Loading...
HomeMy WebLinkAbout022-1096-80-000 Q o p ' o yo ~ I ac 0. C I n o ' I C ~ ry y I 'a I I `C ~ I h I ~ I a z c - m LL c 0 E Q m M Q ~ I N ~ H I co ~ E 0 N 1 o z ~t L m m M F N - z a m cl) cn o o z :!t m co N c 0 m 'v a~ N E M C c N m o Q Q O O Z Z o N 0 coo E N v ~ ~ I ~Nl o> N 0) _ L E V N C l6 0 C N O N N F- 0 o Q o H H FN- o Z > o v N O 0 0 z° 0. LL 7 O V1 > LO L N rn rn } I g a LO 'O N N '"D O 77$ 3 c, w m d C N%`~ N LO `~y 0 'p Q O 0 N W O c U Cc- N c E y O O o U F v o o co ao 00 N . V ~ y O. CL rn C) L() 0 N ~ ° C c O O _ CO N N G1 O O U 0) r 4 a> F- F- N C • N ry l m a 0 E E cLi O co Y N O (4 0 ca 4i E ~ L I E m Rt a T a o rr~~• G~ G W .V d E L c . .3 o y O to a 2 in v A STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER 6~- ADDRESS As w SUBDIVISION / CSM# LOT SECTIO E --T ~ N-R~W, Town of ~r'-( yl i k im 14 ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Si e S 't l/U J INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. i, n ~s BENCHMARK: , er ALTERNATE BM: EPTIC TANK AMP CHAMWE~ HOLDING TANK INFORMATION Manufacturer: ~~r~~~,,;C'S 1 Gf~Cli.S Liquid Capacity: r r ' Setback from: Well House 35 Other Pump: Manufacturer r)6u A) Model# Co 4 Size Float seperation Gallons/cycle: ~ Alarm Location 2rit L12 e2: ;SOIL ABSORPTION SYSTEM Width: 3 , Length / Number of trenches Distance & Direction to nearest prop. line: & ~ Le- S 1 i Setback from: well : House Other ELEVATIONS Building Sewer ST Inlet; ST outlet PC inlet PC bottom Pump Off Header/Manifold Bottom of svstem Existing Grade Final grade ~L DATE OF INSTALLATION: 71 c) PLUMBER ON JOB: f LICENSE NUMBER: 1 INSPECTOR: 3/93:jt Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Hdman Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: Permit HHoollder•s Name: [I City E) Village ~J_ Town o : State PI WANG, x CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: ✓l/tJ. J /mar I~P 0S /411'1_f ~ 1. TANK INFORMATION ELEVATION DATA - TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ~l?"C~uJf'S~Frr~ ^G 7 Benchmark Q J• Dosing Aer n Bldg. Sewer Holding,---- St/~if Inlet TANK SETBACK INFORMATION St/j0 Outlet TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake _r Septic > 50 NA Dt Bottom Dosing q NA Llsa4er / Man. Aeration-— NA Dist. Pipe Holding,-~' Bot. System PUMP/ Sid INFORMATION 086.P Final Grade Manufacturer ` Demand G6 _Cis era C'c;. 5 Model Number Lc~r<O 3 `J I~A ction~ Sy TDH Lift Lri mead stems 'TDHFt oss Forcemain Length /j:5_ Dia. a'' Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length / No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSION 7 DIM I N SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufactur SETBACK CHAMB INFORMATION Type O i Model Number: System: mcv Md. 166 OR T DISTRIBUTION SYSTEM Header / Ma ifold Distribution Pipe(s) „ x Hole Size x Hole Spacing Vent To Air Intake Length S , Dia. Length 4;):;' / Dia. Z Spacing o ~Sl r VS, SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of T xx Seeded/ Sodded xx Mulched Bed / Eenter Bed / T dges Topsoil E] Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATTQJI: Kinnickinnic.,33.28.18W, NE, SW, County M 12, ~B.Y1'l,-31U~ Plan revision required? ❑ Yes ❑ No Use other side for additional information. 