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008-1031-60-100
/* Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division INSPECTION REPORT GENERid-L INFORMATION (ATTACH TO PERMIT) Personal information you provice may be used for secondary purposes [Privacy Law, X15.04 (1)(m)j. ~~ii'ii;"PraXfel" me: ^ City ^ ~I~p~~~l~r"r~Wnshi CST BM Elev.; Insp. SM Elev.: BM Description: 60 ~' 60.x' - ~Aw~~ ~T~A\~ ~Hwn nvrvnmr+r rvrv TYPE MANUFACTURER CAPACITY Septic per- ~ ~--~ Dosing Aeration Hotdin TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. vent to Air Intake ROAD Septic ~ ~'~ ` ' - NA Dosing A Aeration NA Holding PUM'~/SIPHON INFORMATION Model ber ' _ GPM TDH Lift , , - ' ~Lriction System TDH F.ortemain Length H SOIL ABSORPTION SYSTEM (t-n\ .~ ll.,._.. ~. ~~ _ ELEVATION DATA countSt. Croix Sanita~~~Vo.: State Plan ID No.: .~--. Parceldf~Nr~ 031-60-100 ~,_~~'.lb,rcQ.Ler STATION BS HI FS ELEV. Benchmark ~ ~ ~~ ~Z~~b (~fl . ~ r Bldg. Sewer ,.. p / ~S~ qs ~~ r St / Ht Inlet ~ °(.0 9 ,~~ St/ Ht outlet ~. ?j!~ 9'~(• a~ Dt Inlet '-~ r---~ Dt Bottom ^°~' Header /Man. p• 3S Z • 3 r T ~n.gz 9l•~~ Bot. System l2-cam ~o. S S Final Grade u 5• ZS ~ 3'• ~S! cover .. a .L.e ... o .B~G~D TRENCH Width r Len th t ~ v N O Trenches ~ e PIT No. Of Pits Inside Dia. Liquid Depth DIMEN 3 (o •S `•`' ` DIMEN I N SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manu ct rer: ~.- n T ~Q SETBACK .u INFORMATION TypeO ~ ~ Q f ~ , ~ CHAMBER OR UNIT o e Number.` - a System: , >~ E~ 6~ + u DISTRIBUTION SYSTEM ~~S• I~+-(~.~, v Header! M ni old ~ Distribution s Hole Size cing Vent To Air Intake r Length ~'""' Dia. ~ Length Dia. Spacing ob SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over µ Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center (p~ Bed /Trench Edges Topsoil ^ Yes ^ No ^ Yes ^ No COMMENTS: (Include code discrepancies, persons present, etc.~nspection #1: o `f /~ O( Inspection #2: Location: 429 250th Street, Woodville, WI 54028 ~(N~W 1/41/4 11 T2 ~F~1- 11128161620 -Lot 3 1.) Alt BM Description = r ~~~~ cJ -{- rj (~e~ 2.) Bldg sewer length = ^- 29 ~~r,~ -amount of cover = 2 ~("~ Sal l ~ ~ a~ s ~~ f ~ 3) Ewe s ~-,~,.,~I rte..-E'-`~ ~`1~a- ~ ~ ~~ ~w . ~ `( Plan revision required? ^ Yes ~No U her ide f additi nal infor atlon. ~'t Z-S o~ ~ ~ T ($- ~S~D- 71~97~~M5~~ Date Inspector's Signature Cert. No. -_ ' ,, ~u C ~ku'u~ ~x" V '.~ ~''c~,~... tuts u.vt,cu. d • httach com late Ions Cta the countti ca = ani+°) for the s ~ c _ r ss than 8-112 a 1 1 inches in Sdze. County State Sanit • Permit Nur»ber E7 Che i~ ~ .~" ' 8~~ZS ~ p Lion atate; Pian 1. u. Number 3 \ rho d c I. A Iication Inforrnatio:a -Please Print alt Information Lacatltan: y !'roperi+' t3wnsr ]vamc t~ti, .nSm~ '~S; r ~ ~ ~ r ~ u p..rt` I td~.^. ~, R lor? t~` N S ~ "C{ 1" (t~ r+sl /4 J 4 Jt/4 ~ ~ r ~ Yj y rC 1~ . . . . Pro eri • Ownsd's iviaiiin Address ^~""" Lot Numhsr Bioefi Number t "` ~~ ~~ ~ ~ ~"v ~ 4 ~ Z /~ ~G~ t~ ' Cdtg.. State a Zip Cade Phans Numb~rZ ~% Subdivision Name Qr CSivt Numb ~r II Type of Building: ~eheck one) L _.._.. _~. ®Cit}` ^ l~illagc l ar 2 Family I3+veiling - Na. of Bedrooms: ~~O+Vn Ot ~ t'tdDilCft..OmriderCdat (deSCfdAe 125C): L~~,.k ~-4l ~ ® Mate-o+vned III "Cyge of Permit: {Check only one box on line A. Check box an line I3 if applicable) Nearest itoad~ S ~ t C !gt) 1. ^ I+iew'3ystetn 2. F~ Izeplacement 3. ©Replacement of ~#. ~l Addition to Parcel "Pay Number(s) I ~~ U ~/ ' ~ U - i ~ U ~' - /~ t o~stenz Tank Onh• Existin System . B) Pemtit Number Date issued ~ a 6~ G l~ A Sanita rerrrtit,vas reviotisl ' rsstiti~ IV Type oC PUWT system: (Check ail that apply) ~ 14 - I ~'0 i~ Nan-laressurized tn-ground ^ l~4ound ®Sand Filter Q Constructed Wetland i u?tessurized In-gr.,und Q I-lulditxgTank 1~ ;mate Pass j Q I?rip Line €~ At-grade r t ^ Aerobic Treatment tSnii 1;7 Recirculating.. ~I (3ther: of, . ~~ V laisnQrsal!'I'rPatteter_t t~.rett Irtft)rmation: 1. P}esign Flow (gpd) 2. DispersalArea 3. Dispersal Asea 4. Soil Appl+cation _. 5. Percolation Race .._. - _.-_~..... ' 6. System Elevation 7. Finns Grade f Required Prttposcd Rate tGais.ldaylsq. fl.} (It4in.{inch) / Ef~^~r3ation VI Taal; Cap acity in Total # of Manufacturer Prefab Sitc Steel Fiber- Plastic Information La llans Lallans Tanks Can- Con- glass Crete structed Ne+u 6~isting Tanks Tanks ® Q Q Cl i 1..1 W v v..i VII Resgnnsibitity Statement ~~~ the undersi ed, assume res onsibiiit o sC'aTlikti S shod°rn ar, the at:a~4ted Ions. I , Plumbsr's Nanas (pri»tl Plum Signature { s ps): D.t}'7tviPRS Nca. ~ I3usinsss Phane Number er's Address (5uest, City. State. Zip e) P :'Iii ':rsuntyl;i,'`Isart..ent ~istr ~bt•.Iy - Cl Disapgraved Sanitady Pennii Fee (insiudes Ground+vater Date Issued Iss ing Agent Signature (No stamps) ~Appraved t~ C?wner Given Initial Adverse Sur arge Fe^ffe} / • ~ Z (~ ~ 1 (i Iieteit7tinatddiie .. .l k .. IX. CQnditiocls of prtavallxeasuns for ~asa~~S -; _' (~ S_ D •~,5 I~^~ ~¢^~. '~r (JV ~ u S~ t.~ ~-~ ~ r ~ ! vwu.S~'" `~ ~ .1 7 ~ L} / ~ rj j~ / is /0 j ~p! ~~ - C ~~ ~ U ~f ! I~~d ~~~~ ~r~p~{ ~i' h ~ C ~ /' ij }'~n ; ~ L a ~~ c -s 1iv'e. ~ f f`~t,k ~ I ~:"' U t~ I l~ alt t ~ ~ ~~~ + S f ~ ~ ~ ~ (3 'S / ~ Y ~./ ~ 4 h Ef 4 ~'1~ I~RR ~G! ~~ ~~~_ ,~3r~~o-,,G 3 _ c ~ ~~s ~ z ~ ~ ~ ,r G2,s~ ,~?. ~~ ~C~, wGr? (~ c _._.~ ~ ~ ~ o ~~ ~ + ~ ~ ~i .a w~~( e i. : _ , .+ 1 i r' \ _._~ ,,~~ 3' G' ~r`, I i c ~ i r ~ j r • . ~ ~, F • ~" ~~ qy e ~ ~ i ?, ~ l c -, .. - f.~, e~ {~tf / { t~•-!~ ~ F ~--~ v~ ~ . ~ ~ ~ ftfJ ~P ~~ ~~.. ~t J~ "Y ~a '° ~~~ _ r ~ ~ L~ ~~,., ~ if G~ ~ ~ ~°'~ r1 ~ ~ g'~ "` ~ f3 ~ rr~~ 4J,' h ~ C ~ ` ~f ~0,~ ~ ~G:. t t ~~~Gk L~ % ~,1 . _~.SN ~uf G ~k~„ 1~r?7 f~~r~ ct~ t~J via P.~l°~,ra~)t~ ~ ~, ~ ~~ v} ~' e ~ ~"' ~ 6 ~ 5"~ t ~~~ ~ ~(( ,l~csl~sL 2~ ~ ' ! ~~ ~ ~ ~ ~~~~ ~~. 3 1" __ _ ___r ~; ! t '~ ( ~ { t k ", 1 f ~ i ~ ~' .~ ~ ~ =~ _.~- ~ 1. } e- n e ~` as ~ ~ g 5~, S' v,~ 0 i e ~ . ~ o~ ~ , ~ a ~ ~~, ---~ .~~ ~~', 3 0 Wisu~nsin Department of Commerce r Division of Safety and Buildings v SOIL EV in accordance with Wis. Adm. Code ,, ', RT Page ~ of ~ . ~'- r c:ou~ty S't-. C~ 1X Attach complete site plan on paper not less than 8 1/2 x 11 inches insize. d~~f ~- include, buf not limited to: vertical and horizontal reference point jeM), dire and Parcel; LD. percent slope, scale or dimensions, north arrow, and location and; distance to nearest roe(! `?'~ ; OU6 -) b3 ! - 60 - l 0 U Please print all information. R ~ ~1 C~O,~, Reviewed by Date Personal information you provide may be used for secondary purposes (PriVaty Law, s. 15Aj~'j(~ 1G`~ Z 2 Property Owner P ovation p~~ r ~"'t~] ~--~'X `~ ...~ ! NW ,. 114 S w 1/4 S ll. T Z'O N R 16 E (o Property Owner's Mailing Address - s:o # r .81ot;k # Subd. Name or CSM# ~ Z a 'Zsp `~- sT, 3 - e.s~. Vv L. 6 r l~+s~ 16 t~ City State Zip Code Phone Number ^ City ^ Village ®Town Nearest Road woc~ov t~L~ ~v~ S~loz (~ tS) 648 -3'~I~~ ~, ~f~-~~~ ~iZ ~c~ ~v~ ^ New Construction Use: ® Residential / Number of bedrooms ~_ Code derived design flow rate 60 U GPD ~ Replacement ^ Public or commercial -Describe: Parent material iJ L.