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Home My WebLink About038-1055-80-200 Q z N Co CIO O ° ey ao m 0 1 i A ~ I G I II' x N O I o z N 3 m LL C (0 O 0I Q ~ co 00 z E o z It d m M H w a m c 0 o z v' c c_ m Z o d c o N H N z E 72 2 M ` N O 7 "Q N O 0 •N ~ a ~ ~ I 0 Q z co z w N z co 4) N H t0 £ N O) i y ~ y m d a CJ c c G a a c 0 N Q O E H H F- 0 o U N Z LO > 4. t~1 I Z o O O O 3 a a a m a z C14 N } M 0) ~~l Q O N O O L U) LO E N CL N U) a aNi m fry _ CY) 6 N Q m Cl) CD O H O 0 m H c 3 r.+ N o o o c E LO co th 0) E 10 N Y B N Q t o 00 f0 C O N 3 N • co Cl v rn N E m .m L Q cn o fn N O y V ~ a I as a . • c a m •2 m Parcel 038-1055-80-200 01/06/2006 07:57 AM PAGE 1 OF 1 Alt. Parcel 13.31.18.239D 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 - OPDAHL, EINAR S & LUCINDA M EINAR S & LUCINDA M OPDAHL 1330 210TH AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1330 210TH AVE SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 3.600 Plat: N/A-NOT AVAILABLE SEC 13 T31N R1 8W PT SE SW BEING LOT 5 Block/Condo Bldg: CSM 9/2467 3.60 ACRES Tract(s): (Sec-Twn-Rng 401/4 1601/4) 13-31 N-1 8W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1070/628 WD 07/23/1997 946/630 2005 SUMMARY Bill Fair Market Value: Assessed with: 119007 200,200 Valuations: Last Changed: 10/13/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.600 38,000 158,800 196,800 NO Totals for 2005: General Property 3.600 38,000 158,800 196,800 Woodland 0.000 0 0 Totals for 2004: General Property 3.600 38,000 158,800 196,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 130 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, 11 CC DIVISION LABOR BOX HUMAN REDLATIONS PERCOLATION TESTS (11J) MADISON W 53707 (H63.090) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/I k RM§XITY: LOT NO.:BLK. NO.: SUBDIVISION NAME: SE 1/4S11/4 13 /T31 N/W8xF (or) W Star Prarie n/a n/a n/a COUNTY: S BUYER'S NAME: MAILING ADDRESS: St. Croix Bruce Zacharias 1R.#3, Box 71R, Osceola, Wi. 54020 USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE DESCRIPTIONS: E ER OLATION ®Residence 3 n/a New ❑Replace 1-28-92 3-18-92 TESTS: RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND PRESSURE:SYSTEM-IN-FILLHOLDINGTANK: RECOMMENDED SYSTEM: (optional) CiaS ❑U CS ❑U ~S ❑U ❑S ®U ❑S ®U trench 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: n/a Floodplain, indicate Floodplain elevation: n/a decimal' PROFILE DESCRIPTIONS page 12 BxB BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 1 7.25 98.96 none >7.25 .75bl.1., .75bn.s.l. 2.00bn.c.s., 3.75bn.m.s. B 2 7.00 98.96 none >7.00 .67bl.1. .58bn.sil., .83bn.l.s., 4.92bn.c.s. B 3 6.92 97.56 none >6.92 .83bl.1., 1.08bn.sil. .50bn.l.s., 4.50bn.c.s. B_ 4 7.33 96.26 none >7.33 .83bl.1., 1.08bn.sil., .58bn.l.s., 4.83bn.c.s. B- 5 6.83 96.16 none >96.16 .83bl.1. .50bn.sil. .67bn.l.s. 4.83bn.c.s. B- decimal' PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER XXXXX AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIODS PER INCH P-1 4.00 none 3 6 6 6 <3 P-2 4.00 none 3 6 6 6 < P-3 2.60 none 3 6 6 6 <3 P-_ P_ PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. De 1 