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016-1060-60-100
N 4 ~ c ,~ 0., O O N V A •~ N O •~ O U `~i q O w II ~~ oll' H .~ a> A t~ W ~ ~ Z o N F f4 o z a7 ~ r N N r I N D7 ~ a R °v > R a v! J U a L O W dN• O ~ O O C M a~ O N C9 ~ ~ ~0a ad;~ c ~ ~ c°~a~ v C 7 LL C 3 O V d C p M U~ If! d a m ~ O O ~ °~ d c 0 ~ Y O C~ fp N C y ~ y O O N L ~ C ~ O S y ~ N d ~ ~ ~ a ~ ~ Y ~ ~ lp C Y C fA _ r w ~ C ~`. ~ d ¢ m N O E ~~ °~rn ~ ~ ; N O N z ~~ „~ C ~ C N ~ V) C f0 ~ •t6 tll t ~ C -p ppp)C.d G1~ "C ~N to ~ H ~ N Q Q .~.~ l!. N ~ ~! N O O ~~ ~ d c Y O +p„ f3 N C y O ~ O C ~ N C ~ ~ N C Y ~ ~ C w ~ C C f0 m ~ ~ C m w c3 ~ a~ O ~U o~ E~ O N z ~~m~ °'y C p C T C p ~ tp tq L ~ :- ~ ~ ~~~~ppQpp ~ ~ ~ a~ O~ y O N Q QCIL ~ ~~ N N ~ ° i a ~ a i ~ O O i CC O •~A p V •N N •> ~ ~ O !A ~ > _ N = z N y ~ ~ d ~ ~ O lp O N ~ N ~ N y a ~ 0 ~ S ~ a ~ ~ o w 4 z v C N 01 d N m .. J ~ c 0 ~ C7 a ~ u~i o a ~ vii Z ~ v v ~ O Z O Z O ~ Z O Z ~ ~~ ~ 4 ~~ _ O 3 O m ~ a d m m 0 n in z l in m Q n iI1 z 1 in 4 a ~ ~ ~ c o = O n~ 'p C N G . n c0 ~ ' +% ~ ~ N ~ (~ ~y N ,> •C ~ ~ N .~ ~ Z ~ Y Z g~ Z ~ Y Z c g ~ Z ~ d E .. a w c °rdra • ~ 3 3 a a a N N ~- N O d ~ ~ Vim/ C ~: =€ a a ~ c m ~ N V I I I I i I I I I I 1 I I Cr I I II J\ I I I I I I I I I O I w I O Z 'O i M I I o I C I .`~_~- I z° I c I N I I w i I o I Z ~ I I I I I a' I :: i I >` I °~'a'$I C C ~ ~ I 7 C N ~ I g ~ I I I I I Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMi~TION (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 W Iz, Jose h J & Gloria M Glenwood Townshi CST BM Elev: Insp. BM Elev: BM Des~cri~pti"o~n~ TANK INFORMATION TYPE MAC Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic .-~--- Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss S em Head TDH Ft Forcemain Length Di . to Well SOIL ABSORPTION SYSTEM '\ Ilj~(-I8N I~ ~ 1 ELEVATION DATA county: St. Croix Sanitary Permit No: 55 State Plan ID No: Parcel Tax No: 016-1060-60-100 Section/Town/Range/Map No: 28.30.15.424A HI 1 FS encnmarK f>~ ~~ ~Z ~?l~tZ ~ •O~ Alt. BM Bldg. Sewer 13-~3 ~ 9.3g SUHt Inlet )~•2D (~ ~d •`~Z. SUHt Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot. System Final Grade St Cover ~ ^ N~ r /~ BED/TRENCH Width Length No. enches ENSIGNS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG EL KE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: NIT Model Number: DISTRIBUTION SYSTEM / Header/Manifold Distribution x Hofe Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Onlv Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil >~ Yes (J No L Yes ;_ j No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1JT~w~'~~3 Inspection #2: ~-' Location: 2986 130th ve Glenwood City, WI 51l4013 (SE 1/4 SE 1/4 28 T30N R1p5W) NA Lot ~;..rv~vit ParParcel No: 28.30.15.424A 1.) Alt BM Description =~~¢+~.~ tiQ~W"rIOL+<gQ,) S/ ~~'~' `'F. ~'~~ ~~ ~' ~ ` ~ ~~ 2.) Bldg sewer length = ` Q-K~t~ ^~'-+4 6 5 T• 1, -b ~,''~'~._ ~ ~•~C~ ST/~ s - amount of cover = J J ~ ~kw! ~ ~ ~,ss~ 3 Conytour~C ~ ~ ~ /1 ~ n j~ _ n`~ D T an re isi n Re uired? _;~ Y Ji No ~j ~ j~ Use other side for addition ormation. L ~-y!- ~~L.~ ~ ~ - SBD-6710 (R.3/97) 1- . -_ Date ~ / e is Signature Cert. No. GQ~aI ~ ~-C.e ~~~~ c. '~~ ' ~ C~" G~ ~~, ~1 ~ I `2 . , ~~~ ~~~ Wisconsin Department of Commerce PRIVATE SELIUAGE SYSTEM Safety and Buildir+~ Division ) INSPECTION REPORT GENERAL INFORMATION (ATTACH "I'O PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holders Name: Walz, Jose h J & Gloria M City Village X Township Glenwood Townshi CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY ~ Septic y //'' ~1~G~ ~. Dosing Aeration ~ Holding TANK SETBACK INFORMATION ~ to Holding P/SIPHON INFORMATION Manufacturer Demand i GPM odel Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well r ~. SOIL ABSORPTION SYSTEM County: $t. CrOiX Sanitary Permit No: 55 State Plan ID No: Parcel Tax No: 016-1060-60-100 Section/Town/Range/Map No: 28.30.15.424A ELEVATION DATA STATION BS HI FS ELEV. Benchm k ~ ` ~ z lJt3 .~ ~ Alt. BM Bldg. Sewer ` 3. St/Ht Inlet St/Ht Outlet Dt Inlet Dt Bottom HeaderlMan. Dist. Pipe Bot. System Final Grade -- -_ ..._..._.._ St Cover ~ BEDITRENCH Width Length No. Of Trenches ~ PIT DIMENSIONS No. Of Pits Inside Dia. liquid Depth DIMENSIONS SETBACK SYSTEM TO P!L BLDG WELL LAKE/STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM HeaderJManifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing :~~ SOIL COVER x Pressure Systems Onlv xx Mound Or At-~rada Qvatems Only Depth Over Depth Over xx :Depth of xz SeetiedlSodded xx Mulched Bedlrrench Center Bed(rrench Edges Topsoil Yes No 0 Yes ~ No COMJVIENT (Include c ~ iscrepencies, sons present, etc Inspection #1: r~~~' Z~ ~ `.Inspection #2: f--~--L.,__.~ Locati~• 9 6130th A e Glenwood City, WI 013 (SE 1!4 S 1!4 28 T30iJ R15W) NA Lot Parcel No: 28.30.15.424A 1.) Alt BM Description = 1 2.) Bldg sewer length = ~„Q ~~ ~~„ 5~ ~~~^•~ ~ +~l -amount of cover = ~ '" _ ~' 3.) Contour = Plan revision Required? s ~ No ,~~~ Use other side for additiona rnform ion I--~~ ~_ _ _' SBD-6710 (R.3l97) ~ 1~ Date y Insepctors Signature Cert. No. i~ G County Sanitary Permit Application ST. CROIX COUNTY WISCONSIN In accord with 15.04 St. Croix County Sanitary Ordinance ZONING OFFICE ~' Personal information you provide may be used for secondary purposes ST. CROIX COUNTY GOVERNMENT CENTER [Privacy Law. S. 15.04(1)(m)] 1101 Carmichael Road ,'~ J~_v~',_~ Hudson, WI 54016-7710 ~ (715)386-4680 Fax (715)386-4686 Attach complete plans for the system on paper not less than 8-1/2 x 11 inches in size. County Sanitary Pg~it # ^ Che i R E L I V E D n 1. Application Information -Please Pr nt all Information Location: Z ~. I Property Owner Name APR 0 3 2003 `Zvt S E 1!4 $E 114, Sec a 8 os h ~ . 