HomeMy WebLinkAbout024-1043-10-000 0 O` $T. CROIX COUNTY ZONING OFFICE
St. Croix County Courthouse N '
911 4th Street COUNTY
�
Hudson WI 54016 � �� v
Telephone (715)386-4680 p� �..
h�
( 6
1
The St. Croix County Zoning Office offers the service of septic
and water inspections to Lending Institutions, Realty Firms, and
private individuals.
Completion of this form is essential so that the property can be
located.
Please provide the following information, enclose appropriate
fee made payable to St. Croix County Zoning Office, and mail,
along with form to the above address. Testing will be done as
soon as possible after fee and form are received.. /
WATER TESTING----------------------------FEE: $ 25.00 y
(For nitrates and coliform bacteria)
WATER TESTING FEE: $175.00
(For VOC'S)
SEPTIC SYSTEM INSPECTION-----------------FEE: $25.00
(Determines if system is properly functioning at time of
inspection)
Property owner's name ODE 5 lV/-9 A/GG
Property owner's address 7�T
Legal Description 5k,/ 1/4 of the NW 1/4 of Section 33 , T z 9 N-R 17 k/
Town of PLEAsa&�-r Lot Number Subdivision Name
FIRE NUMBER LOCK BOX NUMBER JVO1LJ
Color of house Realty sign by house?*c:� If so, list firm:
4c-A) L-c 46ouc y
PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP,i.e,COPY OF PLAT BOOK,
WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET.
Testing of residential water requires a sample that is fresh. If
the home is vacant, and has been so for some time, the water line
must be ur
9 Y 9
ed b running the water for several hours
before the
P
test can be conducted.
Many WINTER
TESTING: Man times water lines are turned off, or sill
cocks are turned off, making access to the home necessary. If
this is the case, please make proper arrangements with this
office to ensure time when entry may be gained.
Firm or individual requesting services: Ctici�cr
Telephone Number y S -fa 17/
REPORT TO BE SENT TO: . fee, CZ�, t�n�pp
m2
ignature
/
PLEASANT VALLEY - RUSH RIVER T• 28 N-R.17 W 19
J l • II SEE PAGE /
• Cyr>/ •C b 4 • • /oye. t1
Feed/ich tl p w v �o
CC Jar✓-sQ k
. Ha �v p V h°• ooh. T
. h'a sow �� » ate°` a
X8 77 'ob..
C aC hh loocf. c°o3 �`»
cTon Pc dd
cry> hn
VO- 1Q� /) .•' /-'o...�, Lo�,ai. Hi/� .Csnn
� � qtl/n/�m Chrisfiagson•
b 1 Z •G NAAS 7361
•C,p h -/> 141{I �p °` �U X56. y
J F\�
NPeeb r
oa�
Liu
N I,6 a 5o arc VJ w �� tl�, ra Ba 0
• t Rm, a ce, ,TO 60 Ho/
_ F /> - sn.• >, .,,. r hn-Older:en Eai/4 aiy CQ rYSt-
/•i.`J - S h:,:"sP f //1 >. > 4C y=4.0 4 • 4o f/ueJ)/r/k 40 >Sa740 .rr/C
LJ'dd/e' • >Le'�/'b4 e// ,�`�, ,7 <.a fL
f a
r
1 \ i o>r'>/e
T/ �a
eo 7: �dc beg °�bara-
7e
2/.948 Jea,>,�c� fa <>,y t _ r •- � , s •
7778
60
74 n o>5
I t �J BO• C 3 pQ� Gt-
Ti,rbm°r>
n t
N p so / oo• s�.> -E: J V ZQ •'
• R
!� P,>s d 0 tly \C � w�'\vv � l✓.i/o -, .� �Ve?: vv �,".,.,,I-_,J t,:>d ,Sti/ov son
stay- Cv �b 0 \tlp NC 7 I
Ny C<7 'J 043 •<S/n..�>F/ �� \�° fie; Y /1/'n T I
✓ —_� R S j y
i� -- 3 4 -I
13_
85
U
Q /H c /30 bo.<1
d'�> U �`� ✓/<..Sc_ / ate, 7ti __9 _ ] -A 73 /39 kV
W • ' 76 t.. �S • 4
hqo C 0 :c7 _--_
s2ro on � �C 0 h r �- Da-Fn�in h
0
7-c --- •. c.