the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings he. ~r~c cent of land slope. Pry SYSTEM ELEVATION 94.96 N ST I ~ ~ ~ ~ f r E € , i S10 k T_ i j € 777 V 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 3-18-92 ADDRESS: CERT F TION NUMBER: PHONE NUMBER (optional): 1554 200th. AVe., New Richmond, Wi. 54017 115-2#6-6200 /117 / 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 - SRD - 6395 To be a complete anti accurate soil test, your report must il')Clude: 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 3, MAXIMUM number of bedrooms or cormercial use planned; 4, Is this a new or replacement system; 5- Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; B. Pt SE use the abbreviations shown here for writing profile; descriptions and -r- ircl the plot plan; 7. EGIBILE diagram ace itely locating your test locations. Drawing to s e is preferred. A n^,y be used if desiB, '-:enchmark and elevation point are clearly shown, and are permanent; 9. C ~,I ~ropriate boxes 'D dates, names, ad = ti, flood plain data, percolation test exemp- tic i "e.; 10i If the c n (such as floc ' elevation) do _)ply, place N-A. in the appropriate box; 1 1 . Sign the i place your 4 address and your _ ,,,tion number; 12. Make dies anti distr& e as required. ALL "OIL TESTS MUST BE FILED WITH THE LOCA` IRITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS es and Textures r Symbols -1-ne (over 10") BR Bedrock Gobble (3 - 10") SS - Sandstone gr Gravel (under 3") LS - Limestone - nd H High Caro v. _e Sand n, ium Sane' - Sand - Is - I Sand Loam < Less Than Brown Loam - Black si - Garay ~cl - C' _y Loam Yellow scl ly Clay Loam ri - Red sicl -Clay Loam rnot - Mottles SC Clay wi' - with sic - -:'ay fff - few, fine Xc - cc - comm pt - inm Many, m t:I distim p - promine HWL - High wa, Six -xtures surface k i ' disposal BM Bench M VRP Verticirl .ce Point TO THE OWNER: sc test, t is the first step in Securing a sanitary permit. The county or the Department may ret;uest 1 r t „ coil test it) the field prior to permit issuance= A comple*" set of plans for the private -i at d a permit application must be submitted to the approp ` . local authority in order to obtain a permit. The sanitary permit must be obtained and posted prior `-srt of any construction, 1 w,stontrn Deoa•trnrrt of Industry. ~)UIL uL:)%_nIr i Ivtr ttt.t vrl t Labor and Human Relations % U isM (Attach Soil Profile Location Map • To Scale • On A Separate, Signed Sheet) Rladrton.:.t =j:C- Page ` L r cuTVEaw.~ soatvK.oarl currerrt~+ousarv[otavut rrlneNtsurerlua a ~srtcr n.ooorwrat Bruce Zacharias 1-28-92 crop land outwashio n/a ACCreea CITY UATt U► cCl"" aHt L wro oro.e R.R.#3, Box 71R, Osceola, Wi. 54020 St. Croix 4~8 1paMN/ 1 Nt 1040. NUNG9rl Star rarle SE«,r SW 13 31 1411,1118 DORM 14 4 1 (:SUB LOT n/a 13LOCK n/a BM/DIvistoR/a X NEW REPLACE - [j _ 1 Honton Depth Oomrnant Color Mottles Structure Limiting Fanorr LaangGPD sq. n. In Munsell u. St. Cont. Color Texture Gr. St. Sh. Consistence Roost Boundar Depth Trench Bed 1 -9 10yr4/2 none 1. 