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HomeMy WebLinkAbout038-1007-80-000 Q) °o w 00 y 3 o 3 0 a 0 w, 0 M ao m o c O c o I Li m L (D c O O N c '5) 3 O d X 0 m N ~ ~ 4= O 0 'O m Op NN> O 'a L p N O > v y o~cTa aic0 rc aEicm3° oL0a Q T cn c N mL 0 3p V N m'D E C 3 L m L 3 75 - '-N (n 7 m u 'S L (O l4 w O N O L (n m o m U h p O N _ w C: E ~O OL N OM N.C .5 o N N N .a 3 L N m J U) N N = U N O 'C 70 Lam, w C Z O .O U C C L C d -O LL C M U) O E N _ m 0 O y d n~ocu 3 °aaa)j2 ?r 3v•rnm c o co a d aumi.0o°c E Q mv(D U co m c) i d N N Z C C O L z w I' a m a m N z 0 m E z d w n • ° c o Z aUi Z o tq F- Y' ( Y) (D a v 2 v 2 M N N j N N 3 0) 0 (,7A N m m m O d N C LY (D (n • O O L AV ~ U) L L d 'mU O N Q O O N Q O Q " z co z n z m z z O (i d N N (C £ m m VI ~ Z a c O. m CL m 2 c O E H d a c O C G % a S} M O ca v N N N E U E fn N N EI -O U Z co > EL ~ F- ~ d ao O m 0 0 0 0 0 0 z z m m m ~aaa > z Cl) co ~1 7 O fA co 04 M 00 U) C O > 6) •-wl N N m m- c~ m p L` O U O O O CL M -6 en fn 'O m N .an O d N 00 N Q} CIO (n Q Z S nN O 04 co (D 7- W 7 w O O c N C U) co h c L O 30 ~ O E 12 t 4) o :3 O c o. C LL O O 4 W N Q N W a) o m a -2 L N cn m m N N E N O (Q - O2 c m N (D CD C .O. O C 7 M_ _ O N- Z N W N 'O F- C N Q1 r O r..( « r N m L E o ai O E rs v Eo • a p co M O co O O S H LL O N Z (n O ~ ik w E m E d a m a z L: CL CL • c d d y c d m c t A Liam 11 0 Nu 0Nu STC - 104 AS BUILT SANITARY SYSTEM REPORT j"C~1 frn OWNER ADDRESS 61, 16 -/,9 7 SUBDIVISION / CSM# © LOT # SECTION~_T~1N-R_W , Town of ~f ,n j/ I'~! ✓Y 2. 3l . 1 $ • 22c ST. CROIX COUNTY, WISCONSIN PIA X VIEW S1 EyER THING WITHIN 100 FEET OF SYSTEM / Q, J-! 1 0~ o Q~ 12 t 1~ J 71 fi CP ~ `Gt9 INDI W Provide setback and elevation information on reverse of this form- Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: 4 4-::n Gf ALTERNATE BM: f f ? aAn !7 0 /t.- /0/- SEPTIC TANK / PUMP CHAMBER / HOLDING..TANK INFORMATION CXyy Manufacturer: ~I e 5 t-+- Liquid Capacity: E& v-4-~ Setback from: Well House ,4'w other,;? l~ V Pump: Manufacturer Model# Size Float seperation Gallons/cycle: Alarm Location -:SOIL ABSORPTION SYSTEM ~ . Width: / r Length Number of trenches 3 ~ Distance & Direction to nearest prop. line: Setback from: well: House Other ELEVATIONS ~y'ha.c~G /O/. Building Sewer ST Inlet; ST outlet PC inlet PC bottom Pump Off Header/Manifold Bottom of system , tf7 H G/ Existing Grade Final grade DATE OF INSTALLATION: PLUMBER ON JOB: lr. LICENSE NUMBER: INSPECTOR: 3/93:jt LW,jUX;,,A-rA18f,&WIE 2.31 E SEWAGE SYSTEM County: Labor and Human Relations Safety and Buildings Division INSPECTION REPORT (ATTACH TO PERMIT) sanitar rmi GENERAL INFORMATION Permit Holder's Name: ❑ City ❑ Village X Town of: State P v.: nsp. BM Elev.: , BM Description: Parcel Tax No.: 11 R TANK INFORMATION ELEVATION DATA A9300243 /(D TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic , Benchmark 3 35 0 Dosi n Aeration Bldg. Sewer Holding - St/ Ht Inlet TANK SETBACK INFORMATIM St/ Ht Outlet TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic --q 55/ ti SC) NA Dt Bottom Dosing NA Header. 