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HomeMy WebLinkAbout026-1114-70-000 N ~ O o c (1) h ~ o o 0 0. O~ O c i cc 0 72 O C U f0 a) y O C z v IL C O 0 a ~ N M r z GGo z O O z d d cones am H U 0 O z v ° c V r O y 4) z z N O c E -a N N p 03 0 C N CL 2 C d U) L p 0 3 z co z p N Z o d c wit 'a w 3 N - f0 3 y U c co L co co N ow U d d z O O O •N io 3CL CL IL IL z tp °i cN) Q rn rn Z a cc Cl) con 0 N O O) E O O O Z) O m C d Cl) m Q N Q C O O O N N 'O o0 3 2 y C c E ~0 o coc ~°c C a °o V n_ ca -6 O a m N O v c U o p c o = Cl) O ° CV U L O) E E V) OF- c L • N U OOi O G R U cO O O d' 0 ~ 0 2-~ L (n a ` a • Cg a d m r~ 3 r A c°~CL 03 vici Parcel 026-1114-70-000 10/19/2005 04:57 PM PAGE 1 OF 1 Alt. Parcel 01.30.18.660 026 - TOWN OF RICHMOND Current f 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 O - BLIETZ, DALE L & LOIS J DALE L & LOIS J BLIETZ 1435 176TH AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1435 176TH AVE SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 2.000 Plat: 2630-WILLOW RIVER MEADOWS SEC 1 T30N R18W SE NW & NE SW LOT 8 OF Block/Condo Bldg: LOT 08 WILLOW RIVER MEADOWS 2.OOAC Tract(s): (Sec-Twn-Rng 401/4 1601/4) 01-30N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1058/127 WD 2005 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/20/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 47,300 182,300 229,600 NO Totals for 2005: General Property 2.000 47,300 182,300 229,600 Woodland 0.000 0 0 Totals for 2004: General Property 2.000 47,300 182,300 229,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 206 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wr swInssn Department of Industry, SOIL AND SITE EVALUATION REPORT Page L of 3 Labor and 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 / OOC N t 0- GOVT. LOT SGT 1/4 /~1/4,S T _40 N,R fB ,R(or) W PROPERTY OWNER':S !LING ADDRESS LOT # BLOCK # SUBD. NAME OR # CITY, ST ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE WOWN NEAREST ROAD Q New Construction Use ~j Residential / Number of bedrooms 3 Addition to existing building Replacement [ ] Public or commercial describe Code derived daily flow 5d gpd Recommended design loading rate 7 bed, gpd/ft2trench, gpd/ft2 Absorption area required (o 3 bed, 112 563 trench, ft2 Maximum design loading rate _ 7 bed, gpd/ft2 trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations AIX Parent material S Z.l i45 h Flood plain elevation, if applicable It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for s stem IRIS ❑ U [as ❑ U S ❑ U 26 ❑ U ❑ S Ek ❑ S Mu SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Tn ch ;:•.>..:<z<x:::::; a m 5 ryJ `iFiZ S 0 {o 7tl ^ rt o- 7 0 317 Ground Z 5 't q1 2 D7.5 yK / ig ; l a m 5 13 /-s 4M C~ 5 44 elev, _ l %ft 8 7 n `ff No ro P_ ("n S ®S rU /►l L1- Depth to limiting factor > Remarks: Boring # cL p `F~YL ~o tJ ..S Z- Z D r~- 7 D E S C rl.. 'al m 9 t'C M /q 10 /y : .3 Ground 9'/-37 /D tt 5/ C aS / vtqy- 1 2 3 ffe t 7- 9D o `f/ toe) E L°o,S 4 S 'l , b' %~ft IVE Depth to ~ ~ , limiting factor ?I rd I,.. f Remarks: ` CST Name:-Please Print P bone: Address: .5 .575'Le),, ~ Gtr Signature: Date: AIA CS 7 PROPERTYOWNER/wriGl~ SOIL DESCRIPTION REPORT Page Hof 3. PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bow Roots Bed iT in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed rerxh Z D-Z7 0 b G SCI 4 Z 3 Ground 7: 3$ , 5 2 /S D 4) ye , -3 