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Document Number Document Title
962534
St. Croix County BETH PABST
REGISTER OF DEEDS
Occupancy Affidavit ST. CROIX CO., WI
RECEIVED FOR RECORD
Dei- (1 / J J U;aI Jrc)T- 08/28/2012 12:42 PM
Name - (Owner) Typed or printed EXEMPT
REC FEE: 30.00
being duly sworn , states, under oath, that: PAGES: 1
1. He/she is the wner`/ owner of the following arcel of~ /land located in St.
Croix County, Wisconsin, recorded in Volume Page ~ 2/ Document
Number'~5U St. Croix County Register of Deeds Office: Recording Area
/ Name and Return Ad ess
A parcel of land located in thely w oft ~ of Section 2 0 DAvl D -T- y~1-L be4 F~
T 6 N - R I v W, Town of /Cf IMOAf D St. Croix
~ I t~
County, iscons be duly described as follows (include lot no. and 7ay ; ~ 7 e C 4y - V/ p t 7
subdivision/CSM or detailed legal description): YoluM e p 1 v
LOT / or C 9nFlg-b SvKi(ey MR P t- e"'-d d n Z &-l0(00 - 3C~-
On 1020 e- 2 2 99 as -Do C-G( & -n -i- Wo- y16 q 6 ,5,5 Le jh7 Parcel Identification Number (PIN)
r7~ AlWYy of 4.e uc'- % aw-l?a.F a)CS✓%oF e E V~( 211j -r3 Jl Rlag W-
As owner of the above described property, I acknowledge that the septic systerh serving this residence is sized for a
2 bedroom home, or a design flow of'-'300... d. The design flow is calculated by as uming 150 gpd for 2
individuals per bedroom. There are currently x occupants living in this residence; -11 occupants are permitted
based on the design flow. Therefore the septic system serving this residence is code compliant. However, I
understand that if there are intentions to exceed the number of permitted occupants, the system will need to be
modified to accomodate any increased wastewater flows and/or contaminant loads. I also acknowledge that I will make
this information available to any future parties interested in purchasing this properly.
Dated this day of t y r~J
O ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN )
authenticated this day of. 17A4-1, 47 1 4~ St. Croix County. ~4
Personally came before me this d~ r~ day of U q
the above named
*
TITLE: MEMBER STATE BAR OF WISCONSIN
(if not to me known to be the person(s) who executed the foregoing
authorized by § 706.06, Wis. Stats.) instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY
7 ' LA ~ RIY~ `Sf ~L/AL/S `
ublic, State of W is on IZ ,
(Signatures may be authenticated or acknowledged. Both are not My Commission is psm*"mnt ; ,"not e e rat d [e :
ry) Date: I/ ~ c k . i0 jm '0
necessary.) - a xn -ni
'i~ f~
"THIS PAGE IS PART OF THIS LEGAL DOCUMENT - DO NOT REMOVE
O r
This lnfamatlon must be completed by submitter. document title. name 6 retumd and PIN (if requin.: Oill@~TMarpof!' Qis?i,s the
granting clauses, leagat description. etc. may be plaoed on this rust page of the document or may be plooed on adiiiU" M:
document. &W Use of this cover page adds one page to your document and 1&2219-M re~na fee. Wisoons/n`Si tutR b8 ~f 7.
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Parcel 026-1060-30-110 08/28/2012 10:53 AM
PAGE 1 OF 1
Alt. Parcel M 20.30.18.297A-10 026 - TOWN OF RICHMOND
ST. CROIX COUNTY, WISCONSIN
Current ❑
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O - WALDROFF, DAVID J & JULIE A
DAVID J & JULIE A WALDROFF
398 RIVER RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 1478 CTY RD A
SC 3962 SCH DIST NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 1.820 Plat: 2299-CSM 08-2299 026-90
SEC 20 T30N R18W PT NW NE BEING PT OF Block/Condo Bldg: LOT 01
LOT 1 CSM 8/2299 1.82AC INCLUDES
P2986-10 Tract(s): (Sec-Twn-Rng 401/4 1601/4)
20-30N-18W
Notes: Parcel History:
Date Doc # Type
07/23/1997 9/43
07/23/1997 887/615
2012 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 09/27/2011
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.820 22,200 54,600 76,800 NO
OTHER G7 0.000 0 10,500 10,500 NO
Totals for 2012:
General Property 1.820 22,200 65,100 87,300
Woodland 0.000 0 0
Totals for 2011:
General Property 1.820 22,200 65,100 87,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel 026-1060-30-050 06/13/2005 08:28 AM
` PAGE 1 OF 1
Alt. Parcel 20.30.18.297A 026 - TOWN OF RICHMOND
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): * = Current Owner
* WALDROFF, DAVID J & JULIE A
DAVID J & JULIE A WALDROFF
398 RIVER RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 1480 CTY RD A
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC{
Legal Description: Acres: 35.150 Plat: N/A-NOT AVAILABLE
SEC 20 T30N R18W PT NE NE & PT NW NE EXC Block/Condo Bldg:
PART TO CSM 8/2299 & PT TO CSM 17-4514 &
EXC PT TO WALDROFF MEADOWS III Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
20-30N-18W NE
Notes: Parcel History:
Date Doc # Vol/Page Type
05/08/2003 720532 17/4514 CSM
12/20/1999 615773 1479/210 WD
07/23/1997 824/221
12/05/1990 464663 887/615 LC
2005 SUMMARY Bill M Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 07/01/2004
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 34.000 4,500 0 4,500 NO
OTHER G7 1.150 9,900 89,800 99,700 NO
Totals for 2005:
General Property 35.150 14,400 89,800 104,200
Woodland 0.000 0 0
Totals for 2004:
General Property 35.150 14,400 89,800 104,200
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch M
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Gf'].G lf.`.S~r•d'1' r4n. STATE BAR OF VVj5,L'rjXSJW FORM 1-a-8 srACa wca9WVWo 9ca tY:,awrao CAT.