(~-el ~"l. nV~"LJ (~ S~ Flood Plain elevation if applicable N f~ ft. General comments and recommendations: ZZ~T~.pYvl1~ ~~ 3 e~2tS, ~-e~ ~'>c 6 Z _ S ~ C.UA.1 G W 1 ) 0 U~v(7-S 0 F ~-}1G1~ C1f~P~2l7y S~ULtitl/n~~E1Z L~CC-~ Ct+A--~l3~R-5 ~C~Z ~°.~-L_ ~o~ wl ar ~.~ c ~~s ~n ©~ -~r ~z.~ti . q 1_o I C-s>~-No~- ~,~ ~~ z a Boring # ^ Boring ® Pit _ Ground surface elev. 'Z y- S ft- r)Pn+h +n limi+inn far+nr 7 1 h ~ Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ft~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~ -~ l~~t R. 31 Z - s t l `~S b k Y~'I.~I- Q, S l ~ ~- . S . 8 ~- -~ $-~g t8 30 102310 ~.s~lz~y - - Sa ! 6~s1 sbk lesb~ wr ~~~ mint- es ~w - - :i •~! -~ .~ y 30-x.03 ~-s~123~y _ 6r~.s os 9 wt ~ - . ~ i . Z i qf• d ~Sr . !o Boring # ^ Boring Pit Ground surface elev. Ct ~. 3 ft non+r, +., cmr+r.... sue..:,.. 5 ! l1 ~ Horizon Depth Dominant Color Redox Description Texture - ~ Structure Consistence ~- Boundary Roots Soil Application Rate GPD/ft2 in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 ~- ~ tote 3[z _ si 1 Z~s~k vn`R-- a,s ~ v ~ ~ s • 8 Z S'-!.6 lOy2 3l6 - St ~ ZmSbt2 N1'f1-- ~g - . S -S~ 3 15 Z~ ~.sYe.~y - Gt-s 1 ~esbk m v•ft-- c~v - . y . b ~-Iv5 ~ • S y2 3/y - C1- !.S O ~ ~ - . 7 -- Z `t . 6 • rte-.__ . _...__...... ..,,..5 _ ,,,,. ~„ ,,,y,~ a„~ , ~„ ,.,,, ~ ,~~ rny:~ - tmuent iFY =13oUs < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Si ature CST Number Arthur L. Gdegerer ~~` ~S 220254 r~aaress {.,) e g e r e r S o 11 Testing & Design .S e r V 1 C e Date Evaluation Conducted Telephone Number 421 i1. I~iain St. diver calls, t7I 54022 y_ 3- O~ 7Z5-425-0165 ~I .2 L Property Owner ~~-+~'~ (_ ~~ B i # ^ Boring Parcel ID # ~ 8 - lD3 ~ - bd - 1 a o Page Z of a or ng ® pit Ground surface elev. ~} S - S ft, Depth to limffinn facfnr > LO ? ~.. Horizon .Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ft= in. Munsell Qu. 5z. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 ~..8 10`t~31Z -- si I bl-c mfg. ~S ? v'P- .S -~ 2 8 ~ t o ~r Iz 3/6 - s; - 1 sbk m `P ~ cs ~ • ~ .~ ~ 3 ~ 7A-31 ~.s ~srz 3! - csb~ rnv ft- ~ - • y •6 3',1~ -~-s~2 ~v - G1• is U ss m) ~ ~ -~ ~. z r 4•~ ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. SoH Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Etf#2 'NO ~ i>v ~..L ~- tv ~- V ~ ~ U 13 ~ - ~ ~ t. IIIG S`~S -+ 5 IN BUT 12E. ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= in. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 'Effluent #1 = BODs > 30 < 220 mglL and TSS >30 < 150 mg/L • Effluent #2 = BODa < 30 mg/L and TSS < 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. ssas.33o trt.arool i ,, ~i~~ N I 1SQ~ ~- O N I v w ~L B~"1 ~`Z ~ C3p CZwi 1'}U -vi E /PLOT PLAPJ vScale 1'= 4v' ~~R-~z- Ib NO. jog _ 1~~1 ~ b~ - 1~O - __ ~~ ~ ~ Page 3 of n~zpft ~J F-~ ~t n v ~-l.rr- 0 P~0'P~'aL~. A ~L~~>v G ~ ~zt~-i ~! ~=~ :LLB X ~j r i I s~~e ~t.~48 t l1 r~ 8.1 J . i LL 3 8. ~ ~ I ~ ! . , Z ( Q~ - t ~~ r ~~ ~3_Z~ - ~ ~~~ ~ ~ ~. ~z h~ ti~_v~ _~_f"[ _-e,?.:LU:C~,O.' O~:_B~T~'awi_:=4F .i`}tivS:~' Slpr?vG'- ---- ~oT~, e~+~h1 u~ZS tv~r t=e~-s~a~F - s~ ~-~~va~n o~ s -_ ~, ~`h~~ ~,/-3-t CST Signature Date 715-425-0165 220254 O1- E,S Telephone Ito. CST i~1o. Job PdO. s r Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWYS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the tn-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- Table 1: Svstem Design Specifications Sanitary Permit Number 3 2 Number of Bedrooms Design Flow -Peak (gpd) a~ Estimated Flow -Average (gpd) t1~0 Septic Tank Capacity (gal) oo ZS3 Soil Absorption Component Size (ftz) 2 -' c ~ Type of Wastewater D estic Table 2: Soil Absorption Component -Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow -Peak (gpd) 2.Sj - as ~~- Maximum Influent Particle Size (in) 1/8 Maximum BOD5 (mg/L) 220 Maximum TSS (mg/L) 150 P~'~s ~~ ~ Tab le 3: Maintenance Schedule Septic Tank Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the se tic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter hall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the Management Plan for a Septic Tank and Soil Absorption Component fr{ter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a sepfic or other Treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The afmosphere within The sepfic or ofher treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank maybe difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 • ' Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep-rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. 3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM t7wner/Buyer v ~ ~ / /? /~ ~ ~~ ~ Mailing Address ~ ~ 2 ~ - ~ 5, ~ ` ~ s c Lt,/U o G c~ , ~ i~ ~C ~ • ~ S -~/ ~ ~ ~ Property Address ~`~~'` ~- / {Verification required from Planning Department far new construction) CitylState W G U ~~ `' ~ ~ r I e- ~` Parcel Ideatificatian Number U~' ~ ~ ~ ~ 3 ~ -~ U - ~ a ~7 Y T(;AI~ DESCRIPTION > Properly Location N~~ Y<, ~/~/ %,, Sec. ~ .~, T 2 ~N R ~ ~ W, Town of ~ ~~ ti ~ ~`t' ~/' 'L cs~ Lot # 3 - - ~--, Certified Survey Map # ~~ q2/ .Volume C~ .Page ## I ~ j 7 Volume ~ 3 ~ ~3 ~ ~ .Page ~# ~ . Warranty Deed # _ _ Spec house D yes f~1 no Lot lines identifiable CI'ycs Q no ~S,~E1VI, Y,.~NTENANCE ImpiOpes trse and maintenance of your sept:C System Could result sn its premalure ;allure t0 handle wastes. Proper maiateaancc oosssists of pumping nut the septic tank every three scars or sooner, if needed by a licensed pumper. Wfsat you put into the system can affect the function of the septic tsnk as a treatment stags in the waste disposal s}~stcm Z7se property owner agsees to submit to St. Croac Zoning Departsanent a ceriificatian form, signed by the owner and by a masterptumber, jau:aeyrnan plumber, restrictedPlumber or a licensed pumper verifying that (1) the oa-site wastawaterdisposal system is is ptaper operating condition and/or (2) aRer inspection and pumping {if necessary}, the septic tank is less than 113 full of sludge. Uwe, the undersigned have read the above requirements and agree to maiutaia the Private sewagt disposal system with the standards set fortis, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. CertifiCatian stating that your septic system lies been maintained szstrst be completed and returned to the St, Croix County Zoning Office within 3t} days of the three year expirations date. SIGNATURE OF APP ICANT DATE OWNER CERTIFICATION I (we} certify that all statements on this form are trsse to L'~e hest of my (our} Ia:owledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Offrce. X~o , , SIGNATURE O APPLICANT DATE *««««* «««««« qay information that is min-represented may result in the sanitary permst being revoked by the Zoning Department. «« IacIude with, this applieatioa: a stamped warranty dced from the Register of Deeds office a copy of the certified survey rznap if reference is made in the wsaanty deed /~% /~~` 580934 STATE (1AR OF WISCONSIN FORM : - 19A2 yo~`~'~3~`~~c~~`1 DC`CUMENT NO. Jeffrey A. Leaf and Jane K. Leaf, husband anc~wi~e" _ _. _.