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HomeMy WebLinkAbout032-1017-60-000 Q) ° o a) o p o a°. O� °' O 69 O O� c 0. p C � I I N m I N 3 I I I (D d E E E c' a a' a� N V 5 N 3 Z N a) w N - a) a Z LL C E {i � y IL C .� p a a) O > O O 3 m a 3 3 c Q p c Q ai E Q r it 3 co CL Z y z if E E rn w 1 � .. o r o I ;.; o 'E E o o Z i E C E V z a m a m a m c O o z - c c c > > > w ( 2 o c o w o a) fq t- rn m y m f0 N Z c E c E c 70 1 a) M I N O) O N CL N O In CL V N O O a) Q O Q O Q w p m N ZZ Z�Z Z � Z Z p. .. d ! .. a ., d p '° E R E R E N Z p CL m .. o o m o 0 CL ' m o c0 o G G a` n o O G a` ~ ° y �' ` a� c° - o o m E c N c v G G a m (' o M fA N m o N to fA m N 0) v .0 o o f v H H H H H H H H F- ,._ N N "'333 ° "'333 n X333 ° m Zool O O O O O O 60 0 0 0. a s a d 0. 1 o a a a *�. IL C d m SI 0 � 0 Q N ) O N I' N U) w U O rn rn z w a) Z @ _) c } Iry p o M co o 0 M� - 1 o 0 0 °° m o p E N O) a: m ° o y u o p p m y )) o Q Z O LO N C U') U) C N N C O O O N O N O a) Y O O C M y U. �p 0 (0 0 ~ m O Y p N N C E O E Q J= C- o N N E U c (n 1 1 2 w U _ S 0� cfl In ° � o :� E 3 zz Z. Z N N a) Z 'O (0 a) ' H O O M 04 CO O 'O p 0 m f0 O "O a)) O N p O N N C5 N O E 70 U� I O O (n W O O ',. g {- W W O Z N F - Z m M 0 Z �? Z f/) CC E a E m ✓� E a 4) a EL a w a L a �. • CL m aD _1 A v a 2! O N L O in v O m U a DEPARYMENT OF INDUSTRY INSPECTION REPORT FOR SAFETY & BUILDINGS . P.O. BO, 7 9UMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION .O. BOX 7969 77qq..77 BUREAU OF PLUMBING NER,Te'4, 1N —R19W CONVENTIONAL El ALTERNATIVE State Planl.D.Number: Town of Somerset ( 'D of assigned) Holding Tank In- Ground Pressure Mound G race Development ❑ 1:1 NAME OF PERMIT HOLDER: J ADDRESS OF PERMIT HOLDER: INSPECTION DATE: - Gary Ed ett 6692 Saddlewood Road, Woodbury, MN 5512 ' U BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.. Name of Plumber: MP /MPRSW No. County Sanitary Permit Number: Thomas A. Wang 3231 St. Croix 99051 SEPTIC TANK /HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: DYES ONO DYES ONO BEDDING: VENT DIA.: VENT MATL. HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: (VENT TO FRESH ALARM. FEET FROM LINE: AIR INLET: ❑YES ONO ❑YES 1:1 NO NEAREST DOSING CHAMBER: MANUFACTURER. J BIEDDING LIQUID CAPACITY PUMP MODEL. PUMP /SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ONO DYES ONO OYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF - PROPERTY WELL: BUILDING. VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM uNE AIR INLET: PUMP ON AND OFF) DYES ONO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the dep of lowin LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH: LENGTH: NO.OF J DISTR. PIPE SPACING. COVER P DIA.. #PITS. LIQUID BEDITRENCH ` TRENCHES MATERIAL: DEPTH: DIMENSIONS GRAVEL DEPTH FILL DEPTH I DISTRPIPF DISTR. PIPE IDISTR. PIPE MATERIAL: NO. DISTR NUMBER OF :PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES ABOVE COVER. ELEV. INLET. ELEV. END. PIPES FEET FROM LINE: AIR INLET: NEAREST MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- 1:1 YES 0 N meets the criteria for medium sand. TIONS MEASURED. SOIL COVER I TEXTURE PERMANENT MARKERS OBSERVATION WELLS DYES ONO DYES 1:1 NO DEPTH OVER TRENCH /BED -- ] DEPTH OVER TRENCH /BED DEPTH OF TOPSOIL. SODDED SEEDED. MULCHED: CENTER. EDGES. ❑YES 1:1 NO 1:1 YES ONO DYES 1:1 NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH: LENGTH. NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER s EO/T4 E, NGFf TRENCHES: MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL NO. DI LEi✓AT DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEV.: ELEV. . DIA.. ELEV. .. PIPES. DIA.: ION i4NCJ INI`F- P�.R,IITII�I HOLE SI HOLE SPACING. DRILLED CORRECTLY. COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO APPROVED PLANS: ❑ DYES E NO YES ONO (�` PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: C, „ � FEET FROIV� LINE: .