HomeMy WebLinkAbout038-1165-10-000 Wisconsin Ddpartment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Buildi:g Division
INSPECTION REPORT Sanitary Permit No:
(ATTACH TO PERMIT) 514896 0
GENERAL INFORMATION State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)i.
Permit Holder's Name: City Village X Township Parcel Tax No:
Bil rien, Joseph & Ros mary I Star Prairie, Town of 038 - 1165 -10 -000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No:
/66,'x$ A'i-�- &Y\ otr - 30.31.18.785
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER r.. N CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
3. 163 .9 /ao
WeS 3 Z I Alt. �?\� G�� ��5 %
Aeration � LL Bldg. Sewer
Holding St/Ht Inlet
b
TANK SETBACK INFORMATION SUHt Outlet $ • t 5 .
TANK TO & P/l WELL BLDG. Vent to Air Intake ROAD •L �S, • t
Septic c m S
Header /Man.
F; til �L �hZ •b9
15 . Z
Aeration Dist. Pipe �°DS • Z
Z
Holding Bot. System c r Z
&4r . , Ig (23
Final Grade .7 �a
PUMP /SIPHON INFORMATION `n, .97
Manufacturer G PMand St C ve r J •�L 74 Model Nu er F 7 I
Q�i1 Value ; $ r�.
TDH i 11 [ift Friction Loss System Hea TDH Ft
Forcem Length Dia Dist. to Well
SOIL ABSORPTION SYSTEM
BEDITRENCH Width / Length No. Of Tre nches PIT DIMEN No. Of Pit Inside Dia. Liquid
DIMENSIONS «G
SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer ; ► — ,� +
INFORMATION CHAMBER OR ��
Type Of System: _7 I `i 1 N UNIT Model Number/ t
l f� Q _ 7 Ca�u 4 4 G�J
DISTRIBUTION SYSTEM 15 t--15+ = q 5 v�
Header /Manifold Distribution x Hole Si e x Hole Spacing Vent to Air I ke
�j Pipe(s)
Lengt Dia T Length Dia Spacing \ -
r�, s
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 • �O i Bed/Trench Edges Topsoil Yes ❑ No Yes E] No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection
Location: 1926 County Road C Somerset, WI 54025 (SW 1/4 SE 1/4 30 T31N R18W) Crestview Addition Lot 21 ' Parcel No: 30.31.18.785
1.) Alt BM Description = ` ��Ja -�-� �z C.O�I.CJ�+� O�• + + � "�'
2. Bldg ewer length
g 9
- amount of cover = jls S f"� /
Plan revision Required? ❑ Yes No 1
Use other side for additional information. z"i
Date Insepcto Slgnat Cart. No.
SBD -6710 (R.3/97)
Co1111Y erce.wi.gov Safety and Buildings Division County
201 W. Washington Ave., P.O. Box 7162 St. Croix
'sco n s 1 n Madison, WI 537"162 Sanitary Permit Number (to be filled in by Co.)
Deparla errt of commence 5 1 L 6 1 9 &
Sanitary Permit Application state Transaction Number
In accordance with s. Comm, 83.21(2), Wis. Adm. Code, submission of this form to the appropri vernin Project Address (if different than mailing address)
unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned S are
submitted to the Department of Commerce. Personal information you provide may t o used for seco Same
es in accordance with the Privacy Law, s. 15.04 1 m Stats.
I. Application Information - Please Print All Information
Property Owner's Name Parcel #
Joe & Rosemary Bfignen 038 - 1165 -10 -000
Property Owner's Mailing Address Jull i Property Location
1926 Co. Rd. C ST. CROIX COUNTY 5
Govt. Lot
City, state zip Code I SW ' /,. SE %, section 30
(circle one)
Somerset, Wl 54025 5 247 -5541 T 31 N; R 18 W
II. We of Building (check all that apply) Lot #
1 o_r_2 Family Dwelling -Number of Bedrooms 3-2AI iihYle, 21 Subdivision Name
11 Public/Commerciat - Describe Use Crestview Additio
Na ❑ Cit Of
0 State Owned - Describe Use CSM Number U V
Na
TH' own of Star Prairie
III. Type of Permit: (Check onl ne box on line A. Complete line B if applicable)
A' New System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
B• ❑Permit Renewal ❑Permit Revision 13 Change of Plumber 11 Permit Transfer to New
List Previous Permit Number and Dqte Issued
Before Expiration
IV. Type of POWTS S stem/Com nent/Device: Check all that apply) ,Q
Non- Pressurized In- Ground ❑ Pressurized In- Ground � ❑ At -Grade ❑ Mon > 24 in. of suitable soil El Mound < 24 in. of suitable soil
❑ Holding Tank 11 Other Dispersal Component (explain) 1 & ' Ai re ftnent Device (explain)
V. Dispe rsal/Treatment Area Information: 45 Infiltrator " W" chamb @ 20.0 s .ft EISA / chamber + 3 air end caps A 5.8 EISA 17.40 sq. ft.
Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System E on
450 gpd 0.5 in -situ soil OL 900.00 sq. ft. 917.40 sq. ft. 94.25'
VI. Tank Info Capacity in Total # of Manufacturer
Gallons Gallons Units °' 1� o
New Taroks Existing Tanks
Septic or Holding Tank 1,000 1 Weeks Concrete X
/ Dosing Chamber r c
5 S lr
VII. Responsibility Statement- I, the urifiersigried, assn a res 'bility for iii,14iijibn of the POWTS shown on the attached plans.
