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HomeMy WebLinkAbout030-2017-70-000 ,41 1 Z,o• X22 1 s STC - 104 ` AS BUILT SANITARY SYSTEM REPORT OWNER ~At,) SL~tr I~~ ADDRESS ~p,~ j/ l C~ U> R 1 q SUBDIVISION / CSM# LOT # SECTION___L_T Q~ N-R aV W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 8a 7G1 a ~ k Sv z INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. 1 s U ! BENCHMARK: 'j ? F ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: W'Z' L Liquid Capacity: 1000 House as Other Setback from: Well q5' Pump: Manufacturer Model# Float seperatZ Gallons/cycle''- - Alarm Location SOIL ABSORPTION SYSTEM Width: -S Length S U Number of trenches 3 Distance & Direction to nearest prop. line: Setback from: well: House Other F-tPr~et; 9Co-9a ~~p- ~(o•~7(n H•iy%, ,ji~rw ~FtNC1, 95.9 4 y y ELEVATIONS 3' G Building Sewer ST Inlet, 99. 3 I ?9 C~u ST outlet _ X00. 7~n PC inlet PC bottoms Pump Off Header/Manifold o - Bottom of system I b'- i~ N1 5 Existing Grade SV) TYR- Final grade o • a~, ~akj - g71a DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: .1 INSPECTOR: 3/93:jt sOrAWWM;_,trA&fIhTd9,~,FPH 1.29.2t7.422A1 SWOE LOT 1, HWY. 35 PRIVATE SEWE SYSTEM County: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division ST. CROIX (ATTACH TO PERMIT) Sanitary Permit No.: GENEkAL INFORMATION 193438 Permit Holder's Name: ❑ City ❑ Village ❑xTown of: State Plan ID No.: IEL M ST. JOSEPH CST BM EIev.: Insp. B Elev.: BM Description: Parcel Tax No.: l ( r 030-2017-70-000 A~l TANK INFORMATION ELEVATION DATA A9300102 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ZC/4 u, . t c Benchmark Old Gv Dosi g Aeration Bldg. Sewer Holding St/ Inlet TANK SETBACK INFORMATION St/ Outlet TANK TO P/ L WELL BLDG. AirI to ntake ROAD Dt Inlet rl Septic 7 1- NA Dt Bottom Do rrrg NA Header/ Man. Aeration NA Dist. Pipe v Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade MarSufacturer Demand Model Number GPM TDH Lift Friction System ~ T D H L He Forcemain Length Dia. Dist. To well SOIL ABSORPTION SYSTEM BED/TRENCH width Length No.0f7 enches PIT, No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING.,, Manufactu SETBACK CHAMBER r INFORMATION Type O ?f. / Number: System: OR UNIT DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe(s) i~ x Hole Size x Hole Spacing Vent To Air Intake Length ~ /Dia- ,G 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 - Lrj-I yes NO R"/ Trench Center, R Bed /Trench Edges ` TopsoiL_--- es COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: ST. JOSEPH 1.29.20.422A1,SW,NE, LOT 1, HWY. 35 -r' r t i y~~ F n l-~~ r ~r` n! ,:r." r ~t~ ~I r'C 7. /i !7(J 'P 1Z/ v l.l' 01--1 Pi+ -7 A '1176 _4 .1 , Plan revision required? ❑ Yes [i~f~o Q3 q Use other side for additional information. O ~7 SBD 6710 (R 05/91) s _i , , 1 Date Inspector's Signat re Cert. No. 1 ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: A y , /J1 C ~ des C i /1/1z-4"/ ILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY. STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ / C~ 3 8'f1 x 11 inches in size._ Check i rev $.on to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER L APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION SA) % AIF '/4, S T,,??, N, R ~ZO E (or) PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # II &A oa . CITY, STATE ZIP CODE PRONE NUMBER SUBDIVISION NAME OR CSM NUMBER e1so~J sy-~i~ 1 t5 -3 57 444 II. TYPE OF BUILDIN (Check one) CITY : NEAREST ROAD , ❑ State Owned VILLAGE Sf U, H w ~4 3,5 ❑ Public Q 1 or 2 Fam. Dwelling-# of bedrooms 2L P EL AX N ER( ) III. BUILDING USE: (If building type is public, check all that apply) Z 70 1 ❑ ApVCondo 2 ❑ Assembly Hall 60 Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. Ng4ew 