8,$!S i Aeration NA Dist. Pipe r 310 i Holding Bot. System 5" al Grade 78~~j S3~ PUMP/ SIPHON INFORMATION Manufacturer Demand I Model Number GPM TDH Lift Friction ste TDH Ft oss Forcemain Length Dia. Dist.Towell SOIL ABSORPTION SYSTEM BED/TRENCH width i Len th No. Of Tr ches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS /C DIMENSIONS LEACHI Manufacturer: SETBACK SYSTEM TO P/ BLDG WELL LAKE/STREAM INFORMATION Type O CHAMBER tuber: System: ,-),0-: >1Z ORUNI DISTRIBUTION SYSTEM Header Distribution Pipe(s) r A x Hole Size x Hole Spacing Air Intake Length Dia. _L Length 33 Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade S s On Depth Over q s Depth Over xx De th Of xx Seeded /Sodded xx Mulched Bed /Npc#r'Center Bed /1fj0 LAdges Topsoil E] Yes [31 No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: STAR PRARIE 2.31.18.22E - /r r Plan revision required? ❑ Yes [ o Use other side for additional information. SBD-6710(R 05/91) Date Inspector's Signatur Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: DILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY . STATE SANITARY PERM T # -Attach complete plans (to the county copy only) for the system, on paper not less than 8% x 11 inches in size. l:hQ` eck if revisi 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 %a 4.) Y4, S vZ T fl, N, R / E (of.og> PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER II. TYPE OF BUILDING: (Check one) ❑ State Owned VILLLLAGE NEAREST ROAD ~1 A'~ `u mar/ ❑ Public or 2 Fam. Dwelling-# of bedrooms PARCH L NUMBER( S) Ill. BUILDING USE: (If building type is public, check all that apply) O !r^ ~D p 7 _ 1 ❑ Apt/Condo fJ 20 Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ 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. ❑ New 2. &1eplacement 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 30 ❑ Specify Type 41 ❑ Holding Tank 120 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 5'D I b"' 4t3 41/ 41 _K1, 12 . 7 6 Feet - L Feet VII. TANK CAPACITY Site in allons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New lExisting Gallons Tanks Concrete structed glass App' Tanks Tanks Se tic Tank or Holdin Tank 161 G f e i F1 - Li Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber' Name (Print): Plumber's Si nature: (No Stamps MP/MPRSW No.: Business Phone Number: 10, C6-p, Z - ~ 71v- l ' Plumbs Address (Street, City, State, Zip Code): IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date ssueq Issuing Agen Si Surcharge Fee) Approved ❑ Owner Given Initial J. /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-k66-3815,,, 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. Ill. 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, nurnber 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 SUR&ARGE - 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.11188) I Plot Plan Project Name ~1 erg ,Gi~~ Byron Bird Jr. System Elevation CST# 3479 Benchmark __&,5_~ 5 H.R.P. C7 Boring O Well i 30 , f 9° - t b° ~8 LOT PLAN PROJECT 6-e`'el- firm eve ADDRESS /k- 1146,0 1/4/So2 /T,?/ N/R/~W TOWN Sfu, e COUNTY 7,Gr",/x .MPRS Byron Bird Jr. 3`318 DATE BEDROOM CLASS PERC--~!