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HomeMy WebLinkAbout016-1020-95-000t Parcel #: 016-1020-95-100 04105/2007 05:06 PM PAGE 1 OF 1 Alt. Parcel #: 10.30.15.164A-10 016 -TOWN OF GLENWOOD Current X ST. 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 O -MURPHY, JAMES M &JEANNE BETH JAMES M &JEANNE BETH MURPHY 1669 HWY 128 GLENWOOD CITY WI 54013 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description ' 1669 HWY 128 SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 20.000 Plat: 4499-CSM 17-4499 016-03 SEC 10 T30N R15W SE NW LOT 2 CSM 17-4499 Block/Condo Bldg: LOT 02 (20 AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 10-30N-15W Notes: Parcel History: Date Doc # Vol/Page Type 08/09/2006 831744 WD 08/04/2003 733618 2346/233 EZ-U 05/09/2003 720912 2237/167 WD 05/09/2003 720911 2237/166 EZ-I more... 2007 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/26/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 9,000 179,000 188,000 NO AGRICULTURAL G4 18.000 2,400 0 2,400 NO Totals for 2007: General Property 20.000 11,400 179,000 190,400 Woodland 0.000 0 0 Totals for 2006: General Property 20.000 11,400 179,000 190,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 09129/2005 Batch #: 05-25 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 RECEIVED tMsoonsinDepartrnentof OIL VALUATION REPORT page~of~ oivision of safety and Buildings N O V 1 3 200 in accordance with Com 85, Wis. Adm. Code ~ Attach complete site plan on r nd~t ~8~fi~1~`nche in size. Plan must County ~ inducts, but not Nmited to: verb ~~e int ( M}, direction and Pancel i.b. percent slope, scale or dimensions, north arrow, and location an distance to nearest road. ~~~ "~ ~~~~ "" ~~--eo Please pr/nt all information. Reviewed b~ ~ ~ ~ Date ~ Persoeal krtormatlorf you provide may be used for seoorWery purpoaes (Privaey Law. s. 15.04 (1) (m)). Property Owner .,y A A Property Location `D ~/ e / ~ /'~ f~ e ,S Govt tot 1/4 G/ 1/4 S /~ T ~Q N R / i~r} W PtopertyOwner's Mailing Address dot Block # Subd. Name ar CSM# 6 S ~ ~02 ~ out -~ 4~ / ,~ e. State Zip Cade Phone Number ^ ~ ^ Village f ~ Tovm crest Road Err d~ , f % .S' d/ (~7/.5'>~6.5 = /8' G Ste- ~v /..z New Carrstruction Use: ~ Residential / Number of bedrooms _,~ Code derived design flow rate ~ ~f~ G~ ^ Replacement ^ PubGc or commeraal^ Desaibe: Par+erit material ~~~ Gr/.9r ~ ~/~~- f=lood Plain elevation'rf applicable ~ ~ ~~ ft. General oorrrrrtaras ~ recorrtrrtendations: `<~ (- J l~- ~~ o ~~ Batng # L~ 2~/ pepar ura~g ~ 83 in. Pit Ground surface elev. © ~ b R to 1' factor ~ ~ Floriaon Depot DorNnant Redox Desaiption Texture Structure Consistence Boundary Roots G in. Munsep Qu. Sz Coat Color Gr. Sz Sh. 'ER#1 'E~ o- d - ~ S A C p- O /O R 5 r i¢,G - S V , ,~ 3" 0 6 6 -- ~- G' S -- , ,~ .~- ~ s6~ v ,,-- -- - d ® # Q ~~ Ground surface elev. ~ • ~ft. Depth tD lirrdting favor ~_ in. SoN ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fP in. MunseN Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#t 'Eff#2 //~ - 6 ~ A - ~.~ ---- 6 v,c ---- , trrNJent if7 = tlW >>rJ-U < T1V mglL 8n0 1 SJ >3U < lbU mglL /~ - tnwenr ~~ = aw _ av m~y-. a«u ~.~ ~ ~r «yr~ Address Date Evaluation Conducted Telephone Number ,~ ~viJ Property owner ~e/vN E7L/i /~'I~f ~'.S Paroel !D # d~c~' lDd2 ~ ~D-ADO Pass ~ a~ ® ~"~ ~ ~ f~nns 7 ,~ ^ Pit Ground surface elev. ! r ~ tt Depth to Hrtdting factor ~. ~ i~~ Rate Horiaon Deptl~ DorninaM Redox Description Texlure Stnacrixe Corrsistenoe Boundary Roots GP DAF in. MunseU Qu. Sz. Cont. Color Gr. Sz Sh. •FJf#1 •Etfff2 o~ 1 3 ---- si s A s a , S 2- ~ - -~' S/G ~ G' s , 6 3 0 ~' L CS ,2, -- .S'G s 1~- U -- -~ ^ Pit Ground surtace elev. R Depth to lirruting factor ~• Sal ication Rate Horizon Depth Dominant Redox Description Texture Stnxxure Corrsistenoe Boundary Roots GP D/fE in. MunseU Qu. Sz. Cont. Color Gr. Sz Sh. "Eff#1 •Efflf2 a ^ Pit Ground surface elev. R to 1'm~iting factor in. # ~ ~~ SoU Rate Florizon Depth Dormant Redox Description. Texarre Strur~ure Consistence Boundary Roots GP D/(t° in. MunseU Qu. Sz. Cont. Color Gr. Sz Sh. •Eff#1 'Etf#2 • Effluent #1 = BOD, > 30 <_ 220 mglL and TSS >30 < 150 mglL • Effluent #2 =BODE _< 30 mglL and TSS < 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-2t~b-3151 or TTY 608-264-8777. s~uwtrr.