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AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP f 1~ti7
SECTION T N-R_W
ADDRESS X/'UGH ST. CROIX COUNTY, WISCONSIN
SUBDIVISION LOT,,~LOT SIZE ~4 r -~sPLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
/a a a
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INDICATE NORTH ARROW
BENCHMARK: Elevation and description:-7PI 6& 9 l l
Alternate benchmark
SEPTIC TANK:Manufacturer: 151%,oWwas7- Liquid Cap. Ida 6'
Rings used: -Manhole cover elev: Final grade elev:
Tank inlet elev.: Tank outlet elev.:
No. of feet from nearest road:Front_,EL, Side , Rear Ft.
From nearest prop. line:Front , Side, Rear Ft. 76"'
No. of feet from: Well 13d ' , Building:
!52Z
(Include this information in the above plot plan)
(2 reference dimensions to septic tank)
SEE REVERSE SIDE
PUMP CHAMBER C S 1/ S7`~ ~f~All
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.
i
Distance from: Well Building
SOIL ABSORPTION SYSTEM s v S fa T~
d
Bed: Trench: Seepage Pit:
Width: Length Number of Lines: Area Built
Exist. Grade Elev. Proposed Final Grade Elev.
Fill depth to top of pipe:
No. feet from nearest prop. line:Front Side, Rear Ft.
No. feet from well: No. feet from building
HOLDING TANK
Manufacturer: Capacity:
No. of rings used: Elevation of bottom tank:
Elevation of inlet:
No. feet from nearest prop. line:Front , Side , Rear Ft.
No. feet from: Well , building , nearest road
Alarm Manufacturer:
INSPECTOR:
DATE: PLUMBER ON JOB•
LICENSE NUMBER: - ~Z
6/90:cj
`1919AI3J9 partmelntOofi Inu,ry28 . 19. 16B ~RI~/AT~ f EWA E SYSTEM County:
,Labors Vu man Relations INSPECTION REPORT
Safety and Buildings Division ST. CROIX
(ATTACH TO PERMIT) Sanitary Permit No.:
GENERAL INFORMATION 171464
Permit Holder's Name: ❑ City ❑ Village [Town of: State Plan ID No.:
YES JAMES J & LISA J IKTROY
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
r ~~~r Q>a c 040-1002-80-100
TANK INFORMATION ELEVATION DATA A9200229
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic 6" Benchmark a,U4< j p d ,
Dosing 7"
Aeration Bldg. Sewer
Holding St/Ht Inlet ~_7S 9569
TANK SETBACK INFORMATION St/ Ht Outlet 7,6 d~_ gS, yz
Vent
TANK TO P/ L WELL BLDG. Air Ito ntake ROAD Dt Inlet
Air 7~S y.
Septic 7 P _1y" o' do ~ NA Dt Bottom /04 01/_ 3
Dosing] > d NA Header / Man.
Aeration NA Dist. Pipe 3,q 91. 7c1
Holding Bot. System 98 t-jg',/~
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer am~ Demand U 9fl.qV
Model Number I, I GPM
TDH Lift Friction System TDH 10^~\~Ft
Forcemai n Length 40 / Dia. Dist. To Well -7S
~
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSION v / DIMENSIONS
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING M facturer:
SETBACK
Mode Number:
INFORMATION CHAMBER
Type 0 ,
~S 1l3
/ N OR UNIT
System:
DISTRIBUTION SYSTEM
Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length Dia_ Length (L Dia. -La/- li Spacing ~O y /
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over i xx Depth Of xx S ded / Sodded xx MvIched
Bed/Tr nchCenter l' Bed /Trench Edges Topsoil i. es ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)`'°`" ' -
'i
r. Z l
Plan revision required? ❑ Yes CLd'NO g `
Use other side for additional information.
