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Home My WebLink About040-1133-95-000 o m f r m n 0 m U) i z co O C') O N O O O N O 'mom Y• (D (D : Oo 'r7 ~C l11 co a Z N CO :3 C (p O W (D ` 1\ CD 0- m O O p 7 cn CO O O C fD 7 S (D -n 'O 3 rv o .^r !V 7 N O C !i y N O 03 C D N ° ° CD (n < co CD FD 3 10 0 _A CD 0 CDL (1(D a C ;s < C Z -0 v (0 Tt W rn'1 0 = 1 "D A G N Z D TJ 3 v O o Z3 O c N O fn K CD Z p H n N s N W Z (D 3 W 9 ZDWO O r N o d ° CD p 'a N 00 N r N N ; CD a, w m a Oo CD -i to 4- z Z CD Z o C Q rv rn oa a A z 0 r~ ~s z rn o O c Z N cwn W v m eo CD CD C1_ c ° m a -v S N CD w w o a Q CD m o a S N (D y O 1 N H O S < O (D N I ~ 3 ? a m t N 0 0 A o ,b "0 CD A m fn O o :E c y 6 o CL I Parcel 040-1133-95-000 12/15/2005 08:35 AM PAGE 1 OF 1 Alt. Parcel 35.28.19.556F2 040 - TOWN OF TROY 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 O - BROWNE, R&G-TR % KATHLEEN WEYERS R&G-TR % KATHLEEN WEYERS BROWNE 40 SUNVIEW DR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 1.045 Plat: N/A-NOT AVAILABLE SEC 35 T28N R19W 1.045A IN NE SE LOT 2 Block/Condo Bldg: OF CERT SUR- VEY MAP IN VOL I PAGE 136 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 35-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1058/L33, QC 07/23/1997 535/32b I 2005 SUMMARY Bill M Fair Market Value: Assessed with: 103098 265,400 Valuations: Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.000 38,000 217,400 255,400 NO Totals for 2005: General Property 1.000 38,000 217,400 255,400 Woodland 0.000 0 0 Totals for 2004: General Property 1.000 38,000 217,400 255,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 205 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 3 Parcel 040-1134-70-000 12/15/2005 08:35 AM PAGE 1 OF 1 Alt. Parcel 35.28.19.556L 040 - TOWN OF TROY 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 O - BROWNE, ROBERT S & GLADYS ROBERT S & GLADYS BROWNE 40 SUNVIEW DR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 0.500 Plat: N/A-NOT AVAILABLE SEC 35 T28N R19W.5 AC IN NE SE N 135 FT Block/Condo Bldg: OFS873FTOFW 160 FT OFE747FTOF NE SE Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 35-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 473/378 2005 SUMMARY Bill M Fair Market Value: Assessed with: 103105 20,800 Valuations: Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.500 20,000 0 20,000 NO Totals for 2005: II General Property 0.500 20,000 0 20,000 Woodland 0.000 0 0 Totals for 2004: General Property 0.500 20,000 0 20,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT q its SEC. T`~~ y W W N I; R C~ ~JC - 1 -';r 0 W N S a I I l\UDRkSS 4C~0 V~ ST. CROIX COUNTY, WISCONSIN. 1 "5 ~!ItU I U I lON LO`C LOT SIZE PLAN VIEW UiniN nees rind dimensions to meell requirements of 1163 HOW EVERYTHING WITHIN 100 BEET OF SYSTEM 47- Indic at N r h rrc w QkNCHMARK: (Permanent reference Point) ouscribe: P I_evati-on of vertical reference point -Slope at site: KKPTFC- TANK: Manufacturer: Liquid Capacity: lpCpC} C~-t Number of rings on cover ~ Tank mel ankittletrElevationn:G(~+'}bG'., 'l'ank inlet El nation: PUMP CHAMBER Manufacturer: Number of gallons -Cons • Total capacity of Number oI gal. pump s t for a C cycle ______gal distri.but:i-on. lines gallon: size of pump head; gallon per minute- horsepower ;brand name of pump and model number Type of warning device HOLDING TANK: Manufacturer - Number of gat_ons_ _ Elevation of manhole cover 'type of warding device- _ SEEPAGE PTT SIZE; _-Number of p-i.ts feet diameter feet liquid dc~th seepage pit inlet pipe-elevation bottom of seepage pit elevation feet. SEEPAGE RED SIZE: number of lines width t length1§11 i the deptl SEEPAGE TRENCH: width _ -length _ PERGOLAT LON RATE AREA I I", UI, It ED AREA AS BUIL`i'~p ~j IN SPI CI'OR DATHD - G._ PLUMBER ON JO1 ` - LI C H N S 4 NUMB[; It ~ G G ~ r 7~ 7p~ o0 DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING VADISON, WI 53707 CONVENTIONAL ❑ALTERNATIVE 'Itfatae5Plann IID. Number ❑ Holding Tank [:1 In-Ground Pressure ❑ Mound ~ rJ O~ ~L NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: abent Browne R. R. 3, RiveA FaM , WT 54022 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. IT ELEV.. NF SE, Section 36, T28N-R19W, Town o{ Ttoy Name of Plumber. JMPIMPEISW No.. County Sanitary Permit Number. ich.aeZ Hawkin6 5926 St. ctoix 49448 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV. WARNING LABEL LOCKING VER P VI D. PR ID AnA '9C" ES ONO YES ONO BEDDING. VE DIA.. VENT MAIL 11111 WATER NUMBER OF ROAD PRNOPERTY II, WELL. [WILDING. VENT TO FRESH ALARM FEET F C` LI r~ AIR INLET O ❑Y NEAREST 7{ ` DYES NNA DOSING CHA BER: MANUFACTURER. JBEDDING. LIQUID CAPACITY PUMP MOD PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PR OV IDED. PROVIDED DYES ONO DYES ONO DYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH LINE AIR INLET. (DIFFERENCE BETWEEN FEET FROM PUMP ON AND OFF) DYES ONO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing jL111,TI1 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; COVE INSIDE CIA. 3L PITS LIQUID BED/TRENCH TRENCHES f M IAL PIT DEPTH DIMENSIONS '0M, GRAVEL DEPTH FILL D P DISTR. "P, DISTR. PIPE DISTR. PIPE MATERIAL. N7D DISTH NUMBER OF I PROPERTY WELL. BUILDING. VENT TO FRESH BELOW PI ABOVE COV R 111V . INLE f FEET FROM 1 _j ELEy END. ~ PI LINE AIR INLET ES 2y C . L) 1 417-': 72 NEAREST-~ V 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 ONO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS i DYES ONO DYES ONO DEPTH OVER TRENCH: BED DEPTH OVER TRENCRBED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES DYES ONO DYES ONO DYES ONO 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. NO. DISTR. DISTR. PIPE DISrHIBUTION PIPE MATERIAL & MARKING. ELEV.. ELEV.. DIA.. ELEV.. PIPES DIA.'. ELEVATION AND DISTRIBUI ION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED DYES NO DYES NO COMMENTS: PERMANENT MARKERS: JOBSER1ATION WELLS: NUMBER OF PROP ERTV WELL: BUILDING. FEET FROMLI"E: 2 L 1:1 YES ❑ NO OYES NO NEAREST ~tdL t10'1 1106% pact,, 7• o ' , O'C ` Sketch System on l Retain in county file for audit. Reverse Side. AT I TITLE. D I L H R S B D 6710 (R. 01/82) - wlsconsln APPLICATION FOR SANITARY PERMIT D1 L. H COUNTY (PLB 67) OEPRRTTEnT OF UNIFORM SANITARY PERMIT # ~ In OUSTRV, LRBOR 6 HUmRn RELRTIOns /J X -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'/Zx 11 inches in size. -SPe reverse side for instructions for completing this application. PLEASE PRINT PROOPERTY OWNER MAILING ADDRESS, PROPERTY LOCATION yam= ~ 1/4 ~,1 /4 S T',^,, N, R E (D W 'TOWN OF:: LOT NUMBER BLOCK NUMBER SUBDIVISION NAME JNEWF~ST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER TYPE OF BUILDING OR USE SERVED 1 or 2 Family Number of Bedrooms: ❑ Public (Specify): - r ir- THIS PERMIT IS FOR A: V ,New System ❑ Tank Replacement ❑ Repair l~ Replacement Soil Absorption System ❑ Revision ❑ Privy ❑ Alternate System ❑ 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 ❑ 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: 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): V. Private ' Joint Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of lumber (Print): Signature: ! MP/P_ N No.: Phone Number: PI umber's Address: Name of Designer: COUNTY/ DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved U/ ❑ Owner Given Initial (j 7 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. 