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Home My WebLink About026-1000-30-110 C-) zol H W ~ 00 Fl a z Pd I 0 30n T~ o >v • rt O o W O N tI Cy F-~ ~p 1-h P+ 0 I ~ Q %D rt F-I :r =r O (D 3 £o o m is 4' r-i M N o o w CD N R °o a° o I oo ° O ~ I A J ~ ~ eo ~ o o + ~ C ? O W + N (D nom' 0 CD CD "VI U) w F~ C (D C__~y! CL a £ O 3 0 =9 CD CL M 0 OD 00 Q 00 0 fLr a 1_ n~ 'cn-Q o 0000 j• z co) co) (D H a z o O' T v _v o G) CD ~ _ 9 C ! CO o 1 OV I r ~ ~ J w o. a zmo O 0 D n 7 ~r CD CA l►1 C D G7 C (ND W n N z CD z CD ~ N G I .mss ~ w CL A j Z -I + aov ~o CD + z °o z co H m z I ~ W Z(D -4 < D p X N (D a N (D ? D < (pn O c 0 "1 (n N C ~o o o a ( (D +~o (D (p CD a v C W (D O _ d CD ~ I O =or maps ~ K 0 O CD mav 'O (D b ~(pCD~ ene o 7 W +07 I N + N 0 o I +to ~ q o (D yQ I H a Parcel 026-1000-30-110 12/12/2005 03:34 PM PAGE 1 OF 1 Alt. Parcel M 01.30.18.213-10 026 - TOWN OF RICHMOND 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 - BUELL, WILLIAM L & GAIL S WILLIAM L & GAIL S BUELL PO BOX 149 NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description ' 1455 CTY RD K SC 3962 NEW RICHMOND / C7 SP 8020 UPPER WILLOW REHAB DIST rC~ I b ti+-- t qa SP 1700 WITC L wf- Csw, Legal Description: Acres: 7.370 Plat: N/A-NOT AVAILABLE SEC 1 T30N R18W PT NW1/4 NE1/4 LOT 2 Block/Condo Bldg: C.S.M. 8/2153 8.58AC & EXC 66FT PRIVATE ROAD AS SHOWN OF SD CSM 852/627 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 01-30N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 852/627 D & La~q 2005 SUMMARY Bill M Fair Market Value: Assessed with: 95276 469,000 Valuations: Last Changed: 06/20/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 7.370 73,800 328,400 402,200 NO Totals for 2005: General Property 7.370 73,800 328,400 402,2000 Woodland 0.000 0 Totals for 2004: General Property 7.370 73,800 230,700 304,5000 Woodland 0.000 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 137 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges 00 Total 0.00 0.00 PUMP CHAMBER Manufacturer: Liq Capacity: Pump Model: Pump/S on Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch a ation: Gallons per cycle: Alarm Manu turer: Alarm Switch Type: Numb 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: ~Z Width: Len$th:_ Number of Lines: Area Built: u~ Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, ( Rear,O Ft~ " Number of feet from well: Number of feet from building: (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: / y Inspector. Dated: Plumber on job: License Number: 3/84:mj Form-STC- 104 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP SEC. To0N-R~W ADDRESS 2 ST. CROIX COUNTY, WISCONSIN A) 6-20 Q SUBDIVISION W LOT r3 V q- SIZE C19 PLAN VIEW Distances and dimensions to meet requirements of IIHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM b`~ V 15~ 4 3 (o ~j INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: 1 Q e) Proposed slope at site: SEPTIC TANK: Manufacturer: (/~S Liquid Capacity: Number of rings used: 8 Tank manhole cover elevation: Tank Inlet Elevation: Do Tank Outlet Elevation: 7~7 `sue Number of feet from nearest Road: Front ,&Side,0 Rear, 0 O feet From nearest property line Front,O Side,aRear, O feet Number of feet from: well building: I- (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE Wisconsin Department of Industry, INSPECTION Labor and Human Relations Safety & Buildings Division REPORT Bureau of Plumbing Inspection Date i6> > r Name of Premi es P Addmsc @;1 egal Description Oily/Township County Master Plumber Name and Address Master Plumber Firm Name and Address Plan I.D. No. Sanitary Permit No. Journeyman Plumber/Soil Tester Licensed Person's Name(s) and License Number(s) ' '::?