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030-1095-90-200
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KIZ_I ii - llf.{1 W a Z w Wi si 1,11 -11 J U. / ~ 4y .� ° CD �� ,• ;�fl� �;fie• •,x � /I/. 1 � s Z \ IT u \ to i _ 3 ,19-£z£1 3.c►,►o.00s ter. !:•f•Maoc K M,•JM l0 1/..{ 1„1 If 2M,1•41. 4 C •a••f..o�oas f.�+ E� x+171 dh(1 y� _aali uu ru as onwif+ss. w. tann.n i" , wk Parcel #: 030-2085-10-000 06/01/2009 02:50 PM PAGE 1 OF 1 Alt. Parcel#: 32.30.19.722 030-TOWN OF SAINT JOSEPH Current Ci ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type #of Units 00 0 Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner 0-JOHNSON, SHARON R SHARON R JOHNSON 630 MAIN ST N APT 403 STILLWATER MN 55082 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description 434 ROLLING HILLS LN SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 3.800 Plat: 05-093-JOHNSON PARKWAY SEC 32 T30N R19W PT N 1/2 SW 1/4 JOHNSON Block/Condo Bldg: LOT 1 PARKWAY LOT 1 EXC COM W1/4 COR SEC 32, TH N 89 DEG E 1200.25;TH S 13 DEG W Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 351.30';TH RTO E DEG E 32-30N-19W 342.80'TOIS PORTION OF L BEING AD LOT 1 CS M 7/2060 BY more... Notes: Parcel History: Date Doc# Vol/Page Type 03/06/2008 870122 QC j� 01/03/2008 866639 QC /A T l 02/14/1995 525919 1111/339 WD 2009 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/12/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.800 75,800 0 75,800 NO Totals for 2009: General Property 3.800 75,800 0 75,800 Woodland 0.000 0 0 Totals for 2008: General Property 3.800 75,800 0 75,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch#: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 M1 i Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER �U �?.r'J. p TOWNSHIP 5 01)__ SEC. T 30 N W ADDRESS 0 I )N � � � ST. CROIX COUNTY, WISCONSIN Lb r�e SUBDIVISION LOT LOT SIZE C� PLAN VIEW 0)*D Distances and dimensions to meet requirements of I1, HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM POO ' l3' 33' 9+� ?y• I8x36 Bw N INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Pj !f.,Q A o J, Elevation of vertical reference point: 10 0. 0 Proposed slope at site: SEPTIC TANK: Manufacturer: Q > Liquid Capacity: a Uc) Number of rings used: I " Tank manhole cover elevation: Tank Inlet Elevation: 19.8q Tank Outlet Elevation: 19,q ` Number of feet from nearest Road: Front,O Side, Rear, O feet - From nearest- property line . ' Front, � O Side, Rear, feet � O Number of feet from: well building: ot� � (Include this information of the above plot plan)( 2 reference dimensions to septic tank) ', SEE REVERSE SIDE w PUMP CHAMBER Manufacturer: Liquid Capacity: " Pump Model: _ Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear,© Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). �°e 3 AND = X-80 SOIL ABSORPTION SYSTEM 1�y�. � Bed: Trench: QQ Width: � C� Len$th: 3(p . Number of Lines:�- Area Built:_ Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, ®Rear,0 Pt .RO Number of feet from well: Number of feet from building: 71 (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, ©Rear, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: ((�� Dated: 9 Plumber on job: Y. V!3 y �� License Number: f y 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDING LABOR&HUMAN RELATIONS DIVISION