SBD-6710 (R 05/91) Date I pk qr's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER: '
=77UILHO SANITARY PERMIT APPLICATION
In accord with ILHR 83.05, Wis. Adm. Code COUNTY
ATE SANITA RMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than Chi k 8% x 11 inches in size. ❑ ChefCk if rev sionto 'porevi s application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. :5e:> PROPERTY OWNER PROPERTY LOCATION
~'rn S N, R 1417 E (or
PROPERTY OW ER'S MAILING AD ESS LOT # BLOCK #
_5_2 0 Fell led
CITY, STATE ZIP CO PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
II. TYPE OF BUILDING: Check one CITY NEAREST ROAD
( ) State Owned
VILLAGE ~ +U~~
ka =N OF. Zj=
❑ Public 01 or 2 Fam. Dwelling-# of bedrooms ~ AR ELTAXN MBER )
III. BUILDING USE: (If building type is public, check all that apply)
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 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1.0 New 2. EI Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 511 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 [9 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
REQUIRED (s( . ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) p~ p ELEVATION
T ~D o. ~0 r Feet 77' 7s Feet
VII. TANK CAPACITY Site
in allons Total # of Prefab. Fiber- Exper.
Manufacturer's Name Con- Steel Plastic
INFORMATION New lExisting Gallons Tanks Concrete App
Tanks Tanks structed glass 1-1 F] I T7
Septic Tank or Holdin Tank D d c✓d9
Lift Pump Tank/Si hon Chamber r V, El I F1 n 1 11 El
Vlll. RESPONSIBILITY STATEMENT
1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Print): Plumber's Signature: (No Stamps) PRSW No.: Business Phone Number:
t °4 SG Q r` F/ Z_
lumber's Address (Street, City, State, Zip Code):
4 7 O eic L✓-
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (includes Groundwater ate Issued Iss ' g Agent Signatur 7 1amps)
Approved El Owner Given Initial Surcharge Fee)
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 - f K
1. A sanitary permit is valid for two (2) years.
2.1, 'Your s'anttary 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, AI(r.evisions 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 coUaty 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'systdm.is to be: nstalf'ed'.
II. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling.
III. Building use. If building type is Public, check all appropriate boxes that apply.
IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or
repair.
V. Type of system. Check appropriate box depending on system type.
VI. Absorption system information. Provide all information requested in ##1-7.
VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of
tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all
septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received
experimental product approval from DILHR.
VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g.
MP, etc.), address and phone number. Plumber must sign application form.
IX. County/Department Use Only.
X. County/Department Use Only.
Complete plans and specifications not smaller than 8'/ x 11 inches must be submitted to the county. The
plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of
holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service;
streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system
areas; and the location of the building served; B) horizontal and vertical elevation reference points;
C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump
performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if
required by the county; E) soil test data on a.115form; and F) all-sizing_information. .
GROUNICMATVi 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.
4
SBD-6398 (R.11/88)
P
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PROJECT INDEX SH;.,"]-,T
UWNER : /1~tf S ,
//tJ1~SD.~ 4jlS . S o~
I0DRESS :
SITE LOCATION:
S Si c . ! . T Z S J -7-,, tv-o o 1--
PROJECT DESCRIPTION: S%; ~,eUl,r cav-vTy
N C!~X i ST/A) G"'" /3 vk~i • t D E. v~ ~G~ S
o~'G TC 5 7's !N'r~ ~'i Soi/SiPt~
i
f I /3- ; s.~'v 7- S~~f -sd-u~ll r
P 14E 1 . PLOT PLAN V I !:iJ;S ~yaQ' -,yrv
PAGE 2. MOUND CROSS SLCrIGI7 c~ SY~ I'M I VII d
.J
t.
PAGE 3. PI~?E LATERAL LAYOUT"
PAGE 4. DOSING OR SIPHON CHAMBER CRO S SE
IV, N-1
PAGE 5. PU14P PERFORMANC" SPEC"] OR SIPII01
PLUMBER: SITE EVALUATER/ DESIGNER
HOMESITE SEPTIC PLUMBING CO.
655 O'NEIL RD., HUDSON, WIS. W1 tjr Z
ROBEnT ULBRIGHT
,NIS. MP, STER PLUMBER LIC. NO. 3307 M.P.R.S.
