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sin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
.y and Building Division
INSPECTION REPORT Sanitary Permit No:
430228 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)]. 5 3
Permit Holder's Name: City Village X Township Parcel Tax No:
Thompson, Peter Troy Township 040 - 1168 -40 -000
CST BM Elev: Insp. BM Elev: BM Description: / Section/Town /Range/Map No:
/06 .6 06, r fa h 35.28.20.641C
TANK INFORMATION ELE TION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark a� n
Dosing Alt. BM
Aeration Bldg. Sewer " Isi 3 -
/o y �J
Holding / SUHt Inlet
I 17 v,,- ►�' c f r ��- Z I /,93.0 (0
TANK SETBACK INFORMATION S tlet a. 7
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
`
Septic Dt Bottom
Dosing Header /Man.
Aeration Dist. Pipe
Holding f Bot. System
��� s� G
PUMP /SIPHON INFORMATION . ail rade
Manufacturer Dema t Cove
Model ber
TDH Lift Friction Loss System Head TDH Ft
Forcemain Length ia. Dist. to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length jNo. O Trees PIT Di I S No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS
SETBACK SYSTEM P/L JBLDG IWELL LAKE /STREAM LEACHING Manufac r:
INFORMATION CHAMBER OR
Type O ystem:
V159 Number:
DISTRIBUTION SYSTEM
Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake
Pipes)
Length is 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 R] Yes 7MN
/-�
COMMENTS In Jude code discrepencies, persons present, etc.) Inspection #1: /I Inspection #2:
Location: 224IIIwac Road River Falls, WI 54022 (Government Lot 5 35 T28N RR20W) NA Lot Parcel No: 35.28.20.641C
1.) Alt BM Description = � aJ4iY� N wk� Tv SLk V1__
2.) Bldg sewer length = !� / �.�G CAd* O 6VJ_ � f S�
- amount of cover = /
a
Plan revision Required? Yes u No
Use other side for additional information. t CP
SBD -6710 (R.3/97) Date Insepctoes Sign ture Cert. No.
U
HOLDING TANK SERVICING CONTRACT
Contract Date
fuAusT 1 1 X03 This contract is made between the
Holding Tank Owner(s) Name(s) and Pumper's Name
ETM 3. - r*0"f -50) 1 JARR, S 5EP % ic 5 -2 vtct
We acknowledge the installation of (a) holding tank(s) on the following property: (Provide legal descriptions:)
All that part of Lot 5, Section 35- 28 -20, lying
N of a line 1693.8 feet N of the S side thereof,
and S of the center line of a ravine running
- - -- Easterly and Westerly across said Lot 5; the - - - - - --
1. T1 Easterly end of said ravine being 2077 feet more he
p or less N of the SE corner of said Lot 5. Tank
Q nent.
2. The owner agrees to have the holding tank(s) serviced by the pumper and guarantees to permit the pumper
to have access and to enter upon the property for the purpose of servicing the holding tank(s). The owner
agrees to maintain the access road or drive so that the pumper can service the holding tank(s) with the
pumping equipment. The owner further agrees to pay the pumper for all charges incurred in servicing the
holding tank(s) as mutually agreed upon by the owner and pumper.
3. The pumper agrees to submit to the local governmental unit that has signed the pumping agreement and to
the County, a report for the servicing of the holding tank(s) on a semiannual basis. The pumper further
agrees to include the following in the semiannual report:
a. The name and address of the person responsible for servicing the holding tank;
b. The name of the owner of the holding tank;
c. The location of the property on which the holding tank is installed;
d. The sanitary permit number issued for the holding tank;
e. The dates on which the holding tank was serviced;
f. The volume in gallons of the contents pumped from the holding tank for each servicing;
g. The disposal sites to which the contents from the holding tank were delivered.
4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event of a
chaiige in this contract, the owner agrees to file a copy of any changes to this service contract or a copy of a
new service contract with local governmental unit and the County named above within ten (W) businebs
days from the date of change to this service contract.
Owner(s) Name(s) (Print) Owner's Signature(s) Subscribed and sworn to me on this date:
P A� Today's Date
P mper's Name (Print) er's Signat Notary Public Signature
1 j "/L
Pumper's Registration Number Commission Expiration is
2
Safety and Buildings Division (ommnty
201 W. Washington Ave., P.U. Box 7082 ST. CROIX i
Vi Madison, W i 53707 -- 70$2 Sanitary Permit Number (to be filled in by Co.)
Department of Commerce (G08)2b1-6546
Sanitary Permit Application State Plan I.D. Number
in accord with Comm 8321. Wis. Adm Code, perazmal information you provide � � = 1 m%AA5 - I D
may be used 1br swAmdary purposes Pnvacy taw, si Yriqled Address (if different shirt mailing address)
L Application Information — Please Print All SO. ILWACO ROAD
Property Owner's Nartte Parccl # GOV Lot 45 Block #
r
PETER THOMPSON { k , 040 - 1168 -40 -0 _
1'rvpaiy CJwrtcv's Mailing Adtirws Locat (�l 4 5
67 2520 PARK AVE. SO. y., 35
City. Statt
MPLS, M 55404 61 - 871 - 070 8 T 28 20 (eirrlecxme)
N; R W
IL Type of Building (check all that apply) Subdi vision Name C5Iti Number N I or 2 Family Dwelling - Number of Be drocmms 2
Ll i'ttblic:Casutaciai - Dmcritxm: Lase _ .
❑ State bummed - Ikw the I fsc ❑City_LJVittag Towltsltip of TROY
III. Type vfP'errrrit: (Check on bare oe l ine A. Complete lice B if Applicable)
A i I New System .� RzplaexntemII Syst, n ❑ Treatnte WHoldurg Tank Ropbaarmuxmt [kdy Other Modification to Existing SYACM
—� - -
B. ❑ Pi rrnt xanewai Permit Kevwon ❑ Change of LJ Permit Tran4fer to New Lisa Previous Permit Number mid Date i ssued
llef0fe Expiration Plumber Owner
IV. Type of POWTS System: Check all that a i
U Non - Presstuized lh- Grcwnd LJ titcwnd> 24 in. ofsuitable sal H Mound < 24 in. ofsuitabie soil ❑ Au -Grade LJ Singic Pass Sand Filter
Ccxtsiructrd Wedammd ❑
Pressurized In-Ground hold 'rank ❑ Pest Finn ❑ Aerobic T.Ament Unit ❑ Recirculating Sand Fiber ❑
Rcrimmiatim Synth tic Mettin Fier n t.eachingChammmher ❑ Drip line n Gravel -less Pipe: ❑ (dw, (explain)
V.Dispersa lClreatment Area Infunuation:
Design Flow {gpd3 Design Soil Application Ratc(gpdsf) Dispersal Area Required (so Dispersal Area Proposed (st) System Elevation
300
VL Tank Info t=ry is Tout Number Manufacturer - Prefab Site Steel Fiber Plastic
Gallons Galkwms ofIinitc Concrete Constructed Glass
New Exmstmua
Tunes Tsmles
Septic or Holding Tank X 2000 1 WIESER 1
Aerobic T,ea tUnit
n chwnher
VII. Responsibility Statennent- 1, the gmiffsigmeC assrune respumibilky for fsabMallou of the POV fS sho+ es time athw4wd phmmm oL
Plumber's Now (Print) P s Si MPfMPRS Number l lnainecs Phrwie Number
s-
TODD FEATHERSTONE 242514 71 - 381 -1704
Plumber's Address (Street, City, State, Zip C
P.O. BOX 467 H UDSON, WI 54016
VIII. Coun tDe artment Use Only
Approved LJ Disapproved Sanitary Permit Fee (includes Gfvundwater Dale Issued Agee Si o Stamps)
Surcharge Fee)
❑ Owner Given Reason far Denial I 3 2 S j5 2AD
M Conditions of Ap for Utsapproval
4 I f
nttnb ceawlete ph= (to fame Csuoty only) for the system an paper net kss than Ka i 11 iadm is Am
l_
Project: PETER THOMPSON
N Legal Description: GOVT. LOT 5 S35 T
28N R20W
Subdivision Name: N/A
Scale: 1: / 's.� Q /
Parcel ID: 040-116840-000 Lot No.: GOVT. LOT 5
RECEIVED
r
JUN 0 4 2003
SAFETY & BLDGS. DIV. C
0-
'
EXISTN G - t-N 1C
Giza RBA►ai�p ap
� by
fFXr��� X 41
flDAA30
\ O fit,
ffotbi &3c-
\ Tl•1t�in
CORRECTION NEEDED
SEE CORRESPONDENCE
o
Qp
3
L
� I
P
MOTES
�. QQJC1a "¢R�c - Et�V. ! �O -O�'. a� CO)J :ET F'00 -� AT uuSE .