4& elev. 6 ft. _ 9 40 S Depth to limiting factor Remarks: Boring # A~o p z ti 3 /z :nw,pwx:?p} M Z 0- z7 /D rL }14 D G c a m5 b r•( !Yt ~ L , S Ground 9.8v 7• y q1 fa y1b x) - S m S r✓r¢ ~9 Ytt ft. Depth to limiting factor Remarks: Boring # 3z- /01 - a ~D S O S ,(Ji4- , , -Az f Ground : elev. 79- 'ft. Depth to limiting ? Ot~D `r Remarks: Boring # Ground elev. ft. Depth to limiting factor FT Remarks: SBD-8330(R.05/92) STEELfS SOIL SERVICE ZOO- 10 X19 Gary L. Steel OW16-she e-9 eve C.S.T. 2298 New Richmond, WI 54017 MPRSW-3254 DE r v+ I e-K Of) n-S`ln uw- 1 dyl =n C. (715) 246-6200 Sc- Yl~ N U) Y,1- s - ~~oti lZ (,d /'l= loot K6, P,P~ by ~ S. e. ko 4- az'yl 6 • z 48• --0 zrs~ oS . 1=1-9.5 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER_,. ADDRESS /3,0 -A 1ej eJ-4V~ SUBDIVISION / CSM W i A-% LOT ~ SECTION_ _T_36 N-R_L,~_W, Town of ~Gd► mc-0 4 ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHYTHING WITHIN 100 FEET OF SYSTEM y r ~v 1 ti P n I kCATE NOR-PH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. D StD~c 5 (?~nM~n ~L' BENCHMARK: ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING..TANK INFORMATION Manufacturer: }emu S e Liquid Capacity: Setback from: Well House__ZX Other Pump: Manufacturer 4/.4 Model # Size 7 Float seperation Gallons/cycle: Alarm Location AIX :SOIL ABSORPTION SYSTEM Width: Length Number o es i Distance & Direction to nearest prop. line: 7 5 i Setback from: well: House /d 6 Other G~ yL ELEVATIONS r u~~ Building Sewer 9, ST Inlet. S 3 ST outlet I ` PC inlet ,011A PC bottom Pump Off Header/Manifold 96' Bottom of system Existing Grade Final grade / ~DATE OF INSTALLATION: PLUMBER ON JOB: v-•.r` LICENSE NUMBER: INSPECTOR: 3/93:jt LW~Ts pertRX9W&i y, 01. 30.18 .Fq"Aff S jk S TJW HWY "G CdU cJ Human Relations af INSPECTION REPORT ety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) sanitar r it Permit Holder's Name: ❑ City ❑ Village R Town of: State Plan o.: ev.: Insp. ev.: BM Description: X Parcel Tax No.: 66, 5 0-~ Q26-3334-20-000 TANK INFORMATION ELEVATION DATA A9300267 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ® Benchmark 16 3~ 3 /0 /I ZIA Dosing Aeration Bldg. Sewer ~.yS 99.5/ Holding St/ Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet Vent TANK TO P / L WELL BLDG. Air Ito ntake ROAD Dt Inlet Septic - NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe 7,9 9S Holding Bot. System V5~ PUMP/ SIPHON INFORMATION Final Grade 9g. % Manufacturer Demand S ~ C~,~~ 3,~t 99,1 Model Number GPM TDH Lift Friction System TDH Ft oss Forcemain Length Dia. hi Dist. To Well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. Of Trenches IT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS / 7 a DIMENSIONS SETBACK Manufacturer: SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING INFORMATION TypeO CHAMBER Mode Number: System: `ice 7 /llI/f 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: RICHMOND 01.30.18.661,SE,NW,LOT #8,CO. HWY "GG",WILLOW RIVER Plan revision required? ❑ Yes ❑ No Use other side for additional information. l07 3 t4ct i.e. SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL. COMMENTS AND SKETCH : . SANITARY PERMIT NUMBER: SANITARY PERMIT APPLICATION ILHR In accord with ILHR 83.05, Wis. Adm. Code COUNTY STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 19'90 6) o~ 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 rt^(C. S '/a %S T30,N,R/k r)W