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit # - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 9 Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 130 Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-ln-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. Y TE ~EV. 7. FINAL GRADE l~Sa REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./ ch) n $ 5 EPTION .1010 PQ 9% u Feet Feet l 1~ 1 S Q CAPACITY lilt-It VII. TANK Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concr to Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank .-L+- lobe, it Q f 1 Li 17 Lift Pump Tank/Si hon Chamber El 0 1 El VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): PI T S ature: (No St mps) MP/MPRSW No.: Business Phone Number: w, LAYv*eS~ 3Y0y '71s 8c,-9b~b Plum er's Address (Street, Ci St at , Zip Code): 110 Ms fa~~sou S - N -h~Jso►~ Misr; .:r' IX. C NTY/DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee (includes Groundwater Date Issued issuing ent Sig ure (No m Approved ❑ Owner Given Initial Surcharge Fee) Adverse Determination J J 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. 11. 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. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump -performance. curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) i Y ~ ~ ~ ~ a } off, f •P I ~ ~..r ~ . ~ ~ « , . OYN sit to t 1_ _ _ * tf ~1.. ff 77- 1E le, V4 Do, 0 Mb N y by i ~ f t \ 4 ,k I + t 11 'ICA ,FRESH AIR IPLUTS AND OBSERVATION PIPS bpproved Vent Minimum 12" Bove: f~~J> } 6 Cast iran Above PQJ'' tent Pipe To Final GraOn-._-_._ 1 I sh H a y Or Synthetic Cover) c:j~ Min. .rrr l~C~fj►-CC1`;t! ~ i Over Tee Aggregate Perform t ed Pipe Cori !rz';; 3Rr noath Pipe ^(~4aE'.i ~.C' rtC"rf~r l' i ?`';I J =3p L k:',~l~1 n E 4 VIDA7ZAI~ 2- DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS tNDUST'iY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.O.-BOX 7969 N, WI 53707 HUI;lIAN RELATIONS (ILHR 83.09(1) & Chapter 145) LOCATION: EC ION: TOWNS HIP/M T.Y: OT NO.: BLK. NO.: SUBDII VISION NAME: Scv 1/ tvC 1/ / /T21 N/RIO E ( r) 5`rr. 5o s p 1-~ / s~1 COUNTY: MAILING ADDRESS: STCeoi'1C STAN >r4akS 1410 If r IIToP t'lD~c , /`/vL7L7VAJ Zvi . S/ 0,0 Z USE 4r/ - Cv 3 7 DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: ROFI IT DESCRIPTIONS: • 4Residence 3 Op- 4 ZNew ❑Replace ~~C. 1,je/ 1~G IZ / lV ~c po~,~~o - ~-~..e r s ~ 9 F r RATING: S- Site suitable for system U- Site unsuitable for system • ONVENTI NAL: MOUND: IN-GROUND-PRESSURE: rF]S YSTEM-IN-FILL OLDING TANK: R COMMENDED SYSTEMW=405 ©S ❑U E]S ❑U E]S ❑U ❑ S EA T(30 x LS If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: CGrrs S Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS $C SA7rkligs' BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. EST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- DAr4 B- 2- 105 7 7. C. 91o 00 B- 3 /,/e f , 2--7 ' 91,0 8.x,1 /22. /02,72' 0 z, 7z 'ho > i22. B-S 112 /02-.-70 JL ?'l° 3 13-6 P 11522-' 50RfFtC-R c!~IeVf7_/off S OF e.- PERCOLATION TESTS EST DEPTH WATER IN HOLE T T TIME DROP I WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES' AFT RSWELLING I ERVAL-MIN. p RI 1 PERIOD 2 PERINCH P_ / (o ;iv l1, 0 2 12 P_ 2 9g',S i Z t ' l P- 80 99 a' i !Zj 6, P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface 11 elevation /~at all borings and the direction and percent of land slope. / ~fti[ ST giUG~ 9 / Q ',00/ : T/C N 3, 7 SYSTEM ELEVATION. Z0 w _t E.u = fa I L I T- pL ,v i _ _1_ i P sw- I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME print TESTS WERE COMPLETED ON: c,OMESITE SEPTIC PLUMBING CO. jc t IS (Cl / _ 655 O'NEIL RD., HUDSON, WIS. 540_16_ ADDRESS: ROBERTULt3RIGHT CERTIFICATION NUMBER: PHO E NUMBER (optional): 4IS- MASTER PLUMBER LIC. NO. M07 M.P.R.S. y~ 2 3t _ MINN. CST SIGNATUREI: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. 