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HomeMy WebLinkAbout030-2042-30-100 § � / / % ( � \ 0 f E §/ \ F- / /j , E)2 E OE D —,x ¢ Cca 0 (D \ §®a§a.\ \ k/Eg�2 9 2 � \ � > LL § - ° # )/ ) 5)22E J # s � / w E Z z' 0 z / k � m \ z a 2 .. / B 2 2 - ) $ J 3 z m w 2 o / z '0 _ ^ \ \ . ƒ \ j } ) k \ � 2 . a ) 2 c a. 0. 3 @ \ - 0 ■ 6 » 3 a o a = k \ \ k k k \ s 2 2 a k § § J e m = 2 v 2 § § o G U) § \ \ E U) § § % 2 = N ) ° . o 2 J z 2 , ■ % k § 2 c cl / 2 E 9 r- \ 6 q / S k \ [ \ 7 L / § ` 7 § / 2 « § , « ) 75 ( \ @ § CD- \ E 20 « w \ k / § 0 2 f / \ 2 2 § ; k C � LL: a �) ' k 0 § \ 3 a 2 0 & 3 Parcel #: 030-2042-30-000 02/11/2005 05:13 PM PAGE 1 OF 1 Alt. Parcel#: 26.30.20.493C 030-TOWN OF SAINT JOSEPH 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 MCCONAUGHEY,SHAWN&BARBARA SHAWN&BARBARA MCCONAUGHEY 1398 20TH ST HOULTON WI 54082 Districts: SC=School SP=Special Property Address(es): "=Primary Type Dist# Description " 1398 20TH ST SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.020 Plat: N/A-NOT AVAILABLE SEC 26 T30N R20W 3.02A IN NE NE LOT 1 Block/Condo Bldg: CSM VOL III PAGE 718 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 26-30N-20W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 585/325 2004 SUMMARY Bill#: Fair Market Value: Assessed with: 6072 173,100 Valuations: Last Changed: 07/09/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.020 75,700 94,600 170,300 NO Totals for 2004: General Property 3.020 75,700 94,600 170,300 Woodland 0.000 0 0 Totals for 2003: General Property 3.020 44,300 78,800 123,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 208 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS I LABOR 1.HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISON 'P.O.BOX 7969 BUREAU OF PLUMBING MA ISON WI 53707 NW44,N 4,S26,T30N—R20W nCONVENTIONAL ❑ALTERNATIVE IS,,,, fassigne VD,Number: of assigned) Town of St. Joseph ❑Holding Tank ❑ In-Ground Pressure ❑Mound 20th Street NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Ken Knefelkamp Route 1, St. Joseph, WI 54082 9-0cI- g 3. av BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: C .ELEV. Name of Plumber: MP/MPRSW No.: County: Sanitary Perron Number: Donavin Schmitt 3205 St. Croix 112651 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY: TANK INLET ELEV.'. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER to ""✓ / 0 PROVIDED. PROVIDED. ❑YES ❑NO DYES ON BEDDING. VENT DIA.. VENT MATL: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING.IV ENT TO FRESH ALARM FEET FROM LINE. AIR INLET EYES ONO DYES ❑NO NEAREST DOSING CHAMBER: MANUFACTURER BEDDING'. LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING C0V ER PROVIDED: PROVIDED. OYES ENO ❑YES ❑NO DYES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM `I"E AIR INLET PUMP ON AND OFF) DYES ONO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKING Or excavation. (If soil can be rolled into a wire,construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH. LENGTH. IN OF DISTR.PIPE SPACING COVER INSIUE DIA 3P1T5 LIQUID BED/TRENCH i /� TRENCHES MATERIAL: PIT DEPTH DIMENSIONS ,G1. S GRAVEL DEPTH FILL DEPTH IDISTR PIPE DISTR.PIPE DISTR.PIPE MATERIAL. NO.DISTR. NUMBER OF PROPERTY WELL BUILDING VENT 70 F RE51I BELOW PIPES ABDVE COVER ELEV INLET ELEV.END. PIPES FEET FROM LINE AIR INLET NEAREST--10 MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. ❑YES El NO SOIL COVER ITEXTURE PERMANENT MARKERS OBSERVATION WELLS OYES 1:1 NO ❑YES NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER. EDGES. 1:1 YES 0 N DYES ONO 1:1 YES ONO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH'. LENGTH. NO.OF LATERAL SPACING GRAVEL DEPTH BELOW PIPF FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL NO DISTR DISTR.PIPE DISTRIBUTION PIPE MATEHIAt.