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030-2081-70-000
o O 0 d o ti a 0 c v _ M v m o' o c U a N E o c a a n z L O C 0 Z L 4 ! y 3a�im Q c o a m rn CL m c o ' x a X co °1 E 0 CL _ N x N O O U N w N O U Z � O U O a) c Z€ '� c Z `n c m c o a a� O 3 m rne� LL CO L LL CO 3� COL T L C Z 3 � Q U C -p N to �� U Cl) O N N — W Z y y N Z ±+ O = O w V O O Z d d d d N Cl) Z a d m c O O Z c V Q v O rn O y d Z c ° c Ln z Z m c E 72 E v M ' N m y o m 3 n � a (D m 0 o a) Q ° Z6" o d Q ° z m z o z m z N Z E E N E Q CO ++ c Q ++ C t0 CO H d ► N C O i CO H Q Q a� N 0 o o a - o c a 9 �w �v (n fn fA (j @ fA N t/� x W`J o b FL LL •►v �an.Q �aaa a 4.; y w ►� ° v� ' m t0 J U = rn rn } __ Z tE j m w c d j CD c CD V N a) 2 2 a) N Q C '° d Q} Cn ca c 4) Q z Cn p a 7 a a 7 w M W c M rl- N C C Cn ° O O O N CS O V' 1 r N U d p� C r 0 Q Y O E C N co N rn 4 Q N N a) O V L y 7 N a) U a) C.' N O O Y y a) F- c N n C p d a) V Ny M C_ • co Cn d 0 ° C E O U . co O N O Oc O N U) U) O Z U) In M O Z c Z � ^ 0 *t ++ £ 0 ` a) Q L: a L: a cc CL c �d C r� r A t0a� oU) Oai 0 CO) 0 3 v 0 d r� it r T .. r: c ono °WTI ��C O- (D y N x O N � � u O O C ? C 0) V \ 1 N O O. 7 N -4 7 C) O �1 CD cn z D C CD C L O j C C (o C 0 M T "a 0 0 0 - � 9 x O — �t C-�cr Taa a J ('o _ m a N N Z (Do 0 O D a m "IRA, CD y N d N C to N G (D � a CD (6 O O ' la Z n N C s_ 3 M C P (? 7 O < O m W CL z 0 p 0 Z o 3 m D A O y f O. 7 Q ( j o_ y 7 Q O o . _ v C I o a CD N C ~� IN Z 7 � N O (D O O - N 3 ch =r x � CD o 0 CD Cr ba CD Cl. f o Z 0 c O o fv! O m V N v 0 ° o _. O (� a a co Q 0 ti O O Q O � A fA O ° o ° i Parcel #: 030 - 2081 -70 -000 04/07/2005 12:01 PM PAGE 1 OF 1 Alt. Parcel #; 25.30.20.694 030 - TOWN OF SAINT JOSEPH Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * SPRINKLE, KURT E KURT E SPRINKLE 1377 PINE VIEW TR HOULTON WI 54082 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1377 PINE VIEW TR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 4.410 Plat: 2644 - WOODLAND HILLS SEC 25 T30N R20W WOODLAND HILLS LOT 17 Block/Condo Bldg: LOT 17 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 25- 30N -20W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 1154/198 WD 07/23/1997 1002/55 LC 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 6404 177,400 Valuations: Last Changed: 07/12/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.410 118,300 56,200 174,500 NO Totals for 2004: General Property 4.410 118,300 56,200 174,500 Woodland 0.000 0 0 Totals for 2003: General Property 4.410 69,400 48,000 117,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 134 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count y Safety and Buildings Division INSPECTION REPORT cm IX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary EeJ3 cwblb LL i Personal information you provice may be used for secondary purposes [Privacy La s.15.04 (1)(m)], ii 25 PerngtpWjT4AajT e: KURT ❑ City ViIImRfgn of: State Plan ID No.: CST BM Elev.; Insp. BM Elev.: BM Description: Parcel Ta d 1 10.: _2081 -70 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Aeration Bldg. Sewer Holding St /Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. ventto ROAD Dt Inlet Air Intake Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft Forcemain Length Dia. mead Dist. To well SOIL ABSORPTION SYSTEM RED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSION SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: SETBACK CHAMBER INFORMATION Type O Model Number: System: OR UNIT DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length 'Dia. Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes [] No ❑ Yes E] No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: ST. JOSEPH 25.30.20.694,NW,NE 1377 PINE VIEW TRAIL Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert. No i ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: . a e s € a a i i t t < { e.. 7 } _ S } E E l i E € f f i ve e z i a e „Ems :.. ....__. .a.... ...< e.. l ! t < E S mm e.� Mme m..j. e I t � � S 1 .. e .a t .�.