Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
012-1021-90-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 408240 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Mahoney, Donald I Erin Prairie Township 012 - 1021 -90 -000 CST BM Elev: Insp. BM Elev: BM Description: (] TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark t� _ Alt. BM jHo!1di7ng Bldg. Sewer • Ht Inlet /0- Z , Z TANK SETBACK INFORMATION t Outlet Ll TANK TO P/L WELL BLDG. Vent to Air Int ke ROAD Dt Inlet Septic �5 / {—� Q 1, Dt Botto Dosing Header /Man. A Ion Dist. Pipe Holding Bot. System 5 Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover PM 3 • Q �.S Model Number H Lift Friction Loss m Head TDH Ft TD rcemain Length Dia. Dist. to SOIL ABSORPTION SYSTEM BED /TRENCH WidthLen th No. Of Trenches PI Of Pits Inside Dia. Li ui DIMENSIONS - Z r S O SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING er: INFORMATION CHAMBER Type Of Syste } zZt >6 f , r0 D Model Number: DISTRIBUTION SYSTEM J Header /Manifold Distribution x Hole Siz x Hol cing Vent to ' ntake s Pipe(s) S Length 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 �] Na L Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: :2 / OZ Inspection #2: Location: 1663 No. County Rd GG w Richmond, WI 54017 ( W 1/4 NW 1/4 8 T30N R17W) NA Lot Parcel No: 08.30.17.115B 1.) Alt BM Description = �0� �• 'brQj,, "I S YGtvS / 31 -/� \ 2.) Bldg sewer length = Z�' �� see P ve Q'6(A3 S0,h•i favy 1pe''�cT 1 / !O J s `` amount of cover = y 5- 01 do Gwm*,�� Plan revision Required? ', Yes No Use other side for additional information. ___J t SBD -6710 (R.3/97) Date Insepctor's Sig ure Cert. No. t �D X 1,ax POWERS EXCAVATING INC. 1969 185th AVE NEW RICHMOND, WI 54017 JULY 15, 2002 RECEIVED JUL 3 1 2002 ST. CROIX COUNTY ZONING OFFICE Dear Sir: On July 15, 2002 I inspected the sewer system at the Don Mahoney home and it appears to be wor ' and has no visual sign of failure. Sincerely, Calvin Powers MPRS #220537 D12 - 107- » 10 - OVO 08'.'30. 1'+- 11 6 � - +ry Pe-6twE �k- lb6 N o. C- .. U- CaC� lo T.S.- � « -- r W , z+ ,► #td H.i1ar. g Divkim 'MI w, Ate.. to. soot �R� Cf`o /1 hdn , wr 33a m - 7zdz Sib � DO of mi� can 'r Y-o'L- js s' air c' !Q� CC Pftmk A � NtII— �..� � D t Beet r>e.,� AS Ltne ois RECEIVED 9 Facd ft ubw p•eq ow.er'e � Ad6ug e 2002 © - 1 --`1 —o� p+�o► Lot:otie. lib'. sttra ST. CROIX COUNTY N R l �P CSp Lot N odw t � er Nun �� � JL TAP Of & �DwemWg aveat a S I V 1 or 2 Ata�r — labor of eit�,eotoo � oci4' D r to - l>wft Va Dv Q sole 0-m d 1 n 1 r f �'�7M +K!les Kaeeat seebr rtte IBM sei 6e A a seYttte lair itleead �enliieee iee s i!! 10 Now 2 D a l 9j 3 Rq*=mm of b❑ AAiieios W I c'brot tt Sl..ilery �l:eeit p+oesdt NamDor Dose JET. ' . a[ ire �L1nac a/ Nrt .eaMa b hr hdmmW wO 44 D MW b u© t+ cmd 47 D smd Mw so D Comuumd WW 22 D Pmamined b4koo d 41 H T , Q a$* paw 510 V* Lim 43 D A*Gtm a 4a D Amobic Thou u a s D v A�. se D other Da l clew ( Anse Sad p am s�ete.. Btowlbo Ftoet tirade ely- acts Ra cwt abvad , VL Tmk lr& in mm biwm as see of 7umb r. e , suei Mar piss& bins Daft Cbmwb& '�- 8�.e.n�.c- a" fltr Morl.i�i..ftb. ro'pYt9i..a... a�e,raiet AoaDee"e �..tiere : Adimu lKA D� i (eebtdee tiaaaderaeer Does hrued (No a� +.rrt.e ws.c...�..tr> 6.s,eo... 3111 mli" V,A rl\a� r\ S t� �1� N LO y� p S 8' - r,31 N l 7 W 1 (03 N � / j c n,.i IL; S(JO 7 / /o 5 c / lztIT � e "Q ( kZ�0' aAD S S'7 A - rip 4 ) SA, Sid / �1 1 c� �l I �a 9 Z6,,.,a o n S w `1�e N lq S 8' T'31 N (o �3 N �{- Q4 r ` .2sz ` m on W� SVOI 7 /o 5c) a464 7 �S 1 �a [T Sid ` �'1 1 c' C9 Ixl 4l �i 40 . POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE WFORM TION SYSTEM SPEC1114CATION& ()vvner Ca f\� Septic Tank Capacity al ❑ NA Permit Septic Tank Manufacturer p NA DESIGN PARAMETERS Effluent Fitter Manufacturer ❑ NA Number of Bedrooms 3 ❑ NA Effluent Filter Model 100 ❑ NA Number of Public Facility Units © NA Pump Tank Capacity al CFMA Estimated flow (average) o d auda Pump Tank Manufacturer Cr Design flow (peak), (Estimated x 1.5) j (� g aVd ay Pump Manufacturer A Soil Application Rate at/da /W Pump Model A Standard Influent/Effluent Quality Monthly average • Pretreatment Unit A Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection 0 Other. Pretreated Effluent Quality Monthly average Dispersal Call(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L ❑ In- Ground (gravity) ❑ In- Ground Ipressurizsd) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Colifonn (geometric mean) 510 cfu /100ml ❑ Drip - Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Off. ❑ NA Other. ❑ NA Other: ❑ NA 'Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTEN SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: month(s) (Maximum 3 years) ❑ NA earls) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ' month(s) (Maxbnum 3 yam) ❑ NA year {s) Clean effluent filter At least once every: �' — � ❑ month(s! earls) ❑ NA Inspect pump, pump controls & alarm At least once every: ❑ month ❑ yeaar(s) rcs) A Flush laterals and pressure test At least once every: ❑ month(s) ❑ year(s) Other: At least once e ❑ month(s) A �': ❑ year(s) Other. 