&MARKING ELEV.. ELIV.. DIA, ELEV. PIPES DIA: ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING. GRILLED CORRECTLY COVER MATERIAL pLANSCAL LIFT CORRESPONDS 70 APPROVED OYES ONO ❑YES ONO COMMENTS: PERMANENT MAR KERS: OBSERVATION WELLS. NUMBER OF PROPERTY WELL: BUILDING Q FEET FROM LINE J DYES El NO I ❑YES ONO NEAREST i� 02 J D Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE. TITLE 1 DILHR SBD 6710(R.01/82) Zoning, Administrator —�° SANITARY PERMIT APPLICATION COUNTY ��D�x � DILHR In accord with ILHR 83.05,Wis.Adm.Code STATE SANITARY YPPERMIT# Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER 816 x 11 inches in size. —See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES LANO PROPERTY OWNER PROPERTY LOCATION '/4 — /a, S T , N, R ,Z6 E(or PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME IVA CITY,STATE ZIP CODE PHONE NUMBER CITY NEAREST ROAD,LAKE OR LANDMARK •r, � Q� �►Z ❑,VILLAGE: r 1 7 TOWN II. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family OR ❑ Public(Specify): III. PURPOSE OF APPLICATION: (Check only one in#1. Check#2,3 or 4,if applicable) 1. a. X New b. ❑ Replacement c. ❑ Replacement of d.❑ Reconnection of e.❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit## Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in#1 and only one in#2) 1. a. Conventional b. ❑Alternative C. ❑Experimental 2. a. ❑System- b. ❑ Holding C.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. DC Seepage Bed b. ❑seepage Trench c. ❑See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 14. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): 13 C h,5" Feet DC Private ❑Joint El Public VI. TANK CAPACITY Site INFORMATION in allons Total #of Prefab. Fiber- Exper. New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks strutted Septic Tank or Holding Tank ®� S ❑ ❑ Lift Pump Tank/Siphon Chamber ❑ ❑ ❑ VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system shown on he attached plans. Plumber's Name(Print): Plum Signature:(No Stamps) P WSW Business Phone Number: felt! u Plumber's Address(Street,City,State,Zip Code): Name of Designer: 111. SOIL TEST INFORMATION Certified Soil Tester(CST)Name ` CST# z'E� 12 Ptf CST's ADDRESS(Street,City,State,Zip Code) Phone Number: IX. COUNTY/DEPARTMENT USE ONLY ❑ Disappw roved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) inApproved ❑ Oner Given Initial Surcharge Fee �Y ac oz, Adverse Determination 1 �- w X. COMMENTS/REASONS FOR DISAPPROVAL: SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber r INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT ' APPLICATION TO THE APPLICANT: 1. This 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. A new permit may be needed if there is a change in your building plans, system-Iodation, estimated wastewater flow (number-of-bed- rooms, etc.), depth of system, or type of system; 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. Private sewage systems must be properly maintained,The septic tank(s)should be pu-mped by-a licensed pumper whenever necessary, usually every 2 to 3 years; 6. If you have questions concerning your private sewage system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 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 where the system is to be installed; ll. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. Responsibility statement: Installing plumber is to fill in name, license number with appropriate prefix (e.g. r MP, etc.), address and phone number. Plumber must sign application form. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Departme'nt Use Only; v X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8/2 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; dosing or pumping chambers; 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. ------------------------------------------------------------------------------------------------------------------------------------------------------------ GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was the result of over 2 years of steady negotiation and public debate. The groundwater bill Ground ate- included the creation of surcharges (fees) for a number of regulated practices which Wiscor,in`s e can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried reasure' is used in your building is returned to the groundwater through your soil absorption o system or the disposal site used by your holding tank pumper. The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- t water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398(R.03/86) APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, ("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property (cke, �e &6 Location of Property �� h;, Section , T 3 j N-R W Township Nailing Address L(o �- Address of Site f�/? 