2/f/ak mvfr 2/f c none .3 .2 E I C v = 2 -18 10yr3/4 none s.l. 1/2/sb mvfr 1/f c none .6 .5 98.9 3 8-42 10yr3/4 none C.S. /f/sg. ml 1/f G none .8 .7 4 2-87 10yr5/5 none M.S. 1/f/sg ml 1/f n/a none .8 .7 ~2 Morison Depth Dominant Color Mottles Structure Urrvttng Factor/ Loeang.OPOsq R. Q Munsell u St. Cont. Color Texture Gr. St. th. Consistence Roots Boundary 0:11h Trench Bed 1 In. 1 -8 10yr4/2 none _ 1. 2/f/ab mvfr 2/f c none .3 .2 Elev = 2 -15 10 1/2/sb mvfr 1/f c none .6 .5 98.9 3 5-25 10yr3/4 none l.s. 1/f/gr ml. 1/f G none .8 .7 4 5-84 10yr 3/4 none C.S. 1/f/sg ml 1/f n/a none .8 .7 I Norton Depth Dominant Color Mottles Structure Limiting Factor/ LadrngOPt)sa It. 13•3 In. Munsell u. St. Cont. Color Texture Gr. St. Sh. Consistence Roots Bounds Depth Trench Bed 1 0-10 1 4/2 none 1 2 f sb mvfr 2/f C none .3 .2 Elev = 2 10-2 1 5/4 none sil. 2 m sb mfi 1 f C none 0 0 7.56 3 23-2, 10yr3/4 none l.s. 1/m/sg ml 1/f G none .8 .7 4 29-8 10yr 3/4 none C.S. 1/m/sg ml 1/f n/a none .8 .7 I Horizon Depth Dominant Color Mottles 'Structure Umtttng Factor/ LeaangGPtYsq. n. E. 4 In. Mun ell u. St. Cont. Color Texture Gr. It, Sh. Consistence Roots Bounds Depth Trench Bed 1 0-10 1 4/2 none 1. /m/sbk mfr f C none .3 .2 Elev = 2 10-2 1 r5/4 none sil /m/sbk mfi /f C none 0 0 96.2 3 3-3 10yr3/4 none l.s. 1/m/sg ml /f G none .8 .7 4 0-8 10yr3/4 none c.s. /n/sg ml /f n/a none .8 .7 13 _ Horizon Depth Dominant Color Mottles Structure it wrig Factor) LoaangaPOsq. h. 5 In. Munsell u. St. Cont. Color Texture Gr. St. Sh. Consistence Roots Boundar Depth Trench e.a 1 -10 10yr4/2 none 1. 2/m/sb mfr 2/f/ C none .3 .2 Elev = 2 0-16 10yr5/4 none sil. 2/m/sb mfi 1/f C none .0 .0 6.1 3 6-24 10yr3/4 none l.s. 1/m/sg ml 1/f G none .8 .7 24-8 10yr3/4 none C.S. 1/m/sg ml 1/f n.a none .8 .7 Additional Remarks: RECOMMENDED SYSTEM TYPE: trench,--v___ a e # 12 Soil series BxB 0 lot on back bm=top of 1"steel pipe at el. 100' w/marker pipe 9 CVO ~ ~ I L4 other Site Features: 94.96 _ 1-29-92 (715 )246-6200 2 CST tg re Date Signed Telephone No. CST a Systcm Elcvation Gary L. STeel 1554 200th. AVe.. New Richmond, CST Name (Print) City Stale Zip 3 r ~ t qa Olen 21 ~Cf t 1L'0 I I G~Sf or 9~ r AS BUILT SANITARY SYSTEM REPORT OWNER ru C--iL an~ a._n TOWNSHIP ,S y- o r 1,-e. LW SECTION'3 _T 2 N-R-Y ADDRESS A ~ ST. CROIX COUNTY, WISCONSIN C/' G n ~tt L) 3 SUBDIVISION ALL _ LOT - LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM r .25~ ao ~ ta a tts b ~ stele 1 a INDICATE NORTH ARROW 106 Jam," .?/0, BENCHMARK:Elevation and description:_ Qe 1 Sfe~l 54%k-e e; Alternate benchmark SEPTIC TANK: Manufacturer: Paotps Liquid Cap. loo Rings used:-/--Manhole cover elev: 6/?%9/Final grade elev: Tank inlet elev.: 6 Tank outlet elev.: Cn,.5 i No. of feet from nearest road:Front_x_, Side , Rear Ft./S'y From nearest prop. line:Front , Side, Rear Ft. 7-5 No. of feet from: Well _(2 , Building: (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE A` L f J . I 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: X02 Length l~ Number of Lines:--z2-Area Built Exist. Grade Elev. 9 7~-sc Proposed Final Grade Elev. Fill depth to top of pipe: a~ No. feet from nearest prop. line:Front , Side X, Rear Ft.