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HomeMy WebLinkAbout030-1022-60-300 v M a o o � I E•°- N A? � E 0 0 COOa��i $.o � r c O N m• oS y 9 Z r O y C 7 f0 N Z f0 LL c j( c 3 .o °' yM Q)1-- o 4) -0 W M w E <C o N U I O M > � I M Z w G Z y � c O I O Z c U N C O O 7 N Of •N � ' O O III CL L L c O OZ Fes- Z w Nz V N l0 N .. m pd� ooIL � � °- Z N p 7O d F- 0 O O Z •N R aaa CL o N o ono ono aNi fn J U m M M } Cl) LO a Q o N N o M p p m � d CD '�j• j � d Q } Cn Q CD 0 3 m y c E O CtS M �N FO- d O O O M C U d 0 0 p� L O O U O N N 7 O M O C n "' O E M = L n l O F� O N _ O M • � CO tp O C O � I v � m R € a a :: IL • CL 2 d E c c rrww 3 _1 A CiCL Ov� ci Parcel #: 030-1022-60-300 02/18/2005 1o:34 AM PAGE 1 OF 1 Alt.Parcel#: 6.29.19.95A-30 030-TOWN OF SAINT JOSEPH Current X'' ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): `=Current Owner "DULON,JOSEPH F&D'ANN E TR JOSEPH F&D'ANN E TR DULON 1193 CTY RD V HUDSON WI 54016 Districts: SC=School SP=Special Property Address(es): "=Primary Type Dist# Description SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 5.818 Plat: 1488-CSM 16/4304 SEC 6 T29N R1 9W LOT 2 CSM 16/4304 Block/Condo Bldg: LOT 2 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 06-29N-19W NW Notes: Parcel History: Date Doc# Vol/Page Type 07/02/2004 767683 2608/522 QC 10/11/2000 631584 1550/94 WD 2004 SUMMARY Bill M Fair Market Value: Assessed with: 4901 327,700 Valuations: Last Changed: 07/07/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.818 134,900 187,500 322,400 NO Totals for 2004: General Property 5.818 134,900 187,500 322,400 Woodland 0.000 0 0 Totals for 2003: General Property 5.818 79,100 159,000 238,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 566 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 VOL 16 PAGE 4304 APPROVE OCT 2 5 2002 KATHLEEN H. YALSH ST.CROIX COUNTY °'"'r REGISTER OF DEEDS Planning Zoning and Parks Committ a ST. CROIX CO., NI MAY 2 9 2002 .,, s°}n'V�.v��� �`; >a® RECEIVED FOR RECORD N _TN00024115 0E \� O 05 -29-2002 10:45 A 8034' v of reCOrged witnin 30 days of � �, p9 �7P 1 val date approval shall 0 n D , a Z CERTIFIED SURVEY HAP %to� �i� m o' -�� �Q�—� r m COPY FEE: 3. z ` 'sg�,�;� �� r moo_r- �°�G�]L�DD ��l OO 4[�GG°�@ -o [�05!--- o�o(1Yutlo_ [� --------------- D \\ ---------- m \ \ i _p,>, (S00°0048"E) WEST LIN NW1/4 n 0 S00°2415"W N00 024'15"E $Q„ 635.76' S00°2415 'w co 09.3N 143 90, ' 00°2415" 229.14' 740.490 >r cn Z O m r rn N00°24'15"E 406.42' o K N3 0 En 3 10 .7 ' 125.41' rn 8. . Z- r vl rG' z mm ��Q :: : : : m p�Z u j 03 �° mm ` '`' ' ''gyp OD �D CD Q I /� !� O o !� „� + m l Oo �1 ry1� �+' 1� �00 O 1911 X) m a p Boo by� � . I 'C -q 0o s O 7 / Il 14 0 D I� '� O0 rn 'Q OIO � �► 0 8 T 0 1 = N � m r" yC Z i m' <-04 rn wr� lou ; c I r I VN.-. z Q !� v ��IP O�Z IN, j CD I c ss o I� IpyOz � r� 251.35' 218.98' mx\ 0 0 - o I X� ^� :42 0 -± N00°00'00 470.33' �I w i N A Z Ia ON N J Ocn 10 >z �_ IQ D! Oct z 1' _ Id G7�Z \ 2n ' s RI O � _ S > o -don lQU 14 t0 � MEW rm- � s I� A NrD c ANN I s O� CD 0 QZ @.