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HomeMy WebLinkAbout182-1027-10-000 c yoll'~ao d 3 > > 3 0 13 (D 3 - I >v Cn -y 0 S CnC-0 0 O `C • O E CD N co n y O N N O C fD v O7 j N ►0 CD C) N N 3 0 W 7 O O N n N n v \ 1 CL C/) C) 0 CCDD = CD CD O N 0 o 3 O 5 w a: C) p U, U) D a CD w n b _0 m(n W a t 3 CL Cn CA A C) 0 W lot C G CD o X NO) 0 r- (n CD co co rT 4:1 z O 00 m !i Z v 0 CD -4 -1 N m m CD- Q O O< N Cn = y 9~ y v th -Oi O !r r .di N N c r N CD CL d a N N o z~z o D 5 i 1 m O 0 N a W I j CD ? CU • Cm I C~ 4:z. CD CD C CD Z 4:1 '0 N W CD Q W c W C1 CD Z n 7 rte- Z rn Z CD Iii Z c c TJ o a N Cx~ O z CL A O v O ? o ti :3 z - ca -0 w N a 3 z 0 a ~ N O Z W m z CD m (O A f W CD n C2 O n a D T ~ v c CD Z a N O CD CL CD - Cn O' ~ O CD A I p=j CD A 7 ~ A N n nd S O CD O U7 V A O N A CD ' a EA O o CD C) CL Parcel 182-1027-10-000 01/22/2007 03:11 PM PAGE 1 OF 1 Alt. Parcel 311812-12-03-00-00-000 182 - VILLAGE OF STAR PRAIRIE 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 TODD H OLSON O - OLSON, TODD H PO BOX 92 STAR PRAIRIE WI 54026 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 450 HILL AVE SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 8.700 Plat: N/A-NOT AVAILABLE SEC 12 T31 N R1 8W IN NW NE THE WEST Block/Condo Bldg: 331.633' OF NW NE LYING NORTH OF HWY "H" AND EXC FLOWAGE RIGHTS ALSO COM N1/4 COR Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) SEC 12;TH S 00 DEG W 126.44'POB;TH S 00 12-31N-18W DEG W 166.17';TH N 41 DEG W 90.33';TH N 32 DEG E 116.59'POB FKA PARCEL 224B Notes: Parcel History: Date Doc # Vol/Page Type 09/24/2002 691554 1987/484 QC 02/05/2001 637966 1583/104 WD 07/23/1997 833/569 07/23/1997 781/342 more... 2006 SUMMARY Bill Fair Market Value: Assessed with: 182731 307,000 Valuations: Last Changed: 09/08/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 8.700 100,000 148,900 248,900 NO Totals for 2006: General Property 8.700 100,000 148,900 248,900 Woodland 0.000 0 0 Totals for 2005: General Property 8.700 100,000 148,900 248,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 127 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 • Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT VJJV"i OWNER TOWNSHIP SEC. 2 T--3 N-R ,45 W ADDRESS ST. CRUIX (U"'1TTY, WISCOiv~j_r4 ar SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H 63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ??,,r 13 0Si'l ' ti- t1 S i 1 I &tj INDICATE NORTH ARROW . ~r BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: lr>~L Proposed slope at site: SEPTIC TANK: Manufacturer: Liquid Capacity: c2Q Number of ri;igs used: C-o~ Tank manhole cover elevation: f Tank Inlet E_evation: Tank Outlet Elevation: Number of fei:t from nearest Road: Front, Side,0 Rear, ® S ~00 feet From nearest property line Front,0 Side,0 Rear, 0 feet Number of feet from: well 4 building: j (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CIIAMBER i Manufacturer: j Liquid (rapacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet- Bottom of tank elevation: Pump off swite elevation: Gallons per cycle: Alarm Manu-acturer: Alarm Switch Type: _ Number of feet from nearest property line: Front, CSide, O Rear, 0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORBTION SYSTEM Bed: Trench: Width: y~ Length: .60 Number of Lines: Z Area Built: Fill depth to top of pipe: Z Number of feet from nearest property line: Front, Side, © Rear, O O ht 617' Number of feet from well: Number of feet from building: t (Include distances on plot ptan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Are- Built: Has /i'~-ither a drop box O or distribution box O been used on any of the above soil alsorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Nun4ber of feet fr m nearest property line: Front, 0 Side, Rear, O Ft. / Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: - Inspector: Dated: ~ -=-2 Plumber on job: ~,o~S Z S License Number: 3/84:mj DEPF AENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LAB( ,I HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. X 7969 BUREAU OF PLUMBING MAf )N, WI 53707 ®CCONVENTIONAL ❑ALTERNATIVE State Plan I.D. Number: of ass~gnedl