Loading...
HomeMy WebLinkAbout034-1002-10-100 \ 0 . \ D � i § § � k ) � a � ] [ \ / g 5 $ z § U. 0 / / ) ®) § < C2 ± � = n ƒ § \ z . § z / ) § z a m I S � B z ® c \ t z :!t J a \ m @ r = 2 2 / & e k N CL n } . c -� ƒ /) / o / $ .. } § t c 2 ~ � 6 3 § 2 7 : 7 � a { A r \ § o a 2 £ ® k \ / k k k 7 \ � n } � - 0 2 2 2 . ) \ \ \ \ D I \ \ \ o E \ ' n \ J � < § c c k 2 / \ / _ ) E o � 2 \ 8 $ a J 8 8 _ . e c 2 2 a o d k \ ` \ � § � \ \ G . w \ \ k / § D o n : R 0 z 5 e ■ @ % . I f } M C m � 0- 0 k k J a 3 & J Parcel #: 034-1002-10-100 02/13/2006 05:24 PM PAGE 1 OF 1 Alt. Parcel#: 02.29.15.176 034-TOWN OF SPRINGFIELD 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-TEIGEN, SCOTT J&KRISTI A TRST SCOTT J &KRISTI A TRST TEIGEN 1274 RUSTIC R4 GLENWOOD CITY WI 54013 Districts: SC=School SP=Special Property Address(es): '=Primary Type Dist# Description " 1193 RUSTIC RD R4 SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 10.150 Plat: 1598-CSM 06/1598 SEC 2 T29N R15W NE NE LOT 1 OF CSM Block/Condo Bldg: LOT 1 6/1598 EXC PT TO NSP ALSO COM NE COR NE1/4 SEC 2;TH N 88 DEG W 797.67';TH S Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 00 DEG E 83.05' POB;TH S 00 DEG E 02-29N-15W NE NE 833';TH N 89 DEG W 531';TH N 00 DEG E 833';TH S 88 DEG E 10.59';TH S 12 DEG W more Notes: Parcel History: Date Doc# Vol/Page Type 05/01/2003 719723 2227/133 WD 04/09/2003 716478 2199/401 TI 07/12/2002 683956 1926/37 QC 02/14/2000 618282 1490/21 WD more 2005 SUMMARY Bill#: Fair Market Value: Assessed with: 81811 160,600 Valuations: Last Changed: 05/26/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 12,950 119,100 132,050 NO UNDEVELOPED G5 8.150 6,700 0 6,700 NO Totals for 2005: General Property 10.150 19,650 119,100 138,750 Woodland 0.000 0 0 Totals for 2004: General Property 10.150 19,650 119,100 138,750 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 113 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 PUMP CHAMBER Manufacturer: Liquid Capacity: Pump el: Pump/Siphon Manufacturer: P p Size Elevation of et: Bottom of tank elevation: Pump off switch elevat Gallons per cy6le: Alarm Manufacturer: Ala Switch Type: Number of feet from nearest propert ine. Front, '.. Side, O Rear, Ft. Number of t from well: Numbe feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: / �7 0 Width: r Length: U Number of Lines: v`. Area Built: 7J�U Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side,Rear,O Pt D Number of feet from well: �� Number of feet from building: y� (Include distances on plot plan). SEEPI�GE PIT Si Number of pits: Diameter: Liquid the Bottom of seepage pit elevation: Area Built: Has either a drop box or distribution box O b used on any of the above soil absorbtion sytems? (Check o ). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevati of bottom of tank: Elevation of inlet- Number of fee from nearest property line: Fro , O Side, O Rear, OFt. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: �� o� g_ (�� Plumber on job: +�G License Number: AI jJ 14!5) 3/84:mj -tqk Z ` ? Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER f. 6?I A /CJd TLiQeN TOWNSHIP /Iiq/:_l Gd SEC. 2. T t�f N-R 1-5--W ADDRESS ST. CROIX COUNTY, WISCONSIN ���NGrJd Oct G'' % 1�V � �'� ✓� y0/3 SUBDIVISION LOT ,©LOOT SIZE PLAN VIEW r Distances and dimensions to meet requirements of IIHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM N 3 U N '20 „.oini+e tR e e 9M f ��/ S�pt-iC rAnlK r vzNt-s 66 AZ W INDICATE NORTH .ARROW ope t C BENCHMARK: Describe he vertical reference point used _See BUR�t w iit, Elevation of vertical reference point: 10a ! Proposed slope at site: SEPTIC TANK: Manufact firer: 4,1' 2 A�S Liquid Capacity: /oy-D e'—A4 Number of rings used: ,�_ Tank manhole cover elevation: Tank Inlet Elevaticn: O, Tank Outlet Elevation: =f�, 'ZI-2 Number of feet from nearest Road: Front,w Sideo Rear, O /a 1 