Ar.�y s� v(�Nl a 3o�F.ge,>e law/P 21 b oa � y /y� l�\_ ,r/ 7 �aj
CL
i� r rce
`� • //P-a nr J f
Bo 90 (; /�n4 Fr F- tl Lue/%x. Lys
FOR . , nsoc
.,. .s
fja.F.Ee ,mac
y
„7 yO /s9 -✓" -•, go \� V
Jamas 7 -
//
.ao r Oro e�. /s �J '0 // r :on 0 JJo,>ai�E- nNU�N
/oo -c • 4a a, o _ / /•�� - 796 ? / ,77aC17--
�/ ¢Lowe// t /•n c a/d
4/ f na,/2-
i spa
$rop�f/mea �t 00 ti% v`i.p e 9. 7 /c J�ifr :he� (.Y>a, �s•J /_2,_9 c uso5
yn 16-7 /dr
Q E GA.i�:>
- C5 F.>s C
R11 A
y`ccfucaF 6:iz>— v \ 4 Y Fors c/arc F y f
` a/, a /`la v p ^� �
f/ s r,
• : / /, f,,, T - s nee v v
K/RCL � uh W Rl R 'J 'S h!/
2
z3o / ![,>!' // O / /G„� •!� � �� U1. /10 0 ZJe y V�U�,
4
S 3
_.”
M ¢ S 6'Q ns >o Obi
,M• _ / a `• r�Fa•K3.>a a e s/so./u�c�y a✓hu3 ro r.e° Cr h acYe bY
l✓cOft
00 fh 4 CENTERVI
21 sa/4¢•a
-9'j c��.vr l C p ,_ F ��z /E- d+•o d 0 F/ra> e Y h d �ro,> �"
wea_ � o.> FF•/e 'J _ ThoF� k 4 Be/ N�..QJ
<son 40 /zo � ) i7F•�; 90 ;'. f9c[ L-r'.
AMR 4F,, n'/'r1j:/' f/s 1i,!' /2o • pp%�a d 1.
I.
'
PIERCE COUAtrV rL7;v7\
PLEASANT VALLEY TWP.�k-RUSH RIVER TWP.
I
"QUALITY FIRST" r
AABY
yt1 can: (7151684-2856 = True Value
CPC ' NURSERY f' Hardware
it
.M &ORCHARDS
J' D I
RON DEBBAN- OWNER L�,
LANDSCAPING • DESIGN • INSTALLATION • MAINTENANCE r FNIGIDAOIE
Custom Tree Moving- Nursery Stock- Bedding Plants& Bulbs Authorized PAINTS
Lawn&Garden Seed & Supplies- Home-Grown Apples&VegetablesC 4�H Dealers 1
Form Museum a fA>tll�ly affair 698-2377
Route 1 •Highway 63 8 1-94- Baldwin, Wisconsin 54004
Al m/ Woodville
'I
1
a,
COMMERCIAL TESTING LABORATORY, INC.
514 Main Street, P.O. Box 526
Colfax, Wisconsin 54730
715 - 962 - 3121
800 - 962 - 5227
ST. CROIX ZONING REPORT NOA 04664/01 PAGE 1
ST. CROIX COUNTY REPORT DATE! 5/04/90
COURTHOUSE DATE RECEIVED+ 5/02/90
HUDSON, WI 54016
K6A
ATTN! THOMAS C. NELSON ��'�•. l/y/! I (�
17,A 33- 00
OWNE
RS Pleasant ey
LOCATION: Surface Discharge, Possible Effluent
COLLECTOR: M. Jenkins
SOURCE OF SAMPLE+ SW, NW-Sec.33-T28N-R17W
FECAL COLIFORMS 40,000/100m1s
Fecal Co l i, 4/100m 1.
LAB TECHNICIAN: Pam Gane
WI Approved Lab No, 19
OF•\NDEOENpENf
< Means "LESS THAN" Detectable Level Approved byi
® PROFESSIONAL LABORATORY SERVICES SINCE 1952
COMMERCIAL TESTING LABORATORY, INC.
514 Main Street, P.O. Box 526
Colfax, Wisconsin 54730
715 - 962 - 3121
800 - 962 - 5227
N ST. CROIX ZONING REPORT NO*' 04664/01 PAGE ,1
ST. CROIX COUNTY REPORT DATE: 5/04/90
COURTHOUSE DATE RECEIVED: 5/02/90
HUDSON, WI 54016
ATTNS THOMAS C. NELSON
OWNERS _ fteasant Valley
LOCATIONS Surface Discharge, Possible Effluent
COLLECTORS M. Jenkins
SOURCE OF SAMPLES SW, NW-Sec.33-T28N-R17W
FECAL COLIFORMS 40,040/100mis
Fecal. CoLi, 4/100mL
LAB TECHNICIANS Pam Gane
WI Approved Lab No. 19
OF.WDEDENpFNl
3� �s
O
A < Means "LESS THAN" Detectable LeveL Approved by2
y*
® PROFESSIONAL LABORATORY SERVICES SINCE 1952
yy yy RR
COMIVITCIAL TESTING LABORATORY, INC.
