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034-1090-90-025
)% 4 K k 6 ©a§�\ k \£% Rf2c2z 2 ` *k / CO -0 0 a $ �); 2 k0) 2 V; E li \ U) U) ajo§§g2aq kU) r 2 mEE'a= ■§ Q 4) S (D 4) 2 )� . 12 § <Im_='')c 2 - « E � _§ § § � « m / k CL co \ ® $ 7 E r � } -� C 2 } z z 1 " t $ F © 2 ■ 0) Cl) 12 CL R k 2 § C-4 ■ U) U) _§ £ ƒ I § § k EL -� a a a t ' 2 v k § § k § § $ / \ \ CO § c . . 7 k 4 A / 2 \ \ k #A a m e 2! 2 2£ \ LO \ m t \ ] j m § U, \ d - Cl) § / 't o ) /) � 2 � a ■ k % I �$$ caf o L) a 2 o U) 0 . RECEIVED St Croix County JAN Z `l 2009 Planning & Zoning Department St Croix County Government Center ti N I N G o F Fic� F I CE 1101 Carmichael Road zoNiNO Hudson, WI 54016 - 7710 RE: Holdin g Tank @ 712 Pioneer Road Wilson WI The holding tank placed at 712 Pioneer Road, Wilson, WI, Town of Springfield has not as yet been hooked up to the home located there. There is no one living there, or has there been since the time of purchase. Therefore, no service or maintenance should be required. 0 Completion date is unknown at this time. 0 Sincerely, © c�0 '7� 34 Roman Zins 420 Cedar Street # 1 Baldwin, WI 54002 ST. CROIX COUNTY <, WISCONSIN PLANNING & ZONING DEPARTMENT M N M M ■� moguls St. Croix County Government Center _ 1101 Carmichael Road �A.. • a.s .y-- -° ' Hudson, WI 54016 -7710 - - " Phone: (715) 386 -4680 Fax: (715) 386 -4686 December 31, 2008 ROMAN ZINS 2839 73RD AVE WILSON WI 54027 RE: Holding tank at: TOWN OF SPRINGFIELD Dear Homeowner, St. Croix County is required to maintain records of servicing events for all septic systems. The owner of the any POWTS (Privately Owned Wastewater Treatment System) is required to report to the governmental unit every inspection, maintenance, or servicing event, as per Comm 83.55 and ss. 145.245_of the State Statutes. The state requires reporting of every event to be submitted by the owner or owner's agent within 30 days of each event. We currently have no records of your holding tank being serviced! Please have your septic pumper contact the zoning office at 715- 386 -4680 with your dates of service. If you have receipts from previous pumping events those can be sent into the zoning office to the address at the top of the page in place of having the pumper contact us. In the future most septic pumpers will take care of the reporting requirements if you request them to do it. Please be aware that you are currently in violation of State Statues and failure to report servicing events for your holding tank could lead to citations. Please feel free to contact me with any questions or concerns. Sincerely, Ryan Yar gto Zoning Technician Wisco qin Department of Commerce County: Safety and Building Division PRIVATE SEWAGE SYSTEM St. Croix INSPECTION REPORT sanitary Permit No: 453171 0 GENERAL INFORMATION (ATTACH TO PERMIT) W 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: Zins, Roman I Springfield Townshi CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding r � St/Ht Inlet ( St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet f Dt Bottom Ito I Dosing � Header /Man. Aer on Dist. Pipe Hol dingy f (�/ Bot. System W . Final Grade PUMP/ HON INFOR ATION Manufacturer Demand St Cover GPM Model Number TDH Lift,. Friction L System Head TDH Ft Forcemain Lengt Dia. F —t. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Widt Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of Sys UNIT Model Number: DISTRIBUTIO STEM HeaderlManifold Distribution I x Hole Size x Hole Spacing Vent to Air Intake ipe(s) r.angth Dia Le Dia Spacing SOIL COVER Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of r Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / Inspection #2: Location: 2938 73rd Ave Unknown (SW 1/4 SW 1/4 28 T29N R15W) NA Lot �JO ��`�1yt� � rcel No: 1.) Alt BM Description 2.) Bldg sewer length - amount of cover Plan revision Required? Yes Use other side for additional information. SBD- 6710'(R.3/97) - Date $e or's Signatur Cert. No. Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division „ INSPECTION REPORT Sanitary Permit No: 453171 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: Zins, Roman I Springfield, Town of 034- 1090 -90 -025 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 28.29.15.584D10 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes 0 No ® Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 2938 73rd Avenue Wilson, WI 54027 (SW 1/4 SW 1/4 28 T29N R1 5W) Plat of Hersey Lot 5- 913I1<37 Parcel No: 28.29.15.584D10 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? Yes No T 1 Et - q T l Use other side for additional information. - - - - -- SBD -6710 (R.3/97) Date Insepctor's Signature Cart. No. Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 viseons�n Madison, WI 53707 - 7162 Sanitary Permit Num (to be filled in by Co.) e artment of Commerce (608) 26(;x,3151 ys Sanitary Permit Application State Plan I.D. Numbeer� In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ?ql a ! 3 may be used for secondary purposes Privacy Law, s15.04(1)(m) Project Address (if different than mailing address) �LDG� O.0 I. Application Information -Please Print All Informati rT1 Pro Owner's Na me Parcel k Lot N Block �m I A)_5 MAY () 6 2004 Property Owner's M ailing Address gi i tJ i , Property Location _ Sf -e— ZONING OFF City, tate , '[i,Section tY• Zip Code /Phone Num -�berp C & t_ (O� �(XJ - �E12 ircle of Buildi a pply) T� N. R E o r W) ) .Type g (check all that a l tk or 2 Family Dwelling - Number of Bedrooms / Subdivision Name CSM Number El Public /Commercial - Describe Use Yt'W414_ ; fD "40 P a�� ❑ State Owned - Describe Use ❑City_ ❑Village Nownship o(fJ III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System '[te placement System Y P Y ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS S stem: (Check all that ap ply) ❑ Non - Pressurized In -Ground ❑ Mound > 24 i suitable sot rid < 24 in. of suitable soil El At-Grade 11 Single Pass Sand Filter ❑ Constructed Wetland El Pressurized In -Gro )(Holding Tank ❑ P Filter El Aerobic Treatment Unit El Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter El Leaching Ch3mbt rip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Appl �n Rate( sf) Dispersal Area Re u ed (sf) Dispersal Area Proposed (sf) System Elevation N VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New I Existing Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit (! Dosing Chamber VII. Responsibility Statement- I, the tmd igned, assume responsib' 'ty r installation of the POWTS shown on the attached plans. Plumber's Na me (Print) lumber Si gna re MP /MPRS Number Business Phone Number Plumber's Addre ss (Street, City, S t ip Code) ount /De artmen (Use Onl A roved ❑ Disapproved Sanitary Permit Fee ('ncludes Groundw Date Issued Is n A en i e N PP Owner 8� ( Ps) Surcharge Fee) ? ❑Owner Given Reason for Denial 4y , IX. Conditions of Approval /Reasons for Disapproval Attach complete plans (to the County only) for the system on paper not less than 81 x 11 inches in size SBD -6398 (R. 01/03) L o'r4 ow•aM �'.�.S- 1��c+ ��la- �4- 1 o a- QoobO�_oo� X -7- lYw 1n 1 � T 2, 3!3 .0$ �w C /y� .o Y: w. R,� �� ra \ 1S3 � •.:tee a� 13H r2s Q 1 in i Ct Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 Y TDD #: (608) 264 -8777 iseons►n www commerce state wi www.wisconsin.gov n.gov Department of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary December 11, 2003 CUST ID No.227548 ATTN: POWTS Inspector TIMOTHY H MITTLESTADT ZONING OFFICE ABC SEWER ST CROIX COUNTY SPIA E742 HWY 12 W 1 101 CARMICHAEL RD KNAPP WI 54749 -9074 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 12/11/2005 Transaction ID No. 949843 SITE: Site ID No. 669217 Roman Zins Please refer to both identification numbers, Pioneer Street L above, in all correspondence with the agenc Town of Springfield St Croix County SW1 /4, SW1 /4, S28, T29N, R15W CSM /Subdivision: Hersey Plat; lotsE 2-19 2 -5, blocks: 37 & 38 FOR: �J Description: Proposed One Bedroom Holding Tank Object Type: POWTS Component Manual Regulated Object ID No.: 934858 Maintenance required; Replacement system; 150 GPD Flow rate; 4 in Soil minimum depth to limiting factor from original grade; System: Holding Tank Component Manual, SBD- 10571 -P (r.6/99) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Holding Tank Component Manual for Private Onsite Wastewater Systems" SBD- 10571 -P (R.6/99). • Comm. 83.54(2)(c) - A meter, with remote reading device, shall be installed by a properly licensed plumber, on th water system, t hat a equately measures the amount o wa er use v w all hydrants which do not discharge into the sanitary system. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 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. Stat • Comm 83.52(3) - The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. • Comm 83.22(7) - 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. con, Aw TIMOTHY H MITTLESTADT Page 2 12/11/03 Owner Responsibilities: • Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. In the event this holding tank system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, Fee Required $ 60.00 &4 Fee Received $ 60.00 Balance Due $ 0.00 Gerard M. Swim POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm WiSMART code: 7633 jswim@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 Henry F Grote , Certified Soil Testing RECEIVED DEC _ 8 2003 Roman Zins - Holding Tank 3AFETX & BLDGS Transaction # c DIV. Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manual: Holding Tank, SBD- 10571 -P (6/99) Location: Lots 2 -9 & 2 -5, Blocks 37 & 38, Hersey Plat SW 1/4, SW 1/4, Sec. 28, T 29 N, R 15 W Town: Springfield County: St. Croix Date: November 12, 2003 Owner: Roman Zins Address: POB 36 Roberts, WI 54023 Plumber: Tin Mittlestadt Signature: License # MPRS 27548 Attachments: 6748 -Plan Approval Application SBD 8330 page l: cover 2: plot plan 3: tank detail 4: maintenance information G ;EPARWENT OF COft4WERCE UIVISKM Of SAFETY AND BUILDINZS �t E C:Ut RESP DENCE page 1 of 4 1 Lcyl ` oH..e�� ', �.g - L�lo� ��la, 3 4 - 10O Ltp- , + o� a't: 2. 1 2 -r - . 7 - IY Q w 1 n VVT 2, - S , 2. o z o 4U � w l� h --QC �w H1 1 I �- ,L1 14 1 HOL'Di Hip - .TANK`CRutiS- 'SIftIION ANU SnCLh "IC7C1LuKs Approved Approved Locking Vent Cap Weather Proof (Manhole Cover 1 L 1 Junction Box `^/ •• »�� 4�� I�vL �1,.4o 12" I Vent Pips Final Grade I 4" I I i Approved Joint Water Tight Seal High Water . Alarm Switch SPECIFICATIONS �. Approved I 1 Joint v/ TANK Manufacturer: A M- � F"C- Pipe Tank Size: t-P Gallons Extend 3' Onto ALARM Manufacturer: S S � °'��"� S ���" ! Solid Soi ' Model Number: \d\ ►�`"' Switch Type ►•����� » NUMBER OF BEDROOMS ��avw�'oh OWNER'S NAME: ADDRESS: Po 36, LEGAL DISCRIPTION: Sw Ito Lw k ,Sec. zv I T 1 - 9 N Y W TOWNSHIP MUNICMALITY: S :- L-: a= COUNTY: C,, 0 `..� v 1>Y (S �oe� ��l�g, hMQ.�•t 1�1.. Huffcutt 2000 LP -HD Holding Tank Tank interior = 149" x 70" x 53.5 " /(12" x 12" x 12 ") = 322.9 ft Tank weighs 17,000 lbs w/ cover Anchoring requires: 1.5 x 322.9 x 62.4 - 17,000 = 13223.4 lbs To p tank surface - [161 x 78"/(l 2 12 x )] /9 =9.69 y d 3_ 2 sand backfill @ nominal 2500 lb/ yd = 0.67 x 9.69 x 2500 = 16,230.75 lb Holding Tank Maintenance Information As a condition of plan approval, a copy of these plans must be given to the owner and this information reviewed with the owner. The capacity of this system's holding tank is 2086 gallons. Under Wisconsin average use conditions of nominally 50 gallons per person per day, the tank will become full after about 20 days of use by two people. Water conservation measures including the use of low flow water fixtures will extend this time frame and are recommended. A water meter must be installed on the potable water service to this residence. The holding tank is equipped with an* alarm which is installed 12 inches below the maximum water level of the tank. The alarm will function when about 556 gallons of capacity remain; this is about five and one half days of average flow for two people. At this time a licensed septic pumper must be called to pump the tank before maximum capacity is reached. Septage disposal will be by approved methods according to the Holding Tank Servicing Agreement filed with the county permit application for this system. The licensed pumper is required to submit a report to the county within ten days of any servicing - such as pumping - of this system. Any questions regarding the performance of this system may be referred to the installing plumbing contractor, ABC Sewer, at 715- 665 -2112, or to the St. Croix County Zoning Office at 715- 386 -4680. Page 4 of 4 U/13103 TRU 12:18 FAX 715 .186 486 � ST C �ooi k �tM CC0T11�ITY SEFM TAM WDnNNAM s rr AM QwNMtSW CBRTtKCWh0K Vogt 4 Abift Addlwfe i �� �� ? f� Plenetiq f Dep.sboeat fac vow / nsf.