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HomeMy WebLinkAbout032-2054-50-200 h p u°9 a ao c o c a p CL CD I I 0 I 0 N y n � I J � � I h c I N � I (D o Z c c LL c E I co Z y E U) E Z N a0 •LO- IM- W o O z v c d z g z N 0) p y y N y C •Pftt) O Z m Z N _ Z 000 d N rn I LO cm 0 }y r- 0 C d O cL !V O Z rG Gr ra m ' Z N > a $ 3 $ = a Z U. co • a a a Z5 CL �V g ) aO CO W W •1 o to J V y Z a u N 00 M ° ° .5 'p cp m y C d 0 V LO wo_ r d p w Y! C w+ O C O 'C E LO O N CO O p U �o F c c+ a W Cl L yC N N Z i.. N a> E m .a+ 7 ° E C L O y O R • co r fn FL- O Z y Z Fp- rL e� L40 € a _ • ee a 5 � m a c E .c c :: + Parcel #: 032-2054-50-200 04/25/2006 09:39 AM PAGE 1 OF 1 Alt. Parcel#: 15.30.19.703C 032-TOWN OF SOMERSET Current IXf ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner O-KULIBERT, JEFFREY L&LIANA J JEFFREY L&LIANA J KULIBERT 1505 63RD ST SOMERSET WI 54025 Districts: SC=School SP=Special Property Address(es): "=Primary Type Dist# Description " 1505 63RD ST SC 5432 SCH D OF SOMERSET SP 1700 WITC I I Legal Description: Acres: 4.960 Plat: N/A-NOT AVAILABLE SEC 15 T30N R19W SE SW 4.96ACRES LOT 2 Block/Condo Bldg: CSM 7/1986 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 15-30N-19W Notes: Parcel History: Date Doc# Vol/Page Type 09/22/1998 587467 6. WD 847/27 07/23/1997 0 07/23/1997 407 1--��fYT b �Lliv� 2006 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/23/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.960 57,800 205,400 263,200 NO Totals for 2006: General Property 4.960 57,800 205,400 263,200 Woodland 0.000 0 0 Totals for 2005: General Property 4.960 57,800 205,400 263,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 140 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Form - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER"t Q -IA OLAJNft TOWNSHIP '`�jm,r���/j�ET SEC. /9- T JON-R 17 W ADDRESS/ 3/gN ST. CROIX COUNTY, WISCONSIN S dM jot S g-T 4 ),s e . SUBDIVISION LOT .2 LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I•ZHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM NoR-rN �R n PfRTY ,h.i N� S no S6 'Tv �sT ARv AERIV (� ---- 9 g" � _ _ ��• LA A oPo.3t ko ,vl way �o{O�` Afe Porto snk r� �Rd rat RTY 1„ve INDICATE NORTH ARROW /Up Sc i4L� BENCHMARK: Describe the vertical reference point used / � :Y�;y,,) St'�l�Lf Elevation of vertical reference point: /400 Proposed slope at site: / SEPTIC TANK: Manufacturer: -A/j£S £JP Liquid Capacity: /000 AS Ai. Number of rings used: / Tank manhole cover elevation:.._ zQ/,(�1/ Tank Inlet Elevation: Tank Outlet Elevation: - 3 Number of feet from nearest Road: Front,O Side,O Rear, , �, feet From nearest property line Front 10Side, DRear,0 /3` g• feet Number of feet from: well �2 t building: 13 (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE 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). SOIL ABSORPTION SYSTEM p i Bed: Trench: Width: /$ Length: 36, Number of Lines: Area Builtq�!Ks'l Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, (Rrkear,O Ft ✓ �/� Number of feet from well: Number of feet from building: 9 (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, 0Ft. Number of feet from well: Nuukber of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: -- - Dated: Plumber on job: OV Jr, License Number: b b I 3/84:mj . • i DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX 7969 BUREAU OF PLUMBING MADISON,WI 53707 €,-,SO4-,S15,T30N-R19w [CONVENTIONAL ❑ALTERNATIVE (if assPgned)DNumber Town Ob SomeAzet El Tank El In-Ground Pressure El Mound G and StAeet NAME OF PERMIT HOLDER'. ADDRESS OF PERMIT HOLDER: INSPECTION DATE Ronatd Thoenne�s Ro to 2, 318N, Sometuset, wI 54025 (J.8 o 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: Gary Zappa i3300 St. C)Loix 112712 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY: TANK INLET ELEV. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER ,) O IDED PROVIDED t/%r tip YES ONO DYES kNO BEDDING. VENT DI A. VENT MATL. HIGH WATER NUMBER OF IROAD////���s :�,--rys//''{{ PROPERTY WELL' BUILDING. VENT 70 FRESH ALARM. FEET FROM A / J _)E �, 1. (AIR INLET DYES NO DYES ` NO NEAREST Ja/C / DOSING CH MBER: MANUFACTURER BEDDING'. LIQUID CAPACITY I PUMP MODE L. PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED'. PROVIDED'. 1:1 YES ❑NO [:]YES ONO OYES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PR OPERTV IWELL BUILDING VENT 70 FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) DYES ❑NO 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'. JILENGTH NO.OF DISTR.PIPE SPACING COVER INSIDE CIA #PITS LIQUID BED/TRENCH TRErA0*S t pTERIAL! PIT DEPTH DIMENSIONS 1p GRAVEL DEPTH FILL DEPTH 1#4 PIDISTR.PIPE DISTR.PIPE MATERIAL. NO. TR. NUMBER OF PR OPERTV WELL eUILDING VENT TO FRESH BE LOW,PIPES AB V COVER IN�,E ELE .END: f.. PIPES_ LINE � AI T, FEET FROM(", ,.' -� j L. e�,. NEAREST--► / 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. 1:1 YES ONO OIL COVER TEXTURE PERMANENT MARKERS OHSEH VATI(N WE LLS ❑YES ❑NO ❑YES NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES ❑YES El NO OYES ONO DYES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LENGTH. NO.OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES. DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL NO DISTR DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING ELEV ELEV.. DIA.. ELEV. PIPES OIA.'. ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS ❑YES ❑NO 1:1 YES El NO COMMENTS: PERMANENT MARKERS: JOBSERVATION WELLS: NUMBER OF PR OPERTV WELL: BUILDING. FEET FROM LINE S DYES 1:1 NO DYES 1:1 NO NEAREST 0 � 2ti S"S' Sketch System on Retai. in county file for audit. Reverse Side. SIGNATURE DILHR SBD 6710(R.01/82) �- .r a Zoning Admini stAtrn �. : .._ TIT P%.HR SANITARY PERMIT APPLICATION C , C2R61 x In accord with ILHR 83.05,Wis.Adm.Code .�,,.:.µ,.o..,.....,,�... � STATE SANI ARY PERMIT# /iai a —Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER 8%x 11 inches in size. —See reverse side for instructions for completing this application. [FORIVARIANCE TION 1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. ❑YES NO PROPERTY OWNER PROPERTY LOCATION '/4 '/4, S — T d, N, R E (or PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME CITY,STATE ZIP CODE PHONE NUMBER CITY NEAREST ROAD,LAKE OR LANDMARK VILLAGE 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. ® 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. X 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. tK seepage Bed b. ❑Seepage Trench c. ❑ Seepage Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): J � Feet ®Private ❑Joint ❑ Public VI. TANK CAPACITY Site in aallons Total ##of Prefab. Fiber- Exper. INFORMATION Manufacturer's Name Con- Steel Plastic New xisting Gallons Tanks Concrete structed glass App. Tanks I Tanks Septic Tank or Holding Tank 4, /000 77 / - Lift Pump Tank/Siphon Chamber I I I ❑ ❑ ❑ VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name(Print): Plumber's Signature:(No Stamps) -W/MPRSW No.: Business Phone Number: Plumb Vs A res ( reef,City,State,Zip Code): Name of Designer: ✓. L U^. /� Vill. SOIL TEST INFORMATION Certified Soil Tester(CST)Name CST## edit �- CST's ADDRESS(Street,City,State,Zip Code) Phone Number: a C - ` c �S - 03R IX. COUNTY/DEPARTMENT USE ONLY r_1 Disapproved Sanitary Permit Fee Groundwater Date Issuing Agent Signature(No Stamps) S rcharge Fee Approved ❑ Owner Given Initial 2 L9 1 r CV Adverse Determination 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 INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION 4 �. 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 location, 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 pumped 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; II. 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. 