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Parcel 038-1067-80-200 09/24/2007 08:54 AM
PAGE 10F1
Alt. Parcel 16.31.18.291 D 038 - TOWN OF STAR PRAIRIE
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 - O CONNOR, BRIAN J
BRIAN J O CONNOR
1336 BEACH ST
CRYSTAL LAKE IL 60014
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 1044 210TH AVE
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 13.080 Plat: N/A-NOT AVAILABLE
SEC 16 T31 N R1 8W PT SW SE & PT SE SW Block/Condo Bldg:
BEING LOT 3 OF CSM 10/2873 13.08 ACRES
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
16-31N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1190/360 QC
07/23/1997 1112/220 WD
2007 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/13/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 13.080 87,400 189,000 276,400 NO
Totals for 2007:
General Property 13.080 87,400 189,000 276,400
Woodland 0.000 0 0
Totals for 2006:
General Property 13.080 87,400 189,000 276,400
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Wisconsin Department oflndustry, SOIL AND SITE EVALUATION REPORT Page of
Labor and Human Relations
G±vision of Safety 8, Buildings in accord with ILHR 83.05; Wis. Adm. Coda
COUNTY
Attach complete site plan on paper not less than 8 1/2 x 11 inches in sike. Plan must include, but
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. TC:>
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
i
PROPERTY OWN! • PROPER~;t.OCATION,J
r°30VT LOT 1/ V 114,S T N,R ! E (orG
PROPERTY OWNER':S MAILING ADDRESS LOT; BL # ,`SUBD. NAME OR CS #
CITY, STATE ZIP CODE PHONE NUMBER Ot CAGE OWN r NEAREST ROA
XNew Construction Use J Residential / Number of bedrooms Addition to existing building
Replacement [ ] Public or commercial describe
Code derived daily flow /SO gpd Recommended design loading rate bed, gpd/ft2__7_trench, gpd/ft2
Absorption area required 01J bed, ft2 5d3 trench, ft2 Maximum design loading rate bed, gpd/ft2 , 1 -trench, gpd/ft2
Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark)
Additional design / site considerations S~-e D
Parent material tr>' Flood plain elevation, if applicable
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING T K
U= Unsuitable fors stem XS O U S O U MS ❑ U S ❑ U ❑ S U ❑ S U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Myclaly Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
X. 16 1,4
<<::;. x
Ground
le
99 ft.
Depth to
limiting
. 161
factor
Remarks:
Boring #
LM- 14 W/
Ground
lev.
/ ?ft.
Depth to
limiting
factor
3.3 Remarks:
CST Name:-Please Print - Phone:
U~ d / 6
Address: 56
1 _
Signature: 01- ate: CST Number:
c
PROPERTYOWNER SOIL DESCRIPTION REPORT Page of
PARCEL I.D. # t
FDepth Dominant Color Mottles Texture Structure Consistence Bo~r>dary Roots GPD/ft
Horizon
Boring #
sell Qu. Sz. Coat Cola' Gr. Sz. Sh. Bed ranch
Mun
o 2 C
Ground
v.
ft.
Depth to°
limiting
~t
3•
31 Remarks:
Boring # Z 2 f /
Ground
Aa ft.
Depth to
limiting
facto'
' I Remarks:
Boring #
Ground ,,,,J{
I
Depth to
limiting
Remarks:
Boring # '
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(R.05/92)
Soil Test Plot Plan
Project Name Pamela Beckstrom Byro ird Jr.
Address 1052 210th Ave 4 ~ Z~',
Somerset Wi 54025 #3479
Lot Subdivision Date 10/7/94
SW 1 /4 SE 1 /4516 T 31 N/R18 W Township Star Prairie
Boring ()Well. PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Base of Property Line Stake
System Elevation 95.6 *H R P Same as Benchmark
210th Ave
0
L 6r- 3 --u~
B-1 B-2
1%
Pri A Slope
15' 15'
Bedroom 0 3 25' 30' B"3 30' 75' * M.
