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Home My WebLink About018-1004-00-000 S . CROIX COUNTY WOO'-, WISCONSIN rrrr~Nrn~ ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER rte' 1101 Carmichael Road fit Hudson, WI 54016-7710 (715) 386-4680 November 8, 1996 File Ref: 61-96 Errol F. and Hilda I. Gooding 1188 192nd Street Baldwin, Wisconsin 54002 RE: Amendment to September 13, 1996 Board of Adjustment Decision Dear Mr. and Mrs. Gooding: The St. Croix County Board of Adjustment has reviewed the decision rendered on September 13, 1996 concerning your Game Farm Hunting Club, and has amended No. 9 and No. 12 of the conditions. The enclosed document is the formal amended decision. If you have any questions, please do not hesitate in contacting me. Sincerely, Thomas C. Nelson Zoning Administrator pe Enclosure cc: Marcia Ivy, Clerk of Hammond FINDINGS, CONAMENDED CLUSIONS, DECISION AND ORDER OF THE ZONING BOARD OF ADJUSTMENT ST. CROIX COUNTY, WISCONSIN Case: 61-96 Complete Application Received: June 28, 1996 Hearing Date: July 25, 1996 Dates of Publication: Weeks of 7/8/96 and 7/15/96 FINDINGS OF FACT Having heard all the testimony, considered the entire record herein, and conducted an on-site inspection, the Board finds the following facts: 1. The applicants are Errol and Hilda Gooding, whose address is 1188 192nd Street, Baldwin, Wisconsin 54002. 2. The applicants on June 28, 1996 filed with the Zoning Office an application for a special exception use for a Game Farm Hunting Club. 3. The applicant is the owner of 255 acres and will be purchasing 160 acres in January of 1997 which is the subject of the application. The property is located in the NW, of Section 2, T29N-R20W, Town of Hammond, St. Croix County, Wisconsin. 4. The subject property is presently used for dog training, raising game birds and farming. 5. The property is zoned Ag/Residential under the current Zoning Code of the St. Croix County Zoning Ordinance. 6. The Town of Hammond supports the application. 7. Introduced at the July 25, 1996 hearing as Exhibit 1, was an aerial photograph identifying the locations of the proposed projects. 8. Introduced at the July 25, 1996 hearing as Exhibit 2, was a second aerial photograph identifying in orange the boundaries of the game farm area, total of 416 acres and in purple, the Sporting Clays Safety Zone. 9. Introduced at the July 25, 1996 hearing as Exhibit 3, was a series of pages for the Sporting Clays Range, outlining hours as being 9:00 a.m. to dusk daily, insurance through Sportsman Insurance Agency. Included in the packet was a general layout of the shooting stations and the safety zone; diagram of the shooting station; types of clay pigeon traps to be used; some flight patterns on the course with a key explaining symbols; and a diagram of a tower. 10. Introduced at the July 25, 1996 hearing as Exhibit 4, was a brief narrative titled "Game Farm and Hunting Club" indicating 416 acres of the licensed game farm will be used to hunt pheasants, quail, chuckar partridge, hungarian partridge and mallards. The contents of Exhibit 4 were read into record. 11. Introduced at the July 25, 1996 hearing as Exhibit 5, was correspondence from Errol Gooding to the St. Croix County zoning Board stating the Sporting Clays Range would consist of 3 courses to be located in Sec. 2, Town of Hammond. The Game Farm and Hunting Club is to include 255 acres, owned now, and 160 acres to be purchased in January of 1997. All 415 acres is now licensed as a Game Farm by the Department of Natural Resources. The contents of Exhibit 5 were read into record. 12. Introduced at the July 25, 1996 hearing as Exhibit 6, was July 9, 1996 correspondence from the Town of Hammond stating support without objection of Gooding's request. 