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AS BUILT SANITARY SYSTEM REPORT
OWNER 4L4olr.&,, C" TOWNSHIP (9
SECTION L- 535 T___r N-RAW
ADDRESS ST. CROIX COUNTY, WISCONSIN
SUBDIVISION N fi LOT ,u, /1- LOT SIZE V. t9PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
r
s 4/
pry.:
ice,
473,
'
INDICATE NORTH ARROW
d~ ;Otr~rna n,f l~~ Ceyn odk~"
BENCHMARK: Elevation and description:
Alternate benchmark )U'A
SEPTIC TANK: Manufacturer: Liquid Cap. _1,0-0o
Rings used:eF Manhole cover elev:WC1_Final grade elev: &/0
Tank inlet elev.:~&.'p Tank outlet elev.:
No. of feet from nearest road:Front1__1 Side 1.5 , Rear Ft.
From nearest prop. line:Front ,5, Side>7 , Rear}-Ft\ lot
j~
No. of feet from: Well 300 , Building:
rf~~
(Include this information in the above plot plan
(2 reference dimensions to septic tank)
SEE REVERSE SIDE
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IN
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PUMP CHAMBER
Manufacturer:-12 Liquid Capacity: y0
Pump Model: L 40 Pump/Siphon Manufact.: N-A Pump Size A). 4.
Elevation of inlet: Z/O , Bottom of tank elevation ff(o.6
Pump on elev.:2iT&-Pump off elope.:Gallons/cycle:
Alarm: Man.: j. GJ-er,t~ n Switch Type : _Location
,~►2~lalldl~ll~,t T
Distance from nearest prop. line: Front -~S, Side? 5, Rear >SFt.
Distance from: Well -3 OU ' Building 2 5
SOIL ABSORPTION SYSTEM
Bed: .-Trench: Seepage Pit:
Width: -Length Number of Lines: Area Built
Exist. Grade Elev. Proposed Final Grade Elev.
Fill depth to top of pipe:
No. feet from nearest prop. line:Front Side Rear Ft.
No. feet from well: No. feet from building
HOLDING TANK
Manufacturer: Capacity:
No. of rings used: Elevation of bottom tank:
Elevation of inlet:
No. feet from nearest prop. line:Front , Side Rear Ft.
No. feet from: Well , building , nearest road
Alarm Manufacturer:
INSPECTOR:
DATE : K?2- bLUMBER ON JOB: LICENSE NUMBER: MP S9r75
6/90:cj
i
TD SANITARY PERMIT APPLICATION
ILHR In accord with ILHR 83.05, Wis. Adm. Code COUNTY
0
S TE SANITARY PERM T #
-Attach complete plans (to the county copy only) for the system, on paper not less than 1 5_Q r
8% x 11 inches in size. ❑ Ch k if revision to previous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. - D '2
PROPERTY OWNER PROPERTY LOCATION
E '/4 E t/4, S 3r T AIR , N. R or) W
PROPER WNER'S MA LING ADDRESS LOT # BLOCK #
~ N, r1. 1V:A.
CITY, STAT ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
' . ~ NEAREST ROAD
II. TYPE OF BUILDING: (Check one) [J State Owned CITY
R(
❑ Public ~ 1 or 2 Fam. Dwelling-# of bedrooms., _ -PARCEL TAX NU ME
111. BUILDING USE: (If building type is public, check all that apply) O k - to v ! le
1 ❑ Apt/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
30 Campground 70 Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
40 Church/School 8 ❑ Mobile Home Park 120 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. ❑ New 2. [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 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ~ In-Ground 420 Pit Privy 13 E] Seepage Pit Pressure 43 ❑ Vault Privy
140 System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. GALLONSPER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7.FINAL
ELEVATION GRADE
REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch)
