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Parcel 29.30.19.814 030 - TOWN OF SAINT JOSEPH Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(sO = Current Owner, C = Current Co-Owner O - LITFIN, DAVID D & COLLEEN F DAVID D & COLLEEN F LITFIN 410 HIGHLAND VIEW RD HOULTON WI 54082 Districts: SC = School SP = Special Property Address(es): Primary Type Dist# Description 410 HIGHLAND VIEW SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 16.370 Plat: 2450-SHADY RIDGE SEC 29 T30N R19W PT E 1/2 SW 1/4 LOT 1 Block/Condo Bldg: LOT 01 SHADY RIDGE 16.37 AC Tract(s): (Sec-Twn-Rng 401/4 1601/4) 29-30N-19W Notes: Parcel History: Date Doc # Vol/Page Type 10/16/2001 659228 1739/21 WD 07/23/1997 1202/86 WD 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 04/26/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 16.370 138,500 158,800 297,300 NO Totals for 2007: General Property 16.370 138,500 158,800 297,300 Woodland 0.000 0 0 Totals for 2006: General Property 16.370 138,500 158,800 297,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 121 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER_ TOWNSHIP---J-/, -T -eZelL SECTION ~T 3N-RW ADDRESS ~IlG ST. CROIX COUNTY, WISCONSIN SUDDIVISION_ LOT LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM # V eti~ g r ~I ~ ale -A 1I1 S~IV rv II I~ INDICATE NORTH ARROW BENCIIHARK: Elevation and description: Alternate benchmark SEPTIC TANK:I-tanufacturer:_ 01,e&Cor fs e Liquid Cap. 12-~5 0 Rings used: I- Manhole cover elev: Final grade elev: 0 Tank inlet elev.: Tank outlet elev.: No. of feet from nearest road:Front , Side, Rear -Pt. /G:~) From nearest prop. line:Front , Side h , Rear Ft. No. of feet from: Well ~Z , Building: 2 S - (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Gl/ Liquid Capacity: Pump Model: Pump/Siphon Manufact.: Pump Size Elevation of inlet: Bottom of tank elevation Pump on elev.: Pump off elev.: Gallons/cycle: Alarm: Man.: Switch Type: Location Distance from nearest prop. line: Front`, Side_, Rear-Ft. Distance from: Well Building SOIL ABSORPTION SYSTEM Bed: Trench: X Seepage Pit: ';v Width: S Length'Tz Number of Lines: 3 Area Built Exist. Grade Elev. Proposed Final Grade Elev. Fill depth to top of pipe: r No. feet from nearest prop. line:Front , Side , Beare Ft. No. feet from well: a01, No. feet from building lao 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: ` 2 "7 PLUMBER ON JOB: LICENSE NUMBER: f~~itJ Y2, Z'K 6/90:cj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING LABOR & HUMAN RELATIONS DIVISION P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION MADISON, WI 53707 State Plan I.D. Number: SW 4 • SW 4j Sec . 29 , T30-R19 (If assigned) Town of St. Joseph Holdin ~ CONVENTIONAL ❑ ALTERATIVE g Tank ❑ In-Ground Pressure ❑ Mound i or NAML*OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Fugina 1410 Hiahland View. Hudson, T aq o Britt- BENCH MARK (Perms nt reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT ELEV.: CST REF. PT. EL Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Roc,er St. 128844 SEPTIC TANK/ Timm HQ'01NQff*W: : OUTLET EV.: WARNING LABEL LOCKING COVE MANUFACTURER: LIQUID T77 TANK INLE EV. AN P OVIDED: PROVIDED: , 11 • YES ONO OYES NOS BEDDING: VENT DIA.: MATL.: HIGH WATE NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT T RESH ALARM: FEET FROM LINE: 1 AIR INLET ❑ YES ❑ NO ❑ YES Y NO NEAREST MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVDED: 0 ❑ YES ❑ NO ❑ YES ❑ NO GAILLOUSPIT5 CYCLE: PUMP AND CON OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF ❑ YES ❑ N NEAREST R: MATERIAL AND MARKING: SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH: LENGTH: Y NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID BED/TRENCH 9V 1' 0 TRENC E MATERIAL: PIT DEPTH: ' /,zp DIMENSIONS 115 9 '7 L GRAVEL DEPTH FILL DEPTH DIST PIPE DIST PIPE DISTR. PIPE MATERIAL: NO. I TR. NUMBER OF PROPERTY WELL: BUI G: VENT TO FRESH BELOW PIPES: ABOVE COVEFA: ELEV. INLET: ELEV. END: Cre56 "I P}I FEET FROM LINE: )l r AIR INLET: NEAREST MOUND SYSTEM: Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ❑ YES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ❑ YES ❑ NO ❑ YES ❑ NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH: NO. OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEVATION AND ELEV.: ELEV.: DIA.: ELEV.: PIPES: DA.: DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑ YES ❑ NO ❑ YES ❑ NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: ❑ YES ❑ NO 1-1 YES -1 NO NEAREST t L., Sketch System on Q Ret In n county file for audit. Reverse ~~Si~ /e -70 OD T C SIGNATU TITLE: SBD 6 07'I (R. 06/88) SANITARY PERMIT APPLICATION O'[LHFR In accord with ILHR 83.05, Wis. Adm. Code COON A~~ -MMEMMM STATE SANITARFE, -Attach co mplete plans (to the county copy only) for the system, on paper not less than 8% x 11 inches in size. n us application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. S - Q 05- PROPEFffY OWNER PROPERTY LOCATION -5 G.i'/a %a, S Z9 T 36, N, R l~l (or) PROPERTY OWNER'S MAILI G ADDRESS LOT # BLOCK # CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER / IV k II. TYPE OF BUILDING: Check one)' CITY NEAREST ROAD S Public ❑ State Owned VILLAGE : LJ Public ❑ 1 or 2 Fam. Dwelling-# of bedrooms - A FICEL TAX NUM ) III. BUILDING USE: (If building type is public, check all that apply) `Z 0 R 8 30R 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 P9 Other: Specify ~~TBr IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ❑ New 2. Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.0 Repair of an Existing System System System in9 System Tank Only Exist 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 El Seepage Bed 21 ❑ Mound 30 El SpecifyType 41 El Holdin9Tank 12 Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 430 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) T/ ele, 74::~ ELEVATION / 2 s cc s S -34 it 11, ~0 Feet 95' ftl Feet VII. TANK CAPACITY Site C, I 5c> in allons Total of P INFORMATION if Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Ex er. New istin Gallons Tanks oncrete glass App. structed Tanks Tanks Septic Tank or Hold! n Tank / L ( ~N5e✓ Lt Dd, L-1 F-1 F1 F-1 'Ll El El 10:1 F-1 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. Plumb 's Name (Print)-- Plumber's Signature: (N Stamps) MP/MAP $lLil No.: Business Phone Number: Ni✓c~% 4~? I -72Z 321 Plumber's Address (Street, City, State ZI Code): ►5 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Approved ❑ Owner Given Initial Surcharge Fee) 9 0 6,c Adverse D min t' n S f X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. 