Loading...
HomeMy WebLinkAbout020-1359-27-000 ' ST. CROIX COUNTY ZONING DEPARTMEN'F'~ ~~_ ! _J.! ~ ,~ ~, , ~. AS BUII.T SANITARY REPORT ~ ` ~' ~ ` ,~ / Owner - --' Property Address ~l 7 ~~~'° R. ~~ City/State 1~ a~ ~cx Le al Descri tion: `~ri `~ . Lot ~~ Block ` Subdivision/CSM # '/a S~ '/4, Sec. ~, T o~l `/N-R~W, Town of PIN # SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer Size ST/PC I,~oo / Sib Setback from: House ~ Wellfso P2 Pump manufacturer C3z3u.eU`z Model ~~~ Alarm location - (HOLDING TANKS ONLY) Setbacks: Service road Meter location '- Alarm location --- SOIL ABSORPTION SYSTEM: Type of system: ~ Width ~ ! Lexsgth ~~ ` Number of Trenche~ Setback from: House ~ Well ~ P/I, ~ Vent to fresh air intake ~- S~ ELEVATIONS: Description of benchmark Description of alternate benchmark i Elevation JD y Elevation ~s~ Building Sewer ~ ~ y0 ~STlHT Inlet y~, S-s ST Outlet PC Inlet ~ 9~ ~ d r PC Bottom 9,~7, 7sHeader/Manifold '- Top of ST/PC Manhole Cover ~ `~ / i Distribution Lines () / ~ /~ 7.3 () / ~ ~~ ?3 ~ ( ) Bottom of System /oo~dS i ~ ~o - as~" ~ ( ) la ~~e ~ Final Grade O /~ `f~ /Q ( ) () Date of installation 31a316~ Permit number .3 s3,~ ~ 7 State plan number ' Plumber's signature License number o~ 03S,Z_ Date ld3lZ~a Inspector ~.~--z- Vent to fresh air intake Water Line Complete plot plan ~ NOTICE: Pl rovide the following: ~ ~ ~~ .r p ja. • A plan view sketch showing everything within 100 feet of the sys~'~ DECEIVED ~ ~ ~~.,~, ~' ~~~0 ~.. • Two horizontal reference points to center of septic tank manhole cai~~r. st~x ~, ,_,-; • Show alternate benchmark, if applicable. \~~ ,,~~ `~ I~~ 2 PLAN VIEW N _,~ 1 a?3/a ~-~/\ ~~ ~ I ~ ~~ ~ dS~ ~'-` I -~G C ~ ~, ~`~~ ~~~ INDICATE NORTH ARROW a ., Wis~nsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division INSPECTION REPORT ,GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: ^ City ^ Village ^ T7Qwn of: se Homes Hudson Township CST BM Elev.; Insp. BM Elev.: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~~,~ ~Zf9t> ~$QD Dosing ~ ~L~, Aeration Holding TANK SETBACK INFORMATION TANK TO P/ L WELL BLDG. vent to Airlntake ROAD Septic ~ ~jp r ~ 6 p~ ~3 ~ e--- NA Dosing NA Aeration NA Holding PUMP /SIPHON INFORMATION Manufacturer e~~ Demand Model Number a ~ f ~j~ GPM TDH Lift$.9~ Lriction (, IZ System _. TDH 1p•t Ft Forcemain Length ~oi Dia_ ~ N Dist. To Well ~ ~ o ELEVATION DATA County: St. Croix Sanitary Permit No.: 353287 State Plan ID No.: ~~ Parcel Tax No.: 020-1359-27-000 STATION BS HI FS ELEV. Benchmark a , ~-~ U,~ ~ (~ , ~ ' Alt. BM ~, z 5- a5 . S v Bldg. Sewer 13. ~5 g6,9a St / Ht Inlet ~ ~ZO q~i• S'S- St/ Ht Outlet ----' Dt Inlet ----- Dt Bottom B,O~ ~~, ~-S Header /Man. Dist. Pipe $ Q.0.3 I ~~ ~3 Bot. System 5 I • S D • So ~ aD, Z S" Final Grade b.~ off! / O~ St cover c/ ~~ ,y~ D Z. R SOIL ABS.II[~PTION SYSTEM 171 ~D~ ~.~~ ~o~o Pi.l,~ ~-rb.,r~d„ i ~:ar _.~•r«~ _ `T9.8o .$~Br RE Width t Len ~ No. f T enches PIT No. Of Pits Inside Dia. Liquid Depth DI EN I N ~J ~5 DIM N I SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING ~~(.