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HomeMy WebLinkAbout024-1036-40-100 o ((DD W W o CL g C: C (D rt (D tom-' Afi 3v0 m O ! C ~ O fp N rt (D t~ 3 n 3 ~1. o N T # t-h En ic) H- U) A --I Z a 4 (D 3 3 7 w iv p I. o. z z 0 N ~i Oo c3 CD CD~ vI ~~W ~y w O 0-0 0 7 7 CD N d w p R (D 0 C A I Q n (D n O O C v 00 v C C J a aD CD N m co a o 7 N 7 W Di cn r_ C m a o o m L' H n ` o o ter (tl a' (M z 00 m m y° e (D f-h O 4 W (D T In ` d(D W z 000~~ ~i• N• U) O c ~ z W (CD H 3 N N N D p rt p') Q v v o QQ 00 ~ v VO - z 3 d F- ~C J z Z zca z 0 0 O D a N 7 ~ C COD I w ~ a o CD -I N O A Z a A G I j M N O p M m w CL CL ID z O FF z w z CD w i CL y a I ~y a ~ o 0 I 3 0 o o a 7 N I a° O ID y 0 ►1 o a I.R o C I v I ~ a a n m N O W O o~ A I ~ O W DO V O A 69 0 I ti b p (D e 'b O CL ti Parcel 024-1036-40-100 10/16/2006 03:55 PM PAGE 1 OF 1 Alt. Parcel 30.28.17.232C 024 - TOWN OF PLEASANT VALLEY 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 DARRELL & ROBIN DUNN O - DUNN, DARRELL & ROBIN 1547 18TH AVE RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1547 18TH AVE SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 6.460 Plat: N/A-NOT AVAILABLE SEC 30 T28N R17W SE NW 6.455 ACRES LOT 1 Block/Condo Bldg: CSM 7/1847 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 30-28N-17W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 784/359 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/03/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 6.460 51,900 165,300 217,200 NO Totals for 2006: General Property 6.460 51,900 165,300 217,200 Woodland 0.000 0 0 Totals for 2005: General Property 6.460 51,900 165,300 217,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 314 Specials: User Special Code Category Amount I Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear, 0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width: V Length: 6 Number of Lines: _ Area Built Fill depth to top of pipe: L r ~i Number of feet from nearest property line: Front, n Side, ® Rear, Ft Number of feet from well: Number of feet from building: to d / (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: /f Dated: Plumber on job: TT License Number: 03 I 3/84:mj Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP 411NEC. -Fe T N-R~W ADDRESS 1`d /,///S' ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW I Distances and dimensions to meet requirements of I•ZHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Li ,a ~ J r 100 s~ I,fjS INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used x3 0//", ( J Q fCi Elevation of vertical reference point:' /d(~ Proposed slope at site: SEPTIC TANK: Manufacturer: lv 1I "S7 Liquid Capacity: ee' L Number of rings used: 3 Tank manhole cover elevation: Tank Inlet Elevation:' Tank Outlet Elevation: f Number of feet from nearest Road: Front,@ Sideo Rear, O feet ,.From nearest property line Front,(DSide,ORear,0 /~f feet Number of feet from: well 2Sj') , building: , (Include this information,of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.G. BOX 7W9 BUREAU OF PLUMBING MA,OISON, 1/(II 53707 SE 4, N,01 S30,T28N-R17W KNCONVENTIONAL ❑ALTERNATIVE State Plan 10.Number, El Holding Tank ❑ In-Ground Pressure ❑ Mound Town of Pleasant Valley Evergreen Drive NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER INSPECTION DATE: p~ Y Darrell Dunn Route 2, River Fralls, WI 54022 0,010 - ) ,'3v r -lc- BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV. CST REF. PL ELEV.. Name of Plumber: MP/MPRSW No County Sanitary Permit Number: Thomas A. Wang 3231 St. Croix 96034 I i I SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED. PROVIDED. ❑YES LINO ❑YES LINO BEDDING: VENT DIA.'