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HomeMy WebLinkAbout038-1091-90-110 a O ~ N O Oq O M C O O co O N N ~ 'Fu o N y C O a, M j O -0 r 0 N Co OO O C'J V Q,roN d o~ rn h 0) U CQ a) w I v ~~2 o0 O .E N z N p N O. c •C LL. C TO1O-_ ? o cc ~ E^Q'ON a 3 M I 00 z = °o z ~ m ~ I a m 04 o I c C7 ~ O z a c w (D Z Z N H S O O I c E ~ -o cn a) 0 3 N ~+J o Q) Q CD c • N (n L O O °a, Q w O z co z O N Z N R N N d c V co y N ` p o C) G G a ° yp Q U~f1l z~> 3 a~ z •N ~aaa u, a o ~ E cD (n in J U rn rn } N 00 v CO 00 a) _ N C) C) z N O O) .0. 0 'p d1 Q fn o ~r O 'I r 7 r O o 0 3 0~o H e J 0 CO t o E°- n 0 N v°, N u oo CD '0 1 Q o c a, r~ a) _ a s c s, 'c r N E E a °r a u~ o o y 00 0° M o o N E E g O N (A CO O Z N =7 L5 SO I V v~ d R € a EL • e~ CL a, m c ~1 A 0 at !0 NV Parcel 038-1091-90-110 02/14/2006 07:55 AM PAGE 1 OF 1 Alt. Parcel M 22.31.18.378610 038 - TOWN OF STAR PRAIRIE Current IXST. 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 PHILIP R & CINDY J BOWE O - BOWE, PHILIP R & CINDY J 2084 110TH ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 2084 110TH ST SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 1.310 Plat: N/A-NOT AVAILABLE SEC 22 T31 N R1 8W PT NW NW LOT 1 CSM Block/Condo Bldg: 8/2226 1.41 ACRES EXC PT TO HWY DESC 993/460 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 11-31N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 993/460 WD 07/23/1997 874/492 Bill Fair Market Value: Assessed with: 2005 SUMMARY 119403 201,500 Valuations: Last Changed: 10/14/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.310 27,200 170,800 198,000 NO Totals for 2005: General Property 1.310 27,200 170,800 198,000 Woodland 0.000 0 0 Totals for 2004: General Property 1.310 27,200 170,800 198,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 310 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 q FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER-f-';',,,) TOWNSHIP SECTION T N-R W ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION ; LOT LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 1 r q INDICATE NORTH ARROW BENCHMARK:Elevation and description:•t~Z, Alternate benchmark SEPTIC TANK:Manufacturer: Liquid Cap. Rings used: n Manhole cover elev: Final grade elev: Tank inlet elev.: Tank outlet elev.: No. of feet from nearest road:Front Side , Rear Ft. From nearest prop. line:Front , Side , Rear, Ft. No. of feet from: Well 1 Building: (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE - r PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufact.: Pump Size Elevation of inlet: Bottom of tank elevation Pump on elev.: Pump off elev.: Gallons/cycle: Alarm: Man.: Switch Type: Location Distance from nearest prop. line: Front-, Side-, Rear-Ft. Distance from: Well Building SOIL ABSORPTION SYSTEM Bed: Trench: Seepage Pit: Width: Length Number of Lines: Area Built Exist. Grade Elev. Proposed Final Grade Elev. Fill depth to top of pipe: No. feet from nearest prop. line:Front , Side , Rear Ft."-* No. feet from well: No. feet from building .11 7 F HOLDING TANK Manufacturer: Capacity: No. of rings used: Elevation of bottom tank: Elevation of inlet: No. feet from nearest prop. line:Front , Side , Rear Ft. No. feet from: Well , building , nearest road Alarm Manufacturer: INSPECTOR: DATE: PLUMBER ON JOB: LICENSE NUMBER: 6/90:cj 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 MA ISON 153707 State Plan I.D. Number: NW ,NW,,Sec. 22,T31-R18 CONVENTIONAL ❑ ALTERATIVE (If assigned) Town of Star Prair Ho ding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTI A P 1 i Bowe Dr. Chi i)iAa Fa I 1.q WT REF. PT. V. ST REF. PT. EL r• BENCH MAR (Permanent reference point) DESCRIBE IF DIFFEREN OM PLA V e$" Name of Plumber: MP/MPRSW No.: County: Sanitary, ermit Number: Mi h 1 Wilson SEPTIC TANK t , n ~ MANUFACTURER: LIQUID CAPACITY: TANK INLET EL71., ANK OUTLET EL V.: WARNING LABEL LOCKING COVER ~m PROVIDED: PROVIDED: /60,. 