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AS BUILT SANITARY SYSTEM REPORT
OWNER;fbr'~
TOWNSHIP /_F''
ate-
SECTION L _T_L.3,,__N_R rS W
ADDRESS j,'4,. --e, / ST. CROIX COUNTY, WISCONSIN
SUBDIVISION' yJr~. LOT-4 ~OT SIZE__.~~~ S
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
INDICATE NORTH ARROW
J /rr l
SENCHMARKzElevation and description Cx Z40 ,
Alternate benchmark
SEPTIC TANK: Manufacturer:
1~ r' Liquid Cap.
Rings used: t ~
Manhole cover elev:Final grade elev: _ S
'rank inlet elev.:._`` / j'
-_Tank outlet elev.:
No. of feet from nearest road: Front i ---,--Side , Rear Ft.
From nearest prop. line : Front , Side"--- Rear Ft .
+To. of feet from: Well Building: ;'Include this information in the above plot plan)
1?2 reference dimensions to septic tank)
SEE REVERSE SIDE
PUMP CHAMBER
Manufacturer: Liquid Capacity:
Pump Model: Pump/Siphon Manufact.: Pump Size
Elevation of inlet: Bottom of tank elevation
Pump on elev.: Pump off elev.: Gallons/cycle:
Alarm: Man.: Switch Type: Location
Distance from nearest prop. line: Front_, Side-, Rear-Ft.
Distance from: Well Building
SOIL ABSORPTION SYSTEM
Bed: Trench: Seepage Pit:
Width: Len th Z )
g Number of Lines. Z Area Built Exist. Grade Elev. Proposed Final Grade Elev.-C~-
Fill depth to top of pipe: Z ,1 - o
No. feet from nearest prop. line:Front , Side, Rear Ft.-L~
No. feet from well:4~_-No. feet from building._ '5
HOLDING TANK
Manufacturer: Capacity:
No. of rings used: Elevation of bottom tank:
Elevation of inlet:
No. feet from nedrest prop. line:Front , Side , Rear Ft.
No. feet from': Well , building , nearest road
i
Alarm\\14
a_pidfacturer :
INSPECTOR:
t f
DATE : I , Z PLUMBER ON JOB :
LICENSE NUMBER: ~Jlil SLIDZ 5
6/90:cj
I>rA~e+'~larcnro~ 1.30.18 . ~~,AO"p►GOS~YiVI GG County:
Labor and Hur>1an Relations INSPECTION REPORT
Safety u~ldings Division ST. CROIX
(ATTACH TO PERMIT) SanitaryPermitNo.:
GENERAL INFORMATION 175630
Permit Holder's Name: ❑ City ❑ Village ❑xTown of: State Plan ID No.:
RICHMOND
ev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
(0p i n CS f I` 026-1003-30-000
TANK INFORMATION EL VATION DATA A9200374
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic ~;1 J:7 Benchmark y g
Dosing
Aeration Bldg. Sewer
g
Holding St/Ht Inlet (Q,7 9%_7
TANK SETBACK INFORMATION St/ Ht Outlet ,0 ! c1 q 7
Vent
ii to ntake ROAD Dt Inlet
TANK TO P/ L WELL BLDG. A
Ar I
Septic 'l 1 yo i NA Dt Bottom
Dosing NA Header / Man. -7 y 9 11 FSc f
Aeration NA Dist. Pipe t $%,S,4
Holding Bot. System g'9 y q-j SS
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand
Model Number GPM
TDH Lift Friction System TDH Ft
Forcemain Length Dia. Fi Dist. To Well
SOIL ABSORPTION SYSTEM
BED /TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS I a- U °2i DIMENSIONS
SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM
LEACHING Manufacturer: - Ile INFORMATION Type O ecJ CHAMBER Model Number:
System: OR UNIT
DISTRIBUTION SYSTEM
Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length Dia Length Dia. Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched
Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: ((IIriclude code disscrancies, persons present, etc.)
