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HomeMy WebLinkAbout038-1054-90-100 C, CD M r p v~ I p fA 4) co CD 0 4 0 C I c 'o - oc c m NN omm aU c ySo I mo I L -ID E 4) g y y y I w o A `-'O (D E a ~oLL ao U L CL 0 a) N y y umi 0 N y r c N c E _ m m z E°~ I z'o~> {L c Op'o U. C § E O L 4)a O O) N I c - 3 - ! v wmio€ o ~ a~ca> °c aci x a y ¢ N U I c d a 8 N r 3 3 z E I E _ o I o z o € o M M a oo a m F- N I I O I O z$ j C I C ao+ Z c O c O N F- ~ E '2 (D (D .5 1 ~~ww v OF Cl) a m I a y I y C o z°mz O I zmz N ~ p N C l0 E V N I y A 2 CL CL O 4 N N y d N Y ° c r G r ~ a a L• I c r C G r a a y z- X33 n a I °33 n a 0 I~ z 3aaa I ~aaa y a z z CV CA oN 'Una N I'a0 )M a f U) j ti ~oA I~~o LO CD C4 I c o o D I~ m a O y c m y C 01 N ~ U d y a~ ° I M y} (n io LO 0 O N 7 a~ N I W O p y y C y c O O L O E tCy U o o m o co LO rn C~ i Q 0) (n rO w C'S c 1 (9 y coo y E a CL E m oN~i o v 0. op 'f0 N C m m I _y C o o O d O t0 y v v I N FL- H C v ao 00 ` L O O O d' 3 t rabi mcl OD m Y 0) o 2 m m o y E E U • o U M M z_= 2 m o z N 2 N 0 ~ ~ I V I A a v~ m a EL L IL u IL g _1 A cia2 i0aic°~ 10v~ici Parcel 038-1054-90-100 11/30/2006 05:02 PM PAGE 1 OF 1 Alt. Parcel 13.31.18.234A 038 - TOWN OF STAR PRAIRIE Current XST. 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 - BREWSTER, JEFFERY P JEFFERY P BREWSTER 2153 CTY RD C NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 2153 CTY RD C SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 1.766 Plat: 2460-CSM 09/2460 SEC 13 T31N R1 8W PT SW NW BEING LOT 1 OF Block/Condo Bldg: LOT 1 CSM 9/2460 1.766AC Tract(s): (Sec-Twn-Rng 401/4 1601/4) 13-31N-18W SW NW Notes: Parcel History: Date Doc # Vol/Page Type 03/12/2003 712956 2169/219 QC 944/324 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/05/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.766 28,900 164,200 193,100 NO Totals for 2006: General Property 1.766 28,900 164,200 193,100 Woodland 0.000 0 0 Totals for 2005: General Property 1.766 28,900 164,200 193,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 134 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Id j 480685 CERTIFIED SURVEY MAP Located in part of the SW; of the NW'-4 of Section 13, T31N, R18W, } Town of Star Prairie, St. Croix County, Wisconsin. OWNER SURVEYED FOR SURVEYED BY George Birkholz Jeffrey Brewster A & E Land Surveying 2175 32nd 2154 Cty. Rd. C P.O. Box 325 New Richmond, Wi. 54017 New Richmond, Wi. 54017 New Richmond, Wi. 54017 Tel.(715) 248-3382 TEL.(715) 248-3542 Tel.(715) 246-4319 COUNTY GENERAL NOTICE: Each parcel shown on this map is subject to State and County laws, rules and regulations (i.e., wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel 'c6~tact the St. Croix County Zoning Office for advice. LEGEND 19 Found St. Croix County Aluminum monument o Set a 1" x 24" Iron Pipe weighing 1.68 pounds per linear foot. Highway deed in volume 622, page 108. F ~ MAR 191992► SCALE 2 IAReg sto 01 Leed Ll 9 I =loo NW CORNER SECTION 13-31-18 SL Croix Co„ W1 D 50 0 too N 70' UNPLATTED LAND N - , 377.66 N 83° 29 40 E 0 311.95 _ 0 IC 65.71cn Z ~°am ~N Iz m N ° 0 1 "p & Nn W Ir Iz 60' 60' IiD:!0 it ml 0 0M c' L 07 ( 124 46' 1-1 IDlmom in I~ ~DRiVE_ N87°28 II W I~ 0 I-1 ON -4 I~ ~O M EXISTING IR1 I._.1 y~r n TRAILER _ IO CZ) F0 IZ TO BE REMOVED o IM2 ID omz m fV y Im N me jr- Bearings are refer- wty-n ~ A I _ Z mo ID rri .4 I rv 0.Z enced to the west ID I~ N i o x I I Q line of the NJV114 m _ tv w - I I;n assumed to bear IZ .4 rn . too, N0001'18"E. I~I I 60,00 189. 