~~_S_~, ~ ` INFORMATION Type O~ ~ ti 3~ _ Z S I Z r ~ ---- CHAMBER OR UNIT !~ o a Number t - C ~ System: l i r H ~ DISTRIBUTION SYSTEM ~ {"Z 5 -~ ~ ~ Header / Mani old « Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length -~_--- Dia. ~ Length -~ Dia. .--_ Spacing ~ ~~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ^ Yes ^ No ^ Yes ^ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: 3 /23/00 Inspection #2: / / Location: 947 Dailey Road, Hudson, WI 54016 (N W 1/4 SW 1/4 16 ,T29nN R19W) - 16.29.19.2123 Parkwood Meadows -Lot 27 S ~~`~"' °'~~ rear oe~,~-~~P . 1.) Alt BM Description 2.) Bldg sewer length = Z3 -D -amount of cover = > ~ H 5~ ~~~, Plan revision required? ^ Yes ~$( No _ I Use other side for additional information. 3 3 SBD-6710 (R.3/97) Date Inspector's Signature Cert. No. ~~~" Dai~e 1C~ ,,~ `~SIC011S%n SANITARY PE MiT APPLICATION , Department of Commerce In accord with Comm .~ m n ~ -~~_ 1 Safety and Buildings Division 201 W. Washington Avenue P O Box 7302 Madison, WI 53707-7302 • Attach complete plans (to the county copy only) for a em, or~ape~ noti~ss h i i county _~ S an 81/2 x 11 t nches n size. ~~, cv, • See reverse side for instructions for completing thi c° IicatlOn State Sanitary Permit Number Personal information you provide may be used for secondary pure ~~ ~ a -- ~ ~ ~.f c~ ~ ^ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. F~-t 5~ ' .;:' ~` State Plan LD. Number I. APPLI ATION INFORMATI N -PLEASE PRI y~ L I ; „ O ~`~~~ Prope y Owner Name Prop o tion ,~~ Pr erty Owner's Maili Address L r Block Number .~_.__. Cit , Stat Zip Code Phone Number (71,~ J Subd+ Ion Na a or CSM Nu ber 1 . P F B ILDING: (check one) ^ State Owned ^ !t~ ^ VII age Near st Road Public 1 or 2 Famil Dwellin - No. of bedrooms Town OF III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) (~- aZ~m - 13Sa - ~~ ~o~ . (~, 1 ^ Apartment/Condo ZlZ3 2 ^ Assembly Hall 6 ^ Medical Facility/ Nursing Home 10 ^ Outdoor Recreational Facility 3 ^ Campground 7 ^ Merchandise: Sales/Repairs 11 ^ Restaurant/Bar/Dining 4 ^ Church /School 8 ^ Mobile Home Park 12 ^ Service Station /Car Wash 5 ^ Hotel /Motel 9 ^ Office /Factory 13 ^ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1 _ p~ New 2. ^ Replacement 3_ ^ Replacement of 4. ^ Reconnection of 5. ^ Repair of an ______System ________System _____________ TankOnly_____-________ Existin~System ___-____ Existing System B) ^ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ^ Seepage Bed 21 ^ Mound 30 Specify Type 41 ^ Holding Tank 12 Seepage Trench ~,1~ 22 ^ In-Ground Pressure Z,! 42 ^ Pit Privy 77 ' 13 ^ Seepage Pit ~ A ~ 43 Q Vault Privy /-rX'Q'"'''~' 14 ^ System-In-Fill - ~ = 7 r VI. ABSORPTION SYSTEM INFORMATION: - 7. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Pert. Rate 6. System Elev. 7. Final Grade //~n1 Required (s ft.) Pro~ojse/d (sq. ft.) (Gals/day/ q. ft.) (Min./inch) Elevation ~ 7 ~ 5~ V s , Feet Feet . / (o.3i o VII. TANK Capaaty INFORMATION in gallons TOtdl # Of Manufacturer s Name Prefab. Site con- l Fiber- Plastic Exper. N E i ti Gallons Tanks concrete stee glass App ew x n s strutted Tanks Tanks Septic Tank or Holding Tank ~ ~-- ~ ~ ^ ^ ^ ^ ^ Lift Pump Tank/Siphon Chamber ~ ~ ^ ^ ^ ^ ^ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite age system shown on the attached plans. Plu er' m • (~t)~~~~ Plumber' ignatur : (N to s) /MP~ No.: Business Phone Numbe~ ~~ ~ 3 ?