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HomeMy WebLinkAbout020-1106-70-000 � 77 OD2 w K . E i E \ 0 $ 2 0 I . o \ \a 2 }a ) k ƒk , 2 � ; LL 0 0 CL E� %cl) 2n} E $ a m 0� § M ƒ f / / } co \ .. k c .. E \ c § i E - ® L .. � ƒ E2f / S c § o a ) © c z } 10 k k k .2 j j _ 0 , M I � a 2 2 pfti 0 m o J j q ! } 2 ) § § m ° E � 2 � c ; 0 ° \ \ g § � % a ` E _\ \ 21-0 o \ k } \ 2 - § / \ 2 f { k D / : \ ) 3 4 2 U E « k § C E ) k k S § , Q 0 a 2 � o $ J � t Parcel #: 020-1106-70-000 12/20/2004 03:40 PM PAGE 1OF1 Alt.Parcel#: 35.29.19.421 C 020-TOWN OF HUDSON Current ❑X ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales.Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): *=Current Owner *PARSON, STEVEN&MARQUERITE STEVEN &MARQUERITE PARSON 671 KINNEY RD HUDSON WI 54016 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description *671 KINNEY RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: '10.000 Plat: N/A-NOT AVAILABLE SEC 35 T29N R19W SE NE S 330 FT OF N 396 Block/Condo Bldg: FT BEING CERT SURVEY MAP IN VOL III PAGE 669 ORD Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 35-29N-19W Notes: Parcel History: Date Doc# Vol/Page Type 08/31/2004 773008 2646/347 QC 07/23/1997 811/491 07/23/1997 580/446 2004 SUMMARY Bill#: Fair Market Value: Assessed with: 48479 347,200 Valuations: Last Changed: 10/29/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 10.000 88,000 180,600 268,600 NO Totals for 2004: General Property 10.000 88,000 180,600 268,600 Woodland 0.000 0 0 Totals for 2003: General Property 10.000 88,000 180,600 268,600 li Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 105 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 i Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER 7PIRSON TOWNSHIP .' SEaN SEC. T_N-RLW ADDRESS N d ._ ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I•I.HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Eas� BUR JAW lo' If' 18x-% Beo w s' S ' ,�- to,?, fob �• S7' 750941 R,mp ChAMbtk !g' ' 1000 9A1 1S Q SePtic ��. ao• 3 �eDRoo� Horne, INDICATE NORTH ARROW n( <- BENCHMARK: Describe the vertical reference point used ^ I" 5tee.( F'112e. Elevation of vertical reference point: �o, o Proposed slope at site: SEPTIC TANK: Manufacturer: Lj?=e k5 Liquid Capacity: oW C4 Iq _ %A -r0C 0 Number of rings used: Tank manhole cover elevation: HE Got/Jeff 0�Tank Inlet Elevation: 07 Tank Outlet Elevation: 90.0a foumvAii o(,1 WOK 100.0 Number of feet from nearest Road: Front,Q Side 10 Rear, Q oveR )000' feet Shot: .Srj From nearest- property line 4Front.0 Side,O Rear,(D L I E3 feet Number of feet from: well , building: Q O' (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE j i FOUND -S7 �oo.o 0 100 7 PUMP CHAMBER T Manufacturer: Weeks Liquid Capacity: '150 -Ai Pump Model: Pump/Siphon Manufacturer: ZQ� II?:� Pump Size Elevation of inlet: 9()• 0a Bottom of tank elevation: K Pump off switch elevation: -K Gallons per cycle: / Alarm Manufacturer: V Edop Alarm Switch Type: LZ N)eA EfZh� I MR RCUR4 Number of feet from nearest property line: Front, O Side, O Rear,@ Ft. (All Number of feet from well: 170 Number of feet from building: 9 � (Include distances on plot lan). HeADepc 93-(03 73.(o3 — shdt a•� SOIL ABSORPTION SYSTEM god o� / 110 1 Bed: Trench: Width: 18 Length:_ Number of Lines: _ Area Built: Fill depth to top of pipe: V' Number of feet from nearest property line: Front, O Side, O Rear,©Pt .� Number of feet from well: Number of feet from building: /00e (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, OFt. Number of feet from well: Number of feat from building: Number of feet from nearest road: Alarm Manufacturer: C� Inspector: Dated: I - Plumber on job: License Number: M ERS 0 3 I G 7 3/84:mj ~ w •►DEPARAVIENT OF INDUSTRY SAFETY&BUILDING INSPECTION REPORT FOR LABOR&HUMAN RELATIONS DIVISION P.O.BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES&APPLICATION MADISON.WI 53707 State Plan I.D.Number: SL 4,NE y,S35,T29N-P19W (If assigned) Town of Hudson �CONVENTIONAL El ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound E DER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Steve Parson 420 1/2 Oak, Hudson, wi 54016 BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF.PT.ELEV: Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Richard Hopkins 1059 St. Croix 119478 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED: PROVDED: ❑YES ❑NO ❑YES ❑NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER I NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM: FEET FROM LINE: AIR INLET: ❑YES ❑NO ❑YES [--]NO NEAREST DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: P PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVDED: ❑YES ❑NO ❑YES ❑NO I ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF) ❑YES ❑NO NEAREST--* SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: MATERIAL AND MARKING: or excavation. (If soil can be rolled into a wire,construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: BED/TRENCH WIDTH: LENGTH: NO.OF DISTR.PIPE SPACING: COVER PIT INSIDE DIA.: 0 PITS: LIQUID TRENCHES: MATERIAL: DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO.DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV.INLET: ELEV.END: PIPES: FEET FROM LINE: AIR INLET: NEAREST----00- MOUND SYSTEM: Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ❑YES ❑NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER I TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ❑YES ❑NO ❑YES ❑NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: 7SOD�DED' SEEDED. MULCHED: CENTER: EDGES: ES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL: NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING: ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.: ELEVATION AND DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑YES ❑NO ❑YES ❑NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: ❑YES ❑NO ❑YES ❑NO NEAREST } , y 9 5 Z Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE: TITLE: SBD-6710(R.06/88) Zoning Administrator TUILHA SANITARY PERMIT APPLICATION In accord with ILHR 83.05,Wis.Adm.Code COUNTY C�o 1 X STATE SANITARY PERMIT# —Attach complete plans(to the county copy only)for the system,on paper not less than // 9141 72,y 8%x 11 inches in size. ❑ Check if revision to previous application —See reverse side for instructions for completing this application. STATE PLAN I.D.NUMBER I. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION 51' QII F_ 'Otj Sf— % N lC%,S Tl�9, N, R E(or) PROPERTY OWN R;S MAILING ADDRESS LOT# � BLOCK# ^ t� dl 6 ! ;t r CI l STp�TE ZIP CODE PHON NUMBER SUBDIVISION NAME OR CSM NUMBER 11. TYPE OF BUILDING: (Check one) ❑State Owned O V LLLLAGE: u asd 1 NEAREST R y1 D 1 ❑ Public �1or2Fam. Dwelling—#of bedrooms- PA L AX NUMBER( ) 1" /_ 'r` 11�'NI III. BUILDING USE: (If building type is public,check all that apply) I D J C (�V— 1 /0(a --70-0O o 1 ❑ Apt/Condo 1 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. TYtPPEE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. t�l.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 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 GRADE REQUIRED sq.ft.) PROPOSED(sq.ft.) (Gals/day/sq.ft.) (Min./inch) ELEV TION G 3 6 <r' 9a (9 Feet Feet VII. TANK CAPACITY Site in oallons Total #of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New istin Gallons Tanks Concrete structed glass App' Tanks Tanks Septic Tank or Holdina Tank — U U O Q S Lift Pump Tank/Siphon Chamber O / (/,) Vlll. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name(Print): Plu is Si nature: Stamps) ( MP/MPRSW No.: Business Phone Number: ��s 4 7f )3%- a Plumber' Addr (St r`e`yyt,City, te,Zip C ): R. IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee(Includes Groundwater Date Issued Iss ' g Agent Signature No S mps) Approved ❑ Owner Given Initial Surcharge Fee) Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(formerly Plb-67)(R.11/88) DISTRIBUTION: Original to County,One Copy To:Safety&Buildings Division,Owner,Plumber INSTRUCTIONS }` ►, 1. A sanitary permit is valid for two (2)years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. 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. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this 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/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 1t5 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring,groundwater, ground- water contamination investigations and establishment of standards. SBD-6398(R.11/88) APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owners) 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. -----------------------------------------�------Afs-------------------------------- Owner of property �I/�1�(,/ C./� ©A / Location of property 1/4 Ale- 1/4, Section 3, T_=?2 N-R /Y W Township hCICAS'o ni Mailing address yao Address of site Subdivision name Lot number • Previous owner of property .L�s'Y!