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a o ° ° y O a o 0 ai t C a O c '3 n :3 0 0-0 1 ry v c v N> io (D of E a) ~ U CL LO a) m(D ixa jE L O Cl' N N N C p C O C x `y w N E 0 C) ~ 3 'II H V Z dai w._ N ca Ecn tea' ) -a O 00 a 00 t Z y X m O 'E Z a) 7 a3 a) a) 7 N O LL C 'O .O~a a) LL c Np O co N d O Y f~ U c v v>;irn c o avi c a) O L O N O a) p L Q- <1 ¢ 1 c 3 E U o V `~L~IF st D /y ^ N W W = O O Z Z d d t a d N 00 ~~U) co am 0 z v~ N dzal ° w of w E v ID a) wV :3 N j a) a) N yCL P ~N L L I~ 1 o 0 o zmZ rl z a d r ~I d Of LOW (ei Y O N co _r_ CL -0 Y O a U Z N> IT F- F H 2 co o F F F CL m a O O O O O O • _m a as a a a n. fA J U U) -0 (N CN O rn rn N M a) Oi r r m 0) Z O Cl) 7- zz _0 r~ O Of 0) (o C, 0 N O N 0 0 0 0 I- 0) O O 'Ip p p O N N N O ._p 'O t tD O N a) N a) (D _ m N c N m N c LL` M M U v Q > U) o v Q > ~1 is O 0) ~j 0 O 3 O N C 0 ) 0 ( y C IV ° W H O ° O 'o c E Cc (0 CD CD co " W O U 7 N c c 1 'C a) 0 0) O 0 0 0 N E N U d N N N Lr n C J C N N N E E m W 'y "d C a) a) ` O c 7 N V N Op U co I~ (7 z a) U 0Oi N a) t ,0, 'O M ch ICI N N C C 0 2 7 E E 'N O '6 3~ F-- c L -6 E O O Y E N O Z N F H J O Z 2 Z (n V f = = E RS G7 (D CL `ate a 4) S E 'E a 2 O~ U O U U t C)o I a p d c ~ o I ~ I o I N N i I z C I ~ ~a I C LL z y O z O0 v Z a m d z o o z v ° c p m w :!t 0 rn z fA IZ- c Cl) N 7 N C • N II d L O I p N 0 z z z N _ Z rn aci E N t~ l0 I ~a a to m L d 0 G d c bip Z~>° a N o a z •N ~aa N IL 0 c 3 00 c m U = rn co N N 0 E N M C O O n' N U) N Vf co N c N •p d Q m u N C N (D Al O C 00 C y O O O 0 0 30 - U a 0 0 r- -0 C4 (IJ ED N C 0) 0 d 7 N N 'O Y y0 .yd.. 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U Ili O w p N Z d c c z fA F- O N c E E o N V E N O N III N C N CO • wall) U) CL = = (V C ~p O O (D Q O O Q Q O v_ z m z z z o J z N VIII N d e N E 16 U i A in 4) (D CL a 0. w C O N c a a Y M a Q a U co z N> F H 1- d 2 a F- d p 0 0 0 Un 0 0 0 z •~a _ ~aaa ~aaa N 7 O (n N N N M M 1~ fA J U s Cy) OMi } .0 OOi 0_ Z - O Z 7 -O Cl) 00 r- 0) CD 0 N O N F- 0) d m N m 0, 'n c (U O a O O 7 CL r- o Q o Q> Q A ° U c 0 3 1 w e rn a c p W Ic- ° o Cn o 'c c E m 0 0 0 v c c c v°> a (M o0 p co E N ,^Lj W C 'O _C (U C EO O V C. o V co r^ CU z U N 00 F- N 0` r1 N C _ • 7, N I'- C O CO N O O QOj N 0 E U O O O Y> N O z F- J O N z mow.. In Cd r r..+ I a= E a, E m W M CL CL EL Q Z a w a r w c d c rrww• cg a d CD _1 A tia~ ',oin10 c°~ Ov40 U 716Z44 5r57FAr ;r~v 5-1/ S~'TE 41?' E s s ' 1 ~0 4uzo gzu fills SYo 22 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER / VJ 714,1 ADDRESS 3-74e ✓-A S T 5a l3~VIOW T . ~5"ao 3 SUBDIVISION / CSMI LOT SECTION-7 T 2-9 N-R 19 W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. / E'l~v~Tio~ - /0 a -O BENCHMARK: -6077-0/1 ! ~E OF S 1 P 1J (T ALTERNATE BM: ,~F)e~sr-Ia6-- EX sn~ cr SEPTIC TANK / PUMP CHAMBER / Manufacturer: &11 /ESe~ Liquid Capacity: /mod Setback from: Well> ASV House 1-~ Other Pump: Manufacturer ;iFOIE Ci Model# 13? Size T~ I/OU Float seperation 9 g Gallons/.cycle: Alarm Location ON *ORA 17base- SOIL ABSORPTION SYSTEM Width: / Length 8 y , Number of trenches Distance & Direction to nearest prop. line: J~3 +0 Setback from: well: DSO ' House ~S Other o~ ~X /'Sna G' 7fi vrf 5 ELEVATIONS N&r Nor "07 Building sewer evo4a.4,1ST Inlet; /f'NdUA4.,' ST outlet /r.~au/~✓ PC inlet PC bottom 9/ Pump Off Header/Manifold Bottom of system Existing Grade Final grade ©G~ l I ` 3 DATE OF INSTALLATION: PLUMBER ON JOB: 1;~ ' 2A L17P (,C 14 T- LICENSE NUMBER: M PP S IoM ~Sati INSPECTOR: 3/93:jt JIM 4~Se pit -a ro1983 v 84 c'w, b 'I W► ~ti. CERTIFIED SURVEY MAP Qz LOCATED IN THE SE 1/4 OF THE NE 1/4 AND THE SW 1/4 OF THE NE 1/4, SEC. 7, T28N, R 18W, TOWN OF NN ICKI NN I Cl ST. CROIX COUNTY, WISCONSIN. OW LUCILLE VORWALD RT. 1 , RO RTS, W 154023. W114 COR. SECTION DESCRIPTION ON 7, T28N, RI8W. - 1,, - (COUNTY SURVEY MONUMENT FOUND.) U N PLATTED LANDS 0 NORTH 378.31' I 33.00 345.31 C :c rT z I I S~''F "1D :r m y '-1 ~ IW 3.00 ACRES 'rn APPROXIMATE I - A 1130,683 SO.FT.) FORTY LINE. (119 ,284SQ,Fr.TOROM) ~ • n Cn Imo. ~ tr •A 33-1-33'--l •Z c I:n I •p :z :c 33. 345.31 :r• r, SOUTH 378.31 D I:M, aT~ co U. N,P LA TTE D LANDS W W T D I NOTE: BEARINGS REFERENCED TO .r •b NORTH 264.81 THE E-W QUARTER SECTION LINE. •z 33.00 231.81 (ASSUMED BEARING WEST.), v *.(n :c n I I l r SCALE I 100 33 ryl I~ 050' 100 200 m LOT 2 D •-I le N C-1 m m 2.00 A CRES rn p (87,122 SO. Fr) (or, O -i C) I n> ( 76,265 SQ.FT. TO R.O.WJ Z ~ ~ _ t0 W ~ I I D 0-SET I °X 24" IRON PIPE WEIGHING. O :Z 1.6 LBS. PER LINEAL FOOT. cf) ~ o I i 33.001 2 31.81' APPROVED SOUTH 264.81 I lo JUL 61983 U N P LATTE D LA N,DS E 114 COR. SECTION T 0' ST. C^.OIX COUNTY 7 T28N R18W. COMP.,~HE,-IVVE PARKS PLANNING (COUNTY,SURVEY_ N I AND Z;-: rO'^"''1FE 83-60 MONUMENT FOUND.) Volume, 5 Page 1302 THIS INSTRUMENT DRAFTED BY j. o N~N , c 1- r ~ Q Gv~S T Ad r c - r ~ o ~ 00 Sep - G r ~ ` nl Q ~ ~ 0 y `'3 n ~ y o R~ 0 3 0 I ~ m ~n~ Hd 0 14k n " ~ ~i Eats T Lo 7 .0 1 /o- L-7 ~3 ULBRICHT & ASSOCIATES CO. 655 O'Neil Road • Hudson, WI 54016 Reg. Designers of Engineering Systems 715-386-8185 Private Sewage Consultants .43 373' SAS ST ~se f c sysf Q.,(,Vt ilt s sT -bf po~ Qi'~f ~i✓`0~ Zvi tot f f ec to -C 4V AOO o m s 7` S c f Afto 0/1~ ,-41 Us 7- i4A o 02 ~ u4~- 07- N v7- 4~ h w ems` s1/ s f 4-4 S -C M' s..a /CID LQQ9W pa n iNIC 7.28. + Q County: Laborland Human Relations ~ VA I L EWAGE SYSTEM Safety and Buildings Division INSPECTION REPORT (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 1 Q19996 Permit Holder's Name: ❑ City ❑ Village K, Town of: State Plan ID No.: ev.: Insp. BM Elev.: BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA A9300301 ~b TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Aeration Bldg. Sewer Holding St/ Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. Airi to ntake ROAD Dt Inlet Ar I Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction Syestem TDH Ft Forcemain Length Did. II ff Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Di;. Liquid Depth DIMENSIONS DIMENSIONS SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type O CHAMBER Model Number: System: OR UNIT DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only / 'I Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ IN ❑ Yes ❑ No x,21' COMMENTS: (Include code discrepancies, persons present, etc.) tit LOCATION: KINNICKINNIC 7.28.18.100E Plan revision required? ❑ Yes ❑ No T-1 I Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: flILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY STATE SANITARY P RMIT -Attach complete plans (to the county copy only) for the system, on paper not less than //Ilyyft~~, //YYJJY/I 8i4 x 11 inches in size. ❑ cneck re is t p us application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. $ ?3 - O 3 513 PROPERTY OWNER PROPERTY LOCATION IS' ,A4,or / 4/.SS C SE Y. &W S ' T19 , N, R !a E (or) W ROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # S 3 S r-. S • 6f*~ 2- 1 CITY, STATE , ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER D > 1 3 Z o14 yl;qk l N,t/ 15,3,oe) 3 i$f O41-3 17 (0o(. S PeS II. TYPE OF BUILDING: (Check one) [I State Owned CILTMLAGE EAREST ROAD ❑ Public [l or 2 Fam. Dwelling-# of bedrooms f/ N NUMBER(S) PARCEL TAX III. BUILDING USE: (If building type is public, check all that apply) 02.