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HomeMy WebLinkAbout020-1365-09-000~, ~~~, ~~~ ~ f ` ~-~~>~ ,~~ ~ ,~"` nxuuilnuu, ~ `~ ~ ~_-- IINM ^~ ~ ~ ~".:gin. ~ Il lld _.. -, a ~` ~.,~,_ ~- , . i _ ,.. _- March 13, 2001 P.C. Collova Builders Attn: Laurie 705 County Trunk E Hudson, WI 54016 ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 Fax (715) 381-4686 RE: Septic Inspection for P.C. Collova Builders located at 653 Laurie Lane, Riverpark Meadows (Lot 9), Hudson Township, St. Croix County, Wisconsin Dear Laurie: A septic inspection of the above referenced property was conducted on 11/30/2000. This property is located in the SE 1/4 SW 1/4 of Section 15, T29N R19W, Riverpark Meadows (Lot 9), Hudson Township, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a four (4) bedroom home. If you have any questions regarding this, please contact our office at (715) 386-4680. Sincerely, F. ~~~ e ~ n So ntag Zoning Technician /sm cc: file s ' ,.~.....aspo. .. ..n.,.....w.w ~....~ ._............... ..~. ... .. rayow~~ Division of Safety and~Buildings ~n aa:oraance wiui ~.omm oa, vvis. twm. was - Couniy 81/2 11 in in i Pla must h h l l t l th A t t it x c es s ze. n comp an on paper no ess an t ac e e s e p include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Govt Lot i(J E 1/4 ~}t/4 S ~S T L N R j cj E (or~ Property Owners Mailing Addre Lot # Block # .Name or CSM# City State Zip Code Phone Number ~ City ^ village ®.Town Nearest Road n, ~ c . a . (~ New Construction Use: ~ Residential / Number of bedrooms _~~'~ Code derived design flow rai!e ySG?/G D d GPD ^ Replacement ff ^ Public or commercial -Describe: Parent material US~TtLtC.~ S ~ Ftood Plain elev on if applica~r.. ft. ~`. r, General comments S YSfi ~'-'~ ~(ttla 1 ~'a ~` ~ (~ . 1 f~ ~ = `'' '_ ~} and recommendations: ~ r': Ifs V 'f'• t ~`Q.11 ~ ~.~b n. a G . J d ~ ... t. -; ~, ~ _ I~ ~"' g r~ C l ~('!~' - 1 1~ /`~-` /. l ~ ~q )k ~. 1 R/~~ ~ ~/ s ~.r~l 13or: ~q S ~ls ~'-, ~ ` ~r~~/i. Z~NI~'+I~~ i`~'~ ~- . N6 BF'F7~~ ,. Boring # ^ Boring ~~ \~,~~/' _ - _ _ ~.~-~ c1T (~ pit Ground surface elev. •~Qd ft. Depth to limiting factot~- ~' ~ ~ ~ ~z Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fP in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. *Eff#1 'Eff#2 I 0- z ~ ~-- s- i ~ -~ c s -- - 5 •$ Z ~~ rns D ml - - .'7 1 Z Boring # ~ Boring Pit Ground surface elev. • ~~ ft Depth to limiting factor ~~ in. Soil liption Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. *Eff#1 'Eff#2 Z ~ -zZ i --- -~'r ~ s ~-- . 