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HomeMy WebLinkAbout036-1066-50-000 -0 0 Q e 3 o N ^ O m t3 ~ I n. c I o ° ~ I N U (0 ~ -0 N G C co S co O 61 N C3 N CL O ~ rn C = I > 3 o N ~o o ~ L ~ LL pt c .0 ai 1 a) E O N y N E Q > ON N N U CO ~ N E o z 7 d N IL m N H Cn O O z d c r r 7 m z d C V) F- z E .O O a m 'a 0) o ~ N o N c • ly d t c g c O m o Q z I- z 4 z N co (D C L CL a U cO V r O d N •o N d ❑a i Z Fy- H FF-- e d a O O O z • o a a a a E fA J V ' ~ mrn OM, rn ~ 't LO (p O O = O m n a m aNi cn C-4 Q t.(1 O O O O N C y O N O ~ O E O ~ CQ r Q C O O M 3 O U C C io O O_ \lr.__//11 O E O N .2 LO LO 00 E L4 U • y'l, co W O O Ca V) ~'~1 M Y O O O N f/) > N O F- UJ W d a L. a L a • a c `Iv £ L c c L) CL 0 U) 0 a 4 o w h 0 u> v a o ~ I ° co o lu O N r a d' co (O co (n 3 Y U C O d F, N y C E O 0 y C C 0 U) d a N `O O O N N C Z 'O N 7 LL C L 0 ca U) 072 L c L ' 28a) m -0 ° U 3 E Q c ~ U (6 M cl E .3 U) = i L "Z:!t d w N m U a m i U o r O l d Co r ' ~ r 7 y w d Z V1 F- r O c,~ ~ I c c a°i m 2 M =3 (D N Q N c Q ) L C O (tea O O`Q Z F- Z o N Z N ~ I C m E c N ` N i ICI O 06 n a m U N 2 d O ` O a) 'It G LO D a a' E O O..O d d -O Z ►~+i _ a a a w. a E U V 3 O (n O N J V rn rn Z Z N N O ,t O O O E `T C(17. O.. _ .O".. N.... Q } 4 co d 00 to U) O CO C O C C E (O d o o'I E c c'- 'l co F Q E E 4..w p CO -E I-- A L L 7 N rr ~ M c _Y 00 7 • M 6 co O O N E E v L O N (n > N O N CI E c7 v ~ CD M y a xc c L 0. i E rr~~ L `~1 A vat; Omti ( a ST. CROIX COUNTY WISCONSIN ZONING OFFICE 1 g M N N q q q ■,.R~ ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 Post-it`" Fax Note 7671 _ Date 574m pages 0-I I To From CRQ Co./Dept. Co. Cam. U I` May 20, 1994 Phone # Phone # 3% _q (Q Fax # Fax # Mr. Stuart Johnson Knutson Mortgage Company 12941 Ridgedale Drive Minnetonka, Minnesota 55305 RE: Septic Inspection for Arnold Volkert Property Dear Mr. Johnson: An inspection of the septic system for the Arnold Volkert property was conducted on May 11, 1994. This property is located in the SE, of the SW; of Section 28, T31N-R17W, Town of Stanton, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a three bedroom home. Enclosed also is a copy of our inspection report as well as a copy of the As-Built Sanitary System Report. Should you have any questions with regard to the above, please do not hesitate in contacting our office. Sincerely, Mary J. Jenkins Assistant Zoning Administrator mz w STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER y,\ ADDRESS AJP .a) c~vri. r t~ 2 S`gc~ 7 SUBDIVISION / CSM# LOT # SECTION a F T 3 / N-R W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ~y 6d Ue ' i b S 4 Q INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. -e r / BENCHMARK: c~ ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: Liquid Capacity: .i 6-0-V Setback from: Well House / Other Pump: Manufacturer Model# Size Float seperation Wf~ Gallons/cycle: Alarm Location N/A SOIL ABSORPTION SYSTEM Width: S Length (00 Number of trenches .3 s Distance & Direction to nearest prop. line: r Setback from: well: aad House 626S Other ELEVATIONS Building Sewer ST Inlet; /U ST outlet, X06 3y PC inlet W .P PC bottom Pump Off Header/Manifold 95 Bottom of system 3 ~-S Existing Grade