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HomeMy WebLinkAbout030-2094-80-000 ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner Address oZ City/State Legal Description: Lot ) 7 Block Subdivision/CSM # Y. A)F-'14 , , Sec. , T_ILN-R_Z Town of ~5T PIN # Q fl ao f V - 1~_ _ SEPTIC TANK - DOSE CHAMBER HOLDING TANK INFORMATION: i Tank manufacturer Size ST/PC >Ooo/ Oo Setback from: House _10 Well - P/L Pump manufacturer Model /37 Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM: Type of system: Width Length y 7 Number of Trenches Setback from: House 7~ Well P/L Vent to fresh air intake ELEVATIONS: Description of benchmark T& 5 ; Elevation J3 9s Description of alternate benchmark J f ~v E G.•.~ Elevation ?,7r. Building Sewer _ r V d) ST/HT Inlet ) 311 ST Outlet PC Inlet / T, S, PC Bottom ! 7, 30 /Header/Manifold 1 /a Top of ST/PC Manhole Cover l Distribution Lines { } 30 ( ) Bottom of System ( ) 3, 9 y ( ) ( ) Final Grade { } ( ) Date of installation S i 2Permit number 0 R 112 $ I State plan number S22 yaflg Plumber's signature License number 111, / 7 VS4 Date / / Inspector T.tiw Complete plot plan NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW 1 ~p 30 ys_, 1• 1 w' ~R. INDICATE NORTH ARROW NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW N 1 30~ 1. INDICATE NORTH ARROW Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: ,Labor and Human Relations INSPECTION REPORT ST. CROIX Safety ano Buildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 284289 Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.: THROW, TOSHA MARIE ST JOSEPH CST BM Elev.: Insp. BM Elev.: BM Desc iption: Parcel Tax No.: ~J n ~ tea/ 030-2094-80-000 TANK INFORMATION ELE TION DATA s T 7 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 3 6~ PL'Gc Dosing n / wt (.ryi'. 3.75 Aeration- Bldg. Sewer 3 O 9D, 37 Holding St/Ht Inlet TA K SETBACK INFORMATION St/ Ht Outlet 111,4 TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet ti A Air Intake Septic NA Dt Bottom .SAS Dosing NA Rsa4w Man. NA Dist. Pipe Hin Bot. System 3 9 7 PUMP INFORMATION Q 6:PM, Final Grade Manufacturer[Demand Model Number E33 36 t P TDH Lift p0 A `riction, 17 1 System 110 TDHyFt Force main Length )I Did. F~ " Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length,,/7 . No.Of T enches DIMENSIONS P1T No. Of Pits Inside Dia. Liquid Depth DIMENSIONS LEACHIN Manuf SETBACK SYSTEM TO P / L BLDG WELL LAKE /STREAM INFORMATION Type 0 e, r ; CHAM Mode O IT 1 A_ System: yy<4,4 DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing 1 5/ yp 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 ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: ST JOSEPH.29.30.19,NE,SW HIGHLAND VIEW LOT 17 /(.E CcL11~A Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710(R 05/9°1)) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: r e ~ Safety o and Bu ilding Water Systems v.■`~■■~ SANITARY PERMIT APPLICATION Bur 201 E. Washington Ave. ` In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8112 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Permit Number agz/,9 V The information you provide may be used by other government agency programs ❑ Check it revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION 62 7 _ ~C> P% 3 Prop y Ow er Name Property Location ~ 1/4 .S LL( 114, S a T~ N, R or) Property Owner's Mailing Address Lot Number Block Number City, State 1 Zip Code Phone Number Subdivision Nam or CSI~(I Number t II. TYPE F BUILDING: (check one) E] State Owned City Nearest Road ❑ Village E] Public 1 or 2 Family Dwelling - No. of bedrooms Town OF Cdr III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo - o / LI - 0 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10E] 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. X New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an ------System --------System Tank Only______----- Existing System _________Exl--- -System - B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11E] Seepage Bed 21 ,Mound 8 1 x L/7 v /.j,~ l , 30E] Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22E] In-Ground Pressure 42 ❑ Pit Privy 13E] Seepage Pit 43 ❑ Vault Privy 14E] 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 Require. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./in ch) Elevatiory Feet Feet TANK Capacity VII. INFORMATION in gallonTotal # of Prefab. Site Fiber- Exper. Gallons Tanks Manufacturer's Name Concrete con- steel glass Plastic App New Existing strutted Tanks Tanks Septic Tank or Holding Tank Q~~ OCt a ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber' ignature: (No Sta s) PRSW No.: Business Phone Number: Plumber's Addre s Street, City, State, Zip Code): yc-~t a r ~l z s~ IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sa itary Permit Fee (indudes Groundwater ate Issue Issuing Agent Sig re (No Sta Sps) Approved ❑ Owner Given Initial SurchargeFee) Adverse Determination _Q~~ X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: .98 (R. 05/94) DISTRIBUTION: Original to County. One copy To: Safety 6 Ruildings Divi.ion, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe 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, 608-266-3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one online 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/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to 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 8 112 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 it 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. I SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations February 25, 1997 2226 Rose Street La. Crosse WI 54603 WEGERER SOIL TESTING 421 N MAIN STREET PO BOX 74 RIVER FALLS WI 54022 RE: PLAN S97-40083 FEE RECEIVED: 180.00 THRON, TOSHA NE,SW,29,30,19E TOWN OF ST JOSEPH COUNTY OF ST CROIX MOUND SYSTEM The Department has reviewed the above-referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based on chapter 145, Wisconsin; Statutes, and chapters iLHR 83 and 84, Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter ILHR 82 or in chapters ILHR 50-64, Wisconsin Administrative Code. This plan submittal approval will expire two years from the approval date, or if a sanitary permit is obtained, plan; approval will expire on the day the initial sanitary permit expires. The licensed plumber responsible for this installation shall keep one set, of plans with the Department's stamp of approval at the construction site. The installer shall notify the appropriate inspector when inspections can be made. All permits required by the city, village, township or county shall be obtained prior to installation. Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Sincerely, Oraerd M. Swim Plan Reviewer Section of Private Sewage M4q (608) 785-9348 lV~ SUDA-7997 (R. 10194) S97-4 ~ 3 Page of 6 MOUND SYSTEM FOR RECEIVED A 3 BEDROOM RESIDENCE FED 2 4 1997 SAFETY & BLDCS. DW LOCATED IN THE NF 1/4 OF THE Sw 1/4 OF SECTION T 3U N, R11 W, TOWN OF ST_ S~tF Sr. cR1JLX COUNTY, WISCONSIN. INDEX PAGE 1 'of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW-CROSS SECTION PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR SYSTEM NAOE STt~l.wrr~iz, ►-~iv ssoaz ~ f t0los 30 7 4c-'09 PREPARED BY E M y zel®~fE`rQW~ J „ GEEZER SOIL TESTING „~,~~~,s 4~, AND. ~ T.~; •a:-~ DES = GEN SEFt~1 I CE e • ARTHUR L. $ 0^`-pR L F.O. 201 74 421 K. 11AIK ST. Gll:Yi _,FTH, RIVED FXIS. III 54022 was. 0 o` • 715-425--01b i o mar wssu;m" JOB NO. a - 3 0 PLOT PLAN Page Z of 6 Scale 1"=4p ' LT..too ,o ON ~vp o'F L-C)T ~f1RAJ~SZ Flo ~ "-T- 1.1 Ave 0o rvoT ~~~~+t-cT' DISZV~Z{3 OR t Hts tt~q Z~~~ S Z g' J 3Z, .Or Z~1 o h v 8.3 131 1►p 6 1 , 1 11 111 ' ` ~O cF~1~PV C ' 7 Zr z ~ 111 s 7 ♦SS°'- Z lpvC \ 5 n w'EU__'TO 8E 'VT L-iNST So' F-1 ►"UVN_"D \ C 44 ~p _ ..