� j... ._., m,d S x e j x a I € s t s < a e a t I Safety and Buildings Division Visconsin .SANITARY PERMIT APPLICATION 201 B.WashingtonAvenue Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less Count than 8112 x 11 inches in size. - r C &I I • See reverse side for instructions for completing this application State Sanitary Permit Number Personal information you provide may be used for secondary purposes E] Chec l revision to p2 v� us application (Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION Pr rty Owner Nam P ope Location U �JI�L �,/ 1/4 QF 1/4,S 25 T,3() R ZOE (or) P operty Owner's ili g Addre�/s ,`f C Lot Number Bloc Number 37 r� L l Q / /7 Cit ,State Zi Coe Phone Number Subdi ision Name or CSM umber 0000 of 1�1 �V PZ 1 (7/5 )5j Z f L L '� P F B IL IN : (check one) ❑ State Owned ❑ it Ne est Road Village E `� Public 1 or 2 Family Dwelling - No. of bedrooms Town of �T �S / e '2 I11. BUILDING USE (if building type is public, check all that apply) Parcel Tax Number(s)) A -5. 2--b -61 4 1 ❑ Apartment / Condo �� _�� 7( 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant / Bar/ Dining 4 ❑ Church / School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel / Motel 9 ❑ Office/ Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. ❑ New 2.',RReplace ent� " "" ❑ 3 Replacement of 4econnection of 5 ❑ Repair of an ---- _- System -- - - - - -- System �Op� ctly Tank Only -------- - -- - -- xistingSystem -- - - - - -- Existing System - ,dzR,Kr- -� - - - -- B) A Sanitar y Permit was p Issued. Permit Nu y9 �9 mber Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 Seepage Bed 21 ❑ Mound 3 ❑Specify Tye 41 E] Holding Tank 12 Seepage Trench 22 ❑ In- Ground Pressure l� 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Requ iired sq_ ft.) Pro (sq. ft. ) 7q. /sq. ft.) (Min. /inch) ? levation 50 6 � --� / / Feet Feet Capacit VII. TANK in Ca gallo s Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existin strutted Tanks Tanks Septic Tank ` (, £ El 1 11 El El 1:1 Lift Pump Tank `� 13 1 0 El El El NSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Slap ature: (N Sta s) MP /MPRSW No.: Business Phone Number: OFF ZZ< x i 3 2 y �r P Address (Street, City, State, Zip Code): ES.SZ= r— IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing 9trilSignature (No Stamps) Approved ❑ Owner Given Initial "12116C taD Adverse Determination CPU /loo IIf� i r aa X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: (JNn cow. p �>F ,G h cw rcSt K� ©-I'kc q c /ear r - c ko1V�G W i �� h ^#c A If I AAA PC 4 C i �`4wlpW,t� ?kt, 4&y4 'v �.k I it o4 t S VW fA, too disllllll�. w k: I !yWIvdr_s &A" SBD- 6398 (R.11 7) DIS UTI N: O i to Count O e copy To a y ui dings Division, Owner, Dlumber�� l INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at.a 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 and Buildings Division, 608 - 266 -3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. 11. 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 on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /orexisting 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 fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. May -07 =99 08.47A Viebrock Companies 715 294 -4444 P_01 stl� May 7, 1999 I Y.O. Box 187 Osceoki. WI 54020 Rod Eslinger Ph 715 - 294 -21 Fax #294 -4444 St. Croix County Zoning 1101 Carmichael Rd. Hudson, WI 54016 715- 386 -4680 Dear Rod, A *t�r / cto�Ox wiI I►G r/g / /•w :.c Per our conversation today I understand a conditionAPimpermit Kurt Sprinkle of, 1377 Pine View Trail Houlton , WI. This will allow use of the existing septic system attached to the existing garage arriage house until a new house on the same property is completed. The new house ill incorporate a new tank and be connected to the existing drain field, which will be mo ified to accommodate the requirements of the new house. Upon moving into the new ouse the old system will be dismantled by: (])removing all existing plumbing fixtures om the garage /carriage house and (2) collapsing the existing holding tank cover and filing it in. Dismantle of the old system will be completed within 30 days of final inspection new house. Sincerely, IV /tom h 4 At ' ocl� h �'�Irr"l�✓� sfrv �s b" John Kalmon Viebrock Construction, Inc. S r2. C• I r 6VDj a "T4 SoL 46'raV) rryvlifi, Post -W Fax Note 7671 Dale 0of► / To Vo D From Att40 co./DeptIT, 6120N, Cou co. Phone k 30 r_ _ O Phone N - 2 A _71 aS Fax N 166 _ b Fax M _ 9`` A 'S�-Pi XW �y AIE Py 5 C 0- A(,R 2n )37 - Pl-v°E L 'I i- Ir O 2 „ l-O ReL _NIA 11 j Pi?opi-)mn .3 An LlsE FOCI STI Ivy \ ` � r1o Use 97AS i"b 16tO cwt_ : EEV 1c- TAII�K 4LL �+ L)Mf- - 10 EC Ai3AKY�t _ f _ r <-- ---- -F,7XI ST(JJ 6 i 2 x S6 J FED i s i A3:AD/7a"(-- lZ X lL 7� SE ADE I Q 0 br;tN 3tE I TG fPAJE UIEv✓ - RAIL 6r KTRItib VIAL+_ S.1/ 12.01k1 Lk 151 DYb A-AvSE I .