House
15' Rep A 15'
B B-5 100' to
orthern P.L.
l
n
' t ti, ~ yl
i
kR PRAIRIE PLAT
T 31 N • R-1gowner) POLK CO See Page 112 For Ailll ev
.
900 POLK/ST CROIX RD 1000 1100 _ CARDINAL DR 1200 1300
PC All- At
~ o. T--
Yod 40 at W
Randall & Douglas ^I EDAR 0 Mary Rivard c 3" tr CEDAR " Phyws STAR
o Demulling LAKE enke t
261 o 2 S NT- 2 85 PRAIRIE
CEDAR TON DR I 2
200 00 c g° DR 0 n 1
Rodney n oo t A ~?r 3 3~ SI t.
Rivard
AL4 d' a p IF a 4 5 N u
q Z 8
p Y , @,_, °1S a n a c~nst Vincent & `7 .6 b
q g$ Doreen
40 95th 128 CUa '.~F+ C~~'~ C o~ pm ~i i Wilson 80 M
0 t j Z mw 1=b 8 UN~ B
Pa~md■• L sm. tr • can & Susan - 0 20 ff` TO 1 9']- -
u 1
Meeds o 19 &S
Heintz tt
Abra-
fi 6" $I /Utrea & 38 H
uu)i 4o c JZ S 60 hamson 39 tr
13 0 .4 o { g o tr a Normm as v 8 41 Larson - u ~ 240 y DL s ~m ^ Ne!Kn t& io 12cSl 121 c•I
17 se o2
UA ~N 80 1 r F""ky 1
d&B 4 D & L 20 &J KE Mas RaDiane I c ;4. vin • N T& s 20 Fern 1 s a :o OLD MIL t3 K J & tamle•
ate 15 raac r H a s alcac- ao Parnell Me 4 M~^wn RD Dann I F n ~ Sin
lake 16 w s ET 15 34 a c " Estate 0 Gary w Ahlness t 40 cn N rmo 40
Re
V JS 41k Tel ro 6' Pemeh g Jessen OY N N~ C 24 C/I
20 Bruce dec.
y a tr a vad ~y tr L&C IS a U O O 81 = ° 40 O0 J¢ t N h di Edin son
32 N_neMolw+ey - 7 tr Z- 35 I &D
1chutte 117 _ _ 40L 40 14 40
S 221 st Richard It
cs s A„E ° s g m oMero 3 Sandor g~ w Patricia
1ta Hansen : xe>s CC i 14 N Janet t g e Anderson
o n Norman ems- I Crbdhons
s<a to Eric 120 ~ & o ce 4s'" a H Nemeth 77 3 LE 82 farm
eat s 1o Wolf 40 IL s Manta I ! :M m Scott SR chard IE Harlan C Inc
20 tr 109 m ~ eR : 3 Counter zCph1a° Vehrs
renman
Vojel 40 A O.n° S RV 13 80 ~~EP 1Si
N•enla 20 tr D7 o t wee guy Rob11 W
ert e chrUt- 15 QQ o Wallrieh B~
& S 2p ° h w Pattic & M 70 1.2 & Patsy s Estates
Larson .0
AVE Brenda w R N T 77
30rh Clarence BE Rivard T & R 20 , J & D 20 z g David Alice
koden Leona 42 Crkhton Aronson Cook Q ' ra Ewer- 60 r
40 Trust n 100 uuprMe 20 W1o R 8 I&L a a el tr I 80 135 es son 1
tr R- 15 Everett
~ & Adeline ° e •2 s 17 d 'Alice Nell Mupre~ 3 Bruce 21 V p
s roo~e 1 12 Talmage Hemen- x~- •
sl Cloutier m 23 ^t~ aw~k~ 45 way Emerson
Trust 77 0 55 B 38 , 39 way
Mary 40 40 75
Steven &
Darrell thia& T, 1, P & F s Sc FD s C U & Patricia tones 20 v
vea ° C
C
211 " Folie Germain as ~ ASP d ~ Tai a 37 80 E zo
79 127 AN Glaser Wieken' r0a
D 1!