['~T LSZ' ZSF~20►'1 ZYC►~~kS. y~\ 0 1- ~ ~ M LUCp`'(~ 110VM7 ~~ZLU 'Vo prr_/`j HU~1sE ~ (~j C Lam- 2rJ 'Fib W1 oV S lTI T1tC ~sF! 2S 1,o~N S LU~~~ D~ --y-~~ ll"t 0 V~.Jp ~ g CDT D~5'N~~-a ~ . O• $S %rA IGV~L(~IVij M I TD,101 ~ Ea NOTES: -1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. (L required) 3. Install 4" observation pipes with approved caps. ( 2 required) 4. -Septic tank to be Woo 16So gallon capacity manufactured by YA t ~~w~`s ZV t~~~3r ~1 S r ~ ) nj e . 5. Bench Mark SEI~: "Cj v e 6. Divert surface water around system to. prevent- .ponding at the uphill side. Page '-10f 6 Approved Synthetic Covering Rs~-r~ c 33 Distribution Pipe Medium Sand H _ _ G Topsoil F Elev. \ \ Z - S -J " E D " 3 ` „ b Z % Slope Bed Of 2M 2 -2 (Force Main Plowed Aggregate From Pump Layer D \-o Ft. Cross Section Of A Mound System Using E \-i6 Ft. A Bed For The Absorption Area F o-$ Ft. G • o Ft. A 8 Ft. H \-S Ft. Linear Loading Rate= •~o GPD/LN FT B 4-7 Ft. Design Loading Rate=0.4 GPD/SQ FT I V~ Ft. J g Ft. K 10 Ft. A! tei-I rate +os4t4w)- L (,1 Ft. -of-- Fo Main W 3Z Ft. L TO bservation Pipe 8 \ K F Ir--- - - - -moo' - Force Main Distribution Bed Of 2M- 2 2 Pipe Aggregate I Observation Pipe Permanent Markers (Anchor securely) Plan View Of Mound Using A Bed For The Absorption Area Page Of 1 Perforated Pipe Detail 0 End View Perforated End Copt As PVC Pipe Install permanent-marker sooc6 at end of each lateral Holes Located on Bottom, Are Equally Spaced Q S PVC Force Main i Q PVC Manifold Pipe Distri ution Pipe Last Hole Should Be I Next To End Cap End Cap P Z Z Ft. Distribution Pipe Layout S y Ft. X Ll8 Inches Y V$ Inches Hole Diameter )IV Inch Lateral Inch(es) Manifold Z Inches Force Main Z Inches # of holes/pipe Invert Elevation of Laterals \\3.0 Ft. Place 1st hole -L4 "from center of manifold with succeeding holes at 1-1$'intervals. Last hole to be next to the end cap. Combination Sept:ic;Tank and PUMP CHAMBER CROSS SECTION AMD SPECIFICATIOMS ' PAGE 5 OF 6 VENT CAP WEATHER PROOF JUKICTIOIJ DOX H"C.I. VENT PIPC APPROVED LOCKIMG lO' FROM DOOR. MAKIHOLE COVER K71'IH AtR wP►RNIAlG L14pEL .iKIDOW OR FRESH IjJTAKE cwapulr J t i I I Y" MIIJ. I IB'Mlu. lh _ PROVIDE I IlJLE T AIRTIGMT SEAL I II v APPROVED JOINT 84PFL~S A I I ! APPROVED JOIAITS I I ( W/C.I. PIPE4Pvc W/C.I. PIPEOR Tank construction I ICI ALARM shall comply with .I I I ILHR 133.15 and 83.20 B I I i I ON C I I c~Y..'l5 I LLEV. FT. PUMP ~ OFF D CONCRETE Ezzu. 92, 00 DLOCK 3" APPRwei RISER EXIT PERMITTED OIJLJ IF TAIJK MA►JUFACTURCR HAS SUCH APPROVAL. BEDDINQ SEPTIC E SPEC.IFICATIOAIS DOSE NUMBER OF DOSES: 3• S3 PER DAy TANK MANUFACTURER: TANK SIZE: GALLOWS DOSE VOLUME r GALLONS ALARM MAUUFACTUFCLR: S'J' ~~u S`4.S'TLy1S IWCLUDIN6 BACKFLOW: SI MODEL KIUMBER: CAPACITIES: A= IKICHES OR 30~ CALLOUS SWITCH TYPE' B= qZ IIJCHES"OR _L G( LLOU5 PUMP MANUFACTURER. C=IUCHES OR S3 CALLOUS MODEL WUMDER. 33 D- 9 INCHES OR_ 6y GALLONS SWITCH TJPE: I'~ CCJj2 IJOTE: PUMP AMD ALARM ARE TO BE MIMIMUM DISCHARGE RATE GPM INSTALLED OM 5EPARATE CIRCUITS . Zo.ZS VEKTICAL DIFFERENCE BETWEEN PUMP Off AUO..015TRIBUTION PIPE.. FEET t MIKIIMUM METWORK SUPPLY PRESSURE . . . . . 