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HomeMy WebLinkAbout026-1091-80-000 -p O 1 4. o I I ~ p °e3 o 00 5q a~ ° C o o 0 N Mi N w I o I O O ~ Z III 7 l4 II LL O I M z E _W Z = 00 Q V z E a a m ? ~ Cl) Cl) i-- .0 C z D O Z U c V O y a~ Z c ° N to F- i', ° Z c E O O M N O O p a) O cu Q z co z o I N Z n y c N E N N O l0 ~ U) iv Y _ m _ d - CL awe : co 0) > 21) 0 d N c O O C a C N ¢ 75 U) U) U) L~ 7U Z~I N z.-> O O O O ° •ti a a a a L 3 ~y O O N M M z hi v1 U Q rn rn Z w m o M o co j E -s c co ti a U 2 Q2 (°j y ¢ U) C~ O aM0 N f~q O c ~ N C 3 o c c E t .0 0. Q) CL .0 a 00 Q) In E E O O O r M L 00 LO CD F- F- N W N U _N U1 E E U • y,~' O M O O N M -7 UJ cO ~ V ~ ~N d R3 a at ° L La • cf a m m E L c c _1 A c°~ a 2 II, o N) u s t. Parcel 026-1091-80-000 04/23/2007 05:05 PM PAGE 1 OF 1 Alt. Parcel 31.30.18.478A 026 - TOWN OF RICHMOND 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 O - BRENNAN, ERIC M ERIC M BRENNAN 1283 CTY RD A NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 1283 CTY RD A SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 13.990 Plat: N/A-NOT AVAILABLE SEC 31 T30N R18W PT SW NW BEING LOT 1 OF Block/Condo Bldg: CSM 9/2514 13.99 ACRES Tract(s): (Sec-Twn-Rng 401/4 1601/4) 31-30N-18W Notes: Parcel History: Date Doc # Vol/Page Type 03/14/2003 713196 2171/345 SD 12/14/1999 615522 1478/189 QC 07/23/1997 1119/224 QC 07/23/1997 1005/362 WD more... 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/30/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 13.990 87,800 130,100 217,900 NO Totals for 2007: General Property 13.990 87,800 130,100 217,900 Woodland 0.000 0 0 Totals for 2006: General Property 13.990 87,800 130,100 217,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 526 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 w r DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS ' INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 HUMAN RELATIONS MADISON, WI 53707 (H63.090) & Chapter 145.045) aS.- LOCATION: SECTION: TOWNSHIP/M&A LITY LOT NO.:BLK. NO.: SU IVISION NAME: W 1/'41W1%4 31 /T30 N/R18)&(or) W Richmond a n /a n /a 619-780-9560 COUNTY: CKXOEIM/BUYER'S NAME: MAILING ADDRESS: St. Croix Jeff Olson 5143 Long Lake, Rd., Mounds Villa Mn. 55112 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: I-P-R-0-FI-L-E--D- S RIPTIONS: ERCOLATION TESTS: Residence 3 n/a ONew ❑Replace 5-30-92 5-30-92 RATING: S= Site suitable for system U= Site unsuitable for system 0c), 6- /0 q/ fO --6,D Q / 1/ 7YA CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (o tional) ®S ❑U EIS ❑U ® S ❑u ❑ S fi]U ❑ S ®U conventional 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: n/a I Floodplain, indicate Floodplain elevation: n/a decimal' PROFILE DESCRIPTIONS page 43 13x$ BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- 1 86 95.20 none >86 0-10, 10yr3/3, l.; 10-25, 10yr4/4, gr. Co. S., - 25-86, 101 414, Co- R_ 2 84 103.35 none >84 0-7, 1 3/3, 1.; 7-11, 10yr5/4, sil; 11-24,10yr- B- 4/4, gr. Co. S•• 24-84 10Yr4/4 Co. S. ~ 3 82 102.60 0-14, 10yr3/3, 1.; 14-26, 10yr4/4, gr. Co. S.; B-3 none >82 26-82 1 4/4 co. S. 103.35 0-10, 10yr3/3, 1.; 10-22, 10yr4/4, s.l.; 22-84- g_ 4 84 none >84 1 4 6 Co. S. 95.80 0-7, 10yr3/3, s.l.; 7-14, 