. VENT MATE.. HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING'. JVENT TO FRESH ALARM. FEET FROM LINE. AIR INLET. ❑YES LINO ❑YES LINO NEAREST DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES NO ❑YES LINO ❑YES LINO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PROPERTY WELL BUILDING - I (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET: PUMP ON AND OFF) ❑YES LINO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing r,-,TH DIAMETER MATERIAL AND MARKING FORCE ]71 or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH LENGTH.. NO. OF DISTR. PIPE SPACING. COVE INSIDE CIA. #PITS. LIQUID BED/TRENCH TRENCHES MATERIAL: PIT DEPTH. DIMENSIONS I L GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL. NO. DISTR. NUMBER OF PROPERTY WELL: BUILDING'. VENT TO FRESH BELOW PIPES. ABOVE COVER. ELEV. INLET ELEV. END PIPES. FEET FROM ! LINE. AIR INLET: NEAREST MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. ❑YES LINO SOIL COVER TEXTURE. PERMANENT MARKERS'. :TER]VATICIN WELLSLINO YES NO DEPTH OVER TRENCHBED DEPTH OVER TRENCH;BED DEPTH OF TOPSOI L. JSODDED. SEEDED: MULCHED. CENTER EDGES. ❑YES LINO ❑YES LINO ❑YES LINO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH'. LENGTH. NO.OF LATERAL SPACING'. GRAVEL DEPTH BELOW PIPF. FILL DEPTH ABOVE COVER'. BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE IMANHIOLDMATERIAL NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING'. ELEV.: ELEV.. DIA.'. ELEV.: PIPES. DIA.: ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED ❑YES LINO _ ❑YES LINO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING'. l FEET FROM LINE: J\ S LINO ❑ YES LI NO INEAFEST 4;7~ l Sketch System on Retain in county file for audit' Reverse Side. SIGNATURE: TITLE. Zoning Administrator DILHR SBD 6710 (R. 01/82) INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION s Y f TO THE APPLICANT: 1. This sanitary permit is valid for two (2) years; 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable; 3. All revisions to this permit must bdappreved ythe 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- 4 rooms, etc.), depth of system, or type of system; 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation; 5. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years; 6. If you have questions concerning your private sewage system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description where the system is to be installed; ll. 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 when application is disapproved. Complete plans and specifications not smaller than 8'/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to-scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; dosing or pumping chambers; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form. GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was the f result of over 2 years of steady negotiation and public debate. The groundwater bill Groundn s Ater included the creation of surcharges (fees) for a number of regulated practices which WisCOr' can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried n sure is used in your building is returned to the groundwater through your soil absorption 0 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- i water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398 (R.03/86) SANITARY PERMIT APPLICATION COUNTY Z] DILHR In accord with ILHR 83.05, Wis. Adm. Code 1, 5T (f t 61 STATE SANITARY 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 NO PROP TY OWNER PROPERTY LOCATION % K,S 30 T 4,N,R (o63> Uar re-U up, h 14 '07 10 PR ER OWNER'S MAILING ADDRESS LOT NUM ER BLOCK NUM13ER SUBDIVISION ME C STATE t ZIP CODE PHONE NUMBER CITY NE EST ROAD, LAKE OR L¢(VDMARK ❑ VILLAGE : 1-/ 521;zAr eI'w ere 1rh tl II. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family. OR ❑ Public (Specify): III. PURPOSE OF APPLICATION: (Check only one in #1. Check # 2,3 or 4, if applicable) 1. a. New b. ❑ Replacement c. ❑ Replacement of d. ❑ Reconnection of e. 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. 