�� ❑YES ❑NO ❑YES ❑NO NEAREST 7. SZ L`7`� Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE: TITLE: DILHR SBD 6710 (R. 01/82) Zoning Administrator SANITARY PERMIT APPLICATION COUNTY � OILHR In accord with ILHR 83.05, Wis. Adm. Code I STATE SANITARY PERMIT # —Attach complete plans (to the county copy only) for the system, on paper not less than STATE PLAN I.D. NUMBER 8% x 11 inches in size. —See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION — PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑ YES VNO PROPERT OWNER PROPERTY LOCATION t4 N C , it � F% ' /a,S T3 N,R /P E( PROPERTY OWNE A IN D RES LOT MBER BLOCK NUMBER SUBDIVISION NAME 6 a e2 R ITY, TATE . ZIP CODE PHONE NUMBER CITY ST ROAJ1 LAKE,014 LAN MARK ,le 5� a ❑ VILLAGE . TOWN OF 11. TYPE OF UILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family OR ❑ Public (Specify): III. PURPOSE OF APPLICATION: (Check only one in ##1. Check ## 2,3 or 4, if applicable) 1. a. ® New b. ❑ Replacement c. ❑ Replacement of d. ❑ Reconnection of e. ❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. A Sanitary Permit was previously issued. Permit## 9616 s Date Issued g 3 3.M An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner /building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in ##1 and only one in ##2) 1. a. ® Conventional b. ❑ Alternative c. ❑ Experimental 2. a. ❑ System- b. ❑ Holding c. ❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In -Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check o ne) 1. a. 9Seepage Bed b. ❑ Seepage Trench C. ❑ See a e Pit l FX5/d 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY: (Mi nutes per inch): REQUIRED (Square Feet): PROPOSED ((Square Feet): C/� 0 � c1 0�0 � • � C Feet IR Private ❑ Joint ❑ Public VI. TANK CAPACITY ## of Prefab. Site Fiber- in allons Total Manufacturer's Name Con- Steel Plastic Exper. INFORMATION New xisting Gallons Tanks Concrete glass App. Tanks Tanks structed Septic Tank or Holding Tank ❑ ❑ Lift Pump Tank/Siphon Chamber ❑ ❑ ❑ El I VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plum per's Name (Print): Plu Signature: (No Stamps) MP /MPRSW No.: Business Phone Number: ham, s A "n - 3 a 3 / Ya k Plumber's A dress ( reet, City, St te, Zip Code • Nam esigner: r VIII. SOIL TEST INF014MATION Certifi I Tester (CST) Na a CST # A CST's ADDRESS (Street, City, State, Z Code) Phone Number: IX. COUNTY /DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater I Date Issuing Agent Signature (No Stamps) rcharge Fee Approved ❑ Owner Given Initial °� \ ` Q ` , y _ Q� 1 Adverse Determi c7► V `� [ �1 lv TdI X. COMMENTS /REASONS FOR DISAPPROVAL: lo SBD -6398 (formerly Plb -67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber r • 0 �"r� over tic �e y 'e�r Q S,kP loop qq �. e�"t�c 5 a 63 �a �o f 8/ky6' gl v DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, C DIVISION LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS (H63.09(1) &Chapter 145.045) LOCATION: SECTION: OWNSHIP UNICIPALITY: OT NO.: BLK. NO.: S DIVISION NAME: /S�'�/ /T? 1 N/R /q E ( rl W V - S �l V -- COUNTY: , OW ER'S BUYER'S AME: MAILING ADDRESS 6 �� USE DATES OBSERVATIONS MADE ff�� NO. BED .: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: R OLATION TESTS: YvResidence j New ❑Replace <?v• —P 7 l RATING: S= Site suitable for system U= Site unsuitable for syst �r r ONVENTIONAL: MOUND: IN- GROUND - PRESSURE: SYSTEM- IN- FILLHOLDING TANK: R YSTEM:(optio7l) JS DU &S DU ®S ❑U �S QU DS NJ VOhIf If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5)(b), indicate: S'S / I Floodplain, indicat Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER- INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 1,d �,6 F617 5 /* IL B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL - INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL -MIN. PERIOD 1 PER PERIOD 3 PER INCH v l P- .5 P- s 7 J 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 aka �, 3 o• �j tN F E E I a C , Alqo z F DEPARTMENT OF INDUSTRY INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. 