HomeMy WebLinkAbout026-1173-27-000 'n Department of Commerce PRIVATE SEWAG M County: St. Croix
,nrt Building Division
INSPECTION REPORT Sanitary Permit No:
479234 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: City Village X Township Parcel Tax No:
Landucci, Nathan I Richmond, Town of 026- 1173 -27 -000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No:
CST BM Elev: Insp. BM Elev: 7
/6d m C, 21.30.18.1381
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic H 5 ! Benchmark
IIOSlt7g Alt. BM
M k 6,A- •b 97 °7$
Aeration Bldg. Sewer
Holding St/Ht Inlet 9�3 3 C
/ J
TANK SETBACK INFORMATION St/Ht Outlet - 7 I
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic 4 5 i A ) z 1 /Z f Dt Bottom
Dosing Header /Man.
Aeration Dist. Pipe
9.3 9z
Holding Bot. System
a .3 q,, y5 df�
, /
PUMP /SIPHON INFORMATION Final Grade `f.6 97 -75
Manufacturer Dem and St Cover Z I w • ( C
Model Nu er vl J
TDH Lift Friction Loss Syste ad TDH Ft
Forcemain Length Dia. Dist. to well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length 12-71 No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dial. Liquid Depth
DIMENSIONS 3 / D Z 7� `--_ —_
SETBACK SYSTEM TO � P/L BLDG IWELL LAKE /STREAM LEACHING Manufacturer.
INFORMATION CHAMBER OR Bid
Type Of System: nn i d - (� UNIT
C o r� ChL /z �C J A Model Number:
J 1"'T' a c� rs n
DISTRIBUTION SYSTEM Z z ,
Header /Manifoll Distribution Spacing Vent to it Int x Hole Size x Hole akp
Pipes) \ \ Z o w\
Lengt Dia_ Length \ 1 Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only �✓e�
Depth Over Over xx Depth of xx Seeded /Sodded xx Mulched
Bed/Trench Center r 2 Bed/Trench Edges Topsoil Yes j No Yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2:
Location: 1085 145th Avenue New Richmond, WI 54017 (NE 1/4 SE 1/4 21 T30N R1 8W) Waldroff Meadows IV Lot 27 Parcel No: 21.30.18.1381
1.) Alt BM Description J1_1 4v_ C60-C
d�
2.) Bldg sewer length = 'Z
- amount of cover = ,
Plan revision Required? Yes ' :, o r v� ------
Use other side for additional information. _`� —L --J —__
Date Insepctor's Sig ture Cert. No.
SBD -6710 (R.3/97)
ety County 5A (1 -, g
201 Washington �x 71 l
,. = adi n, WI 53707 — 7162 Sanitary Permit Number (to be filled in by Co.)
N 2q6
Department of Commerce State Plan I.D. Number
Sanitary Permit A P
"f different than mailing address)
Code era t Address l
Wis.
Adm. > P Projec 2]
Ws
wi Comm 83. � J
in accord v+i .
