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HomeMy WebLinkAbout042-1012-80-000 C U -0 0 ° c p a ao > ~r V a o c I 0 Ile y ~ u O N y N w N U m I N w O Q_ O C ~ Z y w LL. C m N O O > 3 O Q N I 3 r, v Z i!i I co ~ o L rn N W Vii.. a m N LO H Z I O O Z d U O c Q ~ L N CD Z E ' N a~ N Q O m O O O Q U 0 Z m z p I Z r N co O ~ L d a 'w b o ,n o y N L m O \ y~ D O a co E -6 __V U N Z N> O H H H OS= O O O O m z° U • a o N Lf) ai Z rn rn N J U I ~ rn rn ~ c o o A~ > N O N L O N LO O = in ~ ,n 4- O I 6 N N N m CO w U) ca ,V p L N C O E O n c U (n V) O 6~ O O 2i (0 O c c O O co O J Y Y B N `vl i CV 00 C c c v p~f O N 0) et; '00 N CR H N N f0 7 2" ~ N co O s,3 N M M U O ~ II N d m a at a a w • ca a c rhv E L c `~1 A v a O in V III STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER GAY 1 17tc> `d U`^~ ADDRESS l C d SUBDIVISION / CSMW LOT SECTION___5_T12 f N-R /,W, Town of c~ ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERY.HING WITHIN 100 FEET OF SYST M ~ d INDICATE NORTH ARROW`' Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: f0(X1Ae4- ALTERNATE BM--,©yy`,~ ~In-U 1 (J EPTIC TAN / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: ed.-,/ ~ a " I Liquid Capacity: Setback from: Well 10 tee,/ House Other Pump: Manufacturer Model# Size Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION S-TSTEM Width: Length Number of trenches Distance & Direction to nearest prop. line: ~>.LI t Setback from: well: House Other 77 ELEVATIONS// Building Sewer Adz 7 ST Inlet: ST outlet AM, i PC inlet PC bottom - Pump off Header/Manifold -"'02,,,57-Bottom of system /tea Existing Grade %Q S,°lfjFinal grade A)w" u' rd 3 d.5~ DATE OF INSTALLATION: 'G6 PLUMBER ON JOB: L/spy- & C)r LICENSE NUMBER: l l y INSPECTOR: 3/93:jt Wisconsin Departmeni of industry, PRIVATE SEWAGE SYSTEM County: Labor and _Human Relations INSPECTION REPORT ST. CROIX Safety'anc Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: Permit Holder's Name: LARRY ❑ City ❑ Village ❑ Town of: State Pla , X CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax loo TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic S Benchmark /00 ' Dosi ng Aeration Bldg. Sewer Holding -A St/Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet Verit TANKTO P/L WELL BLDG. Airito ntake ROAD Dt Inlet Septic >d y NA Dt Bottom Dosing NA Header / Man. /d 3 4 7 V Aeration NA Dist. Pipe -7 a 103, Holding Bot. System 9,7 /0 a . PUMP/ SIPHON INFORMATION Final Grade /o G , Manufacturer Demand 3. / ;7, Model Number GPM TDH Lift Friction System TDH Ft Forcemain Length Dia. Fi Dist. To Well SOIL ABSORPTION SYSTEM RED/TRENCH Width) I Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS / DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION TypeO CHAMBER Model Number: System: ~Os ~U ~~jp, OR UNIT DISTRIBUTION SYSTEM 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 xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) ~1 LOCATION: WARREN 05.29.18.77,NE,SE,115TH AVE.,LOT 2 Plan revision required? ❑ Yes ❑ No Use other side for additional information. //v c (o a SBD-6710 (R 05/91) Date Inspe or's Signature Cert No ADDITIONAL COMMENTS AND SKETCH ' SANITARY PERMIT NUMBER: I ~R SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05, Wis. Adm. Code G r .ro STAT SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ ~Vr3 8/z x 11 inches in size. revise n to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION /rr rp G%%a ^/a, S T , N, R o PROPERTY OWNER' MAILING ADDRE LOT # BLOCK # /!a GO CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER _ o P as b Of 1 <LT" 11. TYPE OF BUILDING: (Check one) ❑ State Owned VI AGE NEAREST ROA arch ❑ Public n1 or 2 Fam. Dwelling-# of bedro S AR EL TAX NUMBER( S) 111. BUILDING USE: (If building type is public, check all th apply 1 ❑ Apt/Condo 2 ❑ Assembly Hall 60 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 130 Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. 