yet From nearest-troperty line Front 10 Side,®Rear,O C'j f :et e Number of feet from! well building: „Z (Incl,mlp this information of the above plot plan)( 2 reference dimensions to septic ank) SEE RFVFRSE SIDE r II 'DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS ON I LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS BUREAU OF PLUMB DIVISING P.O.BOX 7969 MADISON,'WI 53707 CONVENTIONAL ❑ALTERNATIVE State Plan l.D.Number'. NEB,NEB,'S 2,T 2 9N—R 15W (11 assigned) Town of Springfield ❑Holding Tank El In-Ground Pressure ❑Mound Rustic Road 4 NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Leland Teigen Route 1, Glenwood City, WI 54013 0._ 9 -1'7 0;� BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF.PT.ELEV. Name of Plumber. MP/MPRSW No County: Sanaar PPermit Number: Gale Smith 5690 St. Croix 102798 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIOUID CAPACITY. TANK INLET EIEV.. TANIK�Oy7LE T.,E LE V.. WARNING LABEL LOCKING COVER 1 4f G? f" PR IDED. PROVIDED: ff YES ❑NO ❑YES NO BEDDING VENT DI VENT M TL HIGH WATER NUMBER OF ROAD: PRO PERT WELL: BUILDING. VEN O FRESH ALARM FEET FROM / LI"� Q (AIR INLET ❑YES NO OYES NO NEAREST DOSING C AMBER: MANUFACTURER BEDDING-. ILIOUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED: PROVIDED. ❑YES ❑NO ❑YES ❑NO ❑YES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH LINE AIR INLET (DIFFERENCE BETWEEN FEET FROM PUMP ON AND OFF) DYES ❑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' NO OF DISTR.PIPE SPACING COVER INSIUE DIA rtPIiS LIQUIBED/TRENCH TREOdCAES / -^ ^ MAjfRIAL: PIT DEPTH DIMENSIONS S GRAVEL DEPTH FILL DEPTH IDIST R PIPE DISTR PIPE DISTR.PIPE MATERIAL: NO.DISTR NUMBER OF IPROPE RTV WELL BUILDING VENT TO FRESH BELOW PIPES ! ABOVfCQVER ELEV INLET ELEV frND. t",7 PIPES FEET FROM LINE? NEAREST-� MOUND SYSTEM: 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- meets the criteria for medium sand. TIONS MEASURED. El ❑NO SOIL COVER ITEXTURE PERMANENT MARKERS Of1SEHVATION WE LLS ❑YES 1:1 NO El YES El NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED =PSOIL SODDED SEEDED MULCHED CENTER EDGES ❑YES El NO DYES ONO ❑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 MANIFOLD MATERIAL NO DISTR GIST R.PIPE DISTHIBUTION PIPE MATERIAL&MARKING; ELEV.. ELEV.. DIA.. ELEV.'. PIPES DIA.: ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL PLAN$CAL LIFT CORRESPONDS TO APPROVED OYES ❑NO OYES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL'. BUI LDING FEET FROM LINE: 0 l 0 ❑YEES ONO ❑YES 1:1 NO NEAREST � ss - � 31 Sketch System on min county fite'�for audit. Reverse Side. SIGNATU r.A."�...•-" TITLE Zoning Administrator I DILHR SBD 6710(R.01/82) INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION TO THE APPLICANT: 1. This sanitary permit is valid for two (2) years; 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable; 3. All revi,$ions 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; 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% 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 Nit 8r included the creation of surcharges (fees) for a number of regulated practices which Wisco In'S can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried resure e is used in your building is returned to the groundwater through your soil absorption u system or the disposal site used by your holding tank pumper. a 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- t water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398(R.03/86) SANITARY PERMIT APPLICATION COUNTY (�MiLHR In accord with ILHR 83.05,Wis.Adm.Code STATE SANITARY PERMIT# /6 'Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER 8''h x 11 inches in size. —See reverse side for instructions for completing this application. PETITION I. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE El YES 9NO PROPERTY OWNER PROPERTY LOCATION % '/4, S _2 T„2�/ , N, R r)W PRO ERTY OWNER'S MAILING A RESS LOT NUMBER IBLOCKNUMBER SUBDIVISION NAME �— CITY,STATE r ZIP CODE PHONE NUMBER CITY NEAREST ROAD,LAKE OR LANDMARK yj 10 TOWN OF-El VILLAGE : O of AS JV II. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family OR ❑ Public(Specify): III. PURPOSE OF APPLICATION: (Check only one in##1. Check##2,3 or 4,if applicable) 1. a. ❑ New b. ® Replacement c. ❑ Replacement of d.❑ Reconnection of e.❑ 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. Z Conventional b. ❑Alternative C. ❑ Experimental 2. a. ❑System- b. ❑ Holding C.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. ❑ 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): ❑ Feet Private Joint ❑ Public VI. TANK CAPACITY Site in llons Total #of Prefab. Fiber- Exper. a INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete strr cted Steel glass Plastic App Tanks Tanks Septic Tank or Holding Tank X ❑ 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) P PRSW No.: Business Phone Number: SM Plumber's Address(Street,City,State,Zip Code): Name of Designer: VIII. SOIL TEST INFORMATION Certified Soil Tester(CST)Name CST# 6 e .Stiff 1 'f-,q CST's ADDRESS(Street,City,State,Zip Code) Phone Number: IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) Di Approved ❑ Owner Given Initial a Srrc�h'arge Fee ' " j-j '-*_ — Adverse Determination �/�`— d "�o�J '�� o ' /' O � X. CO ENTS/REASONS FOR DISAPPROVAL: SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber APPLICATION FOR SANITARY PERMIT S T C - 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 Z-zt,,x GU �.� Location of Property , � _N . Section �_, T N W - R / Township Mailing Address / Subdivision Name Lot Number f Previous Owner of Property Total Size of Parcel - -2 � ___ - Date Parcel was Created Are all corners and lot lines identifiable? x Yes No Is this property being developed for resale (spec house) ? Yes No Volume and Page Number 11:fZ as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: Warranty Deed 2. Land Contract 3. Other recordings filed with the Register of Deeds Office In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (We) ceAti6y that a.0 statements on .th.ia bonm ane tAue to the beat 06 my (ouA) knowledge; that I (we) am (ane) the ownen(b) oA the pnopenty dachi.bed in .thin .in�oAmation �oAm, by vi tue o4 a wwftanty deed neconded in the 066ice 06 the County RegisteA o� Deeds as Document No. �' and ha 1 (we) pneaentey own the puposed s.c to ion the sewage pod system (on 1 (e have obtained an easement, to tun with the above desc�ri.bed pnopeAty, 4on the co"tAucti.on o6 said ystem, and .the same has been duty neconded in the 0 ice o6 the County Re en oA Deeds, as Document No. D ) • SIGNATURE OF OWNE SIGNATURE OF CO-OWNER (IF APPLICABLE) DA E SIGNED DATE SIGNED DOCUMtNT NO. sun us W A This Y. w I 9. ' 4 a9 x ....1i�i ..-...._..Deed, ..d. b«�.... :O.-•Tei eat.a«�. �r."� �. ..... IL am C06 •«•....•..................................................................................... Z�' ..i........I+did.9.. bipas.............................................•............._...... . ..... ..... ....... ................................................................................. k ........... .... ......... . . ................................. .................................................................................................. , Wltnesse th. Tbat the afid Q=tw,roe a•alaabie eearidwatiea...... of,-ola doll=.and.otb=.vA1%& e..0maidwitJCM............... as�wns. aea••trs to Greater the followias dsseribW real•sam is ............8r...Ck0jX.... Coaaty. State of Wisconsin: • 90 A part of the NB 1/4 of NE 1/4 of Section 2, Township 9 North x'79 fast Tom P • . of field, St. Croix County, Wisconsin dewwibed as: Tat>nseesiNat Lot 1 of Certified Survey Mep No. 1598 reoorded , Octaber 28, 1985 in Volume 6, page 1598, as document #406509. O.Oo, P .v� yj�yjyy This ka.."09! ............... hesseetieed . Xk) (if net) ".x?9 Together with all and singular the hereditaaw.ts and appneteaaneas tberanatn bsieaghlt- • And...X11 QVifi .0...1$ ............................. ..».....