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HomeMy WebLinkAbout042-1079-10-120 _0 0 Cp O Oo N Oi r T N C DO 0. 0 o Eoo C E - N ~ O) N 0-5 d C ~ 3 m E U m~~ ~ o o-0~,E ~ C : O C a o c N a) Q o > 0 00 m V U c W N N CO a 0 > a> pN c y E 'O 00 - m O .d L N '006 (U z O _ U (n N d c _U v m LL C a m O - 0 3 O N c c - o -o c o ~ ow=crna~ E d co o V) m~ c m U CU ~ v a 00 Z O LL. ~ 'i O z`-I NtN--zl am i o z ? ° d Z 'd° c v) P a E -0 0) Jy N a Q) \~.1~//1 G 41 Q) H ~ C ® Z F- z N r+ O C i N d - d = a m W V N d i N LO > z U) (n E 33: 3: c~z 0 0 0 •*a ~ a a a CL r o N o o l!i J U rn rn n Cl) C 'O N O - 0 0 N m r E O O O _ = V V m 00 Lo Q) N cn a) O d -o d ~ N ~ c c O CN C4 O O t N C O 3 d ~ O V) U) O CL O CD C, 0 O O 17 G a) V C N E E N N N C o O V V V O Q~ L 0000 sr1, 0} n • ~ C', ol E E ca n o co r' O N> Y r O -5 US C~ Ln E d V~ m m m o. • m C d y y c E ` C d ' ('~^1 ~ O c6 c 3 m O U a O N U r - Q'0 9 ST. CROIX COUNTY ZONING OFFICE St. Croix County Courthouse 911 4th Street Hudson, WI 54016 Telephone- (715)386-4680 service of The st. Croix County Zoning ofllnstitutionsh,e Realty Firtnaepand and water inspections to Lending private individuals. n2iortm can—ho r thin form pr 1 please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning Offwill bandonaaias along with form to the above address. soon as possible after fee and form are received. S / WATER TESTING----------------------------FEE: $ 25900 (For nitrates and coliform bacteria)FEE: $175.00 WATER TESTING (For VOCPS) ----------FEE: $25.00 SEPTIC SYSTEM INSPECTION----- (Determines if system is properly functioning a;--t1-=6 of inspection) Property owner's name _ s address 79 - /U 3=�StQ caner e R o T N Property 4 of Sect on _____. —.- Legal Description 1/4 of the ______.1/ Town of Lot Number `_..Subdivision Name e t n� vi TYTI KS2 -- color of house 9 Realty sign by house?__If so, list firm: PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP, .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 water for lorsome severaltime,hours before the line must be purged by running the test can be conducted. WINTER TESTING: Many 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: Telephone Number REPORT TO BE SENT TO: Closing date Signature ST. CROIX COUNTY ZONING OFFICE St. Croix nty Courthouse 911 4th Street Hudson, WI 54016 Telephone - (715)386-4680 The St. Croix County Zoning Office titutionshe Realty Firmsepand and water inspections to Lending private individuals. e following information, enclose appropriate fee e p payable to St. Croix County Zoning Office, and mail, please provide th along with form to the above address. Testing will be dons as soon as possible after fee and form are received. --_------------------ -FEES $ 25.00 LJ WATER TESTING - - (For nitrates and coliform bacteria) WATER TESTING FEES $175.00 (For VOWS) FEE: $25.00 SEPTIC SYSTEH INSPECTION---- of (Determines if system is properly functioning at inspection) Property owner's name r 7 r\lf N Property owner's address 1 4 of Se on e 1 4 of the / tion / _----- TownDescription ---Lot Number Subdivision Name Town o f --- F T g,K ItL�KF� t�(JCK BOX 2ttl2i @E8. Realty sign b house?__If so, list firm: Color of house Y 5. y P COPY OF PLAT BOCK, AT ALL ppg3IBLE, A , .e r PL BABE INCLUDE, MA IF WITH LOCATION SHOWN, AND A COPY OF THE LI STING SHEET. of residential water requires a sample that is fresh. If Testing some time the water line s vacant and has been so for i the home i • hours bet ors the i must be purged by running the water for several test can be conducted. WINTER TESTING: Nang times waccessitostheehomenenecessaryr siif cocks are turned off, making this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual re a st-_ng services: Telephone Number1 J REPORT TO BE SENT TOs Closing date Signature r i COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715 - 962 - 3121 800 - 962 - 5227 ST. CROIX ZONING REPORT NO.S 12106/01 PAGE 1 ST. CROIX COUNTY REPORT DATE: 10/30/90 COURTHOUSE DATE RECEIVED: 10/29/90 HUDSON, WI 54016 ATTNS THOMAS C. NELSON OWNERS \ Anthony Koshenina LOCATIONS 794-M1. _Ave., F oberts COLLECTORS M. Jenkins SOURCE OF SAMPLES Kitchpn faucet COLIFORMS 0 /100 ml INTERPRETATIONS Bacteriologically SAFE NITRATE-NS 5 ppm Under 10 ppm is safe for human consumption. Coliform Bacteria/100 ml Nitrate-Nitrogen, mg/L LAB TECHNICIANS Pam Gane WI Approved Lab No. 19 Of.NDWEpDEHr 'i Sr YO O A ' W 1 < Means "LESS THAN' Detectable Level Approved byi �� PROFESSIONAL LABORATORY SERVICES SINCE 1952 1 COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715 - 962 - 3121 800 - 962 - 5227 ST. CROIX ZONING REPORT NO.: 11936/01 PAGE 1 ST. CROIX COUNTY REPORT DATE'* 10/25/90 COURTHOUSE BATE RECEIVED*. 