HomeMy WebLinkAbout032-1007-80-300
STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER G~ r /
ADDRESS
SUBDIVISION / CSM# LOT #
SECTION TF2 N-R W, Town of
ST. CROIX COUNTY, WISCONSIN
aka ~
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF S )STEM
1
!v u
~ ,r
S
f-i~pf ;2 5-D Jot
✓GK
IN ICATE NORTH ARROW
Provide setback and elevation information on r verse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK: l4 X074
ALTERNATE BM•
SEPTIC TANK / PUMP C~~HAMBER / HOLDING TANK INFORMATION
Manufacturer: ~Z:c-= lf~j Liquid Capacity: e~-m
Setback from: WellHouse rr,7 Other
Pump: Manufacturer Model# Size
Float seperation Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
Width: Length Number of trenches
Distance & Direction to nearest prop. line:
Setback from: well: P House Other ,300
ELEVATIONS
Building Sewer &Z - ST Inlet , ST outlet O~
PC inlet - PC bottom ,Pump Off f
Header/Manifold Bottom of system y~ cam/ /
Existing Grade /Q Final grade
DATE OF INSTALLATION:
PLUMBER ON JOB : S/~ o rt r~S`
LICENSE NUMBER: ~3/1!!~
INSPECTOR:
3/93:jt
LsTrUN~Sart~6lNb`tlr'y.3.31.19.4T/6~D• T County:
Labor and Human Relations INSPECTION REPORT
Safety and'Buildings Division
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.:
93 7
Permit Holder's Name: ❑ City ❑ Village C7 Town of: State Plan ID No.:
fRqWM,jv.:K1RX Insp. BM Elev.: BM ~"cription: Parcel Tax No.:
TANK INFORMATION ELEVATION DATA A9400060
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic d . aZ, Benchmark ~ led, a ~
Dosing ® 164 , , A4 C dV a 7~
Aeration Bldg. Sewer
f, 33
Holdin St/ Inlet 6v,9
eel TANK SETBACK INFORMATION St/*f outlet (p Ud ?6'
TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet
BMI-
Air Intake
Septic ?/fir >oZS' -SSA NA Dt Bottom
Dosing NA Header4l_. 10-Y7. 970y'
Aeration P~A Dist. Pipe d, 91,93
Holdi, Bot. System /(,1/ 9 , 87
PUMP/ SIPHON INFORMATION rade l~ j,2 dd,(3
Ma r Demand a- ` 7- SLj p
do ~ 3,
Model Number GPM
TDH Lift Fri * n e ad TDH Ft
Force mai ength Dia. Dist. To Well
SOIL ABSORPTION SYSTEM
BED /JREfltGN- Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Depth
DIMENSIONS f7 DIMENSIONS
ufacturer:
TWrj
SYSTEM TO P / L BLDG WELL LAKE / STREAM LEAC
SETBACK CRAM
INFORMATION Type Of Ile,-Y pct `-3/0'f0 / umber:
System: /QS > JU NIT
DISTRIBUTION SYSTEM
Headed Distribution Pipe(s) x Hole Size x Hole Spa g Vent To Ai take
Length Dia. , Length 4~z Dia. Spacing L
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade ~ts Only
Depth Over Depth Over xx Depth Of eeded / S ed xx Mulched
Bed /-TgRMa-Center Bed / T eWftfdges 3,;~ ( Topsoil ❑ Yes ❑ No Ye No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION. S MERSET 3.31.19.484,N 1/21SE SE CO. RD. T
o iA
lie
//~i~yTIYx.('dTTC/~f/TJ`'/rLec- Q r^ C✓ : i_ r . ,
a vision r ire Yes
Use other sid for additional information. 707 S.-• l
SBGR 05/91) ~ Date Inspector's Signature Cert. No.~
SANITARY PERMIT APPLICATION
In accord with ILHR 83.05, Wis. Adm. Code COUNTY ,
TOILHRO
STATE NIT Y PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than X~ ! 3-7
8% x 11 inches in size. ❑ Check if revision to previous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROPERTY OWNER PROPERTY LOCATION
PROPE TY OWNER'S MAILING ADDREtS LOT # BLOCK #
r-
CITY, STATE ZIP CODE =PHONE MBER SUBDIVISION NAME OR CSM NUMBER
vZ
II. TYPE OF BUILDING: (Check one) ❑ State Owned VILLLLAGE NEAREST ROAD
❑ Public 0 1 or 2 Fam. Dwelling-# of bedrooms 72 ARCEL TAX NUMBER(S)
Z
111. BUILDING USE: (if building type is public, check all that apply) d
1 ❑ Apt/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash
50 Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line Bit applicable)
FZA
New 2. ❑ Replacement 3. ❑ Replacement of 4.E1 Reconnection of 5. ❑ Repair of an
A) 1. Ln
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
REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) / ELEVATION
.5_Z) `j ::f C.E , 7 b - Feet OY- Feet
VII. TANK CAPACITY Site
in allons Total # of 's Name Prefab. Con- Steel Fiber- Plastic Exper.
