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016-1068-40-000
s ~; o N C O. 5q h ~i ti O n O O N O ti .i ~~ L • ~1 O N • rna ~~ V •~ O r`I..i t C O _O C ~I ire CC T'. .~ A O Z 'o C '' 3 N C N U y M ~ a I '; a~ ~ W ~ .- Z ~ ~ v '~ z ~ ~, a ° ~ a m m ~ z N ~ z ~ fp '~ ~ ~ '~ d Z d' N fA F- ~ V N C m r III y N N I C ~2 Z Z a ~ N N p1 y ~ d ~ M C .y NO I ~ y d ~ Seca I ~ N y N z.-> ~ OOO T a a a a II' U 3 o vi ~ '', $ °o °o I, y J U l ', ~ o 0 ~ r ~ C7 N ~-- 7 O O C > '6 Q 'O _~ i ',. L ~ l6 O O y N ~' 00 C ~I '. ~ y C a m ~ I I ~ ~ ~ N O to O _ o °3 ! ~ o ~ M C - ~ O M C7 ~ ' (A M O 7T ~" E a~ ::,~ a ~a 3 a ~ a d s `m y c E ~ .E ~ ~ ~ ~I U a~ I' O N v ~o o° I N I I I I I I I ~ I Z I ~ I .p Q s I I I I o I ~ I w ~' o I c Z ~ ~ I m I o I ~ I N C O O U Z C N N m C E m `° N I U a z = `°" I ~ o I z ~ ~ I ~~ I Q ~ } I Z ~ o _ N o E ~n ~ ~ d N W p~ N Q ~ ~ ~ ~ m ~ ch °' I N ~ C ~ ~ N N ~ ~ ~ ~ ~ .~ ~ r N z ~ Cn I I I i ii, WisGRnsrn .©e~artment of Industry, S O I L . N ~?:-SITE EVALUATION R E P O R T . Labor and,::Human. Relations ~ ~^. Division of SafeC~ 8 Buildings in aCGOfd with ILHR 83.05, Wis. Adm. Code Page E of 3 Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must includ©, but ST' Cf2~ t X not limited o vertical and horizontal reference point (BM), direction and % of slope, scal© or PARCEL LD. # ''dimensioned, north arrow, and location and distance to nearest road. ~~~- 1 ~~~"~~ APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIE DBY DATE ec, (~ S ~ a pfaOPERTY OWNER: PROPERTY LOCATION '.~f~I~~ 1-J~~tN-~J; ~66VT-~e~ 1/4 1/4,S.3Z T 30 ,N,R /,~'f;~jtW PROPERTY OWNER':S MAILING ADDRESS LOT ~ BLOCK # SUBD. NAME OR CSM # • CITY, STATE 'h~= ZIP CODE PHONE NUMBER ^CITY ^VILLAGE ~JCOWN N REST ROAD ;'CoL~NWOO.O t,i1S 5~~~3 f7~)Z.65-7~7~/ C~L~UI~ODl~ 130"~~`f}V~. [, j New::Construction Use Residential /Number of bedrooms f~ Addition to existing building Replacement [ J Public or commercial describe Code derived daily flow ~ 50 gpd Recommended design loading rate 0 •s bed, gpd/ft2 D. b trench, gpd/tt2 Absorption area required 37.5 bed, ft2 ~ Vench, tt2 Maximum design loading rate ~ ~ S bed, gpd/ft~ ~ - l,~ trench, gpolft2 Recommended infiltration surface elevation(s)10 b~ D~~2~J11N~b ,SY ~~ referred to site plan benchmark) Additional design /site considerations 2 ~ 5A/UD }~~ Q u r ~~ lh c ,~- / f~ LA1~~~P'F~ I Z'r ~" Parent material" ~OL~tGA-~-"f t ~r_ Flood plain elevation, if applicable /V~}- h ~ °S'= Suitable for System CONVENTIONAL IN~GROUND PRESSURE AT•GRADE SYSTEM ~Ir FILL HOLD " ~U =Unsuitable for s stem` ' ^ S U S ^ U ^ S .®'U ^ S ~J U ^ S L~S(U ^ S ~•'% SOIL DESCRIPTION REPORT U Depth.; Dominant Color Mottles T Structure istence Con Bo rx~x Roots GPD/ft Horizon in. Munsell Qu. Sz. Cont. Color exture Gr. Sz. Sh. s y u Bed Trt~ Z s'/a 1U / 3 y S I ~ ~ 1'1^~~L, F'; r'1"\-1 Y ~--5 ~ ~ ,-' 0. ( 3 10-/~ IDY `/ 3 51 ` I msb, Y,`\ ~_s O, z- 0.3 4 ~y-ZO fb viz ~~ fc>-~ ~ ~. s•,1 i o~~~b ' r ~~, r- ~: > o, 2 ~ o, S 2p- t0 Y2 3 rp C~.d t o y C~ 1 m5bl Y~t\-~ <= s -' p ,Z ~O, 3 ~ 2q 37 !oX/~3 mad ti sc~ mSbIL ,~~ -- 02:0,3 Remarks: ~Dt21z0A1S 3 ~~} H~ `~ 2-mp~ • SDM~ Gr IN AL1_ +-1c~I~I znNs L $-l~0 0 Y ..3/='• - 51 ~ Z rn,sb r'f~~\~r C.S _ D,`_> ' (), (o 20-25 7,5 Y 3 -" S t I ~:~ n k' C S - 0• `1 . S `~, ~~ •~,;, Remarks: SD.M~. Zm of ib-13''1 So~n~ a~r' L;~ n!-~_ HU"~ I z.n~JS N . r ~.~-,. - ~ - ie:-Plea o Pr!'n,t,~ Prrone. 2t) ~ ttUL~-IST~ ~'71~~C^-P7~~ ~2ZO Y30-n~,q.t-;E, ~tv~~.1~,.cs~Ur ~:,~-to~z ``,~i; z""~ ~C~~, / „~ Date: 'fGS ~~':.~0 ' PROPERTY OWNER 1-F~tN~n1 _ SOIL DESCRIPTION REPORT Page ~ of ~ PARCELLD.fs d~~' 101.E y(~ Boring # „kw'>: ~~w:ti ~_~ 3 :. fi~3. ~~< ~:~<< Ground elev. /~ rt. Depth to limiting fact Boring # Ground elev. ft. Depth to limiting factor Depth Dominant Color Mottles Structure Consistence BouxJa Roots GPD/ft Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. ry Bed Trend Z 5-1Z loy s~ _ s~ r 0 5 CS ~.