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HomeMy WebLinkAbout182-1016-40-200 °o p 60i � o e c °o N oD N rn ti r C ZO :1 y N. ti ?'€ I U N I W d L 6 c c TLL _ t0 3 O E @ M Z iii co E Z I Y O O O 2 '` c V O y to H o fO0 y CL y N N N N O • L l0 O N Q O ? O Z m Z N y C C N �1 l0 06 m ,6 C - d Q �e = U) m C7 0 'c a ' U.) 000 z Y IL 7 0 vii O N J V ''0 OOi OOi Z CID @ 4 4 O O O E 65 O m m C a C) N N 41 41 Q >- (n Q _ L 3 r 'O E qg O N O U N O N O to $� O Y C c U n. O ►n C O (n U O W 4 =C -p pp C 40 U� N y N Z Y�1 N M N 2 � w 7 E C .00 aD O O O p t6 U o > Y O Z _ Z v C� ` d a CL cc CL r dt a m c E c = += 1 A C) o cn V 1 Parcel #: 182-1016-40-200 01/12/2006 04:11 PM PAGE 1 OF 1 Alt. Parcel#: 311801-24-03-00-00-000 182-VILLAGE OF STAR PRAIRIE Current X 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 SCOTT A&SHERRY L KITTEL O-KITTEL,SCOTT A&SHERRY L 505 5TH ST STAR PRAIRIE WI 54026 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description *505 5TH ST SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 3.245 Plat: N/A-NOT AVAILABLE SEC 1 T31 R1 8W SE NW 3.25AC COM N1/4 Block/Condo Bldg: COR SEC 1 S 2028.22 FT TO POB S 250.78' S 89 DEG W 563.72'N 250.78'N 89 DEG E Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 563.72'-POB FKA PARCEL 163E 01-31N-18W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 790/375 2005 SUMMARY Bill#: Fair Market Value: Assessed with: 139206 289,000 Valuations: Last Changed: 09/08/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.245 20,000 233,500 253,500 NO Totals for 2005: General Property 3.245 20,000 233,500 253,500 Woodland 0.000 0 0 Totals for 2004: General Property 3.245 20,000 233,500 253,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 133 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 PPF Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER 4'c � TOWNSHtP Z�7._ lJr °'i z- SEC. T ,Y/_N-R LSE _W ADDRESS /2( .�j ST. CROIX COUNTY, WISCONSIN SUBDIVISION ¢ LOT &I LOT SIZE �N.hFS PLAN VIEW Distances and dimensions to meet requirements of I1I4R 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 1,4 r-- INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used e14rw o62,, Elevation of vertical reference point: Proposed slope at site: SEPTIC TANK: Manufacturer: �� j�iLiquid Capacity: �Jndp Number of rings used: O Tank manhole cover elevation: 166 S$ Tank Inlet Elevation:-F9 3 Tank Outlet Elevation: Number of feet from nearest Road: Front,(IV Side,O Rear, O / 17x feet —r From nearest property line Front,O Side Rear,O �'=4 feet Number of feet from: well building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: p/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch evation: Gallons per cycle: Alarm Manufa urer: Alarm Switch Type: Number o feet from nearest property line: Front, O Side, O Rear,0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM _ / Bed: Trench: L/ idth• . C 2� � Length: 6 Number of Lines: 2 Area Built: Fill depth to top of pipe: 2-0 Number of feet from nearest property line: Front, O Side, aRear,0 Ft ._� Number of feet from well: ��g Number of feet from building: 79 J (Include distances on plot plan). i SEEPAGE PIT Size: Num r of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a rop box O or distribution box O been used on any of the above soil t absorbti sytems? (Check one). HOL G TANK Manufacturer: Capacity: Number of rings ed: Elevation of bottom of tank: Elevation o inlet: Number feet from nearest property line: Front, O Side, O Rear, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: Plumber on job: License Number: it 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX 7969 BUREAU OF PLUMBING MADISON.M 53707 SEq NW!4,S1,T31N-R18W kRCONVENTIONAL E-1 ALTERNATIVE State sign Plan 1.D.Number: (lf ased) Town of Star Prairie ❑Holding Tank ❑ In-Ground Pressure ❑Mound Co. Road 'tH" NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Scott Kittel Route 3, New Richmond, WT 54017 1642-V / _-S(1 BENCH MARK(Permanent reference pomti DESCRIBE IF DIFFERENT FROM PLAN. REF.PT.ELEV.: CST REF.PT,ELEV. Name of Plumber: MP/MPRSW No rS,y. Sanitary Permit Number:Gar L. Steel 3254 t. Croix 106073 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER PROVIDED. PROVIDED: DYES ONO DYES ONO BEDDING: VENT DIA, I VENT MATT HIGH WATER NUMBER OF ROAD. PROP E RTV WELL: BUILDING: VENT TO FRESH FEET FROM ALARM LINE-. AIR INLET: ❑YES ❑NO 1:1 YES ❑NO INEAREST—` DOSING CHAMBER: MANUFACTURER BEDDING: ILIQUID(.APACITV PUMP MODEL PUMP;SIPHON MANLY ACTOHEH WARNING LABEL LOCKING COVER PROVIDED. PROVIDED. ❑YES ONO OYES ONO ❑YES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PHOPEHTV WELL BUILDING VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET: PUMP ON AND OFF) EYES 1:1 NO NEAREST' SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing I ENGTII OArw TER IMATIHIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease until FORGE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH'. LENGTH NO.OF IDISTH PIPE SPACIN(I COVER INSIOL DIA -PITS LIQUID BED/TRENCH THE NCHES MATERIAL: I,I� DEPTH DIMENSIONS �Z GRAVEL DEPTH -FILL DEPTH 11E)ISEV ITI-I PIPE DISTH PIPE. DISTR.PIPE MATERIAL NO DISTIL NUMBER OF PROPERTY WELL. BUILDING. VENTTOFRESH BELOW PIPES ABOVE COVER . If, f ELEV.END PIPES FEET FROM ';LINE AIR INLET. NEAREST —�---w► 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. DYES F-1 NO SOIL COVER TEXTURE PERMANENT MAHKI HS OEiSEHVATION WELLS ❑YES 1:1 NO DYES NO DEPTH OVER TRENCH BED DEPTH OVFH TRENCH BEU Of PTH OF TOPSOIL tiO DOE I) SEE UFO MULCHED CENTER EDGES ❑YES. 1:1 NO 1:1 YES ❑NO 1:1 YES El NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LENGTH NO.OF LATEHAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER IIED/TRENCH TRENCHES DIMENSIONS. MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL NO DISTH UISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING ELEVATION AND ELEV.'. ELEV. CIA. ELEV. PIPES DIA DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECT LV COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS EYES 1:1 NO DYES ONO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING. L FEET FROM LINE /,j/� S• �J El 1:1 NO ❑YES ❑NO NEAREST' LA $� (.,"�� b 0 0, Q_ A0 }S 1 Sketch System on ✓� Retain in county file for audit. Reverse Side. SIGNATURE. TITLE. DILHR SBD 6710(R.01/82) Zoning Administrator SANITARY PERMIT APPLICATION COU14TY In accord with ILHR 83.05,Wis.Adm. Code at. Croix STATE SANITARY PERMIT# /v69d�-A3 —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. PETITION 1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES NO PROPERTY OWNER PROPERTY LOCATION Scott Kittel SE '/4NW '/4, S 1 T 21 , N, R 18 "Dr)W PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME R.R.0, New Richmond, Wi. 54017 n/a n/a n/a CITY,STATE ZIP CODE PHONE NUMBER 77f CITY NEAREST ROAD,LAKE OR LANDMARK New Richmond Wi. 54017 715 246-5609 vILLAGE:star Prarie Co. Rd. ##H I1. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family 3 OR ❑ Public(Specify): 111. PURPOSE OF APPLICATION: (Check only one in#1. Check;!#2,3 or 4,if applicable) 1. a.QNew 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. aconventional 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. ❑ Seepage Bed b.4�1 seepage Trench c. ❑ Seepage Pit 2, PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 15.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): 94.92 upper est [ rivate ❑Joint El Public class 1 495 500 94.32 low V1. TANK CAPACITY Site in allons Total #of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete strructed Steel glass Plastic App Tanks Tanks Septic Tank or Holding Tank 1 Weeks Concrete Lift Pump Tank/Si hon Chamber --- -- ❑ Li ❑ VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installati n of the private sewage system shown on the attached plans. Plumber's Name(Print): Plumber' nature:( am ) lyWMPRSW No.: Business Phone Number: Gary L. Steel 3254 715 46-6200 Plumber's Address(Street,City,State,Zip Name of Designer: 988 N. Shore Dr. , New Richmond, Wi. 54017 VIIL. SOIL TEST INFORMATION Certified Soil Tester(CST)Name CST# 2298 Gary L. Steel CST's ADDRESS(Street,City,State,Zip Code) Phone Number: 988 N. shore Dr. , New Richmond, Wi. 54017 715 246-6200 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater Date Issui Agent Signature(No Stamps) 1A Approved ❑ Owner Given Initial r!c'}harrg'e Fee Adverse Determination f2o "06 X. CO MENTS/REASONS FOR DISAPPROVAL: o �o�h Ve),Ud ct� 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 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; 11. 