10/22/90 HUDSON, WI 54016 ATTN*. THOMAS C. NELSON OWNER. Anthony Koshenina LOCATION*. 794 103rd Ave.. Roberts COLLECTOR: M. Jenkins SOURCE OF SAMPLE; Kitchen faucet COLIFORM 50 /100 ml INTERPRETATION'* Bacteriologically UNSAFE NITRATE S ppm Under 10 ppm is safe for human consumption• CoLiform Bacteria/100 ml Nitrate—Nitrogen, mg/L 1 e LAB TECHNICIAN: Pam Gane WI Approved Lab No. 19 r •�t� , ��` ? �.\NDEVENDEM. '9 fr 7 �0 A V > ( 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 iell& 800 - 962 - 5227 I, ST. CROIX ZONING REPORT NOO 11936/01 PAGE 1 ST. CROIX COUNTY REPORT DATE: 10/25/90 COURTHOUSE DATE RECEIVED HUDSON, WI 54016 ATTNS THOMAS C. NELSON J" OWNER! Anthony Koshenina LOCATION: 794 103rd Ave., Roberts COLLECTORS M. Jenkins SOURCE OF SAMPLE: Kitchen faucet COLIFORM: 50 /100 ml INTERPRETATIONS Bacteriologically UNSAFE NITRATE-N: 5 ppm Under 10 ppm is safe for human consumption. Coliform Bacteria/100 ml Nitrate-Nitrogen, mg/L i LAB TECHNICIAN: Pam Gane i WI Approved Lab No. 19 OF.%NDEDENO T, O= �P u s Z o Means "LESS THAN" Detectable Level Approved by: PROFESSIONAL LABORATORY SERVICES SINCE 1952 Parcel 042-1079-10-120 06/27/2005 12:01 PM PAGE 1 OF 1 Alt. Parcel M 29.29.18.4498-20 042 - TOWN OF WARREN Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 05/18/2004 00 0 Tax Address: Owner(s): * = Current Owner * FRENCH HOMES INC FRENCH HOMES INC PO BOX 250 ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 794 103RD ST SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 3.410 Plat: 4749-CSM 18-4749 042-04 SEC 29 T29N R18W PT NW NW & NW NE BEING Block/Condo Bldg: LOT 1 PT OF LOT 1 CSM 8/2284 NKA CSM 18-4749 LOT 1 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 29-29N-18W NW NW Notes: Parcel History: Date Doc # Vol/Page Type 11/09/2004 779453 2692/346 WD 05/18/2004 762990 18/4749 CSM 07/23/1997 885/184 2005 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/22/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.410 44,000 162,500 206,500 NO Totals for 2005: General Property 3.410 44,000 162,500 206,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 • FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT TOWNSHIP G-~'~~p-~► OWNER SECTION `J-TN-R ADDRESS Z9Y /Q -1-A41- A ST. CROIX COUNTY, WISCONSIN LOT SIZE SUBDIVISION PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ' l- a O O INDIC TE NORTH ARROW BENCHMARK: Elevation and descri tion : Alternate benchmark SEPTIC TANK: Manuf acturer : W.,& j (wj°!aLiquid cap . > ;_2 do Rings used:2,zManhole cover elev: ?,Z Final grade elev: !'~•a Tank inlet elev.:_W,3 _5'_ Tank outlet elev.: _Z9. 0 '1 No. of feet from nearest road:Front e, Side , Rear ,Ft. .L From nearest prop. line:Front Side , Rear Ft. wee No. of feet from: Well $ r , Building: 30 (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE PUMPrCHAMBER , Manufacturer:. 1~4fi Liquid Capacity:_9QQ Pump Model:-R Z_Pump/Siphon Manufact.:Pump Size .7~ Elevation of inlet:- 9S~SX Bottom of tank elevation Pump on elev.: Pump off elev.:~Gallons/cycle: ~l J Alarm: Man.:_ 4~7u b4,ko CaSwitch Type: Location , c Distance from nearest prop. line: Front Side-, Rear Ft. /Q Distance from: Well Building 9S SOIL ABSORPTION SYSTEM Bed: Trench: Seepage Pit: yi Width:. --LengthALy -ro' Number of Lines: Area Built_/ Exist. Grade Elev., 3.y2pr oI~Final Grade Elev. 974 ~93,o~9~a~ Fill depth to top of pipe: . i No. feet from nearest prop. line:Front f Side , Rear Ft-J.2/ Q No. feat from I~ we 11._Z.!LNo. feet from building ~S 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: r LICENSE NUMBER: 6/90:cj F L DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING LABOR•& HUMAN RELATIONS DIVISION ,,PP.M.