s Final grade DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: 3/93:jt BENCHMARK: lc~~ tr~ s:a-I IvS " / U~ / r~ ALTERNATEBM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: Liquid Capacity: Setback from: Well Ze House le Other Pump: Manufacturer- Model# Size Float seperation N r-1- Gallons/cycle: Alarm Location- rV/A SOIL ABSORPTION SYSTEM Width: S Length 60 Number of trenches Distance & Direction to nearest prop. liner s ~23.c Q L Setback from: well: aaO House b26S Other ELEVATIONS Building Sewer ST Inlet; /U ST outlet. ~DG .3y PC inlet iU/ PC bottom - Pump Off - Header/Manifold- 9S Bottom of system 3.~S Existing Grade 9 s Final grade DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: /5 INSPECTOR: 3/93:jt h ~isr dartTrl TtiQ tt 8.31.17, VAltSEWXgf'%SitM County: Labor and Human Relations INSPECTION REPORT Safety and'ButIdings Division (ATTACH TO PERMIT) Sanitary Permit No.: 6ENERAUINFORMATION 208957 Permit Holder's Name: City ❑ Village R Town of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: B"escription: Parcel Tax No.: TANK INFORMATION ELEVATION DATA A9400079 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Benchmark Septic 02,6 jj a Dosing 73136 Id d , Aeration Bldg. Sewer Holding St/Ht Inlet - 6 TANK SETBACK INFORMATION St/ Ht Outlet y A)L3 TANK TO P/ L WELL BLDG. Airinta to ke ROAD Dt Inlet Ar I Septic NA Dt Bottom Dosing NA Header/ Man. q q(, Aeration NA Dist. Pipe yg Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft oss Fi Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. enches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type O r CHAMBER Model Number: System: I'h 4j r i ~ ~ S a 36 OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over „ xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) .LOCATION: Stanton.28,31.17, SE, SW, Highway 64 ~ r I } 3 1t 61, (f l5 ' Plan revision required? ❑ Yes ❑ No Use other side for additional information. [ 2L SBD-6710 (R 05/91) Date spector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: I ' ~~ILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY ° t~ h0 1 qs STATE SANITARY PERMIT -AttacFi complete plans (to the county copy only) for the system, on paper not less than oO~r!rJ)OIQJq 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 f PROPERTY LOCATION i 61 S.c- Y,& 510 Y4, S,? 8 T31 , N, R / r) W PROPERTY OWNER'S MAILING ADDRESS - LOT # BLOCK # ~ ` 19560 ___/fir CITY, ST E ZIP CODE PHONE NUMBER SUBDIVISION / VME OR CSM NUMBER , v S'yt7 >In Z2Y` 71917 II. TYPE OF BUILDING: (Check one) 11 State Owned ❑ VILLLLAGE 1 a~ NEAREST ROAD e r I JQJXW OF: Z Z" 12 QRCEL AX NUMBER(S) T ❑ Public K1 or 2 Fam. Dwelling- # of bedrooms III. BUILDING USE: (If building type is public, check all that apply) 4!:!~_3/ms - 16 4 - 0 10 Apt/Condo {e 2 ❑ Assembly Hall 60 Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 30 Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (C eck my one in line A. Check line B if applicable) A) 1. ❑ New 2.AReplacement 3. ❑ Replacement of 4.0 Reconnection of 5.0 Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 9Seepage 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 REQgUsIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELE%ION6 q2 / 9 / X A / .