E Holding Tank ❑ In-Ground Pressure 1:1 Mound NAME OF PERMIT HOLDER: JADDRESS OF PERMIT HOLDER'. INSPECTION DATE Mcu,Lk Yoe PO Box 97, Statr. Pfc.aiAie, WT 54026 A i101VIQV zoo 6) BENCH MARK: (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELEV.. N(V NE, Section 12, T31N-R18W, Town ob StoA Pnai/t e Name of Plumber. IMP/MPHSW No. County Sanitary Permit Number_ GaAy Steet 3254 St. Cuix 49470 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET EL V.. WARNING LABEL LOCKING COVER Lj pp \ PROVIDED PROVI D CCaZ~O I ilr7{~ -Z V52 ES ENO IjNO BEDDING. VENT DIA VENT MATL. HIGH WATER NUMBER OF ROAD: PROPERTY WELL BUILDING. VENT TO FRESH A LARM. FEET FROM LINE AIR INLET. DYES ENO DYES ENO NEAREST DOSING CHAMBER: MANUFACTURER BEDDING: LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOO CKING COVER PROVIDED'. PRVIDED: DYES ENO EYES LINO DYES 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) DYES ENO NEAREST- SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE JLFN(,,TH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH. LENGTH NO. OF DISTR. PIPE SPACING COVER INSIDE DIA. SPITS LIQUID BED/TRENCH THENCHES y M A i PIT DEPTH DIMENSIONS ~U~ GRAVEL DEPTH FILL DEPTH UISTR. PIPF DISTR PIPE DISTR. PIPE MATERIAL. N0. D STH NUMBER OF PR OPERTV WELL: BUILDING: VENT TO FRESH BELOW PIPES ABOVE COVER ELEV. INLF T E EV. END PIPES LINE . I AIR INLET. FEET FROM ~7 N l~ ' .O~ 7 Z" 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 NO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS DYES ENO DYES ENO DEPTH OVER TRENCH RED DEPTH OVER TRENCH. RED UEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES DYES LINO DYES ENO OYES ENO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LENGTH NO.OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPF FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEVATION AND ELEV.. ELEV.. DIA.. ELEV.. PIPES. DIA.'. DISTRIBUI ION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS DYES ENO DYES ENO COMMENTS: Q PERMANENT MARKERS OBSERVATION WELLS: NUMBER OF PR OPERTV WELL: BUILDING'. O JoC. FEET FROM LINE. DYES ENO DYES ENO NEAREST- t S~ I Sketch System on ~9_ 7 etain in county file for audit. Reverse Side. SIGNA TITLE. DILHR SBD 6710 (R. 01/82) l f~ Wisconsin APPLICATION FOR SANITARY PERMIT p D I L H R COUNTY ''OEPRPnnrnEnT OF (PLB 67) UNIFORM SANITARY PERMIT # = InOUSTRV,LRBOP&HUTRn RELRTIOn5 ~'~/y7C1 -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 OJWNER MAILING ADDRESS _ PROPERTY LOCATION t;+TY: VILLAGE: /4 1/4, S T,T/, N, R A9 E (or) W TOWN-Of=: , LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER TYPE OF BUILDING OR USE SERVED 1K 1 or 2 Family Number of Bedrooms. ❑ Public (Specify): THIS PERMIT IS FOR A: New System ❑ Tank Replacement ❑ Repair Ell Replacement Soil Absorption System ❑ Revision ❑ Privy ❑ Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. ❑ Seepage Bed ~I 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 z/ 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 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 1, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of tuber (Print Signature: / /MPRSW No.: Phone Number Plumber's Ad ess: J Name of Designer: COUNTY/ DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: Disapproved 1 6F(..' -p/, Owner Given Initial f 1`, 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 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. APPIACATION FOR SANITARY PERMIT i1ji.:, 'ipplik:,tiuu it~ini t:) to ht (.ouipIL•I'd to Iu11 :aud ~I};nod by thy' uwui't(ss) 01 lL, pruperty being; developed. Any inadequacies will only rer;nlL in delays of the permit issuance. Should this development be intended for resale b owner/contractor by , ("spec house"), then a second loan should he retained and completed when the property is sold and submitted Co this office with the appropriate dead recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Uw~icr ul I'rupcrty - _f Location of Property ~ U) `4, Section f. -e-' T N - R W M i i_1 i_ng Address - - _ Subdivision Name Lot Number f Previous Owner of Property Total Size of Parcel _ C Date Parcel was Created Are all corners and lot lines identifiable? L`- Yes No is this property being developed for resale (spec house) ? Yes L----No Volume and Page Number _ J as recorded with the Rcg;i-steer of Deeds INCLUDE. WITH 'T'HIS APPLICATION ONE OF THE FOLLOWINC: 1.. Wat.