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Parcel 030-1053-60-000 02/18/2005 05:12 PM
PAGE 1 OF 1
Alt. Parcel 23.30.19.197U4 030 - TOWN OF SAINT JOSEPH
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): * = Current Owner
' ZAHLER, DOUGLAS J & BONNIE L
DOUGLAS J & BONNIE L ZAHLER
1412 RIDGE RUN
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description 1412 RIDGE RUN
SC 3962 NEW RICHMOND
SP 1700 WITC
Legal Description: Acres: 2.200 Plat: N/A-NOT AVAILABLE
SEC 23 T30N R19W GL 1 LOT 4 OF CSM 1/238 Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
23-30N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
09/28/2000 630698 1546/115 WD
07/23/1997 825/199
07/23/1997 740/39
07/23/1997 726/402
2004 SUMMARY Bill Fair Market Value: Assessed with:
5173 181,000
Valuations: Last Changed: 07/08/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.200 60,700 117,400 178,100 NO
Totals for 2004:
General Property 2.200 60,700 117,400 178,100
Woodland 0.000 0 0
Totals for 2003:
General Property 2.200 35,600 90,800 126,400
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 108
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
` Form- STC- 104
AS BUILT SANITARY SYSTEM REPORT
OWNER ' TOWNSHIP SEC. T N-R / W
ADDRESS ~ ST. CROIX COUNTY, WISCONSIN
SUBDIVISION LOT LOT SIZE e~t t 1
PLAN VIEW 1 ( fi
Distances and dimensions to meet requirements of I1,HR, 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
R
1
INDICATE NORTH ARROW
BENCHMARK: Describe the vertical reference point used
Elevation of vertical reference point: Proposed slope at site:
SEPTIC TANK: Manufacturer: Liquid Capacity:
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,
feet
0
From nearest property line Front,O Side,O Rear, O
feet
Number of feet from: well , building:
(Include this information of the above plot plan)( 2 reference dimensions to septic tank)
SEE, REVERSE SIDE
PUMP CHAMBER
Manufacturer: Liquid Capacity:
Pump Model: Pump/Siphon Manufacturer: Pump Size
Elevation of inlet: Bottom of tank elevation:
Pump off switch elevation: Gallons per cycle:
Alarm Manufacturer: Alarm Switch Type:
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).
SOIL ABSORPTION SYSTEM
Bed: Trench:
Width: Length: Number of Lines: Area Built:
Fill depth to top of pipe:
Number of feet from nearest property line: Front, O Side, O Rear, 0 Pt
Number of feet from well:
Number of feet from building:
(Include distances on plot plan).
SEEPAGE PIT
Size: Number of pits: Diameter:
Liquid depth: Bottom of seepage pit elevation:
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: Capacity:
Number of rings used: Elevation of bottom of tank:
Elevation of inlet:
Number of feet from nearest property line: Front, O Side, O Rear, O Ft.
