HomeMy WebLinkAbout032-2074-30-000
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Parcel 032-2074-30-000 01/06/2005 09:44 AM
PAGE 1 OF 1
Alt. Parcel M 14.30.20.785C 032 - TOWN OF SOMERSET
Current ❑X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): * = Current Owner
* SCRUTON, WILLIAM H & MARILYN R
WILLIAM H & MARILYN R SCRUTON
1515 TWIN SPRINGS RD
HOULTON WI 54082
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 1515 TWIN SPRINGS RD
SC 5432 SCH D OF SOMERSET
SP 1700 W ITC
Legal Description: Acres: 1.720 Plat: N/A-NOT AVAILABLE
SEC 14 T30N R20W 1.72A IN GI-2 LOT B OF Block/Condo Bldg:
CSM VOL 1/254
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
14-30N-20W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1085/518 WD
07/23/1997 1085/517 QC
07/23/1997 579/431
2004 SUMMARY Bill Fair Market Value: Assessed with:
11212 318,300
Valuations: Last Changed: 07/24/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.720 27,500 242,400 269,900 NO
Totals for 2004:
General Property 1.720 27,500 242,400 269,900
Woodland 0.000 0 0
Totals for 2003:
General Property 1.720 27,500 242,400 269,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 109
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
SUR EYOR'S RE CjqT
ORD
CERTIFIED URVEY PLAT
A6 C
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APPROVED
ST. C OIX COUNlY
COMPREHENSIVE PARKS PLANNING
%3~iL; i~.2UGt/_ AND ZONG13' COMMITTEE
APPROVAL OF 1, 40R SUBDIVISION
DO =5 N 0 T ;v EA 11 A v. ,I_ FOR SEPTIC
RJER TO H62.20
IAM 2 6 1976 ~ =
Note: -9- Indicates Iron Pipe found in place.
-o- Indicates Iron Pipe Set,
Scale: 1 Inch equals 100 Feet.
Bearings shown are recorded on the Plat of TWIN SPRINGS ADDITION.
333465
(see other side)
tial 11 ~
Volume 1 page 254 F I t F D
z,. Ju 9 1 76 W
&M 0! CONNEtt r-.. O
kold " it Dead° F;
&OIX Qvvy,
+1~11:ooao4o
Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3
Labor aa ~-d Human Relations
%visibl-15Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
Attach complete site plan on paper not less than 8 1 e iol i 'Pan must include, but
not limited to vertical and horizontal reference poitSt erection 0 o" pe, scale or PARCEL I.D. #
~ \ q
dimensioned, north arrow, and location and di ' c fo n re cad. _
APPLICANT INFORMATION-PLEASE rNT e'1`Oi p 10 RE EWED B DATE
c '
PROPERTY OWNER: PROPERTY LOCATION
r, ° Ct !taOV.!f. LOT 4 114,S T 30 N,R or W
Wm. & Marilyn Scruton' T\IW F 1
PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK# SU
4040 Restwood Rd.
CITY, STATE ZIP CODE r CITY ❑VILLAGE [SOWN NEAREST ROAD
Circle Pines MN. 55014 (6 9 Twin--Snrins Rd.
461 New Construction Use [ Residential ! Number of bedrooms 3 [ J Addition to existing building
j ] Replacement [ j Public or commercial describe
Code derived daily flow 450 gpd Recommended design loading rate • 4 bed, gpd/ft2.5 trench, gpd/ft2
Absorption area required 379 bed, ft2 -175 trench, ft2 Maximum design loading rate • 4 bed, gpd/ft2 •5 trench, gpd/ft2
Recommended infiltration surface elevation(s) 94_q9 ft (as referred to site plan benchmark)
Additional design / site considerations na
Parent material i i Mj-_f-nnP „ni anrj. Flood plain elevation, if applicable na ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem ❑ S :~R U EkS ❑ U ❑ S RU ❑ S A-21 U ❑ S ®d1 ❑ S QdU
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 Trends
l.v 1 0-10 10 r3 3 none sl lmsbk mfr cs 2f .4 .5
2 10-20 7.5 r4/4 none sl lmsbk mfr if .4 .5
Ground 3 20-27 7.5 r4/6 none sil lmsk mfr 9w if .4 .5
elev.
94-49 ft. 4 27-55 7.5yr4/4 none sicl lfsbk mfr gw na .2 .3
Depth to 5 55-75 10yr6/3 none fragm ted limestone na na np np
limiting
factor
551-
Remarks:
Boring #
t 1 0-11 10 r3 3 none sl lmsbk mfr cs 2f .4 .5
2} 2 11-16 7.5 r4/4 none sl lmsbk mfr cry if .4 .5
Ground 3 16-28 7.5 r4/6 none scil lfsbk mfr CrW na .2 .3
elev. 4 28-60 •8
94.45 It.
Depth to 5 60-75 10 r6 3 none fro ted limestone
limiting
factor
60"
Remarks: H-4 contains many stones
CST Name:-Please Print Phone:
Gar L. Steel - -
Address:
Signature: Date: CST Number:
PROPERTY OWNER Wm. Scruton SOIL DESCRIPTION REPORT Pages of 3
PARCEL I.D. # 032-2074-30
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Cont. Color Gr. Sz. Sh. Bed
ITw&
3 1 0-10 10 r3 3 none sl lmsbk mfr gw 2f .4 .5
2 10-20 7.5yr4/4 none sl lmsbk mfr gw if .4 .5
Ground 3 20-24 7.5yr4/4 none sicl lfsbk mfr gw na .2 .3
elev. c2P y7.5yr5/2
ft. 4 24-41 7.5 r4/4 7.5 r5/8 sicl lfsbk mfr gw na .2 .3
Depth to 5 41-6 5yr3/4 none is Osg mvfr gw na .7 .8
limiting
factor 6 60-75 10yr6/3 none fragm nted lime tone
24"
Remarks:
Boring #
- 1 2msbk mfr C1w 2m .5 .6
4 ? 2 10-27 7.5yr4/4 none sl 2mgr mfr gw if .5 .6
3 27-41 7.5yr4/6 none sil lfsbk mfr gw if .4 .5
Ground
elev. 4 41-62 7.5yr4/6 none sl w/ ragmented limestone 10yr /3
93-..45- ft.
