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Home My WebLink About038-1118-80-000 4 STC - 104 AS BUILT SANITARY SYSTEM REPOy OWNER o6Pc- I`O'm ppC,c~ ADDRESS K dt d~~1~ SorherSe'[ ~Z S~p2S SUBDIVISION / CSM# LOT # SECTION _T_N-R_W, Town of r f i, e ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM mw P zp~ Ca^16o 14n. q Iwo f(!Zo N E--- 2"i' ~bm INDICATE NORTH ARROW 93 - S'r. Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. A BENCHMARK : Iron ~t pe Q-~ L„OT L^* ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: Inioy, ' ~recaZf LMt,J~) Liquid Capacity: IWO -a Setback from: Well 10+ j0r;1 House ?4' Other Pump: Manufacturer 4;C Model# bSP 33 Size Float seperation Gallons/cycle: Mi5 Alarm Location 6" CA-we ~Lcz+ b,,, ~ S. SOIL ABSORPTION SYSTEM Width: J 27 Length . `t 3 Number of trenches Distance & Direction to nearest prop. line: 4ra." IJo~t~ ~;one Setback from: well: llbt Ar;il House 13C~` Other ELEVATIONS Building Sewer ST Inlet ST outlet PC inlet PC bottom Pump OffA Header/Manifold Bottom of system Existing Grade Final grade DATE OF INSTALLATION: 3 1!3j PLUMBER ON JOB: LICENSE NUMBER: coQ SSOB INSPECTOR: 3/93:jt Ly T i;.,gWfjrp;;4rie.29.31M0XTE!ffiWRt S jkftreet County: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION Permit Holder's Name: ❑ City E] Village R Town of: State Plan ID No.: lev.: Insp. BM Elev.: BM Description: Parcel Tax No.: lot? ELEVATION DATA A9400020 318610 TANK INFORMATION BS HI FS ELEV. I TYPE MANUFACTURER CAPACITY STATION t Septic f Benchmark pl. /000 V1~'~ rs ~n l Dosing Aeration Bldg. Sewer 11. S S 29, ?S Holding St / Ht Inlet TANK SETBACK INFORMATION Stl Ht Outlet I~.15 ~'~.d s TANK TO P/L WELL BLDG. ventto ROAD Dt Inlet Airlntake Septic 7a~► rug ' NA Dt Bottom 11A S g ~,95 4.CT 1+1 ~4 Dosing ab' NA Header/Man. s q" 4.B 1 G(o-59 Aeration NA Dist. Pipe 4 ~S ~ie:Cs Holding Bot. System 5.~ -S.:!9 PUMP/ SIPHON INFORMATION Final Grade Manufacturer A Demand Swr? 1 S,6S gS>"15 Model Number 3l> 1/0 GPM EFc Lift O°\ Friction ystem\ TDH ~I~q Ft mead ema in Length 1-pi Dia. Dist. To well ) S'U' SOIL ABSORPTION SYSTEM BED/TRENCH Width Le_ jg No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~~tt DIMENSIONS LEACHING Manufacturer: SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM INFORMATION Type O Vk"(13 CHAMBER Model Number: System: _j , a lUl~ 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 E] Yes El No E] Yes E] No i, COMMENTS: (Include code discrepancies, persons present, etc.) { v 0 LOCATION: Star Prairie.29.31.18W, SE, NW, 93rd Street a ~S f T . 1 t1 t I n, rte. k N,~~>~ ' ,t h F Vi`` k,11 f° A l Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R 05/91) Date I e oCs Signature Cert. No. February 15, 1994 Mr. Lawrence Dahms 1020 North Broadway Menomonie, Wisconsin 54751 RE; Sanitary Permit for Robert L. Groepper Dear Mr. Dahms: Enclosed is Sanitary Permit No. 199989, and other documents from within our file regarding the Robert L. Groepper property. If you have any questions or if you need anything else, please let me know. Sincerely, /s/ Mary J. Jenkins Mary J. Jenkins Assistant Zoning Administrator St. Croix County, Wisconsin mz Enclosure r~ E 1p4R 1 SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COYNTY STATE iERMiT # -Attach complete plans (to the county copy only) for the system, on paper not less than 8i~ x 11 inches in