-~L No. feet from well: No. feet from building To~ r 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: PLUMBER ON JOB: Qlve rS LICENSE NUMBER: 6/90:cj LOCATION: STAR PRARIE 13.31.18.238A,SE,SW, 210TH AVE., LOT 5 Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division y. . -^w (ATTACH TO PERMIT) Sanitary Permit No.: UNERAWNFORMATION 1149,421 Permit Holder's Name: City ❑ Village] Town of: State Plan ID No.: ZACHARAIS, BRUCE Fs'T A R PRAIRIE CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: /00,0 1 1,60, t/,fs7~ ~ acr- TANK INFORMATION ELEVATION DATA A9200166 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic __P6 W6Benchmark Dosing Aeration Bldg. Sewer Holding St/ Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic I l NA Dt Bottom , Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System d y q 5 , PUMP/ SIPHON INFORMATION Final Grade Ufa N 9Y, Manufacturer Demand j,;. - 3,3 x'8.9 Model Number GPM TDH Lift Friction System TDH Ft Dia Dist. To Well Force main Length . I-I SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS a'- O DIMENSIONS LEACHING Manufacturer: SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM CHAMBER Mode Number: INFORMATION Type O System: ;Z S' 7 ~ OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) I 1 ' 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 a ~ ` Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (InclluudI6~ode discrepancies, persons present, etc.) Plan revision required? ❑ Yes ❑ No ~ Use other side for additional information. 165 29 9 SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: f M. f r 17 DILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code CouN STATE SANI Y PERMIT -Attach complete plans (to the county copy only) for the system, on paper not less than 1:1 /Q / 8% x 11 inches in size. Check rev soon to pr`vious 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 b 1^ S . '/4 S / T , N, R /9 or) W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # N/~ 03 CITY, STATE P ODE PONE NUMBER SUBDIVISION NAME O CSM NUMBER ed w cvto a to II. TYPE OF BUILDING: Check one) CITY NEAREST ROAD ( State Owned VILLAGE LTOWN :5"tfar )GO SL ❑ Public 41 or 2 Fam. Dwelling- # of bedrooms a PARCEL AX NUMBER(5) III. BUILDING USE: (If building type is public, check all that apply) J _ ~O~ Q d 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 70 Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 40 Church/School 8 ❑ Mobile Home Park 1120 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. IK New 2. ❑ Replacement 3. ❑ Replacement of 4.0 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 220 In-Ground 420 Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 12. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE A1_5 REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION nw Z" ® 7aD 7,;~-e) • t'o o~ 2 -3 771 74 Feet . d Feet VII. TANK CAPACITY Site in alIons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed -7 7 F1 T-7-7 I Septic Tank or Holdin Tank Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation 91,the onsite sewage system shown on the attached plans. Plumber's Name rmt): Plumber's Signat e: ( Stamps) MP/MPRSW No.: Business Phone Number: t rs 1-5 " 7/.S_ P umber's Address (Street, City, S , Zip Code): IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sa 'tary Permit Fee (Includes Groundwater a e Issued Issuing gent Signat No S ps) Surcharge Fee) Approved El Owner Given InitialfJ. - / Y Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. 