/.~ - Plum er'sAddress Street, ~ tate,Zip ode): S ~Q IX. COUNTY /DEPARTMENT USE ONLY ^ Disapproved S nary Permit Fee (IndudesGroundwaser ate ssue Issuing Agent Signature (No Stamps) Approved ^ Owner Given Initial ~ Surcharge Pee) ~s ~ ~""~-"-9°~ Adverse Determination e X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: SBD-6398 (R. 4/99) DISTRIBUTION: Original to County; One copy To: Safety & Buildings Division, Owner, Plumber ,.. INST~tUCTIONS ~ - ~ "' ~~`~ 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Lgde will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer /Renewal Form (SBD-6399) to be submitted to the county priorto installation 5. Onsite sewage systems must be properly' maintained. The s~-ptic~tank(s) must be pumped by a licensed pum-per wheriever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Divisien,60S-266-3151 ~~-- ~ ~ - • - ~ - ~ ~~ - - -- To be complete and accurate this sanitary permit application must include: !. Pr-operty owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is tote insfa(fed' ~ --`- ` - II. Type of building being served- Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one online A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide alf information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for a!I septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. Vltl. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc:), address and phone number. Plumber mustsign appGication form. IX. County /Department Use Only. X. County /Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The. plans must include the fott"owing:" A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; welts; water mains/water service; streams and lakes; pump or siphon tanks; 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 i~ required by the county; E) soil test data on a 1 15 form; and F) gall sizing information. GROUNDWATEi2 SURCHARGE 1983 Wisconsin Act'410 included the creation of surcharges (fees) for a number of regulated ~practiceswhich can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. ., ~r .~ ~~ LaCasse Custom Haines. INc. ' NW'~SW'~ S16-T29N-R19W town of Hudson lot #27-Parkw~0od Meadows This sofa evaluation vas conducted to satisfy a zoning requirement, it may or may .not be suitable for your use. The location of the test may or may not be as shown as Permanent lot lines were not established at the time the teet•was conducted. S N 1"=40' Bt~i.= top of SW lot stake ~ el. 100.00' Alt. HyI.= toy of NW lot stake ~ el. 104.50' ~~~ ~~ ~'•' _ ~ ` ~`'0"~ t~"_ ~~~s~ ~~~e ~~) ~~~~ bl . ..'L ~ ~ 0~ 8~ r ~~. ~~. 2 ~S~ N~ w~~ /o7Qo /goo a - ~a ~~- r.~..~ ayx 3~, 8 = ~~3. a' 9~~ T 34. `~' S~. ~. /OO, as ~ ~" V 1~~ ~o~3s7 ~, fit' T ~• s' ~~ Wiscoesin Department of Industry, SOIL AND SITE EVALUATION R E P O R T Labor and.Human Relations I~ivesinn of Safaty R Ruildinns ~.