13. Introduced at the July 25, 1996 hearing as Exhibits 7, 8 and 9 were petitions signed by neighbors of the Goodings, opposing a Game Farm Hunting Club and a Sporting Clays Range. Stated concerns included: depreciation of adjoining property values, undesired levels of noise created by day long shooting and the safety to people, children, pets and large animals. 14. At present, the Goodings train 150-175 dogs per year for the public. As a part of training the dogs, they shoot birds and work the dogs, so they can be handled by their owners when they go hunting. They have found through the business people had an interest for an area to hunt. 15. A game farm hunting club is a permitted use on CRP land. 16. Nelson clarified that Gooding has a game farm license which allows him to raise and maintain birds and then utilize those birds as he wishes, in this case, shooting over dogs. This particular permit goes into an actual use as in propose, that is different than what he is doing right now, which is bound by the special exception use. 17. Gooding testified that the area to be purchased would be used to hunt and train dogs. He has purchased tags to maintain 100 dogs and trains and sells 150-200 dogs per year. 18. Several neighbors appeared and testified at the July 25, 1996 concerning their opposition to a Game Farm Hunting Club and a Sporting Clays Range. 19. Major concerns of the neighbors were increased noise, increased travel on already dangerous roads, decrease in property values and safety issues. 2 CONCLUSIONS OF LAW The Board concludes that: 1. The Board of Adjustment has authority under Section 17.70(5)(c)4 to approve special exception uses. 2. Special exception uses may be terminated as per 17.70(7) (d) of the St. Croix County Zoning Ordinance if the plan or the conditions of the decision are not followed. 3. Section 17.15(6) (j) allows a special exception for licensed game farm hunting club. DECISION On the basis of the above Findings of Fact, Conclusions of Law, and the record herein, the Board approves the applicant's request for a special exception use for a Game Farm Hunting Club on the following vote: Chairman J. Bradley Yes T. Filipiak Yes N. Golz Yes A. Jensen Abstained J. Neumann Yes with the following conditions: 1. This decision expires on September 13, 1997, if no project activities have commenced. No construction may begin or continue after this date unless an extension is granted in writing by the Board of Adjustment prior to the expiration date. 2. The applicants must complete this project according to the plans submitted. Minor changes in the project must be submitted to and approved in writing by the Zoning Office before the project starts or continues. Major changes must be brought back to the Board of Adjustment for review and approval. 3. The applicants are responsible for obtaining any permit or approval required for the project by municipal, town or county zoning ordinances or by the U.S. Army Corps of Engineers before starting the project. 4. The applicants must provide confirmation that they have completed the permit process with all other regulatory agencies. 3 # r 5. The applicants must allow free and unlimited access to the project site at any reasonable time to any Zoning Office employee who is overseeing the project's construction, operation, or maintenance. 6. The Board of Adjustment may change or revoke this decision if the project becomes detrimental to the public interest. 7. The applicants must keep a copy of this decision at the project site at all times until the project has been completed. 8. Tom Nelson, Zoning Administrator, shall be notified prior to beginning the project. Call him at (715) 386-4680 so that compliance inspections can be made. 9. There shall be no discharging of guns within 600 feet from neighboring residencies and the applicants must post signs at those boundaries. 10. The hours of operation shall be a half hour after sunrise to a half hour before sunset, seven days a week. 11. There shall be a capacity of one (1) hunter per ten (10) acres, recognizing that there are 295 acres available. 