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HomeMy WebLinkAbout036-2006-30-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 569573 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. Permit Holder's Name: Village X Township Parcel Tax No: City Weiss, Terrence& Margaret Stanton, Town of 036-2006-30-000 CST BM Elev: Insp.BM Elev: BM Description: Section/Town/Range/Map No: 2Slj m C.5—F 31.31.17.655 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. i Septic Benchmark abt r o.,�.er 'ILSt� 4-7Z /64-'17- D95il,g�' Alt. BM ` Bldg.Sewer FJW SUHt Inlet TANK SETBAC St/Ht Outlet INFORMATION $ TANK TO 6 P/L WELL BLDG. ent t Air Intake ROAD t � r� O SeL 7Z , 1+0X� 3� Dt Bottom .q3 7y, Z4 p Z� z Header/Man. 7 'F Af �L q � 1 Dist.Pipe -7-3 , 9 Bot.System .� ?"Jr. 9 d/< Final Grade ,/t / !!/66 , PUMP/SIPHON INFORMATION 'T Manufacturer Demand St Cover 3Zd / 4..-- 3" 16 Model Number c..6 le TDH lFriction Loss System Hi TDH Ft Forcemain I Lengtr Dia. Dist.to well SOIL ABSORPTION fSYSTErf BED/TRENCH Width Len th� No.Of Trenches PIT DI NSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 3 � SETBACK SYSTEM TO P/L JBLDG WELL LAKE/STREAM LEACHING Manufacturers- � .1 f INFORMATION Type Of System: CHAMBER OR .L 11 1 e. 6 �� 1?. 13'7 ' �-r , I UNIT ModeuJumb r: �DISTRIBUTION SYSTEM �J 154-/66J1 V_ vS d/ Header/Manifold� Distribution Ix Hole Si� Ix Hole Sp sing Vent to Air Intake / Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bedrrrench Center [/.to Bed/Trench Edges iTopsoil � vQC g � Rfl No ,Yes � No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / / Inspection#2: / Location: 1473 185th Avenue New Richmond,WI 54017(SW 1/4 SE 1/4 31 T31 R1 7W) Oak Ridge Estates 1st Additi Parcel No: 31.31.17.655 ,5z&1.)Alt BM Description= 1 r`�'`a� �� ''�— Cam`G,�,� /�Ck d Z� 2.)Bldg sewer length= ]. -amount of cover= X%,J' I i Plan revision Required? ❑ Yes No Use other side for additional inform on. ((! SBD-6710(R.3/97) Date Insepctor's Signa a Cert No. KNUDTSON PLUMBING& CONTRACTING,LLC 927 15M ST.648447MPRS ROBERTS,VA 54M-8M6 CELL651470-1737 .. t1 Nt of s /50 cr�LL Lem oe I 4e,It ea,,, A -- - :+G" County St Croix Safety and Buildings Division ED 201 W.Washington Ave., P.O.Box 7962 Sanitary Permit Number(to be filled in by Co.) r O Madison,WI 53707-7162 222 4 j Co 73 IAN ST CRp1Q hermit Application State T"ansxtion Ntuttber In accorda 03... ).Wis.Adm.Code,suhmission of this form to the appropriate governmental unit /V is requi o obtaining a sanitary permit. Note-.Application forms for state-owned POWTS are submitted to Project Address(if different than mailing address) the Department of Safety and Professional Servies. Personal i6mmation you provide may be used for secondary purposes in accordance with the Privacy Law,s. 15.0 l)(m),Stats- 1473 185th Ave 1. Application Information-Please Print All Info n Property Owner's Name / Parcel 4 Terrence & Margaret Weiss - S Pmpeftg Ommer's Mailing Address Property Location 1473 185th Ave. Govt.Lot • City.State 'Lip Code Phone Number SW /,_ SE '%,, Section 31 New Richmond Wi. 54017 . 31 17tcircleone) I N-, R 1?or W 11.Type of Building(check all that apply) I at ( 1 or 2 family Dwelling-Number of Hedroom 4 Subdivision Name &-e Block Oak Ridge Estates ❑Public/Commercial-Describe Use -- --- ❑City of ❑ State Owned-Describe Use C:SM Number ❑ Village 3 A;� Gt�(f 5 c� t 6 4-/��-�S Town of Stanton Ill.'type of Permit: (Checkonlyeacb6zooliacA. Complete line B if applicable) A. ❑New System ®Replacement System ❑TreatmentlHolding'fank Replacement Only ❑Other Modification to Existing System(explain) B. ❑ Permit Renewal ❑Permit Revision ❑Change of Plumber List Previous Permit Number and Date Issued ❑Permit Transfer to New Before Expiration Owner 43706 IV.Type of POW TS S stem/Com aent/Device: Check all that apply) IN Non-Pressurized to-Ground ❑Pressurized In-Ground ❑At-Grade ❑ Mound>24 in.of suitable soil ❑-Mound<24 in_of suitable soil ❑Holding Tank ❑Other Dispersal Component(explain) ❑Pretreatment Device(explain) lets V.DispcirwaVTrealeent Area Information: Design Flow(gpd) Design Soil Appth Rat pdsfl Dispersal Area Requir s Dispersal Area 1sfl Sysum I lcvation 600 01 857 . 14 900 96. 