INFORMATION New istin Gallons Tanks Manufacturer oncret stCon glass App.
Tanks Tanks
Se tic Tank or Holdin Tank' '3 El El _11- F1
__Z+ - Fj 0 El
Lift Pump Tank/Si hon Chamber
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber' Name (Print): Plumber's Si nature: (No Stamps) MP/MPRSW No.: Business Phone Number:
Plum s Address (Street, City, te, Zip Code):
& c> C r^ Gf/ f ' de,
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sjnitary Permit Fee (Includes Groundwater a s us issuing Agent Signa (No S ps)
Approved El Owner Given Initial Surcharge Fee)
Adverse Determination v
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS
2
1. A sanitary permit is valid for two (2) years.
2. Your sanitary perm " may be renewed before the expiration date, and at the time r f ei ie& 1il any new
criteria in the 'ri+isconsin Administrative Code will be applicabie.
3. All revisions to thi's permit must be approved by the permit issuing authority.
4 Changes in ownership or plumber requires a Sanitary Permit Ti ansfe./Renewal Forin SR-) 635.9) to be
submitten to the county prior to installation.
5. Onsite sewage systems rnust be properiy rriaintained. The sc, ii tanks) me:5t be Fs, , ad 4 Licensed
pumper whenever necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local co&, itch-nisti ator 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 parczl tax n1imber(s) of
where.the system is to.be,installed.
II. Type of bin ding being served. Check only one and complete of bedrooms if 1 or 2 Family I'weliing.
III. Building use. It 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, vcorrnection, or
repair.
V. Type of system. Check appropriate box depending on system type.
Vt. Absorpti,-n system information. Provide all information requested in #1--7,
VII. Tank information Fill in the capacity of every new andior existing tank, ~s :h?, Iola' ~
Ait
lUrnJer of
tanks an'" rianufactUrer 5 mane. Indicate prefab or site constructed anry `t,ater i „ r :r; or all
septic, p,-,in ./siphon and holding tanks for this system. Check experim(.; ~i _,prov3 iks neceived
experim n`lal product approval from DILHR.
Vill. Responsibi?ity statement. installing plumber is to fill in name, license n. El r with a. r r fir fix (e.g.
MP, etc.), address and phone number. Plumber must sign applications fc -M.
