HomeMy WebLinkAbout026-1040-50-000
Q o ~ o
k~ a)
O
C
c
rw
N 1
ti I r. .O -
N f0
y C N O)
` O LO
0
LL
y ~ o
E2
o am co
II ~ rn~
N 00 N
h O co N
Z-o
0 lo
O N (n
O) a
Z N O O
C I-
7
LL O_ c Lo
O C ~ X
d N N
a 3 N
m
z w
E
ao
C
- o
z (D
M 0M w IL m
c
0
O z :!t c
m z ~ ~ o
co P a) zz
E
-o a) M
N N 7
j~
O)
~~V 7 C a~
N d
m
N
C
a)
LL L
C 'O ~ O
-
w
O Q
m
O Z m z
0
N Z
~ N N
v _ E c
M N %
cn 0) 4)
a) 0- U C U)
c0 4) i LQ) " 0 0
co N C o
D D a
)n E E 'a N
M O L fA fn O 3 v
- O O
ov
~I'~~33 CL IL
►'i O O O Z p
.N ~aaa
0) Ln co
U) J U O 0) ~ }
O O O
C
O ~
U N 7
N
Cl) ~ a) Q
O O c y
00 3 c O C E co co
O
L c N O
O 0 a) co m ~
4Or O Y c 3 7
N" a~ v N o E U
O E Z~ o
L O 0 N O - I-
C~
m M y a
'5 EL L:
CL > co CL
E L c 3
A v a II O N 0
Parcel 026-1040-50-000 09/19/2007 07:34 AM
PAGE 1 OF 1
Alt. Parcel 13.30.18.194 026 - TOWN OF RICHMOND
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O - DERRICK, STEVEN J
STEVEN J DERRICK
1438 CTY RD G
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 1438 CTY RD G
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 37.370 Plat: N/A-NOT AVAILABLE
SEC 13 T30N R18W SE SW EXC CSM 12/3441 Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
13-30N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
02/15/2005 787544 2750/191 ALC
01 /31 /2003 707784 2127/39 ALC
08/09/2002 686473 1944/309 WD
08/09/2002 686472 1944/307 QC
more...
2007 SUMMARY Bill Fair Market Value: Assessed with:
Use Value Assessment
Last Changed: 08/09/2007
Valuations:
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 31.300 4,100 0 4,100 NO 00
UNDEVELOPED G5 4.700 2,400 0 2,400 NO
OTHER G7 1.370 4,100 114,500 118,600 NO
Totals for 2007:
General Property 37.370 10,600 114,500 125,100
Woodland 0.000 0 0
Totals for 2006:
General Property 37.370 10,700 114,500 125,200
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch 223
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
STC - 104
AS BUILT SANITARY SYSTEM REPORT 10C" c
~Q0 f OWNER
ADDRESS_ j$ RCS G
R~r- tj 1
SUBDIVISION / CSM# LOT #
SECTION3 T 3 0 N-R W, Town of t C.11 V11 (3-y%-
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
~Z
r
5 5~
I
41
00-
t~ INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this
form.
Provide 2 dimensions to center of septic tank manhole cover.
j I
BENCHMARK:
~ I
ALTERNATE BM:
i
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: CAc l_Q-a9 Liquid Capacity:
Setback from: Well ~l House 427 Other
Pump: Manufacturer Model# 3&k,3--
~ P
/j~ ~S~• S Size_.
Float seperation Gallons/cycle:
Alarm
Location cd-2
SOIL ABSORPTION SYSTEM
Width: Length .5-Q Number o~s
Distance & Direction to nearest prop. line: Sd, -q/p
y
Setback from: well: 360 House q'J Other
ELEVATIONS
Building Sewer ST Inlet. 9 d, S3 ST outlet
PC inlet-.(?/, ~o PC bottom 6 2, U Pump Off dic
Header/Manifold ,Q Bottom of system d
Existing Grade_ g Final grade /Do
DATE OF INSTALLATION: ~f~"
PLUMBER ON JOB:
LICENSE NUMBER: ~.S•6 3
INSPECTOR:
3/93:jt
~Vfisconsi i Department of Industry, PRIVATE SEWAGE SYSTEM County:
Labor ahdHuman Relations INSPECTION REPORT ST. CROIX
Safety and Buildings Division
(ATTACH TO PERMIT) Sanitary Permit No.:
~I GENERAL INFORMATION
Permit Holder's Name: ❑ City ❑ Village Town of: State Pla I o..