0 V1.Tank Info Capacity in Total #of Manufacturer Gallons Gallons I:nits o New"ranks Existing funks P o l y l o k 525 v �; filter _ r- 9. Septic orI Wing Funk 1250 1570 Powers Cement Prod Dosing Chamber Fu zjWieser filter 4ankl Vll.Responsibility Statement- 1,the undersigned,ass me spoasib' h forms on ofor shown on the atterbed plans Plumber's Name(Print) Plum s MP/A1PRS Number Business Phone Number Keith Knudtson 648443 651-470-1737 r Plumber's Address(Street,City.State,Zip Code) 411 ' 927 150th St. Roberts/Wi. 54023 VII1. ' JDe artment Use Only Permit Fee Date ssued Issuing nt Signature Approved S 00 Z - 14 r riven Reason for Denial 1X.Condit' }9ttasons for Disapproval 1 $@pt1C tank,effluent filter and persal caul must all be services-1-miffitilnod as per management plan prcv jea by:plulstger. 2 €14 iotl�ck requirements must oe mairiE (1 M ble Code/ordinances.' Altseh to compkete plans for We syqtem and submit to the County only on paper sot kas than 81/2 111 inehm in size SBD-6398(R. 11/11) CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Terry Weiss Owner's Name: Terrence&Margaret WEISS Owner's Address: 1473 185TH Ave. New Richmond Wi. Legal Description: SW I/4 SE 1/4 S. 31 T. 31 N R 17 W Township: Stanton County: St. Croix Subdivision Name: Oak Ridge Estates Lot Number. 33 Parcel ID Number. Page 1 Index and title Page 2 Plot Plan Page 3 System Sizing&Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test&House Plans Designer/Plumber. Keith Knudtson License Number: 648443 Date: Phone Number (651)470-1737 Signature Designed pursuant to the in-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P(N.01101). Page 1 KNUDTSON PLUMBING& CONTRACTING,LLC 927150TH ST.648"7MPRS ROBERTS,WI 540234LS26 CELL 651-470-1737 aP- tjp+tSt Lei , 0.) 4 V i Soil Atwomtion&ntwm Q ss Section f--- ft 99.80 ft r Sdiedule 40 Final Grade PVC Vent Pkm 97.00 Vft Vent Cap it Leaching --► 96.00 ft Chamber —. System Elevation 3.00 ft 6.00 ft ft Soil Absomtion System Plan View ft 3.00 ft 6.00 ft Leaching Trench 1 Chambers 4-Dia. Trench 2 Header Vent Or Observation Pipe Trench 3 LAaching Chamber SoeciHcaflons Manufacturer And Model EISA Rating 20.00 sq ft per chamber Soil Application Rate 0.70 gpd/sq ft 600.0 gpd Design Flow s 0.70 Soil Application Rate + 20.00 EISA= 44.00 Chambers 3 rows of 15.00 chambers each. Page of Q Filters' i ~ -525 EFFLUENT FILTER Fl�_-525 Filter is rated for O;flOfl GPD (gallons per day) 1116- Filtration Slots Narm it one of the largest filters �AmemN14 as class. It has 525 linear feet ? 5°filtration slots. Like the" —� Accept PVC rok PL-122,the PolyloknsonHendle -� has an automatic shut :all installed with every filter. a' the filter is removed for ning, the bail will float up and poranly shut off the system so lae .:fluent won't leave the tank 525 Linear Ft ofljlE other filter on the market can FlltrationSlots :ike that claim. ;n�cPO k -PL-525 Maintenance. Aeeepts4•PS' SCHO.40 Pipe . The PL-525 Effluent Filter should gate efficiently for several years 7 - - under normal conditions before ---r.: - -requiring cleaning. It is recom- mi tended that the filter be cleaned every time the tank is pumped or at least every three years. If the ' ' batvveen nstalled filter contains an optional While this filter ; alarm, the owner will be notified can handle larger flov,s and can be by an alarm when the filter needs used in commercial servicing. Servicing should be i applications it is NSF bone by a certified septic tank idential use only. = —+ G.Def aor pumper or installer. Automatic Shirt-Off U.S.Patent No#6,015,488 Bell When Filter is 1.-Locate the outlet of the 5,871,640 - Removed 5,871,640 septic tank. - 2. Remove tank cover and pump tank if necessa ry. PL°5525 Installation: 3. Glue the filter housing to 3.- Do not use plumbing when the 4" or 6" outlet pipe. If filter is removed. Ideal for residential and com- the filter is not centered '- 4. Pull PL-525 out of the housing. mercial waste flows up to under the access opening 10,000 Gallons Per Day (GPD), use a Polylok Extend & 5. Hose off filter over the septic Lok or piece of pipe to tank. Make sure all solids fall 1. Locate the outlet of the center filter. See page back into septic tank. septic tank. 19-21 for Extend & Lok 6. Insert the filter cartridge back 2. Remove the tank cover and information. into the housing making sure pump tank if necessary. 4. Insert the PL-525 filter f the filter is property aligned into its housing. and completely inserted. 