~oot WIESER conce~ RT. 2 (Hwy. 10) MAIDEN ROCK, WI 54750 • 715-647-2311 • FAX 715-647-5181 Parcel #: 016-1020-95-100 01/12/2007 12:45 PM PAGE 1 OF 1 Alt. Parcel #: 10.30.15.164A-10 016 -TOWN OF GLENWOOD Current X' ST. 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 O -MURPHY, JAMES M &JEANNE BETH JAMES M &JEANNE BETH MURPHY 1669 HWY 128 GLENWOOD CITY WI 54013 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description * 1669 HWY 128 SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 20.000 Plat: 4499-CSM 17-4499 016-03 SEC 10 730N R15W SE NW LOT 2 CSM 17-4499 20 AC Block/Condo Bldg: LOT 02 ( ) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 10-30N-15W Notes: Parcel History: Date Doc # Vol/Page Type 08/09/2006 831744 WD 08/04/2003 733618 2346/233 EZ-U 05/09/2003 720912 2237/167 WD 05/09/2003 720911 2237/166 ore-1 9f1AR SI IMM~RY Bill #: Fair Market Value: Assessed with: 165225 Use Value Assessment Valuations' Last Changed: 07/26/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 9,000 179,000 188,000 NO AGRICULTURAL G4 18.000 2,400 0 2,400 NO Totals for 2006: General Property 20.000 11,400 179,000 190,400 Woodland 0.000 0 0 Totals for 2005: General Property 20.000 11,700 179,000 190,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 09/29/2005 Batch #: 05-25 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 fn y ~ Z ~ Z ~ Z T. Z N 2 c~ m ~ d O 3 m O 3 m O 3 l9 O to O~ ~• m a .. ~ A ~ ~ ' ~ ¢ v+ a n°`i° ~ ~ p~ ' ~ °~ ~ y c c ~ > ~ > `° > `a c B o ~ a . . ~ cnZ (n v U?Z (nZD m co D ~~ w D co D y a a ° a a - o o m ° 0 0 . ~ ~ a m a c m 'p: ~ C C C W 'i3 o =~ ~ ~ ~ a ~ C 0o a a a ~~ rn = W m W ~ a a n ~ ~ ~ ~ N a Z 0 ~ ~Q O O ° ° ~i ~m m °~ -' m 5: ~ ~? S c w n ~ -, m 3 0 3 y bi N j ~ O a 3 m N_ N ~ (D ~ ~' ~ y ~ ~ 7~p Np, W N N N '~ a C r y fD ~ ~ ~. r. N~ N Q ~ O C~ p~~ to O p C O~ N O ~ 1~ y N N O. 7~ N -~ fp 7 p ~ f0 fD K N pK '~W{ C7~dp N 01 x,p..N 'O~ 'g 7 O Z y p N~ 41 ~ fND N Q W a `~ ~~ W O d a lB a~ c °- -m ~ ~ ~ o au; ~ g~ m wK D. O ~ ~ .~ W W 7 (D ~7p ~ N Q ~ aDi ~ 7c N ~ n ~ N ~~ ~ G. ~ ~ ~ S a ~ d °3c~fD ~~p~ c o37~m~ w~v O C 6~ G ~~ O ~ C (a (O O^ W O C S N ~ ~p O _f ~~ O y fD N ~ O. N O 7 m-•"' ~ o ~a:fN a£o 1 1 .1. ° °~ ° ° V ° 3 m o ~ 3 c d # ~ ~ ~ o ~ W N o d . ~ ~ ~ N S ,..~ N Q O C o °. y o c 3 " ~ .. ~ d 0 N A ~ .a A ~Z ~ Z ~ ~ o Z Z P d G A'+ i+7 0 p ~1 ~' ~• O ~• ~7 A A S Q N 0 0 V ry oa o Q W Q Wisconsin Daaartment of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Swanson, Dou Glenwood Townshi CST BM Elev: 1 ~~ Insp. BM Elev: ~~D BM Description: ~~# ~ S c~ S`'~' TANK INFORMATION TYPE MANUFACTURER CAPACITY eptic - ~ 5 (r' L~ t Z J~D Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD "~' ~ ~ osing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand M Model Number TDH Lift Fri ion Loss System Head TDH Ft Forcemain Length . to Wen county: St. Croix Sanitary Permit No: 430075 0 State Plan ID No: Parcel Tax No: 016-1020-95-000 Section/Town/Range a 10.30.15.~~~ ELEVATION DATA STATION BS HI FS ELEV. Benchmark ~ ~/ ,,,/ OY ~ ~b Alt. BM Bldg. Sewer 7-~1 p ~L / 7'a~3 SUHt Inlet g/r_ 2 ~J p ~`2/ 7 St/Ht Outlet ~~ ~ q~ ~7 Dtlnlet Dt Bottom Header/Man. y, p~ ~ 1d~ q'` •9 Z. Dist. Pipe g~~a al• z Bot. System 10.9 I d ~~ R a .Q~ Final Grade -- •°~ 6.,gZj ~ ,d •S over ~ 3 ~~ ~, 7 ~ SOIL ABSORPTION SYSTEM ~~'i~ bl BED/TRENCH DIMENSIONS Width 3- L '~ `~ Length 7t~'Z~' ~ . Of T enches '~ PIT DIMENSIONS ~ No. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER R Manufacturer: tpr ~t p/~ Vd o ~fa"~il'JL T Of S . ype ystem: „ ~ n ~. _ 1/~ 'cC// f pv I ~' / ~ ~ ~/ Model Number: DISTRIBUTION SYSTEM Header/ ifol~,- L J j rl Length ' J Dia "~ Distribution pipe(s) ~ ~ ~1! Length Dia Spacing x Hole Size x Hole Spacing Vent to Air Intake SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ~ , i-] Yes ~ ] No [] Yes ( j No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/1~/~ Inspection #2: / / Location: 1669 St Hwy 128 Glenwood City, WI 54013 (NE//''/4 NW ,1/4 10 T'3n0N R15W) NA Lot 2 Parcel No: 1 .30.1 . 1.) Alt BM Description = ~' CQ,~,~ ~ _r'J ~ ' ""t "~~~~r ~ ~ S ~J ~~ °r~/ ~ (G~-~- 2.) Bldg sewer length = .6 ~ ~; ~ ~ ~ (pd ,~~~ W P -amount of cover = ~ ~ £ ~ ,. 10 ~~ ~-' Aq?~~- /'. - - L ,, ~,, ~ Sit.. ~'0 ~vL `~ ~~ / ~ _YDvbSZr. va-~tt4Y~ i~2s ~~.Z ~oca~e~Qr-^•'~'^P~~rr'~~-Y~ _ _ _ 0 1 ~j ~-- - Plan revision Required? ~,~ Yes ~ 'i No I tl ~ i I ~ I I~ ~`t7C1' '~~-~ i ~ ___ __ !~ Use other side for additional Information. ~ i I / ~ ! __-_ ~~''~'.__ J t ~~~ _~a D~e ~ ~ Pt ~ ~nsepctor's Si ature~~ ~~e'~./~-~ C/~u"'C~~rt. No. SBD-6710 (R.3/97} J , Safety and Buildings Division County ~ m ~ 201 W. Washington Ave., P.O. Box 7162 S ~ ~~ ,,~~0~~,~ Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608)266-3151 ~2QD ~~ Sanitary Permit Application state Plan LD. Number ~~ In accord with Comm 83.21, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law s15.04 1 Project Addre~~s++s (if dill t than mailing address) Cc~ Ca~'ic9t') A ~ I. Application Information -Please Print All Infor tion j, l~ ~ n S ~` `[ ~~ ~ ~ Prop`Ry Owner's Name S ~`v~ ~~ ~j Parcel # Lot # ~ Block # Uo-u w ~ ~o n .., v /4- /d.~a-95-cco Property Owner Mailing Address ~ ~~:~~y~~:~FF,~ Property Location a 5 s ~ ~ Section ~~ ~~ ~~ '• '• City, State Zip Code Phone Number v( I,UO'Ot'jC. ~, w~ S ~ ,3 ~ trcle~~ ~ T c~ N R°~ II. Type of Building (check all t a apply) t~ ~ ; / ~ S bdi i i N CSM N b ~l.or 2 Family Dwelling -Number of Bedrooms u v on s ame er um ^ Public/Commercial -Describe Use * e~ d ^ State Owned -Describe Use ^City_^viltage ownship of~i It n u,oQd III. Type of Permit: (Check only one box on line A. Complete line B if applica le) A' `New System ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System B• ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued $efore Expiration Plumber Owner IV. of POWTS S stem: Check all that a I .Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ n Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain) 3(, V. Dis ersal/Treatment Area Information: t,,,K ; Design Flow (gpd} Design Soil Application Ra f) _ Dispersal Area Required (sf "Dispersal Area Proposed (sf} ys Elevation ~ Od D •`~ ~~ x"23. ~ 90 . z , VI. Tank Info Capaci m To Number Manufacturer Prefa Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tank s Tanks Septic of Holding Tank ~C • 27~ ~~ ~Z ~~ ~ ~ ~ SE ~ ~/ 1'~ Aerobic Treatment Unit /J ~ _ (,~(/ Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plu is Signature MP/MPRS Number Business Phone Number ,C /t J /tzi Y~~s aa-~~ ~ ~ ~~5-l~3-~s~ o Plumber's Address (Street, City, State, Zi C e ~ /55 4 5~A?c- t~ ~ t~ Yc~v~ t..c,6- w ~ S¢~~5 VIII. Coun /De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issu' g Agent Signatu (No Stamps) ^ Owner Given Reason for Denial Surcharge Fee) ~S ~ ~~, ~~ ~ IX. Conditions of Approval/Reasons for Disapproval I,, -,,• ' . • ,~ . - n ~ ~ ~a ~ ` wtpch complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD-6398 (R. 01/03) C~~® ~~"v i ~~ ~) FROM NARTHLAND PLUMBING, INC. FAX NO. 715-643-2520 Jun. 12 2003 11:20AM P3 • ~ 'A a rl~.~~~ r/7 ~'• /'`'~ 7 q .s % '~ i'~ a" ~~~+~l.:,r ~~~ ~ ~ ~ 1, y ~ ~ % /; ~, : / 1~.1 ~l' .I.~'''1 f ~ ~~rV1! Sri ~ .~~ j1 ..1 ~,. w L: ; I ~ ~ .. .. . r.... ~ . _ .,.~...~~_, ---; ~-• i ~ ~ ~ i"^ ....~. ~.....r -'.y~---r._' i ~ ~ iii'' . ~_ gX~ i i Al' i I I I' e ~~ ~ ~ i FROM NORTHLAND PLUMBING, INC. FAX NO. 715-643-2520 Jun. 12 2003 11:19AM P2 Calculations and Car~lwings Site Conditions infiltration f~levations ... ...... ......