D AT I, : „r lAtNN. IN3 FALLER & DESIGNER LIC. N0.00663
2 9ej 24e
SIGNATURE:
aS92 - 016"79
IJ
JU?I 1 2- 1992
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Straw, Marsh Hay, Or
Synthetic Covering
Distribution Pipe
Medium Sand
SYSTEM
Topsoil H. - F G F it Vh1,/0,✓
3 C
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= 4 % Slope
-:;l~ticll Of i"- 2 ,2 Force Main Plowed
s u 9 ESTER ~'l o vu p 7~,v. ~o,~~-~ 9~0, O
Aggregate L dyer
Toe t 1;vE F /C-t'A rAo,v
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Cross Section Of A Mound System Using
~EI~A For The Absorption Area F 75 Ft.
G /0 Ft.
E StGW A
QNS~ ~!9yu~ A y Ft. H /S Ft.
B ~y Ft.
I k1to J~
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yO~tACS Position /y Ft.
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A I°
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Distribution Of
Pipe Aggregate
Observation Pipe Permanent Markers
c~ppr-o 544:L'L RODS
Plan View Of Mound Using A For The Absorption Area
S92-01679
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Page 3 Of 3
• 0/ D O /Um E fo 0/ ~ T' U c ~oiP cF
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Perforated Pipe Detall
V,66AT doe VAcv.16-
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End Vie-
PVC End Cap) PVC Pipe
I . N
C OD s Holes Located On Bottom,
Are Equally Spaced
P
PVC Force Main
w
P
Distribution
Pipe
Lost Hole Should Be
Next To End Cop
End Cop Distribution Pipe Layout P
Ft.
S~~G~ S~STE~
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Inches N
Signed: ' Lp,~10i` Hole Diameter ~y Inch
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Inch(es)
License
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Force Main Inches
EE CD~R~SIP # of` hol es/pipe
S ?00'-5-- Invert Elevation of Laterals ?00'-5-- Ft.
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S92-01679
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PUMP CHAMBER CROSS SECTIOIJ AND SPECIFICATIONS P G
-VEIJT CAP
11"C.I. VENT PIPE ff7 WEATHER PROOF APPROVED LOCKING
JUUCTIOIJ BOX MANHOLE COVER
25' FROM DOOR, ~~~~ltv(~ IA13EI
WINDOW OR FRESH 12"MIN.
AIR INTAKE
« ~~f U.17~ON GRADE I
iApt4" MOO.
Z_ I r-
q-7, 0 18" MI IJ.
COLJDUIT
v,4 r/ eti
UJLET PROVIDE I II
- - - AIRTIGHT SEAL
J
( I I I
y I ~G / I I I APPRCJED JOINTS
APPROVED JOINT A IN /~~1 I III W/C.I. PIPE
W/C.T. PIPE I / U~ I
XTENDIIJG 3' O-1 i I I I ALARM EXTEAIDIIJG 3'
x/71 l I i I ONTO SOLID SOIL
EOIJTO SOI-10 SOIL B 'Do
I' l V NO 3,3 J I I oN
G gb c ~
ELEV. FT PUMP ~ --i
OF
F
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SAN ~ ~ BLOCK,
iod -
RISER EXIT PERMITTED OIJL'i IF TAIJK MAUUFACTURER HAS SUCH APPROVAL
SEPTIC SPEC_ IF ICAT IQKJS
E - -
DOSE ~I/D~y~sr~nN P,~EC.~s 7-
TA NKS MANUFACTURER: NUMBER OF DOSES: PER DA-4
TAWK SIZE : 7S~ GALLOI`JS DOSE VOLUME 150 157
LttltZi 41,r~M /?r-, IKJCL'UDING BACKFLOW: GALLOWS
ALARM MANUFACTURER: (.S
MODEL NUMBER: L' U • CAPACITIES: A = ~(O INCHES OR 300 GALLONS
GALLONS i
SWITCH TYPE: B= Z INCHES OR 31f
Z o//En ~
PUMP MANUFACTURER: C= INCHES OR /<OQ GALLONS ~
MODEL NUMBER: 97 D= i3.S INCHES OR ZSZGALLONS I
5WITCH TYPE: IJOTE: PUMP AMD ALARM ARE TO BE
INSTALLED ON SEPARATE CIRCUITS
MINIMUM DISCHARGE RATE -30 GPM
VERTICAL DIFFERENCE BETWEEN PUMP OFF AUD DISTRIBUTION PIPE.. 70 FEET AAlk SPECS .
