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HomeMy WebLinkAbout040-1105-70-110 S a o 0 o C O O N E N 'I', v I L x B C Y O C E ~ O I G O O as o I o 0 c z o Li w ~ I -30 - E a m v I O co 0 E rn z " o co a m N F- (n C N O C C9 N O Z d H U) CD ~ I E o `h E E `o • 'IVA N O O C N O 2 Z Z N N O O Z C 'a lzt N N N E a l u C a E 'R O co 00 = V) ° D O d m m N 0 C) Z m Cc FL 3: a) 0 0 0 z° ►N►~ c n. G. IL a g J p In LO o N N fA ~ U ~ rn rn ~ w m _ co E 0 0 M O p d N ~V a O Q C6 od O O O Q y C O r c C O O N C O a) w cn 4_ m O 0 CL CL - -0 N c 3 'n E E m a) _ O O Y S O O d1 H H j O r^+ ~ O 00 • h v r` C, aa)i N N E E U L. O N F- J N O - '7 U) O R I E 'c c r~ A U a j 0 N U STC - 104 AS BUILT SANITARY SYSTEM REPORT _ 1I11II. OWNER ADDRESS r SUBDIVISION / CSM# LOT SECTION ~ T :~S1 N-R ~ W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Q tax K ~ C g`xy9' ~e~ ~S i b i6 i G INDICATE NORTH APRON i Provide setback and elevation information on reverse of this fourl. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: AM. 0 ALTERNATE BM: . SEPTIC TANK / PUMP ~CHAMBER HOLDING TANK INFORMATION Manufacturer: ~r~l~)C5~ Liquid Capacity: C),O6 Z7A Setback from: Well`s House & Other Pump: Manufacturer cell Model# `~C3ll~ size //-"3 Float separation Gallons/cycle: rr Alarm Location SOIL ABSORPTION SYSTEM r r ~ Width: Length ! 7 Number of trenches l,rnr°S dE' Distance & Direction to nearest prop. line: ~OC~' So~z7`1 Setback from well: House Other ELEVATIONS Building Sewer ST Inlet. ST outlet PC inlet PC bottom Pump Off Header/Manifold Bottom of system Existing-Grade Final grade DATE OF INSTALLATION: PLUMBER ON JOB: C~/I Q 5 Ci~t~ G( LICENSE NUMBER: d~ 1 Cl~ 5 I INSPECTOR: 3/93:jt Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM Labor and Human Relations Countv Safety and Buildings Division INSPECTION REPORT ST. CROIX % GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: Permit Holder's Name: ❑ City ❑ Village ❑ Town o : State PI LEWINSKI, JOSEPH & JAN X CST BM Elev.: , Insp. BM Elev.: BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ~ p J- ' , PCB /11 Benchmark $9' / Dosi ng Aeration Bldg. Sewer g St/ 0( paS' o? TANK SETBACK INFORMATION St/ Ht Outlet Verit TANK TO P / L WELL BLDG. A ir Ito ntake ROAD Dt Inlet Air Septic 414 NA Dt Bottom 0,0 1& Dosing NA Header_ Aeration NA Dist. Pipe 9~7 Holdi Bot. System c'? gg /,j PUMP /f 4NFORMATION Final Grade Manufacturer C~ Demand Model Number GPM P 6L) TDH Lift ~A, Friction 66 Systems TDH a At Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED / TRENCH Width , Length' / No. Of Trenches PIT Of Pits In ia. Liquid Depth ` _j I DIMENSIONS 7 DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE /STREAM LEAC G urer: SETBACK L MBER INFORMATION Type O v i Model Number: System: M~Af?C~ >/C~j 75 T1,11 ~ R UNIT << DISTRIBUTION SYSTEM n ' Header lA4aad Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length 36 Dia Length 114E: Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes E] No ❑ Yes E] No s. ~s rl , 3.,0 3 s, , COMMENLS.: (Include codR discrepancies, persons present, etc.) / X11 _ LOCATION: Troy/. 27.2 . ~9W, SW, NW, Lot 1.,, Bjerst t Lane i Plan revision required? ❑ Yes ❑ No Use other side for additional information. S l SBD-6710 (R 05/91) Date Inspector's Signature Cert No. 