-- CONVENTIONA _ tN- ROUND SSURE CONVENTIONAL LIFT MOUND HOLDING TANK SEPTIC TANK SIZE LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ABSORPTION AREA PERC RATE BED SIZE Benchmark V.R.P. Assume Elevation 100' Location of Benchmark azv~ * H.R.P. 0 Borehole Q Well Scale Feet O Perc Hole System Elevation Vent 12" Gradp TYPAR COVERING 2" 12" 3' 4 g' O 3' 3 I 6 " Sewer Rock 1.2' / Ir I i C?? - lit "blue 0 Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page - of Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY 1,2 11 Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but Gr 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. e :F APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED DATE PROPERTY OWNER: _ PROPERTY LOCATION -,e- r'a- l~ , /^/7d I^ GOVT. LOT I,~-A 11&J 1/4,S T N,R E (org2 PROPERTY OWNER':S MAILIN ADDRESS LO BLOCK # SUBD. NAME OR CSM # CITY, ST TE ! ZI.~_O.ODE PHONE NUMBER _ CITY VILLAGE OWN NEAREST ROAD ~u l 3 T r ry L. [ ] New Construction Use [ Residential / Number of bedrooms [ J Addition to existing building Replacement [ j Public or commercial describe Code derived daily flow 4teM gpd Recommended design loading rate 2 ed, gpd/0~ trench, gpd/ft2 Absorption area required 6,43 bed, ft2 6 4 -9 trench, ft2 Maximum design loading rate 7 bed, gpd/ft2_~trench, gpd/ft2 Recommended infiltration surface elevation(s) 93. ft (as referred to site plan benchmark) Additional design / site considerations Parent material !94, t 5 Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem WS [I U ~ El U 5?S El U jo S El U 1:1 S 0U El S GNU SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Bou Y Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench <j.•. ° 1 Z Ground elev. Depth to limiting factor 02 Remarks: Boring # 5 h~ • G r _ o / 1911 10 Ground elev ft. Depth to limiting ~f t~}cor Remarks: CST Name: Please Print Phone: Address: Signature: Date: CST Number: , 7 PROPERTY OWNER SOIL DESCRIPTION REPORT Page _of PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench ze ?Z Ground e v. AA. Depth to limiting factor Remarks: Boring # 4vi Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor 1 Remarks: SBD-8330(8.05/92) S T C - 105 ' i SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER (-a~.rA h1 ~i ADDRESS 4al -Se FIRE NUMBER i 3fJ CITY/STATE Sta i, ZIP PROPERTY LOCATION:,& 1/4 1/4, SECTION_..,)_, TAN-R iB W TOWN OF ~-fiv St. Croix County, SUBDIVISION LOT NUMBER-f_. 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'-- St. Croix co. Zoning Office 911 4th St. Hudson, WI 54016 STC-loo This application :Corm is to be completed in full and signed the oa,ner(s) of the property being developed. hn inadequacies will only result in delays of the permit issuance. Shou ld 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 ; _ Location of property /~/C 1/4 N y1/4, section Township 1 S ' Mailing address /,5//, Address of site v subdivision name - Lot no.-3 . Other homes on property? es Previous owner of property > Total size of parcel arc Date parcel was created Are all corners and lot lines identifiable? No Is this property being developed for (spec house)? Yes _2_No Volume_,..J'_and Page Number dl as recorded. with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWIPIG: _ A WARFUUITY DEED which includes a DOCUMENT NUIWER, VOLUME AND PAGE, NURDI R & 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. referencos to a certified Survey Map,, the Certified Survey Map PROPKRTY OWNER CERTIFICATION I(we) certify that all statements on this form are true to th best of my (our) knowledge that I we e the