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Home My WebLink About028-1013-20-000 O O 3 v 0 d ~l ~ n r+ v m ro fD- a c a ro 3 _ ` 1 O co g S 7 Z o cn = o ~s n N N N 0 CO c C N `C j~ • (D 3 c: O 0 ~ j S N ~O H ~]/l Co O W a fp z d N co O CD W ;17 N Q O N m m (.J m n 7 (Up (D N cn p O m e CD n W O 3 o ) N co 7 O N d C N O = CD c a) C D CD a 00 f' a, NW ° s c Q c O o 3 O ? I~ V~V CL F~ o W m m w w :E4 G a Z N 0c) can ~ 0 r ,O. a o (roD x Z 0 0 0 G r; El co o f N y N o m ,t H cncncn aQ o m C M v N N O :3 < CD Ul v, „ m q v a 90 00 m C Q lfl O N O CD J N 3 a W ~ ~ I z r. ~ N o D D o O ~ a d 1 N N I Ul c - OIo m I ul n 3 O W OZ = -I N A Z ro C. 5i a 00 C) z z '0 tr1 171 O I • I-t7 W a M N V cn (D 00 CL z td O 0 z 3 w rt m v (1+ G' H. 3 rt O y z 7t G C a N N C r-, rat ~ 30 o a 3 cn oo ° 3 3 z a O (D o c ro C a M :17 N N (D (D (D (D _ "p y C O 7 N CD- y A (D T. N. O N 00 A d C) fi O N O a N O W N N pN A ~ p a x in- , °o Parcel 028-1013-20-000 01/23/2006 03:56 PM PAGE 1 OF 1 Alt. Parcel 11.28.17.65B 028 - TOWN OF RUSH RIVER 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 THOMAS L & JANET L DELONG O - DELONG, THOMAS L & JANET L 478 200TH ST BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 478 200TH ST SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 20.000 Plat: N/A-NOT AVAILABLE SEC 11 T28N R1 7W S 1/2 OF NE NE Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 11-28N-17W Notes: Parcel History: Date Doc # Vol/Page Type 10/08/2004 776567 2672/342 WD 07/23/1997 841/596 2005 SUMMARY Bill Fair Market Value: Assessed with: 82753 253,400 Valuations: Last Changed: 08/30/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.000 20,000 163,200 183,200 NO 05 PRODUCTIVE FORST LANDS G6 19.000 66,500 0 66,500 NO 05 Totals for 2005: General Property 20.000 86,500 163,200 249,700 Woodland 0.000 0 0 Totals for 2004: General Property 20.000 22,700 98,700 121,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 202 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 028-1013-40-000 01/23/2006 03:56 PM PAGE 1 OF 1 Alt. Parcel 11.28.17.66B 028 - TOWN OF RUSH RIVER 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 THOMAS L & JANET L DELONG O - DELONG, THOMAS L & JANET L 478 200TH ST BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 20.000 Plat: N/A-NOT AVAILABLE SEC 11 T28N RI 7W S 1/2 OF NW NE Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 11-28N-17W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 841/596 2005 SUMMARY Bill Fair Market Value: Assessed with: 82755 Use Value Assessment Valuations: Last Changed: 08/30/2005 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 11.000 2,000 0 2,000 NO 05 AGRICULTURAL FOREST G5M 9.000 15,800 0 15,800 NO 05 Totals for 2005: General Property 20.000 17,800 0 17,800 Woodland 0.000 0 0 Totals for 2004: - General Property 20.000 9,400 0 9,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Total Special Assessments Special Charges Delinquent Charges 0.00 0.00 0.00 Form-STC- 104 AS BUILT SANITARY SYSTEM REPORT OWNER i%" 'TOWNSHIP SEC. T N-R ; W ADDRESS ST. CROIX COUNTY, WISCONSIN w SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of ILRR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 4 i I I S Oo Gi. o i I=•usr -ro i i q6 r~ r 1 , L~ ~ t INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used ;jf,,~~ Elevation of vertical reference point: :e ~ Proposed ~ '1 slope a~site: SEPTIC TANK: Manufacturer: .j ~ Liquid Capacity: jG' Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front,0 Side,o Rear, Q feet From nearest property line : Front,0 Side,0 Rear, O feet Number of feet from: well 11 building: _ (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Liquid Capacity: Jam, Manufacturer: pump Model: Pump/Siphon Manufacturer: ~/.r e f 0~ Pump Size Elevation of inlet: Bottom of tank elevation: ~Pump off switch elevation: Gallons per cycle: cZ fly Alarm Manufacturer: 