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Zo 24 ctn. , i LEGEND SECTION CORNER MONUMENT O 1" X 24" IRON PIPE WEIGHING 1.68#/LINEAL F00"' SURVEYED FOR: EDWARD GERMAIN, Box 66A, Somerset, Wi. 5402S DESCRIPTION: A parcel of land located in the S1/2 of the SE1/4 of Section 9, T31N, R19W, Town of Somerset, St. Croix County, Wisconsin described as follows: Commencing at the S1/4 corner of said Section 9; thence NO°S3'32"E (true bearing) 1328.03' along the West line of said SE1/4; thence N89°59'E 912.03' along the North line of said S1/2of the SE1/4 to the point of beginning; thence N89°53'E 423.57' along said North line; thence S54°55'25"E 97.511; thence Southwesterly 179.52' along a 270.09' radius curve concave Southeasterly whose chord bears S34°51'31"W 176.23; thence S15°49'02"W 122.02'; thence Southwesterly 250.32' along a 253.48' radius curve concave Northwesterly whose chord bears S44°06'31"W 240.28'; thence S72°24'W 299.281; thence N8°08'34"E 586.86' to the point of beginning. I certify that the above description and map are correct and that I have fully complied with the provisions of Sec. 236.34 of the Wisconsin Statutes , DATE: April 3, 1975 0 - Map No. - 4 2 G O NS 40~1 FRANCIS H. OGDEN FRANCIS H. 1-~ OGDEN 47% { S-as2 • ` RIVER FALLS,, Wis. a MFR y h, <5 794 ,SUR~,•~ r:, Volume 1 Page 120 / y L L 0-9 uu I dum-LOA % (v i 'STIVA MAIM J~b p. s ,J~1 ! ZpoT 'S w Z N3090 'H SIONV8J _ Z Z V - V L 'ON deW Z 88 - S NH(I00 ' H S I0NVdd ~'rs,~/S; S ®~''~hRNe0S L 6 i i T ady : S.Lt/( / •sa n uTSUOOST a o a T l ~ ~ ~S M u~ ~ V£'9£Z o S ~o suoTs,noa atP u1?M paTTdwoo XTTnj anetl 7 3.eui pine joaaaoo aae dew pue uOTjdTaosap anoge aup ;etp AjT;aao JNINN1938 • f?UT1UUT.?a1 do 1NIOd Jo 4UTod aup 0 6 UOTJoaS Jo auTT IseH p?es 2uoie ,00'99 M,VZ,OS aouatj: ,szootz ,ss , Z£' S££T H, 6S,68N aouaLp I V/THS p?es Jo V/THS atj~. 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CROIX COUNTY WISCONSIN sf ^ ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 715 386-4680 June 24, 1988 Mr. Byron Bird Jr. Route 4, Box 6 Amery, WI 54001 Dear Byron: Enclosed you will find the paperwork for the Mitch Banger permit. I have made a copy of all the paperwork for you. I have also enclosed the receipt to prove that you paid for the permit. Sorry about the inconvenience that this has caused you. If you should have any further questions, please feel free to give me a call. Sincerely, ~ O-"w "C) Roxann Croes Administrative Secretary rc Enclosure i DEPARTMENT OF INDUSTRY, ~Q r ~C INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS "\>i,~r PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON,.WI 53707 ` v s - v) )U CONVENTIONAL ❑ ALTERNATIVE State Plan LD. Numbec (It assigned) w❑ Holding Tank ❑ in-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: JADDRESS OF PERMIT HOLDER: m.INSPEJTION DF.TF. Mitch Banger Rt. 1, Somerset, WI 54025 BENCH MARK (Permanent reference point) DESCRIBF IF DIFFERENT FROM PLAN. REF. IT. ELE V.. CST REF. PT. ELE V.. NW SE, Section 9, T31N-R19W, Town of Somerset Name of Plumber: IMP/MPRSW No. County: Sanitary Permit Number: Byron Bird, Jr. 3318 St. Croix 75034 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED. 'YES ❑NO ❑YES ❑NO BEDDING: VENT DIR.: VENT MATI_.: NIGH WATER NUMBER OF ROAD: PROPERTY WELL : JBUILDING: VENT TO FRESH ALARM : LINE: AIR INLET: FEET FROM ❑YES ❑NO ❑YES ❑NO NEAREST DOSING CHAMBER: MANUFACTURER. BEDDING: 11-1011111 CAPACITY. PUMP MODEL JPUMP/SIPHON MA NUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO GALLONS PER CYCLE: PUM P AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL BUILDING. IVENTTOFRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET. _ NEAREST 1110 PUMP ON AND OFF) DYES ❑NO I SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of lowin : rvr,r l DIAMETER JMATERIAL 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. OF DISTR. PIPE SPACING: COVER JINSIDE DIA. #PITS. LIQUID BED/TRENCH TRENCHES. MATERIAL: PIT DEPTH: DIMENSIONS GRAVEL ULPTti FILL DEPTH DISTR. PIPE DISTR PIPE DISTR. PIPE MATERIAL: NO. DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES ABOVE COVER: ELEV. INLET ELEV. END. PIPES. FEET FROM LINE: AIR INLET: NEAREST MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. ❑YES ❑NO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS ❑YES ❑NO ❑YES ❑NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH!BED DEPTH OF TOPSOIL. SODDED. SEEDED: IMULCHED. CENTER EDGES. ❑YES ❑NO ❑YES ❑NO ❑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. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING. ELEV.: ELEV.. DIA.. ELEV.: PIPES. DIA.: ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED ❑YES ❑NO ❑YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST Sketch System on Retain in county file for audit. Reverse Side. TIT LE: DILHR SBD 6710 (R. 01/82) 77DR w wisconson APPLICATION FOR SANITARY PERMIT _ HR IPLB 671 ~,tGr0 , COUNTY UNIFORM SANITARY PERMIT # OEPfS1TTT1Ef1T OF j~ L IflOUSTRY, LRBOR 6 HUn1Rr1 RELRTIOf75 (/~/j Q -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'/zx 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT ADDRESS _ PROPERTY OWNE MAIL~G or, GJp f '74 Zc2 J~~ 5rel-I' or, PROPERTY LOCA/TIIOO CIT : 1/4, S , T N, R Y-IL ~E E (or OWN OF LOT NUMBER BLOCK NUMBER SUBDIVIS ON NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER TYPE OF BUILDING OR USE SERVED . 1 or 2 Family Number of Bedrooms. ❑ Public (Specify): THIS PERMIT IS FOR A: New System ❑ Tank Replacement ❑ Repair Replacement Soil Absorption System ❑ Revision ❑ Privy ❑ Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued ❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed X Septic Tank Capacity ZlItnte? Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer: IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): 3 6 Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber (Print): Signature- MP/MPRSW No.: Phone Number: Plumber' dress: / Name of esigner: .cj I^ OO Act COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved ~q / ❑ Owner Given Initial S -2 946 A Approved Adverse Determination Reason for Disapprova : Alternate course(s) of Action Available: 0 ILHR-SBD-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398 To be complete and accurate the permit application must include: 1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in a city, village or town); 2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.); 3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks. 4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of square feet to be installed; 5. Complete the section on water supply; 6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi- fication, place your license number in the space provided and sign the permit in the signature block; 7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the permit; 8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation. Failure to comply will void the sanitary permit. 9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable. 10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system, depth of the system, type of system. 11. All revisions to this permit must be approved by the permit issuing authority. 12. A complete plan including a plot plan, drawn to scale or with complete dimensions. 13. Horizontal and vertical elevation reference points that are permanent and clearly shown. 14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s) to system, building sewer and vent observation pipe(s). 15. The permit issuing agent may require a cross section drawing of the effluent disposal system. TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning your system, contact your local code administrator or the Bureau of Plumbing, DILHR, State of Wisconsin. 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 ! 1ZC,"eL-L M car E rrL- Location of Property 5VV 14 Si✓ 1%, Section , T N - R W Township SOMe(LST_ Mailing Address Subdivision Name GS M Lot Number Previous Owner of Property Total Size of Parcel %«S T S Date Parcel was Created 9-77 Are all corners and lot lines identifiable? X Yes No Is this property being developed for resale (spec house) ? Yes No Volume -7,q and Page Number g as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. 