4ark & eto Geald . w• tr trk = - Ralph & 20 ° A• I hanger 2 •M Laudc
id xe -
- Cloutier as ols6n- & & Mary ty 00 1 Dav 140
o Mary Mondor main
rud 40 7o s 33 s Rosene/ tev D 1s Railsbaek s
is
ref Anderllk/ 98 z 78 Iuof II noa v1 nts
SG s DC 9 Bonestroo I xeh - g8 t E f3
It 27 tr 4 ed. 1s Fritz ! w a CC 1
& violet r 102
Oe _ s KM a wDb 156 3_ _ 75 X14 Asplrmd 80 qtr
n 200th AVE
Gerald & '*ee - Stu &
re aenx a' it Marcella ~ I
Dan Gets 7 tr Backes s 3° trr & risty ' Genevieve
/ Trust 34 ha-Wickep- i\ 4- Francois
D M L
u) Ramona Pun a AS. & Janet 100
1--p Moulton -.2 cm,) Ls 56 DF p 1 +e1 220 remO Olson 160 195th AVE 217 21 97
Hansaus, 12, tr
ley
3S 9 Bird Caltr 40
tr n 80 meoa 40
. 3 t
M" to tr tr 192nd AVE R d St Croix
egg D
w t Myers III 103 11 • ' 40 _8_0>~ f 120 Houk 72 =
nal~ J & L 22
B ws~ & Robert - O - _ - - James& t icon O SSaoiIC C-per
Brlgh- per iiOGp b ^ Carolyn I 1 I co mea ao Co Health t Of St &k
ton 40 40 5 F. / cralg ,w 1 40 c" ~,o
>Sherman p3 I
hery & Mary Center 120 ¢ I
& Jan NR Glenn KK T L ,
Boucher OR 50 Club Inc N~ wZ
40 120 ~J
o s 158
dou Is C 'd ~1s c a r D&Pa BeM 11,
K 13 1 185th AVE ore
n 1 Russell 13 n o 1zz
STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER rQ ~
ADDRESS f a
sa~~ ~ L S y a~
SUBDIVISION / CSM# - LOT
SECTION T 3 ` N-R 1,n6,'W, Town of S~-V r Pet\,w v-,
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
15
z
o X19-
` t~
INDICATE NORTH ARROSq
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK: ~to
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: IA .4 An m Liquid Capacity: Setback from: Well (p House //c Other
Pump: Manufacturer Modelt - Size
Float seperation Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
Width: L/&Q '
2 Length Number of 1-~~ o~
Distance & Direction to nearest prop. line: 75 j~
/ i
Setback from: well: e6 House ~f Other
ELEVATIONS
'I -
Building Sewer AIA ST Inlet. ST outlet 9'7.9
PC inlet PC bottom Pump Off
Header/Manifold Bottom of system
Existing Grade q Final grade C7 1?.,5
DATE OF INSTALLATION:
'
PLUMBER ON JOB: oq=~
LICENSE NUMBER: j
INSPECTOR:
3/93:jt
10
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 Plan o.:
BECKSTROM, WARREN 0
star- pr-air-iQ
CST BM Elev.: Insp. BM Elev.: BM Description:
Parcel Tax No.:
TANK INFORMATION E EVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic / A~ 90 Benchmark '
Dosing
Aeration Bldg. Sewer o
a3 /ao~ l
Holding St/Ht Inlet ycl7 qg, a
TANK SETBACK INFORMATION St/Ht Outlet
TANK TO P/ L WELL BLDG. Airi to ntake ROAD Dt Inlet
Air I
Septic >d-51 (C), 19 ' Sa E- NA Dt Bottom
Dosing NA Header/Man. rI sa. q~, lam.