6,NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cells) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (arol) Zi UP AND OPERATION For new Ponan that may d j � to � of the POWTS Pegs` of of the tank's) removed mt Process and /or check treatment tankls) for the damage trio to cellist. tf h Presencs of painting Products or other ch Y a sepiage serve operator prior to use. � concentrations emica System start up sha8 not occur are detected ected have the conten. Durdisching Power when soil condit are frozen at the infiltrative surface, urged to the dispersal ce ranks may c fill effluent. 7o avoid this aNisi in one lax normal hi�twater levels. When pow is restored the ex situation have dose, overloading the cellist and may result in the back excess was tewater will b Power to trio effluent contents of the pump tank removed u or surface discharge o restore normal Pump or contact a Plumber or POWTS M by a Sept Seiage Saryi�yng Operator levels within the Pump tank. M aintainer to assist in manuagy open Prior to restorinj Do not drive or Park vehicles over tanks operating the Pump controls tc within 15 feet down sloes es and duel cells. Do not drive or park nvur' or d isturb or com pact, the ar Reduction or elimination of Of any the follow ur a the absorption area. soil Otherwise d et POWTS: antibiotics; Mg i4om trio wast mprove the performance tms; bab wa stewater stream ma y w' foundation drain 'SUMP Pu des; sanitary napkins; mptci cigarette s; condoms; cotton swabs ;'degreasers; dental floss; and Prong the life of the fr Painting Products: Pestici table peelings; gasoline; grease; mss; disinfectants; fat; ABANDONMENT tampons; and water softener brine. des; meat 8 Ms; medications; oil; When the POINTS faits and /or is Permanently taken out of Properly and safely abandoned in compliance with chapter service the following steps shad be taken to insure Comm $3.33, Wisconsin that the system is • All Piping to tanks and Pits shall b Ad ministrative Code: e disconnected and the abandoned pipe openings sealed. • The contents of all tanks and Pits shah be removed and • After p diseased at by a Septage Servicing Operator. P Ping, all tanks and pits ater and removed or their covers removed and the void s soil. gravel or another inert solid materialbe . excavated a CONTINGENCY PLAN Pace fitted with If the POWTS faits and cannot be ropaifed the following replacement system: measures have been, or must be taken, to ❑ A suitable re Provide a code compliant system. Placement area has been evaluated and ma The replacement area should be y be utilized for the location of a replacem required setbacks fro existing prot and proposed struct from disturbance and compaction and should not b b in y snit absorption result in the ure, lot lines and welig infringed upon b need for new soil and site evaluation to establish a suitable allure to protect the replacement area will comply with the rules in effect at that time. replacement area. R 0 A suitable ePlacorrtersi systems must repl acem ent area is not available due to setback and /or soil limitation B arr technology a holding tank may be installed as a last D Trio site has not b resort to replace the failed i'OWTS. � advances in POWTS been evaluated to ident' evaluation must be dY a suitable replacement area. Upon failure of the may be into to locate a suitable replacement area. If no replacement a available holding last resort dtank ailed as a to replace the failed POWTS. are is a site © Mound and at -grade soil abs y infiltrative surface. absorption s stems may be reconstruct in place following removal of trio biomat at the Reconstructions of such ad systems must comply with the rotes o effect at that time. < WARNdYt3> > SEPTIC. PUMP AND OTHER TREATMENT TANKS MAY CONTAIN TREATMENT ENTER A SEPTIC. PUMP OR O LETHAL GASSES AND/OR i SUFFICWNT OXYGEN. DO NOT PERSON FROM THE INTERIOR OF A TAN M A Y BE TANK UNDER ANY CMCUMSTANCES. (X:q MAY RESULT. RESCUE OF A DiFFlCUl7 OR IMPOSSiBLE ADDITIONAL COMMENTS POWTS INST LER Name @ties �QrS POWTS MAIIMTAINER Phone (o S - 1 Name Phone '� OPERATOR ER ) Name LOCAL REGi1LATORY AUTHORt7Y Phone Name c Phone S docurnern was drafted comPiiance with aria er Pt Comm 83 . 22 ( 2 1ib!