10yr4/3, l.s.; B- 5 82 none >82 14-82 10 4 4 B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD I PERIOD 2 PERIOD PER INCH P_ 48 none 3 6 6 6 <3 P_ none 3 6 6 6 <3 P_ none <3 -3 6 6 P-. P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction nd percent of land slope. SYSTEM ELEVATION 99.35 E 3 E s 4 i a 3 610 { t ~ 1 ~ t t I i 3 € r t t I i s E I, the undersigned, hereby certify e s '18 t rted on this form were ma~by~me fi aAcoi'd v tffi't~p-rdcedures and methods specified in the Wisconsin V Administrative Code, and that t r t tion of the tests are correct to the best of my knowledge and belief. NAME (print): Cr TESTS WERE COMPLETED ON: Gary L. Steel zF 0 - _-Z7 5-30-92 ADDRESS: Z c C3 CERTIFICATION NUMBER: PHONE NUMBER(optional): - - 1554 200th. v i- 01 fie f, kon CST U DISTRIBUTION'Original y t a A % r' , Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - W'TRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 To be a cc j accurate soil test, your rel'- =c:st include. 1. Complete le, ~ i iption; 2. The us, gust clearly indicate whether this is a residence or commercial project; 3. MAXI giber of bedroom= or commercial use planned; 4. Is this ament sy! 5. Compi ,.;:ability rating b. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER -YSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 0. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Di,rsing to scale is preferred. A separate sheet r~,~?y hF~ used if desired; 8. Make sure your 1. irk and vertical elevation reference point ar )own, and are permanent; 0. Complete all appi -rJate boxes as to dates, names, addresses, flood plai lata, percolation test exemp- tion, if appropriate; 10. If the irrforrnatiort (such as flood plain, ,pion) does riot ap,` N.A. - the appro, box; 11. Sign the form and place your current and your certifica+ n.r , 12. Make legible copies and distribute ~'i red. ALL SOIL TEu I =JaT BE FILED 1".ITH THE LOCAL AUTHORITY WITHIN 30 DAYS C'F COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures /mbols St - (over 10"? SR col_7 ')Ie (3 - 10") SS gr I (under 3LS - L HGW - u; :ivvater i cs d perc - i un Rate nled 5 id Bldg fly Sand Loam Bn fit :.IM Bt sr - Cy C I- iarri Y - -tow _ ':,layLoarn R Loam Plot - w/ .,y f$f f fine, fainr c' common, coarse rrrrn Many,.rnediurn ;s r - d - distin'(It,l - p prominent High 4vat{?r level, :xtmfl~ surface wa, f,, disposal 13enc4.Mark _ VRP Vertical F t i TO THE OWNER- T' unty or _)e Del~artr t may request . r ghn z or A ruction. N 17 n... Q F I X., 11~ ~2 119~1 JUL 2 d 19920- 5 ~r f /✓J JAMBS O'CONNELL S pegistet ot Deeds 486437 SL Oft Co., W, CERTIFIED SURVEY MAP Located in part of the NWh of the NW's and in part of the SWh of the NW's, all in Section 31, T30N, R18W, Town of Richmond, ° St. Croix County, Wisconsin. ° b NW Corner of 41 Section 31 -W z/ OWNER y Hank Van Dyk u, M 5 0 / CD co CD 051, 00~ / oo~ p~ P.O. Box 127 o New Richmond, 17 / \ cP. L. 4J <86 ~I 's, NOTE: Abandoned house and ~ w JN / - 1• P~~o~~;r'o~ foundation to be removed. ° W 04 00 ,Z.\F. ova •°o C'2;Q N z o . rn X L O z6o, 1__*1 • m o i 41 s o~ Z.► LOT 1 g s3 13.99 Acres (609,360 Sq. Ft.) Including R/W 12.83 Acres (558,717 Sq,.