LOCATION : CHMOND' 3 0.18.13 B , LOT 3, CO. RD. GG
4
Plan revision required? ❑ Yes ❑ No b
Use other side for additional information. "It_Q
SBD-6710 (R 05/91) Date 61 Inspector's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
D.~LHR SANITARY PERMIT APPLICATION COUNTY
In accord with ILHR 83.05, Wis. Adm. Code St. Croix
~e
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than ❑ `
Chet i ews on to `i V v
8'/z X 11 inches in size. Ch 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
Allyn F. Johnston SE '/4 SE t/4, s 1 T 30 , N, R 18 )FR(or) W
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
Box 64 3 n/a
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
New Richmond, Wi. 54017 715 246-7696 vol. #9- a e 2517- doc. #486555
111. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD
❑ State Owned ❑ VILLAGE : R1Chm9rid Co. Rd #CZ
ARCEL A NUMBER(S)
❑ Public 9'1 or 2 Fam. Dwelling-# of bedrooms 3 PER, IQWN OF:
111. BUILDING USE: (If building type is public, check al that apply) /00 2n1--~
1 ❑ Apt/Condo J~J
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. [4NeW 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.E] 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 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
REQQUUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) 99.23 ELEVATION
490 600 •75 <3 97.63 Feet 102.90 Feet
VII. TANK CAPACITY Site
Total # of Prefab. Fiber- Exper.
INFORMATION New Gallons Tanks Manufacturer's Name oncret Con- Steel glass Plastic App
structed
in a"Tan
Tanks Septic Tank or Holding Tank x ee LS X
Lift Pump Tank/Si hon Chamber
Vlll. RESPONSIBILITY STATEMENT ,
I, the undersigned, assume responsibility for installation f the onsite sew ge system shown on the attached plans.
Plumber's Name (Print): Plumber's ure: (No Sta ) MP/MPRSW No.: Business Phone Number:
Gary L. Steel 3254 715 246-6200
Plumber's Address (Street, City, State, Zip Co
1554 200th. Ave., PTew Richmond, wi. 54017
IX. COUNTY/DEPARTMENT USE ONLY
L] Disapproved Sanitary ermit Fee (Includes Groundwater Date sue Issuing Agent Sign re (No Stam )
A Surcharge Fee)
Approved ❑ Owner Given Initial U6 Adverse Determination
X. CONDITIONS OF APPROVAL/REASON FOR DISAPPROVAL: (I V
SBD-8398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS y
Y
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 (Sl3D 6399) to be
submitted to the county prior to installation.
5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed
pumper whenever necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code administrator or the
State of Wisconsin, Safety & Buildings Division, 608-266-3815.
To be complete and accurate this sanitary permit application must include:
1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of
where the system is to be installed.
II. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling.
III. Building use. If building type is Public, check all appropriate boxes that apply.
IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or
repair.
V. Type of system. Check appropriate box depending on system type.
VI. Absorption system information. Provide all information requested in ##1-7.
VII. Tank information. Fi!I 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 fo, all
septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received
experimental product approval from DILHR.
VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g.
MP, etc.), address and phone number. Plumber must: sign application form.
IX. County/Department Use Only.
X. County/Department Use Only.
Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The
plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of
holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service;
streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system
areas; and the location of the building served; B) horizontal and vertical elevation reference points;
C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump
performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if•
required by the county; E) soil test data on a 115 form; and F) all sizing information.: `
- - - - -
GROUNDWATER SURCHARGE
1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of
regulated practices which can effect groundwater.
The monies collected through these surcharges are used for monitoring groundwater, ground-
water contamination investigations and establishment of standards.
SBD-6398 (R.11/88)
•
•
STC-100 ,
'I~tiis application form is to be completed in full and signed b
tho octiner(s) of the property being developed, 1~ny inadequacies
will only result in delays o~ the permit issuance. Should this
development be intended for resale by owner/contractor,(spec
1~ouse), 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 pro. erty 1/4 Gr 1/4, Section
~ T N-R~88_W
Township
I•lailing address ~ ~
Address of site
Subdivision name_ YU~,~ ~
Lot no.
other homes on property? es
Y No
Previous owner of property
Total size of parcel ~j ~ S
Date parcel was created
Are all cvrnors and lot, lines identifiable?
~es No
Is this property being developed Por (spec house)?__Yes No
volume~~~nd page Number ~ 3 ~ as recorded, with the Re iste
of Deeds. g r
T.idCLUDE WITH TIIIS 11PPLICIiTION THE T'OLLOWING:
~ rV1\ItIZAIr'1'Y DLED which includes a DOCUHLNT NU2iI3ER, VOLUHE AND PAGP.
