HomeMy WebLinkAbout008-1017-90-200 (2),S/. Croix County Planning and Zoning
Detail Sanitarv Inlormation
ll'ednesda1,, blarch 28, 2007 at 3:06:21 PllI
Page I of I
Computer #:
Parcel #:
Municipality:
008-1 01 7-90-200
06.28.16.89C
Eau Galle, Town of
Notes
lssuer/lnsoector
Not determined
Jim Thompson
Maintenance
Scheduled Pumo
6t28t2003
5t23t2009
Sub/Plat:
Lot:
GSM:
NA
2
Vol. 09 P9.2662
Section:
TN/RNG
114',ll4:
Othqr Bequiremettts
2nd Notification 3rd Notiflcation
Wl Fund:
Additional Notes
Checked location of POWTS as northerly duplex
1200 gal. Midewest septic tank to 12' x 60' bed.
6
T28N R16W
NE 1/4 SE 1/4
Owner: Vandermeer, Melvin 2165 - 2167 55th Avenue Baldwin, Wl 54002
State Permit: 199835 lssued: 09/13/1993 POWTS Dispersal: Non-Pressurized ln-ground
County Permit: 0 lnstalled: 0612211994 POWTS Detail: Bed - Seepage
POWTS Pretreatment: NA
Permit: New
Bedrooms: 3
As Built
Yes
Signecl Off: Yes
Plumber
Hudson, Dale
1st Notification
04t20t2006
Money Owed
$0.00
Date Pumped
5t23t2006
PROPERTYCITJNER.S./?z 3 AOORESS BLOCK Tt//
PHONE NIJITEERCITY.
,tfLL,42
ztP cooE ocDrZa ov/N
,e
in accord with ILHR g3.05. iMs. Adm.Code
COUNTY
PARCELI.D. '
C-o,
::not to
dmeosioned
APPLICANTIN FO R UATIO N.i'I.EASC.P RINT ALL INFONiUATiON
.Plan must indude. tx,rt
o[ slope. scale or
PNOPERTYLOCATION
GCnn LOT
REI/IEWEO BY OATE ..
ul5C; r 2g .N.R [(o)w
SUBO. HAIIE OR CSM I
NEAREST ROAO6
u1
LOT I
M Ne', corcfiucfon u* P( ReddenEd / Number of bedroons
ItRefficernent llpubl"corcsnmercialdescribe
Code derived daity frorr 6(X) gN
Abeorption area requir ed S<zs 1;;6,92 5 OC f ench, ft2
Hecornmended lnfilfadon surface elevatioo(s)
Additboal desQn / si te considerators
Parent rnaterial u
Reconnnendeddeslgntoading rate . 2/ bd.,g4/#.,5 trenCi. 96r#
,ffi* design bading rae , I bnd. gpd/tP_. 5_berch. gd:le
tt (as referred to site flan berrfrmark)
Flood plain elevation. i[ @icable ft
H(X_ollrc TAl0(DS EU
SOIL DESCRIPTION REPORT
Boring #
Ground
elerr-
/o51ffitL
Deph to
Imiting
tactor
25,,
Borlng #
GPO/fr
Trerrf
5
5
,4
Remarkb
2m 5 6
LL{
,'l/V?9 It)Ground
elenr.
/o'/,lzn.
Oepth lo
tmiting
laclu tt3.{ '
Remarks
r
S = SuitaHe kr s!6tem
U = UrsuitaHe kf system
cot{1/El{TloN.Attrs ,Eu Jrs Du
tJcL$t0 NGrcWOPRESSJREtrs Elu os tsu
ATCR^OE SYSTBI H FLLDS EU
Horizon Depth
in.
Dominant Cotor
Munsell
trrloSes
Ar. Sr Cont Cdor Texture Structure
Gr. Sz. Sh.Corsistence Borday Roob
Bed
/o-Z{/oyR-il //,t,s) I tj,,2cs/4 m(fr Cuo Zf.,L z5-f3 avR ql-sc/z{r/{n{r C,'2T .1
3 fi-79 az$2 ,a/
c L6/ sYf ls
5/r^q.m/{.NA .5TV
/0-L /v/St /Zrni/{{./
ilA >l 7 r.,n4n
e 1,0
CD 5
3.'
234
czd sy*2 csl(
sl{
rn{NA
L
3
/
t",/c
Si;netur: t------\/r--lrr/"-{_'.
{
/\
'- 26-q3 ?
CST Nune:-Ptcasc prht Dqh-Phonc:
lddress:75'Cfu-ss78
17
0ate:CSI Numbor
v.t I 1
U
t{o Deptlr Domlnant Cotor
in. --: Munselltffi
Ground
elar.
,/o3,lzn.
Deph to
Imiting
t*lor us6
:
Remarkb:
:.G
''Bed Trc<':5 a,(
4a
L
,_
Motfles' Ou. Sz. ConL Color
Texture Structure
Gr. Sz. Str-Cors'stence Bordary
:"/!.<_. ' -
Roots
/rL ./QvR $v--_,-_ A/4 si/.2'm *LX'DVfl Qt)2 ,rt
Z 2-U -zqlxrT ilrl '. _rc
s;/e Qr 2 c;l:#,'/nv{-'C LJ 2f ,5_
3 s4-7?10YR /e cz/ sark U
-s. /2 r 'l'(n{,/uA "/1/n
Boring #
H'-,-Uffi€
aa \-l;t vl
L1se#.$
Ground
elsr
ft
Deph to
limiting
taclor
.:
Remarkb:
Boring f
t:#s
l,*
-*-ri
Ii"-**!.i
Ground
elc/.
fL
Deph to
limiting
tactor
Boring fl
Ground
ekr.
fr
Deph to
tmiting
tactor
Remarkb:
--Remarks:
Boring f
i'7..Y.$ii:{.:-:(.!
iil HiX l:*i$ t+
+l{:I!$ffiAii*FY. - .'...11a.r.a-aa
I
.l
I
nl -
COUNTY
S/. Cro;*
APPLICANT INFO R UATIO N-P LEASE PR tNT ATL INFO N U EriON
PARCELt.0. t
REVIEWEO BY
,oy suBo. t{rJ-{E oR ou, y'r/
PNOPERTYLOCATION
@w. tot pf vt S y' w,s f, T Zt ,N,R /L fl (clw
OATE
NEffiEST ROADttaL Ave,
Hq_o[.tc TANKn's Au
GPD/ft
Bed Trerrt
-2 2t)
.3
g
-7 ,9
s+,Ll- J
Z/T)-3
,1 ,8
}{ N* ComEucfon
I I Replacement
Code derived daity forrl 2O-gX
Absorption area required _ bed. ft2_ trench, fP
U*p{ Residential / Number of bedrooms /
I I Pubficor comrnercial describe
Reornrnended lnfilEation surface elevaUon(s) tt (as referred to site flan berdrmark)
Additiooal des(1n / site consideraliors
Parent material Flood plain elevation. if apflizbk
SOIL DESCRIPTION REPORT
Boring f
Reconnnended design loading rate '7 bed ,g*rte-' 8 rench. g$/fp
' l,laxirnum desQn bading rale - 7 k:d.gpdt* ._$_Eerdr. gtr/tP
ft
V t^)
Ground
elev.
/o. Z,tn-
Deph to
limitirg
Borlng #
Gtound
elev.
/03,ln.
Oepth to
tmiting
f$r"
:
f Remarks:
Remarks:
o 4 t
,/E
PROPERTYOIJNER
f r,r1
I
ESS
t),t (7/5t 6 3803
ATETY.CI ST
I cl
PHONE NUI/BER
PROPE RTY OI/NE R.S [,!{ILI NG
ZIP COOEf rr'oo
4L
ocnY Dfa
BLOCK T
VILI-AGE
S = SultaHe for srslem
U = UrsuitaHe hi system
cofift/Ef.tTtoitALEs Du Es tru
trcu{D NCrcLNOPRESSJRE.[!s ou ATCTRAOEEs uu SYSTBT
DS
N FLLEu
Horizon Depth
in.
Dominant Color
Munsell
tuloUes
Al Se ConL Cdor Texture Structure
Gr. Sz. Sh.CorsisEnce Bqrda/RooE
I D'3 /oYR //s -fune S,'/1-q,/ns[K rY)S.C t^,t sf
z_3-27 /o y,< v/y ;.1{ Sr / ctl{m {n a5 CM Z
2)n-3q 76Yf lh
ilont
/Vone C -1 -':f OC C.;C{,7
4 37 -5{7,5 None (ei o C Sq
IJ
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s8-8L //on(Ci-*'
aoCSq mer{rw7,f o
a'3
:fua-
tr'/rO,,/ rrl s,V
zJw,Lc sl(
m {f Cto
C r^r*{',.z3 -24
ZL-85 c5
v n/-u-oc s3
?
.,L
tu,
/0 't/<
7,5 yR ,t
/o YR r/s
/Vo
CST Nrnrc:-Pleasc Prhr -> O /e f ilut'o Phonc 7/r-6?4- 33 7s
S[netr.rr:C
)\
?- /?-
rddress: IZO p?*sqb
0ate CSI Numbor:3+t?-v
I
L.
