATION: • y G D
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.) PROPOS (sq. ft.) (Gals/day/sq. ft.) (Min./inch) 7l ELEVATION
/ 37 5 / - Feet /0/ 0 Feet
VII. TANK CAPACITY Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
Septic Tank or Holdin Tank '
El I F-1 I El
Lift Pump Tank/Si hon Chamber
VIII. RESPONSIBILITY STATEMENT
1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Print): Plumber's Signature: (No Stamps) -MP/MPRSW No.: Business Phone Number:
T ZrIA& 33e 71
Plumber's Address (Street, City, State, Zip Code):/
l0 SS D' veiG /e• 11Pj-v-~ S ~P
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sani ry Permit Fee (includes Groundwater Date issued I ng Agent Si na a (No Stampg)
Approved ❑ Owner Given Initial 3,140 Surcharge Fee)
Adverse Determination
X. NDITIONS OF APPROVAL/REASON51 OR DISAPPROVA :
%4 &Y,14
SBD-6398(R.08/93) DISTRIBUTION: Original to County, One Copy To: Safetya Bu Id' gs Division, Owner, Plumber
i j
t
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
submittedto 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, 608-266-3815.
To. be comp.le4e, 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. Bui-lding use. If building type is Public, check all appropriate boxes that apply.
IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or
repair.
V. Type of system. Check appropriate box depending on system type.
VI. Absorption system information. Provide all information requested in ##1-7.
VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of
tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all
septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received
experimental product approval from 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% 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,siphan, 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 SURDHARGE
1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of
regulated practices which can effect groundwater.
The monies collected through thesb surcharges are used for monitoring groundwater, ground- ,
water contamination investigations and establishment of standards.
SBD-6398 (R.11/88)
x
ULBRICHT & ASSOCIATES CO.
655 O'Neil Road - Hudson, WI 54016 Reg. Designers of Engineering Systems
715-386-8185 Private Sewage Consultants
PROJECT INDEX
DILHR Plan I.D. # S95-02213 Date
Owner Morris Tewinkel Phone 715-425-5191
Address N8072 Hwy. 29, River Falls, Wis. 54022
Legal
R2Description Part of Gov't Lot 2, SE 1/4, NE 1/4, Sec. 26, T28N, '
0W.
Town of __Troy_-------- County
~ St. Croix
C.S.T. Robert Ulbricht CSTM2482 Installer
Local Authority/ Supervision
St. Croix County Zoning De t
PROJECT DESCRIPTION
existing seasnal destroyed by fire. It will be rebuilt, in m exact completely
on the St-Croix River bluff as approved and allowedabyothe
Wis. DNR & St-Croix County Zoning Dept. It will be re-built
as a 3 bedrm. sized home, estimated daily wasteflow: 450 gals.
Soils are permiable ( .5 GPD/Ft2) but seasonally saturated
at 3011. A mound system is proposed. There is only one acceptable
area to site a system, and it will require thaT an old well and
cistern be properly abandoned per all state codes. A new modern
well will be relocated, as shown, more than 50' from the new
mound basal area. (the existing well will lie 431, from the mound
toe line.)
Pg.l PLOT PLAN VIEWS
Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS
Pg. 3 PIPE LATERAL LAYOUT ``a~aunnununuur~,
P9.4 DOSING CHAMBER CROSS SECTION s
CNSl
ROBERT W.
Pg.5 PUMP PERFORMANCE SPECS ,gRICNT }
D1160
; , - H MUK
S I G t;$
~'~~ryn~nmuntmaa~~N
1
IhE
~C~, 7- 1 O~ • os'
d 3 N
of~ aa,.
I i o I ~Z
I ~ owl ~ ~1 ~ _
_ R1 es
ti y o
• .e--. sip' Tor4L of I~ ~ ~ eo
N 1444 4v M I O ff..