� PLiI��P rH P.r � .E�R C.fiu�5 SECTIOI,; AIJG �P ECIFIt:t.110'1` VCI.T CAP E "'T PIPE WEATNE KPROOF APPROVED LOCi''�PlC• ,JIJUCTIOtJ BOX �MAMHOLE COVEF. DOOR, i2�MIU. WIIJOOW OR FRESH } AIR O'TAKE I GRADE COWDUIT \ 111 PROVIDE 1 - -~ IMLET AIRTIGHT SEAL { I I I APPROVED JU:UTS APPROVED JOUST A (� i WJC.Z. PIPE W /C.I. PIPE I I EXTEIJD1>SG �' ALARM EXTENDIW(a 3' ONTO SOLID SCIL I ii OQTO SOLID SOIL D t I I ON C LLEV..._ FT. PUMP OFF D COUCKETE CLOCK i A UFACTURGR HAS SUCH APPROVAL. �- RISER X17 PCRMITfED Q1JLy IF TAIJK M N SEPTIC f SPECIFICATIOW DOSE TANKS 1 MAWUFACTUFLEK: IJUMBER OF DOSES: PER DA`J TAWK SIZE: GALLOWS DOSE VOLUME (� ^ /ALARM MAIJUFACTUKER: �1S:II` �` PLC -R� IMCLUDIM& SACKFLO ��.� J� 1�/� AttONS MODEL WUMDCR�,: — CAPACITIES: A= IIJCH(5 OK GALLOIJS 'SWITCH TYPE' AAf'QC'L)R2 8= Z INCHES OR GALLOU PUMP MAUUFACTURER: `-C ) D.S Gs - 7 INCHES OR � � GALLOUS MODEL MUMDER: CPaLJ �YlvoE�, -� Dw !j— INCHES OR GALLOAIS SWITCH TYPE: - 7Qo_gfz IdOTE: PUMP AND ALARM ARE TO CE MIMI MUM DISCHARGE RATE GPM INSTALLED OW SEPARATE CIRCUSTS VE RTICAL DIFFERENCE DETWEEW PUMP OFF ARID DISTRISUTIOU PIPC -. FEET + MIAIIMUM ►NETWOR SUPPLE PRESSURE .. .. . ... . . . _ ,. FEET + FEE7 OF FORCE MAIN X _1 - f�oprr_FP,{CTIO►IFACTOR.. 2,5 FEET -- , TOTAL D HEA �S5 FEET `W6 IAITERIJAL DIME WSIOMS OF TAQK: LE~ _i&TH ;WIDTH - ; L.IGUID OE:PT Ii If • / M OD EL • • • • PO4 P0 Su bmers i b l e Pump �D5 ` a im" ec c ns METERS FEET MODEL: 3871 harge 5 9 3° 7 `Solids :maximum Motor u� R , n s f _ +': A 7 25 Single phase. 115V Materials of Construction = 5 xo Bras s/thermoplastic 5 15 EPOS Features and Benefits C ° 0 *Top suction eliminates a 3 10 impeller clogging. 2 EPO4 5 • Corrosion resistant , construction. ° oo io xo 3o ao 5° ustx� •Float actuated switch. ° 2 4 6 6 ;° ;2 ,• CAPACITY METERS FEET 7 25 MODEL DVP03 Pump Specifications Features and Benefits a 6 20 4 h and 1 /2 HP • EPO4 impeller- semi -open design 5 Up to 60 GPM with pump out vanes to protect ,5 Maximum head to 32' mechanical seal. = 3-10 Discharge size 1' /2' NPT • EP05 impeller - enclosed design p Solids: 1 14 ' maximum for improved performance. • Rugged glass - filled thermoplastic M ' 5 All motors feature ball casing and base design provides 0 - ° 5 ,° 15 zo x5 3° 35 u.s.crM bearing construction. superior strength and corrosion Single phase: 115V resistance. 0 z CAPACITY 6 8 'O Materials of Construction • Cast iron motor housing for Cast iron efficient heat transfer, strength, Thermoplastic and durability. p • n resistant Stainless steel Corrosio threaded I s te e l shaft. stainle s ee aft. • Available for automatic and manual operation. • CSA listed models available. I All Models are designed for continuous operation and feature stainless steel hardware. i , lyy4�11 �5Ah1 Y1 ,ExHIBIT�RuUP TRAFFI 715 294 - 4 .110.6154 F. 1!1 P.02 ST CP,01X COUNTY SE!"M TANK ,MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address t �`7 7 T&VII M 4- �iAN W Property Address _ (Verification required from Planning Department for new construction) CityJState Parcel Identification Number 0 !O -- 7,0 - 70 -00 LEGAL 00 IPTION Property Location ' /,, %, Sec. , T__IQN - R_I Q_W, Town of - Jt*VfK• Subdivision i Lot # 1 Certirled Survey Map # Volume . Page 0 Warranty Deed # si 3 6+ Volume �r'S�' - Page # Spec house D yes# no Lot lilies identifiable D yes D no SYSTEM HAMMANO Improper use and risaintenanceof youx septic system could resdt in its prawatwo failure to handle wastes. Propet nudatcamce oonsists of pumpi out the septic tarok every dirge years or sooner, if weeded by a licensed pumper. What you put into the system can &Veer rho function of the septic tack as a trea0009 stage is ft waste disposal sy rem. 7k Perri inner agrees to submit to St. (koitt Zoning Depsttment a eersfi"On fomn, signed by the owner and by a naasterplvmbec, jou¢neymaapllrmber, mstrietedp1wnbear or s hoomedpumper verifying dw (1) the on - site wastewatcrdisposal system is in proper operating eonditioa aaftr (2) after inspection and p (if necessary), the septic tank is less than 113 farll of sludge. 