11//'1/n Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear, Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Trench: Bed: Width: Length: =,l> Number of Lines: Area Built: Fill depth to top of pipe: X Number of feet from nearest property line: Front, O Side, O Rear,0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: D' meter: r i Liquid depth: Bottom of ~e age p- levation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Cap ity: Number of rings used: 1 vation f ottom of tank: / r Elevation of inlet: line: Front, O Side, O Rear, 0Ft. Number of feet from nearest proper y Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: Plumber on job:! License Number:/ i ~3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS P.O. BOX 7969 PRIVATE SEWAGE SYSTEMS DIVISION MADISON, WI 53707 1i BUREAU OF PLUMBING O CONVENTIONAL XALTERNATIVE Stale n ID.N-lb- ❑ Holding Tank ❑ In-Ground Pressure Mound assigned) 8500756 NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Earl Huenink Baldwin, WI 54002 4.51 S BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELEV SE NE, Section 11, T28N-R17W, Town of Rush River Name ,t Plumber. MP/MPRSW N,, County Sanitary Permit Number. Everett Boldt 4489 St. Croix 58949 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY: TANK INLET ELEV.. TANK OUTLET ELEV.: WARVINING LABEL LOCKING COVER PRODED: PROVIDED- k (i 7%~ tJ l-~ NYES DNO DYES ~~ff L•_`N BEDDING: VENT DIA.. VENT MAT L. HIGH WATER O VENT FFE BER OF ROAD: PR OPERTY WELL BUILDING VENT TO FRESH A JLAM FROM LINES Z (AIR INLETDYES O L-EYES ENO REST CO J DOSING CHAMBER: MANUFACTURER BEDDING. LIQUID CAPACITY PUMP MODEL. PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED PROVIDED V+ t~ DYES NO C AYES ENO DYES ENO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL e. NUMBER OF PROPERTY WELL BUI LDING. VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE ~r- AIR IN ET PUMP ON AND OFF) DYES ENO NEAREST ~0!~1 k `r Lt SOIL ABSORPTION SYSTEM. Check thesoil moisture at the depth of plowing FORCE LEN T ; DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until t the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH. LENGTH NO. OF DISTR. PIPE SPACING COVER BED/TRENCH INSIDE DIA s Plrs uoulD DIMENSIONS TRENCHES MATERIAL' PIT DEPTH. GRAVEL DFPTH FILL DEPTH UISTH. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR NUMBER OF PROPERTY WELL. BUILDING. VENT TO FRF& BF LOW PIPES gB(7VE COVER ELEV. INLET ELEV. END. PIPES LINE. FEET FROM 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. DYES ENO SOIL COVER TEXTURE f PERMANENT MARKERS OBSERVATI:00NN:VVVV ELLS DYES ENO DY_ENO DEPTH OVER TRENCH:BED DEPTH OVFR TRENCH;BED DEPTH OF TOPSOIL SODDED SEEDED. CENTER ! - EDGES MULCHED DYES ❑O JYES ENO YES ENO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LENGTH NO. OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER . BED/TRENCH - rRENC HE DIMENSIONS J MANIFOLD A PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. NO DISTR DISTR. PIPE DISTRIBUTION PIPE -MATERIAL & MARKING. ELEVATION AND ELEV 1 ELEVp ' CIA ELEV / PIPES Dln: DISTRIBUTION IN HOLE SI E HOLE SPACING. DRILLED CORRECTLY FORMATION ~ COVER MATERIAL. VERTICAL LIFT CORRESPONDS TO APPROVED r PLANS 1_I ~A ES ENO DYES ENO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPE,$J WELL: BUILDING. FEET FROM EKES ENO EYES ENO NEAREST Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE - TITLE. ....4... DILHR SBD 6710 (R. 01/82) f i wismnsin APPLICATION FOR SANITARY PERMIT ~ D I L H R s~ X COUNTY oEaggTmEnT of (P L B 67 ) - InOUSTRYITB 6HUTgngELqTlOnS UNIFORM SANITARY PERMIT # -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'/2x 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNER t MAILING A RESS 4 /q E ~~L E? w / rt/ r /3 c/ Ca,/ r .J Lam' i S 5 jL U PROPERTY LOCATION CITY: Sr l4 Nfl 14, S ~j , T~ N, R OF. S ( or) LOT ;7A BER BLOCK NUMBER SUBDIVISION NAME N ARE ST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER IVA /Yr+ ,sus c~ 0 7~5`;F: TYPE OF BUILDING