5 .9 * Effluent #1 = BODg > 30 < 220 mg/L and T55 >30 < 150 mg/L ° tmuent ~~ = rwu5 ~ au mgrs ana ~ a~ ~ ~u « ~~ CST Name (Please Print) ignature CST Number l~r ~'/r~1 ~ ~w a~ ~ ,--~~< ~~-_-_~ ZS3 Gam/ A~~ Dabe Evaluation Conducted Telephone Number Z// 3 ~'~ S~ ~~.e rs e--~ ~ Gr// ,502 .S' //- S`"- o U ~j,5 , z y7- Gov ~ Property Owner CO ~~O (f a Parce11D # Page ~ of 3 Boring # ^ Boring >~ Pit Ground surface elev. 9q..~ ft Depth to limiting factor 131 in. Soil lication Rate Horizon Depth Dominant Color Redox Descxiptbn Texture Structure Consistence Boundary Roots GP DIft? in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. *Eff#1 *Eff#2 i -t ~-- gel c, - . 5 .8 ~ L -` "- . ~ 1.2 ^ Boring # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting factor in. Soil licatbn Rate Horizon Depth Dominant Color Redox Description Texture Structure . Consistence Boundary Roofs GP DffF . in. Munsell Qu. Sz. Cont Cobr Gr. Sz. Sh. 'Eff#1 *Eft#2 [] Boring Boring # ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 * Effluent #1 = BODS > 30 < 220 mglL and TSS >30 < 150 mglL * Effluent #2 = BODS < 30 mg/L and TSS < 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-2648777. ssv-s3ao ~x.o~roo~ PAGE~OF NAME ~p ~ I nya~ LOT# _C LEGAL DESCRIPTION N~'~4~/LI/4,5 I,~T IQ,N,R(Q E (or) SCALE: I" BM 1 ELEVATION rQ~ •U BM 1 DESCRIPTION ~{,pp a \r Goa<<•}r.'c. Qoy BM 2 ELEVATION ~ ~, q (/ BM2DESCRIPTION ~-p~ p~ ~oc,>~4a~e'~~n SYSTEM ELEVATION ~(,~~6 ALTERNATE ELEVATION 7 ~i • ~ U ~ K 1 t .~ t r 1 ~ ~ /* x '' Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safeiy and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice may oe usea for secondary purposes Irnvacy Caw, s.~5.04 (1)(m)] Permit Holder's Name: ^ City ^ Vi T n of: P.C. Collova Builders, ~t~dsgn'4'ownship CST BMElev.:- Insp. BM Elev.: BM Description: lb 4 s~ ,~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. vent to Air Intake ROAD Septic > ~p ~ C/ Z ~ ~ / NA NA Aerati NA Holding PUMP /SIPHON INFORMATION Manufacturer Demand Model Number M TDH Lift Lriction S stem TDH Ft For ain Length Dia. D. Well ELEVATION DATA countySt. Croix Sanitary,2er~yi$,~lo.: State PIJanL /~IFFDL ~NL 7o~L.: Parcel Ta~~lol'365-09-000 STATION BS HI FS ELEV. Benchmark 3,D az b t. Bldg. Sewer ~St Ht Inlet Ht Outlet ~ Z ~, Header /Man. Dist. Pipe ~ ~ ~ s- Bot. System c~ G' 9 PS 2 Final Grade ~ ~ ~! St cover Z r P f S~ SOIL ABSORPTION SYSTEM /~ ~ /_ ~ _ , ~ _/ BED / ENC Width i Length , No. Of Trenches w PIT No. Of Pits Inside Dia. Liquid Depth DIME 3~ ~S Z DIMEN I N SYSTEM TO P/ L BLDG WELL LAKE /STREAM L ING Manu acturer: ~ SETBACK r INFORMATION TypeO ~ ~ ~ CHA T Moe umber: System:, Sb Q -- I DISTRIBUTION SYSTEM Header / Mani old / ~ r l ~ Distribution Pipe(s) ~ ~ x Hole Size ~ x Hole Spacing Vent To Air Intake 4 Dia. Length Length ~, ~,~ Dia. ~^ Spacing /~/ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ^ Yes ^ No ^ Yes ^ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: ~~ / ~D/DD Inspection #2: / / Location: 653 Laurie Lane on WI 54016 (S 1/4 SW 1/4 15 T29N R19//W) - 152919216/9 Rive/rpark Meadows -Lot 9 1.) BM Description ~'P ~o~af~o~^- 3, o ~Stv~ ~}~o ~.. p-/~r 5 iti s 1~~t(/(~ :n 3~ Chah~Nr torn caG~i cne! 2.) Bldg sewer length = Z/ ~ ~~°~`st~ -amount of cover = ~ 3jp`/ Y) wo ~~ l~ `'~ ~"'~~ `, .~~ s 5 ~~ wNV~~ 9~O ~ P-w /~. ~a.~ ~-.. ~ n.~ cc~ ~'c v.`s ,`on ~i/ 7Lc5~ d~P~~~O/OZ<~Qr/iis~~I~P's0 Plan revision required? [~ Yes ^ No (~ Use other side for additional information. I SBD-6710 (R.3/97) Date Inspector's Signature Cert. No. 1053 (,}~-~,~ ~~ can) . Sanitary Permit Appiicatia~n ', safety & Buiidin$s vivisio r !n accor9 ~+a~ Comrt 83.21. >a'±s. Adm. !'ode ~ 201 w', Washington Avi `~~~rQi~.~~hi See reverse side for insructions for ear^ !etin thts a plicat~an PO Bax 730 Personal inforrttatio!! you provide ma} tse used forgsecondan purposes I~ Madison. Wt 337f!7.730 Gepartmsnt of Gommerao ~ [Privacy Lain. s. 15.04! 1 jirtt)) ~, (fiubmtt completed form to sou+tty if r state owae~ Attach com isle lens to the count' coo • only) for the s~~stem. ctn n 8 •I~'2:: i t inches in siu, Stan Sani Permic Number i~ Cheek if revisi i i - ionr Cntmry Su-e Plot I. Q. Number i : S ~ ~ ~ i. licatta [nfarmation -Please Print sll Information •~` '' lion: y one , . ; c r 'CO erty Location ~ ~ y I ~ ' ~ ~'= •`~~11~A5~ i14. S ~ T N. R~/~ or t _ property Owner's Mailin=Address - ~ ^n L t'N ber Biock Number t7'. State Zip Cnde Phone . ,.~ FF~~'E' ~ ivision Nama nr A4 Number Gt % Jr YOIr~ /J ~~• -~' 7'''"- ' ~ - I'is / ~/ Z Y ct Y ~ a o ~s II Type of 8u11dinS: {cbeck one) ,~ - No of Bedrooms: ~ Dwellin D 1 ar 2 Fatuit ~ City D Village ,,~ g . y 0 Public/Commercial(describe use): ,Town ce ~ » State-owned ~ S III Type of P~rrait: {Cheek only one box on line A. Check box on fine B if applicable) Nearest Road , A) 1. ~Naw System 2. D Replacement 3, D Replacement of 4. D Addition to Parcel Tax N- ui+tber(s) S stem Tank Gnl Sxistin S stem 62~ -135 - _ ~ B) Q A Sanit Permit was reviousl ~ issued Penn t umber 15. Z~ . I°1.21 ~` IY, Type of POWT System: (Cherie all that apply} ,3O S.Q~ w• uda ,. ~ ~b ~ > sa 3 x 9Y T~ ~~~ s 1~Non•ptta:stu'itxd !n•ground 0 Mound ^ Send F11toc D Constructed Wetland D Pressuriaod ht•grcwnd D Holding Tank O Single Pass D Drip Line O At-grade r to Aerobic Treatment nt C1 Retire B : ~ e r' ~ A ~ ,r . -- (oo . .. 3 x. 9 3 ~ ~S ~.