9hre. the Undersigned have head the above requirements and some to maintain the private sewage disposal system with the standards set forth, l aeK as set by the DePatt mi of Commerce and the Deparnnew of Natural Reson es, State of Wisconsin. Certification stating that your septic system bas been maintained must be completed and teturned to dre St. Croix county Zoning Office within 30 days of rite &ree year ' ti ou date. SIGNA APPLICANT DATE QWM CMXtTIFICA'l 0_N Y (are) oestify duct alt statemgats on this form at true to the best of my (our) knowledge. I (we) am (are) the ownat(s) of rite paoperty above, by virtue of a warranty deed recorded in Register of Deeds Office. SIONA F PLICAATI' DATE * * * * ** Any information that is mis4 prescnted way result in the sanituy permit being revoked by the Zoning Deparonent. •• Indude with this application: a stamped warranty deed from else Register of Deeds office A copy or We certified survey reap if reference is made in the wactanty deed OTC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER _'/� 11 ADDRESS SUBDIVISION / CSM# !r�l s LO SECTIO T -?4 N - _ W, Town of y ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ,�f ti1.r`j I', l 9G • 7-f 95%94 INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. i BENCHMARK: n ., � �'� 1 �f J C /�,�,. ', 4Z 20,2 ALTERNATE BM: , SEPTIC TANK / PUMP CHAMBER / HOLDING ..TANK INFORMATION I Manufacturer: Liquid Capacity: Setback from: Well House Z/ Other Pump: Manufacturer Model# Size Float seperation Gallons /cycle: Alarm Location ':SOIL ABSORPTION SYSTEM Width: Length Number of trenches Distance & Direction to nearest prop. line: 141 /2' Q- Setback from: well House Z_ y Other ELEVATIONS Building Sewer ST Inlet; ^ .; ST outlet 99, PC inlet PC bottom Pump Off Header /Manifold Bottom of system Existing Grade Final grade DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: q INSPECTOR• 3/93:jt B20Y�11 �+ LQQ4r w; t,JV9id4¢C .25,T30NPRW&S p WAGE vS WSTrA County: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: 193479 Permit Holder's Name: ❑ City ❑ Village [Town of: State Plan ID No.: JOS EPH ev.: Insp. BM Elev.: BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA A9300142 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic a;&c 04 4& Benchmark 7f 14D Dosing Aeration Bldg. Sewer Holding St/ Inlet TANK SETBACK INFORMATION Stot Outlet 67 1 ' TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet , Air Intake Septic >l 42 � NA Dt Bottom Dosing NA HeaderAAL&A R Aeration NA Dist. Pipe $, Wt Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufac Demand °p Q. Model Number GPM TDH Lift Friction System Ft Loss Forcemain Length Dia. Fi Dist. To well SOIL ABSORPTION SYSTEM BED / T4*NN Width 7 Length �� No. Of T , nches PIT f Pits Inside Dia. Liquid Depth 1A 1 D � DIME I N SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING nu acturer: SETBACK INFORMATION Type O A4�J CHAMBER OR UNIT � j � � p` � �� Model Num er. System: i!V-Ag' DISTRIBUTION SYSTEM Header 1.14% w4eld Distribution Pipe(s) , „ / x Hole Size x Hole Spacing Vent To Air Intake Length _4! Dia. Length �5' 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 /Td"@ Center Bed /isorach Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: NW,NE,SEC.25,T30N -R2 (PINE VIEW TRAIL) 3 %�4 � - c� o,ba.�- ale, -c -Y- • .. � � d. -� fe :4 06;dd4.9� Plan revision required? ❑ Yes �o - Use other side for additional information. SBD -6710 (R 05/91) Date Inspector's Signatur Cert. No. SANITARY PERMIT APPLICATION TDILHR in accord with 1LHR 83.05, Wis. Adm. Code COUNTY STATE SA I – Attach complete plans (to the county copy only) for the system, on paper not less than 8% x 11 inches in size Li Check 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 INFORMATION. PROPER OWNER PROPERTY LOCATION '/4 ' /a, T , N (or PROPERTY OWNER'S MAIL NG ADDRESS LOT # BLOCK # CITY ST TE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CV BER IL TYPE OF BUILDING: (Check one) ❑ State,Owned VILLLAGE : NEA ST RO D OFZ ❑ Public [?] 1 or 2 Fam. Dwelling -# of bedroo PARCEL TAX NUMBER(S) ' 111. BUILDING USE: (If building type is public, check all that apply) 9 � — 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 W. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ICJ New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit ## — 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 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 Feet Feet VII. TANK CAPACITY Site INFORMATION in a al Ions Total # of Manufacturer' Con- Steel Prefab. Fiber- Exper. New istin Gallons Tanks s Name Co ncrete glass Plastic App Tanks Tanks structed Sep tic Tank or Holdin Tank Lift Pump Tank/Siphon Chamber /,%�_ El = 1n:FF; 1- 0 1 L J Ll VIII. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for instal tion of the onsite sewage system shown on the attached plans. Plumb 's Name (Prino: Plumber' ign tur mps) MP /MPRSW No.: Business Phone Number: I Pldrn ber'i; Address (Street, Ci , State, Zip Co S ' IX. COUNTY /DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate issued Issuing Agent Si stamps) ❑ Approved ❑ Owner Given Initial Surcharge Fee) �- Adverse Determination X. CONDITIONS OF APPROVALIREASONS FOR DISAPPROVAL: l< ,( ( 6 1 SBD4M (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber PAC C 0 I • � j, Cry S S� � ^ ..,•'� Q 7! � I y • G� Ole, Ak Welt A" Qb6falsoes 4 • ' 11 wov" Wt cap f. ' flall geode i0• ii' M••• P1 40 C••1 (►w! �;• ?, *� /I••{ o••a .. vwu No ' Ma 0 1N. W ir11ib+it C•.a1e• •' Too 4 ' A �IN•H�• .. . . �•M•11 1y• • !'wlw•1•• PIr• YN•v • � �CwiMt T ««La1.� M ••11•i• 0 • I i�N•A hC � .. D 1:1s. < �rup cD �' � 9r I . vw*J ton aol� Iil.�• . 01 3TKIDUTIo►.! PIrC APPRO` /ED S•(NTIIETIC COV 2~ of hGO RJ:6l1TE -•�� ... - ' - "M ATERIg1. OR 1 0 0F Sian M OK MARsI• N,Ay • ., . , ELAY, o ' `^ °�rt AGGIiCGATC '� %// •,• c� DISTR{bUTl�i) ►IP[ To U AT �C�.Z+ _ {uCHC3 BCVOW OR1GILlAI, •i.lAOL A" AT LEAST &O ILJCHLL OUT Ll0 MOlIC THAN 42. IAICI{CS OL1.pW FINAL. C+MOC '1 I M DaPN EIACAVATtOP FXOpi 0 KibwA .L 6XADF. WILI. 9C 1 i ©E T t O EACAV -._ IuGHES P F ATIoN 1' ,oM a�{(,INqL GRAPE WILA. S C � 1NCHC5 J 3161ica: L•IGCusC DATC Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page[_ of Labor and Human Relations Division of Safety r£ Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but S J not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROP R OWNER: PROPERTY LOCATION -� - GOVT. LOT kJ 114 1 14,S PROPERTY OWNER.3 MAILING ADDRESS LOT # BLOCK # SUBq. NAME OR CSM # CITY TA ` ZIP COD PHONE NUMBER [ [ �f0 N NE EST, OAD Ar / ) - S'�� -Ii 7-V [q New Construction Use j}O Residential / Number of bedrooms [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 3ZP- gpd Recommended design loading rate Z _ bed, gpd /ft _,k_�_ trench, gpd /ft Absorption area required jr L bed, ft _- trench, 111 Maximum design loading rate . 7 bed, gpd1ft gpd/ft Recommended infiltration surface elevation(s) _ft (as referred to site plan benchmark) Additional design / site co si erations - - - - Parent material LE .�_��, l' ? a_ ,F, Flood plain elevation, if applicable N1,4 ft S = Suitable for system CONVENTIONAL MOUND IN GROUND PRESSURE AT - GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem 0S OU ®S OU ®S OU CAS OU OS oU OS OU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench t Ground elev. JA C Depth to limiting factor Remarks: Boring # is x: z Ground elev. ft. Depth to limiting factor Remarks: CST Name:—Please Print Phone: A ddress: ) Signature: Date: CST Number: ' II 11 i I I i •I i i t I i i I• �{ i �� I I � i I 1 I b ( 1 - � I I i; j I i I, I / ( 4 V I I i I S T C - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER /BUYER ADDRESS _:? , - FIRE NUMBE Zf CITY /STATE Zip g_y PROPERTY LOCATION: AL-1 /4,_1/4, SECTI - TOWN OF �� Ll , St. Croix County, SUBDIVISION LOT NUMBE 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 septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification 'form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1). the on -site wastewater disposal system is in proper operating condition and ( 2 ) after inspection and pumping ( if necessary), the septic tank is less than 1/3 full of sludge and SCUM. I /Ile, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix Co. Zoning Officer within 30 days of the three year expiration d te. SIGNED: DATE: St. Croix co. Zoning Office 911 4th St. Hudson, WI 54016 a Q I � 90'0£ti �,05,£Z ° z N OD 9 s N r O a ui o w "� _ U Q V/1 3N 30 t /I MN 30 3NI-I ISd3 F'19 cli _ Ln co 09 o aj0`Z 2 N 0L'ti1£1 M „0£,t1 °0 S ,oL'te£ _o s o s. I N ` c `9 o f . 