OR USE SERVED 1 or 2 Family Number of Bedrooms. ct ❑ Public (Specify: THIS PERMIT IS FOR A: New System ❑ Tank Replacement ❑ Repair ❑ Replacement Soil Absorption System ❑ Revision ❑ Privy X 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 U 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 - - - Gallons Tanks Concrete Constructed Steel Fiberglass Plastic Septic Tank Capacity 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 Gallons Tanks Concrete Constructed Steel Fiberglass Plastic Septic Tank Capacity ~e.)o Lift Pump/Siphon Chamber C) 0 0 /V e_ Manufacturer: I ~S c~ PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): WATER SUPPLY: F !S~e_ 4C, ;Z Stt ` XPrivate ❑ Joint ❑ Public I, the undersigned, hereby assume responsibilitVt tion of the private sewage system shown on the attached plans. Name of PI ber (Print): ~ty ~ ~ ~ 7 Z t, cy MP/ MPRSW No.: Phone Number: m,7 Plumber's dress: Name of esigner: C✓e rae f ,fit L~~f f COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved L~ti~ Ll Owner Given Initial / / Jv Approved Adverse Determination Reason for Disapproval: Alternate course(s) of Action Available: DILHR-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 w :e' is _erver_f, it 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. SEE PAGE 15 \60UNDANY p II RD ° '(c _°bOn ~ 0 ~\1 f~A~ v~ ~a to ~ e ~ 0 • 12~a Lub ~ha/e.z 0'I ~'"b \ °Y ~IC1 ] • p Dap ? `I ~00 0 [T! o ao v c 4 ~ C 1 n v v~ C ao 6z6s a n C F q m cc T ~i, A O q A~ 6 i. k~ ~a 0.r. A o c. m o a o "a p `F ~n . °2 w a j rj b y o b° A r A 1 ~ ay 9 s• Rm A •ann oo~~ b ~ v an 4 ~r~ 0 ~ o0 0 \ ~ 1•R e ~QA n yA ° ° D Nees e/so o~ o~pry no i ~ . •ti fb' ` ~ 4 5A ~ ~ = 0 ~ ti ro ~ 3 0 0. Led "ate Z P o¢ ~ ° ~ 3 tin O ° 0~ u " Np b C~ A Z Fedf vA oi~o 4o ti 4 m~ oa ~p s °y m Ss4h 4~o a ~l, ~o • 411 'A SqM aq0 aa 0'~ 6 Z~ p o a ti. ~ do/ph • y. R~"L °AQ<l~o~ e~n cGm~p.o0. N 7^, t'Hy° ~\~1 ue Rr ti 1 C o S nT °R a m v No. u9ERr . ~ ~ W o n ro ~ ~ eU3r9e'- e. ~'o <~e~° ~~s b~'C v • M• l 0 80 4 C o 0 D 0 A ~ .y° e9- ~ ~ tTarnes fe e~sl` ~Cjco~ e ~ ~a J Me~fo.~ Dr \ ~ 1 0 cSi¢ro/~/a.~ p~ ~ 0~ A Timme~rna n ~0 ~ o • ~i x N E.r A 8¢ go a \ rb 0 fix " 0 ~ y ° 'M • He bei'f_ • ~ V 7,5 v o ~ n y c~d~c ~,a Q ti ~ C~ ~ ti ~r ~ m a~ p s n o d o~ F b A n0 ie Ny .Cx ~G~ on3°ad~ + 4~P OAA y, 04 • ^xi ~n y0 0 rPCr n Sao ~H n 45 3 q0 '°dr ° T~~ Y Ari Ilk ` ~a m R• o Dq` 5P N 0.y' a k H m @R A ~c~7j ~~m P a C~yT 30 or J.sM:~•,9/~ e.9r a ,Pcrd/,5 ,CrRS: V ~ee.F P~QUSe ° a c o o o m o ?v ° Z ti •ti v A vn~ ~R . ~mrh lo` Q• 6z /ss n ~ x 0 ~+co P b N q v 0 TQ "P L/Nf DR 0 ftr 59n`O Y: • . n O "Rq o A nl r H r •°A.~ y D. 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J 1 O A h~is1% ~a _ p rp OR, " ti a as ~ ~ m ;~c N ~O ~ °~1~ C4 ~ ~ inA >%nh ERZi .XT^ \ ~ ~`4 ^3~n• wa ~ ~ 4j~° i~ mA4 0 hq o~RS. 0'n m 1 •-,tt"eev 4o 0A CC ~o ao vrD3 ` CAJ 4 rp4 OD ao ~i nrbk o n, A~ ~ ~A Horb. k~ gas T oNcU 3 ~0. °a sm T 0~, m ~M~~n4 NERWOQD a Ong 4 U~y y, M N NCAND aa l~ OR C , 0 2G~ °Fl° • 0 jAio ~ ?op, • ti j30 0 v~n.be to • r ^ k ~ 0 ~ Q~ V7~* 1 by 0 • ~n R oA ~rj~ O Ap J 0 ~i\ ~r 0 2 111 A~Q d1yN 6 G,CM N ~QR G y°? ~JA0(p 41 ~i E ye~re SCa- ~'Oq J j ~ m ~a ~ C 1~ on~ om A o n ~ m0'r • ~ mho La~sa~ ~a.6a O~nA ~ Illvvv o ti 010 H ~I A,13 ~ R bCC 0. 0 Pr o\ F j C mcoI $ p \ oq~ zo A` fozo ° o~ 3R p~j W C W %/a d Q er?o 0 j Q Q, O a C C/ ~k r Q -DI /s/ M N AVE. $ Q n" 6 Ma~.e a 3.