--Y- t.) E3cl ding R/W ~Wj - NWj / J I -9 3/ O S7104,& ' 117.63' --I o CO .tom / V i „ v M L1P~~ r , 17A LLJ C114 w/ / / ti y ~ti boo ~0~~ c~N~/ ; , : . • 00 CD# U I ~ ~ 0a e°~< a0e 'tio~y•01` ~ti° ohs ~ E.'; . 7TCt3l6;NT?y c`. L!Jj K)I / ```cococa4 ~oy0'~~y S`1O ::,~t17~~3tirtdst~st+eEF#l~lntting Y I I , ('J .,o CI~L`4'fr:Ttttte6. ~ Di I (_r) I Q )I D- I qtr 3dQ at>~ns at LEGEND pn+;ct>3te -,J S2005802911 / Aluminum County Section MonumeAtlm~ 137.02' ttE~ 14- • I" Iron Pipe Found -0 i 0 11t x 24" Iron Pipe Set, weighing 1,68 lbs. per linear foot Existing Fenceline H z 100' Roadway Setback O N ( ) Previously Recorded Dimension `A~ Marsh Area Wk Corner of SCALE IN FEET Section 31 VOLUME 9 PACE 2514 0 100 200 400 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS . SUBDIVISION / CSM# LOT # SECTION . 2L T„26 N-R_,Z,9_W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW y W EVERYTHING WITHIN 100 FEET OF SYSTEM o" B~ G' -~s .di INDICATE NORTH ARROW Provide setback and elevation information on reverse of this TOM- Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING-TANK INFORMATION Manufacturer: b) ~ Liquid Capacity: Setback from: Well House Other Pump: Manufacturer Model# Size Float seperation Gallons/cycle: Alarm Location :SOIL ABSORPTION SYSTEM Width: Length Number of trenFhes Distance & Direction to nearest prop. line: ~L- ,42Z Setback from: well: 9 _ House Other ELEVATIONS Building Sewer ST Inlet: 91-179 ST outlet. PC inlet PC bottom Pump Off Header/Manifold Bottom of system 9, Existing Grade Final grade DATE OF INSTALLATION: ✓ PLUMBER ON JOB: LICENSE NUMBER: -2;;2 ~ INSPECTOR: ~I 3/93:jt I I LQQ11TJAVrartRZQ9t16 4, 31.30.18 #AT[k9FWMEtVSTEM County: Labor and"HumanRelations INSPECTION REPORT Safety and Buildings Division (ATTACH TO PERMIT) sanitar rmit GENERAL INFORMATION Permit Holder's Name: ❑ City ❑ Village ❑ Town of: State PI X ev.: Insp. BM Elev.: BM tioplemeND Parcel Tax No.: TANK INFORMATION ELEVATION DATA A9300193 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark /dd Dosing Aeration Bldg. Sewer -7 Holding St / IX Inlet o TANK SETBACK INFORMATION St/ IJK Outlet ~3 (,7 S Vent TANK TO P/ L WELL BLD . Air itontake ROAD Dt Inlet Air Septic NA Dt Bottom Dosing NA Header/Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft Loss Fi Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSION DIMENSIONS LEACHING Manu acturer: SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM INFORMATION Type O CHAMBER Mode Number: System: 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 31.30.18.478A. (CTY RD A) c ~ G Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: SANITARY PERMIT APPLICATION couNTY DILHR In accord with ILHR 83.05, Wis. Adm. Code STAT SA ITA ERMIT# -Attach complete plans (to the county copy only) for the system, on paper not less than El ~ 8% x 11 inches in size. ~ e 41 t sous 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 Ad%A/ IL) '/4, S,-:? , N, R IZ(or PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # CI , STAT e-' I ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER II. TYPE OF BUILDING: (Check one) El State Owned VILLAGE : NEARE OAD 61 NW OF: Z/z ❑ Public 'P 1 or 2 Fam. Dwelling-# of bedrooms ZZ PARCEL AX N MB I( S) 111. BUILDING USE: (If building type is