1 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 submjtted 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. f 6. If you have questions concerning your onsite sewage system, contact yourf6cal code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system.is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8'f2 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 tacks; 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; (Jose 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) APPLICATION FOR SANITARY PERMIT 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 propertytis sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property Li C_ e_, Location of Property- 5; ;t SLR 'lt, Section T N - R .-:L- W f9wnship CL Mailing Address v Subdivision Name Lot Number Previous Owner of Property ~PJ/l y~ I 1 1C-i' c-) - - Total Size of Parcel 3, p Date Parcel was Created G-z Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No 630 as recorded with t Register of Deeds Volume and Page Number INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract 3. Other recordings filed with the Register of Deeds Office 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 the Certified Survey Map shall also be required. _ _ PROPERTY OWNER CERTIFICATION I (We) een.ti,6y that att 6tatement6 on thiA Sonm cute tkue to the beAt o6 my (oun) knowledge; that I (we) am (are) the owner (s) o6 the pnopenty de c abed in this .in6on.mati,on Jonm, by vi Cue. o6 a waA&anty deed recorded in the 066.ice o6 the County Reg"ten o6 Deeds as Document No. ; and that I (we) p%aenay own the proposed site Jon the sewage pod system (on I (we) have obtained an easement, to tun wAth the above deaeh.ibed pnopeAty, bon the. constn.u.cti.on oJ. said System, and the same has been duty necotded in the 066.ice o6 the County RegizteA o6 Deeds, as Document No. 1 _ ~1~ . -ff Inn r,;( CAS SIGNATUR F 0 ER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED DOCUMENT NO. WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA STATE BAR OF WISCONSIN FORM 2-1982 482386 X18 -~4~p U._ 1 REGISTER'S OFF ST. CROIX CO., WI Dennis-.A,-._.Tornio._and. Nancy..-C,_ Tornio-,._, Recd for Record II husband.-and. wife. APR 2 3 1992 - - C t P. M conveys and warrants to Bruc.e.-J.-Za.e.hari.as...and.... i t ~ usban.d. and..wl e-_ ..haur.a..h.....Zachar.i,as j.. as...sure.ivo.rshi~..mar.it.al ..property... Re I,0 Dee 9 it ~I - - - I the following described real estate in _ St. CroiX County, i _ State of Wisconsin: Tax Parcel No___________________•--•-....-•_ I I Part of South Half of Southwest Quarter of Section 13-31-18 described as follows: Lot 5 of'Certified Survey Map filed March 26, 1992 in Volume "9", page 2467. I I I I 7-0 FES I is This homestead property. (is) (is not) Exception to warranties: municipal and zoning ordinances, easements and restrictions of record. Dated this y L da oF April... 