HomeMy WebLinkAbout008-1080-60-100
STC - 104
AS BUILT SANITARY SYSTEM REPORT
~q ~UP1tiG01C~
OWNER °
/C.
ADDRESS
SUBDIVISION / CSM# LOT #
SECTION T N-R W, Town of 1U a G
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
p
s Cpnt£"
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK'
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: Liquid Capacity:
Setback from: Well House Other
Pump: Manufacturer Model# Size
Float seperation_ Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
Width: Length Number of trenches
Distance & Direction to nearest prop. line:
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:
LICENSE NUMBER:
INSPECTOR:
3/93:jt
wiscgnsin Department of Industry, PRIVATE SEWAGE SYSTEM County:
1- I-..iorahJ Human Relations INSPECTION REPORT ST. CROIX
Safety and Buildings Division
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No
Permit Holder's Name: ❑ City ❑ Village Town of: State PI o..
BERGER, ARNOLD A
Insp BM Elev.: BM Description: Parcel Tax No.:
CST BM ,Elev.:
1 00-9-
TANK INFORMATION, ELEVATION DATA 1o~2~I9~
TYPE MANUFACTURER CAPACITY STATION BS HI FS-__ ELEV.
Septic Benchmark
,r
Dosing
Aeration Bldg. Sewer
Holding
St /fit Inlet a5
TANK SETBACK INFORMATION St /,0 Outlet
TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic ? NA Dt Bottom
Dosing NA AjjAdr / Man. AG
Aeration NA Dist. Pipe
Holding Bot. System
- F- f
PUMP/ Sliq_ 4 N INFORMATION Final Grade
Manufacturer
Demand
Model Number - GPM
TDH Lift Friction System, j' TDH Ft
Loss He
Forcemain Length. Dia. Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT - No. Of Pits Inside Dia. iqu Depth
DIMENSIONS DIMEN I N
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEA M acturer:
SETBACK
INFORMATION TypeO CH Model Number.
System:, OR UNIT
DISTRIBUTION SYSTEM
Header / Manjold I Distribution Pipe(s) I x Hole Size I x Hole Spacing I 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 E] Yes E] No ❑ Yes El No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: Eau Galle.28.28.16W, SW, SW, 10th Avenue
Plan revision required? ❑ Yes ❑ No
Use other side for additional information.
SBD-6710 (R 05/91) Date Inspector's Signa re Cert No
~DIL~ SANITARY PERMIT APPLICATION co TY
In accord with ILHR 83.05, Wis. Adm. Codes _ I x
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than C
8% x 11 inches in size. ❑ Check if revision 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 _
PROPERTY OWNER'S MAILING ADDR S LOT # BLOCK #
CITE, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
II. TYPE OF BUILDING: Check One CITY NEAREST ROAD
( ) ❑ State Owned VILLAGE :
' c , " - ' i 1i /f 1. c
❑ Public 151 or 2 Fam. Dwelling-# of bedrooms ~ PARCEL TAX NUMBER( )
III. BUILDING USE: (If building type is public, check all that apply) l<' ,
1 ❑ Apt/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ RestauranUBar/Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify
IV. TYPPEqq 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
VI. ABSORPTION SYSTEM INFORMATION:
1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE
_ REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION
r `
7 Feet t'C Feet
VII. TANK CAPACITY Site
in allons Total of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper.
INFORMATION New xisting Gallons Tanks Concrete structed glass App.
Tanks Tanks
Septic Tank or Holding Tank ( C~~G &L,- -.-Z~
Lift Pump Tank/Si hon Chamber, f / F>a F-1 F1 Ll I L1 F-1
Vlll. 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 Sign ure: (No Stamps) MP/MPRSW No.: Business Phone Number:
y
i
o4
C`_ ~4tiP
Plumber's Address (street, City, State, Zip Code):
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Ag nt Si ature (N Stamps
Surcharge Fee)
Approved ❑ Owner Given Initial rf e%
Adverse Determination o~ ,54
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety a Buildings Division, Owner, Plumber
SAFETY & BUILDINGS DIVISION
State of Wisconsin
Department of Industry, Labor and Human Relations
June 1, 1994 2226 Rose Street
La. Crosse WI 54603
I
WEGERER SOIL TESTING
PO 74
RIVER FALLS WI 54022
RE: PLAN S94-40385 FEE RECEIVED: 180.00
BERGER, ARNOLD
SW,SW,28,28,16W
TOWN OF EAU GALLE 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.
I
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.
I
Sincerely,
y/^
AA_ V A4
erard Swim
Plan Reviewer
Section of Private Sewage ~•;A 5a
(608) 785-9348
411.9R/ 1 " + -
10
.c
SBD 6423(R.01/91)
' e
Page \ of
6
MOUND SYSTEM
FOR
A 3 BEDROOM RESIDENCE
LOCATED IN THE S W 1/4 OF THE Sw 1/4 OF SECTION _LB , T ZS N, R lb W,
TOWN OF aj' ij GpL„Lts , ST, (Z-IZUI)( COUNTY, WISCONSIN.
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
PA GE 5 of 6 PUMPING CHAMBER
PAGE 6 of 6 PUMP PERFORMANCE CURVE
PREPARED FOR
BPI uOlliltilt 1-1/ 5 gooZ
PREPARED BY
WEGEFRER SO I L TEST I NG R3 a q ,
AND.
o.a+a. o..os JII ~EI3ES = GV1 SERE1 = CE $ y%
® . ARTHUq L
® e 4M[t.:itri
® D-91; F ae
P.O. BOX 74 421 M. KAIM ST. m H s,:o +Tw.
RIVQ? FALLS. VI 54022 ipp °i w s
w
715-4~ r-0165 .'/,J~~ O e~'
$
S I G O
N'" ZS, 194Y
RECEIVED
MAY 2 6 1994
SAFETY i sum. M. JOB NO. a q-
` 6
PLOT PLAN Page Z of
Scale 1 Sri ' N
a'
a
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bm. PlkS11C ~LPE w/~
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3 BD~ZV~-~ / /J
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Cali ~ 31q O 111~ -
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W eA- N 3F I-vr LAST So F-01" 1 lyuuKjt~ 1-~~J1l
LAST ZS' FP-OM I 'Vx/k S .
osIOH OF SAFETY
0 2, kv~i 1-p
l
NOTES: tvSY Ll~~ 0(= gO 1'~RLS Pli')~GNL~
1. Elevations shown are existing ground elevations unless otherwise noted.
2. Install permanent markers at end of each lateral. ( 2. required)
3. Install 4" observation pipes with approved caps. ( Z required)
4. Septic tank to be gallon capacity manufactured by
w S ~Z Cps,OIAL PR4DuCY3• Tt?J1z `p aG wgsm .'Is0 G*tt `1ft,~k
5. Bench Mark sIE-~ "pul~-- r-,L-kN
6. Divert surface water around mound to prevent ponding at the uphill side.
Page 3 Of b
Approved Synthetic Covering
Distribution Pipe
Medium Sand
H ~G
Topsoil F Elev _
3 °l q S
-J I E p _
b
(o % Slope
Force Main Plowed
Trench of k12,"-2,k12," From Pump Layer
Aggregate
Undisturbed D t•O Ft.
Soil E ) - 3 Ft.
Cross Section Of A Mound System Using F O-~ Ft.
I Trench For The Absorption Area G 1•~ Ft.
A 5 Ft. H I- S Ft.
B S Ft.
I S Ft.
Linear Loading Rate= 6.0 GPD/LN FT 8 Ft.
Design Loading Rate= 0.3 GPD/SQ FT
K 10 Ft.
L at S Ft.
°-Posi ti on of Force Mai n W Zg Ft.
L
- B K hAQin--
W Distribution Trench Of 2~ - 2 2~
Pipe Aggregate f
1 J
Observation Permanent Markers
Pipes
(Anchor securely)
Mound Using 1 Trench For Absor tion Are
1,4
Page Of
Perforoted Pipe Detoll
0
End View
End Cap. y. )Perforated
PVC Pipe
~o~so ooca
Install permanent-marker
at end of each lateral
Holes Located On Bottom,
Are Equally Spaced
Q End Cap
tonally
ti PVC Force Main
u111R`~ .
Distribution
Pipe xt
` tgl~3tst~
Lost Hole Should Be
Next To End Cap
I
Distribution Pipe Layout
P 3 S Ft-
X 5 b Inches
Y S 6 Inches
Hole Diameter 1/y Inch
Lateral ) Inch(es)
Manifold - Inches
Force Main Z Inches
# of holes/pipe g
Invert Elevation of Laterals ~00.0 Ft.
4
Place lst hole Z~from tee with succeeding holes at $6~intervals.
Last hole to be next to the end cap.
PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS ' PAGE S OF 6
VENT CAP
'i"C.I. VEM7 PIPE
WEATHER PROOF , APPROVED LOCKING MANHOLE
10' FROM DOOR, JUAICTION 80X COVER WITH WARNING LABEL
WINDOW OR FRESH 12~MIU.
I_
AIR INTAKE I
GRADE
rTL 600 I ~r IAJ U.
7 16" MIAI.
CONDUIT--
18"IKIN.~
:q, PROVIDE I
IMLET
AIRTIGHT SEAL I I i I
I I
APPROVED JOINT A Tank construction shall comply APPROVED JOIIJTS
with approved with ILHR 83.15 and ILHR 83.20 I III
pipe extending ALARM
3 feet onto IS i II
solid soil. HD~pI. ( I oM
! Both sides of ' DC 1NuSt ~w•,.•tank . OF BAF
t~it510K 0~ I
CL E V. a 0 2,S FT.--
PUMP—-, --j
J OFF
P `
$g 00 COWCKETE BLOCK
3" ApPRWED
RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL. BFOOING
SPEC.IFICATIOPIS
DOSE W~~Z C.(14/C [T NUMBER OF DOSES: PER D/►y
TAWA MANUFACTURER:
TANK SIZE: GALLONS DOSE VOLUME z
GALLONS
ALARM MAWUFACTURER' S- S. - S`tSTis INCLUDING DACK/LOW: 114 O.3
MODEL I.IUMBER: CAPACITIES: A= S INCHES OR ~ GALLONS
SWITCH TYPE: ~Z CLJ{ZY 8= z INCHES OR 40` I G( LLOL15
PUMP MANUFACTURER: ZO ~'L CW-Ij~,AN Y C= 1 INCHES OR 7yb'3 GALLOWS
MODEL MUMDER: S 3 D- IS INCHES OR 3 0U- $ GALLOWS
SWITCH TYPE: Yn ~1ZC~~ZY MOTE: PUMP AWD ALARM ARE TO OE
MtWIMUM DISCHARGE RATE-18'-)'Z G PM INSTALLED OW SEPARATE CIRCUITS
VERTICAL DIFFEILEMCE DETWEELI PUMP OFF AWD_DISTRIBUTIOW PIPE.. FEET
+ MIUIMUM NETWORK SUPPLY PRESSURE . . . . . 2.50 FEET
+ Z S FEET OF FORCE MAIM X ~ 76 F oo ftFRICTIOU FACTOR.. O ` lq FEET
TOTAL OtIUAMIC HLAD = ~Z FEET
DIAMETER
321 ~1 •
IWTERWAL DIMEWSMLJ~ OF TAWK: LEQ&TH ;WIDTH ;LIQUID DEPTH
BOTTOM AREA - 231= - GAL/INCH
AS PER MANUFACTURER = 1O, O S GAL/INCH
~ W (vGE 6 0. 6
W W
HEAD CAPACITY CURVE 4'/8 61/4
"53-55" SERIES 45/8
25
m
TOTAL DYNAMIC HEAD/ I 47/8
FLOW PER MINUTE
EFFLUENT AND DEWATERING o
CAPACITY
20 HEAD UNITS/MIN -11/2 -
111
/2 NPT
a FEET METERS GAL LTRS 43/16
W 5 1.52 43 163 m
= 10 3.05 34 129
V 15 4.57 19 72
Q 15 19.25 5.87 0 0
Z
Q 4-
.10-
0 Q Is.~2
F- 2
5-
9 15/18
- - a]
0
I
US 10 20 30 40 5,0 33/32
GALLONS
LITERS 0 80 160
FLOW PER MINUTE
CONSULT FACTORY FOR SPECIAL APPLICATIONS
• Piggyback Mercury Float Switches • Available with special cord lengths of 15',
available. 25', 35' and 50'.
• Variable level long cycle systems • Alarm systems available.
available. • Duplex systems available.
Standard cord length - automatic 9 ft.
Standard cord length - non-automatic 15 ft.
SELECTION GUIDE
M53/55 SERIES Control Selectlon 1. Integral float operated mechanical switch, no external control required.
Model Volts-Pit Mode Amps Simplex Duplex 2 Single piggyback wide angle mercuryfloatswitch ordouble piggybackmercury float
M53/55 115 1 Auto 8.0 1 or 1 & 7 - switch. Refer to FM0477.
N53/55 115 1 Non 8.0 2 or L8` 6 3 or 4 & 5 & Mechanical alternator 10-0072 or 10-0075.
D53/55 230 1 Auto 4.0 1 or 1 & 7 - 4. See FM-712 for correct model of Electripal Alternator, "E-Pak.
E53/55 230 1 Non 4.0 2 or 2 & 6 3 or 4 & 5 S. Sensor mercury float switch 10-0225 used as a control activator, with E-Pak (3) or (4)
float system.
53 Series - Wt. 231 bS. -.3 H.P. 55 Series - Wt. 25 I bs. -.3 H.P. 6. Four (4) hole "J-Pak junction box, for watertight connection or wired-in simplex or
duplex operation. P/N 10-0002
7. Two (2) hole "J-Pak"junction box, for watertight connection or splice, P/N 10-0003.
For information on additional Zoeller products referto catalog on Combination Starter, FMO514; CAUTION
Piggyback Mercury Float Switches, FM0477; Electrical Alternator, FMO48Q Mechanical Altema- All Installation of controls, protection devices and wiring should be done by a qualified
nator, FMO495; Alarm Package, FMO513; Sump/Sewage Basins, FM0487; and Simplex Control licensed electrician. All electrical and safety codes should be followed In addition to the
Box, FM0732 most recent National Electric Code (NEC) and the Occupational Safety and Health Act
(OSHA).
RESERVE POWERED DESIGN
For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump.
MAIL TO: P.O.80X 16347
Loulsvllla, KY40256-0347 Manufacturers of .
Y4216 0216 Lane
O1ZZZ1j-ff 01 SH1PT0: Loulst48e 3280 , KOld Millers
p
® (502) 778-2731. 1(800) 928-PUMP QUALITY AVM-9 FA'CE ,F
FAX (502) 774-3624
Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of 3
Labor and Human Relations
Division of Safety Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
~.v ~X
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but c.
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
A~ DSO - b ~ G ~Z GGV;--L$T S W 1/4 S W 1/4,S ZS T Z, $ N,R 16 E (or&W
PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
Z 3 3 Z I p PU - - -
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE 00 ____jNEAREST ROAD
~Pcl~WltU I.vl S~10UL (CIS) 68~/- 373(, GItIL~ lQl 1-- 1~rQE`,
New Construction Use [SCj Residential / Number of bedrooms Addib.Qn to existing building
[ ] Replacement [ ] Public or commercial describe
Code derived daily flow LASO gpd Recommended design loading rate - bed, gpd/ft2 3 trench, gpd/ft2
Absorption area required 31S bed, ft2 S trench, ft2
q • S t Maximum design loading rate o S bed, gpd/ft2 0.6 trench, gpd/ft2
Recommended infiltration surface elevation(s) 01 ft (as referred to site plan benchmark)
Additional design / site considerations h~ w/ 5 X 1 S ' T1Z ~►y CV , " t ry , t ` of SA AJ'to Ft t_ L-
Parent material s 1 T Flood plain elevation, if applicable N ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem ❑ S ®U ® S ❑ U ❑ S IM U ❑ S IOU ❑ S ®U ❑ S WU
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Structure GPD/ft
Boring # Horizon Texture Consistence Botr>dary Roots
In. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench
1 0-4, 10-tVZ_ 3!Z - si` Z`~Sbtic -£w a,s - o.S o- 6
1
z 6- 4 10 '-1 I- z- - s i Z F S bh try f h c s o, s 6.
Ground 3 z9-Sb S"(z to ti~z s/z 51 o•,. m`F1- - -
elev.
tiV3D_ ft. CD e-6 `I- GK S N►\J'~b Depth to
limiting
factor
Z9 t
Remarks:
Boring #
-a 10`12 jl2 _ S 1 1 Z i 35~ t M f ct.S - o,S o•~
.3 Z,S-yD S'-► 2. 31 ~Z~. ~ Is/t~ S~ ~\.L O~ 1'n `i l~ - - -
Ground
elev.
C) 6•1~ ft.
Depth to
limiting
factor
ZS1 .r'° 4
Remarks:
T Name:-Please Print Phone:
Arthur L. We erer 71°~y2§
ress:
egerer Soil Testing & Design Service-P.O. Box 74 River Falla,tW -5+022
Signature: Date: CST Number:
Gy-6y 4~- t3_9 M00576
r
PROPERTY OWNER SOIL DESCRIPTION REPORT Page L' of 3
PARCEL I.D. #
Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed TW&
< 0_8 ~~~-t2 31Z SIl Z'~~~K Mph Cx- _ 0.5 u• 6
D. S U.
s 'I Z Sbh f~ c S -
t
Ground 1~-2~ • S R 3L~ - S 1 Z m Sb►2 `rn v ~h S _ S o•
elev. Z ~.S`iR SLf3
99,b ft. y Z7_So S `t 1z- 31 `f to ~co2 Sri s, Tug O ~ vn `f - -
Depth to ZO S N-,I ' xj o 1 S L~ I
limiting
factor
Remarks:
Boring #
E3
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(R.05/92)
PLOT PLAN Page 3 of 3
SCALE 1"= 30
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3/y'~ DtR• P~kST1C PtPE w/CRfiN o
a
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iw~ wtuv*~~,
S=
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/
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o1 j
y ~•ZI C'L °16
i
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B • ~ --~-Ou t~i~T cflrl P ~ cT p1~
eL r,)%tEL Ci C)
~3~ ` Loo O ~ Z / n
iupl~ :
~OuSE 70 ~ t:. ~1' LAST ZS' ?~0 M r-i u u~,~
LA--MLELL k a k di Su' 't
o-Z1 To
Z 30 `17t S7'.
-L3-`2~ (715 425-01 65 M00576
CST Signature Date Signed Telephone No. CST #
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER
MAILING ADDRESS 3
PROPERTY ADDRESS
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE
PROPERTY LOCATION SR&z' 1/4, 1/4, Section - T W
TOWN OFo ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMBER
CERTIFIED SURVEY MAP , VOLUME, PAGE , LOT NUMBER
Improper use and maintenance of your septic system could result in its premature failure to handle
wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed
by licensed septic tank pumper. What you put into the system can affect the function of the septic tank
as a treatment stage in the waste disposal system.
St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost
of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County
accepted this program in August of 1980, with the requirement that owners of all new systems agree to
keep their system properly maintained.
The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner
and by a 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.
VWe, 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: ~9
St_ Croix County Zoning Office
Government Center
1101 Carmichael Road
1 Judson, 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.
Ownerofproperty -e
Location of property, %.,J 1/4 S'bJ 1/4, Section T ?Q N-R /mow
Township E14U 61A Z - c-- Mailing address J Al
Address of site
subdivision name Lot no.
Other homes on property? Yes X No
Previous owner of property f'~ r
Total size of property
Total size of parcel
Date parcel was created
Are all corners and lot lines identifiable? ~XYes No
Is this property being developed for (spec house) ? Yes X` No
Volume /and Page Number: 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. S` r' / / / , 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.
C-Cr
Signature of A nt
P ca Co-Applicant
Date of Signature Dat of Signat re
STATE. HAR OF N'ISC'()NSI\--FORM I1
• DOCUMENT NO LAND CONTRACT Individual and Corporate
o~R; N DATA
i_j 3 VC!-
589 u~ rli-tt'r, bl an,l III'! Ien ,erald Britton and Joyce REG;51 ~Fr1CE
t-)n, hnsba n:i and wife and each in their c •:n r c,: c
r i +r: t 1 Rte d. f;-,t yR?c tr 010--'
herein called Vendor, wh.cthrr cme. ~r
and Arnol,i erg°er and °ernice F. 9er~;er, .,r~. ~pvof~ _A-D. 19--?c
,u =ban(? an,1 w1 i _ as joint tenants, M.
herein c ally- I Pun'h-er, wh,•th- Iir i,-.
WICNF.SSF.TH: That the Vendor, in cons+deratwn of the payments to be made and the _
-111nants and a,- reements by the Purchaser to be performed, as hereinafter set forth, n of eo,l+
~
hereby sells .,not agrees to convey unto the Purchaser, upon the prompt and full perform- RETUR TO
core by the Purrhever of the cJVenents and agreements of this contract to he by the ~
Purrha-r pert-r!rr d, the following described real estate in 't Croix -
• County, State of 11'isconsm:
Tax Key +
"l"ie ch o~ th' S'rl: of Sectlon 741 T1F1" n iT"!'i, o~ This is - homestead prop, rr.-
i-iction ? z - :Ir: ; the ~7h oI' of section 33, except
} 5 acres in the southwest corner of the sWlir of NW's of Section 33, it
1'eina mutll,-ii ly understood between the rnrt 1e:; hereto the said 5 ace es Is
to be suvvt:vYed in the su!older of 1979 and the description from the survey is
to be the description to be used as to this excepted 5 acres, all in
own 24 IT
orth, Rance 16 '.'?est.
together with all buildings, improvements, fixtures and appurtenances, now or hereafter erected thereon, including all screen and storm
doors and windows, attached mirrors, fixtures, shades, attached floor covering, hot water heater, furnace. oil tank and light fixtures
which shall be a part .4 the real estate.
The Purcha,-, in considereti,~n .)f the covenants and air cments herein :raa;sle tb t eehey Vendor, da~Tees to purchase the above
- - - - '
described premises, and to pay therefor to the Vendor at such place - - - -i-rect,,
the sum of one hundred eighty Thousand and n0/100
in in manner following: $ 1 n O at the execution hereof, the receipt whereof is hereby acknowledged, and the balance
of s 1714 000-. 00- - tyKCtdu=rw..ithsuterr_SLnrisvc.lLpnctina`ithe~yLa_s_shalLrcrn~w~!s^--!i.mnsritirne-+uaPaadrat-ihefate _
~1T:5 44 4- 4, tie&n-+.r------- «r------------------rkx `Ar+1R an-Fkc-----_- "
- - - - - - - - - - - - - - - - - - - - - - - ------rlar wu!.+ci-tkw drriir~~-Q+. rt kaF.w~wwfl e-y-:~n~inic~rc~F-~i+al k-l~fall•y-prT iii ri,Ytkitr
--------------------rMrs'fr1TTM7,MrtrtTr7)f. as stated on attached '.L*xhibi.t:tAt'
Purchaser further agrees. unless ex_used by Vend.,r, to pay monthly payments sufficient reasonahly to anticipate the payment of
taxes, special as-e;sme•nts, fire •i extended _2)verage premium.; and such other insurance premiums as Vendor may require, and Pur-
chaser agrees to cake such payments to .he Vendor an-i hereby authorizes Vendor to apply the same in payment of such items._
r%
Said payments :ha I1 _t app tu d first to interest can the unpaid !),Ilance at the• r rte herein specified and then to principal. Any
amount may be pr, p.-I c.,h-it premri, ~r fee upon principal at any time, and i.^.tere, sI shall be calculated at all times on the unpaid
halance on the daily rata basis at 15n0 of the annual rate.
In the event If 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 i and in such case accruing interest from month to month shall be treated as unpaid principal) is less
than the amount that :aid indebt dness would have been had the monthly payments been made as first specified above; provided that
monthly payments shall he c or-nued in the event of cr.dit of any proceeds of insurance or condemnation, the condemned premises
being thereafter ex, lulled herefrom. !
The Pureh ^ hereby states that he is satisfied wi-' "re title as shown by the abstract-title insurance commitment submitted to
him for exam.inat i. the Vendor agrees to deliver the ab act-title insurance policy to the Purchaser when the full purchase price
hereunder ;hall fha,. been paid. The Purchaser agrees to pay the cost of later continuations of abstract title insurance-
r ,.T.h t_ 5~~.'u1-.c ,;'z:ilr l ac ~i dubs-2uuJai cllairl } :ia..y c ~rx~c t.~..-t lut+la W - 44ix;~t a + io•ri~r r ~t t-he - ore Yr:rs rr- M+el Z` e.~r ej -s•s -s
:au4f~•rr.'.-.ie»~+r -rfrrtn.: r•e!trerHi-r t•a"-k-irrrararr<-r-rTr-rnt-r:rtrtf.Iran-rrs-itr' ptrhC-y-1)f ttt-It-MTLrrtnt'f.1-1TrThr1:0T,,,7 fTIM'pMMtaTe
PT n-e,-t!,..-f'c.r.fr.rs rr-t er Fx.--r+r. rn:.c!-ew-heron v re+, --t o- lie---Fir er ky-a-in-K»axr--ei~+nts~+n yam,-+n4-g sett-e*Hwl A Vend ur is-I UJ& 1r1_
iiki miir!•i!-~nia!•t,.-i4,art,rth7-, 7re-:-tri7 rn-(2"ia-rterctrmraMg-ntr.,Yr7cr7; IN'trM'I?M t'f1t11-.JT"77MZ1Trt-MTr2'WCrT05r 7'XrrrTToT15yr
t•fits-.rTt,,_ ~r met-4 1-:a4.:. e.a Ayam. Lu=i bj-,d-tht_EULCh~ser %1wr_wiLi4,__r tics ~L.r. ~•a:r"in g, vF ai;l3^_ bjtic 4~aea t,, .i iA W v- - "itw 19)
4"wearFt-+`rae•e'*it'+.1=-sa--Ah-0re+e4-&fh4-4x i<M4,,hM I-,+ err-tre ve- ess,+_ 17i -h -whtrk tree ectrfythr-t rt ?r-n rfurn isfir arttte-
~rFxY-+r^.-t3?rrv~+F:-zrrrtm!.
The Purchaser shall be -,title.: to takt possession of said premises on 19_ In case
possession is to be obtained by the Vendor he shall have a reasonable time after such date in which to remove any occupCnt. The
Pur;.: haler shall he entitled to remain in possession as long as he performs all covenants and agreements herein mentioned oh his part
to be*performed and no longer.
t
LAND CONTRACT -INDIV'IDI'iL ANT, CORPORATE -STATE BAR OF WISCONSIN, FORM N!' 1 i 11471
4p, I
T„IS SPACE RESEr:YED FOR RELORDIN'~ DATI
'SIN F0Iy 15-
DOCUMENT No. eTAASSIGNmENT OF LAND CONTRACTsrr
A t-;
1.026na 10
5034 o P,. VOL E 'S
OFFiGt 0 X CO
Assignor,
whether one or more, for a valuable consideration, assil;ns d fOf R8Ci3rO and conveys to -tate..o-fWi s ons-i.zl,-.DePar_<melli -of- Veteran3-. 4 1993 _ _ R
M
£airs 5_
- ("Assignee"
-
♦ ift
. F
:
5LL't
whether one or more) the (lferAxexiar Purchaser's) interest in a Land Contract of U+°eds
f ..March 119.29 . , executed by
dated the. --1st------------------ day o..March
Gerald-41. Britton_and._.Iogce -Britton. - - -
- 'RETURN TO
as Vendor to x,.
AMOLD. G.. MERGER S. BERNICE..F..-.BERGER.. husband. anal.
-
otif-e- as.. -Qint_tenants
as Purchaser
h State of Wisconsin,
on ]ands in __S~.__Cra~ix------------------------------------ County,
4w` together with ( the indebtedness therein referred to and) all the interest of the
" Assignor in the Land Contract and the lands described therein, which Land Con-
tract was recorded in the Office of the Register of Deeds of said Cou•.ty, on }
Fehxuary--Z3-------•• 19.7.9-__, as Document Number---355n1$Z_, in ,
XF,Rel) (Records) (Image) Yg
The of (Mortg's) on (Page) 607-609-------- -
`
4. ( Vol.) 5-a9----
A
x The Assignor covenants that there is now owing and unpaid on said Land Contract, the sum of SIXTY--
------------------Dollars,
and also interest xk~XXx~XXXXxxxxxpecxixxtt~taXxzm~x~~~'Xx-XXXxxxxXXXxXXXxxxXXxXX xx
that Assignor is the owner of the above described interest in the Land Contract and has good right to assign the same,
and that the condition of the title of Assignor's interest is the same as at the time of recording the Land Contract.
- PARAGRAPHS APPLYING IF THIS IS AN ASSIGNMENT OF PURCHASER'S INTEREST: (Strike either 1. or 2.)
By accepting and recording this assignment, the Assignee agrees:
- ~ It~~~aiaa€4c>~a,`ea~ns+~rRVaxeoxR~aic#~,cS~:~~kst9cl~t~s~,cl~xx ,m1ue,1~x5oRa~ox~x~~t1
~ ~mtmssc~ax3xuxdi~~cst~ctdfe~cloRadc£1t>ltEt,'tatxxxdt~toc>ttstbdxbo~a~tecat~wixiadecoaxf4ac~si~°
wbi48~X~x sxd: R9alcki:~:o;E ~iltocka~dc Qsostxaatac f~
' 2. That this Assignment is given for collateral purposes only, and that the Assignor agrees to continue tom e
a all payments required on the Land Contract and to comply with all terms and conditions thereof. The Assignor retains the the right to occupancy of the e on the part
of the Assignor the obligation s curedshe eby, the Assignee'serem y
mortgage. In the event of default
shall be a foreclosure as if it held a mortgage.
B®899s3Dd8tl~0t4III~1iM2 a4KNR~x
gg~~~aA~cYtbtdd3xT>~3$~tAc?dx7[$Sl~'Jii~}d'gIt ~jgx&y#titc~CLCXR'}S~~Ydir7lXdt
fCx ~hiaC isxu x omcpmstexa~tgxlsm xGc tt4C t~exXan2dox'x Sac~t~as~IC pgx4tlls xtDti~>3~
s lc c~Z x£~t a[it xNtAR*M<*%1K~PAR►kvI: AR)-ftxtbxvI:=vRwAxAsLAaai "WXxaailat>AIX&3CRMSE&*bixXWVWx
r a~aardxlf®s3 ki~5exx-xl3at>~~s'spoxesx'!$tsax
x~tx~')eiex~aai~aa~tstlcRk#btQc~x>tdasr'~xoaiarastxia~d-Jatxi~avecdes ~~ast~GmnSanebcx~IxRxzScs~ar
~0111tkA~cRb~'oc~A~9~St§tbc10,c4PRItdRSt~)[oczec7ti~X~itanod~lodxaF.xBnriad ~zx~k~ofcnldt~at~lrl"•~sigi~~0k~
aa1li(4ACtcR~1 ~RI~RAX k7l"asn xikXleX9aR~R~4xtt%XUWXIXC4~actx+tnx>Midicaticm
~'1P.~x~fAHd7@4~>~Yx~icbc§pk~.+i[MR§t y'R~C7►4t9t1ta~chlCt#~~~ ,
I is--------------- homestead property.
„ (18) ('s'-ant) (f 1
- 19.- - •
-
- - - 1 v. -
Dated this - - day of
1:-~<~z (SEAL) ,
- (SEAL) - ARNOLD G. BERGER y-
.
------------------(SEAL) - - .(SEAL)
s¢
BERNICE F. RG
- - - -
AIITgENT3CATION ACKNOWLEDGMENT
'
STATE OF WISCONSIN
ss.
' Signature(s)
l ------County.
authenticated this day of _ 19----- Personally came before me cc~t~his _ _ day of
A fp U 1-J_- 19_L 3__ the above named
' 1_n -e-~ o- 6 ~xr!,_~.E
It < i-----
TITLE: MEMBER STATE BAR OF WISCONSIN -
(If not. - - - '
authorized by § 706.06, Wis. Stats.) to me known to be the person who executed the..
foregoin nstrument and cknowledge the same.
c "
T-11S INSTRUMENT WAS DRAFTED BY
,C -S /r Try f /1'
oQ ~N -
State--of
Notarv Public - ---5- 124 olJ-..--_---County, Wis.
Veter_ans..Af£axrs_------ - -
(Signatures may be authenticated or acknowledges. Poth My Commission is permanent.(If not, state expiration
~mPP
This conveyance exe. rom date: - Z_7 - ~ -----------'19 ~ )
are not necessary-.)
fee and return under section 77.25 (10) - -
Wisconsin Statutes.
-Names of persons signing in any capacity should be typed or printed below their signatures.
aTATF. BAR OF WISCONSIN w,scon>in Legal Blank Co. Inc.
yj ASS1GNbIE NT OF LAND CONTRACT FORM No. 15 - 1982 DSilwauker, Wis.
r -