IX. County/Department Use Only.
X. County/Department Use Only.
Complete plans and specifications not smaller than B1/2 x 11 inch, 2s mU.-, be >ubmitt,: f . !h nty. The
plans mist include the following: 1k) plot pian, drawr, to scale or wit~ : n•fi~le`:? diiii a.'ior, of
hold ,no '-,W(,'s), septic tank(s) or other treatment tanks; bUi dlr;.~ d•;,. well< wet ata,' service;
strearns -And lak(is, pu'rnp -r siph!:n tanrii; ciistriblition boxes, Cri kr systp, f°n) ~?s+t system
areas, grid he locator: of the building sar.'ed, 9) horizontal atY•_' u t cs, _ ,ati ~
C) complete specificatons for pumps and controls; (lose voium,~r; N vat:on ditfere ice-, h i fi.:.i loss; pump
performance curve; pump model and pump manufacturer; D) cross section of the soil abclorp'ion 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 nunl`?~~r of
regulated practices which can effect yrc,undwater
The r-nonies r:okected throl;C`.';h thi.;i Si_;r"cha Cg.e s at u: ed for nonitort^_; gra: r z r•.y
water contamination investigations and estabiishmer, to starodards
SBD-6398 (R.11/88)
PLOT PLAN
PROJECT ADDRESS S'
f l4 ~~1/4/S3 /T~'/ N/ eTE W T N COUNTY Z:f Gip MPRS Byron Bird Jr. 3318 D45
BEDROOM CLASS PERC CONY IONALXIN-GRO ND PRESSURE
CONVENTI NAL LIFT `'MOUND- HOLDING T IK
SEPTIC TANK SIZE _~~~~LIFT 4NK SIZE
DOSE TANK SIZE 10 HOLD11• TANK SIZE
ABSORPTION AREA 2 0 PERC RATE L BED SIZE Ia X d-~
Benchmark V.R.P. Assume Elevation 100'
Location of Benchmark
* H. R. P. -j~ -
a Borehole Q Well Scale Feet
O Perc Hole System Eleva for Uent
12
Grade
TYPAR COVERING
2"
12" 3' 4 6' O 3'
I Sewer Rock
i 6 „ 1.2' /
3~° s
~w
rim
r
e
wr
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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
'INDUSTRY, CC DIVISION
HUMAN REDLATIONS PERCOLATION TESTS (11J) MADP.O.ISONBOX
W 53707
LHR 83.09(1) & Chapter 145)
LOCATION: SECTION: CW.NS~HIP MUNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME:
-'/45''/a /Tj N/R/ E ( o~erSz
COUNTY: MAILING ADDRESS:
D r I" Olst I^` C o'L
USE 10, DATES OBSERVATIONS DE,;74cj )p ".f
NO. BEDRMS.: COMMERCIAL DESCRIPTION: ROFILE NS: A I N TESTS:
I~Residence 3 New ❑Replace
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional)
5S I
[:]U DS u IDS u
s C]u Ss ❑u
If Percolation Tests are NOT required DESIGN: If any portion of the tested area is in the
under s. ILHR 83.09(5)(b), indicate: Floodplain, indicate Floodplain elevation:Q
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIG HES TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B- 144A, .5/
B- a mod'
B- 7
r
B-
PERCOLATION TESTS
TEST TH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIO 2 P PER INCH
P- <
P. r
P- 6
P
P-
P-
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope.
SYSTEM ELEVATION 96- ~~~,s-. / Ga•
t ~
I {
i I
' I i I M
17
I
o
- I
,40
i~
E I
L . 1 . _ . I l_
_i, All I -
I, t e 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 (pri TESTS WERE COMPLETED ON:
ADDRES . CERTIFICATION NUMBER: PHONE NUMBER (optional):
CST" IGNA UR :
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DI LHR-SBD-6395 (R. 10/83) - OVER -
St. un weyy D jwlmeat
`PERMIT*OR ACCESS DRIVEWAY TO COUNTY TRUNK HIGHWAY
DIST'MBUTION:
` l: White -'Applicant
2. Blue - Township Permit Number
3. Canary - County
Name and Address of Applicant Highway County
Town - Village - City
4
s Type of Driveways Number of Driveways Pro osed Land Use Completion Date
l Location of Driveways
t
side of the highway LF 941106 A-A-DJV 3Z Np .IG `3 i~ W
I /~~i Quadrant `~~-fir' Section- Township North Range
Required Drainage Structure A If No Drainage Structure, State why
Description of Proposed Work (include special restrictions, intersection clearances, other details and reference to
any sketches which may be attached.)
l
Any driveways shall be constructed in accordance with all requirements printed on the reverse side, and any special
conditions stated herein. The maintenance of the driveways shall be the responsibility of the applicant.
Issuance of this permit shall not be construed as a waiver of the applicants obligation to comply with any more
restrictive requirements imposed; by local ordinances.
4az
4G
tore of Applicant llatite
Approved by St. Croix County
High)ya Commissione~r~ Date QQ
l~J
GENERAL REQUIREMENTS ACCESS DRIVEWAY PERMIT REQUIREMENTS SPECIAL REQUIREMENTS
Conditions of Issuance Commercial - Rural: ,
FIRST: The permittee, indicated on the reverse side hereof, represents Rural type highway cross section. Driveways service commercial or
all parties in interest, and that any driveway or approach constructed by or industrial establishments.