�e 1A)���a qqA - ,spy ftWCtY roc &0 W- ya -W y+, Sec. C �L T R,45 Tojn of SI%47g F AD E e sy rb� i Bar y bftp # . V4btna wpb► Dw # yav,� voitana 2 pop # 3 9 Z Spec bcnn O yap an Lot limes Ma dfmble 13 yes 0 m �aQ k�r 7otpvpe�we wd aot oepdo s«ultin iii a5a�ne to Maebwasaer. Pier ee ega�eiat dpompiep an to Ospda twit emy dwn Ye or a000er. iP aeeamd by • Gomsal power. W1wt>oa pet ietc ms apsim vet efllxtAee ttaatlsa ad8�s eepefa pmk ae a eie etsMe ib 4te awls dsooeel ayrma< iLe pvpa(y eiwaor a�eeu a submit a fit G�ois 2)oeisp Depettueeet • aesti$R+edon dam. sipiod 1y ire owse+e ssd b7 a aeeualrsl+l . 4 me4i�0edpiomberaeaSoeaeedpeuapes dies( 1 )6baaa- si0e...etswaoer�tpo.etsJ 0 1 Von is in gapes vpsal� oots�ih'oa teld/ar (� aflee jmpeetios and Cdasw�tY� We septic mac b less drta ]!3 evil aI'e1�e` ttiu �+t taa,ere.lme eagefNeueeeee aad same. a atsfasta is lilrttos etrim�e dlepeeel apatu� wM stardnde eetl bra, imeiw tutiectij+ eDep, tlmmtet�omwaoe.. �dtereD�seatafi�etdltrao�moee .Slsoaafriatoao�. Cetd�aaliaa 6�7�+9f �6etaa�ptoedatvtbaoottlpb�odaad 0odaSo tigs&CowoWZwe1t011oewidA&W aIclbe isow � asliuriss ins. � 3 s MMIV to CW APPOCAM DAU 2 (ws ONOY *a W Moloomis as tide film tee nos a tdo best of aw (a* - 1(we on (w) o`jpn*) of *md*d above; bf vbaes Of a asetaW deed noonkd be Rosiner of Doe& Offim f 2M (W DATE e80roe A I btmoeDiaa drat it mis- tap�eat stedmq�:���l� io !6s ssai4C1►peemit btaeg tassics4l�' �e T�mimiE Depatom """ " lodoi& wM Ws @NO= = a s%mpW wstwt W deed g *@ itgdaw adored: miss t► OW of to oeNfad teenier soup if me>Me me a made k *a wou Siq dud t 22 - --... _. r... ............. Suva 7 �. 2476P 460 749453 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., NI RECEIVED FOR RECORD 12/18/2003 10:30AK $L craft County HOLDING TANK AGREE![ENT Hok" Tar*Agroan ent EXERT # bk� Pion l S FEE: 13.00 TRANS TRA FEE: COPY FEE: 3.00 Nwne — (Ow w) Typed or pdnied CC FEE: batq tlwy sttant , shlr, ttad7► taw twb PAGES: 2 L gWft it da ettiowyrR Uwwordtlr �� OW loodbd b 8L A a[hadlaw j is 16 at a2? - log,; TI1W.7aaot S � 5 .! caaa ar bagddly area.. t+m IaI aa.od R o 2 3 dtbiMd kyl ae.mptioo,: U 3- n 9 0 - 7v I Aarllwr.e txdR � w.adu�aM.dp�w.e.p1 m.rbrpwb " dhDMddY�0wak1olM dtow4odppwyuyfarmsadbwdarrd tMdampp�wMooragaraatlrta WrcMbwModOR 0r dtapppoora(pwparawAiwiwddrwrgr AYLwwpowly OJT am otaewlemmWbyaarafd,W �rwr sw4rb�r4wdpdrdreri�wlwwlrw�Ywda�sba�s0 da�drC1►Ce��t1. MOL Adm Godt srOL 1A Wk. stole. Y II -- A540Mdrow�wdb0w aooll�bltMMlarwdlwy /wwdtRlydw darw6rdpirpwb.�aptwbdVww>0 to� V CJtJ I. owwr waw baadwwb :+ op a , d txaa a lMlo. 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YMa Ada code. b Maws MddYr! twat wN7od wd b I7, sow d to ow*sd wm a trdt 'tare dwwr 0r0wr b 0b ■ DOPY d ortp dW*W % h 11rMor awiaat or• aapltdswrrwvlaaawdNd,t�h M�MM( tOlwrYtwllgrhanadobddtwpbbaaMawwd. ti. llr aarirr apwtt b aoabrct M• s g"!l m dor Ck MR lit I o. Adm OW% ab dwi WAN! b dw aotgr rn a aaadwnW bwir • wood OoM7 0t• r1lYfob� nk 7M slownrwrl trig d owmw aabr 4m the p b - - 11M1 a tatdgaawpb800 o wttMttalM Otw L kwlstR wY. Adw► cadL b.idrott M b! aSwdinO ad awltaal0wcw01ot0aabeaddwwawdl7rNilwwrb0w0wprsr 7. lbbrpawnndd.0e.tdtt�upsta .t11obA.aawwr,wdm4bM Gf lwawaar. firawwratw0diwddoapaowiwd to go ndo1M d dodo, red b atwr YM wsoiiod � a rapMar ar daado b1 a wrwwr Wid1 M prwlk IM aYWroa d a apfoowwntbMaalaaaMadbyw0ww�w poplrydrwtarhdd Whbbw~ • awrn ttwon dt� G .21 3 t � G JOEL. KRAEME . . 