may be used for secondary purposes Privacy Law, sl Q
oration — Please Print All information � I � u 5 � �� � �
1. Application information
Parcel # Lot # Block #
Property Owner's Nme
f '" - i C�, -' L a ( C Property Locat
Properly Owner's Mailing Address r
n J � L Section C�
Zip Code Phone Number
n / ire] on
City, S,� < 'S d
N, E r W
ct )---- / VV D C M Number
II. Type of Bnilding (check all that apply)
Subdivision ame
2 Family Dwelling— Number of Bedrooms
❑ Public/Commercial — Describe Use []City OV - ge ship f
i 1
E3 State Owned —Describe Use
III. Type Permit: (Check only one box on.. . ne A. Complete line B if applicable)
[I Other M to Existing System
A. ew System ❑ Replacement System El Treatment/Holding Tank Replacement Only
ist Previous Permit umber and Date Issued
❑ Change of ❑ Permit Transfer to New ` - O ,�
B. ❑p Renewal it Revision Plumber Owner ? j � J
Before Expiration
IV. a of POWTS System: (Check all that a 1) At Grade Q Single Pass Sand Filter
In ❑Mound ? 24 in. of suitable soil C] Mound < 24 in. of suitable soil
oil Pr tu'� ❑ Aerobic Treatment Unit [I Recirculating Sand Filter
ound ❑ Holding Tank ❑ Peat Filter `
Constructed Welland '] PrMlulZed In- e ❑ Other (explain)
ng Chamber [I Drip Line
[I Gravel 1 Pip
Recirculating Synthetic Media Fil
tion:
Dis ersal Area oposed (sf) System Eleva n
V> Di ersal/Treatment Area forma d Dispersal Area Required (sf) P (
D Flow (gpd) Design 1 Application Rate(gp sf) / J
g�
Prefab Site teel Fiber Plastic
Manu r
/ •J TOW Number Concrete
facture Glass
VI. Tank Info Capacity in Constructed
Gallons Gallons ofunits
New Existing
Tanks Tanks e
Septic or Holding Tank
Aerobic Treatment Unit
Dosing Chaml+er
MP/MPRS Number Business Phone Number
VII. Responsibility Statem T, the undersig
- assume responsibility for installation of the POWTS shown on the Business plans. w
Plumber's Name (Print) Plum S,3 gnatur
S
Plumber's Address (Street, City, late ode
VIII. Conn /De artment Use Onl Sanitary Permit Fee (in es Groundwater
Date Issued lssuin Agent Signature (No Stamps)
JXApproved ❑ Disapproved Surcharge Fee) I
❑ O f a �s� cam, �Co
DL Con ditio Applrova 3� t S
SYSTEM OWNER:
1 Septic tank, effluent filter and C7� -tom I
dispersal cell must all be serviced / maintained
as per management plan provided by plumber. - k l k—
2. All setback requirements must be maintained
as per applicable code /ordinances.
Attach complete plans (to the County only) for the system on paper not less than 81f1 x It inches in size
SBD -6398 (R. 01 /03)
r )SSURE PLAN
PROJECT Nathan Landucci DDRE S 2871 Leaion Ave N. Lake Elmo Mn 55042
NE i/4 SE 1 /4S 21 /T 31 W TOWN Richmond COUNTY ST. CROIX DATE
4
MPRS Shaun Bird 226900 6/15/05 BEDROOM 3
CONVENTIONAL )00( IN-GROUND CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22
IL BENCHMARK V.R.P. Top of Power Box ASSUME ELEVATION 100' Filter Zabel A -100
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
M * SYSTEM ELEVATION 93.2/93.1 5' below qrade
150' Property Line
2 -3' X 69' Cells with >3' Spacing 10'
35' 35' B-
0 3
-3 ST
20' 10'
ro Town Road
Pro 3 Bedroom
House
Well is to meet all
Plans Designed Using setbacks required by
Conventional Powts WDNR
Manual Version 2.0
Vent
>6„ Standard Biodiffuser
of Cover Leaching Chamber with 31.1 ft2 of Area Cole.
6' Long
11"
3 4" Grade at System Elevation
TDDRE N
PROJECT Nathan Landucci S 2871 Le aion Ave N. Lake Elmo Mn 55042
NE i/4 SE 1 /4S 21 /T 30 W TOWN Richmond COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE 6/15/05 BEDROOM 3
CONVENTIONAL XXX IN- GROUND SSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22
kk BENCHMARK V.R.P. Top of Power Box ASSUME ELEVATION 100' Filter Zabel A -100
❑ BOREHOLE O WELL * H. R. P. Same as Benchmark
SYSTEM ELEVATION 93.2/93.1 5' below qrade
.M.
150' Property Line
2 -3' X 69' Cells with >3' Spacing 10'
B- 35' 35' B -1
ents
20' 10'
B -3 ST
20' 10'
Pro Town Road
Pro 3 Bedroom
House
Well is to meet all
Plans Designed Using setbacks required by
Conventional Powts WDNR
Manual Version 2.0
AL
Vent
> 6" Standard Biodiffuser
of Cover Leaching Chamber
with 31.1 ft2 of Area
6' Long
11"
3 4" Grade at System Elevation
RECEI _ nn
Wi sconsin Departmen of Commerce ; OIL EVTION REPORT Page of
Division of Safety and uildings �� ,
JUN 1 �7inZrytf lance 'h Comm 85, Wis. Adm. Code County �t
Attach complete site Ian o IM "410 1/2 11 inches in size. Plan must
include, but not limit to: vc'at refere a point (BM), direction and Parcel I.D.
percent slope, scale dimen�iQl r tion and distance to nearest road.