for him is for the bona fide purpose of providing access to his property, and ,
not for the purpose of parking or servicing vehicles, or for advertising, 1. WIDTH OF DRIVE. No driveway except as hereinafter provided shall
storage,or merchandising of goods on the highway right of way. have awidth greater than 35 feet measured at right angles to the centerline
SECOND: Except in cases where the indicated driveway access may be of the driveway, except as increased by permissible radii. In no instance
constructed by forces acting on behalf of the County in relation to a high- shalt a driveway have a width greater than 62 feet (including flare of return
way construction or reconstruction project, the permittee shall furnish all radii) measured along a line 10 feet from and parallel to the edge of the
materials,do all work, and pay all costs in connection with the construction highway pavement,
of the driveway and its appurtenances on the highway right of way. In ev
ery instance, the subsequent maintenance of the driveway and of its at 2. RETURN RADI I. No return radius projected between the edge of the
purtenances within the limits of the highway right of way shall be the highway pavement and the driveway shall be greater than 40feet. Usually
responsibility of the indicated permittee, who shall be obligated to pay all these radii will be determined by the restrictions given in Section Numbers
costs and accomplish all works necessary in relation to the said main- - 1, 3, and 4. -
tenanceof the driveway facility. Materials used and the type and character
of the work shall be suitable and appropriate for the intended purpose. The 3. ANGULAR PLACEMENT OF DRIVE. The angle between the cen-
nature of construction shall be as designated and subject to approval of the terline of a driveway serving two-way traffic and the ecJgeof the pavement
Highway Commissioner. The driveway installation shall be made without shall not be less than 45 degrees. Where suitable precautions are taken, or
jeopardy to or interference with traffic- using the highway. Highway Sur. one-wayoperat ion Tong divided highways permits only one-way operation
faces, shoulders, ditches, and vegetation which are disturbed--by the of the driveways, the angle of the entrance drive to grantee's property may
driveway, installation shall be restored to at least the pre-existing con. be decreased. The angle of the exit drive with the highway pavement shall
ditions by the driveway constructor. Any such facilities disturbed by be not less than 45 degrees. -
operations relating to the subsequent maintenance of the driveway shall be -
restored to the satisfaction of the Highway Commissioner by the permittee. 4. ISLAND AREAS. An island ofa minimum length of 10 feet shall be
THIRD: No revisions or additions shall be made to the driveway or its - maintained between driveways serving the same premises. (The
appurtenances on the right of way without the written permission of the measurement shall be along a line 10 feet from and parallel to edge of
Highway Commissioner. pavement.) The permit shall specify that the island area, if less than 20 feet
in length or 10 feet in width, is to be defined by curbs, posts, boulders,
FOURTH: The County Highway Department reserves the right to make - masonry walls, guard rail, etc. Materials used to define the island, except
such changes additions, repairs and relocations within statutory limits to concrete curbs, shall be painted white. The side of the island next to the
the driveway or its appurtenances on the right of way as may at any time _ highway shall be not less than 10 feet from the pavement edge. The side of
be considered rtecesS3ry -to facilitate the relocation, reconstruction, the island farthest from the highway shall be at the rightof -way line.
widening, and maintaining of the highway, or to provide proper protection -
to life and property on or adjacent to the highway. The area within 5 feet of a property line shall be a restricted area over
FIFTH: The permittee, his successors or, assigns agree to hold harmless which no driveway may be developed. The 5-foot restriction shall be
p(e County of St. Croix and its duly appointed agents and employees measured parallel to the pavement edge and shall be effective between the
against any action for personal injury or property damage sustained by s"*e~ right of-way line and a line 10 feet from and parallel tg thgpaygment edge.
reason of the exercise of this-*ermii. - - This is to serve as an island area should the adjoining property owner
SIXTH: The Division of Highways does not assume any responsibility for request a permit for a driveway.
the removal or clearance of snow, ice or sleet, or the opening on windrows "
of such material, upon any portion of any driveway or entrance along any _
state highway, even though snow, ice or sleet is deposited or windrowed 6n
said driveway or entrance by its authorized representatives engaged in
normal winter maintenance operations.
Location, Design and Construction
The location, design, and construction of the driveway shall be in ac- - -
cordance with the following policy and limits, which limits are in no case to
Noncommercial -Rural: -
be exceeded unless specifically authorized by the Highway Commission.