12. The Game Farm Hunting Club shall be open to the public September 1 to April 1 yearly and may be open on holidays. 13. The Game Farm Hunting Club will be used for organized hunting. 14. Individual dog training shall be allowed year round. 15. Accepting this decision and beginning the project means that the applicant has read, understands, and agrees to follow all conditions of this decision. APPEAL RIGHTS This decision may be appealed by any person aggrieved by filing an action in certiorari in the circuit court of this County within 30 days after the date of filing shown below. The County assumes no liability for and makes no warranty as to the legality of any 4 construction commenced prior to the expiration of this 30-day period or the identity of any person who may claim to be aggrieved by this decision. ZONING BOARD OF ADJUSTMENT Signed chairperson Attest-.,.~''~~ Zoning Administrator Dated: 11/8/96 Filed: 11/8/96 5 ST. CROIX COUNTY WISCONSIN `t ZONING OFFICE" rrrrf r r n r r a r p: ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road ' Hudson, WI 54016-7710 (715) 386-4680 September 13, 1996 File Ref: 61-96 Errol F. and Hilda I. Gooding 1188 192nd Street Baldwin, Wisconsin 54002 RE: Board of Adjustment Decision Dear Mr. and Mrs. Gooding: The St. Croix County Board of Adjustment has reviewed your application for a special exception use for a Game Farm Hunting Club and a Sporting Clays Range. The Board has approved the application for a Game Farm Hunting Club with conditions, however they have denied the request for a Sporting Clays Range. The enclosed documents are the formal decisions regarding your application. If you have any questions, please do not hesitate in contacting me. Sincerely, Thomas C. Nelson Zoning Administrator pe Enclosure cc: Marcia Ivy, Clerk of Hammond FINDINGS, CONCLUSIONS, DECISION AND ORDER OF THE ZONING BOARD OF ADJUSTMENT ST. CROIX COUNTY, WISCONSIN Case: 61-96 Complete Application Received: June 28, 1996 Hearing Date: July 25, 1996 Dates of Publication: Weeks of 7/8/96 and 7/15/96 FINDINGS OF FACT Having heard all the testimony, considered the entire record herein, and conducted an on-site inspection, the Board finds the following facts: 1. The applicants are Errol and Hilda Gooding, whose address is 1188 192nd Street, Baldwin, Wisconsin 54002. 2. The applicants on June 28, 1996 filed with the Zoning Office an application for a special exception use for a Game Farm Hunting Club. 3. The applicant is the owner of 255 acres and will be purchasing 160 acres in January of 1997 which is the subject of the application. The property is located in the NW', of Section 2, T29N-R20W, Town of Hammond, St. Croix County, Wisconsin. 4. The subject property is presently used for dog training, raising game birds and farming. 5. The property is zoned Ag/Residential under the current Zoning Code of the St. Croix County Zoning Ordinance. 6. The Town of Hammond supports the application. 7. Introduced at the July 25, 1996 hearing as Exhibit 1, was an aerial photograph identifying the locations of the proposed projects. 8. Introduced at the July 25, 1996 hearing as Exhibit 2, was a second aerial photograph identifying in orange the boundaries of the game farm area, total of 416 acres and in purple, the Sporting Clays Safety Zone. 9. Introduced at the July 25, 1996 hearing as Exhibit 3, was a series of pages for the Sporting Clays Range, outlining hours as being 9:00 a.m. to dusk daily, insurance through Sportsman Insurance Agency. Included in the packet was a general layout of the shooting stations and the safety zone; diagram of the shooting station; types of clay pigeon traps to be used; some flight patterns on the course with a key explaining symbols; and a diagram of a tower. 10. Introduced at the July 25, 1996 hearing as Exhibit 4, was a brief narrative titled "Game Farm and Hunting Club" indicating 416 acres of the licensed game farm will be used to hunt pheasants, quail, chuckar partridge, hungarian partridge and mallards. The contents of Exhibit 4 were read into record. 