12!kNew 2. ❑ Replacement 3. ❑ Replacement of 4.E] Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit 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 420 Pit Privy 13 ❑ Seepage Pit Pressure 430 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.) PROPOS (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION S_~_ YAIK 4Z r , /?,/-o~ eet of Sreet VII. TANK CAPACITY Site in allons Total of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New istin Gallons Tanks Concrete structed glass App. Tanks Tanks Septic Tank or Holding Tank Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumb Name (Print): Plumber's ' nature: (No Stamps) MP/MPRSW No.: Business Phone Number: Plu is Ad ress (Street, City, State, Zip Code): ~y f o IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Approved ❑ owner Given Initial rl1J Q Surcharge Fee) Adverse Determination O O~~a ` J 1~&j X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(R.08/93) 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 may be renewed before the expiration date, and at the 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 sub ed to the county prior to installation. 5. Orisiewage 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 & 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 in 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 in ##1-7. VII. Tank information. Fill in the capacity of every new and/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 filli 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% 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, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) PLOT PLAN PROJECT rr Cil^dv,SDr~ ADDRESS _J/~~. 1/4]!~ 1/4 S/T,z^1RZ`W TOWN l~Lrrr~~ COUNTY., x MPRS Byron Bird Jr. 3318 DATEo22 e~- - BEDROOM__~ CLASS PERC__,,V=- CONVENTIONAL IN-GROUND PRESSURE CONVENTICSNAL LIFT MOUND HOLDIN G TANK SEPTIC TANK SIZE LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ABSORPTION AREA PERC RATE _ L BED SIZE fax Benchmark V.R.P. Assume Elevation 100' Location of Benchmarks ©4~~n Cl Borehole Q Well Scale = Feet O Perc Hole System Elevation , Uent 12 Gradp TYPAR COVERING 2" 12" 3 4 g' O 3' 3' O 3 3' O g I Sewer Rock i 6 " 1 2' 1 8' 2 ® /5 t 7 3 h C E RT I F I ED SURVEY MAP LOCATED IN THE NE I/4 OF THE SE 1/4 OF SECTION 5, T29N, R18W, TOWN OF WARREN, ST. CROIX COUNTY, WI. N_07E: BEARINGS ARE REFERENCED OWNED BY: LOUIS ROLF I i 70 THE E-W QUARTER LINEA RECORD I t BEARING.) I UNPLATTED LANDS W 1/4 CORNER SEC. 5 O f COUNTY MONUMENT O O EI/4 CORNER SECi,5 F E W QUARTER LINE OUNDi I IRONPIPE FOUND1. FA S T EAST 867. 98 EAST - - - 37 39 10_78_ 360. 00, 60 00' _ T 360.0 0 147.9 82 30.06 359.98 ? 359.98' x48.35' O O 347S 89° 26' 51 E O S 89° 2 6' 51E S89°26'51"E ° ~ LO T I U) S 09.26'51"E to N O N O M - O N C.S. M. ~o 0 0 ° BUILDING SETBACK N j N (n' ° p O O. 0 M ° Z- L 0 T 2 O LOT 3 ~ EAST Z ° M 207. 4 4 Q 0 5.00 ACRES 3 n 5.00 ACRES a 3 J. a 1'217, 787 SO. FT. 1 p ( 217, 78 7 SO. FT. 1 ^ ° ° 4.77AC. EX C. R.O W. 4.74 AC. EXC. R. 0. W ^ N - ,n t 207, 936 SO FT.) O t 206, 687SO.FT.1 co e M N ° O O W Lr) V 1p O O 1,~ M - a V' M W 3 60. 00 360. 00 O M A_E ~ wESr 720.00' _ M C, cn N W n z w o 0 Q Z z p J . w cn z o' L 0 T 4 28.00 ACRES W. ° ( 1,219,747 SO FT.) 27, 71 AC. EXCLUDING ROAD R.O.W. W, t I, 207,032 SQ.FT.) Z. Yl/ (L J. b~ Z: ~a ~o N8905512 W 1300. 