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. :5v- . (2/-01%X • See reverse side for instructions for completing this application State Sanitary Permit Number The information you provide may be used by other government agency programs ❑ Check it revision to revious application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION S - 7 j operty ne Name t erty &W Loc tion be 01,3!, . ,S~4 14,Sa7 T,-t rN,R E(or)W Propert Owner' Mailing Ac]dr s Lot Number Block b r 6 erg 10L, C y, State . Zip Code Phone Number Subdivision Name or CSM Number 'uir S bad I1. TYPE OF BUILDING: (check one) ❑ State Owned 171 ❑ itL(ag N rest Road ❑ VII e rU 1'tQPublic 1 or 2 Famil Dwellin - No. of bedrooms ToOF 11,14e 111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) /~1 / 1 ❑ Apartment/ Condo l V 1( `l ID 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 / Mote[ 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. E] Replacement of 4. Reconnection of 5. E] Repair of an System _____System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 1 1;1~ Seepage Bed L 4 Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42E] Pit Privy 13E] Seepage Pit 43E] 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 Required (sq. ft.) Proposed (sq. ft.) (Galslday/ q. ft.) (Min./inch) Elevation CZI Feet Feet VII. TANK Capacity in gallons Total # of Prefab. Site Fiber- Ex er. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel Plastic p New Existing strutted glass App. Tanks Tanks Septic Tank or Holding Tank (tGs~ ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber © - ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage s tem shown on the attached plans. Plumb's Name: (Print) Plu e ' Si nature:/( o tam s) Business Phone Number: Plumber's Address( treet City,Sta , Zip Code): j tic IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ant Signature A roved Surcharge fee) pp ❑ Owner Given Initial Gyj 2 Adverse Determination O~ /G0 /0 X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-6398 (R. 015/94) DISTRIBUTION: original to Counly, One copy To: Safety & Buildings Di-,ion, Owner, Plumber I 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) aintain>Sd. 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 cr 2 Family Dvveclling. 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 ° throuc h 7. VII. Tank. information. Fill in the capacity of every new/or existing tank, list the total clallons, numhcr of tanks and manufacturer's name, indicate prefab or site constructed and tank material Cc!), plete f ]r all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks receives, experi-rnenal product approval from DILHR VIII. Responsibility statement. Installing plumber is .o fill in game, license numl er s„iih appropriate --)refix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County / Department Use Only. X. County / Department Use Only. C: rnolete plan a~5t '•l_aecificatior~s not smaller t an 8 1/2 x 11 inches must be su!,-pitted to the :.c unty. The plans must it dude the fosi(Iw~r.., H" plot plan, drawn t ;ycaie or with complete , Io- az' ~r f -1 ng tank(s), septic ~re~. ~,ant tanks building ,_.tjcr;, wells, Ovate ma,a,~a +i S: ~E.', sIrEoi s .'r~akes, pumporslphon t ~ qtr >u~~on :u l ::orpuon sy-,' E)IF:cemer;t sys+;.--i ar-: ;;;t.i o the building served,- ti reference rte' , lE`_spcLlfti.., tp,Ir-Irl a'-t .ontros,dose voluine, c _ ii', -in l,llif+ere_f~C ,.i;{• li:_~ , p:.'.mp perfcr ✓e; P11IT1p rT1o,_-:'' u,er, DI crosssectlon l Ul ,:7c SOIi abSOrptlGn a~s'1 pf ri Jj<<;;d br Otr•i~ 'llzlr'Ig information_ i GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated prac,u(_es vvhich can effect groundwater The monies collected through these surcharges are Lsed for monitoring groundwater contamination investigations and establishment of standards r3 SAFETY & BUILDINGS DIVISION I i I State of Wisconsin Department of Industry, Labor and Human Relations July 26, 1994 2226 Rose Street La Crosse WI 54603 WANG EXCAVATING THOMAS WANG W9672 770 AVE RIVER FALLS WI 54022 RE: PLAN S94-40721 FEE RECEIVED: 180.00 LEWINSKI, RICHARD SW,NE,27,28,19W TOWN OF TROY 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, erard 'Swim Plan Reviewer Section of Private Sewage (608) 785-9348 5079R/ 1 SBD-6422 1 R. 01/81) wa ar e~l~l s~~1 G 1 ~ S 4 40~'~.