Loading...
HomeMy WebLinkAbout010-1078-70-010 ~ ~ o I ° 0 ova I d ~ o I o ~ a~ I O U N 'a I M O E Q1 x Its I ~ € I a L I ° z E I c U. c ~p-DO t I O U N 3 0 a 0 z° E I v y Cl) I Z y I cD Z j = c I z `m m co U) o I c t9 o z d ~ ~ y I d Z z U) E o N M I ~ z z o ~ I N z ao ~ N I R ~y ~p N y ~ y C O ~i coa CD U) U) (1) El z •N ~aaIa v a c N J U~ 9 It ~ N a~ o 00 m y O JE cc O o o I' ~ ~ I r N O E O U y O d O O O O 0 > N C CL C A N 01 V co ~ O C C E ° too r- M v o y °c d C N 0Dm 0.4 Y `ry)' CO • ~1 O M W N O Z N fun) O ~ I rig m € a #t EL : a I • a d 2 d ee c y ~r-ww i ~1 A ciao' ac°~ t Parcel 010-1078-70-010 03/31/2006 09:55 AM PAGE 1 OF 1 Alt. Parcel 32.30.16.478B 010 - TOWN OF EMERALD 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 - DOUGLAS, BRUCE G & JUDITH A BRUCE G & JUDITH A DOUGLAS 2264 CTY RD DD BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 2264 CTY RD DD SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 25.130 Plat: 4418-CSM 16/4418 SEC 32 T30N R16W LOT 1 CSM 16/4418 Block/Condo Bldg: LOT 1 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 32-30N-16W SE SW Notes: Parcel History: Date Doc # Vol/Page Type 09/03/2003 738602 2398/206 WD 12/11/2002 701867 2077/169 QC 1089/589 WD 962/269 2005 SUMMARY Bill Fair Market Value: Assessed with: 80559 161,200 Valuations: Last Changed: 10/19/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 15,000 82,700 97,700 NO UNDEVELOPED G5 7.000 10,500 0 10,500 NO PRODUCTIVE FORST LANDS G6 16.130 40,000 0 40,000 NO Totals for 2005: General Property 25.130 65,500 82,700 148,200 Woodland 0.000 0 0 Totals for 2004: General Property 25.130 65,500 82,700 148,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 124 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 r.. A r✓ STC - 104 AS BUILT SANITARY SYSTEM REPORT JO11~ OWNER -2DC2 v/~0/ ADDRESS GZCfy 7•fJ11 -~-J~ SUBDIVISION / CSM# rr /LOT SECTION .3? T 30 N-R W, Town of Z;i 2erc? /GY ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM tf. INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. i BENCHMARK' Co ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING..TANK INFORMATION Manufacturer: P,SPr,~ Liquid Capacity: /ob0 Setback from: Well 175 / House ~Q Other Pump: Manufacturer 611or?/(> Model #Ls)Z- C)3' L Size / Float seperation Gallons/cycle: 141 Alarm Location j~,~,ale,- Z~g,/," :SOIL ABSORPTION SYSTEM > Width: -7', Length ?V , Number of trenches Distance & Direction to nearest prop. line:?/o 5ou-7'~ Setback from: well: 2-05' -o 5House /00 , other ELEVATIONS Building Sewer ST Inlet; ST outlet /n ~PC inlet /IQs, PC bottom 4U/.Pump Off Header/Manifold Bottom of system '7, 75 Existing Grade IDS-715 Final grade DATE OF INSTALLATION: 1 PLUMBER ON JOB: fYuo,~-ar- LICENSE NUMBER: Mp ~l INSPECTOR: ; /fjo/I'J SOI'~ 3/93:jt a v~al JOT BOLDT'S PLUMBING & HEATING, INC. 820 MAIN STREET BALDWIN, WISCONSIN 54002 (715) 684-3378 FAX (715) 6843144 z9~ y, /zoo N~ ~y. 3~. a, idoo~4/, 391 PC. SePi' e- 33' ~~X 52 obs10 Nome a 300 'to ~~lL/p y WisconsinDepartment of.Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Buldings Division (ATTACH TO PERMIT) Sanitary Permit No_: GENERAL INFORMATION 224629 Peby H 16,N6Nan)%AVID ❑ City ❑ Village IR Town of: State Plan ID No.: Emerald CST BM Elev.: , Insp. BM Elev.: BM Description: Parcel Tax No.: 256 TANK INFORMATION ELEVATION DATA P p AS TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic / - Benchmark Dosing Aeration Bldg. Sewer 09 Holding St/ Inlet T TANK SETBACK INFORMATION St/#E Outlet <r d 6,1 ' TANK TO P/L WELL BLDG. AiirIntake ROAD Dt Inlet (j )9 Septic ; NA Dt Bottom / 6; 9 Dosing04- NA Fir/ Man. bpd~'~ / Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade - Y/ Manufacturer 'CYO Demand 76 Model Number L~JEd~3//G ~GP TDH Lift Friction I•'~f System TD p~t Ft Loss Head Forcemain Length tJ 9, Dia. a " Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width / Leng / No. Of Tr nches PIT No. Of Pits I ia. Liquid Depth DIMENSION DIM ` SYSTEM TO P / L BLDG WELL LAKE/STREAM LEA nufacturer: SETBACK MBER INFORMATION Typeo la--.) , Moe Number: System: /yam✓?~( ~'<;i / OR UNIT DISTRIBUTION SYSTEM Hem/ Manifolda-rd Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length 5L2 / Dia. Spacing 214- yc/ y "1 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Deer Depth Over xx Depth Of / xx Seeded/ Sodded xx Mulched f-::: ~ch Center xr .B,ed-t-Trench Edges Topsoil ~ C] No E] No COMMENTS: (Include code discrepancies, persons present, etc.)-µ.cl I ~LOCATION: E erald.32.30.16W, SW, SE, County Ro~Ld,DD 05 L,-n 9r', i Plan revision required? ❑ Yes Use other side for additional information. 8 1~ / SBD-6710R 05i91) pector s Sign atu a Cert. NO- ~ ~ ~ - ~ Date Ins'~ ADDITIONAL COMMENTS AND SKETCH 1 s SANITARY PERMIT NUMBER: A W ~~t".':""'._ f~,:`,f.i~=~lC!-[-C...=(~,/} ~ b ~1;~4-t..~',.~ ~ .,~.r-,CG'..-~ fc i G~tJC~(`c? C_.4')')'~ %?JG2t/ / Y"`'' `7 aE~<---t'C~,.~--,--. ,~;~~0'r°-J~~ ~ f ~~',1i-' ~l II 7 DILHR SANITARY PERMIT APPLICATION E 131 In accord with ILHR 83.05, Wis. Adm. Code COUNTY TY memo STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than v446 9 / 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. S9 - Z-101116 PROPERTY OWNER PROPERTY LOCATION ~e 01 - :D~ d c~ CJ'/a 5j %4, S 3 Z T 3' , N, R IZ 42 (or) PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NU Z;ct Ir-),o,'~. 5Z/00Z_ 1(1-1-5 l?y-3N II. TYPE OF BUILDING: (Check one) CITY / NEAREST ROAD i ❑ State Owned VILLA =N OF. GE ~G/y,Lo 4Q( / ❑ Public IN1 or 2 Fam. Dwelling-# of bedrooms ~ PAR LTAX NUM ER( III. BUILDING USE: (If building type is public, check all that apply) -10-7E 16 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 40 Church/School 80 Mobile Home Park 12 ❑ Service station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1.2( 4 New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ 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 ❑ Seepage Bed 21 Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE 1~ REQUIRED (sq. ft.) PROPOSED(sq. ft.) (Gals/day/sq. ft.) (Mindinc ELEVATION / 50 3 75 3 7e/ 4O 17.Z.