9 61 o r1 ~, M.. GJA-~Z. T 30 N, R ~.J 1r(o W Property Owners Mailing Address ZONING OFFICE Lot Number Block Number 3o a 8 r a o f~- A vc . ~oA~ - cs ~-ca ~- City, State Zip Code Phone Numer Subdivision Name or CSM Number j G (~ehu~oei~ Cr~ w l .5~6 I ~ 715- alp5-~q~ ~Zy -- -?0( p~ 3 p~ , 11 Ty f Building: (check one) ~ ~ -y,,,_~, n~ ^City ^Village own of 1 or 2 Family Dwelling - No. of Bedrooms: g, 3~ Y~ P ~~ i , ~~ '- U ^ Public/Commercial (describe use): ~ - ~ ^ State-owned Nearest Road ,ZQ~(r ~ ~~ ~~ `" ~ II. Type of Permit: (Check only one box on line A. Check box on line B if applicable) C Parcel Tax Number(s) A) 1.^ Repair 2. Rec 3.^Non-plumbing 4. ^ Rejuvenation ~~~ _ I Olo O _ ~ O ~ ~, n I~ I Sanitation B) / Permit Number (y~State Sanitary Permit was previously issued ~ ~ ~ 7 Date I su d TnS~~led 9 ~d J d IV. Type of POWT System: (Check all that apply) ^ Non-pressurized In-ground ~ Mound ^ Sand Filter ^ Constructed Wetland ^ Pressurized In-ground ^ Holding Tank ^ Single Pass ^ Drip Line ^ At-grade ^ Aerobic Treatment Unit ^ Recirculating ^ Other . Dispersal/TreatmentArea Information: /->' ~ ~,~: yt! ~ ~ ~ aA ' d of S• 3 '- ~-~ hS 1. Design Flow (gpd) 2. Dispersal Area ~ .Dispersal Area I 4. Soil App cation Rate 5. Percolation Rate 6. System Elevation L~f~~ s{GtZ ~/ 7. final Grade i ~~ Required ~ ropesed (Gals./day/sq.ft.) (Min./inch) ~ Elevat on 3~-l~ ~~-~P { I. Tank Information Capaicty in Gallons Total # of Manufacturer ! Prefab Site Con- Steel Fiber- Plastic New Existing Gallons Tanks h•1.~ k I- J ~ f t~' ~±~i~ Concrete structed glass Tanks Tanks j tt ~ f, /CfC~Q ~ ^ ^ ^ ^ .2e- k- Qlj / ^ ^ ^ ^ 11. Responsibility Statement I, the undersigned, assume responsibility for repair/reconnenction/rejuvenation/installation of non-plumbing for the POWTS shown on the attached plans. A license is not required for terralift repair or the installation of non-plumbing sanitation system. Plumber's Name (print) Plum er' Signatu a (no st s): MP/MPRS No. Business Phone Number Plumber's Address (Street, City, State, Z od ). ~ i~s~ sr,~T~ rz.~ l ~ ,~o Y~~~~~ w/ s¢7as I{I. County Use Only ^/Approved Disapproved Owner Given Initial Adverse Sanitary Permit Fee y'~~a~ d ~ Pate I sued ~/ I ing Ag t Signatur stamps) .- `~ /// ~~ ~ Determination IX. Conditions of Approval/Reasons for Disapproval: II L " " ,~~ , j{~ -~s b r7 n S ~'~!/h~ fI i~ CG~Y7'Z°YI.~ r,BGl2. I"~ u I ~-- ~7~fe v ~ ~ Y P ~ -~l u ' . e e ~ S , ~ - ,, yv~ ~ h ~ r< - l'J A-dd ~ h a y Vf (~ _ _ L , '7" 1'Y1.S`+'t Yl <j !Y rvW /n~~j ~ hV ` ~1 ~ ~f•G~e 1 ~~~1~ 0'''~ ~ s/ - n ~a6ain e ~ r .. .a 2 I ~ - r 3 EX15T1~~ Mr1vn1+~ ~~r.1x ~ PvmP -E(r1a-Lt/.J-r~~ ~y Dr.v~B>/~1 C~2ZFI~0/J ~Rm Sv6mr~7e=.A • v e ~r G ~ _ V (µ ' {~ (i,~ vn ~l~ -{'9 ~yl. ~'Z~Y~-AJ4~ ~'`~ ~' ~ Y_ ~ ~.s~k ~ ~1 ~'~-~'~...L° t '' 3 S~ `'/ ~ ~' . - ..-/ ~i . Q~n-fly- G ~~ ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the ~DSE~'E-{ ~~ ~L.-yl~ t.~ W AcC-Z residence located at : 5~ 1/, Sir ~, Sec . 2$ T 3o N, R ~ Sr W, Town of ~TZ..EIvG~JDG ~ St . Croix County, Wisconsin. Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced . Did flow back occur from absorption system? Yes No line. Approximate volume or length of time: Capacity: Q a,~ Construction: Pre b Concrete Manufacturer (if known) : S Age of Tank ( if known) : /P gallons Steel Other (if no, skip next minutes (Si~fiat e) ~ ' '~ R ~~--3 (Title n _3 (D__ ~~ J (Name) Please Print ft7 ~ z2~1 ~7_ (License Number) Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank, to the best of my knowledge, will conform to the requirements of ILHR 83, Wis. Adm. Code {except for inspection opening over outlet baffle). r~ Name S' nature ,~ ` 1 ~ Q G reV ~f MPRS Z ~ (lV c e.~-l~L /kj~ t~ . P f~ ~ , r/1 ~ c c2-- ~ rn c z c~ 0 ~ r- ~.3 "~ ~ ~ ,' ~- m -~ m ~ ~ 0 m _, . ,^ . ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREBMBNT AND OWNERSHIP CERT117ICATION FORM Owner/Buyer Mailing Address 3u2~ Ib1~~ hve_. Property Address 2 ~' ~ ~o ~ 3 ~ ~` ~+~ ~ • , - -r, . /~ ~ ,/j (Verification required from Planning Department for new construction) ,~~/171~~ _ ,~ic~-/a(vo-(ill- /D City/State ~le~~ oed ~1 W -Z- Parcel Identification Number ®( - 1 ~ bC~~ ~~ .. OOO~i_ 'Tk~.r;S ~aLl C'S~'1 ~~/y42~ LEGAL DESCRIPTION .. ~` ~q9?~a? Property Locatio s L '/s, SE _~,, sec. 2 $ . T .~ ~ N-R ~~w,•"1•own of Gle~lwoo Subdivision Lot # Certified Survey Map # .Volume .Page # 1'~~ Warranty Deed # <~,~~ ~ ~~olume /~ G 3 ,Page # 3 ~~ ~I~ ~-~3 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 agrees to submit to St. Croix Zoning Department a certification foam, signed by the owner and by a mast~rphxmber, journeymanplumber, restrictedplumber or a licensedpumper verifying that (1) the on site wastewaterdisposal system is is proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full 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. SI(JNA OF APPLICAN z, a3 DATE OWNER CERTIFICATION I (we) certify that all 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 virtue of a warranty deed recorded in Register of Deeds Office. SIGN OF APPLICANT DATE ****** Any information that is mis-represented may result in the sanitary permit 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 Page Z of Z~ START UQ AND OPERATION For new consCruction,'prior to use of the POWTS check treatment tankls) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tankls) removed by a Septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal celllsl in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • AIt piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shalt be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or=must be taken, to provide a code compliant replacement system: ^ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ^ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a Last resort to replace the failed POWTS. ~~ ^ The site has not been A~~-i~~=+p~+ *~ ~a~-•'~•- - - •'•-~'- -'- e ite tank Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS 7~S-lo~~_>S Z d ~ ~:r_,~••Q ~to.1_ /fir, -~, a_ ~ ,~h ~ ~G.