--- --- -Jo-hn~: 'i`axler and Gloria A. cum•cys'and ~~•arrants to __ --- Traxler, Y.usband and wife __.___________ _ __- St .,. Croix Coulu} the foliou~tng dexnbed real estate In _~_ . ------------ ---- State of Wisconsin: .~ ._.. . aEGI~Sfc~r'a QFF~CE cHO~x ~o., w~ cT ~ ~.G'.; Syr a.:zor. JUN 1 5 1998 s:oo AM Reohier of ~~~d-!,.~~,,,,, i H;S SFACE 9F~ERVED `•".)~ RECOFD',NO ::A?A V AME A~•Li - " UAN ADD S ;~ ~ ~o-~ Po ~ ' ~~ d~bz~~ ~ wS S `~ ° I 008-1031-60-100 - aAFCEI IDENTIFICATION NUMBER. _,,. Part of the North rest Quarter of the Southwest Quarter (NWT of SW's) of Section Eleven (il), Township Twenty-eight (28) North, Range -- Sixteen (16) West; Town of Eau Galle, St. Croix County, Wisconsin, being Lot 1 of Certified Survey Map No. 471, recorded in Volume 2 of Certified Survey MapQ of St. Croix County on Page ..471, more recordedaDecemberr19ea1985LoinTVolume36,oYager1617edasuDocuments No. 407921. AN~FER s So is Thts t~l ~J(: Exception to Warranties: hums>tea~ property Easements and restrictions of record. Dated this ~_._--- day of _ ~ ~V'~ ~ (SEAL). • - (SEAi.; AUTHENTICATCON Signature(s) authenticated this day of . C9- A.D , to 98 ~ ~ , ~~ (SEAL) ref A. Lea - (SEAL) Jane K. Leaf ACKNOWLEDGMENT State of Wisconsin, ss St. CtoiX _County. Personativ carne before me this day of _, C9~, the abo~'e named Jeffrey A. Leaf and Jane K. ._ _ - Tl I LE: MEMBER STAT[ BAR OF `.VISCONSIN - - "~• (If not, ~ -- authon-ed by ~ ~ Ob i~t`, ~Vis Stats.) ~:+~' ~'~~ to me knos+n to be the person ,~._. µ' o eeetuted the forego+ng .,,F rr • ~/ su a nt a~ru ackr war gc th ~ ame. T41S INSTRUMENT WAS DRAFTED BY ~~~ '* .~ Y G` _._ - - ,~ f~ ^x 1 A 1~ 't ~'% --~- Thomas A. McCormack ~ t 1, _d1~~°-~-------- Baldwin, WI 54002 ~ ~~~~ ~ : N~oFan• Public, S"t-LYo+X Counq, ibis (Sig.~atures may be authenticated or ac!:now°ledg~d- &~i~i St~S>~t'~l ~•'~\iy :omm;ssx~n Is ~rnTanent- (If not, al-Tte exptranoGn date 1_.~__-- . ly_l~__ .1 necessary) ,~ Jj• ' -•.,... '- e: ------- 4~i.. J,f ,l,'I • ham. tiamcs of Ixrwrs s~gnmd m ~n~~ ,.~pxuc shindd tr...ypcd or nn;:~td ba`~~y'uIW ,N,~S~ ~ &' :. .,o ~~ ~.r~iF. BAR VF ++iSCpA~I~ 6t :..r,nee is - - -- - _...-. ., L2 Form Vo. 2 - 1~ri2 • 03r22;o1 THIS 11:03 FA$ 716 396 4666 ST CR% CO ZONING f~001 t• s Form - S '1' C -~ •-"" '~ AS BUILT SANITARY SYSTEM REYbRT ctu. (ra //G C UWNEA y ~~ f~ (/ `_ L C w ~ TowNSH?P SEC. I~ T 2~ N--R IV W ADDRESS f2 /c,~ 1•s~37~`r( C~ P~ ST. CROIX COUNTY, WTSCONSI41 S~ol3 ~- SUBDIVISION i~/A LOT ~ LpT SIZE ~ ae r, PLAN VIEW Distances and dimensions to meet requirements of ILtkR $7 SHOW EVEflFTBING WITHIN 100 FEET DF SYSTEM i _. y ~' ..~ ;. . ~- ~ D~ ~vr u%~ . ~, r 4 ~, Q i ~( /~~ r... ... ; I .r 2 Cd 1~Vt BQNCHMARK: Describe the vertical reference point used Td~ ~~ ~{ X Elevation of verCioal referen/Ic//e points ~ (} J Proposed slope at site: SE!'TIC TANK: Manufacturer: We ~fe2 Liquid Capacity; ~2 5 G Number of rings used: _~ Tank manhole cover elevation; _" Tank Inlet Elevation: ~~.(1 Tank Dutlet Elevation; ~~• GS` Nu:¢bar of Pest From nearest 8oad: Front, Side~Rear,~ 1~ / feet From uearest•proherey line : Front,O Sid~e~a3z,~ _ ~,~~'~ feet Number of feet from: well ~_ , buiiding: U~ 4 _____ (Include this informatior. oP the above plat plan)( ~ference c.imensians tc segtic tank) SEE REVERSE SIDE 03i22~Ia1 'THC? li:oa FAX 715 386 X686 ST CRX CO ZONING • DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS P.o. aox ~es9 MAOI`ON' WIsi3707 >, ~J CflNVEN?IQNAL ^ ALTEflNAT1VE s'•'^ fifaf ^ HoldingTank l~ In-Ground Pressure ^ Mound N OF P RMIT HOLDER. h0 ?PERMIT MOLOER~. fNSPEC710 A ~~ k~~r5~? /3 i - ' ~ «f,n M ral~r nfepoem ESGR!6E IF D:FFEREN FROId PLAN PEF, PT. ELEY,'. ~c1 a~ >/ ~~v'P~~/tom d~~ ~a,~- ~~' ~Nnm. PI mn..r. MPlM PRSW Nri O,IwI 5a~nmv Pcnnn Num~~ ~o0i SAFETY tt BUILDINGS DIVISION BUREAU OF PLUMBING Plan LD. 4Vmba: t:..~~ PL ELEV SI=PTIC ANKiHOIDiNGTA_N~_ __~~ ,,, „_,!,_.~...__.. P/A~fhCTUgER. UOt11O CAPACITY f N~ :rvtC~l' i I ~' ~ !r,rvK qUf Li I ' LL V. 4NARNjN[i LABEL iT IOCKIN4 COVER ] ~ ~ '•~ PflaV'DED: PRQVIIlED Z/ti/~~~'i~ /~~ tl , f ~ ~(~' ~ ~ ~ DYES CNO OYES GIN d[ Nu. VLN'1 UTA.~ v v'f nu ~! MI tH A t. NUMBER OF ROAD: VI2UVL'q TT WELL. UUIL:)INC' v, T F 1 t /"I IAlnrt+n NNE G.~ AIR IN ET I ^ FlET FRdM. ~ ~ .YES ^NO i ~ ~ t'-'~ (-IVES J,N~ _ NE;4Rl:ST^~-~_~~ ~ / ,,.,.,,~, DOSING CHAMKEiR~ __ jMANl1F ACTURER 4ECI:rINr, I n1Ullt Gnvn p, v ruMr rnagi 1 Purmvi°,tt'I, sp; y'ANUr nt IUfItH WARNING LAEEI LOCK!ND LOVER ( I I ( PROV10LU rlvpvlEx:o ~ ~ EYES CJN4 _ -_L I LIVES L~NO ! CJYES ~NO ~~ Nr~CY Lam.-J~_- PIJM AN[! TIS t,. (1~°F',I(A11(I~NnL NuMB~R OF PFIC)VER 1'+' "JF! I l'SIIUINtI V,N F M !ID'FFERENCE BETVNEEN FFE.T FROM `'"E ~ 41q INLET `(PUMP ON ANO OFF; Q YES G NO N~ARF5T-~' 801E ABSORPTION SYSTEM. Ghe_~ the Bail m+T3tur8 i+t the dCpEN U! pi0w'uly r. c.:u I,Ir,raf rr rl a•,ATU.I ;: 4Nf. ~,1AUK:Ni, ar excavsTia!T, 41t wit can be rolled !nto a wirR, ConStruClian Sh3H CRRSP. yntil FGRCE the sail is dry enough tD continue.) MAIN ' rrulvcwlrlnwln~ CV QYCEA. ~~~~-'~•~'~ ~~d/TRCNCH' DIMENSIONS wlrorN„r ~ ~ LEatstH 7 i y~ 'V•1 N:! cu llnE;~ IN.. H PIPF SVI, f'. tI~FN{]I}i~ / :~(y( CIY- ,nvtt+ ~~ PIT .. la'.: INI.I~t nln. _+ Lloulo OEYTIr ~•+ L ' H ~br:lllW!~`l~G L~-_~ Il,f UI•(In AEC?VEQpVER 11!S ~.If V"I JI EIk4' INlE1,El ~ y1N PIPE 1•.• fNp UISI V. VIV, Plal L ~- ....-- N'~ d,la i tY 1M8ER OF i> NEARSSTOM IS 7TH V LANE ~ •~W. VJLL: NUiLUINh, q / D VENT TO SN AIrvINLIT MOUND SYSTEM: 7 A? _ Mound site plowed perpendicular t slope Check the texture of the fill material for and furrows thrown upslape; mound systems to make certa;n that it meets the criteria for rnPd;um sand. nYES uND _ 11 F_(7L/F Tl x t 11NL ~~ PFII"7l.NI N i MAI1 ~. PRdV#DE A DIAGRAM OFSYSTEM OIU REVERSE S117E- SNOW ELEVA- TIONS MEASURED. I IlItlI NYntftiry WELLS ~n10 ^YES ^NO nerln nvrn urr vran nrn DEY t'~I rlvt It lnt rvs:n neu Irl 1'wlp irU•SnIL tItIR Ir rrueu p„nry t:kN /ER FDC,ES ^YE$ []NO LJYES, CJ NO ^YES C~NO PRESSURIZED DISTRIBUTION SYSTEM: ;f41UU+ LENa;nr 4UW t.A'IaaAl, y'nGIN(i ;•~nvr l„rsl t';n r; Er;w rul" ~ M L QED/TRE•NCN (TRENCH ES. DIMENSIONS i FnnwF01 D PUMV "d AIaIIF (1LU 'fl$'I'fr PI^E MANtF ULU MAfEHIAL r;;t U15iN _ ISLyi~n ~~ ulSTru rlu It rv PI r I'IA YMIAt A .K INI: ELEV.. EtFv (nrA iEl Ev PIPFS DIA: ELEVATION AN DISTFt#BUTION ~ L ~ HOLE SIZE ~UEESVACWU 171ul1i.L7cluvli4aar __ - C:Avi'n+1ATfulAt TIL'hl LII i ~(lfnq`us'UNU$ „EA IllAPPHUYEO INI ORMATION ' I N ' DYES O o ~ YE NO N COMMENTS; ~. ~ !PERMANENT MARKERS. __ ~UQSERVATION ViEU's. -i ~~ ~ ~ YKUVE F{TV NUMBER QF LINE. D vvF 1, L, . flUII DING, v!YES G PIO DYES L~ NO NEAREST M: Skelch SvEtem an -f~etain in county file for audit, Reverse Side. ~j-.