-FaIlLy Dead 2. Land Contr~wt. 3. Other recordhili,,:; Bled with (--w Kug,Ister of Ue.ed:. Office 1_n addition, a certified survey, if available, would be 1-1011)tul so as to :avoid delays Of the reviewing; process. -I f the deed description reJ eretices to a Certified Survey Map, the the Certified Survey Map shall also be required. PROPERLY OWNER CERTIFICATION I ((fie) ee.na,i.~y that (.O'tstatements on thus Aonm VLe tnue, to the best u6 my (uaA) kktowtedge; that I (we) am (ace) the uwnih (d) o6 the prtupenty danibed art ,thic5 i_vt~jonmcLtion Omni, by v~.~zaue- o6 a wavzanty deed Aeeor ded in the 066ice o~ the. County RegZstn o Deeds as Document No. % ~ ; and that I (we) p~tment y owt .the. pnopose-d site ~on the sewage c~cspo a.~ lsyatem (OA I (we) have uUtained an e.aseme.nt, to nun with the. above desnibed pnopeAty, bon the cuyothuc ion,o~ said system, and the same has been dafy n.eeon.ded 4.n the 0~6-6ee u6 the Counts Reg4ztvi- ot~ Deed',, as Doetunent No. _ SIGNATURE 01' OWNEk, SiGNA1u,.. O-0 NCR APPLICABLE) DATE. SIGNED DATE SIGNED L ~ Y S T C - 105 r J' SEPTIC TANK MAINTENANCE AGREEMENT 0 St. Croix County 0 y OWNER /-ti~1'fE K_ L., &t&+hJ'BOX NUMBER ~f Fire Number C 1 T Y /STATE~_ PROPERTY LOCATION it, 1AT-it, section N> K~ _W> Town of e4~^ 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 p mp r. 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 three year expiration. c I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with ~ the standards set forth, herein, as set by the Wisconsin Depart- 110 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. ~ S1.CNEll - DATE f - - - - - St. Croix County Zoning Oftice. P.O. Box 98 Hammood, WI 54015 715-7!6-2239 or 715-425-8363 Sign, date and return to above address. DIVISION PARTMI_IN TOF REPORT ON SOIL (BORINGS AND FTY IN()USIi{Y„ f'.O DIVISION I JMAN I131f CATIONS PERCOLATION TESTS (115) MADISON, WI ,3107 I~UMA (H63.090) & Chapter 145.045) UBDIVISK)N N AME i - 1OWNS1iIP/MIIN(.IPAttTY LOTN6 TION (SECTION BLK. NO - - -k, 11 R1R E lorl W~ -P~/ ~1~ /a tMAl L ING ADDR ESS WN` R,'S780YFP'., NAMES UNTY J DATESOBSERVATIONS MADE Wit --N--- PROFILE DESXRIPTIONERZZSLA~I~N TESTS I NO BEDRNLc~ COMMER~TA(. DESCRIPTION r,~ "I /IResidence l / l1J evv &eplace RATING S- Site suitable for system U= Site unsudahle for system -/lll MF~~~ - - l OLDING TANK: RECdM ND E U SYSTFM~lopoon.tll 1(i)NVLN I IONAL MOUND. IN-GROUNDPHF_`,;SUR L- .iYSTFM IN -I I I H S UPI _ L"J S (u S UlD- -E]S ( if -Ll S ~U ~I) Percol ttion Tests at eNOT reUuu erii Df_SIGNRPiF If any portion of the tested arts is in the / under s . 1163A9(5) (b), indicate: ~Floodplain indicate Floodpl tin elevation- PROFILE DESCRIPTIONS - - PTH T( GR UN_DWATFR INCHES CHAR ACTEH OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH - IBORING TOTAL ELEVATION c EST FIIG-11 T 10 BEDR CK IF OBSF VED (SEE ABBHV ON BACK.) NUMBER DEI FN IN. _013~ERV ED~ 1 , - ri l~ 1:1-..-5+=-~tct / •r W~ a J `.<72, L-- Q l_ t~dS 7s Jg~:17 ;~0 ?~5~ A•~J/S ~Yy.4 1/.' / i. ! f' / - /1 ~Q~ l ) B_ ~B_ PERCOLATION TESTS B TER IN HOLE TEST TIME DRONCHES RATE MINUTES HAF TER SWELLING INTERVALL MIN. RIQD p R PER INCH 2 rJ 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 ho 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 perce of Land slope. >✓a"~Z ^J SYSTEM ELEVATION o . _Xy) ee fSr- 1 _50 Ir, Till 4r~ I r - 1, the undersigned, hereby ceYlity that the soil tests reported on this f m were made by me in accord with the procedures and methods specified in the Wiscon Administrative. Code, and that the date recorded and the location of the tests are correct to the best of my knowledge and belief. TESTS WERE COMPLETED N NAMf-~Lttrint) CERTIFICATION NUMBER PHONE NUMRERtoptu,ni CST S NAT UR E -0ION'. 01iqu,al and one copy to Local AuthoiitY, Pt opety Owner and Soil Te,wi_ - Ili 'HD 63t)5 0i Ua/R?) 0V FR ~P I 11)fj J ciGO ~jJ. ,t~ ' ~s\I -jD v ~ L~-rte