Z• E�.EVAYIONS Stiawr.� ASE- LXtSl7�U �C�:>l..�t� E� -cvt= j'7��' -ag, - -
3 • NBC'. -EST C�Rot��'�zTtr U.U� S 4�E Abp, )fib ' ►JORi31 quD t�'P4. 1�0` EAST OF�1`1K loCAT01J.
`f• �XIS Nz0 SvPt'�y jS � f1 St�r�No APP. 10� ' 1Jo12T?i A C- LC 1S
Transaction l.D : -- - -- -- -- - - - - - -- - - -- . - - ---, _ - --
Page 3 of 4
k
Safety and Buildings
PO BOX 7162
' MADISON WI 53707 -7162
TDD #: 608 264 -8777
�sconsin www.commerce.state.wi.us /sb
Department of Commerce www.wisconsin.gov
Jim Doyle, Governor
Cory L. Nettles, Secretary
June 17, 2003
CUST ID No.242514 ATTN. POWTS Inspector
TODD C FEATHERSTONE ZONING OFFICE
FEATHERSTONE EXCAVATING INC ST CROIX COUNTY SPIA
368 TOWER RD 1101 CARMICHAEL RD
HUDSON WI 54016 HUDSON WI 54016
CONDITIONAL APPROVAL Identification Numbers
PLAN APPROVAL EXPIRES: 06/17/2005
Transaction ID No. 875836
SITE: Site ID No. 657584
Peter Thompson - Dwelling Please refer to both identification numbers,
S Ilwaco Rd above, in all correspondence with the agency.
Town of Troy, St Croix County
Government Lot 5, S35, T28N, R20W
FOR:
Description: Replacement Holding Tank / 300 gpd
Object Type: POWT System Regulated Object ID No.: 907068
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:
n h
1. On page 3, all of the lot lines or the parcel size were not shown as specified t e approved holding t ank
component manual. Also, the system plot plan does not show adequate parcel location information.
2. As specified in the approved holding tank component manual, lter meter shall a installed that meets
the requirements of s. Comm 83.54(2)., Wis. Adm. Code. All exterior hydrants shall be excluded from
the metered flow. The meter shall be installed downstream of all point -of -entry water treatment devices. p
A control valve shall be installed on each side of the meter.
A copy of the approved plans, specifications and this letter shall be on -site during construction and open to 4P
inspection by authorized representatives of the Department, which may include local inspectors. All permits Q/V DFp
required by the state or the local municipality shall be obtained prior to commencement of
construction /installation /operation.
In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions SEE Cp
L
should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this RR 'SF
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.
The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the
installation, operation or maintenance of the POWTS.
TODD C FEATHERSTONE Page 2 6/17/03
AEPagel Fee Required $ 60.00
Fee Received $ 60.00
Balance Due $ 0.00
POWTS Plan Revi er II ,Integrated Services WiSMART code; 7633'
(608)266-2889, M - F, 0630 - 1500 Hrs
pepagel@commerce.state.wi.us
cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544
CONCRETE HOLDING TANK DESIGN
M.
INDEX AND TITLE SHEET
Project PETER THOMPSON
Owner PETER THOMPSON
Address 2520 PARK AVE. SO.
MINNEPAOLIS, MN 55404
Legal Description GOVT. LOT 5 S35 T28N R20W
Township TROY County ST. CROIX
Subdivision Name N/A Lot No. GOVT. LOT 5
Parcel ID Number 040 - 1168 -40 -000
Plan Transaction ID Number
� y BLOGS•
Index and title sheet 5 Page 1 $pF� & DIU
Holding tank specifications Page 2
Site plan
Maintenance and contingency plan Page 4
Designer TODD FEATHERSTONE o!T
Signature Phone No. 715- 381 -1704 j l�tl�
License Number 242514 Date 05/28/03 �4
Y qd' e F
Designed pursuant to: �h
Holding Tank Component Manual For POWTS
SBD- 10571 -P (R.6/99)
Version 2.0 (03/01) Page 1 of 4 --
HOLDING TANK SPECIFICATIONS
2 Number of bedrooms
Non- residential estimated flow (gpd)
2000.0 Minimum holding tank volume required (gal)
2000.0 1Proposed holding tank capacity (gal)
WIESER Tank Manufacturer
W2000 -MR Tank model number
LEVEL ALARM Alarm manufacturer
LVL -1 Alarm model number
Tank Dimensions and Data Tank Anchor Calculations
X for round tank 13540 Ibs Weight of tank and cover
53.0 Liquid depth below inlet invert (in) 1.50 Safety factor
7.0 Maximum depth of soil cover (ft) 32885 Ibs Weight of anchor required
66.0 Height (in) Outside 38.1 in Soil cover req. for anchor or
151.0 Length (in) Dimensions 8.1 yd' Concrete counter weight
86.0 Width (in) I Only
ED
HOLDING TANK CROSS SECTION SUN TV
SAFETY & BLDGS- DIV.
manhole cover with
locking device and finished vent cap
junction warning label grade
box
4" min. 12" min.
� 24 in.
Manhole and vent locations T
conduit � vent pipe
may be reversed. 18" min.
— 12.0 in. building sewer
service -- ./, - •— •— • -- --- - -- -- ._._._ inlet
blind plug alarm on Note: All tank joints, and
to seal joints between tank
outlet openings and piping are
Electrical as per 41.0 in. sealed watertight. All
NEC 300 pipe and vent materials
and Comm 16 comply with Comm 84.
3 in. bedding under tank. Tank is anchored as necessary to negate buoyancy.
Project: PETER THOMPSON
Transaction Number: Page 2 of 4
Project: PETER THOMPSON
N Legal Description: GOVT. LOT 5 S35 T28N R20W
Subdivision Name: N/A
Scale: 1: D Parcel ID: 040- 1168 -40-000 Lot No.: GOVT. LO T 5
aJ
RECENED J
JUN 0 4 2003
SAFETY & BLDGS. DIV. �-
2
9s.
EX.I SPtJ 6 1Q1J�C
\ Ex! ST /,vG i1 yC,2
ae f1En�ipp,���
\ O E1.102.� t
F}o�Ds
\ Tf1►.�Yt
9 g:4 , O
g. 0.0
CORRtCT10N NEEDEDE
SEA CORRESPONDEN
Hqp
Q
3
>� fi
P
��TES
ENV. !D J -OQ' a� cot�cRET �boli►a�
AT CL�Ik"S: 0= No�SE.
2• E��VAI"10NS SFy ' N A2E EX1S_T7/3
a. N�RREST [�>zoP� U1JES ��E Rip, lob ' ►.J0Ri34 qua pvl Nl- kno' EAST aFTt\��K I.oCADWQ.
`f X1S�►,3G Nz� SvP��y 1s t= +Z,c�f a SlorJ�v� APP. !oo ' kJ6RT)J A IS
'R> ZG WSTlLU'M.� StsuT)4 of
(Transaction I.D : Page 3 of 4
a L
HOLDING TANK MANAGEMENT PLAN
This Private Onsite Wastewater Treatment System ( POWTS) has been designed, and is to be installed and
maintained according to Comm 83, Wis. Admin. Code, the Holding Tank Component Manual (SBD- 10571 -P
6/11/1999), and the ST. CROIX County Sanitary Ordinance.
1. This POWTS is designed to accommodate an estimated domestic wastewater flow of 400.0 gpd.
2. The owner of this POWTS is responsible for system operation and maintenance, including all provisions in
the attached Holding Tank Servicing Contract and Maintenance Agreements.
3. Each time the wastewater in the second tank reaches a level of 12" below the inlet invert (at which time the
alarm will activate), the pumper listed in the current Servicing Contract must be called to empty the tank's
contents and dispose of them in accordance with NR 113, Wis. Adm. Code.
4. At each service event, the service provider should visually inspect the condition of the tank, risers and
manhole cover(s) and verify that the alarm system functions and manhole locking devices are present.
Discrepancies are reported to the owner in a timely manner for corrective action. All corrective actions
shall comply with the county sanitary ordinance and Comm 83 and 84 Wis. Adm. Code.
5. All service events or inspections of this POWTS shall be reported to the county within 10 business days.
6. The owner may not remove any of the wastes from the holding tank(s), or cause such wastes to be
removed by any person not authorized to do so under Ch. 281, Wis. Statutes. The discharge of wastes
from this holding tank to the ground surface, including intentional discharges and discharges caused by
neglect, constitutes a failing POWTS and may result in issuance of correction orders or a citation by the
county or state.