~ SIGNA URE ~~~ ~ i {) LF DiLMR SBDGTIO lR, 01)$21 r~1~'~~'~•-~LyC~. ~ .flpl~-~...v' 1_ `' C - '--- i)3i~3%'Q1 THL 11:04 FAX 715 386 4686 ST CRX CU ZOArI\G C(1j003 ' '~"~ '.~xor,-~, APPLICATION FOR SANRAR'Y PERMIT ,~j ~~ -: _' wiw.o_9eoanTrnan.as UNI~QCIR~M~ ITAf:tYPEFIRF1T,~r ~i~ rnwsTAV,upvow 6-WnWnl~cliTlOnS O"•7 Op• y/j -At*,aeh complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8Yax 11 inches in size. --See reverse side far instructions for cornpletinA this application. PLEASE PRINT ROoFaRTY OWNER ~~ ~ ~ L,~ --~ MAILIPIG ADOR&SS ~..~~. w~ ~.~ '"~ tv' ~~O t 3' PROP6RT N r'~ T ~'114~lI~l/4 S ~ R i t N ' CI Y: iv GF T~ ~ ~ L ~~~ . . . , . oy ;n : . l0T NUMBER BLOCK NUMBER U I l I NAM N AR 5T' F A..O~p t_AK~'G}R''LANDMARK STATE PLAN I, D. NUMBER YYPE OF BUILDIPIG OR USE SERVED ~ , a -- 1 or 2 Family Plumber of Bedroorns: [i Pul,liC (Specify}: ('HIS FERM17' t$ FORA: New System ~ Tar!k Replacement ^ Repair r° u ReplaCernent Soil Absorption System ^ Revision ^ Privy Alternate System ^ ReCennectOri ^ Petition for MOdificat4on IF THI5 r5 A CoNVENTIONAI SYSTEM COMPLETE THIS BLOCK. _ ~^ ~ Seepaye Bed ^ 5eepageTrench ~~ Seepage Pit ^ Holdiny'fark - ~ 5ystem•In•Fitl ^ In•Ground Pressure ^ Vault Privy ^ Pit Privy l ^ Exis*.ing, Eor Which A Previous Permit Is On File, Permit # iss4ed i ~ An Exist!ng System That Has Been Inspected And !s Comp+iarrt As Far As Soii Conditions. ~~ Tq[al fPof Gallons Tanks Pre!ab. Site Stec! Fiberglass Plastic Concrete Constructed Septic Tank Capacity ~ ~C Lift Pump TenklSiphon Chamber HOldiny Tank capacity Manufacturer IF THIS 15 AIV ALTERNATIVE SYSTEIt4 COiYIPLETE THIS BLOCK' ^ Mound Q In-Ground Pressure Total Gallons i>fof Tanks Prefab. Concrete Site COnstruutW Steer Fiberglass Plastic Sept c Tank CaAatty ~ a lift Pump/SiohOn Chamber Manufacturer: PERCt)lATI4N RATE IMinut~es per inch): A 4RP710N AREA REOUTAEO (Square Feetl: ABSORPTION AREA WATER SUPPLY: -~. PROPOSED (Square Faett: • D ' ~ 0 ~, ~ ~ ;~ Private ^ Joint ^ Public I, the undersigned, hereby assume respcnsibiiity for ins'•allatian pf the privaXe sewage system shor~m on the attached plans, W Name Of cumber ( :intl' Signatu ec MP/MPftSW WO.; Phnne Number: Plumber' Andress: rJame 0( Designer: ~ _ CO UNTY/DEPARTMENT USE ONL Y Signature of Issuing Agent; Fee; Date: _ ~i DiaapprowJ ~~ ~`~© ~' ~~ ~+~ ^ bwnsr Given IniCisi ` u apP~v~*~ _~ Adverse Getermination~J Reason far ig ra Alternate courselsl of Action Available: __._._ _ _____ _J DILr-rR.Seo-6398 (R.5ra7i DiSTR18UTtON: Original ro County, One Copy To. Bureau of Plurnhing, Owner, Plumber p3~22lp1 THU 11:05 FAX 71~ 386 4686 ST CRX CU ZONING ~ OOd 4 t~ 5 i l r lv~ r7 ~~ ~/ ~ yz s ~ ~ n, J r F F- ~ ,~,.,, ~ ~ ~ ~ ~z y ,~ ~~!- _ ~ 13~n.. r 1~~~~. ~ ~ ~ ~l G ~, ~'~'j J71Z. r. 5ys`~r~ ~'~r~r~~iLw ~/ ~ 5' ~ ~xG,r` ~xT~ ~,1,srtiv~tiow Y~lo~-4 -_..,,.} ,~ ~ . -----,,._~ ~_..~ fi i ~ ~ 3.~ ~ j ~ RG~~~, fig, ~, ~~,~ ~ k ~,~;:~. ~--.~.---..._.... .~ ~6' _._ ... _.._.... _ . _ -------,~ ~~ 6' I ~~ I ~' 1 ~ l y ~ ~ ~ L ~~~ ~ ~ ~ ~ 1 /~ ~ 1 I ~ ~ Jt ~ ~ ~.--_ --- (1 I f - ~ 1 ~ ~ ._.... ~w ___. ~~ ~ ~ ~ i 1 l ~ ~ r ~~.'® ~,r ~ w, 1 I` ~ ~~~-^,r, t ~ ~'~~, ;c.. ~ post` I ~ ~ t r I~7 ~ i ~ 1 ~ a M .~ ...... .... ,.._. __. _._.._,._.__.._.__ ~. _ ___...._.___.-~_.... l~,._.____.... ---~--~ ~ ~ ~i ~ _._.. _.~.~_.._... ~ ~~a.. t~ i r_ ,.. y' ...,r . . , 03'?2/01 THU L1:Dd F.9k 713 386 4d&? ST CR.I' CO ZONIA'G 6EF"ARTM"t170F REPORT ON SOIL BORINGS AND INbUSTRY, PERCOLATION TESTS (1~5) LABOR ANO FJVMdN kELATIONS (H63,09(11 d Chapter 186-4451 .S i/- ~TO'NN 1P!MVNICIPAUT4'; UT N~...: BLK. Nt}-~ Il r n ~NlR~6E lwlw rr.~ ter: ~,~ UMTY: AM : AIL N ' -u Kn iS y1~7~/i l sor. !L ! MoodyFLL.ri ~,!i' USE DATKS GBSERV (~ ~J- 17N.,T6 TQM~tC .:AA S _ ~1 '~'~~ l~R.eidcrce i ! ~ I !/!'7 WNW Qp~~ ! v! °1 ,. / l w S-SnewitirblatorsYStam U=Sldntsuitable f~jdp7 SAFETY & SUIL61NGs bJVlslOra P.O. BOX 7969 MAb1SQN, WI 5370' ~I! Paredlati0n "-eats aro IJ4T ra0uhpd DS51 I If t1nY portion Of tha tegad N4 i3 Ir. +ne ~ndar e. H$3,091511L1, cntfica»: Q '~ ,Q 14 Flooddaln, lnd/cate PloadRta4n e4e~a:wn: ~ J PROFILE pE8CRIPT1pN5 IBOR1mG TOTAL } NU°ABlea DEpf-N tN- ELEVATION '"HT R . ~^ -I ?IE5 - HR R .L 4!°H HI'yK~SS, C~;aq~EXl'Uft E, RPiO DEPTH TO 96 RO ~C IM CIBSER"dEp ISEE A6R'i.ON 9ACr*.I a• !']•6' c G' .S'fiC. SiCaro'r~~~_y~'pa, '6-.~ T).o~ .5't /C3' :7'I,tG.S'tC .b_.. /TLf`l.S (3n rt, g•~~ 7-°~ `~ ~ ta' as'8[s,~,a2.af~n sCy-5_ tl~~- 16° C)~ ~~.0~ ~ C~1 .d'~~ e~_/„~_/~lys'~•• 4~•S~M. n}/L• Jar_,>~. 7r .. ;" di~T Tlrar-«,'$~LATtONTESTSZ/_ /•/Tl pZ_OR (.SJ/h1 OEPTF' R'/t ER I"r HOL I _ .r "' ' R - nu IJ ~ t RUMEER ItJt;irE£ AFT R "N LLrtJG IN*ERVA -MIN. re 75 ~• ?r __ PEq 1NCH v. ____._. _ ____.__ -__ P _ _ P- P. '- P.~ -- -- -- _ _ - --- ---J- -- II ---- -'J PLOT PLAN: Show IocetlBns d1 per0o1atl0n tests, sui~ borinss and llre dimension; of fuitaDie 4011 ereas, Indic+te awls or dlrtanees. Deaafbe whet ere tM hari- eenref and verelna! r;levNlen relarenca points and show thou IOaatidn do the plot plan, Shover t'e m~tspe aUUadon st a'I 4;orings and the dinc[lon and pe+eent SYSTEM ELEVATION ~,~-~ 3. S' _ S,E ~' ,~+'7'fi~~Gll~o! S1, t,c7 ' rrl 1, tl+e undarcigned, Hereby 0artily that the soil Het; neportad on this Corm were meWa by me in aeCUrd with the procedures and mrttwds 4pacitiad rn the iAiisronsin Adrt~~istrati.s Cods, and that tha data recorded aad +he location of tha tas+s aro mrrsd so +he best of my knowledga and balier. NR +prin4: tHSTS W R C rAOL ETED ON: -~---~ IR D ~ N e R~~ PNO ENUMBERIOprinr^'^7u ~} ~ ~/_7h~~ n s" 7' Gr/o odl~iLl,c G[Ji~ syUr,~ ~ ~ /'~ d 6 71i~-GYF ~.YaZ D15TRIBUTtONf OriBinat and one ropy to Lpcal Autlarlry, PrppertY Ownar end Soil Testm. DILHR-S8D~3951R, 02/82) -OVER - .' U3'22!Ol THf.? 11:07 RAX 715 3a6 0484 ST CRX CO ZO'.VING _ ~ ',y, I I i I i i I i ~ r~aoa ~ys-'j~~. ~xL~L~d, ~l~r'' ~ 1~~ n ~ ~~PL rL j' Jl c ~ ac's i. i of I ~' Y ..__~ S- ..... >I S ~ ~ _ .....:._ - i{ - - .---.-_._. __ _._ ~ 1 t,_ . _... ,, j c.rl/1ch I ~ F~~ I I I ~ ~ W~ l '~; ~ s~ r ~ p~ r ~' ~ ~ ; i r! r I~ ~ ~ ',~ i I, C i 1 _~ ~ ~ I~-_ . I~ ~-- ~ ~'' 'w Ci 771. I~' ; ~ - ,~'s i s,~.., i a , ~1z ~ r„ ~ ~ ~ ~ ~... _._...