/�/ �¢�-✓9' �IJcT©,�id� �T�/�o/�E� Total size of parcel A2 Date parcel was created Sc f �� Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) . Yes o Volume and Page Number 5 & as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER, and the SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. ------------------------------------------------------------------------------- PROPERTY OWNER CERTIFICATION I(We) certify that all statements on this form are true to the best of my (our) knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the Office of the County Register of Deeds as Document No. y 76 S/ ; and that I (We) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the same has been duly recorded in the Office of the County Register 59-Deeds, as Document No. ) . Signature of Owagr Signature of Co-Owner (If Applicable) Date of/Sigo4ture Date of Signature DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1-1992 THIS SPACE RESERVED FOR RECORDING DATA WARRANTY DEED 3— G III em 811 PA%491 a E ISTER S OFFICE Emil Affolter and Lorraine R G Ti Deed, made between __-_. -- ST. CROIX CO., WI R. fo ter , husband and::_w f-e,___arid_ ftud.ol_p---- .--_ Rec'd for Record ..... --- •-- Affolter--.Fam l-y -Trust-,_• by.-•-EOAI--•Aff-Ql-ter............... Tr-u s t e e Grantor, ------------- --- ----- . ------ ------. MAY 2 4 1988 and---------Ste.xeR..J.- -Pax.so-a------------------------------------------------------------- 1 :00 PM ----------------------------------•-----------•---------•-------------••-----------------•--+ Grantee, � Witnesseth, That the said Grantor, for a valuable consideration------ ! Register of Deeds -------------------------...-------------------------------------------.............................�_-__.___._ ; RETURN TO conveys to Grantee the following described real estate in -------St...-_CrolX.-_____ is County, State of Wisconsin: 1' South 330 feet of North 396 feet of Southeast Tax Parcel No- ----------------------------------- Quarter of Northeast Quarter ( SEk of NEk) of Section 35 , Township 29 North, Range 19 West . (This deed is given in fulfillment of a Land Contract between the parties dated September 1 , 1978, recorded Sept. 6, 1978, in Vol . 580, page 446, as Doc . No. 351433, St. Croix County Register of Deeds' office. ) JANSFER q�ES00 This .......15 not....... homestead property. (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And-Emil- --.Af f ol-ter-,__Lorraine.-R._ _-Af f olt-er•,--_and _--Af-f olter_.._-a$-.Trustee, warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements and rights of way of record , if any , and will warrant and deefid the same. Datedthis -- -------•------/ -----------------•--- day of ------------------------Apr i 1------------------------------- 19_88 - RUDOLPH AFFOLTER YAMILY TRUST n (SEAL)---•--•-- -- �1`G-/!-----/-/�•J--�_ - --------(SEAL) Emil Affo,: 1 , Trustee ------- ---------- -------- -------------- ------------- (SEAL) -----(SEAL) * * -------- Lorraine--R.---.Aff olter--------- AUTHENTICATION ACKNOWLEDGMENT Signatures) STATE OF WISCONSIN Pierce ss. ----..............................County. authenticated this --------day of........................... 19...... Personally came before me this ._ __ ......day of Apr 11..... ... ..............•-- 19---$$ the above named ---------------------------------------------------------------------------••--- Em_i 1...Adf of t er an-•- Lorraine R. * ------------------------- ----------••-•---------•-----------•-------- Af f olter TITLE: MEMBER STATE BAR OF WISCONSIN (If not, ------------------------------------------------------------ -----------------------------------------------------------------•-------------- authorized by § 706.06, Wis. Slats.) to me known to be the person S---------- who'exegted the foregoin instrument and ackno ledge the amts 1 � I THIS INSTRUMENT WAS DRAFTED BY qq� • 0 C L. Gaylord , Attorney --------------------------------...................... --------------------- � � . �- River Falls , WI 54022 *•---` �! ? M = !�}� ------•--- > •------------------------------ Notary Public ......PierC-e (Signatures may be authenticated or acknowledged. Both My Commission is permanent.