~. ~ S YS7 Tro ''T'Whs eta s c~ ~e 1 yo 4 160.0 b.1/yl foe S i c~e wct~~ ~,wt~s S"S" G, tJ e ~l iOncl ly g Condit a;1eA s sfew to 6e ~g ~~E avtdone~ ~ toes o~ INDUS" IS1 s DEv• QivoN SSE GO tpyw~' o-`~ n Ba ~ ~3 loo.o ~o txIsT • `Opp b ate' o '3~ 6P, RECEIVED Q,t JUL 18 1994 SAFETY b BURS. Div. -teak Via. ~a e L~~ea S Straw, Marsh Hay, Or S94-4072 1 Synthitic':'Covering ASrAA C__ 3 Distribution Pipe Medium and 1' H - IG ILL. 611 Topsoil :rrs._.~.ss. F 3 E D % Slope ' ' • Bed Of 2 Force Main Plowed Aggregate Layer • (6" Below Pipe) ' 0 -Ft. ~ Cross Section Of A Mound System Using E " Ft.. A Bed For The Absorption Arco F Ft. G 1,0 Ft. A Ft. H Ft. gned: B g-7 Ft. CS 5 cense Number: 3D 3 K Ft. &zN14P•' . i to v _ L 67 FVi~~ - ritto • J Ft. ~.rOT Alt nate Position I Ft. Of. • W It. e Force Main o' to s° J Observation Pipe c°F~RE K Ei I ---------------'~I Distribution Bed Of ' 2r- 2 %Z Pipe Aggregate Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area ~J . c ma~~~oiJ P'p~' . ~v Q ~ Las+ hola Shoop 6G r%cx~ ~o e~dl cap X 1 n chc y I ~l n e~ mw.►~ColA rorcC t'r1Gi n d~A . cJ% cs hull per 01 P o~ diti or'440, coil 3a31 ~~310NS R >k *1~Y~S 6: ~3 9~' uBO Del. q,V1S . E Oft; ~ 1 l 1 1 ic-lu.vr" i..-1 1 PTIC TANK 6 PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS . 6tp4-40'21 CI VENT PIPE 12" MIN. ABOVE GRADE WEATHER PROOF 25' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MANHOLE COVER W/ PADLOCK 6 FINISHED GRADE L4" CI RISER WARNING LABEL 6" MIN. r 4" MIN. ABOVE G ADE_ 8" IN. 6" MAX. ET WATER TIGHT SEALS [7A GAS- TIGHTS 4" BAFFLE A SEAL PROVED PIPE i , jj-ALM INTS W/ CI ONTO ~,~t~ Sc,I~ ON PIPE OLID3SOILTO ID pp C L PUMP OFF ELEV. 0050 T. 1- OFF RISER EXIT D PERMITTED ONLY IF TANK MANUFACTURER HAS APPROVAL 3" APPROVED BEDDING UNDER TANK if--o CONCRETE PAD SPECAf TIONS 17• v0 Ts PTIC / DOSE .va-~E • ? NK MANUFACTURER: )'Y1i U OSES PER DAY: NK SIZES: SEPTIC 10= FGA E p INCLUDING DOSE BACK: . t~ GAL. RM MANUFACTURER: E INCHES = 3D GAL. MODEL NUMBER: SWITCH. TYPE.: B = 2 INCHES = 3GAL. 6 14P MANUFACTURER: EEC'G~ C = 3 INCHES = ai GAL. MODEL NUMBER: L SWITCH TYPE: Np _ D = 5 INCHES _GAL. . QUIRED DISCHARGE RATE GPM PUMP E ALARM WIRING AS PER ILHR 16.23 WAC .RTICAL DIFFERENCE BETWEEN PUMP 0* .:'F AND DISTRIBUTION PIPE . Rd FEET MINIMUM NETWORK SUPPLY PRESSURE . . . . . . 2.5 FEET _g5 _ FEET FORCEMAIN X 1,5-4 FT/100-FT. FRICTION FACTOR FEET TOTAL DYNAMIC HEAD FEET i NTERNAL DIMENSIONS OF PUMP TANK: LENGTH WIDTH 4'6"; DIAMETER LIQUID DEPTH 3~1 DATE: III TGNED: LICENSE NUMBER: !9' 1 C9 7 L 2 1/88 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS • INAUSTRY, DIVISION LABOR P.O. BOX 76 HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 (ILHR 83.0911) & Chapter 145) LOCATION: SECTION: TOWNSHI UNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: 42 N /MN/RAE (o ® , as7 ~'av t - COU TY: ~ . DDRESS: USE - ` DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DES N: PROFIL ESC IPT ONS: E R COL ATt N TESTS: Residence , ew,7 RATING: S= Site suitable for system U= Site unsuitable stem` , 2 s1` ___j CONVENTIONAL: MOUND: JIN-GROUND-PRESS YSTEM)N-)NO❑LDINCy"T,A K: RECONDED JYSTEM: (optional) ❑sau Ns❑u ❑sC s If Percolation Tests are NOT required DESIGN RATE:., f ortion of the tested area is in the under s. ILHR 83.09(5)Ib1, indicate: $ r , dplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- N60~f _?6 "?,y ~ ~f f 1 'I P-30 rk Cki s ; + j 3a-yy" a B- i B- a b'~ 3 I ~a B s it ~Y 3 b 5; 3b- ba r> 00 B- R V `3l W FvxclareJ A s fo m► B- b~ 96,E o I, 6_?o (19 An 9 Ile PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 P R PER INCH P a D 1 y81 P_ tr 30 e P- P- P_ PLOT - PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION ISO~ ~ i r 3 E , I I I i s.._.e.. - X1 1 4 N Joo, u P3 t E f rp 1 i I f 