Depth to
limiting
factor
41"
Remarks:
Boring #
1 0-17 10yr3/3 none 1 2msbk mfr gw lm .5 .6
5 2 17-37 7.5yr4/4 none sl lmsbk mfr gw if .4 .5
3 37-64 7.5yr4/6 fld 7.5yr5/8 sicl lfsbk mfr gw na .2 .3
Ground
elev. 4 64-72 10yr6/3 none fragmented limestone
94.95 ft.
Depth to
limiting
factor
37"
Remarks:
Boring #
Ground
elev.
ft. I
Depth to
limiting
factor
Remarks:
SBD-8330(R.05/92)
STEEL'S SOIL SERVICE
Gary L. Steel 1554 200th ~ve.
Wm. & Marilyn Scruton
CSTM2298 NW4SW4 S14-T30N-R20W New Richmond, WI 54 17
MPRSW 3254 town of Somerest (715) 246-6 00
lot #B csm vol.1-page 250
N
1"=40'
BM= top of tel. ped bracket at el. 100' /
drain area from culvert to be diverted away /
from mound area.
\ es. _ F
v
1p rl-
S ' Z.7 /8 17' /y
Gary L. Steel
5-26-94
9 10
STC - 104 L9
AS BUILT SANITARY SYSTEM ORTRM
AL t 2 2 996
OWNER C tai,,
CpijN;Y
--CkV!vut~FFtCE
ADDRESS
SUBDIVISION / CSMJ_ f+ i j
LOT
SECTION
-T_W , Town of
ST. CROIX COUNTY, WISCONSIN
PLAN VIE
SHOW EVERYTHING WITHIN 1 0 FEET OF SYSTEM
~l
3y~tSx
so'
~ ~G scs~
4
i
i
INDICATE NL02Zc1A9R0W
Provide setback and elevation information on reverse of this for'Tl.
Provide 2 dimensions to center of septic tank manhole cover-
BENCHMARK
ALTERNATE BM:~~~A~~ ~C~ /
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: LE ~ Liquid Capacity:
Setback from: Well HouseL-Other
Pump: Manufacturer Model{ 5-6,Size
Float seperation Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
f r
Width: Length Number of trenches
Distance & Direction to nearest prop. line:
Setback from: well: 1A2 House _ Other
ELEVATIONS
Building Sewer P_i4v ST Inlet. ST outlet
PC inlet PC bottom^ Pump Off
Header/Manifold Bottom of system
Existing Grade Final grade. X19
DATE OF INSTALLATION:
PLUMBER ON JOB: -
LICENSE NUMBER:
INSPECTOR: 1 lz2
3/93:jt
4 Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County:
Labor and Human Relations INSPECTION REPORT ST. CROIX
Safety and Buildings Division
(ATTACH TO PERMIT) SanitaryPerm itNo.:
GENERAL INFORMATION
Permit Holder's Name: ❑ City ❑ Village Town of: State Pla
SCRUTON, WILLIAM
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic {J / r Benchmark 3,17' /00.
Dosing ao lX/`~s V i ao.ot)
Aeration Bldg. Sewer /Sj 9{.99
Holding St/ Ht Inlet p 9 y ✓ 5 `
TANK SETBACK INFORMATION St/ Ht Outlet
TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet 9_3/ 9
Air Intake •C
Septic > 0 S - NA Dt Bottom /-2, 71'
9o
Dosing w g - g r NA Header / Man.
Aeration NA Dist. Pipe Z/,Q 16d. VY
Holding Bot. System q. 7,51
4.
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand
Model Number LF03 /Z (1/, GPM
TDH Lift Lriction l I Systema5 TDHFt
Forcemain Length Dia. u Dist. To We"I S.,
SOIL ABSORPTION SYSTEM
BED/TRENCH Widt Lengt No. Of TrQnches PIT No. Of Pits Inside Dia. Depth
DIMENSION C / DIMENSIONS
SYSTEM TO P/ L BLDG WELL LAKE /STREAM LEACHIN nu acturer:
SETBACK
INFORMATION Type O CHA R Moe Number:
System,;In.:,a_a .5. ~J 8 ` /U yr /L~~ w~l ~ UNIT
DISTRIBUTION SYSTEM
Headed Manifold Distribution Pipe(s) yy , x Hole Size, x Hole Spacing Vent To Air Intake
Length Dia-1 Length Dia. Spacing A"
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: SOMERSET-14.30.20W, NW, SW, TWIN SPRINGS ROAD
's,~i U 1
z, `5,71
Plan revision required? ❑ Yes E] E No
Use other side for additional information. 3~ ~0 6
SBD-6710 (R 05/91) Date I ector's signature Cert. No.