11. Introduced at the July 25, 1996 hearing as Exhibit 5, was correspondence from Errol Gooding to the St. Croix County Zoning Board stating the Sporting Clays Range would consist of 3 courses to be located in Sec. 2, Town of Hammond. The Game Farm and Hunting Club is to include 255 acres, owned now, and 160 acres to be purchased in January of 1997. All 415 acres is now licensed as a Game Farm by the Department of Natural Resources. The contents of Exhibit 5 were read into record. 12. Introduced at the July 25, 1996 hearing as Exhibit 6, was July 9, 1996 correspondence from the Town of Hammond stating support without objection of Gooding's request. 13. Introduced at the July 25, 1996 hearing as Exhibits 7, 8 and 9 were petitions signed by neighbors of the Goodings, opposing a Game Farm Hunting Club and a Sporting Clays Range. Stated concerns included: depreciation of adjoining property values, undesired levels of noise created by day long shooting and the safety to people, children, pets and large animals. 14. At present, the Goodings train 150-175 dogs per year for the public. As a part of training the dogs, they shoot birds and work the dogs, so they can be handled by their owners when they go hunting. They have found through the business people had an interest for an area to hunt. 15. A game farm hunting club is a permitted use on CRP land. 16. Nelson clarified that Gooding has a game farm license which allows him to raise and maintain birds and then utilize those birds as he wishes, in this case, shooting over dogs. This particular permit goes into an actual use as in propose, that is different than what he is doing right now, which is bound by the special exception use. 17. Gooding testified that the area to be purchased would be used to hunt and train dogs. He has purchased tags to maintain 100 dogs and trains and sells 150-200 dogs per year. 18. Several neighbors appeared and testified at the July 25, 1996 concerning their opposition to a Game Farm Hunting Club and a Sporting Clays Range. 19. Major concerns of the neighbors were increased noise, increased travel on already dangerous roads, decrease in property values and safety issues. 2 • CONCLUSIONS OF LAW The Board concludes that: 1. The Board of Adjustment has authority under Section 17.70(5)(c)4 to approve special exception uses. 2. Special exception uses may be terminated as per 17.70(7) (d) of the St. Croix County Zoning Ordinance if the plan or the conditions of the decision are not followed. 3. Section 17.15(6) (j) allows a special exception for licensed game farm hunting club. DECISION On the basis of the above Findings of Fact, Conclusions of Law, and the record herein, the Board approves the applicant's request for a special exception use for a Game Farm Hunting Club on the following vote: Chairman J. Bradley Yes T. Filipiak Yes N. Golz Yes A. Jensen Abstained J. Neumann Yes with the following conditions: 1. This decision expires on September 13, 1997, if no project activities have commenced. No construction may begin or continue after this date unless an extension is granted in writing by the Board of Adjustment prior to the expiration date. 2. The applicants must complete this project according to the plans submitted. Minor changes in the project must be submitted to and approved in writing by the Zoning Office before the project starts or-continues. Major changes must be brought back to the Board of Adjustment for review and approval. 3. The applicants are responsible for obtaining any permit or approval required for the project by municipal, town or county zoning ordinances or by the U.S. Army Corps of Engineers before starting the project. 4. The applicants must provide confirmation that they have completed the permit process with all other regulatory agencies. 