(1l(d)&(fl and 83.5401, (2) & (3), Wisconsin Administrative Code, ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND `` �, OWNERSHIP CERTIFICATION FORM Owner/Buyer ' D© o-\ I I 1 o�0rio- Mailing Address _ ��93 k) P4 C4 �)4,to P -, � T ,3d 1 5 y0 I Property Address - (Verification required from Planning Department for new construction) City /State Parcel Identification Number o 12 -- l o z t - ' of o G LEGAL DESCRIPTION Property Location W /,, N w y,,, Sec. 2 a T 3Q N -R_W, Town of Er �— Subdivision , Lot # Certified Survey Map # Volume . Page # Warranty Deed # x5 Volume , Page # S Spec house ❑ yes $ no Lot lines identifiable (9 yes ❑ no SYSTEM MAINTENANCE Improper use and maintenanceof 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 pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber; restrictedplumber or a licensedpumper verifying that (1) the on -site wastewaterdisposal system is iii proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, here* as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 34 da n of the three year expiration date - SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of (7 roperty described above, by virtue of a warranty deed recorded in Register of Deeds Office. `% 7 /1 1 0 L SIGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.' *' * *' '• Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed u �� arrn �1 - Dr. —To Hurband nit WI r tV� Pa�E�W 61. 253828 P ik; $ ibenture, Jude this 24th. days of ' March -, ' between Owen J. Coughlin and Bridget boughlin, husband and wife"'and .each in their own individual capacity, of the Town of Erin Prairie , • • St. Croix County, Wisconsin - parties of the Brae •Donald. J. Mahoney and Theresa Mahoney, of the same place husband and wife, as joint tenants, parties of the second part. Wftntoortq, That the said part ies of the first part, for are, in consideration of the sum of • One ($1.00) dollar and other valuable consideration - - to them in hand paid by the said parties of the second part, the receipt whereof is hereby confessed and acknowledged, have 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, as joint tenants, the following described real estate situated in the County of St. Croix , Wisconsin, to -wit: Commencing at the Southwest corner of the Northwest q uarter (NWT) of Section Eight (8) Township Number Thirty (30) North of Range Number Aeventeen (17) West, .St. Croix County, Wisconsin; thence North Seven hundred forty -three feet to the point of beginning f this description; thence East Three hundred (300) feet; thence North at right angles One hundred sixteen (116) feet; thence West at right angles Three hundred (300) feet.; thence South to s ; beginning; CO#ttbM with all and singular the hereditaments and appurtenances thereunto belonging or in anywise appertaining; and all the estate, right, title, interest, claim or demand whatsoever, of the said part ies 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. Cc babe a n b to i?Olb, the said premises as above described with the hereditaments and appurtenances, unto the said parties of the second part, as joint tenants. Anb tot 440, Owen J. Coughlin and Bridget Coughlin, husband and wife, ' parties :- of the first part, for themseZves, , their heirs, executors and administrators, do ,- covenant, grant, bargain and agree to and with the said parties oL the second part, and to and with the survivor of them', his or her heirs and assigns, that at the time of the ensealing and delivery of these presents they are well seised of the premises above described, w i { TI • r , ds of r good, sure, perfect absolute and indefeasible estate of inheritance in the law, in fee simple, and that the same are free and clear from all incumbrances whatever. and that the above bargained premises, in the quiet and peaceable possession of the said parties of the second part, as joint tenants, against all and every person or persons lawfully claiming the whole or any part thereof they will forever WARRANT AND DEFEND. ]n Uittnt0O Wbertot, the said part i of the first have set their hand s and seal s this 24th. day Of ) '-o h , 19 58. Signed, Sealed and Delivered in PFesence of � r..1� -- .:_. _._...... .... - -....._—(Seal) (( nn Bridget CouAzin H„ ghg9 .. ....._.__..._......._. __..._ ..__ .............._..._�(Sea1) . �......_...__ .............................._ ..._ ....... _.._.,.._.........._...