~~9s Feet 9 7 Feet VII. TANK CAP CITY in allons Total #of Prefab. Site Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks strutted Septic Tank or Holdin Tank Ov0 _7__ Lift Pump Tank/Si hon Chamber -11-F I _::~_FTT VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Pr' t): r lumbekrZeNo ' igna Stamps) /MPRSW No.: Business Phone Number: 64/11, Plumber's Address (Street, CState, Zip Code): /mss- IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Si s) Surcharge Fee) r~ r l Approved ❑ Owner Given Initial ~O Adverse Determination 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 - ' 1... A sanitary permit is valid for two (2) years. - 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsitl5 sewage systems must be properly maintained. The septic tank(s) must be pumped by a, licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) Ara 0o X),j O 5,zl°`? A m 6 eo to O r 4, 1670 93, 3 C's X6a) ~ I P 40 ~ a CO Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page _Z_ of Labor," Human Relations Division of Safety Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION=PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION I 71- GOVT. LOT,5 C 1/4 S tAl 1/4,S T N,R ,&(or) W PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUED. NAME OR CSM # 5o a" '14 CITY, S /rTE ZIP ODE PHONE NUMBER ❑CITY VILLAGE KOWN NEAKS ROAD C'-1C) a 42jil _ (~i~~ " (J New Construction Use in Residential / Number of bedrooms _3 [ J Addition to existing building Replacement ( J Public or commercial describe Code derived daily flown gpd Recommended design loading rate _bed, gpd/ft2 trench, gpd/ft2 olft Absorption area required 5 bed, ft2 n trench, ft2 Maximum design loading rate bed, gpd/ft2 trench, gp 2 Recommended infiltration surface elevation(s) Parent 3 ft (as referred to site plan benchmark) Additional design / site considerationnCI i material 7~- ~i , Flood plain elevation, if applicable c~ ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem Q S O U .®S ❑ U as D U , -S ❑ U O S /f34 C] S Eg~a SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourxiary Roots GPD/ft in. Munsell Gu. Sz. Cont Color Gr. Sz. Sh. Bed Trench 0-17 19 NO- 2/1 0 /0 C 'S ~ ~ ,3 - ©r>7C= . S ; s~i rvt ~ ~ ~ ~ • In Ground h2 m- 4/4 4 ✓C-~ 5 n'r S6 J- elev. 3 z 0 z.l C► S~ f 1 v~PvL Depth to limiting factor > „ Remarks: Boring # _ ><y I a iv ~fz 3l3 ~C~ 1 ~s~ s a P 0 IV - 1 ,4; X X2, 1J- O C 3 S a V 4L, A)A- 0,4 Ground 5 , elev. q -7 1 3 12 ~ft Depth limiting factor Y-21_ Remarks: CST Name:-Please Print Address: All N f' l z Z ~T z"J l Signature: Date: CST, Number: / PROPERTY OWNER v►oVk - - SOIL DESCRIPTION REPORT Page? of -3 PARCEL I.D. Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. Bed ITrerxh La M r Ground ,4 . elev.cg7 Depth to limiting fa t~ or Remarks: Boring # is D vit U G' l z s1 0K 5 - 67 14 Ground - a~ L- 0 - s IYl yv~4 ✓fl I , j elev. Depth to limiting factor 7 r~37 V Remarks: Boring # Ground - elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. h. Depth to limiting factor Remarks: 36D-E330(R.05/92) STEEL'S SOIL SERVICE Gary L. Steel 2884;4 of -0rive C.S.T. 2298 yi no New Richmond, WI 54017 MPRSW-3254 Y R) (715) 246-6200 :3vn do Oc7y'vt 6+L _ 61-100, e, tL 18-4 1~' Izo 202~~'~~l moo' f¢, 24' 393' s,C' C°srvt t r c) S S ; ~ C 1 V r1 Q l~l V t t~ ~ ~ s ~ n-~ • I C . s a('S~ ~1 Froth Air I111016 And ODt•rratton Plp• ~~/j~ Q ~j~~ ~APVt•rld veal cep ~b~~""'w ~r~''~'Y! lJ~.I~V ktn4nun~ 12'Aeor• • / ~ ~O~ a.