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HomeMy WebLinkAbout276-1043-70-200 ~ ~ ° I II ~ I h ~ O ° d o I 01 a 0. m c co 0 0 M ° N y coi a A ~ c m M ~0i o p~ O. N LL = m N ap y N p C > N S' C NO NAM N r O 3 45 - C*4 CD w ° 3a °0- E cp r ac ° gLL N 'COD X X~'a c 3 o CD a'c o o N p Lo CyT N TC-O M N C Z dU pL cc (D C CL c t . - p O O O O ~ E m d oo N t7 N -lZ 0 p 3 O CL O. N -gyp p 0 N•c 0 L) T C O c.1 d I Q ZL N ca dLL N 0O. E > a~ U N M v CD o w E .0 rn Z o N = o (D ~ v •E L Z d d U C\l - (n d m ca M F N C C O °0 c C7 O O o z v c o N E B o d Z c m f- ° (D z E € c (D 0 m cc (u ~"4J = o c N Cl. • c O CD c I c -O Q C N U O Z co z Z N ~l y c NV y E Lo CL 0 N d !U ~ O O N N ~ G a a m N 0 y y N o H H d ~j O 0 • IV LL a a a Z° m EL > ~l d Q' N N 1}}~~ U) J U > rn rn z `l c Ul) o o E _ ° r Q N m N C a s w~ ° E y ~ I O N Q 0 > U d 0 0 O N O O c O c tl d 0(D S.i M M 3 y N u) R d N ~ O 1 H 7 CO N" Z r 'O O a to d e- (D N T O E c c z 0 :3 • N co H O z N H Z (n O E d M a • ee a m d `irl +r E c c ~ A ciao 0 U) Parcel 276-1043-70-200 01/27/2006 04:59 PM PAGE 1 OF 1 Alt. Parcel 36.28.19.322Q 276 - CITY OF RIVER FALLS Current X 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 - CRANSTON, JOSEPH B & SUZANNE R JOSEPH B & SUZANNE R CRANSTON q274 Dis tricts: SC = School SP = Special Propvfty-Azktress(Qs): Primary Type Dist # Description * 7 E DR I / SC 4893 SCH D OF RIVER FALLS RIVERSID SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE SEC 36 T28N R19W SW NE (FORMERLY P729 TN Block/Condo Bldg: TROY) LOT 13 AND M & B DESCRIPTION DANATE PARK Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 36-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 08/11/2005 803150 2864/435 QC 08/09/2005 809871 6 WD 01/14/2005 785003 2731/341 10/12/2004 776805 2674/110 LC 2005 SUMMARY Bill M Fair Market Value: Assessed with: 133132 245,300 Valuations: Last Changed: 10/30/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 36,000 158,700 194,700 NO Totals for 2005: General Property 0.000 36,000 158,700 194,700 Woodland 0.000 0 0 Totals for 2004: General Property 0.000 36,000 158,700 194,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 308 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 040-Ml-50-000 01/27/2006 04:51 PM PAGE 1 OF 2 Alt. Parce : 36.28.19.729 040 - TOWN OF TROY Current ST. CROIX COUNTY, WISCONSIN Creation Date ate Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner VERNON L & CAROLYN A RASMUSSEN O - RASMUSSEN, VERNON L & CAROLYN A ANNEXED TO CITY R.F 00000 Districts: SC = School SP = Special erty Address(es): Primary Type Dist # Description * 7 IVERSIDE DR r1 SC 4893 SCH D OF RIVER FALLS ~i SP 0100 CHIP VALLEY VOTECH (p Legal Description: Acres: 0.000 Plat: 03/58-DANATE PARK SEC 36 T28N R19 LOT 13 XC PT FOR RD IN Block/Condo Bldg: LOT 13 VOL 545 PAGE 21 DANAT PARK ALSO 04AC 2AST OF L S /522 BEG SW COR Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) FrQp LOT 1 CSM 89 E . 'S ALG 36-28N-19W S LINE LOT 1 & N LINE LOT 13 DANATE PARK ADD'N TH N 55 DEG W 79.92' SWLY 33 DEG W more Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 772/530 2005 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 02/09/1990 Description Class Acres Land Improve Total State Reason Totals for 2005: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2004: General Property 0.000 0 0 0 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 Total 0.