3 w 1 rn a� w w w V `co �.. _ x Op /= - Q 00) Dt Q 00/ d z N � �"� `� �2 "M �/ S to S s� �t 0) t Z ,L6'£ £ 9 3 „LZ Ot, °0 N -adod onand 1 06 - I Z9 M „LZ,Ov.0 S U �6'SSZ ��7,£,boo£51 Q o o I 6/ ° �� O to �► N O LLJ cfl w o ° — o E£ E£ a O 99 M w x _M C� 00'00t, N f oM CV N _ 3 „LZ ,O� °O N � N th `� n w ° z ao cD _ co V) J LLJ Z _M 0 ti. ti U N 0 - Q r w O L�7 rn O =0 O N � N o, 00'SSZ _O o 8£811 3 LZ Ot7 °0 N 4j tc) z a 0 p ao oe 00 ' OOt C w Q i N -11111 3 „LZ Ot °0 N Z di t J w; _w W� -; �� ` �' d• ro I �'i W� CL YOl 10MME 56 Purchaser promises to pay when due all taxes and assessments levied on the Property or upon Vendor's interest in It and to deliver to Vendor on demand receipts showing such payment. Purchaser Shan keep the improvements on the Property insured against loss or dams�e occasioned by fine, sx tended covasge perils and sucb other hazards as Vendor may require, without co- insurance, through insurers, %pproved by Vendor, is the slim of $..tu1.l insurable- Ya- ttI1'at Vendor than not require coverage in an amount more ` than the balance owed under this cou,ract. Purchaser shall pay the insurance premiums when due. The policies shall contain tL.: standard clause In favor of the Vendor's interest and, unless Vendor otherwise agrees in writinx, the original of an policies covering the Pro perty shall be deposited with Vendor. Purchaser shall promptly give notice of loss to insurance companies and Vendor. Unless Purchaser and Vendor otheswist agree in writing, insurance proceeds shall be applied to restoration or repair of the Property damaged, provided the Vendor deems the restoration or repair to be economically feasibly > • - Purchaser covenants not tr commit waste nor allow waste to be committed on the Property, to keep the Property In good tenantable condition and repair to k the Prop tty free from liens superior to the lien of this Contract, and ant • . to comply with. all laws, ordinatio" regulations affecting the Property. t" Vendor agrees that in case the pur -'rase price with interest and other moneys shall be fun paid and an conditions Shall be folly performed at the times and in the =minor above specified. Vendor will on demaady execute and deliver to the Purchasar, a Warranty Dead, in fee simple, of the Property. free and clear of all liens and encumbrances, except ' any liens or encumbrances crested by the act or default of Purchaser, and except: - «..... ... ......... ... ....... ....... ....-- •.......-- •-- •-- ............... - •-- .._..._ - -- -- -- - ,> -- ..... -- -- - --- ... •-- -• - - -- .__- :......_ ...... .._..._.... «------- - - - - *• -------------- --- . ' - l Purchases &grace that time is of the essence and (a) In the event of a default in the payment of any principal or 'a interest which continues fora period of ...6a -_ days following the specified due date or (b) in the event of a default in yy� Manes of as other obligation of Purchaser wh',ch continues for a period of .---6Q.- days following written notice " ihereoi by Vendor delivered personally or mailed by aartiBed mail), then the entire outstanding balance under this contract shall become tely due and payable in full, at Vendor's option and without notice (which Purchaser hereby waives), end Vendor stall also have the following rights and ramedies (subject to any limitations provided by law) in addition to those so Tided by law or in equity: (i) Vendor may, at his option, terminate this Contract and Purchaser's rights, title sad nteresL in the Property and recover the Property back through strict foreclosure with any equittyy Of redemption to b .