2'52 FEET + 155 FEET OF FORCE MAIN X 1.61 F/ofrFRICTIOIJ FACTOR.. z. SO FEET io TOTAL OJWAMIG HEAD = ZS'Z 5 FEET Pump chamber DIAMETER 381 IWTERWAL DIMEIJ610LIf OF TAWK: LEKaGTH - ;WIDTH - ;LIQUID DEPTH BOTTOM AREA 231= GAL/INCH AS PER MANUFACTURER GAL/INCH ME Series 1/3 through 1-1/2 HP Effluent Pumps Performance Curve CAPACITY LITERS PER MINUTE O 50 100 150 200 250 300 350 400 450 100 90 28 BO M 24 v7 70W w~OO 20 M LI- 60 ? Z 0 Q 50 M$~$ 16 w W_ 2 Q 40 M~$O 12 O F- O f- 30 2S. ZS 6 20 X33 10 4 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 130 CAPACITY GALLONS PER MINUTE • 1101 Myer; Parkway, Ashland, Ohio 44805-1923 M"19 419/289-1144 FAX 419/289-6658 Telex 98-7443 K3327 8/92 Printed in U.S.A. -w, aw Givision of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY St. Croix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but 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 INFORM - INFORMATION REVIEWED BY DATE PROPERTY OWNER( -TAA Z(~ I PROPERTY LOCATION Jo Ann Persico Bruce GOVT. LOT NE 1/4SW 1/4,S29 T 30 N,R 19 xR PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM tt #328Co. Rd. #F 17 na Highland Hills phase II CITY. STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE KFOWN NEAREST ROAD Hudson, WI. 54016 (715 386-8236 St. Joseph Co. Rd. #E J)"ew Construction Use Residential 1 Number of bedrooms 3 (I Addition to existing building [ I Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate • _'bed, gpolft2 •6 trench, gpd12 Absorption area required 375 bed, ft2 375 trench, ft2 Maximum design loading rate . 5 bed, gpdm2 •6 trench. gpdnt2 Recommended infiltration surface elevation(s) 112.50 It (as referred to site plan benchmark) Additional design / site considerations na Parent material glacial till Rood p9n elevation, if applicable ana It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN RLL HOLDW, U = Unsuitable for svstem I ❑ S ®U -q~S ❑ U I ❑ S ®U I ❑ S ® U I ❑ S (3U ❑ S SOIL DESCRIPTION REPORT I Depth (Dominant Color I Mottfes Texture Structure Consistence Roots GF Boring # Horizon in Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 1&txclay bee 1 1 ~0-12 10yr4/2 none 1 2msbk mfr gw 2m .5 mm% 2 12-27 10yr5/3 none sil 2mgr mfr I gw If .5 Ground 3 27-37 7.5yr4/4 none sl lmsbk mfr 9w na .4 elev. c 2p /.5yr5/2 111.5Qt. 4 37-84 7.5yr4/4 7.5 r5/8 sl lmsbk mfr na na .4 Depth to limiting factor 37 I Remarks: Boring # 1 0-10 10yr4/2 none i 2msbk mfr gw 2m .5 2 0-20 10yr4/4 none sl 2msbk mfr gw if .5 3 0-26 7.5yr4/4 none sl 2msbk mfr 9w na 5 Ground elev. 4 26-60 7.5yr4/4 none sl lmsbk mfi na na .4 111.5Qt. ~ X991 ~AR 4 limiting factor +6011 ( G Remarks: CST Name:-Please Print Gary L. Steel PhOm: 715-246-6200 Address: 54017 1554 2(JQth. Ave. New Richmond, WI. Date: CST Number: Sgnature: 6-27-S4 cstm 2298 Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page I of 3 Labor and Human Relations Division of Safety & Buildings in accord wit . Adm. Code COUNTY St. Croix Attach complete site plan on paper not less than 8 1/2 as in si„ Plan Jude, but not limited to vertical and horizontal reference point (B ectio 1 gfrslope, c or PARCEL I.D. # dimensioned, north arrow, and location and distance rest road REVIEWED BY DATE APPLICANT INFORMATION-PLEASE PRINT INFdI iZ'*IdN J 3 PROPERTY OWNER: ` PROPE CATION Jo Ann Persico Bruce Peterson p OT NE 1/4SW 1/4,S29 T 30 N,R 19 x>I~(or) W PROPERTY OWNER':S MAILING ADDRESS BLOCK # SUBD. NAME OR CSM # #328Co. Rd. #F na Highland Hills phase II CITY, STATE ZIP CODE PHONE NUMBER ❑VILLAGE [)TOWN NEAREST ROAD Hudson, WI. 54016 (715 386-8236 St. Jose h Co. Rd. #E [yPew Construction Use Residential / Number of bedrooms 3 [ J Addition to existing building j J Replacement [ J Public or commercial describe Code derived daily flow 450 gPd Recommended design loading rate • S bed, gpd/ft2 •6 trench, gpd/ft2 Absorption area required 375 bed, ft2 375 trench, ft2 Maximum design loading rate bed, gpd/ft2 trench, gpd/ft2 Recommended infiltration surface elevation(s) 112.50 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material alacial till Flood plain elevation, if applicable ana ft HOLDING TANK S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL U = Unsuitable fors stem ❑ S ® U nS ❑ U ❑ S ®U ❑ S ® U O S 13U ❑ S 13U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed rends 1 r 1 0-12 10 r4/2 none 1 2msbk mfr gw 2m .5 .6 :gy 2 12-27 10 r5 3 none sil 2m r mfr if .5 .6 Ground 3 27-37 7.5yr4/4 none sl lmsbk mfr 9W na .4 .5 elev. c 2p 7.5yrb/2 111.51ft. 4 37-84 7.5yr4/4 7.5 r5/8 sl lmsbk mfr na na .4 .5 Depth to limiting factor 37" Remarks: Boring # 1 0-10 10yr4/2 none 1 2msbk mfr gw 2m .5 1.6 2 2 0-20 10yr4/4 none sl 2msbk mfr gw if .5 .6 3 0-26 7.5yr4/4 none sl 2msbk mfr gw na .5 .6 Ground elev. 4 26-60 7.5yr4/4 none sl lmsbk mfi na na .4 .5 111.5Qt. Depth to limiting factor +60" Remarks: CST Name:-Please Print Gary L. Steel Phone: 715-246-6200 Address: 1554 th. Ave. Ne Richmond, WI. 54017 Signature: Date: CST Number: , a'~ l! C l~ 6-27-94 cstm 2298 PROPERTY OWNERPersico/Peterson SOIL DESCRIPTION REPORT Page 2. of 3 PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Barxk~ry Roots GPD/ft in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. Bed (Trench 1 0-7 10 r4 2 none 1 2msbk mfr cTw 2f .5 1.6 3 , 2 7-21 10yr4/6 none sil 2msbk mfr gw if .5 1.6 Ground 3 21-48 10yr4/4 none sl 2msbk mfr gw na .5 I.6 eev. 110!70ft. 4 48-6 7.5yr4/4 fif 5yr4/4 sl lmsbk mfi na na .4 .5 Depth to limiting factor 48" Remarks: Boring # Ground elev. ft. Depth to limiting factor F-7 Remarks: Boring # Ground elev. ft. Depth to limiting factor FT Remarks: Boring # Ground elev. ft. i Depth to limiting factor i Remarks: SBD-8330(8.05/92) PROPERTY OWNER Pers ico/Peterson SOIL DESCRIPTION REPORT Page 2-• of 3 PARCEL I.D. # Boring# Horizon Depth Dominant Color Mottles Texture I Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed I er& 1 0-7 10 r4/2 none 1 2msbk mfr 2f .5 1.6 3 r 2 7-21 10yr4/6 none sil 2msbk mfr gw if .5 .6 Ground 3 21-48 10yr4/4 none sl 2msbk mfr gw na .5 .6 eev. 110I70ft. 4 48-6 7.5yr4/4 fif 5yr4/4 sl lmsbk mfi na na .4 .5 Depth to limiting factor 48 Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # •x.Y;e:: Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. j ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel Highland Hills phase II 1554 200th Ave. CSTM2298 lot #17 New Richmond, WI 54017 MPRSW 3254 NE4SW4 S29-T30N-R19W (715) 246-6200 t town of St. Joseph N 1"=40' BM.= top of NE lot stake at el. 100, 40 C) 14- 89, ~ownSla 1 pr b~ r<3- i Gary L. Steel 6-27-94 FROM 04-83-97 08:14AM TO 17153869391 415 P.212 RTC - 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 TQ~V-la Location of property_,VE .1/4_5W1/4, Section 21 T 30N-R_jy W Township - Jose ph Ma i t ing addres s Address of site _ h►1~ V Subdivision name ` Lot no. C7_._. Other homes on property? _Xes__No Previous owner of property e, "Clm v V 'W Total size of property Y_`,~1',•r.t Total size of parcel 13 Ac, Date parcel was created _ Are all corners and lot lines identifiable? _X Yes No Is this property being developed for (spec house) ? A Yes __No volume 1190 and Page Number 322 as recorded with the Register of-Deeds. 1.AA)fi ctrv~ INCLUDE WITH TRIB APPLICATION THE FO1LOWrX68 A WARRANTY 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 review+ng process. If the deed description references to a Certifl®d Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that al.l statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No. , and that 1 (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above describcd property, for the construction of said system, and the same has been duly recorded in the office of the County Register of Deeds as Document No. Signature of Applicant nt Co-Applicant Date of Signature Date of Signaturc FROM 04-03-97 08:13AM TO 17153869391 415 P.1/2 STC- 105 SEPTIC TANK. MAINTENANCE AGREFMEl^TK' St. Croix County OWNEPJBMR shu. ~r-~otr