7. No one should enter a holding tank for any reason without being in full compliance with OSHA standards for
entering a confined space. The atmosphere within these tanks may contain lethal gases, and rescue of a
person from the interior of the tank may be difficult or impossible.
8. In the event that this POWTS fails and cannot be repaired, a code compliant replacement holding tank may
be installed in the same location (a new sanitary permit is required for such a replacement). Connection to
municipal services would also be considered at this time if they are deemed available to the property.
9. If this POWTS is replaced, or its use discontinued, components no longer in use it shall be abandoned in
accordance with Comm 83.33 Wis. Adm. Code.
10. If there is a problem with, or question about this installation, the following persons should be contacted:
a. Installer ........................... FEATHERSTONE EXC., INC. Phone: 715 - 381 -1704
b. Service Provider ................ TRI COUNTY SANITATION Phone: 715 -386 -2130
c. County Zoning or Health Dept. ST. CROIX ZONING Phone: 715 - 386 -4680
11.
Project:
Transaction Number: R ecelvel) Page 4 of 6
Jul � 4 2003
SAFETY & BLDGS• DIV,
J 2360 P 167 735199
KATHLEEN H. WALSH
REGISTER OF DEEDS
ST. CROIX Co., vI
RECEIVED FOR RECORD
Document Number
Document Me 08/12/2003 02:00PH
HOLDING TANK AGREEKENT
St. Croix County EXEMPT #
Holding Tank Agreement TRANS F EE: 11.00
COPY FEE:
CC FEE:
[S tate Plan Transaction Number - PAGES 1
rz. J . - ToA"P.50 N
Name — (Owner) Typed or printed
being duly sworn , states, under oath, that:
1. He/she is the owner /part owner of the following arcel of land located in St.
Croix.County, Wisconsin, recorded in Volum�l� Pag . Document
• ording Area
All that part of Lot 5, Section, 35 28 -20, lying
Side thereof , � and Return Address y '
he S /v
N of a line 1693.8 feet N of t Q c)- �yp�h�D
and S of the center line of a ravine running � So
Easterly and Westerly across said Lot 5; the
Easterly end of said ravine being 2077 feet more
o40r
or less N of the SE corner of said Lot 5. Parcelldenti(icatlonNumber(PIN)
Agreement Date: 1 • "" V - • ` .)
4 1 r amdl
use of
We acknowledge that application Is being made for the Installation of (a) holding o purpose of a bov e d escribed pro a ty or th Al prop
the existing premises requires that a holding tank be Installed on the property f or the e
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 falls 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 s. 254.59, Slats., 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 speclal assessment for current
services rendered. The charges will be assessed as prescribed by s. 60.0703, Slats.
2. The owner agrees, pursuant to s. Comm 83.54 (2), and Comm 82.40(3)(e), Wis. Adm. Code, to have a•water meter installed in the structure.
y
The waier meter snail bE mstailed by a plumber auu6vr by ;err 4iip u''•:% o` C'v 1: 16iC 2 :o n r.-::° LaCh l ^.q�gn;!!nns, v "th S:f!d lnat9ilatlen
complying with State regulations and manufacturers specs ic3tions. The owner agrees to be financially responsible for the purchase, '
Installation, maintenance, and repair of the water meter, and agrees to allow the govemmental 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
ser
a�
From: TODD FEATHERSTONE To: PETER THOMSPON Date: 11/1412002 Time: 2:54:30 PM Page 3 of 3
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Own AA,-
T
Mailing Address - 3 a' i t
Property Address 2 T7 LV) A G-0 i ,-11, Y k vLI c-
(Verification required from Planning Department for ueW constiuctioa)
City/State Parcel Identification Number -0 -4 O L4 M40- QO D
LEGAL DES-CRrMON
G
Property Location %, ' /., Sec. . T 2 $ N N -R W. Town of Ti�-'y t
E c- PA i�- Ut-t;-- i j tw "L
Subdivision r N Lot.• #
-.
/--
Certified Sauey Map # , Volume . Page # _
W&n2nty Deed # _ "? ` E Volume- Page #
'T
Spec house ❑ yes ❑ no Lot lines identifiable ❑ yes ❑ no
SXSTEM MAINTENANCE
Improper rase and maw tenaaocof yoerr septic system could result in its prcmaturc f&&= to Dandle wastes. Pcoperaaamtenance
consists of pamping out the septic tank every three years or soouu, if needed by a licensed pumper. What you peat into the system
can affect the 6wfi — m of the septic tank as a treatment stage in the waste disposal system..
The property owner agmes to rAudl to St. Croix Zoning Department a ce rtificateoa foam, signed by the owner and by a
nuLderPlumber •]ourneymanPlumber, rcstridodphunber or a heeosedpumper verifying that (1) fire on -site waswwaterdisposal system
is m proper operating condition and/or (2) afterinspection and pumping (if necessary), the septic tank is less thaw 113 full of sludge.
Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards
set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of W isoonsin. Certificatica
ecatiog your septic system has been maiaotixd rarest be completed and retun2ed to the St Croix County Zoning Office within 30
days f tbwe y9Rr expiration date.
0
SIGNATURE. OF APPLItAW DATE
QVMM CERTIFICATION
I (we) certify that ail statements on this form are true to the best of my (our) lmowkdge. I (we) aura (are) the owner(s) of
the dex d above. by virtue of a warranty deed seconded in Register of Deeds Office.
SIGNATURE OF APP DATE
•ass *• Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department ••• "s
ss Include with this application: a stamped warranty deed from the Register of Deeds office
a copy of the certified survey sup if reference is made in the warranty deed
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katherstone Excavating, Inc.
P. O. Sox 467
Hudion, WI 54016
715 - 881 -1704 651486.1987
August 4, 2003
John Ruemmele
273 Turnberry Court
Hudson, WI 54016
RE: Holding Tank Agreement for Peter Thompson
Dear Mr. Ruemmele:
Enclosed is a Holding Tank Agreement for Peter Thompson. I understand this will be
reviewed at the next town meeting on August 11, 2003.
After it is signed, please send to Mr. Thompson so he can take it to the Registrar of
Deeds.
Mr. Thompson's address is:
Peter Thompson
2520 Park Ave. So.
Mpls, MN 55404
Sincerely,
Todd Featherstone
Featherstone Excavating, Inc.
TF /srt
Wisconsin Department of Canmem c SOIL EVALUATION REPORT Page ..1. of 3_
Divisfon of safety and Buildings
In accordance with Comm 85, Wis. Adm. Code Courtly
Attach (xrrnplete site plan on paper not less than 8 112 x 11 inches in size. Plan must but
Include, not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. t�V - l � (. 'W- 4 - OaD ate
Reviewed by
Please print all Information.
Personal inlonnetlon you provide rney be used for secondary purp0Ses (Privery Lew. S. 15.04 (1) (r
Property Locatiar
Property Owner
Govt. Lot 4j+ fit S 55 T L$ N R L O JN f W
Property
Ovmer's Meltlrtg Address Lot Block # Sub d, tine or WMM
-^-
2 Nearest Road
City tale Zip Code Phone Number ❑ city L � Village Town
Tl� S . 1LUJ
t M �5VD { lz) -U70
El New Construction User Residential / Number of bedrooms _ 3 Code derived design flow rate — �_._�_ - - - - -- =- GPO
F2gplucoment [] Public or cornmercial - Describe: _ - -- - - - --
B� RAC1Y� Flood Plain elevallon if applicable
Parent material er __.• ! __._ __ - - -- — ((-
Genca
al mmerlts 4li A I MOIA>J�
and recommendations:
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'15�1FUM- T:1R�
vrtDF -_1 af31.00
t_0pat,mG RlKtE O
❑ Boring fr
a Hosing # 1 lg_ Depth to limiting �_
(`,round surface Bleu. _ C0 ft. factor
Pit Soil icaU(xt Rate
Horizon Depth Dominant Color Redox Description Texture c tract sn. Consistence Boundary Roots GPDI 1 Eff #2
in. Murtse! au. Sz. Cont. Color
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❑ Boring c
Boring # Pit Ground curia - -ce elev. _q5 7 f Depth to limiting factor G ate
. _ 3 _... in- Soil POIff n PO_ lit
i1a Dept;; Oo^t!nznt Color Redox Description Texture Gr Sz 5h, Gunslstence Boundary Roots .Effirl ' Eff#2
in. Munsell Qu. Sz. Cont. Color
I 5 7)1 ►I m rn�s_
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• Effluent #2 = BOO � 30 mg and TSS < 30 mg1L
• Effluent #1 = BOD > 30 220 ntg and TSS >30 < 150 in CST Number
CST Name {Please Print) Signature 2- �3
J M�ti? V �� �b �UV - - - - pate Evaluation Conducted Telephone Number
Address } 5� LJ 2 - ?-S -
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Property owner tHOMES Parcel I D a r Q 40 _ II d - - 066 F'age Z of
? Boring # F1 Bonn q r
J pit Ground surface elev. _ A. L ft. Depth to limiting factor _ t— in. 5013 Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlft
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#I 'Eff#2
6 -McL Cb Zvi 0.5 p.6
-3 1 o j lea i S b 0.5
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a Boring 0 � Boring
❑ pit Ground surface elev. _ ft. Depth to limiting factor in. Sai Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure I Consistence Boundary Roots GPO /ff
in. Munsell Qu. Sz. Cont. Coior Gr_ Sz. Sh. Eff #1 'Eft#2 I
r
i
❑ Boring # ❑ Boring w
❑ Ground surface elev. _ ft. Depth to limiting lactor in.