13 yea � awd b► Prptwt• L -nw prtwtl et twer �ltw oot:utrr.r- Itstratw:- vbbrlMwewdwrr..oapblydA�+t+� d1a8,armtldltlsodebf/�rrdldarl pr•ww.a..ob..aw o, rdetQaYtwq,trpoNloltMet.dlLtlwM M MMdNd�ww�drwgM /b�awdd104aMwlra/IM IArarllYoowr aiYtarr a ad dROrl: ORIGmv RECEIVED 1935 Wisconsin Department of Commerce SOIL E UATION REPORT / ' �`'� Page 1 of 4 Division of Safety and Buildings in accordance with Co Wis. Ado . ic,4 Q� Certified Soil Testing Coun Attach complete site plan on paper not less than 8 %x 11 inches in size ii. CROIX cou,y i St. Croix include, but not limited to: vertical and horizontal reference point (BM), r NING OFFICE Par I I.D. percent slope, scale or dimemsions, north arrow, and location and distance nea 34- 1090 -70 -000 + 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 Zins, Roman Govt. Lot SW 1/4 SW 19 S 28 T 29 N R 15 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# POB 36 2 37 08 Hersey Plat City State Zip Code Phone Number Lj City I Village 16 Town Nearest Road Roberts I WI 1 54023 715 - 749 - 0101 Springfield Pioneer St. New Construction Use: 16 Residential / Number of bedrooms 1 Code derived design flow rate 150 GPD ✓'. Replacement w Public or commercial - Describe Parent material loess over till Flood plain elevation, if applicable NA General comments and recommendations: shallow soils over seasonal saturation & low flow indicate holding tank only FT] Boring # I Boring Pit Ground Surface elev. —100 ft. Depth to limiting factor 0 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -8 10YR 3/1 - sil 2 m gr ds cs 1f /m .5 .8 2 8 -23 10YR 3/1 c1d 7.5YR 5/8,4/6 sil 2 f -m sbk dsh cs if .5 .8 3 23 -30 2.5Y 5/4 c3p 10YR 6/2 sil 0 m dsh - 0 .2 lacks A +4 "; presumptive limit is 0" Boring # _.j Boring to Pit Ground Surface elev. —97 ft. Depth to limiting factor 0 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 `Eff#2 1 0 -4 10YR 3/2 - sil 2 m -c gr dsh cs 2fl m .5 .8 2 4 -8 10YR 3/1 f1 d 7.5YR 5/8 sil 2 f -m sbk dsh cs 1 m .5 .8 3 8 -30 10YR 5/4 m2p 7.5YR 4/6,5/8 I OYR 6/2 sil 1 m sbk dh - 1 m 2 3 I lacks A +4 "; presumptive limit is 0" * Effluent #1 = BOD 30 < 220 mg /L and TSS >3P < 150 mg /L • Effluent #2 = BOD < 30 mg /L and TSS < 30 mgr CST Name (Please Print) Signa re CST Number Henry F. Grote c 222774 Address Certified Soil Testing Date Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 8/8/2003 715 - 233 -0398 i t , Property Owner Zins, Roman Parcel ID # 34- 1090 -70 -000 + Page 2 of 4 37 Boring # Boring (j Pit Ground Surface elev. —97 ft. Depth to limiting factor 0 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Ef1#1 *Eff#2 1 0 -4 10YR 3/2 - sil 2 m -c gr dsh cs 2f1 m .5 .8 2 4 -13 10YR 3/1 c2d 7.5YR 5/8 sil 2 f -m sbk dsh cs 1 m .5 .8 3 13 -31 10YR 5/4 m2p 7.5YR 4/615/8 sil 1 m sbk dh - 1 m .2 .3 I OYR 6/2 lacks A +4 "; presumptive limit is 0'; pits B -2 & B -3 done 7/16/01 for Deea Gailfus F-1 Boring # I 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 ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # j Boring j Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtftl in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 i 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. SBD -8330 (R.07 /00) Certified Soil Testing ow•o�M ', �.g - lob a., 3�4 - to�tr,_'}c (C d#5 a Re C3 , 0o _Ooo Sl.v - Sw - S 1 2 - 7-q- lr w ( n l 1 1 lV �7 9� C f � I f �w� J cp Draft4k by Howar o o c _ J L _ _ l J J �`� ' -4, 7 7 I ' 1 J— _J J 1 1 SW — — � CL 3 m m m 1 33' L_ ¢ �y S r Y�pJ CD o p, D C7 Z I S (� J R-50' / _— _ -� J � o 3 co N IO f N �� —_ Co O J J — �o r J Z �o OQ I NJ j CO o L71 :3 LP Z I 6 Q J J J r J m o co — J Qr 1 8 J 1 0 1 a h co i0 1 S 9 1 �O 77.7 '50 E ,........, �o o Q a� IN 415,�j N�o 1 co 0 1 N In �cn _ J 1 � i� �� A $ 0 _ s o I� c0 0 — r ,9 ' w G) = . 1 C D �� �" ' 2 -1 ce Lri Z I ?' co _O J �r _8 ' — J w " ry /irmnmm�n"�` ° � (rl IC OI0� J � r D! r IC 1r O 'AN 4 �'' _ �, J r p c� .p O W N� 1 I N � , J _ � � to c7vpv v v I� I Q CJ _ �f l�r ) J — Nrn r J oc wa BY &T �.� ' I , t — �r J — wr �,r .� 3 -A a.. o �r� w �� 3w �r 1 p ;coao ;c� :rtoN v I N 1_ — �J ,, r � r r J to W p a n o F ? O ° m Z r i J � =r w p o> c 'QS" �— '� _ / LL; ,ST — — 1 s o l�� J ° 79.36 = z 33 -56' - -- _ _E _ I .. a � � E �- I �� I - '� T - 1 -�!ACq T — — _ v� r Oi J o � r' c rn n a � � ?' 7g -- ED — r J $ IC �- _ '36 O _ �i w o W o 0 Rzm �/ 126 8 ' 1. — — rs� -v cle �a w ° Qr 9 hE 373`�� .87 9• `° WI O c 0 w 3 o v o 2 v ° a �J �r / I � �0'0°W C, o p J �r ' rt C A I Z I J �v ay- a :*- a v 0 .r o O J �7 a y v/ n °, o o a ° I 10 R- 1 5 0 ' av' w a n Z O J J a m p 7 rt o I J J ;--_l t. I p 0 J. 4 J 1 0 CL CL a n CL CV 0 ca 9 C g a CL CL 0 m ° o C co Co I IN I �— _ LE GEND a ABC SEPTIC 7156652112 P.1 _ '" - `` .