MIIMIMUM NETWORK SUPPL`J PRESSURE . . . . . . . . . . . 2.5 FEET EAGl _ t o~ ~L1.
} /o FEET OF FORCE MAIN X F ",FLFRICTIOIJ FACTOR.. Z FEET f,Un'S I~•~S
TOTAL OL3UAMIC. HEAD FEET
INTERNAL. DIMENSIONS OF TAIJK: LENGTH ~ d ;WIDTH jLIQUID DEPTH
PGE
W
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DEWATERING i 22 70 165
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12 40_
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30 138 MODEL
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^SEWAGE and
DlF 6 25
1TERING 6 20 MODEL
i ~ 15 MODEL 161
4 7
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5 53, 55,
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GALLONS 10 20 30 40 50 60 70 80 80 100 110
24
75 LITERS 0 80 160 240 320 400
,22 FLOW PER MINUTE
70
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Q 285
LU 55
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I a 14 45 MODEL
I Z 294
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o 3280 Old Millen Lane
GALLONS 10 20 30 40 50 60 70 so 90 100 110 120 '130 140 1sp 160 170 160 180 P.O. Box 16347
-4 1
-4- 1 Louisville, Kentucky 40216
LITERS 0 b0 160 240 320 400 480 560 640 720 (502) 778-2731
FLOW PER MINUTE
.r S 92 -1-6-7 Q
L97! Cast Iron Sedes MEAD CAPACITY
- UNITS/MIN
Feet Meters Gal. Ltrs.
i' \ • Automatic or Non-Automatic. 5 1.52 57 216
l~ i • s H.P., 1 Ph., 115V or 230V. 1a 3.05 51 193
{ I \ • clogging vortex impeller design. 15 4.57 43 163
j 20 6.10 27 104
s '/z" solids (sphere).
NPT discharge. Lock vase: <4.5
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A a~td
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tu~ S arfioat operated submersible (Nema 6) mech-
Jt,:`y 1 ` tV~ 01-anical switch. 97 Series
listed '/^A sc-zzzs
V 1 • Auto tic reset thermal overload protection. nu,
s a~Aatr1(ess steel screws, guard, handle and arm and
?t -m ' Q'a I' assembly.
Watertight neoprene' [_T' ring between motor and
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~ Canadian Slanaaros
pump housing. 0 Assoc App,o,al
avalldUle
N97, non-automata, available packaged with a piggyback mercury
'A floaf switch.
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S T C - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER Jah~•e s Gyc 9
ADDRESS S^ O ~e.-,,gvcQY~ leek FIRE NUMBER
CITY/STATE f!a d 5"'0~✓ ZIP
PROPERTY LOCATION: 1/4?S_'AE- 1/4, SECTION T N-R 1 _W
TOWN OF St. Croix County,
SUBDIVISION /GL_ , LOT NUMBER eK_ .
Improper use and maintenance of your septic system could
result in its premature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three
years or sooner, if needed by a licensed septic tank pumper. What
you put into the system can affect the function of the septic tank
as a treatment stage in the waste disposal system.
St. Croix County residents may be eligible to receive a grant
for a maximum of 600 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. ':~2"
St. Croix co. Zoning Office
911 4th St.
Hudson, WI 54016
S T C - 100
This application form is to be completed in full and signed by
the owner(s) of the property being developed. Any inadequacies
will only result in delays of the permit issuance. Should this
development be intended for resale by owner/contractor,(spec
house), then a second form should be retained and completed when
the property is sold and submitted to this office with the
appropriate deed recording.
Owner of property iTdrn e _T j40~-4,e$'
61
Location of property.Sf 1/4 SE 1/4, Section T X N-R_IZ W
Township T s
mailing address 3-Z2a
Address of site
Subdivision name Lot no.,--1Z6x-
Other homes on property? yes No
Previous owner of property
Total size of parcel !'-~z a e
Date parcel was created
Are all corners and lot lines identifiable? Yes No
Is this property being developed for (spec house)? Yes K No
Volumeand Page Number as recorded with the Register
of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE
NUMBER & THE SEAL OF THE REGISTER OF DEEDS. In addition, a
certified survey, if available, would be helpful so as to avoid
delays of the reviewing process. If the deed description
references to a Certified Survey Map, the Certified Survey Map
shall also be required.