,g
ffi,rt:tf*.T$
$ zjt
!-:F,I;"S'i'ii
sod o.,/,'c
e
/1/o n e
..:Sfuclute'Gr. Sz. Sh.
uflt-
R
oepth Oominanl Color
---'. Muns6ti 'SzCont
Yoq.6 C&(Texiure':'- in;..I Ou:
SF
Grfirif
elet./o/i4LrL
DAhb
Ini6q
.8
.8
laclo. ^)_2{,
Bod(E I 33Z
.r/4/,3
-8
.g
Oe0h b
I(l!tng
. l&b() to9"
Borino fl -
Ground
elEJ.t
Deph to
IdIlE
t*to(
Boling f
Gromd
dd-
fl-
5
!i;c
.,t.1
_2t{,l:i '!(
iAr
,1ay
"''z
3
e-1
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t-r/
I o-5 ,1OYR
7,5
l/oy.e s!// ,, SLK
Z 5-/?tU,ne sc/te./ crsLK
3 /r-L-t Notc /cs
t Nonz alc.<o
Bn 7,78
Remarks:
! Jilinsin Depar.trnent ol tndustry,r,abor ard Human Relations
Division of Safety & Buildings
SOIL AND SITE EVALUATION REPORT
in accord with ILHR 83.05, Wis. Adm. Code
Page _ of _
t'
COUNW
PARCEL I.D. #
REVIEWED BY DATE
PROPERTY OWNER:lnLlile-fi,nr PROPERTY LOCATION
GOW. LOT 114 1/4,S T ,N,R E(u)W
P ROPERTY OWNE R' :S [,tAl Ll NG ADD RESS LOT #BLOCK#SUBD. NAME OR CSM #
CIW, STATE ZIP CODE PHONE NUMBER()flcffY DvlLL,AGE E:l'owN NEAREST ROAD
Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must include, but
not limited to vertical and horizontal reference poirrt (BM), direction andT" of slope, scale or
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION-PLEASE PRINT ALL !NFORMATION
[ | New Corstrudion Use I I
ItReplacement ll
Residential/ Number of bedrmms
Public or commercial describe
I I Addition to existing building
Code derived daly flow
-
gpd Recornrnended design loading rate beO, gM2-fench, gp&1t2
Al6orption area rEuirec
-
uec, tz-ftndr, ft2 iihimum design loadirE rarte bed, gp<iln2---rench, gpdrlt2
RecomrEnded hfiltatioo surlace ela,ation(s) ft (as refered h site phn bendrmaft)
Add$onal design / site conside(atiorB
Parent material _Flood plain elevation, if applicable ft
S = Suitable for svstem
U = Unsuitable foi system
CONVENNONALtrs tru MCXJNODS trU
IN€ROUNO PRESSUREtrs nu AT€RADEDS DU
SYSTEII hI FIUtrs tru HOLDING TAr,lKtrS DU
Boring #
Ground
elev.
fL
Deph to
limiting
factor
SOIL DESCRIPTION REPORT
d UZA-^- JS
,z ,eE )(,,2 ' ),/z
A-ct -
Horizon Depth
in.
Dominant Color
Munsell
MoUes
Qu. Sz. Cont Color
Texture Structure
Gr. Sz. Sh.
Consistence Borday Roots G P D/ftz
Bed Trcrdr
I
:
.^
Initial:Date
PROPERTY OWNER SOIL DESCRIPTION REPORT Page _d
PARCEL II'.,
Boring #
M
Gound
elat.
fr
Deph b
limitins
,acbr
Remarks:
GP O/rtztuloUes
Ou. Sz. Cont Colo{
Texture Structure
Gr. Sz. Sh Corsistence Bo-rdry RoobHorizonDepth
in.
Oominant Color
Munsell Bed TrErdr
I
:
II
IIIIIII
III
III
Boring #
Grcurd
ft
Deph b
Imilinsffi(
elw
Soil pit locations
^IN
St. Croix County Planning and Zoning
Detail Sanitary lnfornration
Fridol,, Dccutht I l,2009 ot l:1S:JSPilI
Page I o! I
Computer f:
Parcel #:
Municipality:
Owner: Vandermeer, Melvin H.&Doona2165-2167 55th A\,/enue Baldwin. Wl 54002
State Permit 199835 lssued: 09/13n993 POWTS Dispersal: Non-Pressurized ln{round
County Permit: 0 lnstalledi Odl22l19e4 POWTS Detall: Bed - Seepage
POWTS Pretreatment: NA
008-1018-10-500
06.28.16.90840
Eau Galle. Town of
Sub/Plat: NA
Lot: 2
CSM: Vol.21 Pg. 5244
Section:
TN/RNG:
1l41l4i
6
T28N R16W
NE t/4 SE 1/4
Permit: New
Bedrooms:3
lssuer/lnsoector
Not determined
Jim Thompson
As Built
Yes
Signed Oil: Yes
Plumber
Hudson, Dale
Other Reouirements
Wl Fund:
Additional Notes
Checked location of POWTS as northedy duplex.
1200 gal. Midewesl septic tank to 12'x 60'bed.
Fka lot 2 ol CSM 9/2662 #008-1017-90-200/.89C
N4onev Owed
$0.00
Maiilerlanca
Scheduled Pumo
6t28t2003
5t23t2009
9t14t2012
Date Pumped
5123t2006
9118t2009
Nolificatign
Notification
0d.120t2006
Parcel #: 008-1017-90-200 1210512005 01:51 PM
PAGE 1 OF 1
Alt. Parcel #:
Current X
Creation Date
06.28.16.89C
Historical Date Map #
00
SC = School SP = Special
Description
BALDWI N-WOODV! LLE AREA
WITC
pales Area Application #
OO8 - TOWN OF EAU GALLE
ST. CROIX COUNTY, WISCONSIN
Permit # Permit Type
0
Districts:
Type Dist #
sc 0231sP 1700
Tax Address:
MELVIN H & DONNA M VANDERMEER
1919 6OTH AVE
BALDWIN WI 54002
Owner(s); O=CurrentOwner, C=CurrentCo-Owner
O . VANDERMEER, MELVIN H & DONNA M
Property Address(es):
- 2165 55TH AVE
2167 55TH AVE
* = PrimoU
Plat: 2662-CSM 0912662
BlocUCondo Bldg: LOT 2
Tract(s): (Sec-Twn-Rng 40 114 160 1/4)
06.28N-16W NE SE
Legal Description: Acres:
SEC 6 T28N R16W PT NE SE BE]NG LOT 2 OF
csM 9/26621.52 ACRES 2165 &2167 55TH
AVE
Notes:
2OO5 SUMMARY BIII #:
1.520
Fair Market Value:
0
Parcel History:
Date Doc #
0712311997
0712311997
Vol/Page
1104t129
1 033/1 30
Assessed with:
Type
LC
Valuations:
Description
RESIDENTIAL
Class
G1
General Property
Woodland
General Property
Woodland
Last Changed:
Total State
154,600 NO
1111s12000
Reason
Totals for 2005:
Totals tor 2004:
Acres
1.520
1.520
0.000
1.520
0.000
Land
18,900
18,900
0
18,900
0
lmprove
135,700
135,700
135,700
154,600
0
154,600
0
Lottery Gredit: Ctaim count: 0 certification Date: o4l11t2oo1 Batch #: PRGRM
Specials:
User Special Code Category Amount
Total
Special Assessments
0.00
Special Gharges Delinquent Ghar-ges' 0-.00 0.00
:\ t L,lLl-lH
Fi- .aaD*!Fa.{Ld3rtft,\14
in accord with ILHR B3.OS. Wis. Adm. Code
60 fr/'le./,t,t st ,tU..
PROPERTYCM'NER
ADORESSPROPERTYC$'NER€qz3 ,m,
qTY. STATE
7/51(3,
zrP cooE PHOl.lE Mrl,,tsER "2#ffi
Ne{iy cofts[ucfon use IX Residen6d / Number of be<trooms
[ | Reptacernent t I PLtfrc or conrrnercjat d
Code derived daity lat €<T gfi
Absorplion area requted 5OO W,fi2 -*x> tench. fP
cb
Parent material /
Recomrnended lnfl Eation surface elaralioo(s)
Addrliooal desqn / site consideralims
S = Suitable for system
U = UrsuitaHe tci system
cofi{vEffIto$tLDs Eu lJou.{0
-Ers Du
r.{CMUNOPR€SSI.,REDs.Eu ATCRAOEDS ,NU
SfSTAN H FLLDs ^tsu
I
Atta_chcomPte te eite plln on P.per not tcsr than I ll2 x lt inchcs ln eizc. plan nxrsl inctudo. tx.rl
rlot finited lo verfcel end horizontat relercrrco pornl (8M). direclion ar.6.A ol slope, scale or
dme nsioned. norlh a(row. and &ccation and dstance lo nearosl road.
APPLICANT INFO RUATION-P LEAS E P RIHT A LL IN FO R M A TIO N
PROPERTYLOCATION
_9. c '.Y/'(2 I
@vr. LoT /.*- v15 T zt
'{.R
flIuu
PARCELI.O.,
REVIEWEO BY OATE
l"tI-ollrc TAr.tK!s ^&u
GPD/ft
Bed Trerd
g
toil-')<-.