~ Site Type: (Private I ~ I Trench #1 Tr®nch ~k2 Trench #3 °k5lape 996 # of Sedtvom$ 4 D®pth to limiting fad g4 in Soil Application Rate: 0.4 gallft^2 Effluent Quality EfF #i ~ Design Flow: 600 gal/day Max SOD 220 mg/l Max TSS 150 mg/I ~~ontour Elev: Irrfittrstion Elev: l.imitincl Factor Elev: Treatment and Dispersal zOnE: Cover Materiel Required: Finished Grade Over Cell: 94.50 94.00 93.50 90.92 90.82 x.92 Ft Ft 87.50 87.00 86.50 3.a2 x.92 4.42 ~~ 0 0 Oln~ 94.50 94.00 93.50 i Distribution Celi Septic Tank Choos® chamber type: Septic Tank PAsnufacturer. ese~r C rxrete tnf'daa~r ~"~~ _.,._,--__ .,. ,~.~ ...w~ Septic Volume Chosen• 1 P Laying Length: 6,22 F# Effluent Filter Selected: ~ I A100 EISA Determined Area: 31.1 Ft2 ~,,,; ~i„K„~ „~ ~, p. proviestt to avow renio+al cf filer. o~n:,a m Qpen 8gttom Area; 15.50 f / t2 °xni ""'° ~ °f "~ °~' Chamber Height: 12 Inches Required Inflftrative Area: 1500.0 Ft2 Total i! of Chambers: 49 Total Cell Length: 304.8 Ft Cross Section of Septic Tank Cross Section of Cell Cover Materiel Observfition Pipe (iFrequired) ~ r Final Grade ~~ - - ~~ Ground ~orrtour L.eeGhing System Chamb®r ~~.~..,u_. 12" Min 8" Min All Joints to be water tight u~u~- or :fttuent Sth40 Fiber Ptpe Plan View of Typical CeA . l.~th- L 6 I. 6 - O O }~btNl ~ ~ Obaervatlat+ ~... Obscrrra4~at tN~al16 a Sch ~O ~ i i Pt~c F'pc PVG Pyre ~~ Page 3 of 5 In-Ground System Management Plan pursuant tp comet 83.54 W. A. C. Owner`s Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make periodic inspections of the components, checking for surface discharge, treated effluent levels, etc. The owner or owner's agent is required fo submit necessary maintenance reports to the appropriate jurisdiction and/or the department. Septic Tank: Septic tank(s) are to be inspected routinely and maintained by department approved individuals when necessary in accordance with their approvals. The use of chemiceUbiological "treatments" is not required or recommended. If such additives are used, make sure they are approved by Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & Leaned as necessary, with provisions to keep solids from passing the septic during removal. No more than t/3 of the usable tank volume may be occupied by sludgelscum. 3 year inspection: If tank has greater than 1/3 volume sludge, tank contents must be emptied and disposed of in accordance with NR 113 wsconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank, then the owner must be notified of when pumping should be done as to not exceed 1/3 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. Absorbtion Cell The absorbtion component must remain free of ponded surface water prior to pump operation. If 4 inches or more water level is detected in the observation pipes, the owner must be notified of possible problemsffailure. The designed daily flow capabilities of the component should never be exceeded. Trees and any other deep rooted vegetation should never be planted, or allowed to grow anywhere on the component. Activities OTHER than mowinglmaintenance (i.s. excessive walking, pets, vehicles, etc...) could compress the component and reduce it's absorbtion capabilities and/or possibly cause it to freeze in winter conditions. Perton»ance Monitoring: Performance monitoring must be done at least once every three years following the installation or at the time of a problem, complaint, or failure. Contingency Plan: tf the septic tank or other components therein (inGuding floats, alarms, etc) become defective, the defective tank or component must be replaced immediately to ensure that the system can operate as designed. If the absorbtion component cannot accept wastewater or ponds wastewater to the surtace, the component must be repaired or replaced in it's current location by removing the clogged bacterial mat, aggregate/leaching chamber cell, and distribution piping within the cell and replacing failing components in order to return system to proper working orcier as required. If repair is not feasible, a new system is to be constructed in a designated replacement area ST CROIX COUNTY SEPTIC TANK MAII~TENANCB AGREEMBNT AND OWNERSIiII' CERTIFICATION FORM OwnerBuyer ve Mailing Address ~ 995 L' ~ft (~ ,~ ~~E~l/~o-a s~ .