DERRICK, STEVE X
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
Ss
TANK INFORMATION ELEVATION DATA IL16
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark i 5l $T f~jf~ o'
Dosing 17 C.Y~, 7q~ r
Aeration- Bldg. Sewer
Holding St/ fit' Inlet 9.3 S9
TANK SETBACK INFORMATION St/ d outlet / 5- 93,09"
Ventto
l(p '
TANK TO P/ L WELL BLDG. A
i Intake ROAD Dt Inlet 7/41
Septic >a:)' NA Dt Bottom
Dosing "S6 d > ex d/' NA 1 beftdrt/ Man. 9 6~1
Aeratio NA Dist. Pipe 16 " , UD '
Holding Bot. System / p,a.~/
PUMP / SNFORMATION Final Grade
Manufacturer S Demand
Model Number 1 GPM
c-:v 3 rfi
TDH Li (p1 Friction System TDH &I ~Ft
Forcemain Length3~0' Dia. 3" Dist. To Well'
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length i No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSION DIM
Manufactu
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHIPM-
SETBACK . INFORMATION Type O r7t4,.. o 6e i p r CHAMBER
Ezli -Model Number:
2CO /1
OR UNIT,---'
System:oN` /0
DISTRIBUTION SYSTEM
Header / Manifold r Distribution Pipe(s) / x Hole Size x Hole Spacing Vent To Air Intake
Length Dia. Length ~ Dia. Spacing ~P
SOIL COVER x Pressure Systems Only xx Mound Or At-Gr System
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 resent, etc.) .a
LOCATION: Richmond.13.30.18W, SE, SW, Cty. Road G
of ( Cl~ `4 YC- ~G~ iu k: t rr~k e f ;,.a-c / ~'j ~iLl cwt ~y t C ( . P lr't"i w,
Plan revision required? ❑ Yes PI-ho
Use other side for additional information. S--
SBD-6710 (R 05/91) Date Inspector's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH -
SANITARY PERMIT NUMBER:
SANITARY PERMIT APPLICATION COUNTY
■i In accord with ILHR 83.05, Wis. Adm. Code
S~
STATE SAN, +T Y P rT
# -Attach complete plans (to the county copy only) for the system, on paper not less than `t ~Iq 8% x 11 inches in size. ❑ Check if revision
to previous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROPER~DT.(_PWNER PROPERTY LOCATION
J~ 1kr .5j5 % S,.0% S 13 T3C7 , N, R ~r or) W
PROPERTY OWNER'S MAILIN~/~DDRE ^ LOT # BLOCK #
(v"~tt,_ (v7
CITY, ST T Z CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
TU1 S ! 3 0 OL e- f,
11. TYPE OF BOIL I (Check one) 0 CITY NEAREST ROAD
❑ State Owned O VILLAGE : 71__d
rVTOWNOF: ❑ Public 1 or 2 Fam. Dwelling-#of bedrooms A P RCELTAX NUMBERO
III. BUILDING US : (If building type is public, check all that apply) (f) "
1 ❑ Apt/Condo {o T
20 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 eOther: rvice Station/ r Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 Specify
IV. TYPPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1.`K New 2. ❑ Replacement 3. ❑ Replacement of 4.E1 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 r;;:?r 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) CG ~ / 6 ELEVATION
6co Q~ r 5 N Feet lad • ~ 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 5 F1 17- R
Lift Pump Tank/Si hon Chamber 750 'Q.S 6 r-S
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Print): Plumber's Si gnat re: o Sta ) MP/MPRSW No.: Business Phone Number:
(o Sias
~Pelum,bers Address (Street, City, State, Zip Code): , 1 Q
19(09 N a!2 t IC i 2 `J_' O I
IX. COUNTY/DEPARTMENT USE ONLY
X❑ Disapproved San' ry Permit Fee (Includes Groundwater ate Issued Issuing Agent Signature mps)
R7j~~arge Fee) _
Approved ❑ Owner Given Initial , , E.// ,il 9
Adverse Determination C)
X. CONDITIONS OF APPROVALIREASONS FOR DISAPPROVAL:
SBD-6398(8.08/93) 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.
Il. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling.
Ill. 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.