Flood
SOIL DESCRIPTION REPORT
SUBO. HAIIE OR CSM,
NEAREST ROAD55&,4,
rench. gpfe
gtrrtP
fr
NLJ
5c;
"r7
.2
Ground
elw.t//.27 tt
.3
,J
I
.7 1,8
,Z 3
3
Deph to
Iofting
taclor /t3o'
RemarG
Bortng #
Ground
elw.
//oDa.
Depth lo
tmiling
lactor18"
Remarks:Arn e AS B-/
I
Horizo Depth
in.
Dominant Color
Munselt
tulodes
Qr. S. Cont Cdor Texture Structure
Gr. Sz. Sh.
Bqrday Roob
/o:o ,a,/o n e 5 2-, tL/.
CorsisEnce
CUJ Z
Z zo -3,/o 4 /\/ort e C Crr)/r
3 3o-3 /o C/
rT, S LK -Fn
,olf -Cu)Z
32-56 '/7,5 rf5 /r)/A c<)-75_Lrl /o YP ln6 m {.Z
o-8 tUo rl e rfS /Au)
8-5,1 C I LK ,n{.7,5 yfr
/
L /oyfl
/OYR t/4
CST Nerne:-Pleasc Prht ))a le- f , /Juo/to r-Phono
y'ddrcss.
?ZO 5/0oz-
-68 -s37 E
CSI Nurnbor
SQnetrx
/2a,'n o I ol ,,s,'D,,.
- /3- ?1 3
Boring f
n
Becornrnended 2 tli$fr.
Maximum
/oyR t/t /4V{rV
ezP 7,|Yft/z /.-r*lk
1 sg
.1l-
, z'ol r <yf{
ezrl-f@
i
I
'e v -Sa rtds
/{
0ate.
Boring f.l{orlzo
Goud*r.///: zofr,
Deprr b
td6ng-tu>_22
Eoring fl
Oeplh
in.
Oominanl.Color
Munsell
l/bt0es
Orr. &. Cor[ Cdor Texture Slruclure
Gr. Sz. Sh.Eo'lrJat1o"*l Rools
o-31 /ay<aA-il;ne cs */r/C t^)/1
Z .5 lR A/"rt.5q a,C/,,)3 '14-J1
(A)on€.2 Qr tS -So n lL
5
L L/
POtit/
8ed Trt<,
7 ,8
Remarkb tne asi B-
ffi
elal
Groqrd
-ltDeph to
Inft,rg
lacloa
Rem
IIrrIII
r
Boring flffiEa6ffi
Growd
elelf
-ltDeptt b
Inri6.{
Ho(
eleY
Boring I
_tt
Deptr lo
fai0ng
hclor
Groud IIII
Remarks:
3
t Au / t/""1.4ce,-r
=I=
BOLDT'S PLUMBING & HEATING, INC.
/"-t oL
820 MAIN STREET BALDWIN, WISCONSIN 54002
(715) 584-3378 FAx (715) 684-3144<r l{,Ave.
I
-70 >o
JB-N, ,roo,o'
Bt - //t,fl'
pz - // o.7 3'
Bs- //l,zo
No.
k)ell
o
D /-a r.)h- By ,
T"),.)"- 8- /Juolr,--
,Ll f' (;6, Lg
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,
, ' src 1od
AS BUTLT 8ANITARY 8YSTEM REPORT
owNna ,A4c- I lZ r.l.r4rer
ADDRESs Al1 I :;:ft,/ue-,
tit *-h),.
SUBDIVISION / CSU#2a a -) -//LoT #
sECTroN (, T Z? N-n- /l w, rown or 6, G"/
8qbST. CROTX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WTTHIN lOO FEET OF SYSTEM
3, ///"c/e / DraD,Inq
U
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
l,f f.BENCHI'I,ARK:at-\ -)
ALTERNATE BM:
SEPTIC TANK / PUMP CHN,TBER / HOLDING TANK INFORMATION
Manufacturer:,fu/,'n/u, "J z,/ZM aLiquid Capacity
Setback from: WeIl /70'House i /5 other
Pump: Manufacturer /VA Moder# l/f, size /UA
Float sepera xion //
Alarm Location 1,,/rt r) (-
GaI lons/cycle:/Vrl
SOTL ABSORPTION SYSTEM
width , /5 Length GO Number of trenches B"-o/ rToo f,
Distance & Direction to nearest prop. Iine:
/
,/o' S--t'h
Setback f rom: wel l : laO House 68 Other
Building Sewer
PC inlet NA
ELEVATIONS
/
ST fnlet ./06,52 ST outlet ,/06 , /'6
PC bottom N 4 Pump Off /UA
Header/l{anifold Bottom of system
Existing Grade Final grade
DATE OF INSTALI,ATION:
PLUMBER oN JOB t --D,cl
LICENSE NUMBER:/4P ZZZC
?-
INSPECTOR:
3/e3:7t
yn 50
II
,
\./
t A, / t/""1,4cs,
.ssr{ Ave_
-ril=
BOLDT'S PLUMBING & HEATING, INC.
820 MAIN STREET BALDWIN, WISCONSIN 54002
(715) 684-3378 FAX (715) 684-3144
D'rlt x
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5:r,
,
Dell
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ah
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syl;f f.u r{
6rc
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o
I j
LOGfrBIoHertBilifIotGAi[fiE . 5 . 28. 1 6 CfrglAtf SEWAG E SySTE M. Labor and Human Relations; ili"rr:;i'a"u"'ring, Drvisron lNspEcTloN REpoRT, - (ATTACH TO PERMIT)
GENERAL INFORMATION \
TANK INFORMATION
TYPE MANUFACTURER CAPACITY
Septic il/,'d r r t ST lre cas&1. zaD c]ot
Dosing
/
Aeration
Holding
TAN K SETBACK INFORMATION
TA,NK TO PIL WE LL BLDG Vent to
Arr lntake ROAD
Septic @ ,1) '41 NA
Dosing NA
Aeration \\-)'A
Holding
---.-
PUMP / SIPHON INFORMATION
Manufacturer Demand
Model Number
TDH Lifr I-n t TDH Ft\
Forcemai ngth Dia
SOIL ABSORPTION SYSTEM
ELEVATION DATA A93OO24L,o/i=9*
Permit Holder's Name
rl. rlntrrtl.rtrElTa rTF? I,TLT
qEir tr Villase
Q
rown of
Ertrr l.!lt T Er
ESTBI('rEIEO:*
/), )'
,'1fi3p: EUITlev.:
ta), rtl
--*--
).{PtBM{escriOtiodf"-
\Y41\( '2 S I !r(a
ou nty
anita rhit
ffi
ParcelTax No
rrfrcr-,r f.r.l ?-cln-1Af\
ELEVHIFSSTATIONBS
/0),4/y' SS'Benchmark
///, /33.4)'9r4'tL,
6. 't
7 (r("t2Bldg. Sewer
f,,tP <<&5t I y. lnlet
r.3b /06. /? 'ltW(. outlet
.-*/(+Dt lnlet
t4*Dt Bottom
/5.3?'9?,r7'HeaderJ*W. -
??, oa',Dist. Pipe
Qr 9z/(. s7Bot. System
// 7e'o2,6Final Grade
d, 23/" sa%:ffie
BED / TRENCH
DIMENSIONS
Wrdth /)Length
U,)ttto of Trenches PIT \
DIMENSIbNS.-
No Of Prts
SETBACK
INFORMATION
5Y5TEM TO PIL WELL LAKE / STREAM LHCFnNe-=
CHAMBEN.
OR UNIT
ufactu rer
TypeOl 77u ' Covu
sistem: & I tr U r .ffielNumber
DISTRIBUTION SYSTEM
Header 10dasi{etts
Lenoth /t' Dia._v_
Distributron PrpeG),
Length <c/,/Dra Spacrng U
x Hole Size x Hole Spacing Vent To Air lntake
xx Depth Of
Topsorl w-edSodded
fl No !Yes ENo3/ -y'J'
Depth Over
Bed /Tre+cffiges
Depth Over
Bed tVudtCenter 3 /': y';
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade s Onl v
COMMENTSI (lnclude code discrepancies, persons present, etc.) + I -t3 rf,
,:t
aa.o.W f,r C-L 7/MI
LOCATION:EAU GALLE,6.28.16 LOT 1 /-q/'(t
>U
,r/,
w<o
T
Uz-<2
,/
Htx,/@n
L 's'Ze 2
@on@ '*24,<"l&kt>efc
@3 ---,Oy'o
*
.6 /"r/,,%
&1_
fr,aU,: -!^()6 Ca./42
?
Use other side for additional information
c,"Y[*-W: brl &d &, * !, t,
Pla n revision required? fl Yes 6 Ars
Date
)7.'7az-<
Cert No
.7 S'b/;zr--:.a4 '4b4at
7
(*Insoector's Sionatu//-.;-&4#,
I
I
H -)
D
-
--.-GRv
W
'i9
BLDG
y'"
/7v?
/1
0
a,
g trITLHFI SANITARY PERMIT APPLICATION
ln accord with ILHR 83.05, Wis. Adm. Code
-Attach complete plans (to the county copy only) for the system, on paper not less than
8%x 11 inches in size. r ,
-See reverse side for instructions for completing this application.
I. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
cou5l C-o/
ST Mrr #
previous application
STATE PLAN I.D. NUMBER
lL:a sEVl,s 6 r Z8,N,R /C I (or) w
PROPERW LOCATION
14e/ur'.bnJ..,4,crPROPERW OWNER
BLOCK #ftrlLOT #
/
PROPERW OWNER'S MAILING ADDRESS/?23 6oG A,te.
ZIP CODE
54@L
PHONE NUMBER
()
SUBDIVISION NAME OR CSM NUM ,r r{4CITY, STATE
O"ldi,'/,-, /^)',
NEAREST ROAD
VILLAGE
6
7
I
I
trtrtrtr
0o{'/0/ 7 '
.*<z*
-rJ ^Co//c
ll!. BUILDING USE: (lf building type is public, check all that apply)
Other: Specity
ll. TYPE OF BUILDING: (Check one)State Owned
Med ica! Faci I ity/Nursi ng Home
Merchandise: Sales/Repairs
Mobile Home Park
Off ice/Factory
10
11
12
13
1E2Z3E4E5E
ApUCondo
Assembly Hall
Campground
Church/School
Hotel/Motel
Outdoor Recreational Facil itY
RestauranUBar/Dining
Service Station/Car Wash
E proti" E , o, ZFam.Dwellingff of bedroo ^r'tL
!V. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
Replacement 3. E Replacement ofSystem Tank Only
B) E n Sanitary Permit was previously issued. Permit #
5.4.
Date lssued
Reconnection of
Existing System
A) 1.f,t n"* z.
System
Pressurized Distri bution
21 E uound
22 Z ln-Ground
Pressure
Other
4, E Holding Tank
42 l-) Pit Privv
€ I Vault Piivy
B
Non-Pressurized Distri bution Experimental
30 E Specity Type
V. TYPE OF SYSTEII: (Check only one)
11
12
13
14
Seepage Bed
Seepage Trench
Seepage Pit
System-ln-Fill
2. ABSORP. AREA
REQUIRED (sq.ft.)
Or'to)./
3. ABSORP. AREA
PROPOSED (sq. tt.)
?c'rt
4. LOADING RATE
(Gals/day/sq. ft.)
-7o
5. PERC. RATE
Y"nt
6. SYSTEM ELEV.
78.5 Feet
7. FINAL GRADE
ELEVATION
/'C'(,' Fggt
VI. ABSORPTION SYSTEM INFORMATION:
CAPACITY
in gallons Plastic Exper
App'
Prefab.
Concrete
Site
Con-
structed
Steel Fiber-
glassNew
Tanks Tanks
Total
Gallons
#ot
Tanks Manufacturer's Name
VII. TANK
INFORMATION
xSeotic Tank or Holdino Tank /zm /ze -1 t )ee,Ks xLitt Pump TanUSiphon Chamber
VIII. RESPONSIBILIWSTATEMENT
t, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
MP/MPRSW No.:
66 Zq
Business Phone Number:
(7/l t6t4 -33 6
Plumber'e Signature: (No Stamps)
D"Z, i:7,/u.4or-
Plumber's Name (Print):
-D o/n. {, ,4u&an
(Street, City,
a /o/ ro i,r-c
IX. COUNW/DEPARTMENT USE ONLY
I
Date lssueo
?/o-f)-
San itary Perm it Fee (lgctu-oes$tp:3f *""t
E Rpproveo
Disapproved
Owner Given lnitial
Adverse Determination
Etl
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD€398 (formerly Plb€7) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
-/oa
2J-
Repair of an
Existing System
t-t
INSTRUCTIONS
A sanitary permit is valid tor two (2) years.
Your sanitary permil may be renewed before the expiratioA date, and al the time ot renewal any new
criteria in the Wisconsin Administrative Code will be applicable.
All revisions to this psrmit must be approved by the permit issuing ,ruthority.
Changes in ownership or plumber requirss a Sanitary Permit fransier/Renewal Form (SBD 6399) to be
submitted to the county prior to installation.
Onsite sewage systems must be properly maintained. The seF,tic tank(s) must be pumped by a licensed
pumper whenever necessary, usually every 2 to 3 years.
ll you have questions concerning your onsite sewage system, conlact your local code administrator or the
State ot Wisconsin, Salety & Buildings Division,60&266-3815.
To be complete and accurate this sanitary permil application must include
l. Propgrty owner's name and mailing address. Provide the legal description and parcel tax number(s) o,
where the system is to be inslalled.
ll. Type ot building being served. Check only one and complete # ol bedrooms it 1 or 2 Family Owelting.
lll. Building use. ll building type is Public, check all appropriate boxes that appty.
lV. Type of permit. Check only one in line A. Complete line B il permit is for tank replacement, reconnection, or
repair.
V. Type of system. Check appropriate box depending on system type.
Vl. Absorption syslem information. Provide all intormation requested in #1-7.
Vll. Tank information. Fill in the capacity ol every new and,/or existing tank, list the total gallons, number ol
tanks and manufacturer's nam6. Indicale prelab or site constructed and tank material. Complele lot all
sePtic, pump/siphon and holding tanks for lhis system. Check experinrental approval only i, tanks received
experimental product approval trom DILHR.
Vlll. Responsibllity statement. lnstalling plumber is to fill in name, license number with appropriate pretix (e.g.
MP, etc.), address and phone number. Plumber must sign application lorm.
lX. County/Department Use Only.
X. County/Departmenl Use Only.
Complete plans and specilicalions not smaller than 8% x 11 inches rnust be submitted to the county. The
plans must include the lollowing: A) plot plan, drawn to scale or with ccmplete dimensions, location of
holding tank(s), septic tank(s) or other treatment tanks; building sew€ rs; wells; \yater rnains/water service;
streams and lakes; pump or siphon tanks; distribution boxesi soil absorption syslems; replacement system
areas; and the location ol the building served; B) horizontal and vertical eievation relerence points;
C) complete specilications for pumps and controls; dose volume; elevation diflerences; ,riction loss: pump
perlormance curve; pump model and pump manulacturer; D) cross srtclion of the soil absorption system it
required by thobounly; E) soil test data on a 115torm; and F) all sizing information.
GBOUTTDWATER SURCHARGE
1983 Wisconsin Act 4'10 included the creation ol surcharges (lees) tor a number ot
regulated practices which can elrect groundwater-
The monies collecled through these surcharges are used lor monitoring groundwater, ground-
waler contamination investigations and establishment of standards.
t
't.
2.
3.
4.
5.
6.
s8o-6:t98 (R.11/88)
D LH R D\.'IL AIYL' DI I tr, trYALUAI IUN HE,POH I -
in accord with ILHR 83.05. Wis. Adm. Code I
COUNIY
Plan must include. but S/. C fo lx
o[ slope. scale or PAflCELI.O.,
A P P LI CAN T I NFO R TIATTO N-P L EAS E P R I !\IT A L L t,N FO R M ATIO N REVIEWEO BY OATE
PNOPERTYLOCAIION
@Yr. LoT NE u1 S vl,sLrZt ,N.R filslw
suBo. r{ArrE oR csM , /r1
NEAREST ROAOAve.
,D{ N* comrudion u* X Residential / Number of bedroorns
I I R@cement I I public or cornner.irt d*ib.
wdatuddaty tutl-20-gS Recom*nded deslgn badrng rao .7 bed, noof__E_r.*i, noong
Abcoetbn ar6a roqulrca 851 w,tP 857 vq*,tP Marinum des{n bading rate .7 bed. gpd/rp___:_.,g_uendr, gpdre
Reommended infil [ation surfae eloratirrn(s)
PROPERTYCIVNER
rl1Lr
I Y!I (7/5t 6
CITY.STATE
FROPERTYCII'NER.S
ZIP COOE;400 PHONE NUMBERt),"E
BLOCK I
Suitable for srstem
UrsuitaHe kri system
S=
U=
co+{l/E {TtoNALEs Du Llcx.N0Es tru NCtrLNOPRESSI,RE
XUs DU Es uuATCMOE STSTBI N FLLDS EU
Addiliooal desQn / site considerations
Parent material
Boring #
plain elevation. if apd'rzble ft
Hq.OU,IG TANKDb Au
SOIL DESCRIPTION REPORT
ND
GPD/ft
Trerrf
-2 ,3
.5
r
,g
.9
sf .zl- 5
ZIT)-3
1 .8
Ground
ela/.
/o.Z!8L
Deph to
lirni6ng
JYz'
Borlng #
:
{* nemarkb:
/ytr
Gtound
elev.
/o3,ln.
Depth lo
Imiting
lactor /)
Remarks:
Horizon Depth
in.
Dominant Color
Munsell
l,IoUes
Ou. Sz. ConL Cdor Texture Structure
Gr. Sz. Sh.CorsisEnce Bqrdary Roots
BedIo-3 /oyR //s /Vo ne -S/ /<c,/nsLK -$n Ct.l 3f
1 3-27 v/y/oyR ilonu qc/eyr
v / csl{m {.a5 cm Z
3 u-31 7,€Y*lh None esTAr oc s3 //v)cu)c{,7
4 37 -59 t6infr None cs g c sq
U
rn /C u,).7
5 s8-82 Mne Csx
-U
OCSA ,rt/.17,rY<
U
i
o'3 ,i/,n./n s[K fmsv
sJt*.*{"
C t^l
C r^.1 .L3 -24
21-85 c5
v n/oc 5
/ csIK
)
/
Z n€
/O YR
/0 t
7,5
CST Nrmc:-Ptease Prhr i-> o /e tr,ilu/=on Y'' 7/s-ag4-3378Address:tza /Yo,'* _t/,)
0ate:?- /?-CSI Numbsr:31 t
SQnaturr C
Cstn 13
(as referred to site plan bencfimark)
l"y
I trcnvl,r
sad or.1,'" ^/,ar',
)
_tUun e
None
U
Rools ^Bei,
: sltuctute
Gr. Sz. Sh.BardeyTexturel/lo6es .