~s _...,_._~ { / :.i ~ i i ~` J~ ~ '~~ k~v r~.. _..... _ i ' . n5i2:iU1 THU 11:D8 RAY 716 986 C68~ SuRVE1tQR"S CERTIFT ,. ST C2i Ca ZON12dC: Q006 1, JEROME CHARLES WITTSTOCK, Wisconsin ReglStered Land Surveyor, hereby Certify that I have surveyed, divided and mapped apart of the Northwest quarter of the Southwest Quarter of Section 11, Township 28 North, Range 16 West, Town of Eau Galle, St. Croix County, Wisr.Onsin, being Lot l of Certified.Survey Map No. 411, retarded in Volume 2 of Certified Survey Maps of St. Croix County on Page 471, more particuiariy described as foliowsi Commencing at the west quarter Corner of said Section 11; Thence S 00006'28" W, 562.04 feet; Thence 5 88°04'32" E. 33.02 feet to the northwest earner of of said Lot 1 and point of beginning; Thence continuing S 88004'32" E, along the north line of said Lot 1, 550.00 feet to the northeast corner of said Lat 1; Thence S OD006'~8'' W, along the east line of Said Lot 1, 117.40 feet to the southeast corner of said Lot 1; Thence N 88°04'd2" W, along the south line of said Lot i, 55D.OD feet to the southwest corner of said Lot 1; Thenr_e N tm°Ob`28" E, along the west line of Said Lot 1, 717.00 feet to the poink of beginning. Said parcel contains 394,152 square feet or 9.05 acres. That I have made such survey, land division and map at the direction of Dennis Mathison. Route 1, Woodville, Wisconsin. That such map is a correct representation of ttre exterior boundaries of the land surveyed and the suhdivision thereof made. That I have fully complied with the provision of Chapter 236.34 of the Wisconsin Statutes, Chapter A-E 5 of the Wisconsin Administrative Code and the suhdi~oison regulations of the Towm Of Eau 6a!]e and County of 5L. Croix in surveying. dividing and mapping the same. DATED THIS 7'"!~pAY OF ~~~„rR~~, 1985. ,, ?r n. •: { JE M H L eg s ere an rveyor ~~a , auua..es venns'rocx a-~ero rEaa+ONK rrro. Yolwoa b p8$8 1b17 ~~ '.., IWE2„OS2 e , 04/22,'01 THL' 11:05 FAQ%-715 486 0684 ST CRR CO 20NING X005 F~! ~'~~ a919B5 CERTIFIED SURVEY MAP N0. 3~3_. '"'`*+ VaLIJME_ 6 ____ ,PAGE b.~r~ . LOCA7EO /NTNE NORTNWI=ST QUARTER QF THE SOUFNWEST QUARTER OF SECTJON ! 1, TOWNSMJP 2@ NORTH, RANGE IB W£ST,T(1WN OF EAU GALLE',ST. CROIX CQUlYTY, Wr5C4NSlN. 8E1NG LOT ! OF CERTlFlEA SURYEYA~4P N0 4T! RECQRLEA pV VOLUd4E '' 2 OF CERTJF/ED SURVEYMAPS OF 5T. CRO1X CQl.WTY ON PAQ~ 471. WEST pftpRTER CORNER SECT/AV ll, 728M., R.16 W. " ~~ a • FouN ar: •R40 n .3fr 0 os~r~"„~a"R!'-ROD { nj WElGNWG I.BDt LIB./L.F. , I ~ ~x FERti'f i BEARINGS AREREFERENCEO 1i? TiIE WEST LJRIFQFTNE80UTHW88T ~CROAY7ED AS~NOO°Oet28~Ff/. SCALE!": lOQ~ 'c .~......r ~ ~ SURV~YOR'B NOTE OEEO RECORDED 1N VOZ!!ME 582, PAGE a/Si; CREATED PRIOR TO i CERTlFlEO SURVEY MAf NO 4F1, 3h'OWS OWNE'FiSN1P Ttl r.+~ WEST AND SDOU~TrM}~L/$NyEyS/gOFpT7iEppN~tW~W1~DF p~arE 5 SWf~/~4. CEpRnFIED SuRVfr ~~ WI `~ `;^1 ~F~1STSdDEOF'IOTiEOr„38pNSA~N dD~DbflO+AVAL~~~N~L D~ t O ~4! ~ SSE a w ~ ~ ~ rer,sa3 so Fr. ;~ ~ ~ . .. !! 4,31 ACRES a, ... ~ ~a 7 O v ~ ~.- ..~ ~\ ~ O h ~ cwrvrs \ ~ ~ a ~ ~ \ n 1 . tnf ~~ ' acvnc til o ~~ s@a•8 3z'E 5so,oo' ~ \. , ~, ' ~ ; ,. ~~ "! ~r .- i a~ ` ~ W of a .N ti ,. ~ ~ g d H N ~ a ~f ~.. O ~ Q ~ , ,, <,~ a\ y ~ `~ APPROVED DES 17 »85 `'~`•, i ~ ~ ~ ~~. CRalx tab'nrr REMkNfiYF Pwxrg /IANrNV1, ~ ~~ I wnD ONI fnJ,~ra •. ~',~ g~N~ N86°O4 32 W 580.00 1 V~ i N~ - ------------ - =-~ ~ sourxwesr CORNER secTloN r1,r.28N.,R.rsw, -( FGtWD d '~ 1 RON PIPE 1 PREPARED FDR• ff!':i! CD.~P"M,! "!?A' 0_°MN!5 M4/MASCW, ON'NCR an.i fi'. ~,(;1 F'/11.',f! kT. !~ WOOOYff.L,E ,~: rr .rrxu:,~v s'~r5r SEE REVERSE FOR CERPIF1CArlON PACE ± Df $ Ynl,ume 6 Page 1617 1S't. Croix County Planning and Zoning Detail Sanitary Information Friday, February 02, 2007 at 3:35:37 PM Page 1 of I Computer #: 008-1031-60-100 Sub/Plat: NA Section: 11 Parcel #: 11.28.16.1620 Lot: 3 TNIRNG: T28N R16W Municipality: Eau Gaile, Town of CSM: Vol. 06 Pg. 1617 1/4114: NW 1/4 SW 114 Owner: Leaf, Jeff 429 250th Street Woodville, Wf 54028 State Permit: 83787 Issued: 07/09/1986 POWTS Dispersal: Non-Pressurized In-ground Permit: New County Permit: 0 Installed: 07/11/1986 POWTS Detail: Bed -Seepage Bedrooms: 3 WI Fund: POWTS Pretreatment: NA Notes Issuerilnsoector As Built Plumber Other Requirements Additiona{ Notes Monev Owed Harold Barber Yes Stang, Joe corrected errors on notecard -verified Leaf was $0.00 Tom Nelson Signed Off: No owner and sold to Traxler. File with 2001 replacement -installed 1250 gai. septic tank to 24' x 53' bed - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner: Traxler, John 429 250th Street Woodville, WI 54028 State Permit: 383925 Issued: 04/12/2001 POWTS Dispersal: Non-Pressurized 1n-ground Permit: Replacement County Permit: 0 Installed: 04/25/2001 POWTS Detail: Trench -Seepage Bedrooms: 4 WI Fund: POWTS Pretreatment: NA Notes Issueritnsoector As Built Plumber Other Requirements Additional Notes Monev Owed Not determined NA Stang, Joe $0.00 Kevin Grabau Signed Off: Yes Maintenance S_cheduied Pump Date Pumped 1st Notification 2nd Notification 3rd Notification 4/25/2004 9/29/2005 04/20/2006 9/29/2008 'L Form-STC- 104' •"'"' ~ AS BUILT SANITARY SYSTEM REPORT a.ur l'a !lam OWNER ~ g ~f n e {/ L e a TOWNSHIP SEC. __1_.____ T 2~ N-R ~~ W ADDRESS ~ ~~. wvv C~`t~ ST. CROIX COUNTY, WISCONSIN 5"yo ~ 3 SUBDIVISION /J~f} LOT PLAN VIEW Distances and dimensions to meet requirements of ILHR, 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM --~.,. 2 ~~ , --- ~. i i ;_ ii I ~Jf~ - vt ,~/~ ~ .~ ~-- ~~ n ;, 1 LOT SIZE CfC r,~ r 2 c d ~ /t BENCHMARK: Describe the vertical reference point used TG~ G~ ~ X Elevation of vertical reference point: _ 1 Q~j Proposed slope at site: SEPTIC TANK: Manufacturer: W e~Se ~ Liquid Capacity: ~2 S G Number of rings used: ~_ Tank manhole cover elevation: Tank Inlet Elevation: ~ ~ Tank Outlet Elevation: ~U• G S"~ Number of feet from nearest Road: Front,O Side, Rear, O ~ L~~ feet From nearest property line : Front,O Side,~ear, O ~~'~ ~~ feet .~ Number of feet from: well ~ l~} building: ~-- (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE /~ PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: `! ~Z. Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear, Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: ~ Trench: Width: ~ ~~ Length: S~ ~ Number of Lines:~_ Area Built:~2 f~ i Fill depth to top of pipe: ~~~ Number of feet from nearest property line: Front, O Side, © Rear,Ol~t.~.3© Number of feet from well: ~ ~~" Number of feet from building: N ~'~ (Include distances on plot plan). SEEPAGE PIT Size: Liquid depth: Area Built: Number of .pits: Diameter: Bottom of seepage pit elevation: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Dated: f~ Front, O Side, O Rear, OFt. Inspector:.y~ Plumber on job: ~~ License Number: ~ J%~~ ~. ~ ~~6 3/84:mj DEPARTMENT OF INDUSTRY, LABOR & HUMAN RELATIONS P,O. BOX 7969 MADI$BN~WI X3707 INSPECTION REPORT FOR PRIVATE SEWAGE SYSTEMS CONVENTIONAL ^ ALTERNATIVE ^ Holding Tank ^ In-Ground Pressure ^ Mound SAFETY & BUILDINGS DIVISION BUREAU OF PLUMBING State Plan 1.0. Number: (11 assigned) w N OF P RMIT HOLDER: AD S F PERMIT HOLDER: INSPECTIO A B (Perm nt refer nce ppmt ESCRIBE IF DIF FEREN FROM PLAN REF. PT. ELEV.: CST REF. PT. ELEV.: Name o PI mben MP/MPR1SW Nn~.