1111 HR-1;RD_F,1 5SR._11-01FI) - OVER H O M a W Q a_o a v Lj MZO c a J z S V 1, ~ C=l v, ~ a=►-w~ e w - ac ~ °e W~oIL 2 a • a- I ~L1 j i I I a Q N ry i i 1!~ qJ ~ i to GY ! 1~ I l~ T 1 P Y \ 96 r IP 1 1 0 . J cv J c- ~ J 0 v ri t~ ~3lYl$ - - - EPARTMENT OF REPORT ON SOIL BORINGS A ~t~ -~4~7st TY & BUILDINGS INDUSi4RY, ,j DIVISION LABOR °N° PERCOLATION TESTS (115 P.O. BOX 7969 HUMAN RELATIONS ON, WI 53707 LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO. BLK NO.: N Sly /Pf N/R 2DE cor► W Sf oss F~~ CO NTY: OWNER'S BUYER'S NAME: M LING ADDRESS: USE DATES IRSER E NO. BEDRMS : COMMERCIAL DES R PTION: PROFILE DESCRIPTIONS: IPERC A O STS: Residence New ❑ Replace ~d{, f~ . /L RATING: S= Site suitable for system U= Site unsuitable for system 350b- sTiP4rlS CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) G/~!', fQ ~t~ K IS ❑U ❑S U ®S ❑U ❑S ,®U ❑S ®U C'av ,vi~my~s~- ~ 9/•~Jfi~~D If Percolation Tests are NOT required DESIGN RATE: S TEMIEL If any portion of the lot is in the under s.H63.09(5)(b), indicate: I 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. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 7t •,ea. 'TAN Sc. ~ B- 10,7 q o f % >10,5' ~O ,Pe 6Aj, SL LY. ~ /3N 7A v L M ed~ 94 5A AJD B- 3 160 -0 !O 7 ,BN ` S L, 2 9 ,l3w , L AN -r/ z- T , Co 7 " 7"Ae)9)• L, jI.8AJ ~ S. 4A / PT. S 16 "A&- 6A)- L 4 /o'' G ~ • 4A), Tie ,J Si B-7 ~i 1/0 o" NJ&-&J.-6,1 $IL u ff 0,f-G. Afotr PERCOLATION TESTS F~DM yy~~ t/~ TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN PERIOD 1 PERIOD2 PER PER INCH P_ 60 22vr-k- 62 zZY2 P- Coo ' 93. Z 0 P P-. I -2 0 P- so,, P- PLAN VIEW: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slop. 'qep &0;r7 M 3'~aLJ11 f3. S Fr. 0 :5-X,4C- Tf-I ~o • ! /tT SYSTEM ELEVATION 8Q ~Ef PT. 9 s 7 3 P~ S ;3 gy c F z X 1 a0 ,~w' _ _ - tN ~o _ _ #6010 tf n~ c R -11- . ~ ~ { ` ~ ' Lo,w s auk _j ~ fIR~~1'" o~ TAE • 160.0 Fr 1, the n ersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures methods specified in the Wisconsin Admimistrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print : T STS WERE COMPLETED ON: A'Mexr wl Mlcx/ ,4.v . / /yp_- ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER optional): s ,rc U /,r/ 122- 1110,0,Pcze. CS SIGNAT RE: DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester. DILHR-SBD-6395 (N. 03/81) •-DPARM ~NT OF REPORT ON SOIL BORINGS fiIL?:~~• _ ETY & B DIVISION IN D tJSsffi l(, LA$OR AND PERCOLATION TESTS (1 ) `,.1r - P.O. BOX 7969 HUMAN.RELATIONS ' DISON, WI 53707 LOCATION: SECTION: TOWNSHIP/ UNICIPA ITY: OT O. BLK. BDIVISION AME: /TIT N/R1)E (or) W f C i COUNTY: OWNER'S BUYER'S NA AE- MAILING ADDRESS: I - USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESRIPTION: I S: PERCULATIM TESTS: Residence gNew ❑Replace It ~J !l'~ j ~2~ Z RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) A)AZ, z ~~~1A_7_17> rv -u iosau ❑ s ©u ®s au a s au ❑ s au o If Percolation Tests are NOT required DESIGN RATE: SYST EL 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. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 6 B- 711' /FGA CK ,gGLUfJi~lt, i~T OSiTf B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 P R PER INCH P- P- P- 4, 4 P P- 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/nshow ctheir location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slop. Cou,~/ K~~~(1,/~ v f r G%t A7- ~fT SYSTEM ELEVATION 1*vfc-1U ~vo 7r- 77 T z a 6 _T 3 C'vs/'sTS o~ ...,9Gvi/i~iL STS, tN 0& I-L _wo r__- rt?.., ....