7 YES ❑ NO ❑ YES NO BEDDING: '9'EiJT DIA.: MEW~MATL.: HIGH WATE NUMBER OF ROAD: PROPERTY WELL' BUILDING: VENT O MESH G. . /t C.o• ALARM: FEET FROM LINE: t / AIR IN ET ❑ YES NO ❑ YES NO NEAREST MANUFACTURER: BEDDING: LIQUID CAPACITYLN P MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVDED: YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO GALLONS PER CYCLE: PUONTRO T IONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF ❑ YES ❑ NO SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: ATERIAL AND MA NG: or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue. CONVENTIONAL SYSTEM ,5 --,M gCJ a. _ WIDTH: LE N OF DISTR. PIPE SPACING;FFEET INSIDE DIA.: # PITS: LIQUID BED/TRENCH TRENCHES: / PIT DEPTH: DIMENSIONS /V17 - GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PI E DISTR. PIPE MATERIAL: UMBER OF PROPERTY WELL' BUILDINVENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV. I LET ELEV. ENDr fn'e ~•.r FROM LINE: f AIINLET;9-EAREST-♦ o~~ ~e^~JL MOUND SYSTEW.t l ' a F 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 TEXTUR PERMANENT MARKERS: OBSERVATION WELLS; ❑ YES ❑ NO ❑ YES ❑ NO rDE TH TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: DED: MULCHED: EDGES: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH: LENGTH: NO. OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH A BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.: ELEVATION AND DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑ YES ❑ NO ❑ YES ❑ NO PERMANENT MARKERS: OBSERVATION WELLS: iAREST MBER OF PROPERTY WELL: BUILDING: COMMENTS: ET FROM LINE: ❑ YES ❑ NO ❑ YES ❑ NO e aO 6cf b 600~ dl ) 6LXW Cwl a~ etain in county file for audit. 42 Sketch System on Reverse Side. SIGN LIFE: ',,~TITLE: SBD-6710 (R. 06/88) / SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05, Wis. Adm. Code a--WLHR STATES NITARY ;E~R"M'I(T~# -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ ChecTc if re siofrfo pr6v s application 8'i4 X 11 inches in SIZ@. STATE PLAN I.D. NUMBER -See reverse side for instructions for completing this application. 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. ERTY LOCATION PROPERTY OWNER S~ T-3 i , N, R E (or LOT # BLOCK IF PROPERTY WNER'S MAILING ADDRESS CITY, STATE rZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER C h; ~ w NEAREST ROAD N II. TYPE OF BUILDING: (Check one) ❑ State Owned ILLAGE: ❑ Public 01 or 2 Fam. Dwelling-# of bedrooms ARE AX NUM R( ) III. BUILDING USE: (If building type is public, check all that apply) a3$- loq 9( ) 1 ❑ Apt/Condo 10 ❑ Outdoor Recreational Facility 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 11 ❑ Outdour Recreational Dining 30 Campground 70 Merchandise: Sales/Repairs 12 ❑ Service Station/Car Wash 4 ❑ Church/School 8 ❑ Mobile Home Park 1g ❑ Other: Specify 5 ❑ Hotel/Motel 90 Office/Factory IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) r of 1 ew 2. ❑ Replacement 3.E1 Replacement of 4. El Ex Reconnection sting System 5 ❑ Ex sting System A) System System Tank