19..92 (SEAL) .....(SEAL) Dennis A. Tornio - - _ . . (SEAL) Gw / Tye` (SEAL) Nancy C. Tornio I AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ii SS. ST. CROIX County. 3r,. authenticated this --_.-'..day of 19------ Personally came before me this a ' 19_92. the •4tliov ~ - - - ---D-ennis---A-•---Taa:rlio--arid---Kanc • * T_arnio- huba_r>~? and:.wif TITLE: MEMBER STATE BAR OF WISCONSIN (If not, ; authorized by § 706.06, Wis. Stats.) to me known to be the person S_:2.._ foregoing instrument and acknowledge.the s t THIS INSTRUMENT WAS DRAFTED BY ' Judith A. REMINGTON Lpp,,W Remington OFFIC g. . - Notary Public - ES I New._Richmond-,---WI 5 4 017 - - - - - he A...... .w's - County, T.. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. ( kgRtxx4 &Xgxik*kx are not necessary.) dom. ) i - - 19 - •Names of persons signing in any capacity should be typed or printed below, their signatures. WARRANTY DEED STATE BAR of WTSCONSTN Wisconsin Legal Blank Co.. Inc. 7 4 31060 0 MAN K-1 LLq 0 2 - z MAR 2 6 7992•- Bearings are referenced to the south line t1 o JAMES O'CONNELL of the SW} of Section 13, assumed to bear CD > > Register of Uaeds S 8 8 ° 34' 1011E . Z w y. St. Croix Co., WI -7 _j O 0 0 C, u, o o~ trJ I:zj H cn o • 0 co A CD C" O V w cn cn w o CD r N o 01 o+ w c o m o x C, = M _ III r z I I C . I vi . i Iv v. 3 N -o - g t7 1 I cC H C7 Y -1 O L.VT u I LVT C I a " 7 = I I - I - 1 x o to rt r I = - (t v 0 r- Cn 6 CL m fD 0 S00°13137"E, 570.00' ~=o cn n n En rt* r I 34.951 535.05' a n :Z N O W a co 3C 3C co M. 0 N o b 100' 0 o t =C >C N :0 4s a~ o A - n~ O l~ro 35.49rh 534.51' 'E c I~ a Ic_ N0001313711W 570.00' C" ~ rt IfT n I H - En 0 rh w„ Z- o (D a 1r o I~co 'N IC= P. rt rt _ IC. En 12> ~0 10 I P ~ I s w w__ 1 _ = I ~ n 0 M C-) I_~ _ 1 IE ICJ -n I ° En ~ CR co __-I IErI Io .1E coo T7 I~ 1~~ a N. w aft' m ICJ o m I< I t_ I> I< IC7 I-i 1_~ --h F y o CD 80 Iz I(!' If 1 IfTj Z r.t:r n j> ' I ICJ IC7 V/ T rn 1Q3 I r_ m 1W ti IT> o~o m S0001612711W 611.00' I~~ SW of the SW 36.78' 574.22' ICJ SE of the SW 3 o I f H 0 D Iv O Qj co 1-no -,00, z f,. co co co oI`o p wco o Q O~ N 3 7.3 6 f O1 r* r~+'L~ o - w ' 330.381 ,100016-271-E 367.74' C H - ° Ln J% H 333 rt rt o w SL 1 `h i w N u o Fi O I - o rn rn o 4- n Ffi I 'v, I I V o 243.261 N a Ln a M h%i ft N00°1612.711E v+ ' cn ' V J r L 174 AT 1 I nNIPL IH I 1 t1 T T 0 TF u U O N t - - - rr K a y A~ L AN D" S-3 > _ o APPRO VM 03 v ~r H cn C t 1 . CMX COOK R 4 4, 0 C" 0 r• N M J'onVr•hansfve Plw Wk* 1 a N 1] m 0 • O n w cn cn zOflkV and rr rr o_ rn sy Parks ComirrAt't o I \ r fr C-) o ~ K not recorded w *11thin 36 days of " aWdvM dS% *wevv shs*bi PAGE 2467 *A * void VOLUME 9 (Continued Next Page) L .j IVNIDIHO v J ¢ OO m Fa \ 2 W O H p W a 1'1 ¢ a p m ° x III F h W o= w ° Z in Z Z Z WQ WC < < o 0 'S 0 .2 Ch at a LL m W pCD W O~ M M co y x w F 2 U. o O w w Z Z J U' a W a~ o i O LLm O Y H} Q LU ; w = S °~>N a P5 < S O< S Fn ` U w U U I- a U ix x Ix < W LU w U ~ V a F g Q ~ Q' ~ O W Z Oq ~ Z H J Z K W N U J.w O Z 4c cc I.