�y1�4 Main Street-, P.O. Box 526
-Coltax, Wisconsin 54730
7 - 962 - 3121
8 - 962 - 5227
ST, CROIX ZONING REPORT NO.: 04454/01 PAGE 1
ST. CROIX COUNTY REPORT DATE: 4/30/90
COURTHOUSE DATE RECEIVED: 4/27/90
HUDSON, WI 54016
ATTN: THOMAS C. NELSON
OWNER: Mrs. Delores Wang
LOCATION: Rt. 2, Box 106, River Falls
COLLECTOR: M. Jenkins
SOURCE OF SAMPLE. Kitchen faucet
COLIFORM: 0 /100 ml
INTERPRETATION: BacteriologicaLly SAFE
NITRATE-N: < 1 ppm
Under 10 ppm is safe for human consumption.
CoIiform Bacteria/100 m
Nitrate-Nitrogen, mg/L
LAB TECHNICIAN: Pam Gane
WI Approved Lab No. 19
oF,\NDEPENDFHT.
u �
< Means "LESS THAN" Detectable Level. Approved by:
�P'� ® PROFESSIONAL LABORATORY SERVICES SINCE 1952
y
SAFETY & BUILDING
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR DIVISION
LABAR & H". AN RELATIONS ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION
P.O. BOX 7969
State Plan I.D. Number:
MADISON, WI 53707 (If assigned)
SW 4, NW 4, Sec . 28 , T28-R17 ❑ CONVENTIONAL ❑ ALTERATIVE
Town of Pleasant Vall~ Holding Tank ❑ In-Ground Pressure Mound
ADDRESS OF PERMIT HOLDER: INSPECTIO ATE: I
at Miller Rt. 1, River Falls, WI r
L TREF.P LEV.: 4
;Name EO MIT LDER:
CH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN:
j~ d~ n -3
P/MPRSW No.: ounty: Q Sanit Permit Number:
3378 St. Croix 28845
C rlHeise
ab
SEPTIC TANK/' 10 K:
LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING pRO V ID ED: OV
MANUFACTURER: ES `6'
LJ e SR - ) (T ✓I o YES ❑ NO ❑ YES 6~No
BEDDING: 4E.NT DIA.: VEldfi-MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT T FRESH
¢ ,O . ALARM: FEET FROM ~ LINE* ~ AIR IN L T
❑ YES NO CQ-S,c YES O NEAREST
DOSING CHAMBER / b h.~t c o-~'/'7 = 4' NARNINP
MANUFACTURER: BED IN LIQUID CA A PUMP MODEL: PUMP/StPFIAN MAN FA~CTU~RER: PROVID DLABEL pROVIDED:OVER
~J ~ tom' YES ❑ NO YES El NO
S ❑YES NO S
GALLONS PER CYCLE: OPERATIONAL: NUMBER OF PROPERT WELL: BUILDI G: VENT TO FRESH
PUMP AND CONTROLS LINE: f ~ / AIR INLET: ~
(DIFFERENCE BETWEEN I FEET FROM Q tiffs
PUMP ON AND OFF Gjcc YES ❑ NO NEAREST
LENGTH: DIAM TER: MATERIA~AND ARKING:
SOIL ABSORPTION SYSTEM. Check the soil moisture at th depth of plowing FORCE ~
or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN / G` / U
the soil is dryenouc h,to continue.)
Ca~IVIE I SY T1 iF. INSIDE DIA. # PITS: LIQUID
WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING:
BED/TRENCH MOATERIAL: PIT DEPTH:
---TaEtQCNES;.
FRESH
DIMENSION
PROPERTY WELL: BUILDING: VENTTO
GRAVEL EPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: PIPES: TR NUMBER OF LINE: AIR INLET:
BELOW PIPES: ABOVE COVER: ELEV. INLET: ELEV. END:
NEA ST
MOUND SYSTE - pr
Mound site owed perpendicular to Check the texture e fill material for PROVIDE A DIAGRAM OF SYSTEM
slope and furrows thrown unstop: mound systems to make certain that it ON REVERSE SIDE. SHOW
❑ YES X`NO C meets the criteria for medium sand. ELEVATIONS MEASURED.
PERMANENT MARKERS: OBSERVATION WELLS;
SOIL COVER TEXTURE:
('Cry u- i ` ! YES ❑ NO YES ❑ NO
SEEDED: MULCHED:
DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED:
CENTER: EDGES: r tr"_ , ❑ YES NO YES ❑ NO /[EYES ❑ NO
PRESSURIZED DISTRIBUTION SYSTEM. 2, ' M. Z, Y = , s4
WIDTH: LENGTH: N OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER r
BED/TRENCH / T ENCHES:
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR. PIPE ANIFOLD MATERIAL: NO. STR. DD:SA
DISTRIBUTION TR. PIPE D"BUT 9N ai ERIAL & MMARKING:
ELEV.: ELEV.: DIA : EL V.: STrn ' J - PIPES-
661 ELEVATION AND C g~j 9 7JY C, 3 `I pvc, 1 r' J
VERTICAL LIFT COONDS TO
HOLE SIZE", HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL. APPROVED PLAN ~
INFORMATION ' ❑YES Nv
ICJ = R7``t 48 , YES ❑ NO
PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL:
COMMENTS: FEET FROM LI>~ 97?