~ f in H a t e d • , 20• 42' Above Plpf _ 4' Cost tree To F10161 Cl•de Vent pips wree tier Ot SrntWit Ceretlnd lttn 2' A/l.epele 0041 Plp♦ 01410 i►ellon Ptp• e s -Too t C' A1lte/e1• Beneele Ilpe ° Petiet•led PIP• Yel•r o "~•Ce.pllnl TNedeellnll At Belleet 01 ifelem pro 05t 9' v")J11on SOIL FILL • DISTKIBUY101.1 PIP[ . APPROVED Sy1JruETIG COVr 2" OF hGGREGAlE op, 9" OF STRAW, ~l OK MARSH HAy MEV. OF-Lf~ E>; taf'/P' •OPlL-21/~ AGGRCGATE 1111 OIST11I9UTIOU PIPE YU DE A7 IMCHES BELOW ORIGIUAL GRADE AMU AT LEASTLO IIJCHES BUT 1,10 MOPC THAI) 42 INCHES OELOW FIMAL GRADE I MAXIMUM DaMl OF FXCAVATIou FX011 ORIGWAL 69ADF WILL DE 7 rurrlMUM p~ Ili o ExcAv IUCHEs P F ATIc" FRO^ 0~16WAL GR4DF- WILL ac ~ InJCHEs SIGWED: LIGCUSC WUMBEIt: DATE: .L . 11tH ti THIS,S A MEMORANDUM TAX BILL AND NOT A TAX RECEIPT 589 rd ' w b' i I ¢ a ~J z w O 00 Q N ~r a a GIN I. i~ z o o cf z :D p 0-K U r -rig U ¢ } a O a X LL a a Z O p z IA r a ~ Z :1 a ?,'o I► mo m 1 ¢ U U Z W_ LL Q d ¢ 2 WIT to ¢ a px h- Q ~ f- . ~a Ow z.Z .(r .1 W Do g w 1 Ow a ¢ LL } -J%o N y " m I¢ t- a f. y j / 2 ¢ fl~ u w Y; ° O Qi' z us t C) p w ? ' a M a N ICE ¢8 M ¢ i 0 > al a ¢ U m O+ W a o - O.p _I CL l w O Z a W - r P M, < j - {Y J w p T w ¢ n- O m Z O / LL X G o tn-4rti1~!"1 r-o+acn Il oi 03 001 cu 1 ? W y~ pry', a +a~ l~- tr P'1 rat M 0 a,! I`' 1 c> oi as U) tn r Q 7- o N a N° a a a Q w gat k w t- to Z x< z Fn! J Z',w w - a G1 IL u- IL ' o cJ5 ! O 0% f-- V . < lz.t. ca 0 ma O~Lfh[1M CJ a x a3: x W 3. F- Q ` o U~ ~J H`► Ns cc w - Q sz r^+ w' Q z,QD 10 Q iJ w OJ LL Q ~Jp td t F"' I to w Af M w I~ - LLI I Cal a i o Q' ini w In m yr %T N w 2 co z f~- C.- LA a eJ ¢ 'I ?,-I w r F i~ y r OOZ w a 0 PLI C( d' LA M1 w 0.i ~ a < a VS R!'! !'T N ti O' _ ❑ a a rq o o I~- ~ m ~^^+1 v> > t"'1 v z ° W M w I W z fJe O O a Z> O IT 1> ° O cr- u r w¢ .I L' + Q 1 a W Q Q o w ? 0 < rn:x r E F- ¢ o CU wzdc3 w za to r-r~!~► { Z< z w e ~w~lTo lx►-xarQ o ' Qooa 'j z m h- M o _ J p a anti m C13 ~1 t.~ wow- 1 Z 'D ~ oy ~ co ~ `.'nIm~nu~w ►-ac Q .Ja ¢ X J J C1 W tx aLT , U a ¢ f r, OJ ly. Z w m Z ~ 3 N , u IL a .Z V (n` a v o a .Q Z X: p Q V O:20 s I, 1~ tLlG~~3W r¢wa ~¢ws'w N aQVa O up a r LL 1 U _ z LL 0 d]. Up ifl s ifs ~'i-~A? j ~ w I SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER_ ADDRESS: tf Ala Rir fiU FIRE NO: LOCATION:- 5tAj 1 4 1/4,, SEC. TOWN OF: 5- ST.-CROIX COUNTY SUBDIVISION: f(l {Q, LOT NO. 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 a 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 to help with the cost of the 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 the St. Croix County Zoning a certification form, signed by the owner and by a master 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. Certification from 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 DNR. Certification form must be completed and returned to the St. Croix County Zoning officer within 30 days of the three year expiration