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Home My WebLink About008-1038-60-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 6 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Gin erich, Ura& Ma Eau Galle, Town of 008-1038-60-000 CST BM Elev: Insp.BM Elew BM Description: Section/Town/Range/Map No: 13.28.16.195 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg.Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic IT Bottom Dosing Header/Man. Aeration Dist. Pipe Holding Bot.System Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist.to Well SOIL ABSORPTION SYSTEM BED/TR ENCH Width Length No Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBLDG IWELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia I 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 0 Yes � No � Ye7L] o COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / / Inspection#2: / / Location: 311 County Road B Woodville,WI 54028(SW 1/4 SW 1/4 13 T28N R16W) 40 acres Lot Parcel No: 13.28.16.195 1.)Alt BM Description= 2.)Bldg sewer length= -amount of cover= Plan revision Required? ❑ Yes ❑ No ! F T Use other side for additional information. Date Insepctors Signature Cert.No. SBD-6710(R.3/97) nvo County Sanitary ration ST.CROIX COUNTY WISCONSIN Gp� p In accord apert 12 St Croix County Sanitary Ordinance PLANNING&ZONING DEPARTMENT Y Pe you provide may be used for secondary purposes ST.CROIX COUNTY GOVERNMENT CENTER [Privacy Law.S.15.04(1)(m)] 1101 Carmichael Road Hudson,WI 54016-7710 �} (715)386-4680 Fax(715)386-4686 a com I ns he system on paper not less than 8-1/2 x 11 inches in size. County Sar� ❑ Check if revision to previous application L Application tnformationt,, ' rint all inf ion Location: Property Owner Name 2 5w 1/4 fl,) 1/4,Sec /3 [ y T :Z'g N, -- R I& E(or) Property Owner's Mailing A614ress Lot Number Block Number City,State Zip Code Phone Numer Subdivision Name or CSM Number II T e of Building. (check one) =ity ❑Village Town of d �� I1 or 2 Family Dwelling-No.of Bedrooms: I /� 1 - ❑ Public/Commercial(describe use): G.t)�'�' l ca') &'t _ y ❑ State-owned Nearest Road It.Type of Permit: (Check only one box on line WChe box on line B if applicable) 6 arcel Tax Numbe ) A) 1.❑ Repair 2.❑ Reconnection pumbing 4.❑Rejuvenation (/on ��" W� ' B) Permit Number 6 � / Date I su ❑ State Sanitary Permit was previously issued 7S r, �� $ /Z. 1V.Type of POWT System: (Check all that apply) ❑ Non-pressurized In-ground ❑ Mound z 24 in.suitable soil ❑ Mounds 24 in.suitable soil ❑ Mound A+0 ❑ Sand Filter ❑ d Wetland ❑ Peat Fitter ❑ Dr-ine ❑ Pressurized In-ground Holding Tank ❑ Single Pass ❑ Other ❑ At-grade ero ,c reatment Unit ❑ Recirculating V.Dispersal/Treatment Area Information: 1.Design Flow(gpd) 2.Dispersal Area 3.Dispersal Area 4.Soil Application Rate 5. Percolation Rate 6.System Elevation 7.Final Grade Required Proposed (Gals./day/sq.ft.) (Mindinch) Elevation r VI. Tank information Capaicty in Gallons Total #of Manufacturer Prefab Site Con- Steel Fiber- Plastic New Existing Gallons Tanks Concrete structed glass Tanks Tanks ❑ ❑ ❑ ❑ ❑ ❑ 11 ❑ VII.Responsibility Statement I,the undersigned,assume responsibility for repair/reconnenction/rejuvenationlnstallation of non-plumbing for the POWTS shown on the attached plans. A license is not required for terraiift repair or the installation of non-plumbing sanitation system. Plumber's Name(print) Plumber's Signatut o�tamps): MP/MPRS No. Business Phone Number Plumber's Addr s(Street,City,State,Zip Code) VIII.County Use Only �/ DisappE!15� Sanitary Permit Fee D to Issu d