Only Date Issued B) ❑ A Sanitary Permit was previously issued. Per-*-*# - V. TYPE OF SYSTEM: (Check only one) Other Non Pressurized Distribution Pressurized Distribution Experimental 41 ❑ Holding Tank 21 ❑ Mound 30 ❑ Specify Type 42 ❑ Pit Privy 11'-Seepage Bed 12 ❑ Seepage Trench 22 ❑ In-Ground 43 ❑ Vault Privy 13 ❑ Seepage Pit Pressure 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: ELEVATION 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. MRC. RAE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) ( "Feet _ 3 ,~3 5 Y Y Feet a 115 CAPACITY Site Fiber- Exper. VII. TANK in allons Total # of Prefab. Con- Steel glass Plastic App INFORMATION New istin Gallons Tanks Manufacturer's Name oncrete structed Tanks Tanks e 1-j F1 I Sa tiC Tank or Holdin Tank Lift Pump Tank/Siphon Chamber Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown oPnRt a attached pla Business Phone Number: Plumber's Name (Print): Plumber's Signature: (No Stamps) M No.: Plumber's Address (Street, City, State, Zip Code): IX. C NTY/DEPARTMENT USE ONL Issuing A nt Signature (No Stam Disapproved Sanitary Permit Fee l SurchagerFeej Water a e ssude Approved ❑ Owner Given Initial a~!} ' Adverse Determination. X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber SBD-6398 (formerly PIb-67) (R. 11188) 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 a MP, etc.), address and phone number. Plumber must sign application form. PPropriate prefix (e.g. 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 us(-,,d for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (8.11/88) NITARY PERMIT vmesks) of FOR SA the ° delays by od '01 AppLlCATlOt1 l T O _ 1DD and Sig nly - e % £°L to v%a the 5 in tul s Will intende be to With be comQleina e4 i 4ment ~ )t% sh t'hiy o £iCe- - m is to d AnY y deve second ed to • i t tiotn devel Sh°uld ten and submit w~ j3 C) applica bgi9 e• e)' s old - - W Trig topettY yuanc XAO eaLtY is the Q trait 1 of ~sQec QLO4 the Q Conttac en the otding • - ' owner IMvIeted W deed tec P` tiot► c t,optiate - ' Q V~ 11 A' Sec a9v -'^ot QtoQettY N Y~ 11A OWnet of Qtopettl Location p ~ ST~z a 33 ~ s~{-I a°t ~ Wnyhip ~ ~ ' ~ Toailing address 1c SwAa~~ M,PQE0 of site p~,~D ddtess o~ A ubaivi5ion name i GAG ~ • S ~ A S Lot nuet wnet of QtoQett1`~\ Rc2~5 t~qD pt o x No evi°us ° 'el Yes Yes tal Slie of 'Pat tented dentitiable? ouye)I let of Deeds' With the Reg' - _ - T° to parcel Was c od lot lines i e tot tesale kSQec %t Da ,nets a developed ~41 , as tecot all co bein9 to Number OLLOWINO' was survey 1t 1g thi$ Q and page - ON THE F~~ ~ titied tocess ~tveY - pLIOATi ce t Wing 4 £ied S Vo)►ume - - THIS AQ N aition 1 the to tre Cett - NCLHpR odes a g, l ka delay ~veY MaQ - - - D NX% ~iVia OS f o Oaet°titled tout) R~RY D8F' T~}g R helBtul ces to a t of mY bed in/' W1►R OF d be eten bey cti o des the ga Le o W Lipti°n tut ea • T1F1OATitt e to toQettY the Ottice lWe aveiaeea d also be te9 - ORR CEO tm at the o d Wk, ndj he kve( ~hshall IPVL s oil oWnetl n Y deed c em ot 1 tot ytatem ate) the a walla al sYs topettY Abe of - that all We) am rue of t No• a diyp° ctibe Q ded in cettlt tbat L t r by v ay Docum the se above aes ulY tecot 1lw wleage1 oration to of Deeds rite t° itb the hay bee 6 I vJ\O ' 'owner `lt ApF this out l Re nl the ,,,,,Se 'co tuand th 0 cU ent go. r yyyte ~eedgr ay lute of - r t LesentlY ar ea s% cti ntY Registe of Signa oOI%Sttxl sb Coo t g ~natute the < oOWnet ate o f tote a , S ign Cl a of gi9natute