HomeMy WebLinkAbout231-1065-70-000 /VVisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count y =
Safety and Buildings Division
INSPECTION REPORT St. Croix
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.:
Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)1. 363831
Permit Holder's Name: ❑ City ❑ Village ❑ Pwri of: State Plan ID No.:
City o f Glenwood /b 302 c{
Insp. BM Elev.: BM Description: Parcel Tax No.:
Lro .0 I 1 v0 ,0' I ? wk q -� �w'�aa.
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic b�wesk �r2Ca�� Ics60 65D Benchmark 1'/4ti 0 1, j0 Jp O'
Dosing C o X batik Alt. BM 5 } LM] 9 b • 35
Aeration Bldg. ewer
9 3 ;/ 9.31 9 6.7 9
Holding St / Ht Inlet 35
7a � 9 3•T5
TANK SETBACK INFORMATION St/ Ht Outlet —
TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet ___
Air Intake
Septic —57 ' 43r NA Dt Bottom c('i" C•�q ci0,31 `
Dosing " aE ' _6 3 � NA Header /Man.
bl � �. • 9 3
Aeration NA Dist. Pipe y `Z ` , [ } 96.93
Holding Bot. System �i,ll 4.8,1 44'!
l0 4.83 g 6.2�
PUMP/ SIPHON INFORMATION Final Grade e cF
Manufacturer d ma
Den .2 '
wta'�i c- Z St cover 32 a ouc ��cI 96 1 f2_
bbti Model Number Sw 33 �5P' GPM
' Friction S stem '
TDH Lift `,D`{ L D `+� He 2.S TDH 9.0' Ft
Forcemain Length (p' Dia. 2 11 Dist. To Well (�
SOIL ABSORPTION SYSTEM
TRENCH Width , Len th ► N O Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIME •5 DIM ENSION S
SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
SETBACK CHAMBER
INFORMATION Type O , r Model Number:
System: lmokw --15 54 C4 — OR UNIT
DISTRIBUTION SYSTEM ��
Header/Ma ifo y Distribution Pipe(s) � x Hole Size x Hole Spacing Vent To Air Intake
Length _ is 2 Length $I2 Dia- 2 spacing '
P 9 ► ��
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Syste s Only
Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched
Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes No ❑ Yes ❑ No
COMMENTS (Include code discrepancies, persons present, etc.) Inspection #1: 05 ►o /oo Inspection #2: / /
Location: 407 Walnut Ridge, Glenwood City, WI 54013 (NW 1/4 SE 1/4 23 T30N R15W) - 23.30.15.896 Walnut Ridge
Estates -Lot 1 Opa): –C`, TT) = A' %Ldt
1.) Alt BM Description =
2.) Bldg sewer length=
- amount of cover =
3.) contour = C `�CI.aF acE 5•�S ° io1' v� r� as (w,.�or
t{ r_�.,Q aka- W w.wN.k. w: « d� �� oue� r�c- yrpa,.,,� w•P.A� �N[�.«� .v6� C�ue� CRC Qe�02� '�' l �Q
Plan revision required? ❑ Yes (� No S Z 6
Use other side for additional information_ b
�BD ..a S " � ` - +I-,-,- � Date Inspector's Signature Cert No.