PROPERTY OWNER'S MAILING ADDRE~ LOT # BLOCK # w S CITY, ST E ZIP CODE PHONE NUMBER SUBDIVISION N E O SM NUMBER wt 5Y6,1`7 7r . WA- AMO ~ 1a~ AI t/,, h Aztdow.s II. TYPE OF BUIL NG: (Check one) CITY NEAREST ROAD State Owned O VILLAGE : • ❑ Public f41 or 2 Fam. Dwelling-# of bedrooms OFARGE1 AX R( . III. BUILDING USE: (If building type is public, check all that apply) 02 _ # 9 v 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 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) 1il X New 2. ❑ Replacement 3. ❑ Replacement of 4.0 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 119 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 00 85 7 A 1 • A //7Q . " 9X Feet . Feet VII. TANK CAPACITY Site in gallons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks strutted Septic Tank or Holdin Tank tma L:J.a. Z4_L r Lift Pump Tank/Si hon Chamber Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Pri Plumber's Sign e: (No Stamps) fife/MPRSW No.: Business Phone Number: r► d urn rY /~5 715- Plumber's Address (Street, City, State, Zip Code): 1194 S Age- 4) - ya 7 1/~ IX. COUNTY/DEPARTMENT USE ONLY A❑ Disapproved itary Permit Fee (Includes Groundwater Date Issued Issuing Agent Sig Approved ❑ Owner Given Initial 1,7 G8 Surcharge Fee) Adverse Determination ICJ / 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 swnership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the o,_jnty prior to installatio 5. Or,., t :ryw:i e :.systems must be properly ~aintairied. The J ;r tiv tank(s) mu .-t be Pttrrrped by a' Licensed pumper whenever necessary, usually every 2 to 3 years. w. *a, 6. If you have questions concerning your onsite sewage system, contact your locat-code.adn;irtistrator o-r ie" 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. IL Type of building being served. Check onlYone 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- VIL Tank infurmation. Fill in the capacity of every new and/or existir~, t-.r list the total gali,_)ns, number of tanks >,rrd manufacturer's name. Indicate prefab or site construe ~id and tank material. Complete for all septic, purnp/siphon and holding tanks for this system. Check t:; rira~cntal approval only if tanks received experim,?ntal produut approval from DlLHt Vli! Resrnon ihility statement. Installing plairnh-~r is to fill in narne ;iclw.rise numbe! fttift, appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign apfriil.;A on form. IX. County/Departrent Use Only. X. County/Department Use Only. Complete plans and specific:atio is not smaller than 8% v 11 Inc es mast he submitted to the county. The plans must include the foiiow?ng: A) plot plan, drawl to scale ~_:r'ovit`j icoaiplc:te dirnensions, location of holding `ank(s), septic iark(s;i )r ether treatment tanks; bui!dino ,_-s. wells; water mains~vater service; streams and lakes; purno or swhofi tanks; distribution box,es i! bso+= tl„rt systc-rms, rep;as=emert system areas and the location of the bui :',r,o served, B) horizonta~ ant: vertica, devaficn ,~eferr -r, point:z; C) complete specifications for pumps and controls; dose volume; elevat on differences; fricuen 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,siging inforrnatiort. - - - - - - - - - - - - - - - - - - - - - - - - - - GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges. (fees) for a num Der of regulated pr<ac±ices whic:t~ =-an effect g-oundwa`a, Tfle monies Collect d tr.rG7 y i t -srsrcharges art, use," fir rl,s01,Of water C'.ontaminatton investigations and establishn c,i, 1~rt, __~.r is SBD-6398 (R.11/88) .d f f l 1 • WMV e t t ? ~ f ~ i i , • 1 ! i~~ i i 1 t _ f r , { f , I f I 1 I i P ~ I S 14 1 r a5-f?