40 SOUTH LINE OF THE NE-SE U N P L A T T E D LANDS ~~~aeosro~t 0 A, C In W ,u 4 0 W •+a DSPRINGVALLEYY V) O 0 = SET 1"X 24" IRON PIPE WEIGHING 1.13 p w MT Laioo nd Fluman Relations uyu y , U 1 L A N U 51 1 t t V A L U A 1 1 U N h t F' U H 1 1 Z rage 1 of 3 Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code `J COUNTY St. Croix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference poi , {fM),, n and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and h,j%.rfeaL 042-1012-80 APPLICANT INFORMATION-PLEA DINT AI~INFO N REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Louis Rolf GOVT. LOT NE 1/4 SE 1/4,S 5 T 29 N,R 18 :k(or) W PROPERTY OWNER':S MAILING ADDRE c~- 1 6, V J- LOT # BLOCK # FSUBD. NAME OR CSM # 1099 115th. Ave. na na CITY, STATE ZIP PH . R. ❑CITY ❑VILLAGE EJOWN NEAREST ROAD I , WI. 5401~ Warren New Ri hm t5=45 115th. Ave. 6 40 [*New Construction Use" Residential riot"ti~tfieoflis -2 [ j Addition to existing building j j Replacement [ ] Public or commercial describe Code derived daily flow 300 gpd Recommended design loading rate .4 bed, gpd/ft2 .5 trench, gpd/ft2 Absorption area required 750 bed, ft2 600 trench, ft2 Maximum design loading rate • 4 bed, gpd/ft2 - 5 trench, gpd/(t2 Recommended infiltration surface elevation(s) 101.27 ft (as referred to site plan benchmark) Additional design / site considerations recommend trench system Parent material galcial drift Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for svstem El S0 U M S ❑ U 0S ❑ U ®S ❑ U ❑ S 13U ❑ S ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence ( Boundary Roots GPD/ft in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. Bed rertdi 0-12 10yr3/2 none 1 2mgr mfr cs 2f .5 .6 2 12-31 10yr4/4 none sil lfgr mfr gw if .2 .3 Ground 3 31-10 10yr5/4 none 1 vfs Osg mvfr na na .4 .5 elev. 105.05ft. Depth to limiting factor +100" Remarks: Boring # 1 0-21 10yr2/2 none 1 2msbk mfr cs 2f .5 .6 2 k 2 21-43 10yr4/4 none sil lfsbk mfr gw if .2 €.3 3 43-92 10yr5/6 1 fs Osg mvfr na na .4 .5 Ground 105.9@ Depth to limiting factor +92" Remarks: CST Name:-Please Print Gar L. Steel Phone: 715-246-6200 Address: 1554 200th. Ave., New Richmond, WI. 54017 Signature: Date: CST Number: 9-19-94 cstm 0229 PROPERTY OWNER Louis Rolf SOIL DESCRIPTION REPORT Page 2 of ~3 PARCEL I.D. # 042-1012-80 Boring # Horizon Depth Dominant Color Mottles (Texture I Structure Consistence Bartt~ry I Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ITrench a < 3 1 0-14 10yr2/2 none 1 2msbk mfr gw 2f .5 j .6 -1 2 14-36 10yr4/4 none sil 2cpl mfr gw if np i .2 i Ground 3 36-55 10yr5/8 none sil lfgr mfr 9w na .2 ~.3 elev. 105.6Qt. 4 5-100 10yr5/6 none 1 fs Osg mvfr na na .4 ! .5 Depth to limiting factor +100" Remarks: Boring # 1 0-10 10yr2/2 none 1 2msbk mfr gw 2f .5 .6 K; 4 2 10-40 l 0yr4/4 none sit 1 f sbk mfr gw if .2 .3 3 40-1 CO 10yr5/6 none of s Osg mvfr na na .4 '.5 i Ground elev. 104.69.. Depth to limiting factor +100" Remarks: Boring # 1 0-12 10yr3/3 none 1 2msbk mfr gw 2f .5 ::.6 2 12-24 10 r4 4 none sil 2msbk mfr if .5 .6 3 24-88 10yr5/6 none f s Osg mvfr na na .5 E.6 Ground elev. 105.39. Depth to limiting factor +88" Remarks: Boring # Ground elev. 1 ft. Depth to limiting factor i Remarks: SBD-8330(R.05/92) STEEL'S SOIL SERVICE Gary L. Steel Louis Rolf 1554 200th Ave. CSTM2298 NE4SE4 S5-T29N-R18W New Richmond, WI 54017 MPgRSW 3254 town of Warren (715) 246-6200 N 1"=40' BM.= top of se corner of elec. transformers concrete slab C el. 100' N,W''•tor,.r v Z 11.6-1 I35 gyp'`{' 1 `2 z z8 y. 1 ~ 9' Il nn 10 8 _ 3 1~ `~~c G Z)9~ ~3• z boa ~ Gary L. Steel 9-19-94 vvlb4mibul Labor uNaruiwtions uwuy' labor and Human Relalation SUIL AIVU 511 t =VALUA I IUIV HtNUH I rage 1 ul 3 Division of Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must in I St • Croix c ude, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. 