Aeration NA Dist. Pipe 7.(, V ~b
Holding Bot. System
J ea n
PUMP/ SIPHON INFORMATION Final Grade j vy g9, d,2-
Manufacturer 1 Demand cc,'-~J y
-1/1 9 21,
Model Number GPM
TDH Lift Friction System TDH Ft
Loss Forcemai n Length Dia. Fi Dist. To Well 7 F
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No.Of Tr ches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS .2 DIMENSIONS
SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACHING Manufacturer:
SETBACK
INFORMATION Type Of IYUt_~ CHAMBER
OR UNIT Model Number:
system: : /vleq
DISTRIBUTION SYSTEM
Header / Manifold Distribution Pip/e(s) / x Hole Size x Hole Spacing Vent To Air Intake
Length Dia. Length Dia. Spacing (o
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 ~~,~~r, Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
162. -.2 /O ~Wy
LOCATION: Star Prairie.16. 1.18W, SW, SE, Lot 3, 210th Avenue
'7~
'Illy
Plan revision required? ❑ Yes [t (No }
Use other side for additional information.
SBD-6710 (R 05/91) Date A(AspAt4's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH ,
SANITARY PERMIT NUMBER:
SANITARY PERMIT APPLICATION COUNTY
In accord with ILHR 83.05, Wis. Adm. Code j-, 0, V. 0 ly
#
STATE SPJVIY313
-Attach complete plans (to the county copy only) for the system, on paper not less than tC~-J~1~J) ~~~/JJ1l [k~' 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.
PROPERTY OWNER PROPERTY LOCATION
W r h ~-5 ! 1^O r1'1 .Jr-'W %4 5 g%, S T3/ , N, R 18' ) W
PROPERTY OWNER'SMAILIN ADDRESS LOT # BLOCK # _
0 02'0 A ADDRESS
J -5 Q CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
r W17 1.5fOA5 G 5 /x'1 061 ! 0 %94 -73
II. TYPE OF BUILDING: (Check one
17 ) State Owned 13 CITY VILLAGE: r : ~ n r(+t`e ou Q TOWN NEARES~ROOAD:~,~-~~'
ff~~
❑ Public N1 or 2 Fam. Dwelling-#~ of bedrooms ~ PARCEL TAX NUMBER(S)
lD6 7 ' ~a
III. BUILDING USE: (If building type is public, check all that apply) 038
1 ❑ Apt/Condo
2 ❑_Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 80 Mobile Home Park 12 ❑ Service Station/Car Wash
50 Hotel/Motel 90 Office/Factory 130 Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ® Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy
130 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
REQU R D (s q. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION
i~' v IP l AJ A- 9s~.P Feet 99Feet
VII. TANK CAPACITY Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name oncrete Con- Steel glass Plastic App
Tanks Tanks ' e structed
Septic Tank or Holdin Tank I.wO Uts Y'
Nr - LL_ _L M_
Lift Pump Tank/Si hon Chamber I L1 I F1 r7H] 0 F-1 Fj
Vlll. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Pri Plumber's Signature- o Stamps) DIP/MPRSW No.: Business Phone Number:
d4-9~. 71S )07A -XS
Plumber's Address (Street, City, State, Zip Code) :
IX. COUNTY/DEPARTMENT USE ONLY
Disapproved Sa i ary Permit Fee (Includes Groundwater ate Issued Issuing Agent Si n mps) X Approved ❑ Owner Given Initial ,(V surcharge Fee) 6
Adverse Determination
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398(R.08/93) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new
criteria in the Wisconsin Administrative Code will be applicable.
3. All revisions to this permit must be approved by the permit issuing authority.
4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be
submitted tg 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.
If. 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.
1
SBD-6398 (8.11/88)
(~4 r r ~e.`v~ i~.~ikS~cr ~ln~ ,S c,,~ -S&• +T.~/-/B~
05
/ a 57'. C wo
/LA,
Lbt.3
/3, o~ Qcre4s
43 7a a Q
Ali- I
~C
P.
l ry14
~C IIQ
~l
cis,
E/ 1160.0
Seal. /
15 63 rnpRst
w a /off`
.a 1-. C,ro 1 0
r wet Z t S a~ ° 'bklQ,~ c 50771 e~ '
✓ , fret,. Al, 11111116 And Obtorrallon Plpe
L.eT3
Minim, 12-,.Dort ADDrorl~ Venl Cap
rlnel ',ad.
