HomeMy WebLinkAbout038-1036-20-000 (3) l CE1VEG
2011
Wisconsin Depa ent of Commerce SOIL EVALUATION R &I._..�,. Page of
Division of Safety quilcJ' �� 'UfVTY
L : `.Veil,xONINC�Q�'Fa i with Comm 85,Wis. Adm. Code
�Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must County< l
include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D.
percent slope,scale or dimensions,north arrow,and location and distance to neare road. Q
Please print all information. o?p?/y Z �. view D/at
Personal informabon you provide may be used for secondary purposes(Privacy Law,s.15.04(1) ).
Property Owner Property location
rr.th L C4 " cc-ka f 4i"1-6 Govt.Lot 1/4 _ 1/4 S O T 3 N R E(o(WD
Props ers Mailing Address V Lot# Block# Subd. Name or CSM#
'J / !� /1?e
City State Zip Code Phone Number ❑City ❑Village 'Town Meares Road
❑ New Construction Us • Residential/Number of bedrooms Code derived design flow rate .� 2S"?J GPD
Replacement ❑ is or co m/eraal-Describe: �!_
Parent material Flood Plain elevation if applicable 41, ft.
Generalcomments Al�n - 7— 1.
and reoorrrnerxlations: X�M-v'��� �� I"l�O r-� > Ka—
Boring*
System Type � �System Elevation `Boring g�
pit Ground surface elev. ! ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
In. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 I •Eff#2
f D-� 0 /ti. - ---- f�
Z- 6 -s�z
Boring# a Boring
opit Ground surface elev.! O-I aft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2
Effluent#1 =BOD >30 1220 mg/L and TSS>30 1150 'Effluent#2=BOD <30 mg/L and TSS<30 mg/L
CST 1VWN(Pleas@ Print) CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted Telephone Number
1008 192nd Ave, New Richmond, WI 54017 715-246-4516
Property Owner_ Parcel ID# Page of
1-1 Ong# ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2
❑ Boring# ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor )n• aoilEplication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu.Sz. Cont Color Gr.Sz.Sh 'Eff#1 'Eff#2
❑ Boring
F—I Boring# Pit Ground surface elev. ft. Depth to limiting factor in.
❑ Soil lication Rate
Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2
EEH
Effluent#1 =BODS>30:S 220 mglL and TSS>30:E 150 mg/L 'Effluent#2=BODS<30 mg/L and TSS<30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
s13134330(t.6=)
Soil Test Plot Plan
Project Name Viginia Schumacher and Family Shaun B"
Address 1791 Stanford Ave f
St. Paul Mn 55105 CST #226900
Lot ------ Subdivision --------- Date 7/2-5/11
SE 1/4 SE 1/4S 8 T 31 N/R18 W Township StarPrairie
F1 Boring Q Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Bottom of siding
System Elevation TBD *HRPSame as Benchmark
Squaw Lake
B-1
Scale is 1" = 40'
25' unless otherwise
25' 25' 40' 60' noted
Existing 0'
25' bedroom cabin
ivy B.M.* 15'
10' 6'
Well
Driveway/Cabin Lane
70'
°a
Property Line - F;
Cam , ,
Property c
Line to
f - „
100th St.
Area not suitable for
systems due to irregular
slopes 100th ST.
0,6 q-75fof' 961SEYq
Wisconsin Department of Health and Social Services
01b._#67 3/70 Division of Health
SEPTIC TANK PERMIT APPLICATION
TYPE or USE BLACK INK
A. OWNER OF PROPERTY
Name // Address (Street,.City, Zip(`ode)
B. LOCATION OF PROPERTY WI.M SYSTEM WILL BE CONSTRUCTED ALTERS* OR EXTENDED COUNTY
Check One:
CITY VILLAGE LEGAL DESCRIPTION
TOWNSHIP
C. IS LOCAL PERM REQUIRED FOR THIS WORK? YES NO PERMIT NUMBER
D. SEPTIC TANK CAPACITY le-<e0'0'' Gallons NEW INSTALLATION X, REPLACE2"1ENT ADDITION
MATERIALSs Prefab Concrete Poured in Place Steel Other
NUMBER OF TANKS TO BE INSTALLEDs
E. TYPE OF OCCUPANCY
Check One: One or Two Family Residence Cocmercial Industrial Other
(Specify)
Number of Persons to be Aocommodated 4— Number of Bedrooms
F. APPLIANCES, ETC: Food Waste Grinder YES NO Automatic Clothes Washer YES�� NO
Dishwasher YES _ NO Automatic Potato Peeler YES NO
Other (Specify) —7
G. MASTLR PLUMBER MAKING INSTALLATION
Name: zC1 /�. I ; sir. Addresss JG_'�1.1�'c N`'rr,�-z. :-�Lioense Number:
MP
Signature of Applicants MP RSW
Address: /
H. (To a Completed by Issuing Agent)
Date of Application `? /1`// 49 Fee Paid f T
Permit Issued (date)_ I �� ` 0 _ Permit Humber Z
Agent (Name) ;Y;rL .i. LA � t �j ir,•, For4 � ��F-C�i �
Town, Village, City, County, etc.