-)-- / 0/ ( 79T:5-000 1 ❑ Apt/Condo 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 onl one in line A. Check line B if applicable) A) 1. ❑ New 2. Replacement 3. ❑ Replacement of 4.0 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 lr 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) ppl~yy ELEVATION Feet 0220,L5; Feet (pO0 00 /~//t- dd~ 15 VII. TANK CAPACITY Site INFORMATION in gallons Total # of Manufacturer's Name Prefab. Con- Steel glass A Fl ass Plastic App. New istin Gallons Tanks Concrete structed pp. Tanks Tanks ZOks 12.00 •u C Septic Tank or Holdin Tank Lift Pump Tank/Si hon Chamber '75o '75O ( 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) MP/MPRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Cod ASS p . - f/~D~o~✓ S. CP . IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date issued Issuing Agent mp ) El Approved El Owner Given Initial Surcharge Fee) /V - Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Pib-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 revisio^s to this permit must be approved by tie per rnit issuing authority. 4. Changes in uwnership or plumber requires a Sanitary Permit Transfer,'Renewa! Form (~j!3) 6399) to be submitted to the county prior to installation. 5. Onsite sewage sy• t ems must be property maintained. Thf tank-l's) mi.~;t be pLJM[; ~d 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 aid mailing address. Provide the legal description and parcel tax number(s) of where the system is to bet installed. ll. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling. 111. 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. Absorptio- system information. Provide a!1 information requested in ##1-7. VII. Tank ; nformation. Fill n the capacity of e ry new and/or tank, list the bufaf g d!o-s, number of tanks and manufacturer's name. Indic;a:ti.: prefab or site can ;i, ti, "I'd and tank material. G );npiete for all septic-, uurop-'siphon and holding tanks f`` this SystE-m. Check = r rr:er?tal approva' onky if tanks received expF r;o lnrn,;, ct approval from Dll hF~ . Vill. Respon, i-bility statement. Installing plumber is to fill in nar e., ~rceose numbe- ,vith ar)nroprwie prefix. (e.g. MP, etc.); 3 and phone number. Plumber must sign: a3 F7 ! :;-;)c~^ form. IX. County/Departiment Use Only. X. Courrtyi~)epartment Use Only. Con,; et> Mans and specifications riot.~:maller than 8'/s x 11 inchas must be "ubrnitted to the county. The ps ns rs7t~ t include the following: p c` r,;-n, drawn to scale :°r• itt1 corsnplete dm1ensroie. ,;cation of hoidinf < Sse )tic 'a nk(S) or other tk Amen' tanks; b,.jjjjir ,E?+ INFa et Ta r -i o,,, ter service; strean-is : yod la,'-es, pump or siph«:I lank distribution boXEt:, errs re ;%-en? e'.It system areas, dcit. :cation of +he bui } of izont l c tica .tf Y3tl ^ r0rerce l oint.::; C) complete specifications for pun;p s r f;d controls; dose volurr,~, alevation : jfie rences; fr icl:.:n loss; pump performance (=urve; pump model and pump manufac=turer; D) ct,oss section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. - - - - - - - - - - - - - - GROUNDWATEIR SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practises wl-ict, can effect groundwater. The -,,;•nie i r:okocted through these surcharges are us,d ror monitoring gru,s,,dwater,r<~~.•nc:;- wal,- orntamination investigations and establishm(. r-i ,_,f Standards, SBD-6398 (R.11/88) * SAFETY & BUILDINGS DMSION i i State of Wisconsin Department of Industry, Labor and Human Relations October 11, 1993 201 East Washington Avenue .P. 0. Box 7969 Madison WI 53707 ROBERT ULBRICHT 655 O'NEILL ROAD HUDSON WI 54016 RE: PLAN S93-03513 FEE RECEIVED: 180.00 LISSECK, MARTY SE,NW,7,28,18 TOWN OF KINNICKINNIC 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. Sin ely, Peter E. Pagel Plan Reviewer Section of Private Sewage (608) 266-2889 88D."97 (R. 01/911 ti 1 ULBRICHT & ASSOCIATES CO. 655 O'Neil Road • Hudson, WI 54016 Reg. Designers of Engineering Systems 715-886-8185 Private Sewage Consultants PROJECT INDEX DILHR Plan I.D. # 693-03513 Date ocr. ,P - /993 Owner / hRTiN Phone Address 37& 5 r. So 134V P0R T, M S Soo 3 Legal Description SE, ~iGtJ, 5E'C . 7, T 2 eV , /,0 cc, Town of lK' A, 1ti> (I 1'4, /A,' /•G County 57- 6,&1')( C.S.T. -U 1, 6 2 ~k7-- C Sr,41 yy~Z Installer Local Authority/ Supervision Sr, GR01A C7 'y. Zoe I A-)6- Ziff PT PROJECT DESCRIPTION A (7V6~ ) 00~1&X Ca~.~~tiT~ov L SEtV Tie S YS Tt-ti ct ~l sa./5- IC -So.-j,t l / y/ S 4 T VA j Tf 0 ~E/otv TL►r's 47- 21/ eo,PE- 4a tt,4 /14,0 T ~ p TiG ~.t vk rod - ~o~r/o /i.y N 7- AV•yp CA 4,414-440 &CPY/ 1346- ~1ov v~ 60i!/ Gv-v S 7-AP cT~~ ~ls~ ~FSi v /0-10IN G- ~ AS S►ut- S-04S (fie /o0 2-f Pg. 1 PLOT PLAN VIEWS sty'~~ Pg.2 SYSTEM CROSS SECTIONS &.a*~ M P IE A o S 0 35 1 3 Pg. 3 PIPE LATERAL LAYQS0 AWL a P .4 DOSING CHAMBER CROSS YEC g ROBERT W. Pg.5 PUMP PERFORMANCE SP FP PN usa 5A (r ~G~ HUDSON, 00 5 \rr\ ``~,1~, P7 • 4c 11 %1 UN rn y °o b to ~1 N 1^ m (,c7~sr DoT - m S93-o3513 w~ mwtob low, R. o m A. t ' jr. r b n c~D O W O H ~ ' 1 cn ~ O b NN w CLN O m~- c oo n w co ss~ 9 O. h r t O r. o o •N N M ~cocr o w (D 4ccb rIL m r o 1 a. cn ems' - o a m m ',Q cr J _ nb w WOO es ZANY fmDpmrtrtrj ese cup O N F+. OIPAi v ~i E L O C v .3 rt• Z ~ rt L N- n M 0 ti U as\ I a ~ W o I Z rn ' EgST L.G . a oR- 1Tc 1s 5 /NV &R 7- EGEV4-r1*0,vs ra P o F R 0 C K 1~' 7' z s Page - Of _ 5 T(;p OF ~y iAT-E P6LS • P~ Synthet' Covering Distribution Pipe V OQ` i ' s y rykm o c frEV,~n•~+ t F y~. 