1rU1•IUIR & TIII; SERL or TIIE ItEGISTLIt OF DEEUS.
certificci surve In addition, a
y, if available; ;would be helpful so as to avoid
delay3 of the reviewing process. If the deed description
referenco~ to a certified survey Map, the Certified survey Map
shall also be required.
PROPEsT~TY OWNER C);ItTIFICATION
I(~~'e) certify that all statements on this form are true to the
best of ny (our) knowledge that I we am
the property described in this informrlition form, by virtue sof oa
warranty deed recorded in the,`office of the County Register of
Deeds as Document No.
o~:n the ro o~ ► and that I (we) presently
P p ~ed sitQ for t e sewage disposal system or I (we)
oUtair~ed ari easement, to r n the above described property, for
il~e construction of s id system, and the .same hae been duly
recorded in the off County Register of deeds as Document
No.
I
~ I',
si e o ap licant
Co-app], cant
r'
Date of Signature
Date oP s gnature
9 62 hnLE2
I I' 1 _
u - i THIS SPACE RESERVED FOR RECORDING DATA
DOCUMENT NO STATE BAR OF WISCONSIN FORM 11-1982 li
NO.
LAND CONTRACT
~,I( Individual and Corporate
TO BE USED FOR ALL 000 IS FINANCED AND IN OTHERNNONCONSUMER ~1 REGISTER'S OFFICE
486750 $250
- - - - i-- _ACT _TRANSAOTIONS~-
. _ - _ ST. CROIX CO., YY1
_ _ Recd for Record
Contract, by and between
AUG0 5 1992
~b.and..~zzd--wile...... -S----------------
aur_iraxiarsh.ip--- mari.tal_.pr_np.ex_t ("Vendor",
Ally__._____ F. Jo~nston and 8:30 A. M
n_
whether one or more) and____....._. Q~
I
Linda--M-t---~TQns_ax~.,.__hlasl~axld-.axial--- wi
vorshp__ martal.__p_xS~ex.y ("Purchaser", whether one or more).
Vendor sells and agrees to convey to Purchaser, upon the prompt and full per- Regigof Deeds
formance of this contract by Purchaser, the following property, together with the
rents, profits, fixtures and other appurtenant interests (all called the "Property"), - - -
Count State of Wisconsin
St. Croix
in_......•--•• County, ( RETURN TO
Lot 3 of the Certified Survey Map recorded in
Volume "9" of Certified Survey Maps on Page
~i 2517 as Document No. 486555, being; a part of
the Southeast 1/4 of the Southeast 1/4 of Tax Parcel No.
II Section 1, Township 30 North, Range 18 West,
ii TOGETHER with access thereto to County Trunk
li Highway "GG" over the road easement shown on
said Certified Survey Map.
i
!
i
This iS nOt . homestead property. i'
(is) (is not)
Purchaser agrees to purchase the Property andn to
following at 2 Ri ChM0Ln_ ~4is.cojasln.._., I'
the sum of g 10 5g0 0_, 0 0 (a ) $ 5 ,_..0 0...0...
at the execution of this Contract; and (b) the balance of $ 5_x 5 O Q...Q O together with interest from date
hereof on the balance outstanding from time to time at the rate of..... XilIQ---(9 o_) per cent per annum
i ! until paid in full, as follows :
I
Monthly payments of $125.00 commencing September 3, 1992.
j
i
Provided, however, the entire outstanding balance shall be paid in full on or before the_._....3rd_._....._.. day of
Februar.. 19..9.7._ ( the maturity date).
Following any default in payment, interest shall accrue at the rate of 1 Q._.. % per annum on the entire amount
in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire
principal balance).
Purchaser, unless excused by Vendor, agrees to pay monthly to Vendor amounts sufficient to pay reasonably antici-
pated annual taxes, special assessments, fire and required insurance premiums when due. To the extent received by Vendor,
Vendor agrees to apply payments to these obligations when due. Such amounts received by the Vendor for payment of
taxes, assessments and insurance will be deposited into an escrow fund or trustee account, but shall not bear interest
unless otherwise required by law.
I Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any
i amount may be prepaid without premium or fee upon principal at any timey-- -----------------------------AYA XXW
Xt~'aa~•~ ~'p~i l~o~p~ ~1~t~ ~e~~l~~to~o~ ~~'o~ ~
In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long
as the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be treated
i I as unpaid principal) is less than the amount that said indebtedness would have been had the monthly payments been
I; made as first specified above; provided that monthly payments shall be continued in the event of credit of any proceeds
of insurance or condemnation, the condemned premises being thereafter excluded herefrom.
j Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser
for examination except: The land contract from Louise Forrest a/k/a G. Louise it
Forrest to Lynn T. Forrest, Jr. and Nila M. Forrest, dated July 20, 1985,1
(I and recorded July 25,1985, in Volume 717 of Records on Page 107 as
Document No. 403799, which Vendors agree to pay in full.
it
Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall ~I
be retained by Vendor until the full purchase price is paid. I1
date of closing. X~sXXXX
Purchaser shall be entitle to take possession of the Property on
*Cross Out One.
SFLCtilillar STATE
FORM No. 11 - 198 WISCONSIN I C 1 , Stock NO. 13011
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uoigaod Aug ao aoiad assiloand ptsdun aatqua agI ao; mel qu ans Xeut aopuaA (iii) ao :Xouami;ap Aug so; algeil aq i1sg9
aassgaand pus alss lsiDipnf Is pauolDng aq 11egs Blaadoad aqI Juana gaigm ut 'aapunaaag anp squnotue aaglo pug 41nulap
;o a1up agI u0 IDa;;a ui a-ua agq Is. uoaaagl Isaaalui g4tm 'aDuuleq 2utpus4sgno aaiqua agq;o JuautBed 11n; pus aJeipatuutt
ladutoo 04 JoealuoO still ;o a0usutao;aad Di;toads ao; ans Xitu aopuaA (q) ao ! (tuaapaa of slte; aasegoand Blaadoad
ail; ao3 lequaa se pus lagaluoO sigJ IIl3In; of eanltu; ao; sa2iump paqupInbll sic pagta;ao;: aq Ilsgs aassgoand Bq pled
Xlsnoieaad squnouta Its I.uana goigM u!) aapunaaag anp slunotus aaglo pus alep gons uo IDa;;a ut aqua aqI is Iing;ap ;o alep agI
utoa;uoaaagl lsaaalut g1lm 'a0uiliq 2utpusls4no oa14ua aqj ;o quautBid lin; s,aasegDand uodn pauolllPuoa aq of uo14dutapaa
;o BIlnba Bus gJtm aansolaaao; 10ta1s g2noagq ijDiq Blaadoad aql aaeoaaa pus Blaadoad agI ui gsaaaqut pus 01111 's4g21a
s,aassgoand pus lasaluoO still aJsuttuaal 'uo1ldo stq Is 'Bstu aopuaA :B4tnba ui ao mill Xq papinoad asog4 of uoillPPs
ut (msl Bq papinoad suoi4e4lutt[ Aug of 4aafgns) saipamaa pus S41[212 2u1MO[[6; 81S ansq oslu Ilggs aopuaA pus '(sanigM
Bgaaaq aasegoand gotgm) aoigou gnogqlM pug uo1ldo s,aopuaA Is 'l[n; ut alquAud pug anp Alagaipamtut atuooaq llegs
IDgaquoD still aapun aous[sq 2utpusgsgno aa.quo agI uagq ' (!lout pat;tlaao Xq paltstu ao Blleuosaad paaanilap) aopuaA Xq;oaaagl
0a14ou ua}Jtam 2utmollo; sXsp •-"-O £ -;o poiaod a ao; sanuil uoo il3tgm aasegaand ;o uoi4u2ilgo aaglo Aug ;o aoustuao;aed
ui Iing;ap a;o Juana aqI ut (q) ao agep anp pat;!Dods aqI 2utmollo; sXep"••••O£ ;o potaad a ao; sanutquoo gotgm isaaalut
ao lgdioutad Bus ;o IuatuSud aqj ut glns;ap s ;o Juana aql ut (e) pug aouassa aqI ;o si atull Isgl saaa2g aasggaand
-auOjj.._ :4da3xa pus 'aasggaand ;o I1ns;ap ao Jos aqj Bq r,*jvaao saousaqutnoua a0 sua[l Bus
4daoxa 'seausaqutnoua pug suail Ili ;o iualz pus aaa; 'XJaadoad aql ;o 'aldtuts aa; ut 'paaQ BJusaaeb a 'aassgoand all
04 aaetlap pus elnoaxa 'pus[uap uo IluA iopuaA 'pagtoads eeoge aautium aqI ul pus satutl aqI Ie patuao;aad Blln; aq I[eg9