5. Replace and secure the 7. Replace septic tank cover. septic tank cover. -; ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Terrence & Margaret Weiss Mailing Address 1473 185th Ave Property Address 1473 185th Ave (Verification required from Planning&Zoning Department for new construction.) City/State New Richmond Wi. parcel Identification Number w ° Q'lo d -606 LEGAL DESCRIPTION Property Location SW 1/4 , SE '/4 , Sec. 31 T 31 N R 17 W, Town of Stanton Subdivision Plat:Oak Ridge Estates Lot# 33 Certified Survey Map# , Volume , Page# Warranty Deed# 388906 (before 2007)Volume 676 ,Page#236 Spec house OyesEho Lot lines identifiable Oyesono SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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 pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in§SPS.383.52(1)and in Chapter 12-St.Croix County Sanitary Ordinance. The property owner agrees to submit to St.Croix County Planning&Zoning Department 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/or(2)after inspection and pumping(if necessary),the septic tank is less than 1/3 full of sludge. I/we,the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth,herein,as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St.Croix County Planning&Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on is form are true to the best of my/our knowledge. I/we am/are the owner(s)of the property described above,by virtue of a arranty deed recorded in Register of Deeds Office. Number of bedrooms 4 6 /z� � SIGNATURE OF APPLICANT(S) DAT ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning&Zoning Department. *** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV.04/12) Page Z of Z START tap AND OPERATION %r new construction, prior to use of the POWTS check treatment tankls) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(sl, 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 cell(s) in one large dose, overloading the cell(s) 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, time 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 rife 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 fairs and/or is permanently taken out of service the following steps shall be taken to insure that the system is property and safety abandoned in compliance with chapter Comm 83.33,Wisconsin Administrative Code: • Ali piping to tanks and pits shall be disconnected and the abandoned pipe openings seared. • The contents of all tanks and pits shall be removed and property disposed of by a Sept:age 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 comptimit. 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 time 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. ❑ 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. alu tan -be' e a ea �R.Dl-l18 FF;AA `FDl2-I�f� �I�JS'T7ZClC.�'L Dr.t k ❑ 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 9VTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE ADDITIONAL COMMENTS e POWTS INSTALLER POWTS MAINTAINER Name I .,- �< e'_ Name Phone 1 &51— 4-76- 1-7-3 -7 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORfTY Name p W re s _Y;01 Name- f5t. C ( U 2 J1�(l Phone _ 6- - Phone —7(S— 3�Co-- This document was drafted in compliance with chapter Comm 83 22(2)(b)(1)(d)&M and 83.54(1),(2) &(3),WiDonsin Administrative Code. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page Z FRE WDFtN1ATION SYST13A SPECV:WATIONS Owner ner °ft - Septic Tank Capacity a � /Z!✓(J gal ❑ NA Permit# c�_ - Septic-Tank Manufacturer :t'5e— ❑NA DES)GN PARANIETStS Effhx mt Flier Manufacturer t o ❑ NA Number of Bedrooms f� ❑ NA Effluent Filter Mode) �JZ ❑ NA Number of Public Facility Units NI::r4A Pump Tank Capacity �1'PJA Estimated flow(average) 1/dU gallday Purnp Tank Manufacturer �lQA Design flow (peak), (Estimated x 1.5) ° (,P40 gal/day Pump Manufacturer `X'VA Son Application Rate (�.7 aUdayne Pump Mode) X IA Standard lnfluendt1fluerit Ouality Monthly"maw" Pretrratneff t Unit Fats,Oil& Grease (FOG)• 530 mg/L ❑Sand/Gravel f"kw ❑ Peat fir Biochemical-Oxygen Demand (BODJ 5120 mg& ❑ NA ❑Mechanical Aeration ❑wedand Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection D Other: Pretreated Effhnerit Quality Monthly average D" Collis) _,A•(j-s (D"Oe. ❑NA Biochemical Oxygen Demand (BODJ 530 mg/L ) roh�-Grsund (gravity) ❑ In-Ground (wed) Total