HomeMy WebLinkAbout018-1073-50-000Parcel #: 018-1073-50-000 ou2si2oos 10:34 AM
PAGE 1 OF 1
Alt. Parcel #: 33.29.17.512A 018 -TOWN OF HAMMOND
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 CaOwner
O - IG4UTZ, JAMES M
JAMES M ItAUTZ
PO BOX 162
HAMMOND WI 54015
Districts: SC =School SP =Special
Type Dist # Description Property Address(es): /~= rimary~
ltJ~ Gt-
~
(
SC 2422 ST CROIX CENTRAL ~ ~,,
,
SP 1700 WITC
,~ ~~n
/G 7
7~~
Legal Description: Acres: 35.00 Plat: N/A-N T AILABLE
SEC 33 T29N R17W NE SE EXC PT TO HWY & Block/Condo Bldg:
EXC PT TO CSM 6/1730
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
33-29N-17W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/20/2004 769324 2620/325 EZ
11 /03/2003 745456 2447/533 EZ-U
06/25/1 7 561461 1247527 V~D
~...
2005 SUMMARY Bill #:
90731 Fair Market Value: Assess~h:
Use Value Assessment
Valuations: Last Changed: 08/24/2005
Description Class Acres Land Improv Total State Reason
RESIDENTIAL G1 2.000 26,000 133,500 159,500 NO
AGRICULTURAL G4 21.000 3,000 3,000 NO
UNDEVELOPED G5 12.000 9,800 9,800 NO
Totals for 2005:
General Property
Woodland
Totals for 2004:
General Property
Woodland
35.000 38,800 133,500 172,300
o.oo0 0 0
35.000 38,800 19,800 58,600
0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch #:
Specials:
User Special Code Category Amount
/V v
%h~
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Wisconsin Dapartment of Commerce PRIVATE SEWAGE SYSTEM
Safety aril ESUilding `Division
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: City Village X Township
Kautz, James M Hammond Townshi
CST BM Elev: Insp. BM Elev: BM Description:
retit~ wcntznnertnti ~t GveTinnl Here
TYPE MANUFACTURER CAPACITY
Septic
F G
D'C7p ~atr0
Dosing
Aeration
Holding
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD
Septic ? ~~ 1
Dosing ~0,~-~ ~
Aeration
Holding
PUMP/SIPHON INFORMATION
Manufacturer ~ Demar
`~ pR.O W`I4rTtC.- GPM
`,~ odel Number _ (p0
F
Q Hl ift O Friction Loss System Head TDH
Forcemain Length Dia. ~ ,r Dist. to well ~1
N J
SOIL RPTION SYSTEM
RRENCH idth Length ~ No. gf Trenches
21
county: St. Croix
Sanitary Permit No:
420741 0
State Plan ID No:
Parcel Tax No:
018-1073-50-000
Section(fowNRange/Map No:
33.29.17.512A
STATION BS HI FS ELEV.
Benchmark
(.O
X01.0
8O•t7l
Alt. BM r
Bldg. Sewer I - G •ZQ I
fit'
St/Ht Inlet Is• bo g'S`. y0
St/Ht Outlet
Dt Inlet
Dt Bottom ' ~ ' ~ r
Header/Man. (T (o• ~p 9Y•~/
I
Dist. Pipe
Bot. System
Final Grade ~ S
R S. 30
St Cover \
e J
PIT
Dia. (Liquid Depth
INFORMATION CHAMBER OR `' `f:'rC~O/
Type Of System: I UNIT
~v • ~ ~ ~ C~~ _ Model Number: Zu
DISTRIBUTION SYSTEM n..... ` P /_ ~ S
Header/Manifold
u Distribution
Pi x Hole ze x Hole Spacing Vent to Air Intake
~
h s)
h Di
i
L
S 7 p~ /
a ,
Dia
Lengt engt
ng
a
pac
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
CON~IAENT (Includ code d' .cr en ies persons rese t, etc.) Inspection #1: ~G'C./• l~'+/~ Z =i Inspection #2:
Location: 634 Cty Rd T Hammond, WI 54015 ( E 1/4 SE 1/4 33 T29 N R17W) 35 acres Lot o: 33.29.17.512A
f ~~~~ ~~ ~~ ff~~~~~~~~,,
1.) Alt BM Description = ~ mP Ofr 1f'~+~+'r`~~"~ . ~ S
2.) Bidg sewer length = /
-amount of cover = > S, 0 r 50~~
~
~
• (~
• ( ~- 20 = 9~•pvr
Z ~ • ~° " ~3 ' 3~ 1
n ~,
,, ,
,~,
3) p+~.uu',o u 6 io --~t " .~.~I'I~""~'~ ~~ ~ 3 $ • ~ 9 2 .~ ~
Plan revision Required? ^~ Yes ~ No ~- t }' 2aD3 ~ A _ ~ ~ ~ (S-Z.
~
er side for dditional i omiption.
Us o ~~^
KJ'6`-~
~
~
~~
~ -
o ~
~
C i
~V
~ _
Insepctor's Signature
- Cert. No.
SB
71•• (7
.1 .
r
•
r ~
l
j ~ ~~
,
S ~ 1 K~.c~rAllt+ ~ 5 ~"~ r r `lam h~- w-+-~'6u,/ /
O-.Q Sa:Q.S . ~b l ~ r~u,.; •~-rr~ {-d,, t~p~^.
Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched
Bed/Trench Center Bed/Trench Edges Topsoil
Yes
~ No
~
Yes
~ No
RECEIVEQ
A
`R ' Safety d Buildings Division County
I, - DEC g 2~~8/~ Wash gton Avc., P.O. Box 7162 5
~ Madi a, W 153707 - 7162 Sanitary Permit Nunrbcr (to be ll d in by C
Oscan nST CRO X COUNTY ) 263151 ~~/
Department of Com rce Stau Plan tD,Number
Sanitary er tion x ~ r/1T
In accord with Conan 83.21, Wis. Adm. Code, personal information you provide
maybe used fnr secondary purposes Pavacy Law, s15.04(lxm) Prgect Addrzss ddiSerent than mai'ing mess)
low ~o~~ tY JG~V` T
1. Application lnformatioa -Please Print All Information ~~O
Parcel N Lut p Block n
Propert Owner's Name /~ ~ 35~~°
y~ t R V I ~/ property Location ~i~
Property Owuer's Mailing Address
(~t„~p T
~~ ~,., ~~~,. Section 3~
Cit State T
Wd- Zip Code Phone Number
-791x'5333 .,~ p ~r^ _
T !/-( N; R~~(cE oe~W ) J I Z- ~ 1
11. Type of Building (check all that apply) ~ ~~ ~~ ~ Subdivision Name C M Number
~~ ~ ^~ ,
Ja ~
^ I or ? Fanrily Dwelling - Number of Bedrootru /_ ~ ~ 3a
(Q
D PublicJCommereial -Describe Use _~~
~~~s / ~
~ ~ 1 ~ ~µ-d ~ /'~ ^City_^Village ownship of
D Stale Owned -Describe Use
e of Permit: (Check only one boi on Ilse A. Complete line B if applicable)
p
111. Ty
A' ,.
y
JO New System ^ Replacetrrent System ^ 'IyeatmenUHolding Tank Replacement Only
~ ^ Other Modification to Existing System
~1 list Ptnvious Permit Numbs end Date Issued
B. ^ Permit Renewal Permit Revision - ^ Change of
mber
Pl ^ PermitTransSerto New
r
Own q 7~f /
~~N ~~ 03
Be Core Expiration u e
IV Type of POWI'S System• (Check all that apply)
Pressurized ln-Ground ^ Mound ? 24 in. of suitable soil ^ Mound < 24 in. of suitable soil
~l
^ Sin a Pass Sand Filter D
^ At-Glade gl
on -
D
Constnrcted Wetland ^ Pressurizod ln-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatrneat lJnit ^ Recirculating Sand Filter
Cbamber ^ Dri line ^ Gravel-less Pi Other lain
Recirculati» S thetic Media Fiber
V. Dis ersal/I'reattnent Area lnfor
Design Flow (gpd) Design Soil Application Rate(gpdsf)
Disp~~ lea Required (si)
Di I A
r~ ~ posed (sn S stem Elevation
Y ~~ ~ ~
Prefab Site Steal Fiber Plastic
V1. Tank Info Capacity m
l Total
Gallons Number
of Units Matt acttuer
~ .'~~~_ ~~ ~ Concrete Constructed Glass
Ga
Ncw ons
l
Exiwing ~~ „Q(L~ (~ ~/~
$c~~ic ~e~ pVp (/VV ' ~
Aerobic Trca~mcnt Unit
DwinK Chamber O(~ OV
VII. Res nsiblll Statement- I, the under d, ass nslbW for lnstatlatlon of the POWTS shown on the attached lens.
MP RS Number Business Phone Number
Ptun,}xr~ ame (Print, Pl : signal ~,o /396 Z ?/~slz3S- ~
~,f,z
Plumber's Address (Street, City, State, 7~p ~/
Lli_ n q ~n r' .A~/f_ /~~l~l D11i1 ~?1 /~ 1~r ,S'~?
V111. ount /De artment Use Onl
Sanitary Pcnnit Fee (includes Groundwater Date Issued Issuing A nt Si rur wimps) ~
proved ^ Disapproved Surcharge Fee) ~ //~ /~ jot/G
5 (J ~~ _/ Q
^ Owner Given Rtasoo for Denial
lX. Conditions of ApprovaUReasons for Disapproval DGm~~~~ZG~~ Ll~
~YSTEM OWNER: -n - y,/
1 Septic tank, effluent filter and ^~~lX j
dispersal cell must all be serviced /maintained ~J~~U
as per management plan provided by plumber. ~ Q~ ~ G'~
as per applicable code/ordinances.
Attaeb complete plans (to the County ooly) tou~~~~ on r oo Asa tbatHlR x 11 In ~ • e
~ ~~
~~ ~,(~~~~~/mot-s~.~ ~/~Q/j/ft Qjjjy /~, t
SBD-6398 (R. 01/03) /~ ~- ~/~
•~
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
Safety and Building [hivision ,
` INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name:
Kautz, James M City Village X Township
Hammond Townshi
CST BM Elev: Insp. BM Elev: BM Description:
TANK IN FORMATION
TYPE MANUFACTURER CAPACITY
Septic
Dosing
Aeration
Holding
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD
Septic
Dosing
Aeration
Holding
PUMP/SIPHON INFORMATION
Manufacturer Demand
GPM
Model Number
TDH Lift Friction Loss System Head TDH Ft
Forcemain Length Dia. Dist. to Well
SOIL ABSORPTION SYSTEM
ELEVATION DATA
County: $t. CroiX
Sanitary Permit No'
0741
State Plan ID o:
Parcel Tax No:
018-1073-50-~8@'
Section/Town/Range/Map No:
33.29.17.512
STATION BS HI FS ELEV.