Plumber's Name (Print) Plumber' Signature MP/MPRS Number Business Phone Number
James K. Thompson 1 30021 (715 ) 248 -7767
Plumber's Address (Street, City, State, Zip Code
340 NqoWs on Lake Lane, Osceo a, WI 54020 -5413
VIII. oun /De artment Use Onl
pproved I ❑ Disapproved Permit Fee Date Issued Iss ' g Agent igna
0 Owner Given Reason for Denial
JY I � ftg tig a QpprovaUReasons for Disapproval I /U •C� 4.6
1 Septic tank, effluent filter and {/ !6rre
dispersal cell must all be serviced / maintained ��c✓—
as per management plan provided by plumber. cF,f G S� .
setback requirements must be maintained
as per applicable co0a&RM%Q;" plans for the system and submit to the County only an paper not less than 8 1/2 x 11 ieches in An
SBDl6398 (R 01/07) Valid thru 01/09
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Dep artment 1
Wisconsin artment of Commerce SOIL EVALUATION REPORT wage of 3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations
Attach complete site plan on paper not less than 8 x 11 Inches in size. Plan must County
include, but not linked to: vertical and horizontal reference pant (BM), direction and St. Croix
Percent slope, scale or dirrieneions, north arrow, and location and distance to nearest road. Parcel I.D.
38 -1165- 10-000
Please print all Intro r a
Rev" B Date
Personal iniomulim you - 11R ft1 f �-
Property Owner tion
Joe & Rosemary Bilgrien Govt. Lot SW 1/4 SE 1/4 S 30 T 31 N R 18 W
Property Owner's Mailing Add s U Lot # Block # Subd. Name or CSM#
1926 Co. Rd. C UNTY 21 Crestview Addition
City tate t i J City J Village 16 Town Nearest Road
Somerset 1 51 715) 247 - 5541 Star Prairie Co. Rd. C & Bilgden Lane
New Construction Use: 16 Residential / Number of bedrooms 3 Code derived design flow rate 300 GPD
ir' Replacement I Public or commercial - Describe:
Parent material Glacial drift in leva tion, if applicable Na
General comments
and recommendations: Site suitable for replacement conventional dispersal ( Flogl
h 0.5 gpd /sq.ft to ding rate. Install trenches
at 94.2 ' Existing dispersal cell elevatoin = 94.30'.
7 f Boring # J Boring
t I 16 Pit Ground Surface elev. 98.64 ft. Depth to limiting factor >95 in. Sol Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roads G
in. Munseil Qu. Sz. Cont. Coke Gr. Sz. Sh. - Eff#1 -E 2
1 0-15 1Oyr3/2 none sit 2%bk mvfr cs 2fmc 0.6 0.8
2 15-27 10yr3/3 none sit 1fsbk mvfr Cw lfmc 0.4 0.6
3 27 10yr4 /4 none sl lmsbk mfr iw 1fmc 0.4 0.7
4 42 -95 7.5yr4/4 none s,I%,sl Osg, 2msbk ml /mvfr - If 0.5 1.0
Horizon #4 consists of an unso rted mix 10yr4 Osg Is , 10y r414 Osg and 7.5yr 4/4 2msbk sl.
F Boring # —j Boring 16 Pit Ground Surface elev. 97.87 ft. Depth to limiting factor >88" in. Sop Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW
in. Murrell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 - Eff#2
1 0-15 1Oyr3/2 none sil 2fsbk mvfr gw 2fmc 0.6 0.8
2 15-25 10yr4/4 none fsl lfsbk mvfr cw 1fm 0.4 0.6
3 25 -37 7.5yr4/4 none fsl 1msbk mvfr cw 1fm 0.4 0.7
4 37 -54 7.5yr4/4 none Is Osg ml iw 11fm 0.7 1.6
5 54-88 7.5yr4/6 none gr Is & sl Osg, 2msbk ml /mvfr - 1fm 0.6 1.0
I I T F - -T
Horizon consists an unsorted mix of 7, yr4/6 Osg gr Is 7.5yr4/6 2msbk gr sl.
" Effluent #1 a BOD 5 > 30 < 220 m9/L End TSS >30 < mg/- Effluent #2 = BOD 130 mg/t. a nd TSS S mg/L
CST Name (Please Print) Signat . CST Number
James K. Thompson 3602
Address A.C.E. Soil & Site Evaluations,-"'
valuation Date Evaluation Conducted Telephone Number
340 Paulson Lake Lane, Osceola, WI 54020 6/3/2008 715 - 248 -7767
Property owner Owner Joe & Rosemary Bilgrien Parcel ID # 038 - 1165 - 10-000 Page 2 of 3
I 3 I Boring # I Boring
L�,.� 1 Pit Ground Surface elev. 96.83 ft. Depth to limiting factor >80" in. Sol 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
1 0-12 10yr3/2 none SO 2%bk mvfr gw 2fmc 0.6 0.8
2 12 -17 10yr4/4 none sil 1fsbk mvfr cw ifm 0.4 0.6
3 17- 7.5yr4/4 none sic] 2msbk mfr c+nr 1fm 0.4 0.6
4 25-36 7.5yr4/4 none Is & si 49, 2msbk mUmvfr iw 1fm 0.6 1.0
5 36.47 7.5yr4/4 none Is Osg ml iw 1fm 0.7 1.6
6 47-80 7.5yr3/4 none s,ls,lfs Osg ml - - 0.5 1.0
Horizon 44 consists of an sorted mix 7.5yr4/4 Osg Is, 7.5yr4/4 2msbk fsl. Horizon #6 consists of an unsorted mix of 7.5yr4/6 Osg s, 7.5yr4/4 Is $
5 _ 7.5yr3/4 Osg Ifs.
<i
❑ Boring # J Boring
J Pit Ground Surface elev. ft. Depth to limning factor in. Soil application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDJr
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
F—I Boring # Boring
Pit Ground Surface elev. ft. Depth to limiting factor in. Sod 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
* Effluent #1 = BOD 30 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOD 1 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 (807/00) A.C.E. Sol & Sro Ev"Vons
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'- ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF AN EXISTING SEPTIC TANK
This is to certify that I have inspected the septic tank presently serving the
residence located at:
5cJ ' /4, 5E '/4, S ction 30 , Town N, Range 1 W, Town
of —'' �'a�fte St. Croix County Wisconsin. Upon
inspection, I certify that I have found the tank(s), to the best of my
knowledge, will conform to the requirements of Comm. 84.25, and it (they)
appear(s) to be functioning properly,
Most recent date of service
Did flow back occur from absorption system? Yes t� No
(if no, skip next line.)