1
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
x
J ~ ry~
c,
;T
L
SANITARY PERMIT APPLICATION
In accord with ILHR 83.05, Wis. Adm. Code COUNTY
STATE SANITARY R IT #
-Attach complete plans (to the county copy only) for the system, on paper not less than p9 9F
8% x 11 inches in size. ❑ Check if revision to p evious application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROPE TY OWNE PROPERTY LOCATION
'/a, S T , N, (or
A" ilk I I;e
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
CITY T ZIP DE PHONE NUMBER SBD VISION NAME OR CSM NUMBER
II. TYPE OF BUILDING: (Check one CITY N ARE ROAD
:
❑ State Owned 0 VILLAGE
OF:
❑ Public ~ 1 or 2 Fam. Dwelling-# of bedrooms PARCELTAX NUMBER(S)
Ill. BUILDING USE: (If building type is public, check all that apply)
1 ❑ Apt/Condo
20 Assembly Hall 60 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 130 Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. PQ New 2. ❑ Replacement 3. ❑ Replacement of 4.E1 Reconnection of 5.E1 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 Z1 Mound 30 ❑ Specify Type 41 El Holdin9Tank
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) ELEVATION
Feet Feet
_17 7~ VII. TANK CAPACITY Prefab. Site Fiber- Exper.
in allons Total # of Manufacturer's Name Concrete Con- Steel glass Plastic App
INFORMATION LNe xist in Gallons Tanks structed
s Tanks
Septic Tank or Holding Tank
Lift Pump Tank/Si hon Chamber. S
Vlll. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumbe s Na a (PrintPlumber's ignature: {No mps) MP/MPRSW No.: Business Phone Number:
r
Plu ber' Address treat, City, fate, Zip de :
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sa nary Permit Fee (includes Groundwater ate ssue Iss 'ng Agent Signat re o Stamps)
Surcharge Fee)
0 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 41
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 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)
SAFETY & BUILDINGS DIVISION
State of Wisconsin
Department of Industry, Labor and Human Relations
April 27, 1995 2226 Rose Street
La. Crosse WI 54603
K 0 CONSTRUCTION
KIM 0 CONNELL
308 MIDPINE CT
STAR PRAIRIE WI 54026
RE: PLAN S95-40276 FEE RECEIVED: 180.00
SCRUTON, WILLIAM
NW,SW,14,30,20W
TOWN OF SOMERSET COUNTY OF ST CROIX
MOUND SYSTEM
The Department has reviewed the above-referenced submittal.
Conditional approval is hereby granted for the system plan submittal. All
noted items must be corrected. The review and approval of the system is based
on chapter 145, Wisconsin Statutes, and chapters ILHR 83 and 84, Wisconsin
Administrative Code, and is contingent upon compliance with any stipulations
shown on the plans. This system has not been reviewed for the code
requirements set forth in chapter ILHR 82 or in chapters ILHR 50-64, Wisconsin
Administrative Code.
This plan submittal approval will expire two years from the approval date, or
if a sanitary permit is obtained, plan approval will expire on the day the
initial sanitary permit expires. The licensed plumber responsible for this
installation shall keep one set of plans with the Department's stamp of
approval at the construction site. The installer shall notify the appropriate
inspector when inspections can be made.
All permits required by the city, village, township or county shall be
obtained prior to installation.
Inquiries should be directed to me at the number listed below. Please refer
to the plan number shown above.
Since . y, '
erard M. wim
Plan Reviewer
Section of Private Sewage
(608) 785-9348
8232R/ 1
SUDA-7987(8. 18M)
Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM Safety and Buildings Division
Laborand Human Relations REVIEW APPLICATION Bureau of Building Water Systems
r
~ Hayward Office La Crosse Office Madison Office Shawano Office Waukesha Office
209 W 1 st Street 2226 Rose Street 201 E. Washington Ave 1340 E Green Bay Street 401 Pilot Court, Suite C
Rt 8, Box 8072 LaCrosse, WI 54603 P.O. Box 7969 Suite 300 Waukesha, WI 53188
Hayward, WI 54843 Phone (608) 785-9334 Madison, WI 53707 Shawano, WI 54166 Phone (414) 548-8606
Phone (715) 634-4804 Fax (608) 785-9330 Phone (608) 267-5119 Phone (715) 524-3626 Fax (414) 548-8614
Fax (715) 634-5150 Fax (608) 267-0592 Fax (715) 524-3633
INSTRUCTIONS: To save time, schedule your review with one of the offices listed above prior to submittal. Fill in all applicable data and submit this
form together with fees and plans/information. Your submittal must be received at least one working day prior to the appointment at the office
where your review was scheduled. Please call any of the listed offices if you need help filling out the form or hav995-462fo
e os onhat inmatiosubmit. PLEASE PRINT VERY CLEARLY. A sample of a completed form is on the reverse side for your reference. 1. APPOINTMENT INFORMATION -if you have
scheduled an appointment, fill in the information requested below to save time:
Appoint ent Date Reviewer Nam Plan Identification Number
- / - - - 1,
2. PROJECT INFORMATION If this review is a revision or extension to your existing
plan identification number, provide that number here:
Proje t Name
City E]Village @ Town Of: County
k k~l )
Protect Location
~E or v
GOVT. LOT v 111/4,5 T. ~ N ,R
3. APPLICATION FOR 4. FEE COMPUTATIONS FEE SUBMITTED
System Type (check one): System Type I (include new and existing tanks)
Up To 1,500 gallon septic tank $110.00 ......../lam
A At-Grade 1,501 - 2,500 gallon septic tank $120.00
H Holding Tank 2,501 - 5,000 gallon septic tank $160.00 .
M Mound 5,001 - 9,000 gallon septic tank $ 200.00
N F Non-Pressurized In-Ground (conventional) 9,001 -15,000 gallon septic tank $ 300.00 .
P n Pressurized In-Ground Over 15,000 gallon septic tank $500.00
O ❑ Other: Up To 1,000 gallon dose chamber $ 70.00 yo -
1,001 - 2,000 gallon dose chamber $ 80.00
Building Type (check one): 2,001 - 4,000 gallon dose chamber $100.00 .