Benchmark
Alt. BM
Bldg. Sewer
SUHt Inlet
SUHt Outlet
Dt Inlet
Dt Bottom
Header/Man.
Dist. Pipe
Bot. System
Final Grade
St Cover
BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
Type Of System: UNIT Model Number:
DISTRIBUTION SYSTEM
Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake
Pipe(s)
Length Dia Length Dia Spacing
SOIL COVER x Pressure Svstems Only xx Mound Or At-Grade Svstems Onlv
Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched
Bed/Trench Center Bed/Trench Edges Topsoil
Yes No
~ Yes [] No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / //_
Location: 634 Cty Rd T Hammond, WI 54015 (NE 1/4 SE 1/4 33 T29N R17W) NA~t ot~~ 3S~~v'~~'
1.) Alt BM Description =
2.) Bldg sewer length =
-amount of cover =
Inspection #2: / /
Parcel No: 33.29.17.5128 : S~ Z A
Plan revision Required? ~J Yes ~~ No i- ~ ~~ --- i IIr~I ~ j~ _ '~
' I~L 1
Use other side for additional information. i i___ __
SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No.
T.L~ . Sinz Plumbing. Inc.
E5609 708th Ave. ~~'~''~ ~~TZ PCo T ~~''-~ Phone: (715) 235-2644
Menomonie, WI 54'751 N~ 5 ~ 33 Z9 ~ 7 ~ Fax: (715) 235-2592
Tom ~ oG ~-fi~w~ o.~ r~
c f w~~.,~ ~ ~.
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GPM
s-7/s" s-5/8" (1x8.27) 1.AIl dimensions in inches. (Metric for international use).
(98.42) 5" (127)
2. Component dimensions may
s-7/8" _ vary ± 1/8 inch.
(98.42)
3. Not for construction purpose
1 unless certified.
3_7/g~~ DISCHARGE
(98.42) 1-1/2" NPT 4,pimensions and weights are approximate.
FLOAT
SWITCH S.We reserve the right to make revisions to our product
and their specifications without notice.
~~ HYDROMATIC®
10-3/16"
(258.76) ~ . ~
3-5/8"
(92.07)
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~' Safety and Buildings Division
201 W. Washington Ave., P.O. Box 7162 County
~T ~t'b i C
~~~~ Madison, W1 53707 - 7162 Sanitary Permit Number (to be filled in by Co.)
,~~~
(608) 26031.51 Z ~ ~~
Department of Commerce
lication
it A
P
it
S
State Plan LD. Ntunber /
pp
erm
ary
an , ~}
ersonal information you provide
C
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Ad
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1,
In aceord with Comm 8 ProjeiK Address (if dill t than mailing address)
maybe used for seco>Ytary purposes Priv b 3 ~( ~n ~/ ~.d - T
1. Application Information -Please Print All lnforma n S ,
0~3 - So -ooa -
Prope Owner's Name '~.~ 11 -~^
Z ~IaIA/t ~ Wl 1 ~- ~ Parcel # Lot #k _ Bloc
~l~
Property Owner's Mailing Address
ZONING OFFI ~E Property location CrSM (0 t `t ~ ~.t-*
(o~~ o to D T - o ~ p - ~o ~ - so ~ . s/ a a u~ ~~ti ~ ~~., section ~3
Ci ,State Zip Code Phone N
I~LOi'VO ~~
~ d) ~
9~v"533 p,
T Z-I N; R~~ Eo?~) • S~ Z
11. Type of Building (check all that apply)
3
Subdivision Name ~SM Nturtber
I
or 2 Family Dwelling -Number of Bedrooms _ - 1. J
~ /1
/'~
^ PubliclCotnmercial - Descsibe Use
/
3 ~ ^Village~'I'ownship of N.~
^City
/
^ State Owned- Describe Use _
ti
111. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A" ~/ New System ^ Replacement System ^ TreatmenUHolding Tank Replacement Only ^ er Modification ~s System
B. ^ Permit Renewal ^ Permit Revi ' ^ Change of ^ Permit Transfer to New
st
and
Before Expiration Plumber ~`ng
1V. T e of POW'1'S S stem: Check all that a I
Non -Pressurized ln-Ground . ^ Mound ? 24 in. of sui a soil ^ Mound < 24 in. of suitable s ^ At-Crrade ^ Single Pass Sand Filter
Constricted Wetland ^ Pressurized In-Cttound ^ Holding ^ Peat Filter ^ Aerobic reatment Unit ^ Recirculating Sand Fitter ^
Recirculating Synthetic Media Filter Irxhing Chamber Dri ^ Grave)-less ^ (exp
V. Dis ersaUTreatment Area Info 3/ ~~ -
Design Flow (gpd) Design Soil Application Rate(gpdsfJ Dispersal equired~t3' Dispersal Area Proposed (sf) ti
Sa . ~ / Z / 2/ Z 9~~ 3
Vl. Tank Info Capacity in Total Number ~M~~a~nQ er Prefab Site 1 Fiber Plastic
e~~r~'vl ~ Concrete Constructed Glass
Gallons Gallons of Units - , /
/
Ncw Existing [~(J
Tanks Tanks
septic oekLiWiie~%nk
~D
~
'OD~
' ~
~ 1T ~~
Aerobic Twatmert Unit
Di»ing Chamber
V11. Responsibility Statement- 1, the unde ned, a sponsib' ' for installation of the POWTS shown on the attached plans.