3 Y 5. The applicants must allow free and unlimited access to the project site at any reasonable time to any Zoning Office employee who is overseeing the project's construction, operation, or maintenance. 6. The Board of Adjustment may change or revoke this decision if the project becomes detrimental to the public interest. 7. The applicants must keep a copy of this decision at the project site at all times until the project has been completed. 8. Tom Nelson, Zoning Administrator, shall be notified prior to beginning the project. Call him at (715) 386-4680 so that compliance inspections can be made. 9. There shall be no discharging of guns within 200 yards from neighboring residencies and the applicants must post signs at those boundaries. 10. The hours of operation shall be a half hour after sunrise to a half hour before sunset, seven days a week. 11. There shall be a capacity of one (1) hunter per ten (10) acres, recognizing that there are 295 acres available. 12. The Game Farm Hunting Club shall be open to the public September 1 to April 1 yearly. 13. The Game Farm Hunting Club will be used for organized hunting. 14. Individual dog training shall be allowed year round. 15. Accepting this decision and beginning the project means that the applicant has read, understands, and agrees to follow all conditions of this decision. APPEAL RIGHTS This decision may be appealed by any person aggrieved by filing an action in certiorari in the circuit court of this County within 30 days after the date of filing shown below. The County assumes no liability for and makes no warranty as to the legality of any 4 construction commenced prior to the expiration of this 30-day period or the identity of any person who may claim to be aggrieved by this decision. ZONING BOARD OF ADJUSTMENT Signed Chairperson A Zoning Administrator Dated: 9/13/96 Filed: 9/13/96 5 Parcel 018-1003-80-050 01/27/2011 08:09 AM PAGE 1 OF 1 Alt. Parcel 02.29.17.22C-10 018 - TOWN OF HAMMOND Current ❑X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - GOODING, ERROL F & HILDA IRENE ERROL F & HILDA IRENE GOODING 1188 192ND ST BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1188 192ND ST SC 0231 SCH D BALDWIN-WDVILLE SP 1700 WITC Legal Description: Acres: 16.685 Plat: N/A-NOT AVAILABLE SEC 02 T29N R17W N 1/2 OF NW NW EXC NSP Block/Condo Bldg: R/W FKA 018-1003-80 (22C) EXC PT TO CSM 14/3993 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 02-29N-17W NW NW Notes: Parcel History: Date Doc # Vol/Page Type 127933 149/441 WD 2010 SUMMARY Bill Fair Market Value: Assessed with: 86371 Use Value Assessment Valuations: Last Changed: 11/04/2008 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.500 27,000 149,200 176,200 NO AGRICULTURAL G4 7.685 1,400 0 1,400 NO UNDEVELOPED G5 3.500 7,800 0 7,800 NO AGRICULTURAL FOREST G5M 4.000 11,200 0 11,200 NO Totals for 2010: General Property 16.685 47,400 149,200 196,600 Woodland 0.000 0 0 Totals for 2009: General Property 16.685 47,400 149,200 196,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 10/27/2005 Batch 05-44 Specials: User Special Code Category Amount 010-GARBAGE SPECIAL ASSESSMENT 60.00 Special Assessments Special Charges Delinquent Char es Total 60.00 0.00 T00 12/03/2009 04:21 PM Parcel 018-1004-00-000 PAGE 1 OF 1 Alt. Parcel 02.29.17.24 018 - TOWN OF HAMMOND ST. CROIX COUNTY, WISCONSIN Current X Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - GOODING, ERROL F & HILDA IRENE ERROL F & HILDA IRENE GOODING 1188 192ND ST BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1188 192ND ST SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 02 T29N R1 7W 40A SE NW Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 02-29N-17W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 871/466 2009 SUMMARY Bill M Fair Market Value: Assessed with: Use Value Assessment Last Changed: 11/04/2008 Valuations: Description Class Acres Land Improve Total State Reason COMMERCIAL G2 3.000 16,000 37,200 52,200 NO AGRICULTURAL G4 18.000 2,900 0 00 NO UNDEVELOPED G5 18.000 25,600 252,,6600 NO AGRICULTURAL FOREST G5M 1.000 2,000 Totals for 2009: General Property 40.000 46,5000 37,200 83,7000 Woodland 0.000 Totals for 2008: General Property 40.000 46,500 37,200 83,7000 Woodland 0.000 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: Category Amount User Special Code Special Assessments Special Charges Delinquent Charges 0.00 0.00 0.00 Total ~ o D FEB '19 2001 `~QOO. 12 ST. CROIR COUNTY SI.