~ pso` _ p R o h R • " 9ma/d £ ° O>f L ° ~ Bo • ~ ~e ~ • a j ~ O~ A Avo/¢/ gild/c ~a ck~ /NN/-VALLEY SEE PAGE /9 v Parcel 022-1075-60-030 12/20/2005 04:46 PM PAGE 1 OF 1 Alt. Parcel M 27.28.18.420A-05 022 - TOWN OF KINNICKINNIC Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 05/20/2004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner MERLE C NIELSON O - NIELSON, MERLE C 145 CTY RD JJ RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 1291 EVERGREEN DR SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 7.859 Plat: 4752-CSM 18-4752 022-04 SEC 27 T28N R18W PT SE NE & PT SW NE CSM Block/Condo Bldg: LOT 4 18-4752 LOT 4 (7.859 AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 27-28N-18W NE Notes: Parcel History: Date Doc # Vol/Page Type 05/20/2004 763246 2576/548 AFF 2005 SUMMARY Bill M Fair Market Value: Assessed with: 143781 219,200 Valuations: Last Changed: 08/11/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 7.859 80,000 141,600 221,600 NO Totals for 2005: General Property 7.859 80,000 141,600 221,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 022-1075-60-026 12/20/2005 04:45 PM PAGE 1 OF 1 Alt. Parcel 27.28.18.420A-11 022 - TOWN OF KINNICKINNIC Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 05/20/2004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner THOMAS L JACKELEN O - JACKELEN, THOMAS L 145 CTY RD JJ RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 8.803 Plat: N/A-NOT AVAILABLE SEC 27 T28N R18W PT SE NE & PT SW NE EXC Block/Condo Bldg: CSM 11/3215 EXC CSM 12/3496 ALSO THAT PT OF SW NE LYING ELY OF HWY EXC CSM Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 12/3304 EXC CSM 17-4506 & EXC CSM 18-4752 27-28N-18W NE Notes: Parcel History: Date Doc # Vol/Page Type 2005 SUMMARY Bill Fair Market Value: Assessed with: 143780 21,800 Valuations: Last Changed: 08/12/2005 Description Class Acres Land Improve Total State Reason UNDEVELOPED G5 8.803 22,000 0 22,000 NO Totals for 2005: General Property 8.803 22,000 0 22,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 022-1075-60-025 12/20/2005 04:46 PAGE 1 OF 1 F 1 Alt. Parcel 27.28.18.420A-10 022 - TOWN OF KINNICKINNIC Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 05/20/2004 00 4 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - NIELSON, RETIRED RETIRED NIELSON Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 26.662 Plat: N/A-NOT AVAILABLE SEC 27 T28N R18W PT SE NE & PT SW NE EXC Block/Condo Bldg: CSM 11/3215 EXC CSM 12/3496 ALSO THAT PT OF SW NE LYING ELY OF HWY EXC CSM Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 12/3304 EXC CSM 17-4506 27-28N-18W NE Notes: Parcel History: Date Doc # Vol/Page Type 2005 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 04/22/2005 Description Class Acres Land Improve Total State Reason Totals for 2005: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 kn 7 y P se y 4 p ro _ M ~ u t f _ . ` J1 1 fp 1n c t,y 44 LLI 4 t, F m II z~ <E: 1 Page / Of / cJi*S ' Straw, Marsh Hay, Or Synthetic Covering I Distribution Pipe Medium Sand Topsoil H e E O W9 0 y . b Q~'`'a9u % Slope Bad Of Yom" 2 -2 Force Main Plowed Aggro-late From Pump Layer Of C3 OF ross Section Of A Mound System Using E--T--a5 ct>P~~~ t A Bed For The Absorption Area F 7' G /,0 A S Ft. H /H 5 . Signed; 2 rz~'~ 8 3~0_ Ft. License Number: Ft. Date: - J 7, Ft. K /O, /aSFt . Alternate Position L O..~SFt. of Force Main W a~•~SFt. Observation Pipe 8 K StIl A I _ - a W ---------------•I Force Main From Pump Distribution _ Bed Of 2 Pipe 2 2 Aggregate Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area tea 1 R L. u e N N K z~ Page Of - ....w `r cl wt' WiS two lk" P•__- ifor9t2d Pigs o41011 v~ 1~ I'M En 4 coo )PIrforoted x PVC Pipe R Hok~z I.RCO►ed On 8oltgm Aft E44011y Spaced ~4{"" 4 d 4 PVC Force Moir j"L pv~ Manifold! PjaeL [f istri}tution 4I11+natr Position of 4k h Pipe ForcR MoFtO ' " Loal, M~►R; ~lts►ufd tat s NO 14 End Gap 9 _ E" r." f?slributian Pitts layout p v~c3 i It, R s~ h ci =x Inches s .7 Y,. Inches SignedHole A1amer Inch I,teral / Inch(es) L i cq►" i Number : P 9 Manifold oZ Inches Date Forte lhai t4` Inches _ # of holes/pipe " r Invert Elevati A of tairo rals fib. _ r S , }f 3 tI K HYDR##Om RTIC H-82 PUMPS 28 24 20 Bob" = 16 D { = 12 sV'~!s Ig 8 10- 4 SUBMERSIBLE rf 5 10 15 20 25 30 35 40 45 U.S. GALLONS PER MINUTE SUMP Head-Capacity: SV25 and SV33 Submersible Sump ppm MejC. Solids IY Sphem; 4 Pole, 60 Hz PUMPS 28 20 24 a.~ x 9 fs Y. 12 I. iii.. s Ae ~-8 y < 8 y Rye J c~c, ` 0 forr` y'. 1,. 