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. 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) FA G~ w ` CONVENTIOIIAL SCIL ABSORPTICI'JI SYSTEM: FOR A 3 L3E'DC~llvwi VD ef Z Me-n tt Fr-) ST` ~.o©►~ ~r~ G H ov sE _ AtJ~ A 1 BDRY't (Z,~S ~ DCXIGE', LOCATED IN THE SWINOF THE S /Iy CF SECTION Zq T 30 N J R ~9 W, TOWT OF ST TL)5~ 415T- cRu 1X, COUNTY, WISCONSIN . INDEX PAGE 1 OF 4 TITLE SITTEET PAGE 2 OF 4 PROJECT DATA PAGE 3 OF 4 P LCT P LA N PAGE 4 OF 4 PLAN; VIEW-CROSS SECTION PREPARED FOR: UPUT C FU G l NZA L41V_) "tGF1Lr\IUp V1Ew `c~ovLlbl.~,wl 540$2 f _~,,~~aaNeen~ 0 toms PREPARED BY:~,.~'. ~X ARTHUR L WEGERER + 0.915 P S.LSM Wis. rs WE C3 F:ZCEFC SC>` I t_ TEST I hIG AND E-::- E3 I CE; 1-4 SEFctir' I CE SIG P.D. BOX 74 421 M. MAIN ST. FIVER FALLS, MI 54022 91 99 715-425-0165 ~O$ of 0 - Z 2 O PROJECT DATA Page 2 of This conventional trench type system will serve a 4 bedroom house. Three bedrooms are available as "Bed and Breakfast" rooming. The fourth bedroom is occupied by the owners as their residence. ABSORPTION AREA Class 3 perc rate. Tourist rooming house 0.9 X 3 X 200 = 540 sq ft 1 bedroom residence 1 X 300 = 3.00 sq ft Total = 840 sq ft 1200 sq ft of absorption area will be installed which also provides suitable area for a 4 bedroom residence. SEPTIC TANK Tourist rooming house 3 rooms X 100 = 300 gal. 1 bedroom residence 1 X 150 = 1.5.0 gal. Total = 450 gal. Plus 750 Total =1200 gal. A 1250 gallon precast concrete septic tank will be installed which is also suitable for a 4 bedroom residence. sc.a~tL _ _ X10' q i , ? x.., j tr`v r \ \1 n1 ~5i~ r`M1S ~ j r' 19iJ I till i", , f1l", ai, s~-4ED E`XtST. S~1~TIC -iPNtt PrvD DR~wELL - TD SE F)a/\NAO►JED 4 -25 x «s DER 0oa~ l1.iST'Kl~.. \ZSO GRl_. w t ~`S ~ Cp+~l C\2E'~ e.Z 2 I a'3 V.Sr 1 4op `75' of z.S~oF W, PvC 5 14" PVC I )tom SZ'hl.L Al ~ I ~ \ cLeltAlovT' NOV St S S ~ \ SHED r 16 L g6 I ~ II 0 B• I Q x W 6cLl. 3EU C!1 l~ l`~(Lk EL Nt 0wz sy Tb? Of W Et- s ~ G bRtu~wK`i Vl 1^N3 ~ t tiN S C,o ~ t pvc w "cz 4\AE V3IESER_._CAI,~CCZELic- QRS?I1l~ZS 6 olaoP BcaxEs _ 83' - " S, 2 SOt_1pWIl~L "p1PE PE2FoRA'r~'D PlP~ I J J Z_ CReSS . T1oN F;t:.h~1~Pa5 i 3 s j SS 11Y... ~ 2 1 1 L71 0 :.ri t/"Cr -VENT P! isE tiV; AI'PRAVE~ CAP NZ" AP_PRIIV@A ,S`3NTf;~I'1C RSOVE Tr7N~SHED C.4VERTK7fG oR ..QF G-R be .AIL-__Elti~-- l» uo~~c C.TEis STRRW - - ►=x,,,15 3 E~ ai•4o e ~ 40.70 611 of )/Id-m Z%21 NGRGRESKM Z BE~w F1P.e_ AND _2'•~ c1F_ _ - PERFoR,!~T_L~= P_-t~~~ ~ AG6RE6A?E _A~~IE_:~Q_E_ - ~2ATZ'O~t'1 6F ='1"'REiJC13 ~9~' -~~.f~cE: ri~xIMUN 4Z'` CUV~R ova UIST1~LBti~~.. _SsrP~-r -~Z~P.