~ ~ _ i , I ~ j 1 t !75, j 1 a , 1 / I f ~ i i I ba , 11{ 1 ( , [ j I { I + t fff F j Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page L of 3 Labor aid Human Relations Divisioirof Safety & 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 PARCEL I.D. # not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or dimensioned, north arrow, and location and distance to nearest road. - APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION / 009 V- .m .1~C. GOVT. LOT 5G., 114 n)U 1/4,S / T _40 N,R /6 9(or) W PROPERTY OWNER':S ILING ADDRESS LOT BLOCK # SUED. NAME OR # CITY, ST ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE MOWN NEAREST ROAD OT, S cW7 ( Z ZO CO ' New Construction Use Residential / Number of bedrooms 3 (J Addition to existing building (J Replacement (J Public or commercial describe Code derived daily flow SD gpd Recommended design loading rate 7 bed, gpd/ft2_A5_Vench, gpd/ft2 Absorption area required 3 bed, ft2 - o3 trench, ft2 Maximum design loading rate _bed, gpd/ft2-,-JL-trench, gpd/ft2 Recommended infiltration surface elevation(s) 9J? S.3 It (as referred to site plan benchmark) Additional design / site considerations IVA Parent material~h. 1 ~4S l~j Flood plain elevation, if applicable ft ' S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT GRADE SYSTEM IN FILL HOLDING TANK U 9 Unsuitable fors stem RI S❑ U' caS ❑ U As ❑ U ®-S ❑ U ❑ S .®-U ❑ S RW SOIL DESCRIPTION REPORT Depth Dominant Color - Mottles Texture Structure Consistence Boundary Roots GPD/ft Boring # [Horizon in. Munsell Clu. Sz. Cont. Color Gr. Sz. Sh. Bed rertdi v- Q rn s e,-,( to rZ C S 2.5 17-5,Y12 1~/ SL 2 m m 4o2 a to S • !a CZD7.5~m q1 /e T. .1 amsoi w► 12 Co k~ 5 . Ground. Z 5 5 K elpv Depth to limiting factor Remarks: Boring # o- !z A10 N a- a Msor( m Vx- (21) i • I Zr, z-7 oKe= 71q-_ J o 6- SCL aRwt50)< M4rz 64) SS Ground 37 10 s'L 614 No ig r- r r t v it 0 ele!s• 7- 9a loyti- 5`/ rvd C C°o © s _ A,'~ /1/ 7 lyric Depth to limiting facts 4 Remarks: CST Name:-Please Print ~C-Gh one` r, G Address: _ 6' • ~~-O Signature: Date: CST Number: y 3 CsA"P-i - 9B PROPERTYOWNER~~,wr~~/'~ ppy~S~- SOIL DESCRIPTION REPORT Page 17--of PARCELI.D. # i Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench .w ~o 7 G Sc ~sB z 3 Ground 7-38 , 5 rL 3 /0 /S p S rn cJ fo- elev. -7 j- V- 0 /a Iv 6 ft. - 7 S /1 S /f- i I-eg Depth to limiting i factor rye,, Remarks: Boring # e ` D qv D (-Z- rtJ rYt S~i~( cc~ a z7 /0 Mt D c-a ►~Sb r4 .S Ground elgv., ft. L Depth to i limiting factor 796 cc Remarks: Boring # . o. z rL 3/z G / ZrylS~3r( l' Q . G ~'D S O S Ground ' elev.. cf~ft. ; Depth to limiting i r factor 'Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD•8330(R.05/92) STEEL'S SOIL ,SERVICE Gary L. Steel Orive C.S.T. 2298 New Richmond, WI 54017 MPRSW-3254 ~E r r I C K OU ris-IvL u`d i &vi r1'1 C- (715) 246-6200 SC Yy- IV U)% _5 / f 30~ - X /Bt -/a W12 / AalWaL'--z d ~do -'1.',4CE 4-, ~ ~lK er. 11) P, (2 by d / i Z?' s,►azls~ os . x G'(J~-~ ~ PAGE O F darn Oen5-~rL~ U S S e c 1 u n O t e 0 S 5 1 e Fresh Air InI916 And ObcerY011on Pipe Approved Vent Cap Minimum 12' Above Final Grade 20- 42v Above Pipe _ 4" Cod Iron To Final Grad• Vent Pipe Marsh Nay Or Synthetic Covering Min. 2• Aggregale - - Over Pipe I t - I Distribution Pipe 0 0 0 0 -Tee ! Aggregat Plpe e Beneath Perforated Pipe Below o -cooing Terminating At Bottom of System 9'9r/ p~1,Pa5eD ~ina~ qr~.