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION NW 4 A f N, l 5 War30729 , T29 -R18 St to Plan I. Number: VENTIONAL El ALTERATIVE 4 assigned) -4 Town oren, Lot:~art f Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Anthony Kosheninp ~ 794 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: St Roberts WT 94091 REF. PT. ELE ST REF. PT. ELE /,~v ,6 Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Henry i SEPTIC TANK/ o,C C~~E/ MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: 6,6, r, I a7 YES ❑ NO ❑ YES NO BEDDING: VEidT DIA.: VENi-MATL. HIGH WATER MBER OF ROAD: PROPERTY WELL: BUILDING: VENT O FRESH ~C. O• ALARM: FEET FROM LINE, AINLE / W 11 NO NEAREST ❑ YES NO C6 ❑ YES DO MANUACTURER: BE S FNG CHAMBE I mo, LIQUID CAPACITY- PUMP MODEL: PUMP/8}BF16A1 ANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: Z Z (-JtL,-'S ❑ YES NO 97 0 YES ❑ NO YES ❑ NO PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH GALLONS PER CYCLE: LINE: / AIR INLET: (DIFFERENCE BETWEEN p3 FEET FROM / y5 ~~S/ PUMP ON AND OFF lG~o liY• YES ❑ NO NEAREST -11110- ~o~ LENGTH: DIAMETER: MATERIAL AND MARKIN SOIL ABSORPTION SYSTEM. Check th soil moistu a at the depth of plowing FORCE C/CS(;n~. Sc~'. 0 wG. or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN 5 the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH: LENG~T H: NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: PI BED/TRENCH L7"Y 7 TRENCHES: MATERIAL: DEPTH: DIMENSIONS S 74 3 /,5 GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISP E~MFjTERIAL' O TR. NUMBER OF PROPERTY- WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COV R: ELEV. INLET: ELEV. END: jl"r~~(. C~Q /WL PIPES: LINE: AIR INLET: / FEET FROM G? ? > -70 ~ 7aS 42" s 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 [:1 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: TNO.OF RENCHES: LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: 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: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: `n ❑ YES ❑ NO ❑ YES ❑ NO NEAREST ~ Y1 I r C Ct..I ' C...lz /3rl /1nv_ r• .ae^ e.LCiq, I l e Ti -7 ain in county file for audit. 2 f✓~ Sketch System on 7 J Reverse Side. ~~r _p7 , ~7f SIGNAT RE: TITLE: nnSBD-671 0 (R. 06/88) 9,, SANITARY PERMIT APPLICATION DILHR In accord with ILHR 83.05, Wis. Adm. Code COUNTY _0 STATE SANITARY PER # -Attach complete tans to the county copy only) for the system, on paper not less than plans (to p~ 8'/z x 11 inches in size. E] eck if revision to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. N' PROPERTY OWNER PROPERTY LOCATION ,U A110 QSA e cvl A.I+ Al &)'/4 Al W14, S 1 T N, R le E (or W PROP Y OWNER'S MAILING ADDRESS LOT # BLOCK # TPRT /o3 4 ST T- oi-r //-1[ -7 c.1_1 s # , CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER o C2n Gvi. s~ez3 3zs 4 L:I CI II. TYPE OF BUILDING: (Check one ~~~.N NEAREST ROAD , El VILLAGE T State owned G~ ~Q 3 I~ I EL AX N M ER ) f _RC ❑ Public 1 or 2 Fam. Dwellingof bedrooms P 111. BUILDING USE: (If building type is public, check all that apply) 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 El Campground Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining W "0 4 El Church/S of 8 Mo ile Home Park 12 El Service Station/Car Wash tel 9 ❑ Office/Factory 13 ❑ Other: Specify 5 El Hote o IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1.0 New 2. ~Q Replacement 3. ❑ Replacement of 4. ❑ 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 es 7 43 ❑ Vault Privy 13 Seepage Pit Pressure - r~f- X / 3 ELEVAT~o~S 140 System-In-Fill 2_~O- r 3 eeva VI. ABSORPTION SYSTEM INFORMATION: 510 1 y 7 o 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 77 FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) 00 if O 1 _ F ELEVATION ~~Q /'000 100-5 , _ Feet 47 -2 .O Feet Vlll. TANK CAPACITY Prefab. Site Fiber Exper. in allons Total # of Manufacturer's Name oncrete Con- Steel glass Plastic App INFORMATION New istin Gallons Tanks strutted Tanks Tanks Septic Tank or Holding Tank X 2,00 Lift Pump Tank/Si hon Chamber 00 Vlll. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): PWlump er's Signature: (N Stamps) MWMPRSW No.: Business Phone Number: 4 olle- 1 3 S d- -7 14W _ Plumber's Address (Street, City, State, Zip Code): • ;O y. 6 S ' 0 8d_P_ _5 WIS. S o z IX. LINTY/DEPARTMENT USE ONLY a \j Issuing r alit Signatur Stam ❑ Disapproved Sanitary Permit Fee (isurohag rF ej water E71,V ue Approved ❑ Owner Given Initial Ad ve a De rmination 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 l INSTRUCTIONS 1. \1A 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'qq 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. 11. 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 systmem. 