~_ . r-l~1SHm SuRPActz ~ c~Ruvlp~ t~RAt~uAGE, _ _ State of Wisconsin ` Department of Industry, Labor and Human Relations SAFETY & BUILDINGS DIVISION PRIVATE SEWAGE PLAN APPROVAL Western Regional Office 2226 Rose Street LaCrosse, Wisconsin 54603 WEGERER SOIL TESTING & DESIGN Owner: BRITT FUGINA P.O. BOX 74 410 HIGHLAND VIEW RIVER FALLS, WI 54022 HOULTON, WI 54082 RE: Plan Number: S90-40705 Date Approved: November 12, 1990 Gallons Per Day: 450 Date Received: November 12, 1990 Project Name: FUGINA, BRITT Location: SW,SW,29,30,19W BED & BREAKFAST Town of ST.JOESEPH County: ST CROIX The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped 'conditionally approved'. This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. This approval will expire two years from the date approved or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. The Section of Private Sewage has reviewed these plans for private sewage system code requirements only. These plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the Wisconsin Administrative code. This approval is for the following components only: 1ti~1 i 117 r - REPLACEMENT CONVENTIONAL Inquiries concerning this approval may be made by calling (6 1785)19348;r-,,'4 Sincerely, rV GERARD M. SWIM 9,' 1 Section of Private Sewage ~ZI~ Division of Safety and Buildings 4PP039/0009n/42 cc: BRITT FUGINA X Private Sewage Consultant SBD-6423 (R. 08/88) DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX N WI 53707 HUMAN RELATIONS (ILHR 83.0911) & Chapter 145) LOCATION: SECTION: OWNSHIP OTNO.:BLK.NO.: SUBDIVISION NAME: W '/a 5U'/a Z /T3c3N/R►9 E (.1W lep-'a - - C NTY: OWNER'S BUYER'S NAME: LIN ADDRESS: OS)~~oIX $RI TUC-.# A V1 w OUVM#j Wt USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DES RIPTION: I 1 LATIONCT~ESTS: Residence ❑New Replace ©GTO S 890 ~ r V ~ ~c e O c.-~ 0 tLS +C Z tc. ~~C - NM~.e RATING: S= Site suitable for system U° Site unsuitable for system Z / CO Vg NTIO❑NAL: IMOUND:❑~ IN-G®NDQESSURE:SYS EM-IaULHOaLDINGTANK:RECOMM~ D~~~T~`(optional) If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s. I LHR 83.09(5)(b), indicate: CLASS 3 Floodplain, indicate Floodplain elevation: N A PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH 1% ELEVATION OBSERVED EST. HI HE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B I B .6? X 3. 3 46 N >'7.6-7 11"8csLTS 9 `4 y ge, S. SiL/ 1~ 2d$eN r S. 61 "IPd~15 B- B Z, 8So ' S o > E3.SV 919LS 24"Y&g M- S, s~ d MS Co b B- B- 3 9.9Z 9>33 No >9-9 Z ~s~rS QNS►C 2s✓Ras~ 7-7"R405 B- PERCOLATION TESTS c TEST DEP H WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER AFTERSWELLING INTERVAL-MIN. p I R PER INCH P- I S .OO NoNC[ 9s o ' z I A P- 2 3.10 NaNkA S.t 30 1 P-3 t a ~3v P- P- F-LoA.Vrow 'C t><QG 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 Sbsmr M_ CLENIA-r IONS _ - _y._.. 1 ....~.~I___.. tA 90.70 { 1 I i 1 .40 O N g2.2 ~ A- I l !4 J s": C kit! . - _ LnICWMdQ ~C 'Gp OF WEELc.. 3Z.' , SaurN 5!4 _ pF /JoL4 C I 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPL TE4 ON: I~iA~?~I% ~ou SON t Sae. .JC~Q~~Y/NC, /U 8 9d ADDRESS: / l CERTIFICATION N MB R: PHONE NyMBER(optional): 407 SE~o~lt~ ST iT~fUflSo~, Wt S~{O)~ 3 C T ATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) -OVER - S T C - 10 5 SEPTIC TANK MAINTENANCE AGREEMENT ~ St. Croix County w OWNER/ BUYER o ROUTE/BOX NUMBER Fire Number S`~/l~_ rt CITY/ STATE ZIP M M PROPERTY LOCATION:.'Section, T3 ON. RW, Town ofd- St. Croix County, S. '-ion ,..'LPG-'er=ber_. 