Orr. Sz ConL Ce(
3Ch)a-
2it ,7.eh,45z
.,1mt3
s$c-a.!to-5 ,/aYR
.2C,r)/ as[K mL
e-e.)/c-sLNonL,lJ
.7,n/oNonc7,5yR ,l,l
o/l
Trerd
,8
,8
.3
3
-7 -8
.8
' ,P-'Ig!-.
SF
cdrird-
dev.
,/o/44_L
Depth Oominant Color:r Munsell-|n..
h
.9/4/
Boring
Goud
0e0h b
fin'lins
. lacld) to9'
Bodng f
Grourd
elerr.
It
Deph h
frni[.8
lacto,
Boring f
Ground
elev
It
Oegh b
tfiiting
bcto.
Bn7 7,78
SATETY & BUILDINCS DIVISION
State of Wirconain
Department of Industry, Labor and Human Relations
August 30, I993 201 East tlash I ngton Avenue
P. 0. Box 7969
[tladl son ]rI 53707
BOLDTS PLUiIBIiIG
820 itAlit sT
BALD}JI1{ }JI 54002
RE: PLA[{ s93-02{36
VANDER iIEER, IIELVII{ - LOT I
itE,sE,6,28,I6l'
TO}IiI OF EAU GALLE
ITOUI{D SYSTE1I
FEE RECEIVEO:'r 80.00
COUI{TY OF ST CROIX
The Department has revlewed the above- referenc ed submlttal.
Condltlonal approval ls hereby granted for the system plan submlttal. All
noted ltems must be corrected. The revleu and approval of the system ls based
on chapter 145, l{lsconsin Statutes, and chapters ILHR g3 and 84, HisconslnAdmlnlstratlve Code, and ls contlngent upon compllance wlth any s pula ons
shoun on the plans. Thls system has not been revlewed for the code
requlrements set forth ln chapter ILHR 82 or ln chapters ILHR 50-64, tJlsconsln
Adml nl stratl ve Code.
Thls plan submlttal approval w11l explre twolf a sanltary permlt ls obtalned, plan approvtnttlal sanltary permlt explres. The llcenselnstallatlon shall keep one set of plans wlth
approval at the constructlon slte. The lnsta
lnspector nhen lnspectlons can be made.
years from the approval date, oral wlll explre on the day the
d plumber responslble for thls
the Oepartmentrs stamp ofller shall notlfy the approprlate
Al1 permlts requlred by the ctty, vlllage, townshlp or county shall beobtalned prlor to l nsta I latl on.
Inqulrles should be dlrected to me at the number llsted below. please referto the plan number shoun above.
Sl nc ly,
er
Plan Rev l
Section of Prlvate Sewage
(608) 266-2889
E ca
EID-?rI rR. llr/.l,
F"}
.hTt(
t
in accord with ILHR 83.05. Wis. Adm. Code
COUNTY
PARCELT.0. I
REVIEWEO 8Y
u1
SUBO. I{AIIE OR CSM,
C-o,
NEffiEST ROAO5s6
iita pt-dnAi PaPor lrct tessthan I lf? x t 1 irches ln eize. plan must i ndude. txrt
r-not to.aid horizonial rdference point (Bl"{).diriiiii,6n a{./.ot slopo. scate or
dmensi6ned. rbrth arrow. and tocalion and di,stance lo nearest road-
AP PLICATITTN FO R TIATIO N-P I.EASE P R IHT ALL INFONiUNTION
PR@ERTY
m1n LoT
LOCATION
OATE .
glwsd T 2g ,N.R ,//, u(otw
LOT I
PROPERTYCI/{NER
f
NG AOORESSPROPERTYOilNER.S./?z 3 ELOCK r//l
/)"
CITY.
't-O r I
zrP cooE PHONE NIJIIBER ryowN
,//r-
M N* comrucfon u* P( Residefltial / Number of bedrooms
I I Replacernent t I publ'rc or @mme(cialdescribe
Code derived daily fw 6(T) gN
Absorption area requir ed ScXs 66.12 5 OC trench, ft2
Hecommended lnfilfation surface elaratbn(s)
Addiliooal desln / si te consideratiors
Parent rnaterial
Reconnnen@ deslgn toading rale . '/ b*., g@_, 5 uenctr. gd/tP
.l'',{axirnum design bading nle , I tyed,gpir/€_, 5 bench. gtrfP./tt (as referred to site plan berrtrmark)
Flood plain elevation. if apflkzble ft
SOIL DESCRIPTION REPORT
HI-oll.lG TANI(Ds &',u
GPD/ft
Bed Trerrf
.5 .L
,L
,I ,L
.4 5
0lu.
Boring #
Ground
ela/./o5,ffi tL
Deph to
limitirg
faclor
25,,
Eoring #
Remarkb
2m
L{
v
L
Ground
eler.
/o,/,Jzn.
Depth lo
Imiling
larc,lu tt3{'
Remarks:
f
S = SuitaHe lor system
U = UrsuitaHe hi srctem
oio/Et{Ttof0tl
D s Eu JVS DU
lrcL${0 NCrcLi{OPR€SSI.'REDS EU
STSTBI N FLLDS EU
Horizon Depth
in.
Dominant Color
Munsell
tr,loUes
AJ. Sr Cont Cdor
Structure
Gr. Sz. Sh.
CorsisEnce Borday RooE
/o-Zl 76' yB-|f,/t,s;/ ti".2 c s//.m4r Ct 2f
.}L 2t-f3 10vR +/d sc /2t tl{Ct,Z{"4
3 *-79 -zov*4/6
c Ld sy*/s
,/VA s /r-q..
,/7){"
m/{.NA NA 5
V
Ct-I t2t
UY t)
i
I
Cr'L St /Zr-s/{m/{.
s,/vsr.n /{n 5z-34
3'l-fo .J
scl t q,2 CSLK
S#
rln{NA
U
R EGE
L
3
/oyefk
eai
AUG 2
;FTY t T
S'Bnrlut: t ,--)
/t--lrr/"-f
/.y'/rt*on
,2
2(-q 3 3
CST Namc:-Pleaso Prht /J)O/ (-Phone:7tt'C?"- s 378Itddress:ZrP
CSI Numbor
L la
trL
,5
ATCR^OEDs Eu
Texture
[:]
ed
CD
/V?9
D
) 199:
0ate:
l:i
Bo.ing f Oepth
- . in. -
OominanlColor-r Munsell
GDrrd
elet .
./o3 ,lzn
lo
Boring fl
Groqd
el6r.
_lt
oegh to
6dtng
lacb.
Boring fl
w:
Deph to
[miting
laclcr
GJound
eliv- i
_lt
Rem
Eoring fl
Grornd
_tt
oeptr b
f.ri6ng
bcld
l/toues . . .'Ou.SzContColo(Texturd , Structure
Gr. Sz. Sh.o'L i.,A ,n-
./o 'hv 'c'ip :.5_
3 5 5c ml,/u/4 ,/rt ,.4
;L
L
,/Vr'/, ",- l'/rr,o/t t /4,' e r-/,,/
Slrow, Morsh HoY, Or
Synlhetjc Covering
Pase L Cf 4
Medium Sond
6,'Topsoil
Sign ,/.-
t't-'ci, /-
License Number:
Date, 7 26-2-3
Al terna te
of
Force
Dislribul ion Pipe
G
rl
b
e
Be
ggre go t e
(6" Be low P i pe)
Cross Sec tion Of A Mound Syslem Using
A 8ed For The Absorption Areo
/:,'"ra/rr-
A 5 rt.
B ./Co 71.
K 'o Ft.
L ',1() Ft-
J { rt
Forc e Moin
Observotion Pipe \
t ,'- 2\Plowe d
Loye r
D ,/, O Ft.
e /./O rt.
AJF -',/3 Ft.
G /,o Ft.
H /',5 Ft.
Pos i ti on
Main
I tC Ft.
* zs rr.SgB -0243 6
L
B K
Forc e Moin
r
w o
I\
\Disl ribut ion
P ipe
Bed Of ,"-Z';
Aqqregote
Observo tion Pipe Pe r monen? Morkers
H
-,r ar
Plon View Of Mound Using A Bed For The Absorplion Areo
,Hi'-'Zl'Z'?
Dlstribution PIpe Detai I For A Four Lateral Netr'ork
Pase Z of_L
PVC Force tta i n
llcles Equally Spaced
0n Bot tom
g{9'[grr
ed )ge
End CapAl terna
Force Ha n 0
ti
P\\
$e?
PVC Distributi
PVC Hanifold Pipe
S i gned:f
License Nusrber z 14 P 6{.?-?