-I, Feet 109. ~Z Feet 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 structed Septic Tank or Holdin Tank OQ /~OC~ ~i C Lift Pump Tank/Si hon Chamber c7 r 000 Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) MP/MPRSW No.: Business Phone Number: 66z-?_ 715 ~,94 337 S Plumber's Address (Street, City, State, Zip Code): _f 7yo0 Z_ IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved S wtaPit Fee (includes Groundwater [-Date sssLed Jy~ ssuing Agent Signature (No Stamps) Surcharge Fee) (ji.~] [ l Approved ❑ Owner Given Initial Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Pib-67) (R. 11/88) 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 Sanillary 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 'n 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; reply-.ment 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 March 18, 1994 2226 Rose Street La Crosse WI 54603 BOLDTS PLUMBING 820 MAIN ST BALDWIN WI 54002 RE: PLAN S94-40116 FEE RECEIVED: 180.00 DEJONG, DAVID SW,SE,32,30,16W TOWN OF EMERALD 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. Sincerely ' erard Swim Plan Reviewer Section of Private Sewage-,V`_ (608) 785-9348 3315R/ 1 se1).642s M. a 1191 Qi D.I L FI R In accord with ILHR 83 05 Wis. Adm. Code COUNTY Sf, C>^o,x - e~te stU anon aper rat less•than 8112 x 11 inches in size. Plain must include, but AttachrcompY p( p _ . _ A PARCELI.D. 8 not &Tked to jertical w04t0rizontal tetersncst point '(1311, duec!' x (slope b M -11 11 dmeasioned, north arrow, and location and distance to noaresiv .00--4 REVIEWED BY DATE APPLICANT'INFORM ATION-PLEASE PRINT ALL INFORM.ATION GNT.LOTS/,J 114$1'1/4,S3ZT 30 N,R 164(,w FPROPERMTYYCW NER PROPERTY LOCATION ` NEFVS MAILING ADDRES S LO~~ " :4 SUB-. NAME OR C ZIP CODE PHONE NUMBER ❑cT QVIUAGE TOWN NEAREST ROAD b~ -ct104 t~. SyooL (7,s)6P5►-3ayZ ~ir,eral~ f✓w 1,0 rcode New Construction Use ~Q Residential / Number of bedrooms 3 Replacement Public or commercial describe derived daily flow 41550 gpd Recommended design loading rate bed, gVie trench, gpdO Absorption area required --3- 7 S bed. fl2 3 7 51 - trench, 112 - Ma*num design loading rate • -6 bed. gpdte-, trench. gpd/ft2 Recommended infiltration surface elevation(s) It (as referred to site plan benchmark) Additional design I site considerations material /o 4 Flood plain elevation, it applicable Parent S =Suitable for system 0ONVENTKINAL MOUNO rlGROUNOPRESSUaE ATr,1uDE SYSTEM IN FU HOLDING TANK U= Unsuitable fors tem [I S OR U WS ❑ U ❑ S 041 Is Cg U ❑ S [5f U ❑ S NU SOIL DESCRIPTION REPORT Depth Nlotdes Texture Structure Consistenceleandary Roots PD/ft Boring # Ho rizo rri nselt Qu. Sz Cont. Color Gr. Sz. Sh. / C 5 Z Y) Z /n CW ZvGround o sl c S6 ~~1' - • y -5 elev. /o8.8Sf4 Depth to limiting factor Remarks: r j Boring # f j CS Z7' 1' ZmS4r: n~~ Idyg~ 3 S/f / .5 Z- 9-/Z .17, 5 ' P ! y Z to r.Q :S GfOUr1d I elev. ~o K IIAR 1 Depth to - - limi(ng factor - > Z8 Remarks: ICST Name:-Please Print L), /e Z-, L J u 0/r.0 Plane: 7/ j ' Ggy - -3379 _ Address: 8Z0 /'tea,'>^ Sy`'• yso Idw/,Y,- ltd.' 5yooL Signature: Date: CST Numba: Boring Horizo Depth Dominant Color MoUles in. Munsell :Sz Cont. Color Texture Structure Consistence ~G.PO%fl~ Gr. Sz. Sh. ftrday Roots Z. /f+ /~,~yyy ~I// o Si ~.yl, /y♦~! °ged Tkft: C3 CS r A/O V r Y I 2 \~~//h t• Depth to liffiting Wor Remarks: Boring # Ground elev. tL Depth to fimi6ng factor Remarks: Boring # yc x„- ~e Ground elev. IL Depth to limiting !actor Remarks: I Boring # Ground elev. IL Depth to - t limiting factor 1 Remarks: 94 40116 S A Mound Using A Trench For The Absorption Area Cross Section Of H O F 6" Topsoil Medium Sand Fill --il E D 3 Plowed Layer O~t - 211" Aggregate, D /-D Ft. pq,4ge Below Covered With Ft. Ha Or Synthetic Fabric E Ft. co F •75 Ft. H I_•5 Ft. ~ rrr~sj4F'sa~ ~vrsrar+ SSE Go lan View of Mound Using A Trench For The Absorption Area Force Main Loca~►ow J Distribution Pipe Observation Pipe permanent Markers W $ \Trench Of IM - 2,,2" Aggregate I L W 2 q Ft. K 1.3 Ft. - Ft. Ft. L /2d Ft. J /O B ZY Ft. License ~G 29 Date: -~Z- Plumber: /y Signed : 7~` X94 401 6 2~~ y Distribution Pipe Detail For Two Lateral Network Holes Located On Bottom r r, ale, PVC ~ Are Equally Spaced PVC Force Hain ce All H. Y 1 X 7 -1 7X PVC Distribution Pipe P P X * Last Hole Should Be Next To End Cap T i P 92 Ft.~ ALT P Hole Diameter ~ Inch X Inches Lateral Diameter 2 Inch(es) Y Inches Force Main Diameter Z Inches # Of Holes/Pipe ALT = IZ Mc+t~S Invert Elevation Of Laterals,~t. Signed: License Number: Date: PRIVATE SEWAGE SYST If- Conditionally „;PrdS OF 1NDUSTltY , DEPT. W1t1 1 OF Sr~rt; k SEE PAGE = GF V PUMP CHAMBER CROSS SECTIOIJ AKJD SPECIFICATIOUS S94 401 16 VENT CAP 'i••C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING > 25' FROM DOOR, JUNCTION BOX MANHOLE COVER WINDOW OR FRESH 12"MIU. AIR INTAKE GRADE I y" MIN. ( I I B" /''C11J. CONDUIT-/-- 18"MIN. ' 11~ $Y$~ROVIDE INLET ASE A HT SEAL I I i I APPROVE ~ D JOINT A col, G" I I APPROVED JOIKITS w/c.2. PIPE p I III W/GI.. PIPE EXTENDING 3' I II EXTENDING 3' OWTO SOLID SOIL B w Z ~iS I I I ALARM ONTO SOLID SOIL p Dot. ELEV. / FT. PUMP OFF CONCRETE BLOCK RISER EXIT PERMITTED ONLY IF TAIIK MAMUFACTURER HAS SUCH APPROVAL SEPTIC E SPEC.IFl'CAtl0KJS DOSE- TANKS MANUFACTURER: WMBER OF DOSES: L -PER DAy TANK SIZE: ~U!'O GALLONS DOSE VOLUME ALARM MAMUFACTUFLER: SL) C lece-11--rO INCLUDING 6ACKFLOW: GALLONS MODEL NUMBER: 9 CAPACITIES: A=z3'Z31MCAES OR .2/4-09 GALLON5 SWITCH TYPE: ce B= z INCHES OR IL'S GALLONS PUMP MANUFACTURER: gozw/ C= 5/'771AICHES OR L3-Y-,1-5G ALL0IJS MODEL NUMBER: 3 /l D - 17- INCHES OR 2 7 GALLONS SWITCH TYPE: l~iercL~~Y MOTE: PUMP AMD ALARM ARE TO BE MINIMUM DISCHARGE RATE 8 • o~ GPM INSTALLED ON 5EPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEU PUMP OFF ARID DISTRIBUTION PIPE.. NXA FEET (O► jZ + MIIAJIIMUM NETWORK SUPPLY PRESSUR~~,E/~_ _ , • • . • , • _ 2.5 FEET + , FEET OF FORCE MAIN X :9-f F/p~,FRiCTIOM FACT01t_ /"O FEET TOTAL D9MAMIC. HEAD FEET (4,'Z(; QIti lN.) IKITERKIAL DIMEWSIONL OF TANK: LENGTH ;WIDTH lO ;LIQUID DEPTH 31GUE0: LICEOSE NUMBER: DATE: -3 Performance Submersible Effluent curVeS. Pumps o~ METERS FEET 90 MODEL 3885 25 80 SIZE 3/4' Solids G wE,SH 70 = 20 WE10H J Fa- 60 - WE07H 15 50 WE05H 40 10 30 WE03M WE03L 20 5 10 0 0 0 10 20 40 50 60 70 80 90 100 110 120 GPM I 1 i i 0 10 20 30 m3/h CAPACITY HGOULDS PUMPS. INC. SB'ECA FALLS NEW YOM 13148 METERS FEET 120 MODEL 3885 35 110 WE15HH SIZE 3/4" Solids 30 100 ~ 90 25 80 Q 70 Z 20- -i F 60 0 F - 50 WE05HH -147 15 40 10 30 2Q 5 10 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM 1 , 1 1 0 10 20 30 n-P/h CAPACITY 81985 Goulds Pumps, Inc. Effective July, 1985 C3885 • • v. • r.,.. v• 1 t: in accord with ILHR 83 OS. ws. A dm. Code Attach _ . - _ COUNTY ~ompTe'te sit®'~`an on y 1 ' P paper not lewhan 8.112 x 11 inches in site J C r not Plan rrwst.indude; but fimited.to ~erticaT aid horizontal reference - O !~C - Writ (134 direction Y. dimensioned. north arrow, and location and distance to.nearesf atoad.nd of Slope. scale or PARCELLQ. . APPLICANTINFO'RUATION P LEASE PRINT ALL INFORM.ATlOH REVIEWED eY DATE PROPERTY CWNER O., t O Y% : e c PROPERTY LOCATION PROPERTY ONNEWS MAILING A00RESS GOVT. LOTSW 114 S1/4,S jZ T 30 N,R LOT BLOCK # SU80. /6 W NAME OR CSM a ( CITY, STATE 21P CODE PHONE NUMBER X14 A~O~Wi~ r• S'SrOOL (71 Cicay ❑VILLAGEMOWN !NEAREST ROADD 16P51-3vy2., ~ Fiy,era /~y/ X New Construction Use H.u ~Q Residential / Number of bedrooms 3 1 1 Replacement Public or commerdal describe Code derived daily now V50 gpd Recommended design loading rate bed , Absorption area required bed fit • 9P trench. gpd/ft2 Recommended infiltration surface elevation(s) trench, Maximum design foadng rate -bed. 9P012 trench, gpd F Additional design / site considerations ft (as referred to site plan benchmark) Parent material od plain elevation, it applicable - N/9 h S = Storable for system ooNV Motxdo Ro U = Unsuitable for n tom ❑ S ll PFGIlOt1rIDPRESSURE his °s CRU AT~WDEE 09 1 U SYSTEM IN FILL ❑S - as s SOIL DESCRIPTION REPORT Boring # Horizo Depth Dominant Color Howes in. Munsell Qu• Sz Cont Color Texture Structure Consistence B G P D/ft S / /O YR y Gr. Sz. Sh. otrtc y Roots Bed Trend- aav~...~~ Z- 7-O -7,--5 Ye S 2 m s,~>~' /YI CS Ground sy Z m S /'7 7 C W Z Vf elev. •5 Depth to limiting factor „ ~ 2 (o Remar Boring # 4=~ Z s~ Z ms~ r~ _ C S Z ~ 5 . ~ 6 x 9-1 Z /75 Yje - y. c~ zv.~ . j ,6 Ground Z~ Sys ~~-7 I/ elev. Depth to Gmiling (actor Remarks: I CST Name:-Please Print " ~alf ~N GI CISQY~, ('hone: Address: 71::5-&`? Y- 3378 signatur.: W ~ I.J.. 5`/0o L - /y Xt4Y~ Date: CST Nu nb; - Structure Roots boring # `.Gf'0 De lh Dominant Munsell Color Si. Mo Horizo P - Texture . Sz. Sh. Y Bed €Tr~cx: - Contttles. Color tau: -42 Ground _ elev. Depth to inviting factor - - Remark's: Boring # 131 Ground elev. t~ Depth to Gmi6ng factor Remark's: Boring # Ground elev. It. Depth to limiting factor Remark's: Boring # Ground elev. tL ` Depth to fmiting factor Remarks: Wisconsin Department Relations Industry, ).Tabor and Human Relati SOIL AND SITE Division of EVALUATION REPORT Safety & Buildings Page _ of in accord with ILHR 83.05, Wis. Adm. Code Attach complete site plan on COUNTY paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.O. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY LOCATION FPROPERTY ER: lGOVT. LOT _5( 114 1/4,S T ER':S ILING ADDR j N,R E (or) W LOT # BLOCK # SUBO. NAME OR CSM # CITY, STATE ZIP CODE PHONE NUMBER ( ) :CITY VILLAGE (►FeWN NIREST ROAD rGode w Construc tion Use M-Residential / Number of bedrooms placement Public or commercial describe [ 1 Addition to existing building erived daily flow gpd Recommended design loading rate bed, Absorption area required bed, ft2 2 91~ft2 trench, gpd/ft2 Recommended infiltration surface elevation(s) trench, ft Maximum design loading rate bed, 9 2 trench, gpd/ft2 Additional design / site considerations ft (as referred to site plan benchmark) Parent material Flood plain elevation, if applicable It S = Suitable for system CONVENTIONAL MOUND U =Unsuitable fors stem ❑ $ [IC ❑ S IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL ❑ S El U ❑ S ❑ U ❑ S ❑ U HOLDING TANK SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Motes in. Munsell Qu, Sz. Cont Color Texture Structure Consistence Bouxl~ry Roots GPD/ft k Gr. Sz. Sh. Bed rends Ground _ elev. ft.~ Depth to limiting factor S E Initial: Date 16-41 Page - of PROPER7y0WNER SOIL DESCRIPTION REPORT PARCEL I'0' Mottles Texture Structure Consistence Bcux3rY Roots Depth DominantColor G P D/ft Gr. Sz. Sh. Bed rer~ Boring # Horizon in Munsell Qu.Sz.Cont. Color .•:.~b.'~•'~.riitivt Ground elev. ft. Depth to limiting factor Remarks: Boring # a `'"`';x Ground elev. ft. Depth to limiting factor soil pit locations tN STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER _ t Teal , , MAILING ADDRESS 2Z 41 q u PROPERTY ADDRESS Sc3•~ (location of septic system) Please obtain from the Planning Dept. CITY/STATE PROPERTY LOCATION -57-t,) 1/4 1/4, Section -fZ T 3U N-R-~~ TOWN OF ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIEDSURVEYMAP= VOLUME PAGE LOT NUMBER//X 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 a ation ate. SIGNED: DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 S T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. An inadeacies 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 Dv; j f,nA_ 'I' Location of property U,) 1/4 SF 1/4, Section 3Z T-_3~9 N_R_Zl,_W Township ~-y►1a~q~~ Mailing address V vl ~~M I l 1 1 l.L. ` / t+ Address of site s' Subdivision name - Lot no . other homes on property? Yes No Previous owner of property Total size of property _ % 4CJ"r~S Total size of parcel Date parcel was created Are all corners and lot lines identifiable?,,y-Yes Is this property being developed for (spec house) ? Yes No No Volume / and Page Number S90 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 Count Re Deeds as Document No. Si 9'7 and ( Y gister of we p own the proposed site for the sewage ,disposaltslstem) orr I ently 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. Signature of pl'cant Co-Applicant l Date of Signature Date of Signature • CHARLES CUDD CO. P.02 o,5-03-1994 09:59 612 731 4669 ~I CO- THIS SPACE Re59MV90 FOR P90ORDINO DATA DOCUMENT NO. WARRANTY DEED STATE BAR OF WISCONSIN FORM 2-1992 519788 REGISTER'S C." I ST. CROIX C0.,1ti l and Susan H . DaJ~n Marion P. pe 7on hu®band and w f.. Ree'dtorRecord ' AUG 3 1994 M t {I; 8:45 , A. v ;;d g• and...'I''err i...... ' I! conveys and warrants to . d6l..... 32 .I'~g. • p .eUrY.