10 20 30 40 W 60 U.S. ~~0~ia..r:rsrGALLONS PER MINUTE Head-Capacity: SP33 and SP25 Submersible Sump Pumps Max. Solids SP33,'/i" & SPZS,'/4"Sphems; 115 Volts, 60 Hz., 1750 RPM E '140 120 _fiIM HEAD x ,080 EFFLUENT 60 d Spt0H 40 20 PUMPS SPgpk I -0 20 40 60. 80 100 120 140 U.S. GALLONS PER MINUTE Head-Capacity: SP50H, SP100H and SKR150 High Head Effluent Pumps Max. Solids SP50H, SP100H & SKH150, 3/4,, Spheres; 115 Volts, 60 Hz, 3450 RPM LL DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISON, WI 53707 P.O. BOX 76 HUMAN RELATIONS (H63.09(1) & Chapter 145.045) LOCATION. g f5 SECTION: pp / TOWNSHIP/ Y: LOT NO.: BLK.. NO.: SUBDIVISION NAME: lYie COU11NTj: OWNER'S BUYER'S NAME: MAILA N~ ADDRESS: 141 U e A,/ Al A,' USE DATES OBSERVATIONS MADE Residence NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFI I_.E DES RIPTIONS: PERCOLATION TESTS: New ❑Replace C;2 141, RATING: S= Site suitable for system U= Site unsuitable for system ON1E1 TI111L: MOUND: IN-GROUND PRESSURE:SYSTEM-IN-FILLHOLDINGTANK: RECOMMENDED SYSTEM: (optional) ~S u Ms ❑u Eu Zu ❑S ~u If Percolation Tests are NOT required DESIGN RATE: [Fflloodplain, an yportion of the tested area is in the under s.H63.09(5)(b), indicate: indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL ELEVATION D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH, Qom] OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- r , Q + ! ! r / Q f4 % r r r v~ .4 R°w f r 'S4 S-1 r, Al A1,5_, B- 3 B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOiPERIO 2- P RI_D PERINCH P_ rr Q jQ / P - - rj % P- ~ M /IV r! O Q , / ~f O P- O d rj r' 7 tr '44, P_ 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 98. . ' ' t . . a e E w . TN } i s i } I i , i i I ) } 1, 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 (print): TESTS WERE COMPLETED ON: ADDRESS: CERTIFICATION NUMB PHONE NUMBER optional): S URE: . DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - re o o 6Q y fin/ e.- 4 Lag .e t Va C q l1n O i q M o Elo v ri- ofd i I e/ 4J > - 9 n' iii / ~ • ~ - Nt~ 41- PLAN APPROVAL Saf an etau ofPlu bangs Division ~ DILHR P.O Box 7969 ❑ General Plumbing Plans Madison, WI 53707 ❑ Private Sewage Plans Telephone: (608)266-3815 OFFICE USE ONLY Plan Identification No. Gallons Per Day PRIORITY PLAN REVIEW ONLY Plan Review Petition For Modification Project Name Project Location - Street No. or Legal Description County ❑ City ❑ Village ❑ Town of: The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped "conditionally approved". This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. ❑ FOR GENERAL PLUMBING PLANS: This approval will expire two years from the date approved below. If construction has not commenced before the expiration date, new plan approval must be obtained. ❑ FOR PRIVATE SEWAGE PLANS: This approval will expire two years from the date approved below or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. Comments: By: James Sargent Bureau Director If Questions Plans Approved By: Date Approved: Contact cc: ❑ OWS ❑ DPS ❑ H&R & Rec. San. Section ❑ County ❑ Local PI ❑ Facilities Need Analysis Secti(A- ❑ UW-SSWMP ❑ Plumber ❑ Department of Agriculture DILHR-SBD-6099 (R. 01/84) ❑ Owner ❑ Other SBD 6678 (R. 08/83) (Plb 100a) (Wis Stats. S. 145.02) Detach And Return STATE OF WISCONSIN DILHR Upper DIVISION OF SAFETY & BUILDINGS Portion Of This Form With - BUREAU OF PLUMBING r ` { v 201 E. WASHINGTON AVE. RM 141 Any Return Corresponds 6 P.O. BOX 7969 f MqA V MADISON, WI 53707 608-266-3815 DATE: ~Q~V/~S r98$ ' PROJECT: PLAN ID. DETACH HERE - - - - - - - - - - _ - - - - - - - - - - - PROJECT NAME PLAN ID. This is to acknowledge receipt of your plans and specifications for the above-indicated project. Preliminary review indicates the required fee is $ Fee Received is $ ❑ Plan accepted for review. ❑ Underpayment- Please submit additional fee. Plans will be held in abeyance. ❑ Plans being returned. ❑ Overpayment-Refund forthcoming. ❑ Additional information required. SEE BELOW. ❑ No fee has been remitted. Plans will be held in abeyance. 