Date:7"2(- ?3
P
S
x
x
* Las t lb I e Shou I d Be Hext To End Cap
x
T
Y P /tr Ft.
s 3 Ft.
x '/8 ! nches
I nchesY_21
t'lole Diareter
Lateral Dlanpter
Z-
/?
I nch
lnch (es )
t{anifold Diarrrcter 2 lnches
Force ttain Diarrc,.t-i- lnches
, tblcs Per Pipe /3
tnvert Elevation Of Laterals /OC, 11 Ft.
s
?,!PAr.t, -' at i
P!ll1P CHA/^,glR Cp.0ss SIC:rorl ArrlC, :pECtFtCi i-ror.ls
Vf UT CAP
Y..C.I. VE.UT PIPE
>- a:'tac.^1 00,3R.
WINCOW 3R FRESH
AIR INTAKE
t6"A lU.
I z'A tu.
\^/EAT I{E RP KOO F
JUUCTTO[-r 80X
GRA OE
APFROVEO L?CAII.:6
AANHOL E COVE F.
Y'Atu.
)
I e" F:iu.
g{
set
pe PROVIOE
T]6HT SEAL
APPROVED JOI
w/ c.t. etet
.'l
EXTENOtU6 3.
oNTO SOLID Sot L
A APPNOVED JCI
wlc.=. PIPE
EXTENOIUG 3
oNro 50LrD S
t-
rIE
F
J
c
o
@
Far\a'd
<{
C\r
Atu/
I
6tr
C'}(!)
ELEv 97,11 ,r.
AOOE L UUI-\BER,:
sWITCH T5PE,:r-C tl r
PUIAP AAUUFACTURER:,, /ry'
^^OOEL
UUIT6ET.:/i){0 3 /14
sWITCH TYPE:t_f l^
c^PACITTES; e = 29'61 tucHEs o^ 558 ,LB
6= L INCHEsor. 37,7
c= 9,39 rucHEs onl_77,17
o = I 2 rpc HEs o*2?6 ''l Z
NOT E:PUAP AND ALARI1 ARE TO DE
INSTALLEO O[J SEPIRATE CIRCUITS
PU|^P
-
COUCRETE 6LOCK
x KISER EXIT PERATTTED OI.JL5 IF TAUK
^^AUUFACTURER,
HAS SUCH APPROVAL
SPEC.IFICATIOUS
uJ..5 kLr.ateEn oF oosEs:
00sE voLutlETAIJK SIZ tr :./Ot2 <2 GALLOIJS
A LA R A /'\AUU FACTU RE R :-s J /: /,-c INCLUOING 6ACKFLOW:/'/-7,/_(,
/-?
PER DAY
GALu O N
GALI.OI
GALLCL
GALLC L
GALLOI
l,\tN I f{uft 0tscHAR,6E RArE 60 ,?l GPl{.
AvERTtcAL DIFFEREN.E oETwE,Eu puAp oFF Auo orsrRl.urro' prpE-- o FEET
+ AIUIAUi'1 NETWoRK SUPPLY PRESsuRE.... ..... .. e.5 FEET
+ 40 FE ET oF FoRcE rllrN x /'O8 FYoonFlrcrlou FAcTor,-'a'/ FEET
xCOUDUIT
,NLET
ALAR}^
OU
OFF
TOTAL O5NAI,1IC HEAD /Z FEE T
7rIUTERNAL oII,lEUsIoNt or TAuK: LEucTH o ;wlDTH a,o ;LrQuro DE PT H 53"
SIGUEO:a€
')
L<L ICE.US E UUA 8E R:/4F' 4(" 2q DArE , 7- Zl- 7i
a
seprrc i
a
OOSE
TA TI KS t^AU U FACTU R.E R. :/
-T
DOCUMENT NO E;q,??,re,, 1,30STATE BAR OF WISCONSIN
LAND CONTRACTIndividual and Corporate
(TO BE USED }'OR ALL TRANSACTIONS WHERE OVER
$25,OOO IS iIINANCED AND IN OTHER NON-CONSUMERACT TRANSACTIONS)
PACE RESERVEO FOR RECOROING DATA
505?27
Contract, by and betweot ---A.f ch---.J-,.--
M.e-r.Le...8a.).<.er-,.- h-usha-nd . an.d.. vi f.e--.
NEGISTER'S OFTICE
$T. Cf?OiX CQ-, \,"'l
Rec'd br Qocord
sEP I 1ee6
-Ba.ls-e. r- -a r-1-d -. - - -- --.
("Vendor",
whether one or more) ana-----l-'t-91=-Vf H. V n-d-e-r-Me-e-r and
..-.D9nn3..-!-{-'...-Y-?.rt.Q.e-r- Me-9-r--r.--h-tr-gh,-a-n-d- -a.rr-Q--.r{}.f-e.,---hp-ldlnE-..as
9-\I(Y-lY9-f:!]:+p--m-f-t-!-a,}--pfp-pgfLy ("Purchaser", whether one or more).,
Vendor sells and agrees to convey to Purchaser, upon the prompt and full per- ii
formance of this contract by Purchaser, the following property, together with the ,'
"H-g €*,-ei+tt
J Rqpscr o, Docd$
rents, profi
in--.-.
ts, fixtures anSt. Croi d other appurtenant interests (all called the "Property"),
-I-- ----- -- County, State of 'Wisconsin:
purchase the Property
sT..\'r'E IlAlt oF IYIS(loNSII'.i'l(lIl\I \o II-198:
RETURN TO
Tax Parcel No. --
Part, of Northeast Quarter of Southeast Quarter (UE2 of
of Section Six ( 6 ) , Township TwenLy-Eight North ( T28N ) ,
Sixteen West (ntOW), described as follows: Lots Two (Z
Three (3) of Certified Survey Map filed Auguffi
Page 2662.
This is not
xxla (is not)
honrestead proPertY.
SET),
R ange
) and
in VoI. "9",
and to pay to vendor at .Q- p-1eqe .ge9ig-n-e!gQ-.F.y-.Yenggf.-.,
--. in the following manner: (a) $-4,-3-QQ...-QQ
at the execution of this Contract; and (b) the balance of S -7-,-Q-0-0-..0-0------- together with interest from dste
hereof on the balance outstanding lrom time to time at the rate ot--Si,l!-. L6-%) . - .- ,----- per ceni per snrum
until paid in full, as follows r 66nu.1 payments of $3,500.00 principal , together
with accrued interest, commencing August 75, 1994, and on the same
date of each year thereafter.
Provided, however, Lhe en!iU) oulstanding belance shall be paid in full on or before the.-.------l-5th...--.-- aay ot
.....41L9!l.s-!...... rg.Y?... t the nlaturity dutc).
Following any defaulr in payfient, interest shall accrue at the ,ut" ot -!-1-1---"t" per annum on the entire amount
in default (which shall include, without liDritation, delinquent intelest and, upor acceleration or matutity, the eutire
principal balance ).
Xrrcllr[!6]!,loxlaa:€!(fflcIIxr(Xx!&.r<'gEdexr.tflXxxElqxt(Xirn.8trxr [.IfltlftXrIXI[ftXXXtlr(fiIEIEl[L*XfOCX
IInfdatt:txat)G:aac)<lFEr&:rxgaEillflaxx)c'fl()(0dixqo,ttexb(9{!(exsoarodr(Dc'<ldrex&re)cloxt&tcriExD{jrdED[DOtA,uE tlt,f
I-fftfll,(dgd(s(t0D{rgfofxtrrett.xiKtdr(sex&Ug[ltooxx&fix&D(xgucr(*t xlnlrs]r'5,"f0{Eodt9'{f.<Xar:tdfxl:t(!6Ea$rl$<
14(96,(IE.Eso€ffirdci'Glxm(9(]rit}de)d(,{xira*i!to(xxxsclofjdsrd.m(0rffirxJ(rod(lturdoJtxfii(!@dcErD(
mtxx*tlcrxhxxsgi,c*>Fx:lgocx
Payments shall be applied first to interest on the unpaid balance at the rste specified and then to principal. Any
amount may be prepaid \,!,ithout Dremium or fee upon principal at any time after...-J-an-Ua-r--y.---1---..-, r€-4---. lmq
t6[raxr,aYxrcxXXrftF4ttECI(,(AO(PrrniiSaIr$a6D[x )lit*Xs)Oln(xr.XehXdrX
In the eveDt of any prepay'rnent, this contract shall not be treated as i[ default with respect to payme[t 8o long
as the unpaid balance of principal, and interest (and jn such case accruing interest from month to month shall be treeted
as unpaid principal) is less than the amount that said indebtedness would have been h4d thb lngnlhtli ..panfeqts been
made as first specified above; provided that monthly pa!.rnents shsll be continued in the elgnt;f iredit ot arly'irbceeds
of insursnce o! condemnation, the condemned premises being thereafte! excluded herefrom.
Purchaser states that Purchaser is satisfied with the title as shown by the title eYidence submitted to Purchaser
for examination ercept:
NONE
Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an sbstract, it shall
be retained by Vendor until the full purchase price is paid.