~_~ POWTS INSTALLER Name ~~~ syvt ~-T~-( Phone , / '~ l S r 2l0~- `1 pOWTS MAINTAINER Name Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Phone Name Ct~ t D N !/J Phone ~ l ~ ' 3 ~(o - ~6 ~~ This document was drafted in compliance with chapter Comm $3.2212)ib)itlld-&if) and 83.5411), i2) & (3), Wisconsin Administrative Code. POWTS OWNER'S MANUAL & MANAGEMENT PLAN FILE INFORMATION Owner ~j-~ ~~~ ~ ~~ Permit #-~/ DESIGN PARAMETERS Number of Bedrooms ^ NA Number of Public Facility Units A Estimated flow (average) ~~ O al/da Design flow (peak), (Estimated x 1.5) ~s~ al/da Soil Application Rate ~ C~' - ,11i1,c. al ay/ft2 St dard Influent/Effluent Qualit Monthly ave rage' Fats, Oii & Grease (FOG1 530 mg/L Biochemical Oxygen Demand (6005) 5220 mg/L ^ NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (80D5) _<30 mgJL Total Suspended Solids (TSS) 530 mg/L ~NA Fecal Coliform (geometric mean) 510° cfu/100m1 Maximum Effluent Particle Size YB in dia. ^ NA Other: ^ NA "Values typical for domestic wastewater and septic tank effluent. ~I At11ITCMARIf`C C/`LlCfll ll C SYSTEM SPECIFICATIONS Page ( of Z Septic Tank Capacity al ^ NA Septic Tank Manufacturer ^ NA Effluent Filter Manufacturer ^ NA Effluent Filter Model ^ NA Pump Tank Capacity al ^ NA Pump Tank Manufacturer ^ NA Pump Manufacturer ^ NA Pump Model ~ ^ NA Pretreatment Unit ^ Sand/Gravel Filer ^ Mechanical Aeration ^ Disinfection ^ NA ^ Peat Filter ^ Wetland ^ Other: Dispersal Cell(s) ^ NA ^ In-Ground (gravity) ^ In-Ground (pressurized) ^ At-Grade Mound ~C(STj~IJC~ ^ Drip-Line ^ Other: Other: ^ NA Other: ^ NA Other: ^ NA o~r+~~~ ~ r...-...vim v Service Event Service Frequency inspect condition of tankls) At least once every: ~ - 3 ^ ear(s)Is) (Maximum 3 years) ^ NA Pump out contents of tankls) When combined sludge and scum equals one-third IY,) of tank volume ^ NA Inspect dispersal cell(s) At (east once every: ^ month(s) (Maximum 3 years) 2 -3 ~year(sl ^ NA Clean effluent filter S ~''~-~ ~a At least once every: ^ monthls) ( yearls) ^ NA Inspect pump, pump controls & alarm At least once every: ~ ysa-ls)Is) ^ NA Flush laterals and pressure test At least once every: ~ ^monthls) ^yearls) ^ NA Other; At least once every: ^ month(s) ^yearls) ^ NA Other: ^ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tankls) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third IY31 or more of the tank volume, the entire contents of the tank shat! be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. ~ _ ,~ r - ~ y ,~~~ -_ "~+` ~~"'~ ~ FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER !} /~ ,~~J / r~ TOWNSHIP GL ~NcvD~ c~ SECTION ~ T ~D N-R~W (!i ADDRESS -- d /i~ ~ V ~ ST. CROIX COUNTY, WISCONSIN ~rL, e N k~o o c~ G'` /~T`Y `v i SURT?TVTSTO-~ .._ LOT "`"ti-.,OT SIZE-' PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM In ~ryry 9a' ~ ~ ~h E - vJ ~ ® r _ _ _ _ _ ~-.~~~ Ma ~-/ iv d 5,7~ ~n,~k z,37 ~-.___ i 3 ~~ ~ I 1 ~,g' '~ ~H~ ~ ~~1 w~~~ ~~ 01=' /.~o t~ Avz. ~M ado ~~~ ~~ /.~~ ~ l~ ~ N S ~ ~ 2 , 31 io 3 ~8~ M ~ SeP t, c; ~~ T~ N ~~ 5 ,~ b f INDICATE NORTH ARROW ~~ ~~ -~ ~'~~ BENCHMARK: Elevation and description : ~"D P !~ /= T~~ ~ f'hiy lY B ~~~ Alternate benchmark SEPTIC TANK: Manufacturer : ~t/.~ P ~ -S' Liquid Cap. / D v~J Rings used:~Manhole cover elev:~3~~Fina1 grade elev:~f~~2 Tank inlet ele~~.: .~ Tank outlet elev.: ~~., ~~ /~ No. of feet from nearest road:Front, Side , Rear Ft. ... . , PUMP CHAMBER Manufacturer: W .ems ~ /~s Liquid Capacity: 8(.! G ~eL~e.R Pump Model:~_Pump/Siphon Manufact.:2~~L.LP~ pump Size Elevation of inlet: ~y~ 6 9' .Bottom of tank elevation ~d~ ~~ ~ •'' i o ~ Pump on elev.: ~~ n2 Pump off elev.: ~~~ Gallons/cycle: / D / Alarm: Man.:~,TZ=Ley~f"~O Switch Type: e Location J~( MO~d1Le ~01~(~ Distance from nearest prop. line: Front2J6 Side,, Rear_Ft. Distance from: Well /~ / Building_ / ~/ SOIL ABSORPTION SYSTEM Bed: Trench: -~"r Seepage Pit: ~~~ ~~ Width:~Length ~ Number of Lines:~_Area Built 3 ~~ Exist. Grade Elev. ~ Proposed Final Grade Elev.-~,.,~.~~ L ~ Fill depth to top of pipe:_ ~ ~. ~+~. feet frari nearest ~~pr~~op. iine:r~ront„Z(L, SiQe Rear Ft. No. feet from we11:~~.2.~._No. feet from building_/,,~~ HOLDING TANI~r Manufacturer: Capacity: No. of ngs used: Elevation of bottom tank: ----~'~^~ Elevation of in No. feet from neares line:Front , Side Rear Ft. No. feet : Well , building Barest road ---__:, Alarm Manufacturer: P~,.~:~ #iae7~ y DATE : ~ ~ / ~ `J'~ INSPECTOR: PLUMBER ON JOB : .~G~. /~f LICENSE NUMBER : /~'J/~ S'~9G 6/90:Cj _~ •-- '-- FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER U ~/ff/% ~¢'f / J-/~7'~ TOWNSHIP GGE'/~/~vD~c~ SECTION~T ~D N-R~W ADDRESS~fi~L/ -- /,~Q 7"'~} i¢V~ ST. CROIX COUNTY, WISCONSIN ~L,~N~vooc~ Gtir~'X ~yi~ SUBDIVISION ___.___.. LOT ''LOT SIZE~- PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Alternate benchmark SEPTIC TANK:Manufacturer: 1i1.~ ~ /~(^ ~ Liquid Cap. /D'az~ Rings useds~Manhole cover elev:~3~~Fina1 grade elev: ~ f~ Tank inlet elev.:~'~ /~ Tank outlet elev.: ~~,~~ ~~ T No. of feet from nearest road:Front, Side , Rear Ft. _•~i~ BENCHMARK: Elevation and description : f o p O /' T~1 ~ ,p/~p IY e ~~ d . ~"' L_-. ~~ PUMP CHAMBER Manufacturer: G~-' .ems ~ ~~.5 Liquid Capacity: 8G' l/ ;ZoeLc.~R Pump Model:~~_Pump/Siphon Manufact.:2~'~L-L~~Pump Size1 i Elevation of inlet:~Bottom of tank elevation ~d~~~~ ~~ii .~ 1 Pump on elev.: p~?, o2 Pump off elev.: ~~,~ Gallons/cycle: / ~~ Alarm: Man.:s,T~lc-~~'f?D Switch Type:~LLocation_IN MD~dlL~ ~Ohfe Distance from nearest prop. line: Front/6 Side, Rear_Ft. Distance from: Well / ~ ! Building / 7/ SOIL ABSORPTION SYSTEM Bed: ~ Trench: -~^ Seepage Pit: Width:_~`Length ~ Number of Lines:~_Area Built 3 ~d Exist. Grade Elev. .*~ Proposed Final Grade Elev.~_L~~ L ~ Fill depth to top of pipe: ~ ~. No. feet from nearest prop. Iine:Front~i, Side Rear Ft. No. feet from well :~~_No. feet from building_ / ,~~ HOLDING TANl~C° Manufacturer: Capacity: No. of ' ngs used: Elevation of bottom tank: _._..