60X.7969 BUREAU OF PLUMBING MADISOft wI 5�d,IF31N -R19W E1x �`�, Town of Somerset ONVENTIONAL 1:1 ALTERNATIVE State Plan l.D. Number (If El Tank El In- Ground Pressure ❑Mound assigned) Grace Development 10;M F PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: S Y, 2t ray Edgett 6692 Sandlewood Road, Woodbury, MN 55125 BENCH MARK (Permanent reference point! DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.: Name of Plumber: 7_ 7SWN'County: Sanitary Permit Number homas A. Wang 231 St. Croix 99025 SEPTIC TANK /HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: I OYES ONO DYES ONO BEDDING: VENT DIA. I VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL BUILDING: VENT TO FRESH ALARM: FEET FROM LINE: LAIR INLET: DYES ONO DYES LINO NEAREST' DOSING CHAMBER: MANUFACTURER 7ING, LIQUID CAPACITY PUMP MODEL. J PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: S NO ❑YES ONO DYES ONO GALLONS PER CYCLE: P UMP AND CONTROLS OPERATIONAL: NUMBER OF ': PROPERTY WELL. BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) OYES ONO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGTH J DIAMETLR MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH. LENGTH. NO. OF DISTR. PIPE SPACING: COVER J INSIDI CIA.. #PITS: LIQUID ,RED /TRENCH TRENCHES. MATERIAL: PIT DEPTH: DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PIPF DISTR. PIPE DISTR. PIPE MATERIAL. NO. DISTR NUMBER'. OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES. ABOVE COVER ELEV. INLET ELEV. END. PIPES FEET FROM LINE: AIR INLET: NEAREST MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- El YES NO meets the criteria for medium sand. TIONS MEASURED. ❑ SOIL COVER I TEXTURE PERMANENT MARKERS: OBSERVATION WELLS ❑YES ONO DYES ❑NO LENTE. TH OVER TRENCH /BED DEPTH OVER TRENCH /BED :=OF TOPSOIL SODDED. SEEDED. MULCHED. : E DGES'. ❑YES El NO ❑YES 1:1 NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH LENGTH: NO. OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPF FILL DEPTH ABOVE COVER: BED /TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR, PIPE MANIFOLD MATE7PIPES) O. ISTR. fSTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEVATION AND '. ELEV.'. ELEV.'. DIA. ELEV.: : A.: 04STRISIUTION ! INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS. El YES ONO OYES El NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEE # FROM LINE: DYES 1:1 NO DYES ❑NO NEAREST Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE'. TITLE: Zoning Administrator DILHR SBD 6710 (R. 01/82) QILHR S ANITARY PERMIT APPLICATION C'� ?' C �� In accord with ILHR 83.05, Wis. Adm. Code STATE SANITARY PERMIT #/ 9gdas -Attach complete plans (to the county copy only) for the system, on paper not less than STATE PLAN I.D. NUMBER 8% x 11 inches in size. -See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION FOR VARIANCE ❑ YES NO PROPERTY OWNER— PROPERTY LOCATION Go- iPq r6q& & % .3jF %, S A T , N, R 1 E (o W PROPERTY hEFJ l l b f�DR��S a d bu LOT NUMBER BLOCK NUMBER SU * IVISION AM I CITY, ATE ZIP CODE PHONE f#JMBER TT CITY NEAREST ROA AK R LANDMARK VILLAGE: �Q e . ' er TOWN OF II. TYPE O BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family OR 1 Public (Specify): 111. PURPOSE OF APPLICATION: (Check only one in ##1. Check ## 2,3 or 4, if applicable) 1. a. 9 New b. ❑ Replacement c. ❑ Replacement of d. ❑ Reconnection of e. ❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit ## Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner /building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in ##1 and only one in ##2) 1. a. RQonventional b. ❑ Alternative c. ❑ Experimental 2. a. ❑ System- b. ❑ Holding c. ❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In -Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) ^S, /�,/,��,r 1. a. ❑ Seepage Bed b. seepage Trench-3 c. ❑ See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM Q LEVATION 6. WATER SUPPLY: Minutes per inch): REQUIRED (Square Feet) : PROPOSED (Square Feet): � �SS ` Wo AL, Feet N Private ❑ Joint ❑ Public VI. TANK CAPACITY Site in g allons otal ## of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank D Z !CC`Q ❑ Lift Pump Tank/Siphon Chamber ❑ ❑ ❑ VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name (Print): PI b 's Signature: (No Stamps) MP /MPRSW No.: Business Phone Number: *a � �,b hi � lumber's Addr ss (Street, City, State Code ✓ N ame o esigner: e ` s � Qaa V II. SOIL TEST INFORMATION Certifies Soil Tester (CST) Name � CST ##�� CST's ADDRE (Street, City, ( State, Zip Code)1. Phone Number: re �� Id IX. COUNTY /DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature (No Stamps) ISA I Approved F Owner Given Initial � /� V U ' o � � ur Fee GNU Adverse Determination / X. COMMENTS /REASONS FOR DISAPPROVAL: SBD -6398 (formerly Plb -67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner /contractor, ( "spec house "), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of Property Location of Property 1 % �� �, Section , T_22 N - R�_ W Township Mailing Address �� S aI7 (�J d i aof O Address of Site Subdivision Name raz c c e o Le e Lot Number 1 � Previous Owner of Property Total Size of Parcel Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume and Page Number as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING A Warrantq Deed which includes a Document number volume and page number and the Seal of the Register of Deeds In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. _ DOCUMENT N STATE BAR OF WISCONSIN MW 11 -1982 THIS SPACE RESERVED FOR RECORDING DATA LAND CONTRACT !� Q� (T Individual and Corporate 4253 Vt*� b 5,000IS USED AND IN OTHER NON - CONSUMER ' ACT TRANSACTIONS) REGISTERS OFFICE Contract, by and betwee Ronald R. Werth and ST. CROIX CO.,, WIS Donna M. Werth, husband and wife Wd. iior Rtsloolyd 9* 7t ( "Vendor ", y Of May whether one or more) and Gary C. Edgett and Marilyn J. Edgett. - - �•.�..... A.D. I�Q li9 husband and wife, as marital gxQgerty with rights 8:30 kAL of (" Purchaser ", whether one or more). Vendor sells and agrees to convey to Purchaser, upon the prompt and full per- ^LX`h - r_ d ft � formance of this contract by Purchaser, the following property, together with the rents, profits, fixtures and other appurtenant Interests (oil called the "Property "), In St. Croix County, State of Wisconsin: RETURN TO Tax Parcel No. Part of the NE of the SEA of Section 6 -31 -19 described as follows; Commencing at the NE corner of said Section 6; thence S 5 W on the E line of said Section 6, 1165.52 feet; thence S 88 FJ 1384.29 feet; thence S 5 W 1061.54 feet; thence 88 E 672.39 feet; thence S 27 29'10" E 215.22 feet; thence S 24 L 240.16 feet to Place of Beginning; thence S 24 E 98.92 feet; thence S 59 W 690.41 feet; thence S 89 W 335.0 feet, more or less to the W line of said NEk of SEk; thence N on said W line 417.0 feet more or less to a point S 88 W from the Place of Beginning; thence N 88 21' E 890.0 feet, more or less, to the Place of Beginning. TOGETHER WITH road easement and SUBJECT TO conditions as shownin Volume 517, page 595. T M This is not homestead property. or &rw (is) (is not) Purchaser agrees to purchase the Property and to pay to Vendor at a designated place CXAKA the sum of S 16 900.00 in the following manner: (a) $ 2.6 85. 