7,9 4 -J ELevAricAj % Slope uAla R %C D Bed Of it Force Main Plowed Aggregate Layer ?7' 7f U41jF9P,,l roa- D /.0 Ft.' ~l • 75- E 5 Ft. Cross Section Of A Mound System Using A Bed For The Absorption Area F • ~O Ft. • G A 0 Ft. A Ft. H l S Ft. ~bo area Z5 ft. NOW the 60310pe edge 01111 6 9-3,4 Ft. SOLI A1611101 808M must remain uadistu~6ed, K -146r Ft . ( >'i, = L 4 P-& Ft. S93-035 13 j 8 Ft. T /S Ft. Force Main W z9 Ft. L Observation Pipe g K A 0 ~O W Distribution Bed Of i Pipe Aggregate Observation Pipe Permanent Markers of GMPED s~EEL Roos Plan View Of Mound Using A Bed For The Absorption Area DAii-)/ SAS TE F/cccJ / r.4 /3/E 4 00 4 'P,PoPosEO BAs A-Z 93 /7y3 S1J. Fr' 1 Page 3 Of -5- 0/ U D /vm e ~o ~ yU F~` or Z T'v c ~oR cF Ids YIACE li4$ r ~10le Perforated Pipe Detail zV Lei (rti r Fob v t t Pm - vAt v i 1 0 End View )Perforated _-T End Cap A, PVC Pipe Holes Located On 6ollonl. Are Equally Spaced R ;.Y Q PVC ( Manifold Pipe Distribution Isr Pipe Hale Should Be Neat To End S93-03-5 1 ~~folD/ M Distribution Pipe Layout P Ft. R FoPcE ~`'li4ii✓ ,i 3/0 Fr o Z f ~G XInches y Inches pNSITE SEWAGE SYSTEM Hole Diameter y In.'`. . • Lateral 1= Inch(es) Manifold " - Inches AP~ 0~ i. Force Main " Inr•:les ' DEPARTMENT OF IND . LABOR AND RE TiONS # of•: holes/pipe /3 , DIVISI 0 ETY D B Invert Elevation of laterals 9= Ft. NC g E C RRE9P0 . • ~DiSTROBL)rtO&l 3)%50 HA RVE RATE FoR E'Acc Ij' L ATER AL P rr- ©TiS (P ~ Z-7 7, MtN • -TOTAL- "DiS?Ri,ZUT"l0Aj DIScHARG E RArE- F0 Q, Ive TWO FZK 30. yZ ..~2 Mi►J ~ ~ ~ ~NfMVM ti CA p WISE 3~ 6-4C14,11cv F • i\ PUMP CHAMBER CROSS SECTIOU AMD SPECIFICATIONS Pf}yE OF S^ VENT CAP 4"C.I. VENT PIPE APPROVED LOCKING T WEATHER PROOF JUNCTION BOX MANHOLE COVER Z5' FROM DOOR. IvAtAll,OC~ iA~~ WINDOW OR FRESH 12"MIU. I AIR INTAKE I yRAD,r GRADE I 'I"MIN. I 18"MIU. COIJDUIT-- 0 A/ 0- 0 `I4. 1 __-q_ PROVIDE I INLET -7 AIRTIGHT SEAL I (I APPROVED APPROVED JOINT A lN~ 1 K I (I JOINTS W/C 1. PIPE tA W/C.2. PIPE 1 ~0 I ALARM EXTENDING 3' EXTENDING 3' ~O r ( I ( ONTO SOLID SOIL OuTO SOLID SOIL B , I(~ r ' I I I . 3~ I ~I H1 i ON I ELEV. FT. PUMP---- OFF D . g5 k OCpOl~ BLOCK vet f iod !E RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL &xl'STiNG- S P E C. I F I*CAT I Oki S S 9 3 M 0 3 513 SEPTIC E AIOA5f 2 TO 9E DOSE 1 GUiFS ie com' It 49 - TANKS MANUFACTURER: IJUMBERSOF DOSES: PER OAy TANK 51ZE : GALLOIJS DOSE VOLUME G•s ' L~UE~ ~~~IP~ GO INCLUDING BAGKfLOW: 157 GALLONS ALARM MAULIFACTURER: MODEL WUMBER: ' CAPACITIES: A= 25 INCHES OR yoo GALLONS SWITCH TYPE: ItickeuRy A/e f r B= Z INCHES OR 3 Z GALLONS PUMP MANUFACTURER: 0041145-A r-= INCHES OR LE -7 GALLONS MODEL NUMBER: Y2- ff l 'IS, V On INCHES OR /6 GALLONS SWITCH TYPE: ~I'r QhCK ME~PtvPy f/oaf NOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATES-GPM INSTALLED ON SEPARATE CIRCUITS 7 z5 -rAA)k SPECS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. FEET ✓ . . . . . . . . . . 2.5 FEET EAC(A- I' + MINIMUM NETWORK SUPPLY PRESSURE + 7O FEET OF FORCE MAIM X 210-5 F/o,stFRICTIOM FACTOR.. " JF12- FEET 40r'S ~t!p A~STOTAL MMAMIC HEAD = ~O'✓r 7 FEET T 77 7 INTERNAL. DIMENSIONS OF TANK: LENGTH ;WIDTH ;LIQUID DEPTH A Own SEWAGE SYSTEM AP OV DEPARTMENT OF I 5 Y, LABOR AN AN LATIONS DIV SAE AN IN SEE CORRESP FENCE N - t HEAD CAPACITY CURVE 3 7/8 6 1/4 rf MODEL "98" 30 4 5/8 25- 3 /8 = 6-20 1*4 5 15 o4 4 10 _ f ,I 1 1/2-11 1/2 NPT 2 5 y U.S. GALLONS 10 20 30 40 50 60 70 80 0 - LITERS 80 160 240 ',lF ' 0 FLOW PER MINUTE I TOTAL DYNAMIC HEADIFLOW PER WrWTE I EFFLUENT AND DEWATERING , CAPACITY 12 • , HEAD UNITS/MIN - FEET METERS GALS LFRS 5 1.52 72 273 10 3.05 61 231 V 15 4.57 45 170 3 5/16 - 20 6.10 25 95 - Lock Valve 23' s y\.9 x` 0 3 1 CONSULT FACTORY FOR SPECIAL APPLICATIONS ~ 3 i Electrical alternators, for duplex systems, are available and • Mercury float switches are available for controlling single and supplied with an alarm. three phase systems. R. Mechanical alternators, for duplex systems, are available with or • Double piggyback mercury float switches are available for wlthout. alarm. switches. variable level long cycle controls. SELECTION GUIDE ' Standard all models - Weiht 39 lbs. - H.P. 1. Integral float operated 2 pole mechanical switch, no external control required. 2. Single piggyback mercuy float switch or double p' gyback mercury, float 98 Series Control Selection switch. Refer to FM0477. J Model Volts-Ph Mode Amps Simplex Duplex 3. Mechanical alternator 1044J72 or 10-0075. M98 115 1 Auto 9.0 , 1 or 1 & 7 - 4. See FM0712, for correct woo el of Electrical Alternator, "E-Pak". 5. Mercury sensor float switch 10-0225 used as a control activator, specify N98 115 1 Non 9.0 2 or 2 & 6 3 or 4 & 5 duplex (3) or (4) float system. D98 230 1 Auto 4.5 1 or 1 & 7 - 6. Four (4) hole "J-Pak", jur--tion box, for watertight connection or wired-in sim- F.98 230 1 Non - 4.5 2 or 2 & 6 3 or 4 & 5 plex or duplex operation, 10-0002. 7. Two (2) hole "J-Pak", for watertight connection or splice. CAUTION For information on additional Zoeller produas refer to catalog on combination starter, FM0514; All installation of controls, protection devices and wiring should be done by a quali- Piggyback Mercury Switches, FMO477; Electrical Alternator, FMO486; Mechanical Alternator, fied licensed electrician. Ail electrical and safety codes should be followed includ- FMO495; Alarm Package, FMO513; Sump,'Sewage Basins, FM0487; and Simplex Cogtrol Box, ing the most recent National Electric Code (NEC) and the Occupational Safety and FM0732. Health Act (OSHA). - i RESERVE POWERED DESIGN For'unusbal conditions a reserve safety factor Is dn'-g"ineered into the design of every Zoeller pump. MAIL TO. P.O. BOX 16347 Louisv f,,,, KY 40256-0347 Manufacturers ol.. . SHIP 7f7` 3220 O ,'r, P✓lli;ers lane /939 a. Louisvlde, KY 4x216 A !114111 K /CA" 'f ,ii iS^F (502) 778-2731 i FAX (502) 774 3624 i * rte;.°-~- _ _ _ _ _ _ _ . - ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK ~m This is to certify that I have inspected the septic tank presently servin the Seek bU X residence located 9 at: ~ SL 1/4, 1/4, Sec. , T N, R ~aQ W, Town of /tiWIV/ Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. PaV4--P 4,L~ /OIjG Last time serviced Did flow back occur from absorption system? Yes No (if no, skip next line) Approximate volume or length of time: gallons minutes Capacity: 126-0 6415 - Construction: Prefab Concrete Steel Other Manufacurer (if known) : Age of Tank (if known) : a0 5 (Signature) (Name) Please nt (Title) (Li se Number) (Date) Form to be completed by licensed plumber (s.145.06, Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements of ILHR-83, Wis. Adm. Code (except for inspection opening over outlet baffle). Name_g,o&-r z1fJr~'lay gnature Me-/MPRS 3`36 7 5/88 4 3 JIJL C) 1 D 365-927 N~ 9^83 v 84 OWN &.