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HomeMy WebLinkAbout038-1014-50-100 � l PUMP CHAMBER Manufacturer: Li id Capacity: Pump Model: Pump/Si on Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: XSYSTEM h elevat Gallons per cycle: Manufacturer- — Alarm Switch Type: t rom nearest property line: Front, O Side, O Rear, Ft. Number of feet from well: umber of feet from building: distances on plot plan). SOIL STEM Bed: Trench: L�f I r (-2,)Width: `� Len$th: Number of Lin es: Area Built: Fill depth to top of pipe: C Number of feet from nearest property line: Front, Side, O Rear,O Ft Number of feet from well: r Number of feet from building: IfT7 (Include distances on plot plan). SEEPAGE PIT Size: Numbe of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a dro ox O or distribution box O been used on any of the above soil absorbtion syt s? (Check one) . HOLDING TANK Manufacturer: Capacity: r Number of rings used: Elevation of bottom of tank: Elevation //I inlet: Number 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: — / �j Plumber on job: License Number: ;✓� 3/84:mj t Form - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER L-� -� /� TOWNSHIP SEC. T 3 / N-R -W I ADDRESS i ST. CROIX COUNTY, WISCONSIN __2 SUBDIVISION �� 1 j LOT LOT SIZE (� 3� - Io► �f-S�-A� PLAN VIEW Distances and dimensions to meet requirements of IIHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM T►" S L 3 z` t C/ (r 5 � INDICATE NORTH ARROW BENCHMARK: Describe the vertical'reference point used 4"_'ci 60, 1!24L Elevation of vertical reference point: Proposed slope at site: SEPTIC TANK: Manufacturer: t< Liquid Capacity: Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: 6.�! Z Number of feet from nearest Road: Front Side, Rear, O feet From nearest property line Front,0 Side,9 Rear,0 feet Number of feet from: well building: �- (Include this information of the tbfov' e plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE a � ti 24 1998 FILED ST.CR01X COUNTY 5GS 755 NOV 1 9 1997 SURVEYO RECORD �, KATHLEEN H.WALSH ;..� 5't 1,W6.,WI CERTIFI EY MAP LOCATED IN PART OF GOVERNMENT LOT 1, SECTION 3, T31N, R18W, TOWN OF STAR PRAIRIE, ST' MOIX COUNTY, WISCONSIN. OWNERS LEONARD & JULETTA PEPIN "' LEGEND 2387 CARDINAL DRIVE NEW RICHMOND, WI 54017 97 ALUMINUM COUNTY SECTION CORNER MONUMENT FOUND NW CORNER SECTION 3 ,..4�Y 1" IRON PIPE FOUND ....,:;r�rer.: ;!v.-'••canning • w w {;irk:, %om�tnttee 1" X 24" IRON PIPE SET WEIGHING N 0 0 1.68 LBS. PER LINEAR FOOT r, ..n•dCd d I� w " I) _ 2 IRON PIPE FOUND a, o z z WIT' ' ., c.ay"of Lu z LU X rte+ma)a void 100' ROADWAY SETBACK LINE z m o O 7) EAST= ,90 T� �. DOUGLAS UGL�4S J, cn, �•� � ZAHLER w�-- -- 1558.74' mod` 68. \0 u- o w LFN, q� p l // Fw- z ,p� S �- ti s S o • S , O s91 � o s v z Li •� 2 �• J9 SAG' CORNER W1/4 RN R 6 SECTION 3 � 9 z HOUSE \ d D I \ r ® WELL �i `� SEPTIC 9), \ co. FUEL TANK LOT 3 w v d O� CD 1.116 ACRES FT. 3 = w 48,605 SQ. ~ N i• 1.00 ACRES EXC. R\W o ,yam `� 43,562 SO. FT. o L) 0 GARAGE a"• �� cy�` � 3 w OLIN, S �2 �,�. w p m p In ry Li o o \� O. ZZ N d S 86.58'08" E c~n ¢ \ 69.26' '��' ^jam �• v/ umj 'T OINT DRIVE 0 V 0 3 ,. SCALE IN FEET 1 = 50 o l 0 25 50 100 VOLUME 12 PAGE 3381 Parcel'#: 038-1014-50-100 09/08/2005 05:00 PM ti PAGE 1 OF 1 Alt. Parcel#: 3.31.18.37B 038-TOWN OF STAR PRAIRIE Current )(I I 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-WOOD,WARREN W&ELIZABETH A WARREN W&ELIZABETH A WOOD 2389 CARDINAL DR NEW RICHMOND WI 54017 Districts: SC=School SP=Special P rty-AddresALe "=Primary Type Dist# Description `2386 CARDINAL DR SC 3962 NEW RICHMOND SP 1700 WITC ( SYS.46 y SP 8055 CEDAR LAKE/N R Legal Description: Acres: 1.182 Plat: 0610-CSM 12/3381 SEC 3 T31 N R18Wpp��' L THE Block/Condo Bldg: LOT 3 _11/2 NW14 BEING LOT 3 CSM 12/3381 LSO CONI NW�, ' 1. V I S �'—" Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 640.75;TH E 1558.74 FT TO NWLY COR LOT 03-31N-18W 3 CSM 12/3381;TH S 28 DEG W 103.94' POB;TH S 28 DEG E 117;TH N 87 DEG W more Notes: Parcel History: Date Doc# Vol/Page Type 07/08/2002 683620 1923/303 EZ 03/02/2000. 