~' o. 3 f 2-19 >. 5YR 7 -~ S J ~ Z 1'11~~1 >Y~r CiJ ~'. Q ~ ~ a s~J Remarks: .° •' . PLOT PLAN Property Owner 5b5~pN i-IANSOnI Legal Description LbT l~ GSM VOL,Z~ PG . S15, 5 EC, 3 Z, 7~,.3 6 /~ ~ !Z 15 w J TO ~~ or ~~Eni wooo~ sr~ u2olx ~ou,+rl-y~ W 15~.~1 S/ nl . SI?~ f~aJ~iZ~SS : 2 8 ~3 13O~+~~vE. OT• x 1 Z tl c AP'P>f;Ax. 1t oo to w~sr p/ L Q [3z ~ ~~1.9~' WELL G PUMP o -p~Przox• ~ ~ Loci ~ aA a~ ~ o N~M1 ~W>=J-LI~1C~ ~ ~1 r o /~L£(~TKtC. ~ Ll~~ ~/ ~c ~t ~t ~ ~r ~ ~c x 1 ~L®®'~ ~~,//L ~~ Signed CST ~ d d~"''"ti.J ~p3707 Date D~.1y~6~K 19~ 199 _ ;c 0 0 Page ~ of 3 Legend :~N ~/~ ~ ~C~~ W ~~ ~D ~~6 .o ~,a Q w~~N P $,h #Z Co/zou,uD~UR~C~ Ar" L ~I -cGe pq K ? K~2~ -- ~0 N O? .D 4S~'f ZUCJB = soil boring w/backhoe ,' g, 22 fl CRS SI'T £ l ~J ~ j1,q 5 c~t_ 13O~}~y~ .Db NoT p~STUR6 Q$3 ~G'` ~~ £L lO3.SD' ~'~XIS'i1a16 ~~\Uy /aU'~ ?~ .ST ~p ~1 fl81 Ex,srtw~o a~D pounl>~-riua ~-L~ EL I~1.O' ~~~o S~P~ ~$~1.#2 ~ttK~~o~x~llesE ~~~ ~Un ~ ~ Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). Permit Holder's Name: ^ City ^ Village ^ 17bwn o >ell, Milt Glenwood Township CST BM Elev.: Insp. BM Elev.: BM Description: / ~~ / ( U ~t r d `G TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic f c~ ~ r p J d Dosing L ~. ~a ~S ~'j Ho ding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. vent to Airlntake ROAD Septic > dG' ~/adr ~j~~ ^~~ ~' NA Dosing > 6 ~ ~(UU ~ 3 ~ ~~~Z~ NA A tion NA Ho g ,c rvmr > >rrnvrv nvrvnw~rl r wry Manufacturer ~ L~ Demand Model Number P v ~./ 3S• I GPM TDH Lift ~ Friction ~ LL FS~rstemZ 5 TDH ~, ~ Ft Forcemain Length Z ~ Dia. 2 ~~ Dist. To Weli SOlL ABSORPTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No.: 363907 State Plan ID No.: Parcel Tax No.: 016-1068-40-000 STATION BS HI FS ELEV. Benchmark ~~ 0 ~ 0 ~, 6 rr ~ v Alt. BM + ~ S y z Bldg. Sewer 0 ~/ Ht Inlet ~ , Q y 9j , d Dt Bottom ~/ Z Header /Man. Y (<~ `~ L. 3 Dist. Pipe y' ~ y ~ G' 9 Z Bot. System s'3 .~ 2 4(' ay i G • L Final Grade St cover , ZS °f ~ ,79 r .s ~ .S` o BED /TRENCH Width ~ Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMEN I N ~ ~ S ~ Z ~ DI SYSTEM TO P/L BLDG WELL LAKE/STREAM ~ Manu r: SETBACK INFORMATION Type O ~- ~ ~ I ~ CHAMBE Mo um er. System: ~ / / OG rj 7 nG 0 OR UNI DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length , ~/~ Dia. Z ~~ ~ .~ Length,~,,_ZS Dia. ~ Spacing ~~ I ~ 3 ~~ ~-' SOIL COVER x Pressure Systems Oniy 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 ^ Yes ^ No ^ Yes ^ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: tl~ l ~ `~ lbw Inspection #2: ~ / 1 S'/ o0 Location: 2$63 130th Avenue, Woodville, WI 54028 (NW 1/4 NE 1/4 32 T30N R15W) - 323015475B -Lot 1 1.) Alt BM Description = `~*p ~ ~ ~°U^~~<?'%a-- 2.) Bldg sewer length = /ya ~ ~r<,.-off ;~S~a(~<oP -amount of cover = > ~ ~`"" I"~` 3.) contour = `., d ~ (~~. 0~ ~ - y.~~•e/C ~,~,as ~ e~Ga~iw~ U,el~> a rPw oKC ~ ~ d~~`~(c~ Plan revision required? ^ Yes ~No ~~-~ Use other side for additional information. ~' / ~ ~~ ~ L SBD-6710 (R.3/97) Da a Inspector's Si ture Cert. No. S~_ ~~~ Safety and Buildings Division ~•ISCOnsin SANITARY PERMfT APPLICATION P°o eow3o2ngtonAvenue In accord with ILHR 83 , ~ i~.(A rr), ~ Madison, WI 53707-7302 Department of Commerce ~ - • Attach complete plans (to the county copy only) fort ~'~ em, pa,~r,r i1Q county than 8 v2 x 11 inches in size. . _ ~~~p,, ST CROIX ,~.,. , r°" St to Sanit r Permit Number • See reverse side for Instructions for completing this app9lcatlpn. `„~ a ~ 6 3 y+ 0 Personal information you provide may b e used for secondary purpos s-' '• ,yT ~~ ~~ ~ Check if revision to previous application / [Privacy haw, s. 15.04 (1) (m)]. Zd'~ l9 ~ (38 ~ U e , ~ ~ ~ ~' ~ ' State Plan LD. Numbe rSITE ID # 187298 ,, I. APPLICATI N INF RMATION -PLEASE PRIN I TIO ~ RANS ID 302160 Property Owner Name c-,-"~,., ~ ~~ p~ LOt ion N R S T E 'W j MILT SELL , .