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HomeMy WebLinkAbout042-1098-50-100 c N Co a O be. o !^r a c c O O C. O O N O 5 U w N I M C 76 0 i Q w t o sL CL 'L N - I N (D Ir ~ ~ ~ c ~ I 0) O> C N C ~ v .N 0 0 3 o E N V C Z co p U N 3 FI3 O y LL C O p N O 'Do C C d 7 N N '6 N N p O N E Q ~-oco Eca U f6 ~ N 0' tl! co E Z O O L Z y y Lo N w a m c) H Z c 0 O Z :!t U d Z ~ ~ C O !A F- m N Z C O E 'O ~o 0) Cl) 4) cu RJ a ct •ti L s c ~~yy a ~1, c O C Q z z z E Z N _ 00 N N N E > (D Q> L ~ LL G R N Y C 00 N N d E 6 E O p'coa ° 75 Q ° LO CL IL IL a j N o co rn N to J V Q o> rn } LO ;S "D > O O L ~ E N n D U) Q) O I V N ~ _ O ) C ~ N N ^J p C N C y O O > O C E I- co GC O E o 3 I', a0i c v°> spa d 0) °o ty\ E c C6 f C c c E co a> rn co l w c LO a~ O ° 04 04 M M a) o m ca v> m E O z N (n o = E a • CL m :o N a' E o c c °3 ~1 A U a O U) v s s 't STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER-5 TC; .~atr,✓i;~ ADDRESS 11?4 ey SUBDIVISION / CSM9 LOT 9 SECTION_T N-R W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM A y i INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 7_ dimensions to center of septic tank manhole cover. r BENCHMARK: ~L ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: ~dlw 9~ ej./ Liquid Capacity: IVO z, Setback from: Well 4la House _,_?D ' Other Pump: Manufacturer Model#!rlF Size Float seperation 6~a Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: Length Number of trenches Distance & Direction to nearest prop. line: ad ' Setback from: well:lOd House Other ELEVATIONS Building Sewer ST Inlet. ST outlet PC inlet PC bottom Pump Off Header/Manifold Bottom of system Existing Grade Final grade DATE OF INSTALLATION: f! t~/ PLUMBER ON JOB: I LICENSE NUMBER: P~ INSPECTOR: -2 - 3/93:jt I's~r~siip`artt~i1uSt13jl? • 29.28W, PR~VAtE SEAGE SYSTEM County: Lebor and Human Relations INSPECTION REPORT Safety and Buildings Division ST. jr-RC)T)c GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: Permit Holder's Name: ❑ City ❑ Village IR Town of: State Plan ID No.: NARNXEN IF STEVEN WARREN CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 0 2w 9 ~~,o~t /d. CPI',es TANK INFORMATION ELEVATION DATA A9300368/,?zy/93 -)fin TYPE MANUFACTURER CAPACITY STATION BS HI S ELEV. Septic < t / Benchmark ~3 ell 11A491 d, l'- Dosing Aeratiorq- Bldg. Sewer St/ Inlet 9H J 9S ~j~ ' TANK SETBACK INFORMATION St IX outlet 49 TANK TO P/ L WELL BLDG. Aeintake ROAD Dt Inlet 9,,.361 9s. 16 Septic NA Dt Bottom pc)_ 5 ' Dosing wa- >/6i)' 19-0/ - NA Headed i S Aeratio NA Dist. Pipe ' Holdi Bot. System t` PUMP INFORMATION Final Grade Manufacturer (n~ PAY r 1 + -7. 941 -4 Model Number ~(o GPM TDH Lift ~j Friction Syesatem TDH Ft Forcemain Length r Dia. .2 " Dist. To Well~S(~r SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Li Id Depth DIMENSIONS 3 DIMENSIONS SYSTEM TO P/ L BLDG T WELL LAKE/STREAM LEA aaal acturer: SETBACK INFORMATION Type O A CHAMBE Moe r: System: C 7do, OR U DISTRIBUTION SYSTEM Header / Manifo)d Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air_Lntake Length Dia. Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade my Depth Over Depth Over a „ Topsoil Depth Of eeded/Sodded xx Mulched /Trench Center B*eL/Trench Edges a0 -3~O Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.} LOCATION: WARREN.35.29.18W,NE,NW,70TH AVE. Plan revision required? ❑ Yes to Use other side for additional information. /p7 9 SBD-6710 (R 05/91) Date Inspector's Signatur Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: r~ ` z- 3 f 13. 1W If) 736 co t.reci2~,/ (,W,97)' C~ ,lam = z~'- 3~'~ DILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 1:1 /Wq j 8% X 11 inches in size. Check if rewsio 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 %I or-9PV j, A) d_jrA4e41 PROPERTY LOCATION ,r/ '/a &)1/a, S 31- Tal, N, R E (or PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # /,TY 9! 20 7-11 llog CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER -t t~ ` /S 75i- ~8 Q 7- o V37 II. TYPE OF BUILDING: Check one CITY NEAREST ROAD ~Or ~J X~7711 ( ) State Owned VILLA =N W: GE : dA1 ❑ Public Ell or 2 Fam. Dwelling of bedrooms ~ PARCEL TAX NUM 111. BUILDING USE: (If building type is public, check all that apply) fQ loft 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) A) 1.0 New 2. Z 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 30 ❑ Specify Type 41 ❑ Holding Tank 12 91 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. SYST M ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ~S'. 