~e. a 4 v , Lffo -7_ . GO ,25F /3D7rI/v,C%Lb I ~ E F I, 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. NA E (print : TESTS WERE COMPLETED ON: o1~-P~-f C 4A) ' / /elf 2-1 ADDRESS: RTIFICATION NUMBER: PHONE NUMBER optional): - / ,l~®S ~Xc~IU /~fJ o UD~~ oiY ~3 UW CST SIGNATURE: DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester. DILHR-SBD-6395 (N. 03/81) ♦ ,mot 4 ..yy4 par Volume 1 Page 171 i CERTIFIED SURVEY MAP 'N 88°23`55" E 530.00 -0 _ bo 0 ON ~ LO 3 5.137 ACRES M w _0 - 0 O 0 z 436.20' 4 66' ROAD EA435 SEMEN ~ S 88°23'55" W 495.59` •ti`' 1120.00' ti 9 014-,yp' w N 37018'45" W LOT 2 O 98.53 'sr~ 5.45~ ACRES v m N 88023`55`. E 36302' 0 00 0 0-1 46001'05,, 1.28' 11 W 0ri~~~a~ :r F.Sa ~ ~s•I • 3~.~Cr~ ~8To29'25" 3050 •40.. o l1 00 O S 88 23`55" W 449.23` \~0 r~7 /f, ' ~s ",moo G E Q s~ LOT" 1\F °2 6 1975 tv • • \ 5.026 ACRES AkqLm o' C*NN F f bloods Skiiraf~ (fig ~p \ s 0 • a, „a µ S 88°48`35"Wo`c~t \ 00~~ 141.37+ 2 {94.53 \ 5.74 s i 't= ; I"= 200' • • 36.08° , o S 82°04' 30" W 270.27 0 k 24" IRON PIPE `NEIGHING 1.13 LBS. • C:T.IA V PER LINEAL FOOT ~Q ~ wN • a~ T • aw w0 CURVE LOT RADIUS CHORD CHORD CENTRAL, NO. NO. LENGTH LENGTH BEARING ANGLE 1-2 1 1985.08' 517.54' N 38005'35" W 1405_8'50 3-4 ROAD 199.00` 299.27' N 11* 96'451' E" 97031`00`° 4 -5 ROAD ! 99.00` 96.94' N 74-18'0!$" E 28011 `40" 6-7 3 133.00` 102.75' S 65°0'33" W 45°26°4411 2 133.00' 236.70 S 2,5° 32' 35" W 1 25042'40'1 i SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER 1-7 L) ADDRESS: ct ~~>o FIRE NO: LOCATIONS 611/4, SEC.T _N-R Zd W, ST. CROIX COUNTYST TOWN OF: s SUBDIVISION: LOT NO. ®G~J -r 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 p,it 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 to help with the cost of the 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 maintainci. The property owner agrees to submit to the 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 from 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 sat forth, herein, as set by the Wisconsin DNR Certification form must be completed and returned to the St. Croix County :cninc Officer within 3o days of the three year expiration date. SIGNED:- : DATE: St. Croix Cour±i.y Zoning Office 921 4th St. Hudson, W1 5,4016 S T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor,(spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of property - Location of propert4-"'1/41/4, Section N_RZ~J W Township Mailing address Address of site subdivision name Lot no. ~k? Other homes on property? yes ~L No Previous owner of property /7`~~ ~S Total size of parcel C 1-,f 5. Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)? Yes No volume and Page Number A as recorded. with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER VOL N U2iE UMBER & THE SEAL OF AND PAGE THE REGISTER OF DEEDS. In ce add rtifie addition d survey, if available, ;would be a helpful s delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Surve shall also be required. y Map 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 o five of the County Register of Deeds as Document No. j own the proposed site for the sewage disposal t system ) orr I e(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. ignature of applicant Co-applicant Date of Signature Date of Signature VOL -411 QA ~E 609 f1~. TNI:r bY'AC:s HtS/RYF.U fUM rt a'.:OkDINw DA1A FORM _r"uT J STATE BAR On `yISCON, IN FORM 11-19 LAND CONTRACT ' (ndi du 1 •nd f. r yur>.te , T~; I. t gTtI;rl USED FOR ALT. TRANSACNONA tS FINa\FDN'nN OTHtR NON-CONS13MER REGISTER'S OFFICE Stan Flanks ST. CROIX CO., WI i,.'ontract, by and between Redd for Record ("vendor„, ~Qt fnJu 1 ? 1991 y or me-e) and.. i~an ChU (e---. _ •,~t- 11:30 _ A. M ("Purchaser", whether one or more). RsaM4rcf0eeds ;iesla and agrees to convey to Purchaser, upon the prompt and full per- this contract by Purchaser, the following property, together with the x9flts.