Rural type highway cross section. Driveway serving farm or residence
(A) A driveway shall be located and restricted as to width as necessary property.
so that the entire driveway roadway and its appurtenances are contained "
within the frontage along the highway of the property served. At public 1. WIDTH OF DRIVE. No noncommercial driveway or combination of
highway intersections a driveway shall not provide direct ingress or egress driveways shall have a width less than 16 feet nor greater than 24 feet
to or from the public highway intersection area and shall not encroach on measured at right angles to the centerline of the driveway except as in-
or occupy areas of the roadway or right of way deemed necessary for of - creased by permissible radii.
festive traffic control or for highway signs or signals. A driveway shall be - -
so located and constructed that vehicles approaching or using it will have 2. RETURN RADII. No return radius projected between the edge of
adequate sight distance in both directions along the highway. highway pavement and the driveway shall be greater than 30feet.
(B) The number of driveways permitted serving a single. property - 3. ANGULAR PLACEMENT. The Centerlineof that part of the driveway.
frontage along a state trunk highway shall be the minimum deemed - lying on the state right of way shall always be at approximately right
necessary by the Highway Commissioner for reasonable service to the - angles to the pavement.
property without undue impairment of safety, convenience, and utility of
the highway.
Commercial • Urban
(C) The island area on the right of way between successive driveways or
adjoining a driveway and between the highway shoulder and right-of-way Urban type highway cross section. Driveway serving commercial or
line shall remain unimproved for vehicular travel or parking. Such areas industrial establishment.
shall be considered as restricted and may be filled in or graded down only -
as hereinafter provided in paragraph (G). 1. WIDTH OF DRIVE. No driveway shall have awidth greater than 35
feet measured at right angles to the centerline of the driveway, except as
(D) The surface of the driveway connecting with rural-type highway increased by permissible radii.
sections shall slope down and away from the highway shoulder a sufficient
amount and distance to preclude ordinary surface water drainage from the 2. R ETURN RADI I. The return radii projected between. the line of face
driveway area flowing onto the highway roadbed. of curb of the highway and the driveway shall be determined by the
Engineer, basing his decision on the type of traffic and the restrictions
(E) The driveway shall not obstruct or impair drainage in highway side given in Section Numbers 1 and 4. In all cases, the entire flare shall fall
ditches or roadside areas. Driveway culverts, where necessary, shall be within the right of way.
adequate for surface water drainage along the highway and in no case less
than the equivalent of 15-inch diameter pipe. The distance between culverts 3. ANGUALR PLACEMENT OF DRIVE. The angle between the cen-
under successive driveways shall be not less than 10 feet except as such terline of the driveway and the curb line shall be not less than 45 degrees.
restricted area is permitted to be filled in under the provisions of
paragraph (G). 4. ISLAND AREAS. Case 1: Sidewalk adjacent to curb. An island of a
minimum length of 6 feet, measured along the curb line, shall be placed
{F) When curb or gutter is removed for constructing a driveway, the between each entrance to a state highway. The curb shall be left intact for
new connections shall be of equivalent acceptable material... and curb this length.
returns provided- or restored in a neat, workmanlike manner. The
--driveway surface shall connect with the highway pavement and the Case I[: Sidewalk remote from curb. An island of a minimum length of
sidewalk, if any, in a neat, workmanlike manner. The driveway con- 10feet measured along the right-of-way line shall be maintained between
struction shall include replacement of sidewalk areas which are - each entrance to a state highway. All flares shall be tangent to the curb
inadequate or become damaged by reason of vehicular travel across the line.
sidewalk.
A curb length of not less than 3 feet shall be left undisturbed adjacent to
(G) The restricted area between successive driveways may be filled in each property line to serve as an island area should the adjoining property
or graded down only when the following requirements are fully complied owner request a permit for an entrance.
with : r
1. The filling in or grading down shall be to grades approved by the _ Noncommercial - Urban:
Highway Commissioner and, except where highway drainage is by means
of curb and gutter, water drainage of the area shall be directed away from Urban type highway cross section. Driveway serving residence property.
the highway. roadbed in a suitable manner.
1. WIDTH OF DRIVE. No noncommercial driveway or combination of
2. Culvert extension under the restricted area-shall be of like size and - drivewaysshall have awidth greater than 24 feet measured at right angles -
equivalent acceptable material of the driveway culvert, and intermediate to the centerlineof the driveway, except as increased by permissable radii.
manholes adequate for clean out purposes may be requiredwhere the total
culvert length exceeds 100 feet. 2. RETURN RADI I. The radius of the return connecting the line of face
of curb of the highway and the edge of driveway shall not exceed 10 feet. In
3. Where no highway side ditch, separates the restricted area from the all cases the entire flare shall fall within the right of way.