- V Ois raalrl' tns at Aran lnformatinm - ~ 5~~~ t. Design w (gpd spars isprns# Area oil Application rcolateat Rate b. stem evation ed Rate {Gals./day/sq. ft) (MinJineh) ~ ~~ 8' D Required Propos 7. in ads Elevation 6r! fr~~ p ~S7 O S7 ~ ~~ I VI Taak Capacity in Total ~ of Manufacturer Prefab Site Steel Fiber- Plastic Infot»taatton Gallons Gallons Tanks Can- Con- glass New Existing cress strutted Tanks Tanks ~ ' i ~- i VII Respowibiiity Slats®ent tht: tend assurtte sea on ibili fcr installation of the POWTS she he attached Isms. umber's Name (print] Plumber's ignawre (no stamps): a. tts Hasa Phone Nttmba i~~it.w 3c u ~ y o7o27Q ~ .~- 3 - /Q~ Plumber's Addrea (3treet, City sate, ip ) ~ S' a z`r`'- GJ c Ul VIII Cottlnty/~Depsrtmeat U:a Onfy D Disapproved Sanitary Permit Fes (includes Grou -vator u Issued sluing A/ent tgnature o stamps) Approved ~ O Owner Given Initial Adverse S ~~ Fee) ~ Q ZS-2~O ? 2S i i o . on o nat Determ fix. Cn(r~nditfoas onf Approvs! IReasoas for Dlupprovnal~ t1~ l ~c-E~tx~ ~ocu~~n..S ~ ~ SWX ~eC.o% J vrviJ.~,~~.~. se~4~- -~.~C- -~1~ ~` ~, ~"' P~ s r~e.n+~~.~.sHa.~c~ C ~^ SHD•63~4B (R 07!00) ~~ CB`~av~- fat ~ ~.Y~eY/°~''/~ Sc~~t ' R ~O ,din/ / ~fG 9S ~ °`~ ~ ~6~,~ of O 9 0. ~ ~ V ~, ~ : ~ j ~ h ~ s ~ ~ ~ b 0' h~~ alb .~ ~.~~ w ~ ~~r v~~~l ~ ~ ~ ~" ~ a~ s' o% _ ~` s~~ ~y' V"er~consin Department of Commerce SOIL AND SITE EVALUATION ~ of Division of Safety and Buildings Page Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County n include, but not limited to: vertical and horizontal reference point (BM), direction and ~ . Cral percent slope, scale or dimensions, north arrow, and location and distance to nearest road. parcel I.D. # APPLICANT INFORMATION -Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~ _ 2 Property Owner ~ ` Property Location -t ~-C~~`I~VC Govt. Lot ~(,~ 1/4S~ 1/4,S ~ ~ T Z ~ ,N,R ~~ E (or~ Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# ~t~~ C ~ ~ . L (ever PUtk t ~+~.cia City State Zip Code Phone Number ty ^ Village Q Town Nearest Road ^ Ci ~uaSv'(1 ~ tiat ~~i5 )5y4- "9 ~-~ sa G-avr~°~ la e L (~. New Construction Use: ~ Residential / Number of bedrooms Addition to existiny building ^ Replacement ^ Public or commercial -Describe: Code derived daily flow Uu gpd Recommended design loading rate - ~ bed, gpd/fit ~ 8 trench, gpd/ft2 Absorption area required ~`~1 bed, ft2 7 Sn trench, ft2 Maximum design loading rate • 1 bed, gpd/ft2_~trench, gpd/n2 Recommended infiltration surface elevation(s) a ~~ ~ C~ ft (as referred to site plan benchmark) Additional design/site considerations ~ ~ ~ ~ C~ Parent material ~-U-E-1a.XA SI7 Flood plain elevation, if applicable N ~ ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system [~c.S ^ U ©S ^ U [~ S ^ U Q S ^ U ^ S [y3 U ^ S ~ U SOIL DESCRIPTION REPORT Boring # l Ground elev. qt. Z0 ft. Depth to limiting factor ~-( in. Boring # Ground elev. ~c) , 5Cn ft. Depth to limiting factor l/ in. Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots GPD/fl2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ,Trench o--~ ~~ ~31i - sal I c., ~u~ . ~ ~ -3 3 ~y -1 ID r y ~ r1~5 o m1 c.S - . `~ ; . ~ ,.Qrj., Remarks: ~ "rr~. s~_ 'l5 1(~ ~ ~- L `~ Sr` I ~ f'Y1Cc~l. fY1-~r " C ,~{° ~ 3 ~ '-awl ! r ~l '_' m5 OS rY~ I ~c~, ~ sl ~ ~~ r~~ . g --- •,. :• ZONING ~l~ ' ,°`~~ ~.. f . , ~ ~ `; v, 3(e%'2.'r Remarks: ;ST Name (Please Print) Signature / ~ Telephone No. -7iS'-Z~f 7- `008' 4ddress Date CST Number PROPERTY OWNER ~U 11 ~ tIU. SOIL DESCRIPTION REPORT PARCEL I.D.# Boring # 3 Ground elev. CJL'~ft. Depth to limiting factor ij[~in. Boring # ~ / Ground elev. q/, /tl tt. Depth to limiting factor ~in. Boring # S Ground elev. q/' Zd tt. r. Page Z of Horizon Depth Dominant Color Mottles Texture Structure Consistence B d R ts 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. oun ary oo Bed ,Trench I D-I~ /0 3~Z- -- Sr Ivr~bk rr~r ~5 lv~' • Z ~~ • 3 6. ~ 8Z.Fl Remarks: 3 ~-n ryl~ - rn5 ~s q•6 a~s' c, ' Remarks: Horizon Depth Dominant Color Mottles T t Structure Consistence Bounda Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color ex ure Gr. Sz. Sh. ry Bed ,Trench 2 i~-ai ~ ~~ -- ,~-, ~ rn 1 cs - . ~ ; Depth to limiting factor Lin. Boring # Ground elev. ft. Remarks: Depth to I I I I I I I limiting ` ` factor in. Remarks: SBD-8330 (R.9/98) -~ _._. __ ff NAME Ira ~ ~ c~ t ~C1 Ua SCALE 1 "_ ~~ U f BM1 ELEV . ~/,~, OCR DESCRIPTION- ~ a-F ~"yurp~~e l4y BM2 ELEV . 9S , U ~ DESCRIPI'].'ON--~a~ /'~o~P;ve ~afh~G~ SYSTEM ELEV. ~[`7,-/C~ ALT . ELEV . FS ?~ ~ 0 CONTOUR EL• EV . ~~c~ n f PAGE ~ OF ~ LEGAL DESCRIPTION Sw-5w-/o-~9'-/9-W N' Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private-@nsite Wastewater Treatment System (POWYS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- Table 1: System Design Specifications Sanitary Permit Number '}'i; R2 Number of Bedrooms Design Flow -Peak (gpd) cs0 Estimated Flow -Average (gpd) afl Septic Tank Capacity (gal) Soil Absorption Component Size (ft2) 5~ Z R ~ `~ Type of Wastewater Do estic Table 2: Soil Absorption Component -Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow -Peak (gpd) 5 ~ 2 51 . ? Maximum Influent Particle Size (in) 1/8 Maximum BODS (mg/L) 220 Maximum TSS (mg/L) 150 Tab le 3: Maintenance Schedule Septic Tank Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the zc~..~ ) .' Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding Tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the sepfic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of fhe Tank maybe difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 S'1' CRUIX CUUN'I'Y SEPTIC TANK MAINTL~NANCB AGItLBMCNT AND OWNL'RSI-iIP CL~RTIFICATION FORM Owner/buyer p, ~ . t b ~ ~ oV'A 6 ~ ~ t1 S ~n~ t-. Mailing Address -70~ ~u . ~c d : ~' /~v~su-v (,v :~ 5 ~-v 1(,a Property Address ~ A ' ~ ~° ~ eL.U (VcriGcation required from Planning Department for new City/State _ /" ~l/ ~ ~/~ w,,,z' Parcel Identification Number LEGAL DESCRIPTION Property Location ,~ %, ~L(~ y~, Ste, ~ ~?~N_~_W, Town of ~~~i~_, Subdivision Lot ~E CertiCed Survey Map 1'>! VOiUIIIC r- ,Page # Warranty Decd ~ ~~~~ Volume ~~ ~ Page # Sow Spec house ^ yes l~ no Lot titles identifiable J~ yes ^ no SYSTEM MAINTENANCE Fmproper use and maintenanceofyout septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the aeptie tank every three years or sooner, if needed by a licensed pumper. What you put into We system can aII'ect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification foam, signed by We owner and by a masterplumber, journeyman plumber, restrictedplumber or a licensed pumper verifying that (1) We on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), We septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and We Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three ycaz expiration date. / / S GNATI:IRIs Or APPLICANT DATC OWNER CERTIFICATION I (wc) certify that all statements on this form are true to the best of my (our) knowledgE. ,I (we) am (are) the owner(s) of e property described above, by virtue of a warranty deed recorded in Register of Deeds Ollice. /(J /~~ SIGNA F APPLICANT DATC «««««« My information Wat is mis-represented may result in the sanitary pcrniit being revoked by flit Zoning Department. • ««««• «* Include ~vitlr this appllcallon; a stamped warranty deed from tl~c Itegistcr of Deeds office a copy of the certified survey map if reference is made in flit wannnty decd 5TATE DAR OF \VICONSIN FORM 2 - 1981 \4ARRAK(~-TYDEED L'OCUhtENT NO. °l r• ~'~ ~ J PAC' Q v~2 . ~ 1 ~3 }larjorie }lalernee, Frances August and Faul i(9tner nu tenent9 n cuss°on a k/a Francis _ _ Auxus[ cvnvc•,•a and watr1n15 tc •~• .O_ OV3 Ills sera, IILC., a . Nlscottsin Corporaticn it G~62167'' K11'iIILEEN H. NfIISH REGISTER OF DEE1)5 ST. CROIX CO.t UI RECElUEO FOR RE[OAD 01-06-1999 9:I0 AM Yq~RANTY GEED ElO:Mtf N CERT COPY FEE: CORY f[Ea TRANSFER FEEL 1710.ID kECCRDIH3 FEE: 12.00 PAGE9: 2 Trim ~.AC! n[S Cr1vID IOr1 n[C9nDrr:O DATti dre tollnuind deserilxd :sal cturt,n gt,'~'rro~x Cur.nrr LAVI1 ' J. ~STREL~~ sralc .tt wicttns;n: 304 L -1CU5T . ' t. sE 1/4 sa' 1/4 sec. lo-r24N-RL9W excepting thereltom Lot I HUUSON, WI 540"c=T of Certified Su:'/ey Maf racorded in Vo1,7 of Cetcified ' Survey }+apo, page 2089 ae Uoc. No. 44)307, also excepting 02U-1010-20 • the ratltcad right of t.a~. 