8141 na 14931-122 08/18/1999 608752 1449/570 QC 09/28/1998 587850 1360/299 LC more... 2005 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/12/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.182 28,400 102,600 131,000 NO ,Z,3g L Totals for 2005: General Property 1.182 28,400 102,600 131,000 Woodland 0.000 0 0 Totals for 2004: General Property 1.182 28,400 102,600 131,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch#: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOXJ969 BUREAU OF PLUMBING MA"DISOIN,wi ¢3707 [ � S3 T31N-R18W CONVENTIONAL State Plan I.D.Number: ALTERNATIVE (If assigned) NEk,NWIa, , ❑Holding Tank El In-Ground Pressure El Mound Town of Star Prairie arkinal Road NAME OF PERMIT HOLDER: JADDRESS OF PERMIT HOLDER: INSPEC N DATE: Leonard Pepin 40438 Daily Road, Fallbrook, CA 92038 �, - g7 t�.V� BENCH MARK(Permanent reference point)o7RIBE IF�IFF MNTOM PLAN: c % �' REF.PT.ELEV.: CST REF.PT.ELEV.IL( t/ V Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: ary L. Steel 3254 St. Croix 92538 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: JWARNTNGLABEL LOCKING COVER ^ PROVIDED: PROVIDED: 1 ,�(o I�a,Z?v ®YES ONO IQYES NO BEDDING: VENT DIA.: VENT MATE HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENTLE FRESH /t _ ALARM: FEET FROM TT LINE V AIR INLET: OYES O C1L —]YES �NO NEAREST �V DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY'. PUMP MODEL: PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: E YES ONO ❑YES ONO DYES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL BUILDING AIR INLET.FRESH (DIFFERENCE BETWEEN FEET FROM LINE PUMP ON AND OFF) OYES ONO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH: LENGTH: NO.OF JDISTR.PIPE SPACING'. COVER INSIDE DIA. SPITS ILIOUID BED/TRENCH TRENCHES: I MATERIAL: PIT DEPTH: DIMENSIONS 7 GRAVEL DEPTH DISTR.PIPF DISTR.PIPE DISTR.PIPE MATERIAL: NO. R. NUMBER OF PROPERTY WELL: BUILDING'. V NT TO FRESH BELOW PIPES'. ABOVE COVEAE1 INLET ELEV.END:Q ^^� PIPE: FEET FROM LINE. / , AIR INLET: Clj �„ WV Cpl. NEAREST--► MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. ❑YES NO SOIL COVER ITEXTURE PERMANENT MARKERS OBSERVATION WE LLS 1:1 YES El NO ❑YES 1:1 NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. ]SODDED IMULCHED["EUED] CENTER'. EDGES: ❑YES ❑NO YES El NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH: LENGTH'. NO.OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL'. NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING ELEV, ELEV.: Df A. ELEV.: PIPES. DIA.: ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VtHTICAL LIFT CORRESPONDS TO APPROVED DYES NO OYES El NO COMMENT PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF LINE: ERTV WELL: BUILDING: Q L FEET FROM l? YES ONO 1-1 YES ED NO NEAREST Sketch System on Retain in county file for audit. Reverse Side. �1 \' SIGNATURE: l; , TITLE. Zoning Administrator DILHR SBD 6710(R.01/82) 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 Co de will be a pp licable; 1 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 maintaineo. The septic tank(s) should be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years; 6. If you have questions concerning your private sewage system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 608-266-3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description where the system is to be installed; II. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. Responsibility statement: Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. Fill in designer name if applicable; VIII. Soil test information:Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given wht+n application is disapproved. Complete plans and specifications not smaller than 8'i2 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 ater included the creation of surcharges (fees) for a number of regulated practices which Wisco in's can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried reasure.l is used in your building is returned to the groundwater through your soil absorption o system or the disposal site used by your holding tank pumper. The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- f water, groundwater contamination investigations and establishment of standards. Groundwater, SANITARY PERMIT APPLICATION COUNTY 7 D1LHR In accord with ILHR 83.05,Wis.Adm. Code /� STATEAANITARY PERMIT# —Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER 8%x 11 inches in size. —See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES N No PROPERTY OWNER PROPERTY LOCATION Leonard Pepin NE 1/,NW % S 3 T31 N, R 18 (or)W PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME 40438 Dailv Rd. n a n a n a CITY,STATE ZIP CODE PHONE NUMBER CITY NEAREST ROAD,LAKE OR LANDMARK F r k 9202 El VILLAGE: 11. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family 3 OR ❑ Public(Specify): Ill. PURPOSE OF APPLICATION: (Check only one in##1. Check##2,3 or 4,if applicable) 1. a. IN New b. ❑ Replacement c. ❑ Replacement of d. ❑ Reconnection of e.❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit## Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in##1 and only one in##2) 1. a. ®Conventional b. ❑Alternative c. ❑ Experimental 2. a. ❑System- b. ❑ Holding C.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In-Fill Tan k V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. El Seepage Bed b. See a e Trench c. F-1 See a e 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): 27 750 750 98.20 Feet 1;Private ❑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 I Tanks structed Septic Tank or Holding Tank X 1000 1 Weeks Concrete ® ❑ Lift Pump Tank/Siphon Chamber ---- — ❑ VII RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installatigfi of the privates age system shown on the attached plans. Plumber's Name(Print): P ture:(Nos p j t�/MPRSW No.: Business Phone Number: Ga L. Steel 1 (715-240-6200 Plumber's Address(Street,City,State,Zip Co e): Name of Designer: 988 N shore Dr. New Richmond Wi. 54017 VIII. SOIL TEST INFORMATION Certified Soil Tester(CST)Name CST## Ga L: Steel 2298 CST's ADDRESS(Street,City,State,Zip Code) Phone Number: 988 N. shore Dr. , New richmond. Wi. 54017 715-246-6200 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) Approved ❑ Owner Given Initial { 1100 urcharge Fee /� Q Adverse Determination �+' '�� °�/�v X. COMMENTS/REASONS FOR DISAPPROVAL: P10h AediZ4�ltcj b�' '7'h6)_r1C1S C- �JZ IS dA`1 SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing.Owner DIL R SANITARY PERMIT APPLICATION COUNTY �� In accord with ILHR 83.05,Wis.Adm. Code STATECk�ArN�ITARY PERMIT## Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER 8'h x 11 inches in size. —See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES X NO PROPERTY OWNER PROPERTY LOCATION Leonard Pepin NE 1/,NW '/a, S 3 T 31 , N, R 18 (or) W PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME 40428 Dailv Rd. n a n a n a CITY,STATE ZIP CODE PHONE NUMBER CITY NEAREST ROAD,LAKE OR LANDMARK llbrook Ca. 92028 n O VILLAGE 11. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family 3 OR ❑ Public(Specify): III. PURPOSE OF APPLICATION: (Check only one in##1. Check#2,3 or 4,if applicable) 1. a. N New b.❑ Replacement c. ❑ Replacement of d.❑ Reconnection of e.❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit## Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in##1 and only one in##2) 1. a. ®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. nx Seepage Trench c. ❑ Seepage Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 14. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): 27 750 750 98.2.0 Feet Q Private ❑Joint ❑ Public VI. TANK CAPACITY Site in gallons Total ##of Manufacturer's Name Prefab. Con- Steel Fiber- plastic Exper. INFORMATION New structed xisting Gallons Tanks Concrete glass App. Septic Tank or Holding Tanks Tanks Tank X 1000 1 Weeks Concrete ® El El 1:1 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's Signature:(No Stamps) jt /MPRSW No.: Business Phone Number: Gary L. Steel 1 (715-746-62on Plumber's Address(Street,City,State,Zip Code): Name of Designer: 88 N shore Dr. New Richmond Wi. 54017 VIII. SOIL TEST INFORMATION Certified Soil Tester(CST)Name CST## Ga L: Steel 2298 CST's ADDRESS(Street,City,State,Zip Code) Phone Number: 988 N. shore Dr. . New richmond Wi. 54017 715-2 6-6200 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) FZ Approved ❑ Owner Given Initial l urcharge�Fee � 1�J Adverse Determination ��() 'L V 0`_' �/7 ` �w'1JJ X. COMMENTS/REASONS FOR DISAPPROVAL: j)10 ��tPlfi�t✓�G' b y �'hv� rs C_ A)„E �Sf SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber r APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor,, ("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of Property Leonard Pepin Location of Property NE 1% NW 1%, Section 3 , T 31 N-R 18 W Township Star Prarie Mailing Address 40438 Daily Rd. Fallbrook, Ca. 92028 Address of Site R.R.#2, Box 106 A New Richmond, Wi. 54017 Subdivision Name n/a Lot Number n/a Previous Owner of Property Sherman Stromen Total Size of Parcel n/a Date Parcel Was Created 6-27-86 Are all corners and lot lines identifiable? x Yes No Is this property being developed for resale (spec house) ? Yes x No Volume 715 and Page Number 180 as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and page number, and the Seal of the Register of Deeds. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION 1 (We) eehtf.6y that af-t statemenza on thi.6 6onm are tAue to the beat o6 my (our) knowledge; that 1 (we) am (are) the owne&(a) o6 the pnopeh ty dea n i.bed in this .in6onmat.ion 6o4m, by viAtue o6 a waAAanty deed neconded in the 066.ice o6 the County Reg.caten o6 Veedsas Voeument No.413846 ; and that I (We) pt aentey own the pnopoaed bite bon the aewage dispozat eya em (on I (we) have obtained an easement, to nun with the above debehibed pnopehty, bon the eonatnuction o6 said ayatem, and the dame has been duty necon in n the 066ice o6 the County Reg.i.a.ten o6 Veede, ab Voeument No. ) . S ATURE 01t OWNiR SIGNATURE OF CO-OWNER (IF APPLICABLE) _ cf_ F f DATE SIGNED DATE SIGNED u oocu MENT NO. WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA STATE BAR OF WISCONSIN ppFORM 2-1982 � 3 Btl�Y, 45PAGE180 RMSMS OFRCE Sherman K. Stromen & Isabelle Stromen ST CROIX 00.v WISi husband and wife ' ---------••------...---•--........-•------•--------•--•-•-•-•..........................•--•----------------..... 1 Recd. for Record this 27_ t — •---------------•-----------•---..._.._..----------•---------------------------•--•-=---••-- • June 86 -----• day of_.,,.,ne A.D. 1 qs conveys and warrants to ..T.i�QIX_d.. .._-.P2ax1...