Loading...
HomeMy WebLinkAbout038-1105-50-000 STC - 104 AS BUILT SANITARY SYSTEM REPORT o d~0 xoZtt Mzn 5~ ADDRESS_ Ale w SUBDIVISION / CSM# LOT # SECTION~_T N- W, Town of s2r ~"~~rs ST. CROIX COUNTY, WISCONSIN d G PLAN VIEW SH W EVERYTHING WITHIN 100 FEET OF SYSTEM i a~ ;o INDI,CA NRRTx. AR a L Provide setback and elevation information on r v-erse~~~ 1 h k- 4,. Sr rn Provide 2 dimensions to center of septic tanagc6 ver. INGC BENCHMARK' I!°'~ c?^ ALTERNATE BM' SEPTIC TANK PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: 1'ele~/rS Liquid Capacity: d e~ l / Setback from: We 11- House Other Pump: Manufacturer Model#Size Float seperation Gallons/cycle: `Zu Alarm Location ew 101 SOIL ABSORPTION SYSTEM 4 Width: Length Number of trenches s Distance & Direction to nearest prop. line: /o Setback from: well: IV-S~ House 'B Other 0 A- /ELEVATIONS Building Sewer ST Inlet. ST outlet c PC inlet PC bottom fl, Pump Off ZK f oZ Header/Manifold Z Bottom of system yJ j Existing Grade Z$,/4 Final grade DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: ~Y~ INSPECTOR: 3/93:jt Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: L%bor-ihd Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings. Division GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: Permit Holder's Name: ❑ City ❑ Village ❑ Town of: State PI SUKOPP, SCOTT X _ -M'AT, PRAIRIE CST BM Elev.: Insp. BM Elev.: BM escription: Parcel Tax ©1 10,0, 'o"L LC..G, ;t TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark /0a,yl° /00- Dosing JC Q Aeration Bldg. Sewer g 7, a 3 Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet 6,07 q/, 3q Vent TANKTO P/L WELL BLDG. Airito ntake ROAD Dt Inlet Septic >a 78 q' NA Dt Bottom g/, -7V Dosing >~S -79 2Z_ NA Header/Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade S /C) Manufacturer s r Demand jj J & J Z1, of q7 q 7 a ...t_,. Model Number ( ~DGPM 1 ~a 9.7N qa,7 TDH Lift 1,5q Friction ` System +5 TDH 111~~ Ft Forcemain Length Dia. Dist. To Welly a Sri Vol SOIL ABSORPTION SYSTEM BED/TRENCH Widt Length,_/g No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION TypeO / p cD l /d S ! /1 - CHAMBER OR UNIT Mode Number: System: mblylA DISTRIBUTION SYSTEM ~Hteade'r /Manifold Distribution Pipe(s) x Hole Size x Hole pacing Vent To Air Intake Length Dia. Length 9 a,S Dia. Spacing 11q 11 3(0 ? 31, 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, pers ns present, etc.) , LOCATION: STAR PRARIE 26.31.181.440B,SE,`'NE,CO. RD. CCU,y Plan avislon required? ❑ Yes ❑ No Use other side for additional information. ~y F.i E(,(•{ ,c F SBD-6710 (R 05191) Date s ctor's signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ' I I SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY C 7L STATE SANIT Y ERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than C? a sq 8% x 11 inches in size. ❑ Check if revision to previous application -See reverse side for instructions for completing this application. STATE PLA I.D. NUMBE 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. g PROPERTY OWNER PROPERTY LOCATI L. '/a f , N, R_/, E (or W PROPERTY O R'S MAILING ADDRESS LOT # BLOCK # CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER 5 - II. TYPE OF BUILDING: (Check one) ITM NEAREST ROAD El State Owned ❑ 171 V CITY ~G ❑ Public ~ 1 or 2 Fam. Dwelling-# of bedroom PARCEL TAX NUMBER(S) III. BUILDING USE: (If building type is public, check all that apply) O s G 50 I 3o 4z,~2 1 ❑ Apt/Condo ~J 2 ❑ Assembly Hall 60 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 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. El New 2.,nJ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit • Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 Lr 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 7,5' 3 7," ~ 16-01.2 Feet a Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New xistin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank Lift Pump Tank/Si hon Chamber +B VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) MP/MPRSW No.: Business Phone Number:: / Pum is Address (Street, City , State Zip Co IX. COUNTY/DEPARTMENT USE ONLY Y❑ Disapproved Sanita Permit Fee (includes Groundwater Date Issue Issuing Agent Signature (NtS amps) Approved ❑ Owner Given Initial Surcharge Fee) U Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(R.08/93) DISTRIBUTION: Original to County, One Copy To: Safety a 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 Saniitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill 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. i GROUNDWATER SURCHARGE i 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) SAFETY & BUILDINGS DMSION ~I State of Wisconsin Department of Industry, Labor and Human Relations August 12, 1994 209 West First Street Route 8, Box 8072 Hayward WI 54843 BIRD, BYRON JR 896 68 AVE AMERY WI 54001 RE: PLAN S94-20615 FEE RECEIVED: 180.00 SUKOP SCOTT SE ,N 31,18W TOWN STAR PRAIRIE COUNTY OF ST CROIX MOUND SYSTEM The Department has reviewed the above-referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based on chapter 145, Wisconsin Statutes, and chapters ILHR 83 and 84, Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter ILHR 82 or in chapters ILHR 50-64, Wisconsin Administrative Code. This plan submittal approval will expire two years from the approval date, or if a sanitary permit is obtained, plan approval will expire on the day the initial sanitary permit expires. The licensed plumber responsible for this installation shall keep one set of plans with the Department's stamp of approval at the construction site. The installer shall notify the appropriate inspector when inspections can be made. All permits required by the city, village, township or county shall be obtained prior to installation. Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Sincerely, 4 1? r y . ansky Wastewater Specialist Senior Section of Private Sewage (715) 726-2544 Friday's 4334R/ 1 ssa~ ia. non PLOT PLAN PROJECT Scott Sukopp ADDRESS 1956 Co. Rd. CC New Richmond Wi 54017 SE 1/4 NE 1/4s 26 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX MPRS BYRON BIRD JR. 3318 DATE 7/19/94 BEDROOM 3 CONVENTIONAL IN-G UND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND XX)OC SEPTIC TANK SIZE 1000 Gallons LIFT TANK SIZE DOSE TANK SIZE 800 Gals HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 375 BED SIZE 8'X 47' BENCHMARK V.R.P. Top of Garage Door Sill ASSUME ELEVATION 1001 ❑ BOREHOLE O WELL *H.R.P. SW Comer of Garage SYSTEM ELEVATION 100.2 ft PRIVATE SEWAGE SYSTEM Conal t«f2a14f APPROVOM DEPARTMENT OF INDUSTRY LABOR AND HUNIAN RELATIONS DIVISION OF SAFETY AND BUILDINGS S C RRE c t/4 inch = 10 Feet 900 ft"2 Bask A a North Lot line B-3 Slo pe JW_ Garage B -1 B -2 B. M. Co. Rd. CC D 3 Bedroom T Existing House Q W e l l Existin System to be :ProVerly Dis osed South Lot Line S94,020615 PRIVATE SEWAGE SYSTEM Page _ Of C onditiona~li Straw, Marsh Hay, Or Synthetic Covering AS -7 -l C 3 -73 DEP RTMENT OF INDI,I$T& LAOO AND HUMAN RELATIONS S o n d DI~VISI ~J WOWD ft&DINGS 6" Topsoil E N C E 3 E D -ta Slope Bed Of i"- 2 i2 Force Main Plowed Aggregate f' Layer (6" [3e l ow Pipe) D } Cross Section Of A Mound System Using E d~.