4,001 - 8,000 gallon dose chamber $120.00
D ® Dwelling, 1 or 2 Family 8,001 -12,000 gallon dose chamber $140.00 .
P Public Building Over 12,000 gallon dose chamber $160.00
S State-Owned Building Up To 5,000 gallon holding tank $ 60.00
5,001 -10,000 gallon holding tank $100.00 .
Code Derived Daily Flow gpd Over 10,000gaIIon hold in r~~o.... $150.00
Check If Replacing Existing System Experimental System (additional one time fee) $ 300.00 .
Revisions To Approved PlaAPR.2 $ 60.00 .
Petition For Varianc jj~/~ $ 100.00
Petition For Variance rte vARM, . $225.00
Plumbing $225.00
Revision $ 75.00
Groundwater Monitoring Groundwater Monitoring - Per Site $ 60.00 .
(other than a proposed subdivision)
Site Evaluation in Lieu of
Groundwater Monitoring Site Evaluation in Lieu of Groundwater Monitoring $ 60.00
Subtotal:
Priority Review: Enter same amount as Subtotal:
MAKE ALL CHECKS PAYABLE TO: SAFETY AND BUILDINGS DIVISION Total Fee: 1=
5. SUBMITTING PARTY INFORMATION
Telephone No (include area code & extension) Company me - VConac, erso
No. & Street Ad-dress Or P Box City, Town or Village, S te, Zip code
Aerobic or prepackaged treatment system fees are calculated based on equivalent size septic tanks and dose chambers
2 Revision fees are not applicable to temporary holding tanks or extensions to existing approvals
NOTE: Fees are pursuant to Wis Adm. Code, Chapter ILHR 2, and are subject to change annually
The information you provide may be used by other government agency programs 1Privacy Law, s 15.04 (1) (m)l.
SBDW-6748 (R. 09/94) OVER
"'+Jd1U1n"""""""'Ur JUIL AIVU 51 I t tVALUA I IUIV Hth'UH 1 rage 1 0l 3
abt,; 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 St. Croix
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or _ PARCEL I.D. u
dimensioned, north arrow, and location and distance to nearest a V s I~r ~s 0 3 2 - 2 0 7 4 - 3 0
APPLICANT INFORMATION-PLEASE PRINT ALL INFOMTIOTf L Vl REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
Wm. & Marilyn Scruton GOVT. LOT NW 1/4 SW 1/4,514 T 30 N,R 20 xfc(or) W
PROPERTY OWNER':S MAILING ADDRESS LOT x BLOCK SUED. NAME OR CSM #
4040 Restwood Rd. B na csm vol 1 page 250
CITY, ircTATE Pines, MN. ZIP S8D 4 Pi ONE y,fep ,99 []CITY []VILLAGDCUOWN NEAREST ROAD
t0~ (1 622) / 4 Somerset Twin Springs Rd.
(xJ New Construction Use [ )q Residential / Number of bedrooms 3 [ J Addition to existing building
j J Replacement ( J Public or commercial describe
Cain derived daily flow 450 god Recommended design loading rate • 5 bed, g. d • _6 trench, gpd/R2
Absorption area required 375 bed, ft2 375 trench, ft2 Maximum design loading rate .5. bed, gpd/ft2 •6 trench, gpd/ft2
Recommended infiltration surface elevation(s) 98.85 ft (as referred to site plan benchmark)
Additional design / site considerations contour line 97.85
Parent material limestone uplands Flood plain elevation, if applicable na ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
u
U= Unsuitable fors stem O S ® U ( as OIL; O S E1 ❑ S 91~U C 3S [3U ❑ S IN
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence BOIIxlary Roots GPD/ft
in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. I Bed ITrench
0-12 10yr2/2 none 1 2msbk mfr gw 2f .5 .6
v 1 ,Jii; S
2 12-22 10yr3/3 none sil 2msbk mfr gw if .5 .6
Ground 3 22-31 7.5yr4/4 none sil 2msbk mfr gw na .5 .6
elev. c1d
4 31-65 10yr5/4
98.55 ft, 7.5yr5/6 sicl 2msbk mfr gw na .2 .3
Depth to 5 65-72 10yr7/6 fractured limestone
limiting
factor
311,
Remarks:
Boring At
1 0-12 10yr3/2 none 1 2msbk mfr gw 2f .5 .6
~X 2 2 12-27 10yr3/3 none sit 2msbk mfr gw if .5 .6
3 7-41 10yr4/4 c p7.5yr5/6 sil 2msbk mfr gw na .5 .6
Ground
elev. 4 1-70 10yr5/4 c2p 7.5yr5/8 sicl M na I na, np i .2
98.55 ft.
5 70+ 10yr7/6 fractured limestone
Depth to
limiting
r:
factor
271,
Remarks:
CST Name-Please Print Gary L. Steel Phone: 715=246-6200
Address. 1554 24th. Ave., New hmond Wt. 54017
Signature: Date CST Number
PROPERTY OWNER Wm. Scruton SOIL DESCRIPTION REPORT Page'Q of- }j
032-2074-30
PARCEL I.D. x S . J pw - 40"27 6'
- c
Boring # Horizon Depth Dominant Color Motfies (Texture Structure Consistence Boundary Roots GPD/ft2
2c;:in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. Bed (Tram
s€ 1 0-13 10 r2 2 none 1 2msbk mfr 2f .5 1.6
3
2 13-26 10yr4/4 none sil 2msbk mfr gw if .5 1.6
i
Ground 3 126-41 7.5yr4/4 c2p 7.5yr5/6 sil 2msbk mfr gw na .5 j.6
37.25 ft. 4 141-64 10yr5/4 c2p 7.5yr5/8 sil M na na na np .2
Depth to
limiting
factor
26"
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
ms
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev. I
ft.
i ~
I
Depth to
limiting
factor
Remarks:
SBD-8330(8.05/92)
S95-40276
STEEL'S SOIL SERVICE
Gary L. Steel Wm. Scruton 1554 200th Ave.