__(Seal) Eva G. Lynch f4tate of Wi0ranoin, St. Croix C ss. ounty. On this the 24th. day of March ' 19 58, before me, J. E. Hughes the undersigned officer, personally sba pP Coughlin and Bridget Cough) n h�nc nd a pp eared Owen J . ndwn or sans a onl raven to be the persons whose name s subscribed to the within ins'rument and ackrowledr-ed that he executed the same for the purposes therein contained. t In witness whereof I hereunto set my hand and official seal. ► ; Hugh ' * Notary Public, St Croix County. Wisconsin. i My Commission expires November 20 '1960 . �'. � (To be filled In If el�ned iota r > f'uh. i,: � (N. 8--Ch. RY Win. /tote. orortdre that all te.trat•rnt■ to be reeorded .boll have plainly Printed or t"errltlen tbereou the We0 of the araalora, pantNa wltae.eea and notary.) Cd Co: LO Co i i a o; 2 N i a ( n ,h N_ • O ro 0 • r � �; a. .a A � 3 .y a I QJ to Old 1 o A ,q' C M: `o U E-+ Form -STC- 104 AS BUILT SANITARY SYSTEM REPORT OWNER f ` q 11*_ " SHIP r� n PtO 11^t +q� SEC. T 3D -RI ADDRESS t°r r ST. CROIX COUNTY, WISCONSIN & 6 1 t s i t SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I•LHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM CIO v R JyO4b ^1 •7 r ` V � INDICATE NORTH ARROW Lot L�v.G �.~Jl 1 '� BENCHMARK: Describe the vertical reference point used �►�\ l!- ?0w ur '?G Elevation of vertical reference oint: / p f dQ Proposed slope at site: S � SEPTIC TANK: Manufacturer: ?OCA'trf 6kyA w quid Capacity: ,0�--Sd Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front_, Sid5ear, O feet From nearest-property line Front 1 0 Side 4�Rear, O y feet Number of feet from: well 104 _" , building: 01 r '} (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE T PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump /Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: ` ` Trench: . Width: Length: S Number of Lines : t_ Area Built: a Fill depth to top of pipe: Number of feet from nearest property line: Front, & Side, O Rear,O1?t.7-W Number of feet from well: / 0V Number of feet from building: 7Z (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: �jZ ��� Inspector .p Dated: Plumber on job: � 1 � � YN u _ License Number: 3/84:mj DEPARTMENT OF INDUSTRY INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RiFLATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 79169 BUREAU OF PLUMBING MADISON, WI 53707 ERXONVENTIONAL ❑ALTERNATIVE I State Plan I.D. Number: ❑ Holding Tank ❑ In- Ground Pressure 1:1 Mound (II assigned) NAME OF PE iM1T HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Donald Maloney R. R. 1, New Richmond, Wr 54017 _o BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT, ELEV.: SW NW, Section 8, T30N -R17W, Town of Erin Prairie Name of Plumber: MP /MPRSW No.: coumy: Sanitary Permit Number Cal Powers, Jr 1563 St. Croix 69603 SEPTIC TANK /HOLDING TANK: MANUFACTURER. LIQUID CAPACI TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: DYES ❑NO DYES ONO BEDDING: VENT DIA.: VENT MATLL. H R ROAD: PROPERTY WELL: I BUILDING:IVENT TO FRESH ALARM: LINE: AIR INLET: ❑ DYES NO ❑Y O DOSING CHAMBER: MANUFACTURER. 7E ING LIQUID CAPACIT PUMP MODEL. PU /SIPHON MANUFACTURER. - WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: E E1 NO DYES ❑NO I DYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER 'i OF PROPERTY WELL I BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET: PUMP ON AND OFF) ❑YES ❑NO NEARESC SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: �y WIDTH. L. NO. OF DISTR. P E SPACING. COVER INSIDE CIA.. #PITS: LIQUID SiE T ENCH TRENC HES. r , Mir RIA SIT DEPTH: v±IE.NfIS GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE JOISTR. PIPE TERIAL: NO. D R BER' ©F PROPER WELL BUILDING: VENT-TO FRESH OM BELOW PIPES ABOVE VER. ELEV. INL T ELE ; EN - * �,. PIPES. F- .{. FR LIN c'` �9 AIR 71 IN' ET 1 J 1 f i ... f N EAR E ST F � .. MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- DYES ❑NO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEXTURE J PFRMANENT MARKERS J OBSERVATION WELLS DYES ❑NO ❑YES ❑NO DEPTH OVER TRENCH /BED DEPTH OVER TRENCH /BED DEPTH OF TOPSOIL: SODDED SEEDED: MULCHED. CENTER EDGES: 1:1 YES ❑NO ❑YES ONO DYES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: c WIDTH: LENGTH. NO.OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER: TRENCHES: rk�fME`!~sEEtG}�1S '' MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. I D ISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: -ray,. ELEV.: ELEV.: DIA.. ELEV.: PIPES: DIA.: ' ELIWAT O A IO IST,RI U1 o r j HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED ItUFtElRMATL?N PLANS: DYES 1:1 NO ❑YES ❑NO COMMENTS- PERMANENT MARKERS: OBSERVATION WELLS: NUM604 Of PROPERTY WELL: BUILDING: �,!'l� F ,]F LINE: j �� L1 YES El NO DYES 1:1 NO 11EAI ST fJ' u v Sketch System on Retain in county file for audit. Reverse Side. SIG NATUI�� TITLE: Y „ DILHRSBD6710(R.01 /82) """ y. �—° �"-° FZ--, APPLICATION FOR SANITARY PERMIT DILHR OUNTY (PLB 67) UNIFORM SANITARY PERMIT uSTRV,LRBOR&HUMRn RELRT10nS �V D e e — Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8 %x 11 inches in size. —See