7 ( I t I 6 , r , I I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMP ETE ON: ADDRESS: CERTIFICATIO UM ER: PHONE UMBER(optional): CST SIGN E: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) - OVER - INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 To be a complete and accurate soil test, your report must include: 1. Complete legal description; 2. The use suction must clearly indicate whether this is a residence or commercial project; 3. MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing scale is prefered. A separate sheet may be used if desired; 6. Make sure your benchmark and vertical elevation reference point are clearly shown, and are permanent; 9. Complete all apropriate boxes as to dates, names, addresses, flood plain data, percolation test exemption, if appropriate; 10. If the information (such as flood plain, elevation) does not apply, place N.A. in the appropriate box; 11. Sign the form and place your current address and yur certification number; 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st - Stone (over 10") BR - Bedrock cob - Cobble (3 - 10") SS - Standstone gr - Gravel (under 3") LS - Limestone 's - Sand HGW - High Groundwater cs - Coarse Sand Perc - Precolation Rate med s - Medium Sand W - Well Is - Fine Sand Bldg - Building Is- Loamy Sand > - Greater Than 'sl - Loamy Sand < - Less Than '1 - Loam Bn - Brown 'sit - Silt Loam BI - Black si - Slit Gy - Gray cl - Clay Loam Y - Yellow scl - Sandy Clay Loam R - Red sicl - Silty Clay Loam mot - Mottles sc - Sandy Clay w/ - with sic - Silty Clay Ill - few, fine, faint 'c - Clay cc - common, coarse pt - Peat mm - Many, Medium m - Muck d - distinct p - prominent HWL - High water level, surface water Six general soil textures BM - Bench Mark for liquid waste disposal VRP Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department may request verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a permit. The sanitary permit must be obtained and posted prior to the start of any construction. n 454482 %Oor CERTIFIED SURVEY MAP JOSEPH E. LEWINSKI AND JAN M. LEWINSKI J- Part of the Southwest 1/4 of the Northuest 1/4 and the Southeast 1/4 of the Northwest 1/4 of Section 27, Tot.nship 28 North, Range 19 West, Toim of Troy, St. Croix: County, Wisconsin. 3 Oimer's Address: 166 Bjerstedt Lane Dated.: August 3, 1989 River Falls, WI 54022 yi§~d: 00September 13, 1989 NO/ .4e 3 /O E / 43' 0 2 2 UNP~ATTED LANDS % ~o 0 It, S 00.09/6"E 342.73' ` ~O`O S 99 • 30'4 4 "W 6?0. 43' C 2 7 6. 73 33. 00' ry N Q: 309. 73 33.00 tu %U r C N = hj I ,I ALL BEARINGS REF. TO THE EAST/WEST //4 q 3 h LINE OF SEC. 27, r 28N, R 19 W, ASSUMED h 1 j 3 2 W p 3I S89.20'30W N 00 O ,44 W a v , N M tu ;t h~ Q OI I \ ® j q 1+ C4 0) 4z hW ~k t„ m \ \ W y ^S 3 W ° V C W y * h` Q w Q ®O\~ 3 Q O h W i \ OInc'.icates 1" x 24" iron °j 2 Q h % pipe weighing 1.13 lbs/lin.ft. > \ v ~ {y m m Q: set. 0 ~ i v,\ • Indicates N i Q 4' c p W c\ l" Q: iron g A° m pipe found.. N h 4 v w \ Z ® vl O Q ~ ~ W O 'S .0 \ ®Q\°~ aZ\ -f'0\ 1ra V J \ ;v; O ~r d O. 7 g h N O QI 0 ~ \ h W V • miN \O W \O ® \ \ u ODA- Q 1•, o w 3 o O(9) M N V y r, h O ®I O Q N Q O N O 0 in 3I m I MC, °~r o ❑ ? bI p IWI 3 0lo S W h W .4 r5 b . O m O I L h 2 b m 3I ~ ~ OIO O OhI O N N Z J a n~ Q b h W N1,;I OIOO Otp a ~ h J 3 m O h Nl M0M ~b ~ N rob 126. 38' I ZI y O 742.60' 266. 