SBD-6398 (R.11/88)
• , t. i
: a
19 3k
t
i
0_4 v
1
y
- - 1
-r-
c
1 i j
' i
e +
, i
1 t
~ r
!
t
e I-
•
i
j
f ` •
r
-
i
f
+
i j
r 4 ~ ~ l
1 { _
k
P I S
e
I 1 ~ t
I t
Wisconsirf Department of Industry, SOIL AND SITE EVALUATION REPORT Page of -3
Labor and Human Relations
Division-of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY ,
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but Sf ` C. , t°
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
PROP TY OWNER: PROPERTY LOCATION
SN ZQ,v r t C.1r GOVT. LOT _5'e 1/4.5L01/4,S I 3 0 N,R 8 ,obr) W
PROPE . ff R':S MAILINWpRESS LOT # BLOCK # SUBD. NAME OR CSM #
~o NA- N €k 3so aced-
CITY, STATN IP CODE PHONE NUMBER ❑CITY VILLAGE OWN NEAR ST ROAD
mbviA J vi SVO) l (7A aW ,,?0 t *40 G
XNew Construction Use [ ] Residential / Number of bedrooms [ ] Addition to existing building
Replacement [ ] Public or commercial describe
Code derived daily flow 301:~-> gpd Recommended design loading rate iS bed, gpd/ft2 • "ench, gpd/ft2
Absorption area required 6-06 bed, ft2 5CO trench, ft2. Maximum design loading rate ! _bed, gpd/ft2 ' t- trench, gpd/ft2
Recommended infiltration surface elevation(s) 94210 ft (as referred to site plan benchmark)
Additional design / site considerations W.0.
Parent material Flood plain elevation, if applicable ft
t:lunisuitable able for system C..QQNVENTIONAL M UND I -GROUND PRESSURE AT-GRADE SYSTEM FILL HOLDIN T NK
fors stem }~,S El U S❑ U S❑ U ❑ S U E] S U ❑ S U
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
/ p- - - 5~ Sb r ~f
"K
Ground o2~1•b6 $ O W
elev. 5
ft. m 5 /'~1 tr-~
Depth to
limiting
actor
Remarks:
Boring # a m sbk rr► 5 e_
-a 7 S, ~lC rn-~r S C Z ,S
L/ ko ay- s 1 5 r~ w i s
Ground
elev. _ F_ S/ D G g r , 5 1.
tt.
57 r s o G rr, ~
Depth to 17 16
limiting
fact
Remarks:
CST Name:-Please Prin Phone: lf~ -
er ! 04
Address: ~r d $ fi/ 7
Signature: Date: CST Number:
PROPERTY OWNER 5~)cojwt-tc%ic SOIL DESCRIPTION REPORT Page o~. of
PARCEL I.D. #
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
Bed Tench
io rn s~k mfr c
.2 Sb rtj -S
Ground -S 3 S- K S G 5b k v 60 1 . S ,elev.
1r ft• D 55/ G S D G S rn of r w 1 , S-
Depth to .51-46-1 ] S d G C, rr~ W . 8~
limiting
faces tR°.ry lS" / C Sb It rn J-~r
Remarks:
Boring #
~h::{ / D'/2. ?~S D 5 ~ bk rnfr- Sc ,3 ~ ~l ~S
.3 5 S 7, S G Sbl rn~lr (,S ! S ,L
Ground
ele
M ft.
Depth to
limiting
factor
Remarks:
Boring # /
arn~bk rn~ Sc ;Z ,S
>
Ground e S k rA ~r H W .S 1!
elev.
Depth to 7~'"~ 1 c 9 In d
limiting
acto~
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
FT-
factor
Remarks:
SBD-8330(8.05/92)
r i
:
'
r
I ,
,
. ~ 1
U
-
i i
t
I
t
, L
! 9 _ 4
! 1 t
x ,
' i
c
I t
i
, a
- -
i I
I
s
i
i
t '
I
I I 1 s i
i
fi
i
s
i i
1
,
_ I t
Icy-
,
,
-t i
i
-
r
, v
I I ~
,
I C i s 5 i 1__
PAGE OF
Cr~SS Sec~lvn CX A Sy5tern
Fresh Air Inlels And Ob6orwallon Pipe
~---Approved Vent Cap
minimum 12" Above
Final Grade
20- 42" Above Pipe _ 4" Cast Iron
To Final Grade Vent Pipe
Mash May Or Synthetic Covering
min. 2" Aggregate
i
uOver Pipe
Distribution over Pips
Pips 0 0
ple 0 0
6" Aggregate o P
Bentel It Plpe erlaated Pipe Below
o -Coupling Terminating At
Bottom 01 Syslem
Prp~oSe~ i'Inwl: gr,,.cl< j
~I c.) Ion ~~~/~j\
SOIL FILL
DISTRIBUT101'.1 PIPE APPROVED S4WPETIC COVER
• c M° ° ATERIAL- OR 9" OF STRAW
N l-
r OF AGGREGATE OP, MARSH "AM
to OF 12 -2t~t AGGREGATE
ELEV. OF / 6 r FEF.T_.