PROPERTY OWNER CERTIFICATION
I(we) certify that all statements on this form are true to the
best of my (our) knowledge that I (we) am (are) the owner(s) of
the property described in this information form, by virtue of a
warranty deed recorded in office of the County Register of
Deeds as Document No. , and that I (we) presently
own the proposed site for the sewage disposal system or I (we)
obtained an easement, to run the above described property, for
the construction of said system, and the same has been duly
recorded in the office of County Register of deeds as Document
No.
.AlWIAn
S gnature of ap licant Co-applicant
Date of Signature Date of Signature
J
Irv
- - •s~..µ ~ s v~~'
~ m~
r/......~-.lea.,
.
Witnes+sef .not As 004 &moor* 9W is
}
" agave" to Gram the toMillt iererlrli 1~1i rawflo AMA-
i i counts. Stne of wrna.ia:
part of the fit' of the M% of Dectioo 1, dip . v
it vast* VMS of !t"# stwo, post ly
11MM~~ `
f to lumps toot o0o of Certlf sd ftg"l
1671, as doom mt ao. 42%611.
of C.s.m.0 p~481
s or assivm am p0- A1iMli
Buyers, tisir bliss, staiooer►soac
fsca having 7 cattle an t W *beVG-~tcriDa , .
O&U &t
property for a pesiud of five years Elmo the fiats sf! i~
~ ~ deed. ~~1.:
x
a
FRIM
This-As-not . bamoo fld lrwat►.
a~ tr e►rtf r •
Tapth.r via as "d tr ~weeMl erd llNsteew~eos th.nlna har~i.S:
And. Gr-aA-N_4ir'si~i tee iM eliit iieaVeiia~ halt
warraata that the tkb r W . .
easements, restriotl4*0 'ate rights-of-way of seoord
and will warrant and defend the aYM. J €+i
` /TV -0 .
Dated this . . . • des of ro
. .
.Ct,.~,~-,,~.,r- .....(SiAL)
L G. _ ,a:,.
awrence Ls~wst Jr. Frederick s
(SZAW
.
Mark B. I,en•rts
8
AvaamTICATZON Aosttowr.snoUKNV
- STATZ OF WISCONSIN
te(a) ..I!~...~»~.•.t.........
lAnmrft
thr Mir ' ! ►It..« . u«~1 ree....ns «.e. balers mW w. •-~ril #
is........ rie-sfea~ili'
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TITLE: riXM= STATZ OAi OF WISOONMN ..........••..•....~M M......' ;ay
(avthorisod b1.f 'tiM~. wr. •Siar.) to som knows to be the Pnm .............e ft asrlatoi t4 f;
faeeSaia~ rotrseertnt mad sd1I1M1~~ahIR
s
Tms INaTa samff wws 066"" a1/
JAM
i,t1sL Itatar7 hblk
ley Qeau.iaa is pormas"t. (If mak t~~ :b
! tSipaaees sy be ionhsaellen~d ~e riielaw~lt 986 l
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we lot aocoooa's.) 4WD:
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"IM-m _ _.3 i
ST. CROIX COUNTY
WISCONSIN
41i,
ZONING OFFICE
41 r, y '
ST. CROIX COUNTY COURTHOUSE
x
911 FOURTH STREET O HUDSON, WI 54016
(715) 386-4680
May 28, 1992
Division of Safety and Building
Bureau of Plumbing
P.O. Box 7969
Madison, WI 53707
To whom it may concern:
An onsite investigation of the James & Lisa Hayes property, located
in the SE 1/4 of the SE 1/4 of Sec. 1, T28N-R19W, Town of Troy, St.
Croix County has been conducted.
This onsite revealed suitable soils at a depth of 13" below which
seasonally saturated soil conditions were observed. This site does
meet the requirements of the A+4 rule and is therefore suitable
fore a replacement mound requiring 23" of sand fill.
Should you have any questions, please feel free to contact this
office.
in Lerely:, : -
"James K. Thompson
Zoning Administrator
cj