Suspended Sol& (TSS) 530 mg/L ❑ NA 0 At-Grade 0 Mound Fecal Conform (gamic mean) 5104 cfu/100rn) ❑ Ddp-Line ❑ Other: Maximum Effluent Particle Size a in ilia. ❑NA �1ef ❑ NA Other ❑NA Onion: 0 NA *Values tvpNNd for donresuc wastewater and septic tank e#fkm-& OUIW. ❑ NA MAIN TENMCE SCHEDULE San&*Evan Service Freqtmncy Inspect condition of tanks) At{east once every: s)s) {ln 3 years) Q NA Primp out contents of tank(s) When combined sludge and scum equals one-third %) of tank volume ❑ NA inspect dispersal cell(s) At)east once every: °yearts}s) (Ma3tircum 3 years) 0 NA Clean effluent filter At least once every: 1, yee(s)s) ❑ NA Inspect pump, aari p, pump controls &alarm At least once every: 0 ears(s) ❑ s) Rush laterals and pressure test At least once every: 0 months) NA ❑Yearls) At least once every: ❑month(s) 0 NA 0 yearls) Other. 0 NA MAINTENANCE INSrRUcTioNs Inspections of tanks and dispersal cis .shall be made by an individual carrying one of the following licenses or certifications: Master Plumber•. Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Sepuge Servicing Operator. Tank inspections must include a visual inspection of the tank(s)to identify any missing or broken hardware, identify any-cracks or leaks, measure the volume of combined sludge and scxrm and to check for any bank up or ponds ng 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 Pondmg of effluent on the ground surface. The pond'mg of effluent on the ground surface may indicate a failing c ormfi'bon And requires the knmediate notification of the local regulatory audhwrtry. When the Combined accumulation of sludge and scum in any tank equals one-third %) 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 Admkniistrative Code. All other services, including but not limited to the sevmV of effluent fitters,mechanical or presstunzed comporuents,Pretreatment units, and any servicing at bntwvals of S12 moriths, shalt 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. Parcel #: 036-2006-30-000 07/18/2006 05:30 PM PAGE10F1 Alt. Parcel M 31.31.17.655 036-TOWN OF STANTON 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 O-WEISS,TERRENCE F&MARGARET TERRENCE F&MARGARET WEISS 1473 185TH AVE NEW RICHMOND WI 54017 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description * 1473 185TH AVE SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 1.200 Plat: 2240-OAK RIDGE ESTATES 1ST ADD OAK RIDGE ESTATES 1ST ADD LOT 33 Block/Condo Bldg: LOT 33 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 31-31N-17W Notes: Parcel History: Date Doc# Vol/Page Type 2006 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 05/06/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.200 20,000 165,700 185,700 NO Totals for 2006: General Property 1.200 20,000 165,700 185,700 Woodland 0.000 0 0 Totals for 2005: General Property 1.200 20,000 165,700 185,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 137 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 rr. _ sa i�rsc ! ►� c i sssrr!i"--- � P W. a1ds. a < doy On. 19A13 as 5 C. ep�it3+e >ret�sovea � . _ _. -----• --- - - ..........-....-------- - - --- -._ - - - V. j the p*M Grantor fmr a valuable'ean9dw..r:na. � a.M ot� he CM ideral,m" 'Tb k --- -- - -- 00111711,2TS to awl`A M ialte fol3vwhL$'damerawd.reel estsAve,fn +ccilmsy°. Sty of W- _ -- -- .' �._,. r 21„ Rea_-t.-.Lp� Tax Parcel Noe Twat "Conk Ridge. Estates FYrst A UH t1j= to the Tort of Stan-cm. / ject to re a=ded easemertts, reservations; and rights of way- This a'.5 not: h0 m&Rt, d property. -ogedWr � aA< lat tlslt 6c e d appurtenances theraunto L"elon Ire, A . ... � 2 �%� g elnts ............................... ..--------------------------------.- . ................................ vrarrants that the titia is good, indefc;asfble in fit* simple and free and clear of encum_rance:s e:_er I, m- a meptIm s and will warrant and defend the same. � . . ........ . .. . .... _ . .._.. . _._ ... . ...... ........ ...(SEAr..) _.....��:?f.._'. .:..L:�_.-�C�! ._.............(SEAL) Vem W, Weeks • ................. . . ..................................... . ._ ................ .. _ ..- ". . .. ..,. .... . ,.-.....(SEE\L) L� ��( -'...G.�/. .:......._.._...(SEAL) Emilie Weeks AUTHENTICATION ACHNOW_1 EnGMEN•T Signatxrre(ft) STATE OF WISCONSIN -- St. Croix gg anthenticated this day of........................... 19------ Personally came before me a tcttat"Uto',_day a2 GCtOber 2.7t t --- a .famed g ................................. ---•------••-----._.