YES El NO C~rYES 1-:1 NO NEAREST
4 &e
os 44
-bap .5,F f Ie 97,
_l
fain in county file for audit.
Sketch System on SIGN URE: TITLE:
Reverse Side.
SBD-6710 (R. 06/88)
-°~°SANITARY PERMIT APPLICATION
-DLNR In accord with ILHR 83.05, Wis. Adm. Code COUN ~~q
STATE SANITARY PERM #
-Attach complete plans (to the county copy only) for the system, on paper not less than eck i f~
8% x 11 inches in size. re ision to previous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. Is 1!2A
PROP TY r NE / PROPERTY LOCATION
r-k 6 / r ''/4WW"/4,S T28,N,R I (or)W
PROPERTY OWNERS MAILING ADDRESS LOT # e BLOCK #
r V 19""
CITY STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
4Z-1 K/
II. TYPE OF BUILDING: (Check one) ❑ State Owned VILLLLAGE NEARESn ROAD
❑ Public ❑ s yt~
1 or 2 Fam. Dwelling-#ofbedroom PARCEL TA N 6ty .-`Q - L0-00 4
III. BUILDING USE: (If building type is public, check all that apply) Z _ -2,? 9 13 1 3 3 - 1 ❑ Apt/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
30 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. ❑ New 2. N Replacement 3. ❑ Replacement of 4.0 Reconnection of 5. ❑ Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 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 (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION
4-So 7-5 3 /1,21 ~Z Feet Feet
VII. TANK CAPACITY Site
in gallons Total #of Prefab. Fiber- Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name oncrete Con- Steel glass Plastic App
Tanks Tanks structed
Septic Tank or 060 t O&V 0 F]
Lift Pump Tank/Si hon Chamber c,(;, S'
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Print): Plumber's Signature: (No S ps) MP/ PRSW Business Phone Number:
C /04 4~ -0
tflf
Plumber's Address (Street, City, State, Zi Code): _
r
0 4,;7 A
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater a e Issue Issuin Agent Signature (No Stamps)
Surcharge Fee)
Approved E] Owner Given initial
Adverse Determination
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Pib-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS '
1. A sanitary permit is valid for two (2) years.
2. 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 or the
State of Wisconsin, Safety & Buildings Division, 608-266-3815.
t
To be complete and accurate this sanitary permit application must include:
1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of
where the system is to be installed.
II. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling.
III. Building use. If building type is Public, check all appropriate boxes that apply.
IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or
repair.
V. Type of system. Check appropriate box depending on system type.
VI. Absorption system information. Provide all information requested in ##1-7.
VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of
tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all
septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received
experimental product approval from DILHR.
VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g.
MP, etc.), address and phone number. Plumber must sign application form.
IX. County/Department Use Only.
X. County/Department Use Only.
Complete plans and specifications not smaller than 8% 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)
APPLICATION FOR SANITARY PERMIT
STC-100
is application form is to be completed in full and signed by the owner(s) of the
operty being developed. Any inadequacies will only result in delays of the permit
suance. Should this development be intended for resale by owner/contractor, ("spec
use"), then a second form should be retained and completed when the property is
Id and submitted to this office with the appropriate deed recording.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
ner of Property f rrC T1 -
4 e"
cation of Property Section T~N-R I W
vnship Scrvt Q l --r-
.iling Address J,, 3- 170b Q74
.dress of Site
►bdivision Name
)t Number
-evious Owner of Property -tI p- S WO, /10
►tal Size of Parcel C)Qc_ e
ite Parcel was Created
i
.-e all corners and lot lines identifiable? Yes No
i this property being developed for resale (spec house) ? Yes No
)lume and Page Number as recorded with the Register of Deeds.
S7-7
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
Warranty Deed which includes a Document number, volume and page number, and the
seal of the Register of Deeds. In addition, a certified survey, if available, would be
!lpful so as to avoid delays of the reviewing process. If the deed description refer
ices to a Certified Survey Mai,, the Certified Survey Map shall also be required.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
PROPERTY OWNER CERTIFICATION
(we) eeh.ti.6y that a t &tatement~s on tW onm ane tkue to the but 06 my (oUn)
towtedge; that I (we) am (ahe) the owneAW o6 the pnopexty ducxibed in -tlu,d
e6ofcmati,on 6onm, by vi tue o6 a wa~rAanty deed neeonded in the 06Kice 06 the
,unty Regis ten o6 Oeed6 ass Document No. / 3 and that I (We) pneaentty
m the pnopoaed .bite bon the sewage di.6poa Zys e.m (on I (we) have obtained an
:a ement, to nun with the above deb cn i,bed pnopeh ty, bon the eonztAuc ti.on o6 aaid
,a.tem, and the same has been duty neeonded in the 066ice o6 the County Regi4ten o6
.ed6, ab Document No.