Da -No i,~ ! • DOCUMENT NO. STATE BAR OF WISCONSIN FORM 2-1982 THIS SPACE RESERVED FOR RECORDING DATA 11 WARRANTY DEED 460035 M", 8 74PAGE 492 REGISTERS OFFICE ST. CROIX CO., WI Gene E. Swanson and Kathleen G. Swanson, Recd for Record Husband and wife at JUN2 91090 10:00 A. M conveys and warrants to o Register of Deeds Philip R. Bowe and Cindy J. Bowe RETURN TO the following described real estate in S t . Croix County, t_ State of Wisconsin: Tax Parcel No: Part of the NW 1/4 of NW 1/4 of Section 22, Township 31 North, Range 18 West, St. Croix County, Wisconsin described as follows: Lot 1 of certified Survey Map filed June 21, 1990 in Vol, "8", page 2226, Doc. No. 459764. I'R S ~0 $_jy~ 1P FEE I~ This is not homestead property. (is) (is not) Exception to Warranties: Dated this 2 7 t h day of June 9 0 '19 (SEAL) (SEAL) Gene E. Swanson (SEAL) Zzt~ (SEAL) Kathleen G. Swanson AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF VA9U0 l MX Minn sot a SS. ramsey County. authenticated this day of _ 19 Personally came before me this 2 7 t h day of ' Tune .19 90 the above named • - gene- Swanson an wanson, us"an an i TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be T e per on s who executed the authorized by § 706.06, Wis. Stats.) fore oing ins rume==n~ me . THIS INSTRUMENT WAS DRAFTED BY First Security Title lwass 2785 White BEar Avenue, Maplewood M K Sa er Notary Public Ram c e 3t County, WAX MN (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) date: 9 ) Wo289 R; y~r Val I e y 90-_780 'Names of persons signing in any capacity should be typed or printed below their signatures. NAf-ISE'e COUNTY SB2 NTF 0021 WARRANTY DEED STATE BAR OF WISCONSIN NelcOm ~rtcs A1AF2. r,, rerG _ aR`FtXi1rS-P.0 Box't f1POt3^8reea13ay, WI 54307-0208 Form No 2 - 1982 * DEPARTMENT OF SAFETY Q REPOR 1 ON SOIL; ~Q~IN:$~ ~ND. ~ INDUSTRY, LABOR AND R.4 PER C Q. ON. TESTS HUMAN F{ELATIONS , , - `t83.ot+tr~ cmpa 1461 Molr►1 I~ LOCATION- U lP'AitITV. c0'/ Au) 4 ZTz /TS/ N/RISE (o ra.irie COUNTY: IMAILING. r $ E 7 DA _ T AT ~ !lV lONE MADE' BEORi C IA Residence a` OReP , r t RATING: Sa Site suitable for system U• Site unsuitable for system _W if -IOUN-T L. MQUN IN.CiROUN S DU D:PKR M N4 L LDING A ECOMli1#"N $i I'#:Ict~t~on.I) rims ou 'K.S OU El S R If Percolation Tests,are Na3T taquked DRsIGN RATE: Ff',aRy pl,~r#ioli ol't+fs thte~,i~ lia"fR Nla r- ' , µ , , under s; ILli 83.(*(5)fbl, indipp#e:,' ry A floodplain indCSrtelotrdp{atri,Nwattpn.< y , , 'PROFILE QIEOC1Ip'f'iQN,S' v ~al_ , ,:r w * MNO-A -IN-0 EPI H N. ELEVATION , A • 1 - a ' E RV._C4 9A , : < 11 h awe, ,r-.: , Ito &'D /da` ~y jj; y0 KX~ ilcl''zt f ~'!dA' "i~!!,r'si'! # {t PERCOLATION TESTS TEST i DEPTH , AT IN HOLE TEST TIME A NUMBER INCHES AFTERSWELLING INTER AL MIN. =ZA-Fli ego, x•. P • , PLOT PLAN: $how locations of parcol;twa tests, soil borings antl the dimensions of syltsble'soif orsa. Indicate scale ,or dlabt~ae: 'Devilr4 a oW ar+ tht~ hWl=y s/xtital and vertical elevation reference points and show their 'locattpn on the. X144" plan, Show ;the surface alswtion at 41l bcwkW sold tli disso"ii and pelgnt; of land slope, A`' SYSTEM ELEVATION - ' Ile l ~i @t } F J_` l ire_ i' 14 Z? 1 r r 1 9L 1. 