reverse side for instructions for completing this application. PLEASE PRINT PRO ERTY OWNER MAILING ADDR S M ' PROPERTY LOCA ION G'ifiY: 1/ 1/4, S , N, R (or)40 TOWN LOT NU BER BLOCK N MBER SUBDIVISI NAME NEAREST R AD, LAK OR LANDMARK STATE PLAN I.D. NUMBER Ic 4 1 /i TYPE OF BUILDING OR USE SERVED f 1 or 2 Family Number of Bedrooms: 3 ❑ Public (Specify): THIS PERMIT IS FOR A: ❑ New System ❑ Tank Replacement ❑ Repair W Replacement Soil Absorption System ❑ Revision ❑ Privy ❑ Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. �I Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank l 'A System -In -Fill ❑ In- Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued ❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump Tank /Siphon Chamber Holding Tank capacity Manufacturer: IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In- Ground Pressure Total *of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump /Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): Private ❑ Joint ❑ Public 1, the undersigned, hereby assume responsibility for installation o the private sewage system shown on the attached plans. N of Plumber (Pr i Sig e: MP /MPRSW No.: Phone Numbe a Plumb 's Address: Name of Designer: COUNTY /DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved p` ❑ Owner Given Initial i CA c— O p ? G J Approved Adverse Determination Reason for Disapproval: Alternate course(s) of Action Available: DILHR -SBD -6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398 To be complete and accurate the permit application must include: 1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in a city, village or town); 2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.); 3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks. 4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of square feet to be installed; 5. Complete the section on water supply; 6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi- fication, place your license number in the space provided and sign the permit in the signature block; 7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the permit; 8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67 -T) to be submitted to the county prior to installation. Failure to comply will void the sanitary permit. 9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable. 10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system, depth of the system, type of system. 11. All revisions to this permit must be approved by the permit issuing authority. 12. A complete plan including a plot plan, drawn to scale or with complete dimensions. 13. Horizontal and vertical elevation reference points that are permanent and clearly shown. 14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s) to system, building sewer and vent observation pipe(s). 15. The permit issuing agent may require a cross section drawing of the effluent disposal system. TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning your system, contact your local code administrator or the Bureau of Plumbing, DILHR, State of Wisconsin. :YOL P�u25 'u . 2 Deed-To ri Onse N OIL 253828 ONO �ii beuture, Made thi 24th„ day of March ,1958 , h�rwcon ()'Aron .,j • (!.., . , 1, s �lpie I t j ,A t,Lw irie, • St. Croix County, Wisconsin parties of the first part, and .Donald J. Mahoney and Theresa Mahoney, of the same place - - - - husband and wife, as joint tenants, parties of the second part. Ulitntoortb, That the said par ies of the first part, for an, in consideration of the sum of • One ($1.00) dollar and other valuable consideration - - xmavax 1� to them in hand paid by the said parties of the second part, the receipt whereof is hereby �i confessed and acknowledged, have 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, as joint tenants, the following described real estate i situated in the County of St. Croix , Wisconsin, to -wit: I� I Commencing at the Southwest corner of the Northwest quarter (NW4) of Section Eight (8), Township Number Thirty (30) North of Range Number Seventeen (17) West, St. Croix County, Wisconsin; thence North` Seven hundred forty -three feet to the point of " beginnin of this description; thence East Three hundred 300) feet; thence North at right angles y One hundred sixteen (116) feet; thence West at right angles Three hundred (300) feet; thence South to beginning; Zzogttgtr, with all and singular the hereditaments and appurtenances thereunto belonging or in anywise appertaining; and all the estate, right, title, interest, claim or demand whatsoever, of the said part ies 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. Z[o babt enb to 1lo1b, the said premises as above described with the hereditaments and