2
Z):
OP OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE)
- 7
.TE SIGNED DATE SIGNED
DOCUMENT NO. STATE OF WISCONSIN FORM i-1982 TK AGE RESERVED FOq RECORDING DATA
WARRANTY DEED
I~
461032 1I1 REGISTER'S Of f ICE ~
This Deed, made between ..D-e_1_o_reS..J..__.WaCtg,._.a-.si_►lg].e... ReClrAecxd
----w.ornan-, - 80002 ~99~
o
. . _ _ , Grantor, I
and..-Ratr-icia- A-.--Miller -ler- - 0 awl
- - - - - - - - - - - - - - - - - - - - Register of Deeds
-
I - Grantee,
i
I Witnesseth, That the said Grantor, for a valuable consideration......
I Sixty-one --Thousand--Dol l-ar-s--(.$61.,-OQO~_______________________________ RETURN TO
conveys to Grantee the following described real estate in St;..Cro}X-------------
County, State of Wisconsin:
i
Lot One (1) of Certified Survey Maps, recorded in
Vol. 4, page 964, being part of the Southwest Tax Parcel No: 33-------------------------- -I~ M
Quarter of Northwest Quarter (SW4 of NWI), Section
33, Town 28 North, Range 17 West.
I
f
r
This l_S_____--------------- homestead property.
(is) (is not)
Together with all and singular the hereditaments and appurtenances thereunto belonging;
And---- Bel-or-es--1.---Wang-----------------------------------------------------------------------------------------------------------•--•--------
warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except
i
~ I
i
i
and will warrant and defend the same.
,
Dated this -~x:, day of May . 19 ......90
i
4sW (SEAL)
- - - - - - - (SEAL) - - - - - - - - -
Del orang.._..._..U--------------
(SEAL) -------------------------------..--(SEAL)
THENTICATION ACKNOWLEDGMENT
S ature s STATE OF WISCONSIN
e- Wang
ss.
County.
authenticated this _r_day of---------- ay_...._._... 19__ 9O Personally came before me this ................day of
19 the above named
Robert R. Gavic
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not-
authorized by § 706.06, Wis. Stats.) to me known to be the person who executed the
foregoing instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY
ROBERT R. GAV I C
-
-----Spri-ng--Val•l-ey;--W1--54767-------------•----------- Notary Public County, Wis.
(Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration
are not necessary.)
date: 19---------
*Names of persons signing in any capacity should be typed or printed below their signatures.
STATE w1 S1N
FORM No. 1--1982 Stock No. 13001
STC - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER 4.
ROUTE/BOX NUMBER FIRE NO.
CITY/STATE q i d e.r°' (h-, ZIP --S q
PROPERTY LOCATION: 'SLA) 1/9 1/9, Section 33 , TAN, R__L3 W,
Town of Tiensa-10+ VCA e , St. Croix County,
Subdivision , Lot No.
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
$3000 of the cost of replacement of a failing system, which was in operation
prior to July 1, 1978. St. Croix County accepted this program in August of
1980, with the requirement that owners of ALL NEW SYSTEMS agree to keep their
systems properly maintained.
The property owner
agrees to submit to St. Croix County Zoning a certification
form, signed by the owner and by a master plumber, journeyman plumber,
restricted plumber or a licensed pumper 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 form 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 Department 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.
SIGNE try
DATE 7 1 f-0
St. Croix County Zoning Office
St. Croix County Courthouse
911 9th Street
Hudson, WI 59016
(715) 386-4680
Sign, Date, and Return to above address
J
INDU
DEPARTM~NT , OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
' NDUSTRY, DIVISION
LABOR.AND PERCOLATION TESTS (115) MADISOP.O. BOX N W 5739069
HUMAN RELATIONS
(H63.09(1) & Chapter 145.045)
LOC TION. SECTION: OWNSHIP UNICIPA Ia Y LOT NO.: BLK. NO.: SUBDIVISION NAME:
I /a Ta.-N/ ~ E (o ew l~
COUNTY:
601 k OWNER' BUYERSNAME: h IMAILI[VQADDRES,•`Uer & 11~ 44
USE DATES OBSERVATIONS MADE
_ DRMS.: COMMERCIAL D SCRIPTI N: PROFI )DES RI TIONS: PER LITO TESTS:
,Residence NO.! ❑ New Replace Q' q
QL~
RATING: S= Site suitable for system U= Site unsuitable for system
rONVENTTIONAL: MOUND: IN_ -GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMEND SYSTEM:(optional)
S [so OS ❑U ❑S NU ❑S U ❑S U tntier~,
„'.:n If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the
under s.M63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.)