5 4% F, -yam /t~ 1 4" 1 11 N lop ski T t - I I f I _ .n a,,4,+• y 7 A it +r. - .4. z ' I I` t 1..:I I, the undersigned, hereby certify that the soil tests reported't1n•this form were rnadoby me in accord With the procedures ond mtthods specified in the Wisconsin Administrative Code, and that the data recorded and the location; of,'3he tests are correct;to the pest of my knowledge so belief. NAME print T $WERE WMPLIET40 ADDRES GEfiTIF{GATIQ NU14lBEk.:. PHONE E ' T SI ly _ = .DISTRIBUTION: Oroqinal and one copy to Local Authority, Property Owner and S, r , DILHR-SBD-6395 M. 10/831 r ' STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER PHIL-q-) +9n1U Cinlt~y C) 0E ROUTE/BOX NUMBER FIRE NO. CITY/STATE Ne-Li I c~-IM O l7 ZIP SYd! 7 PROPERTY LOCATION: A)") 1/4 ~JL% 1/4, Section , T 31 N, R -i$_W, Town of S T92 Pr R~~iE , 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. SIGNED DATE 0 A wire) c,2 7 9 ~O Gr_ 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 r 40 LNo. a rl 3 -j t? 4 0 ca B d O i r •~a y, ~ 1p~ INDUS OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY RY, DIVISION LABOR AND PERCOLATION TESTS (115) It P.O. BOX 7969 HUMAN RELATION MADISON, WI "53707 (ILHR 83.0911) & Chapter 145) nfd,,,~C(~ Waod~ LOCATION: SECTION: OWNSHIP U IPALITY: OT NO.:BLK. NO.: SUBDIVISION NAME: 1/ W 1/ ?-7- /T3/ N/RiRE (o W 5~a~r raav4p_ / 5 W. .1 r123 COUNTY: MAILING ADDRESS: USE -7 DATES O ERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: I ROFI LE DESCRIPTIONS: PER A ESTS: Residence /J/``/~. ,KNew ❑Replace l ~~S~~a m RATING: S= Site suitable for system U= Site unsuitable for system l / y C VENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) S ❑U S ❑U $ ❑U ❑ S NU ❑ S ®U CaU."L If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the AP under s. ILHR 83.0915)(b), indicate: NA Floodptain, indicate Floodplain elevation: I` ` PROFILE DESCRIPTIONS k S 4 BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTU AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HEST TO BEDROCK IF OBSERVED (SEc~E ABBRV. ON BACK.) All, B- 80 IDO h Q~g ' go 6 B- %o /017 r~ 90 © t~~! S 1 - 77 e r 1 ,q 4 R.. p K cs B- % i / B- co D/day 0r- I rIloci •t s B- 96 /b/l$ti 9D Qri„ j'Lrr 191 s/ T. X12.0-/40",i'w P c!(j`~ 5 - ~ B- PERCOLATION TESTS EST DEPTH. WATER IN HOLE TEST TIME DROP I WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. P RIOD 1 PERT D2 P R PER INCH P- 3 .~Z i ~~y ! Z P-0 Z P- P- P_ kc 16 P_ 114 14 -P. e.. 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. SYSTEM ELEVATION. ' t I g-I f ~ a 3 3 F , _ -4 i 1 y 1re # i r liA V L'L-.~. t r y N E 3 ; I r t E a S. 64 e- ;'5 , * co F. t ` I, the undersigned, hereby certify that the soil tests reporte is form weFs` by m accord with the procedures and method[ specified in the Wisconsin Administrative Code, and that the data recorded and the locati e tests jil rrect, to est of my knowledge and belief. l NAME (print): v TESTS WERE COMPLETED ON: LToL V_-- / 48 9'o ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): L is `757 -a-XS-1 CST SI NATUR DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R, 10/83) - OVER - INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 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 diagram accurately locating your test locations. Drawing scale is prefered. A separate sheet may be used if desired; 8. Make sure your benchmark and vertical elevation reference point are clearly shown, and are permanent; 9. Complete all apropriate boxes as to dates, names, addresses, flood plain data, percolation test exemption, if appropriate; 10. If the information (such as flood plain, elevation) does not apply, place N.A. in the appropriate box; 11. Sign the form and place your current address