~.~/{ Cou Samt ry Permir 'N/uJ~mber: SEPTIC TANK/HOLDING TANkf. /`- 'J'~ ' ~/e~ MANU FACTUR ER ~ ~ ~ n • l (/V-~P/{~-vC/ LIOUID CAPACITY ~} ~ ~~G.v~ . T NK INLET ELEV.. ~, ~ f TANK OUTLET ELEV.. / J~~`(a ~ WARNING LABEL PROVIDED: ^YES ^NO LOCKING COV ER PROVIDED: ^YES ^NO BEDDING. YES ^NO VENT DIA.: 4~ (I r VENT MATT ~ "' HIGN WATER ALARM ^YES ^NO NUMBER OF FEET FROM NEAREST- ROAD: ~~ PROPERTY LINE: WELL: ~ 6UILDING: ~~\~ VENT TO FRESH AIR INLET. DOSING CHAMBER: MANUFACTURER. BEDDING: LIOUlO CnpnClTV Punnp MODEL PUMP: SIPHON MnNUF nC,T UREH WARNwG LABEL LOCKING COVER PROVIDED. PROVIDED: ^YES ^NO ^YES ^NO ^YES ^NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PH OPEH7Y WELL BUILDING VENT TO FRI (DIFFERENCE BETWEEN FEET FROM ILINE 1AIR INLET: PUMP ON AND OFF) ^YES ^NO _ NEAREST---~ SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing ~ - ..IAMF TE H MArE HInE ANn MAHKw<; or excavation. (lf soil can be rolled into a wire, construction shall cease until FORCE MAIN the soil is dry enough to continue.) rnAl\/CI\ITI Aa.IAI CV CTLM• BED/TRENCH WIDTH ~ ~ LENGTH NO OF THENyfjES DISTR PIPE SPACI N('. COVE1+ IAL PIT iNS1I~E Uln zp1T5 LIQUID DEPrH DIMENSIONS ~~ !f ~ /;R:?VEL f1FPiH FILL DEPTH UIST H. PIPF UISTH PIPE DISTR. PIPE MATERIAL N STH NUMBER OF PROPERTY WELL. BUILDING VENT TO FRESH BELOW P ES ABOVE COVER EL EV. INLF I ELEV ENU ' ~7 P FEET FROM LINE AIR INLET: ~j Q ~ ~J~ // - NEAREST =~ f 9D M(]tlNr] SYCTFM• ~oI ..l C,1 A. Y.S- Mound site plowed perpendicular t slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. ^YES ^NO SOIL, COVER TEXTURE PEHhAnNf N! MnRKF HS OfSSEHVATIUN WELLS ^YES ^NO ^YES ^NO DEPTH OVER TRENCH BED DEPTH OVFH TRENCH BEU _ DEPTH OF TOPSOIL St1DUFfJ SEE UFU MULCHED CENTER EDGES __ ___C~YES._ _ ^NO__ ^YES C~NO ^YES ^NO PRESSURIZED D_ ISTRIBUTI f WIDTH. BEDlTRENCH DIMENSIONS MANIFOLD ELEV.: ELEVA7lON AND DISTRIBUTION INFORMATION HOLE SIZE COMMENTS: /'" Sketch System on Reverse Side. DILHR SBD 6710 1R. 07/82) >YSTEM: LENGTH NO. OF TRENCHES'. LATERAL SPACING GRAVEL DEPTH BE LUW PIPE PUMP ELEV. MANIFOLD DIA. DISTR. PIPE ELEV. MANIFOLD MATERIAL NO UIS PIPES HOLE SPACING GRILLED CDNRE CTLY COVER MAT ERIAL NARK EHS: OBSERVATION WEL YES ^NO ^YES DISTR. PIPE UISTHIBU 710N PIPE JIA VERTICAL LIFT CC PLAPIS ^YES NUMBER OF PROPERTY FEET FROM uNE NEAREST etain in county file for audit. AL & MARKI ~~~ w,s~°nsrcm ~ APPLICATION FOR SANRARY PERMIT ~ DILHR (PLB67) ~ OEPFig7TTEr1T OF ®~~~ IrtOUSTRV,lR000 6MUmfin FlELriT1°r15. OUNTY UNIFORM SANITARY PERMIT # S"3 `J8' ~/ -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'/Zx 11 inches in size. -See reverse side for instructions for completinu this application. PLEASE PRINT PROPERTY OWNER MAILING ADDRESS PROPERT LOCATI N ,,,, ~@,++ G!1/4 Td-QN 5~/~1/4 S ~ R ~ ( CITY: ~~ ~ L ~-~ , . , , or TOWN OF: ~} .. ~ LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD LAK OR LANDMARK ~~~~ ~~~ STATE PLAN I.D. NUMBER TYPE OF BUILDING OR USE SERVED / ~ Q -~ y~ 1 or 2 Family Number of Bedrooms: ~' [] PuLlic (Specify): THIS PERMIT IS FOR A: New System ^ Tank Replacement ^ Repair i~ Replacement Soil Absorpiion System ^ Revision ^ Privy ^ Alternate System ^ Reconnection ^ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. Seepaye Bed ^ Seepage Trench ^ Seepage Pit ^ Holdiny Tank J System•In-Fill ^ In-Ground Pressure ^ Vault Privy ^ Pit Privy ^ Existing, For Which A Previous Permit Is On File, Permit # issued ^ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total- Gallons #of Tanks Prefab. Concrete Site- Constructed Steel Fiberglass Plastic Septic Tank Capacity Q ~( Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer IF THIS IS AN ALTERNATIVE SYSTEPJI COMPLETE THIS BLOCK: ^ Mound ^ In-Ground Pressure Total Gallons #ot Tanks Prefab. Concrete Site Constructed Steel Fiberglass Plastic Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE (Minutes per inchl: ABSORPTION AREA REQUIRED (Square Feet1: ABSORPTION AREA PROPOSED (Square Feet): WATER SUPPLY: 6 • 0 - ..Z O ~ 6 a pZ. ~, Private ^ Joint ^ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber IPrintl: Signatu e: ~ MP/MPRSW No.: Phone Number: Plumber' Address: / Name of Designer: COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: ~~ ~ Fee: J~~~D / Date: ~~ ~~ Approved ^ Disapproved ^ Owner Given Initial Adverse Determination Reason for is ro Alternate coursels) of Action Available: ui~tiht-St3D-6398 (R. 5/82} UtSTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber i _ - - •~ OLr St) )L ~~STji. >p~ ~'~ S /~cl~, ~r ~' ~~!~~1 ~ ~ ~ ~~Z Gr F11 p 13~~ r l~~~h- ~ ~,~ ~ ~ ~ 2L~ ~1 tz l /1/~ SG~~r~- J Z -__ 1- i .r~! l3~~ I I Iy0 /~~I~rri ~' ~ 6' 3 ~ ~~ y ~~ r s'. Tr ~ ` _ S3 A j ~ ~s ~ ac _~ ~~ ~ r ~~~ i nosT I~(~ i Y _..._...~_..._y i 3. S ~ - _5 ~ o~~~ ~ ~ ! ; t ~; V... I j ~~ ? ~~ ~~ 'I-~ ?`~~ 1 DE~'ARTM"-NT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND., ~.. PERCOLATION TESTS (115) MADISON W 53707 HUMAN~RELATIONS ' ~-}~• (H63.09(1) & Chapter 145.045) LOC~AT SE TION: TOWNSHIP/MUNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: w '/ '/ / /T ~N/R/(oE (or) W t~Gl ~ x/t~ L,~ COUNTY: OWNER'S BUYER'S NAME: .ta 17~ 'y1 i MAILI G ADDRESS: FGGk ~~ y~oZ~ vooa IZ 1 C oiu t / h ~ S ~~h ~ v 1SE NO. BEDRMS.: COMMERCIAL DESCRIPTION: .Residence / / New ^Replace DATES OBSERVATIONS MADE ROFt D R DNS: A ION T STS: RATINGS S= Sita suitable fnr system U= Site unsuitahle for system / f>YGL' 7 ~ ~ / / f ONVENTIONAL: ~,S ~U~ MOUND: ~.S DU IN-GROUND-PRESSURE: ~S DU SYSTEM-IN-FILL D S 1~U HOLD NG TANK: D S ~lU RECOMMENDED SYSTEM:loptional) yx ~/o ~~d -- ~E os If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(51(b-, indicate: ~~ o --" ~ Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL PTH TO GR UN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED E I HE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- f7-~' ~ G' . S'f3C. siC a~.o'13„ L y ~''lTh 8-~ ~. ~' ?. S~ ~d ~ ..7~l3L. SIL d' h ~ `"~ ~ UN Iz- s- ~ _G' .~' G' ,?'fit. SIL.' .QJ3n SC ~_3~~~ /t. B-S _oi x'7.4' /o' .~'l3C ~ sL. ~'/•S~n. n. B- /~CfL~'_ ~r<! /~/G7 R~4JE~t1'tir~fCOLATIONTESTS~'`N2 Q~.Q~' (J~/~~ TEST DEPTH WATER IN HOLE TEST T E DROP IN WATER LEVEL-INCHES R TE MINUTES NUMBER INCffES AFTER SWELLING INTERVAL-MIN. p Rt D t P RI D PER INCH P- P- P- P- P- P- •T 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. .SYSTEM ELEVATION ' .~. 3S ~ S,~ ~ a~TTr~~ ~ ~ ~ S ti ~ ~T TN I, the. undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print : S T.~ ~,~~- ~ /-~r~~~ TESTS WERE COMPLETED ON: -~o-~ ADDRESS: _ got ~J ~tNr H ~ ~' ~~ a~(~,CL,rL Gt/i S~`1~U~. g' CERTIFICATION NUMBER: /~y o6 PHONE NUMBER(optional-: 7/S-G~~-ay6 CST SIGNAT RE: f ~~~ ~ ~•~ DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. OILHR-SBD-6395 (R. 02/82) -OVER - 1 t ~. ~,s l~~ r~~~~~~ ~~i S .. ~ ~~vlL r I~oLrL ~ ~ c ~ ~'S i ~l ~fY I i. -~ _ _ __..