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:
3/84:mj
bEPARYMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P:O. BOX 7969 BUREAU OF PLUMBING
MADISON, WI 53707
' CONVENTIONAL ❑ALTERNATIVE state Plan LD Number
Ilf assign edl
❑ Holding Tank ❑ In-Ground Pressure ❑ Mound
NAME OF PERMIT HOLDER. n ADDRESS OF PERMIT HOLDER INSPECTION DATE yil"
Kenneth J. Herink R. R. 1, Roberts, WI 54023 l-
_ o
BENCH MARK (Permanent reference point) ESCRIBE IF DIFFERENT FROM PLAN BEE. PT. ELEV.. CST HEE. PT. ELEV
NE SE, Section , T30N-R19W, Town of St. Joseph
Name of Plumber. JMPIMPRSVI No (:aunty Sanitary P,,- N-, I,,,
Stephen Aaby 5184 St. Croix 75013
SEPTIC TANK/HOLDING TANK:
MANUFACTURER. LIQUID CAPACITY. TANK INLET ELL V. TANK OUTLET ELEV WARNING LABEL LOCKING COV ER
S C? PROVIDED PROVIDED
L• t' 7 L VYES E-11\10 ❑YES NO
TI IL-I
rLH NUMBER OF H p. vROPERTV wFLL. BUILDING To FRESH
B VENT DIA VENT MA 1"'LA`" AN^/1 wn IVENT
AIR INLET
FEET FROM
❑YES NO
YES NO NEAREST
Ci(I
DOSING AMBER:
MANUEACTURER BEDDING. LIQUID CAPACI rv PUMP MODE I PUP SIP...... WARNING LABEL LOCKING COVER
PROVIDED PROVIDED
❑YES ❑NO YES ❑NO ❑YES ❑NO
GALLONS PER CYCLE: PUMP AND CON THOLS OPERATIONAL NUMBE F HUI fI1' WELL BUILDING VENT TO FRESH
(DIFFERENCE BETWEEN FEET O „ aIR INLET
PUMP ON AND OFF) ❑YES DNO NEA ST
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing E H MATT HIAL AND MAPKINI,
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:
wiDT LENGTH NO OF 111TH PIPI 11,V '.INt, _~JV1H ~;;II:L f~lA IS
P T LIQUID
BED/TRENCH HINCIIrS 6 ntrHlA: --I PIT DEPTH I' I DIMENSIONS
GRAVEI_ DEPTH FILL DEPTH VISTA PI f DISTH PIPE DISTR. PIPE MATERIAL NO DISI.+ NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH
BELQw PIPes~ ABOVE COVER 111V iNl l r j .3p
v I vD Pier FEET FROM LINE ~ nl~vt.E~.
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 PFHMANf%T%'AI~ KIHS uHSEHVAn()NwELLS
Ej_YES CJNO ❑YES ❑NO
DEPTH OVEH TRENCH BED JDEPTH DVI-H 1HENCII HrI I)(PTrI OI TI)PSOIL 111DF1'. JF. . MULCHED
CENTER EDGES
L_~YES L_]NO ❑YES ❑NO ❑YES ❑NO
PRESSURIZED DISTRIBUTION SYSTEM: _
WIDTH LENGTH NO. OF IATEHALSPACING GHAVE L DEPTH HE LOW PIPF FI LL DEPTH AHOVE COVFH
BED/TRENCH TRENCHES
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR PIPE MANIFOLD MATERIAL NO UISTH UISTH PIPF DISTHIBUTION PIPE MATFHIAL & MARKING
"'v . ELEV. DIA ELEV. PIPES DIA.
ELEVATION AND
DISTRIBUTION
INFORMATION HOLE SIZE HOLE SPACING DRILL E D CORHF C I I Y COVEH MAI EHIAL VENT ICAL LIFTCORRESPOND$TO APPROVED
PLANS
❑YES ❑NO ❑YES ❑NO
COMMENTS: PERMANENT MARKERS'. JOBSERVATION WELLS J~~F'EUEMT BER OF PROP ERTV WELL. BUILDING
FROM LINE
❑ YES ❑ NO ❑ YES L_ NO EAREST---*
4` G ; , 12 S
~t
Sketch System on fT Ir1 county file for audit.
Reverse Side.
SIGNATUR TITLE
DILHR SBD 6710 (R. 01/82) M /
wlsconsln APPLICATION FOR SANITARY PERMIT '
DiLHR s~`c~e►X COUNTY
oevRRTmEnT oc (PLB 67) UNIFORM SANITARY PERMIT #
- InOUSTRV.LRBOR&HUMAnRELRTIOnS
-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 MAILING ADDRESS
f
PROPERTY LOCATION 00XV:
/ 1/4 ,E1/4, S T3QN, R 16 (or)TOWN OF: 7-
p S
LOT NUMBER JBLOC NUMBER SUBDIVISION NAME N~EEARES ROAD, LAKE OR LA DMyA~R/K STATE PLAN I.D. NUMBER
F- S~JI~n. ff
TYPE OF BUILDING OR USE SERVED
1 or 2 Family Number of Bedro.)ms. 3 ❑ Public (Specify): 1111
THIS PERMIT IS FOR A:
X New System ❑ Tank Replacement ❑ Repair
Replacement Soil Absorption System ❑ Revision ❑ Privy
u Alternate System LJ Reconnection Petition for Modification
IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK.
