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HomeMy WebLinkAbout030-2025-80-000 / y 2 \ ? � 0C; w ¥ o w 0 / i2 RED 2 77 8 £ ag -" 0k a %k// § _»n o ) o 7 / ) �__ �- o =a �� _= 0 , moo , )f2 ° Et) [ % ° K2&(� / m --. ! 0 o� � � c._ =- o !j °2$2k �Kk°- x� E= E ) 7.q = . xo 7 /tkkk\ o E 8 0 r o.0 ca t Go0§ cQ]2.0 Af '} r- B (D E 2�5 "0 j I 5 §ƒf §(f$ƒ�f§ m 2 � § §§ k(D=Ca 2 3 � �«= 23=7E) 4)t9 ) & »EE/ § Esc£ &) CL / C*4 � E ) ] t 0 � z - ' @ / ) � m 0 z 2 \% . k k k ) z £ E ) + / of ± .� / ƒ § j § o \ k .. z f } � ) .. \ E � 0 } ) k @ R t / 2 a D a ® % E \ ƒ k \ \ - t @ a 2 n § \ 2 -j Q / / / ° CO k § \ 2 D § 7 % E ad # o ._ a 2 � � k 8 \ . o $ s f E Q / 4 4 (D / = Cl) k § ) § + r- N I ( ) k � , / @ k . k / / E { { § g § G ) ° o z / 4 2 \ ■ � / « z 1 « k 0 � % E 0 J 0 9z \ a 2 k ) LO) Parcel #: 030-2025-80-000 03/04/2005 12:57 PM PAGE 1OF1 Alt. Parcel#: 22.30.20.438B 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 " SHAWN&KONNIE HELWIG HELWIG,SHAWN &KONNIE 1457 PINE TREE LA HOULTON WI 54082 Districts: SC=School SP=Special Property Address(es): '=Primary Type Dist# Description * 1457 PINE TREE LN SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 1.130 Plat: N/A-NOT AVAILABLE SEC 22 T30N R20W PT GL 2 N 167 FT OF S Block/Condo Bldg: 623.2 FT OF W 294 FT OF E 528 FT Tract(s): (Sec-Twn-Rng 401/4 1601/4) 22-30N-20W Notes: Parcel History: Date Doc# Vol/Page Type 11/13/2000 633576 1559/178 WD 07/23/1997 981/326 WD 07/23/1997 832/487 07/23/1997 715/540 2004 SUMMARY Bill#: Fair Market Value: Assessed with: 5913 231,600 Valuations: Last Changed: 07/09/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.130 51,100 176,700 227,800 NO Totals for 2004: General Property 1.130 51,100 176,700 227,800 Woodland 0.000 0 0 Totals for 2003: General Property 1.130 30,000 149,100 179,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 138 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715 - 962 - 3121 800 - 962 - 5227 ST, CROIX ZONING REPORT NO.: 27941/01 PAGE 1` ST. CROIX COUNTY REPORT DATE: 8/24/92 COURTHOUSE DATE RECEIVED: 8/20/92 HUDSON, WI 54016 ATTN: THOMAS Co NELSON Kq l�f h `r OWNER: Harry 6 Norma Wetter LOCATION: 1457 Pine Tree Lane, Houlton COLLECTMS M Jenkins DATE COLLECTED: 8-19-92 TIME COLLECTED± 3:00pm SOURCE OF SAMPLE: Outside faucet , - DATE ANALYZED:8-20-92 TIME ANALYZED:2:00pm COLIFORMI: 0 /100 ml INTERPRETATION: Bacteriologically SAFE NITRATE-N: 5 ppm Above 10 ppm exceeds the recommended Public Drinking Water Standard. Coliform Bacteria/100 ml Nitrate-Nitrogen, mg/L `t. C cn G) zr0 N G _ m LAB TECHNICIAN: Pam Gane 3 OF."NOEPEA&D N G WI Approved Lab No. 19 i O A V D < Means "LESS THAN" Detectable Level Approved by: PROFESSIONAL LABORATORY SERVICES SINCE 1952 ST. CROIX COUNTY ZONING OFFICE St. Croix County Courthouse aa J 911 4th Street Hudson, WI 54016 JA Telephone - (715) 386-4680 The St. Croix County Zoning Office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals. Completion of this form Ja essential qg that tag property can Djg located. Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning Office, and mail , along with form to the above address. Testing will be done as soon as possible after fee and form are received.. WATER TESTING----------------------------FEE: $ 35.00 (For nitrates and coliform bacteria) WATER TESTING FEE: $185.00 (For VOC'S) SEPTIC SYSTEM INSPECTION-----------------FEE: $25.00 (Determines if system is properly functioning t . time of inspection) / PROPERTY OWNER'S NAME: ! �' PROP. ADDRESS: ��� ��� CITY 'Legal Description 1/4 of the 1/4 of Section ')-Z Town of Lot Number Subdivision: FIRE N04BER / `4J_ USX NUMBER 0 30 F6_1 V 3 Color of house ,)c Realty sign by house?