~r- tgres nd other appurtenant interests (all called thz "Property"1, t. t rO1X ~ount~r County, State of Wisconsin. RLTURN To Ta- Parcel No. . Part of S I; of "!E 'a of Section 1, Township 20, 4orth, Panne 20 'Nest, St, Croix County, Wisconsin described as follows: Lot 1 of Certified Survev Mao filed Auoust 26, 1975 ir, Vol. 1, nape 171, Doc. 11o. 328857. Together with and Subject to 66 foot road easement as shown on said Certified Survey ~Iao. ti is not, homestead property. 0s) (is not) 1 ucba5 r a s r'1'a,e the E'roperty and to pap to Vendor at wherever _._...he._..re...ver desinnated GW y~u in the lollowin manner: (a) 5~ ~'a urn of ' . - $ . r execution of this Contract; and {b) the balance of ~i.... 1.5. _..,...1.5_.1 , together with interest from date a pet cent per annum r-aa on the balance outstanding from time to time at the rate of sail paid in full, as follows: one hundred thirty dollars to be paid on the 15th day of each month starting on Aunust 15, 1991 and 5130.9`1 each month thereafter Pr"'Qi 41 huWetier, the en `'a outstanding balance shall be paid in full on or before the.._-.......5... day of Ul _ 19_- ( the maturity date). y ioiti n any default in payment, ii.lerest shall accrue at the rate -f per annum on the entire amount t ich s ail include, without limitation, delinquent interest and, upon acceleration or maturity, the entire ai~ce , r'ur::. _r, arazss excu::e.d by Vendor, agrees to pay monthly to Vendor amounts su ficient to nay reasonably antiei- a ! 1e= ticial assessments, fire :md required insurance premiums when due. To the extent received by Vendor, et atiees to apply pa_,ruents to these obligations when due. Such amounts received by the Vendor for payment of and insurance will be deposited ii.to an escrow fund or trustee account, but shall not bear interest t otherwise re:uired by law. Paynien i'.all be applied first to interest on the unpaid balance it the rate specified anti then to principal. Any tlUl V _ ; arr,o =mt may be prepaid without premium or fee upon principal at uiy tune after..... x0 txer4xA xxU XiA x~t),x"kxXOVgXX,)(MX*X)(, AXpU sa"Xhxxxvoo*xxx In the event of any prepayment, this contract shall not be tre.ited a• in default with respect to payment so long as the unpaid balance of principal, and interest (ard in s-ch case accruing interest from month to nionth shall be treated a3 -.inpaid principal) is less than the amount that said indebtedne8s would have been had the monthly payments been z~ z `;r- t specified. above; prnvided that monthly payments shall be continued n the event of credit of any proceeds nsorance or car {enuiation, the condemned premises being thereafter excluded herei rom. °urc ;ser st. s that Purchaser is satisfied with the title as shown by the title evidence submitted to P+rchaser ..-....nir.aticn except: none ee to ;ay the cost or future title evidence. If title evidence is in the form of an abstract, it shall r r i- I t tl niircha N price is paid. irlt t.t~1 to tnke .,o._es,ion of the Prnm,rty on.. sl'dl ~ 1-i i:. r, t F N'LU :7~ t , n f.e n, Rl ~ .:u, +~S?t' 4 a• or upon Vendor's interest ur -'r promises to pay when due all tas s and assessmtan~ ;eeie on the Property " ? w deliver to Vendor on demand receipts shnw=r.g`rtc}Itp,used against loss or damage occasioned by fire, eX- through insurers , z^haaer shall krtp t"e irupravements on the Prop' y erase perils an3 suchther hazards .