13 60 60' N89058 42"W 249.13 UNPLATTED LANDS LOT AREA C I 76,940 sq. ft. (1.766ac.)INCLUDING R/W 62,161 sq. ft. (1.427ac.)EXCLUDING R/W o~ WI/4 CORNER 4~~oottoaree~s4 SECTION 13-31-18 LU 010 IN 40' CON F. r a` > s' io, •.MM• , % This instrument was drafted by Douglas Zahler T7,.1 9 n___ 2z" Parcel 038-1198-80-000 1 1/30/2006 05:03 PM PAGE 1 OF 7 Alt. Parcel 13.31.18.1052 038 - TOWN OF STAR PRAIRIE Current X I 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 - BIRKHOLZ, GEORGE M & MARION V GEORGE M & MARION V BIRKHOLZ 2175 132ND ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 2155 CTY RD C SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 1.664 Plat: 2304-PINE ACRES 2000 SEC 13 T31N R1 8W SW NW OUTLOT 1 PINE Block/Condo Bldg: LOT 01-1 ACRES Tract(s): (Sec-Twn-Rng 401/4 1601/4) 13-31N-18W SW NW Notes: Parcel History: Date Doc # Vol/Page Type 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/12/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.664 29,600 8,500 38,100 NO Totals for 2006: General Property 1.664 29,600 8,500 38,100 Woodland 0.000 0 0 Totals for 2005: General Property 1.664 29,600 8,500 38,100 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 0.00 0.00 Total 0.00 T. 31 N-R.18 W. STAR PRAIRIE POLKt COUNTY yy Gesrcc J • 7 > rte. Luehman ,a C !s. yenry iase W C ®l1~ o C h e sn.T,es s Napp Lars an 69 6s ~Q • y y \ W y C' _L7ou91as ` g Q'0 sr. ae c s J tl l a tl~ C•0 /zo. Bb h y W C,~ -Dona/d o o~tlC~ i€ `s on a ~ti @ o vr~ av eM~/i:> Kats. R:~a~d aJ(n CEDAR L. F~ b~W c.tE. 44 o^ C N h`CO CJ~ F•h `9 wC° o//y WUJ •/Vc/son ® v bz.s a . 0'O~\ J~~ tl~ Cj~ zb/./z o ~ Oh M ~ QI 0aCI zoz m i` C0 m ~v v zC~ m o 0~ `v /zz/9 ® C ) t o L 2tl ~svFb ° a 0 N J 0 /3z ~r✓//e )Y y • a o R~'a dd- " s b O•' m~ /2uss Lueck v`0 CAL '3. 4bWm sa poi ~'7 Robed- ~tl m~ ^Cm`TA ® • cS1 ohbcen ® v~ l C x 0 ,posett¢ • l '1 'V'~ D S ~J .l 40 /S!o "=9`~a~d /bo i~Ne~~Q~~etl~ ~7 ~N MdC.e jbtl ~~~W%SOn W ytltl Ne/s ® Mu//an tl~ F ~ ~ ~ ~1~ ~ ~ [ceJ tl~ ~~C /zb r ~ i / d H p Oczo ~ RaAd~ n 9~l ~E / Ft kOfE Norman HUN ¢o~ atio Y o Gene t H/ a ..F-° ¢o eraci Leeek van re I:~. " ~ .u wW $h Ne/son ::,ez/a o c5u// wed - C n 4 79 /mer~4 Af P,IRIE 0i)~bN y/~~y "^C° ° ® Lorra.r~c o f9/ice ~o,) m tlo~0 °"G 27R ZS `CCV ~ Ea / 6d iiYy Ne/soo ; °ok .q ~ ry Lo/son ~ ~ ry~ ~ S~ ~n `-'tasoeo V`~cl oZ on w. ® a~+' /4soz as • FW O i ~ C ~ex ao a?rte Z~~ B° o MrL • a 0 ✓7/aye., • Fein ° ° eta/ , ~j 'V1 9_ -C N~ I ~/775 - eas- ~ Ia/ljlna /bz.9/ z16.7B • P `um ~~e ~ 4O - • P es c Re. tL' ~iv I-- ~ ne ~¢hr rs I F„c s E he/ 40 m • p L " f1av / erson /bo CC °rx d o /il ~ew- J Ca//5 n C V W ~r9i/ F Ma Gary e.-z° ya~rei/r. I K i Q ¢o ae e' sow vo s 5°n a9etonBs • y.~ iu ,ck /oi3/cr Is. o~ er ¢ c 4o B ,y,r., lson sa..s> : eo on .re G. o g. t°~ • 4~Patd • Z~RVid GHARMONr NaLs c SQUAW L• F H.