3r LION Ca a J.20© la 62 c ~yFeet 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 Tanks Tanks structed Septic Tank or Holding Tank Lift Pump Tank/Si hon Chamber 7s e r 6./ Vlll. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) MP PRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code): C O " IX. COUNTY/DEPARTMENT USE ONLY p Disapproved Sanitary Permit Fee (Includes Groundwater Date ue Issuing Agent Signa ure WApproved El Owner Given Initial y~ I y9O Surcharge Fee) 7 7 Adverse Determination 7Y 1 Q pj 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 (SSD 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 ny'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 SURCHARZ'9E 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies co Iected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) S 7`-e U ~ ;v / w ~ d ~ort°r` °F y q i ~ •Ba h 3T-o a ~l 21; Z 651 PAGE OF PUMP CHAMBER CROSS SECTION ARID SPECIFICATIOIJS VENT CAP M°C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING JUNCTION BOX MANHOLE COVER 25' FRCM DOOR, WINDOW OR FRESH 12 M"'~ I AIR INTAKE i GRADE I y.. MIN. ~G...~.-. 5" AIM. CONDUIT PROVIDE AIRTIGHT SEAL I ~ i I I ~ APPROVED JOINT A III APPROVED JOINT5 W/C.Z, PIPE. I III W/C.M. PIPE EXTENDIt,IC• 3' I II ALARM EXTENDING 3' ONTO $OLID SC; L. B ( I ONTO SOLID SOIL I I I oN C. I I i pjl pump-, OFF 11~, ~ O e i An • CONCRETE BLOCK RISER EXIT PERMITTED GJLy IF TAIJK MANUFACTURER HAS SUCH APPROVAL SPECIFICATIOKJS SEPTIC AND L~ DOSE TANKS MANUFACTURER: k. J,~;.e5 TPy~i I~S'2~esl HUMBER OF DOSES: y PER DAy TANK ;IZE GALLONS DOSE VOLUME ALARM MANUFACTURER: Ste!~~c qc~ C',~~ INCLUDING BACKFLOW: /_7 GQILONS MODEL IJUMBER' CAPACITIES: A= INCHES OR JEW GALLONS SWITCH TYPE: - A-f vC_ _ 8 = INCHES OR 32/ GA'_LOAIS PUMP MANUFACTURER: =-12_L INCHES OR Zl-'q, GALLOWS MODEL NUMBER: q D INCHES OR GALLONS SWITCH TYPE: L2Zej'C- NOTE: PUMP AND ALARM ARE TO BE PUMP DISCHARGE RATE LY GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE B'1'M/EEAI PUMP OFF AMID DISTRIBUTION PIPE.. J, FEET + MINIMUM NETWORK SUPPLY PRESSURE , . , , , . . . , , FEET + ~ v FEET OF FORCE MAIN X LIZ FYoFTFRICTION FACTOR.. L-~ FEET TOTAL Dti JAMIL HEAD = FEET INTERNAL, DIMENSIONS OF TANK: LENGTH ;WIDTH IS- ` ,LIQUID DEPTH 51GNE D:~ F ~1s a~ LICEAlSE 1JUMBER: r DATE -117- W (W l~rly~ ur o HEAD/CAPACITY CURVE 4'k 6A . MODEL 97 a1c 30 ~ i • g 4% 25'- o ~ . - 1h-11hNPT W 6 20' 43/16 U z 15' Y 93 4.- 0!2 Q - O 10' 2 51- us I 0- 10 20 =40 50 60 70 GALLONS LITERS 0 80 160 240 1011/76 FLOW PER MINUTE TM"L Dw1AA11C NEAWLON PEA MM U EFRUEIIT AND DMATEa1N6 CAPACITY MEAD UMTSrMw 35/16 FEET METERS GAL LTRS 5 1.52 56 212 T 10 3.05 46 174 15 4.57 35 133 20 6.10 15 57 Lock valve 23.75' CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available • Mercury float switches are available for controlling and supplied with an alarm. single and three phase systems. • Mechanical alternators, for duplex systems, are avail- • Double piggyback mercury float switches are available able with or without alarm switches. for variable level long cycle controls. SELECTION GUIDE 1. Integral float operated 2 pole mechanical switch, no external control required. Standard All Models - Weight 33 lbs. -1h HP 2 Single piggyback wide angle mercury float switch or double piggyback mercury float switch. Refer to FM0477. 97 Sarks control Selecks 3. Mechanical altemalor 10-0072 or 10-0075. Modal YDRs-Ph Mode Amps Simplex Duplex 4. See FMO712 for correct model of Electrical A temator. -E-Pak". A497 115 1 Auto 120 1 or 1 S 7 - 5. Mercury senses float switch 10-0225 used as a control activator, specify duplex (3) N97 115 1 Non 120 2 or 2 & 6 3 or 4 & 5 or (4) float system. D97 230 1 Auto 6.0 1or1b7 - 6. Four (4)hole "J-Pak", junction box, forwatertight connection or wired4n simplex or C97 230 1 Non 6.0 2 or 2 E 6 3 or 4 d 5 2 pump operation, 10-0002. 7. Two (2) hole "J-Pak", for watertight connection or splice, 10-0003. CAUTION For information on additional Zoeller products refer to catalog on Combination AN installation of controls, protection devices and wiring should be done by a Starter, FMO514; Piggyback Mercury Float Switches, FM0477; Electrical Atternator, qualified licensed electrician. AN electrical and safety codes should be followed FM-0466; Mechanical Alternator, FM0495; Alarm Package, FM0513; and Sump/- including the most recent National Electric Code (NEC) and the Occupational Sewage Basins. FM0487. Safety and Health Act (OSHA RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. 