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HomeMy WebLinkAbout038-1170-10-000 oo p a ~ ~ I V G Q N h y "Q I St ~ Z C lL c O ~ I Q Cl) z yj E o 0 'a I z d m M w d m c o I o z v °c U d Z v ° C O H a z 7 Cl) ` _ N N O 01'•1,1/ ` O O N Q Q' O (n I •AJ d U) L O Q 0 ~ o Q ~ I N ~ zco z ~ U) 2 6 O ° E E N a~ LO Y i g C m c C) c d G a c ° N = 3: 3' 3r U " 0 0 0 0 o FL 3 g Q) ~ c ~ y rn rn ~ fq J V ~ O O } MV N Y (n 00 0 ° w _ m d N N 'O d Q N C 0 3 y c o o E ° co f- F- o a15 ) c 0) °o r \ 00 O- 'c O 'p N v MN 3 M C O O O O N _ O 00 c" 2 c O O C6 Cn I E N O N ~ ~ {n T .r xt n w R a F) 2 y a rw E t A U d 2 O ~ n U 7 -,STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS SUBDIVISION LOT # -ell SECTION /.;?_T _"3/ N-R eL W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW E rERYTH1ERYTHING WITHIN 100 FEET OF SYSTEM sy ~ rS/3 y" INDICATE NORTH ARROW Provide setb k and elevation information on reverse of this form. Provide 2 d mensions to center of septic tank manhole cover. ~M r BENCHMARK: ? ~r ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: Liquid Capacity: Setback from: Well ' House Other Pump: Manufacturer Model#Size Float seperation Gallons/cycle: Alarm Location -:SOIL ABSORPTION SYSTEM Width:_ Z -Length S Number of trenches Distance & Direction to nearest prop. line: r Setback from: well: _ House Other ELEVATIONS Building Sewer ST Inlet ST outlet PC inlet PC bottom Pump Off Header/Manifold Bottom of system Existing Grade ~~yl Final grade DATE OF INSTALLATION: PLUMBER ON JOB: , J LICENSE NUMBER: INSPECTOR: 3/93:jt Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Permit Holder's Name: ❑ City ❑ Village Town of: State PI o JARCHOW, JOHN a CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 00 Dosing 1311") _1Z-77 /dU Aeration Bldg. Sewer 4.9 Holding St/Ht Inlet ~7, TANK SETBACK INFORMATION St/ Ht Outlet 1~77 Verit TANK TO P/ L WELL BLDG. AirIto ntake ROAD Dt Inlet Air Septic >as / 5=2 / 0~_Z O ~ NA Dt Bottom Dosing NA Header / Man. /OS, V// Aeration NA Dist. Pipe g ' /Q S 32 Holding Bot. System ' ~v q, PUMP/ SIPHON INFORMATION Final Grade 6-.1-71 /074 Manufacturer Demand 167.73 Model Number GPM TDH Lift Friction System TDH Ft Forcemain Length Dia. If Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS / y DIMENSIONS SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type O CHAMBER Moe Number: System: 3y</ OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded TE] x Mulched Bed / Trench Center Bed / Trench Edges Topsoil Q Yes ❑ No Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: Star Prairie.13.31.18W, SE, SW, Lot 4, Star Dusk Drive r Plan revision required? ❑ Yes Erllgcc _ Use other side for additional information. (J%3 r., .V (o Z SBD-6710 (R 05/91) Date spector s Signature Cert. No. r ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: - Safety and Buildings Division v~.~f,1iR SANITARY PERMIT APPLICATION Bureau of Building water systems 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Permit Number aVo 773 The information you provide may be used by other government agency programs ❑ Check it revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Propert Owner Name Property Location :54F1 14 Stc~1/4, S j_T T , N, R E (or) Property Owner's Mal in A dress Lot Number Block Number Cit tat44:~ Zip Code Phone Number Subdivisio ame r CSM Num r f- 1 I ( , ~ I. TYP BUILDING: (check one) ❑ State Owned ❑ CNearest f3oad ❑ Vil age / Public 1 or 2 Family Dwelling - No. of bedrooms _ Town OF 111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 2 Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel / Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. ;g