'VV` T Subdivision Name _ . Lot Numberj� Previous Amer of Property ju� Total Size of Parcel Date Parcel was Created )C. o GIL 2),"7 LC1 7`6 Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume _5 end Page Number �j 7 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 refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. I - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION i (ode) ceJt.Li.6y that ate AtatementA on tl'.th �onm ane tAue to the best o6 my (ouh.) hnowtedge; that I (we) am (anal e owner(a o 6 .the phopeh ty dens oti.bed in thi s .tn601mation 6orun, by viAtue o6 a waAAanty deed tecokded in the 066.ice 06 the County RegiAteA o6 Deeds ah Document No. � 3 9a 0 ; and that I (We) pneeentty son .the pftopobed bite bon the (sewage diAS o,S eyes em (on I (we) have obtained an ea.a ement, to nun with the above deg cAibed paopen ty, bon the eonAtnuati.on o6 aa.id Aya.t , and tke came ha.e been duty A cohded .in the 066.ice o6 the County Re9jAteh o6 fl i IGNA 0 OWNER SIGNATURE OF CO-OWN R (IF AP ICABLE) DATE SIGNED DATE SIGNED I DOCUMENT NO. WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA STATE BAft OF-WISCONSIN FORM 2-19821 428650 --- - ?� REGISTERS OFFICE Norman C. Knefelkamp and Kathleen Knefelkamp, j ST. CRIOiX 00., WIS. ----------------- husband and wife - - Recd. for Record thls31st .- - -- --------------------------------------- ---------------------- . .- -- - - -- y of J_ u�.._aD. 1987 ii conveys and warrants to -Kenneth..J..- Knefelkamp and 9:30 A ---- --- i"li�l Ziusk� d.._ xtd..wife.t .----..... marital pty - ------ ------ ----------- -------------- • w.r. ------------- -- ------------ ----------- -- -- ------ .......----.-----..._..._-..__..-..._._._-_-....._--.......----------...------------. ............................ r RETURN TO �1 -..._... .... Kenneth C. Knefelkanp ---- -- ----- ------------------------------------ ------ ----- .. .--------------- ---•----------- Rt. 1 Box 608 County, -S - - the following described real estate In St....CrlJl�. ..................... St. Joseph-, —WI- 54082 State of Wisconsin: Tax Parcel No: I� A parcel of land located in part of the NE4 of the NEh of Section 26, I, Township 30 North, Range 20 West, further described as follows: Lot one (1) of the Certified Survey Map recorded October 27, 1978 in Vol. 5, page 1857 as Doc. # 428430 �i j ii I II i This -_is not homestead property. (is) (is not) j Exception to warranties: ii Dated this -------31St......---• ------- -------- day of --- `�u1y---- -------------- --....... --------• ----------..._., 19.$.7... ---- --------- -- • -----(SEAL) (SEAL) i I' Norman C. Knef�l--•-mP--- ----------------------------------- ----------------------- ..........(SEAL) `. "......(SEAL) ii athleen Knefel p � I AIITHENTICATION ACKNOWLEDGMENT Signature(s) NQX-m. ,11__- ---and-- STATE OF WISCONSIN Kathleen Knefelkamp ss. ---------------------------•--------•------•----------•------------------------ ...................•------------------ County. authenti d Pt �._ of.___ )l�.�t_____________ 19._$7 Personally came before me this ---_------------day of •wy ---------------------------- 19........ the above named �' -•--------------------------------------•------------------------------•-------- * Hush F Gwin --------------NIA --------------- TITLE: MEMBER STATE BAR OF WISCONSIN i (If not- -------------------------------------•---- - authorized by § 706.06, Wis. Stats.) ------------- -------- to me known to be the person ............ who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY -----•---------•-----•---•--------------------—---—`-----------•---_ —- _Attorney_Hugh---------------------------------------F. Gwin, Gwin & Gwin *-..------ -- ----- ------ - 430 2nd St_._,_ Hudson, WI 54016 Notary Public _.. ___-_--.-- ._County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent.(If not, state expiration are not necessary.) date: *Names of persons signing in any capacity should be typed or printed below their signatures. WARRANTY DZRD STAT$ BAR OF WISCONSIN Wisconsin Legal Blank Co. Inc. FORM No. 2-- 198E �:i,... cv ' atzbt'•.� 0 —i)- avou Lu NHO! ,. 0 0 co WO d ■ M C c M L O T A 41 V 41 c 1r � Y�j Q Z Z 9 2C U) 0 cm 3 ` 1Y, �� •C J.' CI N W O N = y N CO p I M - - Y d p IA CI 0 co Go M tp c CL.p to O O O l •.1 O O d O O1 L p In In .t N d 4- w ,4- N N W Y CC Z •1 .� C 2 W d \ WI 3 i ~ ter C c zt m •-t I O L • .1 LIJ O N J Ir I O +t 4J J L _ I I z C N •♦1 X co m 41 Go M I M 0 Z _ =I N Ifs UI _ N V 1 ^• to O t0 = co O1 Cl c Id .r N ac ,- 0 Z S4 z O -•1 V 4 y X �" Ln w Q V �4 to LL) O T N L. O Z W L.I _ co 41 W 4 i `" 10 'MuSSI£ho68N .1eaq o4 pamnsse y/1 3N a4; LLB p L �� •� Jo aut144uou 044 o; paOua.OIQJ s6upeaq ¢ "' o .0 1 __�►- N d1 N O O Z O 7 4J O cm O O I O C1 Y, H 1 CI L c Z N I Q? •~ 3 O � ia}4ejd bq pauMo spuej pa; etdun — o•1 d N 1 t N 1 o ci ° 100'99 109'8Sh N S0191000N M 3.1 a/ 1- c 109'hZS to L I N L J I 4j 1 Z L �I O O al -4 1 0-4 a i v o 41 1 W o ..1 CC 1 WO V G. O W C I d t7 - • - O Q co \-• C O .-t O .r 4• 00 - O I in O M NI Z T O ~ C' N to O C I In O y N 4m M, S o N 'J O 0 to 'C I r- In to I as w" ++1 w wr ++1 ° M t ~ M 061 7 1 j s AIIS0191000S � C/7 c m 1- L ■ � v o .I24;e1d Aq pauno spu81 p83480un ►-r Q \ 4+ C W N O C = N V LLJ U of SURVEYOR'S CERTIFICATE I, Allen C. Nyhagen, registered Wisconsin Land Surveyor, hereby certify that by the direction of Norman Knefelkamp, I have surveyed, described and mapped the land parcel which is represented by this Certified Survey Map; that the exterior boundary of the land parcel surveyed and mapped is described as follows: A parcel ofa�njl located in part of the NE 1/4 of the NE 1/4 of Section 26, T30N, R20W, Town of St. Joseph, St. Croix County, Wisconsin, further described as follows : Commencing at the NE corner of said Section 29 ; thence N 890-43 ' -55" W along the North line of the NE 1/4 , 991. 00 feet to the point of beginning of this description; thence continuing N 890-43 ' -55" W, 250 . 00 feet; thence S 000-16 ' -05" W, 524 . 60 feet; thence S 890-43 ' -55" E, 250 . 00 feet; thence N 000716 ' -05" E, 524 :60 feet to the point of beginning. Together with a 66 foot wide easement as measured at right angles for a Private Road as shown on this map; Above parcel is also subject to all other easements of record. That this Certified Survey Map is a correct representation of the exterior boundary surveyed and described; that I have fully complied with the current provisions of Chapter 236 . 34 Wisconsin Revised Statutes and the Land Subdivision Ordinance �t;,4e County of St. Croix in surveying and mapping same. ��``'�'" ' 4 ALLEN C NYHAGEPd A E-1407 t iC G 1 ►,___._ HUDSON, l 6 Allen C. Nyhagen fop Np SUa�r�'a�j. �`olt CB%���� CERTIFICATE OF THE TOWN OF ST. JOSEPH I, do hereby certify that this Certified Survey Map has been approved by the Town of st. Joseph this day of , 1985. CLERK OF THE TOWN OF ST. JOSEPH The roadway shown on this map is a private roadway. Any maintenance cost of the private roadway, after its approval by the Zoning Administratol as a standard road, shall be shared pro-rata by the adjoining property owners . Should the private roadway be taken over' by a municipality as a•=pub3�' , 'CGntmC`�""CO'S'C'""'C''iurear'tee""`�ro�1'�°�`.be,..,a.._.