9 8 - SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: I SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code CoffV 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 ;49-7/4 revision to ious application -See reverse side for instructions for completing this application. STAT PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY NER PROPERTY LOCATION G n0u "Pt F% f, s 3? To'Y, N, R 6 E (o~ PROPERTY tW NER' f4AILIf4G A ESS LOT # BLOCK # C K, STATE f Z~CODEt PHONE NUMBER SUBDIVISION NAME OR CS ER -e 11. TYPE OF BUILDING: (Check one CITY I NEAREST ROAD ❑ State Owned VILLAGE 1 -3 R TOWU OF: PARCEL AX NUMBER(S) ❑ Public R 1 or 2 Fam. Dwelling-# of bedrooms - III. BUILDING USE: (If building type is public, check all that apply) 0 " 1 ❑ Apt/Condo v 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ❑ New 2. Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.0 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 W Mound 30 El Specify Type 41 F-1 Holding Tank 12 ❑ Seepage Trench 22 In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 1140 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 L REQU151CD sq. ft.) PROPO ED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION Feet 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 Holding Tank ` fJ 1/,e-a5'7 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. Plumber' -Name (Print): Plu r' Signature: (No Sta s MP/ )A No.: Business Phone Number: , 4_ . J, -'::~;~2 /44-~ /It Plumber's ddr (Street, City, Sta Code): 2 ~ bi~ IX. -COU TY/DEPARTMENT USE ONLY ps) ❑ Disapproved Sani ry Permit Fee (Includes Groundwater ate Issued Issuing A n nature o b Surcharge Fee) 5~ppr,ved ❑ Owner Given Initial /~3 Adverse Determination O`d X. CONDITIONS OF APPROVALIREASONS 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/ea r s. 6. If yotr 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 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 siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. I SBD-6398 (R.11/88) I SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations September 13, 1995 2226 Rose Street La Crosse WI 54603 WEGERER SOIL TESTING 421 N MAIN STREET PO BOX 74 RIVER FALLS WI 54022 RE: PLAN S95-41088 FEE RECEIVED: 180.00 WANG, GARY NE,SW,33,28,18W TOWN OF KINNICKINNIC COUNTY OF ST CROIX MOUND SYSTEM I i 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, ennis Sorenson Wastewater Specialist Section of Private Sewage (608) 785-9336 SHOA-7887 (K. IWN) r Page of 6 MOUND SYSTEM S '95-41088 FOR A BEDROOM RESIDENCE LOCATED IN THE Ne-1/4 OF THESW 1/4 OF SECTION 33,TZ8N, RIB W, TOWN OF t►J}J ~Ch o/j1j 1 C S1'. C,\ZU~X COUNTY, WISCONSIN. I INDEX PAGE l 'of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PA GE 3 of 6 PLAN VIEW-CROSS SECTION PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPING CHAMBER PA GE 6 of 6 PUMP PERFORMANCE CURVE RECEIVED PREPARED FOR SEP - 7 1995 G 42~f ►-v G } 1 y --t' covr-'ry SAFETY a Km. INV. w~ s~lozz PREPARED BY WEC-,EFCER SO = TESTING R yFTHL ER i AND i G'');5 p x tv 6L.LSVIORTM, 13EE; I CCTV ICE Wis. F.G. sBOX 74 421 K. KAIK ST. d RIVFF. FALLS_ VI 54072 S I GIS oea 715-4%r--0IbS ~~~1`I!1!!l1~N~, S ~T', 2 , lg q 5 JOB NO. S - Z~ 3 PLOT PLAN Page Z of Scale 1"= 10 ' S95-41088 L 1 d ~2.Y~I \~.0 ~D I _O V i ao tioY CW-1antr atz ~1S~UW3 YrFls 'en '116 ~ v P ? G ~!'1 -t~L, 100, u' alV S P! Iz~ III I ZS o r L u u LmSY~cL Ly of Rotun,GS, U 9(~) o , ' 1p ~ s H-mV s ~ ~-LS`hN6 YU 3E iJ 3 ~ 1 ~l3 - ; th3~►.