(If not, state exprak. are not necessary.) date: QQ ------------� �t•-----•-------------- 19.. T--•) *Names of persons signing in any capacity should be typed or printed below their signatures. STATE BAR OF WISCONSIN H.cMiOerco,np&w FORM No. 1-1982 Stock No. 13001 i J l ' 1p 11 I2 1 lL ED AUG 29 1978 N &An 0. • 2 0 a Ott W� r, CERTIFIED SURVEY MAP 9 '° J., Arthur L. Wegerer, registered land surveyor, hereby certify: That in full. compliance with the provisions of Chapter 236.34 of the Wi.Sr,oniin Statutes and the provisions of the St. Ctoix County Sub- division Ordinance and under the direction of Emil and Rudolph Affolter, owners of said land;' have surveyed, divided, and mapped said parcel of land, that said plat correctly represents all exterior boundaries and the subdivision of the lane surveyed; and that thi:; land is located in the S .L of the 11111, of Section 35, T29N, I'119W, Town of Hudson, St . Croix County, Wisconsin, To-wit: Commencing at the Ell, corner of said section, thence N0 007'54"E along the East line of the NE 4., 918.87' to the point of beginning, !. thence continuing N00071 �411E 329.77' , thence S89 032130"W parallel with the north line of the SE4-NEE 1320.9$' to the centerline of Kinney Road, thence 90°09t05 11W along said centerline 329.771 , thence N89 032130"E 1321.09' to the point of beginning. ' Said parcel contains 10.00 Acres and is subject to road right- c,f-wad, over the westerly 33' thereof. NOTE: No building permit shall be issued for this lot until such time as the Westerly 1331 of the Easement Road is . .built to County standards by the purchaser of this land and approved by the Zoning Office. , •p'ROVED ARYHUR L r WEGERER - S - S-963 zo coo :iw CO''' ELLSWORTH i �. WIS. OR SUBDIVISION '•.� •'••......•••• : APPROVAL OF jHfAN iN,pppOVAI FOR +�'•.4tf NOj M' jam. pOES $IZE OR SEPjIG SY.. BUILDING H62•�0• REFER j0 o = I" X 24" IRON PIPE WEIGHING 1.13 LBS./LINEAL FOOT SCALE IN FEET 200 100 0 200 NE COR. OF NW COR. OF THE SE 1/4-NI THE SE 1/4 -NE 1/4 _ a _ � it $ ° a�n'w EASEMENT ROAD ' w I90,�635.. !287.98 89o2g36 0 U $ LOT . I Ln A. f� U 1 rrf x 10.00 ACRES z I M N I tND (D W I " 90°-3$24,. 4 �!o 8902325 N89°32�30�E 1288.09 A 1321.09' z U lD EAST LINE OF THE . o NE 1/4 OF SEC. 35 °�° m Volinne 3 Page 669 E 1/4 COR. SEC. 35, T29N, R19W r - 1- STC - 105 r " Y • H SEPTIC TANK MAINTENANCE AGREEMENT _ o St . Croix County z d ' l 9 OWNER/BUYER l/,E�J 4SOh/ m ROUTE/BOX NUMBER_ //?//1/�E /[ Fire Number v CITY/STATE (/ S0") �:_ _ZIP PROPE'R'TY LOCATION :14 , NE 14, Section_�,j T 21 m , R W, Town ofUGy,SOa✓ St . Croix County , Subdivision Lot number Improper use and maintenance of your septic system could result in its premature failure to handle wastes . Proper maintenance cun- sists of pumping out the septic tank every three years or sooner , if needed , by a licensed septic tank LumLer . What you put into the system can affect the function of the svpLic tank as a treat- ment stage in the waste disposal system . St . Croix County residents maw be eligible Lu receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1 , 1978 . St . Croix County accepted this program in August of 1980 , with the requirement that owners of all new systems agree to keep their systems properly maintained . The property owner agrees to submit to St . Cruix County Zoning a certification form, signed by the owner and by a master plumber , journeyman plumber , restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping ( if nec- essary) , the septic 'tank is less than 1/ 3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. HH I/WE, the undersigned , have read the above requirements and agree to maintain the private sewage disposal system in accordance with x H the- standards set forth , herein , as set by the Wisconsin Depart- w ment of Natural Resources . Certification form must be completed and returned to the St . Croix County Zoning Office within 30 days of the three year expiration date . SIGNED DATE St . C>>oix Cjunty Zoning Office P .O. f•o x 98 Hammond , WI 54015 715-7S16-2239 or 715-425-8363 Sign, date and return- to above address. ,INDUS TRY, OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTRY, c DIVISION BOX 7 LABOR HUMAN AND ONS PERCOLATION TESTS (115) MADISON WI 53707 (H63 .09(1) &Chapter 145.045) LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: S - / 40PNE'/T N/R E co — — vt.