HomeMy WebLinkAbout004-1032-30-200
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STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER :.)e Its ~~r
ADDRESS 3) k J Al
SUBDIVISION / CSM# S7 A e, LOT ~ AJ
SECTION T A- /
2e N-R /e-7W, Town of e
ST. CROIX COUNTY, WISCONS N
ITHIVN IEW
SHOW EVERYTHI G 100 FEET OF S STE
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77
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INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form-
Provide 2 dimensions to center of septic tank manhole co~er-
BENCHMARK:
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: 1J&,,kGS P, Liquid Capacity:
Setback from: Well 7y0 House 3~-~ Other
Pump: Manufacturer IYA Model# Size
Float seperation Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
width: Length -715 Number of trenches z
Distance & Direction to nearest prop. line: /ad
Setback from: well:-370 f House 3gP' Other
ELEVATIONS
Building Sewer ST Inlet. ST outlet
PC inlet PC bottom Pump Off
Header/Manifold Bottom of system
Existing Grade Final grade
DATE OF INSTALLATION: ~p' e"~a•- ~5
PLUMBER ON JOB:
LICENSE NUMBER: /yfA,s
INSPECTOR: y
3/93:jt
Wisconsin Depaertmentof Industry, PRIVATE SEWAGE SYSTEM County:
La~or and Human Relations
Safety INSPECTION REPORT ST. CROIX
and Buildings Division
GENERAL INFORMATION (ATTACH TO PERMIT) SanitaryPerm itNo.:
Permit Holder's Name: ❑ City ❑ Village ❑ Town of: State P1 2"A?
MILLER, JOHN X
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark /bL/ se ioo•
Dosing
Aeration Bldg. Sewer
Holding St/ Ht Inlet
TANK SETBACK INFORMATION St/ Ht Outlet - / 97,9 Vent
TANKTO P/L WELL BLDG. AirIto ntake ROAD Dt Inlet
Air
Septic is 5 -ILI d >a S NA Dt Bottom
Dosing NA Header/Man. 116,0 93,8 s
Aeration NA Dist. Pipe i~.9y 9 3; 6
Holding Bot. System
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand Ala
Model Number GPM
TDH Lift Friction System TDH Ft
i Loss H ead
Forcemain Length Dia. Dist. To Well I F
SOIL ABSORPTION SYSTEM
BED /TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS ~S DIMENSIONS
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
SETBACK CHAMBER Moe Number:
INFORMATION Type 0
System: ~'/0' o ~ A X70 1~ 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: Cady.14.28.15W, SW, NW, County Road N
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l~/~'t..:1L1~![.tiC.Q/ ;,,~~~FL C:^ ~y-. .i1• ~A~. s-r: ; .1 ` / ~
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Plan revision required? ❑ Yes No G r
Use other side for additional information. kd- t_, (o
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SBD-6710 (R 05/91) Date ...,_or's Signature Cert. No.
I
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
i
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= SANITARY PERMIT APPLICATION
e:'~l`r■llr~ In accord with ILHR 83.05, Wis. Adm. Code 113,
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than El 01993-1)
8% X 11 inches in size. Check if revision t6 previous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROPERTY OWNER j PROPERTY LOCATION
6" r1A: Z I+!'.t/ D h KI `if % AJ.) S Tag , N, R & (or 10
PROPERTY OWNER'S MAILING ADDR LOT # BLOCK #
.31 olSr 61v 4L W /1/0 1
CITY, S~TATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
l~J; S04 o a r s'7 4 e,
1
II. TYPE OF BUILDING: (Check one CITY
❑ State Owned VILLAGE NEAREST ROAD
d~
❑ Public D41 or 2 Fam. Dwelling- # of bedrooms 3 PARCEL TAX NUMBER ) /C
Ill. BUILDING USE: (If building type is public, check all that apply) j 30
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 120 Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. L.LN 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 300 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
VI. ABSORPTION SYSTEM INFORMATION:
1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE
REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) T l 93, (o ELEVATION
1 TZ ?.T. bFeet 45,,,~ Feet
VII. TANK CAPACITY Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION New xistin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
Septic Tank or Holding Tank Ze l CIA
Lift Pump Tank/Si hon Chamber
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plum er's Name (Print): Plumber's Signature: (No St psI MP/MPRSW No.: Business Phone Number:
716
Plumb is Address (Street, City, State, Zip Code):
0J;- ",26 fA
IX. COUNTY/DEPARTMENT USE ONLY
mp )
❑ Disapproved Saagiitary Permit Fee (include g round water Date Issued Issuing A nt Signature No
;~/Approved ❑ owner Given Initial
Adverse Determination
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398(R.08/93) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new
criteria in the Wisconsin Administrative Code will be applicable.