New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5- ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 1 1,Ef Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 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./i h) , Elevation Feet eet VII. TANK Capacity INFORMATION in gallons Total # of Manufacturer's Name Prefab. - Fiber- Plastic Exper. Gallons Tanks Concrete Con- Steel glass App. New Existing strutted Tanks Tanks Septic Tank or Holding Tank El El Lift Pump Tank /Siphon Chamber ❑ ❑ 1:1 1:1 1:1 VIII. RESPONSIBILITY STATEMENT c I, th ndersigned\ a me responsibi ity fo inst la n the nsi sewage system shown on the attached plans. JPlue' Name (P PI limb s Sig ~Stam MP/MPRSW No.: Business Phone Number: 1 Plum ,be, ddress tr e , City, te, ip o IX. COUNTY/ DEPARTMENT USE ONLY Tit Signature ture (N am ❑ Disapproved Sanitary Permit Fee (includes Groundwater aE:~2= Surcharge Fee) Approved F] Owner Given Initial /A Adverse Determination l~ X. COND ITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Divr ion, Owner, Plumber INSTRUCTIONS F 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe renewed before the expiration date, and at a 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 and 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 on 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 for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/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 receives experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number wi .h 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 specificatiorss not smaller than 8 1/2 x 11 inches must be su.~nitted t,-+tC,,unty. T!rie plans must i-ociude the following: A) plot plan, drawn to scale or with complete dir~-ier,siom,~loc,,tr.:r~ 'nG, ding tank(s), septic lo -Ik{s) o, other treatment ranks, building sewers; wells; water mains/wrjt, ce ,'r( i rc lakes; pump or siphon tar:k ; u t ibution boxes; soil absorption systems; replacement system area;.... tt C 4,- the building served; ztx~ral and vertical eievocion reference points, C) corplete spe+ for _ur;.p, :~oritrols; dose volume; e e4,;t;on di `terences, friction loss; pump performance curve; pump model ,arc rump r ~nufC:+c Arer; D) cross section of ulse soil absorption system if required by the county; E) soil test data on a 115 or m, ar:d F) ..-111 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 contamination investigations and establishment of standards. t~En /silt= ~,71)~5~/~= !e9/~ moo, . G~ ta• IeA; i Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of Labor and Hurrtan Relations Divisipn of Safety 8 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 a 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 PROPE TY OWNER: PROPERTY LOCATION ' GOVT. LOT ` - 1/ td 111,S/ T N,R ~'(orN P P RTY OWNER':S M LING ADDRESS L531 I BL CK# SUBD NAME R CSM n Z AT CI STAT ZIP CODE PHONE NUMBER ❑CITY VILLA XOWN INEARE-ST ROAD kl~ New Construction Use K] Residential / Number of bedrooms [ ] Addition to existing building j J Replacement [ J Public or commercial describe • Code derived daily flow gpd Recommended design loading rate ~ 7 ed, gpd/ft2-,-,? -trench, gpd/ft2 Absorption area required bed, ft2, 5-/*, _:r trench, ft2 Maximum design loading rate --L-bed, gpd/ft2, S _trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerati ns Parent material Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable forSys m eAS ❑ U S❑ U ®S ❑ U Jos ❑ U ❑ S X U ❑ S O U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundety Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench kv: Ground elev. /rte ft. Depth to limiting factor Remarks: Boring # - a ZY i --X Ground elev. /,:D;r L ft. Depth to limiting factor Remarks: CST Name:-Please Print Phone: ,S Address: O Signature: Date: CST Number: PROPERTY OWNER -Id/L SOIL DESCRIPTION REPORT Page-::2 Of PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourclary Roots GPD/ft in. Munsell Qu. Sz. Cqnt Color Gr. Sz. Sh. Bed Tw& Ground l ' - elev. . Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) sfr aTi' a2s` ~ ag' • 507Ar96 f~ 1EADOWWS FIRST A®®-LT-10N LOCATED IN THEA LEGEND SW 1 /4 AND SE 1 /4 SW 114 • OF_NOTES 1 1/4' X 30' ROUND SOLID IRON BAR SET. E C T I O N 1 3, T 3 1 N. R 1 8 W, NEIGHING 4.173 LBS./LN. FT. O DENOTES 1' IRON PIPE FOUND STAR PRAIRIE, ST. CROIX CO.. WIS. 0 DENOTES 2' IRON PIPE FOUND 0 DENOTES 3/4' IRON PIPE FOUND 6 6 7 TO ONE (1) COMMON ACCESS POINT 0 DENOTES 4' DIA. ALUMINUM CAPPED ST. CROIX CO., KEEN LOTS 6 6 7; AND RESTRICT LOTS 4, 5, a, COUNTY SURVEYOR'S MONUMENT FOUND. AND 18 TO ONE (1) ACCESS POINT AS DESIGNATED UTILITY EASEMENTS DENOTES ACCESS POINT FDA PRIVATE DRIVEWAYS SSESSOR, USER, NOR LICENSEE, NOR OTHER PERSON (NORTHERN STATES POKER COMPANY) 19 ICULAR INGRESS OR EGRESS WITH C.T.H. 'C'. (ST. CROIX TELEPHONE COMPANY) ALL OTHER LOTS CORNERS ARE STAKED WITH SHOWN ON THE PLAT, OTHER THAN BY NAY OF THE _ L07 LINES hh---- 7 3/4' X 24' IRON PIPE WEIGHING 1.13 LBS/LN FT LANDS ~Y OTHERS r SCALE. 1' - 100• - - NORTH LINE SW-SW 6 SE-SW 0' 50' 100' 200' 300' 400' 26' _ 230.00- - - - - -200.00' - 200.74' - T - 374.61'----- 5.88151'11'E. 1524.04' _I 9: B 12 0 13 o N 48.095 SO FT. pLLI d ---'D< --o 85.948 SO. FT. - 14 1.10 AC. m 1.26 45 ACI.. ry 63, 196 SO, FT. Z - 'A a 1.45 AC. .P 16 q A., $ + / 49, 759 SO. FT. i O so -174. (20; 1.14 AC. o 1p!~N ~2. 00' 26) 3g .2.% (19J A. J U 01 '!!'E 267.00' N (9) * b t61 w' ~7.12'f0'E I V i 248.50' Y -LSe. CB o0, If rd i \ I W KOI slri er ciw~_ O0• (Ilr I W a.v 17 11 0! p N 69.094 SO. FT. O p rori \ ~j\ 10~ i~ 1 8 u 1. 59 A C. \ op A ✓ \ \ 57, 426 SO.FT. .32 AC.~ of 5 " 11 1 90. 393 SO. FT. 90, 726 SO. FT. / ~ a \ r ~ J i 2.09 AC. ,'2.08 -2BB, 00'_-.-.- 208.13'- A. RAEFAGE NBB '34' 10'W 496.13- F W., I EASEMEN71 1 - - - - - - - -ARE[ N o r04 .1\) ~no• ..or r : 6 T71o» are no oOjeCt:on; to thin pt,a r•i;: , resD-a ;u c E ENtt to 1# tic 1t.6. eMi 1 1110 VYIa AdmnO and 236.21 Code as (W3 cs;ats and ILHR Z5 of LOT 1 • logs r ~0 u.' I ` I Provided 236.12 (6). wi Siam I - - - 1-j pO _C _S M . TORN I 3 NBB•34'SO'W 336.0 Certified thia.l~ day of„Oa~r.....1A9 V. 3, P. _73_9_ 9£Nt;'H N4gX N n) rOP OF / - /HON PIPE \ I tOQ ECEV c 991.71 152.30'--I "N US.G S. O4 rUN DT.IftrtnNM of Aprteultun/. Trade i COPSUnNf Pruteefion LOT 5 ' v - in C. S. M. m o ~ V . 9, P. 2467 0 ' - o X - - w a~ A a LOT 1 w o iD C. S. M. 3 VI ^ o V . 7, P. 2029 I ~Iro~ in OW_S I Tit (0 N1 I o I 0 I a' 2 96 pl ~I -i l u l C71 > I mep ~ NN X22, ~g AR C7) S88 *51 '11 "E 267. 00' 4 (81 r 4' \ o / \ ` ~f= 109.00- 82 -15820 Ss (9 X2 S) 9e 6 / / T~ .00 - - - 9 De . 00,/ ' / ~15i ' 30 W/ DE A. P, ` IO~SS \ 99 0 6 ' - W f - DOyr'~ ✓01NT DRIVEWAY \ (23~ EASEMENT r0 0e . LOTS 6 & 7 6B 99. 114 j rA~ 00, 4~1I Q) 57 6 90.393 S0. FT. 90, 726 SQ. FT. °I I n S 888 034 - r0 -w - - 1,210' n L 1 20 119,032 SO. FT. 2.08 AC . 2.08 _ 12, (13 0 L - 2. 73 AC. Z Q. C. G E DRAINAGE i EASEMENM I REA fo_ AN 9e6M (30' wrOE) 66 Q TO 11p p1U m E0T10 I EL SSG S p RE t BELo u STORM vqA 6' -I 3 N88 34'10"W 336.01' I~ ey BENCH MARK TOP OF I " IRON PIPE 304.60' (0 EL EV = 994.73 _ 152.30'-___ U.SGS DATUM 14881 44 '00 "W 4561.90' °o~ LOT 5 v co - co ' o r I I V. 9, P. 2467 0 I I ti N co F- - - N (D to i I o (D 2 3 NT I c N' U) UNlTRY MEADOWS " UN TRY - 0 o ~ 5, PA PE 96 I i OI - co COO - - - N. 88 0 3 4'10 " w W. STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER Jo~v~ 57 Ltv-c~ ~arc~ec~ MAILING ADDRESS Lz "C - P-S--PROPERTY ADDRESS /3-2 ts- (location of s^epctic system) Please obtain from the Planning Dept. CITY/STATE `6 -P_ r K 1 M M-Lc( , LO / -S-4 / ~ f PROPERTY LOCATION~,6- - 1/4, 1/4, Section T_,_~N-R_ZL_W TOWN OF q r ~ra ri C ST. CROIX COUNTY, WI SUBDIVISION ~.o c h YYje cG o w S - s ~A elcF; LOT NUMBER_ CERTIFIED SURVEY MAP , VOLUME , PAGE LOT NUMBER Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if 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 com leted and returned to the St. Croix County Zoning Officer within 30 days of the three a xpi at SIGNED DATE: 9, q~ 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 :106 S, LlrQ 74re-,6to Location of property 1/4 1/4, Section _ ,T_?/ N-R Z8! W Township f9mrPe_ Mailing address '7A(, _7,OA 5-~-. Address of site 1-of # (,vc~n l/Y1 ~-E-,` /3 aster ,(~C ~.Y~'t'u VYl ecc.c( cs-w S L.~~ 5~ Lot no. Subdivision name Other homes on property? -Yes No Previous owner of property lql je vj 1- . L" vide 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 AZZ 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 in the office of the County Register of Deeds as Document No. S©S 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. #tu e f Applicant Co-Appli t 71, ".2 F Date of Signature Date of Signature ,91&i'lASni A?rATlielf►~! Slate Bar of Wisconsin Form 2 - 1982 i 532'U~8 WARRANTY DEED DOCUMENT NO. voi.1133Pa GE49&-_ i .~.,V;1 S7. CPO;'' CJ ` Recd fof P4=rJ Allen L. Lunde, a married person, AUG 2 1995 ' Et 2:30 P.M conveys and warrants to John L. Jarchow and Laura Jo Ree!a;sr of Cesds Jarchow, husband and wife, J`= THIS SPACE RESERVED FOR RECORDING DATA NAME ANC RETURN ADDRESS John L. & Laura Jo Jarchow 726 72nd Street the following described real estate in St. Croix Somerset, WI 54025 County, State of Wisconsin: J ~ I 4 lpANSL (Parcel Identification Number) it FF-B II Lot 4, Country Meadows First Addition in the Town of Star Prairie, St. Croix y I County, Wisconsin. II I I i 1 41. V I a ~I I _ This is not homestead property. Z (is not) +ti Exception to warranties: Easements, restrictions and rights-of-way of record, if any. Dated this uo day of July '1995- (SEAL) (SEAL) un e aAllen L L. ~Ld f (SEAL) (SEAL) r. I I AUTHENTICATION ACKNOWLEDGMENT Allen L. Lunde STATE OF WISCONSIN SS. cODnly. day of July 19 95 Personally came before me this day of a!• 19 the above named $ c• Sd land SATE BAR OF WISCONSIN authorized by §706.06, Wis. Stats.) to me known to be the person who executed the foregoing instrument and acknowledge the same. r THI!~ INSTRUMENT WAS DRAFTED BY ' _Kristina_ 0g_land _ y Attorne lv at L-aw Notarv Public County. Wis. t g (Signatures may be authenticated or acknowledged. Both are not My commission is permanent. (If not, state expiration date: V necessary.) _ , 19 ) 4 'Names of Pear r agmng in any capacity should he typed or primed blow their signatures WARRANTY DEED SLATE BAR OF WISCONSIN Wisconsin Legal Blank Co. Inc Tl I FORA No. 2 - 1982 Mdwaokee. Wis 11 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 HUMAN RELATIONS \ / MADISON, WI 53707 - j.,• ~p (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: TO NSHIP/ NICIPALITY: LOT O.: BLK. NO.: SUBDIVISION NAME: -.e'/so% 13 /T 31 N/R/,?E (or►W COUNTY: MAILING ADDRESS: x 6?3- 9'z- 4? Jr 8 d z USE DATES OBSERVATIONS MADE IND. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence 0.- New ❑Replace Z 2- Z pQ a 8 1950-3 RATING: S= Site suitable for system U= Site unsuitable for system / 7J ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM•.(opt' nal) S CU ®S CU ®S CU CIS ®U CS.