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 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 ownst/con and completedt when the property Is sold and submitted to this office 0 appropriate deed recording. e Owner of property c~ N-R V , Location of property ~l/4 W 1/4, Section T-_.L Township / Mailing address Address of site -79 1 l © 3 IP ' lubdivision name Lot number 21L Previous owner of property Total size of parcel Date parcel was created Ace all corners and lot lines identifiable? an to Is this property being developed for resale (spec house)? Yes =No Vol"" ~nd Page Number ~as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DIED which includes a DOCUMENT NUMBER, VOLUME AND PACE NUMBER, and the SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I(we) certify that all statements on this form are true to the best of my .(oilt) knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recor ed in the Office of the County Register of Deeds as Document No. ~2 71 EL- Y ; and that I (We) Presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, .to run with the above described property, for the construction of said system, and the same has been duly recorded in the Office of the County Register of Deeds, as Document No. = ~ 1• - Signatu of Owner Signature of Co-Owner (If Applicable) 6~-,;?6_~a -X6--10 Date of Signature Date of Signature J j - r 4 WARRANTY DEED DOCUMENT NO. • STATE OF WISCONSIN-FOR31 9 Vol_ 394, D~ F t, 594 THIS SPACE RESERVED FOR RECORDING DATA i C7 F! C S FE THIS INDENTURE, Made by --Louis-- tI,__R4s-S R E G I ST E R Sl-. C1201X CO., ~t - Rt3c'd for RF:cord th,_; nth - - Tunti D. iy 63 grantor --of - ,St-,_ Cr0iX County, Wisconsin; hereby conveys and warrants day OI _ _t to Anthony L.Xoshenina a_nd-AlicQ:A.Koshenina,-husband at ahd wife as joint tenants .41 , grantee -5--- RETURN TO of St. Croix County, Wisconsin, for the sum of I ) - Seven Thousand Seven Hundred and no/100 (17, 700.00) - - - - a the following tract of land in _ St • Croix County, State of Wisconsin; my Th~tit past of the Southeast Quarter of the Southwest Quarter (SLu of Swl) of Sectln;I `Jwr O described as follows: Commencing at the Southeast (SE) corner thereof, thr ncc z.orth t Six (6) rods, thence West Sixty-eight (68) rods, more or less, to the highway, thence youth Inn the Last line of the highway to the South line of Section Twenty, (20), ti- n'.-the South line of Section Twenty (20) to the place of beginning; also the .crti) `j " I' i(' (Id,,) of the lvorthwest Quarter Section Twenty-nine (29), except that port i tt.cruct l.y .ng north of the highway; all in Township 'T'wenty-nine (29) North, Ranf,e ;ii ht. ~r (1~) We:;t. Subject to easements of record. The above descriVcd premises contain ttIhty-Lao I,,nd 5/10 (82.5) acres, more or less. j ,ubhowever, to a mortgage to The Federal Land Bank of St. Paul, dated Octoucl' 1 , 19j4, anal rccordea October 21, 1954, in the office of the Register of Deeds for t. Croix County, Wisconsin, in the original, amount of $4,800.00, the unpaid balance: r )f which th -,1,antecs assume and agree to pay. a rt r,t17S aced is given and accepted in fulfillment of a land contract between Louis J. 11,111tian _~cGs as vendors, and Murray T. Jones and Elizabeth L. Jones, husbur rd • a urchaser., dated March 8, 1955, and recorded November 20, 1956, in the oc'fce +c of the C lstcr of Deeds for St. Croix County,' WiscOnsirl, in Volume 322, pacre 161, the ~ry u ,uz r n 1scrs having assigned their interest therein to the above named , rantec:s by y: in _i,,nr;)cnt, dated October. 8, 1958, and recorded in the office of the tZ.i,ister of in V)o:l_umc 352, page 151E Doc•. No. 255757. a 44 r, T,~ f h~7.C ;r _ hand and ec 1 IN tite aid ,r r.ntor ha _s-- - hereunto Set this la}' of 1:ay 1. D., 19 63 1C; N D AND SEALED IN PRESENCE OF (SEAL) r J(IHN I). HEYWOOD Donna 01stad Rr S t` S'I'A'I1; of, WISCONSIN, w frt. bin~~, County rk Pcra~on•dly came ht fore me, this day of - May A. D., 19 6 ' . he aboie named Louis J. Floss to me !:norm to be the p"I,on -_rcho executed the foregoing insirume t and acknowledged the same. j JOAN D. BLYWOOD NOTARY_ ~ r S6tgrL , This instrument drifted bye ' ~ Notary Public St. CroiX_ -otmty, Wis. Ei<EYL1001) AND HAY ES., Attorneys_ at..7 w t ' Ihlycommission im:4Ii:2Ss) (Is) _-permanent. (Section 59.51 (t) of the Wimco-in Statute@ provides that all Instruments to be recorded shall have plainly printed or typewritten thereon the f II tl names of the grantors, grantees, witnesses ana notary). . 