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HomeMy WebLinkAbout038-1186-70-000 WisFonsin 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. 363900 Permit Holder's Name: ❑ City ❑ Village ❑ jown of: State Plan ID No.: Collova Star Prairie Township CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: ' e 0'o 0 038- 1186 -70 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ,`�/ � SEcr rG�45� 060 Benchmark -Z Alt. BM Aeon Bldg. Sewer 1' 7 .Z Holding t Ht Inlet TANK SETBACK INFORMATION St Ht outlet je v TANK TO P/ L WELL BLDG. Air l to ROAD h Air Intake Septic NA slug — -� NA Header/ Man. Aeration N Dist. Pipe C� 3t y, ZS Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade x facturer Demand St cover oc , Model Number -- GPM �, „ TDH Friction System TDH Ft orcemain Length Dia. en SOIL ABSORPTION SYSTEM A BED / RE C Width Length No. Of PIT No. Of Pits Inside Dia. Liquid Depth DIME DIMENSION SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING' Manufact v INFORMATION Type Of MB Model Numbe System: DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length JF Dia Length 1 Dia. Spacing a� lvk A16 `— 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 ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: (e Inspection #2: Location: 138121 Ith Avenue, New Richmond WI 54017 (SW 1/4 SE 1/4 13 T31N R18W) - 13.31.18.948 Prairie Flats - Lot 17 h�ry Seel 46F Ad ro� �t`� �w [o�d� ( Ijij W tve, ..t / 1.) Alt BM Description =%b f ccrhf r �1.4M. IC �i o/ k o -{ Z y et'6 — , 1p/rn"— = ! 'Z ' 2.) Bldg sewer length - amount of cover • I � S� �c. w 1,, Z C1✓ ���. car t,.� I d6 Plan 44 i r " equirg6i� s L Yes g No Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's gnature Cert. No J� ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: i 3 e E t � S 3 .....< � .. .... .e.. ..... � .see ... m. ,.. P.: ...e ,. .., .... m �e _. 3 e e E [ 3 , e e E r � a I FROM Schumaker Plumbinq FAX N0. : 7153863121 Oct. 17 2000 02:27PM P1 Sthumaker Pluwnbing 1070 SCOTT RE) HUDSON WI 54016 Phone S Fax (715) 388 -3121 NO. OF PAGES: RE: L01 P�. SPECIAL INSTRUCTIONS: FROM: Safety & Buildings Division Sanitary Permit Application 201 w. Washington Ave I Sr. accord %k.tn Comrn S3.? 1. N'z', Adm. Code ?O Box 730 NV Sec reverse side for instructions for compieting this application Madison. WI S37n7 -730 Personal information you provide may be used for secondary purposes (Submit completed form to county if r Department of Commerce j [Privacy Law. s. 15.04 1)(m)) state owne. Attach cam fete plans (to the county CoRy only for the sYstcm. on P r not less than 8. Sj x 1 i inches in size. County s State Sanitary ermit Number / Check tf revision to previous application fate Ptah 1. D. Number ° Location: 1. A 1cat1 Information - Please Print all Information pay carton operty Owner Name , f 114. S T A'. fir or Lot Number Block Number Pnopaty Owner's Mailing Address � Subdivision Name a SM Number City, state Ztp ode Phone Number S col 0 City 11 Type of Building: (check one) 0 village 0 1 or 2 Family Dwelling -No. of Bedrooms: (!?[Town of p Publie/Commercial (describe use): a -� O State - owned Nearest Road Check IU Type of Permits (Check only one box on line A. box on line B if applicable) A) 1. tNew System 2, 0 Replacement 3. O Replacement of 4. = Addition to Parcel Tax Number(s) System Tank Only Existin S stem 3 � ­S/. / A � y� H) Aermtt Number 7 asued A S an it ary Permit was previously issued 3 3 00 F V. Type of POWT 5 stems. (Check all that apply) 0 Sand Filter 0 Constructed Wetland Non -prams wd 1n•ground 0 Mound O single Pass 0 Drip Line Pressurized UmFound 0 Holding Tank p 0 At -Fade O Aerobic Treatment Unit 0 Recirculating 0 Other: V R Area Informations c ` 5 FO ow (gpd) 2. apes 37 ispersal Area 