©U If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST. HIGHES TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) C7 Z"Bl/, /z-Z'/-'C.on.~.'~ zb-Yo ',t.&.7,s B- f 107. 3S > 89 d -moo" '10114J ~0 83 83-69^ 8 - - B- z 89 jUS.~ >80 '4l/- ~ •,r.s G p - ~v ins B- 3 x. D,/ s 'l 8- 3 9 •F . 6n.J g- - -3 B- 06. QS o- /Z" z - Yo, .C.64-3" 1 30- F W - 8o `mss. 6b - 69 _7S B- S 8o o S . > 8o a / 7- y en .s. - , '4 y- 39 s. B- Rv as 3 8,0 3 - INJ 4 / - 8a ' PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PER 10 PER INCH P_ 1 Z-- / D / / i P- z 1 e 7 P- 3 Z 8 P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. 3. SYSTEM ELEVATION y_ - , - E - - - _ 1 T 1 f t i . o- . , E 0-.1 ~11 3 i -44 ~ - - 3 o 4- AVM' °f. a~ TN T jr Z- 1 34K / Z 10 ! z _ I 112 i i Alk I; the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the proced %beh meTh s(jci~ie n the WiW-o iAdministrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge an 9z „K Zv NAME (print l: TESTS WERE COM D ON: OvTr (20 r ADDRESS: CERTIFICATION NUMB P NQM1~ optional): ~/3- 1 Yv f c J- ?2° Y CST IGNATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) - OVER - r INSTRUCTIONS FOR COMPLETING FORM IIS - SOD - 6395 To be a complete and accurate soil test, your report must include: < 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 3. MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement system: S. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing scale is prefered. A separate sheet may be used if desired; 6. Make sure your benchmark and vertical elevation reference point are clearly shown, and are permanent; 9. Complete all spropriate boxes as to dates, names, addresses, flood plain data, percolation test exemption, if appropriate; 10. If the information (such as flood plain, elevation) does not apply, place N.A. in the appropriate box; 11. Sign the form and place your current address and yur certification number; 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st - Stone (over 10") BR - Bedrock cob - Cobble (3 - 10") SS - Standstone gr - Gravel (under 3") LS - Limestone 's - Sand HGW - High Groundwater cs - Coarse Sand Perc - Precolation Rate med s - Medium Sand W - Well is - Fine Sand Bldg - Building Is- Loamy Sand > - Greater Than 'sl - Loamy Sand < - Less Than 'I - Loam Bn - Brown - Silt Loam BI - Black si - Slit Gy - Gray cl - Clay Loam Y - Yellow scl - Sandy Clay Loam R - Red sicl - Silty Clay Loam mot - Mottles sc - Sandy Clay w/ - with sic - Silty Clay fff - few, fine, faint 'c - Clay cc - common, coarse pt - Peat mm - Many, Medium m - Muck d - distinct p - prominent HWL - High water level, surface water Six general soil textures BM - Bench Mark for liquid waste disposal VRP - Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department may request verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a permit. The sanitary permit must be obtained and posted prior to the start of any construction. ST. CROIX COUNTY WISCONSIN ZONING OFFICE "1 p p ■ rrrri ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 October 27, 1995 Hartman Homes P.O. Box 326 Somerset, Wisconsin 54025 ATTN: Becky RE: Septic mnspection for Property Located at 1325 Star Dusk Drive, New Richmond, Wisconsin I Dear Becky: An inspection of the septic system for the above address was conducted on October 4, 1995. This property is located in the SE; of the SW;'of Section 13, T31N-RlSW, Lot 4, Country Meadows First Addition, Town of Star Prairie, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a three (3) bedroom home. Should you have any questions, please do not hesitate in contacting our office. Sincerely, Ma y Je ins Assistant Zoning Administrator St. Croix County, Wisconsin mz