i Th_% MAII.JNG ADDRESS _ PROPERTY ADDRESS (location or septic s m) Please obtain from the Planning Dept. CITY/STATF HOW AO r,.) W; S92 AL t3,__ PROPERTY LOCATION 1,',4, 04 1J4, Soctiou , 'T 3 D -N-RW TOWN OF~ ~s Y o2L ST. CROIX COUNTY, WI SL'SDMSION il~r,a ~j~,y S LOT NUMBER eE MAP , VOLUME PROEc~4__yQ LOT NI;~MBER ~Impropet use and maintenance of your septic system resuld result it, its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licon%ed septic tank pumper. What ynU put into the system carpv, afl'wt the function of the septic tank aK a treatment stage in the waste disposal system. St. Croix County resident may be eligible to receive is g. ant for a rnaxirnum of 60% of the cost of replacement of a failing systett), whirli wan in operation pri3. to July 1, 19? 8. St. Croix County accepted this program in .August of 1980, with the rrquirement tl;: t owacts of all new systems agrcc to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a "ilification Conn, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a Iicestsed pumper verifying that (1) the on-site wastowater disposal systena is in proper operating condition attd (2) after inspection and pumping (if necessat'y), the septic tank is less than: V3 full or" sh-Age and scum. VWe, the undersigned have read the above requirem ants and agree to maintain the private !trwage 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 btu completed and returned to the St. Croix County Zoning Officer within 30 days of tbo three year expiration date SIGNED: DA'It: ~ - St. Croix County Zoning Office Government Center 110! Carmichael Road Hudson, Wl 54016 11/93 I _ w S00°18' 8"E 487.89' I Y-/ U a p o • W1 r i J M I , !A LL. o~ O N ! . K O OI cr N c ( O U v) o O N~ a o w ! ti - M 0 !n N ® 2 wl ° O O MM / ~i _ M I I ' 1 CL I I I 302. 57 i Ln I 35 wl OI ; zl S02°48'04"E 440.43' i Ji UI w : I I pl C) I N tD ~ . QO 0 : Z : N W F- N (D z b M Q w 0 z w N 3 : w N - 0 W W I~ W~ a: w 000 _ 0 a p N 6 OD O 0 p dN LC) I - - I { co z f 0) N J _ O g O G LI pl O W N zj- >I QI W N I U) : W 3 Z N N liI w I J N I C _ • l0 Q~ o 0 440.50 0q N N03°2T%06"W N C') I r I I W I N o l I JI w1 OI w ° ~I z1 cnl ° 0 rr-i Ji UI zl M z wl 01 of 9 Q s Q u I > I o f J I w N W N z ~ 01 iv N LD o LLJ C; I c0 = co °co Q i N z JI z ~I 0) ::D I w z N D Veci'iq(1~r39 i STATE BAR OF WISCONSIN FORM( 11 - 1931" 1 LAND CONTRACT i Indi.Idual aed Coryo,vte 5 GA3 !i ITO BE USED FOR ALL TRANSACTIONS WHERE OVER REGISrER5 OFFICE DOCUMENT NO I 535.00013 FINANCED ANr` IN OTHER NON-CONSUMER ! ACT TRANSACTIONS) -------_I ST. CROIX C 1 . Ya II Contract, by and between -Highland Hills rJUL: IT 1996 a PartnershiD. - i ("Vendor", at 10:45 AM whether one Or more) and Tacha -_rMron, Fbolsterof Ceeds ("Purchaser", whether one or more). Vendor sells and agrees :o convey to Purchaser, upon the prompt and full perfor- mance of this contract by Purchaser, the following property, together with the rents, li profits, fixtures and other appurtenant interests (all alley the "Property"), in THIS SPACE RESERVED FOR RECOR O DATA St. Croix County, State of Wisconsin: NAME AND RETURN ADDRESS I~ I~ ~j (Parcel Identification Number) i! l Lot 17, Highland Hills First Addition to the Town of St. Joseph, St. Croix 11 County, Wisconsin. ~f _ $ XIMI§fER l it This 1S not homestead property. u XW ) IS nOt I~ Purchaser a reel to.purchase the Property and to pay to Vendor m place Vendor directs the sum of 0 1 • CD in the following manner. (a) S 4.000.00 at the execution of this Contract; and (b) the balance of S 36 0W • OO , together with interest from date hereof on the balance outstandin, from time to time at the rate of ei t percent per annum until paid in full, as follows j Commencing on the 27th day August, 1996, and on the22t:h day of