--;L—If so, list firm: PLEASE INCLUDE, IF A ALL POSSIBLE, A HAP,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual re uestin g services: Telephone Numbe��Q-`/ o REPORT TO BE ENT TO: ao 0 L CLOSING DATE• Signature 7 7' o,:7 S C . a T -0 c v 5z T vim' 5—.9,P oc7 ST. CROIX COUNTY r a WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE Irv;,3 911 FOURTH STREET • HUDSON, WI 54016 - (715) 386-4680 Aug. 20, 1992 Pat Branch Edina Realty 200 East Chestnut Stillwater, MN 55082 Dear Ms. Branch: An inspection of the septic system on the property of Harold & Norma Walter located at 1457 Pine Tree Lane, Houlton, WI was conducted on Aug. 19 , 1992. At the same time a water sample was obtained for testing. The results of that testing will be sent to you as soon as we receive them back the laboratory. At the time of inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. S ' cerely, r1 Mary J. Jenkins ,.Assistant Zoning Administrator cj i PUMP CHAMBER Manufacturer: / t Liquid Capacity: A Pump Model: / Pump/Siphon Manufacturer: N A Pump Size Elevation of inlet: 0& 4 Bottom of tank elevation: ?!k 44 Pump off switch elevation: /1/ Gallons per cycle: /V A Alarm Manufacturer: Alarm Switch Type: & 4 , Number of feet from nearest property line: Front, O Side, O Rear Ft. 111A Number of feet from well: /,V A ���+++ Number of feet from building: /J/ A (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: .) Width: .S Length: /DOS Number of Lines: Area Built: Fill depth to top of pipe: N 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: �/ A Number of pits: Diameter: Liquid depth: /L Bottom of seepage pit elevation: Area Built: �/ A 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: 41A Number of rings used: Elevation of bottom of tank: LY Elevation of inlet: Ab- A Number of feet from nearest property line: Front, O Side, O Rear, 0Ft A A Number of feet from well: 0& +4 Number of feet from building: lie .4 Number of feet from nearest road: A Alarm Manufacturer: Inspector: — Dated: Plumber on job: License Number: 3/84:mj Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT � f I OWNER / $ £ N 11 04 V A bt TOWNSHIP Z= -ZOS A f,/-4 SEC. ? *?, T 3 V N-R 20 W ADDRESS IQ I-t3 G X 2 7 4 ST. CROIX COUNTY, WISCONSIN SUBDIVISION ' X LOT /?/ A LOT SIZE 3 /4C. PLAN VIEW Distances and dimensions to meet requirements of 11-HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM i i s s/Z' INDICATE NORTH ARROW 0 BENCHMARK, Describe the vertical reference point used 7 47 If Elevation of vertical reference point: / Q O ' Proposed slope at site: , SEPTIC TAP't: Manufacturer: (J N/�, Liquid Capacity: Numbel of rings used: Tank manhole cover elevation: /j/ Tank I filet Elevation: 41A Tank Outlet Elevation: N A' Number of feet from nearest Road: Front 10 Side Rear, O feet ?rom nearest property line Front,0 Side,ORear,O /l! Id feet Number of feet from: well , building: Al A (Include tiis information of the above plot plan) ( 2 reference dimensions to sept1c tank SEE REVERSE STDP DEPARTMEWr OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX 7569 BUREAU OF PLUMBING MADISMADISON,WI 53707 O 4j l 53707 ON-R20W K*CONVENTIONAL ❑ALTERNATIVE (tatePlan I.D.N—ber: Town of St. Joseph El Holding Tank ❑In-Ground Pressure ❑Mound HWY 35 & 64 y NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: CA H.B. (IKE) Risenhoover Route 1, Box 276, St. Joseph, WI 54082 /C)-21!q—'q7 - }- BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.EL .. JrSTRIF.PT,ELEV.. Name of Plumber MP/MPRSW No.. County: Sanitary Permit Number: Rick Troff 3225 St. Croix 102782 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.'