«« warrants tbat the title is goode tadefaasible in fee simple and free and e4ar et a age abraacee resell recorded Protective covenants, ®asea>MbIl and restrictions of record, if any a and M iU wamat and defend the same. } Dated this .. ..� 1........ ................. ... day of .....DY .. . . ... ..... .... .............. •_.., 1l..�r.. (SEAL) U� l . � r r' ..................... .... .......... .. ... ... ..._.....QR. ............. . .............. .._ .(SEAL) . .... (ssAL) a ' ......... fl AUTasNTICAT=ON ACKKOWLSDGM NT &gaatar+(s) . . .................... .................... STATE OF WISCONSIN ft. Croix a 1 J anthenticated this ........day of.......................... 19...... Personally came before sue thL —6tj%..-...-JbW at .................................................................. .....RPr [4 7C..............._..... lA .« the ebm wMad 7! • ..............7agYald�.. ....««-..................«. la .......... ....................... ........................................... TITLE: bfE1IBE$S ATE BAR OF WISCONSIN �J ...............................................vM" � (If not. .. .:.... ........... ....... .... .. _..»..................................r:'-.. `- anthorisW by 4 706.06. Wis. Stets.) _ t '•c....•......... to me known to be the parspi�c; t instrnao►ent and the THIS INSTRUMENT WAS DRAFTED By � ftobert F. Wall .-.... .!.. ... `. _r......... 522 Seoorid Street, P.O. Hox 15L .J ...-..M...Git�so n- _- !' ................... ........... fty-Isom W1. ..54016................. .._................... Notary Public .....St.. (Sirnatums may be authenticated or acknowledged. Both my Commission if Pe �(fi .so eta 0 data: are not necessary.) . 4-17-t38.... .... . .... �!d...'ly. .. 1l.........) 1 •Nw or P•rwr•iefife if AnT eavacitq•bAwld be UDai or t-rinW beluw owir mgfatur". �. WAaaAN" t asa aTATR asn or V t�.a w esa rem lift t—rep SURVEYOR'S CERTIFICATE I, Leon R. Herrick, Registered Land Surveyor, hereby certify that I have surveyed, divided and mapped a part of the Northeast Quarter of the Northeast Quarter of Section 2, Township 29 North, Range 15 West, Town of Springfield, St. Croix County, Wisconsin, more particularly described as follows: Beginning at the northeast corner of said Section 2; Thence N 89055111" W, 928.43 feet to the point of beginning; Thence S 03000100" W, 300.41 feet; Thence N 89055111" W, 343.84 feet; Thence N 07003'56" W, 201.53 feet; Thence N 11046'21" E, _102.18 feet; Thence S 89055111" E, 363.50 feet to the point of beginning. Said parcel contains 109,400 square feet (more or less) or 2.51 acres. That I have made such survey, land division and map at the direction of Leland Teigen, Box 178, Route 1, Glenwood City, WI 54013, for Ingvald and Olga Teigen, owner of said property. That such map is a correct representation of the exterior boundaries of the land surveyed and the subdivision thereof made. That I have fully complied with the provisions of Chapter 236.34 of the Wisconsin Statutes, Chapter A-E 5 of the Wisconsin Administrative Code and the subdivision regulations of St. Croix County in surveying, dividing and mapping the same. Said survey is subject to existing roads and easements of record. DATED THIS Q 6* ZDAYOF �! B —�Q 1985. Leon R. errick egistered Land Surveyor LEON R. HERRICK S-1303 - R • MENOMONIE• ; %� Wis. Vol. 6 Page 1598 PAGE?OF-. i : FILED OCE28.)985 110 JE3 O'CONNIU Rpffrr of 406501 44 crou 4 _'_!