3. All revisions to this permit must be approved by the permit issuing authority.
4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be
submitted to the county prior to installation.
5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed
pumper whenever necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code administrator or the
State of Wisconsin, Safety & Buildings Division, 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 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 13% 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 and controls;
dose volume' elevation differences' friction
loss; pumps • 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)
JOB All
TIMM EXCAVATING SHEET NO. OF Z'
Route 1 Box 192 _
WILSON, WISCONSIN 54027 CALCULATED BY OO*O ' DATE ~ ~y PS
(715) 772-3214 (715) 386-5443
MPRS #3224 WI MPCA #696 MN CHECKED BY DATE
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PRODUCT 205-1 Inc., Gmton, Mass. 01471, To Order PHONE TOLL FREE 1.0.22 1 4
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TIMM EXCAVATING SHEET NO. 'L- OF Z
Route 1 Box 192
WILSON, WISCONSIN 554027 CALCULATED BY DATE
(715) 772-3214 (715) 386-5443
MPRS #3224 WI MPCA #696 MN CHECKED BY DATE
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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, • DIVISION P.O. BOX HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53 07
(ILHR 83.09(1) & Chapter 145)
LOCATION: SECTION: UNICIPALITY: OT NO.:BLK. NO.: SUBDIVISION NAME:
sw~/ Nw~/ t~ /TZe N/R)sE 47~~
chc3~`t _ COUNTY: MAILING ADDRESS:
s1 • 5-7')x "rv ss t~ s
USE DATES OBSERVATIONS MADE
ray NO. BEDRMS.: COMMERCIAL DESCRIPTION: PERCOLATION TESTS: ER ROFILE DESCRIPTIONS: I~sltsesidence Ll N3N New ❑Replace I q -10 - 40
M- PN
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MrODUfND: IN-GROUNDSYSTEM-IN-FILLHOLDINGTAANK:R ECOMMENDED SYSTEM: (optional)
S ❑U LEIS ❑U I,~1 S ❑ ❑ S ®.U ❑ S Lt Z `TR-ek►cnez- txmcN 5'x r oo" L-0,Qc
If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the
under s. ILHR 83.09(5)(b), indicate: C L PAS ~s Z Floodplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED EST. HES TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
1 80 N.A, ti~NL Z~. Se*-t-_ 1tGL: Z or
B- 7- 7S v > _?S y
S 8 $ 01- y > &8 ) f
B- 6 ~ 8 A6. 0 -2 F S EE F~ l 3
B- Q6.2 7b „
B-
B-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP I WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH
P-
P-
P- 6 - tstl W *3 L 6 P e ea s e ,
P-
P-
P-
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
zontal and vertical elevation reference points and show their loca~!'Qn on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope. 9 31 L
SYSTEM ELEVATION gz.`
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I, the undersigned, hereby certify that the soil tests reported on this form were made by me in yy(th the procedures and methods specified in the Wisconsin
Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
WEGFBEB OIL TESTING
NAME print : AND TESTS WERE COMPLETED ON:
RVICE
ADDRESS CERTIFICATION NUMBER: PHONE NUMBER (optional):
X 74 421 N. MAIN ST, ~T caoo S~ (0 7 tS- LIZ5_0/6S
RIVER FALLS; W1 54022 CST SIGNATU E:
715-425-0165
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. ~~GL } 0J=
DILHR-SBD-6395 (R. 10/83) - OVER -
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INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395
To be a complete and accurate soil test, your report must include:
1. Complete legal description;
2. The use section must clearly indicate whether this is a residence or commercial project;
3. MAXIMUM number of bedrooms or commercial use planned;
4. Is this a new or replacement system;
5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER
SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS;
6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan;
7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing scale is prefered. A separate sheet
may be used if desired;
8. Make sure your benchmark and vertical elevation reference point are clearly shown, and are permanent;
9. Complete all apropriate boxes as to dates, names, addresses, flood plain data, percolation test exemption, if
appropriate;
10. If the information (such as flood plain, elevation) does not apply, place N.A. in the appropriate box;
11. Sign the form and place your current address and yur certification number;
12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL
AUTHORITY WITHIN 30 DAYS OF COMPLETION.