-do wt CERTIFIED SURVEY MAP oz LOCATED IN THE SE 1/4 OF THE NE 1/4 AND THE SW 1/4 OF THE NE I/4, SEC. 7, T28N, R 18W, TOWN OF KINN ICKI NN I C, ST. CROIX COUNTY, WISCONSIN. OWNED BY LUCILLE VORWALD RT. 1, ROBERTS, WI 54023. WI14 COR. SECTION DESCRIPTION ON REVERSE 7, T28N, R18W. rn - (COUNTY SURVEY W (i. MONUMENT FOUND.) UNPLATTED LANDS v ° NORTH 378.31' 33.00 345.31' 1 C- .c nl SyFO . ~ .r m w D ,D LOT I -I p 1W 3.00 ACRES _ (130, 683 SO. FT) •rn APPROXIMATE FORTY LINE. ( 119, 284 SOFT. TOR.O.W.) o, W ,Q .4' Ul 334-3341 ' D •Z c ~ .p .Z I.:C0 W :c 33: 345.31 :r SOUTH 378.31 D I rn~ m UN PLATTE D .rn .v ' W LANDS, .o 0) D v I NOTE: BEARINGS REFERENCED TO :D I b a'- NORTH 264.81' THE E-W QUARTER SECTION LINE. •z 33.001 231.81 (ASSUMED BEARING WEST.), :v m1 I; 'z o . n I L4 ( SCALE -1"=100' 0' 50' 100 200' m co IN LOT 2 D •-i C-) IcD m mi 2.00 A CRES :m o ~ p (87,122 SO. FT) -I 0 C) N ( 76,265 SOFT. TO R.O.W) , I 1 Z ~o r W N :r 1 ET I "X24"IRON PIPE WEIGHING i m II ti D O=S m :Z 1.6 LBS. PER LINEAL FOOT. : cn n j 33.001 231.81' APPROVED SOUTH 264.81 JUL 61983 U N P LATTE •D LANDS E114 COR. SECTION T ST. C^.OlX COUNTY 7, T28N, R18W. v COMP---HEASIVE PARKS PLANK" (COUNTY SURVEY_ I AND Z::'. '.j^ t'0;h'4!-FE 83-60 MONUMENT FOUND.) VoL;r.1 c^ae 1?'02 THIS INSTRUMF_NT DRAFTED BY CERTIFIED SURVEY I, Arthur L. Wegerer, registered land surveyor, hereby certify: That in full compliance with the provisions of Chapter 236.34 of the Wisconsin Statutes and the provisions of the St.Croix County Subdivision Ordinance and under the direction of Lucille Vorwald, owner of said land, I have surveyed, divided, and mapped said parcel of land, that such plat correctly represents all exterior boundaries and the subdivision of the land surveyed; and that this land is located in the SE4 of the NE~ and the SW4 of the NE4 of Section 7, T28N, R18W, Town of Kinnickinnic, St. Croix County, Wisconsin, to-wit: LOT 1 Commencing at the East Quarter Corner of Section 7; thence West along the East-West Quarter Section Line 1188.501 to the point of beginnin , thence continuing West along said line 345.441; thence North 371.311; thence East 345.44'; thence South 378.311 to the point of beginning. Contains 3.00 Acres subject to Town Road right-of-way over the South 33' thereof. LOT 2 Commencing at the East Quarter Corner of Section 7; thence West along the East-West Quarter Section Line 522.721 to the point of beginning; thence continuing West along said line 329.001; thence North 264.811; thence East 329.001; thence South 264.811 to the point of beginning. Contains 2.00 Acres subject to Town Road right-of-way over the South 33' thereof. Dated this day of 111)h1-f ,1983• a'ZL' d. Arthur L. Wegerer S-963 Kozel, Wegerer and Assoc.,Inc River Falls, WI IIy1i15i 17 ((,l, ,o ARTHUR L. ; WEGERER S-963 ; ELLSWORTH WIS. „(„1111 Volume 5 Page 1302 S T C - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER ADDRESS? S T~ S © FIRE NUMBER CITY/STATE _ 134y46k Ti 9*4( Zip .S .SOD 3 PROPERTY LOCATION: 1/4, 1/4, SECTION , T N-R W TOWN OF , St. Croix County, ' SUBDIVISION= , 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 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 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 overifying 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 Co. Zoning Officer within 30 days of the three year expiration date._ 4l~ti j SIGNED: 1 l I yqDATE:_ St. Croix co. Zoning office 911 4th St. Hudson, WI 54016 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,(spec house), thenia second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Zz.~-"-9 S/ C------ -----f Owner of property M/01/. Location of'property 1/4 A 1/4, Section 7 , T LN-R ~EW Township ACI'vt/ Mailing address X75 S dt, S7-, S. X3,4 /~o~p 9kZ+t+i AIR /Z. FVtO -2 Z. Address of site 96 vl ~_'~+P 1t+v~Q Subdivision name_ &/1 39 5 iz -7 tlD~' - 130 ~t no. 2-- other homes on property? _yes=No Previous owner of property GvC~I~ ~/Q,Qev~ Total size of parcel 0 J Date parcel -was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)? Yes No Volume f0~` 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 & 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 r le office of the County Register of Deeds as Document No. o , 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 County Register of deeds as Document No. I Signature of applicant Co aPPlic . Date of Signature Dat of gnature DOCUMENT NO. STATE BAR *WlbR410; ~U 1T-1882 TNIS SPA~e RESERVED FOR RECORDING DATA LAND CONTRACT (3 ITO Ii F. USED FOR ALL TR:\N.ZACTIO?79 WHF.RF. OVER STa. 00 IS FINANI-F.D AND IN OT11i•:R NON-CONSUMER Ac,r TRANSACTIONVi REGISTERS OFFICE ST. CROIX CO., WI& Contract by and between ....-Lucile M. VOrwaldr Recd. for Record this 25th ask-/a_ Lucile. Vorwald, a single woman - day of J an . A. D. 1963 • ("Vendor", whether one or more) and------- .-_Martin---C-....Liss...:..... a--_--__-•__•___- of 8'30 A M: ("Purchaser", whether one or more). G"Ma of Dwdl Vendor sells snd agrees to convey to Purchaser, upon the prompt and full per- formance of this contract by Purchaser, the following property, together with the rents, profits, fixtures and other appurtenant interests fall called the "Property"), ~~ALTY WORLD in.........-S.t~--craiX County, State of Wisconsin: REToR Ken Lee Agency, In Rea! Estate-Aur. r-;a;; 129 South Main River Falls, WI 54022 Tax Parcel No- . . Lot Number Two (2) of that Certified Survey Map as recorded in the St. Croix County Register of Deeds' office, in Vol. "5", page 1302, as Document No. 385927, as located in the SEX. of the NE4 and the SA of the NE4 of Section 7, T28N, R18W, Town of Kinnickinnic, St. Croix County, Wisconsin. This A s---not.-.,.--_ homestead property. not) Purchaser agrees to purchase the Property and to pay to Vendor at such place as reasonably directed the sum of $ 52,.00-0Q--------- in the following manner: (a) 5..000.00 at the execution of this Contract; and (b) the balance of 47,.QQQAQQ-------------- together with interest from date hereof on the balance outstanding from time to time at the rate of---- .tEta_.UQ]* per cent per annum until paid in full, as follows: * The interest rate shall be adjusted on a yearly basis throughout the term of this contract to a rate equal to one (1%) percent below the Federal Land Bank Farm Rate (without stock) of River Falls, WIsconsin, as adjusted on July 1, 1984 and yearly thereafter on July 1 throughout the term of this contract. An additional $5,000.00 principal payment shall be made twelve (12) months from the date of closing, thereby reducing the outstanding principal balance by a like amount. Further, principal and interest payments of $453.00Vpee}r~ month shall commence thirty (30) Sys 1 o e 7~t~tfCr,'t?4j 1e tGttd~fdt~t 1bacl4r Lr ta~I ee bai~d1A fu-tl" eorr tfore the.