@.H. M S00 003'37"E 635.76' 0O o q L@ ll DH I EAST LINE OF THE 0� C Z NW1/4 OF THE NW1/4 Z Z- 4 Z MHpA4LD AHD@ �o m >�4E °-n-n 1: A 0 • C-qN-N a-On O Z Z -4 m �� � a) to r r to 'i to-^ O N BEARINGS ARE REFERENCED TO THE O 0 x o o m c o or*i o m r O 0 -n-16 cn z m. c '0 c m WEST LINE OF THE NW1/4 OF SECTION O Do m o m o Z o m 6, ASSUMED TO BEAR N00'24'15"E O�Z �''� r ; X00 , D m _ _ o rn Zc 0r ��DD-�rZ O W m rtn W D � -4 o oc v Z ODRZ>NOOO o".R.0 N p� r� Z --I M Z O N C top C7 (= N C-) CD � m=00 --1 Zz TI o� mmtnm o zr O o m rT1 = D � D D�mm N �c m OCNCi� ?Z D ?j -1n Z O o O m rAC)L CD rrcn � 0 7 Io o o D g oo r,>ZM �r^z'` �� z n D o0m ZC zo�tnm tn�ont tno / I Z z -'_ D c Z ci r^N'0 i to D = li1 f rn 0 2 m K-i Nmmvt (2��r=- `O Om m Z{ II �DQf,C Mm m v ; rtD � -I �ZV'_Orrn -1�:� 'A N N w? z O O m D , Z m :5 SHEET 1 OF 2 SHEETS m Vol.16 Page 4304 • I 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: ,j Length: 56 Number of Lines: Z Area Built: Sdo Fill depth to top of pipe: -�/Z // Number of feet from nearest property line: Front, O Side, O Rear,0 Vt / Number of feet from well: 4 301 Number of feet from building: 73 (Include distances on plot plan). SEEPAGE PIT ,�`�/ Size: /1'/ Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box 0 or distribution box O been used on any of the above soil absorbtion sytems? (Check one) . HOLDING TANK Manufacturer: 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: Dated: Plumber on job: //. -�►..� License Number: ".S Sa Z)0 3/84:mj Form - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER j, oe ,Q.oJ,0-t TOWNSHIP SEC. T Z/� N-R 1 W ADDRESS k6ru_`` L ST. CROIX COUNTY, WISCONSIN ,are LJ,s ..� 16 SUBDIVISION /1/p 5 p&Uj�:, LOT LOT SIZE PLAN VIEW 0 KA Lo T— l� Distances and dimensions to meet requirements of ILHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM LA IS�Gwc f✓Ovn Lie Z- SX to f,.�.xr,cLr rs 1 0' o- INDICATE NORTH ARROW Caner e+� �lC,.d �APR c C BENCHMARK: Describe the vertical reference point used eoeA er 0r'6-"V_ I Elevation of vertical reference point: 16D Proposed slope at site: Z,-/,)��;5t/�EPTIC TANK: Manufacturer: / ,gyp �'S Liquid Capacity: Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front,O Side,o Rear, O feet From nearest property line Front,0 Side,0 Rear,O feet Number of feet from: well �v'!/ building: lR (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 BO X 7969'&HUMAN RELATIONS P:O. PRIVATE SEWAGE SYSTEMS DIVISION P.©'8Q BUREAU OF PLUMBING MADISON,WI 53707 NW-4, NW-4, S6,T29N—R19W XT CONVENTIONAL ❑ALTERNATIVE State Plan 10.Number: IIf assigned) Town of St. Joseph ❑Holding Tank ❑ In-Ground Pressure ❑Mound Cty Road V NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION 6ATE: Joe Dulon Route 2 Box 192 Hudson W1 54016 BENCH MARK(Permanent referent pomt) ESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF.PT.ELE V.. Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Roger Timm 3224 St. Croix 95977 SEPTIC TANK/HOLDING TANK: 1777 LIQUID CAPACI4NREST ANK INLET LEV.: TANK OUTLET ELE V.. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: �� �� ❑YES ❑NO ❑YES ❑NO DING: VENT DIA.: NT IHIGHWATER ROAD: PROPERTY WELL: BUILDING:IVENT TO FRESH ALARM: LINE ,�S AIR INLET: OYES ONO ❑YES ONO VJ DOSI NG CHAMBER: MANUFACTURER: 7Y ES LIQUID CAPACITY. PUMP MODEL. PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED:❑NO OYES ONO OYES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL BEE,OF :PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET: PUMP ON AND OFF) DYES ❑NO NEAREST' SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing FORCE LENGTH IDIAMETER MATERIAL AND MARKING 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. COVER JINSIDE DIA.. #PITS. LIQUID TREN ES 6 J. MAVRIAL• PI. .. 1! RYk•! A V / DEPTH: GRAVEL DEPTH FILL DEPTH IDISTR.PIPE DISTR PIPE DISTR.PIPE MATERIAL: NO.DISTR {1t1�BE R, !.PROPERTY WELL. 77.7 UILDING: VENT TO FRESH BELOW P ESQ 1( ABO E CO ER EL INL T ELE D PIPES- LIN AI�N INLET f [�2 r �Ir04 S 2 7 ?- .5 I ET R I 7� 93 1 A0 : MOUNDS STEM: 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- ❑YES ❑ meets the criteria for medium sand. TIONS MEASURED. NO SOIL COVER ITEXTURE PERMANENT MARKERS JOBSE WELLS. OYES ONO OYES ❑NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. SODDED. SEEDED. MULCHED: CENTER EDGES. DYES ONO DYES ONO ❑YES ED NO PRESSURIZED DISTRIBUTION SYSTEM: i %WIDTH. LENGTH. NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER: ( TRENCHES: `•;MANIFOLD PUMP MANIFOLD DISTR,PIPE MANIFOLD MATERIAL: NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING: ELEV.: ELEV.: DIA ELEV. PIPES. MIA,: HOLE SIZE HOLE SPACING. DRILLED CORRECTLY. COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO APPROVED PLANS. ❑YES F-1 NO OYES ONO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: PROPERTY WELL BUILDING: LINE: : YES ❑NO ❑YES : NO #YC11=1 Sketch System on 1� � �r�RA�w.lt Retain in county file for audit. Reverse Side. SIG TITLE: DILHR SBD 6710(R.01/82) Zoning Administrator l 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; 0. 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 T o be complete and accurate this sanitary permit application must include: Property owner's name and mailing address Provide the legal description where the system is to be installed; I!. Type of building or u.se 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; 111. 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'/z 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 ,omrrronly known as the groundwater protection law. This change in statutes was the exult of over 2 years of steady negotiation and public debate. The groundwater bill Ground}arWo. - ciu yed tbe ;reation of Iurchai,ges ( esl for a number of regulated practices which \Nisco in=s an effect groundwater. The surc.l arc, took effect on July 1, 1984. All of the water that buried 'tlfE3 S used ir: yo�ir building is returned tc: the groundwater through your soil Fbsorption u system or the disposal site used by your holding tank pumper. 