#~"~J t_~ _.,,_~:.7 i~,~._~'~®n.3 cam c . Owner's Name and Address 1,4 I Til. r r I 4 j 3 t i + t Pageof Signature of Responsible Licensed Person (only one needed) Signature of Plumbing Con?ultantl,Private Se7age Consultant \ f CO to: Check all Original: pIeS that apply S13D-6192 (R. 11/8s) District pILHR lumber Owner Q' /Local Ins{ . '0 Ot~e 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 NW1-4,NE~ 1,S1,T30N-R17W State Plan I.D. Number: ~pI I CONVENTIONAL ❑ ALTERNATIVE (If assigned) Town of Richmond ❑ Holding Tank D In-Ground Pressure El Mound Co. Road K NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: _ INSPECTION DATE: Lloyd Peterson 12,38 North'2nd , New Richmond, WI 54017 /0-1-, 37 L3-3a B C H I ARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.. fl E- S GSA • VO,D "UI Name f Plum MP/MPRSW No.: County: Sanitary Permit Number: Gar L. Steel 3254 St. Croix 92509 SEPTIC TANK/" "K: MANUFA URER: LIQUID CAPAC TV. TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL JLOCKING COVER O ~ ~ ~ f PROVIDED: PROVIDED: /76 "Li YES ONO DYES NO BEDDING : ~fl T DIA.: AT L.: HIGH WA ER NUMBER OF ROAD: PR PERT WELL: BUILDING: IVIII TO FRESH L L JALARM: FEET FROM LINE: / y r AIR INLET ~Z ' YES NO T`r G~ DYES NO NEAREST Z J~ tj w oT DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY. PUMP MODEL. PUMP/SIPHON MANUFACTURER: WARNING LABEL JLOCKING COVER PROVIDED: PROVIDED: DYES ONO DYES ONO DYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL BUILDING. AIR NLBTRESH (DIFFERENCE BETWEEN FEET FROM LINE PUMP ON AND OFF) OYES ONO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moistureat the depth of plowing LENGTH DAND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN c CONVENTIONAL SYSTEM: s , L~L.*, VFtier ?b.c?q WIDTH: LENGTH . INO.OF DISTR. PIPE SPACING. COVER , INSIDE CIA. &PITS LIQUID BED/TRENCH TRENCHES I M TER 1, ~2 PIT DEPTH DIMENSIONS it 1A I ~L - LOW PIP:S WELL: BUILDING: V NT TO FRESH GRAVEL DEPTH FILL DEPTH UISTH. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. D R. NUMBER OF PROPERTY PPES FEET FROM LINE: /1 AIR INLET : ABOVE COVER: ELEV. INLET ELEV. END I d• (p 7 J tCIDI , ~t7~ !a. ~.Z3t 7r 5 STM 0a 9 Z NEAREST------*- MOUND SYSTEM: 7~ r 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. DYES NO OIL COVER TEXTURE JPERMANENT MARKERS OBSERVATION WELLS DYES ONO DYES ONO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL- SODDED SEEDED MULCHED CENTER: EDGES. DYES ONO DYES ONO OYES ONO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH: LENGTH. ND. 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 ELEVATION AND ELEV.. ELEV.: DIA.: ELEV.. PIPES DIA.. DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING: DRILLED CORRECTLY COVER MATER IAL. PLANS VERTICAL LIFT CORRESPONDS TO APPROVED . OYES ONO DYES ONO COMMENTS: V) I ( PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: Jt FEET FROM LINE. yr a' DYES ONO DYES ONO NEAREST C ,t ,vn ao / a 4 Juo -yy-- , g2.3tlCi~ d1J X01' Cayaq,_ '~I I i 4E Sketch System on Retain in county file for audit. Reverse Side. SIGNA TITLE. -Allff ps ~ nis for 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 Code will be applicable; 3. All revisions to this permit must be approved by the permit issuing authority. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation; 5. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years; 6. If you have questions concerning your private sewage syste. 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; 11. 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; W. 