date. SIGNED:' G~ DATE: f~~- St. Croix County Zoning Office 911 4th St. " Hudson, WI 54016 STC-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 r Location of property~1/4 x_1/4, Section T N-R W Township 1-tailing address r Ili Address of site I L3 Q 6 „7 S -16 17 name F~ Lot no. Other homes on property? es No Previous owner of property Uj 06 Y\ Total size of parcel _ Date parcel was created Are all corners and lot lines identifiable? -2c-yes No Is this property being developed for (spec house)? Yes yNo volume 54s and Page Number as recorded. with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WRRRANTY DEED which includes a DOCUMENT NU11BER, VOLUME AND PAGE NUMBER & THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available., ;would be helpful so as to avoid delays of the reviewing process. If the deed description references to a certified survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I(we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No. own the , and that I (we) presently proposed site for tie sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of County Register of deeds as Document No. Signature of ap~licant Co-appl cant Date of signature Date of Signature DOCUMENT NO. STATE BAR OF WISCONSIN-FORM 2 C C~~j WARRANTY DEED BOOK 525 uea 596 THIS SPACE RESERVED FOR RECORDING DATA .328031 BY THIS DEED, Grace E Gowan, Single REGISTERS OFFICE ST. CRoix CO.. WIS. Recd for Record this--X0-ttb_ Grantor conveys and warrants to Arnold H. Volkert and Dorothy A day Of-°,Iu1y ----A'D' 19'75 Volkert, husband and wife at___,__8.jaQ M. Reg star Of Deeds Grantee 8 for a valuable consideration of one dollar and other valuable RETU N TO consideration the following described real estate in St. Croix County, State of Wisconsin: Tax Key # This is homestead property. The East one-half of Southwest quarter (E2 of SWID of Section 28, Township 31N, Range 17 West, except a parcel of land heretofore deeded to the grantees by a deed dated September 30, 1965, Recorded October 1, 1965 in Volume 417, Page 358, Register of Deeds Office, St. CroixtCounty, Wisconsin. This deed is given pursuant to the terms of a land contract dated May 25, 1964, Recorded May 27, 1964, in Volume 404, Pages 99-100, Register of Deeds Office, St. Croix County, Wisconsin. FEES Exception to warranties: EXEMPT Executed at New Riehmnn.d, Wisconsin this th day of Jul 19 SIGNED AND SEALED IN PRESENCE OF (SEAL) Grace E. Gowan (SEAL) (SEAL) (SEAL) Signatures of Grace E. Gowan authenticated this 9th day of Wm. W. Ward Title: Member State Bar of Wisconsin -or-0th,_-r Party AlAhofi¢ed -uadas SVW -d~9G.Q6-vi¢. STATE OF WISCONSIN l 1 ss. County. Personally came before me, this day of 19_, the above named to me known to be the person- who executed the foregoing instrument and acknowledged the same. This instrument was drafted by T,_ R_ RPdngtrn Notary Public County, Wis. New Richmond, WI 54017 The use of witnesses is optional. My Commission (Expires) (Is) Names of persons signing in any capacity should be typed or printed below their signatures. H.C.Millw Compairy M WARRANTY DEED-STATE BAR OF WISCONSIN, FORM NO. 2 - 1971 ~I Wisconsin Mpartment of Industry, SOIL AND SITE EVALUATION REPORT