P.O.BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES&APPLICATION fy�p'Sgj 1J Y71 J 0' 1 9W State Plan I.D.Number: jT��o yw� j t 7 W Ii CONVENTIONAL ❑ ALTERATIVE (If assigned) Town of St . Josep Lot 1 Rollin Hil� bgf[i @g Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Jeff Johnson 1231 Rolling Hills Lane Hudson 1f31(10 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 t . Croix 1119547 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER ,r o� Cr PROVIDED: PROVIDED: t . ®`YES ❑NO ❑YES tSNO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM: FEET FROM LINE: AIR INLET: ❑YES NO ❑YES NO NEAREST 11-4 DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: P PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED:PROVDED: El YES ❑NO E]YES' ❑NO ❑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--I► SOIL ABSORPTION SYSI 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 INSIDE DIA.: #PITS: LIQUID TRENCHES: MATERIAL: DEPTH: DIMENSIONS )S 3� I PIT-.. GRAVEL DEPTH FILL DEPTH DISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO.DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BE OWtPIPES: ABOVE COVER: ELEV.'INLET: ELEV ND: Pl s: FEET FROM LINF '4 ^ AIR INL,ET� 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: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑YES ❑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: ELEVATION AND ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.: DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑YES ❑NO ❑YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: 4AREST- 2.3 MBER OF PROPERTY WELL: BUILDING: LIE ET FROM r� ❑YES ❑NO ❑YES ❑NO -7. Sketch System on Retain in county file for audit. Reverse Side. ATURE: C TITLE: Zoning Administrato SBD-6710(R.06/88) Thomas C . Nelson DILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05,Wis.Adm.Code couNTY� 1.lS ,nommmoms STATE SANITARY Ftrtnni i # , –Attach complete plans(to the county copy only)for the system,on paper not less than ❑ /ev WP,. �8%x'11 inches in size. Check if sios 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 - �r ..Jo� dtj N F. %aS %,S3a T36, N, R 12 E(or PROPERTY OW R(�$rAILING A D�E$� ���e LOT BLOCK# NA CI STATE 11 ZIP CODE PHON N �MBER SUBDIVISION N R CSM NUMBER CITY NEA T ROAD II. TYPE OF BUILDING: (Check one) State Owned ❑ VILLAGE S+ �d.K �� '1l f 1 Q� ❑ Public a1 or 2 Fam. Dwelling–�#of bedroom PAR EL TA NUMB O J l� 111. BUILDING USE: (If building type is public,check all that apply) 3�� 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. IRNew 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 R.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 �,f REQ IR D sq.ft.) PROPOSED(sq.ft.) (Gals/day/sq.ft.) (Min./inch) Q l ELEVATION -f S O TV Gay C � 4-3 S 1 A Feet �0- Feet CAPACITY VII. TANK Site in allons Total #of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New Existing Gallons Tanks Concre a glass App. Tanks Tanks structed Septic Tank or Holding Tank 10 — j()00 Lift Pump Tank/Siphon Chamber 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 er's Signature:( Stamps) MP/MPRSW No.: Business Phone Number: ��� 7/,5 �S�-�od0 Plumber's Address(Stree ty,State, ip Coa I): Kie_I IX. COUNTY/DEPARTMENT USE ONLY 1HP a proved SaniT), Surcharge ermit Fee(Includes Groundwater a e ssue Iss i Agent Signat (No tamps) Approved ODiswner Given Initial Fee) Adverse Determination I 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 ' N, , 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. iL 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. 