~RVEYOR. S RECORD CERTIFIED SURVEY MAP w Errol F. and Hilda I. Gooding Located in part of the Northwest '/4 of the Northwest 114 and in the Southwest o/o f the Northwest cousin. of Section 2, Township 29 North, Range 17 West, Town of Ham N LEGEND BEARINGS ARE REFERENCED INDICATES 1' x 24' IRON PIPE SET TO THE NORTH LINE OF THE (MIN. WT -1.13 LB1LW. FT) NORTHINEST 114 OF SECTION 2, 0 INDICATES i' IRON PIPE FOUND T 29 N, R 17 W, ASSUMED AS S 89'35'14' W ~ SOIL BORINGS (PROPOSED SEPTIC SYSTEM) SECTION CORNER MONUMENT (AS NOTED) SCALE IN FEET 1' ~O• x INDICATES FENCELINE T150 75 1 0 3 0 -ses rl#'w 20.29- w WO NoRTNUNeN 1,a s~'ssu•w 11 ~ v - - 1304780' NORTH 114 CORNER j~jER SECTOVZ T29 N. R 17 w T29 N, R 17W (FOUND BERNTSEN g pLUMMUM MONUMENT) 1 AWMW MONUMENT) ~Ir I -LANDS 3 ARA7TE_D_ \ 3 see- sol~ o g w 3 83vols" E CO ' 8 Os'44'31- IN Ur46 N 88'46'20" E $ '"E 304.60' I 1 271.50' , 63&6T 8U 1 .00` I I vx ~ 1$ 1100. $ g, ~ ~I I I z LOT 1 I g~ 1,803,625 SQ. FT. OR 41.406 AC. i I ~ 192[Zd STREET 11? (1, 760,298 SQ. FT. OR 40.411 AC. I $ I EXCLUDING ROAD RIGHT OF WAY) _ N x ~ SOUTHUNE_NW1/j-l 114 _ _ _ I 3 g NORTH UNE SWJA WI14 - - - - - - ~ I 13 ax o Z 1 8 ~ Q. OWNERS ADDRESS I CO I I~ x 1188192nd STREET I I BALDWIN, WI 54002 I tL; X I i I DATED: Q x 1100' I ~ooooopp~UppO .00'J c4" `yGONaIA 00000 ° ° ° 100, 1277.46' 400 000 23 N 88'6G48" IN 1310AW = S ° LAU ~1N f' ~ • X31 >k e 1 13 . - UNPLATTED -LANDS ° RIVER o o FALLS. wl° o °o S WEST 114 COTRNNENRr R 17 W p0 I 0000 000p0~ooo0 oo~pp°~~~ooo I I I THIS INSTRUMENT DRAFTED BY JERALD L LARSON III SHEET 10F 2 Vol. 14 Page 3993 SCfiH c m_1W3 c e g c a w ai 3A . ~ p r4 ...eu N N O O ti ••L W=W LA- -CZ Le om :o- wwo+ LL* CN = 0-4 y ~ " W CMTIFIED SURVEY MAP Errol F. and Hilda I. Gooding Located in part of the Northwest % of the Northwest % and in the Southwest of the Northwest of Section 2, Township 29 North, Range 17 West, Town of Hammond St. Croix County, Wisconsin DESCRIPTION: That certain parcel of land located in part of the Northwest 1/4 of the Northwest 1/4 and in the Southwest 1/4 of the Northwest 1/4 of Section 2, Township 29 North, Range 17 West, Town of Hammond, St. Croix County, Wisconsin, more particularly described as follows: Commencing at the North 1/4 corner of said Section 2; thence along the North line of the Northwest 1/4 of said Section 2, S 89° 35' 14" W, (assumed bearing on the North line of the Northwest % of said Section 2), a distance of 1304.60'; thence along the East line of the West 1/i of said Northwest %4, S 000 07' 49" W, 658.58' to the POINT OF BEGINNING of the parcel to be herein described; thence continuing along said East line, S 000 07' 49" W, 1313.08'; thence N 89° 56' 48" W, 1310.46' to the West line of said Northwest 1/4; thence along said West line, N 00° 18' 09" E, 1306.30'; thence N 89° 45' 20" E, 536.57'; thence N 00° 12' 59" E, 297.11'; thence S 65° 24' 29" E, 429.50'; thence S 83° 09' 35" E, 86.97'; thence S 06° 44' 31" W, 106.77'; thence N 89° 45' 20" E, 304.50' to the POINT OF BEGINNING, containing 1,803,625 square feet or 41.406 acres, being subject to the right of way of 192°' Street for roadway purposes over the Easterly portion of said parcel as shown on this map and subject to all other easements and restrictions of record. State of Wisconsin) County of Pierce) I, Laurence W. Murphy, Registered Land Surveyor, do hereby certify that by direction of the Owners, Errol F. and Hilda I. Gooding, I have surveyed and divided the lands shown hereon