~OU~ C'o IRS PC~c J NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. required) 3. Install 4" observation pipes with approved caps. ( Z required) 4. Septic tank to be 1606/6S gallon capacity manufactured by `Fn 1 ~ w k2-ST~ R 1~ S , A j C. 5. Bench Mark S l~'l3 0 OF 6. Divert surface water around mound to prevent ponding at the uphill side. Page -1 Of ti95-41088 Approved Synthetic Covering ~)S-7r1 C- 3 Distribution Pipe Medium Sand Topsoil H F G Elev. lOl• S 3 E p " \ b % Slope Bed Of i„- 2 %2 Force Main Plowed Aggregate From Pump Layer D 1.5 Ft. ,Cross Section Of A Mound System Using E Z-o Ft. F 6.43 Ft. A Bed For The Absorption Area G l,O Ft. A 8 Ft. H l- S Ft. Linear Loading Rate=Q•5-7 GPD/LN FT B 4-7 Ft' Design Loading Rate= o.1 GPD/SQ FT j l1o Ft. J q Ft. K lZ Ft. L -1 ( Ft. fnrr__ _ :n W 3 3 Ft. L J Observation Pipe---,,," A ------------------~t Force Main ~ „ i „ ol~nos 1 Distribution \--B ed Of 2 - 2 2 Pipe Aggregate I Observation Pipe Permanent Markers (Anchbr securely) Plan View Of Mound Using A Bed For The Absorption Area . Page Of Perforated Pipe Detail S 9 5 ®4 1 Q g 0 End View Perforated PVC Pipe End Cop) e ~ Install permanent marker i at end of each lateral Holes Located On Bottom, Are Equally Spaced Q S PVC Force Main Q PVC Manifold Pipe I *'q . Distn ution Pipe Last Hole Should Be I Next To End Cap ` End Cap /J P Ft. ISisiribution Pipe Layout S_ Ft. X g Inches Y~ Inches p Hole Diameter Inch Lateral J Inches' Manifold Z Inches Force Main Z Inches # of holes/pipe b Invert Elevation of Laterals 102.00 Ft. bxl•l1 = *-)•eL xy= z--g.08 GPM tl Place lst hole Z~ from center of manifold with succeeding holes at 14(6" intervals. Last hole to be next to the end cap. r Combination Septic Tank and ISS9 5 M4 (3_ PUMP CHAMBER CROSS SECTIOIJ AND SPECIFICATI JL-v VEUT CAP WEATHER PROOF JUIJCTIOU 90X 4r C.I. VENT PIPE APPROVED LOCKING .10' FROM ODOR. MANHOLE COVER wIT~ Z wARr.1fIJ6 LIN<3EL. .jiwDOW OR FRESH AlK IMTAKC Cor~Dut r f i Y" MIM. 97 lb'Mlu. 18"!'l I A1. ~ PROVIDE I IMLE7 AIRTIGHT SEAL I I I V 3AVPFusS A I I i APPROVED JOINT$ APPROVED JOIfT I II W/C.I. FIPE,*PuF- w/c.i PIe. jan cons;tru :tion I III ALARM t > shall cbmply.,''zvith I.H :I>3..,15 a,td;.8,20 o I 1 'D 1> I I oW C ~f-83 FT. -_J a. PUMP OFF F COUCKETC OLOCK APPROVEC RISER EXIT PERMITTED OWLy IF TAWK MANUFACTURER HAS SUCH APPROVAL gC00 INra ........1111....... SEPTIC SPCC IFICATI0US f 005►EK MAtJUFACTURCR: L-J~ A~ ST ►JUr+ESER OF DOSES: 3.~ PER DAB TAWK :,IZC: l~u~ X650 GALLOUS DOSE VOLUME r S.S. CAL ~1?A SV 5TGI S IIJCI-UDIUG BACKFLOW: 13 ~O GALLOWS ALARM MANUFACTURER: MODEL 1JUM13ER: 1Ol NLy CAPACITIES: A= IMC14E5OR 3~b GALLOyS 5WITCH TYPE: Y'1 C~JR B= INCHES OK =L CY ~LLOLIS PUMP /MAIJUFACTURER: C-yOVt't>S 'Pu" IDS. IIuC, Cr $ ILICHES OR `~IO GALLOUS MODEL IJUMDER: D- 1O INCHES OR 11~ GALLONS ~1`~LC.UIZ-LJ MOTE: PUMP AWD ALARM RE TO 6E6 SWITCH TYPE: MIAIIMUM DISCHARGE RATE GPM INSTALLED OW 5EPARATE CIRCUITS Za- O VERTICAL DIFFERENCE DETWEEIJ PUMP OFF A►JD..0I5TRIDUTIOW PIPE.. \S'`71 FEET + MIIJIMUM WETWORK SUPPLY PRESSURE 2.50 FEET 9 5 T. FEET OF FORCE MAIN X ~'I`F/Ofi.FRICT10/.1 FACTOR-. 1' 53 FEET TOTAL Dy1JAMIL HEAD = lQ"ZO FEET Pump chamber DIAMETER 3>3" ' IIJTERAIAL DIME.IJ5101J~ OF TA1JK: LE.KJGTH ;WIDTH - ;LIQUID DEPTH BOTTOM AREA - 231= - GAL/INCH AS PER MANUFACTURER = 1~•O GAL/INCH performance `turves METERS FEET S95-41088 90 I - MODEL 3885 25 80 SIZE 3/4" Solids Q WE15H - 70 w i I - - = 20 WE10H J I 60 % I F WE07H - - - - - - I 15 50 WE05H } 40 I L _ WE03M - i - - - i 10 30 WE03L - - - 20 19. 20r I 10 28, o$ ' C. 