X 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
`J 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
Septic Tank Capacity 6 00
Lift Pump Tank/Siphon Chamber
Holding Tank capacity
Manufacturer: 's IC-"t C )Z, O -
IF THIS IS AN ALTERNATIVE SYSTENII COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure
Total # of Prefab. Site Steel Fiberglass Plastic
Gallons Tanks Concrete Constructed
Septic Tank Capacity
Litt Pump/Siphon Chamber
Manufacturer:
PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY:
(Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet):
6 1 s~ 6 y!} Private El Joint El Public
1, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans.
Name of Plumber (Print): Signatu e: / MP/MPRSW No.: Phone Number:
Plumber Address: Name of Designer:
-57 ` Gvc~~v/'LC;.~/?~ 41
COUNTY/DEPARTMENT USE ONLY
Signature of Issuing Agent: Fee: Date: Disapproved
Jt Ly y.7 L~ Owner Given Initial
Approved Adverse Determination
Reason for Disapproval:
Alternate course(s) of Action Available:
DI LHRSBD 6398 (R 5 82) DISTRIBUTION: Oriqinal to County, One Copy To; Bureau of Plumbing, Owner, Plumber
APPLICATION FOR SANITARY PERMIT
S T C - 100
This application form is to be completed in full and signed by the owner(s) of il,L.
property being developed. Any inadequacies will only result in delays of the permiL
issuance, Should this development be intended for resale by owner/contr~rctor,("sE>ec
house"), then a second form should be retained and completed when the properly is
sold and submitted to this office with the appropriate deed recording.
- - - - - - - - - - - - - - - - - - - - -
Owner of Property i j_ J_
Location of Property
Section T N- R W
Township
Mailing Address
Subdivision Name
Lot Number '
Previous Owner of Property r'; 1 I-
Total Size of Parcel
Date Parcel was Created
Are all corners and lot lines identifiable? Yes No
is this property being developed for resale (spec house) ? No
Volume and Page Number as recorded with the Register d I)(edr,
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 Certificd Survey
Map, the the Certified Survey Map shall also be required.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
PROPERTY OWNER CERTIFICATION
1 (We) ee4ti6y that aU 6tatement6 on .thi.6 6o4m cute .titue to the b"t o6 my (utc )
know.bedge; that I (we) am (are) the owner. (s) o6 the pnopetLty deg c4 bed iii Obf-s
in4u.4mati,on Jo4m, by viAtue of a wcvvtanty deed neeonded in the 06J-1-'ce u6 tl«
County Regi4.ten o4 Deeds ae Document No. ' ; and that I (we)
pneaent.by own the pn-oposed bite bon the sewage posa.P aya•tem (on I (we) havc
ob-ta,%ned an ~ ement, to stun with the above de~sc&ibed pnopelt.ty, bon •the-
eon.6tAucti.on o6 said system, and the same has been duty neeonded in the 06fi,CC,
o6 the County Regis.ten o6 Deeds, as Document No. )
~i
y.
S 'f C - 105 l'
rl
SEPTIC TANK MAINTENANCE AGREEMENT
0
St. Croix County
L~
OWNER/BUYER-
ROUTE/BOX NUMBER Q-2 re Nulllbur
f
CITY/STATE X. t I,
PROPERTY LOCATION: SuCLiull N W
Town ul' St. Croix Count
Subdi.vis to ll 1.uL nuulbor
Improper usu `slid mainCenancu of your supCic system could result in
its premature failure to handle wastes. 1'rupur maintunance con-
si.sLs of pumping out the supLLe Lank every three years or sooner,
if aeuded, by a licensed suRQj Lank humpor. What you put into
Chu system can affect. the fuuCLtun of Chu septic Lank an a Cruat-
mu"C stale in Chu waste disposal system.