______._ _.____ s- ~ o _ _ _.. -_ - - ~,~,~ f ~ 1tl~ati ~ j ~ ~'%, c.. '' I I , i I ~) ~ ---- • - f I i __ ~ _ ~{ .Sr~~ f~~~ ~ ~ l / (~ 3 w,~ ~~~ ~ i ,,~, ~- . _- .- ss - --_--~ ~=~ ~ +_. `~ 02'`~ V I~ _ ~~ i ,~ ,~ iM 1 APPLICATION FOR SANITARY il'utiIIT STC- 100 This application form ie 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/contrac~~~,("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 3e~~ ~-~. ~! ~ ~ J 14 n C Location of Property ~t1•? ~G J~,!'~, Section ___~~__T, T ~ N - R ](n W Township ~. 0. ~ Mailing Address ~-OIJ~~'e.., ~aocly, Ike t~ ~ S~D~~ ` Subdivision Name Lot Number Previous Owner of Property l)2hr~~ -~- 1).Ql7pra,(~-~ M,gy`l-~t~~~r, Total Size of Parcel ^~'~]S (0~~ ~ X ~1~~. bT / Date Parcel was Created ~~' 3 t - ~5 Are all corners and lot lines identifiable? ~ Yes No Is this property being developed for resale (spec house) ? Yes ~~ No Volume ~ ~ Q and Page Number _~~~ as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract ~~. 3. Other recordings filed with the Register of Deeds Office 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 the Certified Survey Map shall also be required. PROPERTY OG1N~R CFRTIFICATTON 1 (G-e) een~.i.~y ~ha~ a.P~ 6~azemen~a an ~h.i,d ~anm ane ~icue .ta .the beb.t a~ my (aun) , h.naw.eedge; xh.at I (we ) am (ane ) ~h.e awnen (b) a ~ the p~co peaty ded e~u.bed .cn .th.ia ~,n~onma~.%an ~an.m, by v.ihtue a~ a wa~vcan~y deed hec nded ~.n the 0~~~.ce o~ .the Caunty Reg.e.a.ten o~ Deedb as Doeumewt No. ® ~ and ~h.ax I (we) pn.eden~y awn .the ~vr.apaaed e.ete fan ~h.e aewage pab byb~em (an I (we) have ab~ai.ned an easement, xa nun w.c.,th .the above deae~-.%bed pnapenty, ion the eon6~.u.ct.%.an a~ ba.i.d 6 ya.tem, and .the eame has been du.~y neeanded ~.n the 0~~~,ee a~ .the Cowtity Reg.%a.ten o~ Deeds, a,6 Document No. ) . NATU OF OWNER SIGNATU OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED /, STC- 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER J e t~r~C.4 ~ ~ ~Vq-Ytt ll~- L~Ctt ROUTE/BOX NUMBER ~i~ ~ Fire Number CITY/STATE ~~Qc7~t111~~- 5~~~,~ ZIP PROPERTY LOCATION: I~_~~Z, SU1~ ~, Section ~~ T ~g N, R~W, Town of ~~,A [~c.~~t. St. Croix County, Subdivision Lot number Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents m_~. a maximum of 60% of the cost of which was in operation prior to accepted this program in August owners of all new systems agree maintained. be eligible to replacement o July 1, 1978. of 1980, with to keep their receive a grant for f a failing system, St. Croix County the requirement that systems properly The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank. is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. 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 Depart- ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNED DATE ° ~_~~,g'g U St. Croix County Zoning Office P.O. Box 98 H N H a r r H N 0 d a H [+'f 0 E z x N ro Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. _._i_ .~ __._..._. oocuMENT No. I STATE BAR OF yVISCON3IN FO$M 1-198 swls inecs ReseRVeo t•OR RECORDIMO DATA J - • l ~ WARRANTY DEED 1~_ _~ __- -_ _ _- -___.-_.__._...-_ -- ~. ~ r~rGiSTERS OfPICE This Deed, made between __. Denn i s _ L_.___ Math i son _--•-_-„__ ST. CROiX CO., WIS,~ _ and -Deborah__A.•-_Mathison_,___husband-_and__wife_.____ Roc'd, for Record }Etas 17th --- - ---- ---- ----- ---- ----------------------------•-------------------------------- Jan ~"$'6 °Y o ._-~______A.D. 19_ _. ---- -- -- -- ------- --------- ------------- -----------------•------------•------., Grantor,. <~nd ---_J.ef-fr-eV---A-•---Leaf---amd_-Jar~~.-~-t---Leif.i-----------------------... 8:30 A ~ __h_usb_and__,3n~3-__wi_£e-r___as---~.Q_1-17t_-_te11~(lt~s .................•--.--- - ----- ~Mr N WMIr~ .-•-----•-------•--•----•-----•--•-------..._, Grantee, ~11trieSSetr1, That the said Grantor, for a valuable consideration_._.._ 0_ne___do-ll~ar_-and-_o-th_er--_va_].ual~~-e_.cQ>a.eide~:dt_i?n- ---_~~_.__~_~"~.__~ RgruRN to conveys to Grantee the following described real estate in __-_St~.._CxA].X.__..._.. County, State of Wisconsin: Part of the Northwest One-Quarter of h ~;,,~,;,,•. _...__-._... _~_ - - _-: ~~ Souhhwest' one=Qu~>a`C°~'i~""'r`P`~i'""'T~"4""oSWl 4) of ,, , Section 11, township 28 North, Range 16 West, ~ TazParcelNo :........................... being a part of Lot 1 of Certified Survey No. 471, recorded in Volume 2 of Certified Survey Maps at page 471, St. Croix County, more particularly described as follows: commencing at the West quarter corner of said section 11; thence S 00 06" 28" W, 562.04 feet; thence S 88°04' 32" E, 32.02 feet to the Northwest corner of said Lot 1; thence continuing S 88° 04' 32" E, along the north line of said Lot 1~ 550.00 feet to the Northeast) corner thereof; thence S 00° 06' 28" W along the east line of said Lot 1, 717.00 feet to the Southeast corner thereof the point of beginning; thence N 88°04' 32" W, along the South line $f said lot 1, 550.00 feet, to the Southwest corner thereof; thence N 00 06'28" E~ along the West line of said Lot 1, 375.66 feet; thence S 88°04' 32" E, 550.00 feet to the east line of said Lot l; thelice S 00°0~6' 28" W along the east line of .said Lot 1, 375.66 feet to the point of beginning, The foregoing description is intended to be Lot 3~ Certified Survey Map No. 1617 recorded in Volume 6~ Certified Survey Maps at page 1617. ""5~ This -__1S_IlQt----._-__ homestead property. (is) (is not) ~ ~ ~ i. y ` - • Together with all and singular the hereditamenta and appurtenances thereunto belonging; And ------Gr.ant_ax------------------------------------------------------------------------------------------------------- ------------...-------- warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except and will warrant and defend the same. Dated this - -----------------------•-•------~.~.-------- day of -----------------.December ---- 19----- 85 ~ ` _.._ - -- - ----- --------•---------------------------(SEAL) -•- ------------•--•---._........-:.-- -••-•---•-------•----:.:-!(SEAL) * Dennis L. Mathison - --------------------------(SEAL) .---- - -........_-/~"'.mCt,~Ll`. ~!~aQWT!~(SEAL) eborah A. Mathison ,. „ .. AUTHENTICATION ACHNOWLEDGFN<ENT Signature(s). _-- ,: ---------------------------------------------------- STAT>~ OF WISCONSIN authenticated this .•..___-day of_____________•----.___-_.., 19..__.. TITLE : MEMBER STATE BAR OF WISCONSIN (If not- ------------------------------------- sa. --+~~..r.__ ~1= Q?:#---------•----.County. Personally came before me this ...-_~~._....._day of .________December_ ________-__~ 19.85___ the above named Dennis L. Mathison__a~__Deborah__A. Mathison ' authorized by § 706.06, Wis. Stats.) to me known to be the person __ s.-...