042-1012-80 APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Louis Rolf GOVT. LOT NE 114 SE 1/4,S 5 T 29 N,R 18 f (or) W PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 1099 115th. Ave. na na na CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE JaOWN NEAREST ROAD New Richmond, (715) 246-5459 Warren I 115th. Ave. [*New Construction Use ~ Residential / Number of bedrooms 2 (j Addition to existing building j j Replacement ( j Public or commercial describe Code derived daily now 300 gpd Recommended design loading rate .4 bed, gpd/ft2 .5 trench, gpd/ft2 Absorption area required 750 bed, ft2 600 trench, ft2 Maximum design loading rate • 4 bed, gpd/ft2 •5 trench, gpd/ft2 Recommended infiltration surface elevation(s) 101.27 ft (as referred to site plan benchmark) Additional design / site considerations recommend trench system Parent material galcial drift Flood plain elevation, if applicable na It S = Suitable for system CONVENTIONAL I MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for svstem I IDS U 13S ❑ U ®S O U ®S u I 0S ®U I ❑ S I NU SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Boring # Horizon Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed ITrt t 1 0-12 10yr3/2 none 1 2mgr mfr cs 2f .5 .6 2 12-31 10yr4/4 none sil lfgr mfr gw if .2 .3 Ground 3 31-10 10yr5/4 none 1 vfs Osg mvfr na na .4 .5 elev. )5.05ft. Depth to limiting factor +100" Remarks: 3oring # 1 0-21 10yr2/2 none 1 2msbk mfr cs 2f .5 .6 2 2 21-43 10yr4/4 none sil lfsbk mfr if .2 .3 3 43-92 10yr5/6 1 fs Osg mvfr na na .4 .5 Ground Depth to I limiting factor 92" Remarks: CST Name:-Please Print Phone: Gary L. Steel 715-246--6200 Address: 1554 200th. Ave., New Richmond, WI. 54017 Signature: ' ? Dar ~y A ;ST Number: PARCELI.D.#r 042-1012-80 Bonft # Horizon Depth DominantColor Mottles Texture I I Structure Consistence Bourriary Roots GPD/ft I in. Munsell Qu. Sz. ConL Color Gr. Sz. Sh. Bed ITrench 3 <::Y 1 0-14 10 r2/2 none 1 2msbk mfr gw 2f .5 ; .6 MEMO 2 14-36 10yr4/4 none sil 2cpl mfr gw if np 1 .2 Ground 3 36-55 10yr5/8 none sil lfgr mfr gw na .2 1.3 elev. 105.6%. 4 5-100 10yr5/6 none 1 fs Osg mvfr na na .4 .5 Depth to limiting factor +100" Remarks: Boring # 1 0-10 10yr2/2 none 1 2msbk mfr gw 2f .5 .6 2 10-40 10yr4/4 none sit lfsbk mfr gw if .2 .3 3 40-1(0 10yr5/6 none of s Osg mvfr na na .4 .5 Ground elev. 04.6}_ Depth to limiting factor +100" Remarks: Boring # 1 0-12 10yr3/3 none 1 2msbk mfr gw 2f .5 .6 h 5': 2 12-24 10yr4/4 none sil 2msbk rnfr gw if .5 .6 3 24-88 10yr5/6 none f s Osg mvfr na na .5 .6 Ground elev. i 05.3Q Depth to limiting factor +88" Remarks: Boring # I I Ground elev. ft. Depth to limiting tactor Remarks: BD-8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel Louis Rolf 1554 200th Ave. CSTM2298 NE4SE4 S5-T29N-R18W New Richmond, WI 54017 MPRSW 3254 town of Warren (715) 246-6200 t N 1"=40' Bt.= top of se corner of elec. transformers concrete slab @ el. 100, N3 J35 l I /4' Z 28 5 loo's- 1'7-Z Ilip -34' 2) 7 2- 10 Gary L. Steel 9-19-94 STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County ~4 OWNER/BUYER MAILING ADDRESS //OG 6ar_r lG PROPERTY ADDRESS (location of septic system) Please obtain from the Planning Dept. !cd' tLOx~c~fc ~f~~ CITY/STATE lV , /ecv ~ Z~ fl PROPERTY LOCATION 1/4, Al-IF 1/4, Section, T 9 N-RZOO_W TOWN OF ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAP Sl9 , VOLUME /d , PAGE 86 , 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 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. I/We, 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 Cannichael Road Hudson, Wl 54016 103 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 Location of property 1/4 s 1/4, Section S TAY -N-R_Le:_W Township Mailing address ll©c r~L?isc ~ ors r.u j yd / 6 Address of site l ) S ~~L~ /~j6~ Subdivision name Lot no. 1;? other homes on property? -Yes No Previous owner of property la 99 Total size of property cf Total size of parcel 2~r Date parcel was created / ~vu~.