Purchaser shall beentitled to take possession of the Property on---,---..9-?-!-e--,,o-f .g1p-9i-LS-..,.-.-.--,xg(xxx
Purchaser agrees to
the sum of g.l-1-r-3-QQ,-8-Q--
LAND CONTRACT - Individual and
firrp(rlate
Wisconsin Legal Blank Co. Inc
Milw;rukee, lVis.
il
Purchaser promisea to pay when d,ue all taxes and assessments levied on the Property or upon Vendor's interest
in it and to deliyer to Vendor on demand receipts Ehowing such payment.
Purchaser ohall keep the implovementa on the Property insured against loss or damage occs6iond by 6re, ex-
tended coverasE perils alld 8uch other hazsrds as Vendor may rc{uirc, without co-insurance, thJough insurers approved
by vendor, in the gum of $--ftf-L[ - -in$ffIablg.,t/alug-., but Vendor shall not requile coverage ia an amount lior€
than the Salance ovred undi:r this Contrsct. Purchaser shill pay the insurance premlums when due. The policies. shall
contain the stahdard clsuse iD favor of the Vendor's interest aid,- unless Vendor oiherwise agrees in writin8' the original
of all policies covering the Property sh&ll be deposited with Vendor. Purchaser shall promptly give notice ol loss to
insurarice compsnias and Vendoi. Unlesa Purchi,ser and Vendor othcrwise agree in wiiting, insurar.:e proceeds shal)
be applied to lestoration or repsir of the Property damaged, plovided the Vendor deems the lestortlicn or rep^ir to be
economically feasible.
Purchaser covenants not t4 commit waste nor allow waste to be conlnitted on the Property. to keep the Properly
in good tenantable condition snd repair, to keep the Property lree from liens supelior to the lien of this Contract, and
to comply with alt lawE, ordinances and reSulations sfrecting the Property,
Vendor a8rees that in case the purchase price with int€rest snd other nroneys shsu be fully psid and stl conditions
shatl br fully performed at the times ind in thd uannef, above specifred, Vendor iill on demand, execute ond deliver to
the Purchasir, a Warranty Deed, in fee limple, of tho Propertt, frec and clear oI 8ll liers and encumbrancea, except
:: lt:t::: :*:::::::* i1:: ::::: ::::: :: :_':::::""'
and excep'i:
iiitOSiiiorI3t
Purchaser aglees that time is of the essence and (a) in the event of a default in the payment of any principgl or
interest which continues for a period of .-90-.-- asy" following the specified due date or (b) in the event of a default in
psrformance of any other obligation of Purchaser which continues for a period of---90... days follo\r,ing written notice
ahereof by Vendor (delivered personally or hailed by certified mail), then tlie entire outstanding balance under this contract
shall bec6me immeiliately dui and payable in ful[ at Vendor's 6ftion and without notice-(which Purchaser hereby
waives), and Vendor shall also heve the lollowing rights and remedies (subject to any limitetions provided by law) in
additio; to tho8e provided by law or in equity: (i) Vendor may, at his option, ternrinatc this Contract and Purchaser's
risht8. title and interest in the Propert, and recover the Property back through stlict foreclosure with any equity of
redemption to be conditioned upon Purchaser's full payment of thc entire outstonding balance, with interest thereon trom
the daie of default at the rate in effect on such date and other amounts due hereunder' (ln which event all allrounts previously
paid by Purchsser shsll be foreleited as liquidated damages for failure to fulfiu this Contract xnd as rental for the
irroperiy if purchaser fails to redeem); or_(ii) vendor may sue fol. speci{ic perfornrance of this Cor)tracl to conlpel
imnicdiate and full payment of the entire outstanding balaDce, with intclcst thcrcon ^t thc rrte in effcct on tho (ltrte of
default and other ahdunls due hereunder, in which ivent the Propefiy sh:rll be auctioned at judicial sale and ['ulchaser
shall be liable for any deficiency; or (iii) Vendor DTali suc at Iflw for thc entirc unpaicl purch4sc pricc ot lln)' Dortio-n
thereof; or (iv) Venitor may diclare thii Contlact at an end and reurove this Contractasacloud on titlc in a quicL-title
action if the equitable interast of Purchaser is insignificant; and (v) Vendor nra]'hlvc Purchaser cjectcd ltom losscssion
of the Propertt and have a receiver appointed to collect any rents, issues or prolits duting the pgndency of ant- action
under (i), (ii) or (iv) above. Notwithstanding any oral or written statements or actions of Vendor, an election of any
of the folegping remedie8 shall only be binding upon Vendor if and when pursued in litigation and all costs and expens€s
including riasonable attorneys fees of Vendorlncurred to enforce.any remedy hereunder (r'hether abated or not) to the
extent not prohibitad by law and expenses of title evidence shall be added to principal and paid by Purchaser, as i -
curred, aDd shsll be included in any judgment.
Upon the commencehent or during the pendency of sny action of foreclosure of this Contract, Putchaser cohsents
to th6 a;Dointment of 6 receiver oi tti"-pio""ii". includins fiomestesd interest, to collect the renta, issues, and proffts of
the Prodeiiy auiing ttre penaencv of such rictioir, and sucE rents, i6sues, and profits when so collected shall be held ahd
applied as the court shall direct.
Purchaser shall not transfe!. sell or convey any iegal or e,iuitable interest in the Property (by assignment of anl'
of Purchaser's rishts under this Contract or by option, long-term lease or in any othe! way) without the prior written
congent of Vendoi unless either the outstanding balance payable under this Contract is {irst paid in full or the interest
conveyed is a pledge or assignment of Purchasei's interesf under this-Contract solel! as security for an indebtedness of
Purcliaser. In-thelvent of iny such tranafer, sale or conveyahce without Vendor's written consent, the entire outstandinB
balgnce rayable under this Contract shsll become immediat€ly due and payable in full, at Vendor's option without notice.
Vindor ghall make all payments when due under an:r mortgage outstahding against tle Property on the date of
this Contract (except for any inoitgaee grant€d by Purchase!) or under any note secured thereby, provided Purchaser
makes timely psymint of the amountJ then due under this Contract. Purchaser may make any such payments directlt' to
the Mortgagee ii Vendor fails to do so and all payrhents so made by Purchaser shall be considered payments made on
this Contrsct.
Vendor may qraive any delault without waiving any other subsequent or priol default of Purchaser,
All terms ot this Contract shall be binding upon and inure ta -the_bene6ts of the heira, _legsl re-piesentatives,
Eucceaaors and as8igr6 of Vendor snd Purchaser. -(If iot an o- er of the Property the lpouse of Vendor tor a ealuabl€
a;;;id;r;aio; join; -trerein to ietease homiiieaa right! in ahi subject Property dnd agrees to join in the execution of the
deed to be mede in fulfillment hereof.l
Deted this -1!.
Melvin H. vanderMeer
h .. day of .,...,-..Aqg .-..-... .-., 199 3
8ufu'
ust
:tu l-: il. L:Z* h*+.-- . rsn,i.'t L4.\-<-
^
Arch ,J. Baker
D.e.n rl.* *, t/..ar*l*?]7Qt-L Gnx.t
authentica -day of--
...... (sEAL)
(SEAL)
t$)tt"
* Merle Baker* Donna M. \IanderMeer
AUTHENTICATION
sisnsture ( s ) o( a e ll a t.t,. -. y-e n 0.9.-r.lte.e-{.......STATE OF WISCONSIN
)
.. ...P!: 919ir.........county.
) s8'
Personally came before me thle .--9-t--h......dav or
...F. ep.t 9$.bg.f. rs..9.3.. the above named
...!_te..L-v..r_1...8.'...yenqe-f l'!ee.r-..8.4!1,.............-.-..
A CEN OW I,EDGMENT
nd
8th q t er 1e...9-3
Thomas A. McC Arch J. Baker ":J"""-1" ",j " '
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, ------..-......
sutholized bv Q 706.06, Wis. Stats.)
THIS INSTRUMENA WAS ORAFTEO BY
Thomas A, Mccormack
Baldlfin, wr 5400 2
ck
to me known to be the person.F....----
foregoing t
..-.1,r.-,--..-r,'',-.. )
, fl?*!t.t t' !!:12t4.14i-......... ..
Notarv iubtic .....9.!.:...9.I9.i.T.......-........countv, wis.
Mv Commission is permanent. (If not, state expilation
date: .-.--....---..,-- ---.-.....--.' 19..-.....')
(Signatirres may be a\rthenticated . or acknowledged. Both
are not necessary')
i :'r+r"-* , *-""" .itninE in anv cspscitv shoultt be tvped or printeil b€low their ''i8nltd!i'i i r.
l,aND coNTIACf - It.llrldr.l .!d coiDot.t - 8.... B.r ol wl'cor.ln. r-' irot ' !- i"li t
U
\.-
503?7G This instnument drafted by Fran Bleskacek proj. N0.88-3i-I93
\E/
T2 8N, R I6W,Located
Town of
in
Eau
part of the
GaIIe, St.
LEGEND
CERTIFIED SURVEY IVIAP
NEL of the SEk of Section 6,Croix County, Wisconsin.