S 6710 (R.3/97)
x
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
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Safety and Buildings Division
1 W. Washington Avenue
2
%6 SANITARY PERMIT APPLICATION 0 consin P O Box 7302
Department of Commerce In accord with Comm 83.05, Wis. A e 3 Madison, WI 53707 -7302
• Attach complete plans (to the county copy only) for the systeryr, bn, '6a not I' � e ' \ my
than 8 112 x 11 Inches In size. a , �° /
• See reverse side for instructions for completing this applica6 r w-,O S nitary Permit Number
�' 3633 �
Personal information you provide may be used for secondary purposes p � ❑ if revision to previous application
[Privacy Law, s. 15.04 (1) (m)].:,:
I - ''+ SS t�" "•� St tP an I.D. Number
I. APPLICATION INFORMATION -PLEASE PRINT ALL RMAT 0 2 `F
Property Owner Name y P otati
N, R/S E (or )ffl
pperty Owner's Mailing Address tt* bir' ( Block Number
City, State Zip Code Phone Number Subdivision Name or CSM N,4mber
CUM % 7
1 . TYPE OF BUILDING: (check one) ❑ State Owned WC It Nearest Road
Public 1 or 2 Family Dwelling - No. of bedrooms _3 ° Tow OF el. v � i�o
III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) �. �0 • 1 5. Gq t
1 ❑ Apartment/ Condo — 3 — 7 O
2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining
4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash
5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify
IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable)
A) 1. rpf New 2. ❑ Replacement 3, ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an
- ___System ____,___ System _____________ Tank Only______________ Existing System _________Existing System
B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non - Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 ® Mound 30 ❑ Specify Type 41 ❑ Holding Tank
i 12 [] Seepage Trench 22 ❑ In- Ground Pressure / F-- 42 ❑ Pit Privy
13 E] Seepage Pit r • � 8 I 43 ❑ Vault Privy
14 E] System -In -Fill S, .Z
I. ABSORPTION SYSTEM INFORMATION:
! 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade
., Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation
[ y5C 1 7-:C $' 4 . 2 Feet Feet
acit
VII TANK in Cap allo S Total # Of Prefab. Site Fiber- Plastic xppr.
Gallons INFO Gall Tanks Manufacturer's Name Concrete Con- Steel ass
New Existin strutted
Tanksl Tanks
Septic Tank or Holding Tank �Q r ❑ I ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamberl ❑ 1 ❑ ❑ ❑ ❑ 1 ❑
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name: (Print) Plumber' ignat ps MP /MPRSW No.: Business Phone Number:
e o er �s oy'y
Plumber's Address (64reet, City State, Zip Code):
I .S ST &, e" le
IX. COUNTY/ DEPARTMENT USE ONLY
(I ate I A gent Signature (No Stamps)
11 Disapproved ( Groundwater Issued ssuin S nitary Permit Fee Surcharge fee)
g g g P
,Approved [:1 Owner Given Initial (/
Adverse Determination -S b ,,. N
X. CONDITIONS OF APPROVAL / REASON_S FOR DISAPPROVAL:
d D (,
SBD -6398 (R. 4/99) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS +
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit maybe renewed before the expiration date, and at a time of renewal any new criteria in the
Wisconsin Administrative Code will be applicable.
3. All revisions to this permit must be approved by the permit issuing authority.
4. Changes in ownership or plumber' requires a Sanitary Permit Transfer / Renewal Form (SBD -6399) to be submitted to the
county prior to installation
5. Onsite sewage systems must be properly maintained`The septic tank(s) must be pumped by a "licensed pumper whenever
necessary, usually every 2 to 3 years.
6. If yQu,have„questiohs concerning your onsite sewage system, contact your local code administrator or the State of
Wisconsin; Safety'and Buildings Division, 508- 266 - 3151.
To be complete and accurate this sanitary permit application must include:
I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the
system is to be installed.
II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling.
III. Building use. If building type is public, check all appropriate boxes that apply.
IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair.
V. Type of system. Check appropriate box depending on system type.
VI. Absorption system information. Provide all information requested for numbers 1 through 7.
VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and
manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and
holding tanks for this system. Check experimental approval only if tanks received experimental product approval from
DILHR.
VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.),
address and phone number. Plumber must sign application form.
IX. County/ Department Use Only.
X. County/ Department Use Only.
Complete plans,;iind specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must
"irielude the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic
tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon
tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served;
B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume;
elevation differences, friction loss; pump performance curve; pump model and pump manufacturer; D) cross section
of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information.
----------------------------------------------------------------------------------------------------
GROUNDWATER SURCHARGE
1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can
effect groundwater.
The monies collected through these surcharges are used for monitoring groundwater contamination investigations
and establishment of standards.
Safety and Buildings
4003 N KINNEY COULEE RD
LA CROSSE WI 54601 -1831
TDD #: (608) 264 -8777
isconsin www.commerce.state.wi.us
Department of Commerce Tommy G. Thompson, Governor
Brenda J. Blanchard, Secretary
March 24, 2000
CUST ID No.224974 ATTN. POWTS INSPECTOR
ZONING OFFICE
MICHAEL J HASSETT ST CROIX COUNTY SPIA
1503 FAIRWAY ST 1101 CARMICHAEL RD
EAU CLAIRE WI 54701 HUDSON WI 54016
RE: CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 03/24/2002 Identifi 4 rs
Transaction ID No o 302744
Site ID No. 188423
SITE: Please refer to both identification numbers,
Site ID: 188423 above, in all correspondence with the agency.