4 VIII. Responsibility statement. Installing plumber into 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-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, ground- water contamination investigations and establishment of standards. SBD-6398(R.11/88) A►'I'UCATION VOR SANITARY PERMIT , i 1 r S T 5 100 tit NO This application form in to be completed in full and signed by the owner(s) 'of the }; property being developud. Any inadecluncic s will only result in delays of the permit` issuance. Should this duvelaplent ba Intended for.resale by owner/contractgx, ( spec �nyj house"), then a second Form'ril old he rutninud and completed when" the property is , , i sold and submitted to Lh in office with the`appropriate deed recording. } '+ I-" - - - - - - - - - - - - - - - - //- - - - - - - - - - - - - - - - -- - -_,;. Owner of Property � Beryl /� JDhNff1/� l , t , Location of Property J54146/1 Si;,. Section 32 , T 36 N R W Township JET �y����f1 irz13r. Mailing Address SQ� i Subdivision Name Lou Number 6 Previous Owner of Property (rj�/Q<1C2_Z77_46/9/ 00A/ " Total Size of Parcel 3. 53 acres rA1CA1&1011ti2 &k/ 3, 01 gCres SxcC Date Parcel was Created `J 101" Are all corners and lot lines identifiable? Yes No +} t Is this property being developed for resale (spec house) ? Yes ,r Volume $ 39 and Page Number _�?/ as recorded with the Register of Deeds ttir .1" . 7r FOLLOWING: b > > L.ICA"ION ONE OF THE INCLUDE WITH THIS APPLICATION 0 1. Warranty Deed 4� 2. Land Contract I r 3. Other recordings filed with the Register of Deeds Office a� ,: In addition, a cerLf f I od murvvy, I i nva l i nh l u, would be helpful so as to avoid' del}aysta }I'a A of the reviewing parer. m". f f th}+ dnvd dv"c(• I ptlon references to a Certified Survey yon Map, rho the Car L l f l ud Ilill'vny h► p oho I I On"}}n h" ruquired. 1 (11}111( I, V1 R 1FICATION i I (We) cekti.6y that aft baa,teuientb on this 6oAm ane Me to the but o6 my (OUX)AH, A c� 4 knowledge; .t'l & I (we I am (tvie�) .the. own (z ) o6 the p4opetty deschibed in thia + pi ell, K�4 in6onma.t�.on l6o!>m, by v.tii,tue. o� a ukr!c!i�uia� de td !�eeacded In the 066ice 06 the xt�'vu C County PegiA tut o6 Pads as 1�clr.( uu�r(.t: N(,, 7 s2 and that I (we) nneaentty oun the t>>i pomd We Q 4hV Awage (Ct.6poaaZ system (oA I (We) have obtKned an easement., to moi cui,th the nbove, desui,.bed pn.opekty, bon the constutcti.ox o6 said „yAtcm, and the same haA been duP.y adcoaded in the 066.tee o6 the Courtly Regiz t:ex o6 Veeds, as Uunumea.t No. ) . SIGNA' RE (IF Milt SIGNATURE Or C0 OWNER (IF APPLICABLE) IfIv 916, • 4 DATE SIGNED ___ DATE SIGNED :` ' O,>CUMEPJT NO. 'WARRANTY DEED STATE BAR OF WISCONSIN FORM 2--1982 447 52 I .� wc! 839 PAGE 615 REGISTER'S OFFICE Gerald A. Johnson and Linda D. Johnson CROIX Co., WI . ST.Recd for Record his wife ... .......... MAY 0 31989 at 11:15 ..... . .............................. A.M con�•r,-K and warrants to .............Jffrey A. Johnson and Sharon R.,, ,7ohnson.,...hu5band..and..w.ife...as.. marital. survivors,hi ... ro •sr ty....... ...... ..... RegtsterofDeods P P.. p i ..... .... ... ............................... ........ .. ..................... ....I.. .... ..... - it ....-.. .. RL•TURN TO Gwin & Gwi.n _ 430 Second St. _ ..... .:: .... ....... .. . Hudson, WI 54016 I ... .. .. . ... ........... St. Croix Count the ''tmowing described real estate in ............... ...... . y, f state of Wisconsin: I Part of Tux Parcel No: ..D.30.-1-195.-8.Q. A parcel of land located in part of the NEk of the SWk of Section I 32, Township 30 North, Range 19 West, described as het- 1 of a Certified Survey Map filed January 6 , 1989 in Vol. 7 of Certified Survey Maps, at page 2060 as Document no. 444 a ice of the Register o . ee s. TOGETHER WITH AND SUBJECT TO any other easements , covenants, reservations or restrictions of record, if any but this shall not be deemed to extend any such other recorded encumbrances beyond the term established by therefor. II II This is not....... homestead property. (4) (is not) Exception to warranties: 2nd da or . ..... May. 1989 Il kted this . . ......... ... y I I .........................................(SL .. . ( L A ) i S 1. ►....Ge,rald..A•...J.....nson............ ......... ................. . ...................(SF.A1.) ... ... P'�/X,.f' (SEAL) i Linda, D., Joh(/nson... ... . li AUTHENTICATION ACKNOWLEDGMENT 'ignaturr!(s) •, STATE OF WISCONSIN ....N�A......................................... St. Croix ss. ... ....... . .....................County. II authenticated this ........day of........................... 19...... Personally came before me this ...�11a......day of M a l l........................1 1 9 19..8 9 the above named I' Gerald A. Johnson and.Linda D.• •• • .. Johnson �.;,. ........... ................................................... �,tn).,, .......... ..... . �t I r1l I.E: b1 EMBER STATE BAR OF WISCONSIN �t.`�'�5r�•rrti.�o!f.. ..... (if not, '.Ir....... �.. �0.,... .....,�� authorized by § 706.06• Wis. Stats.) to me n v' to th )ers n `�,'� �?: •w to •xectittfditlte • y,• .•-. � foregoil 'nstr c and kn>�46t rg ld"'00.01 '••N ' I T'iIS INSTRUMENT WAS DRAFTED BY ! i/4f���• W,Y AttY. Hugh �....Gwin,.. Gwin & Gwin.. A •...Hu H.....Gh►i.n `'moo ................. . ' ... 430 Second St. , Hudson, WI 54016 , Not. Public ...........�,r.. !kli .......CD tf}1, Wis (Signatures may be authenticated or acknowledged. Moth my 6mrnins)on is pprmunent.(1• ton rl.1.tutlt' 1 are not necessary.) dak-t--........................,........................ ... ., 19....... .) i of persons sicninc in any capacity shuuld tw typed or printrd boluw tlu•ir eiR�u�lurox. WASIRArJ•rV.T.*•AT►. .. STA•rr nAn,nr! Q/tC!•.n.tot - .....4......... .. -- wk.A! ....-....._-...a s CERTIFIED SURVEY MAP Located in part of the NE} of the SW} of Section 32, T30N, R19W, Town of St. Joseph, St. Croix County, Wisconsin. OWNER LEGEND J C L Land Developer's Inca r' 19 St. Croix County Section Corner Monument 863 Strawberry Drive 0 V Iron pipe found. Hudson, Wi. 54016 0 lu x 2411 Iron pipe weighing 1.68 LBS/linear foot set. SCALE IN FEET 1bO 50 0 100 2.51 south of fence N8905615711E East E West one—quarter line 1700.25' W, corner 41 south E} corner Section 32 153,703 sq. ft.)INCLUDING R/W of fence Section 32 �i 3.53 acres ) s �I 131,205 sq. ft.) r.l EXCLUDING R/W a� 3.01 acres ) , — o e CSM vol. 5, pg. 1359 O - " LOT 1 N �I O cl u 1 41 I N900001 0011W