-------•-•-... ............ Vem W. Weeks an315 � 4 ........... _ TITLE f_ oiiiBEA STATE BAR OF[Si=fFCONSIN .............................................�''-�� t ....r+.... �r r authorized by g 90GAG, Wis. StatsJ to jn �. wn to be the pers on . Y°,p. �r�plati,3ltLlteti�t.le forinstrunien�d ackny�v��fy'ge. ��1 aCle.. THIS trlSTRUP.4=NT %VA5 DRAFTEE?8Y �).... .........`L..._!_!._ -._-1.-:~- '6 ,%IIi1t�BITS:............. Eric_J. -- tnf3eil�--Box IS7__-- ....---•-• -• • ---° ------------- Hetty_I:. Han•a1z New Ric d� Wisccnsin 54017 N"" - -------- Polk _... ________________ Notary Public ------- ....County, Wis. (Simlat4ress may 'he authenticated or acknowledged. Both My Commission is permanent.(if not, state expiration are not necessary) date: Jan--$..................... ... 19��(....) •riamo of peranw eirniox in any mpo ity should be typed or printed below their gignat.- - .- Itcbil ,conp.R,M STATE. MNo wfs92 h ORII 2 Stock No. 13001 P.1 .oR°S LO•E � "HI W o5�0$ AT THE .5 N � 35 -° �� v �g 1323.52 w N 1.22 ACRES .0 Ln- THENCE a < ti of 38 ti S1191003 _ CE M o N win N 1.32 ACRES cli 243.94 ° a a THENCE C" -.E 2 0 r , 33 33 �} 264.65 JOV - SO°5 N 45°11 16-70 po 24 50� 8 1 4 wB 6 6 S po ze TO THE OAK RIDGE �R �o N 8 o?Se 64„ �`b.. Qe TH NO N 8 0 °5 $ AIL J_ BOUNDAI E ' 7A9 S.e O D 2I 6 . 82 ' ,3 W 301.82 v5$O6 TH ° 851$ _ DI RECTI 0 C> \4 TH . N) 34 0' \ Four, cv W 1.26ACRES a 'p � 13205;, ���� � OF THE 6056`qy a��° 4 \ N OTED. � 3 w CD 3 � �. TOWN C o o i 2``gb'�i. ` MAPPIN( IRON rri `•Fi/ / 00� /- 23 14194 50"` o yo6� �p a°33 ti ti0 0 �59 �` 3 3 CATED l 1.20ACRES 8•M. TOP OF O TRANSFORMER — � - REVISED E `ij a 25 . O/ rV� BOX. Soo ° 2S2 ELEV.- 987.10 35` 6�1 3 271 U.S.G.S.DATUM,p° OWNER S 86032,06"w TIONS /�y I"X30" IRON PIPE - ` - - - AS WEIGHING 1.68 32 c�I Nj -� Lo ' THIS PL 58� 11 LBS./LIN. 2.05ACRES THIS PL ET � 200' Fs C9�-S0 2'CONTOUR LINE 0 0 J i OF THE 2o° [l., ORDINAF HIGH WATER EL.977 c°� �� O° 3 Zi SUBM I T' ESTIMATED LOW A \ F ,4) 6 a -D WATER EL. 973.0 J REGIONi APRIL 23,1975 EL. 973.5 6 U.S-G.S. DATUM S •\ O 286 o�ZO , - N Q Q AND DE) o z y6 o Fr O SERVI CE op PA R & OF NEA ��C� 195°18'36 S303934� o Z > WITNES OUT T ,�, c' SE NOTE . I IN THE 40 1.05 S.-36' C s to ACRES j 59 '598, l� r / - 235.16'; r �•� ,' •G� ,�, �• � � .�, , °5�� o` STATE 23 I i �� o�0 5i°,�° ;,�oti I o ST. CR( \03 ? C^ 7 9.29 ' 45.4 PE 1 1 303°39'2 R►86° 4 I'Ir 256. 1 ABOVE RECORDED�/AS N 2 �7/E RECORDED AS 1 �7Li K 25 . \ �' 6 45.33'� � WHO E)( ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the following residence: (Street address)1473 185th Ave New Richmond Wi. located at: SW V4, SE y4, Section 31 , Town 31 N, Range 17 W, Town of Stanton , St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of SPS. 384.25, and it (they) appear(s)to be functioning properly. Most recent date of inspection or service 5/9/14 Did flow back occur from absorption system? Yes No X (if no, skip next line.) Approximate volume or length of time: gallons minutes Tank Capacity: 1250 Construction: Prefab Concrete X Steel Other Manufacturer (if known): Powers Cement Products Age of Tank (if known)- 30 Years Permit n mber (if o ) 43706 Keith Knudtson Licensed Prim er Signature) (Print Name) 648443 MPRS (Title) (License Number) MP/MPRS 05-09-2014 (Date) Form to be completed by licensed plumber (Dept of Safety and Professional Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 2/2012 m m > ■ cc Old IZ p W E m J A VJ T m y C m 'S� �q c0 = a = a�' V � ° m x LL x z c E EM ,y. K n K E°■ L OI m LL 'm o o° w a° a a d d d H rn m � yy $°LU g �R 0 8 a Z 00 200 ui C;) . . . . Co CD . . CN M CN 27 08 . . ■ . . . ' : :■: .. . . . . . . . �. . . . . . . . . . . . . . . . . . . . . . . qD LIJLo Cq (D . . . . . . . . . . . Et . . . . . . . . . . . . . . . . . . . . . Lu . 43. 90 ZL . . . . . . . . . . . . . . . . . ■ . ■ ■ ■ . C) . . . . . . . . . . . �e { .s.r. a,r•..... �. 6� .rte-. 1 t IIA� Rill I 1 1111 -7 # Tit j z a ■ A I! : r. r t _ f r 4 P Own K=R ' ® '4 '77 r F V /wj - o4e g9tk f l4ee ,'� �,� , 1490 p "IT Q; VVVT �/ A f x - 6drxn� j vt/ _ well // [� G'Yt'G. 4 v 4 1 h O 60. d h 'I p o C o m oLOol m (D aNi M co N L 30 to ~ Q U L O O co U fA.- 7� C pnj () p = 0OQ'O m 'C M MZ:.