s
DI•STRIat~TI0A1 PIPE TO BE AT LEAST WCNES BELOW ORIGIMAL GRADE
A►JU AT LEAST LO 11JCHES BUT {JO MOR AIJ 42 IMCNES 6ELOW FINAL GRADE
MAXIMUM 06QrH OF ClAcAVAT100 FROM ORMI AL f KAoF WILL BE IAICRES
MINIMUM ACPT1t OF EXCAVATION Rohe 0IK141WAL GR49E WILL. BE III 04ES
ca"
SIGAIED:
LIG EIJ SE IJ1JM5E R: J
a DATE 2-
♦ ~ F
C r~ c~
✓ PAGE OF/6
=
PUt- P~C`HAMBER CRO55 SECTION AND SPECIFICATIONS
VEWT CAP
~ `i"C. I. VENT PIPE
WEATHER PROOF APPROVED LOCKING
Z5' FRCM DOOR, JUNCTIOM BOX MANHOLE COVER
WINDOW OR FRESH 12'111 U.
AIR INTAKE I
M
GRADE ~ I
I
I `i" MIIJ,
COQDUIT
I6"MIN. ,
11~ . .
IM I_. 1; 1. PROVIDE I
AIRTIGHT SEAL I III ` '
I I I `
APPROVED JOINT I
W/C.I. PIPF. I I APPROVED JOIAI
EXTEN01W. 3' I I I I W/C.I, PIPE
ONTO S01.10 SC:! . - I I ALARM EXTENDING 3'
ONTO SOLID W
a B
c I I OM
•I I
PUMP
r. OFF
0
CONCRETE BLOCK
RISER EXIT PERMITTED ONLY IF TAUV, MANUFACTURER HAS SUCH APPROVAL
SEPTIC AND SPECIFICATIC)KJS
DOSE TANKS MANUFACTURER: w~-
NUMBER OF DOSES: PER pAy
TANK :,IZE: LSD GALL 0IJS
DOSE VOLUME
ALARM MAAIUFACTURCR: _SJ I.9_c-irlC_. IIJCLUO!!!;• %FLOW: GALLONS
MODEL NUMBER: -Z0 l ~d-LJ
INCHES OR2 / GALLOWS
SWITCH TYPE; IO'c CAPACITIES; A=
t~ ~9L B= INCHES OR a-~ •7
] GALL0U5
PUMP
MANUFACTURER: - 1 n
C = IWCHE S OR o4~~•S GALLOIJS
MODEL Al U M B E R: _(d)~ C7 3/ y L ---FZ- /~a ~
D" IAICHES OR CALLOUS
SWITCH TYPE: 6Gfy~{~YI.G~ NOTE: PUMP AND ALARM ARE TO BE
PUMP DISCHARGE RATE _ 2A20 _Gpt/1.9 IN5TALLED ON SEPARATE CIRCUITS
VERTICAL DIFFERCNCC D~CEAJ PUMP OFF AND DISTRIBUTIOIJ PIPE., FEET
+ MIUIMUM NETWORK SUPPLY PRESSURE •
CQ 2.5 FEET
+t3SD FEET OF FORCE MAIN X i 53FjorLFRICTIOIU FACTOR., ~Q FEET
I~ TOTAL DYNAMIC HEAD = /v1~ 5-gFEET
INTERUAL RIMEWSIOQt OF TANK: LENGTH l_ -;err H -;LIQUID DEPTH 4/~
51GUED: LICENSE IUUMBER: _ 456 DATE: ~L)
-111-
m~
t
F r.