- •. .... 1935 LUATION REPORT ES/A Wisconsin Department of Commerce i Page I of 4 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Certified Soil Testing Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D. percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. 34 1090- 70 -000 + Please print all Information. Rev' a Date Personal information you provide may be used for secondary purposes (Privacy law, s. 15.04 (1) (m)). Z Q Property Owner Property Location ' Zins, Roman Govt. Lot SW 1/ SW 1/4 S 28 T 29 N R 15 W Property Owner's Mailing Address L Block # Subd. Name or CSM# POB 36 2-9,2-5 37 &38 I Hersey Plat City State Zip Code Phone Number l y _j Village �f/ Town Nearest Road Roberts WI 1 54023 1 715 - 749 -0101 Springfield Pioneer St. New Construction Use: J6 Residential /Number of bedrooms 1 Code derived design flow rate 150 GIRD ✓! Replacement J Public or commercial - Describe Parent material loess over till Flood plain elevation, if applicable NA _ General comments � and recommendations: shallow soils over seasonal saturation & low flow indica a holding tank onl� � - L - j - w. '� 1 Boring # J Boring 0 Pic Ground Surface elev. —100 ft. Depth to limiting factor 0 in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary I Roots GPD /ftr / in. Munsell i Ou. Sz. Cont. Color Gr. Sz. Sh. - Eff #1 'Eff#2 1 0 -8 10YR 3/1 - sil 2 m gr ds cs 1f /m 5 8 2 8 -23 10YR 3/1 c1d 7.5YR 5/8,4/6 sil 2 f -m sbk dsh cs if .5 .8 3 23 -30 2.5Y 5/4 c3p 10YR 6/2 sil Om dsh - - 0 .2 E77 L I I l acks +4'; presumptive limit is 0" -- FT] Boring # J Boring ✓J Pit Ground Surface elev. —97 ft. Depth to limiting factor 0 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/R' in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'Eft#1 - Eff#2 1 0 -4 10YR 3/2 - Sil 2 m -c gr dsh Cs 2f1 m 5 8 2 4 -8 10YR 3/1 f1 d 7.5YR 5/8 sil 2 f -m sbk dsh Cs 1 m .5 .8 3 8 -30 1 DYR 5/4 m2p 7.5YR 416,5/8 10YR 6/2 sit 1 m sbk dh - 1 m 2 3 lacks A+4"; presumptive limit is " Effluent #1 = BOD 30 220 mg/L and TSS >3P < 150 mg /L ' Effluent #2 = BOD < 30 mg /L and TSS < 30 mgL CST Name (Please Print) S)gna re CST Number Henry F. Grote c 222774 Address Certified Soil Testing ate Eva do Conducted Telephone Number E. 4366 353rd Ave., Menomonie, Wl 54751 8/8/2003 715- 233 -0398 ABC SEPTIC 715SG52112 p•2 Property Owner Zins, Roman Parcel ID # 34 - 1090 - 70 + Page 2 of 4 IE Boring # J Boring Pit Ground Surface elev. — ft. Depth to limiting factor 0 in. Sol Application Rate Horizon Depth Dominant Color Redo: Description Texture Stricture Conaistenoe Boundary Roots = in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 W510YR 3/2 _ sil 2 m - gr dsh cs 2 f1 m . /1 c2d 7.5YR 5/8 sil 2 f -m sbk dsh cs 1m .5 .8 /4 m2p 7.5YR 4/6,5/8 I OYR 6/2 sit 1 rn sbk dh - 1 m .2 .3 lacks A +4•; presumptive Ilmit is 0•; pits B -2 3 B -3 done 7/16/01 for Deea Gailfus ED Boring # J Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Sol Application Rate Horizon Depth Dominant Color Redox De wiptlon Texture nature Consistence Boundary Roofs m• Munsell tau. Sz- Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 I I ❑ Boring # J Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Horizon Depth Dominant Color Redox Deacri Sol Application Rate Murrsell Ate► Te% Structure Consisterim Boundary Roots �• Sz. Cont. Color Gr. Sz. Sh. - Eff#1 - Eff#2 f l r _ I I I I I Effluent #1 = BOD s mg/L and TSS >30 < 150 mg/L > 30 < 220 • Effluent #2 a BOD c 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 suo - earn (R .07/w) need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608- 264 -8777. • U. 2409P 392 -7,4iZjZI It STATE BAR OF WISCONSIN FORM 2 - T' KATHLEEN H. WALSH Document Number WARRANTY DEED' REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Steven C. Banvai RECEIVED FOR RECORD and Roman Zins Grantor, 09/15/20@3 10 : 00AM Grantee. WARRANTY DEED Grantor, for a valuable consideration, conveys and warrants to Grantee EXEMPT # the following described real estate in St. Croix County, State of Wisconsin REC FEE: 11.00 (if more space is needed, please attach addendum): TRANS F 45.00 Lots 2, 3, 4, 5, 6, 7, 8 and 9, Block 37 AND Lots 2, 3, 4, and 5, Block 38, CC COPY FEE Village of Hersey, St. Croix County, Wisconsin. PAGES: 1 Recording Area Name and Return Address KRISTINA OGLAND ATTORNEY AT LAW P.O. COX 339 HUDSON, WI 54016 34- 1099 -70- 000; 34- 1090 - 95-000 roe enti tcauon um r This is riot homestead property (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of September 2003 * * Steven C. Banyai AUTHENTICATION ACKNOWLEDGMENT Signatures) Stev C. Ba nyai— — — STATE OF ) County ) authenticated this ( day of September , 2003_ l_.