Page of Lato.f and Fl3man Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. If dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION.; PLEASE PRINT ALL INFORMATION R EWED DATE PROPERTY OWNER: PROPERTY LOCATION GOVT. LOT,5 1/4 S 1/4,S ZIT N,R / f(or) Z_7L C7 PROPERTY OWNER': S MAILING ADDRESS LO # BLOCK # SUED. AME OR CSM 1 NE NUMBER ❑CI VILLAGE KOWN 1__JNIEAKS ROAD CITY, STTE ZIP ODE PHO -71 -7 [ ] New Construction Use in Residential / Number of bedrooms 3 [ ] Addition to existing building Replacement [ ] Public or commercial describe Code derived daily flow +O gpd Recommended design loading rate ~_bed, gpd/ft2 - trench, gpd/ft2 Absorption area required bed, ft2 ~n trench, ft2 Maximum design loading rate _bed, gpd/ft2 S trench, gpd/ft2 Recommended infiltration surface elevation(s) .3 s ft (as referred to site plan benchmark) Additional design/ site consideration] 0,0 F Parent material -7111-11 ;1-> Flood plain elevation, if applicable - it S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U =Unsuitable fors stem S ❑ U • I S ❑ U EM ❑ U /E3-S ❑ U ❑ S />84 ❑ S E17 I SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft Boring # Horizon in. Munsell Gu. Sz. Cont. Color Gr. Sz. Sh. Bed Trertdi Ground < 5- O 4/1j, d t1 L~ S a_ s 1 elev. 3 z D ftft. p i Z IJ S Cn s~ r 04L , s A) A- WA- Depth to limiting factor > Remarks: Boring # 0 rd r, /4 Ground 1 . L D rO C= 1) ~S 0 S o V 4L k04- vO)4 O 5~, elev. q -I 2 a to C, ?`ff 1 A Depth to limiting fact/or M1 Remarks: CST Name: Please Print Phone: J I tiCU S ~ Address: - j~Z2J 1 ffl -/"~t~f' ~`Z- lv~' , 0 I Signature: w i _ _ Date: _J7 ~ S z PROPERTY OWNER no A SOIL DESCRIPTION REPORT Page?- of 3 PARCEL I.D. # 3 ' - / - ~d Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Baurdary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed (Tmrxh 0--Zl T4 o7 C) 1j e rS 144 56 Ground W4 v4(- ku~i ,4 . 5 elev.q-7 Depth to limiting factor Remarks: Boring # 44 Ground - a ~~G C -S Iyl V rvA ✓fl In ye- elev. Depth to limiting factor I Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # 4•. Ground elev. ft. Depth to limiting factor Remarks: SBD-MO(R.05/'92) STEEL'S SOIL SERVICE Gary L. Steel / rive C.S.T. 2298 Y) no New Richmond, WI 54017 715 246-6200 MPRSW-3254 4o w v? U )~3vy\ &V3 a4L- 001 bI"' po II ~ ~ c~,,~,,n sad ~ ~ ,n _ ~yy) ~ ~ ark ~ 'E5 kJL Wil lZO/ I zo' 202 I50 , 1,¢, 24' 3 93 s, ~ . C°omvt e~ IL Parcel 036-1066-40-100 06/05/2007 05:04 PAGE 10F 1 Alt. Parcel 28.31.17.432A-20 036 - TOWN OF STANTON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner 0 - PIKE, ROBERT J & MAXINE M ROBERT J & MAXINE M PIKE 1642 HWY 64 NEW RICHMOND WI 54017 Districts: SC =School SP =Special Pr pe 'pty Address(es): Primary Type Dist # Description * 1 HZ 64 SC 3962 NEW RICHMOND ` f 2 SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC 7 G Legal Description: Acres: 3.990 Plat: 4633-CSM 17-4633 SEC 28 T31 N R1 7W PT SE SW LOT 1 CSM Block/Condo Bldg: LOT 1 17-4633 (3.99AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 28-31N-17W SE SW Notes: Parcel History: Date Doc # Vol/Page Type 10/15/2003 743687 17/4633 CSM 07/23/1997 1080/367 / WD 07/23/1997 1033/415 LC 2007 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 