~ u 1 w ~~ n_~_ Page 1 of ~_ .. ~ - 111 QVVVIV ..Ills IL1111 VV.V V, •.IJ. ..u•••• vva.l ~.r COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. not limited to vertical and horizontal reference point (B c ip~`ar'd% of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distanc gfte~r rind,-`' ;: ~':y., 020-1029-30 DATE R IEWEDBB Y APPLICANT INFORMATION-PLEASE PR T~'LL INF~RATION'~~`°•, -~ - ~ y PROPERTY OWNER: "'•-;~` ~ .~ PRO ERN LOCATION t, ' LaCasse Custom Homes, Inc. °~%~ GQV~. LOT ]VW 1/4 SW 1/a,S 16 T 29 ,N,R lg #(or) W PROPERTY OWNER':S MAILING ADDRESS „`. s r ~9 L('~T' BLOCK # SUBD. NAME OR CSM # ~ ~~ C~3/ •2 na Parkwood Meadow CITY, STATE ZIP CODE ~ 0 ^ TY ^VILLAGE [~I OWN NEAREST ROAD Hudson WI. 54016 1 -, 381-~4~ .- f w, Hudson Meadowood Ln. (X] New Construction Use ~ ] Residential / Numbe dindm 4 ( ]Addition to existing building (]Replacement ( ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .7 bed, gpd/ft2 .8 trench, gpd/ft2 Absorption area required 858 bed, ft2 750 trench, ft2 Maximum design loading rate . 7 bed, gpolft2 .8 trench, gpd/ft2 Recommended infiltration surface elevation(s) 100.25 ft (as referred to site plan benchmark) Additional design /site considerations na Parent material outwash Flood plain elevation, if applicable na ft S =Suitable for system U=Unsuitable fors stem CONVENTIONAL ®S ^U MOUND ~S ^U IN-GROUND PRESSURE ®S ^U AT-GRADE ®S ^U SYSTEM IN FILL ®S ^U HOLDING TANK ^S ®U SOIL DESCRIPTION REPORT Boring # 1 Ground elev. 103.9 ft. Depth to limiting factor +88.' Boring # 2 Ground elev. 104.5 ft. Depth to limiting factor +~n~~ Depth Dominant Color Mottles T r t Structure Consistence BoLrtda~ Roots GPD/ft Horizon in. Munsell Qu. Sz. Cont. Color ex u e Gr. Sz. Sh. y Bed Trends 1 0-9 10 r 2 2 none 1 2msbk mfr gw 2f .5 ~ .6 2 9-27 10 r 4/4 none sil 2msbk mfr gw 2f .5 .6 3 27-88 7.5 r 4 6 none cos Os ml na na .7 .8 Remarks: 1 0-12 10 r 2/2 none 1 2msbk mfr gw 2f .5 .6 2 12-32 10 r 4/4 none sil 2msbk mfr gw 2f .5 .6 3 32-90 7.5 r 4 6 none cos Os ml na na .7 .8 Remarks: CST Name:--Please Print.. Gary L. Steel Phone: 715-246-6200 Address: 1554 200th. Av .New Richmo WI 54017 Signature: Date: 7_10-99 CST Number: m02298 PROPERTY OWNER LaCasse Custom Homes SOIL DESCRIPTION REPORT PARCEL I.D. ~ 020-1029-30 Boring # ;:~. Ground elev. 104.5 ft. Depth to limiting facto+90 ~~ Boring # ....>::> Ground elev. 1Q4.6ft. Depth to limiting factor ~~ Boring # 5 ~< Ground elev. 104.2 ft. Depth to limiting factor +84" Boring # Ground elev. ft. Depth to limiting factor Page 2 of ~ 3 Horizon Depth Dominant Color Mottles Texture Structure Consistence Bo~xxiary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends 1 0-11 2 11-24 10 r 4 3 none sicl 2msbk mfr 2f .4 .5 if n .2 4 32-90 7.5 r 6 none cos Os ml na na .7 ': .8 ~, ZJ S rr Remarks: 1 0-13 10 r 2/2 none 1 2msbk mfr gw 2f .5 .6 13-24 10 r 4 3 none sicl 2msbk mfr 2f .4` .5 3 24-34 10 r 4 4 c2 7.5 r 5/8 sil m na gw if np .2 4 34-90 7.5 r 4/6 none cos Osg ml na na .7 .8 SZ. Z ~. Remarks: 1 0-13 l0yr 2/2 none 1 2msbk mfr gw 2f .5! .6 2 13-31 l0yr 4/4 none sil 2msbk mfr gw 2f .5 .6 3 31-84 7.5 r 4 6 none cos Os ml na na .7 .8 Remarks: Remarks: SBD-8330(8.05/92) ~ •r , • ' STEEL S SOIL SERVICE Gary L. Steel LaCasse Custom Homes, INc. 1554 200th Ave. CSTM2298 ~4~4 s16-T29N-R19w New Richmond, WI 54017 MPRSW-3254 town of Hudson (715) 246-6200 lot #27-Packwood Meadows This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted. N~ 1"=40'~ BM.