CSTM2298 NW4SW4 S14-T30N-R20N New Richmond, WI 54017
MPRSW-3254 town of Somerset (715) 246-6200
1
N
1"=40'
BM.=top of SE lot stake st el. 100'
100 +
~o ~s~o P ~ q 3 i
~jv: ,'~Aa~~G ®5 ~
13' 8 M
Gary L. Steel
10-19-94
WORKSHEET - MOUND SYSTEM DESIGN 895 -40P,,76
PROBLEM:
Design a mound system for aRe
..ust
The site characteristics area:
Depth to groundwater or bedrock in.
Landslope %
Percolation rate
Distance from dose chamber to distribution system. ft.
Elevation difference between Dump and distribution systern ft.
Step 1. WASTEWATER LOAD = BF'- 1L gal
Step 2. SIZE THE ABSORPTION AREA
A) Area required =
sq. ft.
B) 6E;d or trench length (B) ■ ft.
C) Bed or trench width (A) _ ft.
- D) Trench spicing (C) _
xJ} Wastewa ter load .24 coal/f 2 ■ / r
t /day B ft.
tr 'i ems
Step 3. MOUND HEIGHT
A) Fill depth (D) ft.
B) Fill depth (E) D slope A)+P) r/ ft.
f va (8~ x 1,16
C) Bed or trench depth (F) _ ;t•
D) Cap and topsoil depth (G) = ...1... ft.
E) Cap and topsoil depth '(H) _ ft.
,~iRn•
Licenue Nu:
of lp
X95-4 27 6
Step 4. MOUND LENGTH
A) End slope (K) ■ + F + H x 3 .
,(,Qc,-?_ ft.
2n9th 4 1--5)- 12. IeL2S
B) Total d (L) ■ B + 2(K) . ft.
Step 5. MOUND WIDTH
Al) Upslope correction factor = « LLZ
A2) Upslope width (J) (D + F + G)(3)(factor) ^$1--) ft.
7, W
BI) Downslope correction factor ■
B2) Downslope width (I) ■ (E + F + G)(3)(factor) ft.
CI) Total mound width (W) for bed ■ J + A + I .
8f 8~ =s'~ 7,-'2
C2) Total mound width (W) for trenches ,
J +
(no. trenches -1)(c) + A + I ft.
Step 6. BASAL AREA '
A) Infiltrative capacity of natural soil ■
B) Basal area required ■ wastewater flow :
natural soil infiltrdt e•capacity ■ sq. ft.
CI) Basal area available for bed for sloping sites ■
3;~' L? Y(gt9-6)
C2) Bas areay avail le for trench for sloping sites glA~
B W_ CJ+A
'A „ sq, ft.
C3) Basal area available for trench or bed for level,
S
Sign: sq. ft.
License 1"U:
Data:
*zq~~
Step 7. DISTRIBUTION SYSTEM S95-40276
7A) SIZE DISTRIBUTION SYSTEM
1) Hole size = /,J in.
2) Hole spacing in.
3) Distribution pipe length 4) Distribution pipe diameter ■ _ in.
5) Spacing between distribution pipes in.
6) Distance from sidewall to distribution pipe = in:
76) DISTRIBUTION PIPE DISCHARGE RATE .i ft.
1) Number of holes per pipe
2) Flow per pipe = XBGPM,
7C) SIZE MANIFOLD
1) Manifold iscentral/ end
2) Manifold length = ft.
3) Number of distribution lines =
4) Manifold diameter = in.
7D) SIZE FORCE MAIN
1) Minimum dosing rate = GPM
2) Force main diameter r / in.
3) Friction loss = 1• / ft.
7E) TOTAL DYNAMIC HEAD
1) Vertical lift = 42 ft.
2) Friction loss = , 4 J ft.
3) System head 2.5 ft. _ 2, S_ ft.
Total dynamic head _ 13•G ft.
Ucergo: ~
Date
: S Pvt.. ~ o P /Q
S4541°40276 kd"-S'~ew~
7F) PUMP SELECTION
1) Pump selected will discharge GPM at ft.
total dynamic head.
2) Pump model and manufacturer
A/
7G) DOSE VOLUME
1) 10 times void volume of distribution lines gal./cycle
2) Daily wastewater volume 4 doses/24 hrs. _ gal./cycle
3) Minimum dose volume = 1;~ gal./cycle
7H) DOSE CHAMBER
1) Minimum capacity required = s`z~a- 75zYf9/ &t~ gal.
sign:
Licvnoo "u:•
Date:
.
rja o/ ea0k) E S ~D
~Sf-P'n c 7s
d
too,
OPR
moo'
Page-(-Of--40-
t rh SCyt9UJ~N
y
~ 9.5-402Z6
Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe
Medium Sand
H G
ILS's ` 9
Topsoil - F
_-31 E D
co? $ Slope Force Main Plowed Layer
Bed of Y`21S"
Aggregate
Cross Section of a Mound System Using
A Bed For The Absorption Area D~ 46 Ft.
~Ft.
F R4 Ft.
AFt. G f, D Ft.
$ Ft. HFt.
Signed: - K Ft.
L l 7. S' Ft.