----1st-------------- day of August-__----------------.., 19..93_. ( the maturity date). Following any default in payment, interest shall accrue at the rate of w per annum on the entire amount in default (which shall include, without limitation, delinquent interest arid, upon acceleration or maturity, the entire principal balance). See the contract interest rate as above specified. N~ 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 after. .date-.Of-.CAQS=g10O0000 xxmo ' In the event of any prepa~-ment, this contract shall not be tre.ited aq in default with respect to payment so long as the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be treated as unpaid principal) is less than the amount that said indebtedness would have been had the monthly pa}ments been made as first specified above; provided that monthly payments shall be continued in the event of credit of any proceeds of insurance or condemnation, the condemned premises being thereafter excluded herefrom. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except: easements, restrictions anct rights of way of record, if any. Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall be retained by Vendor until the full purchase price is paid. Purchaser shall be entitle to take Possession of the Pr^nerty on_..date.-of-closing. 19$3-.. . -Cr-. Out One. LAND CONTRACT-individual and 97ATF. nAR OF WISCONi1N wi....... - L-i 11'ank Cn. Inc. Corporate FORM Nn. 11 - 1982 Ml1-'--, 1P:a. VOL 669 EA E 15 5, Purchaser promises to pay when due all taxes and assessments levied on the Property or upon Vendor's interest ` in it and to deliver to Vendor on demand receipts showing such payment. Purchaser shall keep the improvements on the Property insured against loss or damage occasioned by fire, ex- tended coverage perils and such other hazards as Vendor may require, without co-insurance, through insurers approved by Vendor, in the sum of $.full--1??SLlYa?le__Vclltl~__„ bill: Vendor shall not require coverage in an amount more than the balance owed under this Contract. Purchaser shall pay the insurance premiums when due. The policies shall contain the standard clause in favor of the Vendor's interest and, unless Vendor otherwise agrees in writing, the original of all policies covering the Property shall be deposited with Vendor. Purchaser shall promptly give notice of lo9a to insurance companies and Vendor. Unless Purchaser and Vendor otherwise agree in writing, insurance proc-cds shall be applied to restoration or repair of the Property damaged, provided the Vendor deems the restoration or repair to he economically feasible. Purchaser covenants not to commit waste nor allow waste to be committed on the Property, to keep the Property in good tenantable condition and repair, to keep the Property free from liens superior to the lien of this Contract, and to comply with all laws, ordinances and regulations affecting the Property. Vendor agrees that in case the purchase price with interest and other moneys shall be fully paid and all conditions shall be fully performed at the times and in the manner above specified, Vendor will on demand, execute and deliver to the Purchaser, a Warranty Deed, in fee simple, of the Property, free and clear of all liens and encumbrances, except any liens or encumbrances created by the a-_t or default of Purchaser, and except: ..easeR)M.tS.,.-reStsi-ticns and rights- of. Y--°f..recordl if anya Purchaser agrees that time is of the essence and (a) in the event of a default in the payment of any principal or interest which continues for a period of 30... days following the specified due date or (b) in the event of a default in performance of any other obligation of Purchaser which continues for a period of .311.... days following written notice thereof by Vendor (delivered personally or mailed by certified mail), then the entire outstanding balance under this contract shall become immediately due and payable in full, at Vendor's option and without notice (which Purchaser hereby waives), and Vendor shall also have the following rights and remedies (subject to any limitations provided by law) in addition to those provided by law or in equity: (i) Vendor may, at his option, terminate this Contract and Purchaser's rights, title and interest in the Property and recover the Property back through strict foreclosure with any equity of redemption to be conditioned upon Purchaser's full payment of the entire outstanding balance, with interest thereon from the date of default at the rate in effect on such date and other amounts due hereunder (in which event all amounts previously paid by Purchaser shall be forefeited as liquidated damages for failure to fulfill this Contract and as rental for the Property if purchaser fails to redeem) ; or (ii) Vendor may sue for specific performance of this Contract to compel immediate and full payment of the entire outstanding balance, with interest thereon at the rate in effect on the date of default and other amounts due hereunder, in which event the Property shall be auctioned at j-adicial sale and Purchaser shall be liable for any deficiency; or (iii) Vendor may sue at law for the entire unpaid purchase price or any portion thereof; or (iv) Vendor may declare this Contract at an end and remove this Contract as a cloud on title in a quiet-title action if the equtiable interest of Purchaser is insignificant; and (v) Vendor may have Purchaser ejected from possession of the Property and have a receiver appointed to collect any rents, issues or profits during the pendency of any action under (i), (ii) or (iv) above. Notwithstanding any oral or written statements or actions of Vendor, an election of any of the foregoing remedies shall only be binding upon Vendor if and when pursued in litigation and all costs and expenses including reasonable attorneys fees of Vendor incurred to enforce:any remedy hereunder (whether abated or not) to the extent not prohibited by law and expenses of title evidence shall be added to principal and paid by Purchaser, as in- curred, and shall be included in any judgment. Upon the commencement or during the pendency of any action of foreclosure of this Contract, Purchaser consents to the appointment of a receiver of the Property, including homestead interest, to collect the rents, issues, and profits of the Property during the pendency of such action, and such rents, issues, and profits when so'collected shall be held and applied as the court shall direct. Purchaser shall not transfer, sell or convey any legal or equitable interest in the Property (by assignment of any of Purchaser's rights under this Contract or by option, long-term lease or in any other way) without the prior written consent of Vendor unless either the outstanding balance payable under this Contract is first paid