0 The r:o es .cllected through these surcharges are credited to the grounc'vtrate r fund adrr�inis rec by .he Department of Natural R-sources. These funds are used for monitoring ground- 1 ttr, g, ?undwater contamination investigations and es"ablishment of standards. aroundwatF:, 's worth protecting. SDD-6398(8.03/86) (— SANITARY PERMIT APPLICATION COu 51L R In accord with ILHR 83.05,Wis.Adm.Code ' —' STATE SANITARY PERMIT# 9 7 —Attach coniplete 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 LdJ NO PROPERTY OWNER PROPERTY LOCATION O~@ jUtj% /yCJ%a,S T 7,f, N, R / (or) PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAM Z &G.,5 h-7, A44 Yfwa 4,�� CITY,S ATE ZIP COQ 7 PHONE NUMBER O CITY ' NEAREST R� LAKE QR LANDMARK VILLAGE �: 'v/ TOWN OR 11. TYPE OF BUILDING OR USE SERVED: 00:90-- /O vZ p2— 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.❑ 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 1. a. INConventional 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 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): _34, 3 gGo I oFr,70 Feet :4 Private ❑Joint ❑ Public VI. TANK CAPACITY Site in gallons Total # Manufacturer's Name Prefab. Fiber- plastic p INFORMATION New xisting Gallons Tanks Con- Steel A s Concrete structed glass App. Tanks Tanks Septic Tank or Holding Tank 1zy ❑ 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) MP/MP�No.: Business Phone Number: /y1r,� 3zZ IM5 -27Z 3 Plumbe s Address(Street,City,Sta Zpi Code): Name of Desi ner: 45&y� GcJ�cs b' `z 7 c VIII. SOIL TEST INFORMATION CertifiedS it Tester(CST)Name CST# cr to d hn CST's ADDRESS( eet,City,State,Zip Code) Phone Number: a 2 _S- 7/S B-6 a IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Signature(No Sta mps) Approved ❑ Owner Given Initial Surcharge Fee 1��ing;ent Adverse Determination t� . X. CTMENTS/REASONS FOR DISAPPROVAL: I SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber Timm JOB SHEET NO. OF z Excavating Co. CALCULATED BY i 7�i DATE Z T(!P7 - R I, Box 192, Wilson, WI 54027 CHECKED BY B91�E SCALE _ ....... ........... __ !__.. _. _..��, -L. _...... .. ^"7-ice..... .:......... ..............j..... .. ...._ .._ i e D � , i go we 46 fk) El- S� CDY`hv1 K c a� Timm JOB SHEET NO. OF Z • Excavating Co. e�� CALCULATED BY 4�°� ���"'�'' DATE R 1, BOX 192, Wilson, WI 54027 CHECKED BY ®.A / i�s �Z SCALE 93. i CO r Cwta,Maw.OWL DEPARTMENT 0F. REPORT ON SOIL BORINGS AND SAFETY&BUILDINGS INDUSTRY, r DIVIS WON LABOR AND PERCOLATION TESTS (115) MA oF so HUMAN RELATIONS (1-163.090)&Chapter 145.045) LOCATION:N SECTION: =S-r NICIPALITY: OT NO.:BLK.NO.: SUBDIV S10 AME: T p �M N t!w '/41'/ 1� N/If /°I�(or 1'1-� � J S f' COUNTY: WNER' R'S NAME: 17WE DSS: T Z $ax i6Z /4.-bSo k W1 --94,016 USE _ DATES OBSERVATIONS MADE NO.B ORNIS : COMMERCIAL D 1 TION [APOResidence nNewReplaice 7Ay 21 Igg7 1 Mny 28,192"7 halo'. $oaf -So IL<. ON 2 - C44 np RATING:S-Site suitable for system U-Site unsuitable for system S SATTRkr QNV TI : MOUND: _I IN____O(UNDPR S S -1N-FIILL OLDING TA K:RECOMMENDED SYSTEM:(optional)❑� ❑ J�� ,`LIZS.J S ❑U S ❑Y ❑S U C)ONVEN"rlDnra l 'I�nK.NCs If Percolation Tests are NOT re wired DESIGN RATE: 4 I(any nortinn of the tested area is m the under s.H63.09(5)(b),indicate: CLIIASS 3 Floodnlain, indicarte Flood NA elevation: fVA PROFILE DESCRIPTIONS BORING TOTAL T U ATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE,AND DEPTH NUMBER ,K ELEVATION OBSE V D TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) 7" t. S 1 S RN L 'S " h&N MS B- 9.92 45.62 /�oN 9. 