License ~9 I ~ 6 Ft. SAGE SYSTEM
Date : qs- nallY
C0p1ditto
O ~fl~
REV►
~AAN
-AM501ok Position of E PENCE
Force Main"- $E
I L I
J Observation Pipe
Imo--- K
Fj B
r-----.----- 1
0
I A-X x
A I
W IO
Distribution Pipe Bed of V -2Y'
Aggregate
Observation
I Pipe Permanent Marker
Plan View of Mound Using a Bed For the Absorption Area
P49e .z Of,1C1
Sc ei to
S95-402
Perforated Pipe Detall
n
nd vi•et
Perforated
End Cap • PVC Pipe
d,,►~ Holes Located On Bottom,
J Are Equally Spaced
J
Q
PVC Forte Main
i
.7
Q PVC Mordtold Pipe
Alternate Position Of
Distribution Force Main
Pipe
Lost Hole Should Be
Next To End Cap
End Cop Distribution Pipe Layout P - S Ft.
R
S y8„
X Inches
Y 7L Inches
Signed: Hole Diameter IX/ Inch
Lateral 0 Inch(es)
License Number: Manifold inches
Date: Force Main " Inches
„
01 1 # of holes/pipe
.5,01u4hvert Elevation of sIWQ.V Ft.
~s
5~ G0 E~~
b
w
~e
V A
b
A
4J
44
y=-
r r r r r
' w IV
rrrr
W 4)
A W rrr - - - - r - -
1 rrr - r -
r -
r ► - r'r
rr-rrf
O C~`
My J
N - ,
N
a
w ~
O
o~
43
N
O
w a°~
p I
o ~
n a c
a
PA E OF
PUMP CHAMBER CR055 SECTION A►JO SPECIFICATIONS ScrCu
VENT CAP S95-40276
`i• C.Z. VENT P I P C
WEATHER PROOF APPROVED LOCKING
JUWCTIOU BOX MAWHOLE COVER
~ 25' FRAM DOOR,
WIQDOW OK f RCSH 12~MIU,
AIR INTAKE
GRADE
I y~ MAJ.
18' MI lJ.
CONDUIT Ell
INLET PROVIDE I l
P nditto~ A IGHT SEAL I i I( V
I
APPROVED JOIIJ'f A® SID Z ( i APPROVED JOIAITS
W/C.I. PIPE RE~p o* I III W/C.X. PIPE
EXTENDIU(s 3 >k ~ I I EXTENDIUG 3
ALARM
50s
OQTO SOLID $01L B NY 6 I II ONTO SOLID SOIL.
I I
C b ONVi~
• PUMP
OFF
0
CONCRETE BLOCK
RISER EXIT PERMITTED OQLy IF 'TANK MAIJLWACTURZP HAS SUCH APPROVAL
SPEC,IFICAT IOIJS
i:P71C AND _
,)SL TANKS MAIJUF'ACTURER: (DUMBER OF DOSES: PER DAy
TAKJK LIZE: ~~_t5 GALLOIJS DOSC VOLUME: GALL0IQS~ ~
ALARM MANUFACTURER: CAPACITIES: A= IUCHES OR --<_Y_/ GALLOQ5
MODEL NUMBER: B= 7 IkJCHE5 OR 29GALLOU5
SWITCH TYPE: C=I"HES OR -L?-? GALLONS
PUMP MANUFACTURER: On IQLHES OR 71'_ GALLOU5
MCMEL NUMBER'. l~/eOT WOTE', PUMP AND ALARM ARE TO BE
bWIICH TJPE: 4EL IU5TALLED ON SEPARATE CIRCUITS
PUMP DISCHARGE RA'T'E GPM 1Sr
VERTICAL,DII,FERENCE bETWEEN PUMP OFF AND DISTRIBUTION PIPE_ e,r- FEET
+ MINIMUM NETWORK SUPPLY PR~~E$G$URE 2.5 FEET
+ ~ FEET OF FORCE MAIN X .,ZL.L-„F/oo iLFRICTION FACTOR., FEET
TOTAL 0y1JAMIC HEAD = FEET
87
IQTERIJAL DIMEW 10Nf► OF TAUK: LE►JGTH ;WIDTH -;LIQUID DEPTH
91GJJEDt LICEUSE UUMBERt - ~,L DATE:yZ
y p h~6,~ /~i ~f ~G
RI ~ ~ M JFy y ~.V 1G' 1:
Performance.' blr~
Curves Pumps
METERS FEET S 9 t 4 0- ~ 7
MODEL 3885 3~s
25 80 SIZE 3/4" Solids
WE15H
70
20 WE10H
60
~ - WE07H
15 50
W EOSH
40
10- 0 WE03M
20 WE031
5
10
0 0
0 10 20 30 40 50 80 70 80 90 100 110 120 GPM
0 10 20 30 mom
CAPACITY
u GOU LDS PUMPS, INC.
56*cA Falls Pew rocM 1310;
METERS FEET
120 MODEL 3885
35 110 WE15HH SIZE 3/4tt Solids
100
30
90
25 80
20 70
60
O
50 WE05HH
15
40
10
20
5
10
0 0
0 10 20 30 40 50 60 70 80 90 100 110 120 GPM
L i
0 10 20 30 W/h
CAPACITY
01985 Goulds Pumps, Inc. Etfectiye Juty, 1985
1,aol
VVl5QUf1Yl wvrMlullwllluilli wu uy' ,UIL ANU 511 t IZVALUA I IUN hk=IJUM I rage 1 or 3
Lab' •arlNuman Relations
Dwision of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but St . Croix
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. 0 3 2 - 2 0 7 4 - 3 0
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
Wm. & Marilyn Scruton GOVT. LOT NW 1/4 SW 1/4,SL4 T 30 N,R 20 xk(or) W
PROPERTY OWNER':S MA!I.ING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
4040 Restwood Rd. B na csm vol 1 page 250
CITY, STATE Pines, M. ZI5C0~ 4 PHONE yllM~E4199 CITY OVILLAGD C JfOWN NEAREST ROAD
g8 DE 62)7/8 Somerset Twin Springs Rd.
