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� o a % § � j & A § k \ § o§ § CL t � I: / 2\C X2222 � §fF7 $ . a ® =its � � � § � ` �2Q0 % a 2 2 . ) 2 }© § 0 7gn.) okA\k ) ) § U) c \ LL . Z C C�02.9 � M U) (D \ § ) Mt % \ z E Ef . 2 � k $ � 0 § § � B B 0 ■ - I § 3 0 $ z 7 7 E z E 2 2 n N ti C) § \ k ) c / z 2 m . ) « i 2 $ k ~ � £ r E % £ § 0 � § k 2 M 2 Z 0 IU) U) _k 20 } \ 3 K & ® Z £ 0 a a 2 IL -� k o B . 0 5 5 2 U) 3 u o = » ! ) \ / k I § \» _ a 2 � k co < t a � \ % 4 z e R CL 2 0 § r 0 k cl \ / ) ) \ ■ a } 2 0 § 5 0 k z k � -� © E 0 2 © c § j j \ j \ 0 z / k ) ■ EL \ . 2 a » ' l c a § � & J a 2 �; o 3 J . , ; � 0 DOCUMENT NO. STATE BAR OF WISCONSIN FORM 3-1982 . —QUIT CLAIM DEED KATHLEEN H. WALSH Voi.1444PAGE418 REGISTER OF DEEDS ST. CROIX CO., WI Ronald J ....................................................•-................ RECEIVED FOR KM .................... 07-26-1999 10:00 M .............. -------.------- . . - .. ..... .k................. - ............... ................ ......... quit-claims to )PtriciaA Reid, /a Patricia tr Reid Schachtner QUMIVT CAIN DEED ........................-------- ......... ............. ........................... .......................... CEff COPY FIX: ........................................... .................. ................ .. .......................... COPY FEE: 2.00 TWOR FEE: RECORDING FEE: 14.00 ............................................ ....... .......................................................... pffiBs I the following described real estate in --St.-CrOix..............................County, State of Wisconsin: II 149TURN TO it Pa4riaa- p-- kecQ A parcel of land located in part of the S111/4 of the la,'1/4 ; AIR(oR -50th 1 � of Section 10, T31N. R19W, Town of Somerset, 3t. Croix County, Wisconsin; further described as follows: 402-Ir Oyherset-, LAI, 5 Oo encing at the NW corner of said Section 101 thence Tax Parcel No: 11 -724'00"W, along the west line of the M11/4 of said 10611-q&,30D il ij section, 1312,96 feet to the point of beginning= thence 0 continuing SOV24100"W, along said west lined 66.00 feet,; i1thence 589015104"E, 571.31 feet; thence SOO 27'32"W, 413.75 '! feet; thence S70059'22"E, 538.45 feet; thence N6521'22"E, I i1276.63 feet to the east line of the 3161/4 of the ffi:1/4 of :i said section; thence N00 27'32"E, along said east line, .I 530.00 feet; thence N89'15"04,%, along the north line of the SW1 /4 of the 1,1,'1/4 of said section, 1332.31 feet to the ( point of beginning. Parcel contains 10.87 acres (473.308 Square Feet). a600e cQescv:,pficv-1 ► &o L-woam o-s Loi-A Ceti e4 mar, do(01, 565 Y,?1,6y" cj&Scri'VOM, 0150 D14uctes c:,jAtj0+ i 5air u e map, This .....not .............. homestead property. 63'Y*(is not) Dated this .......;ZA ... ......................... ..................... Y�o..... ... .. .. day of ... . ..... ....... (SEAL) ....................................................................(SEAL) ...........................—.........-.................... ................I................................................. ..................................... ...............................(SEAL) ....... ......I......... .............. ............................(SEAL) ............ . .. ....I... ... .... AUTHENTICATION ACKNOWLEDGMENT Signature(a) ......................................................... STATE OF WISCONSIN ......................•........................................................ k..........Coa.ty. authenticated this ........day of........................... 19...... Personally came before me this .........day of I,A%. the above named ...................... ......................................................... ................................................................................ ............................................................. ............... TITLE: MEMBER STATE BAR OF WISCONSIN II ............................... (If not........................................................... ................................................................................ authorized by § 706.06, Wis. Stats.) to me known to be the person G.)..... who executed the foregoing instrument and acknowledge the same. Iii it THIS INSTRUMENT WAS DRAFTED BY P ............. .......................... ............................. .......atricia.-A...R.e.i.ii............................................. U.................................... ............................................... ............... N o t n n y P u b I I e ...............County,Wis. (SiLmature, cony be —thenticat-1 or wkno.-kdred. Both My Commission is permnsiciii.or not, state oxpirntlnn nre not necLssnry.) date: .. . ................ to........) aco Notary Pull State of Wisconsin _ ` 49164G NOV 16 Aq SL Cn a le West line of the NWI of Section 10 S000241 011W 0 3933.86' N UL 1312.96' :TO4 2.. I-U�O-TH STREEET 0 OD to 11 M Ct CL = irri cc CD rn eq CD ob lop co M IL 474.14' 0 APPROVED 0 East line of the SWJ of the NWJ of Section 10 1"N 0 -T. CROIX COUNTY ___4_ tionsive Planning Zoning and k If not recorded rn v.:.zhin 30 days of approval sliall be Bearings are referenced to the west line of the NWJ of Section 10, assumed to bear S0002410011W. CD VOLME 9 PAGE 2565 r • xY, SOMERSET 4N' PLAT T-31-N • R-20-19-W : E (Landowners) POLK CO. See Page 112 For Additional Names. ; ` -- 300 400 POLK/ST CROIX RD 500 600 700 800 _ N R z Tu i11 ^,0 31 David 3 Morten! Wayne tr a Opal •��- - 17 T 3 N3 a Atice °$ Pioneer • O Malik DKB Peterson Haase w s3+W 'omrd- _l h woTrust 72 is�y 32 .1 -H 44- 58 35 T^'✓ JR 9 �l ,= 41 c P. m Inc Leo a AM 0 Eduard Kowsld IF is 41 oc ittlow, n .5 C rte. z � & 1y 167 actin C venture o $waM 20 nsbbs n 3 5 e sarana &C 36 WOam p ma m -a h Christenson I•c.c Haase n + a c s 7 ` y7 154 r r s rt IR 1 232nd a M 24 Chu a Trust a k7r asusan 294 AVE ' C Mass tv to 230th AVE 3 21 N irate >: V41t WK �T o Donald& R o JR M 2 Y ary H I Fe;` °D Debra r 41 14 CaM AVE 5 $ • I y Potting 60 0 m N IN[g:AG ro : 7tmt Family yo Delaittre I 9 a Kinin x i 3 O S U 1 I e tr tz n 8 3 uoew a S Barbiri W E O ` ' I co ilOC xaosoo brmdt d'yn� 4 a SQ Mam xtl � 72 126 40 R INE Pasrt h rggg o sI aa a w sD.n 2m 0 AK a Eda s1 �uFourth y Edward I 35 Baptist Baptist 0 I 6 tal 114 Plourde ° 222nd I C`ro Elaine - FtF i "- IQ : 1221st Z0 AVE Family LP Trust 74,AVE 210 Cook 74 34 — -- — — 151 160 1 80 I �Iu� 11 40 22 C rtr °'""° 'no Wa�Lsh K�nart 31 e�y oar 4 aai� ohn a.s.3 Schaehtn 70 w3o .... ��I ��n 8 Family a.asN 40 r 50 O n a R AVE 21 t- ,� w1m y u rtnsa4 NB b d I ►� a � 18 tr 3 ° 271 I e tr \ �! 3 1 n Louis& lass =o tr 50 Tpy� n.s... d ohn 215th AVE 3 !] p Mer M A G ST 1�ray . CRO51 2ri s 79 5 Trust 16■r�v6s Inc 150 asb �y R I V Robert - B a C++ David `wr�bd- r°' MarOeB dF „ a � Carufel tr SShar�o A td'a' h1 i 4 30 2 21.1 3 79 3 210th AVE Wiaiter& J(� 85 CiCi�m>iD so r GgJ 's 3 5d c Martin Donald$ Debra 141 e. -a rra� g op. I a Renee el Germain � "u -_L- �.. 