3280 47 Millers Lane Manufacturers of ' /Old O. Box 16347 • Louisville, Kentucky 40216 N O Z ELLEW TZ7. (502) 778-2731 • FAX (502) 774-3624 /J~eurr LWAY iVCT /f3y Lzbor and Human Relations Y, S V I L AND SITE R T Page of 3 Division of Safety & Buildings in ac!A 83.05, Wis. Adm. Code AW 1 4D'iG/t// J TEST - COUNTY Attach complete site plan on paper not less th / 1 in4hn n must include, but 1 T e& not limited to vertical and horizontal referenc 'W(diEbnd pe, scale or PARCEL I.D. # dimensioned, north arrow, and location and ~taance a j APPLICANT INFORMATION-PLEASE 11NT 1'N RTION REVIEWED BY DATE PROPERTY OWNER: "wRAOFS f7?, .~i ~c~o CqU PERTY LOCATION ~~9UE CO W4F S ryiN ~Nry L VT. LOT tiE 1/4 AAfA/4,S 35 T 27 N,R / E (o i D PROPERTY OWNER':S MAILING ADDRESS i 15vf O CF ti OT # BLOCK OR CSM # /J~s Z3-ffl 7 If a&-- sue. CITY, STATE + ZIP CODE PH UM E []CITY ❑VILLAGE DOWN NEARESTOAD /c ~ie TS K/1S S~D Z 3 7/rj - r y.3d kl1fle 7,07 (j New Construction Use [ )j Residential/ Number of bedrooms 3 [ J Addition to existing building j)Q Replacement [ J Public or commercial describe Code derived daily flow gpd Recommended design loading rate ~ bed, gpd/ft2 5 trench, gpd/ft2 Absorption area required _',_,ged, ft2 trench, ft2 Maximum design loading rate bed, gpd/ft2 ' -5 trench, gpd/ft2 Recommended infiltration surface elevation(s) Pj 3 ft (as referred to site plan benchmark) Additional design/ site considerations ~+SE ov~~ 7iefffiC-4S - .OW 'dox Parent material 5C5 S~~ri,t~p ,vTr~o • "01 7'tv Flood plain elevation, if applicable ft S =Suitable for system CONVENTIONAL MOU D Q U IN-GS UN D PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U=Unsuitable fors stem R] S El U MO N- 5S ❑ U F1 ❑ U ❑ S Q u SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Try ~ - /o Y,P 3/3 7-f, z , sd,~ 7 cS 34- . S . ~ t 5 Yk y S/ o, S G Ground 13 5G -75 YX 51,6 S/ D C, se ,h,, ie Q S - . y - elev. Depth to !o ' fo limiting factor „ / ,P~ C3 ,s U jp` ~jQ,! EGG t rv I'S' .571Tf 7-/ Remarks: i s @S S I Boring # 4 -ice /o 313 -><,e z 1- 23 /o Y X Y/i' /o y 2, f, YAe /,h4 f,e e s .2 f , s , G Ground ' yJP 75y~ s~~ f4f 46//y elev. G' yD /o `1'e 4~0l J; , f 9ie 6"'e , S L n. 7 Syl s/~ 61 Depth to ~s 69, -f S n limiting factor~ y L nMr-1KIA1 %0 1 I've 1=- s Remarks: 4 CST Name _Please Print HOMESITE SEPTIC PLUMBING HUDSON, WIS. 54016 Phone: _3~6 Address: ROBERT ULBRIGHT a 1C Nn 3m7 m-P-R-S. Signature: MINN. INSTALLER 6 DESIGNER LtC. N0.0M Date: CST Number: f2- .2- PROPERTY OWNER SOIL DESCRIPTION REPORT Page: Ztir PARCEL I.D. # e4 S T 141 7- of Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 7e` a L:# D - cI Log 3/3 o47 Z-,., 4,< , - c 3 f- -y G ~3 Y 2z, 10,vw x1to, 2j, -56& Ground '75 fie S100 X MeE- l',G 9X I ft. S O, S ~,v►1L i 7 • e Depth to a limiting ZrfE O ~Gw /4fi9ili-- ~ T~ aF TPi E factor a _ Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring Ground elev. ft.' ~ Depth to limiting j factor Remarks: SBD-8330(8.05/92) !%eT, etf loT ~y r = /,30710 El76-E pF lwDOD 6- 4 T S E Cp~QN~`~ . ~'L EUiJ T/d.J = O. j ~ 3 /3~XM y4 FAM h~OS- I 3Q ! G 45 'off 0 I i 50 -3 9.0 $y s/o~E 1\ C 4 if' B This test site APPROVED for a conventional septic system. r 7 >t L.ev hTCOAj S -s S/STE•ci 41 -7 3 0 82 /04 yo scA~~ : ~o 7.7 3 ° - ~AcerhaF ~~'Ts A°7-, ORIGINAL G~~T l04/-Y s Til l/O,J HOMESITE SEPTIC PLujoNG Co. I,Qc c?vi/ eo -rO ~QU 855 OWEIL RD., HUDSON, WIS. 54010 ROBERT ULBRIGHT CST' 9?6 2- 7- WIS. MASTER PLUMBER LIC. NO. 3307 M.P fl& Y~Z ~it~D~J ~Q~y~- MINN. INSTALLER 3 DESIGNER LIC. No, 009AN s FILED DEC 2 31992► 0 JAMES n'r~nrvNELL f f Aegis?e: ;1,,Dods SL Croix CO., WI 493239 rd~ N Z sq {v . r1h -'t9., rt n v.i o = z Bearings are referenced to the north line of '~''O the NE} of Section 35, assumed to bear p I- , N89°34'42"E. sa C: 00 m Zoj) u ) s N to ~ . ' 16 UNPIjATTED LANDS O. ai ^ M N00015'17 "W 394.88' M0 361.88 0 0 rt %D P. rt ¢ 33.00 :CD co z ly co 00 Ix w P. w w I iC lJi 100' N w iz y a N F'S m ~_j la W 0 N IC=7 ct C = O = m t+7 1-h ~i o I :U F_ rt 00 ::r N El Q (D w 10 z kt~ Iz 0 41'r IC m p w it I> 0 O C-) ,z Iro r " W 't3 Fn M IN 1 _ I iq O m .