[/•c 7'y , Gt/> s'~ ~.3 Property Address / ~ ~~ ~ ~ ~ u ~ ~~~ ~' (Verification required from Planning Department7or new City/State G/en cc~~~' ~~T GIJ~Pazcel Identification Number fJ/~y~" ~d a0 - 9y oo a LEGAL DESCRIPTION Property Location ,~~. %s, ~'/4, Sec. ~ T 3~ N-RLW, Town of GI~nuJoCG~ Subdivision .Lot # ~ Certified Survey Map # `7 f 5~~~1 ~i Volume `~~.~.Page # .y~q Warranty Deed # .~z~ Q / Z- .Volume ~ ~ ~ ~ .Page # / ~ ~ Spec house ~ yes ~ no Lot lines identifiable yes ~ no SYSTEM MAINTENANCE 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 pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agc+ees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mastorplumber, journeymanplumber, restrictedplumber or a licensedpumper verifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 fun of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that an statements on this form are true to the best of my (our) knowledge I (we) am (are) the owner(s) of the property descn'bed above, by v' a of a warranty deed recorded in Register of Deeds Office. S l ~ l t'i3 SIGNATURE OF APPLICANT DATE *~**** Any information that is mis-represented may result is the sanitary peraut being revoked by the Zoning Department. ****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed ~i ~~ sue, 5 i a5 ~cSUG- Swa..hspn -~! E. '~4 IJ fin( `~•q.. S ~fid T 3o of R V~ ~,, v -r 2 s~:e~t~cC~N~y Cs L~ w o m~ ~rv ~ s~t-~ic~ ~- 4 ~E .~, r1,c-~(E-2S ~jtopcsSED p 1nt Q l.L. b . ; O~ ~, / 9~ ti q3,y qty ~ q~.v o~ I r ~ q` ~ ~o S / / ~' I 83 0 / ~ ~5 . ~,,N- d2- /~ / ~~, °. 4 • w~soonsin Department of Commerce SOIL EVALUATION REPORT Page ~ of Division of Safety and Buildings RT ( - . In BCCOrpanOe WIUI wmm tf.7, WIS. Aom. woe ~~ty ~ Plan must not l in size l it l a than 8 112 x 11 inch h t Att ' ° ~ an on p per . ac comp e e s e p ess es include, but rwt limited to: vertical and horizontal reference point (BM), direction and p~ I,p• / / ~ ~~ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ~/ d ' / D D -~ ~~~ Please print all In e ~ bz i to ~ Personal fnforrnation you Prm'~ may be used for dar~i~, s. 15. (1) (m)). ~. l~. I ' ~ `~ Property Owner P rty Location 7'"' ~ Q Govt. Lot 1/4 1/4 S ~Q. T3o N R ~~ ~~ W Property Owners Mailing Address Lot # Block # Subd. Name or CSM# /ti 1 2 ST. CROiX COUNT ~ "' ~- City S e Zip Code e ^ vltage [,Town Nearest Road ^ New Construction Use: ~ Residential / Number of bedrooms ~_ Code derived design flow rate fs D4 GPD ^ Replacement ^ Public or commercial -Describe: ._-_-- -.----__._--Y ~-- Parent material ~~ /~ ~ / ~ L 1`' i L L Flood Plain elevation 'rf applicable N f.-~' ft. General oomrrler>ts and recommendations: A ~,/ y~ ~~'s-t r j~ 'L1~t~X~. w. ~~ S c~A t 4.t t 1 I Borir>g # .~ BO""g GI.~C. 1~J s ~C Q' . I J kX~ Pit vrouna surrace erev. ~ _=T n. uepui iv ia~awy ~auu~ i v v a i. Shc ication Rate Depth Dominant Redox Desaiptlon Texture Structure Consistence Boundary Roots GP D/fF &I. MunseU Qu. Sz Cont. Cdor Gr. Sz Sh. 'Eff#1 •Etf#2 o- % ® - S 2M M~ 1~S ~ ~' ,~ D S ~ C A.6 / . / ~-7 91~ ZS" / I . G d~ •~4' ~-~-' # ~ Bonng // ® Pit Ground surface elev. .~ ft. Depth to limiting factor ~~O in. Sal ication Rate Horizon Depth Dominant Caor Redox Desaip6on Texture Stnxxure Consistence Boundary Roots GP D/f~ in. Munsea Qu. Sz Cont. Cdor Gr. Sz Sh. •Eff#1 •E1f#2 ~ - ~ ~~6 Mr'r cs ,6 (. ~ aJf ~.9i • Effluent #1 =BOO > 30 < 220 mglL and TSS >30 < 150 mglL • Effluent 1r1 = BoD < 30 mgll. and T55 < 3u mg/L CS. T Nem@ (Please Pfint) y., Ignatur@ w CST Nu-Tlber :4L ~ SNI e ~~' ~~~ ~ ~. ~ ~ A~~ Date Evaluation Conducted Telephone Number .