= top of SW lot stake ~ el. 100.00' ~ Alt. BM.= top of NW lot stake ~ el. 104.50' ~~~ ~~ 8~ D `~ k~ 1,200 ~'~ ~~`~ ~ ~~ 8~ ~ ~~ ~~ ~~~ ~~ Gary L. Steel 7-10-99 Sep-O1-99 10:30A r_a~c ,.~ - _-••• _.~~a~,R t:KOSS SECTION AND SPECIFICATIONS -- 4" CI VENT PIPE I?" MtN. A80YE GRADE ~ TS' FROH DOOR, WINDOW OR E w~1•y~ pRpOF FRESH AIR INTAKE JUNCTION BOX APPROVED VITH CONDUIT MANHOLE c FINISHED GRADE 4• CI RISER W/ pA0t,0~ 6" MIN. WARNING i 18" IN• 6" MAX. INLET . / '; ~ ~ i• WATER TIGHT SFAL$ Gg_ ~ • „ 4 -•~--- TIGHTS 1 ~ BAFFLE CI PIPE - SEAL , ~ APPROVED 3' ONTO . 9 ~ LM JOINTS W/ 50LID -~- ' ON PIPE 3' 0 SOIL C ' SOLID SOI PUMP OFF ELLV . FT•• -'-' ~ ~ •~ OFF RISER D PERMITTCD IF TAyK MAIYUFAC TU! 3" APPROVED BEDDING UNDER TANK HAS APPRO' SPECIFICATIONS CONCRETE PAD SEPTIC / DOSE ~ - •- -• •---------- -- -•- -....._ ........ . TANX MANUFACTURER: NUMBER DOSES PER DAY: •rnNK S_: SEPTIC ~ GAL. ~-.._. . DOSE DOSE VOLUME INCWDING ~ G L' F LOf~18AC a I ~ iARH MANUFAC'1'IJRER MODEL NUMBER SWI?CH TYPE: PUMP MANUFACTURER: (YODEL NUNBFR ; SWITCH TYPE: REQUIRED DISCHARGE RATE K • ~= GAL . __ GPACZTIES: A :~.. ~NCHES = L/~S~y,~ ""+" B = _~ INCHES = ~0~ -" C ~~INCHES = ~~~ --_.~_ ~"" D ° ~ INCHES = /~ GPM PUMP 6 ALARM MIRING AS PER ILHR 16.23 VLRTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE • MINIMUH NETWORK SUPPLY PRESSURE _ FEET • ~.Q~~ FEET FORCEMAIN X ~FT/ 100 •FT. FRICTION FACTOR • . FEET TOTAL DYNAMLC HEAD ~aSFEET INTERNAL DIHENSIONS OF PUMP TANK: LENGTH - FEET WIDTH ; DIAME'l•FR 1 - LIQUID DEPTH a ~J IGNED : _ LICENSE NUMBER: n~ww_ ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer 1.., ~ ~~ s ~ Z l~cnn-Q,• t ,ly C Mailing Address .5 ~ ( -wt cC t.t, ~c ~~ ~i~ ~/r. ry Property Address , ~l `r ~' ~~ I_ L. e ~/ t2 (Verification required from Planning Department for new City/State /~c~,~ Sa---~-- Parcel Identification Number ~a~ - f O~ ~/ -- ~['~ LEGAL DESCRIPTION Property Location ~'/,, ~_ %,, Sec. f(o , T,~N-R,~_W, Town of ~lads~ Subdivision ~~~h la~m~r,1 Yyi,e~~~c~ ~s .Lot # ~ 7 Certified Survey Map # -- ,Volume ,Page # Warranty Deed # ~ l (n ~ y~2 .Volume ~" Page # o7b Spec house ~l yes ^ no Lot lines identifiable 1~ yes ^ no SYSTEM MAINTENANCE Improper use and maintenanceof your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect 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 form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the 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 the 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 y r ex iration date. ~~ Zaoa SI NA OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the erty describ d above, by virtue of