suolj!Puoo T1s pus p!ud Blln; aq llggs sBauout aaggo pus Isaa94m gltm emad asetlaand aqI isea ut Iegl seaa2'9 aopuaA
•Xlaadoad aqj 2utloalls suotgeln2aa pus saouguipao 'sm81 [Is gltm Aldtuoo oI
pus 14osaluoO stgl ;o nail ago oI aoltadns suatl utoa; aaa; Xlaidoad all daa31 (n 'atedaa pus uotltpuoo algelusual pool ui
Blaadoad aqI daa)i of 'Blaadoad agI uo pa14lututoo aq of agsem molls aou 9498m IttutttOD 01 IOU SIU73UOAOO aassgoand
•alg1sga; B go
a ao uoilaaolsaa aqI 9tuaap aopuaA aqI papinoad 'pa2uump Xlaadoad aqI ;o aisdaa so not pafldds aq
digs 9paa0oa '2u.4lam ut aaa2e astmaaggo aopuaA pus aasegoand ssalu us satusdutoo aousansui
OI ssoj ;O 03140u DA12 AS ut aasegaand •aopuaA g4lm pallsoda padoad 91S 2u1a9no3 samilod 11s ;o
1sutStao aq4 `~ull!•~ ui saaa2e astmaaglo a un 'pug ,aopuaA aqI ;o none; ut asnei0 •paepusi9 aqI utsquo3
I[sgs sai0![od agy anp uagm sutnttuaad aousan se oand •JosaluoO still aapun pamo aoug[sq agl usgl
aaout Iunouxa us ui a2ea3eo3 all eqs aopuaA Inq - ;o urns agI ut 'aopuaA Bq
paeoadds sag agI 193unansut-oa Jnogltm 'aatnbaa Xiut aopuaA us spaezsq aaggo go ad a28a8AOD papual
q pauoisezoo 92gump ao ssol IsuteSe paansut Xlaadoad agI uo 9luautaeoadutt agJ aas[ Bugs
•quatuXgd gons 2utmogs sldiODaa pueutap uo aopuaA 04 aaetlap of pus Jt u!
190aalut s,aopuaA uodn so Blaadoad aqI uo patnal sluatussasse pus saxel Ilu anp uages Bed of sasttuoad aassgoand
~~7~~~d z96 100
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER S
ADDRESS: Gv~ • FIRE NO:
LOCATION: , 1/4, % 1/41 SEC._Tc3 r~ N-R 1 W,
~
TOWN OF
ST.•CROIX COUNTY_
SUBDIVISION:
__/V//~_ LOT NO. 3
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 to
help with the cost of the 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 the St. Croix County
Zoning a certification form, signed by the owner and by a master
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. Certification from will be sent approximately
30 days prior to three year expiration.
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 NR.
Certification form must be completed and returned to th St.
Croix County Zoning Officer within 30 days of the thre yea
expiration date.
SIGNED:
I.
DATE:
St. Croix County Zoning office
911 4th St.
Hudson, WI 54016
BUILDINGS
NT Y, OF REPORT ON SOIL BORINGS AND SAFETY & DIVISION
INDUSTRY, P.O. BOX 7969
LABOR AND PERCOLATION TESTS (115) MADISON, WI 53707
HUMAN RELATIONS (H63.090) & Chapter 145.045)
LOCATION: SECTION: TOWNSHIP/)i~~7CRfY: LOT NO.: BLK. NO.: SUBDIVISION NAME:
SF '/4 SI~4 1 /T3o N/R vltor► W Richmond n/a n/a n/a
COUNTY: UYER'S NAME: MAILING ADDRESS:
St. Croix Allyn F. Johnston Bor. 64, new Richmond, Wi. 54017
DATES OBSERVATIONS MADE
USE PROF D C O S: A T TS:
NO. BEDRMS.: COMMER IAL DESCRIPTIO
~tesidence 3 n/a ~fvew ❑Replaca 7-6-92 7-6-02
RATING: S= Site suitable for system U_= Site unsuitable for system
MIS VENTONAL: MOUND: I_N-GROUNDPRESSE: SYSTEM-IN-FILL HOLDING NK: RECOMMENDED SYSTEM:(optional)
~U S QS []U S EAU ❑ S QU trench split level
If Percolation Tests are NOT required DESIGN RIf any portion of the tested area is in the n/a
plain, indicate Floodplain elevation:
under s.H63.09(5)(b), indicate: Flood
PROFILE DESCRIPTIONS page 28 DkB
BORING TOTAL DEPTH T GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED tzs I. H ST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
-11, 10yr3/2, L.; 11-26, 10yr4/6, sil.; 26-34,-
B 1 90 1.02.90 none >90 [r 1 90 7 5 r1l 4 co. s .