4. oil Application .Percolation 6. yseem Elevation ade Elevation Roquimd 3 ' 7 Prapvsed 3 r Rate (Gals,lday /sq R.) (Min,linch) Yi Tank Capacity in Total of Mane acturer r nab Con- Steel Fiber- Information Gallons Gallons Tanks Plastic j New Existing crew strutted Tanks Tanks i ledcJ c Vii Responsibility Statement the und" assume res nsibilit for insutllation of the POWTS sho the attaehod lane. Business Phone Number ptusabees Now (print) htmber'a ipsutre ( stamps): •( Piamw 's Address (Street, City, State. Zip Code) VIII County/Department Use 01111Y i one Si elute (N o etam ps) D Disapproved Sanitary Permit a (Includes Grou water Da Issued lsau Sn i Approved O Owner Given Initial Adverse Surcharge Fee � Y O D Z lJ U n1 / � Determination IX. Conditions of Approval Ateasous for Disapproval: reViS(c-' Wa5 54�tnr as red wed v, et,J code 4"4 r�s w q SBD -6399 (R 07 /00) I � /DDtG k� Q r �k Z Y � � a ` v J �, z y ��J Wisconsin Department of Commerce SOIL EVALUATION REPORT Page � of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code s . Attacn complete site plan on paper not less than 8112 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontsi reference point (BM), direction and Parcel l.D. percent slope, skate or dimensions, north arrow and location and di stance to nearest road, 3 ZC° — / (� �— 7Q — 00 O Please print all information Reviewed b Date Personal Intarmatlon you provide may be used for secondary purposes (Privtoy Law, s. 15.04 ( (mil'. (� Property Owner Property Location i Govt, Lot 11 114 S T 3/ N R E or,+ Property Owner's Mailing Address Lot 0 Block # Subd. Name or C5W 7d o 1 7 - e- Ity state zip code m City C Vlliege EtTowin Nearest Road 1� New Construction laser Residents! ! Number of bedrooms ,� _ Code derived design flow rate S GPD ❑ Replacement ❑ Public or commercial n Describe: Parent material K )a 40o S - 4 Flood Plain elevation If applicable ft. General comments and recommendations j I / I Boring # ❑ Boring p; Ground surface eiev. 7� ft. Depth to limiting factor _/¢_�_ in, Safi ICet€cn Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots /ff In. Munsel€ flu, Sz, Cont Color Gr. Sz. Sri. •Eff#1 `EW � el a© 7.S F �GJ Z 2 Boring �8 02 i< De L... J ®pit Ground surface elev. pth to limiting factor 16D - - In. goal Application Rate Horizon t Depth Dominant Color Redox Description Texture Structure Consistence Boundary' Roots GPa/fF In. Munseil Qu. Sz. Cont. Color or. Sz. Sh. ' •Eff#1 •Eff#2 .6 Y Z " 1 �f 9z.��' 6Y. 2 � 1o10, 7- • Eitluent #1 x e0D 30 ZZG mgJL and TSS sap 1150 myL ' E1fluEnt #2 ; 800 < 30 mg& and TSS 5 30 mg/L j CST Name (Please Print) Signswre CST Number j ' //,, a /-,-7 S'c m ��'e y �/ 79 -5?Q Address C /� l �Jn Date Evslu Conducted Telephone Numbe 7, i i 1 D J GQ Property Owner P G co l a 'i � _ P arce l ID Page -:F of . Boring * I ' Q Pit Gro cnd s.rrfece eleu. tt. Depth to limiting factor in. old licaWn Rate Horizon Depth Dominant Color Redox Desorlptlon Texture Structure Consistence Boundary Roots WWI In. Munsall Qu. Sz, Cont Color Gr, Sz. Sh. 'Eff#1 'Eff#2 a s' 3 / G lj �y2 • i j Boring # ❑ Boring ❑ Pit Ground surface elev, ft. Depth to limiting factor in. Still A licat:on Rata Horizon Depth, Dominant Color Redox Description 'texture Structure Consistence Boundary Roots GPD/fF in, Mun sell Qu. Sz. Cont Color Gr, Sz. Sh. `001 'Eff#2 i l Borin I Bering # I %.. • f Pi Ground surface ele ft, Depth .o I:mit!ng .actor in. Soil Application Rate Horizon Depth Dominant Color Redox Description, Texture Structure Consistence Boundary Roots in. Munsall Qu. Sz, Cont. Color Gr. 8z. Sh. 0 0#1 'Eff#2 i r f Effluent #1 SOP, > 30 1220 mgiL ano TSS -30 160 mgiL ' Effluent #2 = BOD 130 mg /L and TSS 1 30 mgiL 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 