9 Otto Loin 19 1 4 4oI i�'rns't L 156 205th AVE° 2 Bo tr -- . �mtr Rivard 3 in, I 2 ,john y"Kai s ^ ss, A n ' 2 `ti DO 10� K � Wlckly 14 44 &Dvas a •r 20 ^>^o Louis& - O: • r c >o S 39 Lorraine 279 16 _ 23 ` x u h' - iadtej� 1r _ D E lkiml oseph $ $ 1; h AVE ph. _ &Dawn I3 n ; 7 rn4 8 Neumann 91 1 s` blsNr a - a IyfneCliff N o �.. y � I Partnership $A "s Elizabeth o- � _ n>,159 37 a 1`� ames 2 7 n nsa- Landry G 6 N_ R.. 79 n 192ntl Lew 40 ' SSampaip� rwu.ee i en-a B0 a uma b' 3 ^ s-a -Victor a Virginia LFi 99 U Dad FJaloe Lawson Donald D Ds l C g&C 24 F M� - 717 T� H 49 etal 49 40 � M Wr gg� rn - 111_-10 101 p6�-3 G 40 pp n _ OkP m� ^ LaD 0 r 3 L-dae .75 11 40 80I ■ A Il s "' 13 r. tr Samud I all ` - 't yy Belisle 1 a,t✓ia 90 m •ro 184th e t;. a• 14151 s 183rd pG w4T 40 m AVE fo 1P6a 541 f Q 4 merset SU vaW 115 �_ tr a tI 41 Lo 33 sa.: 180th AVE � RSET'S'PAGE 62 180th AVE 0 Utz "The Real Estate Guys" */,M W Team 1 Realty Buying or selling on this page David Bracht&Jack Harrison _ 712 Rivard Street,Suite 100 or Any other page call Somerset,Wisconsin 54025 Dave & Jack! Office:(715)247-5900 ■aI- Toll Free:(888)223-3283 "You've Fax: (715)247-4880 got a friend Dave's e-mail:dbracht@daveandjack.com in the business Jack's e-mail:jarrison@daveandjack.com J Website: www.davidbracht.com 60 J PUMP CHAMBER s 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: a� Trench: l Width: fob- Length: �E�_� Number of Lines: Area Built: A, Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, Rear,pt .,:9oo Number of feet from well: � Number of feet from building: `D (Include distances on plot plan). e-04 �- SEEPAGE PIT Y �� �� f� Cf� 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• t Dated: `" Plumber on job: License Number: 3/84:mj Form - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER h �`" TOWNSHIP ��Oji-i er S-c SEC. /,57)_ T ✓�6 N-R�W ADDRESS //�oX �y� ST. CROIX COUNTY, WISCONSIN SUBDIVISION ---- LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I1HR 83 :.`n SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM j 0dD U e - �•! ( -� I�Ica cc c r 5 " Da INDICATE NORTH ARROW �h en BENCHMARK: Describe the vertical reference point used 6 �a�� Elevation of vertical reference point: ,/ero, / Proposed slope at sat-- e: SEPTIC TANK: Manufacturer: Ze) -e .c A Liquid Capacity: dad c� Number of rings used: /L Tank manhole cover elevation: Tank Inlet Elevation: / Qd2 Tank Outlet Elevation: Number of feet from nearest Road: Front,O Side,Q Rear, O I'J�—p feet From nearest property line Front,OSide,O Rear,0 / feet Number of feet from: well/zo to e_/ building: H (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE S '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 SW4, NW4, S10, T31N-R19W 2%ONVENTIONAL ❑ALTERNATIVE State Plan I.D.Number Town o} N. Somerset Ilt assigned) ❑Holding Tank ❑ In-Ground Pressure ❑Mound 50th Street Pine Lake NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HO LDER. INSPECTION DA Ron Schachtner Route 1, Box 94F, Somerset, WI 54025 '7_3l- T7 BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN. REF.PT.ELEV.: CST REF.PT.ELEV.. Name of Plumber: JMPIMPRSW No.-. County Sanitary Permit Number: Byron Bird Jr. 3318 St. Croix 96068 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY. TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER Q 9 / PROVIDED: PROVIDED wuj�o �. (� `, I �, (�Z I l0 , ]U YES ❑NO EYES 1�iNO BEDDING: VENT DIA, I VENT MATL. HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM O C O LIN� 1 `I I AIR INLET: FEET FROM J �- DYES NO ❑YES NO INEAREST DOSING CHAMBER: MANUFACTURER. JBIEDDING LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ONO OYES ONO ❑YES ONO TO GALLONS PER CYCLE: PU MP AND CONTROLS OPERATIONAL. NUMBER OF PROPERTY WELL. BUILDING. LE FRESH (DIFFERENCE BETWEEN FEET FROM uNE AIR INLET. PUMP ON AND OFF) ❑ IV ENT YES ❑NO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH: LENGTH' NO. �F: DISTR.PIPE SPACING. CO