9 Z 'IL-r% $QN C-M s'fG+R. B- Z P.7 94.9 o > 9.Z� Zg' V7►Lt 7" CSiL T &Y SiL 3Z'' a3N gtL N."ft&q M it �/ w 24"PiLL 30"Gv Si C. <-4 M AT .aNTUFA4 iV B- 9.6? 95.21 ONE >9.67 zo°6aNS:L 42"khRkN MS frGQ. l S9 B- B- PERCOLATION TESTS TEST EPTH WATER IN HOLE TEST TIME D R V L-1 S RAT MINUTES NUMBER AFTER WELLING INTERVAL-MIN. IjIQQ.t._ PE i0_ _ PER INCH P_ 7 No 5.37 >2 ? Z < � P- 2 3 E 19S.01 3Q) P- I CA 9S, 1 0 p_ �1Lr1� LQ i3L_.!Q P- Pp PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings anti the direction and percent of land slope. SYSTEM ELEVATION as .70 5 err, Loc n t' a "Jr tow ff tip- •I � ) ,.w. eye �., f.a / ( a � �� �• il�Mt uwrvecoavro •, ♦rnDa J7 t / 4 ' 21 ENCL CORN(;R SWIMAI IN6, 'BASELINZ* fS thT�NS'o^i OF` WEST" RAr*(.L PAIN �L.v ry �aaao Poo t- FENCIE-I.►Nr;•� 1,the undersigned,hereby certify that the soil tests reported on this form were made by me in accrual with the procedures and Inelle cis specifieti io the Wisconsin Administrative Code,and that the data recorded anti the location of the tests are correct to the hest of my know1wige and belief. A printA� - T WERE COMPLETED ON: ,l4R V 6 304 sbN _� a .►� Lac -- � PHONE N MBE Atoplonat►;CERTIFICATION NUMBER 4 - og 7 SVON f� 5 _4u 1I. S401 16, CST`$IG A'(URE: DISTRIBUTION:Original anti one copy to Local Authority,Property Owner and Soil Testeo. r` l)Ii_HR SBp G395 fg-t?2f82) COVER • H z • H a r ST C - 105 r a H SEPTIC TANK MAINTENANCE AGREEMENT o St . Croix County z ty a H OWNER/BUYER 6e ROUTE/BOX NUMBER # Z- � , Z Fire Number .CITY/STATE )4/0 c�01 LeJ/,S ZIP PROPERTY LOCATION:_jV , Yc1�l' , Section, T L N, R_/ W, Town of St . Croix County, Subdivision 5 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 m_ y 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 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- 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 . SIGNED �. DATE ka St . Croix County Zoning Office P.O. Box 9&i Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address . APPLICATION FOR SANITARY PERMIT STC - 100 This application form in 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 Property1 Location of Property rlU , Section-, T_ Z F N-R W Township b ?sailing Address Z Address of Site Subdivision Naere Yr.�� rr ■VIII.�. . .- Lot lumber �n _ r+rl .r�.rl..►.I�.�.r.r../�.�—.rar—rr—.r.-.r r Previous Owner of Property .�� /d Total Size of Parcel 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 --:fs..a... and Page Number ,/3Z 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 (Wel etkti6y that W a#atemenz6 on th.i.6 6onm ate tAue to the befit o6 my (out) know.tedge; that I (we) am (ate) the owneA(6) o6 the ptopeA ty de6 eh i bed in xhi6 .in6oknwti,on 6otm, by vihtue 06 a wamanty deed tecoaded in the 06 .ice o6 the County Regi6ta o6 Veed6a6 'Document No. zz - ; and that I (Ule) pnezenfity own the pnopoded site bon the 6ewage ctizpoiat system (on I (we) have obtained an easement, to tun with the above debeAubed ptopenty, Got the' constAuCt on o6 said by6tem, and the Game ha6 been duty neconded in the 066.ice of the County Reg.i6ten o6 Ueed6, a6 Voe meet No. ) . r SIGNATURE 01# OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) III d . (7 .: .,:•.. ,....».. .. _,._. `Yr"r'il.