20. 12' Aber, Plpr
4- Coll lion
To /Inel Oro,. Venl Pipe
►/.r►, H. Or S mM
Ik Cev er In
000 r2PO9Orepelo
Dl.lrlb•11o, . .
PID. e O O Toe
t
-AOar.o.le
Uenee111 Pip. o P.rlorole, PI
o De 8.iw
C"'All T.redn.llnl Al
dollom 01 Sr►~em
PrO 0 t D pit n ~ 9 ~1% (It
Vto..T tv/)
SOIL FILL
• DISTRIBUTIO1.1 PIPE
e
2~OF,&GGREGAII, r/~ Y `APPROVCO S`)JT14CTIC COVCR
T IA OR 9" OF 5-rAAw
OR
MARSI-
H A`i
CLEV. OF- e El;'1'~_ ~1b' lrr•0P1/Z AGGRCGATE ~p~v~
015'"RI5JTIU),1 PIPE T •'AT ~
A►JU AT LCASTLO INCHES BUTL1,10SMORC THAN y2 ES BELOW ORIGLIJAL GRADE
►JCHES BELOW FINAL GRApC
AA)ctMUM DaPrH OF EXCAVAT1,00 F40M OR16NAL
1Ux~r'1uM 69AK WILL
01=Pni OF EXCAVAT10" r'ROM g1644AL R4Pf- WILL of INCHES
6C ~ INCHES
SIGIJCO: ~ -
LIGCNSC 1.1UMBE11: ~
DATE
- • 110
W D
Wisconsin Department bons Industry, SOIL AND SITE EVALUATION REPORT Labor and Human Relations Page _ Of
'Division of ~Q.%fety & Buildings
in accord with ILHR8; 1QSj'WtS. Adm. Code
COUNTY t
Attach complete site plan on paper not less than 8 1/2 x 11 inks ut size. Plan must include, but -
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 neareat.-toad.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION-- REVIEWED BY DATE
PROPERTY OWNE PR " ARTY LOCAT40N
>w GOVT: LOT y 1/4 1/4,S T N,R /#E {or
PROPERTY OWNER':S MAILING ADDRESS LOT # ~EOCtC # SUBD. NAME OR CS #
CITY, STATEg ZIP CODE PHONE NUMBER CC1TY - I LAGE OWN NEAREST ROAD
,KNew Construction Use Residential / Number of bedrooms [ ] Addition to existing building
j ] Replacement [ ] Public or commercial describe
Code derived daily flow gpd Recommended design loading rate , 7 bed, d/ft2
gp yQ_trench, gpd/ft2
Absorption area required 613 bed, ft2 Sd3 trench, ft2 Maximum design loading rate , bed, gpd/ft2_-Ltrench, gpd/ft2
Recommended infiltration surface elevation(s) S, ft (as referred to site plan benchmark)
Additional design / site considerations
Parent material 0LC0_,XAZI Flood plain elevation, if applicable k/ ft
rU:= table for system cpNVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING 4I
NK
suita ble fors stem j$1 S❑ U S❑ U CMS ❑ U I S❑ U E3 S U E] S U
SOIL DESCRIPTION REPORT
'
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Clu. Sz. Cont. Color Gr. Sz. Sh. Bed
Trench
Ground 3 7 eJ
q~le
f ft.
Depth to
limiting
factor
-3.7
Remarks:
Boring #
3 LM- "Oro
D O~
Ground
lev.
ft.
Depth to
limiting
facto
3,3 Remarks:
CST Name:-Please Print L Phone:
Address:
1
Signature: ao' ate: CST Number:
12 7- q1 ~~24
PROPERTYOWNERirc~lsr~/~sf.- SOIL DESCRIPTION REPORT Page-of
PARCEL I.D. # '
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench
1
. s 11(
IfIlY Ground
Z ft.
Z
Depth to
limiting
fact
3, 1 Remarks:
Boring# .Ile
-i 11,7qA~ o&~
Ground
ft.
Aa
Depth to
limiting
facto
lid
" I Remarks:
Boring # e ,
Ground
I
99 ft.
Depth to
limiting
y Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(8.05/92)
Soil Test Plot Plan
Project Name Pamela Beckstrom Byro ird Jr.