1. Plan Submission ❑ Soil boring and percolation test data on 115 completed ❑ Additional information shall be submitted in duplicate unless by Certified Soil Tester. (1 copy) specifically noted. ❑ Petition For Modification signed by county, owner and ❑ Plans not clear, legible or permanent. notarized. (1 copy) ❑ All information submitted shall be signed, dated and sealed or ❑ Complete data relative to anticipated use of building. stamped in accord with Section ILHR 83.08 (2) (a) Wisconsin ❑ Deed restriction required. (1 copy) Administrative Code. ❑ Affidavit enclosed. ❑ Condominium declaration. (1 copy) ❑ Plot plan showing location of land parcel (distance from nearest road intersection, etc.), lot size and all distances from IV. Holding Tanks private sewage system to buildings, lot lines, well, water- ❑ Holding tank profile showing vent, manhole, alarm, course, swimming pools, water service piping, all weather ser- and manufacturer if state approved. Complete vice road, etc. Show benchmark with permanent elevation. construction details if site constructed. ❑ Holding tank agreement signed by owner and local II. Pressure Distribution Systems (Mound or Inground Pressure) unit of government (sample enclosed). ❑ Application for Use of an Alternative System signed by owner ❑ Reason for installing holding tank. Statement from and notarized. (1 copy) county or soil boring and percolation test data on ❑ County onsite required. (1 copy) ❑ Design calculations. 115 completed by CST, showing that a soil absorption system ❑ Soil boring and percolation test data on 115 completed by cannot be installed on the land parcel. Certified Soil Tester. (1 copy) ❑ Affidavit for all-weather service road (enclosed). ❑ Cross section of system. ❑ Pipe lateral layout. ❑ Plan view of system. V. Dosing Information ❑ Verification to Exception Status Form by county. (1 copy) ❑ Calculations for total dynamic head and gallons pumped per cycle. III. Private Sewage Systems ❑ Size, length and depth of force main- E] Ground slope with 2' contours in entire area of soil absorption ❑ Detail and model of pump or automatic siphon, including system extending 25' minimum on all sides. size, pump curves, drawdown, and average flow rate (GPM). ❑ Location of area suitable for replacement system - provide soil ❑ Cross section of dosing tank showing pump(s) or siphon(s), data. ❑ Construction details of septic, holding or dose tank if site VI. Systems in Fill (Fill must be placed prior to plan submission.) constructed, or tank manufacturer if state approved. ❑ Total area filled (fill to extend 20' beyond edge ❑ Construction details and cross section of soil absorption of trench before side slopes begin.) system. ❑ Depth and type of fill. ❑ Copy of signed onsite report by county or district staff. C 100 Owner of Property rog/Z . /~u e Nir/ J" .Location of Property S~_ NE Section ~0 N k /7 W Township RuSf~ rC~ ✓~2 Mailing Address /~r4 L S Subdivision Name A/14 Lot Number Al" Previous Owner of Property Total Size of Parcel 17L 6 Date Parcel was Created Ara all corners identifiable? X Yes Nu Include with this aUplication one of the fullowii, .Certified Survey Map .Deed .Land Contract, or .Other Legal Document which describes the pruperty PROPERTY OWNER CERTIFICATION I (We) certify that all statements on this form are true to the best of my (our), knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed record ~j in the Office of the County Register of Deeds as Document No, ~g ; and that 1 (we) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the some has been duly recorded in the Office of the County Repigtar of Deeds, as Document No. SIGNATURE OF OWNFLA• SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE b10 EO DATE SIGNED H Ui r'J 1 C - 105 r Y SICP'C 1_C TANK MA I NTI~NANCE' ACKGEMENT H 0 St. Croix County o 0WNE'K B U Y E K ~AR A*,, A-' KOUTH/BOX NUMBER I~irU Numher CITY/STA7'I? f1~.