Please print all information. Reviewed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner Property Location
Govt. Lot 1/4 j` 1/4 Sa, T3 N R \ E (o
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# /1
';_ V / k Ig"—, /Na I Wu..( epvc ur-
City State Zip Code Phone Number ❑ City ❑ Villag con Nearest R d
ew Construction Use: sidential / Number of bedrooms `7 Code derived design flow rate GPD
❑ Replacement ❑ Public or qpmmercial - Describe:
Parent material U k .0 /mil Flood Plain elevation if applicable
General comments 4 �.� lt/�.��:�N`^^✓ _
and recommendations:
Boring F-11 # [� Boring
y 1,�J Pit Ground surface elev. ft . Depth to limiting factor 7 ' y in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Qr. Sz. Sh. •Eff#1 'Eff#2
a y3.z�
Boring # Boring
Pit Ground surface elev. Oft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munseli Qu. Sz. Cont. Color gr. Sz. Sh. 'Eff#1 •Eff#2
2— -- -
-� p—i1 N 1
3• Zo
• Effluent #1 = BOD > 30 226 mg/L and TSS >30 1 150 mg/L ' Effluent #2 = BOD 1 30 mg/L and TSS < 30 mg/L
CST IVartte (Please Print) Sig e,— CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted Telephone Number
1008 192nd Ave, New Richmond, WI 54017 -�� �— j 715- 246 -4516
I
Property Owner _ Parcel ID # Page of
F Boring # D Boring f
IZ & Pit Ground surface el ft. Depth to IimiGng factor I �' in. I Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr, Sz. Sh. 'Eff#1 'Eff#2
r
E Boring # ❑ Boring
❑ pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
F Boring # ❑
Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description- Texture Structure Consistence Boundary Roots GPD/fE
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eft#1 'Eff#2
I
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777.
I
SBD -9330 (8.6100)
Safety and Buildings Division County C l
201 W. Washington Ave., P.O. Box 7162 1 fU)
Madison, WI 53707 — 7162 Sanitary Permit N bar (to be filled in by Co.)
,Sconsin (608) 26 A 2 3 L l
r7 71naccord n o Commerce tare P1anI.D.Number
nitary Permit APplicatio
with Comm 83.21, Wis. Adm. Code, personal information you provide project Address (if different mailing address)
may be rued for secondary purposes Privacy n r
I. Application Information - Please Print All Information I o Ii Jv
Property Owner's Name
JUN 0 6 2005 Parcel # Lot # Block
a " Prope ca n
Property Owner's Mailing Address ZONING OFFICE �-�
'/4, 5/x' '/4, Section
Zip Code Phone Number
City, �State
�
S o /, Ss J /� p ?d / ,QcF one)
II. pe of B ing (check all that apply) Subdivision CSM er
Family D . ng - Number of Bedrooms " O ry e
❑ Public/Commercial - cribe Use ` ❑City ❑Villa / ip of
El State Owned - Describe
III. Type Permit: (Check one box on line A. Complete line B if app ' ble) Q2 (p ( '73 2q" )
A ❑ Other Modificatio ng System
S stem ❑ Repl ant System ❑ Treatment/Holding T eplacement y
List Previ Perm r and Date
B. ❑ Permit Renewal ❑ Permit Revis ❑ Change of Pe it Tr `
Before Expiration Plumber Owne
IV. a of POWTS System: (Check all that 1 e El si s Sand Filter El
on - Pressurized In- Ground ❑ Mound ? 24 in. of s ble soil Mound < 24 in sui it it ❑ Recircu g Sand Filter
Q I /
Constructed Wetland ❑ Pressurized T round 11 ❑ Aerob Holdr T ❑Peat Filter ex ry
Recirculating Synthetic Media Filter ching Chamber rip Line [] Gravel-less Pipe (explain)
)
V. Dis ersaVrreatment Are nformation: S System
Flow (gpd) Design Soil A lication Rate(gpd Dis
p p ea Required (sf) Dispe ea Pro s fl tem Elev on
sig Y � {6
J ,
C aci in Total Number Manufacturer efab Site S 1 Fiber Plastic
VI. Tank Info tY ncrete Constructed Glass
Gallons Gallo of Units 12 A -�
New Existing -
Tanks Tanks
Septic or Holding Tank
Aerobic Treatment Unit
Dosing Chamber
Responsibility nsibili Statement a undersigned, me responsibility for installation o POWTS shown on the attached
Ph on e Num er
VII p tY M Num
Plumb 's ame (Print) Plumber's Si ure
Plumber's Address (Street, Ci fate, Zip
2= ?