CL i 26.081 71 o ; `` M o I u 6'•, `` \ ��'� " N90 00 00 W , CSM vol. 6, pg. 1522 26.08' t - 2� \ t,�0 -------------------- ` s' `' ✓ W o vt, „r «qty: J \\4 f 5 \yco LEM C. ev O \\;' yam\ '0 �°� •o\ unplatted v o, \ n \ lands 0) a co \ ° a SEE DETAIL ON SHEET 2 4 M s .o 'y�., ��'• io N9000010011E 510.431 c �� 459.381 � MATCH LINE LOT 2 x.13 2 , J,f SHEET 1 OF 2 SHEETS i t F MAM 0o06N MuBlilloM 191'081 ISS'iLi Mu6£iS0o6SN 1IM P 019 100'L91 91 - 91 iS£'L9 IZI'L9 9116018490 11M CCo91 4E1'£L !Z1'E4 Mu11i91oESN ulliE0o81 9 JZO'0£ 100'0£ MnOSi6Zo99N u9SiZZ04 e Mu8ll1IORN Mu9lllloOLN W041 i00'L91 MuOlillaO N u00i00oZ1 l00'E£Z 1i - £1 MiiBliiioOLN Mu1ZiSl089N lE9'S l£9'S AijM E1o69N u1SiSSol 100'491 Zi - II 3u8lilloOLS 3u8hl lo9ZS iZ1'ZZ.I 169'611 3u8lilioO S io00lOQoZ1 100'L91 01 - 6 3u8lilloRS 3400046S 19£'ISZ jSE'6£Z 3 Rs£ 0o6SS uZ1i81OT9 I00'E£Z 8 L Mu00lOOoO6N 681illo8ZN 19L'Slz iS1'SOZ Mu6£tSOo6SN 1IM 0 019 100'00Z 9 - S !86'£6 j60'E6 MuEhiB£o M u0Si1So9Z 3 06'01 !£8'01 h S'O1lLSoO9N uS0lEloii 9 191'11 19L'II MA'Sli0Eo89N uSOiZZoE e Mu8illio8ZN M dlilloOLN 119'911 !SE'E1i MuBllllo M 1100100oZ1 100'00Z MA li floOLN MwHoOoSgN iEZ'L IEZ'L Mu M 60o69N nZIi10oZ 100'00Z Z - [ SONIaV38 1N39NV1 HAND HAND 9NINV38 319NV H1SN31 838WIIN 38V QHOHO QUGHO 1VNIN33 SHOD 3A M F DELTA CONSTRUCTION, INC. Lon # r 4K #Wei ._ FT ,r • FT dhow Livinip boom Location On Plan I . , IV. ... FT L/viMy �'M __.'T F 1+I I tJ. �FT r FT 3/ P0/1.vq /TINS Z.41VIC 4e 0wrA r` �' .Ti .Anwt. ;.ddrees t: H t STC - 105 y . y 'S 11 'TANK: MAfN'PLNANCE AC1tl.l:MLN1' St . Cro"ix "County °� v OWNER/BUYER ,�+y-/C +� lft . VGY►Iwo ROUTE/BOX NUMBER /p�3� /�oice ��� we Fire Number '107.3/ CITY/STATE t/�/SO Z P "' /AV YItOPl'lt TY LOCA1'ION : 4, -. 'Seetx/un ,? 1' il ;"` !2 -W,• , Town of ._571056e#..", St . Croix County Subdivision Lot "numbe r Improper use and ma`in"tenance of ,your supti(' SyStem could result "in its premature fai1ure.,to "handle ':wastes . " Proper; in int ell ancetcan silts of pumping out" the septic ;tank , evury tliree :'year"s o,r.` soo"ner ,4. k if needed , by, a" lic`ense'd sup tic ,`tank' . �uinher. What yo'u pu`C into :< 4 the system can affect the funeti'on 'of,. 'tl c " S >>Lic tank, as a ""treat " inert stage; ln, the " waste disI)osal system .,' St ;Croix. (.ouitty r"e idents ..ma' bL eliglb:le. tci reexelv.e` a !;rant," 'or 4, a ;maxi'mum of 60/ yof the+ cost of �repl�accment . of a Mailing "s"ystem,ti 'fit � 'S whit h; was •inoperataon ;prio"x to��Jul 1 , 1978 S[": �('ro� aGounty y ?. S J:�f k„.-,+ a,.r accepted this prugr�ams_ -,q, ugusC*~oL11c)8U.r with the.` req`uirLme nt `.that' n.,.. ,..x.,,74 w i+ y t d k tt r. n, r uwner.9 of '_all new systeius abree� to keep their Sys?tems° properly �f � 1r4{ malntainad . 1'IIe..' ru ert p p ' . y ;"ownur agrees to "submit 'to St :" .C,roix `Cou"n"ty 2oniri"g a . certification. form,. signed " �y the ".owner "and by a master plumber , journeyman; pl'umber ,f restricted p'luIn er u"r a ,liter"led 'pumper. veri x f in "that.", 1 the on site ° wasCewa ter dis uSal s �steili'; i,s;� n � Y 6: ) .; P Y. propert operat'in'g condition' and:,• (2) after� ln'spection -and `pu,np,inb ;(if. 