~-y~J3 i, Property owner 1~G'N/, -~ ¢~'~1 ~/~G~'',S' Parcel ID # ~~~' 1o~G~ `- ~-/ '' ~ Page ~_ of -~ Pit Ground surface elev. ~ ft. Depth to limiting factor ~ in. Soil ication Rate Horizon Depth Dominant Cdor Redox Description Texture Structure Consistence Boundary Roots GP D/ff in. Munsell Qu. Sz Cont Color Gr. Sz Sh. `Eft#1 `Eff#2 ~! '- ~. ~'- ~^ / J /6 G ~ - a -- S/CL ,~ ~ 6 ~t C S ~ 1 ~- ! ` Boring # r~~p ~~ ~ p/ l~0 Pit ' Ground surface elev. ~~~~i 7G+ ft. Depth to limiting factor ~ in. Soil ication Rate Depth Dominant Color Redox Description. Texturq Stnxxure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz Cont Color a Gr. Sz. Sh. 'Eff#1 `Eff#2 1 r~ -- :~ s- .. ~ ~ G~ ~- ~ ~ TT ~r~I" /''' T~ A ~C `:i ~ i S ~ V~ ~ r 2 l' -~` '~ ~ ~ 32 -Y'L- ,S o~~# o ~;~ Pit Ground surface elev. ft. Depth to limiting factor in. e..:~ w....r.,....:..., o.,~., 'Effluent #1 =GODS > 30 < 220 mg/l. and TSS >30 < 150 rr. The Department of Commerce is an equal opportunity servic need material in an alternate format, please conta sao-~~~~.~, -- ~ r ~ s services or 5~s (~ ('o.~s..'ls L.A~.r ~ ' ~' t ~ ~ -I ~. ' ~yT ~ II ~ _ _- __ _.. - _ . _ - ~ 1 -._ _ X _ ~ ' ~ ~ ~ _.._ G' O __ _ ___ __.. ._ ~ _~ i ~ _ r_ I - -- - - - ~ -- - ___ - - _ __ - _- ~ I _ ~ ~ I - _ _ 1. -_ - -- -- ___ ___ -_ _-- I . -~ -~ ~ ' ~ --- - l -- 1 I - _I - -t - } I - - -- I ~ _ - -~I - = _ ._ _ . I --- - ~_ ~_ _ ~ -- -- . -- -- - - - - -. ___I -_._ _ I ~ ~ ~ ' f / -- i - i _ \ I ~ 1 ~ _- _._ - _.._- ___. -_ ` _. _1 _._~. --_ .____ .-_._ _I__ _- _- _ ___. _. .____ -y -. _i ___ - - -___. _ _. ___..._ _-..- ____ .. .__ -_ ___ ' i -____ __. _ I-. _~ ' _ r _y ~_. ___ _ _-. __ ~ . ~ ~ ~ ~ ___. __ r ___ ~ _- _ _ ~.__ _ .~ ~' 9 ~ , - ___ -- --- , - -- ~ - -P - -- - --- ~ -- - ; _ `_ I $ - - - - --- ~ -- ~ - - -- --- -- -- ' _ _ ~ _-__ -- `7 _ - -- / -- - - ~ -- -- -- - I- - -- -- - - - - - - -- - ° S ~ ~ j -- -- - - - - ~- -- __ -_ . - --- -- - - - - --- --- -- -_ _- - -- ~ I -- ~- - i--{ -- -- _--- - -- _ ,-- - --- - ~ -- --- ~ ~ ~ ' _. ~ ---_ - -_- -- ~ --- --- - - j-- i {-- - - ~ ~ ~ ~ ~ -- ~ -- - ~ f" ~• - --- - _- - - --- -- - - --- - I ~ ~ -_ - - - _ _ ~--- - ~ 1- -- ~ ~ ~ -- I --- ___ ,_- --- - - ~ ---- -- - 1---- ~ --- ~ --- ~ ~ __ _ - - - - - - _ __ --- - __ I - - - - - - ~ ~ - i ~ I ~ -- - - ~ ~ ' - I -- {--- ~ ~ -- a ~ - -- - -- - _ - - _~' _~ 1 --- -- - - - i -- - - - `` f- ~~ ~ ~ I -- 1-- -- --- --- --- -- --- - - _ --- -- -- -_ -- , - l~t~hvJ Chambers Project Name: Cover Page Page 1 of 5 0 Table of Contents p9• 1 Cover page 2 Calculations and Drawings 3 Management and Contingency Plan 4 Plot Map total # of pages: 5 Designer Name: License #: Date: Ph. #: Signature: Lyle J. Myers 224617 715-643-2520 Design Methods Used 9N-OROUND Sal ASSORPTIOM COMPONENT MANUAL FOR PRNATE ONSfTE WASTEWATER TREA'f1u~NT SYSTEMS' (Versia~ 1.0) SBD-1070SP (R.FiJ99) 3bAdvisemerrt N12486 220th St, 8oyceville, wl 54725 Ph:775-643.6068 err~l: ~U~~ ~ ,~ 20Q3 ~~ ~IXC(~i_. . , Owner's Name Doug Swanson Owners Address 2995 CTH Rd S Glenwood City, WI 54013 Legal Description NE ~ '/~, Nw '~ '/. Sec 10 7 30 N, R 15 w ~ Township Glenwood County Saint Croix Subdivision N/A Lo## -PJIA~ ~~~ Parcel ID# Page 3 of 5 In-Ground System Management Plan pursuant to comm 83.54 W. A. C. Owner's Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make periodic inspections of the components, checking for surtace discharge, treated effluent levels, etc. The owner or owners agent is required to submit necessary maintenance reports to the appropriate jurisdiction and/or the department. Septic Tank: Septic tank(s) are to be inspected routinely and maintained by department approved individuals when necessary in accordance with their approvals. The use of