public, check all that apply) /C q1 eonrc 1 ❑ Apt/Condo 2 ❑ Assembly Hall 60 Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 30 Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 40 Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 130 Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. IAJ New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ 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 300 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 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) ELEVATION Feet Feet VII. TANK CAPACITY Site in allons Total of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App ITanks Tanks structed Septic Tank or Holding Tank - - s Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installati of the onsite sewage system shown on the attached plans. Plumber' N74r (Prim): Plumber' Si ture• No to MP/MPRSW No.: Business Phone Number: als 0 I s ddr (S rest, City, S te, Zip Code): P 71'_71?1,e: IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date ssue issuing Agent Signature a) ❑ Approved ❑ Owner Given Initial Surcharge Fee) ~ -~3 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. 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. - - - - - - - - - - - - - - - - - - - - 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) TNIS e1ACa aeeCaVea "M "COMING DATA 00CUMEW NO. wARRAWY DEED RQVC STATE BAH WIPIDONSIN 9-iMe T V VOL 962 PACE 03 REGISTER'S OFFICE s~a~oo(co~,wt, • _ and H•ndrik W. Can Dyk sad sonni• L Van Dyke husband , L AAC~d ~Of ~001d wifaA. aawparitat„ propk ty.tritli.riAhts .nrvivoahi AUG031992 y j 230 ooetwys and warrants to .~4fT4Y..,. O~oa,•,a lingli_pas~on,_ d 3 M µ ww........... r ...................www ReTURN, To r, i. ......w. ....w w ...w................w................w.y ' the following deserRA4 real estate in .tuf=f • KRU.. • .---Counts, ' .Staff, Of Winualsin: Talc Paced No:.......... . Peat of the Ho thWest Quarter Of thIS Hbrthwest Quarter (IW3 of NN;) , aid part of the Southwest Quarter of the Northwest Quarter (SKI of Nov}) of Section 'Thirty-ans (31), dip Thirty (30) North, of Range Eighteen (18) Mast, described as follows: Lot 1 Of Certified Survey Map filed July 28, 1992 in WIme -9- of Certified SfaveY Maps, Document No 486437.. , _ pegs 2514 as aAgITX ao This I1l._A9t....._..w.. homestead property. 00 (is not} - Zj"ption bo warranties: Dated this day of .L..X. ITASM if................................ il.~~.... w wr _(SEAL}LV ~~s~ kt Hanndri~t ~1rt..-VAu.DTk • w. _ ...(SEAL) .I~..!~...... (SEAL) • 7777 ._._.w_.......:r_,, e,a 3 ~ ~ -,$OJO~A~.R-~t.._YA>i<_11J~.........................:...... AUTH>ANTICATION, ACKNOWLSDOMMUT (sI STATE OF WISCONSIN . pit QKPAX_--------- ---------Cos 1. authenticated this ._...___day at..'~~:.._ ww I!_:_._ Paraonally earn- before use tbis 3rd w ov.