~d - R'ahacd r/ Q,^ C F/an- e Pcs I Nemefh 9ndecs os C~roig~ Giese ® yi~ f°a e/aP~ Ha lssan tl /20.22 Lv~ '90' .QBo ~ 3 80 jMa~orr ~ tl ~ /zo 5 'C d 40 -eo • _ by ,g~.iea .Bii.Eho/3 ®n/v Mr tors .s.o wn.a; ~o NoJ ~l~P¢u/¢ m r e%son • /60 ,s.t .Bettesocc w ~ c. 9 \~F,~a- 4o y /,TZ ® L Fa s"0 s Ma 3¢ n JER I 7e has. t vanes ,ss~n,~ Be// I .W ,o fD.i ¢o n6ma ~ y "o M/fnn 3.P / ~ a ~ 4~arrc W,eraeme'c'm,n ~ ~ ~ L E o Le;ems E9 L Inc y0 Sa • a O Dosede/ zoo-b¢ hnsom Fa¢rson B° 0 79 /ZO 4o I ~n ,e a. nn ~c/•m¢ ~ ,eob-t C1~p ,3es e!- ° C " Wm y ~'o oases; etux ° ~x 6ovHC R.Bo U ca~.s 35 b ~ J1 gfM • De.,n,s Esfher H1p a y f Guci//c Le c/a e.vice bo ,sa "roB wsM b y Davi /yc/ n ld fo v c prton V r Geona Lei ~o reen e a ya a7 `l 3 o B 7 785 fi. c.a .9ai//¢~ea oden n/eum¢¢n ~ero one ecti`- Y h~/•sti/~e f C¢u/ /4S 4° /oo EfM R'~ o ,~1dei •a5 m tl B oe,E 40 a ¢ s s s H ~ R.a. F~ 40 > aCa • cStra d s N • W Ma/9 g~/ `Ctl tl^ W v mce e cvrrat ~ 0 0 vX'~ a ° 0 ,Pobarfi h'a//u~d T¢/m 9e ~ ~ ° enway E arson ~ U 0 C~~ s C/outic.- T C5°10 `4 Ga¢~ n s 0 7 60 • Bo 0 ~t v G• 70 o h oo+ 77 h°Y 32tl `n 6 bo bd96 SB R tl z~ Ein er sa CO H Dance// C x r KH. Dona/d BO C y Hahn 4 Lester vU O~ q C nfh.+a. U ban ~Pob t ~7 0 a ~9 'V p to m'Od y .`~Fo//e !~'erma.n -a C: Coo.E CA fJsoi nd T i. Bo ,zo ,6 w~° /z77S zF ~v~y 4 Y i R tp H. l•0 R 7 0 John J 1107 011 b m NeRn Laces YGynd¢ L. • 4 E/asne Rober/' 1 ~ sabe/ RUdO/~Oh '~a~'¢/G!! 'tea/P a /`7¢ y Cp JFR i9 ~G'r d F Maxine 01 F a Pam/son ~l,er /moo n53 P¢cht tea/ oa vo/Eacr 79 BO uvl~ s. Omar go Bo M u//on F it3 C u i /yo Mc P¢u/ G~ z37 sRoa~ct Larson gv .fKC. rr 12 on 5-4"9 7asePh Lc..-,Dyne , s o Charm/es .9 /zo s:n- Fls / cd W W" 63 B 7e-e 2. ¢yd h'a/.;erson tlr 0 9strom CO'Q Lf c Bo v Keifh 95 Ba ~ /30.37 ` ' t . e. Tho csa~ u. 3rd ack a a Joe Franco/.s B76 + ¢ .N. ~Ma Ge//¢ .3.i bl 6 cu B/RO OR. J siCe ~ac.Ees ylarp tl Thorns L. 9 ~ oc,rd - ~ beet gD is /amcsra O.phO ~ ,8 row zsz./ yo Maitraje¢n nt 20 /2o to ~~'0 ¢i kPS eq ~ltlQ Loo /oo evS~Co. V.~ zoo ~ //B.2S ~ l o p ¢ ° ~•@I R Q . • i// ~ f3 hQihs ry UARRY• A n 9 VN l J ~wiF9K\ be'c fyo \1 ;`Cln " ~ P u o S smite I ~ ~u ~~a ~ °a ~ ~;eN_ po CC i n~uoo~so. / Oa o tl\ 3 ARRY La.,o:,rcz RO /zo titl A7~F/E 6 i~ - C C ~ - % o . l~ ooh ° Names f ~ 0 8a ^ • N ~w~ 0• ~vW ' .,C~~ Vo%t' ~ y, ~ 80 McLeod ~tl y.o 7 u M z6o Qy ~ n L. ~ 64 ones ec./ m ¢ FCaro- q-o 40 moo- Q C t /eo q •Y ° cSf. G'ro/x - ivasF N de C y` v ph- .Q o ~ RaJ £ C ° y Q y 0 /bo flea /th Genstar- ° ~ /2'. ? n ~ ~ 4a'Yat @ l P-a y- a so ar a b Fag /en acy ~C Jso•• U io° Jose h ~ ~h ~ sse// /sb coed Nef y JZ T R Ma~ ~o~ o X F/¢~d ick ct.~x 0 u 1 >o a.o s. A K 3 R-v¢ d '~tl~` i~`4~ oo N ~O Er EW RI 3 ~ ° W am E l pan R bFrt to /6B Jo hi> .333 Q\ Fs vis f Ce co /ia s _ ~e yBk ~ c dy aC B~ po INE ~~~hh:' de T Y Wayne /s/ E00 H' beat f W.TDoar d bC0 61 • a s,anu ,eo[ vt m S> a¢6 4 v~ Lau a ~7i.; et¢/ 3 CU 65 m. Ra /c9h, aK xnrs_ . fCaro/ ~ //oo ~ .Pebh¢ .mm a/ BS 11 r m: Inc 7872 vas °n 64 Dus eo a eoa a .,°n e _ StCroir 'Ay --SEE PAGE 63 G/s x, ©/96B ,Poch o d Map Rev /779 I S££ PAGE 53 D'S SKOGLUND OIL CO. BERNAR Phone: 246-4767 Schwan Plumbing J NORTNTOWN New Richmond, Wisconsin Heating & HIGHWAYS 64 & 65 NORTH 54017 Hardware SOMERSET NEW RICHMOND, WISCONSIN 54017 Sales - Service & Repairs DEEP' ROCK Plumbing -Heating & PHONE: 2A6-2236 O Phone: 247-3764 Pump Work * Somerset, Wisconsin PHONE: 248-3760 T W I N CITY Cili ti1.F.R Bulk Form Delivery Star Prairie, Wisconsin PHONE: 439-2905 'yi Gas - Fuel Oil - Diesel • AS BUILT SANITARY SYSTEM REPORT 'R CZo2e TOWNSHIP -SEC.