-v I y o O Cij " rt. l0 I i __4 H 33' 33' E m -n it7f im 1> l0 W ;z n z rn n txj t7 I r N cn z l0 (D or 1 z 0 -Pi- I~ :j C/) IZ rr n C. 1W I I > ' UJ p. < ct. N to N Cn r 0zo 00 rt w is N cn o w N co r+ o to p o w w r a r 0 C) cn a F a M I- W C' C, 0 -0 w V M N I APPROVE o to a w .n N p p r^ ,p X rt I~ m -n I N 0 0 M r X :3 :j rt C". _ 6 6' rt r W < fD N ST. CMX COf1W` 1.0 T LO tm Ln I 4ofnpIehansivs►Rl:,ttt ~ N co ' Zawng ww F,. or F F 33.00' to marks <resiaril " - I O O' 362.041 te rat reeavww tin rt S00°15' 17"E 395.04' M- z a atl~+r a UNpLATTED LANDS .a a~rshdatbe z A) M * sndlill~ vr+i 4r y, TT s 0 W Iv O tr0oC h t7j c a. 7 & r - W. M- p h a (D 1'.0 rr o F..i a gyp-0 CO . c • co Urtl I (n z y - U3 ti -'j 0 ro hxj h -p M z C* O£ 01 00 :r4 (t 1-- 11 to z w M Ul !A z a- cr n w z a r• N O (D H o O o W > w N ~ V7 C> 0 N O to C) Voluine 9 PAGE 2578 SEPTIC TANK MAINTENANCE AGREEtiENT St. Croix County OIMER/BUYER A02A fKo ROUTE/BOX NUMBER/31A Fire Number • ' ! ~ d r zip r? CITY/,STATE~_ PROPERTY LOCATION:'&Je~7 Section 3~_,• T_ , R Town of GJa e~ St. Croix County, 7 C S~~ Subdivision- -AOW Lot number. Improper use and maintenance of your septic system could result in its premature failure to handle wastes.- Prover maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licens'ed' 's'ept'ic tank um er. What you put into the system can affect the unction o. t e septic tank as a treat- ment-stage in the waste disposal system. St. Croix County residents'-may be eligible to recieve a grant for a maximum of 60% of the cost.of replacement of a failing system, whic was in operation prior to-July 1, 1978. St. Croix County that eeoftall program in to keep their system properly owners maintained. The property owner agrees to.submit to St. Croix County Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or..a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and -(2)-after inspection and pumping (if nec- sformcwillkbessentsapthan 1/3 proximately130£daysdpriordtoc~. Certification three year-expiration. PA 0 I/WE, the undersigned have read the above requirements and agree 0 to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Depart- V ment rnedrto the Certification form completed and ret u of the three year expiration.date. SIGNE 14 DATE St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 386-4680 Sign, date and return to the above address. S T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor,(spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of property ~ f T 1 i Location of propertyjLx!L1/4 ~ 1/4, Section '3S ~ T q N-R /FW Township Mailing address C/ a ~`~ldZ3 Address of site . f) 2.. Subdivision name Lot no. Other homes on property? yes-No Previous owner of property/ - j Total size of parcel ' .4 Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)? Yes _)~_No Volume/0 q~and Page Number as recorded. with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER & 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.C and that I (we) own the proposed site for the sewage disposal system orr I e(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. Al' Zid Signatur f app icant Co-applicant Dat o ig ature Date of Signature 42 , DOCUMENT NO. WARRANTY DEED THIS s►ACK aaaavan roll ascoRoome IIAT& STATE OF WISCONSIN-FORM 2 t. I 5oss~5 VOL 1040PAGE 06 1 This indenture, Made this.. day of October Ej-00 :l A. D., 19 93 betw Dorwes Farmsr Inc: , een t a Corporation duly organized and existing under and by virtue of the laws of the State of Wisconsin, ,orated t____ Roberts Wisconsin, party of the first part, and Steven J. Warnken and Judith M. . husband and wife as survivorship marital rag vi. part les of the second part. WItatw--ta, That the said party of the first part, for and In considerationof the sum of valuable consideration "'u TO to it prid by the said parL.Je_c of the second part, the receipt whereof is hereby confessed and acknowledged, has given, granted, bargained, sold, remised, released, aliened, conveyed and con- - firmed, and by these presents does give, grant, bargain, sell, remise, alien, convey, and corfirnl nnto~ - _ _ _ the said part_ie3...-_ of the second parr thf-i r heirs and assigns forever, the following described real estate, situated in y the County of St. Croix State of Wisconsin, to-wit: r Part of NW 1/4 of NE 1/4 and Part of NE 1/4 of NW 1/4 of Eh Section 35, Township 29 North, Range 18 West, St. Croix e f jl County, Wisconsin described as follows: Lot 2 of Certified Survey Map filed December 23, 1992 in Volume 9, Page 2578, as Documnet Number 493239. a. ar N>9CE8MRl, oowmmns DEsollur ION on RX"Man WON) Together with all and singular the bereditsments and appurtenances thereunto belonging or In any wise appertaining; and aU the estate, right, title, interest, ddut or demand whatsoever, of the said party of the first part, either in