-~` tla, 32 30 r 15 /~~ Property Owner's Mailing Address /~;////// 184 250TH STREET t 1 Block Number City, State Zip Code Phone Number Subdivision Name or CSM Number ~ WOODVILLE WI 54028 415 )698-2164 ~ II. ILDI (check one) ^ State Owned ity Nearest Road ~ a Public 1 or 2 Famil Dwellin - No. of bedrooms n OF GLENWOOD 130TH AVENUE Tow III. BUILDING USE: (tf building type is public, check all that apply) Parcel Tax Number{s) 016-1068-40-000 1 ^ Apartment /Condo 3 Z- 3 - /~ y ~" S~ 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 box on line A. Check box on line B, if applicable) A) 1 _ ~ New 2. ~ Replacement 3_ ^ Replacement of 4. ^ Reconnection of S, ^ Repair of an _-____System ____--__System- -_TankOnl~r_ __ Existing System ____-___ Existin~System ---------- ----------- B) ^ A Sanitary Permit was previously issued. Permit Number 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 Pressure 1 42 ^ Pit Privy ~"~ 13 ^ Seepage Plt k 43 ^ Vault Privy 14 ^ System-In-Fill ~r nl~ 6 /, 2s,~ VI. ABSORPTION SYSTEM INFORMATION: 7. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Pert. Rate 6. System Elev. 7. Final Grade 450 ~ Required (sq. ft.) Proposed (sq.j~) (Gals/day/sq. ft.) ( in./inch) ~ Elevation // ~ 375 375 ~ ~~X 1.2 N/A .96.25 Feet 98.55 Feet VII. TANK Ca acct INFORMATION in silo s Total # of r Manufacturer s Name Prefab. Site l S Fiber- Plastic Exper. Ne E i ti Gallons Tanks Concrete tee glass App w x s n strutted Tanks Tanks tic Tan oruvldirag-Tank 1000 1000 1 IDWESTERN PRECAST ® ^ ^ ^ ^ ^ Pump ank r 650 650 1 IIDWESTERN PRECAST ® ^ ^ ^ ^ ^ V SPONSIBILITY STATEMENT t, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plu is Signature: s) MPlMPRSW No.: Business Phone Number: ENNIE HELGESON 220292 715/772-3278 Plumber's Address (Street, City, State, Zip Code 1229 770TH AVENUE, SPRING VALLEY WI 54767 IX. COUNTY /DEPARTMENT USE ONLY ^ Disapproved Sanitary Permit Fee (~ndudesGroundwater ate ssue Issuing Agent Signature (NO Stamps) Approved ^ Owner Given Initial d /~ Surcharge Fee) '`f' ZS GU verse Determination A ~ X. CONDITIONS OF AP/PROVA/L /REASON/S FOR DISAPPROVAL: ~ ov~l~o /a ;,, ~ ~a1,c ~ ~ to reF~,v y S ~~~ 0r ~Z har->t/~~iT P~aC JO C ~ / Gr G'~L/ ~r at.~irr 3 S ~ ~^ w~. ]R.S f b ~ ~ r a~ ~ ~ l ~l ~ (~ SBD- 6398 (R.11/97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber NSTRlhCT10 N 5 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiratipn date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer /Renewal Form (SBD=6399) to be submitted. to the county priorto installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning. your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing-address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. UI. Building use. If building type is public, check al{ appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County J Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. ~ ~ ~scons~n Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi. us Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary March 17, 2000 CUST ID No.267341 WEGERER SOIL TESTING & DESIGN 421 N MAIN ST PO BOX 74 RIVER FALLS WI 540 ~ ~ ~?""'• _~.__ ~ RE: CONDITIO PPR~AL ~~ PLAN APPROV I., I~XPI>~s~ n~6~/2002 SITE: "'~ Site ID: 187 98 St. Croix Cou Facility: Milton FOR: Description: Object Type ir, ~ .. F ~' " - c ' l- .~ { ; . '- ST C~~%. ~~~-y.. JOtIWx'I' ,F ty; Tow~9 .'~~~ ~e11,Residence ,.- ~, Three Befit System POWT System Regulated Object ID No.: 652614 Identification Numbers Transaction ID No. 302160 Site ID No. 187298 Please refer to both identification numbers, above, in all corres ondence with the a enc . The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sin erely erard M. Swim POWTS Plan Reviewer -Integrated Services (608)-785-9348, Mon. -Fri. 7:15 AM to 4:00 PM j swim@commerce. state.wi. us ATTN: POWTS INSPECTOR ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 DATE RECEIVED 03/13/2000 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 BALANCE DUE $ 0.00 WiSMART code: 7633 T'ITL~, S bl-~.L i MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE Page ~ of 6 LOCATED IN THE NVJ Z/4 OF THE N~, 1/4 OF SECTION 3 Z ,T 3D N, R ~S W, TOWN OF C-~L.