---°"`-~ Elevation of in No. feet from neares Iine:Front , Side , Rear Ft. No. feet f Well , building nearest road Alarm Manufacturer: INSPECTOR: DATE : / ~ / ~ ~~ PLUMBER ON JOB : ,,~~C ~~~: LICENSE NUMBER : ~/I/~ S~YG 6/90:Cj _. • DEPARTMENT OF INDUSTRY, LABO MAN F~ELATIONS . .BOX 7969 S,~' ~/12DISDN; W1,53; 071 ~w Tawn a~ G.~eviwaad 30~h Ave. NAME HOLDER: 9 ~ O O Q BtLf.Qn Sm.(.th Mab-(,ee ~s~ate~, G~.eVlwaad C-(.~y, GII 54013 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: ,LS 7 ~ ~~ ~S I V d / . . D Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Gage w. Smith 5690 S~. Cna " 8769 TANK INLET ~ /~ ~ ~ ~ ~ ~a PRO DED: PR ~ rr ~ 61.(! YES ^ NO ^ YES NO BEDDING: DIA.: © ~Y~1V~MATL.: G' O. HIGH WATER NUMBER OF ROAD: ALARM: ~ PROPERT LINE: / WELL: BUILDING: VENT FRESH / AIR INLET ^ YES NO , ~~ . FEET FROM ^ YES NO NEAREST ~ w ~/CID ~~ ~Z DOSING HAMBE ~~. r .T = O. ' $,. ~ '~ _ ~ ACTURER: MA N UF BE ING: PACITY: ID A C PUMP MO EL: PUMPFCWFI6I~LMANU A R: WARNING LAB L PR VIDED: LOCKING COVER PR VIDED: ~ ~ ) (ICJ ^ YES O ~ p ~ $c/CJ e ~ ~J f ~~'" YES ^ NO YES ^ NO GALLONS PER CYCLE: PUMP AND CONTROLS ATIONAL: NUMBER OF PROPERTY LINE: WELL: BUILDI G: / VENT TO FRESH AIR INLE ~ / I r EEN ~/ N O P S ^ NO T ~ ~ ~rU ~~ Z~ "" 2 - UMP ON AND OFF E NEARES -~ SOIL ABSORPTION SYSTEM. Check the soi moisture at the depth of plowing FORCE LENGTH: f DIAMETER: MATERIAL AND MARKING: ' / ' or excavation. (If soil can be rolled into a wire, construction shall cease until ~ ~ ~ Ir MAIN the soil is dry enough to continue.) Irn~lv~urlnuel cvcrFUl• SEPTIC TANK/ WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: I BED/TRENCH DEPT H: DIMENSI GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR. NUMBER OF PROPERTY WELL: B TO FRESH BELOW PIPES: ABOVE COVER: ELEV. INLET: ELEV. END: PIPES: FEET FROM LINE: AI NEAREST ~~~ MOUND SYSTEM: ' ~ : y'u7y .3~/ - f : ; ,r %°..', 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 ~~~.2~ ~,~~ ~Np Sa'~,d meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER I tx l uHt: ~.C~~G ~ 3..._ Sc 1 S,. DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED D THS OF 1 CENTER: EDGES: PRESSURIZED DISTRIBUTION SYSTEM: WIDTH: LENGTH: NO. OF LATER a-i1g1tIRENCH _ / / ~~/ ~ TRENCHES: DIMENSIONS (~ JCf- , MANIhVLU ' !'UMY / MAMYVLI ELEVATION AND E ~,•, ~ ELE~ 16~ DIA . n r DISTRIBUTION HOLE $~E: HOLE SPACING: DRILLED INFORMATION /~/ '~ . ~~ // ^ NO COMMENTS: ._........... - - - S ^ NO ,~ -~ ~ . ,~'' ~,Id~ = 9s~ ~~ INSPECTION REPORT FOR ON-SITE SEWAGE SYSTEMS SAFETY & BUILDING DIVISION OFFICE OF DIVISION CODES 8 APPLICATION State Plan I.D. Number: CONVENTIONAL ^ ALTERATIVE (lf assigned) ^ Holding Tank ^ In-Ground Pressure ~ Mound ~ c ADDRESS OF PERMIT HOLDER: INSPECTION DATE: _ ~ c, ~~ Vi !ES ^ NO DES ^ NO ~DED: /_ SEEDED: MULCHED: ^ YES C~"NO ES ^ NO S ^ N( RAVEL DEPTH BELOW PIPE: rf D MATERIAL: NO. DISTR. DISTR. PIPI PIPES: e DIA.:~ ~' COVERCOVER MATERIAL: T ~~ DN w NU ~BER OI ~E TFROM YES ^ N .3 N E // c~ , c({) ~vr- VERTICAL LIFT CORRESPONDS TO APPROVED PLAN -r-~y_ ~ ES ^ NO PROPERTY WELL: I BUILDING: - LIN Sc, ~ a/~ ,~ ~~ . o -~-~ CAI-IITAQY D~QSAIT ADDI 1(t_ATIA111 ~' ~IL'HR __.._.. ~.... _........ -- - ---- - - ---- In accord with ILHR 83.05, Wis. Adm. Code iIIllllllllllC.~°....,...~,,,w co _ r on paper not less than -Attach cmmplete plans (to the county copy only) for the system STATE SANITARY PERMIT # ~ (~ , 8i~ x 11 inches in size. ^ ~ ~ ~~ chec i revisi n eviousappiication -See reverse side for instructions for completing this application. sTATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION. _ ~~`-- , PROPERTY OWNER? .. ~ S PROPERTY LOCATION ~ ~ %a, S,~ T , N, R / ~Or W -- %a PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER ~.~ ci.: . ~'7F' ~' .~ o I.3 ~ ~s ~ ~'` ~ 11. TYPE OF BUILDING. (Check one CITY ~ NEAREST ROAD ) State Owned O VILLAGE ~^~~ ~ , Cd` ~ r~ . ~# of bedrooms A EL TAX C~ ERO 2 F Dwellin bli m ^ P ~ 1 ~ g or a . u c III. BUILDING USE: (If building type is public, check all that apply) ~ / / ~ J ~~G ~~ ~C - O G 1 ^ Apt/Condo 2 ^ Assembly Hall 6 ^ Medical Facility/Nursing Home 10 ^ Outdoor Recreational Facility 3 ^ Campground 7 ^ Merchandise: Sales/Repairs 11 ^ Restaurant/Bar/Dining 4 ^ Church/School 8 ^ Mobile Home Park 12 ^ Service Station/Car Wash 5 ^ Hotel/Motel 9 ^ Office/Factory 13 ^ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ~ New 2. ^ Replacement 3. ^ Replacement of 4. ^ Reconnection of 5. ^ 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 13 ^ Seepage Pit Pressure 43 ^ Vault Privy 14 ^ System-In-Fill I VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRAD REQUIRED (sq. tt.) PROPOSED (sq. tt.) (Gals/day/sq. tt.) (Min./inch) ELEVATION ~ ' ~ ~ Feet ~. UJ~ Feet ~ VII. TANK CAPACITY in allons Total # of ' f t N M Prefab. Site Con- Steel Fiber- Plastic Exper. INFORMATION New istin Gallons Tanks ame anu ac urer s oncret glass App Tanks Tanks structed Se tic Tank G Lift Pum Tank/Si hon Chamber X 4 AV VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) MPNNQ.: Business Phone Number: Plumber's Address (Street, City, State, Zip Cod e) : ~~ *+ .,c IX. C LINTY/DEPAR ENT USE ONLY r ved A ^ Disapproved ^ Owner Given Initial Sanitt88ryry Permit Fee (lnciudes Groundwater ~ ~rcharge Fee) ~ a e ssu Issuin Agent Sign lure (No Sta ) pp o ~~. p ~ Q Averse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: ~ I SBD-6398 (formerly Pib-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety ~ Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. "` 2. YDUf 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. A1.1 revisions to this permit must be approved try the permit issuing authority. 4. Changes in ownership or plumber requires a ~~anitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly'maintaineii. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 10 3 years. _ _ ~ _ , , 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the ' State of Wisconsin, Safety & Buildings Division, 608-266-3815. ' To be complete and accurate this sanitary pet'mit application must include: F . ;, I. Property owner's name and mailing address. Pr~~vide the legal description and parcel tax number(sj of where th.e system is to be installed. - II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling, II1. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Compl~ate 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 a// septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIN. 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'r`i 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; distrilwtion 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 11:i 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 S T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor.,("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of Property ~,~ Z-ZZl ~.--% ~~~, ~~~~ Location of Property ~--'~ ~~'~~', Section ~ ~ _., T,,~ N - R ~W Township ~ ~~,~ c ~ z'-z"~-cf~' Mailing Address ~?~z~~~-~c' e~ ~,1L R" _ / ~ Subdivision Name Lot Number Previous Owner of Property ~1 2«'.Y~~~'.l~ ~l ~~~ ' Total Size of Parcel _ 1 ~ L" /.'~~~' 'Z~ Date Parcel was Created ~ ~ Lr' ~~ Are all corners and lot lines identifiable? Yes ~~ No Is this property being developed for resale (spec house) ? Yes ~ No Volume and Page Number as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract '''~ ~. Other recordings filed with the Register of Deeds Office 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 the Certified Survey Map shall also be required. PROP~RTy OUINFR C~R7I~ICATION I (wet ce~%{~y ~h.a~ a,P.e, bzatemen~s on zh.%.6 ~anm ane ~lcue ~o zhe be~s~ a~ my (owc) ~znaw.2edge; ~ha~ I (we) am (ane) the awnPJ[ (b) a4 .the pn.apehty deischi.bed ~.n .th.%a ,~n~atima~i,an ~arrm, by v-v~.tue ob a wa~vcarLty ~d~e~e/d necarcded ~.n the O~~.ice a~ fi~ie CauvLty Reg-us~en o~ ~Deed~ ab ~ocumenx Na. ~t~l ; and ~ha~ 1 lwe) ~ne~sentey awn the pnapo~ed d.cte fan zhe b age paa bybZem (an I (we) have ab~ac:ned an ea~5ement, ~o nu.n w.cth ~h.e abave de,~cnibed pnapehty, ion ~:he conb~cuct%an o~ ea-t.d ayb.tem, and the tame ha6 been du,ey neeanded ~,n the 0~~~.ce afi the Cvunty Reg.us~elc o~ ~eed.~, a~ Daeument No, y~.3 f ) fir ~ i . , ~~ , Nie~ser g• Pattop .od J„L..fia~b~ll~, tlinaaaota Y `~X ~iyaid~ta. ~ ......... ... ...........................rAA...«......... .-...................................... .«......... - eswesss std waeeattis •b ...~&~i~1..~t~..~ ~ •1?~lA~i4e..i"Ia •f~~tt.. .. .. .. ~. .~iA..1{i>d..1t~~8..tu:.AliE7[~XfIT. A~..l~~~..~Q~RT~i~ .............. r~. ..............r........._...rr..r...._.._.R......... yR.. ...................... r....... r..r.....«...w...r. u..~.uM.;s Mreeib.e.,wi•«iow ~ ........~~.~~ro~x ....................Cwett~ /tab ~ Rieeunis: ~~ ~` .~ ~, ~. .v F_ ~ f T ~ >~'tf ~~ p. a. ~f~ .._ ~ ar~r ~~ xx:.~ {Y±~ ~ ~ >. ~~ { ,r ~~~~ ~=~ ~..~~ TRAM- ,. North one halt (N 1/2) of the Southesat quarter (SE 1/4} and the Southesat quarter (SE 1/4) of the Southeabt quarter (SE 1/4), Section Twenty-eight (28), Township Thirty (30) 1lorth, Range Fifteen (15) Wes+.. ~~. This .... iP.r. YIOt heasNt~ad t~'sWrtlr- Mrt tv ost) ..... !; E:eep~ ~ ~ 3ubjettt to easements and rights of xay of recor8, ' county coning ordinances, it any. `-_=~ ~` - " ~ Dated this ..............~~............... .. dar of . .............Augt+tat:............._................ 1990 1`{F t` ..........:.........................................................(SEAL) ........................... ................ _ tS~Aj,~ ,- -~ ..... .... ..A..iG1....hF.....(SEAL1 •-. .!$~Ji-i ~ ~+'=~, ... r~ ,. ~ >~,:ti i AQT1[1!!f?IQA?IOhi ACEN0WLEDd1tENT ~ }4 '9 .., ~ ~~ ,~pwtitn~e(y .r....I~t,Cbf~,..IY..PA.t.~Oa .................. 8TATE OF WISCONBIN ;,. } ' ~ ~ J s L. Gaspbell ................ sf. ~`' {..'~~4 .. «.....":"~' ........... .._.... - ....Pw~sonaUi-sawn befih wts:thk the aLon~ ttas-~ ~. `" ,~ TIT l[EIiBER A'1'• OF WISCONSIN .. ....... ......... .- `~' ~•y i IIM.OSS.~~/is.~8tsts.)...° ................ to me knows to br.~...._................ .. .. ~ ... ........ .. .. .•.-•pstsett•..•••--.. who.exars'led.tM j ; fotazoit~ ittstrotuent and aeknowhsdp the. same . : ~` ;_-; `} twos u+sntuwun wns ae~o w ~: '" ~f ...~:NAcis X. Rivard, ....................................................... ~"`~: - ! .... Glenwood. Via. wI.54013 ................•---•• Notan+..--•-•--...............................:. ~. .. ,....... .. .. Pnblk ............ ............... :Coant~, Wis. tagr M aWl~tiinbi oe akaserisdesd. Huth )ty Cotatnissiea is pe:a+anent. (if tat, Mate expiratiea ~'. i1! Illy t~01~Mlf.) dab : ................................................. :, 19.. ... ~ s1l~t~ at nwMas stf~its is w set~Uls t~N rt Rrfk1 K selta./ 4dw. wh .iswa~w. 3TC - 105 OWNER/BUYE' ROUTE/BOX CITY/STATE FIRE N0. ZIP ~! .~ PROPERTY LOCATION:~_~1/4 _~ /~ 1/9, Section , T,~_N, R~W, Town of C~.EJE~>,,-~--~."~'~-.-1~`~ , St. Croix County, Subdivision ---~"~~---- , Lot N o . "-"`~ Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a LICENSED SEPTIC TANK PUMPER. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County Residents MAY be eligible to receive a grant for a MAXIMUM of $3000 of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of ALL NEW SYSTEMS agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping o f necessary), the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Department of Natural Resources. Certification form must be completed and returned to the St.Croix County Zoning Office within 30 days of the three year expiration date. ~7 SIGNED_ ~~.r'1_t '~ i ~ .