ABBREVIATIONS FOR CERTIFIED SOIL TESTERS
Soil Separates and Textures Other Symbols
st - Stone (over 10") BR - Bedrock
cob - Cobble (3 - 10") SS - Standstone
gr - Gravel (under 3") LS - Limestone
's - Sand HGW - High Groundwater
cs - Coarse Sand Perc - Precolation Rate
med s - Medium Sand W - Well
is - Fine Sand Bldg - Building
Is- Loamy Sand > - Greater Than
's1 - Loamy Sand K - Less Than
'1 - Loam Bn - Brown
'sit - Silt Loam BI - Black
si - Slit Gy - Gray
cl - Clay Loam Y - Yellow
scl - Sandy Clay Loam R - Red
sicl - Silty Clay Loam mot - Mottles
sc - Sandy Clay w/ - with
sic - Silty Clay fff - few, fine, faint
'c - Clay cc - common, coarse
pt - Peat mm - Many, Medium
m - Muck d - distinct
p - prominent
HWL - High water level,
surface water
Six general soil textures BM - Bench Mark
for liquid waste disposal VRP - Vertical Reference Point
TO THE OWNER:
This soil test report is the first step in securing a sanitary permit. The county or the Department may request
verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system
and a permit application must be submitted to the appropriate local authority in order to obtain a permit. The sanitary
permit must be obtained and posted prior to the start of any construction.
lop
SOIL DESCRIPTION FORM
(Attach Soil Prof i lu Location Map On a Suoarate Sheet)
CLIENT Z L QA A 7-1 L l-1..ER LINEAR LOADING RATE: 3
PURPOSE 'Fra"," Sk'-~QR g~1STel SLOPE. L~~
DESCRIPTION BY'L)l~C L• ~~G~Z ASPECT:
DATI SHPT I Q , 1 9 4 0 CURRENT LAND USE: J~E L `J ^ ~Qa'Z L ~
S
COUNTY/STATE ST L°-RU lk e-6QQY'f 1 l tJ VEGETATIVE COVER: (s, lc'
LOT DESCRIPTION Sw /S/ N W 16~ S Zr- 141 I Z8N / R I SL--l DRAINAGE CLASS' w~L L/n)4FT~,
LOCATION OF C kA~ GALLONS PER 50. FT. PER DAY: O ` 6O
PARENT MATERIAL(sMKPTIISOIL SERIESt AJ~sO S l
rEIMUDS'
Q
HORIZON DEPTH MATRIX COLORS MOTTLES TEXTURE STRUCTURE CONSISTENCE CLAYSKINS/ PORES ROOTS PII -BOUNDARY REMARKS
in. 010 1st Gr. Sz. Sh . COATINGS
$o G west- s1 - Or p1 rN\
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OTHER SITE FEATURES/NOTES:
cc o n^Ge CF 3
LIMITING FACTORS/DEPTH: Signature Date CST k
i
PORES ROOTS PII BOUNDARY REMARKS
WRIION OEP111 MATRIX COLORS MOTTLES TEXTURE GSTRUCTURE CONSISTENCE FCOAG
in. moist
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OTHER SITE FEATURES/NOTES: BOOS 76
-/b - Pit Gt? 3 of 3
Date CST N
Signature
LIMITING FACTORS/DEPTH:
iu~l`,C.c_. i h 1i __i 1 rii . i~ 11 •:+'~IVU .UU1, t _
6Ta loo
gttsd 14, and signed
This a lioatian form is to be compY lpy , tu►3Any inadequacies will
owner(a or the property peing devtaloi~adhould this..