~c~e~ 199y Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)? Yes c No Volume to and Page Number,2867 as recorded with the Register of Deeds. Vat-u ~,aT rZ3_19 y 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. 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 office of the County Register of Deeds as Document No. Signature of Applicant Co-Applicant Date of Signature Date of Signature "DOCUMENT NO STATE BAR OF WISCONSIN FORM 11 - 1982 His SSG;E 'tv D EQ" RECORDING DATA LANDCONTRACT VOL~i pad;297 Individual and Corporate ',C BE USED FOR ALL. TRANSACTIONS WHERE OVER 52590G $25 00015 FINANCED AND IN OTHER NON (^NSUMEP pCG1J 1 ' t AI,T TRANSA,C. IONS; flC CI' J C ST CROIX ^0 t l Janny Contract, by and between PCC'd.cr - - (-'vendor FEB 1 3 1995 whether oneormore) andarry 'row son °n,'. .lenslne :rUwSOn r - - Purchaser", whether one or more)j Vendor sells and agrees to convey ;o Purchaser, upon the prompt and full per- formance of this contract by Purchaser, the following property, together with the rents, profits, fixtures and other appurtenant interests (all called the 'Property"), l ~ i)lK I 'n- - County, State of Wisconsin RETURNTO ._3 of ec inn ownship j n r 1 II ~ ~ ,Des*, "own )f 1arri,n, described as ot P ir~ey dap °i ' - e.. in olume of ..er,tfiea - - ll!" i I.a. 1 r? ?3(,'), a-; ocliiont X10. 52 51 ~4, :t. '~.T- )_X =o'u `Y ,I7 Dn~in Tax Parcel No. i ; :IRANSH L ji 37.50 C. L. I This _ 1'' n0` -homestead property. (is) (is not) P-:rchaser agrees to purchase rie Property and to pay to Vendor at ;+,h Aver .°iew R Crm the sum of . > -__in the following manner: (a) at the execution of this Contract: and (b) the balance of $ with interest from date hereof on the balance outstanding from time to time at the rate of_--__? per cent per annum until paid in full, as follows: A `)a/°'e ;1 T" D.? t two and seventy seven cents '0 'r-e na.'td on the l 5th of f.he month sta-tine t 5;gar h 5 r01 t!)'i'inuinp- witil -)aid ii Fu' which is amortized over (5' five years or paid in 'u-, wit.}i Co 1. ',ayments when Tade shat ' he credi `e,' f; ient 3CC:Ili'11?1 i 1'.erast Ind T)a'an:'e to she reduction F pr!nci7)'e. Provided, however, thy entire outstanding balance shall be paid in full on or before the ?-th f ift-eenthday of the maturity date). Following any default in payment, interest shall accrue at the rate of per annum on the entire amount in default (which shall include. without limitation, delinquent interest ard, upon acceleration or maturity, the entire principal balance). ?•'_`S t') yt F"llrri,I:i- .r 31 7 taxes 3n'; _ i-is iron -1 Purchaser, unless excused by Vendor, agrees to pay monthly to Vendor amounts sufficient to pay reasonably antler pa'ed 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 ;axes. assessments and insurance will be deposited into an escrow fund or trustee account, but sha!I not bear interest unless otherwise required by law. II Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any amount may be nrepaid without premium cr fee upon principal at any time after _ 7!Febrtlary- t9 ~5 OR) 3ihera~ay.be~n pcrpayleen! a6txatcsprs~lerat3out R Sri.'