648.264.8777. Sp:�b�au[a.o�:oq /Y Y0 r a M • r Y 0 Safety and Buildings Division Vi sconsin SANITARY PERMIT APPLICATION 2 01 W Washington Avenue P O Box 7162 Department of Commerce In accord with Comm 83.05, Wis. Adm. Code Madison, WI 53707 -7162 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. S / --"" G d t • See reverse side for instructions for completing this application State Sanitary Permit Number 3&3 1 0 cC Personal information you provide may be used for secondary purposes ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan Review Transaction Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATI N Property Owner Name Property Location 5 14)114 e va, 5 T &/ , N, R lF E (or)o Property Owner's Mailing Address Lot Number Block Number !7 City, State Zip Code Phone Number Subdivision Name or CSM Number ( f S )5 ,S`s6 /►/ �' a .A.. 7 II. TYPE OF BUILDI (check one) ❑ State Owned " It� Nearest Road ❑ VII age Public M 1 or 2 Family Dwelling - No. of bedrooms Town OF ;n'& N III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 31 . g q , 1� 1 ❑ Apartment/ Condo 3 -•y /�G _ o d 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. IZ 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 12 (gSeepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit ' 43 E] Vault Privy 14 E] System-In-Fill a S x 5� VI. 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 y�6 7a If-All- 1 7,S' r 0 Feet 'If, Feet VII. TANK Capacit g all o ns Total # of r Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete con- Steel glass Plastic App New Exist in structed Tanks T nks Septic Tank or Holding Tank AC , ud G 7 JI,c/ a ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber I I I I ❑ ❑ I ❑ I ❑ I ❑ ❑ 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's Signature: (No Stamps) P PRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code): ! � l IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved anitary Permit Fee (includes Groundwater D ate Issued Issuing Agent Signature (No Stamps) A roved ,� pp El Owner Given Initial Surcharge fee) Adverse Determination X. CONDITIONS OF APPROVAL/ REASONS f OR DISAPPROVAL: , a_S RA, C- - Z� �� acv\ @G / C S -� re, a %h If SBD 398 (F 12/99 r DISTRIBUTION: Original to County, One copy To: Safety a 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 ode will be applicable. s C pp 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 you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608 - 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. Ill. 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 isto 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 and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include 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. �r d r y � u 1� p h t� � N fdoo �Pj'L G .ice v t� ° • G ,wi%consirt Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of Bureau of !egrated services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. # APPLICANT INFORMATION - Please print all information Re 'ewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). � Z v . Prope Owner Property Location L�n Ca5 2 Govt. Lot 5&/ 114,<;t_C 1/4,S T 3 / ,N,R /r E (or)C Property Owner's Mailing Acldresq Lot # Block# Subd. Name or CSM# 3 Z3 -S41,, ,� 7 I Prajrie, Fj qfS City �� A State Zip Code Phone Number ❑ City ❑ Vill a Town Nearest Road 6New Construction Use: E9 Residential / Number of bedrooms '� Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow 41's-V gpd Recommended design loading rate a 7 bed, gpd/ft E trench, gpd/ft Absorption area required 13 bed, 0 � 2 trench, ft Maximum design loading rate -L?