&-.JulQtta.-E�._.. t 3:20 P & Pepin�__.husband .and_wife,___as__-J Q. n ._t.�nan .•.•-_ ------------------------••--•-•---••-•------•-----------•--------•-•------ ................................................................................................................. RETURN TO ................................'----:....----------- •---..........-----------------------------•---••-•--• Warren W. Wood, Ltd. .. ---follo ng..-------i d.......•--•------- St; Croix--------..................-- i Box .99, New Richmond, WI the following described real estate in --------------------------- x------------------County, jState of Wisconsin: -- Tax Parcel No: .............................. A parcel of land located in the NW4, Section 3 and in Gov't. Lot "1" , Section 3-31-18, Town of Star Prairie, Wisconsin, more fully described as follows: Commence at a point on the W line of said Section 3, said point being on the center line of Town Road S2°01 'W, 826. 2 ' from the NW corner of said Section 3 and the POINT OF BEGINNING for parcel to be described; thence continue S20011W along center line of said Town Road 744 ' to the intersection of the center line of Town Road leading to Cedar Lake; thence proceed N87°16 'E 773. 6 ' along center line of said intersection road; thence proceed N89°47 'E along center line of road a distance of 511. 91 ; thence proceed N61057 'E along center line of said road a distance of 107. 61 ; thence proceed N32049 'E along said center line of road a distance of 515. 71 ; thence proceed N33024 'E along said center line a distance of 326.431 , thence proceed N570391W along Sly line of a 6 acre parcel 267 . 68 ' to an iron pipe; thence proceed NO°28 'W along Wly line of said 6 acre parcel 643.47 ' to the N line of said Section 3; thence proceed S890321W along said N line of Section 3 a distance of 530. 98 ' to an iron i e; thence p p proceed S6 0401E along a 13.8 acre parcel a distance of 187. 3 ' to an iron pipe; thence proceed S58034 'W along said 13.8 acre parcel a distance of 126.4; to (continued on attached sheet) ii IIThis ._--__-.1s--1101----- homestead property. II (is) (is not) .�tSt�iVSr' a f Exception to warranties: Jaa �x i;I � .a Dated this ...............• 7th-----•---------•------- day of .--.......June -•............................••-•----•.., 19..86... I f (SEAL) •-.----- (SEAL) ---•--- Sherman K. Stromen Isabelle Stromen --•--•------------------------•------------........---•--------- i -•--------------•---••-•--•--•---•-------•-•----------------..._.. -•----•------•-------- .......(SEAL) (SEAL) �I AUTHENTICATION ACKNOWLEDGMENT Signature(s) ............................................................ STATE OF WISCONSIN ---------•-----------------------------------------------•---------------------- St. Croix ss. --- - -- ---- ---- authenticated this _..------day of........................... 19---- - - --- - - ----------------County.Personally came before me this .? day of -7-- ---th------ j June f 19-1 - the above named Sherman K. Stromen and ---------------- -------------------------------•---------------- * Isabelle Stromen , TITLE: MEMBER STATE BAR OF WISCONSIN ,�,•�r;; •--------•--------------------- , (If not, ------------------- -�w----_.----..K_. ...-•--------...--•--•-••---...... authorized b 4--_-------------- ----'.: ------------------•--------------- i I y § 706.06, Wis. Stats.) to me known tb be t,h,� �?erson --------._ who executed the for ing ing�ru t taifi0 Ncyno7ledge the same. THIS INSTRUMENT WAS DRAFTED BY j Warren W. Woody Ltd. . , ro Attorneys at Law ------------ -------- ---------•--------------- ary Pub11Lr; ...Cr'Ol .