B- >4 ,Db atoo 3k' 9%(-3;0 5 g~ ~rc~ ~ *ugrt o7 t oy,.
i,
B- 60 .30
B-3 IN 1 d 1` /100 (.3 1, Po br,S'c to/ko s
B- ~.ao /o<►~~ 30 ay 1` B 1,7 o9, 5,0 etc f,? fg y '
B- 1,66 ~o o?~s'~Bn roc a ~v~,
B-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTE
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD1 PERIOD2 PERIOD 3 PERINCH
P- 10o 0
P eo 3 o
P- oc3 C~ 3
P-
P-
P_ tl
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope.
SYSTEM ELEVATION loot S 0
11600 a l ~o sKr aye
s ern-l E , ~ ,
1'N, I [ ~3~ ~ ri _w i
_ _b 4s e_LC 1.mQ N
-In
E ,
i ac's 4
Ito
tar~ 1 yo le -
sa v ; C'6"_f itrC
I 1 1 !!t TO 1 , ! 4 ~ ( _ .r _
E t i i I l 1 t
i ' t I
I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin
Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
NAME (print) TESTS WERE COMP ET DO
l
ADDRE CERTIF TION NU BER PHONE NUMBER(o~tional):
0 r d'
'41 htx na Ley llis
CST SI U E:
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 02/82) - OVER -
INSTRUCTIONS FOR COMPI L . , _ '3 FORM 115 - SBD - 6395
To be a cc d accurate soil test, your report elude:
1- Complete, It, I ation;
2. The use r.;_ clearly indicate ether, this is a or cornmerl ct;
3, MAXIMUM number of bedrooms mercial use pianned;
4. Is.this a new or e-Ant system;
5, Complete the ty rating boxeu A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL.
OTHER SYSTEM' ARE RULED OUT BASED ON SOIL CONDITIONS;
6, PLEASE use the at Deviat ions here for writing profile descriptions and completing the plot plan;
7. M lt-E A LE-I`°' n ty locating yc,.*r test locations. Drawing to scale is preferred. A
~.E rP sheer if
B, your I 'k and elevation nee point are clearly shown, arm are permanent;
S_ C ali:pi i. to boxes as dates, names, ?resses, flood plain data, percolation test exemp-
flood plain, elevation) do r, apply, place N.A. in the appropriate box;
11 . ,our current address and yo _t lion number;
13, distribw , as required. Jill- TESTS MUST BE FILED WITH THE
AUTHO6 - N ; -SAYS OF C 7N.
ABBREVIATIONS FOR CER, ~ SOIL T
1 S: i~& ites and Textures Other Symbols
over 10") BR - Bedrock
cc[" - 1011) SS - Sane .;le
gr - -1 It der 3") LS - Lin
x.s HGW - High
rld Perc PLrC,,.'-, e
s - rd W Well
Bldg I I,'
- I d j
r
- ran - ! i
- am BI Black
Gy Gray
'Cl Y Yellow
sci - { Loam R Red
sic! - ay Loarn mot Mottles
sC Clay
sic: - qty fff - f int
c cc - c f,rn
P1 mm - P_' . r . m
m - Muck d - disti
p pron
Pik L - High vv
rt' ~xtures srl
disposal - F 1v vertir poii7t
Tn ` 'NER:
is th -c . Th - y tr,. Y~ Y r-
,n
to
{
I
CERTIFIED SURVEY MAP
CALVIN WANG
Part of the Southwest 1/4 of the Northwest 1/4 of Section 33, Township 28 North,
Range 17 West, Town of Pleasant Valley, St. Croix County, Wisconsin.
o Indicates 1" x 24" iron pipe weighing 1.13 lbs/ft. set.
yI it/°O'OOOOE 808. OO, "a e FFNcG
o
o I o ash m
s. o S OMQ
o m
o o. 00 u
m W
0IW
G OT Z
G T /
10 I /O A C •QE.S S •O ~I C.2ES J
o I A (8.92Acc~5. NET) ~ C4.75~',ce~s~lsr) 0 Q 'o
? ( o 0
I0 N ~0
r 91
o ~o
01
0. ,01 0 moo, 0 0
o=
8
W i
/V9 0000°!~/ 80 .00'
r'c O Ciw TY g C/R. - -
C/ME/vTJ SCALE / 200'
i4 ~ .BOG. E S EO
B S 7-0.4 Y .c~h/ELGi~/Cy
o: !Ei v
E"J / S TO~'2 Y l~DY6GL /ic/~
APPROVED
JUL 16
~ 1 t 19$0
F
JUL Sr, CROIX COUNTY
C`? J! GOµkELL COMP"ENENSIVE PARKS PtA„ ..>;p
1~r eI , ~J/ AND ZONING' COMM10"
State of Wisconsin)
:
County of Pierce)
,1~i
I, James L. Murphy, Registered Land Surveyor, do hereby certify that by direction
of the Owner, Calvin Wang, I have surveyed and divided the lands shown hereon in
accordance with official records, Chapter 236 of Wisconsin Statl# anc~~~plUi~11M lii
ances of St. Croix County; and that the above map and description arl wak
correct representation thereof. ~ •A•°'• W'••.%~~'O/
l AMES L.