GOULDS SUBNtERSIBLE
SEWAGE AND EFFLUENT PUMPS
,i . r
EP0311
I= DISC.
f. ,t.. p7UPFP0311 142 EP0311 1/3 HP 115 V Effluent Pu1R 1/2" solids 256.80 172.10
Submergible
MODEL EPM11
'Ilk w Effluent Pump
t
METERS FEET SIZE '/a" SOLIDS
•`rsw~, ` i~ 25
xis 6 20
c5.
i
'may la , 4
1 C 10
2-
0- 0 0 ♦ El Ell
e 12 16 20 24 26 32 36 aP 0
0 2.5 5.0 7.5 m'/h
CAPACITY
Perfonnance
Curve 3885
90 - MODEL 3885
zs SIZE '/4" Solid
S 20
WEO7H-. ,
16 so
• - 40 o5H x 1~'
10-
30 WE
wEOx - - -
20
10 - - - - -
0 0
0 10 20 00 40 60 QO 70 00 00 100 - 110 • 120 am
r J
c.. 10 20 30 m'M
CAMCM
LIST DISC.
Gq(>Fi+'E0311I. 142 WE0311L 1/3 HP 115 V Low H 3/4' solids 491.55 329.35
GOL WE0311M 142 WE0311M 1/3 HP 115 V Mod H 3/4" solids 491.55 329.35
~~ke 3/4" solids 704.25 471.85
(I7I1FY>i011H 142 WE0511H 1/2 HP 115 V High H
Fll~ r
09UPWE07121i 142 WE07i2H 3/4 HP 230 V High Hd. 3/4" solids 843.65. 565.25
x r 1
~i S k
*****SEE RSd,CWING PAGE FM PFRFCk0ANC7+ AND SPECIFICATIONS.
DEPT 30 PAGE 07u
pp'1'E 10/88 -
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER U.-¢• ~~2- `r
MAILING ADDRESS
PROPERTY ADDRESS
(locatio f septic system lease obtain from the Planning Dept,
CITY/STATE SL 1 6,'`cS~ S >5 )
PROPERTY LOCATION 1/4,563 114, Section J3 , T ~a N-R~W
TOWN OF P16%rnnrv~ ST. CROIX COUNTY, WI
SUBDIVISION hJ LOT NUMBER 404
CERTIFIED SURVEY MAP , VOLUME PAGE" , LOT NUMBER. A)J.&_
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 (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.
1/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 completed and 'returned to the St. Croix
County Zoning Officer within 30 days of the three year exp' anon date.
SIGNED: a c..-
DATE:
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
S T C - 100
This application form is to be completed in full and signed by the
owner(s) of the property being developed. Any inadequacies will
only result in delays of the permit issuance. Should this
development be intended. for resale by owner/contractor, (spec
house), then a second form should be retained and completed when
the property is sold and submitted to this office with the
appropriate deed recording.
Owner of property r I c-1c,
Location of roperty5e, 1/45LJ' 1/4, Section TIZ N-R l W %I cav
i
Township klc,66:3n~ Mailing address G-~"ti
Address of site 01-1
Subdivision name Lot no.
Other homes on property? --4--Yes No
Previous owner of property
Total size of property
Total size of parcel
Date parcel was created
Are all corners and lot lines identifiable? S_Yes No
Is this property being developed for ('spec house) ? Yes No
Volume I-9CY and Page Number psJ 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
1 Deeds as Document No. 3 7 Z / 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 s 'd system, and the same has been duly recorded in
the office of a County Register of Deeds as Document No.
Si n ture of Applicant Co-Applicant
Date of Signature Date of Signature
Wisconsin Department of Ki %enui
GRANTEE:
^ H C Millerco
" ' PanrM
NT NO.
STATE BAR OF WISCONSIN - FORM I1
/ n LAND CONTRACT-Indlvldual and Corporate
wQ` 6Q~~AGE2 THIS SPACE RESERVED FOR RECORDING DATA
397~9Z aa!!V .
CONTRACT
,byandbetween William H. Derrick and-Mar RDGWTER$ OFFICE
Ann Derrick, husband and wife
sr. CR04X cn, WIS.
whether one or more) and Steven
J ("Vendor", Recd for Recoi c~ih~ _
. Derrick
a t
Nov
day of N_ °=ta. D. 84
Vendor sells and agrees to Convey to Purchaser Puron this et one or more), at 11 :15' A
mane of this Contract by Purchaser, the following \ I
_.,Pom_ P.an full per for. ' rents, profits, fixtures and other appurtenant interests (all called the "Property"), ar of
County, State of Wisconsin:
I See Schedule A which is attached hereto and made FR
ItETUAry TO
a part hereof as though fully set forth.
+I
-
1
Tax Key No.
i,
'I
~i ..1
r
e
k
N.
i
i
1
I
L
r
ti~ hl x )l t)i>t r tit No.
PROPERTY OWNFFRS COPY