St. Croix County, City of Glenwood City
NW1 /4, SETA, S23, T30N, R15W
Sudivision: Walnut Ridge - lot 1
Facility: Steve Booth Proposed Residence
FOR:
Description: Three Bedroom Mound System
Object Type: POWT System Regulated Object ID No.: 653140
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall
be met during construction or installation and prior to occupancy or use:
• A Sanitary Permit must be obtained from the county where this project is located in accordance with the
requirements of Seca 145.135 and 145.19, Wis. Stats.
• Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with
the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats.
A copy of the approved plans, specifications and this letter shall be on -site during construction and open to
inspection by authorized representatives of the Department, which may include local inspectors. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction /installation/operation.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
j Sincerely, DATE RECEIVED 03/15/2000
//
FEE REQUIRED $ 180.00
FEE RECEIVED $ 180.00
erard M. Swim BALANCE DUE $ 0.00
' POWTS Plan Reviewer - Integrated Services
(608)- 785 -9348, Mon. - Fri. 7:15 AM to 4:00 PM
jswim @commerce.state.wi.us WSMART code: 7633
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Page-/— of --iL
PRIVATE SEWAGE SYSTEM
INDEX AND TITLE SHEET
Property Owner(s .�t'� 0�0 r,✓
Project Name: rW
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Credential Number: D -� /s•� ' Date:
Address: /so i.t4/.. r �r
Phone Number: 71s 8.fy 9,o.
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RECOVED
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Page S Of G
SEPTIC TANK E'PUMP CHAMBER CROSS SECTION SPECIFICATIONS
4" CI VENT PIPE 12" MIN. ABOVE GRADE 6 WEATHERPROOF
?' /0 *# FROM DOOR, WINDOW OR JURCTION BOX APPROVED
FRESH AIR INTAKE — WITH CONDUIT MANHOLE COVER
W/ PADLOCK 8
FINISHED "
GRADE CI RISER �— WARNING LABEL
y — - � -..,__ 4 " MIN.
18" IN. 6" MAX.
INLET �►
WATER TIGHT SEALS GAS- '►
rodrt _� A TIGHT 1
Z ►, \/PPROVED
A SEAL JOINTS WITH
APPROVED ,ell rr� i 1- ALM
PIPE APPROVED PIPE
3 ' ONTO
—
3
ONTO SOLID C � i ON SOLID SOIL
SOIL PUMP OFF ELEV . 87o FT.- -- OFF RISER EXIT
D PERMITTED ONLY
IF TANK
MANUFACTURER
HAS APPROVAL
3" APPROVED BEDDING UNDER TANK
CONCRETE PAD
SPECIFICATIONS
SEPTIC / DOSE
TANK MANUFACTURER: /p�uFfou rr, /. ✓ G. NUMBER DOSES PER DAY: _l?, 19_
TANK SIZES SEPTIC /000 GAL.
DOSE VOLUME INCLUDING x(0.6 t3.3 =
DOSE GAL. FLOWBACK: /C3 9 GAL.
ALARM MANUFACTURER: „j, CAPACITIES: A = ,7W INCHES = .�,�7 g GAL.
MODEL NUMBER: / i
SWITCH TYPE: /7'ar�t c az r �y, y B = 2 INCHES = d! 8 GAL.
-/ �L INCHES = /c,, 9 GAL.
PUMP MANUFACTURER: /�' yO�vir�r� C =
MODEL NUMBER:
SWITCH TYPE: D = _7 INCHES = GAL.