~'`,~br?'l l'{2~ DATE ~` ~~ 7 _ ~~ St. Croix County Zoning Office St. Croix County Courthouse 911 4th Street Hudson, WI 59016 (715) 386-9680 Sign, Date, and Return to above address SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County DEPARTMENT OF REPORT ON _SOIL__ BORINGS AND SAFETY & BUILDINGS •INDUSTRY, DIVISION -._ LABOR AND• ~ PERCOLATION TESTS (11J) MADISON WI 53707 HUMAN RELATIONS (ILHR 83.0911) & Chapter 145) L CATION: ~/ ~/ SECTION: N/R~ W 2 /T TOWNSHIP/~: LOT NO.: ~ BLK. NO.: - SUBDIVISION NAME: a ~ cor- ,~o ~~ - ~,, NTY 00 0 CBUYER'S NAME: MAILING ADDRESS: ~i --,lja/3 (f ~f ^ / ~ ~7 ~`w ~/. /~~,,~/ j n 1T ' w ~ ~/ ~ ~ V L ~/S O~ 4~ ~ / 1 ICF I NO. BEDRMS.: COMMERCIAL DESCRIPTION: L~Residence ? ~-a New ^Replace RATING: S= Site suitable for system U= Site unsuitable for system DATES OBSERVATIONS MADE PR FILE DESCRIP IONS: PER OLATION ESTS: ~~~ ~- 90 6-~. ~ 90 CO NVENTIONAL: DS ®U MOUND: ~S ^U IN-GROUND-PRESSURE: DS ~U SYSTEM-IN-FILL ^S ®U HOLDING TANK: LAS DU RECOMMENDED SYSTEM:loptional) /~DUIV d If Percolation Tests are NOT required DESIGN RATE: If an ~ y portion of the tested area is in the under s. ILHR 83.09(511b), indicate: 3~ ~iM Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- / i 9/ / ~ o ~ o ' ` ~ L '~ ~ B- ~ ~ ~i ~ ~ ~~~ ~ ~ ~ ` N d7~~ B- s- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD PER INCH P- 9 ~. P- a ~ 4 ~ ~- 3s2. P- ~ 1/2 P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. , SYSTEM ELEVATION .. ' ' o /oTH vim' Pei ,F~e v; ~!' g P3_- y1,~~ _ 3 ' ' p~ ,.6' 37 ,~... y8 ~; ~.~"~Ds~o~~ QM /oo' ~oA o~ ~"e`~'P~Ia/Ye : wed 0 '~ ~'N ~' aTRt.lCTi~' 7 ~IVIPLETt' ~~ M ~ 1~ - C~ - ~ ~ ~~< ~.>mplste ~ a~' y«u€" rep a~ . ~. J le: ~;il t~P,t:;rtl. , ~. 1S t}5SS ... yfi~~' '~, . Cort~p~ ; , ~~'~p ~ic~x~~~. ~~ ~~~ IS SLSITA~3` . ~~ TA1~K C1L~r p ALL L3°d"HE~ SYS-. ~ ~ IJLEI~ f~~~T ~' ~C~ C~ SC?!L _ . t'l"EASE e€~ ,~.1r€;~iatic:ns s~~ff~.°,s~ two itin~s ~r ..:~ti ~Woplt~tin t:~ ~~l~t plan; 7. ~~,~l~E A Ll* ~._ fliaeirarn accure atir~y your ; ;. ~2rati~riny ffs sea[e is pra~errcd. A rat._ : <'Y E~e~iaser.~l i; desired; ~ rrr ise€~ichrr,ark anrS ~~ertir:al eleveiior~ reY~ ;t are c;ii~arly shf3vvn, and are parrvtar~erti; E ,a,.. . C;~ ~ '~; all a~ai~ropriat€' [:~xaxas as ' narnc s, aii:.~ > :~, ioad plain data, perc..t~{atio€`~ test ex~;n~p- ~rr~r~ria~~e, I~7. fn {srreh as rIi ;i ~::~}does s.c3t a~~piy, i:~iac~ ('~i.A. in tine apprises€~?a~e br~x; 11. Si, ,a ~~~~: tc ,~ and plaeix yraur i;t11~€. a, ~~ ~ ar~i yizur i,+~rtifi~ation nr€n~ber; 12, Fake (€.gitrde copies anci clistrik~ute as ~ >c,,.€ired. ALL S{}iL TEST; t~~LJS'd` ~ FILED ~~'tTl-( THE LOCAL AllTl-#G(;1TY L'U(TH3N 3tl GAYS C?F Ct}l~~F'LETiC3N. A ,.~l1ATlC~N R CEF~TII _ E aTEf~ 1 ssaii SeparziYas and Textcxres S~ - ~` ~ ~~~'~ i;,~ -- Grza•a;~? (seder 3"! '`s _ Sane) iJS -- Caarse Sand €~aec1 s - 1~~1ec~iiam Sa€~d ~s -~ >^ine Sa.~c 6s - Li;;arr€y Sartc9 '~`si -_ r=y Loac-t~ ;51 .._ 1 ; ~rt~ ~yli -... ~E~Y: LOi3Il1 si -Silt cl S~€r€*lv Glay Li?an~ Still - -,(ty ="'~fay Loam? sie - y 1 ~C ...... $~'~ty t7t - F`~;«t >~, _~. ~ti7ui;ii. env' t}( f~E,;'ii~ ra? Si:il .Q' (€i.(t3iC~ kx'tiStB e1iS ' ;zaE ~. 0 C)ti~€:r Synsbols ~~ ...._ ~Pdri>C1C LS _ Lc€~~es'tr~,~e NGtr~i - H~€~1~ e'~i7YQ€.€€~d~Vati:r P?Yi; - ~2YCOI8ti E)n ~att; };fit _ Ghiel E ~(€1~~ -- ~3rr,lcli€~~~ ' ~ _ Greater TE:a€1 - Leas ~ I~~~n ;3r~ - ~3rot~u€~ ~I B1auk Gy - Gray Y Yel(o~v R - E~ec1 rtlf)C _ l~£:3kt~eS b1t/ -- L^^J1tPl off __ fe~a, line, faint cc -- r;o~~?mi~rl, coarse i~;€~~ - <_ s€~ediu€~r ~:~ ~- ~,,>mir~?rat H~~?rL - ~ih water Icvel, SLt r~ailF: 1n1 ~ tC'r 1~~~ 3er€c:~t lt~(a€•k ~.? F~''t~ - ~ff',rt€Cai ~e{'f: reriLX: ~£3€rlt a TO THE fJWNER; ~/ /v a,~ ~~c~; ~``.~'' ~ ve ...~..__..~ 7"eL~ pyo/Ve Pad .... ..~ 1 25 Ft, R~STR~c~'[D a.N-F,A I~ St}61~E5'i'~D R~-Q.avrE ~ B~ ~yT ~ ( G'F Tk'l~ ~CEZC~ MAt--t { /D ~ /ate' ~ L i __~_ ~ I N l ,fie ~,~. ~,~ ~ ~ ~ ~ ~ _ x ,~ ~ ..~ oc ° ~~ ., ~; ~- WAGS ~~~~~.~ ~,, ~ ,l~.~M {4iq, ~~, ~, Ma~fLe /~+ro ~ ~, 4..«~ / ~ ~' ~~ -• ~ A~w~~ -~ ,~ ~,~i ti ~J;ir~~' ~ pf ~ T a ~ ~ ... t .~ ,~- ;, ~~ ~`o ,L, ,.~. ~-. r ~' (~~'d~~~5~~ w elf si7~`~ ,, Straw, Morsh Hay, Or Synthetic Coverinq~ Page _ Of istribution Pipe Medium Sond -~ _ I .~...... Topsoil =:__---,~_- F `J ~ ~ - ~~ o E " 3 = _,.. , , b I~~SI~E j~ "~o slope ~~~"' • ' y~,ll Bed Of 2•- 2 %2 Force Main ~~c~w ~ Aggregate From Pump ~~ .. t;}S Ate ;R1r1-AjaD r~ A F IND~ST~Y . ~ ILEti+v DEt,A~jME tStON ~ row Section Of A Mound System Usinq `S~,iD~;~~~ A Bed For The Absorption Areo sf~ ~fl>t Signed: ~/ ~~~ License Number : ~~~_.L_e __ Date: ~~- ~7-' 9G' -_-- Alternate Position of i--`~~~.. Force Main L G Plowed 1_ayer i ~ .~1 Q . E ~ 1~.~... F . ~'~ c _/, o_ H L-> ='1 Observation Pipe--~ ~ ~ _ K b` .~~.-___.__.----------o ~~ ( - - ~.4,.,.t ,~ A I-- - -~-----------•----------- _ _ - ( Force Moin W ° ~_~_-.`.r~ __._...-_,_ From Pump Distribution Bed Of Z•- 2'2~ Pipe Aggregate I Observation Pipe Permanent Mark~s,~,,,D ~.. ~. ~ (;(o~ A ~ Ft. B ~!~ Ft. I I~~,~ F t . J 7,,_d~~ F t . K /p,~J Ft. L ~Lj~[~F t . W~~,~6 Ft. Plan View Of Mound Using A Bed For The Absorption Area ~ • .' ., Eno Co • End ~ 'erloroted 'VC Pipe x A. fx j ,~ P~ / PVC Monitold Pipe ~~~ PVC Force Moin From Pump \ .,t~ , i Distribution ; ---~ .Pipe ~ Lott Mob SAoutd 8• Nett To End CaD "; End Cop - Distribution Pipe Layout Signed : L2~ ~ ~„~,,~~ v License Number : /YJ /~ ,S'6~ p Oate: __ 7 - /7-- JD ~ ,,,~1:.::y ~~~~~s~~-. ONSITE SE~`dAGE 5Y5TEM '_ :~. ~ ® ~ ' QCPAR~(4iEN iNnUS1RY, LApOR Ahp ,lt~1 HELAI{ONS fON OF ~E ' INGS ,.. SEE COHRES i3NCI.t~~E ,.,,,., Page ._ Of •~ ~~ Locoted On Bottom, s EQuolly Spoced ,\ Alfernofe Potlllon 01 Force Moin From Pump P 9~- ~ ~~' S "~-^ X ~~~ Y ~~~ Hole Diameter Lateral " Manifold " Force Main " Inch _ 2 Inch(es) Inches _Z~ Inches r. `; ~. ~~~. . ~> Perforated Plp• Oetoll •r 'i"C.I. VENT PIPE ~ 25~ FROM DOOR, ~,JINJDOW OR FRESH AtR INTAKE Y!~ i8"MIN. F PUMP CHAMBER CROSS SECTION ARlD SPECIFICATIONS ' VEAIT CAP 12"M I U. l ( GRADE l I CONDUIT ~-'-" PAGE APPROVED LOCKING MANHOLE COVER OF y" MIND. V ~~~~~ \ \~: ~n ,~ ~( ~ ~~S~~ES=Ytl PROVIDE ~~~ TIGHT SEAL I A I ~~ NS LAZ1,Q I N B ~ ~ art;:' LAE'S~-'R AND ~ I D PF;~ZH~^.tIJ~ ,GN ©~ S ~ ~ I .r ~. C ~ ~ ~.