. In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long as the unpaid balance of principal, and interest (and in such case accruing interest from monti, to month shall be treated as unpaid principal) is less than the amount that said indebtedness would nave been had the monthly payments been made as first specified above; provided that monthly payments shall be continued in the event of credit of any proceeds of insurance or condemnation, the condemned premises being thereafter excluded herefrom. P, -chaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except: Purchaser _4 ees%4o Pay ,111C cost of future title evlderce. If title evidence is in the form of an abstract. It ;hall be retained by Vendor unti a fulloprctfbse price is paid 1) I L ' T_ Purchaser shall be entitled to lake possession of the Property on Sr,e rrla ••ss O~~ O„e SBtt LAND CONTRA^T--Individual and STATE BAR OF WISCONSIN Corporale =uPM No 11 - 1 -i2 Pbfiner promises to pay when dUe all taxes and assessments levied, on the Property or Upon Vendo/9 interest a iii it and to deliver to Vendor an demand receipts showing such payment Q Purchaser shall keep lho Improvements on the Property Insured against irss or damage occastuned by fire, ex- tended coverage perils and such other n"ards as Vendor may require without co-insurance, through insurers approved , by Vendor, in the sum of S ) r "11ln 0 _ Cut Vendor shall not require coverage to an amount more - than the balance uwed under this Contract. Purchaser shall pay the insurance prommins when due The l,oucias shall contain the standard clau°e in favor of the Vendor's interest and, unless Vendor otherwise agrees n writing, the original of all policies covering the Property shall be leposAed with Vendor. Purchaser shall promptly give notice of loss to insurance companies and Vendor Unless Purchaser and Vendor otherwise agree in writng. insurance proceeds shall S" be applied to restoration or repair of the Property damaged, provided the Vendor deems the restoration or repair to be economically :easible. Purchaser covenants not to commit waste nor allow waste to be committed on the Property, to keep the Properly zz 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. 6 Vendor agrees that in case the purchase price with interest and other moneys shall be fully pad and all conditions y shall be fully performed at the times and to the manner above specified, Vbador will on demand execute and deliver to 4 the Purchaser, a Warranty Deed, fee simple, of the Property, free any clear of all (lens and encumbrances, except any liens or encumbrances created by the act or default of Purchaser. and except: _ _+.One - - - j Purchaser agrees that trine is of the essence and (a) :n the event of a default in the payment of any principal or interest which continues for a period of 45 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 6r, days following written notice thereof by Vendor (deli~ gyred personally or mailed by certified mall), 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 followinp rights and remedies (subject to any limitations provided by law) In addition to those provided by law or In equity: (1) Vendor may, at his option, terminate this Contract and Purchaser's rights, title and interest in the Properly and recover the Property back through strict foreclosure with any equity of redemption to be conditioned upon Purchaser's full payment of the entire outstanding balance, with interest thereon from the date of default at the rate in effect on such date and other amounts due hereunder (in which event all amounts previously paid by Purchaser shall be forfeited as liquidated Damages for failure to fulfill this Contract and as rental for the Property if Purchaser fails to redeem); or pi) Vendor may sue for specific performance