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 's'ept'ic tank um er. What you put into the system can affect the-function o the-septic tank as a treat- ment stage in the waste disposal system. St. Croix Counter residents may be eligible to, recieve a grant for a maximum of 60% of the cost.of replacement of a failing system, whit was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all'new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a mater 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 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 Depart- w meet of Natural Resources. Certification form must be completed ►d and returned to the St. Croix County Zoning Office ithin 30 days of the three year expiration date. SIGNED DATE St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 386-4680 Sign, date and return to the above address. APPLICATION FOR SANITARY PERMIT 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, -A- got 1 /'V' ht Location of Property 3 F Section N-RW 2 2 Township ='a ~ea=oggf~ Nailing Address X1,46 y ~~Jst l`~ Address of Site I'I Subdivision Name 414 Previous Amer of Property Af~ Total Size of Parcel .2s 14c-eye-s' Date Parcel was Created J" /C/ $ Are all corners and lot lines identifiable? zYes No Is this property being developed for resale (spec house) ? Yes No Volume and Page Numbers as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and a e number, and the i5k 3- 413 t? 35-~ 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 refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION t IwoI coJt,LL6y that au statement's on th1A ohm ake, th.ue to the best o6 my (ouh) hncwCedge; that T (we) am (ahe) the owneh k) o6 the pnopehty descAi,bed in thiA .in6olmati.on 6o4m, by v•ihtue o6 a waAAanty deed kecoAded in the O66tce o6 the CourLy((/ RegUSteJt 06 Ueedh ah Uoeument No. ; and that I (we) phebentty sun t C phopoaed bete 6oh the sewage. diS_POS dys em (oh. 1 (we) have obta'ne n ecusement, to Run with the above de ottbed phopeAty, 6oh. the eonbthuc,Lion o ea,td b yetem, and the sane has been duty Aeeohded .tn the O e o6.' County R giAteA 06 Veede, ae Vocwnent No. J. SIGNATURE p ER G OF CO-OWNER (IF APPLIC LE) EbWE SIGNED nATR grrNVn ti es Ims raw not .......,...«..~.......w-,+w'! 1 ! xnp - fib. r . d . * r,=y; • n'W . IOL~ .r _ t 8!, 17- '715"It)w r ,ti L : ~s3 1 tlf r rd~ - 48!1 ~ i J.-. >Mtt O[ 0.1 Md W t Of oft ' of Section 29-30-19~c ~~rlbad:_~`Ot tae IMI CoibM Of said'ae:tian 291 thence 1#!'00.22 ' iLha Sd. sMI feat to 00 ceatetiieie of C.T.N. 'ft" a~ciWit: lA0MIt0`contialtl~rg t!N9'00.23"$- 3.93. ~1~2'`tt' • 7Z irate ~ ngrtlrehr ; C;T.ti ' tipt no WA. WWW aa~c t, Mr, ~'~t' 'Wi't tD',.. ~ mar .~ea~ 48~~ 1 d a si7r.#diot rid.;' MAW 1d' MA Wiese dhow. dress *W"I' > r~.e1E *dallVe 2?2.~ j8 .33 i! "is poil* at CuMtUft 4*. e , cweltast ~3st s 107.12' 16~ +~1° ` err+ax 3Si.d3 : ft@4 theme northerly alag di 6> 'M`tts3 point of tWgM1 l throe N18'43001"W 1 l0 f+ t`: 1435.% fgas thence 000'00'018E al" the nest lisle R1E Best. :f11 am rl ine of said C.T.N. "E", acid (xisterline be** MC Uot and theastsrly whose central angle weaszutes 1!