~1wpp~ , ST• C~rptX COUNTY, WISCONSIN. ~.oT_ l of GSM VIE, Z1 Ptt~~ _SZ5 p~e~ ~~ ~t ptb _ lOVB- uD __ -- INDEX PA GE 1 'of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW-CROSS SECTION . PAGE 4 of b DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPTN G CHAMBER PAGE 6 of b PUMP PERFORMANCE CURVE PREPARED FOR ~ ~ L~- S !~L. L _ _ _ _ _ _ ~6~ z so 'rt+ sT. wOo©VILL~~ k1\ S~pZo PRE'PARED` BY P.®.V~1.T.S. C0~2~~t1011 C1~~y r ~D :PAR h1FNT DY CND BUiLD1~IGS IViS N F AF SEE GOR PONDENCE WEGE[~E(~ SAO I L .TEST = NG o~~®e0~t4010 DES 2 Gt~l SEF?V I CE ,~°~~ Q~~~"~s~-~ ~~ e~ P.o. Boz 74 sz1 ~. 1SAI!! sr. : ARTHUPL RIVfF. F~LS. YI 5402z ~* = w~cEa~R ~ 1I5-4[.,-OI65 ~ 2 /`ELt~riOg7H. , Z ,, ..,~ , ~~'~~~90 b~~~ 3-~-00 JOB NO. 0 O -3~ i PLOT PLAN • ~ Scale 1 "_ ~~D ' Page Z of ~, ~, X30 T~ ~ v o • U ~ , 1-0 Z 9.O `Rt ST, Z. _ ~.,~ , ~.i FJF ~~CZ.~.ss : ~ ~~ ~,~-~- L t,.,~ oE= 8 .Z z. ReR.c I~R~ZC.ill 2863 X30 `nf Rve~. __ ,~~' Do DoT c.~-n~i~eT oR- ~' I t2.gz? y ,l ~ D ~S'~v~Z.~ '1'ti1.S -°s1~ . ~~ '~ ZS f 3 t\ 8.3 ~ ~~ `~t2S~ 1" 2® ~ ~~~ • ~gt,Ee 3 -Z a e-0 _ ~ so'oF Z to Llad° @oy~~R Cyt f t?VC F.nt , ~~ ~~5• ~ a+~~z ~6' ZS ' '~S~oF y°PVC f p~ ~P, ~o cPcTtO~ 0~ L-X.tST 1-JG ~2~VY ~ ~ b C2..h~ ~1wlE ~~ -~-: tip0.0~oti Splk-~_°~1j P~3UUE'GRFIUM~-1-~_1_Q"_Di.K`C1~~ 8~ ~-Z- - Lst- . Cfl0.0 • _ti ~ l ti" '~ ~ , _ .. °t ~ ., _. _ S U+Kfl~ ~ LX LSTi~ 6 1.v 2Z.C_ NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. ( Z required) 3. Install 4" observation pipes with approved caps. ( Z required) 4.~Septic tank to be ~Opp~650 gallon capacity manufactured by 'h'1 ~Dw ~~ZN ~ 1Z~3T, 1 ~lJ c . 5. Bench Marks S~ 1°~$oV~. 6. Divert surface water aroundsystem~to.prevent.ponding at the uph-ill side. Approved Synthetic Covering Page 3 Of ~ F~STM C ~3 Distribution Pipe Medium Sand _ H_ ~~ Topsoil F Elev. q b.Z S -J I ~ D ~~ 3 Lt ~~ - - -_..~ ~~ ~Q % Slope Force Main Plowed Trench of %2"-2%2" From Pump La er Aggregate y Undisturbed @~'' ••~.'$,~'t. Soil E 1 •ZS Ft. Cross Section Of A Mound System Using F o-~ Ft. 1 Trench For The Absorption Area G 1•a Ft. A S Ft. H 1• S Ft. 6 -1 S Ft. " I l ~ Ft. Linear Loading Rate= ~•~ GPD/LN FT ~ -1 Ft. Design Loading Rate=p-Z.q GPD/SQ FT K 1Z Ft. L °I"q Ft. Aa-e Position of Force Main ~ W ZS Ft. I_ J ~ fuse B -~~-- K tDta>'n A ~- -- ---:.--- - w Distribution ~ Trench Of 2 - 2 2Y Pipe Aggregate 1 Observation Permanent 1 Pipes Markers • (Anchor securely) Mound Using ! Trench Far Absorption Area Page ~ Of . ~ Perforoted Pipe Detail End Co Install permanent marker at end of each lateral Holes locoted On Bottom, Are Equolly Spaced last Hole Next 7o End Gop End View 'erforoted 'VC Pipe Distribution Pipe Layout ~p P 3b•25 Ft. X finches Y 3~ Inches Hole Diameter `'.finch Lateral ~,~~ ~~ Force Main »'~~;,~ Inches ~ of holes/pipe 1S Invert Elevation of Lateralsg6•"1:SFt. 1Sx1.~1= ~1.SS~2. 3S•I GP-'~1 H Place 1st hole ~S from tee with succeeding holes at 3 ~Fintervals. Last hole to be next to the end cap. Combination Septic Tank and PUMP CHAMBER CROSS SECTIOIJ AND SPECIFICATIOtuS ' PAGE S OF -VE1.lT CAP ~ WEATHER PROOF ~uucTlou Box 'i'C.Z. VEAIT PIPC ~ APPROVED LOCKItJG ~ lO' FROM DOOR, \ MAIJHOLE COVER ivlZli '.JINDOW OR FRESH ~ \ t'`~Aft,~3IIJG C.r~gEC.. I8"MIN. I1.ILET Approved joint w/• PVC pipe A~IIJTAKE ~ ~ n f I ~ 't-l~ 0.