�aJ COUNTY R'S/B NAME: It MAILING ADDRESS: e- 42 0.1 S' USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: Ppesidence 3 _ E'IKew ❑Replace. RATING:S=Site suitable for system U=Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK:RECOMMENDED SYSTEM: optional) If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the -.---- under s.H63.09(5)(b),indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-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- l (J >07 , 3iQvrmS B- �`� A/ /m6 3. � Gn c � /,�/?"'o S B- q > /�3 , .� S� /.6 �R�S/'� ��6 ,9 � c w ��� 3i?ns/ /P%3�c B- B- S, / �3 5 /CS/ n �✓ �d S w 5, RI C 5 PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD 3 PER INCH P- P- P-- e?i 3 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 _ _ t € l t l" V � � ----- ...m_ k - TN 3 c , € € I t E € , I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: � DAVE FQGERTY PLUNGING o ADDRESS: CERTIFIC IO MBER: PHONE NUMBER(optional): #3233 #3289 Fogerty Heights Road ROBERTS,-WISCONSIN 54023 C NA Phone 749-3656 DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) —OVER — w"'► Y INSTRUCTIONS FOR OMPLETING FORM 115 - SBD - 5395 To be a complete and accurate soil test,your report must include: 1. Complete legal description; 2. The use section must dearly indicate whether this is a residence or commercial project; 1 MAXIMUM number of bedroorns or commercial use planned; 4. Is this a new or replacement system; 5. Complete the suitability rating boxes.A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; B- PLEASE use the abbreviations shown} here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A separate sheet may be used if desired; S. Make sure your benchmark and vertical elevation reference point are clearly shown,and are permanent; 9_ Complete all appropriate boxes as to dates, names,addresses, flood plain data, percolation test exemp- tion, if appropriate; 10, If tiEe information {such as flood plain,(levation)does not apply, place: N.A.in the appropriate box; 11. Sign the form and place your current address and your certification number; 12. Make legible copses and distribute as rerluired. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st - Sillnr- (over 10") BR Bedrock cola Cobble (3- 10"; SS - Sandstone q Gravel {under 3") LS Limestone *s _ Sand HGW High Gioundwatei. cs Coarse Sand Pere -- Pt rcolation Rage Seri s Medium Sand W 1IJt=,Er fs .._ Fine Sand Bldg ._ Building Is - Loamy Said > Greater Than sI Sandy Loam < - Less Than Loam Bn - Riovvn sit - Silt Loam BI - Black s'i - Silt G led Clay Loam Y Yellow set Sandy Clay Loam R -- f'(;ci siol - Silty Clay Loam mot - 110ottles sr: -- Sanely Clay vv - with sic - Sih"/ Clay fff few, Erne, faint c Clay ec - common,coarse rat - Peat inin - Many, medium _.. E4?ric d - distinct p -- prominent HWL - Hlclh watrlr level, Six general soil textures surface water for liquid waste disposal BM - Bench Marl: VRP - Vertical Reference Point I TO THE OWNER: his Scl,l lest report is th,l first Step or sacllring a sanitary permit. -.9e county or"t e lepartment may reGUeSt 1'o, o' this suil tps*, 'rl nt; fil!ld prior t'+ p=,'M?7. E SiE.krit,H, A complete see )I pans for the piivate it=."It1 c'3 permrC Ai7t�l lC:ii'r r`N"i ;l"3 t!si .)F,. st_,I)n1i'r�te d t 'he apps opriaie local aE�t-..l-mi,ity in ordf',r to i?a r.c7t(1 zi.;''bnit. i he as n lass y neilTiit must be C.bu3 '—d ardd poFte'd prior to the. Stan of eny't"nnSt#�1.)C`t II ,, 4' ��"� ' :�„' :: � ��� � � f L '.. �. ; ., U �. { �.� �����\ � � � � � � \ 2» \ \ ����� . \ � . / . ° � f� � I-,P Q. L T 6 7 PLOTA H 1 ► SE C T I M\1 P L R OJ ECI < I- N X., 4x� or V' N A M E -3 _ "AM E (1-A LL-L— goo K',P L I C E NJ A 2! L 0 AT 10 NJ E :-I# 10S I... E ........... A P M PLO efe _VY of ey 73, 19 it I 1 1 (8x3b 'GO/0 slope- I" NIP 13 MOU►JD 160 fj 76f _c 41 1" Steel ?I Fe q4 (at C.01Nki'L 7-SO 14 V) by -eel fe fur,\ -tpl'X �N, fo-3'T 1000 JAI Note (4t'fjW-#I1S 75 P tj 4P(Li e 14 TY0 !ur !jA I IUD 0 -FRESH All', INLETS AND OBSERVATIO P I.E?E cnoss SECTION Approved Vent Cap Minimum 12" Above Gxw Final Gr it AV 4" Cast Iron Above Pipe Vent Pipe To Final Grade— Marsh Hay Or Synthetic Covering Min. .2" Aggroy' Over Pipe DistribuLi Tee �ipe Aggregate Perforated Pipe Below 8'e I Beneath Pipe c, Coul)l i n g Terminating At BoLLopi of System