~l< . DR- .\-RE .SOIL FILL DISTk1BUTlOl.]' PIPE APPROVED s4HETiC COVER 2"oF1g6GREGA?~-/~ MATfROR 9~~OF STRAW ~ 11ARSN HAJ R e feOF l2-21/2 AGGREGATE Z." FEET. DISTR151JTIOU PIPE TO Br- AT LEAST - INCHES BELOW ORIGIIJAL. GRADE A►JU AT LEAST20 INCHES BUT 1.10 MORE THAI) HZ IMCNES BELOW FINAL GRADE MMIMUM WN OF F-XEAVAT100 FROM ORI&WIAL OXADR WILL BE 5pi IIJCHES MIKIMVM OEM of FACAVATION FROM 0R16IWAL. GROE WILL. BE INCHES 51GUED: L I C E M S E AJUMBER: ~S a DATE: > Ol`-~_~ a a 60331 60 425.10 ~ 1.07#a m .0 1 o Willow 2.oZ ~`a o' 18 16 River LOS Agn 19 .00 20 Meadows 4 a= *AM 15 2.15 ACM 14 a us 2= " 13 21 ~S 2.16 ACM a L= AOM V 7y4~~. 361.13 v 9 1 0 N 161.13 no 10 263.16 2.01 AWN 2= ACM o A Y 2.00 ACM 12 2 22 2.61 AO 2.00 AOM e za 214135.2! Public ^ xis 46.)4 x 8 x 7 23 « zoo ACM 222 ArtM 200 AGM ,1a1 ~,ps ~6 in N 266 206.30 24 sago A zoo AoM - 2. 6AOM zs2t ABoM ~y AMU 5 a 316.33 e " 2A1 AtlM 25 il. 44 27 zos AOM 0.4Y °e m M 29 a=AaM e 4 ~ . z32 AOM rr.60 w r w LO ACM a_ wfbw i16m A 478.33 X6$7 ' 77.60 city of Now fthmo w I SI 26 p s 3 z3o AOM V.; s, ~a 2.11 AMU sa~.os 30 4t° 2M AOM n6 no 211.03 o S us 20 C 4W" Rd. W a in 32 33 « « li . « ^ I= 0"n «1 !4 AdM 2 X « 31 o . 1.61. Aa= L 203 AMU w ~ ~ n 200.50 326 37 22tl Highway GG (715) 246-2320 RRICK Route 1 oi~i New Richmond CONSTRUCTION Wisconsin SL~':'rC "~I:IK wRL:1TTi:IA:SC Ac:ZZ~:!E:1T Sr.. Crv z» Cuuttc~s w, L L o w et v~2• Jni J07' Owrrc:zl~u•t~:c AIC44.aE4- G. SMVet'Ls MOUTF! 90:'- YII"SBF_/so S I-A-V U ~oS- Eire ^Iumber~ CIT7! STaIT ~ 0 ZZP -S~Q l7 S ~ / 30 ~ P^7pERT7 r_O(=TION: Section T ` :'own of Coq-AjOJkW St. Croix CaunC7, Gil LAX w Subdivision 4PSn- A44S oOed.i Loa cumber Zaiproper use Xad maintenance of your seacic syscam could result La its pramacsrs failure Co handle wasces. Proper maintenance can- sizes od pumpiag out Cho septic caak aver7 three years or sooner. L. needed. by a Licensed seocis tank oum per. %hac you puc Laco the sys cam can at ac: Cho Cunce:un ad Cho sepc_c tank as a c. eac- mane stage :a :he waged diaoosa+ svscam. St. Croix Cauncy residence may be al igibLa cc receive a grant for a maxmaxau_m ud 60Z ud Cho case ur replacement of a failing syscam, which was La operation pr_or to July L. L478. St. Croix Cuunc.r accepead this program La Augusc of L980, fetch the requiremanc chac- owners or all meta svs_tams agree co keep chaLr systems properly mai.a caimed . T%e prOger_7 Owner agrees to submi.c CO Sc. Croi= Cuunt7 Zsniag a cerci`icac_on forth, sighed by the owner and by a mas.ear plumber, lour:teyman plumber. ='esc_icead pLamber or a Licensed pumper vert- Ey::tg chat Cho on-site rascawacar disposal system Ls Ln prone,: ooeracistg condimion and (2) aff'! ar Lasaec_Lon and umoLa j" eoc- assay the seocic manic is Less Chan L ' ? !3 fort of sludge and scum. Carti!icacion form jfil be sent aporosiaacsly 30 days pr:ar co three year atpiracion. LlUE. the undersigned, have read the above requirements and agree cc mai :caim the ortlraca savage disposal system Ln accordance rich the standards sac for„t, herein. as sac by Cate IJLseonsia Depart- mena of lacural Resources. CarCi__cac_on forts must be