~ ~ J. ,~i~~MIN,~t'sR1!1Dc I y~~-tJS~~crora PIPt w/H-tt~tsri-r ~t-P 3 ~yPFL~S Tank construction shall comply with ILH;; 1;3.15 and 33.20 LLEY.8g-~ FY 8q• ~O ~ CONDUIT I I ~-- .v, ~~; ~\~; 1 PROVIDE I AIRTIGHT SEAL PUMP -~ ~_,~ . ~J ~ ~, COAICRETE BLOCK-- ~(~ MIA.I. 1 ~ ~ 19' /yllu. III III III II ALARM Approved joint w/ PVC pipe I ~ o~, I OFF RISER EXIT PERMITTED OIJLy IF TAf`JK MANUFACTURER Hq5 SUCH APPROVAL~3,•Ap~'FD 8><DO I avG SEPTIC F SPECIFICATI~f~1S . DOSE TAfJK MA-JUFACTURCR:~~'p1'~~~~ ~~~~ IJUMEi ER OF DOSES: 3 3S TAAJK :,IZC : 1~4a ~ 6Sp GALL0IJS DoSC PER D VOLUME r Ay ~ - ALARM r MA-JUFACTURI`R; S.S. ~1~~~ S`i$~~s INCLUDING 6ACKrLOW: tab GALt_OIJ,S MODEL 1JUMgER: `~ ` ~w CAPACITIES: A- 1$ IUCHCS OK 30 to - GAIL Old S C~ SWITCH TyPC: _ ~~~~1Z' I B ~ Z INCHES OR ~~ =L G PUMP MAIJUFAGTURER: G DU L,1~ S _ _ S ~~~ (~LLOUS 1~o MODEL I.IUMHER: 3~Z) ~PO ~L C = IuLHES OR tiO CALLOUS 0= INCHES OR ~,~ GALLOA75 SWITCH TYPE: _ ~"~1~u=U1~-E/ IJOTE: _ PUMP AUO ALARM RE TO Cy'IO MIlJIMUM DISCIiAR6E RATE 3S. ~ Gp!„~ b INSTAlLEO OAJ SEPARATE CIRCU ITS VERTICAL DIFFEREIJCf DETWfEU PUMP OFf AuD..D15YRIBUTIO-J PIPE.. 6'~Z- FEE7 + Mlt~lIMUM 1~IETWORK SUPPLY PRESSURE , 2.50 FEET f ~0 FEET OF FORCE MAIIJ X 2.y3F%orrFRtCTtou FACTOR., O•~'~F FEET TOTAL Oy1JAMIC HEAD = ~° 6~ FEET As per manufacturer 1.-1. p gaI/in. .~ __ Liquid depth 3gti ' A a c D ~. ,; ~. • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. 3871 EP05 APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS Pump: EP04 • Solids handling capability: 3/4"maximum. • Capacities: up to 55 GPM. ,- ~"'-', • Total heads: up to 24 feet. • Discharge size: l'/z"NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Pump: EP05 • Solids handling capability: 3/4" maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size:lYz"NPT. • Mechanical seal: carbon- rotary/ceram ic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP, 115 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: l0 foot standard length,16/3 SJTO with three prong grounding plug. Optional 20 foot length,16/3 SJTW with three prong grounding plug (standard on EP05). METERSIIFEET 10F 0 a U a z 0 J H 0 s s 5 4 3 2 1 0 3( 2; 2( 1; i( 00 0 2 Available for automatic and manual operation. Automatic models include Mechanical Float Switch assembled and preset at the factory. FEATURES ^ EP04 Impeller: Thermo- plastic Semi-open design with pump out vanes for mechanical seal protection. ^EP05 Impeller: Thermo- plastic enclosed design for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ~~ ^ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ^ Motor Cover: Thermoplas- tic cover with integral handle and float switch attachment points. ^ Power Cable: Severe duty rated oil and water resistant. ^ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTING SA• Canadian Standards Association (CSA listed model numbers end in "F" or "AC".) ~ ~ ~~ ~ ~ ~ i --~SGPM r ' I - -- ~--2s Fr , ,- i ~ ' ~ ~ I ~ ~ ' ~ i i I EP ' ~ ~' ~ 05 -~ ` - ~ - ~ - EP04 ~ -i~ ~ iu zu su 4 6 $ CAPACITY ~~ 6 c~i= ~ Uoulds ~~]~31~~~'~1~3~~ ~~~~~~~~ ~~mp 4U 5U GPM 1.0 12 m3/h ©1995 Goulds Pumps, Inc. Effective May, 1995 wisoonsin Department of Industry, SOIL AND SITE EV A L U AT I~-N-I~EeO R T Labor and Human Relations Division of Safety 8 Buildngs ~/~ ~, ~' + r `, •,, in arr•nrri with II 1-IR AZ n I/Vi ~iirri.'C`nrFo `~._ Page ~ of 3 ~ `-l COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches In Ze:~i~lan must)pt~dflq~lp~b~t Ste` C'~ lk ~ not limited to vertical and horizontal reference point (BM), drection a %`of sloe, scale Or '~. ;:.` PARCEL LD. # dimensioned, north arrow, and location and distance to neazest roa ~ -, ~, ~ ~ ~, ~ O l b - L Q (J$ - ~ (~ a ~ ;;.,y APPLICANT INFORMATION-PLEASE PRINT ALL INFORM~I,TION ~ REV DB DATE , ~ ..~s,~t, , 1..4 Z PROPERTY OWNER: ~ ATION i r"1 t.LT s~2.~-.. `, >\Kr~ va, N,C~'~ua,s3ZT 3~ ,N,R l 5 Et°~ PROPERTY OWNER':S MAILING ADDRESS. LOT # BLOCK # S .NAME OR CSM # CITY, STATE ZIP CODE PHONE NUMBER wol,~vt~~~, ,wl S~t.p2.& (BLS) Z65:~o~~ ^CITY ^VILLAGE MOWN ' ~ L.