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038-1014-10-000
a o a) o a) °O_ h o O 4 h I I 0 N E ti y 0 m CL .0 y U) N N L N a 0 3 E z y c Z a c Z n LL N LL c y 00 C O)e CD > N 10 L N a 6 I E Q U.- E Q c V m N O CL x cc OD Z E E Zw am am ce c,) z 0 0 z a v w d Z w : 0 H C a) z Q) a) c t c o v O v O L0 Q 2 Z Z = z z w z U, c O O N d d d 16 C C. 10 w m C. to w O` C H d d N N d N T O O G C d a 'O G G a oo N w c frn 0 U>• _j 0 cnn rN w ~ v~J E 3 3 3 EL S cLi 3 3 3 z° c • 4.; 3 a a a 3 as a s N IL a) m N 7 0 N y U)JC~ ~rn z° U m U 3 a Q V N T U L O m Q z in L O d Q}~ m 0 U') N H N H N Al 03 ;O N N C C H C E O O r"i O cio ~ w y m a) V d O a QI C -O N E c V y Ci w °r co 0 ° .N c 0-0 cb M a Z o aNi Z c~ ayi w c ID • m cn m o c E ma) a c o O O O V) S N O Z 2 N 0 Z- d' CO m € CL € a #t EL is a 4-, L• LL W- rr`wI~i ° c c c _1 A uIL2 ONV 1 030)0 Parcel 038-1014-10-000 04/19/2005 01:50 PM PAGE 1 OF 1 Alt. Parcel 3.31.18.36D 038 - TOWN OF STAR PRAIRIE Current [_X j ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * HARVIEUX, DAVID J DAVID J HARVIEUX 2355 W CEDAR LA NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 2355 W CEDAR LN SC 3962 NEW RICHMOND SP 1700 WITC SP 8055 CEDAR LAKE/N R Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE SEC 3 T31 N R1 8W PT GI-1 COM S LN GI-1 & Block/Condo Bldg: HIWATER LK, TH N 50 DEG W ON MEANDER LN 120 FT, S 39 DEG W 99.3 FT TO S LN E Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 155.6 FT TO POB EZ-UT-1274/573 03-31 N-1 8W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1131/544 LC 2004 SUMMARY Bill Fair Market Value: Assessed with: 29587 117,000 Valuations: Last Changed: 10/12/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 73,600 48,600 122,200 NO Totals for 2004: General Property 0.000 73,600 48,600 122,200 Woodland 0.000 0 0 Totals for 2003: General Property 0.000 44,800 38,800 83,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 221 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 IUA- J N, STC - 104 AS BUILT SANITARY SYSTEM REPORT , F REcE~~.0 OWNER David Harvieux t `14 1 T97 ST C11 ADDRESS 2355 W. Cedar Lane COUNTY co y0N1NGOFFtCE New Richmond, WI 54017 SUBDIVISION / CSM# Govt. Lot 1 LOT 36 D SECTION 3 T 31 N-R 18 W, Town of Star Prairie ST. CROIX COUNTY, WISCONSIN L PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM t ~ tHVA1 r 114 (c e d ,L G n Y ~ /L6ICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover- J BENCHMARK: L- ALTERNATE BM: / / OLDING TANK INFORMATION Manufacturer:_ 14 i t , Liquid Capacity: 3 e?0 0 Setback from: Well House Other- "'t,(-ma , c:. Pump: Manufacturer Model# Size ►r Float seperation Gallons/cycle: Q 3 G o Alarm Location -4& Mpff-,, I t ' GUS SOIL ABSORPTION S STEM Width: Length Nu er of trenches Distance & Direction to nearest pop. line: Setback from: well: Hou a Other ELEVATIONS Building Sewer !'S ST Inlet: ST outlet: 1W inlet 9 PC bottom Pump Off Top o,F' _I CPS ~Cf ' -6 x 93' Yv Bottom of 17' Ad MJ ° 2 51 Final grade 'n o l DATE OF INSTALLATION: PLUMBER ON JOB: / Ro t LICENSE NUMBER: C) J INSPECTOR: L a 3/93:jt 1 ST. CROIX COUNTY WISCONSIN ZONING OFFICE N N O R ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 November 12, 1997 Bryon R. Bird, Sr. 1359A 100th St. Amery, WI 54001 Dear Bryon: Pursuant to our conservation on November 11, 1997, the St. Croix County does require as-builts to be submitted by the installing plumber to the zoning department. Please find enclosed a STC-104 as-built report and the elevations shot on the eleventh. Complete and send the as-built report to the: St. Croix Zoning Department Attn: Rod Eslinger 1101 Carmichael Road Hudson, WI 54016 Holding Tank Manufacture: Huffcutt 3000 gallons Benchmark: Top of cement pad (entry way) 100.00' Instrument Height 105.25' Building Sewer 98.75' Holding tank inlet 98.29' Top of Tank 99.29' Bottom of Tank 93.44' Final Grade 100.08' Sincerely, R~ Rod Esli ger Zoning Technician Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: ,Safety and Buildings Division ST. CROIX a , INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) SanitaryAf9fllo4: Personal information you provice may be used for secondary purposes [Privacy La , s.15.04 (1)(m)]. 7l HARVIEUXNa DAVID ❑ j \V n of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description: Parcel TI~._] 01410-000 - 0_ t loc> TANK INFORMATION ELEVATI N DATA A9700478 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 5.25 /ra~~~ /00 Dosing Aeration Bldg. Sewer s~ 9F•75-~ olding v ~~C~ ~,et r -9t(g)nlet TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. AirI to ntake ROAD Dt Inlet Air I Septic NA Dt Bottom Dosing NA Header/Man. Aeration NA Dist. Pipe olding 130" G r Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand 9 I 5L7C 2_'7 Model Number GPM ` _j TDH Lift Friction Sy em TDH Ft oss ad Forcemain Length Dia. V Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length o. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE / STREAM LEACHING Ma f turer: SETBACK INFORMATION Type O CHAMBER Moe umber: System: OR UNIT DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacin SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only f xx Seeded / Sodded xx Mulched th O Depth Over Depth Over VP111p Bed /Trench Center Bed /Trench Edges il ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, et LOCATION: STAR PRAIRIE 3.31.18,NE,NW 2355 WEST CEDAR LANE L( CA16-VC vac I t/ ~7 Plan revision required . ❑ Yes ❑ No j(( 10/711 Rd g&e:, A/ 7 Use other side for additional information. SBD-6710 (R.3/97) Date Inspector's 5 nature e ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ! Safety and Buildings Division SANITARY PERMIT APPLICATION Bureau of Building water systems 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 8 112 x 11 inches in size. St. Croix 0 See reverse side for instructions for completing this application State Sanitary jPermit Number The information you provide may be used by other government agency programs 0 Check it revision previous application (Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION 97 11193 Property Owner Name Property Location G Wt David Harvieux NE1/4 NW 1/4, S Vt 7 W , Al, R 18 E (or) Property Owner's Mailing Address Lot Number Block Number 2355 W. Cedar Lane 36 D Ci~ty, State Zi Code Phone Number Subdivision Name or CSM Number New Richmond WI 4017 (71548 3086 Road 11. TYPE OF BUILDING: (check one) ❑ State Owned ❑ City age Star Prairie Nearest Cedar Lane ❑ Public 1 or 2 Family Dwelling - No. of bedrooms 3 ❑ VII Town OF III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 000 - 101q- /0 1 ❑ Apartment/ Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. ❑ New 2. Q Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an _____System________System_____________TankOnly Existing System _________ExlstingSystem 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 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ® Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area It. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation 450 Feet Feet Ca aat VII. TANK in gallons Total # of Prefab. Site Fiber- Exper- INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Existing strutted Tanks Tanks Septic Tank or Holding Tank X 3000 1 of f cutt Conc. ❑ ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑ VI11. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plu is Signature: (N Stamps MP/MPRSW No.: Business Phone Number: Byron R. Bird 220528 268 8317 Plumber's Address (Street, City, State, Zip Code): 1359A 100 St. Amery, WI 54001 IX. COUNTY / DEPARTMENT USE ONLY FEE]] isapproved Sanitary Permit Fee (Includes Groundwater Date Issue Issuing A nt Si a No mps Surcharge Fee) l (Approved wner Given initial -4Z C,' dverse Determination vv /(/6 X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SHD-6398 (R. BS/94) ` DISTRIBUTION: original to County, one cupy To: Safety & Buildings Division, 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. Cinsite 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: 1. 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 on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system- Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7_ VII. Tank information. Fill in the capacity of every new/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 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater.' The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. SAFETY AND BUILDINGS DIVISION 15837 USH 63 Hayward, WI 54843 Department of Commerce Tommy G. Thompson, Governor 07-Nov-97 William J. McCoshen, Secretary Byron Bird Sr. 1359A 100 St Amery WI 54001 Dave Harvieux Plan ID 9711193 NE,NW,3,31,18W Municipality of Star Prairie Inspector: Leroy G. Jansky County of St Croix (715) 726-2544 Private Sewage plans including the following element(s): HOLDING TANK 450 gpd The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(2)(e), Wisconsin Statutes, is responsible for compliance with all code requirements. This plan action is subject to the comments on the plan. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department. All permits required by the state or local municipality shall be obtained prior to commencement of construction/installation/operation. This project is under the supervision of a state inspector. As inspection concerns arise feel free to contact the state inspector at the number listed. The inspector for this project is listed above. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Please refer to Plan ID number listed at the top of this page when making an inquiry or submitting additional information. Sincerely, Patricia Shandorf POWTS Plan Reviewer (715) 634-4870 WORKSHEET JOB DESCRIPTION: Residential three bedroom home. Size and shape of Lot, the Well location and setback requirements result in insufficient area to install a code compliant POWTS at this Site. HOLDING TANK SIZING CALCULATIONS: 1. 3 Bedroom Residence 2. Minimum Required Capacity = 2,000 Gal. 3. Tank Manufacturer & Capacity being installed: 3,000 Gallon Huffcutt NOV0719g7 97 ,11193 X7.5 _ 7 V 'l ~/V( «-r fve 5~;~1 CL) DAVID HARVIEUX 2355 W. Cedar Lane New Richmond, WI 54017 Govt. Lot 11 NE4, NW4, S3, T 31 N, R 18 W, Lot 36 D Town of Star Prairie, St. Croix County 3 Bedroom, Daily Flow 450 gpd .W.I.S 3000 Gallon Concrete Huffcutt Tank 0 la~'tlo lly Size & Shape of Lot, the Well location and setback requirements VED result in insufficient area to DEPARTME OFC CE install a code Compliant POWTS. D ON OF FET AND BU DINGS SE CORRESPONDENC ~cec vt HOLDING TANK CROSS SECTION (no scale) WEATHERPROOF JUNCTION BOX HIGH WATER WARNING DEVICE LOCated IN/ON 4MA CKING DEVICE AND BUILDING SERVED RNING LABEL AT COVER _T__ F 12" MINIMUM t4" MINIMUM MIN. 2" VENT WITH GRAD E RETURN BEND OR 4" WITH ; APPROVED VENT CAP. /0' MIN. FROM DOOR, WINDOW OR FRESH q 18" MINIMUM AIR INLET AIRTIGH T SEAHIGH WATER _ IT ALARM SWITCH - - - - BLIND PVC OR CI PLUG DEPARTMENT APPROVED JOINT WATERTIGHT JOINTS ARE INDICATED BY UNLABELED ARROWS *PROVIDE APPROVED PIPE FROM INLET TO 3' BEYOND EDGE OF UNDISTURBED SOIL 3" Bedding Under Tank SPECIFICATIONS TANK MANUFACTURER: HUFF.CUTT_ CONCRETE PRODUCTS, INC. TANK CAPACITY: 3000 GALLONS LEVEL ALARM, MODEL 101 HW Inlet MERCURY SWITCH Length = 1416" Width = 7'6" David Harvieux 2355 W. Cedar Lane New Richmond, WI 54017 Govt. Lot 1, NE4, NW4, S 3, T 31 N, R 18 W Lot 36 D Town of Star