issuin ent Signature star Lid Approved verse 1 �Z L . � /` ; /q \ D r ,n ,J ` IX.Conditions of A!p,r,o val/Reasons or Disapproval: nl r n II STE NER /� /�� 1'IU O� c�,tlDt i �O vVN. �. Se e`f and (( / j L d C✓�. � S :a; maintained G. Gtc— /Y CJ Be�eMlrk.coue ony,r�:r�,,; z A-t l 5 .c�_5 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 176 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Gin erich, Ura & Ma Eau Galle, Town of 008-1038-60-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 13.28.16.195 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header/Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM uid BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liq Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) 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 I El Yes [E No Ell] Yes 7No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 311 County Road B Woodville, WI 54028 (SW 1/4 SW 1/4 13 T28N R16W) 40 acres Lot Parcel No: 13.28.16.195 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? a Yes Fre No ~i Use other side for additional information. ! SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. ~ounty Sanitary Permit Application ST. CROIX COUNTY WISCONSIN GOVT o ord with Chapert 12 St. Croix County Sanitary Ordinance PLANNING & ZONING DEPARTMENT ~ 'Personal information you provide may be used for secondIFuST ST. CROIX COUNTY GOVERNMENT CENTER X-C [Privacy Law. S. 15.04(1)(m)j Ilk 1101 Carmichael Road Hudson, WI 540167710 ~ ~ l a.---a-~-- (715)386-4680 Fax (715)386-4686 mplete plans for the system on paper not less than 8-1/2 x 11 inches in size. itary Permit # ❑ Check if revision to previous application pWF ~ LD 1. Application Information -Please Print al information Location: g Property Owner Name 45LJ 1/45/4, Sec /3 lar T Jr N, R X 9) W Property Owner's Mailing Address Lot Number Block Number City, State Zip Code Phone Numer Subdivision Name or CSM Number a IV'( 159 QJ' II TYPA of Building: check one) amity ❑ Village own of ® 1 or 2 Family Dwelling - No. of Bedrooms: ❑ Public/Commercial (describe use): ❑ State-owned Nearest Road It. Type of Permit: (Check only one box on line A. Check box on line B if applicable) -3/1 Parcel Tax Number(s) 11.0 Repair 12. El Reconnection 13.EVN/on-plumbing 4. ❑ Rejuvenation ~ 6 ~D ~ c ~ 1 A) Sanitation 3 Permit Number Date Issued -I - TLI N /f M B) ❑ State Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) .T I~ Non-pressurized In-ground ❑ Mound z 24 in. suitable soil ❑ Mound 5 24 in. suitable soil ❑ Mound A+0 ❑ Sand Filter ❑ constructed Wetland ❑ Peat Filter ❑ Drip Line ❑ Pressurized In-ground Holding Tank ❑ Single Pass ❑ Other ❑ At-grade ❑ Aerobic Treatment Unit ❑ Recirculating Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application Rate 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed (Gals./day/sq.ft.) (Min./inch) Elevation I. Tank Information Capaicty in Gallons Total # of Manufacturer Prefab Site Con- Steel Fiber- Plastic New Existing Gallons Tanks Concrete structed glass Tanks Tanks 32D ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ II. Responsibility Statement 1, the undersigned, assume responsibility for repair/reconnenction/rejuvenation/installation of non-plumbing for the POWTS shown on the attached plans. A license is not required for terralift repair or the installation of non-plumbing sanitation system. Plumbers Name (print) Plumber's Signature (no stamps : MP/MPRS No. Business Phone Number Plumber's Address (Street, City, State, Zip Code) Z ZZLZ, 7_3 (-d Ill. County Use Only ed Issuin