appurtenances, unto the said parties of the second part, as joint tenants. anb tyt %sib, Owen J. Coughlin and Bridget Coughlin, husband and wife, parties of the first part for themselves, their heirs, executors and administrators, do I covenant, grant, bargain and agree to and with the said parties of the second part, and to and with the survivor of them, his or her heirs and assigns, that at the time of the ensealing and delivery of these presents they are well seized of the premises above described, as of good, sure, perfect absolute and indefeasible estate of inheritance in the law, in fee simple, and that the same are free and clear from all incumbrances whatever. and that the above bargained premises, in the quiet and peaceable possession of the said parties of the second part, as joint tenants, against all and every person or persons lawfully claiming the whole or any - part thereof they will forever WARRANT AND DEFEND. 31n U UlDcrcot, the said part ies of the first have hereunto set their hand 3 and seal 3 this 24th. day.of r C h 19 58. " ��_ ..�'_.....��. °'_.�li���- ..._.._ Signed, Sealed and Delivered in Presence of Owen Bridget Co tJin ......... ...... ........_.-- ......... _.__..._ ..... _ _.._ ... _ ... . ............ _....._(Seal) __.. _..__..._.... _ ..... -- ._- ;�-- -- --- ' (Seal) Eva G. Lynch - V�tatr of Wh3ronenn, ss. St. Croix County.) On this the 24th day of March 19 58, before me, J. E. Hughes the undersigned officer, personally Coughlin and Bridge t �.sbac ; end wife Cou et appeared Owen J. g g , -n vn or s:j 5 . � or11y proven) to be the persons whose name 3 subscribed to the within ins'rument and acknowledged that 11 e executed the same for the purposes therein contained. It In witness whereof I hereunto set my hand and official seal. Notary Public. St. Croix County, Wisconsin. My Commission expires November 20 1900 . (To be filled In IC v;, -ncd i IN FI-4 h. bH Wt-. Stints. provides that all lnstrnmrnts to be recorded shot) have plainly printed or lypewritlen thereaa the names of the arontors, rrantees, witne.— and pot.".) ni cz Go Lo ` h 7i L1J N b cu A ] [' fl), N c m -ri N' 0 sk u O vi u LIZ .f' cd tw b0 q fri W v o 0 1 4);4.1 o 4. E-4 cc l i i 1 APPLICATION FOR SANITARY PERMIT ST 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 t0 � Location of Property ,j '4 1L� �4, Section _ , T N - R W Township Mailing Address �T Subdivision Name Lot Number Previous Owner of Property Total Size of Parcel Date Parcel was Created Are all corners and lot lines identifiable? X Yes No Is this property being developed for resale (spec house) ? Yes_ No Volume and Page Number a5 O as recorded with the Register of Deeds -W 3 INCLU WI THIS A PPLICATI ON O NE OF THE FOLLOWING: 1. rranty Deed z � an - 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. ------------------------------------- PROPERTV OWNER CERTIFICATION 1 (We) eexti4y that aU .btatements on th 6 4onm ane true to the best 04 my (out) knowledge; that I (we) am (ane) the owneA (,$) o4 the pnopen ty d" cAibed in this kn4o�unatc:on 4onm, by vi tue o{ a waivcanty deed tecotded in the 044.iee o4 the County RegisteA o4 Deeds as Document No. a 5 Z y; and that I (we) puzentty own the pnoposed site Am the sewage p04 dybtem (o& 1 (we) have obtained an easement, to nun with the above desenibed p&opehty, 4on the eo"thuc t io n o � b a.id .6 yes tem, and the same hays been duty heconded in the O � � ice o� the County Re.gi6ten o4 Deeds, a6 Document No. ) . C M cJ�'v SIGNATURE OF 0 ER SIGNATURE OF CO -OWNER (IF APPLICABLE) DATE S GNED DATE SIGNED O y r 1D S S U) 3 O O ui w M (D `c O p o o a 3 v`° ��'MDZ Q p C p W X m `�' 3°`°c°p7 A 0o CD ° m aN co .. w rF j C CD �A3a o °���w 0 CD �owo� w p O L 5- a: r cn „wr„r N � m w �° W O 9 � ° a —CD D �N cr it, Qo (D ODc_ ° IN =w n ° � w ° o �aQ° w =ota °_ rn C v°', P N `D �_� N Z D w = C f _Z a a N CD 9 n N O y a D (D o "' , 7 " O a .: e = c g w ~ - A & > vi lu t ac0 C m ° 0 3 CD o gym �am� w 1 0 o, w = (RD a: f ma = 1 � 6 C N C — . a D w co 3 CL O O A y w G) a. � �awo m - C ID 7 w(n° a$� � ° sH C to C � � 3 ` c �• c c C) (a Q � A ° ( ; O o g a c. c ° 0 m --1m c 'DD S CL C N 0 Q. m :> 0 0 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY &BUILDINGS INDUSTRY, DIVISION LABOR A ND PERCOLATION TESTS (115 MADISON WI 53707 HUMAN RELATIONS (H63.09(1) &Chapter 145.045) 1 LOCATION: SECTION: TOWN SHIP /M LITY: LOT �O.:BLK.,NO.:SUBDIVISI NNAME: /T_ NX7 f (or) W COUNTY: OWNER'S BUYER'S NAME: M L NG ADDR SS: USE DATES OBSERVATIONS MADE I i NO. BEDRMS.: 1 COMMERCIAL ESCRIPTION: PROFILE DES RIPTIONS: OLATION TESTS: Residence _3 ❑New Replace I RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN- GROUND - PRESSURE: SYSTEM- IN- FILLHOLDIIN