law or equity either ID possession or expectancy of, in and to the above bargained premises, and their hereditaments and appurtenances. To have and to hold the said premises as above dcxribed with the hereditaments and appurtenances, unto the said put iea_ of the second part, and to t e r heirs and assigns FOREVER 4 And the said Dorwes Farms, Inc-, party of the first part, for itself and its successors, does covenant, grant, bargain and agree to and with the said parr ies of the second part, 1@lr heirs and assigns, that at the time of the ensesling and delivery of these presents it is well seized of the premises above described, as of a good, sure, perfect, absolute and indefeasible estate of inheritance in the law, In fee simple, and that the. same are free p~an~.d,..~..clear from all encumbrances whatever.-and easQaten S. rp-cprv_atinnc and ~ and that the above bargained premises in the quiet and peaceable possession of the said part__.-i83 _ of the second part, their heirs, and assigns, against all and every person or persons lawfully claiming the whole or any part thereof. it will forever' WARRANT and DEFEND.} In Witness Whereof, the said _ Dorwes Farms- - Ino•,.,,. party of the first part, has caused these presents to be signed by__.As7.Xj_d_Cwlas_ _._Zr ,9,1,d.Qu"nd Se -r - ary +x its President, and countersigned by- its Secretary. 3 " Hudson at Wisconsin, and its corporate seal to be hereunto mixed, this - _ day of OctoberA. D. 19.x_ SIGNED AND SEALED IN PRESVNCE Or DORWES FARMS, INC. Cssyerab Name ' % 1 coaxrERElaxsa: David Cowles STATE OF WISCONSIN St. Croix County. t Personally came before me, this. 6th--._.__ day of.._.N._. tQb2?~.._.._....-_._._........ A. D.. 19..63... . David- Cowles Praidmt, and..._.S .et iL.._,;_.......... ~ssefa~I at of the above named Corporation, to me known to be the persons who ex t r eAg*/`,instrument, and to me known to be such > President and Secretary of said Corporation, and acknowledged that they exec 1he'f6_iegoing'fn3trum t as officers as the deed of said Corporation, by its authority. ~yAA, ZeO- TNIf INSTRUMENT WAS DRAFTED BY Y NOTARY Notes : Pubii t . Croix nn Wis STEPHEN J. DUNLAP ems' My comipa 'on fex Tres rAa H---on~ Wisconsin _ p (is) (Sectioe S9.St (t) of the Wisconsin Statata 1~-. -.--r..TM~. _ - ' th provides that all instmmeots to be IetYjed shall have atdd~y pr~Med or type+riit tlrcrew r names o[ the Srantors, rfantees, witnasp and salary, Section )9.313 similarly r8gairq thlt the namc oI , Ike persm wbq Q semen s. amuy which, drafted such imtramerk shall Is printed. tty~pewritten, stain at wtW6i thereon in a less wanm.) -we WARRANTY DDFD-D>• Corooratlsa a7A pOOlr W1 t., We. 2 9CONNN wbconata Lead Blank Co. Ine. ) Mllwwkae, w:. ~.r_..}~., a -.ter.. ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 September 9, 1992 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An onsite soil investigation of the Dorwes Farm Inc. property, located in the NE1/4 of the NW1/4, Sec.35, T29N, R18W, Town of Warren, St. Croix County, WI., has been conducted with the assistance of Bob Ulbricht, CST# 2482. This onsite revealed suitable soil for onsite sewage disposal to a depth of 48" while meeting the requirements of the A + 4" rule. This site should be suitable for a mound septic system having 12" of sand fill or an At-Grade system. Should you have any questions, please feel free to contact this office. Sinc rely, mes K. ?hompsdn Assistant Zoning A, 'strator cc: file k ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE r - 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 September 9, 1992 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: ' An onsite soil investigation of the Dorwes Farm Inc. property, located in the NE1/4 of the NW1/4, Sec.35, T29N, R18W, Town of Warren, St. Croix County, WI., has been conducted with the assistance of Bob Ulbricht, CST# 2482. This onsite revealed suitable soil for onsite sewage disposal to a depth of 48" while meeting the requirements of the A + 4" rule. This site should be suitable for a mound septic system having 12" of sand fill or an At-Grade system. Should you have any questions, please feel free to contact this office. Sinc rely, mes K. ?homps/n Assistant Zoning Aoptinistrator cc: file Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of Labor ad 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 ~ Z PROPERTY OWNER: PROPERTY LOCATION GOVT. LOT 0,,) 1/4 ~J 1/4,S _2F-7 ,N,R E (or) W PROPERTY, 0WNE ':SAIL G