REQUIRED DISCHARGE RATE 30. y�? GPM PUMP E ALARM WIRING AS PER ILHR 16:23 WAC
VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE . 7.8 FEET
+ MINIMUM NETWORK SUPPLY PRESSURE . . . . . . 2.5 FEET
+ ao FEET FORCEMAiN X T. FT. FRICTION FACTOR . _� FEET
TOTAL DYNAMIC HEAD = /o • 7 FEET
INTERNAL DIMENSIONS OF PUMP TANK: LENGTH ,�'i � , WIDTH 7o ; DIAMETER —
LIQUID I5E`PTA yam"
f
I�1r
Y'O4orf.v r/G
SW/S SW/S
Typical Application * Sum /Effluent um Typical lication* Sum /Effluent puT
capacities SW /SDNS25 • to 44 GPM (2.8 Vs) Capacities SW/SD/VS33 • to 48 GPM (3.0 Vs)
Heads SW/SD/VS25 - to 24 h (1.3 m) Heads SW/SD(VS33 • to 26 ft (13 m)
Electrical SW /SD/VS25. 115V, le, 8.OFLA, 60Hz Elect SW/SD/VS33. 115V, le, IO.OFLA, 60Hz
Motor SW /SD/VS25. 1/4 HP shaded pole w /thermal overload Motor SW /SD/VS33. 1/3 HP shaded pole w /thermal
1550 RPM overload 1550 RPM
Minimum Recommended SDNS25 =12" (304.8mm) Minimum Recommended SD/VS33 =12" (304.8mm)
m D iameter SW33 =18" 457 mm)
Diameter SW25 =1 B" 451 mm p _ (
Sum Diame ( ) ,Su
Automatic Operation SW = Vide angle float Automatic Operation SW = Vide angle float switch
(manual available) SO = Diaphragm pressure switches (manual available) SO = Diaphragm pressure switch
VS = Vertical float switch _ Co __ . VS = Vertical float switch
YS = Single cord Mate rials of ruction Cast iron and engineered thermoplastic
Materi of Construction Cost iron and engineered thermoplastic _ Impeller Thermoplastic vortex
Impeller Thermoplastic vortex Discharge Size 1- 1 /2 "NPT(38.lmm)
Discharge Size 1 -1/2" NPT(38.1mm) Solids handling 1/2" (12.8 mm)
Solids handling 1/2" (12.8 mm) Power cord 10', SJTW, (20' o tional)
Power cord 10', SJTW, (20' optional) Superior Features • Carbon/Ceramic mechanical seal
Superior Features • Carbon/Ceramic mechanical seal • Oil filled motor w /automatic reset
• Oil filled motor w /automatic reset thermal overload thermal overload
• Uses single row ball bearing construction • Uses single row ball bearing construction
• Piggy -back plug available for easy maintenance and • Piggyback plug available for easy
replacement maintenance and replacement
97 30
SD3 SW33 533
r
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W
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C( Z
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Capacity U.S. G.P.M. O 10 , 40
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Wisconsin Department of Commerce SOIL AND SIT fiVAI.UATION
Division'of Safety and Buildings Page of
Bureau of Integrated Services in accordance wit 4.111 JR 83:QJ, Wi§ �Adm. Code
ti County
Attach complete site plan on paper not less than 8 1/2 x 11 inches iry'si� , Plan i f } 11 ��
include, but not limited to: vertical and horizontal reference point ( _direction and' "''L� jz C O
percent slope, scale or dimensions, north arrow, and location and cf stafice to'noWst„lroad. Parcel I. D. #
APPLICANT INFORMATION - Please p rint all infor
P oUN uie ed by Date
Personal information you provide may be used for secondary purposes (Privacy S? 1 FFICE
Property
t Owner
/ e R oe � vt. Cjb 1/4S' 1 /4,Sa T3v ,N,R �� fir) W
Property Owner's Mailing Address Lot # Block# Subd. Name or CSM#
/ / o� a '— k Lf t R/ d el
City State Zip Code Nshone Number EN City ❑ Village ❑ Town Neare t Road
�•e ooc% '" � (7/s�,�6.s= ' dr Gee t,u C �7`" G�,�L u t �
New Construction use: ® Residential / Number of bedrooms Addition to existing building
Replacement ❑ Public or commercial - Describe:
Code derived daily flow // :O gpd /� Recommended design loading rate _bed, gpde e trench, gpd/ft
Absorption area required bed, ft /.j trench, ft 2 / Maximum design loading rate _ bed, gpd/ft J% trench, gpd/ft
i 6 as referred to site plan benchmark
Recommended infiltration surface elevation(s) ft ( p )
Additional design /site considerations kS l e•N^'�"
Parent material �� C / , L Flood plain elevation, if applicable 11 4
ft
S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank
U = unsuitable for system E] S U ®S ❑ u El ®U ❑ S ®U ❑ S V ❑ s E? U
SOIL DESCRIPTION REPORT
Boring Horizon Depth Dominant Color Mottles Structure GPD /ft
g Texture Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
.* - 7 !r S
Ground
elev. 7-Ayll?
