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Parcel 036-1077-70-000 07/20/2006 04:33 PM
PAGE 1 OF 1
Alt. Parcel 31.31.17.486A 036 - TOWN OF STANTON
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
GENE N & MARLYS E SYLTE O - SYLTE, GENE N & MARLYS E
1400 CTY RD K
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 1400 CTY RD K
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 1.550 Plat: N/A-NOT AVAILABLE
SEC 31 T31 N R1 7W PRT SW SW COM 3 RDS 8 Block/Condo Bldg:
LINKS E OF SW CORNER, E 193.32'N TO RR,
WLY ON RR TO POND, SLY ON POND 28 RDS Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
MOL TO POB EXC COM 248.1'E OF SW COR. N 31-31 N-1 7W
16T E 65' S163' W65' TO POB & EXC P486E
EZ-U-1216/449
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 894/153
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 08/27/2002
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.550 12,000 71,600 83,600 NO
Totals for 2006:
General Property 1.550 12,000 71,600 83,600
Wooland 0.000 0 0
Totals for 2005:
General Property 1.550 12,000 71,600 83,600
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 122
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges:
0.00 0.00
Total 0.00
Form- S T C - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP _>r~s,Jz1~1 SEC. 3 T -N-R f7 W
ADDRESS ST. CROIX COUNTY, WISCONSIN
Ir ti ~ -7
6.4
SUBDIVISION _h LOT - ~L LOT SIZE z
PLAN VIEW
Distances and dimensions to meet requirements of H 63
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
c , CSC
I '
Y
I
i
I
_ i
J 3',SS
i ~
I i
*gl
yy%T- INDICATE NORTH ARROW
C,1;2 h
L IL
BENCHMARK: Describe the vertical reference point used
Elevation of vertical reference point: =
,'d`O „ Proposed slope at site: ,
SEPTIC TANK: Manufacturer:,
c-Capacity:
Number of rings used: d Tank manhole cover elevation:
Tank Inlet Elevation: Tank Outlet Elevation: Q~
Number of feet from nearest Road: Front,O Side,O Rear, O feet
From nearest property line Front, O Side,O Rear, O~I feet
Number of feet from: well ~ C building:
(Include this information of the above plot plan)( 2 reference dimensions to septic tan
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 Ft
Number of feet from well: `-..y
Number of feet from building:S
(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:
~ l
Dated: Plumber on job:
License Number :
1 3/84:mj
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P.O. BOX 79F,9 BUREAU OF: PLUMBING
MARISON, WI 53707
CONVENTIONAL ❑ALTERNATIVE State PlanLD.Number
f assigned)
El Holding Tank ❑ In-Ground Pressure ❑ Mound (I
NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER'. INSPECTION DATE:
Mrs. William Mc Gee R. R. 1, New Richmond, WI
BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. R F. PT. ELEV.: CST REF. PT. ELEV.'.
SW SW, Section 31, T31N-R17W, Town of Stanton
Name of Plumber. JMPIMPRSW No. County Sanitary Permit Number:
Cal Powers 1563 St. Croix 58921
SEPTIC TANK/HOLDING TANK:
MANUFACTURER: LIQUID CAPACITY. TANK INLE TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER
.n /-g q PROVIDED: PROVIOED.
,YES ENO EYES ENO ] ~ J
BEDDING. VENT DIA.. VENT MATL. HIGH WATER NUMBER OF AD: PROPERTY WELL BUILDING. VENT TO FRESH
ALARM FEET FROM LINE. / AIR IfQL~
EYES ENO C - EYES ENO NEAREST ECG f
DOSING CHAMBER:
MANUFACTURER . 7ING LI QUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER
PROVIDEDPROVIDEDS ENO EYES ENO EYES ENO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERTY WELL BUILDING I VENT TO FRESH
(DIFFERENCE BETWEEN FEET FROM LINE AIR INLET
PUMP ON AND OFF) EYES LINO NEAREST
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGTH DIAMETER 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:
WIDTH. LENGTH NO. OF DISTR. PIPE SPACING. COVER JIDIA ttPITS. LIQUID
BED/TRENCH / n TRENCHES TERIL: PIT oEPTH
DIMENSIONS /v(
GRAVEL DFFTH FILL DEPTH UISTH PIPE DISTR PIPE DISTR. PIPE MATERIAL. N DISTR. NUMBER OF PROPERTY WELL. BUILDING. [VENT TO FRESH
BE L()W PIPES ABOVE COVER ELE V. IQNLFr ELEV. ND PI ES ALINE AIFj{N FT
L~ . U 7(d -2 7 ~ 7 ,2 NFEET EARESTO--► S 7 c7 S •L
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-
E meets the criteria for medium sand. "IONS MEASURED.