Prairie St. Croix County WI G// 3 Bedrooms DAILY FLOW = 450 9-Ir PRIVATE SEWAGE SYSTEM Department ofcommeros Safety and Buildings Division REVIEW APPLICATION Bureau of Integrated Services Hayward Office LaCrosse Office Madison Office Shawano Office Waukesha office 209 W. 1 st St 2226 Rose Street 201 E. Washington Ave. 1340 E. Green Bay St. 401 Pilot Court, Ste. C Rt 8, Box 8072 LaCrosse, WI 54603 P.O. Box 7969 Suite 300 Waukesha, WI 53188 Hayward, WI 54843 -Phone (608) 785-9334 Madison, WI 53707 Shawano, WI 54166 Phone (414) 548=8606 Phone (715) 634-4804 fax (608) 785-9330 Phone (608) 266-3151 Phone (715) 524-3626 Fax (414) 548-8614 Fax (715) 6345150 Fax (608) 267-9566 Fax (715) 524-3633 INSTRUCTIONS: To save time, schedule your review with one of the offices listed above prior to submittal. Fill in all applicable data and submit this form together with fees and planstinformation. Your submittal must be received at least two working days prior to the appointment at the office where. your review was scheduled. Please call any of the listed offices if you need help filling out the form or have questions on what information to submit' PLEASE PRINT VERY CLEARLY. A sample of a completed form Is on the reverse side for your reference. Personal information you provide may be used for secondary purposes [Privacy Law, s. 15.04 (1)(m)]. 1. APPOINTMENT INFORMATION - If you have scheduled an appointment, fill in the information requested below to save time:- Appointment Date Reviewer Name Plan Identification Number ll ~7 ,97 97 11193 2. PROJECT INFORMATION If this review is a revision or extension to your existing plan identification number, provide that number here: . Project Name County DAVID J. HARVIEUX ❑city ❑Village ®Town of: ST. CROIX Project Location Lot GOVT. LOT 1 NL4 NW1/4,s3, T 31 N,R 18E(or)I Star Prairie 3. APPLICATION FOR 4. FEE COMPUTATIONS FEE SUBMITTED System Type (check one): System Type '.(Include new and existing tanks) A ❑ At-Grade Up To 1,500 gallon septic tank ....................................$110.00...:.................. H ® Holding Tank 1,501 - 2,500 gallon septic tank .....................................$120.00...................... M ❑ Mound 2,501 5,000 gallon septic tank .....................................$160.00...................... N ❑ Non-Pressurized In-Ground (Conventional) 5,001 - 9,000 gallon septic tank .....................................$200.00...................... P ❑ Pressurized In-Ground 9,001 -15,000 gallon septic tank .....................................$300.00...................... O ❑ _Other. Over 15,000 gallon septic tank .....................................$500.00...................... Up To 1,000 gallon dose chamber 70.00...................... Building Type (check one): 1,001 2,000 gallon dose chamber 80.00...................... D [3 Dwelling, 1 or 2 Family 2,001 - 4,000 gallon dose chamber ...............................$100.00...................... P ❑ Public Building 4,001 8,000 gallon dose chamber ...............................$120.00...................... S ❑ State-Owned Building 8,001-12,000 gallon dose chamber .................$140.00..... Over 12,000 gallon dose chamber .................$160.00...................... 60.00 450 Up To 5,000 gallon holding tank $ 60.00 Code Derived Daily Flow gpd 5,001 -10,000 gallon holding tank ...................................$100.00................,..... Over 10,000 gallon holding tank ..................................$150.00...................... ® Check If Replacing Existing System Experimental System (additional one time fee) ................$300.00...................... Revisions to Approved Plan 2 60.00...................... Petitions for Variance: Setback ...................................$100.00...................... Petition for Variance Site Evaluation .........................$225.00.:.................... Plumbing .................$225.00...................... Revision 75.00...................... ❑ Groundwater Monitoring Groundwater Monitoring- Per Site 60.00..... other than a proposed subdivision ❑ Site Evaluation in Lieu of Groundwater Monitoring Site Evaluation' in Lieu of Groundwater Monitoring 60.00 60.00 Subtotal: Priority'Review: Enter same amount as Subtotal: 6 MAKE ALL CHECKS PAYABLE TO: SAFETY AND BUILDINGS DIVISION Total Fee: 5. SUBMITTING PARTY INFORMATION Telephone No. (include area code & extension) Company Name Contact P r on Bird , S r . ( 715 ) 268 8317 Byron Bird, Sr. Plumbing t3Y No. & Street Address or P.O. Box City, Town or Village, State Zip Code 1359A 100 St. Amery, WI 54001 1 Aerobic or prepackaged treatment system fees are calculated based on equivalent size septic tanks and dose chambers. 2 Revision fees are not applicable to temporary holding tanks or extensions to existing approvals. ~vca WORKSHEET JOB DESCRIPTION: Residential three bedroom home. Size and shape of Lot, the Well location and setback requirements result in insufficient area to install a code compliant POWTS at this Site. HOLDING TANK SIZING CALCULATIONS: 1. 