ent Signatur Disapproved Sanitary Permit Fee d to 7) Approved wrier 'tial Adverse Zz $ tion G IX. Conditions of Approval/Reasons for Disapprova \ + l ti Q L Nb NO- ~~bW ~ v~ V~aa~ IVl~GcT] G4 ~ ~ ~JGI~IW re_ 1_514, r i 1AJ o Z ~ p.", c,ctX P f t A.5 PW4111 ati CJ- Ln64Z. 07't 3 ~ ~ ~ r • • J • a VV r i iiiiiiiiiiiiiiiiiii i► i iii . DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1-2003 8 1 0 3 1 6 1 WARRANTY DEED TX : 4080973 966865 BETH PABST THIS DEED, made between Wayne Albrigtson and Josephine Albrigtson REGISTER OF DEEDS husband and wife ("Grantor" whether one or more) conveys and warrants to Ura ST. CROIX CO. WI H. Gingerich and Mary Gingerich, husband and wife ("Grantee", whether one 11/06/2012 3:32 PM or more), the following described real estate in ST CROIX County, State of Wisconsin: EXEMPT#: NA' REC FEE: 30.00 The SW'/, of the SW% of Section 13, Township 28 North, Range 16 West, and TRANS FEE: 532.50 the NW'/ of the SW% lying South of Highway "N" of Section 13, Township PAGES: 1 28 North, Range 16 West, all in the Town of Eau Galle, St. Croix County, Wisconsin. RETURN TO St. Croix County Abstract & Title Co. Inc. 219 S. Knowles Avenue New Richmond, WI 54017 Tax Parcel No: 008-1038-60-000 This is / is not homestead property Exception to warranties: Municipal and zoning ordinances and agreements entered under them, recorded easements for the distribution of utility and municipal services, recorded building and use restrictions and covenants, and further except 2012 real estate taxes. Dated this 31 st day of October, 2012. e Albrigts , os phin n Albrigtson AUTHENTICATION ACKNOWLEDGMENT Signatures authenticated this day of STATE OF WISCONSIN 20_. ss. COUNTY OF ST CROIX TITLE: MEMBER STATE BAR OF WISCONSIN Personally came before me this 31 st day of October, 2012, the (If not, above named Wayne Albrigtson and Josephine Athrigtsq, authorized by § 706.06, Wis. Slats.) husband and wife to me known to be the person(sj'r koT(k'pf ted the foregoing instrument and acknowledge th~Qe...-•~ 14 L17 A THIS INSTRUMENT WAS DRAFTED BY Robert L. Loberg / Loberg Law Office dio ` Notary Public County'.AAs: 1212439 / alm My Commission is permanent. (If not, state.expltatjon date. (Signatures may be authenticated or acknowledged. Both are not necessary.) / Zdl 1ytAn~NTY DEED Form No. 1-2003 2012 Property Record I St Croix County, WI Assessed values not finalized until after Board of Review Property information is valid as of Nov 5 201210:27PM OWNER CO-OWNER(S) WAY NE & JOSEPHINEA LBRIGTSON 2578 10TH AV E <-w0bbVILLE, WI 54028 PROPERTY DESCRIPTION PROPERTY! INFORMATION. SEC 13 T28N,R16W 50A SW SW S OF HM N Parcel ID: v' 008103860000 ProtiettyAddress: 311 CTY RD B, , Alternate ID: 13,28.16.195 School Districts: Municioality: TOWN OF EAUGALLE , SCH D BALDWIN-WDVILLE . Other, Districts:. DEED INFORMATION wrrc Section Tow rr Ran e Otr Ott Section Otr Section Vo me Para ? Document 13 28N 16W SW SW 1011 280 Lot: Block;. Plat Name NOT AVAILABLE LAND V)UATION Valuation Date: 0610612012 TAX INFORMATION Code Acres Land Value Improvements Total fj 1.000 5,400 5,000, 10,400 Net Tax Before .Lotterv. First Dollar Credits: 0.00 42,000 8,900 0 8,900 Lottery. Credit; 0.001 ! 