•2?'IMI"', weasurts 677.90 feed Metxv southeasterly Said'CWW, 4804`18 feet to the point of beginning. Also all that part., rfy IMF; of 0ectim 29~-30-19, lying soutlwrestsrly of the centerline at C.9*. R 4MMMU M puals ore- subject to right-oNwigy for C.T.tI. "!:"and the West3 ' !aM Object to Bali other easements of ervord. 4 ' with and'svbN ct to a foot wide Private ft" distant as. weasuttd at right angles and radial ly fray the f0lkleing iilhet ieg at the SO Corner of said Section 29= throe lb9.00.2 MOM 11",C9 tfie StA1c of Section 29, 390.81 feet to the centect ine of thenW, N22'4434"E 33.72 feet to the northerly right-of-lay of C.T N. *r- , t?o `beginning of this centerline description, also being them foot. radius carve concave southeasterly whose central angle' ,:Made cbor4 bsas~ N46*05'04"E and measures 116.62 fertsthengt: r< ear "o[ SAW ahuwe 118.34 foot to the point of ~Iti • taurgencyt theabel feet' to !ho point of curvatuae of a S06.76 foot radius cusvet tdMsse 1 angle measures 110161100 aAj whhose clrorc+d baecs . 45'52 feats mm- r P northeasterly along the arc of said -a fl44' at ors ;Onwe N53'452596; 301.36 !goat to the point of a 11~ ` " *MW concave s utl v rlY Mh=m central an91e ever aN . 1 3.3t"E and nvasums 219.52 fieatt thence carbon d Wft .2U.I meet to the X Pow of tangency; thence N8A•2911302103.23 f of~ wtlCes a of a 221.16 foot radius curve concave weaeierly ~ a (Oonti mak Ilse lol lowing rage) xr14Wr~ war r ' • ~ `may , r!". i' Si { A ! ,r #i► drmood g Qt ~if~at aE #116':00 spot ~dUg1 ever ~x~ 74*'~4'00• AM cM E-mss as tfiW we of am cmi~e' 263.SS OSt to 30 .10 feet to O a mt W of m Memo feota j a at this OftawU r d~ariptlot. -file b JubuVect the ri¢ht_CW_ W of C.T.K. "ir" A. Reserving onto grantors, their heirs. am ~s~c,rs T " . tss the land contrrct between the parties is paid and so4 h. OWr the 66• ride private road described above. L nr: e' c ATV : c '1. A Y~ - -mow ~ 1t. 5,17702 R19W, SHADY MIDGE LOCATED IN HART OF THE SWI/4 OF THE SWI/4 AND THE SEI/4 OF THE SWV4, ALL IN SECTI TOWN OF ST. JOSEPH, ST. CROIX COUNTY, WISCONSIN; BEING PART OF LOT I OF CE SURVEY MAP RECORDED IN VOL . 7, PG. 2081 AT THE ST CROIX COUNTY REGISTER OF DEEDS CURVE DATA O',JTYIED~- GINA I can for toms curls clan =0 me 1119111 Tusm ect 0. LUSH 1ISL 103116 stlsn ANTI owls 111113; yon ysrcel s o ham on la this wslap (plea) is a to State, and County god toles reguu lati lation life., 1.1 0 1755.1{' I141116t417'IS.s•l ]].24' ]1.0' So 101 1'!'.'1 Ifi°11'11.1 purchase, nor de m le let size, aceaeh to o parcel, sac.). ilCroix °IT0.1 orcdaeiveloping any percel contact the 8t. 7.7 1 1 It277;..117' ' )1°5. 11°1.1111' a1411'll..t 141.11' 111.11' Niel l'31.1 1'.s Canty Zoning or de Office and appropriate Town Board for device. advice. nf411'N't 01.11' l.l. 05002'10.1 ]°0'507 C '.a t ' 7/°u'u• m%rnv 13f.3n :f42.13' IS 137°a'n•1 111411'13.1 la ] ul.t. u1411a. a41r1'.'t ]a.n' )57.11' 61.2 im 'loo'n" 11-l1 0 1/10.1. 1!411'11• 1000171'1 11111.11' Itl.l. 0500.51'1 S6/411'12'1 17.17 ] 1151.1'.' 