~ I?..MIR ttA.I:..PrO-?e.33y Ij R~Isar~t mom I' ~ "Pi-F.'rVOIN _T15 the fallowing described real estate in .....5•t•••~ State of Wisconsin: Tax Parcel No ~I That art of the Southeast Quarter of the Southwest Quarter SE 1/4 of SW 1/4) and the Southwest Quarter of the Southeast FEE I, Quarter (SW 1/4 of SE 1/4) of Section Thirty-Two (32), Township Thirty North (T30N), Range Sixteen Waft (R1bf,aToineof Emerald, as St. Croix County, Wisconsin, lying Easterly o des follows: Commencing at the Southwest corner of said Southeast Quarter of the Southwest Quarter (SE 1/4 of SW 1/4)E thence S86°42'36° E, assumed the bearing, along the South line of said Southeast Quarter osouthwest Southweet'Quarter (SE 1/4 of SW 1/4), corner of that certain parcendV recordedMinnVolumee850Sof Limited Partnership in that warranty deed thence N3017'24"E, ' Records, page 339, as Document No. 451219E 111 783,00 feet along the east line oPOINTdOFaBEGINNINGhofnsaidwliaeE corner of said parcel., being thence continuing N3°17'24"E lof9th~ Southeast Quartereoftthene of extension of the li said parcel, to the north line said Section Thirty-Two ;i Southwest Quarter (SE 1/4 of SW 1/4) of rcel in said V' 850 of Records, ii (32), being the terminus of said line. EXCEPT p page 339. This i-A- APtr...... homestead property. II XAX (is not) Easements and restrictions of record, and sixbject to the terms ' Exception to warranties: and conditions of that certain Farmland Preservation agreement ii office of the Register of needs for (dated June 2, 1981, and recorded .7une 15, 1981, in the I; St. Croix County, Wis nsin, in vol. 630, page 605, as Document No. 371465 ,1894 I1 l/ Dated" this r,~~.......... day of Vv I 1'. M; G'L~G1' , (SEAL) (SEAL) * ,Mairion...p ...p.,....n9 ~ i f ..........{REAL) 4m...hX.ti (SEAL) Susan 14. Delon AUTHENTICATION AONNOWLEDGM ENT II I~ STATE OF V715CONISIN. aitnaiore (is) - as. day 01 St . Croix pare.......y came before me 1 this authenticated this ........day of 19. 4' ` 16.9A.. the above named Mar.i~ r~.. • . TITLE -.MEMBER STATE BAR OF WISCONSIN . . (It not, . i' • State,) to .me "known to •be the per, n s..... .d'the autbori:ed by ~ 708,08, R' e• O foseeo! lrietrument n ra, nowlt~i~ PHIS IN97RUMEN7 WAS CRAFTED BY " r Thomas A. McCormack . yy~ ' Wia. '1 Baldwin, WT 54002 Notar Public ..7. Fii. .'ti.; epiration a...................................................... No t pmblic.. is per manent, (If r+ v Signatures may be authenticated or acknowledged, Both are not necessary,) date; 'i ~ r OakManor( 24/28 Series. A N`' `Ipj y,tn -1 VV 1 t 1 1 1 ~1 ' YIL YY 1 1 1 