Feet .0 Feet
4-1:)o 3 qS (0 01
VII. TANK CAPACITY Prefab. Site Fiber- Exper.
in allons Total # of Manufacturer's Name Con- Steel glass Plastic App
INFORMATION New istin Gallons Tanks Concrete structed
Tanks Tanks
Septic Tank i
n-C'S N A 1 ~41 F-1 I F1 I El 1~ M+LL
Lift Pump Tan r
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
MP/MPRSW No.: Business Phone Number:
Plumber's Name (Print): Plumber's ature: (No Stamps)
8°1S ~►lS a35- 6
Plumber's Address (Street, City, State, Zip Co
IX. COUNTY/DEPARTMENT U ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater a to Issued Issuing A nt Signature (No Stam )
7 /
Approved ❑ Owner Given Initial Surcharge Fee)
/ O7 z
Adverse Deb
X. CONDITIONS OF APPROVAL/REASONS FR 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. t a
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 c:ompiete 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. Comp ete for all
septic, pump/siphon and holding tanks for this system. Check experimental approval only if ranks 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 'or monitoring groundwater, ground-
water contamination investigations and establishment of standards.
SBD-6398 (R.11/88)
`VGi~n3ihi6epartntof IGL 35.28 • IPRIVA
Labor and Human Relations YEE'WA'GNYSEMB County: Safety and Buildings Division INSPECTION REPORT ST. CROIX
(ATTACH TO PERMIT) Sanitary Permit No.:
C,ENERAL INFORMATION 171501
Permit Holder's Name: ❑ City ❑ Village (Town o : State Plan ID No.:
ANDERSON, CLARK EAU GALLE
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
Q l;} t4, 6. & 008-1097-10-000
TANK INFORMATION ELEVATION DATA A9200266
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic r Benchmark g (01,$ D 1 b d.
Dosing U~
Aeration Bldg. Sewer
Holding St/Ht Inlet
TANK SETBACK INFORMATION St/ Ht Outlet )p to C(~, a -
Vent
TANK TO P/ L WELL BLDG. AirIto ROAD Dt Inlet cI
Air Ito O ~ 0 9).0
Septic >5 300 d0 :1 z a NA Dt Bottom Sb g(o
Dosing S' 3P blb, NA Header / Man.
Aeration NA Dist. Pipe
Holding Botyst m
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand
Model Number GPM
TDH Lift Friction SyRead stem's TDH `)0,6 Ft
Loss Forcemain Length .61 1 Dia3 Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of renches, PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSION f N 7 DIMENSIONS
SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
SETBACK
INFORMATION Type o CHAMBER
>JS_ '73 06 OR UNIT Model Number:
System:
DISTRIBUTION SYSTEM
Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length Dia. a'u Length 19- Dia. 2!~- Spacing qq
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over v Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched
Bed/Tr nchCenter Bed /Trench Edges Topsoil 0-yes ❑ No Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
Is 1) sr~ f'
(00 0
Plan revision required? ❑ Yes n No pp~~~, 11 Use other side for additional information.
SBD-6710 (R 05/91) Date ` Inspector's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH "s
SANITARY PERMIT NUMBER:
~ -C.~'\ Z.7-N-CJ U 1~ } 1 ~ ~ '~,,1 ~ ~,.c a e.
Bowman Plumbing, Inc.
Jack Bowman - Proprietor
Master Plumber No. 5875
2819 Knapp Street
Menomonie, WI 54751
(715) 235-4634
FAX (715) 235-3650
April 16, 1992
Zoning Department;
Mr. Anderson would like some information on Wisconsin Funding
at the time of the on-site is done.
Anderson present system is discharging in the ravine. If you
have any questions, please call.
Sincerely
to
Loretta Larrabee
CST 3719
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Bowman Plumbing, Inc.
Jack Bowman - Proprietor
Mastbr Plumber No. 5875
2819 Knapp Street
Menomonie, WI 54751
(715) 235-4634
FAX (715) 235-3650
Page 4 of 4
SOIL DESCRIPTION REPORT l
Clark Anderson '
NEhNE4S35T28N/R16W
St. Croix County
Eau Galle Township
I
LEGEND --/f - - _ _ -
BM: 100.' screw with red ribbon
xy,
in pine tree with red ribbon
row 0~
Borings dug with backhole
8
System area meets all setback
y
Scale 11'-401
ti'`1 as K
"i d' ~ QS 70
4
T 1
3
Loretta Larrabee CST 3719 '
I
Bowman Plumbing, Inc.