1I°17'11' 07°11'11'1 161. tt.71' 142007'51.1 14sh1'O.1 no pole or buried cables are to be placed such that the 11.15 0 1701.1'.' 1'.°II'a• n1415'S1'1 142.1. 742.1. fIS41l'l.t 5{141.5]'1 installation would disturb any survey stake, or obstruct 1 1101.1'.' 1/415'1'.• 0141.It•1 117.71' tl1.n' Ns41l'42•t Su°Sref7 vision along any lot line or street line. 1 1701.11' 11411'11' 8S°1T7.1 250.42' 711.0' 00°51'11'1 16l°n'S]'I 1'ha disturbance of a survey stake by anyone is a violation 16•2 1 1755.46' 41411'17' St l°1170.1 111.0' 117.0. 0141.51.1 8S°sl'ISof Section 236.32 of Wisconsin Statutes. Utility 8asesents lFt 0 1155.1. OS°15'13• tu41.7f.5'1 171.1. 134.14 1041.51'1 10°15'267 u herein set forth are for the use of publio bodies and private public utilities having the right to serve the area. Rv4 CORNER sECTgN z9 _ ~ LET $ N C. S. M s - L. 7, FIG. 2081 U_JELKiED LANDS \ N86'S9'39'W 833.88' LOT C SSVOO'22'W 795.98' _ 420469' lu.n ~i. Ins I 1 LA Nom HIGHL 0 T \ \ / r N LO ! 6 /-401 ` _ \ HILLS 1D / >t6.37 AERIES I0 :111 a 4.00 Aedxs / 13 f 1 10 .4.x42 so. FT. s u.242 :o.F`E IV' Lor ~ L~-JI ~ ~ LOT 7 / U 1 ;L I ~i M2913E0 103.2 1 LOT 8 § Low L7T 3 Y AREA \ 'c4c > . ~i(~`~. HIGH_ AND $ ,y / h //~Q I HILLS 547702 e / c6ISHR'S OFFICE, h. MIS CO. IK I '44'34'E 5114 CORNEA Ma D.I SW CORNER nY9'00'xx'E 11 33.72 ""M 29 X Ae.u,• Lis SECTION 29 l9p.IPl' N89'00'22'E 2v2s' V 73.73'\ sOUTN IAE OF 'IRE SWAMI. SECTION SO \ AaflnN a o ead. UY?BATTED LEGEND ~-(I>~„~~y✓ J M ALUMINUM COUNTY SECTION MONUMENT FOUNO '.°"C"- C PLAT LOCATION ~ ' ANDS I Vgtw ? e 1. IRON PIPE FOUND D • 318 Q 2'F 30' IRON PIPE SET, REIGNING 3.45 LIPS. PER LINEAR FOOT -I - - O I' , 24- MW PIPE SET. WEIGIUNO 1.40 L60. PER LINEAR FOOT L vn v - ROAOwAY SETBACK LINE IWIDTM AS SNOWMI I 12• WIDE UTILITY EASEMENT t '-NWI/4--NEI/4 - EAISTIN° ORINE NILLlAR~ a-1 "WING FENCE LINE V 7= 14aNLARD i v OA NIL L3 OOII J1 1 CI , III FIRST ATION SwV --I-SEI/4- R~iY 'I 2 ST I~ ~1 ~,tE 8040 sr SCALE IN FEET 1 570' loo so o ao 200 300 E EAST SECTION 29, T30N , R19W q'' -FT I 1 ST. CROIX COUNTY WISCONSIN N - , -a ZONING OFFICE ~yP ~rrrrNr.~ O _ r"" q '0 COUNTY GOVERNMENT CENTER 1101 Carmichael Road S7 Ot t Hudson, WI 54016-7710 ZOPIINOSIG. (715),386-4680 SEPTIC INSPECTION T REQUEST FORM Please specify desired test(s) & remit appropriate fee with application. Outside water lines are often turned off during winter months, making access to the home necessary. Please make arrangements with this office to insure that entry can be gained. ❑ Water (VOC's) $185.00 ❑ Septic $50..00 Water (Nitrate & Bacteria) 45.00 0 Nitrate & Bacteria 'Water (Lead Concentration) 21.00 retest $15.00 Owner: tl ll 61 o ra. Requested by: Address: ; ' ; Address: ZIP Telephone W: ( l' ) 25g r / l Telephone W::, ( / ) Property address (Fire W & Street) / ~47 d/ Location: Sec. , T N, R W, Town of L2~~ Realty firm: Lock Box Combo: Closing Date: 03 0 - Zo99 - i0 - 000 2q.90.1-9-814- TO BE COMPLETED BY PROPERTY OWNER PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORMS Water sample tap location: Is the dwelling currently occupied? es ❑ No If vacant, date last occupied: Age of septic system: Septic tank last pumped by: Date: Previous Owner's Name(s): Have any