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Parcel 030-1093-60-002 02/25/2005 10:29 AM
PAGE 1 OF 1
Alt. Parcel 32.30.19.341 F 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
SHARP, BARBARA A
BARBARA A SHARP
456 CTY RD E
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 456 CTY RD E
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 4.740 Plat: N/A-NOT AVAILABLE
SEC 32 T30N R1 9W NW NE LOT 4 OF CSM Block/Condo Bldg:
5/1479
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
32-30N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1015/51 QC
07/23/1997 707/631
2004 SUMMARY Bill Fair Market Value: Assessed with:
5566 245,700
Valuations: Last Changed: 07/08/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 4.740 96,700 145,000 241,700 NO
Totals for 2004:
General Property 4.740 96,700 145,000 241,700
Woodland 0.000 0 0
Totals for 2003:
General Property 4.740 56,800 113,800 170,600
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 119
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Form - S T C - 104
M
AS BUILT SANITARY SYSTEM REPORT
OWNER 11 111 S l7 F~ r° ~1 TOWNSHIP ,;.)i" ~ SEC. T 3C) N-R _W
ADDRESS ST. CROIX COUNTY, WISCONSIN
SUBDIVISION } LOT LOT SIZE
PLAN VIEW 030-lo13 ~~/3q 1 P7
Distances and dimensions to meet requirements of ILH-R, 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM K-d
'C';
INDICATE NORTH ARROW
BENCHMARK: Describe the vertical reference point used`,
Elevation of vertical reference point: Z4~~' Proposed slope at site:
SEPTIC TANK: Manufacturer: LtiLiquid Capacity:
Number of rings used:
t%'k Tank manhole cover elevation: /D
Tank Inlet Elevation: __f ii/~ Tank Outlet Elevation:
Number of feet from nearest Road: Front,3-Side 10 Rear, O , feet
From nearest property line Front,0Side,0Rear,0 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 elevat~c4i: Gallons per cycle:
Alarm Manufacturer: Alarm Switch Type:
i
Number of feat from nearest property line: Front, Side, Rear O O Ft.
0
i' Number of feet from well:
Number of feet from building:
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed: Trench:
Width:(? Length: Zvi Number of Lines: Area Built:
Fill depth to top of pipe:
Number of feet from nearest property line: Front, O Side, 0 Rear,0 P't. C?
Number of feet from well:
Number of feet from building: 67(
(Include distances on plot plan).
SEEPAGE PIT
Size: Number of pits: Diameter:
Liquid depth: Bottom of seepage pit elevation:
Area Buac-
Has eit r a drop box O or distribution box O been used on any of the above soil
abs tion sytems? (Check one).
HOLDING TANK ;
Manufacturer: Capacity:
Number of ringsi6 d: Elevation of bottom of tank:
Elevation -F '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: klls2
~~/~J
License Number:
3/84:mj
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
0. BOX 7969 BUREAU OF PLUMBING
MADISON, WI 53'.07
XX CONVENTIONAL ❑ALTERNATIVE atate Plan 1. D.
i l i f as:iGnecf I
Holding Tank ❑ In-Ground Pressure ❑ Mound
`:AME OF PERMIT HOLDER. JADDRESS OF PERMIT HOLDER ;~NSPECTION DATE
Dennis Sharp R. R. 1, St. Joseph, WI r - i 70
_ i
~
40 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV. . CST REF. PT. ELEV
NW NE, Section 32, T30N-R19W, Town of St. Joseph, Lot#4
;Na,ne of Plumber. MP,MPRSW No County 3n,tary Permit N-her_
i
Gary L. Steel 3254 St. Croix I 64928
SEPTIC TANK/HOLDING TANK:
MANUFACTURER. ' LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER
PROVIDED. PROVIDED.
Z DYES LINO DYES LINO
BEDDING. VENT CIA VENT MAT L. JHIGH WATER NUMBER OF ROAD: PROPERTY WELL BUILDING. VENT TO FRESH
ALARM. FEET FROM •i7 LINE I AIR INLET.
DYES NO DYES NO INEAREST 7S
DOSING CHAMBER:
MANUFACTURER BEDDING-. LIQUID CAPACITY PUMP MODEL T PUMPfSIPHON MANUFACTURER WARNING LABEL LOCKING COVER
PROVIDED. PROVIDED.