Pit
Snit licatlon Rate
P p
Horizon Depth Dominant Color Redox Descri tioo Texture Structure Consistence boundary Roots GPDIff
in. Munsell Qu. Sz, Cont. Color Gr Sz. Sh. ' Efff l + 'Eff#2 ;
I
' Effluent #1 = 000 > 30 < 220 m9rL end TSS >30 < 150 mg/L ' Etrueut #2 = BOO, < 30 mg/L and TSS 30 ri
The Department of Commerce is an equal opportunity :ervicc provider and emrinye.r. I f you need assistance to access services or
need material in an alternate format, please contact the department at 608- 266 -3151 or '17Y 608 - 264 - 8777.
WD -93311 to LW)
} j ON & LuNDQUIST , LTD.
ATTORNEYS AT LAW
W-A 14?
i
PETER THOMPSON w, tOkIa6 '(612) 332-0920
JOHN W. LUNDQUIST �r(' 100 MARQUETTE BUILDING
np 400 MAROUETTE AVENUE SOUTH
March 9, 1704 MINNEAPOLIS,MINNESOTA 55401
Mr. Tom Nelson Mr. Darrell Richer
St. Croix County Zoning Route 3, Box 262
Administration Office River Falls, Wisconsin 54022
1030 Davis
P.O. Box 227
Hammond, Wisconsin 54015
Re: St. Croix River Property
Dear Messrs. Nelson and Richer:
I am enclosing to each of you a copy of the plans drawn by the archi-
tect which shows the existing cabin and the final plans for our
proposal which we are submitting to you for approval. Please feel
free to call James Stageberg if you have any questions about the
plans. They are substantially as we discussed at our meeting at my
cabin. A letter from Mr. Stageberg is enclosed about these plans.
I would like to make several points about the application:
1. The plans utilize only the existing exterior structure
of the cabin and therefore are consistent with the
philosophy and regulations that you have explained to
me. The only exception is the small vestibule onto
the deck which is minimally intrusive, and which will
have a very positive impact both in terms of energy
efficiency and cleanliness for the cabin.
2. The plans remove both the front deck and numerous
support beams on the front of the cabin so there is
actually less visible structure from the River. In
addition, the cabin itself will be much more stable;
for instance, the existing roof joists have all bent
and the cabin has no insulation whatsoever. The cabin
will be much stronger and more energy efficient.
3. The existing windows, screens and paint job on the cabin
are generally inadequate. We wil be putting in weather-
tight windows, putting a new roof on the cabin and paint-
ing all of the existing siding to blend with the environ-
ment.
4 . It has been my concern to have a cabin which blends with
the environment and is environmentally sound. I planted
300 conifers in the Spring of 1983 and will be removing
the propane tanks in favor of a woodburning stove.
Mr. Tom Nelson
Mr. Darrell Richer
March 9, 1984
Page Two
5. The upgraded sanitation system will be a material
benefit to the ecology of the River. Presently, the
flush toilet simply empties into a cesspool. he new
holding tank, which has been approved by Troy Town-
ship, will be an important attribute. The plans for
this sanitation system are enclosed and have
bee
n
forwarded to the State of Wisconsin forap royal
The Holding Tank Agreement and pumping g Agreement
are also enclosed.
in which
The result of these improvements
will be structurally sound, blends er
and is ecologically superior.
We will be responsive to any further suggestions you have. I am
hopeful that approval will not be too time
can commence when weather permits us to get a truck down the road.
Thank you both for your assistance and cooperation in this matter,
and if you have any questions, please call.
Very truly yours,
Peter Thompso
PT:cb
enclosures
cc: Mr. James. Stageberg w/o enclosures
Mr. Art Wegerer w/o enclosures
ARCHIl-M PLANNERS
fire Owl Pa6"s inc
115 N FOURTH ST MINNEAPOLIS MINNESOTA 55401 612/3 -.751,199
8 March 1984
Mr. Peter Thompson
100 Marquette Building
400 Marquette Ave. So.
Minneapolis , MN 55401
RE: Cabin Renovation
Dear Peter;
The enclosed developed plans conform to the preliminary plans
submitted to you earlier by our office and which you presented to
the Wisconsin D.N.R. for their review.
I have reviewed the St . Croix County Zoning Regulations as well as
the Wisconsin D.N.R. Guidelines for the scenic easement affecting
this area. In all respects I believe these proposals meet the
regulations as well as the guidelines .
I am looking forward to a spring start of construction. Please let
me know if you need anything more from me in the meantime .
Sincerely,
The Stageberg Partners , I .
J Stageberg
JES :ss
1
State of Wisconsin \ DEPARTMENT OF,NATURAL RESOURCES
' Kinnickinnic State park r S Cerraro•aemdny
r �. � S��ary
Route 3, Box 202 arch 23, 1984
River Falls, . -isconsin 54022
M49 2�'9
a- � File Ref:
Mr . Peter Thompson ""SF
100 Marquette Building
40o Marquette .Avenue South
Minneapolis, Minnesota 55401
Dear Yr. Thompson;
I recently received a copy r,,f your final plans (dated Jan.
1984) for the proposed remodeling of your cabin located on
the St. Croix River. I reviF:wed the plans with the St. Croix
Riverway Coordinator, Jake: iandervc,rt, as is required in
cases where the prop(-rty is ca-rered by a Scenic Easement.
Based upon these plans, the Wisconsin Department of Natural
Resources has no objections to the proposed. remodeling.
Therefor, this "Letter will, serve as the Department's consent
for you to proceed. You will still need to obtain the required
township and county zoninfr pc---mfits, however. If you should
decide to deviate from t1,(- plains as submitted to the Depart-
ment, such deviations will need to be submitted to the De-
rartment before construction.
I wish to take this opportunity to thank you P'or your coop-
eration with the Scenic Ease:-gent Program. It is with the
cooperation of citizens like yourself, that the environment
of the St. Crc1.7 River will be nrotected.
Sincerely,
Darrel. L. i.cher
Park Supt.
Kinnickinnic State Park
and Lower St. Croix Scenic -ti verway
Tom TTelson, St. Croix. Conan L, zoning
Jake Vandervort, Lower . Croix Riverway Coordinator
5 - 15 -7
THOMPSON & LUNDQUIST , LTD.
ATTORNEYS AT LAW
'(612) 332-0920
PETER THOMPSON
100 MAROUETTE BUILDING
JOHN W. LUNDOUIST np 400 MAROUETTE AVENUE SOUTH
May 11, 1104 MINNEAPOLIS,MINNESOTA 55401
Mr. Tom Nelson
St. Croix County Zoning s�9v -
Administration Office V0 9�
1030 Davis
P.O. Box 227
Hammond, Wisconsin 54015
Re: St. Croix River Property
Dear Mr. Nelson:
I am enclosing an updated architectural plan showing the front
of the cabin with some changes. The bay windows designated
earlier have been replaced by flat windows. I am also sending
a copy to Darrell Richer for his information upon instruction
that any changes to their earlier approval be updated.
I have decided to postpone commencing the remodeling until
September. I hope we have no problem obtaining an approval
from your office by that time.
I have also decided to do the structural and upper level work
now but to postpone remodeling the lower level.
If you have any questions, please call.