� 3 O�fh°O`O c a)co O O cUC N a :01"1 O N N y L 7 m U'p O O N O C O- cc x Q .0 O O N Q c o Q U')U) me O z c g r 1 +� z c NN p O 7 N C O cyq N •N 'p � (n t zpmz Ln G m }�y 0 CL 1 sue+ V v c G a y Co M L A P P :3 o t�v1 X333 •N m 30a0 a a . z a> T rn y a1 \ n M } a) o o 0 Q OO c0 O N N N N N r N 0) �= 0o N III 'p H O) N ce)f� a1 O Q } U Q p _ O r.+ O O U C O E C C O O tf) O N M_ � C OL+ c0' 0I (D N c0 a O O O O O O m N m N N N N N N v C O �_ O cq c0 0 'a Z .G+ '00 In CO n c0 3� N C y C) d N p E C L IT l=xl ~ fO ce) M w N n O N N p m U •�1 O M fn Iq O Z N 2 I— 4d fn C i E a a CL Z •2 r A vat ', 0U) AS BUILT SANITARY SYSTEM REPORT .i S E C . /T �N IN-R12 W OWNER � ,��C{ /j ,�[_S S TOWN SHIP,��d��QhJ ADDRESS ST . CROIX COUNTY , WISCONSIN . r JL SUBDIVISION 10A,` I L.,' �5,A zS LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 0) WtL SHOW EVERYTHING WITHIN 100 FRET OF SYSTEM i I v di t N r t1h rr w BENCHMARK: (Permanent reference Point) Describe : 7Oi° Elevation of v4ertical reference point : 16 © / Slope at site : ,i?/D SEPTIC TANK: Manufacturer :��,�-�%•��^ A,:,C zs Liquid Capacity : Number of rings on cover : Tank manhole cover elevatio Tank Inlet Elevation :^���� Tank Outlet Elevation :?` ',K�Z PUMP CHAMBER Manufacturer : Number of gallons Number of gal . pump set for a cycle gallons ; Total capacity of distribution lines _gallon : size of pump head ; gallon per minute horsepower ;brand name of pump and model number Type of warning device HOLDING TANK: Manufacturer Number of gallons Elevation of manhole cover Type of warning device SEEPAGE PIT SIZE; Number of pits feet diameter feet liquid depth seepage pit inlet pipe-elevation bottom of seepage pit elevation feet . SEEPAPF BED SIZE : number of lines ' width lengtY tile dept e en th g SEEPAGE TRENCH: width_ �. PERCOLATION RATE ,I ,,, ,,J AREA REQUIRED � l AREA AS BUILT r� INSPECTOR DATED r PLUMBER ON JOB]!2; LICENSE NUMBER �/ � 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 FK1CONVENTIONAL ❑ALTERNATIVE 11 "t Planl.D.Number: ❑Holding Tank E] In-Ground Pressure F-1 Mound assigned) NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATF Terry Weiss 335 Oak Ave. , New Richmond, WI '_T_ .3 BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.P,..,EV.: CST FTEF.PT.ELEV.: SW SE, Section 31, T31N—R17W, Oak Ridge Estates, Town of Stanton Name of Plumber: MP/MPRSW No County Sanitary Permit Number: Cal Powers 1563 St. Croix 43706 SEPTIC TANK/HOLDING TANK: MANUFACTURER: s1 "" -IQUID CpPACITV: TANK INLET ELEV.: TANK OUTLET ELE V.. WARNING LABEL LO IN ER / ( � PR VIDED: P VI � � YES ❑NO YES 1:1 NO BEDDING: VENT PIA.: VENT MATL: HIGH WATE NUNi��',R. �" ROAD: PR OPERTV IWELL.�e-''` /// BUILDING: VEN O FRESH C ALARM FEET FIR0 704 LIN f JA INLE ❑YES O / ❑Y NO NEARest DOSING C M ER: MANUFACTURN BEDDING: LIQUID CAPACITY PUMP MODEL. PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: DYES ❑NO ❑YES ONO OYES ONO GALLONS PER CYCLE: PUMPAND CONTROLS OPER I NAL NUMBEA'01 'PROPERTY WELL BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN 'OM LINE AIR INLET : PUMP ON AND OFF) ❑YES NVAI3EsT' SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of p wl g LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall ceale un ' the soil is dry enough to continue.) MA CONVENTIONAL SYSTEM: yy� °WIDTH: LENGTH. NO.OF DISTR.PIPE SPACING. COVER JINSIDE DIA.. TS. LIQUID A: �nWC 11 TRENCHES: / IV197flR IAL• DEPTH. )DI5 7 // GRAVEL D PTH FILL DE TH DISTR.PIPE DISTR_PIPE DISTR.PIPE MATERIAL: NO-D PROPERTY WE BUILDING: VENT TO FRESH BELOW PI S. A VE COVER: ELEV.INLET EL V. ND PIPE LINE Al R INLET: MOUND SYSTEM: a 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 NO meets the criteria for medium sand. TIONS MEASURED. ❑ SOIL COVER TEXTURE PERMANENT- RKERS: OBSERVATION WELLS ❑Y ❑NO DYES ONO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. 