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT OWNER jYj TOWNSHIP 7~1 SECTION T/ W ADDRESS 3 Jl , eP S ! -e PG` ST. CROIX COUNTY, WISCONSIN ,Cvh&&~ Z~211 1 ~e SUBDIVISION ( LOT~LOT SIZE ° PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM r I I 1 tA-t 13 faDp~~~ gel ~c Apron ~pnn~eI CX/SI//lq ~5 INDICATE NORTH ARROW ~,'"~•~r sidp Q r, BENCHMARK:Elevation and description: Alternate benchmark SEPTIC TANK: Manufacturer:M Q S 1'/ 45fLiquid cap. ~0455) Rings used: Manhole cover elev: Final grade elev: Tank inlet elev.: Tank outlet elev.: No. of feet from nearest road:Front Side , Rear Ft. Yl~ From nearest prop. line:Front, Side , Rear Ft. No. of feet from: Well ~5 r Poi Building: (Include this information in the above plot plan) (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 ele','ation Pump on elev.: Pump off elev.: Gallons/cycle: Alarm: Man.: Switch Type: Location Distance from nearest prop. aline: Front_, Side_, Rear_Ft. Distance from: Well Building SOIL ABSORPTION SYSTEM Bed: Trench: Seepage Pit: Width: Length Number of Lines: Area Built Exist. Grade Elev. Proposed Final Grade Elev. Fill depth to top of pipe: No. feet from nearest prop. line:Front Side Rear Ft. No. feet from well: No. feet from building HOLDING TANK Manufacturer: Capacity: No. of rings used: Elevation of bottom tank: Elevation of inlet: No. feet from nearest prop. line:Front , Side , Rear Ft. No. feet from: Well , building , nearest road Alarm Manufacturer: INSPECTOR: DATE: PLUMBER ON JOB: LICENSE NUMBER: 6/90:cj I Parcel 040-1181-40-000 01/27/2006 04:51 PM PAGE 1 OF 1 Alt. Parcel 36.28.19.728-1 040 - TOWN OF TROY Current X 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 - RASMUSSEN, VERNON L & CAROLYN A VERNON L & CAROLYN A RASMUSSEN ANNEXED TO CITY R.F 00000 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 75 RIVERSIDE DR SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 0.404 Plat: 03/58-DANATE PARK SEC 36 T28N R1 9W LOT 12 DANATE PARK Block/Condo Bldg: LOT 12 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 36-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 2005 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 02/09/1990 Description Class Acres Land Improve Total State Reason Totals for 2005: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2004: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 040-1181-30-000 01/27/2006 05:05 PM PAGE 1 OF 1 Alt. Parcel 36.28.19.72713 040 - TOWN OF TROY Current X' 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 - RASMUSSEN, VERNON L & CAROLYN A VERNON L & CAROLYN A RASMUSSEN ANNEXED TO CITY R.F Districts: SC = School SP = Special P erty Addresses . * = Primary Type Dist # Description * 1274 RIVF.RSIDE DR 7 SC 4893 SCH D OF RIVER FALLS 1 SP 0100 CHIP VALLEY VOTECH `v Legal Description: Acres: 0.177 Plat: 03/58-DANATE PARK SEC 36 T28N R19W DANATE PARK NW 1/2 LOT Block/Condo Bldg: LOT 11 11 COM NE COR LOT 11, TH S 70 DEG W 141.7 FT, SLY TO E RAD 190.22 FT & S 13 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) DEG E 89.21 FT, NE 169.77 FT NW - POB 36-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 2005 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 02/09/1990 Description Class Acres Land Improve Total State Reason Totals for 2005: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2004: General Property 0.000 0 0 0 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 Total 0.00 0.00 0.00 SANITARY PERMIT APPLICATION V .DILHR In accord with ILHR 83.05, Wis. Adm. Code couNTY STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than E] / ,~at 8% x 11 inches in size. Cn evious application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPER WNER PROPERTY LOCATION SS Sit % E_ S 36 TP~,N,R l~ E o W PROPERTY OWNER'S MAILING ADDRESS LOT # /,,3 BLOCK ,t) 9 6 TY, STAT ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUM R l s o0) 'arl 11. TYPE OF BUILDING: (Check one) F] State owned O VILLAGE : N REST ROf D 10 4WN OF: ❑ Public ®1 or 2 F t•0/''S tt~ am. Dwell Ing of bedrooms PARCEL TAX NUMBER( J) III. BUILDING USE: (If building type is public, check all that apply)~l G ~/0©~ CC~/~ ~~4 1 ❑ Apt/Condo 2 ❑ Assembly Hall. 60 Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ RestaurantlBar/Dining 40 Church/School 8 ❑ Mobile Home Park 1120 Service Station/Car Wash 50 Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ❑ New 2. ❑ Replacement 3.' epl acement of 4. ❑ Reconnection of 5. ❑ Repair of an System System ank 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 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 140 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 (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION Feet Feet VII. TANK CAPACITY Site in allons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New istin Gallons Tanks Concrete structed glass App' Tanks Tanks Septic Tank or Holdin Tank OV I L<~PS CG S I:E~= 7- Ej F] F, F Fj Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plurybwfi Signature. (No Stamps) [*R49EDSW Business Phone Number: S Uan / -3 x31 P;- %9V- Plumber's Address (Street, City, to e, Zip ode): p VW IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date ssue Issuing Agent SI? I Approved ❑ Owner Given Initial Surcharge Fee) ~ L Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plbf7) (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. -,Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be . submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must"be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator"dr 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. 111. 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 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) LoQQ„T . 'PjQXj,A&9,28.19.728~RIVATE SE A YSTEMERSIDE D County: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division ST. CROIX (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 186516 Permit Holder's Name: ❑ City ❑ Village ❑KTown of: State Plan ID No.: Y TROY ev.: Insp. BM Elev.: BM Description: Parcel Tax No.: Cso <-00'`L-0 --I- 040-1181-40-000 TANK INFORMATION ELEVATION DATA A9200400 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic n j_-j %a- 0 v Benchmark Dosing Aeration Bldg. Sewer Holding St/ Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet Yo Vent irito ntake ROAD Dt Inlet TANK TO P/ L WELL BLDG. A Septic Q s0 Z NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System 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 _7 BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK CHAMBER INFORMATION Type O 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: (Include code discrepancies, persons present, etc.) LOCATION: TROY 36.28.19.728. SW,NE, LOT 13, RIVERSIDE DR. art ° i r t.c.~~}}QNVCr C7 LI) ru/1 L3.~f~Q _5 I` v r r CA.~t(~ (-c Plan revision required? ❑ Yes [ No Use other side for additional inform tion. -1 S SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. STC - 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 ~eU'&)14 S SSL° . Location of property5Wl/4 ZY 1/4, Section 3C, , T_' -N-R_W Township fQ Mailing address r ~9 _ a Address of site 2 Subdivision name PQn Q Lot no. F Other homes on property? x yes No Previous owner of property Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)? Yes V" No Volume and 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 the office of the County Register of Deeds as Document No. own the proposed site for e ewagef d sposalt system) Orr Ie(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. 1 Si ature of a li.cant Co-applicant Dat of Signature Date of Signature FORM 339-WARRANTY DEED-TO JOINT TENANTS. • , t 2.745 PV b ~atVt«~ N. C. MILLER CO.. MILWAUKEE '21 63 0 1 80011 J ! PAU"f This Indenture, Made this.. _ 16th .....dayof................. Au tIst 60 A. D., 19-_.