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/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8'/i 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 stet included the creation of surcharges (fees) for a number of regulated practices which Wisco irt's a can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried Te3SttB is used in your building is returned to the groundwater through your soil absorption u 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 RC-3 Nki\ . �j (C�r^1nLc S Location of property %,41_ J yv 1/9, Section , T CJN-RW Township Mailing address tell L f, 1��� ��� E=�3 (LtCkvVxOt4lo Address of site Subdivision name Lot number 4— Previous owner of property ?� �-� CPU/ISM Total size of parcel / 10 fiC a s Date parcel was created JGAG Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house)? Yes _N0 PA 4 . Volume ��S and Page Number as recorded with the Register of Deeds. --------------------------------------------------------7---------------------- 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. ; 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 R is e f Deeds, as Document No. ) . Signature of Owner Signatures Co-Owner (If Applicable) �S kk T4 WE Z'k t � 8� Date of Signature Date of Signature e DOCUMENT NO. STATE BAR OF WISCONSIN FORM i-1982 THIS 9PACVIRESERVED FOR RECORDING DATA WARRANTY DEED 43.S REGISTER'S OFFICE Th• D ed e made between .... ....................................................•- Glen W. WlMST. CROIX CO., WI " -------------•-------•---• ----'•-- -_.._..._......__...----•----•- --...------......_..---•-•-••---•-•• Recd for Record - ---- -------- Grantor, �A -,.�a§9� and_._Ronald N. Thoennes_ and hori �". Thoennes , f_. _.--Husband -and wife as marital survivorship___. .__ of 8:30 A M property -- - - ------ --.. --------- --------- --------- ---•---.. .-----.._ _.._..__- --•-•------.., Grantee, Witnessetbi, That the said Grantor, for a valuable consideration______ R.0131ar of Dead$ Glen M. Wiese ----------------------------------------- ------------- ............................ --= - conveys to Grantee the following described real estate in St• Cz'01X RETURN TO County, State of Wisconsin: A parcel of land located in the E 1/2 of Tax Parcel No- ----------------------------------- I the SW 1/4 of 15-30-19 described as follows: Lot 2 of Certified Survey Map filed June 11, ' 1988 in Vol. "T' , page 1986. ,'`IIRANSF v3 FFE This is` not ------- -------- ---------- homestead property.. (is)N(is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And--•---Glen M. Wiese •--•--•- •-••---•---_---- --- --------------------------------------------- warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and rights-of-way of record, if any. and will warrant and defend the same. Dated this day of June 88 ' _ '----------------------------------- _.._..... -_•... .................................................. 19......... - - - ...... -_. .. ._.(SEAL) �'-' dl (SEAL) * .... ......... ...... .............. ...- Glen-M-.•_Wiese. ................ ........ _... •--_---• ..... ...............(SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT -' Signature(a) ------------------------------ STATE OF WISCONSIN __....- ss. -•---- - - -- --------------- - - St. Croix --------------------------------------County. authenticated this --------day of_--------------------------- 19_._.__ Personally came before me t#}is . _.____.day of June o000 ------------------------------------------- 19-------- the above named glen ---Dies'e-------------------------------•--------------- ------ -------------------------------------------------- -------------- .......---•---.._..----------------•-------------...._..---.._..---•.._.._------ TITLE: MEMBER STATE BAR OF WISCONSIN - -------------------------------------------------------------- (If not- ------------------------ authorized by § 706.06, Wis. Stats.) ----------------------------------------------------------------------- to me known to be the person ____________ who executed the fo oing mstr nt n a i owl ds l ye THIS INSTRUMENT WAS DRAFTED BY E P • `. �s_t_ina__0 landLundeen. = ----- --------- - .. Alice J J. l e i s_c Yi�te@P��r�J°n .Attorney at Law ---- -------------------- --------------------------------------. - Notary Public -----------------------------------------' r O 1X ------ ----------- -------- - -- ----------- County, Wis.(Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) date: _June-- 11 'Names of persons signing in any capacity should be typed or printed below their signatures. WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Co. Inc_ FORM No. 1-1982 Milwaukee, Wis. CMI'1Fli-D SUIMV y 1•J,i' GLiE M. WIL7)L r+ of tir I ,rth er.t. 1/n t'' -; ,,thw,rr1, 1/4•and th,• Soutbe[,et 1/4 of ttc Southwest 4 of Sc%tSon 15, TownsT,i;. 1:--rth, hange 19 West, Town of Sorr,eraet, St. Croix Count.:, •.isccr,j:in. •Indicates I" iron bar found. *Indicates 1 112" iron piTx found. Otndicat t" ea 1" x 2+ irn pifv welPhinQ sc•Lr,N r(rr , '• ?OO• 1.13 lbs./lin. ft. set. O 3O' /a' ?nc' !OC' •oo' 3ou' R rs e4.•SO'I!"[ f33 Or9 / ._'``j,•L- ,� ` �f d^:.,A•J�.l,// r.+i 7" z fPl./7' F. i �'�t.l D'_— --R£S 1 SO Fr. t.!/J RCR£S 7 SO.Fr, q ! 4 Z Q I • ;, y 0 lo: ♦ I Z �« � � J ISO•00'00"( IlS.7/ t� l C y Lor 2 cars N(T• 4.801 ACM IF SO.Fr. w , t !� ti I �-+- N!O.00'00"( f!!.I!' � • O° p a 2 t YO.lt' 4.l1.l6' 8 I L_o or 3 I .00 o IN cc*.1([./s,r3ON1 Q. D •66 ACRES °O , 9 I w,/co—rY r 114.6 1 O s0 Fr. �i p SUR V,rOR's NON,/ l`,,, n w N(l I.I70RcRrf "iry $r/I cc*. Src.r3.rlON,.D/4.w, =/!! $* Fr. - r///!"rRON P",£OUNO/ r r rr/D 4 NDO.00'OO"( (56.0!6 / SW CON,Sr,/I SD'//I 66'ROAPOAr r15r Nr Nr Ric. IN vOL.SD/, Fr6rJ 1DD- Joe 00[-3534.15, Sr. coo,( co,NrY !�N'!L 11 rrfO LA NOS ��� SGOIY r� Dated: 10 f!cvember 1985 �� .S�\ Vol. PA;- `�..`I ALIHI; Pf�`/'/ _ Certified Survey Mnps — m W H1' °C Laurence W. Murphy Ct. Croix County, Wisconsin Registered land Surveyor ' r . t t ' STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER6Wi1Al� ROUTE/BOX NUMBER FIRE NO. 6 •ls t Imo( ZIP CITY/STATE CO► PROPERTY LOCATION: LI Z'1/4 4V� 1/4, Section (�� , T '30 N, R (S W, Town of St. Croix County, Subdivision , Lot No. — Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a LICENSED SEPTIC TANK PUMPER. What ou put into the system can affect the function of the septic tank as a Y P Y P treatment stage in the waste disposal system. St. Croix County Residents MAY be eligible to receive a grant for a MAXIMUM of $3000 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 lumber, journeyman lumber, form, signed by the owner and by a master p , � yma p , restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), 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. I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Department 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 G DATE YlA k-lL: St. Croix County Zoning Office P.O. Box 98 Hammond, WI 54015 (715) 796-2239 or (715) 425-8363 Sign, Date, and Return to above address i r DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTRY, DIVISION HUMAN , PERCOLATION TESTS (115) P.O. BOX 7969 HWMAN RELATIONS \ / MADISON,WI 53707 (H63.090) &Chapter 145.045) LOCATION: SECTION: r _ TOWNSHIP MUNICIPALITY: L T N .:BLK. SUBDIVISION NAME: S E ��SW�� /5 /• 30 N/R/9 L wow SOMERSET FUTURE C.S. M. COUNTY: I QAULR:SXUYER'S NAME: MAILING ADDRESS: ST. CROIX GLEN W/ESE R3 RIVER FALLS W/ 34022 USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCI SCRIPTION: / (l PRO DE CR PT OER ATION TESTS: Residence ,y New ❑Replace 6 - 17 - 85 7 - /8 - 85 RATING:S=Site suitable for system U=Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK:RECOMMENDED SYSTEM:(optional) 7S ❑U ©S ❑UJS ❑U ❑S ©U ❑S ©U CONVENTIONAL If Percolation Tests are NOT required DESIGN RATE: q If any portion of the tested area is in the under s.H63.09(5)(b),indicate: CLASS {� Floodplain,indicate Floodplain elevation: PROFILE DESCRIPTIONS BORINGI TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER IDEPTH IN, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- I 6.8' 101.6' NONE :7 6.8' Bn 0/ (/.O') Bn 8/1 f /. O') On 18 t4.8) B- 2 7.01 102.1 ' // 7. 