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/contract.Q ,("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 A-, L ~Location of Pro ert p y iI L. ~4 ~4, Section T N R, W ~ r p Township C P 1 !c f _ Mailing Add;'ess~ ('i'ce Subdivision Name r ~ Lot Number A- Previous Owner of Property /1 Total Size of Parcel Date Parcel was Created ( 7.~--!--~ Are all corners and lot lines identifiable? c 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 I (We) eeAti,6y that aU statement.6 on this 6oA.m ahe VLue to the best o6 my (oun) knowledge; 4hat I (we) am (cute) the owns (s) o6 the ptope&ty desnibed in .thin in6oAmation bo&m, by virtue of a wa4Aanty deed teeoA.ded in the 046ice oA the County RegiSteA o6 Deeds as Dodiument No. ; and that I (we) prcesent y oun the p'koposed site 6oA the sewage ~o-,s-YFsystem (on I (we.) have obtained an easement, to tun with the above de,6n bed ptopeAty, Got the. eorest,Tuction ob said system, and the same has been duty tLecortded in the 066ice o6 the County Regtis-teA. o6 Deeds, as Document No. ) . SIGNATURE ,GAF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE'SIGNED DATL SIGNED y S `l' C - 105 r • r y SEPT LC TANK MAINTENANCE AGREEMENT o St. Croix County d H O W N FIR ~ H U Y E k ROUTE/BOX NUMBER 17 Fire Number CITY/STATl: !,ti' -r PROPERTY LOCATION, f Section t !_L - N, R Z. W, Town o1 - 1`= St. Croix Cuunty> Subdivis1u►? ~ Lot number I improper use and maintenance of your septic system could resuLL in its premature'Lailure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a li_censod scL>tic tank humLer. What you put into the system can aff_ect the funetioa 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 atoms 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 waster plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (_L) the on-s-Lte wastewater disposal system is in proper uperatlnb condition and (2) alter inspection and pumping (if nec- essary), the septic tank is less than 1/3 full of sludge and scum. Cert fication form will be sent approximately 30 flays prior to three year expiratLon. o F G l/WE, the undersigned, have read the above requirements and agree cn to maintain the private sewage disposal system in accordance with x the standards set Lorth, herein, as set by the Wisconsin Depart- 'b went of Natural. Resources. Certification foCW must be completed and returned to the St. Croix County Zoning Oflace within 30 days of the three year expiration date. j UATE' St. Croix County 'Lolling Office P.O. Box 98 Hammond, W1 54015 715-196-2239 or 715-425-8363 Sign, date and return to above address. ► L~ H C ~J 11 15 Rev. 9/78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION: %4, Section ,T_N,R_E (or) W, Township or Municipality Lot No. , Block No. County Subdivision Name Owner's%Buyers Name: Mailing Address: TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS SOIL MAP SHEET NAME OF SOIL MAP UNIT PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE BOLE AFTE INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- P- P- P- - P- P- - - SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES B- B- B- B- B- B- PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. ° _ -I . - , 6 a 3 a ~ . a 4 , ._a~ ~N ~ r 1 a , r ~ a E ~ s w KK ..e: ! 1' S t 7 '9 ~.-3 a a ° a r i Y 3 5 1 i Y S S ya-^J_ F 3~. s 1 c F I, the undersigend, 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 location of test holes are correct to the best of my knowledge and belief. Name (print) Certification No. Address .Name of installer if known Copy C -Property Owner CST Signature 14 • ~ r fl t t WOW& 1 Y a 47 ` S~tA _ s jr, LX h x ~~i t~ a So v ~-p 71, i 49 046 0 5oti O ~ i ~ , ~ ~ r i , y ~ rr': 500 • ► 600.0 A s r,~. iI /L I GIs i r" j Nom, , s 3s- a s r 1 i 0 U~ N R 0 p CN ~ ~z e4 f p - v i- a 'I OJI 1 .-w' CrX 2 v ro r v~ L C2 i LI) r,j r c~ 4 ( -5,~ 6 - 60 q Q w 37vp 69 ti - oru r2 ~o ? r.0 I'~ ~ 1 ~ _ Gv