02' N 00 • 17' 4 0 "E 868.37' / ® - ; o SUNDOWN H11 I-$ 4-0 O `,,~~IIIIIIIlfl~l / / i - - - - - - ©O 1 0 \9C. 0 /V,9 ph% W-04, LAURENCE': hl O m? W MURPHY • WI N M - O NS/ t N~' • :pIVER S~Vol. 8 Page 2180 % : IS % 41*, C , Certified Survey LANV Maps ► : / z ~~~1/1~1~►1~ St. Croix County, o~ pl / kn Wisconsin. -j ©O Laurence W. Murphy APPROVED / SHEE T / OF 4 Registered Land Surveyor -DV-2:--1 1,989 Si'. CROD(COLINTY Ct?A N84043 M PARKS PLAN WM AND ZON NG CON"TTEE STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County n 41 OWNER/BUYER .k f~ N A 'f o 'I'll 'S 1 MAILING ADDRESS /~6 0 PROPERTY ADDRESS 1~L (location of se tic system) Please obtain from the Planning Dept. f- z CITY/STATE X0'0 L Lo 1 ~ 1~ ~ PROPERTY LOCATION 3W 1/4,&0 1/4, Section ~T N-R _W TOWN OF ST. CROIX COUNTY, WI SUBDIVISION , LOT NUMBER CERTIFIED SURVEY MAP, VOLUME , PAGE LOT NUMBER I 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 mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. 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 expiration date. SIGNED: - DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson. WI 54016 11/93 S T C - 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 1( 1 P). Location of property ,30J 1/41/4, Section r,Ta N-R_Z~ W Township trt T1 Mailing address l~ T l 16 1 [,,a, C VY^ 1-75LY-S A 2 Address of site Subdivision name_ Lot no. r~ Other homes on property? Yes No Previous owner of property Total size of property A1,4 Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house) ? Yes No Volume and Page Number as recorded with the Register of Deeds. 1~ 9 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 ffice of the County Register of Deeds as Document No. 3X/ and that I (we) presently own the proposed site for the sewage disposal system or I (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 off' n~e4of the County Register of Deeds as Document No. Si nature of Applicant Co-Applicant 2 Date f /signature Date of Signature VOL C4r„? - - T TNIf s►A1:i RLS[RVLD FOR RtCORO1N0 DATA .z DOCUMENT NO. STATE BAR OF WISCONSIN FORM 11- t988 LAND CONTRACT , • IRdl.idual and Cnrporat. RE FOR ALL TRANSACTIONS O OVER;j ,J ,1/..►V._ $y5,0oo 00 1s 9 ri PINAN D AND D IN OTHFR OTHER NON-C-CONSUMER j ACT A A • ACT TRANAP(.•TIONS) REGISTEkti OFFICE - ST. CROM CO., WIS. I Ruth Lewinskil a ainle Recd. for Record this 20th li Contract, by and between • erson day of July A.D. 19_' f P._.. r ("Vendor". whath6r one or more) and...... JgQeph• E.__T.tgl+!ille~ki<._ei14~__~111..__ ..t Lexi.aaki._ huahand__and_-wife,.-aa.-;point..tenants ("Purchaser", whether one or more). beYler of Deeds I Vendor sells and agrees to convey tt purcha er, upon the prompt and full per- formance of this contract by Purchaser, the following property, together with the ~1 rents, rofits, fixtures and other appurtenant interests (ail called the "Property"). =C~ GaYW p St. Croix County, State of Wisconsin: RtruRM TO ATTORNEY AT LAW 113 E. ELM ST- RIVER EALL.S, W IS_ _ 54022_ j SA of NWT except strip 26 feet wide on South Side i and except West 789.62 feet lying Northly of Town Tax Parcel No Road, in Section 27, Township 28 North, Range 19 West. trj This is ig homestead property. (is) (is not) Purchaser Property and to pay io Vendor atsuch- place__as_ reasonablar•directed 6100 0.to0 urchase the None• rees the sum of in the following manner: (a) 62 OOO 00 ,together with interest from date at the execution of this Contract; and (b) the balance of :$-.-------a----- per annum ine-- per cent p hereof on the balance outstanding from time to time at the rate of................. until paid in full, as follows: $498.89 per month, beginning September 1, 1984, and continuing on the 1st day of each month thereafter until all principal and interest have been fully paid. (Parties agree that the purchase price for the house and 5 acres is $50,000; the balance of $12,000 is apportioned to the remaining acreage.) Provided, however, the entire outstanding balance shall be paid in full on or before the........... lgt......... day of September-----_----•-----.--, 19_99_. ( the maturity date). - ° per annum on the entire amount Following, any default in payment, interest shall accrue at the rate of 9...