'nec ' t; essay -i y) , the septic:'tank is less than 1/.3 full of shudge .,and . scum Certification form will be 8entL.''app'r'oxim'ately 30;:days prior Az to t three year expiration .' •� ` I/WE, the undersigned ,. ,have �. ead� the, above requirements and " agree, ± cn to maintain the private sewagg "di"spo,sal system i'n'- ac"c`ordance'`.with:. ' 1_4 , the- standards Set forth', herein;"; as.'set by the Wisconsin ,D.epaxt ment of Natural Resources . Certification form must :"he completed a and returned �_to; the St : Croix Co_unty!' Loring Office within30xdays � ' of the three year Jexpiration datreE s rs 'SICNED t , yDA W ! fr t P St . Ctl"oix County Zoning Office P.. 0 f•ox 98 C; Hammor d , ,WI 54015 715=7� 6-2 2 3 9 or 715-425-8363 Sign , date and return to above address Y r " ,....., � ,3=v s�a v� K.'':�jy"'''`T.c.. a.. i _, .'*2^a'"# •S"'x3 ;- -car,;s �. WDUS REPORT ON SOIL BORINGS AND �FETY&BUILDINGS INDUSTRY, C DIVISION HJJMA AND PERCOLATION TESTS (115) MADISON,WOI53707 H).1MAN R E _ATIONS� (H63.090)&Chapter 145.045) / , OWNSHII`/MUNWFPArWY: 0. : SUBDI N N ME: 1 "/4 J✓ / ii jv'NR� Lor s p COUNTY: WN AM : 5�C I(tr A.d J g j S pw ti Awe/;& i' w-';-t k .Sdh USE DATES OBSERVATIONS MADE 23kesklence 3 Pr4ew ❑Replace /F f/ y ` � 0 iRATING:S-Site suitable for system U-Site unsultable for system OV J E_, .1mg L .JV IN ❑� ❑S - [Is 5 .RECOMMENDED SYST/1W / �711>�,MS i. If Percolation 'ests are NOT required DESIGN R TE: If any port ion of the tested area is in the under s,1-163.0"(5)(b),indicate: s Floodplain,indicate Floodplain elevation: - �RQFI:.t-GsSCRIPTIMIS ELEVATION - BORING AL A NCH N S ,COLOR,TEXTURE,AND DEPTH NUMBER DEPTH B VED TO BEDROCK IF OBSERVED. EE ABBRV.ON BACK.) El- I B- 1"� n.67' > , 7s 7, ,g"�3,I siJr J. B_ PERCOLATION TESTS DEPTH ATER IN HOLE TEST TIM! 7 BOIS IN WXY11 EEVIVIRMES RATE MINUTES NUMBER I U69 AFTER SWELLING INTLRVAL-MIN. QQ2 PERICU33 PER INCH P P- 2 a- P- P- PLOT PLAN: how locations of percolation "in, soil borings Issd the dimensions of suitable soil areas. Indicate scale or dimness.Describe what are the hori- zontal and van cal 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 �! _ _.- _ I -, -r_ 1 00 5 01 kn• 3 19 s I i 1.6 1 B3_I♦'s .,f AXI.C.. i 1,the undersig ied,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 date recorded and the location of the tests are correct to the best of my knowledge and belief. NAME Xlrw7 TEST WERE M ETED ON: iilw ADD CERTIFIC I MBER: PHONE NUMBER(optional): of it CST SI NA E- 1 DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. I DILHR-SBD-6?95 (R.02/82) +- -OVER- i R Q. L. �� 7 PLOT A �, � ► � . 0S � SEC () P R 0 J LCT PLUMB E I.� NAME k ��1�N s a., ._._._ NAME ms 'I C L 0 C AT 10 ��. J2��I'�N� 1�� �.�>� L I C E N ST :ff._... Jo.s g__...._ ..__. :_. ... _.__ . . ._.. (._�A.T E �. :. .. aU__._.1_9 y _ _.. P LO 1 M A_P N�fie: ACPrj� IDY5 W,1)s . 1���� r'a OM S-101 c sv b F'rz�r� 5<py; L ' . 2 �_ So'--� lip QQ� 104 1 v I�x 3b ��n 9p 3 )(Pe — — IP y5' is ' -x 33 SO' 11 1. 03 am D ' TOP Spec) 1� 1N 9RUI ems« Ks L= Igo,o j Y k= Peas hole S. S • 4 �U' es 3.3'_.._... .._ FRESH AII? INLRTS AND OBSERVA'1100 PIPE C12nSS SECTION ' Approved Vent Cap Minimum 12 M' m Above b ,. A o Final Graco_�__� �oU'aa 4" Cast Iron Above Pipe , Vent Pipe To Final Grade*----_. Marsh Hay Or Synthetic Covering Min. 2" Aggreg'�1l Over Pipe `�- Distribut-ii� Tee Pipe _..._....__..I._ Aggregate v Perforated Pipe Below �aRorv. OR Beneath Pipe < Coupling Terminating At Bottom of System