Dated: 2 May 1980u0 MURPHY •'s
Vol. 4 Page 964 j James L. Murphy = S- 1 0 4 2
Certified Survey Maps L,-Registered Land Surveyor RIVER FALLS, .Jd
St. Croix County, Wisconsin %~d'j;•• Wisc. viol. 4 Page 964 LAND aaa~
iu1uu it
j
DESCRIPTION:
That certain parcel of land located in the Southwest 1/4 of the Northwest 1/4 of
Section 33, Township 28 North, Range 17 West, Town of Pleasant Valley, St. Croix
County, Wisconsin, more fully described as follows;
Commencing at the West quarter corner of said Section 33, the POINT OF BEGINNING
of the parcel to be herein described, thence N 000 05' 00" E 808.00' along the
West line of the Northwest 1/4 of said Section 33;
thence N 90° 00' 00" E 808.00';
thence S 00° 05' 00" W 808.00';
thence N 90° 00' 00" W 808.00' along the E/W 1/4 line of said Section 33,to the
POINT OF BEGINNING, containing 14.99 acres, more or less, being subject to ease-
ment over the Westerly 33' thereof for Town Road purposes and also Southerly
portions of said parcel for C.T.H. M purposes.
(For purposes of this description, all bearings are referenced to the E/W 1/4
line of Section 33, Township 28 North, Range 17 West, assumed N 900 00' 00" W)
James L. Murphy
Registered Land Surveyor
w
i
i
Vol 4 Page 964
ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
ST. CROIX COUNTY COURTHOUSE
911 FOURTH STREET • HUDSON, WI 54016
Ron FWAS (715) 386-4680
Nov. 1, 1990
Division of Safety and Building
Bureau of Plumbing
P.O. Box 7969
Madison, WI 53707
Dear Sir:
An on site investigation for the Deloris Wang property located at
the SW 1/4 of the NW 1/4 of Section 33, T28N-R17W, Town of
Pleasant Valley, St. Croix County revealed suitable soils at a
depth of 24" below which seasonable high ground water was noted.
This site should be suitable for a mound.
Should you have any questions, please feel free to contact this
office.
Sincerely,
ames K. Thompson
Assistant Zoning Administrator
cj
.l
t
I MOVE THE EARTH -
AILPORT EXCAVATING
1042 South Main
RIVER FALLS, WI 54022
CARL P. HEISE (715) 425-2175
Owner
MOUND SYSTEM
FOR
A _3 BEDROOM RESIDENCE
LOCATED IN THE :2W!l OF THE ~1j k OF SECTION a$ , T aN, R) _W,
TOWN OF_PEASgeII_LJQ' , _Q[`7~_•_____ COUNTY, WISCONSIN.
INDEX
PAGE 1 of 6 TITLE SHEET
PAGE 2 of 6 PLOT PLAN
.PAGE 3 of 6 PLAN VIEW-CROSS SECTION
PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT
PAGE 5 of 6 PUMPING CHAMBER
PAGE 6 of 6 PUMP PERFORMANCE CURVE
PREPARED FOR
9:T 2
R:Vty 540zZ
PREPARED BY
;,t~ :r
CARL P. HEISE
CST-3314 MPRS-3378
1042 SOUTH MAIN
RIVER FALLS, WI 54022
PL 07- FLAN Pd 9c, 2 C) f- 6
X11.
a
1 P~ 1taiJ~a
Y 4 ' h
yll ` 9'.t~ "a~~'
TI A, V- XISt (IBC: SkVV-rC 'TAOK WAI a~
IiaS~Fc7zD t=t't 5'i"2i'CT vRi; I SCva4~L~lE;Si AtJ~
F~tS A131> WSr BE P-F- PAty, Vr-
fN~CESSA,i;.~( C=crc Cut=cttMM1~ U:~ Gt(, iLt~FZ
li7 ~ ~.l~a~►F~r
6*15r1,;j w ELl
0 ~>lISTIwf~
TeRsm~a w~~ ~><`sriw~ FA)I)VvC. ORYweLL
To 8E Aayw paNED
~~C1ST ~yv4 Q 0
~fpYA o, TWALLTvrw
ROD C-4 pGtm C,,Y d ig_rIZ
i
i
s N .
uUj THC ARCA Z S Ft ,
s o E3~ ~cuu~ 'MC- ~r►ctti't> McIS1
• RctivuN v~►~Sr L,~Z3~ ~
a~
3 p3h
91 62
49
41
~l
i 6
200 yQ Q M 5 Pl 1L( ~tiv Power Pv~
AwF EL. 100.00
C7~' RD M _
S~t'~Gr✓ OF. 6
-6`~Zo s'' or S1'raw*pmorsh Hay, Or
Fy~,PSLOVED Synthetic Covering ;
Distribution Pipe
Medium Sand I
-J.G
Topsoil j5L- 1 _2 15
3J JE
b
I b'
3 % Slope
Bed Of Z- 2 % (Force Main Plowed
Aggregate From Pump Layer
D J_,r -
T---gross Section Of A Mound System Using
~tY r: A Bed For The Absorption Area
,r f G I t=t'.