4.500 2,600 0 2,600 FirstDollar Credits 0100 09,M 2.500 3,800 0 3,800 Net TaxAfterL 0.00 Amt.. Due Amt. Paid Balance 50.000 20,700 5,000 25,700 Tax '0.00 0.00 0100 TotalAcres: 50.000 SpecialAssrrnt 0.00' 0.00 0,00 Assessment Ratio: 010000 Special Chrg 0.00 0.00 0,00 Mill Rate: Not Available Delinquent Chrg 0.00 0100 0.00 ! Fair Market Value: Use Value 'Assessment Private Forest 0.00 0,00 0,00 Woodland Tax 0.00 0100 0.00 Managed Forest 0.00 0100 0,00 INSTALLMENTS Prop. Tax Interest 0:00 0100 Spec. Tax Interest 0.00 0100 Period End Date Amount Prop, Tax Penalty 0.00 0100 Spec. Tax Penalty, 0100 0.00 Other',Charges 0.00 0.00 0100 TOTA L 0.00 0.00 0.00 . Over-Payment 0,00 PAYMENT HISTORY (POSTED PAYMENTS) Genet Special Date Receipt # source Tvpe Amount Tax Sta Us Assess.'Status Interest Penalty Total ► 8 1 0 4 3 1 3 Document Number Document Title Tx : 4082004 St. Croix County 7 BETH PA ST Non-Plumbing Sanitation Affidavit REGISTER C DEEDS ST. CROIX CO., WI a RECEIVED FOR RECORD Name - (Owner) Typed or printed 11/08/2012 4:09 PM EXEMPT being duly sworn , states, under oath, that: REC FEE: 30.00 He/she is the owner of the following parcel of land located in St. PAGES: 1 Croix County, Wisconsin, recorded in Volume Page Document Numberoust. Croix County Register of Deeds Office: Recording area A parcel of land located in part of the '/4 of the '/4 and the Name and Return Address '/4 of the SW '/4 of Section J- , T~ N - R-&W, Town of uhp ~:"ser`4 12&:L 30 a 5'y. ,Eac~ ~ca/le, St. Croix County, Wisconsin, being duly described as (2~dw.~ W Syoo 1 follows (include lot no. and subdivision/CSM or detailed legal - description):' e Slv-;Jv' -F tA eSlvj ef tw 13, -Tmt,,,cl,,p .2r A,rfA /D 3 B'(~('~ODO /QCn3e 16' WCSft gnG/ ~(/((i Y aIr t+te SW y'af 5,a*A aF jay (va,. "A' 0 -7A) Parcel Identification Number(I)IN) ~lP 41OtT~1 /R4'/-J4-/6 WPST/All %w fA, TOVh @-A 'is. /!CI 5r CTD Ix C, L/~'fyy / SC Ok S' 1. A new structure on this lot will be used as a habitable dwelling, but will contain no plumbing for potable water and/or wastewater. Occupants of said structure utilize a vault privy for disposal of human waste, which was authorized by a non- plumbing sanitation permit in compliance with Sections 12.A. l.g and 12.3a.2 of the county sanitary ordinance. 2. No plumbing maybe installed in the premises served by the non-plumbing sanitation;d .vice,until a sanitary permit has been obtained for installation of a code-compliant POWTS. 3. The contents ofthe vault shall be disposed in accordance with NR i 13, Wis. Adm. Code. 4. This agreement shall be binding on the owner, their heirs, assignees and/or land contract purchaser. i also acknowledge that I will disclose this infonnation to any parties interested in purchasing this property in the future. Dated this _ day of /y r' • 2 AUI TiCAT104N ACKNONVLE )GiNIENT Signature(s) STATE OF WISCONSIN ) r 74 s~ )SS. O ) authenticated this day of St. Croix County. Personally came before me this L*- day of - the abeve named % CA4 to me known to be TITLE: MEMBER STATE BAR OF WISCONSIN the person(s) who executed the Ibregoing instrument and acknowledge the (If not, same. authorized by § 706.06, Wis. Stats.) AMANDA DUROW THIS INSTRUMENT WAS DRAFTED BY Notary Publlc St01e of Wlsconsln W,rn GcinGPr~c~ PAQVIGU( D AW Notary Public, State ol'Wisconsin (Signatures may be authenticated or acknowledged. Both are not My Commission is permanent. II not, state expiration dart: necessary.) Date: r 220 "THIS PAGE IS PART OF THIS LEGAL D0CUA1ENT - DO NOT REV10VL" This information must be completed by submitter: document Jule, name & return address. and PIN (if required). Other information such as the granting 1 QUises, leagal description, etc. may be placed on this first page of the document or may be placed on additional pages of the document. Note: Use of this cover page adds one page to your document and $2.00 to the recording fee. Wisconsin Stauues, 59.43.