~NI~Op~ NEAREST ROAD `30 `T1i- ~U~ - [ ]New Construction Use [,~ Residential ! Number of bedrooms 3 [ J Addition to existing building .C'CJ Replacement (J Public or commeraal describe Code derived daily flow u,S C~ gpd Recommended design loading rate - bed; gpd/ft2 • Z 9 trench, gpolft2 Absorption area required 31 S bed, ft2 3Z S trench, ft2 Maximum design loading rate S bed, gpolft2 - 6 trench, gpd/ft2 Recommended infiltration surface elevation(s) °1.6-~5 ft (as referred to site plan benchmark) Additional design /site considerations iti10UKip w ! S' Sal S' `R~v e.~(- _ ~ r,y ~ ~ 5 " or= S~~ ~~ ~~ Parent material ~ t5s oven.. G lt~CLP~tr `r1~-~ 'Flood plain elevation, if applicable f`1 K1 ft S =Suitable for system U =Unsuitable fors stem CONVENTIONAL ^ S [~U MOUND ~ S ^ U IN-GROUND PRESSURE ^ S ~.U AT GRADE ^ S ®U SYSTEM IN FlLL ^ S ®U HOLDING TANK ^ S ® U SOIL DESCRIPTION REPORT Boring # ":;w Ground 9~6 0 ft Depth to limiting factor Z6"' Boring # Z~ Ground elev. 9 ~.8 tc Depth to limiting factor > 5 7 `~, Horizon Depth Dominant Color Mottles Texture Structure Cons"~stence BalxJagr Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. g~ tertdt Z -t -LS I.a ~~ ~Cl y - si I Z`FSb k n1`~i- Cc~ _ - S . ~ 3 lg ~6 ~•~~fz~r! - gl ~,csUk rnU`P>,- C S - •4 -S z6~ S `tit Ely ~~ ~Q Sls~ L o~ ~f~ _ . 3 •~ Remarks: Remarks: o-s . t.o~c tz ~ c z - s~ ( Z~sb ~ n1~ ~s - . S ~ ~ Z $-33 l0`r;{Z ~`~~ - siJ Z'FSbk ft') `FI- c-S ~ - S • ~ 3 3-57 ~~.SyR 3! - Gas[ ~.~°-Sb~ h1V~. - -~ .S ~STName:-Please Print Arthur I;. WeQerer' Phone: 715-425-0165 ' ~egerer Soil Te ting & Design Service-P.O. Box 74 River .Fa11s,WI. 54022' 5gnagrre: ©~ ~ 3 b Date: 3 ~ _ O O CST Number:. ' 220254 PROPERTY OWNER 5~-~- SOIL DESCRIPTION REPORT PARCEL I.D. # ~ L b - L Q ~$ - ~0 Boring # M~:tt.+jo,}.v `Y,a:'ta:a~~ ~~ ~3 3 ~` Ground elev. a(Z? ft. Deplh to limiting factor ZI`'~ ~ ~. \~ Boring # ~~.~ ~<vivv \:m'' Ground elev. ft. Depth to limiting factor Boring # ~~ ::~:...:.:.:t;:: t<; xgk ~~~ ~>: •<fi>~: ~;`~ t,:::':, ..r: Ground elev. tt. Depth to IimiGng factor 3oring # c# 2k around ;lev. lt. )epth to imiting actor t _:~ Page ? of ~ Horizon Depth in Dominant Color Munsell Mottles Qu Sz Cont C l Texture Structure Consistence Botxtdaly Roots GPD/ft . . . o or Gr. Sz. Sh. Bed Trerxh ~-~ 1D `tiZ 3!2 ~ S! ~ Z S~Fz 0.S - g $- ~ .~ ~ s i 1 z.`Fs b l~ m `Fh ~ s , g . b 3 ty-z~ ~ ~s~2~~u - ~ 1m sb~ m~'r ~.s .~ .s y Zi -s l s~ 2 yi ~-~, s~f 2 s /tj s ~ 1 0~-, m ~i- - N~ • Z Remarks: Remarks: Remarks: Remarks: n oo•~Nn •,~ .,•,, PLOT PLAN SCALE 1"= ~l0 ' Page 3 of 3 _ ~; X30 `R !- 19 u ~ _ o• U ~, 1-0 2 q o `Rt sT. boo tzess : (I~ ~r ~. ~,,,,~- o ~ $ . z. z ~e.c~ 1~ mzc.~t l Z86~ `30 `R4~ !~-v~. t tl-q.2? y 1 D lS~N1Z-$ '1'~F'1S -'t1~ . i ~"~ / ZS 1 ~~ ~ 1 y~ ~~ i ~ ~~z5~ ~n ~~ ~ i !' ~- - to to Lab°_ @ ``^-a~ I ~~ °~' Rs.p, ~ ~ ate, ~- ~2. ~~ 8n1t~Z ~S '~~ 0 ~ ~v p,~,' ~P L-~c.~ST lnJG PR.1.V~( 3 ~3 D'~y"1 ~Ow1E - ~3~~-!-- ~-, ~DO.O~ ON spIIZEq`'' i'~uuFGP~tr~--11v_~Q"~~''c~~ ~. ~_ 3 _. $ - 00 CST Signature Date Signed ~ ~Lg~~ G W ~_ .. , 00-3~, z-i.ozsy _(715 ) 425-~1 ~5 _ Telephone No, CST # vnsconsinve runen~orinousay, SOIL AND SITE EVALUATION REPORT labor and Human Relations Division of Safety & Buildngs In aCCnrd with II HR R~ n5 VVic Aram (:nrlc Page ~ of 3 . ~ COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but Ste` C'~ 1~ not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. ' O 1 Nj - l ~ ~8 - ~ C~ APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Y`'1 t L~ 5~2,L. Gtr 1VVJ 1/4 N F. 1/4,S 3 ZT 3D ,N,R 15 E (al~~W PROPERTY OWNER':S MAILING ADDRESS. l8 Z S o `ni- ST . LOT # BLOCK # SUED. NAME OR CSM # ~ - csr~ V~ ~. Z - pg s ~ 5 CITY, STATE ZIP CODE PHONE NUMBER >~o~vt~~~,,1•vf St_L0~ (1L~ZbS=~oZyt ^CfTY ^VILLAGE MOWN ' NEAREST ROAD 6L~.Nt,~a~L~ `3p `lit I~Ut- (I New Construction Use [,~ Residential / Number of bedrooms 3 [ ] Addition to existing building ,~ Replacement (] Public or commeraal desait>e Code derived daily flow ~I,S C~ gpd Recommended design toading rate - bed; gpd/ft2 • z 9 trench, gpd/ft2 Absorption area required 3"•1 S bed, ft2 3'15 trench, ft2 Maximum design loading rate ~ s bed, gpd/ft2 - 6 trench, gpolit2 Recommended infiltration surface elevation(s) °I.1;,.