TANK: RECOMMENDED SYSTE :(optional) S ou J ou mu J U J c J � If Percolation Tests are NOT require DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5)(b), indicate: Floodplain, indicate F l o odplain elevation: A Z4 PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER- INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH 1%, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- .3 - ;; 1- 3 B- B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL - INCHES RATE MINUTES NUMBER W>Ie+W-S AFTERSWELLING INTERVAL -MIN. PERIOD 1 PERIOD - 2 PER PER INCH P- P- .3 iS P- is 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. i SYSTEM ELEVATION G• A 4* --j — ----- IN ._ _. .Aa..._. : { i ' { __1 - ------- L 4 i _ _ ____�_� _�a�_ _ � - -- , IL �t AWE I, the undersigned, hereby certify hat 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. NAM print : TESTS WERE COMPLETED ON: AD RE S. CERTIFICATION NUMBER: PHONE NUMBER (optional): CST SI A 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 - 6395 s To be a complete and accurate soil test, your report must include: 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 commercial 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; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE cliagram accurately locating your test locations. Drawing to scale is preferred. A separate sheet may be used if desired; 3, Make sure your benchmark and vertical elevation reference point are clearly shown, and are permanent; 9. Complete all appropriate boxes as to dates, names, addresses, flood plain data, percolation test exemp- tion, if appropriate; 10. If the information (such as flood plain, elevation) does not apply, place N.A. in the appropriate box; 1 1 . Sign the form and place your current address and your certification number; 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st - Stone (over 16 ") BR - Bedrock cob _ Cobble (3 - 10 ") SS - Sandstone gr - Gravel (under 3 ") LS - Limestone * s -- Sand HGVI' - High Groundwater cs - Coarse Sand Pere - Percolation Rate coed s - Medium Sand W Drell I's Fine Sand Bldg - Building Is - Loarny Sand > - Greater Than sl - Sandy Loarn < -- Less Than �I Loam Bn -- Brown sit - Silt Loam BI - Black s Silt G - Gray 'cl - Clay Loam Y -._ Yellow scl -- Sandy Clay Loam R Recd sicl - Silty Clay Loam mot - Mottles sc - Sandy Clay w/ _ with sic - Silty Clay fff - fLw, Fine, faint c - Clay cc -- common, coarse Fit - Peat rnrn - Marry, mr;cdiUrn m - Muck d - distinct p - prominent HWL - High water level, Six general soil textures surface grater for liquid 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 rrlay request verification of this soil test in the field prior 10 permit isst.ance. A complete set of plans for the private sewage system and a psirmit application must be submitted to the appropriate local authority in order to obtain a permit. The sanitary perrnit must be obtained and posted prior to the start of any construction_ PAGE OF Crc)SS S e-4Q. o� IJ�Q S y�te� Frstb Ak InIGIS And ObServallon Pipe J -- Approvsd Vent Cap Minimum 12" Above Final Grad* 20 42" Above Pips _ 4" Cost Iron To final prods Vent Pips Marsh Hay Or Synthetic Covering Min. 2" Aggregate Over Pipe Distribution Pips — Lo 0 0 0 0 — Too 01 Be nea t h Plp• Aa $ got pip• a Bs Perforated Pipe Below o — Covplina Terminating At Bolcom Of System PP SOIL FILL DISTRIBUTIOVI PIPE APPROVED S-49PETIC COVER 2 "CF j\ ?E. --��� a OR M AR'SN RA,- OF STRAW (o OF 12 -2 /Z AGGREGATE CLEV. OF. &L FEET____ F- W7 Dis rRIF�UTION PIPE TU BE AT LEAST _ WCHES BELOW ORIGIM4L GRADE AML) AT LEASTZO IKJCHES BUT MO MORE THAK1 HZ IMCNES BELOW FIKAAL GRADE MAXIMUM ®EPrH OF EXCAVATE O FROM OKi &w+aL 6RAoF- WILL BE _�_ INCHES PUMMUM ® r1i of EXCAVATIOM FROM '01kI4IagL 6Rac€ WILL BE –,<�92 — INCHES SIGWED: LICEUSE DUMBER: DATE: Z ,1A I >>o WC /-71 100�� r i p BS re Y/, .7 i I� 4�,X 9,0 a� 1. ERIN PRAIRIE - I � � T. 34 N. R.i 7 W. 45 SEE PAGE 5 K PO I /eonISEE PAGE 59 AVE, D Mar zi.3 S y a a J E ETT ILLp►y 43v J�..»es s �f)ice u�(� w,` /r/ch o v �` n Ny M 6 �C _ `rp d. Be// • ,ZJ. %ina_n Casay / 49 q Mt e1h , ll�� v y %�e/y tl� o avi t7Rona /d 2 O. W R.fR. 74 Bs. :: �O /son ,c Mar .boa /VBa /scar/ 3 o Ma /b errei . Thomas N Ly /e it T won a s ,$Sq i2o C d N 2345 C'o 9h /in Y NpFo/df .Eoy /u.�d Cu^ irn z � u.� .Z }o .h p 24 /60 239.2lo a r £ WILLOW ° 70 M . y ° d R!/N o z • d He /en \ pp . . AVE. � RI yER o9 `*c .:� � yy m .0 ,� � %� �• . / /.' How i8rid9 et ..s 43n9 Q X tl 0 �5 �� Gi %/ • 0 ao •Qou h u C v U David • 9 Te resa. on Q a,- Q Q NaseZ/ Dorreen Nancy Y F ° SsG La wren e e TN ,sy Paterson �c� it 's ' •F P vV co".. \ 79 4o • a.. .� Hare AVE. O Lounse. /54.7 / B G L Ly /e iT NPPo/dt �C o 280 Andrew C � Z Forrest eLjeo�.o z.3a s .