Jack Bowman Proprietor
Master Plumber No. 5875
~2819 Knapp Street
Menomonie, WI 54751
(715) 235-4634
FAX (715) 235-3650-
T1= PAGE
Anderson
NE4NEaS35T38N/R16W
Eau Galle Township
Plot Plan • 1 of 10
Plan view of mound 2 of 10
Pipe detail 3 of 10
Pump chamber 4 of 10
Pump curve 5 Of 10
Soil Description °report 6 thru 9 of 10
On-Site........................ 10 of 10
~P 393
Bowman Plumbing, Inc.
Jack Bowman - Proprietor
Master Plumber No. 5875
2819 Knapp Street
Menomonie, 'WI 54751
(715) ,235-4634 N
FAX (715) 235-3650
Pun PLAN
y
- Clark Anderson
NEkN1EkS35T28N/R16W
St. Croix County
Eau Galle Township •
BM 100.1 screw with red
ribbon in pine tree wit I ~
rep ribbon
System EL. 95.6' 3
Scale 111=40' +
System meet all required
setbacks q6.1
-~Ck q0 V.
~iJ c r
* (SITE SEWAGE SYSTEM
/ack Bowman MP 5875 on dldivna Gl
APP- r E.
CEP tMT Or • .
AND HUMAN RELATION
IVIS!(,; MLUY:VuS
v SEE, CORRESPONDENCE
Y m~
4
Page Of/
Straw, Morsh Hay, Or Oaf Z~
Synthetic Covering
Distribution Pipe
Medium Sand
Topsoil _ H G
~J I F
E „ D
3
% Slope
Bed Of. 2 Force Main Plowed
ONSITE SEWAGE SYSTEM'
Aggre,4bte Layer
Conditionahli)
6 D 1.0 Ft. APF Cho Section Of A, Mound- System Using E 1•0 Ft.
A Bed For. The Absorption. Area F. Is Ft.
-
DEP RT N i Or REA i 10NS G ~ Ft.
ON 01
A 8. e5 _ Ft. H 1.5 Ft.
Z4,
rc B 47..0. Ft.
Licn Umber
'Y.. Oat . \lf//y10 Ft.
.
J 9..(6 Ft.
r Ft.
Force'Main w Ft.
L
A
w 0
Distribution Bed Of 2M- 2 %2M
Pipe` Aggregate
• Observation Pipe Permanent Markers
Plan V1ew Of Mound Using A Bed For The Absorption Area
s. F'~~1N
S5
Pertorated Pipe Detail
/ End View
Perlorotel! .
oD
Eno Cap PVC Pipt
Ja`.oa
p' Holes Located On Bottom,
S Are Equally SPOCId
Q
- 9
Q pvc
Moriifold Pipe
Disiribulion
Pipe Force Main
Last Hole ;Should 8•
Nest To End-Cap
End, Cap Distrltwtion Pipe Layout
P a3.s6 Ft.
R (o4
S 3a w,J,~
X 30 Inches
Y 2.1 Inches
Signed: Hole Diameter Y* Inch
Lateral 1 Inch(es)
Licens umber: mp s875 ' Manifold a Inches
Date: Force Ma i n - Inches
ONSfTE SEWAGE SY `fi` f1A # of holes/pipe -0
ot 6tlUj2lZ I'n'vert Elevation. of 'Lateral s 9'0.1 Ft.
AP""kRAORkV'
Effl D
OCPA1 T aF iND,i j r';i30H AP HUWN RELATIONS
fVISiOtJ C1F '"HF i'Y' A''dJ Ei~liLDING5
SEE COMESPE2I+DENC€
PAG F 4- C; F -4O
PUMP CHAMFER CRb$S. SECTIOIJ,.ArJG'SPECIFICATIOkJS
VCIJT'CAP S7, LAO`S ~
y"C.I. VENT PIPE
71
WCAT14EK PROOF APPROVED LOCKING
JUQC,TIOAI SOX MAWHOLE COVER
25 FROM DOOR,
WIAIDOW OR FRESH 12 MIU. ,
AIR IUTAKE
GRADE 1
4' MIM. -11G
mij.