3 Bedroom Residence 2. Minimum Required Capacity = 2,000 Gal. 3. Tank Manufacturer & Capacity being installed: 3,000 Gallon Huffcutt ~Xd _ t 5 DAVID HARVIEUX 2355 W. Cedar Lane New Richmond, WI 54017 Govt. Lot 1, NE4, NW4, S3, T 31 N, R 18 W, Lot 36 D f, 3 Town of Star Prairie, St. Croix County 3 Bedroom, Daily Flow 450 gpd 3000 Gallon Concrete Huffcutt Tank Size & Shape of Lot, the Well location and setback requirements result in insufficient area to install a code Compliant POWTS. _ cube ~1 HOLDING TANK CROSS SECTION (no scale) WEATHERPROOF JUNCTION BOX HIGH WATER WARNING DEVICE LOCate.d IN/ON LOCKING DEVICE AND BUILDING SERVED WARNING LABEL AT COVER CONDUIT 12" MINIMUM 4" MINIMUM MANHOLE - MIN. 2" VENT WITH MIN.24" ID GRADE RETURN BEND OR 4" WITH APPROVED VENT CAP./0' MIN. FROM DOOR, WINDOW OR FRESH - 18" MINIMUM AIR INLET AIRTIGHT SEAL HIGH WATER - 1' ALARM SWITCH - BLIND PVC OR CI PLUG DEPARTMENT APPROVED JOINT WATERTIGHT JOINTS ARE INDICATED BY UNLABELED ARROWS *PROVIDE APPROVED PIPE FROM INLET TO 3' BEYOND EDGE OF UNDISTURBED SOIL 3" Bedding Under Tank SPECIFICATIONS TANK MANUFACTURER: HUFFCUTT, CONCRETE PRODUCTS, INC. TANK CAPACITY: 3000 GALLONS LEVEL ALARM, MODEL 101 HW Inlet Length = 1416" MERCURY SWITCH Width = 7'6" David Harvieux 2355 W. Cedar Lane New Richmond, WI 54017 Govt. Lot 1, NE4, NW4, S 3, T 31 N, R 18 W Lot 36 D Town of Star Prairie St. Croix County WI 3 Bedrooms DAILY FLOW = 450 Wisconsin Department of Industry, SOIL AND SITE EVALUATION 'Labor and Human Relations Page of Division of Safety and Buildings 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 size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and ro C ©V y~ 54. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. # 03 - to/ -/o APPLICANT INFORMATION- Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Tao • c. r V `i f' V A Govt. Lot 0 E 1/4 M\)}1/4,S 3 T 3' N,R f $ E (or 1~ Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# a355 Q. a a, L it city State Zip Code Phone Number [:1 City ❑ Village fig Town Nearest Road M64 L~1.t•.otA W-1 5'1011 ( IIS)AYS-308(0 S-~ar L e v, v-P ❑ New Construction Use: ® Residential / Number of bedrooms 3 Addition to existing building © Replacement U ❑ Public or commercial - Describe: Code derived daily flow 15 0 gpd Recommended design loading rate bed, gpd/ft2 trench, gpd/ft2 Absorption area required bed, ft2 n trench, ft2 Maximum design loading rate bed, gpd/ft2 trench, gpd/ft2 Recommended infiltration surface elevation(s) qQ. (o77 ~ ~ft (as referred to site plan benchmark) Additional design/site considerations U Parent material Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system El S ® U ❑ S ®U El S ® U El s ® u El S 2 U. S ❑ U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 t o- u DI ZIl I F(oFes- ~ , y Ground 3 -W s u- map 17. KR 7/1 t./ S L . rte ~btiC,, F^ -if •5 + 4i elev. Depth to J 0 7 Y P IDY 1/1S l~ • ~ r~ t 7 , , S re•. S , limiting factor Remarks: 1 0% Qa* "b A" oZ It1 Boring # Ground elev. ft. ' Depth to limiting factor in. Remarks: CST Name (Please Print) y Signature Telephone No. Z~K~~ -a~% -isp ~Dckt,rsu Address Date CST Number CJ o Or~ -E , S-ta-q, r` Gam. r . < 0= 11 - S y oab r SOIL DESCRIPTION REPORT PROPERTY OWNER Page of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Structure G~pjft2 9 in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. ' Depth to limiting factor in. Remarks: SBDW-8330 (R. 08/95) Set. J ~ S 9oll I Iz '00000 .110 M D ~ 4- O N o C Ia B- A L r t vy\ i 436 o ~ _ _ , ~ ~ ~ ~ 1 _ ~ i ~ ~ i ~ -j- - ~ ' ~ - ~----~--s- ' ~ 1 { ! - ~ - - I ~ + _i. ~ - - _ i ~ 1 ~ w - 1 __l_ HOLDING TANK SERVICING CONTRACT lontiact Date This contract is made between the Holding Tank Owner(s) Name(s) and I Pumpers Nam We acknowledge the installation of (a) holding tank(s) on the following property: (Provide legal descriptions:) SZ? •SE'C 3 T3'//~l /81•✓' PT C L / eo/y S L At GL / E ~llG~4T~e L Tf/ nt .S® O~`C~ oN /fet4A4©EZ /.N Iza ~f/a 537 O wfa liSl' ff~ 3 E7r T-a S L. nl E 155---6 FT r'o P®B 1 . The owner agrees to file a copy of this contract with the local governmental unit that has signed the pumping agreement required in Ch. II-HR 83.18(4) (b), Wis. Adm. Code and with the County of S'i eX01X 2. The owner agrees to have the holding tank(s) serviced by the pumper and guarantees to permit the pumper to have access and to enter upon the property for the purpose of servicing the holding tank(s). The owner agrees to maintain the access road or drive so that the pumper can service the holding urn(s) with the pumping equipment. The owner further agrees to pay the pumper for all charges incurred In servicing the hoiding tank(s) as mutually agreed upon by the owner and pumper. 3. The pumper agrees to submit to the local governmental unit which has signed the pumping agreement required by s. II-HR 83.18 (4) (b), Wis. Adm. Code, and to the County, a report for the servicing of the holding tank(s) on a semiannual basis. The pumper further agrees to include the following in the semiannual report: a. The name and address of the person responsible for servicing the holding tank; b. The name of the owner of the holding tank; U. The location of the property on which the holding tank is installed; d, The sanitary permit number issued for the holding tank; e. The dates on which the holding tank was serviced; f. The volumes in gallons of the contents pumped from the holding tank for each servicing; g. The disposal sites to which the contents from the holding tank were delivered. 