-_(. ...........County, Wis. (Signatures may be authenticated or acknowledged. Both My Commissloi!► }3• exmarfezy--: If not, state expiration are not necessary.) January t 1 date: ............................... 19.••--- -•) I� *Names of DMons signing in any capacity should be typed or printed below their signatures. j WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Cu. Inc. FORM No. 2— 1982 Aiilwaukee. Wis. �, Q1 •. 60bK ���PACE�C71 an iron pipe; thence proceed S720181W along said 13.8 acre parcel a distance of 250' to an iron pipe; thence proceed S410171W along said . 13.8 arce parcel a distance of 470' to an iron pipe; thence proceed S600321W along said 13. 8 acre parcel a distance of 288.5' to an iron pipe; thence proceed S860131W along said 13.8 acre parcel a distance of 165 ' to the POINT OF BEGINNING. Said parcel containing 43.13 acres including Town Road Right of Way. This Warranty Deed given in satisfaction of a land contract dated March 5, 1977, recorded' on March 18, 1977, in Volume 550, at Page 354, ' as Document No. 338646. i z . H r STC - 105 r SEPTIC TANK MAINTENANCE AGREEMENT o St . Croix County z C; a H OWNER/BUYER Leonafrd Pepin ROUTE/BOX NUMBER R.R.#2 Fire Number CITY/STATE New Richmond, Wi. ZIP 54017 PROPERTY LOCATION : NE 14, NW 14, Section 3 , T 31 N , R1_W, Town of Star Prarie , St . Croix County , Subdivision n/a , Lot numbetn/a Improper use and maintenance of your septic system could result in I its premature failure to handle wastes . Proper maintenance con- sists of pumping out the septic tank every three years or sooner , if needed , by a licensed septic tank pumper . What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St . Croix . County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1 , 1978 . St . Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained . The property owner agrees to submit to St . Croix County Zoning a certification form, signed by the owner and by a master plumber , journeyman plumber , restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping ( if nec- essary) , the septic *tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration . Ho F I/WE, the undersigned,, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x H the standards set forth , herein, as set by the Wisconsin Depart- b ment of Natural Resources . Certification form must be completed and returned to the St . Croix County Zoning Office within 30 days of the three year expiration date . S I C N E D�jt%�i,'.ti•l/�� � i�l�%�-,_�- - — 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 . —T INSTRUCTIONS FOR OMPLETING FORM 115 -' SB - 6596 � V To be a complete and accurate soil test,Your report Must incluciea 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 3. MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement system; S. Complete the suitability rating boxes.A SITE IS SUITABLE FOR A 1101-DING TANK ONLY IF ALL 01-HER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; & PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 1. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A sel:a'rat€a sh eet may be used if desired; 3. Ma,<e sure Your ber€chrnirk and vertical elevation reference point are clearly shown,and are permanent; S, Complete all appiotsriate poxes as to dates, names,addresses, flood plain data, percolation test exemp- Lion, if approprlale; 10, 1'1,the information (sucl-, as flood plain,elevatioc)does not applY, Oac*e N A,in the approt.wiate box; 1 ;. Skier the form and placer your ;current address and Ycaur-certification number; 12, Nllake legible, copies and distribute as requir,�=-I. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION, ABBREVIATIONS FOR ERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st. -- Swna (over 10") BR Bedrock cn5 -- f,rrn3rE = 13- rB SS — Sandstone gr — travel (LWOIer 3") US — Lkre-,stone Sand HGVV -- High &otindwattr 5 - ca -e Sand pr,�c — P c c la k)n Fiats, rrtrzr ., r9 .;li€arr; Sand lv ii fl t> gar€#i k a samy Sa€ar; — r 'titer Ti.aara r,ai dy Lo,rn < Les;T hao l — �;r.r En — Br n�,.�_ ,,, ..... gilt Loar?t Bi ._. F`<ck sr Sill. ( y /✓F {al €y CE lay l Y F SS,tr sc:, .._ rr.r.'y Clay _agar R — r Sri cl — l C ay Loam. rnoF _ Ms Iot Jes ss ,uy C31a4 v ' F — S I y d.,,.l a'y fff _ f,tV 1 , faint Clay c,c - c ,rrTarrtoc : ssarsr; ;l -- 1)2iat ni ral — fvil ii"€fit, m`diurn HWL _._ Hrgh v as ?r level, Six roam• ai sr.0 textures sufface vtvator for liquid v aste disposal L3M — Bench Mark VRP Vertical Reference Nc int TO THE 1NF ; Lhe!� sod ie3t t-s pot is the first in ,eCurinq a sane:arp permit.The county or the Departrms;rrt may request f,r,a, .mot of d"k, sod trust r. he field pviul to t='rru-tit: issuance, A complete sot of prams fo., the private sy3!.-i m =:rl a porn-lit a. p!k'.irrkm must he sw,,,mioted to the local ziotlso;ity in order to r,F,,.;it the sar.rtmv t,. aril„saast be s;f �ti rr z�I'and g-tasted ear€ter to the start of any construct € n, DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISON,WI 53707 P.O. BOX 7969 HUNAN-RE�ATIONS \ / (H63.09(1)&Chapter 145.045) LOCATION: SECTION: TOWNS HIP/ CY: LOT NO.:BLK.NO.: SUBDIVISION NAME: NE ��,N'/,WW'/4 3 /T31 N/Rl8 FK(or)W Star Prarie 1 n/a I n/a COUNTY: OWNER'S/B ME: MAILING ADDRESS: St Croix Leonard Pepin 40438 DAily Rd. Fallbrook, Ca. 92028 USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: 10esidence 3 n/a aNew ❑Replace ( 4-9-87 4=10=87 RATING:S=Site suitable for system U=Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND PRESSURE:rE]S YSTEM-IN-FILL HOLDING TANK:RECOMMENDED SYSTEM•(optional) 0 S ❑U 0 S ❑U ©S Flu OU ❑S ElU conventional If Percolation Tests are NOT required DESIGN RATE: 4 I If any portion of the tested area is in the under s.H63.09(5)(b),indicate: n/a Floodplain,indicate Floodplain elevation: n/a decimal' PROFILE DESCRIPTIONS page 3 AND2 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- 1 7.91 101.70 none >7.91 .58bl.1. 2.00bn.s.sil. 4.08bn.s.1. 1.25r.bn. s.l. B- 2 8.01 104.00 none >8.01 .67bl.1. 2.17bn.s.sil. 2.25bn. .s.l. 2.92bn.s.1. B_ 3 6.83 102.00 none >6,83 .75 bl.l. 1.75bn.s.sil. 3.00bn.l.s.&gr. 1.33 bn. .l. B- 4 7.00 i02.00 none >7.00 .58 bl.l. 1.75bn s B- 5 7.00 103.37 none >7.00 7 B- deci ' PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER Irk AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD 3 PER INCH P_1 3.30 none 30 21 P_2 3.80 none 30 13/4 P_3 3.80 none 30 11 P-. P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION 98.20 4- _ _ T. _ �.. --�. ��_�IL�� _...1�..T-�.-�--�.�.. A.J..,...ej..�,.... 1.,..�_.� ".l.l..�....,......,�................_-n-..—. ,.,.. E,.., ...........��__ ..���'.`..7.......,�[.y, i, ..,,,.,,,...,.;. � __..._..._....�..._......�._..........�W�. .__... ._ I -- � tN y4 t 1 i i I C f I i tt 3 S E 99 I,the undersigned,hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods speci ied in the Wisconsin Administrative Code,and that the data recorded and the.location of the tests are correct to the best of my knowledge and belief. NAME(print): TESTS WERE COMPLETED ON: Gary L. Steel 4-10-87 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): 988 N. Shore Dr. New Richmond Wi. 54017 Z948 -246-6200 CST SIGN, RE: DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) —OVER — .r, Leonard Pepin NE-',,NW-, S.3 T31N R18W Star Prarie, Township Of "I iz C ' Gary L. Steel 988 N. Shore Dr. New Richmond, Wi. 54017 MPRSW 3254