04/17/2007 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.990 22,000 122,800 144,800 NO AGRICULTURAL G4 2.000 600 0 600 NO Totals for 2007: General Property 3.990 22,600 122,800 145,400 Woodland 0.000 0 0 Totals for 2006: General Property 3.990 20,500 122,800 143,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 -0 0 y o o a p 6- N 4 O N a' N 7 O C O N N N N O III : O O e L C C C i co a Z 3 a N co L C N O O cC Z CD 'C p ° N Z 3 (0 U ~ LL c° N j p CO U ° o C Q f0 I 3 Cl) vl, m m Z i O w o 0 O L) o I p, U Z d d N c N IL m C " L O o a~ G 0:'.!t L ° w C > -p 7 _ N U, co 0) F- a o o a d z m E m yU f v U o -00 N p _ .U m ~2 o (D 4),2 N N N p C _ N fi L O C - O Z0L. n v :tR O °`a w Z Z o N Z O N 0 _ N N N N t0 O C > {V > ? CL w Q C 0 N N L 10') iT' O C3 a CL CO N LL 0' O a~ O O O Z 0 0 •►~t ~ maaa a cn L O O N U U) o o ° Z ~l N N M 4 U r1 A~ (O N O N N - E N O ~ ~ C 0- N Q d Ir i D m = Q Z Q R O N N O O C H O N 7 (0 co 0 0 1 N O O C B O O r _ M 01 N N V a0 pj N j OLO ' n N N d' r . 1". N N 2 N N N W '~O N CO 'r]!V)I ~"q N M E O O 'O L • ?o o U) W M O N Ix Z U) R1 O ~ V c ~ w~i E ~ E d m a xt a a • a m a E L c c A Q a 2 O N 0 POLK COUNTY L 65 Ner/}7uscn 3 O/e ys,c M w s{ ence h.vh qo /aB B r9user7 Me/ bra .ee~ W .POy Jacabsor7 \ W l C L, ~ °~x U' oes .9/6erf S 0~ ~ l~ /I/ 73 Ca o% /63 ~ ~ zz6 ~ v ~ •0 un 4s .Posea.nrr ~ ~tl~ ON 11en a ° rss.89 `I.(1\ New s u~ © Ne z117 0 V ~c~mc9 N vj~Q Q~~• L/n Boson /a RS ~0 ~ tl ° .Dorn 49/ice f /o d v o ~ ~ sa W /60 F Ire /er- " y k \ o,' ~ ® ~oberf W Q C ~ He%/ Rusk Bo C h f/oyd C o ~•v 2j v a L ngaQr. ^ eLea /~oche w o Q f Lo/a `C~ Wind3 e r ~cha.d .rJ ba.r` 30 ~'o u,E.s C Vo 9.:: Q ~l 40/ C3oche ~ ~ 4o Han/en BO kG ~~j /GO 44 er FLV r4° H ::Jnmes H NO Wa rd . •y1/a ne To /%a of v( a/p/j E Pe nrck i o /yam y /e ao H es y o p ayarite T 40 (I~~ 76 .Kwe er 6o F/oyd 19, 40 Bo C h ° on 0 0 '~+3!aw~ence ~ /ei/ rrrr7 ' . ~V n~ v ~ rio May `C l51 4 Mavis Croes • c7a.,~es - 9 CGl'/ .Don 5 fTnn u,Bors \ • • .Du~urS cToL,rsson /in~r i//roan zoo ,6efhke Bo 197 t:sA. ::160 n 3o37s w 3 44- OAKR OG L. Me^ R v ~ < ti~ ~ Bo BO = C /Go z¢o vacobsor7, e~ eed ,C3ros. /s7 ~q v Zee cccd f M arc/ 7s_ I f/en~y eta/ 1s4 D o ~E/:nor` 40 YJ I/a/Fer sy K ue9er Lei/en ~o < • r/an a 76 d tl H/f F Crisd/>ome LaVere v p'~' W \ ~Sa }e Fa m Inc lyi//ia n I~ua..ne s *r17 a C q~ cTa t3 40 /2o N/a ys A6 Car/ Conrad f+/Jarr/a_ .C'*r17 /`Je/v.n Amscfi/er Bet/7Fe ~5a6ean Q E~° Kno ~/o/Eer7 6o Jacobson n 8° 0 0 J'` ° </ermaa PP /GB /yorrrs 64o -017 Ile n La~5017 16 74 Leo F I •Edward /GO • Eu9ene~. r'P' 40 rc/ar~. Brea W ~ y, Mmcioo ~ammes .~i'usch.Fe ` V • 'v zerf' V\C10 V Npkins7 Fjan,~/ir7 z M zo p~ ~ \ rs 4. l nrd L a0 l C° R. Ei6s Y W~a~ d o~ N• 60 W - ° /6o a ~v~ & Jmes rGa 6osfor7 fe hens h~ o q ® v~ P Bo 4 ° L. 40 • so LALJ u W Chaff/es S f ~ b h o er L //a. ~X man e Bo Be B° e N tl h o /rs. E//en oan Cicra/d Pam/ We a J ~Fr~ E ~asfe ~s Casey I 01-a Ee ~'C` Pa/~h arrzs M y o o N well, /iB p~V) rs6 y f3ar elf ? C /60 rsc.s /6o efun 7714 sd Q3 v~ 160 v 3G C `C zoo ~o/and .Poland Q 0 vci E(Ward s rPay~,~err {/efirs Bernd V w l ~ , ~ ~ Ciao./e. J e rP•c-/ia~d ~/eiLSOn O A W -C Fiv~ C. //6.s ~V C~ ~ ~ i/vicker/ - rn hre N zoo De/be~Y