size. ❑ Chectd previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY WNER PROPERTY LO/CATION ~'F %4 Af41%,S T N,R (or)gD PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # 7 6 - CI STATE 21P CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER EI~S>r i " ✓'f 7-56 II. TYPE OF BUILDING: Check one CITY NEAREST ROAD ( ) 11 State Owned TV-=N OF: VILLAGE : / G ❑ Public ~1 or 2 Fam. Dwelling-# of bedrooms PARCEL TAX M O G III. BUILDING USE: (If building type is public, check all that apply) 0,3? „ / 1 ❑ Apt/Condo / Q 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 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. ER New 2. ❑ Replacement 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 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 410 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, ABSO% 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 Feet r Feet VII. TANK CAPACITY Site in gallons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufactur~re~me Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank A000 - /119&-.4 S Lift Pump Tank/Si hon Chamber 90 Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. PI mber's Name (Print): Plu be Signature: (No Stamps P/ PRSW No.: Business Phone Number: )A uAj_r14aAto Plumber's Address (Street, City, State, Zip Co /1020 el-4 !cJ - . Aftp"4, 1, S Z IX. OUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sani~ar Permit Fee (Includes Groundwater Date Issued ng Agent Signat (No Stam s) Approved E3 Owner Given Initial f(~~ifw(( D~j~ Surcharge Fee) 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. You'rsanitary 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. Onsite sewage syster'`ns 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,saniiary 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. If. 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. Vlll. Responsibility statement. Installing plumber is to fM 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) soittestdata 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,.tl~ibse surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. ' SBD-6398 (8.11/88) IOWAI 1;)4,D ma -a E91 ~I C2 V X's C2 0 ~ • ~ e tv, ~ • 6' v R. b N 0 ` o n r ° rn O Z - W/V ~r~~~ y t r S~ Nei ~9 31 I ~ I~ .J7is%AUCfS W~L To .~eAiuFiEl~ _ /50 Mrs, Sajo NWprT- VE/rs pE,2I Diet ) pioau6 5,0,E ,9-47~ HALVERSON BROS., INC. 1020 North Broadway Menomonie, WI 51 ~6 091- ' ~CDaF2~L. • ~QO~i~PP2 S~ ~tki/ .`~5 3/ l P~ , PAGE .3 OF' 3 PUMP CHAMBER CROSS SECTION ARID SPECIFICATIONS VENT CAP 4"C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING ?-!S' FROM DOOR, JUNCTION BOX MANHOLE COVER 12"MIU. WINDOW OR FRESH I AIR INTAKE I GRADE I `I" MIN. IB"MIIJ. COIJDUIT-- IB"MIN. INLET PROVIDE I AIRTIGHT SEAL I I I I III T APPROVED JOINT A I I' I APPROVED JOIWTS W/C.I. PIPE ~ I I I XW/c.l. PIPE TEIJDIIJG 3' EXTENDING 3' H&VERSON BROS., INC. I 1 I ALARM ONTO SOLID SOIL ouro SOLID SOIL B 1020 North Broadway I I enomonie, WI 547 1 oN a I I ~T I ELEV. FT. PUMP OFF D CONCRETE BLOCK RISER EXIT PERMITTED OWL4 IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E SPECIFICATIOAIS DOSE TANKS MANUFACTURER: Ml00FS11 " AM41 INC IJUMBER OF DOSES: PER DAy TANK SIZE: AQW 1,460 GALLONS DOSE VOLUME. ~OS GALLONS ALARM MANUFACTURER: 6-1 INCLUDING BACKFLOW: oh MODEL NUMBER: 161 Tff 1 CAPACITIES: A= /0 INCHES OR GALLOWS SWITCH TYPE: //rnE~[~~(r B=- INCHES OR 1~GALLOUS PUMP MANUFACTURER: 1/1W10 C = /0 INCHES OR I9:Z~ GALLONS MODEL NUMBER: 3871 D=INCHES OR ~ ~ GALLONS SWITCH TYPE: /Yi,E ey" NOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE goGPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. 