[x] New Construction Use (xj Residential I Number of bedrooms 3 [ ] Addition to existing building
[ j Replacement [ ] Public or commercial describe
Cede derived daily flow 450 god Recommended design loading rate • 5 bed, gpd/112 •6 trench, gpd/ft2
Absorption area required 375 bed, 112 375 trench, ft2 Maximum design loading rate • 5 bed, gpd/ft2 - 6 trench, gpd/ft2
Recommended infiltration surface elevation(s) 98.85 ft (as referred to site plan benchmark)
Additional design / site considerations contour line 97.85
Parent material limestone uplands Flood plain elevation, if applicable na ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U= Unsuitable fors stem 0S O U as O U 13S DU O S nu O S [aU O 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 rertdi
1 0-12 10yr2/2 none 1 2msbk mfr gw 2f .5 .6
1
2 12-22 10yr3/3 none sil 2msbk mfr gw if .5 .6
Ground 3 22-31 7.5yr4/4 none sil 2msbk mfr gw na .5 .6
98! 5ev. 5 ft. 4 31-65 10yr5/4 c1d7.5yr5/6 sicl 2msbk mfr gw na .2 .3
Depth to 5 65-72 10yr7/6 fractured limestone
limiting
factor
311,
Remarks:
Boring #
1 0-12 10yr3/2 none 1 2msbk mfr gw 2f .5 .6
2
2 12-27 10yr3/3 none sil 2msbk mfr gw if .5 .6
c
3 7-41 10yr4/4 7.5yr5/6 sil 2msbk mfr gw na .5 .6
p
Ground
elev. 4 1-70 10yr5/4 c2p 7.5yr5/8 sicl M na - np •2
98.55 ft
5 70+ 10yr7/6 fractured 1' estone `
4 21,
Depth to
limiting L~7 10
factor I } j
27"
Remarks: rk: a 9
CST Name:-Please Print Gary L. Steel Phone. 71=24C-62
Address: 1554 2 th. Ave., New hmond Wt. 54017
Signature: Date: T CST Number:
M 10-19-94 cstm 02298
PROPERTY OWNER Wm. Scruton SOIL DESCRIPTION REPORT Page 1 of 3
PARCELI.D.# 032-2074-30
Boring # Horizon Depth Dominant Color Mottles Texture
I Structure Consistence Barr{ary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh Bed ITrench
.
3 w 1 0-13 10 r2/2 none 1 2msbk mfr 2f .5 1.6
«v' 2 13-26 10yr4/4 none sil 2msbk mfr gw if .5 i.6
Ground 3 26-41 7.5yr4/4 c2p 7.5yr5/6 sil 2msbk mfr 9w na .5 ~.6
97.25' ft 4 41-64 10yr5/4 c2p 7.5yr5/8 sil M na na na np .2
Depth to
limiting
factor
26"
Remarks:
Boring #
~4~~i} iir:•
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft. ~
I
Depth to
limiting
factor
Remarks:
SBD-8330(R.05/92)
r
STEEL'S SOIL SERVICE
Gary L. Steel Wm. Scruton 1554 200th Ave.
CSTM2298 Nw4Sw4 S14-T30N-R20N New Richmond, Wl 54017
MPRSW 3254 town of Somerset (715) 246-6200
1
N
1"=40'
BM.=top of SE lot stake st el. 100'
108 -f-
8.2. s{ 8"
171
13 $ A4
Gary L. Steel
10-19-94
4 G)
CERTIFIED UR EY PLAT
zo 7Q ~ b
5
90 • ~
IS'l
r
E
s9 'joo•°'
w J.
7-e vo •
SB ~
APPROVED
ST. C;,OIX COUNTY
COMPREHCN;'iIVE pARY.`> PIANNIN
AND ZON1 l 0 COMMITTEE
APPROVAL ►i 1012 SUBDIVISION
' DC?'.;'NC?1 ' :v. l F SEPTIC
i1A. 1~1=~K I i-I62.20
Note: Indicates Iron Pipe found in place.
-o- Indicates Iron Pipe Set.
Scale: 1 Tnch equnls 100 Peet.
E3earinE,s shown are recorded on tEio E'1a t of `j,WIN SPRINGS ADDITION.
-c -L w una -et;uuii snail not oe aiscloseo to'otners unless, in the
insured in litigation in which any third party asserts a claim adverse to the title reasonable judgment Of the Company, it is necessary in the administration of
irnntinned nn inside hark rnver 1
ST. 48 CNTY. 109 PROP. 4 IRAN. 101A
Re-Issue Liability:
ORT FORM 402 ALTA OWNER'S 10-17-92
PREMIUM: $50.00 ORDER NO. S 941184 H POL ICY NO. SV2386143
AMOUNT $35,500.00
SCHEDULE. A
1. POLICY DATE: July 6, 1994 AT 9:15 A. M.
2. THE INSURED HEREUNDER, IN WHOM TITLE TO THE FEE SIMPLE ESTATE
IS VESTED, AT DATE HEREOF, IS:
William H. Scrr_tton and Marilyn R. Srrr..tton, husband ,and wife
3. THE LAND REFERRED TO IN THIS POLICY IS DESCRIBED AS FOLLOWS-
PARCEL 1:
Part of government Lot in Section 14, fown~>f~iA 30, Range ,_'0
described as follows: Lot "B of the Certified Sr_trvey Map
recorded June 9, 1976 in Volume 1 of Certifier! Si_trvey Maps,
Page 254 as Document No. 333465, St. Croix County, Wisconsin.