. ITANKOUTLET ELEV.. WARNING LAB L LOCKING COVER PROVIDED: PROVIDED OYES ONO DYES ONO BEDDING'. VENT DIA.. VENT MATL.: HIGH WATER NUMBER OF ROAD: 1PROPERTY WELL: BUILDING. VENT TO FRESH ALARM FEET FROM LINE: AIR INLET OYES ❑NO DYES ONO NEAREST DOSING CHAMBER: MANUFACTURER JBIDOING LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ❑NO ❑YES ONO DYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONA L. NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) 1:1 YES ONO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKING or excavation. Iif 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 DISTR.PIPE SPACING. COVER IN!IUE DIA -PITS LIQUID A I BED/TRENCH TRENCHES MATERIAL! DEPTH DIMENSIONS 5' Icy PIT 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. 1:1 YES ONO SOIL COVER JTEXTURE PERMANENT MARKERS jOII11HVATI11N WE LLS OYES 1:1 NO ❑YES NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED =PSOIL ISODDID s EDEU MULCHED CENTER EDGES ❑YES ❑NO iDYES ONO 1:1 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 MNO DISTR fS TR.PIPE DISTRIBUTION PIPE MATERIAL&MARKIN(; ELEV. ELEV. CIA.. ELEV.. PIPES A.'. ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY ERIAL PVERTICAL LI FT CORRESPONDS TO APPROVED DYES ONO DYES ONO COMMENTS: PERMANENT MARKERS: JOBSERVATION WELLS NUMBER OF PROPERTY WELL: BUILDING. FEET FROM LINE DYES 1:1 NO ❑YES ONO NEAREST G�1 1 Sketch System on l� Retain in county file for audit. (s Reverse Side. ,,.��"� -5 �` ITITLE. A -/, oniTig A nistrator DILHR SBD 6710(R.01/82) 1 r (V�"U� �(e { t 162. 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 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; Il. 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 ar4.pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form. ------------ --------------------------------------------------------------------------------------------------------------------------------------------- •,"�"'_"" ,. ens 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 Gr�oundwgef-- included the creation of surchar ges (fees) for a number of regulated practices which + 9 ( � � 9 p Wiscor4r3� oar. effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried treasure iti 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. , e none^s colle tec' through these sLircharges are credited to the groundwater fund adminis- -,rec9 by 'he ?ep artment of Natural R so. rces. These funds are used for monitoring ground- t ate., gr,)uridwater contamination investigations and esl,,ablishrnent of standards. Grcundwate.,', s worth protecting. ,AD-6398(R.03/86) ZEE ILHR SANITARY PERMIT APPLICATION CON, eR.1 u In accord with ILHR 83.05,Wis.Adm. Code �"*" 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 PROPERTY OWNER PROPERTY LOCATION 1 SF HOOV17R S(0 % F- %, S 2a T30, N, R o't0 6(or PROPERTY OWNER'S MAILING ADDRESS LOT NUM ER B SUBDIVITR NAME $ o �!�" CITY,STATE ZIP CODE PHON NUMBER CITY NEAREST ROAD,LAKE OR LANDMARK UXT _* O 71� 4nwb VILLAGE:J� TQ `p II. TYPE OF BUILDING OR USE SERVED: 7 J V 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 AW Replacement c. ❑ Replacement of d. ❑ Reconnection of e-0 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. Mconventionai 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. See a e Trench c. ❑ seepage Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 14. ABSORPTION AREA 5 SYSTEM E ATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square(Square Feet): PROPOSED(Square Feet): Q { '4qJ �� ! J Feet DZ Private ❑Joint ❑ Public CAPACITY VI. TANK #of Name Fiber-refab. Site Manufacturer's in Ions Total Mft 's N Con- Steel Plastic Exper. INFORMATION New xisting Gallons Tanks Concrete structed glass App. Tanks Tanks Septic Tank or Holding Tank l ©OO t? ❑ ❑ ❑ Lift Pump Tank/Siphon Chamber ❑ I ❑ ❑ 1 ❑ El VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name(Print): Plu er's Signature:(No St ps) 4WMPRSW No.: Business Phone Number:_rr Plumber's Address(Street,City,State,Zip Code): Name of Designer: 54t Vlll. SOIL TEST INFORMATION Certified Soil Tester(CST)Na;a CST# CST's ADDRESS(Street,City,State,Zip Code Phone Number: P Oj L. 0 3 86 T IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) rFApproved ❑ Owner Given Initial ` ,l '1 ,charge Fee Adverse Determination � 1�V•0V 1/0 X. COMM NTS/REASONS FOR DISAPPROVAL: SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber 1 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 /Y /E,f/ Location of Property d• , Section .2� , T 3- N-R ao W Township �f Q Hailing Address _4 /C Address of Site �F Subdivision Name Ate/ . Lot Number 7- fdA Previous Owner of Property Total Size of Parcel A-13 �C Date Parcel was Created /S? ZL Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes -j- No Volume n/S' d an Page Number S ' --s...�.� g `� 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 (G1e) eeAti6y that aU .atatementb on this 60nm ake tAue to the beat o6 my (ouk) knowledge; that I (we) am (ah.e) the owner(d) o6 the pnopen ty dens eh i.bed in th.i.a .in6o4nm ti,on 6o4m, by viAtue o6 a wa Aawty deed neeonded in the 066.ice o6 the County Regi.6ten o6 Deeds as Voeument No. ,� and that I (We) pheaent:ty own the pnopoded bite bon the aewage diAp e 4 4 em (on I (we) have obtained an eaaement, to nun with the above de cAibed pnopexty, bon the eonatnucti•on o6 eaid dyetem, and the dame hab been duty neeoicded in the 066-ice o6 the County Reg.iaten o6 Veeda, as Poeeument No. ) , SIGNATURE Old OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) LS DATE SIGNED DATE SIGNED t. y ..... , , IriiQOirlM S0 i.. TiMG«Mw r ~,Bwzba............a A. !t eeahoov�r to , aid .Huls .................... �" �.,� .„.. »�.... yA. a .».......a...a a. •+•i••..! '+ i,. band..... ...,............................_... 8830� _ _ _ ij , �--rte--���- •'� � uE ,.•....a»....... �.,.._,.....�. � ��a�^ ^,.�}l{•a"s�' �{" �� , Tut ft"d'w r not Y { d I_ '.; D The North 167.0 feet of South 623.2 feet of most `x 294.0 feet of Rast 528.0 feet of Government Lot 2, � rJ Section 22, Township 30, Range 20, St. Joseph k �, ( Township. Containing 1.13 acres, more or less, �! subject to an easement for roadway purposes over the West 33.0 feet of the above described tract, . together with an easement for roadway purposes i over and across the West 33.0 feet of the East ` 528.0 feet of the South 456.2 feet of said Government Lot. t* �1 di U This ....... ..is............. � IIaaGGtGad property. i_ (is) (ilfl #�+ Rated t1aM ............... .'i ... .......... .. day of .......... --J.. ................ . .. .............. ............ (SEAL) Bar ara A. R sen wr, Y r ............................................... . . lo;naerly..&4�k.AlCd..3►R..,�Q�k........ d ................................-............... .:..... .(SEAL ) • ....................... .................... .. • Hulen. . ....RiseMfoowt .. AVlIRalt=iowltolr ACKNO W LNDQD18>11W o(s) ............................................................ STAIR OF WISCONSIN ;> C .a»....._..................................................................... WASHINGTON ............... t,. of.................. .. .. I$...... PGrGOnally cam* before MW July.................................. . _.................................... Barb"&.. .. .......,.... ............................... •- ' 'l'I'!'LR: lIRH>!RR STAIR sAR O!WISCONSIN (It w akRAhf?PX4 ....hfr ..� .....»........., ' wtine(a�1 b i' wr; i: . .................. ........................................................... ........R...,. x to me k to be the person ..A.. VAD %9100fir%Mtrument.,and aak ty Ate, ri Twig INSTRNM6NT WAG ORA/TGD aV - < € 52 Paul A. Wlff #1185 ......... ..... ............... ....._... _. :_ P, rte- . �• vr�rn� •...... ... _ ..... ... ". . i..ashiutt......