YES ENO
SOIL COVER TEXTURE JPERMANENT MARKERS JOBSERVATION WELLS
EYES ENO EYES ENO
DEPTH OVER TRENCH BED DEPTH OVER TRENCHBED DEPTH OF TOPSOIL SODDED SEEDED MULCHED
CENTER EDGES.
EYES ENO OYES ENO EYES ENO
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: PI JNODISTR DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING
ELEV.. ELEV.. DIA. ELEV.. P PES. DIA.:
ELEVATION AND
DISTRIBUTION
INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TD APPROVED
PLANS
EYES ENO EYES ENO
COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL. BUILDING:
FEET FROM LINE:
❑ YES ❑ NO ❑ YES ❑ NO NEAREST
L
Sketch System on :R aln county file for audit.
Reverse Side.
SIGNATURE- TITLE.
f
DILHR SBD 6710 (R. 01/82)
consin AP PLICATION FOR SANITARY PERMIT1LHR COUNTY
PIP REnTOF (PLB 67) UNIFORM SANITARY PERMIT
#
EZ7: STRV,LRBOR 6"UMRn RELRT1Or1S
-Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 81/2x 11 inches in size.
-See reverse side for instructions for completing this application. PLEASE PRINT
PROPERTY OWN R MAIL G ADDRESS
PROP TY LOCATION VLLLAGE:
<',4 1/ 4 1 1/4, SU , If . N, R (Dr)t NO TOWN OF: lnt ,
LOT NUMBER BLOCK NUMBER JSUBDIVI`SJON NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER
n 1;;9 1 1
TYPE OF BUILDING OR USE SERVED
P
Lj 1 or 2 Family Number of Bedrooms. F-1 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.
y;' 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 / t'
Lift Pump Tank/Siphon Chamber
Holding Tank capacity
Manufacturer: ) ? - ~E f
IF THIS IS AN ALTERNATIVE SYSTENJI 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):
u , e.`. j~52 2( Private ❑ Joint ❑ Public
I, the undersigned, hereby assume responsibility for installation of t e p ~vate sewage system shown on the attached plans.
Name of Plrumber (Prix Signa / r~ MP/MPRSW No.: one Numbey:
Plumber's Address: r Name of Designer: /
COUNTY/ DEPARTMENT USE ONLY
Signature of Issuing Agent: Fee: Date: ❑ Disapproved
G Z4t~ ~S ❑ Owner Given Initial
A4 Approved Adverse Determination
R son 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.
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, 1 c DIVISION
LABOR AND PERCOLATION TESTS (115) MADISOP.OBOX 76
N WI 3707
HUMAN RELATIONS
(H63.09(1) & Chapter 145.045)
LOC4TION:_ SECTION: ,.TOWNSHIP/-MUNICIPALtTY- LOT,NO.:BLK.fFo.: SUBDIVISION NAME:
r
COUNTY: OWNER'S/BUYER'S NAME: MAI ING ADDRESS:
JO/USE DATES OBSERVATIONS MADE
NO. BEDRMS.: ICOMMERCI/\L DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS:
14Residence ❑ New Replace I
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUN~`D-PRESSURE: SYSTEM-IN-FIILLHOL IING TANK: RECOMMENDED SYSTEM:(9ptional)
Cis EU [is ❑U QS EA EIS EJU EIS 1
If Percolation Tests are NOT reQuire~ DESIGN RATE:
If any portion of the tested area is in the
under s,H63.09(5)(b), indicate: ) Floodplain, indicate Floodplain elevation:
4/;✓~
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH tad, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B- _ 11 ~ S.'4IN~9.E.0
r~ "
A~
B-
B-
B-
PERCOLATION TESTS
r r
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER HNCt+ES AFTERSWELLING INTERVAL-MIN. PERIOD1 PERIOD2 PERIOD3 PERINCH
P_ &,94ZA T- P-
P- Z S_
P_
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, ~'✓c~~~~,~--
SYSTEM ELEVATION i
j ~ t t
ING T/aj a z::
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I, the undersigned, hereby certify that the soil tests reported on this form were deby 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 corre-nt p the best of my knowledge and belief.