each and every month j thereafter, equal monthly installments of principal and interest in the amount of I' $344.16. Provided, however, the entire outstanding balance shall be paid in full on a before the 2 h day of July ,19 98 (the maturity date). Following any default in payment, interest shall accrue at the rate of 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 Vmonthly to Vendor amounts sufficient to pay reasonably anticipated 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 b the Vendor for by payment of taxes, assessments and insurance will be deposited into as 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 and then to principal. Any amount may be prepaid without premium or fee upon principal at any time w In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long w the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be crated 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 continued in the event of credit of any proceeds of insurance or condemnation, the condemned premises being thereafter excluded berefrom. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except: `t.. l Purchaser promises to pay when due all taxes and assessmcnts levied on the Property or upon Vendor's interest in it and to deliver to Vendor oa de3 Ad receipts showing such payment. Purchaser shall keep the improvements on the Property insured against loss or damage occasioned by fire, extended coverage perils and cnch ot'ser hazards as Vendor may require, without co-insurance, through insurers approved by Vendor, in the sum of $ - NIA- but Vendor shall not require coverage in an amount move than the balance owed under this Contract. Purchaser shall pay the insurance premiums when du`_ The policies shall contain the standard clause in favor of the Vendor's interest and, unless Vendor otherwise agrees in writing, the ongtaal of ail policies covering the Property shall be deposited with Vendor. Purchaser shall promptly give notice of loss to insurance companies and Vendor. Unless Purchaser and Vendor otherwise agree in writing, insurance proceeds shall be applied to restoration or repair of the Pr. petty damaged. provided the Vendor deems the restoration or repair to be economically feasible. Purchaser covenants not to commit waste not allow waste to be committed on the Property, to keep the Property in good tenantable condition and repair, to keep the Property free from liens superior to the lien of this Contract, and to comply with all laws, ordinan%;ts and regrtatioas affecting the Property. Vendor agrees that in case the purchase price with interest and other moneys shall be fully paid and all conditions shall be fully performed at the times and in the manner above specified, Vendor will on demand, execute and deliver to the Purchaser, a Warranty Deed, in fee simple, of the Property, free and clear of all liens and encumbrances, exce t any liens orf w nc mbrances createdby the ac or default of Purchaser, and exceyc --Fast~enti~~ tr?ctions a-Q of ~Lw_0r if an any, Purchaser agrees that time is of the essence and (a) in the event of it default in the payment of any principal or interest which continues for a period of days following the specified due date or (b) in the event of a default in performance of any other obligation of Purchaser which continues for a period of days following written notice thereof by Vendor (delivered personally or mailed by certified mail); them the entire outstanding balance under this contract shall become immediately due and payable in full, at Vendor's option and without notice (w Bich Purchaser hereby waives), and Vendor shall also have the following rights and remedies (subject to any limitations provided by law, a addition to those provided by law or in equity: (i) Vendor may, at his option, terminate this Contract and Purchaser's rights, title and interest in the Property and recover the Property back through strict foreclosure with any equity of redemption to be conditioned upon Purchaser's full payment of the entire outstanding balance, with interest thereon from the date of default at the rate in effect on such date and other amounts due hereunder (in which event all amounts previously paid by Purchaser shall be forfeited as liquidated damages for failure to fulfill this Contract and as renal for the Property if Purchaser tails to redeem); or (ii) Vendor may sue for specific performance of this Contract to compel immediate and full payment of the entire outstanding balance, with ;nterest thereon at the rate in effect on the gate 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 declare this Contract at an end and remove this Contract as a cloud 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 Property and have a receiver appointed to collect any rents, issues or profits during the pendency of any action under (i), (ii) or (iv) above. Notwithstanding any oral or wrixtrn statements or actions of Vendor, an election of any of the foregoing remedies shall only be binding upon Vendor if and when pursued is titi pition and all costs and expenses including reasonable attorneys fees of Vendor incurred to enforce any remedy hereunder (whether abated or not) to the extent not prohibited by law and expenses of title evidence shall be added to principal and paid by Purchaser, as incurred, and shall be included in any judgment. Upon the commencement or during the pendency of any action of foreclosure of this Contract, Purchassr consents to the appointment of a receiver of the Property, including homestead interest, to collect the rents, issues, and profits of the Property during the pendancy of such action, and such rents, issues, and profits when so collected shall be held and applied as the court shall direct. Purchaser shall, not transfer, sell or convey any legal or equitable interest in the Property (by assignment of any of Purchaser's rights tinder 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 full or the interest conveyed is a pledge or assignment of Purchaser's interest under this Contractstalely 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 ttotice. Vendor shall make all payments when due under any mortgage outstanding against the Property on the date of this Contract(except forany mort3age 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 if Vendor fails to do so and all ^ tyments so made by Purchaser shall be considered payments made on this Contract. Vendor may waive any default without waiving any otb^r subsequent or prior default of Purchaser. All terms of this Contract shall be binding upon and inure to the benefits of the heirs, legal representatives, successors and assigns of Vendor and Purchaser. (If not an owner of the Property the spouse of Vendor for a valuable consideration joins herein to release homestead rights in the subject Property and agrees to join in the execution of the deed to be made in fulfillment hereof.) Doted this N6 - day of Jules H-ighland Hills, a Partnership (SEAL) ~:A ' O~ (SEAL) JoAnn Persico, Individually and as Tosha M. Thron - Power o Attorney or Bruce Peterson aM Roger Ruelin (SEAL) (SEAL) i AUTHENTICATION ACKNOWLEDGMENT mss) STATE OF WISCONSIN ss. St. Croix County audwatkated this day of _,19- Personally came before me this day of T111 W , l9__% the above named 1nAnrt PPrgicn TnfJi1irit1a113 arci ac Prwer • -rueSm fpr_ Bogor P.-nice Reteimon and TnIE: MEMBER STATE BAR OF WISCONSIN Ruel s.. ,,.,a Toghia M lbron (If not, authorized by §706.06, Wis. Stats.) to me known to be the persons the . MP