Plumber~slame (Print) Pl 's ~ MP/MPILS Number Business Phone Number
Plumber's Address (Street, City, State, Zip
~ S6o ~8 ~' ~ ~wc~t.t ~ ~~~s-~
Vll Coun /De artment Use Onl
Sanitary ermit Fee chides Groundwater Date Issued uing ent Si a s)
Approved ^ Disapproved Surchar Fee) ~
~ p
~
~
al
J
J L
l 0 0 3 ~l~Wh
2 ~/ / ' a!
^ Owner Given Reason for Denial
IX. Conditions of ApprovaUReasons for Disapproval Lam n ~ ~ ii ~~`~~// ~.~ ~~~
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SBD-6398 ~R. 0 /03~ ~ /°'~~l G~~~~~-(.~-_ /~"_I
~~:~.2uc~~L-~~ Si-c-~/z¢,pa~4.tOn- 3~/3/~3 -rw 6-k~ 2v-a,c~
T.L. Sinz Plumbing Inc.
E5609 '708th Ave. ~~ '~"~ ~ohCTZ ~'~o T ~-~ Phone: (715) 235-2644
Menomonie, WI 54'151 N~ ~~ 33 Z9 ~~ `'`~ Fax: (715) 235-2592
Tom ~ o ~ ~--rtm wi o,.~, p
C v-- N!-n "~ r n
/ ~ POWTS OWNER'S MANUAL & MANAGEMENT PLAN. Page I of 'l/`
3,._
FILE INFORMATION
Owner ~,~ ~
Permit # 2 D
DESIGN PARAMETERS
Number of Bedrooms ~j ^ NA
Number of Public Facility Units $MA
Estimated flow (average) ~ p0 al/da
Design flow (peak), (Estimated x 1.5) t.~..sp al/da
Soil Application Rate I ~ al/da /ft~
Standard Influent/Effluent Quality Monthly average"
Fats, Oil & Grease (FOG) 530 mg/L
Biochemical Oxygen Demand (BOD5) 5220 mg/L ^ NA
Total Suspended Solids (TSS) 5150 mg/L
Pretreated Effluent Quality Monthly average
Biochemical Oxygen Demand (BODE) 530 mg/L
Total Suspended Solids (TSS) 530 mg/L ~NA
Fecal Coliform (geometric mean) u/100m1
Maximum Effluent Particle Size Ya in dia. ^ NA
Other: ^ NA
"Values typical for domestic wastewater and septic tank effluent.
SYSTEM SPECIFICATIONS
Septic Tank Capacity OtaO al ^ NA
Septic Tank Manufacturer ~~ T ^ NA
Effluent Filter Manufacturer -(pp ^ NA
Effluent Filter Model Z,yE.t-~ L~ O NA
Pump Tank Capacity al .8'NA
Pump Tank Manufacturer ,0'NA
Pump Manufacturer ~0"NA
Pump Model ~ 8NA
Pretreatment Unit
^ Sand/Gravel Filter
^ Mechanical Aeration
^ Disinfection ~
^ Peat Filter
^ Wetland
^ Other: ~e'WA
Dispersal Cell(s)
-Ground (gravity)
^ At-Grade
^ Drip-Line ^ NA
^ In-Ground (pressurized)
^ Mound
^ Other:
Other: ^ NA
Other: ^ NA
Other: ^ NA
•IAIGITCw1 A111 /~C CPLICIII II C
1\IMII\ILI\f11•VL VVIIVVVLI.
Service Event Service Frequency
Inspect condition of tankls) At least once every: ~ ^ ear( ,Isl (Maximum 3 years) ^ NA
Pump out contents of tankls) When combined sludge and scum equals one-third (Y31 of tank volume ^ NA
Inspect dispersal celllsl
At least once every: 3 ^ month(s) (Maximum 3 years)
ear(s) ^ NA
^monthls) D~ iE5 ^ NA
Clean effluent filter At least once every: ~B'year(s)
^ monthls) ^ NA
Inspect pump, pump controls & alarm At least once every: ^yearls)
~
~l
l(si ^ NA
Flush laterals and pressure test At least once every: yea
s
Other: At least once ever
y~ ^ month(s)
^yearls) ^ NA
Other. ^ NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank
inspections must include a'visual inspection of the tankls) to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface.
The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding
of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals on„e-third IY,1 or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and' disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment
units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
}
,'~ • Page "~of y
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals
that may impede the treatment process and/or damage the dispersal cell(s1. If high concentrations are detected have the contents
of the tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal ce(lls) in one large dose, overloading the ce(lls) and may result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist~in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at-grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the following steps shah be taken to insure that the system is
properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or•must be taken, to provide a code compliant
replacement system:
~A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
D A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS
technology a holding tank may be installed as a last resort to replace the failed POWTS.