� L � � ausr .zao \ 0 Rober Rzgucl7`a E /ea.rore M Chute zya l Gi //en etaJ B /aisPJ' I60 TH _ /6a z �o Y gO c: a/ U • Gx F • Q • Te e s a f s • AYE. `� \ ° oeterson 40 9m 0 n vv H /berT /'an o Bo k V tl � M�r /¢n .� Uh Kun3 do 80 //6.96 s a Vtln Ha kir>s . \Y,� ay •� � y P v zoo �Ta.re s J � Ter -Rae �c .s 240 iT H/i ch- �enr,.s Fl e rS ' � /sa.b `Q Ilonah�e Gt/es V. e//, efuK M.IC bah I6 �e�r�;� 1 5 �5/oddard Q ej /o9 C7 lh Y Do oth zoo uiZ /OD Peterson ®o W Thomas 8o Don u0's Q ~ tl Frida rno/ a j v L..9uri'o w Dair Inc a C tl Ca r; 9 �• Po /� rockPah/ GeunE/nk j Uahn f W 0, �0 el, a, BO ao •� 6 • ' e�Qyhriy /sy,3 .320 l9 G • • do a to en W nr (• .• W � Caro / n y R N E R Denn /s y sm t •� u s9 rocoha /er yo u y ° v Grate ke W \ C ° 8o y Is'B¢ 99 ® • Emmert E C.Lemke O� � �o�a /d Roy � p t) p C d • 3B NCO y tl { Ma 9uer:te v /in- �� 0; `C y J,e�n/s rjrn.ce. .320 v,3s �� Ma /o.�@y �n �w , � Emmert Le FrmS 4a [Tames zoo Do,oth E 9nna/Nas.e C Kru en a o- K - .A y "lax 3 9 Haro /d ibnow /° /60 �% ,N �' �JOr�a, ✓an eta/ Phi /PS HO //y oh r 1.0 O� c�EV •Kamm Doris ✓ate /sits 3iB. os Ar�.sor� /zo aro/ � tl � C F f Kareri ai 5 Q� g - 229.44 Karr .� /bo Igo r AVE. v,u IJe--, J, i/rth r- RZ. 0 arrie ene anrt/xt L. E er>, C o ao b R_ ysn 70. /6 Flrfhur L. t h'eri�buc% M. %d ed . / /o efux �V, V V zoo obersll?, O /40 � Ed. Le k E yC44C m �C N ' �`� �Q ' Wv Jls'� ene.��tl En 40 zao o s °9 UZ sE 40 Richard � � _ Louis H f E. �TudU J Har y h' ennS C ° h cSarr�.s.Ei V `' U/ferYs W�'c E /i/>o/" .5tafs o/t y EGracE v o /bo N W ner f7//cn f C Emrn rf ®O C �� • C /¢s / c 09 F /4 9./3 K t7,Bery 44499 Q h £R .ea.mrn L Z�a tlo v s v14x q Tom g C: ro <0 m. f Ka / C 3 T AVE a A J• Bo do poa F �W / f`� s qa� • te/d \ V Phi /,o • .� t Tu ,q tcc o 5fa f- -9ho /f� e.3o 0 2 B 4O Bcc/ w x scores/ LarnJ. Kuh /.r ar/ k6J110 a cbC D. . R. Qua/n /zo Howard /zo /ss .ch. �W¢Jke� 63 C VPhi Bo 16o v p ao h vh n /69.84 S Y L. 40 /39 k 3 o r/er� tl v Ka�Ga a uj V \ ona/7Les �O f o /orenrg c WY /am, yn %, i ' /zO a /so VJ ai /r e 'A f La✓e/% X-C, C S � $ F Mar 'C w Q Dairy C c5e sh2n �C n 99 S Rif 3 tl /60 • ��W c PG terson Ca ° y 0 \ 0� /zo C° NqR ��Tea�n U /oo� V ' e1' n gi Da /ton r ytl v o� <TC'nsen SC `0 °o �� T/Som�o i hu /sf 3 E 10TH 7z Q e N 2B.S Y F 40 /9BS Roc.Efo � .'�/aa. �.n /s, Inc. SEE PACE 3/ cSt C o.:r rrfy wis FARM COUNTRY SERVICE NEW RICHMOND AMA ` FIRESTONE PHONE: 246 -4238 ON THE FARM SERVICE RIVER FALLS Tractor Tires Light Truck Tires .. PHONE: 425 - 7671 Car Tires LAKELAND PLANT New Richmond 54017 PHONE: 436 -8886 or 386 -3922 Route 3, Box 317A l�iz Miles East on County K 246 -5040 SAND GRAVEL -READY MIX CONCRETE Parcel #: 012 - 1021 -80 -100 09/07/2006 03:38 PM PAGE 1 OF 1 Alt. Parcel #: 08.30.17.115A -30 012 - TOWN OF ERIN PRAIRIE Current Xi 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 - MCNAMARA, DANIEL CARL DANIEL CAR MCNAMARA C - MCNAMARA, KRISTI A KRISTI A MC MARA 1663 CTY RD G NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description ' 1663 CTY RD GG SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 1.770 Plat: 4500 -CSM 17 -4500 012/03 SEC 08 T30N R17W P SW NW SM 17 -4500 Block/Condo Bldg: LOT 02 LOT 2 (1.770AC) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 08- 30N -17W SW NW Notes: Parcel History: Date Doc # Vol /Page Type 11/11/2005 811873 2927/120 QC 06/17/2004 766108 2597/415 NAME CHG 07/28/2003 732158 2332/265 WD 04/23/2003 718398 17/4500 CSM more... 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 11/07/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.770 26,600 125,600 152,200 NO Totals for 2006: General Property 1.770 26,600 125,600 152,200 Woodland 0.000 0 0 Totals for 2005: General Property 1.770 26,600 125,600 152,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 z H 9 STC - 105 r r a H r SEPTIC TANK MAINTENANCE AGREEMENT r' 0 St. Croix County z r a OWNER /BUYER ROUTE /BOX NUMBER Fire Number CITY /STATE /t� �?�c -�: ZIP 1 ' PROPERTY LOCATION: ,I W 14, Section T 3 C) N, R W, Town of c St. Croix County, Subdivision 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 II the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix,County residents m 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 i 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 inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. H 0 E I /WE, the undersigned, have read the above requirements and agree � to maintain the private sewage disposal system in accordance with x H the standards set forth, herein, as set by the Wisconsin Depart - 'v ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNED PlYV DATE I ' 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.