11ODDED SEEDED. MULCHED. CENTER: EDGES. DYES NO ❑YES ONO OYES 1-1 NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LENGTH: NO.OF LATERAL SPACING: R DEPTH BELOW IPE FILL DEPTH ABOVE COVERTRENCHES: MANIFOLD PUMP MANIFOLD DIST .PIPE MANIFOLD MATERIAL ;TH. DISTR.PIPE DIS IBUTION PIPE MATERIAL&MARKING: ELEV.: ELEV.. DIA.: ELEV.V.. ,PES. 1)A,: HOLE SIZE HOLE SPACING. DRILLED CORRECTLY. COVER MATERIAL: VIER CAL LIFT CORRESPONDS TO APPROVED PLAN DYES ❑NO y+V DYES 1:1 NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: . ROPERTV WELL: BUILDING: INE: I El YES 1-1 NO OYES El No l T 2� /3 5.cJf ,OC 70L S t Sketch System on county file for audit. Reverse Side. � StGNATUR E: TITLE: DILHR SBD 6710 (R.01/82) f INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398, To be complete and accurate the permit application must include: 1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in a city, village or town); 2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment,30 seat restaurant, etc.); 3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks. 4. Indicate the design percolation rate listed on the 115 soil test report,the number of square feet required by code and the number of square feet to be installed; 5. Complete the section on water supply; 6. PRINT the name of the master plumber or master plumber restricted who will install the system,circle the appropriate license classi- fication, place your license number in the space provided and sign the permit in the signature block; 7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the permit; 8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation. Failure to comply will void the sanitary permit. 9. This permit may be renewed, and at the time of renewal any new criteria in the Wis.Adm. Code will be applicable. 10. A new permit will be needed if there is a change in,estimated wastewater flow, (number of bedrooms,etc.), location of the system, depth of the system, type of system. 11. All revisions to this permit must be approved by the permit issuing authority. 12. A complete plan including a plot plan,drawn to scale or with complete dimensions. 13. Horizontal and vertical elevation reference points that are permanent and clearly shown. 14. Piping detail including pipe size, separating distances, distances between beds if appropriate,tank locations,effluent line from tank(s) to system, building sewer and vent observation pipe(s). 15. The permit issuing agent may require a cross section drawing of the effluent disposal system. TO THE OWNER: This is valid for two years.Changes in your building plans or locations may require you to obtain a new permit.Private sewage systems must be properly maintained.Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years.If you have questions concerning your system,contact your local code administrator or the Bureau of Plumbing,DILHR,State of Wisconsin. lLISC°neln APPLICATION FOR SANITARY PERMIT r DILHR COUNTY (PLB 67) inous TT R V,LR BOOF UNIFORM SANITARY PERMIT#17V/Jr —Attach complete plans in accord with s. H 63.05,Wis.Adm. Code for the system, on paper not less than 8'/2x 11 inches in size. —See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNER MAILING ADDRESS 7 P OP LOCA ON rr�� VILLATE: 1/ - 1/4, /, N, R / I (orkY TOWN OF: LOT NUMBER B NUMBER SUBDIVISION NAME NEAREST R D, AKE OR L�NDMARK STATE PLAN I.D. NUMBER TYPE OF BUILDING OR USE SERVED / Y4 1 or 2 Family Number of Bedrooms: 1' ❑ Public (Specify): THIS PERMIT IS FOR A: New System ❑ Tank Replacement ❑ Repair ❑ Replacement Soil Absorption System ❑ Revision ❑ Privy ❑ Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank ❑ System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued ❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump Tank/Siphon Chamber Holding Tank capacity 1 i Manufacturer: IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Mines per inch)/ REQUIRED (Square Feet): PROPOSED (Square Feet): i ! LY Private El Joint El Public I,the undersigned, hereby assume responsibility for installation, f the vate sewage system shown on the attached plans. Name?of Plumber (7*, ): Sign re MP/MPRSW No.: Phone Number: Plumb s Address: Name Designer: j COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved ❑ Owner Given Initial Approved Adverse Determination Reason for Disapproval: Alternate course(s)of Action Available: DILHR-SBD-6398 (R.5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing,Owner,Plumber -F- .� .� � I 1 I i 1 Y r ...4 J in z I i i I i I fi--rt I I �0 1 1 , , x 6 - oil .r• ! .,..j ._ �x-.n .•.r.r.xnw x.•-..,..,u -. ..re..n.a� a..:-..e ....-wn<t..u.�. ... ........... .... ... �: ...m.... ........