+s Vendor may rr tuire, without co-lnsurance approved but Vendor shall not require coverage in an amount more hunt shall in the sum of a the insurance premiums whey due, The pore original ;Z'.ance owed under this Contract- Purchaser shall pay rom -es give notice. of loss al promptly ' standard clause in favor of the Vendor's interest and, unless Vendor otherwise o m Insurance proceeds shall i+'i.,s covering the Property shall t deposited with Vendor. Purchaser shall ._.npanies and Vendor. Unless Purchaser and Vendor otherwise agree in writing, to restoration or repair of the Property damaged, provided the Vendor deems the restoration or repair to be by feasible. the Property r arasar covenants not to commit waste nor allow roasts to he committed on the Property, to keep free I .En`:antable condition and repair, to keep the affect ng the Prrom liens superior to the lien of this Contract, and ly with all laws, ordinancea and re,,,ula i be fully aid and all conditions Vendor agrees that in case the purchase price with interest free, and d or vilson all J ena d, ex ecute and de ver other moneys performed at the times and in the manner above specified, Vendor Rill a demand, e>ceute and deliver to clear rt ally' p none and n to z l aser, a Warranty Deed, in fee simple, of the Property, <nz or encumbrances created by the set o. default Purchaser, and except . . - essence and (..a.) in the event of a default in the payment of any p Pu r chaser rir.aipal or -----time--------is---of -the' in the event of a default in e agrees that notice -sit which continues for a period of ...15--- days following the specified ode u a15 t asybalanlce under thtenontract )f by of a.,y r ( other obligation ly Purch aser which continues for a rout notice (which Purcha, under tb € hereby nal „f by Vendor (delivered porn, p y ay tee in of bcertified othen n the outstanding law} in full', r) and immediately Vendor shall aldueso handave pay the following rights and remedies (sut'cct to, any limitations provided by titn; terminate this Contract and ParcU LseUf Vendor may, at his o lio and with i with interest any the equity r. tle and inter those ntee t provided in by law Pr roin equity: (~I) back' through strict foreclosure uity icily and recover the Property - lion to be conditioned upon purchaser's full payment of the entire outstanding balance, this Contract whicheventallamountspreviously andCas r rental t for of default at the rate in effect on such date dandamages other for amounts failure due to fuhereunlfill. hereunder (in by 1'uipurch shall be to a ur, llii) Vendor may sue for specific performaace t ,ka if purchaser fails to redeem); with interest thereon at the rate in effect on the date of event ance, the Property shall be auctioned at judicial s Gle e or aPur pc a er f..c.lt and and fu ether full payment amounts due the entire hereunder, in outstanding ng balance, orn h liable fur any deficiency; or (iii) Vendor inay sue at law for the entire unpaid purchase p P or (;v) Vendor may declare this Contract at an end and remove this Contract as a cloud on title in a quiet-title have Purchaser ejected from possession f the e±luitahle interest of Purchaser is insignificant; rents, issues Vendor or may profits during the pendency ted of any action t'Property and have a receiver appointed to collect any i'er (i)(ii) or (iv) above.