-~.S ft (as referred to site plan benchmark) Additional design I site considerations t"'tOUlt~'~ w ! S k~ $' Zl~~ ~Ef _ h~l t,V ~ t 5 " o>= S~~ .Fr L.t_ Parent material ~ mss ovt~rz. G t..r~e,Lt~ ~~~ 'Flood plain elevation, if applicable I`1 ~ ft S = Suitable for system U =Unsuitable for stem CONVENTIONAL ^ S L~.U MOUND ~ S ^ U IN-GROUND PRESSURE ^ S X11 AT-GRADE ^ S ®U SYSTEM IN FlLL ^ S ®U HOLDING TANK ^ S ® U SOIL DESCRIPTION REPORT Boring # ~. . 'I Ground elev. 9~b.0 ft Depth to limiting factor ~6k Boring # Z Ground elev. 9~-8 ft Depth to Gmibng factor ~ 51 ~~ Horizon Depth in Dominant Color M ll Motfles Q S Texture Structure Consistence Borrxlary Roots GPD/ft . unse u. z. ConL Color Gr. Sz. Sh. g~ rerldi 1 0 -~ L~ `1tZ 3 L 2 - s' I z~~b Lc ~.`E~ ~-s - - s ~~ Z ~-c8 ~o ~~ qty - st I Z~sb k In`~t- ck, - - 5 .6 3 1g ~b ~•S~.sz1f~ - gl 1,~-sU~r mu`~L- C S - -~I -S ' ~~ S `ti R- ~C y ~ ~ X12 SltS L Owl l~vt.'Fl- - - 3 • `f oe..,~.~,~. ~ o$ b0`1tZ ~L 2 S• ~ 1 S Z~ b~ W-.~y- ~s - s~ 6 Z $-33 ~o~lz ~~y - si.) Z'~sbh -~ `~- cS ~ - 5 .~ 3 3-57 `1.SyR 3! - G-..sl ~~Sblz VYIV'Fi.• - -~( .S Remarks: ,STName:-Please Pnnt Phone: Arthur L. We~erer' 715-425-0165 ' ~egerer Soil Te ting & Design Service-P.O. Box 74 River .Fa11s,WI 54022' Signature: ©~ ~ 3 6 Date: 3 ~ ~ O O CST Number.. ' • 220254 PROPERTY OWNER 5~-~- SOIL DESCRIPTION REPORT ~ Page?of PARCEL I.D. # ~ l b - 1 Q ~~ - ~0 Boring # \M.\ ~• :Z ~~'\^'l~ ti~..v.' ~~ °3 Y .Ground elev. °LZ ~ it. Depth. to limiting fa~ `~~ Boring # ~~:~4}.: :..~:r::.::..: `~`~ p:: A`# ~`~ti Ground elev. ft. Depth to limiting factor Boring # ~~ ~ ~:~ .:;> <,. .::~ ~:;; Ground elev. it. Depth to limiting factor 3oring # £<..., :> `s` ~<i~ around ;lev. ft. )epth to imiting actor Horizon Depth in Dominant Color Munsell Mottles Qu Sz Cont C l Texture Structure Consistence Botxid~ary Roots GPD/ft . . . or . o Gr. Sz. Sh. Bed Trends ~ o-~ 1~ ~ tZ 3l2 ~ s~ I Z s~F~ a~s - .g .~ Z $_f~ 1O`1fZ c{f~ - SI~I "2,`~Slik )vt`Fh ~S ~ . 5 •~ y zrl-s~ s ~2 yi ~-isH2 s/li s cl c~~, m~ - ti~ l • Z Remarks: i `` S .. 1 Remarks: Iemarks: Remarks: ~ s~ PLOT PLAN ,; Page 3 of 3 , SCALE 1"= ~l0 ' o•U ~- l'o 2ao ~ sT. i Z86~ X30 ~ ttv~. _ -_ - - - - _ ~ ~o ~n-t- c.owi. P ~-eT 42 i ~~ / ~ ZS 1 ~ &.3 1 P 2® ~~ ~ I ~ gw ' a~ RS, o i ~ C?~ t ~l Ch/ fi 8r~~-Z b' ZS ;rte o ~ ~v L-~c ~ S T 1 ~1 G P 21 V ~( 3 ~3 D R~1 • ~wlE .. -~'!-_- ~ ~00,0~ oN_splKE _:q~' _Pp3uu~_G-.~tr~_=~ti_lo"_D~'n~ 1~'PP- (~ ~of= ~ LXLST)-.+6 W ~u oo-3b - - - zZ.oZ,Sy ; . -- ~." i~~ 3-.~- 00 (715 ) 425-n7 ~5 CST Signature Date Signed Telephone Nc. CST # ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer i1'1 ~ I -f - ~ p ,L L Mailing Address / 8 ~ ~~ ~ L> `~ ~ ~- fir' Jon ~u~ ~~~ ~ /% `~ ~a ~~ Property Address Z ~ ~ ~ (Verification required from Planning Department for new construction) City/State LEGAL DESCRIPTION Parcel Identification Number ~~~ -" /~Lfl-`~~' Property Location ~ '/4, J~'t '/4, Sec. 3~, T 3~? N-R_1~ W, Town of ~o lehw~c~ ~ Subdivision ,Lot # Certified Survey Map # ~'~~ ,Volume ~~ ,Page # J~ Warranty Deed # !~/ ~ ~C5 ,Volume > ~ ~ a ,Page # 3~~ Spec house ^yes ®no Lot lines identifiable ®yes ^ no SYSTEM MAINTENANCE Improper use and maintenanceof 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 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/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Lowe, the undersigned have read the above requiremer.±s snd 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 yea piration date. ~..