- bed, gpd/ft L— trench, gpd/ft Recommended infiltration surface elevation(s) ® ft (as referred to site plan benchmark) Additional design /site consider Parent material Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ® S ❑ u El S ❑ U ®S ❑ U ❑ S iE U ❑ S ®U [I ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench ' Ul j 0- 7, Ground �� $- I�S S In k Cyr ys'n. ; Depth to limiting tS.� factor Remarks: Boring # x .S C� /4Bi� MAW � 7 , , r3 5'� l� �" .. •r !•'{' I I I /. $' Ground el ves v '� 1A 4 Yy C' C, Depth to ST CRp X limiting factor ZONINGOFFICE 7 /03 in. Remarks: CST Name (Please Print) Ignature `Telep IO)AWt 0 Address Date CST Number ` , ''� S �' -e 14/.4c SyYo c ( �° S 9' Q37 3 'Vo 9 l SOIL DESCRIPTION REPORT PROPERTY OWNER Page of PARCEL I.D.i Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 13 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Ground elev. ft. , Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # , Ground elev. ft. Depth to limiting factor ' Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) Sw sySt3 3 INRl Sr� STa„ &..LA / 7 574- li!! m — ro, ,," 6 c - �Z,, T /66 s la 5 fo aSc t I I � f 37' [ I r 1 Wisconsin Oepartment of Commerce SOIL AND SITE EVALUATION Page 1 of Divishn of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code Gille Tnxcicin & Excavating, Inc. Attach complete site plan on paper not less than 8 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix _ percent slope, scale or dimensions, north arrow, nand distance to nearest road. parcel I.D.# APPLICANT INFORMATION - P �rirt�' a/! info ; tion. - Personal information you provide may be ndary p (Privacy t:a s. 15.04 (1) (m)). Re ie By Date p, Property Owner -� Property Location C se Dan _ Govt. Lot SW 1/4 SE yo 13 T 31 N,R 18 perty Owner's Mailing Address Lot # Block # Subd. Name or CSM# 323 Sawmill Lane t'y� r~ 17 j Prairie Flats City State .3i /jy ' umber E] City ❑ Village Town Nearest Road New Richmond Wl -4 Star Prairie Hwy 65 New Construction Use: �fid& drooms 3 [:]Addition to existing building Replacement F 1 1 Pl describe Code Derived daily flow 450 gpd Recommended design loading rate .7 bed, gpd/ft .8 trench, gpd/fl? Absorption area required 643 bed, ft' 562 trench, fF Maximum design loading rate .7 bed, gpdff 2 .8 tr ench, gpd/ft Recommended infiltration surface elevation(s) `>47 S__ ft (as referred to site plan benchmark) Additional design / site considerations * se-e- r o - v i s i o n t Parent matedal - sh Flood plain elevation, if applicable ble for system Conventional Mound In - Ground Pressure AT - Grade System in Fill Holding Tank itable for system ®S ❑ U ® S El U ® S ❑ U ❑ S ❑ U ❑ S ®U ❑ S N U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft Boring# Horizon in Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. C onsistence Boundary Roots Bed Trench 1 1 0 -12 7.5YR2.5/1 ---- - - - - -- SEL 1FABK MVFR AW 1VF .2 .3 2 12 -22 7.5YR4/6 ---- - - - - -- CL 1 FABK MVFR AS 1 VF .2 3 Ground 3 22 -9 6 7.5YR5/3 ---- - - - - -- S 0 -GR ML - - -- - - -- 7 .8 ele- - - -- - -- v .73 Depth to limiting — — factor 96 in. -- Remarks: 2 1 0 -10 7.5Y R2.5/1 ---- - - - - -- SUL 1FABK MVFR AW 1VF .2 .3 2 10 -28 7.5YR4/6 ---- - - - - -- CL 1FABK MVFR AS 1 VF .2 .3 Ground 3 28 -96 7.5YR5/3 ---- - - - - -- S 0 -GR ML - - -- - - -- 7 8 ele vV. Depth to limiting -- - -- -. - - -- factor 96 in. Remarks: CST Name (Please Print) Signature: , �/ Telephone No. Denni Gille / g k / J / q�r y / 715 268 - 6637 Address p t CST Number Ref # 372 140th Street Amery, WI 54001 9 N97 3409 107 (Bariwl5 (o £7� PRPPEA YOWNER: Casey Dan SOIL DESCRIPTION REPORT Page 2 of _ ;,PARCEU I.D.