2 FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . 2.5 FEET + / O FEET OF FORCE MAIN X FY0 FLFKICTION FACTOR.. A o 3 FEET TOTAL D9UAMIC HEAD = 20' FEET INTERNAL. DIM WSIONS OF TA1JK: LENGTH ;WIDTH ;LIQUID DEPTH SIGIJE LICERlSE tJUMBER: M P.5-666 DATE: INJ)US TIY' F r REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INpUSY~i y DIVISION LABOR AND"' PERCOLATION TESTS (115) P.O. HUMAN RELATIONS .O. BOX 7969 WI 53707 (H63.090) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/MUNI?NIICCIIPPALITY::: - rOT NO.:BLK. NO.: SUBDIVISION NAME: COUNTY'/ OWNER'/63/ N/RAMS: (o MA ADDRESS 4/OT kNO 4J - "OWN 14Y,4 S S ~ CAO iX )Poll " j !7t"/ wr X-4 041 39417 ,flu c-4.9,vA4J T /t 4WE'' d/s .v . USE DATES OBSERVATIONS MADE OFILE DESCRIPTIONS: [PERCOLATION TESTS: N0.BEDRMS.: FCOMMVERCIAL DESCRIPTION: P1VI'DOO1_5 Residence New ❑ Replace LK I AM /I - a I-d3 tioU Z/-PRATING: S= Site suitable for system U= Site unsuitable for system /7 UQ/JCONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLD INGTANK:RECOMMENDED SYSTEM: (optional)(0/SSQ F7- R-1 S ❑U ®S ❑u 0S ❑u ❑S Du ❑S au awa /oAmi- r. If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: IN Fr. PROFILE DESCRIPTIONS BORING TOTAL ELEVATION D DWATER-I N CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) U3i' >P, 0 •9/'P/,a,;.Zs, 16',aA) .Ls e6 ,~Ok 6:01 .67'/3,). 7"0. B-2- > jo ' Ae. Qa J.OJO ' L s W,^ GR , . 5 ' 0WO-/3•v 00. (0 qq S ,A Y G~ 8 7 AV e5 wr B-3 oI mss, .`/2 'au, ~S, 7, ' &V, . S . -WidY, - S-0 C S w B- 6 f 3~2 ' Q/' &J. 1-5, 00a ' A' j' G S, 7 ' iA.v C S • B- S 9~, 941' i 33 "Pk--'6V- 1-s, Cs 164, B- PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER IN r r. AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD3 PER INCH P- eta- Z_ r L /62"e 7_013C - P- C :vU ec aJ P / P v Z /,u c 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. ho 77-OM d SYSTEM ELEVATION F 8&5v c5* x 64 ~J•9 7-1;90 c~ Lim -F . i I z 3 i ~ I I I - - 1( t I S l 1 ~,tionai ~e ti 8 __j._ 1, 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 re n , ~q~i pp~~fa tests are correct to the best of my knowledge and belief. ft vQ NAME (print : TESTS WERE COMPLETED ON: ADDRESS: Cos CERTIFICATION N BER: PHONE ~S U NUMBER (optionaq: 4oG~$ ~ 54016 L L 13ELAPIL CS SIGNATURE:? wc~Cn / 'IISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. HR-SBD-6395 (R. 02/82) - OVER - INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 To be a cotY~plete and accurate soil test, your report must iric:lude: 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 3. MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement system; 5. Complete the suitability rating boxes, A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A separate sheet may be use(.] if desired; 8. Make sure your benchmark and vertical elevation reference point are clearly shown, and are permanent; 9. Complete all appropriate boxes as to dates, names, addresses, flood plain data, percolation test exemp- tion, if appropriate; 10. If the information (such as flood plain, elevation) does not apply, place N.A. in