Depth to
limiting
factor
ain.
Remarks:
Boring #
0-1.2 AO S CS 9 60
�� is Q e4 M 6 F� G s M
did Al - T M
Ground
a
Depth to
limiting
factor
i . Remarks:
CST Name (Please Print) Signature Telephone No.
Address Date CST Number
PROPERTY OWNER Sie 4 fh SOIL DESCRIPTION REPORT Page 4 9
// 0 9 'Z of
PARCEL I.D.#
Boring Horizon Depth Dominant Color Mottles Structure 2
g in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots
Bed ,Trench
l 0. 1,2 /o — 6 " 1 A M s Ir At � R al S y &o .1
S'l6 M A ht M E AS
Ground
elev.
"
Depth to
limiting
fa for
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
in.
Remarks:
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
Boring #
...........................
...........................
Ground
elev.
ft.
Depth to ,
limiting
factor
in. Remarks:
Boring #
..........................
Ground
elev.
ft.
Depth to
limiting
factor
in. Remarks:
SBD -8330 (R. 07/96)
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Fh ; :: t 10. i ipr. 1 2000 10:3 H F1
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWN F
.R.sHIP CERTIFICATION FORM
Owner/Buycr�A�Vc _. 0&t t
Mailing Address
Property Address C_- Vt Wo 0
(Verification required from Planning Department for new con';tniction)
Ci 'Iv W_T_ Parcel Identification Number 70
LEGAL �LF_,SCWJ!1_1_Q_N
Property Locatiou -3 T
_N 'N To*m of
Sec. 2 .30 N-R
Subdivisioll Lot
, .
Certified Sutwey N1aP Pale # 3225
Warranty Deed ft Voltune
1± page 22
Spec house L3 yes 110 Lot 1uies identifiable X yes ❑ no
$ySTEM A2 kIN'MNANC
Improper use and maintenance of you: septic system could result in its premature failure to handle wastes. Proper maintenance:
consists of puinping out the septic tank every three years or sooner, if needed by a licensed purnper. What you put Luto the system
can a ff ec t th fu of the s Cant, as a treatment stage in the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system
is in proper operating condition andfor (2) after inspection and pumping (if necessary), the septic tank is less than 113 full of sludge.
Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the Standards
set forth, herein, asset by the Department of Commerce and the Department of Natural Resources, State of Wisconsln Certification
stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30
days of )he three year expiration date. 00
SIGNATURE OF AFFLICAIN V DATE
OWNER RTIFICATION
I (we) certify that all statements on this form arc tn4t to the best of my (Our) )a I (we) am (are) the owners) of
the described a bove , by virtue of a warranty (teed recorded in Register of Deeds Office.
SIGNATURE OF APPLICANT DATE
••** ** Any information that is mis-represented may result in the sanitary permit being revoked by the aujug Department,
ss include with this application. a stamped warranty deed from the Register of Deeds office
a copy of the certified survey map if reference is nuide in the warranty deed
A
'i
STATE BAR OF WISCONSIN FORM 1 — 1982 li Es 1041
WARRANTY DEED it KATHLEEN N. WALSH
DOCUMENT NO �� ylll A � (�(� i' E:r.�xsrEF� OF D:D
`{ (PAQ ?Ji1 ST. CROIX CO., y WI
RECEIVED FOR RECORD
This Deed made between. Marvin C. Bo oth and Jean
M. Booth 11 -01 -1999 9:30 AM
— i!
ii WARRANTY DEED
-- i' EXEMPT P
j� and Steve M. Booth and r y sr L K Grantor, CERT COPY FEE:
COPY FEE;
a-s. joint tenants wit r; h t- - Of s u r e ; ., -' u.nmar r e d TRANSFER FEE: 24.00
PAGES: FEE: 10.00
Grantee, fi
Witnesseth That the said Grantor, for a valuable consideratio �!
ran o s
li
conveys to Grantee the following described real estate in S t . C . n i i!