WARRAHTY DEED 1` if
TiGHSMEZ L .1Z ! CIFF
~ kt ask ~a ST. CROIX 4. I
This Deed alga. Edward bte ~ Reed for Record ii
lldwa.rd__, Rim r bt,, a s ngte man I.!
Dc.C 20,199 RM I
Crent►tor, y~; i
iron r3 s?l d T , LYE d ro. F:1r ins Tl~..~ r lU;r. d rts(E Y f 0 v-.~
Avbar•i :a _w fe i~ T*-*" t sr ofgeerts
{ 1
lj t
WitneSsse:fh. That the said Grantor, fox a Y>e tuable comic)eraion_...._
_ _ -1-1 . -
I
!'nu»2v_.. State. of WSReanuin: 9
Lot I of the Certified Survey Map recorded Ts= Pared No f
in Volume 8 of Certified Survey Mans on
Page 2233 as. ocu:nent No. 4646SS., being a part
I
of the Northwest 1/4 of the Northeast 114 and
nar.t of the Southwest 1/4 of the Northeast 1/4 jj
ca--•jon 29, Township 30 North Range I :Vest
This deed is given in partial satisfaction of that land contract )
I,Prk.P~n. Grantor, and Grantee dated December _4 , 1990, and recorded
in the c•• Croix County } F&.lst.er vl LGGt1? c ,aan
in Volume 8$7 of Records on Page 61S as 9ecuement lvo, 464663.
- 510
Ft ~
.,This _...._.5....71Q.t........ homestead property. l~
(is) (is not) F
Together with all and singular the hereditaments and appurtecsnces thereunto belonging;
And_....... Gxa:X1t.Qr.....................................
warrants that they title is good. indefeasible U. fen simple and free and dear of oncumbrai:ces except
municipal zoning ordinances and easements of reco.,d I1
and will warrant and defend the same. t~{
Dated this -i~".46-'.1/~-.._....._._ day of )Q.CeI?h
. .L... (SEAL) ...(SEAL)
a/ e .r
• ._...Edwar~I .a Me Edw arkt r d
k~ •J M ' ~1
........(SEAL) (SEALi
f .
1
4 A1?'I'NENTZCATZON ACSNOWLED(3M39NT ~
Si;~rcatar+ ) K_f_._F. :T. x~ ..h 7Ckt__.s?~ _a sTAYE OF WISCONSIN y
}
'
t-.-----.. - )
County. 56.
authenticated th'IsZJ? bda> ?~1?eY' 1P.9~ Personally carne before me this day of
1 e_'-"-.. - 14 the z+hove named
S ......,_.-~1p.r_ a
TITLE. MEMBER STATE BAR OF' WISL O.TSi.7
CLt)(r#iDC1C._
f to rn known to be the person _-1 who executed the
foreroin ; :nstrumcnt and acknowledi, tr.. aarne.
WAS :r;:~ u~
7 I3AKKE. NORIN9 v , SCE{?IhtAkrC i.:R , SKINNER .
is N'ew Rz Zmpn_ F ri4O17 .
Colmty. Wis.
l.5e n ,t r l e, selt'.:en_i_ateel _tl+i•,wln.ggr.t. 12ot}i ;.i~ t'nnnnui=aicn is f.er. lz z='• r..
it r., not ..CCf-':^cer..1 lA )
tl lift: .
•LSnmew n[ T.`reu rY tCninR ?n wny sl+w; •tx .•u..o icS Fn. t.y io of or ,uir.l.~.1 Qal.,.. h,.r uvr . .n.