All
~ e
\ ~o ~ I by-
ND • ~U T L
CPOSS SECTiok) Or M000D W'Tti QED
Dev OF ro
Ayg~QcSgTE
•DI ST (tif3~T% 00 G, TI~iGkaE59 Pi P«'&- sysrEM
of T°P so(L eIfvhrioa
11 k
Uui FORM ToE u N
r
~E F cc
RATIO MEU.
sAup . a 111 i//iii
C)p
uu• FdRM
% SIoPE FORCE EIrV/1TIoa Uu~l~
-fib I a HAW (3~v 9t'' So
E Fr. iNVF-Rr o f 2- 1ATER/4(5
F .92- FT Top of ROCk /00-32.
'G o Fr /-r oo / 3
OF 2• I AGT E R A IS
• Top
H FT.
PLAN VIEW of= Moo-k3C) wi rrt 13E D
FvRc.E MAW A ( Fr-
I f3 6O3 Fr,
I 12-
K Fr
13 97
C d ` i 7
K T F.r
W 31
o~ l
Bev of
To I i" a
PVL. cAFPp-D A AgqPG IIrTE ~ t
, Y c
N
HEAD CAPACITY CURVE 3 7/86 1/4
MODEL "98"
o 4 s/e
e
25
a /8
20 v 6 , tk4;'35/1 1S 46
• ~ 10
2 1 I/2-II 1/2 NPT
S -
0
IF
TE GALLONS
LI 10 20 30 40 50 60 70 80
urErts - •
80 160 240
0 FLOW PER MINUTE
TOTAL DYNAMIC NE400LOW PER bvWTE
EFFLUENT AND DEWATERW
CAPACITY 12
HEAD UNITS/MIN •
V
FEET METERS -;;-Ls L'FRS
5 .1.32 72 ..^73
I 10 3.03 at
231
is 4.57 4s 170
20 5.+0 23 os 3 5/16
Lock Val"
CONSULT FACTORY FOR SPECIAL APPLICATIONS
• Electrical aftefnators, for duplex systems, are available and • Mercury float switches are available for controlling single and
supplied with an alarm. three phase systems.
Mechanical alternators, for duplex systems, are available with or a Double piggyback mercury float switches are available for
without. alarm switches. variable level long cycle controls.
I r{ , SELECTION GUIDE
Standard all models - Weight 391bs. I/2 H.P.
1•`I"eflrelnoatoperated 2poarFNlchar>icatswitch. noexternal Control required.
98 Series Control Seleetlon 2• Single piggyback mercury flat switch or double pl2gyback mercury, float
switch
Polar
. Volts-Ph Mode Amps Sim lex ex: 9. Mechanical al to FM0477. .
Du alternator 10-0072 of 10-0075.
M98 115 1 uto 10 _-L or 1 a 7 - 4. Soo FM0712, for correct model of Electrical Alternator, "E-Pak".
115 1 9.0 o d 3 0 4 b 5 5. Mercury sensor float switch 10-0225 used as a control activator pecity
D98 230 1 Auto 4.5 1 or 1 d 7 - duplex (9) or (4) float system,
E98 290 1 Non 1.5 2 gj, z 8 0. _ 3 or 4 8 5 6. Foul"(4) hole "J-Pak", Junction box, for lMiMteJ ht connection or wired-in sim-
plex or duplex operation, 10.0002.