St. Croix CuuuLy rusidenLb play be uligiblu Lu ruc rive a gVanL for
a Maximum of 60% of the cusL of ruplacumunL 01 a failing System,
which was in operation prior to July 1, 19713. St. Croix County
accepted this program in August of 19BU, wiLh the ruqulruwunL Chat
owners of all new stuuls avrue to kuup their systems prupurly
maintalnud. _
The prupurLy owner agrees Lo submit to St. Croix County Zoning a
cerLificariun form, signed by Chu owner and by a oldster plumber,
journeyman plumber, rusLricLud plumber or a llcensud pumper veri-
fying that (i) the un-Site wastewater disposal sysLcm is in prupur
uperULing cuudiLion and (2) after inspection and pumping (if nuc-
essary), the sepCic tank is less than 1/3 full of s1udgu and scum.
CurCifieaLion form will be :aunt approximately 30 days prior Lo
three year expiration. H
I/WE, the uadursigned, have road Chu above reyuirume"La and agree v~
to maintain Chu private sewage disposal sysCum in accurdauce wiLh rl
the standards uuL forth, herein, as set by the Wisconsin Depart- 'U
went of Natural Resources. Certification Form must be compluLud
and returned to Chu St. Croix County Zoning Offl,qu wi.Lllfu 30 days
of Chu thruu year uxplrOL lon dale.
S I G N E D DATE 7-
I•
St. Croix (ounty Zoning Mice
P.U. jinx 9t
Hammu,ld, W1 54U15
715771)6-2239 or 715-425-13363
Sign, date and ruLuru Cu auuv,. ..'-truss.
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F
DEPARTMENT OF REPORT ON SOIL BORINGS N FETY & BUILDINGS
INDUSTRY, J BORINGS A ~ 1- x
DIVISION
LABOR AND PERCOLATION TESTS (115) PON WI 53707
HUMAN RELATIONS
(H63.09(1) & Chapter 145.045)
LOCATION: SECTION: - TOWNSHIP/fAt-H{CIPALITY: LOT NO.: .NO ' 1i$ I N
-4', 1/ 1/ N/R; /E (~)W _
COUNTY: O UYER'S NAME: ' MAILING ADDRESS:
+r
r i J
USE 1. DATES OB
NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DE IO RCOLATION TESTS:
Residence " 3~ - -
E e~ New ❑Replace
p~ IZ f f J, d / ~f'/ ~j
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUNDPRESSURE: SYSTEM-IN-FILL E U
HOLDING TANK: RECOMMENDED SYSTEM:(optional)
& S3 5 _5 U
INOT requird DESIGN ATE:If an
y portion of the tested area is in the dicate:'L fy Floodplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS %41 1~r >,~/~fL /T
BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEEPT/H IN, L OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK -1
7
s• .
J -7 6-
s . 4 77_f 7U157 "S") /_5
0, S 00. 3.-)-r 14
B-
3 .3 tr - f A1 ceu4-e , 7 3 /3,V l,4
I
/L ke7-
B-
PERCOLATION TESTS -~Irutr~
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PER 3 PER INCH
P- s~~, %,C s J,-, /t, r yz -
P_ soiz_ -5- 11A
P-
-
r
~P_
j 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
o'fland slope. 5VS✓£~j IN ~et'Er~ 3,-aa.-r3 j
SYSTEM ELEVATION E-~ s 'cT
r
qx
70
LQ
TN
r
tlaV77 AE-F, PF /5
20
r
X9-7` I-S7- aAv4~e
E T°`'
-AP po. 'C/'C-6"f Ti"o /ao. a
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 (print): TESTS WERE `COMPLETED ON:
Ite
RT. 3O'NEIL RD., HUDSON, WIS. 5 016 t/. d
ADDRESS: ROBERT ULBRICHT CERTIFICATION NUMBER: PHONE NU BER(optional):
MS. MASTER PLUMBER LIC. NO. 3307 M.P.R.S. 3F(-,P/
CST SIGNATURE-
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DIL.HR-SBD-6395 (R. 02/82) _ OVER -
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SfP1iG "tiU~,ttlNG CL,. Ilu ROBERT ULBRICH WIS. 540I
tVls. MASTER PLUMBER
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