10yr3/ L. 112. 32, 10vr4
B 2 90 102..90 none >90 ,5yr[I/4, sl•; 42-90, 7.5yr4%4, co.s.
101.30 0-9, 10yr3/2, 1, 9-24, 10yr4/6, sil.; 24-42,-
6 3 S6 none >S6 7.5vr4/4,s1.• 1,2-86, 7.5 rG/4, co.s.
40 0- l.0yr3 2.,L. ; 6-Z4, luyr , si.I. ; 24-3Z,
B- 4 R4 99. none >84 r4/[. sl. • 32-84 7.5 rzI/4, co.s.
0-12, 10yr3/2, 1.; 12-26, 10yr4 6, sib.;
none >>84 6-3 ,
`''~0 6 3 mot. s_l, l0ATr5/4-10 6/31 • 36-44-
B- 5 ~l.~.
7.5yr4/4, sl-•; 44-84, 7.5yrLI/4, co.s.
B-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH
P- 1 4l+ none 3 6 6 6 <3
p 2 none
+
none
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. 99.23=upper trench
SYSTEM ELEVATION 97.63=1ower trench
,
` I
v0 i 1 v
~~~_`fir X11; a ( I
It:
,
,
Ploy.
JN
I !
.
I
i
I
'JV~~
I
eb,
1
L3~ . ! i I ~ Dp~r i N i
.
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
Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
TESTS WERE COMPLETED ON:
NAME (print):
Gary L. Steel 7-6-Q2
CERTIFICATION NUMBER: PHONE NUMBER(optional):
ADDRESS: 155+ 200th Ave., New Richmond Ili. 54017 22 715 246-6200
CST SIGNFf-. E:
DISTRIBUTION: OFirl,inal and one copy to Loral Authority, Property Owner and Soil Teter,
Fill Fife cr l?-6tttr. (B !r.~i;~21 OVER
STEEL'S SOIL SERVICE
t554 200th. .
Gary L. Steel
C.S.T. 2298 New Richmond, WI 54017
MPRSW-3254 (715) 246-6200
Allyn F. Johnston
SEkSE , S11 T30/i1 P18/W
Richmond, township 014-
(00'
#7"A 0
q40
T\ f f? 0
t
3C
(6Kn
41
G
Tv~ 1010
G y L. Steel
I RSw 3245
8-4-92
REPT131 RICHMOND ST. CROIX COUNTY ZONING PAGE 1
10:/12/92 16:08 REQUESTS FOR INSPECTION WORK SHEETS FOR: 10/13/92 AREA: MJ
-Activity: A9200374 10/13/92 Type: CONVSEPT Status: PENDING Constr:
Address: RICHMOND 1.30.18.13B, LOT 3, CO. RD. GG
Parcel: 026-1003-30-000 Occ: Use:
Description: 175630
Applicant: JOHNSTON, ALLYN Phone:
Owner: JOHNSTON, ALLYN Phone:
Contractor: GARY STEEL Phone: 246-6200
Inspection Request Information.,...
Requestor: STEEL, GARY Phone:
Req Time: 10:10 Comments:
Items requested to be Inspected... Action Comments - Time Exp
00012 FINAL INSPECTION
Inspection History.....