.highway roadbed, permanent provision may be required to separate the
area from the highway roadbed, to prevent its use for driveway or parking 3 ANGULAR PLACEMENT. The centerline of the driveway may be
purposes by construction of a border, curb, rail, or posts deemed adequate either parellel to the property line of the lot for which access is requested,
by the Highway Commissioner. - or at right angles to the curb line. -
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER ✓
MAILING ADDRESS 7C co ..5 Cj
PROPERTY ADDRESS a~ I G ~~l
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE ~o 6~fEf
PROPERTY LOCATION Si= 1/4, _5~~7 1/4, Section T_2_L_N-R W
TOWN OF Sam /tf~ j ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMBER
CERTIFIED SURVEY MAP , VOLUME PAGE oZ~O, LOT NUMBER
Improper use and maintenance of your septic system could result in its premature failure to handle
wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed
by licensed septic tank pumper. What you put into the system can affect the function of the septic tank
as a treatment stage in the waste disposal system.
St. Croix County residents may be eligible to receive a grant for a maximum of 60%. of the cost
of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County
accepted this program in August of 1980, with the requirement that owners of all new systems agree to
keep their system properly maintained.
The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner
and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1)
the on-site wastewater disposal system is in proper operating condition and (2) after inspection and
pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum.
I/We, the undersigned have read the above requirements and agree to maintain the private sewage
disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR.
Certification stating that your septic has been maintained must be completed and returned to the St. Croix
County Zoning Officer within 30 days of the three year expiration date.
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. Any inadequacies will
only result in delays of the permit issuance. Should this
development be intended for resale by owner/ contractor, (spec
house), then a second form should be retained and completed when
the property is sold and submitted to this office with the
appropriate deed recording.
Owner of property ejALOl~- C i V
Location of property S 1/4_S1/4, Section -3 ,T_~LLN-R l9 W
Township Sowites~~j Mailing address ,2370 CG
Address of site
Subdivision name Lot no.
Other homes on property? Yes_'<, No
Previous owner of property V c t4 Ce,,=
Total size of property y igcQEs
Total size of parcel ~l y~c~Zi S
Date parcel was created Pe,c -?C0
Are all corners and lot lines identifiable? X Yes No
Is this property being developed for (spec house) ? Yes No
volume c181 and Page Number .290 as recorded with the Register
of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE
NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a
certified survey, if available, would be helpful so as to avoid
delays of the reviewing process. If the deed description
references to a Certified Survey Map, the Certified Survey Map
shall also be required.
PROPERTY OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the
best of my (our) knowledge that I (we) am (are) the owner(s) of the
property described in this information form, by virtue of a
warranty deed recorded in the office of the County Register of
Deeds as Document No. y!7j6'.-2r , and that I (we) presently
own the proposed site for the sewage disposal system or I (we)
obtained an easement, to run the above described property, for the
construction of said system, and the same has been duly recorded in
the office of the County Register of Deeds as Document No.
Signature o Applicant Co-Applicant
-y-5V
Date of Signature Date of Signature
1. _
VOL 5.3 4 o"E 83
. ~V~ 0,,'~• : ~~t r4Fr.. 7
'Y ` astir
'7a -4
COUNTY COURT PROBATE ,E11
St. Croix
STATE OF NISCONSiII
ORDER OF wIMAARY SETTLEMEN
IN THE MATTER OF THE ESTATE OF Y
Sylvester E Crottyalso known a
r
Sylvester Crotty,
Deceased. A s s' t 'w
1
} sv~ 1%
'
File No.
F y E ~ S x Q~ ggqppptttttt
petitioner ha
PETITION for the summary ving appeared la~ fr'
settlement of this estate having been hears, and the
- rtm ent of Avenue ,
~ y
and the Wisconsin Depal ared or waived notice, and other appearan
r.Fnc
ah}~-adob, straloe having appe
person and by attorney. ~ana'~}re'? x
{ being as follows:
3- c,
And on all the evidence, records and proceedings herein, the Court finds that
paae•aAi1t{ld
* tl~telt'~t''e►
x '
without notice) we
The petition came on for hearing ( < < ,
-ip
Z• The estate is one properly to be settled under S. 867.01;
tenancy with c l
3. The decedent died owning the following property in, joint
aw~ho survived 1nm
Viola Crott y
Viola R.: Crotty, also known as
REAL ESTATE•i wertero3E an thin ,b lz `
'E a out•east Quarter of Ahe Northe st Qu
or.