Approximate volume or length of time: gallons minutes
Capacity; o
Construction: Prefab Concrete _� Steel Other
Manufacturer (if known): U cchc,
.A a nk (1i um known): �sf�lAd V65*191 — / 7Yeu�.S
censed Plumber Signature) (Print Name)
(T (License Number) fVtF-LMPRS
ate)
Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes)
or licensed disposer (NR 113 Wisconsin Administrative Code)
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner / �OSP
Mailing Address � ('o, )6
Property Address
(Verification required from Planning & Zoning Department for new construction.)
City /State 4,D1 Parcel Identification Number 03 "y'/16 S-_ / -
LEGAL DESCRIPTION
Property Location 5 t/a , - ' /a , Sec. 36 , T -3 / N R A8 W, Town of
Subdivision Lot #
Certified Survey Map # # J�,Q Volume -- Page # �'—
Warranty Deed # 5 , Volume Page #
Spec house no Lot lines identifiable es
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
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. Owner maintenance
responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the
owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site
wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is
less than 1/3 full of sludge.
Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the
standards set forth, herein, 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 Planning &
Zoning Department within 30 days of the three year expiration date.
Uwe certify that all statements on this form are true to the best of my /our knowledge. [/we am/are the owner(s) of the
property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
Number of bed-rooms
SIGNATURE OF APPLICANT(S) DATE
** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning &. Zoning Department. * **
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed.
(REV. 08/05)
Conventional Septic System Management Plan
Pursuant to Comm 83.54, Wis. Adm. Code
n rai
The conventional septic system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall be maintained
in accordance with component manual SBD- 10705 -P (N.01 /01). All local and/or state rules pertaining to system
maintenance and maintenance reporting shall be complied with.
Septic Tank
Septic tank servicing mechanics comply with Comm, 83.54(1)(e). Septic tank to be located within 150' of service pad, with
bottom of tank to be <_ 15' below service pad elevation. The operating condition of the septic tank and outlet filter shall be
assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in
the tank exceed 1/3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR
113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48, Stats. If the contents of the tank are
not removed at the time of a biannual assessment, maintenance personnel shall advise the owner of when service will be
needed to maintain less than 1/3 scum and sludge accumulation in the tank. The outlet filter shall be cleaned as necessary to
ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank
that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be
serviced if the alarm is activated. Septic tank manholes risers, access risers, and covers should be inspected for water
tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of
service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater
than 8 inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank.
No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank
abandonment shall be in accordance with Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS
component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If
such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings
Division.
$oil Absorption Cell
Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should
be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for
vegetative maintenance) over the system is to be avoided. Soil compaction may hinder aeration of the infiltrative surface
within and above the system and will promote frost penetration during cold weather months. Cold weather installations
(October - February) dictate that the system be heavily mulched for frost protection.
Influent quality into the system may not exceed 220mg/L BOD5, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not
exceed maximum design flow specified in the permit for the installation.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the
owner. Levels above 4 inches indicate an impending hydraulic failure requiring additional, more frequent monitoring.
Effluent flow shall be alternated between dispersal cells on a two -year schedule by use of a diversion valve. Valve to be
switched diverting effluent from dispersal cell currently in use to resting cell on a two -year cycle coinciding with septic tank
inspection and maintenance.
Coutiggencx Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the
system in proper operating condition. Excessive ponding within the dispersal cell will be eliminated by installing a new soil
absorption cell to bring the system into proper operating condition.
Questions on the operation or maintenance of the system should be directed to the installing plumber or the County Zoning
Department.
• n(lr"t rMf =t•JT Nr, WARRANTY DEAD ••.. _4• .,• r.,.,,�r, .
It Nl'(N FO RM 2— 18£i2
^� s- ` _ ;.''_tI�`4 4;14
Recd for Record
C
23C •--• _ _ _ C11 R l l tC a s .. a _. ., . - n
_ of 11.15 A_:M
_ Joseph � ni_,�r�,.e,t �i_ i A�` ft i�oofDeeds
cot:crl� and u:.rr:utto So r
-. .. _. �$
Rosemary - Bilo*rien.,.- husband .arid w f e as marital.
survivorship - property.-._ _
the following described real estate it Si<.. - CY'Cl7X.._ ..... ...... ...count,.
State of Wiscons
T:.:. TRY Parcel No: - _.- __- _.•_______ ____ _________
Lots 20 and 21, Crestview Add;ti.on in the Town of Star Prairie, St.
C,roIX Cou W isconsin. _
TOGETHER WITH an easement over the private street shown as Wood Land-
:_
and R ern_ rYr nr; v'a..as shown on said Plat .
Tic Deed is S9 CTPrl 1ri ZI1111111UCJJ
dated May 25, 1990, recorded May 30, 1990 in the Qt'i•1ce of the Re•
of Deeds for St. Croix County In Vol. 872, Page 71, #459065.
FEE
EXEMPT
This _I- s not ....., homestead property.
(is) (s not)
Exception to warranties: easements, reStrj_ctiDns and rights -of -way
of record, if any.
Dated this ..... my of -. - Arnri.l _ ._ 10
(SEAL) . �L1!J '•JGS�L r i:r \I.i
Cbar.l-eS.. E.._..S.eaman ......... _ -.... ... Renee Fl. Seaman.
.(SEAL) (SEAL)
A TJ T H R N TICA.TI0N ! CKNOtrt
Signatures) - - --- •----- STATE OF K')S(;V :Siir j
1 cA.