# - -- —__ Gille Truck & Excavating, Inc. Depth Dominant Color Mottles Structure GPD/ftz Horizon Texture onsistence Boundary Roots - in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. g� Tr h 3 1 0 -11 7 .5YR15/1 SIL IF MVF AW 1VF .2 3 2 11 -20 7.5YR4/6 ---- - - - - -- CL 1FABK MVFR AS 1VF .2 .3 Ground ---- - - - - -- S 0 -GR ML - - -- .7 .8 elev 3 2 - 9 8 7.sYRS /3 - - - -- 73 Depth to limiting - factor 98 in. , Remarks: 4 F 0 -10 7.5YR2.5/1 ____- SIL 1FABK MVFR AW 1VF .2 .3 10 -32 7.5YR4/6 ---- - - - - -- CL 1FABK MVFR AS 1VF .2 3 Ground 3 32 -96 7.5YR5/3 ---- - - - - -- S 0 -GR ML - - -- 7 8 elev - - -- Depth to limiting - -- - -- factor 96 in. - -- - - -- -- Remarks: ---- _ -_ - -- - - 5 1 0 -11 7.5YR2.5/1 — ---------- SIL 1FABK MVFR AW IVF .2 3 — 2 I1 -32 7.5YR4/6 ---- - - - - -- CL 1 MVFR AS 1VF .2 .3 Ground 3 32 -96 7.5YR5/3 ---- - - ---- S 0 -GR ML - - -- -- - . 7 .8 Depth to � —- limiting - - -- -- -� factor I Z q0 AT q - 96 in. Remarks: - - -- - - - - - - -- - - Ground elev Depth to limiting - - -- - — factor Remarks: -- Low l 7 S/� 7c ye: �Z,, T /00 fo to aS� 37 � � l 6 So / I a� r , ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM P. C. COLLOVA BUILDERS, INC. Owner/Buyer er MN #1073 WI #15195 Y (7 t „IS) 54 Mailing Address Aa�� HUDSON, WISCONSIN 54016 Property Address 15 ,? l 02 // - 7 1 � 1 9 !/C (Verification required from Planning Department for new construction) City/State S f4 P- pv" dL( £ VJ r Parcel Identification Number 0 38 118, 70 O O O LEGAL DESCRIPTION Property Location - :5W %,. SE V4, Sec, l j , T-�j N -R W, Town of - A /Z erZA ( tft f Subdivision PIZA ( R K Lot # I Certified Survey Map # Volume . Page # Warranty Deed # f0 0 0 ( Volume 141�P Page # 6 - 2 0 Spec house)dqes ❑ no Lot lines identifiable*es ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature.failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank 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 masterplumber, joumeymanplumber, restrictedplumber or a licensedpumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 da e e year expuz on date. P 11— 6GRAIURIt OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the escribed above, by virtue of a warranty deed recorded in Register of Deeds Office. S / /ho b fGNXf0kh 8F APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department."" ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed STATE BAR OF WISCONSIN FORM 11 — 1982 600661 r LAND CONTRACT KATHLEEN H. WALSH Individual and Corp orate REGISTER OF DEEDS (TO BE USED TOR ALL TRANSACTIONS WHERE OVER DOCUMENT NO. $25,00015 FINANCED AND IN OTHER NON - CONSUMER ST CROIX CO., WI ACT TRANSACTIONS) RECEIVED FOR RECORD Contract, by and between Daniel J. Casey and _ j 04 -05 -1999 9:30 AM �Pt.ty ey htlGhanA ;i d wife aG LAND CONTRACT survivorship marital property ( "Vendor ", EXEMPT N whether one or more) and P_ C. Co Bui Inc. CERT COPY FEE: COPY FEE: TRANSFER FEE: 570.00 ("Purchaser", whether one or more). RECORDING FEE: 12.00 Vendor sells and agrees to convey to Purchaser, upon the prompt and full performance PAGES: 2 of this contract by Purchaser, the following property, together with the rents, profits, fixtures and other appurtenant interests all all pp ( called the "Property"), in _ St. Croix Copae of Wisconsin: THIS SPACE RESERVED FOR RECORDING DATA Lots 8 , 9 , 1 0 , 1 3 , 1 4 , 1 5 NAME AND RETURN ADDRESS 18, 19 and 21 of Prairie Addition in the Town of Star ?Ott P_ t ✓IjLSN Prairie, St. Croix County S3q S. �rdw�fS ✓E Wisconsin. Alf- IC (1 Mdw e✓ � 038 - 1185 -80 -000, 038 - 1185 -90 -000 mg - 118h — 01- 00 03R- 118 -30 -000 PARCEL IDENTIFICATION NUMBER 038 - 1186 -40 -000. 038 - 1186 -50 -000 038 - 1186 -70 -000, 038 - 1186 -80 -000 038- 1186 -90 -000, 038 - 1187 -10 -000 This is not homestead property. (is) (is not) Purchaser agrees to purchase the Property and to pay to Vendor at 323 Sawmill La. New Ri chmond , W I the sum of $ 1 Q0 , 000 00 in the following manner: (a) S 10 _ nQn - n n at the execution of this Contract; and (b) the balance of $ 180 , 000 . 