- nditioned upon Purchaser's full payment of the entire outstanding balance, with interestthereonfI the date of defan i :.t the rate in effect on such date and other aruounts due hereunder (in which event all amounts previously raid by Purchaser Shall be forefeited as liquidated damages for failure to fulfill this Contract and as rental for the Property if purchaser fails to redeem); or (ii) Vendor may sue for specific performance of this Contract to compel immediate and fall payment of the entire outatanding balance, with interest thereon at the rate in effect on the date of default and other amounts due hereunder, in which event the Property shall be auctioned at judicial sale and Purchaser shall be liable for any deficiency or (iii) Vendor may sue at law for the entire unpaid purchase price or any portion thereof; or (iv) Vendor may daare this Contract at an end and remove this Contractasacloud on title in a quiet -title '- action if the equitable interest of Purchaser is insignificant; and (v) Vendor may have Purchaser ejected from possession of the Pr •perty and have a receiver ap pointed to collect any rents. issues or profits during the pendency of any action under 11). (ii) or (iv) above. Notwithstanding any oral or written statements or actions of Vendor an election of any of the foregoing remedies shall only be binding upon Vendor if and when pursued in litigation and all costs and expenses including reasonable attorneys foes of Vendor incurred to ,erdorce:any remedy hereunder (whether abated or not) to the extent not prohibited by Iaw and expenses of title evidence shall be added to principal and paid by Purchaser, as in- curred, and shall be included in any judgment. Upon the commencement or during the pendenty of any action of foreclosure of this Contract, Purchaser consents to the appointment of s receiver of the Property, Includin homestead interest, to collect the rents, issues, and profits of the Property during the pendency of such action, and such rents, issues, and profits when so collected shah be held and' applied its the court shall direct Purchases shall not transfer, sell or convey any legal or equitable interest in the Property (by assignment of any of Purchaser's rights under this Contract or by option, long -term lease or in any other way) without the prior written consent of Vendor unless either the outstanding balance payable under this Contract is first paid in fail or the ir'srest conveyed is a pledge or assignment of Purchaser's interest under this Contract solely as security for an indebtedness of Purchaser. In the event of any such transfer, sale or conveyance without Vendor's written consent, the entire outstanding balance payable under this Contract shall become immediately due and payable in full, at Vendor's option without notice. Vendor shall make all payments when due under any mortgage outstanding against the Property on the date of this Contract (except for any mortgage granted by Purchaser) or under any note secured thereby. provided Purchaser makes timely payment of the amounts then due under this Contract. Purchaser may make any such payments directly to the Mortgagee it Vendor fails to do so and all payments so made by Purchaser shall be considered payments made on this C ontract Vendor may waive any default without waiving any other subsequent or prior default of Purchaser AB terms of this Contract shall be binding upon and inure to the benefits of the heirs legal representatives. suecsesors and assigns of Vendor and Purchaser. (if not an owner of the Property the spot ss o1; Vendor icr a valuable consideration Joins herein to release homestead rights in the subJegt Property and agrees to join in the execution of the `- deed to be made in fulfillment hereof.) + Dated this day of ------- APrI.1 % .......................... , �? ° --------- (SEAL) (SEAL) •. SEAL) . - --- - -.- . • Troy « P. Hurd : ........................ Kurt E. Sprinkle ....................................... « :............_....... :_ .•...(SEAL) . .......... ._.....__...................... ............: :._(SEAL) • ...---• . ......................... ............................... ' .......................................................... ,.:.;.: AUTHENTICATION ACHNO W L13DOUNNT Signatmv(s) .......... .............. STATE OF WISCONSIN Kurt E. Sprinkle .. .. ... ............. ......_.._._... - -- ................................... a ............... ........... .. ..........Conn ty. authenticated ,.3t " Ly Of. .. Aptru. ........ 19 Personally came before me this - - -- -day of A ......... «..... _. ........................... ... ...................................... . 19........ the above named A "�t ..• ............................................... ••-- •--- ...........