DYES LINO DYES LINO DYES LINO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PHOPERTV WELL BUILDING SENT TO FRESH
(DIFFERENCE BETWEEN FEET FROM LINE aIR INLET
PUMP ON AND OFF) DYES LINO NEAREST
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing ENCSr:+ uIAMETER MATERIAL 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:
BED/TRENCH WIDTH ~ LENGTH NO. OF DISTR. PIPE SPACING COVER INSIDE CIA -PITS LIQUID
TR ENC HAS. M IAL: PI•r DEPTH
DIMENSIONS JS C%~/
GRAVEL DEPTH FILL DEPTH DISTH. PIPF DISTH PIPE DISTR. PIPE MATERIAL . N0. DI R NUMBER OF PROPERTY WELL. BUILDING. VENT TO FRESH
BELOW PIPES AIR ECOVER. ELEV ET ELEV PIPES LINE AIR INLET
.
Z t~ ~r FEET FROM
~s~4-
~ NEAREST
MOUND SYSTEM: v 4' Mound site plowed perpendicular to slope 7:e heck the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM
and furrows thrown upslope: ound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA-
YES NO ets the criteria for medium sand. TIONS MEASURED.
D LI
SOIL COVER TEXTURE PERMANENT MARKERS JOBSERVATION WELLS
DYES LINO DYES LINO
DEPTH OVER TRENCH :BED DEPTH OVER TRENCH: RED DEPTH OF TOPSOIL SODDED SEEDED MULCHED
(CENTER EDGES
DYES LINO DYES LINO DYES LINO
PRESSURIZED DISTRIBUTION SYSTEM:
WIDTH LENGTH. NO. OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER
BED/TRENCH TRENCHES
DIMENSIONS
MANIFOLD PUMP MANIFOLD JDISTR. PIPE MANIFOLD MATERIAL. NO. DISTR. jD:STRPIPE DISTRIBUTION PIPE MATE HAL & MARKING
ELEVATION AND ELEVELEVDIAELEVPIPESDA..
DISTRIBUTION
INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED
i PLANS
DYES NO DYES LINO
COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING.
7 FEET FROM LINE.
~L DYES LINO EYES LINO NEAREST
U O ei.! 6
'2,
Sketch System on etain in county file for audit.
Reverse Side.
SIGNATURj ~ TITLE
.
DILHRSBD67101R.01/82)
wlsconsln APPLICATION FOR SANITARY PERMIT
D I L H R COUNTY
1EnT OF (PLB 67) UNIFORM SANITARY PEERMIT #
QEPRP TR InOUSTPV, LRBOR 6 HurnRn RELRTIOnS ♦ ~ q ~ s^'
-Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'/2x 11 inchhr_es in size.
-See reverse side for instructions for completing this application. PLEASE PRINT
PR ERTY OWNER MAILING ADORE
inn IS 'her ,+4- 'k0
PROPERTY LOCATION C+T-Y:
01 /4 0 L 1 /4, S 3`Z , T-i~N,R
1 5~(ar) w TOWN OF: DJ
LOT N MBER BLOCK NUMBER SUBDIVISION NAME NEAREST OAD, A OR LAN MARK STATE PLAN I.D. NUMBER
N A- A) tie 1 ~ -t #
2
TYPE OF BUILDING OR USE SERVED ~A' ~y / lQg J
1 or 2 Family Number of Bedrooms: v 1 ' 60 - oo`
❑ ~ublic
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
Septic Tank Capacity
Lift Pump Tank/Siphon Chamber
Holding Tank capacity
Manufacturer: C1~ C~ &S Q C
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):
Private ❑ Joint ❑ Public
I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans.
Name Plumber (Print): Signature: rPRSVV No.: Phone Number:
Plumber's Add ss: f~ Name of Designer:
COUNTY/DEPARTMENT USE ONLY
Signatu e of Issuing Agent: Fee: Date:
(-1 ❑ Disapproved
K1 } % ~ c ~{l~~J / ~t r ~0 Approved Owner Given Initial
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 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
S T C - 100
This application form is to be completed in full and signed by the owner(s) of the
property being developed. Any inadequaoies 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 ~4- ct x 2,- i4
Location of Property
Nti ection
newly,
S
T ;~6N - R 19 W
Township
L _
Mailing Address ~~L f~ cc~D
Subdivision Name
Lot Number
Previous Owner of Property __-RrGCCQ- Z,_ a r
Total Size of Parcel S- Qf-~e s
Date Parcel was Created .