DRESS LOT # BLOCK # SUBD. NAME OR CSM # CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLA 9E EYOWN NEAREST ROAD c. , 5 o z Wiz, ( ) ` ` - [ J New Construction Use [ residential / Number of bedrooms CS7` [ ] Addition to existing building j eplacement [ ] Public or commercial describe Code derived daily flow gpd Recommended design loading rate bed, gpd/ft2 trench, gpd/ft2 Absorption area required bed, ft2 trench, ft2 Maximum design loading rate bed, gpd/ft2 trench, gpd/ft2 Recommended infiltration surface elevation(s) It (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable ft i S = Suitable for system CONVENTIONAL- MOUND U IN C~-YN--GRW PR_.WuRE AT-GRADE SYSTEM IN FIL HOLDING TANK 1:1 U = Unsuitable fors stem S L9t1 S ■ U ? ❑ U ❑ S Q-tr ❑ TA SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon . Texture Consistence Boundary Roots In. Munsell Qu. Sz. Cont- Color Gr. Sz. Sh. Bed Trench Ground` elev. ft. 3.)-U' - _i Depth to limiting factor, ~ Remarks: Boring # Ground elev. ft. Depth to limiting f _11r t CST Name:-Please Print Phone: Address: Signature: Date: CST Number: PROPERTY OWNER SOIL DESCRIPTION REPORT Page , of. PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bowd3y Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trends }ti•} Ground elev. n. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # k;\ Ground elev. ft. Depth to limiting factor Remarks: Boring # 44 Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) a wssconsm Uepartment s~ustry, SOIL AND SITE EVALUATION REPORT Page / of 3 ~bor and Human n Relations _ Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY f 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. ou SiT APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION Ua~rlC'y~'~'v REVIEWED BY DATE PROPERTYOWNER: O0f2wES F/tPM :Z:~VC , % PROPERTY LOCATION f~~ Dive CdGt1/~5' - 13,OX 70;'t' GOVT. LOT N,67- 1/4 NW 1/4,S 35 T Z9 N,R E (o'~J , PROPERTY OWNER': ILING ADDRESS X /f LOT # BLOCK # D. NAME OR CSM #T ~ 7 /3y9 70 ,9v-e- (fv &:s l,awF CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE RFOWN NEARESTJROAD ~o~i /i?T S ~/S S%0 2-3 715) 74"9- 3y~~' cv~4R,Pt-✓ 70 rl cAg- [ on Use Residential / Number of bedrooms 3 [ ] Addition to existing building Replacement [ ] Public or commercial describe teed daily flow yso gpd Recommended design loading rate s bed gpd/ft2 trench, 9Pdlft2 Absorption area required 3?5 bed, 112 3 ?S trench, ft2 Maximum design loading rate S bed, gpd/ft2 ~O trench, gpd/ft2 Recommended infiltration surface elevation(s) P -3 It (as referred to site plan benchmark) Additional desi n / si rations S''T,' iS Sv~T / ovc S 9 to _ E y ,~.e .~iovv~ ys 7`~~_--7 Parent material 5G5 JECV~Tr S%~T~ S~cT sFp~ of ,TS Flood plain elevation, if applicable. tip-- ft S =Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U =Unsuitable fors stem ❑ S E U ®S ❑ U ❑ S ®U ~ S ❑ U ❑ S 9 ❑ S WU 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 Trench 4 O /p /o ye 2 S/ ~,f, N& ~Q S s S , G 2 f xgk;,~-~~~ /o 2,f 5-ht js2Vf G~ Ground h ve_- / Yoe %f-1 7*4v G ,,fr ,tr 5 h/voG~ - opt , elev. Z 7-5 ye f sy ft. 3/-5y /G ,y//rveE sd~ d v q. j , , y Depth to S limiting y 7C7 /a y~ 51Y `c/ % U f Sh& M1 u f , 2 f3~~ Remarks: S• TE 14E£775 eselzeE Pi `TS Boring # o- y /0'y"? j/Y/2- s./ 2, , shlC 2U+ 6 10 Lo TS Ground elev. 7 S YiC' 5/6 S,dk d v K .C / . 5/ ` • S 93 ft. 516 ~ 1, f, Sh& QU1- y • S Depth to C • 5~ 5 /,P S lp limiting A& facts, s~ i nR,GINA,l i Remarks: CST Name:-Please Print rf ^ISIL RD., HUDSON, WIS. 54016 Phone: 71!~ -3 ddress: Q ULBRIGHT ,946. N, tt ME PLUMBER LIC. NO. 3307 M.P.R.S. Signature: Liu. NU00663 Date: c f2 CST Numb;: f ~ ibR wt S ~~Yk~ 'T uc PROPERTY OWNER SOIL DESCRIPTION REPORT Page ,Z Of PARCEL I.D. # Depth Dominant Color Mottles Texture Structure Consistence GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Y Roots Bed Tw& -2 -7 13-31 lo ye y!~ s,/ Sb~ ti s Z s , A& vL, a a) i y S s rx ~G s/ -f 13 ;7 Ground i yo elev. d ~5.36 it. C, o y7 7 S M 5/G - S O. 9e S c 6 Depth to e2- 7'~d y/e '516 cS2~R 2 3 limiting ; facto ~r 41 i 9 Remarks: Boring # -14- A VA Ground {I elev. for a C nvent nal se pt f3 ft. See a lanatio , Depth to limiting factor Remarks: _ Boring # z.n ;.