/ CERTIFIED SURVEY MAP NO. 1598 Z VOLUME 6 , PAGE 1598 LOCATED IN THE NORTHEAST QUARTER OF THE NORTHEAST QUARTER OF SECTION 2, TOWNSHIP 29 NORTH, RANGE 15 WEST, TOWN OF SPRINGFIELD, ST. CROIX COUNTY, WISCONSIN. N. 1/4 CORNER OF SECTION 2. U N P L A T T E D L A N D S (FOUND 3/4' RE-ROD.) -- - - - ' - -- --- '- N E. CORNER OF SECTION 2. (SET 2"IRON PIPE WITH ST. N. LINE OF THE N.E.114 OF CROIX CO,BERNTSEN ALUM. SECTION 2 CAP IN CONCRETE.) -/340.65= p FENCE s5' S 89055'11"E S 89 5511"E _X-�i X o N 89 55'11"W 1,316.29' 4. 363.50' V 928.43' -- W N.W. CORNER OF THE N.E.1/4 OF N . THE N.E.114 OF �!p 0 SECTION 2. C -, hi p QI 21 CM �RiV QI of 4Y _4 -Ij cf NTFQG�,yE 3 O `\ WELL 3 d OI O g WI of °t O 1`, 0 �i LO T I p aj .ql109,400 SO.FT.• HOUSE Ix -it a t__ O 2.5/ ACRES 21 0 O N WITH RD.R/W J1 ZI Z 101,100 SQ.FT e �I 2.32 ACRES WITHOUT RD.R./W 33.25' 3)0.59 APPROVED N 89055'11" W 343.84' v i ACT 02 1984 UNPLATTED LANDS ST.C-Mx COUNI Y 616' CI?D MMENSINE PAk;ZS MANNING 41M ZONNv COMAVtiEE 33 133' W LEGEND Z }` W SECTION CORNER (AS NOTED.). a? ~ v SET I 4 n x30 n RE-R D. WEIGHING I � O o 4.30 LBS./L.F. BEARINGS ARE REFERENCED " O SET 314"x 24"RE-ROD WEIGHING TO THE NORTH LINE OF THE SCALE: = I O® 1502 LBSIL.F. NORTHEAST QUARTER OF SECTION 2, T.29 N.,R.15 W. 0� 50� IOC/ 2G0' (ASSUMED AS S89055'11"E.) •���•S.C'rrrr�•q..• PREPARED FOR: LELAND TEIGEN R * w• eox 179,Rourf l I,.RRICK " GLENWOOD CITY,WI 54013 5-1303 OWNER:INGVALD a OLGA TEIGEN MENOMONIE, RFD I % V1JIS. • iv GLENWOOD CITY,WI 54013 ��♦ ����S�ss��/��e��� ♦ �,9 ............ ''�� SURVt ''00 CEDAR �rPORArICN C04 W1,SON AVENJE Vol. 6 Page 1598 A'ENO6ICN/E,WI 54751 1715123°-9091 PAGf L OF 2. z N a r ST C - 105 r • a H SEPTIC TANK MAINTENANCE AGREEMENT o St . Croix County z t7 I I��YY//11,,�� n a OWNER/4&3=P-Ol.� ctnd tJ NLGc� �� ^ �� M ROUTE/BOX NUMBERR /Jd� Fire Number`/ .CITY/STATE -- -ZIP PROPERTY LOCATION :,&,E_� ;4, Section- sZ_, T,2- ,FN, R_Zj--W, Town of /4/--i^�Lo� 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 pdt 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 0 E 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- 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 y � St . Croix County Zoning Office P.O. Box 98. Hammond , WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address . r- EM, 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES � S DIVISION OF HEALTH,BUREAU OF ENVIRONMENTAL HEALTMF 3 P.O.BOX 309 MADISON,WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TES S.i �;- LOCATION: %, ' t T�N, R��W,Township or�� Lot No. , Block No. County - T I Subdivision Name Owner's Name: Mailing Address: ' e 1~ TYPE OF OCCUPANCY: Residence X No.of Bedrooms —7 Other EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT X DATES OBSERVATIONS MADE: SOIL BORINGS .Z•O P1 PERCOLATION TESTS 5�-•3-Z�.�� SOIL MAP SHEET - —Z SOIL TYPE A /N PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL,INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 PI 8 e- Ale30 [P-33 ;L 0, 1 1 1 / JF P-71 SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER,INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) f 11 JOY B_ ? >7;L" 8 is i 3 ".S G 1--) y ., S•C3. 2- O " 72 O 6 " o `' j " x a PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitabb areas. Indicate umber of square feet of absorption area needed for building type and occupancy. 2 Indicate scale or distances. Give horizontal and vertical reference points. Indicate SAW lv - /0 �• — � 3 3 o ' s 10� N — — -- — – 0 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 location of test holes are correct to the best of my knowledge and belief. Name (print) p,��L e SM/ �/% Certification No. ���� Address—nom ��edv Zg o v d C/�`V /� /• Name of installer if known GA-<e -' M%71-N f.npv A—i nnal Al ITYAnRITY CST Signature r c Smith Plumbing & Heating PHONE (715) 265-4838 ^ GLENWOOD CITY, WISCONSIN 54013 y N/l�L iN „�v�� piiv cs t/7C� b pl- 10 Cc rmb 0 s-ys t-e m Z-z,4 e v5. v e. ---'--A 00 loollo T'yPN� G Re e4 b �► o c0 p �a f— 5