and yur 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 10") BR - Bedrock cob - Cobble (3 - 10") SS - Standstone gr - Gravel (under 3") LS - Limestone 's - Sand HGW - High Groundwater cs - Coarse Sand Perc - Precolation Rate . med s - Medium Sand W - Well is - Fine Sand Bldg - Building Is- Loamy Sand - Greater Than 'sl - Loamy Sand - Less Than '1 - Loam Bn - Brown 'sit - Silt Loam BI - Black si - Slit Gy - Gray cl - Clay Loam Y - Yellow scl - Sandy Clay Loam R - Red sicl - Silty Clay Loam mot - Mottles sc - Sandy Clay w/ - with sic - Silty Clay fff - few, fine, faint 'c - Clay cc - common, coarse pt - Peat mm - Many, Medium m - Muck d - distinct p - prominent HWL - High water level, surface water ' Six general soil textures BM - Bench Mark for liquid waste disposal 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 may request verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a permit. The sanitary permit must be obtained and posted prior to the start of any construction. _ JUN 2: 11990 a JAMCB ()'(;()KNELL d~.~ !..-.:.T ,Xlu1.. y. ~ ,1. Y~ ~a C s n>✓ RingiCici 6': 'Go., 4C9764 St. Croix Co.. WI CERTIFIED SURVEY MAP NO. 2226 Located in part of the Northwest Quarter of the Northwest Quarter of Section 22, Township 31 North, Range 18 West, Town of Star Prairie, St. Croix County, Wisconsin. TI-IIS ALSO BEING LOT 1 OF CERTIFIED SURVEY MAP AS _ RECORDED IN VOLUME 1 PAGE 123, Doc. # 327157. 1 NW CORNER 1 SEC. 22-31 -18, ' E 188A2'~" ; 2.4 FOUND ' ttD a MONUMENT,NTY G~vN 1 Y ~''i 76°5O 0 AY W , N P O.C. 895.67' _ - w^ N ,y4.05 N ° Rg0t.23 r Ww~ N6Goo 0 La T / \ - "I I SEE NOTE A 33 \ '53 F L \ I o N NOTE: Future right-of-way of N- N d I Ia 1/t1/10 1 N ~ C.T.H.I fC11 as planned is N OR ~ I o: , - - - - N 55 feet, from centerline. N N LOT I 'tom N The: additional 22 N - m a 7D X%10 W feet would need T' a kill 6 i A N 1 ~ ,m tn1~ ° to be acquired by the ~ I WEST LINE NW 1/4 County. 1 1 i T C: F.Cl,0 ,1 N SEC.22-31-18. SQRVEY MIAP - t W / to ` Z N i ° ° N 260.32~ jg pt' R' 1 1 0 1 1 N O,w WEST QUARTER N I 622~0 1 1 i CORNER SEC.22-31-18, COUNTY MONUMENT. , z m I R-r F_._rlFte__r.,1C„ - - - a L07 41 Ili F:. - - - - Cn - - - GARAGE N ' Bearings are referenced to N the west.line of the NW 1/4 ' 'i~ of Sec. 22-31-18, which is L 0 T 2 m assumed as S00°45'321W. A o GAR. DRIVEWAY t t~ DECK HSE. 0-4 %0 NORTH ` I 1 1 33t \ \ 299.23' 34.12' 13 SCALE: I INCH = 100 FEET -LOT 4 - - - N 89°41'05"W 333.35' 1- 0 20 5o 10o zoo' l-. •i 2 ',1_ I~r1t I iFivi: Jti,Y :~I_Y LEGEND P-3. ;P3- (';URREN'iLY i_C_i 7 P:_41' F PUBLIC LAND CORNER. DUI?iiiY CI:.' • = A FOUND 2" IRON PIPE - - - - - 1 •--A FOUND I" IRON PIPE. Surveyed by the direction of the owner: 0 _ A I" BY 24" IRON PIPE SET, Gene E. Swanson +18~titT~iC~;'1' WEIGHING 1.13 LBS.(MINIMUM) f#tl PER LINEAR FOOT. Rt. 2 ~ ,,,.e.•:.: i':~ : R = AS RECORDED. New Richmond, WI 54017ir . VS ' !Ar" THE FOLLOWING AREA'S ARE BASED ON EXISTING RIG-IT OF WAY 0 r . ~ ~ Area of Lot 1 hereon 61,608 square feet (1.41 acres) ;fir RONAUW17. 1~r: w including road right-of-ways; 47,276 square feet (11.09 acres): 10HNSUtJ excluding road right-of-way. pi f.1 Ei'We . : n w (a. :mot Area of Lot 2 hereon 81,752 square feet (1.88 acres) includin road right-of-way; 71>476 square feet 1.64 acres) excluding road ~.ij~I j right-of-way. Pices~QSUR r#age This instrument was drafted by R.F.J. APPROVED Vol. 8 Page 2226 2 1 1990 5T CMIX COLWTY r ,LAND N n CO ON I FNc SEE OTHER SIDE FOR DESCRIPTION.