'NALIRAN'TY DEED--STATE OF WISCONSIN, F011.14 NO. 9 S. C. -IJA CO.. MILWAUKEE H a r S T C - 105 r • a H SEPTIC TANK MAINTENANCE AGREEMENT ~o St. Croix County z d a H OWNER/BUYER Fire Number ROUTE/BOX NUMBER pp3 CITY/STATE ZIP /V /V y PROPERTY LOCATION: 0) ~(,lJ Section ~~9 , T R 1 Q _W, Town of St. Croix County, Subdivision Lot number. Improper use and maintenance of your septic system could result in I its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into i the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to H three year expiration. o z I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with H the standards set forth, herein, as set by the Wisconsin Depart- b ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNED s _ i 9 / DATE Z. 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. DEPARTMENT•OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX N WI 7969 HUMAN RELATIONS , 53707 (ILHR 83.09(1) & Chapter 145) LOCATION: TOWNSHIP/Mw40eiP*tff Y^ OT N NO.: U VISIOR NAME: tiw'/N0)'/ Z n'LyN/RIPE(o►W Gv'4lePF+." Phie OIL 2,.7 Aea, COUNTY: MAILIN ADDR S: S4. c RoeX 4tir#V PY /_'oSA £ti1-,VA- ~cI Z.03 ft,_Q S+- 20 (3 ER r S 4Ufr 5'Yd j 2._ uSE - 3 1 DATES OBSERVATIONS MADE A R TION: PROFILE DESCRIPTIONS: PERCOLATION TUTT-1 lop I Residence • `7 d h ❑New ,I Replace I _ I Cf CO IQ 1"170.1 RATING: S= Site suitable for system U= Site unsuitable for system SCS 07 SAP&s As F fto-j 6, wA d /e'y 'rolls CONVENTIONAL: MOUND: IIN-GROUND-PRESSUR TEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM:loptional) DS DU E:] SDU DS DU ❑S BU ❑S lU -rR£vA4,e s -wroy, 1) pop If Percolation Tests are NOT required DESIGN RATE: FFFloodplain, f any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: CCA-S S ~-J indicate Floodplain elevation: .2./'D rb. ff tC, "/du- PROFILE DESCRIPTIONS m BORING TOTAL P R UNOWATER•INCHES CHARACTER OF SOIL WITH THI KNESS, COLOR. TE TURE, AND DEPTH N (NUMBER DEPTH IN, ELEVATION OBSERV D EST. HIGRrS TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) h1 r /.d' v- ~j.~~uvt~X I,S I L-/ Q,1 'Sy. Flocory Ji i /0 '0.!-S' B. l ~'.0 9G y r g o e6~u /s pt- 1A s ' o~ 7,-44 X. K'0 - a... aqwng-a car fu.. 9R $,,vos ~e ~s~rr of r" 1,4y g. S eF oPa- /3o. I5 Z g- Z D 9~ $3 > 7S -n,-sy- si, i~S ' 8-0 - fy. 810etr 411) $7,r'~TiFiEO ~i3u7 Zlu,~aA°~rL TEJrru EDP S• 1 S ay-Sy. /nary $ C1 14 • Sy. 01^1 0ef• 4,1 .77 B- 3 9 0 92.00 > d 3 0 • h,, ~R~ ' d 011?- ~N . S. ' A.'aQ o'e - 3., . o 'h,<rv of n~! 6~•' ~ s, s ~ti B- /St 3.0 C kE 5 h 13- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP I WATER V A MINUTES NUMBER INCHES* AFTERSWELLING INTERVAL-MIN. PERIOD t P RI D PER INCH P- % , 8 CP G Y P-3 0, P- P_ 1.1 P_ ~t r v S'Pt.vD S 7,,Pf 7-9 Z ,y LOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Detttxibe what are the hori• )ntal 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 16 4 1 land slope. I l f 6 - 't 12f u c{,t = q3. o ' '4 I'D Ple Tiir'E v G Gt.. ' O ;YSTEM ELEVATION. G~ SEE- PL.oT P("~j P&vt~.f~'- S/pE- y .o wS Tt it -t- le c v e-&t ce 7 r ~ H 0 C?l V) z~ 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 dministrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. 'AME (print : HOMESITE SEPTIC PLUMBING CO. TESTS WERE COMPLETED ON: 655 O'NEIL RD., HUDSON, WIS. 54016 DDR SS: UCBRIGH I CERTIFICA112 N NUMBER: PHONE NUM ER(optional : W IS. MASTER PLUMBER LIC. NO. 3307 M.P.R.S. 2 y JV/Ss ' CST SIGNATURE- ISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. 1 M a ~ ~ lV ` Do a I v+ - i- _ 1 Y I 3 row A 1~ N 7 V o~J 4u~ t GL W a H ~ n. N . St 3 w ~ zo `.0 Cj u J ZS2 ZZ Q W ao jC.r l U US~Q~j T Q ~ ~ W O C~~ v Q ~mr~ ~l (IQ CL b It; CL ~ z. 3? z zp D k v -V a FOR) ~ ~con ~ G ~ ~ m V m25 ~ - ~ ' r r r G75) C C ' it' C7 4 -h v ~A► O CY) fn In 1n ~ N ~~m c N 47 s r O~ ?t n I lb t v1 b L ' 4 L N ~J ~ , vO' Co o d0 W • -P G k^ °N \ n c \ Q LrA ~ N Is\ Iv N' W / , , ~ ~ I cJ o / C tit H O ~~6 41 p { 1 ` Z Fresh Air Inlets And Observation Pipe Approved Vent Cop i v Minimum 12" Above { Final Grade 97 0 r~ 4" Cast Iron Above Pipe Vent Pipe' -to Final Grade si. r: , - yihthetiC Covering 5 Mill. 2" Aggregate Over Pipe Disitibuflbn Tee { Pipe 0 0 0 0 0 ; (O Aggregate • ° Pertbraled Pipe below Beneath Pipe o Coupling Termina11nq At Bottom Of System sysTM '73,0~ W s. 1 V Fresh Air Inlets And Observation Ripe' Approved Vent crap Minimum 12" Above j Final Grade 7.3 o i 4" Cast Iron 3& Above Pipe Vent Pipe' "to Final Grade ' Marsh Hey Or Synthetic Covering Min. 2" Aggregate Over Pipe Distribution ~ c4, r-) zy Tee pipe 0 0 0 0 0 , Ag9reg f i~ Cv ate o Perforated Pipe 0e10w Beneath Pipe 0 Coupling Terminollho At Bottom Of SysAA G oCvEs i j:PE".yG w Fresh Air Inlets And Observation Pipe - Approved Vent Cap Minimum 12" Above Final Grade 9.2. 