- between.. . J.cseph H., S.c.nult.z and 'JA cc 14. ;`.chultz,..husband-_and wife and each in his I ~I and.. h_er-.own .right . . _ . - - --------part. of the first part, • ` iI li and Vernon L. Hasrntsscn. ar_d Caroler. A. Iasi ussen,, husband and wi,re, I I _ II as joint tenants Witnesseth, That the said part... of the first for and in parties of the second part. part, consideration of the sum of E,n Act e cr ~ousan,i and Ho 100 Doll r - to in hand paid by the said parties of the second part, the receipt whereof is hereby confessed and Fw• acknowledged, ha_ given, granted, bargained, sold, remised, released, aliened, conveyed and confirmed, and by these presents do. give, grant, bargain, sell, remise, release, alien, convey and confirm unto the said parties of the second part, in joint tenancy, their heirs and assigns forever, the following described real estate, situated in th(; County of 3 C%roix , and State of Wisconsin, to-wit:' t l O l a1)C O al e'd s0" Cast --ter of t'.,, II t " q aa r.ortlwost quart L ;i -~^e S C - _tF O. nrt ca"'. quarter of SE' ti or 2 ' T X f .-rc~ _ -i r:, F11rtr C', rr7CS rl_II E~i as f o] '}-n 3J t ,E'. r L• ~inOr,,~T rYiJSt a.LO".~ .l' ,~1, of sai;, t l o. _ a di stance of 363•0 ff-ct, (22 ro'~), 4 .r O 13 5.6 1-cc. ,-t,YFrCe S 890171 E a d stance of henr-e following. said river so1:t, - , p~ Jt a crsc yl of said r~ ver and said quart_£r line, thence l.o said q,zu te'r L..c to c_-,± of beginning, the above parcel cortair 1, e3, cr'e or loss, and sty?,~c_t tl,c following exception, O~J3' r o a r.ctr'CEa rBt'3.1..i.t' { G 9o,3t at the center of sa...d Soctior 0 dL alOr~ a quid ~(r lino a distance of 49.5 feet, (3 roc`;:), n l~z r {J a J~ ot•anC y r , S400_1 a ra; e of 187.0 feet, ^iOT'e n, l t l1f r1-,m3t, ewn to the inter C'(-t f- '9053' yJ along said quart _L-.. L . I f L E 1 4 ii r Together, with all and singular the hereditaments and appurtenances thereunto belonging or in any wise p' appertaining; and all the estate, right, title, interest, claim or demand whatsoever, of the said part ...i.es of the first part, either in law or equity, either in possession or expectancy of, in and to the above bargained premises, and their hereditaments and appurtenances. To have and to hold the said premises as above described with the hereditaments and a ppurtenances, unto the said parties of the second part, in joint tenancy, and not as tenants in common, and to their respective heirs and assigns FOREVER. SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNS UYER fa S 'W Eefi ADDRESS: j /u e r'-' FIRE NO: LOCATION:_ 5 1/4, 1/4, SEC. 3 C~ T c Y N-R_,Z~'_W, TOWN OF: ST. CROIX COUNTY SUBDIVISION: It LOT NO.~1 5 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 DNR. Certification form must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: / WILY 1,/ DATE : St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 Form - ST C - 102 ONE AND TWO FAMILY -The existing system must be inspected for compliance to bedrock and high groundwater requirements of the code. This, in many instances, will require a soil test to be conducted by a Certified Soil Tester or an on site by this office. If the existing system does meet minimum requirements for groundwater and bedrock depths and if it is functioning, an addition can be added in most instances without updating the existing system. If the existing system is utilized for the addition, every attempt should be made to locate and reserve an area which is suitable for a code complying replacement system for when the system fails. If the addition will substantially increase the wastewater discharge, the existing system shall be replaced with a code complying private sewage system. 1/4 1/ Subdivision & Lot Section Township 73,4y `_F.6_r zayev~Ljr GUj SyaZ~ r Rural Route # Address Post Office Zip Code (I)(We) , plan to (build an addition to, remodel) the building ft -the above named location. The present private sewage system has been working satisfactorily as far as disposing of wastes. If the present private sewage system does fail, it will be replaced with one that is code complying. (1) (2) (Owner's Signature) Date Subscribed and sworn to before me this ~o ay of 19 Notary Public County, Wisconsin My Commission Expires :2-Lq-~6 ST. CROIX COUNTY (County Authority) Plot plan attached (show location of building addition to drainfield and septic tank). Include soil testers report form. • W 0,14t, c , -po N W Cr " V) lot to ~4 q~- con % IQ) t- ZZ 4p -,U tv Norj va 4i1 J x t ....',tray- Z R C C t . rte ► . 