4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event of a charge in this contract, the owner agrees to file a copy of any changes to this service contract or a copy of a new service contract with the local governmental unit and. the County named above within ten (10) business days from the date of change to this service contract. Owner(s) Name(s) (Print)) Owner Signature(s) -176-'l -0 ~ Subscribed and swom to me on this date: C,w-o4 A . Q/0 ,Qra Today's Date I I Pumpers Name (Print I Pump s Signa K Notary Public Signature - I idIT Pumpers Registration Number Fratlon ° • 6: • • ~s W • , Drafted by ti ,Il Wisrjnsin Department of Industry, HOLDING TANK AGREEMENT Safety and Buildings Division Labor and Human Relations Bureau of Buildings and Water Systems ' This space reserved for recording data Document No. /Plan Identification No. This agreement is made between the governmental unit and holding tank Agreemen Date owner(s) Govern ental nit Holding Tank Owners S .Q v.r`7 J.io,e N6 uX Parcel ID No. 34' z~ Ci4ROL A ~oNlt/S'oi✓ We acknowledge that application is being made for the installation of (a) holding tank(s) on the following property: (Provide legal land description) Sire 3 7-3 /N /8G✓ P7- GG / o s LN GG / ir j411 WA 7_45%e' 44- 7-W N 6-C 0,65G A,,- 0AI/fOAM0459 ZAI /2ca i S -37 4`E6 Al 9'7- 3 i"r 7-0 S Z, G 1SS f7 ---r 70 M Return To or that continued use of the existing premises requires that a holding tank be installed on the property for the purpose of proper containment of sewage. Also, the property cannot now be served by a municipal sewer, or any other type of private sewage system as permitted under Ch. ILHR 83, Wis. Adm. Code, or Ch. 145, Stats. As an inducement to to issue a sanitary permit for the above described property, we agree to do the following: 1. Owner agrees to conform to all applicable requirements of Ch. ILHR 83, Wis. Adm. Code relating to holding tanks. If the owner fails to have the holding tank properly serviced in response to orders issued by the governmental unit to prevent or abate a human health hazard as described in s- 254.59, Stats., the governmental unit may enter upon the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by s. 66.60, Stats. 2. The owner agrees, pursuant to s. ILHR 83.18 (10), Wis. Adm. Code, to have installed in a new building or new structure a water meter approved by the County and State. The water meter shal! be installed by a plumber authorized by the State to conduct such installations, with said installation complying with State regulations and manufacturers specifications. The owner agrees to be financially responsible for the purchase, installation, maintenance, and repair of the water meter, and agrees to allow the governmental unit Co enter the above described property on a regular basis to read and/or inspect the water meter. 3. Owner agrees to pay all charges and costs incurred by the governmental unit for inspection, pumping, hauling, or otherwise servicing and maintaining the holding tank in such a manner as to prevent or abate any human health hazard caused by the holding tank. The governmental unit shall notify the owner of any costs which shall be paid by the owner within thirty (30) days from the date ,)f notice. In the event the owner does not pay the costs within thirty (30) days, the owner specifically agrees that all the costs and charges may be placed on the tax roll as a special assessment for the abatement of a human health ha:,ard, and the tax shall be collected as provided by law. 4. The owner, except as pc ovided by s. 146.20 (3) (d), Stats., agrees to contract with a person who is licensed under Ch. NR 113, Wis. Adm. Code, to have the holding tank serviced and to file a copy of the contractor the owner's registration with the governmental unit. The owner further agrees to file a copy of any changes to the service contract, or a copy of a new service contract, with the governmental unit within ten (10) business days from the date of change to the service contract. 5. The owner agrees to contract with a person licensed under Ch. NR 113, Wis. Adm. Code, who shall submit to the governmental unit and the county on a semiannual basis a report in accordance with s. ILHR 83.18 (4) (a) 2., Wis. A :n. Code, for the servicing of the holding tank. In the case of registration under s. 146.20 (3) (d), Stats., the owner shall submit the report to t're governmental unit and the county. The governmental unit or county may enter upon the property to investigate the condition of the holding tank vrrhen pumping reports and meter reading! may indicate that the holding tank is not being properly maintained. 6. This agreement will remain in effect only until the governmental unit responsible for the regulation of private sewage systems,certifies that the property is served by either a municipal sewer or a soil absorption system that complies with Ch ILHR 83, Wis. Adm. Code. In addition, this agreement may be cancelled by executing and recording said certification with reference to this agre ,rst in such manner which will permit the existence of the certification to be determined by reference to the property. 7. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shall submit the agreement to the register of deeds, and the agreement shall be recorded by the register of deeds in a manner which will permit the existence of the agreement to be determined by reference to the property where the holding tank is installed. Owner(s) Name(s) - Print Not, i d O er(s) Signat re(s) r Q ® , vlE Subsch ed and sworn to before me on this date: Notary Public ZIOLZ Governmental Unit Official Name - Print vernmenta! Unit Offical's Si ure ✓ / N t7 My commission expires: Governmental Unit Official Title - Print ! 96 The information you provide may be used by other government agency programs !Privac; Law, s. 15.04 (1)(m)l SBDW 6123 (R 09/94) 8TC-loo This application form is to be completed in full qpd signed by the owner(s) of the property being developed. Any ¢nadequacies will only result in delays of the per*tt 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 dubmitted to this office with the appropriate deed recording. 