<f Ground elev. ft. Depth to limiting factor Remarks: Boring Ground elev. + ft 1 Depth to limiting factor Remarks: SBD-8330(R.05/92) c l- 1 72) PLOT ~o'~ wES ~~4RN S I I 5C,41-E-: 1fl~ 30 pl-0 'IV t 3 ~ ol~ -39 ~,EI SG 5 T~~<< I o E/oyE ~1!s 52- f/3 Z3 O O N 2 ~ Zy "U vy 3 Vl v 30 a 6A _ /j a 7'To~v EDI!r-JF' p SiDi d lr 93 G o~ A, f l 6V f40 T/? dF 93.G Abv.SF h This test site NOT A'PPR sEID for a conventional septic sY. 011. NOMESRE SEPTIC PLUMBING CO. &; O'NEIL RD., HUDSON, WIS. 54016 ELF uATi oA1 11 lz ROBERTUIBRIGHT c57-11.ai, S W- MASTER PLUMBER LIC. NO. 3307 M.P.R.S. .~O MINN. INSTALLER & DESIGNER LIC. N0.00663 0) RECEIVED N ~i q.3, .5G SEP 1 4 1992 95.3G ' Scow TM w ORIGINAL 3 / ZONINGOFFICE X;\ s • Yom. ~.~y GG SU~gESTEI~ Td~ L/.vE O~ ~10U,vQ 19 3, • MDv vP 5ySTE,,-r ~F/ia of rm V (Gc> i~1~. la " s~~v0 \ y'S. SO J ~'CiS T/%v S f/PjfDE 21~Vf,E.~P ~~'o/~OJE1~ C~L'~ y ct y 3 ' 7b f sconsin spar nto Industry, AND SITE EVALUATION REPORT Page / of 3 `for and Human Relations DiVWon of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code ' COUNTY ST 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. vu SiT~ APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION { 1FI0~frIo v REVIEWED BY DATE TiN ofr .roa 9 ~z 2--i -y- PROPERTY OWNER: 3a0?weS FAPM =x, G , C/o PROPERTY LOCATION 01~4ue Cow/&-v - / 3Qf/ 70""- .yu.L Sa.~ GOVT. LOT NF- 1/4 NW 1/4,S 35 T 2-9 N,R !0' E (o W PROPERTY OWNER': LING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # ~T of 2- 7 i3y9 70 /f 41-t- (s:r~ MVA&:3 l,Its CITY, STATE 7's w/S ZIP CODE PHONE NUMBER []CITY []VILLAGE KFOWN NEAREST OAD aeo~3~~' S'yo23 (~i5) ~y9- 3y~d' c~~FR,Pt~~ 7d 1~ [ J New Construction Use [xJ Residential / Number of bedrooms [ J Addition to existing building Jrh Replacement [ J Public or commercial describe Code derived daily flow yS~ gpd Recommended design loading rate • s bed, gpd/ft2 trench, gW Absorption area required 3?S bed, ft2 3 )5 trench, ft2 Maximum design loading rate S bed, gpd/ft2 , trench, gpo1ft2 Recommended infiltration surface elevation(s) s-~ P 3 It (as referred to site plan benchmark ) Additional design / site rations s' TE i S SuiTrJ~/E-- ~c y fp,~ ~IOV-vp SS/.r 7i~j Parent material 545 Q SaweTr 511-7-1- S/cT sFot;y "7x- Flood plain elevation, if applicable *-4- ft 6W-W _67 rU= Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT GRADE SYSTEM IN FILL HOLDING TANK Un suitablebrs stem ❑S ®U ®S ❑U CIS OU ®S ❑U [IS ®U ❑S J!~U 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 Toxh 4 0-/0 /o yX y z S./ f, sb,t ,e s s 2 s, c / /0 yx Y S fs JL zvi ,5 G Ground h vE / YR 31Y i•v G r ~r- elev. ft. 7 5 Ye 5 h~eo Pov - Ily 3 sy i ,wX7v,~E o f , s6K vii ~i Depth to 's lot gg d-I a - 7 limiting a y 70 /a ye 51f 1, u f 56& irYl V ~i , 2 . 3 i Remarks: Boring { - 3e) /0y/e yl~e' ?;f -foe cr?Li S 2uf .S C. ,o pS `i~lv io ;~y 44, G/~f Lo TS i Ground ! elev. -y 75YR S/G s/ s k d VA sYX see 1 f, shk dok . , y . s Depth to limiting /0 y1e .5 5/ Il Uf .rhK Y/j ~ ' j facts, s Remarks: CST Name.=Please Print t66 O'NEIL RD., HUDSON, WIS. 54016 Phone: Address: j M. WSTE'R PLUMBER LIC. NO. 3307 M.P.R.S. Signature:- ~ L~Gln/ Date: rf CSZy~~--- ibR WES ~>fiiPM ,JG { PROPERTY OWNER SOIL DESCRIPTION REPORT Page 2-of PARCEL I.D. 0 Boring # Horizon Depth Dominant Color Mottles Texture Structure consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Rvxh 0 ,3 To r e y Z S ,F .yes s 2f s • 6 i, /3-3/ log sb,~ d S Z of . 5 . G 13, yD 7 sYA Y(; sdk d vl, a w i y S elev. - S e,6 .7 ; • 0 y c It. C, o y7 S yie ~G o f 9~ ~s 11-00 1 Depth to e2- 7-~d d YR -?6 ~Z'R s/ Sr. /w" I.3 limiting factor~~ _ Remarks: Boring # 1 13, I Ground elev. i ft I Depth to limiting factor _ Remarks: Boring # _ Ground 1- 1 4•t- ~ elev. Y It Depth to ' limiting 4 factor ' I Remarks: Boring I i Ground = elev. It, Depth 10 limiting factor Remarks: 741 PLOT PLA IQ S ci4 L, 30 • = A}Gl~~ a~ p, TS /S9 pR'~ 3 Ell SG 5?Tt f3fDRii 39 o w Sys 5z O O N " Zy 3 `u v 30 a lj,y, _ /315 TTo y EDd-'lF ~C 73. o)c Af;p Si0%06r A °.v p 4o r/? 53. G /fot~.SF 0 0~ e/e ilfrieo = /O o, o h~ 10 11 2 1 A ~ ~ 9 S E P HOMESITE SEPTIC PLUMBING CO. 666 O'NEIL RD., HUDSON, WIS. 54016 ST OF OX ROBERT ULBRIGHT CST,' `.;tV E L1= v.A'r oA u COUNTY WK MASTER PLUMBER LIC. N0.3307 M.P.R.S. Z ZONING OFFICE MfNN. INSTALLER & DESIGNER LIC. NO. 00663 y -~w T (3i '73, 5G ~-,ptlc systefr~b See expt",r4ation. ~3 95.3G' D G G ~'E-s rEv Tom- <i:v 9 31 SU~ E p~ ~lDU.vQ • MDU.vp 5ysTE.