the appropriate box; 11. Sign the form and place your current address.anrl ytxir-certification number; 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS So ,ates,and Textures Other Symbols st - Stone (over 10") BR - Bedrock cob - Cobble (3 - 10") SS - Sandstone gr - Gravel (under 3") LS - Limestone *s - Sand HGW - High Groundwater cs Coarse Sand Perc Percolation Rate rued s - Me,,"• °m Sand W - Well fs - Fir and Bldg Building Is r Sand > Greater Than =s Loam < Less Than I - Bn - Brown *sii - t L.ram BI Black si Si` t Gy - Gray cl - Clay Loam Y Yellow sc:l Sandy Clay Loam R - Red sicl - Silty Clay Loam mot - Mottles sc. Sandy Clay w1 with sic - Silty Clay fff few, fine, faint c Clay . cc common, coarse or Peat n}m - Many, medium n) - Muck d distinct p - prominent HWL - High water level, Six ge : soil textures surface water for lir;+rwaste disposal BM - Bench Mark VRP - Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department may request v i., "cation of -his soil test in the field prior to permit issuance. A complete set of plans for the private syste anrt ° , n,;+ raoplicatior) mu;t srrt~amitud to the appropriate local authority in order to a t' `y ~.rmit must I•e c. z and posted prior to the start of any construction. REPORT, ON SOIL QORiN&S PERCOLATION TESTS ~I 1V A6- A' UY._4 44 T 0/1-- PLO r PLAM PROTEe " r. Q. p6hexr k1'yle ~r S~ C~pfX ~Q r/ NOMESITE TESTING CO. AT. 3, O'NEIL ROAD BOB ULB,k i.' 4 AUDSON, WIS.._.-. 54016 e5 r- ss'- az PRoPoSED 11om most 64 Z~ Fr. o mete "a-4f 41.1- TEST ve.45. PROPOSED W C u M v6r we- 5o Fr. de Ibefr F#foAl A« TEs~- S ~ EXistiw! 6- tWELl- ` PEQG /4CAT~~Wf HRN~ hgl9EAfv OR 5400,04 Bowes yee;z . BM vorli ,#i. ~PEFE,ptwcE- Poiwr' -kP ~F Nw /-,or <5g # R16-F 9r. As v" T //?O.1) / `)1'91 O'r "'--o 0.4.)y M LE GE N D e1E't hr10A1 0.9 110t. feF Pr _ c~ o . o Fr q-, IROA) I~ h 2 Nod dZ• L or • ,i I 1 Q YP A ys w 13 0LTERA)A(TE A 0 O I t~ cEvr~,p Got 13 I r FGA T f y 3 No ME.4 so OE-413 Ir # j d~ DPr~W~ty, SGo/>ES . ! ~ P,p'i ~'ATr G~riV~ L DR%NE" ~aD I f E SC LE R'QUARTER SECTION Each side large blue squares= 10 chains, 4U rods, 6G0 feet; area of sears 10 acres. F- 300 Ft. 1 Inch Each side smart red squares=2.5 crrains, 10 rods, 155 feet; area of squire .625 of 1 acre. .mss • ~ ~ - rz3' ' 1p G C ~~-t• alit, Z-o I nom', fir. r u• i Rmani.~ -Z i It v ti y. C; i I i I I ,C t r SCALE FOR QUART-R QJARTER } Each side large blue squares- 5 chains, 20 rods, 330 feet; area of square 2.5 acres. SECTION, 200 Ft.- 1 Inch I Eacn :,de small red suua:es= .$cqa ns. 5 cuus,82 feet; area of square .ISS25 of 1 acre. PRONTO LAND MEASURE 20-40 KAP SHEET PRCgTQ LAND MEASURE - - Ccoyi~em, riff 7,.~snys 1v1+r.rrorl AANt•lthn4 MMMe►~ . jY,~7 r..~YCz: moo /V•w. Corner J08 NO. 75-9 E,y of Nw SUR wv~' Y MA P r'~. PART Of SEl/y of VWlAy f'Stc.R9,T3IN,218W h Town of .~*4r rr~lr/e , Si Croi r Co., Wis. _ N 88 I ~ ~ N8~•s'L•6 A7 I , , v TOWN 123.0 P _ 0.83 A. o"' N ° who m Z 1A tA. 41 • g r 383 SL w mac. /33L* ~ o INDICATES IRO IPE"LLSIAKE 8A-5-W--9*-"'A"--9URVEY MADE Z/"/7 I~ r OAT E z - z 57-75' 143.75°~ 6 6. 6 SCALE CV U• i7s'• /33, o DRAWN l R. G JAMES R. GRUBB i DV C SC rLE RQDARTER SECTION Each side late blu! squales= 10 cnalnss0 rods, 660 feet; alga of squats 10 aces. 400 F4 1 Inch I Each sloe snall led squates_2.5 chains, 10 toss, 165 feet; area of $qua's ,625 of I actg. N, ` v' V I C'J I a. N I 471- -0 . Syt S> ~ c _ i i fro i III„' t.; S~ ~D - N1' GI ~ grv ~t 1i i f1 ~ O.Y. ] t y I )JI SCALE FOR QU:.FT:R QJA.RTER ucn side large blue squatese 5 cnalns, 20 loos, 330 feet; atea of squat* 2,5 aces. SECTION, 200 F1..