4,------------------------- Owner of property ©AVta 11,4,eV/,6CJX Z_A,eoe_ q -t'r Location of property 1/4 1/4, Section 3 T31 N-R /c9 W Township57A_X ,afP~E Mailingaddress 2355 ~ic%ST ~Epe}„e Env' v,tilO, 5~4t Address of site 23SS Al, Ep44 ZA1 Subdivision name Lot no. Other homes on property? -Yes- -No Previous owner of property V" 45u1(( Total size of property , It,' `X Total size of parcel Date parcel was created Are all corners and lot lines identifiable? -O_Yes No Is this property being developed for (spec house) ? Yes _ -No Volume and Page Number .5-¢4- as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: 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 reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all 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. ff.24572 own the proposed site for the sewage ,disposal tsystem ) orr I e(we) obtained an easement, to run the above described 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. re of A ZSigna pp icant Co-Applicant 7 LZ 97 STC- 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County ~a~i~lS'or✓' OWNER/BUYER QAVID ✓ /-~A 'v1E40c' Z art 0414 MAILING ADDRESS 23325" A4r.77_C,--4).4X ZAAr6. / 14CWkCWMOi►/~1*154{1!' PROPERTY ADDRESS ;Z3 S L,0_a <Q~ ~ • (location of septic system) Please obtain from the Planning Dept. CITY/STATE A/Z 44417 PROPERTY LOCATION 1/4, 1/4, Section .`j T 31 N-RI_W 1*4ST. CROIX COUNTY, WI TOWN OF ,57.4e- SUBDIVISION LOT NU-MBER CERTIFIED SURVEY MAP , VOLUME , PAGE , LOT NUMBER 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 licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement. that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a ma,,ter plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. UWe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year e iration date. SIGNED: GE%' DATE: J Zz ~7 St. Croix County Zoning Office Government Ccnter 1101 Carniichacl Road Hudson, %VI 54016 11/9 vol... PacE J DOCUMENT NO. STATE BAR OF WISCONSIN FORM 11-1888 TNa arACa ReesRVae FOR ReCORDiNe DATA it LAND CONTRACT Indlviduai and Corporab (TO BE USED FOR ALL TRANSACTIONS WHERE OVER - ~ 5315'7IV 125,000 IS FINANCED AND IN OTHER NON-CONSUMER y.6iJ9CaSS 0 CF~~ ACT TRANSACTIONS) COntraOt, by and between Inez E. Harvieux, unmarried J U L 21 199b ("Vendor", t at .15 P. whether one or more) and.... David_.J. _Harv_ieux ("Purchaser", whether one or more). ~...R..J Vendor sells and agrees to convey to Purchaser, upon the ptompt and full per formance of this contract by Purchaser, the following property, together with the rents, BBrofits fixtures and other appurtenant interests (all called.the "Property") , /#W N _ 1n..... St... 'roix * II r"Ilty, state bt Wisconsin: RKTURN TO b&uid Net r/v~it" t5_9 dJ cti( S'1• II j Tax Parcel No. _038=1014=10 Part of Government Lot One (1) in Section Three (3), Township Thirty-one (31) North, of Range Eighteen (18) West, St. Croix County, Wisconsin, described as j follows: Commencing on the South line of said. Government Lot One (1) and the high water mark of Cedar Lake; thence North 50° West on the meander line 120 feet; thence South 39052' West, 99.3 feet to said South line; thence South 89°41' East on said South line, 155.6 feet to the place of beginning; together with all land between said meander line and Cedar Lake, and together with access road from above parcel to the town road. E50M This non homestead property. (is) (is not) Stillwater Minnesota Purchaser agrees to purchase the Property and to pay to Vendor at .............................r....... , the sum Of Q,.QgQ. qQ in the following manner: (a) at the execution of this Contract; and (b) the balance of $..27xQQQ..QQ together with intereat'from date heteot on the balance outstanding from time to time at the rate of.... .§5 per cent per annum until paid in full, as follows: ! $350.00 per month or more at the option of the Purchaser, commencing on l April 5, 1993 and thereafter on the 5th day of each successive month until March 16, 1996 when the balance on the contract plus accrued interest shall II be paid in full. Provided, however, the entire outstanding balance shall be paid in full on or before the.... l6th day of ` MaLCbL 19...26. ( the maturity date). Following any default in payment, interest shall accrue at the rate of.. 6.......% per annum on the entire amount in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance). I' 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. i Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any gmount may be prepaid without premium or fee upon principal at any time after... March•16............. 1893_,_ (OR) there may be no prepayment of principal without permission of Vendor.* In the event of any prepayment, this contract shall not be treated as in default with respgct to payment to long 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 continued irr the event of credit of any proceeds of insurance or condemnation, the condemned promises being thereafter exclucred herefrom. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except: none Purchaser agrees to pay- the cost of future title evidence. If title evidence is in the form of an abstract, it shall be retained by Vendor until the full purchase, price in paid. ! Purchaser shall beentitledto take possesefon of the Property on....... March 16 p -Cron Out Ons. 19.93.... LAND CONTRACT - Iudivldual and STATE BAR OP WISCONSIN Wi.wn.in Lesal Blank Co Ino. Corporsta FORM No. 11-1082 M11-ka., wi.. VOL ~1131PAGE J4t~ s Purchaser promises to pay when due all taxes and assessments levied on the Property or upon Vendor's in in it and to deliver to Vendor on demand receipts showing such payment. Purchase shall kee thesuch improvementa on the Property insured against loss or damage occasioned by fir=oeexd- tended coverage pails and p other hazards as Vendor may require, without co-insurance, through insurers apP by Vendor, in the sum of $.Tull_fnsurah_1_e..va1m........... but Vendor shall not require coverage in an amount more than the