�— -� Personally came before me this _ -- day of the above flamed * Kristine Ogland — TITLE: MEMBER STATE BAR OF WISCONSIN (If not, _ _ _ _ to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Slats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY Attorney Kri stin a Ogla — - - * __ __ _ - _ • -- --- -_..__ Hu dson, W I — _ - Notary Public, State of _- My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ) * Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co.. Fond du L . wl STATE BAR OF WISCONSIN 800.65. 2021 WARRANTY DEED FORM No. 2 -1999 f. • STATE BAR OF WISCONSIN FORM 2 - 1999 WARRANTY DEED Document Number This Deed, made between Steven C Banyai Grantor, � 1 and Roman Zins Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Lots 2, 3, 4, 5, 6, 7, 8 and 9, Block 37 AND Lots 2, 3, 4, and 5, Block 38, Village of Hersey, St. Croix County, Wisconsin. Recording Area Name and Return Address 34- 1090 -70- 000; 34- 1090 - 95-000 Pa rce enti tcation r ( ) This homestead property (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of September 1 2003 * * Steven C. Banyai — * * AUTHENTICATION ACKNOWLEDGMENT Si natures Steven C Ban ai STATE OF - —_ __- —,— ) Signature(s O -- -- Y - - -... - - ) ss. _. -- -.- - -- -- -- County ) authenticated this .L_- day of Septe mber 2003 day of Personally came before met Is - _ the above named * Kristin O gland - - - - - -- - - - - - - -- - - — TITLE: MEMBER STATE BAR OF WISCONSIN ___. - - - - -- - - - - -- - -- (If not, to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Slats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY - - -- - - - Attor Kr istina O gland * -- - - - - - _ _ -_- Huds W I Notary Public, State o _- _ _- - - - -- - - - - - -- My Commission is permanent. (If not, state expiration ate: (Signatures may be authenticated or acknowledged. Both are not necessary.) -- -- -- ) Information Professionals Co., Fond du l ;; . WI * Names of persons signing in any capacity must be typed or printed below their signature. 800 -65:' 2021 STATE BAR OF WISCONSIN WARRANTY DEED FORM No. 2 - 1999 i Document Number Document Title St. Croix County Holding Tank Agreement tate Plan Transaction Number - Name — (Owner) Typed or printed being duly sworn , states, under oath, that: 1. He/she is the owner /part owner of the following parcel of land located in St. Croix County, Wisconsin, recorded in Volume Z4 Da Page . Z- Document Numbe St. Croix County Register of Deeds Office: Recording Area Name and Return Address A parcel of land located in the' /4 of they �'/4 of Section T�_ N— R I W, Town of SCR/ N G r /EZ. D J St. Croix County, Wisconsin, being duly described as follows (include lot no. and subdivision/CSM or detailed legal description): Agreement Date: Parcel Identification Number (PIN) ga4d' s We acknowledge that application is being made for the installation of (a) holding tank(s) on the above described property or that continued use of the existing premises requires that a holding tank be installed on the property for the purpose of proper containment of sewage. Also, the property cannot now be served by a municipal sewer, or any other type of private onsite wastewater treatment system as permitted under Ch. Comm 83, Wis. Adm. Code, or Ch. 145, Wis. Stats. As an Inducement to the county to issue a sanitary permit for the above - described property, we agree to do the following: 1 . Owner agrees to conform to all applicable requirements of Ch. Comm 83, Wis. Adm. Code relating to holding tanks. If the owner fails to have the holding tank properly serviced in response to orders Issued by the governmental unit or the Department of Commerce to prevent or abate a human health hazard as described in a. 254.59, Stats., the governmental unit (Town) may enter upon the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by S. 66.0703, State. 