~ll• Iti~~~~ I - $£E GOP.R£S NOENCE ~ I 1 PUMP-~.[~~ D_ .. ~ l INLET APPROVED JOlA1T t;l/C.I. PIPE E' ~E1~lDING 3' ONTO SOLID SOIL ELEV. FT. CONCRETE BLOCK-~{ IB"MIU. I;i ICI III I l I I ALARM II I I ~ o NJ I OFF ~~ APPROVED .I~ItJ i W/C,=. PIPE EXTEAIOIUG 3' ONITO SOLID SOIi •~ RISER EXIT PEP.MITfED ONJL`J IF TAI.JK MAIJUFACTURER NAS SUCH APPROVAL SEPTIC E 1D~~ ~~L SPEGIFICATIOf`!S DOSE j', TANKS MAAIUFACTURER: W ~ ~ ~s NJUMBER OF DOSES: ~ PER DAy TANK SIZE : ~Q O GALLOA] 5 DOSE VOLUME ~j ,r- ALARM MANUFACTUREfZ: S_fic°Lc°tL' t.~Z o IKICLUOIAIG 6ACK~F,L~O,W: ~O ~~~7 GAttONS MODEL NJUMBER: ,~D ~ /T ~ CAPACITIES: A=~~! IIJCHES OR ~ GALLOAIS SWITCH TYPE: M e 1~~ ~ R `~ n g =~INICHES OR s~~ GALLOIJS PUMP MANUFACTURER: ~,L ~-/G'~ /'S C =~I-JCHES OR 18 ~ GALLO*JS MODEL NUMBER: q~ D=~-INCHES OR ~ GALLONS SWITCH TYPE: ~-~ eLe[~T~D lS"D~'O IJOTE: .PUMP AND ALARM ARE TO BEY MINIMUM DISCHARGE RATE--~~=sr~„r~Q-GPM fNSTAtLEO ON SEPARATE CIRCUITS VERTICAL DIFFeREN1CE BETWEEI,! PUMP OFF AND DISTRIBUTION PIPE.. ~ ~ FEET -!- MIAIIMUM NJETWORK SUPPLY P/RE/~SSpUR~E/, ~2.5gp FEET /~ -~- / ~6 FEET OF FORCE MAIN X ~,.. ~rl~F/oopr.FRlCTlo~1 FACTOR.. FEET Q (~ "r"!~ ~Y.~ ° ~+~ TOTAL DYNAMIC HEAD - ~-.Lr7-t- FEET /i ~i INJTERNAL DIMENJSIONS OF TAiJK: LENGTH ;WIDTH ._.[L_L_-.;ttQU4D DEPTH f ~ ,~ r SIGNED: ~~L~,/ N/~ LICEhISE IJUMBER:~-~~_~7 D DATE: /~'h~9L WEATHER PROOF' JUNCTIOAl BOX •~ . a7 W ~ ~_. 8 25' a = 6 20' V a ~ 15' 0 ~ 4 N O F' 10' 2 0 ~- US GALLONS LITERS 5' HEAD/CAPACITY CURVE MODEL 97 50 M97 Automatic 1 .5 115 12.6 33 lbs. D97 Automatic 1 .5 230 6.3 33 I bs. N97 Non-Automatic 1 .5 115 12.6 33 lbs. E97Nnn-Automatic 1 .5 230 6.3 33 lbs. TOTAL DYNAMIC HEAD FEET/ METERS CAPACITY GALLONS/LITERS cAPACITr HEAD UNITSIMIN FEET METERS GAL LTRS 5 1.52 57 216 10 3.05 51 193 15 4.57 43 163 20 6.10 27 104 Lock Valve 24 .5' 80 160 240 320 CONSULT FACTORY FOR SPECIAL APPLICATIONS • High water alarms available. • Electrical alternators for duplex systems available with mercury float switches. • Long cords available. • Mechanical alternators available for duplex systems. • Over 130°F. - 54°C. special quotation required. • Variable level long cycle systems available. Zoeller Co. can provide complete packaged systems or combination of cornporents including controls, pumps, polyethylene and fiberglass basins. SINGLE PHASE UNITS Cast Iron Model Ph H.P. Volts Amps Wt. 110 400 RESERVE POWERED DESIGN ~ „~ ~ ~ ~" For unusual conditions a reserve safety factor is an engineered/design part~r~~e ler~iump. 3280 Old Millers Lane Manufacturers of .. . (502) 778-2731 `QU.I[~TY PUMPS SNCE ~~~~ ~~ ST. CROIX COUNTY wiscoNSiN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET ~ HUDSON, WI 54016 (715) 386-4680 July 17, 1990 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 Dear Sir:' An on site investigation for the Brian Smith property, located at the SE 1/4 of the SE 1/4 of Section 28,T30N-R15W, Town of Glenwood, St. Croix County, revealed suitable soils at a depth of 24 inches below which seasonable high ground water was noted. This site should be suitable for a mound. Should you have any questions, please feel free to contact this office. Sincerely,,,(, ,~ / ames K. Thompson Assistant Zoning Administrator cj r rr , GLENWOOD PLAT ~ ~l~ - I ~~0 - ~0 -Q(~ IJ / ~l,~zv o~6-/0(-~ -~,o Ioa ~. - 2 T-30-N • R-15-~ ~ - ~. f ~~ , ~ ., r, ~ _ .. .. ~ :, ,. , .: (Landr `) 2 ~/ • ~ a Y L See P e 112 For Additlonal Names. G/ FOREST PAGE 72 ~_ O + 7 ~~ ~ ~ ~~ " 2900 3000 DUNN CO. g S 3100 180th AVE M~p~ 3200 3300 4 2 , ~/ Y $ ShNla 1 Z N EA & Clan t t~+ 21 ~ N ""1 2 VJaOda t -~ ~ /~` Wagner ~'~ 103 P"~16 63 N s ^ '~" stela 30 Meivht \ ~~ ^ `~ ~_}~ s o N s S s NE I~tcL &° •°. s 8 4 f a~tt..n < 5 8 3 e S e ~ Iaun S O _ Michael 128 Hen ~ '~ ~ 2e, ~I ~ 1~ Slmonu ~`= ~ CJ~ t drSarah a Pitt ~ og 136 tot m Bahnub I p 'o y~`,JE!., y~U° ti. CasseBius ~ e ~~~ ` ,o a~0 a ~~ t ,o a ts' N 9 B 3941 ~. Ta a ,0 1 ~,CG .. 151 775th AVE 80 X I 234 , Huold rn o CqE f Steven ~~ G Ernest & June ~ Davld ~ ~ tr & Patrlda ~(~ 1 _-~~~ 81 d qu~mce a Severson ~, ~ c.» Sack ~ Gabower , ?3 .. Gordon Warner I ~ a Pa ~~~ ,,,~• Taut m ~ '~ ~ g Carol _ Bacon Jxkelrn ¢ 126 ~S /'/ffr/~/%1 80 92 100 1 170th AVE 217 ~y ~ ~ r 2581~~o q E ~~ 182I g `c, ~.. "~ ~a °° S Gerald n° S .°, S _ ~ _ _ +" . ~. _ o a VV - ~ ^I '.~ ~ Frank & M 5°a°iih5°a°'"" 'o ~ a ~ ~ I ~ n Daniel 1 o Donna h.. ~ 0 80 kQ r >: ~ ,. ~~ i< $~ury I ~9 Warner Wan I.yn~ ~!y IWBBam Jgt Jean atr 10 w Fount SqN ~.t_o. S , e 160 ~ sa s~ Marko ~ Or 165th ~Q~~ I & ~~ s>, 20 65 •.~ I ~ O 6 152 40' AV 2 160 t'! Ober ~~~_,~ D~ DaL I larnn wma- ~ an,ma G n$ $~ 8 Wayne m Shdla$ 23 S L 11 Waldroff roll ~ 200 ~ p h .o Bonte ~ ~ e~ 3 & Torleq Newcombe 151 rase, ~ Anderson Asp1 &~Shdla ~D 35 tlCC~~ m ~ Yoder Dav-ddo 79 ~~ Q 3d X ^ ~~ N ~l' N Illerrsa Q 71 160 Wapser 80 s u t s 40 80 6: 160 z n 226 Hoffman t z ~ z ss RD : 15_9 8 gpp Ker 8c Chue a tpO°'»s>.y z a ~~ 160th AVE laE 20 g N~ ~ H~~ ~ : z tA:: •.u~ •7~.. 4 • a I w g ~ ~ Yang ~ ~' -~ F„ Richard IaD 20 £ ~, & Rose pamlth c°°°" ~ ° • T0tl` ~-'~1.~ M{ Paul a a Idd 80 40 38 $Gram N Brown ~ r a Luks ~ ra r'°0' v t~ 1 p ro, 35 » ~~ 13 Susm I ~ 1 ~r ndier S ~~ ~g~g N ~_~ Narow ~ Robert w +°" (Gregory s.r >o _ L u11oN E K N zo a~o 9E ~y4fsxc ~" Palewlcz iw s`.s°4° & Lynn °y ^ - 1P1E D a1 160 110 ,r ~ 70 ,~^ F z 39 so~Ba~nser 74 Dts "' I a tr Cj_ ((~~xr~~ f p m J Jr t 1~ n y s 85 ! a Fa1CrAld I 80 ~Ti a W~~ y ~ ° Dak$Karla PWe6e~rson ~' .9~'.fl 92 y ~ z ii[au~nra~~~ ~ o john der 80 ; $ e~ KermBkr 40 Fred R O E`~ ~~ `~ ~ Corporation I timothy ~~ Oe stsesna r4tdwd ,szw ~~~'~> so6ert omen Barbara 'F Anderson mC1 aOOOOi gloss rave tl moo' ~, Drinlatua n x~ 4 ' 150th AVE 120 140 .o G ~o r Rio ~ 40 ,1S 3 OQ 79 119 150th AVE 217 s & trry net• H FJBson ~ s $ Kds a4 ui ~ a1 a Snsm 20 r BnKe 2 ~~ Ohman g01VirY 8 ~~ .r °aS~ Anderson 70 H » to 60 }i~sron 5103 40 ~- ^ stir: $ sans ar laberx sY6re £ ,pG \ ~ ~~~~ Konder $ ~O~ y0~ O /3 Jphn ~ 77 3 t2] ¢p roa 143 t= 145th AVE 133 78 ~ ~~ 8e^ 117 0 ° gyp[ 183 ~ E ~ ~ 3 M Wa ~ 198 ~~~ A ° e nn~aa ~ ~ °a'v"' GLEN OD ro is ~ X N Carton ~ •~~ ~~ u•.e • '8~ weber ~ ~ CITY s~ Dawa `~~ ~ 31 ~'v'io 200 , '~ (7 vans 40 12 ~ ~ .