(Specify)
Note: The application cannot be considered for filing until all of the above questions are answered and the
fee paid. Agents will forward application, the fee of $1.OU for each septic tanK and the third copy
of the permit (canary) to the Division of Health. Checks ana money orders should be made payable to
the Division of Health.
Do not write in space below - FOR DEPARTMENT USE ONLY .
I. DATE RECEIVED °� r 7 G ACCEPTED BY RETURNED
(Initials) (Date) See Corres.)
FEE RECEIVED VALID. No. � C��c� PERMIT NO. .
(Yes or No
REVITWED BY APPROVED _ DATE
(Initials) Yes or No
COMPLETT OTHER SIDE
SEPTIC TANK PERMIT NO.
R Z P 0 R T O N S O I L P Z R C 0 L A 7 1 09 T Y S T
A N D S O I L B 0 R I N G S
TO
DIVISION OF HEALTH - PIAMING SSCTIbN .
P.O.Box 309, Madison, Wis. 53701 ;
r ,
Pursuant to H 62.20, Wis, Administrative Code
P S R C 0 L A T I 0 N T E S T
Test Depth Character of Soil •Hours Water Test Time . Drop in or Level Inohes Minutes
Number Inches Thickness in Inches Sines Hole in Hole interval Second to Next to Last To Fall
let Netted Ovsrni in Minutes Last Period Last Period Period One,Inch
Example
P 0 3611 Top Soil 101 Clay 26" 25 Yes or No 30 1/2 1/2 1/2 60
s F , ! .can r: 1
v RECORD DATA FROM MINIMUM OF 3 TEST HOLES
Compute size of absorption area in accord with H 62.20 Wis. Administrative Code.
S O I L B O R I N G S Minimum 361 Below pro osed Ab§ ion S stew
Boring Total Depth Depth to Ground Water Depth to Bedrock
Number Inches Observed Estimated Observedl Estimated Character of Soil with Thickness in Inches
Example
B - 0 72'1 721 Black*Top Soil 12" Clay 181!j Sand 181• Gravel 24'
cam--
RECORD DAT-A FROM MINIMUM OF 3 BORE HOLES
PE OF OCCUPANCYt
RESIDENCES Number of Bedrooms _ OTHERS (Specify) Number of Persons
D WASTE GRINDER* Yes No Dishwashers T93L No �_Automatic Clothes Washert Yes Ne
FFLUENT DISPOSAL SYSTEM: NEW EXTENSION ADDITION REPLACEMENT
Tile Size No.Lin.Fest Trench Width Depth Number of Lines
Seepage Bed: Length Width =/ Depth Tile Size No. "Lines
Seepage Pits Inside Diameter Liquid Depth
I+ the undersigneds hereby certify that the percolation tests reported on this form were made by me or under m•- super-.
vision in accord with the procedures and method specified in Chapter H 62.20 (13), Wisconsin Administrative Code, and
that the data recorded and location of test holes are correct to the best of my knowledge and belief.
NAME c I= J G I� l \ TITLC /V�
Type or Print
REGISTRATION N0. or •MASTE/R PLUMBER LIC£NSIs N0.