L ~ T e site snot been evaluated to identify a s 'able replacemen ea. Upon failure e a soil and site
'v f " ev lua on st be pe m locate a 'able re m rea: If replace t area is available a holding tank
ma a install ast resort to a the failed POWTS.
O Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
< <WARNING> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER
Name ~'(.5(fJZ 1..T3Lr t~~-
Phone ,~ S Zb
nA~A/TC AA Al1UTA1NFR
r V~~ ~ V .
Name
?.` 5l ~ ~'L(~ b' N i...
Phone ~'~ 2~ ~t.{~t.~
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name
Phone
Name ST (~ ~0/1C C° D 7~
Phone -- t.~(o p
This document was drafted in compliance with chapter Comm 83.22(211b)11)(dl&(f) and 83.54111, (2) & (31, Wisconsin Administrative Code.
ST CROIX COUNTY
SEPTIC TANK MAINTBNANCB AGRBBMENT
•-AND
OWNERSHIP CBR1'IFICATION FORM
tailing ddress ~ ~a ~ ~ ° ~ ~ 2 f ~~ ~
mpor'ty ddress ~ 3 T
(Verification roquired from ~~epadment for uaw coast<ucNoa)
p,,rn ~ ~~ Parcel Identification Number ~ g `- ~ ~ ~ ~ , ~~ ~~~
~ty/stat - 3 Sh.
1~ JJ` 1.7C~~Jli~~
/ , _ ~ W Town of~~•
'ropCrty 'on=.'/., ~ /., Sec. ~ T~N ~ •
. Lot # ______:
ti_L.1S.w ~~ ~ ~
Survey Map # , `f ~ 5 ~Z .Volume ~ ~ .Page #
~~ y(p ~ Volume ~~ Page # ~~
~ Deed # -
Spec hose ^ yes no
Lot lines identifiable ~ yes ^ no
~, ~ - -
Proper use ~ mamteoanceof your septic system could result in its premature failure to handle wastes. Proper maiatenancc
eoosists p~P~B out ~ septic tank every three years or sooner, if ended by a licensod pumper. What you Put into the system
can the function of the septic tank as a treatment stage is the wastie dlspo~ ~~'
a form, signed by the owner and by a
property owner agrees to submit to S't. Croix Zoning Department that ~i) ~ on-ci~ wastewst~ ~~
msz~ ~ journeyrnanplumbe~ rplumber or a lioensedpumpetv~Y~8 ~ ~c tank is loss than I/3 full of sludge.
is is operating condition and/or (2) after inspoction and pumping (if wry),
to maintain the private sewage disposal system with the standards
i~ ~ Nava read the above rogrents and agree of Natural Resources, State of Wisconsin. Cetiification
sd forth. as set by the Department of Commarce anal the Depa to the St. Croix County Zoning Office within 30
da~g t your 'c system has boon maintained must be completod and ret<uaed
Sys, ~ three oxpiration date.
~~ ~D_3
DATB
p R C R~CATION our knowl e I we am are the owner(s) of
I (we) certify that all statements on this form are true to the best of ear of ~~ OPFce. • ( ) ( )
~ descn'bed a ve, by virtue of a warranty deed recorded is Regist ?/ p 3
DATE
~ OF APPLI
Any information that is mis-representedmay result in the sanitary permit besng evoked by the Zoning Department. «'*'«s
ssssas
« Ind do vrith this applicaQon: a cramped warranty deed from the Register of Deeds office dad
a copy of the mod survey map if refer ~ made in the warranty
,-
r
RECEIVED
MA~ 1 3 2003
V~ftsconslnDepartmmtotCornmetve SOIL. EVALUATION REPOR Pag¢ ~ ar 3
Divis+on of Salefy and Bulidings 57. CR
M aocordenco with Comm 85. Wls. Adm. Cad C3Gk~ING OF
Attaoh complete Nte plan on papw rat less than 8 1!2 x 11 inches b srze• Plan muse ~
ndude, put not Nmlled to: vertical and horizontal rnferenc6 point {BM), directbn •nd Peel I.D. D/ (I_ /0 ~ 3 - SU W ~ .
percent ebpo, scale of dimensbtu, north ertow, and Ioceelvn and dlsto~ce b nearest road, Q '
Please print A!I Uformatlon. ~ by Date
Peroonet InMnnation you Drovlda may Ds vaed for sraeondJry Durpases (Privacy Law. a 15.04 (t I lm)J ~ f'U V
Property Owner Property Locatbn
_ .~I M Govt. Lot 114 114 S T ~ N R ~ (o~
Property Ownefsldeiiing Addre a ~ Ld 8 Block p Subd. Name or CSMM
P. U . /~,ax ~(~ Z T/
City tale p Code hone um r ~ City ^ Village [~ Town Nearest Road
794-5333
[~ New Consrrudbn Use: ~ Rosidentisl /Number v1 bedrooms ~_ ~ _ _ Code derived doslpn Aow r7tD9 _ ~G53Z~f! t7 ~ ---- GPD
^RePtacernent ^ Pubbcoroommorcial-Desulba: _-_-_~___.--_-_--_ -.-._--
Parent materiel -~~~- --,__-------___---- Fbod PIOUI elevation rTepplk,3ble ___----~,~~- -- g.