020=1016-90~ 010-1025-90 tlE l/G NW l/4 SeC. 15-T2?N-R14W excepting tharefrcm hot lP~r'tetuEUnftc~iiti'vfuttnEn o! Cart if led Survey flap recorded in Vol. IU of Certified ' Survey Mapc, page 2)01 ae Dac. Vo. SC7728. tlt: L/4 NE 1/G Sac. 15-T29N-R19W Tlrl, Ss noC hrxnc[lc,dpmpvly --lk)-- ('s nDJ F.x:cptlDn l0 'AlfUnli[f: /F ~ ~~ [>~led this •~_____~__ day of June ~--/, ~J' . ~,• J4 99 Frances Au ust 'nU&u9~n~Xr~ ' ,~.,`itte~' ~.y';~ri't• I'atll nStn~r ''~'~'~'•:ri;; ;S' _Irartorle~slernee •f'fr. ~•`'-•~i"~ sir sl' .i; AUTl1ENT1CAT10N adella~ i I ----- audnUJcated Ihh dry of , ;9_ .l 1111:.: ~tl:hlDtK ~lAlr 114R OF WISCONSIN (I(hUl, _ (SEnt) , AcxNO\vitDCn+ENr ~i Start. oI \~tis~~~hon SEE ATTICFIED~~ 1BHlfIDIT "A" '~ J( r r. King CDllray ~ feno:nl:y carnt bcfure me Ihla 2Gth day of ii .IunC , 19 9q _, tl,e abort nanerd I --- ~ Irancea ugut:t j audlorlndby 1706.06, Wis. 51~t:J _ ----- ! ID rct Y.nuwr. !o ht person _ HUo tscwlyd the fcregdrg insl t r. 1 ac r n whdge ar t. ~ , T.119 I`aitgUlAffll l'!45 DRA:TEn av Hev>rood 6 Car_ S.C, b TTaltcr !lodynlacy 204 Locust St., P.Or $cx 125 Na son, III 54015 Kllt Natlry F`ublic, g •.-....__._ ConnN:.S1Jio~ I:A (Slbr.D:cris nwy bs nuax~tlca:ed or aclvlow'.eddtd. frith stt not }ly cuann(ccinn la ptmm~ern. ;If ncl, sum explr_linn der.: ' neecanDry) Septeober 1, 2001 IS}pT-_) ';Irma of lxrrenre~ymebin n,r opnaytbmrld by ry•prd er pnnud brlow lnar,iprawra.~. ~~ ~ ~ ~~ ' ll'rt0.nANlV DECD aTAi! D.\t OF WISCONSIN wirarnfern Dw Cu.. vc. Form Pro.l. l9Pa Mt+a/ue. vhs. , ' _' 2 ~ i LOT 25\`, '` LOT 6 •~ (, I ~ ~ _ G`(~ I NORTH GUAR TER CORNER ` ~ SECTION I5 -FOUND (~ AL UM 1 NUM MONUA~N T SECTION 10 ~ • SECTION 15 ; ~ `.~ ••...•...••.391. T6' N •~ i , ~ , '~ tia\• i ~~ HIGH WATER ~ i !". ' ELEVATION= 913. 2' ~, ,~ , ~. ^-~ ~ ~~ ~~ LOT 24 ~~ ~ ' -------------- L /~ ~ ~ S ~ ' ~ .• -.,'~l~ ~~,~ ~~''• I 3.74 ACRES ~~ `~" 162, 7f 7 S0. FT. ` ~~ . 1 ~ ~ ' •. ` 1 ~ ~ J so: S `~ h ~ DRAINAGE J ~\~d1o \~ ~ ~ 3`. LOT 8 ``., ~\ og ~ ~ o •``j~ ~ ~. ~ ~ AREA ,~ Q _ o, ~l _ ~ \ ~ ~ ~ . ., ;..; g S?• . ` i i ~ '•. i i `' ` ~' / - - i LOT , • ,, ~'9~j ~`,~ ~•.•~~~ ~`-- • r . ,~ , 2.8 ES ~ ~:, - ~~' i 125, 352 S0. FT. ~ ~ ~~ `. ~ ` -"-' ~: I ~-,; 1 ,,r DRA 1 NAGE ' ~ 84. 4,9 ~ J ~ -~ ,~ N ~ / - N : t ~'. O ~~ 3 ~~~~_ _ / \ ~~ O 1~ ~.. ~ I 1 1 v: o : ,, ~ I Y X14 ~ ,,/f ~• , ~ 6 \~ LOT 13 i ~ ~ ~ LOT 10 '~ f7 ~ 6 ~~ ,5 3. 10 ACRE i ~ ~ ~~ 135. 198 S0. j .'r _, 2. 80 ACRES ,: i `. ' _ i `~ 122, 055 SO. FT. ~ ~, ~ 3 / \ i ~ .' i s , ` ~ J : o N o~ :"' ' ' , ' N :N 1 ~ 1 ~ ' -_ 1 N ~ : ~O ~ / 1 • ~ ~ - ~ ; o~ HIGH WATER )' i O ~