�^ t�- THIS SPACE DESERVED FOR RECORDING DATA
County, State of Wisconsin:
NAME AND RETURN ADDRESS
Steve M. Booth
I'
l
517 Main Street
Part of Outlots 36 and 37, Assessor's Plat Downing, WI 54734
of the City of Glenwood, St. Croix County,
Wisconsin described as follows: Lot 1 of �I
Certified Survey Map filed March 20, 1997
in Vol. 11, Page 3223, Doc. No. 556962. 231 1065 -7Q
PARCEL IDENTIFICATION NUMBER
This _ i s n r homestead property.
(is) (is not)
Together with all and singular the hereditaments and appurtenances thereunto belonging;
And _.... _they
warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except
easements and encumbrances of record
and will warrant and defend the same.
Dated this —.— _ _ day of U) . ctob E'_( q C4
(SEAL) Marvin C . B o o t h (SEAL)
Y �
- — -- ` �'� `fig _._ `l w
:✓ fi r . —
(SEAL) Jean M. B o o t h (SEAL)
VC' +
AUTHENTICATION �' \�j�•�01A�t�••�% ACKNOWLEDGMENT
.
Signature(s) =* • * : State of Wisconsin,
–`�:;; . • . �1 S t . Croix Count
authenticated this day of — —� 19 �! CaF P sonally came before me this _ �,• day of
October
the above named
TITLE: MEMBER STATE BAR OF WISCONSIN
(if not, _
authorized by §706.06, Wis. Stars.) to me known to be the erson
p who executed the foregoing
instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY Cheryl W i Z y k o s k i
_ James H. Krave
Glenwood City WI 54013 County, Wis.
�—.A Nota ry Public � x
(Signatures may be authenticated or acknowledged. Both are not My commission is permanent. (If not, state expiration date:
necessary.)
Names of persons signing in any capacity should by typed or printed below their signatures. "
WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc.
Form No. I - 1982 Milwaukee. Wis
-
FORM N0. 985 -A
g
Stock No. 26273
CERTIFIED SURVEY MAP NO
VOLUME , PAGE ial
BEING A PART OF OUTLOTS 36 AND 37 OF THe ASSESSOR'S
PLAT OF GLENWOOD CITY, AND PART OF THE N.W. 1/4 OF THE
S.E. 1/4 OF SECTION 23, T.30 N., R.15 W., CITY OF CLENWOOD
CITY, ST. CROIX COUNTY, WISCONSIN.
Z
O .r
® Peod C.S.M. NORTH IS REFERENCED TO THE NORTH
CO ;p`� ASSUMED I TO BEAR 500' 13'08H� H IS
Z
OL a �o-g�1
'� 300'13'25'E
293.40 0 \ \ 1 \11l{IIQIlU18p / / J
cr 30.1 s0 C7�'' w
M
Q _ _ - �•.
yC c
s I� Ai o =O� �a a n
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el
tn
U�
213.86' 30013'25'
NOO W 165.27
CL
y� 379.13'
7 0�
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Lu L 1L b M °
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NOT W25"W ? o l
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km 900`13'OWE 9q.70 d
� n ...�
U 306.50 _... - N00'... 08.....
...... . - __ - ._ .,_ .... 1
CEDAR CORPORATION
604 WILSON AVENUE
MENOMONIE, W! 54751
(715) 235 -9081 PAGE- 1 ..OF -3
FORM NO. 985-A
Won'-
Stock No. 26273
CERTIFIED SURVEY MAP NO.
VOLUME , PAGE
BEING A PART OF OUTLOTS 36 AND 37 OF
THE ASSE SSOR S
PLAT OF GLENWOOD CITY, ANP PART OF THE N.W. 1/4 OF THE
S.E. 1/4 OF SECTION 23, T.30 N., R.15 W., CITY OF GLENWOOD
CITY, ST. CROIX COUNTY, WISCONSIN.