VER INSIUE DIA. #PITS. LIQUID "BED/TRENCH �� TREMARIAL' PITDEPTHDIMENSIONS GRAVEL DEPTH FILL DEPTH LIST" PIPE IP PIPE MATERIAL NO.DI UMBER'O WELL: BUILDING. VENT TO FRESH BELOW PIPE ABOVE COVER. ELEV.INLET E EV.END PIPES FEET FROLINE AI LET �S �Iq.g5 2 2 5 2 NEAREST ou N Svf 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. OYES ONO SOIL COVER ITEXTURE PERMANENT MARKERS OBSERVATION WELLS 1-1 YES ❑NO DYES NO DEPTH OVER TRENCH'BED DEPTH OVER TRENCHiBED DEPTH OF TOPSOIL. SODDED. SEEDED. MULCHED: CENTER EDGES'. El YES ❑NO ❑YES ONO ❑YES 1-1 NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LENGTH. NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER. 0ED/i`RENCH TRENCHES. DIMEwows MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL IND.DISTR. DISTR PIPE AND DISTRIBUTION PIPE MATERIAL&MARKING: :I ELEV.: ELEV.: DIA.. ELEV.. PIPES. DIA.: EI:EVAi'JON 01S MBUTION INFORMATION' HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL PLANS VERTICAL LIFT CORRESPONDS TO APPROVED ❑YES ONO ❑YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF .PROPERTY WELL: BUILDING: FEET FROM LINE: OYES El NO EYES ONO NEAREST /0,.2 5 Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE / TITLE: DILHR SBD 6710(R.01/82) 1, �' Zonin g Administrator r j 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. Prcperty owner's name and mailing address. Provide the legal description where the system is to be installed; II. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. Responsibility statement: Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given 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 result of over 2 years of steady negotiation and public debate. The groundwater bill Ground ater included the creation of surcharges (fees) for a number of regulated practices which WisCO in's a can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried Tea5utB is used in your building is returned to the groundwater through your soil absorption e system or the disposal site used by your holding tank pumper. The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- f water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398(R.03/86) -- SANITARY PERMIT APPLICATION COUNTY �ILHR In accord with ILHR 83.05,Wis.Adm.Code 511`-Cro STATE NITA PERMIT# VRY 61� Ir -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 I. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES NO PROPERTY OWNER PROPERTY LOCATION D!a c `tG/!//�i!•^ sW%1j1W11., S O T , N, R` E (or PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME C CITY,STATE ZIP CODE PHONE NUMBER CITY EARE T ROA K R LANDMARK VILLAGE : -� 5A� -7 ;m ! II. TYPE OF BUILDING OR USE SERVED: U' p- IUD 7"' Ir 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. X New b. ❑ Replacement c. ❑ Replacement of d.❑ Reconnection of e.❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit## Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in##1 and only one in##2) 1. a. gConventional 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. C9 Seepage Bed b. ❑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): G (O 5 41 /Z /? Feet Private ❑Joint ❑ Public VI. TANK CAPACITY ## Prefab Site in allons Total of . Fiber-Manufacturer's Name Con- Steel Plastic Exper. INFORMATION New xisting Gallons' Tanks Concrete structed glass App. Tanks I Tanks Septic Tank or Holdina Tank flit 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/MPRSW No.: Business Phone Number: �a -*7 /o Plumber' ddress(Street,Ci y,State, 'Zip C e): Name of Designer: � t' /' c •� d�7 //tom �' VIII. SOIL T ST INFORMATION l000l Certified X��e,oi ter(CST)Name CST# i,s.