in full or the interest conveyed is a pledge or assignment of Purchaser's interest under this Contract soley as security for an indebtedness of Purchaser. In the event of any such transfer, sale or conveyance without Vendor's written consent, the entire outstanding balance payable under this Contract shall become immediatly due and payable in full, at Vendor's option without notice. Vendor shall make all payments when due under any mortgage outstanding against the Property on the date of this Contract (except for any mortgage granted by Purchaser) or under any note secured thereby, provided Purchaser makes timely payment of the amounts then due under this Contract. Purchaser may make any such payments directly to the Mortgagee if Vendor fails to do so and all payments so made by Purchaser shall be considered payments made on this Contract. Vendor may waive any default without waiving any other subsequent or prior default of Purchaser. All terms of this Contract shall be binding upon and inure to the benefits of the heirs, legal representatives, successors and assigns of Vendor and Purchaser. (If not an owner of the Property the spouse of Vendor for a valuable consideration joins herein to release homestead rights in the subject Property and agrees to join in the execution of the deed to be made in fulfillment hereof.) Dated this .-...First ( 1 ) - - day of ------•--July--- 1983_ .C(SEAL) t~ u ___..(SEAL) Lucile _M.---VorWald._"Vendor"------.-_-- ' _--.Martin .C...i,issick "Purchaser"_.. ----...(SEAL) (SEAL) =_1 AUTHENTICATION ACKNOWLEDGMENT °f Signature(s) STATE OF WISCONSIN ^ ss. St. Croix ----------County. authenticated this ___...-day of------------------------ 19 Personally came before me this I........ day of J111Y------------ 19---U. the above, tianted Luc}~~ M- Vorw jd------------------------- . . Mali n..C.---Lisslck----- TITLE: NIE'vIBER STATE BAR OF WISCONSIN U (If not, - - - - authorized b ' y § 706.06, Wis. Stats.) to me kma~n to be "person _..S------- who executed the fore- ing iist m>ent and aeknowt ~}gr_~aame. THIS INSTRUMENT WAS DRAFTED BY J/----.-..--..... _ Leo A...Fleskar,..Attorney- a . _II n net ee----l Falls, Wisc-olis111---------- I 40ary Public Pierce-_.. ---County, Wis. (SiLmatcres may he authenticated or acknowledged. Both y Commission is-pcnrmrnt. (,f not, state expiration :Ire not necessary.) date: January 18 19..-87.•) - - - - - •N-ws of persons ~igninw in any caimcity should be t)'I)eii or printed below their signat-es. LAND CONTRACT - individual and Corporate - State Bar of Wlacanain. Form No. 11 - 1992 j - i~ ~z_ ~ ~ 1/ ~ e< . ~ I. l 7 y V _ ~ 1J'" 4 _ iPly~ Pi1//S GuiS . SYO zZ WKacoru'n Depar age tmenta n of Industry, SOIL AND SITE EVALUATION REPORT P 3 -Lof Labor and Hkxnar, Rel Division of Safety a Buikings in accord with IL.HR 83.05, Wis. Adm. Code COUNTYs, 77 CIeO'' X Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference pant (B", direction and % of slope, scale or PARCEL I.D. # dirnensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION GOVT. LOT SE 1/4tiW 114,S 7 T ZP N,R /9 E(arj PROPERTY OWNER':S MAILING ADDRESS LOT s BLOCK tt SUED. NAME OR CSM # 375 5ra ST Se. CITY, STATE ZIP CODE PHONE NUMBER QCrTY []VILLAGE 2rOWN NEAREST ROAD / f3i4 flop T, A'/ ;90 5572-;13 351- OkW 3 iNN~ 'Gs~/N,c~ i G 4'0116 ( j New Construction Use [t(ResidenW / Number of bedrooms y Addition b existing buildng Lgtepfacement •be ]>VP Iex i?E~~ i- uAV i'T- Code derived daily flow 10100 gpd Recommended design loading rate S bed, gpd/ft2 trench, W* Absorption area required 5 ?0 bed, ft2 500 trench, ft2 Maximum design loadng rate S bed, gpdfii trench, gpdAt2 Recor m ded infiltration surface elevation(s) 3 R (as referred to site plan benchmark] Additional design/ site considerations $i'TE Sd~ T,rQiE ov cy I&v-,P 1V&61w0 T'y~E SYSTEM Parent material SC5 - Sr1Nr~'fiGo 4 M,9 &,r o Flood pblo elevation, d Wkable N/f it G L 7-11.1 S able for System CONVENTION MOUND a s~D pP-SURE o s L Liu o F~L HOLDING TAW OS O U L9 9 0 o s G ft- SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bo ift Roots GPD in. Munsell Qu. Sz. Con, Color Gr. Sz. Sh. Bed o-/o 7s /e Y15- s,/ .2, 56x C5 v _5 .6 131 d-25 7,syh' y / 5/ ~,f sdr n~fk Cs /vf ,s Ground e 2-F- 7S' 5 YR y y 2' s sc f 5Ae vf/ tip N P elev. 9 ft. 176,e i ?.p.✓ Gr it S vi CO S ~~V 5 I Nmitirq L facb~ RIGH L Remarks: f~CT /vE //(TGrJ Sgp~t (rE o9-T ✓`-y Boring # O- S2 7 s ~/2 s, 2f Sb - of e e s 3 Lj S• G 51 N ~L . Y s yR y y 5c1 AJ Ground C. 2 elev. Q' ~5 75 yR i R ps/~ 5,t C 0, nMAsSiUE i N . N fL Depth ID limiting for a co venti nal septic. system. factor On a3do Remarks: i Nainse:-Flaaaa Prini Phone: Address: p'5 / N L /l~0 ffv~,tDa Cv/. Syo!(o 9' Z L - 93 esT/'~ 2Y~Z Signature: Date: CST Number. No TE 10 50115 1.~e low S " E 11672y fi f"y 740 4111ss, 4c Before Ioca1 zoning CO Permits can be granted _ rs TE~i $rTE l~.ts sFp~ THIS PROJECT WILL REQUIRE STATE LEVEL ~S .vay' ~ L i0. PLAN APPROVAL. Plans 74,, will need to be submitted SUS TR Q/E" c by a qualHMd designer DUD s y/S T>EM . per I.L.N.R. eus (2) ' Ir al PROPER! FY ilMRTV SOIL DESCRIPTION REPORT pap a 3 PARCELLD.t Depth Dominant Color Males Texture Stricture ConsisWm Bounclety Roots GPD Boring # prizon In. Munsell Chu. Sz. Cunt Color Gr. Sz. Sh. Bed TWch 2=6k ►vf.P CS 3ui . S O-e -7, S7 Yle sye 3,w, hk 4,-(2 s !uF S . _5 • y - s Gmw4 )~s 7,s y,~ 60 C y8. y. zs s yr~ y 2- 5~- sc / Z.f 6,~ of - r~ NP DP.A o l . to 2,5 Remarks: T Boring # Ground elev. R Depth to Nmiting factor Remarks: Baring # Ground elev. tt Depth to Ong bow Remarks: Boring # Gramd elev. ft Depth to fimiiing factor LL Remarks: eon ooon,o ^Conrn x 7'7 1sy~ ? c~J M v 1 O i v 1 W O o vs, - - - - - - - - - M V. h i I ~ I I i i Q I w -7 1 ~i 1!