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Racint" .. County. r
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if not - ----- - -------'-- -----'-- --.. .. ..... a
authnriTod by L 406.0R_ Wis. Stats.) t.-. kr.n.cn f >*- 'rfiv,+nr_on . avlte, •.•:cc'r fi•a-
fm nirtC Shr .;t r
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. FORM - STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP
SECTIO _ = 3 T�N -R_La_W
ADDRESS S.� ST. CROIX COUNTY, WISCONSIN
SUBDIVISION L2"4 C LOT4 LOT SIZE
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
•
C
\ l r
a A u n
3
�\
INDICATE NORTH ARROW
BENCHMARK: Elevation and description: /�i4, /idI 4 c -
Alternate benchmark q ,J
SEPTIC TANK: Manufacturer: /_ /��f���' Liquid Cap. _
Rings used: / Manhole cover elev:.Qa Fnnal grade elev:
Tank inlet elev.: / Tank outlet elev.: �7
No. of feet from nearest road:Front , Side Rear Ft.
From nearest prop. line:Front , Side Rear Ft.
No. of feet from: Well ) , Building: 32 1
(Include this information in the above plot plan)
(2 reference dimensions to septic tank)
SEE REVERSE SIDE
I
PUMP CHAMBER
Manufacturer: ity:
Pump Model: Pump /Si n Manufact.: Pump Size
Elevation of inlet: Bottom of tank elevation
Pump on elev.: Pump off elev.: Gallons /cycle:
Alarm: Man.: Switch Type: Location
Distanc from nearest prop. line: Front_, Side_, Rear_Ft.
D' ance from: Well Building
SOIL ABSORPTION SYSTEM
Bed: Trench: Seepage Pit:
Width: i Length r Number of Lines: Area Built
Exist. Grade Elev. Proposed Final Grade Elev.
Fill depth to top of pipe:
--��
No. feet from nearest prop. line:Front , Side , Rear 47 ':E._;�—/�
No. feet from well: 11 S No. feet from building -f;e�
HOLDING TANK
Manufacturer: ty:
No. of rings used: Elev on of bottom tank:
Elevation of inlet:
No. feet from nea st prop. line:Front , Side , Rear Ft.
No. feet fro Well , building , nearest road
A rm M facturer:
INSPECTOR:
DATE: PLUMBER ON JOB
LICENSE NUMBER:
6 /90:cj
�9'10� y
D PARTMENT OF INDUSTRY, R SAFETY & BUILDING
� INSPECTION REPORT FO
LABOR &HUMAN RELATIONS DIVISION
ON -SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION
P.O. 80X7969
'MADff ffl 53707 State Plan I.D. Number:
SW-,,, E 4, Sec . 30, T31 -R18 CONVENTIONAL ALTERATIVE
(If assigned)
Town of Star Prai
Co. Rd. C Lot 21 '� t Holding Tank ❑ In- Ground Pressure ❑ Mound
NAME OF PERMIT HOLIDER : ADDRESS OF PERMIT HOLDER: INSPECTION DATE:
Jose h Bil Tien 1 1315 S. Greele #1 STillwater MN OS
BENCH MARK ermanent reference point) DESCRIBE IF DIFFERENT FROM PLAN ' REF. PT. ELEV/ CS EF. PT. ELEV
Name of Plumber: MP /MPRSW No.: Count . Sanitary Permit Number:
Gary Steel 3254 St. 149003
SEPTIC TANK oC 5 $Z-
MANUFACTURER: LIQUID CAP TANK INLET EL .: TANK OUTLE WARNING LABEL LOCKING C& q/ , ` g 1 / PROVIDE : PROVIDED:
C f /(o U! ES ❑ NO ❑YES
BEDDING: yr#T DIA.: }��rT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH
G.O . C.Q ALARM FEET FROM LINE: p AIR INLET
❑ YES L� ❑YES NEAREST —� �� d 3e
R:
MANUFACT EDDING: LIQUID CAPACITY: PUMP MODEL: PUMP /SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
❑ YES ❑ NO I I ❑ YES ❑ NO ❑ YES ❑ NO
GALLONS PER CYCLE: PUMP AND C ONAL: NUMBER OF 1PROPERTY WELL: BUILDING: VENT TO FRESH
(DIFFERENCE BETWEEN LINE: AIR INLET:
PUMP ON AND OFF ) YES ❑ NO NEAREST --�
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: MATERIAL AND MARKI
or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN
the soil is dry enough to continue.)
CONVENTIONAL SYSTE ,g5 c S , l
BED /TRENCH WIDTH: NO OF DIS R. PIPE SPAC : COVER INSIDE DIA.: ID
"5 / 6 O TRENCHES: �/ MAT L: P D 7H:
DIMENSIONS
I GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE TERIAL: NO. D T NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH
BELOW P PES: ABOVE OVER: ELEV. INLET: LEV. END: '��L.� �Q�� PIPES: FEET FROM LINE: AIR INLET:
r� �� ,.34� o�2 NEAREST 4
MOUND SYSTEM: ,qs'
Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM
slope and furrows thrbwn unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW
❑ YES meets the criteria for medium sand. ELEVATIONS MEASURED.
SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS;
❑ YES ❑ NO ❑ YES ❑ NO
DEPTH OVER TRENCH /BED DEPTH OVER TRENCH /BED D S OF TOPSOIL: SODDED: SEEDED: MULCHED:
CENTER: EDGES:
❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO
PRESSURIZED DISTRIBUTION SYSTEM:
BEDlTRENCH WIDTH: LENGTH: NO. OF LATERAL SPACING: AVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER:
TRENCHES:
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR. PIPE I MANIFOLD MATERIAL: NO. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING:
ELEV.: ELEV.: DIA.: ELEV: PIPES.
ELEVATION AND
DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VER 17SU T CORRESPONDS TO
INFORMATION APPROVE
❑ YES ❑ NO ❑ YES NO
PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PR - TY — T WELL: BUILDfING :
COMMENTS I FEET FROM LINE:
❑ YES O NO ❑ YES ❑ NO NEAREST - ►
Reta' n county file for audit.