' Northeast Quarter of the outhmaat
acres of the Southeast Quarter °,msri3oThirtstonell
North 24
j (SEA of gE ) , all in (Saction TWest, `~St. Croix. County, isconsin. r
North# of Range Nineteen 19)
904.4 f ry $ F_,.
New Richmond
,f PERSONAL ESTATE: Of
av ngs cl~ count 11004589, Bad 49QF.19
Savings Account 434466: Bank of 03ceola" I,033-95_
Account, Hank oi' Osceola u ,40Q
Checking .()0 k
Livestock and Machinery
RECi1 &TERi OFFICE
a { ST. CMIX COw W ;
Rees for raw
daY at D. 19-7 6
Ire
R at
I! eeienl~jt*e fi+ne~kia~eeclrked~-litetstateirrlire~ollo*~T+~P~'Y:
i4
d * Strike as appropriate.
1i Strike as appropriate.
867.0t
No. 60•A (Adopted 1910) 0 RDER OF SUMMARY SETTLEMENT #
• I TMi! SrAt;t RLSlRVLD IOR
DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1-•198a RECORDING DATA
,.-~IIfA~R~zY DEED
491626 L FAGS 90
-
Tl 1s eed, made between ..Vio•la- .Crotty..-a/k/a------------ RE0I5TERai. ~~QI'S CO.,
Viola R. Crottx...a singleerson ~ , WI
Ree'd for Record
Grantor.
NOVI 61992
.Mark .J Crott _ . a sin le .
and..... y g P of 10.00'' A•AAMAA
Grantee,
R~ptd~r of O~edi
Witnesseth, That the said Grantor, for a valuable consideration-_-.--
6.1-.;
ro.• RETURN TO
1X
conveys to Grantee the following described real estate in $t
County, State of Wisconsin:
The North 24 acres of the Southelst 1/ o
the Southeast 1/4 of Section 3, Township 31 Tax Parcel No-
North, Range 19 West.
$ qTxAN2n o e -
-
This ..1.5... homestead property.
(ia) (is not)
Together with all and singular the hereditaments and appurtenances thereunto belonging; -
And Grantor
the
title is good, indefeasible in fee simple and free and clear of encumbrances excep
warrants that the title
municipal zoning ordinances and easements of record
and will warrant and defend the same.
13th November . 19.-
Dated this of
~ll..t.(a'-uJ•---G......._ Q1~~-u•~(.P_IdJ--I~~ (SEAL)
' iola.--- rutty-------------------------••--••-
a/k%a Viola R. Crotty ,--_(SEAL)_
I
(SEAL)
•
AUTHENTICATION ACKNOWLEDGMENT
STATE OF WISCONSIN
Signature(s) sa.
5t_,.._ AlZ-Qi -------------County.
..__.day of
authenticated this day of-------------------------- 119 Personally came before me this ._fl.
November 19.9 2 . the above named
Viola Crott aJk/a
_ ,~t, P R yy V i o la._..... C r u t tY------------------------------------------
e
•
TITLE: MEMBER STATE BAR OF fP~~~~'`bK ~••••.Oy.'s
• - - ° ~ s--------------
(If not, .
authorized by 1706.06. Wis. Sts me know the erso wh executed the
orego' inst - e d a novel ge t same. /
_ \PUBLIC~r
THIS INSTRUMENT WAS DRAFTED B'j~ e, s• • a~ _
BAICICE.NORMAN•x•_S.C .:...........•.•__.,,j of1't~`LQa•' Arlene-P.-Reardon
New Richmond, WI 54017
Notary Public PO•1k-------•------------ County, Wis.
My Commission is permanent. (If not, state. expiration
(Signatures may be authenticated or acknowledged. Both AUguS t.• 1 19.9
3--•) ~
are not necessary.) date:
-Names of persons signing in any capacity should be typed or printed below their signatures.
STATE BAR OF WISCONSIN Misemoansin Leer ~l, Blank Co. Ine-
Ww!utwNTY DEED - vnR~s Nn. I•R2