only result in delays of the permit josuance (s"a
development be intended for resale by /
house), than a socsaondf a d should
atlbmiCtad to retained
42 iuan~+ ice 1 with tho" :4'`
the property is a
appropriate dead recording. rrrwww.r_rM.wrw r~rr ww ww••Mwrrwww~ www_w
swwwrw►r~wwwwww MM ww.rww•
f, rrrsw~ ~ .
_11er
_ John-
owner or property X,vcaL•ion of Pi pPartY5 L/4 IV 1./4, section
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W Ike
Township Mailing address -1
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wwal+~ll+• - - n•I
Address of s 1 to
subdivision name n in, Lot no.,
other homes on propartyT Ys►l~,r_.....-NO
Erovioue owner of property ~ r
.r.... .
O!'t _
Total rise of prof? Y Q IL
Total size of parcel?
Date poxeel waa oroated
Are all corners and lot lines identifiable? --k-yes No
Yes
xs this property boirg davoloped for (*pea hOUFO)?
Volume r lo' 7 as recorded with the ReBli.
. , ,
' acid A Pa a t~uA1b03
of Deeds.
rr wr w•~~~~.rrrr www=~,r~.•.r~rwww~ws t
rra Y~Mwww w_wwwrrww_wrwMMrwwww_----r••_-.
INCL'vua MITR Ts=s ApRL=CATtcix TRR TOLLOWZNa
A VARRWTY DUD which includes es a DO A MT A p9 NUMBERi x L a AND
i-13ER AND THE SEAL o
certified survey, it available, would be helpful so an to ap~r ,
delayer of that reviewing irooess, it the deed descrio' , ,
references to a Certified Survey leap, the certified survey'..
shall also be required.
VRODERTY OWNER GIRTIVIeNTION
T (we) certify that all statements on this form are true to '
boat of my (our) knowledge that I (we) am (are) the owner(s) o
prooarry described in this information fora, by virtue
warranty deed recorded the o Tice of the Cour1well egis
Deeds as Doctima+nt No. a and that X pre
own the proposed aita for the sewage disposal system or h _
obtained an easement, to run the above described property, f
aonatruatS.bn as said sYatom, and tho same has been duly resort d
tho office of the County Register of Deeds as Document NO
w
C`-' A+~~
s gnatux ~►ppiivan •a DP l 1c ant
Dates of signature
Dots of Signature D
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JUbLKto LHW r'.H. i1) •vl rir r 1Q ~ ; 11 D0 ivu .UUl., r .
OTC 105
$EFTIC TArlX MAINTENANCE
&t. Cfbts county ,
NEW" r MAO te
MAUM0 A&DI g
SL[OL -Z5
>Pll<OgEii7"Y ADDRESS (loeatton or Septic systwn) PksM Putabt Gout the planning Dopt.
s'cJ N~ ~ y.. T Z_ g~~~~a►
MopXRTV LOCATION 114. 114, WIN 9
v !sky tr. CRODC COUM. wY
LADT ~Y.R
IV1b1UN .