of this Contract to compel immediate and full payment of the entire outstandng balance, with interest thereon at the rate in effect on the date of default and other amounts due hereunder, in which event the Property shell be auctioned at judicial sale and Purchaser Shall be liable for any deficiency; or (ill) Vendor may sue at law for the entire unpaid purchase price or any portion thereof; or (jv) 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 inte A of Purchaser Is Insignificant; and (v) Vendor may have Purchaser elected from possession of the Property and have a receiver appointed to collect any rents, Isruee 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 axpenses including reasonable attorney's fees of Vendor incurred to enforce any remedy hereunder twhether 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. Upon the commencement or during the pendency of any action of foreclosure of this Contract, Purchaser consents to the appoinhnent of a receiver of the Property, includin homestead interest, to collect the rents, Issues, and profits of the Property during the pendency of such action, and suc9 rents, issues, and profits when so collected shall be held and applied as the court shall direct. Purchaser shall hot transfer, sell or convey any legal or equitable interest in the Pruperty (by assignment of any of Purchaser's rights under this Contract or by option, long-term lease or to any other way) without the prior written consent of Vendor unless either the outstanding balance payable under this Contract 1s 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 indebtedness of Purchaser. In the event of any such transfer, sale or conveyance without Vendor's written consent, the entire outstanding balance payable under this Contract shall become immediately due and payable In full, at Vendor's ootlon without notice. Vendor snail make all payments when due under any mortgage outstanding against the Property on the date of this Contract (except for any mortgage granted by Purchaser) or under any note secured thereby, provided Purchaser makos timely payment of the amounts then due under this Contract. Purchaser may mike any such payments directly to the Mortgagee If Vendor fails to do so and all payments so made by °urchaser shall be considered payments made on this Contract. Vendor may waive any default without waiving any other subsequent or Drlor default of Purchaser All Perms of this Contract shall be binding upon and Inure to the bencnts of the heirs, legal representatives, successors and assigns of Vendor and Purchaser. (If not an owner of the Property the spouse of Vendor for a valuable consideration loins herein to release homestead rights In the subject Property and agrees to join In the execution of the deed to be made in tulfillment 4ereof.) Dated this i da f J n iSEAL) / C i! r l Yo /f./t '~C/l % S -7 (SEAL) If Al ISEALI 64- ------(SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) TA T E OF WISCONSIN authenticated this---day 19 Pefsonaliy came before me this_of 9 ~I t rhe above named, y o-2 - - - r rt - Ile TITLE. MEMBER STATE BAR OF WISCONSIN ,,...rr' (If not, to rrR Known to be the pe r xecuttsd the authorized by § 706 06, Wis. Slats) o+~gojng nst(unlent an~ THIS WSrRurvtENT WAS DRAFTED BY r ) ; s 11 0111.E TO.lbO❑ a C Jt' ~ # J Notary Public nty, Wis. I`:1Y C'.)rnmiss-un is per d11A, hfJ xpiration, (Signatures may be authenticated or acknowledged Both late m -r are not necessary) WF~' t9` 'Names of persons s,yn.nq i any apaC,ty snoop CC'VLrd ~;r C te,1 L,f10w the,l Y Qraiure! SB11 'rr ;Car; Stns Bar of Wisconsin LAND CONTRACT- Individual and Corporate Form No. 11-1992 -