property described in this informa of ) am (are) th tion form by e virtue virtue s) of owner( a warranty deed recorded in the office of the County Register Deeds as Document No. ~ of Dec th d and e ► that I (we) rese or the p ntl obtained an easement to run g disposal system or I (we) the construction of said systethe m, sands thdescribed same haso be been d u I recorded in the office of Count Y, for No. County Register of deeds as Document signature of aplicant c -a p cant Da44f Signature 'y~5t Da e f s gnature r ~d 0 1 co (0 ^a'p -N THIS SRAC[ RESLRV[D FOR R[CORO1Nm DATA STATE BAR OF WISCONSIN FORD 11- im LAND CONTRACT t11006n## assn CnrporeRr a £Fa, . + P r,t ALL T~A? F,1 W ,I : i - a} t^ rent ~I „ k1QntA been nth& as ~of' any iproceeds I 'i P r(,kaser 9t1i'.F9 yi{i. Y~,.itt,~ 7t.:•.~ ,v t_ t L:* 8 f.t lt`,w 1.,ubmft ed t4 Purchaser Yw'<d171.F'a.~kPt~J7",: &"EGP,r for i it I ' f rt r.1 11 css t,(., psa> when Cue all taxes anr, i4sioK8mentq levied on t e Property or upon Vondor's interest i k) V e :doi on derr,arrl receipts showir. j such payment. • f £ nt+fap the ]InTJril✓1. rz"A On t.lttj r iipkr4 vi°t1lr 'l tiy;hl Y':4'- or damage Ol"casioned by fire, ex- m~,r,! «4 tt at, it 4+l''',,sr irr, Vendor naa1 441r#l:TICC, through lnauror$ approved s g a' , is tixr 3Iaa we n an amount more The oliciea ahall wi'n'ing, tjt ,i inal 1, sv, n 1. lrvs to s r ! 1 r P CvW4 a , --Al-y of . ~Cf 'F ♦ „1., 4 'till Parcel 038-1007-10-000 09/14/2005 02:40 PM PAGE 1 OF 2 Alt. Parcel 2.31.18.19 038 - TOWN OF STAR PRAIRIE Current 'L,j( 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 - REBECK, KENT C & MARLENE K TRST KENT C & MARLENE K TRST REBECK PO BOX 302 NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 3962 NEW RICHMOND SP 1700 WITC SP 8055 CEDAR LAKE/N R Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE SEC 2 T31N R1 8W PT NE SW ALL LANDS Block/Condo Bldg: LOCATED BETWEEN THHEWLNN NE SW SEC 2 & W LN LOT 1 CSM 5/1235, WHICH LIE Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) NLY OF SWLY 02-31N-18W PROJECTION ISTING 20' PRI EASE MENT AS SHOWN ON- 5/1235 Notes: Parcel History: Date Doc # Vol/Page Type 01/23/2001 637256 1578/191 WD 07/23/1997 1158/377 WD 07/23/1997 958/67 07/23/1997 669/590 more... 2005 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/12/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 189,800 12,200 202,000 NO Totals for 2005: General Property 0.000 189,800 12,200 202,000 Woodland 0.000 0 0 Totals for 2004: General Property 0.000 189,800 12,200 202,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 038-1007-80-000 09/14/2005 02:41 PM PAGE 1 OF 1 Alt. Parcel 2.31.18.22E 038 - TOWN OF STAR PRAIRIE Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner 0 - FIRNER, GERALD E & MARYANN GERALD E & MARYANN FIRNER 146 W KING ST ST PAUL MN 55107 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description _ SC 3962 NEW RICHMOND 2 SP 1700 WITC J SP 8055 CEDAR LAKE/N R Legal Description: Acres: 0.561 Plat: N/A-NOT AVAILABLE SEC 2 T31N R1 8W PT NE SW LOT 3 OF CSM V Block/Condo Bldg: 5/1221 ALSO LOT 5 OF CSM 5/1236 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 02-31 N-1 8W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 966/89 07/23/1997 919/283 07/23/1997 669/595 07/23/1997 