in accordance with official records, Chapter 236.34 of Wisconsin Statutes and the Ordinances of St. Croix County and that this map and description are a true and correct representation thereof. Dated: November 13, 2000 NOTE: Each parcel shown on this map is subject to State, County, and Township laws, rules and regulations (i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office and appropriate Town Board for advice. ~l►`$COMa~4► ~ W. Mu 8 ~t LAND Vol. 14 Page 3993 ~M THIS INSTRUMENT DRAFTED BYJERALD L LARSON SHEET 2 OF 2 n (4 O 3 -V 0 o C7 d ~ 3 m m a A~ -a A I o gt c CD m /1 I CD 0 I cn N Z O w aG) 2 o iO O eC ~1 • S G c° O 3 N CAD rvl `1 N D : _ O 1 ❑ N N d j CJ N T N W 00 O, N N L 0) C 0 o o D O co p co 3 O Q' ° o O N N + C = O R CD CD fn p ~ m a !II CD CD D C o T CA N C 0 a) J O O 00 CD a (0 N O N Ln r) N :3 ~f p O° CD y ° d 'D co O O O w °Y c`twi c ! < z OIQ a C N N N j! ° D ! CD N CO Q. A o q Z co Z O p r O D 0 ro O O O vc N CD c ro i c rn CD Cn I, D ~ II ~ A n a ° A C N N M < O W ID i 0 ? Z1 v 3 Z CD A W CO) -00 IcnD > 7 CD CD W CO 7 N C !i x 3000 °Z d O d =f vroi 7 fD a m ° 0 fD y w =3.0-3 D CD L7 a v c, ;o 3 i CD 0 ch N O a Cl 0 CD N 0 ~ A ° o(D 0 (D O Cl- r Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21. Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 _ W1 ~i nsin Personal information you provide may be used for secondary- purposes Madison, WI 53707-7302 Oepa ment Commerce (Submit completed form to county if not Privacy Law, s. 15.04(I)(m)] ] state owned. Attach com letc plans (to the county co only) for the system, on paper not less than 8-1/2 x I 1 inches in size. County State Sanitary Permit Number ❑ Check if revision to previous application State Plan 1. D. Number N/ 4 I. A li nformation - Please Print all Information Location: f 4e Property Owner Name ~j Property Location d11V OFq,V&l ~XTo L sl!> 114 V44, S Z T21 N, R1 E or W Property Owner's Mailing Address Lot Number / Block Number 8r /yam City, State Zip Code Phone Number Subdivision Name or CSM Number 1-191 `1o O Z (7/ S) 71~6 ' Zy3L CS.~r G 3 3 42.3 3 3 II Type of Building: (check one) ❑ City 1 or 2 Family Dwelling - No. of Bedrooms: 3 ❑ Village ❑ Public/Commercial (describe use): 3&Town of ❑ State-owned III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest Road ~1:1 S7-- A) 1. New System 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Addition to Parcel Tax Number(s) O System Tank Only Existing System e7o 3 B) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) 9Non-pressurized In-ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In-ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At-grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: 9A% a V Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals./day/sq. ft.) (Min./inch) Elevation ff . s 5'3.so s~.s~ VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks 1L11:P&e f M ❑ ❑ ❑ ❑ P • C_ 6150 LSD ❑ ❑ ❑ ❑ ❑ VII Responsibility Statement 1, the undersigned, assume res onsibilit for installation of the POWTS shown on the attached plans. Plumber's Name (print) Plumber's Signature (no stamps): MP/MPRS No. Business Phone Number RD/3EP- 7-2 7~ I ~ 2- 2-1 3 ~ S ~~-s • 3& 'APf Plumber's Address (Street, City, State, Zip Code) Coss d 1 A'a ; L ,~l~ • '~~so-•J GZ'Ji. S yol VIII County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) ❑ Approved ❑ Owner Given Initial Adverse Surcharge Fee) Determination I 777_ IX. Conditions of Approval /Re sons for Disapp ova : -5 ~t rvck~,re iy,( s w . Lek -(%kc y_*,-AdA iS ocotrn..Qh.i~uvaol uae-w..ta•livtc,.~{t~vSe was e~6 skeA prsAr`~o~/!at /~Wn fti►a+tMa3..laola~rfi'`~ 016vyt,4s C6WV~vwh~µ,Si~/~( I~-v( V•^~iw-tiv►G~ . ~La~wnS►Y`n ~j "te lLtvt►tG~ C tttotl,~ 1Sd del 5) will rx wkt u view STaeuZ-CG~cftlvh~1 ~nr►~~ . (Voss 4441 wtt_ I e SC 6htk s o{ eQ do ...-F re Cwt a w beat P,Gh tT...✓ ~a /.U 4 awJ! 's 61~ %owrt laa.s Inv a j ~-c.f-nrt. 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