~~ (fl / 1 ~/~ SIGNATURE OF APPLICANT 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 pro erty describ bove, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE 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 .. ~~. ti~1.1282p~~L3(~6 Margie J. Hansen, conveys and warrants to Milton G. Sell and Nancy E. Sell, husband and wife, holding as survivorship marital property, the following described real estate in St. Croix County, State of Wisconsin: 'M~t`; J. H sen Part of Northwest Quarter of Northeast Quarter (NW '/, of NE '/.) of Section Thirty-two (32}, Township Thirty (30) North, Range Fifteen (15) West described as follows: Lot One (1) of Certtfisd Survey Map filed No~erober 29, X977 in Val. Z; Page 515. Grantor, being first duly sworn, on oath deposes and says that on November 16, 1999, when she acgt!ired title to the above-described premises, by virtue of that certain Ouit Claim Deed from Joseph A Hansen, grantor's former spouse, said premises were not the homestead of any person. Exception to wt;; rar.tie~: a!I easements and restrictions of record, This is not homestead property. Dated this 31'' day of December, 1999. A'•iT'HEI•Il'l: AT10N 5lpnature(s) ~. authenticated this _ ~a,r ~~± -- sgnoGrs ~ ~ ~~ nsrrn - -- TITLE: MEMaER STn• 1"c DAR OF VJIuCON:11:V (H not, eutharized by§7r76.08, Wsi" Stats.) `rF?IS : y$TRl `~ ~ NT {%r AS DRAFT ED BY Thomas A. McCormack 8etdwin, WI 54002 1Es 1659 ~ REGISTER OF DEEDS 5T. CROIX CO., MI AECEIVEf FOR RECORO 01-06-i'.000 10115 All ~TTTO IEEI CERT COOT FEE: COPY FEEL TRAItSFEA FEE1 98.00 DING FEE 1 10.00 Ttromas A. Mcc:ormack 1020 ~o" avs. saktwln, wl 5400z 01 & 1088-40 (Parcel identification Number) ACKNOWLEDGMENT S?ATE OF WISCONSIN uT.r,ROK GOtJNTY Personalty came before, me thB 2A1h day of December, 1989, the above rrarned is .re k., . o ty Blc person(s) wtto nor :uteri t repolnp irwtr sM acknowledya the !4TF ' alpneturo ~.~I ~ . ~ type or prl rd name ~- . Ncta,; :'chic St. Croix County, vl~isconain. ~ L ' ~ My commleeien Ie permanent. (IG ~ ~! *~~ •Narnea of persons slpNnB in any capeclly ilwu' pnnled txlow their sgnaturp. iMxmWai ProhuroMH ComanY fOnU Ou 1a0. Wnem,w ewx~saoz+ ~. I~ : ~~' CERTIFIED SURVEY N0. 515 Part of the N41; of the NE4 of Section 32, Town 30 Glenwood, County of St. Croix, State of Wisconsin, of Certified Survey Maps, page 5~,r~as Certified 34541 J NORTH LINE NE I/4 SEC 32, /' T 30 N, R 15W ~~orth, Range 15 West, Town of described in Volume 2 Survey No. rat ~ CAST ALUMINUM MONO I ~ NE COR. SEC. 32, T 3( R 15 W ~~_ ' ti TOWN ROAD EAST WEST 1331.07' y OO 798.55' ~ ~ S 00° 30' 20° W om ~ -i ~ d0 ° ag 3 3 . 0 0' - z ~° ~ 5 e9 _ p ,~ ( DoT ~ a ~' m y Z ~ ~ ..~~° I,S~ 6.22 ACRES ~ p o °" ~ ° a o '~ 1 (357, 921 SQ/FT) ` ~ m~ ° m W ° c W ~U ~o' ,rte /Z~-( W .~ LEGEND: p 3/4" z 30" ROUND IRO Z f N o r ~ ° y ~ m ROO WEIGHING 4.17 LBS/L. F. 0-+ EXIST. BLDGS • ,~O ~, ° r m a ro SCALE : 1 "= 200' m ~~O 388.02 413.87' /g4 S 96° 51' 40" W N 86° 52' 00" W l00 O O l O 2 0 3 0 APPROVED ~ e a APPROVAL OF THIS MIN ~ F ~ E D N OV 2 3 1977 OR SUBDIVISION DOES NOT MF~N gpp NOY 2919 ROVgL pOR DWG SITE OR SEPTIC ~ ~~ o, ~~~ ST. CROIX COU: ~TY SYSTFM„ i0 H6Z 2Q ~tw e1 0. COMPREHENSIVE, PARKS PtANNINa . , ~ ~ 4 ~ ~ ~ ' ANP ZOhiING COMMITTEE Wt~oo44 ' I, LEON R. HERRICK, Registered Land Surveyor, hereby certify: ~ ~ ~ That I have surveyed, divided and mapped a part of the NW; of the NE; of Section 32, T30N, R15W, Town of Glenwood, County of St. Croix, State of Wiscon- sin, more particularly described as follows: Commencing at the Northeast corner of said Section 32; Thence West 1,331.07 feet; Thence S. 00'' 30' 2G" W. 33.00 feet to the point of beginning; Thence S. 00° 14' 14" W. 459.4s feet; Thence N. 860 52' 00" W. 413.87 feet; Thence S. 860 51' 40" W. 388.02 feet; Thence N. 00° 30' 20" E. 458.03 feet; Thence East 798.55 feet to the point of beginning. 34541 ,~~~ti LEON R. ' HERRICK 1 S-I303 MENOMONIE~ tQ. ~~ ~~' ~'-~..SUR~r.~`~ Said parcel contains 357,921 square feet, more or less (8.22 acres ±). That I have made such survey, land division and plat by the direction of Bruce Konder. That such plat is a correct representation of all exterior boundaries of the land surveyed and the subdivision thereof made.