= I Inch ! Eacn :we small red s wales-:.;;5 ;OL;, 82.5 feet; ales of 'Quale .15625 of 1 sue. PRONTO LAND MEASURE 10-40 MAP SMEET PRONTO LAND MEASURE Cnovnpnt. 1567..1ames mamiitdn Adair, flint, wcmaan I~ I I - 488 K II I I 76 sp I V ~I I LOT 2 487 F I _ N 5 vv //4 NE /14 2886 N • I - I $ 487 J ( I I 4c68 K 4871 LOT 2 i 487 H 59065' 29~eO, N•1 L14 488 NW f G • I 487E ~ 68 H • 1 488E _ :488 4889 487 D 4880 N 487 A 293 0~/ 488 ° 487 C / 488 ° lot 487 / 4888 05 e 1z}g 0 E 1 192.10 1 490C ' I 165 A N ~ °I 44. 140.9 123 I It ' LOT 489 H M 9 H ' , /4 - ~ _ NW 288' S % 119.? SE G ' 175• , c~ I 4891 - u' LOT 2 38t 20 \ /a?$ 0 / 490 J 494 43o►,5 _1 N 114 - 92? - 40L1 Z PG. 53_3_ cs_.M 49 0' K I 430 490 G I s~ ?0 190 I '63 S' 4 89 A I I I 490 ° N 490, I 369.8' ~ rig: f STC-105 SEPTIC TANK MAINTENANCE AGREEMENT ~Q St. Croix County OWNERBUYER D f er fro e,oo may' MAnmG ADDRESS / S~ f St Sa rn r ~5 t~ !Ji $ S j0 a'2 PROPERTY ADDRESS 9 93rd ST. S7A~ >oRg~ , 7w ~stip S . (location of septic system) Please obtain from the Planning Dept. CITY/STATE /2 ~F G1 S . PROPERTY LOCATION S E 1/4, 1/4, Section T 31 N-R1,9' W TOWN OF S Tf/hF ST. CROIX COUNTY, WI SUBDIVISION b N F LOT NUMBER CERTIFIEDSURVEY MAP" ~ eCA• b( O6VOLUME p PAGE LOT NUMBER 6 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 pirati_on' date. SIGNED: DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 y . t STC - loo This application form is to be completed in full and signed by ~he owner(s) of the property being developed. Any inadequacies will only result ~n delays of the permit issuance. ,Should this development be intended for resale by owner/contractor,(spec house), thenla 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 a 6 P'r7~ - > o ~ Py- Pv Pr 1 . Location of property 5 El/4 A/_L4-)114, Section c2t _L Z' 3 N-R~W Township Mailing address -/75 Sol% S~, ~S'o~,~,ser~ Address of site /qS y3rc~?. Subdivision name /Vv ti,F- Lot no. /V d/v Other homes on property? yes No Previous owner of property Total size of parcel a rr e Date parcel ,was created g7~ -~S 75-- 'Are all corners and lot lines identifiable? X Yes No is this property b eing developed for (spec house)? Yes No 1 4 Volume s~// and , Page Number as recorded with the Register of Deeds. INCLUDE WITI4 THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, 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 (off ) knowledge that I (w_q) 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.UDd.1033 aa~e S73 , and that I own the proposed site for t sewage disposal syst(we em) orreI e~wej 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 applica Co-app ~c nt Date of Signature D to of Sig ature~ "Cull veyances exempt Irani the Ice because of Section '/7.25k 1), (21), (4) w (If) wu also cxcwpt II uln tlic rk~uuu. ivu raoru I:. ,,slur with respect to conveyances exempt under s. 77,25+(2) unless the transferor is also a lender for the transaction. r u ~L - This Deed made between . r Robert F. Kluwe and Dolores Y. Kluwe, r; ^c' u riccc„C1 t • husband .and -wife ~i Grantor, II S EP 14 1993 } and........ RQbert..JA.--...G OppgX..and...