Are all corners and lot lines identifiable? i:/ Yes No
Is this property being developed for resale (spec house) ? Yes /
No
Volume and Page Number 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
1 (We) eenti.6y that a t statements on this 6onm sae .tAue to the but o6 my (oult)
hnowP.edge; that I (we) am (ane) the owneh (s) o6 the pnopen ty des cA i.bed in this
in6o4nati,on 6onm, by vi tue o6 a wahnanty deed neeonded in the 066ice o6 the
County Reg.i_e.ten o6 Deeds as Document No. t i ; and that I (we)
p4uentey own the proposed site bon the sewage pas ays.tem (on I (we) have
obtained an easement, to Aun with the above deseh.ibed pnopehty, bon the
con t4u.cti.on o6 said system, and the dame has been duty tecoAded in the 066ice
o6 the County Reg.c.s.ten o6 Deeds, as Document No.
~.~flit a
SIGNATURE OF WOER SIGNATURE OF CO-OWNER (IF APPLICABLE)
L L 5 Lt ~ G1 P6,
DATE SI/G"NED DA SIGNED
H
Cn
a
r
ST C- 105 a
H
SEPTIC TANK MAINTENANCE AGREEMENT Ho
St. Croix County z
d
OWNER/BUYER
ROUTE/BOX NUMBER / Fire Number
74
CITY/STATE AIID ZIP
CVE'41 N W '/q
PROPERTY LOCATION: NV q Ne1~ 14, Section, T N, R ~q _W,
St. Croix County,
Town of, S?~• ~aS~2e)-N
Subdivision Lot number
I
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 y
three year expiration.
z
I/WE, the undersigned, have read the above requirements and agree
to maintain the private sewage disposal system in accordance with H
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 .1W
DATE
St. Croix County Zoning Office
P.O. Box 98
Hammond, WI 54015
715-796-2239 or 715-425-8363
Sign, date and return to above address.
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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
DIVISION
INDUSTRY, . P.O. BOX 7969
LABOR AND PERCOLATION TESTS (115) MADISON, WI 53707
HUMAN RELATIONS (H63.09(1) & Chapter 145.045)
LOCATION :-1 SECTION: TOWNSHIP /~I.ITY: LOTNO.:BLK.NO.:SUBDIVISIONNAME:
l AV~
6 L0 1L /a 32. /Te3 VIIJ9i(or)W r ~ s
COUNTY: Otl/BUYER'S NAME: AILING DDRESS:
r DATES OBSERVATIONS MADE
USE
NO. BEDRMS.: C PROFILE DESCRIPTIONS: PER OLATION TESTS:
OMM ERCIAL DESCR I PTION:
5~aesidence New ❑ Replace Z '2
RATING: S= Site suitable for system U= Site unsuit'a'ble for system
COg7NV NTIONAL: MOU : IIV-GROUND PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional)
s ❑u❑u SEA 0 s ®u ❑ s au
If Percolation Tests are NOT required DESIGN RATE::~ If any portion of the tested area is in the
under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS- Z_-
Olt Si ~n r
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DERT+++N. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
r 3 c~
ell
B- I CC' /0 X1 0
My C4,11
B-3 6
B ~f ! Z A) O 1'l% T 7 CJj i `L93 ,,1.5. L,: 7 -,6 ii
C, f) 3Z C IV7 c z.
o
B-
11 i PERCOLATION TESTS
~~~-S'r71 Fql
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
PER INCH
NUMBER AFTERSWELLING INTERVAL-MIN. PERIODt PERIOD2 PERIOD3 3
P 5 a
P- 7-
<
P-
P-
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 /o0=1
{
t
. t ( ; I
-h
r
4
.o to Su-r v
R / - - -
0n SoL"_kg4 C
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,6 K N /o Y'
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,
ti-
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:
CERTIFICATION NUMBER: PHONE NUMBER (optional):
ADDRESS:
11;r Z_
{rtLr~ i r1>3.•~~~1~ i i G~~Y1i~ri t~ 1 CST SIGNAT
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
i
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