00 at the execution of this Contract; and (b) the balance of $ 14, 215.00 ,together with Interest from date hereof on the balance outstanding from time to time at the rate of ten (10) p er cent per annum until paid in full, as follows: Monthly payments of not less than $150.00 °to be app1ied''firsr "'°"� then to principal, with the entire principal balance due and payable three (3) years from the date of closing; buyer may prepay the land contract in any amount at my time without penalty. Provided, however, the entire outstanding balance shall be paid In full on or before the 4th day of May , 19 90 ( the maturity date). Following any default In payment, Interest shall accrue at the rate of 1 0 % per annum on the entire amount in default (which shall Include, without limitation, delinquent Interest and, upon acceleration or maturity, the entire principal balance). Purchaser, unless excused by Vendor, agrees to pay monthly to Vendor amounts sufficient to pay reasonably antici- pated annual taxes, special assessments, fire and required Insurance premiums when due. To the extent received by Vendor, Vendor agrees to apply payments to these obligations when due. Such amounts received by the Vendor for payment of taxes, assessments and Insurance will be deposited Into an escrow fund or trustee account, but shall not bear Interest unless otherwise required by law. Payments shall be applied first to Interest on the unpaid balance at the rate specified nd than to prin 1 al. Any amount may be prepaid without premium or fee upon principal at any time after May , 19 —(OR) (OR) fhaMaprX kW*ft*P1dw h=Ilgteicsade d=:lokytWKhM In the event of any prepayment, this contract shall not be treated as In default with respect to payment so Iona as the unpaid balance of principal, and Interest (and In such case accruing Interest from month to month shall be treated as unpaid principal) is less than the amount that said Indebtedness would have been had the monthly payments been made as first specified above; provided that monthly payments shall be countinued In the event of credit of any proceeds of Insurance or condemnation, the condemned premises being thereafter excluded herefrom. H z N STC - 105 r a y SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z d OWNER /BUYER 1r �''� _{ ROUTE /BOX NUMBER X91-1 �� ��° (� ��. Fire Number CITY /STATE u�� !� J �v ZIP 5519f PROPERTY LOCATION: /V Section Vj , T 3 ( N, R W, Town of 56/x'( er Se St. Croix County, Subdivis ion � / PIfP 61 ',oke4 Lot number. Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper What you put into f the system can affect the function of the septic tank as a treat- ment 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 systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on -site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. 0 E I /WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x H the standards set forth, herein, as set by the Wisconsin Depart - v ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 day of the three year expiration date. r SIGNED DATE St. Croix County Zoning Office P.O. Box 98- Hammond, WI 54015 715- 796 -2239 or 715 - 425 -8363 Sign, date and return to above address. DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY &BUILDINGS IN4USTR�:, C DIVISION BOX 76 HOMAN RELATIONS PERCOLATION TESTS (115) MADISON WI 537 9 53707 (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP LOT NO.: BLK. NO.: SUBDIVISION NAME: NE �� ,fE 1 /4 6 /T31 N/Itg i (or) W Somerset 1 11 n/a I Grace Development COUNTY: §ft1tRFtM BUYER'S NAME: MAILING ADDRESS: St. Croix(, Ed ett 1 6692 Sandlewood Rd. Woodbury, Minn. 55125 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMME CIAL DESCRIPTION: IPRO I RIPTIONS: P TESTS: Residence 3 n�a ®New ❑Replace I� D — � n RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN- GROUND PRESSURE: SYSTEM- IN- FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) ❑x S IA 1 12S ❑U x❑ S ❑U ❑ s ©U ❑ S 0U I conventional trench 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: Class 2 Floodplain, indicate Floodplain elevation: n /a decimal PROFILE DESCRIPTIONS 1 0m c2 BORING TOTAL D PTH TO GROUNDWATER- INCHES CHARACTER OF Soil WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTRM. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B -1 7.01 99.95 none >7.01 .67bl.1. 1.926.Sil. 1.08bn.s.1. .67r.s.1. 2.67bn.s.1. B -2 7,67 94.50 none >7.67 .50bl.1. 1.50bn.sil. 1.00bn.s.l. 4.67bn.l.s. B -3 1 7.08 92.54 none >7.08 .67bl.1. 2.08bn.sil. 4.33 bn.s.l. B -4 7.58 94.35 none >7.58 .50bl.1. 1.58bn.sil. 5.50 bn.l.s. B 7.42 90.45 none >7.42 .75bl.1. 3.00bn.sil. 3.67 bn.l.s. B- PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL - INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL -MIN. PERIOD 1 PERIOD 2 PE RIOD PER INCH P- P- P _ se eS gn rate P PLOT PLAN: Show locations of percolation tests, soil borings and the dinliensio a61 e` I'areas.'Iri licate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the (plot h S w the surface elevation at all borings and the direction and percent of land slope. upper trench =90.0--- SYSTEM ELEVATION lower trench = 89.04 tAn) i r� ►no 4. � N hz �� f 21 !�. -__ l p. E E N I _ _ _ r _.-_.. C" C.D�Nr Ste �, J t pa, � "r over Pic y "Pe►�. �o3y top 6 sleet P��O� tol MArkeraht r 33t 1 fib` $m >ao` N,E A r,2 Olt o' b'y pro has e� ` $A.e - .��5 �o ` 8 �� ST. CROIX COUNTY ZONING D1tL�FV'` AS BUILT SANITARY QAt Owner Property Address=' - ?SO , . City /State sr' 1�.. t �; "'�; ; Legal Description: Lot p-• Block — Subdivision/CSM # %,' /,, Sec. � TN -R,/ Town of r✓ -5,,gz -LP-4a Q, PIN # O 0 SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer Op-ef " - Sze ST/PC / Setback from: House t Well O P2 Pump manufacturer Model' Alarm location (HOLDING TANKS ONLY) Setbacks: Service roa Vent to fresh air intake Water Meter location _ -- Alarm location SOIL ABSORPTION SYSTEM Type of system: Width 3 Length � Number of Trenches Setback from: House la' Well Ji P/L � Vent to fresh air intake 16r ELEVATIONS Description of benchmark Elevation Description of alternate benchmark Elevation sT Building Sewer _ ST/HT Inlet ST Outlet PF Inlet Header/Manifold 2 2 Top of ST/PC Manhole Cover Distribution Lines /off• Bottom of System Final Grade Date of installatiomeg // er t umber -5 /� ;OZ State plan number Plumber's signature License number Dat Inspector Complete plot plan Q Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count y- Safety and Buildings Division INSPECTION REPORT ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitar y324606• Personal information you provice may be used for secondary purposes [Privacy L , s.15.04 (1)(m)). ,pyre " MIRE S f,'1' Town of: State Plan ID No.: CST BM Nov.: Insp. BM Elev.: BM Description:"fC 1;I Parcel T ��3�- 1017 -60 -000 1 TANK INFORMATION ELEVATION DATA A9800495 ie�116 8' TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ���;� c !/� Benchmark �, O� /G6� ee) r Dosi ng x J i<; r > N�. ' S ,.. a i _ /s 3' s \ /G5, 07 Aeration Bldg. Sewer Holding St /�ft Inlet TANK SET13ACK INFORMATION St / I K Outlet `s L /�oz 3`/ i ntake TANKTO P/i WELL BLDG. Air to ROAD Dt Inlet ir Septic y 15D - �O /S ' J4 NA Dt Bottom Dosing eadeN- ^ �� / g �. > g �?� ZS i9,o3 �� 9.17 Aeration A Dist. Pipe - -- Holdrng Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demander Model Number M ,, el_---" 3,?