VIII. Coun /De a ent Use Onl Issuing Agen t Signature (No Stamps)
Sanitary Permit Fee (includes Groundwater Date Issu gn
X Approved isapprov Surcharge Fee) �-
Reason far e ✓ " _ O }
IX. Condit' s Approva 1
STEM OWNER:
1 Septic tank, effluent filter and
dispersal cell must all be serviced / maintained
as per management plan provided by plumber.
2. All setback requirements must be maintained
as per applicable code /ordinances.
Attach complete plans (to the County only) for the system on paper not less than 8112 x 11 inches in sin
SBD -6398 (R. 01 /03)
�•y � d k #�1�
.P'
7
air
S
PLOT PLAN
PROJECT Nathan Landucci ADDRESS 2871 Leaion Ave N. Lake Elmo Mn 55042
NE 1/4 SE 1 /4S 21 /13N 18 W TOWN Richmond COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE 5 /31 /05 BEDROOM 3
CONVENTIONAL XXX IN -GROU PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22
BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100' Filter el A -100
❑ BOREHOLE O WELL * H. R. P. Same as Benchmark
SYSTEM ELEVATION 95.6/95.7 4' below . de
Property
Line
Well is to meet all Plans Designed sing
tbacks required by Conventional wts
R Manual Vers' n 2.0
V t
>6 „ Standard Biodiffuser
of Cover Leaching Chamber
with 31.1 ft2 of Area
6' Lo
Grade at System Elevation
"
B -2 34
2 -3' X 69' Cells with >3' Spacing
P edroom
Vents use
150
20'
ST
63' B -3
25'
66'
Slope B.M. * #2 Top of
ey Iron @
9 '
M. * 200' Prope Line
Wisconsin Department of commerce SOIL EVALUATION REPORT page l of 3
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
County St. Croix
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D. pending
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 2
Please print all information. Revi by Date
Personal information you provide may be used or s b biEo(fi+rivacy Law, s. 15.04 (1) (m)). j i9 Q
Property Owner Property Location
David Waldr �. , Govt Lot NE 1/4 SE 1/4 S T 30 N R 18 E
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
398 River Ro ;_ !: 27 - Waldroff Meadows IV
City State Zip Code I Phond _ _ t ity M Village ■ Town Nearest Road
Hudson WI 54016 ( 715 - 549 - 6601 1 144th Avenue
New Construction Used Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD
Replacement F1 Public or commercial - Describe:
Parent material Loess over outwash sands Flood Plain elevation if applicable NA ft
General comments
and recommendations:
1❑ Boring # 11 Boring
El Pit Ground surface elev. 100.00 ft. Depth to limiting factor >90 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 - 6 10yr3 /2 - sit 2msbk dsh as 2f .6 .8
2 6 -14 1 3/2 - sit lmpl dsh cw if .4 .6
3 14 -30 10yr4 /4 - sit lmsbk dsh cw - .4 •
4' 30 -90 7.5yr4/6 - s Osg dl - - .7 1.6
2 Boring # Boring 0 99.35 ft >90
pit Ground surface elev. . Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fti
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -9 10yr3 /2 - sit 2msbk dsh as 2f .6 .8
2 9 -18 1 4/4 - sit 2msbk dsh cam' if .6 .8
3 18 -24 1Oyr4/4 - sit lmsbk dsh cw if .4 .6
4 24 -32 7.5yr4/4 - is Osg dl cw - .7 1.6
5 32 -90 7.5yr4/4 - s Osg dl - - .7 1.6
5 1
* Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signature CST Number
Thomas C Nelson "�' 227387
Address 1 qS z 1 16 4, 51 hcj IZK ry a Date Evaluation Conducted Telephone Number
(�l y 71 -24{ - 115 "1
Property Owner Waldroff Meadows IV Parcel ID # pending Page 2 of 3
3 ft
Boring Boring
g Q Pit Ground surface elev. 99.60 Depth to limiting factor >90
❑ in.
Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. "Eff#1 "Eff#2
1 0 -9 1Oyr3/2 - sil 2msbk dsh as 2f .6 .8
2 9 -16 1 4/4 - sil 2msbk dsh cw if .6 .8
3 16 -26 10yr4 /4 - A lmsbk dsh cw - .4 .6
4 26-32 7.5yr4/4 - is Osg dl cw - . 1.6
5 32 -90 7.5yr4/4 - s Osg dl - - .7 1.6
95.
L f
8
❑ Boring # Boring
Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "Eff#2
❑ Boring # Boring
Pit Ground surface elev. ft. Depth to limiting factor in.
Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2
" Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L " Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777.
I
Waldroff Meadows IV
Lot 27 Scale 1" = 30'
BM1 Top of iron pipe 100.00'
BM2 Top of iron pipe 99.50'
B1 100.00'
B2 99.35'
B3 99.60'
aa�
q
N o d
ti
50
Sri P
L •�
f
`gy �4
00%
Thomas Nelson
227387
maintenance and Contingency Plan for a Septic System
Maintenance Plan um ed once every 3 years.
p p
1, peptic Tank is to be
once a ear. Please note: a larger filter is being installed in
2. Effluent filter is to be
cleaned on y
order to extend the maintenance interval of the filter: actions pipes at the ends of
3. Once every 3 years, cells are to be inspected via t he inspections
the cells.
to limit greases, garbage, and water conditioner discharge into the system.
4.Owner agrees 9
5. The owner agrees to save this plan.
6. Do not plant trees nor park nor drive over sy stem.
7. Watershed is to be diverted away from system
8. Discharge into system is not exceed those required as per Comm. 83
n ncy Plan
If stern fails, determine cause of failure, use a` >ernate of and install new
Option #1. Y
tested replacement area.
sy stem at a lower elevation, by removing chambers, removing biomat,
Option #2. Y
and install new system.
• lacement area, and system elevation
Option #3. No adequate area is suitable for rep
cannont be lowered. Install holding tank as last resort.
3. Replace any other failing components as needed.
Plumber: Shaun Bird 715- 246 -
St. Croix County Zoning 715 -336 -4680
Pumper Tom Mondor 715- 246-5
Shaun Bird #226900
ST CROIX COUNTY
• SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
U�
OwnerBuyer LA
Mailing Address � 8 � � L � � 0 ✓� �� � �A
Property Address S
(Verification required from Planning Department for new construction)
Parcel Identification Number
City/State d -
LEGAL DESCRIPTION
��� 1/ 1 / <, Sec. Z( . T 3 ( N -R �� W, Town of
Property Location ___ Z
Lot # ,�_
Subdivision -p
age
Certified Survey Map # Volume S- 3
Warranty Deed #
�� 5"b � - Volume 13 , Page #
Spec house ❑yes ❑ no
Lot lines identifiable ❑yes ❑ no
SYSTEM MAINTENANCE remature failure to handle wastes. Proper maintenance
Improper use and maintenance of your septic system could result in its P a licensed pumper- What you put into the system
consists of pumping out the septic tank every three years or sooner, if needed by
can. affect the function of the septic tank as a treatment stage in the waste disposal system- b owner and by
t a certification form, signed y a
m
The property owner agrees to submit to St Croix Zoning Departmen �t (1) the on -site wastewater disposal sYs
masterplumber, journeymanPinmber, restrictedplumber or a licensedpumper the tic tank is less than 1/3 full of sludge .