Item: 00012 FINAL INSPECTION
Dr.PARfiMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY; DIVISION
P.O. BOX 76
LABOR AND PERCOLATION TESTS (115) MADISON WI 3707
HUMAN RELATIONS (H63.09(1) & Chapter 145.045)
LOCATION: SECTION: TOWNSHIP/ICY: OT NO.: BLK. NO.: SUBDIVISION NAME:
SE '/4 S4 1 /T3o N/R i( ~E or) W Richmond n/a n/a n/a
COUNTY: UYER'S NAME: MAILING ADDRESS:
St. Croix All 1 F. Johnston Box 64, new Richmond, Wi. 54017
USE DATES OBSERVATIONS MADE
NO. BEDRMS.: COMMERCIAL DESCRIPTIOTES34slew IPR FFI LE DE CRIPTIONS: LATION TESTS:
~esidence 3 n/a ❑Replace 7-6-92 7--,5-92
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional)
CAS ❑U 2S ❑U <i1 S ❑U ❑ S DU ❑ S ❑U trench s lit level
If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the
n/a Floodplain indicate Floodplain elevation: n./a
under s.H63.09(5)(b), indicate:
PROFILE DESCRIPTIONS page 28 Dk-B
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B- 1 90 102.90 none >90 --11, 10yr3/2, L.; 11-26, 10yr4/6, sil.; 26-34,-
1 • 31-90 7 4 4 Co. s .
90 102.90 none >90 .-129 /2.1 L• ; 12.-32, 10vr4 6, si.1., ; 32-42
B_ .5yrl}/!F, s1_,; 42-Q0, 73yr4/4, co.s.
3 86 101.30 none >86 0-9. 10yr3/" I. 9-2G., 10yr4/6, sil.; 2.4-42,-
6- 7,5 [t/4,s1, • 2-86, 7.5yr4/4, co.s.
0-S, 10yr3 2,L.; 3-2 , 10yr , Si_-.;
B- 4 PA 99.40 none >84 r4/4 . sl. • 32-84 7.5 r4/4, co.s.
98.90 n-12, 10yr3/2, 1..; 12-26, 10yr4 6, sil.; 26-36,
B- 5 [ none >84 6/3 not. sil. 10yr5/4-1 6/31. 36-44-
7.5yr4/4, sl.; 44-84, 7.5yrLI./4, co.s.
6-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERI PER INCH
P-1 44 none 3 6 6 6 <3
P-2 f none _
p- 3 44 none 6 6 <3
P__
P-
P- _
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope. 99.23=upper trench
SYSTEM ELEVATION 97.63=1ower trench
1
+0 ~ ~ -
a
ti
p'
QT .~F~u l°S -
I
tN
t gym..
E
_1 _4
m I
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
Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
NAME (print): TESTS WERE COMPLETED ON:
Gary L. Steel 7-6-92
ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional):
1554 200th. Ave. New Richmond Wi. 54017 22.8 715 246-62.00
CST SIGN E:
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 02/82) -OVER -
~ J
INSTRUCTIONS FOR COMPLETING FORM 115 - S BD - 63915
To be a corn irate s<, our report must include:
1. Complete le I des+ ion;
2. The use section must clearly indicate whe is is a residence or commercial project;
3, MAXIMUM number of bedrooms or cc r use planned;
4. Is this a ne.° or replacement system;
5. Comply suitability rating boxes. A Si SUITABLE FOR A HOLDING TANK ONLY IF ALL
OTHER '(-r :MS ARE RULED OUT BASED )N SOIL CONDITIONS;
0. PLEASE r a abbreviations shown here for profile descriptions r :I completing the plot plan;
7. MAKE '1 ISLE (~€i .n ,ccurately locati ~ your test locations. Or ~ to scale is preferred. A
seal tay fie; to 'esired;
£ . y benchmar' ^d vertical eference ro' tare cIr arly rn permanent;
0. Corn ~e all a~ . G)pria?e s as to date s, addres, : od p est exemp-
tion, if appr
10. If the infer , ~h as flood plain, does not apply, place N in the appropriate box;
1 1 . Sign the for.. lace your current addr, your certification num`
12. Make legible r~ and distribute; as ALL SOIL TESTS I-.-- - -E FILED WITH THE
LOCAL AUTHC -TY WITHIN 30 DAYS " MPLETION.
ABBREVIATIONS FOR CERTIFIED SOIL TESTES
Sail Set: nd Textures Other Symbols
st - ar 10") BR
Col.) (3 - 10") SS -
gr - 0, ider 3") LS - Li r
- HGW rundwater
e - id Perc - on Rage;
need d kfv
fs Bldg -
is - sndr~
5ar Loam < L
wl - Lr>arn Bn
"sit Silt Loam BI
si - Silt Oy
I - Clay L n Y -
Say , r L R -
- Sii-, C I mot
- Sandy C`Ir;y ti,rj
sic - S ty Clay fff
C CC
r d - i
p
HIN _
Six ger ~r es
fo+ li- apcsal BfUi - - k
VRP no;. t
TOT NE:
cart ,
3y rectuest
private
r3 loot so /69
J? V-
fit G `DO ~ ~D /,2a /GA-.Zo J~L 3 NEtI.