Together, with a non-exclusive roadway easement for Ingress
and Egress 66 feet in width as shown on the above Certified
Survey Map.
PARCEL 2:
Lots 59, GO and that part of Lot 61, Twin Springs. ftddition in
the Town of Somerset, described as follows-. Beginninq at the
West corner of Lot 61, thenre '3 feet Northeasterly along
roadway, thence Easterly along the renter of a gully to the
East corner of said Lot, thence Southwesterly 11710 feet to the
South corner of said Lot, thence Northwesterly 150 feet to
place of beginning, St. Croix County, Wiscar►Nin.
IIIIIIIIIIIIIIIIIII «OLDREPUI3LC
1 Till*
ORT Form 3M
` • '99 7s s7
800 7880
(I lop
~j~ p 07 n~ 6Za ~3 2
6A I
87
J a "8/O. r ai~p T Pa 7g! 78 lyl4p 198.55 zsu
6 H
e ap 3` lop 3 ~Z@.
815 n 7+ ! y/ ( %.)k 93 D -
L
¢ r Ja a6 etn~ y 4~ `o~is 786)4-10
68 786 A 7s3 8
~ GOVERNMENT LOT 3 F
785 8 _ f/ f CsM 766 C
OVE-- ENT LOT ? 4
785 a ~ se v4 _ s
Gy v4 Ar
y^ e
791
30 _ -20
o
C~bi-Y R/IiF,p 796
8 ! tNT 4~T
IZO
14
t 83p pq E L.
344
19 _
846 785 p
AAA
_s.
~4.' " 84¢ 845
7 A
796 spa . $41 ~2.
C s /K MC. Bac A / ~ ~
.
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
1 St. Croix County
OWNER/BUYER c l't. Ml LWc I K,
MAILING ADDRESS Llo40 A,'P-AEc eec1 ~,,OaA C~ r -le FL4
PROPERTY ADDRESS I ~W)A& 1 ~-df
(location of septic system) P1 e obtain from the Planning Dept.
CITY/STATE
PROPERTY LOCATION _ 1/4, Sk) 1/4, Section i T_,3 0_N-R 2,0 W
TOWN of
ST. CROIX COUNTY, WI
B
SUBDIVISION
LOT NUM 3ER (QC
CERTIFIED SURVEY MAP VOLUME_ PAGE 5q, LOT NUMBER 333
~S-
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.
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 yeaf--e~x~iration te.
SIGNED: y 1,,-,
DATE: h~
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
S T C - 100
Y 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.
1 ( y
Owner of property
Location of property_4&) 1/4 Sl~l/4 , Section ~x `i~N-IC_W
Township Mailing address
Address of site
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 lines identifiable? _-Yes No
Is this property being developed for (spec house)? -Yes < No
Volume M,§, 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 informati.on form, by virtue of a
warranty deed recorded in the office of- the County Register of
Deeds as Document No. 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 Deed; as Document No.
Signature of Applicant Co Applic nt
Date of Signature Date of Signature
Y ~
GJC_UMENT No. WARRANTY DEED 7W5 'FA'.E R-:iCRVED FOR RECORDING DATA
STATE BAR OF WISCONSIN FORM 2 - 1982
y,~~ 1G~ ~ra~F51•8 r_
Bonnie J. Stone a single person,
JUL 6 1994
_ .
conveys rrants to William H. Scruton and Maril -R.
wa - . . Marilyn / 9:15
t~cruton husband and-wife ~ y
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ti.' following described real estate in St....CrO1X.- County, - - -
State of Wisconsin:
Tax Parcel No:
Part of Government 2 in Section 14, Township 30, Range 20, described as follows:
Lot "B" of the Certified Survey Map recorded June 9, 1976, in Volume 1 of Certified
Survey Maps, page 254, as Document No. 333465, St. Croix County, Wisconsin.
Together with a non-exclusive roadway easement for Ingress and Egress 66 feet
in width as shown on the above Certified Survey Map.
Lots 59, 60 and that part of Lot 61, Twin Springs Addition in Town of Somerset
described as follows:. Commencing on West corner of said Lot 61; thence NEly on
roadway 23 feet; thence Ely in centerline of gully to Ely corner of said Lot 61;
thence SWly 100 feet to S corner of said Lot 61; thence NWly 150 feet to Place
of Beginning.
The consideration is paid to an accommodator as part of a 51031 exchange.
A
is not
This homestead prcperty. ;yt
(is)@'u~Y' I
Exception to warranties: Easements, restrictions and rights-of-way of record,
if any.
[gated thisA 15Pim day o: _ J Uvl 19 94 .
(SEAL) (SEAL)
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it
I
(SEAL) _ (SEAL.I i!
ACKNOWLEDGMENT
i
FLORIDA
Signature(s) .!4'!.!~c STATE OF
Bonnie J: "Stone Ss.
'I tS
County. authenticated this 3.1-day o*--._-_- ne__..._..• 199-q Po-son'nVy , rn;c before nnn this 1.1y
o°
June - l9_ _ 94 - the above named
Bonnie J. Stone...
i
to me known to be the peron - - who executed the
fore * g instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY
Kristina 0 land
9......................... , RANDAtt {C. IERNR
- ---------Attorney at Law Prot. Count}, w;r.
at,
(Signatures may be authenticated or acknowledged. Both 31~ ommission .Is.'-Perniana nLl ([f no state expiration
are not necessary.)
- t
)ersons signing in any capacity should he type.l or printed below thrir sigi. L::1,1". ~ J
TY DEED STATE BAR OF WISCONSIN Wssconsln Legal Blank Co. Inc
FORM No. 2 - tv,142 Milwaukee. WKConSin