�yt�IYC�_"expense. H z �n a r ST C - 105 a H SEPTIC TANK MAINTENANCE AGREEMENT o St . Croix County z d a OWNER/BUYER t ROUTE/BOX NUMBER ti Fire Number CITY/STATE 6 C)� ZIP ! V "- PROPERTY LOCATION : NE �4, lv� Section _"�6 T 36 N , R �dW, Town of s� 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 con- sists of pumping out the septic tank every three years or sooner , if needed , by a licensed septic tank pumper . What you put into If the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St . Croix . County residents may be eligible to 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 . Croix 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 H three year expiration. o z I/WE, the undersigned , have read the above requirements and agree r, to maintain the private sewage disposal system in accordance with H the standards set forth , herein, as set by the Wisconsin Depart- 'd ment of Natural Resources . Certification orm m st be completed and returned to the St . Croix County Zoning Of a w ' 30 days of the three year expiration date . SIGNED DATE St . Croix County Zoning Office P .O . Box 981 Hammond , WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address . DEPAFATMENTOF REPORT ON SOIL BORINGS AND SAFEYY&BUILDINGS INDUSTRY, DIVISION i LABOR AND PERCOLATION TESTS' (115. ) - .. P.O.BOX 7969 HUMAN RELATIONS l � � MADISON;WI 53707 (1­163.09(1)&Chapter 145.0451• L A I TOWNS P TY: NO.: NAME: 1/ / ao N/R 2dB(or)W os h J COUN �t_791BUYE A // 1 7GoZ �/ USE DATES ISBSERvAtiow MADE B O MERCIAL T O np;' Beesidence 3 ttawew ❑Replace I �• 23-9677-2-3 6 RATING:S-Site suitable for system U-Site unsuitable for system ONVENTIONAL S ❑U• M�S. IN-G____�S ❑U ❑S- -F LL O�LDING TANK:RECOMMENDED SYSTEM:loptio all S {ICy' If Parmiation Testr ,r,NOT reuuirod IDESIGN i TE: �rl .Gnn n�the test-d aroi i,in•tk- I Lindz:s.{IG3.:,9(5l�u;,ifNiieNte: i *� {uodpiain indicate Flood!+laitt elevation: i PROFILE DESCRIPTIONS BORING TOTAL HTO GROUNDWAT -INCHES CHARACTER H THICKNESS,COLOR.-TE TORE,AND DEPTH NUMB Dom, ELEVATION g RV TO BEDROCK IF OBSERVED IS AdBRV.-ON BACK.) B- 00 0.A)6 y /o 461 l,' 6/7 S. 1- 5 e-.3 �v.7� 80` �L 7'� 7S ' . 1. �� .� r �� n.C. 4 B- PERCOLATION TESTS TEST NUMBER DEPTH AFTER SWELLING INTERVAL--MIN. RI LEVEL-INCHES RApER INCH ES P. 3 P- s 3 to G. 4 3 P- 2 3W N O (s < P — P- — PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describd 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 �zg Pam- 4` 0 l"tS 4I P( y W(mAy�lsflAi loo' a, IN Si z '` --3 �5 Sic t ,� e. IV qooM 1,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':he best of my knowledge and belief. NAME print TESTS W �.. PLETED O N: `y� (, l — r �) ADDRESS: . CERTIFIC PHONE NUMBER(optional): / ST SIG DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SSD439S(R,.02/82) —OVER — t I L APP 1 1 Ly I I { - }} I - I 074 if Ir 1 let : , f I I i I i I I I � f , I - I , - I -I t t } �I L JCL S - I I } t I i 1 4 1 1 - -- - I I I • I � I I [ i I - - -� I i I - I 1 { t-_ f-.-4- : , r 1 , r 4 , I , I t I 1 - I I , I , II ' L 1 I {- - ,_ � I Ii I I i . t i j ; I I I - � I 1 - I I , I _ I I I j t I ; I I f � f i I I I ' I I I � I r h i f I t t } I i ' I I f I Parcel #: 030-2042-30-100 04/01/2005 10:52 AM PAGE 1 OF 1 Alt.Parcel#: 26.30.20.493D 030-TOWN OF SAINT JOSEPH Current X: CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): "=Current Owner ' KENNETH J &MICHELLE KNEFELKAMP KNEFELKAMP, KENNETH J &MICHELLE 1400 20TH ST HOULTON WI 54082 Districts: SC=School SP=Special Property Address(es): "=Primary Type Dist# Description * 1400 20TH ST SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.010 Plat: N/A-NOT AVAILABLE SEC 26 T30N R20W NE NE LOT 1 CSM 7/1857 Block/Condo Bldg: EXC S 154.60'ALSO BEG NW COR LOT 1 CSM 7/1857 N 89 DEG W 105'S 370'E 105'N Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 370'-POB 26-30N-20W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 822/83 07/23/1997 786/623 2004 SUMMARY Bill#: Fair Market Value: Assessed with: 6073 194,800 Valuations: Last Changed: 07/09/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.010 75,600 116,000 191,600 NO Totals for 2004: General Property 3.010 75,600 116,000 191,600 Woodland 0.000 0 0 Totals for 2003: General Property 3.010 44,300 83,700 128,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 221 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00