~ TN, R~W .O. ADDRESS - , ST. CROIX COUNTY, WISCONSIN. 3DIVISION LOT LOT SIZE . PLAN VIEW -Distances & dimensions to meet requirements of H62.20 t SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ' Y"Jws.( ~ 3,, ~y 70 I - 'TIC TANK(S)_ MFGR. CONCRETE STEEL NO. of rings on cover~~^ % Depth 6 DRY WELL INCHES NO of width length area no. of lineswidth length S' area de th to top of pipe I'' vREGATE ~ .={K RATE AREA REQUIRE ( S' ' AREA AS BUILT Isciaimer: The inspection of this system by St. Croix County does not imply complete I.=pliance with State Administrative Codes. There are other-areas that it is not possible inspect at this point of construction. St. Croix County assumes no liability for item operation. However, if failure is noted the County will make every effort to zermine cause of failure. _ EASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYST --INSPECTOR ATED1b_2 PLUMBER ON JOBS LICENSE NUMBER Z REPORT OF INSPECTION-INDIVIDUAL SEWAGE SYSTEM San iatan y Penmi 39 State Septic NAME Township Sa~. Cno.ix County Locaat.ionS o6Ad4i., SectionAT'31N,RPSW SEPTIC TANK I Size gattonz Numbers ob CompanZments Distance Fnom: Wet 6t. 12% on greaten scope Bu.itd.ing 6t. Wettands ~ . H.ighwaaten = 6t. DISPOSAL SYSTEM Distance Fnom: Wett 8 O bt. .12% on gneaaten scope ^ 6t. Bu.itd.ing •S~ 6t. Wettands Fat. H.ighwaaten - bat. FIELD DIMENSIONS: width o6 atnench 6t. Depth o6 rock below Cite 'Z---in. Length o6 each tine-3/4p 6aF. Depth o6 rock oven t.ite 'r-, in. Number: o6 tines Depth o6 at.ite below gradee?.in. Toatat tengath o j tines ~6 t. Sto pe o6 tn.ench in pen 100 it. J Distance between t ines__4L__jat. Depth to bedrock Totat abs onbtion ateajAL~ 6t2 Depth to gnoundwaten 6t. ~160 _ y Requ.ined anea 3 6t2 PIT DIMENSIONS: Numbers o6 p.i Gnavet around pits yes no Outside d.iam e t. Depth below inlet 6t. 2 Totat abs o bt.ion anea 6t z A Area nequ.ined 6t2 rn 'I INSPECTED By TITLE I I I 197 APPROVED h4d DATE REJECTED DATE 197. f i f I 4 f E EH 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES E DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION STS LOCATION: ~%'Aj/a, Section/3 &N, R~(or W, ownshi or ~y 7 W Q& Lot No. , Block No. County s -li r' k Cb~visn Name Owner's Name: qE~ e Mailing Address:afo k Utl 4l L TYPE OF OCCUPANCY: Residence No. of Bedrooms Other I EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS - PERCOLATION TESTS SOIL MAP SHEET 3~~ yU SOIL TYPE PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P ` P-;3 3cd 1:3 ~ -3 icy 3 ~z SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) 8 ;1V ~rV~ 7 7 9 A 7 'IBC r'~i / r - •x'r' / d ~ S' ~ Z (0 c Al 6" 7 i3 c, *J- - , ;7._~ (c v' 7 a^rS Bt`s rr-9~ 3y- ~(p r$ . NQU (e PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet ~u' blear as. Indicate number of square feet of abso needed for building type and occupancy. WW/ ca or distances. Give horizontal and vertical reference p n . Indicate slope. o E C- ~ ~ 98 ON r ti G t 4F i 07 o IN ► j '1- tN S r qV 00.