chemicat/biological "treatments" is not required or recommended. If such additives are used, make sure they are approved by Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & cleaned as necessary, with provisions to keep solids from passing the septic during removal. No more than 1/3 of the usable tank volume may be occupied by sludge/scum. 3 year inspection: If tank has greater than 1/3 volume sludge, tank contents must be emptied and disposed of in accordance with NR 113 wsconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank, then the owner must be notified of when pumping should lie done as to not exceed 1/3 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. Absorbtion Cell The absorbtion component must remain free of ponded surtace water prior to pump operation. If 4 inches or more water level is detected in the observation pipes, the owner must be noted of possible problemsffailure. The designed daily flow capabilities of the component should never be exceeded. Trees and arty other deep rooted vegetation should never be planted, or allowed to grow anywhere on the component. Activities OTHER than mowing/maintenance (i.e. excessive walking, pets, vehicles, etc...) could compress the component and reduce it's absorbtion capabilities and/or possibly cause it to freeze in winter conditions. Pertonnance Monitoring: Performance monitoring must be done at least once every three years following the installation or at the time of a problem, complaint, or failure. Contingency Plan: If the septic tank or other components therein (inGuding floats, alarms, etc) become defective, the defective tank or component must be replaced immediately to ensure that the system can operate as designed. If the absorbtion component cannot accept wastewater or ponds wastewater to the surface, the component must be repaired or replaced in it's current location by removing the Dogged bacterial mat, aggregate/leaching chamber cell, and distribution piping within the cell and replacing failing components in order to return system to proper working order as required. If repair is not feasible, a new system is to be constructed in a designated replacement area .. ~~~~ D~+~IG DA~T4~E.Git~ ~~ti.?'Y r~a~: hIG. ; '1~-~:C`:;-i;~~3 ~ I f i I , ~,.~~ ;,'~1,. r. ~ ~ I ''1 i ~ i~ ~~ I l ~ I ~ ~ ~ .j ., ~ .. ~. . ~ .j ~ ~ ...~ 17'~ ~ . j..._~.. ~ i 1 j ti ~ "'~' .. ~~ i I 1 ~ ' t ~ ~ w_.! . ! i ~ ~ .. . t ~ ~ r ~ ~; . 4 ~ . _ , .W _ .; ., . ~ ~ .....;.. .. A ~. '' _ '~ ~ , , i - ~ i ~ ~ ~ ~ ~ ~W. I i ~ ~ 4 .~ I 1 . ~~ w ~ i ! ~ ~ ~ 1' I ! ., ~ ~ w~ I ...~_ i . ice ....I-.~ III 4 j - ! .... ! b... ! ~ t .. ~ V . ! _ 1.- ~ 4 i. - _..~.~ ~ ... _„_, i.. .~., ~ r # ~ ~ _ ~ .... _.. _._. ~.._ t w _ i ~ - ~ 4 I { i j -~-- _.~.i~. i _! ~. I 4~ .. ~ ! t ,~,. ~„ .y, 1 ~ ~ ~~ .{...... .~ ~ , 2237 ~~ '' 67 STATE BAR OF WISCONSIN FORM 2 - 2000 ' Documen~ Number WARRANTY DEED This Deed, made between Kenneth Maes and Mary Ann Maes, husband and wife, Grantor, and Douglas L. Swanson and Michelle M. Swanson, husband and wife, as survivorship marital property, Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croiz County, State of Wisconsin (if more space is needed, please attach addendum:) See Attached Ezhibit A ,~ * Kenneth Maes * M A es Name and Return Address Ij ~~L Edina Realty Title, Inc. ` ~ 3C~ 400 South Second Street #115 C~- 3 0 ~ Hudson, WI 54016 plc, - ro a o - 9' S -~-~~ Parcel Identification Number (PIN} Ibis is not homestead property. (asJ (is not) Exceptions to warranties: Easements, restrictions, and rights-of--way of record, if any. Dated this p~~ day of April , 2003 * AUTHENTICATION Signature(s) authenticated tl~ (J , TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Brent R. Johnson - Locomen, Nelson, Cole & Stageberg, P.A. Hudson, Wisconsin (Signatures may be authenticated or aclrnowledged. Both are not necessary.) 