balance owed under this Contract. Purchaser shall pay the insurance premiums when due. The policies shall contain the standard clause in favor of the Vendor's interest and, unless Vendor otherwise agrees in writing, of lows al of all policies covering the Property shall be deposited with Vendor. Purchaser shall promptly give notice proceeds shall insurance companies and Vendor. Unless Purchaser and Vendor otherwise agree in writing, insurance be applied to restoration or repair of the Property damaged, provided the Vendor deems the restoration or repair to be economically feasible. Purchaser covenants not to commit waste nor 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, ordinances and regulations affecting the Property. Vendor agrees that in case the purchase price with intdIgmt 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, except any liens or encumbrances created by the act or defalAt of Purchaser, and except: ..MQrle Purchaser agrees that time is of the essence and (a) in the event of a default in the payment of any principal or interest which continues for a period of ...30.- 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 .30..... days following written notice thereof by Vendor (delivered personally or mailed by certified mail), then the entire outstanding balance under this contract shall become immediately due and payable in full, at Vendor's option and without notice (which Purchaser hereby waives), and Vendor shall also have the following rights, and remedies (subject to any limitations provided by law) in 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 forefeited as liquidated damages for failure to fulfill this Contract and as rental for the Property if purchaser fails to redeem) ; or (ii) Vendor may sue for specific performance of this Contract to compel immediate and full payment of the entire outstanding balance, with interest thereon at the rate in effect on the date of default and other amounts due hereunder, in which event the Property shall be auctioned at judicial sale and Purchaser shall be liable for any deficiency; or (iii) Vendor may sue at law for the entire unpaid purchase price or any portion. thereof; or (iv) Vendor may declare this Contract at an end and remove this Contract asacloud 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 0), 00 or (iv) above. Notwithstanding any oral or written statements or actions of Vendor, an election of any of the foregoing remedies shall only be binding upon Vendor if and when pursued in litigation and all costa and expenses including reasonable attorneys fees of Vendor incurred to enforceAny 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 in- curred, and shall be included in any judgment, yy consent& Upon the commencement or during the penden my including homestead interestforeclosure of this to collect t e rents tissues, and profits of to the appointment of a receiver of the Property, , g the Property during the pendency of such action, and such rents, issues, and profits when so collected shall be held an 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 under this Contract or by option, long-term lease or in any other way) without the prior written consent of Vendor unless either the outstanding balance payable under this Contract is first paid in full or the. interest. conveyed is a pledge or assignment of Purchaser's interest under this Contract. solely as security. for an iudell#edneas of Purchaser. In the event of any such transfer, sale or conveyance without Vendor's written consent, the entire outstanding balance payable under this Contract shall become immediately due and payable in full, at Vendor's option without notice. Vendor shall make all payments when due under any mortgage outstanding against the Property n the date of this Contract (except for any mortgage granted by Purchaser) or under any note secured thereby, on provided make thelMortgagee if,Vendortfails tondos oh and all payments so made byuPurchaser ashalll be considered directly to this Contract. Vendor may waive any default without waiving any other subsequent or prior default of-Purchaser. All terms of this Contract shall be binding upon and inure to the benefits of the helrei legal representatives, successors and assigns of Vendor and Purchaser. (If not an owner of the Property thq'Spouse of Vendor for a valuable consideration joins herein to release homestead rights in the subject Property and agrees to. join in t44 execution of the deed to be made in fulfillment hereof.) ' ~~.r ;_:E.':., 19.93.... 16th March Dated this day of ~/ql GLs~( (SEAL) Inwieux ........(SEAL) SEAL) David J. vieux AUTHENTICATION ACKNOWLEDGMENT .,TE OF WSS40NS= Signature(s) MINNESOTA . ' ty. authenticated this ........day of 19..---. Personally came before me this ..115th...... day of arch 19_9;).. the above Bamed Inez..E.•.`.I argie474~..111lWaSxiBl1..BA11.......... David. ,...H1 rY.k~ax TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by $ 706.08, Wis. Stets.) to fns kun:Fn to be the person who, executed the for inn instrument and //acyk//y//11~~//ppwledge the same. THIS INSTRUMENT WAS DRAFTED BY / V1 . Rheinberger Pt Rheinberger Rheinbererr 5~I5• Qren Avenue Norfh---•-•-••-----.... • J........Dhn...................... S.t~ ] 1.4CataL._.MN.._.55Q82................................... ' Notary Public . . . . ....................CountY, Wis. !~f►ti!(ill.h+~l/bA9~{'91 Zpml'a (Signatures may be authenticated or acknowledged. Both My Commiss JOHN H. RHEIN~A~ER ) ere not necessarY•) date: NaryM--•-- . Washington County shames of persons sianiaQ in any capacity should be typed or printed below their signatures LAND CONTRACT - Indl.iduol and Corsonte-State Bar of Wisconsin. Fors No. 11-1969 VOL 1131 PAGE 546 ADDENDUM TO LAND CONTRACT Between the undersigned dated March 16, 1993. 