- CO ~O aOs V 'y J LU co co < F- LL < O LA +6 q U O x0 U~in S wF 3 q w w = to H <z`C~Z ZZti3 moo' WO•-W z a OCaa•= ai-N2 i CO 3 a N V Q W N i a p U3~W W i W !V aCO LAC! pa WW O Q p q x H Z ia. oLLnW~ Y •(U ci►+ v 4! a h- w IA q v m y W a~ N3a J m Z V V N W OD P..4 0 W w co x N a q ►-r 3 '9 ° : a¢ M OD .Z -i m 0 LL f- o W p 0i O i w o > Z m>- I- x co ca N. ' Z ~ Z O MMUlU LL ciu I V IL ~ O IL M X MC~C~ p W M V 2 M.-W X a0 am --0) 0) W00 O a • r ST C- 105 r • 9 H SEPTIC TANK MAINTENANCE AC.ftEEMEN'I' p St. Croix County z 0 a OWNER/BUYER ~PK~~ Q I'► ari 0. S ROUTE/BOX NUMBER Fire Number CITY/STATE ZIP PROPERTY LOCATION:-%, Section, T=:~ZN, R W, Town of St. Croix County, Subdivision A Lot' number' Improper use and maintenance of your septic system could result in its premature failure,to handle wastes. Proper maintenance con sists 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 treat- ment stage in the waste disposal system. • i 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 systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after ins pumping (.if nec- essary), and essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form wil•1 be sent approximately, 30 days prior to three year expiration. 0 • E I/WE, the undersigned, have read the above requirements and agree CA to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Depart- ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zonin a within 30 days of the three year expiration date. SICNED DATE St. Croix County Zoning Office P.O. Box 98• Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. DEPARTMENT OF r REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISON W 7969 HUMAN RELATIONS (1-163.090) & Chapter 145.045) LOCATION: SECTION: TOWNS4IP/1104XITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: SE 1/4S4/ 13 /T31 N/Ff 8xE (or) W Star Prarie n/a$' n/a n/a COUNTY: OW(UMS/BUYER'S NAME: MAILING ADDRESS: St. Croix Bruce Zacharias R.#3, Box 71R, Osceola, Wi. 54020 USE DATES OBSERVATIONS MADE NO. BEDRMS.: ERCIAL DESCRIPTION: (PROFILE DESCRIPTIONS: 1PERCOLATION ESTS: ®Residence 3 COMM n/a a~wew ❑Replace 1-28-92 3-18-92 RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: IMOUND: OUIN-GROUND-PRESSURE: TIS TEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM:(optional) ~DS ❑U CS ❑U 9 S ❑U ®U ❑ S ®U trench If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: n/a l Floodplain, indicate Floodplain elevation: n/a decimal' PROFILE DESCRIPTIONS page 12 BxB BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IM, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- 1 7.25 98.96 none >7.25 .75bl.1., .75bn.s.1. 2.00bn.c.s., 3.75bn.m.s. B 2 7.00 98.96 none >7.00 .67bl.1. .58bn.sil., .83bn.l.s., 4.92bn.c.s. 13- 3 6.92 97.56 none >6.92 .83bl.1., 1.08bn.sil. .50bn.l.s., 4.50bn.c.s. B_ 4 7.33 96.26 none >7.33 .83bl.1., 1.08bn.sil., .58bn.l.s., 4.83bn.c.s. B- 5 6.83 96.16 none >WW (o.93 .83bl.1. . 50bn. sil . . 67bn. l . s . 