~~ r ~i ~'~,~ ~6: sy~~Ce rr~ ~ ~e~ . veP 9' y 3 0
Gaw~f 93~ f10
r--~ n .,
Boring K
Pk Ground suiface Wev. ~ ' ~ ~ ft. Depth b Ymiting fgptor __~_5._ U ,_ b.
Sob ic9tlOn Rate I
-
tionzon Depth Oomtnant Color Redox Oescrlptlon Texture Shutture Consistence Boundary Roots GPDItt'
in. Mansell Qu. Sz. Cont. Cobr Gr. Sz. Sh. 'E}f111 'EffM2 I
~ -~2 ~ z i ~) . a
z iZ~ZB ~kl'+ s ~ e . ~ 4
,--- ~ ~ k, . e 5 -- . o . 9
Boring N I~~ Bonng
l~ Pit Ground aurtace elev. ~~ K. Depth W 6nMing factor _~~ ,_ tn. Rna anntir-ntinn Rata
Horizon Oupth Dominant Cobr Redoz Ooacription Texture Strudure Consistvnco Boundary Roots GPD/ft=
In. Mansell Qu. Sz. Cont Coby Gt. Sz. 3h. 'Ei1M1 'Et5Y2
_-
~
~~
' Effluent Nt = 80D > 30 _<220 mg/l and TSS >30 < 150 mg/L ' EIRue - 800 < 30 mg/l. and TSS < 30 mgfL
CST Name (Please Print) nature % ~~~ , ~TNumber it
ddress Dale Evaluation Conducted Te4phone Number
r _
- 4 ~
_L~G!rT_ ~ Parcal ID p -
Property Owner _._ _ ____..-- _~__----•--__----- Pew ' ~ ~ ~- 3
^ Boring
Bonn9 # ~ plt Ground surface elev..~~~ tt.
Depth to liming factor S /~-~ ~+
Sod A GceCOn Ra
Horizon
~
z
3
~-i Depth
ln.
0-rz
11.2g
z$-s~
51-(.U Dotnln2nt Color
Muncell
Ip 313
1
o
~.t r 31 ~•o Redox Destxiptbn
Qu. Sz. Cont. Cobr
-'~"
---
~ . 5 `~ Texture
Si I
~~i
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Gr. Sz. $h.
2
k
Orr• CAnSi6tenae
•~
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m ~
.~ Boundary
c
~
~ S
~' Roots •E~GPD
lv . S
~ ~ ~
'-
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.-. ff4Eft112
. ~
9
' S
Bourg # ^ Boring
^ Pit Ground surface elev. -T--_ R ~DW ~ In9 facsor .----- in. SOd ~ adon Ra
Ho~aon Depth Dominant Color Redox Oescrlptivn texture Stnxture Consistence Boundary Roots GPO/tf
in. Mansell Qu. Sz• Cont. Cobr Gr. Sz. Sh. I •EffAtt •EtfA'2
Boring
Boring K Ground surface elev. ,._______ ft. Depth to limning factor _~__~__ ~• -
^ Pit Soil A dfcadon Rate
Horizon I Depth Dominant Color Redox Ooscription 7estune Structure Consistence Boundary Roots 1tY
in. Mansell Qu. Sz. Cont. Cobr Gr. Sz. Sh. 'EriN1 I 'Ettle2
' EMuent kt ~ BOD, > 30 ~ 22A mglL and TSS >30 < 150 mg/L ' Etlluent u2 = BOD, < 30 mg/l and TSS < 30 mglL
'fhc Department of Commerce is an equal opportunity sorvicc provider and employe. if you need nesistancc to access services or
need material in an alternate fumtat, please contact the department at 608-266-3151 or TTY 6U8-264-A777.
sYD~U)OIP.Vl/VD)
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_.._._--._... ~~ ~ 3
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SYSTEM F.LEVATION,~-~ 7~ 30 ~=~3..~0 ~ (~
SYSTEM TYPF, (~ ~ n ~'4-~~3~s n J ,~ + ---
.
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:.,eC
02/25/2003 21:31 FA% 17152352592 TLSINZPLLTMBING
T.L. Sint Plumbing Inc.
E5609 708th Avenue
Menomonie, WI 54751
FAX TRANSNIITPAL
Date: 07 to D
Phone: (715) Z35-2644
Fax: (715) 235-2592
No. of Pages:
(including cover)
To: ST ~ ~ ~~ t 1~ C pc-~-~T'~
.4ta~:
From: ~ ~ c Z~
Subject ~}i~CcS c ~ ~~ 1 -" ~ d~ ~"~ ~. ~'
5~, ~ -~=~ ~~-~5 vas ~- ~~
31 ~ ~~ ~ 3 c,~~ ~ -eft
~~
r
~, ~`~.'
Sigiature:
f~ o i
•
DOCUMENT NO.
YOL 1690PAGE109
652463
KATHLEEN H. WALSH
kEGISTER OF DEEDS
ST. CkOIX CO., WI
RECEIVED FOR RECORD
07-30-2001 9:30 AN
REAL ESTATE MORTGAGE SATISFACTION
WESTconsin Credit Union, Iocated in the County of Dunn, State of
Wisconsin, does hereby certify and acknowledge, that a certain
mortgage, made and executed by JAMES M KAUTZ, now held and
owned by the credit union above named and recorded in the office of the
Register of Deeds in and for St Croix County, in the State of Wisconsin,
to wit:
Description provided below:
NE'/~ OF SE'/.OF SECTION 33, TOWNSHIP 29 NORTH, RANGE
17 WEST.
NOTE: THIS PARCEL CONTAINS CSM IN VOLUME 6 OF CSM,
PAGE I T30, AS DOCUMENT 418552,
ST CROIX COUNTY, WISCONSIN.