s • I F~/da / 67a yf . , J Fra k fiauser F/oyyd ~A na~ ~ramper 1 nda 2097 ~fephens /'/-`A/arna.rcz. /60 Jfi>'isfon Lumph,eyJ /60 Eb°e"4 • p0 /40 • 7 Bo • ~ e Edw. L¢wrence E/mer- g Frr~ ~Q$~ hh d~ vcken 4o Orv¢/ y 4 ,Baler/ ~7B8zn'j 7P _ /_emar7 o Frrday "E r2o d v ous/~e~ o R0 ~ E C Bo /6 M (/orria Fe I //a/c/j p N 97 Bern e Ann • 0 !V 65 ar rzo tl U/rich ~ tle 0 n /Go Chrisfan 4 'U ~ J B/ y • W Loretlzc ` 0 _ AroensPat y) Befh Ee\~ • za6 ° \R u Jfn A' J 1 B/ Ivor F° c/send C E La von Euyene 40 ooyy _ lea c~ s; o ° C Gre r7 ,Barb v /rl/h~fe.~7///is Kdo/P rnk Errc.E.s or7 " u ..oa n E p j l r(iumrr7\ 3/6.47 /z0 /vea/6clea • fJ/<c 37 A1.1 zoo F 9 8o eo , ~9/ . • 9 . 0-9 ,e 64 • 'Toe 40 9mos 79s Cod T Tam kar/ :7 5 Leo j • Fiancors /edeicso~ /q/e t e/ Bros. .Lariise y am er /an andra- f Senses ~ossTeGa~ /zo rzo 3 Woyoe 5 !~/e//s BO ~i'sss /60 N~ RI H OND 3~o Mork 5 Bernard rsg.3 cBdy L~1~1. rs7 ® 15`o Francis Ca/ 6 Phy//is C 140 m fire /yarfin n Pow ie al": ffa vey sE/den a o p Pi6o y k aYi4: Cfiri fiaosor7 Cleo /1-`fJdams LOOSE /Jarfin 9arJ 16o Carer/ ePofus R. W Bo rho 6o 6o POND 7nziser Tarser D~ 41 r2o rao • 7f /zo F L m K ®/%7z Roc~E' ord /EyaPP~G~F~ 431 c. SEE PAGf St. Cro.e oc... y Wis. New Richmond POLFUS IMPLEMENT INC. Granite Works CANNING PHONE: 246-2011 CORPORATION PHONE: 246-6565 s;el • MARKERS - MONUMENTS BRONZE TABLETS NEW RICHMOND, WISCONSIN NEW RICHMOND, NEW RICHMOND, 54017 WISCONSIN 54017 WISCONSIN Y ~21 Y 2 742687 APR 1 20 04 xATX8 W GE 463V333 a S ICRO XOF CO. DEEDS RECEIVED FOR kECORD 10/15/2003 09:15AH CERTIFIED SURVEY MAP 886•-F COPY FEES PAGES: 2 y o CERTIFIED SURVEY n LOCATED IN PART OF THE SOUTHEAST 1 /4 OF THE SOUTHWEST 1/4 OF SE TOWNSHIP 31 NORTH, RANGE 17 WEST, TOWN OF STANTON, ST. CROIX CO ONSIN. NOTE:' LYNN ALL BEARINGS ARE REFERENCED TO THE SOUTH LINE OF THE SW 1/4 OF SECTI 28, TOWNSHIP 31 NORTH, RANGE 17 WEST, ASSUMED AS N 8841'46' W. 21~ OWNER: ROBERT PIKE, 1642 STATE ROAD 64, NEW RICHMOND, WI 54017 CAUTION - SEE SHEET 4 IGHWAY SETBACK RESTRICTIONS PROHIBIT IMPROVEMENTS. Q. O NO ADDITIONAL PUTTED LOTS MAY TAKE ACCESS FROM THIS EASEMENT Al, sURv1, (fj y CONFORM TO UNLESS COUNTY ACCESS MUCTURES ARE ACHIEVED. SETBACKS AND 0 # N V 55-64-3s06-2DD3 '39 { V" / S 88'41'46` E p 210.06' ,o~Wi~~1~~~~ I (~~I I z z m $ S 88'41'46" E I !m d 120.03 i_ t y,4 LOT 1 D = (i, SCALE: 1*- 150' C4 (A 173785 S. F. I 66' ~ z0 ~5-moo D 3.99 Ac. a LEGEND G~ ~1v' / h / d p SET 3 4' BY 18' IRON i "'J BUILDING .3 / ~v` w`1~~ r PIN WT. 1.50 LBS./FT. 00 Z FOUND COUNTY N 88'41'46" W A,~ / c~' (0 3' ALUMINUM MONUMENT j V ` m to R.A RECORDED AS 32.27' P` Z 46 - - - - - 66' ACCESS EASEMENT '18 GARAGE 0/ V~ p j ~ d ❑ 66'r V w 100' COUNTY SETBACK $ (A oum -~i- - - HIGHWAY SETBACK LINE N 88' 1'46w W . I 01'18'1 " W N 00'01'58" W 14xgyr- 55.01' SW COR. 0 8*41'46" W 2 , 5 --------'"J SEC. 28 g ^ - R.A.(N 89.35'W) b_ Lo 4 • • H. 64 ^ o "ACCESS RESTRICTED. U) SEE NOTE , ON PAGE 2" u7 S 1/4 COR. SEC. 28 N 88'41'46" W 2646.03''' SOUTH LINE OF THE SOUTHWEST 1/4 OF SEC. 28 APPROVED 8T. CROIX COUNTY Plannino Zoninn W Puke Committee 1 SHEET 1 OF 2 OCT 15 2003 If not recorded within 30 days of approval date approval shall be null and void Vol 17 Page 4633 ' % . 1