comoLecad and rscs_:ted co the Sc. Croix CaunCy Zoning 0 .ice within la* days of the three rear ax?ir:scion data. S C.. GII q I A T I 2S Sc. CrO-: Counvr :on,a~ 7.j. lox ?ammama. jZL0? J APPLICATION FOR SANITARY PERHIT 8TC-100 phis application fotm is to be completed in full and signed by the owner(s) of the iroperty 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 0l LL-0 UJ el yt'rL ~ac AI Location of property. k t4W , Section , T 30 N-R W Township /C! C44 A4 O KI ~O Meiling Address _ ~`tJS 74o 4yc Address of site ! SA4"C Lot Number r---- Previous Ownet of Property _ L1E~~z4.t Q c _s c,4 t / 0 , r Total else of parcel Date Parcel was Created Are all corners and lot lines identifiable? Yes No to this property being developed for resale (epee house) ? Yes No Volume and Page Number Yt(C as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWIM 'A`Wartanty beO which Includes a Document number, volume and page number, and the Seal of the ReRleter at Deeds. In addition, it certified survey,,If available, would be helpful so so to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Hap, the Certified Survey Hap shall also be requited. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERM FICAT10N 1 (?del ceittk that d1A Ata,temERU oil .tUA 604m ape tAue to the be3•t o6 my (ouh) hnc.,utedget that 1 (we) am lapel the avnen(b o6 the pkopeAty descAibed .tn .t1UA tn4onme-Uon 6o4m, by v-Atue 06 a wnnn.awty deed neconded in the 06 ice o6 the Coun,(y RegjAteA o6 Oeed3a~s Ooeumentt No. VSS Z.O to ; and that 1 fwej prtesentty aun the prtoposed site 4ak the Actuahe duspos eyb em (o)t i (we) have obtained an cahemtnt, to rtun w.cth .thr. above deAchtbed pupwr/, oh the eonAthuctton o6 said eyetvn, and the same kae een dut Accohded .tn the ~dtce o6 the County RegiAteA a$ Veede, Voemntnt No. SS 2.0 ~ I. REGISIER'S OFFICE . De>rzickr , I. ST. CROIXCar WI ' Micl►ael R.. SEevertst William tl. Reed for Record will jam. m.. Derrick, Thomas. 0. Der0i. 41 ,1tIN ~9 1:l~U Ronald L. Derrick as. te►lants-in-common al 8:30 ~1. M ranrl•iq alul I,arr:rnts In Willow. ItiVex. J.v n. $91tu. a CnuAA .....Venture. ~ Re011tnoldeed~ 1........ ' . . nRrunN ♦e Lhr. towivitlk derl•t11.111 rent ertnte it, St...Craix ...U011"tfr ante d tl'IFCOnt111: TM Cueet Not ~I ttteast Quarter Sotttlleast Quarter of Nvrtllwest Quarter and Not of Southwest Quarter of Section It Township 30 North, Range 18 West. rLr7 1 . u ~ tlbti Iui1NE~l~H11 1ttnliePlc~ ,,IIIAr~~inl~'I.:L.; , VIM. tt41 (In 1100 I-Nerl'11011 t1. tlntrllnttti►! Muttieipal dM Zoning ordineneeNt easements bend irriAtrietivns~ df reeordt /~'~I dnt• ar .Janu Xx.. t 94. 11111611 11114 . ` at;nt, 21 ........ISPA1.) lay Michael It...ateVI!!A..... ~ ....William M., derxi.ck .1r i t (!;IIAI .....tSrAM ~~`Ct! t ~c.... William t' ok TliQxae L t be 1W e.4, [ ~ f -RStiRl.~itl-~ ~ M e N t AUTIt"NT1dAT1UN Mich 'arATF (IF WISCUNGIN - wt_..l~am N.~_Uerr ckr w1~1m M; a.. A 1119t11Vt•1~t,t Vi^!t nn Countxt tV1n. r►11 g 1 not state illlrn/ln~ AM I't-'xQN. 1,11t011~ y ttntllq•? 1'a1R~ln1l le pctlllallent,li~ , 11. Qt"11 tool ti . (•t11111111 . ~ 1►~ ~C4IhC? 1U.r... ' .1rnlcd nr arltu111c1eA•te11, Itnth Met (;11,n+llurl•n nmv Itc nulhl•nl . ate not twea:+n11.) t Ind Ih~Ir ~IRnFlotr+. ~iKeh"1^ tt~l IHnuh 1... 1... U1U•~1 1"' . rnpn~lly eland.) I.r t}P:••1 for 1-1 I.t Irnlntt In eat STA it tvlat•ONnIN ...n~N nt prr~nn! ? 11,411 T V,,nnANtT 111'1 n