a warranty deed recorded in Register of Deeds Office. j 1 ~/ z o©U SI NATURE PLICANT DATE ****** Any information that is mis-repre~s tried may result in the sanitary permit being revoked by the Zoning Department. ****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed ii STATE BAR OF WISCONSIN FORM 1 - 1982 WAR1RAANTY DEED DOCUMEf~1T NO. ~I `l~I..1`}~2PAGE 2Q6 Howard LaVenture, three-fifths This Deed, made between Arlene LaVenture two-fifths ~! (3/5) interest in and , ii (2/5) interest in, as tenants in cottmton. ,Grantor, and S,,B r A- S`i ~ ~rsvt of I ~'1 / G Grantee, Witnesseth, That the said Grantor, for a valuable consideration conveys to Grantee the following described real estate in County, State of Wisconsin: St. Croix LOT 27 OF PLAT OF PARKWOOD MEADOWS, TOWN OF ST. JOSEPH ST. CROIX COUNTY, WISCONSIN 6 1 6542 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR REC~tD O1-05-000 1:10 PM WARRANTY DEED EXEMPT R it CERT COPY FEE: COPY FEE: RED FEE: 10.00 PAGES: 1 THIS SPACE RESERVED FOR RECORDING DATA NAMEAND RETURN ADDRESS ~,,~C.a-,~`.rL. }~,~~.~- 1 Svc, ,. _ .. PENDING d ~•O - !4 zQ --'Q PARCEL IDENTIFICATION NUMBER bao -~1o a~ - ~~ ;; This deed is given in partial satisfaction of certain land contract dated February 19, 1999 acid recorded in Volume ~i01~ Page 6-lti as Document Number 598116 which was subsequently assigned by assignment dated May 28, 1999 and recorded in Volume 1431 , Page 352 as Document Number 604323 ;~ This is not homestead property. (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And Grantor !' warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except all liens, covenants and restrictions of record, if any and any liens or~~ encumberances created by act or default of the Grantees and will warrant and defend the same. Dated this ~ ' mss- Zbma day of January X1Xj 2000 AUTHENTICATION Signature(s) ~; i ~. (SEAL) (SEAL) Howard LaVenture ~' (SEAL) ~h / ~ ~b (SEAL) Arlene LaVenture ~v 6 authe tic d his ~ ~y of ,~A Walter Hodynsky TITLE: MEMBER STATE BAR OF WISCONSIN ACKNOWLEDGMENT State of Wisconsin, ss County. Personally came before me this day of 19 ,the above named V.J_IVI_ I V VOL. 1 _ I Z PAGE_1841 DOC..~ _ I 329_897___ I L_OT 2 I C.S.M _ I VOL. 4 I PAGE 106 D_OC. ~ _ ~ 370960_ I POINT OF I E BEGINNING ~3 ~..~~ ~R~ Ml~l~ M_ LANE_ W 1/4 CORNER SECTION 16 T29N, R 19W CAP) TSEN BENCHMARK: TOP OF CAP I ELEV.=915.58 ~~ QI J~ of ~I JI Z~ ~I ! UIWII~HhL .r;r~ ~ I 5' ~ I I p ~, EAS MENT '"'~ "- 1 Q ~ o $ 0 2.565 ACRES z 2.501 ,~ ~.,.•z Q - (3 2.985 ACRES z 111,738 S.F. 109,; U 130,035 S.F. N ~ 0~''• 2.101 ACRES N ,c,°0~ ti 91,519 S.F. ~ I;~ ~..~ti1~ ~ ~o LANE ••'~ N 9°46' 00" W ~ 398.10' ~Z ` A`~~ _ _ ' 25.00 373.10 ! N `V ` 25' ~ G~ ~ ~' . ' i 1oa o~',' ~'~,~ I I I 9 ~ ~• 2.450 ACRES ~ ~6a~ ~ / ~~', 106,716. S.F. .,/ ,, F. ~ ~ ~ ~ ~ 50', ~ 50' ;l 6,~ / ~ i I - / ~ '~~ 9 °'ti~ a/O ~ ~ 331'331 33 I 1 ~$ 143, rn ~% ~_ 16 I rng S-89_53' 29" E _ - ~' ~ ~ _ _ _ _ _ _ _ ~ M r I od I '~ - ~ o rn 2.928 ACRES I .. ~-- Imo' '" 127,564 S.F. I ° N o .. ~ ° ~ S 89°53' 29" E ~ I °o, 28 ~ ~~......