2. The owner agrees, pursuant to s. Comm 83.54 (2), and Comm 82.40(3)(9), Wis. Adm. Code, to have a. water meter installed in the structure. The water meter shall be Installed by a plumber authorized by the Department of Commerce to make such Installations, with said Installation complying with State regulations and manufacturers specifications. The owner agrees to : be financially responsible for the purchase, Installation, maintenance, and repair of the water meter, and agrees to allow the govemment8i unit or the Department of Commerce to enter, the above - described property on a regular basis to read and/or Inspect the water meter. 3. Owner agrees to pay all charges and costs incurred by the governmental unit or county for Inspection, pumping, hauling, or otherwise servicing and maintaining the holding tank In such a manner as to prevent or abate any human health hazard caused by the holding tank. The governmental unit shall notify the owner of any costs which shall be'paid by the owner within thirty (30) days from the date of notice. In the event the owner does not pay the costs within thirty (30) days, the owner specifically agrees that all the costs and charges may be placed on the tax roll as a special assessment for the abatement of a human health hazard, and the tax shall be collected as provided by law. 4. The owner, agrees to contract with a person who is licensed under Ch. NR 113, Wis. Adm. Code, to have the holding tank serviced and to file a copy of the contract with the governmental unit. The owner further agrees to file a copy of any changes to the service contract, or a copy of a new service contract, with the governmental unit within ten (10) business days from the date of change to the service contract. 5. The owner agrees to contract with a person licensed under Ch. NR 113, Wis. Adm. Code, who shall submit to the county on a semiannual basis a report detailing the servicing of the holding tank. The govemmental unit or county may enter upon the property to Investigate the condition of the holding tank when pumping reports and meter readings may indicate that the holding tank Is not being properly maintained. 6. This agreement will remain in effect only until the county office responsible for the regulation of private onsite wastewater treatment systems certifies that the property is served by either a municipal sewer or a private onsite wastewater treatment system that complies with Ch. Comm 83, Wis. Adm. Code. In addition, this agreement may be cancelled by executing and recording said certification with reference to this agreement In such manner which will permit the existence of the certification to be determined by reference to the property. 7. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shall submit this agreement to the register of deeds, and the agreement shall be recorded by the register of deeds in a manner which will permit the existence of the agreement to be determined by reference to the property where the holding tank Is installed. Owner(s) Name(s) - Please Print Subscribed and sworn to before me on this date: Notarized Owner's Signature(s) Notary Public Governmental Unit Official Name, Title - Please Print My Commission Expires Governmental Unit Official Signature Drafted by: Personal Information you provide may be used for secondary purposes [Privacy Law s. 15.04(1)(m)) "THIS PAGE IS PART OF THIS LEGAL DOCUMENT— DO NOT REMOVE" This information must be completed by submltter document title. name & return address and &V (if required). Other Information such as the granting clauses, legaa/ description, etc. may be placed on this first page of the document or may be placed on additional pages of the document. &LC Use of this cover pag adds one page to your document and Wisconsin Statutes, 50.517. ♦ �' . 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