- WA.nRANTY tmErs ATAT8 RAA or vvuA 0_4sfN a'r.r:•n~in r1-1 M-6 C
FOR.NI Na. 1-•19iC'
Iv
14-79PAG'[ 210 6 z
KATHLEEN H. WALSH
REGISTER OF DEEDS
ST. CROIX CO., WI
RECEIVED FOR RECORD
This Deed, made between Edward Merkt a/k/a Edward J. Merkt, a single 12-20-1999 10:00 AN
man, Grantor, and David J. Waldroff and Julie A. Waldroff, husband and WARRANTY DEED
wife, Grantee.
Witnesseth, That the said Grantor, for a valuable consideration conveys EXEMPT M
CERT
to Grantee the following described real estate in St. Croix County, State CERT COPY COPY FEE:
FE: 6 5.60 TRANSFER of Wisconsin: RECORDING FEE: 12.00
PAGES: 2
Recordin Area
Name and Return Address
BAKKE NORMAN, S.C.
P.O. BOX 50
NEW RICHMOND, Wl 54017
tsee attached list)
(Parcel identification Number)
SEE ATTACHED SCHEDULE A.
EXCEPT Lot 1 of Certified Survey Map recorded in Volume 8 on page 2299 as Document No. 464655, which was
previously deeded to Grantees by Warranty Deed dated December 26, 1990 and recorded on December 28,
1990, in Volume 889 of Records on page 435 as Document No. 465220.
This deed is given in satisfaction of the Land Contract dated December 4, 1990, and recorded on December 5,
1990, in Volume 887 of Records on page 615 as Document No. 464663.
This is not homestead property.
Together with all and singular hereditaments and appurtenances thereunto belonging;
And Grantor warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances
except easements, highways, utility rights and reservations of record, and will warrant and defend the same.
Dated this ~Sday October, 1999..
'Edward Merkt a/kla Edward Merkt
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE of WISCONSIN
ST. CROIX COUNTY
Personally came before me this day of October, 1999
the above named Edward Merkt a/k/a Edward J. Merkt to me
authenticated this day of known to be the person(s) who executed the foregoing
ins um cknoledge the samey~ i
,-Y-j Of
signature
vsignature
type or print name type or Air t name
TITLE: MEMBER STATE BAR OF WISCONSIN roix County, Wisconsin.
~r9 t' ,$ermanent. (if not, state expiration date:
(If not,
authorized by 706.06, Wis. Slats.) 0
THIS INSTRUMENT WAS DRAFTED BY Namesq&person g in any capacity should be typed or
Timothy J. Scott ri~U d Btly ei ig ures.
BAKKE NORMAN, S.C.
(Signatures may be authenticated or acknowledged. Both are not
necessary.)
information Pmfessionais Company Fond du Lac. Wisconsin Boo-655-2021
s •
FORM - STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER S"d//j-~ TOWNSHIP ~Ai~2rrS'1~
SECTION '?0 T_g N-R, jW
ADDRESS ST. CROIX COUNTY, WISCONSIN
SUBDIVISION 't4 iA LOT LOT SIZE ,fir , 46g,-, c
PLAN VIEW C S ~ S/ 2 -Lq I
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
@ 11
1°
1I~~ G
34-
-49 j
-
1A 6 #1
~gr
' INDICATE NORTH ARROW
BHNCHM&RK: Elevation and description: r~cc
Alternate benchmark
SEPTIC TANK:Manufacturer: /~/~~,6l~Sl"-/~•Liquid Cap. q5o-g /
Rings used: O Manhole cover elev :Final grade elev:
Tank inlet elev.:, F7~ Tank outlet elev.: -5,7
No. of feet from nearest road:Front ~ ide , Rear Ft. 80 '
From nearest prop. line:Front ; Side , Rear Ft. 80 '
No* of feet from: Well L=14- , Buildings, /8'
(Include this information in the above plot plan)
(2 reference dimensions to septic tank)
SEE REVERSE SIDE
' t
PUMP aVMER
Manufacturer: Liquid Capacity:
Pump Model: -Pump/Sip Manufact.: Pump Size
Elevation of inlet: Bottom of tank elevation
Pump on elev.: ump off elev.:_Gallons/cycle:
Alarm: Man.: Switch ZnA: Location
Distance f om nearest prop. line: Front , Side, Rear Ft.
Dista a from: Well Building
SOIL ABSORPTION SYSTEM
Bed: Trench: t--seepage Pit:
Width: g Length Gy Number of Lines:-/ Area Built 3 ;~j 14Exist. Grade Elev.-
9~ Proposed Finial Grade Elev. Y',v
Fill depth to top of pipe: Z
No. feet from nearest prop. line:Front_4,~ Side
Q , Rear
No. feint from well: No. feet from building_ 3
HOLDING TANK
Manufacturer: Capacity:
No. of rings used: Elevation of bottom tank:
Elevation of in t:
No. feet fr nearest prop. line:Front Side_ Rear Ft._
No. fe from: Well, buildinnearest road
Al Manufacturer:
INSPECTOR:
DATE : 9- lea PLUMBER ON JOB:_,Z~Lcl
LICENSE NUMBER: ,~i2SGt).~z5
6/90:cj
j,
4 5 ~
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING
LABOR & HUMAN RELATIONS DIVISION
P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION
MADISON, WI 53707 Ying State Plan I.D. Number:
NW4fNE4,Sec.20,T30-R18 CONVENTIONAL ALTERATIVE (If assigned)
Town of Richmond
Co Rd. A ❑ Hol Tank ❑ In-Ground Pressure ❑ Mound
NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE:
Edward Merkt 1480 Co. Rd. A, New Richmond, WI S
BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ST REF. PT. ELEV..
a S Ue occ'~. = 00.S .d
Name Of Plumber: MP/MPRSW No.: County: Sanitary Permit Number:
Gary L. Steel 3254 St. Croix 128728
SEPTIC TANK/H ac~c S 87 S -W ' '
MANUFACTURER: LIQUID CAPACITY: TANK INLET E TANK OUTLET ELEV.: WARNING LABEL LOCKING COV R
. LAS ' ~ ! PROVIDED: PROVIDED: G.
v\ ~I Ile o:1CP YES ❑ NO ❑ YES NO
BEDDING: \46W DIA.: VE#T MATL.: HIGH WATER UMBER OF ROAD: PROPERTY WELL: BUILDING: VENT O MESH
C ALARM: FEET FROM LINE: - r AIR I ET:/
❑ YES NO ❑ YES r9l NO NEAR
EST-► /d`
DOSING CHAMBER:
MANUFACTURER: BEDDING: IQUID CAPACITY: PU PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER
PROVIDED: PROVDED:
YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO
GALL ER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING NT TO FRESH
PUKE
(DIF RENCE BETWEEN ROM
LINE: AIR INLET:
U P ON AND OFF ❑ YES ❑ NO NEARS
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETE : MATERIAL AND MARKING:
or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN
the soil is dry enough to continue.
CONVENTIONAL SYSTE 5erry~
BEDITRENCH WIDTH: LE NO.OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID
/ / TRENCHES: MATERIAL: PI DEPTH
DIMENSIONS S (0
GRAVEL DEPTH JBL~' DEPTH DISTR. PIPE DISTR. P E DISTR. PIPE M T RIAL: NO. I TR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH
BELOW PIPES: VE COVER: ELEV. LET: ELEV EN / a e PIP S: LI A~n
AIR INLET: /
910, / S/ a te54.~ NFEET EARESTO-~ 7~r0 3p/ 7p
MOUND SYSTEM: '
Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM
slope and furrows thrown unslope: terns to make certain that it ON REVERSE SIDE. SHOW
❑ YES ❑ NO meets the crl a for medium sand. ELEVATIONS MEASURED. SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS;
❑ YES [:1 NO ❑ YES E-1 NO
DEPTH OVER TRENCH/BE DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: S DE D: SEEDED: MULCHED:
CENTER: EDGES:
YES ❑ NO [:1 YES ❑ NO ❑ Y S El NO
PRESSURI D DISTRIBUTION SYSTEM:
BED/ TRE H WIDTH: LENGTH: NO. OF LATERAL SPACING: GRAVEL D TH BELOW PIPE: FILL DEPTH ABOVE COV
TRENCHES:
DIMENS NS
MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: O. DISTR. DISTR. PIPE DISTRIBUTION PIP MATERIAL & MARKING:
ELE ATION AND ELEV.: ELEV.: DIA.: ELEV.: ES: DIA.:
DI RIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIA VERTICA FT CORRESPONDS TO
INFORMATION APPR D PLANS
❑ YES ❑ NO ❑ YES ❑ NO
COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING:
I FEET FROM LINE:
❑ YES ❑ NO ❑ YES ❑ NO NEAREST
0.v tti /~S /S"B ~dYr+ o WCO~/. /T •
~?l~ ~ • ~ 'c.4 0'1'1 Q /
C4-1
e
• ~/~~~m
Sketch System on R a' n county file for audit.
Reverse Side. SIGNATU TITLE:
r
SBD-6710 (R. 06/88)
DILHR SANITARY PERMIT APPLICATION
In accord with ILHR 83.05, Wis. Adm. Code COUNTY
St. Croix
STATE SANITARY PERMIT
-Attach complete plans (to the county copy only) for the system, on paper not less than ~J -7 a
8% x 11 inches in size. E] Ch l f re ision 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
Edward J. Merkt BUY 1bave(/t/, NW Y, NE S 2 . T 30 , N, R 18 *(or) W
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
1480 Co. Rd. #A n/a ~ n/a
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME SM NUMBER Z -
New Richmond Wi. 4017 715 46-5511 n/a
II. TYPE OF BUILDING: heck one) ❑ State Owned VILLAGE NEAREST ROAD
.Richmond Co. Rd. #A
❑ Public 1 or 2 Fam. Dwelling- # of bedroo S R R low EL AX NU ER() Nzuj Q
111. BUILDING USE: (If building type is public, check all that apply) 2050. / ~ o2 !l L4 7 ~
1 ❑ Apt/Condo d J v /
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 80 Mobile Home Park 12 ❑ Service Station/Car Wash
50 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.)P4New 2.E] Replacement 3. ❑ Replacement of 4.0 Reconnection of 5.0 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. G ON R DAY 12. 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
300 330 330 .91 <3 95.48 Feet 99.10 Feet
VII. bUCK' 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 structed
Septic Tank or Holdin Tank x 10 0 1 Weeks-C. P. F1 n F1
Lift Pump Tank/Si hon Chamber I F1 LJ 1 0 1 F-I
Vill. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for install ion of the~o~ntasite sewage system shown on the attached plans.
Plumber's Name (Print): Plumber's ature: (N m M/MPRSW No.: Business Phone Number:
Gary L. Steel V,IIV-1 3254 715 246-6200
Plumber's Address (Street, City, State, Zip ode
1554 200th. Ave., New Ri ond, Wi. 54017
IX. C LINTY /DEPARTMENT USE ONLY
Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing A ant Signature (No S m
Approved ❑ Owner Given Initial Surcharge Fee)
.0 Ave et rmin io
10 n
N 5 U
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 11/88) 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
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:
1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of
where the system is to be installed.
il. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling.
III. Building use. If building type is Public, check all appropriate boxes that apply.
IV. Type of permit. Check only one 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.
Vill. 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)
STEEL'S SOIL SERVICE
Gary L. Steel 988 N. Shore Drive
C.S.T. 2298 New Richmond, WI 54017
MPRSW-3254 (715) 246-6200
Edward J. Merkt
NW-14N04- S20 T30N R18W
Richmond, township
f!
7G c~ ~5k
0
i
41
Q
` Odd
~to
_/10 f Gary L. Steel
M,?qd-s lg/r nIFbZ// 8-1-90
x~ t tt ea . 10
® C p ~19905 ~ ~Eg n'CONNEL~' /
t" Re9'slet 01 De as
CERTIFIED SURVEY MAP
Located in part of the NW 4 of the NE h and in part of the SW'✓
of the NE4, all in Section 20, T30N, R18W, Town of Richmond,
St. Croix County, Wisconsin.
LEGEND OWNER
County Section Monument - Aluminum David Waldroff (Ed hlerkt)
Cap Found. 398 River Road
Hudson WI 54016
( 211 Iron Pipe Found
• 111 Iron Pipe Found
O 111 x 2411 Iron Pipe Set, weighing 1.68 lbs. per linear foot.
- ---4 Existing Fenceline North line of the NEI of Section 20
East East
V-
810.72' 1774.341
NJ Corner of NE Corner of
M
Section 20 o Section 20
L M
L O c0
N0 ° C
C) ° Unplatted Lands ~b S4/
N
0 r_ o C~ of
S89°56'27"W 266.34
1.5 rf~\
W o w
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a w -0 Jye \o N 1
N y ° IVEWAY S'o\
01 4- '0 Q CYl\
r- 0 9)
Shed . /
E JT
ro C N V/
N •.-1 N
CD ~ ro CP
LOT 1
M s
'o
ON 79,455 Sq. Ft. (1.82 Acres) Including R/W
01 0o s,
CM 61,103 Sq. Ft. (1.40 Acres) Excluding R/W
cm J 1
LO J
41 I W M dal n0
z
no 00
O
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•~h~ eC~ti~ ana~.
41
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1
-41
/ i SCALE IN FEET
41 t
41 tn
0 25 50 100
L
VOLUME 8 PAGE 2299
4
APPLICATION FOR SANITARY PERMIT
STC-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 I (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 94LOig-" , 4
Location of property (L_~ -1/4 ~1/4, Section Z-6 , T_L~?(LN-R_IA_W
Township D~ ,,•v`•r► ,C!
Mailing address t4)
''ll al ` . SY- d ~7
Address of site ~hcwsx wovtd
Subdivision name Q))4 P~v p-e-t+X S-,u 1r7yac Y-f
no ~-es
Lot number /A
Previous owner of property 'G 11774filK
Total size of parcel
Date parcel was created
Are all corners and lot lines identifiable? 4----~-Yes No
Is this property being developed for resale (spec house)? Yes
Volume o (0 5 and Page Number bas 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.
---------------------------------------------------------7---------------------
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. 2-O ; and that I (We) _Zo presently own the proposed site for the sewage disposal system (or I (we)
have
obtained an easement, to run with the above described property, for the
construction of said system, and the same has been duly recorded in the Office
of the C unty Register of Deeds a Docs~ment No.
Signature of Own Signature of Co-Owner (If Applicable)
Date of Signature Date of Signature
WARRANTY DEED. STATE OF WISCONSIN-FORM No. I
P. C. YIIIEP CO.. YIlYPY4Ll
Joe Merkt & Wife
NUMBER New Richmond, Wis. Received for Record this 7th
i
202084 TO I April A. D., 19 43 at 91
Edward Merkt
`II ! New Richmond, Wis. David Hope, Register
d,
This Indenture, Made this 11th day of January A. D.
between Joe Merkt and Addis Merkt, husband and wife and also in her individual capacity, °
parties of the flr/t'
Ir Edward Merkt, New Richmond, Wisconsin
j part Y of the
WITNESSETII, That the said part i es of the first part, for and in consideration of the sum of F'
r~
° One Dollar and other valuable considerations
to them in hand paid by the said part y of the second part, the receipt whereof is hereby confessed and acknowledged,
given, granted, bargained, sold, remised, released, aliened, conveyed and confirmed, and by these presents do give, grant, bargain, sell, remiss,
alien, convey and confirm unto the said part y of the second part, his heirs and assigns forever, the following d
estate, situated in the County of St. Croix and State of Wisconsin, to-wit:
I°
The Southwest Quarter of the Northeast Quarter (SWNE) of Section Seventeen, (17), and RAL",
part of the Northeast Quarter of the Southwest Quarter (NESW) of said Section Seventeen (17) whin
,i
lies south and east of the main channel of Willow River (except the right of flowage from Willow'r
of said above described land) and the Southeast Quarter (SEl1-) of Section Seventeen (17) and all tht
part of the East Half of Northeast Quarter (E'~-NE4) of Section Twenty (20) which lies north of the
right of way of Chicago, St. Paul, Minneapolis & Omaha Railway Company and all that part of the1
'lit Half of Northeast Quarter (WSNE,l) of Section Twenty (20) which lies north of the Public Highway
from the City of Hudson to City of New Richmond as now established. All in Township Thirty (30) li
gl
of Range Eighteen (18) West, containing 305 acres more or less.
The consideration above the mortgago is less than One Hundred Dollars.
rTOGETHER with all and singular the hereditaments and appurtenances thereunto belonging or in any wise appertaining; and all the
title, interest, claim or demand whatsoever, of the said part i es of the first part, either in law or equity, either in possession or expectancy of, in =
above bargained premises, and their hereditaments and appurtenances.
TO HAVE AND TO HOLD the said premises as above described with the hereditaments and appurtenances, unto the said party of
E part, and to his heirs and assigns FOREVER.
AND THE SAID Joe Merkt and Addie Merkt, husband and wife
for themselves ,.their heirs, executors and administrators, do covenant, grant, bargain and agree to and wldil
part y of the second part, his heirs and assigns, that at the time of the ensealing and delivery bf thus
they are well seized of the premises above described, as of a good, sure, perfect,
rl
indefeasible estate of inheritance in the law, in fee simple, and that the same are free and clear from all Incumbrances whatever, excepting
Land Bank loan in the sum of Sixty three hundred & no/100 Dollars which said second party hereby as
Ifs' and agrees to pay
and that the above bargained premises in the quiet and peaceable possession of the said party of the second part, his
assigns, against all and every person or persons lawfully claiming the whole or any part thereof; they will forever WARRANT AND
fi a
IN WITNESS WHEREOF, the said part ies of the first part he ve hereunto set thei r hands and seals this 11th
day of January A. D., 19 43
Signed and Sealed in Presence of Joe Merkt
Mary M. Swenby
Addie Merkt
i
I, Margaret c
„wenbY Sager
' H STATE OF WISCONSIN,
YM } as.
St Croix County.
fff° i
1.i Personally came before me, this 11th day of January
the above named Joe Merkt and Addie Merkt, husband and wife and also in her individuallcapacity
w to me known to be the person s who executed the foregoing instrument and acknowledged the same.
Oscar A. Swenby
°
(Seal) Notary Public, St. Croix
My Commission expires May 30th A
i
`f
f,
1
I
,
L ! P
I
t
>3` ;l 119
Toe IZerkt and C:ddic, IIIerlrt, Rinht of 1.,Va:y Fasement.
his Wife, Con. 4b1, etc.
Dated Sept. 19, 1939•
-tc- A.ck. S_pt. 19, 1939.
Roc. June 211., 19 40.
II `t It. Croi. Coa,nt~r L,1F; c t r i c Sri rrP3 rr par -e 71.
Coor,erative, a coo,:,erative
association.
Re ci to as : TI-ie r i -;ht to c lter upori =:Iic lands of ti-le undersigned
~Isituated in St.. Croix Col nt,y , anti more ,ai~ti cularl7r described as
follows: SV - of Idst;.` of an' ~1.' of S-;c. 17; also na.rt of
1'd of oz Scc 20, 1Iri r and, be_i.n-; ,,J of railroad tracks, all in
30-16; and to place
, co;:lstruct, c); erate, rer.- i_r, maintain., relocate
and replace ti"iereon :Lnd in or ar on 2..1.1 street-s' roads or M7,hways
on or abutti_n~,, said lands an electric trarisiii lion or distri_bat.ion
I line or system., and to cut and trim trees anJ shrubbery to the ex-
±C'nt neceSSclr~rT tO t11E1i1 Cl! ar' Of' SC11.d el3Ctl'1C line Or SITS te1iL,
an(]. to cut doom fr.01,1 time to r,irio all -lead, weak, leaning or dan-
tre >
j r;O1'C iIS ~rGu t`')C? t .Lr_a t:r1.l arlot1_;h. to t l.e wires :Ltl falling.
.In granting this easement it is imderstood t1iat at pole locations
II onily a ill,-,le 'ole and. ar>,r)tartenatic_;s J71..1__L ba Used mid that, the lOC-
jlatI.on of tile poles will be such as to form t,)e least possible inter
jlfereilce to f.arirt o erU I,;i_ont o _c ~'s it doc>s riot r.iaterially increa e
Ii the cost o ' construction. To h.avG _nd to iold saisaid
;asp gent, t;<~-
:I7et_rler wit_i all and s in;l:ular the ri;rllts and . ?ra_viler~es a ,~)ertc;inill(,.
theretc), unto said coor'erat:ive a-,soci-atlo1, its successors and assi,,ns
forever. f'1.2.3 Coil v0ya.ncc stied be I)i d.1 Ll,- on the Ilgirs, rer,'resent-
latives, `tssinriS and gray gee c" of the -ran tors.
l
~ --120
Toc~ sic rkt and. A _Ic:li.e P,4,-rkt, Ilarranty Deed,
l husband aYa(1, ri_`_'G, >znCI `also 111 Co-l. G. tc.
her individual capacity, ( Datod Jan. 11, 19)0.
t ck. Jan. 11, lo)13.
-to- 1rec. n~nri1 7., 19I
Tn '126 s ir. -.)af;e
dward Merkt
~~'~r of ivls of Sc;c 17 and all that part of 31r,'- of 3ti' of said
ti,ac 17 Which lie., S and 1; o j` the I ai.ri cll., tmel of
l"j3_llc)ti°r River (.-rear t
flee ri,,-hit or' i'1c;~r4 re fro 1;illow fti.vcr of said above d.eseribect land
::a
and th- SE, o l.
r 7 ,oC 20
sec 1' a.t.1 that art= of the 7,': of of S)
wlich .Lies IT Of the Railroad. Y'i_; 1t of 1'`a7 Of 0. I{y. Coe
and all that part of l of of Sf-lc 20 ?'r?'ti ch lies N of the Public
firhway running; from the Citz,, of iTa:udson to Cit-V of New Richmond as
now established; all in 30-_l{:', containinr' 305 acres more or 1_ess.-7
R 17 h
~ . L_ cc
ecl_e~• isidel g.ti ore above flee rnor t r.a e is less tan
4"100, That sa ~_r7 nrelz, P: os arc free ancl. clear from all lnc-r,mbrances
tirriatever, e ?cceptlnrT Fc;(ac~ral T,ai_i 1, nk loaii in the utu,i o
LJi.11C1. Said `,nc(.1n d )a-r,t7T 3h~r 1,, u11~'s ~Lnc1 a "rocs to pay.
-121.
t) i
Lim~ o1,
Redeemed July 31, 1952 by Idtward J. ?.Terkt.
3 0
STC - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER S Ed u i Aiid ~ tP kb K
ROUTE/BOX NUMBER T FIRE NO.
CITY/STATE ZIP
PROPERTY LOCATION: 1/4 /4, Section Ll~ , T__? R18 W,
Town of W10-A mvti St. Croix County,
Subdivision Lot No.
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 a 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
$3000 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
systems properly maintained.
The property owner agrees to submit to St. Croix County Zoning a certification
form, signed by the owner and by a master 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. Certification form will be sent approximately 30 days prior to
three year expiration.
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 Department of Natural Resources. Certification
form must be completed and returned to the St.Croix County Zoning Office within
30 days of the three year expiration date.
SIGNED G~zZ
DATE 7' Z
St. Croix County Zoning Office
St. Croix County Courthouse
911 4th Street
Hudson, WI 54016 r
(715) 386-4680
Sign, Date, and Return to above address
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
N
INDUSTRY,` DIVISION
LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX 7969
N WI 3707
HUMAN RELATIONS
(H63.090) & Chapter 145.045)
LOCATION: SECTION: TOWNSHIP/M TY: LOT NO.: BLK. NO.: SUBDIVISION NAME:
IN' W 1~VE1/ 20 /T30 N/Rl84(or) w Richmon
n a n a n /a
COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS:
St- Edward J. Merkt 1480 Co. Rd. #A, New Richmond, Wi. 54017
USE DATES OBSERVATIONS MADE
NO. BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE DESCRIPTIONS: PERCOLATION ION TESTS:
I tgRResidence 2 n/a ~lew ❑Replace 7-24-90 7-24-90
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional)
HS ❑U ETS ❑U S ❑U ❑ S `n~jU ❑ SOU conventional
If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the
under s.H63.09(5)(b), indicate: n/a Floodplain, indicate Floodplain elevation: n/a
decimal' PROFILE DESCRIPTIONS page 35 Sha
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTIOM ELEVATION OBSERVED EST. HIGHES TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B-1 6.67 99.10 none >6.67 1.42bl.1. 1.00bn.sil. .50bn.l.s. 3.75bn.c.s.
B 2 6.92 99.08 none >6.92 1.58bl.1. .92bn.sil. .50bn.l.s. 3.92bn.c.s.
3 7.25 98.98 none >7.25 1.08bl.1. .75bn.sil. .42bn.l.s. 5.00bn.c.s.
B- 1'
4 6.67 99.22 none >6.67 1.50bl.1. .92bn.isl. .58bn.l.s. 3.67bn.c.s.
B-
B-5 6.83 99.00 none >6.83 1.33bl.1. 1.08bn.sil. .50bn.l.s. 3.92bn.c.s.
B-
decimal' PERCOLATION TESTS
LP-2 DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
ERSWELLING INTERVAL-MIN. PERIOD t PERIOD 2 PER PER INCH
3.62 none 3 6 6 6 <3
3.60 none 3 6 6 3.50 none 3 6 6 6 <3
P
P-
P-
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori
zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope.
SYSTEM ELEVATION 95.48
f
{
I
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I ~ I ie
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TV
'N
1
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t ~
73 t
t 3 i
I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin
Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
NAME (print): TESTS WERE COMPLETED ON:
Gary L. Steel 7-24-90
ADDRESS: CERTIFICATION UMBER: PHONE NU ER(optional):
1554 200th. Ave., New Richmond, Wi. 54017 2298 1715-246 200
CST SIGNAT
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 02/82) -OVER -
1J
INSTRUCTIONS FOR COMPLETING FOR 115 - SBD - 6395
To be a complete and accurate soil test, yoLtr report mUst include:
1. Complete legal description;
2. The use s, i must clearly 'irate whether this is a residence or commercial project;
3. MAX("' ` sber of be,<, or commercial use planned;
4. Is th Placement y~._-n;
5 ` itabilit:y ratir^' . _-as, A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL
O I"" SYSTEMS ARE RULI -UT BASED ON SOIL CONDITIONS;
6. PI the abbreviations here for writing profile descriptions and • the plot plan;
7 -1- r"IBL;" diagram r-iy locating y -rr test locations. Drawing to J, A
3 :a !feed 11 Cf„ f;
.;rk an 3l elevation r > point are cloarly shown, I lanent;
9. to boxes l 'o dates, names, Iresses, flood plain data, percolatio st exemp-
t
10} as flood . !ai^ r,!evatic,i) dr°° ox;
11. your cur it It d yrir z `i r
12 and di--i: ~ wired. ALL AL TE SST BE ) ITH THE
L, L tU1'HORITY WITHIN _ `)AYS OF COMPLETION.
ABBREVIATIONS FOR CERTIFIED SOIL TESTERS
Sol ' T cures Other Symbols
st - 1 BR Bedro,
or) b SS
gr -r 3") LS Limesto
xy HGW - N,
Perc F t,
W W
Bldg I _
Sand `j Grea;.~ Than
Loam < - Less than
L Bn Brown
Loam BI - Black
Gy - Gray
- Y Yellow
iy Loam R - Pd
Loam not - P,I ;tles
J wf
sic - clay f f f c cc
pt P Inrn
nt - d-
i
HWL - High vva
nxtur~ sur` :r ~
I `1~M - Bonch
R Terence Point
r;
-IE OWNER: v .
~i: c >t :~y t ~W St
~1