654/435 2005 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/12/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.561 107,000 79,600 186,600 NO Totals for 2005: General Property 0.561 107,000 79,600 186,600 Woodland 0.000 0 0 Totals for 2004: General Property 0.561 107,000 79,600 186,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 so / 6g' / E / A 2~ 50 N6 0 O Z C.S.M. 0.. ~ C.S.M. VOL. 5, PAGE 1236 ~-j 1 VOL. 5, PAGE 1236 m HOUSE t 1 WITH _ DECK l0 .W .0 tD LOT - 5 C S. M. VOL. 5 PAGE 1236 n0aM,'V A O O O \9 e'tCC~•ro g2 g5 r .~7t o n 3~ r' 361 g2' so to m y M S~x\5~ E PO P~ 0 0 ,Kr r- .4P c d'. a Aa Od i~ a i XO ^+Kd im ~oa0AU p m rh q M A 'Z R rKWt+lr• O° l0 r A I- t r A tr Q ~ A - nj a n C, -4 G. r- Z LOT- 3 CO O O r• A at `J M7 A G O C. S. M. VOL.5 A rr < ° PAGE 1221 e» :r o O 90' A N A ► H G n ~•wrA v oraEA ►rE 2N ~ .P rn r ?n m N mo OD0 p tir+Earo O a N 7 NtAa A O o n <re• (D p ~ ~o p 00 n rn a 3 o to 0 r x LEGEND O 1"IRON PIPE SE g2~e • 1° IRON PIPE: FO Z~~gS 56 I t Y 3813 76 ST. CROIX COUNTY CERTIFIED SURVEY MAP LOCATED IN PART OF THE NE 1/4 OF THE SW 1/4 8 GOVERNMENT LOT 2 OF SECTION 2, T 31 N, R 18 W, TOWN OF STAR PRAIRIE, ST. CROIX COUNTY, WISCONSIN. _UNPLATTED _LANDS N. 00 56' 19" W. 199.24' 20' ~ Z B~Ar 2 N~UgE ~ rn /Y o 8 3 m Q 44 DEC 1.:1982 27, lc~ o N. 5° W. 190.16' C 15' 30 2 \Ti9 kp n ~o rs < • 6'~JO A can Q Po \ ' "zo o z s; 0, 2 m -n (n 74 o N.' 0° 12' 55" W. 195,38' 7J O A'~o/ w ma W > D O o S, m ~ S N `T \c 24.5' S. 10 03' 27" W. 223.31' 'L Z . M D O \ m ` O ED rp~V 1. \ O. O m \ N i9c~ "o OS., z a U) y o~ o B ~~gE z -n z S. 0° 37' 05" W. 244.79' 20' r ~~o UNPLATTED LANDS A ~ O a ^ O O cN' b O M D v m z rk 0 omo •OO • O .n b' -`.u Nj~yR~ y a) Z C") C -i N - - - yew (D ~ y co m ~ , :r _ rn x o o m Or,~ - W e'; As o O z D z A iv O) = A O O M >z O r- -01 o:u Z y O O y y rn ? N Z7 O z7 r I = zD E~ -0) WQ-i O-0 _O c~ O c (D c = m z m o) z 01 R c~I n m Z a D r- 'D v -n °°v D u; R .i~ p o G) Z ~ p crn A ~ m o D O co •;m n < n ~ z m z (n r^ O ~l-•titi Z Ora D TI O D O -n ° 0O o m ti o ' (f) -n -i c z IZ (n a: z R m 3 m n (D rn M 7-1 Q o VOLUME r , PAGE 1236 CERTIFIED SURVEY MAPS this instrument was drafted by ken hodkiewicz~--'- JOB N4 82 - 29 ST. CROIX COUNTY, WISCONSIN 00 FILED GGT t 51S82 A"s 0, CoKk>:u or 386. 24 sods ST. CROIX COUNTY CERTIFIED SURVEY MAP LOCATED IN PART OF THE N E 1 /4 0 F. T.H E S W 1/4, SECTION 2, T 31 N, R 18 W, TOWN OF STAR PRAIRIE, ST. CROIX COUNTY, WISCONSIN; ALSO BEING PART OF LOT 3 AS DESCRIBED IN VOLUME 4, N. 890 14' 06" W. N. 89° 14' 06" W. PAGE. 1130 OF CERTIFIED SURVEY MAP, 400.00' NORTH LINE OF SE ST. CROIX COUNTY, WISCONSIN 1 o 3~ QUARTER I 62 66 02 SECT/ON 2 - 31 - /8 SECT/ON 2 N3R- /8 IRON R/PE FOU/VD 6a 0 2~6 15 In l l' 1 ~ 1~ LEGEND S~ 5 I Ooo o b 0 1" X 24 IRON PIPE SET O WEIGHING 1.68 LBS. / LIN. FT. 62 PR 2" IRON PIPE FOUND O XIS ( 20 / 1~ • 1" IRON PIPE FOUND O E Q 1 - 3/8" IRON PIPE FOUND dpi 0 In FENCE LINE .I o O 1~ THE NORTH LINE OF THE SE 1/4 OF SECTION 2 - 31 - 18 IS ASSUMED TO o 0 N to BEAR N..89° 14' 06 W. A O 1r O q o t~4 W E T Q, t as `41 I~ 1 s~ 4 SCALE*. ONE INCH EQUALS SIXTY FEET ,O ~e z 52\g E• 0 50' 100' 200' o G 3\ 5 Z 0 . 