Address 1052 210th Ave ,
Somerset Wi 54025 6prm #3479
10/7/94
Lot Subdivision Date
SW 1 /4 SE 1/4S1 6 T 31 N/R18 W Township Star Prairie
Boring O Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Base of Property Line Stake
System Elevation 95.6 *HRpSame as Benchmark
210th Ave
g
b
r
B-1 B-2
1%
Pri A Slope
15' 15'
Pro 3 Bedroom 25' 30' B-3 30' 75' * M.
Ouse
15 Rep A 15'
B- B-5 100' to
Northern P.L.
0
1
s FILED ~
JAN 2 5 2
8 ~►llium N. W 110
5~5~5fi Reclstera 3 AL%l
L St C~ O'!
CERTIFIED SURVEY MAP
Located in part of the SW} of the SE} and in part of the SE} of the
SW}, all in Section 16, T31N, R18W, Town of Star Prairie, St. Croix
County, Wisconsin.
OWNER NOTE
Warren Beckstrom ® 3/4" Iron Pipe Found N02°04'13"E, 2.21 feet from
1052 210th Avenue computed position.
Somerset, Wi. 54025
LANDS
~
North line of the SE$ of the SW >i UN PLATTED
N89°45'33""W North line of the SW% of the SElt N
25.50' N89 °26'24"W 663.09' 7 1-
pp l
e1 C a lot
d 7' w
i q
I e 13.08 Acres Inc. R/W IL a
569,871 Sq. Ft. 1'U o o
X 12.80 Acres Exc. R/W
~c g c o ~
x ? w 557,627 Sq. Ft. Irn N ,
a °m 3 'o
C - C = N89°32'03"W ld WO 00 It
-n 0
0 A C p 330.001, el I r- N B C ~
Ct n C N LOT 3 ~o AemIIzv w, :
n d o~ c c. A ro ( o m `I
n• rr A a rt coo -+I w ~r I
r, rt g:
LOT 2
S r
N 3 7.49 Acres Inc. R/W
o 326,370 Sq. Ft.
o► c H w 7.21 Acres Exc. R/W r
314,215 Sq. Ft. c
O ~ 0
N ~ ~ C ~ A I
_ 7 T I
DER i IFIED SURVEY SHEDS n cnttaa!( LOT
MAP [3
CERTIFIED SURVEY
VOL. S g
PG. 1152 H0!SE MAP
SEPTIC
VOL. 7
N89°4 1 " . -
SW Ccrnor •25 50 1 G. 2t7? 5
W . W „W
ti.:• • i ri dp
Section 16 W LJI
S8905812911E in 662.641
N892648.441 g
t~l . - - I P-Lar- 332.63' 330..1' 589°32103"E
m
6 O p a 1987.83'
332
, 14
N89°49'3911g S$9°32'03"E 662.61'
25.50' South line of the SEQ.------ ~ SE Corner 1
/South 1 i ne of the SWlt Secti one~6 • 2-10TH AV - i J U E Section 16,
LOT I R :•.'.'•.="JR~'r4. -TED LANDS
CERTIFIED SURVEY MAP
VOL. 9, PG. 2S93 `"C~ , u 4', `j • ` R' tr. ,F
Sd-ALE IN SF.Ef
Sie.
WIS.
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: sMOTTO; sg pagT.zosaP sT paddgw pug paAaAans
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Aga.zaq '.zoAeAans pugq uT.suoosTM P8a9I TB9~ 'uaSggAH • 0 uaTTV 'I
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER CL~ tJ E [~E c u.,~rr,~ nn
MAILING ADDRESS 105-2- '2. t a T1,V -YG . , SC M '0_2-~ , 1~1 5 4a2S
PROPERTY ADDRESS /0 #y 'L 1 o l-4 _NV E
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE 'e2oM<"V-Se / W1 54oZS-
PROPERTY LOCATION '5\N 1/4, SE 1/4, Section 1 to , T 3 I N-R W
TOWN OF 2! pLln4 E ST. CROIX COUNTY, WI
SUBDIVISION t -;L LOT NUMBER
CERTIFIED SURVEY MAP , VOLUME '01 , PAGE 99, LOT NUMBER 3
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 year expiration date.