A_ Ft. H 1 S.',- ,L B j.Z Ft.
Ft.
+ +J~-Ft.
K Ft.
L 7 ! Ft.
W Ft
70b serv on Pipe
K
~ t
1 • ' M
Bed Of - 2
~D'istribution'
2 2
Pipe Aggregate
Observation Pipe Permanent Markers
40
Plan View Of Mound- Using A -Bed For The Absorption Area
Per lor aIed Pipe Dololl
Pig g (A
End Vir.
(/1 Perloro+ce
Enb Cop-/ -PVC F+pc ~P`g11p~?J=!)7 Y~FiRY.tr~ - ,
Jp/°o„ce Lr rr loco+rl Gn Eso>>om,
O' ~O`4 Ore E ouolly Spoced
S
Q
PVC rorce'Moin
From Fump
PVC
/Wnilolb PIPt l~
II _ '
~G+s+++out+o~• ,
r+pr
Lost Holt Should Be I
1 o End Cop
F A Gnr. mriribution Piet Loyoui
I
P 22
S '
X D r
Y~°---q
Hole Diameter ~4 Inch
Manifold 2 Inches
Force Main 2 Inches
Laterai I Inch(es)
Holes Per Lateral Q 24 -17z - 120 -jig, - 211, - 2G4
v
P
r~va
/"t F~ 1
w,yiYot ~e "r
Z rte.
r ' fif1N'
F[v
S, L✓ i .
r
PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS ~a 5 of
s
VENT CAP
4"C.I. VENT PIPE frT WEATHER PROOF APPROVED LOCKING
JUNCTION BOX MAWHOLE COVER
25' FROM DOOR,
WINDOW OR FRESH 12"MIU.
Alf; INTAKE
GRADE I
ELeV 'i"MIN.
•
41 .41
18"MIN.
COIJDUIT--
18"MIN.
~ 111
PROVIDE I
IAILET A-J AIRTIGHT SEAL I I 1 ~
j II
APPROVED JOINTS
APPROVED JOINT A
W/C.I. PIPE ( III W/C.I. PIPE
EXTENDING 3' 3LL 'IUN~ I I ALARM E%TEAIDIU(- 3
OWTO SOLID SOIL ONTO SOLID SOIL
II.
ON
M 4 I
ELEV. FT PUMP -_X
OFF
D
ELEV. CONCRETE BLOCK
RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL
_ SPEC.IFICATIOUJ
DOSE
TANKS MANUFACTURER. \A) LGI'CS IJUMBER OF DOSES: PER DAB
TAWK SIZE: P300 GALLOWS DOSE VOLUME 13Co. 24 GALLONS
ALARM MANUFACTURER' 11C L109. INCLUDIMG BACKFLOW:
MODEL NUM6ER: ILL V CAPACITIES: A=Z-4- INCHES OR 06 -4 GALLONS
SWITCH TYPE: B= 2- INCHES OR . GALLOWS
PUMP MANUFACTURER: ZDEUP C=- v~ IQLHES OR GALLONS
MODEL NUMBER: vy -.qv D- INCHES OR Z/ GALLONS
SWITCH TYPE: I ly twy./ NOTE: PUMP AND ALARM ARE TO DE
MINIMUM DISCHARGE RATE GPM INSTALLED ON SEPARATE CIRCUITS
VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE..FEET
+ MINIMUM NETWORK SUPPLY PRESSURE 2.5 FEET
+ _~.4 - FEET OF FORCE MAIN X 1_~_F/ooF>+FKICTION FACTOR.. L2 FEET
TOTAL DtJUAMIC. HEAD FEET
• LITERNAL DIMEWSIONS OF TANK: LENGTH ;WIDTH ELI UID T
I
BoYtar-I ARC - 3, 14i k -2= In 3. Z3J = .,L.~. Z - GP'tlr~lh•
(,E G of
2-2-
cc w
W W
U.
W
115
i 34
110
32 -105-
30 100 -
95
28
90
26 85
EFFLUENT 24 80 MODEL
and Q 75 MODEL 189
22
DEWATERING = 70 165
U 20 65'
Q
Z 18 __60-
_
55
Q 16 ODEL
0 50 163
MODEL
F- 14 45 1188
12
35 -
10 MODEL
30 MODEL
137, 139 185
8
25
6 20- MODEL
15 - 161
LJC_L
4 7
10
MODEL
2
5 53, 55,
57,59
0
GALLONS 10 20 30 40 50 60 70 80 90 100 110
LITERS 0 80 160 240 320 400
FLOW PER` M N6TE -