+w...-�.i.r ��Ilrl��rr� ■ ■ rri...�� `'.r. DATE SIGNED DATE SIGNED DOCUMENT NO. STATE BAR OF WISCONSIN-FORM 2 WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA 322322 e0 9'' '12 >A'%';E .32' REGISTERS OFFICE BY THIS DEED, Harold D, Du nn ;_and Mary Jean Dulon. sT. cROtx co.�was. his wife and in her Bran behalf, Recd for Record this-M._ day of_iMR1___-__A.D.19 Z4 Grantor conveys and warrants to Joseph F. Dulon and D'Ann $a3�_� M: E. Dulon, husband and wife as joint � , tenants. _ Re'g ar of Di •4? Grantee S for a valuable consideration RETURN TO the following described real estate in—S-t-- Croix County,State of Wisconsin: A parcel of land located in the Northwest Quarter of the Northwest Quarter of Section 6,, Township 29 Tax Key N North, Range 19 West, Town of St. Joseph, described This is not homestead property. as follows: Commencing at the Northwest aorner of said Section 6; thence South 0°22150" West (true bearing) 740 .23 . feet along the centerline of, present County Trunk Highway "V" and the West line of said Northwest Quarter of the Northwest Quarter to the POINT OF BEGINNING; thence North 89°56110" II East 1188.45 feet; thence South 0004125" East 635 .73 feet along the East line of said Northwest Quarter of the Northwest Quarter; thence South 89056110" West 1193.49 feet along the South line of said Northwest Quarter of the Northwest Quarter; thence North 0022 '50" East 635. 76 feet along the said centerline and West line of the Northwest Quarter of the Northwest �IQuarter to the POINT OF BEGINNING; subject to conveyances of the West 50 .00 li feet of the North 229 .14 feet and 'the West 65 feet of the South 406.50 feet ` thereof for roadway purposes . ji TRANSFER $----0 0. FEEException to warranties: j Executed at Hudcmn. Wi goongi n this_ 12th day of April 19 74_. I I SIGNED AND SEALi D IN PRESENCE OF + �� (SEAL) Harold D Dulon (SEAL) ll i f II I I Mary can Dulon (SEAL) I , ,I III i� I I (SEAL) 11 (� Ili l III Signatures of HarQl-d--a D1iOn and Mary Jan nulon, his wife authenticated this 12 th _ day of April 119 74 n D. He ood Title: Member State Bar of Wisconsin)GZ Z!h*22U=Z li Authorized under Sec. 706.06 viz. �! STATE OF WISCONSIN II County. Personally,came before me, this day of 119-1 the above named I to me known to be the person— who executed the foregoing instrument and acknowledged the same. i I I i This instrument was drafted by John D. Heywood, Attorney at Law Hudson., Wigninnsi n Notary Public County, Wis. i I The use of witnesses is optional. My Commission(Expires)(Is) _ Names of persons signing in any capacity should be typed or printed below their signatures. M.CM1�IUCrlrrprry® WARRANTY DEED–STATE BAR OF WISCONSIN, FORM NO. 2 – 1971