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM 0 10 20 30 M3 /h CAPACITY [qGOULDS PUMPS. INC. SB,ECA FALLS PEW YOM 13148 METERS FEET it ,20 i MODEL 3885 35~ t - - - - - - SIZE 3/4" Solids I 110 WE15HH I i 30r 100 - - t - ~ - - I-- ~ --L_- 90 i 25 ~ - , i 80 Q 70 I - w + Z 20 - - - - -i- - 1 -i H I 60~ I i G I _ - - - - - - - i - i - Ir 50 WE05HH 15 I 40 I 10 i 30 44) 20 I I i 5 ' I I 10 I C 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM 0 10 20 30 m3/h CAPACITY 9'1985 Goulds Pumps, Inc. Effective July, 1985 YUisc6nsin Departrient of Industry,- - - SOIL AND SITE EVALUATION REPORT Page \ - of 3 Labor and Humari Relations Dividion of Safety & Buildings in accord with ILHR 83.05 Wis. Adm. Code ' sT, lx Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but COUNTY (2'V_0 not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION C:> !AJ P\M G eetff. LefF 1`lE 1/4 S 1AJ 1/4,S 33 T Z8 N,R E (06 PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE ®TOWN NEAREST ROAD Z LUL1Z 1Fftt_L S j 1.j 1 S LIp t,Z ( ) 4 c.~t~v.~ tC 1 t l~lJiJ IQ c`(V{-q M y [ j New Construction Use (,k] Residential / Number of bedrooms 3 [ J Addikn to existing building j~ Replacement [ ] Public or commercial describe Code derived daily flow L1 SD gpd Recommended design loading rate o , ed, gpd/ft2 - trench, gpd/ft2 Absorption area required 3, 1IS bed, 112 3-I S trench, ft2 Maximum design loading rate o S bed, gpd/ft2 0- 6 trench, gpd/ft2 Recommended infiltration surface elevation(s) l 5 ft (as referred to site plan benchmark) Additional design / site considerations uv>v~ w l 4- q-t' BQb . "t W - L tr L) S Pir F-1 Parent material oy lm C d- c~ r Flood plain elevation, if applicable - ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U=Unsuitable fors stem EIS ®U ®S ❑U EIS ®U ❑S ®U ❑S ®U ❑S ®U 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 Zm s bk w,'F~ S - o s ~.6 -t Z L$' L v `t ti. S 1 G• S o. ~ Ground 3 1$ -3`i ti~`1 ~Z- s1► --)s's►z s/,6 elev. Depth to limiting factor Remarks: Boring # p 1 b O 1 O ~-1 lZ 3 Z S L Z vvl S bH( Y~ j c~+S - o- S i o. L $ 23 lz`IQ s1y S~ l Z'~s1~h wl'~'t ~S x1.:::::><< 3 Z3-y2 1o`~rz s1 ~l P s!s C (3 wt ~I. Ground elev. 'U - S ft. Depth to limiting factor Z3 Remarks: CST Name:-Please Print Phone: f Arthur L__[~TeQerer _ 715-425-0165 egerer Soil Testing & Design Service-P.O. Box 74 River Falls WI 54022 Signature: Date: CST Number: q S -Z7 3 "PI-1 at L`iis M00576 PROPERTY OWNER '-JVNJ 1 6 SOIL DESCRIPTION REPORT Page of . Z # PARCEL IA Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft Boring # rizon in Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Z S' Zmsbk a-S - o•s 10.6 ~5 0. S ~Y6Z . i~ S`iti slra C I 1 esbk `F~- - Ground 18.33 11 elev. 1O~•bft. Depth to limiting factor Remarks: Boring # Ground elev. - ft. Depth to limiting factor Remarks: - Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # K}: j Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92? • PLOT PLAN Page 3 of 3 SCALE I"= 144) ' C,-r. ~A o. S i -a V) ~o ►~,uT cz" a"r G1Z B•1 "W1 -tJL, 100, u' 61v S P I IzC.- 11 ~ ~ Y Zo" ~~"BOV~ G12.pvuU o ~o ' "~2 I w l l S Lu c^-Tjzv6 y ~ ~Jo o ? lU ~ L°`hS1~n2 L ~a 380 of lia oIZ-l wGS. ~y Qke ~ tp t s ~fvu s ~ IJ 3.3 ~j j tf3 Ly1. LUZ 6 R 5 -Z73 SLAT', Z~ L`i`t (715 ) 425-0165 M00576 CST Signature Date Signed Telephone No. CST # L y~ SS EP 2 1977 h, JAME$ O' CONW9U Reg(ifer of Deede; CERTIFIED SURVEY MAP (sr. Croix Cower, to 343429 wls« ken, Lee Part of the Northeast 1/4 of the Southwest 1/4 of Section 33, Township 28 North, Range 18 West, Town of Kinnicki.nnic, St. Croix County, Wisconsin t~l89°40. 