_..... (Slatnatures may be soi4P+eatkatGd er adtnowledRsd, Both 1(y Commission is permanen .I If aGtr dsfa are aet TleaGOary.) date: ...... >r,.' PAUL A '� MaMr PUBLIC-1r/�A S'�`A' R t •them•f MME WW"Is W wewMW A00W M typd.r prin"!�sr Yrlr w. WADMTON CUM �L WtRi kw 1% IaC BTAT►' OAR OI sr �r IMMIX M. 3 i t M1F' n g c � E f; z a.' (a 4. 1� n S _ b 3 i y. . . �a I {,s H • a STC - 105 r a H SEPTIC TANK MAINTENANCE AGREEMENT o St . Croix County z d a OWNER/BUYER ��. ��fZg�}� } ISM to /+000 r ROUTE/BOX NUMBER �jO Fire Number /lag CITY/STATE 67 T05 ��'� (,('� ZlP Jam` oj' PROPERTY LOCATION :1P , 'kk, Section �w T -30N , R 9_Q _W, Town of p /4 St . Croix County , -S SAC �,� �� Lot nu L mber \ 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 , f if needed , by a licensed septic tank pumper . What you put into the system can affect the function of the septic tank Ias 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 fail n system, which was in operation prior to July 1 , 1978 . St . Cr ix County accepted this program in August of 1980, with the requ rement 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 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- c 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 S �! �'/ Vl St . Croix County Zoning Office P. O. Box 98 Hammond, WI 54015 715-796-2235) or 715-425-8363 Sign , date and return to above address . � R INSTRUCTIONS FOR COMPLETING; FORM 115 — SRD — 6395 ' � S To be a complete and accurate soil test,your report maast include: 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 1 MAXIMUM number of bedrooms or commercial use 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; 5. PLEASE use 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; 8, Make sure your benchmark and vertical elevation reference paint are clearly shown,and are permanent; S, Complete all appropriate boxes as to dates, names,addresses,flood plain data, percolation test exemp- tion, if appropriate; 101 If sire information (srach as flood plain,elevation) does not antaly, place N.A. in the apnropri<ate box; 11. Sign the form anal place yeaur current address and your certification number; 12- Make legible copies and distribute as re<luired. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY VVITHIN 30 DAYS OF COMPLETION, ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Sail Separates and Textures Other Symbols st Stone (laver 10") FAR - Bedrock coo - Cobble (3- 10") SS - Sandstone ;I - Gravel sunder 3") LS - Limestone -- 5Ind HGW -- High Groundwater E s ..._ Coarse Sand 9'erc - Percolation Rate reed s - Ca',dium Sand tttl . . Vr,'v;j f - F=ne,Sand Bldg - Budding Is - Loamy Sand Greater Than sl _ Sandy Lorin - Les;, Dian Loam Bn - r3I-ovvra sil Silt Loam BI Back Si - Silt. G __ Gray cl - Clay Loam Y - y("lla,vs sc;i .__ Sandy Clay Loan) R Bets swi Silty Clay Lowe not - Mantles e s„ wady Clay w, vvith sic Silty Clay fff few,fine,faint ,c Clay cc CORIn"on, c0ars;; pa Peat mm - Man"', rnedium ra -- Muck d - distinct p -- prorninent HWL - High vvater leveli, Six general soil texttares surface water feat Belt.