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HomeMy WebLinkAbout038-1060-70-000 f j i § } ! R o I � //ƒ � \ c co . ¢ ) /\ � k §/ f Q) R % E` 43 D 23 § 2 22 ) // 2 7 m ) . \ ) \ CU § < ] m2 co � / \ E § Z � t 0 � z7 22 � . / § ) a m S � § co B 2 . ' y 5 k k / w ) E � . k . .� co § $ Or c ) % Q � z z \ . .. z 2 LO I k £ E % 2 § ` V e ) � k -\ § CL \ E k a e ) } 2 a a E _ 0 <co 00 2 j v « S $k -1 00 \ e 2 ( \ \ = \ k IL n Q) a ; o , % iR ; ) ° 2 0 ; 2 \ E < } E — — ) E to @ - , S § / / j k = CL \ z z { @ ) \ \ \ } o z f / / ƒ \ ® � A CL $ � EL . " a » cc E J k con J 3 a 0 $ 3 T ` Parcel #: 038-1060-70-000 02/17/2006 11:02 AM PAGE 1 OF 1 Alt. Parcel M 15.31.18.264A 038-TOWN 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 MARCEL M JR SIMON O-SIMON, MARCEL M JR 2207 GOOSE LAKE RD NEW RICHMOND WI 54017 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description '2207 GOOSE LAKE RD SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 24.050 Plat: N/A-NOT AVAILABLE SEC 15 T31 N R1 8W 24.05AC NE NW EXC CSM Block/Condo Bldg: 5/1290 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 15-31N-18W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 837/282 f( L(.�y�1� 07/23/1997 83 07/23/1997 7/513 S � /} 2005 SUMMARY Bill M Fair Market Value: Assessed with: 119054 152,100 Valuations: Last Changed: 10/13/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.000 25,000 66,900 91,900 NO UNDEVELOPED G5 23.050 57,600 0 57,600 NO Totals for 2005: General Property 24.050 82,600 66,900 149,500 Woodland 0.000 0 0 Totals for 2004: General Property 24.050 82,600 66,900 149,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 133 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 i f , Form — STC — 104 AS BUILT SANITARY SYSTEM REPORT OWNER fe 1Q.5, E� ,6t TOWNSHIP 5 N O�iJ�� <-SEC T N—R W ADDRESS �D � cfSi ST. CROIX COUNTY, WISCONSIN r / SUBDIVISION LOT LOT SIZE-- PLAN VIEW Distances and dimensions to meet requirements of I•1HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM � `7 l �J I INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used 6 L Cd- rir+ Elevation of vertical reference point: X00 Proposed slope at site: SEPTIC TANK: Manufacturer: _/d,-*--�&T Liquid Capacity: Number of rings used: Tank manhole cover elevation: S� Tank Inlet Elevation: Tank Outlet Elevation: `• B i Number of feet from nearest Road: Front,O Side o Rear, feet From nearest property line Front,O Side,O Rear,O 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: 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 Bed: Trench: Width: Length: Number of Lines: o, Area Built IR Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, Rear,,Ft .(y Number of feet from well: D Zj.9/ Number of feet from building: �a (Include distances on plot plan). e-- d P t /0407 SEEPAGE PIT , S�5 ) s yam. s 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, O Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: �/ °Z6 Plumber on job: 6&n2e2 License Number: a 3` 3/84:mj DEPARTMENT OF INDUSTRY INSPECTION REPORT FOR SAFETY&BUILDINGS LABORk HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX?969 BUREAU OF PLUMBING MADISON,WI 53707 NEB, NW%,S15,T31N—R18W CONVENTIONAL ALTERNATIVE IState I.D.Number: TOWN 0V STAR PRAIRIE El Holding Tank E:1 In-Ground Pressure El Mound Goose Lake Road NAME OF PERMIT HOLDER: JADDRESS OF PERMIT HOLDER: INSPECTION DATE' Roger Jasperson 304 W. 9th Apt. 5, New Richmond, WI 5401 BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN REF.PT.ELEV.: CST REF,PT.ELEV.. Name of Plumber: JMPIMPRSW No Cnumy. Sanitary Permit Number Byron Bird Jr. 3318 St. Croix 106077 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED. ®.YES ❑NO DYES KNO BEDDING: VENT DIA.: VENT MATT HIGH WATER NUMBER OF ROAD: PROPERTY WELL. BUILDING: VENT TO FRESH _ ALARM LINE �Q AIR INLET. DYES ®NO I G1— ❑YES ❑NO NEARESTM 3FJ 35 v DOSING CHAMBER: MANUFACTURER BEDDING. LIQUID CAPACITY PUMP MODEL jPUMP_1IPH1N MANUFACIIIHEI-1 WARNING LABEL LOCKING COVER PROVIDED. PROVIDED: ❑YES ❑NO 0YES ❑NO DYES ONO GALLONS PER CYCLE: 771:1 ND CONTROLS OPERATIONAL NUMBER OF <PHOPEHTY WE L BUILDING VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET. PUMP ON AND OFF) YES 1:1 NO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing vuTH IDIANIF TEff k ItTE JIAI AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease until FORCE the soil is dry enough to continue.) MAIM CONVENTIONAL SYS7 EM: WIDTH VLENGTH NO.OF DISTR PIPE SPACIN(I COVER JINSIOL DIA -PITS LIQUID BED/TRENCH THENN�S , MATERIAL.: PITDEPTH)IMENSIONS GRAVEL DEPTH FILL DEPTH IPF DISTH PIPE DISTR.PIPE MATERIAL NO D H NUMBER OF PROPERTY WELL.:=�jNG VENT TO FRESH BELOW PIPES ABONLf f ELEV END PIPES FEET FRDM LINE AIR INLET N`— e� C1 NEAREST'W----► �O 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- ❑YES meets the criteria for medium sand. TIONS MEASURED. ❑NO SOIL COVER TEXTURE IIIIIIIIANINI MAHKFHS oIISERVAT1oN WELLS _ ❑YES 11 NO ❑YES ❑NO DEPTH OVER TRENCH BED DEPTH OVER TRENCH BED DEPTH OE TOPSOIL Sf1DOFU SFf UFD MULCHED CENTER EDGES : YES. : NO DYES ONO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH TRENCHES LATERAL SPACING (:NAVEL DEPTH BELOW PIPF FILL DEPTH ABOVE COVER DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATEHIAL I NO UISTH UISTR.PIPE DISTHIBUT ION PIPE MATERIAL&MARKING `.ELEV.'. ELEV.. DIA. ELEV. PIPES DIA ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECT L COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS ❑YES NO DYES 1:1 NO COMMENTS: PERMANENT MARKERS JOBSIRVATION WELLS. NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE. F-1 YES El NO El YES 1:1 NO NEAR"I ST 0 r `f � V � t 30 � , SS Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE. TITLE: DILHR SBD 6710 (R.01/82) Zoning Administrator i �ILHR SANITARY PERMIT APPLICATION COUNTY , In accord with ILHR 83.05,Wis.Adm.Code STATE SANITARY PERMIT# �" 0d X'` —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 El YES L�NO PROPER WNER PROPERTY L CATION ef a /a, S T , N, R Al E(or PROPERTY ER'S MAILING A ESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME JOE,(- ld,91% Cc"e CITY,STA E 'ZIP CODE PHONE NUMBER CITY /� EAREST RO LAKE OR LAND K f r �_ VILLAGE:S �„6`.r �� 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. L,New b. El 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. Seepage Bed b. ❑seepage Trench c. El 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): �a may+ L �j� W/� / • Feet 1�Private El joint ❑ Public VI. TANK CAPACITY Site in allons Total ##of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank P ❑ 1 El Lift Pump Tank/Siphon Chamber ❑ 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' ignature:(No Stamps) MP/MPRSW No.: Business Phone Number: 9 _ f 7429 Plumber's ddr (Street, ity,St te,Zi Code): Name of e i r: 1 L o0 VIII. SOIL TEST INFORMATION Certified Soil Tester(CST)Name CST# t r CST's A'" Street,City,State,Zip Code) Phone Number: IX. COUNTY/DEIPARTMENY USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) urcharge Fee LTI Approved ❑ Owner Given Initial 2 '\ 14—j3-8g IRCya",Adverse Determination GLJ 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 , 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 privata 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. 1. Property owners name and mailing address. Provide the legal description where the system is to be installed; H. 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'/z 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 titer -- included the creation of surcharges (fees) for a number of regulated practices which Wisco rlrs can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried r4m;4 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. a 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- f 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 owners) 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 e'3" Location of property �� 1/4 �(� 1/4, Section /� /-/g , T N-R W Township S-/r2Yrri`�� Mailing address L ma nd Address of site �/ /y2�-✓ 1� l cf?rno /�� W �• ����� Subdivision name Lot number / Previous owner of property Total size of parcel 'Q'?, ' � Date parcel was created ZT 1,� 43 %00'? Are all corners and lot lines identifiable? -- o Yes No Is this property being developed for resale (spec house)? Yes _N0 Volume 197 and Page Number 51 '3 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 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. 7 ,;t— ; 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 t e Count Register of Deeds, as Document No. ) . Sig ture of Owner Signature of Co-Owner (If Applicable) Date of Signature Date of Signature I, . ti.`.-,`. yap„ •E G �MYM�Me- t fl Wv . ....lei» low md an « - H .f. �,� �lll�r' � i~II►. 1. in slab ai b.t it we..ie..o*1 N tM i4i Yrt am*. - ! is M ..- - ............ • ..... .ltiors.E•..__.».. . 61 Nwli A. ` ...... ....-..