COUDUIT
Ia•hru~
• ` 11~
WLET PROVIDE. I
- AIRTIGHT SEAL
II v
APPROVED JOINT 'A ( I I APPROVED J011J
W1C.T. PI P¢ I I W/Cm PIPE
RXTENDINC. 3' I II EXTEUDIIVG 3'
01JT0 ,OL10 ALARM
16*s{ s AGE SYSTEM I I ouzo SOLID sol
ow
,i t~ L'E• I
i
CLEv F +
PUMIP OFF
0
NT ` 1. + ;7 t11~,1~AiV RELQ710NS
EDOti' OF li10 'ST
O!OF -;ihi.,:NGS COUCRCTE MOCK
KIS a ~1 fr"l 1`I~ED'OIJLy' IF TAUK MAIJUFACTURER HAS SUCH APPROVAL
SEPTIC E SPECIFfCA*fI0KIS'
DOSt.
TAIJK MAIJUFACT ER: ~ QUMBER OF DOSES: PER DAH
TAW K, J GALLOWS Do'eV 'LUME2 S 3~ =1~'~ ~
LARM1 MAUUFACTUR>` IIJCLUDIAICs IIACKFLOW: 112,5 }.i+fr GALLONS
nocEL uuM>SEit: CAPACITIES: A= IUCAES OR 4 LLOUS
SWITCH TSPL:.,r_._
g=IUJCHES'OR iGA+LLOAJS
PUMP MAUUF.ACTUR[R: C: G tWCHES OR t,AL"LO
MOLEL U1.11I3ER: d. _INCHES OR GALLONS
SWITCH TYPE: t4`1 AL UJ TE: PUMP AWD ALARM ARE TO DE , •
MIIJIMUUh DISCHAl~GE''RATC.GPN IN51"ALLED OIJ SEPARATE CIRCUITS
VERTICAL DIFFEQEAICC 6ETWEE PUM1PaQPlr{1W0 CIETRII,UTIOIJ PIPE:: EETrI
+ MIAIIMUM NETWORK SUPPLY, -PRE1a~yRE i...; 2 FCET
FEET OF FORCC f1Ai1J:~'X FEET
,jrtFRICTIOU FAGTOR: yV
Tr6TALlfi'{1ir~+CIC~ ' HEAb sl f FEET I O~ IQ
IUTE>AL IM OM11 0F TAIJK: LEIJCsTIDTH -;LIQUID DEPTH 31GI`- LICEIJSE AIUMBER:; MP 58 7`~ BATE: Y5
-
e... a
• t
1111 111N
~('E :.ems
CAPACITY (U S.~ G4iI: s/MIN.)
' ;TOTAL:
HEAD. „PUMP
_ °(FEET)"BEF BEF BSE;, SSE BSE SSE 8.00 40 60 50 75 100 200
-1---~ ~ c i - ~ 10 ` 415 135. 155' 180 215 = rr..~-_.~~•' (3
15 84 165, 115 150 185 230
i r - 20 43 68' 65. 120 150 210
j 25 - 28 - 65 -117 175
30 75 145
. 19 I 35 110 ,sI l 1
II i
= 40 - 60 -T
s.oo•
MODEL BEF
ELCTRICQLICHARACiERISTICS Snipping
wt.
BEF 40 rr 4 HP 1.15V-10 60 h gP. 59 Ibs.
SP 60 lbs.
' BEF'60:;. ':.6'HP=115V=-10'60 6z'
BSE450' % 'HP-1-15V-1046 Fiz.PSC 103 Ibs.
~ec Iv^ , Q BSE-75; ?Yi HP-230V-iQ3.60.hz:'PSC 105 Ibs.
BSE-100 1:HP-230V-10-60 hz PSC 1071b9.
'BSEE-200 2 HP=230V-40-66 z PSC 111 ibs.