SURVEYORS CERTIFICATE
1, Steven J. Waak, Registered Wisconsin Land Surveyor, hereby certify that
I have surveyed, divided, and mapped a part of Outlots 36 and 37 of the
Assessor's Plat of Glenwood City, and part of the Northwest 1/4 of the
Southeast 1/4 of Section 2.3, Township 30 North, Ronqe 15 West, City of
Glenwood City, St. Croix County, Wisconsin, and more particularly described as:
Commencinq at the northwest corner of the Southeost 1/4 of sad Section 23;
Thence 500'13'08 "E alonq the west line of said Southeast 1/4, a distance of
663.38' feet; Thence N8q'32'40" E, a distance of 16.50 feet; Thence 500' 13'08''E,
a distance of 306.50 feet to the point of beginninq; Thence northeasterly alonq
the arc of a curve concave to the northwest (with sad curve havinq a rodxas=
3gA7 feet, a central angle= Ig' I I'2W, a chord bearinq= N24'53'55 "E, and a
chord lenqth= 13.33 feet) a distance of 13.3 feet; 'thence northeasterly alonq
the arc of a curve concave to the southeast (with said curve havinq a radius=
178.00 feet, a cent angle= 5q'41'43 ", a chord bearinq= N45'0q'07" E, and
a chord length= 177.18 feet) a distance of 185.45 feet; Thence N74'5q'58 "E,
a distance of 386.00 feet; Thence northeasterly olonq the arc of a curve
concave to the northwest (with said curve having a radius= 573.40 feet, a central
angle= 22'05'15", a chord bearinq= N63'57'21 "E, and a chord lenqth= 21q.68
feet) a distance of 221.05 feet; Thence northeasterly olonq the arc of a curve
concave to the southeast (with said curve havinq a rodius= 245.50 feet, a
central angle= 58'2631 ", a chord bearinq= N82'07'5q" E, and a chord length=
23q.70 feet) a distance of 250.41 feet; Thence 568'38'46''E, a distance of
14-7.56 feet; Thence easterly, southerly, and westerly olonq the arc of a curve
concave to the west (with said curve havinq a rodius= 60.00 feet, a central
anqle= 2g8'50'54 ", a chord bearinq= S 10'45'21 "W, and a chord length= 61.04
feet) a distance of 312.85 feet; Thence N68'38'46 "W, a distance of 143.64
feet; Thence 500" 13'25" E, a distance of 203.41 feet; Thence 58q'23'04 "W,
a distance of 207.50 feet; Thence 500' 13'25" E, a distance of 165.2.7 feet;
Thence 58q'23'04`W, a distance of 618.64 feet; Thence N00' 13'08 "W, a
distance of gq.70 feet; Thence southwesterly alonq the arc of a curve concave
to the northwest (with said curve havinq a radius= gq.g7 feet, a central angle=
10'23'48", a chard bearinq= 565'23'3q "W, and a chord length= 18.12 feet) a
distance of 18.14 feet; Thence N00'13'08 "W, a distance of 71.66 feet to the
point of beginninq. Said described parcel contains 33q,701 square feet, more or
less, or 7.80 acres.
That I have made such survey, land division, and map at the direction of Mr. Mary
Booth, 1444 320th Street, Glenwood City, Wi. 54013, owner. That such map is
a correct. representation of the boundaries of the land surveyed, and
the subdivision thereof mode. That I have fully complied with the
provisions of Chapter 236.34 of the Wisconsin Statutes, � + +� ► 0 i ,,����
Chapter AE 7 of the Wisconsin Administrative Code, and ``��
�,.��`� \ \1n
jCN &���''' %,,��
and the subdivision requlations of Glenwood City in surveyinq,..$� •' ••;I�
divdinq, and mappinq the some. Said survey is subject to STEVEN J.
easements of record, and as shown. WAAK :5
Dated this I day of O T' _ , Igg6. r' =. MEN SOME 0
y2• O
Steve J. Wook R.L.S. 1610
CEDAR CORPORATION
604 WILSON AVENUE
MENOMONIE, WI 54751
(715) 235.8081 PAGE _OF 3
FORM NO, 985-A
g WC ffs-
Stock No. 26273
CERTIFIED SURVEY MAP NO.