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) eenti.6y that att 6tatementb on this 6o4m ane true to the best o6 my (oun) know edge; that I (we) am (an.e) the owner. (s) o g the p4opent y des cA i,bed in th.i 4 in6onmati.on 6onm, by vi tue o6 a wauanty d ed %eco4ded in the 066ice o6 the County Regiateh o6 Dee& a6 Document No. 9~ b ; and that I (we) pn.es entty own the pnopoa ed 4 to bon the sewage pods ystem (on. I (we) have obtained an ea6ement, to nun with the above ducAibed p4openty, bon the conatnucti.on o6 said system, and the same has been duty %ecoAded in the 066tee o6 the County RegiAten o6 Deeds, a6 Document No. o b (e 1. SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED H a STC - 105 r' r a SEPTIC TANK MAINTENANCE AGREEMENT H • o St. Croix County z d a OWNER/BUYER Al r"Gtf 09crz- H ROUTE/BOX NUMBER ~j2~ Fire Number .CITY/STATE 1[V1 ZIP S4-ol-7 foe PROPERTY LOCATION: SW ;4, Ste. 14, Section / T_LN, R/'I W, Town of SOME2Sc-~ St. Croix County, Subdivision Lot number L'oT $ of cs rat 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 0 • E I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x 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 odo DATE -z (o - St. Croix County Zoning Office P.O. Box 9&'= Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. o M 'r m • ~ m (n N N 3 Q (/J C N~ Q1 =r O m N Al (D_ CD :X) K O Cl. co o o W 7 °~~0 3~"w Uj~ ~ z co cc o "a 5 F -a :03. CD CD -0 CD Ca ca :E o n, " 0 - CD OD - CD ;r CD a A i CD CD t0 ~m =(O n~r o3a o..°(Q~w s cQ O m O 0 '"I > O C l< j Z r C Q• 7 CD 0 0 (a W (D O° a CD D C' -~,vv < Cv, c o Qo CD CD D C m L ! ca 0 O n = N 0 0 O J~kc (Q W O (D O' O 06 = CD ~o 0) C4 0 CD " -0 CA ai~v, ~owCD~N Z D (D (D n = -I m am0 3Mm~CA a a y CD , -1 0. CD 0 0 M a s -?C w ~ w a CD 0 (D vi' a (o W (l w :7 3 CD Vai• (n w w C fl et~m_ CD =r °a m _ CD I cn CD Ch 0 Q.(Q CD CD -w vi K = to O O D 0c =+c(Q~NVi m Q CD " n Q 3 0. :3 c 0-0 E wow m~aCSD 0 R1 r: a a a• Q. o (CD o• - f cn' ~ G7 N ~ << co Q; = m N CD 0 ~ m n C O A (D O 7 a V 7 a° Q C t0 (n W (CD (1D C m c ° 0 -3 ID CD CD Co ° z e o L i DEPARTMILNT OF PORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, l - DIVISION LABOR AND l PERCOLATION TESTS (115) P.O. BOX 7969 HUMAN RELATIONS 1 1 \ / MADISON, WI 53707 Y~1 (ILHR 83.09(1) & Chapter 145) LOCATION: SECTI N: p ~ TO MUNICIPALITY: } LOT NO.: BLK. NO.: SUBDIVISION NAME: COUNTY: O ER'S/ U`ER'S NAME: MAILING ADDR/ESS: J?a 2' / O / c~G- ~j Oat USE DATES OBSERVATIONS MADE [XResidence NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DE CRIPTIONSPERCOLATION TES2 New ❑Replace I 'R -10 _s/Ss RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) XS ❑u s ❑u s ❑u ❑ s u fl s u If Percolation Tests are NOT required DESIGN RATE: I 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.) r ~rO G-~y~h Say-~p~i, B- l B- dZ 1/Q B- 3 ~U oh / / rl .s 71 B- ZZ B PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATF EYIE L- E-W 6k RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 MEAIODZ E 3 PER INCH P- P- 02 - 3 P- P_ V - - i 000p, Fpp-- L 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. SYSTEM ELEVATION yam-_ 711 3 s E E NaIlh 3 et 3 3 c~11 3 - r L I r 0 o~V~ 5f P ~ _ s _3~~ _ P E aw E -7- tN 3 E E a E , 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 the location of the tests are correct to the best of my knowledge and belief. NAME,( int): TESTS WERE COMPLETED ON: _ s- ee _,ol AD CERTIFICATION NUMBER: PHONE NUMBER (optional): cr 40 C9 3q 7 ~r 76 CST SIGN U E: 71 DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R, 10/83) - OVER - ~-HE Soil me d i n't TO THE Caw This s3 Lat r . v rc, i Qk~' G co~ADDRESS/~e~~~ ~ ~ f ~ Lt~! c • ~ 1/4/S~/'I~~j N/Rj~ TOWN / COUNTY e- M CLASS PERC_ TIONAL-A CONVENTIONAL LIFT- MOUND- HOLDING TANK- IN-GROUND PRESSURE- SEPTIC TANK SIZE An p fir) LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ABSORPTION AREA Y PERC RATE 3 BED SIZE S PLUMBER LISCENSE NO.-/ :DATE BM Assume ele anon 100' Location of Benchmark a Q Borehole Q Well 0 Perc Hole System Elevation TYPAR COVERING 2.. 2" _ 2.. 2" C4-1 ' (4 1 1 12" I Sewer Rock i I 12 ft. 18 ft. 2 4 ft. /V0 /16'45,,4 f I o ~ fj ":lam v