PERFORMANC>r COAVE MODEL BEF PERFORMANCE WAVE MODEL BSE
PERFORMANCE OUTSIDE THE LIMIT4IItES IS ;COMMEND ED ~ PERFORMANCE OUTSIDE THE LIMIT LINES0 NOT RECOMMENOE
Y
6 r---r~ r
I AEA; LIMIT 1 C+
50 50
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<< 65$ LIMIT
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•
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4 I 50%
o @0% a 20
TO LIMIT
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>f r 0
! 0 50 100 ISO 200 250
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0 110 160 CAPACITY-U.S. GALLONS PER MINUTE
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JUN 181992
- 4'-ETY F- BLOGS. DIV
-J U L- T- 9 2 WED 1 5 : 3 5 B O W M A N PLUMBING P.01
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- T % UL.-,7-92 W E D 15::3s B O W M A N P L U M B I N G P.02
y . SAFETY & BUILDINGS DIVISION
State of Wisconsin
Department of Industry, Labor and Human Relations A-4-1,~~; y~,
PRIVATE SEWAGE PLAN.-APPROVAL Western Regional Office
2226 Rose Street
LaCrosse, Wisconsin 54603
BOWMAN PL94 Owner: CLARK ANDERSON
2819 KNAPP ST 82 CTY B
MENOMONIE WI 64751 WOODVILLE WI 54028
RE: Plan Number: 892--44429 R Date Approved: June 18, 1992
Gallons Per Day: 450 Date Received: June 18, 1992
Project Name: ANDERSON, CLARK Location: NE,NE,35,28,16W
Town of EAU GALLS County: ST CROIX
The plumbing plans and specifications for this project have been reviewed for
compliance with applicable code requirements. This approval is based on Chapter
145, Wisconsin Statutes and the Wisconsin Administrative Code, The plans are
stamped 'conditionally approved'. This approval is contingent upon compliance with
any stipulations shown on the plans. All items that are noted must be corrected.
All permits required by the city, village, township or county shall be obtained
prior to construction. The licensed plumber responsible for this installation
shall keep one set of plans with the department's approval stamp at the
construction site. The installer shall notify the appropriate inspector when
inspections can be made.
This approval will expire two years from the date approved or if a sanitary
permit is obtained, it will expire the day the initial sanitary permit expires.
The Section of Private Sewage has reviewed these plans for private sewage system code
requirements only. These plans have not been reviewed for the code requirements
set forth in Section ILHR 82 for general plumbing or in Chapters 60-64 of the
Wisconsin Administrative code.
This approval is for the following components only:
~JC---- - - REPLACEMENT MOUND
- REVISED MOUND
+ NOTE: The approved changes will become an addendum to the plans previously approved.
1 All other portions of the installation shall conform to the original approval.
Inquiries concerning this approval may be made by calling (608) 785-9336.
$84 Nib R. bl tlll l
,.T~UL--,7-K92 W ED 15::36 BOWMAN PLUMB I MG P . 03
rte'
SAFETY & BUILDINGS DIVISION
State of Wisconsin
Department of Industry, Labor and Human Relations
BOWMAN PLBG
Page 2
Sincerely,
Q.." R . &Os.44M
DENNIS R. SORENSON
Section of Private Sewage
Division of Safety and Buildings
PPP027/0009n/46
cc: CLARK ANDERSON Private Sewage Consultant
seoM~oq uiwu
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75'/v
Bowman Plumbing, Inc.
Jack Bowman - Proprietor
Master Plumber No. 5875
2819 Knapp Street
Menomonie, WI 54751
(715) 235-4634
FAX (715) 235-3650
Page 4 of 4
SOIL DESCRIPTION REPORT
Clark Anderson
NE4NE4S35T28N/R16W
St. Croix County
Eau Galle Township
1
LEGEND - -
BM: 100.1 screw with red ribbon -~1--=-
in pine tree with red ribbon
Borings dug with backhole fog
System area meets all setbacks
\ < 5~
Scale 1"-40' .
T
a 1 J
Loretta Larrabee CST 3719
a E
~U ~ 1v
ST. CROIX COUNTY
~ k
WISCONSIN
ZONING OFFICE
ST. CROIX COUNTY COURTHOUSE
911. FOURTH STREET • HUDSON, WI 54016
(715) 386-4680
May 7, 1992
Division of Safety and Building
Bureau of Plumbing
P.O. Box 7969
Madison, WI 53707
To whom it may concern:
An onsite investigation of the Clark Anderson property, located in
the NE 1/4 of the NE 1/4 of sec. 35, T28N-R16W, Town of Eau Galle,
St. Croix County. This onsite revealed suitable soils at a depth
of 24" requiring 12" of sand fill beneath the mound.