VOLUME , PAGE
BEING A PART OF OUTLOTS 36 AND 37 OF TIE- ASSESSOR'S
PLAT OF CLENWOOD CITY, AND PART OF THE N.W. 1/4 OF THE
S.E. I/4 OF SECTION 23, T.30 N., R.15 W., CITY OF CLENWOOD
CITY, ST. CROIX COUNTY, WISCONSIN.
CURVE DATA
_ ..... .._,....._..._.,_ ..,.. _ -.
CURVE RAOUS CENTRAL ANGLE CHORD LENGTH CHORD BEARING ARC B.T. BEARING F.T. BEARING
__..
1 39 q7 IT 112q" 0.33' N24 53 55'E i L3 3q N34 29 44 "E N15 IB 15'E
..., _. ..... ..... ....... .
2 -3 178.00' 59 4143" 177 18 N45 Oq'07'E i 185.45' N15 18 15'E N74 59 - E
4-5 573.40' 22'05'15' 219 68 N63 57 21"E j 22105 N74 59 58 "E I N52 54 43 "E
.._,. . _,._._._, -.
5 -6 245.50' 58'26'31" 23q.70' N82'07'5q 'E ? 250.41' N52'54'43 "E 1 568'38'46 "E
_ .................. ........._.,...........,........,.............. _.....,._,._,...._,.._._...._..__...,-
7-8 60.00' 298'50'54' 61.04' 510'45'21'W 1312.95' N41'19'S4 "E NKl'4q'12 'W
q -10 185.50' 58 26'31" 181.12' 382 07 5q "W 18q 2C t N68'38 46"W 3!52
I
10--11 633.40' 10'59'43" 121.36' 558'24'34'W € 121.55' 1 552'54'43 'W 563'5476'W
11 -12 633.40' 11'05'32' 122.43' 369'2712 "W 122.63' 563'54'26 "W ': 374'5q'58 "W
10 -12 633.40' 22'05'15" 242.67' 563'57'21 'W 244.18' 552'54'43'W 1 574'59'58 "W
._._._._.,.._....i ---- -... -- -_. ,....- .._.- ..,_.- ,._..,_...._,_
13 -14 118.00' 59'41'43" 117.46' S45'09'O7'W ! 122.g4' 5745q'58 "W ' 515'18'15'W
14 -15 gq.g7' 44'53'30' 76.34' 537'44'5q "W ' 78.33' 515'18'15 "W ; 560'11"45 "W
15 -16 gq.g7' 10'23'48" 18.12' 565'23'3q "W 18.14' S60'11'45 570'35'33 "W
1416.. gq.g7.., _._._..,..,_,55'17'18.»..._ .... ...... ...... 82.77 - . _
...,„.... ..,. -
542' 56' 54" W ...,.. ..f,,, 96.47' .. � ,..,. S15'18'15"W - 570'35'33 'W
OWNER'S CERTIFICATE OF DEDICATION
As owners, we hereby certify that we hove caused the land described on this Certified Survey
Map to be surveyed, divided, mapped, and dedicated as represented on this Certified Survey Map.
We also certify that this Certified Survey Mop is required by 5.236.10 or 5.236.12 of the
Wisconsin Statutes to be submitted to the followinq for approval or objection.
1) City of Glenwood City
Witness the hand and seal of said owners this day of �-� �' � �" , Igg117
In the prese ce of: _e vnc
Marvin C. Booth
STATE OF WISCONSIN)
COUNTY OF ST. CROIX) Je M. Booth
Personally come before me this day of / ?&), � —���- ,QQ6, the above named Marvin C.
Booth and Jean M. Booth, to me known to be the persons whd executed the foregoinq instrument and
acknowledged the same.
Notary Public
St. Croix County, Wisconsin
My commission express
CITY COUNCIL RESOLUTION
Resolved that this Certified Survey Map, benq a part of Outlots 36 and 37 of the Assessor's
Plat of Glenwood City, and part of the N.W. 114 of the S.E. 1/4, Section 23, T.30 N.,R.15 W.,
City of Glenwood City, St. Croix Co., Wi. Marvin C. and Jean M. Booth, owners, is hereby approved.
Dote > G < Approved:
i
I
Date: Signed
CEDAR CORPORATION �
604 WILSON AVENUE
MENOMONIE, WI 54751
(715) 235 -9081
PAGE 3 .—OF J
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