0 3Cv Above Pipe _ 4" Cast Iron -to Final Grade Vent Pipe, Synthetic Covering Min. 2" Aggregate Over Pipe Distribution J"CA .27a.9 Tee Pipe 0 0 0 0 0 , CIO " Aggregate 0 Perforated Pipe Below Beneath Pipe 0 Coupling Terminating At SySTFM Bottom Of System • ' II. PAGE OF PUMP CHAMBER CROSS SECTION AND 5PECIFICATIONS VENT CAP 4%.I. VENT PIPE WEATHER PROOF APPROVED LOCKING JUWCTIOIJ BOX MANHOLE CQVEK 25' FROM DOpgl. 12"MILJ• 4Vi9A0W&'Qael WINDOW OR FRESM I AIR INTAKE I igue GRADE I `i"MIN. i ' 4, -4 ~ I ~ , 16" MI1J. COQDUIT - " _ 2. 5 'f;,) 7~-T IL"j IAILET PROVIDE I - AIRTIGHT SEAL I /l III ( I I APPROVED JpiWTS APPROVED J01 T A U D I II W/C.I. PIPE W/C.I. PIPE tAI I I ALARM EXTEWDIWG 3 EXTENDIMC" 3' ,G ONTO SOLID SOIL j B / 1~S~y~lOa WTO SOLID Will 3, 5 fley I I ON i C; i I I E.L.EV. - FT. PUMP ,r OFF COAICRETE BLOCK k LL RISER EXIT PERMUTED OIJLy IF TAWK MANUFACTURER HAS SUCH APPROVAL ' SEPTIC E SPECIFICATI~I~IS 00 5 E k1~~S CO.y G~ 7~-e TAWKS MA4YFACTURER: IJUMBER OF DOSES: _P~R DA~7 , ~(c 7 ` SIZE: Q GALLOIJ S DOSE VOLUME /0~ TA~,I IAICLUD)WG BACKFLOW:/~ 7(aALLONS ALARM MAWAFACTURE.R: ( /G•S) AOD*L NUMBER: CAPACITIES: A= IWCHE5OR n-GALLONS SWITPH TYPE; M C V y g= z INCHES OR /L 71J5 PUMP MA4WFACTUKER: 2©!: LLCM C~6q7vIWCHE50R.._._..- ®WS D: WINCHES OR GALLONS M0091- MUMBER: ~-7 1/2- H 5WITGH TYPE: P~&(rY (3 ACk Up y f A'5MQTE: PUMP AND ALARM ARE TO OE INSTALLED ON SEPARATE CIRCUITS M4 k I MUM DISCHARGE RATE -G11 5 rAok SPIEGS VERTICAL DIFfEREWCE DETWEEN PUMP OFF AWD QISTRIBUTIOW PIPE.. FEET T + MIAlIM4 A uETWORK 5UPPI.'J PRESSURE . . . . . . ! " FEET EAR -I; X00 FEET OF FORCE MAIN X sy F~o FZFRICTIOU FACTOR.. I ` S y FEET f~4001 Ads. = -.1--=0= FEET TOTAL DYNAMIC HEAD 14. Wovvo IWTE.RhIAI- 01MLWSIOWS OF TAWK: LEtJGy1i ;WIDTH -7~ LIQUID DEPTH 51GWE0: LICEMSE WUMBER: DATE: r oiD Uoly yE" /DO' Orr- 40 - /~C~ s W r HEADI 115 CAPACITY 32110 32 105 - VE 30 100 - - X CU I 26 ! 90 26 85 EFFLUENT 24 8° MODEL and o 75 MODEL 188 DEWATERING = 22 70 165 IN[ I I U 20 65- Q 18 D 55 50 _ 16 O, 163 MODEL F 14 45 188 12 40_ 35 10 MODEL 30 MODEL -137,139- 185 SEWAGE and 6 25 D ,W4TERING 6 20. MODEL -MODEL 161 15 4 g7 10 .r MODEL a to 2 5 53, 55, t 57, Ss 0 GALLONS 10 20 30 40 50 ep 7p 80 90,100 110 24 - LITERS 0 80 150 240 320 400 I 75 22 FLOW PER MINUTE 70 20 65 - I!I 18 - MODEL - - - - 285 ti - - - - - - Z 55 V 60 - Q 14 45 MODEL _ ll Z 294 1 DO- 12 A0_ I r- - i J MODEL 35 293 _ _ z - - - --1 1.- - ?7 10 MODEL - - I H 284 8 25 { MODEL 6 20 - 282 i 4 15 - - 10 MODEL - _ - OELLE/~ O. 2 5 26T, 268 0 3280 Old Ml11M Lane GALLONS 10 20 30 40 50 60 70 80 80 100 110 120 130 140 150 160 170 180 180 PO. BOX 16317 ! 1 Lou/sivik KonWky 10216 LITERS 0 p0 160 240 320 400 480 560 640 720 (502) 778-1731 FLOW PER MINUTE ji "97 Cast Iron Serves HEAD CAPACITY UNITS/MIN Feet Meters Gal. Lim i + Automatic or Nun-Automatic. 5 1.52 57 216 ie. - • fr H.P., 1 Ph., 115V or 23UV. 10 3.05 51 193 • Nun-clogging vortex impeller design. 15 4.57 43 163 PASS@S_- sphere). 20 6.10 27 104 • 1112" NPT discharge. Lock valve: 24.5• • ~JtZat operated submersible (Noma 6) mech- anical switch. Ousted 67 sear. • Automatic reset thermal overload protection. SC-2216 + Stainless steel screws, guard, handle and arm and seal assembly. I + Watertight neoprene "0" ring between motor and pump housing. canad~an standards SA Aswc APP(,"i arailabin N97, non-auromabc, avauaGle packaged wdh a p~yyyGaek aterCUry J w COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715-962-3121 800 - 962 - 5227 ST. CROIX ZONING REPORT NO.: 04935101 PAGE 1 ST. CROIX COUNTY REPORT DATE: 5/10/90 E COURTHOUSE DATE RECEIVED** 5/09/90 HUDSON, WI 54016 5 -1 6/ ATTNI THOMAS C. NELSON CV) co OWNERt Anthony Koshenia' r ` '`GO GOF LOCATION: Rt. 2, Box 65,Roberts/"w 1, O COLLECTORS Mo Jenkins SOURCE OF SAMPLE' Kitchen faucet COLIFORMS 0 /100 ml INTERPRETATIONS Bacteriologically SAFE NITRATE-NS 4 ppm Under 10 ppm is safe for human consumption. CoLiform Bacteria/100 ml Nitrate-Nitrogen, mg/L t1~1 LAB TECHNICIANS Pam Gaue WI Approved Lab No. 19 F,WDEVENpE g S Means "LESS THAN" Detectable Level Approved by' a y~ ® PROFESSIONAL LABORATORY SERVICES SINCE 1952 t o-?' ST. CROIX COUNTY ZONING OFFICE c~ 1 St. Croix County Courthouse 911 4th Street Hudson, WI 54016 Telephone - (715)386-4680 The St. Croix County Zoning of septic and water inspections to Lending f Institutions,1e Realty service Firms, and private individuals. c^oaul etion of this form is samen ' 3 al so that the flrocerty can be- 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. D O WATER TESTING----------------------------FEE: $ 25.00 (For nitrates and coliform bacteria)FEE: $175.00 WATER TESTING (For VOWS) --FEE: $25.0 0 0 SEPTIC SYSTEM INSPECTION--------------- ( Determines if system is properly functioning at 4of 1 inspection) J Property owner's name Z L .41.