486555
~
~ CERTIFIED S U R ~rf &M f10077
VEY MAP S~
LOCATED IN PART OF THE SE; OF THE SE4 OF SECTION 1, T30N, R18W,
TOWN OF RICHMOND, ST. CROIX COUNTY, WISCONSIN.
OzG loQ~ /i /G~ ~o 7/4.e-
..ter \ \ Y BEARINGS ARE REFERENCED
\ /r/ ^ TO THE SOUTH LINE OF THE
\ ry SE I/4 ASSUMED TO BEAR
~P9 ss° N89149'41"W.
N
23 ~0'' N24036 140 EF q
Z I °0 38F Q6.
9 13.54'
N~
00 e 2, ~ S
36,46 SCALE 1" = 200,
m D 0 M 93806 °
rn d I O S GOO 100 0 200
EI/4 CORNER
m LD/ 4 39 (1 SECTION I-30-18
LOT 2 4s 34 /g r ? i 1 CO. MONUMENT
lC Z 218,153, SO, FT. I~-~ SET \ ~V 4
I Z 0 D p 5.01 ACRES W eQCrr .33.00' ;
La \ v ~A \
l"D G1 EXCLUDING R/W 9S
N S
I r OD m l o o°23 h° \ 4 N ,
..pp 258, 108 SQ. FT. _ j (A LANDS IN RIPRAP, 2O \
ID O 5.93 ACRES O- G
J;, UNABLE TO SET. 4/4 48 F~ w y
INCLUDING EASEMENT o \
1....1 , `S0, 9
(Q ~A9O i rn 6" m
~
443.50' / ' 3s' 4e: 11 on
80 429'5°
1r S8904941" E 509.50' co LOT 4 TOIBEI ABANDONtil1.'tiX NI m \
ID O ACTU L POSITION o 510,044 SO, FT. p. In IC
1Z qD FALL DUMP N IT. RAVINE- 1 1,, ~ 11.71 ACRES 0 Ii7 ~iE gi a IZ
I~ LOT 3 EXCLUDING R/W m o? N I'U
I~ 217,8391 SQ. FT. A 11 ~'1 ° m jr
-4 5,00 ACRES ro 525,552 SO. FT. m fn m ID
`I N 12.06 ACRES 1 m I N
o INCLUDING R/W 30 Imo{. v r
0 1
f I~
J, y 1 yl m Q~ N Irn
~f ~ .I Cn iyr\)l 0) I~
8' I~ - - 778.89' - - I 33.00: 6 6.1 i 1Z
509.50 - 811.89' i 10
3821.39 41"W 1 N 89°40 41"W 1321.39 1 I ICn
---SOUTH LINE OF THE SEV4
- N89 49'41"W 2642.78' - - - -
SI/4 CORNER UNPLATTED LANDS
SECTION 1- 30-18 SE CORNER
CO. MONUMENT SECTION 1-30-18
FOUND 2" IRON PIPE
LEGEND COUNTY GENERAL NOTICE
• Found 1" Iron.-,Pipe with plug Each parcel shown on this map is subject to
stamped St..Cxbix County. state and county laws, rules and regulations
(i.e., wetlands, minimum lot size, access to
0 Set 1" x 24" Iron Pipe weighing parcel, etc.) . Before purchasing or developing
1.68 pounds per linear foot. any parcel, contact the St. Croix County
Zoning Office for-advice.
- -r-N existing fence
OWNER somg1j' , f-dPROjED
4~~
Lynn Forrest Jr. :
Rt. 1 Box 30F R J,( ~NAfIU92 ~•A tilUl X92
New Richmond, Wi. 54017 JOHNSG
SURVEYED BY: y i i.", r.- - 11 ,c, ; , ChG'
,X COUNTY
A & E Land Surve in ' M
;,rehe>r►sive Planning
Y g NY, .;Cril
P.O. Box 325 Zoning and
New Richmond, Wi. 54017 'rr + Parks Committee
If not recorded
in 30 days of
this instrument was drafted by Paul Gibson within
approval date
VOLUME 9 PAGE 2517 1pprovai shall be
null & void