-des of " Id 92 named the store nam .._w_ Hendrik V. Van Dyk _aad _Bonnit L. Van DZk TITLZ: MMMER STATE BAR OF WISCONSIN (uno~---- avtborlred by A 708.OA Wis. StatsJ ~ to me known to be the person a forego instrument aeknowl " " THIS INSTRUM[NT WAS DRAFTED •7 / f v Reinstra Van Dyk & Needham, S.C. • y~ - F e Ruth A. Johns T out 2'0 1 lb•cs-ttlcbmOndr•3iz---.SQ►QLZ Notary Public St. CR i.. ' (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, are not necessary.) date: 1,1.3819.4 11 graew at pmeaee shahs is was aen.eltr sboaY be Used or DriaW bds~ tbdr sisertme& WASSANTY DaBD SWATS NZ OW WILSCONSDI WhIConsln Legal Blank Co.. Ine. PORK Ne. a - iaa MRwoukee. w6emsin S T C - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER 4 ,r/ ADDRESS FIRE NUMBER_ 2JLj CITY/STATE f r~, in ZIP PROPERTY LOCATION:A/W' 1/4, 1/4, SECTION T .3d N-R1l'-W TOWN OF_ hC ,-c St. Croix County, SUBDIVISION , 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 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 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 Co. Zoning Officer within 30 days of the three year expiration date. SIGNED: DATE : J a& St. Croix co. Zoning Office 911 4th St. Hudson, WI 54016 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 HUMAN RELATIONS 1 / MADISON, WI 53707 (H63.090) & Chapter 145.045) LOCATION: SECTION: TLOT NO.: BLK. NO.: SUBDIVISION NAME: NW %Mi% 31 /T30 N/11184(or) W Richmond ( n a n /a n /a COUNTY: BUYER'S NAME: MAILING ADDRESS: St. Croix Jeff Olson 5143 Long Lake, Rd., Mounds View, I-In. 55112 USE DATES OBSERVATIONS MADE ODESCRIPTION: PR FI L DES RI I NS: PERCOLATION TESTS: BResidence n/a UNew ❑Replace Il 5-30-92 5-30-92 RATING: S= Site suitable for system U- Site unsuitable for system CONVENTI NAL: MOUND: IN-GROUND-PRESS URE: SYSTEM-1 N-F I LLHOLDING TANK: RECOMMENDED SYSTEM: (optional) ®S ❑U GaS ❑U ® S ❑U ❑ S f?Sl U ❑ S ®U conventional If Percolation Tests are NOT.,required DESIGN RATE: If any portion of the tested area is the under s.H63.09(5)(b), indicate: n/a [Floodplain, indicate Floodplain elevation: n/a decimal' PROFILE DESCRIPTIONS page 43 13xB BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED. EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B_ 1 86 95.20 none >86 0-10, 10yr3/3, l.; 10-25, 10yr4/4, gr. Co. S., B 2 84 103.35 none >84 0-7, 1 3/3, 1.; 7-11, 10yr5/4, sil; 11-24,10yr- 4/4, gr. Co. S.; 24-84, 10yr4/4, Co. S. B_ 3 82 102.60 none >82 0-14, 10yr3/3, 1.; 14-26, 10yr4/4, gr. Co. S.; 26-82 1 4/4 co. S. B_4 84 103.35 none >84 0-10, 10yr3/3, 1.; 10-22, 10yr4/4, s.l.; 22-84- 1 4 6 Co. S. B-5 g2 95.80 none >82 0-7, 10yr3/3, s.l.; 7-14, 10yr4/3, l.s.; 14-82 10 r4 4 B- PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH P_ 48 none 3 6 6 6 <3 P- 2, 7U_ none 6 6 <3 P_ none 3 -6- 6- 6 <3 P-_ P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION 99.35 ffJJ~~ E • 1 . { 10 ~Af 0- IN. - Nc -r _ - - Ile 3I Ui I _ I, the undersigned, hereby certify e s 'I8 t rted on this form were mad6 by me ih aAcWkfi'tA p-rdcedures and methods specified in the Wisconsin Administrative Code, and that t d r t tion of the tests are correct to the best of my knowledge and belief. NAME (print): Cr s TESTS WERE COMPLETED ON: Gary L. Steel Y NR-4 : 5-30-92 ADDRESS: ^ 4 } CERTIFICATION NUMBER: PHONE NUMBER optional 11554 200th W17 715-911r,_r R1 CST SIG ATU 200 ti DISTRIBUTION{"Original and on y t a A %i r' , Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - Alz d) fAlb I i I i r / I~ I I ! i , : I o ~ ~ ~ I I I i i I i ! ~ i ~ i r ~I ~ I I ' I to L I / i - i I I I i j i -4- i i I I I - - ~j A-- It, ~ ~I ' - r----~---- ----T-- T- - - - t- I i - - - _ . _ . --r - - - - _ _ _ ~ - ~ -T - Y - - _ - r - ' - - _ - _ _ __r._ - - - - ~ ~ r - ---t Y ~ _ _ _ ; ' I - - - - Y- - _ - - - - - ! j,0(; C1(,C 11 111 rJ 1111. lJl the NW4, all in Section 31, T30N, R18W, Town of Richmond, / lr E St. Croix County, Wisconsin. NW Corner of Section 31 V ~ t N o, / OWNER Hank Van DYk s ° f s s, d o 0 P.O. Box 127 0.0 CD 00 ti w, New Richmond, WI 54017 C- 41 o X05 p O \ U NOTE: Abandoned house and o 5' O~ \ foundation to be removed. 3C co yZs C- 4.1 0 i ro o X N Y~X m o z zoo" ss, `sc' 6,0 < c, LOT 1 15, 3 . !•`13.99 Acres (609, 360 Sq. Ft.) Inc lu ding R/W 96 / 12.83 Acres (558,717/Sq.-Ft.)-Excluding R/W / o 'k * / NWJ - NW} SWI - NW} , O S71044'34"W -T I n T_ OWZ 50 • ° • ' 117.63' 01 •o ~ H Clio b CD 22 8~ *9Z J I 4)I lea eS / Q `e0 °~a ti 0 ♦ S S`L~ .:L•~YY~1 `1fi: Ult7t~'AF f911i)1f1Q co U LIJ j K)I , ~ / ~rP~°` c~ f`=;n~ts6~tr.Ttitteo co LI L[)I / ~ a ~ L W I Cr) I 'O ~N,i rcu i i~ C)I a_I LEGEND ,~srzvl+dfs~t~1't1s i Aluminum County Section MonumeR&&\& ' S20°58'29"W 137.02' 1" Iron Pipe Found 0 1" x 24" Iron Pipe Set, weighing 1.68 lbs. per e a linear foot - Existing Fenceline s s 100' Roadway Setback s N o ( ) Previously Recorded Dimension O C> ° 1 ° Marsh Area PAG t 0 P SIcc~lol, o~ a Zr~ `Isst~ a y en • ti II//A. Alr UI~C/ Awl q~1N~~I1M PN• . Affe"44 Vest got mwo%m -sues so 480 Above M 4* Coss If$* ie too." foods IN. a l.•~~II$ c•.4,141 o _►y;«.•La j fire lot / ' h••94ft ►1•• • • ►•ilw94•• ►1►• YN•. w... • .~'c"Ifts Tr61•911•1 Al 994196 01 816101 SOIL. r I t.t.' 083TRIDUT101.1 PIPE APPRO`/g0 S-I1JT11ETIC Cow 2~OF 11GGR!<GAit£ "JIATERI^I. OK V OF $TRAM OR MARsI• ►'Ay ELEV. OF.221FEE7-.. •'`«d~` ~UcPYi-t'~i AGGRCGATL OISTRIOUTIou ►IPi To OC AT t.CA>IT ~ IWCHCS BCLOW ORiVII.JAI, •;,{AOC AUU AT. LCAST;O 14CHLL OUT MO MOKC THAN 42 114[18[5 DELOW FINAL ri1tAOL M IMLI it DSPTH•OF F.-KAVAT100 FROM OKIGINAL 6RADw WIL . BE ruKIMV IucHCs M ©EPTN OF EXCAVATION f-POM 04~1411JAL GRAPL Wlt,%. 6C - INCHCS SIG IJ Cr : LIC.CU3C WUMDCIi: ;S 1 ' 10 i ,l I I I I i STC-100 This application form is to be completed in full and signed by the owner(s) of the property being developed. An inadequacies y will only result in delays of the ormit issuance. ,Should this development be intended for resale by owner/contractor,(spec house), thenia second form should be retained and completed when the property' is sold and submitted to this office with the appropriate deed recording. Owner of prop erty~/'~u___ Location of propertyN W 1/4 1yf,✓ 1/4, section 3 , T2_AjfN-R W Township izmj Mailing address l~1 /iF%d;2!!~ ~/~,~~1taY►~.,~~ifd Address of site t" 71' Subdivision name Lot no._L other homes on property? yes- No Previous owner of property L4/ Total size of parcel _/.3 `*7Fgrc,,-g-< Date parcel -was created Jv'w or% I99.~ Are all corners and lot lines identifiable? ~._Yes _No Is this property losing developed for (spec house)? Yes No volume_ and, Page Numberc;~S__/ 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 & 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. , 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 County Register of deeds as Document No. . r i at a of applicant Co-applicant Da&e~of ignature Date of Signature _ j