20" 1 _ - M - 3T g. 49 - - ho u 298.36" J ~ a o N ~ W v, 5 ACRE5 7 .1 ~ Q ~ w a s g o DWE LL. v, a o 0 7 ~ o 0 7 z STOR. SHEDS S :y-COR. 5EC•33 298-36 T 28 N R 18 W SCALE IH• ZOO' S89040'20 l- o Indicates 111 x 241' iron pipe stake weighing 1.13 lbs/ft set. Description: That certain parcel of land located in the NE 1/4 of the SW 1/4 of Section 33, T 28 N, R 18 W, Town of Kinnickinnic, St. Croix County, Wisconsin, more fully described as follows; Commencing at the South 1/4 corner of said Section 33, thence go N 000 001 00" E (assumed bearing) along the North/South 1/4 line of said Section 33 a distance of 2626.72 feet; thence N 890 401 2011 W along the centerline of C.T.H. 1'M" a distance of 379.49 feet to the Point of Beginning of the parcel to be herein described; thence N 890 401 2011 W a distance of 298.36 feet; thence S 000 001 5011 E a distance of 730.00 feet; thence S 890 401 2011 E a distance of 298.36 feet; thence N 000 001 50" W a distance of 730.00 feet to the Point of Begin- ning, the above described parcel containing 5.0 acres,and being subject to easement for County Road purposes over the North 33 feet thereof. APPROVAL OF THIS MINOR SUBDIVISION DOES NOT MEAN APPROVAL FOR State of Wisconsin ) BUILDING SITE OR SEPTIC SYSTEM. County of St. Croix) REFER TO H62.10. I, James L. Murphy, Registered Land Surveyor, do hereby certify that by direction of the Owner, Ken"Lee-, I have surveyed and divided the above described lands in accordance with offical records, Chapter 236 of Wisconsin Statutes and the St. Croix County Ordinances; and that the map and description shown hereon are a true and correct representation thereof. C `,\\\\\uunnHttrpun~i/z Dated: 19 August 1977 O JL. Murphy ~y'~~~''~/~ eLand Surveyor, JAMES L. Vol. Page x 67 APPROVED - POUHPHY Certified Survey Maps = S 1 0 4 2 d St. Croix County, Wisconsin RI-VER FALLS, SEP 21 1977 WISC. S~Q SL cROI p. LAND COMPREHENSIVE PARKS PLANNINt; ~~rrr1111U1111UN\1\\ AND ZONING COMMITTEE STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER (01 P q MAILING ADDRESS PROPERTY ADDRESS R' (location of septic system)' Please obtain from the Planning Dept. CTTY/STATE f AS PROPERTY LOCATION 1/4,-5 F 1/4, Section J T 0 N-R._,&_W e 4 TOWN OF ST. CROIX COUNTY, WI SUBDIVISION r~ LOT NUMBER CERTIFIED SURVEY MAP 7 / VOLUME , PAGE LOT NUMBER Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licensed septic tank pumper.Wlrfyou put into the system can affect the function of the septic tank as a treatment stage in the wasted al system. St. Cro' County residents may be eligible to receive a grant for a maximum of 60%. of the cost. of rep cement f a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted is program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 -,DOCUMENT NO. STATE BAR OF ~.`I~CO`SIN FURJI 1-1952; THIS SPACE I-SERVED FOR RECORDING DATA ! . WARRANTY DEED 't 5'3163 VOL i?;sF497 J This Deed, made between ROge-r G. Radunzel lrt v i L.~. ~ , fix ~ hr RacorJ -and. Cher.i..A.. Radunzel,- husband _and .w.ife...... _ - - - - - - Grantor. 11.00 A. and.... . GarX C Wang. a Single-.man, - - - _ - - F?3 #~raf C~at}3 ~''I - Grantee Witnesseth, That the said Grantor, for a valuable consideration...... C !onveys to Grantee the following described real estate in _ _ Ste-..CrO-~x.