7209 1 2 KATHLEEN H. iIALSH REGISTER OF DEEDS ST. CROIX CO. , MI RECEIYED FOR RECORD 05/09/2003 04:20P1i MARRAHTY DEED EXERT # REC FEE: 13.00 TRANS FEE: 126.00 COPY FEE : 2.00 CC FEE: PAGES: 2 Area ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. -7Y ~ IJ( County ) Personally came before me this ~i~''~~ day of April 2003 the above named Kenneth Maes and Mary Ann Maes, husband and wife to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. * , ,~~ Notary Public, State of WISCONSIN My Commission is permanent. If not, state expiration date: ~ ~- / - d.0o ~o ~ .) ' Names of persons sighing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN INFO-PRO (80055-2021 www.infoproforms.com FORM No. 2 - 2000 223? i' 168 EXHIBIT A Parcel 1: Lot 2 of Certified Survey Map filed Apri123, 2003 in Volume 17 of Certified Survey Maps, Page 4499 as Document No. 7183971ocated in part of the SE '/. of the NW '/, of Section 10, Township 30 North, Range 15 West, Town of Glenwood, St. Croix County, Wisconsin. Parcel 2: Together with a 66 foot easement for ingress and egress, located in part of the SE '/. of the NW '/, and part of the SW '/, of the NW '/, of Section 10, T30N, RISW, Town of Glenwood, St. Croix County, Wisconsin; described as follows: Commencing at the N '/, Corner of said Section 10; thence South 00 degrees 43 minutes 57 seconds East, along the north-south %. line, 1311.56 feet to the north line of the SE 'h of the NW %,; thence South 89 degrees 49 minutes 57 seconds West, along said north line, 902.98 feet to the east line of Lot 1 of Certified Survey Map recorded in Volume 12, page 3502 at the St. Croix County Register of Deeds Office; thence South 00 degrees 10 minutes 39 seconds East, along said east line, 469.29 feet to the point of beginning; thence continuing South 00 degrees 10 minutes 39 seconds East, along the southerly extension of said east line, 66.00 feet; thence South 89 degrees 49 minutes 21 seconds West 521.32 feet; thence South 57 degrees 38 minutes 17 seconds West 300.99 feet to the southeast corner of an easement recorded in Volume 1338, page 570 at above said office; thence South 82 degrees 20 minutes 51 seconds West along the south line of said easement 66.00 feet to the east line of State Trunk Highway "128"; thence North 07 degrees 39 minutes 09 seconds West, along said east line, 66.00 feet; thence North 82 degrees 20 minutes 51 seconds East 51.54 feet; thence North 57 degrees 38 minutes 17 seconds East 305.57 feet to the south line of said Lot 1; thence North 89 degrees 49 minutes 21 seconds East, along said south line, 540.36 feet to the point of beginning. Informational Notes: The real estate property ID or Plat and Parcel Number is 016-1020-95-000. xxx Highway 28, Glenwood City WI File No.: 387939 r i .~ 7 1 8397 CERTIFIED SVRVEY MAP LOCATED IN PART OF THE SE1/4 OF THE NW1/4 OF SECTION 1 O, T30N, R1 SW, TOWN OF CiLENWOOD, ST. CROIX COUNTY, WISCONSIN. O N O O o`i ~ ~ Oz N 3) ~m D ~ ~v m~ N ° N W m Z 5 z c VOL ~ ~ PAGE 4499 KATHLEEN H. ~- REGISTER OF DEEDS ST. CROIX CO. , NI RECEIVED FOR RECORD 04/23/2003 09:50AM CERTIFIED SURVEY MAP REC FEE: 13.00 COPY FEE: 3.00 PAGES: 2 J ~ BEARINGS ARE REFERENCED TO THE NORTH -SOUTH 1/4 LINE OF SECTION -~ ~~~ i r 10, ASSUMED TO BEAR S00°43'57"E. _- -- ~ ~- ~ _ j ~ - ~' ~ m N z m _ ~ PAZ _- Z ~ cn_ _ _~ Q / I ~ D . - ~ ~- ~q°14'33"EL- - -- - ~ cv'r+ ~ ~~ `- v m -- u_ (_--~'- ~ ~ m '-12$_ Noy°3 'o9°w ~ T H 66.0' ~ti -~S ~_. _ - ' --- ~ I ~S, ~rti 66' WIDE ACCESS EASEMENT REC. IN I ~ --_ ~" ~ ~ ~~ _ ~8~' AS2j;, VOL. 1338, PG. 570 FOR LOT 1 C.S.M. I ~ ~ !I O ~ Z~o9 N~ ~i2~SA,S~FFJ REC. 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Planni.,5 ~"~OJXCCIU(~;TY APR ,~ 3 2003 ° (~ h0( ~gCUr _ uau aptrrOV ~ ""r'r dc! vd Ys cif al dale ~t~pro C Z m vaf sh rn dr ;.., _, afl tie ,..,;~ o T A m N m A 0 i 5 m w G m C ~g~~ I~ I~ I~ I~ I~ I I oo I I~ i~ I -, I C~ IV I~ i~ fiiil7 i ~ I~0 I~nn I~ IVu