Very truly yours,
Peter Thompon
PT:cb
enclosure
cc: Mr. Darrell Richer w/enclosure
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21 N. MAIN STREET
KOZEL, WEGERER VER FALLS, WI 54022
& ASSOCIATES, Inc. �q���` '
5) 425-9381
ENGINEERING • • SURVEYING Q A !9 / 5)425-6118
ATTN: DATE
Z�OJ/AJ CC :
Vo -"toz' li�,Nujs sT.
C"T l,C►"'T I�I(��1.� � 4LJ/. S Ste/ S _
SUBJECT:
WE ARE ENCLOSING , SEN43ITTr ,w-'vlB , THE FOLLOWING ITEMS:
Number
of Copies Description
RAJ
SENT TO YOU FOR THE FOLLOWING REASONS:
0 ..FOR APPROVAL O APPROVED AS SUBMITTED Q NOT APPROVED
�r'
[ uR YOUR USE p APPROVED AS NOTED ❑RETURN COPIES
[] FOR REVIEW AND COMMENT OINFORMATION DESIRED
VERY TRULY YOURS ,
KOZEL,W EGE ER.a ASSO-CIATES,1 N C•
BY
1
Department of Industry, Labor arid Human Relations
L Division of Safety & Buildings
0 1 L Bureau of Plumbing
P.O. Box 7969
VEnT OF
11..�6. „�,nraE�aTOns Madison, WI 53707
Tel. (608) 266-3815
ko e ,)e AS 5e7c-J--1 e --t114 C--, IN ALL CORRESPONDENCE
, REFER TO PLAN
Z ,�� /V14; /4 :� /:Z- IDENTIFICATION NO.
, r Q -71L
NAME OF PROJECT
VATE SEWAGE ONLY -
❑ GENERAL PLUMB NG PLANS Z Fee Received: i
LOCATION ► �� � � Priority Plan Review Only 1
a � �s ��V-P 2b
CITY OR TO N COUNTY
1 VO Gv 1
Examina ion of plumbing plans and specifications for this project has been
completed. In accord with Chapter 145, Wisconsin Statutes and the Wisconsin
Administrative Code, the plumbing plans and specifications are approved
contingent upon compliance with the stipulations shown on the plans. Please
review your code for the requirements of each code section noted.
The licensed plumber responsible for this installation shall keep at the
construction site one set of plans bearing the department's stamp of approval.
The installer shall also notify the appropriate inspector of when required
inspections are to be made.
TTn the Avant installAti n bag not ow within
T
nrnval will hp ynifi and haw Plan anpraval Shall be obtainod before work may
In granting this approval, the Division of Safety and Buildings does not hold
itself liable for any defects in plans or specifications, plan omissions or
examination oversight, and reserves the right to order changes or additions if
necessary.
This approval is based on Wisconsin Administrative Code requirements. It
shall be necessary to obtain and fulfill the permit requirements of the city,
village, township or county in which this installation is to be made. Failure
to obtain local permits will automatically void this approval.
Sincerely, `
For Private Sewage Systems Orly:
l This approval is valid for two
years or it wiii he valid until
James Sarg�it
Bureau Dire or the expiration date of the initial
sa-�jtary permit.
LANS REVIEWED BY: DATE:
I AY
cc: Pocla :��D Owner H & R & Rec. San. Section
Plumber Bur. of Health Fac. & Services
ounty Other
DILHR SBD-6099 (R. 05/82)
Department of Industry, Labor and Human Relations MMMMI w�sconsin • Division of Safety & Buildings
IZIDILHR �' Bureau of Plumbing
P.O. Box 7969
-OEPQRTTTEnT OF
�InOU5TRY,lRH3OF16 MlRTWn RELFM3n5 Madison, WI 53707
Tel. (608) 266-3815
t NC, IN ALL CORRESPONDENCE
REFER TO PLAN
�6`-� -f'l TIFICATION NO.
19f 40
r
NAME OF PROJECT ,
aprVATE SEWAGE/ONLY -
El GENERAL PLUMBING PLANS Fee Received:
LOCATION t Priority Plan Review O nl
CITY OR TOWN
vD
Examina ion of plumbing plans and specifica T or this project has been
completed. In accord with Chapter 145, Wisconsin Statutes and the Wisconsin
Administrative Code, the plumbing plans and specifications are approved
contingent upon compliance with the stipulations shown on the plans. Please
review your code for the requirements of each code section noted.
The licensed plumber responsible for this installation shall keep at the
construction site one set of plans bearing the department's stamp of approval.
The installer shall also notify the appropriate inspector of wner required
inspections are to be made.
Ta�-b-a—e ,qj jnctallatinn hac not ho oil@ 1111tbin tula- hoQXIQC ;90 AM
approval will hp void and npw plan approyal sna bi Ghtalaad hafar-,
In granting this approval, the Division of Safety and Buildings does not hold
itself liable for any defects in plans or specifications, plan omissions or
examination oversight, and reserves the right to order changes or additions if
necessary.
This approval is based on Wisconsin Administrative Code requirements. It
shall be necessary to obtain and fulfill the permit requirements of the city,
village, township or county in which this installation is to be made. Failure
to obtain local permits will automatically void this approval.
Sincerely, For Private Sewage Systems Only:
This approval is valid for two
years or it will be valid until
James Sarg t the expiration date of the initial
Bureau Dire or sanitary permit
AN REVIEWED BY: DATE:
cc: DP - WS Owner H & R & Rec. San. Section
Loca Plumber Bur. of Health Fac. & Services
�
unn y""'`,� Other
DILHR SBD-6099 (R. 05/82)
i
HOLDII'tiG TA NF_ Pa Le__) C'-f.
For
A _Bedroom residence
for
Tt� -10M�Soti
Gov• L ul' S
LOCATED IN THE _4 OF THE 4 OF SECTION N R ?A W
TM:TJ OF ��o�f , S► • eT��X OCUNTY, WISCONSIN.
INDEX
PAGE 1 of 3 TITLE SH=E-ET
PAGE 2 of 3 PLOT PLAN
PAGE 3 of 3 HOLDING TANK SECT_ Cllr
PREPARED FOR 8 4 0 o 7 j
�� t�►J � t�poL1 S, M N_ SSyoJ
PREPARED BY
KOZEL, WEGERER AND ASSOCIATES, U- - .
BOX 74 L,21 FORTH NIAIN STREET
RIVER FALLS, WISCONSIN 34022
1
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* KOZEL ■
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PROJECT:
gf ��jf,� Th is o rt
�yf !�J GO V"t Lot' 5,35,2&,
ds+' Tn Troy
Wagerer and Assoc i a Inc.
la th St. Croix WI
min Street
Iii
era . , WF 54022 '
PLAN ID. # 84-00711
A x x
+�.w..r_ w DETAGIi.
.'w"`" x
hompson,. Peter Residence
�tl= 711
PLAN ID,# F s
tls Is" a�kr� nt t�f You plans and specifications#car the a bove�indlsatl ,
idtiatw the re?ciired fee is$ rC3► .
" Fee:ftec eived is _.au tfte additiotial fee.
s :rr
bverpaynien , of
Plans ng°teturna#"
be!!n �4Plansudirnitted writ#i no fees vKifi.be Aiid'tioenal infgrmatian r
} °ftif Coknplete data,relative 1Ia € iu
r #xari stiaq submitted in dupl)eao un- G.72
meted:' �, copies of PL# i,
t►r perixtenent: Deed rest1ctNtin'".
Mali lae was# dated and O Condamiriwm cfechaat3
healed
eiist l rrr �riEl9t bran i 63:0 42t(44 Wisconsin h 4
Afalt eridased, !V. Ilaldlrig" art7t n`
E
[� Profile of
� � ts�6 pond or lri Ground"Pressure manufacturer if' i
Of " errtative site constctetl.` .
n syst+m.si. y.Owner 0 HbCciing t L
5�M44""
vern
#Design calculations � ' Se��
Sc ye�r+gQletiaar ❑ Aeaaan'f instant y
lateral layout: #Ilan'
' u y 1 ►+
an to arty builing
4 rS "this Fiwm bra nt.V t{ Capy)_" course, I4t lines;"fir
1
r =r' Etc.Provide bertcttirvyyi
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aw a
t �=
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.4777 all-sides.
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p .
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x .sta .all Iafera! distar►ees from r �s r r a
="tCi buifdi , lot lutes, well,water Ctcass section Qfilift r
tr �i � SBFIflt9e pipings EtC. ts�' #i
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THOMpSON & LUNDQUIST , LTD.