€id waste disposal BM - Bench Marc VRP - Vortical Reference Paint it T O TH E OWN E a This sor' i st:ep rr is the hest step ira sr;(,uriracl a sanitary petrnit. The county of,the Department may reuUest V 101,c,a...,n of t=,is sail test in the field prior to permit i5s-uaance. A comple=te .seat of pions for the private �evv,;ige sysIcal and a permit aDoftati0n Y)US1 hft SuI,arnitted to the appropriate local autboarty in order to ,hf airl<7 pwrE?j, 'F Ilk, -an tsary pl"I'mlt n1fEst ho obta4?a8d and r)o,;tsd pt for to the Start,of zariv Construction, r DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTRY, DIVISION LABOR ANCJ,, PERCOLATION TESTS (115 P.O. BOX 7969 HUMAN F(ELATIONS \ MADISON,WI 53707 (H63.090)& Chapter 145.045) r LOCATION: SECTION: TOWNSHIPF��TY: LOT NO.:BLK.NO.: SUBDIVISION NAME: sa 1 1/ 27- 1T3D NIR-20 E 4 5r J-osE�r - COUNTY: OWNER'S 'S NAME: MAILING ADDRESS: .5f C4w0%X kr �iE.sf U OdGL Rt/ Sr TD rz?A- , Wi s . USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: pROFILE DESCRIPTIONS: ER A TESTS: AResidence 3 - ❑New Replace — RATING:S=Site suitable for system U=Site unsuitable for system SC s 3.3 `f (,t(f �� l�F�'��/� 'r✓ ;OG&rON r ONVENTIONAL: MOUND: IN-GROUND-PRESSURE:S STEM-IN-FILL HOLDING TANK:RECOMMENDED SYSTEM:(optional) ®s ou os au ©s au as ©u ❑s au �e N0 ,8E/0 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: c,L�S.f 1 I Floodplain,indicate Floodplain elevation: ' V I PROFILE DESCRIPTIONS w ��tGi.•��}L F'7r. BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) , B-/ 7.0 S• v,� B, yy. IS 2.GG' ZY.aN.-�gy. s /•S' f.:�e s/ p - . r 9f� s33 s��0101,• s 2.6 G �a�y )C-:O� - 'S B-� d 61 7� 74-- a, a,,. 4� -z /S Z S , ' .el Fc. o v-z.3 s l . 66 ��• as - � * S) O o,P-Qv B- oF� u oa 7o pi !�iP 7&Xyv i&Gt atAt cautn B- ,s,7- 410 D f�� "04M v �ovv� 7L'.r .!°� e-L-Iss Z' B- �`a w Abt� W :aeD 0A 7r lei, ;1 SEC 0_-4.-i e P&o Po'ays �ey-v �' PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER 11d1511M AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD 3 PER INCH P- Z Z Z P- P_ Z ZZ G -L. P P_ Pte_ 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. 5_40 7'/c Of z�,u,rvow,v 'l SYSTEM ELEVATION �` °DE.`°�i"�'�'�'�� o%e , - ri�rrQio- /?,Px ; { E � w _ l p i - r tN W t ham' I W . .3 f. 1 i . c i x i j ------ I, J C1r E 1,the undersigned, hereby certify that the soil tests reported on thi wer d rr d with the procedures and methods specified in the Wisconsin Administrative Code,and that the data recorded and the location of s are c c a bes y knowledge and belief. t® � NAME(print): ESTS RE COMPLETED ON: NOMESITE SEPTIC PLUMBING CO. C� �0 `Ad'6+ j/—0 ADDRESS: RT. ROBERT ULBRIC N, CERTIFICATION NUMBER: PHONE NUMBER(optional): PLUMBER VA&MASTER LIC.NO. 3307 M.P.R.S. Z vs ,3�(p — l? WNN.INSTALLER&DESIGNER LIC.NO 00663 CST SIGNATURE: DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. D I LH R-S B D-6395 (R.02/82) —OVER— PAGE OF TR e AJA . n. CrrJSS � zc � lun O Is Stern Freon Air Inlelc And Obce114110n Pipe Approved Vent Cap MlMmum 12"ADOVe Final Grade 20-42'Above Pipe _4'Coot Iron To final Grade Veal Pipe Marsh Fay Or Synthetic Cover1110 win 2'A09rapale Over Pipe 01e111bullon Pipe --' o o o o —Tae Aggregate Beneath Pie ° Perloroled Pipe Below Pipe o Covpliny T.rminalln0 Al 8011100 Of System Prp�oSeD �ina� qr�,�1{ . y8o©'f -91 99a S __ �L�cJw� lot'1 'N'///Invo SOIL FILL DISTRIBUTIOF.1 PIPE APPROVED S4MPETIC DOVER OR 9" OF STRAW Z"OF AG6 LEGATE � 41D OR (AARSN HA"J 1e'OF%2-2.1/2 AGGREGATE e8 ALEV. OF`l2 FEET_. a - ate.1 DISTRIB;ITION PIPE Tp BE AT LEAST _ IUCHES BELOW ORIGIMAL GRADE AAIU AT LEP.STXQ 40C Afs 'BUr W MOREL 'Th1W 43L INCHES 15ULOW RIVAL GRADE MAXIMUM DEPTH OF EXCAVAT1100 FROM OWw a 6KAK WILL BE IIJCHES M14JMUM ®EPrh of EXCAVATIOM FROM 01KI411JgL GRAPE WILL BE o1 7 INCHES SIGIJED: LICEUSE IJUMBER: DATE : .-9 ` Q `A 110 OMER PLUMBER VERT. REF. PT. = TOP HULEN B. RISENHOOVER RICk' 'T*RC)Ff.:- ELEV. = IC)(-)' R** 1. BOX 276 RT. 2 BOX 1.70A OF PHONE PED ST. JOSEPH W113. 5/4-092 DERONDA WIS. 54008 PERC = X 1-715-549-6597 MPRS 3225 BORING 3 BEDROOM HOUSE ii .-00N Lr 4,1 DISTRIBUTION BOX W/Vt-N'l" INSPEC-rION BOX OTREC,N 0 -REPAI(? f A7 V ATJ Pad