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ST. CROI X COUNTY
f•,yfir l: t
WI SC O N S I N
h1 r l 21 ' 4
' ZONING OFFICE
796-2239 (HAMMOND)
425-8363 (R I V E R F A L LS)
HAMMOND, W1 54015
May 1, 1984
NeAAbeArt J. Rebhan, CteAAFt ~y 3~
Town o4 Richmond
R. R. 2
New Richmond, WI 54017
Dean MA. Rebhan:
This o44.ice has Aev,iewed the Joet C. SpAingeAA site .located in the SF4 oK
the SW'4 oK Section 1, T30N-R18W, Town o4 Richmond 4oA compUance to so.i e
au,i tab.i -ity and netati.onship ob addition to the existing septic system.
The new addition w.i U in no way inteAA6eAAe with the no"a - maintenance
o6 the system.
Shou,-d you have any questions Aeganding this subject, pf-ease 4eee 4Aee
to contact this o64.ice.
S.inceAAe 2y,
Thomas C. Nelson
Assistant Zoning Adm.in istnaton
TCN:mj
Fo rm - S T C - 102
ONE AND TWO FAMILY
The existing system must be inspected for compliance to bedrock and higli
groundwater requirements of the code. This, in many instances, will require
a soil test to be conducted by a Certified Soil Tester or an on site by this
office.
If the existing system does meet minimum requirements for groundwater and
bedrock depths and if it is functioning, an addition can be added in most
instances without updating the existing system. If the existing system is
utilized for the addition, every attempt should be made to locate and reserve
an area which is suitable for a code complying replacement system for when the
system fails. If the addition will substantially increase the wastewater
discharge, the existing system shall be replaced with a code complying private
sewage system.
s C LJ i 7 30A✓ 418 ~-J 41'e-A "Jt6.ND
1/4 1/4 (Subdivision & Lot 0 Section Township
1e7~1
Rural Route # - Address Post Office Zip Code
{:r-) (We) J0 A- L JhAli-' plan to (build an addition to,
) the budding at the above named location. The present private sewage
system has been working satisfactorily as far as disposing of wastes.
If the present private sewage system does fail, it will be replaced with one
that is code complying,
(2)
(OwngsSignature))
Date
Subscribed and sworn to before me
this J6thiday of April 1984
Notary Public Evonne Moore
Croix
County, Wisconsin
My Commission Expires may 6, 1984
ST. CROIX COUNTY
(County Authority)
Plot plan attached (show location of building addition to drainfield and
septic tank). Include soil testers report form.
1
S T C - 105
SEPTIC TANK MAINTENANCE ACRLL'MENT
St. Croix County
0WNER/4Y, i.. JO&--
ROUTE/Box NUMBER t~c~t, L7C 9
___--fire Number
CITY /STATh' -5 1. 11
PROPERTY LOCATION: ' SC1J i.
---___--'4 ' Section 7 'I' c3G`~ N I<
Town of L~~tc.✓Q St . Croix County,
Subdivision Lot number
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 se)tic tank jumper. 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 Way 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), Lite 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.
ti
O
I/WE, the undersigned, have read the above requirements and agree ~
to maintaiii Lite private sewage disposal system in accordance with x
Lite standards set forth, herein, as set by the Wisconsin Depart-
ment of Natural Resources. Certification form must be completed
and returned to the St. Croix County Zoniul'Office within 30 days
of the three year expiration date.
S 1 G N E 1) ~ - -
1) ATE
Sr. Croix County Zoning Office
P.0. i3ox 98
Hammoid, WI 54015
715-7 36-223.9 or 715-425-8363
Sign, date and return to above address.
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 inadequacies will only result in delays of the permit
issuance. Should this development be intended for resale by owner/contractgv,("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 Joel C J~gNE ~~~~c2
Location of Property S E 4 SW '-4, Section
% T ,30 N - R /8 W
Township 'e"6~,, JGNd '
Mailing Address t 6ox, 2 7C
A/C~ V0,1- 7
Subdivision Name
Lot Number
Previous Owner of Property A.ecf
i4 S F'.2
Total Size of Parcel
Date Parcel was Created 06-6 Z el 71
Are all corners and lot lines identifiable? r
Yes No
Is this property being developed for resale (spec house) ? Yes
k," No
Volume and Page Number !T^ 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 _
(We) eeAti6y that a.PX 6.tatementa on -this foam ahe ,tAue to the beat
o6
my (o
knowledge; that T (we) wI (a4e) the ownea (6) o6 the pnope&ty des ibedin this )
-.n6onmation foam, by viAtue of a wa,uAanty deed teco&ded in the 066ice og the
County Regi,6 ten of Deeds as Document No.
phensentey own the paopo6ed .site boa the 6ewa e ; and that z (we)
obtained an easement, to nun with the above dens embed pnopettty, (boa ~thee1 have
conztAucti.on o6 6aid 6 y6,tem, and the Game has been duly aeeonded in the 066ice
o6 the County Regi6 teA o6 Deeds, az Document No.
C
GNATURE OF OWNER SI ATURE OF CO-Oi~ER (IF' PLICABLE)
DATE SIGNED DATE SIGNED
1. 00 State Septic _
PLB. 68 5.• 00 Sanitary PerrrdtPARTMENT OF HEALTH AND SOCIAL SERVICES
9. 00 Zoning Fees
Division of Health
15.00 P.O. Box 309 NO. 51927
Madison, Wisconsin 53701
Fee Paid 51. 00
(Each Septic Tank 51.00)
STATE SEPTIC TANK PERMIT
Date Issued 4 / 2 / 7 3 '
i i;l is for Purchcse of septic tank Copies:
noes not exempt installation (Wh i te) -Property owner
(Blue)-Tank Retailer
from I3'd or IGC3I BppfOVdl anfj/Or permits. (Canary)-Division of Health
(Pink)-issuing Agent
Ow'ner's Name
.
JoelSpringer Ow'ner's Address
Richmond, W1S
Location (,Legal Description) of Property Where Tank will be Installed New
NE 1/4 of NW 1/ 4 of Section 12 county
Richmond, T30N-R18W St. Croix
Plumber's tiame
Calvin License No. Address
Powers, MP RSW 1563
k atu~ of Person Obtaining Permit New Richmond, W1S
Address if Other Than Owner
Address of issuing Agent (Town V (age, City) Ne`H Richmond, W1S
Old Courthouse Building, Hudson, Wi onsin°uncy
rue: - St. Croix
7Onln Si ature
g Administrator
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