ATTORNEYS AT LAW
PETER THOMPSON *(612) 332-0920
JOHN W. LUNDOUIST 100 MAROUETTE BUILDING
400 MAROUETTE AVENUE SOUTH
January 10, 1984 INNEAPOLIS, MINNESOTA 55401
Ms. Donna Wilcoxson6'�
Route 5
River Falls, Wisconsin 54022 '
Dear Ms. Wilcoxson:
Enclosed please find a copy of the Owner Pumper Agreement I have
entered into with Paul Cudd of River Falls. I am also sending
a copy to Tom Nelson of the Zoning Office with a copy of this
letter. I talked to Art Wegerer who is doing my application to
the State of Wisconsin for the holding tank, and he tells me
that the only additional thing we need before that application
can be made is to enter into the Holding Tank Agreement with the
Town of Troy which I have pending before your Board. I hope that
it can be signed in the next meeting so I can file it with the
Register of Deeds. If you need further information, would like
me present at the meeting, or need anything else, please give me
a call.
Very truly yours,
PeVer Thomps
PT:cb
cc: Mr. Tom Nelson '
Mr. Art Wegerer
Ci� TT G TA""K For
A U DeQrocm residence
for
Gov• l oT 5 - ZE3 1 ZO W,
LOCATED IN THE 4 OF Tim -, OF SECTION 3S N R
T0�"1Z1 OF 'T��c�`f , Si• <Z � IX CCUi TY, �'+ISCONSIN .
IP DEX
PACE 1 of 3 TITLE SHEET
PAGE 2 of 3 PLOT PLAN
PAGE 3 of 3 HOLDING TANK SECT= CN
PREPARED FOR
100 N1.4TZ C;�v t_.1"1"� 3�-�G.
PREPARED BY
KOZEL, WEGEFFF. AND ASSOCIATES , I'- - .
BOX 74 421 NCRTH 1,11AIN ST- L ET
RIVER FALLS, WISCONSIN 54022
1
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•
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• CHARLES
* : KOZEL
E-09415
RIVER FALLS,
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3. Owner agrees to have a quarterly pumping report submitted to the
local government and the county which will state the Owner's name, location
of the property on which the holding tank is located, the pumper's name,
the dates, volums pumped and the disposal site. An annual pumping report
or the fourth quarter report including a su=ary of the pumping history of
the previous year shall be submitted to the Department of Industry, Labor
and Human Relations by the governmental unit responsible, per section 145.01
(15) , Wisconsin Statutes.
4. We guarantee that the holding tank contents will be disposed of at
a site meeting the requirements of chapter NR 113, Wisconsin Administrative
Code.
5. This agreement will remain in affect only until the sanitary permit
issuing agent in St. Croix County certifies that the subject pro-
perty is served by either a public sewer or a septic tank — soil absorption
system that complies with ch. H 63, Wis. Adm. Code. In addition, this Agree-
ment may be cancelled by executing and recording said certification with re-
ference to this Agreement, in the Tract Index indicated above.
6. This agreement shall be binding upon the indicated governmental
unit and the Owner or heirs and assignees and shall run with the deed.
WITNESS our hands and seals this _�_ day of
19�.
TOWN OR MUNICIPALITY OF TROY
OWNERS
by
bye-c- -,, /.�� -
STATE OF WISCONSIN
Personally came before me t is ` day of
19,L the above named
to me known to be the persons who ex cuted t e f&fregoing instrument an
acknowledged the same.
THIS INSTRUMENT 01ARY PUBLIC
DRAFTED BY: AV
My commission expires:
�a
�r Mph - 5 1984
VOL }.� r�� ..3 -RECE D
NOTE: This document is to be recorded in the Tract Index at the �=f,a
of the Register of Deeds in the county indicated below. _�y
Re�'d. r ►� x "' r' ;s 23rd
a Feb A.D, l c8
HOLDING TANK AGREEMENT ay 8:30 A � t„
{
� negltlir of Denrbi
This Agreement is made and entered into nthi this ay of
February 19 by a �.
—, hereinafter called �own-
and Peter T hereinafter called the
"Owner.
We hereby acknowledge that application has been made for a building
permit on the following described property, to wit:
All that part of Lot 5, Section 35-28-20 , lying N of a line
1693 . 8 feet N of the S side thereof, and S of the center line
of a ravine running Easterly and Westerly across said Lot 5 ;
the Easterly end of said ravine being 2077 feet more or less N of the
or that continued use of the existing premises requires that a holding SE corner.
tank be installed on the property for the purpose of proper containment of said
of sewage. We also acknowledge that said property cannot now be served Lot 5.
by a municipal sewer or septic tank — soil absorption system.
Therefore, as an inducement to the County of
St. Croix to
issue a sanitary permit for the above described premises, we hereby agree
and bind ourselves as follows.
1. Owner agrees to conform to all applicable requirements of the
Plumbing Code relating to holding tanks. Any time the Town or Municipality
of Troy through its Plumbing Inspector or Health Offi-�
cer, eems it necessary to pump out the subject holding tank, the Owner
shall have same pumped out in twenty-four (24) hours, or - TroV Township _
will have said work done and charge same back to Owner an ' p ace same on
the tax bill as a special charge. The Owner further agrees- that the Town
or Municipality of Troy may enter upon the property des-
cribed above at any reasonable time, to Inspect, or pump and haul wastes
from the subject holding tank. or
2. Owner agrees to pay all -charges and costs by' the g
Municipality of oy for np Qtionpurping, haul or
otherwise servicTn--4--and maintaining the subject holding tank in such a man-
ner as to prevent or abate any nuisance or health hazard caused by such
holding tank. Troy Township shall notify the Owner of any such
cost which shal I be paid by the Owner within thirty (30) days from the date
of notice and in the event that the Owner does not pay said cost within
thirty (30) days, Owner hereby specifically agrees that all of said costs
anti charges may be placed on the tax roll as a special assessment for the
abatement of nuisance, and said tax shall be collected as provided by
10 sconsin Statute.
DILHR-SBD-6123 (R.3/81 )
VOL J2rG=515
ATTACHMENT
STATE OF MINNESOTA )
ss .
COUNTY OF HENNEPIN )
Personally came befgre me th' s day of Z 14,L4/1.C,�
1984 , the above-named /t ,. rnn 7 ,-r y l -Y
to me known to be the person who exec ted the foregoing instrument
and acknowledged the same.
...sr« ...wti. � Not (,ty Public ;
CAROLE J. BALTHAZOR
NOTARY PUBLIC -MINNESOTA My commission expires :
ANOKA COUNTY
` f My Commission Expires Doc 4 1988
POW
ST. CR01 X COUNTY
W1 SC ON S IN
F F I C E 796- 2239
. {. ZONING O
Poa.t 0666 -Ce Box 227 �
Hammond, WI 54015
<i
j
0 W N E R ���
P U M P E R ' ►
A G R E E M E N T
PLEASE BE ADVISED, that unt.it you ane again not.i.6.ied, 1 wilt
cont,t.act with Paul Cudd & Sons, Inc. 06 Rjypr Fai i cr Wi r.aonR-i-a ---'
01i-acona.in, (Pumpex) , bon. the puxpoae o6 temov.ing att waste 64om the
.&an.itan.y ayatem to be located on the pnopetty and 6u.tuna home .bite
tocated in St. CAo.ix County, W.zacons.in, Townah.ip o6 Troy
being in the 4 06 the o6 Sec. T. N. -R . W.
(OA onone Gutty desctibed as 6ottowa : )
All that part of Lot 5, Section 35-28-20, lying N of a line
1693. 8 feet N of the S side thereof, and S of the center
line of a ravine running Easterly and Westerly across said
Lot 5_* the Easterly end of said ravine being 2077 feet more
or less N of the SE corner of said Lot 5.
Dated th.i.a 1-7_ day o6 19 U-3
(OWNER)
Minnesota Peter Thomps n
S tat e o 6 1"Axvwvirxl
Hennepin as
County oA zMxtxatNO -
Pen.sonnaetyappeaxed be6on.e me th.ia 17777 day o6 - ,
the above named w to me nown to
fie the
peAbq,A'. . .o ep p g A Z Rn oing inatxument and acknowtedg ed tke name.
NOTARY PUBLIC MINNESOTA
' ANOKA COUNTY
My Commission Expires Dec 4 1988 p alL y u tiL LC, �Xx
My Comm . per x
X, �4�ti (,•� , hene.iribe6on.e ne6en.ned to as Pumpers.,
Join in the above agn.eement to the extent that I have a contnac.t with
OwneA as above stated.
UM PER 1
+� 8 OMPSON & LUNDQUIST , LTD.