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; 111. 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'/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 �tT included the creation of surcharges (fees) for a number of regulated practices which WisCO can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried TeasurB a 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- 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 ��(+ n i tL L_ Location of Property _ (,� , Section J , T&.3�N-R 1$ W Townshi-p J Mailing Address Address of Site ti4� Subdivision Name . Lot Number 7 Previous Owner of Property Total Size of Parcel Date Parcel Was Created Are all corners and lot lines identifiable? t­� Yes No Is this property being developed for resale (spec house) ? Yes 4-----No Volume 2 570 and Page Number 3 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. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION I (We) ee ti.6y that att atatemena on thus otm ane true to the beat o6 my (om) knowledge; that I (we) am (cute) the owner(a o6 the pnopeA ty dea cAi.bed in thiA in6oAmati,on 6onm, by viAtue o6 a waA a.nty deed neeonded in the 066ice 06 the County RegiAten o6 Veed6 as Voeument No. �?5, ; and that I (We) pnea entty own the pnopoaed bite bon the 6ewage disposat aya em (on I (we) have obtained an ea,aement, to nun with the above ducAi.bed pnopehty, bon the conatnucti.on o6 aaid ayatem, and the aame has been duty neconded to the 066tce o6 the County Reg.iaten 06 Deeds, ab Document No. ) , SIGNATURE Oh OWNER SIGNAT CO-OWN (IF APPLICABLE) DATE SIGNED DATE SIGNED f ' i 16 DOCUMENT No. STATE BAR OF WISCONSIN FORM i 19s2 THIS SPACE RESERVED FOR RECORDING DATA WARRANTY DEED BOOK 790 P4370 REGISTERS OFFICE This Deed, made between -_DuWayne- J, _LarSOn GIO(X CO., W IS. � .......................:.... Sty � --an Syly_ina-_Lars ..........n _ Rec''d. 6 Record this 4 t h ---- Grantor, day of Sep,t:_...._A.D. 19 ,7 and-.._SCOtt_ . Kittel and Sherry L. Kittel husban 3: 15 P and wife-,'--- as surviorship marital property - ----- •-•-- ---••-•-----•-•-••--- . - �.,..,., --•----------------------------I Grantee, ! , Witnesseth, That the said Grantor, for a valuable consideration..__.. „conveys to Grantee the following described real estate in • CrO l r S.. X RETURN TO I i County, State of Wisconsin: A parcel of land located in the SEJ of the NW J of Section 1 , T31N, R18W, Village of of Star Prairie, St.Croix County,Wisconsin, more""Parcel No: .182:;101_�- Q....... fully described as follows: i Commening at the NJ corner of Section 1 , T31N, R18W; Thence S0008 ' 22" E along the North-South Quarter Section line a distande of 2028. 221 j to the point of beginning: Thence continuing SO°08 ' 22"E along said line' a distance of250. 781 ; Thence S89 051 ' 38"W 563. 72 ' ;Thence No°08122 11W i 250. 781 ; Thence N89 051138"E 563. 72 ' to the point of beginning. Contains 3. 25 acres subject to existing g r oad right-of-way of_wa y over the Easterly 3 thereof. j� F-E This •-----------•-1-5--------- homestead I (is) (is not) Property. Together with all and singular the hereditaments and appurtenances thereunto belonging; I' And.....•-_DuWayne---J_•-._I�ar _S on..axid. �.lvina_.Lrs.on--- ..----•- warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except an and all easements and right--of-ways of record. y i and will warrant and defend the same. 2nd n th's -•-••----•-•-- _d... ------ . ---•-- day of Se?tember ....- 19..$.7_. I :rC .... ----• -1 L ---- -_(SEAL) J� DuWa Larson --....`-'•- ....................(SEAL) ne o •-------•-•-- ----- Scott A. K tt 1 -- • --- •- ' ri f---(SEAL) AL) * ev Larson Sherr L. Kittel y .................... i AUTHENT A ION Si ACKNOWLEDGMENT atu / gn re s �J -- ����-`-o-•.,��?..---... STATF, OF WISCONSIN Josep PGuido to au --- thenticated this o2 County. -----day of •-� 19____J_ Personally came before me this ................ of .......................•----••-•---•-_... ..........................................1 19........ the above named • -------------------•-•--------•----•-----•----._...-------•--•--•--._.....--•_.. TITLE: MEMBER STATE BAR OF WISCONSIN (If not, --------- . --•--------. authorized b Y § 706.06. Wis. Stats.) =----•--------------•------------------------------•---------- to me known to be the person ------------ who executed the THIS INSTRUMENT WAS DRAFTED BY foregoing instrument and acknowledge the same. I, Joseph__ PO P.Box 69 ---•---------•---.._.... ___Guidote ----------•--•-•-------•................. -- --------•-------•-•--.....-----•...................•--------.... .......--- New---Richmond •-w1---54-01-7---------••----•----_-- --•- -- Notary Public -•---•-•----------------•------- ---------County, Wis. (Signatures may be authenticated or acknowledged. Both MY Commission is permanent. (If not, state expiration are not necessary.) date: 19 ) — — - - amea of persons signing in any capacity should be typed or printed below their Signatures. i I ARRANTY DEED STATE BAR OF WISCONSIN -. - �• •�--�••---- -•'• •- - -,;,,, ,.• .. .. E URAI No. I—1982 Wisconsin Leval Blank Co. Inc. ., .,. + . .Mil -, ... ,- m�.�krer'.:•••.���......,........_.. UI[Ofr WY.v.+�t,•,.. .� xX± .i"t+�•.?•f _ wa J H z H 9 r ST C - 105 r" H SEPTIC TANK MAINTENANCE AGREEMENT o St . Croix County z d a OWNER/B-tYY ER 50-0 ROUTE/BOX NUMBER Fire Number CITY/STATE CIFV I U C/� ZIP-^�j'�-2 17 PROPERTY LOCATION: 5, 7 '�� Section / T,� / N , R 45 W, //'P+cs of � ffYi St . Croix County, cstt , 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 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 E z I/WE, the undersigned, have read the above requirements and agree u, to maintain the private sewage disposal system in accordance with H the standards set forth , herein, as set by the Wisconsin Depart- 'b ment of Natural Resources . Certification form must be completed and returned to the St . Croix County Zoning Office within 30 days of the three year expiration date . SIGNED" DATE St . 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 . DEPARTMENT OF SAFETY& BUILDINGS INDUSTRY, REPORT ON SOIL BORINGS AND DIVISION LABOR AND PERCOLATION TESTS (115) MADISON W 7969 HUMAN.RLLATIONS (1-163.090)& Chapter 145.045) LOCATION: SE TION- T� INICIPALITY: LOT NO.:BLK.NOI SUBDIVISION NAME: - �/ �/a /T N/R (or)W Star Prarie In/a n a n/a COUNTY: S BUYER'S NAME: MAILING ADDRESS: St. Croix Scott Kittel 1R.R.3 , New Richmond, Wi. 54017 USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILEDESCRIPTIONS: R A 10 TESTS: Residence 3 n/a QNew ❑Replace l 4—]1-87 n/a RATING:S=Site suitable for system U=Site unsuitable for system 1111 CONVENTIONAL: MOUND: IN-GROUND•PRESSUR : S T M-IN-FILL HOLDING TANK:RECOMMENDED SYSTEM:(optional) E]S ❑u ©s au o S ❑u a S au ❑S f]u step down trench If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5)(b),indicate: class 1 Floodplain,indicate Floodplain elevation: n/a PROFILE DESCRIPTIONS page 4 AOB BORING TOTAL PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER DEPTH ELEVATION OBSERVED EST.HIGHES TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) .58bl.1. 1.92bn.l.s. .50bn.s.1. .42bn.l.s. B- 1 7.25 98.57 none >7.25 .33bn.s.l. 5.58bn.c.s.& r. none >6 B- 2 6.67 . .67 9680 .58 bl.l. 2.00bn.l.s. .92bn. s.l. 3.17bn.c.s.&gr. 97.82 .67bl.1. 1.75bn.l.s. .50bn.s.1. .83bn.m.s. B- 3 17.66 none >7.66 B- 4 17.50 96.02 none >7.50 •67bl.1. .50bn.s.1. 1.83bn.sil. B- b .c. 4 98.42 gr B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD PER PER1003 PER INCH P- P-' P_ sea design rate 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' upper trench=94.92 SYSTEM ELEVATION lower trench=94.32 jj� 61 At,� f _T_ .......... .......... -4- fN ........... I i r i 1 1 � � J i I r 7 II I I I I � TS E r- i I [ r ( �U'f Y1.�.*, i �_ ___�_.___.i i I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: Gary L. Steel 4-11-87 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): 988 N. shore Dr. New Richmond Wi 54017 2 17M-246-6200 C SIGN E: DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) —OVER — l Scott Kittel SE4Nw4 S1T31N. R18W village of Star Prarie c EII T � use � p� S"/6 �/o TT- f7i I ( 1 SJ6 wt Al (L. 83 s. �-k+ Gary L. Steel 988 N. Shore Dr. New Richmond, Wi. 54017 MPRSW 3254