0' On / (0.89 On s / ( 6 .2') B- 3 6.9' /0./. 6' // �, 6, 9' On / (0. 9 ') an 8 / 6.0'J B- 4 6.91 100.61 6.9' an $/ I /.O'! On 8 and or (2.O'! Bn a f3.911 B- 5 6.3' 100.6' 6.3' Bn 8I ( /.0') an 8/ and cob 15.3'/ B- SO/L MAP SHEET 34 PERCOLATION TESTS CHETEK ONAM/A COMP. TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH P- / 2.0' /O J 3//2 " 3114 " 3114 '/ 3 p_ 2 3. 0' 5P, 4 /0 5 " 5112 51/4" 2 P_ 3 2.0' /0 3 //4 " 35116 " 3114" 3 P-_ P 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. INIT IAL SYSTEM ELEVATION REPLACEMENT 98.6' a i N W YA' L UT t _.. _-_ EN- �IV414 NPRO �, N RT1L/�NE SU TA LE,AR A '98 W-_ 4 SEC. 13 1 i T WN ROAD j3 k v _.� TN SCAILEE / = 3� µ CD R A L R'O A S I K �__ 3 P T 0 1 -1RO P,PE,.. Y _T.QPi_P-1 _E_ ry 02 AIBA C K OE� P/Th AS U ED I/O PE C. HOLIE � � ( S C. /5 1,the undersigned,hereby certify that the soil tests reported on this form war y in ac I the procedures and methods specified in the Wisconsin Administrative Code,and that the data recorded and the location of the tests �e rect es" f k wledge and belief. 1 '' 'a NAME(print): 'ES ERE COMPLETED ON: LAURENCE W. MURPHY rpC�BVr 1e - 85 ADDRESS: • �°�. CE ICATION NUMBER: PHONE NUMBER(optional): R/ BOX 36 A RIVER FALLS W/ 54022 - 2445 SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. DI LHR-SBD-6395 (R.02/82) —OVER— n 1� r _ , INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 H To be a complete and accurate soil test,your report must include: 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 1 MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement systern; 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; 6. 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; B. 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 the information (such as flood plain,elevation) 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 copies and distribute as required. 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 — Stone (over 10") BR - Bedrock cot) - Cobble (3- 10") SS — Sandstone gr — Gravel (under 3") LS Limestone "s — Sand HGW High Groundwater cs Coarse Sand Fare - Percolation Rate med s - Medium Sand W — Well fs -- Fine Sand Bldg - Building Is Loamy Sand > - Greater Than 'sl - Sandy Loam < Less Than *1 — Loans Bn -- Brown sil - Silt Loam BI Black si — Silt Gy — Gray 'cl - Clay Loarn Y - Yellow scl — Sandy Clay Loam R — Red sicl -- Silty Clay Loam mot — Mottles se — Sandy Clay w1 - with sic — Silty Clay fff few,fine,faint Ix Clay cc; common,coarse pt — Peat mrn — Many, medium m — Muck d — distinct p — prominent HWL High water level, Six general soil textures surface water- for liquid waste disposal BM — Bench Mark VRP - Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department may request verification of this soil test in the field prior" to permit issuance. A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a perrnit. The sanitary permit must be obtained and posted prior to the start of any construction. • /I/6/ZTN ARoPE/z7Y LX,F- IIJL/J 207- VIVO ClZo U iry ' Sx�-��oti �0 ,�Ns WEST &PFA I Y L XIF LOT o� Q ALT /VOTt=//1oPasEQ /S�/�.fO2P7S7n� UE,..7 .I'rA uc .�T6 02D J��-G 7r 8,,m.zs lop Fire to SY.r Eln -TS ovr2 -j „ SSO' 1no,n -4'A-M PAa PEATY LTivE bF /�'?noni �'L �/ PvG cffLr e�7 Z,,E /\o,,,oZD TVo vIv5s l°sPE S wErr 36 . 61 ` n63 NEw y/oco.s.G AL, .EP12L /^ E w J ' TEn9 of A,y /o M46 rewr-A L=Ne Lev. = oo 0 7o.,—, pr ' a-701 1- Z 15' 1 /�oPoSFD (`j ?o 19, �Ai rAE, r J /. C/2 0=X COunJTY Q� 70' aAAA 6 I 0 60, �'rrtFP��oSto t✓g�c P/toFnts/� DZive�.,AY /Bo' SocrrN 10A0PEA.TY L ,.,E /✓o .SCALE FRESH AJR WLET AIND OR aERVATfOM PIPE .NFL"R''=a ED YE!NT --"A F A60'VE FINAL GRADE E °C f Vii. N "ENT t'[f E i i Y I• r I F r T''• e UNAL G3-...AilE 'MARSH He'.V' OR -3VIN-114ETIC' L E'_-t.N E MINIM.MV1 2"AGGREGATE I DATE: e' ! D!STR IBUTI v N P I PE ..� - I —i— (EF 011.TE:T IN(i C;Y: � ELEVA'TON BED t5-ACiGREGATE +i�OTT" PEF = iF wT D PIPE BELOW r I ) t E ¢ F F il }P aG TERMINATING IS