ATTORNEYS AT LAW
PETER TH ON�q4FCF��!F '°
JOHN W. L _ OUISTjO�Id, �p� 100 MAIROUETTE BUILDING
"'� J7F 400 MAROUETTE AVENUE SOUTH
yq January 10, 1984 MINNEAPOLIS, MINNESOTA SS401
Mr. Tom Nelson Mr. Darrell Richer
St. Croix County Zoning Route 3, Box 262
Administration Office River Falls, Wisconsin 54022
1030 Davis
P.O. Box 227
Hammond, Wisconsin 54015
Re: St. Croix River Property
Dear Messrs. Nelson and Richer:
I am having the architect, Jim Stageberg, prepare final plans which
are substantially identical to the plans we went over at my cabin.
I anticipate they will be finished soon, and I will send you each
copies for approval as soon as they are done. I just wanted to
bring both of you up to date.
Very truly yours,
Peter Thompson
PT:cb
cc: Mr. James Stageberg
"7 8
of e..
C2 4 ' o THOMPSON & LUNDQUIST , LTD.
�19� ATTORNEYS AT LAW
re
R THOMPSONti (612) 332-0920
J H LUNDOUIS 100 MAROUETTE BUILDING
400 MAROUETTE AVENUE SOUTH
December 21, 1983 MINNEAPOLIS, MINNESOTA 55401
Mr. Paul Cudd
Paul Cudd & Sons, Inc.
Route 5, Box 364
River Falls, Wisconsin 54022
Dear Mr. Cudd:
On November 17, 1983 I sent you a Owner Pumper Agreement which is
required by the County for approval of the holding tank. Art
Wegerer has designed this tank for my property on the St. Croix
and confirmed with me that you were familiar with the road to my
cabin and could get your pumper down there. I called your office
again on December 16, 1983 to confirm that you had received the
Agreement and that it was in order. After the Agreement has been
signed, please either send them to me or send a copy to me and
give the original to Tom Nelson, St. Croix County Zoning Adminis-
tration Office, 1030 Davis, P.O. Box 227, Hammond, Wisconsin 54015.
Thank you for your prompt attention to this matter.
Ver truly yours,
Peter Thomps
PT:cb
cc: Mr. Tom Nelson
Mr. Art Wegerer
Ms. Donna Wilcoxson
i
ST. C R O I X C O U N T Y/ rY � " WISC0NSI N
ZONING OFFICE
_ 796-2239 (HAMMOND)
425-8363 (RIVER FALLS)
HAMMOND, WI 54015
DEAR HOLDING TANK OWNER:
Enclosed is the quarterly "Pumping Report" for your holding tank
system. This report must be completed by you and returned to this
department no later than the date specified at the bottom of the report
form.
In addition, we have included a copy of the "Holding Tank Agreement"
you signed when approval was granted to install the system.
Failure to submit timely and properly completed pumping reports would
be a violation of your agreement and H63. 18 (4) (a), Wisconsin Administrative
Code. The County does have the authority under section 145.20 (2) (f),
Wisconsin Statutes to gain compliance in circuit court.
To complete the report, please fill in your name, address and township
in the areas provided. In addition, provide the name of your pumper(s)
and the location of the disposal site(s) . Information pertaining to the
disposal site can be obtained from your pumper. If wastes are disposed
of at'8 municipal treatment plant, indicate the name of the plant. When
.wastes are field applied, we need to know the legal description of the
disposal site to the nearest 40 acres. (e.g. SWh, SWk, Section 20, T29N,
R10W). Occupancy and use sections are self explanatory.
Lastly, the date and volume pumped must be reported for each pumping
event. Enough spaces are provided to report five separate pumpings
each month.
Sign the report and return it to this department by the date indicated.
If you have any questions regarding this matter, please feel free to
contact this office at 796-2239 or 425-8363.
Yours ver
Thomas C. Nelson
Assistant Zoning Administrator
TCN:mj
INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395
i
ai
To be a complete and accurate sail test, your report: must include-
1- Complete legal description;
2. The use section must clearly indicate whether this is a residence or commercial project;
3, MAXIMUM number of bedrooms or cornm{:icial use planned;
4. Is this a new or replacement systern;
b- Complete the suitability rating boxes. A SITE IS SUITABLE FOR A FOLDING TANK ONLY IF ALL
OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS;
6. PLEASE use the abbreviations shown here for whiting profile descriptions an(] completing the plot plan;
7, MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A
separate sheet may be used if desired;
S. Make sure your benchmark and vertical elevation reference point are clearly shown,and are permanent;
S. Complete all app;opriate boxes as to dates,names,addresses, flood plain data, percolation test exemp-
tion, if appropriate;
10. If the information (sLICh as flood plain, elevation)does riot apply, place NA, in the appropriate box;
71. Bird the form acid place your current address and your certification number;
12. Make lec,ible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE
LOCAL Al)THOR#TY WITH IN 30 DAYS OF COMPLETION.
ABBREVIATIONS FOR CERTIFIED SOIL TESTERS
Soil Separates and Textures Other Symbols
St — Stone (over 10") BR — Bedrock
co") — Cobble (3- 10") SS Sandstone
gr Gravel (under 3") LS -- Limestone
S Sand HGW — Nigh Grounckvater
Cs — Corse Sand Pere __ Percolation Rate
rec s — Medium Sand W — t/V("II
is - Fine Sand Bldrj — Building
I s — Loamy Sand Greater Than
S .. Sandy Loam < --- Less Than
l t darn Bn _.._ BrowrS
sil - Silt Loam
BI Black
si Silt Gy _. Gray
cl — Clay Loam Y -- Yello"'v
se; -- sandy Clay Loarn R — Red
sicl -- Silty Clay Loam mot — Mottles
sc -- Sandy Clay ni _- vvitlr
Silty Clay fff - fevv, fine, faint
c Clay rc — common, coarse
pt Peat Gran — Marry, medium
m _ fvluck d — distinct.
p — prominent
HUVL -- High vuatr'�r level,
Six general soil textures surface water
for h(prid vvast.e{disposal BM — Bench Marl,
VRP -- Vertical Reference Point
TO THE OWNER:
r ! test -;port is the first >t=gip ir) securing a sanitaj'y permit_The county or the Department may request
of this s it test in [lle field pI for tr) hermit issuance. A complete set of plans for the private
r �„rY� rr�cl a „�errnit� apd lr ate c; must try submitted to the apt�ronriate local authority in order to
,rcEr= ,t The sanitary t=.rr7,it r€ t,SE: br=crr,:airrsrl W)d posted prior to the start of any construction,
I
EPARTMENT OF C TY&BUILDINGS
D REPORT ON SOIL BORING DIVISION
INDUSTRY, e���.� P.O. BOX 7969
LABOR AID PERCOLATION TESTS (1 ) ���, O DISON,WI 53707
HUM AN RELATIONS (H63.090) &Chapter 145.045) e►
LOT K.NO.: SUBDIVI NAME:
LOCATION: SECTION: TOWNSHIP/IV�AJ+6�RALJ :
6,�.5 �/ �/4 3 s /T N/R2°E c `�—
COUNTY: OWNER'S W4*k*VNAME: M�o � UE-nom �L1�G Y QU�1rT� NULL'• SOU
".C �X Ol"1 pSD N 1-�►►-� - r� o L-� 5 , S S It o 1
DATES OBSERVATIONS MADE
USE IPROFILEDESCRIPTIONS: ER O ATIONTESTS:
NO.BEDRMS.: COMMERCIAL DESCRI=N: Il 10_ ZQ- g 3
,Residence New .Replace N• A•
3O-Zy N -p", rl z- e3
RATING:S=Site suitable for system U=Site unsuitable for system
CONVENTIO AL: MOUND: IN-GROUND PRESSURE:US EM-IN
-FILLHOLDING TANK:RECOMMENDED SYSTEM:(optional)
oS u E]SO .❑S u El S u o�.�)�� `� rc
If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the `
under s.H63.09(5)(b),indicate: N Floodplain,indicate Floodplain elevation:
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER-tid> 3 CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH
NUMBER DEPTH ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.)
1 0•t� \ o.ak tvo �.
o. g' D12�h st I I S S'S
B- - 1.4� - - �� �� 5 s< p. �' Dlc l3nsr { TS i l.t�' I<oh41 S SS�R RT J, y 'of
o.