�cT oa CST's AITDRfigS(Street,City,State,Zip Code) Phone Number: G Lr iG'�fC. �flpC7 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sa ary Permit Fee Groundwater Date Issuing gent Signature(No Stamps) Approved ❑ Owner Given Initial / SyJ�harge Fee Adverse Determination ,L�����1LL•��J7 ` �!� � S y �` �� L' X. C MENTS/REASONS FOR DISAPPROVAL: SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber a �., � . �. ��. r .gip a: 9 '� ` r`" �p y7��. , ��y`�:� � �°� �'` PLOT PLAN PROJECT lvh 1111e- ADDRESS C- . O;V 1/4 4t 1/4/,Vg lT,7/ N/R/�W TOWNA5,,< COUNTY �S���i►o� - ✓�` o�g-- MPRS Byron Bird Jr. 3318 DATE b _J, -5 2 BEDROOl � CLASS PERC_/ CONVENTIONALXIN-GROUN RESSURE CONVENTIONAL LIFT MOUND_HOL ING TANK SEPTIC TANK SIZE LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ABSORPTION AREA Gf:f- PERC RATE G3 BED SIZE /vZ �S- bk, Benchmark V.R.P. Assume Elevation 100' Location of Benchmark _ '"o,e * H.R.P. o -S de�.y<- lclay 0 Borehole Q Well Scale Feet O Perc Hole System Elevation TYPAR COVERING 2" 12" 3' 0 6' Q 3' 64 i 1 Sewer Rock 12' /�oZd �7ra IL t cry �!v � raw M JgAk goo . ^ . � � INSTRUCTIONS FOR COMPLETING FORM 115 ' SBD 6395 To be oomp|eteand uu',U1m?e Soil test,your mpor t mu'sl inn|ude! ' ` 1 C*rnr��Icu' |eqa'idnscri;"k,n; 2, Tho use,section must clearly indiootewhether this iwamuiclonneormommania| pnojeot; 3, K8AX|MUK8 number mf bedrooms mr commarciu{ uuw p|unn*d; 4, |v this a new oz' replacement sympm; 5, Complete thoouitobUity nuing boxes,ASITE IS SUITABLE FOR /\HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED OW SOIL CONDITIONS; 6, PLEASE use the mbbewimionyshown horn fo/mhting profile dou:riFtin^sand completing the plot plan; 7� MAKE A LEGIBLE diagram accurately locating your test locations. DrmyinSto scale is preferred. A separate sheet may be used if desired; , & Make sure'Your benchmark and vertical elevation reference point are clearly shown,and are permanent; 8, Complete all appropriate, boxes ass to dates,names,addresses,flood plain data,poum|atiun test ouenop' ,iun' ifopprnpri'to; , lQ, if the information (Suuh as flood plain,elevation)d000 not apply, place N.A.in the appropriate box; 11� Sign the form and place your current address and your certification nvmbe ; 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS 0FCOMPLETION. ` ^ � ` ABBREVIATIONS FOR CERTIFIED SOIL TESTERS � ` Soil Separates and Textures Other Symbols m — Ston (over 10") 8R — Bedrock cob — Cobble i3 10'') S8 — Sandstone 0, — Gravel (undcr3'') LS — Limestone °s — Sand HGW — HighG,uundwate, cs — Coarse Sand Pero — Percolation Rate —'- med s — 0mdiumSond I VV — Well ts — Fine Sand B|d0 — Building Is — Loamy Sand > — Greater Than / Sandy Loam ( — Less Than °| — Loam Bn — Brown °sU — Sih Loam 8| — Black Si Silt Gv — G,uy °o\ — QovLoum Y — Yellow od — 3oodvC|ay Loam R — Rod oio| — Gi|tyQuvI uam mot — K8mt|eo �c _ Sandy Clay vv/ — with ` / silty Clay *ff — few, fine,-faint � °x — Clay cc — Common, coarse ' pt — Peat mm — Many, me ium m — KIunk d — distinct v — Prominent ' HVVL_ — Highwa�rlevel, ` ° 3ixgnnmmi mh| �xt�mm ,odaneWater fn/\iquidvvastadisposal 8K3 — Bench K8u,k VRP — Vertical Reference Point � , ' TO THE OWNER: ` : | This soil test report bthe first step in securing o sanitary permit. The county wthu Department may request � verification of this soil test in the field prior to permit issuance. A complete se* of plans for the private sewage system and a permit application must lie submitted to the appropriate local authority in order to obtain u pn,nmit. The sanitary permit must be obtained and posted prior to the start of any construction, � ` 1 