$e-Y-grIy._.s?.;_..J. WQr. 9:00 A. ! as-• Ten -nt.... a. 4~?... .O.m?~140 4 1 O , 1 it :i q,C• cU re:ty i Grantee, i I Witnesseth, That the said Grantor, for a valuable consideration....._ _ _ -ET-URN - ---TO- ! I R conveys to Grantee the following described real estate in ....fit..-..rOlx.•-_•-.•- I' County, State of Wisconsin: !I i ! I Tax Parcel No: I Part of SE1/4 of NW1/4 of Section 29-31-18 described as follows: ! From the NW corner of said SE1/4 of NW1/4 fo South 214.5 feet; thence N88e561E 173.9 feet along the North side of an abandoned Town Road; thence S10'251E along the East line of said abandoned ~I Town Road 188.75 feet to the Point of Beginning; thence N88'561E 119.7 feet to the shore of the Apple River; thence on a meander line along said shore S14'571E 166.42 feet; thence S88°56'W 338.0 feet to the East line of a Town Road, thence N0°051W with said East line 161.6 feet; thence N88o561E 175.6 feet to the Point of Beginning. Including all lands lying between said meander line 11 and the Apple River and including a portion of the town road Ij abandoned by the Town Star Prairie pursuant to the certified copy of Resolution recorded in the St. Croix County Register of Deeds office on December 29, 1976, in Volume 1154711 of Records, Page 142. it ii I! This ....1.4 ...l?Qt.......... homestead property. (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; ! Fal And......-Robert F. Kluwe and Dolores Y. Kluwe i warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and rights-of-way of record, if any. ! p .I and will warrant and defend the same. Dated this - ..............t0 day of ...........September...................................., 1x...93.. ~~Cr{~ r .................(SEAL) ....~~`~..................(SEAL) ~I W Robert F. Kluwe Dolores Y Kluwe (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature (a) _..Robert F. Kluwe, STATE OF WISCONSIN Dolores Y. Kluwe County. as. authenticated this to day of...Sept21llb2r 1913 Personally came before me this ................day of lmv . 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 foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY Kristina Ogland at Law Notary Public . County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) date: 19.........) -Names of persons signing in any capacity should be typed or printed below their signatures. WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Co. Ine. FORM No. 1-1982 Milwaukee, Wis. L ST. CROIX COUNTY J WISCONSIN ZONING OFFICE ~IN NNNIN ■.rni ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 February 7, 1994 Lawrence Dahms 1020 North Broadway Menomonie, WI 54751 Dear Mr. Dahms: On February 4, 1994 a sanitary permit application for Robert L. Groepper was brought to our office. I did not issue the permit, as the information provided was incomplete. I am returning the Plot Plan and the SBD-6398 to you for completion. When the proper information is furnished, the permit will be issued. Please complete the SBt-6398 by indicating the number,6f bedrooms, and the nearest road/ On your plot pli, please show the following: Benchmark Lot size; Distance from septic tank to we 1, pump tar to well & drainf ield towel l ; o Slope; Alternate area;,/ Distribution piping detail,-V/ Vent; Super-impose bore holes,V Pump chamber specs & cross section.