~1.[J Ft . r A Bed For The Absorption Area F Ft. G Ft. Signed: Ft. /r B p H L!5 Ft. License Number: / Ft. V4C~Sv•%rG~,9 A 2 K ~ Ft . (jai Date: _ X L Ft.&i, 30' Alternate Position J - 8 Ft. of I O.Tt. Force Main W Ft.,-3'7. 7>6 Observation Pipe K V4, A o ----------------------•I Force Moin Distribution " Pipe bed Of 2 - 2 . I Aggregate Observation Pipe Permanent Markers S9 4 Plan View of Mound Using A Bed For The Absorption Area S94-20615 ~~GF ~ 1 a b~ ~ 5~ Page Of Distribut iol gglpT~e'~.-V&X frE,'-.-El~pteral Network COItG~t[[Ol2R[f6~ A P P R 0 V Alternate Positioq)-- MENT OF INDUSTRY LABOR AND HUMAN aRELATi0 Force Main VISION OF SAFETY AND BUILDINGS ~w S ~CORR - OND- PVC Distribution Pipe PVC Force Main P '*~Holes Equally Spaced PVC Manifold Pipe On Bottom S~ X J X i £s ~ X 2 * Last Hole Should Be Next To End Cap y P,,NM-_Ft . ,;O S Ft. X_3--LI nches Signed: Y-~K. Inches Hole Diameter Inch License Number: 331E Lateral Diameter Inch(es Date: Manifold Diameter Inches' 6 5 Force Main Diameter Inches 9 A. 2 0 v A Holes Per Pipe O Invert Elevation Of Laterals % Ftl60'S-2 , PAGE GF PUMP CHAMBER CROSS SECTIOIJ Ak10 SPECIFICATIONS VENT CAP 'i"C.I. VENT PIPE WEATHERPROOF APPROVED LOCKIMG 2 F JUNCTIOKJ 50X MANHOLE 5 FROM DOOR, V R r7 ~ CO E WINDOW OR FRESH 12"MIU. AIR INTAKE l+ I I yMIW. on JltoEaa c~c o DUI ~ IB"hl'IIJ. 18"MIN. ~ u"m DIVISION OF SAFETY AND BU*Q&r4%E S 111 IKILET I I IRTIGHT SEAL * A S - CORR S ©NDE E PR PERLY SED ALL TANKS I I I I ALARM ILHR 83.15(4)(c) WAC I II B ANCHOR, S NECESSARY I I c ILHW1116b) WAC I ON LLEVZ, FT. APPROVED PIPE I 3' ONTO PUMP--~, OFF D SOLID SOIL CONCRETE BLOCK I i RISER EXIT PERMITTED ONLY IF TANK MAWUFACTURER HAS SUCH APPROVAL SEPTIC E SPECIFIGATIOAJS 9 ~ygat-/v/~,~ DOSE 01.,) TANKS MAKIUFACTURER: IJUMBER OF DOSES: v PER DAy TANK SIZE: GALLONS DOSE VOLUME ALARM MAUUFACTURER: ~.L INCLUDING BACKFLOW:.L.} GALLONS MODEL NUMBER: 224 y CAPACITIES: A=,;?/ 21MCRES OR D GALLOWS SWITCH TyPf: S%;~I 8 =~INCHES OR L/ .L_._ GALLONS PUMP MANUFACTURER: 4OL~~~.~ C. = S INCHES OR /30' GALLOWS MODEL AIUMBER: D- Zd IMCHES ORc2C20__ GALLONS SWITCH TYPE: NOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE-+sL_6PM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEW PUMP OFF AWD DISTRIBUTION PIPE.. FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . " . . . 2.5 FEET ♦ y FEET OF FORCE MAIN X 2- looFLFRICTIOW FACTOR. __1 :r FEET TOTAL DYNAMIC. HEAD = FEET 61 .01 S94 OQ I ILITERNAL DIMENSIONG OF TANK,: LENGTH 7_• /J i~ ,WIDTH ;LIQUID DEPTH ~y SIGNED:.. LICENSE NUMBER: is DATE:_Z2,Z HE AD/. 31 11s- 34 tto , CAPACITY 32 ICS- - CURVE" te°- I es I 26 21 4to 5 _ I EFFLUENT 24 MODEL I and OQ 75. MODEL 100 DEWATERING 22 U ~ 20 65•- Q I Z 16 60 SS - J 16 S0 MODEL b 163 F- MODEL 11 IS 164 12 /0. 35 10 MODEL 30 137,139 MODEL SEWAGE and 2S . _ 1S DEWATERING 6 20- MODEL 15- M D 141 1 _ 97 - 10 W S 5 55, = 57, Se 0 21 60 GALLONS 10 20 30 0 e0 W 70 60 t0 100 11e 7S LITERS 0 6o 160 210 720 400 22 70 • FLOW PER MINUTE 20 es 16 60 - i ODEL- Q 295 W SS 2 16 - - U so _ Q 11 Is MODEL Z 294 O 12 ..40-- -jot 75 MODEL , - 1. _.a 10 297 - - MODEL 0 70 I - 2e1 ' ' 2S s 20• sg4- MODEL - - 282 4 low 10 -MODEL - - - ~ELLE/ , 2 t-_267. 