BUBD ^ . ~ LOTNU ' IM
VOLUME PAGE
CZR DSURVEYMAP
Improper usfi find maintenance of yetrr septio sy w oould result in its pnatnatuaa failun to hsiad
wastes. PMPQf taatatatMCO cu*4s of PUMP14 out the aPtlo tank every throe YOM of = if hood
by tiao *W septla tank pumpsir• WW you out into the system can atI'ck+t the ftimction of the eeptio ttmlc ,
as a treatment Ogg to am WSW dlspoial system.
ble to rooaivo fi sma for a rnaxintum d 0%,, of thi
SL Croix Cam residents may bo olig[
of tepU4matt of 4 bi% system, which wns in opuatM Prior to July 1. 1970, gt, Ctalx -
aeeerted tnm program in August of 1980, with the H grriraneat thAt owners of alt new systems ,
keep tk* oyetem F 1Y msintained(
*me luvv%ty owner agrees to submit to St. Cmix ?rowing a t-(oditication rotrtt, Asned by
and by a maw plumber, juutnoyman plumber, ro mated plumber or M licensed pumper i Eton that'd
the on-site wastewater disposal System is ill proper aporating condition and (Z)
pwupip8 (if neeessory), the septic tank is Wn than l13 full of sludge and scum,
T/We, tho undersigned hive teed rho above requiromentS and agree to maintain the private,
disposal system in awordance with the standards set forth, here!', use W by the Wi W.
Ccttitication stating that your septic h" haen maintained met oompleted and returnad to the St.''
Cuvttty ZQ11% GiTccr within 30 days of the three. yrsr pilau n date(
WN13Tr;
UATF.
rnunty Zoning Ofnca
St. Croix
Govornment Ctsittrr .
1101 emmichooi Road
Hudsuu, W1 $4016 ~ n
v} : s
1
f1CVC_LIMCNT NO %%V1RRANTY DEED ~ • r •d ar -11",,n core a•.. r- n: wT.
• ~•rAT.: r.~r (NF WISCONSIN FORM
Marc K. Deering and Arlene T. Deering, REGISTER'S OFFICE
husband and wife, as survivorship marital ST. CROIX CO., W1
property Recd for Retort4
OCT 171990
,n•I o..•rr;ml< to John W. Miller and Patricia a1 8'30 - A.Mn
J. Miller, husband and wife, as joint $,1WX9 t enants
kter of Deeds
rhe -~anlc of 5pz3nk- alley
to pox 159
,.:i .a! P-tat( 11 St. Croix t_ aDring `lalley, 1i 54757
~ta~~ 1c~.;crn•in:
T::x Parcel No:._..........
The South Half of Northwest Quarter (Sz of NWa) of
Section Fourteen (14), Township Twenty-eight (28) North,
Range Fifteen (15) WAst, St. Croix County, Wisconsin, lying
South of County Highway N.
r•~
T is not
Xx i. z , i
Ex", Easements and restrictions of record, and
further excepting CRP contract No. 524 affecting 8.3 acres and Managed
Forest Plan Contract affecting 19 acres.
~E..A1.i
Marc 'K. De(!-r tuo
Arlene T. Deerin~
AUTHENTICATION XCKNOW LED .htr)NT
Signature(s)
x r ,
-
authenticated this day o: St. C roi r -,;,;1y
car:c h .o r,o ~i da of
90
- - - - - Mafc K. Deering and Arlene T.
Derring
TITLE::',:FJIBER STATE BAP, OF WI.-z C1
(If not..
auchnrimd h} ;Oh.pR, W i3.
3 ..l• Y3.r, j ti.c
NSTF?Uv=N-Vi acaaa--I)
Thomas A. McCormack
Baldwin, WI 34002 ~1v0•*t~. 4 rtc,"J.±•x•~~
(Signature. may he avthrnricated :,r cl
are not necessary.)
Nar. `4 A. Y
W kna.ASTY DCFJ