00 , together with interest from date hereof on the balance outstanding from time to time at the rate of F, i ,3h h percent per annum until paid in full, as follows: Purchase price determined as follows: Lots 8, 9 and 10 $19,900.00 each; lots 13, 14, 15, 18 and 19 $18,900.00 each; lots 17 and 21 $17,900.00 each. A Warranty Deed will be given for each of these lots upon payment of the original purchase price (stated above) of each lot, plus accured interest. Provided, however, the entire outstanding balance shall be paid in full on or before the 29th day of March, 2001 19_ (the maturity date). Following any default in payment, interest shall accrue at the rate of 8 % per annum on the entire amount in default (which shall include, Without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance). Purchaser, unless excused by Vendor, agrees to pay monthly to Vendor amounts sufficient to pay reasonably anticipated annual taxes, special assessments, fire and required insurance premiums when due. To the extent received by Vendor, Vendor agrees to apply payments to these obligations when due. Such amounts received by the Vendor for payment of taxes, assessments and insurance will be deposited into an escrow fund or trustee account, but shall not bear interest unless otherwise required by law. Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any amount may be prepaid without premium or fee upon principal at any time after 3 r C'1 3 C 19 ( J��gt} fp�X ty(}3(L1C}IdCfXtlpNi?x3P$p[tTf 74"l %)CrX1NXCX)6zXdOMrXX In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long as the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be treated as unpaid principal) is less than the amount that said indebtedness would have been had the monthly payments been made as first specified above; provided that monthly payments shall be continued in the event of credit of any proceeds of insurance or condemnation, the condemned premises being thereafter excluded herefrom. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except: None. Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall be retained by Vendor until the full purchase price is paid. Purchaser shall be entitled to take possession of the Property on March 30 19_.9 ' Cross Out One. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Ioc. LAND CONTRACT — Individual and Corporate Form No. 11 — 1982 Milwaukee, Wis. � Q I ° I I � I I 10a iL z0< : `` w v b x N 0 r- Q 0 0 i to (V O) Az I 2 C 4 r r . 3 .,00,00.00 N i ,00 I J ' I 3 U- I I - I cc ° n I 00 a 0 0 N I I r OC to h I r c6 N CD O N Go 0 i I . I i n--�M• ..000 h cq - I h II 1 c o • J i M LO O 7: I M I U CD I 00 > x 0 W I a " I o ,3 „00,00.00 N¢ e i 0 I I Wo rn Q ° LO 4. id 0 0 N 0'I u� r I M„OO,OO.00N I ,00'69Z I o I ° W� . I c0 0: �' ° • cc � cc I r Q 0 N LO ST. CROIX COUNTY ,,`,. = > >,�� WISCONSIN ZONING OFFICE " " " " " " "" nr�i ST. CROIX COUNTY GOVERNMENT CENTER - 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 Fax (715) 386 -4686 December 13, 2000 P.C. Collova Builders Attn: Laurie 705 County Trunk E Hudson, Wi 54o16 RE: Septic inspection for P.C. Collova Builders located at 138121 1th Avenue, Prairie Flats (Lot 17), Star Prairie Township, St. Croix County, Wisconsin Dear Laurie: A septic inspection of the above referenced property was conducted on October 17, 2000. This property is located in the SW' /4 SE' /4 of Section 13, T31 N R1 8W, Prairie Flats (Lot 17), Star Prairie Township, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a three (3) bedroom home. If you have any questions regarding this, please contact our office at (715) 386 - 4680. Sincerely, Jgti Sonncfn'tag Zoning Technician /sm cc: file