,, • Ile a
' L S 13R h7 1•
B IZ O. 6' p'L.D IJOrJ >0 6 0.6 ' N 1,S RR hr 3N
PERCOLATION TESTS
TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RAPER INCH ES
NUMBER INCHES AFTERSWELLING INTERVAL-MIN, PERIOD 1 PERIOD 2 PERI
P _ `
1 L. SOS
P-
P-
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
-x
Eb4LS1. tYL _ ssr -�'r`l'
op o'cr
-
u
y
JN
r
a (_ l I tit!✓ I
__ __>,._ kL
' _..._.,.. .__�..__... ...,,..._s ..... ......._..; ..�............ r-. � - ... -y .1 IKtb
_L._
i
e�
r � I
�.. b�
,
I
I,the undersigned, hereby certify that the soil tests reported on this form were made by me in actor ith 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.
E COMPLETED ON:
NAME( rint): TESTS WER
V-MT)+U% L. w EGA.�,z t - z- 3
ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional):
hut, Son 576 71S-VZS- 9381
CST SIGNAT RE: A
w All/
DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester.
DILHR-SBD-6395 (R.02/82) -OVER -
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
DIVISION
INDUSTRY, PERCOLATION TESTS (115) MADISON W153707
LABOR AND
HUMAN RELATIONS (H63.090) & Chapter 145.045)
LOCATION: SECTION: �TOWNSHIP/NI{}PJ+6fgAL1=Y:
::=NO.: SUBDIVISION NAME:5 1/4 1/ 3 5 /T-Z8 N/R2z E 1 z�`T
COUNTY: OWNER'S/ "�� MAILINCJADDRESS:_
ao*EWSNAME. \OO 1"11°c�2QUt`i'1� E'_�, �yOD JIL7A u��rrt= Avg- . DU
(�T�c.+I P�sbi j 1'' t)'�T" �` �` DA-ES OBSERVATIONS MADE
USE PR'---FILE DESCRIPTIONS:Irt!",C CATION TESTS:
NO.BEDRMS : COMMERCIAL DESCRIPTION: `J_ �A- g 3
❑New Replace Z g 3 N• A.
,Residence
RATING:S=Site suitable for system U=Site unsuitable for system _
CONVENTIONAL: MOUND: IN-GROUND PRESSUREREISZUJI?SEUL)�_- -��"
STEM-IN-FILL HOLDING TANK: RECO�rI✓ENDED SYSTEM:loptional)
EIS u EIS OU a s u o _
If Percolation Tests are NOT required DESIGN RATE: If any portion of the tes ed area is in the ,
under s.H63.0915)Ib),indicate: Floodplain, indicate Floodplain elevation: -_
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER-t**ett 9' CHARACTER OF SOIL WITF THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED ;SEE ABBRV.ON BACK.)
} O•`3/ \SO -1-S SS T
�k Z
I� /i 7 1• y ' �. ' SICIJnSt / T$ 1.or RB)i 5SI�rR l°fT �, y
S \ ----- ---- --- -
\. 2 ' 16o+ �, e c.3 o S - _ ' 60
-8 o. $
p /
S (bet tJ_ L S �3R AT )• }
B- 12. C>. 6' E. >0. 6 ' -°.6 k ; s QR Rr .6'
PERCOLATION TESTS
DROP IN WATER LEVEL- NICHES RATE MINUTES
TEST DEPTH. WATER IN HOLE TEST TIME PER INCH
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD t PERIOD 2 PERIOD 3
P �Z U
P_
r
P-
P-
P-
P- _
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. I^rdicate 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 =+Ievation at all borings and the direction and percent
G� 8� �1t Cry �oCbc o��t�>s
of land slope.1
SYSTEM ELEVATION
I
Chi 1-�
i
\-4-,A v c s.j
R S
P Ips1J1C- 0 �Ol�SF3
P IT o 8 X$ J T1�18ER2�
�► /
r
Z Ay
01,
S
M. �i
r
_ —T � �• !.a I I i I I I - ��3� Si tz� I
--ihe soil tests reported` l ,t\ IOOr —~-- - I 3 S •
1,the undersigned, hereby certify that t ` on this form were made by me in accor ith t'ie 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 knounrledge and belief.
TESTS',jff''ERE COMPLETED ON:
FAD)RESS:(print
z.'nuA �. wEG��Z I/ - Z- 83
CERTIP CATION NUMBER: PHONE NUMBER(optional):
576 u'rt Qox z- �cuS ��iT1t !.u!/ SYoJ�
CST S I GN A`
DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester.
DIL rHI" SBD-6395 (R.02182) -OVER -
ST. CROI X COUP
.. .� I 7j
WI SC ON S IN
""' Z O N I N G O F F I C E 796- 2239
Poa.t 06664-eQ Box 227
tl` -f `11 I Hammond, WI 5401 5
O W N E R
P U M P E R
A G R E E M E N T
PLEASE BE ADVISED, That unfit you aae again noti.6ied, I wilt
con.tAact with Paul Cudd & Sons, Inc. 0 6 River F;;1 1 ta isr.A s j '
Ni4 eonAin, (Pumper) , 6an the putpoa e o6 temov.i.ng aZt waate 6nom the
Aani,tany ayatem to be Located on the piLope4ty and 6utuxe home aite
located in St. Cnoix County, W.i..acona.Ln, Townahi-p o6 Troy
being in the z 06 the h o6 Sec. T. N. -R. W.
(On. Inoue 6 utty d ea c/L i.b ed ad 6 01..1'owa : )
All that part of Lot 5, Section 35-28-20, lying N of a line
1693. 8 feet N of the S side thereof, and S of the center
line of a ravine running Easterly and Westerly across said
Lot 5.1 the Easterly end of said ravine being 2077 feet more
or less N of the SE corner of said Lot 5.
Dated th.c.a day a 6 19 .
G (OWNER )
Minnesota Peter Thomps n
State 06 wa�€�x►
Hennepin as
County 06 xx
Peu.aonnattyappeaned be6on.e me thiA 17i day o6 19 3 .
the above named. Wner to me nown .to -be the
peAeg"r� i� o e � A Z �n o�ng .j.natnument and aeknowtedged the name.
NOTARY PUBLIC ,MINNESOTA
5�
&Uw"-/I
ANOKA COUNTY
My Ccmmission Expires Dec 4 1988 0 a1L y u riA i C, Zx
Opp
my Comm . perm x °1tb�')'
T, lgzv'- .F eciOa heu.eiAbe6o&e %e6etted to a,& Pumpea,
join ..n the above agreement to the extent that I have a eontnact with
Owneu. as above btated.
-
4��- P PER
ST. CROI X COUNTY
j r WI S C 0 N S I N
� t-Ile
ZONING OFFICE
796-2239 (HAMMOND)
425-8363 (RIVER FALLS)
HAMMOND, WI 54015
December 15, 1983
An. Pete Sotheng, Chavcman
Troy Town6hip.
R. R. 3
Hud6on, W1 54016
Dean M. Sotbag:--
Encl'o4ed p.E'ea6e find a town6hip agreement to be jilted out and 4.igned by
town4 hip o j j ici a2.6. Thi a agreement e64 ent c.ae2y .in6 urea that the hoWng
tank wiU be pr o peAt y maintained.
ASteA aP.!' AignatuAe6 have been obtained, it becomea a document which .c,6
neconded in the tna.ct .index with the Reg"ten of Deed6. When thiz ha6 been
completed, the document .us sent to Aadizon jon 4tate apphovat, a6teA which
time danitany peAmita ate i6.6ued at the county tevet.
Should you have any quation4 tegaAding th%a 4ubject, p.E'e"e fleet Sue to
contact thin ojjice.
S.incenet y,
Thomab C. Net4on
A4.6i4tant Zoning Adminibtnaton
TCN:m j
Enceo4uAe: Hotting Tank Agreement
P. Thompson Letter
THOMPSON & LUNDQUIST , LTD.
ATTORNEYS AT LAW
PETER THOMPSON 1612) 332-0920
JOHN W. LUNDOUIST 100 MAROUETTE BUILDING
November 3, 1983 400 MAROUETTE AVENUE SOUTH
n MINNEAPOLIS, MINNESOTA 36401
V
Mr. Darrell Richer
Route 3, Box 262
River Falls, Wisconsin 54022 �'� ,9�
Q�.
Dear Darrell:
Enclosed is a copy of the architect' s drawings of the existing
cabin which I promised to send you.
I 'd like to thank you for coming to my cabin along with Tom
Nelson, and it was, I think, a useful session for all of us.
I am having Art Wegerer do some additional testing on soil
percolation and then will develop- final working drawings with
the architect in accordance with our discussions. As soon as
they are done, I will send them to both you and Mr. Nelson for
approval.
Thank you for your cooperation.
Very my yours,
kyz--
Peter Thompson
PT:cb
, cc: Mr. Thomas Nelson
H - 10 - $3