of the following been observed? ❑Y ITT Slow drainage from house. ❑Y Z Sewage Back-up into dwelling. ❑Y Sewage discharge to ground surface or road ditch. ❑N Foul odors. Other comments relative t system operation: v 1 l~ c I certify that the above information is complete and true to the best of my knowledge. OWNERS SIGNATURE: %c' Cam- DATE : 911- 1/94 t OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION IN TO BE COMPLETED BY INSPECTION AGENCY System design &/or permit on file? ❑Yes ONo Soil series per SCS Soil Survey: sheet # Type of soil absorption system: OBelow grd 0At-Grd OMound Approx. size 'X OGravity ODose ❑Pressurized Ft.2 OBed OTrench ODry Well Molding Tank ❑Outfall pipe OBSERVED DEFICIENCIES 00ther ❑Unknown Septic tank Setbacks: OHouse OWell ❑Prop. line ❑Other Dose tank Setbacks: OHouse OWell OProp. line ❑Other ❑Locking cover OWarning label OPump/Floats OAlarm OElec. wiring Soil Absorption System Setbacks: ❑House ❑Well ❑Prop. line OOther OPonding: ❑Discharge: General comments: INSPECTORS SKETCH OF SYSTEM LOCATION N Inspector Title ST. CROIX COUNTY WISCONSIN _ ZONING OFFICE n ■ None ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 September 29, 1997 Bob & Connie Lotspeich 410 Highland View Houlton, WI 54082 RE: Water Test Results for Bob & Connie Lotspeich located at 410 Highland View, Houlton, Wisconsin, St. Croix County Dear Mr. & Mrs. Lotspeich: Enclosed is the original water test results from Commercial Testing Laboratory for a water inspection that was taken at the above referenced property. If you have any questions regarding this, please call our office at (715) 386-4680. Sincerely, Mary Jenkins Assistant Zoning Administrator Enclosure sm COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715-962-3121 800-962-5227 FAX - 715-962-4030 ST. CROIX COUNTY ZONING OFFICE REPWT NO.; 48749/01 PA 1 ST.=IX CTY GOV.CTR REPORT DATU 9/26/97 1101 CARMICHAEL ROAD DATE RECEIVEDS 9/19/97 HUDSON, WI 5016 ATTN. THOMAS C. NELSON i WI DNR LAB CERTIF.00617013980 MF5332 Method MDL./LOQ Date Kitchen Code AnaLyzed Bob & Connie Lotspeick 9-17 Lead, uo/L < 1 200.9 1/3 9-19-97 The maximum contaminant level (MCL) for lead in drinking water systems is 15 ug/L. The maximum contaminant level (MCL) for copper in drinking water systems is 1304 ug/L. < Means "LESS THAN" Detectable LeveL Approved by'* 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 FAX - 715-962-4030 ST. CROIX COUNTY ZONING OFFICE REPORT NO.! 48571/01 PAGE 1 ST.CROIX CTY GOVCTR REPORT DATE! 9/25/97 1101 CARMICHAEL ROAD DATE RECEIVED! 9/18/97 HUDSON, WI 54016 ATTN! THOMAS C. NELSON INNER! Bob 6 Connie Lotspeich LOCATION: 410 Highland View, Houlton COLLECTOR: M. Jenkins DATE COLLECTED! 9-17-97 TIME COLLECTED! 2200pta SOURCE OF SAMPLE! Kitchen tap DATE ANALYZEDI9-18-97 TIME ANALYZED: 2l00pm COLIFt i 1oWCC-# 0 /100 ml INTERPRETATION! Bacteriologically SAFE NITRATE-N: t 0.1 Ppm Above 10 ppm exceeds the recommended Public Drinking Water Standard. Conform Bacteria/100 ml Nitrate-Nitrogen, mg/L LAB TECHNICIAN! Pam Gane WI Approved Lab No. 19 < Means "LESS THAN" Detectable Level Approved by! PROFESSIONAL LABORATORY SERVICES SINCE 1952