i
7. Two (2) tole "J-Pak", for watertight Connection or splice.
173 Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page /of 3
Labor and Human Relations
Division of Safety a Bulklings in accord with ILI i^ 13.05, Wis. Adm. Code
couNrY sT G/l,Di
Attach complete site plan on paper not less than 8 1/2 z 11 inches in size. Plan must include, but
not limited to vertical and horizontal reference point (Blu), direction and % of slope, scale or PARCEL I.D. dimensioned, north arrow, and location and distance to nearest
road.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
P~tieT ~F
PROPERTY OWNER: PROPERTY LOCATION GOVT c pl-i
RD,Pel-T TEGJi cJ,~LE GOVT. LOT 1/4 A- 114,S2-6 T a N,R zo E ( W
P90 RTY OWNER':S MAILING ADDRESS LOT # BLOCK # SURD. NAME OR CSM # P9.072- zt ,9
CITY, STATE ZIP CODE PHONE NUMBER OCITY (]VILLAGE OWN NEAREST ROAD
v~,P f~lr~ GUi, S~azZ (yes) yZs- spy/ ,Po C~EN~IouT
New Construction Use (]'Residential / Number of bedrooms Addition to existing building
(replacement [ ] Public or commercial describe
Code derived daily flow gpd Recommended design loading rate • S bed, gpd/ft2 trench, gpd/ft2
Absorption area required 375 bed, ft2 3 75 trench, 1112 Maximum design loading rate 15 bed, gpd/ft2 ' & trench, gpd/ft2
Recommended infiltration surface elevation(s) -s ~4f • 3 R (as referred to site plan benchmark)
Additional design /site considerations s/-~ do TES lT~f 644:e
Parent material -57CS S:99'- SXows }S 110O,P7' S~'/, Flood plain elevation, if applicable iV~ ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable for stem ❑ S 01 Ew O U ❑ S Cg' D S ❑ S B4- ❑ S Be-t
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 rerldl
I 0-12- /oYX.3/Z /a," ~r 6/& nN► u-f p, CS / a , s ~
Z 1-~~ io /3 S./ fS6
Ground 3 - 3e ~S ye /l,,,, -rg '25 elev.
ft. io ye ~,o~47-5 /o.-,G- w6_11 oe, f ' yo?k s
AL M
Depth to ?-so I's Y,e 3/ z s/? s /,vm s6,E' '-M of a s N
limiting ;
face S i' s/ / f yt' ti
tor
5
Remarks: *Ael '2rJ,v S ,6X17Y L F J~-
Boring # a z /O 3/L
ye z A-A shk nM Lrf R C-s s C
3
y/3 2-,m shk /c , s :
E..
Ground 3 'ST 7.S s R Zlea :51- / f n+~.C f ~W N sU
elev. cE•Y~ c~,F S
ft.
Depth to 7 - 7 7-5Yit° i-" S u
limiting EY~~7 c J S S'
factor i,
51 " 5-YR 3iy GvE7- s. ~1 >D L,V
PROPERTY OWNER Ma I s W ► J/
SOIL DESCRIPTION REPORT page of 3
PARCEL I.D. #
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence GPD/ft
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Y Roots Bed n
/0 7 -T j5& u7p,
/o ye 3 Sal , / f JX& 444 jrie C57
`f S
C
Ground - 3/ /o M,e 3 s z 4, J/,- MIf R a 41 S
elev.
ft. 3/-52-- 7,S Y 31 sYX l"t .SCV Z sh,~ A,,, of i` q"S ~ fu
N
Depth to -65 75 Vi2 y - V S l,, J-1 40 o'/,
CE.y '
Imiling 7
factor .
31 i
s55 ~
Remarks:
Boring # / 0-4 /d VIZ 31Z 104A 1-01 JX& ~ V; .W C'S 3f S <1
3 q-30 7S Xo~ 31y z
Ground Sam/ ^M Sdk M of 4 S
elev. p _ 7 , S s~4?~.t'~t~~ ~°•~r~~~i~ d S n•,., vf12 : r
ft.
Depth to
smiling
facto „ i
30
5s5
Remarks: XfS 4 fit7P Lii' r-44 V
CcwT~N T,
Boring #
13
Ground
elev.
ft
Depth to
limiting
facto
i
Remarks:
Boring #
i
13-
Ground
elev.
ft
Depth to
limiting
`7 1 v os , 1h F
~ ~ I
d 00 ~3 N
v>
• _ ca
0
Q
I y
"o
o° O O
3 N„ / ~ O W
All
i rn
o R~ m b n
o
ts.