- s k ,k on �oswow .swiu� t n u'1'S -__--« .................. lV-«r. UAW STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER V ROUTE/BOX NUMBEEV P17, FIRE NO. CITY/STATE uJ k- 01 ZIP o PROPERTY LOCATION: IVC 1/4 A 4 1/4, Section /$T N, R W, Town of v- 7alrri P , 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 you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County Residents MAY be eligible to receive a grant for a MAXIMUM of $3000 of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of ALL NEW SYSTEMS agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Department of Natural Resources. Certification form must be completed and returned to the St.Croix County Zoning Office within 30 days of the three year expiration date. SIGNED` DATE St. Croix County Zoning Office P.O. Box 98 Hammond, WI 54015 (715) 796-2239 or (715) 425-8363 Sign, Date, and Return to above address DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY&BUILDINGS ` DIVISION INDUSTRY, ' LA$OR AND PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS (ILHR 83.0911) &Chapter 145) L CA ION E TION: OWNSHI /MUNICIPALITY: OT NO.:BLK.NO.: SUBDIVISION NAME: �14 NQ/ i /T3 N/R/ (or r d!�" + COUNTY: OWNER'S BU ER'S NAME: MAILING ADDRESS: ' 0 7. -5- USE DATES OBSERVATIONS MADE O NO.B-DR': C OMMERCIAL DE CR PTION: TESTS: [i�e `- J4 New ❑Replace RATING:S=Site suitable for system U=Site unsuitable for system ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK:RECOMMENDED SYSTEM:(optional) S ❑U �S ❑U S ❑U ❑S BU El QU I co.,.. DE If Percolation Tests are NOT required SIGN RATE: If any portion of the tested area is in the under s. ILHR 83.09(5)(b),indicate: ad I I Floodplain,indicate Floodplain elevation: n PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROU NDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED ES HE TO BEDROCK IF OBSERVED(SEE ABBRV.ON BA K.) B v-7 s/ 2-3,� 10k �r' -3y�5�is l8� sy, y�. o�.t o -aa 4917 s1 �a - yo�•� S z2aa :g B- a �, 11/o� � �yl _ ` „ L i` v n �' rr, B- B- qj /407 B- �- PERCOLATION TESTS c TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER 4&jQkM AFTER SWELLING INTERVAL-MIN. — PERIOD P RI D PER INCH P P- ,L P- 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 horl- 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 pergent of land slope. SYSTEM ELEVATION T } 7� I j R ii 7 I ' #0 aq ---4— e-16 i i 0 9A r c. a ac S X 0 1 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: o� e #— ADDRE S: CERTIFICATION NUMBER: PHONE NUMBER(optional): / _yq 7 /s"�c 7 CST SIGNATUR : i DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395(R. 10/83) —OVER — PLOT PLAN •PR, JECT r J� W ADDRESS-�j eZ/ 1/4 1/4/ / /T�/ N/ W COUNTY MPRS Byron Bird Jr. 3318 DATE - d BEDROOM CLASS PERC_,Z_CONV NTIONAL, (AW GROUND PRESSURE CONVENTIONAL LIFT_MOUND_HOLDING TANK SEPTIC TANK SIZE LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ABSORPTION AREA PERC RATE BED SIZE ► Benchmark V.R.P. Assume Elevation 100' Location of Benchmark 224 o ®., c.-t� LoY•2 c Go9 C ,-.� * H.R.P. 5,-, e- D Borehole QUwgll Scale Feet O Perc Hole �� Gru System Elevation - ,f 30` TYPAR COVERING 2" r 12" 3' 4 6' Q 39 1 Sewer Rock 12' U_G� G V 0 / l V f k, CIO ,o 3d 5 Q`h r 20 rr o � S/� I,• State of Wisconsin ) ss. County of St. Croix ) i.� Patrick D. Jasperson, of Route 2, New Richmond, Wisconsin, deposes and states that: 1. He is the owner of approximately 22.9 acres of land located in the Town of Star Prairie, together with his father, Roger W. Jasperson. j ' 2. He has applied for a "3 bedroom sewer" through the St. Croix County Zoning Administrator. 3. Until such time during the spring of 1989, he is unable to construct : the 3 bedroom residence. 1 4. From the present until April of 1989, he desires tb.l. . 'live in a one bedroom apartment within the garage that has already been built on the site, using the "3 bedroom sewer". 5. He publicly states that at such time as the 3 bedroom residence has been constructed on the premises sometime prior to April of 1989, the said garage will revert back to use as only a garage. i 6. This affidavit is made for the sole purpose of inducing the St. Croix County Zoning Office and Administrator to permit my living in i the existing garage until such time as my 3 bedroom residence will be j built on the premises. 7. Further your offiant sayeth not, _ Dated this 20th day of April, 1988 at-Hudson, Wisconsin. I;I Patrick: D. Jasperso i . Came before me this 20th day of April, 1988, Patrick D. Jasperson, to me 1, known to be the same person, who acknowledged..this Aff davit, j Deborah M. Staberg �!! Notary Public, St. Croix County, Wis. My Commission expires mCw,j i 'I I� ti I1 il. I it i � �I