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) P.O.MADISON WI 7969 HUMAN RELATIONS (ILHR 83.09(1) & Chapter 145) LO©ATION:, SECTION: OWNS /MUNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: COUNTY: OWNER'S/BUYER'S A E: MAILING ADDRESS: -S� rs� s USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PER OLA-�IOON TESTS: Residence New ❑Replace `✓, g� �Z_ c RATING:S=Site suitable for system U=Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK:RECOMMENDED SYSTEM:(optional) S ❑U S ❑u ❑U ❑S U ❑S )1610U If Percolation Tests are NOT required DESIGN R ATE: If any portion of the tested area is in the under s. ILHR 83.09(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.) B- l /�� �`. Oti e B- M4X B- G f PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER 690066 AFT RSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD 3 PER INCH P P- 02 P- 3 M,.1"t 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. SYS EM ELEVATION 9� Xc�/�."�F')a' • j 11153 lke _ a - • • • � sloe- �,o • F • I,the undersigned, hereby c r i that the0jeests rep on this form were made by me in accord with the procedures and metho specified in the Wis nsin Administrative Code,and tha ata rec�&red and th c ion of the tests are correct to the best of my knowledge and belief. NAME(print): P TESTS WWERE COMPLETED ON: ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): CST SIGNATURE: DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395(R. 10/83) —OVER — L 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 SCC.) 19 '�Z 1%, Section , T,5J N-R_Zf W Township Nailing Addresses f r Address of Sitejt � Subdivision Name . Lot Number Previous Owner of Property 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 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 (Wfl cents that ate a.ta tementrs on 6y this orun ane #Au e to the best o6 my (out) knowledge; that 1 (we) am (cute) the owneAkf o6 the pnopenty deachi.bed in .th,i,a to o4ma tl on 6 6o4m, by v.ihtue o6 a warvcanty deed necon.ded in the O �.ce o the County Reg4Aten. o6 Veedisa�s Vocumen.t No. and that 16(We) phehentty own ,the pnopoaed 6 to bon the sewage daPOSat 6 yes em (on. I (we) have obtained an eaa )nenx, to nun with the above deacA bed pnopenty, bon the cona-tAucti.on o6,_Ajid aotem, and the name has been duty tecotded in the 066ice 06 the County Reg,i.a.ten o6 Veedd, ae Docment No. ) . SIGNATURE 01 OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED Ronald and Patricia R. Schachtner Route 1 , Box 94F ' .h Somerset , WI 54025 Thomas C. Nelson St . Croix County Zoning Agency ,`:,� . DUKE PO Box 98 , 1030 Davis Street Hammond , WI 54015 As a result of our discussion about parcelling off the area of land where we are building our house , we have contacted S & N Surveying . They will survey the parcel and send a description of the area to your office as soon as their work schedule permits . If you have any questions are need additional information , feel free to give us a call at 247-5534 . Thank you , Patricia Reid Schachtner f �^( �12i a' Wyk^ 21 Tricia B. Gruen Notary Public—Minnesota M Hennepin County -- Comm. Ex .ate Y P•9.5-91 H N y 9 r ST C - 105 r 9 H SEPTIC TANK MAINTENANCE AGREEMENT o St . Croix County z d tzJ OWNER/BUYER 'C�� C"J�Ti /2 ROUTE/BOX NUMBER e7- 99/-- Fire Number CITY/STATE 0,4,7 E ZIP t �'j PROPERTY LOCATION : 14, t? �, Section_, T / N , R _W, Town of SC/�`J �S � 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 . H O z 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 DATE St . Croix County Zoning Office P .O . Box 98 Hammond , WI 54015 715-796-2239 or 715-425-8363 Sign , date and return to above address .