Mortgage dated ti/16/97recorded in Volume 1~ of Records, on Page
527Document No. 561461, is fully paid, satisfied and discharged. The
Register of Deeds of said County is hereby authorized to enter this
satisfaction of record.
State of Wisconsin
Dated: 7/30/01
County of Duan
This instrument was acknowledged before me
On: July 30, 2001
By: Gregory Kaiser
As: Real Estate Loan Supervisor `````~~s~NEt~'~tr,T~~~'
By: Tconsin Credit Union _ O~ • ,
.2 * ~.
' oAnne L Lutz !.,,tt` AUB1.~G •,,~'~'
Notary Public State of Wiscoify~ • .. ~p'.~•'
My commission Expires:3/3f ~~~ ~~}',;~"
SATISFACTION
EXEMPT M
CERT COPY FEE:
COPY FEE:
TRANSFER FEE:
RECORDING FEE: 10.00
PRGES: 1
RETURN TO:
WESTconsin Credit Union
444 Broadway
Menomonie, VYI 54751
18-1073-50-000 - 3 ~~
WESTconsin Credit Union
By:
' Gr ry Kaiser
Title: Real Estate Loan Supervisor
This instrument was drafted by:
WESTconsin Credit
JoAnne L Lutz/ RE Loan Processor
/op`k(
Y',
• . 5TATE BAR OF WISCONSIN FORM 1 - 1983 ~"''
56141 I WARRANTY DEED
~~• ~ ~ ~~~
DOCUMENT NO. ~,
i
~+ ~ot_3~47PacE5~7 __
t
?~~ fiEGISTERS 0"F1.E w
This Deed, made between Robert H. Cunningham and _ ~CHCIXCTY.,w}
';~ Joanne L. Cunningham husband and wife as ~~~++ s-
"~` survivorship marital proverty ,JUN 2 5 1997 ~i
,Grantor, µ}~-
and James M. Kautz, a sinele person ~~ 9:30 A Rfl
r i fluplsWr ur DeeJa ~ ~ ~
,Grantee, ,•~~'
- W}tnesse [h, slut dx said Gtantar, for a valtuF'e coruideratian ~ _ . _ ... __._ ' `i
`~'' conveys to Grantee the following described real estate ut St. Croix TNIS SVACE RESERVED FOR RECOROINO DATA i ;'~
''~~". COOn[y Stale Of WiscORSrn: NAME ANO RETURN ADOREaa ~ ~'~~
,~.
Northeast Quarter (NE}) of Southeast Quarter `~ C"ft_ '~j
yT1 (SE}) of Section Thi``~~ty,Y-(33), Township Twenty-nine yyU ~ ,'i
.4~, (29) North, Range 5~5'ttltEeen (17) West. YV1,1,y~.Q~.r~ti u/r~Y~Sf
`t~ NOTE: This parcel contains Certified Survey
"~~ Map in Volume 6 of Certified Survey Maps, page --
I 7
173J, as Document Number 418552. ~ 5/Z ~~~•!
18-1073-50-000 " .5;
SRcres -3 i . 2pl • 17. 512 g D ~ C~ fo 73-Sa_~ ~ fARCEL IOENTIFICAi1pN NUMBER
- Ncr--Yti o-F (031 c-f y •7 k
~1
,w ~
~~ ~d~~ 7~? :.
_r~~ ~5,~
~~~~ ~ ;~~
~,#-~ Th's is homcstcadpropctty
(b) Q(d4i6t1
i~
~•1~ Together with all and singulu the hercdiumenu and appunenances thereunto belonging; :, t{
And Crantnra ,~'
wartants that the title Is good, Indefeasible in fee simple and free and clear o(encumb:ances except Easements, Township and
Zoning Ordinances; Recorded Building and Use Restrictions; Covenants and Real Estar.e
,` Taxes levied in year of closing.
and wiU warrant uid defend the same. , ,
'.. r~.
Dated this __ ~ ~ day of Tana ~~~
r,~ i .19_.9.L_. i r~
/ / ~
~~L• (SEAL) ~~wt /ldr~•/ (SFi1L) ~ s
~,.~ b :~
..
'~ c 1 ,
(sEAI.> (SEAL) .
~f
{; i AUTHENTICATION ACKNOWLEDGMENT ~a
,'~ { Signature(s) State o[ Wisconsin, ~•
~: as.
_ .3C.Cro,X ~`~
~~ authenticated this day of , t9_ Personally nme before me [his ~/ ~n day of t •~
`, June , 19 97 , ~ above named y~.
i.': Rohert H. Cunningham and Joanne L ~.~~_s
~"' ~ Cunningham, husband and wife as ''1~i
`!~ TITLE: MEMBER STATE BAR OFWISCONSI Q~~j ~~ survivorship marital pro ert d f
•~ (If not, ~ p y Y.
~ isr`.
'}s
authorized by;706.Oti, Wis. SutsJ ROTARY 9 to me o to be the person s who executed the [orcgoing ~'if1~i
~-- ... rostrum and atknowkd the same. ?