Should you have any questions, please feel free to contact this
office.
i erely,
Thomas C. Nelson
Zoning Administrator
cj
v v
.0 1
State of Wisconsin
,County of St. Croix ss
THE ST. CROIX COUNTY ABSTRACT COMPANY hereby certifies that the foregoing abstract
consisting of entries No. - _ 2fi to ____36__, both inclusive, is a correc+ abstract of title since _ - - _ _ _ _ _
_ _Maxch _1_4_r _ 1.919 _ _ _ _ _ _ _ _ _ at 1aIO0 o'clock in the _ _ _A_ M, of the lands described in
_ _ the _ C~,pi011 _N4 _ 26 _ _ _ _ _ _ _ hereof, to-wit:
NJ of NEJ of Section 35-28-16•
That, for the period covered by this certificate, said abstract correctly shows all matters affecting
or relating to the said title which are recorded or filed for record in the office of the Register of Deeds
of said County, including Federal Tax Liens and Old Age Assistance Liens filed therein against the parties
listed below.
For the period covered by this certificate, except as shown by this abstract, there are no unsatis-
fied mechanic or material liens affecting title to such lands docketed in the office of the Clerk of the Cir-
cuit Court in said county for the past two years.
That, except as shown in this abstract, there are no unsatisfied judgments, including delinquent In-
come Taxes, docketed in the office of the Clerk of the Circuit Court in said County within the past ten
years, as and against the following named persons which affects the title to the real estate above
described, to-wit:
Andrew Anderson
Clark Anderson
or
Maryellen Anderson.
That for the period covered by this certificate, all instruments appearing in this abstract contain the
necessary number of witnesses and acknowledgments unless otherwise noted.
We further certify that for the period covered by this certificate that we have carefully examined
the records in the office of the County Treasurer for St. Croix County, Wisconsin, and find no record of un-
paid taxes or assessments standing as a lien on the real estate described in this abstract, except as shown
herein. Such examination covers up to and including the taxes for the year 19_7_1- _
That this certificate and annexed abstract and als, any prior certificates, if any, made by the un-
dersigned, covering the same land, are furnished for the use and benefit of any and all owners of the land
described in said caption and their successors in title, including mortgagees and guarantors of title.
Dated at Hudson, Wisconsin, this -_-19th-------- day of fty A.D.
19.72_- at __-]..Q:9Qo'clock in the -AM.
ST. C COU T A T COMPA Y
BY - - -
Secre ry
y`+aiu 4,J4
SEAL
. ~ o unone r~nu
pIYOKU MLMRLR
Form 3 - 1958
James H. Whilcher. Act of Congress.
Patents E. J of S. W. }r, Sec. 23,, T. 28, R. 16.
35 continued
trees within the said land ,
~j The grantor releases all claim to any
i, ores of this agreement includ
sand understands and agrees that the Purvegetation existing on the said
Ithe ri ht to preserve and protect any and protect any vegetation that
g t to plant thereon an deem desirable to. prevent erosion of the
;I the highway lands, and the right
may with the
.e highway A covenant is hereby made
j said St. Croix beautify Cthe r Y authorities
jsoil or to that the said grantor holds the above described
ix ood right and lawful auth
premises by good and perfect title; thatisaid premises are free and
lority to sell and convey the same; oever ex clear from all liens and encumbrasnhall beabinding oncthe grantor,nthe r
,I after set forth. This conveyance
t heirs, executors,., assigns and grantees, and the consideration hofewha -
11fore named is acknowledged to be in fthrough or by reason of the gran -
~
soever
ing and conveying of the said lands.
M
6
Land Contract .
Andrew Anderson and Amelia Con. $1+,000.
Anderson, husband and wife, Dated &t. 22, 1971•
Ack. Oct. 22, 1971.
u -to- Rec. Oct. 28, 1 71.
~ In 1147811, page 1~, #307543 •
Clark Anderson and -
Maryellen Anderson, *4sba.nd
and wife as joint t*ah~s •
10
N2 of NEJ of SeW'An:35-28-1 .v.
Recites: The grantors rtedron the°abovesdescribed premises for
and occupy the residee loca
-
the remainder of their`-lives and e to e past of ingress and egress to
said residence. Further, the eight
ises their two horses for"as long as they elect so to do. artie
Also Recites: Upon compliance of .terms of said Contract, p
l of the first part will deliver to parties of the second part a good
and sufficient warranty Deed, in fee simple, et. and an abstract.
Clark Anderson and Maryellen hec. June u, iiij.