- - / f)(/EUfR GO , County, State of Wisconsin: P. O. BOX 167 -_R VEh FALLS, WI 54022 Certified survey map in Volume 2 of CSM, page 467, as Document No. 343429, filed in St. Croix County Register of Deeds Office on Tax Parcel No: : September 27, 1977, being part of NE; of SW; EXEIMPT 77.25(3) of Section 33, Township 28 North, Range 18 West. A parcel of land located in the NE;SW; of Section 33, Township 28 North, Range 18 West, Town of Kinnickinnic, more fully described as follows: Commencing at the NE corner of that Certified Survey Map recorded in Volume 2, page 467, of St. Croix County Certified Survey Maps,• the point of beginning of the parcel to be herein described; thence S89040'200E 90.00 feet; thence S000001'50"E 730.00 feet; thence N890401120"W 90.00 feet; thence NOOO00150"W 730.00 feet to the point of beginning. Subject to easements of record and being subject to easements over the Nly 33.00 feet thereof for C.T.H. "M" right-of-way purposes. ~I (THIS DEED IS RECORDED TO CORRECT AN ERRONEOUS DESCRIPTION IN A j~ DEED BETWEEN THE SAME PARTIES DATED 10/05/94, RECORDED 10/07/94, IN VOLUME 1098, PAGE 301, AS DOCUMENT NO. 522249.) This ..__._ls homestead property. (is) 14 AN Together with all and singular the hereditaments and appurtenances thereunto belonging; = l And........ Granto-rJa - - - - warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except municipal and zoning ordinances, easements for public utilities, and building II restrictions, if any, and will warrant and defend the same. day of - - ..November....-- _ 19. it Dated this ----------------2nd .4.4. _'o ( it - 4.-SEAL) ` - ` -R... e.. G,- Radunzel - ------------(SEAL) 0,~. .a .......(SEAL) !I ' -Cheri- A.,_.Radunzel--- i AUTHENTICATION ACKNOWLEDGMENT j Signature(s) STATE OF WISCONSIN ' SS. St. Croix /I -----•-•••••-----..County. authenticated this day of--------------------- 19_____ Personally came before me this __.......2nd ...._..day of -------Q,(j6kWi1Q NOV e_., 19.44.. the above named .Ro ger__ G Radunzel and • --Cheri-_A_..Ra_iunzel------ TITLE: MEMBER STATE BAR OF WISCONSIN (If not. - _ L f}t- authorized by 706.06, Wis. Stats.) to me known t $ b pt'rsou~~ who executed the for ing instru ' a natif(i dge the same. THIS INSTRUMENT WAS DRAFTED BY Stuart J. Krue er Attorne C!-~kL1.Gt-1~~n -•-•-g•----'------•--•--------------------- Teresa P or r .~3t ~ River Falls, Wisconsin . i t... ounty. Wis. Notary Public %1.111 St C . :,ro ~~QQ (Signatures may be authenticated or acknowledced with My Commission•.je 12ffitte ~~If,•'not, state expiration w11.P~ are not necessary.) date: 0--7 19-•--- ) -Names of persona eigrinr in any u?acity should be typed - p,4--%.d bel- their signatures. WARRANTY DEED STATE SAY OF WISCONSIN Wi<consin Leval Blana Co. Inc. IDRM Nw I-1982 Mil-kee, Wis. • S T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/ contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of property Location of property.A./r ~1/4 1/4, Section ,T;~N-R_.,Z~_W Township f 1 , ' '<"o A i Mailing address &ez s -T A Address of site al{ y,~. L° Subdivision name Lot no. Other homes on property? Yes__,\-- No Previous owner of property Total size of property Total size of parcel Date parcel was created Are all corners and lot li es identifiable? Yes No Is this property being developed for (spec house) ? Yes No Volume bi and Page Number as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded i the office of the County Register of Deeds as Document No.~ % 6 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. Signat e of Ap licant Co-Applicant ~ h Date/of ignature Date of Signature