62 o r N Q N ° r y _ OWNER 8 PLATTER N In I p x ROSETTA M. WILSON N m n ROUTE 2 1! g C NEW RICHMOND, WISCONSIN rn hOi N _ a ro 54017 0 c m :0 O NOTE- ALL LOTS ARE RESTRICTED z o y TO SALE TO THEIR RESPECTIVE N I< o, = N ADJOINING LOT OWNERS I ro° Un z i A --n W I I L0 O N L W W O p W cl! N D A A I~ m w Z q I~ r to m cOp N cn to n (D )s 0) 0 0) 0 w I~ ° o ,gt~2sa'Lq:~, CL Go W-,-to 1:3Z D t 4 ~wO N -4 co 0 ~ v! i.A x ALLEN C. rn m m G) NYHAGEN 4h - z = S-1407 s' v a-o O N = o HUDSflN, Wt . , . C W ~ z 0) y 0 0)-o co i 0 L04 m> ZG) \ SIGNEDO-sI u,__ I►a.._... DATED )n ° Z cvw W W G) Z ALLEN C. NYHAGE R. L. S. 1407 m t cn i Fn !n VOLUME r , PAGE 1221 T'QV CERTIFIED SURVEY MAPS _ .yz CO ST. CROIX COUNTY, WISCONSIN Cyy'4r 's'!1y \ ' •~!tiF this instrument was drafted by ken hodkiewicz. JOB N4 81 -39-18 c ' 8 9 n 1p _ ~ECE~VE~ FEB 1983 ZONING AS BUILT SANITARY SYSTEM REPORT OFFICE 0 TOWNSHIP SrFQ. PctF~ r, SEC. T3[N-R/1 ADDRESS ST. CROIX COUNTY, WISCONSIN. SUBDIVISION Odd LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 lrh_.EVERYTHING WITHIN 100 FEET OF SYSTEM t a 4 C N5 G I&. e- C Or "U"L C-4 I di a e or'th A row SCALk : BENCHMARK: (Permanent reference Point) Describe: Top o-' r~Ce, Pea a,~or+ ror~~ Elevation of vertical reference point: Slope at site: Sc vT~ SEPTIC TANK: Manufacturer: L-- c -f,ers Liquid Capacity: iooo ' Number of rings on cover Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: PUMP CHAMBER Manufacturer: Number of gallons Number of gal. pump set or a cyc e gallons;, total capacity of- distribution lines gallon: size o pump head; gallon per minute horsepower bran name of pump and model number ; Type of warning device HOLDING TANK: Manufacturer Number of gallons Elevation of manhole cover Type of warning device SEEPAGE PIT SIZE: Number o pits eet diameter feet liquid dept seepage pit in epe-elevation bottom of seepage pit elevation feet. SEEPAGE BED SIZE: number of lines y width length_> the depth ;2y.• SEEPAGE TRENCH: width length PERCOLATION RATE AREA REQUIRED 6rr°r AREA A .BUIL--T--° INSPE-CTOR DATED PLUMBER ON JOB LICENSE NUMBER' g L DEPAATME0* OF1%USTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOFJ & HANN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 ❑CONVENTIONAL ❑ALTERNATIVE State Plan l.D. Number: ❑ Holding Tank F-1 In-Ground Pressure E-1 Mound (of aul9ned) NAM OF PERMIT HOLDER: RESS OF PERMIT HOLDER: INSPECTION DATE: ADD BENCHMARK IP anent reference point) DESCRIBE IF DIFFERENT FROM PLAN: rry REF. PT. ELEV.: CST REF. PT. ELEV.: Y) t % Name of Plumber: MP/MPR 1 No.: is Cou n tery Permit Numb.r: IS4 eo "A 1.6 on I SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL JLPROVIDED: DYES ❑NO PR BEDDING: VENT DIA : VENT MATL.: fOF RDAD: PROPERTY WEL: BUIL ING: AI i S LARM:L FEET FROM uNE. T~Vj1 ❑ YES NO l Y ❑ YES ❑ NO NEAREST DOSING HA BER: MANUFACTURER: BEDDING: LIQUID CAPACITY: UMP DEL PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING OVER PROVIDED: P ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO. GALLONS PER CYCLE: P AN C NTR L oNAL: NUMBER OF PROPERTY WELL: BUILDING: V N FR FEET FROM LINE: AIR INLET: (DIFFERENCE BETWEEN 3I'S PUMP ON AND OFF) YE NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil mo' u e at t deptFyof plow g LENGTH. DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, o strut o'shall cease til FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH: LENGTH, NO. DISTR. PIPE SPACING: V J INSIDE DIA. *PITS. LIQUID BED/TRENCH ~n TRENCHES MAT Au PIT DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH UISTn I F DISTR. PIPE JDISTR. I IAL: .DISTR. NUMBER OF FRUPIcHly WELL: BUILDING: V NT TO FRESH BELOW PIP S ABOVE COVER. ELEV. INLET ELEV. END: L. PIPES. FEET FROM LINE. A AIR INLET. /-Qy I NEAREST MOUND SYSTEM: 4 Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mownd systerlns to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the cdterla fprl medium sand. TIONS MEASURED. ❑YES ❑NO IL COVER TEXTURE PERMANENT MARKERS: OBSERVATION WELLS ❑YES ❑NO ❑YES ❑NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL'. SODDED. SEEDED: MULCHED. CENTER: EDGES. ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH: LENGTH. NO.OF LATEi~L SPACING GRAVEL DEPTH BELOW PIPE. ILL DE H AB V COVER: BED/TRENCH TRENCHE ~,r DIMENSIONS MANIFOLD PUMP MANIF61-6 STR. PIPE IMANI OLD MATERIAL . NO. DISTR DISTR. 1 DISTHIBU I ION PIPE MATERIAL & MARKING ELEV. ELEV.. DIAA.' ELEV., ' PIPES DA: ELEVATION AND e' DISTRIBUTION HOLE SIZE HOLE SPACING IL`LEU OH CI V COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION PLANS ❑NO ❑YES ❑NO ERM N N A r EAE&L COMMENTS: IKERS: OBSERVATION WELLS: NUMBER OF P O ERTV WELL: BUILDING: L FEET FROM yl _ 3 ❑ YES L_.~ NO ❑ YES ONO NEAREST ot % tv 5f ~S $.S9 05 Sketch System on Retai county file for audit. Reverse Side. SIGNATURE ~ I DILHR SBD 6710 (R. 01/82) y. DEPARTMENT cis., REPORT ON SOIL BORINGS AND SAFETY & BULLQING`S, ' INDUSTRY ; DIVISION' P.O. BOX 7969 REANDLATIONS PERCOLATION TESTS (115) MADISON WI 3707 HUMAN (H63.09(1) & Chapter 145.045) LOCATION: SECTION: W S /MUNICIPALITY: OT NO.: BLK. NO.: SUBDIVISION NAME: tiI' 1/4_5,t/4 --x /T.3 j fl/R r v-E (or) S^,r-7 C.i~ tro., COUNTY: OWNER'S BUYER'S NAME: A ADDRESS: ST. crel 'k b a USE DA ES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: New IPROFI E D SC=NS: A I TESTS: [Residence ❑Replace / Z3 -Py /aRATING: S= Site suitable for system U= Site unsuitable for system ONVENTIONAL: MOUND: IN-GROUND PRESSURE: SYSTEM-IN-FILLHOLDI NGTANK:RECOMMENDEDSYSTEM: (optional) ZS DU 1ZS ❑U ~1S ❑U ZS ❑U ❑ S ®U Ved If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5)(b), indicate: /y Floodplain, indicate Floodplain elevation: h/A47 PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHE T TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- /-;Z6 9"st, /YO 7 1 z /-w2 „ Ql L-.S. 1 Q B- 4- 712 f. JOS," _6A, S B- ~r 69' Wake >126 io" Ql LS ' 1 J b" B- /26 CIS- 05", -7126 o aG 'Is* !/d „ B- St l - PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATER INCH ES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD1 PERIOD 2 PERIOD 3 P_ ! 10 n /a - %sr 3 S/ -3 P- ? !J '7 O P- 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 a644 ker_ sj.. _.I M y rdPs t3ore /oC°S rva,h~ o~S L7 ) lv.