Sketch System on
Reverse Side. SIGN LIRE: TI
SBD -6710 (R. 06/88) ;j
AIL. R SANITARY PERMIT APPLICATION
In accord with ILHR 83.05, Wis. Adm. Code COUNTY
St. Croix
-Attach complete plans (to the county copy only) for the system, on paper not less than STATE SANITARY PERMIT # ❑ / C j(�DQ
8% X 11 inches In size. heck If revision to previous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
I. APPLICANT INFORMATION — PLEASE PRINT ALL IN FORMATION.
PROPERTY OWNER PROPERTY LOCATION
Joseph Bilgrien SW %4 SE y/4, $ 30 T31 , N, R 18 or W
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
1315 S. Greeley Apt. #1 21 n/a
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
Stillwater, Minn. 1 55082 1 (n/a Crestview
II. TYPE OF BUILDING (Check one) CITY NEAREST ROAD
State Owned VILLAGE Star Prarie I Co. Rd. #C
❑ Public 9 1 or 2 Fam. Dwelling -# of bedrooms 2 A tax NUMBER S)
111 78
. BUILDING USE: (If building type is public, check all that apply) d�� — �f� S " — 0 V
5
1 ❑ Apt/Condo
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 in line A. Check line B if applicable)
A) 1. ew 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 # _ 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 Seepage Trench 22 ❑ In- Ground 42 ❑ Pit Privy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
14 ❑ System -In -Fill
VI. AB SORPTI ON 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
300 600 600 .50 40 94.33 Feet 97.25 Feet
VII. TANK CAPACITY Site
in allons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper.
INFORMATION New istin Gallons Tanks Concrete structed glass App.
Tanks Tanks
Septic Tank or Holdina Tank 100 01 1 W P
Lift Pump Tank/Siphon Chamber - -- H____
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) MPRSW No.: Business Phone Number:
Gary L. Steel 3254 715 246 -6200
Plumber's Address (Street, City, State, Zip Code):
1554 200th. AVe., New Richmond, Wi. 54017
IX. COUNTY /DEPARTMENT USE ONLY
Disapproved 1 7 / itary Permit Fee (includes Groundwater D ate Issued Issuing A ent Signat No Sta s)
Approved F owner Given Initial G Surchage Fee) Ad r et rmi a i / Co
X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL:
SBD -6396 (formerly Plb -67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
Ca�LHR SANITARY PERMIT APPLICATION
In accord with ILHR 83.05, Wis. Adm. Code COUNTY
•-.�- St. Croix
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than ❑ Z < 1 ?m 3
8% x 11 inches in size. ck if revision to previous application
—See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION — PLEASE PRINT ALL INFORMATION.
PROPERTY OWNER PROPERTY LOCATION
Joseph Bilgrien SW %4 SE %, S 30 T31 , N, R 18 V(or) W
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
1315 S. Greeley Apt. #1 21 1 n/a
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
Stillwater, Minn. 1 55082 1 (n/a Crestview
11. TYPE OF BUILDING (Check one) CITY NEAREST ROAD
State Owned ❑
in VILLAGE Star Prarie Co. Rd. ##C
❑ Public R 1 or 2 Fam. Dwelling - #� of bedrooms __L PA EL T AX N U MBER(S)
III. BUILDING USE: (If building type is public, check all that apply) 03Y ,1 S — -) 0 — 00 U
785
1 El Apt/Condo
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 in line A. Check line B if applicable)
A) 1. Slew 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanita Permit was previous issued. Permit ## — 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 Seepage Trench 22 ❑ In- Ground 42 ❑ Pit Privy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
14 ❑ System - In - Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 14. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE
REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals /day /sq. ft.) (Min. /inch) ELEVATION
300 600 600 .50 40 94.33 Feet 97.25 Feet
VII. TANK CAPACITY Site
INFORMATION in allons Total #of Prefab. Fiber- Exper.
New istin Gallons Tanks Manufacturer's Name C on Con- Steel glass Plastic App
Tanks Tanks strutted
Sep tic Tank or Holding Tank 1000 1 Weeks . P .
: R4 = 0 I El F
Lift Pump Tank/Siphon Chamber --- -- --
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installati#i of the onsite se age system shown on the attached plans.
Plumber's Name (Print): Plumber' i ature: (No "m IMMPRSW No.: Business Phone Number:
Gary L. Steel 3254 715 246 -6200
Plumber's Address (Street, City, State, Zip Co
1554 200th. AVe., New Ric on , Wi. 4017
IX. COUNTY /DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date I ssued Issuing A ent signal No Sta s)
Approved E] Owner Given Initial y,�1t Surcharge Fee)
Adverse D t rmination� ��
X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL:
i
SBD -6398 (formerly Plb -67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS r ,
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit may be renewed before they exp; ration date, and at the time of renewal any new
criteria in the Wisconsin Administrative Code will be applicable.
3. All revisions to this permit must be approved by the permit issuing authority..
4. Changes in ownership or plumber requires a Sanitary Permit Transfer /Renewal Form (SBD 6399) to be
submitted to the county prior to installation.
5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed
pumper whenever necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code administrator or the
State of Wisconsin, Safety & Buildings Division, 608- 266 -3815.
To be complete and accurate this sanitary permit application must include:
I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of
where the system is to be installed.
II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling.
III. Building use. If building type is Public, check all appropriate boxes that apply.
IV. Type of permit. Check only one in 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 in ##1 -7.
VII. Tank information. Fill in the capacity of every new and /or existing tank, list the total gallons, number of
tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all
septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received
experimental product approval from DILHR.
VIII. Responsibility statement. Installing plumber is to Ml 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% 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, ground-
water contamination investigations and establishment of standards.
SBD -6398 (R.11/88)
•' ` APPLICATION FOR SANITARY PERMIT
8TC -100
This application form Is to be completed in full and signed by the omit(s) of
the property being developed. Any Inadequacies Will only result In delays of
the parmit issuance@ -Should, this development be intended for resale by
owner/contractoc,(spec house), then a second form should be retained and
completed when the property is sold and submitted to this office with the
appcopciate deed recording.