-r_ .. �' i .Dip r l Wisconsin Department of Industry, PLB-1 INSPECTION REPORT Labor ,& Human Relations F Safety & Buildings division ,� Bureau of Plumbin .Plattin & Fire Protection Name o r+eM s Date Plan I .D. No. S Tounty Sanitary Permit master PIUMDer irm Name Maress CAt-VipA L--V3 Slo ' Journeyman Plumber ress owner daress Y / 7_7 / l 1 1 J J Discuss-ea with ign ur ( )See Attached. - _ } DILI&-SBD-6192(N.09/80) Signature-of up. � - t e . p s f WMte-Inspector Yellow-Local Inspector Pink-Plumber or ResponsfOe Par i ee -Owner DEPARTMENT-OF REPORT ON SOIL BORINGS AND SAFETY&BUILDINGS INDUST-BY, - DIVISION LABOR i HUMAN REDLATIO,NS PERCOLATION TESTS (115) MADISON WI 53707 LOCATION: SECTION: TOWNSHIP/ TY: L T O :BIL O.: SUBDIVISION NAME: �/ �/ � � /,T3 H/� (or)W = CO NTY: OW R'S BU ER'S ME: MAILING ADDRESS: USE DA ES OBSERVATIONS MADE NO.BEDRMS.: COMMERC AL DESCRIPTION: TffuFME DESCRIPTIONS: PERCOLATION TESTS: Residence '-) I , New ❑Replace RATING:S=Site suitable for system U=Site unsuitable for system ' `➢ CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDI AN K:RECOMMENDED SYSTEM:(optional) s ❑u Ms Ms ❑u ❑s u ❑s u If Percolation Tests are NOT required IDESIG RATE:=fT If any portion of the lot is in the under s.H63.09(5)(b),indicate: Floodplain,indicate Floodplain elevation: 1 r PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) 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 3 PER INCH P- / P- ' 7 P- P_ PLAN VIEW: 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 slop. _ SYSTEM ELEVATION 7 3 pi J 1 r, t 21L ) 3 SO i z i _.� .._..m _.._. .. I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures m thod3 specified in the Wisconsin Admimistrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME rint : TESTS WERE COMPLETED ON: ADDRESS: ' CERTIFICATION NUMBER: PHONE NUMBER optional): CST SI A RE: DISTRIBUTION: Original-Local Authority,2nd page-Bureau of Plumbing,3rd page-Property Owner,4th page-Soil Tester. `ILHR-SBD-6395(N.03/81) • r Forum - S '1' C 100 Owner of Property .Location of Property ' ; Section j ,T _N R_.Z.2_-W T oAs h i p � Mailing Address Al U.-}� Subdivision Name Oak Lot Number -3`3 Previous Owner of Property Total Size of Parcel Date Parcel Was Created Are all corners identifiable? --� --Yes No Include with this application one of the following : ,.-Certified Survey Map . Dead . Land Contract , or . Other Uagal Document which describes the property 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 r corg in the Office of the County Register of Deeds as Document No. 3 j ;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 Register of Deeds,as Document No. ), Si NATURE Of OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED r DATE SIGNED � � ^ . ' DOCUMENT NO. TATE RAIL OF WISCONSIN FORM I Use THIS*V%CS 89699VCD FGA 8grOMING DATA WARRAUTY OM | .... ........................................................ and o County,State of Wisconsin; CA" / ~._ ~~ __ ~~t� ~~~a~_' First ~____- to the -__ of -____' "Ject to recorded easemefits. reservations, and rights of way. � / ^_ --_ warrants that the title is gsodo indefeasible in fee sinqple and free and clear of encumbrances except no meptim and will.warrant-and defend the _-- Octcber vem W. Weeks Signatu"(S) STATE OF WISCONSIN ; U -- ...� Sutherland by I 10114k Wis.St&W farseeing Instrument and aclisowledge the same. (Signatures may be authenticated or acknowledged.Both My Commission IS parvassent.(If not, state exPirstlaft ] � --_No. 13001 / � _ � Parcel #: 036-2006-30-000 07/18/2006 05:30 PM PAGE10F1 Alt. Parcel#: 31.31.17.655 036-TOWN OF STANTON 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 O-WEISS,TERRENCE F&MARGARET TERRENCE F&MARGARET WEISS 1473 185TH AVE NEW RICHMOND WI 54017 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description " 1473 185TH AVE SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 1.200 Plat: 2240-OAK RIDGE ESTATES 1ST ADD OAK RIDGE ESTATES 1ST ADD LOT 33 Block/Condo Bldg: LOT 33 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 31-31N-17W Notes: Parcel History: Date Doc# Vol/Page Type 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 05/06/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.200 20,000 165,700 185,700 NO Totals for 2008: General Property 1.200 20,000 165,700 185,700 Woodland 0.000 0 0 Totals for 2005: General Property 1.200 20,000 165,700 185,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 137 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00