¢ C4 G civil E E d d i 6 E r 2 R1 Ste, abde xP _ 8, S' y °t lpGr Pti +cr € L5Z i S t r ✓ f _ - H q I a I E z CC r )r, y4- j S tct~p Y54 Sh _ _ _n Sgt. TD e~ t i 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 ministrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. (print): TESTS WERE COMPLETED ON: CERTIFICATION NUMBER: PHONE NUMBER (optional): _744- 2.s '1*2 CST a 5-y CPO I SIGNATURE: i iginal and one copy to Local Authority, Property Owner and Soil Tester. - 2/82) OVER y I IONS COMPLETING F ll~n 115 - S BD - 6395 To be, a c -n a ate sG y :ur report mu: 1. C;oml ' 2, T a / indicat this is a r coAnmercia` 3, Iv.X :rms or use E= 7 SyAem; r< . ng box( IS SUIT 3L I: A HOLDIN _ _11K ONLY IF ALL C, .)LEDOU. ONSOIL C~ I vIS; ,.lung 6 iptions and irra the plot plan; i : ~ 7g your cations, ..wing to ~x preferred, A it elevation referer tit at anr~~nt; to dates, names, ° f: -s t exemp- 1 C, d 12 ALL MUST BE FIL THE Y VUIT F YS ;t: MPLE TI( 10K_ CERTIFIED SOIL TESTERS Eturas C bols l RR ?s n _ y U'ay rnin - <n - d _ p it H VV L - tex _ It BM - VRP - tical TO THE n °`n- a -`tary mimit. The county or the Depa~ y request )P to issuance. A complete e priy" y ati_ = to tEte appropriate ~ AGO ~n a perrrril. grit mans( obtained and posted prior to the start ` any ~ )n , O s I Gib 'N~ '9 Ile APPLICATION DEPARTMFNT 5 s~ SAFETY & BUILDINGS INDYSTRr, FOR SANITARY DIVISION LABOR AND PERMIT P.O. BOX 7969 HUMAN RELATIONS (PLB 67) MADISON, WI 53707 Attach plans for the system on paper not less than 8% x 11 inches in size. Include a plot plan that is dimensioned or drawn to scale. Horizontal and vertical elevation reference points must be shown. All appropriate separating distances and physical characteristics as specified in chapter H-63, Wis. Adm. Code, must be shown. An index page or each page must be signed, sealed and dated by the designer. If designed by a Master Plumber, the date, signature and license number must be shown. The owners copy or a legible reproduction of the soil test report must be included. Property Owner- ailing Address: Property Location: City, Village o ,County: rv6 t/ayw'/aS Z /T 3i NCR 1Q' E (or)40 S ST Lot Number: Blk No.: Subdivision Name: Nearest Road, r Landmark: State Plan I.D. Number: S~ (If assigned) TYPE OF BUILDING Number of ❑ Public* ❑ Variance* ❑ Other (specify)* Bedrooms: LiiH or 2 Family *State Approval Required. 3 i I TOTAL NUMBER PREFAB POURED-IN NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE STEEL FIBERGLASS INSTALLATION MENT (Specify) SEPTIC TANK CAPACITY HOLDING TANK CAPACITY ,y LIFT PUMP TANK/SIPHON CHAMBER p MANUFACTURER: ' EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): 29- New ❑ Replacement ❑ Experimental aSeepage Bed ❑ Seepage Pit ❑ N Alternative (specify) 1:1 Seepage Trench j Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner): j ER. Private ❑ Joint ❑ Public / j i { I, the undersigned, hereby assume responsibility for installs ' of the private sewage system shown on the attached plans. i MName of Plumber: Signatur : MPRSW No.: Phone Number: 4/1 L-J4 I Cc C-0 6" Plumber's Address: Name of Designer: 44 '4Z t- LJ ' c- a -G U , L COUNTY/DEPARTMENT USE ONLY i n ire of Is in Age Fee: / Da Date: Q APPROVED Sanitary Permit Number: DISAPPROVED /Reason for Disapproval: Alternate course(s) of Action Available: Change of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to in- stallation. Failure to comply will void the sanitary permit. DISTRIBUTION: White-County, Canary-Bureau of Plumbing, Pink-Owner, Goldenrod-Plumber DILHR-SBD-6398 (N.03/81) ny ~ P r.. ~t F \ 4 v C r p n p ry ILI - r: J y r R rn W ~ J'. r m r ti n ti h ~ i •1) w r ' f a M1 1' C