-------------------------------------------------------------------------------
Owner of property - J - c) srz, -VY � JZosirv►i}9 -tea EiV
Location of property 5W-- /4 5 _ 1 /4, section 3 0 T -R V
Township 'r2i r
Melling address 131 S So Ggcr- _szz
Address of alto LnTs e- q
subdivision name CKcsTJ, ii -
Lot number
Previous owner of property CgL(Cy- SE,4y✓ltInj -
Total sire of parcel He
_
Date Parcel was created q `�' " 5 7_
Are all corners and lot lines Identifiable? Yan - N o
It this property being developed for resale (spec house)? Yes ,� No
Volume * I --and page Number an recorded with the Register of Deeds.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
INCLUDE WITH THIS APPLICATION THE FOLLOWINCt
A WARRANTY DIED which Includes a DOCUMENT NUMBIR, VOLUME AX0 PAGE NURSER, and
the DEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if
available, would be helpful so as to avoid delays of the reviewing process. If
the deed description references to a Ceitifled survey Map, the Certified Survey
Map shall also be required.
-------------------------------------------------------------------------------
PROPERTY OWNER CERTIFICATION
i(Ve) cettlfy that all statements on this form are true to the best of my (out)
knoviedgel that I two) am (ace) the owner(s) of the property described In
this information orm b virtue l :rue of a warrant deed recorded 1 office • Y n r n the L ice of
the County Register of Deeds as Document No. 459 0( 5 ) and that I (de)
ptesently own the proposed alto for the sewage disposal system (or I (we) have
obtained an easement, to run with the above described property, tot the
constcuctlon of said system, and the same has been duly recorded In the office
of the County Register of Deeds, as Document No. - ►J or.J
X - Q'aa2 : z� Q, ).
e
slg tuc of 0 st � Signature of Co -Owner (11 Applicable)
o
Batt of signature Date of Signature
i
wipe A�•� -•. f
• zs4 �.
BTATS ` $AR D WNCO FO RM 11 -1961 r "rs se�cc wwcwvtm row wscowctMa oA +w ?
..# COKMCT
ba* hided a" Ces"Mo
(To HE USED FOR ALL TRAKRACTIONS WHERE OVEN
$t0.eee Is FINANCED AND n4 TT ESRt NUN- CONSUSIER '
REGISTERS OFFICE li
ST.: CROIX CO., WI i
Contract, by and between Reed for RetOnd !:
M. Seaman husband
. ...... ................. ..... I
.................................. ..................... .......... MAY 3 01990 (Vendor ". 01 M j
whether oae or more) and..... JQS.qP.Y).. J .__ Blgrien and -- --- -- - -- ----- 1:00 P.
RGSemarJC-- Bi].grien,...huab8 nd1 ..8nti_. i ISC-. a§._.R?
mu�y�YGx' i j?- •�x'QI? tX.... ( "PurchUW", whether one or more).
Vendor sdb and ag *" to convey to Purchaser, upon the prompt and full per-
i forename of this contract by Purchwr, the following property, together with the
i
rents, P�lits, t and other sppnrtsaant interests (aA called the "Property")
t
in................... ...................................................... County, State of Wisconsin RETURN TO i
Lots 20 and 21, Crestview Addition in the Town
of Star Prairie, St. Croix County, Wisconsin.
TOGETHER WITH an easement over the private Tax Parcel No ............ . ....... . .. ..
street shown as Wood Lane and Riverview Drive
as shown on said Plat.
r.
ILI
This - - nnor, .. homestead property.
(is) (is not)
Purchaser ' chase the Property and to pay to Vendor at .P_14c,e.-- Venuor directs
the sum of =.. -..3 L . '�� _ --
-•- in the following manner: (a) 5...6- } 00.0.00 _. -...
at the execution of this Contract: and (b) the balance of S 2 4 , 0 Q Q.. 0 Q. together with interest from date
hereof on the balance outstanding front time to time at the rat, o: 10% - __. per ce per annum
until paid in full, as follows:
Commencing on June 25, 1990 and on the 25th day of ear►'•aud
every month therafter, equal monthly installments of N neipal
and interest Jn the amount of $257.91.
` ct}-
Provided, however, the entire outstandtnl* balance 1 shall he ia.:i in gull on or h, fare th _.- of
_ Deaemb.er . ................- , 19 -.J.1 ( the maturity date).
Following any default in pacn'ient, int >t :ha:i arc nrr xr,n :! :! ti,,- t•ntir Vint
in default (which shall inci :,ie, n;th If:.•.c,t r t Ire
principal balance).
l excused b} \ �cdnr, ag —us
pated annual taxes, .j) -cial as.sessn r, e,i h•. \'emdnr.
Vendor agrees to apply parr: ents to these li "n c \ a mint iot pa}ment o
taxes, assessments and i e epos
•,,: .. an tr, ='ee t,r.r,ur,t. b >_at, na,
a required by law.
Payments shall he applied first to Merest nn tae• mi-wd •' e rate specific,: and then to principal. any
amount may be prepaid without premium nr `ee :pon pr ;,' A r Ai ti i•`.f • 1�'1
�b�C4cxrrxsci[ eclt4: l�PF{ S""^: lx. r& �aocloxLxa�IC�xtV;�enac�wx :t'�? tr :Cx�- :
In the event of an> I r,pa.n�ent• -his cnr•tr.,ct =i,a:i n:,t i "• r" n
as the unpaid t,aance of praxipa!, and ntere,t anal in w, er, r .. •,.,,ntr r., pit• "nth -!tall t,e treated
as unpaid principal) is less tFan ire .nu >.rnt t'na' d ,,,i• � c nacroer•ts been
`
made as .r = m•
t specified at -ve: prnird :,; n t all ,_ ift •,i a!y proceeds
of i:rurance or , , n , uii -.z atiun. tni• cur :,is -mne +, nrcr, ,sr- I,e n;; + "s� : : :•i, d �, .; ,,
Purchaser suites that Pnrc :,a- is suti�;l with the a. - e :: :ions ! m,itted to Purchaser
for examination except:
°u -ject to the term :� anal nor;'
c
Renee M. .seaman date-: Atai1
"6 page 90 , doc . no .'