\rotwithstand"ig any oral or written statement or actions of Vendor, an election of any rgatihether abated or not) expenses , o r' ,g remedies shall only binding upon Vendor if and when pursued and paid by Purchaser, to he reasa,onnble attorneys fees of f Vendor fititlerevidence shall be remedy to hereunder principal i nde of ~:not proiiihited by law and erpnses d, and shall be included in any judirment. Upon the commencement or during the pendency of any action of foreclosure of this Contract, Purchaser consents ~ie appointment dent of a receiver of the Property, including homestead E ropezty during. the pendency of such action, and such rents, issues, terand e profits collect the re collected s, iss shall and held and b oral ment of any ad a the court shall direct. Purchaser to al or eynitable i.aeresc in the Proper trout the prior written convey a of Ve' shall not transfe r, sell or by o tion long-term lease or in any other way) Purchaser endor rights un under this Contract by balance payable under this Contract is first paid in full or the interest c m .ieat less gnm the outstanding raser. In + e vent of anv such transfer, sale or conveyance without Vendor's written c nsent, the entire out e stan Vendor shall makeh all ll payments t noticsF d is a pledge or assignment of Purchaser's interest under thin Contract solely as security for an indebtedness o f arc.: h- a outstanding against d Property on the wi the, date of this an Contract (except t for is any mortgage alb granted due by i u nderia y mdue and ortgage payable purchaser) or under any note secured thereby, Property Purchaser made yUrP'uaschefaser may shall be considered payments made o rakes timely payment of ttb- fa amounts then due under this Contract. the: 1Tort;'act. if Vendor fails to do so and all naynients so other subsec7uent or prior default of Purchaser. Contract. t*rs Vendor may waive any default without waiving any All terms of this Contract shall he binding upon and inure to the benefit of the heirrs,n°~e peon of h rwentatives not a jon toccessors and assiQtts of Vendor and Purchaser. haf in the subject Proper Yr an dtagTees pta ouse of Vendor fora valuable joi deed torbeoma,len in release rig 16th July , 19.91 Dated this day of EAL - ........(SEAL) an Hanks, 1 ender Daniel M. Schulte, °urchaser u f -..(SEAL) (SEAL) ACKNOWLEDGMENT AUTHENTICATION STATE OF WISCONSIN sa ignatur. (s} ..)t Croix County. 1 6thday of lS pcr-onally came before me ~i} t .:.a d the day of Ju Y 19 the above named Stan Hf hks k~JE:~ TITLE: 11F:~tls! l~ ST \l E BAR OF 1St 0NSIN . who executed t e t(t nc`. s- of .,it, NN is. tat=.) to rite known to } authorized by , foregoing, instru the same. . t, kli 1,* rf IS t^..iFi.•c;`i: VrAS C.H aFTF[i GY t~ _ J1 V @. Countv, Wis. My { lu is per"rnanei tt✓ (iF nt~ ..tat! eN trati ~ n 19. un es y bi ai..}, ,t 'a= r date. t . ~I . . _ i , •,,,t.:i M•Iu.v Lh,.lr . I i A F - nntn. and ff N', 11 1,W ornre-Stwte flsr :+f R'i ~ - d~ ti.TR ~f'T --1n .!"M t..nrn ST CROIX COUNTY SURVEyoR-S RECORD Volume 1 Page 171 CERTIFIED SURVEY MAP N 88°2355" E 530.00' to • Lh O 1v O LOT 3 5.137 ACRES w O 'ham O o`L~ CP 0 `cr' S 436.20 _ -q4~ (66_.-, z 4 66, RO EASEMENT S 88°2355" W /I 435 59 / O © 495.59 ) I 120.00 f o~~ N 1 ~I „ 8 1914'30„ t w N 3701845 W 1(3~ 3 LOT - 0 . • 98.53'- i~.'"' 5.459 ACRES IT If) n m 0 OD N 88°23'55` E 36302 900 • 4690/,05,, 1.28• lt, OD c,~ • ao as,, 328 RiSo ~ ti • ~3s~' 187029'25" 03050 '40" S 88°23'55' W 449.23' 3 ~p 0%, 0' ~e o • • \ O s 90 • o Fit ED • s \ LOT I ~~F9so;'.~, ao AUG 261975 to • • ~S- \ 5.026 ACRES z QS, Aiam 00 CONNEL& d, slaMw of Deady ' • . 1 : \?~•A \ O 9 ~ ~ • • ~ \ gyp, fah • • S 88048 35" W ONa"' 4>0~ SCALE-1"=200' QI 141..37' 2 94.53 \ 5.7_4_ . . • N 7°55 30 W ' 0 = 1" X 24" IRON PIPE 36.08' S 82°04 3tOV,W 270.27 3 WEIGHING 1.13 LBS. ° C.T.H. • PER LINEAL FOOT • ' ' • • w Ir oN • • ~z • m • N • • F- - • • co V • d w • w U) • CURVE LOT RADIUS CHORD CHORD CENTRAL NO. NO. LENGTH LENGTH BEARING ANGLE 1-2 1 1985.08' 517.54' N 38°05'35" W 14°58'50" 3-4 ROAD 199.00' 299.27' N [1- 26'45" E 9703 1'00" 4 -5 ROAD 199.00' 96.94' N 74018'05" E 28011'40" 6-7 3 133.00' 102.75' S 65°40'33" W 45026'44" 6-8 2 133.00' 236.70 S 25°3235" W 125°42'40" vu, . I &5 , I-71