__ who executed the ' ~ ~ ~ l~~goin strument and a now edg the same. THIS INSTRUMENT WAS DRAFTED BY ~ ~~ ~ ~ •. ~ - R4B1rl~T---G-.---W-AL•T-ER•--------------------------~_ _....[2; ` Attorney at Law ;,_ : :----• ---------------------------------------------------------- se,r:-----~ t tar~rLpublic ------•----~-----rOlX---------------County, Wis. (Si;;natures may be authenticated or acknowledged: $oth ~ Y ~azpmission is permanent. (If not, state expiration are not necessary.) '=. `~, ''••.,......1Ia K.~ MB-~----24------------------~ 19---$7 -•) .,;1 b,. ~.~ ,. •Nnmes of persons aignIng in any capacity should be typed or pri4tlp~ below e~~naturee. ~nn~tiva~~~ F ' F'I' 1'r F. R.4R OF Wi9CON3IN f; „- „l. ~, s 7 711!! t h i t r ,,~,. ~ r ~ ~~ .. . ~~ ~: ~~ ABSTRACT OF TITLE TO LAND DESCRIBED AS: - 0 - Dart oi: the Northwest One-Quarter of the Southwest One-Quarter (NWa of SW~) of Section 11, Township 28 North, Range 16 West, being a part of Lot 1 of Certified Survey No. 471, recorded in Volume 2 of Certified Survey Maps at page 471, St. Croix County, more particularly described as follows: Commencing at the West quarter corner of said Section 11; thence S 00°06'28" W, 562.04 feet; thence S 88004'32" E, 32.02 feet to the Northwest corner of said Lot 1; thence continuing S 880 04' 32" E, along the north line of said Lot 1, 550.00 feet to the Northeast corner thereof; thence S 00°06'28" W along the east line of said Lot 1, 717.00 i_eet to the Southeast corner thereof, the point of beginning; thence N 88°04'32" W, along the south line of said Lot 1, 550.00 feet, to the Southwest corner thereof; thence N 00006'28" E, along the West line of :uid Lot 1, 375.66 feet; thence S 88°04'32" E, 550.00 feet to the east line of said Lot 1; thence S 00°06'28° W along the east line of said Lot 1, 375.66 feet to the point of beginning. St. Croix County, Wisconsin. .._. St. Croix Valley Title Services, Inc. r: - ~: ~1.., _~~~w,H~ ` ~ti' Q`' ~O f L r .~ ~~3~ rl _~j ~ ~ ._.:...1.._. ,, ,' ~I '~ ii ~; i ~., ~~ v ~~~ ~: ~ ` .~ ~Q } ~~ ~~ 92 ~~ a." 3 v: b a rr i~ N o .-~ O ~ N ~ ~ ('!~ ~ V r~ v N v ~ x ~ ~ ~ ` x '` .~ T ~ -- ~i -,r v h ~ M ~ ~ ~ .` ~7 DIL SANITARY PERMIT GROUNDWATER. SURCHARGE On May 4, 1984, 1983, Wisconsin Act 41Q was signed into law. This legislation is more com- monly known as the groundwater protection law. This change in statutes was the result of over 2 years of steady negotiation and public debate. The groundwater bill included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that is used in your building is returned to the groundwater through your soil absorption system or the disposal site used by your holding tank pumper. -~~The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- - water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. Sig ature of Issui A e t: Groundwater Fee: Da e: DILHR SBD- s_ n. e~ Coun San(tary Permlt No. ~~ ~ ~ 7 , !~`7~ti~ W O N ~o - ,;~s O ~ O ,N1„IIU~NN,, ~~~ J ~' x H CERTIFIED SURVEY MAP N0. 161 ~+ ', VDLUME 6 ,PAGE 16.~._ LOCATED !N THE NORTHWEST QUARTER OF THE SOUTHWEST QUARTER OF SECTION l 1, TOWNSHIP 28 NORTH, RANGE l6 WEST, TOWN OF EAU GALLE,ST. CROIX COUNTY WISCONSIN. BEING LOT l OF CERTIFIED SIJRVEYh1AP N0. 47/,RECORDED /N VOLUNaE '~ 2 ~F CERTIFIED SURVEYMAPS OF ST. CROIX COGYUTY ON PAGE 47/. WEST QUARTER CORNER BEAR/NGS ARE REFERENCED 12~ THE SECTION l t, T. 28N., R. l6 W. WEST LINE CIF THE SOUTHWEST (FOUND 3/4'~RE-ROD) QUARTER OF SECTION I1-2-16. RECORDED AS NOD 0628 E. IL EGEIOID ~ .~C'ALE~ l ~~= /00' a. • FOUND 3/4 ' RE• ROD O 05ET 3/4 "x 24" RE-R00 / qj WEIGHING 1.502 LBS./L.F. t~ x FENCE UNPLATTED LANDS ~ S88°°04'32'E' 550.00' A SURVEYOR ~S NOTE - DEED RECORDED /N VOLUME 552, PAGE 419, CREATED PRIOR TO CERT/F/ED SURVEY MAP NO. A7/, SHOWS OWNERSHIP TO THE WEST AND SOUTH LINES OF THE NW!/4 OF THE SW!/4. CER77FIE0 SURVEY -- MAP OMITS ROADWAY ON WEST ANO SOUTH SIDES OF LOT 1. DEED -S MEASURED PERPENDICULAR TO WEST ANO SOUTkI LINES OF TH I ~! \\~ NW(/4 OF THESW If4. DEED INCLUAE'S AN ADDITIONAL 0.27 OFLAND ON \ ~' THEE EAST SIDE OF LOT I AND 0.38 O N Ttt4< NORTH SLOE' OF LO T !. tp O ~i \\ ~' ~ \\ N ~ ~. ~ 187,643 S0. FT. ~ ._ ~ \ M ~\ , ~ 4.3 / ACRES ~\ ~ ~ ~` tr , M ORlVf ~pV \ ~ ' ` M ~ ~6 , ' a: O~ O~ ~ I SEPT /C 21 ~ VENTS ~~ 3I ~ S 88 °4'32 "E 550.00' 1 w~ N~ tp 0 0 OI, OI Z A~~ I ~JI ~~ N~ ~~ ,~ ~, i ~ ~~i \~~ % SOT 3 r- ;, • 206, 5 .G'~~ ~ \ \~ 'C ~\ 4.T4 ACRES ~ ~~ - ' J i ~ ~ „ ~' -~~ APPROVED ~\ ~• - - • z \ • • • I <-~2•...I ~i2I g~yOQ` DEC 17 1985 .1 yy~ia0 s(~RV~'0~~~ ST. ~.ROIX COUt•aTY ~~iNlllNlllll{n~~~\~`` COMPREHENSIVE PARKS flAyr~~p • ANO IOAf~IJr_ rn,.,....._ ~~~~~ DE~19 ~ „A,i, a 1985 !~.. ~ 3 co. W~ N ~' hl (p QI O a~ h C O ,~ h ~ 6~ ~O M ,. ~2 ND N 88°04 "32 "W 550.00' _ _ ~ ~ _ ~SOUTHWfST CORNER SECTION Il, T.28N.,R.l6W. -(FOUND I '~ IRON PIPE 1 '• PREPARED FORS CFC.:i7 CORPORf~ "/?N DENNIS MATHISON,OWNER 604 N'l: SC tl AVl"NJE HT. I , WOOOV/LLE „ r%~s~ rss •sosl SEE REVERSE FOR CERTIF1CATlON PAGE ~ OF.~. Vo].~ame 6 Page 1617 .• SURVEYOR'S CERTIFICATE I, JEROME CHARLES WITTSTOCK, Wisconsin Registered Land Surveyor, hereby certify that I have surveyed, divided and mapped apart of the Northwest Quarter of the Southwest Quarter of Section 11, Township 28 North, Range 16 West, Town of Eau Galle, St. Croix County, Wisconsin, being Lot l of Certified.Survey Map No. 471, recorded in Volume 2 of Certified Survey Maps of St. Croix County on Page 471, more particularly described as follows: Commencing at the west quarter corner of said Section 11; Thence S 00°06`28" W, 562.04 feet; Thence S 88°04'32" E, 33.02 feet to the northwest corner of of said Lot 1 and point of beginning; Thence continuing S 88004'32" E, along the north line of said Lot 1, 550.00 feet to the northeast corner of said Lot 1; Thence S 00°06'28" W, along the east line of said Lot 1, 717.00 feet to the southeast corner of said Lot 1; Thence N 88°04'32" W, along the south line of said Lot 1, 550.00 feet to the southwest corner of said Lot 1; Thence N 00°06'28" E, along the west line of said Lot 1, 111.00 feet to the point of beginning. Said parcel contains 394,152 square feet or 9.05 acres. That I have made such survey, land division and map at the direction of Dennis Mathison, Route 1, Woodville, Wisconsin. That such map is a correct representation of the exterior boundaries of the land surveyed and the subdivision thereof made. That I have fully complied with the provision of Chapter 236.34 of the Wisconsin Statutes, Chapter A-E 5 of the Wisconsin - Administrative Code and the subdivison regulations of the Town of Eau Galle and County of St. Croix in surveying, dividing and mapping the same. DATED THIS ~°DAY OF ~yyc-rnR~2 , 1985. JEy ME HARLE IT TOC Reg stere an urveyor JEROME ~ '~ • CHARLES • ' ~.~ i MlITT3TOCK i s-~e~o 6tENOMONIE ; '~~ra.. S U~ 7...`~~``. Volume 6 .. Page 1617 ta~seZ oft g