346. -0
-
SAFETY & BUILDINGS DIVISION
State of Wisconsin
Department of Industry, Labor and Human Relations
July 12, 1995 201 ter}t. Washinyton Avenue
i', 0. Br;x '/969
Madison WI 53707
ULBRICHT & ASSOCIATES
ROBERT ULBRICHT
655 O'NEILL ROAD
HUDSON WI 5401b
RE: PLAN 595-02213 FEE RECEIVED: 180.00
TEWINKEL, MORRIS
Gov LOT 2,SE,NE,26,28,20W
TOWN OF TROY COUNTY OF Sl CROIX
MOUND SYSTEM
The Department has reviewed the above re ercric,ed submittal.
Conditional approval is hereby granted for the system plan submittal. All
noted items must be correc-:ted. the revil>w''a,frd approval of the system is based
on chapter 145, Wi3 ohsln 'atutes,°aid chdpters ILHR 8:3 and 84, Wisconsin
Administrative Codivf, and it crant4toeht. upon r:omplian(-tr with any stipulations
shown on the plans. "'I-his system has not Deer! "viewerl for. the r0 e
requirements set forth in chapter ilHR+82 or in chaptf,r r ILHIt 50-64, Wisconsin
Administrative Code.
This plan submittal approval will expire two years from l:ho approval date, or,
if a sanitary permit is obtained, plan approval wiii expire can the day the
initial sanitary permit tax ;i. rs, The i is used plumber respon0ble for this
installation shall keep one set of plans with the Depar-timant' stamp of
approval at the construction site. The installer shall notify the appropriate
inspector when inspection, can be made,
All permits required by the city, village, township or r7ounty 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.
jn'e, ly j
Page
Plan Reviewer
Section of Private Sewage
(608) 266--2889
SHDA-798718. 10/841
-
o yd 3 0
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER 146011i T _4V h"FL .51 MAILING ADDRESS
,V9072- fftvy. z r' /~2Glf' Cv~,, . s yo z Z.
PROPERTY ADDRESS 17 3 T" /PX
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE
- ~
SE N~
PROPERTY LOCATION 1N /4, 414, Section 2-& N-R 2 0 '
TOWN OF TROY , ST. CROIX COUNTY, WI
VD/• •S?-O ~ 27
SUBDIVISION LOT NUMBER
CERTIFIED SURVEY MAP , 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 needeO
by licensed septic tank pumper. What you put into the system can affect the function of the septic tank
as a treatment stage in the waste disposal system.
St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost
of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County
accepted this program in August of 1980, with the requirement that owners of all new systems agree to
keep their system properly maintained.
The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner
and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1)
the on-site wastewater disposal system is in proper operating condition and (2) after inspection and
pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum.
I/We, the undersigned have read the above requirements and agree to maintain the private sewage
disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR.
Certification stating that your septic has been maintained must be completed and returned to the St. Croix
County Zoning Officer within 30 days of the three year expiration date. J /
it SIGNED:
DATE:
St. Croix County Zoning Office v/
Government.. Center..
1101 Carmichael Road 11/93
Hudson, WI 54016
~ L Y• Y
STC - 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 A'901- s TFlal-woz
Location of property 5:E 1/4 N~:, 1/4, Section 24 T 2? N-R 20 W
Township -neoz Mailing address iye072- may. Z.y
Address of site /73 6-14&,ua u r A-61 /v-&- 'K5; SelOZ
Subdivision name ~'D/ 52- O 12-7 Lot no.
Other homes on property? Yes `-~No
Previous owner of property
Total size of property 2-2-57 4-Az S wi ~yE-,4,v ~
Total size of parcel 2 • ,o~, APp-Gt_, ~,~O
Date parcel was created
Are all corners and lot lines identifiable? Yes No
Is this property being developed for (spec house)? Yes t. No
Volume S2-() and Page Number 0. 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 i the office of the County Register of
Deeds as Document No. Q , 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.
mature of Applic'nt Co-Applic t
f
Dat of Signature Da of Signature
• I
STATE BAR OF WISCONSIN- FORM l
DC4 UME vT NO.