` P /l „~asLio.~ , a r , Property owner's address ZZ 7Y'L3D x- -5-- .~'0 ev7ls , . Legal Description _1/4 of the 1/4 of Section T N-R Town of Lot Number subdivision Name Color of house Realty sign by house?1WIf so, list firm: PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP, .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 purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many 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. / .S P Firm or individual requesting services: Telephone Number ZZ.Z was- .Sy1 ? REPORT TO BE SENT TO: Closing derte signature ST. CROIX COUNTY ZONING OFFICE St. Croix County Courthouse K. j 911 4th Street j GHQ ~.c Hudson, WI 54016 Telephone - (715)386-4680 Firms, and The t~iCroix nspectionsytooLendingflnstitutionsl,e Realtye of septic and water P private individuals. Completion of this form ~ s eanenti a~ so that the nroRerty can be ].~8,ted • 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. D 0 --------------FEE: $ 25.00 S- WATER TESTING-------------- (For nitrates and coliform bacteria)FEE: $175.00 WATER TESTING (For VOCIIS) 0 0 SEPTIC SYSTEH INSPECTION-----------------FEE: $25.0 (Determines if system is properly functioning at of 1 inspection) 7 c1 ~ Property owner's name ,4~~ L mil` e = A _ Property owner's address T a z3D k Legal Description 1/4 of the ______1/4 of Section T N-R Town of Lot Number Subdivision Name Color of house Realty sign by house?77eIf so, list firm: PLBA82 INCLUDE, IF AT ALL POSSIBLE, A HAP,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 purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many 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: S. wPr~~cQ :Telephone Number 7 -51411?I /REPORT TO BE SENT TO: d O 02 Z. -5 71, Closing ftte signature ~ o - kR R E N T29N:-R.18W 29 11 E SEE PAGE 43 E v Clarence P. • z 47brence • • Came /f'a trr HRE y °.o !Jn/.:nifi•d ^'ES /yartiq rr- AakinJ Gtro/d [•.+ConniC At0749;ai, /~.nt:ny Fomru, M b ''t J~ ~7.r9 Abhert 63 L. Mueller . uahn ?7 •rrrr. C/-4 Ix. ~ Micke,tson /rr.:d r/rc a JSine : b~ Agnck man Z"..s b ~ .tl N 7 /e4 9 ^!a Couis f tl ~p q • FxftrerF. • ch i . tTenn/ 3 C W !/crnor. M. Finh nef Zi9 b /iMn eta/ Ra/ ~0 N 3 r m'P ~ ~ Wes.y Nt..tson Y N PM ~y a 40 n J MO N /`/iz Dan sa •2 Fiede cA J/7 sto .S. R. &,ejc Maloney /53.3 5 2io b srw.Tgy b s7 40.49 sod. 9J • • vV Avg N dxf.41 • w tt' JoRn ro V 9:/i,a nnEFrtx//tiS • >a Badman f Dorothy • • K . 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J Sx' F, • tl a r /i0 ZOO /60 /(q /60 YOO ~b y rt • • I' • :'SMAIC::: /yp • Lee a. a Wa/ter• TRMT, tnnCL L~r/4Dar/enC s $ 60 u~ /Veohv:r/a ~B a SLCro/x !/a/ley C e •1 p.s 3$ ttSneeeK Ciir/Stout C d ! q s3 /60 Bo s ` /6 d.J Nanry z3z b ;d~e O ~ Neck vi//e. 239.2 w~ k 0 CC ~ M tl , Z{ y 1 w • GtN ter 1 do QEuyene Find 13 Jt Come/ki y //as S C Leo. p r 0 .y EaN E' !/io/a cSeh~i/t< <fvx gg No/den d V 3 tl `V 0 ~ Mcle.,.,a y 9 tl w B/oorn Eve/yn Te/oe d qv n sc. tl .s„ a~ v o c F l p Vuane ~q /Y7 4 F p • /7464 Mue//er Fred sDeloe*a W • • ~f1° 1~ s cSchu/te 2 \SC?~^ ti~a 7 sM.. y m :a:•s @ Y P tlPa+ T Thdmo tT Roy 4 b ~"i .;.C~'71 TG.s7 Robcrft d p W / s C/oyo t> Q • ~ a; A'ath/een /60 * \ v D v u Rodr f y 11A65 Gye. ~j e; cTbn~s~ •8ty 6~• o'~ • "Vj\ /od. s.f• Riddle ~l A y XiI y~ efa/ 6J • eto I x All Q U22~1 V Pig/2 tl /q i '3l t€ yh ii. /19of 3 q a Sor/dra ~ Cw ~ 236 :Vd.42 Ft/bri f L1~v/d 1 .v u 7 Newel `7ard~n~v- ! /6 o v l W a9 ~ Co°r r L ~ u ~ ~ Jonas ~rahanx • ~ /ti v J ` 0~. r i N Cis Srihi `✓e t /J9 - ® Eor/F C ,,•C 4i//is / tvd n cT~? U /se ss ' i i R MorK O. Fec/iuman ~tl o ~tl a V c•~ Fsr`rrs, r w./tar /4t vo4e Qq 3, vt OBE RTS JJy o • • • • • TT • r• N M O 1 • ,j~UviC a eoro.(c V Z h M aw~ f 0 U A Gcr.•ge Jar~.es Kd 94 v.' s Q,~J bJ4 ,n & COJr er v V S/nrx/e~t Cxf'io/a tMar! s Ku lh 0 6/•w~ OCo-C& tbna- 299.5 won Edie • y = K/ Q V U p be SG /bo Hac(er• a0 ariene 0 ,9nde on d'O @ ,_9 ,9068/ ,Mash ~Ze .1~ Dorris t Horn/in Npgn r y "`r ~C Q Dal/en(s w= ~ , 99./G /I~n U `V F ° v * 9ndefson tlM p 4.o JD AP, 65 Cro y Eon/F O/avs0/ao CC / "a 1 7Di0.ie or, f rSFt~.Eene3 / o . 9QJ( r ` $ ~c R.~/~ardt ie d h ° S.ni th Pechu/n "':l .1' LconyGan- p j,? 3 y ~j 4o k ~'h rM , 6 BG 43 y /60 /Sa. J f7 de San /6 0 • p .De/arRe F~ 0 .e 1R.?.B 4 //J • 7a f 'an hOf-~v/7 7?