~ a w 4f,n x wn 124 p1ON' ~'k9 y ~. G ~~ ~ t3 - 38 B SrgraNa _up z O in+ePh 4 n RS m Z tb tia~m ~ tb T q 15 ur Davld Katlrkm ~ • 34 ~ ~ 231jt ~ pp~~ ohn $ ~~ a Schioeda O ~~ ObermutBer B~ tamer .a n ,P! • L ~ M~ I ~eCutehla \ ~8 a 78~ x sq oes-tm XAlsn 7 mm 00 ~-t w~ • 155 ~~~ 35th A E 'i~g+l~ gpt 1,~ n ~ a-ee ~ so R o DoM an a k t &uE W~~ J h laoasoeaph& ~ ~ 170 ~,~ 00 EBun 8t Lurie O EeK 8 orla i> ~ ~ losePb a ~f s brier so so Tom ,~ na \ ,, Dr>bQ 40 $ ~~~ .m .e ~ S~iber ~v~, nawa Q ~`~ ~~v, 80 r~ a ~ 60 219 40 n 3~ ~o 12 _ ~~~ 3K G so 119 , ~ Bruce ~ as ro 130th AV I1mmu 5 ~ ~ pavtd & ' >r tr N 4 Cares Randy ~ KKod novas 1 ro m ~ d N °~ rn • Therm 4z r I & ulie 67 $ Dom y g0 32 ,s 15 Z;>: ~~ 83 ~~ sir •+ Rottman s.w G aierson son m¢ $ n ~ ~ o~ runt 7 a y B burg ~ 130t~~ E ~, r~ I & I 72 ~ waa ao ~ aq snn,eR so w~ ~ 40 115 °tld w `~ GkOn ~ Tsdgrn 120 ~~' 66 Tdgm t~ N?4 sy~3 ~ n N S aua 36 noew• I _ ~r e,e,~.. p. r ~ tiw a D TDeanna 190 y w a $ 80 watac +s ,~ S ~~ ~ ~nthia g ~~ ~ t rrosby 79 I 40 282 ~ W McGee '~ 9 ~ Dadel & ~~ ,~ w.tee ~uek ~ s ~ Velma ~ 0 p &~ ~ Katherine ,~ ~ iSS ~ 1 Crosyy `~ ass-, ~ iG o 1 265 ro ~ Tuttle g0 DD ..,$ ~s. ,„ 19 4p 163 ¢ 80 ' 40 lam- a :idv..+ '+ HAGAN RD RUSTIC RD #3 SPRQVGFIELD PAGE 42 ~ GLEN H11.LS PHARMACY ROSS' LOCI~RS ^~~ MEAT PROCESSING 127 East Oak • Glenwood City ~ Full Service Pharmacy P '` JIM & TERRI ROSS Offering Brand Name and Generic Drugs • COMPUTERIZED MEDICATION RECORDS I I• I ~ ~ ! 424 1st Street FOR TAXES AND INSURANCES ~ ' ` Glenwood City, WI 54013 • GIFTS • CARD • CANDIES • FREE GIFT WRAPPING (715) 265-4565 (71 ) 265-4833 l ~Vl 1~~1 G'„2ti S~ ~~:, o/~- /ono- /a-i~o y~/~ . oi~ - - ago 5°~D,B - d/,b-/o6o`'~v..~c~ (~(o V ~ D/6- O p-GO -~ may ~ 1 863 ~/~ " 0 '" ~ VOL. 16 PAGE 4424 So -~'d ~~o) ~PScC m /lv ya I~~~iN~J ~/ of .sue %f D/G - /DLoO ~ le0 x417 yay~ R~IS~i'ER OF OB DS ~'~~ $~ %SE~% hLy' drs}zd ~s r;,o -~ o aye ST. CROIX CO., wI ~~ ~b .~kc2E.• ~~~v; ~sn~ 6n sau--~h SFi~ RECEIVED FOR RECORD ./~ _ i~ d 3 Q-~ Av~- CERTIFIED SUR1/El( MAP REC FEE: 15.00 LOCATED IN THE NE1/4 OF THE NE!/4 OF SECTION 33pA~S~~~3 .~/4 OF THE SE1/4 OF SECTION 28 T3oNR15W TpWN OF Gl.ENWOOD, ST. CROIX COUNTY, WISCONSIN. -" SCALE IN FEET i" ~ !50' 0~ 75~ 150 300 ~w~~C~~ JOSEPH s cLaRIA wALZ 3oze looTrl ave. c~ENwoDD CITY. wI. ,4013 BEARINGS REFERENCED TO THE NORTH LINE OF THE N NES/4 OF SECTION 33, ASSUMED TO BEAR N89°21'41'E, -~ PREVIOUSLY RECORDED AS N89°39'33'E. DON 6 JULIE FRIEBIAG C ~ ~ ~ GLENWOOD3CITY, WI 54013 i' /i ~~. Si/4 CORNER, SECTION 28 //~ ~ ~( (ESTABLISHED FROM SOUTH LINE OF 7HE \P~ ~~ ~~ 9 '. TIES OF RECORO) ~SEi/4 OF SECTION 28 ~ l~P~l ,--~ ~~ /~ alb c N89°2!'41"E 1518.33' Ni/4 CORNER SECTION 33 ( TIES ~~COF~ WI'~DTH~E / t~ ~ O :+ ~I ~~ ~ 41~ z~ ~~ .5 • +- 1 LEGEND -{y- - IrDICATES SECTION CORNER T (AS NOTED ). ~ ~ '" _~„c iE SEE~SF£ET ~2 OF 3 ' FOR CURVE LIFO. NORTH LINE OF THE NEi/4 OF SECTION 33 ` APPROXUWTE CENTERLINE OF DRAINAGE WAY I~®U 2 199.897 SQUARE FEET (4.589 ACRES ) ,~~6 NB9°56'3i"W 3BO.OD' O~ ~OT2 of 3 ~~., •DETAU.~ U~NyPI.ATTED LANDS AP P i`'~a FRIEBURG 5T. CROIX COUNTY _ 26 N99°21'4!'E 938.23' NE CORNER, SECTION 33 ( ESTABLISFED FROM TIES OF RECORD ) ~~ ~I~ W ~ ~` ~ ~ m iii di.. ~,~ ~I ~ ~` •.C O N ti~ti fi w ~'~. ~`, SPRINGFIELD PLAT ,'~~~,~ ~~.~~ ~,~.e ~/ ~~`~'-Z9-N • R-15-W _ (Z.i11dOW11erf~ GLENW ~ PAGE S6 ~ Ir See Page 112 For Additlonal N33~OOa. ~ _ 2900 _ I ~ 2800 DD Brian & ) 20 ~, ~u l~ -1 '~ ~ Stevrn I g~ ~ Mary Brl Annis tl °~ ~ pg +'- t a 156 ~ 6c Mom ~. - 8c Donna o ~ 40 ' 7i n~ ~ aa ~ 2 •I 3 g „$ „ u s w 3 29 10 « M u weld d ~-, s9' -0! Ctl~-o.~ 16 Sdm r ~ ~°n aw+s O~o• mot! t~ ~~l t+a~o ~ i D 120 q~' wvt ~ s$ ,w o~ ~ n ~>ro 160 p0 60 saws ~ . ' aFaWu o ii ~ Et3c a: ]uBe ate Cg ~„ ~ y ,t " I, sb -- 3~ .. ~ Seim ~ ~ ~ ~~ aeo & Donna o.r v. ~ ¢Mkhael I a ^ c..evnm ~~ ' d 'S r 92 „ 3 ~ mR ° ct6c Gloria IGa ~~ ^g Thomas ~~ 128 1s09 ~~ NGardna & Ma sync W~ ~ ~ ~1 g „•s ..41 m 160 ~ as a 'fl ~~ ~~ t2o~ ~ ~n a ¢202 _24 ~~ S - ~ ~~~ ~: s~ 510th AVE a Robet ~_ U v I 1 Fa1N QC $Onie may m ~ a~° F O 37 ~ C oekett .5 ~a~ 80 ~ 140 2p ~ $ ~~ 20 Za Glmn ~ eroe a F RI L O m ~ o ansce a Donald lamd ~ 5 ¢~, T~ Mahdn ~ ~ rn Leroy d: Do ° S ~ Diansse Johtlson MRan- ~ Forrest 8attul 75 a 40 ~ Seim Haines N v" ~ 40 80 37 69 720 Gtahm a 240 111 s ~ ~ 0~0 E ~ Robert r so ~_ ~ ~~ 1 o-+' M - &Pamela (~, ierq Paula )pima N ~ g '~ $ LE C$ S~ a g H43 D~99 ~ °r~ ~N ^"'~ YE~ ~~~o~ ovkh- ~3~ ~~~M ~ ~ ~~bl ~~ $ Janet aKk tl { ~~ & 8elty C fi sa b 4°8°°'° ~5a~ ~ GP ii^ V Fk 40 ~ s 5v,ao E ~ lest s rw raas a ara Fx ~ _7• sAas>m E.ebo era xesr R taps Y~ apke ~~ 40 I ~ M ~ anc 4o CiPS ~ ~ t~aos Inc 67 sr 39 o pp N • 37 ~5 m Sb~aOO 0 Eduard & ~ s' a Dn to a t ~~ V ^ w+sn~ a S ~ Sl ~ a o ®e9 C~,essla Jr Donna ~ a. ~ 9. y,,,6 -~ w dI Z >~ James dt 8„ g~ Wollxk eql 60 " Carpi I ' Eatt Sbawn 224 B~ettY 16 drone t y><ms" Vcasim & Item McCartlly 8~ebecea F.° ~ ro ~ r Gage Frye araasdt Her lnc 1ssM ,~, $ai~ 160 Nyhsts I ~~ a Creek 90 • lip Da S etal t 60 r Lyons 1 0 ^ t ayaoe 3~~f8 « S ~ -ames 318 S~ ~ 120 n ',~~ ty,mo- 90th O F_ ~e a ~ ~.r 74 $ M 90th AVE 37 ~ ~•~ o '~ 73 tl s~ E 40 ~ ~ ao AVE kt+boe<r a ~ ~ ~ -~ Dab Dab ash J~ BPeterson y~ R Karin / ' ~ ~ • moos a Swm N M~abo- A 3~ p 120 ~ Saott ~ ' 79 39~ fE71~ ~ so wt G1kG `~N 3 ner 40I ~ ~~-~ a Gr7 lack a llamas i ° n Smith * ~ ro gamey ~` 85th t ~rtn ~ :r Q~ / ,,amts ".d`' m"",' 27 0 eras ~ a.mo. 1 AVE 16o too 4 sda,sbau rs o ~• ~ Ric s~0 ~ antra ro D&a 20 ~~~ David a Leskf ~ Muy BHasd OJ oe ~ ro ~, aDtaoa ~i3 +6 wane ~ 20 Ronald 12` O Lanon 6o MAO°~ ~ ° ~~ I ^ Mavis Ss ,p w do Kay ~ '~y g ~L . 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