aQ' A BEDROOM •'i D{NING ROOM No. 2 12 o°oe~~' ► It1YCHEN 12 1 C,AIMaIAI Clud B Awt Oa Ij IDIIK k pipriNlbwlM4MtrnG R00~1 1 I ' CAtMlplµ C~rIhG I 'f CATHIDRAI CROG I T LIVING ROOM BEDROOM r-- MASTER i 18'•B• No. 3, BEDROOM ; 12' No. 1 13'•4" --1 f on 3852CT/5228 3BEDROOM • 2BATHS • CATHEDRAL TNRU-OUT (1,369 SO.RT.1 Your Local Oak Manor Dealer is: yu/cv Tcr~~, -:V{~ 54729 S i11~E BmNGm 1 b WNGlNG KAFK 9AW947 IMP- r 41 V 16 PAGE 4418 ' XATHLEEH H. VALSH REGISTER OF DEEDS ST. CROIX CO., VI FED 2420 I RECEIVED FOR RECORD 12/04/2002 11: 45AN 5T. RDiY. CO TIFIED SURVEY MAP LOCATED IN PART OF THE SW1/4 OF THE SE1/4 AND IN RfiC FEE: 13.00 COPY FEE : 3.00 PART OF THE SE1/4 OF THE SW1/4 OF SECTION 329 T30N, PAGES: 2 z z R1 6W, TOWN OF EMERALD, ST. CROD(COUNTY, id m I WISCONSIN; MG`JPdLa4GD_dLlMn p~~ Oo ~~IM~ G oD_ -l_ Q1CG3 5.3' m $ r~ ! _ - -_N00°52'21"E - 753 09 _ S00°52'21 'W 7 4' 283.38' 66 ACCESS EASEMENT 436.62_ 33.00' RECORDED IN VOLUME 2049, PAGE 74. iv Z 1 0 7.4 z As M O N .c -i o cn n:i. z r i m Z D BEARINGS ARE REFERENCED TO THE m m i O r 111 SOUTH LINE OF THE SE1/4 OF SECTION ° j : I . Om i 32, ASSUMED TO BEAR S90°'00"E. o I z i Z m i z OO0 ' v~ l m 7T r o. o m m O ZO~ro~ ct) i TO m O wD n1 m 2 ~ Z m A N ) CD m . V7 Z z o vti ~Z~~ = o Q ~zo i O Q rm'~ i c ~q?~. m p GUY WIRES IN (n : GJ::: z i I D \ m z m m FENCED AREA m n '103.23' 325.47' 428.70' :1 1 1. 1 `;S03 OT51 z N p o - N03 07 51"14 904.36' - zjO m j 0 1 0 i t w7 m-0 Z mo N ^lulu~luJ p~ ,,ww::::• y ' C7p 1m in O031~ A~ ~W V. m.•.:•:•.:;. •.:~.~i m CO 00 2 i o iO mo ~nw 1 ~1 N'I~V? I z0 1 O x r wZ ~ -nA~T n ZW ,►D.. ; cl) i NM Qm Iii j. J 1 z L.0Z~ Q" _ n rn l ~ i V'-q b ~P1 O I F. i 66' ACCESS EASEMENT 0 > •~_Y cn ! RECORDED IN VOLUME 2049, PAGE 74. ldZ~•ggv . CA "W 903.00')' ► i f (S2-25'48 Q 800°00'451 W fi 902.90 $ S00°00'45W- 4. 8':::' I 849.90' i - 1~ O t 27 N0Q°00'45"E 1329.68' Q - - NO OY45""609' - - - - 1--T M 1 6' Z o Mop 0 QQ 33 53 1\/ 4 v w v ; r---J . 1 ~ i ~ N Rl pZ ♦r........... Y 041 ' 'v i V -I~ 3: P z z c r~~`~ ♦ O m Z -4 m cn pn p r. 1-1 106 v$ ~ co z OO i c$ O wx omc m oo= g ~o O r c c m m C4 X m c o~ ~C fi Z I 6 g m m~ 0 8> 6 Fn m D i- mzo Ozn Z 1p0 p~ o) m 0 F, c) m O Cb CCO v r- ! T m ccnn n z Z m m Z Z ~m j fJQ rJ Z O n o _0 m : m52' 60' c) n m Z mo -n m -n 1 J„ 70 O g c~ Z8 m 1 112- ~r p D p = O z c z EAST LINE OF THE SW1/4 OF THE SE1/4 z m m LZ') O A 1269.34' ST. CROIX COUNTY o m 60.06 02°59'48"W 1329.42' Planning 7.0ninn and Parks Committee x1 N I ~ nn nn ~ s CD O~1[~C D~ ~I 04[~GG°3~ co 33 52 \ VapRA~- - ~ U 4 2002 THIS INSTRUMENT DRAFTED BY MICHAEL ERICKSON JOB Np 01-92 DATE: 1-07-02 if not , ,:corcled wanm 30 days of , Vol. 16 Page 4418 approval date approval shall be null and Vold L3L ~ Owv~.G r: Sec. 3Z 1~Qve .:~e Joy... ~ -o S. tt ao s~~ sr- 4-N 7o/V 40 S J 4 401 16 J ~ R Q ~ 131 j 25 1-7 76 n~ ~ /ooo8al. o Fnce P C . 0 0 ~ /UOU gAI i ~ 1 C! A Set c. 20 o /vo, 1 fG o~ Prey oSP.~ o O Well /0000 ~ B7- ► 300 s~ . » is OF S /"I P G6 Z 9 35 Acres Cs7'm 3y 13 I~o% 17 /(/of~ .Q 11 1 ~1' ,nes are-