Furct•nsc•r ;tee. na ^ „s ,.. at - ..
he retained b :: Vrn,! .r r.r 'r•
Pure` m, r - n t tai
LAND CONTRAC'. - -1n&, I u•,tl
Corporate 0:\1 � �
a
;ellf�
1
- ohm nil `
Y p� abNl MW the ice' erbrll
'uit � calves Vetriera*;�.:. -
dra$ #r Pureb
wigr Vardor. elM*
)htih�as>a 'flie8se' otlerrrise i�
tM Visdae deaon �i 1
� �. proided >"rres' r,
etas>•it was4 nor allow waste to be committed on the Properly, to serf+
sad repair to the Property free fxo.0 liens superior to the lien of thin Coatraet
!dinmatia sled regulations agoeting the Property.
' �erseiosw Price with interest and other moneys shall be fully paid and eoaditiaas
ipd is tie taanaer above specified, Vendor will on deasaaa, ate and Ms wr IL
a!q�• of the Property, free and clear of all liens and eneooieaasq, ismis
rie ons an rrVA s oP way rocord_ i�::ariy - � -___ --
, ........ ........................................ __
. .......... ...............-•--...................----.........----- •--- ....._..... . - -- - ... -...
�i''' '` , ►_ ?ti- 1n ►. :....,.. .:................... _-...............................---•-••••- •••-- ........................_ .._
� 1.. ... .. ..
„ e Nlril lOf.t�te (a) in the event of s default in the t of io
JJjj wl� bpd or
af ..2..... A,#d Mvwhig the specified due do or (o) in the erynt of a dstaW in
a['.:Parchoser whkh owtinues for a period of ...5.... days following written notice
Ot vadled by esrtified mail), then the entire outoanding balance under this contract
in ML at Vendor's option and without notice (which T' booby
Mowing rights and remedies (subject to any lim.tations p.,,vided by law) in
(i) Vendor may, at his option, terminate this Contract and Parebaser's
ut sad recover the Property back through strict. foreclosure with any equity of
s full payment of the entire outstanding balance, with interest thereon from
d' date n h ereund er and o ther amou is due h d m w event ( hsch all amounts previously
/baH'1;f�Releitod a idated dan.:iges for failure to fulfill thin Contract and as rental for the
i itrlfls is ;eBMaso ); o (ii) Vendor may sue for specifi° performance of this Contract to compel
}ePas111t
of the osstiro outstanding balance, with interest thereon at the rate in effect on the date o,
�*�, l)lltabgenaad�, in which event the Pro sal
Property shall be auctioned st judicial e and Purchaser
s lgly dalAeZelfe -ft" (Ui) Vendor may sue at law for the e.itire unpaid parchas^ prier or any portion
ac : V)p declare this Contract at .n en.: and remove tnis Contract as acload on title in a quiet -title
=! ,
bte ' est -of Purchaser is i:.significant; and (v) Veno^r may have 1' chaser ejected from possession
OfutMde P jf yad ba s receiver a �ppppoora+' 1 to collect any rents, is+zur r profits during toe ?wndency o: ar.y action
( (ii. .or (iv abcvo.AotTrithstan ig any oral or written statements or actions of Vendor, an election of any
of the {eTe�pipg remedies ohr't. only be binding upon Venuor if and when pursued in litigation and all costs and expenses
ineludhog reasounble attoreN� ,,toss of Vendor h-curred '.c enforce any renied.v hereunder (whether abated or not) to the
extent not prohibited by law and expenses of title e�.dence shi,il :1 added to principal and paili by Purchaser, as in-
curred, ..ad sihO be included is ant judg -nenL
El
Upat the commencement or during tl - ndenc of any actior, rerenlosure of this Contract, Purcho "pansenL
to the Nvoiatment of a receiver of the P• y, including homesteau Brest, to collect the r ts, issues, air. profits of
tus prop*rl� during tie o!" of such .n, and such rents, issur : profit when so collector shall be held and
applied 71s tbt court shall id rect.
PaMbaeer shall" tot transfer, sell or co. ay any -gal or eyastable interest in the Prnperty (by assignment of any
Of Parebaser's rights uww Contract o, by -)ption, long - -arm lease or in any other way) without the prior written
consent of Vesriat ataMi osttstanuing bal..nee payable ui.der this Contra t is ."rst paid ;n full it the interesa
en"vod is apii�dgeeo ,,aunt Firehaser's interest nude- this Contract "o e'c : ,; security , r an in._ebtedn"
PwvbA r. Tn the eves: 4 any such transfer, :oak or convey nee without Vendor'F er - onsent, the entire outstan
b. .trace a under t %is Contract shall become immediatel" door a. 1 payable i;. t Vendor's optinn without 1...
Vegdoe shall make all payments when due under am mortgage ou.stand ie Preoercy on the r'
this Cwntin4 {ezaspt for any mortge granted by Purchaser) or under any n• thereby, provided Pun
makes tllladr pya At of ank.anto t..en due n ^der this Contract. Purchaser such ,:97�ments direct!,
this Yco 'tf Ven.'wr to do so and a'.l payments so mr.de h, Purchase Y-red payments Trade
Vendor may default without waiving any other sub> .luent or efault of Pur- haser.
All LseMr of tbb �7itract obeli be binding upon and inure to the br.m. f the heirs. legal rep se.Uku"s.
soccaseors 9 wigus of Vendor and Purchaser. (If not an o•'--te if the Property the spouse of Vendor for ' valuable
>
t ratio., et= 0du to release k -se -ights in the u ect I- operty and We— to join in the execution -f the
deed to be made in fW41I .lent hereof.