266 S ° 3280 OW Millers Lane GALLON$ 10 20 30 10 60 60 70 80 60 100 110 120 '130 110 150 160 110 no too P0. Box 16347 LITERS o so 160 210 320 100 180 $60 610 720 (50Louisville, 2) 778-2731 lucky 40216 FLOW PER MINUTE Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and H man Relations Divipliof'r-of S-Ifety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but St. Croix 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. 038-1105-50 APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Scott & Mind Suko GOVT. LOT SE 1/4 NE 1/4,S26 T31 ,N,R 18 x (or) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 1956 Co. Rd. #CC na na na CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE EFOWN NEAREST ROAD New Richmond, WI. 54017 (173 246-7421 Star Prarie CO./Rd. #CC [ J New Construction Use [~f Residential / Number of bedrooms 3 [ J Addition to existing building j lpfleplacement [ J Public or commercial describe Code derived daily flow 450 gld Recommended design loading rate • 5 bed, gpd/ft2 .6 trench, gpd/ft2 Absorption area required 375 bed, ft2 375 trench, ft2 Maximum design loading rate • 5 bed, gpd/ft2 .6 trench, gpd/ft2 Recommended infiltration surface elevation(s) 100.49 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material na Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ❑ S IOU ®S ❑ U ❑ S ® U ❑ S ®U ❑ S gJ U ❑ S M SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1<Y 1 0-10 10yr3/3 none 1 2msbk mfr gw 2f .5 .6 t 4 2 10-28 10yr4/4 none sil 2msbk mfr gw if .5 .6 Ground 3 28-43 7.5yr4/6 none sl 2msbk mfr gw na .5 .6 elev. 4 43-75 7.5 r4 4 72p yr 98.82 Y / .5Y r5 s mfr na na .4 .5 ft. Depth to LOP limiting s>. factor 28 i• 1 0 Remarks: Boring # . 1 0-11 10yr3/3 none 2 mfr 9w 2f .5 's . 6 2 2 11-20 10yr3/2 none k mfr gw if .5 .6 r 3 20-31 10yr4/2 p 7.5yr5/8 sil lfsbk mfr 9w na .2 ;.3 Ground 4 31-52 7.5Yr4/6 elev. 7.5yr5/8 sl lmgr mfr na na .4 .5 98.82 ft, Depth to limiting factor 71 20" Remarks: CST Name _Please Print Gary L. Steel Phone: 715-246-6200 Address: 1554 200 h. Ave., New Richmond, WI. 54017 Signature: 6-15-9 Rate: cstm 5Rumber: PROPERTY OWNER Scott Sukopp SOIL DESCRIPTION REPORT Pipe of 3 PARCEL I.D. # 038-1105-50 Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Botrxi3y Roots GPD/ft in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. Bed ITrench 3< 1 0-11 10 r3/3 none 1 2msbk mfr gw 2f .5 1.6 ;:2 11-20 10yr3/2 none sil 2msbk mfr gw if .5 .6 Ground 3 0-36 10yr4/2 m P 7.5yr5/8 sit if sbk mfr gw na .2 .3 elev. 98.32ff 4 6-54 7.5yr4/6 7.5yr5/8 sl 2mgr mfr na na .5 !.6 Depth to limiting 00 Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # •i:•hi}n\4•iiiTN: Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. j ft. Depth to limiting factor II Remarks: SBD-8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel Scott & Mindy Sukopp 1554 200th Ave. CSTM2298 SE 4NE q S26-T31N-R18W New Richmond, WI 54017 MPRSW 3254 town of Star Prarie (715) 246-6200 t N 1"=40' BM= top of garage door sill at 100'el. 0 do rgy RS C ~y 301 80 12' 37` .2 u ~j V Gary L. Steel 6-15-94 STC-105 SEPTIC TANK MAINTENANCE AGREEMENT i1 St Croix County OWNER/BUYER C Tf t~ A 11C\ J f-yrPS~ MAILING ADDRESS I C2 C PROPERTY ADDRESS (location of septic s(ystem) Please obtain from the Planning Dept. CITY/STATE ~IVCW ~1 C_Kl r ~C PROPERTY LOCATIONJ~f 1/49 1/4, Section T_V__N-R__W TOWN OF , ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAP - , VOLUME,&,gPAGE 1V, 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 dat SIGNED: DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 S T C - 100 ''phis 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 5464,4- Location of property 1/4 1/4, Section IT j~N-R W Township __4140J Nari p Mailing address RSCQ Cry CL I Address of site A-- Subdivision name - Lot no. Other homes on property? Yes No Previous owner of property Total size of property t Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house) ? Yes ~No Volumel27 ;Z and Page Number 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 o fice of the County Register of Deeds as Document No. 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. ig re o pplicant Co-Applicant 9 - I `9 y Date of Signature Date of Signature • r DOCUMENT NO WARRANTY DEED - ;PA..F RT,ERVEO FIR RECORC,,NG DATA 1 f • p q STATE BAR OF WISCONSIN FORM 2-1982 , VOL 1Q72WE 1.91 y Daniel J. Steel and Kaye E. Steel, husband and wife, •dl`xF rrrd APR 4 1994 conveys and warrants to . .S.rott G._ Sukopp and Mindy. Kae. Sukoppt husband and wife, Y s RETURN TO : _ - . - " the following described real estate in . $t Croix . . Co lnty, - " - State of Wisconsin: Tax Parcel No:.------------------------•--- j I ' f x < :r x. Vv The North 125 feet of the South 425 feet of the East 300 feet of the SEl/4 of z` the NE1/4 of Section 26, Township 31 North, Range 18 West, St. Croix County, Wisconsin. .w L p. This .--ls------------------ homestead property. .y : (is) i J Easements restrictions and rights-of-way of record Exception to warranties: ' ~ if any. Dated this _ day of 19 94 (SEAL) (SEAL) - Daniel J. Steel x - - .(SEAL) ( r\Cy"[ _..._(SEAL) - V l Q <~r ' - - - Kaye E. Steel AUTHENTICATION ACKNOWLEDGMENT Signature(s) Daniel------- J---.---.-Stee-.-- .l 2. . STATE OF WISCONSIN l I Kaye E. Steel } ss. G _ ~ - - - ------County. ' + authenticated this . day of+ 19.._.4 . 9_ Personally came before me this ----------------day of 19-- the above named Kristina Ogland ' - - TITLE: MEMBER STATE BAR OF WISCONSIN - - - (If not, - - - - authorized by § 706.06, Wis. Stats.) to me known to be the person . who executed the i foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY - - Kristina 0 and - - Attorney at Law _ t - - - Notarg Public -Co inty, Wis. ~ . (Signatures may be authenticated or acknowledged. Ruth My Commission is permanent. (If not, state ex( nati~ on j are not necessary.) ) r~ iI date. - - - 19 - . < •alarnea of S' perso ai signing in any caps i!y ah_u41 be ty Vrd or p;mRd biloa hir =iFaaTU rev. _ WARRANTY DEED STA"r F.. BAR OF W:3CU\SIN Vhscors.n Legal flank Co. Inc FORIM No. 2- 1_-2 %A wauiee_ W.sconssn i r~ - - ST. CROIX COUNTY f WISCONSIN ZONING OFFICE 4I rif p 111 lip ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road rw Hudson, WI 54016-7710 (715) 386-4680 October 6, 1994 Attn.: Tammy First Federal LaCrosse 201 South Second Street Hudson, WI 54016 RE: Septic Inspection for Scott & Mindy Sukopp To Whom It May Concern: An inspection of the septic system for Scott & Mindy Sukopp property was conducted on September 9, 1994. This property is located in the SE 1/4 of the NE 1/4 of Section 26, T31N-R18W, Town of Star Prairie, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a three (3) bedroom home. If you have any questions with regard to the above, please do not hesitate in contacting our office. cerely, ~A Mary Jenkins Assistant Zoning Administrator js ,i