4 r 4 'Z ( CO t / W.0 Oig W t c x z?W ul ~ I\ - REPT131• TROY ST. CROIX COUNTY ZONING PAGE 1 11/10/92 10:43 REQUESTS FOR INSPECTION WORK SHEETS FOR: 11/10/92 AREA: TN Activity: A9200400 11/10/92 Type: CONVSEPT Status: PENDING Constr: Address,. TROY 36.28.19.728. SW,NE, LOT 13, RIVERSIDE DR. Parcel: 040-1181-40-000 Occ: Use: Description: 186516 Applicant: RASMUSSEN, VERNON L & CAROLYN A Phone: Owner: RASMUSSEN, VERNON L & CAROLYN A Phone: Contractor: WANG, TOM Phone: 425-9958 Inspection Request Information..... Requestor: WANG, TOM Phone: Req Time: 11:11 Comments: il:00 Items requested to be Inspected... Action Comments Time Exp 00012 FINAL INSPECTION Inspection History..... Item: 00012 FINAL INSPECTION II ~ q~~G~ 3~~~ J ~U. ~~S 524665 CERTIFIED SURVEY MAP LOCATED IN THE NW 1 /4 OF THE NE 1 /4 OF SECTION 36, T28N, R 19W, cr., CITY OF RIVER FALLS, ST. CROIX COUNTY, WISCONSIN. S 87027' 09" E 2640.68' N 1/4 COR. SEC. 36, 720.00' T28N, R 19W 1920.68' NE CORNER SECTION 36, T28N, R 19W WILLIAMS PIPE LINE COMPANY UNDERGROUND 3 PIPE LINE ALONG PROPERTY LINE U1N l-LTTJE Q_ 1~ANDS. ~ o ~ o N N ° FILED S ,7S°S0 38 cn 38296' E 9 DEC 2 8 1994 ► 2 LOT 3 JAMES O'CONNEU C.S.M R99ist dDeab I W POINT OF P 1-Q SL Ow cm,Im BEGINNING Q o ~ DOC_ #512575 ~ co QI g LOT 1 LEGEND: 01 0 114,406 S.F. wl z 2.626 ACRES COUNTY SECTION CORNER MONUMENT, FOUND. QI M N N zl R=268.65' ° 0 1" X 24" IRON PIPE, WEIGHING ~I 0=39°32' 51 " 0 1.68#/LINEAL FOOT, SET. L= 185.43' T=96.58 Ch= 181.77' CB=S 72°46' 26" W 10' WIDE UTILITY EASEMENT 13 N 87027' 09" - g0~~j ~ RIVERSIDE DRIVE ~RS\pE DRIVE S 02°32' 51„ W co 66.00 y - - - - - co 10 ~ w -I- ~ °o, J R=202.65' Z 0=39°32' 51 " o L=139.87' o w T=72.85 cn S 53°00' 00" W Ch= 137.1 1' o 00 CB=S 72°46' 26" W w o 33.08' z uj N w ~ U w w UNPLATTED LANDS z m w = C/) r z = Q wo 3 m Z rn ~ J W (n ft~ co V) O N Q Z H SCALE IN FEET 0' 100' 200' 300' / Vim' DATE: DECEMBER 21, 1994 I THIS INSTRUMENT DRAFTED BY JAMES D. FILKINS SHEET 1 OF 2 SHEETS Vol. 10 Page 2862 h 0~ 2 FILED 6 MAR 1 7, 1995 So,- 3 KATHLEEN H. WALSH Register of DWS ` B S L Croix Co.,wl 526839 CERTIFIED SURVEY MAP LOCATED IN THE NW 1 /4 OF THE NE 1 /4 OF SECTION 36, T28N, R 19W',-' CITY OF RIVER FALLS, ST. CROIX COUNTY, WISCONSIN. UNPLATTED LANDS N 1/4 COR. SEC. 36, NORTH LINE OF THE NE 1/4 T28N, R 19W S 87027' 09" E 2640.68' NE CORNER SECTION 36, POINT OF 339.98' 720.00' T28N, R 19W N BEGINNING i 380.02' 1920.68' n 0 ND L S p/p L `E cli DEDICATED 8TO SHE PUBLIC 3 ,904 P~p£ EpANy I 1.582 ACRES ,~I \ ° N NILI N o plnl!l v)I N N O MI I~IWI~ QI N 75 8-96, V) 0INI~IQIOI JI `f 50' 38„ -,i,3 >In.lol of o LOT 2 w 3 0 195,934 S.F. < co~v ^ 4.498 ACRES ILL- ZI 0 Lo a N LOT 1 :DI Z -10 ° PAGE 2862 I cn _DOC. _#5_24665 I I l ~ I tikI~~~ RIVERSIDE DRIVE 70- o moo NS8o24~ `0°1~. R~00'`~~ ~•~`~•5.y ,o~~~'°° OWNER & SUBDIVIDER it, ,yo0 y'h . o. VERNON L. RASMUSSEN A 73 RIVERSIDE DRIVE RIVER FALLS, WI 54022 UNPLATTED LANDS '99 .0 UNPLATTED LANDS SCALE IN FEET w 0oi 0' 60' 120' 240' 360' 3 LEGEND Zwrn L.i w w COUNTY SECTION CORNER MONUMENT, L Z 0 BERNTSEN CAP, FOUND. 00 N I~ 00 ~ o • 1 " IRON PIPE, FOUND. z 0: zrq w Jz~ o m = 0 1 " X 24" IRON PIPE, WEIGHING 1.68#/LINEAL FOOT, SET. mmo< Fr z N m - - 10' WIDE UTILITY EASEMENT F CURVE DATA # LOT RADIUS CENTRAL ARC CHORD CHORD BEARING TANGENT IN & OUT ' ANGLE LENGTH LENGTH C l 276.66' 05°13' 14" 25.21' 25.20' S 50°23' 23.0" W S 53°00' 00" W S 47°46' 46" W C2 2 342.66' 05013' 14" 31.22' 31.21' S 50°23' 23.0" W S 53°00' 00" W S 47°46' 46" W 0 THIS INSTRUMENT DRAFTED BY JAMES D. FILKINS SHEET 1 OF 2 SHEETS VOL. 10 PAGE 2895