� /6, 92 TDH Li Friction System TD oss ea 7 Fo emain I Length Dia. Fi Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width I Length No. Of enches No. Of Pits Inside Dia. Liquid Depth D IMENSIONS 3 DIMEN I SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHIN acturer: SETBACK INFORMATION Type Of e �S i CHA R Mode Number: System: �yQ.. (C5 /Sd OR UNIT DISTRIBUTION SYSTEM Header/ Header/Maaq= Distribution Pipe(s) x Hole Size x Hole Spacing Intake Length 1 Dia. Length Dia. Spacing " SOIL COVER x Pressure Systems Only xx Mound Or At -Grade tems Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed/ Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.), /z LOCATION: SOMERSET 6.31.19.86F,NE,SE 2350 DELONG ROAD - r l r , Plan revision required? ❑ Yes [!]"No Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signatif Cert No. SANITARY PERMIT APPLICATION Saf E Washington dDe Division Wisconsin I P.O. Box 7969 Department of Commerce accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 81/2 x 11 inches in size. 0— "D - ) II)k, • See reverse side for instructions for completing this application State Sanitary Permit Number The information you provide may be used by other government agency programs ❑ Check it revis. to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INF RMATI N - P& E PRINT ALL INFORMATION Property Owner Name KL perty Loge)W $ T„� I , N R 1 / E (O �- �,�, 4 Propert Owner's Addrg� � ber Block Number City., State p Code Phone Number Subdivision Name or CSM Number .SAP a l_ t-cJ/ II. E F B IL IN : (check one) ❑ State Owned ❑ it are r ad ❑ village i S D Public 1 or 2 Famil Dwellin - No. of bedrooms Town OF III BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) J 1 ❑ Apartment/ Condo `� " �� F ✓ < ���+ �� 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. LTfteplacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an Sntem - _______System Tank Only______________ Existing System - --------- Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) � r �� ✓w p � i �ivj �,. 9 3/k y Non - Pressurized Distribution Pressurized Distribution Experimental Other cAa 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12- 06eepage Trench 22 ❑ In- Ground Pressure s X 43 ❑ Pit Privy 13 [1 Seepage Pit ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 7. Gallons Per Day 2. Absorp_ Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 1 7. Final Grade V T Require (s ) Propo se (r. ft.) (Gals/d y /sq. ft.) (Min. /inch) EI vation �f Feet g- Feet VII. TANK Capacity in gallons Total # Of Prefab. Site Fiber- Plastic Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass App. New Exist in strutted T nks Tanks i g a ",06 ,:W Z � ® ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ 1 ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Prin Plumber's ig ture: (No S s) MP /MPRSW No.: Business Phone Number: r1_1 j -0" 1 ;2 7 64 Plumber's �ess ($tree, State, tip Code): IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater D ate Issued IssuincLAgent Signature (No Stamps) Surcharge Fee) Approved [:]Owner Given Initial I S(O 071 / q p, ' Adverse Determination fill !U X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: Do' Pieces r.61 LAW-4 A .a rm{ ewP*wl • °--! fl1l DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber PLOT PLAN PROJECT Mike Biedrzvcki ADDRESS 2350 Delona Rd Osceola Wi 54020 14,1 1 / 4 AW / 4 S 6 /T 31 /R 19 W TOWN N. Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 - DATE 10/11/98 BEDROOM 6 CONVENTIONAL )00( IN- OUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1200/800 LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .8 ABSORPTION AREA 1144 # of chambers 36 BENCHMARK V.R.P. Top of Nail in Tree ASSUME ELEVATION 100' ❑ BOREHOLE O WELL sH.R.P. same as Benchmark SYSTEM ELEVATION 94.3 Alt. BM Base of Walkout @ 105.0 Delon Road >12„ DGrad dewinder High of Cover pacity Leaching amber with 31.8 2 per chamber 6' Long 1e at System levation CD 400' Well l 18' Existing 6 Bedroom 45' House Alt. 50' 60' 15' Existing 1200 Weeks 800 T Gallon septic Property Line Gallon Tank T tank Failed System appears to be 12' X 72' 100' 80' Vent B -3 3 -34" X 77' Trenches Above ground 6 Spacing effluent found Between Vents near end of Trenches system B -1 4010 - Slope 15 B. M. Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in e r►a # 1 \'� County ►+ISt -- include, but not limited to: vertical and horizontal reference point (B ' action and percent slope, scale or dimensions, north arrow, and location and i9ta ce $5a Parcel I.D. # 1017 �a APPLICANT INFORMATION - Please print all inftio�,�� e i 'Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy haw, s. 15.04 (1) (m)). 1 Property Owner dy cation ' GoOkot 114 /4,S T N,R E (or Property Owner's Mailing Address Lot # Block Subd. Name or CSM# City State Zip Code Phone Number ❑ City ❑ Village ® Town Ne rest ad fj ❑ New Construction Use: Residential / Number of bedrooms Addition to existing building :ba ❑ Public or commercial - Describe: Code derived daily flow D 0 �ppd Recommended design loading rate . 7 bed, gpd /ft ° v _ trench, gpd /f1 Absorption area requires �eYi3_bed, ft 2 J �'�C_Z_ t rench, ft Maximum design loading rate 7 bed, gpd /ft , O trench, gpd/ft Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design /site considerations Se— Parent material Flood plain elevation, if applicable l✓ J ft IU S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank = unsuitable for system � S S ❑ u 49s ❑ u ,i ❑ U I X-S ❑ U I ❑ S u ❑ S .liku SOIL DESCRIPTION REPORT Boring FHohzon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 g in. Munsell ou. Sz. Cont. Color Gr. Sz. Sh. /� Bed ,Trench U5 Ground elev. / Depth to limiting factor Oin. Remarks: sa,t��G' �occ�r�r� 3���n • o�dl/.7 ��� �_�� Boring # r � 3 -1 r J�� 7 Ground elev. 1 2 Depth to limiting factor - 0 . Remarks: CST Name (Please Print) Sig tur Telephone No. s1 15- 6 - 7 Address Date CST Number, rJ vC i 1 Soil Test Plot Plan Project Name Mike and Julie Biedrzycki Shaun Address 2350 Delong Rd Osceola Wi 54020 M #226900 Lot 'r Subdivision Date 1 /(). Ah4 1/4S T 31 N /R W Township N. Somerset Boring ()Well PL Property Line County ST. CROIX IL BM or VRP Assume Elevation 100 ft. Top of Nail with Orange Ribbon in Tree System Elevation 94.3 * H R P Same as Bench Alt. BM Base of Walkout @ 105.0 Delong Road d 400' Well 10' • 8 ' Existing 6 Bedroom 45' House Alt. 50' 60' NR 15' Existing 1200 Property Line T tank septic k Z I Failed System appears to be 12'X72' 100' ]Vent B -3 \ Above ground effluent found 5 , near end of system B -1 40' 40' B -2 10% J - Slope 15' J*j&m. ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the j -, G residence located at: 0� +, 5 ;, Secti n ,� , T3,/ N, R / W, Town of &VW- l dy t' Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced: Did flow back occur,from absorption system? Yes X No (If no, skip next line) Approximate volume or length of time: gallons minutes Capacity: Construction: Prefab Concrete Steel Other Manufacturer: (If known): Age of Tank (If known).: (Signature) Name) Please print (T'ltle) (License Number) Date Form to be completed by licensed plumber (s.145.06, Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements of ILHR 83, Wis. dm. Code (except for inspection opening over o baffle). Name ��� u ��� j�� /% Signature ��� MP /MPRS �� v ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNE CERTIFICATIONN FORM Owner /Buyer Mailing Address Property Address e:2 all' 6.C�10 (Verification required from Planning Department for new construction) City /State ° �j / Gc. 3a l �/ Parcel Identification Numbe LE GAL DESCRIPTION Property Location �L � /4 '/4, Sec. b , T -R 4 , Town of �/ D Subdivision , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # e� 9 , Volume � , Page # _. Spec house ❑ yet>z no Lot lines identifiable �iLyes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed