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HomeMy WebLinkAbout002-1080-80-000 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER R~Q eers ADDRESS SUBDIVISION / CSMI LOT SECTION T N-R W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ~IOw S G , ~-G ~ b V~ LQ~ I' i i X IL) 11 D1: ATE NORTH ARROW Provide setback and elevation information on reverse of this for-N- Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: Sa rr~ -e a S $fi• J`-~ ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer:, Liquid Capacity: Setback from: Well O House _7a2' Other Pump: Manufacturer jneLlep-s Model# SL/ Size Float seperation Gallons/cycle: Alarm Location- .e. SOIL ABSORPTION SYSTEM Width: ~j Length 7-5- Number of trenches l Distance & Direction to nearest prop. line: ,,90d 14- Setback from: well: Sj'l f House s-4/,-- 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: LICENSE NUMBER: ~L INSPECTOR: J-/ 3/93:jt I Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor ancriluman Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No-: GENERAL INFORMATION Permit Holder's Name: ❑ City ❑ Village ❑ Town of: State Pla SPEARS, DAVID X p~ CST BM Elev.: Insp. BM/Ellev.: B MDescription: Baldwin Parcel Tax No.: i/ r~6 5 TANK INFORMATION ELEVATION DATA Zp nay TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic, Benchmark Dosing , A r^ x.35 97~~ Aeratkm- Bldg. Sewer St/ t Inlet Holding TANK ETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. Airl to ntake ROAD Dt Inlet rl ~ Septic NA Dt Bottom Sj' ~l.TO Dosing ,VS -l t I 4. NA HeaderLmonr- Aeration A Dist. Pipe /C0, G Holding Bot. System z OS 90 PUMP / S11HOWINFORMATION Final Grade I r t~/ , , Manufacturer Q 5 Demand Model Number 5 - 19, GPM r ` 9~ yd /J',, r-riC fit= - TDH LiftA Friction, X51 Systema Sp TDH 12 oss Forcemain Length/,5 ^ Qia. HH " Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length i No. Of Trenches PIT No. Of Pits Inside Dia. uid Depth DIMENSIONS 75 DIMENSIONS-- SYSTEM TO P / L BLDG WELL LAKE/STREAM LtACWNC anuficture,: SETBACK INFORMATION TypeO y) CHA R Mo er; System: c„s, Sjd3 ° ~i/✓'~ UNIT DISTRIBUTION SYSTEM / Manifold Distribution Pipe(s) N n x Hole Size x Hole Spacing Vent To Air Intake / f l~l Length Di Length 35 Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over , 7 Depth Over c„ xx Depth Of xx Seeded/ Sodded xx Mulched Bed1 4Center BedlF® clges / ~-.1 Topsoil (D ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) //LOCATION: Ba~dwin.32.29 16W, SW, SW220th Street 1J ` G G•, ~l; ,',d,i~ d X00 ~ ji•' ~ ~ C~yt~r f k-'.K~p~ 1~ce,~[~ eh Z r -70, Plan revision required? ❑ Yes 0"No Use other side for additional information. 1 SBD-6710 (R 05/91) Date Inspector's Si na~tuur/i Cer No. r % }KC ' :Y ? I 1 L"' { C ° . L c~ 'yyl ~cr~~ ry77 lLTV7 e1''(tC~ ~~~~~a ctP 11 / l ~y SANITARY PERMIT APPLICATION accord with ILHR 83.05, Wis. Adm. Code r.'■L■7R C'S 0,pao I I' y STATES ITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than M9 056 8% x 11 inches in size. ❑ Check if revision to previous application N I.NUMBE -See reverse side for instructions for completing this application. [7w-M"k) 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION T.29, N, R E (or) PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER suG G _ ~ ~ G~-C c G l 11. TYP OF BUILDING: (Check one) El State Owned vILLLLAGE - NEAREST ROAD ❑ Public ®1 or 2 Fam. Dwelling-# of bedrooms _a PARCEL TAX NUMBER( S) 111. BUILDING USE: (If building type is public, check all that apply) ~i do- lQ' F-0 - TO 1 ❑ Apt/Condo lJ 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 in line A. Check line B if applicable) A) 1. LJ New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ 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 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill V1. 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) b ► 3S !w• E~LE~VA JION 5- 37r ll~t_ Feet Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks strutted Septic Tank or Holdin Tank vl 70W_ 7 ;,d e'e_' Lift Pump Tank/Si hon Chamber X _7 '.Sly 4 ("'i XL I EJ+R7 El I I n VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) M MPRSW No.: Business Phone Number: ,Z7 - - ) 2 f 'y jj!!::~?Ft7_ ( 71.~5 Plumber's Address (Street, City, State, Zip Code): 16 7,d zlG/1~ IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Permit Fee ~ (Includes Groundwater ate ssue Issuing Agen ignatu o Sta s) / „n Surcharge Fee) Approved ❑ Owner Given Initial 4~{7 Adverse Determination X. CONDITIONS OF APPRO L/REASON✓S~F~OR D PPROVA SBD-6398(R.08/93)_ DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber a 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 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 & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: I 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. Ill. 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 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% 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) SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue P.O. Box 7969 Madison, Wisconsin 63707 State of Wisconsin Department of Industry, Labor and Human Relations December 1, 1994 1340 East Green Bay Street SUITE 300 lg~~~f3<Prff Shawano WI 54166 rJ r WEGERER SOIL TESTI ARTHUR WEGERER 421 N MAIN STREET PO BOX 74 H~ .,,~1a RIVER FALLS WI 54022"~` RE: PLAN S94-31170 FEE RECEIVED: 180.00 SPEARS DAVIDS SW,SW,32,29,16W TOWN OF BALDWIN 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, 44j&11 44,~ Keith Wilkinson Plan Reviewer Section of Private Sewage (715) 524-3627 SBD•6928 (R. 01/91) Page of 6 MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE LOCATED IN THE Sw 1/4 OF THE Sw 1/4 OF SECTION 3 Z , T 1-9 N, R 16 W, TOWN OF COUNTY, WISCONSIN. C INDEX PAGE l 'of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW-CROSS SECTION PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR -lc:)p'v'L lb s v. c~~ CZ s 8 qct s 8 s -m sT- SouTH CC11'TY~G G2pUt, MN SS01L PREPARED BY WEGEF~E F~ SO S L TEST I NG~a ~f q ti' a y C•, v'~a AND 00 DES I t3N SE=-:F; V = CE ~c3'''...<.<.«.,,• r~ ~A get Ly c• a~ A{I.II 17 • 4"^ F.O. BOX 74 421 K. KAIK ST. RIVEF FALLS. MI 54022 y a ONSITE SEWAGE SYSTEM v%G r 715-4~.r-0365 tom' s Ira G 1 RELATIONS l l - Z 0EFARTME% r T9Y, ~ 06 , " :4-31 e~ ;:Li)lNGS Y 70 s s -'f f A, bs JOB NO. 9q-'295 PLOT PLAN Page Z of Scale 1"= 40 i sr1"# 3ao2h 4 N ~n 80 of z wc. 7 .v 1!?SIDt~CE 4"►°~ S LA F•"'' E9.1 1- O to / i /t '/v5 \ 9S. Yl ~ o n ~ ONSITE SEWAUE SYS-I'L 11 0 Q~~t z s Can 99 .0- r, - Coo ~uT cz)-iorteT oR w ?Eia~~E"F ~1glz>~za 1~tlS h1tJ.`A• N~100 1:2 DEPARTM v P., Y 0, Dist{. ~r` V Fit`.c~ v~~ ~:6e3aS d ~ ~ arc; ~ ~ 2 ~O @ E RT ~.NrtfiT So Piwwl Y-1 uu ►,,p x1~ NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. (-Z required) 3. Install 4" observation pipes with approved caps. ( z required) 4. Septic tank to be tWo/6s0 gallon capacity manufactured by 5. Bench Mark 1aK*j is looo'oN t3"c+cc,H,3iy"btA Pvc pipe 'Z .M Z-OL. 100•"1' ON Nta"VilGti, 41"WIN. PuC PIPE wILtTN 6. Divert surface water around mound to prevent ponding at the uphill side. Page 30f b Approved Synthetic Covering Distribution Pipe Medium Sand _ H_ ~G Topsoil _ F Elev_ 3 E b % Slope Force Main Plowed Trench of -,,"-2-,2" From Pump Layer Aggregate Undisturbed D 1.0 Ft. Soil E 1.Z Ft. Cross Section Of A Mound System Using F o•`3 Ft. 1 Trench For The Absorption Area G t.a Ft. A S Ft. H I- S Ft. B -)S Ft. I VL Ft. Linear Loading Rate= 6,1) GPD/LN FT D S Ft. Design Loading Rate= o,13 GPD/SQ FT K 10 Ft. L CIS Ft. t -rv,-r-vrT-o ~cz -reci , i W S Alternate Z Ft. L Force B K Main A 4- - - - - - - - - - ~-►.3t S A'F 0~ p0 S lTE W stribution Trench Of 2N - 2 22« C~17 Pipe Aggregate Permanent Mdt n Markers 'Pip i. a 'n 4 0 Mound Using I Trench For Absorption Area ' Page '4 Of Perforated Pipe Detail 0 End View )Perforated End Cop Pipe Install permanent-marker at end of each lateral Holes Located On Bottom, Are Equally Spaced N Q End Cop * PVC Force Main i 1 Distribution Pipe Lost Hole Should Be Next To End Cop ~'~~~tion Pipe Layout ONSITE SEVIAGE S P 3 S Ft. ~I A11'd'X S (o Inches " Y Sl, Inches a c Hole Diameter lIy Inch r ~r Lateral I'M Inch(es) Manifold Inches 14J NAKly Force Main Z Inches # of holes/pipe s Invert E> V iol of Laterals 1\)0-5 Ft. 0 Place lst hole from tee with succeeding holes at 56 intervals. Last hole to be next to the end cap. Combination Septic Tank and PUMP CHAMBER CROSS SECTION AIJD SPECIFICATIONS, PAGE S OF 6 WEATHER PROOF VEAIT CAP JUIJCT101J box C~ 4"c.I. VENT PIPE APPROVED LOCKING ~ 10' FROM DOOR, MANHOLE COVER wl ti^ wP,RNIIJG L_P.pEI. 'diMJ)DW OR FRESH 1'MIU. C Q~ AIR INTAKE Co►.JDU~T \ I I Y~ MIA1. ~t~ IB'MIIJ. Ib'PIIJJ. I - PROVIDE I III IAILET AIRTIGHT SEAL ~ 0. ~~S I I I ( APPROVED C IVE JOIIJ $ APPROVED JOIWT I .,A I III WI ~U ( I I w/C.I. PIPEo 1 E co uction I II LATEUOIIJG 3' CXTCNDIAJG 3 ALARM th I II ONTO SOLID 601L O►JTO 60WD &OIL 4 d I H~ <T3:.15 and X3.20 w I i Ou I LC'Y FT --J PUMP e}~~'~+~~'~.c. ~ .E F ....i ~ I OFF D COUCRETE LsZy sS. SV'_. 9LOCK 3" APPRovI RISER EXIT PERMITTED OULU IF TAIJK MANUFACTURER HAS SUCH APPROVAL. gEpplµ~ 5PCC.IFICAT10KJS SEPTIC f DOSE \DYJ~TS`Rs`QIJ }7Q~ $T► INC. AIUMBER OF DOSES: 3,1 PER DAy TAwK MANUFACTURER: TANK 51ZC: ~OOI~ l GS0 GALLOUS DOSE VOLUME t S.S. ISLetrw S~t.S'T IS IAJCLUDIAJC, 6ACKFLOW: GALLONS ALARM MANUFACTURER: MODEL MUMBER: »j Hw CAPACITIES: A= `g IAICHCS OR 3010 CALLOUS swITCH TYPE' Y' excliyt Y B= Z INCHES'R 4LLOL15 FRUMP MANUFACTURER: fn4ETtS C- g IIJLHES OR CALLOUS MODEL NUMBEM, S - H D- 10 INCHES OR_ GALLOWS !`'1C~2CURY MOTE: PUMP AVJD ALARM ARC TO K SWITCH TYPE: 1a•1Z- INSTALLED OW SEPARATE CIRCUITS MIAIIMUM DISCKARGE RATE GPM VERTICAL DIFFEREMLE DETWEEIJ PUMP OFF AUD..0I5TRIBUTIOU PIPE.. FE 2.50 FEED t MIIJIMUM AJETWORK SUPPLY PRESSURE + 80 FEET OF FORCE MAIN X F FLFRICTIO►.J FACTOR.. 1,.61 FEET o-~ 6 Y100 7 FEET TOTAL OUWAMIC HEAD = -o DIAMETER Pump chamber _ ILITERIJAL DIMLWSIOW~ OF TAWK: LEWGTH ;WIDTH - iLIQUIO DEPTH 38 BOTTOM AREA 231= GAL/INCH AS PER MANUFACTURER = X7.0 GAL/INCH "OEM 133 NI ad3H Id1O1 + ~ ~ ~ N N N N O N O 00 O N -A m co O N A O O O O • an n y CIO o J a- O '~Od~~j► t p Co ddd a a 5Z5 d~N Y o w dol D O ££WSS 10 ND ° r O _ j z CD cn C) m C) O C cn - m lD m ° 0 N O O N (D N O CA - - - O N O O W O 00 C) O W - ~ I O O O O N W C-" O v 0o .y ~o ~9~ad SH313W Ni ad3H IVIO1 • Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of 3 l,.abor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY - S CQOI.JC Attach complete site plan on paper not less than 81/2 x 11 inches 1' mu's't include, but not limited to vertical and horizontal reference point (BM), dire n$f ale or PARCEL I.D. # dimensioned, noith arrow, and location and distance to ne felt ob Z 1 4-0 - 0 APPLICANT INFORMATION-PLEASE PRINT AL r L'INFO RIIQ~ REVIEWED BY DATE PROPERTY OWNER: -7NW'7' .D @ FT2Iz Friq P, R TION 3UyC d PcUt Sj S •y~ S 1/4 S1 ~171/4,S 3 2 T Z.9 N,R 1 b E (OCW) PROPERTY OWNER':S MAILING ADDRESS s,,, . LOT # B # SUBD. NAME OR CSM # '64 It S 16 S `rn ST. S ov1-H CITY, STATE ZIP CODE PHON I R f❑CITY ❑VIY.LAGE DOWN NEAREST ROAD Cost: (S t ul , Mfv ss of 6 (6l2) 4: V IL % Pc- - f-W I N Z Zl(.N T* S'r. New Construction Use [kj Residential / Number of bedrooms Add' ' to existing building [ ] Replacement [ ] Public or commercial describe Code derived daily flow Eno gpd Recommended design loading rate o, bed, gpd/ft2 - trench, gpd/ft2 Absorption area required Soo bed, ft2 50o trench, ft2 Maximum design loading rate S bed, gpd/ft2 0-b trench; gpd/ft2 Recommended infiltration surface elevation(s) BOO. O ft (as referred to site plan benchmark) Additional design / site considerations * lWy0Z w/ "110 . 1' of S" FILL Parent material l~u IM - o v tz 'D L. t. Rood plain elevation, N applicable N -A - ft S - Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable (or stem ❑ S ®U IN S ❑ U ❑ S O U ❑ S If'U ❑ S ®U ❑ S 01 SOIL DESCRIPTION REPORT ` Boring # Horizon Depth Dominant Color f~Aot>!es Texture Structure consistenoe Baxxiary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench ] o-g 1O`1R ~!3 - S 1 Z`~sbt-c m`F1r CS - O-S O;6 ~e Z $-lq 1o`-I.tz 3/~ s~)) Zmsbk w►~~ cs o.S u.6 Ground 3 19-Zs 1• S %J R- 31 y S I \ cS bh . vn u-kh CL's elev. Ck OS_SfL 2s-V8 `1-S '9R 3/y s,f u sR~ 6 iL s 10 `^1 Yn v'F1~ CS - - Depth to 5 y8-S9 10 `t Q S /7Z 0,1 orn limiting factor ZS" Remarks: Boring # 1 t,-9 10`~R 3 I3 - s t ~ Z'~-3 blz '>''1'~l~ CS - o.S o• ~ Z Z 9-I9 x0`1 R 3/6 s tJ ZVA TVk vvx'f1- ~S o S o.b y s g LS 3 19-Z9 • S `1 R ~1 Ground ` c s Dk k lev. o►el Zft 24-Srd -SbR 3/y !0 SyR !26 Sec6rgl o C cg S S$-6~ lu`2.2 S 1 Z cz<Q11 R- VA, c 1 O w~ wx'~ i _ _ _ Depth to limiting factor zg ~ Remarks: CST Name.-Please Print Phone. Arthur L. We erer 715-425-0165 egerer_Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022 Signature: Date: CST Number: . qy- ) y/ rRu(, t ) 197 M00576 PROPERTY OWNER SP ~''PnZS SOIL DESCRIPTION REPORT Page 2-of 3 PARCEL I.D. # 00 Z- l 0 0 -6,0 Boring # Horizon Depth Dominant Color Mottles Texture 'Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench y. -9 lo` L2 313 - ig ~ Z 310rn C S o. S D. b 3 Z 0/-tl lo`tR 311: St~! -Z 3bvt cL.v _ o,s n• 6 y - S16G 31 ZQSb%T ~h cS _ o•%4 oS Ground lZ_31 '7•S`12S1 elev. eft. 31-38 ~l Utz y/6 S C s) 09'1-S yZ 3!y , c u cs - Depth to S I-aa-qY IOy R S!Z C SIM Yl6 cl dam, ~`~i - limiting factor 1 Remarks: Boring # rs -I 3 _ S t Z S b m`Fh CS - o. S 6 El Z g•_t8 10 `!R 3/r, - Sli' Zrn3bk w,~h, - o.Su- L o sg 3 \ $ -3 y S y R 3 I w 6N5 ( 't o.S hvz n+ u t. c-S - 10.1-/ Ground _ elev. 4sy S 1-92 31V Cl 5 it y/6 if&sl tiOZ.. O ft. Depth to limiting factor Awl Remarks: Boring # _ 13 Ground elev. ft. Depth to limiting factor Remarks: Boring # 13 Ground 3 elev. ft.,', Depth to ` limiting factor Remarks: SBD-8330(R.05/92) J PLOT P LM Page 3 of. SCALE 1"= 30 ' ' - fit. 100.p' pN ~`Hl6l1 31t44 D11j. Qvc- Npla L-L B Z ado ELLO -L 0 - i I m1, 9.5 S \ b+s- LZ 9 9 y HOT. OF ~1.. L d0. p ' 0 ~y~ - ~o"t{-tslt31y401i1 . tL PV p11~~ /LA'tl} . O ~u jUT (!0M P q cT OR N W ~ ~ 1SZvR-i~ `Cli'lS an J~ IaN SF_,D__@E (~T_L Sr ZS' j=1ZWl U%.& C, lye Lj PN,G• 1 , 1_(715 ) 4L-0165 M00576 CST # CST Signature Date Signed Telephone No. STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNERBUYER J i 7t ft~-S MAILING ADDRESS f 0 J e..o f ~O PROPERTY ADDRESS (location of septic system) Please obtain from the Planning Dept. U3 \se. CITY/STATE 7;~)a ~ ~ l~ ~ N PROPERTY LOCATION S t~ 1/4, 1/4, Section 2 T 2-9 N-R W TOWN OF0. ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAP, VOLUMFL°~AGE 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 thr rear expiration d SIGNED: \ s DATE: Ll 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 submitted to this office with the property is sold and appropriate deed recording. Owner of property - ~v.` 5~~~5 ln~~~ ~11~1~ Location of property _S W 1/4SW 1/4, Section 3 2- ,T Z N-R-UQ_W Township &k1w i p-3 Mailing address ~~SS g5~` S So, C O 4CQ f- ^ ~ tr O V e. )0^1 J-S© f L Address of site ~jQ q Z Zd~ C-14 ve- e4 Subdivision name Lot no. other homes on property? Yes No Previous owner of property Total size of property Total size of parcel ~A Date parcel was created ~g f~ /91i~ Are all corners and lot lines identifiable? Yes No Is this property being developed for (spe ho us ? Yes No Volumed © and Page Number S~ 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. 5-2. 00 Q 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 Y i~ N Date of Signature Date of Signature ► DOCUMENT NO. STATE BAR OF WISCONSIN FORM 11-1982 THIS SPACE RESERVED FOR RECORDING DATA LAND CONTRACT ;j 0083 Individual and Corporate i (T BE USED FOR ALL $25,000 IS FINANC it ED AND INCTIONSOTHER ON CONSUMER jl ACT TRANSA) Berkseth Inc.. ST. CROIX CO., WI Contract by and between - $ Recd 1br Record --Vendor", Atl t fG ^ whether one or more) and---------- David -Spears- and Bonita . i . O 1994 A Chewier S' A it (f ("Purchaser", whether one or more). Vendor sells and agrees to convey to Purchaser, upon the prompt and full per- RegiswOf Deeds formance of this contract by Purchaser, the following property, together with the rents, profits, fixtures and other appurtenant interests (all called the "Property"), in St-Croix County, State of Wisconsin: EruRN To 5 ~t S ~I ~~roY~- ~uN SS-a r 6 SW 1/4 of SW 1/4 of Section 32-29-16, St. Croix County, Wisconsin. Tax Parcel No_ I I j This 1S- 110t - homestead property. (is not) i Purchaser agrees to purchase the Property and to lace vendor may direct pay to Vendor at _p.....___ y , the sum of $.26-yOQQ.OO--------------------------------------- in the following manner: (a) $3:~6 .00----- at the execution of this Contract; and (b) the balance of $ 23,QQQ.0O____________________ together with interest from date hereof on the balance outstanding from time to time at the rate of_________ _9._25____________ er cent p per annum until paid in full, as follows: Commencing September 8, 1994, and-'on------ nd on the 8tday of each and every month thereafter, equal monthly installments of principal and interest in the amount of $236.71. I' ~Provided, however, the entire ~~out ding balance shall be paid in full on or before the 8th day of ( the maturity date). II j Following any default in payment, interest shall accrue at the rate of % per annum on the entire amount in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance). ;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, I 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 jl unless otherwise required by law. Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any amount may be prepaid without ~ premium or fee upon principal at any time .*,t%eXXXXXXXXXX ZCHR,) I~ x~hlx~x~x>~4:a~x9P~u~x~X~xRl~~~~x~~xa~cs3o~aXOc?:~>oxx it I In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long II as the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be treated ~I as unpaid principal) is less than the amount that said indebtedness would have been had the monthly payments been jl made as first specified above; provided that monthly payments shall be continued in the event of credit of any proceeds it of insurance or condemnation, the condemned premises being thereafter excluded herefrom. ~I Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser j for examination except: A Mortgage to the Federal Land Bank of Saint Paul in the ii original stated amount of $120,000.00, dated August 24, 1978, and recorded in Vol. 1158011, Page 223, Doc. No. 351288, and a Farmland Preservation Agreement No. 144, dated January 17, 1983, and recorded in Vol. "659", Page 159, Doc. No. 382608. II ii Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall ii be retained by Vendor until the full purchase price is paid. across Purochaser shall be entitled to take possession of the Property on---_day__Of __CZOSing. x Out ne. LAND CONTRACT-Individual and STATE, BAR OF WISCONSIN 'Wisconsin Legal Blank Co. Inc. Corporate FORM No. 11 - 1982 ;Milwaukee, Wis. 4ou1 - A1V _.v,y ..leuv.uDap ..a u...J p.... ,....Y:"!Y ••1-.LJr nm,wa v,t. •sa.injuubls ilaq; %io[aq pg7«lad ao pagSj aq pjnogs .ip..mdu Xuu uc .`1mu2l9 suoszad 30 nuvtz. V, 61 ° :a4up = + , (•AauSSaaau lou aat; _ uotluatdxa aluls 'lou 3i) -luauuuuad si uotssnuutoD SW gloa •pa2palmomlou ao paluotluaglnn aq Suitt saanluu2tS) IS. 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Aiadoad (t n) I a aqJ aoj luluaa su pug IaealuoO stgJ II63In3 of eanltuj aoi sa2umvp palsptnbil su palta;aao; aq llugs aasggoand Aq ptud Alsnolnaad sl unouzu 11g Juana gatgm ut) aapunaaaq anp slunotug aaglo puu algp gans uo pa33a ui alga atlJ it, ilnujap ;o aJgp aqi uzoa; uoaaagl lsaaalut gltm 'aouuluq 2utpuulslno aatlua aqi ;o luamSud lln3 s,aasugaand uodn pauotltpuoo aq of uotiduzapaa so Aitnba Sus gitm aansoloaao; lalals g2noagl 31oeq Slaadoad aqJ aanoaaa pug Alaadoad aqJ ut lsaaalut pus aiili `sig26a s,aasegoand pug IogaluoO stgi aluutuzaai 'uotldo stq ig ISetu aopuaA (t) :Allnba ut to mgl Aq paptnoad asogl oluotitppg ut (mgl Aq paptnoad suotlglltzztl Aug oI loafgns) satpamaa pug s4g2ta 2uumollo; aqi aAeq osi13 Ilugs aopuaA pug ~(santgm Sgaiag aas13g3and gotgm) aotlou Inogltm pug uotldo s,aopuaA Je 'IIn3 ut algsAgd pug anp Alaletpatuuzt atuooaq Iliags Iagaluoo stgl aapun aausluq 2utpuu4s4no aatlua atul uagJ ' (Ituuu pat3tiaaa Aq papiout ao Sllnuosaad paaan119p) aopuaA Sq;oaaagi aatlou ualltam 2uimolloi sSup ()~----;o polaad u aoj sanutluoa gatgm aasggoand So uol4g2tlgo aaglo Sun ;o aouetuao;aad ut linujap u ;o Juana aqJ ut (q) ao alup anp pat;taads aqJ 2utmollol sSup ;o polaad a aoj sanutluoo gatgm lsaaalut ao ludtoutad Aug ;o JuatuAgd aqi ul Ilnu;ap u ;o Juana aqJ ut (u) pug aouasssa aqi ;o si atuti iggi saaa2n aasggoand • • u~ 31 piooa-1 3o LM-jo-sqq za pug - c :Idaaxa pug '-1asvgaand ;o 41ng;9p so Jos agi Aq paluaao saousaqutnaua ao suatl Sul? suoij-3i.1gS;9J s~uawasu~ Idaoxa 'smug-1gtunaue pug suall Ilia ;o asala pug aaal 'Alaadoad agl so Ialdmis aa; ut 'paaQ SlugaastA s 'aasugaand aqJ of -19etl9p pus almaxe 'pusutap uo Iltm aopuaA 'paglaads anoqu aauusui 9gl ut pug samil agi it, pauuo;aad AIIn3 ag hugs suolitPuoo liia pus pied AIIn; aq llrgs sAauouz aaglo pug lsaaalut gilm aotad asggoand aq asuo u1 lugi saaa213 aopuaA -Siaadoad aql 2utiaajjs suolleln2aa pug samnutpao Isms[ Iis gllm Sldtuoo oI pug 'lag-1IuoO stgl ;o uatl aqJ oI aotaadns suall uzoa3 as-1; Slaadoad aqJ daw[ of '-1tedaa pus uolllpuoa alggluuual pool u1 AJaadoad aqJ daa}l of 'Alaedoad aqI uo pailluttuoa aq oI alsum molls aou alsgm ltuztuoa OI IOU sltiguanoa aasggoand 9Igtsvaj Alluattuouooa aq of atedaa zo not caolsaa 9114 suzaap aopuaA 0111 paptnoad 'pa2uurep Alaadoad aqJ ;o atedaa ao uotlgaolsaa of patlddg aq ltugs spaaooad aeugattsut '2utltam ui 99-1213 astmaaglo aopuaA pug aasugaand ssalun •aopuaA puu saiugdutoo aaugansui u'} ssol ;0 9314ou an12 Alldtuoad liegs aasugaand •aopuaA gilm pailsodop aq rives Slaadoad agl 2utaanoa satatlod Iie So luut2tao aqi '$uiltim ui sae-12g astmaaglo aopuaA ssalun 'pug lsaaalut s,aopuaA aqJ ;o aoAvy..ut asnula paupugls aql utgluoa ilggs samilod aqd -anp uagm suimuzaad aau13ansm aqJ Aud llugs aasugoand •loealuop stg3zaapun pamo aougluq aqJ uggi aaout lunoutu u13 u1 a213aenoa aalnbaa IOU Ilvgs aopuaA Inq ' ------so tuns aqJ ut 'aopuaA Aq panoaddu saaansui g2no-1gI 'aougansui-oa Inogltm 'aalnbaa Ault' aopuaA su spauzuq aaglo gans.pu-e sltaad 929-1anoo papual -xa 'a-1t; Aq pauotseaoo 82uump so ssol 4sutg2g paansut Alaadoad aqJ uo slUautanoaduzt aqJ dawl (legs iasvgaancl IuautSed gans 2ulmogs sldtaoaa pugutap uo aopuaA of aantlap of pug lI u1 lsaaalut s,aopu9A uodn so AI-1adoad agl uo Patnal sluautssasss pug saxgl Ilu anp uagm And Ol sasituo-1d aasugaand 61 ei3 -U06.0 % QUA