- U I Nil 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 location of test holes are correct to the best of my knowledge and belief. / Name (print) --Pd )V Iff 1. fk~ Al Cy/ t C KS all Certification No. Address Name of installer if known r CST Signatu COPY A -LOCAL AUTHORITY PLB67 State and County State Permit # - Permit Application County Permit for Private Domestic Sewage Systems County lx: 2,1 *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: B. LOCATION: Section a, T ' R_4,6- (or) -W.Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township . &,4c C. TYPE OF OCCUPANCY: Commercial *Industrial *Other (specify) *Variance Single family_ Duplex No. of Bedrooms No. of Persons_ D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder_YES_kNO # of Bathrooms Automatic Washer YES NO Other (specify) E. SEPTIC TANK CAPACITY '(]Q(-Total gallons No. of tanks *Holding tank capacity Total gallons No. of tanks New Installation Addition _ Replacement _ Prefab Concrete *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2) 3) --Total Absorb Area sq. ft. New Addition Replacement *Fill System Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches Seepage Bed: Length,5,2 Width Depth Tile Depth--'7-/" No. of Lines Q Seepage Pit: Inside diameter Liquid Depth Tile Size Percent slope of land ~ow Distance from critical slope I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Certifi S 'I Tester, ' NAME C.S.T. # 575 Z ~ Zpnd other information obtained from (owner/builder). Plumber's Signature MP/MPRSW# S Phone Plumber's Address - Pe A A4 PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). % y . E E 3 f 3 ~ E 3 € r 1 3 E a _ - W... , y v 1 € E r - - - r i S € a ~ m3 j € Do Not Write in Space Below FOR DEPARTMENT USE ONLY P la - Fes Paid: State nT1 Countys - Da - v Date of Application Permit Issued/Red (date) --Issuing Agent Name Inspection Yes~No Valid* Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 6/1 /76 '-Vt7Co'niiS partme~io'IndPus'ryRIE 13. 31.18.713 SW~NW HWY. C., LOT County: La~orand Human Relations PRIVATE SEWAGE SYSTEM Safety and Buildings Division INSPECTION REPORT ST. CROIX (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 171458 Permit Holder's Name: ❑ City ❑ Village (k Town of: State Plan ID No.: JEFFREY BREWSTER STAR PRAIRIE CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 038-1154-90-000 TANK INFORMATION ELEVATION DATA A9200223 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV- Septic Benchmark D Aeration Bldg. Sewer ' F Holding St/Ht Inlet TANK SETBACK INFORMATION St/ Ht utlet TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic >JPZ~ NA Dt Bottom D NA Header / Man. Aeration NA Dist. Pipe Bot. System Holding E _"Ii~ PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft Forcemain Length Dia. H Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. O Trenches PIT No. O i Inside Dia. Liquid Depth DIMENSIONS .5 DIMEN I N SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Ma cturer: SETBACK ~ INFORMATION Type O F. CHAMBER ~ ♦ Mo a Num er. ° v OR UNIT ~ System: Ilk DISTRIBUTION SYSTEM Header / anifold i ution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length ia. Spacing SOIL COVER x Pressure Systems Only x Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded / So xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) I 3 13 02 ~P Cam. c~ • > ,T