SIGNED: 1k) 9411, G, rs e.G1Q
195"
DATE: Tdh. 36,
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
r
STC-1.00
This application form ~s to be completed in full and signed b
the owner(s) of the property being. developed. Any inadequacies
will only rESUIt ~n delays of
the permit issuance. ,Should this
development be intended for resale by owner/contractor,(spec
house), thenla 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 VVP-[z1z(1 -
Location of property_1/4 5G 1/41 Section N-R- ib,.W
Township 5rtq~,. Pn_A ta4 !
Mailing address 10 r, 2laTN .arc
•~oMaL 54 o~.C
Address of site _ 'L t4TYc
Subdivision name 6.1-5 M 7.3
Laawitjol ro,padli Lot no.
Other homes on property? yes X No
Previous owner of property C~oy_
Total size of parcel
Date parcel .was created
'Are all corners and lot lines identifiable? xYes
No
Is this property being developed for (spec house)? Yes X No
Volume -1and. Page Number 0_1 as recorded with the Register
of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A WARRANTY DEhD which includes a DOCUMENT NUMBER, VOLUME AND PAGE
NUMBER & 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. 390354 , 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 County Register of deeds as Document
No.
3g8 3S4 .
Signature of applicant Co- plicant
:tav,, 3C
Date of Signature
D Ate
of Signature.
U-1
DOCUMENT NO
~j y r STATE BAR OF WISCONSIN-FORM 2
• "t k VOL 1 PAGE' 07 .WARRANTY DEED
Q THIS SPACE RESERVED FOR RECORDING DATA
R6GI1iTERS OFFICE
Peterina Cook a/k/a Petrina Cook, a`widow, ,
r' ST. atax CO., WIS.
Rec'd for Record this 5th
conveys and warrants to Warren F._ Rankaf-rnrn and day Dec -A. D. 19 84
^I"* t-m.-hi-lZband and wife;-2s at 12:30 P K
lolnt tenants, ,
hsbtw DDwd•
RETURN TO
'the <following described real estate in County, I- D
' State of Wisconsin: /~~E~„ ~IC K Mc~N ~ . h/•T- F-Tax Key No.
East Ialf"~of:.the Southeast Quarter of the Southwest Quarter (F' SE'hSWh)
and tYe`-,,Weet half of.the Southwest Quarter of the Southeast Quarter
(WhS~A SE'~d r all' in Section `16-31-18.
This~ldee' is{; 'given in satisfaction of the land contract; dated
Septembe 1969141%recorded'September 9, 1969, in volume 455 of
Deeds age'; 40 and''~,41, as document number 297771.
11 14; r
+ A ~ n
r r
i Fri , +
This homestead property
r"''','. , r}' Yy'y'
Exception o4 rranties:
Dated this day of - , 19 0
(SEAL) ~'~''"''t~ - • (SEAL)
Peterina Cook a/k/a Petrina Cook
(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signatures authenticated th's ' =iay of STATE OF WISCONSIN
,AjGi1 19g SS.
St. Croix X _ounty
Personally came befozeme, t i:s dAy of
* /41 on1 tv~N the above named
TITLE: MEMBER,ISTATE BAR OF WISCONSIN Peterina Cook a/k/a Petrina Cook
(If not,
authorized by § 706.06, Wis. Stats.)
I
This instr'umeet'was drafted by
Warren W..Wood, Ltd. to me known to be the person- who executed the fore-
P . O. $OX ~;+9 9 going instrument and acknowledged the same.
~~Ptiris- P enA' «I. 5A (Q 7
' Z jNJ Y
(Signature
s'.'may {se siuthentlcated or'acknowledged. Both
are not ntcessaiy.'''°~ R Notary Public Croix
Cdunty, Wis.
My Commission is permanent. (If not, state expiration
7 Ai I
WARRANTY Dgifii4tig BAR OF WISCONSIN, FORM NO. 2-1977 ..t