Dated this . .��,!?�.... day of P - �y 19.9
C '.. ... ... .. ......... (SEA..) ��•. .c,� /'/ X1.1; � • �- (S' :Ai.)
Se -m4n e ea
EAI.i o•_•.�. _��,...� (SEAL)
• ..JoEeth J. Bilgrien Fo emary Bilgr i en
AUTa:ENTICATION AChNO LE
Signature(s) _ - -- _ STAi'l ,} , ti< , 'uN 1
s s.
authenticated this - ....day of � 1 t - so, 1 came before wn th,s o
.......day :
4 tr^ abte ntmed
:,ens: ,`S w . oea. ian
TITLE. J1FINIBER STATF: BAR OV R'i:
autho -rn;.' ......
rr.l.l h�; ( R'i- rt.itsJ ttod the
At
< p p �{. * Wis.
�
1!,.- �;,�� r� Mxv �. h� . .. �� �i f�MIMS4 irrtion
I,
•Nona i .. ,. ..
I ANu CONTRAI'T St.tr 1. r „l W,. F,r ♦o ,
SEPTIC TANK MAINTENANCE AGREEIIENT w
St. Croix County
rt
w
OWNER /BUYER sW Ai o
ROUTE /'BdX NUMBER Fire Number 19 o
d
�2 > ZIP
CITY , .. /S TATE o
PROPERTY LOCATION s' ', SC A;, Section 30 T I N, R IF W,
Town of - 57 - 68 2)_zL izX E St. Croix County,
}� Subdivision s„gc - _s - 7 - yrCvJ Lot numbers.
Improper use and maintenance of your septic system could result in
its premature failure to handle wastes. Proper maintenance con-
sists of pumping out the septic tank every three years or sooner,
if needed, by a l'ic'en's'ed' 's'ept'i,.tank um er . What you put into
the system can al ect t e .unetion og t e •s tank as a treat -
ment in the waste disposal system.
St. Croix County residents'•ma'be eligible to recieve a grant for
a maximum of 607. of the cost.of replacement of a failing system,
which was in operation prior to 1, 1978. St. Croix County
accepted this program in August of 1980, with the requirement that
owners of all new 's't'ems agree to keep their system properly
maintained.
The property owner agrees to.submit to St.. Croix County Zoning a
certification form, signed by the owner and by a mater plumber,
journeyman plumber, restricted plumber or..a licensed pumper veri-
fying that (1) the on -site wastewater disposal system is in proper
operating condition and .(2)•after inspection and pumping (if nec-
essary), the septic'.tank is less than 1/3 full of sludge and scum.
Certification form will be sent approximately 30 days prior to
three year'expiration.
H
I /WE, the undersigned have read the above requirements and agree o
to maintain the private sewage disposal system in accordance with
the standards set forth, herein, as-set by the Wisconsin Depart-
ment of Natural Resources. Certification form must be completed •�
and returned to the St. Croix County Zoning Office within 30 days
of the three year expiration.date. y
SIGNED
DATE O 9- '_dA-- 9 q' 0
St. Croix County Zoning Office a
911 4th St.
Hudson, WI 54016
386 -4680
Sign, date and return to the above address.
, 4
D.E §TR Y , OF RE PORT ON SOIL BORINGS AN D SAFETY &BUILDINGS
,IN{ fUSTR, DIVISION
LABOR ANp PERCOLATION TESTS (115 MADISON W 53707
HUMAN RELATIONS
(ILHR 83.09(1) & Chapter 145)
LOCATION: SECTION: TOWNS IP /M ITY: ILOT NO.:BLK. .: SUBDIVISION NAME:
/ /J3/ N/R
COUNTY: WNE�R NAME: MA L NG ADDRE��SS: So
USE d DATES OBS RV4TIONt MADE
NO. BEDRMS.: COMME A DE RIPTION: �v PROFILE DESCRIPTIONS: PERCOLATION TESTS:
Residence +q.rNew Replace 1
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENT ONAL: MOUND: IN -GROUN RESSU : S STE - IN- FILLHOLDING TANK: RECOMMENDED YSTEM :I optional)
®SEu C3 SEA SEIU 10 S ZU DS U
If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the
under s. ILHR 83.09(5)(b), indicate: Floodplain, indic Floodplain elevation: Al
H�j r
PROFILE DESCRIPTIONS
BORING TOTAL DEPTHTOGROU NDWATER- INCHES CHARACTER OF SOIL WITH THICKNES , OLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGM TO BEDROCK I,F OBSERVED (SEE ABBRV. ON BACK.)
B //
0
B - .2 9e W e AAKAlAr
xf- -
B-
B- r,
B- r f� _
7
6-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL - INCHES RATE MINUTES
NUMBER INCHES AFTER SWELLING INTERVAL -MIN. PERIOP4 PE RI D 2 PER PE RI 03 PER INCH
P - + /
P- 3
P-
P-
P-
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope.
SYSTEM ELEVATION
I T
O '
44,
7,6
f
1
I
1
-
.,
I•
I, the undersigned�(ereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin
Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
NAME rint TESTS WERE COMPLETED ON:
A D D55 SS: CERTIFICATION NUMBER: IPHONE NUMBER (optional):
r
CST NAT RE:
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DItHR -SBD -6395 (R. 10/83) — OVER —
1
1
L
� � A
I
I
i
STEEL'S SOIL SERVICE
Gary L. Steel 988 N. Shore Drive
C.S.T. 2298 New Richmond, WI 54017
MPRSW -3254 (715) 246 -6200
Joseph Bilgrien
SW4SE4 S.30T31NR18W, town of Star Prarie
Ocj t -I- t
k4
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40 '
A�
3e
t
5d
e
L 9` 7
� S � l �t 6 � �j�► r5
- 7 Z 0/