---- - - - - -. t't� - e Kristine Ogland TITLE: MEMBER STATE BAR OF WISCONSIN --••- •-•••• ........... ..••- -• . .. . (If no -- -- - .... - " - ................. ........---..........--••--------..............----- .................- •- • - -... £ authorized by 1 706.06. Wis. State.) to we known to be the person ..,.,... ... who efecuted the foregoing instrument and acknowiedie bite same.' f - • THIS INfTRUM[NS WAS DRAFTED BY Kristina ....._.....••••--•-•-•• ......................••.. ............................... ............. - v �i££o'rney' '•Law ........................ :. «. ........ .. ...«.. .._............- -•--•-• °•-..... Notary Public ................... County, Wis. 1 (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) t date: .......................... ................... .. .......... 19 ......... 4 sNams of persons sisutng in any capacity should M typed or printed below their signatures. LAND CONTRACT— Individual and Corporate —Stake Bar at wiseNata. 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'ON 1NMHinoo0 <' • �5 3�ra�o� �o�, tn xt - 02 VOL 10 - 57 f WAGE i y E AN 2�a.. ,✓, r .: i5 �'i"'t•+ W �i"'d {•e}4 ! rr -f + tf 7,s- '. I" .r: e- "' .3• y w....� 3 ..} n Y ro ,�, x,• J!` r k i i ` "i' f .s " 1 r Sf..! T:,•y c r a 3 ° Y ` r Si+C F k fir" ♦v7►{ Lot 17 of woodland 81116 8 t Y f:Tn..'4�a 1"+. j Yr X�' x ubdivision_ located iu "the Section a5 - 330 _ NEI 4 of ' Wisconsin 2O ` To Wn of St. Joseph, $t. Croix County s A,. v _ > •.;i7, ' .."� K r .9:x �w �.X v `• r °0 �r+ p •�"' /I'� ..gar - 3" '..r•,,. .� r . ; riP, -ecr •t" •w""t°„4"°5.i, the N81 /4" ofINB %4 SO cct n fo Ono s -3Q Z0 °OraMor `Iese Iocati4 ti the wly part of the r Iowa of St, Josep?►,., bel*47 - J t r parcel, described: is Vol. ,, %57" Page $ 414 ":r r: ` 11 Doc. No.. 350211 ` an d: d acre fully describe. as folloa at the IN corner of said - H 81 /4 of NS2 /4,.' which, Is al gan�� corner of Lpt 17 of the Plat of` woodlan ao d Bills: filed !larch 76 1976, in,Vol 0 4" of Plate Pa g 20 Doc:' o -� 9 . N 332143, thenct N1 along the w line of said N91 14 of NE1 /4, Which' fe also the. w- Iine Y `` Of said Lot 17, 333.4 feed, more or Ion 8 1** an iron i Nw corner of said parcel described in VoI.. ■577• ` D 54 1, .Doc. at the page X4 N 350211 (but if said iron pipe is not on said w line'" of said N 350212 of N81/4,7 this point shall be the intersection of ths' It line of the parcel described in VoI.' ■577», Page 34t, Doc No ` a rt' 350211 or wly extension thereof with the w line: of said NEi /4 of N81 /4); thence Ely along said N line of the In Vol. "577 Page 541, Doc. No , a d . 350211istance of 126 feet; thence Sly to a point on said 8 line of said N91 14 of NS1 /4 134.94 feet Ely of said sw corner of said Y . N81 _ 4 of wly along said s line of said N81/4 of N81/4 134.94 said ~ SW corner, said point of beginning. im _ i now - I Mky- 11, -99 02:54P Viebvock Companies 715 294 -4444 P_01 Post -It* Fax Note 7671 Date pager May 11, 1999 TO (� Ffp Att 40 c°.1Dept4 7t, Cpo(y CD u Rod Eslinger Phone k 30 (,o _ O Phone a , 7-7 -7l ab St. Croix County Zoning Fax M _ F M _ 9 , 4 1101 Carmichael Rd. Hudson, W1 54016 715- 386 -4680 Dear Rod, Per our conversation May 7 ,h 1 understand a sanitary permit will be granted to Kurt Sprinkle of, 1377 Pine View Trail Houlton , WI. You will allow use of the existing septic system attached to the existing garage /carriage house until a new house on the same property is completed. The new house will incorporate a new tank and be connected to the existing drain field, which will be modified to accommodate the requirements of the new house. The permit will be issued contingent upon (1) removing all existing plumbing fixtures from the garage /carriage house and (2) collapsing the existing holding tank cover and filling it in. Dismantle of the old system will be completed within 30 days of final inspection on new house. Sincerely, John Kalmon Viebrock Construction, Inc. RECEIVED t . - MAY i g 1999 �r ST CROIX -'� COUNTY ZONING OFFcc ` ;`• o $ ^ OZObS IM 0 oa0 'Pb In S£ P2! a1o1S 945 - -- aj n L8l Xo8 '0'd tA - -- W z o co = g ��t� p �s 21 l� - >�21 - t zc1� � I � � S Nd�d ?J00TJ � rc a 1 o ° 62- LZV LZV IN zv E ll o = m 0 � II � O U N C Q 9/Z J 0 I II � o O e5 _ J ip LL. 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