4.83bn. c . s . _T_ I I I rB- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER }SEX AFTERSWELLING INTERVAL-MIN. -PERIOD 1 PERIOD2 PERIOD3 PER INCH P- 1 4.00 none 3 6 6 6 <3 P. 2 4.00 none 3 6 6 6 < P- 3 2.60 none 3 6 6 <3 - 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 94.96 } E r I ~ ~I 4Q` I I ~ f E i m t- STN i~.o~ k . # E E ~ I ~ 3 r , i i f s I 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 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 3-18-92 ADDRESS: CERTY 6J TION NUMBER: PHONE NUMBER (optional): 1554 200th. AVe. New Richmond, Wi. 54017 LL C z2_1 115-2;A-6200 CST SI4-Zu: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. Of I I IR SRf) 6'195 M, 02/p?) r1VFF? - i I ' 1 I I I I~ I l i ' ~ I Lo- I I `1 I ; I I j I I I I I ~ i i i ~ i I j i I I I ~ I ( i I i I I i ~ ~ I r ! fir,-°y~J I I I I I ! 0~ y • I I I I ~ I I j I ! I I ~ i3l I I I ~ ~ I I ~ , I i I I I J i I I i ~ I I I I I I ~ I i ?-I - - - r r I r ~ I I I I ~ I i I I I I j I , Ilrr" i ~ I ~ , ~ ~ I I I ; C- I I ~ I ( (J~ i I I ~ I ! i I I I I I 1 I ~ 1 ' a- , 4 - 1 I L I ! L 1 1- } _ I ~~'I ~ I I ~ ! f r I Lit } I _ ~ ; i I I ~ ~ ~ I i 1 1 ~ t t t I I I ~ I I 1 I ~ I I ~ i I I ~ ~ T" ~ I ~ ~I I I I i I ~ I I j l l l ~ 7 I ~ fi I I ~ I~ I ! i I I I I I I I I I I I i i I I ~ I I r ~ I J I I I I I I I_ ~ I I _ I ' i I ~ I , I I ~ I I ! I ' ! I ~ ~ 1 I I I I ~ I i I I I ~ 1 i : I f I ' ' it - r- - I I I, I I 1. 4' I I i I j I` f I _ I 1 I I I I I I I I i j i t i i I I I i I I ~ I I I I ~ I • I I I I I , I , ' I r I_ 41 ' ' 1 L I ; I I ~ ~ I ~ I I I , , -I - I I I II 1 I ~ I I ! I 1 ' Y T ~ t I I I L I I } I , I I I I i i I I I I - } I I I. i I ~ ~ ~ I I I I j I I I ~ I I I ! 1 i I I - 1- I I I I i- r ' I ~ I I i ~ 1 I ~ t ~ I I I , I I I I I i I , I I I I I r I I r I I I I - - - I I I i I i ! I I I I i . CrvSS J~c~'tOr, o~ ~ l~ct~ S, St'e~-~ Froth Air Inlete And OEeerrollon Pipe Appro.id Vent Cap Minimum 12• ADOr• Final Grad. -rn 20. 42' Agora Plpp -4" Coil Iron To Final Grade Venl Pipe Main Noy Or SrmMtk Covering Mtn 2• Aggregate Over Pipe DI It/14uIlOn Pipe 0 0 0 - Tee 6" Aggregate Beneole Pipe ° Parloreted Pipe (I•larr o -•Co'pling Tarminoling At flolloon of 51614M Ion SOIL FILL DISTRIBUTIOM PIPE Y APPROVED Sy)JPIETIC COVCR 2"01F hGGREGATE "--MATERPJI OR 4" of sTRkW Oil MARSH NAy ELEV. OF 1 / 2"2 x AGGREGATE DISTRI(51JTIQU PIPE TO BE AT LrAS-T IUCHES BELOW AT LEASTLO MCHEL BUT.KIOMOPr- THAN `12IIJCHES BELOW F11n1AL GRADE MAXIMUM OEPrH OF F-X(-/lvAT100 F4011 ORItIWAL Ci tA)R WILL BE MCHES IU iMM pKP rti OF EXCAVATIC J r-KOM C~I6NAL ~RAO WILL BE ..2?,& INCHE S SIGUED: LICEuSE (.)UMBER: J rQ DATE:` t i o REPT131 STAR PRAIRIE ST. CROIX COUNTY ZONING PAGE 1 05/29/92 09:27 REQUESTS FOR INSPECTION WORK SHEETS FOR: 5/29/92 AREA: MJ Activity: A9200166 5/29/92 Type: CONVSEPT Status: PENDING Constr: ,Address: STAR PRARIE 13.31.18.238A,SE,SW, 210TH AVE., LOT 5 Parcel: 038-1055-30-000 Occ: Use: Description: 149321 Applicant: ZACHARAIS, BRUCE Phone: Owner: ZACHARAIS, BRUCE Phone: Contractor: POWERS, CALVIN Phone: Inspection Request Information..... Requestor: CAL POWERS Phone: Req Time: 14:05 Comments: Items requested to be Inspected... Action Comments Time Exp 00012 FINAL INSPECTION Inspection History..... Item: 00012 FINAL INSPECTION I REPT131 STAR PRAIRIE ST. CROIX COUNTY ZONING PAGE 1 05/29/92 09:27 REQUESTS FOR INSPECTION WORK SHEETS FOR: 5/29/92 AREA: MJ SELECTION CRITERIA INSPECTION DATE - 5/29/92 INSPECTOR AREA - MJ REQUESTS SELECTED - 1