__.- in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity. the entire principal balance). Purchaser, unless eycused by Vendor, agrees to pay monthly to Vendor amounts sufficient to pay reasonably antici- pated annual taxes, special assessments, fire and required insurance premiums when due. To the ex6ent received by Vendor, Vendor agrees to apply payments to these obligations when due. Such amounts received by the Vendor for payment of taxes, assessments and insurance will be deposited into an escrow fund or trustee account, but shall not bear interest unless otherwise required by law- Payments shall be applied first to interest on the unpaid balance at the rate specified and they, to principal. An) amount may be prepaid without premium or fee upon principal at any time DtbUiid~t➢ly tX R9tFA1~7~t9c 7C4t alt SR$PRltX tita~~tn~iL~xemc~xe~axaox°~clmc~ la payment so long In the event of any prepayment, this contract shall not be treated as in default with respect, to pay as the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be treated roceeds as unpaid principal) is less than the amount that saiebtedness beoulldtihave been event omc Fred•t of aany p ment been made as first specified above; provided that monthly payments 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 . Purchasers agree that, as part of the consideration of this transaction, in the event they wish to sell part or all of the described property at any time to persons other than members of their own family, they will first offer it, in writing, to the then sur- viving children of Vendor on the same terms they would accept from a third party, and such children shall have 10 days to accept the same, in writing. If no such acceptance is made, Purchasers may sell to any party on the same or more severe terms. Purchaser agrees to pay t e cost of future title evidence. If title evidence is in the form of an abstract, it shall he retained ',y Vendor until the full purchase price is paid. immediately. Purchaser shall be entitle to ca;.e possession of the Property - -CfG9! Oll2 U!'~+' wltil o~ ;rv Stock No. 13011 ,rA-R BAR OF N.l: Mai„, C°++wM M® FUItN No. II - Ild: VD r Pn:chaser promises to pay when else an tries and assessments levied on the Property or upon vendor's tutored in it and to deliver to Vendor os demand receipts showing such payment. purel«.rer shall keep the lm totetnents' os+the Property insured- „gsinst loss or damage occasioned by tire„ rs~ ` Landed coverage perils and sueb other hazards as Vendor may require, without co-insurance, through insurers approved. The po,c by Vendor, in the sum of ;-full,_insL;ablt.Xfly~-., but Vendor shall not require coverage in as amount more ua. shaR than the balance owed under this ContrastV rt winter st Andy uthe Vendor otherwise agrwhen I ees ilk wtiti esooriginal . the standard clause in favor of the a contain of sit policies covering the Property shall be deposited with Vendor. Purchaser sh l Pro ptinsn~rance proceeds shop in writing, insurance companies and Vendor. Zola" Purchaser and Ven or otherwise thendo as r deems the restoration or repair to b* be applied to restoratk u or sepsis of the Property .14'a. provided economically fwible. kee Purchaser covenants not to eami:uIt waste nor repair, to the Properutiree from 1~iens superior to theelien of this Cothe ntract, and is geed tenantable condition and d repair, affecting the Property. to comply with all laws, ordh antes and as a regal and all fond" ions Vendor agues that is case the purchase price with Interest and other moneys shall be fully paid shall be fully performed at the times and in the manner above specified, Vendor will on demand, execute and deliver to a 4 the Purchaser, a Warranty Deed, In fee simple, of this Property, free and