u~ ~ . ,~'-e ~r - -4~~ ti b N.R. Plan revision required? ❑ Yes P'110 [JAI Use other side for additional information. q2~~:~ 5~---I A SBD-6710 (R 05/91) Date nspector's Signature Cert. No. 1 ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: iLHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY STATE SANIT PERMI # -Attach complete plans (to the county copy only) for the system, on paper not less than 11 /n / ~ d 8% X 11 inches in size. Check if revisio toprewous 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 Te 4e Bt- C.. Y4 AWN,, S 13 T3(,N,R W PROPERTY O NER'S M ACING ADDRESS LOT # 9- Cti5 1/tr~ . CITY, STATE W/ ~S ZIP CODE PHONE NUMBER R CSM NUMBER v. o II. TYPE OF BUILDING: (Check one) ❑ State Owned VILLAGE ; s _ NEAREST ROAD I CITY ❑ Public L~J 'l or 2 Fam. Dwelling-#~of bedrooms 2 PAR EL TAXNUMBE O 111. BUILDING USE: (If building type is public, check all that apply) a3 `f 03 _ l05-v-- 9,Dliz 1 ❑ Apt/Condo 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 130 Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ❑ New 2. ❑ 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-Pressur' ed 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 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: LLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ff.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) F6. ELEVATION E 7U !U (/OFeet Cz. Feet VII. TANK CAPACITY Site in gallons Total # Of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New istin Gallons Tanks Concrete st @d glass App. Tanks Tanks Septic Tank or Holding Tank Tank/Si hon Chamber .-*69- El 0 El L1 1 1:1 E] !7e SPONSIBILITY STATEMENT undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plu ber's Signal : (No Stamps) MP/MPRSW No.: Business Phone Number: 0.35' Plumber's Address (Street, City, State, Zip Code). IX. COUNTY/DEPARTMENT USE ONLY 4❑ Disapproved Lary Permit Fee (Includes Groundwater Date Issued Issuing gent signatur Approved Surcharge Fee) ❑ Owner Given Initial Adverse D ermin tion X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Pib-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety 8 Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Yourrsahitary 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.sysSems must be properly inaintained. The septic tank(s) mustbe pumped bya licensed pumper whenever necessary, usually every 2 to 3 years. 6. - If you have questions concerning you„-9nsite.sewage system, contact your local code administrator or the State of Wisconsin, Safety &,Buildings Division,.608-266-3815. v y To be complete and accuratethis 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 aJ15.form; andELall sizlpg>information., GROUNDWATER SIIFICHARGE 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- wat6F contamination investigations and establishment of standards. SBD-6398 (R.11/88) a 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 P. 6ct'_Z'LP Location of property SOL)1/4 YIW114, Section , T 3( N-R1&W Township S:66~ kofr x_ Mailing address 2,1 _5`_5 40 G Address of site Subdivision name_ C-!Sb!Y L/ 9 /-39. aW6 1) Lot no. / Other homes on property? yes ~No Previous owner of property _CPng"L Total size of parcel Date parcel was created 12 /9 199, Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)? Yes _9_0_ volume and Page Number 3 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 ~WZZ5 te office of the County Register of Deeds as Document No. , andthat 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. a r of applicant Co-applicant 6- /7 12 Date of Signature Date of Signature { F low IT- Ly MTUMM TO aAlllril~ ' OtarMlf. Tax PW No: T f of 4fic 6W 00, . F} e of on /s, T3 ~W, lS~/ °O' 4, vo now- ON40. r r. 4 i. a, w t ti NoR~Mattl prop" Pat aatgtl, 3 h ~li0w to day Of 19 MAL (SEAL)S riorl"1 V ; Z- ACKNOWLEDGMENT ° AUTHENTICATION r STATE OF WISCONSIN ss a t)1eiatdratsl - - 4 County a1ltMhtf thro day of _ . 19 PersO ally came before me this_ _ _ d" at 19~- the above nnMtl 4LE MEMBER STATE BAR OF WISCONSIN ~11f01. `T - to me known to be me person .L~ - foregoing instrument and acknowledq authorized by 4 706 06, Will - 5tata ~ ~ .tee>i ► TNiS M5TRJMfNt XWV Sft M1~f FEU 9't w.. - _ 4ioU►y Public, My Comm~sioonn is POMOr+ent. IH p1p1. tM1a Ntlbo Tail P ►rjtEtltt: I 480685 C E R T IF I E U R V E-Y-----M.A Located i part of the SW-,` of. the NW-4 of Section 13, T31N, R18W, Town of Star Prairies T-Vw~or~sin. OWNER SURVEYED FOR SURVEYED BY George Birkholz Jeffrey Brewster Ca,*eP, A & E Land Surveying 2175 32nd 2154 Cty. Rd. C P.O. Box 325 New Richmond, Wi. 54017 New Richmond, Wi. 54017 New Richmond, Wi. 54017 Tel.(715) 248-3382 TEL.(715) 248-3542 Tel.(715) 246-4319 COUNTY GENERAL NOTICE: Each parcel shown on this map is subject to State and County laws, rules and regulations (i.e., wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel cogtact the St. Croix County Zoning Office for advice. LEGEND Found St. Croix County Aluminum monument o Set a 1" x 24" Iron Pipe weighing 1.68 pounds per linear foot. y FILED a Highway deed in volume 622, page 108. MAR 191992► JAMES O'r,•~,,;NELL 9 SCALE r' =loo' N W CORNER Registol of Deeds SE N11 O SECTION 13-31-18 SL CroixCo.. so o loo (W_D LAN _S N 70 UNPL'ATTEo N 377.66 cn N N S-30 29 40 311.95 _ 9 IC 7.5 71~oo N I'p znm ~ri Iz N IC y 0 N I W Ir - 1D '0 M 00 IZ 60' 0 01 m L OT I I~ I ° m 124.46' I--1 If I m U ~n N87°28 I I--~ ID lm0m vs ODRIVE I W _ IrTI 1-{ n pin -I I~ ~p m EXISTING I(] Dc'I I~ Nit- Z r*1 __n TRAILER IZ TO BE REMOVED o 10 omrn m N M M.c _ ID Bearings are refer- ° N° p I Z n_ WS CID - o IZ enced to the west Ir g N-+ A I~ N W x.; IQ line of the N:?dl14 ID -m IN-g IU) assumed to bear 1Z1 rnz m Ioo' N0001'18"E. 60.00' 189.13 I~ 60 60 N89058 0 42" W 249.13' UN PLATTED LANDS W LOT AREA co I 76,940 sq. ft. (1.766ac.)INCLUDING R/W 62,161 sq. ft. (1.427ac.)EXCLUDING R/W 14 CD WI/4 CORNER Aa~y06t39~R~~r~~~ -~ZSECTION I3-31-18 F. sr > 1.77 6 A CA d ~ o N ,*sleet 2W.'41 This instrument was drafted by Douglas Zahler i~ C. -S Vol. 9 Page 2460 S T C - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER of (e,I.~STX~Y ADDRESS FIRE NUMBER CITY/STATE ZIP PROPERTY LOCATION: 1/4,Q~1/4, SECTION 1_, T _N-R_]$_W TOWN OF , St. Croix County, C5M W. 9 V LOT NUMBER_~. Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents maybe 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: 7 - 7 Z St. Croix co. Zoning Office 911 4th St. Hudson, WI 54016 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, G DIVISION LAdOR AN P.O. BOX 76 HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 (H63.090) & Chapter 145.045) LOCATION: SECTION: WN /MUNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME: 4 4 C U TY: OWNER'S/BUYER'S NAME: MAILING lose / D X t e Y~ulr /J a_ v? <<J O USE DATESOBSERVATIONSMADE Lt -2- ~q NO. BEDRI: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: ER OLATIONTESTS: $Residence ❑New Replace ~oz RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) SOU QS ❑U ® S DU ❑ S ZU ❑ S ill a If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5) (b), indicate: ~!a S Floodplain, indicate Floodplain elevation: 0 PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 1,2 B- G B- e/ s ~ 7 B- B- - s- r~ PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH P- G P- G 3 P- G P-_ P_ PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION /X1~~%- ,~y5~~~.• p _ _ a g ~ 1 E ? I~ ee [ X9,02 ` _ _ 1 . © to t //on _ r , 0 _ - _ 3 I i = t 40 f I ~ 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specs onsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (pin • TESTS WERE COMPLETED ON: r4/ r a ADDRE CERTIFICATION NUMBER: PHONE NUMBER (optional): r~ A?V_& ep_GC,! dv ~l 6~'~~/y 3q ;r CST SIGN U DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) -OVER - INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 5395 To be a complete irate soil test, your repot include: 1. Complete legal 17; 2. The use section m rly indic er this is a residence or commercial project; 3. MAXIMUM numt of ?redrooms or rmercial use planned; 4. Is this a new or r, nt system; 5. Complete the -ting boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTE;. ,E RULED OUT BASED ON SOIL CONDITIONS; B. PLEASE use t C Deviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A F diagram ac<;irately locating your test locations. Drawing to scale is preferred. A separate ' b~: used if 0-- re_ 8. Make sure ~imark and . ical elevation ref 'ice point are clearly shown, and are permanent; 0- Complete all =te boxes o dates, names, es, flood plain data, percolation test exemp- tion, if ap, 10. If the ~-fo ~as flood 1 elevation) do apply, place N.A. in the appropriate box; 11. Sirn -'0 ,r, ar,Li your cur Press and yo", ficatiorz number; 12. Make cc- C;stril z(luired. ALL )IL TESTS MUST BE FILED WITH THE LOCA§ .`AUTHORITY : `ITHIN 30 D (S OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS and Textures Other Symbols (over 10") BR - Bedrock Cobble i3 - 10") SS - Sandstone {gavel (under 3'") t Limestone *S - Sand l-?< High Groundwater cs Coarse Sand= - Percolation Rate rned s - Medium Sand - Well fs - Fine Sand Bldg Buildinc. Is - Loamy Sand j - Grea',_ - 4sl - ~ndy Loam Less Thai) +I m Bn °°owr *sil - Loam BI - ck Gy - Y - y low R Red uy mot - MottlPG Clay w1 Clay fff faint C,, y cc - r on, coarse Peat rnm medium - Muck d ct p _ I - > ninent HWL - High waft r ' feral soil textures surface wclig,iid waste disposal BM - Bench Mark VRP - Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department inay reeluest verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a permit. The sanitary permit must be obtained and posted prior to the start of any construction. ~-dre, ca l J®h c-~ /Cno i #well, NeW J y k w t 10