NAME print): TESTS WERE COMPLETED ON:
AD 611-E/SKS:
J~ CERTIFICATION NUMBER: PHONE NUMBER (optional):
CST GN URE•
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 02/82) - OVER
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ErC) ut~ G ~~r►~ J,~~~<'n-i
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Fresh Alf Inlele And Obliiofvollon Pipe
Approved Vent Cap
Minimum 12" Above
Final Grade
20- 42° Above Pipe 4 Cost Iron
To Final Grade Vent Pipe
MOr eh Hoy Or Synthetic Co.ering
win 2" A ggregote
Over Pip•
Oietrlbution
Pipe 0 0 0 0 0 - Too - Ill
b Aggregate o
Beneath Plp• Perforated Pipe Below
_
o Cuypling Terminating AI
Botlom Of System
SOIL FILL
0I57-K113LITIOF1 PIPE
APP R.'aVEO S4A!'(14ETIC .OVER
° -W"-MNTFRIAlt- C;R v" pF 5 RAW
2" OF gGGRF'GA1E ~R MA►tsu HAS
^ ( nF z 2i7 AG C:RECATI-.
t-LEV. OF . i T~E6T_..
DI`, RiRUTIc?11 PIFE TCI 6F. AT LEAST ILJCHF5 BELOW ORIGIIJAL GRADE
AK1L AT LEAS-1 20 )UCHEC 8UT EIO MORE THAvK1 `-12 11,ICHE3 BELOW FItJAL (P.ADE
MAXIMUM MN OF EXCAVATioo FROM 0WI NAL 69AoF- WILL P, L \S- I►~CHEs
INN) MUM OQr)i OF CACAVATI(OW fKOM 1*61 L r'94D Wlt_L ~E ~ C i~tC4ar s
SIG f`1 ED:
t-ICFIJ5E QUMBER:
DATE:
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SEPTIC TANK MAINTENANCE AGREEMENT o
St. Croix County z
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OWNER/BUYER~`D~ "On ~ 171 L .
ROUTE/BOX NUMBER Fire Number
CITY/ STATE -ZIP 5'Y6) i
PROPERTY LOCATION: - , ~4, Section, T N, R1L_W,
Town of Q-to rt St. Croix County,
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 i
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
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. - ?
XSIGNED
XDATE - 1~
St. Croix County Zoning Office
P.O. Box 96
Hammond, WI 54015
715-796-2239 or 715-425-8363
Sign, date and return to above address.
r 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/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 NA}2 C
Location of Property SIN ~4 5 VJ ~4, Section , T 31 N - R / W
Township S/ a /I Yd t
Mailing Address
Subdivision Name
Lot Number
Previous Owner of Property ryL C
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) ? Yes x No
Volume and Page Number O as recorded with the Register of Deeds
INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING:
I. Warranty Deed y
2. Land Con
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 aU statement on this ~otm ah.e tcLue to the best o~ my (ou)c)
fznowtedge; that I (we) am ( are ) the owner (6) o A the pnope,,Lty des elLi bed in thin
.AAotmati.on Aotcm, by vittue o~ a wa4Aanty deed seconded in the O~~ice oU the
County Reg-isteh o{ Deeds as Document No. and that I (we)
pneaentey own the proposed site {ion the Sewage ckzpo6at 6ystem (on I (we) have
obtained an easement, to nun With the above dmcAi-bed pnopen-ty, ion the
eonsthuction oA said syAtem, and the same hah been duxy Aeeonded in the O~6ice
o{ the County Re.g,i~stec oA Deeds, as Document No. )
TSIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE)
ATE SIGNED DATE SIGNED