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 V/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 result of over 2 years of steady negotiation and public deaate. The groundwater bill Ground'wrater - included the creation of surcharges (fees) for a number of regulated practices which' Wisconsin's can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried treasure is used ir, your building is returned to the groundwater through your soil absorption system or the disposal site used by your holding tank pumper. The monies collected through these surcharges are credited to the groundwater fund adminis- leren by the Department ~)f Natural Resources. These funds are used for monitoring ground- 1 vvate,, gr~~ur:Jwater contamination investigations and establishment of standards. Groundv.ate , it's worth protecting. `;BD-6398 (R.03/86) SANITARY PERMIT APPLICATION COUNTY TDILHIR In accord with ILHR 83.05, Wis. Adm. Code ST CROIX STAT 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 9 NO PROPERTY OWNER PROPERTY LOCATION Lloyd Peterson NW WE t/4, S 1 T30 , N, R17 X (or) W PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME R.R.#2, Box 31, New Richmond, Wi n/a n/a n/a CITY, STATE ZIP CODE PHONE NUMBER CITY NEAREST ROAD, LAKE OR LANDMARK VILLAGE: Co. rd. K New Richmond Wi. 54017 715 46-6166 [WITOWNORRichm,ond II. 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. ® New b. ❑ Replacement c. ❑ Replacement of d. E1 Reconnection of e. E1 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. 0 Conventional b. ❑ Alternative c. ❑ Experimental 2. a. ❑ System- b. ❑ Holding c. E1 Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. ❑ Seepage Bed b.:Vl seepage Trench c. ❑ 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): Feet Private ❑ Joint ❑ Public VI. TANK CAPACITY Site in gallons Total # of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App I Tanks Tanks structed Septic Tank or Holding Tank ❑ Lift Pump Tank/Si hon Chamber. ❑ ❑ ❑ VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installa 'on of the private sewage system shown on the attached plans. Plumber's Name (Print): Plumber' i nature: (No Ast IM MPRSW No.: Business Phone Number: Gary L. Steel 3254 715 46=6200 Plumber's Address (Street, City, State, Zip Cg"): Name of Designer: 988 N. Shore Dr. New Richmond Wi. 54017 VIII. SOIL TEST INFORMATION Certified Soil Tester (CST) Name CST # Gary 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 F-1 Disapproved Sanitary Permit Fee Groundwater Date Issuing Agent Signature (No Stam S) ISM ge LPI Approved I ❑ Owner Given Initial r1 S h~ar. Fee Adverse Determination va r-ycl - N X. COMMENTS/REASONS FOR DISAPPROVAL: 06 e6,kid b y 7 vies e /Ul /so/V 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 Location of Property lK) 1%, Section , T -3 4-R ~W Township Hailing Address Address of Site Subdivision Name ^'y9 Lot Number Previous Owner of Property Total Size of Parcel Date Parcel was Created ) g Are all corners and lot lines identifiable? ~s No Is this property being developed for resale (spec house) ? Yes ~No Volume v~ and Page Number ? 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) eeht.l.6y that a.tt 6tatement6 on this 6o4m awe true to the best o6 my (ouh) know.tedge; that I (we) am (are) the owner (d) o6 the pnopen ty dens eh i.bed in this s in6ovnati,on 6ohm, by vi tue o6 a wahhanty deed heeohded in the 066ice o6 the County Regi,6 ten o 6 Veed~s as Voeument No. a 7c; a ; and that I (We) p~t2a ent.ty own fine pnopoaed site bon the .sewage dia~d dy6 (oh I (we) have obtained an ea.b ement, to haft with the above des ch ibed phopehty, 6oh the constnuc ti.on o6 da i.d dyetem, and the came has been duty hecohded in the 066ice o6 the County Reg.iaten o6 Veedd, as Document No ) IGNA Oh OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SI b DATE SIGNED a• DOCUMENT NO. ! NTATZ ME OF WNCONMN FORK I - Ie1r View errs Rs ass s s~Ia aaw~srse elsea WARRANTY OM • 407927 44 /?SPUE49l • Donald L. Reppe f ~ andyY-•Ztepp , huatiand-.. anc~ wife, ~i! STS aw I w~ctrl n..an t. a 7o Wd. for ReI-r'd /Fir as...intte---......