~win! S Z t N ,Sr Sz DD L PIMPERTY LOCA'T'ION: SE a, N16 ta, SeC L i_un T 0Q0 N, I< /7 W Town of R~Sh~ - I'Si✓t ~2 St. Croy County, ubd I V iiu LoL number NA ~i finproper use `au(I mai11 Leit it ttcu of your Septic sYS teIll could result in iLtt premature failure to handle wastes. Proper ma in t ens 11cU Cott - SiSts of puntping out tilt septic tank every Lhree years or sooner, if rtUeded, by it Iicu It sud s.hti- c tank 1~utuhcr. What you put into the sy„tent Can afl cct the l one! oil of tht, :;Upt i_c I ait k it'; .t L I cat - meltL stage in the waste disposal. system. St. Croix CounL -y residents may be eligible to, rur( ivy grtttt lur it maxfIll uIll of 60% of the COSL UI* replaceutuuL of it Iai I iI I g SySLeill , Wit tclt war, fn operatlon prior to July f, 1978. St. C r 0 i X County accepted this program IIt AllguSt - of 1980, WIIIt the rC[I It iremeit I. that_ owners of at 1 Itcw ~;yst(.m!; ,ty;t ot, to kec' 1) t1w I r ~yr;t cnta 1) Y Ili it iit IL it inud. The property owner .Il,It- , to it bill iL Lu 5t_ Croix CuuuLy l.uuiui; ~I certificttt ion 10rIll , signed by Lite owner and by a ma:;ter ) uIli ber, Jour11 UyIll it I 1 plumber, restricted plumber or a licensed pumper vcri- fying t hat (1) the on -site wasLewater disposal sysLent js in proper operating; condition and (2) it fLer inspection and pit Ili piii g ( if uec - essary), Lite septic tack is Less than 1/3 full of sludge and sCLL Ill . CertifLCation form will be :punt at>proxiutately 30 days prior to three year ex1.)iratfon. 0 I/WE, the undersigned, havk' road the above rucluirc'nteuts and agree u to maintain the private sewage disposal r;ysLem in accordance with ~ the standards set forth, herein, as set by the WiSCUnsill Depart- o III Unt o1 Natural Resources. CertifiCatioil Iorut must be completed and returned to the St. Croix County Zoning Offi-Ce w _itliiIt 30 days of the three year uxpLrit Liou 'i.1, h p S I C N ED ll St. Croix County Zoning 01J. ice P.O. 13ox 96 ilantmo,I(I, WI. 54015 715-71) 6-2"23(1 or 715-425-8363 Sign, date and i uuurit to nhuve iuldresz; 5L, rl 23 T- tt `a b ti t L oc . Cl~ ~a II u~ A ro co .70 z 71 , ~ ~ ,~,p~atJt~ qa 14- Tt, i ~1 ate- ~°C V t op A 4o.., LAJ CI, d., it. ST 90, O r ~ 2 7o d N N (D a (D 7C O C; 0 N o o co H Q 0 'c° o E~uSi ~j l< =1 c X. 3 to A c O O 7• (D 'O a (D (D ° o H cn D CD N (D + O . .4 O a 0 0 p 6 (D cD t _ n ? •D (D N m fD a l~ cn -1 m m Pr o3a ocpmao w "C' 0 w 09 ? > > = C rl O c 7 C- c G C 3 6-a-0 l w W O. c or= 0 rrt C ..l W (~D O m 7 O O 0. = co CD W co m c cDi • C) CD w o Q En o O D n (D _ n 1 n f° 0 w 0 0 aO f O m o N m 0 'vii C m M N 0m~m°'cn Z U) l< f ca D _Z o m O O fD ~D CD 0 S CD a (D 0 3 (D (D a a -i CD CC OL 'o Sr m Q (n (D C n' m j En CL ~ ? a co W (A v aC ~m0 ~ U)wmo C m 3 0 3~ 3J CD c _-T 0 o a CD m _-T CD :3 -0 U) 'o CC W (D C 9 n W N O ' m CL 0 (A W w a (D _ O a (aD CO aa.. 0.0 m c '•C `CCp w =r (D G) CD CD O O ~ in' m O g FD* 0 c a 0 O O cQ a C lA _ z a c c N O F O O O -V m As ft CL 0 CD N' 3a o< (a CD nQ K S - ST. CROI X COUNTY s'a a`,` s 1y#t2r; WI SC O N S I N ZONING OFFICE - 796-2239 (HAMMOND) 425-8363 (RIVER FALLS) HAMMOND, WI 54015 March 8, 1985 Division of Safety and Building Bureau of Plumbing P. 0. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the Earl Huenink property, located in the SE4 of the NEB of Section 11, T28N-R17W, Town of Rush River, St. Croix County was done on 10-12-84. Suitable soils were revealed at a depth of 26 inches, below which seasonable high ground water was noted. This site should be suitable for a mound system. Should you have any questions, please feel free to contact this office. Sincerely, c Thomas C. Nelson Assistant Zoning Administrator TCN:mj STATE OF WISCONSIN-DEPARTMENT OF INDUSTRY, LABOR & HUMAN RELATIONS DIVISION OF SAFETY & BUILDINGS - BUREAU OF PLUMBING P.O. BOX 7969 - MADISON, WI, 53707 APPLICATION FOR THE USE OF AN ALTERNATIVE SYSTEM Location: Township 1iYsXd~;tzir: SE Z NE-41S 11 T 28 N/R 17 $ W Rush River St. Croix Street Address: Subdivision: County: Landowners Name: Mailing Address: ,Earl Huenink Baldwin, WI 54002 I (We), the undersigned, hereby make application for an alternative system on the above-described premises. I recognize that the above premises are not suited for a conventional private sewage system. If approval is granted, I agree to have the system installed in conformance with the Bureau's approval of plans and specifications. I further understand that an alternative system is more complex in nature than a conventional private sewage system and as such will require detailed inspection during construction and monitoring after the system is put into use. I agree to permit both county officials charged with administering county sanitary ordinances and Bureau employes or other authorized persons to have access to the above described premises at any reasonable time for the purpose of inspection the construction of or monitoring of the system. I further agree to either personally or by my agent contact the proper county official to arrange the time and date to begin construction of the system. I understand that this application does not permit me (the applicant) or my agent (the contractor) to begin installation. If the system is approved, the Bureau will send the applicant a letter of approval which authorizes construction of the alternative system after all necessary permits have been obtained. I agree to give notice to any subsequent buyer that an application for an alternative system has been made and if installed, that the premises are served by an alternative system and further agree to give the buyer a copy of this application. The Bureau accepts this application subject to this understanding and subject to all the conditions and obligations set out in this application. Signature of Applicant Date STATE OF WISCONSIN Subscribed and sworn to before me SS. COUNTY OF This day of 19~ Notary Public, State of Wisconsin My Commission Expires: DILHR-SBD-6413 (N. 05/81) WISCONSIN DEPARTMENT OF INDUSTRY, LABOR AND HUMAN RELATIONS DIVISION OF SAFETY & BUILDINGS, BUREAU OF PLUMBING P.O. BOX 7969, MADISON, WISCONSIN 53101 Verification of Exception Status for an Alternative Private Sewage System In the County of St. Croix Location SE 1/4, NE 1/4, Sec. 1 1 T 28 N, R 17x) W Town cxxidx~x Rush River Street Address Lot No. Block Subdivision Landowner's Name: Earl Huenink The application for this site is for: ® new construction use. ❑ replacement system use. If this is NEW CONSTRUCTION USE, the alternative private sewage system is: to have one of the first five approvals guaranteed for this year. This is number 59 - 02 - 6 of those applications. (Use one of the first five quota num ers issued to you. [ ]one of the applications needing a quota number. The quota number assigned to this application is - - U for one additional homesite on a farm to be occupied by a parent, child, grandchild, sibling, niece, nephew, or first cousin. [ Ifor an individual lot for which a sanitary permit was issued but was later ruled unsuitable due to new or changed soil criteria established by the department. [...]for an application on file prior to February 1, 1980. LJfor a lot that meets the criteria for a conventional private sewage system. If this is a REPLACEMENT SYSTEM USE, the alternative private sewage system is replacing: ❑ a failing conventional soil absorption system. 0a holding tank that was installed and in use prior to February 1, 1980. ❑ a privy that was installed and in use prior to February 1, 1980. If this is a REPLACEMENT SYSTEM USE and the Jot meets the criteria for a conventional private sewage system, check here I certify that the above information is true and accurate to the best of my knowledge. Name Thomas C. Nelson Si ure (County Official Title Assistant Zoning Administrator Date March 8, 1985 DILHR-SBD-6158 (R 12/82)