1. The purchase price of $30,000.00 shall include i furniture and furnishings, one 12 foot fishing boat with motor and all outside equipment. 2. Seller agrees to pay all real estate taxes due and payable in 1993 for 1992 taxes; and 2/12 and turchaser 10/12 of taxes due and payable in 1994 for 1993 tams. Inez W. Harvieu;, ' r avid J. H vieux as unpaid principal) is less than the amount that saga maeowanrnn wuuw made as first specified above; provided that monthly payments shall be continued irr the event of credit of any procows of insurance or condemnation, the condemned premises being thereafter excluded herefrom. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except: none Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall p~~ paid. Purchaser shall be entitled to take possession be retained by Vendor until the full 'purchase, pric of the Property on....... M~? c[1 6 -Crow Out On. LAND CONTRACT - Individual and BTATR BAR OP W18CON81N Wiwoneln Laal Blank Co. Iw. Corporate It FORM No. Il-1,82 Mil.-kn. Wis. Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX • Safety and ~uildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 299076 Permit Holder's Name: ❑ City Viln!71 ate Plan ID No.: HARVIEUX, DAVID STAR PCST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax - 0388-1014-10-000 TANK INFORMATION ELEVATION DATA A9700393 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic NA Dt Bo m Dosing NA ader / Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer emand Model Number GPM TDH Lift Friction System TDH Ft Forcemain Length Dia. Fi Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Z ngth No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS LEACHING Manufacturer: SETBACK SYSTE O P/L BLDG WELL LAKE/STREAM INFORMATION -Type o CHAMBER Model Number: Syste : OR UNIT DISTRIBUTION STEM Header / Manifold Distribution Pipe(s) x Hole size x Hole spacing Vent To Air Intake Length Dia. Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over I xx Depth Of ~,x Seeded / Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) CEDAR LANE LOCATION: STAR PRARIE 3.31.18.36D 2355 WEST Y,17 Plan revision required? ❑ Yes ❑ No Use other side for additional information. FT1 SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: I SANITARY PERMIT APPLICATION 201 afety and E. W shnlgtonAve sion Aseonsin 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. C✓~ C_ Z: • See reverse side for instructions for completing this application State sanitary Permit Number ag9d'?Ip The information you provide may be used by other government agency programs ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT AL INF RMATION Prope Owner fUa Property Location ~V - 1 /4 1/4,S T , N, R (or~ Property Owner's Mailing A dress Lot Number Block Number City, State Ip Code Phone Number Subdivision Name or SM Number YP BUILDING: (check one) State Owned ❑ itr t Nearest Road 11. T OF r] E] Vil age Public 1 Or 2 Family Dwellin - No. of bedrooms Town OF III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment] Condo 0'13 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. Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an System -ystem Tank Only Existing System Existing 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 11 ❑ Seepage Bed 210 Mound 30 ❑ Specify Type 41 Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42 ❑jPit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation Feet Feet VII. TANK Capacity gallonTotal # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existing structed Tanks Tanks Septic Tank or Holding Tank El ❑ 1 1:1 1:1 1:1 Lift Pump Tank /Siphon Chamber El- 1 ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation f the onsite sewage system shown on the attached plans. Plumbpr,c Na e: Prin) umber's K ture: (No amps P M7 PRSW N Business Phone Number;, 7 lTr 8 r 6 14-~~ Plumber's r s (Street,State, Zip Code): I - 3 ~ o'O GNP IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issue Issuing Age t Sign ure (No St roved surcharge Fee) pp ❑ Owner Given Initial C _4~ D Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-63M (R 11/96) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, 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, 608-266-3151. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. Il. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/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. Responsibilify statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County / Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The-plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. i RESIDENTIAL AND SMALL COMMERCIAL CONCRETE HOLDING TANK DESIGN Single Tank Option INDEX AND TITLE SHEET Project 2 BEDROOM HOLDING TANK Owner DAVID HARVIEUX Address 2355 W. CEDAR LN NEW RICHMOND, WI. 54017 Legal Description GOVT. LOT 1 S 3 T 31 N,R 18 W LOT 36D Township STAR PRAIRIE County ST. CROIX Subdivision Name Lot No. 36D Parcel ID Number 038-1014-10 Plan ID Number S97-20751 INDEX AND TITLE SHEET PAGE ONE HOLDING TANK SPECIFICATIONS PAGE TWO SITE PLAN PAGE THREE HOLDING TANK AGREEMENT PAGE F S. P O.rially C~,nJ>ltti ~Q ` Ofpag~~s~~ of E o R~SPONpE Designer BRADY UTG RD SEE G Signature' Phone No. 715-268-6995 A-11 r License Number MP07456 Date 03-15-97 SBD-10463E (N.05W) 'Vage 1 of 3 ~ra~ i s 1997 S 9 7 2 0 7 5 T ow. HOLDING TANK SITE PLAN Project: 2 BEDROOM HOLDING TANK N Legal Description: GOVT. LOT 1 S 3 T 31 N,R 18 W LOT 36D Subdivision Name: Scale: 1: Y/4 = Plan I.D.: S97-20751 Lot No.: 36D ~ r ld -FAZW- 4A-U~ Page 3 of I