clear of all liens and one nibrancey except or default of Purchaser, and except: easements and ri is of any liens or encumbrances created by the act . May of _ record. Vendor will •pay 1984,rea1,_natate taxess..._ _ _ . Purchaser agrees that ;ime is of the esaence and (a) in the event of a default in the payment of any principal or interest which eantinues for a period of ...IQ... days following the specified due date or (b) in the event of a default to performance of any other obligation of Purchaser which continues for a period of 10-- - days following written notice thereof by Vendor (delivered personal•y 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 i equity: anrecover the Property baclt through stn cteforeclosurer with nany uequ ty rof rights, title and interest in the Property with interest thereon from redemption to be conditioned upon Purchaser's full payment of the entire outstanding balance, w 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 Pilfill this Contract and as rental for the Property if purchaser fails to redeem) ; or (it) 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 far 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), (it) or (iv) above. Notwithstanding any oral or written statements or actions of Vendor, an election of any of the foregoing remedies shall only be binding upon Vendor if and when pursued in litigation and all costs and expenses including reasonable attorneys fees of Vendor incurred to enforce any remedy hereunder (whether abated or not) to ti:e 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. Upon the commencement or during the pendency of any action of foreclosure of this Contract, Purchaser 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 pendency of such action, and such rents, issues, and profits when so collected shall be held and applied as the court shall direct. est-in the-Property-(byt of azw • e psis. written into of Purchasers ri ontract or by option, long-term lease or in an consent of Vendor unless either t e o nee a a er-ttrl on ract is first paid in full or the interest conveyed is a pledge or assi3nment of . s tract soley as security for an indebtedness of ent the entire outstanding Purchaser. In sue transfer, sale or conveyance without en •re the Pr Vendor shall make all payments when due under haw.; mort alter any noin agured thereby oppry on the d haler this Contract (except for any mortgage granted by e any uch payments makes timely payment of the amounts then due under so Contract. ade byuPurchaserashallkbe considered paymentsimade on the Mortgagee if Vendor tails to do so and all payments Contract. Vendor may waive any default without waiving any other subsequent or prior default of Purchaser. All terms of this Contract shall he binding upon and inure to the benefits of the heirs, legal re presentatives, 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.) - day of _-July_ Dated this 18tH 19 - ' ~ -SEAL) .(SEAL) Ruth Lewinski Joseph E. Lewinski • - /j~f i.°.'. (SEAL) (SEAL) 9&Jan M. Lewinski AUTHENTICATION ACSNOWLSDOMSNT Signature(s) .-.Ruth Lewinski STATE OF WISCONSIN as Lewinski and Jan M._ Lewinski..._._. ....County. - .day of authenti to t i. -1.8-.0-day of/-_--...July---------- 19--84 Personally came before me this t.9. the above named aylo-'d..- TITLE: MEMBER STA BAR OF WISCONSIN . . . ([f not. - d-by- $ 706-'.06',- to me known to be the person - . - . . - _ . who executed the - authorize foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY C, L'--Gay-lord-,-,Attorney Notary Public County, River-.Falls,. WI----54022. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (if not, state expiration are not necessary.) date: •Namera ,rr p.-r, eiRninK +n any rap.,.ty sh--1 be typed or prinA•d Md- their siRna: +re,.