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CD
O - Aluminum County Section i,lonument
@ - 1rr x 24tt Iron Pipe Set at Section Corner
(positioned fron existing corner ties)
o - lrr x 24tt Iron Pipe Set, xeighing 1.68 lbs
per linear foot
-.-l+-.------.__,(- - Existing Fenceline
Roadway Setback Line
a 4l4u Iron Reban Found
i\
LAN DS
IAT
l_\-/ I
q
i\,1
v.4 P. li94
AVENU E
East-wes
sg 7059 ' 4
t t/+ line of Section 6
0 17
l,l
S
F
tJ.Jt!tFa
I
FoN]NI
!L'*|!$ii_EQ LANDSUI
I
SILI
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EN.-UPLATTrl
ner of
n6
1[z
E[ Corner of
Section 6
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| 10"ll 1023.7 gr CURVE
Arc- 299
I angent
1 angent
94
nt:::,*;1il1-(Jll Radi us= :i1:'i-''ro ur,,u"cenr.l oi?::- rri.,rr zTrrlr
chord Bearrng=
Chord= 299'0b'Ittt
OOlr)Or\
INIE_Bila\E-
Centerlin e of East Bound Lane
-
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4
3ro9:T
O(')rF OWNER
Arch J. Baker
2171.55th Avenue
EaIdwin, l{I 54002r$llr
PAGEI 2662
oo
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:r
I
---'-Bs{SCALE I N F'EET
o
3
9 SE Cornen of
Section 6
'c0
A U 0b ,_)1
I I I tL3
JA.tn ES 0 NN L ttREaleiofDeeds
ST Crox Co.,wt
F$LED
C _l:l
culql
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-t
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1.01 Acres Exc. R /u
43, 964 S q. Ft.
N
'an
80 2. 151
l
-+-+
(\
I 2 AREAS
-
R/l{ SB7042 ' 15nE
Goroge
House
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FOOT I{IDE ACCESS EASEl.lEiIT
RLOT3
1095. 52 '1315.56'_
I
7.41 Acres Inc. R/Vt
58,510 Sq. Ft.
16.94 Acres Exc. R/W
738,066 Sq. Ft.
1.52 Acres Inc. R/[
66,044 Sq. Ft.bcDttE ?Arcgll-
2.49 Ac res
108,670 Sq. Ft.
e
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2.2r .63 t
roo 200 400
VOLUP1E
1
u
,
,
_[I
(,r,-
1
r5'
O 3/4n iron .?bar found 0oo18r42rrt, 0.12 l.el fror corputed position.
O 3/4r' i.on rebar found sooolSr42rrli, 1.27 fcet fron conputed position.
O East Iine of Lot 2 of Certified Survey t'lap recorded in Volunre 4, Page 1123; previously
recorded as lJ0Oolg'5I'E, 811,75'. Lies casterly of conputed xest Iine of the flEl of the SEl.
SURVEY NOTES
llorth line of th€ El of thc SEI of Section 6, pneviously 'ecorded as S88o00r38rrE' 1317'4ll
on Certified Survey l,lap reco.ded in Volunre 4, Page 1123.
o
SURVEYORI 8 CEREIFICATE
I, AIIen c, Nyhagen, registered gfisconsin Land Surveyor, hereby
certify that by the direction of, Melvin H. vanderMeer, I have
survey;d, mapped and descrlbed the land parcel which is
reprelented Li ttris Certified Survey uap; that the exterior -boundary of the land Parccl Eurveyed and mapped is described as
f ol I ows:
A parcel of land located in Part of the NEI/4
Section 5, T28N, R1591, Town of Eau Galle, St.glisconsin; further described as follows:
Beqinnino at the E1/4 corner of said section 6, thence
E66.ze-rsg"w, along the east line of the sEl/4 of said section,
615.11 feet to thi northerly right-of-way of U.S. Interstate "94"
being on a 6099.58 foot radius curve, concave southerly, whose
cential angle measures 2c48'34", whose chord bears 584c 33'27"w
and measuris 299.06 feet; thence westerly, along the arc of said
curve and said northerly right-of-way, 299,09 feet to the point
of tangency; thence s830O9'10"W, along said northerly right-of-
way, 1023,78 feet; thence NOOo 18'42'.'E,, along the monumented cast
Iine of Lot 2 of certified survey Map recorded in volume 4, Page
lI23 at the St. Croix County Register of Deeds office, 811.55
feet to the east-west ll4 line of said section; thence
s87o59'42"E, along sald east-west 1/4 Ilne, 1315'40 feet to the
ooint of beoinnl.no,
Above described parcel ig subjcct to right-of-way for town road
(55th Avenue) and all easements of record.
I, also certify that this Certificd Survey MaP is a correct
representation to scale of ttre exterior boundary surveyed and
delcribed; that I have fully complied with the current provisions
of Chapter 236,34 of the t{isconsin Statutes and the l,and
Subdivlsion ordinance of thc county of st. croix in surveying and
mapping same.
VOLUME 9 PACE 2662
of the sEl/4 of
Croix county,
\
x
Each parcel shown on this map (plat) is subject to statc and
county laws, rules and regulations (i.e., wetlandg, minimum lot
size, access to parcel, etc.). Before Purchasing or developing
any parcel contact the St. Croix county Zoning office for advice'
a
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sTC 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OI{NER/BUYER ",'ri
''i,,/,, //r.-,
ROUTE/BOX NUMBER /qz -? z2t ,/r'c
CI TYlSTATE /J2 TJ:
FIRE No. t 7z- i
zrc 5zr//
PRoPERTY LOCATION: 4 L tt A str /4, Section 6 ,tZi u,R//-- u,
Town of Ga<a ,(
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 LICEilSED SEPTIC TAIIK Ptl{PER.I{hat you put into the system can affect the function o[ the septic tank as a
treatment stage in the waste disposal system.
St. Croix County Residents llAI be eligible to receive a grant for a t{AXII{tl{ of
$3000 of the cost of replacement of a failing system, which was in operationprior to JuIy L, 1978. St. Croix County accepted this program in August of1980, vith the requirement that owners of AtL NEf SYSTEHS agree to keep their
systems properly maintained.
The property owner agrees to submit to St. Croix County Zoning a certificationform, signed by the owner and by a master plumber, )ourneyman plumber,restricted plumber or a Iicensed pumper veri fying that ( 1 ) the on-sitewastewater disposal system is in proper operating condition and (21 afterinspection and pumping (if necessary), the septic tank is less than L/3 full of
sludge and scum. Certification form wiII be sent approximately 30 days prior tothree year expiration.
Subdivision /w
r/vE, the undersigned, have read the above requirementsthe private sewage disposal system in accordance with thherein, as set by the l{isconsin Department of Naturar Reform must be completed and returned to the st.croix coun
30 days of the three year expiration date.
St. Croix County,+.Lot No. I .
and agree to maintain
e standards set forth,
sources. Certification
ty Zoning 0ffice within
SIGNED )rt.(... //*L^ bt ur-.-
DATE T-3,
St. Croix County Zoning 0fficeSt. Croix County Courthouse
911 {th Street
Hudson, WI 54015
( 715 ) 385-4680
Sign, Date, and Return to above address
t
I
APPLICATION FOR SANITARY PERHIT
sTC-100
Thls appllcatlon form is to be completed in fuI1 and signed by the owner(s)
Ehe property being developed. Any inadequacies wiII only result in delays
the permlt issuance. ShouId this deve Iopment be intended for resale
owner/contractorr(spec house)r then a second form should be retained
completed when the property ls sold and submitted to this office with
approprlate deed recording.
of
of
by
and
the
Owner of property z%c/,r,,k 6/rZ 2P
Locatlonof properq6- t/4 5'l- r/4, section I r/,,. N-a/"1 'u
4r, C-o//cTovnsh I p
Halltng address / ?Z:o &,4,.l (Z S/azz).
b t b7
4,re-55 /uo .
-/"n /IE *LOt )L , t-,-lAddress of site
Subdlvlslon name
Lot number
t: 1.
/u
/nr/ na CSn
Previous owner of property Ar.l BaKe r
Tota1 slze of parcel /,o/'- r'?- \
Date parcel was created
Are all corners and lot IInes ldentiflable? X Yes No
Isth1spropertybe1ngdeve1opedforresa1e(spechouse)?-Yes
Volume and Page Number - as recorded with the Register
No
of Deeds.
INCLUDE }TITH THIS APPLICATIOI{ THE F'OLLOIJING:A SARRAHTY DEED vhich includes a DOCUHENT NUHBER, VOLUHE AltD PAGE NUHBER, andthe gEA[ 0P THE REGISTER OF DEEDS. In addition. a certi fied Eurvey, i favallable, would be helpful so as to avoid delays oi the reviewing process. Ifthe deed descrlptlon references to a Certified Survey Hap, the Certifted SurveyHap shall also be required.
PROPERTY OWNER CERTIFICATIONI(tle) certlfy that aIl sta tements on this f orm are true to the best of m Y (our)knowledge; that I ( we )am (are) the owner(s) oI the property descr ibed inthls lnformation form, b y virtue of a warranty deed recorcled in the 0f f ice ofthe County Register of Dee ds as Document No.I and that I (lrte)presently own the proposed site for the setra ge disposal system (or I (ve) haveobtained an easemenL,to run with the ab ove described property, tor theconstructlon of said system and the same has been duly recolded in the 0fficeof the County Register of D eed s, as Document No.
-V"; /U-^*l '.^ >rrn nSignature of Owner S ignature oI Co-Owner ( I f AppI icable )
CL ".-73o
D ate o S I gna ture Date of Signature
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