5d seepage Bed b. E1 Seepage Trench c. ❑ seepage Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): Feet 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 Tanks structed Septic Tank or Holdin Tank ~C aL'G~ V ; W S ❑ ❑ Lift Pump Tank/Si hon Chamber Li ❑ El ❑ El VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plumbs 's Name (Print): PlMbeSignature: (No Stam s) MP/MPRSW No.: Business Phone Number: Plumber's Add ss (Street, C't , State i Coded , Na esigner: VIII. SOIL TEST INFORMATION Ce ifi Soil Tester (CST) Nan)b CST # J CST's ADDRESS (Stre t, City St te, Zip ode) < Phone Number: d Z l 7J 2 IX. COUNTY/DEPARTMEN USE ONLY ❑ Disapproved S~~yynitary Permit Fee Groundwater Date Issuing Agent Signature (No Stamps) F'l Approved I ❑ Owner Given Initial S r harge Fee Adverse Determination X. COMMENTS/REASONS FOR DISAPPROVAL: 1~,~,2e c~►.~ wo c~ ~ ~I I,c~ ~-,c.,a . hie. ks SBD-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber 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 oGoo Location of Property 1% 1%, Section T N-R~ W Township Ile. Nailing Address SeD 450 a~ Address of Site ,,g Subdivision Name .Lot Number Previous Amer of Property_ _i~JLL j~ ~71 /,nA Total Size of Parcel r e Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume and Page Number(0/6 as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and page number, and the Seal of the Register of Deeds. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION I (We) centti.6y that ate htatementh on this ahe thue to the best o6 my (ouA) hnowftedge; that 1 (we) am (ah.e) the owneh(h for the phopehty descAibed in .this .in6o4mat.ion 6oiun, by viAtue o6 a wa Aant 0eec Bonded in the 066ice 06 the Countyy Reg4Ateh o6 Veedhah Document No. j and that I (We) pneaent.fy own .tlie p1topoded h.ete bon the hewage di-spoh 4y4 em (on I (we) have obtained an easement, to nun with the above de c ibed properrty, bon the eonbtnuction o6 said dyetem, and the tame hae b ~uQy heeonded in the 066iee 06 the County Reg.i.e.ten o6 Veede, ab Voe ment No. l' ) C. SIGNATURE 01 OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED State, of Miseens i ~ 7,(-PAGE cal , ) ss. County of St. Croix nn v The foregoing instrument was acknowledged before me on t 1 1 Date by Thomas E. Hass , Director of Acquired Property of the Federal Land Bank Association Name Title of Northwest Wisconsin as attorney in fact on behalf of The Federal Land Bank of Saint Paul. My commission expires _5/19/91 9 Q BENITA A. MILES Benita A. Miles NataryP"bl1e NOTARY PUBLIC STATE OF WISCONSIN Pierce Wisconsin County \ State State of ) ss. County of The foregoing instrument was acknowledged before me on Date by of the Production Credit Association of Name 7-ale on behalf of said corporation. My commission expires Notary Public County State Drafted By: M;1es FCS, River Fa1~sTWt ° 4 4 M 4~ O 00 X t- N 11 lu "he Q U O •aj rxl C O~ 3 O Ln tij w 43 N r-1 M MWE FI.B/PCA ` LIMITED WAdtRANTY DEED _ This Indenture, made this day of July 19 87 between Federal Land Bank of St. Paul , a corporation, organized under the Laws of the United States, with a post office address of P-0- R[L 199, -River Falls, WT 54022 _ parry of the first pan, and Darrell T11inn anrd Robin Minn, as h1lGhancd grind wifp whose post office address is Rt 2, River Fa11G State of Wisconsin pan ies of the second, WITNESSETH, That the said party of the first part, for and in consideration of the sum of $3,227-50 DOLLARS, To it paid by the said pan ies of the second part, the receipt whereof is hereby acknowledged, does Grant, Bargain, Sell and Convey unto the said part 3 es of the second part, their heirs, successors and assigns forever, the following described real estate, situated in the County Of St. Croix and State of Wisconsin to-wit: A parcel of land located in the SE4 of the NWT, of Section 30, T28N, R17W, Town of PLEASANT VALLEY, St. Croix County, Wisconsin, described as follows: Commencing at the Nk corner of said Section 30, Thence S00002'08"E (assumed bearing) 1317.01' along the East line of the NW-4 of said Section 30 to the point of beginning; thence con inuing along said East line S00002'08"E, 370.00'; thence N89031'00"W, 760.00'; thence N00002'08"W 370.00' to the North line of the SE14 of the NWT of said Section 30; thence S89 31'00"E 760.00' along said North line to the point of beginning containing 281188 square feet (6.455 acres) more or less, and being subject to town road right of way on the North and East as shown and all other easements, restrictions and convenants of record. (The above description is recorded as Certified Survey Map #427638 filed July 1, 1987) in Volume 7 Page 18+7 subject to all existing easements and rights of way; also subject to all taxes on said premises for the year 19_g7 and following years; also subject to all unpaid parts and installments of special assessments on said premises which have fallen due, or will fall due hereafter. TOGETHER with all and singular the hereditaments and appurtenances thereunto belonging or in any wise appertaining; and all the estate, right, title, interest, claim or demand whatsoever, of the said party of the first pan, either in law or equity, either in possession or expectancy of, in and to the above bargained premises, and their hereditaments and appurtenances. TO HAVE AND TO HOLD the said premises as above described, with the hereditaments and appurtenances unto the said part i Q_ of the se- cond part, and to their heirs, successors and assigns FOREVER. AND THE SAID party of the first part, for itself and its successors, does covenant, grant, bargain and agree to and with the said part ies of the second part, their heirs, successors and assigns, that the above bargained premises, in the quiet and peaceable possession of the said part __1e_9___ of the second part, thPi r heirs, successors and assigns, against all and every person or persons lawfully claiming the whole or any part thereof, by, through or under said party of the first part, and none other, it will forever WARRANT and DEFEND. IN WITNESS WHEREOF, the said parry of the first part, has caused these presents to be Aecuted in its corporate name by its duly authorized of- ficers, and its corporate seal to be hereunto affixed the day and year first above written. In Presence of: THE FEDERAL ~AND BANK OF SAINT PAUL By: Thomas E. Hass, Director of Acq. Prop. of the Norte Tide Federal Land Bank Association of NW Wisconsin B R N.l~Acting as Attorney-in fact for the Federal Land Bank of Saint Paul t or: iP. r (o CORPORATE ° Z t • Production Credit Association t"'"Y ° A' a y X Of SEAL l By: D5140 5186 !1 Xj o,oa°6" 1rL H z a STC - 105 r . a y SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z d j 1L~1~1~^ ~J H OWNER/BUYER ~IJ ROUTE/BOX NUMBER L)~x Fire Number CITY/STATE iLL2~- ZIP 3- &2.'a , ~4, Section 20 T O'- N, RW, 1~ 10 PROPERTY LOCATION: Town of F1eQ S4 ii-4 St. Croix County, Subdivision Lot number Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. y 0 E I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with H the standards set forth, herein, as set by the Wisconsin Depart- 'v ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNED `~~,ti~ ~Lc•~ DATE 7" 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. ~ R rRUCTIQNS FOR COMPLETING; FORM 115 - SBD - 6395 ` To be a { ,urate soil test, your report must ir)<au<:lee 1. -;al desr 2 on must cl:.~,rly = whether this is a residence rercial project; 3. M number of bedro r commercial use planned; 4. Is or replacement syIn- 51 Col wit ity ratir A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL O FEMS ARE RULE' IT BASED ON SOIL CONDITIONS; 6, !'I abbreviations here for writing profile d€=seriptions 4 s I of plan, 7, i91-E diagram ac 'y locating your test locations. I-, eterred. A y used i1 c" 11; 8_ chmark a elevation refere tf point are cl 1 arrnanent; 9. ~riate boxes o dates, narnes, =Moo(,l pla t' st exemp- 10 1 ~3ch as fle-1 voion) does 3 plar^ N n. it e box; 11. ace your cur d your c ion nLJ' ~)d distrib{ ALL SOIL TES 1 WITH THE LC 'ITHIN 30 E PLETION. A- IATIW--'a _-gTIFIEQ SOIL -f I Textures _yrn~„GIs 10") B, 1ar~~ 3,7 Is, L > w, - Car rr; bI cl y y ti HE OWNER: is t'~ {i . i r ire u- V F t ,y request r ire private order to a { err7ai ~~d 1;, P f ~t. I DEPARTME~ft OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS ' NTRYY, , DIVISION P.O. BOX 76 LABOR AND PERCOLATION TESTS (115) MADISO N WI 53707 HUMAN RELATIONS (H63.09(1) & Chapter 145.045) LOCATION: SECTION: UNICIPALIT[2t, OT NO.:BLK. NO.: SUBDIVISION NAME: 1/ p /T2 N R/ E (o W e COUNT OW E ER'S N M I L ADD S: Y,~fd; e- 1A Ja C~a ~ e 14- ~11s- Z, 5'~O USE DATES OBSERVATIONS MADE NO. BEDRMS : COMMERCIAL DESCRIPTION: -.New PROFIL R ONS: ER TION TE TS: Residence ❑Replace '3 RATING: S= Site suitable for system U= Site unsuitable for system -PRESS rco OENTIO❑Nu. MHSOUND IN-GROUS EJ URE:S©EM-INF~FILLHOaLDING®NK:RECOMNJENe~DSYSTEM:(optional) If Percolation Tests are NOT re uired DESIGN RATE: If an ~J q y portion of the tested area is in the under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: 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.) pp-I . B- a Od 7 5'v .Qa /.d o Q f 1, 60 +ll~►g Q ~S a,oo Bn ~S ~.0~ Ids B- ~d /G) Mv© D na 61Is A )5 Red, rn f,% ,46 6n ~T B- . Pe) 160.00 0 ,~a 6© 611-5 Aso kel; dh f 3.0o bn 6 0 6G, L'i,' P3 S t%f 5vrjlh A B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 P R PER INCH P- D - P_ 6 P- P-_ P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the 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. 00 r reer~ T__ F 1hd 7. 4 b >JVIV_e~ -next Tt rj. ' ' ~~►1~ ~ _ E tE : lJ i 2 P { 0 I I _ E T V_ j E F .1 € ;w H 1987 3 of-- F i ~ 1 i , , o ~ Ta { I P~ 12C T- _T 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print L4 TESTS WERE C MPLE ED ON: 2 /n ADDRESS: , CERTIFMN N MBER: PHONE NUMBER (optional): le UCf_ t as CST SI TURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - °303 ~°er~ rK '(r ZV e ~ 4,)ec.t~ 'top x3 I Doc ~ ply ~G + t Ie~ fc~ r~, ~ c CERTIFIED SURVEY MAP Located in the SE1/4 of the NW 1/4 of Section 30 T28N R17W, Town of Pleasant Valley, St. Croix County, Wisconsin. Done for: Darrell Dunn R T. 2 RIVER FALLS SCALE IN FEET 0= 150' LEGEND 0' 75' 150' 300' SECTION CORNER MONUMENT 0 OX 24" ROUND IRON PIPE WEIGHING 1.68 LOS./LIN. FT. SET. N 1/4 COR. SECTION 30 T28N,R17W - CENTERLINE UNPLATTED -LANDS - w m 0 NORTH RIGHT-OF-WAY NORTH LINE OF THE SEI/4 OF THE NWI/4 0 0 P ° LINE 1 M o POINT OF I - I 4 73 760.00 10.09I 1 BEGINNING J` Si89° 31' 00"E 727.00' :22.91' Y - 28.27' _ 18 to STREET _ _ - M ,y $890 56' 16"E 759.97' - 33' r 726.97' o I p O O ~i LOT I i yl z I a 01 0_ at - 281188 SO. FT. (6.455 AC.) I SZ1 ~I INCLUDING RIGHT-OF-WAY - - I ;-at WO xW F N JI O o 226393 SO. FT. ( 5.197 AC. ) \ o M W I = w pw,~ ZI N M EXCLUDING RIGHT- OF- WAY - PO ' 1-FI ~pco OI O a al C31,0 I JI W__ 0 1 Ip'I ZZO 2 p 1 Z I WWO O I J W=O WoW 727. 00' 33' 1 W °,w~ ,pp N89° 31 00 W 760.00~~ ZJflf I F to I 3, I I I Qua UNPLATTED_ LANDS_ HARVEY G. = 1 1 mW,o, JOHNSON 's S-1£09 j HU S q~y//yY" vP S 1/4 COR. 0 A parcel of land located in the SE1/4 of the NW 1/4, of Section 30, T28N, R 17W, Town of Pleasant Valley, St Croix County, Wisconsin, described as follows: A Commencing at the N1/4 corner of said Section 30, thence S00°02' 0811E CP (assumed bearing) 1317.01' along the East line of the NW 1/4 of said Section 30 to the point of beginning; thence continuing along said East line SO0° 02' 08"E, 370.00' ; thence N89°31' 00"W, 760.00'; thence N00°o2' 08"W 370.00' to the aso North line of the SE 1 /4 of the NW 1 /4 of said Section 30; thence S89°31' 00"E 76 0.00! along said North line: to the point of beginning containing 281188 square %14*4 feet (6.455 acres) more or less, and being subject to 'town road right of way on the North and East as shown and, all other easements, restrictions and covenants of record. VII' M