WARRANTY DFFD
' r6004 5 f 05 `C 127 { THIS SPACE RESERVED FOR RECORDING DATA
r` 325000 ! Michael P Vocovich and Ruby J HkiGISTERS OFFICE
BY THIS DEED. ST. CROIX CO.. WIS-
Vocovich,-his wife.
Recd for Record this__5_th_.
- day of_F'ebruar~r--A D.19-75
Grantor convey~enwaiarrants to --Morris- S~W_inkel-a na-,~largaret ! M
'
nants) M.
nkel. husband and wife. as oint te at-_ 2;30 P.
- Rnq er of OeeAa
- RETURN TO
for a valuable consideration -
_
- ^
the following described real estate in !8_t~-_C_-r0k__-- County, State of Wisconsin:
A parcel of 2.5 acres located in Government Lot 2, Tax Key a
Section 26, Township 28 North, Range 20 West, lying This is rOt-- homestead property.
west of the centerline of the town road, further described as follows:
From the Southeast corner of said Govt. Lot 2, go West along the South line
of said Govt. Lot 2 a distance of 623.0 feet, thence N 30°10' W a distance
of 378.5 feet, thence N 21°34' W a distance of 527.3 feet along centerline
of town road to point of beginning for parcel to be conveyed herein; thence
continue N 21°34' W along said center line a distance of 285 feet, thence.
S 78°05' W a distance of 382.2 feet to point on bluff above Lake St. Croix,
thence S 25°30' E on a meander line a distance of 250.0 feet, thence
N 83°57' E a distance of 37--.2 feet to the point of beginning, including
all land between said meander line and Lake St. Croix.
This deed is given in fulfillment of the Land Contract between the parties
dated August 12, 1970, recorded August 27, 1970 in Vol. 464, page 316, as
Document #301853, and the Land Contract between the parties dated December
15, 1967, recorded December 22, 1967 in Vol. 439, page 156, as Document
#290916, both in the Register of Deeds office for St. Croix County.
FEE
Exception to warranties:
EXEMPT
Executed at Hudson, Wisconsin -_this 16th day of -_November 19 74 .
-/(SEAL)
SIGNED AND SEALED IN PRESENCE OF
Michael P. Vocovich
--ter T----
~ (SEAL)
Ru_y Vocovich
(SEAL)
_ t (SEAL)
micnaei Y. vocovich and Ruby J. Vocovich,_his wife,
Signatures of
J
authenticated this 16th.-day of-.---November 1974
---xugli--E_Gvri n.
- Title: Member State Bar of Wisconsin of 3t*er~aertf
Authorized under Sec. 706.06 -ri`L. -
STATE OF WISCONSIN
ss.
-----County. 19
Personally carne before me, this_---.----- day of _
the above named to me known to be the person-_ who executed the foregoing instrument and acknowledged the same.
ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
ST. CROIX COUNTY GOVERNMENT CENTER
M~.:~ 1101 Carmichael Road
w.,'. Hudson, WI 54016-7710
4-= - (715) 386-4680
April 8, 1999
Coldwell Banker
Attn: Tina Swan
2020 Washington Avenue
Stillwater, MN 55082
RE: Septic Inspection for Morris Tewinkel located at 173 Glenmont Road, Town of Troy,
St. Croix County, Wisconsin
Dear Ms. Swan:
A septic inspection of the above referenced property was conducted on November 1, 1996. This
property is located in the SE'/4 of the NE'/4 of Section 26, T28N-R20W, Town of Troy, St. Croix
County, Wisconsin. At the time of the inspection, this septic system was found to be code
compliant for a three (3) bedroom home.
If you have any questions regarding this, please contact our office at (715) 386-4680.
Sincerely,
-P%4~
Mary J. Jenkins
Assistant Zoning Administrator
/sm