--I am enclosing a sheet to provide tank specs, and a permit application check sheet, which may be helpful to you in the future. Should you have any questions, please contact this office. Sincerely, Mary J. Jenkins Assistant Zoning Administrator File • ~,e-u.Q ~ off`: o~~~..~,~-J DILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY -Attach complete plans (to the county copy only) for the system, on paper not less than STATE SANITARY PERMIT # 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. PROPER OWNER PROPERTY LOCATION 46 15 &V P Sir Y4 N4JY4,S Z TN,R fg E(or) PROPERTY 07ER'S MAILING ADDRESS LOT # BLOCK # 71 z* J. CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER E~ WZ 1-5,4'0 Zs 71S 2 - II. TYPE OF BUILDING: (Check one) 1:1 State Owned VILLLL.AGE : NEAREST ROAD ❑ Public N* or 2 Fam. Dwelling-#of bedrooms - A EL TAX U III. BUILDING USE: (If building type is public, check all that apply) 0 3 A ~ If - yQ 1 ❑ Apt/Condo .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) r- I A) 1. New 2. ❑ 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 ❑ Mound 300 Specify Type 41 ❑ Holding Tank 12 Seepage Trench 22 ❑ In-Ground 420 Pit Privy 13 ❑ Seepage Pit Pressure 43F-]Vault Privy 14 ❑ System-in-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 12. 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) 96'16 ELEVATION E~3o " CC,4~,S- ' Feet q,0 Feet VII. TANK CAPACITY in allons Total # Of Site Prefab. Fiber- Exper. INFORMATION New lExisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank QQQ Lift Pump Tank/Si hon Chamber p t VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plu Signature: (No Stamps) PRSW No.: Business Phone Number: LAu~ r~ c~9fdr~S 15 23S -O(o Plumber's Address (Street, City, State, Zip~ AD 20 2r 6/l -~Y7S IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No Stamps) ❑ Approved El Owner Given initial Surcharge Fee) Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: H CD 9 K-1 OWly /LOA'S _ z % W ~ N ~ y m U~ ~U N o ~ tl~ _W M 1~ ~ o _ o e R in . `l O y U ?add d ST. CROIX COUNTY WISCONSIN " ZONING OFFICE r r r r r n Olin loom ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 August 2, 1994 Lawrence Dahms 1020 North Broadway Menomonie, WI 54751 Dear Mr. Dahms: On March 30, 1994 a septic system was installed on the Robert Groepper property, Section 29, Town of Star Prairie. At the time the permit was issued you were furnished with an AS BUILT form to be completed after installation, and returned to this office. I have not yet received it. I am enclosing another copy of the form. Please complete and return as soon as possible so that we may complete this file. Should you have any questions please contact me. Sincerely, Mary J. Jenkins Assistant Zoning Administrator cc: File I ST. CROIX COUNTY WISCONSIN ZONING OFFICE M N N N N N M■ ....s ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 May 19, 1994 Ms. Janeen Benoy Bank of Somerset P.O. Box 220 Somerset, Wisconsin 54025 RE: Septic Inspection for Robert L. Groepper Dear Ms. Benoy: An inspection of the septic system for the Robert L. Groepper property was conducted on March 30, 1994. This property is located in the SE', of the NW', of Section 29, T31N-R18W of Section 29, 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 bedroom home. Should you have any questions, please feel free to contact this office. Sincerely, Mary e ins Assistant Zoning Administrator mz