►'1 3 G o V) w y W © o 6 D w W y ti d S ~.1 v W j W v' o % ~ • 4 J n! M j j Lu I } 1 n Q O 3- O 22 eo eo v W • }7vn A O C/) c. z o r z o o N T o o • 0} 3 cn O N y p N o p O N N }.w co co 3 V C O: N x fZD 0 N V O. x O C a `A\ CD 0) 3 N - r 7 V O O n p N N 7 C O O O N C CD 7 m O 3 CD CD 0 0 co (A CO 0 O N N N 0 01 C n ir r. n O l~• m cn < D CD c Cn D 0 p (p O CD I a (D N N a C W ° c N 3 O C O O O O COO fD W CD O J -4 T ~l 1 CO N CO o r- co O COO COO CD N N CD CO) ,.0. a N z N 0 0~ 000- 0 ! FT r CA (A (A (A 0 > o I6 M G O ?r G O w o j CD M CD vpj y CD CD y Cn COD d Q w Of N W N !D T N N z r- o z z z ca z O D D o D CD 0 v O O o a l~l • O O D N lr 'a C C CD ((D 0) N 7. C C COD z CD (D Cfl -1 Cl) ° O A Z O C !A N C y ~ CL 6j 7 (Z 7 o (n N V m o CCDD CAD CD c z a ~ a A c " O s z , 3 3 r" OD fA D y O 0 A CD CD O yf/ CD~ D 3 Fpm? a 3 0. CD CD CD ,V a O' cc •'i• co c N n cC CD O G N CD N p G O d c CD CO ° ° (D N N Z z a ? °pj N M ° d • 0 n N C C O a N 10 3 c' N X 0 01 III 0) CO O. CO 3 2 C CD CT - 'O 4 X p CD c N) s O N x N Q I 'D I 0) - n C d ~ S O CD O N O 7 O CL C+} CD A N CD D'0 ti A t-j r' 69 O b9 O ti N CD * :E CD Q CD ,V CL O L V 1 1 OF 1 Parcel 022-1017-50-000 08/08/2011 PAGE E 04:52 PM F 1 Alt. Parcel 07.28.18.99B 022 - TOWN OF KINNICKINNIC Current XX ST. CROIX COUNTY, WISCONSIN 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 0 - STOPPELMOOR, LOWELL R & DARLA J LOWELL R & DARLA J STOPPELMOOR 974 COULEE TR ROBERTS WI 54023 = Primary Districts: SC =School SP =Special -13 777 Type Dist # De scription SC 4893 SCH DIST RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 3.000 Plat: 1302-CSM 05-1302 022-83 SEC 7 T28N R18W 1.70A SW NE PART OF LOT Block/Condo Bldg: LOT 01 1 CSM VOL 5/1302 ASSM'T INC 022-1017-90 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 07-28N-18W it Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 820/328 07/23/1997 8101195 I 2011 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 09/07/2010 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 50,000 161,800 211,800 NO Totals for 2011: General Property 3.000 50,000 161,800 211,800 Woodland 0.000 0 0 Totals for 2010: General Property 3.000 50,000 161,800 211,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 143 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 00 ,0 00'0 00'0 WWI sa6jego 3uenbullaa sa6aego leloadS s3uawssessd leloadS junowy tio6a;eO apoO leloadS iasn :sleioadS 4o3e8 :a3ea u013e31ppo0 0 :;unoo wlel0 :I!Pejc) AJO740-1 0 0 000'0 PUelpooM 0 0 0 000'0 "doad IeJauaE) :MoZ COI sle3ol 0 0 000'0 puelpooM 0 0 0 000'0 A:padoad leaauaE) L LOZ Jo; WWI uosead a3e3S Ie3ol anoidwl puel saJod sselO uol3dljosea :pa6ueyO Ise-1 :suol}enIBA 000-09-L L0 L-ZZO 0 :y;lM passassd :anleA WPM pled # Me ikbdwwns mz S6 L/0 L 8 166 L/EZ/LO 8Z£/OZ8 L66 L/£Z/LO ads _L abed/10A # ooa ale(] :tio3s!H lamed :sa3oN M8 L-N8Z-LO (17/L 09L t'n 017 bu~1-uMj-oas) :(s)3oeJl 09-L LOL-ZZO/M 43SS3SS`d ZO£L/5 WSO L LO lOl :6p18 opuoOmoom lOl =10 IHVd 3N 3S 17'0£' L M8 f N8Z1 L 03S E8-ZZO ZOE L-50 WSO-ZOE L :3e1d OOE' L :saioy :uol3dlaosaa Ie6a-1 H0310A A311VA dIHO OMO dS STW/ 213AN 1S14 HOS £6817 OS uol3dlaosaa #;sla odAjL tiewud :(sa)ssaippd fqaadoJd leloadS = dS Ioo4oS = OS :s3314s!a I £ZOV9 IM SIH380~1 Hi 331noo 17L6 ' F F11dt/a '8 b 113MO1 '2J00Wl3ddO1S - O idOOW13ddois f v-i ib'a8 2f 113MO1 aaumo-oo juaiino = o 'jaumo juaiino = p :(s)JaunnO :ssaippy Xel 0 00 s3!ufl;o # adA.L IM-Jad #;lwJad # uol3eollddy e9jV saleS # deW a3ea Ie31JOISIH a3ea u013eaJO NISNOOSIM '.11Nnoo XIO2i0 '1S X❑ 3uaima OINNNOINNN JO NMOl - ZZO a00L'8L'8Z'LO laoaed 11`d L d0 l 3Jbd Wd £S:VO LLOZ/20/90 000-06-1LO~-ZZO Ia~Jed nLED f a 'LL -4 Real,, NNELL CERTIFIED 'SURVEY MAP- ffr LOCATED IN THE SE 1/4 OF THE NE 1/4 AND THE SW 1/4 OF THE NE 1/4, SEC. 7, T28N, R 18W, TOWN OF KINN ICKI NN I Cl ST. CROIX COUNTY, WISCONSIN. OWNED 13 LUCILLE VORWALD RT. I, ROBERTS, WI 54023. -W114 COR. SECTroN DESCRIPTION ON REVERSE 7, T28N, R18W. m (COUNTY SURVEY cDil (211 MONUMENT FOUND.) U N PLATTED LANDS ° NORTH 378.31 33.00 345.31' 1 I ~z ( SyF • V I D D m T I • •--1 -I IW 3.00 ACRES _ (130,683 SO. FT) •m APPROXIMATE p W FORTY LINE. ( 119! 284 SQ,FT. TORA.W.) S ~33' 133J • D :z ;z :c 33.0 345.31' SOUTH 378.31 D M m UN PLATTED .m , LANDS D y NOTE: BEARINGS REFERENCED TO •r I •0 °D- NORTH 264.81' THE E-W QUARTER SECTION LINE. • D •z 33.00 231.81 (ASSUMED BEARING WEST.). I :c Q ~1 •v „ .r SCALE 1 = 100' DI D I 0' 50' 100 200' m h~N LOT 2 D rn 2.00 A CRES :m 1 N W (87,122 SQ.FT.) I ,Q O IO -i C) Irv ( 76,2 65 SO.FT. TO R.O.WJ { Ir' _ O W ~ I z lll' I8 o ; r- I m I c _ . O SET 1 X 24 IRON PIPE WEIGHING II 0 :z 1.6 LBS. PER LINEAL FOOT. i •Q L I I APPROVED 1 33.001 23 1.81' SOUTH 264.81 y JUL G 1983 UNPLATTE,D LANDS ST. C':OIX COUNTY T E 114 COR. SECTION 7, T28N, R18W. r COMP.:=HE:-DIVE PARKS rLANNING AND V.% %i? CO"Al ! FFE 83-60 (COUNTY SURVEY MONUMENT FOUND.) Volume 5 Page 1302 THIS INSTRUMENT DRAFTED BY l AS BUILT SANITARY SYSTEM REPORT OWNER 1\~~WNSHIFV tg ~►w~N~C LC . 'T I - R1 W . ADDRESS ST.. CROIX COUNTY, WISCONSIN. SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 AHQ~ VEHXTHING WITHIN 100 FEET OF SYSTEM 13 dr 56 w. R-jz Pp. 01 i l_~va de e o th Arrow SC U: BENCHMARK: (Permanent reference Point) Describer a Elevation of vertica~,,reference point; Slope at site: Z o ~ p a c i ty SEPTIC TANK: Manufacturer: Liquid Ca Number of rings on cover p t.3 ank -manhole cover elevation:___ Tank Inlet levation; Tank Outlet Elevation: PUMP CHAMBER . ~S Number of gallons Manufacturer. Number of gal.. pump set or a cycle d gallons; tota capacity o_F_ distribution lines gallon: size-of pump_'S,,7 head; gallon per minute horsepower 1_; ran name of pump and modal - number Type of warning he cHOLDING TANK; Manufacturer Number of gallons Elevation of 'manhole cover Type of warning device - SEEPAGE PIT SIZE: ~fum er o pits set-diameter feet liquid d6pt ' seepage pit in et pipe-elevation . bottom of ssapa4e pit elevation feet. ile depth`` ~ gt SEEPAGE BED SIZE: number of lines w t lent SEEPAGE TRENCH: idth U length PERCOLATION, RATE ° RE BU LT X~ INS El 'l0 DATED ® 8PLUMBER ON J LICENSE NUMBER DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HU0AN RELATIONS PRIVATE SEWAGE SYSTEMS q` DIVISION PbArOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 RCS ( ®CONVENTIONAL El ALTERNATIVE State Plan I.D. Number: Holding Tank D In-Ground Pressure D Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: I Lk(' , 0(', V,'j LCO)"t ) ~ BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELE V.. Name of Plumber MP/MPRSW No. County: Sanitary Permit Number: 11F SEPTIC TANK/HOLDING TANK: _ LOCKING COVER MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET LEV.. WARNING LAB5UILDING IVIDED: 97.7 PROVIDED: PROS '~J OYES DYES ONO BEDDING. IVIV DIA.: VENT MATL HIGH WATER ~NEUAREST__ M'13ER OF (ROAD: PROPERTY WELL: . IVVENT TO FRESH A XYE LI NEAIR INLETEET FROM DYES ONO S ONO DOSI NG CHAMBER: MANUFACTURER BEDD NG: LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANE) TUBER. WARNING LABEL LOCKING COVER P OV DED: P OVI ED: YES ❑ NO YES E] NO YES ❑ NO P +DO TR I LAL: NUMBER F PROPERTY WEDNGVENT TO FRESH GALLONS PECY L LINE (DIFFERENCE BETWEEN FEET F~MAII,~.~ PUMP ON AND OFF) S ❑NO_ _ NEAREST-__ G~'v ( 7 SOIL ABSORPTION SYSTEM. Check the soil moisture at th pth of plowing 1 METER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until I FORCE the soil is dry enough to continue.) ML _ AIN CONVENTIONAL SYSTEM: WIDTH UE O. OF PIPE SPACING. COVER INSIDE DIA. -PITS JLIQUID BED/TRENCH RENCHES / MAy~IA PIT DEPTH: 11 DIMENSIONS ~ UIR FILL DEPTH UPIPE DI STR. PIPF. MATERIALNO. STHNUMBER OF PERTV BELOW PIPS Af30VE O ER END PIP FEET FROM I-IN Ally NEAREST ,I/ y " 7 . If, 2-5- c 1' MOUND SYSTEM: Mound site plowed perpendicular to slope Chec e; t t e of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mo nd s' to to a certain that it ON REVERSE SIDE. SHOW ELEVA- ets tl} cr' or medium sand. TIONS MEASURED. OYES ONO PERMANENT MARKERS OBSERVATION WELLS SOI L COVER TF XTURE ! OYES ONO DYES ONO . DEPTH OVER THENCH HED DEPTH OVER THEN if BE 1.7T. OF T :SOIL SODDEU SEEDED M CENTEH EDGES j. OYES ONO OYES ONO OYES DNO PRESSURIZED DISTRIBUTION SY TEM: ,MOTH LENGTH NO. OF ATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER. BED/TRENCH rR cHES. DIMENSIONS MANIFOLD PUMP A I FOL D DIS E MANIFOLD MATERIAL PI\J OEDISTR. DDISATR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEVATION AND ELEV ELEV E DISTRIBUTION VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION MOLE SIZE HOLE SPA IN C ILL UCO EC LV COVER MATERIAL PLANS. ❑ ES ONO OYES ONO COMMENTS: PERMA 'NT MA ERS: OBSERVATION WELLS: NUMBER OF "ROPERTV WELL: BUILDING. FEET FROM LINE: OYES ONO ❑~YES NO NEAREST--~ ~0c~ 619 ~ PK~ G~30 Sketch System on t in county file for audit. Reverse Side. s TITLE DILHR SBD 6710 (R. 01/82) y Wisconsin Department of Industry, p3ii INSPECTION REPORT` Labor & Human Relations Safety & Buildings ' ion Bureau of Plumbing, Platting & Fire Prdtectton-i Name o remises Date 5F T. 57 No. Street i y. County Sanitary erm master m er irm ame r ss Journeyman Plumer ress Owner ress ~..•4 s-...•'~±"`,.4 ,c' , • t~ h..-* ~.l • , _ .1.3 ~ w ~ ltd ~ i,~-..~ ~ ~ i~..cni.Lb'~l. >,'1 h" '4• ~K ,'y~/=_~a ~4. fr7. N sr, ' i n , a. T'- J 3. L x~ c r J e~ Sri..;%' . r ~ s ` ~ita~":~J '•p$+ c. • ~ ~ t._2 •Z• ✓ `G ir`;tF} '."°9r"'-• f: A y • / ' ~..-`--w,~.e~ e> / .fi~4;. w•? - ,f°,..+ _ ~ f..:. „cam :../~"G''/f..j ~ '~``-f 7i 1 -l_ J y , r 1 l iscusse with ature ( )See Attached. DIL11R4BD-6192'(N.09/80) gnature o is n a ,as- p i qef White-Inspector Yellow-Local Inspector Pink-Plumber or Responsib eJParty, • 1 < v t J w . P E , m+D14+(.: ~ .~........~cw.w......:. - ..pia.--,.s_. ..+~r . q2 G" z~ Ci- ci- f4? r Y PState and County State Permit # 6i Permit Application County Permit CJ 19 for Private Domestic Sewage Systems County "DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER. OF PROPERTY iling Address: 4 B. LOCATION: %,37- Section T N, R E (or) W Lot# City _LB Subdivision Name, nearest road, lake or landmark Blk# Village Townshi t W Nt C. TYPE OF OCCUPANCY: Commercial *Industrial *Other (specify) Variance Single family Duplex No. of Bedrooms No. of Persons D. SEPTIC TANK CAPACITY t Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete Poured-in-Place Steel Fiberglass Other (specify) New Installation Replacement Lift Pump Tank or Siphon Chamber 7~, Total gallons Prefab concrete X Poured-in-Place Other (Specify) ~ E. EFFLUENT DISPOSAL SYSTEV~j Percolation Rate Total Absorb Area sq. ft. z ;UNew Replacement4- Alternate (Specify) Seepage Trench: No. Of Lineal F. Width Depth Tile depth (top)No. of Tren es Seepage Bed: Length5Z-&~Width 714" r Depth` Tile depth (top) No. of Line Seepage Pit: Inside di etLiquid Depth No. of Seepage Pits Percent slope of land. ~i. Distance from critical slope WATER SUPPLY: Private Joint ❑ Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than present owner: I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the ertified Soil Tester, A NAME C.S.T. -0 4AA and other information obtained from Q %-3,7 (owner/builder). Plumber 's Signature ' P/ # $ 9 2X0 Phone #Q> va - & 57 7 Plumber's Address \ALt QM(Z i 6-3/11 PLAN VIEW: Provide sketch below of system (.include direction of slope and all distances in accord with H62.20. Well loca- tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors property. If well has not been drilled please indicate. i 3 , € I i i i I i F E I Do Not Write in Space Below d~ FOR COUNTY AND ST T~~ E L gARTMENT USE ONLY [ ~r q Date of Application q c~~' Cam- Fees Paid: State C) County to- _ 1~ 0 '1 OZ~ Permit Issued/Rejeoed. (date) Issuing Agent Name O%'~(? (t~t.161Q.l~) Inspection Yes No State Valid# Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 7/1/78 SA t9 SAFETY & BUILDINGS DEPARTMENT OF REPORT ON SOIL BO es INDUTS`f, ' DIVISION ~ P.O. BOX 7969 LAB® AND PERCOLATION TE - HUMAN RELATIONS MADISON, WI 53707 LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO L N BDIVISION NAME: kl';Ovic.~'/,v yr G r FDA ~a,ZCcSZ ~V4 7 /T N/R E (.,-)W COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: 5t1` ~X G11ell,~ 1101PW14LIO iPr I AOOh"r5 USE DATES OBSERVATIONS MADE NO. ftEDRMS.: COMMER . AL DESCR PTION: NS: IPERCOLATION STSCo 7ROF1 LE : FResidence ❑NewReplace 11-4,4Y `d 1Q,e2- /I'1i¢ fl ~g~'Z RATING: S= Site suitable for system U= Site unsuitable for system S65 ScT LOAM CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: S STEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) S U NS ou x neWySMr1&A1, tL &--V ~ ■ ■ s ■u ■ s ~u ■ s ■u f2&0 s~. . If Percolation Tests are NOT required DESIGN RATE: SYS If any portion of the lot is in the under s.H63.09(5)(b), indicate: ( Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGH EST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 54 . &/-~~tio a~>`~~~: s.•1- 11 &~y B-1 Sy 79,7F*r " 61' " B-2- 9117 Fr G "61-Aw- Sit-, 7"/,t-, N. S., Z_ 6z" -13a. ew-4:1- 54o 140il4wf- F1 1'~la /Vo fLi,u B- AU61D his e,~ B- (~5' F ' Z Z y ~ /Q,, 6,y-,3A, f/'L , l7 "Li• /3~ si , 33 ~~OR'Qa SSG 'Ji oMia5-~- 0 P- Cs` - 071-5 '~ea~-1 2 PVE :504kZD 3S4vE~/Ak PERCOLATION TESTS # y jyP• QE D/N TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PE IOD 1 P R D 2 P D PER INCH P_ 2,3 )ta~ /0 176 r P- P- 2 t CQ P- P- 12-6o I 1 /9, cv P- PLAN VIEW: 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,tth~e plot plan. Show the surface elevation at all borings and the direction and percent of land slop. 9(P r rr , a IN o woopSl /3FD "cAwr/av s4 .a SYSTEM ELEVATION ExAcrzy f7_ of2 . _ _ auFRf 1, Q ~ ~ o -Ackc 5170_ I n....g x 2 Dates $/1`7 $2 '5Trv l~~ lnspectorf,~ 3 . ~m N a , I 3!0' E►~ ~ l~ J~q Tr o~v 5 old i ~.T 10 (o 6 • _ ....~e_ . a _ ~ . ~ . . m... J1_ 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures methods specified in the Wisconsin Admimistrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. EADDRESS: t : TESTS WERE COMPLETED ON: CERTIFICATION NUMBER: PHONE NUMBER optional): Ao-d - S"5= ~Z yk2-1 17/S -3 -A/ Div€/c- CST SIGNATURE: ~uEpl ~5 Lcx,gT~~ au~~' y0b ky,sr. I TRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester. R-SB D-6395 (N. 03/81)