~-► iF / E'1/sT/u fo ! y ✓r pC c v ~q-vT' J 57 0` ` 4.4 1 ( ref ,oo / v AA 1 1~ 1 ~ _ t 03/22/2006 08:23 AM Parcel 042-1098-50-100 PAGE 1 OF 1 Alt. Parcel 35.29.18.544A 042 - TOWN OF WARREN Current X_1 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 - ALBRECHT, SUSAN SUSAN ALBRECHT C - JASPERSON, DARIN K DARIN K JASPERSON,ET AL C - TRINASTIC, MARK A 1349 70TH ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1349 70TH AVE SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 5.800 Plat: N/A-NOT AVAILABLE SEC 35 T29N R18W PT NE NW & NW NE BEING Block/Condo Bldg: LOT 2 CSM 9/2578 5.80 AC Tract(s): (Sec-Twn-Rng 401/4 1601/4) 35-29N-18W Notes: Parcel History: Date Doc # Vol/Page Type 06/22/2005 798384 2828/202 WD 11/21/1997 568834 1278/209 WD 11/21/1997 568833 1278/208 QC 07/23/1997 1040/06 WD 2005 SUMMARY Bill Fair Market Value: Assessed with: 79818 248,800 Valuations: Last Changed: 10/23/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.800 50,900 150,100 201,000 NO Totals for 2005: General Property 5.800 50,900 150,100 201,000 Woodland 0.000 0 0 Totals for 2004: ! General Property 5.800 50,900 150,100 201,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 112 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ' -'Parcel 042-1098-50-000 03r22i2006 08:22 AM PAGE 1 OF 1 Alt. Parcel 35.29.18.544 042 - TOWN OF WARREN Current IX I 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 O - DORWES FARMS INC DORWES FARMS INC 1387 70TH AVE ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC I Legal Description: Acres: 26.020 Plat: N/A-NOT AVAILABLE SEC 35 T29N R1 8W 40AC NE NW EXC PT TO Block/Condo Bldg: CSM 9/2578 & EXC PT TO CSM 11/3149 EZ-U-1532/38 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 35-29N-18W Notes: Parcel History: Date Doc # Vol/Page Type 2005 SUMMARY Bill Fair Market Value: Assessed with: 79817 Use Value Assessment Valuations: Last Changed: 07/14/2003 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 26.020 3,500 0 3,500 NO Totals for 2005: General Property 26.020 3,500 0 3,500 Woodland 0.000 0 0 Totals for 2004: General Property 26.020 3,500 0 3,500 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 COMMERCIAL TESTING LABORATORY, INC. 5'14 01n Street, P.O. Box 526 Colfax, Wisconsin 54730 715-962-3121 800 - 962 - 5227 p yi ST. CROIX ZONING REPORT NO.* 29375/01 PAGE 1 ST. CROIX COUNTY REPORT DATE, 9/18/92 COURTHOUSE DATE RECEIVED' 9/16/92 HUDSON, WI 54016 ATTNS THOMAS C. NELSON OWNER. Dar Wes Farms Inc., D. Cowles LOCATIONS 1349 70th Ave., Roberts COLLECTORS M. Jenkins DATE COLLECTED: 9-15-92 TIME COLLECTEDS 2S30pm SOURCE OF SAMPLES Kitchen faucet DATE ANALYZEDS9-16-92 TIME ANALYZEDS2S00pm COLIFORMS 0 /100 ml INTERPRETATIONS Bacteriologically SAFE NITRATE-NS 40 ppm Above 10 ppm exceeds the recommended Public Drinking Water Standard. Coliform Bacteria/100 ml Nitrate-Nitrogen, mg/L 9 10 GO f 10. LAB TECHNICIANS Pam Gane S f £ WI Approved Lab No. 19 ( Means "LESS THAN" Detectable Level Approved byi ST. CROIX COUNTY ZONING OFFICE St. Croix County Courthouse 911 4th Street Hudson, WI 54016 d Telephone - (715)386-4680 h St. Croix County Zoning Office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals. Completion of this form is essential IQ that Jb_q property can he located. Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning Office, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received., WATER TESTING----------------------------FEE: $ 35.00 (For nitrates and coliform bacteria) WATER TESTING FEE: $185.00 (For VOC'S) SEPTIC SYSTEM INSPECTION FEE: . $25.00 (Determines if system is properly functioning at.,time of inspection) PROPERTY OWNER'S NAME : D l'w~~ ~22 C' COuJ le ve CITY..1Q6 be, PROP. ADDRESS: Legal Description 1/4 of the A),) -1/4 of Section, TN-R!S?ui Town of W A-ok"- Lot Nu ~er subdivision: In-JrK p "7V D ~ FIRE NUMBER 13 z,J~/ Color of house v 2 Realty sign by house?~_If so, list firm PLEASE INCLUDE, IF AT ALL POSSIBLE, A KAP,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual requestin services: DeL,ed CoQ1,L. c-, -7 1 Telephone Number & - s 3 W 76 REPORT TO BE SENT TO: Cewknr ~e,16 ~L5 ~~bo13 CLOSING DATE;-., Signature ST. CROIX COUNTY WISCONSIN ' - ;s.. rah. ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 Sept. 16, 1992 David Cowle Dorwes Farms, Inc. 1349 - 70th Ave. Roberts, WI 54023 Dear Mr. Cowle: An inspection of the septic system on the property of Dorwes Farms Inc., located at 1349 - 70th Ave., Roberts, WI was conducted on Sept. 15, 1992. At the same time a water sample was obtained for testing. The results of that testing will be sent to you as soon as you receive them from the laboratory. At the time of inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. Si cerely, Mary J. Jenkins Assistant Zoning Administrator cj NOTE: System is being replaced