~~O,QQ....... I o 2.419 ACRES •N 105,385 S.F. 100' I ' ..............N.@8.°.3'.29.':. W............... ............f.. ~.... ~04.13~ ..................... i Ig c I V t\ ~ ~I 3' I ~ I ~t oe°c:~ ee~. ~' QI I 3 -~ I }I .~"' 2 6 JI d• 2.322 ACRES 3 01 Q . ; O 101,140 S.F. M Q t co Z N 89°53' 29" W ° ° ~ 404.72' z f Q Q 25 2.324 ACRES ;~ 101,213 S.F. • M I N 89°53' 29" W 405.01' 180.01' 180.00' :w ' N 89°53' 29" W - ;N 392.77' o DRAINAGE g;"' ' , $°o N EASEMENT ~°~° ~ ~~ .O NN 180.00' 'o - ~~ N 89°53' 29" ~ W N 3 O ' ur -ano I N ~ 2.389 ACRES ni ~- °o ,°~ 104,082 S.F. N N 't N I ~ '~ I N 89°53' 29" W 3 w •- 392.77' N N I~ I M M n I ~ '~ $ SI o I 31 ' - Z ~' • 2.389 ACRES <o• I 104,082 S.F. ~ Ll.l I ~ Z I I N 89°53' 29" W J 392.77' ~ • ~ .• ~' O .8 I- u~ .° 3 2 • s' o~ N 2.389 ACRES N Q 104,082 S.F. 50~. Q 50' I I ... ---•• • I MI I rv, °'• 6' ~ ~' 3' 33' I~ 33 , • 2^507 ~ ACRES / ~ Y Io .Jan--10-00 10:06A r . UTGARD PLUMBING & HEATING 110 KELLER AVE N. AMERY, WI. 54001 715-268-6995 TO: FROM: COMPANY: DATE: C-t~a~ K Z oti IIyC~- l - /b ~OU FAX NUMBER: TOTAL NO. OF PAGES INCLUDING COVER: PHONE NUMBER: OUR FAX: 7~5-.~68- 6095 RE: P_Ol ^ URGENT FOR REVIEW ^ PLEASE COMMENT^ PLEASE REPLY NOTES: ~~~ ~ ACoSSE ~~~ ,,ms s ,Jan -.10 - 00 10 . 06A ~- P_02 Goulds Submerrsible Effluent Pump " C~ 3871 EP05 APPLICATIOMS Spccitically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP. 115 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord_ 10 foot standard length, 16/3 SJTO with three prong grounding plug. Optional 201oot length, 16/3 SJTW with three prong grounding plug (standard on EPOS). • Fully submerged in high grade turbine oil For lubrication and efficient heat transfer. ^ Motor Housing: Cast iron far efficient heat transfer, strength, and durability. • Motor Cover: Thermoplas- tic cover with integral handle and float switch attachment points. ^ Power Cable: Severe duty rated oil and water resistant. ^ Bearings: tipper and lower heavy duty ball bearing construction. SPECIFICATIONS Pump: EP04 • Solids handling capability: '/a" maximum. • Capacities: up to 55 GPM. • Total heads: up to 24 feet. • Discharge site: 1'/z' NPT. • Mechanical seal: carbon- rota ry/ceram is-stationary, BRJNA-N elastomers. • Temperature: 104°F (40'C) continuous 14D°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable o1 running dry without damage to components. Pump: EP05 • Solids handling capability 3/~" maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size: 1 ~" NPT. • Mechanical seal: carbon- rotary/ceram ic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C} intermittent. "N 1995 GoulGS Pumps YETERS. CFFT a W s U e z 0 J 0 Available for automatic and manual operation. Automatic models include Mechanical Float Switch assembled and proset at the factory. FEATURES ^ EP04 Impeller: Thermo- plastic Semi-open design with pump out vanes for mechanical seal protection. ^ EP05 Impeller: Thermo- plastic encloser! design for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. AGENCY LISTING Crarudian txandar~: Assaiatias (CSA listed rnodet numbers end in "F" or "AC" )