-•-" ' Grantor, i a 1 and.........Lloyd G. Petersonand bonnie P Peterson, husband and wife, as Joint tenants, ..............0 Grantee. - , WitneBSeth, That the said Grantor, for a valuable consideration...... conveys to Grantee the following described real estate is St . CTO.. x "`T""1 TO 6 9 ~!.F3o< County, State of Wisconsin : Taz Parcel No: i Northwest Quarter of Northeast Quarter (NWk of NE;) of Section One (1), Township Thirty (30) North, Range Eighteen (18) West, excepting the East 613 feet thereof and excepting the Certified Survey Map filed August 12, 1985, in Volume 6, Page 1563 as Document No. 404221 in the office of the St. Croix County Register of Deeds, being a part of the NWk of the NEh of Section One (1), Township Thirty (30) North, Range Eighteen (18) West, Town of Richmond. The above described parcel is subject to an easement for C.T.H. "K" as shown on this map and all other easements of record. :r. This ....is not homestead property. (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And grantor -...r. - warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except and will warrant and defend the same. Dated this . 18th, day of December . 1985 _ . _ ~ _ ! SEAL) - l C, 1- (SEAL) • Donald..L,.. Reppe...-- • ..........Fay -.V._.Reppe.................... (SEAL) .......(SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) Of Donald L. Reppe STATE OF WISCONSIN - and Fay RepPe._..........•---• sa h County. authenticated this 18t.' day otDecember . 19 85 Personally came before me this ................day of 19........ the above r"amed . .....................,.t TITLE: MEMBER STATE BAR OF WISCONSIN XXXXXXXXXXXXXXXXXXXXXXXXXXXXX Jtl[tbDC*XlCOp7C,1C7Q2lZAC2fEUCE16WXXXXXXX to me known to be the person who executed the foregoing instrument and acknowledge the same. THIS INSTh UMENT WAS DRAFTED BY BAKKE, NORMAN & SCHUMACHER, S. C. New Richmond, WI 54017 . • Notary Public (Signatures may he authenticated or acknowledged. Roth My Commission is permanent. (If not, state expiration w are not necessary.) date: - 19.........) •Narns of persons eignine in any eaparity should be typed or printed below their ■itnature•. "Ca1rM.Gsgr4® STATE DAR Or WISCONSIN FORM N. I - Illu Stock No. 13001 G H a r ST C- 105 ar H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z d a OWNER/BUYER OLZ a::~~ ROUTE/BOX NUMBER_ 7,3 ,a✓t~ Fire Number C I T Y/ S T A T E A j (A) ~ z i p 9~4d / PROPERTY LOCATION: _14, Section N, R _W, Town of ,p Q St. Croix County, Subdivision Lot number ' I 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. H F. I/WE, the undersigned,, have read the above requirements and agree t4 to maintain the private sewage disposal system in accordance with H the standards set forth, herein, as set by the Wisconsin Depart- 10 ment of. Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office witl n 30 days of the three year expiration date. SICN D A'r E 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. INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 y e To be a complete and accurate soil test, your report must include: 1. Complete legal description; 2. The use section must clearly indicate r this is a residence or commercial project; 3. MAXIMUM number of bedrooms or cciruse planned; 4. Is this a new or replacement system; 5= Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 0. PLEASE us(,, the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A separate sheet may be used if desired; 3. Make sure your benchmark and vertical elevation reference point are clearly shown, and are permanent; 0. Complete all appropriate boxes as to dates, names, addresses, flood plain data, percolation test exemp- tion, if appropriate; 101 If the information (such as flood plain, elevation) does riot apply, place N.A. in the appropriate box; 11, Sign the form and place your current address and your certification number; 12. Make legible copies and distribute as re<tuired. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st - Stone (over 10") BR - Bedrock cob Cobble (3 - 10„) SS - Sandstone gr - Gravel (under 3") LS - Limestone * s Sand HGW - High Groundwater cs Coarse Sand Perc - Percolation Rate hied s - Medium Sand W Well fs Fine Sand Bldg - Building Is - Loamy Sand ) - Greater Than sl Sandy Loam < Less Than ~l - Loam Bn Brown s i I - Silt Loam BI - Black si Silt Gy Gray cl - Clay Loam Y - Yellow scl - dy Clay Loam R - Red sici y Clay Loam mot Mottles SC Clay w/ - with sic - Ciay fft - f ,v, int Y c - cc common, coarse pt - rnrn Many, medium rn - d -distinct 1> - promine! HVVL - High w I',"xtures surface c rof disposal BM - Bench M-k VRP - Vertical Reference Point TO THE C T`- eport is the first ste " 1 Tl. r F =)artment may request this soil test in t plans for .~e private r, ;tern and a rmit appliauthority in order to x;rrrrit. r l~f:rrrr , 1 trr ion my ca c re DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX N WI 53707 'H`UMAN RELATIONS (H63.09(1) & Chapter 145.045) / N1' LOCATION: /Ij SECTION: pR ~rp~ TOTy NO.:BLK. NO.: SUBDIVI ION NAME: /T3Q N/RJ / (or) W YV a TY: O NER'S BUYER'S N ME: MAILING DRESS: X 1h -Id Xj USE DATES OBSERVATIONS MADE NO. BEDRMS.: 1COMMERCIAL DESCRIPTION: A .New DESCRIPTIONS: PERCOLATION TESTS: OResidence 3 _e)tA I A.New ❑Replace & RATING: S= Site suitable for system U= Site unsuitable for system L M ENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMEND D SYSTEM: (optional) S ❑U I cm ❑U S DU 0 S ❑ S pail _ If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate:ss Floodplain, indicate Floodplain elevation: PL)IA PROFILE DESCRIPTIONS 8 00 2 BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER BEPI-N, ELEVATION OBSERVED EST. I HEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 7 0n B- 1 `1= 10 4 B_ 3 &90 )00 rt". 99 / B- NQ A) B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PER I b_5-T_ PER INCH P- P_ / P__ f5" A dy P- P- _ PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil area ate scaler i . Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the Sur levatj~n bori the direction and percent of land slope. G~ C SYSTEM ELEVATION q r1 r° \2 3 3 S ~ V 9 ty) K r.iI,J*~k 106 5+.. ' _-i I s i E pp 3 1 ` E f gd, i E j [ I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: S)461 - (6 - / S"-a r, ; CERTIFICATION NUMBER: PHONE NUMBER (optional): ADDRESS: I I //j., 4 ro roe 4. 2 9/19 CST SIGNA R lj DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) -OVER - I I i DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION P.O. BOX 76 LABOR HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 ' (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TO yl HIP/N$0ftt&H&*L-+TY: OT NO.:BLK. NO.: SUBDIVISION NAME: / Mo N/111 A (o) W , I~,VJ M'} Jam) OU TY: O NER'S BIdYER'S N ME: MAILING ADDRESS: A 'L 9 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence 13 ANew ❑Replace = J3 RATING: S= Site suitable for system U= Site unsuitable for system / 391S NVENTIONAL: MOUND: ND-PRESSURE: SYSTEM-IN-FILL HOLDING TANRECOMMEND D SYSTEM:(optional) ❑U❑~❑~ ❑S : ~i~ If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: D601 i Pr A 1 PROFILE DESCRIPTIONS 06 - BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER Depnm YN, ELEVATION OBSERVED ES IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- cl z A10 13- fi)o All S 1 J.. B- 3 fns" DDS ' 75 5_0 13- 7 Pow E_ 749' . 1. 1 1,51 40 S 4 IA-7. Ado. 13- 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 PERIOD PER INCH P- P- P- P- P- p_ PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil area }ti16te scale ?r di4te~li~ . Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the sur acb~levatj~n bori " ad the direction and percent of land slope. 3q_% r,0 '7 ! SYSTEM ELEVATION g rl E S F i [ jj . ~ y 4! VV t ~ E 5 3 fop ' I I i I ' I ~ I ' i ( f I {ff ( k E t t ~ ~ { I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print : TESTS WERE COMPLETED ON: -/S"- 1 /7 ADDRE • CERTIFICATION NUMBER: PHONE NUMBER (optional): 7 4` CST SIGNA R lj DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - ,r JY) S~r4iS / z1 3°v.p S - 61, F00 FILED 4517,19 2,-7 SEP2 21989+ p S~ O'CONhELL 2 CERTIFIED SURVEY MAP S Ft. CrolCroiot x Ca. W1 J, LOCATED IN PART OF THE NWT' OF THE NET' OF SECTION 1,T30N, R18W, TOWN OF RICHMOND, ST. CROIX COUNTY, WISCONSIN. LEGEND' OWNER St. Croix County Section corner monument - aluminum cap in concrete Lloyd Peterson Rt. 3 • 1" iron pipe found New Richmond, Wi. 54017 0 1" x 24" iron pipe weighing 1.68 pounds per linear foot, set n~='~u -~--x existing fenceline 'EP 2 7 1(i( swamp Va. NJ corner ~ ir•~~•,:..,,. NE corner Section 1-3_0_18 _ _EAST CTH_"K!' _ 308.26' d a north-line of the NEJ_ Section 1-30-18 T 405.00' 275.26' 1939.31' EAST - I =n 242.16' 9 6- C) 1~3 LINE DATA TABLE ° o n c line bearing length CERTIFIED SURVEY 03 CD LOT 1 -a_ b__,.__$00°23r47"E 55.00' I Mae-Y=¢=-~9=i~~~ ~ , a - d WEST 33.00' o ' . . _c_ 78. i 5' A o b - e WEST 33.00' C) m•,' " b - g WEST 66.00' 0.00' 325.00' 1 I ,A ° ~._f EAST 405.0 S00°23'47"E 78.38' \ 477.2e g WEST 33.00' g h S00°23'47 "E 78.61' i o i W j S62°49' 19"W 167.84' TE R AD S62°49'19"W 59.88' o S620491191114 103.57' o a n S62°49'19"W 227.72' 1 ri - i ~ a N WEST 72.25' o rr o o mo S62°49' 19"W 227.72' O m = ° ; a._ ---t - S00°30'08"E 253.92' CD W a ° I I co i Cr -q s S0003010811E 253.34' I i CE ` I I existing house F ~o r- EAST 50.43' f+ I I I i s s- t EAST 66.00' M I I C) ; N d- f SO-002314711E 133.38' 172,671 422.59' - `-d.__.-e._ S0002314711E 55.00' k ` w T 711.69' N SCALE IN FEET 200 loo o zoo WCCCJJ/ Bearings are referenced to the _ north line of the NE} assumed LOT 3 to bear EAST. N co L~ !I 0070 Ila .y»l~"iy+~~p C) 4- c ALLEN c. , -1407 r19 U ~j y `cz A/ ww~j4N' J 599.51' , JdyJqA/a 5lJ`~JG ,..t.' • N89032 13811W 710.681 'J8 risL,yY. ti• 1 NOTE: the area east•'3'fM{e•°`river and south tf~~ south line of the NWT' of the NET' the fenceline is in conflict with a deed w unplatted lands owned by others recorded in volume 461, page 331. O this instrument was drafted by Douglas Zahler job no. 85-26-189 , rr VOLUME 8 PAGE 2153 M .i i a CERTIFIED SURVEY MAP $ e LOCATED IN PART OF THE NW 1/4 OF THE NE 1/4 OF SECTION 1, T30N, R18W, TOWN OF RICHMOND, ST. CROIX COUNTY, WISCONSIN. FILED AUG 12,1985 E 01 BEARINGS REFERENCED TO THE OWNER N'D VX=PE 4 crabs 40=171 NORTH LINE OF THE NE 1/4 OW ASSUMED TO BEAR EAST. R.R. 3 BOX 316 A whim b NEW RICHMOND, WI. 5401711 LEGEND A~ 111 x 2411 IRON PIPE WEIGHING ALt.EN C. 1.68 LBS/LINEAR FOOT, SET. NYHAd$N s SCALE IN FEET r, " S-14107-, HUDSON, 60 30 0 60 Kls, i j4PPROVD <'9 AU G D 7 1985 Mo ST. C;tOIX COUNTY LIP Z N 1/4 CORNER COMPREHENSkVE PARKS P1AWNG NE CORNER SECTION 1 AND kOWIG COMMMEF SECTION 1 COUNTY MONUMENT COUNTY MONUMEN NORTH LINE OF THE NE 1/4 OF SECTION 1 CENTERLINE C.T.H. IIKII EAST EAST 325.001 80.001 0 0 0 0 ' EAST 325.001 I~ z N I C) O O 1 et W /~1 1fi O J .ia o 116,996 sq.ft.) m ~d I co INCLUDING R/W 2.686 acres ) m Im 99,121 sq.ft. ) EXCLUDING R/W ;N c 2.276 acres ) IO I m C w I10_ O N 1 d • to 1 0- O O I E 1~ - T O I0 W~ id I d W Irt O ~ If,, c^' '0' O K o ~ 1'07 O O O O IN let- ct. house i~ Oshed G Cc) WEST 325.001 ynQlatted_lands_owned_by,_Qlatter this instrument drafted by Douglas Zahler Job NO. 85-26 Vol. 6 Page 1563