-C6 7 Dads ekudo/ y f • • k • h KreyJ~? , I 79.43 C/a, F ~arwes ternxs• Zne. _ .fv 94 /or Pe3kar ^b" N Qern° r,` N JOTe3 /60 l /dS6B Kfen 0 \ 111.44 ,Ta S. /.sue Schwa/G.r Z 240 N N p /.x3 r.J7 <J.7,e 1 hO /.to :..T C.: /sS Rebe }.C. R Bert E. V Q o ~ y~ ,Bai/e+y,~ A3esiEau, • t' amc3 V • Glenda ~kiv(1~N _ 1 • Posher lv ark rr- • • R er do B/ s et c` a han to \ /sun4i4~e%n /~'nn, Len- T ~JeweN- tea. es -~rwis D n is aan. ceo' 'x/ nl3.ten o M iNa erti m Manoge Fogrrty f°9er/J[ z nfe/OOn Ne/- ia/ 194 /9J A. / mciT/ Cri. /sf. a Jl a Y a J /.9d6,Qoc.E•o d/1a/o p /s,1 a f' SEE PAG 17 t51. Croix C un/y, ,I /f ~ll Dependable Hybrids PLEASE From Dependable People PATRONIZE THE ADVERTISERS `P • Richard H. Kamm y They Will Welcome . The Opportunity Roberts Wisconsin To Serve You. CALL: 749-3332 ~I ST. CROIX COUNTY { nk WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 - (715) 386-4680 May 9, 1990 Donald S. Overbye /0- / 2 d 229 E. Johnson St. 1320 River Falls, WI 54022 j y1 Dear Mr. Overbye : 7N IO 3 kd _ S4-vcz~ An inspection of the septic system on the Anthony and Alice Kosheina property, Rt. 2, Box 65, Roberts, Wisconsin was conducted on May 8, 1990. At the same time I obtained a water sample for testing. The results of that testing will be sent to you as soon as it is received from the laboratory. At the same time of the inspection as out flow pipe was observed, causing effluent to drain on the ground. The discharge of sewage to the surface of the ground constitutes a failing septic system as defined in s.144.24(10)(d), Wisconsin State statutes. Orders for correction will be issued to the property owner. Should you have any questions regarding this subject please feel free to contact this office. Sincerely, Mary J. Jenkins Assistant Zoning Administrator cj L_ DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTR•':, DIVISION LA+30R AND PERCOLATION TESTS (115) MADISOP.O. BOX 7969 HUMAN RELATIONS N WI 53707 (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: TOWNSHIP/ OT NO.: BLK. NO.: SUBDIVISION NAME: Nr~►~/ N~~/ Zf /T4N/RIPE(o)W Gv/f AePE'v axle of z.7 ~4G-e- COUNTY: MAILING ADDRESS: S4. ~Rof t4N7717~Ny /'OS! fv1',V, 1,7f/4,/ .03 IdX 20 2 Ep T S 4!/J' S'YDQZ USE -7 - 3 j_5 DATES OBSERVATIONS MADE NO. B MS : COMM R IAL D S RIPTION Residence ❑New XReplace I _ 1 G e0 I^ I Q ~O SCS 7 S/fot~S r4S F 12 3 15-0 i15 RATING: S= Site suitable for system U= Site unsuitable for system E 0 A LOA 4 /e ONVENTI NAL: MOUND: IN-GROUND•PRESSURE: SYSTEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM:loptional) OS DU E:]S❑U ©SDU OS CCU OSE]U -rPC4 -)11(4 S-wry~~ ao~ f T -P If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the V t o.J under s. ILHR 83.09(5) (b), "indicate: C L.{ $ S_ Floodplain, indicate Floodplain elevation:^ ~fD r4 f{ "/a-.,'PROFILE DESCRIPTIONS m BORING TOTAL -aEPIHTQ R UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED H TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) r /,D' ~v ~jc~~u LrFip 5/ VE' Z-4. QN Sy. Bloney 777 /,0 4e.4- B- - aquOE' a nw~Q_ w f fc.:...v I R ~ 8.a„u s moo,,., S r of f B- «y~ s o~ aP-~- r3,,. 15 . 0 2 - pa ?3 ' > .7S' $7W,f7%f1FD C1301` UulAVAi4 74,r70eo) S S ' dy - 3 9 D 12-00 Sy, le-100.f 4-q . Qy • Sy. /04M o ' 0,4'- Q.1 , s B- 0 ' h%~c-tURt o ole- o,e B- ~S t 3. O 7-0 PE- of ruAo Q-a. 'l.~Q.P• S , s AA) Jc~-t I L ke 5 Tt . et h IB-~. rt PERCOLATION TESTS DEPTH WATER IN HOLE TEST TIME DROP I WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES' AFTERSWELLING INTERVAL-MIN. PERIOD I P RI D PER INCH l1 p- / 3. ri ' ?tG /0 j~ 2- P_ 2 3, TO- * .4 P- 3 C, p P- 1J 1 P- r N 54,4,0S 7;;e,1 ref 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- O. 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 710 .1. of land slope. Ike u at& = X3.0 ~t <9D/E Tit°E-U Lr:t,. O SYSTEM ELEVATION. c7 G~ SEA pL10 7 pLI~ -i Ptvt sE sipE- ~ .o 147~ TH I N S Tit I l 3 'T 12 E ,,j aj S _ ~e S X 7 GZ z~ 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. N H NAME (print): HOMESITE SEPTIC PLUMBING CO. TESTS WERE COMPLETED ON: 655 O'NEIL RD., HUDSON, WIS. 54016 ADDRESS: Hub Ut8R1Gftr- - CERTIFICAJION NUMBER: PHONE NUM ER(optional): ,118. MASTER PLUMBER LIC. N0.3307 M.P.R.S. 2 y Z 3 11'' CST SIGNATURE- DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. ;ILHR-SBD-6395 (R. 10/83) - OVER - i M p M O O w ny` O vz CV%~ N o S M V a ° As !Jt W Vr 4 Y a O ~ J ~ n- F~ uN 9 or w ~ ko r4 Oa v z Cig aC > Z W V V>_= W L7 Q V d. a- t ~ .s LEA: m 11 il Z J o~ i Qty S p~N~ 6~~