Anderson, husband and wife In "498", page 572, #316591•
1 as point tenants. NJ of NEk of Section 35-28-16
Recites: The purpose of this instrument is that the grantor is
releasing her life estate in this property and the residence located
Ithereon as reserved to the grantor who was a joint grantor in that
certain contract dated Oct. 220 1971, recorded with Office of Registe of Deeds, on Oct 28., 1971, in Vol. ►+478++ of Deeds, pages 14 & 15,
in
strum 6
ent No. 307;43. No. 3). This is homestead property. (Fee #8 Exempt).
174
Roland Smith and Alma Smith, Warranty Deed.
husband and wife, and each' Con. $625.00.
in his or her own right, Dated March 23, 1974.
Ack. Marsh 23, 1974.
'-April 1, 1974.
-to- Reap
Iii, "50, page 192, #321078.
Clark Anderson. 9-2i acres more or less all
~S of_' ~E fof-,.NWu of Section 35-28-16
lying to E of ra lr ad •t
with ~rOico._'of,
Recites: The t'ee!s liabi].tfoPr rt taxes commences
h the date of Ja ..'1,-1974. ( 4;, 70 T an f'' .ee~ .
.
- +r = r 5
Maryellen Anderson, grah~or;N, Q11 Claim Deed.
wife of grantee, G Good and valuable.
Dated March 15, 1974.
-to- Ack. March 15, 1974.
Rec. April 1, 1974.
In "509+x, page 194, #321079.
Clark Anderson, grantee,
husband of,grantor. NJ of NEJ of Section 35-28-16
and
i
Recites: The grantor is hereby assigning to the grantee Further
all interest that she has in the above described real-estate.
the grantor is hereby assigning to.the grantee all of her rights and
title and equitable interest in and to that certain land contract re-
corded on Oct. 28 1971 with the office of Re ister of Deeds, in vol-
ume "478", page 14., #307543• (No. 36)• (Fee Exempt).
176 -
Clay Fultz- In County Court, St. Croix
Baldwin, Wisconsin..... County, Wisconsin.
Judgment.
.....Judgment Creditor, Amount of Claim - $19.30.
-vs- Dated Sept. 29, 1970•
Docketed Sept. 29, 1970•
Andy Anderson- In "2" Sm. Cl., page'34.
Woodville, Wisconsin..... Attorney: None.
.....Judgment Debtor.
1
rl
S T C - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER Mr. Clark Anderson
ADDRESS 82 County B FIRE NUMBER 82
CITY/STATE Woodville, WI ZIP 54028
PROPERTY LOCATION: N 1/4, N 1/4, SECTION 35 , T 28 N-R 16 W
TOWN OF Eau Galte , St. Croix County,
SUBDIVISION N.A. , LOT NUMBER N.A.
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
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 Mr. Clark Anderson
Location of property _F,1/4 NE 1/4, Section 35 , T 28 N-R 16 W
Township Eau Galle
Mailing address #82 County B
Woodville, WI 54028
Address of site same
subdivision name N.A. Lot no. N.A.
Other homes on property? yes XX No
Previous owner of property Roland and Alma Smith
Total size of parcel 146 acres
Date parcel-was created Oct 1971
Are all corners and lot lines identifiable? XX Yes No
Is this property being developed for (spec house)? Yes XX No
i
Volume478 and Page Number 14 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. 307543 , 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. 307543
41\& o o C,_ nl_A
Signature of applicant Co-applicant
Date of Signature Date of Signature
ST. CROIX COUNTY
1
WISCONSIN
14P Mr &
ZONING OFFICE
ST. CROIX COUNTY COURTHOUSE
911 FOURTH STREET • HUDSON, WI 54016
(715) 386-4680
~W
May 7, 1992
Division of Safety and Building
Bureau of Plumbing
P.O. Box 7969
Madison, WI 53707
To whom it may concern:
An onsite investigation of the Clark Anderson property, located in
the NE 1/4 of the NE 1/4 of Sec. 35, T28N-R16W, Town of Eau Galle,
St. Croix County. This onsite revealed suitable soils at a depth
of 24" requiring 12" of sand fill beneath the mound.
Should you have any questions, please feel free to contact this
office.
'i%erely,
Thomas C. Nelson !
Zoning Administrator
cj