ADDRESS
DATE -7 SIGNANRE
..1 '
1%
8�+rz,�rz) i
KATHLEEN H. MALSH
REGISTER OF LEEDS
ST. CROIX CO_ , MI
RECEIVED FOR RECORD
12/07/2006 10:30AM
QUIT CLAIM DEED
EXE?907 N 8
REC FEE: 17.00
TRANS FEE:
COPY FEE:
CC FEE:
PAGES: 4
QUITCLAIM DEED Name and Return Address:
Individual to Individuals Stuart E. Schmitz
400 N.Robert Street,#1840
STATE DEED TAX DUE HEREON: S St.Paul,MN 55101 v
Date: �0�3 U 2006 PIN#038103620
THIS IS NOT HOMESTEAD PROPERTY
FOR VALUABLE CONSIDERATION, Marie A. Fourre, now known as Marie A. Fourre Russ,
by her attorney-in-fact Thomas D. Fourre, Grantor, conveys and quitclaims to Constance M.
Zirrney,Mary Elizabeth Fourre,Virginia L. Schumacher,Margaret A. Fourre, and Mark W. Fourre,
Grantees, real property in St. Croix County,Wisconsin,described as follows:
See Legal Description Attached
together with all hereditaments and appurtenances belonging thereto.
The consideration for this transfer is less than $500.00.
AJfrx Deed Tax Stamp Here
Marie A. Fourre, aWa Marie PC Fourre Russ
by her attorney-in-fact Thomas D.Fourre
STATE OF N o(" Ca(0 4AO— �
)ss
COUNTY OF 86 S'&1'1 )
I
The foregoing instrument was acknowledged before me this 30 d of Uc-t.6e r, 2006,by Thoinas D.Fourre,
attorrre ,�r�-�aet.fpr Marie A.Fourre, Grantor.
N TARY a
r -
THIS'1 S CJ1vT1✓NT WAS DRAFTED BY: TAX STATEMENTS FOR THE REAL PROPERTY
DESCRIBED IN THIS INSTRUMENT SHOULD BE
SENT TO:
Stuart E.Schmitz
Schmitz&Schmidt,P.A. Virginia L.Schumacher
400 N.Robert St.,#1840 1791 Stanford Avenue
St.Pail,Minnesota 55101 St.Paul,AIN 55105
(651)291-2405
9 of 4
t.' t
An undivided one-half interest in the following described
property; Commencing at a point 800 feet West and 825
feet North of the Southeast corner of the Southeast Quarter
of the Southeast Quarter (SE4 of SE4 ) of Section Eight
(8) , Township Thirty-one (31) North, Range Eighteen (18 )
West; thence East to the East line of said Southeast Quarter
of Southeast Quarter (SE4 of SE4 ) of Section Eight ( 8 ) ;
thence North 150 feet; thence West to the West line of
said Southeast Quarter of Southeast Quarter (SE-1, of. SE'-,)
of said Section Eight (8) ; thence South 150 feet; thence
East to the point of beginning, St. Croix County, Wisconsin.
I
2 of 4
Parcel #: 038-1036-20-000 08/09/2011 08:02 AM
PAGE 1 OF 1
Alt. Parcel#: 08.31.18.158D 038-TOWN OF STAR PRAIRIE
Current [X 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
O-SCHUMACHER,VIRGINIA L
VIRGINIA L SCHUMACHER C- FOURRE,THOMAS D
CONSTANCE M ZIMNEY,ET AL C- LALLY, CATHERINE
1791 STANFORD AVE C- FOURRE, MARGARET A
ST PAUL MN 55105-2043 C- FOURRE, MARK W
C-ZIMNEY, CONSTANCE M
more...
Districts: SC=School SP=Special Property Address(es): `=Primary
Type Dist# Description 3 1.
SC 3962 SCH DIST NEW RICHMOND
SP 8050 SQUAW LAKE RHAB&MANAGE u
SP 1700 WITC
Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE
SEC 8 T31 N R1 8W N 15OFT OF S 975 FT OF Block/Condo Bldg:
6 rd SE SE J
�� y
Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
r S s I
08-31N-18W
Notes: n Parcel History:
Date Doc# Vol/Page Type
� ' 7�-7 �(�' -.W 10/29/2007 863172 QC
rUAU \ 12/07/2006 840201 QC
08/10/1987 428950 787/56 PR
2011 SUMMARY Bill#: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/13/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.000 116,900 35,500 152,400 NO
Totals for 2011:
General Property 0.000 116,900 35,500 152,400
Woodland 0.000 0 0
Totals for 2010:
General Property 0.000 116,900 35,500 152,400
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
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