THIS INSTRUMENT WAS DRAFTED BV * pUBUC * C'~---~
~'-~~ MUZA b MUZA LAW OFFICE ~ .~
. T~ ` '
I Menomonie, WI 5475 L ~ ~ ~ ~ ~~~ e ~ ~ -
NotaryPulic, -SE•Qro;A, CountgWis. ~~i
:p (Stgnaturcs may be authenticated or acknowledge of My commission is permanent. (If not, state expiration date: .''li ~s
necessary.)
• Namq o(prnons signing in any apxlty should by lyprd or pinged lxlow th<ir siglulwn. ~~.•.
WARRANTY DEED STATE 9AR OF WISCONSIN WfyoMin Logy &uW CO yc y^{L_+~
Form No 1 1982 M;,a,~w ~ ~-~
w.aa Ft/oBa U 1 9 6 7 P 4 1 4 ~rAl,,~,p
' QYI.mMl+e.nM.n AgocWion 1969
DOCUMENT N0.
SATISFACTION OF REAL ESTATE MORTGAGE - BY LENDER
The urxiersigned Lender certifies that the following Is fully paid and satisfied:
Mortgage executed by James M Kautz and Suzanne M. Kautz
to Lender and recorded in the office of the Register of Deeds of
st. Croix County, Wiscons(n, as Document No.
650055 ,in yoT ume 1672 PaQea ,
- - Naums/Page/Fxa
531- 546 ,covering the real estate described
below:
6 8 96Et1 A. YALSH
REGISTER OF DEEDS
S7. CROIX CO.. YI
RECEIVED FOR RECORD
09-0~-2002 1i:30 A)M
EXEIPTA~7ION
REC FEES 11.00
TRANS FEE:
COPY FEE:
CERT COPY FEE:
PAGES: 1
Recording Aroa
Y
Name and Retum Atldrue
Loan Proeesaing
The First National Bank
PO Box 187
Hudson, u: 54016
oa ~csr!
(gt{n ~UUn~.j i~- T o/8-X1073-50-200 5~
Parcel k:sntifler No
Lot One (1) of Certified Survey Map in Volume Six (6) of Certified Survey
Maps, age 1 , As Document Number 41655Z~ire~in -St. Croix County
Regis er o ee s Of ice Octo er 27, 19 6, Being Located in Northeast
Quarter Of The Southeast Quarter (NE 1/4 of SE 1/4) Of Section Thirty
Three (33), Township Twenty Nine (29) North, Range Seventeen (17) West,
Town of Hammond.
Subject to C.T.H. eT" right of way.
St. Croix County, Wisconsin.
^ If checked here, real estate description continues or appears on attached sheet.
STATE OF WISCONSIN Dated AUGUST 26. 2002 ,
County of St. Croix The Firat National Bank of Hudson
NAME O LENDER
This instrument was acknowledged before me By
On AUGUST 26. 20Q2 Title Senior Vice President
by Alan N. VanDenBrceke and Alan L. Kollenbach ~~an H. VanDenBroeke ~~`
(NameB d person(s)) /n~~"~~
aS Senior Vice President and Vice Preside loon Attest 1~~`°"' -- - f
(TYPe d aultariry, e.g., Icer, t 4,,~ -'
The Fi rar Na Tonal Ba k _ ~ a~a, Tj(le Vice President
of ... _ _ _ ..._ rr ~~_..._...:
1 v
• Z * .3.
• i.
• ~erv~ R. Daniels %~- • nt~v _
T
/~ ~ ..
Notary Public, Wisconsin '''qp,,,,,,,a~
My Commission (Expires) ps) 7/2aJas
+~ Alan L. K~~ ha -h
This instrument was drafted by:
FNS Hudson/Cheryl Daniels
m~PwNn
*Type or print name signed above.
i,
,...
~ ~
Hrl_,~; i~i/i%~s~
~,~~ .~
~ ~ / (,r,.J ~
i o/~~/o ~3 - ~o -~~b
this instrument was drafted by Douglas Zahler job no. 86-32 0
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NO1°39'54"W 330.00'
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- C.T.H. "T" ~~ - 525.22'
SO1°39'54"E 330.00' east 1• a of the SE
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unplatted lands owned by others
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COMPREFIcNSIV~ ?ArcKS NVh~HNG
AliA 20rrING CO.•ni.v11EE
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», ~ytv, iw; ~'bwn of Hamm°nd, St. Croix County, Wisconsin;
further described as follows:
Commencing at the EQ corner of said Section 33; thence SO1°39'54"E
along the east line of the SE 4, 525.22 feet to the point of
beginning of this description; thence continuing SO1°39'54"E,
along the east line of the SE 4, 330.00 feet; thence S88°20'06"W,
660.00 feet; thence NO1°39'54"W, 330.00 feet; thence N88°20'06"E,
660.00 feet to the point of beginning.
Above described parcel is subject to right-of-way for County
Trunk Highway "T" as shown on this map and 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 of the County
of St. Croix in surveying and mapping same.
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Allen C. Nyhagen date
Pale ].730
Jessie I~ye -
Subject:
Location:
Start:
End:
Recurrence:
-0 1073-50-000
33 .17.512A
Sinz, Kautz, 420741
Hammond
Wed 12/17/2003 2:30 PM
Wed 12/17/2003 3:30 PM
(none)
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