con dition and/or (2) after inspection and pumping (if necessary'), septic
is in proper operating with the standards
ements and agree to maintain the private sewage disposal system Certification
vwe, the undersigned a read the above requir of Natural Resources, State of Wisconsin
thin 30
Depart of Commerce and the Dep artment Office wi
set forth, hgtein, set y the system has been maintained must be completed and returned to the St. Croix County Zoning
stating that yo ti ;
days of the 1 y expiratiodate. 5 1,34 0 ,r
DATE
SIGNA O APPLICANT
p CE R CAT our knowledge. I (we) am (are) the Owner(s) of true t
e e . that all statements on this form are, r ecorded em best of R m of Deeds Office'
the p pe d c above �by virtue of a warranty
/ aJ
DATE
IGN F APPLICANT « « « « ««
« « « « «« Amy i that is mis- represented may result in the sanitary permit b revoked by the Zoning DePar�ent.
app li ca ti o n:
a stamped warranty deed from the Register of Deeds office
«« Include with this app • a copy of the certified survey map if reference is made iu the warranty deed
1�
U. 2 8 13 P 5 13 796507
State Bar of Wisconsin Form 2 -2003 HATHLEEN H. WALSH REGISTER OF DEEDS
WARRANTY DEED ST. CROIX Co., MI
Document Number Document Name
RECEIVED FOR RECORD
06/02/2005 12:30PH
WARRANTY DEED
THIS DEED, made between David J. Waldroff and Julie A. Waldroff, husband and EXEMPT #
wife ( "Grantor," whether one or more), REC FEE: 11.00
and Nathan L. Landucci, a single person TRANS FEE: 116.70
COPY FEE:
( "Grantee," whether one or more). CC FEE:
PAGES: 1
Grantor, for a valuable consideration, conveys and warrants to Grantee the following
described real estate, together with the rents, profits, fixtures and other appurtenant Recording Area
interests, in St. Croix County, State of Wisconsin ( "Property") (if more space is
n please attach addendum):
of 27, aldroff Meadows IV. St. Croix County, Wisconsin. IA Estreen & Ogfand
kD ; 304 LoCUSt Street
Hudson, W1 54016
Part of: 026- 1062 -60 -000
Parcel Identification Number (PIN)
This is not homestead property.
(is) (is not)
Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any.
Dated 0 �
(SEAL) 1/ (SEAL)
* * J. Waldroff
(SEA (SEAL)
* *Ju ' A. Waldroff
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) David J. Waldroff and Julie A. Waldroff
husband and wife STATE OF )
authenticated on ) ss.
1 Z6�/, COUNTY )
*Kristina O land I Personally came before me on ,
TITLE: MEMBER STATEfBAR OF WISCONSIN the above -named
(If not, to me known to be the person(s) who executed the foregoing
authorized by Wis. Stat. § 706.06) instrument and acknowledged the same.
THIS INSTRUMENT DRAFTED BY:
*
Attorney Kristina Attorney Kristina Ogland Notary Public, State of
Hudson, WI 54016 My Commission (is permanent) (expires: 1
(Signatures may be authenticated or acknowledged. Both are not necessary.)
NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED.
WARRANTY DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003
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Parcel #: 026- 1173 -27 -000 12/06/2007 08:01 AM
PAGE 1 OF 1
Alt. Parcel #: 20.30.18.1381 026 - TOWN OF RICHMOND
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
10/21/2004 00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner
O - THOMPSON, GLENN L & SANDRA E
GLENN L & SANDRA E THOMPSON
1085 145TH AVE
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description " 1085 145TH AVE
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 1.610 Plat: 10- 036 - WALDROFF MEADOWS IV 020 -04 LOTS 25/4
SEC 20 T30N R18W PT NE SE BEING WALDROFF Block/Condo Bldg: LOT 27
MEADOWS IV LOT 27 (1.610AC)
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
20- 30N -18W NE SE
Notes: Parcel History:
Date Doc # Vol /Page Type
08/08/2006 831676 WD
09/06/2005 805563 2882/341 EZ -U
06/02/2005 796507 2813/513 WD
12/20/1999 615773 1479/210 WD
more...
2007 SUMMARY Bill #: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 08/09/2007
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.610 25,300 188,500 213,800 NO 02
Totals for 2007:
General Property 1.610 25,300 188,500 213,800
Woodland 0.000 0 0
Totals for 2006:
General Property 1.610 25,300 118,900 144,200
Woodland 0.000 0 0
Lottery Credit: Claim Cou 1 Certification Date: 06/01/2007 Batch #: 07 -03
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
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